Psychiatry part 1

PSYCHIATRY part 1
1-Risk of suicide increase e in the following : a-male sex. T b-deliberate self harm. T c-married male. F d-alcohol dependence. T e-depression. T 2-In depression: a-wt. Loss . T b-sleep disturbance. T c-deliberate self harm T d-alcohol abuse. T e-can present to GP with minor symptoms. T 3-Obssecive compulsive disorders: a-fluxotine can be used. T(SSRI) b-behavioural therapy can be used. T(relaxation training) c-psychodynamic is the best treatment. F d-is a psychosis. F e-common in elderly . F (common in adolescence and early adulthood) 4-Dementia: a-Alzheimer patient says I dont know in the test. F b-vascular dementia characterized by stepwise deterioration in cognition. T c-Pick is the 3rd common dementia. F(In young onset dementia, frontotemporal
dementia (FTD) is an important cause after Alzheimers disease, however overall frequency is 1Alzheimer 60% 2- multi infarct 15-20% 3- lewi 15-20%)

d-Lewi dementia present with visual hallucinations. T e-in chronic vascular dementia there is neurofibrillary tangles ? FALSE( this in alzeheimer) 5-Mental state examination: a-stereotype associated with schizophrenia. T b-mutism associated with malingering . ?( no association found) c-perseveration associated with mania. F d-visual hallucination with depression. ?causes are schizophrenia and hysteria ans severe mood disorder but still not typical feature of depression) better to leave it e-disorientation and anxiety. F
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Psychiatry part 1

6-Schizophrenia; a-atypical anti psychotic is the 1st line treatment. T b-benzodiazepine is effective in treatment of ve symptoms. F c-affective symptoms are of good prognosis. T d-of good prognosis if occur in young age. F e-Tardive dyskinesia is a reversible complication.F(dyskinesias disappear over a period
of 3 years in 60% of patients. However, the remainder have persistent symptoms)

7-Alcohol-in regard delirium tremens: a-symptoms occur 6 hours after withdrawal F week b-carries mortality of 19%. F??????(15%) c-associated. With delusion. T d-biochemical evidence of liver dysfunction in more than 90%. how much) e-characteristically occurs more at night. T 8-Conduct disorders in children: a-associated with school truancy. T b-there is difficulty in dealing with the authority figures. T c-may be associated with dissocial (antisocial ) in adulthood. d-respond well to antipsychotic. F e-associated with dysfunctional family background . T 9-ECT: a-EEG should always be given to all patients. F b-C/I if patient taking tricyclic antidepressants. F c-C/I if having pacemaker. ? d-is the treatment of choice for mania resistant to drugs. e-may be used in pregnancy. T

F???? it occur but

10-Psychdynamic psychotherapy: a-depend on conscious , cognition and behaviour. F b-transference is the therapist emotion reaction to the patient. F c-first work was done by Si. & Froid. T d-dreams can be interpreted using a dream directory. ? e-target the unconscious cognition and behaviour. ? 11-Overeating is a recognised feature in the following: a-anorexia nervosa. F b-bulimia nervosa . T
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Psychiatry part 1

c-puerperal psychosis. ?F d-depression. T e-social phobia . F 12-In the treatment of depression: a-Dothipine is safe in overdose. F b-lithium may be used to augment tricyclic antidepressants. d-MAO & TCA are dangerous together. T e-Wt. Gain is a good predictor to outcome. F 13.Schizophrena: a. There is a strong genetic factor. T b. Increased suicidal risk. T c. Chlorpromazine is the treatment of choice. F d. In men has an earlier age of onset than women. T e. Catatonic symptoms are good prognostic feature. F 14.The following are risk factors of Alzheimers: a. Trauma. T b. High educational level. F c. Low educational level. T d. old age. T 15. Regarding Suicidal attempts: a. Past history of suicide. T b. More in females. T c. All should be hospital admitted F???? d. Drug over-dose is the most common mode. T 16.Rregarding Depression: a. In male is more common than female. F b. There is motor retardation. T 17. Anxiety: One. Incidence in females is double the males. T ??(in generalized anexity the incidence in 2:3) b. Benzodiazepine is the treatment of choice for all types. F 18. Chlorpromazine: a. Has an Anti-Prolactin affect.
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Psychiatry part 1

19. Mania can present with: a. Agitation. T b. Grandiose delusions. T c. Affection of mood. T d. Sleep disturbance. T e. Social promiscuity. T 20.the following are True about Affective Disorders: One. Bipolar Disorders is commoner in Females > Males. F(equal) Two. In Bipolar Disorders, recovery is complete between episodes. T Three. In Bipolar Disorders, mania is common in elderly. F ???? Four. In Bipolar Disorders are common above the age of 30. F 21. The following are True about Phobias: One. Agoraphobia is the commonest type. T Two. Agoraphobia is common females than males. T Three. Chlorpromazine is used for the treatment of Panic Disorders. F Four. Cognitive therapy is the treatment of choice. T Five. Social Phobia is equal in females & males. F(more common in women and in those
of low socioeconomic class.)

22. In Child Autism; One. Echolalia can occur T Two. Unwillingness to be touched. T Three. Loss of eye to eye contacts. T Four. Loss of Imaginative Abilities. T

23. Refusal of Schooling: One. May present with Abdominal Pain. T Two. Early return to school is of good Prognosis. ?true Three. It is associated with Separation Anxiety T Four. It is associated with Depressive Illness. T

24. Depression may be presented with, a. Loss of weight. T b. Disturbance of sleep T c. Mild Physical IIIness. T d. Deliberate Self-harm. T e. Alcohol Dependence. T

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Psychiatry part 1

25. The following are True about Dementia; a. Alzheimers Dementia is characterized by Do not know answers in Cognitive Assessment. F b. Picks Dementia is the 3rd common type. F c. Vascular Dementia is characterized by step-progressing disease. true d. Vascular dementia is characterized by fibrillary tangles. F e. Lewy Body type may present with Delirious Episodes. ? 26. The following are complications of Alcohol Dependence: a. Ocular Nerves Palsies. T b. Confabulations. T c. Liver Abnormalities in 90% of Cases. F d. Impotence. T e. Auditory Hallucinations in the Full Consciousness. F 27. In Delirium Tremens: a. Onset after 6 hours of Withdrawal. F b. Mortality of 10% of cases. T???????? c. Delusions can occur. T d. Tremor is not a Feature. F

28. The following Actions of Chlorpromazine are mediated by D2 Receptors: One. Anti-psychotic. T Two. Anti-emetic T Three. Parkinsonian Features FALSE (d1) Four. Postural Hypotension. F Five. Weight Gain. F

29. Cognitive Behavioral Therapy includes: One. Cognitive Process. T Two. Behavioral Process. T Three. Emotional Reaction. ? Four. Biophysiological Aspects. ? Five. Psychological aspects. T 30- Side effects of SSRI are: a. Nausea. T b. Sweating T c. Tremor. T d. Sedation. T
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Psychiatry part 1

e.

Thyroid dysfunction.

31- The following make the diagnosis of Schizophrenia more likely: a. Hallucination in the 2nd person. ? b. Thoughts withdrawal. T c. Catatonic type that responds well to ECT. T d. Past history of sexual abuse in childhood. F e. Tearfulness. F 32- Regarding Child Abuse: a. Sexual abuse is always associated with violence or tendency to violence. T b. Physical abuse is more common in the school children. False <3year c. Rare in teen age girls. F d. In Ireland should be notified to children abuse authorities. T 33- Overeating occurs in: a. Anorexia nervosa. fase b. Bulimia nervosa. T c. Depression. T d. Puerperal psychosis. ? e. Social phobia. F 34- The following are true: a. Anti-psychotic action of Chlorpromazine starts at 20 minutes. ? b. Korsakofs Syndrome resists treatment by massive dose of Bismuth IV. c. Clozapine is the treatment of choice for Schizophrenia. F d. Depressive psychosis best treated by; Monotherapy. ?

35- Vascular Dementia is more likely than Alzheimers dementia in the presence of: a. Step-wise progression. T b. Hypertension. T c. Carotid bruit. T d. Plantar extensor. T e. Short term memory loss. F 36-Depression: More than 60% of patients respond in the first week of treatment. F) Can be caused by calcium channel blockers. T Prevalence is 1% life long. F If bipolar, mood stabilizer should be stopped. F
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Psychiatry part 1

May be associated with pseudo-dementia.

37-Schizophrenia: Visual hallucination is characteristic. F Auditory hallucination is diagnostic. F There is seasonal birth effect. T Confusion and disorientation are rare. F There is a better outcome in the industrialized countries. 38-Deliberate self-harm: More common in males. F May lead to future suicide. T The patient is usually suffering from depression. T May be an attention seeking behavior. T Associated with skin artifact lesion. T 39-Autism: There is language speech delay. T Males affected more than females T( 4:1 Obsessive-compulsive pre-occupied. ? Verbal ticks. ? 40-Phobia: Agoraphobiacs usually suffer from depression. T Simple phobia is considered as delusion. F Social phobia is commonly associated with alcoholism. Uncommon in children. F 41-Antipsychotics: Reduce the threshold for convulsions.

42-Tricyclic antidepressants (TCA): Hypertension is a known side effect. F Contra-indicated in closed angle glaucoma. T In over-dose leads to arrhythmia. T Shorten the QT interval. F(it prolong) Causes delayed ejaculation. F ?(erectile dysfunction, delayed in SSRI) 43-Psychotherapy: Schizophrenia is treated by psychodynamic therapy.
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Psychiatry part 1

Autism is treated by cognitive therapy. ?F Panic attacks are treated by cognitive therapy. T Phobias are treated by cognitive therapy. T Depression is treated by arbitrary inference. F (by trating arbitrary inference) 44-Opiate addiction: More common in developing countries. F More common in deprived urban areas. T Female tendency for addiction is more than males. F More than 30% 0f patients have hepatitis c infection. T Cross addiction with diazepam occurs. T 45. Alzheimers Disease: a. Affects men more than women. F b. Delta & Beta waves occur in EEG. ? c. High Neurofibrillary Tangles correlate with increase in Severity. TRUE d. Commonest cause of Dementia at any age. FALSE e. Is Common in patients with Downs Syndrome. T f. May be Familial in 10% . true g. Reduction in the Biochemical Matter correlates with Cognitive Therapy. ???? 46. Anorexia Nervosa: a. Of poor prognosis if affected Lower Classes. ? b. Dental Problems commonly occurs. T c. FSH does not return to Normal even after treatment F d. There is Hypokalemia. T????(should be excluded) e. There is increased level of Cortisol. T 47. ECT: a. Used in the treatment of Puerperal Psychosis. t ?????(its used in puerperal depression) b. Is better than Medication in the treatment of Depression. F c. Is more successful in Depression with Delusion. T d. Is of no use in Neurotic Depression. true e. Has been validated in Double Blind Trials.? f. It caused brief memory Disturbance after Application. T 48. Clozapine: a. Causes Aranulocytosis. T b. Is used in the treatment of Resistant Schizophrenia. T c. Does not cause Tardive Dyskinesia. T d. Acts on DI Receptors. T
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Psychiatry part 1

49. Temporal Lobe Epilepsy: a. Dejavu occurs. T b. Smell Hallucinations occur. T c. Is followed by Paralysis of one or two Limbs for one or two Hours. ? d. Anti-social Behavior occurs. F e. Consciousness is affected. T 50. Obsessive Thoughts: a. Can usually be resisted. T b. Are usually Acted-upon. T c. Coming from the subjects own Mind. T d. Are Rituals. T e. Are associated with Depression. T 51. Delirium is more common when the those conditions are present: a. Hypothyroidism. T b. Broncho-pneumonia. T c. An Unstimulating Environment. ? d. Treatment with Benzodiazepines. T e. Increasing Age. T 52. Anxiety Neurosis: a. Twins studies proved Genetic Elements. T b. Found in men more than women. F c. Cases of Patho. Anxiety are usually referred to Psychiatric Clinic. ? 53. Enuresis: a. Is associated with a Psychiatric Disorder in the majority of cases. F b. Can be treated by Antidepressants. T c. Runs in Families. T d. Occurs during Non-REM sleeping. T e. Occurs in 1% of the Teenagers. ?TRUE (1-2%) 54-The following are used in prophylaxis of mania: a. L-tryptophan. F b. Lithium citrate. T c. Lithium carbonate. T d. Carbamazepine. T e. Phenytoin. F 55-Symptoms of mania include: a. Irritability. T b. Loss of judgement. T c. Primary delusion. F
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Psychiatry part 1

d. e.

Auditory hallucinations. F e- Third person hallucination. F

56-First Rank symptoms of schizophrenia include: a. Primary delusion F b. Delusional perception. T c. Flight of ideas. F d. Thought block. ??????(THOUGHT WITHDRAWAL)T e. Hallucinations on third person. T 57-Depression is characterized by: a. Late insomnia. T b. Loss of weight. T c. Weight gain. ????????? d. Loss of appetite. T e. Delusion of poverty. F 58- Features of post-traumatic stress disorder include: a. Depressed mood. T b. Elated mood. F c. If she sees someone involved in the accident, they remind her of the accident. d. Vivid dreams about the accident. T 59-Delirium Tremens: a. Should be treated in a dark room. F b. Hallucinations are mainly auditory. F c. There is vitamin deficiency. ?true d. Is fatal in 10% of cases. T 60-Tricyclic antidepressants can cause: a. Chest pain. ? b. Blurring of vision. T c. Constipation. T d. Hypotension. T e. Weight gain. T f. Dry mouth. T 61-ECT is characterized by: a. Tonic clonic seizures. T b. Loss of consciousness. T c. Significant risk of cardiac arrest. F
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Psychiatry part 1

d. Usually refused because of fear of pain. ? e. Analgesia is used. FALSE ?(anaesthesia) 62-In schizophrenia: a. Males are affected more than females. F b. Usually presents before the age of 60. T c. Life events may be a precipitating factor. T d. Amphetamine may aggravate it. T e. Third person hallucination is characteristic . T 63-The following sexual problems are encountered in psychiatric clinics: a. Erectile dysfunction. T b. Vaginismus. T c. Transvestitism. T d. Sadomasochism. T 64-Hallucinations: a. Of Auditory type involving the Third person are characteristic of Schizophrenia.T b. Are Misinterpretations of External Stimuli. F c. Of Visual type suggest Organic Disease. T d. Of Smell suggest Frontal Lobe Lesions. F(temporal) 65Compulsions: a. Are not usually resisted. F b. Checking is rare. F c. Are usually single acts. T d. Are seen Senseless by the patient. T e. PET reveals increased blood flow to the orbitofrontal cortex. T??? 66-Suicide: a. More common in males. T???? b. 60% are associated with Depression. T c. More in the never married. T d. Previous failed Attempts decrease the Risk of Suicide. F e. Is considerable in chronic depressive illness. T 67- Life Events: a.Females stand life events more than males before developing Endogenous Depression.? b. Threat leads to Anxiety more than Depression. T c. Loss of Threats precedes Relapse of Schizophrenia only. ? e. Unemployment increases the Impact of life Events. T f. Loss of confidence increases ht impact of life events. T 68. In Anorexia Nervosa: a. Amenorrhea is more common than in Bulimia Nervosa.
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Psychiatry part 1

b. Weight loss of >25% is required to make the Diagnosis. F c. Patients have Distorted Body Image. T d. Increase Growth Hormone Levels. T e. Fear of eating in Public is a Bad Prognostic feature. T???? f. Endocrine abnormalities nearly always revert to normal after restoration of weight. T 69. Alcohol Dependence Syndrome: a. Is Suggested by MCV of 90. F b. Is Suggested by Irregular Pattern of Drinking. F c. Is Suggested by Altered Alcohol Tolerance. T d. Can be detected by (CAGE) questions. T e. Ingestion of 15 units per week in an adult male is needed to make the Diagnosis.F 70. The following suggest a diagnosis of delirium rather than dementia. a. Abrupt onset. T b. Sudden Behavioral Changes. T c. Preserved Sleep Rhythm. F d. Variable Cognitive Functions. F e. Visual Hallucinations. F ?(occur in both) 71. The following Conditions may present with Depression: a. Hypothyroidism. T b. Addissonss Disease. T c. Pellagra. T d. Pheochromocytoma. F e. Cushings Syndrome. T 72. Benzodiazepine Adverse Effects include: a. Confusion. T b. Respiratory Depression. T c. Aggression. T 73. Opiate Dependence includes: a. Hypersexuality F b. Constricted Pupils. T b. Shivering. F c. Peripheral Neuropathy. ? d. Diarrhea. F

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Psychiatry part 1

74-Side Effects of Selective Serotonin Re-uptake Inhibitors (SSRI) include: a. Nausea. T b. Sweating. T c. Tremors. T d. Sedation. T e. Confusion. T 75-The following make the Diagnosis of Schizophrenia more likely: a. Auditory Hallucinations in the Third Person. T b. Thought Withdrawal. T c. Catatonic type responds well to ECT. T d. Disorientation in Time & Person. F e. Past History of Sexual Abuse in Childhood. ? f. Clozapine is the Treatment of choice. F 76-Child Abuse: a. Sexual Abuse is associated with Violence or tendency to Violence. b. Physical Abuse is Common in Preschool Children. true c. Rare in Teen age girls. F d. In Ireland you must notify to Children Abuse Society. T 77-Over Eating occurs in: a. Anorexia Nervosa. false b. Bulimia Nervosa. T c. Depression. T d. Puerperal Psychosis.? e. Social Phobias. F 78-Symptoms of depression: -Sleep disturbances T -Delusion F -Wt.loss T -Flight of ideas F

79-in assessing drug overdose: -Taking history from relatives is important if available -Increase drug dose increase psychiatric illness F -History is often concealed T -Suicidal note is of no importance F -Recurrent suicidal attempt decreases the risk F
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Psychiatry part 1

80-Anorexia nervosa : -Occurs In early age than bulimia T -treatment is always by hospitalisation F -Cannot occur in males F -Genetic factor is not proven ?FALSE -Drug treatment is the only treatment F 81-Schizophrenia (good prognosis) -Old age T????? -Normal premorbid personality T -Family history of affective disorders -1st Rank symptoms F -Insidious onset F

82-ECT ---Can't be given without consent ? FALSE -Only effective in psychotic depression F -Contraindicated in ischemic heart disease ?TRUE -Contraindicated in patient not taking fluids F -Causing irreversible damage to mamilary body. F 83-Causes of delirium Cushing syndrome T Acute alcohol withdrawal Mania F Schizophrenia F Vit. B1 deficiency T

84-delirium tremens Treated in dark room F Risk of developing convulsions T Hypersomnia F Vit. Deficiency T Mainly auditory hallucination F 85-post traumatic stress disorders Vivid dreams re-encenting the accident Increased mood F Decreased mood T Flight of ideas F
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Psychiatry part 1

When encounter somebody from the accident will remind her with the accident 86-benzodiazepine withdrawal Confusion T Aggression T Respiratory depression F Weight gain F Cognitive impairment T 87-when examining a patient with delirium for orientation Mention the name of the president ? Name of the ward T Mention serial 7s ? Time passed ? Overview of the aim of the interview ? 88-Autism Common after 30 month T Obcessive behaviour F Delayed speech T Always high or normal IQ F Common in female . F (4M:1F)

GOOD LUCK

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