Paper B Mock Exam 6: 2023

Which of the following is an absolute contraindication for repetitive transcranial magnetic stimulation (rTMS)?

A young adult male on clozapine therapy presents with flu-like symptoms, elevated C-reactive protein (CRP), and increased troponin levels. Which of the following ECG findings is MOST consistent with myocarditis induced by clozapine?

A 28-year-old female with a history of bulimia, and frequent use of diuretics and laxatives, presents to the emergency department. Her ECG shows a prolonged PR interval and prominent U-waves. Which of the following is the MOST likely electrolyte abnormality associated with these ECG changes?

An elderly male with a diagnosis of Alzheimer’s disease recently had his dose of donepezil increased to 10mg. He presents to the emergency department following a syncopal event. On examination, he has an elevated respiratory rate (RR) and bradycardia. Which of the following ECG changes is MOST consistent with donepezil toxicity?

A 43-year-old male on citalopram therapy recently began taking an over-the-counter decongestant. He presents to the emergency department after experiencing a seizure. Given the combined medication usage and clinical presentation, which of the following ECG changes is MOST likely observed?

A 45-year-old patient on antipsychotic treatment is found to have a QTc interval of 490ms on an ECG. Which of the following is the MOST appropriate INITIAL management step?

A double-blind controlled trial is studying the effects of aripiprazole vs placebo on patients with schizophrenia. Among the adverse events reported, syncopal collapses are being evaluated. If the absolute risk reduction (ARR) of syncopal collapses with aripiprazole compared to placebo is 5%, what is the number needed to harm (NNH) for aripiprazole in terms of inducing syncopal collapses?

Which of the following best describes a retrospective cohort study examining the association between past cannabis exposure and the development of psychosis?

A 41-year-old patient presents with poor self-neglect, history of a kidney transplant 4 years ago, and whose father passed away in his 40s. The patient is found to be confused with imaging revealing a frontal lesion. Which of the following conditions is MOST likely responsible for this clinical presentation?

A 16-year-old patient presents with progressive difficulty in walking, slurred speech, and frequent falls over the past two years. On examination, there is loss of proprioception, absent deep tendon reflexes, and a positive Babinski sign. Given the clinical presentation, which of the following genetic findings is MOST likely associated with this condition?

An elderly patient presents with a 3-year history of progressive difficulty in walking, frequent falls primarily backward, and difficulty moving the eyes vertically. On examination, the patient exhibits a rigid posture with neck dystonia and has an expressionless face. Which of the following is the MOST likely diagnosis for this patient?

A 15-year-old patient with a recent diagnosis of anorexia nervosa is brought to a mental health clinic. The psychiatrist suggests systemic family therapy as a part of the treatment plan. Which of the following statements BEST describes the primary focus of systemic family therapy?

A clinician is working with a family where the parents are constantly in conflict, and their 12-year-old son has become increasingly disruptive at school. The clinician decides to employ Structural Family Therapy as part of the treatment plan. Which of the following interventions is MOST characteristic of Structural Family Therapy?

A family, consisting of parents and two adolescent children, present to therapy due to ongoing conflicts. During sessions, the therapist frequently explores how the parents’ experiences with their own parents influence their current interactions with their children. The therapist believes that unconscious processes and unresolved past conflicts play a significant role in the current family dynamics. Which therapeutic approach is the therapist MOST likely using?

During a therapy session, a therapist instructs a teenager, who frequently complains about feeling isolated and left out in the family, to intentionally spend more time alone in his room for the next two weeks. The therapist believes this directive might disrupt the current family dynamics and bring about a new perspective or change. This technique is an example of:

During a therapy session, a therapist emphasizes the importance of understanding a patient’s social context, interpersonal relationships, and how they play a role in the current symptoms. The therapist is particularly interested in examining the “social milieu” of the patient. This approach is MOST characteristic of:

A 6-year-old male child presents with a recent onset of seizures. Additionally, his parents report that he has shown significant speech regression over the past few months. Despite previously having age-appropriate speech and language skills, he now struggles to understand spoken words and communicate verbally. Which of the following diagnoses is MOST consistent with this presentation?

A 40-year-old patient with bipolar disorder has been stable for several years and, after discussing with the clinician, a decision is made to taper off the antipsychotic medication. To minimize the risk of relapse and withdrawal symptoms, what is the recommended minimum amount of time for tapering off antipsychotics in bipolar patients?

A 58-year-old patient with a history of significant cardiac problems, including a recent myocardial infarction and QTc prolongation, requires initiation of an antipsychotic medication. Considering the patient’s cardiac risk factors, which of the following antipsychotics is the MOST appropriate to prescribe?

A patient presents with a 6-month history of persistent low mood, decreased interest in daily activities, and fatigue. Physical examination reveals fat collections on the back of the neck (“buffalo hump”), rounding of the face (“moon face”), and purplish-pink stretch marks on the abdomen. Given the clinical picture, which condition should be highly suspected?

A 50-year-old patient presents with complaints of lethargy, persistent low mood, mouth ulcers, and a tender red tongue. The patient has been on phenytoin for seizure control for the past 10 years. On examination, the patient appears pale. Given the clinical presentation and the medication history, which condition should be most suspected?

A patient presents to a psychiatric clinic with complaints of irritability, mood swings, and difficulty concentrating over the past year. The patient also mentions a tingling sensation in the hands and feet. Blood tests reveal macrocytic anemia. Based on the symptoms and findings, which of the following hematological conditions is the most likely diagnosis?

A female patient presents to the clinic with complaints of persistent dry skin, developing ocular cataracts, and a noticeable reduction in hair on her arms over the past year. Her blood work shows an increased parathyroid hormone (PTH) level and hypercalcemia. Based on her clinical presentation and laboratory findings, which of the following is the most likely diagnosis?

A 37-year-old male presents to the psychiatric clinic with complaints of chronic fatigue, anhedonia, irritability, and increased sensitivity to stress over the past several months. On examination, the clinician notices hyperpigmentation of the skin, especially in the creases of his palms. Laboratory tests show hyponatremia and hyperkalemia. Based on the clinical presentation and laboratory findings, which of the following endocrine conditions is the most likely underlying diagnosis?

A 14-year-old boy presents to the Child and Adolescent Mental Health Services (CAMHS) with recurrent, intrusive thoughts and repetitive behaviors that he feels compelled to perform to alleviate his distress. What is the first-line treatment recommendation for this condition in this age group?

A 28-year-old patient presents with a long-standing history of body dysmorphic disorder (BDD). They have previously been treated with sertraline and are currently on the maximum dose of citalopram. Despite these treatments, the patient remains functionally debilitated due to the severity of their symptoms. What would be the next recommended step in pharmacological management for this treatment-resistant case of BDD?

A researcher conducted a study with a sample of 16 participants and found a standard deviation (SD) of 4 for the data. If the researcher wants to calculate the standard error of the mean (SEM) for the study, which of the following computations should be used?

A 45-year-old woman is being treated with tamoxifen for breast cancer. Which of the following antidepressants should be avoided due to its potential to reduce the efficacy of tamoxifen?

Which of the following antipsychotic medications has the best evidence for treating psychosis in Parkinson’s disease?

In a patient with Parkinson’s disease experiencing visual hallucinations while on levodopa therapy, which of the following medications is most appropriate to add for symptom management?

Which of the following is most indicative of a diagnosis of Lewy body dementia?

Which of the following is the best predictor of a positive response to electroconvulsive therapy (ECT)?

Which of the following procedures is approved by NICE for the treatment of treatment-resistant obsessive-compulsive disorder (OCD)?

For which of the following conditions has the National Institute for Health and Care Excellence (NICE) approved the use of Deep Brain Stimulation (DBS)?

Before starting a lady on Memantine, which feature of her presentation should be of most concern?

Which of the following symptoms is MOST indicative of a diagnosis of early onset schizophrenia in a 13-year-old?

Which of the following is a reason to avoid community detoxification for alcohol substance misuse aiming for abstinence?

Which of the following interventions is considered a primary prevention strategy for individuals with an ‘at risk mental state’ to prevent the onset of a first episode of psychosis?

Which of the following best describes a Type 1 error in the context of hypothesis testing?

If the confidence interval (CI) for the difference between two means includes which of the following values, it indicates that the difference is not statistically significant?

For a patient with poorly controlled epilepsy who presents with an episode of psychosis, which medication is most suitable?

Which medication is commonly prescribed for patients diagnosed with certain types of paraphilias to reduce sexual drive?

A patient with moderate learning disabilities (LD) and a diagnosis of bipolar disorder mentions to his GP during a routine check-up that he can drive. His risk record indicates that such a claim could be a sign of relapse. Which of the following concepts may result in the GP disregarding this claim due to the patient’s learning disabilities?

When a GP asks a patient with mild learning disabilities (LD) if they have “butterflies in their stomach” when discussing symptoms of anxiety and stress, this query might be problematic due to concerns related to:

For a lady with moderate learning disabilities (LD) who becomes distressed during menstruation, presenting with self-injurious behavior like hitting her stomach and aggression towards staff, which of the following would be most suitable to alleviate her distress directly associated with menstrual symptoms?

Which of the following best describes a graphical representation in which age is grouped into 5 categories to check frequency?

Which of the following is the most appropriate graphical representation to compare the incidence of three different diagnostic conditions across four different wards?

Which of the following is the best graphical representation to demonstrate the relationship between blood pressure and cholesterol levels in a group of patients?

Which of the following best describes the principle of “intention-to-treat” (ITT) analysis in clinical trials?

Which of the following best describes the p-value in statistical hypothesis testing?

Which of the following best describes the primary purpose of an Analysis of Variance (ANOVA)?

Which of the following best describes the primary application of the Chi-square test?

Which of the following best describes the primary application of the Student’s T-test?

Which of the following is a primary reason for choosing the Mann-Whitney U test over other statistical tests?

Which of the following best describes the application of the Friedman test in statistical analysis?

Which of the following statistical measures is primarily used to represent the variability of a dataset?

In the treatment of refractory obsessive-compulsive disorder (OCD), which of the following medications is considered particularly effective when first-line treatments have failed?

In a pregnant individual presenting with an affective state, which of the following medications is most commonly considered for prescription due to its relatively safer profile?

James, a 29-year-old with Body Dysmorphic Disorder (BDD), has been on Sertraline 200mg for 3 months and has been undergoing CBT. Despite treatment, he continues to spend hours looking in the mirror and is distressed. He has previously taken Fluoxetine. What is the next best step in management?

Which of the following medications is most appropriate for treating affective stupor?

Which of the following best distinguishes catatonic stupor from affective stupor?

Which of the following is the recommended initial management for bulimia nervosa?

Which of the following statements regarding the prevalence of eating disorders is true?

In Tourette’s syndrome, what is the male to female ratio?

Which of the following is a recommended pharmacological intervention for children with vocal tics?

Which of the following medications is primarily recommended for a child exhibiting features of ADHD?

In a child exhibiting bipolar symptoms, including reduced need for sleep and a belief that they can fly, which medication would be most appropriate to consider as an initial treatment?

Which of the following medications is considered relatively safer for the management of manic episodes in pregnant women?

For a patient presenting with a mixed affective state, which of the following medications is most commonly recommended as a first-line treatment?

A patient presents with moderate to severe bipolar depression and is not on any medication specific to bipolar disorder. Based on treatment guidelines, which of the following is the most appropriate first-line treatment recommendation?

A patient with moderate to severe bipolar depression is unresponsive to treatment with fluoxetine combined with olanzapine or to quetiapine alone. Based on current treatment guidelines, what is the next most appropriate management step?

According to both ICD-11 and DSM-5 criteria, for what minimum duration must symptoms be present to diagnose cyclothymia?

A woman presents to the emergency department with aphonia. Her husband mentions that his mother recently moved in with them permanently. Which of the following is the most likely diagnosis?

Which of the following is the most common presentation of Fragile X syndrome?

A 5-year-old child is brought to the clinic by his parents who are concerned about his development. He has a characteristic high-pitched cry, noticeable since birth. Additionally, the child demonstrates some facial dysmorphisms. Based on these features, a certain genetic syndrome is suspected. Which of the following additional findings would be MOST consistent with the suspected diagnosis?

Considering the known pharmacological properties and clinical effects of gabapentinoids, specifically gabapentin and pregabalin, which of the following statements is MOST likely to be true?

When interpreting a forest plot evaluating the efficacy and tolerability of treatments like TMS and ECT, which term refers to the method used to enhance the efficacy of a stimulus by administering a preliminary stimulus before the main stimulus?

Which of the following formulas correctly represents the calculation for the negative likelihood ratio (LR-) in diagnostic testing?

Which of the following formulas correctly represents the calculation for the Number Needed to Treat (NNT)?

A recent study reported on readmission rates following engagement with crisis services or inpatient care. The readmission rates were 23% for the crisis service group and 21% for the inpatient group. If the hazard ratio’s confidence interval crosses 1, which of the following interpretations is correct?

Which of the following best describes the primary advantage of using the hazard ratio over the relative risk in analyzing time-to-event data?

In case-control studies, why is the odds ratio typically used instead of the relative risk?

Which of the following is an advantage of using binary data in medical research?

Which of the following best describes the type of categorical variable represented by “gender”?

Which of the following best describes the type of data represented by “height”?

Which type of data is best represented by a scale of “1-mild, 2-moderate, 3-severe” or a “1-5 rating scale”?

Which of the following statements regarding vascular dementia is true?

Which of the following statements regarding transference is true?

Which of the following is a universal prevention strategy for alcohol misuse?

When considering the financial implications for a company with an employee attending regular CBT and therapy appointments during working hours, which type of cost best describes the lost productivity due to their absence?

A 28-year-old patient presents with muscle rigidity, tachycardia, and jaw clenching. Which of the following substances is most likely to be responsible for these symptoms?

Which of the following withdrawal syndromes is most commonly associated with increased appetite and vivid dreams?

Which of the following substances is associated with the least physical dependency?

Which universal statement about suicide is correct?

Which of the following conditions can lead to a defendant being deemed unfit to enter a plea in court?

In which part of the justice system is psychiatric input most frequently required?

Which of the following statements is true regarding features of Dialectical Behavior Therapy (DBT)?

Which of the following percentages best represents the prevalence of post-partum depression?

If a sibling or parent has Alzheimer’s disease, what is the percentage risk of inheriting Alzheimer’s disease?

Which of the following statements about the automatism of epilepsy is most accurate?

Which of the following is a common clinical feature suggestive of psychogenic non-epileptic seizures (PNES) rather than epileptic seizures?

In female-perpetrated homicides where the perpetrator is psychotic, which age group of female victims is most likely to be targeted?

Which of the following is the best predictive factor of recovery after a traumatic head injury?

In an RCT flow chart comparing the efficacy of three treatment arms: Venlafaxine only, Venlafaxine with Aripiprazole, and Venlafaxine with placebo, what key information would be crucial to determine the study’s internal validity?

Following a head injury in a 11-year-old child, which of the following is a likely neuropsychiatric sequelae?

Which of the following tools is most commonly used to assess the quality and ensure the appropriate reporting of publications in a meta-analysis?

Which of the following best describes the statistical method to determine the mean difference between two groups at 12 weeks?

When comparing the efficacy of a treatment to a placebo in a clinical trial, which of the following best describes the method to determine the odds ratio for remission?

In the context of a quality improvement project, which of the following best represents a Nolan question, one of the three essential criteria?

What is the commonly accepted probability (α) for committing a Type I error in hypothesis testing?

A new intervention reduces the mortality rate by 50% compared to the old treatment, but the result is not statistically significant. Which statement is true?

In bipolar disorder, which of the following is a gender-specific difference in presentation?

What class of drug is mephedrone?

Which substance with long-term use can cause the most cognitive decline?

A 61-year-old presents to the clinic with a Mini-Mental State Examination (MMSE) result from two weeks ago as 28/30. Now, two weeks later, her score is 19/30. What is the most likely diagnosis?

A mother presents to the clinic concerned about her child who has autism and is becoming increasingly agitated and difficult to manage at home with severe temper tantrums. Mother has not been able to identify any triggers at home and is asking for advice. What is the appropriate next step?

What are likely MRI findings for a patient with non-complicated chronic alcohol misuse?

What are likely imaging findings for Alzheimer’s disease?

Which group of people are most likely to commit arson?

Which of the following best describes a situation in which a new test was found to be as effective as a recently used effective gold standard test?

Which of the following best describes a situation where a group of people are tested and then re-tested after several years to determine the power of the initial test?

Which of the following features is most indicative of the therapeutic approach used in motivational interviewing?

Which of the following genes is most commonly associated with Rett syndrome?

Which of the following syndromes is most likely to present in a young child with hyperactivity, moderate/severe learning disability (LD), and hypertelorism?

According to ICD-11 and DSM-5, from what age do symptoms of ADHD need to have been present for a diagnosis to be made?

Which of the following behavioral interventions is primarily directed at the antecedent of a problem?

In individuals with gender dysphoria, which mental disorder has been found to have an increased prevalence?

Which of the following best describes a core concept of Transactional Analysis?

Which of the following is most likely an antecedent to increased gaming in young people?

Which of the following is the best graphical representation for displaying the distribution of a single continuous variable?

Which of the following graphical representations is best suited for visualizing individual values in a small to moderate dataset while preserving the data’s actual values?

Given that the variance for a set of data is 16, what is the standard deviation?

You are analyzing a flow chart of a randomized control trial (RCT) involving an open-label phase. There were 200 participants initially enrolled in the open-label phase. At the end of this phase, 40 participants remitted on venlafaxine and 10 remitted on placebo. What is the percentage of participants that remitted during the open-label phase?

According to NICE guidelines, which of the following is the recommended first-line pharmacological treatment for children with Obsessive-Compulsive Disorder (OCD)?

According to NICE guidelines and the UK marketing authorisation, which of the following medications was approved for up to 12 weeks of treatment for moderate to severe manic episodes in bipolar I disorder in young people aged 13 and older?

In which of the following patient groups was lurasidone found to be efficacious?

Which of the following best describes the primary mechanism of action of lurasidone?

A patient presents with a mixed affective state and is not currently on any antipsychotic or mood stabilizer. According to best practice guidelines, which of the following medications should be offered to the patient?

A patient is diagnosed with mania and is currently on an antidepressant as monotherapy according to the British National Formulary (BNF). What is the appropriate management step as recommended?

Which of the following electronic databases is primarily focused on providing access to systematic reviews and randomized controlled trials pertaining to healthcare interventions?

In the context of a clinical research study, which term is most accurately described as a consistent and non-random flaw in the methodology or design that leads to incorrect results, often favouring a certain outcome?

In the context of epidemiological research, confounding occurs when the effect or association between an exposure and an outcome is distorted by a third variable. Which of the following strategies is NOT commonly used to reduce the risk of confounding?

In the context of randomized controlled trials (RCTs), which of the following methods does NOT directly pertain to methods of randomization, but rather to the process of ensuring that the sequence of random allocation remains hidden from both the researchers and study participants until the moment of assignment?

Which of the following researchers is NOT directly associated with a traditional set of criteria for arguing a cause-and-effect relationship in epidemiology?

Which of the following best describes a characteristic of a diagnostic test that allows it to correctly identify individuals who do not have the disease under study?

In the context of interpreting “survival” curves, which method provides an estimate of the survival function from lifetime data and can incorporate censored cases?

When analyzing data from a clinical study comparing the mean difference in blood pressure between two independent groups of patients (Group A: patients taking Drug X and Group B: patients taking a placebo), which of the following statistical tests is the most appropriate?

In a study comparing pain scores before and after a specific intervention in the same group of patients, which of the following statistical tests would be the most appropriate to use?

A researcher is analyzing data from a study examining the relationship between two variables: the number of hours of sleep and the reaction time on a cognitive test. The data is not normally distributed. Which of the following correlation coefficients would be most appropriate for the researcher to use?

In a healthcare economic evaluation, a team is tasked with considering not just the direct healthcare costs and outcomes, but also the indirect societal costs, such as lost productivity, alongside the benefits converted into monetary terms. They aim to provide a comprehensive economic view that extends beyond the confines of the healthcare system. Which of the following economic evaluation methods is best suited for such a comprehensive assessment?