MCQ

Psychiatry Year 5 2009/2010 FPSK

USIM
1. The following are true regarding poorer
prognosis of major depressive disorder
A.
B.
C.
D.
E.

Previous history of similar episode

Dysthymia continues after remission
Good family support
Presence of personality disorder
Patient with chronic general medical
illness

2. The following are true regarding postnatal

depression
A.
B.
C.
D.
E.

Incidence of 0.2%
Presence of heat intolerance
Vegetative symptoms
Onset at 3 days after delivery
Past history of similar incidence

3. Characteristics of social phobic disorder are

A.
B.
C.
D.
E.

Fear to be scrutinized
Fear to be seen in public e.g. at parties
Absence of avoidance
Repetitive behaviour
Fear to speak to an audience

5. The following are true regarding posttraumatic stress disorder

A. Onset is 2 days to 4 weeks after the
event
B. Characterized by intrusive flashback
C. A persons vulnerability predisposes to
the occurrence
D. Can experience PTSD after being told
of the event
E. Comorbid with depression is rare
6. Delusion is a belief which
A. Is not true to a fact
B. Cannot be corrected by an appeal to
reason of the person entertaining to it
C. Out of harmony with an individuals
education and surroundings
D. Is a disorder of the contents of a thought
E. Invariably occurs secondary to
hallucination
7. The common defense mechanisms in
delusional disorder are

A.
B.
C.
D.
E.

Denial
Suppression
Reactive formation
Sublimation
Projection

8. Below are auditory hallucination

A.
B.
C.
D.
E.

Thought echo
Autism
Ambivalence
Thought withdrawal
Looseness of association

9. The following are true about auditory

hallucination
A. Commentary auditory hallucination
points towards schizophrenia
B. Hallucination is disturbance of
perception in absence of external
stimulus
C. Pseudohallucinosis is the same as
imagination
D. Hypnopompic hallucination occurs at
the point of falling asleep
E. 3rd person auditory hallucination refers
to the patient as he/she.
10. The epidemiology of personality disorder
A.
B.
C.
D.
E.

Antisocial is more common in prison

Narcissistic is more common in women
Borderline is equal in both sexes
Avoidant is more common in females
Dependent is equal in both sexes

11. The following are features of histrionic

personality
A.
B.
C.
D.
E.

Sexually seductive
Attention seeking
Self-dramatization
Impulsivity
Recurrent suicide attempts

12. The following are true of obsessivecompulsive disorder

A.
B.
C.
D.

Compulsion is a useful action

Distressing thoughts
Excessive doubt
Acute onset

E. Irresistibility
13. The following are true regarding neurosis
A. Precipitants are normal life stressors
B. Prevalence twice in males than females
C. Abnormal symptoms in form of
intensity
D. No impairment in reality testing
E. They are formal thought disorders

19. The following are true regarding delirium

tremens
A.
B.
C.
D.
E.

Hypokalaemia
Hypomagnesaemia
Excessive sweating
Drowsiness
Hunger

20. The features of Alzheimers dementia are

14. The following are true regarding neuroleptic
malignant syndrome
A. Symptoms include muscular atony
B. Females are more affected than males
C. Mortality rate is 20%
D. Can be treated with amantidine
E. Commonly due to atypical
antipsychotics
15. The following are first rank symptoms
A.
B.
C.
D.
E.

Poor empathy
Autism
Ambivalence
Somatic passivity
Delusional perception

16. Good prognostic factors in schizophrenia are

A.
B.
C.
D.
E.

Strong family history of schizophrenia

Not in a personal relationship
Insidious onset
Withdrawn or eccentric personality
Identifiable precipitating factor

17. Characteristic symptoms of Korsakoffs

psychosis
A.
B.
C.
D.
E.

Catatonia
Confabulation
Disorientation of time
Echolalia
Narcolepsy

A.
B.
C.
D.
E.

Atrophy of the brain

Narrowed sulci
Enlarged ventricles
Decreased gliosis
Neurofibrillary tangles

21. Suicide risk is higher in

A.
B.
C.
D.
E.

Female
Person with histrionic personality
Adolescent
Patient with good support services
Schizophrenia

22. Suicide in elderly is

A. More common compared to middle age
B. More common in females
C. Associated with the presence of
physical illness
D. High in those living in adverse
conditions
E. Less common in married persons
23. Drug dependence of morphine
A. Tendency to decrease dose
B. Presence of auditory hallucination
C. Can be divided into physical and
psychological dependence
D. Causes brain damage
24. Characteristics of opiate withdrawal

18. The following are antipsychotics

A.
B.
C.
D.
E.

Haloperidol
Risperidone
Benzhexol
Chlorpromazine
Olanzapine

A.
B.
C.
D.
E.

Constipation
Rhinorrhoea
Hunger
Mydriasis
Piloerection

3.
4.
25. Side effects of SSRI are
A.
B.
C.
D.
E.

Nausea
Insomnia
Sexual dysfunction
Precipitation of manic symptoms
Headache

27. Behavioural therapy can be used for

A.
B.
C.
D.
E.

Disturbed manic patients

Residual schizophrenia
Catatonic schizophrenia
Premature ejaculation
Anorexia nervosa

28. Indications for electroconvulsive therapy are

A.
B.
C.
D.
E.

GAD
Bipolar mood disorder
Catatonic schizophrenia
Major depressive illness
Autism

29. The following are antiparkinsonism drugs

A.
B.
C.
D.
E.

Aripriprazole
Orphenedrine
Benztropyl mesylate
Procyclidine
Phenelzine

Other history to diagnose patient (5m)

Choose one diagnosis and suggest its
treatment (2m)

Essay (Choose 3 out of 5, and then pray)

1.
2.
3.
4.
5.

ADHD (5m)
Rehabilitation for schizophrenia (5m)
Postpartum psychosis (5m)
Management of anorexia nervosa (5m)
Complications of alcohol dependence
(5m)

MCQ Psychiatry Year 6 2010/2011 FPSK

USIM
1. Effects of lithium toxicity
A.
B.
C.
D.
E.

thyrotoxicosis
tinnitus
hypotension
tardive dyskinesia
choreiform movement

2. Multi-infarct dementia usually present in

A.
B.
C.
D.
E.

depression
personality disorder
disturbance of global functions
insidious in onset
labile mood

3. The following are good prognosis in

schizophrenia

30. Drugs that cause hyperprolactinaemia

A.
B.
C.
D.
E.

CPZ
Lithium
Haloperidol
Risperidone
Midazolam

A.
B.
C.
D.
E.

lack of precipitating factor

insidious onset
good premorbid personality
presence of affective symptoms
family history of schizophrenia

4. The following are true regarding culturebound syndromes

PMP Psychiatry Year 5 2009/2010 FPSK USIM
Ahmad , a 19-year-old unemployed Malay man,
presented with a three-day history of disturbed
and aggressive behaviour at home. He was
paranoid of his father, slept poorly and depressed
when his fianc died two months ago. Ahmad
also took ecstasy pills for six months.
1.
2.

A. automatic obedience occurs in Lata

B. in Piblokto, the sufferers jump into the
cold water.
C. Koro is associated with unresolved
oedipal complex.
D. Susto involves mutation into
cannibalistic monster.
E. Windigo is described as soul loss.

State possible differential diagnoses and

their reasons (6m)
State one investigation and its reasons
(2m)

5. Features of borderline personality disorder

include
A.
B.
C.
D.
E.

transient mild psychotic episode

exaggerated expression of emotion
feeling of emptiness
extreme devaluation
self-importance

6. In mental retardation
A. majority of cases belong to profound
group
B. in profound severity, IQ ranges between
20-34 chromosomal abnormality is one
of the causes
C. pharmacological treatment has minimal
role
D. the diagnosis requires onset during
childbirth

A. tactile hallucination is commonly found

in schizophrenia
B. it is a form of perception in an absence
of stimulus in external objective space
C. voluntary in nature
D. good prognosis for schizophrenia
12. Formication
A. is characteristic of organic psychiatric
condition
B. is present in marijuana abuse
C. it is a feeling of small insects crawling
under the skin
D. is not responsive to antipsychotic
treatment
E. is treated along with withdrawal
symptoms of substance
13. The following are true regarding delirium
tremens

8. The following are true regarding akathisia

A. internal feeling of restlessness
B. is partially relieved by pacing
C. is caused by chronic use of
benzodiazepines
D. is less with clozapine
E. is alleviated by beta blockers
9. The following are true regarding abnormal
movement
A. mannerism is non-purposeful movement
B. tics is involuntary muscle twitching
C. spasmodic torticollis is twisting of head
and neck due to muscle spasm
D. echopraxia is a person imitating the
movement of another person
10. Features of pathological grief
A. behaviour resembles that of the dead
person
B. searching behaviour of the deceased
person is common
C. hallucination is one of the
characteristics
D. presence of insomnia indicates anxiety
E. low mood persists for more than 6
months
11. The following are true regarding
hallucination

A. commonly occurs due to abstinence on

5th day
B. associated with visual hallucination
C. crawling of insects under the skin
D. is one of the severe withdrawal
symptoms of amphetamines
E. profound gross tremors
14. The following are true regarding fetal alcohol
syndrome
A. occurs in social alcohol drinkers during
pregnancy
B. cause low birth weight baby
C. cause restlessness after birth
D. cleft palate
E. high intelligence baby
15. The following are true regarding anxiety
disorder
A.
B.
C.
D.

best treated with antipsychotics

rare psychiatric disease in communit
maintenance treatment with anxiolytics
responds to antidepressants

16. Psychotic disorders secondary to general

medical conditions more likely to have
A.
B.
C.
D.

prolonged prodormal phase

visual hallucination
grandiose delusion
olfactory hallucination

E. worse in the evening

17. The following are true regarding formal
thought disorder
A.
B.
C.
D.
E.

PSYCHIATRY 2012/2013 (SET 1)

MCQ
1.

incoherence
derailment
thought withdrawal
thought echo
confabulation

18. The following are true regarding cognitive

functions
A. disorientation of time earliest of three
components
B. know name of recent PM is test for
recent memory
C. similarities between different objects
test for abstract thinking
D. backward counting 20 to 1 is test for
concentration
E. understanding proverb is a sign of
general intelligence

2.

The exercise of serial 7 to test for

a)attention
b) conceration
c)orientation
d) memory
e) insight

3.

Regarding Schneider's First Rank

Symptoms.
A. though echo
B. ambivalent
C. aggresive
D. Auditory hallucination
E. Looseness of association

4.

The following statements are true about

Manic Features
A. Irritability
B. Autistic thinking
C. Loosening of association
D. Social anxiety
E. Infectious jollity

5.

Passivity phenomenon.
A. made action
B. sense of mood of being controlled
C. delusional of control

6.

BDZ side effects

A. overdose can be lethal
B. Delirium in elderly
C. reduce anxiety

7.

Which are true regarding Sexual

disorder :
A. SadismB. PhedophiliaC. VayorismD. Exhibition-

19. Delirium in elderly

A. is caused by a small number of general
medical conditions
B. is gradual in onset
C. is a disturbance of consciousness
D. tend to have sundowning pattern
E. is a reversible condition
20. The following are true regarding personality
disorders
A. more common in women
B. in men occurs at later stage compared to
women
C. more reliable diagnosis made after
teenage years
D. is a component of Axis II
E. best treated with psychoeducation

1.SSRI medication (antidepressant):

a) Paroxetine
b) escitalopram
c) apipripazole
d) Ariprazole
e) mitrazapine

E. Necrophilia-

OBA :

8.

Illusion
A. Disorder of misinterpretation
B. Occur in delirium
C. Is a Schneiderian 1st rank
symptoms
D. Indicate patient is not in reality
E. Is a perceptual disturbances

9.

Anti social personality disorder

A. Impulsiveness
B. Deceitful
C. Persistent irresponsibility

1. 30 year old malay gentelman was brought in

due to aggresive behaviuor. he had behavioural
changes since 10 years ago. He had talking to
himself, wandering around, poor self hygiene
and hoarding old unused things in his house. 1
mo ago he complained that the neighbour are
trying to harm him. he believe that he had special
powers to heal people. Family members had
brought him to hospital several times for
treatment. He stopped taking medication once he
felt he was normal. what is the diagnosis?

10. Delusional Disorder

A. Bizarre
B. Well-systematic delusion
C. Impaired function
D. Prominent hallucination
11. Which are antipsychotic medication:
A. Quatiapine
B. Clozapine
C. Olanzapine
D. Benzhexol
E. chlorpromazine
12. Alcohol withdrawal:
A. Sedation
B. Psychomotor retardation
C. Sweating
D. Tremor
E. Delirium
13. Indication for ECT:
A. Chronic schizophrenia
B. Resistant mania
C. Subnormal intelligent
D. Post-partum blue
14. Hallucination
A. Occurs in normal person
B. Occurs in absence external stimuli
C. Occurs in conversion disorder
D. Auditory hallucination present as
thought echi
E. Occurs in cerebral lupus

a.Bipolar mood disorder

b.Paranoid personality disorder
c.Schizophrenia
d.Schizotypal Personality disorder
e.Schizoaffective Personality disorder
2.

Bipolar type 2 is
A. Depressive phase
B. Depressive and manic
C. Depressive and hypomanic

3.

Early side effect of lithium

A. Course tremor
B. Hypothyroidism
C. Edema
D. Tardive dyskinesia
E. Fine tremor

4.

My head is red. I have a cat. My bed is

wet
A. Clang association
B. Looseness of association
C. Rhythm
D. Panning

5. Miss A presented with GAD symptoms. What

would be the drug of choice?
(Venlafaxine)
6. 39 years-old housewife with five children
diagnosed with Bipolar Mood Disorder after the
birth of her first child. She had frequent relapse
due to non-compliance to her medication.
Below are the effect towards her children except
:
A. Behavior stealing and lying
B. Child abuse
C. Learning difficulty

D. School refusal
E. Symptoms of depression
7.what can reduce the negative symptom in this
chidren with mother who was diagnosed with
bipolar 1 disorder and not well controlled.

employment program. He is only watching

television at home currently. During the
interview, his mother helped him to answer most
of the questions. His mother was not keen for his
to work as she worries he will distressed.
What is the component of her high express
emotion?

A. had good attachment with father

B.healthy father
C.go to playground with father
D.father do single parenting
E. good financial support
11. A 32 year old teacher was unhappy with her
transfer to a new school in Sabah 3 years ago.
She blamed lack of basic amenities such as clean
water and electricity as her main reason to
transfer back to previous school in Kuala
Lumpur. She experienced difficulty in sleeping,
weight loss, palpitation and lethargy. She also
lost the pleasure of teaching, only prefer to teach
Art subject, before she likes to teach science and
mathematics. Each day, she dreaded to school,
prefer to stay in hostel than meeting people. She
feel inadequate and inefficient as teacher.
What is her diagnosis?
A. Adjustment disorder
B. Acute stress reaction
C. Dysthmia
D. Major depression disorder
E. Social phobia
12.the best method to treat her is
a. cognitive therapy
b. supportive therapy
c. antidepressants
d. hypnotics
e. transfer to another school
13. Mr Tan openly declared that he will not
employ anyone with psychiatric problem to work
in his restaurant. He believes that someone with
psychiatric illness is not able to work properly.
What is being demonstrated by Mr Tans
behavior?
a.
b.
c.
d.
e.

Bias
Discrimination
Generalized
Stigma
Stereotypes

14. Mr Y, a 35 year old man diagnosed with

schizoprehia was assessed for supported

A.
B.
C.
D.
E.

Authorization method
Harsh parenting
Critical comment
Hostility
Overinvolvement

15. This high express emotion will

A.
B.
C.
D.
E.

influence his compliance to medication

increase his relapse
increase insight
predict poorer outcome
improve his skill

16. 38 years old forest worker was brought in

with history of nonsence speaking, reduce of
cencentration and sleeping disturbance. He also
complained of fever and bilateral perietal
headache. He came back from forest camping
one week ago. On examination, he was febrile,
had short attention span and was disorientatied
with time and place. His speech was sometimes
irrevent. There was right oculomotor palsy. What
is the most suitable diagnosis?
A) Brief pyschotic disorder
B) Schizophrenia
C) Delirium secondary to encephalitis
D) Drug-induced psychosis
E) Schizophreniform disorder
17. 25 years old mother reported frequent
thought of strangling her 2 years old child. Each
episode caused palpitation, sweating and she was
driven to consciously cleaning her specticular
glasses claming that would drag her from the
unwanted thoughts and giveing her a sense of
relief. She admitted that she loved her child and
would never commited such act. She had a
feeling of loosing control and going crazy.
What is the diagnosis?
A) Panic disorder
B) Generalized anxiety disorder
C) Obsessive-Compulsive Disorder
D) Delusional disorder
E) Schizophrenia

18. What is most suitable psychological

treatment for the above senario?

him infertile as he felt his private parts

being pulled several times. His father
noted that he was not sleeping well and
talk to himself. He also neglected his
hygiene for the past 6 months. MSE
revealed a uncooperative and hostile
man with poor personal hygiene and
was preoccupied with his thoughts. He
has no insight. Laboratory
investigations and physical examination
was normal.
a. Give 4 psychopathological features.
b. Give 3 differential diagnoses.
c. What is your provisional diagnosis.
give 2 reasons.
d. what are 3 principle management
in treating this patient
e. Name one pharmacological agent
useful in the treatment of this
patient.

A) Supportive psychotherapy
B) Explosure and respond prevention
C) Psychodynamic psychotherapy
D) Family therapy
20.patient with history of aggressive behavior,
refuse to take oral treatment. what to do?
a. continue persuade the patient to eat meds
b.physical constraint until patient to eat meds
c.nursing at isolation room
d.sedate with IM injxn
e.tell patient that under law he cannot refuse
treatment
KFQ Psychiatry Sem 2 (2012/2013)
1. Miss F presented with low mood, loss of
appetite, sleep disturbance for 8 weeks duration
after her father died of pancreatic cancer. She felt
guilty for unable to do things for her father. She
occasionally heard his fathers voice and felt that
her father was around her.

3.

28 yo lady,sent to hosp by office mates.

6 months office work affected affected.
Said other office mates spread rumour
about her affair with boss. Said boss
madly in love with her and send love
messages by wavelength that made her
difficult to concentrate. Boss and others
denied all of the allegations. She said
that due to her affair, she was pregnant
6 month, could feel fetal movements.
Thinks that people far away in London
can hear her thoughts.
a. Give 5 psychopathological features.
b. Give 3 differential diagnoses.
c. What is your provisional diagnosis.
give 2 reasons.
d. what are 3 principle management
in treating this patient
e. Name one pharmacological agent
useful in the treatment of this
patient.

4.

56 year old, palpitation, tremor,

sweating, worried about daily activity.
a. Give 3 Differential diagnosis
b. Provisional diagnosis- GAD
c. Management
d. Medication use to treat

a. Give 2 differential diagnoses (2 marks)

b. 2 other relevant histories that you would like
to clarify to come to diagnosis. (2 marks)
c. 2 psychotherapy you would like to offer to
her. (2 marks)
She declined the psychotherapy. She come back
from oversea after 4 months and complained of
low mood, anhedonia, guilt, low energy, cannot
concentrate and she believed that she has
pancreatic cancer but investigation result missed
that. She would go die if she confirm that she has
pancreatic cancer.
d. What is her diagnosis? (2 marks)
e. What are the type of medication and name the
example. (4marks)
Type
2.

Example
A36-year old single male was brought
into the Psychiatry clinic by his father
after he assaulted his neighbour. He
claimed that his neighbour wanted to
kill him by blowing radioactive material
into his house. He knew this because
the TV newscaster was talking about it
for the past few months. He also
thought his neighbour wanted to make

Psychiatry exam questions 2012-2013 (SET 2)

a.
b.
c.
d.
e.

MCQ
1.

2.

Tactile hallucination
a. Occurs in cocaine abuse
b. Alcohol withdrawal
c. Alcohol intoxication
d. Cannabis intoxication
e. TLE
Delusional perception
a. Diagnostic of schizophrenia
b. Criteria in 1st rank
c. Frequently occurs in
schizophrenia
d. Frequently occurs in BMD
e. Secondary to visual
hallucination

Clozapine
Lorazepam
Lithium
Haloperidole
Amitriptaline

8.

Violence is associated with

a. GAD
b. Antisocial personality
c. Catatonic feature
d. TLE
e. Depression

9.

Bipolar in manic phase

a. Has history of stressors
b. Has history of hypomanic
c. Cannabis used
d. Irritable symptoms

10. Psychosexual disorder

3.

Depressive illness
a. Diurnal variation
b. Anhedonia
c. Blunted affect

a.
b.

4.

5.

6.

7.

Suicide and suicidal attempts

a. Asking about it will increase
the risk for the patient to
attempt the suicide
b. Talk about suicide in not a
serious matter
c. Associated with O trait
d. Increase risk in patient with
history of previous suicide
attempt
e. Increase risk in highly
educated schizophrenic patient
Differences between organic and
functional disorder
a. Dysphagia
b. Orientation
c. Poor memory
d. Inability to do serial sevens
e. Vivid visual hallucination
Differences between Senile dementia
and multiple infarct
a. Mood lability
b. Focal neurological sign
c. Cannot perform serial of
sevens
d. Memory loss
e. Time of onset

c.
d.
e.

Vaginism: involuntary muscle

spasm of the outer third of
vagina
Transexuality: the person feels
transsexual arousal by cross
dressing
Fetuism: sexual arousal
through inanimate object
Sadism: sexual arousal by
inflicting pain to their body
Gender identity: sexual desire
towards same gender

11. Side effect of medications

a. Clozapine: metallic taste
b. Diazepam: convulsion
c. Amitriptyline:
12. Drugs that can cause or exaggerate
seizure in ECT
a. Chlorpromazine
b. Amitryptiline
c. Fluoxetine
d. Haloperidol
e. Lithium
13. Prognostic factors of schizophrenia
a. Absence of family history of
mood disorder
b. Absence of family history of
schizophrenia
c. High intellectual
d. Absence of stressor
e. History of affective disorder

Medication for panic disorder

a.
b.
c.
d.
e.

14. Addiction is characterized by:

a. Cannot recover after
methadone
b. Chronic and relapsing
7.

Female, young, has sx of anxiety like

afraid of going crazy, continuous
palpitation. Dx?
a. Impending panic attack
b. Panic disorder without
agoraphobia
c. GAD

8.

Hearing voices for 2 years. Parents

brought to traditional healer. Why do
you think the parents delay the
treatment for their son?
a. Medication is not effective
b. Negative labeled to PSY
illness
c. Traditional medications are
effective
d. Patient does not trust with the
medications available

9.

Short term for family counseling. The

best method is?
a. Supportive management
b. Education
c. Dream analysis
d. Force association
e. Change

OBA
1.

Scolded by his father than the patient

verbally abused his mother. Defense
mechanism?
a. Sublimation
b. Projection
c. Regression
d. Reactive formation
e. Displacement

2.

Mr R. 46 y/o. dx: schizo. Seen sitting

around the house. This can be
attributed:
a. Delusion
b. Depression
c. Hallucination
d. Negativism
e. Side effect of medication

3.

45 y/o male, low mood insomnia and

anhedonia. Can be due to
a. Hypothyroid
b. Cushing s dss
c. Burelleosis
d. Addison dss
e. All of the above

4.

NMS, presented with

a. Hyperthermia
b. Muscle flaccidity
c. Leukopenia
d. Pulse rate changes
e. Fluctuate consciousness

5.

Characteristic of sleep
a. The length differs according to
the age
b. Good sleep is important to
prevent psy illness
c. Mind is active during deep
sleep
d. It is psychological and
behavioral phenomena
e. Absence of wake fullness

6.

47, Male, presented with bilateral

involuntary chorea. PE: normal
findings. Ix that should be done

MRI
VDRL
History from care taker
CT brain
Blood IX

10. PE reveals: pupil dilated, can

accommodate, not reactive to light,
irregular margin. Cause:
a. Opioid withdrawal
b. Opioid intoxication
c. Canabies
d. Hemosyphilis
PMP
Trigger 1
20, male, malay. Brought in d/t aggressive
behavior. Presented with:
Hearing voices instructing him
Can see his cousins house in kota
kinabalu
Feels like friends want to do harm to
him
Untidy appearance, sitting on the chair
rocking to and fro
Speech could not understand

10

Speech change from one topic to

another

1.
2.

List 4 differential diagnosis

Six psychopathology and explanation
(from text)
Six history want to obtain and reason
2 investigation for a diagnosis and
reason

3.
4.

Trigger 2

5.
6.
7.

University student, always go to

nightclub, social party. soul and spirit
lifestyle
Using drugs on and off
What is your provisional diagnosis and
reason
4 drugs that can cause this presentation
Acute management to this patient

Trigger 3

Use ketamine. Symptoms subside after

treatment

8.

How does ketamine cause mental and

behavioral changes
9. How long want to give meds
10. Prognosis for the patient and your
reason
OSCE
Station:
1. Defense mechanism
2. Management for alcohol intoxication/
withdrawal
3. Antidepressant (TCA)
a. Mechanism of action
b. Side effects
c. Indications
d. Type of antidepressant
4. Station with patient and prof fadzillah
a. Patient has panic disorder.
Consult patient about the
disease and choice of treatment
5. Stages of acceptance to a disease
(theory(x ingat))
a. Denial
b. Acceptance
Modified clinical exam
Patient BMD in Manic phase

1.
2.
3.
4.
5.

Summarize the case

Pathophysiology presented in this case
with evidence
Further history that you would like to
ask
IX
MX

PSYCHIATRY POSTING YEAR 6 2013-2014

MCQ
1. Autistic:
A. speech therapy not effective
B. occupational therapy not needed with speech
therapy
C. aggressive behavior is treated with antipsychotic
D. self injury can be managed by behavior
therapy
E. psychoeducation to carer has limited role.
2. Clinical features of autistic:
A. avoid and no eye contact
B. appear normal at birth
C. repetitive behavior is uncommon
D. antipsychotic is used to treat aggressive
behavior
E. no different in interaction
3. Neuropsychiatry complication due to alocohol
dependant:
A. wernickes karsakoff
B. hallucinosis
C. Delirium tremens
D. pathological jelousy
E. Depression
4. MDD:
A. best treated with BDZ
B. co-morbid with panic disorder
C. co-morbid with anxiety disorder
D. cannot be diagnosed if hallucination is present
E. with melancholic feature is not severe
5. OCD:
A. both obsession and compulsion
B. product of patients own mind
C. not distressful to patient
D. obsession occur in the form of image
E. response to SSRI
6. Differences of depression and dementia in
elderly:

11

A. in depression, onset of forgetfulness is

insidious.
B. in depression, low mood with apraxia and
agnosia.
C. in depression, alogia more than confabulation.
D. in depression, guilty.
E. in depression, involved perseverance.
7. Features of supportive psychotherapy:
A. therapeutic relationship
B. Active listening
C. Ventilation and emotional release
D. sympathic listening
E. negative counter-transference.
8. Tic disorder can be cathegorized according to:
A. type
B. talkativeness
C. duration
D. onset
E. frequency.
9. CBT
A. is indicated to depressive and anxiety patients
B. can be given to psychosis patient.
C. challenges maladaptive and faulty thought
D. it is therapist centered
E. it focus on emotion only.

OSCE
1.

Specimen : Lithium Box

Q1: What is the maintenance dose of
this drug? (2m)
Q2: Baseline investigations to be
performed before starting this drug
to patient ( 4m)
Q3: 4 side effects of lithium (4m)

2.

Specimen: Cymbalta ( Dulofaxine)

Q1: what is the class/ group of this
drug? (2M)
Q2: What is the aim of
antidepressant treatment? (4m)
Q3: What is special therapeutic effect
of this drug compared to other
antidepressant? (4M)

3.

Specimen: Picture of fierce man

holding knife, parang ( aggressive
patient)
Q1: how you manage aggressive
patient? (10m)

4.

Specimen: Picture of self-injury and

cutting wrist (indicate suicide and
DSH)
Q1: name this condition? (2m)
Q2: scenario given: 22 y.o lady
frequently had quarrel with her BF,
feel lonely and attempt self injury.
What is probably type of personality
disorder she had? (4m)
Q3: scenario given: 42 y.o lady with
u/l mental illness commit suicide.
What is differential diagnosis of her
psychiatric illness? (4m)

5.

Specimen: zyprexa (Olanzapine)

Q1: what syndrome caused by this
drug? (2m)
Q2: describe the syndrome ? (8M)
(Description yg based on WHO tu)

6.

Scenario given: 72 y.o man had

problem in placing things-become
more forgetful, sometimes appear
irritable, mood swings. He does not

10. Alzheimer Disease

A. is first atrophy of frontal lobe
B. Donapezil is
11. The following are good prognostic factors in
schizophrenia (mcq)
A. presence of mood symptom
B. long prodromal phase
C. starts at the early age of life
D. primarily by negative symptoms
E. has family hx of mood symptoms
OBA.
1. En sazali, surgeon, impatient. Currently take
medication for 2 month. He feels calmer and
however reduces body weight. What type of
medication.
A. Amphetamine
B. anti-psychotic
C. thyroxine

12

recognize his family members and

forget his belongings + Wandering
around and etc..
Q1: state the criteria of dementia
based on DSM 1V if you are
suspecting dementia (6m)
Q2: if you are suspecting Dementia
of Lewy Body, what are specific
symptoms you would like to ask? (
4m)
7.

Specimen: Zoloft, Luvox, Lexapro

Q1: what is common disorders
treated by this drug? (4m)
Q2: common side effects caused by
this drug? (4m)

8.

Describe suicidal risk assessment and

how you manage it. (10m)

9.

Specimen: Multi drug panel test/ kit

Q1: what is the name of this tool?
(2m)
Q2: what is the function of this tool?
(2m)
Q3: what is specimen needed to use
this tool? ( 2m)
Q4: briefly explain the indication.
(4m) when to use, for what kind of
patient and etc.

10. Scenario: 28 y.o engineer of oil and

gas has been diagnosed with MDD at
private hospital. Currently he was in
partial remission. He came to you
and complaining of fatigue and
insomnia and asking for sleeping
pills. Briefly consult the patient upon
prescribing the medication. (10m)
11. Specimen: Seroquel (Quatiapine)
Q1: what is the group of this drug?
(2m)
Q2: indication of using this drug?
(4m)
Q3: 2 most common side effect of
using this drug? (2m)
12. Specimen: Fluphenazine Depot
(Fluanzol)

Q1: group of this drug? (2m)

Q2: indication of using this drug?
(4m)
Q3: frequency, method and site of
administration of this drug? (4m)
13. Specimen: haloperidol and sulpride
Q1: what is the mechanism of action
of these drugs? (2m)
Q2: common side effects (4m)
Q3:
14. Specimen: a form of questionnaire
(MMSE)
Q1: what is this tool? (2m)
Q2: it function as screening tool or
diagnostic tool ? (2m)
Q3: what is the function and
indication? (2m)
Q4: comment on the scoring and the
severity. (2m)
15. Specimen: Picture of Unilateral and
bilateral ECT
Q1: What is this procedure? (2m)ECT
Q2: How the difference of the
modalities ..as regard of its side
effect? (2m)
Q3: indication of ECT? (6M)
16. Specimen: Xanac- BDZ
Q1: state the general precautions of
this drug? (2m)
Q2: why this drug must be given in
caution to elderly ? (4m)
Q3: describe on sleep hygiene. ( 4m)
17. Specimen: Tiger, Wine, beer,
Q1:what is the name of delirium
causing by this substance withdrawal?
(2m)
Q2: symptoms of withdrawal of this
substance. (4m)
Q3: management for alcohol
withdrawal (4m)
18. Scenario: your colleague referring
case of a woman presented with
talkativeness and poor sleep. She had
no history of psychotic sx or other
sx.
Q1: what other sx you want to elicit
from this patient (4m)
Q2: differential diagnosis for this
patient (4m)

13

Q3: x ingat. (2m)

Q2: this condition is codeable to

stand alone in DSMiv, True or False
( 2m)
Q3: Differential diagnosis of this
condition? (4m)
Q4: treatment for this condition (2m)

19. Scenario: A young women presented

with palpitations and choking
sensation. She had no history of
psychotic sx or substance abuse.
Q1: what other sx you would like to
elicit to dx panic attacks? (4m)
Q2: how to diagnose panic disorder
based on DSM 1V ? (6M)

23. Scenario: a man was brought because

causing nuisance to the public. He
appears unkempt, poor hygiene. He pay
attention to your question when
being asked.
Q1: how you want to ask and elicit
information regarding Auditory
hallucination? ( 6m)
Q2: what is the subtypes of
schizophrenia based on DSM 1V?
(4M)

20. Specimen: a letter

Dear doctor,
As i was walking along the street, i
saw a cop with a cappuccino. What
do u know?
Knowing something is good. I know a
lot of things. Things that make
wonders and will save the world
from all problems. Isnt it great? I felt
like the Great Wall of china.

24. Scenario: a man c/o AH for 5 weeks.

The voices make discussions on him
and on what he is doing. He also
complained of someone is putting
sim card behind his left ear so that
he can communicate with the alien.
Q1: explain 2 psychopathology in this
man. (4m)
Q2: define delusion. (3m)
Q3: if this patient is normal
previously and had no life
functioning impairment, what should
be the diagnosis? (3m)

Yours sincerely,
Victor the creator of victory.
Q1: list 4 psychopathology in this
letter. (4m)
Q2: what is your provisional
diagnosis ( 2m)
Q3: give one relevant ddx. (2m)
Q4: give one type of pharmacological
agent suitable for long term
treatment for this problem. (2m)
21. Specimen: clozaril
Q1: what is the indication of this
drug (2m)
Q2: common side effects. (4m)
Q3: administration of this drug
required WBC and ANC monitoring.
Briefly explain the frequency and
duration of the monitoring. (4m)
22. Specimen: pictures of salman khan
increase libido, aggressive,
disinhibition, spending spree and etc.
Q1: name this condition (2m)

PSYCHIATRY & MENTAL HEALTH I 2014

(SET 1)
MCQ (T/F)
20 Questions
1)

Which of the followings are true regarding

Wernickes encephalopathy
A) Dementia is the main feature
B) Triad of unsteady gait, opthalmoplegia
and confusion
C) It is preceded by alcoholism
D) Intravenous thiamine is the treatment
E) Seizure is a usual complication

2) Which of the followings are true regarding

electroconvulsive therapy
A) Indicated in high suicidal ideation

14

B)
C)
D)
E)

Side effect is long term memory loss

Indicated in catatonic schizophrenia
Contraindicated in pregnancy
Contraindicated in cerebral hemorrhage

3) Melancholic features of major depressive

disorder
A) Anhedonia
B) Excessive guilt
C) Agitation
D) Hopelessness
E) Diurnal variation of mood
4) Delusion
A) Fixed false belief
B) It is not acceptable by culture
C) It can be challenged by doctor
D) It can be shared with more than one
person
E) Occurs in post traumatic stress disorder
(PTSD)
5) Symptoms of panic attack
A) Nystagmus
B) Parasthesia
C) Fear of going crazy
D) Choking sensation
E) Acute dystonia
6) Regarding benzodiazepines
A) Addiction is a rare complication
B) Has a role in chemical restraint
C) Can cause muscle rigidity
D) Short acting is used to treat panic attack
E) Long acting is used to treat alcohol
withdrawal
7) Selective Serotonin Reuptake Inhibitor
(SSRI)
A) SSRI is more effective than tricyclic
antidepressant (TCA)
B) Overdose is less dangerous in SSRI
C) Side effects are anorgasmia and reduce
ejaculation
D) SSRI increases suicide risk in all
patients
E) Onset of action of SSRI is faster than
TCA
8) Delirium tremens
A) Is a medical emergency
B) Induces status epilepticus
C) IV thiamine is mandatory
D) Can cause autonomic instability
E) Potentially fatal

9) Visual hallucination
A) Common in schizophrenia
B) Occurs commonly with auditory
hallucination
C) Commanding type is diagnostic of
schizophrenia
D) Associated with intoxication and
withdrawal of alcohol
E) Associated with general medical
condition (GMC)
10) Mental state examination consists of
A) Serial 7
B) Mini mental state examination
C) Intensity of affect
D) Premorbid history
E) Cognitive behavioural therapy
11) Anxiety disorder
A) Hypochondriasis
B) Hypomania
C) Obsessive compulsive disorder
D) Social phobia
E) Panic disorder
12) Abnormal thought process
A) Suicidal ideas
B) Flight of ideas
C) Looseness of association
D) Erotomania
E) Perserveration
13) Bipolar affective disorder
A) With depressive symptoms indicate
mixed state
B) Is diagnosed with only one manic
episode
C) Hallucination is more common than in
schizophrenia
D) Delusions are mood congruent
14) Catatonic schizophrenia
A) Is rare
B) Has increase risk of getting dehydration
C) Electroconvulsive therapy is indicated
D) Has increase in libido
15) Causes of suicidal tendency in schizophrenia
A) Commanding voices
B) Post schizophrenic depression
C) Disorganized behaviour
D) Avolition and alogia
E) Extrapyrimidal side effect
16) Schneiderian First Rank symptoms
A) Delusional perception

15

B) Delusion of reference
C) Thought echo
D) Diagnostic for schizophrenia
17) Pressured speech
A) Is a disorder of thought
B) Is a criteria for mania
C) Is a type of neologism
18) Substance dependence
A) Symptoms occur within one month
duration
B) Tolerance is when the same amount
does not give the desired effect
C) Withdrawal is when there is increase in
amount of substance taken
D) Has prognostic value with co-morbid
psychotic illness
E) Associated
with
physiological
dependence
19) Psychopathology
A) Neologism is a new word formed by
patient which has no meaning
B) Circumstantiality is a delay in
communication to reach the point
C) Echolalia is imitation of interviewers
movement
D) Loosening of association in mood
disorder
E) Clang association are words that have
same sound but different meaning
20) Side effects of typical antipsychotic
A) Dystonia
B) Tardive dyskinesia
C) Perplexity
D) Akathisia
E) Hyperprolactinemia
OBA
10 Questions
1) Mrs A thought that her neighbour tried to
harm her and her family by blowing
radioactive material into their house. She
refused to cook because the kitchen was
facing the neighbours house. There was no
hallucination and she was able to function
and take care of her children. What would
be the most appropriate diagnosis for her?
A) Schizophrenia
B) Schizophreniform
C) Delusional disorder
D) Bipolar mood disorder

2) Patient has been diagnosed to have

schizophrenia with depressive symptoms.
His BMI is 30kg/m2. He has a strong family
history of Diabetes Mellitus. What is the
most suitable medication for him?
A) Seroquel
B) Olanzapine
C) Clozapine
D) Fluvoxamine
3) Mr B was explained by the doctor about his
wifes illness and the need to comply with
medication and depot injection plus the need
of having full family support. Which of the
following suits the explanation given?
A) Psychoeducation
B) Cognitive behavioural therapy
C) Insight oriented therapy
D) Family therapy
4) Mr C is a 20 years old mechanic who loves
to work alone and claims to do well without
his family. He has no friends and no
girlfriend. He loves to do solitary activities.
What kind of personality disorder does he
have?
A) Paranoid personality disorder
B) Schizotypal personality disorder
C) Avoidant personality disorder
D) Schizoid personality disorder
5) Mr D works as a clerk. Yesterday, he
presented to the hospital with disorganized
behaviour. Before this, he was apparently
well. Laboratory investigation revealed
increase in Gamma Glutamyl Transferase
(GGT). What would be the most appropriate
diagnosis for him?
A) Schizophreniform
B) Schizophrenia
C) Alcohol intoxication
D) Major
depressive
disorder
with
psychosis
6) The doctor explained to Mrs E that the
medication she takes would give effect in 3
4 weeks time. Before that, she will
experience the side effects of the medication
first such as GI disturbance. Which of the
following medication suits the explanation
given?
A) Lithium
B) Escitalopram
C) Risperidone
D) Clomipramine

16

7) Neat, clean and tidy

Excoriation & desquamation of skin of
fingers
Does not shake hands when offered
Anxious
Aware disturbance is a product of his own
thought
Which of the following suits the criteria
given?
A) Social phobia
B) Generalized anxiety disorder
C) Acute Stress Disorder
D) Obsessive compulsive disorder
8) Patient is aggressive and irritable. She also
has pressured speech and labile mood since
5 years ago. The current medication causes
her to have muscle rigidity and tremors on
both hands. What is the most likely
combination of her medication?
A) Haloperidol and fluvoxamine
B) Lithium and risperidone
C) Lithium and sodium valproate
D) Olanzapine and diazepam
9) Nama saya Mas.. emas intan berlian..
berlian beli di pasar.. beras belum beli..
Which of the following suits the
psychopathology above?
A) Loosening of association
B) Clang of association
C) Neologism
D) Derailment

oral intake, psychomotor retardation, feeling of

guilt and insomnia. She also had loss of interest
as she no longer spent her time in the night clubs
as before. Her family members could not be
contacted. The Medical Officer in the Emergency
Department diagnosed her as Major Depressive
Disorder.
Mental State Examination revealed poverty of
speech and stooped posture. There were old and
new slash marks over the ventral aspect of both
forearms. Her housemate who is not close to her
told that she had financial problems involving
loan sharks. She was involuntarily admitted for
her own safety. All other investigations were
normal.
1.

List 3 differential
reasons.

diagnoses

with

2.

Name ONE medical condition that

mimic Major Depressive Disorder and
ONE investigation to rule this out.

3.

Give 2 reasons for the involuntary

admission.

4.

List 5 possible suicidal risk factors in

this patient.

QUESTION 2

10) Miss F had been a victim of snatch theft 3

months ago. Since then, she could not sleep
and had nightmares but it resolved within
one week.
However, 2 months ago she had a recurrent
panic attack which lasted for 10 minutes.
Because fear of going crazy, she did not go
to work. What would be the most
appropriate diagnosis for her?
A) Adjustment disorder with anxious mood
B) Post traumatic stress disorder
C) Panic disorder
D) Acute stress disorder

Miss NA, a 28 years old lady was brought to the

hospital by her officemates. For the past 6
months, her office work had been greatly
affected by her behaviour. She believed that
other officemates were spreading rumours about
her affair with her boss. She said that her boss
was madly in love with her and sent love
messages by a wavelength that made her difficult
to concentrate. The boss and other officemates
denied all the allegations. Due to her affair, she
was 6 months pregnant and could feel the fetal
movements inside her tummy. She also believed
that people far away in London could hear her
thoughts. Besides that, she felt that her feeling
was under control causing her to become moody
and irritable.

PMP

a)

QUESTION 1
Miss WA is a model in a designer fashion house.
She presented to the hospital with history of poor

List 3 additional information you would like

to know to help with the diagnosis.

b) List 5 psychopathology in this patient.

c)

What is your provisional diagnosis?

17

6) Regarding benzodiazepines :
d) List 3 differential diagnoses.
e)

Name ONE medication that can help to

resolve the psychosis in this patient.

[GEN05] PSYCHIATRY END POSTING

EXAMINATION 2014 (SET 2)

Addiction is a rare complications

Has a role in chemical restraint
Activates inhibitory neurotransmitter
Short acting is used to treat panic attack
Long acting is used to treat alcohol
withdrawal

7) Delusion

MCQ
1) Negative symptoms in schizophrenia
A.
B.
C.
D.
E.

A.
B.
C.
D.
E.

Avolition
Poverty of speech
Flattened affect
Hallucination
Delusion

A. Can occur in obsessive compulsive

disorder
B. Occur in amphetamine-induced
psychosis
C. Can occur in panic disorder
D. Can occur in somatoform disorder
E. Can occur in paranoid personality
disorder

2) Relative contraindications for ECT include:

A.
B.
C.
D.
E.

Brain tumor
Pregnancy
Intracerebral hemorrhage
High suicidal ideation
Recent MI

3) Melancholic features of MDD

A.
B.
C.
D.
E.

Agitation
Insignificant anorexia
Diurnal mood variation
Hopelessness
Excessive guilt

4) Side effects of typical antipsychotics

A.
B.
C.
D.
E.

Dystonia
Tardive dyskinesia
Perplexity
Akathisia
Hyperprolactinemia

5) Panic disorder
A. Presence of intermittent anxiety
B. Agoraphobia is common
C. Anticipatory anxiety for more than 6
months
D. Relaxation technique is part of therapy
E. Psychosis is common

8) Serial 7 is a test used for

A.
B.
C.
D.
E.

Attention
Concentration
Orientation
Short term memory
Perseveration

9) Psychopathology
A. Neologism is a new word formed by
patient which has no meaning
B. Circumstantiality is a delay in
communication to reach the point
C. Echolalia is imitation of interviewers
movement
D. Clang of association are words that
have same sound but different meaning
E. Loose of association is disorder of
thought content.
10) Delirium Tremens
A.
B.
C.
D.

Is a medical emergency
Can cause autonomic instability
Can reduce the threshold of seizure
Hydration is one of the component have
to be monitored

18

11) Selective Serotonin Reuptake Inhibitor

include
A.
B.
C.
D.
E.

Paroxetine
Escitalopram
Fluoxetine
Mitrazapine
Duloxetine

12) Catatonic schizophrenia

A.
B.
C.
D.
E.

It is rare
Increase risk of dehydration
Respond with ECT
Increased in libido
Acute psychiatric emergency

13) Post Traumatic Stress Disorder (PTSD)

A.
B.
C.
D.
E.

Symptoms last for 2 weeks

Avoidance
Dissociative
Delusion
Hyperarousal

14) Pressure of speech

A.
B.
C.
D.

Is a criteria for mania

Is a disorder of thought
Occur in normal patient
Is a feature of melancholic depression

15) Substance dependence

A. Symptoms occur within 1 month
duration
B. Tolerance is when the same amount
does not give the desired effect
C. Associated with physiological
dependence
D. Has prognostic value with comorbid
psychotic illness
E. Withdrawal is when there is increase in
amount of substance taken
16) Component of Schneiderian First Rank
Symptom
A. Delusional perception
B. Delusion of reference
C. Thought echo is a part of auditory
hallucination
D. Is diagnostic for schizophrenia

E. Thought broadcasting is part of

hallucination
17) Dysthymic disorder
A.
B.
C.
D.
E.

Headache
Insomnia
Muscle tension
Chronic low mood
Nihilistic delusion

18) Cognitive Behavioral Therapy (CBT)

A. In acute psychosis
B. Need active participation from the
patient
C. Identify negative thought to be
corrected
D. Interpretation of dream
E. Is suitable in mental retardation (MR)
patient
OBA
1) Mr R was diagnosed with schizophrenia 20
years ago. Since 5 years ago, he developed
rabbit
mouth syndrome. He developed
pouting and lip smacks and it was exaggerated
when was anxious. What is the best to describe
this condition :
A.
B. Is an extrapyramidal syndrome and
should be treated with benzhexol
C. Tardive dyskinesia that should be
treated with clozapine
D. Tardive dyskinesia that should be
treated with benzodiazepine
2) 34 years old teacher, low mood, anhedonia,
suicide and want to jump from building. She also
had suicidal attempt in the ward by using pieces
of broken mirror in the toilet by slash herself.
What is the best treatment?
A. Anti-depressant with oral
benzodiazepine
B. Anti-depressant with parenteral
benzodiazepine
C. Anti-depressant with electroconvulsive
therapy
D. Anti-depressant with cognitive
behavioral therapy

19

3) Patient has been diagnosed to have

schizophrenia with depressive symptom. His
BMI is 30 kg/m2. He has strong family history of
Diabetes Mellitus. What is the most suitable
medication for him?
A.
B.
C.
D.

Seroquel
Olanzapine
Fluvoxemine
Clozapine

4) A 21 years old gentleman was brought to ED

due to abnormal behavior. He thought that his
father is a undercover spy for US and injured his
father. He involved in fight with his brother
before this due to minor things. He also not
compliance to medication and denied that he is
having a mental illness. What is the indicator for
future violence in this patient?
E.
F.
G.
H.

Diagnosed as schizophrenia
Non-compliance to medication
History of previous violence
Poor insight

5) Mr C is a 20 years old mechanic who loves to

work alone and claims to do well without his
family. He has no friends and no girlfriend. He
loves to do solitary activities. What kind of
personality disorder does he have?
A.
B.
C.
D.

Schizoid personality disorder

Schizotypal personality disorder
Paranoid personality disorder
Dependent personality disorder

6) The patient was compliance to the medication

and able to go to work for the past 3 months.
However, he still feel that others
are..
A.
B.
C.
D.

Add on other anti-depressant

Continue psychoeducation
Cognitive behavioral therapy
Electroconvulsive therapy

7) I like to eat steak with stick, not lipstick,

cause it give stick to my teeth, then I develop
tics
A. Loose of association
B. Pressured speech???

C. Clang of association
D. Punning
8) A 20 years old male works as steward at
department of food and beverages in a hotel,
behave aggressively and causing public
nuisance. Family members claimed that this is
the first time and he has no medical illness. The
investigation revealed Increase gamma glutamyl
transferase (GGT).
A. Bipolar mood disorder
B. Alcohol intoxication
C.
9) Bipolar type 2 refers to
A. Second episode of bipolar disorder
B. Depressive episode with history of
hypomanic episode
C. Bipolar illness without family history
D. Bipolar illness with only one manic
episode
PMP
1) A 22 years old university student was brought
to the emergency department due to the suicidal
attempt that she tried to jump from 8th storey
building. She had the attempt after knowing that
she failed her previous semester examination.
Upon further questioning, her friend claimed that
months ago, she started to have low mood, loss
of interest in her study and co-curricular
activities, however unsure of the duration. Her
friend also notice her abnormal behavior when
she sometimes mumbling and talking to herself.
She also started to become socially withdrawn,
isolated from friends for the past 3 months. She
lost 8 kg and claimed to have loss of appetite.
She denied of any medical illness and illicit any
drug.
On MSE, she appeared thin, lethargic, fatigue.
A. What is the provisional diagnosis? (2m)
B. Outline your suicidal risk assessment
for this patient? (10m)
C. State ONE biological test to rule out the
organic causes in this patient. (2m)
D. What is the pharmacological agent that
you want to start in this patient? (2m)
E. Give 2 examples of the pharmacological
agents in Q4 (4m)

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2) A wife was brought in to the emergency

department by her husband with the complaint of
slowness in doing house chores for the past 3
months. She spent hours in the bathroom bathing
and cleaning herself.

4.

24 years old man developed epilepsy. Which

of the following drugs are harmful to his
epilepsy?
A. Fluphenazine
B. Clozapine
C. Amitryptiline
D. Lithium
E. Haloperidol

5.

Regarding alcohol hallucinosis

A. Occurs during alcohol intoxication
B. Presented visual hallucination
C. 95% has prolonged symptoms even
after abstinence
D. Fulfill criteria of schizophrenia
E. Medication is not needed

6.

Vascular dementia
A. Most common type of dementia
B. Has acute onset
C. Has stepwise deterioration
D. Early symptoms of changes of
emotion and personality
E. Extensor plantar response indicate
cereberovascular accident

7.

Following are true regarding cognitive

behavioral therapy
A. Takes longer period and the effect
is long
B. Directive and active session
C. Involves behavior and cognitive
only
D. Modify the emotion and behavior
by changing the cognitive function
E. Related to free association

8.

The following are true regarding approach in

supportive psychotherapy
A. Guidance
B. Interpretation
C. Reassurance
D. Encouragement
E. Free association

9.

Gender dysphoria
A. Marked incongruent between ones
experience gender and assigned
gender
B. Including transvestic fetishism

She said that the intrusive thought and was

illogical but irresistible.
She was distress and
1.
2.
3.
4.
5.
6.
7.

She also developed low mood,

What is your provisional diagnosis?
(2m)
Give FOUR reasons for your diagnosis.
(8m)
Give ONE differential diagnosis. (2m)
State ONE pharmacological agent that
useful in treating this patient. (2m)
Give TWO examples of the
pharmacological agent in Q4. (4m)
Identify ONE psychological therapy
suitable for this patient. (2m)

Psychiatric (PAY6014) Posting Group A

2016/2017
MCQ Questions
1. Antidepressant include
A. Aripiprazole
B. Escitalopram
C. Imipramine
D. Paliperidone
E. Chlordiazepoxide
2.

3.

Following drugs have mood stabilizer

properties
A. Bromazepan
B. Olanzapine
C. Lamotrigine
D. Lithium
E. Escitalopram
40 years old man complained of depression,
low mood with psychotic features for the
past one month. What are the differential
diagnosis?
A. Borderline personality disorder
B. Substance induce disorder
C. Brief psychotic disorder
D. Major depressive disorder with
psychosis
E. Schizophrenia

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C. DSM IV called gender identity

disorder
D. Treated by castration
E. Including transsexual gender

B.
C.
D.
E.

Reflex hallucination
Delusion of control
Waxy flexibility
Depersonalization

10. Exhibitionism
A. Intense sexual arousal for exposure
ones genital to an unsuspecting
person
B. Being naked during protest
C. May progress to be rapist
D. Treated with ECT
E. Paraphilia disorder

15. The following are the good prognostic factor

for schizophrenia
A. Compassion and perplexity
B. No family history of affective
disorder
C. No family history of schizophrenia
D. High intelligence
E. No stressful life events

11. Transcultural psychiatry

A. Acculturation is process a person
acquires his culture from very early
life
B. Race in concept by which human
being grouped primarily by
physiognomy
C. Need of understanding difference
between Muslim and Islam to
understand the Islamic medicine
D. Stigmatization lead to high seeking
treatment behavior

16. Distinguish between organic and functional

disorder
A. Poor orientation
B. Poor memory
C. Visual hallucination
D. Cannot spell WORLD backwards
E.

12. The following are true

A. Narcissistic afraid of
abandonment
B. Paranoid chronic feeling of
emptiness
C. Borderline intense labile
relationship
D. Schizoid prefer solitary activities
E. Dependent recurrent suicidal
attention
13. Intellectual disability
A. DSM IV definition include age
onset before 18 years old
B. DSM IV and ICD 10 classify into
mild, moderate, severe/profound
C. DSM IV include definition of IQ
less than 70
D.
E.
14. Which of the following is the Schneiderian
1st rank symptom
A. 3rd person auditory hallucination

17. Which of the following are not important in

diagnosis MDD in medical impatient unit
A. Suicidal ideation
B. Excessive guilt
C. Insomnia
D. Low appetite
E. Previous episode of MDD
OBA questions
1. 34 years old gentleman diagnosed with
schizophrenia developed EPS with low dose
olanzapine. What is the most appropriate
change of medication for this patient?
A. Low dose CPZ
B. Low dose haloperidol
C. Quetiapine
D. Clozapine
2.

Regarding open-ended question

A. Are you in trouble?
B. What is troubling you?
C. How good are you feeling?

3.

A 33 years old scantily clad woman comes

to your office complaining that her fever
feels like she is burning in hell. She
vividly describes how the fever has affected
her work as a teacher.
A. Histrionic

22

B. Borderline
C. Narcissistic
D. Anti-social
4.

Ratio male-to-female autism

A. 1:1
B. 4:1
C. 2:1
D. 3:1

PMP question
The on-call psychiatrist prescribed patient with
tablet Fluvoxamine 100mg every night. His wife
complained she is worry because patient
frequently hearing voices asking to kill himself.
1) How does Fluvoxamine help this patient?
2) Gives 6 side effects of this medication
3) How would you assess his suicidal risk?

4.

Specimen: a letter
Dear doctor,
As I was walking along the street, I saw
a cop with a cappuccino. What do you
know?
Knowing something is good. I know a lot of
things. Things that make wonders and
will save the world from all problems.
Isnt it great? I felt like the Great Wall of
China.
Yours sincerely,
Victor the creator of victory.
1) List 4 psychopathology in this letter
2) What is your provisional diagnosis
3) Give one relevant ddx
4) Give one type of pharmacological
agent suitable for long term
treatment for this problem

OSCE questions
1. Extended matching question
A. Pseudo-hallucination
B. Elementary hallucination
C. 2nd person auditory hallucination
D. 3rd person auditory hallucination
E. Extracampine hallucination
F. Illusion
G. Hypnopompic hallucination
H. Hypnogogic hallucination
1) Think shadow of tree as a ghost
2) Underlying mental illness, always hear
his friends talking about him
3) Hearing voice singing from inside his
head. Sure it is not real.
4) Hearing of buzzing sound
5) Seeing things when he is falling asleep
2.

Picture of electroconvulsive therapy

equipment
1) 3 indications for following procedures
2) 3 relative contraindications for
following procedures
3) 3 preparations for following procedures

3.

Picture of Xanax (Alprazolam)

1) Name group of the drug
2) 3 indications for following drug
3) 6 side effects of this medication

23