A 7 year old boy has multiple motor tics and makes clicking sounds at unpredictable intervals.

What is
the diagnosis?
Your answer was Tourettes syndrome which is correct
Tourettes syndrome correct answer
Normal varient
ADHD
Autism
Hyperekplexia
Explanation:
Tourettes is diagnosed by the presence of multiple motor and at least one vocal tic over a year with no
more than three tic free months. The onset must be before the age of 18 and autism, drug use and non
tourette causes of tics must be ruled out.
A 19 year old is brought to A+E. He was on a night out 2 nights ago and is described by his friend as a
"party animal". He is now acting very oddly. He is clearly hallucinating and is speaking rapidly. He is
euphoric and laughing inappropriately. He appears agitated and his affect is blunted. His pupils are
dilated and he is tachycardic. What is the most likely diagnosis?
Your answer was Amphetamine induced psychosis which is correct
Amphetamine induced psychosis correct answer
Schizophrenia
Cannibas induced psychosis
Bipolar disorder
Heroin use
Explanation:
Amphetamine is a stimulant and this, cocaine and other hallucinogens can lead to psychosis as seen
here. The other symptoms and clinical findings are inkeeping with this. The fact this patient was on a
night out and is described as a party animal may suggest recreational drug use. Amphetamine induced
psychosis can occur with drug misuse acutely or can be associated with chronic misuse. Cannibas tends
to lead to depression and anxiety although it less commonly has been associated with manic like
psychosis. Schizophrenia is less likely in this case as the findings are more in keeping with drug
induced psychosis. There is no history to suggest bipolar disorder. Opiates lead to pupillary constriction
and are less commonly associated with psychosis.
A 45 year old patient who is known to drink excessively presents in acute alcohol withdrawal. On
examination he appears malnourished. He is commenced on diazepam. His BM is 4.2mmol/l. What is
the next course of action?
Your answer was Commence IV Thiamine which is correct
Commence IV Thiamine correct answer
IV dextrose
IM glucagon
Liason psychiatry
IV magnesium

Explanation:
In patient who suffers from alcohol dependency there is a high risk of thiamine deficiency which can
lead to Wernicke's Encephalopathy. In any patient with alcohol withdrawal IV thiamine should be
commenced. There is a theoretical risk of precipitating Wernicke's encephalopathy in patients with
alcohol dependency if they are given IV dextrose before thiamine as oxidation of glucose utilises
thiamine and it is therefore advised to give glucose concurrently or after thiamine. Patients with alcohol
dependency are at risk of hypoglycaemia and thus BM and formal glucose should be measured.
Similarly they are at risk of hypomagnesaemia and this should be measured. Both hypoglycaemia and
hypomagnesaemia should be treated if required however in this case IV thiamine can be commenced
and bloods awaited. A BM should be performed before commencing treatment.
A 45 year old male was brought to A+E. He was found wandering the streets of a city and was unsure
of where he was or who he was. He could not recall anything from his past. Which of the following is
the most likely diagnosis?
Your answer was Transient Global amnesia which is incorrect
Fugue state
correct answer
Transient Global amnesia
Transient Ischaemic Attack
Malingering
Multiple personality
Explanation:
The above history is indicative of Dissociate fugue or fugue state. In fugue state there is complete loss
of memory including their identity and patients are unable to recall a long period of their life and the
patient is usually found wandering. This can last for months. Sometimes patients take on a new identity.
In transient global amnesia there is global loss of recent memory with the patient unable to retain new
things and unable to recall recent memories. The patient often repeats themselves and can become
agitated.
A man is brought to the GP by his wife. Over the previous 4 months he has been aggressive, rude to
strangers and has noticeable memory loss. He is not on any medication, does not smoke or drink and
takes no recreational drugs. On examination his BP is 145/9 mmHg, bloods are normal including
thyroid function, and there is nothing else to note. An MRI shows increased T2 signal in the frontal
lobe white matter and frontal lobe atrophy. A PET scan demonstrates hypometabolism in the front and
temporal areas. What is the most likely diagnosis?
Your answer was Picks disease which is correct
Picks disease
correct answer
Alzheimers disease
Stroke
Lewy Body demetnia
Huntington disease
Explanation:
Picks disease is a progressive frontotemporal dementia characterised by the presence of tau and
ubiquitin proteins in the degenerating cells and has no known cause. It causes behavioural and
personality changes such as lethargy, disinhibition, and apathy. It also causes a loss of executive
function and memory but these occur AFTER the personality change. An MRI shows increased T2

signal in the frontal lobe white matter and frontal lobe atrophy and PET scans typically demonstrate
hypometabolism in the front and temporal areas.
You are reviewing a patient who tells you she feels like a failure. She has no friends and claims no
body would want to be her friend, lives alone, has never had a partner, finds it hard to interact with her
family, has feelings of rage in between longer bouts of emptiness and self harms. Her notes detail 8
previous suicide attempts, including two whilst admitted. What is the diagnosis?
Your answer was Bipolar depression which is incorrect
Borderline personality disorder correct answer
Bipolar depression
Dissociative disorder
Substance abuse
Schizophrenia
Explanation:
Borderline personality disorder is defined by the DSM IC TR as a pervasive pattern of instability of
interpersonal relationships, self image and affects, as well as marked impulsivity, beginning by early
adulthood and present in a variety of contexts, as indicated by five (or more) of the following,
-efforts to avoid abandonment,
-unstable interpersonal relationships,
-identity disturbance,
-impulsivity,
-suicidal behavious,
-affective instability,
-feelings of emptiness,
-inappropriate anger or paranoid ideation.
It is common for BPD to occur alongside su
You are reviewing a patient who tells you she feels like a failure. She has no friends and claims no
body would want to be her friend, lives alone, has never had a partner, finds it hard to interact with her
family, has feelings of rage in between longer bouts of emptiness and self harms. Her notes detail 8
previous suicide attempts, including two whilst admitted. What is the diagnosis?
Your answer was Bipolar depression which is incorrect
Borderline personality disorder correct answer
Bipolar depression
Dissociative disorder
Substance abuse
Schizophrenia
Explanation:
Borderline personality disorder is defined by the DSM IC TR as a pervasive pattern of instability of
interpersonal relationships, self image and affects, as well as marked impulsivity, beginning by early
adulthood and present in a variety of contexts, as indicated by five (or more) of the following, efforts to

avoid abandonment, unstable interpersonal relationships, identity disturbance, impulsivity, suicidal

behavious, affective instability, feelings of emptiness, inappropriate anger or paranoid ideation. It is
common for BPD to occur alongside substance abuse, depression and other disorders,
bstance abuse, depression and other disorders,

Which of the following is false regarding obsessive compulsive disorder?

Your answer was The dose of SSRI needed to treat OCD is lower than depression which is correct
The dose of SSRI needed to treat OCD is lower than depression
Clomipramine may be trialed if SSRIs dont prove effective
The chance of developing OCD is increased if you have a first degree relative
Surgery on the cingulate cortex is a last resort but effective treatment in 30% of
patients
CBT is an effective treatment
Explanation:

correct answer

The dose of SSRI needed to treat OCD is higher than depression

Which of the following is not commonly found in a manic episode of bipolar disorder?
Your answer was Pressured speech which is incorrect
Visual Hallucinations correct answer
Hypersexuality
Low attention span
Pressured speech
Elevated mood
Explanation:
Visual hallucinations are rare in bipolar mania and would warrant investigation for an organic cause.
Somatisation disorder is a diagnosis of exclusion in which multiple symptoms are found to have no
physical cause. The symptoms are often vague and occur in different systems. The patient normally has
a previous diagnosis of mental illness, the symptoms started before the age of 30 and usually will have
rejected other professionals advice. The main difference between this and malingering is that
malingerers choose to produce the symptoms to receive a conscious benefit from the illness. It is
thought to be a way of dealing with stress as it is more common in people that have underwent
traumatic experiences. Treatment is with CBT and antidepressants.
A 24 year old female presents to her GP with feeling anxious. On further questioning she states she is
constantly ruminating about things. On numerous occasions she constantly obsesses about whether or
not she has locked the doors or switched off the gas and she has to go back three or four times to check
if this is the case. She has also had repeated images of violent acts which she tries to resist but cannot.
What is the most likely diagnosis?

Your answer was Obsessive compulsive disorder which is correct

Obsessive compulsive disorder correct answer
Anxiety
Depressive disorder
Schizophrenia
Obsessional personality
Explanation:
This patient is demonstrating both obsessions and compulsions. The thoughts are her own and are
resisted which is contrary to schizophrenia where they often believe thoughts are inserted. Anxiety and
depressive symptoms are often observed.
Which of the following could be used to distinguish dementia from severe depression
Your answer was Grasp reflex which is correct
Grasp reflex
correct answer
Visual disturbance
Weight loss
Testosterone level testing
Weight gain
Explanation:
The grasp reflex is a primitive reflex that babies have and lose at about 6 months. If something is put in
their hand they will grab onto it. With neurone loss, particularly in the frontal lobe, this reflex
reappears.
Which of the following is characteristic of Lewy Body dementia?
Your answer was Hypersensitive to SSRIs which is incorrect
Fluctuating mental state
correct answer
Aphasia
Symptoms worse on exertion
Hypersensitive to SSRIs
Auditory hallucinations
Explanation:
Lewy Body dementia is easily mistaken for Alzheimers and Parkinsons disease. The core symptoms are
rapidly fluctuating cognition, visual hallucinations and parkinsonism, particularly shuffling gait,
reduced arm swinging, reduced facial expression, cog wheel rigidity. Tremors are less common buy
may exist. Hypersensitivity to neuroleptic is an important feature and these drugs must be avoided.
An elderly man is on the ward due to a left sided pneumonia. He becomes acutely distressed and
punches a nurse. His notes state that he drinks 4 pints of beer a day. On examination his temperature is
38.1 C, BP is 110/60 mmHg, pulse is 95/min and regular, there is consolidation at his left lung base, his
white cell count is raised significantly and renal function is impaired. What has caused his symptoms?
Your answer was Delirium secondary to infection which is correct
Delirium secondary to infection correct answer
Delirium tremens

Undiagnosed dementia
Wernickes encephalopathy
Korsakoffs psychosis
Explanation:
The white cell count, temperature, hypotension, heart rate, renal impairment and consolidation strongly
suggest delerium. Alcohol is a common problem to consider but less likely in this case.
A 68 year old woman that drink 4 glasses of wine per evening is admitted to hospital. Her history
includes controlled hypertension and a previous admission for a urinary tract infection. The nurses ask
you to see her as she appears to be acting strangely. She has a slightly lowered haemoglobin but the rest
of her bloods are normal. Which of the following symptoms would strongly suggest alcohol
withdrawal?
Your answer was Amnesia which is incorrect
Insects crawling up the walls
correct answer
Hearing the voice of her mother
Aphasia
Delusions about being an angel
Amnesia
Explanation:
Alcohol withdrawal can cause tremors, agitation, nausea and vomiting, visual hallucinations and
convulsions. Alcoholic hallucinosis is hallucinations when withdrawing from alcohol that is less severe,
has no autonomic effects and cannot lead to the potentially lethal convulsions of delerium tremens. The
visual hallucinations tend to be at the visual periphery and insects are often the offending sight.
Formication is tactile hallucinations that feel like insects crawling on the skin and is common.
A 29 year old man is brought in by his friends. He claims that his phone is allowing the government to
read his thoughts and his girlfriend cheated on him with someone from the government. His history
notes a previous diagnosis of anxiety 5 years previous that was not treated. He has returned from a trip
to Africa with his friends and on the trip they used mefloquine for malaria prevention, used cannabis
and drank excessively. There is nothing else of note. What is the diagnosis?
Your answer was Personality disorder which is incorrect
Mefloquine induced psychosis correct answer
Schizophrenia
Personality disorder
Acute alcohol withdrawal
Illicit drug use
Explanation:
A rare side effect of mefloquine is unexplained anxiety, mood change, depression (including suicidal
ideation), hallucinations and confusion. It is contraindicated in patients with recent psychiatric
problems, seizures or recreational drug use.
A lady is referred by her GP with visual hallucinations, periods of both mania and depression and a
belief that her child is the messiah. She had given birth 5 days previously. What is the diagnosis?
Your answer was Postpartum psychosis which is correct

Postpartum psychosis correct answer

Postnatal depression
Bipolar disorder
Adjustment disorder
Baby blues
Explanation:
Postpartum psychosis describes the onset of psychotic symptoms following birth. It is most common in
first time mothers and those with a history of psychiatric illness. Symptoms includes mania,
overactivity, flight of ideas, disinhibition, delusions which are often grandiose, visual hallucinations,
and swinging between hypomania and mania. Baby blues is a mild moodiness that effects over 75% of
mothers, tends to last a few days and symptoms include tearfulness, irritability, insomnia, feelings of
isolation and hypochondriasis. Postnatal depression can occur up to a year post partum and symptoms
include low mood, low self esteem, guilt, exhaustion, anhedonia, social withdrawal, sleep disturbance,
low sex drive, weight gain and many others. The Edinburgh Postnatal Depression Scale can be used to
evaluate for signs of postnatal depression.
A man presents to his GP on the insistence of his girlfriend. He was in a motorcycle accident in which
another friend died 4 months previous and since then he has been low in mood and now hears the voice
of his dead mother. He has lost 8 kilos in weight. Examination and blood tests reveal nothing. What is
the likely diagnosis?
Your answer was Post traumatic stress disorder which is incorrect
Psychotic depression
correct answer
Adjustment disorder
Post traumatic stress disorder
Post concussion syndrome
Bipolar disorder
Explanation:
Psychotic depression is characterised by low mood, anhedonia, delusions and hallucinations.
Adjustment disorder cannot be diagnosed if there has been a recent bereavement. Post traumatic stress
disorder is unlikely due to the hallucinations and post concussion syndrome is characterised by a
headache, dizziness and psychological symptoms such as anxiety or depression.
Which is not a side effect of lithium?
Your answer was Weight gain which is incorrect
Red eye
correct answer
Hypothyroidism
Polyuria
Weight gain
Dry mouth
Eyelid ptosis
correct answer
Polydypsia
Tremor
Explanation:

Lithium has an incredibly long list of side effects. Up to a quarter of patients develop hypothyroidism.
Polyuria occurs as the lithium damages renal tubule cells causing nephrogenic diabetes insipidus.
Weight gain and dry mouth are also very common.
A 68 year old man is agitated and is suffering from insomnia during a hospital admission for an elective
operation. He is very sensitive to noise and bright lights, and complains of sore muscles. He has a long
history of anxiety and controlled hypertension. Examination and blood results are normal. What is the
most likely problem?
Your answer was Benzodiazepine withdrawal which is correct
Benzodiazepine withdrawal correct answer
Sepsis
Anxiety
PTSD
Anaesthetic reaction
Explanation:
Benzodiazepine withdrawal syndrome describes the clinical picture of someone withdrawing from
benzodiazepines that have dependence. It is characterised by agitation, sensitivity to light and sound,
insomnia and sore muscles. The onset of symptoms depends on the half life of the drug used. Serious
cases of withdrawal can cause seizures with a high mortality rate.
Which of the following gives the strongest indication that a suicide attempt was serious and not a cry
for help?
Your answer was Timed so that intervention is highly unlikely and takes measures to prevent discovery
or intervention which is correct
Timed so that intervention is highly unlikely and takes measures to prevent discovery correct
or intervention
answer
Drug addiction
Did not make any final plans such as making a will or leaving a note
Taking excessive amounts of paracetamol as the method
Phoned the samaritans during the act
Explanation:
The Beck suicide intent scale identifies the strongest indicators of suicidal intent as isolation from
other, timing so intervention is highly unliekly, active precaution against discovery or intervention, no
contact with potential helper, the creation of a will or similar, writing a suicide note, and planning that
has taken more than 3 hours.
Which of the following would suggest delirium rather than dementia?
Your answer was Fluctuating level of consciousness which is correct
Fluctuating level of consciousness
correct answer
Shouting
Confused more about the present than the past
No tearfulness
Low MMSE score
Explanation:

Delerium is characterised by an acute onset, fluctuating levels of impaired consciousness, nocturnal

worsening, poor concentration, sleep wake cycle disturbance, hallucinations and agitation. A cause of
the delerium should always be sought.
You are asked to see an 81 year old woman by her daughter. The daughter explains that her mother was
started on haliperidol 3 days earlier and has become feverish and extremely confused. The daughter
describes a progressive change in the mothers personality over the past 3 years. What is the most likely
diagnosis?
Your answer was Neuroleptic malignant syndrome which is correct
Neuroleptic malignant syndrome correct answer
Stroke
Alzheimers
Delerium
TIA
Explanation:
The patient is suffering from neuroleptic malignant syndrome which has been caused by giving
haliperidol to a patient with Lewy Body dementia. Its symptoms include pyrexia, altered
consciousness, sweating, rigidity and autonomic imbalance.
Which of the following is not commonly found in a manic episode of bipolar disorder?
Your answer was Low attention span which is incorrect
Visual hallucinations correct answer
Pressured speech
Elevated mood
Low attention span
Hypersexuality
Explanation:
Visual hallucinations are rare in bipolar mania and would warrant investigation for an organic cause.
Which of the following is common secondarily to alcohol abuse?
Your answer was Lower levels of bipolar syndrome which is incorrect
Morbid jealousy
correct answer
Agorophobia
Depression
Lower levels of bipolar syndrome
Increased creativity
Explanation:
Secondary diseases caused by alcohol abuse include morbid jealousy, Wernickes and Korsakoff
syndrome. Conversely, alcohol abuse may be secondary to problems such as depression.
Which of the following is common secondarily to alcohol abuse?
Your answer was Lower levels of bipolar syndrome which is incorrect
Morbid jealousy

correct answer

Agorophobia
Depression
Lower levels of bipolar syndrome
Increased creativity
Explanation:
Secondary diseases caused by alcohol abuse include morbid jealousy, Wernickes and Korsakoff
syndrome. Conversely, alcohol abuse may be secondary to problems such as depression.
Which of the following supports a diagnosis of alcohol dependence syndrome?
Your answer was History of falls which is incorrect
Continued drinking despite physical harm
correct answer
Drinking a variety of alcohol types
History of falls
Morbid jealousy
Drinking despite criminal convinctions related to drink
Explanation:
The signs of alcohol dependence syndrome are narrowing of the drinking repertoire, strong drink
seeking behaviour, high tolerance, withdrawal symptoms, awareness of a compulsion to drink, drinking
to avoid withdrawal or reinstatement of dependence after abstinence.
Which of the following suggests a good prognosis for anorexia?
Your answer was Adult onset which is incorrect
Short duration
correct answer
They do not exercise excessively
Adult onset
Weight loss has not been severe
No history of psychological problems
Explanation:
A long duration of illness is a poor prognostic factor for anorexia nervosa. Psychological problems,
including abnormal social adjustment as a child, is a poor prognostic factor as is adult onset. Excessive
exercise is not known to be linked to prognosis.
What is the most common presenting symptom of anorexia nervosa?
Your answer was Amenorrhoea which is incorrect
Excessive physical activity correct answer
Damaged teeth
Amenorrhoea
Peripheral oedema
Social isolation
Explanation:
The ICD 10 diagnostic criteria for anorexia nervose includes a bodyweight 15% below the expected
weight for the patients height, avoidance of food, excessive exercise, vomiting, use of appetite

suppressants, distorted body image, amenorrhoea or low libido in men and delayed onset of pubery (if
younger). The earliest symptom tends to be excessive exercise as the others take longer to develop.
A 31 year old woman attends her GP as she cant stop worrying about most things in her life. She is
worried about her job as she cannot concentrate and thinks she will be fired soon. She feels low in
mood, cannot sleep well and hasnt been socialising for at least 9 months. What is the likely diagnosis?
Your answer was Generalised anxiety disorder which is correct
Generalised anxiety disorder correct answer
Agoraphobia
Panic disorder
Social anxiety disorder
Depression
Explanation:
The ICD 10 criteria for Generalised anxiety disorder says that the patient must have had 6 months of
anxiety almost every day. There must be one or more autonomic symptom such as palpitations,
sweating, trembling or dry mouth. At least 4 of the following symptoms must be present including
difficulty breathing, feeling of choking, chest pain, nausea, dizzy spells, derealisation, fear of losing
control or dying, hot flushes or cold spells, numbness or tingling sensations, muscle tension or aches,
restlessness, irritability or sleep disturbance.
A 41 year old complains of low mood and problems sleeping which get a lot worse during the winter
months. The rest of the history and examination reveal nothing of note. What is the likely diagnosis?
Your answer was Seasonal affective disorder which is correct
Seasonal affective disorder correct answer
Depression
Bipolar disorder
Dysthymia
Normal
Explanation:
The diagnosis of Seasonal Affective Disorder is controversial. The American Psychiatric Association
DSM IV criteria does not recognised it as an individual condition, but as a cluster of symptoms of
depression disorders or bipolar syndrome. When classed as a condition, it is described as the onset of
low mood, sleeping problems and often weight gain during the winter months. It is thought to be
related to falling levels of light as the treatment is often with bright light to mimic natural daylight.
A 31 year old man is brought to see you by the police. He is unable to recall his name, address or any
personal details. He is not agitated but is confused as to why he cannot recall the information. Recall
tests show that he can form new memories. The next morning, he remembers who he is and that his
company had just went bankrupt. He is low in mood but has no other problems. What is the diagnosis?
Your answer was Dissociative amnesia which is correct
Dissociative amnesia
Major depression
Catatonic state
Vascular dementia

correct answer

Bipolar affective disorder

Explanation:
Dissociative amnesia is defined as retrograde amnesia in the absence of antegrade amnesia with a
psychological cause. It may be global, as in this case, in that the patient cannot remember a lot of their
past such as their name or specific in which they forget a particular event or time. It typically starts
suddenly, usually in response to a major event such as the loss of a partner, and ends suddenly within a
few days.
A 26 year old female presents to her GP, writing on paper, that she can no longer talk. She had no
problems with her voice before and no medical history of note. She has recently lost her job and has
recently been told her flat is being repossessed. A full examination is unremarkable. What is the most
likely diagnosis?
Your answer was Conversion disorder which is correct
Conversion disorder correct answer
Somatisation disorder
Hypochondriac
Epilepsy
Stroke
Explanation:
Conversion disorder is the presence of neurological symptoms without an organic cause. Symptoms
can include paralysis, blindness, aphonia, deafness, gait problems, neck cramps and many others.
Diagnosis starts by excluding all neurological disease, attempting to exclude feigning the symptoms
and then finding the psychological cause of the illness. It name derives from the theory that repressed
psychological pain is converted into psychical symptoms.
A 39 year old male complains that in the past few weeks he has been losing control of his body. He
describes an irregular movement that spreads throughout his body which he cannot stop. His history
has nothing of note. What is the diagnosis?
Your answer was McLeod syndrome which is incorrect
Huntingtons disease
correct answer
Lewy body dementia
Wilsons disease
McLeod syndrome
Early onset parkinsons disease
Explanation:
Huntingtons disease is an autosomal dominant disease that causes cerebral degeneration. Jerky
movements which the patient cannot control is the most common and characteristic feature. The
mildest and earliest symptoms are restlessness or small uncontrolled movements. The disease rapidly
worsens with rigidity, writhing, abnormal posturing and dementia. There is no cure, treatment is for
symptoms of problems and most live less than 20 years after its initial presentation.
A newborn baby has thin lips, a smooth philtrum, small eyes and a small head. Whilst examining him
he suffers a seizure. What is the diagnosis?
Your answer was Williams syndrome which is incorrect

Fetal alcohol syndrome correct answer

Noonan syndrome
Aarskog syndrome
Down syndrome
Williams syndrome
Explanation:
The three facial characteristics of foetal alcohol syndrome are small palpebral fissures, a thin vermilion
and a smooth philtrum. This symptoms may be very slight in mild exposure to alcohol during
pregnancy. Growth abnormalities, such as a small head or being very small, are common as are
neurological problems such as epilepsy. Behavioural problems, learning disabilities and cognitive
impairment often present as the child develops. Diagnosis is controversial and is often based on a
combination of symptoms combined with known maternal alcohol exposure.
A woman has not left her house for 2 months. The last time she was out she suffered a panic attack on
the train and the thought of going out again makes her very anxious. What is the likely diagnosis?
Your answer was Agoraphobia which is correct
Agoraphobia
correct answer
Social phobia
Psychosis
Hypomania
Dissociative disorder
Explanation:
Agoraphobia is a fear of places where you feel that you might not escape easily to a safe place which is
usually your home. This includes open spaces, transport such as trains or buses, shops, bridges or
anywhere that is not your home. Thinking about going to these places may cause anxiety and panic
attacks often occur in these situations. Social phobia may be specific, such as a fear of public speaking,
or generalised in which patients have a fear of social encounter and act to avoid social interaction.
A mother is concerned about her 6 year old son. He causes a lot of problems with his siblings, does not
concentrate, is liable to emotional outbursts and teachers describe him as unruly. He has no medical
problems and apart from being very active, his examination is otherwise normal. What is the most
likely problem?
Your answer was Attention deficit hyperactivity disorder which is correct
Attention deficit hyperactivity disorder correct answer
Tourettes syndrome
Aspergers
Learning difficulties
Early onset bipolar
Explanation:
ADHD is a triad of inattention, hyperactivity and impulsivity which is more common in males. The
symptoms must have been displayed in two separate settings and have lasted six months or longer. It is
important to compare the symptoms to other kids their age.

The previous question:

An 8 year old boy is falling behind at school. He was one of the brightest in the class but has become
quiet and unconfident, especially during English lessons. There is no history of note and physical
examination is unremarkable. What is the likely diagnosis?
Your answer was Dyslexia which is incorrect
ADHD
correct answer
Dyslexia
Asperger syndrome
Conduct disorder
Normal
Explanation:
Dyslexia is a learning disability that impairs a persons ability to read. It manifests itself in many ways
such as problems learning the alphabet, delayed developmental milestones or poor spelling. It can
easily be unnoticed until later in life, such as university, by the sufferer compensating for their
difficulty.
Which of the following would be used to describe the inability to form new memories?
Your answer was Anterograde amnesia which is correct
Anterograde amnesia correct answer
Retrograde amnesia
Prosopamnesia
Source amnesia
Lacunar amnesia
Explanation:
Anterograde amnesia is the inability to form new memories. It may be caused by trauma, drugs such as
benzodiazepines or alcohol, seizures and many other things. Retrograde amnesia is the loss of previous
memories, prosopamnesia is the inability to remember faces, source amnesia means that you can
remember information but not the source of the information, and lacunar amnesia is the loss of memory
about a single specific event.
uring her parents divorce, a 12 year girl spent 2 days crying a lot, not speaking or communicating in
any way. Since then she avoids confrontation and if the divorce is brought up she becomes extremely
emotional. What is the diagnosis?
Your answer was Reactive anxiety disorder which is incorrect
Repression
correct answer
Reactive anxiety disorder
General anxiety disorder
Depression
Lacunar amnesia
Explanation:
Repression is when you choose to block out a bad memory. It differs from amnesia in which memories

are either not stored or lost.

Which of the following demonstrates the Premack principle?
Your answer was Taking away a childs toy when it is bad which is incorrect
Giving a child a new toy if it has done its homework
correct answer
Taking away a childs toy until it has done its homework
Taking away a childs toy when it is bad
No longer rewarding a child for doing their homework
A child achieving a reward which they didnt realise they could earn
Explanation:
The Premack principle is when a person agrees to perform a less desirable activity to subsequently get
access to a more desired activity. It is used in a variety of psychological therapies.
Which is an example of social learning?
Your answer was When a child starts to pretend to use a sword after seeing one in a film which is
correct
When a child starts to pretend to use a sword after seeing one in a film
correct answer
When a group solve a problem together
When a community spread a message, such as a warning, between each other
Using Facebook to study
Reading your friends study notes
Explanation:
Social learning is when you observe a behaviour, retain it and then reproduce it. It is learning by
example.
What is the Garcia effect?
Your answer was An avoidance reaction based on a previous negative reaction to the taste of
something which is correct
An avoidance reaction based on a previous negative reaction to the taste of something correct answer
When an anorexic patient feigns weight gain to pretend they are complying with
treatment
Avoidance of something due to an irrational thought or idea
The term used to describe the enamel damage from repeated vomiting
A term used when a bulimic patient gains weight despite frequent purging
Explanation:
The Garcia effect is an aversive reaction in response to a taste that previous gave a negative effect.
Avoiding a berry if it has previously made you sick would be an example. This can be a problem if the
sickness was unrelated, if you got the flu after eating grapes for example.
Who would be most likely to suffer anaclitic depression?
Your answer was Orphan which is correct
Orphan
A new mother

correct answer

A new father
A newly widowed man
An elderly man in a care home
Explanation:
Anaclitic depression is a rare type of depression that occurs when a childs caregiver is removed for a
prolonged period early on in life, usually when the child is between 6 months and 3 years old.
A child has not started to babble. At which age should a child start babbling 2 or 3 words repeatedly?
Your answer was 4 months which is incorrect
1 year
correct answer
4 months
10 to 12 weeks
18 months
2 years
Explanation:
By 8 weeks a child should be vocalising.
By 3 months they should be making vowel noises.
By 1 year they should be babbling a few words.
By 2 years they should be making simple sentences.
Which of the following is NOT associated with tuberose sclerosis?
Your answer was Hypomelanic macules which is incorrect
Glossitis
correct answer
Learning difficulty
Kidney tumours
Epilepsy
Hypomelanic macules
Explanation:
Tuberous sclerosis is a autosomal dominant disorder that effects most organ systems. Most sufferers
will have hypomelanic macules which are pale patches of skin. Epilepsy and learning problems are
very common and kidney tumours, angiomyolipomas, are found in 60 to 80 percent of patients also.
Other signs include facial angiofibromas, retinal lesions, liver tumours and periungal fibromas.
Which of the following is NOT a feature of Prader Willi syndrome?
Your answer was Hypertonia which is correct
Hypertonia
correct answer
Mental retardation
Short stature
Obesity
Undescended testicles
Explanation:

HYPOtonia, mental retardation, short stature, obesity, undescended testicles, strabismus, overeating
due to an insatiable appetite and extreme flexibility are common signs of Prader Willi syndrome.
Which of the following is NOT a feature of Lesch Nyhan syndrome?
Your answer was Long limbs which is correct
Long limbs
correct answer
X linked genetic inheritance
High levels of serum uric acid
Self mutilating behaviour
Hypotonia
Explanation:
Lesch Nyham syndrome is a rare X linked disease which results in high levels of uric acid throughout
the body. Epilepsy, facial grimacing, involuntary writhing, hypotonia and developmental delay are
common neurological signs. Gout like arthritis, kidney stones, recurrent UTIs and haematuria are signs
of the high uric acid levels. The most characteristic sign is self mutilating behaviour, which often starts
as biting of the lips and progresses to finger biting and head banging.
What is the most common inherited cause of severe intellectual impairment?
Your answer was Fragile X syndrome which is correct
Fragile X syndrome

correct
answer

Prader Willi syndrome

Lesch Nyhan syndrome
#Although Down syndrome is a more common genetic abnormality, fragile X syndrome
more commonly causes mental retardation. The other conditions are rare.
Which of the following is strongly linked with Alzheimers?
Your answer was Downs syndrome which is correct
Downs syndrome
correct answer
Rett syndrome
Marfan syndrome
Lesch Nyhan syndrome
Fragile X syndrome
Explanation:
Most individuals with Downs syndrome develop the cerebral plaques and tangles that are normally
associated with Alzheimers disease. This does not mean that they all have Alzheimers disease, but 10%
do by 45 and over 50% do by the age of 60.
Which of the following is a long acting opioid antagonist ?
Your answer was Naloxone which is incorrect
Naltrexone
Naloxone
Nalorphine

correct answer

Buprenorphine
Oxymorphone
Explanation:
Naltrexone is a long acting opioid receptor antagonist that is used for the treatment of opiate addiction.
Naloxone is a fast acting competitive antagonist used to reverse opioid overdose. Nalorphine is an
unusual opioid that has antagonistic and agonistic effects, and can be used to reverse overdose or
provide anaesthesia. Buprenorphine and oxymorphone are synthetic opioids.
What is acamprosate used for?
Your answer was Smoking cessation which is incorrect
Maintaining abstinence from alcohol
correct answer
Alcohol intoxication
Inducing rapid alcohol withdrawal
Smoking cessation
Maintaining abstinence from benzodiazepines
Explanation:
Acamprosate is a centrally acting compound that supports abstinence from alcohol in detoxified
patients. It should be combined with support of some sort and may be used alongside naltrexone.
Which of the following is NOT as use for bupropion?
Your answer was Anorexia nervosa which is correct
Anorexia nervosa
correct answer
Depression
Smoking cessation
Anxiety
Seasonal affective disorder
Explanation:
Bupropion has been recommended for all of the conditions except anorexia nervosa. It is
contraindicated in individuals with a lower seizure threshold, such as epileptics, those undergoing
alcohol withdrawal and anorexics.
What is Disulfiram used for?
Your answer was Treatment of alcohol dependence which is correct
Treatment of alcohol dependence
correct answer
Treatment of opioid dependence
Treatment of delerium tremens
Reversal of alcohol intoxication
Prevention of Wernickes encephalopathy
Explanation:
Disulfiram, also known as its trade name Antabuse, is used to treat alcohol dependance. It blocks the
enzyme acetaldehyde dehydrogenase. The build up of acetaldehyde in the patients system quickly
results in a very harsh range of symptoms including nausea, vomiting, headache, flushing and
palpitations. It is often given under supervision and in conjunction with other supportive therapies.

Which of the following would be prescribed for ADHD?

Your answer was Modafinil which is incorrect
Methylphenidate correct answer
Modafinil
Lorazepma
Calpol
Fluoxetine
Explanation:
Methylphenidate is commonly known as Ritalin. It acts as a central nervous system stimulant,
increasing levels of dopamine and noradrenaline in areas of the brain that regulate attention. When used
it should be combined with behavioural therapy.
A 31 year old lady avoids leaving her house unless she has to. She has gained a lot of weight and thinks
that people talk about her when they see her. When she does leave the house, she does it at times when
she thinks the neighbours will not see her. She knows her reaction is excessive but she cant control how
she feels. What is the diagnosis?
Your answer was Delusional disorder which is incorrect
Social phobia
correct answer
Agoraphobia
Bipolar disorder
Delusional disorder
Depression
Explanation:
Social phobia is the fear of embarrassing yourself around people which results in the patient avoiding
social situations. It is not agoraphobia as she can leave the house, it is not delusional disorder as she
understands that it is unreasonable, and she does not exhibit enough features to suggest bipolar or
depression.
Which has the highest mortality?
Your answer was Anorexia nervosa which is correct
Anorexia nervosa
correct answer
Schizophrenia
Alcoholism
Depression
Prescription medication addiction
Explanation:
Anorexia nervosa has a high death rate with some suggesting 10 20% per decade. Most recover fully
but it is estimated that 20 40% become chronic. Complications from the disease is the most common
cause of death, such as arrhythmias, with suicide accounting for the next highest percentage.
What percentage of people with anorexia nervosa are male?

Your answer was 10% which is correct

10%
correct answer
1%
1 to 5%
50%
35%
Explanation:
It it suspected that 1 in 10 anorexic nervosa sufferers are male, but this number appears to be growing.
Males are less likely to present and are diagnosed less frequently.
What receptor does buspirone exert it action?
Your answer was Serotonin which is correct
Serotonin
correct answer
Noradrenaline
GABA
Histamine
Adenosin
Explanation:
Buspirone acts on serotonin receptors. It is used in the treatment of generalised anxiety disorder and
has a favourable side effect profile with low addictiveness.
A 34 year old female presents with a week long history of nausea, headache and muscle spasms. A full
history reveals depression treated with fluoxetine and examination is unremarkable. What physiological
imbalance could be the cause?
Your answer was Hypokalaemia which is incorrect
Hyponatraemia
correct answer
Hypernatraemia
Hypokalaemia
Hyperkalaemia
Hypomagnesaemia
Explanation:
Hyponatraemia is a well documented side effect of fluoxetine, and other antidepressants, and can cause
a variety of symptoms that worsen in line with the degree of depletion including nausea, vomiting,
headache, confusion, fatigue, appetite loss, restlessness, weakness, spasms, seizures, and coma.