FMGE Psychiatry Flashcards

24 sample cards from the Psychiatry deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What is conversion disorder (functional neurological symptom disorder)?

   Neurological symptoms (weakness, paralysis, seizures, blindness) incompatible with recognized neurological disease, not intentionally produced, often associated with psychological stressors.

2. What are the three main dissociative disorders in DSM-5?

   Dissociative identity disorder (DID), dissociative amnesia (including dissociative fugue), and depersonalization/derealization disorder.

3. What characterizes dissociative identity disorder (DID)?

   Two or more distinct personality states (identities) with recurrent gaps in recall of everyday events, personal information, or traumatic events; often associated with severe early childhood trauma.

4. What are the diagnostic features and a key physical complication of anorexia nervosa?

   Restriction of intake leading to significantly low body weight, intense fear of weight gain, and disturbed body image. Complications include amenorrhoea, bradycardia, osteoporosis, and lanugo hair.

5. What distinguishes bulimia nervosa from anorexia nervosa?

   Bulimia features recurrent binge eating with compensatory behaviours (vomiting, laxatives, exercise) but body weight is usually normal or above; anorexia is defined by significantly low body weight.

6. What is a classic dental/physical sign of self-induced vomiting in bulimia nervosa?

   Russell's sign (calluses/scarring on the dorsum of the hand) along with dental enamel erosion and parotid gland enlargement; electrolyte disturbance is hypokalaemic metabolic alkalosis.

7. What distinguishes binge-eating disorder from bulimia nervosa?

   Binge-eating disorder involves recurrent binge eating with distress but WITHOUT regular compensatory behaviours, and is commonly associated with obesity.

8. What are the diagnostic criteria for insomnia disorder regarding frequency and duration?

   Dissatisfaction with sleep quantity/quality (difficulty initiating, maintaining sleep, or early waking) occurring at least 3 nights per week for at least 3 months, causing daytime impairment.

9. What is obstructive sleep apnoea (OSA), and what is its first-line treatment?

   Repetitive upper-airway collapse during sleep causing apnoeas/hypopnoeas, snoring, and daytime sleepiness; first-line treatment is continuous positive airway pressure (CPAP).

10. How are parasomnias classified into NREM and REM types, with an example of each?

    NREM parasomnias (occur in deep slow-wave sleep, early night): sleepwalking and sleep terrors. REM parasomnia: REM sleep behaviour disorder (acting out dreams), and nightmare disorder.

11. List the four phases of the normal human sexual response cycle (Masters and Johnson).

    Excitement (desire/arousal), plateau, orgasm, and resolution.

12. Give examples of common sexual dysfunctions in men and women.

    Men: erectile disorder, premature (early) ejaculation, delayed ejaculation. Women: female sexual interest/arousal disorder, female orgasmic disorder, genito-pelvic pain/penetration disorder.

13. What defines a paraphilic disorder (as opposed to a paraphilia)?

    A paraphilia (atypical sexual interest) becomes a paraphilic disorder only when it causes distress/impairment to the individual OR involves harm/risk to others (e.g., paedophilic, exhibitionistic, voyeuristic, frotteuristic disorders).

14. What is gender dysphoria?

    Marked incongruence between a person's experienced/expressed gender and their assigned gender, lasting at least 6 months and causing clinically significant distress or impairment.

15. What is the most common cause of dementia, and its characteristic neuropathology?

    Alzheimer's disease; characterized by extracellular beta-amyloid plaques and intracellular neurofibrillary tangles (hyperphosphorylated tau), with cortical atrophy and acetylcholine deficiency.

16. How is delirium distinguished from dementia in terms of onset, course, and consciousness?

    Delirium: acute onset, fluctuating course, impaired consciousness/attention, often reversible. Dementia: insidious onset, progressive course, clear consciousness (until late), generally irreversible.

17. Why is late-life (geriatric) depression sometimes misdiagnosed as dementia, and what is this called?

    Depression in the elderly can present with prominent cognitive impairment that mimics dementia but reverses with treatment; this is called 'pseudodementia' (depressive cognitive disorder).

18. What are the three core symptom domains and the age-of-onset criterion for ADHD in DSM-5?

    Inattention, hyperactivity, and impulsivity; several symptoms must be present before age 12, in two or more settings, for at least 6 months.

19. What are the two core domains of autism spectrum disorder (ASD)?

    (1) Persistent deficits in social communication and social interaction; and (2) restricted, repetitive patterns of behaviour, interests, or activities (including sensory abnormalities), with onset in the early developmental period.

20. How does conduct disorder differ from oppositional defiant disorder (ODD)?

    Conduct disorder involves repetitive violation of others' basic rights or major societal norms (aggression to people/animals, destruction, deceit/theft, serious rule violations); ODD is a pattern of angry/irritable mood and defiant/argumentative behaviour without serious rights violations.

21. What is the most common anxiety disorder of early childhood, and its key feature?

    Separation anxiety disorder: developmentally inappropriate, excessive fear or distress concerning separation from attachment figures, lasting at least 4 weeks in children/adolescents.

22. In Indian mental health legislation, which Act replaced the Mental Health Act 1987, and what key rights did it introduce?

    The Mental Healthcare Act, 2017, which decriminalized suicide attempts, introduced the Advance Directive, the Nominated Representative, and the right to access mental healthcare; it also regulates the use of ECT (banned without anaesthesia and in minors except in specific cases).

23. Name the four core ethical principles of medical/psychiatric practice.

    Autonomy, beneficence, non-maleficence, and justice; supported by confidentiality and informed consent.

24. What landmark legal standard defines criminal responsibility ('insanity defence'), and what is its Indian statutory counterpart?

    The M'Naghten Rules (defect of reason such that the person did not know the nature/quality of the act or that it was wrong); in India this corresponds to Section 84 of the Indian Penal Code (now BNS) covering acts of a person of 'unsound mind'.

What this deck covers

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