Transcript MCQs - The Cambridge MRCPsych Course

MCQs
Dr Syeda Monazza Ali
ST5 rehab/recovery team.
1.
A 27 year old man is involved in a road traffic
accident, three months later he presents with
distressing feelings, flashbacks, nightmares, and
hypervigilence. What is the likely diagnosis
Choose one answer.
a. Generalised anxiety disorder
b. Adjustment disorder
c. Post traumatic stress disorder
d. Obsessive compulsive disorder
e. Schizophrenia
2.
A primary school teacher suspects Aspergers
disease in one of her pupils. Which of the
following will rule out the diagnosis:
Choose one answer.
a. Stereotyped activities
b. Narrow interests
c. Abnormalities of social behaviour
d. Normal IQ
e. Retardation of language development
3.
The Cognitive Developmental Theory was given
by
Choose one answer.
a. Erikson
b. Winnicot
c. Piaget
d. Freud
e. Beck
4.
Goffman is associated with the following?
Choose one answer.
a. Total Institutions
b. Sociogenesis
c. Asyndesis
d. Antipsychiatry
e. Stigma
5.
Cognitive dissonance can result in a change in
Choose one answer.
a. Attitude
b. Attribution
c. Obedience
d. Group behaviour
e. Confirmity
6.
Ravens' Progressive Matrices test is used to assess
which of the following?
Choose one answer.
a. Orientation
b. Premorbid intelligence
c. General intelligence
d. Attention
e. Executive functions
7.
A 51 year old man presents with with 6 months
history of headache, and problems with smell.
What is the most likely diagnosis?
Choose one answer.
a. Alcoholic hallucinosis
b. Temporal lobe epilepsy
c. Somatisation disorder
d. Meningioma
e. Lewy body dementia
8.
Which of the following is true statement regarding
Addenbrookes cognitive examination test revised (ACE-R).
Choose one answer.
a. It is a cognitive test for assessing dementia and
delirium.
b. A score of less than 82 has high sensitivity and
100% specificity for dementia.
c. The ACE-R incorporates MMSE but the items
from MMSE are not used for scoring ACE-R
d. ACE-R does not incorporate MMSE.
e. A score of less than 82 has high specificity and
100% sensitivity for dementia.
9.
Your patient puts out his arm for hand shake
then withdraws and then offers it again. He
repeats this 23 times before coming to a rest
without making any contact with your hand. This
is an example of what type of behaviour?
Choose one answer.
a. Mitgehen
b. Posturing
c. Non-cooperation
z. Ambitendence
e. Automatic disobedience
10.
The feature that indicates depression rather than
grief following bereavement include
Choose one answer.
a. Retardation
b. Social withdrawal
c. Brief hallucinations
d. Poor sleep
e. Poor appetite
11.
Which of the following statements about placebo
is incorrect?
Choose one answer.
a. Placebo-induced analgesia may be blocked by
naloxone
b. Placebo response rate in depression can be
more than 30%
c. Placebo response rate in schizophrenia is very
low
d. Pharmacologically active
e. Placebos may produce adverse effects
12.
The most common type of seizure with an aura is
Choose one answer.
a. Petit mal
b. Pseudo-seizure
c. Atonic seizures
d. Complex partial seizure
e. Grand mal
13.
Which of the following questionnaires can be used
to identify psychiatric 'caseness' in general
population
Choose one answer.
a. Present State Examination
b. Hamilton Anxiety Rating Scale
c. General Health Questionnaire
d. Beck's Depression Inventory
e. Structured Clinical Interview
14.
The following is true regarding
Chlorpromazine?
Choose one answer.
a. Valproic acid increases Chlorpromazine
levels
b. Chorpromazine increases Valproic acid
levels
c. Chlorpromazine decreases valproic acid
levels
d. None of the options
e. Valproic acid reduces
15.
Organised knowledge about the world is stored in
Choose one answer.
a. The semantic memory store
b. The short-term memory store
c. The implicit memory store
d. The episodic memory store
e. The Iconic sensory register
16.
Long-term memory for autobiographical events is
called
Choose one answer.
a. Implicit memory
b. Semantic memory
c. Episodic memory
d. Echoic memory
e. Procedural memory
17.
Flashbulb memories are encoded
Choose one answer.
a. Only in the visual mode
b. Only in the auditory mode
c. Within strong emotional contexts
d. By people with autistic-spectrum disorders
e. By the process of repeated exposures
18.
Formication is an abnormality of which
perceptual system?
Choose one answer.
a. Kinaesthetic
b. Tactile
c. Olfactory
d. Nocioceptive
e. Visual
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19.
A lady presents with the belief that she is dead.
Collateral from her husband reveals that she has
been feeling low for a number of months. What is
the most likely diagnosis according to ICD-10
Choose one answer.
a. Schizoaffective disorder
b. Severe depression with psychotic features
c. Moderate depressive episode
d. Schizophrenia
e. Severe depressive episode without psychosis
20.
A 80 year old gentleman was started on Fluoxetine for his
depressive illness. Three weeks later he presents with
lethargy, confusion and muscle cramps. Select one
investigation of choice in this patient
Choose one answer
a. CT scan b. U&Es
c. Fasting glucose
d. FBC
e. ECG
21.
The assessment of a patient with alcohol
dependence should include routine blood tests.
Which of the following abnormalities would be
expected on haematological investigation of an
individual with alcohol dependence
Choose one answer.
a. Reduced MCV
b. Reduced AST
c. Reduced urea
d. Raised MCV
e. Increased INR
22.
The following can be seen in a patient with
anorexia nervosa who is known to induce
vomiting
Choose one answer.
a. Zinc deficiency
b. Osteoporosis
c. Hypomagnesaemia
d. All the above
e. Hyponatremia
23.
Progressively increasing amounts of delta and
theta waves are seen in
Choose one answer.
a. Schizophrenia
b. Depression
c. Organic psychoses
d. Anxiety disorders
e. Dissociative disorders
24.
A depressed patient with a history of CVS
problems was started by his GP on fluoxetine.
After few days of treatment he started
complaining of feeling lethargic with muscle
aches, and malaise. What is the likely cause
Choose one answer.
a. Myocardial infarction
b. Anaemia
c. Heart failure
d. Delirium
e. Hyponatraemia
25.
A known schizophrenic patients has been well
treated and left hospital seven months ago. For
the last 2 weeks, he has been having symptoms
of social isolation, poor eating and sleeping. His
most likely diagnosis is
Choose one answer.
a. Undifferentiated schizophrenia
b. Adjustment disorder
c. Major depressive disorder
d. Post Schizophrenic depression
e. Residual schizophrenia
26.
Kane et al are associated with the introduction of
which of the following drugs
Choose one answer.
a. Lithium
b. Clozapine
c. Chlorpromazine
d. Imipramine
e. Haloperidol
27.
To which group of antipsychotic drugs does
sulpride belong
Choose one answer.
a. Phenothiazine
b. Thioxanthine
c. Dibenzazepine
d. Substituted benzamide
e. Benzisoxazole
28.
A patient started on clozapine three weeks ago
complains of generalised weakness,
breathlessness and palpitations. Select one
investigation most appropriate for this patient
Choose one answer.
a. Chest X-ray
b. Echocardiogram
c. CT scan
d. ECG
e. FBC
29.
A patient has raised prolactin and
amenorrhea: investigation of choice is
Choose one answer.
a. CT head
b. EEG
c. Lumbar puncture
d. MRI head
e. SPECT
30.
A patient with history of bipolar affective disorder
being treated with lithium develops arthritis and
sees his GP for the same. He develops coarse
tremors a few days after starting treatment with
the pain medication which his GP had given.
Select ONE investigation which is required to be
done immediately
Choose one answer.
a. CT scan
b. ECG
c. U&Es
d. Serum lithium levels
e. FBC
31.
Select one investigation for a patient on
Olanzapine presenting with weight loss and thirst.
Choose one answer.
a. FBC
b. Thyroid function tests
c. Fasting glucose
d. U&Es
e. LFTs
34.
Who is credited with developing electroconvulsive
therapy as a treatment for schizophrenia
Choose one answer.
a. Prochaska and Di Clemente
b. Cerletti and Bini
c. Kuhn
d. Legrain
e. Kane
33.
A 20-year-old lady with a history of hepatomegaly
develops tremors, rigidity and dysarthria. She is also
noticed to have cognitive deficits. Which of the
following findings would be consistent with this
presentation
Choose one answer.
a. Low serum B12 levels
b. Increased urinary catecholamines
c. Raised mean corpuscular volume
d. Acanthocytosis
e. Low plasma caeruloplasmin
34,
A 45 year old lady has been taking lithium for her
bipolar illness for the last 20 years. She now
complains of weight gain, lethargy, tiredness and
hair loss. Select the investigation of choice to assess
her
Choose one answer.
a. U&Es
b. Thyroid function tests
c. Serum lithium levels
d. FBC
e. ECG
35.
Which of the following drug has least effect on QTc
prolongation
Choose one answer.
a. Chlorpromazine
b. Risperidone
c. Olanzapine
d. Quetiapine
e. Aripiprazole
36.
You notice repeated tonic spasms resulting in
closure of right eye in a woman who can resist this
briefly while talking to you. She is able to carry out
most of her daily activities including watching
television normally. This is best described as:
Choose one answer.
a. Blepharospasm
b. Tonic seizure
c. Hemifacial spasm
d. Catatonic posturing
e. Tic
37.
Excessive sensitiveness to setbacks, tenacious sense
of personal rights and distrust in relationships are
features of which of the following personality
disorder
Choose one answer.
a. Paranoid
b. Schizoid
c. Borderline
d. Anankastic
e. Histrionic
38.
The book The Myth of Mental illness was written by
Choose one answer.
a. Jung
b. R D Laing
c. Foucault
d. Beattie
e. Thomas Szasz
39.
A 36 year old woman while traveling in traffic can
hear her own thoughts aloud despite the sound of
exhaust of vehicles. She is aware that her thoughts
are being heard by others as well, but does not
seem to be worried about this. The
Psychopathology being described is
Choose one answer
a. Functional hallucination
b. Thought broadcast
c. Thought diffusion
d. Thought echo
e. Thought insertion
40.
Which of the following is the single most
useful tool for diagnosing dementia
Choose one answer.
a. CT scan
b. Clinical interview of patient and carer
c. MRI scan
d. SPECT scan
e. EEG
41.
The following is a Cognitive distortion
Choose one answer.
a. Rationalisation
b. Splitting
c. Displacement
d. Projection
e. Personalisation
42.
The time needed to cross taper Venlafaxine and
start Duloxetine is
Choose one answer.
a. 2 weeks
b. 1 month
c. 1 week
d. 2 months
e. 45 days
43.
Which EEG waveform typically has a frequency of
greater than 13 Hz
Choose one answer.
a. Delta
b. Theta
c. Alpha
d. Gamma
e. Beta
44.
Which of the following drugs can increase serum
lithium levels
Choose one answer.
a. Furosemide
b. Paracetamol
c. Propranolol
d. Mirtazapine
e. Salbutamol
45.
Which of the following described cognitive
dissonance
Choose one answer.
a. Beck
b. Freud
c. Aron
d. Festinger
e. Piaget
46.
A mother wants to know what is the risk of
schizophrenia in her son who smokes cannabis
Choose one answer.
a. Two-fold increase in risk
b. No association between cannabis and
schizophrenia
c. Four-fold decrease in risk
d. Two-fold decrease in risk
e. Four-fold increase in risk
47.
Which of the following is a noradrenaline reuptake
inhibitor
Choose one answer.
a. Fluoxetine
b. Agomelatine
c. Reboxetine
d. Paroxetine
e. Risperidone
48.
A patient with chronic schizophrenia on
antipsychotic medications says during the
interview that "my nurse needlebutton me daily".
Which of the describes his use of words
Choose one answer.
a. Paragrammatism
b. Neologism
c. Metonym
d. Paraphasia
e. Asyndesis
49.
A 53 yr old lady has been going to the GP for 5
years for different complains of chest pain, joint
pain, and skin problem. Nothing was found on the
physical examination and all her tests have been
negative but she continues to report symptoms.
Her diagnosis is most likely to be:
Choose one answer.
a. Factitious disorder
b. Somatization disorder
c. Malingering
d. Conversion disorder
e. Hypochondriasis
50.
A young lady presents with weight loss, BMI less than
17, amenorrhea, and excessive excercise. What is
the likely diagnosis
Choose one answer.
a. Unspecified eating disorder
b. Anorexia nervosa
c. Atypical bulimia nervosa
d. Atypical anorexia nervosa
e. Bulimia nervosa
51.
Which one of the following is Characteristic
of depersonalisation disorder
Choose one answer.
a. The experience is objective
b. Associated with emotional numbness
c. Affect is always pleasant
d. Can easily be differentiated from
derealisation
e. Environment seems unreal
52.
The person who described 6 basic emotions is
Choose one answer.
a. Power
b. Baird
c. Ekman
d. Piaget
53.
The gene for Huntingtons disease is present of the
following chromosome.
Choose one answer.
a .4
b. 21
c. 6
d. 5
e. 22
54.
The term schizoaffective psychosis was coined by
Choose one answer.
a. Kanner
b. Bleuler
c. Kretschmer
d. Kraepelin
A 20 years old Jamaican man who has immigrated
to the UK develops schizophrenia. Which of the
following is most likely to be true
Choose one answer.
a. His immigration is likely to be due to psychotic
experiences
b. His parents are likely to be from a lower
socioeconomic class
c. The risk of schizophrenia in his parents is likely to
be similar to the risk in the native population of the
UK
d. He is likely to be poorly educated
e. He is likely to seek professional help early in the
course of his illness
56.
A student passes the MRCPsych exam having
based their revision of previous exam MCQs but
the student who has based their revision on text
books fails the same exam despite having gained
vast knowledge. The bias involved in this example
is
Choose one answer.
a. Barnum effect
b. Halo effect
c. Recency effect
d. Practice effect
e. Hawthorne effect
57.
Select the type of delusions commonly seen in
depression
Choose one answer.
a. Mood incongruent delusions
b. Grandiose delusions
c. Delusions of control
d. Bizarre delusions
e. Nihilistic delusions
58.
Which of the following is a cluster C personality
disorder
Choose one answer.
a. Obsessive-compulsive personality disorder
b. Borderline personality disorder
c. Schizoid personality disorder
d. Paranoid personality disorder
e. Anti-social personality disorder
59.
Which of the following is a precursor of serotonin?
Choose one answer.
a. 5-Hydroxyindole acetic acid
b. Dopamine
c. Melatonin
d. N-Acetyl serotonin
e. 5-Hydroxytryptophan
60.
A 5 year old girl has developed ADHD. Which of the
following would have contributed to her illness
Choose one answer
.
a. Exposure to lead during first year of life
b. Mother had obstetric complications during the
delivery
c. Mother smoked during pregnancy
d. Mother contracted influenza during the
pregnancy
e. Aspyhxia at birth
61.
A boy is able to appreciate that a volume of water
contained in a tall, narrow, vessel can be of the same
volume as that with a lower level, contained in a short, wide
vessel. Which of Piaget's developmental stages is he in.
Choose one answer.
a. Preoperational stage
b. Formal operational stage
c. Concrete operational stage
d. Sensorimotor stage
e. None of the options
62.
A patient is referred to the community mental health
team (CMHT) with psychotic symptoms. He is
assessed by the CMHT and he appears to have
negative symptoms as well. Which of the following is
a tool to assess his mental state and to monitor his
progress on treatment?
Choose one answer.
a. General Health Questionnaire (GHQ)
b. Mini Mental State Examination (MMSE)
c. Hamilton Anxiety Rating Scale (HADS)
d. Global Assessment of Functioning (GAF)
e. Brief Psychiatric Rating Scale (BPRS)
64.
The following is the focus in Dentology
Choose one answer.
a. Virtue theory
b. Actions
c. Principalism
d. Consequences of actions
e. Utilitarian values
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A family who migrated to the U.S.A successfully
manages to adapt to the culture (especially at work),
whilst managing to retain some of their traditions and
beliefs. This is an example of which of the following?
Choose one answer.
a. Assimilation
b. Melting pot
c. Acculuration
d. Accomodation
e. Enculturation
Enculturation is the process of learning one's first and
original culture. That is, the socialization process that
influences how we behave, think, and feel from early in
life. Acculturation, on the other hand, is generally
considered to be the process of learning a second
culture. In contrast to acculturation, assimilation is
understood to be the abandonment of one's first
culture in favor of a second culture.
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According to Holmes and Rahe Stress Scale, which of the
following life event is most likely to cause stress and ill health
in an individual
Choose one answer.
a. Illness
b. Imprisonment
C. Marriage
d. Divorce
e. Retirement
Holmes and Rahe developed a stress scale where they
gave a 'life change unit' score to each life event to
measure the impact of the life event. The highest score was
for Divorce (100 life change units), followed by Divorce (73),
Marital separation (65), Imprisonment (63). The scores for
Marriage is 50, illness -53, & retirement 45.
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An 18 year old prefers to be alone and enjoy activities that
other people find eccentric. His mother has a diagnosis of
Schizophrenia. He thinks he will do fine in life as long as he
wears black shoes. What is the likely diagnosis?
Choose one answer.
a. Schizophrenia
b. Schizotypal disorder
c. Schizoid disorder
d. Mania
e. Depression
Schizotypal disorder is characterized by eccentric behaviour
and anomalies of thinking and affect which resemble those
seen in schizophrenia, though no definite and characteristic
schizophrenic anomalies have occurred at any stage. There is
no definite onset and its evolution and course are usually those
of a personality disorder. It is more common in individuals with
relatives who have schizohprenia. The ICD-10 Classification of
Mental and Behavioural Disorders, pp 83-84.
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The theory of mind develops at the age of
Choose one answer.
a. 6 years
b. 4 years
c. 7 years
d. 3 years
e. 5 years
Theory of mind is the ability to appreciate that minds
contain mental states, e.g beliefs, desires, intentions and
to use this knowledge to predict another person's
actions. 'Theory of mind' studies have suggested that
children can take the perspective of another person at
about 4 years of age. Companion to Psychiatric Studies,
8th Edn, 2010, p 104.
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A 30 year old man sees a shadow of the tree in
the dark, and feels that a person is out to attach
him. This phenomenon is termed as?
Choose one answer.
a. Delusion b. Synaesthesia c. Pseudohallucination
d. Hallucination e. Illusion Illusion is transformation
of perceptions, coming about by a mixing of the
reproduced perceptions of the subject's fantasy
with natural perceptions. Illusions are
misperception of a real stimuli as opposed to
hallucinations which are perception without a
stimulus. Sims' Symptoms in the mind, 4th Edn, 2008,
p
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Tarasoff case is related to which of the following
Choose one answer.
a. Equality b. Consent c. Capacity d. Confidentiality e. Intelligence
The Tarasoff case is related to confidentiality about protection of
others. A brief summary of the Tarasoff case: A young man in the
University of California was infatutated by a fellow student called
Tatania Tarasoff.She rejected his attention and he subsequently
went to receive psychotherapy. During the therapy sessions, he
mentioned to his Therapist that he was planning to kill Tarasoff, and
that he wa splanning ot purchse a gun. Though the Therapist
recognised the danger posed by this man, and attempted to have
him admitted to a psychiatric ward, and broke confidentiality to
inform the police, they did not warn either Tarasoff or her relatives.
Two months later, the patient killed Tarasoff. The parents of Tarasoff,
took the Univsersity of California to court, and the court ruled that
clinicians had a duty to warn and otherwise protect third parties
potentially at risk from their patients. Turner M, Kennedy M. Tarasoff
and the duty to warn third parties. Psychiatric Bull 1997; 21: 465-466;
Companion to Psychiatric Studies, 8th Edn, 2010, pp 776-777
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25 year old man says that he can smell
music. This phenomenon is termed as?
 Choose one answer.
 a. Functional hallucinations b. Illusion c.
Synaesthesia d. Extra-campine
hallucinations e. Auditory hallucinations In
synaesthesia, a sensory stimulus in one
modality is perceived as a sensation in
another modality. Sims' Symptoms in the
mind, 4th Edn, 2008, p 109
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Which of the following can be used to test
constructional apraxia?
Choose one answer.
a. Rorschach test b. Luria test c. Stroop test d.
Serial subtraction e. Clock drawing test The
clock-drawing test is used for screening
cognitive impairment and dementia and as a
measure of spatial dysfunction and neglect. It
was originally used to assess visuoconstructive abilities. Agrel B & Dehlin O, The
clock-drawing test, Age and Ageing 1998; 27:
pp 399-403.
 Which
of the following drugs is linked with
Ebstein's anomaly?
 Choose one answer.
 a. Carbamazepine b. Sodium valproate
c. Topiramate d. Gabapentine e. Lithium
Lithium treatment early in pregnancy has
been associated with cardiac
abnormalitiesin the fetus, particularly
Ebstein's anomaly. Shorter Oxford
Textbook of Psychiatry, 5th Edn, 2006, p
524.
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A hospital manager is presenting data to a trust
board. He said murder of 2 hospitals instead of
merger of 2 hospitals. This is an example of which
of the following?
Choose one answer.
a. Parapraxis b. Perseveration c. Paragrammatism
d. Logoclonia e. Neologism Parapraxes are minor
errors, such as a slip of the tongue, thought to
reveal a repressed motive. It is the unconsciously
motivated lapse from logic. It is considered part of
normal thinking and is also known as freudian slip.
In this example, the hospital manager
unconsciously appears to not be in favour of the
'merger of 2 hospitals', hence the freudian slip of
calling it a 'muder of 2 hospitals'! Synopsis of
Psychiatry, 9th Edn, 2003, p 282.
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A 30 year old man who works full time at the local
council office has headache, abdominal pain and
dizziness. He feels tired and has a fever. Which of the
following is he displaying?
Choose one answer.
a. Illness behaviour b. Healthy behaviour c. llness d.
Sick role e. Abnormal illness behaviour In this
scenario, the person is displaying an illness. Sick role
concerns the social aspects of falling ill, including the
right to be exempt from social roles, and the
obligation to seek appropriate treatment to get well.
Illness behaviour refers to those behaviours that
individuals engage in once they believe that they
are ill. If the behaviours displayed by individuals who
are ill is not in keeping with what is expected, it is
termed abnormal illness behaviours. Companion to
Psychiatric Studies, 8th Edn, 2010, p 112.
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A man reported that while walking on the street
he hears voices immediately after hearing an
exhaust of a car. What is this phenomenon
referred to?
Choose one answer.
a. Thought broadcast b. Reflex hallucination c.
Thought echo d. Functional hallucination e.
Thought insertion In functional hallucination the
normal perception of the stimulus and the
hallucination occur in the same modality. In reflex
hallucination a stimulus in one sensory modality
produces hallucination in another modality. Sims'
Symptoms in the mind, 4th Edn, 2008, p 116.
2.
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The four principles of medical ethics are
Choose one answer.
a. Consent, Beneficence, Malificence and Justice
b. Autonomy, Beneficence, Confidentiality and Justice
c. Autonomy, Beneficence, Non-malificence and Legality
d. Autonomy, Non-beneficence, Non-malificence and
Justice
e. Autonomy, Beneficence, Non-malificence and Justice
The four principles of medical ethics are Autonomy,
Beneficence, Non-malificence and Justice Savalescu J et
al., Medical Ethics and Law: The Core Curriculum