Psychiatry exam for medical students, June, 2010

Name and surname:

Index No:

1. The correct statement is:

a) Data from informants are never important
b) Diagnosis in psychiatry is highly dependent on precise history and assessment
c) Diagnosis in psychiatry is highly dependent on laboratory and neuroimaging

2. if the patient is experiencing that people around him are talking about him, he is
experiencing:
a) religious delusions
b) somatic delusions
c) ideas of reference
d) olfactive halucinations

3. The correct statement is:

a) During the psychiatric interview examinator should consider age, education,
cultural background of the patient
b) During the psychiatric interview the examinator should only pay attention to sings
and symptoms
c) During the psychiatric interview the examinator must explain all of the symptoms
and signs observed

4. Sopor is a disorder of
a) Consciousness
b) Thought process
c) Perception

5. orientation is assessed according to:

a) time
b) place
c) persons
d) him/herself

6. Delusions (the correct answer is):

a) can always be corrected logically
b) are fixed false beliefs outside of patients culture
c) examinator should agree with the patients delusions to establish rapport

7. if the patient believes that “other people are trying to harm him” he is
experiencing
a) religious delusions
b) somatic delusions
c) paranoid delusions
d) grandiose delusions

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8. Give an example of grandiose delusions:
_____________________________________________________________________
_____________________________________________________________________

9. obsessions are:
a) disorders of perception
b) persistent, intrusive thoughts
c) always a sign of mental disorder

10. the correct statement is:

a) In depression patient often appears sad and quiet, but can also be anxious
b) In schizophreniaa he appears happy, full of joy, but can also be dysphoric, angry
c) In depression there can be inadequate affect

11. halucinations are:

a) disorder of attitude
b) false perceptions without a sensory stimulus
c) misinterpretations of a sensory stimulus

12. illusions are seen in anxious persons:

a) true
b) false

13. antipsychotic drugs are (the correct statement is):

a) only used in the treatment of schizophrenia
b) have no serious side-effects
c) ameliorate symptoms of psychotic disorders: hallucinations, delusions, bizarre
behavior, disordered thinking and agitation
d) never used in treatment of children and adolescents

14. parkinsonism is a consequence of

a) GABA receptor blockade
b) Elevated levels of prolactine
c) Dopamine receptor blockade
d) Anticholinergic effect

15. anticholinergic effects are:

a) amenorrhea, galacthorrhea, gynecomastia, impotence
b) orthostatic hypotension
c) agrannulocitosis
d) dry mouth, urinary retention, blurred vision, constipation, exacerbation of the
narrow angle glaucoma

16. Fever, extrapyramidal symptoms, delirium, autonomic instability, elevated WBC

and CPK are the symptoms of _________neuroleptic malignant
syndrome__________________________________

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17. Antidepressants are indicated only in major depression:
a) true
b) false

18. Plasma levels of lithium carbonate should be between ________________

19. during the treatment with valproate a doctor should check:

a) thyroid function
b) liver enzymes
c) renal function
d) white blood cell count

20. benzodiazepines act via the____GABA_________________ transmitter system

21. social skills training enhances:

a) the interaction between defense mechanisms
b) abilities in interacting with others and coping with everyday tasks
c) traits of the personality

22. concordance rates for schizophrenia in twin studies are (the correct answer is):
a) greater in DZ than in MZ twins
b) around 100%
c) lower in DZ twins than in MZ twins

23. Nigrostriatal pathway is important _______dopamine_________ system

24. Acetilcholine is important for _____cognitive____________ functions

25. delirium is:

a) syndrome characterized by: thought withdrawal, delusions ang hallucinations
b) a consequence of a medical condition, and therefore a medical emergency
c) none of the above

26. dementia:
a) can not be distinguished from mild memory changes in the old age
b) is an acquired syndrome of impaired memory and cognition
c) does not lead to the impairment of social functioning

27. The most common forms of dementia are:

______Alzheimer’s______________________ and
_____vascular___________________
28. Alzheimer’s dementia is a consequence of the deficit in
___cholinergic________________ transmition

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 29. Patient 33 years old, presenting with loosening of associations, believing that
people are plotting against him, experiencing that everybody is looking at him in
the street, convinced that the speaker on TV is “talking to him in a special way”,
hearing threatening voices, is probably suffering from
________________paranoid schizophrenia_______________________

30. predictors of a poor prognosis of schizophrenia are (correct answers are):

a) late onset
b) male gender
c) positive symptoms
d) negative symptoms
e) comorbid substance abuse
f) female gender
g) early onset
h) family history of schizophrenia
i) insidious onset

31. Treatment for the first episode of psychosis should last:

a) as short as possible, because of the serous side-effects of antipsyctotic drugs
b) at least 1-2 years
c) life-long

32. the patient presenting with non-bizare, well-systemized delusions, that involve
situations that could occur in real life, and that fit into a complex scheme that makes
logical sense to the patient is probably suffering from:___delusional
disorder_______________________________

33. the occurrence of tolerance and withdrawal should point a clinician to:
a) substance abuse
b) acute intoxication
c) substance dependence

34. recurrent substance use resulting in a failure to fulfill major role obligations at work,
school or at home; recurrent substance use in situations in which it is physically
hazardous (e.g. driving), recurrence substance-related legal problems, and continued
substance use despite having persistent social or interpersonal problems caused or
exacerbated by the effects of a substance (without other signs or symptoms). Should point
physician to:
a) substance abuse
b) acute intoxication
c) substance dependence

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35. maladaptive behavior, mood lability, impaired judgment, slurred speech,
incoordination, unstedy gait, nystagmus, spoor or coma, after the alcohol consumption
point to:
a) acute intoxication
b) dependence
c) abuse
d) withdrawal

36. dysphoria, nausea, vomiting, muscle aches, lacrimation, rhinorrhoea, pupillary

dilatation, sweating, yawning, insomnia, piloerection are the symptoms of heroin:
a) withdrawal
b) intoxication
c) abuse

37. maladaptive behavior, mood lability, impaired judgment, slurred speech,

incoordination, unstedy gait, nystagmus, spoor or coma, after the alcohol consumption
point to:
a) acute intoxication
b) dependence
c) abuse
d) withdrawal

38. sweating, tachycardia, tremor, insomnia, nausea, vomiting, visual, tactile or auditory
illusions and hallucinations, agitation, anxiety and seizures (not due to a general medical
condition) are seen in:__alcohol withdrawal, Delirium

39. myosis, drowsiness, sopor, coma, respiratory depression, hypotension are signs of
opiate:
a) withdrawal
b) intoxication
c) abuse

40. flashback can occur after the use of:

a) cannabis
b) glue
c) LSD
d) heroin

41. In treatment of depression the best effects can be achieved with:

a) antidepressants
b) psychotherapy
c) combination of antidepressant treatment and psychotherapy

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42. Bipolar disorder is often comorbid with:
a) depressive disorder
b) schizophrenia
c) alcohole and substance abuse

43. depression is more common in:

a) men
b) women
c) equally common in men and women

44. „Typical“ symptoms for a depressive episode are:

a) depressed mood, lack of energy, loss of interest, fatigue, social withdrawal
b) paranoid delusions, loosening of associations, hallucinations
c) insomnia, loss of appetite, tachycardia, sweating, shortness of breath

45. if a young male patient with the history of substance abuse and family history for
bipolar disorders is presenting for the first time with a severe depressive episode, the
history should be carefully taken inquiring for:
a) previous developmental disorder
b) complications at birth
c) previous episodes of hypomania
d) decrease in libido

46. According to ICD 10 specific developmental disorders of speech and language ,

specific developmental disorders of scholastic skills and specific developmental
disorder of motor function belongs to:
a) Behavioral problems In childhood
b) Disorders of Psychological Development
c) Specific developmental disorders

47. Disorders characterized by qualitative abnormalities in reciprocal social interactions

and in patterns of communication, and by a restricted, stereotyped, repetitive repertoire of
interests and activities are of clinical picture of disorders know as:
a) permanent
b) pervasive
c) prominent
d) Childhood autism

48. Autisms are severe impairment of developmental disorder which presents before:
a) age of 1 year
b) age of 2 years
c) age of 3 years

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49. The main marks of hyperkinetic syndrome are :
a) inattention
b) irritability
c) hyperactivity
d) distractibility
e) impulsivity

50. A tic is an ( mark appropriate definition):

a) involuntary, rapid, recurrent, nonrhythmic motor movement (usually involving
circumscribed muscle groups) or vocal production that is of sudden onset and that serves
no apparent purpose
b) nvoluntary, rapid, recurrent, nonrhythmic motor movement (usually involving
circumscribed muscle groups) and vocal production that is of sudden onset and that
serves no apparent purpose
b) involuntary, slow, recurrent, nonrhythmic motor movement (usually involving
circumscribed muscle groups) or vocal production that is of sudden onset and that serves
no apparent purpose
c) involuntary, rapid, recurrent, rhythmic motor movement (usually involving
circumscribed muscle groups) or vocal production that is of sudden onset and that serves
no apparent purpose