1
Q
1. Dolores, the patient in the film clip, exhibited the following symptoms during the interview
A. Looseness of association
B. Flight of ideas
C. Depressed affect
D. All of the above
A
Answer: A. As can be seen from the film clip, Dolores did not have depressed affect, in fact her emotions were in harmony with the ideas she was expressing. Her face and body language showed happiness/pride when she was talking about her shirt. She also did not have a flight of ideas, it was more of the shakeyness of the connections of her ideas.
2
Q
2. It is said to be the center of motivation
A. Deep limbic system
B. Temporal lobe
C. Prefrontal cortex
D. Cingulate
A
Answer: C. According to the trans ‘Introduction to Clinical Psychiatry’, the prefrontal cortex is the motivation center.
3
Q
3. If Dolores is confined in Ward 7 of PGH, during mileu therapy, the team should address rebuilding/recovery of which of the following?
A. Executive ego
B. Synthetic ego
C. Self confidence
D. Super ego
A
Answer: B. While executive ego remains intact in patients with psychiatric conditions, it is their synthetic ego that gets shattered, and is the entity that the team in Ward 7 tries to reconstruct.
4
Q
- On confinement at Ward 7, which of the following will most likely happen?
A. She will be given a hospital gown
B. She will be asked to wear an ID
C. She will not be allowed to bring her personal things/needs because the ward will provide for her needs
D. She will be assigned a bed
A
Answer: D. Ward 7 of PGH adapts mileu therapy. One of mileu therapy’s thrust is to create an environment close to a harmonious home.
5
Q
5. Dolores has problem in focusing and with her attention span. Which part of the brain most likely is impaired with this kind of problem?
A. Deep limbic system
B. Temporal lobe
C. Prefrontal cortex
D. Cingulate
A
Answer: D. According to the ‘Intro to Clinical Pyschiatry’, the cingulate allows shift in attention from thought to thought.
6
Q
6. A 35yo married man awoke one morning with a paralyzed right arm after observing his wife’s close involvement with a friend the previous night. Physical examination was within normal limits. What somatoform disoreder could he have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
D. Conversion disorder
A
Answer: D. Having a sudden neurologic symptom – paralysis of R arm, after a seemingly traumatic experienceis suggestive of conversion disorder.
7
Q
7. A 36yo woman fell at work and since then had had constant back pain unrelieved by medication. At first, no physical pathology was found. However, following repeated investigation, the 4th orthopedic surgeon she consulted diagnosed a protruding intervertebral disc. She went into surgery but experienced no symptomatic improvement. She has been quiet disabled for 3 years, dependent on her husband, and moderately depressed. What somatoform disorder could she have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
D. Conversion disorder
A
Answer: B. Depression may have been the psychological factor exacerbating the pain felt by this woman. This is characteristic of pain disorder.
8
Q
8. A 57yo woman presented dramatically to her general practicioner in a state of agitation, complaining of headache and dizziness, and convinced that she had a brain tumor. She settled temporarily after PE, reassurance and the help of anxiolytic medication. Her mother had recently died of cancer, two brothers and one niece had also died of cancer, and her daughter had survived cancer. In the preceding month, her 2 unmarried daughters had told her that they were planning to leave home. What could she have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
C. Conversion disorder
A
Answer: C. This patient is firmly believing that she has brain tumor, even though there are no clinical manifestations to support her claim. This patient is suffering from hypochondriasis.
9
Q
- A 45yo woman with a history of intermittent asthma since her teenage years developed more severe and more frequent attacks. History revealed an impending separation and increasing hostility between herself and her husband. What seems to be her diagnosis?
A. Psychological factors affecting a medical condition
B. Factitious disorder
C. Conversion disorder
D. Malingering
A
Answer: A. Clearly, the anxiety of an impending separation, has exacerbated a true medical condition.
10
Q
- A 35yo lawyer had been having strange “attacks” about once a month for several years. An “attack” was usually heralded by a sudden feeling of nervousness and awareness that his heart was pounding. This was followed by the experience that all objects in his visual field had diminished to about half their normal size and by the perception that people’s actions took on a mechanical, jerky character, “as in silent movies”. These symptoms would be accompanied by the experience that he had become someone else (“I don’t know who, but not myself”). Recently, while driving his car, his “attack” occurred and he perceived that his arm had become detached from his body and continued to steer the car “on their own”. What could he be suffering from?
A. Depersonalization disorder
B. Dissociative fugue
C. Dissociative identity
D. Dissociative amnesia
A
Answer: A. Words like ‘I don’t know who, but not myself’ shows estrangement from one’s self. The patient’s arm, steering the car on their own is a sense of absence of control of his actions. These two manifestations say a lot about depersonalization disorder.
11
Q
- Ganser Syndrome involves which of the following symptoms?
A. Complete or partial loss of the ability to perform movements that are normally under voluntary control
B. Temporary alteration of the state of consciousness by the loss of usual sense of personal identity
C. Paralogia with clouding of consciousness
D. An individual feels taken over by a spirit or power
A
Answer: C. According to WebMD website, Ganser syndrome is a type of disorder where one acts that he has physical/mental illness even though he has not. Purpose is usually to gain attention or sympathy. One symptom of this disease is that the patient appears confused.
12
Q
- Which disorders are thought to occur when patients suffer bodily symptoms and ill health which are best understood to be psychological or social rather than biological in origin
A. Disorders of somatic function or perception
B. Mood disorders
C. Psychotic disorders
D. Personality disorders
A
Answer: A.
13
Q
13. The patient has a fear of the disease, physical symptoms, may or may not have an actual physical disease but is unable to voluntarily control her illness. What would she likely have? A. Conversion disorder B. Somatization disorder C. Hypochondriasis D. Pain disorder
A
C
14
Q
- The patient may or may not have a fear of a disease, has physical symptoms, no physical disease but has voluntary control over the illness. What would the patient have?
A. Psychological factors affecting a medical condition
B. Factitious disorder
C. Conversion disorder
D. Pain disorder
A
B
15
Q
15. Around 4-6% of medical students can present with this disorder A. Body dysmorphic disorder B. Pain disorder C. Hypochondriasis D. Conversion disorder
A
C
16
Q
16. A patient points in fear at the long white curtain billowing in the wind, saying that it is a white lady waving at her by the window. This is an example of A. Hallucination B. Panphobia C. Illusion D. Apparition
A
C
17
Q
- A hypnagogic hallucination is defined as
A. A false sensory perception occurring while awakening from sleep and is generally considered nonpathological
B. A false sensory perception occurring while awakening from sleep and is generally considered pathological
C. A false sensory perception occurring while falling asleep and is generally considered nonpathological
D. A false sensory perception occurring while falling asleep and is generally considered pathological
A
C
18
Q
18. The persistent, irrational, exaggerated and invariably pathological dread of a specific stimulus or situation is called A. Phobia B. Fear C. Anxiety D. Noesis
A
A
19
Q
19. Indirect speech that is delayed in reaching the point but eventually gets from original point to desired goal A. Loosening of association B. Word salad C. Circumstantiality D. Tangentiality
A
C
20
Q
20. A patient reports that his thoughts can be heard by others as though they were being broadcast over the air. This is an example of A. Thought withdrawal B. Thought insertion C. Thought blocking D. Thought control
A
Answer: This was a bonus since it should be thought broadcasting.
21
Q
21. A 40-year old man is brought to the emergency room on account of a laceration sustained while doing construction work. He is a fairly good worker, has a family, and gets along well with others. He is convinced however that a former classmate is spying n him and plotting to take way his wife. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
A
C
22
Q
22. A 35-year old woman has lived in a psychiatric facility for the past 10 years. She spends most of the day rocking, muttering softly to herself, or just staring blankly ahead. She needs help with dressing and showering, anbd she often giggles and laughs for no apparent reason. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
A
B
23
Q
23. A patient presents with hallucinations and bizarre delusions lasting eight weeks. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
A
Answer: D. Timeframe is too short to be diagnosed as Schizophrenia
24
Q
24. Among the following subtypes of schizophrenia, the one with the best prognosis is A. Paranoid Type B. Disorganized type C. Catatonic Type D. Undifferentiated Type
A
A
25
25. Among the following, the highest prevalence of schizophrenia is found among
A. Dizygotic twins of schizophrenic patients
B. Children of two parents with schizophrenia
C. Non-twin siblings of patient with schizophrenia
D. Spouses of patients with schizophrenia
Answer: A. Although this was contested in the feedback. Answer should be B. According to Ma’am’s lecture and the trans, monozygotic twins and offspring of parents with schizophrenia have the highest relative risk of developing schizophrenia.
26
26. Treatment model where is the focus of treatment is the mental disorder
A. Model I
B. Model II
C. Model III
D. Model IV
B
27
27. The phenomenon of sensitization of drug addiction is defined as
A. Decreased in the expected effect of a drug after repeated administration
B. Persistent hypersensitivity to the effect of a drug in a person with previous exposure
C. Neurobiologic mechanisms involved in anhedonia
D. Typically associated with stimulant abuse and increase in serotonergic function
B
28
28. Individual non-pharmacologic intervention most effective for substance abuse prevention
a. Therapeutic community
b. Alcoholics or Narcotics Anonymous
c. Out patients relapse prevention
d. Motivational interviewing
D
29
29. The intense desire to reexperience the effects of a psychoactive substance is known as
a. Priming
b. Craving
c. Physiological dependence
d. Reward
B
30
30. Neurotransmitter mediating cognitive enhancement in Nicotine use
a. Acetylcholine
b. Dopamine
c. Beta endorphin
d. Serotonin
A
31
31. Psychological ways in which individuals react to the stress of illness
a. Carry on as if everything is normal
b. Mastering knowledge about the illness
c. A and B
d. None of the above
C
32
32. Denial
a. Is not normal
b. Is adaptive
c. Is not healthy
d. Facilitates early treatment
B
33
33. Denial
a. Most helpful
b. The opposite of anger
c. Initial psychological reaction
d. All of the above
C
34
```
34. Anxiety
A. Is pathologic
B. May be precipitated by fear of strangers
C. Can be normal
D. AOTA*
```
Answer: D. *According to feedback but we contested this. A and C cannot be true at the same time. Though anxiety can be pathologic, it isn’t always so, C true. B is also true. AOTA would be the best answer if CAN was used instead of IS in option A.
35
35. Fear of the loss or injury of body parts
A. Can be intensified if the patient has surgery during adulthood
B. Evokes derivatives of castration anxiety in men
C. Is always based on meaning of body parts on the patient’s self-esteem*
D. AOTA
Answer: C. *According to the feedback. But AOTA was asked to be considered, since castration anxiety in men was also mentioned in the lecture along with C, and according to the principles of testmanship AOTA would’ve been the “best” choice. If my memory serves me right contested # rin ‘to.
36
36. The 2 basic theories of why we sleep are:
A. For restorative and adaptive functions
B. For learning and memory enhancement
C. For problem-solving and dream
D. For protection and dream
A
37
```
37. Which of the following statements are true?
A. Sleep is a passive process.
B. Sleep is an active process.
C. Sleep does not go through a process.
D. Sleep is not needed by the body.
```
B
38
38. In stage 1 sleep
A. The body movements, eye movements, blood pressure, heart rate are normal.
B. The body movements, eye movements, blood pressure, and heart rate are decreased.
C. The person, when awoken, is disoriented
D. The person cannot be awoken at all.
B
39
```
39. The most refreshing phase that relieves the physical and mental tiredness are:
A. Stages 1 and 2
B. Stages 2 and 3
C. Stages 3 and 4
D. Stages 4 and 5
```
C
40
```
40. Dreams occur in
A. Stage 1, 2, 3, 4 of sleep (Non-REM)
B. Stage 5 of sleep (REM)
C. Non-REM and REM sleep
D. Stage 1
```
C
41
41. Insomnia in DSM IV-TR is defined as:
A. Difficulty in initiating sleep for at least 1 month.
B. Difficulty in initiating and/or maintaining sleep for at least 1 month.
C. Difficulty initiating sleep for at least 2 weeks.
D. Difficulty in initiating and/or maintaining sleep for at least 2 weeks.
B
42
```
42. The hypothalamus or the body’s master clock contains this structure which interprets signals from the retina to control wakefulness.
A. Suprachiasmatic Nucleus (SCN)
B. Ventro-tegmental Nucleus
C. Nucleus Acumbens
D. Nucleus Basalis of Meynert
```
Answer: A
The suprachiasmatic nucleus or nuclei, abbreviated SCN, is a tiny region on the brain's midline, situated directly above the optic chiasm. It is responsible for controlling circadian rhythms.
43
```
43. The structure (scn) in the previous number regulates this hormone secreted by the pineal gland to bring drowsiness and sleep.
A. Acetylcholine
B. Melatonin
C. GABA
D. Dopamine
```
B
44
```
43. The structure in the previous number regulates this hormone secreted by the pineal gland to bring drowsiness and sleep.
A. Acetylcholine
B. Melatonin
C. GABA
D. Dopamine
```
E
45
45. In treating patients with insomnia,
a. Primary treatment is pharmacological intervention
b. Primary treatment is non-pharmacological intervention
c. Psychoeducation is the primary intervention
d. Combine pharmacological, non-pharmacological interventions and psychoeducation as treatment for insomnia.
D
46
```
46. A patient presents with symptoms consistent with a Major Depressive Episode. Which of the following conditions can be considered as a differential?
A. Major Depressive Disorder
B. Bipolar I Disorder
C. Bipolar II Disorder
D. All of the above
```
Answer: D. All conditions require a major depressive episode to qualify for diagnosis.
Major Depressive Disorder: only major depressive episodes
Bipolar I Disorder: depressive episodes + manic episodes
Bipolar II Disorder: depressive episodes + hypomanic episodes
47
47. Which of the following presentations meet the criteria of a Major Depressive Episode?
A. Anhedonia, hypersomnia, lethargy, feeling of hopelessness, and weight gain
B. Weight loss, insomnia, feeling of excessive guilt, indecisiveness, suicidal ideations
C. Psychomotor agitation, insomnia, weight loss, diminished ability to concentrate, fatigue
D. Depressed mood, insomnia, and weight loss
Answer: A.
Criteria for Major Depressive Disorder:
At least 5 out of 9 symptoms (must include a core symptom, underlined below) are present for at least 2 weeks:
1. Depressed mood
2. Anhedonia
3. Weight gain/loss (e.g. a change of more than 5% body weight in a month)
4. Insomnia/hypersomnia
5. Psychomotor retardation/agitation (observable by others)
6. Fatigue, loss of energy
7. Feelings of worthlessness/guilt
8. Diminished ability to think or concentrate/indecisiveness
9. Recurrent thoughts of death/suicide
A meets criteria.
B and C do not include a core symptom.
D. inludes a core symptom but does not reach 5 symptoms.
48
```
48. Which of the following is not strongly implicated in the neurobiology of depression?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Histamine
```
Answer: D. It is postulated that depression is caused by decreased serotonin function. Because of the overlap in the neurotransmitter tracts of the brain, norepinephrine and dopamine are also postulated to be decreased in depression. Only histamine has not been implicated in depression.
49
49. Which of the following is a possible psychodynamic understanding of depression?
A. Repressed anger
B. Re-experiencing a traumatic event when the patient felt helpless
C. Loss of self-esteem because specific needs of the child for validation and role-modelling were unmet by parents
D. Signal for conflicts between id and superego
Answer: C. Psychodynamic Factors in Depression:
• Disturbances in mother-infant relationship
o Feeling of anger turned inward toward the object that was introjected to avoid object loss
• Person becomes aware of discrepancy between high ideals and inablity to meet them
• Living their lives for someone/something else other than themselves
• Loss of self-esteem and self-cohesion because specific needs for validation (mirroring transference) and role-modeling (idealizing transference) of the child were not met by parents
50
50. Which of the following form the cognitive triad?
A. Belief about oneself, the world, and others
B. Belief about oneself, the future, and the world
C. Belief about the world, other people, and their opinions
D. Belief about oneself, expectations of others, and his ability to achieve the expectations
Answer: B. Used in cognitive behaviour therapy
51
51. Which of the following statements are true about mood disorders?
A. Mood disorders are the most common group of psychiatric disorders
B. Males and females have the same chances of developing depression
C. Antidepressants can cause a switch to mania in bipolar patients
D. Mood disorders are caused by hypoactive functioning of specific brain circuits
C
52
52. Which of the following is an acute goal in the psychiatric management of a manic episode?
A. Enhancement of treatment adherence
B. Prevent relapses
C. Management of functional impairments
D. Ensure safety of patient and other people around them
D
53
53. Which of the following statements describe the mechanism of action of anticonvulsants as mood stabilizers?
A. Increase activity of glutamate
B. Increase activity of GABA
C. Decrease activity of GABA
D. Modulate the effects of GABA and glutamate
B
54
54. Which of the following concepts are related to the neurobiology of learning and memory?
A. Conditioned response
B. Synaptic plasticity
C. Learned helplessness
D. Formation of automatic thoughts based on schemas
B
55
55. Which of the following statements can be an effective psychotherapeutic maneuver for depression?
A. Increasing a patient’s sense of mastery and control over his environment
B. Identification and correction of automatic thoughts and underlying schemas
C. Decreasing the gap between expectations and achievement
D. All of the above
D
56
```
56. Which of the following mental disorders has the highest lifetime prevalence rate?
A. Mood disorder
B. Anxiety disorder
C. Psychotic disorder
D. Personality disorder
```
B
57
```
57. Which of the following statements best describes the panic attacks in panic disorders?
A. Recurrent and unexpected
B. Intense and unremitting
C. Debilitating and unbearable
D. Consistent and predictable
```
Answer: A. Recurrent and unexpected
58
```
58. Which of the following describe the core symptoms of generalized anxiety disorder?
A. Worry is that is non-specific
B. Worry that is difficult to control
C. Excessive worry and anxiety
D. A and B
E. B and C
```
Answer: E. Options B (Worry that is difficult to control) and C (Excessive worry and anxiety) are core symptoms
59
59. Which of the following sequence best describes obsessive-compulsive disorder
A. Anxiety that leads to obsessions that lead to compulsions
B. Compulsions that lead to obsessions that lead to anxiety
C. Obsessions that lead to anxiety that lead to compulsions
D. Compulsions that lead to anxiety that lead to obsessions
C
60
60. Which of the following neurotransmitter abnormalities is postulated to occur in anxiety disorders?
A. Increased GABA, increased norepinephrine and increased serotonin
B. Decreased GABA, increased norepinephrine, decreased serotonin
C. Increased GABA, decreased norepinephrine, increased serotonin
D. Decreased GABA, decreased norepinephrine, increased serotonin
Answer: B. Decreased GABA, increased norepinephrine, decreased serotonin
61
61. Which of the following statements best describe pharmacologic treatment of anxiety disorders?
A. Benzodiazepines for symptomatic relief
B. SSRI/SNRI for lasting control
C. SSRI/SNRI for symptomatic relief
D. Benzodiazepines for lasting control
E. A and B
Answer: E. A (Benzodiazepines for symptomatic relief ) and B (SSRI/SNRI for lasting control)
62
62. Which of the following statements are consistent with the psychoanalytic theory of anxiety
A. Anxiety results from psychic conflicts between unconscious wishes of the id and the super-ego reality
B. The pressure exerted by unconscious thoughts on consciousness results in anxiety
C. Goal of therapy is to eliminate anxiety by eliminating conflict
D. All of the above
Answer: D. All of the above
63
```
63. The brain structure that integrates sensory and cognitive information and determines whether there will be a fear response
A. Pre-frontal cortex
B. Hippocampus
C. Amygdala
D. Thalamus
```
C
64
```
64. To which receptor does benzodiazepine attach to?
A. NE
B. GABA
C. 5-HT
D. a-adrenergic
```
B
65
```
65. Which psychotherapeutic intervention is associated with existential theories of anxiety?
A. Cognitive therapy
B. Behavioral therapy
C. Psychodynamic psychotherapy
D. Logotherapy
```
D
66
```
66. Which of the following personality disorders is more common in the biological relatives of patients with schizophrenia compared to control groups?
A. Avoidant personality disorder
B. Antisocial personality disorder
C. Dependent personality disorder
D. Schizotypal personality disorder
```
D
67
```
67. Which of the following personality disorder is more closely associated with mood disorders compared to control groups?
A. Paranoid personality disorder
B. Schizoid personality disorder
C. Narcissistic personality disorder
D. Borderline personality disorder
```
Answer: D. Borderline personality disorder. Patients with borderline personality disorder usually has or had a history of bipolar disorder or MDD (major depressive disorder).
68
```
68. Which of the following defense mechanisms is commonly used by patients with paranoid personality disorder?
A. Dissociation
B. Projection
C. Introjection
D. Reaction Formation
```
B
69
```
69. In an inpatient setting a patient may idealize some staff members and disparage others. What is this defense used by the patient who is ambivalent and divided the staff members as good or bad? When used by the same patient it could be highly disruptive on a hospital ward and ultimately provoke the staff to turn against the patient.
A. Fantasy
B. Passive aggressive
C. Acting out
D. Splitting
```
Answer: D Splitting. This is the defense mechanism used by patients with Borderline Personality Disorders wherein they only classify people or situations into either good or bad. No grey areas.
70
```
70. Paranoid personality disorder can usually be differentiated from delusional disorder by the absence of which of the following?
A. Fixed delusions
B. Ideas of reference
C. Odd behavior
D. Relationships
```
A
71
```
71. 30 year old female appears ill at ease during interview with poor eye contact, aloof, affect constricted, gives short answers to questions and avoids spontaneous conversation. Mental content reveals unwarranted sense of intimacy with somebody she does not even know. She chooses solitary activities and does not enjoy close relationships including being part of her family. She has which of the following personality disorders?
A. Schizotypal personality disorder
B. Schizoid personality disorder
C. Avoidant personality disorder
D. Antisocial personality disorder
```
Answer: B. Inability to enjoy close relationships including family rules out Avoidant Personality Disorder.
72
```
72. 26 year old female goes to the emergency room with history of recurrent slashing of the wrist with unstable interpersonal relationships, chronic feelings of emptiness, problems with sexual orientation, impulsivity and could not control having sex with men. She was abused sexually when she was 10 years old. She would sometimes manifest micropsychotic episodes and depressive symptoms. Which of the following is your most likely diagnosis?
A. Antisocial personality disorder
B. Histrionic personality disorder
C. Borderline personality disorder
D. Avoidant personality disorder
```
Answer: C. Borderline personality disorder. Important points: 1) suicide attempts, 2) feelings of emptiness, 3) history of being sexually abused as a child, 4) unstable relationships
73
```
73. Which of the following disorders can be described as having high degree of attention seeking behavior, exaggeration of thoughts and feelings and makes everything sound more important than what it is. They display temper tantrums, tears and accusations when they are not the center of attention or are not receiving praise or approval. Seductive behavior is common but commonly have psychosexual dysfunction.
A. Borderline personality disorder
B. Histrionic personality disorder
C. Narcissistic personality disorder
D. Antisocial perosnality disorder
```
Answer: B. Histrionic personality disorder. Important points: 1) KSP (kulang sa pansin) -attention seeking behavior, tantrums when not the center of attention, 2) exaggeration of thoughts and feelings, 3) SEDUCTIVE BEHAVIOR
74
74. Unlike patients with the other personality disorders, those with this type of personality disorder are often aware of their suffering and they seek treatment on their own. Over trained and over socialized, these patients value free association and no directive therapy.
A. Histrionic personality disorder
B. Schizoid personality disorder
C. Avoidant personality disorder
D. Obsessive-compulsive personality disorder
Answer: D. Obsessive-compulsive personality disorder. By process of elimination: Schizoid and Avoidant they avoid social interactions (social withdrawal) so they often do not seek treatment. Histrionic naman, their symptoms are not really that alarming kaya they often do not seek treatment as well. On the other hand, OCPD naman, their symptoms are more distinct and alarming kaya patients often seek treatment for the compulsions.
75
75. Persons with this type of personality are pessimistic, anhedonic, duty bound, self doubting, chronically unhappy.
A. Obsessive-compulsive personality disorder
B. Borderline personality disorder
C. Depressive personality disorder
D. Avoidant personality disorder
C
76
76. Which disorders are thought to occur when patients suffer bodily symptoms and ill health which are best understood to be psychological or social rather than biological in origin?
A. Disorders of somatic function or perception
B. Mood disorders
C. Psychotic disorders
D. Personality disorders
A
77
```
77. The patient has a fear of the disease, physical symptoms, may or may not have an actual physical disease but is unable to voluntarily control her illness. What would she likely have?
A. Conversion Disorder
B. Somatization Disorder
C. Hypochondriasis
D. Pain Disorder
```
C
78
78) The patient may or may not have a fear of a disease, has physical symptoms, no physical disease but has voluntary control over the illness. What would the patient have?
A. Psychological factors affceting a medicla condition
B. Factitious disorder
C. Conversion disorder
D. Pain disorder
B
79
79) Which statement is false in factitious disorder?
A. The intentional production of false or grossly exaggerated symptom
B. There is a need to assume the sick role
C. The gain itself is often apparent and conscious
D. Patient often receive multiple hospitalizations
C
80
```
80) The following are types of dissociative disorder except:
A. Dissociative dementia
B. Dissociative fugue
C. Dissociative identity
D. Dissociative amnesia
```
A
81
91. The most common neurodegenerative dementia worldwide is:
A. Vascular Dementia
B. Alzheimer disease
C. Frontotemporal dementia
D. Lewy body dementia
Answer: B. Explanation: in order of prevalence: Alzheimer > Vascular >Lewy Body >Frontotemporal
82
92. Neuropathological findings in Alzheimer disease include:
A. Neurofibrillary tangles and amyloid plaques
B. Alpha synuclein protein
C. Prion proteins
D. CAG trinucleotide repeats
Answer: A.
Pathological Features of Alzheimer’s Disease:
Neurofibrillary tangles (inside neuron)
Neuritic plaques (outside neuron)
Granulovacuolar degeneration and amyloid angiopathy
Neurofibrillary tangles and amyloid plaques from outside neurons will eventually choke the cells until they can no longer function very well.
83
```
93. The type of dementia that often occurs in those less than 60years old and present initially as behavioural or personality changes:
A. Vascular dementia
B. Alzheimer’s
C. Frontotemporal demetia
D. Lewy body dementia
```
Answer: C. Frontotemporal dementia strikes the young, 40-60 and behavioral or personality changes are first to become prominent unlike in Alzheimer where recent memory deterioriates first
84
```
94. Core Features of this type of dementia includes visual hallucinations, parkinsonism, fluctuations in attention and cognition:
A. Vascular dementia
B. Alzheimer’s
C. Frontotemporal demetia
D. Lewy body dementia
```
Answer: D.
Parkinsonism manifests first before dementia (which appears a year after)
Visual hallucinations (people and animals) - the most striking finding because hallucinations are very vivid and repetitive
Fluctuating attention and cognition (awake for 2 days and sleep for the next 2 days)
Parkinsonism (milder symptoms compared to true Parkinson’s disease)
Prognosis: rapid decline
85
```
95. Hallmarks of Parkinson’s Disease:
A. Tremor
B. Rigidity
C. Bradykinesia
D. AOTA
```
```
Answer: D.
Hallmarks of Parkinson disease include:
• Tremor
• Rigidity
• Bradykinesia
• Postural instability
[Trans on Dementia and other Neurodegenerative Disorders, p3)
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96. The triad of AD inheritance, choreiform movement disorder and progressive dementia:
A. Huntington’s disease
B. Corticobasal ganglionic degeneration
C. Progressive supranuclear palsy
D. Wilson’s disease
Answer: A. Huntington's disease, chorea, or disorder (HD), is a neurodegenerative genetic disorder that affects muscle coordination and leads to cognitive decline and dementia. It typically becomes noticeable in middle age. HD is the most common genetic cause of abnormal involuntary writhing movements called chorea and is much more common in people of Western European descent than in those from Asia or Africa. The disease is caused by an autosomal dominant mutation on either of an individual's two copies of a gene called Huntingtin, which means any child of an affected parent has a 50% risk of inheriting the disease.
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97. Progressive midbrain atrophy producing loss of balance, slurring of speech and vertical gaze difficulties:
A. Huntington disease
B. Corticobasal ganglionic degeneration
C. Progressive supranuclear palsy
D. Wilson’s disease
Answer: C.
Features of Progressive Supranuclear Palsy (Steele-Richardson-Olszewski syndrome):
• Loss of balance (falls)
• Vertical gaze difficulties
• Dementia, slurring, choking
[Trans on Dementia and other Neurodegenerative Disorders]
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98. The triad of dementia, ataxia and incontinence which may respond to ventriculoperitoneal shunting:
A. Huntington disease
B. Corticobasal ganglionic degeneration
C. Progressive supranuclear palsy
D. Normal pressure hydrocephalus
Answer: D.
Features of Normal Pressure Hydrocephalus:
• Gait problems (ataxic or apractic)
• Dementia (mild to moderate)
• Incontinence
• May respond to shunting
• Neuroimaging studies reveal enlarged lateral ventricles with little or no cortical atrophy
[Trans on Dementia and other Neurodegenerative Disorders, p3]
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99. Dementia that characteristically involves autonomic dysfunction (orthostatic hypotension and incontinence)
A. Huntington disease
B. Multiple system atrophy
C. Progressive supranuclear palsy
D. Normal pressure hydrocephalus
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Answer: B.
Features of Multiple System Atrophy:
• Ataxia
• Relatively rapid progression
• Autonomic dysfunction
§ Orthostatic hypotension
§ Incontinence
• Parkinsonism
• Group of disorders with the presence of glial cytoplasmic inclusions typically within the cytoplasm of oligodendrocytes, that can have different patterns of clinical presentation
[Trans on Dementia and other Neurodegenerative Disorders, p3]
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100.Most common prion disease accountable for rapidly progressing dementia over a few months:
A. Huntington disease
B. Multiple system atrophy
C. Progressive supranuclear atrophy
D. Creutzfeldt Jakob disease
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Answer: D. Explanation: Huntington Disease, Multiple System Atrophy and Progressive Supranuclear Atrophy are all rapidly progressing dementia non-prion disease. Creutzfeldt Jakob disease is a rapidly progressing dementia prion disease with a mean survival of 5 months
[OS 211] E3
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