Which of the following is a psychosocial risk factor for the development of peptic ulcer?
E. Since the discovery of Helicobacter pylori, interest in the association of peptic ulcer and psychosocial factors has diminished. Nevertheless, psychosocial factors do play a role in the development of ulcers in susceptible individuals. Data from the National Comorbidity Survey have shown that generalized anxiety disorder (GAD) is associated with an increased risk of self-reported peptic ulcer disease. Longitudinal prospective studies have shown that depression and anxiety at baseline increase the risk of ulcer development. Childhood physical abuse, sexual abuse, and neglect are also associated with a statistically increased risk of peptic ulceration in addition to other physical conditions. Acute severe stress in human beings, provoked by wars or earthquakes, can precipitate ulceration in susceptible individuals. Once formed, psychosocial factors can delay recovery and contribute to a worse prognosis.
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Which of the following is NOT a risk factor for the development of peptic ulcer?
E. Lifestyle factors predict the development of peptic ulcer in susceptible individuals. They are potential mediators in the aetiological matrix between stress and ulcer. These include cigarette smoking; heavy alcohol consumption; lack of sleep; not eating breakfast; non-steroidal anti-inflammatory drugs; hard on-the-job labour and low socioeconomic status.
Which of the following is an early symptom/sign of HIV dementia?
A. Organic and neuropsychiatric disorders in HIV are common, and may result from the direct effects of HIV, opportunistic infections, effects of neoplasms, metabolic abnormalities, iatrogenic interventions and others. The prevalence of HIV dementia is around 10–15%. Cognitive changes may be directly due to the effects of HIV itself, secondary to opportunistic infection following treatment, or due to pre-existing psychological morbidity. These changes may be classified into early and late. Early symptoms consist of forgetfulness, poor concentration, balance problems, apathy, withdrawal, dysphoric mood, and dyspraxia. Symptoms that are suggestive of a late change include disorientation, confusion, peripheral neuropathies, slowed verbal responses, indifference to illness, organic psychosis, incontinence, and carphologia (picking imaginary objects and bed linen).
According to the WHO classification, the normal range of body mass index (BMI) is:
B. BMI is a simple index of weight-for-height that is commonly used to classify underweight, overweight, and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2 ). BMI values are age independent and the same for both sexes. However, BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI grading in relation to risk may differ for different populations: underweight <18.50; normal range 18.50–24.99; overweight ≥25.00; pre-obese 25.00–29.99; obese ≥30.00; obese class I 30.00–34.99; obese class II 35.00–39.99; obese class III ≥40.00.
Which of the following is considered the cardinal feature of delirium?
D. The clinical presentation of delirium is defined by psychopathology and temporal course. It is usually of acute onset and the cardinal feature is a disturbance in consciousness. Impairment of consciousness is the key feature that separates delirium from most other psychiatric disorders. There is a continuum between mild impairment of consciousness and near unconsciousness. There is fluctuation in intensity, and symptoms are often worse at night. The other features are an inability to focus and maintain attention, perceptual disturbances, disorientation in time and/or space, rarely to people (though false recognition is common) and almost never to self. Disorientation to time is often the first warning sign of delirium. Attention is poor and the patient is easily distractable, looking either apathetic or intensely focused upon something. Psychomotor disturbance may be in the form of agitation or retardation. Other features may include lability of mood and incoherent speech.
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