MCQS (141)

1) A 23 year old man gave a two week history of episodes of chest tightness with shortness of breath, choking, dizziness, palpitations and shaking. He is terrified of dying. No positive findings on physical examination. Choose one of the following diagnoses? Partial seizures bronchial asthma hypomania Panic disorder acute organic syndrome 2)As regards schizophrenia, one of the following is true: lack of insight is the most common feature in-patient treatment is often necessary less common in developing than in Western countries 3% suicide rate among paranoid type of schizophrenia. does not affect children 3) One of the following statements is correct: epidemiologically, schizophrenia is more common than depressive illness the prognosis of multi infarct dementia is good not all types of depressive illness need antidepressants neuroleptics and antipsychotics arc two different psychotropic medications Electro convulsive therapy (ECT) should not be used because of its serious side effects 4) One of the following is correct: Personality disorder is a major mental illness. suicide is higher in people with learning disabilities than in general population benzodiazepines are highly toxic in overdose. delusions are under voluntary control

high creatinine phosphokinase is a useful single diagnostic test for the neuroleptic malignant syndrome

5) Electro-convulsive therapy (ECT): is dangerous in pregnancy can be given to patients with epilepsy should not be used in mania is contraindicated in the elderly is extremely dangerous in children 6) Tension headache: is the second most common after migraine paracetamol is usually effective mostly occurs among elderly require CT scan and MRI to exclude organic pathology may last for days 7) You are asked to see an 80-year-old man with a two-day history of disorientations, delusion and agitations. Choose the nearest diagnosis: Alzheimer dementia depressive illness delirium severe anxiety schizophrenia 8) One of the following produces physical dependence: glue sniffing amphetamine cocaine cannabis phenobarbitone

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9)

is best treated with small dose of antipsychotics in majority of cases the causes are primary

Insomnia:

initial insomnia is a characteristic feature of depression late insomnia means an early morning waking

Benzodiazepines should never be prescribed. 10) Non-epileptic seizures (pseudo-seizures): Often found abnormal electrical discharges in the brain. Anti-epileptic drugs are usually effective. may be induced by stress Patient often loses his consciousness during the attacks. the attacks are produced deliberately, 11) Serious Drug Interactions may occur between:
mono amine oxidase inhibitors and antidepressant. haloperidol and carbaniazepine diazepam and citalopram lithium and anti depressants beta blockers and anti psychotics 12) One of the following is correct:

delirium tremens can be caused by benzodiazepine withdrawal

poor long term memory is an early feature of multi infarct dementia neuroleptic malignant syndrome is a benign disorder

hypnotic is the treatment of first choice for insomnia but sleep hygiene 13) Hypochondriasis: is anorganic disorder is easy to treat may be caused by depression is more common in developed countries than in developing ones usually has excellent prognosis 14) A consultant physician asked you to see a 44 year old man with a one month history of palpitation, obsessional thoughts, fear, tremors, loss of interest in doing things, a Jloss of five Kg in weight, withdrawal,and poor night sleep, (these symptoms occur for the first time) Which is the most probable diagnosis? generalized anxiety disorder depressive illness conversion disorder eating disorder transient ischemic attacks 15) Common clinical features of moderate depressive illness include: Illusions pseudo-hallucination middle insomnia delusion of guilt in severe depression disorientation 16) Hallucinations are under voluntary control are distortions of real perceptions visual is more common than auditory in schizophrenia are always due to organic cause can be caused by prescribed drugs Collected by Dr.RoYaL pray to me & my family

buspiron is a highly addictive anxiolytic

17) Common features of anorexia nervosa include lack of interest in food breast atrophy loss of axillary hair distortion of body image delusion 18) Common clinical feature of moderate depressive illness include: Illusions pseudo-hallucination late insomnia delusion of guilt disorientation 19) Electro-convulsive therapy (ECT) is dangerous in pregnancy Bone treatment is usually effective should not be used in mania is contraindicated in elderly is the treatment of choice for depressive psychosis 20) The neuroleptic malignant syndrome

is a form of lymphoma induced by long term antipsychotic treatment may be treated with chlorpromazine may be treated with vitamin A is a neurotic disorder high creatinine phosphokinase is a useful single diagnostic tes 21) The following apply to suicide the frequency is higher in children than in adul females commit suicide more often than males suicide is a much commoner event than deliberate self-harm suicide note or making a will suggest high suicidal intent is higher in people with learning disabilities than in the general population 22) One of the following is correct personality disorders are a mental illnes physical and psychological dependence carry same features. benzodiazepines are highly toxic in overdose. antidepressant drugs take about 2 weeks to work. hypersomnia is a characteristic feature of hypomania 23) One of the following is correct about dementia prognosis, usually good with Alzheimer's type. psychotic phenomena are rare depression usually does not occur there is effective treatment in the market Alzheimer's disease is the commonest type of dementia. 24) One of the following statements is correct schizophrenia means split personality.
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antidepressants may be effective in obsessive compulsive disorders. anti-epileptics work as anti-psychotics psychosurgery is still indicated for severe and intractable cases of psychiatric disorders, psychotherapy is the treatment of choice for acute schizophrenia 25) Delirium is usually a benign disorder Disorientation and agitation are common features. Is characterized by gradual onset. Is a rare disorder. Is rare in very young subjects. 26)

Postnatal psychosis hormonal changes are the main cause patient never kills her child suicide is rare ECT is contraindicated most patients recover fully from a puerperal psychosis

27) Non-epileptic seizures (pseudo-seizures) are due to abnormal electrical discharges in the brain Anti-epileptic drugs are usually effective. often there is emotional difficulties. patient usually loses his consciousness during the attacks. the attacks are produced deliberately 28) Cognitive functions impairment of long term memory is the first sign of Alzheimer's disease disorientation is a characteristic feature of depressive illness. attention and concentration may be impaired in depressed patients. consciousness is often impaired in dementia. short-term memory is often impaired in schizophrenia.

29)

Acute stress reaction: a. characterized by severe anxiety

30)

postnatal psychosis:

a. hormonal changes are the main cause b. patient never kills her child c. suicide is rare d. ECT is contraindicated e. most patients recover fully from a puerperal psychosis

31)

postnatal depression: a. is more common than postnatal psychosis

32)

post maternity blues: a. the commonest disorder of pregnancy

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33)

Insomnia: a. is best treated with small dose of antipsychotics b. in majority of cases the causes are primary c. initial insomnia is a characteristic feature of depression d. late insomnia means an early morning waking e. benzodiazepine should never be prescribed

34)

the most serious unwanted effect of antipsychotic therapy: a. tremor b. Tradive dyskinesia c. Chronic constipation d. Akatheisa e. Rabbit Syn

35)

Which one is true about Bulimia Nervosa: a. Body weight is 15% below normal b. Self induced vomiting is not common c. 25% of the pt provide Hx of sexual abuse d. Poor appetite is characteristic feature e. Propranolol is an effective Rx

36)

Which one is true about eating disorder: a. A & B Nervosa are synonymous b. AN is more common in male c. 5-10% is mortality rate in AN d. Usually seen in middle age women

37)

ECT is indicated in: a. OCD b. Severe anxiety c. Severe mania

38)

Which one is true: a. Large dose of withdrawal of benzodiazepine lead to convulsion b. Buspirone is a major antipsychotic drug

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c. Barbiturate is mainly used in anxiety d. Benzodiazepine cause physical not psychological dependence

39)

Which one is true about OCD: a. Is psychotic disorder b. Resistance seldom occur c. Common occur in elderly d. Cognitive behavioral therapy is a useful Rx e. Anxiety seldom accompanies this disorder

40)

Low risk suicide: a. Those who plan in advance b. Those who use dangerous or violent methods c. Has a Hx of previous self-harm d. In male sex e. In pt >40 years

41)

A 55 year old pt complained of 2 months Hx of loss f appetite, loss of interest (Sx of depression).. what is the most likely Dx:

a. generalized anxiety disorder b. depressive illness c. conversion disorder d. eating disorder e. transient ischemic attacks

42)

Somatization characterized by: a. Usually the pt complains of single Sx b. Preoccupation & physical Sx c. Common in our culture

43)

Pathological Bereavement: a. Always normal b. Common when the relationship with the deceased was problematic:

44)

Acutely disturbed pt: a. More can be done by calming, reassurance & constant environment

45)

Generalized anxiety disorder:

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a. More common before 40 b. Prevalence 20% c. Antipsychotic is the Rx of choice d. More in male than female e. Delusion may occur

46)

The most serious drug interaction occur b\w: a. Lithium & Thiazide b. MAOI & sympathomemetics

47)

Acute organic disorder: a. Common in old b. Can be caused by TCA

48)

Psychotherapy: a. Contraindicated in mania b. Should be used with psychotic medication c. One long session is enough d. Social phobia responds better than schizophrenia e. Is effective in infarction dementia

49)

Which one is true: a. Schizophrenia is more common than depressive illness b. Not all types of multi infarct require antidepressant drugs

50)

Chronic schizophrenia: a. Social withdrawal + lack of motivation are parts of its feature

51)

Bereavement: a. Pathological are more common than normal grief reaction b. Does occur in children

52)

Mania: a. Elevated mood is absent b. Associated with psychological Sx c. Must be admitted d. Lithium is contraindicated

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53)

Tradive dyskinesia: a. Neurotic disorder b. Movement disorder due to the use of antipsychotics c. Movement disorder due to the use of anxiolytics d. Acute schizophrenia e. Treated by psychotherapy

54)

Compliance: a. Generally good b. Better in those who live alone c. Counseling the pt has a good effect in the compliance of Rx

55)

Panic disorder:? a. Rare b. In elderly c. Psychological Rx is ineffective d. Carbamazipine is effective

56)

A 77 year old pt with 1 day Hx of disorientation to time, place. Agitation, visual hallucination, poor concentration & uncooperation.. the most likely Dx: a. Delirium b. Dementia

57)

wrong therapy: a. group therapy b. family therapy c. music therapy d. revolving door therapy

58)

all are true with disorientation of time except: a. may be normal b. feature of severe dementia c. occur in schizophrenia but not in delirium d. occur with anxiety e. may occur in children

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59)

regarding Personality disorder, which statement does match: a. schizoid <-> suspicious b. histrionic <-> lack of emotional warmth c. antisocial <-> suggestibility d. dependant <-> fertile ground for jealousy e. OC (another weird term was written) <-> afraid of criticism

60)

Lithium: a. Safe in pregnancy b. Most superior mood stabilizer c. Contraindicated in liver impairment d. Thyroid function must be checked first

61)

Depressive illness always: a. Low mood b. Suicide intent c. Insomnia d. Headache

62)

Depressive illness: a. 10% have a suicidal ideas b. 42% presented with anxiety c. Affect 10% of general population d. Monozygotic to dizygotic ratio is 20:10 e. If one parent has depressive illness, there is 10% their child will be affected

63)

Depressive illness: a. Mostly self limiting, last for 6 months b. 90% recurrence c. In Severe cases, recurrence is 100% d. 6% of cases last for 2 years e. Doesnt occur in schizophrenia

64)

Difference b\w new & old generations: a. New generation are more effective

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b. Cheaper c. Less side effects d. Safer for children e. Safer for pregnant

65)

A pt said that for 2 months, he wash his hands repeatedly, afraid of contamination & repeatedly check the door + (Sx of anxiety).. what is the most likely Dx: a. OCD

66)

Which is true: a. Epilepsy doesnt necessary means LOC b. Hypochondriasis can reveals serious physical illness c. Chronic anemia can cause depression d. All of the above

67)

conversion disorder:

a. Neurotic disorder b. Psychiatry disorder

68)

Which is following is correct

a. 2nd person hallucination mean a person talk to the patient b. Paranoid delusion patient think other people will hurt him

69)

Which is following is correct:

a. Folic acid deficiency cause dementia

70)
a.

The neuroleptic malignant syndrome: is a form of lymphoma induced by long term antipsychotic treatment

b. may be treated with chlorpromazine c. may be treated with vitamin A d. is a neurotic disorder e. medical emergency

71)

One of the following produces physical dependence:

a. glue sniffing b. amphetamine c. cocaine d. cannabis

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e. diazepam

72)

As regards schizophrenia, one of the following is true:

a. lack of insight is the most common feature b. in-patient treatment is often necessary c. less common in developing than in Western countries d. 3% suicide rate among paranoid type of schizophrenia. e. does not affect children

73)

moderate depressive illness:

a. early insomnia b. physical symptoms

74)

antidepressant :

a. have anxiolytic effect

75)

sever depressive illness:

a. low concentration b. occur in young group than elderly group

76)

schizophrenia:

a. lack of insight

77)

long acting BZ:

a. diazepam

78)

mania:

a. acceleration of speech

79)

one of the following is serotonin reuptake inhibitor antidepressant:

a. citalopram

80)

mood stabilizer:

a. carabamezapine

81)

depressive illness:

a. occur in children

82)

culture bond syndrome:

a. Latah
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83)

maternity blues:

a. most common psychiatric illness in pregnancy

84)

regarding suicide:

a. the frequency is higher in children than in adults b. females commit suicide more often than males c. suicide is a much commoner event than deliberate self-harm d. suicide note or making a will suggest high suicidal intent e. is higher in people with learning disabilities than in the general population

85)

illusion:

a. misinterpretation of real external stimuli

86)

** first rank symptoms (not sure of the answer):

a. may occur in mania b. occur in male more than female c. never occur in depressive illness

87)

good prognosis in schizophrenia:

a. there is depression b. insidious onset

88)

antidepressant:

a. take 2 weeks to start

89)

dementia:

a. Alzheimer is most common cause

90)

disorder of perception:

a. delusion in perception ( not the answer) b. ( we forgot the correct answer)

91)

Psychotherapy

a. Psychology is more effective in neurosis than psychosis b. Psychology is more effective than medicine

92)

Schizophrenia:

a. May occur in children

93)

Hysteria:
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a. Deliberately b. Male as common as female c. Common in old patients d. There is usually 2ry gain e. Rare in developing country

94)

Phobic disorder :

a. Social type is the commonest b. Treatment by BZs c. All phobia should be treated d. Treatment by cognitive behavior therapy e. Agrophobia is psychotic

95)

General practice:

a. Ignore patient with repeated suicidal trail b. 30% of patient are psychotic c. All patient should be referred to psychiatrist d. GP shouldn't write psychotropics e. Supportive treatment shouldn't provided by GP

96)

Delusion:

a. Overvalued idea is mild form

97)

Schizophrenia :

a. 3rd person auditory hallucination more common than 2nd person b. Perceptional delusion is more common

98)

Hallucination occur:

a. Panic disorder b. Acute stress reaction c. Adjustment disorder d. anorexic nervosa e. Alzheimer disease

99)

Benzodiazepens:

a. Oxazepa
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100) Antipsychotic:
a. Haloperidol

101) Sever depressive illness feature:

a. Delusion of guilt

102) Diazepam orally:

(Forgot the answer)

103) Stupor:
(Forgot the answer)

104) Acute stress reaction:

a. characterized by severe anxiety

105) postnatal psychosis:

a. hormonal changes are the main cause b. patient never kills her child c. suicide is rare d. ECT is contraindicated e. most patients recover fully from a puerperal psychosis

106) postnatal depression:

a. is more common than postnatal psychosis

107) post maternity blues:

a. the commonest disorder of pregnancy

108) Insomnia:
a. is best treated with small dose of antipsychotics b. in majority of cases the causes are primary c. initial insomnia is a characteristic feature of depression d. late insomnia means an early morning waking e. benzodiazepine should never be prescribed

109) ** the most serious unwanted effect of antipsychotic therapy:

a. tremor
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b. Tradive dyskinesia c. Chronic constipation d. Akatheisa e. Rabbit Syn

110) Which one is true about Bulimia Nervosa:

a. Body weight is 15% below normal b. Self induced vomiting is not common c. 25% of the pt provide Hx of sexual abuse d. Poor appetite is characteristic feature e. Propranolol is an effective Rx

111) Which one is true about eating disorder:

a. A & B Nervosa are synonymous b. 5-10% is mortality rate in AN c. Usually seen in middle age women

112) ECT is indicated in:

a. OCD b. Severe anxiety c. Severe mania

113) Which one is true:

a. Large dose of withdrawal of benzodiazepine lead to convulsion b. Buspirone is a major antipsychotic drug c. Barbiturate is mainly used in anxiety d. Benzodiazepine cause physical not psychological dependence

114) Which one is true about OCD:

a. Is psychotic disorder b. Resistance seldom occur c. Common occur in elderly d. Cognitive behavioral therapy is a useful Rx e. Anxiety seldom accompanies this disorder

115) ** Low risk suicide:

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a. Those who plan in advance b. Those who use dangerous or violent methods c. Has a Hx of previous self-harm d. In male sex e. In pt >40 years

116) A 55 year old pt complained of 2 months Hx of loss of appetite, loss of interest (Sx of
depression).. what is the most likely Dx:

a. generalized anxiety disorder b. depressive illness c. conversion disorder d. eating disorder e. transient ischemic attacks

117) ** Somatization characterized by:

a. Usually the pt complains of single Sx b. Preoccupation & physical Sx c. Common in our culture

118) Pathological Bereavement:

a. Always normal b. Common when the relationship with the deceased was problematic

119) Acutely disturbed pt:

a. More can be done by calming, reassurance & constant environment

120) ** Generalized anxiety disorder:

a. More common before 40 b. Prevalence 20% c. Antipsychotic is the Rx of choice d. More in male than female e. Delusion may occur

121) The most serious drug interaction occur b\w:

a. Lithium & Thiazide b. MAOI & sympathomemetics
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122) ** Acute organic disorder:

a. Common in old b. Can be caused by TCA

123) ** Psychotherapy:?
a. Contraindicated in mania b. Should be used with psychotic medication c. One long session is enough d. Social phobia responds better than schizophrenia e. Is effective in infarction dementia

124) Which one is true:

a. Schizophrenia is more common than depressive illness b. Not all types of multi infarct require antidepressant drugs

125) Chronic schizophrenia:

a. Social withdrawal + lack of motivation are parts of its feature

126) ** Bereavement:
a. Pathological are more common than normal grief reaction b. Does occur in children

127) ** Mania:
a. Elevated mood is absent b. Associated with psychological Sx c. Must be admitted d. Lithium is contraindicated

128) Tradive dyskinesia:

a. Neurotic disorder b. Movement disorder due to the use of antipsychotics c. Movement disorder due to the use of anxiolytics d. Acute schizophrenia e. Treated by psychotherapy

129) Compliance:
a. Generally good
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b. Better in those who live alone c. Counseling the pt has a good effect in the compliance of Rx

130) ** Panic disorder:

a. In elderly b. Carbamazipine is effective

131) A 77 year old pt with 1 day Hx of disorientation to time, place. Agitation, visual
hallucination, poor concentration & uncooperation.. the most likely Dx: a. Delirium b. Dementia

132) wrong therapy:

a. group therapy b. family therapy c. music therapy d. revolving door therapy

133) all are true with disorientation of time except:

a. may be normal b. feature of severe dementia c. occur in schizophrenia but not in delirium d. occur with anxiety e. may occur in children

134) ** regarding Personality disorder, which statement does match:

a. histrionic <-> lack of emotional warmth b. antisocial <-> suggestibility c. dependant <-> fertile ground for jealousy d. OC (another weird term was written) <-> afraid of criticism

135) Lithium:
a. Safe in pregnancy b. Most superior mood stabilizer c. Contraindicated in liver impairment
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d. Thyroid function must be checked first

136) Depressive illness always:

a. Low mood b. Suicide intent c. Insomnia d. Headache

137) ** Depressive illness:

a. 10% have a suicidal ideas b. 42% presented with anxiety c. If one parent has depressive illness, there is 10% their child will be affected

138) ** Depressive illness:

a. Mostly self limiting, last for 6 months b. 90% recurrence c. In Severe cases, recurrence is 100% d. 6% of cases last for 2 years e. Doesnt occur in schizophrenia

139) Difference b\w new & old generations:

a. New generation are more effective b. Cheaper c. Less side effects d. Safer for children e. Safer for pregnant

140) A pt said that for 2 months, he wash his hands repeatedly, afraid of contamination &
repeatedly check the door + (Sx of anxiety).. what is the most likely Dx: a. OCD

141) Which is true:

a. Epilepsy doesnt necessary means LOC b. Hypochondriasis can reveals serious physical illness c. Chronic anemia can cause depression d. All of the above
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