Psychiatry - Mental disorders

Question 1

PSY - 4.1
The following are characteristics of delirium tremens, except for:

A) high risk for suicide
B) fluctuating confusion
C) signs of autonomic hyperactivity
D) tactile hallucinations

Answer 1

ANSWER
A) high risk for suicide
EXPLANATION
Explanation: The symptoms of delirium tremens (signs of autonomic hyperactivity like hypertension, fever, tachycardia; global confusion, disorientation, perceptual disorders as a result of withdrawal from alcohol) make the person unable to make suicidal plans.

Question 2

PSY - 4.2
The person has clear consciousness. He can hear voices that are talking about him and threatening him. For the person, the voices seem to be reality and they are a very disturbing experience, which makes him feel intensely anxious. What do you think the diagnosis is?

A) delirium tremens
B) alcoholic hallucinosis
C) dementia
D) panic disorder
E) obsessive-compulsive disorder

Answer 2

ANSWER
B) alcoholic hallucinosis
EXPLANATION
Explanation: Auditory hallucinations especially threatening voices and hearing dialogues that result in severe anxiety in the person without an altered level of consciousness are all characteristics of alcoholic hallucinosis.

Question 3

PSY - 4.3
The following are typical sympoms of delirium tremens, except for:

A) tonic-clonic (grand mal) seizures at onset
B) auditory hallucinations without an altered level of consciousness and disorientation
C) shaking, sweating
D) confusion
E) disorientation

Answer 3

ANSWER
B) auditory hallucinations without an altered level of consciousness and disorientation
EXPLANATION
Explanation: Both consciousness and attention are altered in delirium tremens (global confusion) and disorientation is also present as the most characteristic symptoms.

Question 4

PSY - 4.4
Among the following, what are the interpersonal relationships of persons with alcohol problems characterised by the most?

A) a high number of reliable friends
B) simplicity of making friends
C) deep and close associations with certain persons
D) simple formation of social relations, but these are not durable
E) generosity, helpfulness, reliability

Answer 4

ANSWER
D) simple formation of social relations, but these are not durable
EXPLANATION
Explanation: Persons with alcohol problems tend to make superficial friendships easily but they show as little endurance in social relations as in any other fields of life.

Question 5

PSY - 4.5
Delirium tremens due to alcohol withdrawal are to be treated with the following:

1) benzodiazepines
2) vitamin B complex (or thiamine)
3) potassium and magnesium preparations
4) disulfiram

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 5

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
Explanation: In the treatment of delirium tremens benzodiazepines play a crucial role in alleviating both the autonomic symptoms and psychomotor restlessness and preventing seizures. The replacement of potassium and magnesium as well as B vitamins is also essential since their concentrations in the blood are typically low in delirium tremens.

Question 6

PSY - 4.6
What is/are the most characteristic symptom(s) of delirium tremens?

1) tremor
2) sweating
3) confusion
4) perceptual disorders

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 6

ANSWER
E) all of the answers are correct
EXPLANATION
Delirium tremens is usually caused by withdrawal from alcohol. Its characteristic symptoms are global confusion, disorientation, perceptual disorders (hallucinations), tremor, sweating and other signs of autonomic hyperactivity.

Question 7

PSY - 4.7
Wernicke’s encephalopathy is characterised by the following:

1) sudden onset
2) nystagmus and ophtalmoplegia
3) confusion along with somnolence
4) lesions of the mammillary bodies

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 7

ANSWER
E) all of the answers are correct
EXPLANATION
Wernicke’s encephalopathy (Wernicke’s disease) is a consequence of long-term alcohol abuse. It is associated with periaqueductal gray haemorrhages at the level of lamina quadrigemina (superior colliculus). Thiamine deficiency appears to be the most important etiological factor. Its onset is usually sudden and its most common symptoms are vertical nystagmus, opthalmoplegia, ataxia and confusion.

Question 8

PSY - 4.8
The diagnostic criterion/criteria for alcohol dependence is/are the following:

1) tolerance (need for increased amounts of alcohol to achieve desired effect)
2) characteristic withdrawal syndrome for alcohol when attempting to stop use
3) a great deal of time spent in activities necessary to obtain or to use alcohol and important social, occupational or recreational activities given up or reduced because of drinking
4) craving

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 8

ANSWER
E) all of the answers are correct
EXPLANATION
Tolerance and withdrawal syndrome are the symptoms of physical dependence, whereas the dominance of activities necessary to obtain or to use alcohol and craving are the manifestation of psychological dependence.

Question 9

PSY - 4.9
The diagnostic criterion/criteria for alcohol abuse is/are the following:

1) failure to fulfill major role obligations at work, school or home
2) alcohol use in situations in which it is physically hazardous
3) alcohol-related legal problems
4) continued alcohol use despite having persistent or recurrent social or interpersonal problems

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 9

ANSWER
E) all of the answers are correct
EXPLANATION
In alcohol abuse there is a continued maladaptive pattern of drinking despite social, occupational, legal, etc. problems caused by effects of alcohol and the criteria for alcohol dependence (tolerance, withdrawal syndrome, psychological dependence) are never met.

Question 10

PSY - 4.10
The following statement(s) is/are true for the neurobiolgy of alcohol use:

1) Alcohol affects several neurotransmitter systems.
2) Chronic alcohol use does not affect the operation of the reward system in the brainstem.
3) The endogenous opioid system plays a role in the appearance of euphoria following alcohol consumption.
4) Alcohol does not influence the operation of cortical areas (e.g. prefrontal cortex).

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 10

ANSWER
B) only the 1st and 3rd answers are correct

EXPLANATION
Chroninc alcohol use affects several neurotransmitter systems (glutamate, dopamine, endogenous opiates) resulting in affecting the physiological operation of brainstem pathways of reward, prefronatlcortex and hippocampus.

Question 11

PSY - 4.14
Which test(s) is/are to be performed to find the correct diagnosis?
A 16-year-old girl has arrived at the outpatient ward with her mother. In the past few months she has lost 15 kilos. She goes running every day. She has insomnia.

1) urine drug test
2) calculating body mass index
3) concentrations of thyroid hormones (blood test)
4) polysomnography

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 11

ANSWER
A) only the1st, 2nd and 3rd answers are correct
EXPLANATION
The concentrations of thyroid hormones need to be determined to exlude hyperthyreosis. Amphetamine is detectable in urine, therefore the urine drug test is also necessary. Anorexia nervosa is based on BMI, so that is to be calculated, as well. However, none of the above mentioned tests is diagnostic in itself.

Question 12

PSY - 4.15
What do you think his most likely diagnosis was?

An 18-year-old man arrived at the hospital on Sunday morning. He was accompanied by his friends. His symptoms were sweating, tachycardia, dilated pupils, psychomotor agitation. His behaviour was hostile, full of anger and he felt furious.
A) alcohol intoxication
B) heroin intoxication
C) acute psychotic state of schizophrenia
D) cocaine intoxication
E) none of the above

Answer 12

ANSWER
D) cocaine intoxication
EXPLANATION
The person’s symptoms were characteristic signs of cocaine or other psychostimulant intoxication

Question 13

PSY - 4.17
Among the following which is not a characteristic symptom of heroin overdose?

A) dilated pupils
B) hypotension
C) hyporeflexia
D) coma
E) respiratory depression

Answer 13

ANSWER
A) dilated pupils
EXPLANATION
A heroin overdose may result in extremely small pupils, sometimes as small as head of a pin (“pinpoint pupils”).

Question 14

PSY - 4.18
Among the following substances which may cause physical dependence?

A) benzodiazepines
B) opiates
C) alcohol
D) all of the above
E) none of the above

Answer 14

ANSWER
D) all of the above
EXPLANATION
All of the above mentioned substance are capable of causing physical dependence as a result of chronic use.

Question 15

PSY - 4.19
The following statements are true except for:

A) Besides “classical drugs” there are a lot of synthetic, so-called designer drugs that have been used recently.
B) Standard urine drug tests are incapable of detecting designer drugs.
C) Synthetic amphetamines, sytnthetic opioids and synthetic cannabionids are all designer drugs.
D) Pathomechanism and possible adverse effects of designer drugs are clearly known.
E) There is an inappropriate legal regulation regarding the use of designer drugs.

Answer 15

ANSWER
D) Pathomechanism and possible adverse effects of designer drugs are clearly known.
EXPLANATION
In most of the cases, neither the pathomechanism, nor the effects and adverse effects of designer drugs are known.

Question 16

PSY - 4.20
The following play(s) a role in the long-term treatment of substance-related mental disorders:

1) self-help groups (Narcotics Anonymous)
2) rehabilitation centres and therapeutic communities
3) social skills training and improving coping skills
4) family interventions and community-based interventions

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 16

ANSWER
E) all of the answers are correct
EXPLANATION
The long-term treatment of substance abuse and dependence is to be complex and individually tailored involving as many of the above mentioned psychosocial interventions as possible since all of them may have a role in the therapy

Question 17

PSY - 4.22
Which of the following statement(s) is/are true?

1) Heroin was temporarily used to treat morphinism.
2) Cocaine used to play a role in the treatment of several diseases at the beginning of the 20th century.
3) Cannabis and its derivatives may have a role in the treatment of glaucoma, cancer-related pain and chemotherapy-induced nausea.
4) Some amphetamine derivatives are used in the therapy for ADHD.

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 17

ANSWER
E) all of the answers are correct
EXPLANATION
A lot of illicit drugs and similar chemical structures are used as medicine

Question 18

PSY - 4.23
Rapid cycling is a special form of bipolar disorder, this means that:

A) the patient has flight of ideas
B) the case isn’t characterized by anxiety.
C) 4 relapses during a period of 5 years
D) Disease episodes follow each other rapidly, the patient has at least 4 different episodes in one year.
E) considerable psychomotor agitation

Answer 18

ANSWER
D) Disease episodes follow each other rapidly, the patient has at least 4 different episodes in one year.
EXPLANATION
Explanation: The definition of rapid cycling is 4 episodes within one year

Question 19

PSY - 4.24
In which condition do patients experience the most severe anxiety after awakening in the early morning hours?

A) post-stroke depression
B) major depression
C) pharmacogenic depression
D) abstinential depression

Answer 19

ANSWER
B) major depression
EXPLANATION
Major depression is characterized by diurnal rhythm dysbalance, patients have insomnia, wake very early and can’t get back to sleep. They also experience their condition’s vicious cycle and develop anxiety.

Question 20

PSY - 4.25
Which is the most common delusion in depression?

A) delusion of theft
B) delusion of guilt and self-accusation
C) persecutory delusion
D) delusions of reference

Answer 20

ANSWER
B) delusion of guilt and self-accusation
EXPLANATION
Delusions are observed in some cases of depression. These delusions are holothymic, fitting into the themes of the depression. Common delusions include hypochondriacal delusions or delusions of guilt.

Question 21

PSY - 4.26
The longitudinal disease course of affective psychoses is characterized by:

A) circularly returning disease episodes
B) slow progression
C) acute worsening of condition alternating with slow progression
D) single episode
E) dementia

Answer 21

ANSWER
A) circularly returning disease episodes
EXPLANATION
Affective psychoses are characterized by circularly returning episodes, symptoms usually resemble symptoms of the previous episode.

Question 22

PSY - 4.28
The following statements are true for bipolar disorder, except:

A) it often runs in families
B) all manic episodes are followed by depression
C) equal distribution between sexes
D) usually begins before the age of 30 years
E) increased risk of substance abuse and suicide

Answer 22

ANSWER
B) all manic episodes are followed by depression
EXPLANATION
It is not a necessary criterion of bipolar affective disorder that all episodes have to be followed by an episode of opposite direction.

Question 23

PSY - 4.29
41 year old male patient complains that he hasn’t accomplished anything in the last 8 years, he feels dissatisfied and unhappy. 12 years ago, when his girlfriend left him he felt depressed. What is the most probable diagnosis?

A) Psychotic depression
B) Schizophrenia
C) Bipolar depression
D) Dysthymia
E) Cyclothymia

Answer 23

ANSWER
D) Dysthymia
EXPLANATION
The chronic dissatisfaction, unhappiness, low self-esteem makes dysthymia the most probable diagnosis. This might have been superposed by a major depressive episode 12 years ago.

Question 24

PSY - 4.30
Symptoms of mania except for:

1) aggression
2) egodiastole
3) secondary incoherence
4) increased critical insight

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 24

ANSWER
D) only the 4th answer is correct
EXPLANATION
Explanation: Mania is characterized by the decrease of critical insight, not the increase, the other 3 symptoms are very typical.

Question 25

PSY - 4.31
Potential complications of untreated affective disorders:

1) suicide
2) pseudologia phantastica
3) alcohol dependence
4) vascular dementia
5) social dysfunction and isolation
6) bulimia
7) tardive dyskinesia

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the1st, 3rd and 5th answers are correct
D) only the 2nd, 3rd and 5th answers are correct
E) only the1st, 2nd, 3rd, 5th and 7th answers are correct
F) only the 2nd, 3rd, 6th and 7th answers are correct
G) all of the answers are correct

Answer 25

ANSWER
C) only the1st, 3rd and 5th answers are correct
EXPLANATION
Affective disorders are often accompanied by suicide, alcohol abuse and social dysfunction, especially when no treatment is received.

Question 26

PSY - 4.32
What are the features of bipolar disorder type II.?

1) Patients of this disease type are not really bipolar.
2) Fulminant manic symptoms during the manic episodes.
3) Manic symptoms are caused by pharmacological treatment.
4) Episodes of hyperthymia only reach the level of hypomania, and usually don’t require hospitalization.

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 26

ANSWER
D) only the 4th answer is correct
EXPLANATION
Bipolar disorder type II, is characterized by less severe hypomanic episodes, alternating with periods of severe depression.

Question 27

PSY - 4.33
Somatic symptoms of depression:

1) insomnia
2) delusions of guilt and self-accusation
3) decreased appetite
4) concentration problems

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 27

ANSWER
B) only the 1st and 3rd answers are correct
EXPLANATION
Explanation: insomnia and decreased appetite are typical somatic symptoms in depression, the other two symptoms also occur frequently but aren’t somatic.

Question 28

PSY - 4.35
Which of the following symptoms are typical for the manic condition?

1) distractibility and increased self-esteem
2) holothymic perceptual disturbances and delusions of grandeur
3) increased activity and decreased need for sleep
4) a specific external factor before the appearance of symptoms

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 28

ANSWER
A) only the1st, 2nd and 3rd answers are correct
EXPLANATION
All of the above symptoms are typical for mania, but there doesn’t have to be necessarily an external eliciting factor.

Question 29

PSY - 4.36
Which of the following medications can cause manic symptoms?

1) cocaine, speed (metamphetamin)
2) corticosteroids
3) high dose antidepressants
4) reserpine

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 29

ANSWER
B) only the 1st and 3rd answers are correct
EXPLANATION
high dose of antidepressants and psychostimulants can provoke manic symptoms. Reserpine and corticosteroids usually cause depression.

Question 30

PSY - 4.37
Sleep pattern in major depression is characterized by the following changes:

1) frequent frightening dreams and awakenings
2) both falling asleep (sleep onset) and awakening happens earlier than usual
3) 4th phase sleep (delta-phase) is increased
4) decreased REM-latency

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 30

ANSWER
C) only the 2nd and 4th answers are correct
EXPLANATION
Typical changes during sleep in MDD patients include early sleep onset, wakening, and decreased REM-latency

Question 31

PSY - 4.38
Which disorders should be considered while establishing a differential diagnosis for affective disorders?

1) expansive intracranial process
2) thyroid gland dysfunction
3) phaeochromocytoma
4) adult ADHD (attention deficit and hyperactivity disorder)

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 31

ANSWER
E) all of the answers are correct
EXPLANATION
All of these conditions might cause affective symptoms and resemble affective disorders, therefore all of them should be considered during the differential diagnostic process.

Question 32

PSY - 4.39
Patients with severe depression are most probably:

1) reckless and careless
2) agitated and anxious
3) hostile and dismissive
4) sad, unhappy and anhedonic

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 32

ANSWER
C) only the 2nd and 4th answers are correct
EXPLANATION
In severe depression patients are agitated, anxious, experience sadness and anhedonia.

Question 33

PSY - 4.40
Characteristics of dysthymia:

1) chronic fatigue
2) social withdrawal
3) insomnia
4) hypersomnia

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 33

ANSWER
E) all of the answers are correct
EXPLANATION
All of these symptoms, chronic fatigue, social withdrawal, insomnia and/or hypersomnia can be a symptom of dysthymia.

Question 34

PSY - 4.41
A 22 year old university student suddenly demonstrates elevated mood at the end of an exam period, his appearance becomes markable and bold, his behavior is careless, he has no critical insight. He is active all the time, spends a lot of money, doesn’t feel tired for more than one week. He has no illness insight, he describes his condition as “superhappy”. Which are probable diagnoses:

1) personality disorder
2) narcomania
3) primitive reaction
4) manic or hypomanic episode

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 34

ANSWER
D) only the 4th answer is correct
EXPLANATION
Explanation: the pressured psychomotor speed, the reckless behavior, the increased unnecessary spending, and the elevated mood are very typical for mania.

Question 35

PSY - 4.42
Typical symptoms of depression:

1) decreased capability to concentrate
2) hypochondriasis
3) weight loss
4) perceptual disturbances

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 35

ANSWER
A) only the1st, 2nd and 3rd answers are correct
EXPLANATION
concentration problems, weight loss and hypochondriacal thoughts are very typical in depression, perceptual disturbances (i.e. hallucinations) are very uncommon.

Question 36

PSY - 4.44
Who gave schizophrenia its name?

A) Emil Kraepelin
B) Eugen Bleuler
C) William Cullen
D) Kurt Schneider
E) Karl Kleist

Answer 36

ANSWER
B) Eugen Bleuler
EXPLANATION
E. Bleuler considered the presence of schisms between thought, emotion and behaviour the essence of the disorder. In 1911, he labelled it schizophrenia uniting the Greek roots szkidzein (to split) and frenosz (mind)

Question 37

PSY - 4.45
The following are the negative symptoms of schizophrenia except for:

A) apathy
B) alogia
C) lack of motivation
D) delusional guilt, sin, worthlessness
E) social withdrawal

Answer 37

ANSWER
D) delusional guilt, sin, worthlessness
EXPLANATION
delusions belong to the group of positive symptoms, regardless of their content.

Question 38

PSY - 4.47
The diagnosis of schizophrenia is primarily based on:

A) clinical observation and the analysis of symptoms
B) alterations in biological markers
C) the Rorschach test
D) Positive and Negative Syndrome Scale
E) the MAWI test (the Hungarian version of Wechsler Adult Intelligence Scale)

Answer 38

ANSWER
A) clinical observation and the analysis of symptoms
EXPLANATION
The diagnosis is based on the thorough exploration of symptoms of perception, behaviour and motor activity. Projective and personality tests may indicate abnormalities present in schizophrenia, but the contribution to diagnosis is low. Up to date, there is no laboratory test for schizophrenia.

Question 39

PSY - 4.49
The following are characteristic of the prodromal phase of schizophrenia except for:

A) it usually begins following puberty
B) presence of changes in perceptual experiences, behaviour, performance
C) progressively intensifying symptoms
D) lack of insight
E) it usually lasts for 2-5 years

Answer 39

ANSWER
D) lack of insight
EXPLANATION
in the prodromal phase of schizophrenia the person has some doubts that their “mild” psychotic experiences are real.

Question 40

PSY - 4.50
The following may have a role in the etiology of schizophrenia:

1) dysfunction of dopaminergic systems
2) alteration in NMDA(N-methyl-D-aspartate)-transmission
3) abnormal brain development
4) alteration in GABAergic transmission in the cerebral cortex

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 40

ANSWER
E) all of the answers are correct
EXPLANATION
all of the above mentioned factors have been proven to have a potential role in the etiology of schizophrenia, but none of them can be regarded as a clear etiological factor.

Question 41

PSY - 4.51
The following diagnosis/diagnoses are to be exluded when diagnosing schizophrenia:

1) Inflammation in central nervous system like anti-NMDA receptor encephalitis
2) Illicit drug abuse
3) Psychotic depression
4) Schizoaffective psychosis
5) Tumor

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 41

ANSWER
E) all of the answers are correct
EXPLANATION
schizophrenialike symptoms may be present in all of the above mentioned conditions, therefore all of them must be excluded before the diagnosis of schizophrenia

Question 42

PSY - 4.52
The following is/are characteristic(s) of the course of schizophrenia:

1) it is always episodic
2) the acute phase is usually preceeded by a prodromal phase
3) there are neither delusions nor hallucinations in remissions
4) in remission behaviour is anot altered by delusions and/or hallucinations

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 42

ANSWER
C) only the 2nd and 4th answers are correct
EXPLANATION
In the majority of cases, the symptoms of schizophrenia show a slow and gradual development (prodromal phase) followed by a chronic course. In the state called remission psychotic symptoms (delusions, hallucinations) may still be present, but these do not alter the person’s behaviour (residual symptoms).

Question 43

PSY - 4.53
Observing behaviour change one suspects psychosis when

1) the change is socially unreasonable
2) the behaviour is threatening personal safety and property
3) the change is inexplicable from the person’s aspect
4) the behaviour is different from what is culturally accepted

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 43

ANSWER
B) only the 1st and 3rd answers are correct
EXPLANATION
one may suspect psychosis when the change in behaviour is socially unreasonable and it is inexplicable from the person’s aspect

Question 44

PSY - 4.55
The following is/are the characteristic(s) of delusional disorder:

1) elaborate and systematized delusions
2) other criteria for schizophrenia are not fulfilled
3) impaired insight and judgement regarding delusions
4) development is not to be linked to a ‘key experience’
5) psychodynamic factors do not play a role in the development of delusions

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 44

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
In the development of delusional disorder both ‘key experiences’ and psychodynamic factors have a significant role.

Question 45

PSY-4.56.1-4.56.5
In which type of psychosis are the following psychiatric symptoms prominent? Match the symptoms with the most probable diagnosis. Diagnoses:

A) mood-congruent delusion
B) primary incoherence
C) echopraxia
D) real visual hallucinations

PSY - 4.56.1 - Drug-induced psychosis
PSY - 4.56.2 - Disorganized type of schizophrenia
PSY - 4.56.3 - Catatonic type of schizphrenia
PSY - 4.56.4 - Mania
PSY - 4.56.5 - Major depression

Answer 45

ANSWER
PSY - 4.56.1 - Drug-induced psychosis - D)
PSY - 4.56.2 - Disorganized type of schizophrenia - B)
PSY - 4.56.3 - Catatonic type of schizphrenia - C)
PSY - 4.56.4 - Mania - A)
PSY - 4.56.5 - Major depression - A)

Question 46

PSY-4.57.1-4.57.4
Who invented the following classifications of the symptoms of schizophrenia? Match the dichotomies with a name.

A) Eugen Bleuler
B) Kurt Schneider
C) Timothy Crow
D) Karl Leonhard

PSY - 4.57.1 - positive and negative symptoms
PSY - 4.57.2 - fundamental and accessory symptoms
PSY - 4.57.3 - first-rank and second-rank symptoms
PSY - 4.57.4 - systematic and unsystematic schizophrenias

Answer 46

ANSWER
PSY - 4.57.1 - positive and negative symptoms - C)

PSY - 4.57.2 - fundamental and accessory symptoms - A)

PSY - 4.57.3 - first-rank and second-rank symptoms - B)

PSY - 4.57.4 - systematic and unsystematic schizophrenias - D

Question 47

PSY-4.58.1-4.58.5
Which group of symptoms do the following refer to? Match the symptoms with an appropriate group.

A) positive symptoms
B) negative symptoms
C) affective symptoms
D) symptoms affecting neurocognition

PSY - 4.58.5 - alogia
PSY - 4.58.4 - working memory disorder
PSY - 4.58.2 - ambivalence
PSY - 4.58.1 - auditory hallucinations
PSY - 4.58.3 - dysthymia

Answer 47

ANSWER
PSY - 4.58.5 - alogia - B)
PSY - 4.58.4 - working memory disorder - D)
PSY - 4.58.2 - ambivalence - B)
PSY - 4.58.1 - auditory hallucinations - A)
PSY - 4.58.3 - dysthymia - C)

Question 48

PSY-4.59.1-4.59.4
Principles of choosing an antipsychotic. Match a medication with an appropriate indication.

A) Long-acting haloperidol depot medication (injected IM)
B) Clozapine
C) Aripiprazole
D) Haloperidol injected IM (short-term treatment)

PSY - 4.59.1 - treatment-resistance; high suicide risk
PSY - 4.59.2 - chronic disease; numerous relapses as a result of medication non-compliance
PSY - 4.59.3 - metabolic syndrome; extrapyramidal neurological adverse effects and endocrine effects (increased secretion of prolactin) in past history
PSY - 4.59.4 - first admission: agitation, hostility

Answer 48

ANSWER
PSY - 4.59.1 - treatment-resistance; high suicide risk - B)

PSY - 4.59.2 - chronic disease; numerous relapses as a result of medication non-compliance - A)

PSY - 4.59.3 - metabolic syndrome; extrapyramidal neurological adverse effects and endocrine effects (increased secretion of prolactin) in past history - C)

PSY - 4.59.4 - first admission: agitation, hostility - D

Question 49

PSY - 4.65
What is likely to be the diagnosis?

The 24-year-old patient has been admitted to hospital for the second time. His sympoms appeared about 2 years ago. He has trouble focusing his attention, he feels anxious and low, and has suicidal ideation. He withdrew from his university studies due to learning difficulties. ’I always had to listen to music in order to be able to concentrate.’ he said. He has been seeing his friends rarely recently and he has given up sports, too. His father is an eccentric and reserved person, who has never been under psychiatric treatment. When being hospitalised for the first time, the patient was diagnosed with mixed anxiety-depressive disorder and he was prescribed tranquillisers and antidepressants. After a short period of taking this medication, he changed his pills for paleolithic diet on his mother’s advice. Current state of mind: auditory hallucinations, bizarre cenesthopathic symptoms, paranoid delusions, obsessive thoughts, anxiety, tension, suicidal ideation, lack of insight

.A) Mixed anxiety-depressive disorder
B) Recurrent depression
C) Obsessive-compulsive disorder (OCD)
D) Schizophrenia
E) Schizoid personality disorder

Answer 49

ANSWER
D) Schizophrenia
EXPLANATION
Explanation: the number and the duration of prominent symptoms like auditory hallucinations, cenesthopathy and delusions meet the criteria for schizophrenia.

Question 50

PSY - 4.66
What indicate(s) a high risk for suicide?

The 24-year-old patient has been admitted to hospital for the second time. His sympoms appeared about 2 years ago. He has trouble focusing his attention, he feels anxious and low, and has suicidal ideation. He withdrew from his university studies due to learning difficulties. ’I always had to listen to music in order to be able to concentrate.’ he said. He has been seeing his friends rarely recently and he has given up sports, too. His father is an eccentric and reserved person, who has never been under psychiatric treatment. When being hospitalised for the first time, the patient was diagnosed with mixed anxiety-depressive disorder and he was prescribed tranquillisers and antidepressants. After a short period of taking this medication, he changed his pills for paleolithic diet on his mother’s advice. Current state of mind: auditory hallucinations, bizarre cenesthopathic symptoms, paranoid delusions, obsessive thoughts, anxiety, tension, suicidal ideation, lack of insight.

1) male sex
2) depressive symptoms
3) young age
4) social dysfunction
5) high level of social functioning before the disease (he was a university student)

A) only the1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct.

Answer 50

ANSWER
E) all of the answers are correct.
EXPLANATION
all the factors mentioned above may raise the risk for suicide.

Question 51

PSY - 4.68
In the differential diagnosis of anorexia nervosa you should exclude the followings, except:

A) Tumors
B) Depression
C) Addison’s disease
D) Cushing’s disease
E) Ulcerative colitis

Answer 51

ANSWER
D) Cushing’s disease
EXPLANATION
In Cushing’s disease obesity is present

Question 52

PSY - 4.69
The symptoms of anorexia nervosa are, except:

A) Weight loss is 15% of the ideal weight
B) There is a body image distortion
C) There is a high suicidal risk at the beginning of the illness
D) It can start at the age of 14

Answer 52

ANSWER
C) There is a high suicidal risk at the beginning of the illness
EXPLANATION
Explanation: Suicidal risk is not hight at the beginning of the illness

Question 53

PSY - 4.70
Anorexia nervosa can be comorbid with:

A) OCD
B) Depression
C) Social phobia
D) Lack of sexual interest
E) All of the above

Answer 53

ANSWER
E) All of the above

Question 54

PSY - 4.72
The patient is publicly exposing his genitals to strange women or girls. The phenomenon is called:

A) Sadism
B) Exhibitionism
C) Pedophilia
D) Transvestism

Answer 54

ANSWER
B) Exhibitionism
EXPLANATION
In exhibitionism the violation of a strange woman’s privacy is involved.

Question 55

PSY - 4.74
Which is the most common cause of the lack of sexual activity in marriage?

A) Old age
B) Marital conflict
C) Depression
D) Somatic illness

Answer 55

ANSWER
B) Marital conflict
EXPLANATION
The most common cause is marital conflict, lack of attunement and communication between partners

Question 56

PSY - 4.75
The phase of human sexual response that occurs after desire is called:

A) Resolution phase
B) Orgasmic phase
C) Excitement phase
D) Ejaculatory phase

Answer 56

ANSWER
C) Excitement phase
EXPLANATION
The stages of normal male sexual response are desire, excitement, orgasm and resolution

Question 57

PSY - 4.77
A patient who has a pervasive and unwarranted tendency to interpret other persons’ actions as deliberatly threatening, has:

A) Schizoid personality disorder
B) Paranoid personality disorder
C) Antisocial personality disorder
D) Narcissistic personality disorder

Answer 57

ANSWER
B) Paranoid personality disorder
EXPLANATION
These patients are characterized by long-standing suspiciousness and mistrust of persons in general.

Question 58

PSY - 4.78
The patient who is superstitious or claims powers of clairvoyance and believes that he has special powers of thought suffers from

A) Bipolar affective disorder
B) Schizotypal personality disorder
C) Borderline personality disorder
D) Schizophrenia

Answer 58

ANSWER
B) Schizotypal personality disorder
EXPLANATION
This disorder occurs in about 3 percent of the population

Question 59

PSY - 4.81
Diagnostic criteria for antisocial personality disorder:

A) Impulsivity
B) Failure to conform to social norms
C) Irritablity
D) Repeated lying
E) All of the above

Answer 59

ANSWER
E) All of the above

Question 60

PSY - 4.82
Which of the following subtype of personality disorders is more common in men?

A) Borderline
B) Antisocial
C) Dependent
D) Histrionic

Answer 60

ANSWER
B) Antisocial
EXPLANATION
The male/female sex ratio is 7:1

Question 61

PSY - 4.84
Somatization disorder is often comorbid with:

A) Paranoid personality disorder
B) Histrionic personality disorder
C) Narcissistic personality disorder
D) Dependent personality disorder
E) Passive-agressive personality disorder

Answer 61

ANSWER
B) Histrionic personality disorder
EXPLANATION
Somatoform symptoms are common

Question 62

PSY - 4.86
What differentiates transient tic disorder from Tourette syndrome?

A) The onset of illness
B) In transient tic disorder there are only motor tics
C) In transient tic disorder there are only vocal tics
D) The duration of symptoms

Answer 62

ANSWER
D) The duration of symptoms
EXPLANATION
In transient tic disorder the duration of the symptomatlogy is less than 1 year

Question 63

PSY - 4.88
Which of the following is not a pervasive developmental disorder?

A) Autism
B) Rett syndrome
C) Münchausen syndrome
D) Asperger syndrome

Answer 63

ANSWER
C) Münchausen syndrome
EXPLANATION
Pervasive developmental disorders are disorders with deficits in social communication and behavioral skills.

Question 64

Typical in Prader-Willi syndrome:

A) Hyperphagia
B) Self-injury
C) ‘Coctail party psyche’
D) Average intellectual functioning

Answer 64

ANSWER
A) Hyperphagia
EXPLANATION
Due to hyperphagia obesity appears

Question 65

PSY - 4.90
The child is not willing to speak in the school, but at home speaks well. The disorder is:

A) Autism
B) Selective mutism
C) Mental retardation
D) None of the above

Answer 65

ANSWER
B) Selective mutism
EXPLANATION
Anxiety is at the background

Question 66

PSY - 4.91
The most common learning disability is:

A) Dyscalculia
B) Dysgraphia
C) Dyslexia
D) None of the above

Answer 66

ANSWER
C) Dyslexia
EXPLANATION
The specific developmental disturbances of the prevalence of dyslexia are the most common, 4 % of the population

Question 67

PSY - 4.92
Typical for Lesh-Nyhan syndrome:

A) Self-biting behavior
B) Consequence of HGPRT deficit
C) Mental retardation
D) Accumulation of uric acid
E) All of the above

Answer 67

ANSWER
E) All of the above

Question 68

PSY - 4.93
Concerning Tourette syndrome, which of the following statements is false?

A) It is characterized by motor and vocal tics
B) Its prevalence is around 5 per 10 000
C) It is usually associated with OCD
D) It does not cause distress

Answer 68

ANSWER
D) It does not cause distress

Question 69

PSY - 4.94
Which of the following is not a feature of Down syndrome?

A) High-arched palate
B) Short stature
C) Protuding tongue
D) Kayser-Fleischer ring
E) Simian crease

Answer 69

ANSWER
D) Kayser-Fleischer ring
EXPLANATION
Kayser-Fleischer rings are typical for Wilson’s disease.

Question 70

PSY - 4.95
Conduct disorder includes all of the following, except:

A) Cruelty to animals
B) Agression to humans
C) Destruction of property
D) Obeying rules

Answer 70

ANSWER
D) Obeying rules
EXPLANATION
In conduct disorder disregard of rules can be seen.

Question 71

PSY - 4.96
In moderate mental retardation the IQ is between:

A) 50-70
B) 30-50
C) <30

Answer 71

ANSWER
B) 30-50
EXPLANATION
In the case of moderate mental retardation, the IQ is between 30 and 50.

Question 72

PSY - 4.97
Similarly to Prader-Willi syndrome, a deletion on the 15th chromosome can be detected in:

A) Williams syndrome
B) Angelman syndrome
C) Di George syndrome
D) None of the above

Answer 72

ANSWER
B) Angelman syndrome
EXPLANATION
The deletion in Angelman syndrome has a maternal origin, while in Prader-Willi syndrome a paternal origin is present

Question 73

PSY - 4.98
These are the diagnostic criteria of dementia, EXCEPT:

A) memory loss
B) amentia, alexia, agoraphobia
C) behavioural change
D) impaired executive functions
E) aphasia, agnosia, apraxia

Answer 73

ANSWER
B) amentia, alexia, agoraphobia
EXPLANATION
Explanation: amentia, alexia, agoraphobia are not among diagnostic criteria of dementia

Question 74

PSY - 4.99
Definite diagnosis of Alzheimer’s disease can be determined by:

A) CT
B) EEG
C) laboratory results
D) neurological examination
E) none of the above

Answer 74

ANSWER
E) none of the above
EXPLANATION
The definite diagnosis of Alzheimer’s disease can be determined by histopathology, CT/MRI and SPECT/PET can help to exclude other disorders.

Question 75

PSY - 4.100
Which one is a reversible dementia of the following:

A) Pick’s disease
B) Post-stroke dementia
C) Parkinson’s disease
D) Alzheimer’s disease
E) Lewy body dementia

Answer 75

ANSWER
B) Post-stroke dementia
EXPLANATION
Post-stroke dementia is a vascular type of dementia, which is potentially reversible.

Question 76

PSY - 4.101
These are true in the differentiation of depressive pseudodementia and dementia, EXCEPT:

A) dismissive behaviour in pseudodementia (“don’t know” answers)
B) undue fluctuation of performance in pseudodementia
C) in dementia in spite of memory impairment complaints of memory problems are often lacking
D) personality change is typical for pseudodementia
E) in pseudodementia a family history of affective disorders is frequent

Answer 76

ANSWER
D) personality change is typical for pseudodementia
EXPLANATION
Personality change is typical for dementia, especially for Alzheimer’s disease. In pseudodementia depressive symptoms are typical.

Question 77

PSY - 4.103
Which of the following is helpful to differentiate vascular dementia and Alzheimer’s disease?

1) MMSE (“Mini Mental State Exam”)
2) Wechsler IQ Test
3) Dementia Index in IQ tests
4) Hachinski Ischaemic Score

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 77

ANSWER
D) only the 4th answer is correct
EXPLANATION
In the differentiation between vascular dementia and Alzheimer’s disease the Hachinski Ischaemic Scale is helpful.

Question 78

PSY-4.104.1-4.104.5
Match the supposed pathology of Alzheimer’s disease with the method of examination!

A) MRI
B) SPECT
C) FDG-PET
D) histopathology

PSY - 4.104.1 - temporo-parietal hypoperfusion
PSY - 4.104.2 - β-amyloid deposition (senile plaque)
PSY - 4.104.3 - neurofibrillary tangle
PSY - 4.104.4 - temporo-parietal hypometabolism
PSY - 4.104.5 - hippocampal atrophy

Answer 78

ANSWER
PSY - 4.104.1 - temporo-parietal hypoperfusion - B)

PSY - 4.104.2 - β-amyloid deposition (senile plaque) - D)

PSY - 4.104.3 - neurofibrillary tangle - D)

PSY - 4.104.4 - temporo-parietal hypometabolism - C)

PSY - 4.104.5 - hippocampal atrophy - A

Question 79

PSY-4.105.1-4.105.5
Match the features with the diagnoses!

A) Alzheimer type of dementia
B) Vascular dementia
C) Parkinson’s disease

PSY - 4.105.1 - temporo-parietal atrophy
PSY - 4.105.2 - multiplex lacunar infarct
PSY - 4.105.3 - hippocampal atrophy
PSY - 4.105.4 - decreased dopamine function
PSY - 4.105.5 - stroke

Answer 79

ANSWER
PSY - 4.105.1 - temporo-parietal atrophy - A)
PSY - 4.105.2 - multiplex lacunar infarct - B)
PSY - 4.105.3 - hippocampal atrophy - A)
PSY - 4.105.4 - decreased dopamine function - C)
PSY - 4.105.5 - stroke - B)

Question 80

PSY - 4.106
What is the supposed diagnosis according to the symptoms?

A 67-year-old woman got lost in a familiar neighbourhood; she was no longer able to do her housework without help. It was difficult for her to express herself and to calculate. The symptoms got slowly worse. She had no history of previous disorders; there were no detectable internal and neurological pathological signs.
A) Vascular dementia
B) Delirium
C) Alzheimer’s disease
D) Depression

Answer 80

ANSWER
C) Alzheimer’s disease

Question 81

PSY - 4.107
Towards the diagnosis which examination is required?

A 67-year-old woman got lost in a familiar neighbourhood; she was no longer able to do her housework without help. It was difficult for her to express herself and to calculate. The symptoms got slowly worse. She had no history of previous disorders; there were no detectable internal and neurological pathological signs.
1) MMSE
2) Laboratory tests
3) CT/MRI
4) abdominal ultrasound

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 81

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
Disorientation, aphasia, dyscalculia, deteriorating executive dysfunctions, no other medical disorders in the anamnesis, gradual deterioration of the symptoms refer to Alzheimer’s disease. MMSE, laboratory tests, CT/MRI are required to set up the diagnosis.

Question 82

PSY - 4.108
What is the supposed diagnosis according to the symptoms?

A 60-year-old man had hypertension, a month ago he had paraesthesia on the right side of his body for a short period, had trouble to find words, memory impairment also developed. Since then there have been periods without symptoms, then episodes with disorientation, and wandering occurred. His state is fluctuating, at nights agitation can arise.
A) Depression with cognitive impairment
B) Alzheimer’s disease
C) Normal pressure hydrocephalus
D) Vascular dementia

Answer 82

ANSWER
D) Vascular dementia

Question 83

PSY - 4.111
These are organic and symptomatic mental disorders, EXCEPT:

A) delirium
B) dementia
C) amnestic syndrome
D) paranoia
E) organic hallucinosis

Answer 83

ANSWER
D) paranoia
EXPLANATION
Paranoia is a paranoid disorder, not an organic and symptomatic mental disorder.

Question 84

PSY - 4.113
What is the first thing to be done in a case of delirium?

A) to calm the patient
B) quick and careful examination to find the underlining disorder
C) the patient has to be sent to the psychiatry acutely
D) the patient has to be isolated from the other patients

Answer 84

ANSWER
B) quick and careful examination to find the underlining disorder
EXPLANATION
In a case of a delirium quick and careful examination has to be done first to find the underlining disorder and then to start its treatment

Question 85

PSY - 4.114
Which of the following is necessary to do in delirium to clarify the etiopathogenesis?

A) to measure the blood pressure, perform an ECG
B) to check the serum glucose
C) medical and neurological examinations
D) careful laboratory analysis
E) all of the above

Answer 85

ANSWER
E) all of the above
EXPLANATION
In delirium medical and neurological examinations, measurement of vital signs, ECG, careful laboratory analysis including serum glucose are necessary to clarify the etiopathogenesis.

Question 86

PSY - 4.115
Which vitamin deficiency is the fundamental factor in the etiopathogenesis of Korsakov-syndrome?

A) vitamin B6
B) folic acid
C) nicotinic acid
D) vitamin B1
E) vitamin B12

Answer 86

ANSWER
D) vitamin B1
EXPLANATION
In the etiopathogenesis of Korsakov-syndrome vitamin B1 deficiency is fundamental.

Question 87

PSY - 4.116
Which of the following are typical of organic mental disorders?

1) there is a causal relation between the psychopathology and the organic disorders
2) the somatic pathology is preceding the psychopathology
3) the course of the somatic disorder and the mental illness are parallel
4) delirium and dementia can evolve not only on the basis of somatic etiology

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 87

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
There is a causal connection between the psychopathology and organic disorders, the somatic pathology is prior to the psychopathology and the course of somatic disorder and mental illness are parallel. Delirium and dementia can evolve only on the basis of somatic etiology

Question 88

PSY - 4.119
The most frequent reason of delirium:

1) central nervous system disorder
2) alcohol and medical drug intoxication or withdrawal
3) cardiovascular disorders
4) metabolic disorders

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 88

ANSWER
E) all of the answers are correct
EXPLANATION
The frequent reasons of delirium include alcohol and medical drug intoxication or withdrawal, metabolic disorders (e.g. hypoxia, hypo-, or hyperglycaemia, electrolyte imbalance, renal or hepatic failure, anaemia, vitamin deficiency, endocrinopathy), cardiovascular disorders (e.g. cardiac failure, myocardial infarct, arrhythmia, shock), central nervous system disorders (e.g. trauma, epileptic seizure, infection, tumour, cerebrovascular disorder).

Question 89

PSY-4.120.1-4.120.5
Match the features with the diagnoses!

A) organic amnestic syndrome
B) delirium
C) organic delusional (paranoid) disorder

PSY - 4.120.1 - clouding of consciousness
PSY - 4.120.2 - impaired long term memory
PSY - 4.120.3 - hallucinations
PSY - 4.120.4 - delusions
PSY - 4.120.5 - confabulation may be an additional symptom

Answer 89

ANSWER
PSY - 4.120.1 - clouding of consciousness - B)
PSY - 4.120.2 - impaired long term memory - A)
PSY - 4.120.3 - hallucinations - B)
PSY - 4.120.4 - delusions - C)
PSY - 4.120.5 - confabulation may be an additional symptom - A)

Question 90

PSY-4.121.1-4.121.5
Match the features with the diagnoses!

A) organic delusional (paranoid) disorder
B) organic amnestic syndrome
C) Korsakov-syndrome

PSY - 4.121.2 - anterograde and retrograde amnesia

PSY - 4.121.5 - beside the elimination of the underlining disorder antipsychotic drug administration may be necessary

PSY - 4.121.4 - chronic alcohol intake is the etiopathogenetic reason

PSY - 4.121.3 - well-structured delusions

PSY - 4.121.1 - thiamine deficiency

Answer 90

ANSWER
PSY - 4.121.2 - anterograde and retrograde amnesia- B)

PSY - 4.121.5 - beside the elimination of the underlining disorder antipsychotic drug administration may be necessary - A)

PSY - 4.121.4 - chronic alcohol intake is the etiopathogenetic reason - C)

PSY - 4.121.3 - well-structured delusions - A)

PSY - 4.121.1 - thiamine deficiency - C)

Question 91

PSY - 4.122
Which of the following is the least possible diagnosis?

A 60-year-old man was taken to the doctor by his relatives. He visited the family and they noticed that he heard voices, and saw people who were not there. His wife died 10 years ago, since then he had lived reservedly, now he could not take care of himself anymore.
A) delirium
B) schizophrenia
C) dementia
D) depression with psychotic symptoms
E) organic hallucinosis

Answer 91

ANSWER
B) schizophrenia
EXPLANATION
The late onset is not typical for schizophrenia

Question 92

PSY - 4.123
The reason of disorientation and confusion was most likely:

A 43-year-old woman was found in the garage, she was unconscious. The engine of the car was running; the door of the garage was closed. At the time of the medical examination the patient was disoriented, confused. The reason of disorientation and confusion was most likely:
A) lead intoxication
B) hypoxia
C) hypoglycaemia
D) petrol intoxication
E) none of the above

Answer 92

ANSWER
B) hypoxia
EXPLANATION
Hypoxia due to CO intoxication is the most likely reason of the symptoms.

Question 93

PSY - 4.124
What would you do if you were the physician, who examined the person at first?

A middle-aged man was diagnosed with Parkinson’s disease. The pharmacotherapy does not seem to improve the gait disturbance. His mood is decreased. He says that he lost his desire to live, would like “to be rid of everything”, if it were up to him he would sleep all day.

A) send the patient to a psychiatry ward because of the high risk of suicide
B) calm the patient down by saying, that Parkinson’s disease could be treated with medical drugs
C) discuss his worries with the patient empathically, and ask him about his suicidal thoughts and intentions
D) send the patient to a neurologist or psychiatrist to complain about his sorrow
E) recommend the patient to come frequently and alert the relative of the suicide risk

Answer 93

ANSWER
C) discuss his worries with the patient empathically, and ask him about his suicidal thoughts and intentions
EXPLANATION
The mood could be decreased in Parkinson’s disease, and the physician should explore the patient carefully to find the depressive symptoms and assess the suicide risk.

Question 94

PSY - 4.125
Anxiety as a symptom can occur in all of the disorders below with the exception of:

A) hypoglycaemi
B) decreased thyroid function
C) pheochromocytoma
D) porphyria
E) hypocalcaemia

Answer 94

ANSWER
B) decreased thyroid function
EXPLANATION
Characteristic features of the decreased thyroid function can be apathy and the slowing down of the patient, but not anxiety.

Question 95

PSY - 4.126
Which of the following statements are not characteristic agoraphobia?

A) the affected person has an intensive and irrational feeling of fear when he/she has to leave his/her home
B) the affected person is fully aware of the senseless nature of his/her fear
C) the administration of an antidepressant can alleviate it effectively
D) the target of the behavioural therapy is the phobia itself, thus it has no focus on the underlying psychodynamics
E) phobic anxiety disorder rarely occurs after it has been treated at least once.

Answer 95

ANSWER
E) phobic anxiety disorder rarely occurs after it has been treated at least once.
EXPLANATION
In an emotionally burdened life situation anxiety can recur even in case of a treated agoraphobia.

Question 96

PSY - 4.128
Which of the following is not characteristic of specific phobia?

A) it is a disease that has a short course and it does not become chronic even without any treatment
B) the presence of an exaggerated, irrational, constant, recurring fear of well-defined, specific objects or situations.
C) a specific situation can evoke the occurrence of an immediate, intensive bout of anxiety
D) the majority of social phobia cases occur in childhood or in adolescence
E) psychotherapies (e.g. cognitive behavioural therapy, relaxation) have a primary role in its treatment

Answer 96

ANSWER
A) it is a disease that has a short course and it does not become chronic even without any treatment
EXPLANATION
The majority of phobias have a chronic course without treatment.

Question 97

PSY - 4.129
The diagnosis of mixed anxiety depressive disorder is established, if:

A) the patient with depression has marked anxiety
B) both depressive and anxiety symptoms are present, but the severity of neither of them meets the diagnostic criteria
C) the anxiety disorder is accompanied by depressive symptoms
D) the depressive symptoms rapidly improve with antidepressant therapy

Answer 97

ANSWER
B) both depressive and anxiety symptoms are present, but the severity of neither of them meets the diagnostic criteria
EXPLANATION
The above mentioned diagnosis is given if both depressive and anxiety symptoms are present, but the severity of neither of them meets the diagnostic criteria of any other illness

Question 98

PSY - 4.130
Generalised anxiety disorder is often accompanied by the following diseases, with the exception of:

A) panic disorder
B) phobias
C) depression
D) (pathological) substance abuse
E) bipolar disorder, manic type

Answer 98

ANSWER
E) bipolar disorder, manic type
EXPLANATION
Generalised anxiety is very often accompanied by panic disorder, phobias, depression, or substance abuse (e.g. alcohol abuse).

Question 99

PSY - 4.131
Regarding the treatment of specific phobias, improvement can be expected from the following behavioural therapy techniques, with the exception of:

A) exposition to stimulus
B) paradox intention method
C) flooding
D) imaginary, “in vitro” desensitisation
E) “in vivo” desensitisation

Answer 99

ANSWER
B) paradox intention method
EXPLANATION
The paradox intention method is a suggested method for the treatment of obsessive-compulsive symptoms

Question 100

PSY - 4.133
Which can be administered permanently in generalised anxiety disorder?

1) antipsychotics
2) buspirone
3) barbiturate
4) antidepressants

A) only the 1st 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 100

ANSWER
C) only the 2nd and 4th answers are correct
EXPLANATION
Buspirone (which is a non-benzodiazepine anxiolytic drug, with far less probability of addiction) and antidepressants can be administered in the long term treatment of GAD.

Question 101

PSY - 4.134
Which of the following groups does panic syndrome belong to?

1) personality disorders
2) affective disorders
3) vegetative disorders
4) anxiety disorders

A) answers 1, 2 and 3 are correct
B) answers 1 and 3 are correct
C) answers 2 and 4 are correct
D) only answer 4 is correct
E) all of the 4 answers are correct

Answer 101

ANSWER
D) only answer 4 is correct
EXPLANATION
Panic syndrome is a subtype of anxiety disorders (the main feature of it being the strong anxiety occurring during the attacks

Question 102

PSY - 4.135
Which of the following drugs can be used in the treatment of panic disorder?

1) antidepressants
2) antipsychotics
3) anxiolytics
4) neuroleptics
5) cognitive psychotherapy
6) mood stabilizers

A) answers 1 and 2 are correct
B) answers 2, 4 and 6 are correct
C) answers 1, 3 and 5 are correct
D) answers 3, 4 and 6 are correct
E) all of the answers are correct

Answer 102

ANSWER
C) answers 1, 3 and 5 are correct
EXPLANATION
Antidepressants, anxiolytics and cognitive psychotherapy are used in the treatment of panic disorder.

Question 103

PSY - 4.136
They are symptoms of panic disorder:

1) vertigo
2) delusions
3) tachycardia
4) hallucinations
5) sweating
6) fear of death

A) answers 1, 2 and 4 are correct
B) answers 1, 3, 5 and 6 are correct
C) answers 2, 4 and 6 are correct
D) all of the answers are correct

Answer 103

ANSWER
B) answers 1, 3, 5 and 6 are correct
EXPLANATION
The following symptoms are characteristic of panic disorder: vertigo, tachycardia, sweating and the attacks are also accompanied by fear of death.

Question 104

PSY-4.137.1-4.137.5
Match the characteristic symptoms with the diagnoses!

A) it is characterised by a feeling of anxiety which occurs during attacks
B) improvement can be expected primarily from behavioural therapy (exposition therapy)
C) it is characterized by a constant feeling of anxiety which is difficult to overcome
D) the person has a fear of getting into humiliating situations in the social environment

PSY - 4.137.1 - panic disorder

Answer 104

ANSWER
PSY - 4.137.1 - panic disorder - A)

Question 105

PSY-4.138.1-4.138.5
Match the characteristic features with the diagnoses!

A) the person is afraid of having a serious disease
B) the person is afraid of infections
C) the person is afraid of being humiliated
D) the person is afraid of experiencing another anxiety attack
E) the constant anxiety affects several areas of the patients’ lives

PSY - 4.138.1 - generalised anxiety disorder
PSY - 4.138.2 - panic disorder
PSY - 4.138.3 - social anxiety
PSY - 4.138.4 - hypochondriasis
PSY - 4.138.5 - obsessive-compulsive disorder

Answer 105

ANSWER
PSY - 4.138.1 - generalised anxiety disorder - E)
PSY - 4.138.2 - panic disorder - D)
PSY - 4.138.3 - social anxiety - C)
PSY - 4.138.4 - hypochondriasis - A)
PSY - 4.138.5 - obsessive-compulsive disorder - B)

Question 106

PSY - 4.140
Which is the most likely diagnosis based on the symptoms of the patient?

A 38-year-old female patient works in a bank; previously, she had no problems with having to work together with many of her colleagues in a single room and that they had lots of clients. However, she has not been able to go to work for 1 month, and she tries to avoid going to places where many people are present, or to places from where getting out is difficult. She does not use public transport either, she neither dares to drive a car and or go shopping without being accompanied by her husband.

A) post-traumatic stress disorder
B) obsessive-compulsive disorder
C) social phobia
D) generalised anxiety disorder
E) agoraphobia

Answer 106

ANSWER
E) agoraphobia
EXPLANATION
In case of agoraphobia the person avoids to go to places from where he/she can hardly get out, or to places where, according to his/her opinion, he/she cannot get help when felling unwell. The behaviour of the social environment (in the above mentioned case: the patient is accompanied by her husband) can reinforce his/her fears and his/her illness.

Question 107

PSY - 4.141
Which of the following statements are false about obsessive-compulsive disorder?

A) It greatly inhibits the patient’s everyday life
B) Recurring, unpleasant thoughts or ideas which cause anxiety
C) The patient doesn’t realize that these thoughts are products of their own psyche instead of an external origin
D) The purpose of compulsive behaviour is to relieve the anxiety caused by obsessive thoughts

Answer 107

ANSWER
C) The patient doesn’t realize that these thoughts are products of their own psyche instead of an external origin
EXPLANATION
Obsessive-compulsive disorder is characterized by recurring, unpleasant thoughts or ideas that cause anxiety, which the patient tries to relieve by compulsive behaviour. The symptoms greatly inhibit these patients’ everyday life. The patients realize that these thoughts are products of their own psyche, instead of having an external origin.

Question 108

PSY - 4.142
Which of the following play a role in the etiology of obsessive-compulsive disorder?

1) According to the cognitive development theory the compulsive symptoms are active avoidance behaviour in response to anxiety
2) Serotonin plays an important part in its pathomechanism
3) According to the psychoanalytic theory, a strict superego and suppressed instincts cause anxiety
4) Genetic and environmental factors also play an important part

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 108

ANSWER
E) all answers are correct.
EXPLANATION
Genetic and environmental factors also play an important role in the etiology of obsessive-compulsive disorder; neurochemically serotonin has an important part. According to the psychoanalytic theory, a strict superego and suppressed instincts cause anxiety, while the cognitive development theory states that the compulsive symptoms are active avoidance behaviour in response to anxiety.

Question 109

PSY-4.144.1-4.144.4
Match the symptoms with the diagnoses!

A) anticipatory tension
B) ego-syntonic obsessive traits
C) ego-dystonic obsessive thoughts and behaviour
D) acute response to psychotrauma

PSY - 4.144.4 - acute stress disorder
PSY - 4.144.3 - obsessive-compulsive personality disorder
PSY - 4.144.1 - obsessive-compulsive disorder
PSY - 4.144.2 - panic disorder

Answer 109

ANSWER
PSY - 4.144.4 - acute stress disorder - D)
PSY - 4.144.3 - obsessive-compulsive personality disorder - B)
PSY - 4.144.1 - obsessive-compulsive disorder - C)
PSY - 4.144.2 - panic disorder - A)

Question 110

PSY - 4.145
Which diagnosis is most likely according to the complaints?

A 27-year-old woman is constantly afraid of infections and contamination; she instantly takes off and cleans every piece of clothing she’s been wearing outside. Whenever she invites guests she is always occupied with what they touch and instantly cleans and disinfects those things when they leave. This inhibits her in her everyday tasks, she’s tense, and nervous because of her complaints and would like to be freed of them.
A) obsessive-compulsive personality disorder
B) generalized anxiety disorder
C) acute stress disorder
D) obsessive-compulsive disorder

Answer 110

ANSWER
D) obsessive-compulsive disorder
EXPLANATION
The fear of infection is the obsessive thought, the cleaning and disinfecting is the compulsive behaviour the patient would like to be freed of.

Question 111

PSY - 4.147
Which of the following illness is characterized by an increased fear of getting ill?

A) hypochondria
B) phobia
C) conversion disorder
D) somatization (Briquet-) syndrome
E) aggravation

Answer 111

ANSWER
A) hypochondria
EXPLANATION
Hypochondriacs are convinced that they have a serious illness that doctors have overlooked

Question 112

PSY - 4.148
Which of the following symptoms are usually present in case of somatization?

1) painful menstruation
2) palpitation
3) anxiety
4) nausea

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 112

ANSWER
E) all answers are correct.
EXPLANATION
Painful menstruation, palpitation, anxiety and nausea can all be present in somatization.

Question 113

PSY - 4.149
Which of the following are true for conversion disorder?

1) the symptoms can raise the question of a somatic illness
2) expresses a psychological conflict
3) attracts attention and the sympathy of others
4) is intentional

A) answers 1, 2, and 3 are correct
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 113

ANSWER
A) answers 1, 2, and 3 are correct
EXPLANATION
In conversion disorder the symptoms can resemble a somatic illness, are in definite connection with some outside event (psychotrauma), with their help the patient can escape from a conflict (Freudian primary illness-benefit) as well as evoke increased attention and sympathy of others (Freudian secondary illness-benefit)

Question 114

PSY - 4.150
Which of the following symptoms are present in conversion disorder?

1) primary and secondary illness benefits are present
2) the symptoms start suddenly and dramatically
3) the patient cannot control the symptoms intentionally
4) limb paralyses and sensory deficits don’t follow anatomical innervations

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 114

ANSWER
E) all answers are correct.
EXPLANATION
In conversion disorder the symptoms start suddenly, the patient can escape from conflicts with their help (Freudian primer illness benefit) and it evokes attention and sympathy of others (Freudian secondary illness benefit). The patient cannot control these symptoms. The fact, that limb paralyses and sensory deficits don’t follow anatomical innervations makes it unlikely that they are caused by somatic illnesses.

Question 115

PSY - 4.151
Which of the following are the disadvantages of somatization disorder?

1) excessive use of medication
2) secondary iatrogenic consequences of invasive diagnostic interventions
3) excessive claim on medical services
4) a frequent change of doctors

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 115

ANSWER
E) all answers are correct.
EXPLANATION
The disadvantages of somatization disorder (chronic neurosis) are: excessive use of medication, secondary iatrogenic consequences of invasive diagnostic interventions, excessive claim on medical services, and a frequent change of doctors.

Question 116

PSY - 4.152
Somatization disorder can be effectively treated by:

1) gradual decrease of unnecessary medication
2) regular check-ups at the doctor’s
3) remaining at one doctor
4) anxiolytic medication

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 116

ANSWER
A) answers 1, 2, and 3 are correct.
EXPLANATION
The therapy of somatization disorder includes the gradual decrease of unnecessary medication, and regular, controlled check-ups by the same medical professional.

Question 117

PSY - 4.153
Which of the following is false for dissociative psychogenic amnesia?

A) Is a memory lapse that can be traced back to psychogenic reasons.
B) Cannot be explained by lesions of the central nervous system
C) Is the multiplication of personality
D) Is the inability to recall memories for the period of hours or days.
E) Usually starts and ends suddenly.

Answer 117

ANSWER
C) Is the multiplication of personality
EXPLANATION
Dissociative amnesia is a memory lapse that can be traced back to psychogenic reasons that cannot be explained by lesions of the central nervous system. It is the inability to recall memories for the period of hours or days and usually starts and ends suddenly.

Question 118

PSY-4.154.1-4.154.5
Match the diagnoses with the symptoms!

A) dissociative amnesia
B) dissociative fugue
C) dissociative identity disorder

PSY - 4.154.1 - Aimless wandering with a sudden onset over the period of amnesia that can last for days

PSY - 4.154.2 - The temporary inability to recall memories

PSY - 4.154.3 - The multiplication of personality

PSY - 4.154.4 - Organized foggy state

PSY - 4.154.5 - The memory lapse can be partial, only regarding emotionally significant experiences

Answer 118

ANSWER
PSY - 4.154.1 - Aimless wandering with a sudden onset over the period of amnesia that can last for days- B)

PSY - 4.154.2 - The temporary inability to recall memories- A)

PSY - 4.154.3 - The multiplication of personality - C)

PSY - 4.154.4 - Organized foggy state - B)

PSY - 4.154.5 - The memory lapse can be partial, only regarding emotionally significant experiences - A

Question 119

PSY - 4.156
Which of the following illnesses should be considered when making the diagnosis above, EXPECT?

A 39-year-old woman has been suffering from pelvic pain for 10 years, which can sometimes be relieved with sedating analgesics. Multiple examinations, including explorative laparotomy have been carried out, yet doctors haven’t managed to find organic causes. The patient denies having low mood or other psychiatric problems, but feels anger towards doctors, who, she feels, cannot cure her.
1) simulating
2) organic psychiatric disorder
3) conversion disorder
4) schizophrenia

A) answers 1, 2, and 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 119

ANSWER
D) only answer 4 is correct.
EXPLANATION
Since disorders of thought, perception, or bizarre behaviour etc. are not mentioned above, schizophrenia should not be considered when making a diagnosis.

Question 120

PSY - 4.157
Which of the following is not true for stress?

A) it also refers to the suffering of the person in danger (distress)
B) it can disrupt the homeostatic balance of an organism
C) it is also referred to aggressive impact
D) doesn’t include the response of the person in danger
E) phases of the general adaptation syndrome are: alarm reaction, phase of resistance, phase of exhaustion

Answer 120

ANSWER
D) doesn’t include the response of the person in danger
EXPLANATION
Stress refers to the suffering of the person in danger (distress), as well as to aggressive impact, and also incorporates the response of the person in danger.

Question 121

PSY - 4.159
Which of the following is not effective when treating PTSD:

A) cognitive-behavioural therapy
B) psychodynamic therapy
C) haloperidol
D) selective serotonin reuptake inhibitors
E) propranolol

Answer 121

ANSWER
C) haloperidol
EXPLANATION
Antipsychotics are not indicated when treating PTSD.

Question 122

PSY - 4.160
Which of the following is true for adaptation disorder?

A) vast environmental disasters can cause it
B) doesn’t cease after the stressful stimulus has stopped
C) reaching a new level of adaptation doesn’t help it cease
D) everyday stressful stimuli can cause severe symptoms that hinder everyday life
E) doesn’t affect social integration

Answer 122

ANSWER
D) everyday stressful stimuli can cause severe symptoms that hinder everyday life
EXPLANATION
In adaptation disorder the patient experiences severe symptoms that hinder everyday life, affect social integration, which are caused by everyday stressful stimuli. They stop however, when the stressful stimulus has stopped, as well as after reaching a new level of adaptation.

Question 123

PSY - 4.162
Which of the following increase(s) vulnerability to PTSD?

1) genetic factors
2) lack of social protection
3) low intelligence
4) separation from parents in childhood

A) answers 1, 2, 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 123

ANSWER
E) all answers are correct.
EXPLANATION
Vulnerability to PTSD increases if social protection is lacking, in case of low intelligence, separation from parents in childhood, as well as genetic factors.

Question 124

PSY - 4.165
What is the most likely diagnosis?

A 32-year-old woman has survived a train accident 2 years ago, the train was derailed. Many were injured, there was chaos and despair. She’s relived the memory many times since, evoking a feeling of despair. She also has similar feelings when an external situation reminds her of it, then she sweats and starts to tremble. Since the accident she’s never travelled by train.

A) acute post-traumatic stress disorder
B) adaptation disorder
C) acute stress disorder
D) chronic post-traumatic stress disorder

Answer 124

ANSWER
D) chronic post-traumatic stress disorder
EXPLANATION
A prolonged pathological state after trauma indicates PTSD

Question 125

PSY - 4.166
The following criteria support the diagnosis:

A 32-year-old woman has survived a train accident 2 years ago, the train was derailed. Many were injured, there was chaos and despair. She’s relived the memory many times since, evoking a feeling of despair. She also has similar feelings when an external situation reminds her of it, then she sweats and starts to tremble. Since the accident she’s never travelled by train.

1) the person has experienced a situation which was potentially threatening to the safety of him/her or others
2) a prolonged pathological state
3) a recurring, compulsive, distressing recall of the stressful event
4) a situation similar to the traumatic event can cause a vegetative reaction
5) a natural response to trauma

A) answers 1, 2, 3 and 4 are correct
B) all answers are correct.
C) answers 1, 2, and 4 are correct.
D) answers 2, 3, and 5 are correct
E) answers 1, 3, and 5 are correct

Answer 125

ANSWER
A) answers 1, 2, 3 and 4 are correct
EXPLANATION
When the person has experienced a situation, which was potentially threatening to the safety of him/her or others; and, a prolonged pathological state ensues with a recurring, compulsive, distressing recall of the stressful event, and any situation similar to the traumatic event can cause vegetative reaction, the diagnosis of PTSD can be established.

Question 126

PSY - 4.167
Which is the most likely diagnosis?

A 26-year-old woman doesn’t dare to go out to the streets without pepper spray even during daytime. She frequently remembers being sexually abused when she was a child. She cannot relax in an intimate situation with her partner. When he touches her, her every muscle tenses, she’s defensive and their sexual life is not balanced.

A) social phobia
B) acute stress reaction
C) adaptation disorder
D) obsessive-compulsive disorder
E) post-traumatic stress disorder

Answer 126

ANSWER
E) post-traumatic stress disorder
EXPLANATION
When the person has experienced a situation, which was potentially threatening to the safety of him/her or others; and, a prolonged pathological state ensues with a recurring, compulsive, distressing recall of the stressful event, and any situation similar to the traumatic event can cause vegetative reaction, the diagnosis of PTSD can be established.

Question 127

PSY - 4.170
Which of the following is true for insomnia?

A) comorbid disorders are not connected with insomnia
B) it is a syndrome with a 9-10% rate of becoming chronic
C) the occurrence of sleep disorders doesn’t increase with age
D) the comorbid illness can always be identified
E) everyday stress cannot cause it

Answer 127

ANSWER
B) it is a syndrome with a 9-10% rate of becoming chronic
EXPLANATION
Insomnia is a syndrome which becomes chronic in 9-10%, its occurrence increases with age. The usual cause is everyday stress. Comorbid illnesses can have a connection with insomnia, but they cannot always be identified.

Question 128

PSY - 4.171
Which of the following are the main types of insomnia?

1) subjectively non-restful sleep
2) disorders of maintaining asleep
3) early awakening and inability to go back to sleep
4) disorders of going to sleep

A) answers 1, 2, 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 128

ANSWER
E) all answers are correct.
EXPLANATION
The four types of insomnia are: disorders of going to sleep and disorders of staying asleep, early awakening and inability to go back to sleep, and subjectively non-restful sleep.

Question 129

PSY - 4.173
Which of the following are used in the treatment of the above the illness?

A 40-year-old woman goes to sleep effortlessly at 11 at night, however, she wakes up at 1-2 a.m. She can’t go back to sleep again for a long time, and even if she can, she wakes up again after a short while. She could fall asleep again after 6 in the morning, but she must get up early to go to work. In the mornings she feels not having slept at all, is exhausted, and fatigued. Otherwise she’s in good spirits and keen.

1) medication
2) lifestyle and sleep hygienic advice
3) therapies other than medication
4) assessing possible comorbid illnesses
5) we give medication for 4-6 months

A) answers 1, 2, 3 and 4 are correct.
B) all answers are correct.
C) answers 1, 2, and 4 are correct.
D) answers 2, 3, and 5 are correct
E) answers 1, 3, and 5 are correct

Answer 129

ANSWER
A) answers 1, 2, 3 and 4 are correct.
EXPLANATION
The basic treatment of insomnia consists of assessing possible comorbid illnesses, lifestyle and sleep hygienic advice, medication and other therapies.

Question 130

PSY - 4.176
Which of the following disorders, which are otherwise grouped within other categories, could be regarded as impulse-control disorders, because of their specific qualities?

1) bulimia
2) alcohol dependence
3) paraphilias
4) drug dependence

A) answers 1, 2, 3 are correct.
B) answers 1, and 3 are correct
C) answers 2, and 4 are correct.
D) only answer 4 is correct.
E) all answers are correct.

Answer 130

ANSWER
E) all answers are correct.
EXPLANATION
Alcohol and drug dependence, as well as bulimia and paraphilias can be regarded as impulse control disorders, because the basic characteristics of impulse control disorders (e.g. patients are unable to resist impulses and urges that are potentially harmful to themselves or others).are present.

Question 131

PSY-4.177.1-4.177.5
Match the symptoms with the diagnoses!

A) pathological gambling
B) trichotillomania
C) pyromania
D) kleptomania

PSY - 4.177.3 - the person commits arson intentionally for pleasure

PSY - 4.177.5 - unconditional belief in a “winning system”

PSY - 4.177.4 - an irresistible urge to steal worthless objects

PSY - 4.177.2 - the essence of the illness is the lack of ability to assess potential risk

PSY - 4.177.1 - patients are unable to resist pulling out their own hair

Answer 131

ANSWER
PSY - 4.177.3 - the person commits arson intentionally for pleasure - C)

PSY - 4.177.5 - unconditional belief in a “winning system” - A)

PSY - 4.177.4 - an irresistible urge to steal worthless objects - D)

PSY - 4.177.2 - the essence of the illness is the lack of ability to assess potential risk - A)

PSY - 4.177.1 - patients are unable to resist pulling out their own hair - B)

Question 132

PSY - 4.178
Which of the following is the most likely diagnosis?

A 28-yearold man lives with his parents, has a job, but has no savings; in fact, he must ask the parents for 1.500.000 Forints although he apparently has no major expenses. His behaviour doesn’t seem to have changed, he goes to work punctually, his colleagues like him. He has a reasonably good salary, but still has debts, which he wants to keep secret; he has a “winning system” for winning the money back.

A) alcohol dependence
B) kleptomania
C) pathological gambling
D) drug dependence

Answer 132

ANSWER
C) pathological gambling
EXPLANATION
The debts, the unconditional belief in a “winning system” and the lack of alcohol or drug abuse point towards pathological gambling.

Question 133

PSY - 4.179
Which of the following provide suitable treatment for the diagnosis above?

A 28-yearold man lives with his parents, has a job, but has no savings; in fact, he must ask the parents for 1.500.000 Forints although he apparently has no major expenses. His behaviour doesn’t seem to have changed, he goes to work punctually, his colleagues like him. He has a reasonably good salary, but still has debts, which he wants to keep secret; he has a “winning system” for winning the money back.

1) SSRI
2) carbamazepine
3) naltrexone
4) bupropion
5) cognitive and behavioural therapy

A) answers 1, 2, 3 and 4 are correct.
B) all answers are correct.
C) answers 1, 2, and 4 are correct.
D) answers 2, 3, and 5 are correct
E) answers 1, 3, and 5 are correct

Answer 133

ANSWER
B) all answers are correct.
EXPLANATION
When treating pathological gambling SSRIs, bupropion, carbamazepine, naltrexone can decrease the impulse, along with cognitive and behavioural therapy.

Question 134

PSY - 4.180
Which statement(s) is/are true regarding suicide?

1) the rate of completed suicides decreases with age
2) women commit lethal suicides more often than men
3) suicides can be reliably predicted based on clinical characteristics
4) an empathetic conversation with a potential victim about his suicidal ideations might prevent the attemp

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 134

ANSWER
D) only the 4th answer is correct
EXPLANATION
An empathetic conversation about the suicidal intent could prevent the attempt (that is why warning signs have to be taken seriously

Question 135

PSY - 4.182
Lifetime risk and prevalence of completed suicide is in:

1) major depression: 3.6-8.5%
2) schizophrenia: 5-10%
3) alcohol dependence: 3.4-6.7%
4) the average population: 14 / 100.000 people

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 135

ANSWER
E) all of the answers are correct

Question 136

PSY - 4.183
Suicide:

1) is the second most common cause of death by young male
2) occurs three times more often by males than by females in every age group
3) divorce, urban residence and unemployment mean increased risk for it
4) is the least frequent in the middle class

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 136

ANSWER
E) all of the answers are correct
EXPLANATION
all of the above are true, suicide is the second most common cause of death by young males (Meehan et al. 1991), the prevalence of suicide has a V-shaped distribution being the lowest in the middle class (Charlton et al, 1993)

Question 137

PSY - 4.184
In case of suicidal behaviour the admission to a psychiatric ward is

1) only possible with the informed consent of the patient
2) not possible if the patient agrees to give up his suicidal intent in writing
3) not needed if the patient agrees to give up his suicidal intent in writing
4) necessary if direct threat of harm exists, even in the absence of the informed consent of the patient, but only in compliance with the appropriate rules and with proper documentation

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 137

ANSWER
D) only the 4th answer is correct
EXPLANATION
Admission to a psychiatric ward is necessary if direct threat of harm exists, even in the absence of the informed consent of the patient and even if the patient gave up his suicidal intent in writing, but only in compliance with the appropriate rules and with proper documentation. It is of high priority that we try to explain the reason of admission to the patient and family, so that they can accept it.

Question 138

PSY - 4.185
How many times higher risk do earlier suicide attempts mean regarding a future attempt?

A) hundred
B) ten
C) two
D) one

Answer 138

ANSWER
A) hundred

Question 139

PSY - 4.186
Future suicide attempters visit doctors with some kind of symptoms during the weeks prior to the attempt, which is regarded as:

A) aggravation
B) presuicidal syndrome
C) cry for help
D) transference

Answer 139

ANSWER
C) cry for help

Question 140

PSY - 4.189
The massive wave of copycat suicides after a widely publicized suicide through social learning is known as:

A) Ringel effect
B) model effect
C) Werther effect
D) cry for help effect

Answer 140

ANSWER
C) Werther effect

Question 141

PSY - 4.192
The indicator(s) of suicidal risk is/are:

1) the 3 criteria of the presuicidal syndrome according to Ringel
2) the score of the item regarding suicidal behaviour in the Hamilton Depression Rating Scale (HAM-D)
3) the score of the short version of the Hopelessness Scale by Beck
4) the WAIS score

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 141

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
Although suicidal behaviour cannot be predicted for sure, the risk assessment can be based on the identification of presuicidal syndrome and the score of the item regarding suicidal behaviour in the HAM-D, furthermore the score of the short version of the Hopelessness Scale by Beck is able to roughly quantify the risk. WAIS score is irrelevant from this point of view

Question 142

PSY - 4.197
Crisis intervention is

1) a short treatment (1-6 sessions)
2) the re-evaluation of the triggering causes
3) activating the reserves of the personality and developing the helping potentials
4) giving advices and urging to change in order to overcome the causes

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 142

ANSWER
A) only the 1st, 2nd and 3rd answers are correct
EXPLANATION
urging and advising does not help in a crisis situation, the other statements are true

Question 143

PSY - 4.198
Which of the following does NOT apply for crisis intervention?

1) it aims cognitive re-evaluation
2) the therapist is non-directive
3) it might be conducted via telephone
4) it aims to totally reconstruct the personality

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st and 3rd answers are correct
C) only the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 143

ANSWER
C) only the 2nd and 4th answers are correct
EXPLANATION
the therapist should rather be directive in this case, the intervention does not aim to totally reconstruct the personality, it focuses rather on the re-evaluation and activation of helping potentials. It might be conducted via phone, too.