Download 1 - Palestine Medical Council

Candidate # (
)
February 2008
Palestine Medical Council Certificate
Examination
Specialty :psychiatry
Time Allowed :
3 hours
ANSWER THE FOLOWING IN FALSE OR TRUE
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1. The following Drugs are recognized to suppress enuresis:
A. Imipramine
B. Phenobarbitone
C. Methamphetamine
D. Propanthaline
E. Nortriptyline
2. in recurrent depression :
A. A common cause of death is suicide
B. A patient’s symptoms are likely to be worse in the early morning
C. There is a tendency for each recurrence to follow the same
clinical pattern
D. ECT is an effective treatment
E. Low urinary MHPG is often found
3. Agoraphobia is characterized by:
A. Panic attacks
B. Avoidance
C. Onset in teens
D. Frigidity
E. Dissociation
4. To be fit to plead the person :
A. Must be able to distinguish right from wrong
B. Must be able to instruct his defence counsel
C. Must be able to follow the progress of trial
D. Many still have delusions and hallucinations
E. May be subnormal
5. Sigmund freud wrote :
A. “beyond the pleasure principle”
B. “psychology of the unconscious”
C. “childhood and society”
D. “character analysis”
E. “Individual psychology”
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6. Long-acting depot neuroleptics :
A. are slowly absorbed ( or are long-acting ) because they are
deeply injected
B. by-pass first-pass metabolism in the liver
C. must be given with an anti-parkinsonian drug
D. are ineffective in the elderly
E. may be effective where oral neuroleptics are not
7. high suicide rates are more common in :
A. men than women
B. spring than winter
C. wartime than peacetime
D. catholics than protestans
E. single than married people
8. Morbid Jealousy is a recognized symptom of:
A. Schizophrenia
B. Manic depressive psychosis
C. Amphetamine addiction
D. Organic brain syndrome
E. Alcoholism
9. the following are typical features of bulimia nervosa :
A. powerful urges to overeat
B. an average age of 16 years for onset of binge eating
C. self-induced vomiting
D. low weight for age and height
E. fear of becoming fat
10. the following are characteristic of supportive psychotherapy :
A. exploration of the transference
B. reassurance for anxieties
C. the encouragement of regression
D. encouraging defensive organization
E. the exploration of dreams
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11. premature ejaculation is :
A. one of the easiest sexual problems to help
B. more likely to respond if a programmer includes the squeeze
technique
C. easier to treat when a couple have an otherwise satisfactory
relationship
D. treatable by the pause technique
E. a common sign of sexual deviation
12. A good prognosis in schizophrenia is suggested by :
A. an acute onset
B. the presence of affective symptoms
C. a family history of schizophrenia
D. the patient living with emotionally over-involved relatives
E. young age of onset
13. The Management of acute Schizophrenic episode in a 24 year old man
includes:
A. Screening for drug abuse
B. Assessing of suicide risk
C. ECT if catatonic symptoms predominate
D. Treatment with chlorpromazine rather that haloperidol
E. Individual psychotherapy
14. The following are found in the mid-brain :
A. dentate nucleus
B. corpora quadrigemina
C.
nucleus of the abducens nerve
D. red nucleus
E. nucleus of the oculomotor nerve
15. The following are part of the limbic system :
A. caudate nucleus
B. amygdala
C. mamillary bodies
D. median forebrain bundle
E. medial lemniscus
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16. Prevalence of the following is increased :
A. schizophrenia in urban areas
B. depression in a middle class suburb
C. suicide in rural areas
D. obsessional neurosis in high rise accommodation
E. epilepsy in prisoners
17. Klinefelter’s syndrome is :
A. commoner in females
B. chromatin positive
C. X-linked
D. Associated with sexual deviation
E. Typically seen in tall men
18. Characteristic features of alcoholic hallucinosis include:
A. chronic psychosis of at least two year’s duration
B. vivid visual hallucinations.
C. Auditory hallucinations
D. Clear consciousness
E. Paranoid delusions.
19. Neurotic disorders:
A. are usually associated with anxiety
B. can be effectively treated with psychotherapy
C. are rarely effectively treated with medication.
D. Are not caused by organic lesions
E. Can be extreme reaction of normal functions
20. The following findings emerged from the international pilot study of
schizophrenia:
A. present state examination can be used in English speaking
countries only
B. schizophrenia is diagnosed more frequently in Russia as
compared to England
C. Prognosis of schizophrenia is more or less similar in all countries.
D. First rank symptoms of Schneider do not occur in developing
countries.
E. Schizophrenia is predominantly a disorder of the developed
countries.
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21. The following statements about infantile autism are correct
A. was first described by krammer in 1943
B. about 4 in every 10000 children are affected by it
C. majority have normal or above average intelligence
D. low IQ sources are because of unwillingness to attempt the
task rather than low intelligence
E. child may b normal at birth and in the first year
22. Features of counter –transference could include:
A. always unconscious
B. may be experienced by patient
C. always a response to transference
D. may be positive or negative
E. does not occur in psychoanalysis
23. Side effects of lithium medication include:
A. reduced secretion of antidiuritic hormone
B. coarse tremor
C. weight loss
D. hypothyroidism
E. drowsiness
24. A delusion is:
A. sometimes expressed by a healthy person
B. usually absurd
C. culturally shared
D. often preoccupying
E. only adhered until contrary evidence is demonstrated
25. The following are at particular risk of alcoholism:
A. social workers
B. cooks
C. Jews
D. adopted children
E. the Irish
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26. Features of borderline personality disorder could include :
A. systematized delusions
B. projection
C. brief psychotic episodes
D. sublimation
E. ambivalent interpersonal relations
27. The following causes of mental retardation are inherited in an x-linked manner:
A.
B.
C.
D.
E.
the fragile X syndrome
tuberose sclerosis (epiloia)
hunter’s syndrome
lesch-nyhan syndrome
homocystinuria
28. The following statements about senile dementia of the Alzheimer type
are true:
A. symptoms of parietal lobe dysfunction indicate a good prognosis
B. it is the largest single cause of dementia in the elderly
C. it affects men more commonly than women
D. it is easily distinguishable pathologically from Alzheimer’s
disease of the presenium
E. choline acetyl transferase and acetyl cholinesterase levels are
reduced in the cortex and hippocampus
29. The following are tricyclic antidepressants:
A. trazodone
B. lofepramine
C. nomifensine
D. L-deprenil
E. Trimipramine
30. The following statements concerning the hyperkinetic syndrome of
childhood are true:
A. the diagnosis is more commonly made in the UK than the USA
B. hyperactivity specific to certain situations is a better
diagnostic criterion than generalized hyperactivity
C. methylphenidate has been used in treatment
D. growth retardation is a side effect of amphetamine treatment
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31. Brown’s work showed the following features to predispose women to
depression :
A. early maternal loss
B. present lack of a confidant or spouse
C. presence of young children below school age
D. poor housing
E. psychopathic presonality
32. disorders of thought from in schizophrenia include :
A. Overinclusive thinking
B. Delusions of grandeur
C. Delusions of persecution
D. Impaired abstract thinking
E. Ill-defined definitions of concepts
33. a deficiency of the following occurs in dementia :
A. Choline acetyltransferase
B. Dopamine
C. Adrenaline
D. Acetyl cholinesterase
E. Serotonin
34. Hypochondriasis :
A. Constitutes about 10% of psychiatric patients
B. Is most commonly seen in social class l
C. Has a better prognosis if it is secondary to depression
D. Affects both sexes equally
E. Is best treated with neuroleptics
35. In a skewed distribution :
A. The median commonly falls between the mean and the mode
B. Median, mode and mean are all equal
C. If positive, the mean has a greater value than the mode
D. Standard deviation can’t be used
E. If negative, the quartile Q3 minus Q2 is greater than Q2 minus
Q1
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36. Benefit from ECT is greater than with tricyclic medication when :
A. There is seizure
B. The voltage is high
C. There is early morning wakening
D. Delusions are present
E. There is diurnal variation in mood
37. The following may occur in normal persons :
A. Deja-vu
B. Depresonalisation
C. Hypnagogic hallucinations
D. Somatic passivity feelings
E. Thought blocking
38. Morbid anxiety can be reduced by :
A. Drugs
B. Implosion
C. Modelling
D. Aversion therapy
E. Group therapy
39. The following associations are correct :
A. Schizophreniform psychosis : Kasanin
B. Schizo-affective psychosis : Langfeldt
C. Dementia praecox : Bleuler
D. Schizophrenias : Kraepelin
E. Schizophrenia spectrum disorder : Kety
40. In normal distribution :
A. 95% of the population lie within two standard deviations on
both side of the mean
B. 68% of the population lie within two standard deviations of the
mean
C. the mean is equal in value to the mode
D. the median is equal in value to the mode
E. the standard deviation is equal to the variance
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41. In the postpartum period :
A. the treatment of psychosis is deferent from psychotic illness
at other times
B. psychosis begins within 3 months in 80% of cases
C. the risk of recurrence in future pregnancies is 1 in 5
D. cerebral thrombo-embolic lesions may present as psychosis
E. transient weepiness is common in the first week
42. Hallucinations may occur in :
A. acute confusional states
B. hysteria
C. drug withdrawal
D. petit-mal epilepsy
E. anxiety states
43. Delusions
A.
B.
C.
D.
E.
:
are held with a certainty that may be shakeable
are reality for the patient
are frequently held by other people
are rarely of personal significance
are usually of a bizarre nature
44. Associatation of morbid jealousy may include :
A. personality disorders
B. schizophrenia
C. manic-depressive psychosis
D. obsessional neurosis
E. hysteria
45. Obsessional rituals :
A. are recognised as ridiculous by the patient
B. are ego-alien
C. commonly involve the theme of dirt
D. are repetitive
E. if resisted lead to relaxation
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46. Symptoms of depression may include :
A. hypersomnia
B. fugue
C. ideas of reference
D. facial pain
E. obsessionl \ compulsive symptoms
47. Recognized adverse effects of benzodiazepines include :
A. aggressive outburst
B. dependence
C. ataxia
D. sleep waking
E. gum hyperplasia
48. Recent trends in drug abuse show that :
A. smoking marijuana leads directly to narcotic abuse in most
cases
B. in studies on Vietnam veterans most heroin users will abstain
with change in circumstances
C. there is a decreasing amount of polydrug abuse
D. smoking heroin has become increasingly popular
E. parental alcohol abuse is associated with adolescent drug taking
49. Dissociative states :
A. occur in hysteria
B. may be seen under hypnosis
C. include fugue states
D. exclude multiple personalities
E. are seen in petit-mal seizures
50. Depression may present as :
A. hysterical conversion
B. schizophrenia
C. an anxiety state
D. shop-lifting
E. hypochondriasis
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51. The following drugs are effective in the treatment of mania :
A. promazine
B. haloperidol
C. lithium carbonate
D. imipramine
E. chlordiazepoxide
52. The psychopathic personality :
A. responds well to psychiatric treatment
B. is characterized by persistent aggressive
behaviour
C. tends to diminish with age
D. leads to failure to establish loving relationships
E. never occurs in those with high IQ
or
53. First rank symptoms of schizophrenia :
A. are always pathagnomonic to schizophrenia
B. include 2nd and 3rd party hallucinations
C. incorporate all passivity phenomena
D. exclude formal thought disorder
E. include incongruity of affect
54. Features of Alzheimer’s disease may include :
A. onset at age 60-70 years
B. amnesia is rarely the first symptoms noted
C. EEG change usually seen in late stages of illness
D. Marked loss of verbal skills on wais
E. Psychotic features
55. Flooding :
A. Occurs only under hypnosis
B. Is used in treating obsessive ruminations
C. Is useful in specific phobias
D. involves unpredictable presentation of phobia stimuli
E. Is also known as a flash back
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antisocial
56. Akathisia :
A. Is typically associated with malingering
B. is appropriately treated with diazepam
C. is usually enjoyable to the patient
D. is a recognized side effect of phenothiazines
E. only involves the lower limbs
57. Counter-transference :
A. is caused by unresolved oedipal conflicts in the patient
B. is characterized by hostility towards the therapist
C. when recognized helps the therapist to interpret the patient’s
experiences
D. only occurs in the psychoanalytic setting
E. should be ignored as far as possible
58. Diazepam :
A. has an hypnotic effect
B. has an anticonvulsant effect
C. has an antidepressant effect
D. releases aggressive impulses
E. is a respiratory depressant
59. An organic basis for mental disturbance is suggested by :
A. concrete thinking
B. altered level of consciousness
C. derealisation
D. verbal I.Q. greater than performance I.Q.
E. delusions
60. Briquet’s syndrome :
A. describe delusions of infidelity
B. is a somatisation discover
C. include auditory hallucinations
D. often leads to frequent admissions
E. has a good prognosis
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