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Psychiatry > 2010 Past Paper > Flashcards

2010 Past Paper Flashcards

1
Q
  1. In pre-adolescent children an increased likelihood of reporting somatic symptoms is associated with all of the following EXCEPT (CHOOSE ONE)

A. Stressful life events with a negative impact

B. Conscientious and perfectionist temperamental traits

C. Difficult behaviour

D. Anxiety traits

E. Above average school achievement

A

D

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2
Q
  1. The following statement is FALSE with respect to the Serotonin Syndrome (CHOOSE ONE)

A. It may be caused by a single therapeutic dose of an SSRI

B. It typically evolves over several days

C. It may be associated with the use of herbal medicines while taking an SSRI

D. Clonus and hyperkinesia are important diagnostic signs

E. It may be associated with the administration of Opiate medication while taking a SSRI

A

A

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3
Q
  1. The following is a list of behavioural disturbances in Mania. Which is LEAST likely to occur in a manic episode? (CHOOSE ONE)

A. Sexual promiscuity

B. Excessive spending

C. Aggression

D. Collecting rubbish

E. Working throughout the night

A

D

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4
Q
  1. A brief intervention for Substance Abuse includes (CHOOSE ONE)

A. Rapid admission for detoxification

B. Confronting, threatening and setting boundaries

C. Regular diazepam for five (5. days

D. Referring to Narcotics Anonymous

E. Support, optimism and absolution

A

d

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5
Q
  1. The acute management of the Malignant Neuroleptic Syndrome includes all of the following EXCEPT (CHOOSE ONE)

A. Ceasing the neuroleptic

B. Switching to Clozapine

C. Regular Diazepam

D. Urgent referral to a Medical Specialist

E. Monitoring renal function

A

B

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6
Q
  1. The following are recognised side effects of Fluoxetine EXCEPT (CHOOSE ONE)

A. Postural hypotension

B. Agitation

C. Headache

D. Sexual dysfunction

E. Appetite disturbance

A

A

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7
Q
  1. Indications for the use of neuroleptic medication do NOT include (CHOOSE ONE)

A. Prevention of relapse in Schizophrenia

B. Insomnia

C. Acute phase of Schizophrenia

D. Severe behavioural problems

E. Mania

A

D

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8
Q
  1. Typical features of Schizophrenia do NOT include (CHOOSE ONE)

A. Distortions
B. Formal thought disorder
C. Hallucinations
D. Limited insight
E. Affective blunting

A

A

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9
Q
  1. The following are all anti – manic medications EXCEPT (CHOOSE ONE)

A. Methylphenidate – (this is a stimulant – used mainly in ADHD)
B. Olanzepine
C. Lithium
D. Epilim (Sodium Valproate)
E. Benzodiazepines

A

A

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10
Q
  1. The following are recognised causes of intellectual disability EXCEPT (CHOOSE ONE)

A. Down’s Syndrome
B. Foetal Alcohol Syndrome
C. Tuberculous meningitis
D. Fragile X syndrome
E. Asperger’s Syndrome

A

E

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11
Q
  1. Which ONE of the following is NOT a risk factor for suicide?

A. Elderly
B. Female
C. Alcoholic
D. Adolescent
E. Bipolar affective disorder

A

B

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12
Q
  1. A history of deliberate self harm occurs most frequently in people with which Personality Disorder? (CHOOSE ONE)

A. Narcissistic
B. Borderline
C. Schizotypal
D. Histrionic
E. Antisocial

A

B

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13
Q
  1. Recognised side-effects of treating 6 - 10 year old children with stimulant medication include the following EXCEPT: (CHOOSE ONE)

A. nausea or decrease in appetite
B. addiction
C. insomnia
D. slowing in growth

A

B

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14
Q
  1. Which ONE of the following is true: children with ADHD are likely to be

A. Over-familiar or disinhibited with unfamiliar adults
B. Popular with classmates
C. Slow learners
D. Disobedient at home or disruptive in class
E. Of above average intelligence

A

C

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15
Q
  1. Characteristic features of ADHD include the following EXCEPT: (CHOOSE ONE)

A. forgetfulness
B. elevated mood
C. fidgeting
D. impulsiveness
E. short attention span

A

B

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16
Q
  1. Which ONE of the following is true of HIV-associated dementia:
    A. The condition is a subcortical dementia
    B. Commonly improves with AZT
    C. Commonly occurs in the early stage of HIV infection
    D. Psychotic symptoms are usually absent
    E. Symptoms usually resemble depression
A

A

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17
Q
  1. In the assessment of a violent patient the following are true EXCEPT: (CHOOSE ONE)

A. Start with a detailed history

B. Assessment occurs simultaneously with containing actions

C. Assessment is complete once the patient is sedated

D. Assessment includes observation for signs of head injury

E. Assessment relies heavily on a collateral history

A

A

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18
Q
  1. Clinical features of psychogenic amnesia include the following EXCEPT: (CHOOSE ONE)

A. retaining the capacity to learn new information

B. an abrupt onset

C. some precipitating emotional trauma

D. no obvious difficulties in communicating with others

E. non-awareness of the memory loss

A

D

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19
Q
  1. Medical confidentiality is justifiably broken in all the following EXCEPT: (CHOOSE ONE)

A. If the benefit to society is greater than that of the patient

B. With the consent of the patient

C. When the patient has died

D. In accordance with legislation

E. In an emergency situation to the benefit of the patient

A

D

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20
Q
  1. The following are characteristic symptoms of frontal lobe syndrome EXCEPT: (CHOOSE ONE)

A. A general lack of drive
B. Lack of foresight
C. Loss of motivation
D. Indifference to the feelings of others
E. Auditory hallucinations

A

E

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21
Q
  1. In the catatonic form of schizophrenia, the clinical picture is dominated by at least two of the following features EXCEPT: (CHOOSE ONE)

A. excessive motor activity
B. marked paranoid delusions
C. waxy flexibility or stupor
D. extreme negativism
E. echolalia or echopraxia

A

B

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22
Q
  1. Clinical response to an adequate dosage of tricyclic antidepressant typically occurs how long after initiation of treatment? (CHOOSE ONE)

A. 1 to 2 hrs
B. 12 to 24 hrs
C. 3 to 10 days
D. 21 to 30 days
E. 4 to 8 hrs

A

D

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23
Q
  1. In the order presented, the medications thioridazine, chlorpromazine, perphenazine, and haloperidol are characterized by ONE of the following:

A. increasing extrapyramidal effects but decreasing anti-cholinergic effects

B. increasing anticholinergic effects but decreasing hypotensive effects

C. increasing hypotensive effects but decreasing sedative effects

D. increasing sedative effects but decreasing anticholinergic effects

E. increasing hypotensive effects but decreasing extrapyramidal effects

A

A

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24
Q
  1. The family of a hospitalized and acutely schizophrenic patient have insisted that they want the patient treated by psychotherapy and not with drugs. All the following are true statements that could be made by the attending psychiatrist EXCEPT: (CHOOSE ONE)

A. psychotherapy alone can have an adverse effect on some schizophrenic patients

B. psychotherapy alone usually has little effect on acute psychotic symptoms

C. psychotherapy can be effective in assisting social rehabilitation

D. in preventing relapse, psychotherapy combined with antipsychotic medication is no more effective than antipsychotic medication alone

E. antipsychotic medication can rapidly relieve psychotic symptoms

A

E

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25
Q
  1. An appropriate therapeutic attitude toward the schizophrenic patient includes all the following EXCEPT: (CHOOSE ONE)

A. tolerance of negative or bizarre behaviours

B. respect for the patient’s need for privacy

C. a consistent approach to the patient

D. a focus on the patient’s pathology

E. a desire to rescue the patient

A

E

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26
Q
  1. A 39-year-old man enters an emergency room complaining of anxiety and extreme sleeplessness. He is noted to be markedly tremulous, and while being examined has a grand mal seizure. This man might be suffering from withdrawal from any of the following substances EXCEPT: (CHOOSE ONE)

A. Diazepam
B. Haloperidol
C. Lorazepam
D. Phenobarbital
E. Alcohol

A

B

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27
Q
  1. The treatment of opioid intoxication is commonly associated with which ONE of the following antagonist drugs?

A. Fluoxetine
B. Haloperidol
C. Diazepam
D. Naloxone
E. Phenobarbital

A

D

28
Q
  1. A 50-year-old male physician with a history of Pethidine dependency is admitted as an emergency patient for possible overdose with that drug. If this is opioid intoxication, the patient can be expected to show all the following symptoms EXCEPT: (CHOOSE ONE)

A. hypertension
B. drowsiness or coma
C. pupillary dilatation in severe over dosage
D. slurred speech
E. cyanosis

A

A

29
Q
  1. A 35-year-old woman appears for psychiatric consultation and demands that her husband be present during the interview. He complains that he has trouble doing anything by himself because of her clinging. She at times idolizes him and, at other times, denounces him as worthless. She has a history of impulsivity with respect to spending and sexuality, and there is a conviction for reckless driving. She acknowledges chronic feelings of emptiness, fits of anger and rage when her husband “abandons” her, and lability of mood.

All the following associated features are commonly found with this disorder EXCEPT: (CHOOSE ONE)

A. suicide attempts
B. co-occurring axis I disorder
C. history of physical and sexual abuse
D. history of dropping out of college just before graduation
E. an absence of psychotic-like symptoms, even with stress

A

E

30
Q
  1. A 35-year-old woman appears for psychiatric consultation and demands that her husband be present during the interview. He complains that he has trouble doing anything by himself because of her clinging. She at times idolizes him and, at other times, denounces him as worthless. She has a history of impulsivity with respect to spending and sexuality, and there is a conviction for reckless driving. She acknowledges chronic feelings of emptiness, fits of anger and rage when her husband “abandons” her, and lability of mood.

The most likely diagnosis is (CHOOSE ONE)
A. dependent personality
B. borderline personality disorder
C. paranoid personality disorder
D. narcissistic personality disorder
E. antisocial personality disorder

A

B

31
Q
  1. Estimates of the lifetime prevalence rates of all personality disorders in the general population range from (CHOOSE ONE)

A. 6 to 10 per 100
B. 3 to 5 per 100
C. 1 to 2 per 100
D. 20 to 25 per 100
E. 0.1 to 0.5 per 100

A

D

32
Q
  1. In patients who have a paranoid personality disorder; which ONE of the following is true:

A. often have a preoccupation with helping the weak and the powerless

B. usually present themselves in a quiet and humble fashion

C. are often litigious (prone to engage in lawsuits.

D. usually also suffer from paranoia
E. have a predisposition to develop schizophrenia

A

B

33
Q
  1. A 25-year-old man is brought reluctantly to a psychiatrist by his parents, who are concerned about his inability to hold a job. They state that since adolescence, he has been impulsive, constantly in conflict in all his interpersonal relationships, and always sees the world and himself differently than do other people. He states he does not use drugs and has no psychiatric symptoms. The mental status examination shows no cognitive deficits and no abnormality of mood, affect, or thinking.

In DSM-IV, the diagnosis would be recorded on axis (CHOOSE ONE)
A. V
B. I
C. IV
D. III
E. II

A

E

34
Q
  1. A 25-year-old man is brought reluctantly to a psychiatrist by his parents, who are concerned about his inability to hold a job. They state that since adolescence, he has been impulsive, constantly in conflict in all his interpersonal relationships, and always sees the world and himself differently than do other people. He states he does not use drugs and has no psychiatric symptoms. The mental status examination shows no cognitive deficits and no abnormality of mood, affect, or thinking.

The most likely diagnosis is (CHOOSE ONE)
A. personality disorder
B. posttraumatic stress disorder
C. schizophrenia
D. obsessive-compulsive disorder
E. major depression

A

A

35
Q
  1. All the following are true statements about depersonalization disorder EXCEPT: (CHOOSE ONE)

A. it must be distinguished from depersonalization secondary to brain tumour or temporal lobe epilepsy

B. reality remains intact during the depersonalization experience

C. in the majority of patients it has a very slow and insidious onset

D. patients express the sense of being detached from their mental processes or body, or of being in a dreamlike state

E. it must be distinguished from occasional depersonalization, which is common and not necessarily pathological

A

C

36
Q
  1. According to DSM-IV, the diagnosis of hypochondriasis requires that the disorder have a duration of at least (CHOOSE ONE)

A. 6 months
B. 3 years
C. 1 year
D. 3 months
E. 1 month

A

A

37
Q
  1. True statements about somatization disorder include all the following EXCEPT: (CHOOSE ONE)

A. it is most commonly seen in lower socioeconomic groups

B. it occurs more often in males

C. it has been called Briquet’s syndrome

D. it generally involves multiple somatic complaints

E. a familial pattern has been observed

A

B

38
Q
  1. A 23-year-old woman was seen in the emergency room stating that “out-of-the-blue” she was seized by intense fear associated with shortness of breath, a pounding heart, shaking, dizziness, a choking sensation, fear that she was dying or going crazy, and a desire to run away. The attack lasted about 20 min. This was the third occurrence of these symptoms in the past 3 weeks.

All the following drugs are commonly employed in the pharmacological management of this patient’s condition EXCEPT: (CHOOSE ONE)

A. alprazolam
B. mono amine oxidase inhibitors (MAOI.
C. imipramine
D. fluoxetine
E. Phenobarbital

A

E

39
Q
  1. A 23-year-old woman was seen in the emergency room stating that “out-of-the-blue” she was seized by intense fear associated with shortness of breath, a pounding heart, shaking, dizziness, a choking sensation, fear that she was dying or going crazy, and a desire to run away. The attack lasted about 20 min. This was the third occurrence of these symptoms in the past 3 weeks.

The most likely diagnosis is (Choose ONE)
A. major depression
B. generalized anxiety disorder
C. panic attack
D. acute psychotic episode
E. hypochondriasis

A

C

40
Q
  1. A 55-year-old married professor without a previous psychiatric history is early in her menopause. In addition to experiencing “hot flashes” and some irritability, she complains of episodes of dizzy spells and memory lapses, which she had experienced on several occasions earlier in life. She denies depressive symptoms either now or in the past. In particular, she should be evaluated for possible (CHOOSE ONE)

A. temporal lobe epilepsy
B. schizophrenia
C. dysthymia
D. panic disorder
E. major depression

A

A

41
Q
  1. The mental status examination of patients with schizophrenia most commonly demonstrates a marked disorder of (CHOOSE ONE)
    A. mood
    B. thinking
    C. memory
    D. insight
    E. orientation
A

B

42
Q
  1. Studies of the relationship between gender and schizophrenia have generally demonstrated which ONE of the following

A. males tend to have a better prognosis than females

B. the lifetime risk of developing schizophrenia is approximately the same in males and females

C. there is a higher concordance rate in male monozygotic twins as compared with female monozygotic twins

D. males tend to respond better to neuroleptic medication

E. the usual age of onset is earlier for females than males

A

B

43
Q
  1. The percentage of schizophrenic patients who ultimately commit suicide is approximately (CHOOSE ONE)

A. 20 percent
B. 1 percent
C. 5 percent
D. 10 percent
E. 30 percent

A

A

44
Q
  1. In the absence of other symptoms, sporadically occurring behavioural automatisms and olfactory hallucinations suggest a diagnosis of (CHOOSE ONE)

A. schizophreniform psychosis
B. non-dominant parietal lobe lesion
C. schizophrenia
D. hysterical personality disorder
E. temporal lobe lesion

A

E

45
Q
  1. Olfactory hallucinations are relatively rare and are most commonly encountered in patients with (CHOOSE ONE)

A. grand mal epilepsy
B. Wilson’s disease
C. parietal tumours
D. partial complex seizures
E. narcolepsy

A

D

46
Q
  1. Symptoms of hyperventilation syndrome commonly include all the following EXCEPT: (CHOOSE ONE)

A. inappropriate laughter or crying
B. carpopedal spasm
C. fainting
D. perioral tingling
E. visual hallucinations

A

E

47
Q
  1. All the following statements about absence seizures are true EXCEPT: (CHOOSE ONE)

A. during a seizure the patient may stare blankly or show automatisms such as lip smacking

B. they are also known as petit mal

C. they are associated with an abrupt loss of attention to the environment

D. patient does not usually show confusion following the episode

E. the loss of consciousness is usually for between 1 and 2 minutes

A

B

48
Q
  1. Suicide may be characterised by which ONE of the following statements?

A. It is a higher risk in girls than boys for children under the age of 12

B. Attempts tend to be more serious in girls than in boys before puberty

C. Attempts tend to be more lethal in girls than in boys during adolescence

D. Attempts are more common in adolescent girls than in adolescent boys

E. It is more often committed by adolescent girls than by adolescent boys

A

D

49
Q
  1. Genetic factors are considered to be of major significance in the aetiology of all the following disorders EXCEPT: (CHOOSE ONE)

A. Tourette’s syndrome
B. posttraumatic stress disorder
C. Alzheimer’s disease
D. schizophrenia
E. bipolar disorder

A

B

50
Q
  1. “Stranger anxiety” typically appears in children at (CHOOSE ONE)

A. 1 year
B. 3 weeks
C. 2 years
D. 6 months
E. 2 months

A

D

51
Q
  1. True statements about personality traits include all the following EXCEPT: (CHOOSE ONE)

A. they are synonyms with habits

B. they are subject to assessment by psychological testing

C. their distribution in a population approximates a bell-curve

D. they are relatively enduring features that characterize the person

E. they are tendencies to show consistent patterns of thoughts, feelings, and actions

A

A/B

52
Q
  1. Match
  2. Mood disturbance
  3. Affect disturbance
  4. Disorientation
  5. Circumstantiality
  6. Perseveration

A 29-year-old patient describes witnessing a terrible plane crash that involved many victims and smiles and chuckles while telling the story

b) An adolescent patient responds to the examiner’s question with the same response he has given to a variety of previous questions

c) A 75-year-old man is asked a question and gives a long answer that incorporates a great deal of tedious and unnecessary details

d) A 40-year-old woman shows little facial expression and states that she has been unremittently sad since the death of her dog

A

A 29-year-old patient describes witnessing a terrible plane crash that involved many victims and smiles and chuckles while telling the story - 1
b) An adolescent patient responds to the examiner’s question with the same response he has given to a variety of previous questions - 5
c) A 75-year-old man is asked a question and gives a long answer that incorporates a great deal of tedious and unnecessary details - 4
d) A 40-year-old woman shows little facial expression and states that she has been unremittently sad since the death of her dog - 2

53
Q
  2. Magical
  3. Blocking
  4. Looseness of associations
  5. Derealization
  6. Depersonalization

a) Discontinuous and illogical stream of thoughts

b) A belief that thought alone can result in the accomplishment of certain wishes or activities

c) Sudden cessation of thinking in the middle of a discussion or sentence

d) The feeling that one is standing apart from oneself and observing one’s own actions

A

a) Discontinuous and illogical stream of thoughts - 3

b) A belief that thought alone can result in the accomplishment of certain wishes or activities - 1

c) Sudden cessation of thinking in the middle of a discussion or sentence - 2

d) The feeling that one is standing apart from oneself and observing one’s own actions - 4

54
Q
  2. Memory impairment
  3. Bizarre delusions
  4. Recurrent self-damaging acts
  5. Perfectionism
  6. Pathological jealousy

a) Paranoid personality disorder
b) Borderline personality disorder
c) Dementia
d) Schizophrenia
e) Obsessive-compulsive personality disorder

A

a) Paranoid personality disorder - 5
b) Borderline personality disorder – 3, 5
c) Dementia – 1,
d) Schizophrenia – 2, 5
e) Obsessive-compulsive personality disorder - 4

55
Q
  1. A psychiatrist find himself annoyed with a quarrelsome patient for no apparent reason, and later notes that the patient reminds him of his quarrelsome and disliked sibling. This is an example of (CHOOSE ONE)

A. identification with the aggressor
B. counter-transference
C. projection
D. reaction formation
E. illusion

A

B

56
Q
  1. A 69-year-old man is suspected of having an acute onset of multiple small cerebral infarcts. The finding on mental status examination that would be most supportive of this diagnosis is (CHOOSE ONE)

A. anxiety
B. delusional thinking
C. depressed mood
D. a change in cognitive functioning
E. inappropriate affect

A

D

57
Q
  1. The following statements concerning neuroleptic drugs are true: EXCEPT: (CHOOSE ONE)

A. They are of little use in the management of affective disorders

B. Haloperidol is useful in the treatment of Tourette’s disorder.

C. They may be useful in the management of wandering.

D. They may produce an improvement in borderline personality disorder.

E. Chlorpromazine has anti-emetic properties.

A

D

58
Q
  1. The following regarding neuroleptic-induced dyskinesias are true; EXCEPT: (CHOOSE ONE)

A. Akathisia is a persistent pathological change in muscle tone.

B. Drug-induced Parkinsonism is more common in women.

C. Idiopathic Parkinson’s disease and schizophrenia rarely co-exist.

D. Extra-pyramidal signs are aggravated by anxiety.

E. Dystonia may be acute or chronic

A

E

59
Q
  1. In the neuroleptic malignant syndrome: which ONE of the following statements is true?
    A. Characteristically, includes hypothermia as one of its presenting features.
    B. Is a life-threatening complication of neuroleptic treatment.
    C. Is more common in older female patients.
    D. Is caused by sudden withdrawal from relatively high doses of neuroleptic drugs.
    E. May occur with only certain neuroleptics
A

B

60
Q
  1. The following are true regarding maintenance therapy in schizophrenia; EXCEPT: (CHOOSE ONE)
    A. Relapse is seldom due to poor compliance with medication.
    B. There is evidence that the use of neuroleptics early in the course of the illness leads to a better outcome.
    C. Relapses probably have an adverse effect on the future course of the illness
    D. Drug holidays have been advocated as a means of assessing the need for continuance of the drug. E. Relapse on withdrawing from a neuroleptic drug may be due to dopamine receptor hypersensitivity
A

A

61
Q
  1. The following are true of clozapine EXCEPT: (CHOOSE ONE)
    A. Is an antagonist at D1, D2, 5-HT2, 1 -adrenergic, H1 histaminergic and cholinergic receptors.
    B. Is a very safe drug.
    C. Has been termed an atypical neuroleptic
    D. May be effective in over one-third of patients who fail to respond to other antipsychotic agents.
    E. Has little effect on prolactin release
A

B

62
Q
  1. Regarding neuroleptic drugs: the following are true EXCEPT (CHOOSE ONE)
    A. When patients with only negative symptoms are treated with older generation neuroleptic drugs, they often show little or no improvement.
    B. Patients with positive symptoms often show an increase in activity and interest in their surroundings when treated with neuroleptic drugs.
    C. Thioridazine is less effective that other neuroleptics.
    D. Chlorpromazine is of relatively low potency.
    E. Haloperidol is effective in comparatively low doses
A

E

63
Q
  1. Which ONE of the following statements is true:
    A. Lithium salts can cause prolonged coma in overdose
    B. Antidepressants should never need to be taken for more than 6-8 months at any one time.
    C. Lithium is equally effective in the prophylaxis of unipolar and bipolar depressive illness.
    D. Lithium and haloperidol are usefully combined in the treatment of bipolar depressive illness
A

A/C

64
Q
  1. The following drugs are particularly dangerous in deliberate overdose EXCEPT: (CHOOSE ONE)

A. fluoxetine (Prozac)
B. lithium
C. imipramine
D. amitriptyline
E. mianserin

A

A

65
Q
  1. The following are true of depressive illness EXCEPT: (CHOOSE ONE)
    A. In unipolar depression, there is a female preponderance of around 2:1
    B. The unipolar forms tend to present in a similar way in successive generations
    C. The initial response to treatment is a good guide to response in future episodes.
    D. Depression has a good prognosis and seldom lasts beyond 6 months
    E. Chronicity is lower for bipolar disorders.
A

D

66
Q
  1. In bipolar depressive illness which ONE of the following is true?
    A. The sex ratio is approximately equal.
    B. A switch from one pole to the other occurs in over a half of bipolar episodes within a few months of admission to hospital.
    C. Unipolar manic illness is always endogenous
    D. Mania denotes a complete loss of insight.
    E. Three or more episodes of hypomania and at least one episode of depression must have occurred.
A

A

67
Q

In severe depressive illness the following are true EXCEPT :( CHOOSE ONE)
A. Delusions of guilt or unworthiness are characteristic features of psychotic depression.
B. If hallucinations occur, they are usually congruent with mood.
C. Paranoid delusions may occur.
D. Around 15% of patients take their own lives
E. Hallucinatory voices, if they occur, characteristically speak about rather than to, the patient

A

A

Psychiatry (17 decks)

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