MCQ exam (Paper 2): Answer Key
History, mental state exam and psychopathology
1. Which of the following is the BEST example of
inattention?
A. The patient interrupts the conversation to ask
when he will be discharged.
B. The patient is oriented and aware of his recent
medical problems but falls asleep during the
conversation.
C. The patient suddenly bursts into tears when you
are discussing his recent amputation.
D. The patient watches a fly buzzing on the ceiling
while you are discussing the prognosis for his lung
cancer, then falls asleep.
E. The patient cannot remember what you have told
him 3 minutes ago. Then he tries to make up the
answer.
2. A 30-year-old man firmly believes that the alien
has put an implant in his body and he feels there
is a pushing sensation on his aorta. Which types of
hallucinations BEST suited his description?
A. Auditory
B. Cenesthetic
C. Gustatory
D. Kinesthetic
E. Visual.
3. Perseveration is MOST commonly seen in which of
the following disorders?
A. Autism
The best answer is D.
A. Impulsive interruptions may
or may not indicate
inattentiveness.
B. Falling asleep may indicate
inattentiveness, but further
information would be needed
to rule out other explanations
such as recent administration
of a sedating medication.
C. Sudden bursts of affect have a
significant differential beyond
inattention.
D. This patient seems distracted
despite discussion of an issue
of vital personal importance
to him. In the context also of
apparent drowsiness, the
clinician should suspect the
presence of delirium.
E. The patient may suffer from
dementia and cannot register
the information.
Author: Roger Ho
Year: 2013.
The answer is B.
Explanation: Cenesthetic
hallucinations are unfounded
sensations of altered states in bodily
organs. Examples of cenesthetic
hallucinations are a burning sensation
in the brain, a pushing sensation in
the blood vessels, and a cutting
sensation in the bone marrow. Bodily
distortion may also occur.
Author: Roger Ho
Year: 2013.
This is an advanced-level question.
The answer is D.
Explanation: Perseveration is a
persisting response to a previous
 B. Attention deficit and hyperactivity disorder stimulus after a new stimulus has
C. Bipolar disorder been presented; it is often associated
D. Frontal lobe dementia with frontal lobe lesion.
E. Obsessive compulsive disorder.
Author: Roger Ho
Year: 2013

4. A patient presents with persistence, The answer is A.

perfectionism and body image distortion. Which
of the following disorders is MOST likely to be
Explanation: Persistence and
associated with the above clinical features?
perfectionism are associated with
A. Anorexia nervosa obsessive-compulsive personality
B. Borderline personality disorder traits and disorders, along with body
C. Delusional disorder image distortion occurring in many
D. Hypochondriasis patients with anorexia nervosa.
E. Somatization disorder.
Author: Roger Ho

Year: 2013

Cognitive assessment
5. Which of the following statement is FALSE
about Mini-mental state examination (MMSE)?
A. A total score of 5 indicates severe dementia.
B. Assessment of orientation to time and place is part
of the MMSE.
C. The MMSE can be administered in Chinese or
English.
D. The MMSE can be used to monitor treatment
progress after initiation of acetylcholinesterase
inhibitors (AChEIs).
E. The MMSE is the gold standard in establishing the
diagnosis of dementia.
The answer is E.
Explanation: MMSE is a screening test
and there is no gold standard to
establish the diagnosis of dementia in
clinical practice. Clinical assessment
by a psychiatrist or geriatrician is
more important than MMSE in
establishing diagnosis of dementia.
Author: Roger Ho

Year: 2013
Psychiatric epidemiology
6. Which of the following settings have the HIGHEST The answer is D.
prevalence of delirium?
Explanation: General surgical patients:
A. Accident and emergency department 10-15%; Cardiac surgery patients:
B. Cardiac surgery ward 30%; Hip fractures: 50%; Age >65
C. General surgery ward admitted to ICU: 70%; Palliative
D. Hospice with palliative advanced cancer patients advanced cancer patients: 88%.
E. Nursing home looking after dementia patients.
Author: Roger Ho

Year: 2013.
7. The worldwide point prevalence of The answer is A.
schizophrenia is BEST estimated as:
Explanation: The worldwide point
A. 1% prevalence is 1% and Singapore is
 B. 2.5% 0.6%.
C. 5%
D. 7.5% Author: Roger Ho
E. 10%.

Year: 2013
Psychiatric aetiology, diagnosis and classification
8. Advanced paternal age is a well- established The answer is E.
risk factor for which of the following psychiatry
illnesses?
Explanation: Advanced paternal age is
A. Alcoholism a risk factor for schizophrenia.
B. Major depressive disorder
C. Obsessive compulsive disorder Author: Roger Ho
D. Generalized anxiety disorder
E. Schizophrenia. Year: 2013.
9. Which of the following social factors is The answer is D.
MOST LIKELY to be associated with relapse
of schizophrenia after hospitalization? High levels of expressed emotion
A. Discrimination (EE) in the families of patients with
B. Financial problems schizophrenia predicted relapse
C. Homelessness following hospital discharge.
D. Increased expressed emotion Psychoeducational family therapy
E. Isolation and absence of family aims at helping the family reduce
member. the factors that constitute
expressed emotion. The therapist
also educates the family about
schizophrenia and the need to
continue antipsychotic medication
indefinitely.

Author: Roger Ho

Year: 2013.
10. Individuals with which one of the following genes The answer is B.
have the HIGHEST risk of developing Alzheimers
disease? Explanation: Homozygous APO E4/E4
increases the risk of developing
A. Homozygous apolipoproteins (APO) E2/E2 Alzhimers disease by 8 times.
B. Homozygous APO E4/E4
C. Homozygous APO E6/E6 Author: Roger Ho
D. Heterozygous APO E2/E4
E. Heterozygous APO E2/E6.
Year: 2013.

General adult psychiatry

11. A 40-year-old man suffered from a heart attack
under general anaesthesia. The doctors in the
operation theatre successfully resuscitated him.
After recovery, he wants to sue the hospital for
causing him post-traumatic stress disorder (PTSD).
He claims the resuscitation process was
extremely traumatic. Which of the following is the
MOST IMPORTANT feature to exclude the
The answer is D.
Explanation: In the new diagnostic
criteria, it is possible for a PTSD
patient not to directly witness a
traumatic event and learn about it
from others after the accident. The
most crucial feature is whether
 diagnosis of PTSD?
A. He does not have past history of PTSD.
B. He has hidden agenda of suing the hospital
and tries to seek compensation.
C. He was under general anaesthesia and he was
not conscious during resuscitation.
D. The process of resuscitation is not considered
to be traumatic in general and doctor
resuscitated him in his best interest.
E. He did not seek treatment from a psychiatrist
after the operation.
12. Common symptoms of panic attacks include the
all of following EXCEPT:
A. Fear of dying
B. Fear of losing control
C. Fear of going crazy
D. Palpitations
E. Suicidal thoughts.
13. Which of the following schizophrenia patients
has the HIGHEST suicide risk?
A. An adolescent with prodromal symptoms and vague
paranoid idea.
B. An elderly retired man with late onset schizophrenia.
C. A middle-aged man with negative symptoms.
D. A middle-aged woman who suffers from simple
schizophrenia.
E. A young male university student who once had high
expectations.
14. Which of the following is NOT a recognized
alteration of sleep disturbance associated with
major depressive disorder?
A. Difficulty in falling asleep
B. Increase in nocturnal awakening
C. Increase in density of Rapid Eye Movement (REM)
sleep
D. Increase in the latency of Rapid Eye Movement
(REM) sleep
E. Reduction of total sleep time.
15. A 40-year-old woman is staying with her god-
brother. She was rejected by her family and she
felt helpless in the past. She needs her god-
brother to make decision for her and her god-
brother asks her to be the housekeeper in
return. One day, her god-brother needs to go to
Vietnam for 1 week and she feels extremely
uncomfortable. Which of the following
resuscitation itself is not a traumatic
process and it is necessary for doctors
to save patients life by resuscitation.
Author: Roger Ho
Year: 2013
This is an advanced level question.
The answer is E.
Explanation: Suicidal thought is not
common symptom of panic attack.
Author: Rathi Mahendran
Year: 2013.
The answer is E.
Explanation: The profile of the patient
at greatest risk is a young man who
once had high expectations, declined
from a higher level of functioning,
realizes that his dreams are not likely
to come true, and has lost faith in the
effectiveness of treatment.
Author: Roger Ho
Year: 2013.
The answer is D.
Explanation: It should be reduction of
latency of REM sleep.
Author: Roger Ho
Year: 2013.
This is an advanced level question.
The answer is B.
Explanation: She is best described to
suffer from dependent personality
because she cannot make decision on
her own, uncomfortable when left
alone and subordination to her god-
 personality traits BEST describes this person? brothers need (e.g. to be a
housekeeper).
A. Borderline personality
B. Dependent personality
C. Histrionic personality Author: Roger Ho
D. Schizoid personality
E. Schizotypal personality. Year: 2013

16. A 30-year-old man comes to see you and he The answer is A.

worries about premature ejaculation. The MOST
appropriate time frame to meet the diagnosis of
Explanation: Premature ejaculation is
premature ejaculation is:
A. Ejaculation occurs within 60 seconds following defined as ejaculation occurs within
vaginal penetration. 60 second following vaginal
B. Ejaculation occurs within 90 seconds following penetration and the patient wishes it.
vaginal penetration.
C. Ejaculation occurs within 120 seconds following Author: Roger Ho
vaginal penetration.
D. Ejaculation occurs within 150 seconds following
vaginal penetration. Year: 2013
E. Ejaculation occurs within 180 seconds following
vaginal penetration.

17. A 30-year-old man suffered from eight episodes of The answer is D.

mood disturbances within a single year. These
mood episodes met the diagnostic criteria for
major depression, mania and hypomania. These
episodes were separated by remission. Which of
the following is the MOST likely diagnosis?
Explanation: This patient has more
than 4 episodes of mania and
depressive disorder in 1 year. He is
too severe for cyclothymic disorder.

A. Cyclothymic disorder Author: Roger Ho

B. Emotionally unstable personality disorder
C. Mixed affective disorder Year: 2013
D. Rapid cycling bipolar disorder
E. Schizoaffective disorder.

Old age psychiatry

18. Which of the following is NOT a predisposing The answer is D.
factor for depression in the elderly?
Explanation: Women have longer life
A. Cerebrovascular accident span compared to men. As a result,
B. Poly-pharmacy women are more likely to be a widow
C. Looking after a spouse with chronic illness
D. Male gender and correspond to option E.
E. Widowhood.
Author: Roger Ho

Year: 2013.

19. Dementia in general is BEST described as: The answer is E.

A. Behavioural disturbance Explanation: dementia is a progressive

B. Global impairment deterioration of cognition, including
C. Impaired memory for personal events (e.g. memory and/or one of four other
marriage, past occupation) cognitive symptoms (aphasia, apraxia,
D. Personality change agnosia, impaired executive
 E. Progressive deterioration. functioning) but it may not be a global
impairment. Impairment memory for
recent events is more common than
personal events.

Author: Roger Ho

Year: 2013.
20. A 65-year-old man presents with memory The answer is C.
loss, which of the following is the LEAST important
indication for a computerized tomography (CT) Explanation: The other factors
scan for his brain: suggest an organic cause.

A. A sudden decrease in cognitive function over a one- Author: Roger Ho

month period
B. Gait abnormalities
Year: 2013.
C. His age
D. Urinary incontinence
E. Use of anticoagulants.

21. For anxiety disorders in the elderly, which of the
following statements is TRUE?
A. Prevalence increases with age.
B. Prevalence rates are lower in women.
C. Common primary diagnoses in hospital population.
D. Highest rates are found in the community.
E. Most anxiety disorders have onset in late life.
The answer is D
Explanation: Majority of anxiety
disorders in elderly has their onset in
young adult and middle age and are
mainly managed by primary
healthcare providers in the
community. In the hospital setting,
are usually comorbid conditions and
are uncommonly primary diagnoses in
the hospital population.

Author: Tan Lay Ling

Date of submission: 27 Feb 2013

This is an advanced-level question

Child and adolescent psychiatry
22. Which of the following is THE MOST IMPORTANT The answer is B.
predictor of bipolar disorder in adolescent
depression? Explanation: Antidepressant is the
most common cause of hypomania
A. Diurnal variation of mood and hypomania is part of the bipolar
B. Hypomanic symptoms after taking antidepressants disorder.
C. Hypersomnia
D. Increased weight Author: Roger Ho
E. Multiple suicide attempts.
Year: 2013.
23. The MOST COMMON reason for children with The answer is A.
autism are brought to medical attention by their
parents is: Explanation: Language delay is the
most obvious sign and most disturbing
 A. Language delays to parents when they discover their
B. Lack of toilet control children are lacking behind in
C. Odd play language development compared to
D. School difficulties other children.
E. Stereotyped behaviour.
Author: Roger Ho

Year: 2013.
24. Which of the following statements is FALSE The answer is B.
regarding separation anxiety disorder?
Explanation: Separation anxiety disorder
A. It involves recurrent distress when separate from
is more common in children and it can
attachment figures.
occur in adolescents.
B. Separation anxiety disorder does not occur in
adolescents.
C. Separation anxiety disorder is associated with school Author: Roger Ho
refusal.
D. The child has difficulty falling asleep at night. Year: 2013.
E. The child may complain of somatic symptoms.

25. Which of the following symptoms is MOST

LIKELY to persist when a young person suffers The answer is D.
from Attention Deficit and Hyperactivity
Disorder (ADHD) becoming an adult?
Answer: Although symptoms of
A. Accident risk hyperactivity and impulsivity often
B. Hyperactivity improve as the child grows older,
C. Impulsivity inattentive symptoms are likely to
D. Inattention persist.
E. Learning difficulties.
Author: Roger Ho

Year: 2013
26. A baby is born with low birth weight, microcephaly, The answer is A.
small eyes, upturned nose and a smooth, undeveloped
philtrum. He fails to thrive and develops seizures. Explanation: This is a classical
Which of the following was he MOST likely exposed
to during pregnancy? description of the facial features of
foetal alcohol syndrome
A. Alcohol
B. Cocaine Author: Roger Ho
C. LSD
D. Methamphetamine
Year: 2013.
E. Inhalants.

Substance abuse
27. The term which BEST describes an altered The answer is B.
physiological state and neuro- adaptation caused
by repeated administration of a drug is: Explanation: The term dependence
indicates physiological changes.
A. Addiction Misuse refers to use of any drug,
B. Dependence usually by self-administration, in a
C. Misuse manner that deviates from approved
D. Withdrawal social or medical patterns. Addiction is
E. Tolerance. non-specific and ignores the concept
of substance dependence is a medical
 condition.

Author: Roger Ho

Year: 2013.
28. While driving, a 40-year-old man with no previous The answer is A.
history refused to stop for the traffic police. He
was subsequently brought into the accident and Explanation: Auditory hallucinosis is
emergency department (AED) by them. You are usually composed of auditory
the resident working in the AED. When you assess hallucination. Sensorium is clear and it
him, he states that he was hearing voices in clear is different from delirium tremens.
consciousness. He admits to a history of alcohol There are not enough symptoms to
use. What is the most appropriate diagnosis? conclude that he suffers from
schizophrenia.
A. Alcoholic hallucinosis
B. Delirium tremens Author: Roger Ho
C. Korsakoff psychosis
D. Schizophrenia Year: 2013.
E. Wernickes encephalopathy.

29. Which of the following BEST describes the The answer is B.

mechanism of action with naltrexone in the treatment
of alcohol dependence? Explanation: Option A refers to
A. Naltrexone acts on the benzodiazepine receptor and benzodiazepine. Option C refers to
prevents alcohol withdrawal. the action of disulfiram. Option D and
B. Naltrexone blocks opioid receptors to decrease alcohol E refer to the action of acamprosate.
craving.
C. Naltrexone inhibits aldehyde dehydrogenase to decrease Author: Roger Ho
alcohol craving.
D. Naltrexone is a GABA agonist and decreases alcohol
craving. Year: 2013.
E. Naltrexone is a glutamate antagonist and decreases
alcohol craving.

30. Which of the following complications is LEAST The answer is D.

likely to occur in cocaine abusers?
A. Arrhythmia Explanation: Cocaine is least likely to
B. Hyperthermia
C. Myocardial infarction be injected via IV route. As a result,
D. Phlebitis phlebitis is relatively less likely to
E. Seizure. occur in patients misusing cocaine.

Author: Roger Ho

Year: 2013

This is an advanced-level question.

31. The primary neurotransmitter involved with The answer is E.

Lysergic acid diethylamide (LSD) is:
a. Acetylcholine Explanation: LSD increases the level of
b. Dopamine serotonin and overdose of LSD is
c. -Aminobutyric acid
associated with serotonin syndrome.
d. Norepinephrine
 e. Serotonin.
Author Roger Ho

Year: 2013.

32. All of the following are true about alcohol The answer is D.
withdrawal EXCEPT:
A. Central nervous system hyperexcitability Explanation: It should be sympathetic
B. Onset 12 to 24 hours after last drink hyperactivity.
C. Peak intensity at 24 to 48 hours
D. Sympathetic hypoactivity Author: Rathi Mahendran
E. Triggered by abrupt cessation of intake in
dependent persons. Year: 2013.

Psychopharmacology
33. Monoamine oxidase inhibitor (MAOI) is LEAST The answer is B.
useful in treating which of the following
disorders?
Explanation: MAOI is least useful to
A. Atypical depression treat OCD.
B. Obsessive compulsive disorder
C. Panic disorder Author: Roger Ho
D. Severe depressive disorder not responding to
selective serotonin reuptake inhibitor Year: 2013.
E. Severe depressive disorder with hyponatraemia
This is an advanced-level question.
34. Which of the following antidepressants is LEAST The answer is A.
likely to contribute to the development of
serotonin syndrome? Explanation: Bupoprion works on
dopamine and norepinephrine. As a
A. Bupropion result, it is least likely to cause
B. Fluoxetine serotonin syndrome.
C. Moclobemide
D. Paroxetine Answer: Roger Ho
E. Venlafaxine.
Year: 2013.

This is an advanced-level question.

35. Which of the following antipsychotics exhibit a The answer is A.

novel mechanism as a partial antagonist?
Explanation: Aripiprazole exhibits a
A. Aripiprazole
B. Clozapine novel mechanism by definition while
C. Olanzapine other antipsychotics listed do not
D. Quetiapine have this property.
E. Ziprasidone.
Author: Roger Ho

Year: 2013.
36. Regarding lamotrigine, which of the following The answer is C.
statements is FALSE?
A. It acts at voltage-sensitive sodium channels. Explanation: Double-blind, placebo-
B. It inhibits the release of excitatory amino acid
neurotransmitters.
C. It is not effective in the treatment of bipolar
depression.
D. Its use can lead to toxic epidermal necrolysis.
E. There is no need to monitor lamotrigine blood
levels during treatment.
controlled trials have shown that it
has acute and prophylactic anti-
depressant effects. It can lead to
severe dermatological condition such
as Steven Johnson syndrome/ toxic
epidermal necrolysis. In Singapore,
there is no blood test to check its
level.

Author: Roger Ho

Year: 2013

This is an advanced-level question.

37. Anticholinergic side effects include all of The answer is A.

the following EXCEPT:
Explanation: Anticholinergic side
A. Bradycardia effect include tachycardia.
B. Constipation
C. Dry mouth Author: Roger Ho
D. Exacerbation of open-angle glaucoma
E. Urinary retention. Year: 2013.

38. In a schizophrenia patient without history of The answer is D.

asthma, the BEST treatment for chronic
akathisia is:
Explanation: Propranolol (beta
A. Alprazolam blocker) is the best treatment in this
B. Benzhexol patient without history of asthma as it
C. Clonazepam does not cause dependence as in
D. Propranolol Option A and C. Beta blockers can
E. Vitamin E. reduce restlessness and tremor.
Option B is more useful for
pseudoparkinsonism.

Author: Roger Ho

Year: 2013.
39. Which of the following psychotropic The answer is D.
medications is MOST EFFECTIVE in preventing
relapse in rapid cycling bipolar disorder?
Explanation: Lithium is less effective in
A. Haloperidol preventing relapse in rapid cycling
B. Lithium bipolar disorder. Valproate and
C. Olanzapine carbamazepine are preferred over
D. Valproate lithium.
E. Risperidone.
Author: Roger Ho

2013
40. Common side-effects of clozapine include the The answer is E.
 following EXCEPT:
Explanation: Clozapine and olanzapine
A. Anticholinergic side-effects are well-known in causing weight gain
B. Agranulocytosis and metabolic syndrome.
C. Sedation
D. Seizures Author: Rathi Mahendran
E. Weight loss. Modified by Roger Ho

2013
41. Common indications for ECT include all of the The answer is E.
following EXCEPT:
A. Contraindications to medication Explanation: Strong suicide ideation
B. Medication failure rather than repeated self-harm is a
C. Previous good response common indication for ECT.
D. Psychotic depression
E. Repeated self-harm. Author: Rathi Mahendran

2013
Psychotherapy
42. In conducting psychotherapy with individuals who The answer is A.
have experienced a traumatic event and suffer
from post-traumatic stress disorder (PTSD), the Explanation: A is the answer. Affect or
following are all recommended techniques emotion should not be avoided in
EXCEPT: psychotherapy.

A. Encouraging avoidance of emotion Author: Roger Ho

B. Examining feelings of guilt
C. Examining the patients response to the trauma Year 2013.
D. Offering consolation
E. Overcoming avoidance or phobia related to the
trauma.

43. A 30-year-old woman with panic disorder does The answer is B.

not respond to an initial treatment with an
selective serotonin reuptake inhibitor (SSRI).
Explanation: The effect of CBT is as
Which of the following treatment is considered
the best approach? efficacious as SSRI.

A. Benzodiazepine Author: Roger Ho

B. Cognitive behaviour therapy
C. Serotonin-noradrenaline reuptake inhibitor Year: 2013.
D. Olanzapine
E. Psychodynamic psychotherapy.

44. Which of the following statements is The answer is C.

INCORRECT about Interpersonal therapy?
A. Has been shown to be efficacious in adult outpatients
suffering from depression.
B. Is more efficacious than psychodynamic psychotherapy
C. Works as quickly as antidepressant medication.
D. Works best in mild to moderate depression.
E. Works best in people facing problems in role transition.
Explanation: Interpersonal therapy is
slower than the effect of
antidepressant because the therapist
needs time to assess the patient and
formulate strategies (e.g.
interpersonal inventory and role play).
 Author: Roger Ho

Year: 2013.
45. A 23-year-old student is seen in the University The answer is D.
counselling centre because of relationship
problems. She has had one serious relationship Explanation: This patient
with her boyfriend that lasted about six months. demonstrates overgenearlization
She terminated the relationship because she because she believes in and follows a
discovered that her boyfriend was seeing general rule on the basis of limited
someone else. During psychotherapy, she examples.
mentions that All men just cant be trusted.
Which of the following BEST describes this Author: Roger Ho
thinking error?
Year: 2013.
A. Arbitrary inference
B. Dichotomous thinking
C. Magnification
D. Overgeneralization
E. Selective abstraction.

Ethics and laws

46. All medical students are required to study The answer is B.
psychiatry so that they are qualified to assess and
manage common psychiatric disorders after Explanation: With competent
graduation. The compulsory psychiatric training is psychiatric knowledge, the future
BEST described by which of the following ethical doctors can provide benefits to
principles? patients when making decision on
diagnosis and management. The other
A. Autonomy concept that is relevant is dereliction.
B. Beneficence Fiduciary duty refers to the duty that
C. Morality the doctor must act in the patients
D. Justice best interest and it is not as relevant
E. Fiduciary duty. as beneficence in this case.

Author: Roger Ho

Year: 2013

Liaison and neuropsychiatry

47. You are a medical resident. A 40-year-old The answer is B.
schizophrenia patient was admitted as a result of
polydipsia. Which of the following statements Explanation: Psychogenic polydispsia
regarding polydipsia in schizophrenia is NOT true? is a common condition for chronic
schizophrenia. The estimates of
A. It is associated with low urine osmolality. prevalence range from 5 to 20%. The
B. It is associated with high sodium in urine. patient drinks excess water and
C. It is associated with low serum sodium. results in diluted urine. The body tries
D. Patients should be investigated for Syndrome of to preserve sodium and results in low
Inappropriate Secretion of Anti-Diuretic Hormone urine sodium. The serum is diluted.
(SIADH). SIADH should be considered for DDX.
E. Polydipsia occurs in between 5 to 20% of patients
suffering from chronic schizophrenia. Author: Roger Ho
 Year: 2013.

This is an advanced-level question.

48. A 40-year-old British man is admitted to the The answer is B.
medical ward. He tries to run away from the ward.
He is very aggressive and the security guards have Explanation: He suffers from delirium
difficulty to stop him. He claims that he is tremens. Intramuscular diazepam has
currently working in the office. The medical poor absorption. Option C and D are
records show that he has been drinking half of a not available in Singapore. Option E is
bottle of whisky every night. You need to order a a depot antipsychotics and it is not
medication to sedate him. He refuses to take any useful in acute setting.
oral medication. Which of the following
medications is the BEST alternative in Singapore? Author: Roger Ho

A. Intramuscular diazepam Year: 2013

B. Intramuscular lorazepam
C. Intramuscular olanzapine
D. Intramuscular quetiapine
E. Intramuscular risperidone.

49. You are the resident working for the liver The answer is B.
transplant team. The MOST common psychiatric
disorder in patients with liver cancer in the week Explanation: Delirium is the most
before and after transplantation is: common disorder and it can be
caused by systemic infection, side
A. Adjustment disorder effect of immunosuppressant,
B. Delirium impairment of liver function, hepatic
C. Generalized anxiety disorder encephalopathy.
D. Major depressive disorder
E. Somatoform pain disorder. Author: Roger Ho

Year: 2013.
50. You are the resident working in the obstetrics The answer is B.
department. Which of the following is the BEST
treatment strategies to treat hyperemesis during Explanation: Benzodiazepine may
pregnancy? cause cleft palate in the first
trimester. Psychoanalysis is not for
A. Benzodiazepines e.g. alprazolam symptomatic relief. SSRI like
B. Relaxation therapy fluvoxamine is associated with nausea
C. Psychoanalysis side effect. Hyperemesis is not
D. Selective serotonin reuptake inhibitor e.g. associated with stimulus. Relaxation
fluvoxamine therapy is the best treatment.
E. Stimulus deprivation.
Author: Roger Ho

Year: 2013.

Vetted by: Dr. Lai YM (2013)