MCQ COLLECTION M AY2009

1. Males are superior to females in:

(a) Verbal reasoning
(b) Throwing accuracy
(c) Mathematical reasoning
(d) Recall of object locations
(e) Performance of spatial tasks
2. Which of the following is a neurotransmitter inhibited by Tetrahydrocannabinol:
(a) L-Glutamate
(b) GABA-A t
(c) Noradrenaline
(d) Dopamine
(e) 5-HT
3. Which of the following areas do not contain cannabinoid receptors: (cns; cb1 receptors are
expressed mainly in cns, lungs, liver, kidneys & endothelial cells, cb2 expressed mainly in immune
& hematopoetic cells)
(a) Respiratory tract
(b) Urinary tract
(c) Arteries
(d) Spleen t
(e) Heart ?t
4. About schizophrenia and weight gain in use of antipsychotics:
(a) Parents of patients with schizophrenia are more obese
(b) Older patients have a high propensity for weight gain
(c) Conventional antipsychotics cause up-regulation of Integrin α receptors
(d) Olanzapine causes down regulation of Integrin β receptors
(e) Haloperidol increases inhibitory effect of Prostaglandin C 1
5. Immature defense mechanisms include:
(a) Projection
(b) Hypochondriasis
(c) Acting out
(d) Sarcasm
(e) Avoidance
6. What feature of migraine distinguishes it from depression:
(a) Exacerbation following vomiting is often seen in migraine
(b) Diarrhoea is common in migraine
(c) Migraine occurs at least 5 times a month
(d) Migraine worsens after sleep
(e) Migraine is triggered by relief of
7. Bleeding abnormality occur as adverse effects in:
(a) Fluvoxamine
(b) Citalopram
(c) Fluoxetine t
(d) Paroxetine

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(e) Sertraline t

8. In selecting SSRI, the Cytochrome P450 inhibitors are:

(a) Moclobemide
(b) Paroxetine t
(c) Sertraline t
(d) Citalopram t
(e) Fluoxetine t
9. Features of juvenile Myoclonic epilepsy ( ans; myoclonic +/- absence, +/- tonic clonic)
(a) Mesial clonus
(b) Absence seizures t
(c) Generalized clonic-tonic seizures t
(d) Akinetic seizures
(e) Temporal seizures
10. Which of the following are true of prion diseases:
(a) Nucleic acid not needed for transmission
(b) Alpert’s syndrome usually begins at the 4th or 5th decade of life –f (alpert’s syndrome is
congenital)
(c) VCJD is rarely associated with blood transfusion
(d) Congo red is a known risk factor
(e) Dementia usually occurs in Gerstmann- Sträussler-Scheinker syndrome
31. About eating disorders :
(a) Nearly 50% of bulimia nervosa is preceded by anorexia nervosa
(b) Depression worsens the outcome of bulimia nervosa
(c) Prevalence of eating disorder is increased in females with depression
(d) Parotid hypotrophy occurs in bulimia nervosa
(e) Metabolic alkalosis is commoner than metabolic acidosis in bulimia nervosa
32. In Personality disorders, the following areas show decreased activity in harm avoidance
(a) Amygdala
(b) Insula
(c) Right orbitofrontal cortex
(d) Medial prefrontal cortex
(e) Anterior paralimbic circuit
33. Borderline Personality Disorder
(a) Prefers being alone
(b) Exhibits some macropsychotic symptoms
(c) Shows deviant response to WAIS
(d) Identity diffusion is common
(e) Often feel independent
34. In Hyperventilation:
(a) There is conscious control of respiration
(b) Respiratory acidosis is common
(c) Cerebral tissue PCO2 is increased

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(d) There is brain vasodilation

(e) Breathing into a plastic bag gives relief

35. In Fibromylagia
(a) Cervical areas are least affected by pain
(b) Thoracic areas are commonly affected by pain
(c) Commoner in males than in females
(d) Hardly occurs when there is Chronic Fatigue Syndrome
(e) Narcotic analgesics are preferred to NSAIDS
36. Common herbal preparation used in Psychiatric treatment
(a) Neem
(b) St John’s Worth
(c) Paw-paw leaf
(d) Mistletoe
(e) lemon
37. A 37 year old woman gave a testimony that she was carrying an 11 year old pregnancy in a
religious gathering. Which of the following would be absent in her:
(a) Amenorrhoea ? irregular menses
(b) Nausea in the morning t
(c) Breast enlargement t
(d) Areola pigment t
(e) Abdominal distension t
38. About Hormone Replacement Therapy and Psychiatry:
(a) Reduced oestrogen enhances sexual enjoyment
(b) Hypoestrogen reduces libido
(c) SSRIs work more with hormone replacement therapy
(d) Anti-dementia drugs are inhibited by hormone replacement therapy
(e) Androgen replacement reduces libido
39. Key features of secret cults
(a) Loose belief system
(b) Non-focused disorganized ideology
(c) Group cohesion
(d) Proselytizing among members
(e) Most members have identity and role confusion
40. In understanding suicide during economic meltdown, the most important concept
(a) Egoistic suicide
(b) Anomie
(c) Menninger retroflex homicide
(d) Narcissistic suicide
(e) Altruistic suicide
41. About Generalized Anxiety Disorder
(a) Females have more health seeking than males
(b) Males have more co-morbid Axis I disorders than females

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(c) The ratio of males to females is 1:1.2

(d) Serotonin Noradrenalin Re-uptake Inhibitors are not as effective as TCAs
(e) Does not usually occur in agoraphobic states
42. About the use of Carbamazepine in Bipolar Disorder
(a) More effective in mixed states
(b) Combined with lithium in refractory states
(c) Induces ataxia
(d) Rarely causes fatty liver
(e) Have been known to trigger the switch
43. In schizophrenia
(a) There is glutamate deficiency
(b) There is reduced phosphomonoesterase
(c) Phosphodiesterase is increased
(d) Gray matter to white matter ratio is reduced
(e) The putamen and caudate shrink
44. About Bipolar disorders:
(a) The ratio of depression to mania in Bipolar II is
(b) In younger persons depression is atypical in Bipolar I but not in Bipolar II
(c) Abrupt onset of the 1st episode of depression is a red-herring for Bipolar Disorder
(d) Dysthymic temperament is as important as Cyclothymic temperament as a risk factor
(e) Presence of psychosis in depression is an indicator of non-bipolar nature
45. In which of the following tests would you expect a person with schizophrenia to perform poorly?
(a) Wisconsin Card Sorting Test -true
(b) N-Beck Test
(c) Tower of London [test planning & pother executive fxn in brain[]left frontal] damage]
(d) Sentence Completion Test [intelligence]
(e) Weschler Memory Test[intelligence]
46. In prescribing psychotropic medications in psychiatry, the most important Cytochrome P450
system:
(a) 2D6 -true
(b) 2C19 ?true
(c) 4A2
(d) 3A4
(e) 1A2
47. In patients with poorly metabolize psychotropic medications, the following are preferred:
(a) Amitriptyline - true
(b) Venlaflaxine -
(c) Escitalopram
(d) Imipramine
(e) Citalopram
48. The following drugs used in clinical psychiatry should be avoided in slow metabolizers:
(a) Mitrazepine --t
(b) Thioridazine

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 MCQ COLLECTION M AY2009

(c) Risperidone
(d) Trifluperazine - ?t
(e) Olanzepine
49. In ADHD
(a) Hyperactivity is reduced in adults -true
(b) 0.7% progress from childhood to adults -false (40-60%)
(c) Non-verbal working memory is disrupted
(d) Verbal working memory appears intact
(e) Reconstitution is rarely involved
50. The major neurobiological correlates of ADHD are located in: (ans; frontal lobe , caudate
nucleus & cerebellar vermis)
(a) Prefrontal cortex
(b) Anterior cingulated gyrus
(c) Striato-insular thalom
(d) Caudate nucleus
(e) Globus pallidus
51. In dual diagnosis of schizophrenia and alcohol dependence, which of the following drugs are no
longer useful?
(a) Disulfiram
(b) Acamprosate
(c) Naltrexone
(d) Topiramate
(e) Olanzepine
52. In nicotine dependence occurring in patients with psychiatric disorder, the following neuroleptics
are usually avoided
(a) Thioridazine
(b) Trifluperazine
(c) Haloperidol
(d) Chlopromazine
(e) Thiothixine
53. Anxiety circuitry system include:
(a) Amgydala
(b) Orbitofrontal cortex
(c) Anterior cingulate
(d) Hippocampus
(e) Insula
54. The following neuropeptides are associated with anxiety disorders:
(a) Substance P
(b) Neuropeptide T
(c) Oxytocin
(d) Orexin
(e) Galamin
55. In the treatment of anxiety disorders, the following antidepressants are not recommended:

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 MCQ COLLECTION M AY2009

(a) Fluoxetine
(b) Sertraline
(c) Paroxetine
(d) Fluvoxamine
(e) Citalopram
56. The following anxiety disorders are more likely to respond to Buspirone:
(a) Panic disorders
(b) Obsessive compulsive disorder
(c) Post traumatic stress disorder
(d) Phobic anxiety disorder
57. The neurobiological basis of nicotine dependence mainly resides in:
(a) GABA
(b) Acetylcholine
(c) Glutamate
(d) Dopamine
(e) Noradrenaline
58. The following characterize nicotine withdrawal:
(a) Bradycardia
(b) Increased appetite
(c) Intermittent hypersomnia
(d) Very mild momentary mood elevation
(e)
59. Medications used in treating nicotine dependence include:
(a) Varenicline
(b) Clonidine
(c) Bupropion
(d) Clonazepam
(e)
60. The most important substrate of cognitive behavior therapy include:
(a) Basal ganglia
(b) Hippocampus
(c) Amygdale
(d) Frontal cortex
(e) Ventral tegmental area
61. A 27 year old man, presented to the psychiatric clinic with persistent erection, suspected to be a
spell cast by his unfaithful wife. The differential diagnosis include:
(a) Ventral septal defect
(b) Chronic asthma
(c) Leukemia
(d) Sickle sell disease
(e) Polycythaemia rubra Vera
62. The following are true of forced normalization
(a) Overdose of antiepileptic drug in patients with mental disorders F

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(b) Abrupt control of seizures in patients mental disorders F

(c) Normalization of EEG in the absence of psychosis F
(d) Alternative psychosis T
(e) Inappropriate combination of antiepileptic drugs and neuroleptics F
63. The major differences between intra-ictal psychosis and primary schizophrenia include the
following:
(a) Absence of negative symptoms T
(b) Better premorbid personality T
(c) Paranoid delusion T
(d) Delusion of reference T
(e) More benign but less variable course T
64. Factors or structures associated with depression in patients with epilepsy include:
(a) Frontal lobe F
(b) Temporal lobe T
(c) Vegetative auras T
(d) Non lateralizing effects F
(e) Early use of Phenytoin sodium F
65. The Geschwind Syndrome include:
(a) Viscosity T
(b) Tangentiality F
(c) Hyper-religiosity T
(d) Hypophagia F
(e) Extreme jealousy F
66. The main difference between vasovagal and cardiovascular syncope include the following:
(a) Recumbent position
(b) Following exercise
(c) Pain
(d) Fatigue
(e) Strong emotion
67. In apoptosis as opposed to necrosis that occurs in the brain, which of the following are present:
(a) Margination of normal chromatin
(b) DNA cleavage into nucleosomes
(c) Cell membrane integrity
(d) Phagocytosis with inflammation
(e) Plasma membrane blebbing
68. The following substances are associated with CVA
(a) Cocaine Hydrochloride
(b) Alkaloid cocaine
(c) Heroine
(d) Amphetamine
(e) LSD
69. The following occur in Locked-in Syndrome (n.b ; locked in syndrome- aka’ pseudocoma is a a
condition xterised by patient wakefulness & awareness but inability to move or communicate

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 MCQ COLLECTION M AY2009

verbally due 2 complete paralysis of all voluntary systems – sometimes sparing eye muscles with
intact cognition. Common causes are stroke,head injury, drug overdose, krait snake bite)
(a) Apparent coma -t
(b) Mutism - t
(c) Alertness
(d) Quadriplegia - t
(e) Extensor spasm
70. In frontal release in patients with cognitive disease, Myerson’s features include: ( n.b ; myeson’s
sign is + glabelar tap/reflex)
(a) Positive palmar grasp -f
(b) Positive snout reflex -f
(c) Negative rooting reflex -f
(d) Neutral suck reflex -f
(e) Equivocal palmomental reflex -f
71. The following are correct about Delirium Tremens:
(a) Occurs 24-36 hours after alcohol withdrawal
(b) Lasts for about 6 days
(c) Hypotonism in at least 30%
(d) Pyrexia is unusual
(e) Mortality rate is about 1.7%
72. The following is true of Cushing’s Syndrome
(a) Polycythmia
(b) Leucopenia
(c) Hypokalaemia
(d) Hypercalaemia
(e) Hyponatremia
73. The following are seen in Hypertensive emergencies:
(a) Retinopathy
(b) Aortic dissection
(c) Intracranial haemorrhage
(d) Acute left ventricular dysfunction
(e) CVA
74. About stroke and mental disorders:
(a) Left hemispheric CVAs cause more depression than those on the right
(b) Left frontal lobe brain injury causes more depression than the right
(c) Lesions in the right frontal area causes more severe depression
(d) Paranoia is unusual
(e) Somnolence rather than agitation occurs in females
75. Symptoms of Tardive Dyskinesia
(a) Athetosis
(b) Chorea
(c) Tics
(d) Rhythmic tremors

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(e) Myoclonus
76. Risk factors for Tardive Dyskinesia
(a) Females in the young age group
(b) ECT
(c) Negative rather than positive symptoms
(d) Presence of depression
(e) Cognitive dysfunction

77. In Parkinson’s Disease, Lewy bodies are found in the following

(a) Locus Coerulus -t
(b) Raphe nucleus -t
(c) Dorsal vagal nucleus -t
(d) Nucleus basalis -t
(e) Hypothalamus
78. The following occurs in Parkinson’s Disease:
(a) Nigral pallor -t
(b) Glial scarring
(c) Diffuse cortical atrophy
(d) Excess striatal input to globus pallidus
(e) Down regulation of D2 binding in the putamen
79. The following are correct about writer’s cramp:
(a) It occurs more in males than in females
(b) Onset is usually in the 2nd decade of life
(c) Affects mainly agonist muscles
(d) The forearm supinates
(e) Some muscle wasting occurs at the wrist
80. About Gilles de la Tourette Syndrome:
(a) IQ is normal
(b) Moderate motor abnormality occurs in the upper limb
(c) Dynorphin increases in the basal ganglia
(d) The CTscan but not the MRI is normal
(e) There is hypoperfusion in the basal ganglia
81. About essential tremors
(a) Onset is usually in the teen age -true [onset usually in adolescent or middle age]
(b) Legs tend to be involved first -false (rarely involve legs)
(c) It is autosomal recessive -true (50% chance of transmission of gene to offspring, but may
never experience symptom)
(d) Thalmotomy is unhelpful – false [thalamotomy & deep brain stimulation are reserved for
severe cases]
(e) Prolonged relief by alcohol is unremarkable -true
82. True or False
(a) Complex partial seizures arise from the medial frontal lobe
(b) Carbamazepine has the highest toxicity

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(c) Lamotrigine is not associated with Steven Johnsons’ Syndrome

(d) Prolactin levels are increased in Pseudo-seizures
(e) Valproic acid is contraindicated in child-bearing women
83. Peripheral vertigo
(a) Occurs intermittently – true []bppv; the archetype usully last about 1 minute]
(b) More disturbing than central
(c) No vertical nystagmus -true [vertical nystagmusm is a cerebellar, horizontal nystagmus is
vestibular]
(d) Often associated with hyper-reflexia
(e) Dysarthria is classical –false [speech is slurred in central vertigo]

84. Cerebral ataxia may manifest as:

(a) Hypertonia
(b) Terminal dysmetria
(c) Gaze paresis
(d) Asynergia
(e) Akinesia
85. Friedreich’s Ataxia
(a) Begins in childhood –true[ onset usually; 5-15yrs]
(b) Is autosomal recessive -true
(c) The neurons in Clark’s Column are preserved
(d) Knee and ankle tendon reflexes are exaggerated -false[deep tendon reflex are absent]
(e) Cardiomyopathy is unusual -false [can lead to cardiomyopathy, diabetes mellitus ]
86. About Papilloedema:
(a) Raised intracranial pressure with subarachnoid obstruction is a common cause
(b) Ophtalmoscopic changes develop over days or weeks
(c) In early phases retinal venous pulses are absent
(d) Temporal edges of the disk are the first to be affected
(e) Visual impairment is typical
87. Myasthenia Gravis:
(a) Occurs after 12 years
(b) Onset is often sudden
(c) Symptoms may be relieved by lithium
(d) Diplopia is rare
(e) Deep tendon reflexes are depressed
88. About Thalamic lesions:
(a) May lead to loss of touch sensation in the contralateral side
(b) May result in increased temperature sensation in the ipsilateral side
(c) Spontaneous pain in the ipsilateral side
(d) Dejerine-Rossy is Thalamic Syndrome
(e) Cutaneous stimulation rarely results in unpleasant sensation
89. True or false
(a) Organic peripheral sensory loss over the trunk do not extend to the midline

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(b) Non organic sensory loss commonly stops at the midline

(c) In psychogenic sensory loss, the transition to normal areas is blurred
(d) Loss of pin prick and preservation of temperature is unusual in psychogenic disease
(e) In organic impairment of posterior column, pseudoathethoid movement is common
90. In brain the circuitory of reward system
(a) Amygdala
(b) Caudate nucleus
(c) Hippocampus
(d) Entorrhinal cortex
(e) Cingulate cortex

91. Most likely to occur as a result of damage to the Orbitofrontal cortex

(a) Executive function impairment
(b) Poor decision making
(c) Mental inflexibility
(d) Impairment of intuitive reflexive social behavior
(e) Amotivation
92. The following chromosomes have susceptibility to schizophrenia
(a) 6p
(b) 10p
(c) 13q
(d) 18q
(e) 22q
93. About autism:
(a) The genes involved are located on chromosome 6
(b) Early development is normal in at least 40%
(c) Taking turns differentiates autism from Asperger’s Syndrome
(d) MRI shows frontal lobe enlargement
(e) The children are often attractive
94. About Mental Retardation:
(a) Peak incidence is 8 – 12 years
(b) Children with profound mental retardation have more psychopathology
(c) Prader–Willi Syndrome is often associated with weight loss.
(d) Sociability and social skills are often unimpaired in Downs’ Syndrome
(e) Seizures also occur in mental retardation with tuberous sclerosis
95. The following amino acids are implicated in Maple Syrup Urine Disease
(a) Pyruvic Acid
(b) Phenylalanine
(c) Leucine
(d) Isoleucine
(e) Valine
96. Which of these is used in Magnetic Spectroscopy:
(a) Iodine-123

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 MCQ COLLECTION M AY2009

(b) Technetium 99m

(c) Xenon 133
(d) T Lithiul
(e) 23Sodium
97. True or False
(a) 1st degree relations of Schizophrenia patients have 10% chance of schizophrenia
(b) Monozygotic schizophrenia twins have 50% concordance rate
(c) 1st degree relations of Bipolar I are 8x more likely to have mood disorders
(d) 90% concordance rate in monozygotic twins with depression
(e) 90% of patients with Tourettes disease have family members with the disease

98. Melanie Klein is associated with:

(a) Paranoid schizoid position -true
(b) Good breast -true
(c) Projective identification
(d) Natural idiom
(e) Objective psyche
99. A malnourished man with chronic disorder of alcohol use:
(a) Ipsilateral optic atrophy
(b) Gerstman’s syndrome
(c) Nystagmus
(d) Pseudobulbar palsy
(e) Anosognosia
100. The following is true of lithium:
(a) It undergoes significant first pass metabolism
(b) Highly soluble in lipid
(c) Not metabolized in the body
(d) Active blood brain barrier transport
(e) Excreted mainly through the lungs.

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