MCQs

Multiple Choice Questions
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Schizophrenia
1. The following concepts are matched correctly with the person

that proposed the idea :
A. Greisinger - ‘unitary psychosis’ T
B. Kraepelin - ‘dementia praecox’ T
C. Bleuler - ‘praecox feeling’ F
D. Langfeldt - ‘systemic schizophrenia’ F
E. Carpenter - ‘deficit syndrome’ T
2. The following are Schneiderian 1st Rank symptoms :

A. Thought echo T
B. Ideas of reference F
C. Somatic hallucinations T
D. Delusional mood F
E. Flatness of affect F
3. Regarding the epidemiology and associations of schizophrenia:

A. Increased rate in Sweden T
B. Increased rate in US Hutterites F
C. Association with brain injury T
D. The positive association with rheumatoid arthritis suggests an F
immunological basis
E. Increased incidence in Afro-Caribbean migrants to the UK T
4. In schizophrenia :
A. The risk of bipolar illness is increased in 1st degree relatives of F
schizophrenic patients
B. The risk of schizophrenia is increased in 1st degree relatives of T
patients with schizoaffective disorder
C. Although eye-movement abnormalities are found in relatives of F
schizophrenics, evoked potentials are normal
D. There is a 10 % risk of schizophrenia in siblings of affected T
individuals
E. There is a 25 % risk of schizophrenia in children of affected F
parents
5. Regarding the aetiology of schizophrenia :
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A. The brains of twins discordant for schizophrenia are normal, F
indicating that brain abnormalities are a significant aetiological factor
B. Chromosome 5 has been implicated T
C. The D4 dopamine receptor gene is located on chromosome 5 F
D. Patients born in winter have an increased risk for the disorder T
E. Exposure to the influenza virus in the 1st trimester has been F
implicated
6. Regarding the aetiology of schizophrenia :

A. Higher incidence in men F
B. Men develop the illness 8-10 years before women F
C. Fertility rates among schizophrenic patients are reduced by 25 % T
D. Increased prevalence in urban settings, particularly among F
females
E. The ‘Breeder Hypothesis’ was proposed by Farris and Dunham T
7. The following statements are about aetiological concepts :

A. Social drift hypothesis suggests that stresses related to deprived F
areas increase the risk for schizophrenia
B. Bateson (1956) implicated the role of the ‘schizophrenogenic F
mother’
C. Lidz (1957) developed ‘Family Schism Theory’ T
D. Schizophrenics have more life events in the 6 weeks preceding F
relapse or admission
E. Life events tend to be clustered in the 3 weeks preceding T
admission
8. The following statements relate to findings in schizophrenia :

A. The brains of schizophrenics are 6 % lighter and 4 % smaller than T
normal controls
B. There is a reduced number of neurones in the temporal lobes T
C. Increased disorganization of neurones in the hippocampus T
D. Schizophrenic patients tend to have enlarged 3rd ventricles T
E. Enlarged lateral ventricles are correlated with good response to F
treatment
9. Regarding brain changes in Schizophrenia :

A. Changes are less evident in the left side of the brain F
B. The syndrome of ‘reality distortion’ is associated with decreased F
blood flow in the left parahippocampal gyrus
C. Psychomotor poverty is associated with increased blood flow in T
the caudate nuclei
D. ‘Disorganization’ is associated with decreased blood flow in the F
right prefrontal cortex, and the right anterior cingulate
E. EEGs show decreased theta activity, especially in the acute illness F

10. Biochemical changes found in schizophrenia include :
A. Dopamine receptor supersensitivity following antipsychotic T
treatment
B. Dopamine underactivity in the mesolimbic pathways may be F
responsible for schizophrenia
C. Reduced GABA receptors in the temporal lobe T
D. Increased GABA receptors in the orbitofrontal cortex T
E. Abnormal cholecystokinin (CCK) function T
11. Neuropsychological abnormalities include :

A. Defects in verbal learning and memory T
B. The Wisconsin Card Sorting Test shows no abnormality in F
schizophrenic patients
C. Impaired short term memory F
D. Normal long term memory F
E. Impairment of verbal memory and learning suggests left temporal- T
hippocampal involvement
12. Predictors of good outcome in schizophrenia include :

A. Florid psychotic presentation T
B. Prominent affective symptoms T
C. Acute onset T
D. Older age at onset F
E. Long initial episode F
13. In schizophrenia :
A. Less than 5 % of suicides are by schizophrenic patients F
B. Suicide usually occurs in the late stages of the illness F
C. Illness course may plateau after the first 5 years T
D. Overall mortality (removing the increased risk of suicide) is F
normal
E. More benign course in developing countries T
14. Regarding the treatment of schizophrenia:

A. Low dose neuroleptics are as effective as other regimes F
B. 5 % of patients are treatment-resistant F
C. Clozapine is a second line drug for treatment-resistant F
schizophrenia
D. ECT can be useful in catatonic, or depressive states T
E. Psychosocial treatments are of little benefit F
15. The following are true of schizoaffective disorder:

A. It was first described by Kasanin T
B. Schizodepressive subtypes are more related to schizophrenia T
C. Schizomanic subtypes are more related to affective disorders T
D. Schizophrenic symptoms are associated with a good outcome F

E. Schizomanic patients have an episodic course, with a poorer F
outcome
16. The following are recognized associations with delusional

jealousy:
A. Depression T
B. Alcoholism T
C. Impotence F
D. Personality disorder T
E. Pervasive sense of inadequacy T
General
1. The following conditions are more common in women :
A. Schizophrenia F
B. Capgras delusion T
C. de Clerambault’s syndrome T
D. Bipolar Affective Disorder F
E. Depression T

2. The following conditions are more common in men :
A. Post-traumatic epilepsy T
B. Agoraphobia F
C. Social Phobia F
D. Wernicke’s encephalopathy T
E. Dissociative amnesia F
3. The following conditions are more common in upper social

classes:
A. Anorexia nervosa T
B. Schizophrenia F
C. Agoraphobia F
D. Depression F
E. Suicide T
4. The following conditions are more common in urban, or

socially deprived areas :
A. Schizophrenia T
B. Depression T
C. Bipolar Affective Disorder T
D. Dissociative disorders of movement and sensation T
E. Epilepsy ?
5. The following associations with suicide are recognized :

A. Peptic ulcer T
B. Non-delusional dysmorphophobia T
C. Huntington’s chorea T
D. Epilepsy T
E. Bereavement in childhood T
6. The following conditions usually have their onset before the

age of 35 years :
A. Schizophrenia T
B. Agoraphobia T
C. Space phobia F
D. Pick’s disease F
E. Dissociative convulsions T
7. The following are recognized associations :

A. Panic disorder and mitral valve prolapse F?
B. Klinefelter’s disease and epilepsy T
C. Phaeochromocytoma and MEN type I syndrome F
D. Insulinoma and MEN type II syndrome F
E. Alcohol abuse and hepatocellular carcinoma T

8. Regarding suicide :
A. Drowning, as a method, is more common among men F
B. It is the number one cause of death among young males aged 15- F
24
C. Only 25 % of suicide victims have a mental illness F
D. Rate is highest in the winter months F
E. Obsessive compulsive disorder is a risk factor F
9. The following conditions are autosomal recessive :

A. Leigh disease T
B. Huntinton’s chorea F
C. Gaucher’s disease T
D. Alzheimer’s disease (familial types) F
E. Parry type of cerebral ceroid lipofuscinosis F
10. The following conditions are autosomal dominant :

A. Tay-Sachs disease F
B. Porphyria T
C. Phaechromocytoma F
D. Metachromatic leucodystrophy F
E. Wilson’s disease F

Eating Disorders
1. Regarding Anorexia Nervosa (AN) :
A. There has been a recent increase in the incidence in the 11-16 age F
group.
B. Ten times more women are affected than men. T
C. Prevalence is of the order of 250 per 100,000 women. T
D. Adverse life events are more common in the ‘early onset’ (<25) F
group.
E. Purging has to be present for the diagnosis to be made. F
2. The following are recognized physical complications of AN :

A. ‘Pseudoatrophy’ on brain imaging. T
B. EEG abnormalities. T
C. Increased heart size. F
D. Prolongation of the QT interval. T
E. Tachycardia F

A. Hypercholesterolaemia. T
B. Increased plasma amylase. T

C. Increased growth hormone secretion. T
D. Decreased cortisol secretion, resulting in a positive F
Dexamethasone Suppression Test (DST)
E. Relative Lymphopenia. F

A. Increased gastric emptying. F
B. Diabetes mellitus. F
C. Acute pancreatitis. T
D. Abnormal secondary sexual hair pattern. F
E. Increased perinatal mortality. T
5. The following are abnormal in AN :

A. Cholecystokinin (CCK) activity. T
B. 5-HT activity. T
C. Dopamine activity. F
D. Thalamic function. F
E. Hypothalamic function. T
6. The following are predictors of good outcome in AN :

A. Late age of onset. F
B. Short illness duration. T
C. Premorbid obesity. F
D. Absence of bulimic behaviour. T
E. Male sex. F
7. Bulimia Nervosa (BN) :

A. Is more common than Anorexia Nervosa (AN). T
B. Has an onset later than that of AN. T
C. Is more common in developed countries. T
D. Often develops with a prior history of AN T
E. Affects 10-20 % of female adolescents at any one time. F
8. Physical complications of BN include :

A. Hyperkalaemia. F
B. Hypocalcaemia. T
C. Injury to myenteric plexuses of small bowel F
D. Urinary infections. T
E. Cardiac arrhythmia. T
9. Associations with BN include :

A. Shoplifting. T
B. Depression. T
C. Decreased sexual activity. F
D. History of sexual abuse. T

E. Lower rate of alcohol abuse than anorexia nervosa. F
10. Regarding the aetiology of BN :

A. There is increased 5-HT activity. F
B. Dopamine abnormalities have been found. T
C. There are abnormalities of CCK activity. T
D. Increased levels of CSF HVA. F
E. MZ:DZ ratios of 10:1 have been found. F
11. The following are true in obesity :

A. Increased levels of measurable neuroticism. F
B. Increased heat production from brown adipose tissue. F
C. Accurate judgement of how much has been eaten. F
D. Eating is more related to internal stimuli, such as gastric activity. F
E. Response to stress includes bingeing. T
Mood (Affective) Disorders

1. According to Leonhard :
A. Bipolar includes only mania F
B. Bipolar I is hypomanic episodes F
C. Bipolar II is manic episodes F
D. Bipolar III is unipolar illness with bipolar disorder in 1st degree T
relatives
E. Unipolar illness can include one episode of mania, but is F
predominantly depressive
2. In the discussion between endogenous vs. reactive depression :

A. In psychotic depression, a continuum theory is most likely T
B. Paykel (1971) found 6 groups of depressive patients T
C. Cyclothymia never becomes major affective disorder F
D. Dysthymia and major depressive episodes can occur and are T
called ‘double depression’
E. Cyclothymia is common in relatives of patients with major T
depressive illness
3. The following are specific to a diagnosis of mania (not

hypomania) in ICD-10 :
A. Flight of ideas T
B. Increased sexual energy F
C. Inflated self esteem or grandiosity T
D. Overfamiliarity F
E. Reckless or irresponsible behaviour F

4. The following are true of Bipolar Affective disorder :
A. One year prevalence of 1 % T
B. Mean age of onset is 21 years T
C. Rates are higher in rural areas F
D. It is more common in females F
E. Marriage has no association with BAD F
5. Regarding the aetiology of Bipolar Affective disorder :

A. The ‘genetic loading’ for mood disorder is greater in unipolar F
depressives than in manic depressives
B. The long arm of Chromosome 11 has been implicated F
C. The gene for tyrosine hydroxylase is on chromosome 11 T
D. The long arm of the X chromosome has been implicated T
E. There is an excess of life events preceding depression, but not F
mania
6. Regarding treatment of bipolar affective disorder :

A. About 50 % of rapid-cycling patients are lithium resistant F
B. About 75 % of bipolar affective patients (non-rapid-cycling) will T
respond to lithium
C. The response rate for carbamazepine is the same as that for F
lithium
D. Valproate may have a role in mixed affective disorder T
E. Clozapine has no role in treatment of BAD F
7. The following are true of depressive illness :

A. Depression has a lifetime prevalence of about 6 % T
B. 25 % of men and 35 % of women have experienced depressive F
symptoms by the age of 65
C. Depressive symptoms have a point prevalence of about 15 % T
D. The one-month prevalence is about 2 % T
E. Women suffer twice as commonly as men T
8. Regarding the demographics of depression :

A. The mean age of onset is 27 years T
B. Women have the peak age of onset in their 40s, while men have F
the peak onset in their 30s
C. Lower social groups have a higher incidence of depression T
D. There is clear ethnic variation in the UK F
E. There is an association between smoking and depression T
9. The following are recognized risk factors for depression :

A. Divorce T
B. Living in industrialized countries T
C. Urban habitation T

D. Obsessional personality traits T
E. Neuroticism T
10. Regarding the aetiology of depression :

A. An autosomal dominant transmission is suggested by the uniform T
morbidity risk among parents, children, and siblings
B. There is no association with parental discord F
C. Parental factors include lack of care and overprotection T
D. 25 % of depressive episodes are precipitated by life events F
E. The risk of depression is increased sixfold in the six months T
following threatening life events
11. Brown and Harris found the following to be vulnerability

factors for depression :
A. Three or more children under the age of 15 at home T
B. Alcoholic husband F
C. Loss of mother before the age of 11 T
D. Wide social support network F
E. Neurotic personality traits F
12. Regarding the psychological theories of depression :

A. Freud said that depression was due to envy F
B. Abraham proposed that failure to develop relationships other than F
the primary love object resulted in depression
C. The concept of ‘learned helplessness’ was proposed by Wolpe F
D. Klein said that if the depressive position was not negotiated, then T
depression would be more likely in later life
E. ‘Ambivalence’ occurs when feelings of love and hostility are T
present at the same time
13. In Beck’s cognitive theory :

A. ‘Arbitary inference’ occurs when conclusions are based on only F
one incident
B. ‘All-or-nothing’ thinking is known as ‘dichotomous reasoning’ T
C. ‘Overgeneralization’ are conclusions that are formed in the F
absence of evidence
D. A ‘stress-diathesis’ model is used T
E. ‘Selective abstraction’ occurs when a person abstracts from the T
whole situation and focuses on a single incident
14. The following biochemical changes have been observed in

depressed patients :
A. Decreased platelet 5-HT uptake T
B. Decreased 5-HT2 receptor binding in platelets F
C. Increased prolactin response to clomipramine F
D. Decreased growth hormone release in response to clonidine T

E. Reduced beta-adrenergic receptors in suicide victims F
15. The following biochemical changes have been observed in

depressed patients :
A. Increased 5-HIAA levels in the CSF of suicide victims F
B.
1. The following statements are true:

A. Bipolar I is characterized by hypomanic episodes only F
B. Bipolar II is characterized by manic episodes and hypomanic F
episodes
C. The term ‘melancholia’ in DSM-IV is equivalent to somatic T
symptoms in ICD-10
D. ‘Endogenous’ depression is characterized by somatic symptoms T
E. ‘Reactive’ depression is characterized by anxiety, irritability, and T
phobias
2. Cyclothymia:
A. Is more common in males F
B. Has a prevalence of around 5 % F
C. Has its onset usually between the ages of 15 and 25 T
D. Results in a diagnosis of bipolar disorder in around a third of T
patients
E. Antimanic drugs are usually ineffective F
3. Dysthymia:
A. Usually presents after the age of 25 F
B. Is associated with chronic medical illness T
C. Is more common in women, and the unemployed T
D. 20 % of patients will develop bipolar disorder T
E. Treatment does not involve antidepressant drugs F
4. Bipolar affective disorder is associated with:

A. Alcoholism T
B. Schizoaffective disorder T
C. Obsessive compulsive disorder F
D. Anxiety states T
E. Cyclothymic personality T

5. Bipolar affective disorder:
A. Is more common in males F
B. Has a lifetime risk of about 1 % T
C. Usually presents in the early 20s T
D. Is more common in urban areas T
E. Has been associated with higher rates in higher social classes T
6. Regarding the aetiology of bipolar disorder:

A. Monozygotic concordance is around 55 % F
B. The risk in 1st degree relatives is about 25 % T
C. Chromosome 11 has been implicated T
D. Chromosome Y has been implicated F
E. Excess life events can precipitate manic episodes T
7. Rapid cycling mania:

A. Was described by Kendler F
B. Has equal incidence in males and females F
C. Is associated with good response to lithium F
D. Valproate can be effective T
E. Is associated with a worse prognosis T
8. Regarding other presentations of depressive illness:

A. Agitated depression is more common in the elderly T
B. Retardation predicts a poor response to ECT F
C. Masked depression is more common with mild/ moderate illness T
D. Brief recurrent depression has no link with the menstrual cycle T
E. Atypical depression may be characterized by hypersomnia, and T
overeating
9. Regarding the demographics of depression:

A. It has an equal sex ratio F
B. Lifetime prevalence is about 6 % T
C. One month prevalence is 2 % per 100 people T
D. Highest 1 year prevalence is in the 45-65 age group F
E. Lifetime prevalence increases with age F
10. Depression is more common in:

A. Lower social class T
B. Urban areas T
C. Industrialized countries T
D. Those who are cohabiting T
E. The unemployed T
11. The following are reported risk factors for depressive illness:
A. Neurotic personality T

B. Childhood abuse T
C. Loss of father before the age of 11 F
D. Three or more children at home above the age of 15 F
E. Low self esteem T
12. The following are true of psychoanalytical theories of

depression:
A. Depression is a defence against mania F
B. Depression occurs when love and hostility are present at the same T
time
C. Regression can occur T
D. Failure to negotiate the ‘depressive position’ of childhood T
E. Learned helplessness was described by Joseph Wolpe F
13. The following drugs are associated with depression:

A. Propanolol T
B. Methyldopa T
C. Reserpine T
D. Steroids T
E. Valproate F
14. The following are true in depression:

A. There is increased plasma tryptophan concentration F
B. There is reduced levels of 5-HIAA in the CSF of suicide victims T
C. The prolactin response to Clomipramine is reduced T
D. The prolactin response to L-Tryptophan is mediated by 5-HT T
receptors
E. CSF HVA levels are reduced T
15. The following are true in depression:

A. There is a reduced response to CRH T
B. There is reduced GH release in response to Clonidine T
C. Somatostatin levels are raised F
D. Cortisol levels are suppressed by Dexamethasone F
E. There is a blunted TSH response to TRH T
16. The following are true of sleep in depression:

A. EEG shows increased stage 3 and 4 sleep F
B. Increase in REM sleep towards the end of the night F
C. Decreased latency to REM sleep T
D. Antidepressant drugs decrease REM sleep time T
E. EEG changes always resolve in depressed patients F
17. The following have been observed in depression:

A. Enlarged lateral ventricles T

B. Loss of temporal lobe volume T
C. Reduction in the size of the caudate nucleus T
D. Increased blood flow in the basal ganglia F
E. Decreased blood flow in the cingulate cortex T
18. In bipolar disorder:

A. Depression is the most common first presentation T
B. The first manic episode is usually before the age of 30 F
C. Manic episodes last longer than depressive episodes F
D. The median length of a manic phase is 3 months T
E. The frequency of episodes increases in the first 10 years T
19. In depression:
A. 10 % will have chronic, unremitting course T
B. 25 % have a recurrence within a year T
C. 10 % will eventually have a manic episode T
D. Mood incongruent delusions indicate a better prognosis F
E. Recurrence is associated with late age of onset F
20. The following are risk factors for bipolar disorder, after a
depressive episode:
A. Psychotic symptoms T
B. Postpartum depression T
C. Older age at onset F
D. Psychomotor agitation and hyperactivity F
E. Feelings of guilt T
Organic Psychiatry
1. The following are true of dementia:

A. Incidence is 5 % in the under 65’s F
B. Incidence is about 30 % in the over 85’s T
C. Alzheimer’s disease is the most common cause T
D. Frontal lobe dementia is the second most common cause in the F
over 65’s
E. Reversible dementias account for about 5 % of all dementias T
2. Regarding the aetiology of Alzheimer’s disease:

A. Females are affected twice as commonly as males T
B. Familial forms are autosomal dominant T
C. The presenilin-2 gene is on chromosome 14 F
D. The gene for presenilin-1 is on chromosome 19 F
E. Trauma is a risk factor T
3. Regarding the aetiology of Alzheimer’s disease:

A. The apolipoprotein ε gene is on chomosome 19 T
B. The Beta-amyloid precursor protein is on chromosome 21 T
C. Trisomy 21 is a risk factor T
D. Presenilin-1 causes about 50 % of early onset dementias T
E. Late onset dementia is associated with alpha-1 macroglobulin F
4. Pathological findings in Alzheimer’s include:

A. Loss of cortical neurones T
B. Amyloid plaques are the critical pathological feature of AD T
C. Relative sparing of the outer 3 layers of cortex F
D. Gliosis T
E. Granulovacuolar degeneration T
5. Neurochemical findings in Alzheimer’s include:

A. Cholinergic loss in the locus coeruleus F
B. Serotinergic neuron loss correlates with depression F
C. Noradrenergic loss is most marked in early-onset dementia T
D. Increased GABA F
E. Decreased somatostatin and CK T
6. Clinical features of Alzheimer’s dementia may include:

A. Long-term memory loss T
B. Disorders of Language and praxis T
C. Depression T
D. Loss of primitive reflexes F
E. Persecutory delusion T
7. Investigations in AD may show:

A. Increase in the dominant alpha rhythm on EEG F
B. Shortening of the P300 potential F
C. Reduced metabolism in the temporal lobes on PET T
D. Reduction in the temporal lobe volume T
E. Loss of theta and delta activity on EEG F
8. Lewy body dementia:

A. Unlike AD, does not result in loss of cholinergic function F
B. Is characterized by Lewy bodies in the cortex and substantia nigra T
C. Results in increased dopaminergic function F

D. May result in hallucinations and delusions T
E. Fluctuations in the presentation exclude this diagnosis F
9. Multi-infarct dementia:
A. Is more common in men T
B. Has been linked to an autosomal recessive heritability F
C. Causes cerebral atrophy and ventriculomegaly T
D. Can be rated using the Hatchinski index T
E. Can result in seizures T
10. In multi-infarct dementia:

A. Depression is rare F
B. Shows a slow, gradual deterioration F
C. PET shows asymmetric changes in the cortex T
D. SPECT shows increased blood flow F
E. MRI shows areas of multiple infarction T
11. Binswanger’s disease:

A. Is more properly called subcortical arteriosclerotic T
encephalopathy
B. Is characterized by abnormal pyramidal function T
C. Gait is normal F
D. Sphincter disturbance is common T
E. MRI shows high intensity lesions distributed evenly throughout F
the cortex
12. Pick’s disease:

A. Is more common in men F
B. Has been linked to an autosomal dominant gene T
C. Is characterized by changes in personality and behaviour T
D. CT shows enlargement of the frontal horns T
E. EEG shows abnormalities in a similar pattern to Alzheimer’s F
13. Pathological findings in Pick’s disease may include:

A. Atrophy of the frontal and parietal lobes F
B. ‘Knife-blade’ atrophy T
C. Senile plaques F
D. Neurofibrillary tangles F
E. Neuronal loss in the outer cortex T
14. Frontal lobe dementia:

A. Is a common cause of early-onset dementia T
B. Is more common in men T
C. There is rarely a family history F
D. Is easily seen on EEG F

E. Pathological findings include gliosis and spongiosis T
15. Huntington’s chorea:

B. Is due to an autosomal dominant gene T
C. Shows incomplete penetrance F
D. The gene lies on chromosome 4 T
E. Usually presents in the 3rd or 4th decade T
16. Huntington’s chorea:

A. Demonstrates ‘imprinting’ T
B. Demonstrates ‘anticipation’ T
C. The gene codes for GABA F
D. Results in reduced levels of GABA in the caudate nucleus T
E. Decreased levels of dopamine in the basal ganglia F
17. Clinical features of Huntington’s disease may include:

A. Dysarthria T
B. Epilepsy T
C. Paranoia and schizophreniform illness T
D. Increased risk of suicide T
E. Depression T
18. Findings in Huntington’s disease include:

A. Caudate atrophy T
B. Increased blood flow in the neostriatum F
C. EEG shows spike-wave activity F
D. Reduced striatal metabolism T
E. Atrophy of the basal ganglia T
19. Prion diseases:

A. Are more common in women F
B. Are encoded on chromosome 10 F
C. Individuals with the E4 apolipoprotein allele are at reduced risk F
D. The familial form is autosomal recessive F
E. Usually have a normal EEG F
20. Normal pressure hydrocephalus:

A. Is more common in the pre-senium F
B. May be preceded by a history of head injury T
C. Is characterized by impairment of memory, pyramidal function, F
and attention
D. CT shows periventricular lucencies and abnormal sulci F
E. Is due to blockage of the ventricular system F

21. The following are true of head injury:
A. The duration of post-traumatic amnesia correlates with the extent T
of brain injury
B. The duration of retrograde amnesia correlates with psychiatric F
disability
C. Frontal lobe syndrome is due to brain damage T
D. Depression is due to brain damage F
E. Aggressive tendencies are not due to brain damage F
22. Regarding psychiatric illness following head injury:

A. Schizophrenia is more common in mild injuries T
B. Affective illness is more common T
C. There is a higher incidence of hypomania than depressive F
psychosis
D. Suicide is more common T
E. Suicide is associated with frontal and temporal lobe damage T
23. In ‘Punch drunk’ syndrome:

A. Morbid jealousy is more common T
B. Pyramidal signs are characteristic T
C. CT scan shows cerebellar atrophy and normal ventricles F
D. Pathological changes are similar to normal ageing F
E. Commonly occurs in boxers T
24. The following symptoms are commonly seen in frontal lobe

lesions:
A. Magnetism T
B. Contralateral optic atrophy F
C. Ipsilateral spastic paresis F
D. ‘Witzelsucht’ T
E. Dyspraxia F
25. The following are seen in lesions of the non-dominant parietal

lobe:
A. Dysphasia F
B. Prosopagnosia T
C. Alexia F
D. Constructional dyspraxia T
E. Body image disorders F
26. Features of Gerstmann’s syndrome may include:

A. Bilateral parietal lobe lesion F
B. Right-left disorientation T
C. Dysgraphaesthesia F
D. Finger agnosia T

E. Dysgraphia T
27. Dominant temporal lobe lesions may cause:

A. Impaired visual memory F
B. Homonymous hemianopia T
C. Impaired verbal memory T
D. Impaired visual memory F
E. Dysprosody F
28. Bilateral temporal lobe lesions may cause:

A. Amnesic syndrome T
B. Cortical blindness F
C. Hyperorality T
D. Hypersexuality T
E. Social-emotional agnosia T
29. Features of occipital lobe lesions may include:

A. Complex visual hallucinations T
B. Visual field defects T
C. Anton’s syndrome T
D. Sensory neglect F
E. Anomia F
30.
Other neurological conditions
1. Regarding Multiple Sclerosis :

A. It is more common in women T
B. Survival is less in women F
C. Survival is greater if onset is at a younger age T
D. Lhermitte phenemenon is almost pathognomonic in a young T
person
E. Visual evoked potentials are abnormal in 10 - 20 % F
2. In Multiple sclerosis :
A. Depression is about as common as in the general population F
B. Dementia can occur T
C. IgG ratios are lower than normal F
D. Oligoclonal bands are seen in the IgM region on electrophoresis F
E. Epilepsy is more common than normal T

3. The following are characteristics of Parkinson’s disease :
A. Bradykinesia T
B. Intention tremor F
C. Cogwheel rigidity T
D. Impaired postural reflexes T
E. Cognitive impairment F
4. In Parkinson’s disease :
A. The risk decreases with age F
B. It is more common in females F
C. Smoking has a negative association T
D. Pesticide exposure is a risk factor T
E. There is a loss of axons in the substantia nigra F
5. In Parkinson’s disease :
A. Rigidity is due to enhancement of long-latency stretch reflexes T
B. Tremor is associated with alpha-gamma co-activation T
C. Tremor is present in only 25 % of patients F
D. Dementia is seen in 15-20 % T
E. Depressive illness is seen in 85 % of patients F
6. Regarding Wilson’s disease :

A. It is autosomal recessive T
B. Onset is always in childhood F
C. Kayser-Fleischer rings are due to copper deposition in the iris F
D. Psychiatric symptoms are related to the severity of the hepatic F
involvement
E. Around half of all patients will have psychiatric symptoms T
14. After Cerebrovascular Incidents:

A. Residual deficits occur in 90 % T
B. Personality change is rare F
C. Depression is common with left hemisphere lesions T
D. Anxiety is common T
E. Emotional lability is more common in those with right temporal F
lesions
15. Multiple sclerosis:

B. Is more common in the northern hemisphere T
C. Progressive conditions are more common than relapsing-remitting F
ones
D. Depression is common T
E. Dementia is not a feature F

16. Regarding the features of MS:
A. Epilepsy is less common than in the general population F
B. Erectile dysfunction can occur T
C. CSF examination shows oligoclonal bands in the IgA region F
D. Optic neuritis results in painless visual disturbance F
E. Symptoms can be improved by a hot bath F
17. Parkinson’s disease:

A. Is less common in women T
B. Is associated with pesticide exposure T
C. Is less common in non-smokers F
D. There is loss of dopaminergic cell bodies in the substantia nigra T
E. Lewy bodies are often seen T
18. Clinical features of Parkinson’s disease include:

A. Increased rate of blinking F
B. Tremor inhibited by purposeful movement T
C. Dementia T
D. Higher incidence of depressive illness T
E. Dementia is less common in men F
1. In Klinefelter’s syndrome :
A. The usual karyotype is XYY F
B. Urinary gonadotrophin levels are reduced F
C. Intelligence is normal F
D. Criminal behaviour is an established association F
E. EEG shows slowed alpha waves T
2. In Turner’s syndrome :
A. There is secondary amenorrhoea F
B. Congenital rectal abnormalities are common T
C. Verbal intelligence is normal T
D. Visuospatial abilities are also normal F
E. The incidence of psychotic illness is increased F
3. In Wilson’s disease :
A. Most cases present in the first two decades T
B. It is an autosomal dominant condition F
C. Hepatocytes are forced to store copper due to increased levels of F
caeruloplasmin
D. Diagnosis is by raised plasma caeruloplasmin levels F
E. Urinary copper excretion is usually elevated T
4. Symptoms of Wilson’s disease include :

A. Changes in personality and behaviour T

B. Epilepsy T
C. Rigidity and dystonia T
D. Visual symptoms F
E. Cognitive impairment T
4. The following are true in Wilson’s disease :

A. The ventricles are normal F
B. The basal ganglia show lesions on CT T
C. Treatment is with penicillamine T
D. It is important to avoid vitamin B6 during treatment F
E. Neurological disturbance responds better than hepatic disturbance T
5. The following are true for porphyria :

A. Haem precursors are readily oxidized to porphyrins T
B. All cases are autosomal recessive F
C. Abdominal pain and neuropathy are rarely seen F
D. Episodes can be precipitated by tricyclic antidepressants T
E. EEG is always abnormal F
6. Regarding mitochondrial myopathy :

A. Transmission is usually maternal T
B. Most cases present after the age of 20 F
C. Smooth muscle biopsy (such as from the rectum) is diagnostic F
D. Limb weakness can occur on its own T
E. It may present as a chronic fatigue syndrome T
7. In Neuroacanthocytosis :
A. Red blood cells are abnormal T
B. Tics are seen T
C. Frontal lobe pictures can be seen T
D. Intellectual impairment rules out the diagnosis F
E. Shrinkage of the caudate head on CT can differentiate this F
condition from Huntington’s chorea
F. May present with OCD T
G. Anxiety and depression are frequent T
8. The following are true for Cerebral Ceroid Lipofuscinosis :

A. It is also called Leigh disease F
B. It can occur in infancy T
C. Only autosomal dominant forms have been recognized F
D. It commonly presents as dementia with motor symptoms T
E. Death is within 6-12 months F

9. In Subacute Necrotizing Encephalomyopathy :
A. It is inherited as an autosomal recessive condition T
B. It is due to a disturbance of thiamine metabolism T
C. The condition usually presents in adolescence F
D. Death is prolonged F
E. It can also occur in adults, when it presents as impaired intellect T
and motor symptoms
10. Hallorvorden-Spatz syndrome :

A. Is a rare pyramidal disorder F
B. Typically presents at a young age T
C. Changes in personality also occur T
D. EEG is normal F
E. CT scan resembles Huntington’s chorea, with prominent atrophy T
of the basal ganglia
11. The following are true of the Sphingolipidoses :

A. They are autosomal recessive conditions T
B. Patients with Gaucher’s disease have a greatly reduced life-span F
C. Most cases of Niemann-Pick disease present in early life T
D. Jewish people have a reduced incidence of Niemann-Pick disease F
E. Tay Sachs disease usually results in death before the age of 2 T
Metabolic, Biochemical, and Endocrine disorders
1. Regarding hyperthyroidism :
A. It is more common in men F
B. It usually presents in old age F
C. A ‘thyroid storm’ is seen in 3-5 % of all patients T
D. Depression is more common than mania F
E. Schizophrenic psychoses are more common than mania T
2. Regarding hypothyroidism :
A. More common in women T
B. It usually presents in the 3rd or 4th decade F
C. Auditory hallucinations may be present T
D. EEG changes are seen in a third of patients T
E. Prognosis is poorer if the presentation has an organic quality F
3. Cushing’s syndrome :
A. Is more common in women T

B. Usually presents in the 3rd or 4th decade T
C. Only a few cases have psychiatric symptoms F
D. Mania is more common than depression F
E. Psychoses are usually depressive T
4. Steroid drug treatment :

A. Is more commonly associated with depression F
B. Symptoms occur after 2-3 months F
C. The mental disturbance is related to the dose of the steroids F
D. Those with past mental illness are more likely to suffer psychiatric F
symptoms
E. Females are more prone T
5. Adrenocortical deficiency :
A. Has equal sex prevalence F
B. May be caused by tuberculosis T
C. Fatigue, weakness, and apathy are the common symptoms T
D. Psychosis is common F
E. Both glucocorticoids and mineralocorticoids are needed to reverse F
the mental symptoms
6. Regarding hyperparathyroidism :
A. It is seen only in MEN type I syndrome F
B. Psychiatric symptoms are due to the effects of elevated PTH F
levels
C. Depression is the most common psychiatric condition T
D. The EEG shows widespread slow wave activity T
E. Rebound psychosis may occur in the first week after treatment T
7. In hypoparathyroidism :
A. Most patients are female T
B. Psychiatric features are seen rarely in idiopathic cases F
C. Secondary hypoparathyroidism commonly presents as an acute T
confusional state
D. Secondary hypoparathyroidism is suspected if there is F
symmetrical calcification in the basal ganglia
E. Generalized seizures may occur T
8. Regarding pituitary disease :

A. Psychosis is common in acromegaly F
B. Libido is increased in acromegaly F
C. The prevailing mood in hypopituitarism is depression T
D. Apathy and anergia are common in hypopituitarism T
E. Symptoms of hypopituitarism will fully resolve with treatment F
9. In diabetes mellitus :

A. MAOIs may potentiate the effects of oral hypoglycaemic agents T
B. In ketoacidotic coma, the level of consciousness correlates with T
plasma osmolality
C. Hyperosmolar non-ketotic coma is common in the elderly T
D. There is a negative correlation between emotional upset and good T
diabetic control
E. Dementia is less common F
10. Diabetes inspidus, insulinoma, and phaeochromcytoma :

A. 10 % of beta-cell tumours are malignant T
B. Insulinoma is commonest in childhood and old age F
C. Lithium therapy can cause cranial diabetes insipidus F
D. 50 % of phaeochromocytomas are malignant F
E. In 5 % of cases, phaeochromocytomas are seen in MEN type II T
and are due to autosomal dominant inheritance
19. Psychiatric manifestations of hyperthyroidism may include:

A. Anxiety T
B. Depression T
C. Schizophrenia is more common than mania T
D. Psychotic depression is more common than mania F
E. Cognitive impairment T
20. Psychiatric manifestations of hypothyroidism may include:

A. Paranoia T
B. Agitation and aggression T
C. Mania F
D. Hallucinations never occur F
E. Slowing of dominant rhythm on EEG T
21. Psychiatric features of Cushing’s syndrome may include:

A. Less common in men T
B. Decreased risk of suicide F
C. Schizophreniform presentation is common F
D. Depression is common T
E. Paranoid symptoms are rare F
22. Psychiatric illness with steroid treatment is associated with:

A. Female T
B. Higher dose T
C. Longer duration of therapy F
D. Previous psychiatric illness F
E. Depression of mood F
23. Addison’s disease:

B. Depressive illness is usual presentation T
C. Psychosis is common F
D. Paranoid symptoms can occur T
E. Glucocorticoids have little effect on the mental symptoms F
24. Hyperparathyroidism:
A. Is associated with phaeochromocytoma T
B. Mood elevation is more common than depression F
C. Can cause cognitive impairment T
D. Hallucinations and paranoia are associated with high calcium T
levels
E. Rebound psychosis can occur T
25. Hypoparathyroidism:
A. Is due to end-organ unresponsiveness to PTH F
B. Psychiatric symptoms are seen in almost 100 % of idiopathic T
cases
C. Is associated with papilloedema T
D. Can result in psychosis T
E. Affective psychoses are common F
F. Is associated with calcification of the basal ganglia T
26. Acromegaly:
A. Commonly causes psychosis F
B. Elation is frequent T
C. Libido is reduced T
D. Can present with apathy and lack of spontaneity T
E. Anxiety is frequent T
26. Hypopituitarism is associated with:

A. Sarcoidosis T
B. Childbirth T
C. Basal skull fracture T
D. Intracranial infection T
E. Pituitary tumour T
28. Hypopituitarism:
A. Generally presents with elevation of mood F
B. Schizophreniform psychoses are frequent F
C. Impaired drive quickly responds to therapy F
D. Can cause reduced libido T
E. Symptoms occur in only a few patients F

Disorders of substrates of cerebral metabolism
1. In cerebral anoxia :
A. Cells of the 3rd, 4th, and 5th cortical layers are more prone to T
damage
B. Cerebellar Purkinje cells are resistant to damage F
C. Subcortical U-fibres are often spared T
D. Boundary zone necrosis is most severe in the fronto-temporal F
areas where the territories of the anterior, middle, and posterior
cerebral arteries meet
E. Diffuse laminar cortical necrosis does not occur if blood flow is T
suddenly reduced (e.g. MI)
2. In carbon monoxide poisoning :

A. Delirium is characteristically seen before unconsciousness F
B. Hypotonicity is usually seen F
C. Hypertonic forms carry a better prognosis T
D. 20 % of patients have a prolonged period of delirium following T
poisoning with CO
E. Following recovery from coma, if there is complete recovery then F
there is no further change in presentation
3. In zinc deficiency :
A. Hypogeusia and hyposmia are often seen T
B. Cerebellar signs are seen T
C. Mania is commonly seen F
D. Memory is spared F
E. Emotional lability is seen T
4. In Pellagra :
A. Nicotinic acid is the main deficiency T
B. It is a triad of gastrointestinal symptoms, skin changes, and T
psychiatric disturbance
C. The Betz cells of the motor cortex and other nuclei are spared F
while the Purkinje cells in the cerebellum undergo degeneration
D. There is an increased risk of suicide T
E. Memory impairment is uncommon F
5. Regarding other B vitamin deficiencies :

A. Panthothenic acid deficiency can lead to seizures F
B. Pyridoxine has been linked to depressive illness T
C. Riboflavin can cause the ‘burning feet syndrome’ F
D. Thiamine deficiency can lead to beri-beri T
E. Pyridoxine is a co-enzyme in GABA breakdown F

6. Regarding Wernicke’s encephalopathy :
A. The incidence is twice as common in men T
B. It is associated with prolonged deprivation of thiamine, with an T
acute fall in levels (e.g. glucose load)
C. Confusion, impaired consciousness, and ophthalmoplegia is the T
classic triad
D. Mental abnormalities are seen in all patients F
E. Hallucinations can occur T
7. In Wernicke’s encephalopathy :
A. Mamillary bodies are affected T
B. The walls of the 3rd ventricle are affected T
C. The hippocampus is spared T
D. EEG shows diffuse slowing T
E. The mortality rate is 20 % T
8. Regarding Korsakoff’s psychosis :

A. Females have a higher incidence F
B. Females present later than men F
C. Mamillary bodies are spared F
D. Memory disturbance is associated with involvement of thalamic T
nuclei
E. SPECT scanning shows increased blood flow in the frontal and F
anterior temporal lobes
9. In Vitamin B12 deficiency:

A. There is a microcytic anaemia F
B. Polyneuropathy can occur T
C. Dementia is a feature T
D. There is a strong association with depressive illness F
E. There may be memory impairment T
10. Folic acid deficiency:

A. Can occur in the elderly T
B. May present with depression T
C. Depressed people have lower levels of folate T
D. High levels of folate are seen in dementia F
E. May occur with anticonvulsant medication T

Intracranial infections
9. Regarding Syphilis infection:

A. Meningovascular infection occurs 10-15 years after infection F
B. Meningovascular infection can cause delirium T
C. Cranial nerve palsies are seen in meningovascular disease T
D. Tabes Dorsalis usually presents in middle age T
E. Tabes dorsalis is due to atrophy of the ventral nerve roots and F
dorsal columns
10. Regarding Syphilis infection:

A. Tabes dorsalis can result in Argyll-Robertson pupils T
B. General paresis causes gliosis and cortical demyelination F
C. The dementing picture is most common in GPI T
D. Cortical atropy is seen in GPI T
E. The grandiose presentation is more common than the depressive F
presentation
11. In Encephalitis:
A. The most commonly cause is herpes simplex in the UK T
B. Herpes mainly affects the parietal and temporal lobes F
C. EEG shows diffuse slow-wave activity T
D. Anxiety and depression can result T
E. Schizophrenia is common F
12. In Aids dementia complex (ADC):

A. Develops in 75 % of those with AIDS F
B. There is no cerebral atrophy F
C. It occurs in the early stages of the illness F
D. Personality changes are frequent T
E. Memory and concentration are impaired T
13. Cerebral abscesses:

A. Occur more frequently in those with congenital heart disease T
B. Are more common in IV drug abusers T
C. Seizures may be an early sign T
D. Local spread affects the parietal lobes F
E. Lumbar puncture is diagnostic F

Mental Retardation
1. The following is true of mental retardation :

A. It is more common in males T
B. 1/3 of cases are due to Down’s syndrome T
C. 15 % of cases are due to an unknown cause T
D. There is no greater incidence in the lower classes F
E. 95 % of cases have organic pathology diagnosed during life F
2. The following are seen in Patau’s syndrome :

A. Trisomy of 17-18 F
B. Absent corpus callosum T
C. Rocker-bottom feet F

D. Polycystic kidneys T
E. Life expectancy is 5-6 years F
3. In Edward’s syndrome :
A. There is mental retardation T
B. Trisomy 13-15 is seen F
C. It is more common in females T
D. Mean survival is 10 months T
E. Heart lesions are frequent F
4. In Down’s syndrome :
A. It is more common in males T
B. Simian crease is seen in all cases F
C. There is brachycephaly T
D. The tongue is enlarged F
E. Cataracts can occur T
5. The following are associations of Down’s syndrome :

A. A-V canal defects T
B. Hirschsprung’s disease T
C. Hearing deficits T
D. Epilepsy T
E. Vascular dementia F
6. The following is true of Fragile X syndrome :

A. It was first described by Martin and Bell in 1943 T
B. It is an uncommon cause of mental retardation in males F
C. Female carriers have normal IQ F
D. Autism is associated T
E. There is a negative association with ADDH F
7. The following are true in Tuberous sclerosis :

A. It is a defect of chromosome 11 F
B. It is autosomal recessive F
C. Shagreen patches are best examined with Wood’s light F
D. Seizures are rare F
E. Intelligence is normal F
8. In the mentally handicapped :

A. The incidence of schizophrenia is the same as the normal F
population
B. Bipolar Affective disorder is seen in 1 in 20 handicapped in- T
patients
C. Hysterical symptoms are more common than in normal controls T
D. Epilepsy is seen in a third of severely handicapped patients T

E. The incidence increases with age, except for Down’s syndrome F
and autism
Epilepsy
1.

Neuroanatomy, neurophysiology, and neuropathology
1. Possible signs of posterior column damage include :

A. Negative rombergism F
B. Diminished tendon reflexes T
C. Hypertonicity F
D. Loss of vibration sense T
E. Loss of proprioception T
2. Features of Alzheimer’s disease may include :

A. Glial proliferation T
B. Cystic necrosis and gliosis F
C. Granulovacuolar degeneration T
D. Multiple micro-infarcts F
E. Arteriosclerosis F
3. Features of upper motor neuron lesions could include :

A. Clonus T
B. Cogwheel rigidity F
C. Flexor plantar response F
D. Preservation of muscle bulk T
E. Increased tendon reflexes T

4. Features of Pick’s disease might include :
A. Frontal and parietal lobes mainly affected F
B. ‘knife-blade’ atrophy T
C. ‘balloon cells’ T
D. Absence of fibrous gliosis F
E. Pick’s cells T
5. Activation techniques in electroencephalography include :

A. Dehydration F
B. Sodium valproate F
C. Alcohol T
D. Hypoventilation F
E. Sleep T
6. Features of Creutzfeldt-Jacob disease include :

A. Neuronal degeneration T
B. Atrophy of caudate and putamen especially F
C. Spongeiform changes T
D. Does not affect the whole CNS F
E. Glial proliferation T
7. Possible features of lower motor neuron disease include :

A. Atonic muscles T
B. Absent reflexes T
C. Loss of 100 % of muscle bulk F
D. Clasp-knife rigidity F
E. Tardive dyskinesia F
8. Features of multi-infarct dementia could include :

A. Senile plaques F
B. Neurofibrillary tangles F
C. Hypertension T
D. Cerebral ischaemia T
E. Cerebral infarction T
9. Functions of the non-dominant cerebral hemisphere may

include :
A. Holistic T
B. Ideational F
C. Pictorial T
D. Geometric T
E. Non-linear T
10. Memory defects occur with lesions in :

A. Medial-dorsal thalamic nucleus T

B. Wernicke’s area F
C. Walls of third ventricle T
D. Broca’s area F
E. Parietal cortex F
11. The limbic system includes :

A. Parahippocampal gyrus T
B. Hypothalamus T
C. Corpus callosum F
D. Anterior nucleus of thalamus T
E. Subcallosal gyrus T
12. Diplopia occurs in :

A. Neuropathy of oculomotor nerve T
B. Parkinson’s disease F
C. Neuropathy of facial nerve F
D. Huntington’s disease F
E. Diabetes insipidus F
13. Associations of benign intracranial hypertension might

include:
A. Chlortetracycline administration T
B. Myxoedema F
C. Polycythaemia T
D. Oral contraceptives T
E. Hypoparathyroidism T
14. Possible structures involved in the accommodation reflex

include:
A. Pretectal nucleus F
B. Edinger-Westphal nucleus (bilaterally) F
C. Lateral geniculate body T
D. Inferior colliculus F
E. Oculomotor nuclei of midbrain T
15. Features of posterior inferior cerebellar artery occlusion

might include:
A. Contralateral Horner’s syndrome F
B. Ipsilateral analgesia (limbs) F
C. Contralateral ataxia F
D. Dissociated analgesia T
E. Ipsilateral analgesia (facial) T
16. Nystagmus occurs in :

A. Brain stem lesions T

B. Labyrinthine disease T
C. Cerebellar lesions T
D. Healthy subjects T
E. Rotational stimulation T
17. Features of basilar artery occlusion could include :

A. Monoplegia T
B. Contralateral cerebellar signs F
C. Quadriplegia T
D. Hypopyrexia F
E. Contralateral cranial nerve palsies F
18. Features of general paresis (GPI) may include :

A. ‘Rod cells’ T
B. Cortical thickening F
C. Thinning of the dura F
D. Perivascular lymphocytes T
E. Spirochaetes found in the brain T
19. Causes of mononeuritis multiplex include :

A. Sarcoidosis T
B. Bronchial carcinoma T
C. Leprosy T
D. Polyarteritis nodosa T
E. Trauma F
20. Features of pseudo-bulbar palsy include :

A. Exaggerated jaw jerk T
B. Emotional lability T
C. Wasting of tongue F
D. Facial muscles’ fasciculation F
E. Dysphonia T
21. Possible causes of sudden blindness include :

A. Vitreous haemorrhage T
B. Hysterical dissociation F
C. Acute glaucoma T
D. Methanol T
E. Prolapsed intervertebral disc F
22. Principal outputs of the basal ganglia go to :

A. Cerebral cortex F
B. Red nucleus T
C. Tectum T
D. Subthalamic nucleus T

E. Substantia nigra T
23. Functions of the limbic system may include :

A. Emotional behaviour T
B. Motivation T
C. Sexual activity T
D. Conditioned reflexes T
E. Memory T
24. Diencephalic structures might include :

A. Pons F
B. Pituitary T
C. Thalamus T
D. Cerebellum F
E. Hypothalamus T
25. Functions of the reticular formation could include :

A. Arousal T
B. Principal input to basal ganglia F
C. Sleep T
D. Vigilance F
E. Principle input to limbic system T
26. Features of the Brown-Sequard syndrome include :

A. contralateral loss of conscious kinaesthesia F
B. Ipsilateral loss of crude touch F
C. Contralateral loss of two-point discrimination F
D. Ipsilateral loss of temperature F
E. Incomplete lateral hemisection of spinal cord F
27. Branches of the basilar artery include :

A. Posterior cerebral artery T
B. Anterior cerebral artery F
C. Posterior inferior cerebellar arteries F
D. Anterior inferior cerebellar arteries T
E. Labyrinthine arteries T
28. Possible features of complete spinal cord transection include :

A. Reflexes initially hyperactive F
B. Loss of all voluntary movement below lesion T
C. Development of automatic bladder in first 3 days usually F
D. Loss of all perception of sensation below lesion T
E. Loss of all reflexes after about three weeks F

29. Possible components of the cerebellum include :
A. Caudate nucleus F
B. Dentate nucleus T
C. Lentiform nucleus F
D. Vermis T
E. Cingulate gyrus F
30. Features of anterior cerebral artery occlusion could include :

A. Contralateral lower limb sensory deficits T
B. Contralateral hemianopia F
C. Clouding of consciousness T
D. Motor aphasia F
E. Contralateral lower limb paresis T
31. Dopaminergic cell bodies are situated in :

A. ventral tegmental area T
B. Substantia nigra T
C. Median raphe nucleus F
D. Dorsal raphe nucleus F
E. Arcuate nucleus of hypothalamus T
32. Telencephalic structures could include :

A. Oculomotor nerves F
B. Basal ganglia T
C. Crura cerebri F
D. Optic nerves F
E. Cerebral hemispheres T
33. Functions of astrocytes might include :

A. Myelin sheath production F
B. Filling the role of fibrous tissue T
C. Lining the cerebral ventricles F
D. Most numerous of the glial cells T
E. Lining the spinal canal F
34. Maxillary division branches of the trigeminal ganglion might

include :
A. Supraorbital nerve F
B. Infraorbital nerve T
C. Superior alveolar nerve T
D. Inferior alveolar nerve F
E. Nasociliary nerve F
35. Components of the basal ganglia may include :

A. Amygdaloid nucleus F

B. Red nucleus F
C. Dentate nucleus F
D. Caudate nucleus T
E. Subthalamic nucleus F
36. Features of carotid sinus stimulation may include :

A. Hyperventilation F
B. Hypertension F
C. Raised intracranial pressure F
D. Peripheral vasodilation T
E. Bradycardia T
37. Components of the cerebellum include :

A. Flocculonodular node T
B. Alveus F
C. Stria terminalis F
D. Fastigial nucleus T
E. Interpositus nucleus T
38. Components of the Papez circuit include :

A. Fornix T
B. Mamillary body T
C. Hippocampus T
D. Thalamus T
E. Cingulate gyrus T
39. Possible components of the Pons include :

A. Abducens nucleus T
B. Oculomotor nucleus F
C. Trapezoid body T
D. Red nucleus F
E. Corpora quadrigemina F
40. Characteristic causes of pre-senile dementia include :

A. Jakob-Creutzfeldt disease T
B. Simple schizophrenia F
C. Subacute spongiform encephalopathy T
D. Manic-depressive psychosis F
E. Punch-drunk syndrome T
41. Possible components of the pyramidal system include :

A. Pyramidal tract T
B. Vestibular nuclei F
C. Anterior horn cells T
D. Cerebellum F

E. Cortico-spinal tract T
42. Components of the direct and consensual light reflexes could

include :
A. Superior colliculus F
B. Lateral geniculate body F
C. Ciliary ganglion T
D. Visual cortex F
E. Constrictor muscles of iris T
43. Components of the limbic system may include :

A. Internal capsule F
B. Median forebrain bundle T
C. Corpus striatum F
D. Isthmus T
E. Medial lemniscus F
44. The circle of Willis is formed by :

A. Superior cerebellar artery F
B. Posterior spinal artery F
C. Posterior communicating artery T
D. Middle cerebral artery F
E. Anterior inferior cerebellar artery F
45. Posterior cerebral artery occlusions cause :

A. Contralateral hemianalgesia T
B. Ipsilateral hemianaesthesia F
C. Spontaneous pain T
D. Ipsilateral hemiplegia F
E. Ipsilateral hemianopia F
46. A left homonymous hemianopia may be due to a lesion in :

A. Left optic tract F
B. Right optic tract T
C. Optic chiasma F
D. Right lateral geniculate body T
E. Left medial geniculate body F
47. Features of cerebellar disease include :

A. Pendular nystagmus F
B. Dysdiadochokinesis T
C. Resting tremor F
D. Past pointing T
E. Scanning dysarthria T

48. Causes of papilloedema include :
A. Central retinal vein thrombosis T
B. Hypoparathyroidism T
C. Cavernous sinus thrombosis T
D. Hypercapnia T
E. Cranial arteritis T
49. The following structures are in the pons:

A. Reticular formation T
B. Substantia nigra F
C. Locus coeruleus T
D. Trigeminal nerve nucleus T
E. Vestibular nuclei T
50. The following structures are in the midbrain:

A. Superior colliculus T
B. Inferior colliculus T
C. Substantia nigra T
D. Ventral tegmental area T
E. Medical longitudinal fasciculus F

Basic Psychology
1. In behavioural psychotherapy :
A. Flooding cannot be achieved in an imaginal way F
B. Systematic desensitization is an aspect of aversive conditioning F
C. Response prevention is characteristically combined with flooding T
D. Physical restraint is no longer used in response prevention F
E. Virtuous circles are a factor in most fear-reduction techniques T
2. Simple phobias :
A. Are commoner in men F
B. Mostly arise de novo in adulthood F
C. Are best treated by relaxation training F
D. Typically lead to symptoms of depersonalization F
E. Are associated with mitral valve prolapse F
3. The following terms are correctly defined :

A. Stimulus generalization is when a response learnt in one situation F
is exhibited in another
B. Primary reinforcers are things such as food and water T
C. Secondary reinforcers are things such as sex, money, etc F
D. Stimulus discrimination is when a learner responds differently to T
two slightly different stimuli
E. Response discrimination refers to the ability to make the same F
response in the same situation time after time
4. The following are true of various types of learning :

A. shaping is also known as ‘cognitive dissonance’ F
B. backward chaining can be used to teach children to toilet T
themselves
C. observational learning is a type of classical conditioning F
D. modelling is a type of observational learning T
E. a programme which begins with reinforcement of the last act in a F
sequence is known as ‘forward chaining’
5. Systematic desensitization :
A. was developed by Skinner F
B. is a form of operant conditioning F
C. is the treatment of choice for obsessional thoughts F
D. relaxation is an essential part of the treatment T
E. drugs can be used to produce relaxation T
6. Variable ratio schedules of reinforcement :

A. can only be used in operant conditioning situations F
B. need proportionally more trials to achieve a given criteria of F

learning
C. increase the resistance to extinction T
D. are more likely to produce emotional outbursts during the learning T
phase
E. are less likely to produce emotional outbursts during the extinction T
phase
7. With reference to conditioning models of behaviour :

A. it is difficult to label any real life situation as totally operant or T
totally classical
B. in the 1940s, several psychoanalysts applied them successfully to F
demonstrate Freudian concepts
C. they can explain either systematic desensitization or flooding, but F
not both
D. they are increasingly demonstrating how unimportant cognitive F
factors are in behaviour
E. they emphasize the importance of timing and order in any learning T
situation
8. In classical conditioning:
A. Thorndike is a key figure F
B. Spontaneous recovery only occurs after a short delay F
C. The longer the time between extinction and reappearance of CS, F
the weaker the response
D. Forward conditioning is when the CS always precedes the UCS T
E. The strength of CR is proportional to the intensity of the UCS T
9. The following statements about classical conditioning are true:

A. The learned immune response is an example of classical T
conditionng
B. Taste aversions typify classical conditioning F
C. Classical conditioning underlies systematic densitization T
D. Second-order conditioning may be a model for the acquisition of T
phobias
E. Incubation means that some stimuli are more likely to become CS F
than others
10. Operant conditioning:

A. Is the same as Instrumental conditioning T
B. Is associated with B. F. Skinner T
C. Extinction and spontaneous recovery do not occur F
D. Positive reinforcers are inherently rewarding, e.g. food, sex F
E. Negative reinforcers weaken a particular response F
11. The following are true of reinforcement:

A. Escape conditioning is an example of negative conditioning T

B. A shuttle-box utilizes avoidance conditioning F
C. Behaviour learned through avoidance conditioning is resistant to T
extinction as it is often reinforced by fear reduction
D. Money is a secondary reinforcer T
E. Secondary reinforcers are also known as ‘conditioned reinforcers’ T
12. In reinforcement:
A. A variable ratio schedule means that reinforcement is given after a F
variable amount of time
B. Gambling is an example of variable-interval conditioning F
C. Partial reinforcement is involved in the development of T
superstitious behaviour
D. Variable ratio reinforcement results in quick, stepped responding F
E. Behaviour learned through partial reinforcement is very resistant T
to extinction
13. Regarding operant conditioning:

A. Punishment is synonymous with penalty F
B. Punishment strengthens positive responses F
C. Shaping is best used when the complete response desired is simple F
D. Toilet training is an example of ‘backward chaining’ T
E. ‘Time-out’ is an example of the use of penalty T
14. Regarding cognitive processes in learning:

A. Seligman described learned helplessness T
B. Insight learning can occur in primates T
C. Bandura demonstrated vicarious conditioning T
D. Practice of a skill is necessary until the point of almost-correct F
performance
E. Sign-learning theory includes the formation of cognitive maps T
15. The following are true of perceptual theories:

A. The ecological view states that the perceptual system constructs F
detail from clues in the environment
B. Constructionism is an example of top-down processing T
C. Weber’s law states that as stimulus magnitude increases, larger F
changes in physical magnitude are required
D. Fechner’s law applies to electric shocks F
E. Weber’s law does not hold when stimuli are very intense or very T
weak
16. In perceptual organization:

A. Camouflage demonstrates reversal of figure and ground F
B. Perceptual phenomena demonstrate Gestalt effects T
C. Gestalt theories are an example of bottom-up processing F
D. Perception of depth and distance illustrate ecological views of T

perception
E. Perception of movement does not rely on movement of the retinal T
image
17. The following are true:

A. Perception of motion depends on interstimulus interval T
B. Perceptual sets demonstrate top-down processing T
C. Chunking of information facilitates processing T
D. The ‘visual cliff’ suggests depth perception develops around six- F
months of age
E. Attention always occurs without conscious effort F
18. The following are true of memory:

A. The capacity of short term memory (STM) can be increased by T
chunking
B. Visually-encoded information fades more quickly from STM T
C. Decay theory suggests that forgetting is item-dependent F
D. Retroactive inhibition suggests that previous learning impairs F
subsequent learning
E. ECT can interrupt consolidation and produce retrograde amnesia T
19. Models of memory include:

A. Dual memory theory T
B. Perceptual Representation System F
C. Transfer-appropriate processing T
D. Constructive memory T
E. Maintenance rehearsal is more effective than elaborative rehearsal F
20. Regarding the neurophysiology of memory:

A. Bilateral damage to the hippocampus produces retrograde amnesia F
B. Basal forebrain lesions can result in a Korsakoff’s type memory T
deficit
C. 5-HT agonists impair cognition since acetylcholine release is T
under inhibitory 5-HT tone
D. Endorphins are involved in memory processes T
E. RNA is involved in memory transfer T
21. Regarding theories of thought:

A. Cognitive maps may exhibit systematic distortion T
B. ‘Home’ is a natural concept T
C. Scripts are mental representations of concepts F
D. Problem solving involves ignoring negative evidence F
E. Incubation can help to break mental sets T
22. The following are true about theories of personality:

A. Adler described ‘striving for superiority’ T
B. Adler emphasized the importance of sexual urges F
C. Jung described ‘introversion’ and ‘extraversion’ T
D. Trait theories employ a normothetic approach T
E. Eysenck used a ‘dimensional’ approach to personality T
23. Regarding personality:

A. Costa and McCrae’s model only holds in Westernized countries F
B. John Watson is associated with personality research T
C. Bandura described ‘reciprocal determinism’ T
D. Carl Rogers described ‘self-actualization’ and ‘self-concepts’ T
E. Maslow is associated with ‘conditions of worth’ F
24. The following are true of motivation:

A. Drive reduction theory is based on the principle of homeostasis T
B. Primary drives are learned desires F
C. People perform best when their level of arousal is low F
D. ‘Need achievement’ demonstrates clear gender differences T
E. Belongingness and love are at the apex of Maslow’s hierarchy of F
needs
25. Regarding emotion:

A. Facial movements expressing emotion are controlled by the F
pyramidal system
B. The James-Lange theory emphasized the importance of T
physiological responses
C. The Cannon-Bard theory described ‘transferred excitation’ F
D. Social referencing only occurs in brain-damaged patients F
E. Facial feedback can drive emotional experience according to the F
Schacter-Singer theory
Social Psychology
1. Regarding social construction of the self and attribution

theory:
A. Festinger described ‘social comparison’ T
B. ‘Relative deprivation’ means that however much we get, it is less T
than we deserve
C. According to attribution theory, in internal attribution, F
distinctiveness is high, and consensus and consistency are low
D. The fundamental attribution error means that we tend to F
overattribute the behaviour of others to external factors
E. The ultimate attribution error means that we attribute others T
positive actions to external causes, and negative actions to internal
causes

2. Regarding attitudes:
A. Attitudes consist of cognitive, affective, and behavioural T
components
B. Attitudes can only be learned through operant conditioning F
C. The ‘mere-exposure effect’ suggests that the more that we are F
exposed to an object, the more negative our attitudes will be towards
it
D. The ‘Elaboration-likelihood model’ says that persuasive messages T
can change people’s attitudes via peripheral and central routes
3. The following are true of theories about attitudes:

A. Leon Festinger is associated with ‘cognitive dissonance theory’ T
B. Cognitive dissonance may be more likely to change attitudes in T
individualist cultures such as Europe or the USA
C. Daryl Bem is associated with ‘Self-perception theory’ T
D. ‘Self-perception theory’ suggests that people infer their behaviour F
to match their attitudes
E. People may change their behaviour in situations where they are T
not sure what their attitudes are
4. The following are true of prejudices and stereotypes:

A. The ‘authoritarian personality’ may be more likely in people who F
were not exposed to punishment, and so feel that they do not have to
obey or defer to others
B. ‘Illusory correlations’ can occur when noticeably objective T
behaviour is performed by a few members of an easily identified
ethnic group
C. The ‘contact hypothesis’ suggests that we are more likely to F
reduce our prejudices when we are exposed to members of the other
group who are of a higher status
D. Norms can be descriptive (what others approve or disapprove of) F
or injunctive (indicate what others do)
E. Deindividuation may cause people to perform aggressive or illegal T
acts in certain situations
5. The following are true of conformity:

A. Compliance occurs when people adjust their behaviour as a result F
of unspoken group pressure
B. Ambiguity of the situation increases the likelihood of conforming T
to a group norm
C. ‘Social impact theory’ holds that the power of a group depends on T
how important and how close that group is to the person in question
D. Women are more likely to conform to a group than men F
E. The presence of others who disobey can make someone more F
likely to be obedient

6. The following are true of aggression:
A. Freud proposed that aggression is a biological urge, and is due to T
Thanatos
B. The amygdala and hypothalamus are involved in aggression T
C. Aggressive behaviour is more likely in collective cultures F
D. Immediate reward or punishment can alter the frequency of T
aggressive acts
E. Aggression is more likely to occur following an expected failure F
than an unexpected one
7. In altruistic behaviour:
A. The ‘bystander effect’ indicates that the more people who witness T
an emergency, the less likely it is that someone will help
B. The tendency to blame oneself rather than the group is called F
‘diffusion of responsibility’
C. Task-oriented leaders are more effective when the task is F
structured
D. Person-oriented leaders are most effective when the group is F
working under time pressure
E. ‘Groupthink’ is likely when the group is isolated, and is under T
time pressure
Psychotherapy
1. Ego functions include:

A. Reality testing T
B. Control of primary drives T
C. Object relationships T
D. Primary autonomous functions T
E. Defence mechanisms T
2. Regarding dynamic theory:

A. The manifest content of dreams shows ‘over determinism’ T
B. Parapraxes are conscious expressions of ego desires F
C. Parapraxes may be completely inhibited T
D. Primary process thinking is based on the pleasure principle T

E. Secondary process thinking is unconscious F
3. Defence mechanisms described by Freud include:

A. Displacement T
B. Projection T
C. Splitting F
D. Projective identification F
E. Turning against the self F
4. The following are true of Freud’s topographical model:

A. The ego develops from the Id F
B. The preconscious uses ‘primary process’ F
C. The unconscious can be seen through dreams and parapraxes T
D. The preconscious maintains the ‘censors’ T
E. Primary autonomous functions are ego functions F
5. Regarding Freud’s structural model:

A. Ego functions include impulse control and object relations T
B. The superego causes primitive irrational guilt T
C. The superego is conscious F
D. Primary processes occur in ego and superego functions F
E. Thanatos and eros are described T
6. In libido theory:
A. The mother is the primary love object T
B. The anal stage occurs between the ages of 3 and 6 F
C. The oedipus complex results from superego formation F
D. Social relationships and play occur in the latency period T
E. Castration anxiety is due to fear of giving up mother F
7. The following are true of other psychodynamic theorists:

A. Reich described ‘striving for superiority’ F
B. Otto Rank said that neurosis is due to the trauma of birth T
C. Horney described ‘penis-envy’ F
D. Anna Freud emphasized the importance of ego-defence T
mechanisms
E. Winnicot described attachment theory F
8. The following are neo-Freudians:

A. Erica Fromm T
B. Bowlby F
C. Horney T
D. Anna Freud F
E. Harry Stack-Sullivan T

9. The following associations are correct:
A. Rogers and the Encounter movement T
B. Berne and Gestalt therapy F
C. Perls and Existential logotherapy F
D. Moreno and Psychodrama T
E. Maslow and Self-actualization T

A. Turning against the self occurs in hysteria and depression F
B. Obsessions involve displacement T
C. Identification occurs in depression T
D. Phobias are due to symbolic expression of the wish in the F
symptom
E. Obsessions are due to a rigid and destructive superego T
Clinical Pharmacology

A. Drugs must be ionized to be absorbed by passive diffusion F
B. In an acid pH, basic drugs will be poorly absorbed T
C. Gastric emptying is delayed by MAOIs T
D. Food increases the absorption of diazepam T
E. Rectal administration results in extensive 1st pass metabolism F
2. Regarding some aspects of pharmacokinetics:

A. Diazepam is 99% protein-bound T
B. Ionized drugs cross the blood-brain barrier easily F
C. Phase I reactions convert the drug to non-active metabolites F
D. Phase II reactions include glucuronidation and sulphation T
E. Hydroxylation is autosomal dominant T
3. Regarding Drug interactions:

A. Carbamazepine can inhibit the metabolism of TCAs F
B. Phenothiazines can induce their own metabolism T
C. Haloperidol inhibits the metabolism of TCAs T
D. Cytochrome P450 inhibition by cimetidine is an important factor F
in healthy subjects
E. Slow acetylators predominate in Europe and Japan F

A. In the elderly, there is a reduction in plasma albumin T
B. There is a loss of body weight in the elderly F
C. In pregnancy, the increase in plasma volume results in an increase F
in the free fraction of a drug
D. First-order kinetics are exponential T
E. Alcohol and aspirin undergo zero-order kinetics T
5. The following statements about the distribution of

neurotransmitters are correct:
A. Acetylcholine is found in the basal ganglia T
B. Dopamine cell bodies are found in the limbic system F
C. 5-HT predominates in the raphe nuclei in the brainstem T
D. Noradrenaline predominates in the locus coeruleus T
E. GABA is found in the peri-aqueductal grey matter F
6. The following are true statements about receptors:

A. 5-HT2A antagonists improve slow-wave sleep T
B. 5-HT1A antagonists are anxiolytic F
C. D2 receptors are found in the limbic system T
D. Antagonism of alpha-2 adrenoceptors leads to reduced NA release F
E. Most antipsychotics are D2 agonists F
7. Regarding benzodiazepines (BZDs):

A. BZDs bind to the gamma-2 subunit of the GABAB supramolecular F
complex
B. BZDs can inhibit the effects of other neurotransmitters such as 5- T
HT
C. Oxazepam and Lorazepam are short-acting BZDs F
D. The BZ1 receptor mediates the anti-anxiety effect of BZDs F
E. The BZ2 receptor is concentrated in the amygdala and septo- T
hippocampal pathways
8. Regarding Benzodiazepines:
A. Tolerance develops in 4-6 weeks of therapy F
B. Withdrawal can cause rebound insomnia T
C. BZDs are effective in phobic states F
D. Zopiclone and Zolpidem act upon the BZ2 receptor in a similar F
way to BZDs
E. Withdrawal symptoms peak at 7-8 days T
9. The following are recognized side effects of BZDs:

A. Ataxia T
B. Drowsiness T

C. Anterograde amnesia T
D. Nightmares F
E. Insomnia F
10. The following are recognized symptoms of the BZD

withdrawal syndrome:
A. Tremor T
B. Depression T
C. Tinnitus T
D. Blurred vision T
E. Sweating T
11. Factors associated with dependence and withdrawal

problems are:
A. Short duration of treatment F
B. Passive-dependent personality traits T
C. Age < 40 years F
D. Concurrent use of Buproprion T
E. High dose and rapid withdrawal T
12. Regarding Buspirone:

A. Buspirone is a 5-HT1A agonist T
B. Buspirone has little effect on DA systems F
C. Effects are usually evident after 8-12 hours F
D. It can cause galactorrhoea T
E. Dysphoria has been reported T
13. Regarding the pharmacological treatment of anxiety

disorders:
A. Placebo-response rate is in the region of 20-30 % F
B. CBT is much less effective than drugs for anxiety F
C. Beta-blockers can cause anxiety F
D. Beta-blockers are associated with nightmares T
E. The effect of Beta-blockers usually takes up to a month to develop F
14. The following statements about antidepressants are true:

A. Mianserin is an SSRI T
B. Reboxetine is a NaSSA F
C. Mirtazapine is a NARI F
D. Trazodone is an SNRI F
E. Nefazodone is an SSRI T
15. Regarding Tricyclic Antidepressants (TCAs):

A. Treatment results in subsensitivity of NA and 5-HT receptors on T
cell bodies

B. Tertiary amines have a higher affinity for the 5-HT uptake site T
C. Tertiary amines are less sedating F
D. Secondary amines have more anticholinergic side effects F
E. Tertiary amines have a quicker peak plasma level T

A. Amoxapine has D2 antagonist properties T
B. Amitriptyline is a secondary amine F
C. Lofepramine is a tertiary amine T
D. Maprotiline is the most selective NA uptake inhibitor of the TCAs T
E. Imipramine is more selective for 5-HT than Nortriptyline T
17. Side effects of TCAs include:

A. Sinus bradycardia F
B. Impairment of memory T
C. Postural hypotension due to alpha-1 adrenoceptor antagonism T
D. Weight gain due to histamine H1 agonism F
E. Negative inotropism T
18. Side effects of TCAs include:

A. Prolongation of the PR interval T
B. Flattening of T waves T
C. Coarse tremor F
D. Raising of the seizure threshold F
E. Cholestatic jaundice T
19. Contraindications to TCAs include:

A. Narrow angle glaucoma T
B. Elderly F
C. Heart block T
D. Previous MI F
E. Prostatic hypertrophy T
20. Regarding SSRIs:

A. They reach peak levels within 1 hour of ingestion F
B. Long-term use results in reduced 5-HT2 function T
C. Fluoxetine has a half-life of around 7 days F
D. OCD is an indication for their use T
E. They should be avoided in people with cardiac disease F
21. Common side effects of SSRIs include:

A. Diarrhoea T
B. Constipation T
C. Loss of appetite T
D. Weight gain F

E. Tremor T
22. Common side effects of SSRIs include:

A. Anorgasmia T
B. Hypertension F
C. Tachycardia F
D. Alopecia F
E. Sweating T
23. Interactions of SSRIs include:

A. Use with MAOIs can result in the 5-HT toxicity syndrome T
B. Lithium T
C. Diazepam and fluoxetine T
D. Warfarin T
E. Anti-convulsants T
24. Regarding MAOIs:

A. Most are selective for MAOI-A F
B. Phenelzine has fewer side effects than isocarboxacid F
C. Hypotension is a major problem with tranycypramine F
D. Fast acetylators metabolize MAOIs at the same rate as slow F
acetylators
E. It is said that atypical depression responds best to MAOIs T
25. Recognized side effects of MAOIs include:

A. Mania T
B. Seizures T
C. Blurred vision T
D. Peripheral neuropathy T
E. Alopecia F
26. Important interactions with MAOIs can occur with:

A. Some cough medicines T
B. Oral hypoglycaemics T
C. NSAIDs F
D. Cheese T
E. Calcium antagonists F
27. Contraindications for MAOIs include:

A. Renal failure F
B. Congestive cardiac failure T
C. Concurrent use of TCAs F
D. Asthma F
E. Phaochromocytoma T

28. Mianserin:
A. Is a weak NA reuptake inhibitor T
B. Is cardiotoxic F
C. Is an antagonist at histamine receptors and can cause weight gain T
D. Has no effect on the seizure threshold F
E. Can cause agranulocytosis T
29. Mirtazapine:
A. Has little effect on histamine receptors F
B. Blocks alpha-2 autoreceptors T
C. Is alerting in its profile F
D. Can reduce appetite F
E. Can cause neutropenia T
30. Trazodone:
A. Is non-sedating F
B. Has 5-HT agonist properties T
C. Should be taken with food T
D. Can cause priapism T
E. Has no effect on cognitive function F
31. Nefazodone:
A. Has sedating properties due to alpha-1 adrenoceptor antagonism F
B. Dry mouth and dizziness can occur T
C. Has a long half-life F
D. Can affect the action of propanolol T
E. Can increase haloperidol levels T
32. Venlafaxine:
A. Is an SNRI T
B. Lacks anticholinergic effects T
C. Has no effect on the seizure threshold F
D. Can be given with MAOIs F
E. Can cause hypotension T
33. L-Tryptophan:
A. Is an effective antidepressant by itself F
B. Should not be used with MAOIs F
C. Can cause agranulocytosis F
D. Peripheral neuropathy may be a rare side effect T
E. Skin sclerosis can occur rarely T
34. Regarding the phenothiazines:

A. Group one drugs include thioridazine F

B. Group three drugs include trifluoperazine T
C. Group two drugs have high levels of antimuscarinic side effects T
D. Group three drugs have low levels of extrapyramidal side effects F
E. Other classes of drugs tend to resemble group one phenothiazines F
34. Regarding other antipsychotic drugs:

A. Droperidol is a butyrophenone T
B. Zuclopenthixol is a thioxanthene T
C. Olanzapine is a dibenzodiazepine F
D. Risperidone is a dibenzothiazepine F
E. Sulpiride is a substituted benzamied T
35. The following are true of movement disorders:

A. Young females are at highest risk of acute dystonic reactions F
B. Extrapyramidal symptoms tend to occur within a few hours of F
drug administration
C. Extrapyramidal symptoms are due to blockage of D2 receptors in T
the basal ganglia
D. Increasing the dose can sometimes help extrapyramidal side F
effects
E. Tardive dyskinesia is due to D2 receptor hypersensitivity T
36. The following are at increased risk of tardive dyskinesia:

A. Female T
B. Affective disorders T
C. Continuous treatment F
D. Organic brain disease T
E. Increasing age T
37. Recognized side effects of antipsychotics include:

A. Sedation due to muscarinic blockade F
B. Nasal congestion T
C. Impotence T
D. Psoriasis F
E. Hypertension F
38. Recognized side effects of antipsychotics include:

A. Retinal pigmentation T
B. Leucocytosis F
C. Prolonged QT interval T
D. Weight loss F
E. Torsade de pointes T
39. Regarding neuroleptic malignant syndrome:

A. Onset occurs after 1-2 months of treatment F

B. Onset is slow and insidious F
C. Symptoms include hypertonicity, stupor, and autonomic instability T
D. Mortality is 50 % F
E. Secondary conditions include thromboembolism, renal failure, and T
cardivascular collapse
40. Risperidone:
A. Has high affinity for the 5-HT2A receptor T
B. Can cause hyperprolacinaemia T
C. Weight loss is frequent F
D. Is less effective than conventional antipsychotics F
E. Headache and anxiety may occur T
41. Clozapine:
A. Has low affinity for D2 receptors T
B. Has low affinity for D1 and D4 receptors F
C. Has few effects on adrenoceptors F
D. Can increase blood levels of warfarin and digoxin T
E. Metabolism by the cytochrome P450 system is not significant F
42. Side effects of Clozapine include:

A. Bradycardia F
B. Weight gain T
C. Hypersalivation T
D. Increase in seizure threshold F
E. Neutropenia and agranulocytosis T
43. Olanzapine:
A. Has lower affinity for the D2 and 5-HT2A receptors than Clozapine F
B. Has higher affinity for the D1 receptor than Clozapine F
C. Causes negligible weight gain F
D. Has high levels of Extra-pyramidal side effects F
E. Can cause marked sedation T
44. Quetiapine:
A. Has a similar binding profile to clozapine T
B. Has a high affinity for muscarinic receptors F
C. Has lower affinity for all receptors than clozapine T
D. Causes less weight gain than olanzapine and clozapine T
E. Can cause constipation T
45. Sertindole:
A. Has low affinity for the 5-HT2A receptor F
B. Specifically targets D2 receptors in the limbic region T
C. Causes high levels of EPS F
D. May cause orthostatic hypotension T

E. Has been linked to sudden cardiac death T
46. Amisulpride:
A. Is a D2/ D3 agonist F
B. Blocks autoreceptors at low doses and can increase synaptic T
dopamine levels
C. Does not increase prolactin levels F
D. Has a similar level of EPS across the whole dose range F
E. Has effects on negative symptoms at low doses F
47. Lithium:
A. Has its main effects on noradrenaline systems in the brain F
B. Works by affecting secondary messenger systems in the cell T
C. Increases the rate of formation of cAMP F
D. Works best with rapid-cycling patients F
E. Is reabsorbed from the kidney T
48. Side effects of Lithium include:

A. Tremor T
B. Muscle weakness T
C. Decreased urine output F
D. Dysgeusia T
E. Weight gain more in men F
49. Side effects of lithium include:

A. Cranial diabetes insipidus F
B. Hypothyroidism T
C. Shrinkage of the thyroid gland F
D. Hypoparathryoidism F
E. Females have thyroid side effects more commonly than men T
50. Side effects of lithium include:

A. Leucocytosis T
B. Acne T
C. Alopecia T
D. T wave inversion and QRS narrowing F
E. Memory impairment T

A. A rise in plasma sodium results in a rise in plasma lithium levels F
B. Dehydration results in a fall in plasma lithium levels F
C. Although lithium can treat bipolar illness, it has no effect on the F
number of relapses
D. Thyroid gland disorders do not respond to thryoxine F
E. Lithium is distributed widely in the body T

52. Regarding lithium toxicity:
A. Fine tremor is an early sign F
B. GI upset tends to occur early T
C. Neurological signs tend to appear later T
D. Hyporeflexia frequently occurs F
E. Coma may occur at high levels T

A. Lithium inhibits the release of iodine, and thyroid hormones T
B. Lithium induces thyroid autoantibodies T
C. Lithium does not cross the placenta F
D. Lithium is excreted in breat milk T
E. Long term treatment does not seem to affect GFR T
54. Increased lithium levels occur with:

A. Bendrofluazide F
B. Aspirin F
C. Metronidazole T
D. NSAIDs T
E. ACE-inhibitors T
55. Carbamazepine:
A. Is a GABA agonist T
B. Affects calcium channels T
C. Induces its own metabolism T
D. Has a short half life F
E. Affects brain 5-HT function T
56. Side effects of carbamazepine include:

A. Ataxia T
B. Diplopia T
C. SIADH T
D. Agranulocytosis T
E. Leucocytosis F
57. Interactions with carbamazepine include:

A. Increased metabolism of tricyclic antidepressants T
B. Decreased metabolism of other anticonvulsants F
C. Neurotoxicity with lithium T
D. Reduced carbamazepine levels with SSRIs T
E. Higher levels of oral contraceptives F
58. Sodium Valproate:

A. Is a GABA transaminase inhibitor T
B. Is absorbed slowly from the GI tract F
C. Should be given with caution in patients with liver disease T
D. Has no effects on the foetus F
E. Can increase the levels of phenytoin T
59. Side effects of Valproate include:

A. GI upset T
B. Weight gain T
C. Ataxia T
D. Thrombocytosis F
E. Impaired platelet function T
60. Side effects of Valproate include:

A. Acute pancreatitis T
B. Renal failure F
C. Hepatic enzyme changes T
D. Hepatic toxicity and death T
E. Valproate should be stopped if jaundice occurs T
Descriptive Psychopathology
1. The borderline syndrome is characterized by:
A. Splitting T
B. Good impulse control F
C. Euphoric affect F
D. Primitive idealization T
E. Feelings of emptiness T
2. Somatic symptoms of severe anxiety include:

A. Impotence T
B. Diarrhoea T
C. Constipation T
D. Hypoventilation F
E. Sighing T
3. Symptoms of combat neurosis include:

A. Anger T

B. Grandiose ideas F
C. Good interpersonal relationships F
D. Lack of guilt F
E. Flashbacks T
4. Autochthonous delusions are:

A. Synonymous with primary delusions T
B. Rarely preceded by a delusional atmosphere F
C. A source of secondary delusions T
D. Pathognomonic of schizophrenia F
E. ‘Brain waves’ T
5. The foetal alcohol syndrome:

A. Occurs with as few as four drinks per day T
B. Causes hydronephrosis T
C. Causes severe mental retardation F
D. Causes cleft lip and palate T
E. Is associated with liver abnormalities F
6. Normal experiences include:

A. Jamais vu T
B. Delusional perception F
C. Derealization T
D. Visual hallucinations F
E. Deja-vecu T
7. In Briquet’s syndrome:
A. There is usually an organic basis F
B. Recurrence is unusual F
C. Somatic complaints are usually multiple T
D. The prognosis is excellent F
E. Surgery is treatment of choice F
8. Dissociative states:
A. Occur in hysteria T
B. May be seen under hypnosis T
C. Include fugue states T
D. Exclude multiple personalities F
E. Are seen in petit-mal seizures F
9. Near-death experiences are:

A. Associated with the name Moody T
B. Seen in life-threatening experiences T
C. A basis for reincarnation F
D. Features of altered states of consciousness T

E. Occurrences in life or death F
10. Briquet’s syndrome:

A. Is allied to hysteria T
B. Occurs in men F
C. Is synonymous with somatization disorder T
D. Has a prevalence of 1-2 % in women T
E. Has sexual symptoms infrequently F
11. Formal though disorder includes:

A. Drivelling T
B. Condensation T
C. Flight of ideas F
D. Perseveration F
E. Transitory thinking T
12. Concrete thinking:

A. Is diagnostic of schizophrenia F
B. Is diagnostic of organic brain disease F
C. May occur in manic-depressive psychosis F
D. Is a defect of conceptual abstract thought T
E. Is tested by interpretation of proverbs T
13. Formication:
A. Is the medical term for fornication F
B. May be seen in delirium T
C. Is a passivity phenomenon F
D. Is a tactile hallucination T
E. May be called the ‘cocaine bug’ T
14. In organic disturbance of mental state:

A. Verbal IQ falls off before performance F
B. Concrete thinking is unusual F
C. Derealization occurs F
D. There is altered level of consciousness T
E. Visual hallucinations occur T
15. Pseudohallucinations occur in:

A. Borderline syndrome F
B. Hypnogogic states T
C. Hypnopompic states T
D. Bereavement T
E. Fatigue T

16. Normal experiences include:
A. Hypnagogic hallucinations T
B. Hypnopompic hallucinations T
C. Depersonalization T
D. Flight of ideas F
E. Over-inclusive thinking F
17. Psychotic depression may be characterized by:

A. Delusions of illness T
B. Jamais vu F
C. Visual hallucinations F
D. Nihilistic delusions T
E. Circumstantiality F
18. Delirium tremens is characterized by:

A. Clouding of consciousness T
B. Visual hallucinations T
C. Lilliputian hallucinations T
D. Olfactory illusions F
E. Auditory illusions T
19. Jaspers described the following disorders of emotion:

A. Apathy T
B. ‘Free-floating’ emotions T
C. Loss of feelings T
D. Changes in bodily feelings T
E. Changes in feelings of competence T
20. Delusional perception:

A. Has two stages T
B. Is an autochthonous delusion T
C. Is often preceded by ‘delusional mood’ T
D. Occurs secondary to a hallucination F
E. Is a secondary delusion F
21. Pseuodohallucinations:
A. Are subject to conscious manipulation F
B. Are dependent on environmental stimuli F
C. May occur in the real world F
D. May possess the vivid quality of normal perceptions F
E. Arise in inner space T
22. Depressive psychosis may be characterized by:

A. Delusions of filth T
B. Delusions of poverty T

C. Delusions of guilt T
D. Primary delusions F
E. Auditory hallucinations T
23. In the postpartum period:

A. The treatment of psychosis is different from psychotic illness at F
other times
B. Psychosis begins within 3 months in 80 % of cases T
C. The risk of recurrence in future pregnancies is 1 in 5 T
D. Cerebral thrombo-embolic lesions may present as psychosis T
E. Transient weepiness is common in the first week T
24. The dysmnesic syndrome occurs in:

A. Neurosis F
B. Uncomplicated psychosis F
C. Korsakoff’s psychosis T
D. Mamillary body lesions T
E. Thalamic lesions T
25. Pseudodementia may be characterized by:

A. Onset with depressive features T
B. Abnormal EEG F
C. Presence of localizing neurological signs F
D. Past or family history of manic-depressive psychosis T
E. Chronic course F
26. Echolalia occurs in:

A. Catatonic schizophrenia T
B. Obsessional neurosis F
C. Mental handicap T
D. Manic-depressive psychosis F
E. Senile dementia T
27. Bromism may present with:

A. Hypomania T
B. Auditory and visual hallucinations T
C. Delusions T
D. Depression T
E. Bad breath T
28. Encopresis in childhood:

A. By definition occurs after age 5 F
B. Has equal sex distribution F
C. Is more prevalent than enuresis after age 16 F
D. Is always due to constipation F

E. May occur in conduct disorder T
29. Features of catatonic schizophrenia include:

A. Forced grasping F
B. Mitgehen T
C. Athetosis F
D. Palilalia T
E. Logoclonia T
30. Eye to eye conduct:

A. Is usually increased in depression F
B. Is never a sign of aggression F
C. Is an essential part of psychotherapy F
D. Is not influenced by cultural factors F
E. Is assessed in the mental state examination T
31. The Capgras delusion:

A. Is allied to hysteria F
B. Usually is associated with organic brain disease F
C. Is also called ‘pure erotomania’ F
D. Is characterized by a pregnant husband F
E. Is also called ‘delusion of doubles’ T
32. First rank symptoms of schizophrenia:

A. Are always pathognomonic of schizophrenia F
B. Include 2nd or 3rd party hallucinations F
C. Incorporate all passivity phenomena T
D. Exclude formal thought disorder T
E. Include incongruity of affect F
33. In the double-blind situation:

A. Two conflicting messages are given simultaneously T
B. Experimental evidence is provided for schizophrenia F
C. A double-bind situation also occurs F
D. Comments on the situation itself are permitted F
E. Both messages are always verbal F
34. Features of hypomania may include:

A. Hypersomnia F
B. Grandiose delusions T
C. Wise business investments F
D. Decreased libido F
E. Poverty of thought F

35. Folie du doute may be characterized by:
A. Vacillation T
B. Delusions F
C. Indecisiveness T
D. Hallucinations F
E. Persistent doubting T
36. Formication:
A. Refers to actual insects crawling on the skin F
B. Occurs in ‘delusions of infestation’ F
C. Is seen when cocaine is withdrawn only F
D. Is a second rank symptom of schizophrenia F
E. Is a disorder of thought content F
37. Simple schizophrenia may be characterized by:

A. Hallucinations F
B. Late onset F
C. Gradual deterioration T
D. Social isolation T
E. Delusions F
38. Hallucinations may occur in:

A. Acute confusional states T
B. Hysteria F
C. Drug withdrawal T
D. Petit-mal epilepsy F
E. Anxiety states F
39. Stupor may occur in:

A. Mania T
B. Depression T
C. Hysteria F
D. Petit-mal epilepsy T
E. Gjessing’s periodic catatonia T
40. The dysmnesic syndrome features:

A. Paranoid delusions F
B. Delusional perception F
C. Ataxia T
D. Peripheral neuropathy T
E. Long-term memory impairment F
41. Hollingshead and Redlich:

A. Published ‘Social Class and Mental Health’ T
B. Based their studies in New York F

C. Showed that upper class patients tended to use hospitals F
D. Showed that lower class patients tended to use outpatient clinics F
E. Are psychoanalysts F
42. Mirror gazing occurs in:

A. Anorexia nervosa T
B. Manic-depressive psychosis F
C. Hebephrenia T
D. Obsessional neuroses F
E. Senile dementia T
43. Pathological excitement occurs in:

A. Retarded depression F
B. Manic depressive psychosis T
C. Catatonic schizophrenia T
D. Delirium T
E. Normal subjects F
44. Obsessional thoughts:

A. Always give rise to compulsions F
B. Are ego-alien T
C. Rarely are of a sexual nature F
D. Are best treated by thought stopping F
E. Usually respond to imipramine F
45. Electrical stimulation of the following causes anxiety:

A. Vagus F
B. Hypothalamus F
C. Dorsal raphe nucleus F
D. Locus coeruleus T
E. Median raphe nucleus F
46. Obsessive rituals:

A. Respond well to behaviour therapy F
B. Are usually anti-social F
C. Are not resisted F
D. Are sensibly regarded F
E. Reduce anxiety T
47. In psychogenic polydipsia:

A. Polydipsia begins before polyuria T
B. Vasopressin may relieve thirst F
C. Urine flow decreases after hypertonic saline infusion T
D. Urine concentration is greater after vasopressin than after fluid F
deprivation

E. Plasma osmolality is lower than normal T
48. Phobias have the following features:

A. Viewed as negative compulsions T
B. Can be reasoned away F
C. Fear proportional to the threat F
D. Described by Marks in 1929 F
E. Involuntary T
49. The Ganser syndrome occurs in:

A. Schizophrenia F
B. Manic-depressive psychosis F
C. Prisoners awaiting trial T
D. Personality disorders F
E. Hysteria F
50. Passivity experiences include:

A. Made experiences T
B. Occur in manic-depressive psychosis F
C. Include echo de la pensee F
D. Are recognized in obsessional neurosis F
E. Exclude thought broadcasting F
51. Characteristic features of anorexia nervosa include:

A. Normal BMR F
B. Hypothermia T
C. Lanugo hair T
D. Hypertension F
E. Phobia of normal body weight T
52. Agoraphobia is:

A. Better treated by flooding than systematic desensitization T
B. Mainly seen in middle age T
C. A fear specific to open spaces F
D. Commoner in women T
E. Commonly associated with depersonalization T
53. The experience of depersonalization is:

A. Usually pleasant F
B. Delusional F
C. Recognized as ‘odd’ T
D. Treatable with phenobarbitone F
E. Recognized as ‘false’ T

54. Animal phobias are:
A. Commoner in men F
B. Usually occur in middle age F
C. Generally non-specific F
D. Treatable with behaviour therapy T
E. A poor diagnostic group F
55. Anaclitic depression is characterized by:

A. Infants deprived of mother in early life T
B. Initial vigorous protest T
C. Severe despair T
D. A phase of detachment T
E. A predisposition to manic-depressive psychosis F
56. Social phobia:

A. Is usually specific to a few individuals F
B. Has an equal sex distribution F
C. Is as common as agoraphobia F
D. Usually develops before puberty F
E. Responds poorly to behaviour therapy F

A. Autoscopy is synonymous with phantom mirror-image T
B. Reflex hallucinations occur outside sensory field limits F
C. Functional hallucinations are experienced with their stimulus T
D. In extra-campine hallucinations, a stimulus in one sensory field F
produces a hallucination in another
E. Functional hallucinations are rare in chronic schizophrenia F
58. Features of shell-shock include:

A. Depersonalization T
B. Guilty ideation of delusional intensity F
C. Derealization T
D. Reliving the battle T
E. Calmness F

A. Koro is an acute anxiety state T
B. Latah is an hysterical reaction to stress T
C. Windigo is a depressive psychosis T
D. Susto is an hysterical dissociation or depressive state F
E. Amok is an acute anxiety state F
60. Auditory pseudohallucinations occur in:

A. Schizophrenia F

B. Hysteria T
C. Manic-depressive states F
D. Drug-induced states T
E. Phobic anxiety state F
61. The following statements are true in schizophrenia:

A. Schism describes hostility between parents T
B. Skew describes a dominant mother and a submissive father T
C. Invalidation describes denial of feelings of family members T
D. Praecox feeling refers to empathic rapport with the patient T
E. Pseudomutuality is a method by which a family system maintains T
equilibrium
62. Evidence for formal thought disorder includes:

A. Inflexibility of personal constructs F
B. Knight’s move thinking T
C. Loosening of personal constructs T
D. Nominal aphasia F
E. A normal repetory grid F
63. The revolving-door syndrome:

A. May be due to cerebellar-vestibular dysfunction F
B. Is part of the revolving-room syndrome F
C. Refers to the cyclical re-admission of institutionalized patients T
D. Generates impressive ‘statistics’ for ‘patient care’ T
E. Rotates patients between system components with adequate care F
64. Schizophrenic thought disorder includes:

A. ‘Woolly’ thinking T
B. Blurring of conceptual boundaries T
C. Paranoid delusions F
D. Omission T
E. Substitutions T
65. Delusions:
A. Are held with a certainty that may be shakeable F
B. Are reality for the patient T
C. Are frequently held by other people F
D. Are rarely of personal significance T
E. Are usually of a bizarre nature F

A. Mannerisms are non-goal directed repetitive movements F
B. Stereotypes are goal directed repetitive movements F
C. Opposition is an extreme form of negativism F

D. Athetosis consists of random, jerky movements F
E. Chorea consists of slow, writhing movements F
67. In Huntington’s chorea:

A. Athetoid movements are usual presenting signs F
B. Gross personality change is very unusual F
C. Children have a less rapid deterioration F
D. The onset of symptoms is usually in childhood F
E. 75 % of affected person’s children develop the disease F
68. Illusions include:

A. Macropsia T
B. Derealization T
C. Misinterpretations F
D. Depersonalization T
E. Micropsia T
69. Features of the Gilles de la Tourette syndrome include:

A. Echolalia T
B. Coprolalia T
C. Coprophagia F
D. Flatus F
E. Echopraxia T
70. Eidetic images:

A. Have been described by Taylor T
B. Are visual hallucinations F
C. Have never been perceived in relation to a real object F
D. May be thought of as ‘photographic memory’ T
E. Are a form of exterocepted visual pseudohallucinations T
71. With regard to psychiatric illness in general practice:

A. Hysteria is very common F
B. Anxiety is relatively uncommon F
C. Psychotic illness is not usually referred F
D. 50 % of neurotic illness is usually referred F
E. Personality disorder is more common than depression F
72. Pseudohallucinations occur in:

A. Dreams during sleep F
B. Lone prisoners T
C. Dreams whilst awake T
D. Long distance lorry drivers T
E. Sensory deprivation T

73. Treatment of postpartum ‘blues’ includes:
A. Antidepressant medication F
B. Reassurance only F
C. Hypnotic medication F
D. Performing a dexamethasone suppression test F
E. Involvement of the husband in helping his wife T
74. Verbigeration occurs in:

A. Extreme anxiety T
B. Ganser syndrome F
C. Senile dementia T
D. Malingering F
E. Catatonic schizophrenia T
75. The following associations are correct:

A. Cameron and concrete thinking F
B. Schneider and condensation F
C. Bleuler and drivelling F
D. Goldstein and over-inclusive thinking F
E. Bleuler and loosening of associations T

A. Delusions are ego involved T
B. Redundancy refers to the predictability of a word appearing T
C. Delusions are idiosyncratic T
D. Schizophrenic thought has a high level of redundancy F
E. Paranoia is another name for paraphrenia F
77. The characteristic hallucinations in alcoholic hallucinosis are:

A. Visual T
B. Tactile F
C. Olfactory F
D. Auditory T
E. Gustatory F
78. Common associations with anorexia nervosa include:

A. Abnormal gastric motility F
B. Lassitude F
C. Primary amenorrhoea F
D. Early morning waking T
E. Bulimia T
79. Phantom limb experiences:

A. Only occur following limb amputation T

B. Include tactile hallucinations T
C. The phantom limb always corresponds in size to the previous limb F
D. Occurs in 95 % of all amputations after the age of 6 years T
E. Are a presenting feature of schizophrenia F
80. The following are true of culture-bound disorders:

A. Latah features penile-retraction into the abdomen F
B. Piklokto is a dissociative state in Eskimo women T
C. Windigo involves mutation into a cannibalistic monster T
D. Koro features automatic obedience, echolalia, and echopraxia F
E. Susto involves loss of the soul T
81. Features of normal pressure hydrocephalus include:

A. Headache
B. Memory impairment
C. Papilloedema
D. Physical and mental retardation
E. A frequently abnormal EEG
82. Features of Pick’s disease may include:

A. Fatuous mood
B. Apathy
C. General euphoria
D. A frequently abnormal EEG
E. Preservation of intellect
83. Features of Alzheimer’s disease might include:

A. Anxious mood
B. Depression
C. Specific abnormalities on EEG
D. A deficiency of GABA
E. A deficiency of serotonin
84. Neologisms occur in:

A. Manic-depressive psychosis
B. Obsessional neurosis
C. Organic brain disease
D. Gilles de la Tourette syndrome
E. Schizophrenia
85. Complications of chronic alcoholism may include:

A. Paraesthesia and pain in the extremities
B. An abnormal pyruvate tolerance test
C. Weakness of the limbs
D. Osteoporosis

E. A decrease in erythrocyte transketolase activity
Neurotic, Stress-related, and somatoform disorders
1. The following are true in anxiety:

A. Heart rate shows reduced deceleration after stress T
B. There is less beat-to-beat variation in heart rate F
C. Increased skin conductance T
D. Increased central NA and 5-HT activity T
E. Imipramine can induce panic in some people F
2. In hyperventilation there is:

A. Bronchodilation F
B. Exaggerated sinus rhythm T
C. Vasodilation of cerebral arteries F
D. Reduced availability of oxyhaemoglobin T
E. Irritability of the autonomic nervous system T
3. The following are associated with phobic anxiety disorders:

A. Enuresis T
B. Sexual problems T
C. Schizophrenia F
D. Dependent personality traits T
E. Major depressive disorder F
4. In agoraphobia:
A. A common fear can be confinement T
B. Women are affected more than men T
C. Panic attacks are uncommon F
D. Mean age of onset is in the teens F
E. The majority of sufferers are unmarried F
5. In agoraphobia:
A. 1st degree relatives of sufferers of panic disorder are at an F
increased risk of agoraphobia
B. Lifetime prevalence is 20 % F

C. Patients tend to have a more unstable home background T
D. About 40 % of patients have depression or dysthymia T
E. There is an association with social phobia T
6. Regarding social phobia:

A. Age of onset is in the late 30s F
B. Men are affected more than women F
C. Alcohol abuse is more common than in other phobias T
D. Six month prevalence is about 5 % F
E. There is a possible genetic link T
7. In social phobia:
A. Dopamine activity may be abnormal T
B. There is a reported association with mitral valve prolapse F
C. MAOIs are effective treatments T
D. Buspirone is as effective as MAOIs F
E. Secondary depression may occur T
8. Regarding specific phobias:

A. They are more common in women T
B. More men suffer from needle phobias F
C. Age of onset is usually in late adolescence F
D. They can be under voluntary control F
E. Avoidance is uncommon F
9. Regarding specific phobias:

A. Boys are more likely to grow out of their phobias T
B. Females suffer from animal phobias more commonly F
C. Illness phobia is characterized by resistance F
D. Blood phobia often has a family history T
E. Classical conditioning is not thought to be involved F
10. Space phobia:

A. Tends to develop in the late 20s F
B. Is frequently accompanied by depressive illness F
C. Is associated with a stable personality T
D. Nystagmus is frequently to the left T
E. Dizziness can occur on turning the head to the right T
11. Panic disorder:

A. Has a lifetime prevalence of up to 3 % T
B. Average age of onset is 25 T
C. Has an equal sex ratio F
D. Is usually due to responses to a recognizable danger F
E. Anxiety is common between attacks F

12. The following substances can induce panic attacks:
A. Flumazenil T
B. Cholecystokinin T
C. Sodium Lactate T
D. Yohimbine T
E. MCCP T
13. The following are true in panic disorder:

A. There is an association with separation in early life T
B. Cognitive behavioural therapy is seldom used F
C. Antidepressants may cause over-stimulation during initial T
treatment
D. PET scanning shows abnormalities in the right para-hippocampal T
area
E. Panic attacks are seen psychoanalytically to involve reaction F
formation
14. Generalized anxiety disorder (GAD):

A. Is characterized by “free-floating” anxiety T
B. Has equal sex prevalence F
C. Can present at any age T
D. Is more common in the third decade T
E. Seldom occurs with depressive symptoms F
15. Regarding the aetiology of GAD:

A. GABA dysfunction has been implicated T
B. Has no genetic predisposition F
C. Has no association with mitral valve prolapse F
D. Psychoanalytic theories suggest that anxiety is a symptom of F
unfulfilled ego desires
E. Male relatives of sufferers are more likely to misuse opiates F
16. The following suggest a poorer prognosis:

A. Syncopal episodes T
B. Hysterical features T
C. Openness to therapy F
D. Derealization T
E. Hysterical features T
17. The Neurodevelopmental subtype of OCD is associated with:

A. Late onset of disorder F
B. More common in males T
C. Less incidence of neurological signs F
D. Eating disorders F

E. Good response to SSRIs F
18. The Primary subtype of OCD is associated with:

A. Episodic course T
B. Mood and anxiety symptoms T
C. More severe F
D. More common in females T
E. Frontal neuropsychological deficits T
19. The following are characteristic of obsessions and

compulsions:
A. Recognized as originating from outside of the body F
B. Resistance to all thoughts or acts F
C. With compulsive acts, the act must be a purposeful one T
D. Acts can be performed without a set of rules F
E. The thoughts or impulses do not have to be unpleasant F
20. Regarding obsessional thoughts, acts, etc.:

A. Obsessional images have the quality of hallucinations F
B. Obsessional convictions may be delusional in intensity T
C. Handwashing is more common in women T
D. Obsessional slowness is more common in men T
E. Carrying out compulsive rituals results in an increase in anxiety F
21. Regarding obsessive compulsive disorder:

A. There is equal sex prevalence T
B. Women present later than men F
C. Mean age of onset is 20 years T
D. Patients tend to present quickly to psychiatric services F
E. Studies have shown a cumulative age effect F
22. The following statements about the aetiology of OCD are

true:
A. MZ concordance suggests a genetic link T
B. Abnormal 5-HT function has been identified T
C. Many Tourette’s syndrome patients have obsessional symptoms T
D. One fifth of OCD patients have tics T
E. GABA function is abnormal F
23. The following processes occur in OCD according to

psychoanalytic theory:
A. Isolation T
B. Projection F
C. Reaction formation T
D. Ambivalence T

E. Denial F
24. Personality traits associated with OCD include:

A. High expectations of unpleasant outcomes T
B. Anankastic traits T
C. Antisocial traits F
D. Perfectionism T
E. Erroneous perception of threat T
25. Brain imaging shows:

A. Increased blood flow in the caudate nucleus T
B. Decreased blood flow in the cingulate gyrus F
C. Orbitofrontal cortical hypoperfusion F
D. Reduced size of caudate nucleus T
E. Normalization of findings with pharmacotherapy T
26. The following treatments can be used to treat OCD:

A. Response prevention T
B. Thought stopping T
C. Behavioural therapy is especially effective for obsessional F
thoughts
D. Clomipramine T
E. Subcaudate tractotomy T
27. Regarding Post-traumatic Stress Disorder (PTSD):

A. Only occurs at a young age F
B. Can be diagnosed if symptoms occur 9 months after a major F
trauma
C. Re-experiencing the event, increased arousal, and persistent T
avoidance are the key symptoms
D. A higher prevalence is reported in males F
E. Hypersomnia is a common symptom F
28. The following are associated with increased vulnerability to

PTSD:
A. Childhood trauma T
B. Heavy alcohol intake T
C. Family psychiatric history T
D. Antisocial personality traits T
E. Recent stressful life changes T
29. The following have been reported in PTSD:

A. Decreased urinary catecholamines F
B. Impaired long-term memory F
C. Reduced hippocampal volume T

D. Reduced response of the Noradrenaline systems F
E. Increased blood and urinary cortisol in chronic PTSD F
30. In Dissociative disorders:

A. Primary gain is the benefit that is conferred by the symptoms F
B. A clear connection with stressful events is needed for the T
diagnosis to be made
C. Freud proposed that the disorder was due to repressed ideas T
D. Kretschmer suggested a role for ‘reflex’ biological mechanisms T
E. Are synonymous with Briquet’s syndrome F
31. Dissociative amnesia:

A. Is more common in women T
B. Is more common in older adults F
C. Is associated with multiple sclerosis T
D. Is associated with epilepsy T
E. There is no history of recent traumatic events F
32. Somatform disorders:

A. Is the same as Briquet’s syndrome F
B. Can include Da Costa’s syndrome T
C. Have equal sex prevalence F
D. Includes irritable bowel syndrome T
E. Include hypochondriacal disorder T
33. Somatization disorder:

A. Usually presents after teenage years F
B. Is comorbid with alcoholism T
C. Is comorbid with personality disorder T
D. The ‘sick role’ was described by Mechanic F
E. Illness behaviour was described by Pilowsky T
34. Hypochondriacal disorder:

A. Is more common in women F
B. Age of onset is usually in the 40s F
C. Is frequently comorbid with anxiety and depressive illness T
D. Has an increased incidence of suicide F
E. Brain imaging shows marked abnormalities F
Alcohol and Drug Misuse
1. The following are characteristic of Alcohol Dependency

Syndrome as described by Edwards:

A. Tolerance T
B. Withdrawal symptoms T
C. Narrowing of repetoire T
D. Desire for need to help F
E. Salience of drinking T
2. Regarding the epidemiology of alcohol dependence:

A. Equal sex prevalence F
B. Women tend to present later T
C. Women are more likely to develop physical complications T
D. Higher rates in the divorced or separated T
E. Lower rates in ‘middle’ social groups T

A. Higher rates of alcoholism among 1st degree relatives of T
alcoholics
B. Higher rates of childhood conduct disorder T
C. Adopted sons of alcoholics have no greater risk of developing the F
disorder
D. Associations with the D2 receptor T
E. Association with antisocial personality disorder T
4. The following biochemical effects of alcohol are recognized:

A. Dopamine release in the nucleus basalis F
B. 5-HT antagonism F
C. Potentiation of NMDA receptor channels in glutamate receptor F
D. Inhibition of GABA receptor complex F
E. Craving may be due to Dopamine release T
5. The following are complications of alcohol misuse:

A. Gastric carcinoma T
B. Colorectal carcinoma T
C. Diabetes mellitus T
D. Renal agenesis F
E. Zieve’s syndrome T
6. The following are recognized neurological complications of

alcohol misuse:
A. Central pontine myelinolysis T
B. Auditory hallucinations in clear consciousness T
C. Extra-campine hallucinations F
D. Optic atrophy T
E. Peripheral neuropathy T
7. The following are features of the Foetal Alcohol Syndrome:

A. Normal IQ F
B. Renal abnormalities T
C. Cleft palate T
D. Congenital heart disease T
E. Macrocephaly F
8. The following are recognized psychiatric complications of

alcohol misuse:
A. Major depressive illness T
B. Suicide T
C. Schizophrenia T
D. Morbid jealousy T
E. Dementia T
9. The following are characteristic of Wernicke’s

encephalopathy:
A. Clouding of consciousness T
B. Visual hallucinations F
C. Ataxia T
D. Ophthalmoplegia T
E. Hypertension F
10. Features of Korsakoff’s psychosis may include:

A. Amnesia T
B. Higher prevalence in women F
C. Orientation F
D. Confabulation T
E. Later onset in women F
11. Structures affected by Korsakoff’s syndrome typically

include:
A. Nucleus accumbens F
B. Mamillary bodies T
C. Floor of the third ventricle F
D. Thalamic nuclei T
E. Frontal lobes T
12. Features of alcoholic pellagra encephalopathy may include:

A. Due to niacin deficiency T
B. Seizures F
C. Confusion T
D. Hypersomnia F
E. Clasp-knife rigidity F
13. Regarding the epidemiology of drug misuse:

A. More common in men T
B. Most cases begin after the age of 18 F
C. Most people present after 6-12 months of continuous use F
D. Around 15 % of opiate addicts have attempted suicide T
E. 75 % of addicts meet criteria for another psychiatric diagnosis T
14. The following have been suggested in the aetiology of drug

misuse:
A. Abnormalities of 5-HT systems T
B. Secondary reinforcement T
C. ‘Peer group activation’ T
D. Projection F
E. Reaction formation F

A. Cocaine acts on the 5-HT system F
B. Hallucinogens increase dopamine activity F
C. PCP acts on the gluatamate receptor T
D. Ecstasy is a 5-HT agonist F
E. Cannabinoids bind to the GABA receptor F
16. Features suggestive of a poor outcome in drug misuse may

include:
A. Episodic use F
B. Antisocial personality disorder T
C. Late onset of abuse F
D. Short history of use F
E. Early drop-out from maintenance programs T
Personality disorder
1. According to Kretschmer:
A. Pyknic types were prone to manic depression T
B. Athletic types were more likely to develop schizophrenia F
C. Asthenic types were linked with criminality F
D. Athletic types were more likely to develop epilepsy T

E. Asthenic types were more likely to develop a depressive illness F
2. The following incidences among the general population are

correct:
A. Paranoid personality disorder: 2 % T
B. Schizoid personality disorder: 0.5 % T
C. Antisocial personality disorder: 3 % of males T
D. Borderline personality disorder: 3 % T
E. Histrionic personality disorder: 2 % T

A. Antisocial personality disorder is more common in prisons T
B. Narcissistic personality disorder is more common in women F
C. Borderline personality disorder has equal sex prevalence F
D. Avoidant personality disorder is more common in women F
E. Dependent personality disorder has equal sex prevalence T
4. The following are features of paranoid personality disorder:

A. Excessive sensitivity to setbacks T
B. Tenacious sense of personal rights T
C. Indifference to praise and criticism F
D. Jealousness T
E. Lack of close friendships F
5. The following are features of schizoid personality disorder:

A. Humourless T
B. Mistrustful F
C. Detached T
D. Unconventional T
E. Unpredictability F
6. The following are features of antisocial personality disorder:

A. Irresponsible T
B. Explosive in nature F
C. Difficulty establishing relationships F
D. Lack of guilt T
E. Blames self excessively F
7. In antisocial personality disorder:

A. There is an increased incidence among MZ twins T
B. There is a link with brain injury in childhood F
C. EEG abnormalities can be observed T
D. There are low levels of 5-HIAA in the CSF of violent individuals T
E. Frontal lobe abnormalities are common F

8. The following are features of borderline personality disorder:
A. Quarrelsome T
B. Poor self image T
C. Unstable mood T
D. Stable relationships F
E. Desultory T
9. The following are features of histrionic personality disorder:

A. Shallow and labile affectivity T
B. Vanity T
C. Pedantic F
D. Afraid to trust F
E. Said to be due to oedipal conflicts T
10. The following are features of anankastic personality disorder:

A. Fear of rejection F
B. Dependence F
C. Orderliness T
D. Preoccupation with productivity T
E. Pedantic T
11. The following are features of avoidant personality disorder:

A. Restricted life T
B. Social avoidance T
C. Excessive cautiousness F
D. Conscientiousness F
E. Afraid to trust others F
12. The following are features of dependent personality disorder:

A. Needs admiration F
B. Fear of not coping T
C. Feelings of helplessness T
D. Exploits others F
E. Envy of others F

Suicide and Deliberate Self Harm

A. Durkheim wrote about ecological views on suicide F
B. Esquirol suggested a psychiatric viewpoint on suicide T
C. Durkheim suggested altruistic, egoistic, and analytic types of F
suicide
D. Thomas Browne coined the term ‘suicide’ T
E. In the Health of the Nation UK 1992, the Government set out F
plans to reduce suicide in the mentally ill by 15 %
2. Associations of suicide include:

A. Unemployment T
B. High rates in winter months F
C. Highest rates in lowest social group F
D. Low rates in upper social class F
E. Increased rates in vets T
3. Increased rates have been reported with:

A. Renal dialysiss T
B. SLE T
C. Epilepsy T
D. Patients with high cholesterol F
E. Peptic ulcer T
4. Features contributing to higher rates among the prison

population include:
A. Prisoners convicted of minor crimes F
B. Prisoners on remand T
C. Previous psychiatric history T
D. Short sentence F
E. Hanging is least common method F
5. Risk factors in depression include:

A. Panic attacks T
B. Delusions T
C. Persistent insomnia T
D. Hopelessness T
E. Agitation T
6. Risk factors in schizophrenia include:

A. Older patient F
B. Low level of premorbid function F
C. Ongoing psychosis F
D. Akathisia T

E. Short duration of illness F
7. Risk factors in alcohol dependence include:

A. Female F
B. Younger age (less than 40) F
C. Period of abstinence prior to attempt F
D. Unemployment T
E. Currently married F
8. Risk factors in neurotic illness include:

A Obsessive compulsive disorder F
B. Panic disorder T
C. Anorexia T
D. PTSD T
E. Bulimia T
9. DSH is more common in:

A. Females T
B. Lower social classes T
C. Asian subcultures T
D. Rural areas F
E. Over 35 years F
10. Predictors of repetition of DSH include:

A. Male sex F
B. Personality disorder T
C. Alcoholism T
D. Previous DSH T
E. Intact personality F
Eating Disorders
1. The following are true in anorexia:

A. Females outnumber males by 2:1 F
B. Increased incidence in lower social classes F
C. More common in occupations associated with food preparation F
D. Co-morbidity with depressive illness T
E. Incidence rising in recent years T
2. The following have been suggested as aetiological factors in

AN:
A. Hypothalamic dysfunction T
B. Decreased 5-HT activity F
C. Regression into pre-puberty T
D. Failure to develop autonomy T
E. Need to maintain family status quo T
3. Complications of AN include:
A. Deranged LFTs T
B. Pancreatitis T
C. Leucocytosis F
D. Cardiomegaly F
E. Cerebral atrophy F
4. The following are seen in AN:

A. Increased testosterone F
B. Decreased Growth hormone F
C. Reduced cortisol F
D. Lowered cholesterol F
E. Increased gonadotrophin F
5. Predictors of poor outcome include:

A. Late age of onset T
B. Low premorbid body weight F
C. Male T
D. Short duration of illness F
E. Bulimic behaviour T
6. Bulimia nervosa:
A. Is more common than AN T
B. Has earlier age of onse than AN F
C. Is co-morbid with AN T
D. Is more common in women T
E. Affects up to 1 in 20 men F
7. Physical complications of BN include:

A. Renal impairment T
B. Seizures T

C. Tetany T
D. Cardiac atrophy F
E. Muscular weakness T
8. Associations of BN may include:

A. Deliberate self harm T
B. Child sexual abuse T
C. Decreased 5-HT activity T
D. Low rates of familial psychiatric illness F
E. Depression T
Sleep Disorders
1. The following are associated with wakefulness:

A. Hypothalamus T
B. TRH T
C. 5-HT F
D. Somatostatin F
E. Noradrenaline T
2. The following are associated with sleep:

A. Acetylcholine F
B. GABA T
C. Raphe nuclei T
D. TRH F
E. CRH F
3. During sleep:
A. GH falls F
B. Prolactin rises T
C. Cortisol is released F
D. Blood pressure is lowest during REM sleep F
E. Pulmonary arterial blood pressure falls F

A. Sleep spindles occur during stage 1 F
B. K complexes occur during stage 2 T
C. Nocturnal enuresis is most likely during stage 2 F
D. Delta waves can be seen during stages 3 and 4 T
E. REM sleep shows high voltage activity F
5. Insomnia:
B. Is more common in lower socio-economic groups T
C. Is co-morbid with psychiatric illness T
D. Is less common in the young T
E. Is less common among the separated F
6. The parasomnias include:

A. Sleep apnoea F
B. Somnambulism T
C. Sleep paralysis T
D. Jet lag F
E. Narcolepsy F
7. Narcolepsy:
A. Commonly involves sleep paralysis T
B. Hypnagogic hallucinations are common T
C. Onset is frequently in middle age F
D. The condition often runs in families T
E. REM latency at night is frequently seen T
8. The Kleine-Levin syndrome:

A. Most cases are in middle-aged men F
B. Incontinence during sleep is frequent F
C. Visual and auditory hallucinations can occur T
D. Plantare reflexes are always normal F
E. EEG is abnormal F
9. Somnambulism:
A. Has equal sex prevalence F
B. Occurs during REM sleep F
C. Is associated with enuresis T
D. Is commonly seen between the ages of 5 and 12 T
E. Never runs in families F
10. In depression:
A. There is shortened REM latency T
B. There is more REM activity in the second half of the night F
C. Antidepressants destroy REM sleep T

D. There is increased slow wave sleep F
E. REM sleep rebound occurs after treatment stops T
11. Alcohol:
A. Decreases sleep latency T
B. Decreases REM sleep T
C. Decreases deep sleep F
D. Decreases REM sleep in the second half of the night F
E. Exacerbates sleep walking T

A. Schizophrenia is associated with reduced REM sleep T
B. Panic disorder is associated with reduced sleep latency F
C. Anxiety is associated with reduced stage 1 and 2 sleep F
D. REM sleep is reduced in alcoholism F
E. REM sleep occurs earlier in the night in depression T
1. The following statements regarding conditioning experiments are

correct :
a) Operant conditioning may be understood in terms of perceptual
expectancies
b) Intermittent reinforcement in operant conditioning leads to greater
resistance to extinction than continuous reinforcement
c) Punishment leads to the diminished probability of the occurrence of a
response
d) The proper control procedure for classical conditioning is one in which
the CS is always presented without the US
e) Negative reinforcement is synonymous with punishment
f) Extinction is the process of gradual disappearance of a conditioned
response on discontinuation of an unconditional stimulus
2. Classical conditioning takes place irrespective of :
a) The time condition between conditioned stimulus and unconditioned
stimulus
b) The genetic potential of the organism
c) The organism’s voluntary behaviour
d) The schedule of reinforcement
e) The nature of the unconditioned stimulus
3. The following statements are true therapies based on exposure and
habituation :
a) Implosive therapy is synonymous with flooding
b) In anxiety disorders, the stronger the conditioned emotional response,
the shorter duration is required for exposure treatment
c) The phenomenon of incubation means that anxiety can arise
spontaneously during exposure therapy
d) The success of systematic desensitization for phobias can be explained
by Kamin’s principle of blocking

e) Higher order conditioned responses usually require longer exposure for
habituation to occur

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Multiple Choice Questions

1. The following concepts are matched correctly with the person

2. The following are Schneiderian 1st Rank symptoms :

3. Regarding the epidemiology and associations of schizophrenia:

5. Regarding the aetiology of schizophrenia :

Copyright © Trickcyclists.co.uk 2003. Unauthorised reproduction, or commercial use prohibited. 1

6. Regarding the aetiology of schizophrenia :

7. The following statements are about aetiological concepts :

8. The following statements relate to findings in schizophrenia :

9. Regarding brain changes in Schizophrenia :

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11. Neuropsychological abnormalities include :

12. Predictors of good outcome in schizophrenia include :

14. Regarding the treatment of schizophrenia:

15. The following are true of schizoaffective disorder:

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16. The following are recognized associations with delusional

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3. The following conditions are more common in upper social

4. The following conditions are more common in urban, or

5. The following associations with suicide are recognized :

6. The following conditions usually have their onset before the

7. The following are recognized associations :

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9. The following conditions are autosomal recessive :

10. The following conditions are autosomal dominant :

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2. The following are recognized physical complications of AN :

3. The following are recognized physical complications of AN :

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4. The following are recognized physical complications of AN :

5. The following are abnormal in AN :

6. The following are predictors of good outcome in AN :

7. Bulimia Nervosa (BN) :

8. Physical complications of BN include :

9. Associations with BN include :

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10. Regarding the aetiology of BN :

11. The following are true in obesity :

Mood (Affective) Disorders

2. In the discussion between endogenous vs. reactive depression :

3. The following are specific to a diagnosis of mania (not

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5. Regarding the aetiology of Bipolar Affective disorder :

6. Regarding treatment of bipolar affective disorder :

7. The following are true of depressive illness :

8. Regarding the demographics of depression :

9. The following are recognized risk factors for depression :

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10. Regarding the aetiology of depression :

11. Brown and Harris found the following to be vulnerability

12. Regarding the psychological theories of depression :

13. In Beck’s cognitive theory :

14. The following biochemical changes have been observed in

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15. The following biochemical changes have been observed in

1. The following statements are true:

4. Bipolar affective disorder is associated with:

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6. Regarding the aetiology of bipolar disorder:

7. Rapid cycling mania:

8. Regarding other presentations of depressive illness:

9. Regarding the demographics of depression: