MRCPsych part 1 written
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Solved Paper Autumn 2006
ISQs
1.Benzodiazepines decreases REM sleep. True (Manc.)
2. Learning starts before birth. True (Thambirajah)
3.Social learning depends on environment. T (Bandura, Thambirajah 29)
4. Stupor is a recognized feature of Schizophrenia. True F20.2 ICD 10
5.Night terror occurs in PTSD. F Kaplan, ICD-10
6. In Oedipal stage resolution it ends with identification with father. T Thambi 32
7.Towards the end of the Oedipal stage there is the development of stable super ego. T Thambi 335
8. Erickson’s initiative vs. Guilt occurs in preschool. T Thambi
9. Mahler described intimacy vs. Isolation. False, It was Erickson's work
10. Piaget described that object permanence is achieved in pre-operational stage. False (Sensorimotor Stage: Simply psychology)
11.Perseveration is a feature of non dominant parietal lobe. False (Frontal Lobe)
12.Diencephalic dementia is seen in Wernicke's encephalopathy. T Lishman p.19
13. Ocular signs are seen in 80% of Wernicke's. True
14.MMSE is good test for early memory loss. False
15.Narcolepsy is associated with loss of muscle tone. T
16 Benzodiazepine increases the slow wave sleep. False. They suppress both REM and Stage 3 and 4 sleep (slow wave). They increase beta waves i.e.fast wave activity in brain.
17.Forgetting old things is due to replacement with news ones. True for short term memory False for long term memory
Forgetting occurs by both decay and replacement mechanisms as far as short term memory is concerned.
Forgetting of long term memory occurs due one of these causes: 1. Encoding failure, 2. Retrieval failure 3. Failure of transfer of memory from short term to long term. Ref.Thambirajah Psychological basis of Psychiatry
18.Alogia is inability to think. False (Poverty of speech)
19.Risperidone is 5HT2 antagonist. TRUE
20.DSM-IV is hierarchical classification. T
21.Lithium is lipophilic. F
22.Translating latent into manifest content is dream work. TRUE
23. Double bind was described by Mahler. False (Bateson)
24. Thumb sucking is abnormal at 4yrs. False (Problems are mainly dental rather than emotional and 4-5 years is a cut off point, so not abnormal).
25. Negative reinforcement decreases a behaviors. False (Increases)
26. Attributional error refers to an individual predisposition to think that others tend to do what they do because of their personalities. TRUE
27. Attributional error means we tend to attribute our own behavior to the environmental factors. TRUE
28. Confabulation will help us to differentiate between depression and dementia. T
29. Mu receptors are involved in dependency. T
30. St John’s Wort decreases the effect of OCP. T
31. In MS the knee reflexes are decreased. F
32. Clozapine should not be given to people with parkinsonism. F
33. Autocthonus delusions are usually ego dystonic. F
34. Hypnogogic hallucination occurs in slow wave sleep. F
35. Aripiprazole levels are elevated by paroxetine. T
36. Risperidone is associated with abnormal temperature regulation. T
37. St John’s Wort reduces the efficacy of oral contraceptive pills. T
38. Carbamazepine has a significant interaction with warfarin. T
39. Waxy flexibility is associated with plastic resistance to gentle moments. T
40 Waxy flexibility is seen in post-encephalitic parkinsonism T
41 Splitting is a defence mechanism noticed in people with hysteria T
42 Marked clumsiness is seen in children with Asperger’s Syndrome.T
43 Personality change is an early feature of Huntington’s disease. T
44 Visual agnosias are associated with the frontal lobe lesions. F
45 Koro is associated with prominent psychotic symptoms. F
46 The DSM -IV is a hierarchical classification. T
47 Pupils non-responsive to light reflex are seen in wernicke’s syndrome. F
48 Paranoid personality disorder is diagnosed before the age of 17 years mostly. F
49 MMSE can pick up mild cognitive impairment in a dementia F
50 According to Beck’s cognitive description of depression people who are different could not find pleasure in any activity. F
51 Anhedonia is inability to feel the feelings. F
52 Pathological grief reaction is associated with the ambivalent relationship with the deceased. T
53 Id is mostly related to the reality principle. F (pleasure principle)
54 Confabulation differentiates between dementia and pseudo-dementia T
55 Pharmacokinetics in the elderly can be altered by reduced total body water. T
56 Brain changes induced with alcohol can be reversible after the remission of the alcohol. T
57 Tri-cyclic antidepressants are a cause of heart block. T
58 Clomipramine increases noradrenergic and serotinergic transmission. T
59 Hypnogogic hallucinations occur in a slow way of sleep. F
60. early morning wakening is the phenomenon seen in the normal grief reaction T
61. Concrete thinking is associated with lesions in orbital frontal lobe. T
62. poverty of speech is a negative symptom of schizophrenia T
63. In non dominant temporal lobe lesions there is loss of geometrical drawing from the memory. T
64. Decreased water content in the body of eldely can effect pharmacokinetics T
65. Diazepam is lipophilic T
66. Mortality in ECT is similar to that of general anaesthetic in minor surgery T
67. Oedipal complex resolves with son identifying the father T
68. Night terrors occur in PTSD F
69. Autochthonous delusions are ego dystonic F
70. In social learning theory it is almost impossible to make a person remove an undesired behaviour without learning the opposite behaviour from their role models. T (Thambi 28-29)
71. Patient has difficulty in shifting from one topic to another in non-dominant temporal lobe involvement. F (Frontal lobe)
72.DSM is heirarchial T
73.pancytopenia is common side effect of clozapine. F
74.lithium is lipophilic F
75.clumsiness in childhood is linked with Aspergers T
76.learning in human stars before birth T
77.Response levels/ levels of responsiveness of the patient are increased in delirium. F
78.Aripiprazole causes little or no rise of prolactin T
79.In motor neuron disease there is complete lack of ankle or knee reflexes F
80. Synaesthesia can be induced by LSD T
81. Primary delusions are not necessarily autocthonous. T
82. Personality disorders are described better on a continuum with normal personality. T
83. Agoraphobia is usually associated with depression.T
84. Apathy is seen in more than 20% patients with Alzheimer’s dementia.T
85. Hemicranial anaesthesia before epileptic seizure would indicate temporal lobe focus. False (Parietal lobe)
86. Specific reading difficulties are significantly associated with males. T
87. Specific reading difficulties are significantly associated with spelling difficulties. T
88. Dopamine is lipophilic. F
89. Lithium is lipophilic. F
90. Aripiprazole levels are elevated by paroxetine. T
91. Risperidone is associated with abnormal temperature regulation. T
92. St John’s Wort reduces the efficacy of oral contraceptive pills. T
93. Carbamazepine has a significant interaction with warfarin. T
94. Margaret Mahler - separation individuation stage has autonomy Vs shame and doubt. F
95. Erik Eriksson’s initiative vs guilt occurs in pres-school children. T
96. According to fundamental attribution theory people tend to attribute their behaviour to personality factors. F
97. In fundamental attribution theory people tend to attribute others behaviour to situational causes. F
98. Reciprocal determinism explains interaction between behaviour, personal factors and the environment. T
99. Waxy flexibility (Flexibilitas cerea) is associated with plastic resistance to gentle moments. T
100. Flexibilitas cerea is seen in post-encephalitic parkinsonism T
101. Benzodiazepines increase the fast wave activity in EEG. False.
Birmingham Course
102. Benzodiazepines do not reduce REM sleep. F
103. In Piagets model, accommodation is the process by which a child tries to modify the newly learned information based upon the existing schemata. F
104. 95% people have IQ of between 70 and 130. T (Wikipedia: Standard Deviation)
105. Verbal IQ in WAIS peaks before the age of 20 years. T
106. Auditory Hallucinations are the commonest hallucinations seen in Alzheimer’s dementia. F
107. 80% patients have eye related signs in the initial examination. T
108. People with anankastic personality give a concise psychiatric history. F
109. Indifference to praise or criticism is a feature of paranoid personality disorder. F (narsisstic)
110. Splitting is a defence mechanism noticed in people with hysteria. F
111. Selective attention is associated with histrionic personality disorder. F
112. Marked clumsiness is seen in children with Asperger’s Syndrome. T
113. Personality change is an early feature of Huntingdon’s disease. T
114. In delirium-response levels of the patient are increased. (This is the main component of the question although this is not the exact wording) F
115. Body dysmorphic disorder is equally associated with males and females. T (e medicine)
116. Factitious disorder can presents with intestinal adhesion. T
117. Social learning theories use personality traits analysis to assess behaviour. F
118. In social learning theory it is almost impossible to make a person remove the behaviour without learning the opposite behaviour from their role models. T
119. Negative reinforcement is the removal of the aversive stimulus on antecedent behaviour. T
120. In behaviour analysis association is made between the antecedent behaviour and early life events. F
121. In behavioural therapy relationship between the therapist and the patient is particularly emphasised. F
122. Double bind hypothesis to be of etiological significance in the schizophrenia was proposed by R.D. Laing. F (Bateson)
123. According to the life cycle theory developmental phases go through a sequential manner. T
124. According to the Erik Erikson’s cognitive developmental model, ego development encounters crises in every stage of the psychosocial development. T
125. Visual agnosias are associated with the frontal lobe lesions. F
126. Agnosia is rare in chronic schizophrenia. True (Birmingham Course) 127. SSRIs are associated with hyponatraemia at therapeutic doses. T
128. Recalling from visual memory is associated with lesions in non-dominant temporal lobe involvement. T
129. Patient has difficulty in shifting from one topic to another in non-dominant temporal lobe involvement. F
130. Concrete thinking is associated with lesions in orbital frontal lobe. T
131. Koro is associated with prominent psychotic symptoms. F
132. The DSM-IV is a hierarchical classification. T
133. Dimensional classification gives more information about the comorbidity.T
134. In ICD – 10, mental retardation is classified categorically. T
135. Pupils non-responsive to light reflex are seen in wernicke’s syndrome. T
136. Learning theory applies even before birth. T
137. In motor-neurone disease knee and ankle reflexes are always lost. F
138. In Piaget’s model preoperational stage children tend to believe that rules should not be broken. T
139. In sensory motor stage of Piaget’s model child has problems with social mistrust. F
140. Moclobemide is a medication, which reversibly inhibits the blocking of the MAO A. T
141. Cyclopyrollones are antipsychotics.F
142. Pancytopenia is a well-recognised side effect of clozapine. F
143. Galactorhoea is a recognised side effect with clozapine use. F
144. Olanzapine use is significantly associated with more deaths in Alzheimer’s disease. T
145. Paranoid personality disorder is diagnosed before the age of 17 years mostly. F
146. Alcohol use in males is more significantly associated with self-harm than compared to females
False
Birmingham Course
147. Reliability is more in diagnosing a dissocial personality disorder when compared to schizoid personality disorder. TRUE
Birmingham Course.
148. Diencephalic amnesia is associated with Korsakoff’s psychosis. T
149. Most of people have a history of anorexia nervosa before an episode of bulimia nervosa. T
150. Inability to recognise the neurological deficits of ones self is associated with involvement of non-dominant parietal lobe. T
151. MMSE can pick up mild cognitive impairment in a dementia. (I think this question is more meant towards diagnosing the dementia) F
152. Implosion therapy involves in vivo exposure to stimuli in a non-graded manner. F
153. According to Beck’s cognitive description of depression people who are different could not find pleasure in any activity. F
154. Attachment disorder remits usually within a period of 6 months. F (pervasive : Ref. Tahmbirajah)
155. Risperidone is a potent 5HT2 antagonist. T
156. Paranoid delusions are not the same as persecutory delusions. T
157. Ambitendency is acting out of ambivalence T
158. Passivity of volition and made volitions are equivalent in terminology. T
159. Persecutory delusions are one of the features of Bleuler’s symptomatology. F
160. Anhedonia is inability to feel the feelings. F
161. Pathological grief reaction is associated with the ambivalent relationship with the deceased. T
162. More than 30% of people with hypomania go on to have episodes of mania.FALSE
Companion to Psychiatric Studies 7th Ed p.427v : "hypomania......relation to BPAD II ..... may in 10% of cases be succeeded by the development of a frank manic episode".
Only reference I could find - and the companion feels hypomania is just a diminutive term for mania unless you apply the principles of DSM IV.
163. Paranoid schizoid position child cannot perceive the whole objects. T
164. Cataplexy is associated with sudden loss of muscle tone after emotional incident. T
165. Ipsilateral facial paralysis with the left-hand sparing is associated with occlusion of middle cerebral artery near its origin. F ( Everything is contralateral when middle cerebral artery is blocked).
166. Dressing dyspraxia may be associated with non-dominant parietal lesions. T
167. Difficulty in recalling long-term memory is due to the old information getting replaced by the new information. False (Thambirajah) Theory of decay and replacement works for short term memory whereas difficulty in long term memory is failure to retrieve and failure of encoding.
168. Most of people have a history of anorexia nervosa before an episode of bulimia nervosa. T
169. Obsessional thoughts typically lead to ritualistic behaviour. T
170. Being an identical twin increases the acquiring of schizophrenia illness. T
171. Stupor is recognised feature of mania. T
172. Freud’s phallic Oedipal phase resolves with the formation of a stable superego. T
173. In Freud’s secondary elaboration is a part of dream work. T
174. Authochthonous delusions are not always primary delusions F
175. Dyscalculia is linked with frontal lobe lesions TRUE
Birmingham Course
176. Adjustment disorder remits usually within a period of 6 months. True (within 6 months of resolution of causing stressor: ref. ICD 10 + DSM IV : emedicine
177. Depression is common in those suffering from agorophobia T
178. Social phobia in women most commonly begins after the age of 35 False (Adolescence : emedcine.com)
179.Dressing dyspraxia may be associated with non-dominant parietal lesions. T
180. Manic episodes decrease in those with BPAD in advancing age compared to their younger counterparts True http://bipolarhome.org/mania
181. Human learning mechanisms function before birth T (Thambirajah)
182. Attributional bias states that people attribute their own behaviour to personal factors F
183.Ambitendency is acting out of ambivalence T
184. Dimensional classification allows greater consideration of disease comorbidity. T
185. Paranoid delusions are not the same as persecutory delusions. T
186. DSM-IV allows hierarchial classification T
187. Maslow stated that the act of satisfying needs is innate and the same in all human beings TRUE Thambirajah
188. Emotion focussed coping mechanisms are associated with better adaptation to physical illness. True [Detecting depression in patients with physical illness---- www.ucc.ie . (University College of Cork, Ireland)
189.Diencephalic amnesia is associated with Korsakoff’s psychosis. T
190. Those with bulimia nervosa commonly have a past history of anorexia nervosa T
191. In people with alcoholic dementia, abstention may lead to some reversal of brain damage sustained T
192. 80% of those with Wernicke’s encephalopathy have eye signs on presentation T
193. Impaired papillary reflex to light is observed in Wernicke’s Syndrome T
194. 95% of the population score between 70 and 130 on the WAIS-III T
195. Verbal IQ peaks before the age of 20 on the WAIS-III False (40-45years : Thambirajah p.50)
196. In schizoid PD there is increased fantasy T
197. Voluntary movements abolish the tremor in Parkinson’s Disease T
198. Passivity of volition and made volitions are equivalent in terminology. T
199. LSD induces synaesthesia T
200. Impaired registration is a feature of impaired consciousness T
201. In behavioural therapy the therapist-client relationship is greatly emphasised F
202. Synaesthesia can be induced by LSD T
203. Waxy flexibility is associated with a plastic resistance to passive movements T
204. A diagnosis of persistent delusional disorder there must be attribution to personal factors rather than sub-cultural ones TRUE ICD-10 ref. www.mentalhealth.com F22
205. Splitting is associated with conversion disorders. FALSE
206. A failure of selective attention is implicated in the psychology of histrionic PD FALSE (This is characteristic of schizotypal disorder; histrionics are attention seeking, not selectively attentive).
207. Paroxetine increases the levels of aripiprazole T
208. Dopamine is lipophilic F
209. Cyclopyrrolones are antipsychotics T
210. MAOIs are competitive antagonists (of MAO and they compete with monoamines for their receptors on monoamine oxidase.)
TRUE.
http://www.cnsforum.com/imagebank/item/Drug_MOAI_2/default.aspx
211. Head injury is a common cause of mania False (Uncommon cause)
212. Auditory hallucinations in Alzeihmer’s Disease only last for a month False, (no evidence in support of one month. )
213. Non dominant temporal lobe impairment is linked with deficits in visual memory T
214. Non dominant temporal lobe impairment is linked with difficulty shifting sets. False
215. An apparent dressing apraxia could be due to hemispatial neglect of the left hand TRUE (emedicine)
216. Non dominant parietal lobe lesions are linked with an apparent denial of disability of one side of the body T
217. According to Piaget, the sensorimotor stage is characterised by social mistrust F
218. Specific reading retardation is more likely in the male gender T
219.Alcohol use in males is more significantly associated with self-harm than compared to females T
220.Presence of psychosis may interfere with assessment of mood disorder. T
EMIs
Extended Matching Question 1:
Choices:
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder
Narcissistic personality disorder
Anankastic personality disorder
Histrionic personality disorder
Borderline personality disorder
Anxious avoidant personality disorder
Choose the most likely ONE
1. 24-year-old student presented his thesis to his college and this thesis got rejected. He says, “the college people couldn’t understand my capability and they don’t know I am an outstanding scientist”. His parents were not surprised by his behaviour like this.
Narcissistic personality disorder
2. A student having ideas of reference, illusions, suspiciousness, about his intrusive thoughts and having bizarre perceptions.
Schizotypal personality disorder
3. 25-year-old man who has poor relationships with his friends and family usually resorts to self-harm in the process of maintaining the relationship with his girlfriend.
Borderline personality disorder
Extended Matching Question 2
Options:
Autoscopic hallucinations
Eidetic imagery
Elementary hallucinations
Functional hallucinations
Reflex hallucinations
Paraedolia
Affect illusion
1. 22-year-old man who can see a detailed clear picture when nobody is there. He can make it go away if he wants to.
Eidetic imagery
2. 30-year-old woman can see herself sitting in front of her.
Autoscopic hallucinations
3. A man feels that his body is shrinking and he feels like this when he hears the lorries rumbling.
Reflex hallucinations
Extended Matching Question 3
Choices:
Abnormal posture, stupor
Prominent delusions
Later onset
Early onset in the adolescence or young age
Premorbid shy and solitary personality
Loss of drive and motivation
Affective instability
1. Paranoid schizophrenia (choose one option)
Prominent delusions
2. Hepiphrenic schizophrenia (choose three options)
Early onset in the adolescence or young age
Premorbid shy and solitary personality
Loss of drive and motivation
3. Persistant delusional disorder (choose two options)
Prominent delusions
Later onset
Extended Matching Question 4
Choose the most likely condition
Options:
Chronic subdural haematoma
Alcoholic dementia
Alzheimer’s dementia
Vascular dementia
Frontal temporal dementia
Normal pressure hydrocephalus
(Still more options are there)
1. 82 year old man was brought by his wife to the accident and emergency department. He has a history of falls. At the moment he is drowsy, has a definite but mild cognitive impairment.
Chronic subdural haematoma
2. A 65-year-old woman presented at the hospital who has an unsteady gate, urinary incontinence and cognitive impairment.
Normal pressure hydrocephalus
3. 84-year-old lady who was living alone was brought by her neighbours when she was wandering in the streets. She is not oriented to time place and person. A CT scan was done which revealed generalised cortical atrophy and periventricular areas of hypoattenuation.
Alzheimer’s dementia
Extended Matching Question 5
Options:
Extracampine hallucinations
Elementary hallucinations
Autoscopic hallucinations
Hypnopompic hallucinations
Hypnogogic hallucinations
Gedankenlautwerden
1. A 40-year-old lady was hearing a bell tolling around wherever she goes.
Elementary hallucinations
2. A 70-year-old woman can see a number of small children and these children are sitting behind her head.
Extracampine hallucinations
3. A man who says that he can hear his thoughts as he thinks.
Gedankenlautwerden
Extended Matching Question 6
Choose the most likely diagnosis:
Options:
Schizoaffective disorder
Pathological grief reaction
Grief reaction
Current episode depression
Post-psychotic depression
Severe depressive episode with psychotic symptoms
Severe depressive episode without psychotic symptoms
Moderate depressive episode
1. A 40-year-old man who presents for the first time with a three-month history of feeling low. He has a disturbed sleep and at time wakes early in the morning. He said that he couldn’t concentrate on his activities. These problems started when his wife left him and he can hear his wife calling out his name when he is drifting to sleep.
Moderate depressive illness
2. A 50-year-old woman who has a past history of many psychiatric admissions recently is very withdrawn isolating herself and told her neighbours that she has no clothes wear and she deserves to die. At times she hears her late husband's voice calling her to join him in heaven.
Severe depressive episode with psychotic symptoms
3. A 22-year-old man who recently had a problem with his girlfriend has been low in mood for 2 weeks. He has always been a shy, solitary and withdrawn person. (Some more description is mentioned)
Mild to Moderate Depressive episode
Extended Matching Question 7
Diagnosis of mood disorders
Options:
Postnatal Depression
Puerperal Psychosis
Depression with psychotic features
Hypomania
(Still more options are there)
1. A lady who gave birth 14 days ago at the moment is crying with no preceding emotional incident. She has poor self care and her husband is quite worried about the baby’s safety as she has been confused on and off by picking up the objects from the floor. She also thinks that the baby is deformed.
Puerperal Psychosis
(Still 2 more questions are there)
Extended Matching Question 8
Choose the appropriate investigations:
Options:
Hyponatraemia
Hypokalaemia
Increased blood glucose
Urinary catecholamines
Serum caeruloplasmin
CT Scan of basal ganglia
Abnormal Synacthen tests
Choose TWO most likely investigations
1. A woman feeling low in mood, lost weight and has got hyper-pigmentation on her body.
Hyponatraemia
Abnormal Synacthen tests
(Addison's disease)
2. A man getting panic attacks, diarrhoea, vomiting frequently and he is tired in between the episodes. He also complained of dizziness. His blood pressure was 170/100 mm of Hg
Increased blood glucose
Urinary catecholamines
3. 17-year-old girl who presented with epileptic seizures and abnormal liver function tests. (There is more description mostly leading to diagnosis of Wilson’s disease).
Serum caeruloplasmin
CT Scan of basal ganglia
Extended Matching Question 9
Choose the appropriate difference mechanism
Options:
Denial
Isolation
Repression
Regression
Suppression
Displacement
Projection
1. A woman who had a bad relationship with her mother couldn’t express her feelings to her mother whereas she used to feel hatred towards other older woman and she couldn’t explain the reason why.
Displacement
2. A woman gets the idea that her mother will fall ill and die and she reports that the thoughts are alien in nature and she is not very disturbed about these thoughts.
Isolation
3. A boy whose father recently died says that he had a bad relationship with him for a long time whereas when reminded he could only remember the good parts of his relationship and not the bad parts.
Repression
Extended Matching Question (EMI) 10
Charles Bonnet Syndrome
Alcohol withdrawal
(Still more options given)
1. An 80-year-old woman living alone could see blue children in her home and recently she has been diagnosed as bilateral cataracts.
Charles Bonnet Syndrome
2. 45-year man after 12 hrs after admission in his preoperative surgery was having illusions, transient visual hallucinations. He has also been tremulous and sweaty.
Alcohol withdrawal (Delirium Tremens)
Extended Matching Question 11
Options:
Abnormal posture, stupor
Prominent delusions
Later onset
Early onset in the adolescence or young age
Premorbid shy and solitary personality
Loss of drive and motivation
Prominent affective symptoms
1.Paranoid schizophrenia (choose one option)
Prominent delusions
2.Hebephrenic schizophrenia (choose three options)
Prominent affective symptoms
Premorbid shy and solitary personality
Early onset in the adolescence or young age
3.Persistant delusional disorder (choose two options)
Prominent delusions
Later onset
Solved Paper Spring 2006
ISQs
1. Cotard's syndrome is causally related to schizophrenia false
2. People with dissocial personality have no problems in maintaining relationships. false
3. Crisis Integrity VS. Despair occurs in old age. true
4. Initiative vs. Guilt age group is seen in pre school children TRUE
5. Oedipal complex is resolved when a boy identifies his father. TRUE
6. MAO metabolises serotonin, norepinephrine and dopamine. TRUE
7. Paroxetine affect level of Aripiprazole T
8. Incidence of depression in Alzheimer's is 40% FALSE (20-25%)
9. GFR < 10ml/min indicate severe renal failure T
10. Carbamazepine affects the levels of calcium channel antagonists T
11. Ideational apraxia is inability to copy after instruction has been understood and there is no motor or sensory impairment True
http://www.nanonline.org/nandistance/mtbi/ClinNeuro/apraxia.html#idea and http://www.nanonline.org/nandistance/mtbi/ClinNeuro/apraxia.html#ideo
12. Personality disorders are more reliable if they are diagnosed on continuum with normal personality. T
13. Diazepam is lipophilic T
14. Protein bound drugs can more easily pass the BBB. F
15. Diplopia is a feature of Wernicke's encephalopathy. T
16. Paranoid schizoid position involves repression as a defence mechanism. F
17. Behavioural assessment includes exploration of underlying factors like childhood events F
18. MAOs have significant interaction with salbutamol F
19. Dibenzodiazapine is Riperidone. F
20. Obsession can be pleasurable F
21. Neurofibrillary tangles are seen in dementia pugilistica T
22. DSM holds neurosis as a major category F
23. ICD 10 holds culture bound syndromes as a separate category F
24. In operant conditioning reinforcer can precede behaviour. False
25. In Lewy body dementia visual hallucinations occur early. T
26. Hallucinations can occur in hypomania. T
Hypnogogic and hypnopompic hallucinations can occur in normal people and so in any psychiatric disorder.
27. Ambivalence is seen in normal grief reaction TRUE
28. Beck inventory is a self-reported questionnaire . T
29. Sibling rivalry is a characteristic feature of the phallic stage of development. False
30. In schizoid personality disorder there is increased fantasy T
31. Psedobulbar palsy is associated with labile emotions T
32. In pure word deafness, speech is not impaired T
33. Sodium Valproate causes significant weight gain T
34. In the UK, most causes of maternal perinatal deaths are associated with psychiatric illnesses T
35. Awareness of health issues can explain the development of simple phobias F
36. Irrational fear is seen in child hood T
37. Irrational phobia for animals is associated with sustained psychophysiological arousal F
38. For diagnosing Mania there should be elation in mood F
39. The law of proximity and difference is involved in Gestalt theory F (PROXIMITY AND CLOSURE)
40. In operant conditioning reinforcement can occur before the behaviour FALSE
41. Fear of strangers is present in the first year of life T
42. Bias in attention can be tested by Stroop test T
43. In learned helplessness, behaviour is not contingent on punishment T
44. Alcohol dependency is more likely with spirits than beer F
45. Persistent delusional disorder involves elaborate delusions for one month F ( 3 months )
46. Night terror is a dissociative phenomenon F
47. Exploring expressed emotions is relevant to behavioural analysis F Only antecedants directly related to the behaviour.
48. Drugs with a high plasma protein binding have increased permeability through the BBB F (opposite)
49. Most drugs which acts on 5HT2 receptors cause sedation False
50. Explaining the side effects of drugs to a patient decreases compliance False
51. Waxy flexibility is plastic resistance to gentle movements. FALSE , not by definition though there may be a subjective feeling of plastic resistance in it. The answer is false
52. Hypnagogic hallucinations occur in narcolepsy T
53. In Cataplexy there is loss of muscle tone in response to an emotional T
54. Bouffee Delirante is a culture bound acute episode of psychosis with violence TRUE
Bouffee Delirante is a culture bound syndrome . TRUE
Bouffee Delirante is a term for acute psychotic episode . TRUE
American Psychiatry recoginzes Bouffee Delirante as a culture bound syndrome. In my understanding it is a culture bound acute psychotic disorder.
Reference
Kaplan and Sadock
DSM IV big version page 899-900.
Visit http://www.psychiatryonline.com/content.aspx?aID=14126&searchStr=bouffee+delirante#14126 to see its enlisting as a culture bound syndrome.
55. Capgras is a delusional misidentification of subjective doubles. F ( Again by defn. false , though there may be a feeling of double in it in some other perspective. )
It is Dopplegenger which is delusional misidentification of subjective doubles.
56. Behavioural analysts look into the antecedents from child hood during the assessment. false
57. Melanie klein started direct questioning FALSE
58. Auditory hallucinations are the commonest hallucinations in Alzheimer’s. F
59. Digit span checks the attention for less than 10 seconds. True
60. Anosmia occurs in temporal lobe syndrome. FALSE
61. In elderly the pharmakokinetics of the drug is decreased due to increased body fat. t
62. Sensitivity to antipsychotic drugs is increased in lewy body dementia. TRUE(60% CASES SHOW IT OXFORD)
63. Disorientation suggests organic cause of depression than functional. TRUE
64. Nominal dysphasia differentiates between dementia and pseudo dementia.
ITS WORD FINDING DIFFICULTY SO TRUE
65. Fear of abandonment is a characteristic feature of emotionally unstable personality disorder.
TRUE.ONE OF DX CRITERIA OF BODERLINE(CORE)
66. Preoccupation with fantasy thinking is characteristic of schizoid personality disorder. TRUE
67. Anosognosia is the hemi neglect of body. FALSE.ITS FAILURE TO RECOGNIZE THE DISABLED LIMB
68. Fluphenazine inhibits the reuptake of 5HT. FALSE.
69. The amount of time spent with their baby by mother is an important factor determining the quality FALSE
70. Koro is a culture bound syndrome associated with prominent psychotic symptoms. FALSE.ITS ANXIETY STATE DUE TO FEAR OF GENITAL REGRESSION NOT DELUSIONAL(CORE)
71. Secure attachment behaviour requires mentally healthy caregiver. FALSE
72. Psychological deficit seen in non-dominant temporal lobe includes inability to learn new word. FALSE
73. Diazepam acts on GABA A receptor complex .TRUE.BDZ R AGONIST AT THESE RECEPTORS.
75. Elderly people absorb the same amount of drug given after oral administration but at a slower rate. TRUE
76. Clomipramine acts on both adrenergic and seretonergic action. TRUE
77. Na valproate increases the level of lamotrigine T 78. Fluexetine increases level of aripripazole T
79. Gait seen in cerebellar dysfunction is short, shuffling and slow F
80. it is better to describe personality traits on a continuum along with normal personality traits.T
81. DSM IV has a major category of neurosis. F
82. Psychological deficit seen in non-dominant (R) temporal lobe includes inability to learn new word. False Non-dominant lobe associated with visual memory.
83. Directive questioning is associated with Klein. F
84. The active metabolite of psychotropic drug can cross BBB. can cross . TRUE
85. Diplopia is a feature of Wernicke's encephalopathy. TRUE
86. Paranoid schizoid position involves repression as a defence mechanism. FALSE.IT IS CHRACTERISED by predominance of primitve defence mechanisms,denial,splitting and primitve projective identification.(core)
87. Behavioural assessment includes HEE (high expressed emotions in family .FALSE.cudnt find any link for family emotions in assessment.
88. MAOs dangerously interact with salbutamol FALSE
89. Attribution theory says that people attribute their behaviour to their personality traits. FALSE.
90. Obsession can be pleasurable FALSE
91. Auditory hallucinations are the commonest hallucinations in Alzheimer’s. False, visual
92. About 40% patients of Parkinson’s dementia have depression. TRUE.40-70% DEVELOP DEPRESSION(OXFORD).20-30% DEVELOP DEMENTIA IN PARKINSONS DISEASE
93. Nominal dysphasia differentiates between dementia and pseudo dementia. TRUE
94. Diagnosis of delusional disorder requires bizarre delusions for at least a months duration FALSE.non-bizzarre for atleast 3mths in ICD AND 1MTH DSM
95. Seduction is seen in emotionally unstable PD FALSE
96. Concrete operational stage coincides with industry Vs inferiority in time frame. TRUE
97.In complex pattern processing proximity and difference is used FALSE
98.In GTD syndrome characteristic ECG changes are seen FALSE
99.The passage of time is altered in people with mania TRUE.any refrence?
100.Night terrors are dissociative phenomenon. false
EMIs
EMI 1
1. A 24-year-old woman is not aware that she dislikes her mother. At the sometime she cannot understand why she feels aggression towards older women in the position of authority...
DISPLACEMENT...
2. A 28-year-old man is quite distressed by his father's death recently. Eventhough he did not enjoy a good relation ship with him but at the moment he can only remember the good moments.
REPRESSION
3. A 54-year-old male gets these thought about his old mother "she will fall ill and die". He rejects these thoughts as being alien and not of his own. He is not distressed or remorseful about these thoughts.
Isolation
EMI 2
Ananakstic personality disorder Borderline personality disorder Narcissistic personality disorder Schizotypal personality disorder Paranoid personality disorder Histrionic personality disorder Schizoid personality disorder
Which Personality disorder is it:
1. A young girl with h/o childhood sexual abuse, having chronic suicidal ideation which she often expresses and gets cross with nurses.
BORDERLINE
2. A man with illusions and suspiciousness and who does not socialises properly and has poor relations with people. No history of hallucinations and fantasy/disroganised thinking(it was like that what i can recall)
SCHIZOTYPAL
3. A university student who gets angry and says on failing of his thesis acceptance, " they are jealous of me because I am extraordinary intelligent". His family says he is always like this.
Narcissistic PD
EMI 3
Which disorder is it?
Schizophrenia Depression Panic GAD Agoraphobia with panic attacks
1. A young person with history of paranoid thoughts and low mood ; his uncle was a long term stay in a Psych hospital.
Schizophrenia
2. A lady who gets anxious all the time with somatic symptoms like palpitations, shortening of breath etc. anxiety worsens when she goes out.
GAD
3. A girl who gets anxious only when she goes out and associated with a fear of death, fainting and dizziness.
Agarophobia with panic attacks
EMI 4
A. GHQ B. Burden Questionnaire C. Hachinski ischemic score D. Alzhiemer's Quality of Life Questionaire E. Minimental State Examination F. Wisconsin Card Sorting Test G. Benton Revised Visual Retention Test H.clinical dementia rating scale
A women has brought in her 79 year old father whome she finds difficult to manage at home as he has become irritable and verbally aggressive towards her:
1. How would you assess the mood of the daughter. Burden Questionnaire ( Birmingham Course)
2. What test would you use to assess the global cognitive funtion of the patient. MMSE
3. If his global cognitive funtions were found to be normal , how would you check frontal lobe.
Wisconsin Card sorting test
EMI 5
1. DT 2. Wernicke's 3. HIV 4. Korsakoff's 5. opiod intoxication
A 30 year old man dependant on alcohol comes to the A and E. He has a wound in his head.
What is the most likely condition he is suffering from.
1. He experiences squirrels over the floor.
DT
2. He has 2 abscesses in groin with bradycardia.
OPIOD TOXICITY
3. He is disoriented and unsteady in his gait.
WERNICKES
EMI 6
Neuropsychiatry
A. Abducent nerve palsy B. Trochlear nerve palsy C. Ataxia D. Anosagnosia E. Gert’s ma F. Anosmia G. Unilateral optic nerve palsy H. Constructional dyspraxia I. Agraphia
1. A man with frontal meningioma A F (Unilateral insomnia) 2. A chronic dishevelled alcoholic A C 3. non dominant parietal lobe lesion D H its anosagnosia+constructional apraxia
EMI 7
Choose one disorder for each of the following patients:
1. A young man whose father died in a car crash 8 months ago. Since then he has suffered from epigastric pain, chest pain, hyperventilation. He feels fearful especially when he goes in a car. GAD
2. A young man who won't leave the house as when he went into a supermarket he became worried that people were looking and laughing at him. Social Phobia
3. An old man with low mood, poor appetite and insomnia. Depressive episode
Disorders: Social Anxiety, Depressive Disorder, Generalised Anxiety Disorder, Episodic Anxiety disorder, Agoraphobia plus panic disorder, Adjustment Disorder, Depressive and Anxiety Diorder.
EMI 8
Choose One which best applies to each case: 1. A woman who sees the colour red when she hears music. Synaesthesia
2.A schizophrenic man who sees the face of the devil in the pattern of cigarette burns on the floor. Illusion ( Pareidolic)
3. A man who hears the voice of a woman in another place. Extracampine
Options: Synaesthesia; pareidolia; completion illusion; reflex hallucination; extracampine hallucination.
EMI 9
Choose one explanation for the following symptoms: A 60 year old man enteres A+E. He tells you he has had a head injury, with a fluctuating conscious level. He has a long history of alcohol abuse. 1_ He tells you he sees squirrels running in A+E. DT
2. He Denies that the left side of his body is present. Bleeding intracranial
3. He has several abscesses in his groins and constricted pupils. Opioid Intoxication
options: Wernicke's encephalopathy; opiate intoxication; intracranial bleed; alcohol intoxication; Korsakoff's; malingering; homelessness; schizophrenia.
EMI 10
Denial Displacement Isolation Reaction formation Rationalisation Repression Regression Projection
Chose one
1. 25 year old woman, brought up by a stict and orderly mother. She always has problem with elderly authority figures. Displacement
2. 25 year old man - probles with father - following death of his father he seems to have no memory or feelings to the events -Repression
3. 35 yr man - thinks that his mother "will fall ill and die" . He claims that these thoughts are alien intusive and does not bother him much. There is no associate guilt or feelings of wishfullness.
Isolation
EMI 11
Side Effects
Motor fits Tics Chorea Tardive Dyskinesia Tardive Dystonia Dystonia Catalepsy Cataplexy
Choose 1
A. A man brings his wife for an outpatient appointment. She suffers from Bipolar Affective disorder and is on long term depot medications (5 years). Her husband complains recently she started to make faces and grimaces in front of relatives which is very embarrassing - Tardive Dyskinesia
B. A young man suddenly collapses to the floor with laughing - Cataplexy
C. A G.P prescribed Haloperidol injection for an agitated man, 4 days ago. Today he presents with painful and stiff neck - Dystonia.
EMI 12
Personality Disorders
Anankastic personality disorder Anxious (Avoidant) personality disorder Dependant personality disorder Borderline personality disorder Paranoid personality disorder Narcissistic personality disorder Schzoid personality disorder Schizotypal ersonality disorder
Choose 1
A. A 18 year man presents with odd beliefs and ideas. He doesn't have any close friends and prefers to be on his own. He appears eccentric with fantasy thinking - Schizotypal personality disorder.
B. A student presents a thesis which was rejected by the college commitee. He becomes furious and says " People are always jealous at him and that he is an outstanding scientist". His family feels that he has always been like this - Paranoid personality disorder.
C. A 30 year old man presents with low mood, irritability and had a lot of unstable relationships. At times, he gets quite angry with his doctor and other staff for not treating him properly. He self harms by cutting his wrist and is unable to take constructive criticism - Borderline personality diorder.
Solved Paper Autumn 2005
ISQs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=226
EMIs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=223
Solved Paper Spring 2005
ISQs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=134
EMIs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=119
Solved Paper Autumn 2004
ISQs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=132
EMIs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=133
Solved Paper Spring 2004
ISQs
http://www.cambridgecourse.com/modules.php?name=Forums&file=viewtopic&t=117
EMIs
Not available yet but more or less same as autumn 2004.
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