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MRCPsych Part II MCQ
By
Dr S M Yagoob
1.Detoxification programme at home is contraindicated if :
[a] Severe craving.
[b] In-patient detoxification- is available.
[c] History of Delirium Tremens.
[d] Suffered one fit over last 2 years.
[e] No previous detoxification under medical supervision.
2.Down's syndrome, there is a high rate of :
[a] Complex Partial seizures.
[b] High tone deafness.
[c] Proximal palmar trirradius.
[d] Strabismus.
[e] Hyperthyroidism
3.Gilles de la Tourrette :
[a] High incidtue of O.C.D. in relatives.
[b] Autosomal dominant with low penctrance.
[c] Echophenomena.
[d] Improvement with Clonidine.
[e] Complex partial seizures.
4.The following drugs produce reduced libido :
[a] Diazepam.
[b] Trifiuoperazine.
[c] Imipramine. -
[d] Carbamazepine.
[e] Benperidol.
5.Prolactin secretion :
[a] Increased in schizophrenia.
[b] Decreased in depresion.
[c] Decreased by some neuroleptics.
[d] Prolactin levels correlate with extrapyramidal side eftects.
[e] Is under serotoninergic control.
6.Characteristics of atypical facial pain
[a] Superficial
[b] Bilateral.
[c] Commonly associated with temporo-mandibular joint abnormalities
[d] Disturbs sleep. [casting syndrome]
[e] Persistent.
7.Wilson's disease:
[a] Autosomal recessive inheritance.
[b] reduced serum ceruloplasmin.
[c] Increised urine copper excretion.
[d] Affects dorsal columns.
[e] Cherry red macular spot.
8.Features of Generalized Anxiety Disorder in middle childhood
[a] Central abdominal pain
[b] Separation anxiety.
[c] Regression.
[d ]Obsessional symptoms.
[e ]Manipulative behaviour.
9.Features of Postraumatic Stress Disorder
[a] Emotional numbness.
[b] Counterphobic behaviour.
[c] Situation-specific anxiety.
[d] Hypervigilance.
[e] Amnesia.
10. Complications at pregnancy of an opiate addict mother
[a] Cleft palate.
[b] Abruptio placentae.
[c] Low birth weiaht.
[d ]Multiple births.
[e ]Intrauterine death.
11.Characteristic features of Borderline Personalitv Disorder
[a] Rigid narcissism.
[b] Feelings of boredom and emptiness.
[c] Impulsive offences.
[d] Outbursts of aggression.
[e ]Can suffer brief psychotic episodes.
12.Specific reading, retardation (Dyslexia) associated with
[a] Conduct disorder.
[b] Glue ear.
[c] Mixed cerebral dominance.
[d] Spelling difficulties.
[e] Higher incidence in boys than girls.
13.Visual hallucinations in the elderly are common in
[a] Untreated depression.
[b] Acute organic psychosis.
[c] Those treated with antihypertensive drugs.
[d] Paraphrenia.
14.In Group Psychotherapy,the therapist aims to
[a] intervene only when the -group gets out of hand.
[b] Create a small democracy.
[c] Form altruism.
[d] Interpretation of idealization about the therapist.
15.Goffman's work:
[a] Applies only to psvchiatric hospitals.
[b] Based on field work carried out in American hospitals.
[c] illuminates institutional behaviour.
[d] Has not had influence in social theory.
[e] Assocated with the three hospital study
16.In psychodynamic psychotherapy the patient needs to
[a] Be of above average intelligence.
[b] Agree with the tennets of psychoanalysis.
[c] Be willing to explore and challenge given for granted assumptions about himself.
[d] Increased inner distress.
17.Dopamine receptors
[a] Research shows that 5-10 mg of Haloperidol is enough to block 80% dopamine receptors.
[b] DI receptors linked to adenylate cyclase.
[c] D3 receptors exist in high concentration in the limbic system.
[d] Sulpiride specifically blocks D 1.
18.Doparnine neurones
[a] Also secrete Noradrenaline.
[b] Exist in rubrospinal tract.
[c] Exist in mesolimbic
[d] Exist in tuberoinfundibular tract.
[e] Retina
19.Cardiac neurosis .
[a] Sharp left inframammillary pain.
[b] Syncope on exertion.
[c] Tingling in both hands.
[d] Orthopnea.
20.Features in Kretschmer's sensitiver Beziehungswahn or Sensitive Reaction
[a] Auditory hallucinations.
[b] Sensitive blushing.
[c] Shameful guilt.
[d] Ideas of reference.
21.Skin conductance galvanic skin response
[a] Increased in depression.
[b] Increase with exposure -desensitization and reduce after it.
[c] Increased in Agoraphobia.
[d] Variable in chronic schizophrenia.
[e] Reduced when administering a short acting benzodiazepine.
22.Korsakov's syndrome
[a] Immediate memory is affected.
[b] There is always a degree of confabulation.
[c] Clouding of consciousness is characteristic.
[d] Can be caused by continuous vomiting.
23.Eisenck's theory.:
[a] Is an idiographic theory.
[b] Extroverts are slower to condition .
[c] Extroverts seek external stimulation.
[d] Introverts have high cortical arousal.
24.Early dementia in a 70 year old , the diagnosis of Alzheimer's is more likely if :
[a] Sudden onset.
[b] Incontinence.
[c] Seizures.
[d] Progressive agnosia.
[e ]Gait disturbance.
25.Guided mourning
[a] Indicated in healthy bereavement.
[b] Based on phobic model.
[c] Based on Freud's idea of cathexis.
[d] Research has shown it to be superior to other treatments.
[e] Compatible with the psychoanalytic theory of working through
26.Homework assignments are prescribed in the treatment of
[a] Personality disorder.
[b] Bulimia nervosa.
[c ]Grief reaction.
[d ]Depression.
27.Bulimia nervosa
[a] Most cases have suffered Anorexia initially.
[b] Most cases have onset in their teens.
[c] Sex ratio different than in Anorexia.
[d] Increased incidence in ballet dancers is a spurious finding
28.Hyperactivity disorder
[a] PET scan shows hypofrontality.
[b] Have strong genetic influence.
[c] Diet is effective treatment in most cases.
[d ]Motor activity declines in adolescence.
[e ]No abnormality of cortical arousal
29.Authoritative parenting
[a] improve self esteem.
[b] Set home rules.
[c] Excess of emotional warmth is related to the onset of psychosis in children.
[d] Retain
[e] Represent western countries
30.Spearman's work
[a] Describes concept of "g"(general intelliaence).
[b] Describes concept of "s"(specific intelliaence).
[c] Derives from factor analysis.
[d] States that intelligence completely due to genetic inheritance.
[e] There is a negative correlation between different sections in IQ tests.
31.Barbiturates intoxication
[a] Nystagmus.
[b] Ataxia.
[c] Increased fast activity in frontaI areas in EEG.
32.Alcohol abuse related to
[a] Carcinoma of oesophagus.
[b] Cardiomiopathy.
[c] Hypertension.
[d] Increase risk of cirrhosis in females
33.Squeezing technique in the treatment of sexual disorders
[a] Indicated in impotence.
[b] Indicated in premature ejaculation
[c] Clomipramine is effective in some cases.
[d] At least one third of cases have organic cause.
[e ]Masters& Johnson disensitization treatment routinely uses imagery exposure.
34.Paraphrenia
[a] CT scans show positive findings.
[b] Precedes dementia.
[c] Affects more women than men.
[e] Show good response to neuroleptics
35.Labelling theory
[a] Is derived from deviance theory.
[b] It is important in psychiatric classifications.
[c] Depends on cultural stereotypes.
[d] Labelling of a group involves attribution of characteristics to all members of the group.
36.Learning theory
[a] Incidental memory more effective than intentional memory.
[b] Primary memory is stored in about 7 bits of information.
[c] Retrograde amnesia produced by retroactive interference.
37.ECT:
[a] Increase Prolactin.
[b ]Memory loss directly related to voltage.
[c] Produces irreversible memory loss.
[d] Less memory loss if minimal dose of anaesthetic is used.
38.Screening tests in General Hospitals setting
[a] Should have cut off points with high sensitivity and specificity.
[b] Includes CAGE.
[c] Scores must have normal distribution.
[d] Includes MMSE
[e] Depressive Anxiety Inventory
39.Dementia
[a] Some cases improve with antidepressants.
[b] More than 20% over 65.
40.Multiple Sclerosis
[a] More likely to be depressed than elated.
[b] If elated, more likely to have intellectual impairment than if depressed.
[c] Eventually causes dementia.
41.Serotonin mediates
[a] Aggressive behaviour.
[b] Sexual
[c] Sleep.
42.Conduct disorder in more than 50%
[a] Poor peer relationship
[b] Criminality in parents.
[c] Emotional symptoms.
43.Unfitness to plead
[a] Can result in acquittal.
[b] Usually applicable to mentally disordered.
[c] Applied when there is amnesia for the event.
[d] Arises from a delusion related to the offence.
44.Adversarial Law
[a] Based on Roman Law.
[b ]Applies to law that arises from statutes.
[c ]Involves a trial with jury.
[d ]Based on common law
45.Juvenile delinquency
[a] Has hereditary basis.
[b] Predisposes to adult criminality.
[c] Girls have higher incidence of psychiatric disorders than boys
46. In Mania:
[a] Blunted response of TSH to TRH.
47.Generalized Anxiety Disorder:
[a] Associated to mitral valve prolapse.
[b] Decrease in the elderly
.
48.In Festinger's Cognitive Disonance there is
[a] Self directed speech.
[b] Bringing up of new cognitions to support preconceptions.
49.In parenting
[a] Charismatic leadership relates to referent power.
[b] Laisser faire parenting associated with drug abuse in children.
50. Object permanance
[a] shape
[b] size.
[c] colour.
[d] brightness.
[e] personal position.
51.Social disintegration associate with:
[a] lncrease delinquency.
[b] lncrease divorce.
[c] lncrease psychiatric disorders.
[d] lncrease suicide rate
52.Cognitive dissonance:
[a] associate with Festinger.
[b] may cause change in behaviour.
[c] there is no affective component.
[d] derives from contradiction in logic.
53.Small group effect:
[a] moral standard effected by group.
[b] the group may change the view about the length of a line.
[c] cruelty may occur as a result of group effect
[e] cohesiveness increase conformity.
54.Personal space:
[a] increase in criminals.
[b] increase in infants compared to adults.
[c] relates to social power.
[e] there are always 4 zones.
55.EEG evoked potentials:
[a] useful in M.S.
[b] in diagnosis of hysteria.
[c] reduced latency in dementia
.
56.Galvanic skin response:
[a] increased in agrophobia.
[b] reduced after treatment.
57.recognised neurotransmitters:
[a] CCK.
[b] ACTH.
[c] Taurine.
[d] GABA.
[e] Glutamic acid
58.The following are CABA inhibitors:
[a] sodium valborate.
[b] diazepam.
[c] carbamazepine.
[d] vigabatrin.
[e] Ethosuximide
59.The following are antjconvulsants acting on CABA transaminase:
[a] sodium valborate.
[b] diazepam.
[c] carbamazepine.
[d] vigabatrin.
[e] Ethosuximide
60.Multiple tics in children:
[a] may be suppressed voluntarily.
[b] should be treated by clomipramine.
[c] associate with OCD in the family.
61.Dementia:
[a] 5%-10% frequency over 63.
[b] prevalence double every 5 years over 65.
[c ]more likely to be MID if over 65.
[d ]recognised cosequence of MS
[e ]Pick's disease is the third cause of dementja
62.Investigations useful in differentiating dementia and pseudodementia:
[a] serum free cortisol.
[b] CXR.
[c] serum ca.
[d] serum vinillyl mandelic acid.
63.features of late paraphrenia:
[a] robust premorbid personality.
[b] fitting a hearing aid is likely to help all those with deafness.
[c] most have first rank symptoms. .
[d] 15% have family history of schizophrenia
[e] no enlargement of ventricles
[f] parahypocampal atrophy
[g] evidence of changes in CTscan prior to onset
64.Features of primary memory:
[a] iconic and echoic memory are part of sensory memory.
[b] if digit recall normal and name and address abnormal then secondary memory is impaired.
[c] semantic organisation
[d] lasts for 20 seconds
[e] affected in Korsakoff's syndrome
65.Paranoid psychosis developing with TLE:
[a] CPZ should be avoided.
[b] lesion more likely to be in dominant hemisphere.
66.Transvestite:
[a] gender identity disturbance.
[b] usually cross dress privately.
[c] mainly for sexual arousal.
[d] usually in unmarried men.
67.Biological as compared to adoptive family in schizophrenia:
[a] more likely to have abnormal personality.
[b] more likely to have alcoholism.
[c] more likely to have organic psychosis.
[d] more likely to have antisocial P.D.
68.OCD:
[a] worse prognosis if associated with rumination than rituals
[b] treat ruminations before rituals.
[c] Worse prognosis if chronic.
[d] Worse prognosis if unmarried.
[e] rumination are successfully treated by thought stopping
[f] never act on rumination
69.Sex therapy: aspects of sensate focus
[a] squeeze technique.
[b] ban on intercourse.
[c] ban on masturbation.
[d] avoid distraction
70.Suicide attempts in depression more likely if:
[a] presvious suicide attempts.
[b] psychomotor retardation.
[c] guilt.
[d] obsessional traits.
[e] insomnia.
71.Visual hallucinations occur in:
[a] cannabis.
[b] phencycline.
[c] amphetamine.
[d] L-dopa.
[e ]morphine.
[f] propranolol
72.Negative theaputic reaction:
[a] conflict between therapist and patient on initial meeting.
[b] deterioration after initial improvement.
[c] related to inappropriate transference by therapist.
73.Group analysis:
[a] analysis of the group by the group in the group
[b] analysis of group behaviour by detached therapist.
[c] psychoanalytic therapy of individuals in a group.
[d] specific method of group analysis.
74. Confusional state in the elderly:
[a] social factors can precipitate it.
[b] pain can precipitate it.
[c] 80% mortality.
75. WHO definition of impairment:
[a] impairment is physical or psychological deficit
[b] disability is inability to perform an action because of impairment.
[c] handicap is inability to fulfill a role
[d] WHO definition include dangerousness.
[e] disability is classified in ICD10
76.Down syndrome:
[a] always present with extra chromosome.
[b] hypothyroidism.
[c] translocation can be transmitted from the father.
[d] always severely retarded.
[e] autism rare with downs.
77.Autism:
[a] performance IQ usually less than 50
[b] can never live independently.
[c] as gets older can make social gesture.
[d] family history of language impairment in sibs.
78.Recessive X-linked disorders:
[a] transmission from father to son is 25%.
[b] mothers have carrier daughters.
[c] sons always develop the disease
[d ]mutation are more likely
79.Dominant transmission:
[a] 25% offsprings affected.
[b] if both parents are dominants all children affected.
[c] consanguineous marriages are common.
[d] frequency in population less than 1%
.
80.decrease prolactin level:
[a] antipsychotic effect.
[b] after epilepsy.
[c] SSRI antidepressants.
[d] after ECT.
81. 5HT effects on CNS:
[a] increase irritability
[b] penile erection
[c] control sleep.
[d] decrease prolactin level.
[e] antipsychotic effect.
82.Somnambulism.
[a] occurs in stages 111 and IV sleep.
[b] familial.
[c] increase with separation anxiety.
[d] treated with benzodiazepines.
83.Lewy bodies:
[a] a.pathognomonic in parkinson's disease
[b] occurs in normal brain.
[c] found in substantia negra.
[d] feature of alzheimer disease..
[e] present in 1/3 of dementias
[f] extracellular
[g] spread in all the cortex
84.Endorphine:
[a] associated with gate theory of pain
[b] never found extra cerebrally.
[c] increase after exercise.
[d] act on dopamine receptors
[e] potentiate dopamine
85.Simple phobia:
[a] almost predominantly females..
[b] seligman's preparedness may be
[c ]more difficult to treat than agorphobia
86.Moclobamide:
[a] less side effects than old MAOI.
[b] no interaction with tyramine.
[c] can be combined with SSRIS.
[d] is irreversible.
[e] short 1/2 life.
87.The following have direct action on NA neurons:
[a] amphetamine.
[b] adrenaline.
[c] N.A.
[d] tyramine.
[e] ephedrine.
88.STM (Working memory]
[a] Stored in chunks
[b] Retrival improved if data organised / heirarchised
[c] Localized in temproparietal area
[d] Affected by destruction of mamillary bodies
89. Heroin addiction in the young female
[a] She is unlikely to use drugs other than heroin
[b] There is an increase in sexual activity
[c] May be associated with a depressive illness
[d] She is often a social rebel from a stable family
[e] She is likely to die of a heroin overdose
90.The following occupations have an increased risk of alcoholism
[a] Bus driving
[b] Being a Doctor
[c] Being a merchant seaman
[d] Being a clergyman
[e] Being an actor
91.The following drugs may only be prescribed for addiction by doctors registered under the Misuse of Drugs (Notification of and Supply to Addicts) Regulations (1973)
[a] Amphetamines
[b] Morphine
[c] Cocaine
[d] Cannabis
[e] Diconal [Dipipanol]
92.Class A drugs under the misuse of drugs act (1971) include
[a] LSD
[b] morphine [and all opoids]
[c] cocaine
[d] amphetamines for intravenous injection
[e] amphetamines for oral use
93.Schedule 1 of the misuse of drugs regulations (1985) includes the following drugs
[a] heroin
[b] barbiturates
[c] cannabis
[d] pentazocine
[e] L sergide
94.Under the Misuse of Drugs (Notification of and Supply to Addicts) Regulations (1973) a medical practitioner must notify the Chief Medical Officer (London or Belfast) of any person believed to be addicted to (this question may not be relevant today , hope the college won't repeat this)
[a] cannabis
[b] cocaine
[c] pethidine
[d] LSD
[e] methadone
95.Clinically important physical dependence occurs due to the following drugs
[a] LSD
[b] morphine
[c] cocaine
[d] amphetamine
[e] cannabis
96.Methadone is an analgesic which
[a] is approximately as potent as morphine
[b] is commonly used to replace heroin in patients dependent on heroin
[c] causes suppression of coughing
[d] is more sedating than morphine
[e] is a Class B drug under the Misuse of Drugs Act (1971)
97.Amphetamine abuse is associated with:
[a] marked increased tolerance
[b] withdrawal delirium
[c] psychoses resembling hebephrenic schizophrenia
[d] visual hallucinations
[e] sleeplessness
98.Recognised complications of heroin addiction include
[a] Nephrotic syndrome
[b] Hepatitis C
[c] Cardiomyopathy
[d] Infective endocarditis
[e] Carcinoma of the Bronchus
99.A hallucinogen:
[a] in pharmacological doses causes gross distortion of perception
[b] significantly alters consciousness
[c] often causes mood changes
[d] never causes distortions of thinking ?
[e] never causes marked change of behaviour
100.The following features help the general practitioner in detecting alcohol dependence
[a] Morning nausea
[b] Shaking on waking
[c] smell of alcohol on breath
[d] Unexplained absences from: work
[e] Hypnagogic hallucinations
101.Characteristic feature of solvent abuse include the following
[a] more common in males
[b] solitary abuse is common in teenagers
[c] blurred vision occurs during intoxication
[d] tricyclic antidepressants are an effective treatment
[e] Hallucinations are usually auditory
102.Features of chronic alcoholism include
[a] Marchiafava-Bignami syndrome
[b] optic atrophy
[c] Campbell de Morgan spots
[d] episodic hypoglycaemia
[e] haemochromatosis
103.Concerning alcohol consumption in the UK
[a] the lowest point in the per capita consumption of all forms of alcohol since the 17th centaury was reached after the second world war
[b] the per capita consumption of alcohol was higher in.the 1970s than it was in the late 19th century
[c] drinking among women has tended to stay fairly constant in the second half of the 20th centaury
[d] the alcohol industry tends to recruit men who are already heavy drinkers
[e] in the 1970s and 1980s there was increased drinking and drunkenness amongst adolescents
104.Female alcoholics when compared to male alcoholics
[a] more often drink alone
[b] are more susceptible to liver cirrhosis
[c] commit fewer antisocial acts when intoxicated
[d] make more suicide attempts
[e] have a family history of alcoholism less often
105.Alcohol dependence is more common in
[a] Negros than whites in North America
[b] married than unmarried people
[c] Jews than non-Jews
[d] doctors than the general population
[e] the middle class than other socioeconomic classes
106.Recognised epidemiological indices of the prevalence of alcoholism include
[a] per capita consumption of alcohol
[b] hospital admissions with central pontine myelinolysis
[c] divorce rates
[d] mortality from liver cirrhosis
[e] convictions for drunken driving
107.Alcohol drinking is associated with an increased incidence of
[a] coronary artery disease
[b] suicide
[c] lung cancer
[d] murder
[e] tuberculosis
108.In alcohol hallucinosis
[a] the patient is confused
[b] hallucinations are usually visual
[c] some patients progress to schizophrenia
[d] the cause is thiamine deficiency
[e] auditory hallucinations are usually experienced as pleasant
109.Recognised features of Korsakoffs psychosis include
[a] thiamin deficiency
[b] a subsequent clinical picture of Wernickes encephalopathy
[c] retrograde amnesia
[d] apathy
[e] unimpaired new learning ability
110.Recognised features of Wernickes encephalopathy include
[a] Clear consciousness
[b] pathological changes to the mammary bodies
[c] ocular muscle palsies ?
[d] vitamin B6 deficiency
[e] nystagmus
111.In the treatment of alcohol problems
[a] specialist referral is always necessary
[b] Individual therapy may be useful
[c] Detoxification can only be done as an inpatient
[d] Antabuse is useful in a patient who does not comply with treatment
[e] Relapse prevention is a useful technique
Answers
By
DR. N. PRADHAN
DR. N. DESHPANDE
DR. V. MURALI
1.Dialectical Behaviour Therapy (DBT)
a)Incorporates elements of the meditation techniques
b)It is used only in group therapy setting
c)Therapy lasts for a minimum of 12 weeks
d)DBT patients have low levels of parasuicide
e)It is used in inpatient settings only
2.The following are characteristic of Wilsons disease
a)Is due to autosomal dominant inheritance
b)Psychotic phenomenon are common
c)CT Scan and MRI scan show a characteristic picture
d)Intention tremor is usually seen
e)Prognosis is worse in the early onset cases
3.The following fears may be present in a 6 year old child
a)Fear of wars
b)Supernatural events
c)Animals
d)Fear of strange objects
e)Specific situational phobia
4.The following are true of the Othelo Syndrome
a)Alcoholism is the commonest cause
b)It may be associated with cerebral tumors
c)Suicidal risk is increased
d)Psychoanalytic psychotherapy is an effective therapeutic intervention
e)The patient is in love with a famous personality
5. Lofexidine
a)ls an alpha 1 adrenergic agonist
b)Can cause rebound hypertension on withdrawal
c)Is used for long term management of opioids addicts
d)Has fewer side effects than clonidine
e)Can be addictive
6. According to the neurodevelopmental hypothesis of schizophrenia
a)Cytoarchitectural disturbances are seen with gliosis
b)Cognitive impairment is progressive
c)Excess of winter births is seen
d)Stereognosis can be seen
e)Females have increased vulnerability to neurodevelopmental damage
7. The following are true of Puerperal psychosis
a)An acute organic clinical picture is more common than an affective
picture
b)Subsequent risk of puerperal depression in future chlidbirth is 20 %
c)ECT is the treatment of choice
d)Onset is usually within the first two to four days
e)Supersentivity of the dopamine receptors has been implicated
8. Clinical features of Multiple Sclerosis include:
a)Inherited by autosomal dominant inheritance
b)Depression is more common than euphoria in the early stages of
the disease
c)It may cause erectile impotence
d)Epileptic seizures are common
e)Causes an elevation of gammaglobulin in the CSF
9. Exhibitionism
a) Commonly seen in young adults as compared to the older age
group
b) Two third of exhibitionists are married
c) The victims are commonly prepubertal girls
d) Masturbation may occur
e) Commonly associated with below average IQ
10. The characteristic features of supportive psychotherapy include
a) An emphasis on the use of defence mechanisms, transferance and
countertransferance
b) The therapist is active and directive
c)Involves cognitive restructuring, reassurance and reinforcement
d)Not useful for patients diagnosed as having chronic schizophrenia
e) Aimed to improve insight
11.The following are true
a) Phencyclidine antagonises neurotransmission at the NMDA receptors
b) Diazepam enhances REM sleep
c) Ecstasy is a hallucinogen
d)Ecstasy stimulates the desire for sexual activity
e) Chlorpromazine is the treatment of choice for PCP intoxication
12.Eye movement desensitisation and reprocessing therapy
a)Is a new method for treating severe personality disorders
b) The Subjective Units of Disturbance scale (SUDs) ranges from O
to 10
c)ls taught in 12 stages
d) Alters the patients evaluation of his/her memories
e) The orienting reflex is thought to be involved in the therapeutic
effect
13.The following are fairly common with school refusal
a) In younger children the most common cause is depression
b) The commonest age is 14-15 years
c)Is more common in males
d)Associated with the lower social classes
e) Younger children have better a prognosis
14.The following are screening instruments
a) CAGE Questionnaire
b) Michagen Alcohol Screening Test (MAST)
c) Alcohol use disorders identification tests (AUDIT)
d) Severity of Alcohol Dependence Questionnaire (SADQ)
e) Griffith Edwards Criteria
15.Tuberous Sclerosis
a) Adenoma Sebaceum is present at birth
b) Characterised by retinal pigmentosa
c)Is compatible with normal IQ
d)Is always inherited by autosomal dominant inheritance
e) Temporal lobe epilepsy is a characteristic feature
16. A young man is referred by his G.P. to the outpatient clinic with a
diagnosis of transsexualism. The following are true
a) Cross dressing produces sexual arousal
b) Also called EONISM
c) Sexual drive is usually high
d) Some studies have shown an abnormal EEG in transsexual patients
e) For an ICD-IO diagnosis, the condition should have persisted for a
period of 2 years
17. In patients with Breast Cancer
a) 50 % of patients undergoing mastectomy develop depression
b)lumpectomy has got less psychiatric morbidity than mastectomy
c)Reconstruction surgeries are associated with improvement
d) Pain has been shown to contribute to psychological morbidity
e) Emotional distress is particularly common with radiotherapy
18. In DSH
a) Subsequent risk of suicide in the following year is more than 10 %
b) 90 % of DSH involve drug overdoses
c) Risk is increased in epileptics
d) Upto 20 % of subjects eventually kill themselves
e) There is a positive correlation with housing problems
19.The following are true of Enuresis
a) The most common cause is the inherited delayed maturation of the
relevant nervous structures
b) Urinary infections account for 5 % of the cases
c) Can be diagnosed in a 4 year old child
d) One third will improve with the use of an enuresis alarm
e) One third of children who have encopresis are enuretic at night
20.The following are true of epilepsy
a)In the simple absence attack there are usually no post ictal
symptoms
b) Gelastic epilepsy is preceeded or accompanied by uncontrollable
laughter
c) Epilepsy due to birth injury accounts for 20 % of the epilepsy cases
d) Few patients with temporal lobe epilepsy usually have evidence of
mesial temporal lobe sclerosis
e) Personality disturbances are more frequent in epilepsy of known
aetiology than unknown aetiology
21. Characteristic features of Huntington Chorea are:
a) More common in males than in females
b) There is a deficiency of acetylcholinesterase
c) Epilepsy & ataxia are more common in the Juvenile type
d) Cerebellum is often the site of maximum change
e) Average life span from diagnosis is l0-15yrs.
22.The following statements are true
a) Geriatric depression scale (GDS) focuses on both cognitive aspects of
depressive illness & physical depressive symptomatology
b) Cornell scale of depression in dementia incorporates information from
carers
c) Mini mental state examination helps to differentiate between dementia
and delirium
d) Hatchinski score below 4 is more indicative of Alzheimers dementia than
MID
e) Cliffton Assessment Procedure for the elderly (CAFE) can be used to
screen for dementia
23. Legal Automatism
a) Is associated with the clinical concept of automatic behaviour
b) Labeled insane automatism if the behaviour doesnot recur
c) Sane automatism includes behaviour caused by brain tumours & epilepsy
d) Sleep walking is an example of insane automatism
e) A finding of sane automatism usually results in acquittal
24. The following are the main components of Clinical Governance
a) Ensures that the clinical standards of NICE & NSF (National Service
Framework) recommendations are implemented
b) Clear policies are aimed at managing the risk
c) It removes the need for professional self regulation
d) The NHS trust executive carries ultimate responsibility
e) All managers are expected to participate fully in audit activities
25. As regard Acute Intermittant Porphyria the following are true
a) Commonest form in the UK is porphyria Variegata
b) The clinical picture of Acute Intermittant Porphyria may resemble
Schizophrenia
c) Benzodiazepine should be avoided
d) Motor peripheral neuropathy may be seen
e) Ceruloplasmin serum levels may be elevated
26.Studies of suicide have shown the following:
a) Recent studies have shown that farmers are one of the occupational group
at greatest risk of suicide in England & Wales
b) Recent trends have shown an increase in suicide in the elderly age group
c) Conduct disorder in childhood is associated with an increased risk of
suicide in adulthood
d) Suicide in the younger age group(l2-14yrs) is often an impulsive action
e) Completed suicide in children is almost unknown under the age of 10 yrs
27.Paranoid illness occurring for the first time in the elderly
a) Delusions seen are mainly of persecutory or grandiose type
b) May be associated with visual impairment
c) Enlargement of ventricles is seen in most cases
d) Schneiderian first rank symptoms are usually present
e) Is usually resistant to neuroleptics
28.Features of Lewy Body Dementia include
a) May present with extrapyramidal features
b) Dementia is typically subcortical in type
c) Episodes of clouding of consciousness occur in 80% of cases
d) Clinical course is shorter than Alzheimers Dementia
e) EEG shows triaphasic waves
29. Inborn errors of metabolism treated by diet include
a) Galactosemia
b) Phenylketolluria
c) Lesch- Nyhan Syndrome
d) Hunter-Hurler Syndrome
e) Homocystinuria
30.With regard to Arson
a) The Male to Female ratio is 9:1
b) In patients with psychotic illness, arson is frequently an indirect
effect of chronic illness than due to delusions or hallucinations
c) 1/3 of arsonists reoffend
d) Arsonists frequently do not commit any other types of offences
e) Both adult and juvenile firesetters constitute a homogenous group
in terms of psychopathological characteristics
31.ADHD in adults shows the following
a) Approximately half the children diagnosed with ADHD exhibit
some symptoms as adults
b) One of the common complaints of these patients is of constantly
losing things
c) The Continuous Performance Test is diagnostic
d) A common coexsistent psychiatric disorder includes anorexia
nervosa
e) Pharmacotherapy has been proven to be of significant benefit
32. Regarding liaison psychiatry
a) There is evidence that elderly people are under represented in the
liaison psychiatry referrals
b) The predominant psychiatric diagnosis in physically ill patients is
anxiety
c) In children with neurological disorder the rate of psychiatric
disorder was four times that of the general population
d) Patients who respond to their diagnosis of cancer by denial
survived longer than those who reacted with acceptance
e) It is better to use the Hamilton Depression Scale than the Beck's
Depression Inventory in patients with physical illness and
Depression
33. The following are associated with Gilles de la Tourette's Syndrome
a) There is usually a family history
b) Vocal ties usually precede motor ties
c) It is usually associated with low intelligence
d) Self injurious behaviour may be seen
e) Obsessive compulsive symptoms occur frequently
34. As regard Body Dysmorphic Disorder (BDD) the following are true
a) There is often an underlying personality disorder
b) Social phobia is commonly seen
c Plastic surgery is contraindicated because patients are potentially litigious
d) BDD can be treated by response prevention
e) It is categorised in ICD10 under Somatoform Disorder
35.Gender identity disorder of childhood
a) Always manifests before puberty
b) Tomboyishness/ Girlish behaviour is sufficient to make a diagnosis
c) Most of these children show transsexualism in adult life
d) In the ICD - 10 it is classified under Disorders of childhood &
adolescence
e) Effeminate behaviour in childhood usually leads to transsexualism
or transvestism in adult life
36.Korsakoffs psychosis is characterised by:
a) Clouding of consciousness
b) Disorder of time & space
c) Confabulation
d) Polyneuropathy
e) Pseudologica fantastica
37.Attention Deficit Hyperactivity Disorder shows the following
a) Commonest age group is 3-7yr.
b) Is likely to improve with CNS depressants
c) May show associated developmental problems, especially language delay
d) More frequent in those with epilepsy
e) Is exacerbated by Sodium valproate & Barbiturate
38. Phenylketonuria
a) Occurs in 1 in 2000 live births
b) Can be diagnosed by amniocentesis before birth
c) Mental subnormality can be prevented if diagnosed before the age of I
d) Can be transmitted by a simple recessive gene
e) Responds to treatment with extra tyrosine in the diet
39. The following are true of Acamprosate
a) It is a GABA antagonist & glutamate agonist
b)Acamprosate can cause maculopapular rash
c) Calcium Carbamide can cause hyperthyroidism
d)Calcium Carbamide blocks an isoenzyme of liver acetaldehyde
dehydrogenase
f) Calcium carbamide has a shorter half life than Disulfiram
40. Behavioural Psychotherapy is
a) The treatment of choice for obesity
b) Based on Seligman's concept of preparedness
c) 80% of OCD's will show improvement
d) Response cost is based on classical conditioning
e) Initial patient screening is not required
41.AID’s encephalitis include:
a) Frank dysphoria is common
b) Memory is characteristically preserved
c) The disease is slowed down by AZT
d) Insight is relatively preserved until late in the disease
e) The EEG is usually abnormal in the early stages
42. The following are features of Narcolepsy:
a) it is a NREM sleep disorder
b) The onset is usually in childhood
c) The routine EEG shows no abnormalities
d)HLADR2 is found in almost all the patients
e) Schizophrenia like psychosis occur more frequently than in the
general population
43.Complications of neurosurgery include:
a)Epilepsy in 10% of patients
b) Increased sensitivity to medication
c) Outspokenness
d) Ataxia
e) Paranoid ideation
44. Trichotilomania
a)Is classified in the ICD 10 under Disorders of adult personality and
behavior
b) It has an equal incidence in males and females
c) It is usually associated with other impulse control disorders
d) Intestinal obstruction is a known complication
e) Prevalence is 0.1 %
45. The following are associated with depression in the elderly
a) First depressive disorders becomes less common after the age of 60
b) There is a high prevalence of family history of affective disorder
among late onset elderly depressive
c) Agitation is more common in this age group than younger adult
depressives
d) 20 to 30 % of suicide are in the elderly age group
e) Prognosis is poor
46.The following are true regarding the Court of Protection
a ) It appoints a receiver to manage the property of the patient
b) Requires the patients to reside at a specified place
c) Is one in which a person gives legal authority to another person
to manage their finances
d) Automatically revoked by the law when the donor loses their
mental capacity
e) The court must give permission to the receiver before the disposal
of capital assets
47.The following are more significant of psychogenic amnesia than
Transient Global Amnesia
a)Impairment of new learning
b) There may be loss of personal identity
c) Typically seen in late middle age or old age males
d) The duration of attacks often lasts for several days or weeks
e)Patients may be suggestible during attacks
48.The following are true of primary care practice
a) Psychosis is the most commonly referred problem by G. P.'s to
psychiatric services
b) Up to 40 % of all psychiatric disorders are referred to the
psychiatric services
c) Psychiatric disorders in primary care are more commonly
associated with physical symptoms than those seen in psychiatric
services
d) G.P.'s use higher doses of Tricyclic antidepressants than
psychiatrists
e) Patients of a higher socio-economic status are more likely to be
referred than those of a lower socio- economic status
49. The association between crime and mental disorder shows the following
a) Regarding schizophrenia and offending minor offences are more
common than serious offences
b) One in six people with manic depressive disorder kill themselves
c) A family member is usually not the victim in altruistic homicide
d) Offending is more likely in mild to moderate learning disability than a
person with severe learning disability
e) The incidence of violence is increased among victims of PTSD
50. In childhood autism
a) Autistic patients are often sensitive to medication
b) Half of them have below average IQ
c) Distractibility is a common symptom
d) Early on in a life it can be confused with deafness
e) There is no startle response
Answers
1.
a) T
b) F (it consists of combination of group and individual therapy)
c) F (therapy lasts for a minimum period of 12 months)
d) T
e) F (it is used in both inpatient & outpatient setting)
2.
a) F (autosomal recessive inheritance)
b) F
c) T
d) F (flapping tremors may be seen)
e) T
3.
a) F (9-11yrs)
b) F (7-8yrs)
c) T
d) F (0-2yrs)
e) T
4.
a) F
b) T
c) T
d) F
e) F
5.
a) F (alpha 2 adrenergic agonist)
b) T
c) F (it is used for opiate withdrawal management)
d) T
e) F
6.
a) F
b) F
c) T
d) T
e) F
7.
a) f
b) T
c) T
d) F
e) T
8.
a) F (etiology remains unknown)
b) T
c) T
d) F (epileptic seizures are rare manifestations occurring in 2% of cases)
e) T
9.
a) T
b) T
c) F (victims are commonly at or around puberty)
d) T
e) F (only 10% have IQ below average
10.
a) F
b) T
c) T
d) F
e) T
Ref: introduction to psychotherapies, Sidney Bloch)
11.
a) T (phencyclidine antagonizes NMDA receptors)
b) F (diazepam reduces REM sleep)
c) T
d) F (ecstasy inhibits orgasm in both sexes)
e) F (chlorpromazine should be avoided as it is kess safe and can increase anticholinergic effect of PCP)
12.
a) F (it is a new method for the treatment of PSTD)
b) T
c) F (it is taught in 8 stages)
d) T
c) T
13.
a) F (in younger children most common cause is separation/phobic anxiety. In older children the most common cause is depression)
b) T (Ref: child psychiatry - Robert Goodman and Stephan Scott)
c) F (boys and girls are equally affected)
d) F (no particular social trends are seen)
e) T
14.
a) T
b) T
c) T
d) T
e) F (Griffith Edwards first described alcohol dependence syndrome)
15.
a) F (adenoma Sebaceoum occurs in early childhood)
b) F (retinal phakomas present)
c) T
d) F (2/3 of cases are by new mutations)
f) (all varieties of epilepsy are seen)
16.
a) F (seen in transvestism)
b) T
c) F
d) T
e)T
17.
a) F
b) F
c) T
d) T
e) T
18.
a) F
b) T
c) T
d) T
e) T
19.
a) T
b) T
c) F (cannot be diagnosed till the age of 5 years)
d) F (2/3 will improve)
e) T
20.
a) T
b) T
c) F (accounts for 2% of epilepsy)
d) F (50% of patients have evidence of mesial temporal lobe sclerosis)
e) T
21.
a) F (equally common in both sexes)
b) F (deficiency is of choline acetyltransferase)
c) T
d) F (frontal lobes are often the site of maximum change)
e) T
22.
a) F (it focuses almost entirely on cognitive aspects of depressive illness)
b) T
c) F
d) T
e) T
23.
a) F (it has no relationship)
b) F
c) F
d) T
e) T
24.
a) T
b) T
c) F
d) T
e) F
25.
a) F (acute intermittent porphyria)
b) T
c) F
d) T
e) F (ceruloplasmin levels are elevated in Wilson's disease)
26.
a) T (suicide in farmers - BJP 1999)
b) F (there has been an increase in younger males in the age group from 25 years to 45 years and a decrease in elderly males in older age group than 80 years)
c) T
d) F (almost half have previously talked about or threatened or attempted suicide)
e) T (Ref: child psychiatry - Goodman and Scott)
27.
a) T
b) T
c) F
d) F (first rank symptoms are less prevalent in the late onset cases)
e) F
28.
a) T
b) F
c) T
d) T
e) F (EEG is nonspecific. triphasic waves are present in CJD)
29.
a) T
b) T
c) F
d) F
e) T
30.
a) T
b) T
c) T
d) F
e) F
31.
a) T
b) T
c) F (can establish the presence of attention deficit but cannot distinguish between primary and secondary attention deficits)
d) F (antisocial P.D, substance abuse, depression)
e) F (psychostimulants have been proved to be beneficial in childhood ADHD)
32.
a) T
b) F (depression - seminars in liaison psychiatry)) T
d) T
e) T
33.
a) F (family history of simple tics occur in 30%)
b) F
c) F (distribution of intelligence seems to be within normal limits)
d) T
e) T
34.
a) T
b) T
c) F (small number of patients do improve with surgery)
d) T
e) F (not included in the ICD - 10)
35.
a) T
b) F (profound disturbed behaviour is needed)
c) F (very few of them show transsexuals in adult life)
d) F (in the ICD - 10 it is classified under disorders of adult personality and behavior)
e) F (it is more likely to lead to homosexuality / bisexuality in adult life)
36.
a) F
b) T
c) F
d) T
e) F (seen in munchausen syndrome)
37.
a) T
b) F (CNS stimulants)
c) T
d) T
e) T
38.
a) F (occurs in 1 in 20,000 live births)
b) F (detectable by postnatal screening of urine and blood)
c) F (it should be diagnosed soon after birth)
d) T
e) F (diet should have controlled intake of phenyalanine)
(it causes thyroid and WBC depression)
d) T
e) T
40.
a) T
b) T
c) T
d) F (it is based on operant conditioning)
e) F
Ref: introduction to psychotherapies - Sydney Bloch
41.
a) F (frank dysphoria is infrequent)
b) F (impairment of memory and LOC are the commonest early symptoms)
c) T
d) T
e) F (EEG is often normal initially with diffuse slowing later)
Ref: organic psychiatry - Lishman
42.
a) F
b) T
c) T
d) T
e) T
43.
a) F (epilepsy is a longer term complication in 1-2% of cases for STT)
b) T
c) T
d) F
e) F
44.
a) T
b) F
c) T
d) T
e) F (recent studies have shown that there is no evidence that prognosis is worse for older patient with dementia than younger patients)
Ref: psychiatry in the elderly - Jacoby & Oppenheimer
46.
a) T
b) F
c) F
d) F
e) T
Ref: seminars in forensic psychiatry
47.
a) F (in psychological amnesia there is a normal ability to retain new information)
b) T
c) F
d) T (in TGA attack is of several hours)
e) T
48.
a) T
b) F (only 5-10% are referred)
c) T
d) F (GP's use lower doses of TCA's)
e) T
Ref: companion to psychiatric studies - Kendell & Zealley
49.
a) T
b) T
c) F (a family member is usually involved)
d) T
e) T
50.
a) T
b) F (75% of autistic children have below average IQ)
c) F
d) T
e) F