November 2010

1. Causes of Wernicke-Korsakoff syndrome include

(a) Gastric carcinoma

(b) Hyperemesis
(c) Carbon monoxide poisoning
(d) Tumour of the 4th ventricle
(e) Alcohol abuse

2. About hippocampal morphology in schizophrenia

(a) There is reduction of the anterior hippocampus in MRI

(b) The orientation of hippocampal pyramidal cells is abnormal
(c) Abnormality of structural imaging gives direct evidence of genetic basis
(d) The amygdala is usually normal
(e) Some neuropsychological abnormality in schizophrenia may be explained by hippocampal abnormality

3. Types of paternalism in medical practice

(a) Group paternalism

(b) Occupational paternalism
(c) Individual paternalism
(d) Fostering
(e) State paternalism

4. The following test are required to monitor the long term adverse effects of lithium

(a) Pituitary gland

(b) Creatinine clearance
(c) Liver function
(d) Serum calcium
(e) Blood glucose level

5. In pregnancy and childbirth

(a) Lithium is safe in pregnancy

(b) Lithium is secreted in breast milk
(c) SSRI do not cross the placenta
(d) Opiate withdrawal may precipitate premature labour
(e) Withdrawal symptoms begins immediately after birth in a child of an opiate addicted mother on methadone

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6. Standard management of opiate withdrawal

(a) Clonidine
(b) Substitute drug therapy
(c) Chlorpromazine
(d) Beta blockers
(e) Clonazepam

7. The following psychopathology occurs more in boys than in girls

(a) Depression
(b) Somatization symptoms
(c) Delinquency
(d) External locus of control
(e) Anxiety

8. Shallow affect is seen in the following personality disorders

(a) Anxious
(b) Dissocial
(c) Anankastic
(d) Paranoid
(e) schizotypal

9. The following are cluster C personality disorders

(a) Emotionally unstable

(b) Dissocial
(c) Obsessive compulsive
(d) Avoidant
(e) paranoid

10.The therapeutic factors of psychotherapy used to combat demoralization are

(a) The procedure
(b) Disclosure
(c) Carthasis
(d) Reaction formation
(e) Healing setting

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11.About SSRIs
(a) Are contraindicated in cardiac disease
(b) Effective in Bullimia nervosa
(c) Have cholinergic side-effects
(d) Fluoxetine has long-lasting active metabolites
(e) Paroxetine has a half life of 24hrs

12.About HIV
(a) Mental disturbances occurs during seroconversion
(b) Cognitive impairment occurs when CD4count is below 400
(c) Toxoplasmosis gondii infection can cause a change in mental functions
(d) HIV in the brain causes functional psychiatric illness
(e) Psychiatric problems only occur in response to learning of the infection and at the time of progression

13.Guilty intent has to be proved in the following

(a) Manslaughter
(b) Murder
(c) Indecent assault
(d) Arson
(e) Assault accompanied by actual bodily harm

14.About Cocaine
(a) Induces anergia
(b) Blocks the re-uptake of brain amines
(c) Suppresses respiration
(d) Cause meiosis
(e) Has a depressant effect on the CNS

15.Cortisol non-suppression occurs in the following

(a) Psychosis
(b) Obesity
(c) Hypomania
(d) 80% of endogenous depression
(e) Professional athletes

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16.The following are piperidine phenothiazines

(a) Flupenthixol
(b) Thioridazine
(c) Sulpiride
(d) Chlorpromazine
(e) Trifluperazine

17.The following drugs interfere with sexual function

(a) Beta-blockers
(b) Benzodiazepines
(c) Haloperidol
(d) Sodium Valproate
(e) Ampicillin

18.Therapeutic factors in behaviour therapy

(a) Imprinting
(b) Generalization
(c) Reward
(d) Abreaction
(e) transference

19.Factors associated with poor outcome of ECT

(a) Old age onset depression
(b) Retardation
(c) Old age
(d) Neurotic personality traits
(e) Above average intelligence

20.The following undergo extensive first pass metabolism

(a) Lithium
(b) Haloperidol
(c) Paroxetine
(d) Chlorpromazine
(e) Carbamazepine

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21.The following differentiates pseudodementia from dementia

(a) Catastrophic response
(b) Short history
(c) Do not know answers
(d) Subjects complains of memory impairment
(e) Dressing dyspraxia

22.The following pairings are correct

(a) Premature ejaculation – SSRI
(b) AD with hyperactivity – haloperidol
(c) Panic disorder – isocarboxacid
(d) Eating disorders – Fluoxetine
(e) Atypical depression – phenelzine

23.Features of unsocialized conduct disorder

(a) Disobedience
(b) Teasing
(c) Individual stealing
(d) Group stealing
(e)

24.True about Lithium

(a) It works through 2nd messenger system
(b) Blood level has to be measured 9 hrs after the last dose
(c) Chronic use potentiates serotonergic pathways
(d) Its effect on cathecholamines in the brain are regionally selective
(e) Its effect is mainly on the membranes

25.About Extrapyramidal side effects

(a) 30% of acute dystonia occurs in the 1 st week of treatment
(b) The Chinese have increased risk of developing Tardive Dyskinesia
(c) Clozapine therapy is often limited by akathisia
(d)
(e)

26.Prognosis of depression in the elderly

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(a) 1 in 5 develop chronic depression
(b) 30% will die wthin 6yrs
(c) Prognosis is worse in males than females
(d) 1st episode depression occurring after 70yrs has a worse prognosis
(e) Physical illness has no impact

27.The original description of Wernicke’s includes

(a) Tremor
(b) Ocular palsy
(c) Ataxia
(d) Apraxia
(e) Incoherence

28.In Parkinson’s Disease

(a) Monoamine Oxidase A Inhibitor can slow the progress
(b) Dopamine agonist are used as adjuncts to L-Dopa
(c) There is degeneration of cells of the pars compacta of the substantia nigra
(d) Surgical treatment reduces the action of indirect D2 pathway of the substantia nigra
(e) There is relative deficiency of cholinergic activity

29.The following diseases have neuro-cutaneous manifestations

(a) Neurofibromatosis
(b) Sturge-Weber
(c) Tay-sachs
(d) Von Hippel-Lindau
(e)

30.The following are true of behaviour therapy

(a) General observation suffices
(b) Concentration on diagnosis
(c) Empirical approach
(d)
(e)

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31.Huntington Disease
(a) Is uncommon in the negroid
(b) Autosomal dominant with 70% penetrance
(c) Is a type of subcortical dementia
(d) Hypersexuality is a feature of late stage
(e) Reduced fertility in unaffected compared with affected sibling

32.Alcoholic hallucinosis
(a) Is accompanied by little or clouding of consciousness
(b) Characterized by 3rd person auditory hallucinations
(c) Accompanied by bizarre non-understandable delusions
(d) Does not have a clear temporal link with alcohol withdrawal
(e) 1/5 are eventually diagnosed as suffering from schizophrenia

33.Features of unorthodox psychiatry practice in Nigeria

(a) Being born again
(b) Satanism
(c) Internal Locus of control
(d) Maoism
(e) Incantations

34.Akathisia is characterized by:

(a) A sense of internal restlessness
(b) Partially relieved by pacing
(c) Not caused by clozapine
(d) Alleviated by B-blockers
(e) Caused by chronic benzodiazepine abuse

35.Therapeutic effect of rationale in psychotherapy

(a) Self discovery
(b) Emotional arousal
(c) Competence
(d) Mastery
(e) Transcendence experience

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36.Rationale in psychotherapy
(a) Demonology
(b) Ritual prescription
(c) Linkage to dominant world view
(d) Safety
(e) Healing symbols

37.Attention seeking behaviour occurs in the following personality disorder [ans;- histrionic]

(a) Anxious/avoidant
(b) Borderline
(c) Antisocial
(d) Narcissistic
(e) Schizotypal

38.Parenting and nurturing behaviour is promoted by the following

(a) Prolactin
(b) Oestrogen
(c) Progesterone
(d) Cortisol
(e) Thyroxin

39.Paranoid personality disorders

(a) Occur in 15-30% of patients
(b) Is found in 8% of non-medical adults.
(c) Is strongly associated with agoraphobia and panic disorder
(d) Overlaps with Passive-Aggressive Personality Disorder
(e) Lacks confidants

40.The following are somatic symptoms of anxiety disorder

(a) Constipation
(b) Tinnitus
(c) Carpopedal spasms
(d) Pallor
(e) Tremor

41.True about Lithium

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(a) It works through Calcium-Potassium ATPase system
(b) Blood level has to be measured 9 hrs after the last dose
(c) Chronic use potentiates serotonergic pathways
(d) Its effect on cathecholamines in the brain are regionally selective
(e) Its effect is mainly on the membranes

42.Alcohol dependence
(a) Is suggested by MCV of 90
(b) Is suggested irregular drinking pattern
(c) Is suggested by altered tolerance to alcohol
(d) Can be recognized by CAGE questionnaire
(e) Consumption of >15units per week in men represents unsafe level of drinking

43.The following makes diagnosis of delirium more likely than dementia

(a) Preserved sleep-wake cycle
(b) Abrupt onset
(c) Visual hallucinations
(d) Variability in cognitive testing
(e) Rapidly changing behaviour

44.The following are associated with depression

(a) Hypothyroidism
(b) Pellagra
(c) Addison’s disease
(d) Phaechromocytoma
(e) Cushing’s Syndrome

45.Standard management of Opiate withdrawal include

(a) Clonidine
(b) Substituted drug therapy
(c) Chlordiazepoxide
(d) B-blockers
(e) Clonazepam

46.Drugs commonly used as mood stabilizers

(a) Olanzapine

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(b) Lamotrigine
(c) Clonazepam
(d) Phenytoin
(e) Sodium valproate

47.B-blockers has been suggested for the management of

(a) Mania
(b) Schizophrenia
(c) Depression
(d) Tremors
(e) Akathasia

48.Drugs used to suppress craving

(a) Disulfiram
(b) Acamprosate
(c) Galantamine
(d) Naltrexone
(e) Quinidine esterase

49.The following drugs are associated with significant risk of congenital malformation
(a) Phenothiazines
(b) Fluoxetine
(c) Benzodiazepines
(d) Carbamazepine
(e) Imipramine

50. Mood disorders compared to normal population

(a) Increased incidence of Carcinoma
(b) CVS disorders are common
(c) Pulmonary disease is more common
(d) Life expectancy is invariably shorter
(e) Life exceptancy is related to illness severity

51.Obsessional thoughts
(a) Are perceived to be alien
(b) Intrusive

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(c) Invariably unpleasant
(d) Commonly accepted as harmless
(e) Resistance is always present

52.In Neuroleptic Malignant Syndrome there is:

(a) Hypothermia
(b) Muscle flaccidity
(c) Increased CPK
(d) It occurs only with the use of Butyrophenones
(e) It occurs only with Clozapine therapy

53.Tardive Dyskinesia
(a) Possibly improves on the long term with cessation of the causative drug
(b) Possibly improves on the short term with increased dose of the causative agent
(c) Occurs more following the use of depot than with oral medication
(d) Only caused by phenothiazines
(e) Less likely to occur if drug holidays are provided

54.Features of somatization disorder

(a) No related physical finding demonstrated
(b) Some weeks duration
(c) Bitter complaints about one part of the body
(d) Onset generally in old age
(e) Individual alters lifestyle as a result

55.Pathological grief reaction is suggested by

(a) Development of behaviour resembling that of the deceased
(b) Intense grief between 3-6weeks
(c) Searching behaviour in the first 3weeks
(d) The first signs of grieving occur after an interval of more than 2 months
(e) Intense anger and depression after 6 months

56.Concerning premenstrual tension

(a) Is a withdrawal syndrome
(b) Associated with increased risk of psychosis
(c) Has no association with criminal behaviour

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(d) Best treated with Amitriptyline
(e) Diet has no effect

57.Disorder of thought form in Schizophrenia

(a) Over inclusive thinking
(b) Grandiose delusions
(c) Persecutory delusions
(d) Thought broadcasting
(e) Circumstantiality

58.Negative symptoms in Schizophrenia

(a) Ambivalence
(b) Blunting of affect
(c) Apathy
(d) Delusional mood
(e) Pseudo-hallucination

59.Compared to girls, boys have a higher incidence

(a) A higher incidence of MR
(b) Better language development
(c) Social phobia
(d) Anxiety
(e)

60.Life events
(a) Women have higher levels of life events prior to developing depression than men
(b) Only loss/threat events preceed relapse in schizophrenia
(c) Having a job increases the impact of life events
(d) Having no confidence increases the impact of life events
(e) Life events involving threat leads to anxiety rather than depression

61.Obsessions
(a) Preoccupies the sufferer despite attempts to exclude them
(b) Are felt to come from outside
(c) Resistance can diminish over time
(d) Can occur in schizophrenia

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(e) Ideas are generally known to be false

62.Tic disorders
(a) Reduce during sleep
(b) May be associated with abnormalities of the mid-brain dopaminergic system
(c) Haldol in low doses can significantly reduce tics in most patients
(d) In Tourette’s Syndrome are accompanied by involuntary explosive obscene utterances
(e) Are associated with demonstrable neurological abnormality

63.In Mania
(a) Insight is impaired
(b) Sexual desires are increased
(c) Irritability is a common feature
(d) Stupor is uncommon
(e) Schneider’s first rank symptoms do not occur

64.Treponema Pallidum infection causes:

(a) Dementia
(b) Grandiosity
(c) Depression
(d) Tabes-dorsalis 3-5 years after
(e) Neurological signs

65.Munchausen Disorder
(a) It is a fictitious disorder
(b) It is a Factitious disorder
(c) Might present as false bereavements
(d) It is more common in women
(e) Abdominal complaints are the most common complaints

66.Factors associated with good prognosis of Schizophrenia

(a) Early age of onset
(b) Normal CT scan
(c) Positive symptoms
(d) A psychosocial precipitant to the episode
(e) Gradual onset

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67.The following are true of PTSD

(a) Persistent hypo arousal
(b) Flashback
(c) Good response to medication
(d) Seeking reminders to the incident
(e) Sleep disturbance

68.Features of transient severe acute non-fatal Cerebral anoxia

(a) Hyperphagia
(b) Athetosis
(c) Monoplegia
(d) Agnosia
(e) Dementia

69.Five year prognosis for schizophrenia

(a) 80% will have completely resolved
(b) 20% will return to work
(c) 25% will be in hospital
(d) 10% will have committed suicide
(e)

70.Features of chronic anxiety

(a) Dry mouth
(b) Reduced peristalsis
(c) Increased perspiration
(d) Tremors
(e) Meiosis

71. Foetal alcohol syndrome includes:

(a) Prenatal and postnatal growth retardation
(b) Mid-facial hypoplasia
(c) Normal developmental milestones
(d) Normal intellectual development
(e) Low birth weight but catch-up growth

72.Clozapine

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(a) Acts by D2 receptor blockade
(b) Can cause agranulocytosis in about 2% of people
(c) Rarely causes Extrapyramidal side effects
(d) Can cause grand-mal seizures
(e) Can be effective in treatment resistant schizophrenia

73. Family interaction and schizophrenia. Patients with schizophrenia are more vulnerable to psychotic relapse
if they live with relatives who:
(a) Are detached
(b) Are hostile
(c) Spend more than 35h/week with the patient in a setting of High Expressed Emotions
(d) Are critical
(e) Are tolerant

74.Child Psychiatric disorders

(a) Are more common in rural areas
(b) Conduct disorder is equal in boys and girls
(c) Speech and language delay predict later psychiatric disorder
(d) Epilepsy does not increase the likelihood of psychiatric disorder in childhood
(e) Chronic physical illness is associated with a higher rate of morbidity

75.Memory
(a) Memory loss for recent events occurs in Korsakoff syndrome
(b) Memory loss can be accurately assessed in the presence of depressive illness
(c) Measures of memory function are stable in delirium
(d) Psychogenic amnesia has a slow onset
(e)

76.Pseudo-hallucinations
(a) Exist only in subjective space
(b) The same as grey hallucinations
(c) Similar to religious vision experiences
(d) The patient is aware of their unreal nature
(e)

77.In perseveration

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(a) There is a structural brain lesion
(b) The patient does not recognize the condition
(c) It is synonymous with verbal stereotypy
(d)
(e)

78.Grief reaction in the mentally retarded

(a) The same as in non-mentally retarded persons
(b) Their expression of grief may tally with their level of mental development
(c) Bereavement does not depend on cognitive development
(d)
(e)

79.SSRIs
(a) Increase seizure threshold
(b) Interfere with the metabolism of warfarin
(c) Safer in overdose than TCAs
(d) Have a high incidence of gastrointestinal side effects
(e) Used in OCD

80.Psychopathology more likely in boys

81.Standard Error
82.Gender differences in ability & exams see update (gender issues by dr omigbodun)

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