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Psychiatry Past MCQ

Total questions: 76

Worksheet time: 42mins

Name
Class
Date
1.

Postpartum depression — select the true statements

a)

Evaluated by Edinburgh scale

b)

Occurs in 10% of pregnancies

c)

Has risk in bipolar

d)

Pseudocyesis commonly seen

e)

Can occur in men

2.

Medication causing manic-like symptoms — select the true statements

a)

Stimulant

b)

Beta blocker

c)

Antipsychotic

d)

Corticosteroid

e)

Antidepressant

3.

Amotivational syndrome by cannabis users — select the true statements

a)

Exhibit apathy

b)

Exhibit psychotic features

c)

Loss of concentration

d)

Insignificant occupational impairment

e)

Loss of ambition

4.

Medical conditions causing anxiety-like symptoms — select the true statements

a)

Anemia

b)

Hypoglycemia

c)

Hydronephrosis

d)

Mitral valve prolapse

e)

Stevens–Johnson syndrome

5.

Cognitive Behavioural Therapy — select the true statements

a)

Is unstructured talking therapy

b)

Involves homework between sessions

c)

Challenges negative automatic thoughts

d)

Is evidence-based for OCD

e)

Aims to explore deep childhood issues

6.

Features suggesting organic psychosis — select the true statements

a)

Visual hallucination

b)

Gradual onset

c)

Encapsulated delusion

d)

Affective blunting

e)

Focal neurological sign

7.

Regarding bipolar disorder — select the true statements

a)

Bipolar II requires at least 1 depressive episode

b)

Past manic history + hypomania = Bipolar II

c)

Grandiose delusion is mood congruent in mania

d)

Suicide risk higher in mania than depression

e)

Medication not indicated in mixed episode

8.

Illness anxiety disorder — select the true statements

a)

Acute onset

b)

Rarely seen by psychiatrist

c)

Preoccupied with fear of illness

d)

Frequent tests reassure patient

e)

Direct confrontation reduces distress

9.

Epidemiology of depression — select the true statements

a)

Onset age 25–35

b)

Equal male/female

c)

Lifetime risk 15%

d)

Suicide risk rate 40%

e)

Lower prevalence than bipolar

10.

Poor prognosis of schizophrenia — select the true statements

a)

Ventricular enlargement on CT

b)

Family history of mood disorder

c)

Late onset

d)

Positive symptoms

e)

Male

11.

Delirium tremens — select the true statements

a)

Affects 5% of alcohol withdrawal cases

b)

Mortality 5–15%

c)

Onset 24 hr after last drink

d)

Seizures occur

e)

Autonomic instability

12.

Good interviewing techniques to build rapport — select the true statements

a)

Writing notes

b)

Confrontation

c)

Ensure confidentiality

d)

Respond to emotional concern

e)

Listen without interruption

13.

Amphetamine intoxication symptoms — select the true statements

a)

Pupillary dilatation

b)

Muscle weakness

c)

Increased appetite

d)

Blurring of vision

e)

Chills

14.

Medical condition precipitating cognitive impairment — select the true statements

a)

Limbic encephalopathy

b)

Diabetes mellitus

c)

Syphilis

d)

Creutzfeldt–Jakob disease

e)

Rabies

15.

Gender dysphoria — true statements

a)

Strong desire to be other gender

b)

Sexual excitement when cross-dressing

c)

Prefer playmates of other gender

d)

Diagnosed only after 18 years

e)

Associated with erectile dysfunction

16.

Features distinguishing organic vs functional psychiatric disorders — select the true statements

a)

Disorientation

b)

Visual hallucination

c)

Poor serial 7s performance

d)

Restlessness

e)

Focal neurological sign

17.

Antipsychotics — select the correct statements.

a)

5HT blockade reduces EPSE

b)

Risperidone increases seizure threshold

c)

Haloperidol is atypical

d)

Anticholinergic causes constipation

e)

Tardive dyskinesia is irreversible

18.

Bipolar disorder — select the correct statements.

a)

One depressive episode = Bipolar II

b)

Past manic history + hypomania = Bipolar II

c)

Persecutory delusion is mood congruent in mania

d)

Reduced social inhibition is feature of mania

e)

Medication not indicated in mixed Bipolar II

19.

Indications for ECT — select the appropriate conditions.

a)

Manic agitation

b)

Catatonic schizophrenia

c)

Postpartum depression

d)

Persistent depressive disorder

e)

OCD

20.

Features of PTSD — select the correct features.

a)

Intrusive thoughts

b)

Idea of reference

c)

Emotional numbing

d)

Increased arousal

e)

Patchy amnesia

21.

Causes of visual hallucination in elderly with diabetes and hypertension — select the likely causes.

a)

UTI

b)

Constipation

c)

Benzodiazepine use

d)

Hypoglycaemia

e)

Dehydration

22.

Illness anxiety disorder — select the correct statements.

a)

Preoccupied with body symptoms

b)

Easily alarmed about health

c)

Avoids risky places/activities

d)

Multiple doctor visits despite normal tests

e)

Responds to treatment

23.

Mental health service in primary care — select the correct components.

a)

Mental health promotion

b)

Early detection

c)

Assertive Community Treatment

d)

Residential care

e)

Supported employment

24.

Evidence-based psychosocial rehabilitation — select the evidence-based components.

a)

Sheltered workshop

b)

Social skills training

c)

Psychoanalysis

d)

Increase family contact to reduce expressed emotion

e)

Cognitive remediation therapy

25.

Suicide — select the correct statements.

a)

Many suicides preventable in community

b)

Suicide in schizophrenia occurs later in illness

c)

Higher suicide in doctors vs general population

d)

Anhedonia is strong predictor

26.

Features of autism spectrum disorder — select the correct features.

a)

Irritability

b)

Impulsivity

c)

Social impairment

d)

Restricted interest

e)

Communication impairment

27.

Personality disorder — select the correct statements.

a)

Patient rarely has subjective distress

b)

Patient has interpersonal conflicts

c)

Responds well to pharmacotherapy

d)

Borderline personality disorder related to bipolar

28.

Negative symptoms of schizophrenia — select the correct features.

a)

Thought withdrawal

b)

Apathy

c)

Anhedonia

d)

Hallucination

e)

Poverty of speech

29.

Loosening of association — select the correct statements.

a)

Also known as knight’s move thinking

b)

Common in mania

c)

Easily distinguished from flight of ideas

d)

Abnormal in stream of thought

e)

Not feature of cognitive dysfunction

30.

Features supporting schizophrenia — select the correct features.

a)

Auditory hallucination

b)

Suicidal thoughts

c)

Sensitive ideas of reference

d)

Delusional perception

e)

Impulsive behaviour

31.

Childhood autism — not a clinical feature. Select the option that is NOT a clinical feature.

a)

Hold on to object and not let go

b)

Repetitive movement

c)

Imitate others

d)

Gaze avoidance

e)

Overactivity

32.

Fight-or-flight reaction (Cannon’s) — select the correct features.

a)

Pallor

b)

Pupil dilatation

c)

Increased heart rate

d)

Hypoglycaemia

e)

Reduced bladder, bowel, and genital function

33.

Physical illnesses mimicking anxiety disorder

a)

Thyrotoxicosis

b)

Ménière’s disease

c)

Hyperglycaemia

d)

Phaeochromocytoma

e)

Paroxysmal tachycardia

34.

Personality disorder — general facts

a)

Diagnosed by enduring pattern deviating from cultural expectation

b)

Paranoid, schizoid, schizotypal are Cluster B

c)

Cluster B = dramatic, emotional, erratic behaviour

d)

Cluster C = anxious and fearful

e)

Narcissistic personality disorder is Cluster A

35.

Benzodiazepine drugs

a)

Triazolam

b)

Alprazolam

c)

Buspirone

d)

Phenobarbitone

e)

Diazepam

36.

Personality disorders include

a)

Avoidant

b)

Antisocial

c)

Adjustment

d)

Obsessive-compulsive

e)

Schizotypal

37.

Psychoactive substance abuse

a)

Formication (insect crawling) is cocaine sign

b)

Hallucinogens may cause dependence

c)

Drug abuse more common in males

d)

Synaesthesia with cannabis use

e)

Methadone useful in opioid detoxification

38.

Causes of reversible dementia

a)

Normal-pressure hydrocephalus

b)

Korsakoff syndrome

c)

Alzheimer’s dementia

d)

Vascular dementia

e)

Vitamin D deficiency

39.

Medical illness directly causing psychiatric disorder

a)

Diabetes mellitus

b)

Parkinson’s disease

c)

Phaeochromocytoma

d)

Hyperparathyroidism

e)

Carpal-tunnel syndrome

40.

Mental-health service in primary care

a)

Mental-health promotion

b)

Identification of new cases

c)

Assertive community treatment

d)

Residential care

e)

Supported employment

41.

Evidence-based psychosocial rehabilitation

a)

Sheltered workshop

b)

Social-skills training

c)

Psychoanalysis

d)

Increased family contact when expressed emotion high

e)

Cognitive-behavioural therapy

42.

Features of illness-anxiety disorder

a)

Preoccupied with having symptoms of illness

b)

Easily alarmed about health

c)

Avoids activities risky to health

d)

Repeated visits despite normal tests

e)

Responds well to pharmacological treatment

43.

Antipsychotics

a)

Haloperidol is dopaminergic–serotonergic

b)

Tuberoinfundibular pathway ↓ libido

c)

Chlorpromazine does not cause sedation

d)

Risperidone has higher EPS than chlorpromazine

e)

Constipation uncommon with high dose

44.

Delirium tremens

a)

Occurs within 24–72 h

b)

Can last ≈ 1 week after cessation

c)

Treat with benzodiazepine

45.

Schneider’s first-rank symptoms of schizophrenia

a)

Depersonalisation

b)

Somatic passivity

c)

Delusion of reference

d)

Second-person auditory hallucination

e)

Running commentary

46.

Drugs causing or precipitating mania

a)

Stimulant

b)

Beta-blocker

c)

Antipsychotic

d)

Corticosteroid

e)

Antidepressant

47.

Benzodiazepine withdrawal features

a)

Anxiety

b)

Hand tremor

c)

Unsteady gait

d)

Incoordination

e)

Respiratory depression

48.

Psychological treatment types

a)

CBT targets automatic thought and behaviour

b)

Psychoanalysis

c)

Interpersonal therapy

49.

49. Effects of alcohol Select the correct statements.

a)

Increases GABA-A neurotransmission

b)

Promotes mesolimbic dopamine release

c)

Chronic alcoholism → B12 deficiency

d)

14 units = max/week for women

e)

ALDH deficiency ↑ dependence risk

50.

50. Differences between mania and hypomania Which features distinguish mania from hypomania?

a)

Irritability

b)

Flight of ideas

c)

Pressured speech

d)

Psychosis-like symptoms

e)

Hospitalisation

51.

51. Medications associated with Ebstein anomaly Choose the medication linked with Ebstein anomaly.

a)

Carbamazepine

b)

Lithium

c)

Sodium valproate

d)

Clozapine

e)

Fluoxetine

52.

52. Amotivational syndrome in cannabis users Identify the features of amotivational syndrome.

a)

Exhibit apathy

b)

Loss of ambition

c)

Poor concentration

d)

Psychotic-like symptoms

e)

Minimal occupational impairment

53.

53. Causes of sexual dysfunction Which of the following can cause sexual dysfunction?

a)

Medication side-effect

b)

Gender dysphoria

c)

Male hypoactive sexual desire

d)

Performance anxiety

e)

Lack of privacy

54.

54. Psychological response to terminal illness Select the accurate statements about psychological responses to terminal illness.

a)

Anger common

b)

Suicidal ideation

c)

Repression

d)

All stages must be encountered

e)

Denial

55.

55. Panic disorder Choose the correct characteristics of panic disorder.

a)

Insomnia is a feature

b)

Duration ≥ 6 months

c)

Feeling loss of control

d)

Restlessness

56.

56. ADHD Identify the features commonly associated with ADHD.

a)

Fidgeting

b)

Elevated mood

c)

Impulsiveness

d)

Stereotypy

e)

Social impairment

57.

57. Antidepressants Select the correct statements about antidepressants.

a)

Efficacy after one week

b)

Mirtazapine is SSRI

c)

TCAs safe in elderly

d)

Cause EPS

e)

Urinary incontinence is side-effect

58.

58. Girls with gender-identity disorder (childhood) Choose statements that accurately describe girls with childhood gender-identity disorder.

a)

Play with dolls/house

b)

Refuse to urinate sitting

c)

Don’t want breasts or menses

d)

May give up masculine behaviour in adolescence

e)

Treat with oestrogen

59.

59. Psychotropic drugs in breastfeeding Select the correct guidance regarding psychotropic drugs during breastfeeding.

a)

Use lowest effective dose

b)

Long-term safety uncertain

c)

Treat maternal illness is top priority

d)

Can breastfeed anytime daytime

e)

Should withhold treatment to breastfeed

60.

60. Medical conditions that may present with psychosis Which medical conditions can present with psychosis?

a)

Epilepsy

b)

Alzheimer’s disease

c)

Myocardial infarction

d)

Iron-deficiency anaemia

e)

HIV infection

61.

64. Techniques to build rapport in psychiatric interview Choose the techniques that help build rapport during a psychiatric interview.

a)

Take notes

b)

Avoid direct confrontation

c)

Show concern for emotion

d)

Do not interrupt

e)

Ensure confidentiality

62.

Anxiety disorder: Select the correct statements.

a)

Nausea/headache = GAD symptoms

b)

Catastrophic thinking in several anxiety types

c)

Agoraphobia = fear of scrutiny

d)

Benzodiazepine limited in post-trauma

e)

Psychological therapy > pharmacotherapy

63.

Suicide: Select the correct statements.

a)

In schizophrenia, suicide occurs later in illness

b)

Anhedonia strongest predictor

c)

All attempts require admission

d)

Usually occurs without warning

e)

Ask indirectly about suicide

64.

A 40-year-old lady fears infection and washes hands 20×/day consistent with OCD. Choose the best treatment.

a)

Counselling

b)

Systematic desensitisation

c)

Motivational interviewing

d)

CBT

e)

SSRI

65.

Common psychiatric cases in medical/surgical ward: Select the most common.

a)

Psychotic disorder

b)

Anxiety disorder

c)

Adjustment disorder

d)

Somatoform disorder

e)

Alcohol-use disorder

66.

Pseudohallucination: Select the correct characteristics.

a)

Occurs in clear consciousness

b)

Lacks substantiality

c)

False perception of real stimulus

d)

Perceived in objective space

e)

Can be voluntarily stopped

67.

Community psychiatry: Select the correct statements.

a)

Trend = closing asylums

b)

Caters for acute + long-term needs

c)

Multidisciplinary service

d)

Primary care involved in assertive care

e)

Reduces hospitalisation rate

68.

Personality disorder: Select the correct statements.

a)

Causes distress to patient

b)

Causes interpersonal impairment

c)

May cause counter-transference

d)

Borderline PD ↔ bipolar

e)

Pharmacotherapy more effective

69.

Initial assessment of a 60-year-old with sudden cognitive impairment: Select the most appropriate initial step.

a)

Work record from employer

b)

Neuropsychiatric assessment

c)

History of medical illness

d)

Alcohol history

e)

Marital history

70.

Somatic-symptom disorder: Select the correct statements.

a)

Acute onset

b)

Rarely seen initially by psychiatrist

c)

Anxiety about serious illness

d)

Repetitive investigations reduce distress

e)

Direct confrontation effective

71.

Use of physical restraint: Select the correct practices.

a)

Should be locking

b)

Monitor vitals every 15 min

c)

Doctor documents purpose

d)

Patient supervised constantly

e)

Release one limb hourly

72.

Mini-Mental State Examination (MMSE): Select the correct statements.

a)

Score 20 = severe dementia

b)

Orientation to time/place included

c)

Can be administered in Chinese/English

d)

Used to monitor treatment response

e)

Gold standard for dementia diagnosis

73.

Maintenance treatment of bipolar disorder: Choose the best option.

a)

Lithium

b)

Olanzapine

c)

Sertraline

d)

Risperidone

e)

Clonazepam

74.

Psychiatric effects of opioid: Select the characteristic effects.

a)

Euphoria

b)

Analgesia

c)

Alertness

d)

Increased energy

75.

Abnormal grief reaction: Select the features suggesting abnormality.

a)

Excessive guilt

b)

Poor sleep

c)

Suicidal ideation

d)

Fatigue

e)

Psychomotor retardation

76.

True hallucination: Select the correct characteristics.

a)

Source originates from self

b)

Subjective space

c)

Insight retained

d)

Perceived by sensory organ

e)

Can’t occur in >1 modality simultaneously

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