Download Neet PG Psychiatry MCQs Question Bank
2.Notaselectiveserotoninreuptakeinhibi- tor a)Fluoxitine b)Fluoxamine c)Buspirone d)Citaloforamin CorrectAnswer-CBuspirone
3.Pavlov'sexperimentisanexampleofwhichofthefollowinglearningtheory? a)Modeling b)Classicalconditioning c)Operantconditioning d)Learnedhelplessness CorrectAnswer-BPavlov'sexperimentisanexampleofClassicalconditioning.Classicalconditioningisaprocessoflearning,bywhichapreviouslyneutralstimuluselicitanidenticalorsimilarresponsetooneoriginallyelicitedbyanotherstimulusasaresultofpairingofthetwostimuli.Ref:Kaplan&Sadock'sComprehensiveTextbookofPsychiatry,9thedition,page647.BeginningPsychologyByMalcolmHardy,5theditionpage54;UniversalPrinciplesofDesignByWilliamLidwell,page174;Psychology:ConceptsandApplicationsByJeffreyS.Nevid,3rdeditionpage176.
4.Whichofthefollowingcouldbeacomponentofconversiondisorder? a)Pseudoseizures b)Derealisation c)Depersonalisation d)Amnesia CorrectAnswer-APseudoseizurecanoccurinconversiondisorder.Paralysis,blindnessandmutismarethemostcommonconversiondisordersymptoms.Anaesthesiaandparesthesiaespeciallyoftheextremitiesarethemostcommonsensorysymptoms.Othersensorysymptomsincludesdeafness,blindnessandtunnelvision.Motorsymptomsassociatedwithitare:abnormalmovements,gaitdisturbance,weaknessandparalysis.Onegaitdisturbanceseeninthisisataxiaabasia,whichisawildlyataxic,staggeringgaitaccompaniedbygross,irregular,jerkytruncalmovementsandthrashingandwavingarmmovements. Ref:KaplanandSadock'sConciseTextbookofClinicalPsychiatry,3rdEditionByBenjaminJ.Sadock,Page279
5.ThemostcommonsubstanceofabuseinIndia: a)Cannabis b)Tobacco c)Alcohol d)Opium CorrectAnswer-ABymostestimates,cannabis(Indianhempplant)remainstheworld'smostcommonlyusedillicitdrug.CannabisisperhapsthemostwidelyuseddruginIndiatoo,duetoit'seasyavailability.Cannabis,asubstancethathasbeentraditionallyusedinIndiaasanintoxicant.ItisproducedfromtheplantcannabissalivaorIndianHempplant.Itgrowsinthewildovermostpartsofthecountry. Ref:Kaplan&Sadock'sSynopsisofPsychiatry9thEdition,Page444,424-27;Park'sSocialandPreventiveMedicine18thEdition,Page635;ShorterOxfordTextbookofPsychiatry5thEdition,Page332-342
6.Whichofthefollowingdrugisnotusedinthetreatmentofakathisia? a)Benzodiazepam b)Propranolol c)Trihexyphenidyl d)Haloperidol CorrectAnswer-DAkathisiareferstosomaticrestlessnesswhichoccurinpatientstreatedwithfirstgenerationantipsychotics.Amongtheoptionsgivenhaloperidolisanoldgenerationantipsychoticwhichcausesasideeffectofakathisia.Drugscommonlyusedtotreatakathisiaarepropranolol,benzodiazepinesandanticholinergics. Ref:AmericanPsychiatricAssociationPracticeGuidelinesforthetreatmentofPsychiatricDisorders2006,page649
7.Thecurrentagentofchoicefortreatmentofbipolaraffective(manic-depressive) disorderis: a)Chlorpromazine b)Haloperidol c)Diazepam d)Lithiumcarbonate CorrectAnswer-DLithiumcarbonateisthecurrentagentofchoice,particularlyduringthemanicphase.Becausetheonsetofactionisslow,concurrentuseofantipsychoticagentssuchaschlorpromazineorhaloperidolmaybenecessarytocontrolmania. Concurrentuseoftricyclicantidepressantsmaybenecessaryinthedepressivephase. Monitoringoflithiumlevelsisnecessarybecauseoftheseriousnatureoftheadverseeffects(neurologic,renal,cardiac).Ref:RopperA.H.,SamuelsM.A.(2009).Chapter57.DepressionandBipolarDisease.InA.H.Ropper,M.A.Samuels(Eds),AdamsandVictor'sPrinciplesofNeurology,9e.
8.Mostcommoncomplicationofmodified ECT a)IntracerebellarBleed b)Fracturespine c)Bodyache d)Amnesia CorrectAnswer-DDi.e.Amnesia*Electroconvulsivetherapy(seizure)increasesproductionofbrainderivedneurotrophicfactor(BDNF)Q.MadsenproposedgenerationofnewneuronsinthehippocampusmaybeanimportantneurobiologicalelementunderlyingtheclinicaleffectsofECT.*ECTismostcommonlyindicated(-85%ofallECT)andmosteffectiveintreatmentofmajordepression(withpsychosis/delusions/orsuicidaltendency)Q.ECTisindicatedinpsychotic(delusional)depressionQbecausenihilisticdelusionsmayinducesuicidaltendency,whereasECTisnotindicatedinneuroticdepression(dysthynia),cyclothymiaQ.ECTmaybeusefulinMDP(bipolar)indecreasingdurationofdepressiveepisode.ECTisnot(orless)usefulinchronicconditionslikechronicschizophrenia(withnegativsymptomsesp)Q.UseofECTisnotthefirstline(choice)oftreatmentinmania&schizophrenia(lithium&antipsychoticsaremainstayoftreatment).PanicdisorderisalsotreatedwithdrugsnotECT. IndicationsofECT *ECTismostusefulinacuteandpositivesymptoms(egsuicidaltendency,catatonia),whereasitisleasteffectiveinchronicconditionsandnegativesymptoms
*ClinicalindicationsofECTinclude Primaryuse Secondaryuse 1.Rapiddefinitive 1.Failureto response respondor requiredonmedical intoleranceto or pharmacotherapyin psychiatricgrounds current2.Riskof episodei.e.drugs alternative are treatmentsout ineffective, weightbenefits contraindicatedor 3.Pasthistoryof haveseriousside poorresponseto effects psychotropicsor 2.Rapiddefinitive goodresponseto response necessitatedby ECT deteriorationof 4.Patient thepatients preferance condition.*ECTshouldbeconsideredwhentheonsetofdisorderisacute,whenchangesinmood,thought,andmotoractivitiesarepronounced,whenthecauseofdisorderisbelievedtobebiochemicalorphysiological,whentheconditioninterfereswiththedailylifeorwhenothertreatmentshavefailed.DiagnosisforwhichECTmaybeindicatedinclude(especiallywhena/wdelusions).Major(Severe)ManiaSchizophreniaOtherDepressionwith(Bipolar(Severeconditions1.Psychosis(i.e.disorder)Psychosis)1.Deliriumd/tdelusionalor1.Psychosis1.Catatoniageneralmedicalpsychotic2.ManicparticularlyQconditionsordepression)Q,whodelirium2.Schizoaffectivesubstanceareguiltriddenor3.Rapidcyclingdisorder(i.e.intoxication
feelworthless,whostatesdepressive2.Catatoniad/tbelieveothers4.Acutefeatures)QandGMC,neuroleptcontroltheirlives&uncontrolledschizophreniformmalignantContraindicationsI.Absolute(relatively)RaisedIntraCranialTensionQd/tfearofbrainherniation. 1. Relative *CerebrovascularAccident(CVA)=intracerebralhemorrhage*RecentMyocardialinfarction(MI)*Severehypertension*Pheochromocytoma-SeverePulmonarydisease*Retinaldetachment-Spaceoccupyingintracerebrallesions(exceptforsmall,slowgrowingtumorswithoutedemaorothermasseffect)*UnstablevascularaneurysmsormalformationsComplicationsDirect(Modified)ECT(whenECTisgivenwithoutmusclerelaxant&anesthesia)MostcommonsideeffectisfractureT4T8spineQCausesdecreasedintraoculartension(JOT).ModifiedECT(withMR&anesthesia)Bothretrograde&antegradeamnesiaisfoundbutthemostcommoncomplicationisretrogradeamnesiaQAntegradeamnesiausuallyresolveswithin5hourswhereasretrogradememorydeficitsmaytake6-9monthsQ
9.Visualanaloguescale(VAS)mostwidely usedtomeasure a)Sleep b)Sedation c)Painintensity d)DepthofAnaesthesia CorrectAnswer-CCi.e.Painintensity
10.Visualhallucinationsisseenin: a)Alcoholism b)Mania c)Depression d)Phobia CorrectAnswer-AA.i.e.Alcololism
11.Allaretrueregardingsomatization dosorderexcept: a)Maintainsickrole b)4-Painsymptoms c)1-Sexualsymptom d)1-Pseudoneurologicalsymptom CorrectAnswer-AAi.e.Maintainsickrole
12.Labelleindifferenceisseenin a)ConversionReaction b)Schizophrenia c)Mania d)Depression CorrectAnswer-AAi.e.ConversionreactionLabelleindifferenceQisin-appropiateattitudeofcalmorlackofconcernaboutone'sdisability.Itisseeninconversion(dissociative)disorderQ(butnotspecific),physicalillnessetc.
13.Markedlyinappropriatesensitivity,self importanceandsuspiciousnessareclinicalfeaturesof a)Aantisocial b)Historic c)Schizoid d)Paranoid CorrectAnswer-DDi.e.ParanoidP
14.Antidepressantdrugusedinnocturnal eneuresisis: a)Imipramine b)Fluoxetine c)Trazdone d)Sertaline CorrectAnswer-AAi.e.ImipramineAdverseeffectsofTCAsl.Anticholinergic-Drymouth,badtaste,urinaryretention,blurredvision,palpitation,constiPation.2.Sedation,mentalconfusion,weakness.3.Increasedappetiteandveigfitgain.4.Sweatingandfinctremer.5.Decreasedseizurethreshold(clomipramine,maprotiline&bupropion).6.Posturalhypotension>MarimumbyamitripSline-Goodman&Gillman11/ep.4j3.7.Cardiacarrythmia;Maximumbyamitriptylineanddosulpin.
15.NotafeatureofWernicke'sKorsakoff Syndrome a)Ataxia b)Psychosis c)Normalpupillaryresponse d)Opthalmoplegia CorrectAnswer-CCi.e.Normalpupillaryresponse
16.ThesiteoflesioninKorsakoff'spsychosis is a)Frontallobe b)Corpusstriatum c)MammilaryBody d)Cingulategyrus CorrectAnswer-CCi.e.Mammilarybody
17.NotinvolvedinWernicke-Korsakoff syndrome: a)Mammilarybody b)Thalamus c)Periventriculargreymatter d)Hippocampus CorrectAnswer-CCi.e.PeriventriculargreymatterKorsakoff'sPsychosis(KP)Itisthecommonestcauseoforganicamnesticsyndrome.Itisalsok/aWernicke-Korsakovsyndrome,becauseitoftenfollowsanacuteneurologicalsyndromecalledWernicke'sencephalopathycomprisingdelirium,ataxia,opthalmoplegia,nystagmus&peripheralneuropathy.ItisapotentiallyreversibleconditionQcausedbythiaminedeficiencymostcommonlyassociatedwithchronicalcoholabusemalnutrition.Butothercausesofmalnutritioneg.starvation,hyperemesisgravidarum,dialysis,cancer,AIDS,gastricplicationorprolongedIVhyperalimentation,alonecanalsoresultinthiaminedeficiency&KP.Neuropathologicallesioncausedbythiaminedeficiencyisusuallywidespreadbutmostconsistentchangesareseeninbilateraldorsomedial(&anterior)nucleusofthalamus,mammillarybodies,andhippocampus,informofsmallvesselshyperplasia;petechialhemorrhages,astrocytichypertrophy°enerationQ.Itdisruptsacriticalcircuitbetweenhippocampus&frontallobes.Thechangesarealsoseeninperiventricular(around3rdventricle),periaqueductalgreymatter,cerebellum,andbrainstem(midbrain,pons,medulla
fornix)assymmetricallesions.Thecardinalfeatureisaprofounddeficitofepisodicmemory,confabulationandlackofinsightintotheamnesiaQ.Itpresentsas:Changeinpersonality(frontallobelike)suchthattheydisplaylackofinitiative,interestorconcern&diminishedspontaneity.-Executivefunctiondeficitsinvolvingattention,planning,setshifting,&inferentialreasoning.-Apathy,passivity&confabulationQareoftenprominent.Thereisdisorientationfortime,emotionalblunting,&inertia.-Thereislittleimpairmentinimplicitmemoryandtheirabilitytoperform(complete)complexmotorproceduresremainintactQ.Typicallygeneralintelligence,perceptualskills&languageremainrelativelynormalQ.Memorydisorder-Profounddeficitofepisodictypeexplicit(declarative)memory1/tlossofautobiographicinformation(oftenextendingbackformanyyears).Severeanterogradeamnesia(learningdefect)forverbal&visualmaterialwithalackofinsightintotheamnesia.Eventsarerecalledimmediatelyaftertheyoccur,butforgottenafewminuteslater.Thusdigitspan,testingtheshorttermmemorystore,isnormal.Storageismildlyimpairedbutretrieval&learningareseverelyimpairedQ.Whenpatientslearnnewmaterialtheywillforgetitatanormalrate,butlearningthenewmaterialisextremelydifficult,andinseverecasesnewlearningisimpossible.Sothesepatientshavedifficultencoding&consolidatingexplicitmemory.-Retrogradeamnesiabacktotheonsetofillness,isassevereasanterogradeloss;buttheoverallretrogradememoryimpairment(i.e.beforetheonsetofillness)isnotassevereasthatofanterogradememory.Newlearning&recentmemoryisgrosslydefectivebutretrograde(remote)memoryisrelatively(variably)preserved,andshowatemporalgradient,witholdermemoriesbetterpreserved.Asaresultthesepatientsretainmoredistantmemoriesdramaticallymoreproficientlythantheylearnnewmaterial.-Althoughremotememoryissurprisinglyintact,patientsareunable
toorganizetheminatemporalcontext.SotheydistorttherelationshipbetweenfactsandfilltheremotememorygapsbyconfabulationQ(avivid&whollyfictitiousaccountofrecentactivitieswhichthepatientbelievestobetrue).
18.Mostcommoncausedementiainadult: a)Alzheimer's b)Multiinfrct c)Pick'disease d)Metaboliccause CorrectAnswer-AAi.e.Alzheimer's
19.InAlzheimer'sdisease(AD)whichofthe followingisnotseen: a)Aphasia b)Acalculia c)Agnosia d)Apraxia CorrectAnswer-CAns.None>C.AgnosiatRej.KaplananalJaadocksSynopsisof Psychiatry10/cpi-t?Aphasia,Apraxia,AcalculiaandAgnosiamayallbeseeninAlzheimer'sDementia.AgnosiainAlzheimer'sdiseaseusuallypresentslateinthediseaseandisnotincludedintheICD-10DiagnosticcriteriafordementiainAlzheimer'sdiseasewithearlyonsetandhencemaybeselectedasthesinglebestanswerbyexclusion
20.Maniaischaracterizedby: a)Paranoiddelusion b)Lossoforientation c)Highselfesteem d)All CorrectAnswer-CCi.e.Highselfesteem
21.Lithiumistreatmentofchoicefor a)UnipolarMDPprophylaxis b)BipolarMDPprophylaxis c)Schizophrenia d)Acutemania CorrectAnswer-BBi.e.BipolarMDPprophylaxisLithium:Indications:Establishedindications:TreatmentofacutemaniaProphylaxisofbipolarmooddisorder.Possibleclinicalindications:Treatmentoftheschizo-affectivedisorderProphylaxisofunipolarmoodilisordertreatmentofcyclothymiaTreatmentifacutedepression(asanadjuvantforrefractorydepression)Treatmentofchronicakoholism(inpresenceofsignificantdepressivesymptoms)6psychoactiveusedisorders(e'gcocainedePendence)Treatmentofimpulsiveaggression.TreatmentofKeine-Levinsyndrome
22.Featureslikeincreasedpsychomotor acitivity,waxyflexinbilityattimeareseenclassicallyin: a)Simpleschizophrenia b)Hebephrenicschizophrenia c)Catatonicschizophrenia d)Noneoftheabove CorrectAnswer-CC.i.e.Catatonicschizophrenia
23.Posttraumaticstressdisorder(PTSD)is differentiatedfromallotherdisordersby: a)Nightmaresaboutevents b)Autonomicarrousalandanxiety c)RecallofeventsandavoidanceofsimilarexperiencesinPTSD d)Depression CorrectAnswer-CCi.e.RecallofeventsandavoidanceofsimilarexperiencesinPTSD-PTSDarisesasresponsetotraumaticevent(criteriaA)thatischaracterizedbypersistentre-experience(criteriaB),persistentavoidanceandnumbness(C),hyperarousal(D),of>1monthduration(criteriaE)causingsignificantdistress&impairedfunctioning(criteriaF)Q.Theonsetmaybedelayed(6monthstoyearsafterevent).-PTSDarisesasadelayed/protractedresponsetoanexceptionallystressfulorcatastrophiclifeeventorsituationwhichislikelytocausepervasivedistressinalmostanyperson(eg.disaster,war,rape,torture,seriousaccident).Itmaydevelopevenafter6monthstoyearsafterstressorQ.-PTSDischaracterizedbyperistent/recurrentintrusivedistressingrecollectionsofstressfuleventeitherinflashbacks(images,thoughtsorperceptions),dreams,relivingexperiences,illusions,hallucinationsordistress/physiologicalreactivityonexposuretoremindersoftraumaticevents.Thereismarked(persistent)avoidanceofstimuli/eventsorsituationsthatarouserecollectionofstressfuleventsandincreasedarousal(hyperarousal)andnumbingofgeneralresponsivenessQ.Partialamnesiaforsomeaspectsofstressfulevents,anhedonia
Partialamnesiaforsomeaspectsofstressfulevents,anhedonia(inabilitytoexperiencepleasure)andalexithymia(characterizedbyinabilitytoidentify&articulatefeelings)maybepresent.
24.Catatoniaisatypeof: September2007 a)Schizophrenia b)Phobia c)Depression d)OCD CorrectAnswer-AAns.A:SchizophreniaSchizophreniaisasevere,persistent,debilitating,andpoorlyunderstoodpsychiatricdisorderthatprobablyconsistsofseveralseparateillnesses.Symptomsincludedisturbancesinthoughts(orcognitions),mood(oraffects),perceptions,andrelationshipswithothers.Thehallmarksymptomsofschizophreniaareauditoryhallucinationsanddelusions,whicharefixedfalsebeliefs.Thesymptomsofschizophreniamaybedividedintothefollowing4domains:Positivesymptoms:Theseincludepsychoticsymptoms,suchashallucinations,whichareusuallyauditory;delusions;anddisorganizedspeechandbehavior.Negativesymptoms:Theseincludeadecreaseinemotionalrange,povertyofspeech,lossofinterests,andlossofdrive.Cognitivesymptoms:Theseincludeneurocognitivedeficits,suchasdeficitsinworkingmemoryandattentionandexecutivefunctionssuchastheabilitytoorganizeandabstract.Moodsymptoms:Schizophreniapatientsoftenseemcheerfulorsadinawaythatdoesnotmakesensetoothers.Theyoftenaredepressed.CatatoniaSchizophreniaThissyndromeoccursinchildren,adolescents,andadults;is
Thissyndromeoccursinchildren,adolescents,andadults;isassociatedwithaheterogeneousgroupofcomorbidconditions;andischaracterizedbyavarietyofsymptomsandsignsofimpairmentoftheexpressionofvoluntarythoughtsandmovements.Typically,thesyndromeofcatatoniaisepisodic,withperiodsofremission.Itcanpresentsinthreeclinicalforms:ExcitedcatatoniaStuporouscatatoniaCatatoniaalternatingbetweenexcitementandstupor.
25.Suicidaltendenciesaremostcommonly seenin:March2003 a)Female b)Youngerage c)Severedepression d)Alloftheabove CorrectAnswer-CAns.Ci.e.Severedepression
26.Sexualstimulationobtainedthroughsome inanimateobjectisknownas:September2003 a)Transvestism b)Fetichism c)Voyeurism d)Zoophilia CorrectAnswer-BAns.Bi.e.Fetichism
27.Allofthefollowingareformalthought disorderEXCEPT:March2013(b,c,h) a)Schizophrenia b)Delusion c)Looseningofassociation d)Mania CorrectAnswer-BAns.Bi.e.DelusionDelusionisadisorderofthoughtcontent(NOTaformalthoughtdisorder/disorderofthoughtprocess)DelusionDisorderofthought;FalseunshakenbeliefnotamenabletoreasoningHallucinationDisorderofperception;Perceptionintheabsenceofexternalstimuli;NotdependentofwillofobserverIllusionMisinterpretationofexternalstimuli
28.Illusionis: September2007 a)Afalseunshakenbeliefnotkeepingone'ssociaocultural background b)Perceptionwithoutstimuli c)Abnormalperceptionbyasensorymisinterpretationofactual stimulus d)Fearofclosedspaces CorrectAnswer-CAns.C:AbnormalperceptionbyasensorymisinterpretationofactualstimulusIllusionisanabnormalperceptioncausedbyasensorymisinterpretationofactualstimulus,sometimesprecipitatedbystrongemotion,e.g.fearprovokingapersontoimaginetheyhaveseenanintruderintheshadows.
29.Whichofthefollowingisnotassociated withdementia:March2011 a)Forgetfulness b)Alterationofconsciousness c)Reducedpersonalcare d)Lossofneuronsinbrain CorrectAnswer-BAns.B:AlterationofconsciousnessThereisimpairmentofjudgementandimpulsecontrol,andalsoimpairmentofabstractthinkingThereishoweverusuallynoimpairmentofconsciousnessindementia(unlikeindelirium)Dementia:ChroniconsetNodisturbanceofconsciousnessCognitiveimpairmentPersonalityalterationImpairedmemoryImpairedjudgmentAbsentdiurnalvariation
30.AccordingtoWechslerintelligencescale scoring,averageIQofanormalchildis: a)50 b)75 c)90 d)111 CorrectAnswer-CAns.c.90
31.Welldressedmancameforfeelingof womentrappedinmanbodyissufferingfrom? a)Paraphilia b)Transverium c)Genderidentitydisorder d)Protterurism CorrectAnswer-CAns.is'c'i.e.,GenderidentitydisorderGenderidentitydisorderThesedisordersarecharacterizedbydisturbanceingenderidentity,i.e.,thesenseofone'smasculinityorfaminityisdisturbed.Genderidentitydisordershasfollowingtwocharacteristics:?1.Astrongandpersistentcrossgenderidentificationwhichismanifestedby:? 1. Repeatedlystateddesiretobe,ortheinsistencethatheorsheis, oftheothersex. 2. Wearingtheclothesofothersex(crossdressing),Preferencefor cross-sexrolesinplaysorfantasies,Preferenceforplaymatesoftheothersex.2.Persistentdiscomfortwithhisorhersex.Importantgenderidentitydisordersare:- 1. Transsexualism:-Ithasallthecharacteristicofgenderidentity disorder(seeabove).Themostcharacteristicfeatureisthatthereismarkedpreoccupationwiththewishtogetridofone'sgenitalsandsecondarysexcharacteristicsandtoadoptthesexcharacteristicsofothersex(perceived-gender),e.g.,Femaletransexualsrequestfor
hysterectomyormastectomy. 2. Dual-roletransvestism:-Itischaracterizedbewearingofclothesof oppositesexinordertoenjoythetemporaryexperienceofmembershipoftheoppositesex,butwithoutanydesireforamorepermanentsexchange(unliketranssexualism).Bothtransexualismanddual-roletransvestismshouldbedifferentiatedfromtransvestism(fetishistictransvestism)whichisnotagenderidentitydisorderandcharacterizedbywearingtheclothesofothersexforthepurposeofsexualexcitment. 3. Gender-identitydisorderofchildhood:-Thisdisorderissimilarto transsexualismwithaveryearlyageofonset(2-4yearsofage).
32.Folie-a-deuxmeans? a)Delusionofpersecution b)Sharingofdelusion c)Delusionofdouble d)None CorrectAnswer-BAns.is'b'i.e.,SharingofdelusionItisalsoknownassharedpsychoticdisorderorsymbioticpsychosis.Itischaracterizedbysharingofdelusionsbetweentwoperson(Folieadeux)orrarelybetweenmoreindividuals(Folieatrois,Folieaquatre,Folieafamine).Thereisadominant(active)personwhoinducesdelusionsintotheother(passivereceptorordependentperson)-4Dependentpersonacceptsthedelusionofdominantperson.Onseparationoftwo,dependentpersonmaygiveuphisdelusions,howevertheactive(dominant)personoftenrequirestreatment
33.REMsleepisassociatedwithallexcept? a)Dreams b)Deltawaves c)Lossofmuscletone d)IncreasedBP CorrectAnswer-BAns.is'b'i.e.,DeltawaveStagesofSleepSleepisbasicallydividedintotwophases:?Non-REM(NREM)orslow-wavesleep:-ItiscalledNon-REMsleepbecausenorapideyemovement(REM)isthereoneletrooculogram,ratherthereissloworquiscenteyemovement.ItisalsoreferredasS-sleep(synchronizedsleep)orquietsleepororthodoxsleepbecausetherediminishedphysiologicalfunctionsandalowlevelofoverallactivity.Itisfurtherdividedinto:? 1. Stage1:-Itisatransitionfromwakefulnesstosleepandis characterizedbydisappearanceofalphaactivityandappearanceofthetaactivity.Thereissloweyemovements. 2. Stage2:-ItischaracterizedbytypicalEEGactivityi.e.,Sleep spindlesandIC-complex'.Noeyemovementoccurs. 3. Stage3&4:-Stage3&4arestagesofdeepsleep.Thesearealso calledslowwavesleepasthesestagesarecharacterizedbyslowdeltawaves.Deltawaveappearancestartsinstage3anddominatedinstage4.REMsleep:-TheREMsleepissonamedasthereisrapidrovingmovementsofeye,i.e.,rapideyemovement(REM)onelectro-oculogram.Itisalsocalledparadoxicalsleepbecausethereisaparadoxicalelevationofbrainactivity&metabolismand
physiologicalactivity.Thehigh-amplitudeslowwavesseeninstage3,4ofREMsleepisreplacedbyrapidlowvoltageactivity(betawave).FeaturesofREMsleepare:- 1. EEGBetawave,Reappearanceofalphawave,Saw-toothwave(low voltagefastactivity),Pontogenital-occipitalspikes. 2. Dreaming3. Otherfeatures:-Generalizedmuscularatony,Penileerection, autonomichyperactivity(Increasedpulserate&BP)andintermittentmovementofsmallmusclegroups.
34.Fordiagnosisofmaniasymptomsshould be- a)>1week b)>3weeks c)>2week d)>4weeks CorrectAnswer-AAns.is'a'i.e.,>1WeekDiagnosticcriteriaforManiaThreeormoreofthefollowingforatleast1week:- 1. Inflatedselfesteemorgrandiosity2. Decreasedneedforsleep3. Overtalkativness4. Flightofideasorracingthoughts5. Distractibility6. increasedgoaldirectedactivityorpsychomotoragitation7. Excessiveinvolvementinpleasurableactivitiesthathaveahigh potentialforpainfulconsequences.Themooddisturbanceissufficientlyseveretocausemarkedimpairmentinoccupational&socialfunctioning,ortherearepsychoticfeatures.Ifthesymptomsoccurfor4days,anddonotcauseimpairmentofsocial/occupationalfunctioning,andpsychoticfeatureareabsent,thenthediagnosisishypomania.
35.Acuteandtransientpsychoticdisorder, onsetofsymptoms? a)<1weeks b)<2weeks c)<3weeks d)<4weeks CorrectAnswer-BAns.is'b'i.e.,<2weeksAcuteandtransientpsychoticdisorderThesepsychoticdisordersarecharacterizedbyanabrupt(lessthan48hours)oranacute(Lessthan2weeks)onsetofsymptoms.Threetypeshavebeenrecognized(accordingtoICD-10). 1. Acutepolymorphicpsychoticdisorderwithoutsymptomsof schizophrenia:-Hallucinations,delusions,andotherpsychoticsymptomsarepresentandarevariedandconstantlychanging,justlikeemotionalstatus.Noneofthemisconsistentastoqualifyforadiagnosisofschizophrenia.Thepolymorphicandunstablepictureischaracteristicofillness. 2. Acutepolymorphicpsychoticdisorderwithsymptomsof schizophrenia:-Polymorphicandunstablesymptomsoccuralongwithconsistentsymptomsofschizophrenia. 3. Acuteschizophrenia-likepsychoticdisorder:-Exceptforacuteand shorterdurationofsymptomstheyresembleschizophreniaintotal.Symptomsoccurforlessthanlmonth.UnderDSMIVclassification,itisclassifiedasbriefpsychoticdisorder.
36.Ataxiaabasiaisseenin? a)Conversiondisorder b)PTSD c)Depression d)Manic CorrectAnswer-AAns.is'a'i.e.,ConversiondisorderSymptomsofconversiondisorderSensorysymptoms(inICD-10dissociativeanesthesia&Sensoryloss):-Anaesthesiaandparesthesiaarecommon,especiallyofextremities.Allsensorymodilities(Pain,temperature,touch,proprioception)areaffectedatsamelevel,andthedisturbanceisnotconsistenttothedistributionofdermatomes.Thus,cliniciansmayseethecharacteristicgloveandstockinganaesthesiaofhandsorfeetorhemianesthesiaofbodybeginningpreciselyalongthemidline.Deafness,blindnessorcontractedvisualfields(tubularortunnelvision).Motorsymptoms(InICD-10Dissociativemotordisorder):-Abnormalmovement,paralysis,Weakness,gaitdisturbances(ataxia-abasia),Aphonia,Torticollis,Opisthotonus,blepherospasm.Seizuresymptoms(InICD-10Dissociativeconvulsions):-Earlierknownashystericalfitsorpseudoseizures,dissociativeconvulsionsarecharacterizedbyconvulsivemovementsandpartiallossofconsciousness.Dissociativeconvulsionsshouldbedifferentiatedfromtrueconvulsions:- 1. Tonguebiting,Urinaryincontinenceandinjuryareuncomomn(in contrasttotrueconvulsions,Inwhichthesearecommon). 2. Neveroccursduringsleep(incontrast,trueconvulsionscanoccur
anytimeandduringsleep). 3. Usuallyoccurinsafeplaceorindoors(incontrast,trueconvulsions canoccuranywhere). 4. Usuallyoccurswhenpeopleareobserving(incontrast,true convulsioncanoccurwithorwithoutpeopleobservation). 5. Normalprolactinlevelinpostictalperiod(incontrast,serumprolactin isusuallyraisedinpost-ictalperiodaftertrueconvulsions). 6. Thereisnoorpartialamnesiaabouttheepisode(Incontrast,true convulsionhascompleteamnesia).
37.Trueaboutanorexianervosaisallexcept ? a)Bingeeatingiscommon b)Unknowninmale c)Ammenorrhoeastartsbeforeseverelossofweight d)Self-inducedvomiting CorrectAnswer-BAns.is'b'i.e.,UnknowninmaleAnorexianervosaislesscommoninmale,butcanbeseen.Thereisbingeeatingandselfinducedvomiting."Amenorrheaoftenprecedessevereweightloss"?EssentialsofpsychiatryANOREXIANERVOSATheterm'`anorexianervosa"isamisnomeraslossofappetiteisararesymptom.Thisdisorderischaracterizedbyselfimposeddietaryrestrictionsleadingtomalnutritionandsevereweightloss.ClinicalfeaturesFemalesarefarmorecommonlyaffectedthanmales.Onsetusuallyoccursbetweentheageof10-30years,usuallyinmidadolescence.Adeliberateandpersistentrestrictionoffoodisusuallytheearliestpresentingsymptom.Thereisintensefearofbecomingofobese,evenifbodybecomesverythinandunderweight.Thereisabody-imagedisturbance.Thepersonisunabletoperceivethebodysizeaccurately.SomepatientscannotcontinuouslycontroltheirvoluntaryrestrictionoffoodintakeandSohaveeatingbinges.Thesebingesusuallyoccursecretlyandoftenatnightandarefrequentlyfollowedbyself-inducedvomiting.Patientsabuselaxativesandevendiureticsto
loseweight,andritualisticexercising,extensivecycling,walking,joggingandrunningarecommonactivities.Patientswithanorexianervosaexhibitpeculiarbehavioraboutfood.Theyhidefoodalloverthehouse,frequentlycarrylargequantitiesofcandiesintheirpocketsandpurses.Theytrytodisposeoffoodintheirnapkinsorhideintheirpockets,whileeatingmeals.Theycuttheirmeatintoverysmallpiecesandspendagreatdealoftimerearrangingthepiecesontheirplates.Thereissignificantweightlossandpatientisunderweight.Amenorrheaisseeninalmostallwomenandlossoflibidomayoccurinmalepatients.Theremaybepoorsexualadjustment.Obsessivecompulsiveneurosis,depressionandanxietylikepsychiatricillnessmaycoexist.Complicationsofmalnutritionmayoccur,e.g.,hypoglycemia,hypothermia,lowBP,bradycardia,leucopenia,endocrinechanges(raisedGHandCortisol,reducedgonadotrophin),andappearanceoflanugohair.
38.Looseningofassociationisanexample of a)Formalthoughtdisorder b)Schneider'sfirstsymptoms c)Perseveration d)Concretethinking CorrectAnswer-AAns.is'a'i.e.,FormalthoughtdisorderThoughtdisorders Formalthought Disordersofthought disorders(Disordersof process thoughtprocess)Racingthoughts:-Anxiety,SchizophreniaRetardedthoughts:-Depression Delusion:-Psychosis Circumstantiality:- (Schizophreniamania, Mania,Schizophrenia depression&others Thought Obsession blocking:- Compulsion Schizophrenia,Severe Preoccupations anxiety Phobias Perseveration:-Organic Depersonalization& braindisease, Derealization Schizophrenia (occasionally Looseningof association:-
association:-Schizophrenia Flightofideas:-Mania Tangentiality Clunging&punning:- Mania&schizophreniaNeologism,wordsalad,Echolalia:-Schizophrenia Inschizophreniaandmooddisorders(depression,mania)allpartsofthethought(thoughtprocessaswellascontent)areinvolved.However,schizophreniaisconventionallyreferredasformalthoughtdisorder.
39.Falseregardingdeliriumtremens? a)Tremors b)Opthalmoplegia c)Visualhallucination d)Cloudingofconsciousness CorrectAnswer-BAns.is'b'i.e.,OphthalmoplegiaDeliriumtremensDeliriumtremensisthemostseverealcoholwithdrawalsyndrome.Itoccursusuallywithin2-4daysofcompleteorsignificantalcoholabstinence.Thisisanacuteorganicbrainsyndrome(delirium)withcharacteristicfeaturesofdelirium. 1. Cloudingofconsciousnesswithdisorientationintimeandplace.2. Poorattentionspananddistractability.3. Visual(andalsoauditory)hallucination,andillusion.Tactile hallucinationofinsectcrawlingundertheskin(formication)mayalsooccur. 4. Markedautonomicdisturbanceswithtachycardia,sweating, hypertension,mydriasis,coarsetremers. 5. Insomnia,psychomotoragitation,ataxia,anxiety. Benzodiazepinesarethedrugsofchoicefordeliriumtremens.Chlordiazepoxideistheagentofchoicewithdiazepamasanalternative.
40.Notusedforerectiledysfunction? a)Betablockers b)Siledenafil c)PG-E, d)Papaverine CorrectAnswer-AAns.is'a'i.e.,BetablockersDrugsusedforerectiledysfunction1.Phosphodiesterase-5inhibitors(Siledenafil,Todafil,Vardenafil).ByinhibitingPDE-5,thesedrugspreventdegradationofcGMPandpotentiatetheactionofNO.ThesearetheDOCforpharmacologicaltherapyoferectiledysfunction.2.Alprastadil(ProstaglandinEl)ItisapowerfulvasodilatorItactsbyincreasingarterialinflowbyvasodilationandreducingoutflowbycontractingthecarporalsmoothmusclethatoccludesdrainingvenules.ItistheDOCforpatientsnotrespondingtoPDE-5inhibitors.Itisdirectlyinjectedintocorporacavernosa.3.PapaverineItisanonspecificphosphodiesteraseinhibitor.Injectionofpapaverinewithorwithoutphentolamineintocorpuscavernosumproducespeniletumiscencetopermitintercourse.Repeatedinjectioncancausepenilefibrosis.4.AndrogensCanbeusedwhenandrogendeficiencyisdemonstratedtobe
responsibleforthelossoflibidoanderectiledysfunction.5.Apomorphine(Laurence9th/ep.546)Adopamineantagonist,isgivenbysubcutaneousinjection.
41.Astudentunabletodeliverspeech beforeaudienceissufferingfrom? a)Socialphobia b)OCD c)Agoraphobia d)Claustrophobia CorrectAnswer-AAns.is'a'i.e.,SocialphobiaPhobicdisordersPhobiaispersistentandmorbidfearofspecificsituation,objectoractivity.Thefearismorbidbecause:? 1. Thefearisirrational:Theobjectsorsituationsdonotproducefear innormalpersons. 2. Thefearisoutofproportiontothedangerousnessperceivedthatthe affectedpersonavoidsthesituationpermanently. 3. Patientisunabletocontrolthefearandisverydistressedbyit. Thecommontypesofphobiaare:?1.AgoraphobiaThisisanexampleofirrationalfearofsituations.Itisthecommonesttypeofphobiaencounteredinclinicalpractice.Itischaracterizedbyanirrationalfearofbeinginplacesawayfromfamiliarsettingofhomeandpatientbelievesthathecannotescapefromtheseplaces,toasaferplace(usuallyhome).Thisfearresultsinavoidanceoftheseplaceswhichincludepublicplaces,stores,crowd,travellingaloneinbus,trainorplane,Theaters,Tunnels,Bridge,standinginlinesmallenclosedroomsorlifts.Thepatientisafraidofalltheplacesorsituationsfromwhereescapemaybeperceivedtobedifficultifhesuddenlydevelops
embrassingorincapaciatingsymptoms.Theseembrassingorincapaciatingsymptomsaretheclassicalsymptomsofpanic.Afull-blownpanicattackmayoccur(agoraphobiawithpanicdisorder)oronlyafewsymptoms(likedizzinessortachycardia)mayoccur(agoraphobiawithoutpanicdisorder).2.SocialphobiaInsocialphobiathereisirrationalfearofoneormoresocialorperformancesituationsinwhichthepersonisconcernedaboutnegativeevaluationorscrutinybyothers,forexample:Publicspeaking;writing/drinking/eatinginpublic;usingpubliclavatories.Fearedsocialorperformancesituationsmayproduceanxietysymptoms,evenapanicattack.Therefore,fearedsocialorperformancesituationsareavoided.3.Specific(simple)phobiaThesearephobiaslimitedtohighlyspecificsituationsorobjects,forexample. 1. Claustrophobia:-Fearofclosedspaces2. Acro/Aerophobia:-Fearofhighplaces3. Zoophobia:-Fearofanimals4. Pyrophobia:-Fearoffire5. Xenophobia:-Fearofstrangers6. Algophobia:-Fearsofpain7. Thanatophobia:-Fearofdeath8. Mysophobia:-Fearofdirt&germs9. Erythrophobia:-Fearofblushing 10. Sitophobia:-Fearofeating11. Ailurophobia:-Fearofcats12. Sitaphobia:-Fearofdogs13. Hydrophobia:-Fearofwater
42.Suicideismostcommonin? a)Depression b)Alcoholdependence c)Dementia d)Schizophrenia CorrectAnswer-AAns.is'a'i.e.,DepressionCauses/RiskfactorsforsuicidePsychiatricdisorders:-Depression(mostcommon),alcoholism(2ndmc),Drug/Substancedependence,Schizophrenia,Dementia.Physicalillness:-Cancer,AIDS,Multiplesclerosis,Headtrauma.Psychosocialfactors:-Failureinlove,maritaldifficulties,familydispute,illegitimatepregnancy.Biologicalfactors:-DecreaseinserotoninOther-Malesex,Age>40years,Single(Unmarried,divorcedorwidowed),previoussuicideattempt,socialisolation.
43.Whichofthefollowingcancausedelirium ? a)Hypoxia b)Barbiturates c)Alcoholwithdrawal d)Alloftheabove CorrectAnswer-AAns.is`d'i.e.,AlloftheaboveImportantcausesofdelirium1.Trauma:-Headinjury,subduralhematoma2.Infection:-Septicemia,pneumonia,endocarditis.3.Metabolic:-Hypoxia,hypercapnia,uremia,CHF,Hepaticfailure,porphyria,metabolicacidosisoralkalosis,water&electrolyteimbalance.4.Endocrine:-Hypo-orhyperpituitarism,Hypo-orHyperthyroidism,Hypo-orhyperparathyroidism,hypo-orhyperadrenalism.5.Drugintoxication:-Alcohol,barbiturates,TCA,anticholinergics,anticonvulsants.6.Drugwithdrawal:-Alcohol(deliriumtremens),sedatives,hypnotics.7.Nutritionaldeficiency:-Vitamin(Thiamine,pyridoxine,Niacin,B12,Folicacid),Protein.8.0ther:-Post-operative,seizures,sleepdeprivation
44.TotalscoreinMiniMentalStatus Examination(MMSE)is? a)25 b)30 c)32 d)35 CorrectAnswer-BAns.is'b'i.e.,30
45.18yearoldgirlwithcircumscribedbald patchwithnoorganicdisease&nobehaviouraldisorderhas? a)Depression b)Trichotillomania c)OCD d)Phobia CorrectAnswer-BAns.is'b'i.e.,TrichotillomaniaAsthereisnoorganicorbehavioraldisorders,thisgirlissufferingwithimpulsecontroldisorderofcompulsivehairpulling,knownasTrichotillomania.ImpulsecontroldisorderThesedisordersarecharacterizedbyfailuretoresistanimpulsivebehaviorthatmaybeharmfultoselforothers.Theremaybeafeelingofreleaseoftensionbydoingtheactandafeelingofguiltaftertheactisover.Importantimpulsecontroldisorderare:- 1. Pyromania(Pathologicalfiresetting)2. Kleptomania(Pathologicalstealing)3. Trichotillomania(Compulsivehairpulling)4. Pathologicalgambling5. Intermittentexplosivedisorder6. Impulsecontroldisordernototherwisespecified Oniomania(Compulsiontoshop/buying)Internetcompulsion(Internetaddiction)CellularorMobilephonecompulsionCompulsivesexualbehavior(sexualaddiction).
46.Pyromaniareferstoanirresistibleurgeto ? a)Setthingsonfire b)Eatoutofproportion c)Sleepforlongperiods d)None CorrectAnswer-AAns.is'a'i.e.,Setthingsonfire
47.Thedeliusionwhichinvolvesreplacement ofafamiliarpersonbysomeoneelseis? a)Capgrassyndrome b)Cotardsyndrome c)Othellosyndrome d)None CorrectAnswer-AAns.is'a'i.e.,CapgrassyndromeDSMischaracterizedbymisidentificationdelusionsofotherorself.Fourmainsyndromesaredifferentiated:? 1. Capgrassyndrome(Delusionofdouble):-Patientfalselyseesa familiarpersonasacompletestrangerwhoisimportingonhimasafamiliarperson. 2. Fregolisyndrome(illusiondefregoli):-Thepatientfalselyidentifies strangerasfamiliarperson. 3. Syndromeofsubjectivedouble:-Thepatientsownselfisperceived asbeingreplacedbyadouble. 4. Syndromeofintermetamorphosis:-Afalsebeliefthatapersoncan transformintoanotherperson.Thesesyndromemostcommonlyappearinschizophrenia.OthercausesareAlzheimersyndrome,headinjuries,anddelusionaldisorders.
48.Inpersonalitydisorder,featuresareall except a)Egodystonia b)Startsinchildhood c)Behaviorismaladaptive d)Disorderresultsinpersonaldistress CorrectAnswer-AAns.'A'i.e.,EgodystoniaFeaturesofpersonalitydisordersMostoftenthefirstsignofapersonalitydisorderappearsinlatechildhoodoradolescenceandcontinuesduringadulthood.Someonewithapersonalitydisorderholdsattitudesandbehavesinwaysthatcancauseconsiderableproblemsforthemselvesandothers.Behaviourislong-standing(notlimitedtoanepisodeofmentalillness).Behaviourispervasiveandmaladaptive.Disorderresultsinpersonaldistressandsocialoroccupationaldysfunction.Behaviorisfixedandinflexible.Personalitydisordersareego-syntonic.Theyarenotduetoadirectresultofdiseaseorsubstance.
49.Sleepwalkingisseeninwhichstageof sleep? a)REM b)Stage1-2NREM c)Stage2-3NREM d)Stage3-4NREM CorrectAnswer-DAns.is'd'i.e.,Stage3-4NREMImportanteventsoccuringduringsleepDeepsleep/slowwavesleepdisorder:-Theseeventsoccurduringstage3&4ofNREM.Importantdisordersare:? 1. Somnambulism(Nightwalking):-Patientwalksduringsleep.2. Sleepterrorornightterrors(pavornocturnes):-Thepatient suddenlygetsupscreaming,withautonomicarousal(tachycardia,sweating).Sleepterrorsarerarelyrememberedinthemorning(incontrasttonightmares).Notreatmentisrequiredonlyreassuranceisrequired.However,inseverecasesbenzodiazepinecanbeused. 3. Sleep-relatedenuresis(Nocturnalenuresis/bedwetting):- Repetitivevoidingoccursduringsleep.Firstlineoftreatmentisbehaviourtherapy.Ifbehavioraltherapyfails,desmopressin(DOC)andImipraminecanbeused. 4. Bruxism(Teethgrinding)5. Sleep-talking(Somniloquy). REMsleepevents 1. Nocturnalpeniletumescence:-Itisspontaneousoccurenceofan erectionofthepenisduringsleep.Itisanormalphenomenonandoccursfor80-120minutespernightNocturnalpeniletumescencecanbeusedtodifferentiatebetweenpsychogenicimpotenceand
organicimpotenceasnocturnalpeniletumescenceispreservedinpsychogenicimpotencebutnotinorganiccauseofimpotence. 2. Nightmares(dreamanxietydisorder):-Theyarecharacterizedby fearfuldreamsoccuringinthelastonethirdofnightsleep.Thepersonwakesupfrightnedandremembersthedreamvividly(incontrasttonightterror). 3. Narcolepsy:-Thisischaracterizedbyexcessivedaytimesleep, oftendisturbednighttimesleepanddisturbancesintheREMsleep.Ageofonsetisbetween10-20years.Thereisirresistabledesiretosleepandboutsofsuddensleepeachlastingfor10-30minutesoccuringduringdaytime.Inmajorityofcasesnarcolepsyisassociatedwithoneormoreaccessorysymptoms:?Cataplexy:-Itisthemostcommonaccessorysymptomandischaracterizedbysuddendecreaseinmuscletoneeither,localorgeneralized.Hypnagogichallucination:-Hallucinationoccuringjustbeforefallingasleep.Whenhallucinationoccursjustbeforeawakeningitiscalledhyponopompichallucinations.Sleepparalysis(leastcommon)Treatmentofnarcolepsyincludestimulantmedications(methyphenidate,amphetamines)ormodafinil.
50.QuodHancmeans? a)Passivepartnerinsexualintercourse b)Womenhavinghighsexualdesire c)Sexualparternerinpedophilia d)Maleimpotenttoparticularwomen CorrectAnswer-DAns.is'd'i.e.,Maleimpotenttoparticularwomen
51.Pagophagiainvolveseating? a)Ice b)Sand c)Clay d)Salt CorrectAnswer-AAns.is'a'i.e.,Ice Eating Geophagia clay Pagophagia EatingiceEating Plambophagia leadEating Amylophagia starchEating Coprophagia fecesEating Cautopyreiophagia burnt matchesEating Tricophagia hairEating Lithophagia stonesEating Geomelophagia rawpotatoes
52.Doppelgangeris- a)Shadowfollowingperson b)Feelingofdoubleofoneself c)Indentificationofstrangerasfamiliar d)Noneoftheabove CorrectAnswer-BAns.is`b'i.e.,FeelingofdoubleofoneselfDoppelgangers(subjectivedouble)isthedelusionthatthereisdoubleofoneself.Apersonfeelsthatdoubleofhimselfexistselswhere.
53.WhatiscontraindicationforECT? a)Arrthmia b)Epilepsy c)HIV d)Cerebralaneurysm CorrectAnswer-DAns.is'd'i.e.,CerebralaneurysmContraindicationsofECTAbsolute:-Increasedintracranialtension.cerebrovascularresponsetoECTincludemarkedincreasedincerebralbloodflowandbloodflowvelocity.Cerebraloxygenconsumptionincreasesaswell.Therapidincreaseinsystemicbloodpressuremaytransientlyoverwhelmcerebralautoregulationandmayresultinincreasedinintracranialpressure.Therefore,theuseofECTisprohibitedinpatientswithknownspaceoccupyinglesion(braintumor)orheadinjury,cerebral(intracranial)aneurysm.Relative:-Recentmyocardialinfarction,severehypertension,cerebrovascularaccident,severepulmonarydisease,Retinaldetachment,Pheochromocytoma.
54.Apatientisknownalcoholicsincelast20 yrs,suddenlyhedevelopsrestlesstremors,agitation.Diagnosis? a)Deliriumtremens b)Psychosis c)Wernicke'sencephalopathy d)Kursakoff'ssyndrome CorrectAnswer-AAns.is'a'i.e.,Deliriumtremens
55.Whichofthefollowingisdelusion? a)Othellosyndrome b)Declerambault'ssyndrome c)Pyromania d)None CorrectAnswer-AAns.is'a'i.e.,Othellosyndrome&'la'i.e.,Declerambault'ssyndromeDelusionaldisorders(Persistentdelusionaldisorders)Delusionaldisorder,previouslycalledasparanoiddisorder,isagroupofdisorderswherelongstandingdelusionsaretheprimaryoronlymanifestationofillness.Persistentdelusionsmustbepresentforatleast3months(ICD-10)orforatleast1month(DSM-IV).Dependingonthecontentfollowingtypeofdelusionsmayoccur. 1. Delusionsofpersecution:-Thesearethemostcommontypeof delusions.Thepatientbelievesthatheisconspiredagainstandharassedorbodilyinjured,spiedorfollowedorpoisonedbyother.Patientbelievesthatheisunderthesurveillanceofpolice,ashisneighbourshavecomplainedagainsthim;orheiswatchedandthenewsinthenewspaperrefertohim. 2. Somatic(Hypochondrical)delusions:-Therearedelusionsrelated tothepatientsbodyoritspart.Thisconditionisalsoreferredtoasmonosymptomatichypochondricalpsychosis(MHP)orhypochondricalparanoia.Examplesare:?Bodyoritspartbeinguglyormisshapen,i.e.,noseisdeformed-->Delusionaldysmorphophobia.Infestationsbywormsorforeignbodies--->Delusionalparsitosis.Emittingafoulodor-->Delusionalhalitosis.
3.Delusionsofgrandeur:-Delusionsofinflatedselfesteemandselfimage.Thepatientmaybelievethatheisanimportantpersonwhoisabletohelpother,ormayreporthearingthevoiceofGodandtheSaints,Confirmingtheirelevatedstatus.4.Delusionsofjealousy(infidelity):-Contentofdelusionsispredominantlyjealousy(infidelity)involvingthespouse-->OthellosyndromeorConjugalparanoia.Elobratestepsaretakentopreventthespousetogooutsite(Locksthespouse,notallowinghergooutside),ortocatchthespouseredhanded(privatedetectives).5.Delusionoflove(Erotomanicdelusionorerotomania):-Moreprevalentamongfemalesandthereisaneroticconvictionthatapersonwithhigherstatusisinlovewithpatient--)Declerambault'ssyndrome.
56.Floodingisatreatmentmodalityusedin? a)Phobia b)Depression c)Mania d)Schizophrenia CorrectAnswer-AAns.is'a'i.e.,Phobia
57.Schizophreniaismorecommoninwhich socioeconomicstrata? a)Middle b)Upper c)Low d)Uppermiddle CorrectAnswer-CAns.is'c'i.e.,Low'Schizophreniaismoreprevalentinpatientshavingalowersocioeconomicstatus".-NamboodiriEtiologyofSchizophreniaTheexactetiologyisnotclear.Expertsthinkschizophreniaiscausedbyseveralfactors.1.Heredity(Geneticfactors)Schizophreniarunsinfamilies.Theillnessoccurin0.5-1%ofgeneralpopulation.However,Firstdegreerelativeofschizophrenicpatientshavea10timesmorelifetimeriskofhavingillness.Theriskis3-6timesand2timesmoreinsecondandthirddegreerelatives,respectively2.EnvironmentalfactorsEnvironmentalfactorsandstressareimportantinprecipitatingschizophreniainmanyindividuals.Thesefactorsare:? 1. Socioeconomic:-Lowsocio-economicstatus,Industrialization; Immigration;famileswithhighexpressedemotions;Nuclearfamilies;Schisms&skewedfamilies;andpseudomutul&pseudohostilefamilies. 2. Drugs:-Drugscausingschizophrenialikestateareamphetamine (mostcommoncausativedrug),LSD,Phencyclidine,ketamine,
Mescaline,Cocaine,Cannabis. 3. Metabolic&Neurologicaldisorders:-Schizophrenialikesymptoms mayoccurinHuntington'schorea(earlystage),homocystinuria,acuteintermittentporphyria,Wilson'sdiseaseandhemochromatosis.3.BiochemicalfactorsDopaminehypothesisisthemostacceptedhypothesisforschizophrenia.Thereishyperactivityofdopaminergicsystem.Thishypothesisissupportedby:1)Amphetamineandcocainewhichreleasedopamineincentralsynapsesinduceschizophrenialikesymptoms;and2)Antipsychoticdrugscontroltheschizophrenicsymptomsbyblockingdopamine(D,)receptors.However,thedipaminehypothesishasbeenquestionedalsoasHomovanillicacid(HVAtheprincipalmetaboliteofdopamine)isnotelevatedandprolactinlevelisnotdecreased(Dopaminehasinihibitoryactiononprolactinrelease).Otherneurotransmittersinvolvedare:-Increasedserotonin,DecreasedGABA,variablechange(Increasedordecreased)glutamate,andincreasednorepinephrine.
58.ECTiscontraindicatedin- a)Veryillpatients b)RaisedICT c)Heartdisease d)Pregnancy CorrectAnswer-BAns.is'b'i.e.,RaisedICT
59.Goodprognosticfactorforschizophrenia is? a)Bluntedaffect b)Earlyonset c)Presenceofdepression d)Malesex CorrectAnswer-CAns.is'c'i.e.,PresenceofdepressionGoodprognosticfactors:-Acuteonset;lateonset(onsetafter35yearsofage);Presenceofprecipitatingstressor;Goodpremorbidadjustment;catatonic(bestprognosis)&Paranoid(2ndbest);shortduration(<6months);Married;Positivesymptoms;Presenceofdepression;familyhistoryofmooddisorder;firstepisode;pyknic(fat)physique;femalesex;goodtreatmentcompliance&goodresponsetotreatment;goodsocialsupport;presenceofconfusionorperplexity;normalbrainCTScan;outpatienttreatment.
60.Timeintervalbetweenacuteand persistentpsychoticdiseaseis? a)1week b)2week c)3week d)1months CorrectAnswer-DAns.is`d'i.e.,1monthsIfsymtomsareforlessthan1months,itistransientpsychoticdisorderandifthereareformorethan1months,itispersistentpsychoticdisorder(persistentdelusionaldisorder).Note:-Diagnosiccriteriafordelusionaldisorder(Persistentdelusiondisorder)hasdifferentdurationsinDSMIVandICD-10:- 1. AccordingtoDSMIV,symptoms(Nonbizzaredelusion)shouldbe for>1months. 2. AccordingtoICD-10,Symptomsshouldbefor>3months.
61.AlphawavesinEEGrepresent? a)Eyeclosedwithactivemind b)Eyeopen,fullyawakeandalert c)Deepsleep d)None CorrectAnswer-AAns.is'a'i.e.,EyeclosedwithactivemindEEGrhythmsandsleepwakecycleFollowingEEGrhythms(Berger'srhythm)areimportantinrelationtosleepwakecycle:? 1. Alpharhythm:-Inadulthumanswhoareawakebutatrestwith mindwanderingandtheeyeclosed,ocrhythmisprominent.Itisaregularrhythmwithafrequencyof8-13Hzandamplitudeof50-100V.Itismostmarkedinparietalandoccipitallobe.Itisassociatedwithdecreasedlevelofattention,i.e.,personisawakebuthasdecreasedattention(relaxed)->Personisthinkingbutwithdecreasedattention(subconsciousthinking). 2. Betarhythm:-Whenattentionisfocusedonsomething,thealpha rhythmisreplacedbyBetarhythm.Itisanirregular13-30Hzlowvoltageactivity.Itismostevidentonfrontallobeandoccurswhenpatientisfullyawakeandalert.Thereforethisreplacementofbetarhythmforalpharhythmiscalledarousaloralertingresponseoralphablock.Thisphenomenoncanbeproducedbyanyformofsensorystimulationormentalconcentrationsuchassolvingarithmeticproblems.PersonisthinkingwithamaximumconcentrationConsciousthinking. 3. Thetarhythm(4-7Hz):-Whenpersonwithalpharhythmbecomes slightlymorerelaxed(asoccurswhenthereistransitionfrom
wakefullnesstosleep,i.e.,stage1ofREM),alpharhythmisreplacedbythetarhythm.Thinkingispresentbutwithevenlessattentivenessthanwhichwaspresentinalpharhythmstage(Deepsubcsonciousthinking).Twotypesofthetarhythmhavebeendescribed:-Hippocampal(occursinmammalsotherthanmen,i.e.,catdogs,etc).Cortical(occursinmen)4.Deltarhythm(3-5Hz):-Itispresentwhenthepersonisindeepsleep(NREMstage3&4)andthereisnothinking.
62.PoorprognosticfactorforSchizophrenia- a)Presenceofdepression b)Femalesex c)Presenceofstressor d)Earlyonset CorrectAnswer-DAns.is'd'i.e.,EarlyonsetPoorprognosticfactors:-Insidiousonset,earlyonset(before20yearsofage);absenceofprecipitatingstressor;poorpremorbidadjustment;hebephrenicsubtype(worstprognosis),simple,undifferentiatedandchroniccatatonicsubtype;longduration(chroniccourse-->>2years);single/divorced;Negativesymptoms;absenceofdepression;familyhistoryofschizophrenia;pasthistoryofschizophrenia;asthenic(thin)physique;malesex;poortreatmentcompliance&poorresponsetotreatment;poorsocialsupport;flatorbluntedaffect;ventricularenlargementonbrainCTscan;hospitalization&indoortreatment
63.Pathognonomicofmaniacepisodeis? a)Elevatedmood b)Grandiosity c)Decreasedappetite d)Increasedsleep CorrectAnswer-BAns.is'b'i.e.,GrandiosityOption'a'isconfusingone.Yes,elevatedmoodisoneofthemostclassicalsymptomofmania.Butitisnotpathognomonic.Pathognomonicmeansasymptomwhichcanbeusedfordiagnosis.Elevatedmoodisnotasymptomofdiagnosticcriteriaofmania.DiagnosticcriteriaformaniaThreeormoreofthefollowingforatleast1week:- 1. Inflatedselfesteemorgrandiosity2. Decreasedneedforsleep3. Overtalkativeness4. Flightofideas5. Distractibility6. PsychomotoragitationorIncreasedgoaldirectedactivitie7. Excessiveinvolvementinpleasurableactivities Importantsymptomsofmania 1. Elevatedmood:-Euphoria,elation,exatlation,ectasy,highself esteem. 2. Thought&speech:-Pressureofspeech(Talkativeness),flightof ideas,delusionofgrandeur,delusionofpersecution,distractibility. 3. Increasedpsychomotoractivity:-Overactiveness,restlessness, increasedenergy. 4. Goaldirectedactivity:-Patientisalert,tryingtodomanythingsat
onetime. 5. Psychoticfeatures:-Delusionsandhallucination.6. Other:-Increasedsexualdrive,aggressivebehavior,decreased needforsleep(insomnia),spendingexcessivemoney,increasedappetite,impairedjudgement,social&occupationaldysfunction,absentinsight.
64.Fatherofmodernpsychiatryis? a)Bleuler b)Freud c)Pinel d)Kraepelin CorrectAnswer-CAns.is'c'i.e.,PinelFatherofpsychoanalysisSigmundfreudFatherofmodernpsychiatryPhileppelpinel
65.Classicaltriadofglobalconfusion,ataxia andophthalmoplegiaisseenin? a)Alzheimer'sdisease b)Deleriumtremors c)Wernicke'sencephalopathy d)Korsakoffpsychosis CorrectAnswer-CAns.is'c'i.e.,Wernicke'sencephalopathy
66.Borderlinepersonalitydisorder? a)Chronicfeelingofemptiness b)Unstableinterpersonalrelationship c)Grandiosity d)Lowselfesteem CorrectAnswer-BAns.is'b'i.e.,UnstableinterpersonlrelationshipBorderlinepersonalitydisorderThecentralfeatureofborderlinepersonalitydisorderisapervasivepatternofunstableandintenseinterpersonalrelationship,selfperceptionandmood.Thepatientmakerecurrentsuicidalthreatsandgestureandasmallproportionofpatientscarryouttheactorselfmultilationlikecuttingorburning.Thepatientshavedifficultyincontrollingtheirangerandimpulsitivity.Thereisuncertaintyaboutpersonalidentity.
67.Personalityassociatedbipolardisorder- a)Antisocial b)Anakastic c)Borderline d)Narcissistic CorrectAnswer-DAns.is'd'i.e.,NarcissisticSymptomsofNarcissisticpersonalitydisordercanbeconfusedwithmanicphaseofbipolardisorder".NarcissisticpersonalitydisorderNarcissisticpatientsaregrandioseandrequireadmirationfromother.ThisischaracterizedbyIdeasofgrandiosity&inflatedsenseofselfimportance;lackofempathywithothers;attentionseekingbehavior;exploitationofothers;andanarrogant,haughtyattitude.
68.Bruxismisseenin? a)NREMstage1,2 b)NREMstage3,4 c)REM d)Anyoftheabove CorrectAnswer-BAns.is'b'i.e.,NREMstage3,4Slowwavesleep(stage3&4ofNREMsleep)disorders:-Sleepwalking(somnambulism),nightterror(sleepterrororpavornocturnus),Nocturnalenuresis,Bruxism(teethgrinding),andsleeptalking(somniloquy).REMsleepevents/disorder:-Nightmares,nocturnalpeniletumescence,Narcolepsy.
69. Childwakesupatnightsweatingand terrifieddoesnotremembertheepisode- diagnosis? a)Narcolepsy b)Nightmares c)Nightterrors d)Somnambulism CorrectAnswer-CAns.is'c'i.e.,NightterrorsSleepterrorornightterrors(pavornocturnus):-Thepatientsuddenlygetsupscreaming,withautonomicarousal(tachycardia,sweating).Sleepterrorsarerarelyrememberedinthemorning(incontrasttonightmares).Notreatmentisrequiredonlyreassuranceisrequired.However,inseverecasesbenzodiazepinecanbeused.
70.Trichotillomania? a)Irresistabledesiretosetfire b)Irresistabledesiretostealthings c)Compulsivehairpulling d)Pathologicalgambling CorrectAnswer-CAns.is'c'i.e.,Compulsivehairpulling
71.OCDisassociatedwithwhich personality? a)Anakastic b)Borderline c)Narcissistic d)Histrionic CorrectAnswer-AAns.is'a'i.e.,AnankasticObsessive-Compulsive(anankastic)personalitydisorder:-Peoplewithobsessive-compulsivepersonalitydisorderaremarkedlypreoccupiedwithorderliness,perfectionism,andcontrol.Theylackflexibilityoropenness.Theirpreoccupationsinterferewiththeirefficiencydespitetheirfocusontasks.Theyareoftenstingyaswellasstuborn.
72.Neurotransmitterinmania- a)Increaseddopaine b)Decreaseddopamine c)Increasednorepinephrine d)Decreasednorepinephrine CorrectAnswer-CAns.is'c'i.e.,IncreasednorepinephrineNeurotransmittersinmooddisordersMostacceptedbiochemicalhypothesisformooddisordersisthemonoaminehypothesis,accordingtowhichserotininandnorepinephrinearethemajorneurotransmittersinvolvedinmooddisorders:- 1. Depression-->Decreaseinserotoninandnorepinephrine.Serotonin isthemostimportantneurotransmitterindepression. 2. Mania-->Increasedlevelofnorepinephrine Patientssufferingfromseveredepressionwithsuicidalintent/attemptappeartohaveamarkeddecreaseinserotinin.AcetylcholineandGABAaretheotherneurotransmitterswhichareinvolvedinmooddisorders.
73.Schizophreniaresultswith? a)IncreasedGABA b)Decreasednorepinephrine c)Increaseddopaminergicactivity d)Decreaseddopaminergicactivity CorrectAnswer-CAns.is'c'i.e.,IncreaseddopaminergicactivityDopaminehypothesisisthemostacceptedhypothesisforschizophrenia.Thereishyperactivityofdopaminergicsystem.Thishypothesisissupportedby:1)Amphetamineandcocainewhichreleasedopamineincentralsynapsesinduceschizophrenialikesymptoms;and2)Antipsychoticdrugscontroltheschizophrenicsymptomsbyblockingdopamine(D,)receptors.However,thedipaminehypothesishasbeenquestionedalsoasHomovanillicacid(HVAtheprincipalmetaboliteofdopamine)isnotelevatedandprolactinlevelisnotdecreased(Dopaminehasinhibitoryactiononprolactinrelease).Otherneurotransmittersinvolvedare:-Increasedserotonin,DecreasedGABA,variablechange(Increasedordecreased)glutamate,andincreasednorepinephrine.
74.Capgrassyndromeis? a)Sharingofdelusion b)Delusionofdouble c)Erotomania d)Hypochondriacaldelusions CorrectAnswer-BAns.is'B'i.e.,DelusionofdoubleCapgrassyndromeisadelusionofdouble.Thedelusionalmisidentificationsyndrome(DSM)DSMischaracterizedbymisidentificationdelusionsofothersorself.Fourmainsyndromesaredifferentiated:? 1. Capgrassyndrome(Delusionofdouble):-Patientfalselyseesa familiarpersonasacompletestrangerwhoisimposingonhimasafamiliarperson. 2. Fregolisyndrome(illusiondefregola):-Thepatientfalselyidentifies strangerasafamiliarperson. 3. Syndromeofsubjectivedouble:-Thepatient'sownselfisperceived asbeingreplacedbyadouble. 4. Syndromeofintermetamorphosis:-Afalsebeliefthatapersoncan transformintoanotherperson.Thesesyndromesmostcommonlyappearinschizophrenia.OthercausesareAlzheimersyndrome,headinjuries,anddelusionaldisorders.
75.Drugusedforcocainewithdrawal symptomsis- a)Floxetine b)Lorazepam c)Phenobarbital d)Nodrug CorrectAnswer-DAns.is'd'i.e.,Nodrug"Tolerancedevelopsswiftlybuttherearenowithdrawalsymptoms.Treament,ifneeded,issymptomatic.Oftennomedicinesareneededandtheusercanstopitsusebyhimselfwhenheiscoercedtodosobythecourtortheemployer"-Namboodiri"Nopharmacologicalagentsreliablyreducetheintensityofwithdrawal,butrecoveryoveraweakortwoisgenerallyuneventful"-Kaplan&Saddock
76.Instuporcatatonia,allareseenexcept- a)Agitation b)Catalepsy c)Mutism d)Akinesia CorrectAnswer-AAns.is'a'i.e.,AgitationAgitationisseeninexcitedcatatonia(notisstuporcatatonia).Featuresofcatatonicschizophreniamaybe:? 1. Excitedcatatonia:-Itischaracterizedbyincreasedinpsychomotor activity,i.e.restlessness,agitation,excitement,aggressiveness,violence.Theimpulsiveactivityoccursinresponsetohallucinationanddelusions. 2. Stuporous(retartedcatatonia):-Itischaracterizedbyextreme retardationofpsychomotoractivity.Itincludesmutism,rigidity,negativism,posturing,stupor,echolalia,echoproxia,catalepsy(waxyflexibility),ambitendency,gegenhalten,stereotypies,stupor,mannerism,Grimicing,automaticobedience.
77.Psychosurgeryisusedin? a)Phobia b)Generalizedanxiety c)OCD d)Depression CorrectAnswer-CAns.is'c'i.e.,OCD
78.RoleofmarijuanainAIDSrelated cachexia? a)Euphoric b)Pschostimulator c)Increasesappetite d)Decreaseemeticfeeling CorrectAnswer-CAns.is'c'i.e.,IncreasesappetiteMari-juanaorcannabissativacontainstheactiveprincipletetrahydrocannabinol(THC),whichasanappetitestimulanteffect.
79.Allareusedintreatmentofnocturnal eneuresisexcept? a)Imipramine b)Alarmsetup c)Voidingofurinebeforesleeping d)Maintainenceofcalendarofdaynightwetting CorrectAnswer-DAns.is'di.eMaintainenceofcalendarofdaynightwettingAllareused.TreatmentofnocturnaleneuresisItconsistsof:? 1. Appropriatetoilettrainingandrestrictingfluidatnight.Encouraging thechildtoemptytheirbladderbeforebed. 2. Alarmtherapy3. Behavioraltherapyusing"bellandpadapparatus"4. Motivationaltherapy5. Ifnon-pharmacologicaltreatmentfails-4Imipramineisthedrugof choice.Otherdrugsusedareoxybutyninanddesmopressin.Recordkeepingishelpfulindeterminingabaselineandfollowingthechild'sprogressandmayitselfbeareinforcer.Astarchartmaybeparticularlyhelpful.
80.Repressedinformationcanbebrought intoconsciousmindbyallexcept? a)Dream b)Focusedattention c)Hypnosis d)Somaticstimulation CorrectAnswer-BAns.is'b'i.e.,FocusedattentionPreconciousthoughtsarereadilyaccessibletoconciousnessbyfocusedattention,butnotunconsciousthoughtswhichcontainsrepressedmemory.Freudadvancedthe'topographictheoryofmind'intheyear1900inthebook'theinterpretationofdreams'.Itdividesthemindintothreedivisions:? 1. Unconscious:-Atraumaticeventwhichhadoccuredduring childhoodare"repressed"(forceddown)intodeeperlayerofunconsciounesswheretheyliedormantwithoutproducinganysymptoms. 2. Preconscious:-Thisistheregionofmindbetweentheunconscious andtheconscious,withaccesstoboth.Theunconsciousmentalcontentscanreachtheconsciousonlythroughthepreconscious.So,Itactsasasensorofconscioustomentainrepressivebarrierforunconsciousmentalcontents. 3. Conscious:Itreferstoattentionconcernedwithregistrationof stimulifrombothwithandwithout.Focusedattentioncanbringpreconciousthoughtstoconsciousness.Butrepressedmemoryisinunconscious.Methodsusedtorecoverrepressedthoughtsare:-
1. Hypnosis2. Dreaminterpretation3. Automaticwriting4. Somaticstimulation5. EMDR(eyemovementdesensitizationandreprocessing)
81.Allofthefollowingareusedtoimprove attentiondeficitinchildrenexcept? a)Cognitiveenhancementtherapy b)Cognitivebehaviouraltherapy c)Cognitiveremeditationtherapy d)Flooding CorrectAnswer-DAns.is'd.i.e.,FloodingInattentiondeficitfollowingcanbeused: 1. Cognitiveenhancementtherapy(alsocalledcognitiveremediation therapy) 2. Cognitivebehavioraltherapy3. Clinicalbehaviortherapy4. Directcontingencymanagement5. Intensive,packagedbehavioraltreatment
82.IndicationsforECTareallexcept? a)Severedepressionwithsuicidalrisk b)Catatonicschizophrenia c)Severepsychosis d)Severmanicattack CorrectAnswer-DAns.is'd'i.e.,SevermanicattackIndicationsofECTSeveredepressionwithsuicialriskorwithpsychoticfeaturesorwithstupor.Sometypesofschizophrenia(catatonicorparanoid)SchizophrenicordepressivestuporSeverecatatoniawithstuporSeverepsychoses(schizophreniaormania)withriskofsuicideorhomicideorphysicalassault.
83.Concretethinkingstageofcognitive development? a)0-2years b)2-5years c)5-10years d)10-15years CorrectAnswer-CAns.is'c'i.e.,5-10yearsCognitivedevelopmentstagesChildrenarenotlittleadults.Untiltheyreachtheageof15orsotheyarenotcapableofreasoningasanadult.JeanPigetdescribedfourmajorstagesofintellectual(cognitive)developmentwhicharerelatedtomajordevelopmentinbraingrowth. 1. Sensori-motorstage(birth2years)2. Pre-operationalstage(2-7years)3. Concreteoperationalstage(7-11years)4. Formaloperationalstage(>11years)
84.Delusionsarefeaturesofallexcept? a)Delirium b)Schizophrenic c)OCD d)Alcoholwithdrawal CorrectAnswer-CAns.is'c'i.e.,OCDDelusionsareseeninpsychoticdisordersOrganic 1. Delirium(Acuteconfusionalstate)2. Substance:-Abuse(alcohol,amphetamines)andwithdrawal (alcohol).Nonorganic 1. Schizophrenia2. Affect/mooddisorders(Mania&depression)3. Othernon-organicpsychosis:-Delusionaldisorders,Schizoaffective disorders.Delusionsarenotseeninneuroticdisorders-,Anxietydisordersobsessive-compulsivedisorders,Dissociative(conversion)disorders,Somatoformdisorders,Stress-relateddisorders
85.Psychoanalysiswasstartedby? a)EugenBleuler b)SigmundFreud c)Bleuler d)Erikson CorrectAnswer-BAns.is'b'i.e.,Sigmundfreud Name ContributionPsychoanalysis,freeassociation,(oedipus&electra Sigmund complex),cocaineinpsychiatry, Freud Repression,ego-defencemechanisms,psychodynamictheory. Phillippe Moralandhumanetreatmentofmentallyill PinelJones Propagatedtherapeuticcommunityconcept. MaxwellKuble Classifiedfivestagesofdeath. RossErikErikson Dividedlifecyclein8stages
86.Hallucinations,trueis? a)Perceivedintheinnersubjectivespace b)Thereismisinterpretationofexternalstimulus c)Thereisnoexternalstimulus d)Canbecontrolledbyvoluntaryeffort CorrectAnswer-CAns.is'c'i.e.,ThereisnoexternalstimulusCharacteristicsofHallucinations:? 1. Absenceofcorrespondingexternalperceptualstimuli.2. Vividness,forceandrealityvalueofanormalperception.3. Theexperienceoccursspontaneously4. Itcannotbeproducedorterminatedatwillbysubject(notin consciousorvoluntarycontrol). 5. Perceivedasbeinginexternalobjectivespace.6. Haverelativepermancy(i.e.remainconstantandunchanged).7. Hallucinationsareusuallyexperiencedalongsideand simultaneouslywithnormalperception.
87.Cotard'ssyndromehas? a)Persecutorydelusions b)Religiousdelusions c)Nihilisticdelusions d)Hypochondricaldelusions CorrectAnswer-CAns.is'c'i.e.,NihilisticdelusionsTypesofdelsionsBasedonthecontentsofdelusions,theyaredividedinto:- 1. Persecutorydelusions(paranoid):-Thepatientfeelsthatheis beingpersecutedagainst.Thereisfalsebeliefthatoneisbeingharmed,threatened,cheated,poisoned,harassedorspiedonorisavictimofconspiracytodamagehisreputation.Thesupposedpersecutorofthepatientmaybepeopleintheenvironment(e.g.,membersoffamily,neighbours,formerfriend)ormaybepoliticalorreligiousgroups.Thesedelusionsoccurinschizophrenia(especiallyparanoid),severeaffectivedisorders(severmaniaorseveredepression),andorganicbrainsyndrome.Thisisthemostcommontypeofdelusion.Delusionofpersecutionmayoccurinthecontextofprimarydelusionalexperiences,auditoryhallucinations,bodilyhallucinationsorexperiencesofpassivity. 2. Grandiosedelusion(expansivedelusions):-Falsebeliefthatoneis exceptionallypowerful,talentedorimportant.Thesedelusionsseenmostcommonlyinmania,However,canalsooccurinschizophreniaandorganicstates. 3. Delusionsofreference:-Falsebeliefthatcertainobjects,peopleor eventshaveintensepersonalsignificanceandreferspecificallytooneself,e.g.,believingthatatelevisionnewsreaderistalking
directlyaboutoneself,orpeoplewalkingontheroadaretalkingabouthim.Thesedelusionsareseeninschizophrenia,maniaandorganicstates. 4. Religiousdelusions:-Falsebeliefpertainingtoareligioustheme, oftengrandioseinnature,e.g.,believingthatoneisaspecialmessengerfromGod.Thesedelusionsareseeninschizophrenia. 5. Delusionsoflove(erotomania):-Falsebeliefthatanotherpersonis inlovewithone(commonerinwoman).Inoneform,termeddeclerambaultsydrome,awoman(usually)believesthataman,frequentlyolderandofhigherstatus,isinlovewithher. 6. Delusionofinfidility(morbidjealousy,othellosyndrome:-False beliefthatone'sloverhasbeenunfaithful.Theseareseeninschizophrenia,alcoholrelatedpsychosis,organicstates. 7. Delusionofmisidentification:-a)Capgrassyndrome(Delusionof double):-Beliefthatafamiliarpersonhasbeenreplacedbyanexactdoublei.e.animpostor.b)Fregolisyndrome:-Beliefthatacompletestrangerisactuallyafamiliarpersonalreadyknowntoone. 8. Delusionofselfaccusationorguilt:-Falsefeelingofremorseof guilt.ItoccurinDepression. 9. Nihilisticdelusions:-Falsebeliefthatoneself,othersortheworldis non-existentorabouttoend.Therearepessimisticideasthatthepatient'scareerisfinished,heisabouttodie,worldisdoomed.Theseoccursinseveredepression.Ifnihilisticdelusionsareaccompaniedbyideasconcerningbodilyfunctionfailure,e.g.,putrefactionofintestines,etc.,thesyndromeiscalledCOTARD'sSYNDROME. 10. Hypochondriacaldelusions:-Falsebeliefaboutone'shealth, patientwronglybelievesthathehasseveremedicalillness,contrarytotheallmedicalevidences.Itisseenindepression. 11. Delusionofinfestations:-Falsebeliefthatoneisinfestedwithsmall butvisibleorganisms.AsamonosymptomaticdelusionaldisorderthisiscalledEKBOMSYNDROME.Itisseeninacuteconfusionalstate(duetodrugsoralcoholwithdrawal),inschizophrenia,indementingillness,andasdelusionaleloborationoftactilehallucinatoryexperiences(secondarytoformication). 12. Delusionofcontrol:-Beliefthathisactions,impulsesorthoughts arecontrolledbyanoutsideagencyandaccordinglycalledasmade
action,madeimpulseormadeaffect.Alsocalledsomaticpassivityexperiences(passivityphenomenon).Commonlyseeninschizophrenia. 13. Delusionsconcerningpossessionofthoughts-Patientswith delusionsaboutpossessionofthoughtsmaylosetheconvictionthattheirthoughtsaretheirown.Mostcommonlyseeninschizophrenia.Delusionsofthoughtinsertion-thoughtshavebeenimplantedbyanoutsideagency.Delusionsofthoughtwithdrawal-thoughtsarebeingtakenoutoftheirmind.Thisisusuallyaccompaniedby"thoughtblock".Delusionsofthoughtbroadcast-unspokenthoughtsareknowntootherpeoplethroughradio,telepathyorinsomeotherway.
88.Oedipuscomplexisrelatedtowhich phaseofpsychosexualdevelopment? a)Oral b)Anal c)Genital d)Phallic CorrectAnswer-DAns.is`d'i.e.,Phallic
89.Mosteffectivetreatmentinborderline personalitydisorders? a)Pharmacotherapy b)Behaviourtherapy c)Combinationofbothpharmacotherapyandbehaviouraltherapy d)None CorrectAnswer-BAns.is'b'i.e.,Behaviourtherapy"Dialecticalbehavioraltherapy(DBT),atypeofcognitivebehavioraltherapy(CBT),hasbeendevelopedspecificallyforthetreatmentofborderlinepersonalitydisorder,anditappeartobethemosteffectivetreatmentforthiscondition".
90.Allarereversiblecausesofdementia except a)Hypothyroidism b)Hydrocephalus c)Meningoencephalitis d)Alzheimer'sdisease CorrectAnswer-DAns.'D'i.e.,Alzheimer'sdiseaseReversiblecausesofdementia1)Surgicallytreatable:-Normalpressurehydrocephalus,braintumors(frontallobetumor),meningioma,subduralhematomaduetoheadinjury,hydrocephalus.2)Medicallytreatable:-Depression,hypothyroidism,alcoholabuse,vitaminB12/folate/Niacindeficiency,anymetabolicorendocrinedisturbance,neurosyphilis,Hashimoto'sencephalopathy,Wilson'sdisease,celiacdisease,Whipple'sdisease,chronicmeningoencephalitis,drugsandtoxin(toxicdementia).Irreversiblecausesofdementia:-Alzheimer'sdisease,vascular(multi-infarct)dementia,Parkinsonism,Huntington'schorea,Lewybodydementia,Pick'sdisease.
91.Visualhallucinationsareseeninall except? a)Delirium b)Depression c)Schizophrenia d)Alcoholwithdrawal CorrectAnswer-BAns.is'b'i.e.,Depression Typeof Causes hallucination Schizophrenia,Organicbrainsyndrome,Alcoholic Auditory hallucinosismanic-depressiveillness,BrainlesionsPontineortemporallobelesions.Organicbraindisturbances:-Delirium,deliriumtremens,occipitallobetumors,epilepsy,dementiaIntoxication(LSD,amphetamines,Alcohol,mescaline),alcoholwithdrawal.Brainlesions Visual 1. Unformedvisualhallucinations:-Disordersof occipitallobeoroculardiseases. 2. Formedvisualhallucinations:-Disordersof temporallobe,upperbrainsteinorthalamusSchizophreniaTemporallobediseases(e.g.,complexpartial lfactory& seizure). gustatory Olfactoryhallucinationmayalsooccurindepression&schizophrenia
Tactile SchizophreniFormication:-Cocaine,alcoholwithdrawal Note:Epilepsyandcerebraldisorderscancausehallucinationsofallmodalitiesdependingonthesiteoflesions.
92.Waxyflexibilityisafeatureof? a)Echopraxia b)Catatonia c)Stereotype d)Mannerism CorrectAnswer-BAns.'B'i.e.,CatatoniaCatatoniamaybeoffollowingtypes:-Catatonicexcitement:-Excited,uncontrolledmotoractivity,notinfluencedbyexternalstimuli.Catatonicposturing:-Voluntaryadoptionofanunusualorbizarrepositionthatisthenmaintainedforsometime.Catatonicrigidity:-Maintainingafixedpositionandrigidityresistingallattemptstobemoved.Waxyflexibility(flexibilitycereaorcatalepsy):-Maintainingofparticularpostureimposedonthepatientbytheexaminer,evenifthepostureisbizarreanduncomfortable,i.e.,thepatientcanbemoldedlikewaxintoapositionthatisthenmaintained.Catatonicstupor:-Patientismuteandimmobile(akineticmutism)butfullyconscious.Catatonicnegativism.-Aseeminglymotivelessresistancetoallinstructionsorattemptstobemoved.Automaticobedience:-Exactlyreversetonegativism,i.e.,unhesitatingcompliancetoallinstructionswithoutapparentconsciouscontrol.
93.TermPsychiatrywascoinedby? a)Moral b)Johannreil c)Bleuler d)Pinel CorrectAnswer-BAns.is'b'i.e.,JohannreilIMPORTANTCONTRIBUTORSINPSYCHIATRY Term CoinedbyMoralEmilKraepelin Demenceprecoce Kahlbaum Dementiaprecox Hecker Catatonia,cyclotymia EugenHebephrenia Bleuler Schizophrenia Eugen Ambivalence Bleuler Freeassociation Sigmund Psychoanalysis, Freud Psychodynamics Sigmunnd Id,ego,Superego Freud Psychiatry SigmundFreudJohannchristionReil
94.AllarefeaturesofKorsakoffsyndrome except a)Antegradeamnesia b)Retrogradeamnesia c)Ataxia d)Confabulation CorrectAnswer-CAns.'C'i.e.,AtaxiaKorsakoffsyndromeKorsakoff'ssyndromeisthechronicamnesticsyndromethatfollowsWernicke'sencephalopathy,andthetwosyndromesarebelievedtobepathophysiologicallyrelated.Korsakoff'ssyndromeischaracterizedbysevereandirreversiblememoryimpairmentsandconfabulationbehaviourintheabsenceofintellectualdeclineorattentiondeficit.Importantclinicalfeaturesare:? 1. Memory:-TheKorsakoffsyndromeischaracterizedbyboth antegrade(i.e.,learning)andretrograde(i.e.,amemoryofpastevents)amnesia.Antegradeamnesiaisseverewithalackofinsight.Retrogradeamnesiaisnotassevere.Newlearningandrecentmemoryareimpairedbutremotememoryisrelativelypreserved.Althoughremotememoryisrelativelypreserved,thepatientisunabletoorganizetheminatemporalcontextanddistorttherelationshipbetweenfactsandfilltheremotememorygapsbyconfabulation.Thereisaprofounddeficitofexplicit(consciousordeclarative)typeoflongtermmemory,withlittleimpairmentofimplicit(unconsciousornon-declarative)typeoflongtermmemory. 2. Personality:-Passiveandmalleablesuchthattheydisplayalackof initiatives,interest,orconcernanddiminishedspontaneity.
3. Other:-Perseveration,lackofmotivation(amotivationalsyndrome), apathy,passivity. 4. Generalintelligence,language,andmotor&perceptualskillsarenot impaired.
95.Diagnosticcriteriafordrugdependence includesallexcept- a)Tolerance b)Withdrawalsymptoms c)Earlycompletionoftasks d)Largerdosethanusual CorrectAnswer-AAns.is'c'i.e.,EarlycompletionoftasksDiagnosticcriteriaforsubstanceabuseTomakeadiagnosisofdependence,threeormoreofthefollowingcriteriashouldbepresent.Tolerance:-Samedoseproducesmarkedlydiminishedeffectoncontinuoususe,thereforeincreaseddosesarerequiredtoproducesameeffect.Withdrawalsymptomsonabstinence.Substanceistakeninlargeramountorlongerperiodthanwasintended.Persistentdesire(craving)orsenseofcompulsiontotakethesubstance.Agreatdealoftimespenttoobtainthesubstance,tousesubstanceortorecoverfromitseffect.Neglectofimportantsocial,occupationalandrecreationalactivities.Continuedsubstanceusedespiteclearevidenceofovertlyharmfulconsequences
96.Suspiciousnessisacharacteristicfeature of? a)Paranoidpersonalitydisorder b)Schizoidpersonalitydisorder c)Schizotypalpersonalitydisorder d)Anankasticpersonalitydisorder CorrectAnswer-AAns.is'a'i.e.,ParanoidpersonalitydisorderParanoidpersonalitydisorderItischaracterizedbygeneralisedmistrustandSuspiciousnessaboutthemotivesandactionsofothersandatendencytointerpretthemasmalevolent.Thepatientbelievesthat:- 1. Othersareexploitingordeceivingtheperson.2. Friendsareuntrustworthyandnotloyal.3. Thespouse/partnerisunfaithful.4. Thereishiddenmeaninginneutralorfriendlyremarks.5. Manypatientshavefeelingofself-importanceandthinktheyare unusuallytalented
97.Earliestsymptomshowingimprovement fromclassicaltriadofWernicke'sincephalopathv.tothiaminetherapy? a)Ataxia b)Ophthalmoplegia c)Confusion d)Allareequallyresponsive CorrectAnswer-BAns.is'b'i.e.,OphthalmoplegiaResponsetothiaminetreatmentinWernicke'sencephalopathyOcularsymptoms:-Earliesttorespond,ophthalmoplegia(ocularpalsies)improveswithinhoursofthiamineadministration.However,horizontalnystagmusmaypersist.Ataxia:-Ataxiarespondsmoreslowlythanocularpalsiesandhalfthepatientsrecoverincompletelywitharesidualataxia.Encephalopathy:-ConfusionandotherCNSsymptomsimprovemoreslowly.Asthesymptomsofencephalopathyimprove,Korsakoff'ssyndromemaybecomeapparentinsomepatients
98.Allaresymptomsofmorphinewithdrawal except? a)Mydriasis b)Yawning c)Lacrimation d)FallinBP CorrectAnswer-DAns.is'd'i.e.,FallinBPMorphinewithdrawalManifestationsofmorphinewithdrawl 1. Lacrimation2. Anxiety&fear3. Mydriasis4. Diarrhea5. Palpitation6. Sweating7. Restlessness8. Insomnia9. Dehydration 10. Rapidweightloss11. Yawning12. Gooseflash(Piloerection)13. Abdominalcolic14. RiseinBP Deliriumandconvulsionsarenotacharacteristicfeatures(contrastbarbiturates)andareseenonlyoccasionally.Treatmentconsistsofwithdrawlofmorphineandsubstitutionwithoralmethadonefollowedbygradualwithdrawlofmethodone.
RecentlytheNMDAantagonistsandnitricoxidesynthataseinhibitorshavebeen
99.Allarerequiredtodiagnosemajor depressionexcept? a)Depressedmood b)Isomnia c)Nihlisticideas d)Decreasedconcentration CorrectAnswer-CAns.is'c'i.e.,NihlisticideasDiagnosticcriteriaformajordepression5ormoreoffollowingsymptomsshouldbepresentmostofthedayforatleast2weeks:? 1. Depressedmood2. Lossofinterestorpleasureinallactivities.3. Decrease/increaseappetiteorloss/gainofweight.4. Insomniaorhypersomnia(Increasedordecreasedsleep).5. Psychomotorretardationoragitation(decreasedorincreased psychomotoractivity). 6. Fatigueorlossofenergy(weaknessorlethargy).7. Feelingsofworthlessnessorexcessiveguilt.8. Diminishedconcentration9. Recurrentthoughtsofdeathorrecurrentsuicidalideationorsuicidal attempt.Atleastoneofsymptomsshouldbeeither:? 1. Depressedmoodor2)Lossofinterestorpleasure--)Thesetwo(1 &2)areessentialcriteria.Therefore1essentialcriterianand4othercriteria(total5)shouldbepersent.
100.Allarefeaturesofpsychosisexcept? a)Lossofinsight b)Presenceofdelusions c)Preservedcontactwithreality d)Personalitydisturbances CorrectAnswer-CAns.is'c'i.e.,PreservedcontactwithrealityPsychosisPsychosisisamentalstateinvolvingthelossofcontactwithreality,causingdeteriorationofnormalsocialfunctioning.Thecharacteristicfeaturesofpsychosisare:- 1. Grossimpairmentinrealitytesting,i.e.,lossofcontactwithreality.2. Markeddisturbanceinpersonalityandbehaviorwithimpairmentin social,interpersonalandoccupationalfunctioning. 3. Markedimpairmentinjudgement.4. Lossofinsight(insightisanassessmentofhowawarethepatientis oftheirownmentalillness). 5. Presenceofcharacteristicsymptomslikedelusionsand hallucinations,thesearecalledpsychoticsymptoms.Themajorpsychosisare:? 1. Organicpsychoticdisorders,e.g.,Delirium,substancerelated psychosis,headtrauma. 2. Non-organicpsychoses3. Majorpsychoses:-Schizophrenia,mooddisorders(depression, mania,bipolar). 4. Otherpsychoticdisorders(thirdpsychosis):-Delusionaldisorders, acuteandtransientpsychoticdisorders,schizoaffectivedisorderNeurosis
Neurosisisageneraltermreferringtomentaldistressthat,unlikepsychosis,doesnotpreventrationalthoughtanddailyfunctioning.Characteristicfeaturesare:- 1. Symptomscausesubjectivedistresstothepatient.2. Insightispresent(symptomsarerecognisedasundesirable).3. Thepersonalityandbehaviourarerelativelypreservedasisthe judgement. 4. Thecontactwithrealityispreserved.5. Absenceoforganiccausativefactor ImportantneuroticdisordersareAnxietydisorders(Panic),Phobia(Phobicanxietydisorder),obsessivecompulsivedisorder,Dissociativeconversiondisorder.
101.Gansersyndromeisafeatureof? a)OCD b)Conversiondisorder c)Dissociativedisorder d)Schizoidpersonalitydisorder CorrectAnswer-CAns.is'c'i.e.,DissociativedisorderDissociativedisorderTheessentialfeatureofthedissociativedisorderisadisruptionintheusuallyintegratedfunctionsofconsciousness,memory,identityorperceptionoftheenvironment.Dissociativedisorderare:- 1. Dissociative(psychogenic)amnesia:-Itisthemostcommontypeof dissociativedisorder.Dissociativeamnesiaischaracterizedbyretrogradeamnesia(inabilitytoretrievestoredmemoriesandeventsleadinguptoonsetofamnesia)andabsenceofantegradeamnesia(inabilitytoformnewlongtermmemories). 2. Dissociativefugue:-Adissociativefuguemaybepresentwhena personimpulsivelywandersortravelsawayfromhomeanduponarrivalinthenewlocationisunabletorememberhis/herpast(i.e.,amnesiaforearlylife).Thereislossofpersonalidentityandthepersonassumesanewidentity.Thereisabsenceofawarenessofamnesiaduringfugueepisode,i.e.,Patientdeniesanymemorylossduringfuguestate.Onrecoverythereisamnesiaforfugueepisodesandrecoveryofmemoryofearlierlife(i.e.,beforetheepisodeoffugue). 3. Dissociativeidentitydisorder(multiplepersonalitydisorder):-More thanonepersonalityappearstopossesstheindividuals,Showingtheircharacteristicbehavior.Atanyinstancebehaviorandmemories
ofonepersonalityisexhibited,patientthenisunawareoftheother'sexistance. 4. Depersonalizationdisorder:-Feelingofdetachmentfromselfis referredtoasdepersonalization.Individualswiththisdisorderwillreportfeelingasiftheyarelivinginadreamorwatchingthemselvesonmoviescreeni.e.,feelingdetachedfromselfandasifoneisanoutsideobserverofoneself.Peoplewiththisdisorderfeelliketheyare"goingcrazy"andtheyfrequentlybecomeanxiousanddepressed 5. Dissociativedisordersnototherwisespecified:-Thesearethe disordersthatarecharacterizedbydissociativeresponsethatdonotmeetdiagnosticcriteriaforoneoftheotherdissociativedisorder.Importantonesare:-DissociativeTrance(Possession)disorders:-Thereistemporaryexchangeofperson'spersonalitybyanewpersonalityusuallyattributedtoaspiritordivinepower.Usuallythepersonisawareoftheexistanceoftheother,i.e.,possessor(unlikedissociativeidentitydisorder).Ganser'ssyndrome:-Alsoknownassyndromeofapproximateanswers.Thisischaracterizedbygivingapproximateanswerstogetherwithacloudingofconsciousness,andfrequentlyaccompaniedbyhallucinationsandotherdissociative,somatoformorconversionsymptoms.
102.Repetitiveirresesistablethoughttodo something a)Phobia b)Obsession c)Compulsion d)Anxiety CorrectAnswer-BAns.is'b'i.e.,ObsessionObsessivecompulsivedisorder(OCD)OCDisananxietydisorderwhichischaracterizedbyrecurrent,unwantedthoughts(Obsessions)andrepettivebehaviors(compulsions).Anobsessionhasfollowingcharacteristic:- 1. Anidea,impulseorimagewhichintrudesintotheconscious awarenessrepeatedly. 2. Itisrecognizedasone'sownideas,impulseorimagebutis perceivedasegoalien(foreigntoone'spersonality). 3. Itisrecognizedasirrationalandabsurd(insightispresent--4 Patientknowsaboutdisorder). 4. Patienttriestoresistagainstitbutisunabletodosowhichleadsto markeddistressoranxiety.Acompulsionhasfollowingcharacteristics:- 1. Itisrepetitive,purposefulformofbehavioriscarriedoutbecauseof strongfeelingofcompulsiontodoso. 2. Itusuallyfollowsanobsession.3. tsgoalistopreventorreducetheanxietyorstresscausedby obsessionhoweveritdonotalwayssucceedindoingso. 4. Itisirrationalorexcessiveandnotrealistic.
5. Insightispresent. ApatientwithOCDmayhaveanobsession,acompulsionorboth(mostlypatientshaveboth).ApatientwithOCDrealizestheirrationalityoftheobsessionandexperiencesboththeobsessionandthecompulsionasego-dystonic(unwantedbehavior).Thepersonispreoccupiedwithdetailsrules,listorder,organisationorschedulestotheextentthatthemajorpointofactivityislost.Thepersonshowsperfectionismthatinterferswithtaskcompletion(e.g.,unabletocompleteprojectbecausehisownovertlystrictstandardarenotmet).
103.Allarefeaturesofneurosisexcept? a)Symptomscausesubjectivedistress b)Contactwithrealitypreserved c)Personalitydisturbances d)Insightismaintained CorrectAnswer-CAns.is'c'i.e.,Personalitydisturbances
104.Allareseeninnicotinewithdrawal except? a)Hyperhydrosis b)Anxiety c)Bradycardia d)Insomnia CorrectAnswer-AAns.is'a'i.e.,Hyperhydrosis
105.Allareincludedindiagnosticcriteriaof somatizationdisorderexcept? a)Sexualsymptom b)Painsymptom c)GIsymptom d)Visualsymptoms CorrectAnswer-DAns.is'd'i.e.,VisualsymptomsSomatizationdisorderTheessentialfeaturesofsomatizationdisorderaremultiplerecurrentsomaticsymptomsoflongduration(chronic)thatarecausedbypsychologicalbasisandnophysicalillnesscanbefound.Thedisorderbeginsbeforetheageof30yearsandthenhasachroniccourse(overaperiodofseveralyears).DiagnosticcriteriaforsomatizationdisorderEachofthefollowingshouldbepresent:? 1. Fourpainsymptoms:-Pain,atleastatfourdifferentsitesor functions?9Head(headache),abdomen,back,joint,extremites,chest,rectum,duringmensturationorsexualintercourseorurination. 2. Twogastrointestinalsymptoms:-Nausea,bloating,vomiting, diarrhea. 3. Onesexualsymptom:-Erectiledysfunction(Impotence),ejaculatory dysfunction,irregularmenses,excessivemensturalbleeding. 4. Onepseudoneurologicalsymptom:-Conversionsymptoms (impairedcoordinationorbalance,paralysis,weakness,blindness,deafness,glove&stockinganesthesia,Paresthesia,seizure,aphonia);Dissociativesymptoms(amnesia);lossofconsciousness.
106.Bleuler'ssymptomsforschizophrenia areallexcept? a)Looseningofassociation b)Affectdisturbances c)Autism d)Hallucinations CorrectAnswer-DAns.is'd'i.e.,HallucinationsEugenBleulerrenameddementiaprecoxasSchizophrenia.Herecognizedthatschizophreniaisagroupofdisordersratherthanadistinctentity.Therefore,heusedtheterm,agroupofschizophrenias.Bleulerdescribedthecharacteristicsymptoms(fundamentalsymptoms)forschizophreniawhicharealsoknownas4'A'sofBleuler:? 1. Ambivalence(coexistenceoftwooppositefeelingsandattitude towardsthesamethinginthesamepersonatthesametime). 2. Autism(Preoccupationwithfantasies,delusionsandhallucinations totheexclusionofreality). 3. Affectdisturbances(e.g.,inappropriateaffect)4. Associationdisturbances(e.g.,Looseningofassociation,thought disorder).Healsodescribedaccessarysyptomsofschizophrenia:-delusions,hallucinations,andnegativism.
107.Negativesymptomofschizophrenia? a)Hallucination b)Delusion c)Ambivalance d)Motorhyperactivity CorrectAnswer-CAns.is'c'i.e.,AmbivalanceSymptomsofschizophreniacanbedividedinto:? 1. Positivesymptoms:-Positivesymptomsarepsychoticsymptoms notseeninnormalindividualsbutare"activelyexpressed"inpatient,i.e.,hallucinations,delusionsandbizarremotoracts.Positivesymptomsaremorecommoninacuteschizophrenia.Theserespondwelltotypicalantipsychotics. 2. Negativesymptoms:-Negativesymptomsarenormallyexpected behaviours,emotions(feeling),thoughtsanddrivesthatthepersonwithschizophreniafailtoexhibit,i.e.,deficitstate(diminutionorloss)ofnormalfunction.Theprominentnegativesymptonsareflatteningorbluntingofaffect,anhedonia,ambivalence(avolition)asociality(socialwithdrawal),alogia,apathy,paucityofthoughtandpoverityofspeech.Negativesymptomsaremorecommoninchronicschizophrenia.NegativesymptomsdonotrespondwelltotypicalantipsychoticsThereforepatientontypicalantipsychoticsmayshowimprovementofpositivesymptomsandpersistentofnegativesymptoms.Morerecentlyathirdcategoryhasbeenproposed.3.Disorganizedsymptoms:-Disorganizedspeech/thinking,anddisorganizedbehavior.
108.Cyclothymiaisatypeof? a)Bipolarmooddisorder b)Majordepression c)Dysthymia d)Persistantmooddisorder CorrectAnswer-DAns.is'd'i.e.,PersistantmooddisorderPersistentmooddisorderMooddisordersmayrunachroniccourseoveryearswithfluctuationofmoodinterposedwithsymptomfreeintervals.Ifsymptomspersistformorethan2years,theyarereferredtoaspersistentmooddisorders.Twomostimportantpersistantmooddisordersare:? 1. Cyclothymia:-Itisasubduedversionofbipolardisorder, characterizedbyepisodesofdepressionandhypomaniathatneve,.havesufficientintensitytomeetfulldiagnosticcriteriaforbipolardisorder. 2. Dysthemia:-Longstanding(persistent,i.e.,2years)mild depressionwhichisnotsevereenoughtomeetfulldiagnosticcriteriaformajordepression.Symptomsaremoreprominentthansigns(moresubjectivethanobjectivedepression).Thismeansthatdisturbancesinappetiteandlibidoareuncharacteristic,andpsychomotoragitationorretardationisnotobserved.
109.Allareanxietydisordersexcept? a)Phobias b)OCD c)Conversionreaction d)PTSD CorrectAnswer-CAns.is'c'i.e.,ConversionreactionAnxietydisordersare:- 1. Panicdisorderwithorwithoutagoraphobia2. Agoraphobiawithorwithoutpanicdisorder3. Specificphobia4. Socialphobia5. Obsessive-compulsivedisorder6. Posttraumaticstressdisorder7. Generalizedanxietydisorder
110.Allarediagnosticsymptomsof schizophreniaexcept? a)Catatonia b)Hallucinations c)Disorganizedspeech d)Socialwithdrawal CorrectAnswer-DAns.is'd'i.e.,SocialwithdrawalDiagnosticcriteriaforschizophreniaCharacteristicsymptoms:-Two(ormore)ofthefollowingfora1monthsduration(orlessifsuccessfullytreated):? 1. Delusions2. Hallucinations3. Disorganizedspeech4. Grosslydisorganizedorcatatonicbehavior5. Negativesymptoms,i.e.,affectiveflattening,alogia. Note:-Onlyoneoftheaboveisrequiredifdelusionsarebizarreortherearethirdpersonhallucinations(runningcommentaryortwovoicesarguingorconversing).Social/occupationaldysfunctionDuration:-Continuoussignsofdisturbancepersistforatleast6months.This6monthsperiodmustincludeatleast1monthofsymptomsthatmeetcriteriaA.Exclusionofmooddisorderandschizoaffectivediorder.Exclusionofsubstanceabuse/generalmedicalcondition.
111.Allaretrueabouttype1schizophrenia except? a)Acuteillness b)Goodprognosis c)Negativesymptoms d)Intellectmaintained CorrectAnswer-CAns.is'c'i.e.,Negativesymptoms TypeI(Reactiveoracute TypeII(Process schizophrenia) schizophrenia)Negativesymptoms(Affectflattening, Characteristic Positivesymptoms poverityof symptoms (Hallucination,Acute speechlossofdrive Typeofillness Delusion,Thought) Chronic Responseto Good Poor neuroleptics Reversible Longstanding Outcome Absent Sometimespresent Intellectual Dopamineoveractivity Structuralchangesin impairment Good brain(dilated Etiology ventricleonCTscanPoor
112.Drugofchoiceforgeneralizedanxiety? a)3-blocker b)Alprazolam c)Buspirone d)Phenytoin CorrectAnswer-BAns.is'b'i.e.,AlprazolamTreatmentofgeneralizedanxietyBenzodiazepinesarethedrugofchoice.Drugsinthisgrouparediazepam,Lorazepam,Alprazolam,Oxazepam,chlordiazepoxide.Otherdrugsusedarebuspirone;TCA(amptriptyline,imipramine,clomipramine,desipramine);SSRIs(Fluoxetine,Sertaline,Paroxetine,Citalopram);SNRIs(Venalafaxine),13-blockers.AnticonvulsantswithGABAergicpropertiesmayalsobeeffectiveagainstanxiety,e.g.,Gabapentin,Oxcarbazepine,Tiagabine,pregabalin,andValproate(divalporex).
113.Persistentpreoccupationwithserious illnessandnormalbodyfunctioniscalled? a)Obsession b)Somatization c)Hypochondriasis d)Conversiondisorder CorrectAnswer-CAns.is'c'i.e.,HypochondriasisHvpochondriasis(hypochondriacaldisorder)Theprimaryfeatureofhypochondriasisispersistentpreoccupationwithexcessivefearofaserious(e.g.,cancer)orincurable(e.g.,AIDS)disease,whichisbasedonperson'sowninterpretationofphysicalsymptomsorsensation,i.e.,misinterpretationofphysicalsymptomsorsensations,forexampleanoccasionalchangeinheartratewillleadapersonwithhypochondriasistofearofheartdisease.Therefore,Hypochondriasisisabnormalpreoccupationaboutnormalbodyfunction,i.e.,bodyfunctioningisnormalbutpatientthinksitasabnormal.Thepreoccupationwiththepresenceofafearedillnesspersistsinspiteofnormalmedicalassessmentandinvestigations.Patientgoesfromonedoctortoanotherforaconsultation.Peoplewithhypochondriasisareabletoacknowledgethattheirfearsareunrealistic(insightispresent),butthisintellectualrealizationisnotenoughtoreducetheiranxiety.Twoimportantfactsdifferentiatehypochondriasisfromsomatizationdisorder:-
1. Patientwithhypochondriasisispreoccupiedwithillness,ontheother handpatientwithsomatizationdisorderisoccupiedwithsymptoms. 2. Hypochondriasispatientispreoccupiedwithoneillness(usually) whilepatientwithsomatizationdisorderhasmany(atleast8ormore)symptoms.
114.Nottrueaboutsomnambulismamong thefollowingis? a)Sleepwalking. b)Patientconsciousnessispreserved. c)Disorderofsleeparousal. d)Lowlevelmotorskill/functionispresent CorrectAnswer-DAns:D.Lowlevelmotorskill/functionispresent.Sleepwalking(somnambulism):Thepatientsmaycarryoutarangeofactivitiesforwhichhedoesn'thaveanymemorylateron.Itmayincludeleavingthebedandwalkingaboutandalsoactivitieslikedressing,movingaroundorevendriving.
115.Testbasedontheprincipleofsuspect's reaction,ifhewitnessesaneventthenhebehavesinacertainwayis? a)Narcoanalysis b)Brainmapping c)Truthserumtesting d)Polygraph CorrectAnswer-DAns:D.Polygraph
116.Intensedepression&miserywithoutany causeis? a)Melancholia b)Majordepressivedisorder c)Mania d)Schizophrenia CorrectAnswer-AAns:A.Melancholia
117.Whichofthefollowingisnottrue regardingdelusionaldisorder? a)Heldwithabsoluteconviction b)Usuallyfalse c)Notamenabletoreasoning d)Occursatearlyage CorrectAnswer-DAns:D.Occursatearlyage.Delusionaldisordermayaccountfor1?2%ofadmissionstoinpatientpsychiatrichospitals.Ageatonsetrangesfrom18?90years,withameanageof40years
118.Keysymptominalcoholwithdrawal syndromeis: a)Sleepdisturbance b)Visualhallucinations c)Tremors d)Delirium CorrectAnswer-CAns:C.TremorsKeysymptom-Tremor. WithdrawalSyndromes Substance Features Yawning?,Insomnia,DysphoricmoodWaterlossfromdifferentorifices?(Lacrimation?, Opioid sweating?,diarrhea?,vomiting,Increasedvitals?(BP,Pulse,RR,Temperature)?Pupillarydilation,piloerection?Hangover(MC)?Hallucinations?(usuallyauditory)andillusions?Insomnia?Tremors/Seizures(Alcoholicseizures/Rumfits):ClassicsignDeliriumtremens: Alcohol Occurswithin5days?ofcompleteorsignificantabstinence?fromheavyalcoholRecoveryoccurswithin7daysCharacteristicfeaturesarecloudingofconsciousness?,disorientation?,hallucinations(mostlyvisualand
auditory)?,illusion?,autonomicdisturbances?,agitation?andinsomnia?.IncreasedordecreasedSleep(hypersomnia?orinsomnia)Psychomotoractivity Cocaine Vividunpleasantdreams?Increasedapetiteandfatigue
119.Whatisproducedbythesupersensitivity ofDopaminereceptors? a)Dyskinesia b)Hyperphagia c)Hyperpathia d)Hypomania CorrectAnswer-AAns.is'a'i.e.,Dyskinesia(Ref:Pathophysiology,pharmacologyandbiochemistryofdyskinesiap.195)Increasedneostriataldopaminereceptordensityanddopaminergicsupersensitivityintheneuroendocrinesystemareassociatedwiththedevelopmentoftardivedyskinesia.
120.Followingarethemajorsymptomsof obsessivecompulsivedisorders? a)Contamination b)Pathologicaldoubts c)Intrusivethoughts d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AIItheabove[RlKaplan&Saddock's|tr/ep.605)OCDhasfourmajorsymptompatterns:-Contamination:-Contaminationisthemostcommonpatternofanobsessionfollowedbywashing(washer)Pathologicaldoubts:-Doubtsisthesecondmostcommonpatternofanobsession,followedbyacompulsivechecking(checkers).Intrusivethoughts(Pureobsessions):-Inthisthirdmostcommonpattern,thereareintrusiveobsessionalthoughtswithoutacompulsion.Suchobsessionsareusuallyr4retitiousthoughtsofasexualoraggressiveactthatisreprehensibletothepatient.Symmetry:-Thisisthefourthmostcommonpatterninwhichthereisanobsessionforsymmetryorprecision,whichcanleadtocompulsionofslowness.Patientscanliterallytakehourstoshavetheirfacesortoeatameal.
121.Allaretrueaboutnarcolepsyexcept: a)Daydreaming b)Hypnagogichallucinations c)Cataplexy d)Suddensleep e)DecreasedREMlatency CorrectAnswer-AAns.(A)Daydreaming[RefNeerajAhuja7th/Ij8-39;Kaplan&SailocklsTextbookofpsychiatry11th/547-50;Harrison19th/189,t7th/172-ZB;CMDT2016/1072]Narcolepsy:DisordercharacterizedbyexcessivedaytimesleepinessoftendistributednighttimesleepanddisturbancesinREMsleep.HallmarkofthisdisorderisdecreasedREMlatency,I.e.decreasedlatentperiodbeforethefirstREMperiodoccurs.NormalREMlatencyis90-100minutes,innarcolepsy,REMsleepoccurswithin10minutesoftheonsetofsleep.Classicaltetradofsymptoms:Sleepattacks(MC)CataplexyHallucinationsatsleeponset(Hypnagogic)anduponwaking(Hypnopompic)Sleepparalysis.
122.Whichofthefollowingisnotasideeffect ofquetiapine? a)Drymouth b)Hairloss c)Suddencardiacdeath d)Dyspepsia CorrectAnswer-BAns.B.Hairloss[RefGoodman&Gilmanli'Vep.463-466]Quetiapineisanatypicalantipsychoticusedforthetreatmentofschizophrenia,bipolardisorder,andmajordepressivedisorder. VeryCommon Lesscommon Rare Drymouth Highbloodpressure ProlongedQTinterval Orthostatic Dizziness Suddencardiacdeath hypotension Headache Highbloodcholesterol SyncopeElevatedserum Somnolence Diabeticketoacidosis triglycerides Nausea Abdominalpain RestlesslegssyndromeHyponatraemia,lowblood Vomiting Constipation sodium. Increased Increasedappetite Jaundice appetite Increasedliver Sorethroat Pancreatitis enzymes Trouble Backache Agranulocytosis movingRapid
Rapid Insomnia Seizure heartbeatWeakness Fatigue Cardiomyopathy Pain Suicidalideation Dyspepsia Priapism (Indigestion) Neurolepticmalignant Peripheraledema syndrome Dysphagia TardiveDyskinesia. Weightgain
123.DOCforschizophrenicpatientwithpoor oralabsorptionis? a)Clozapine b)Fluphenazine c)Sulpride d)Penfluridol CorrectAnswer-BAns.B.Fluphenazine[Ref:TherAdvPsychopharmacol.2014Oct;4(5):198-219.doi:10.1177/2045125314540297]Long-actinginjectable(LAI)antipsychotics(APs)(LAIAPs)haveprovedeffectiveinschizophreniaandotherseverepsychoticdisordersbecausetheyassurestablebloodlevels,leadingtoareductionoftheriskofrelapse.LAIsbypasstheinitialdeactivatingprocessbyavoidingfirst-passmetabolismintheliver.
124. TCAsarecontraindicatedinallofthe followingexcept? a)Narrowangleglaucoma b)Prostatehypertrophy c)ApatientonMOAinhibitors d)Impairedrenalfunction CorrectAnswer-DAns.D.Impairedrenalfunction[RefLippincottp.81]CommonContraindicationsofTCAs 1. Hypersensitivitytothemedicines2. Cardiacconductionabnormalities3. Within14daysofMAOinhibitors4. Urinaryretention5. Narrowangleglaucoma6. Prostateenlargement7. Shouldbeusedcautiouslyinsuicidaltendency,schizophrenia, seizuredisorders,paranoia,impairedliverfunctions. 8. Safetyinnotestablishedinpregnancyandlactation.Not recommendedforchildrenless12yearsofage.
125.Loadingdoseofdiazepamforalcohol withdrawalis? a)80mg b)50mg c)40mg d)20mg CorrectAnswer-DAns.D.20mgRigid:10mgfourtimesdailyFlexible:10mgevery4-6hoursasneededbasedonsymptomstoamaximumof60mg/dayFrontloading:20mgevery2-4hoursuntilsedationisachieved;then10mgevery4-6hoursasneededtoamaximumof60mg/day
126.Confabulationis? a)Astateofconfusionwherepatientisnotabletodescribethe details b)Purposefullyfabricatingstoriestoprojectacertainimage c)Fillinguptogapsbyfabricationtocoverlapsesinmemory d)Afeelingofstrangenesstofamiliarsituationsorevents. CorrectAnswer-CAns.C.Fillinguptogapsbyfabricationtocoverlapsesinmemory[RefKaplan&Sadock's10th/ep.275]ConfabulationItisatypeofParamnesia(Distortedorfalsifiedrecallofeventsinrelationtodetailsortheirtemporalrelationships)Unintentionalfillingofgapsofmemorywithmaterialwhichareuntrueandfanciful.
127.Alcoholwithdrawalisnotassociated with? a)Seizure b)Amnesia c)Tremers d)Delirium CorrectAnswer-BAns.B.Amnesia[Ref:NirajAhuja6th/ep.41]Amnesiaoccursduringacuteintoxication(notduringwithdrawal).
128.DrugofchoiceforTourettesyndromeis? a)Haloperidol b)Amantidine c)Propanolol d)Diazepam CorrectAnswer-AAns.A.Haloperidol[RefKaplan&Saddock10`Vep.557]Medicationforticsuppression(Tourretesyndrome)Neuroleptics-Pimozide,alongwithhaloperidolandfluphenazinearethemedicationswiththemostprovenefficacyincontrollingtics.
129.Scatologiais? a)Eatingdisorder b)Sleepdisorder c)Paraphilia d)Defensemechanism CorrectAnswer-CAns.C.Paraphilia[Ref:NirajAhuja6th/ep.133,134]Scatologia,alsocalledCoprolalia,isadeviantsexualpracticeinwhichsexualpleasureisobtainedthroughthecompulsiveuseofobscenelanguage.Theaffectedpersoncommonlysatisfieshisdesiresthroughobscenetelephonecalls,usuallytostrangers.
130.A40yearoldmarriedmalethinksthathe ismultitalentedandisalwaysoverconfident.Heneverlistenstohisfamilyorfriends.Infactwheneveranyonegiveshimanyadvice,hethinksthattheyhavesomemotiveagainsthim.Heisalwayssuspiciousofhiswife.Allthesearefeatureof? a)Borderlinepersonalitydisorder b)Schizoidpersonalitydisorder c)Paranoidpersonalitydisorder d)Histrionicpersonalitydisorder CorrectAnswer-CAns.C.Paranoidpersonalitydisorder[RefNamboodiri3rdlep.303;NirajAhujaelep.123]Paranoidpersonalitydisorder:Itischaracterizedbygeneralizedmistrustandsuspiciousnessaboutthemotivesandactionsofothersandatendencytointerpretthemasmalevolent.Thepatientbelievesthat: 1. Othersareexploitingordeceivingtheperson.2. Friendsareuntrustworthyandnotloyal.3. Thespouse/partnerisunfaithful.4. Thereishiddenmeaninginneutralorfriendlyremarks.5. Manypatientshavefeelingofself-importanceandthinktheyare unusuallytalented.
131.A25yearsoldmaleisnothappywithits genderandisalwaysindistressduetothis.Hewantstochangesexandhavevagina.Itcomesunder? a)Transsexualism b)Dualroletransvestism c)Genderdysphoria d)Sexualmaturation CorrectAnswer-CAns.C.Genderdysphoria[RefEncyclopediaofrelationshipsacrossthelifespanp.191]*Genderdysphoria(formerlyGenderIdentityDisorder)-Itisdefinedbystrong,persistentfeelingsofidentificationwiththeoppositegenderanddiscomfortswithone'sownassignedsexthatresultsinsignificantdistressorimpairment.-Inthesecases,theassignedsexandgenderdonotmatchtheperson'sgenderidentity,andthepersonistransgender.
132.Characteristicofhistrionicpersonality disorderis? a)Violationofrulesofsociety b)Attention-seekingbehavior c)Unstableinterpersonalrelationship d)Grandiosebehavior CorrectAnswer-BAns.B.Attention-seekingbehavior[RefNirajAhuja6'"/ep.122]Patientswithhistrionicpersonalitydisorderdisplayexcessiveemotionalityandattention-seekingbehavior.OtheroptionsViolationofrulesofsocietyantisocialpersonalitydisorderUnstableinterpersonalrelationshipborderlinepersonalitydisorderGrandiosebehaviornarcissisticpersonalitydisorder
133.Personalitytypeseeninschizophrenia is? a)Schizoid b)Paranoid c)Borderline d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove[RefNirajAhuja6th/ep.125&Internet]Schizophreniaisassociatedwith3typesofpersonalitydisordersi.e.schizoid,borderlineandparanoid.
134.Irresistibleurgetodrinkalcoholis called? a)Kleptomania b)Pyromania c)Dipsomania d)Trichotillomania CorrectAnswer-CAns.C.Dipsomania[RefPeculiaritiesofbehavior]Dipsomaniaischaracterizedbyperiodicboutsofuncontrollablecravingforalcohol.
135.Whichofthefollowingisnotaculture boundsyndrome? a)Amok b)Latah c)Dhat d)Von-Gogh CorrectAnswer-DAns.D.Von-Gogh[RefNirajAhuja6'/ep.65]Importantculture-boundsyndromesAtaquedenerviosDhatsyndromeKhyalcapGhostsicknessKufungisisaMaladimounNerviosShenjingshuairuoTaijinkyofushoSustoAmokKoroLatahWindigo
136.A39yearsoldmalepatientpresentswith waxyflexibility,negativismandrigidity.Mostprobablediagnosisis? a)Excitatorycatatonia b)Stuporouscatatonia c)Paranoidschizophrenia d)None CorrectAnswer-BAns.B.Stuporouscatatonia[RefNeerajAhuja&hiep.62,63]Stuporous(retarded)catatonia:Characterizedbyextremeretardationofpsychomotorfunction,whichincludesmutism,rigidity,negativism,posturing,echolalia,Echopraxia,Catalepsy(waxyflexibility),ambitendency,gegenhalten,streotypies,stupor,Mannerism,Grimicing,Automaticobedience,andverbigeration.
137.SuiciderateinIndiais? a)10.5/100,000 b)12.5/100,000 c)14.5/100,000 d)18/100,000 CorrectAnswer-AAns.A.10.5/100,000[RefInternet;Indian1Psychiatry.2012Oct-Dec;54(4):304-319.doi:10.4103/0019-5545.104793]Indiaranks43rdindescendingorderofratesofsuicidewitharateof10.6/100,000reportedin2009(WHOsuiciderates).InthemostrecentNationalCrimeRecordsBureau(NCRB;MinistryofHomeAffairs)reporttheratein2010roseto11.4per100,000population.Themale:femalesuicideratiowas1.78inIndiain2008and2009.
138.DHATsyndromeis? a)Passageofbloodinurine b)Passageofsemeninurine c)Passageofpusinurine d)None CorrectAnswer-BAns.B.Passageofsemeninurine[RefEncyclopediaofmulticulturalpsychologyp.135]Dhatsyndromeisaculture-boundsyndromeprevalentinIndiansubcontinentinwhichmalepatientsreportthattheysufferfromprematureejaculationorimpotence,andbelievethattheyarepassageofsemen(dhat)inurine.Theconditionhasnoknownorganiccause.
139.Mostappropriatetestforchild psychologisttoevaluatetheintellectualabilityofa3yearoldis? a)StanfordBinetscale b)Denverdevelopmentscale c)Alexander'spassalongtest d)Rorschachinkblottest CorrectAnswer-AAns.A.StanfordBinetscale[RefPsychologicaltestingp.101]Stanford-BinetIntelligenceScaleTheStanford-BinetIntelligenceScaleisanindividuallyadministeredstandardizedtestthatmeasuresintelligenceandcognitiveabilitiesinchildrenandadults,fromagetwothroughmatureadulthood.TheStanford-BinetIntelligenceScaleisnowinitsfifthedition(SB5)andwasreleasedin2003.Itisacognitiveabilityandintelligencetestthatisusedtodiagnosedevelopmentalorintellectualdeficienciesinyoungchildren.
140.Treatmentofchoiceforakathesiais? a)Phenytoin b)Propranolol c)Dantrolene d)Lithium CorrectAnswer-BAns.B.Propranolol[RefKaplan&Saddock's10thlep.1020]"Thefirstlinedrugforakathisiaismostcommonlyalpha-blocker".
141.Functionalsomaticdisorderis? a)Somatizationdisorder b)Chronicfatiguesyndrome c)Hypochondriasis d)Bodydysmorphicdisorder CorrectAnswer-BAns.B.ChronicfatiguesyndromeFunctionalsomaticsyndromes:Theyarecharacterizedmorebysymptoms,sufferinganddisabilitythanbydiseasespecific,demonstrableabnormalitiesofstructureorfunction,i.e.ThereisreportingofsomaticsymptomsandresultantdisabilityratherthanontheevidenceofunderlyingconventiondiseaseprocessThreemostcommonfunctionalsomaticsyndromesarefibromyalgia,Irritablebowelsyndromeandchronicfatiguesyndrome.
142.Cardinalelementofbehaviortherapyis? a)Modeling b)Learning c)Conditioning d)Guidance CorrectAnswer-BAns.B.Learning[RefNirajAhuja6'1*p.220]Behaviortherapyisbasedontheassumptionthatallbehaviors(normalorabnormal)arelearningresponse.Normalandabnormalbehaviorsaresubjecttothelawsoflearningandthesamelawscanbeusedtochangethem.Behaviortherapyisbasedontheoriesoflearningandaimsatchangingthemaladaptivebehaviorandsubstitutingitwithadaptivebehavior.
143.Toleranceisseenin? a)Alcoholdependentsyndrome b)Schizophrenia c)OCD d)Alloftheabove CorrectAnswer-AAns.A.Alcoholdependentsyndrome[RefKaplan&Saddock's10thlep.382]AlcoholdependentsyndromeAlcoholdependentsyndromeusesthesamecriteriafordependenceforothersubstances,i.e.,threeormoreofthefollowing:- 1. Tolerance2. Withdrawalsymptoms3. Alcoholistakeninlargeramountorforlongerperiod.4. Persistentdesireorsenseofcompulsiontotakealcohol.5. Agreatdealoftimespenttoobtainalcohol,tousealcoholorto recoverfromitseffect. 6. Neglectofimportantsocial,occupationalandrecreationalactivities.
144.Treatmentofchoiceforgeneralized anxietydisorderis? a)Benzodiazepines b)Neuroleptics c)Betablockers d)Barbiturates CorrectAnswer-AAns.A.Benzodiazepines[RefHarrison17th/ep.2712;Kaplan&Saddock's10th/ep.626]TreatmentofgeneralizedanxietydisorderBenzodiazepinesarethedrugofchoice.Drugsinthisgrouparediazepam,Lorazepam,Alprazolam,Oxazepam,chlordiazepoxide.
145.Generalizedanxietydisorderis diagnosedwhenanxietyandworrycontinuesforatleast? a)2months b)4months c)6months d)8months CorrectAnswer-CAns.C.6months[RefHarrison17"/ep.2712;Kaplan&Saddock's10th/ep.626]GENERALIZEDANXIETYDISORDERThisischaracterizedbyexcessiveanxietyandworrywhicharepersistent&generalizedandnotrestrictedtoanyspecificsituationorobject.Excessiveanxietyworryoccurforatleast6months.
146.Mostimportantreceptorsinvolvedwith schizophreniaare? a)GABAA b)GABA,, c)DZd d)5-HT CorrectAnswer-CAns.C.DZd[RefKaplan&Saddock's10thlep.470]Dopaminehypothesisisthemostacceptedhypothesisforschizophrenia.Thereishyperactivityofdopaminergicsystem.Thishypothesisissupportedby: 1. Amphetamineandcocainewhichreleasedopamineincentral synapsesinduceschizophrenialikesymptoms;and 2. Antipsychoticdrugscontroltheschizophrenicsymptomsbyblocking dopamine(D2)receptors.
147.Riskfactorforsuicideis? a)Increasedserotonin b)Drugabuse c)Femalesex d)Marriedperson CorrectAnswer-BAns.B.Drugabuse[Ref:NirajAhujaelep.236,237;Essentialsofpsychiatry4th/ep.734]Causes/RiskfactorsforsuicidePsychiatricdisorders:-Depression(mostcommon),alcoholism(2ndmc),Drug/Substancedependence,Schizophrenia,Dementia.Physicalillness:-Cancer,AIDS,Multiplesclerosis,Headtrauma.Psychosocialfactors:-Failureinlove,maritaldifficulties,familydispute,illegitimatepregnancy.Biologicalfactors:-DecreaseinserotoninOther-Malesex,Age>40years,Single(Unmarried,divorcedorwidowed),previoussuicideattempt,socialisolation.
148.A25yearsoldmalec/orecurrent abdominalpainbutbiochemicalassaysandultrasoundabdomenisnormal.Healsocomplainsofconstantheadaches.Hesuddenlycomplainsoflossofvisionofbilateraleyes.Ophthalmologistfindsnothingonexamination.Symptomsaremostprobablydueto a)Bilateralopticneuritis b)Posteriorinferiorcerebellararteryinfarct c)Malingering d)Factitiousdisorder CorrectAnswer-DAns.D.FactitiousdisorderFactitiousdisorderItisalsoknownasHospitaladdiction,hospitalhoboes,orProfessionalpatient.ThetermMunchausensyndromeisusedforthosepatientswhorepeatedlysimulateorfakediseases(intentionally)forthesolepurposeofobtainingmedicalattention.Thereisnootherrecognizablemotive(incontrasttomalingering).ThetypicalpresentationofMunchausensyndromeischaracterizedbyarestlessjourneyfromdoctortodoctorandhospitaltohospital,anever-changinglistofcomplaintsandsymptoms.Thepatienttriestomaintainthesickroletoobtainmedicalattention.
Theremaybeevidenceofearliertreatmentusuallysurgicalprocedure,forexample,multiplesurgicalscars(gridironabdomen).
149.EmileDurkheimislinkedwithworkon whichconditioninpsychiatry? a)Suicide b)Obsessivecompulsivedisorder c)Anxietydisorder d)Schizophrenia CorrectAnswer-AAns.A.SuicideSuicide(French:LeSuicide)Itwasagroundbreakingbookinthefieldofsociology.ItwaswrittenbyFrenchsociologistEmileDurliiheimandpubtshedin1897.Itwasostensiblyacasestudyofsuicide,apublicationuniqueforitstimethatprovidedanexampleofwhatthesociologicalmonographshouldlooklike.
150.Highestinsightis? a)Intellectual b)Emotional c)Psychological d)Affective CorrectAnswer-BAns.b.EmotionalNezirogluandStevensproposedfourdifferentlevelsofinsights:TrueemotionalinsightIntellectualinsightPartialinternallyandexternallybasedinsightDenialofillnessTrueemotionalinsightisrepresentativeofthehighestlevelofinsightpossible.Initthepatients'awarenessandunderstandingoftheirownthoughts,feelingsandmotivescanbeusedtochangebehavior.
151.Extracampinehallucinationstermwas givenby? a)EugeneBleuler b)WilliamHarvey c)RobertMacinoff d)EdenSperoff CorrectAnswer-AAns.A.EugeneBleulerExtracampinehallucinationsThetermextracampineisindebtedtoLatinwordsextra-outsideandcampaneus-field.Itwasintroducedinorshortlybefore1903bySwissPsychiatristEugeneBleulertodenoteahallucinationthatisexperiencedbyaffectedindividualasbeingoutsidetherangeofnormalperception.
152.Hypomimiais? a)Decreasedabilitytocopy b)Decreasedexecution c)Deficitofexpressionbygesture d)Deficitoffluentspeech CorrectAnswer-CAns.C.DeficitofexpressionbygestureHypomimiaHypomimiaoramimiaisadeficitorabsenceofexpressionbygestureormimicry.Thisisusuallymostobviousasalackoffacialexpressivemobility(mask-likefacies).Thisisafeatureoffrontalsubcorticaldisease.
153.Serial7substractionisusedtotest? a)Workingmemory b)Longtermmemory c)Mathematicalability d)Recallpower CorrectAnswer-AAns.A.WorkingmemorySerialsevenssubstractiontestSerialsevens,countingdownfromonehundredbysevens,isaclinicaltestusedtotestmentalfunction;forexample,tohelpassessmentalstatusafterpossibleheadinjuryorinsuspectedcasesofdementia.Thiswell-knowntest,inactivedocumentedusesinceatleastl944,wasadoptedaspartofthemini-mentalstateexamination.Thetestisalsousedindeterminingwhenapatientisbecomingunconsciousunderanaesthetic,forexamplepriortomajordentalsurgery.
154.Whichofthefollowingaresectionsof mentalstateexamination? a)Moodandaffect b)Speechandlanguage c)Cognition d)Alltheabove CorrectAnswer-DAns.D.Alltheabove
155.Obsessiveattentionbyanindividual towardsanotherpersoniscalled? a)Stalking b)Percieving c)Following d)Pressurizing CorrectAnswer-AAns.A.StalkingStalkingStalkingisunwantedorobsessiveattentionbyanindividualorgrouptowardanotherPerson.Stalkingbehaviorsarerelatedtoharassmentandintimidationandmayincludefollowingthevictiminpersonormonitoringthem.Thewordstalkingisused,withsomedifferingmeanings,inpsychologyandpsychiatryandalsoinsomelegaljurisdictionsasatermforacriminaloffense.
156.Mostcommonofallpsychiatric disordersare- a)Anxietydisorder b)Schizophrenia c)Depression d)Mania CorrectAnswer-AAns.A.AnxietydisorderMostcommonpsychiatricdisorder>Anxietydisorders.2dmostcommonpsychiatricdisorder>Depression.
157.Patientwantstoscratchforitchinginhis amputatedlimbisanexampleof? a)Illusion b)Pseudohallucination c)Phantomlimbhallucination d)Autoscopyhallucination CorrectAnswer-CAns.C.PhantomlimbhallucinationPhantomlimbhallucination-Thepersonfeelshisbodypartsintactintheirrespectiveplacesevenaftertheyarelostthroughamputationorinjury.Inthequestiongivenpatientfeelsitchingintheamputatedlimbandtriestoscratchthelimb.Thusitisanexampleofphantomlimbhallucination.
158.Myxedemamadnessincludes? a)Auditoryhallucinationsandparanoia b)Visualhallucinationsanddepression c)Auditoryhallucinationsanddepression d)Paranoiaanddepression CorrectAnswer-AAns.A.AuditoryhallucinationsandparanoiaPsychiatricdisordersinhypothyroidismTheseincludedepressedmood,apathy,impairedmemoryandothercognitivedefects.Hypothyroidismcancontributetothedevelopmentoftreatmentrefractorydepression.MyxedemamadnessconsistingofauditoryhallucinationsandparanoiaisseeninsomePatients.
159.APACHEIIdoesnotinclude? a)Acutephysiologyscore b)Age c)Sex d)Chronichealthevaluation CorrectAnswer-CAns.C.SexAcutephysiologyandchronichealthevaluationKnausetal(1981)introducedthefirsttheAcutePhysiologyandChronicHealthEvaluation(APACHE)modelin1981andrevisedittoAPACHEIIin1985.APACHEIIIwaspresentedin1991butastheregressionanalysismodellingisnotinthepublicdomainitsuptakehasbeenslow.APACHEIIismadeupoffourbasiccomPonents:1)Acutephysiologyscore;2)Chronichealthevaluation;3)Age;4)Urgencyofadmissiontocriticalcare
160.SSRIsshouldbecarefullyusedinthe youngforthemanagementofdepressionduetoincreasein? a)Nihilismideation b)Guiltideation c)Suicidalideation d)Enviousideation CorrectAnswer-CAns.C.SuicidalideationIn2003,thUKMedicineandHealthCareproductsregulatoryagencyconcludedthatallSSNs,withtheexceptionoffluoxetine,werecontraindicatedinthetreatmentofdepressioninyoungpeopleduetoincreaseinsuicidalideationanddubiousefficacy.
161.Ifapersonisasked,"whatwillhedoif heseesahouseonfire"?,Thenwhatisbeingtestedinthatperson? a)Socialjudgement b)Testjudgement c)Responsejudgement d)Noneoftheabove CorrectAnswer-BAnS.B.TestjudgementJudgementItistheabilitytoassessasituationcorrectlyandactappropriatelywithinthatsituation'Socialjudgement:isobservedduringthehospitalstayandduringtheinterviewsession.Itincludesevaluationofpersonaljudgement.TestJudgement:isassessedbyaskingthepatientwhathewoulddoincertaintestsituationslike-houseonfire,manlyingonroad.Itisratedasgood/intactnormalorpoor/impaired/abnormal'
162.Illusionisadisorderof? a)Thought b)Perception c)Affect d)Emotion CorrectAnswer-BAns,B.PerceptionDisordersofperception 1. Alteredperception-Sensorydistortion(micropsia,hyeracusis), Illusion. 2. Falseperception-Hallucination.
163.Ropeseenassnakeisanexampleof- a)Illusion b)Hallucination c)Delusion d)Pseudohallucination CorrectAnswer-AAns.A.Illusionllusionsarealteredperceptioninwhicharealeternalobjectiscombinedwithimagerytoproducefalseinternalpercept.Insimplewords,illusionismisinterpretationofanactualsensoryinput.Forexample:- 1. Hearingoncenameinatrainwhistle:-Trainwhistleisarealeternal stimulus,whichisperceivedasoncename(falseinternalpercept). 2. Mistakingastickorropeforsnakeindarkroom:-Stickisareal externalobject,whichisperceivedfalselyassnake.
164.Womanfirmlyandpersistentlyfeelsher husbandischeatingonherandshedisapprovestoaccePtanyproofgiveninthehusbandssupport'Theotherfamilymembersdonotsupportherbelief.Thisisanexampleof- a)Illusion b)Delusion c)Hallucination d)Perversion CorrectAnswer-BAns.B.DelusionInthequestiongiventhewomanhasafalseunshakablebeliefthatherhusbandischeatingonherandshedisapprovesallherrelativesandproofsinsupportofherhusband.Thusthisisanexampleofdelusion.
165.Withdrawalofwhichofthefollowing causespiloerecton? a)Morphine b)Cannabis c)Smoking d)Alcohol CorrectAnswer-AAns.A.MorphineManifestationsofmorphinewithdrawalLacrimationAnxiety&fearSweatingRestlessnessrYawningGooseflash(Piloerection).
166.Schizotypalpersonalitybelongstowhich clusterofpersonalitydisorders? a)A b)B c)C d)D CorrectAnswer-AAns.A.AClusterA:Paranoid,Schizoid,Schizotypal.ClusterB:Antisocial(Dissocial),Histrionic,Narcissistic,Borderline.ClusterC:Anxious(avoidant),Dependent,obsessive-compulsive(anankastic).
167.Cardinalfeatureofantisocialpersonality - a)Violationofrulesofsociety b)Attention-seekingbehavior c)Unstableinterpersonalrelationship d)Grandiosebehaviour CorrectAnswer-AAns.A.ViolationofrulesofsocietyTheessentialfeaturesofantisocialpersonalitydisorderareadisregardforandviolationoftherightsoftheotherandtherulesofthesociety.
168.
Whichpersonalitydisorder/scanbeapartofautisticsPectrumofdisorders? a)Schizoid b)Schizotypical c)Borderline d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveFollowingpersonalitydisorderscanbediagnosedlaterinlifeinpatientswithchildhoodautisticspectrumofdisorders:Borderline,Obsessivecompulsive,narcissitic,paranoid,schizotypicaland,avoidant,personality.
169.Patientswhoaregrandioseandrequire admirationfromothershaswhichtypeofpersonality? a)Narcissistic b)Histrionic c)Borderline d)Antisocial CorrectAnswer-AAns.A.NarcissisticGrandiosityandadmirationfromothersarefeatureofNarcissisticpersonalitydisorder.
170.MaxdurationoftimespentisinNREM stage? a)I b)II c)III d)IV CorrectAnswer-BAns,B.IIREMsleepoccupies20-30%oftotalsleepandNREMsleepocupies60-70%(stateI:5-70%,stageII:40-50%,stageIII&IV:15_20%)
171.Spousejealousyisafeatureof? a)Othellosyndrome b)Chronicalcoholism c)Stockholmsyndrome d)Clerambault'ssyndrome CorrectAnswer-AAns.A.OthellosyndromeOthelloSyndrome:Whenthecontentofdelusionsispredominantlyjealousy(infidelity)involvingthespouse,personfeelsanunreasonablefearthatapartnerhasbeenunfaithful,ispresentlyunfaithful,orplanstobeunfaithful,itiscalledasOthelloSyndromeorconjugalparanoia.Elaboratestepsaretakentopreventthespousetogooutside(Locksthespouse,notallowinghertogooutside).
172.Allofthefollowingaretrueabout pseudohallucinationsexcept? a)Arisesininnersubjectiveself b)Patientdescribesthesensationsbeingperceivedbymindeye c)Areundervoluntarycontrol d)DistressingflashbackofPTSDisanexample CorrectAnswer-CAns.C.AreundervoluntarycontrolPseudohallucinationPseudohallucinationisaperceptualexperience,whichdiffersfromahallucinationinthatitappearstoariseintheinnersubjectivespace,notthroughoneoftheexternalsensoryorgans.Patientstendtodescribethesesensationsasbeingperceivedwiththe'innereye'or'mindeye'(orear).However,liketruehallucinationspseudohallucinationsarenotundervoluntarycontrol.Exampleinclude:Distressingflashbacksinpost-traumaticstressdisorderortherecentlybereavedwidowwakinguptobriefly'see'herhusbandsittingatthefootofthebed,
173.Deliriumisdefinedas? a)Acuteonsetofdisturbedconsciousness b)Chroniconsetofdisturbedconsciousness c)Progressivegeneralizedimpairmentofintellectualfunctionsand memorywithoutimpairmentofconsciousness d)Disorientationwithoutcloudingofconsciousness CorrectAnswer-AAns.A.AcuteonsetofdisturbedconsciousnessDeliriumisdefinedbytheacuteonsetoffluctuatingcognitiveimpairmentandadisturbanceofconsciousness.Itisalsoreferredtoasacuteconfusionalstateoracuteorganicbrainsyndrome.
174.Allthefollowingdrugsareusedto preventrelapseandmaintainabstinenceincasesofalcoholwithdrawalexcept? a)Disulfiram b)Acamprosate c)Naltrexone d)Propranolol CorrectAnswer-DAns.D.PropranololDetoxification(treatmentofwithdrawal):-BZDsarethedrugsofchoice,e.g.chlordiazepoxiile(Idchoice),Diazepam(2ndchoice).Maintenanceafterdetoxification(topreventrelapseandmaintenanceofabstinence):- 1. Aversiveagent(ileferentagents):-Disulfiram,CCC,metronidazole, Natrafezole. 2. Anticravingagent:-Naltrexone,Acamprosate,fluoxetine, Topiramate,Nalmefene.
175.Whichisthemostcommontypeof persistentdelusionaldisorder? a)Delusionofpersecution b)Somaticdelusion c)Delusionofjealousy d)Delusionofgrandeur CorrectAnswer-AAns.A.DelusionofpersecutionDelusionofpersecutionisthemostcommontypeofpersistentdelusionaldisorder.
176.Dysthymiais? a)Chronicdepression b)Chronicmania c)Bipolardisorder d)Personalitydisorder CorrectAnswer-AAns.A.ChronicdepressionPersistentdepressivedisorder(Dysthymia)Depressionmayrunachroniccourseoveryearswithfluctuationofmoodinterposedwithsymptomfreeintervals(lessthan2months).Ifsymptomspersistformorethan2years,theyarereferredtoaspersistentdepressivedisorderordysthymia.
177.BipolarIIdisorderincludes? a)Cyclothymicdisorder b)Dysthymia c)Singlemaniacepisode d)Majordepressionandhypomania CorrectAnswer-DAns.D.MajordepressionandhypomaniaBipolarII:Oneormoremajordepressiveepisodestogetherwithatleast1hypomanicepisode.
178.Psychoticpatientonantipsychoticdrugs developstorticolliswithin4daysoftherapy.whatisthetreatment? a)Centralanticholinergic b)Peripheralanticholinergic c)Betablocker d)Dantrolene CorrectAnswer-AAns.A.CentralanticholinergicThisisacaseofdruginducedmusculardystonia,whichistreatedbycentralanticholinergic.Drugofchoiceforantipsychoticinducedextrapyramidalsideeffects 1. Acutemusculardystonia-+Centralanticholinergic2. Akathisia-Betablocker3. Parkinsonism-Centralanticholinergic.4. Neurolepticmalignantsyndrome-Dantrolene5. TardivedyskinesiaTerabenazine(TBZ)
179.EugeneBlueler's4Asincludefollowing except? a)Autism b)Affect c)Anhedonia d)Association CorrectAnswer-CAns.C.AnhedoniaBleuler's4'As'are:(l)Ambivalence(2)Autism;(3)Affectdisturbances(inappropriateaffect);and(4)Associationdisturbances(looseningofassociation,thoughtdisorder).
180.Appetitefornonnutritivesubstancesis called? a)Pica b)Apprepritant c)Bulimia d)Bolean CorrectAnswer-AAns.A.PicaPicaischaracterizedbyanappetiteforsubstancesthatarelargelynon-nutritive,suchaspaper,clay,metal,chalk,soil,glass,orsand.
181.Badtripisseenwith? a)Cocaine b)Cannabis c)LSD d)Heroin CorrectAnswer-CAns.C.LSDAcutepanicreactionwithlossofcontrolononself,calledBadtrip,ischaracteristicofLSDorotJrerhallocinogens.
182.Antipsychoticdrugcausingretinal pigmentdisorderis? a)Thiaoridazine b)Clozapine c)Chlorpromazine d)Noneoftheabove CorrectAnswer-AAns.A.ThiaoridazineBluepigmentationofskin,cornealandlenticularopacities,retinaldegenrationcanoccurwiththioridazine.
183.Antipsychoticdrugwithleastextra pyramidalsymptoms? a)Pimozide b)Thioridazone c)Clozapine d)Flupromazine CorrectAnswer-CAns.C.ClozapineAntipsychoticswithnoextrapyramidalsideeffectsclozapine,aripiprazole,quetiapine.Amongsttypicalantipsychotics,thioridazonehasleastextrapyramialsideeffects.
184.Followingistrueaboutalcoholic dependencesyndromeexcept- a)Notolerance b)Withdrawalsymptoms c)CAGEquestionnaire d)Physicaldependence CorrectAnswer-AAns.A.NotoleranceAlcoholdependencehasfollowingcriteria:-(i)Tolerance;(ii)Withdrawalsymptoms;(iii)Takeninlargeramountorlongerduration;(iv)Persistentcraving(desire)totakealcohol;(v)Agreatdealoftimespenttoobtainalcoholortouseit;(vi)Neglectofotheractivities(social,occupational);and(vii)Continuedusedespiteclearevidenceofovertlyharmfulconsequences.TheCAGEquestionnaireisatoolusedtoassessindividualsforpotentialalcoholproblems,includingdependence.Alcoholproducesbothphysicalaswellaspsychologicaldependence.
185.DSMIVcriterionfordepressionis? a)1week b)2weeks c)3weeks d)4weeks CorrectAnswer-BAns.B.2weeksForthediagnosisofminordepression2-4andformajordepression>5DSMIVsymptomsarerequiredforatleastforatwoweekperiod.
186.Theclinicaleffectsoftheantidepressant drugsismainlybasedon? a)Changeinneurotransmitterreceptorsensitivity b)Decreasedlevelofneurotransmitters c)Changeinefficacyofneurotransmitters d)Noneoftheabove CorrectAnswer-AAns.A.ChangeinneurotransmitterreceptorsensitivityTemporalcorrelationofclinicaleffectswithchangesinreceptorsensitivityhasgivenrisetohypothesisthatchangesinneurotransmitterreceptorsensitivitymayactuallymediatetheclinicaleffectsofantidepressantdrugs.Theseclinicaleffectsincludenotonlyantidepressantandanxiolyticactionsbutalsothedevelopmentoftolerancetotheacutesideeffectsofantidepressantdrugs.
187.Theoryofhumanmotivationwasgiven by? a)Pavlov b)AbrahamMaslow c)AliosAlzheimer d)AaronBeck CorrectAnswer-BAns.B.AbrahamMaslowMaslordshierarchyofneedsisatheoryinpsyehslagproposedbyAbrahamMaslowinhis1943paper."ATheoryOfHumanMotivation"inPsychologicalReview.Maslowsubsequentlyextendedtoincludehisobservationsofhumansinnatecuriosity'.Histheoriesparallelmanyothertheoriesofhumandevelopmentalpsychology,someofwhichfocusondescribingthestagesofgrowthinhumans.Maslowusedtheterms"physiological","safety',"beloftingness"andlove,esteem,self-actualization",and"self-transcendence"todescribethepatternthathumanmotivationsgenerallyhavethrough.
188.Mechanismofactionofduloxetineis? a)SelectiveInhibitionofserotoninreuptake b)Selectiveinhibitionofnor-epinephrinereuptake c)Selectiveinhibitionofbothserotoninandnor-epinephrine reuptake d)Noneoftheabove CorrectAnswer-CAns.C.Selectiveinhibitionofbothserotoninandnor-epinephrinereuptakeDuloxetine,isadrugclassifiedunderserotonin-norepinephrinereuptakeinhibitors(sNRJs).Atlowerdosesitismoreprominentserotoninreuptakeinhibitor.Whereasathigherdosesitismoreprominentinhibitorofnor-epinephrinereuptake.Ithasminimaldopamineagonistaction.
189.Medicaltreatmentforparaphillia includes? a)SSRIs b)Benzodiazepines c)Opioids d)Barbiturates CorrectAnswer-AAns.A.SSRIsMedicaltreatmentforparaphillia-Antidepressants,suchaslithiumandvariousselectiveserotoninreuptakeinhibitors(SSRIs)Long-actinggonadotropin-releasinghormones(ie,medicalcastration),suchasleuprolideacetateandtriptorelinAntiandrogens(tolowersexdrive)'suchasmedroxyprogesteroneacetate(10mgqt2hr,withthedosagedoubledevery3daystoamaximumof200mg/day,thenmaintainedforImonthandadjustedasnecessary).Phenothiazines,suchasfluphenazineMoodstabilizers
190.Husbandhavingsuspicionthathiswife ishavingaffairwithanotherman,diagnosisis? a)Illusion b)Delusion c)Hallucination d)Delirium CorrectAnswer-BAns.B.DelusionAdelusionisfalse,firm(unshakeable)beliefthatisnotacceptedbyothermembersofpatient'scultureandsociety.Aboveisanexampleofdelusionofinfedility(morbidjealousy,othellosyndrome)i.e-.Falsebeliefthatone'sloverhasbeenunfaithful.
191.Causesofneuroregressioninachildcan beallexcept? a)Wilson'sdisease b)VitaminB12deficiency c)ADHD d)Ataxiatelengiectasia CorrectAnswer-CAns.C.ADHDCausesofneuroregressionInheritedA.GreYmatterinvolvement-Withvisceromegaly:-Niemannpickdisease,Sandholfdisease(GM2),sialidosis,Goucherdisease,Mucopolyschharidoses(MPS)Withoutvisceromegaly:-TaySachDisease,Rettsyndrome,Menke'skinkyhairdiseaseB.Whitematterinvolvement:-Leukodystrophies:-Metachromaticleukodystrophy,Krebbe'sdisease,Adrenoleukodytrophy,Alexanderdisease,Cannavandisease.Acquired/Demyelinating:-Multiplesclerosis,schilder'sdisease,DevicdiseaseC.Basalgangliainvolvement-Wilson'sdisease,Dystoniamusculardeformans,Huntington'sdiseaseD.Spinocerebeller:-Friedrich'sataxia,AtaxiatelengiectasisE.AcquiredInfections:-SSPE,progressiverubellasyndrome,HIVMetabolic:Chronicleadpoisoning,Hypothyoidism,VitB12&Edeficienry,Drugs(anticonvulsants).
192.A25yearoldmalebelievesthathis penisisdecreasinginsizeeverydayandonedayitwilldisappearonedayandhewilldie.Diagnosisis? a)Obsession b)Somatization c)Hypochondriasis d)Delusiondisorder CorrectAnswer-DAns.D.DelusiondisorderDescriptiongiveninthequestionisofKorosyndrome,adelusionaldisorder.KorosyndromeKoroisaculture-specificsyndromedelusionaldisorderinwhichanindividualhasanoverpoweringbeliefthatone'sgenitaliaareretractingandwilldisappear,despitethelackofanytruelongstandingchangestothegenitals.Koroisalsoknownasshrinkingpenis.Thesyndromeiscommonlyknownasgenitalretractionsyndrome.
193.Haloperidolinducedextarpyramidalside effectsaretreatedby? a)Benzodiazepines b)Barbiturates c)Anticholinergicdrugs d)SSRIs CorrectAnswer-CAns.C.AnticholinergicdrugsCommonlyusedmedicationsforextra-pyramidalsymptomsareanticholinergicagentssuchasBenztropine,Diphenhydramineandtrihexyphenidyl.Anothercommoncourseoftreatmentincludesdopamineagonistagentssuchaspramipexole.
194.Mostcommonsubstanceofabusein India? a)Cannabis b)Tobacco c)Alcohol d)Opium CorrectAnswer-BAns.B.TobaccoNationalHouseholdSurveyofDrugandAlcoholAbuseinIndia?Estimatedusers:(2001) 1. Tobacco-162million.2. Alcohol-62million3. Cannabis-9million.4. Opiates-2.5lakh
195.InNeurolepticmalignantsyndrome, causeofdeathis? a)Respiratoryfailure b)Liverfailure c)Drugtoxicity d)Noneoftheabove CorrectAnswer-AAns.A.RespiratoryfailureCausesofdeathinNMSRespiratoryfailureRenalfailurePneumoniaThromboembolismCardiacfailure
196.Drugwithnomoodstabilizingproperty is- a)Lithium b)Lamotrigine c)Imipramine d)Carbamazepine CorrectAnswer-CAns.C.ImipramineThe5individualdrugsthatcanbeusedasmoodstabilizersare: 1. Lithium2. CarbamazePine3. Lamotrigine4. Valproate5. Asenapine
197.Sexreassignmentsurgeryisdonein? a)Genderidentitydisorder b)Prematureejaculation c)Erectiledysfunction d)Orgasmicdysfunction CorrectAnswer-AAns.A.GenderidentitydisorderManypersonswithgenderidentitydisorderhavesoughtsex-reassignmentsurgery,thatis,physicalchangethatisconstantwiththeircrosssexualidentity.
198.Modafinilisusedforthetreatmentof? a)Narcolepsy b)Sexualdysfunction c)Depression d)Anxiety CorrectAnswer-AAns.A.NarcolepsyModafinilisawakefulness-promotingagent(oreugeroic)usedfortreatmentofdisorderssuchasnarcolepsy,shiftworksleepdisorder,andexcessivedaytimesleepinessassociatedwithobstructivesleepapnea'
199.Agirlwithbadbehaviorlikesmashing andthrowingobjectswasadmittedinthehospital.Therealsoshewasbehavingverybadlywithstaff&abusingnurses.Butshebehavesverywellwithaoneverygoodlookingresidentdoctor.Diagnosisis? a)Bipolardisorder b)Schizoaffectivedisorder c)Borderlinepersonalitydisorder d)Antisocialpersonality CorrectAnswer-DAns.D.AntisocialpersonalityAntisocial(Dissocial)personalitydisorderTheessentialfeaturesofantisocialpersonalitydisorderareadisregardforandviolationoftherightsoftheotherandtheruIesofthesociety.Itischaracterizedbyrepeatedviolationofthelawandrulesofthesociety(drugabuse);physicalaggressiveness;Recklessdisregardforsafetyofselforothers;consistentirresponsibilityinworkandfamilyenvironmentandlackofremorse.Thisdisorderissynonymouswithpreviouslyusedtermslikepsychopathorsociopath.
200.Allofthefollowingareassociated increasedREMlatency,except? a)Firstnighteffect b)SSRIs c)Narcolepsy d)Restlesslegsyndrome CorrectAnswer-CAns.C.NarcolepsyIncreasedREMlatency-PTSDRestlesslegsyndrome.FirstnighteffectSSRI'sTCA'sEthanolLithium
201.Signofoppositionalisminayoungchild isdueto? a)Mentalretardation b)Organicmentaldisorder c)Mentaldistress d)Alloftheabove CorrectAnswer-CAns.C.Mentaldistress"Oppositionalism,tempertantrumsandbreathholdingspellsarenotunusualduring1styearsoflifeandareagetypicalexpressionoffrustrationandanger"
202.Trichophagiaischaracterizedby? a)Compulsivepullingofhair b)Compulsiveeatingofhair c)Compulsiveshopping d)Compulsivestealing CorrectAnswer-BAns.B.CompulsiveeatingofhairTrichophagiaiscompulsiveeatingofhairandisusuallyassociatedwithtrichotillomaniai.e.compulsivepullingofhair.
203.MCcauseofdelirium? a)Infection b)Liverfailure c)Belladonnapoisoning d)Noneoftheabove CorrectAnswer-AAns.A.InfectionInfectionisoneofthemostcommoncausesofdelirium.
204.Generalparalysisofinsaneisassociated with? a)Neurosyphillis b)Alzheimer'sdisease c)Parkinson'sdisease d)Noneoftheabove CorrectAnswer-AAns,A.NeurosyphillisGeneralparesis,alsoknownasgeneralparalysisoftheinsaneorparalyticdementia,isasevereneuropsychiatricdisorder,classifiedasanorganicmentaldisorderandcausedbythechronicmeningoencephalitisthatleadstocerebralatrophyinlate-stagesyphilis.Degenerativechangesareassociatedprimarilywiththefrontalandtemporallobarcortex-GeneralparalysisoftheInsane(GPI)isprogressivedeteriorationofthewholementalandphysicalpersonality.Symptomsincludedexaggeratedkneejerk,Iackofreactionofthepupilstolight,aninabilitytopayattention,a'clouding'ofconsciousness,poorshort-termmemory,tremulousvoice,reflexdisturbances,andretinalanomalies'anddiminishedskinsensation.Patientswereoftenrecognizablebytheirstriking'delusionsofgrandeur"
205.Jamaisvuis- a)Illusionthatwhatoneishearing,onehasheardpreviously b)Aunfamiliarthoughtregardedasrepetitionofaprevious thought c)Unfamiliarsituationsoreventsfeelstrangelyfamiliar d)Feelingofstrangenesstofamiliarsituation CorrectAnswer-DAns.D.Feelingofstrangenesstofamiliarsituationfamaisvu:-Afeelingofstrangenesstofamiliarsituationsorevents.
206.Conventionaldrugusedinthetreatment ofdeliriumis? a)Haloperidol b)Lithium c)SSRIs d)Morphine CorrectAnswer-AAns.A.HaloperidolDrugsusedfordelirium:Typicalantipsychotics:-Haloperidol(Doc),Thioridazine,chlorpromazine.Atypicalantipsychotics:-Risperidone,quetiapine,olanzapine.Benzndiazepines(fordeliriumtremens):-Chlordiazepoxide,Diazepam,Lorazepam,Clonazepam.
207.Characteristichallucinationof schizophreniais a)Auditoryhallucinationscommandingthepatient b)Auditoryhallucinationsgivingrunningcommentary c)Auditoryhallucinationscriticizingthepatient d)Auditoryhallucinationstalkingtopatient CorrectAnswer-BAns.B.AuditoryhallucinationsgivingrunningcommentaryThird-personhallucinations,e.g.voicesheardarguing,commentingordiscussingthepatientorgivingarunningcommentaryonone'saction;arecharacteristicofschizophrenia.Inschizophreniaauditoryhallucinationsarethemostcommontypeofhallucinations. 1. First-personhallucination:-Audibleself-thoughts2. Secondpersonhallucination:-Voicesaddressthepersondirectlyor commandingone'sactionand 3. Third-personhallucinations:-voicesheardarguing,commentingor discussingthepatientorgivingarunningcommentaryonhisactionorthought.Onlythe"thirdpersonhallucinations'arecharacteristicofschizophrenia.
208.Whichofthefollowingtypical antipsychoticdrugisnotavailableindepotform? a)Haloperidol b)Risperidone c)Olanzapine d)Chlorpromazine CorrectAnswer-DAns.D.ChlorpromazineAntipsychoticdrugswithdepotpreparationsarerisperidone,poliperidone,halopetidol,fluphenazine,flupenthixol,zuclopenthixol,olannpine,clozapine,imipramineandquetiapine.
209.Selfmutilationisafeatureof? a)Von-Goghsyndrome b)Catatonicschizophrenia c)Paranoidschizophrenia d)Noneoftheabove CorrectAnswer-AAns.A.Von-GoghsyndromeDramaticself-mutilationoccurringinschizophreniahasalsobeencalledVon-Goghsyndrome'
210.Apatientinventingnewwords,isa featureof? a)Neurosis b)Schizophrenia c)OCD d)Von-Goghsyndrome CorrectAnswer-BAnsB.SchizophreniaNeologism:-Newwordsorcondensationsofseveralwordsthatarenotreadilyunderstoodbyothers.Neologismisseeninschizophreniaandorganicbrainsyndrome.
211.Trueaboutflumazenilis? a)Canbeusedinbarbituratepoisoning b)Specificantidoteforopiateoverdose c)Canbeusedinbenzodiazepineoverdose d)Alloftheabove CorrectAnswer-CAns.C.CanbeusedinbenzodiazepineoverdoseFumazenilisanimidazobenzodiazepinederivativeandapotentbenzodiazepinerecePtorantagonistthatcompetitivelyinhibitstheactivityatthebenzodiazepinerecognitionsiteontheGABAbenzodiazepinereceptorcomplextherebyreversingtheeffectsofbenzodiazepineonthecentralnervoussystem.FlumazenildoesnotantagonizethecentralnervoussystemeffectsofdrugsaffectingGABA-ergicneuronsbymeansotherthanthebenzodiazepinereceptor(includingethanol,barbiturates,orgeneralanesthetics)anddoesnotreversetheeffectsofopioids.
212.Increaseddopaminelevelsare associated? a)Depression b)Mania c)Delirium d)Schizophrenia CorrectAnswer-DAns.D.SchizophreniaDopaminehypothesisisthemostacceptedhypothesisforschizophrenia.Thereishyperactivityofdopaminergicsystem.Otherneurotransmittersinvolvedare:-Increasedserotonin,DecreasedGABA,variablechange(Increasedordecreased)glutamate,andincreasednorepinephrine.
213.Tourettesyndromeisatypeof? a)Ticdisorder b)Mentalretardationdisorder c)Seizuredisorder d)Noneoftheabove CorrectAnswer-AAns.A.TicdisorderTourettesyndrome(alsocalledTourette'ssyndrome,Tourette'sdisorder,GillesdelaTourettesyndrome,GTSor,morecommonly,simplyTourette'sorTS)isaninheritedneuropsychiatricdisorderwithonsetinchildhood,characterizedbymultiplephysical(motor)ticsandatleastonevocal(phonic)tic.Averageonsetbetweentheagesof3and9years.Malesareaffectedaboutthreetofourtimesmoreoftenthanfemales.CommonassociationsareADHDandOCD.
214. Treatmentofchoiceforacutepanic attacksis? a)Barbiturates b)Benzodiazepines c)TCAs d)MAOinhibitors CorrectAnswer-BAns.B.BenzodiazepinesDOCforPanicdisorders-SSRI'sDOCforacutepanicattack-Benzodiazepines.
215.Characterizedbychronic,multipletics? a)Parkinson'sdisease b)Wilson'sdisease c)Shy-Dragersyndrome d)Tourette'ssyndrome CorrectAnswer-DAns.D.Tourette'ssyndromeTourettesyndrome(alsocalledTourette'ssyndrome,Tourette'sdisorder,GillesdelaTourettesyndrome,GTSor,morecommonly,simplyTourette'sorTS)isaninheritedneuropsychiatricdisorderwithonsetinchildhood,characterizedbymultiplephysical(motor)ticsandatleastonevocal(phonic)tic.
216.Whichofthefollowingisnottrueabout sleep? a)REMsleepcomesearlierthanNREMsleep b)REMsleepisalsocalledparadoxicalsleep c)SleepwalkingcomesinNREMsleep d)DreamscomeinREMsleep CorrectAnswer-AAns.A.REMsleepcomesearlierthanNREMsleepTheNREM(withitsfourstages)andREMsleeprepeatseveraltimesanightincyclicmanner,4-6timesdependingonthelengthofsleep.AtypicalcyclestartswithstageIoftheNREMsleepwhichisfollowedbysecond,thirdandfourthstages.REMsleepoccupies20-30%oftotalsleepandNREMsleepoccupies60-70%(StageIoccupies5-10%;Stage2occupies40-50%;Stage3occupies15-20%
217.GammawavesofREMsleepinsleep cycleareassociatedwith? a)Intenseattention b)Subconsciousthinking c)Deepsubconsciousthinking d)Deepsleep CorrectAnswer-AAns.A.IntenseattentionBetaandgammawaves(20-80Hz)occurspontaneouslyduringREMsleepandwakingandareevokedbyintenseattention,conditionedresponses,tasksrequiringfinemovementsandsensorystimulus
218.DrugnotusedinprophylaxisofMDP? a)Haloperidol b)Lithium c)Carbamazepine d)Valproate CorrectAnswer-AAns.A.HaloperidolProphylactictreatmentforbipolardisorder: 1. Lithium(drugofchoice)2. Carbamazepine3. Valproate4. Otherdrugswhichcanbeusedaretopiramate,Lamotrigine,atypical antipsychotics(artpiprazale,olanzapine,quetiapine,risperidone,Clozapine)andGabapentin.
219.Behavioraltherapyisdonein? a)Schizophrenia b)Agoraphobia c)Delirium d)Neuroticdepression CorrectAnswer-BAns.B.AgoraphobiaMostimportantuseofbehavioraltherapy-Phobia&OCD.Otherusersare-Otheranxietydisorders(includingpanic),Eatingdisorders,Autism,ADHD,somepersonalitydisorder,sexualdysfunctions,depression.
220.Featureassociatedwithmaniais? a)Neologism b)Perseveration c)Echolalia d)Flightsofideas CorrectAnswer-DAns.D.FlightsofideasDiagnosticcriteriaformaniaThreeormoreofthefollowingforatleast1week:- 1. Inflatedselfvesteemorgrandiosity2. Decreasedneedforsleep3. Overtalkativeness4. Flightofvideas5. Distractibility6. PsychomotoragitationorIncreasedgoaldirectedactivities7. Excessiveinvolvementinpleasurableactivities
221.Eatingdisorderwithnormalweightis? a)Anorexianervosa b)Bulimianervosa c)Bingeeatingdisorder d)Noneoftheabove CorrectAnswer-BAns.B.BulimianervosaAnorexianervosa-UnderweightBulimianervosa-NormalWeightBingeeatingdisorder-Overweight.
222.Phototherapyisusedinthetreatmentof ? a)Anorexianervosa b)Seasonalaffectivedisorder c)Schizophrenia d)Obsessivecompulsivedisorder CorrectAnswer-BAns.B.SeasonalaffectivedisorderPhototherapyisprimarilyindicatedinthetreatmentofseasonaldepressions.Inadditiontoseasonaldepression,theothermajorindicationforphototherapymaybeinsleepdisorders.
223.Bingeeatingdisorderischaracterizedby ? a)Normalweight b)Weightloss c)Obesity d)Selfinducedvomiting CorrectAnswer-CAns.C.ObesityBingeeatingdisorder(BED)ischaracterizedbyinsatiablecravingsthatcanoccuranytimedayornight,usuallysecretive,andfilledwithshame.TherearenocomPensatorymechanismsassociatedwiththebingetogetridofcalories,soindividulaswithBEDaremorelikelytobeoverweightorobese,whilepatientswithbulimianervosamaybeunderweight,normalweight.
224.Tricyclicantidepressantshaveallofthe followingactionsexcept? a)Anticholinergicaction b)MAOinhibition c)Block5-HTorNEreuptake d)Causessedation CorrectAnswer-BAns-B.MAOinhibitionTricyclicantidepressants(TCAS)areeitherNA+5HTreuptakeinhibitors(e.g.-Imipramine,Amitriptyline)orpredominantlyNAreuptakeinhibitors(e.g.Desipramine,nortriptyline).TCAsarenotMAOinhibitors.AdverseeffectsofTCFsare:anticholinergicsideeffects,sedatior,mentalconfusion,weakness,increaseappetite&weightgain,sweating&finetremor,posturalhypotensionandcardiacarrhythmia.
225.Whichofthefollowingisafeatureof opioidwithdrawal? a)Tremors b)Gooseflesh c)Drynoseandmouth d)Constipation CorrectAnswer-BAns.B.GoosefleshManifestationsofmorphinewithdrawal-LacrimationSweatingYawningGooseflash(Piloerection)MydriasisAnxiety&fearRestlessnessInsomniaAbdominalcolicDiarrheaDehydrationHypertensionPalpitationRapidweightloss
226. PatientandPsychotherapis,both participateactivelyin? a)Psychoanalysis b)Psychoanalyticpsychotherapy c)Psycodynamicpsychotherapy d)Alloftheabove CorrectAnswer-BAns.B.PsychoanalyticpsychotherapyPsychoanalytic(psychodynamic)psychotherapyisamuchmoredirectfromofpsychonalysis.Thepatientandtherapistsitfacetoface.Howevertherapistusuallytalksquitealot,comparedtosilenceinpsychoanalysis.Treatmentisaninteractiveprocessbetweenthepatientandtherapist.
227.ThemaximumDALYlossisforthe followingdisease- a)Schizophrenia b)Unipolardepression c)Bipolardepression d)Mania CorrectAnswer-BAns.B.UnipolardepressionAmongstthepsychiatricdisordersmaximumDALYlossiscausedbymajordepression.
228.Etheromaniasreferto? a)Acutepsychosispostetheranaesthesia b)Etheraddiction c)Excessiveetherusedruganaesthesia d)None CorrectAnswer-BAns,B.EtheraddictionEtheraddictionoretheromaniaistheaddictiontoinhalationordrinkingofdiethylether.
229.Theterm"Dementiaprecox"wascoined by? a)Freud b)Bleuler c)Kraepelin d)Schneider CorrectAnswer-CAns.C.Kraepelin
230.Theterm'id'wascoinedby? a)Freud b)Skinner c)Wayker d)Blueler CorrectAnswer-AAns,A.FreudStructuraltheoryofmind(theid,egoandsuperego)wasgivenbysigmundfreud.
231. Subcorticaldementiaisseeninall except? a)Parkinsonism b)Alzheimer'sdisease c)Wilson'sdisease d)Huntingtonschorea CorrectAnswer-BAns.B.Alzheimer'sdiseaseSubcorticaldementiaisseeninparkinsonism,Huntington'sdisease,wilson'sdisease,progressivesupranuclearpalsy,idiopathicbasalganglioncalcification(Fahr'sdisease),thalamiclesions,multiplesclerosis,HIVassociateddementiaandmultisYstematroPhY.Alzheimer'sdiseasecausescorticaldementia.
232.Formicationisseenwith? a)Acuteamphetamineintoxication b)Chronicuseofamhetamine c)Alcoholwithdrawal d)Cannabispoisoning CorrectAnswer-BAns.B.ChronicuseofamhetamineMagnan'ssyndrome(alsocalledformication)isseeninchroniccocaineandchronicamphetamineabuse.
233.Hangoverfollowingalcoholconsumption canbetreatedwith? a)Pyridoxine b)Thiamine c)Riboflavin d)Niacin CorrectAnswer-BANs.B.ThiamineThiaminehelpspreventthebuildupofglutarateinthebrain,whichmaybeassociatedwithpartoftheheadacheassociatedwithhangover.
234.Mostcommonlyabusedopioid- a)Morphine b)Diacetylmorphine c)Oxycodine d)Bupremorphine CorrectAnswer-BAns,B.DiacetylmorphineDiacetylmorphine(heroin)isthemostcommonlyabusedopioid.
235.Hallucinationsareproducedby? a)Amphetamine b)Morphine c)Paraxetine d)Chlorpromazine CorrectAnswer-AAns,A.AmphetamineAmphetaminepsychosismimicparanoidschizophrenia.Theremaybedeleusionsandhallucinations.
236.Anxietyis? a)Neurosis b)Psychosis c)Personalitydisorder d)None CorrectAnswer-AAns.,A.NeurosisImportantneuroticdisordersareAnxietydisorders(Panic),Phobia(Phobicanxietydisorder),obsessivecompulsiveDisorder&Dissociativeconversiondisorder.
237.Indepressions,thereisdeficiencyof? a)5-HT b)Acetylcholine c)Dopamine d)GABA CorrectAnswer-AAns.A.5-HTDepression=Decreaseinserotoninandnorepinephrine.SerotoninisthemostimPortantneurotransmitterindepression.Mania=Increasedofnorepipherine.
238.Theaminoacidderivedneurotransmitter usedfortreatingdepressionis? a)Serotonine b)Histamine c)acetylcholine d)none CorrectAnswer-AAns.A.SerotonineThethreemainneurotransmittersinvolvedindepressionaredopamine,norepinephrineandserotonin(s-HT).WhenbrainIevelsofoneormoreneurotransmitterareloworunbalanced,depressioncanresult.Generally,antidepressantdrugsworkbyincreasingproductionordecreasingthebreakdownofoneormoreoftheseneurotransmitters.
239.Repetitivetimesworkdoingfor premonitionof? a)Obscession b)Compulsion c)Anxiety d)None CorrectAnswer-BAns.B.CompulsionRepetitiveirresistablethoughts>Obsession.Repetitivepurposefulbehavior(workdoing)>compulsion.
240.Derelation&depersonalisationseenin whichtypeofdisorder? a)Dissociativedisorder b)Personalitydisorders c)Mania d)None CorrectAnswer-AAns.A.Dissociativedisorder
241.Schizoidpersonalitydisorderallare seenexcept? a)Aloof&detached b)Pronetofantasy c)Suspicious d)Introspective CorrectAnswer-CAns.C.SuspiciousSuspiciousnessisseeninparanoidpersonalitydisorder.
242.Narcolepsyisduetoabnormalityin? a)Hypothalamus b)Neocortex c)Cerebellum d)Medullaoblongata CorrectAnswer-AAns.A.HypothalamusNarcolepsyisuniqueinthatthosewhosufferfromittyPicalyfallalmostinstantaneouslyintoREMsleep.Itisthoughtthatnarcolepsyiscausedbyamalfunctioningofthehypothalamusinbrain.
243.MaxdurationoftimespentisinNREM stage? a)I b)II c)III d)IV CorrectAnswer-BAns.B.II
244.NREMSleeptrueis? a)Teethgrinding b)Narcolepsy c)Nightmares d)Sleepparalysis CorrectAnswer-AAns.A.TeethgrindingSlowwavesleep(stage3&4ofNREMsleep)disordersrSleepwalking(somnambulism),nightterror(sleepterrororpavornocturnus),Nocturnalenuresis,Bruxism(teethgrinning),andsleeptalking(somniloquy).REMsleepevents/disorder:-Nightmares,nocturnalpeniletumescence,Narcolepsy.
245.Bruxismis? a)Walkingduringsleep b)Nocturnalenuresis c)Grindingofteethduringsleep d)Sleepapnoea CorrectAnswer-CAns.C.Grindingofteethduringsleep
246.Narcolepsy,nottrue? a)Cataplexy b)Sleeparchitecturenormal c)Lossofmuscletone d)Hallucination CorrectAnswer-BAns.B.SleeparchitecturenormalThereisdisturbedREMsleep.Cataplexy(suddenlossofmuscletone)isthemostcommonaccessorysymPtom.Theremaybehallucinations.
247.Howtodifferentiatebetween psychologicalandorganicerectiledysfunction? a)Nocturnalpeniletumescence b)PIPEtherapy c)Sildenafilinducederection d)Squeezetechnique CorrectAnswer-AAns.A.NocturnalpeniletumescenceOneoftheimportantmethodtodistinguishpsychogenicimpotencefromorganicimPotenceisnocturnalpeniletumsescence&earlymorningerectionwhicharepreservedinpsychogenicimpotencebutnotinorganiccauseofimpotence.
248.Desensitizationisatypeof? a)Psychotherapy b)Psychoanalysis c)Behavioraltherapy d)None CorrectAnswer-CAns.C.BehavioraltherapyTypesofbehavioraltherapyare:-Systemicdesensitization,therapeuticgradedexPosure,exPosure&responseprevention,flooding,aversiontherapy,andoperantconditioning.
249.Stimulantdrugisgiventochildfor? a)Conductdisorder b)Speechdevelopmentaldisorder c)Pervasivedisorder d)ADHD CorrectAnswer-DAns.D.ADHDStimulants(likemethylphenidate,dextramphetamine)arethedrugsofchoiceforADHD.
250.Kleinlevinsyndrome? a)Insomnia b)Anxiety c)Depression d)Hypersomnia CorrectAnswer-DAns.D.HypersomniaKleinelevinsyadromeorsleepingbeautysyndromeisaneurologicaldisorderofrecurringperiodsofexcessiveamountsofsleepingandeating.
251.AccordingtorecentroundsbyDSMwhat codeisgiventopsychiatricdiseasesinICD10? a)E b)F c)P d)G CorrectAnswer-BAns.B.FICD-10isWHOclassificationforalldiseasesandhealthproblems(andnotonlypsychiatricdisorders).ICD-10usesalphanumericcodemadeofanalphabet?incontrastDSM-IVusesnumericalcoding)?'F'isformentaldisorders.Therearel0maincategoriesdenotedbydigits0to9.
252.Whichofthefollowingisthepoor prognosticfactorforOCD? a)Magicalthinking b)Dirtcontamination c)Pathologicaldoubt d)Hoarding CorrectAnswer-BAns:B.Dirtcontamination.OCD-Clinicalfeatures&symptoms:Contamination?Mostcommonobsession.Obsessionofcontaminationcompulsiveavoidingofcontaminatedobjectsexcessivecleaning-->inabilitytoleavetherehomes(duetogermsfear,shame&disgustfromfeces,urine,dust&germs).Pathologicaldoubt?2ndmostcommon.Obsessionofdoubtcompulsivecheckingmostdangerofviolenceforgettingtoturnoffthestove,ornotlockingthedoor,somepatientcantravelbackhomeseveraltimes.Obsessionofself-doubtfeelingguiltyaboutissuesIntrusivethoughts?3rdmostcommon.Intrusiveobsessionalthoughtswithoutcompulsion(repetitivesexualoraggressiveacts,patientsobsessedoftherethoughts,maythinkthattheysupposetoreportthemtothepoliceortomakeaconfessiontothepriest.Symmetry?4thmostcommon.Needforsymmetryofprecisioncompulsionofslowness,patientcantakeanhourtoeatamealorshavetheirfaces.
253.Semensqueeze a)Erectiledysfunction b)Prematureejaculation c)Retrogradeejaculation d)Antegradeejaculation CorrectAnswer-BAnswer:B-PrematureEjaculationSqueezeTechnique:VariationoftheMastersandJohnsonmethod.Asamanapproachesclimax,eitherheorhispartnersqueezesthetipofthepenisjustbelowtheheadofthepenisasheapproachesthepointofclimax.Pressureisheldthereuntilthesensationofimpendingorgasmdiminishes.Thispressurecanevenbehelduntilthereissomereductioninerection.Theprocesscanthenbestartedoveragainsothatovertimeamanprolongsthetimeperioduntilhereachesejaculation.Usefultotreatcasesofprematureejaculation
254.ApatientwithahistoryofRTAbefore2 monthspresentswithcomplaintsofdreamsofaccidents.Heisabletovisualizethesamescenewheneverhevisitstheplace.Henceisafraidtogobacktotheaccidentsite.Identifythetypeofdisorderthathemightbesufferingfrom? a)Adjustmentdisorder b)PTSD c)Anxietydisorder d)OCD CorrectAnswer-BAnswer:B-Post-traumaticStressdisorderPost-traumaticstressdisorder,basicallyatypeofanxietydisorderThoughitsharesfeatureswithotheranxietydisorders,hasitsownspecificcharacteristicsinpresentation.Criteria1:Etiologicallysignificanttraumashouldbepresenttobeclassifiedunderthiscondition.Criteria2:"Intentionality"or"aboutness",animportantfactorinPTSD.PTSDconcernswithmemoryintrusionofpaststressorsintopresent.Nightmares,flashbacks,orrelivingexperiencesshouldberelatedto
thepastexperience.Criteria3:Avoidastimulusoractivitythatprovokesthememoryofpastevent.
255.Freud'stheoryofdreamincludesall except: a)Displacement b)Condensation c)Symbolisation d)Correlation CorrectAnswer-DAnswer:-D-CorrelationSigmundFreudtheoryofdream:Dreamworkinvolvestheprocessofcondensation,displacement,andsecondaryelaboration.Conceptofunconsciousmind:PrimaryassumptionofFreudiantheoryisthattheunconsciousmindgovernsbehaviortoagreaterdegreethanpeoplesuspect.Goalofpsychoanalysisistomaketheunconscious,conscious.Theoryofdream:Freudtheoryofdreamelaboratesthestateofunconsciousmindwithrespecttodreaminterpretation,Processinvolvedincludecondensation,displacement,andsecondaryelaboration.Displacementtakesplacewhenwetransformthepersonorobjectwearereallyconcernedabouttosomeoneelse.Theprocessofcondensationisthejoiningoftwoormoreideas/imagesintoone.
256.Expressionandconsequentreleaseof previouslyrepressedemotioniscalledas a)Regression b)Dissociation c)Abreaction d)Alloftheabove CorrectAnswer-CAnswer:C-AbreactionTheexpressionandconsequentreleaseofapreviouslyrepressedemotion,achievedthroughrelivingtheexperiencethatcausedit.DonetypicallythroughHypnosisSuggestion
257.Allarehabitdisorderexcept a)Nailbiting b)Thumbsucking c)Tempertantrum d)Tics CorrectAnswer-CAnswer:C-TempertantrumDefinition:Habitdisorderisatermusedtodescribeseveralrelateddisorderslinkedbythepresenceofrepetitiveandrelativelystablebehaviourthatseemtooccurbeyondtheawarenessofthepersonperformingthebehaviour.Thefirstgroupofhabitdisorderincludes"TicDisorder"Ticsareinvoluntarymovements,sounds,orwordsthataresudden,rapid,recurrentandnon-rhythmic"InadditiontoTD's,body-focussedbehaviours,Recurrenthairpulling-Trichotillomania(TTM)Skinpicking(SP)Nailbiting,areincludedwithinhabitdisorders.Headbanging,rockingofbody,teethgrinding&thumbsuckingarerepetitivedisorders.Seeninchildrenbetweenagegroupof6monthsto2years.Benign&self-limited.Themovementsserveameansoftensiondischarginginchildren.Aschildrenbecomeolder,theylearntoinhibitsomeoftheirrhythmicpatterns.Undueattentionbyparentscanleadtoaggravationoftheseproblems.
258.Newnameofmentalretardation accordingtoAmericanAssociationofMentalRetardation a)FeebleMindedness b)Madness c)Intellectualdisability d)Mentallyunstable CorrectAnswer-CAnswer:C-IntellectualdisabilityIntellectualdisability(ID),alsoknownasgenerallearningdisability,Mentalretardation(MR),isageneralizedneurodevelopmentaldisordercharacterizedbysignificantlyimpairedintellectualandadaptivefunctioning.
259.Now-a-daysDownsyndromeIsreferred toas. a)Submentaldisorder b)Oligophrenia c)Madness d)Mentallyunstable CorrectAnswer-AAnswer:A-SubmentaldisorderMajorityofchildrenwithDownsyndromefunctioninmildtomoderaterangeofmentalretardation.Downsyndrome/Trisomy21-Geneticdisordercausedbypresenceofallorpartofathirdcopyofchromosome21.Typicallyassociatedwithphysicalgrowthdelays,characteristicfacialfeaturesandmildtomoderateintellectualdisability.
260.A55yearsagedchronicalcoholicmale, presentedwithirrelevanttalks,tremorandsweating.Hehadhislastdrink3daysback.Whatwilltheprobablediagnosis? a)Deliriumtremens b)Korsakoffpsychosis c)Post-Acutewithdrawalsyndrome d)Discontinuationsyndrome CorrectAnswer-AAnswer:A-DeliriumTremensThedescriptionofsymptomsisrelatedtothecondition"DeliriumTremens"DeliriumTremens/AlcoholWithdrawalDelirium(AWD):Mostsevereformofethanolwithdrawalmanifestedby,Alteredmentalstatus(Globalconfusion)Autonomichyperactivity(Sympatheticoverdrive)Mechanism:Alcoholabuseaffectsneurotransmittersystemsinbrainmainlyby,LossofGABAinhibitorymechanism-Reduceschlorideioninflux.AlcoholactsasNMDAreceptorantagonist-Withdrawalincreasestheexcitatoryneurotransmitter.TheclinicalmanifestationsofethanolwithdrawalarecombinationeffectsofGABA&NMDAreceptoractivity.Thuscausingtremors,diaphoresis,tachycardia,anxiety&in
severecasesSeizure.
261.Whatdifferentiatesdeliriumfrom dementia? a)Confusion b)Difficultyincommunicating c)Hallucination d)Suddenchange CorrectAnswer-DAnswer:D.SuddenchangeDeliriumAlsocalledtheacuteconfusionalstate,deliriumisamedicalconditionthatresultsinconfusionandotherdisruptionsinthinkingandbehavior,includingchangesinperception,attention,moodandactivitylevel.Indementia,changesinmemoryandintellectareslowlyevidentovermonthsoryears.Deliriumisamoreabruptconfusion,emergingoverdaysorweeks,andrepresentsasuddenchangefromtheperson'spreviouscourseofdementia.Thinkingbecomesmoredisorganized,andmaintainingacoherentconversationmaynotbepossible.Thehallmarkseparatingdeliriumfromunderlyingdementiaisinattention.Theindividualsimplycannotfocusononeideaortask.
262.MostcommonDRUGcausing dependence? a)Cannabis b)Cocaine c)Heroin d)Amphetamine CorrectAnswer-AANS-A.CannabisCannabis-9millionusers,192millionusers(Acc.ToWHODrugreport2018)Heroin(opioidderivative)-2.5lakhusersItisestimatedthat275millionpeopleusedillicitdrugs,suchascannabis,amphetamines,opioids,andcocaine,in2016whichtranslatesintoanannualprevalenceofillicitdruguseof5.6%.Cannabisismostusedwith192millionusers.Some31millionpeoplewhousedrugssufferfromdrugusedisorders.-(WHODrugreport2018)Ref:ARVINDARORAreviewofpsychiatryp:64,WHODrugreport(2018)
263.MBBSstudentshewaschokingwith dyspnea,chesttightness,anxietyandanimpendingsenseofdoomonexaminationallsystemicconditionswerefoundnormal,thenshewenttopsychiatry.Whatistheprobablediagnosisofthecondition? a)Panicdisorder b)Depression c)Epilepsy d)Asthma CorrectAnswer-AANS-A.PanicdisorderPanicdisorder-severeanxietywithchoking,chestpainandpalpitations.Depression-lowmoodandlostinterestinactivitiesEpilepsy-neurologicaldisorderwithwhole-bodyfatigueandmusclespasmsAnasthma-respiratorydisorderassociatedwithsymptomsofcough,wheezing,etcRef:ARVINDARORAreviewofpsychiatryp:131
264.Apatientwithdepressionwasgiven Imipraminefor2weeks.Relativesnoticedincreasedexcitement,colourfulclothes,increasedtalking.Whatisthenextstepinmanagement? a)AntipsychoticwithImipraminecontinued b)DiscontinueImipramineandstartValproate c)ContinueImipraminealone d)ManagewithValproatealone CorrectAnswer-AANS-A.AntipsychoticwithImipraminecontinuedTheconditionfromwhichthepatientaboveissufferingisabipolardisorderwhichincludesbothdepressionandmania.Soinordertotreatbothantidepressanti.eimipramineiscontinuedalongwithanantipsychoticsuchasphenothiazines,thioxanthenes,etc.AntipsychoticorvalproatealonecannotreducethedepressionandImipraminealonecannotreducethemania.Ref:ARVINDARORAreviewofpsychiatryp.no:111
265.APatientfallsdownoftenwith behavioralchangeandenuresis.Whatistheconditionassociatedwithhim? a)Frontotemporaldementia b)Normalpressurehydrocephalus c)Parkinson'sdisease d)Alzheimer'sdisease CorrectAnswer-BAns-B.NormalpressurehydrocephalusFrontotemporaldementia-Associatedwithpoorbehavioralcontrol,decisionmaking,andlanguage.Normal-pressurehydrocephalus-Associatedwithgaitdisturbance,behaviouralchange,enuresis,anddementia.Parkinson'sdisease-AssociatedwithtremorandmuscularstiffnessAlzheimer'sdisease-AssociatedmainlywithmemorylossandconfusionRef:NormalPressureHydrocephalusByMichaelJ.Fritsch,UweKehler,UllrichMeierP.16;OxfordtextbookofneurologicalsurgerybyAdelHelmyP.94
266.APatientwithdepressivesymptomsfor 6monthsandassociatedwithauditoryhallucinationsfor2weeks.Whatistheprobablediagnosisofthecondition? a)Psychoticdepression b)Schizoaffectivedisorder c)Maniadepressiveillness d)Schizophrenia CorrectAnswer-AAns-A.PsychoticdepressionPsychoticdepression-Depressionalongwithpsychoticsymptomssuchashallucinations,delusions,etc.Schizoaffectivedisorder-Symptomsofschizophreniaandmooddisturbancesoccurtogether.Maniadepressiveillness-Maniadepressionalongwithpsychoticsymptoms.SchizophreniaincludesallthesymptomsofschizophreniaRef:ArvindArorareviewofPsychiatrypage.103
This post was last modified on 23 November 2021