Psychiatry Part I Exam

Psychiatry Part I Exam Sample MCQs

1- Eye to eye contact A.is usually decreased in depression B.is never a sign of aggression C.is an essential part of psychotherapy D.is influenced by cultural factors E.is assessed in the mental state examination

2- Obsessional thoughts A. always give rise to compulsions B. are ego-alien C. rarely are of sexual nature D. are best treated by thought stopping E. usually response to imipramine

3- Electrical stimulation of the following causes anxiety A. vagus B. hypothalamus C. dorsal raphe nucleus D. locus coeruleus E. median raphe nucleus

4- The Ganser Syndrome occurs in A. schizophrenia B. manic-depressive psychosis C. prisoners awaiting trial D. personality disorder E. hysteria

5- Passivity experiences A. include made actions B. occur in manic-depressive psychosis C. include echo de la pensee D. are recognized in obsessive neurosis E. exclude thought broadcasting

6- Animal phobias are A. commoner in men B. usually occur in middle age C. generally non-specific D. treatable with behavioral therapy E. a poor diagnostic group

7- The following statements are true A. 2nd person auditory hallucinations do not occur in schizophrenia B. pseudo-hallucination have prognostic value in schizophrenia C. illusion are invariable in paranoid schizophrenia D. visual hallucinations exclude a diagnosis of schizophrenia E. functional hallucinations may occur in organic brain disease

8- Features of atypical grief could include A. feelings of self-blame B. pseudohallucinations of the deceased C. searching behaviour D. illusions E. misidentifications

9- Features of Alzheimer’s disease may include A. onset at age 60-70 years B. amnesia is rarely the first symptom noted C. EEG changes usually seen in the late stage of illness D. marked loss of verbal skills on WAIS E. psychotic features

10- Features of counter-transference could include A. always unconscious B. may be experienced by patient C. always a response to transference D. may be positive or negative E. does not occur in psychoanalysis

11- Possible features of Electra complex include A. rivalry between daughter and father B. resolved by castration anxiety C. seen in all girls D. converse of the Oedipus complex E. Electra was the step-sister of Oedipus

12- Features of splitting may include A. relates to the paranoid position B. the primary defence according to Anna Freud

2 C. applied to either parents as the object D. related to objective identification E. similar to spitting

13- Physical dependence occur with A. psilocybin B. cocaine C. LSD ( lysergic acid diethylamide) D. morphine E. amphetamine 14- Diplopia occurs in A. neuropathy of oculomotor nerve B. Parkinson’s disease C. Neuropathy of facial nerve D. Huntingdon’s chorea E. Diabetes insipidus

15- Components of the basal ganglia may include A. amygdaloid nucleus B. red nucleus C. dentate nucleus D. caudate nucleus E. subthalamic nucleus

16- The circle of Willis is formed by A. superior cerebellar artery B. posterior spinal artery C. posterior communicating artery D. middle cerebral artery E. anterior inferior cerebellar artery

17- Delerium tremens A. Characteristically begin about a week after the last drink B. Has an insidious onset C. Is a disorder of a reticular activating system D. Is associated with vestibular disturbances E. Has a mortality rate of 5%

18- Contraindications to ECT include A. patients with cardiac arrhythmias B. women in the third trimester of pregnancy C. patients taking anticonvulsants for epilepsy D. raised intracranial pressure E. mania

19- Characteristic features of psychogenic fugue include A. amnesia for the episode

3 B. purposeless wondering C. mutism D. self-neglect E. automatic obedience

20- The following are not indicative of suicidal intent in relation to an act of deliberate self-harm A. leaving a note B. a history of several previous attempts C. failing to alert potential helpers D. taking antihypertensive drugs E. taking an overdose in the presence of others

21- Common features of post-natal depression include A. ataxia B. ideas of reference C. panic attacks D. excessive worries about babies health E. feeling of hostility towards the baby

22- In alcoholic hallucinosis A. perceptional abnormalities are predominantly visual B. conciousness is impaired C. symptoms last for two to three months in the majority of cases D. phenothiazine drugs are usually effective in treatment E. there is an increased familial risk of schizophrenia

23- The following are more suggestive of an affective psychosis than acute Schizophrenia A. mode congruent delusions B. misidentification of people C. imperative hallucinations D. formal thought disorder E. disorientation

24- The EEG can be used in epilepsy A. to exclude the diagnosis B. to assess the adequacy of anticonvulsant therapy C. to decide the safety of stopping treatment D. to assess the side effects of anticonvulsant treatment E. to diagnose pseudo-seizures

4 25- Inhibitory neurotransmitters include A. gamma-aminobutyric acid (GABA) B. aspartic acid C. acetylcholine D. glutamic acid E. dopamine

26- Recognized complications of sodium valproate therapy include A. carditis B. alopecia C. gingival hypertrophy D. hypothyroidism E. bleeding

27- The following statements are correct A. manneristic speech is characterized by constant repetition of words or phrases out of context B. mannerism include adaptive postures which are modified in a curious fashion C. stereotypies include the unusual performance of goal-directed motor act D. stereotypic speech is characterized by alteration in the quality, tone or pronunciation of speech E. stereotypic speech does not occur in organic mental disorders

28- Drugs which should be avoided in renal impairment A. carbamazepine B. lithium C. procyclidine D. artane E. sulpride

29- Delusions A. are false beliefs held with absolute convictions B. are modifiable by experience C. are shared bye those of a common social and cultural background D. when systematized can invariably be traced back to the development of a primary delusion E. are present in neurotic illnesses

30- The superego A. develops before the resolution of Oedipal complex B. arises from the ego C. is entirely conscious D. it is exactly internalized parental authority E. according to Freud is stronger in girls than boys

5 31- Idiopathic epilepsy A. accounts for more than 50% of all cases B. is commoner in men C. in the majority of cases causes focal seizures D. causes higher incidence of psychological disability than other forms of the disorders E. is associated with neurological abnormalities between attacks in 30% of the cases

32- Beta waves in the adult EEG A. are increased by anxiety B. are the dominant component of stage IV sleep C. are increased by alcohol D. have frequency of 1-3 Hz E. are principally occipito-parietal distribution

33- In Korsakoff’s psychosis (dysmnesic syndrome) A. digit span testing is characteristically abnormal B. confabulation is an essential diagnostic features C. disorientation in time is evident D. clouding of consciousness is present E. treatment with thiamine is usually ineffective

34- Characteristic features of histrionic (hysterical) personality disorder include A. emotional shallowness B. argumentativeness C. attention seeking behaviour D. indecisiveness E. sexual promiscuity

35- Hallucinations A. are always perceived as emanating from the surrounding environment B. may be conjured up or dismissed at will C. are distortions of real perceptions D. involve alterations in the intensity, quality or spatial form of stimuli E. have the same qualities as normal perceptions

36- Examples of pharmacodynamic drug interactions include A.competitive receptors site blockade B.induction of liver microsomal enzymes C.interaction by mixing in syringe D.competition for plasma binding sites E.decreased intestinal absorption

6 37- A six years old child brought to the clinic for treatment of her generalized anxiety. Which one of the following behavioral treatments has been found helpful for the childhood anxiety A. relaxation training B. desensitization C. modeling D. contingency management E. all of the above

38- 24-years old male presents to the center with 2 years history of increasingly disabling intrusive thoughts about germs. He spends up to 4 hours a day showering and washing himself. Which of the following would be the most appropriate medication for him A.bupropion B.buspirone C.olanzapine D.clonazepam E.sertraline

39- A young man with schizophrenia over the 5 past years. The patient mother call to say that her son has been talking about harming someone. Which of the following is the single best predictor of violence A. a history of violence B. paranoid thinking C. substance abuse D. antisocial personality disorder E. head injury

40- A 44-year-old man refuses to comply with your request to dispose of his Firearms. He admits to having thoughts of shooting himself. Important factors. In determining the patient’s degree of dangerousness to himself would include all of the following EXCEPT A. medical illness B. substance abuse C. employment history D. political party E. family history of suicide

41- A female patient complains that she unable to experience an orgasm on the higher dose of paroxetine. She prefer to remain on this medication since this is the first time she has not felt depressed in several months. A pharmalogic antidote for SSRI-related anorgasmia include which of the following medications

7 A. citalopram B. floxetine C. venalofaxine D. bupropion E. non of the above

42- A 33-years old female patient suffering from extreme fatigue, crying spells, angry outburst and insomnia several days before the onset of her menstrual period. She has experienced these symptoms for several years. Which of the following medications would be the best intervention for this patient A. nortriptyline B. amitriptyline C. flouxetine D. all of the above E. none of the above

43- Which of the following conditions has an increased comorbidity with social anxiety disorder? A. substance abuse B. depression C. anxiety disorders D. chronic medical illness E. all of the above

44- Which of the following is indicated in the treatment of social anxiety disorder? A. Phenelzine B. Paroxetine C. Cognitive behavioral therapy D. All of the above E. None of the above

45- Which of the following is true about concrete thinking? A. It is usually seen in bipolar disorder B. It is diagnostic of schizophrenia C. It is diagnostic of organic brain disease D. It is a defect of conceptual abstract thought E. It is always seen in schizophrenia

46- Pseudo dementia is characterized by

8 A. Abnormal EEG B. Chronic course C. Onset with depressive features D. Localized neurological signs E. Confabulation

47- Which of the following is true about Capgras syndrome? A. It is also called erotomania B. It is also called delusion of doubles C. It is usually associated with Brain disease D. It is the same as hysteria E. It is seen in husbands of pregnant woman

48- In history taking and mental status examination, all of the following are true except A. Occupational history may give an indication of severity of condition B. Cognitive testing is not indicated if a full history is obtained C. Family history may give a clue about family dynamics D. Mental status examination need not be done in recommended sequence E. Proverb interpretation demonstrates concrete thinking

49- Which of the following conditions does not classically cause emotional liability? A. Mania B. Severe depression C. Psuedobulbar palsy D. Hysteria E. Delirium

50- Which of the following cognitive impairments is found in persons with schizophrenia? A. Deficits in information processing B. Deficits in executive function C. Deficits in language ability D. None of the above E. All of the above

51- Which of the following is considered a bad consequence of deinstitutionalization of schizophrenic patients? A. Some of the patients were transferred to alternative forms of unregulated custodial care like nursing homes and poorly managed shelter systems

9 B. Some patients were let free into nearby communities, which were unable or unwilling to take care of the released patients C. Responsibility for care was transferred to patients’ families, for whom it has become a burden D. Some of the released patients ended up in the prison system E. All of the above

52- The risk of siblings of affected individuals developing schizophrenia is A. 5% B. 10% C. 20% D. 40% E. 50%

53- The risk of schizophrenia is increased in first-degree relatives of patients with A. Depressive disorder B. Bipolar disorder C. Obsessive-compulsive disorder D. Panic disorder E. Schizoaffective disorder

54- A 19-year old man was recently discharged from the hospital after treatment for acute schizophrenia, on his follow-up visit 2 weeks later, he reports having stopped taking the prescribed medication. What should be the next step in his treatment? A. Start the patient on risperidal consta B. Hospitalize the patient C. Report him to the department of health services D. Inquire about side effects from neuroleptics E. None of the above

55- Which of the following drugs has been shown to decrease the suicide rate? A. Carbamazepine B. Olanzapine C. Sertraline D. Lithium E. Valproic acid

56- The following are recognized side effects of lithium at therapeutic dose except

10 A. Thirst B. Fine tremors C. Polydipsia D. Diplopia E. Erectile dysfunction

57- Which of the following antipsychotic also has an antidepressant effect? A. Flupenthixol B. Chlorpromazine C. Haloperidol D. Trifluperazine E. Fluphenazine

58- Which of the following antidepressant blocks reuptake of dopamine? A. Venlafaxine B. Bupropion C. Buspirone D. Mirtazapine E. Fluoxetine

59- All of the following statements are true of the epidemiology of depression except A. The rates are equal in men and women after the age of 50 years B. Women are twice as affected as men between puberty and 50 years C. Girls are four times more affected than boys before puberty D. Point prevalence of depression in 2-3% for men and 5-9% for women E. Increased rates of depression have been observed over the past 4 to 5 decades

60- All of the following neurotransmitter abnormalities are detected in anxiety disorders except A. Increased platelet MAO activity B. Increased activity of central noradrenaline C. Increased central GABA activity D. Increased circulating adrenaline E. Increased circulating noradrenaline

61- Of all the following factors, which is the most important risk factor for the development of post-traumatic stress disorder? A. Individual vulnerability B. Nature of the trauma C. Sex of the victim D. Age of the victim

11 E. All of the above are equally important

62- All of the following are true about hypochondriasis except A. It is more common in women B. Onset is in early adulthood C. Course is chronic with waxing and waning of symptoms D. The belief of having a serious disease is not of delusional intensity E. The symptoms can involve more than one system

63- The percentage of elderly people with depressive symptoms is A. 5% B. 7% C. 15% D. 30% E. 50%

64- In which of the following regions of the brain is a tumor most likely to cause psychiatric symptoms? A. Frontal B. Parietal C. Temporal D. Occipital

65- What is the most common psychiatric manifestation of Cushing syndrome? A. Mania B. Psychosis C. Depression D. Panic attacks E. Anxiety

66- What is the most common offence committed by women? A. Homicide B. Infanticide C. Assault D. Shoplifting E. Hit and run

67- Patients with bulimia nervosa sometimes develop cardiac myopathy. What is the most common cause? A. Electrolyte disturbances B. Starvation C. Loss of cardiac muscle D. Toxicity from ipecac E. All of the above

12 68- What is the mental age of an adult with moderate mental retardation? A. 3 years or less B. 6 years or less C. 9 years or less D. 12 years or less E. 15 years or less

69- Which of the following is common in the childhood history of patients with borderline personality disorder? A. Shyness B. Psychosis C. Conduct disorder D. Sexual abuse E. Magical and odd beliefs

70- For which of the following purposes is the Thematic Apperception Test (TAT) most useful? A. As an aid in the differential diagnosis B. In assessment of motivational variables C. In assessment of a patient’s intellectual level D. In assessment of the risk of suicide in a patient

71- With which of the following is cholestatic jaundice most commonly seen? A. Lithium B. Chlordiazepoxide C. Chlorpromazine D. Fluoxetine E. Amitryptiline

72- Interpersonal psychotherapy differs from psychodynamic psychotherapy in that does not use A. Empathy B. Transference analysis C. The “ here and now” approach D. An attempt to improve social relationships E. Practical procedures

73- Which of the following is the means by which psychoanalysis achieves resolution of conflicts rooted in the past ? A. Regression B. Denial C. Projection D. Projective identification E. Magical undoing

13 74- Multipolar neurone has A.one axon and more than one dendrite B.one axon and one dendrite C.one dendrite and one axon D.one dendrite and more than one axon E.no axon and more than one dendrite

75- Diencephalon includes the following structures EXCEPT: A. Thalamus B. Epithalamus (inc. pineal gland, and habenular gland) C. Hypothalamus (inc. pituitary gland) D. Subthalamus E. Tectum

76- The mesolimbic dopaminergic system   innervates the following structures EXCEPT: A.   olfactory tubercle B.   dorsolateral hypothalamus C.   stria terminalis D.   cingulate cortex E.   parahippocampal gyrus

77- Gerstmann’s syndrome is characterized by all the following EXCEPT: A. right-left disorientation B. finger agnosia C. dysgraphia D. dyscalculia E. dysmnesia

78- Limbic structures include: all the following EXCEPT: A. Insula B. Fornix C. Cingulum D. Hippocampus E. Amygdala

79- Parasympathatic action characteristically includes: A. Dilatation of the pupil B. Increase in heart rate C. Decrease in salivation D. Bronchial constriction E. Decrease in peristalsis

14 80- 5HT is involved in all the following EXCEPT: A. Sleep. B. Sex. C. Aggressive outbursts. D. Thought. E. Mood.

81- The behavior of a patient who remains silent during an interview illustrates which type of resistance? A. Conscious. B. Ego. C. Id. D. Superego. E. Countertransference

82- On mental status examination, the patient's stream of thought reveals a lack of goal directedness, excessive details, and difficulty with closure. This thought pattern is called A. Circumstantiality. B. Tangentiality. C. Thought blocking. D. Perseveration. E. Neologism.

83- Clinical scales on the Minnesota Multiphasic Personality Inventory–2 include all of the following except A. Hypochondriasis. B. Hysteria. C. Lie. D. Psychopathic deviance. E. Psychasthenia

84- Regarding the Hamilton Rating Scale for Depression (HRSD), all of the following are true except A. It contains 17–24 items. B. It has 3- to 5-point severity scales for each item. C. It is weighted toward the neurovegetative rather the cognitive symptoms of depression. D. It is often used in conjunction with the Beck Depression Inventory (BDI). E. It is self-administered.

15 85- In psychiatry, the electroencephalogram (EEG) can be helpful in the diagnosis of A. Intermittent explosive disorder B. Panic disorder C. Bipolar disorder D. Social phobia E. Frotteurism 86- Which of the following personality disorders shows evidence of genetic transmission, on the basis of family risk, twin, and molecular studies? A. Antisocial. B. Avoidant. C. Borderline. D. Dependent. E. Schizotypal

87- The first stage of Erikson’s psychosocial development is A. Identity vs confusionl. B. intiative vs guilt. C. Trust ss mistrust. D. Intimacy vs isolationl. E. Integrity vs despair.

88- As opposed to respondent of Paplovian conditioning , in operant conditioning A. Responses are conditioned by consequent response B. Responses are conditioned by antecedent stimuli C. Behavior is strengthened by absence of response D. Behavior is strengthened pairing of neutral stimulus E. non of the above

89- Which of the following is not considered a perceptual disturbance? A. Derealization. B. Illusion. C. Depersonalization. D. Delusion. E. Hallucination.

90- When interviewing a depressed or suicidal patient, the psychiatrist is advised to do all of the following except A. Begin with assessment of physical appearance and motor behavior. B. Thoroughly explore neurovegetative signs or symptoms and their effect on patient

16 function. C. Be attentive to recent psychosocial stressors (especially losses) and recent anniversaries of significant past losses. D. Allow the patient to set the pace of the interview, avoid excessive engagement, and tolerate long silences. E. Assess both suicidal cognitions and the patient's ability to control self-destructive impulses.

91- A methodological limitation of adoption research, in terms of its ability to separate genetic from environmental influences, is the fact that A. Most children are adopted away at birth. B. The environment begins at birth. C. Adopted children cannot be considered a representative sample of the population. D. Adoptive parents often have as much psychiatric illness as biological parents. E. A false genetic hypothesis (type I error) has been accepted.

92- Common developmental themes of adolescence include which of the following? A. Dependence vs. peer group. B. Family vs. privacy. C. Idealization vs. intellectualized control. D. Identity, role, and character. E. Identity vs. inferiority.

93- The emergence of stranger anxiety is regularly observed by age A. Younger than 4 months. B. 4–8 months. C. 8–12 months. D. 12–16 months. E. 16–24 months.

94- An advantage of magnetic resonance imaging (MRI) over computed tomography (CT) is that MRI. . . A. Provides better detection of calcified brain lesions. B. Is less anxiety provoking. C. Is less expensive. D. Provides better visualization of lesions in the brain stem. E. Requires a shorter period of patient cooperation.

95- Non-goal directed movement carried out in a uniform way is called: A. perseveration

17 B. stupor C. stereotypy D. vorbeireden E. mitmachen 96- Non-dominant temporal lobe abnormalities may produce: A. Aphasia. B. Reduced appreciation of music C. Impaired learning of new words. D. Difficulty planning tasks. E. Confabulation. 97- Confusional state may be caused by all the following EXCEPT: A. Paracetamol. B. Cimetidine. C. Procyclidine. D. Dothiepin. E. Methylcellulose

98- Besides impaired renal function, which of the following is a cause of increased lithium levels? A. dehydration B. ibuprufen C. thiazides D. sodium restriction E. all of the above

99- The following symptoms are recognized features of depression but not of mania A. early morning waking B. motor retardation C. auditory hallucination D. episodic weeping E. nihilistic delusion

100- Munchausen syndrome A. is named after the 18th century German Baron in whome it was first described B. most commonly presents with reccurrent abdominal symptoms C. is not associated with criminality D. is identified more commonly in those of low intelligence E. is more common in females