mcqs

1. A patient while answering examiner question brings many irrelevant details that are boring in nature but eventually does get back to the original point. This is an example of
1. Tangentiality
2. Flight of ideas
3. Loosening of association
4. Circumstantiality

Ans). circumstantiality

· Circumstantiality: Disturbance in the associative thought and speech processes in which a patient digresses into unnecessary details and inappropriate thoughts before communicating the central idea.

· Tangentiality: Oblique, digressive, or even irrelevant manner of speech in which the central idea is not communicated.

· Flight of ideas: Rapid succession of fragmentary thoughts or speech in which content changes abruptly and speech may be incoherent. Seen in mania.

· Loosening of association: Characteristic schizophrenic thinking or speech disturbance involving a disorder in the logical progression of thoughts, manifested as a failure to communicate verbally adequately; unrelated and unconnected ideas shift from one subject to another.

2. All of the following statements are true about schizophrenic patients except
1. There is increased risk of obesity
2. There is increased risk of type I diabetes mellitus
3. There is increased risk of HIV infection
4. There is increased risk of COPD

Ans). B. There is increased risk of type I diabetes mellitus

· Co-morbidities in schizophrenia

o Obesity: due to antipsychotic medications, nutritional imbalance and decreased motor activity.

o Diabetes Mellitus: increased risk of type II diabetes mellitus; due to antipsychotic medications and obesity.

o Cardiovascular Disease: due to antipsychotic medications ,obesity, increased rates of smoking, diabetes, hyperlipidemia, and a sedentary lifestyle all independently increase the risk of cardiovascular morbidity and mortality.

o HIV: a risk of HIV infection that is 1.5 to 2 times that of the general population; due to increased risk behaviors, such as unprotected sex, multiple partners, and increased drug use.

o Chronic Obstructive Pulmonary Disease: mainly due to smoking

o Rheumatoid Arthritis: Inverse association, one-third the risk of rheumatoid arthritis that is found in the general population.

3. Treatment of choice for the patient suffering from moderate depressive episode with atypical features is
1. SSRIs
2. TCA
3. MAOIs
4. Mood stabilizer

Ans).

· Depression with atypical features

o have specific, predictable characteristics: overeating and oversleeping.

o referred to as reversed vegetative symptoms, and the symptom pattern called hysteroid dysphoria.

o found to have a younger age of onset, more severe psychomotor slowing, and more frequent coexisting diagnoses of panic disorder, substance abuse or dependence, and somatization disorder.

o More likely long-term course, a diagnosis of bipolar I disorder, or a seasonal pattern.

o preferentially respond to treatment with MAOIs or SSRIs.

4. All of the following are the examples of cluster A personality disorders except
1. Schizoid personality disorder
2. Schizotypal personality disorder
3. Paranoid personality disorder
4. Depressive personality disorder
5. Ans). D. Depressive personality disorder

Personality disorder subtypes classified in DSM-IV-TR are

· Cluster A

o schizotypal, schizoid, and paranoid

· Cluster B

o narcissistic, borderline, antisocial, and histrionic

· Cluster C

o obsessive-compulsive, dependent, and avoidant.

Depressive Personality Disorder

· characterized by lifelong traits that fall along the depressive spectrum. They are pessimistic, anhedonic, duty bound, self-doubting, and chronically unhappy.

· Does not occur exclusively during major depressive episodes and is not better accounted for by dysthymic disorder.

5. All of the following are the temperament dimensions in the individuals except
1. Harm avoidance
2. Novelty seeking
3. Reward dependence
4. Deceitfulness

Ans d). Deceitfulness

Four Temperament Dimensions

· Harm Avoidance: heritable bias in the inhibition of behavior in response to signals of punishment and nonreward. High GABA concentrations in plasma have also been correlated with low harm avoidance.

· Novelty Seeking: heritable bias in the initiation or activation of appetitive approach in response to novelty, approach to signals of reward, active avoidance of conditioned signals of punishment, and escape from unconditioned punishment. involves increased reuptake of dopamine at presynaptic terminals, thereby requiring frequent stimulation to maintain optimal levels of postsynaptic dopaminergic stimulation.

· Reward Dependence: maintenance of behavior in response to cues of social reward. Noradrenergic projections from the locus ceruleus and serotonergic projections from the median raphe are thought to influence reward conditioning

· Persistence: maintenance of behavior, despite frustration, fatigue, and intermittent reinforcement.