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MRCPsych part I Sep 2003: Roopa & Najat
Please note that the answers we put are not a 100% correct, we recommend that you consult your text books if you have any doubts. All the best with your exam.
Individual statement questions
1. Non – dominant temporal lobe damage can lead to inability to draw a visual design from memory.
2. Non – dominant temporal lobe damage can lead to failure to shift from one concept to another.
3. In WAIS-R standard deviation was intentionally set at 10 points F
4. In WAIS verbal – performance discrepency of 15 points or more could indicate organic brain damage T
5. The repertory grid can reliably estimate intelligence. F
6. Complimentarity is more important than similarity in enhancing friendship. F
7. Health belief can play a role in the genesis of phobias. F
8. Behavioural theories suggest that incubation is involved in the genesis of phobias. T
9. Behavioural theories suggest that habituation is involved in the genesis of phobias F
10. In OCD motor tasks are typically followed by obsessional thoughts. F
11. Intrusive & repetitive mental images can occur in OCD T
12. Magical undoing Is characteristic of anankastic personality disorder F
13. Agoraphobia typically occurs after the age of 35 year. F
14. Simple animal phobia is more common in people with social phobia than in normal healthy controls.
15. The obsessions can be pleasurable in OCD F
16. Bleuler’s primary symptoms of schizophrenia include incongruity of affect T
17. Elementary hallucinations can happen as a distinct voice.
18. Chronic alcoholic hallucinosis typically presents as fragmentary hallucinations
19. Tardive dyskinesia can present after withdrawal of antipsychotic medications. T
20. Declerambault’s syndrome can happen in OCD. F
21. Depersonalisation is associated with disturbance of tactile perception.
22. In depersonalisation surrounding objects appear unreal. F
23. Narcolepsy is often associated with hypnogogic hallucinations. F
24. Rapid shift from wakefulness to REM sleep is a characteristic feature in Narcolepsy. T
25. A plasma level of chlorpromazine is reduced by anti-muscarinic medications. T
26. Clozapine has agonistic effects at 5HT receptor. F
27. Weight gain caused by lithium is more common in women. T
28. Significant weight gain is a side effect of sodium valproate. T
29. Lamotrigine inhibits GABA transaminase. F
30. MAO B enzyme is selectively inhibited by selegiline. T
31. MAO A enzyme is inhibited by selective MAOI inhibitors. T
32. High lipid coefficient increases the amount of drug, which cross the blood brain barrier.
33. You can bypass blood brain barrier by nasal administration of drugs. F
34. Low plasma protein binding enhances crossing blood brain barrier by drugs.
35. Carbamazepine interacts dangerously with Warfarin at therapeutic doses. T
36. Cimetidine enhances the effects of benzodiazepines. T
37. Benzodiazepines enhance liver enzymes. F
38. Benzodiazepines have specific receptors. T
39. Fluoxetine is associated with significant anti-cholinergic side effects at therapeutic doses. F
40. Clozaril has significant anti-cholinergic side effects at therapeutic doses.
41. Pentazocine causes hallucinations. T
42. First pass metabolism explains the difference in the potency of orally & IV administered drugs. F
43. Administration of lithium in the first trimester of pregnancy increases the incidence on foetal heart abnormalities. T
MRCPsych sept 03 continued
44. Conventional anti-psychotics given to the mother during pregnancy can cause extra-pyramidal side effects in the baby. T
45. Previous history of psychiatric disorders increases the risk of post-natal depression. T
46. Disorientation is a feature of puerperal psychosis. T
47. Forced thinking may indicate an episode of Temporal lobe epilepsy. T
48. Dyskinesia is a characteristic feature of Wernicke’ encephalopathy. F
49. The term pseudocysis & Couvade are synonymous. F
50. The term anhedonia is synonymous with complete loss of ability to feel all feelings. F
51. Made volitional acts & volitional passivity are synonymous terms. T
52. Primary delusions are suggestive of acute rather than chronic schizophrenia. T
53. Failure to ask direct questions during a clinical interview may hinder the assessment of severity of low mood. T
54. It is more valid to consider personality disorder as being on a continuum with normal personality than putting them in a separate category.
55. The term neurosis does not exist as a separate category in DSM IV. T
56. ICD 10 has a category for post -schizophrenic depression. T
57. Mental retardation is coded under axis II in DSM IV classification. T
58. Social dysfunction is described under axis II in DSM IV classification. F
59. DSM IV contains global clinical impression scale. F
60. Reliability of psychiatric disorders has improved by findings from international studies.T
61. Koro is a culture bound syndrome with severe psychotic symptoms. F
62. Bufee delirente is a culture bound syndrome associated with violence. F
63. Over-generalisation is a cognitive distortion in depression. T
64. Frontal lobe damage causes alteration in verbal fluency. T
65. Frontal lobe damage causes loss of topographical memory. F
66. Repeating the months of the year backwards can be used to test perseveration. T
67. Perseveration is suggestive of depressive pseudo-dementia rather than a primary memory disorder. F
68. Neurofibrillary tangles are seen in dementia in professional boxers. T
69. Depression in Cushing’ syndrome is directly related to cortisol blood level. F
70. Id anxiety is associated with fears of loss of control over impulses. F
71. Sibling rivalry is a characteristic feature of Freud’s phallic stage of psychosexual development. F
72. In Freud’s psychosexual stages of development latency is associated with conflict between sexual desires. F
73. According to theories of development of attachment, most children should have established a secure attachment by the end of first year, F
74. Attachment to the father can be as strong as attachment to the mother. T
75. Tri-angulation is a term used by family therapists to formulate a family problem. T
76. Patients presenting with acute confusional state are preoccupied by internal themes. T
77. Occlusion of middle cerebral artery supplying the dominant hemisphere is associated with epsilateral brisk reflexes. F
78. Incidence of schizophrenia in people with learning disability is significantly higher than in general population. T
79. Locus of control is involved in the genesis of simple phobias. F
80. Being single & divorced is associated with increased risk of suicide but not DSH. F
81. Social disintegration is associated with increased risk of depression. T
82. Body image disturbance when weight is normal is pathognomonic of anorexia nervosa. F
83. The incidence of anorexia nervosa is higher in the upper social classes. T
84. People with anorexia nervosa report childhood abuse as often as normal controls. F
MRCPsych sept 03 continued
85. Thumb sucking at the age of 4 is associated with emotional disorders in adult life. F
86. Sexual abuse during childhood is associated with drug & alcohol abuse in adulthood. T
87. Projective identification is the main defence mechanism used in paranoid schizoid position. T
88. Repression is a defence mechanism deployed in paranoid schizoid position. F
89. Dreams reported after waking from non-REM sleep are fragmented & non-vivid. T
90. The movements in stereotypy are irregular & repetitive. F
91. The movements in mannerism are not goal directed. F
92. The fear on loud noises happens regularly in 1-year-old children.
93. GPs tend to diagnose psychological symptoms more often in women. T
94. Gertsman syndrome is associated with dyskinesia. F
95. Primary memory & working memory are synonymous terms. T
96. Loosening of association is usually easily distinguished from derailment. F
97. Having no difficulties in initiating relationships is in keeping with the diagnosis of dissocial personality disorder. T
98. Frontal lobe damage can be associated with thought echo. F
99. Depression may cause reduction in REM sleep latency. T
100. Major depression diagnosed according to DSM IV is as twice as common in women than in men. T
101. Adjustment disorder occurs within a month of exposure to the stressor. T
102. Life events preceding the onset of illness is more common in schizophrenia than in depression. F
103. Tangentiality of thinking in a patient with schizophrenia is a reliable indicator of relapse. F
104. Derealisation is associated with unfamiliarity. F
105. In operant conditioning the re-enforcer can precede the behaviour. F
106. In functional analysis of behaviour you link the behaviour with early life experiences. F
107. In behavioural formulation of a case of phobia you should consider looking at feelings, behaviour, attitude & thoughts. F
108. According to Piaget’s stages of development children enter the pre-operational stage after the age of 6 year. F
109. Delaying child adoption until the age of 2 months is associated with emotional disturbance in adult life. F
110. Cannabis abuse increases the risk of developing schizophrenia. T
MRCPsych sept 03 continued
Extended matching items:
A. Alcohol
Theme:
You were asked to see a 35 year old man in A&E. He was aggressive & strongly smelling of alcohol, he had a cut on his head & his level of consciousness fluctuated.
a) Alcohol intoxication
b) AIDS
c) Intra-cranial bleed.
d) Delirium tremens.
e) Korsakoff’s psychosis.
f) Wernicke’s encephalopathy.
g) Heroin over dose
Lead in:
From the above list choose the most appropriate diagnosis for the following scenarios.
1. He sees blue squirrels running on the floor. (a)
2. He neglects the left side of his body. ( C )
3. He has pinpoint pupil, bradycardia, abscess in his groin & marks in his neck. (g)
B. Motor disorders
Theme:
a) Catalepsy
b) Cataplexy
c) Tardive dyskinesia
d) Dystonia
e) Stereotypy
f) Lead pipe rigidity
Lead in:
From the list above choose the most appropriate term, which describes the disorder in the following scenarios.
4) A 35 -year old lady with a bipolar affective disorder came to see you in the clinic with her husband. She has been stable for the last 5 years on an anti-psychotic & a mood stabiliser. Her husband told you that she is grimacing & putting on faces. ( C )
5) A 20-year-old patient was diagnosed by his GP as having schizophrenia. He was started on haloperidol 5 days ago. He presented to a local A&E with painful contraction of neck muscles. ( d )
6) A 32-year old man presented with a history of sudden falls into the ground following laughter. (b)
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C. Neurosis:
Theme:
a) acute stress reaction
b) adjustment disorder
c) depressive episode
d) PTSD
e) Bereavement reaction
f) Agoraphobia
g) Somatisation
h) Normal adaptive response
Lead in:
7) You were asked to see a 56-year old man, who was admitted to the medical ward 10 days ago with chest pain & weight loss (3 kg). All investigations failed to demonstrate an organic cause. His symptoms started following an incident when thieves broken to his flat & stolen his TV & video recorder. Soon after that he returned to enjoy his life. He is optimistic about the future; he would like to be discharged from hospital, but doesn’t want to go back to his flat. His pre-morbid history was excellent & his relatives confirmed his story. (h)
8) A 50-year old lady is finding it difficult to leave her home. 5 months back she was involved in a car crash, her son who died in the accident was driving the car. The accident happened a short distance from her house. She is having repeated flash backs about the accident. Her sleep pattern & concentration are poor. (d)
9) A lady had witnessed her husband having an epileptic fit. He was holding their 2- year old baby when he collapsed. In A&E she was noticed to be very agitated & pacing down the corridors. She was verbally abusive towards A&E staff. (a)
D. Clinical interview:
a) confrontation
b) summoning
c) clarification
d) prescription
e) elaboration
f) explanation
g) empathy
lead in:
10) “you continue to drink alcohol despite my advice to stop drinking” (a) ?
11) “you mentioned the third party involved in the accident many times, do you blame them for the accident” (C )
12) “ I can see that you feeling sad, when talking about your mother” (g)
MRCPsych sept 03 continued
E. Dementia:
a) Alcohol dementia
b) Alzheimer’s disease
c) CJD
d) Chronic subdural haematoma
e) Multi-infarct dementia
f) Normal pressure hydrocephalus
g) Fronto-temporal dementia
Lead in:
From the above list choose the most appropriate diagnosis for the following scenarios.
13) His wife brought an 80-year old man to your clinic. He was malnourished & unkempt, with evidence of poor self –hygiene. He presented with a history of recurrent falls. He has a mild but significant cognitive impairment. (a)
14) 68-year old man with a 7 months history of ataxia of gait, urinary incontinence & memory loss. (f)
15) N 80-year old lady was brought to A&E by her neighbours. She was found wondering outside her home at night.she was disoriented in time, place & person. CT scan was normal; it only showed an area of peri-ventricular lucency. (d)
F. Drug side effects:
a) fatigue
b) agitation
c) myoclonus
d) failure of oral contraception pill
e) hirsutism
f) postural hypotention
g) microcytosis
h) leukoariosis
lead in:
From the above choose at least 2 side effects for the following drugs.
16) Phenytoin (d & e)
17) A patient on beta blockers (a & f)
18) A patient on SSRI has by mistake taken Tranylcipromin. (b & c)
MRCPsych Sept 03 continued
E. Neurology:
a) Wernicke’s aphasia
b) Broca’s aphasia.
c) Alexia with agraphia.
d) Finger agnosia.
e) Non-fluent dysphasia.
f) Prosopagnosia.
g) Contra-lateral visual field defect.
h) Perseveration.
Lead in:
Match the following scenarios with the most appropriate deficit from the above list.
19) Posterior parietal lobe damage. (a)
20) Non-dominant hemisphere damage.
21) Weakness of the dominant hand.
F. Psychopathology:
a) completion illusion
b) Pareidolia.
c) Reflex hallucination.
d) Synaesthaesia.
e) Functional hallucination.
f) Extracampine hallucination.
Lead in:
From the list above choose the most appropriate psychopathological term for each of the following scenarios.
22) A 30 year old schizophrenic man who was stable on medications, described seeing devil’s face when looking at cigarette’s burns on the carpet. (b)
23) A 50-year-old man was admitted to hospital with psychotic depression. He reported hearing his neighbour’s voice talking about him in a post office 2 miles away from the hospital. (f)
24) A patient sees red colour every time he hears music. ( c )
MRCPsych Sept 03 continued
G. Clinical psychiatry:
a) Reduplicative paramnesia.
b) Depression
c) Somatisation.
d) Schizophrenia.
e) Cotard syndrome.
f) Fregoli syndrome.
g) Generalised anxiety disorder.
h) Charles Bunnet’s syndrome.
Lead in:
From the list above choose the most appropriate term that best describes each of the following scenarios.
25) A 50-year old man was admitted to hospital following a head injury. He has recovered from that, but he is still confused. He thinks that hospital staff is against him & that he has been transferred to another annex of the hospital, which is 50 miles away. (a)
26) A 55-year-old man with a history of weight loss, poor energy & lack of motivation. His wife died 6 months ago. (b)
27) A 62-year-old lady, who has cataract, is seeing blue rats running on the floor. Her past medical & psychiatric history is unremarkable & her premorbid functioning is excellent. (h)
H. Clinical psychiatry:
a) Malingering.
b) Factitious disorder.
c) Somatisation.
d) Hypochondriasis.
e) Dysmorphophobia.
f) Persistent delusional disorder.
g) Dissociative disorder.
Lead in: from the list above, choose the most appropriate diagnosis for each of the following scenarios.
28) A 35- year old man is convinced that he suffers from a debilitating neurological disorder affecting his legs making them unsightly. He is convinced that his family & GP are withholding the new from him because his illness is incurable. (d) ?
29) A 33-year-old lady was seen in A&E for a skin rash & abscess. Both were visible on her skin. Looking in her medical notes, she has a long history of repeated physical complaints. These included passing blood in the urine, abdominal pain…etc. all investigations have failed to demonstrate an organic cause. (b)
30) A 58-year-old lady presented with a history of progressive weakness of 5 months duration. She is now wheel chair bound. The symptoms started after she lost her husband & son in a car crash. She has a history of unexplained visual impairment when she was 17. At the age of 30 she had unexplained speech problems. During childhood she had a lot of day dreaming & imagery. (g)
