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MCQ. Electroconvulsive Therapy (ECT)- I

1. The first use of convulsive therapy for the treatment of a psychiatric disorder in modern times is attributed to
A. Ladislaus von Meduna
B. A. E. Bennett
C. Egas Moniz
D. Kurt Schneider

2. The first therapeutic use of electrically induced seizures in the treatment of mental disorders is related to
A. Harold Sackeim
B. Luigi Bini and Ugo Cerletti
C. D. Goldman
D. G. Holmberg and S. Thesieff

3. The sequece of administration of medications in anesthesia for ECT is:
A. Atropine---thiopentone/methohexitol---succinylcholine
B. Succinylcholine---atropine---thiopentone/methohexitol
C. Atracurium---succinylcholine---atropine
D. Atropine--- succinylecholine---thiopentone/methohexitol

4. As per the current evidence, which statement is NOT correct?
A. Bilateral ECT is superior in efficacy to unilateral ECT.
B. Unilateral ECT is more likely to cause cognitive deficits.
C. Brief-pulse ECT delivery is associated with decreased cognitive deficits.
D. Unilateral ECT is administered to the non-dominant hemisphere

5. Which of the following drugs is associated with lower seizure thresholds when administering ECT?
A. Lithium
B. Anticonvulsants
C. Benzodiazepines
D. Barbiturates

6. What is the minimum seizure duration required for effectiveness of ECT?
A. 1 to 3 seconds
B. 5 to 10 seconds
C. 30 to 90 seconds
D. 180 to 200 seconds

7. What is the best accepted placement of electrodes in unilateral ECT?
A. Bifrontotemporal
B. Paritotemporal
C. Occipital
D. D'Elia position

8. What is considered as the gold standard for confirmation of seizure in ECT?
A. Cuff method
B. Electroencephalography (EEG)
C. Electromyogram (EMG)
D. Galvanic Skin Response (GSR)

9. What is the average mortality rate with ECT (modified)?
A. 3-4 per 100,000
B. 10-25 per 100,000
C. 10-20 per 10,000
D. 50-60 per 1000,00

10. Factors predisposing to postictal confusional state include, all EXCEPT:
A. Sine wave ECT
B. High-dose ECT
C. Existing CNS disease
D. Multiple ECT
E. A younger age group

11. Which is the best unit for quantification of ECT stimuli?
A. Millicoulombs (mC)
B. Joules
C. Watts
D. Volt

12. Which of the following is NOT a recommended preparation for ECT procedure?
A. Informed consent in writing
B. Pre-ECT investigations
C. Morning bath, cleaning the oil from the head, overnight fast
D. Premedication with an anticholinergic agent
E. Administration of an anticonvulsant 30 minutes before ECT

13. The most common indication of ECT is:
A. Schizophrenia
B. Generalized Anxiety Disorder
C. Manic episodes
D. Major depression

14. rTMS is found to have antidepressant properties when applied to
A. Temporal– parietal regions of the cortex
B. Dorsolateral prefrontal cortex (DLPFC)
C. Occipital cortex
D. Parieto-occipital cortex

15. The most persistent adverse effect of ECT is
A. Retrograde amnesia
B. Fractures
C. Seizures
D. Hypertension


ANSWER KEY
1. A
2. B
3. A
4. B
5. A
6. C
7. D
8. B
9. A
10. E
11. A
12. E
13.D
14. B
15. A
Reference
1.     Andrade C. Electrical Aspects of ECT. in Handbook of Psychiatry by Bhugra D, Ranjith G, Patel V. Byword Viva Publishers, New Delhi, 2005.
2.     Kaplan HI, Sadock BJ. Synopsis of Psychiatry , Behavioral Sciences/ Clinical Psychiatry. 9th ed. Hong Kong :William and Wilkinson Publishers ;1998.

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