TRAS -1 PSYCHIATRY

1-Risk of suicide increase in the following :

a-male sex.
b-deliberate self harm.
c-married male.
d-alcohol dependence.
e-depression.
2-In depression:
a-wt. Loss .
b-sleep disturbance.
c-deliberate self harm .
d-alcohol abuse.
e-can present to GP with minor symptoms.
3-Obssecive compulsive disorders:
a-fluxotine can be used.
b-behavioural therapy can be used.
c-psychodynamic is the best treatment.
d-is a psychosis.
e-common in elderly .
4-Dementia:
a-Alzheimer patient says I don’t know in the test.
b-vascular dementia characterized by stepwise deterioration in cognition.
c-Pick is the 3rd common dementia.
d-Lewi dementia present with visual hallucinations.
e-in chronic vascular dementia there is neurofibrillary tangles

5-Mental state examination:

a-stereotype associated with schizophrenia.
b-mutism associated with malingering .
c-perseveration associated with mania.
d-visual hallucination with depression.
e-disorientation and anxiety.

6-Schizophrenia;
a-atypical anti psychotic is the 1st line treatment.
b-benzodiazepine is effective in treatment of –ve symptoms.
c-affective symptoms are of good prognosis.
d-of good prognosis if occur in young age.
e-Tardive dyskinesia is a reversible complication.
7-Alcohol-in regard delirium tremens:
a-symptoms occur 6 hours after withdrawal
b-carries mortality of 19%.
c-associated. With delusion.
d-biochemical evidence of liver dysfunction in more than 90%.
e-characteristically occurs more at night.
8-Conduct disorders in children:
a-associated with school truancy.
b-there is difficulty in dealing with the authority figures.
c-may be associated with dissocial (antisocial ) in adulthood.
d-respond well to antipsychotic.
e-associated with dysfunctional family background .
9-ECT:
a-EEG should always be given to all patients.
b-C/I if patient taking tricyclic antidepressants.
c-C/I if having pacemaker.
d-is the treatment of choice for mania resistant to drugs.
e-may be used in pregnancy.
10-Psychdynamic psychotherapy:
a-depend on conscious , cognition and behaviour.
b-transference is the therapist emotion reaction to the patient.
c-first work was done by Si. & Froid.
d-dreams can be interpreted using a dream directory.
e-target the unconscious cognition and behaviour.
11-Overeating is a recognised feature in the following:
a-anorexia nervosa.
b-bulimia nervosa .
c-puerperal psychosis.
d-depression.
e-social phobia .

12-In the treatment of depression:

a-Dothipine is safe in overdose.
b-lithium may be used to augment tricyclic antidepressants.
d-MAO & TCA are dangerous together.
e-Wt. Gain is a good predictor to outcome.

13.Schizophrena:
a. There is a strong genetic factor.
b. Increased suicidal risk.
c. Chlorpromazine is the treatment of choice.
d. In men has an earlier age of onset than women.
e. Catatonic symptoms are good prognostic feature.

14.The following are risk factors of Alzheimer’s:

a. Trauma.
b. High educational level.
c. Low educational level.
d. old age.

15. Regarding Suicidal attempts:

a. Past history of suicide.
 b. More in females.
c. All should be hospital admitted.
d. Drug over-dose is the most common mode.

16.Rregarding Depression:
a. In male is more common than female.
b. There is motor retardation.

17. Anxiety:
1. Incidence in females is double the males.
b. Benzodiazepine is the treatment of choice for all types.

18. Chlorpromazine:
a. Has an Anti-Prolactin affect.
19. Mania can present with:
a. Agitation.
b. Grandiose delusions.
c. Affection of mood.
d. Sleep disturbance.
e. Social promiscuity.
20.the following are True about Affective Disorders:
1. Bipolar Disorders is commoner in Females > Males.
2. In Bipolar Disorders, recovery is complete between episodes.
3. In Bipolar Disorders, mania is common in elderly.
4. In Bipolar Disorders are common above the age of 30.

21. The following are True about Phobias:

1. Agoraphobia is the commonest type.
2. Agoraphobia is common females than males.
3. Chlorpromazine is used for the treatment of Panic Disorders.
4. Cognitive therapy is the treatment of choice.
5. Social Phobia is equal in females & males.

22. In Child Autism;

1. Echolalia can occur
2. Unwillingness to be touched.
3. Loss of eye to eye contacts.
4. Loss of Imaginative Abilities.

23. Refusal of Schooling:

1. May present with Abdominal Pain.
2. Early return to school is of good Prognosis.
3. It is associated with Separation Anxiety
4. It is associated with Depressive Illness.
24. Depression may be presented with,
a. Loss of weight.
b. Disturbance of sleep
c. Mild Physical IIIness.
d. Deliberate Self-harm.
e. Alcohol Dependence.
25. The following are True about Dementia;
a. Alzheimer’s’ Dementia is characterized by “Do not know” answers in Cognitive
Assessment.
b. Pick’s Dementia is the 3rd common type.
c. Vascular Dementia is characterized by step-progressing disease.
d. Vascular dementia is characterized by fibrillary tangles.
e. Lewy Body type may present with Delirious Episodes.

26. The following are complications of Alcohol Dependence:

a. Ocular Nerves Palsies.
b. Confabulations.
c. Liver Abnormalities in 90% of Cases.
d. Impotence.
e. Auditory Hallucinations in the Full Consciousness.

27. In Delirium Tremens:

a. Onset after 6 hours of Withdrawal.
b. Mortality of 10% of cases.
c. Delusions can occur.
d. Tremor is not a Feature.
28. The following Actions of Chlorpromazine are mediated by D2 Receptors:

1. Anti-psychotic.
2. Anti-emetic
3. Parkinsonian Features
4. Postural Hypotension.
5. Weight Gain.

29. Cognitive Behavioral Therapy includes:

1. Cognitive Process.
2. Behavioral Process.
3. Emotional Reaction.
4. Biophysiological Aspects.
5. Psychological aspects.
30- Side effects of SSRI are:
a. Nausea.
b. Sweating.
 c. Tremor.
d. Sedation.
e. Thyroid dysfunction.

31- The following make the diagnosis of Schizophrenia more likely:

a. Hallucination in the 2nd person.
b. Thoughts withdrawal.
c. Catatonic type that responds well to ECT.
d. Past history of sexual abuse in childhood.
e. Tearfulness.

32- Regarding Child Abuse:

a. Sexual abuse is always associated with violence or tendency to violence.
b. Physical abuse is more common in the school children.
c. Rare in teen age girls.
d. In Ireland should be notified to children abuse authorities.

33- Overeating occurs in:

a. Anorexia nervosa.
b. Bulimia nervosa.
c. Depression.
d. Puerperal psychosis.
e. Social phobia.

34- The following are true:

a. Anti-psychotic action of Chlorpromazine starts at 20 minutes.
b. Korsakof’s Syndrome resists treatment by massive dose of Bismuth IV.
c. Clozapine is the treatment of choice for Schizophrenia.
d. Depressive psychosis best treated by; Monotherapy.

35- Vascular Dementia is more likely than Alzheimer’s dementia in the presence of:
a. Step-wise progression.
b. Hypertension.
c. Carotid bruit.
d. Plantar extensor.
e. Short term memory loss.
36-Depression:
More than 60% of patients respond in the first week of treatment.
Can be caused by calcium channel blockers.
Prevalence is 1% life long.
If bipolar, mood stabilizer should be stopped.
May be associated with pseudo-dementia.
37-Schizophrenia:
Visual hallucination is characteristic.
Auditory hallucination is diagnostic.
There is seasonal birth effect.
Confusion and disorientation are rare.
There is a better outcome in the industrialized countries.

38-Deliberate self-harm:
More common in males.
May lead to future suicide.
The patient is usually suffering from depression.
May be an attention seeking behavior.
Associated with skin artifact lesion.

39-Autism:
There is language speech delay.
Males affected more than females.
Obsessive-compulsive pre-occupied.
Verbal ticks.
---------------------------------------.

40-Phobia:
Agoraphobiacs usually suffer from depression.
Simple phobia is considered as delusion.
Social phobia is commonly associated with alcoholism.
Uncommon in children.
---------------------------.

41-Antipsychotics:
Reduce the threshold for convulsions.

42-Tricyclic antidepressants (TCA):

Hypertension is a known side effect.
Contra-indicated in closed angle glaucoma.
In over-dose leads to arrhythmia.
Shorten the QT interval.
Causes delayed ejaculation.

43-Psychotherapy:
Schizophrenia is treated by psychodynamic therapy.
Autism is treated by cognitive therapy.
Panic attacks are treated by cognitive therapy.
Phobias are treated by cognitive therapy.
Depression is treated by arbitrary inference.
44-Opiate addiction:
More common in developing countries.
More common in deprived urban areas.
Female tendency for addiction is more than males.
More than 30% 0f patients have hepatitis c infection.
Cross addiction with diazepam occurs.
45. Alzheimer’s Disease:
a. Affects men more than women.
b. Delta & Beta waves occur in EEG.
c. High Neurofibrillary Tangles correlate with increase in Severity.
d. Commonest cause of Dementia at any age.
e. Is Common in patients with Down’s Syndrome.
f. May be Familial in 10%
g. Reduction in the Biochemical Matter correlates with Cognitive Therapy.

46. Anorexia Nervosa:

a. Of poor prognosis if affected Lower Classes.
b. Dental Problems commonly occurs.
c. FSH does not return to Normal even after treatment
d. There is Hypokalemia.
e. There is increased level of Cortisol.

47. ECT:
a. Used in the treatment of Puerperal Psychosis.
b. Is better than Medication in the treatment of Depression.
c. Is more successful in Depression with Delusion.
d. Is of no use in Neurotic Depression.
e. Has been validated in Double Blind Trials.
f. It caused brief memory Disturbance after Application.

48. Clozapine:
a. Causes Aranulocytosis.
b. Is used in the treatment of Resistant Schizophrenia.
c. Does not cause Tardive Dyskinesia.
d. Acts on DI Receptors.

49. Temporal Lobe Epilepsy:

a. Deja’vu occurs.
b. Smell Hallucinations occur.
c. Is followed by Paralysis of one or two Limbs for one or two Hours.
d. Anti-social Behavior occurs.
e. Consciousness is affected.

50. Obsessive Thoughts:

a. Can usually be resisted.
b. Are usually Acted-upon.
 c. Coming from the subject’s own Mind.
d. Are Rituals.
e. Are associated with Depression.

51. Delirium is more common when the those conditions are present:
a. Hypothyroidism.
b. Broncho-pneumonia.
c. An Unstimulating Environment.
d. Treatment with Benzodiazepines.
e. Increasing Age.

52. Anxiety Neurosis:

a. Twins studies proved Genetic Elements.
b. Found in men more than women.
c. Cases of Patho. Anxiety are usually referred to Psychiatric Clinic.

53. Enuresis:
a. Is associated with a Psychiatric Disorder in the majority of cases.
b. Can be treated by Antidepressants.
c. Runs in Families.
d. Occurs during Non-REM sleeping.
e. Occurs in 1% of the Teenagers.
54-The following are used in prophylaxis of mania:
a. L-tryptophan.
b. Lithium citrate.
c. Lithium carbonate.
d. Carbamazepine.
e. Phenytoin.

55-Symptoms of mania include:

a. Irritability.
b. Loss of judgement.
c. Primary delusion.
d. Auditory hallucinations. e- Third person hallucination.
56-First Rank symptoms of schizophrenia include:
a. Primary delusion.
b. Delusional perception.
c. Flight of ideas.
d. Thought block.
e. Hallucinations on third person.

57-Depression is characterized by:

a. Late insomnia.
b. Loss of weight.
c. Weight gain.
d. Loss of appetite.
e. Delusion of poverty.
58- Features of post-traumatic stress disorder include:
a. Depressed mood.
b. Elated mood.
c. If she sees someone involved in the accident, they remind her of the accident.
d. Vivid dreams about the accident.
e. ---------------.

59-Delirium Tremens:
a. Should be treated in a dark room.
b. Hallucinations are mainly auditory.
c. There is vitamin deficiency.
d. Is fatal in 10% of cases.
e. -----------------------.

60-Tricyclic antidepressants can cause:

a. Chest pain.
b. Blurring of vision.
c. Constipation.
d. Hypotension.
e. Weight gain.
f. Dry mouth.
61-ECT is characterized by:
a. Tonic clonic seizures.
b. Loss of consciousness.
c. Significant risk of cardiac arrest.
d. Usually refused because of fear of pain.
e. Analgesia is used.
62-In schizophrenia:
a. Males are affected more than females.
b. Usually presents before the age of 60.
c. Life events may be a precipitating factor.
d. Amphetamine may aggravate it.
e. Third person hallucination is characteristic.

63-The following sexual problems are encountered in psychiatric clinics:

a. Erectile dysfunction.
b. Vaginismus.
c. Transvestitism.
d. Sadomasochism.
e. ------------------.
64-Hallucinations:
a. Of Auditory type involving the Third person are characteristic of Schizophrenia.
b. Are Misinterpretations of External Stimuli.
c. Of Visual type suggest Organic Disease.
d. Of Smell suggest Frontal Lobe Lesions.
 65- Compulsions:
a. Are not usually resisted.
b. Checking is rare.
c. Are usually single acts.
d. Are seen Senseless by the patient.
e. PET reveals increased blood flow to the orbitofrontal cortex.

66-Suicide:
a. More common in males.
b. 60% are associated with Depression.
c. More in the never married.
d. Previous failed Attempts decrease the Risk of Suicide.
e. Is considerable in chronic depressive illness.

67- Life Events:

a. Females stand life events more than males before developing Endogenous
Depression.
b. Threat leads to Anxiety more than Depression.
c. Loss of Threats precedes Relapse of Schizophrenia only.
e. Unemployment increases the Impact of life Events.
f. Loss of confidence increases ht impact of life events.

68. In Anorexia Nervosa:

a. Amenorrhea is more common than in Bulimia Nervosa.
b. Weight loss of >25% is required to make the Diagnosis.
c. Patients have Distorted Body Image.
d. Increase Growth Hormone Levels.
e. Fear of eating in Public is a Bad Prognostic feature.
f. Endocrine abnormalities nearly always revert to normal after restoration of
weight.

69. Alcohol Dependence Syndrome:

a. Is Suggested by MCV of 90.
b. Is Suggested by Irregular Pattern of Drinking.
c. Is Suggested by Altered Alcohol Tolerance.
d. Can be detected by (CAGE) questions.
e. Ingestion of 15 units per week in an adult male is needed to make the Diagnosis.

70. The following suggest a diagnosis of delirium rather than dementia.

a. Abrupt onset.
b. Sudden Behavioral Changes.
c. Preserved Sleep Rhythm.
d. Variable Cognitive Functions.
e. Visual Hallucinations.
 71. The following Conditions may present with Depression:
a. Hypothyroidism.
b. Addissons’s Disease.
c. Pellagra.
d. Pheochromocytoma.
e. Cushing’s Syndrome.

72. Benzodiazepine Adverse Effects include:

a. Confusion.
b. Respiratory Depression.
c. Aggression.
d.
e.

73. Opiate Dependence includes:

a. Hypersexuality
b. Constricted Pupils.
b. Shivering.
c. Peripheral Neuropathy.
d. Diarrhea.
74-Side Effects of Selective Serotonin Re-uptake Inhibitors (SSRI) include:
a. Nausea.
b. Sweating.
c. Tremors.
d. Sedation.
e. Confusion.

75-The following make the Diagnosis of Schizophrenia more likely:

a. Auditory Hallucinations in the Third Person.
b. Thought Withdrawal.
c. Catatonic type responds well to ECT.
d. Disorientation in Time & Person.
e. Past History of Sexual Abuse in Childhood.
f. Clozapine is the Treatment of choice.

76-Child Abuse:
a. Sexual Abuse is associated with Violence or tendency to Violence.
b. Physical Abuse is Common in Preschool Children.
c. Rare in Teen age girls.
d. In Ireland you must notify to Children Abuse Society.

77-Over Eating occurs in:

a. Anorexia Nervosa.
b. Bulimia Nervosa.
c. Depression.
d. Puerperal Psychosis.
e. Social Phobias.

78-Symptoms of depression:
-Sleep disturbances
-Delusion
-Wt.loss
-Flight of ideas
79-in assessing drug overdose:
-Taking history from relatives is important if available
-Increase drug dose increase psychiatric illness
-History is often concealed
-Suicidal note is of no importance
-Recurrent suicidal attempt decreases the risk
80-Anorexia nervosa :
-Occurs In early age than bulimia
-treatment is always by hospitalisation
-Cannot occur in males
-Genetic factor is not proven
-Drug treatment is the only treatment
81-Schizophrenia (good prognosis)
-Old age
-Normal premorbid personality
-Family history of affective disorders
-1st Rank symptoms
-Insidious onset
82-ECT
---Can't be given without consent
-Only effective in psychotic depression
-Contraindicated in ischemic heart disease
-Contraindicated in patient not taking fluids
-Causing irreversible damage to mamilary body.

83-Causes of delirium
Cushing syndrome
Acute alcohol withdrawal
Mania
Schizophrenia
Vit. B1 deficiency
84-delirium tremens
Treated in dark room
Risk of developing convulsions
Hypersomnia
Vit. Deficiency
Mainly auditory hallucination
85-post traumatic stress disorders
Vivid dreams re-encenting the accident
Increased mood
Decreased mood
Flight of ideas
When encounter somebody from the accident will remind her with the accident
86-benzodiazepine withdrawal
Confusion
Aggression
Respiratory depression
Weight gain
Cognitive impairment

87-when examining a patient with delirium for orientation

Mention the name of the president
Name of the ward
Mention serial 7s
Time passed
Overview of the aim of the interview
88-Autism
Common after 30 month
Obcessive behaviour
Delayed speech
Always high or normal IQ
Common in female