MCQ in Psychiatry

Part II Feb 2005

1. Characteristic features of hepatic encephalopathy include all the following except:

a. Drowsiness
b. Visual hallucinations
c. Flapping tremor
d. Increased fast activity in the EEG
e. Raised blood ammonia concentration

2. Recurrent episodes of clouding of consciousness with lucid intervals are recognized

features of all the following except:
a. Korsakoff’s psychosis
b. Subdural haematoma
c. Multi-infarcts(vascular dementia)
d. Hepatic encephalopathy
e. Transient ischamic attacks

3. The following are characteristic of the new variant of Creutzfelt-Jacob disease

(CJD) except:
a. Early age of onset(19-39)
b. Prominent psychiatric features
c. Rapid progressive onset
d. Exposure to the Bovine Spongiform encephalopathy(BSE) agent
e. Florid prion protein PrP amyloid-plaques in brains of affected individuals

4. The following are more common and more severe in non-dominant parietal lesions
except:
a. Ideomotor apraxia
b. Unconcern over deficit, neglect of grooming, shaving, etc.
c. Dressing apraxia
d. Disturbance of prosodic components to language
e. Anosognosia

5. Regarding senile dementia of Lewy body type, all the following are true
except:
a. Lewy body are intrcellular inclusions
b. Patients present with acute or subacute confusional states
c. Psychiatric symptoms are marked
d. Extrapyramidal signs are remarkable
e. It accounts for 5% of dementia cases in patients over the age of 70 years

6. The following are characteristic features of Korsakoff’s psychosis except:

a. Intact immediate memory
b. Generalized intellectual impairment
c. Impaired recall of registered memory
d. Confabulation is an occasional finding
e. Normal procedural memory (acquired motor skills)

7. The following are associated with frontal lobe lesion except:

a. Impaired visuospatial functions
b. Failure to perform alternating card sorting test
c. Lack of lateralising neurological signs
d. Poor reversed digit span score
e. Grasp reflex

8. The following are recognized features of the aura of focal seizures except:
a. Smell of burning rubber
b. Micropsia
c. Forced thinking
d. Choreiform movement
e. Borborygmi

9. Regarding reciting the months backwards, which one of the following is false:
a. May be affected by intellectual ability
b. May be impaired by anxiety state
c. Is usually impaired in early dementia
d. Is a primarily a test of concentration
e. Is a reliable test of long term memory

10. EEG is of particular value in the differential diagnosis of all the following
except:
a. Early Alzheimer’s disease from early Pick’s disease
b. Cerebral abscess from tension headache
c. Hereditary myoclonus from subcortical epilepsy
d. Absence status from post-ictal twilight state
e. Creutzfeldt-Jakob disease from chronic subdural haematoma

11. In the International Classification of Sleep Disorders, the following are

classified as parasomnias except:
a. Sleep walking
b. Nocturnal leg cramps
c. Obstructive sleep apnoea
d. Nocturnal enuresis
e. Sleep-related painful erection

12. Regarding Narcolepsy, all the following are correct except:

a. First described in 1862 by Caffe’
b. Hypersomnolence is a feature in 80% of patients
c. At least 50% of patients suffer from major affective disorders and/or personality problems
d. The aetiology is unknown
e. About 99% of narcoleptics are HLA-DR2 positive

13. Regarding epileptic psychosis, the following are true except:

a. Psychosis is the specific psychiatric disorder most clearly associated with epilepsy
b. The lifelong prevalence of all psychotic disorders among epilepsy patients ranges from 7 to
12 percent.
c. Patients whose epilepsy has a mediobasal temporal focus are especially at risk
d. Studies on the laterality of the seizure focus suggest an association of a left-sided focus
with psychosis
e. Positron emission tomography (PET) scans may show predominant left temporal
hypermetabolism in epilepsy patients with psychosis.

14. Aftermath severe closed head injury, all the following are true except:
a. At least 10 % of patients suffer from post-traumatic epilepsy
b. The duration of post-traumatic amnesia is probably the best prognostic indicator
c. Recovery may continue for two years
d. Headache is a common sequel
e. Organic personality syndrome is a recognized sequel

15. The following are true regarding the longer-term consequences of cancer except:
a. Major depression occurs throughout the course of illness
b. Major depression affects 10%-20% of patients
c. Major depression is more frequent in those suffering pain
d. Patients with cancer are more depressed than other chronic physically ill patients
e. Both progression and the recurrence of cancer are associated with increased psychiatric
disturbances

16. Post-stroke depression is closely related to all of the following except:

a. The severity of the physical impairment
b. The actual cerebral insult
c. Social network of support
d. History of previous psychiatric disorder
e. History of previous stroke

17. Which of the following statements regarding Alexithymia is incorrect?

a. It may be a cause of psychosomatic illness
b. It is an inability to recognize or describe feelings
c. There is an agreed way of defining it’s characteristics for research
d. It is difficulty in discriminating between emotional states and bodily sensations
e. It is an inability to fantasize
18-Regarding Hypothyroidism; the followings are correct except:
a. Myxoedematous madness denote serious mental disorders associated with thyroid
deficiency in adult life
b. Lithium therapy may be a cause
c. Schizophreniform-like psychosis is the most common psychiatric presentation
d. Dementia may develop slowly
e. Depressed hypothyroid patients do not usually respond to antidepressant drugs

19-The following are discriminating features of thyrotoxicosis from anxiety disorder

except:
a. Preference of cold weather
b. Weight loss despite good appetite
c. Pulse above 90 beats per minute
d. Atrial fibrillation
e. Goitre