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36 psychiatric sessional edit by V(^___^)V

1) 82y/o women was diagnosed as dementia with Alzheimer type, she is taking
mementine, this drug is
a) acetyl cholinesterase inhibitor (donepezil, galantamine, rivastigmine)
b) dopamine antagonist
c) monoamine oxidase inhibitor
d) dopamine agonist
e) NMDA receptor antagonist

2) Exposure and response prevention is treatment of


a) schizophrenia
b) major depression
c) bipolar
d) delusional disorder
e) OCD

3) Antipsychotic medication cause hyperprolectinemia by blockade in


a) incerto-hypophyseal tract
b) mesolimbic tract (by increasing dopamine activity cause positive symptom to
disappear)
c) tuberoinfundibular tract (also cause amenorrhea, male erection disorder)
d) mesocortical tract (for negative symptom by increasing 5HT)
e) nigostriatal tract (reduce dopamine activity  balace dop/ach  extrapyramidal
symptom like dystonia, parkinsonism, akatshia, tardive dyskinesia)

4) Feature to differentiate bulimia nervosa and binge eating is that in bulimia nervosa
there is
a) no binge eating episode
b) low BMI
c) compensatory behavior to reduce weight gain
d) preoccupation in body weight, food and appearance
e) presence of amenorrhea in female
5) 52y/o housewife has gained weight despite normal apetite, she feel tired all the time
and does not care of about anything anymore. She complain of being cold all the time.
On examination she appear depressed, has brittle dry hair and puffy face. Most likely Dx
a) hypothyroidism
b) major depression
c) menopause
d) late onset anorexia nervosa
e) cushing syndrome

6) Exhibitionism is
a) exhibiting one possession
b) type of mania
c) shameless exposure of one genital
d) not a sexual paraphilia
e) manifested only in women

7) Which of following is paraphilia


a) hemophilia
b) dyspareunia
c) pedophilia
d) erectile dysfunction
e) premature ejaculation
side note: paraphilia is disorder of sexual preference characterized by intense sexual
arousal fantasies or urges involving nonhuman/inaminate object, children or other non
consenting person or the suffereing/humiliation of oneself/another partner. Other
example are 1) paraphilia, 2) exhibitionism 3) fetishism 4) frotteurism (rub one genital to
other in public) 5) paedophile 6) sexual masochism 7) sexual sadism 8) cross
dressing/fetish transverism 9) voyeurism 10) necrophilia 11) zoophilia 12) scotophilia
13) telephone scatalogia (can refer pg 136 of lecture note)

8) Clinical feature of attention deficit hyperactive disorder (ADHD) is


a) impairment in reciprocal social interaction (seen in autistic disorder)
b) defective specific speech articulation
c) often interrupt or intrudes other (hyperactivity)
d) eating non edible object
e) restricted or stereotypic behavior ( see in autistic disorder)
side note: other feature are 1) short attention span 2) hyperactivity 3) impulsivity
9) Enuresis (involuntary voiding of urine after 5y/o in absence of organic cause) and
encoperesis (involuntary fecal soiling after normal bowel control achieved around 4y)
are
a) specific development disorder of scholastic skill
b) pervasive development disorder
c) specific developmental disorder of motor function
d) elimination disorder
e) disintegrative disorder

10) C/F of autistic disorder is


a) hyperactivity (seen in ADHD)
b) stereotypic behavior
c) exhibit physical cruelty to animal
d) initiate physical fight (impulsivity seen in ADHD)
e) none of above
side note: othe C/F are lack in social development like not interact with other, lack
language development like echolism articulation disorder and behavior like stereotypic
and obsession to one object

11) 13y/o boy grunt and clear his troats several time in an hour, and random shouting often
interrupt his speech. He also perform idiosyncratic complex motor activities such as
turning his head to right while closing his eye and open his mouth. He can prevent this
movement for brief period of time. Dx
a) oppositional defiant disorder (ODD)
b) ADHD
c) pervasive development disorder
d) separation anxiety syndrome
e) Tourette syndrome

12) 16y/o brought to physician because she told her mother she wish she were dead. She
has been irritable for past several weeks, has been isolating herself in her room and
avoiding friend. She has been complaining of general aches and pain as well. Dx
a) depersonalization
b) major depressive episode
c) anorexia nervosa
d) derealization
e) schizophrenia
13) Disorientation in clear consciousness in characteristic feature of
a) Wernicke encephalopathy
b) Alzheimer dementia
c) delirium tremen
d) acute uraemic encephalopathy
e) hypoglycemia

14) 40y/o female always preoccupied having HIV despite several negative test. Dx
a) somatization disorder
b) conversion disorder
c) munchausen’s syndrome
d) hypochondriasis
e) social phobia

15) Hallucination that is characteristic of lewy body dementia is


a) auditory
b) visual
c) tactile (seen in cocaine user)
d) gustaory
e) olfactory

16) When person have difficulty make decision and keep changing them, he is having
a) automatism
b) anhedonia
c) ambivalence
d) lability of effect
e) perseveration

17) Most important differentiating feature of phobia from other anxiety disorder is
a) fear
b) palpitation
c) avoidance
d) sweating
e) anxiety

18) Person able to maintain uncomfortable posture for long time is


a) negativism
b) posturing
c) dyskinesia
d) catalepsy
e) waxy flexibility
19) Tolerance is
a) strong desire to take the substance (dependence)
b) progressive neglect of alternate source of satisfaction
c) when person abruptly stop substance of abuse
d) need to increase dose to achieve desire effect
e) a preoccupation with procuring sunstance of abuse

20) 34y/o man very jealous of successful younger brother tell his friend that his younger
brother jealous of his look. Defence mechanism here is
a) repression (push away unwanted thought so that in attempt to keep peaceful mind)
b) reaction formation (go beyond denial and act the way opposite of what he/she think)
c) sublimation (use hatred/anger etc in constructive manner)
d) displacement (redirect impulse into something like when anger kick a dog child etc)
e) projection
side note, other type in simple way are 1) denial (block external event that we don’t want
and thus unaware of it), 2) regression (become more childish to unwanted situation) 3)
rationalization (make event less freightening by rationalize it)

21) Young man with psychotic disorder started on antipsychotic. 2 day later he say he is
unable to stop pacing and stay still. He feel jittery and complain his leg move on their
own. Most likely explanation
a) early manifestation neuroleptic malignant syndrome
b) increase in psychosis
c) akathisia (motor restlessness esp leg causing subjective inability to rest)
d) restless leg syndrome
e) tardive dyskinesia (variety of abnormal movement from chewing to facial grimace,
twisting and gyrating body)

22) Presence of russel sign(callus in knuckle) in eating disorder is


a) excessive use of laxative
b) induce vomiting (in anorexia nervosa patient want to look skinny .everytime eat
 induce vomiting by poking throat with finger  repeat  callus in hand aka russel)
c) vigorous exercise
d) weighing frequently
e) mirror gazing

23) Following traumatic event, 17y/o cant remember the event. It is


a) supression
b) repression
c) denial
d) dissociation
24) Sleep spindle and k complexes in EEG seen in
a) stage 1 NREM (alpha dropout, theta wave)
b) stage 2 NREM
c) stage 3 NREM (delta wave)
d) stage 4 NREM (delta wave)
e) REM sleep (flatness)

25) Widely accepted theory of emotion is


a) james lange theory
b) cognitive appraisal theory
c) canon bard theory
d) observational laerning theory
e) psychoanalytic theory

26) Filling in gaps with false information unconsciously is


a) retrograde amnesia
b) anterograde amnesia
c) confabulation
d) false memory
e) pathological lying

27) DOC in ADHD


a) haloperidol
b) impramine
c) atypical antipsychotic
d) sodium vaproate
e) methylphenidate

28) Person unable to perform previously learn task


a) agnosia (loss ability to recognize object)
b) ambivalence
c) aphasia (impairment of language)
d) apraxia
e) automatic obedience (do something without questioning)

29) Need to check door several time to allay anxiety is


a) catatonia
b) negativism
c) compulsion
d) phobia
e) agarophobia
30) Occurance of anxiety and nightmare episode several month after traumatic event is
a) acute psychosis
b) acute stress reaction
c) PTSD
d) adjustment disorder
e) generalized anxiety disorder

31) Heroin is
a) cannabinoid
b) stimulant
c) opioid
d) BZD
e) hallucinogen

32) Methadone is
a) cannabinoid
b) stimulant
c) opioid
d) BZD
e) hallucinogen

33) Tactile hallucination commonly seen in


a) mania
b) schizophrenia
c) major depressive disorder
d) cocaine use
e) BZD withdrawal

34) Circumstantiality is a disorder of


a) thought (see page 211 lecture note for other)
b) emotion
c) motor disorder
d) perception
e) memory

35) Person switch from depressive to hypomania stage, he is having


a) schizophrenia
b) bipolar disorder
c) cyclothymia
d) treatment resistant depression
e) serotogenic syndrome
36) When person worries about everyday issue and has muscle tension and autonomic
arousal for more than 6 month, he/she is
a) panic disorder
b) agoraphobia (fear in situation that can cause in helpless panic situation)
c) OCD
d) Generalized anxiety disorder
e) major depression

37) Person with mania also usually experience


a) psychomotor retardation
b) delusion of guilt
c) indiscriminate behavior
d) anhedonia (loss of previous interest seen in depression)
e) nihilistic delusion (the belief that oneself, a part of one's body, or the real world does
not exist or has been destroyed)

38) Low mood for atleast 2 year without meeting criteria of major depressive disorder is
a) dysphoria (a state of unease or generalized dissatisfaction with life)
b) dysthymia
c) hypomania
d) cyclothymia (mild mood swing between mild depressive and hypomania)
e) alexithymia ( subclinical inability to identify and describe emotions in the self)

39) Regular close monitoring of blood for agranulocytosis is done on person with
a) olanzapine
b) fluexetine
c) clozapine/carbamazepine
d) risperidone
e) sertraline

40) Steven Johnson syndrome likely complication of


a) heroin
b) risperidone
c) valproate
d) carbamazepine
e) clonazepam
side note: other A/E drowsy ataxia, blur vision diploplia vomit skin rash
41) CAGE questionnaire done for
a) eating disorder
b) anxiety disorder
c) mania
d) problem drinker
e) depression

42) Rum fits (alcohol withdrawal seizure) seen in


a) newborn not breastfed
b) person consume excess BZD
c) alcohol withdrawal
d) anger management problem
e) following alcohol intoxication

43) Cataplexy usually trigger by


a) fever
b) startle
c) sleep
d) muscle spasm
e) diarrhea

44) When a person perceive special meaning of thing and event around him, he is having
a) delusion of reference (artist say hello in tv, thought it is only for him)
b) delusion of control (think his though are controlled by someone else)
c) delusion of nihilism
d) delusion of perception (like falling flower sign of him becoming king)
e) delusion of persecution

45) Delusion of jealousy/infidelity seen in


a) alcohol use
b) BDZ
c) antidepressent
d) social anxiety
e) major depressive disorder

46) Early morning awakening seen in


a) major depressive disorder
b) panic disorder
c) OCD
d) paranoia
e) mania (no need to sleep)
47) 24y/o student said it is better for truck to hit him. He is expressing
a) suicidal idea
b) delusion of nihilism
c) death wish
d) phobic avoidance
e) deliberate self harm

48) Word finding difficulty commonly seen in


a) mania
b) depression
c) OCD
d) dementia
e) panic disorder

49) Anhedonia may be seen in


a) paraphilia
b) schizophrenia
c) mania
d) tourette
e) panic disorder

50) Painful contraction group of muscle following antipsychotic


a) tics
b) dystonia
c) cogwheel rigidity
d) chorea
e) stereotype

51) Oculogyric crisis is


a) twitching movement lips and tongue
b) voluntary pressure adopted in schizophrenia
c) form of tic in child
d) uprolling of eye in antipsychotic
e) seen in substance withdrawal

52) When person does not sleep throughtout night, he is having


a) narcolepsy
b) night terror
c) global insomnia
d) early morning awakening
e) phase delayed sleep disorder
53) When Tx involve changing thought process thereby changing behavior, it is known as
a) Jacobson progressive muscle relaxation
b) thought flooding
c) graded exposure (use in simple phobia or anxiety)
d) cognitive retraining
e) cognitive behavior therapy

54) Grandiose delusion usually seen in


a) mania with psychotic symptom
b) hypomania
c) dysthymia
d) major depressive disorder with psychotic symptom
e) OCD

55) Child having difficulty writing keep making spelling mistake most likely have
a) echolalia
b) coprolalia
c) dyskinesia
d) dyslexia
e) apraxia

56) ECG, thyroid function test, FBC, renal profile are prerequisite of
a) carbamazepine
b) valproate
c) lithium
d) lamotrigine
e) benzodiazepine

57) Affect of alcohol withdrawal 48-72hour after which affect his sensorium and makes him
disoriented is
a) panic attack
b) dementia
c) delirium
d) depersonalization (state in which one's thoughts and feelings seem unreal or not to belong to
oneself)
e) derealization ( feeling that one's surroundings are not real)
58) Antipsychotic drug with least extrapyramidal side effect (EPS) is
a) haloperidol
b) trifluoperazine
c) risperidone
d) clozapine
e) fluphentixol

59) Person who wash hand constatntly in fear of germ is having


a) obsession of contamination
b) stereotype
c) delusion of control
d) hypochondriasis
e) munchausens syndrome

60) Command hallucination usually seen in


a) major depressive disorder
b) schizophrenia
c) grief reaction
d) mania
e) alcohol intoxication