1.

Phobia is:
a) Psychosis

b) Fear of animal

c) Anxiety

d) Neurosis

Correct Answer - D
Neurosis
2. Not a selective serotonin reuptake inhibi-
tor
a) Fluoxitine

b) Fluoxamine

c) Buspirone

d) Citaloforamin

Correct Answer - C
Buspirone
3. Pavlov's experiment is an example of which of the following learning theory?
a) Modeling

b) Classical conditioning

c) Operant conditioning

d) Learned helplessness

Correct Answer - B
Pavlov’s experiment is an example of Classical conditioning.
Classical conditioning is a process of learning, by which a previously neutral stimulus elicit
an identical or similar response to one originally elicited by another stimulus as a result of
pairing of the two stimuli.
Ref: Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edition, page 647.
Beginning Psychology By Malcolm Hardy, 5th edition page 54 ; Universal Principles of
Design By William Lidwell, page 174 ; Psychology: Concepts and Applications By Jeffrey
S. Nevid, 3rd edition page 176.
4. Which of the following could be a component of conversion disorder?
a) Pseudoseizures

b) Derealisation

c) Depersonalisation

d) Amnesia

Correct Answer - A
Pseudoseizure can occur in conversion disorder.
Paralysis, blindness and mutism are the most common conversion disorder symptoms.
Anaesthesia and paresthesia especially of the extremities are the most common sensory
symptoms.
Other sensory symptoms includes deafness, blindness and tunnel vision.

Motor symptoms associated with it are: abnormal movements, gait disturbance, weakness
and paralysis.
One gait disturbance seen in this is ataxia abasia, which is a wildly ataxic, staggering gait
accompanied by gross, irregular, jerky truncal movements and thrashing and waving arm
movements.

Ref: Kaplan and Sadock's Concise Textbook of Clinical Psychiatry, 3rd Edition By
Benjamin J. Sadock, Page 279
5. The most common substance of abuse in India:
a) Cannabis

b) Tobacco

c) Alcohol

d) Opium

Correct Answer - A
By most estimates, cannabis (Indian hemp plant) remains the world's most commonly used
illicit drug.
Cannabis is perhaps the most widely used drug in India too, due to it's easy availability.
Cannabis, a substance that has been traditionally used in India as an intoxicant.
It is produced from the plant cannabis saliva or Indian Hemp plant. It grows in the wild over
most parts of the country.

Ref: Kaplan & Sadock's Synopsis of Psychiatry 9th Edition, Page 444, 424-27; Park’s
Social and Preventive Medicine 18th Edition, Page 635; Shorter Oxford Textbook of
Psychiatry 5th Edition, Page 332-342
6. Which of the following drug is not used in the treatment of akathisia?
a) Benzodiazepam

b) Propranolol

c) Trihexyphenidyl

d) Haloperidol

Correct Answer - D
Akathisia refers to somatic restlessness which occur in patients treated with first
generation antipsychotics.
Among the options given haloperidol is an old generation antipsychotic which causes a side
effect of akathisia.
Drugs commonly used to treat akathisia are propranolol, benzodiazepines and
anticholinergics.

Ref: American Psychiatric Association Practice Guidelines for the treatment of Psychiatric
Disorders 2006, page 649
7. The current agent of choice for treatment of bipolar affective (manic-depressive)
disorder is:

a) Chlorpromazine

b) Haloperidol

c) Diazepam

d) Lithium carbonate

Correct Answer - D
Lithium carbonate is the current agent of choice, particularly during
the manic phase. Because the onset of action is slow, concurrent
use of antipsychotic agents such as chlorpromazine or haloperidol
may be necessary to control mania.

Concurrent use of tricyclic antidepressants may be necessary in the

Monitoring of lithium levels is necessary because of the serious

b) Fracture spine

c) Body ache

d) Amnesia

Correct Answer - D
D i.e. Amnesia
* Electro convulsive therapy (seizure) increases production of brain
derived neurotrophic factor (BDNF)Q. Madsen proposed generation
of new neurons in the hippocampus may be an important
neurobiological element underlying the clinical effects of ECT.
* ECT is most commonly indicated (-85% of all ECT) and most
effective in treatment of major depression (with psychosis /
delusions /or suicidal tendency)Q. ECT is indicated in psychotic
(delusional) depressionQ because nihilistic delusions may induce
suicidal tendency, whereas ECT is not indicated in neurotic
depression (dysthynia), cyclothymiaQ. ECT may be useful in MDP
(bipolar) in decreasing duration of depressive episode.
ECT is not (or less) useful in chronic conditions like chronic
schizophrenia (with negativ symptoms esp)Q. Use of ECT is not the
first line (choice) of treatment in mania & schizophrenia (lithium &
anti psychotics are mainstay of treatment). Panic disorder is also
treated with drugs not ECT.
Indications of ECT
* ECT is most useful in acute and positive symptoms (eg suicidal
tendency, catatonia), whereas it is least effective in chronic
conditions and negative symptoms
* Clinical indications of ECT include
Primary use Secondary use
1. Rapid definitive 1. Failure to
response respond or
required on medical
intolerance to
or
pharmacotherapy in
psychiatric grounds
current
2. Risk of
episode i.e. drugs
alternative
are
treatments out
ineffective,
weight benefits
contraindicated or
3. Past history of have serious side
poor response to effects
psychotropics or 2. Rapid definitive
good response to response
necessitated by
ECT
deterioration of
4. Patient the patients
preferance condition.

* ECT should be considered when the onset of disorder is acute,
when changes in mood, thought, and motor activities are
pronounced, when the cause of disorder is believed to be
biochemical or physiological, when the condition interferes with the
daily life or when other treatments have failed. Diagnosis for which
ECT may be indicated include (especially when a/w delusions).
Major (Severe) Mania Schizophrenia Other
Depression with (Bipolar (Severe conditions
1. Psychosis (i.e. disorder) Psychosis) 1. Delirium d/t
delusional or 1.Psychosis 1. Catatonia general
medical
psychotic 2. Manic particularlyQ conditions or
depression)Q, who delirium 2. Schizoaffective substance
are guilt ridden or 3.Rapid cycling disorder (i.e. intoxication
 feel worthless, who states depressive 2. Catatonia d/t
believe others 4. Acute features)Q and GMC, neurolept
control their lives & uncontrolled schizophreniform
malignantContraindications
I. Absolute (relatively) Raised Intra Cranial TensionQ d/t fear of brain
herniation.
1. Relative
* Cerebro vascular Accident (CVA) = intracerebral hemorrhage
* Recent Myocardial infarction (MI)
* Severe hypertension
* Pheochromocytoma - Severe Pulmonary disease
* Retinal detachment - Space occupying intracerebral lesions
(except for small, slow growing tumors without edema or other mass
effect)
* Unstable vascular aneurysms or malformations Complications
Direct (Modified) ECT (when ECT is given without muscle relaxant &
anesthesia)
Most common side effect is fracture T4 T8 spineQ
Causes decreased intraocular tension (JOT)
. Modified ECT (with MR & anesthesia) Both retrograde & antegrade
amnesia is found but the most common complication is retrograde
amnesiaQ Antegrade amnesia usually resolves within 5 hours
whereas retrograde memory deficits may take 6-9 monthsQ
9. Visual analogue scale (VAS) most widely
used to measure
a) Sleep

b) Sedation

c) Pain intensity

d) Depth of Anaesthesia

Correct Answer - C
C i.e. Pain intensity
10. Visual hallucinations is seen in :
a) Alcoholism

b) Mania

c) Depression

d) Phobia

Correct Answer - A
A. i.e. Alcololism
11. All are true regarding somatization
dosorder except:
a) Maintain sick role

b) 4-Pain symptoms

c) 1-Sexual symptom

d) 1-Pseudo neurological symptom

Correct Answer - A
A i.e. Maintain sick role
12. La belle indifference is seen in
a) Conversion Reaction

b) Schizophrenia

c) Mania

d) Depression

Correct Answer - A
A i.e. Conversion reaction
La belle indifferenceQ is in-appropiate attitude of calm or lack of
concern about one's disability. It is seen in conversion (dissociative)
disorderQ (but not specific), physical illness etc.
13. Markedly inappropriate sensitivity, self
importance and suspiciousness are
clinical features of
a) Aantisocial

b) Historic

c) Schizoid

d) Paranoid

Correct Answer - D
D i.e. Paranoid P
14. Antidepressant drug used in nocturnal
eneuresis is:
a) Imipramine

b) Fluoxetine

c) Trazdone

d) Sertaline

Correct Answer - A
A i.e. Imipramine
Adverse effects ofTCAs
l. Anticholinergic - Dry mouth, bad taste, urinary retention, blurred
vision, palpitation, constiPation.
2. Sedation, mental confusion, weakness.
3. Increased appetite and veigfit gain.
4. Sweating andfinc tremer.
5. Decreased seizure threshold (clomipramine, maprotiline &
bupropion).
6. Postural hypotension > Marimum by amitripSline - Goodman &
Gillman 11/e p. 4j3.
7. Cardiac arrythmia; Maximum by amitriptyline and dosulpin.
15. Not a feature of Wernicke's Korsakoff
Syndrome
a) Ataxia

b) Psychosis

c) Normal pupillary response

d) Opthalmoplegia

Correct Answer - C
C i.e. Normal pupillary response
16. The site of lesion in Korsakoff's psychosis
is
a) Frontal lobe

b) Corpus striatum

c) Mammilary Body

d) Cingulate gyrus

Correct Answer - C
C i.e. Mammilary body
17. Not involved in Wernicke - Korsakoff
syndrome:
a) Mammilary body

b) Thalamus

c) Periventricular grey matter

d) Hippocampus

Correct Answer - C
C i.e. Periventricular grey matter
Korsakoff's Psychosis (K P)
It is the commonest cause of organic amnestic syndrome. It is also
k/ a Wernicke - Korsakov syndrome, because it often follows an
acute neurological syndrome called Wernicke's encephalopathy
comprising delirium, ataxia, opthalmoplegia, nystagmus & peripheral
neuropathy.
It is a potentially reversible conditionQ caused by thiamine
deficiency most commonly associated with chronic alcohol abuse
malnutrition. But other causes of malnutrition eg. starvation,
hyperemesis gravidarum, dialysis, cancer, AIDS, gastric plication or
prolonged IV hyperalimentation, alone can also result in thiamine
deficiency & KP.
Neuropathological lesion caused by thiamine deficiency is usually
widespread but most consistent changes are seen in bilateral
dorsomedial (& anterior) nucleus of thalamus, mammillary bodies,
and hippocampus, in form of small vessels hyperplasia; petechial
hemorrhages, astrocytic hypertrophy & degenerationQ. It disrupts a
critical circuit between hippocampus & frontal lobes. The changes
are also seen in periventricular (around 3rd ventricle), periaqueductal
grey matter, cerebellum, and brain stem (midbrain, pons, medulla
fornix) as symmetrical lesions.
The cardinal feature is a profound deficit of episodic memory,
confabulation and lack of insight into the amnesiaQ. It presents as :

Change in personality (frontal lobe like) such that they display lack of
initiative, interest or concern & diminished spontaneity.
- Executive function deficits involving attention, planning, set shifting,
& inferential reasoning.
- Apathy, passivity & confabulationQ are often prominent. There is
disorientation for time, emotional blunting, & inertia.
- There is little impairment in implicit memory and their ability to
perform (complete) complex motor procedures remain intactQ.
Typically general intelligence, perceptual skills & language remain
relatively normalQ.
Memory disorder
- Profound deficit of episodic type explicit (declarative) memory 1/t
loss of autobiographic information (often extending back for many
years).
Severe anterograde amnesia (learning defect) for verbal & visual
material with a lack of insight into the amnesia. Events are recalled
immediately after they occur, but forgotten a few minutes later. Thus
digit span, testing the short term memory store, is normal. Storage is
mildly impaired but retrieval & learning are severely impairedQ.
When patients learn new material they will forget it at a normal rate,
but learning the new material is extremely difficult, and in severe
cases new learning is impossible. So these patients have difficult
encoding & consolidating explicit memory.
- Retrograde amnesia back to the onset of illness, is as severe as
anterograde loss; but the overall retrograde memory impairment (i.e.
before the onset of illness) is not as severe as that of anterograde
memory.
New learning & recent memory is grossly defective but retrograde
(remote) memory is relatively (variably) preserved, and show a
temporal gradient, with older memories better preserved. As a result
these patients retain more distant memories dramatically more
proficiently than they learn new material.
- Although remote memory is surprisingly intact, patients are unable
to organize them in a temporal context. So they distort the
relationship between facts and fill the remote memory gaps by
confabulationQ (a vivid & wholly fictitious account of recent activities
which the patient believes to be true).
18. Most common cause dementia in adult:
a) Alzheimer's

b) Multiinfrct

c) Pick' disease

d) Metabolic cause

Correct Answer - A
A i.e. Alzheimer's
19. In Alzheimer's disease (AD) which of the
following is not seen:
a) Aphasia

b) Acalculia

c) Agnosia

d) Apraxia

Correct Answer - C
Ans. None > C. Agnosia tRej. Kaplan anal Jaadock s Synopsis of
Psychiatry 10/c pi-t?
Aphasia, Apraxia, Acalculia and Agnosia may all be seen in
Alzheimer's Dementia. Agnosia in Alzheimer's disease usually
presents late in the disease and is not included in the ICD-10
Diagnostic criteria for dementia in Alzheimer's disease with early
onset and hence may be selected as the single best answer by
exclusion
20. Mania is characterized by:
a) Paranoid delusion

b) Loss of orientation

c) High self esteem

d) All

Correct Answer - C
C i.e. High self esteem
21. Lithium is treatment of choice for
a) Unipolar MDP prophylaxis

b) Bipolar MDP prophylaxis

c) Schizophrenia

d) Acute mania

Correct Answer - B
B i.e. Bipolar MDP prophylaxis
Lithium: Indications:
Established indications:
Treatment of acute mania
Prophylaxis of bipolar mood disorder.
Possible clinical indications:
Treatment of the schizo-affective disorder
Prophylaxis of unipolar mood ilisorder
treatment of cyclothymia
Treatment if acute depression(as an adjuvant for refractory
depression)
Treatment of chronic akoholism(in presence of significant depressive
symptoms) 6 psychoactive use disorders(e'g cocaine dePendence)
Treatment of impulsive aggression.
Treatment of Keine-Levin syndrome

22. Features like increased psychomotor
acitivity, waxy flexinbility at time are seen
classically in :
a) Simple schizophrenia

b) Hebephrenic schizophrenia

c) Catatonic schizophrenia

d) None of the above

Correct Answer - C
C. i.e. Catatonic schizophrenia
23. Post traumatic stress disorder (PTSD) is
differentiated from all other disorders by:
a) Nightmares about events

b) Autonomic arrousal and anxiety

c) Recall of events and avoidance of similar experiences in PTSD

d) Depression

Correct Answer - C
C i.e. Recall of events and avoidance of similar experiences in
PTSD
- PTSD arises as response to traumatic event (criteria A) that is
characterized by persistent re-experience (criteria B), persistent
avoidance and numbness (C), hyperarousal (D), of > 1 month
duration (criteria E) causing significant distress & impaired
functioning (criteria F)Q. The onset may be delayed (6 months to
years after event).
- PTSD arises as a delayed/protracted response to an exceptionally
stressful or catastrophic life event or situation which is likely to cause
pervasive distress in almost any person (eg. disaster, war, rape,
torture, serious accident). It may develop even after 6 months to
years after stressorQ.
- PTSD is characterized by peristent/recurrent intrusive distressing
recollections of stressful event either in flashbacks (images,
thoughts or perceptions), dreams, reliving experiences, illusions,
hallucinations or distress/ physiological reactivity on exposure to
reminders of traumatic events. There is marked (persistent)
avoidance of stimuli/events or situations that arouse recollection of
stressful events and increased arousal (hyperarousal) and numbing
of general responsivenessQ.
Partial amnesia for some aspects of stressful events, anhedonia
Partial amnesia for some aspects of stressful events, anhedonia
(inability to experience pleasure) and alexithymia (characterized by
inability to identify & articulate feelings) may be present.
24. Catatonia is a type of:
September 2007
a) Schizophrenia

b) Phobia

c) Depression

d) OCD

Correct Answer - A
Ans. A: Schizophrenia
Schizophrenia is a severe, persistent, debilitating, and poorly
understood psychiatric disorder that probably consists of several
separate illnesses.
Symptoms include disturbances in thoughts (or cognitions), mood
(or affects), perceptions, and relationships with others. The hallmark
symptoms of schizophrenia are auditory hallucinations and
delusions, which are fixed false beliefs. The symptoms of
schizophrenia may be divided into the following 4 domains:
Positive symptoms: These include psychotic symptoms, such as
hallucinations, which are usually auditory; delusions; and
disorganized speech and behavior.
Negative symptoms: These include a decrease in emotional range,
poverty of speech, loss of interests, and loss of drive.
Cognitive symptoms: These include neurocognitive deficits, such as
deficits in working memory and attention and executive functions
such as the ability to organize and abstract.
Mood symptoms: Schizophrenia patients often seem cheerful or sad
in a way that does not make sense to others. They often are
depressed.
Catatonia Schizophrenia
This syndrome occurs in children, adolescents, and adults; is
This syndrome occurs in children, adolescents, and adults; is
associated with a heterogeneous group of comorbid conditions; and
is characterized by a variety of symptoms and signs of impairment of
the expression of voluntary thoughts and movements.
Typically, the syndrome of catatonia is episodic, with periods of
remission.
It can presents in three clinical forms:
Excited catatonia
Stuporous catatonia
Catatonia alternating between excitement and stupor.
25. Suicidal tendencies are most commonly
seen in:
March 2003
a) Female

b) Younger age

c) Severe depression

d) All of the above

Correct Answer - C
Ans. C i.e. Severe depression
26. Sexual stimulation obtained through some
inanimate object is known as:
September 2003
a) Transvestism

b) Fetichism

c) Voyeurism

d) Zoophilia

Correct Answer - B
Ans. B i.e. Fetichism
27. All of the following are formal thought
disorder EXCEPT:
March 2013 (b, c, h)
a) Schizophrenia

b) Delusion

c) Loosening of association

d) Mania

Correct Answer - B
Ans. B i.e. Delusion
Delusion is a disorder of thought content (NOT a formal thought
disorder/disorder of thought process)
Delusion
Disorder of thought;
False unshaken belief not amenable to reasoning
Hallucination
Disorder of perception;
Perception in the absence of external stimuli;
Not dependent of will of observer
Illusion
Misinterpretation of external stimuli
28. Illusion is:
September 2007
a) A false unshaken belief not keeping one's sociao​cultural
background

b) Perception without stimuli

c) Abnormal perception by a sensory misinterpretation of actual

d) Fear of closed spaces

Correct Answer - C
Ans. C: Abnormal perception by a sensory misinterpretation of
actual stimulus
Illusion is an abnormal perception caused by a sensory
misinterpretation of actual stimulus, sometimes precipitated by
strong emotion, e.g. fear provoking a person to imagine they have
seen an intruder in the shadows.
29. Which of the following is not associated
with dementia:
March 2011
a) Forgetfulness

b) Alteration of consciousness

c) Reduced personal care

d) Loss of neurons in brain

Correct Answer - B
Ans. B: Alteration of consciousness
There is impairment of judgement and impulse control, and
also impairment of abstract thinking There is however usually
no impairment of consciousness in dementia (unlike in
delirium) Dementia:
Chronic onset
No disturbance of consciousness
Cognitive impairment
Personality alteration
Impaired memory
Impaired judgment
Absent diurnal variation
30. According to Wechsler intelligence scale
scoring, average IQ of a normal child is:
a) 50

b) 75

c) 90

d) 111

Correct Answer - C
Ans. c. 90
 31. Well dressed man came for feeling of
women trapped in man body is suffering
from ?
a) Paraphilia

b) Transverium

c) Gender identity disorder

d) Protterurism

Correct Answer - C
Ans. is 'c' i.e., Gender identity disorder
Gender identity disorder
These disorders are characterized by disturbance in gender identity,
i.e., the sense of one's masculinity or faminity is disturbed. Gender
identity disorders has following two characteristics : ?
1. A strong and persistent cross gender identification which is
manifested by : ?
1. Repeatedly stated desire to be, or the insistence that he or she is ,
of the other sex.
2. Wearing the clothes of other sex (cross dressing), Preference for
cross-sex roles in plays or fantasies, Preference for playmates of the
other sex.
2. Persistent discomfort with his or her sex.
Important gender identity disorders are : -
1. Transsexualism : - It has all the characteristic of gender identity
disorder (see above). The most characteristic feature is that there is
marked preoccupation with the wish to get rid of one's genitals and
secondary sex characteristics and to adopt the sex characteristics of
other sex (perceived-gender), e.g., Female transexuals request for
 hysterectomy or mastectomy.
2. Dual-role transvestism : - It is characterized be wearing of clothes of
opposite sex in order to enjoy the temporary experience of
membership of the opposite sex, but without any desire for a more
permanent sex change (unlike transsexualism). Both transexualism
and dual-role transvestism should be differentiated from
transvestism (fetishistic transvestism) which is not a gender identity
disorder and characterized by wearing the clothes of other sex for
the purpose of sexual excitment.
3. Gender-identity disorder of childhood : - This disorder is similar to
transsexualism with a very early age of onset (2-4 years of age).
32. Folie-a-deux means ?
a) Delusion of persecution

b) Sharing of delusion

c) Delusion of double

d) None

Correct Answer - B
Ans. is 'b' i.e., Sharing of delusion
It is also known as shared psychotic disorder or symbiotic psychosis.
It is characterized by sharing of delusions between two person (Folie
a deux) or rarely between more individuals (Folie a trois, Folie a
quatre, Folie a famine).
There is a dominant (active) person who induces delusions into the
other (passive receptor or dependent person) -4 Dependent person
accepts the delusion of dominant person.
On separation of two, dependent person may give up his delusions,
however the active (dominant) person often requires treatment
 33. REM sleep is associated with all except ?
a) Dreams

b) Delta waves

c) Loss of muscle tone

d) Increased BP

Correct Answer - B
Ans. is 'b' i.e., Delta wave
Stages of Sleep
Sleep is basically divided into two phases : ?
Non-REM (NREM) or slow-wave sleep : - It is called Non-REM sleep
because no rapid eye movement (REM) is there on eletrooculogram,
rather there is slow or quiscent eye movement. It is also referred as
S-sleep (synchronized sleep) or quiet sleep or orthodox sleep
because there diminished physiological functions and a low level of
overall activity. It is further divided into : ?
1. Stage 1 : - It is a transition from wakefulness to sleep and is
characterized by disappearance of alpha activity and appearance of
theta activity. There is slow eye movements.
2. Stage 2 : - It is characterized by typical EEG activity i.e., Sleep
spindles and IC-complex'. No eye movement occurs.
3. Stage 3 & 4 : - Stage 3 & 4 are stages of deep sleep. These are also
called slow wave sleep as these stages are characterized by slow
delta waves. Delta wave appearance starts in stage 3 and
dominated in stage 4.
REM sleep : - The REM sleep is so named as there is rapid roving
movements of eye, i.e., rapid eye movement (REM)on electro-
oculogram. It is also called paradoxical sleep because there is a
paradoxical elevation of brain activity & metabolism and
 physiological activity. The high-amplitude slow waves seen in stage
3,4 of REM sleep is replaced by rapid low voltage activity (beta
wave). Features of REM sleep are : -
1. EEG Beta wave, Reappearance of alpha wave, Saw-tooth wave (low
voltage fast activity), Ponto​genital-occipital spikes.
2. Dreaming
3. Other features : - Generalized muscular atony, Penile erection,
autonomic hyperactivity (Increased pulse rate & BP) and intermittent
movement of small muscle groups.
 34. For diagnosis of mania symptoms should
be-
a) > 1 week

b) > 3 weeks

c) >2 week

d) > 4 weeks

Correct Answer - A
Ans. is 'a' i.e., > 1 Week
Diagnostic criteria for Mania
Three or more of the following for at least 1 week : -
1. Inflated self esteem or grandiosity
2. Decreased need for sleep
3. Overtalkativness
4. Flight of ideas or racing thoughts
5. Distractibility
6. increased goal directed activity or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high
potential for painful consequences.
The mood disturbance is sufficiently severe to cause marked
impairment in occupational & social functioning, or there are
psychotic features.
If the symptoms occur for 4 days, and do not cause impairment of
social/occupational functioning, and psychotic feature are absent,
then the diagnosis is hypomania.
 35. Acute and transient psychotic disorder,
onset of symptoms ?
a) < 1 weeks

b) < 2 weeks

c) < 3 weeks

d) < 4 weeks

Correct Answer - B
Ans. is 'b' i.e., < 2 weeks
Acute and transient psychotic disorder
These psychotic disorders are characterized by an abrupt (less than
48 hours) or an acute (Less than 2 weeks) onset of symptoms.
Three types have been recognized (according to ICD-10).
1. Acute polymorphic psychotic disorder without symptoms of
schizophrenia : - Hallucinations, delusions, and other psychotic
symptoms are present and are varied and constantly changing, just
like emotional status. None of them is consistent as to qualify for a
diagnosis of schizophrenia. The polymorphic and unstable picture is
characteristic of illness .
2. Acute polymorphic psychotic disorder with symptoms of
schizophrenia : - Polymorphic and unstable symptoms occur along
with consistent symptoms of schizophrenia.
3. Acute schizophrenia - like psychotic disorder : - Except for acute and
shorter duration of symptoms they resemble schizophrenia in total.
Symptoms occur for less than lmonth. Under DSM IV classification,
it is classified as brief psychotic disorder.
 36. Ataxia abasia is seen in ?
a) Conversion disorder

b) PTSD

c) Depression

d) Manic

Correct Answer - A
Ans. is 'a' i.e., Conversion disorder
Symptoms of conversion disorder
Sensory symptoms (in ICD -10 dissociative anesthesia & Sensory
loss): - Anaesthesia andparesthesia are common, especially of
extremities. All sensory modilities (Pain, temperature, touch,
proprioception) are affected at same level, and the disturbance is not
consistent to the distribution of dermatomes. Thus, clinicians may
see the characteristic glove and stocking anaesthesia of hands or
feet or hemianesthesia of body beginning precisely along the
midline. Deafness, blindness or contracted visual fields (tubular or
tunnel vision).
Motor symptoms (In ICD-10 Dissociative motor disorder) : -
Abnormal movement, paralysis, Weakness, gait disturbances
(ataxia-abasia), Aphonia, Torticollis, Opisthotonus, blepherospasm.
Seizure symptoms (In ICD-10 Dissociative convulsions) : - Earlier
known as hysterical fits or pseudoseizures, dissociative convulsions
are characterized by convulsive movements and partial loss of
consciousness. Dissociative convulsions should be differentiated
from true convulsions : -
1. Tongue biting, Urinary incontinence and injury are uncomomn (in
contrast to true convulsions, In which these are common).
2. Never occurs during sleep (in contrast, true convulsions can occur
 anytime and during sleep).
3. Usually occur in safe place or indoors (in contrast, true convulsions
can occur anywhere).
4. Usually occurs when people are observing (in contrast, true
convulsion can occur with or without people observation).
5. Normal prolactin level in postictal period (in contrast, serum prolactin
is usually raised in post-ictal period after true convulsions).
6. There is no or partial amnesia about the episode (In contrast, true
convulsion has complete amnesia).



37. True about anorexia nervosa is all except
?
a) Binge eating is common

b) Unknown in male

c) Ammenorrhoea starts before severe loss of weight

d) Self-induced vomiting

Correct Answer - B
Ans. is 'b' i.e., Unknown in male
Anorexia nervosa is less common in male, but can be seen.
There is binge eating and self induced vomiting.
"Amenorrhea often precedes severe weight loss" – Essentials of
psychiatry
ANOREXIA NERVOSA
The term '`anorexia nervosa" is a misnomer as loss of appetite is a
rare symptom. This disorder is characterized by self imposed dietary
restrictions leading to malnutrition and severe weight loss.
Clinical features
Females are far more commonly affected than males. Onset usually
occurs between the age of 10-30 years, usually in mid adolescence.
A deliberate and persistent restriction of food is usually the earliest
presenting symptom. There is intense fear of becoming of obese,
even if body becomes very thin and underweight.
There is a body-image disturbance. The person is unable to
perceive the body size accurately.
Some patients cannot continuously control their voluntary restriction
of food intake and So have eating binges. These binges usually
occur secretly and often at night and are frequently followed by self-
induced vomiting. Patients abuse laxatives and even diuretics to
lose weight, and ritualistic exercising, extensive cycling, walking,
jogging and running are common activities.
Patients with anorexia nervosa exhibit peculiar behavior about food.
They hide food all over the house, frequently carry large quantities of
candies in their pockets and purses. They try to dispose of food in
their napkins or hide in their pockets, while eating meals. They cut
their meat into very small pieces and spend a great deal of time
rearranging the pieces on their plates.
There is significant weight loss and patient is underweight.
Amenorrhea is seen in almost all women and loss of libido may
occur in male patients. There may be poor sexual adjustment.
Obsessive compulsive neurosis, depression and anxiety like
psychiatric illness may coexist.
Complications of malnutrition may occur, e.g., hypoglycemia,
hypothermia, low BP, bradycardia, leucopenia, endocrine changes
(raised GH and Cortisol, reduced gonadotrophin), and appearance
of lanugo hair.
38. Loosening of association is an example
of
a) Formal thought disorder

b) Schneider's first symptoms

c) Perseveration

d) Concrete thinking

Correct Answer - A
Ans. is 'a' i.e., Formal thought disorder
Thought disorders
Formal thought
Disorders of thought
disorders (Disorders of
process
thought process)
Racing thoughts :-
Anxiety, Schizophrenia
Retarded thoughts :-
Depression
Delusion :- Psychosis
Circumstantiality :-
(Schizophrenia mania,
Mania, Schizophrenia
depression & others
Thought
Obsession
blocking :-
Compulsion
Schizophrenia, Severe
Preoccupations
anxiety
Phobias
Perseveration :- Organic
Depersonalization &
brain disease,
Derealization
Schizophrenia

(occasionally

Loosening of

association :-
association :-
Schizophrenia
Flight of ideas :- Mania
Tangentiality
Clunging & punning :-
Mania & schizophrenia
Neologism, word salad,
Echolalia :-
Schizophrenia
In schizophrenia and mood disorders (depression, mania) all parts of
the thought (thought process as well as content) are involved.
However, schizophrenia is conventionally referred as formal thought
disorder.
 39. False regarding delirium tremens ?
a) Tremors

b) Opthalmoplegia

c) Visual hallucination

d) Clouding of consciousness

Correct Answer - B
Ans. is 'b' i.e., Ophthalmoplegia
Delirium tremens
Delirium tremens is the most severe alcohol withdrawal syndrome. It
occurs usually within 2-4 days of complete or significant alcohol
abstinence. This is an acute organic brain syndrome (delirium) with
characteristic features of delirium.
1. Clouding of consciousness with disorientation in time and place.
2. Poor attention span and distractability.
3. Visual (and also auditory) hallucination, and illusion. Tactile
hallucination of insect crawling under the skin (formication) may also
occur.
4. Marked autonomic disturbances with tachycardia, sweating,
hypertension, mydriasis, coarse tremers.
5. Insomnia, psychomotor agitation, ataxia, anxiety.
Benzodiazepines are the drugs of choice for delirium tremens.
Chlordiazepoxide is the agent of choice with diazepam as an
alternative.
40. Not used for erectile dysfunction ?
a) Beta blockers

b) Siledenafil

c) PG-E,

d) Papaverine

Correct Answer - A
Ans. is 'a' i.e., Beta blockers
Drugs used for erectile dysfunction
1. Phosphodiesterase-5 inhibitors (Siledenafil, Todafil,
Vardenafil).
By inhibiting PDE-5, these drugs prevent degradation of cGMP and
potentiate the action of NO.
These are the DOC for pharmacological therapy of erectile
dysfunction.
2.Alprastadil (Prostaglandin El)
It is a powerful vasodilator
It acts by increasing arterial inflow by vasodilation and reducing
outflow by contracting the carporal smooth muscle that occludes
draining venules.
It is the DOC for patients not responding to PDE-5 inhibitors.
It is directly injected into corpora cavernosa.
3. Papaverine
It is a nonspecific phosphodiesterase inhibitor.
Injection of papaverine with or without phentolamine into corpus
cavernosum produces penile tumiscence to permit intercourse.
Repeated injection can cause penile fibrosis.
4.Androgens
Can be used when androgen deficiency is demonstrated to be
responsible for the loss of libido and erectile dysfunction.
5.Apomorphine (Laurence 9th/e p. 546)
A dopamine antagonist, is given by subcutaneous injection.
 41. A student unable to deliver speech
beforeaudience is suffering from ?
a) Social phobia

b) OCD

c) Agoraphobia

d) Claustrophobia

Correct Answer - A
Ans. is 'a' i.e., Social phobia
Phobic disorders
Phobia is persistent and morbid fear of specific situation, object or
activity. The fear is morbid because : ?
1. The fear is irrational : The objects or situations do not produce fear
in normal persons.
2. The fear is out of proportion to the dangerousness perceived that the
affected person avoids the situation permanently.
3. Patient is unable to control the fear and is very distressed by it.
The common types of phobia are : ?
1. Agoraphobia
This is an example of irrational fear of situations. It is the commonest
type of phobia encountered in clinical practice.
It is characterized by an irrational fear of being in places away from
familiar setting of home and patient believes that he cannot escape
from these places, to a safer place (usually home). This fear results
in avoidance of these places which include public places, stores,
crowd, travelling alone in bus, train or plane, Theaters, Tunnels,
Bridge, standing in line small enclosed rooms or lifts.
The patient is afraid of all the places or situations from where
escape may be perceived to be difficult if he suddenly develops
 embrassing or incapaciating symptoms. These embrassing or
incapaciating symptoms are the classical symptoms of panic. A full-
blown panic attack may occur (agoraphobia with panic disorder) or
only a few symptoms (like dizziness or tachycardia) may occur
(agoraphobia without panic disorder).
2. Social phobia
In social phobia there is irrational fear of one or more social or
performance situations in which the person is concerned about
negative evaluation or scrutiny by others, for example : Public
speaking; writing/drinking/eating in public; using public lavatories.
Feared social or performance situations may produce anxiety
symptoms, even a panic attack. Therefore, feared social or
performance situations are avoided.
3. Specific (simple) phobia
These are phobias limited to highly specific situations or objects, for
example.
1. Claustrophobia :-Fear of closed spaces
2. Acro/Aerophobia :-Fear of high places
3. Zoophobia :- Fear of animals
4. Pyrophobia :- Fear of fire
5. Xenophobia :- Fear of strangers
6. Algophobia :- Fears of pain
7. Thanatophobia :- Fear of death
8. Mysophobia :- Fear of dirt & germs
9. Erythrophobia :- Fear of blushing
10. Sitophobia :- Fear of eating
11. Ailurophobia :- Fear of cats
12. Sitaphobia :- Fear of dogs
13. Hydrophobia :- Fear of water
42. Suicide is most common in ?
a) Depression

b) Alcohol dependence

c) Dementia

d) Schizophrenia

Correct Answer - A
Ans. is 'a' i.e., Depression
Causes/Risk factors for suicide
Psychiatric disorders : - Depression (most common), alcoholism
(2nd mc), Drug/Substance dependence, Schizophrenia, Dementia.
Physical illness : - Cancer, AIDS, Multiple sclerosis, Head trauma.
Psychosocial factors : - Failure in love, marital difficulties, family
dispute, illegitimate pregnancy.
Biological factors : - Decrease in serotonin
Other - Male sex, Age > 40 years, Single (Unmarried, divorced or
widowed), previous suicide attempt, social isolation.
43. Which of the following can cause delirium
?
a) Hypoxia

b) Barbiturates

c) Alcohol withdrawal

d) All of the above

Correct Answer - A
Ans. is `d' i.e., All of the above
Important causes of delirium
1. Trauma : - Head injury, subdural hematoma
2.Infection : - Septicemia, pneumonia, endocarditis.
3.Metabolic : - Hypoxia, hypercapnia, uremia, CHF, Hepatic failure,
porphyria, metabolic acidosis or alkalosis, water & electrolyte
imbalance.
4. Endocrine : - Hypo- or hyperpituitarism, Hypo- or Hyperthyroidism,
Hypo- or hyperparathyroidism, hypo- or hyperadrenalism.
5.Drug intoxication : - Alcohol, barbiturates, TCA, anticholinergics,
anticonvulsants.
6.Drug withdrawal : - Alcohol (delirium tremens), sedatives,
hypnotics.
7 .Nutritional deficiency : - Vitamin (Thiamine, pyridoxine, Niacin,
B12, Folic acid), Protein. 8.0ther : - Post-operative, seizures, sleep
deprivation
44. Total score in Mini Mental Status
Examination (MMSE) is ?
a) 25

b) 30

c) 32

d) 35

Correct Answer - B
Ans. is 'b' i.e., 30
 45. 18 year old girl with circumscribed bald
patch with no organic disease & no
behavioural disorder has ?
a) Depression

b) Trichotillomania

c) OCD

d) Phobia

Correct Answer - B
Ans. is 'b' i.e., Trichotillomania
As there is no organic or behavioral disorders, this girl is suffering
with impulse control disorder of compulsive hair pulling, known as
Trichotillomania.
Impulse control disorder
These disorders are characterized by failure to resist an impulsive
behavior that may be harmful to self or others. There may be a
feeling of release of tension by doing the act and a feeling of guilt
after the act is over. Important impulse control disorder are : -
1. Pyromania (Pathological fire setting)
2. Kleptomania (Pathological stealing)
3. Trichotillomania (Compulsive hair pulling)
4. Pathological gambling
5. Intermittent explosive disorder
6. Impulse control disorder not otherwise specified
Oniomania (Compulsion to shop/buying)
Internet compulsion (Internet addiction)
Cellular or Mobile phone compulsion
Compulsive sexual behavior (sexual addiction).
46. Pyromania refers to an irresistible urge to
?
a) Set things on fire

b) Eat out of proportion

c) Sleep for long periods

d) None

Correct Answer - A
Ans. is 'a' i.e., Set things on fire
 47. The deliusion which involves replacement
of a familiar person by someone else is ?
a) Capgras syndrome

b) Cotard syndrome

c) Othello syndrome

d) None

Correct Answer - A
Ans. is 'a' i.e., Capgras syndrome
DSM is characterized by misidentification delusions of other or self.
Four main syndromes are differentiated : ?
1. Capgras syndrome (Delusion of double) : - Patient falsely sees a
familiar person as a complete stranger who is importing on him as a
familiar person.
2. Fregoli syndrome (illusion de fregoli) : - The patient falsely identifies
stranger as familiar person.
3. Syndrome of subjective double : - The patients own self is perceived
as being replaced by a double.
4. Syndrome of intermetamorphosis : - A false belief that a person can
transform into another person.
These syndrome most commonly appear in schizophrenia. Other
causes are Alzheimer syndrome, head injuries, and delusional
disorders.
48. In personality disorder, features are all
except
a) Ego dystonia

b) Starts in childhood

c) Behavior is maladaptive

d) Disorder results in personal distress

Correct Answer - A
Ans. 'A' i.e., Ego dystonia
Features of personality disorders
Most often the first sign of a personality disorder appears in late
childhood or adolescence and continues during adulthood.
Someone with a personality disorder holds attitudes and behaves in
ways that can cause considerable problems for themselves and
others.
Behaviour is long-standing (not limited to an episode of mental
illness).
Behaviour is pervasive and maladaptive.
Disorder results in personal distress and social or occupational
dysfunction.
Behavior is fixed and inflexible.
Personality disorders are ego-syntonic.
They are not due to a direct result of disease or substance.
 49. Sleep walking is seen in which stage of
sleep ?
a) REM

b) Stage 1-2 NREM

c) Stage 2-3 NREM

d) Stage 3-4 NREM

Correct Answer - D
Ans. is 'd' i.e., Stage 3-4 NREM
Important events occuring during sleep
Deep sleep/slow wave sleep disorder : - These events occur during
stage 3 & 4 of NREM. Important disorders are : ?
1. Somnambulism (Night walking) : - Patient walks during sleep.
2. Sleep terror or night terrors (pavor nocturnes) : - The patient
suddenly gets up screaming, with autonomic arousal (tachycardia,
sweating). Sleep terrors are rarely remembered in the morning (in
contrast to night mares). No treatment is required only reassurance
is required. However, in severe cases benzodiazepine can be used.
3. Sleep-related enuresis (Nocturnal enuresis/bed wetting) : -
Repetitive voiding occurs during sleep. First line of treatment is
behaviour therapy. If behavioral therapy fails, desmopressin (DOC)
and Imipramine can be used.
4. Bruxism (Teeth grinding)
5. Sleep-talking (Somniloquy).
REM sleep events
1. Nocturnal penile tumescence : - It is spontaneous occurence of an
erection of the penis during sleep. It is a normal phenomenon and
occurs for 80-120 minutes per night Nocturnal penile tumescence
can be used to differentiate between psychogenic impotence and
 organic impotenceas nocturnal penile tumescence is preserved in
psychogenic impotence but not in organic cause of impotence.
2. Night mares (dream anxiety disorder) : - They are characterized by
fearful dreams occuring in the last one third of night sleep. The
person wakes up frightned and remembers the dream vividly (in
contrast to night terror).
3. Narcolepsy : - This is characterized by excessive day time sleep,
often disturbed night time sleep and disturbances in the REM sleep.
Age of onset is between 10-20 years. There is irresistable desire to
sleep and bouts of sudden sleep each lasting for 10-30 minutes
occuring during day time. In majority of cases narcolepsy is
associated with one or more accessory symptoms : ?
Cataplexy : - It is the most common accessory symptom and is
characterized by sudden decrease in muscle tone either, local or
generalized.
Hypnagogic hallucination : - Hallucination occuring just before falling
asleep . When hallucination occurs just before awakening it is called
hyponopompic hallucinations.
Sleep paralysis (least common)
Treatment of narcolepsy include stimulant medications
(methyphenidate, amphetamines) or modafinil.
50. Quod Hanc means ?
a) Passive partner in sexual intercourse

b) Women having high sexual desire

c) Sexual parterner in pedophilia

d) Male impotent to particular women

Correct Answer - D
Ans. is 'd' i.e., Male impotent to particular women
51. Pagophagia involves eating ?
a) Ice

b) Sand

c) Clay

d) Salt

Correct Answer - A
Ans. is 'a' i.e., Ice
Eating
Geophagia
clay
Pagophagia Eating ice
Eating
Plambophagia
lead
Eating
Amylophagia
starch
Eating
Coprophagia
feces
Eating
Cautopyreiophagia burnt
matches
Eating
Tricophagia
hair
Eating
Lithophagia
stones
Eating
Geomelophagia raw
potatoes
52. Doppelganger is-
a) Shadow following person

b) Feeling of double of oneself

c) Indentification of stranger as familiar

d) None of the above

Correct Answer - B
Ans. is `b' i.e., Feeling of double of oneself
Doppelgangers (subjective double) is the delusion that there is
double of oneself. A person feels that double of himself exists
elswhere.
53. What is contraindication for ECT ?
a) Arrthmia

b) Epilepsy

c) HIV

d) Cerebral aneurysm

Correct Answer - D
Ans. is 'd' i.e., Cerebral aneurysm
Contraindications of ECT
Absolute : - Increased intracranial tension.cerebrovascular response
to ECT include marked increased in cerebral blood flow and blood
flow velocity. Cerebral oxygen consumption increases as well. The
rapid increase in systemic blood pressure may transiently
overwhelm cerebral autoregulation and may result in increased in
intracranial pressure. Therefore, the use of ECT is prohibited in
patients with known space occupying lesion (brain tumor) or head
injury, cerebral (intracranial) aneurysm.
Relative : - Recent myocardial infarction, severe hypertension,
cerebrovascular accident, severe pulmonary disease, Retinal
detachment, Pheochromocytoma.
54. A patient is known alcoholic since last 20
yrs, suddenly he develops restless
tremors, agitation. Diagnosis ?
a) Delirium tremens

b) Psychosis

c) Wernicke's encephalopathy

d) Kursakoff's syndrome

Correct Answer - A
Ans. is 'a' i.e., Delirium tremens
 55. Which of the following is delusion ?
a) Othello syndrome

b) Declerambault's syndrome

c) Pyromania

d) None

Correct Answer - A
Ans. is 'a' i.e., Othello syndrome & 'la' i.e., Declerambault's
syndrome
Delusional disorders (Persistent delusional disorders)
Delusional disorder, previously called as paranoid disorder, is a
group of disorders where long standing delusions are the primary or
only manifestation of illness. Persistent delusions must be present
for at least 3 months (ICD-10) or for at least 1 month (DSM - IV).
Depending on the content following type of delusions may occur.
1. Delusions of persecution : - These are the most common type of
delusions. The patient believes that he is conspired against and
harassed or bodily injured, spied or followed or poisoned by other.
Patient believes that he is under the surveillance of police, as his
neighbours have complained against him; or he is watched and the
news in the newspaper refer to him.
2. Somatic (Hypochondrical) delusions : - There are delusions related
to the patients body or its part. This condition is also referred to as
monosymptomatic hypochondrical psychosis (MHP) or
hypochondrical paranoia. Examples are : ?
Body or its part being ugly or misshapen, i.e., nose is deformed —>
Delusional dysmorphophobia.
Infestations by worms or foreign bodies ---> Delusional parsitosis.
Emitting a foul odor —> Delusional halitosis.
3. Delusions of grandeur : - Delusions of inflated self esteem and
self image. The patient may believe that he is an important person
who is able to help other, or may report hearing the voice of God
and the Saints, Confirming their elevated status.
4. Delusions of jealousy (infidelity) : - Content of delusions is
predominantly jealousy (infidelity) involving the spouse --> Othello
syndrome or Conjugal paranoia. Elobrate steps are taken to prevent
the spouse to go outsite (Locks the spouse, not allowing her go
outside), or to catch the spouse red handed (private detectives).
5. Delusion of love (Erotomanic delusion or erotomania) : - More
prevalent among females and there is an erotic conviction that a
person with higher status is in love with patient—) Declerambault's
syndrome.
56. Flooding is a treatment modality used in ?
a) Phobia

b) Depression

c) Mania

d) Schizophrenia

Correct Answer - A
Ans. is 'a' i.e., Phobia
 57. Schizophrenia is more common in which
socio​economic strata ?
a) Middle

b) Upper

c) Low

d) Upper middle

Correct Answer - C
Ans. is 'c' i.e., Low
'Schizophrenia is more prevalent in patients having a lower
socioeconomic status". - Namboodiri
Etiology of Schizophrenia
The exact etiology is not clear. Experts think schizophrenia is
caused by several factors.
1. Heredity (Genetic factors)
Schizophrenia runs in families. The illness occur in 0.5-1% of
general population. However, First degree relative of schizophrenic
patients have a 10 times more lifetime risk of having illness. The risk
is 3-6 times and 2 times more in second and third degree relatives,
respectively
2. Environmental factors
Environmental factors and stress are important in precipitating
schizophrenia in many individuals. These factors are : ?
1. Socioeconomic : - Low socio-economic status, Industrialization;
Immigration; familes with high expressed emotions; Nuclear families;
Schisms & skewed families; and pseudomutul & pseudohostile
families.
2. Drugs : - Drugs causing schizophrenia like state are amphetamine
(most common causative drug), LSD, Phencyclidine, ketamine,
 Mescaline, Cocaine, Cannabis.
3. Metabolic & Neurological disorders : - Schizophrenia like symptoms
may occur in Huntington's chorea (early stage), homocystinuria,
acute intermittent porphyria, Wilson's disease and
hemochromatosis.
3. Biochemical factors
Dopamine hypothesis is the most accepted hypothesis for
schizophrenia. There is hyperactivity of dopaminergic system. This
hypothesis is supported by: 1) Amphetamine and cocaine which
release dopamine in central synapses induce schizophrenia like
symptoms; and 2) Antipsychotic drugs control the schizophrenic
symptoms by blocking dopamine (D,) receptors. However, the
dipamine hypothesis has been questioned also as Homo vanillic
acid (HVA the principal metabolite of dopamine) is not elevated and
prolactin level is not decreased (Dopamine has inihibitory action on
prolactin release).
Other neurotransmitters involved are : - Increased serotonin,
Decreased GABA, variable change (Increased or decreased)
glutamate, and increased norepinephrine.
58. ECT is contraindicated in -
a) Very ill patients

b) Raised ICT

c) Heart disease

d) Pregnancy

Correct Answer - B
Ans. is 'b' i.e., Raised ICT
59. Good prognostic factor for schizophrenia
is ?
a) Blunted affect

b) Early onset

c) Presence of depression

d) Male sex

Correct Answer - C
Ans. is 'c' i.e., Presence of depression
Good prognostic factors :- Acute onset; late onset (onset after 35
years of age); Presence of precipitating stressor; Good premorbid
adjustment; catatonic (best prognosis) & Paranoid (2nd best); short
duration (< 6 months); Married; Positive symptoms; Presence of
depression; family history of mood disorder; first episode; pyknic
(fat) physique; female sex; good treatment compliance & good
response to treatment; good social support; presence of confusion
or perplexity; normal brain CT Scan; outpatient treatment.
 60. Time interval between acute and
persistent psychotic disease is ?
a) 1 week

b) 2 week

c) 3 week

d) 1 months

Correct Answer - D
Ans. is `d' i.e., 1 months
If symtoms are for less than 1 months, it is transient psychotic
disorder and if there are for more than 1 months, it is persistent
psychotic disorder (persistent delusional disorder).
Note:- Diagnosic criteria for delusional disorder (Persistent delusion
disorder) has different durations in DSM IV and ICD-10 :-
1. According to DSM IV, symptoms (Non bizzare delusion) should be
for > 1 months.
2. According to ICD-10, Symptoms should be for > 3 months.
 61. Alpha waves in EEG represent ?
a) Eye closed with active mind

b) Eye open, fully awake and alert

c) Deep sleep

d) None

Correct Answer - A
Ans. is 'a' i.e., Eye closed with active mind
EEG rhythms and sleep wake cycle
Following EEG rhythms (Berger's rhythm) are important in relation to
sleep wake cycle : ?
1. Alpha rhythm : - In adult humans who are awake but at rest with
mind wandering and the eye closed, oc​rhythm is prominent. It is a
regular rhythm with a frequency of 8-13 Hz and amplitude of 50-100
V. It is most marked in parietal and occipital lobe. It is associated
with decreased level of attention, i.e., person is awake but has
decreased attention (relaxed) -> Person is thinking but with
decreased attention (subconscious thinking).
2. Beta rhythm : - When attention is focused on something, the alpha
rhythm is replaced by Beta rhythm. It is an irregular 13-30 Hz low
voltage activity. It is most evident on frontal lobe and occurs when
patient is fully awake and alert. Therefore this replacement of beta
rhythm for alpha rhythm is called arousal or alerting response or
alpha block. This phenomenon can be produced by any form of
sensory stimulation or mental concentration such as solving
arithmetic problems. Person is thinking with a maximum
concentration Conscious thinking.
3. Theta rhythm (4 - 7 Hz) : - When person with alpha rhythm becomes
slightly more relaxed (as occurs when there is transition from
wakefullness to sleep, i.e., stage 1 of REM), alpha rhythm is
replaced by theta rhythm. Thinking is present but with even less
attentiveness than which was present in alpha rhythm stage (Deep
subcsoncious thinking). Two types of theta rhythm have been
described : -
Hippocampal (occurs in mammals other than men, i.e., cat dogs,
etc).
Cortical (occurs in men)
4. Delta rhythm (3-5 Hz) : - It is present when the person is in deep
sleep (NREM stage 3 & 4) and there is no thinking.
62. Poor prognostic factor for Schizophrenia-
a) Presence of depression

b) Female sex

c) Presence of stressor

d) Early onset

Correct Answer - D
Ans. is 'd' i.e., Early onset
Poor prognostic factors :- Insidious onset, early onset (before 20
years of age); absence of precipitating stressor; poor premorbid
adjustment; hebephrenic subtype (worst prognosis), simple,
undifferentiated and chronic catatonic subtype; long duration
(chronic course —> >2 years); single / divorced; Negative
symptoms; absence of depression; family history of schizophrenia;
past history of schizophrenia; asthenic (thin) physique; male sex;
poor treatment compliance & poor response to treatment; poor
social support; flat or blunted affect; ventricular enlargement on brain
CT scan; hospitalization & indoor treatment
 63. Pathognonomic of maniac episode is ?
a) Elevated mood

b) Grandiosity

c) Decreased appetite

d) Increased sleep

Correct Answer - B
Ans. is 'b' i.e., Grandiosity
Option 'a' is confusing one. Yes, elevated mood is one of the most
classical symptom of mania. But it is not pathognomonic.
Pathognomonic means a symptom which can be used for diagnosis.
Elevated mood is not a symptom of diagnostic criteria of mania.
Diagnostic criteria for mania
Three or more of the following for at least 1 week :-
1. Inflated self esteem or grandiosity
2. Decreased need for sleep
3. Overtalkativeness
4. Flight of ideas
5. Distractibility
6. Psychomotor agitation or Increased goal directed activitie
7. Excessive involvement in pleasurable activities
Important symptoms of mania
1. Elevated mood :- Euphoria, elation, exatlation, ectasy, high self
esteem.
2. Thought & speech :- Pressure of speech (Talkativeness), flight of
ideas, delusion of grandeur, delusion of persecution, distractibility.
3. Increased psychomotor activity :- Overactiveness, restlessness,
increased energy.
4. Goal directed activity :- Patient is alert, trying to do many things at
 one time.
5. Psychotic features :- Delusions and hallucination.
6. Other :- Increased sexual drive, aggressive behavior, decreased
need for sleep (insomnia), spending excessive money, increased
appetite, impaired judgement, social & occupational dysfunction,
absent insight.
64. Father of modern psychiatry is ?
a) Bleuler

b) Freud

c) Pinel

d) Kraepel in

Correct Answer - C
Ans. is 'c' i.e., Pinel
Father of psychoanalysis → Sigmund freud
Father of modern psychiatry → Phileppel pinel
65. Classical triad of global confusion, ataxia
and ophthalmoplegia is seen in ?
a) Alzheimer's disease

b) Delerium tremors

c) Wernicke's encephalopathy

d) Korsakoff psychosis

Correct Answer - C
Ans. is 'c' i.e., Wernicke's encephalopathy
66. Borderline personality disorder ?
a) Chronic feeling of emptiness

b) Unstable interpersonal relationship

c) Grandiosity

d) Low self esteem

Correct Answer - B
Ans. is 'b' i.e., Unstable interpersonl relationship
Borderline personality disorder
The central feature of borderline personality disorder is a pervasive
pattern of unstable and intense interpersonal relationship, self
perception and mood.
The patient make recurrent suicidal threats and gesture and a small
proportion of patients carry out the act or self multilation like cutting
or burning.
The patients have difficulty in controlling their anger and impulsitivity.
There is uncertainty about personal identity.
67. Personality associated bipolar disorder -
a) Antisocial

b) Anakastic

c) Borderline

d) Narcissistic

Correct Answer - D
Ans. is 'd' i.e., Narcissistic
Symptoms of Narcissistic personality disorder can be confused with
manic phase of bipolar disorder".
Narcissistic personality disorder
Narcissistic patients are grandiose and require admiration from
other.
This is characterized by Ideas of grandiosity & inflated sense of self
importance; lack of empathy with others; attention seeking behavior;
exploitation of others; and an arrogant, haughty attitude.
68. Bruxism is seen in ?
a) NREM stage 1,2

b) NREM stage 3,4

c) REM

d) Any of the above

Correct Answer - B
Ans. is 'b' i.e., NREM stage 3, 4
Slow wave sleep (stage 3 & 4 of NREM sleep) disorders :- Sleep
walking (somnambulism), night terror (sleep terror or
pavornocturnus), Nocturnal enuresis, Bruxism (teeth grinding), and
sleep talking (somniloquy).
REM sleep events/disorder :- Nightmares, nocturnal penile
tumescence, Narcolepsy.
69. Child wakes up at night sweating and
terrified does not remember the episode-
diagnosis?
a) Narcolepsy

b) Nightmares

c) Night terrors

d) Somnambulism

Correct Answer - C
Ans. is 'c' i.e., Night terrors
Sleep terror or night terrors (pavor nocturnus) : - The patient
suddenly gets up screaming, with autonomic arousal (tachycardia,
sweating). Sleep terrors are rarely remembered in the morning (in
contrast to night mares). No treatment is required only reassurance
is required. However, in severe cases benzodiazepine can be used.
70. Trichotillomania?
a) Irresistable desire to set fire

b) Irresistable desire to steal things

c) Compulsive hair pulling

d) Pathological gambling

Correct Answer - C
Ans. is 'c' i.e., Compulsive hair pulling
71. OCD is associated with which
personality?
a) Anakastic

b) Borderline

c) Narcissistic

d) Histrionic

Correct Answer - A
Ans. is 'a' i.e., Anankastic
Obsessive-Compulsive (anankastic) personality disorder : - People
with obsessive-compulsive personality disorder are markedly
preoccupied with orderliness, perfectionism, and control. They lack
flexibility or openness. Their preoccupations interfere with their
efficiency despite their focus on tasks. They are often stingy as well
as stuborn.
 72. Neurotransmitter in mania -
a) Increased dopaine

b) Decreased dopamine

c) Increased norepinephrine

d) Decreased norepinephrine

Correct Answer - C
Ans. is 'c' i.e., Increased norepinephrine
Neurotransmitters in mood disorders
Most accepted biochemical hypothesis for mood disorders is the
monoamine hypothesis, according to which serotinin and
norepinephrine are the major neurotransmitters involved in mood
disorders : -
1. Depression --> Decrease in serotonin and norepinephrine. Serotonin
is the most important neurotransmitter in depression.
2. Mania --> Increased level of norepinephrine
Patients suffering from severe depression with suicidal
intent/attempt appear to have a marked decrease in serotinin.
Acetylcholine and GABA are the other neurotransmitters which are
involved in mood disorders.
73. Schizophrenia results with ?
a) Increased GABA

b) Decreased norepinephrine

c) Increased dopaminergic activity

d) Decreased dopaminergic activity

Correct Answer - C
Ans. is 'c' i.e., Increased dopaminergic activity
Dopamine hypothesis is the most accepted hypothesis for
schizophrenia. There is hyperactivity of dopaminergic system. This
hypothesis is supported by: 1) Amphetamine and cocaine which
release dopamine in central synapses induce schizophrenia like
symptoms; and 2) Antipsychotic drugs control the schizophrenic
symptoms by blocking dopamine (D,) receptors. However, the
dipamine hypothesis has been questioned also as Homo vanillic
acid (HVA the principal metabolite of dopamine) is not elevated and
prolactin level is not decreased (Dopamine has inhibitory action on
prolactin release).
Other neurotransmitters involved are : - Increased serotonin,
Decreased GABA, variable change (Increased or decreased)
glutamate, and increased norepinephrine.
 74. Capgras syndrome is ?
a) Sharing of delusion

b) Delusion of double

c) Erotomania

d) Hypochondriacal delusions

Correct Answer - B
Ans. is 'B' i.e., Delusion of double
Capgras syndrome is a delusion of double.
The delusional misidentification syndrome (DSM)
DSM is characterized by misidentification delusions of others or self.
Four main syndromes are differentiated : ?
1. Capgras syndrome (Delusion of double):- Patient falsely sees a
familiar person as a complete stranger who is imposing on him as a
familiar person.
2. Fregoli syndrome (illusion de fregola): - The patient falsely identifies
stranger as a familiar person.
3. Syndrome of subjective double: - The patient's own self is perceived
as being replaced by a double.
4. Syndrome of intermetamorphosis: - A false belief that a person can
transform into another person.
These syndromes most commonly appear in schizophrenia. Other
causes are Alzheimer syndrome, head injuries, and delusional
disorders.
75. Drug used for cocaine withdrawal
symptoms is-
a) Floxetine

b) Lorazepam

c) Phenobarbital

d) No drug

Correct Answer - D
Ans. is 'd' i.e., No drug
"Tolerance develops swiftly but there are no withdrawal symptoms.
Treament, if needed, is symptomatic. Often no medicines are
needed and the user can stop its use by himself when he is coerced
to do so by the court or the employer" - Namboodiri
"No pharmacological agents reliably reduce the intensity of
withdrawal, but recovery over a weak or two is generally
uneventful" - Kaplan & Saddock
 76. In stupor catatonia, all are seen except -
a) Agitation

b) Catalepsy

c) Mutism

d) Akinesia

Correct Answer - A
Ans. is 'a' i.e., Agitation
Agitation is seen in excited catatonia (not is stupor catatonia).
Features of catatonic schizophrenia may be :?
1. Excited catatonia :- It is characterized by increased in psychomotor
activity, i.e. restlessness, agitation, excitement, aggressiveness,
violence. The impulsive activity occurs in response to hallucination
and delusions.
2. Stuporous (retarted catatonia) :- It is characterized by extreme
retardation of psychomotor activity. It includes mutism, rigidity,
negativism, posturing, stupor, echolalia, echoproxia, catalepsy (waxy
flexibility), ambitendency, gegenhalten, stereotypies, stupor,
mannerism, Grimicing, automatic obedience.
77. Psychosurgery is used in ?
a) Phobia

b) Generalized anxiety

c) OCD

d) Depression

Correct Answer - C
Ans. is 'c' i.e., OCD
78. Role of marijuana in AIDS related
cachexia?
a) Euphoric

b) Pschostimulator

c) Increases appetite

d) Decrease emetic feeling

Correct Answer - C
Ans. is 'c' i.e., Increases appetite
Mari-juana or cannabis sativa contains the active principle
tetrahydrocannabinol (THC), which as an appetite stimulant effect.
 79. All are used in treatment of nocturnal
eneuresis except ?
a) Imipramine

b) Alarm setup

c) Voiding of urine before sleeping

d) Maintainence of calendar of day night wetting

Correct Answer - D
Ans. is 'd i.e Maintainence of calendar of day night wetting
All are used.
Treatment of nocturnal eneuresis
It consists of :?
1. Appropriate toilet training and restricting fluid at night. Encouraging
the child to empty their bladder before bed.
2. Alarm therapy
3. Behavioral therapy using "bell and pad apparatus"
4. Motivational therapy
5. If non-pharmacological treatment fails -4 Imipramine is the drug of
choice. Other drugs used are oxybutynin and desmopressin.
Record keeping is helpful in determining a baseline and following the
child's progress and may itself be a reinforcer. A star chart may be
particularly helpful.
 80. Repressed information can be brought
into conscious mind by all except ?
a) Dream

b) Focused attention

c) Hypnosis

d) Somatic stimulation

Correct Answer - B
Ans. is 'b' i.e., Focused attention
Preconcious thoughts are readily accessible to conciousness by
focused attention, but not unconscious thoughts which contains
repressed memory.
Freud advanced the 'topographic theory of mind' in the year 1900 in
the book 'the interpretation of dreams'. It divides the mind into three
divisions :?
1. Unconscious : - A traumatic event which had occured during
childhood are "repressed" (forced down) into deeper layer of
unconsciouness where they lie dormant without producing any
symptoms.
2. Preconscious : - This is the region of mind between the unconscious
and the conscious, with access to both. The unconscious mental
contents can reach the conscious only through the preconscious.
So, It acts as a sensor of conscious to mentain repressive barrier for
unconscious mental contents.
3. Conscious : It refers to attention concerned with registration of
stimuli from both with and without.
Focused attention can bring preconcious thoughts to consciousness.
But repressed memory is in unconscious.
Methods used to recover repressed thoughts are :-
1. Hypnosis
2. Dream interpretation
3. Automatic writing
4. Somatic stimulation
5. EMDR (eye movement desensitization and reprocessing)
 81. All of the following are used to improve
attention deficit in children except ?
a) Cognitive enhancement therapy

b) Cognitive behavioural therapy

c) Cognitive remeditation therapy

d) Flooding

Correct Answer - D
Ans. is 'd. i.e., Flooding
In attention deficit following can be used :
1. Cognitive enhancement therapy (also called cognitive remediation
therapy)
2. Cognitive behavioral therapy
3. Clinical behavior therapy
4. Direct contingency management
5. Intensive, packaged behavioral treatment
82. Indications for ECT are all except ?
a) Severe depression with suicidal risk

b) Catatonic schizophrenia

c) Severe psychosis

d) Sever manic attack

Correct Answer - D
Ans. is 'd' i.e., Sever manic attack
Indications of ECT
Severe depression with suicial risk or with psychotic features or with
stupor.
Some types of schizophrenia (catatonic or paranoid)
Schizophrenic or depressive stupor
Severe catatonia with stupor
Severe psychoses (schizophrenia or mania) with risk of suicide or
homicide or physical assault.
 83. Concrete thinking stage of cognitive
development?
a) 0-2 years

b) 2-5 years

c) 5-10 years

d) 10-15 years

Correct Answer - C
Ans. is 'c' i.e., 5-10 years
Cognitive development stages
Children are not little adults. Until they reach the age of 15 or so they
are not capable of reasoning as an adult. Jean Piget described four
major stages of intellectual (cognitive) development which are
related to major development in brain growth.
1. Sensori-motor stage (birth 2 years)
2. Pre-operational stage (2-7 years)
3. Concrete operational stage (7-11 years)
4. Formal operational stage (>11 years)
 84. Delusions are features of all except ?
a) Delirium

b) Schizophrenic

c) OCD

d) Alcohol withdrawal

Correct Answer - C
Ans. is 'c' i.e., OCD
Delusions are seen in psychotic disorders
Organic
1. Delirium (Acute confusional state)
2. Substance :- Abuse (alcohol, amphetamines) and withdrawal
(alcohol).
Non organic
1. Schizophrenia
2. Affect/mood disorders (Mania & depression)
3. Other non-organic psychosis :- Delusional disorders, Schizoaffective
disorders.
Delusions are not seen in neurotic disorders -, Anxiety disorders
obsessive-compulsive disorders, Dissociative (conversion)
disorders, Somatoform disorders, Stress-related disorders
85. Psychoanalysis was started by ?
a) Eugen Bleuler

b) Sigmund Freud

c) Bleuler

d) Erikson

Correct Answer - B
Ans. is 'b' i.e., Sigmund freud

Name Contribution
Psychoanalysis, free association, (oedipus & electra
Sigmund complex), cocaine in psychiatry,
Freud Repression, ego-defence
mechanisms, psychodynamic theory.
Phillippe
Moral and humane treatment of mentally ill
Pinel
Jones
Propagated therapeutic community concept.
Maxwell
Kuble
Classified five stages of death.
Ross Erik
Erikson Divided life cycle in 8 stages
 86. Hallucinations, true is ?
a) Perceived in the inner subjective space

b) There is misinterpretation of external stimulus

c) There is no external stimulus

d) Can be controlled by voluntary effort

Correct Answer - C
Ans. is 'c' i.e., There is no external stimulus
Characteristics of Hallucinations :?
1. Absence of corresponding external perceptual stimuli.
2. Vividness, force and reality value of a normal perception.
3. The experience occurs spontaneously
4. It cannot be produced or terminated at will by subject (not in
conscious or voluntary control).
5. Perceived as being in external objective space.
6. Have relative permancy (i.e. remain constant and unchanged).
7. Hallucinations are usually experienced alongside and
simultaneously with normal perception.
 87. Cotard's syndrome has ?
a) Persecutory delusions

b) Religious delusions

c) Nihilistic delusions

d) Hypochondrical delusions

Correct Answer - C
Ans. is 'c' i.e., Nihilistic delusions
Types of delsions
Based on the contents of delusions, they are divided into :-
1. Persecutory delusions (paranoid) : - The patient feels that he is
being persecuted against. There is false belief that one is being
harmed, threatened, cheated, poisoned, harassed or spied on or is a
victim of conspiracy to damage his reputation. The supposed
persecutor of the patient may be people in the environment (e.g.,
members of family, neighbours, former friend) or may be political or
religious groups. These delusions occur in schizophrenia (especially
paranoid), severe affective disorders (sever mania or severe
depression), and organic brain syndrome. This is the most common
type of delusion. Delusion of persecution may occur in the context of
primary delusional experiences, auditory hallucinations, bodily
hallucinations or experiences of passivity.
2. Grandiose delusion (expansive delusions) : - False belief that one is
exceptionally powerful, talented or important. These delusions seen
most commonly in mania, However, can also occur in schizophrenia
and organic states.
3. Delusions of reference : - False belief that certain objects, people or
events have intense personal significance and refer specifically to
one self, e.g., believing that a television news reader is talking
 directly about oneself, or people walking on the road are talking
about him. These delusions are seen in schizophrenia, mania and
organic states.
4. Religious delusions : - False belief pertaining to a religious theme,
often grandiose in nature, e.g., believing that one is a special
messenger from God. These delusions are seen in schizophrenia.
5. Delusions of love (erotomania) : - False belief that another person is
in love with one (commoner in woman). In one form, termed de
clerambault sydrome, a woman (usually) believes that a man,
frequently older and of higher status, is in love with her.
6. Delusion of infidility (morbid jealousy, othello syndrome :- False
belief that one's lover has been unfaithful. These are seen in
schizophrenia, alcohol related psychosis, organic states.
7. Delusion of misidentification : - a) Capgras syndrome (Delusion of
double) : - Belief that a familiar person has been replaced by an
exact double i.e. an impostor. b) Fregoli syndrome : - Belief that a
complete stranger is actually a familiar person already known to one.
8. Delusion of self accusation or guilt : - False feeling of remorse of
guilt. It occur in Depression.
9. Nihilistic delusions : - False belief that oneself, others or the world is
non-existent or about to end. There are pessimistic ideas that the
patient's career is finished, he is about to die, world is doomed.
These occurs in severe depression. If nihilistic delusions are
accompanied by ideas concerning bodily function failure, e.g.,
putrefaction of intestines, etc., the syndrome is called COTARD's
SYNDROME.
10. Hypochondriacal delusions : - False belief about one's health,
patient wrongly believes that he has severe medical illness, contrary
to the all medical evidences. It is seen in depression.
11. Delusion of infestations : - False belief that one is infested with small
but visible organisms. As a monosymptomatic delusional disorder
this is called EKBOM SYNDROME. It is seen in acute confusional
state (due to drugs or alcohol withdrawal), in schizophrenia, in
dementing illness, and as delusional eloboration of tactile
hallucinatory experiences (secondary to formication).
12. Delusion of control : - Belief that his actions, impulses or thoughts
are controlled by an outside agency and accordingly called as made
 action, made impulse or made affect. Also called somatic passivity
experiences (passivity phenomenon). Commonly seen in
schizophrenia.
13. Delusions concerning possession of thoughts - Patients with
delusions about possession of thoughts may lose the conviction that
their thoughts are their own. Most commonly seen in schizophrenia.
Delusions of thought insertion - thoughts have been implanted by an
outside agency.
Delusions of thought withdrawal - thoughts are being taken out of
their mind. This is usually accompanied by "thought block".
Delusions of thought broadcast - unspoken thoughts are known to
other people through radio, telepathy or in some other way.
88. Oedipus complex is related to which
phase of psychosexual development ?
a) Oral

b) Anal

c) Genital

d) Phallic

Correct Answer - D
Ans. is `d' i.e., Phallic
89. Most effective treatment in borderline
personality disorders?
a) Pharmacotherapy

b) Behaviour therapy

c) Combination of both pharmacotherapy and behavioural therapy

d) None

Correct Answer - B
Ans. is 'b' i.e., Behaviour therapy
"Dialectical behavioral therapy (DBT), a type of cognitive behavioral
therapy (CBT), has been developed specifically for the treatment of
borderline personality disorder, and it appear to be the most
effective treatment for this condition".
90. All are reversible causes of dementia
except
a) Hypothyroidism

b) Hydrocephalus

c) Meningoencephalitis

d) Alzheimer's disease

Correct Answer - D
Ans. 'D' i.e., Alzheimer's disease
Reversible causes of dementia
1) Surgically treatable:- Normal pressure hydrocephalus, brain
tumors (frontal lobe tumor), meningioma, subdural hematoma due to
head injury, hydrocephalus.
2) Medically treatable:- Depression, hypothyroidism, alcohol
abuse, vitamin B 12/folate/Niacin deficiency, any metabolic or
endocrine disturbance, neurosyphilis, Hashimoto's encephalopathy,
Wilson's disease, celiac disease, Whipple's disease, chronic
meningoencephalitis, drugs and toxin (toxic dementia).
Irreversible causes of dementia:-
Alzheimer's disease, vascular (multi-infarct) dementia,
Parkinsonism, Huntington's chorea, Lewy body dementia, Pick's
disease.
91. Visual hallucinations are seen in all
except ?
a) Delirium

b) Depression

c) Schizophrenia

d) Alcohol withdrawal

Correct Answer - B
Ans. is 'b' i.e., Depression
Type of
Causes
hallucination
Schizophrenia, Organic brain syndrome, Alcoholic
Auditory hallucinosis manic-depressive illness, Brain
lesions →Pontine or temporal lobe lesions.
Organic brain disturbances : - Delirium, delirium
tremens, occipital lobe tumors, epilepsy, dementia
Intoxication (LSD, amphetamines, Alcohol,
mescaline), alcohol withdrawal.
Brain lesions
Visual
1. Unformed visual hallucinations :- Disorders of
occipital lobe or ocular diseases.
2. Formed visual hallucinations :- Disorders of
temporal lobe, upper brain stein or thalamus
Schizophrenia
Temporal lobe diseases (e.g., complex partial
lfactory & seizure).
gustatory Olfactory hallucination may also occur in depression
& schizophrenia
Tactile Schizophreni
Formication :- Cocaine, alcohol withdrawal
Note : Epilepsy and cerebral disorders can cause hallucinations of
all modalities depending on the site of lesions.
92. Waxy flexibility is a feature of ?
a) Echopraxia

b) Catatonia

c) Stereotype

d) Mannerism

Correct Answer - B
Ans. 'B' i.e., Catatonia
Catatonia may be of following types:-
Catatonic excitement:- Excited, uncontrolled motor activity, not
influenced by external stimuli.
Catatonic posturing:- Voluntary adoption of an unusual or bizarre
position that is then maintained for some time.
Catatonic rigidity:- Maintaining a fixed position and rigidity resisting
all attempts to be moved.
Waxy flexibility (flexibility cerea or catalepsy): - Maintaining of
particular posture imposed on the patient by the examiner, even if
the posture is bizarre and uncomfortable, i.e., the patient can be
molded like wax into a position that is then maintained.
Catatonic stupor:- Patient is mute and immobile (akinetic mutism)
but fully conscious.
Catatonic negativism .- A seemingly motiveless resistance to all
instructions or attempts to be moved.
Automatic obedience:- Exactly reverse to negativism, i.e.,
unhesitating compliance to all instructions without apparent
conscious control.
93. Term Psychiatry was coined by ?
a) Moral

b) Johann reil

c) Bleuler

d) Pinel

Correct Answer - B
Ans. is 'b' i.e., Johann reil
IMPORTANT CONTRIBUTORS IN PSYCHIATRY
Term Coined by
Moral
Emil
Kraepelin
Demence precoce Kahlbaum
Dementia precox Hecker
Catatonia, cyclotymia Eugen
Hebephrenia Bleuler
Schizophrenia Eugen
Ambivalence Bleuler
Free association Sigmund
Psychoanalysis, Freud
Psychodynamics Sigmunnd
Id, ego, Superego Freud
Psychiatry Sigmund
Freud
Johann
christion Reil
 94. All are features of Korsakoff syndrome
except
a) Antegrade amnesia

b) Retrograde amnesia

c) Ataxia

d) Confabulation

Correct Answer - C
Ans. 'C' i.e., Ataxia
Korsakoff syndrome
Korsakoff's syndrome is the chronic amnestic syndrome that follows
Wernicke's encephalopathy, and the two syndromes are believed to
be pathophysiologically related. Korsakoff's syndrome is
characterized by severe and irreversible memory impairments and
confabulation behaviour in the absence of intellectual decline or
attention deficit. Important clinical features are:?
1. Memory:- The Korsakoff syndrome is characterized by both
antegrade (i.e., learning) and retrograde (i.e., a memory of past
events) amnesia. Antegrade amnesia is severe with a lack of insight.
Retrograde amnesia is not as severe. New learning and recent
memory are impaired but remote memory is relatively preserved.
Although remote memory is relatively preserved, the patient is
unable to organize them in a temporal context and distort the
relationship between facts and fill the remote memory gaps by
confabulation. There is a profound deficit of explicit (conscious or
declarative) type of long term memory, with little impairment of
implicit (unconscious or non-declarative) type of long term memory.
2. Personality:- Passive and malleable such that they display a lack of
initiatives, interest, or concern and diminished spontaneity.
3. Other:- Perseveration, lack of motivation (amotivational syndrome),
apathy, passivity.
4. General intelligence, language, and motor & perceptual skills are not
impaired.
95. Diagnostic criteria for drug dependence
includes all except -
a) Tolerance

b) Withdrawal symptoms

c) Early completion of tasks

d) Larger dose than usual

Correct Answer - A
Ans. is 'c' i.e., Early completion of tasks
Diagnostic criteria for substance abuse
To make a diagnosis of dependence, three or more of the following
criteria should be present.
Tolerance :- Same dose produces markedly diminished effect on
continuous use, therefore increased doses are required to produce
same effect.
Withdrawal symptoms on abstinence.
Substance is taken in larger amount or longer period than was
intended.
Persistent desire (craving) or sense of compulsion to take the
substance.
A great deal of time spent to obtain the substance, to use substance
or to recover from its effect.
Neglect of important social, occupational and recreational activities.
Continued substance use despite clear evidence of overtly harmful
consequences
 96. Suspiciousness is a characteristic feature
of ?
a) Paranoid personality disorder

b) Schizoid personality disorder

c) Schizotypal personality disorder

d) Anankastic personality disorder

Correct Answer - A
Ans. is 'a' i.e., Paranoid personality disorder
Paranoid personality disorder
It is characterized by generalised mistrust and Suspiciousness about
the motives and actions of others and a tendency to interpret them
as malevolent. The patient believes that :-
1. Others are exploiting or deceiving the person.
2. Friends are untrustworthy and not loyal.
3. The spouse/partner is unfaithful.
4. There is hidden meaning in neutral or friendly remarks.
5. Many patients have feeling of self-importance and think they are
unusually talented
97. Earliest symptom showing improvement
from classical triad of Wernicke's
incephalopathv. to thiamine therapy ?
a) Ataxia

b) Ophthalmoplegia

c) Confusion

d) All are equally responsive

Correct Answer - B
Ans. is 'b' i.e., Ophthalmoplegia
Response to thiamine treatment in Wernicke's encephalopathy
Ocular symptoms :- Earliest to respond, ophthalmoplegia (ocular
palsies) improves within hours of thiamine administration. However,
horizontal nystagmus may persist.
Ataxia :- Ataxia responds more slowly than ocular palsies and half
the patients recover incompletely with a residual ataxia.
Encephalopathy :- Confusion and other CNS symptoms improve
more slowly. As the symptoms of encephalopathy improve,
Korsakoff's syndrome may become apparent in some patients
 98. All are symptoms of morphine withdrawal
except?
a) Mydriasis

b) Yawning

c) Lacrimation

d) Fall in BP

Correct Answer - D
Ans. is 'd' i.e., Fall in BP
Morphine withdrawal
Manifestations of morphine withdrawl
1. Lacrimation
2. Anxiety & fear
3. Mydriasis
4. Diarrhea
5. Palpitation
6. Sweating
7. Restlessness
8. Insomnia
9. Dehydration
10. Rapid weight loss
11. Yawning
12. Gooseflash (Piloerection)
13. Abdominal colic
14. Rise in BP
Delirium and convulsions are not a characteristic features (contrast
barbiturates) and are seen only occasionally.
Treatment consists of withdrawl of morphine and substitution with
oral methadone followed by gradual withdrawl of methodone.
Recently the NMDA antagonists and nitric oxide synthatase
inhibitors have been
 99. All are required to diagnose major
depression except ?
a) Depressed mood

b) Isomnia

c) Nihlistic ideas

d) Decreased concentration

Correct Answer - C
Ans. is 'c' i.e., Nihlistic ideas
Diagnostic criteria for major depression
5 or more of following symptoms should be present most of the day
for at least 2 weeks: ?
1. Depressed mood
2. Loss of interest or pleasure in all activities.
3. Decrease/increase appetite or loss/gain of weight.
4. Insomnia or hypersomnia (Increased or decreased sleep).
5. Psychomotor retardation or agitation (decreased or increased
psychomotor activity).
6. Fatigue or loss of energy (weakness or lethargy).
7. Feelings of worthlessness or excessive guilt.
8. Diminished concentration
9. Recurrent thoughts of death or recurrent suicidal ideation or suicidal
attempt.
At least one of symptoms should be either :?
1. Depressed mood or 2) Loss of interest or pleasure —) These two (1
& 2) are essential criteria. Therefore 1 essential criterian and 4 other
criteria (total 5) should be persent.
 100. All are features of psychosis except ?
a) Loss of insight

b) Presence of delusions

c) Preserved contact with reality

d) Personality disturbances

Correct Answer - C
Ans. is 'c' i.e., Preserved contact with reality
Psychosis
Psychosis is a mental state involving the loss of contact with reality,
causing deterioration of normal social functioning. The characteristic
features of psychosis are : -
1. Gross impairment in reality testing, i.e., loss of contact with reality.
2. Marked disturbance in personality and behavior with impairment in
social, interpersonal and occupational functioning.
3. Marked impairment in judgement.
4. Loss of insight (insight is an assessment of how aware the patient is
of their own mental illness).
5. Presence of characteristic symptoms like delusions and
hallucinations, these are called psychotic symptoms.
The major psychosis are : ?
1. Organic psychotic disorders, e.g., Delirium, substance related
psychosis, head trauma.
2. Non-organic psychoses
3. Major psychoses : - Schizophrenia, mood disorders (depression,
mania, bipolar).
4. Other psychotic disorders ( third psychosis): - Delusional disorders,
acute and transient psychotic dis​orders, schizoaffective disorder
Neurosis
 Neurosis is a general term referring to mental distress that, unlike
psychosis, does not prevent rational thought and daily functioning.
Characteristic features are : -
1. Symptoms cause subjective distress to the patient.
2. Insight is present (symptoms are recognised as undesirable).
3. The personality and behaviour are relatively preserved as is the
judgement.
4. The contact with reality is preserved.
5. Absence of organic causative factor
Important neurotic disorders are Anxiety disorders (Panic), Phobia
(Phobic anxiety disorder), obsessive compulsive disorder,
Dissociative conversion disorder.
 101. Ganser syndrome is a feature of ?
a) OCD

b) Conversion disorder

c) Dissociative disorder

d) Schizoid personality disorder

Correct Answer - C
Ans. is 'c' i.e., Dissociative disorder
Dissociative disorder
The essential feature of the dissociative disorder is a disruption in
the usually integrated functions of consciousness, memory, identity
or perception of the environment. Dissociative disorder are :-
1. Dissociative (psychogenic) amnesia :- It is the most common type of
dissociative disorder. Dissociative amnesia is characterized by
retrograde amnesia (inability to retrieve stored memories and events
leading up to onset of amnesia) and absence of antegrade amnesia
(inability to form new long term memories).
2. Dissociative fugue :- A dissociative fugue may be present when a
person impulsively wanders or travels away from home and upon
arrival in the new location is unable to remember his/her past (i.e.,
amnesia for early life). There is loss of personal identity and the
person assumes a new identity. There is absence of awareness of
amnesia during fugue episode, i.e., Patient denies any memory loss
during fugue state. On recovery there is amnesia for fugue episodes
and recovery of memory of earlier life (i.e., before the episode of
fugue).
3. Dissociative identity disorder (multiple personality disorder) :- More
than one personality appears to possess the individuals, Showing
their characteristic behavior. At any instance behavior and memories
 of one personality is exhibited, patient then is unaware of the other's
existance.
4. Depersonalization disorder : - Feeling of detachment from self is
referred to as depersonalization. Individuals with this disorder will
report feeling as if they are living in a dream or watching themselves
on movie screen i.e., feeling detached from self and as if one is an
outside observer of oneself. People with this disorder feel like they
are "going crazy" and they frequently become anxious and
depressed
5. Dissociative disorders not otherwise specified :- These are the
disorders that are characterized by dissociative response that do not
meet diagnostic criteria for one of the other dissociative disorder.
Important ones are :-
Dissociative Trance (Possession) disorders :- There is temporary
exchange of person's personality by a new personality usually
attributed to a spirit or divine power. Usually the person is aware of
the existance of the other, i.e., possessor (unlike dissociative identity
disorder).
Ganser's syndrome : - Also known as syndrome of approximate
answers. This is characterized by giving approximate answers
together with a clouding of consciousness, and frequently
accompanied by hallucinations and other dissociative, somatoform
or conversion symptoms.
 102. Repetitive irresesistable thought to do
something
a) Phobia

b) Obsession

c) Compulsion

d) Anxiety

Correct Answer - B
Ans. is 'b' i.e., Obsession
Obsessive compulsive disorder (OCD)
OCD is an anxiety disorder which is characterized by recurrent,
unwanted thoughts (Obsessions) and repettive behaviors
(compulsions).
An obsession has following characteristic : -
1. An idea, impulse or image which intrudes into the conscious
awareness repeatedly.
2. It is recognized as one's own ideas, impulse or image but is
perceived as egoalien (foreign to one's personality).
3. It is recognized as irrational and absurd (insight is present --4
Patient knows about disorder).
4. Patient tries to resist against it but is unable to do so which leads to
marked distress or anxiety.
A compulsion has following characteristics :-
1. It is repetitive, purposeful form of behavior is carried out because of
strong feeling of compulsion to do so.
2. It usually follows an obsession.
3. ts goal is to prevent or reduce the anxiety or stress caused by
obsession however it do not always succeed in doing so.
4. It is irrational or excessive and not realistic.
5. Insight is present.
A patient with OCD may have an obsession, a compulsion or both
(mostly patients have both).
A patient with OCD realizes the irrationality of the obsession and
experiences both the obsession and the compulsion as ego-dystonic
(unwanted behavior).
The person is preoccupied with details rules, list order, organisation
or schedules to the extent that the major point of activity is lost.
The person shows perfectionism that interfers with task completion
(e.g., unable to complete project because his own overtly strict
standard are not met).
103. All are features of neurosis except ?
a) Symptoms cause subjective distress

b) Contact with reality preserved

c) Personality disturbances

d) Insight is maintained

Correct Answer - C
Ans. is 'c' i.e., Personality disturbances
104. All are seen in nicotine withdrawal
except ?
a) Hyperhydrosis

b) Anxiety

c) Bradycardia

d) Insomnia

Correct Answer - A
Ans. is 'a' i.e., Hyperhydrosis
 105. All are included in diagnostic criteria of
somatization disorder except ?
a) Sexual symptom

b) Pain symptom

c) GI symptom

d) Visual symptoms

Correct Answer - D
Ans. is 'd' i.e., Visual symptoms
Somatization disorder
The essential features of somatization disorder are multiple
recurrent somatic symptoms of long duration (chronic) that are
caused by psychological basis and no physical illness can be found.
The disorder begins before the age of 30 years and then has a
chronic course (over a period of several years). Diagnostic criteria
for somatization disorder
Each of the following should be present : ?
1. Four pain symptoms :- Pain, at least at four different sites or
functions –9 Head (headache), abdomen, back, joint, extremites,
chest, rectum, during mensturation or sexual intercourse or
urination.
2. Two gastrointestinal symptoms :- Nausea, bloating, vomiting,
diarrhea.
3. One sexual symptom :- Erectile dysfunction (Impotence), ejaculatory
dysfunction, irregular menses, excessive menstural bleeding.
4. One pseudoneurological symptom :- Conversion symptoms
(impaired coordination or balance, paralysis, weakness, blindness,
deafness, glove & stocking anesthesia, Paresthesia, seizure,
aphonia); Dissociative symptoms (amnesia); loss of consciousness.
 106. Bleuler's symptoms for schizophrenia
are all except?
a) Loosening of association

b) Affect disturbances

c) Autism

d) Hallucinations

Correct Answer - D
Ans. is 'd' i.e., Hallucinations
Eugen Bleuler renamed dementia precox as Schizophrenia. He
recognized that schizophrenia is a group of disorders rather than a
distinct entity. Therefore, he used the term, a group of
schizophrenias.
Bleuler described the characteristic symptoms (fundamental
symptoms) for schizophrenia which are also known as 4 'A's of
Bleuler :?
1. Ambivalence (coexistence of two opposite feelings and attitude
towards the same thing in the same person at the same time).
2. Autism (Preoccupation with fantasies, delusions and hallucinations
to the exclusion of reality).
3. Affect disturbances (e.g., inappropriate affect)
4. Association disturbances (e.g., Loosening of association, thought
disorder).
He also described accessary syptoms of schizophrenia : - delusions,
hallucinations, and negativism.
 107. Negative symptom of schizophrenia ?
a) Hallucination

b) Delusion

c) Ambivalance

d) Motor hyperactivity

Correct Answer - C
Ans. is 'c' i.e., Ambivalance
Symptoms of schizophrenia can be divided into :?
1. Positive symptoms :- Positive symptoms are psychotic symptoms
not seen in normal individuals but are "actively expressed" in patient,
i.e., hallucinations, delusions and bizarre motor acts. Positive
symptoms are more common in acute schizophrenia. These respond
well to typical antipsychotics.
2. Negative symptoms :- Negative symptoms are normally expected
behaviours, emotions (feeling), thoughts and drives that the person
with schizophrenia fail to exhibit, i.e., deficit state (diminution or loss)
of normal function. The prominent negative symptons are flattening
or blunting of affect, anhedonia, ambivalence (avolition) asociality
(social withdrawal), alogia, apathy, paucity of thought and poverity of
speech. Negative symptoms are more common in chronic
schizophrenia. Negative symptoms do not respond well to typical
antipsychotics Therefore patient on typical antipsychotics may show
improvement of positive symptoms and persistent of negative
symptoms.
More recently a third category has been proposed.
3.Disorganized symptoms :- Disorganized speech/thinking, and
disorganized behavior.
 108. Cyclothymia is a type of ?
a) Bipolar mood disorder

b) Major depression

c) Dysthymia

d) Persistant mood disorder

Correct Answer - D
Ans. is 'd' i.e., Persistant mood disorder
Persistent mood disorder
Mood disorders may run a chronic course over years with fluctuation
of mood interposed with symptom free intervals. If symptoms persist
for more than 2 years, they are referred to as persistent mood
disorders. Two most important persistant mood disorders are :?
1. Cyclothymia :- It is a subdued version of bipolar disorder,
characterized by episodes of depression and hypomania that neve,.
have sufficient intensity to meet full diagnostic criteria for bipolar
disorder.
2. Dysthemia :- Long standing (persistent, i.e., 2 years) mild
depression which is not severe enough to meet full diagnostic
criteria for major depression. Symptoms are more prominent than
signs (more subjective than objective depression). This means that
disturbances in appetite and libido are uncharacteristic, and
psychomotor agitation or retardation is not observed.
 109. All are anxiety disorders except ?
a) Phobias

b) OCD

c) Conversion reaction

d) PTSD

Correct Answer - C
Ans. is 'c' i.e., Conversion reaction
Anxiety disorders are :-
1. Panic disorder with or without agoraphobia
2. Agoraphobia with or without panic disorder
3. Specific phobia
4. Social phobia
5. Obsessive - compulsive disorder
6. Post traumatic stress disorder
7. Generalized anxiety disorder
 110. All are diagnostic symptoms of
schizophrenia except?
a) Catatonia

b) Hallucinations

c) Disorganized speech

d) Social withdrawal

Correct Answer - D
Ans. is 'd' i.e., Social withdrawal
Diagnostic criteria for schizophrenia
Characteristic symptoms :- Two (or more) of the following for a 1
months duration (or less if successfully treated) :?
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms, i.e., affective flattening, alogia.
Note :- Only one of the above is required if delusions are bizarre or
there are third person hallucinations (running commentary or two
voices arguing or conversing).
Social/occupational dysfunction
Duration :- Continuous signs of disturbance persist for at least 6
months. This 6 months period must include at least 1 month of
symptoms that meet criteria A.
Exclusion of mood disorder and schizoaffective diorder.
Exclusion of substance abuse/general medical condition.
111. All are true about type 1 schizophrenia
except?
a) Acute illness

b) Good prognosis

c) Negative symptoms

d) Intellect maintained

Correct Answer - C
Ans. is 'c' i.e., Negative symptoms
Type I (Reactive or acute Type II (Process

schizophrenia) schizophrenia)
Negative symptoms
(Affect flattening,
Characteristic
Positive symptoms poverity of
symptoms
(Hallucination,Acute speech loss of drive
Type of illness
Delusion, Thought) Chronic
Response to
Good Poor
neuroleptics
Reversible Long standing
Outcome
Absent Sometimes present
Intellectual
Dopamine overactivity Structural changes in
impairment
Good brain (dilated
Etiology
ventricle on CT scan
Poor
112. Drug of choice for generalized anxiety ?
a) 3-blocker

b) Alprazolam

c) Buspirone

d) Phenytoin

Correct Answer - B
Ans. is 'b' i.e., Alprazolam
Treatment of generalized anxiety
Benzodiazepines are the drug of choice. Drugs in this group are
diazepam, Lorazepam, Alprazolam, Oxazepam, chlordiazepoxide.
Other drugs used are buspirone; TCA (amptriptyline, imipramine,
clomipramine, desipramine); SSRIs (Fluoxetine, Sertaline,
Paroxetine, Citalopram); SNRIs (Venalafaxine), 13-blockers.
Anticonvulsants with GABAergic properties may also be effective
against anxiety, e.g., Gabapentin, Oxcarbazepine, Tiagabine,
pregabalin, and Valproate (divalporex).
113. Persistent preoccupation with serious
illness and normal body function is
called ?
a) Obsession

b) Somatization

c) Hypochondriasis

d) Conversion disorder

Correct Answer - C
Ans. is 'c' i.e., Hypochondriasis
Hvpochondriasis (hypochondriacal disorder)
The primary feature of hypochondriasis is persistent preoccupation
with excessive fear of a serious (e.g., cancer) or incurable (e.g.,
AIDS) disease, which is based on person's own interpretation of
physical symptoms or sensation, i.e., misinterpretation of physical
symptoms or sensations, for example an occasional change in heart
rate will lead a person with hypochondriasis to fear of heart disease.
Therefore, Hypochondriasis is abnormal preoccupation about normal
body function, i.e., body functioning is normal but patient thinks it as
abnormal.
The preoccupation with the presence of a feared illness persists
inspite of normal medical assessment and investigations. Patient
goes from one doctor to another for a consultation.
People with hypochondriasis are able to acknowledge that their
fears are unrealistic (insight is present), but this intellectual
realization is not enough to reduce their anxiety.
Two important facts differentiate hypochondriasis from somatization
disorder : -
1. Patient with hypochondriasis is preoccupied with illness, on the other
hand patient with somatization disorder is occupied with symptoms.
2. Hypochondriasis patient is preoccupied with one illness (usually)
while patient with somatization disorder has many (at least 8 or
more) symptoms.
114. Not true about somnambulism among
the following is?
a) Sleep walking.

b) Patient consciousness is preserved.

c) Disorder of sleep arousal.

d) Low level motor skill/function is present

Correct Answer - D
Ans: D. Low level motor skill/function is present.
Sleep walking (somnambulism):
The patients may carry out a range of activities for which he doesn't
have any memory later on.
It may include leaving the bed and walking about and also activities
like dressing, moving around or even driving.
115. Test based on the principle of suspect’s
reaction, if he witnesses an event then
he behaves in a certain way is?
a) Narcoanalysis

b) Brain mapping

c) Truth serum testing

d) Polygraph

Correct Answer - D
Ans:D. Polygraph
116. Intense depression & misery without any
cause is?
a) Melancholia

b) Major depressive disorder

c) Mania

d) Schizophrenia

Correct Answer - A
Ans:A. Melancholia
117. Which of the following is not true
regarding delusional disorder?
a) Held with absolute conviction

b) Usually false

c) Not amenable to reasoning

d) Occurs at early age

Correct Answer - D
Ans:D. Occurs at early age.
Delusional disorder may account for 1–2% of admissions to inpatient
psychiatric hospitals.
Age at onset ranges from 18–90 years, with a mean age of 40 years
118. Key symptom in alcohol withdrawal
syndrome is:
a) Sleep disturbance

b) Visual hallucinations

c) Tremors

d) Delirium

Correct Answer - C
Ans: C. Tremors
Key symptom - Tremor.
Withdrawal Syndromes
SubstanceFeatures
Yawning°, Insomnia, Dysphoric mood
Water loss from different orifices° (Lacrimation°,
Opioid sweating°, diarrhea°, vomiting,
Increased vitals° (BP, Pulse, RR, Temperature)°
Pupillary dilation, piloerection°
Hang over (MC)°
Hallucinations° (usually auditory) and illusions°
Insomnia°
Tremors/Seizures (Alcoholic seizures/Rum fits): Classic
sign
Delirium tremens:
Alcohol Occurs within 5 days° of complete or significant
abstinence° from heavy alcohol
Recovery occurs within 7 days
Characteristic features are clouding of consciousness°,
disorientation°, hallucinations (mostly visual and
 auditory)°, illusion°, autonomic disturbances°, agitation°
and insomnia°.
Increased or decreased Sleep (hypersomnia° or
insomnia) Psychomotor activity
Cocaine
Vivid unpleasant dreams°
Increased apetite and fatigue
119. What is produced by the supersensitivity
of Dopamine receptors ?
a) Dyskinesia

b) Hyperphagia

c) Hyperpathia

d) Hypomania

Correct Answer - A
Ans. is 'a' i.e., Dyskinesia
(Ref: Pathophysiology, pharmacology and biochemistry of
dyskinesia p. 195)
Increased neostriatal dopamine receptor density and dopaminergic
supersensitivity in the neuroendocrine system are associated with
the development of tardive dyskinesia.
120. Following are the major symptoms of
obsessive compulsive disorders ?
a) Contamination

b) Pathological doubts

c) Intrusive thoughts

d) All the above

Correct Answer - D
Ans. is'd'i.e., AII the above
[Rl Kaplan & Saddock's |tr/e p. 605)
OCD has four major symptom patterns :-
Contamination : -
Contamination is the most common pattern of an obsession followed
by washing (washer)
Pathological doubts : -
Doubts is the second most common pattern of an obsession,
followed by a compulsive checking (checkers).
Intrusive thoughts (Pure obsessions) : -
In this third most common pattern, there are intrusive obsessional
thoughts without a compulsion.
Such obsessions are usually r4re titious thoughts of a sexual or
aggressive act that is reprehensible to the patient.
Symmetry: -
This is the fourth most common pattern in which there is an
obsession for symmetry or precision, which can lead to compulsion
of slowness.
Patients can literally take hours to shave their faces or to eat a meal.
121. All are true about narcolepsy except:
a) Day dreaming

b) Hypnagogic hallucinations

c) Cataplexy

d) Sudden sleep

e) Decreased REM latency

Correct Answer - A
Ans. (A) Day dreaming
[Ref Neeraj Ahuja 7th/ I j8-39; Kaplan & Sailockls Textbook of
psychiatry 11th/547-50; Harrison 19th/189, t7th/172- ZB; CMDT
2016/1072]
Narcolepsy:
Disorder characterized by excessive daytime sleepiness often
distributed night time sleep and disturbances in REM sleep.
Hallmark of this disorder is decreased REM latency, I.e. decreased
latent period before the first REM period occurs.
Normal REM latency is 90- 100 minutes, in narcolepsy, REM sleep
occurs within 10 minutes of the onset of sleep.
Classical tetrad of symptoms:
Sleep attacks (MC)
Cataplexy
Hallucinations at sleep onset (Hypnagogic) and upon waking
(Hypnopompic)
Sleep paralysis.
122. Which of the following is not a side effect
of quetiapine?
a) Dry mouth

b) Hair loss

c) Sudden cardiac death

d) Dyspepsia

Correct Answer - B
Ans. B. Hair loss
[Ref Goodman & Gilman li'Ve p. 463-466]
Quetiapine is an atypical antipsychotic used for the treatment of
schizophrenia, bipolar disorder, and major depressive disorder.
Very Common Less common Rare
Dry mouth High blood pressure Prolonged QT interval
Orthostatic
Dizziness Sudden cardiac death
hypotension
Headache High blood cholesterol Syncope
Elevated serum
Somnolence Diabetic ketoacidosis
triglycerides
Nausea Abdominal pain Restless legs syndrome
Hyponatraemia, low blood
Vomiting Constipation
sodium.
Increased
Increased appetite Jaundice
appetite
Increased liver
Sore throat Pancreatitis
enzymes
Trouble
Backache Agranulocytosis
moving
Rapid
Rapid
Insomnia Seizure
heartbeat
Weakness Fatigue Cardiomyopathy
Pain Suicidal ideation
Dyspepsia
Priapism
(Indigestion)
Neuroleptic malignant
Peripheral edema
syndrome
Dysphagia Tardive Dyskinesia.
Weight gain
123. DOC for schizophrenic patient with poor
oral absorption is?
a) Clozapine

b) Fluphenazine

c) Sulpride

d) Penfluridol

Correct Answer - B
Ans. B. Fluphenazine
[Ref: Ther Adv Psychopharmacol. 2014 Oct; 4(5): 198-219.doi:
10.1177/2045125314540297]
Long-acting injectable (LAI) antipsychotics (APs) (LAI APs) have
proved effective in schizophrenia and other severe psychotic
disorders because they assure stable blood levels, leading to a
reduction of the risk of relapse.
LAIs bypass the initial deactivating process by avoiding first-pass
metabolism in the liver.
 124. TCAs are contraindicated in all of the
following except?
a) Narrow angle glaucoma

b) Prostate hypertrophy

c) A patient on MOA inhibitors

d) Impaired renal function

Correct Answer - D
Ans. D. Impaired renal function
[Ref Lippincott p. 81]
Common Contraindications of TCAs
1. Hypersensitivity to the medicines
2. Cardiac conduction abnormalities
3. Within 14 days of MAO inhibitors
4. Urinary retention
5. Narrow angle glaucoma
6. Prostate enlargement
7. Should be used cautiously in suicidal tendency, schizophrenia,
seizure disorders, paranoia, impaired liver functions.
8. Safety in not established in pregnancy and lactation. Not
recommended for children less 12years of age.
125. Loading dose of diazepam for alcohol
withdrawal is?
a) 80mg

b) 50mg

c) 40mg

d) 20mg

Correct Answer - D
Ans. D. 20mg
Rigid:
10 mg four times daily
Flexible:
10 mg every 4-6 hours asneeded based on symptoms to a
maximum of 60 mg/day
Front loading:
20 mg every 2-4 hours until sedation is achieved; then 10 mg every
4-6 hours as needed to a maximum of 60 mg/day
126. Confabulation is?
a) A state of confusion where patient is not able to describe the
details

b) Purposefully fabricating stories to project a certain image

c) Filling up to gaps by fabrication to cover lapses in memory

d) A feeling of strangeness to familiar situations or events.

Correct Answer - C
Ans. C. Filling up to gaps by fabrication to cover lapses in
memory
[Ref Kaplan & Sadock's 10th/e p. 275]
Confabulation
It is a type of Paramnesia (Distorted or falsified recall of events in
relation to details or their temporal relationships)
Unintentional filling of gaps of memory with material which are
untrue and fanciful.
127. Alcohol withdrawal is not associated
with?
a) Seizure

b) Amnesia

c) Tremers

d) Delirium

Correct Answer - B
Ans. B. Amnesia
[Ref: Niraj Ahuja 6th/e p. 41]
Amnesia occurs during acute intoxication (not during withdrawal).
128. Drug of choice for Tourette syndrome is?
a) Haloperidol

b) Amantidine

c) Propanolol

d) Diazepam

Correct Answer - A
Ans. A. Haloperidol
[Ref Kaplan & Saddock 10`Ve p. 557]
Medication for tic suppression (Tourrete syndrome)
Neuroleptics - Pimozide, along with haloperidol and fluphenazine are
the medications with the most proven efficacy in controlling tics.
129. Scatologia is?
a) Eating disorder

b) Sleep disorder

c) Paraphilia

d) Defense mechanism

Correct Answer - C
Ans. C. Paraphilia
[Ref: Niraj Ahuja 6th/e p. 133, 134]
Scatologia, also called Coprolalia, is a deviant sexual practice in
which sexual pleasure is obtained through the compulsive use of
obscene language.
The affected person commonly satisfies his desires through obscene
telephone calls, usually to strangers.
 130. A 40 year old married male thinks that he
is multitalented and is always
overconfident. He never listens to his
family or friends. Infact whenever anyone
gives him any advice, he thinks that they
have some motive against him. He is
always suspicious of his wife.
All these are feature of?
a) Borderline personality disorder

b) Schizoid personality disorder

c) Paranoid personality disorder

d) Histrionic personality disorder

Correct Answer - C
Ans. C. Paranoid personality disorder
[Ref Namboodiri 3rdle p. 303; Niraj Ahuja ele p. 123]
Paranoid personality disorder:
It is characterized by generalized mistrust and suspiciousness
about the motives and actions of others and a tendency to interpret
them as malevolent. The patient believes that:
1. Others are exploiting or deceiving the person.
2. Friends are untrustworthy and not loyal.
3. The spouse/partner is unfaithful.
4. There is hidden meaning in neutral or friendly remarks.
5. Many patients have feeling of self-importance and think they are
unusually talented.
131. A 25 years old male is not happy with its
gender and is always in distress due to
this. He wants to change sex and have
vagina. It comes under?
a) Transsexualism

b) Dual role transvestism

c) Gender dysphoria

d) Sexual maturation

Correct Answer - C
Ans. C. Gender dysphoria
[Ref Encyclopedia of relationships across the life span p.191]
* Gender dysphoria (formerly Gender Identity Disorder)
- It is defined by strong, persistent feelings of identification with the
opposite gender and discomforts with one's own assigned sex that
results in significant distress or impairment.
- In these cases, the assigned sex and gender do not match the
person's gender identity, and the person is transgender.
132. Characteristic of histrionic personality
disorder is?
a) Violation of rules of society

b) Attention - seeking behavior

c) Unstable interpersonal relationship

d) Grandiose behavior

Correct Answer - B
Ans. B. Attention - seeking behavior
[Ref Niraj Ahuja 6'"/e p. 122]
Patients with histrionic personality disorder display excessive
emotionality and attention-seeking behavior. Other options
Violation of rules of society → antisocial personality disorder
Unstable interpersonal relationship → borderline personality disorder
Grandiose behavior → narcissistic personality disorder
133. Personality type seen in schizophrenia
is?
a) Schizoid

b) Paranoid

c) Borderline

d) All of the above

Correct Answer - D
Ans. D. All of the above
[Ref Niraj Ahuja 6th/e p. 125 & Internet]
Schizophrenia is associated with 3 types of personality disorders i.e.
schizoid, borderline and paranoid.
134. Irresistible urge to drink alcohol is
called?
a) Kleptomania

b) Pyromania

c) Dipsomania

d) Trichotillomania

Correct Answer - C
Ans. C. Dipsomania
[Ref Peculiarities of behavior]
Dipsomania is characterized by periodic bouts of uncontrollable
craving for alcohol.
135. Which of the following is not a culture
bound syndrome?
a) Amok

b) Latah

c) Dhat

d) Von-Gogh

Correct Answer - D
Ans. D. Von-Gogh
[Ref Niraj Ahuja 6'/e p. 65]
Important culture-bound syndromes
Ataque de nervios
Dhat syndrome
Khyal cap
Ghost sickness
Kufungisisa
Maladi moun
Nervios
Shenjing shuairuo
Taijin kyofusho
Susto
Amok
Koro
Latah
Windigo
136. A 39 years old male patient presents with
waxy flexibility, negativism and rigidity.
Most probable diagnosis is?
a) Excitatory catatonia

b) Stuporous catatonia

c) Paranoid schizophrenia

d) None

Correct Answer - B
Ans. B. Stuporous catatonia
[Ref Neeraj Ahuja &hie p. 62, 63]
Stuporous (retarded) catatonia :
Characterized by extreme retardation of psychomotor function,
which includes mutism, rigidity, negativism, posturing, echolalia,
Echopraxia, Catalepsy (waxy flexibility), ambitendency, gegenhalten,
streotypies, stupor, Mannerism, Grimicing, Automatic obedience,
and verbigeration.
137. Suicide rate in India is?
a) 10.5 /100,000

b) 12.5/ 100,000

c) 14.5/ 100,000

d) 18/ 100,000

Correct Answer - A
Ans. A. 10.5 /100,000
[Ref Internet; Indian 1 Psychiatry. 2012 Oct-Dec; 54(4): 304-
319.doi:10.4103/0019-5545.104793]
India ranks 43rd in descending order of rates of suicide with a rate of
10.6/100,000 reported in 2009 (WHO suicide rates).
In the most recent National Crime Records Bureau (NCRB; Ministry
of Home Affairs) report the rate in 2010 rose to 11.4 per 100,000
population.
The male: female suicide ratio was 1.78 in India in 2008 and 2009.
138. DHAT syndrome is?
a) Passage of blood in urine

b) Passage of semen in urine

c) Passage of pus in urine

d) None

Correct Answer - B
Ans. B. Passage of semen in urine
[Ref Encyclopedia of multicultural psychology p. 135]
Dhat syndrome is a culture-bound syndrome prevalent in Indian
subcontinent in which male patients report that they suffer from
premature ejaculation or impotence, and believe that they are
passage of semen (dhat) in urine.
The condition has no known organic cause.
139. Most appropriate test for child
psychologist to evaluate the intellectual
ability of a 3 year old is?
a) Stanford Binet scale

b) Denver development scale

c) Alexander's pass along test

d) Rorschach inkblot test

Correct Answer - A
Ans. A. Stanford Binet scale
[Ref Psychological testing p. 101]
Stanford-Binet Intelligence Scale
The Stanford-Binet Intelligence Scale is an individually administered
standardized test that measures intelligence and cognitive abilities in
children and adults, from age two through mature adulthood.
The Stanford-Binet Intelligence Scale is now in its fifth edition (SB5)
and was released in 2003. It is a cognitive ability and intelligence
test that is used to diagnose developmental or intellectual
deficiencies in young children.
140. Treatment of choice for akathesia is?
a) Phenytoin

b) Propranolol

c) Dantrolene

d) Lithium

Correct Answer - B
Ans. B. Propranolol
[Ref Kaplan & Saddock's 10th le p. 1020]
"The first line drug for akathisia is most commonly alpha-blocker".
141. Functional somatic disorder is?
a) Somatization disorder

b) Chronic fatigue syndrome

c) Hypochondriasis

d) Body dysmorphic disorder

Correct Answer - B
Ans. B. Chronic fatigue syndrome
Functional somatic syndromes:
They are characterized more by symptoms, suffering and disability
than by disease specific, demonstrable abnormalities of structure or
function, i.e. There is reporting of somatic symptoms and resultant
disability rather than on the evidence of underlying convention
disease process
Three most common functional somatic syndromes are fibromyalgia,
Irritable bowel syndrome and chronic fatigue syndrome.
142. Cardinal element of behavior therapy is?
a) Modeling

b) Learning

c) Conditioning

d) Guidance

Correct Answer - B
Ans.B. Learning
[Ref Niraj Ahuja 6'1* p. 220]
Behavior therapy is based on the assumption that all behaviors
(normal or abnormal) are learning response. Normal and abnormal
behaviors are subject to the laws of learning and the same laws can
be used to change them. Behavior therapy is based on theories of
learning and aims at changing the maladaptive behavior and
substituting it with adaptive behavior.
 143. Tolerance is seen in?
a) Alcohol dependent syndrome

b) Schizophrenia

c) OCD

d) All of the above

Correct Answer - A
Ans. A. Alcohol dependent syndrome
[Ref Kaplan & Saddock's 10thle p. 382]
Alcohol dependent syndrome
Alcohol dependent syndrome uses the same criteria for dependence
for other substances, i.e., three or more of the following : -
1. Tolerance
2. Withdrawal symptoms
3. Alcohol is taken in larger amount or for longer period.
4. Persistent desire or sense of compulsion to take alcohol.
5. A great deal of time spent to obtain alcohol, to use alcohol or to
recover from its effect.
6. Neglect of important social, occupational and recreational activities.
144. Treatment of choice for generalized
anxiety disorder is?
a) Benzodiazepines

b) Neuroleptics

c) Beta blockers

d) Barbiturates

Correct Answer - A
Ans. A. Benzodiazepines
[Ref Harrison 17th/e p. 2712; Kaplan & Saddock's 10th/e p. 626]
Treatment of generalized anxiety disorder
Benzodiazepines are the drug of choice. Drugs in this group are
diazepam, Lorazepam, Alprazolam, Oxazepam, chlordiazepoxide.
145. Generalized anxiety disorder is
diagnosed when anxiety and worry
continues for at least?
a) 2 months

b) 4 months

c) 6 months

d) 8 months

Correct Answer - C
Ans. C. 6 months
[Ref Harrison 17"/e p. 2712; Kaplan & Saddock's 10th/e p. 626]
GENERALIZED ANXIETY DISORDER
This is characterized by excessive anxiety and worry which are
persistent & generalized and not restricted to any specific situation
or object.
Excessive anxiety worry occur for at least 6 months.
 146. Most important receptors involved with
schizophrenia are?
a) GABAA

b) GABA,,

c) DZd

d) 5-HT

Correct Answer - C
Ans. C. DZd
[Ref Kaplan & Saddock's 10th le p. 470]
Dopamine hypothesis is the most accepted hypothesis for
schizophrenia. There is hyperactivity of dopaminergic system. This
hypothesis is supported by :
1. Amphetamine and cocaine which release dopamine in central
synapses induce schizophrenia like symptoms; and
2. Antipsychotic drugs control the schizophrenic symptoms by blocking
dopamine (D2) receptors.
147. Risk factor for suicide is?
a) Increased serotonin

b) Drug abuse

c) Female sex

d) Married person

Correct Answer - B
Ans.B. Drug abuse
[Ref: Niraj Ahuja ele p. 236, 237; Essentials of psychiatry 4th/e p.
734]
Causes/Risk factors for suicide
Psychiatric disorders: - Depression (most common), alcoholism (2nd
mc), Drug/Substance dependence, Schizophrenia, Dementia.
Physical illness: - Cancer, AIDS, Multiple sclerosis, Head trauma.
Psychosocial factors: - Failure in love, marital difficulties, family
dispute, illegitimate pregnancy.
Biological factors: - Decrease in serotonin
Other - Male sex, Age > 40 years, Single (Unmarried, divorced or
widowed), previous suicide attempt, social isolation.
148. A 25 years old male c/o recurrent
abdominal pain but biochemical assays
and ultrasound abdomen is normal. He
also complains of constant headaches.
He suddenly complains of loss of vision
of bilateral eyes. Ophthalmologist finds
nothing on examination. Symptoms are
most probably due to
a) Bilateral optic neuritis

b) Posterior inferior cerebellar artery infarct

c) Malingering

d) Factitious disorder

Correct Answer - D
Ans. D. Factitious disorder
Factitious disorder
It is also known as Hospital addiction, hospital hoboes, or
Professional patient.
The term Munchausen syndrome is used for those patients who
repeatedly simulate or fake diseases (intentionally) for the sole
purpose of obtaining medical attention. There is no other
recognizable motive (in contrast to malingering).
The typical presentation of Munchausen syndrome is characterized
by a restless journey from doctor to doctor and hospital to hospital,
an ever-changing list of complaints and symptoms.
The patient tries to maintain the sick role to obtain medical attention.
There may be evidence of earlier treatment usually surgical
procedure, for example, multiple surgical scars (gridiron abdomen).
149. Emile Durkheim is linked with work on
which condition in psychiatry?
a) Suicide

b) Obsessive compulsive disorder

c) Anxiety disorder

d) Schizophrenia

Correct Answer - A
Ans. A. Suicide
Suicide (French: Le Suicide)
It was a groundbreaking book in the field of sociology.
It was written by French sociologistEmile Durliiheim and pubtshed in
1897.
It was ostensibly a case study of suicide, a publication unique for its
time that provided an example of what the sociological monograph
should look like.
150. Highest insight is ?
a) Intellectual

b) Emotional

c) Psychological

d) Affective

Correct Answer - B
Ans. b. Emotional
Neziroglu and Stevens proposed four different levels of
insights:
True emotional insight
Intellectual insight
Partial internally and externally based insight
Denial of illness
True emotional insight is representative of the highest level of insight
possible. In it the patients' awareness and understanding of their
own thoughts, feelings and motives can be used to change behavior.
151. Extracampine hallucinations term was
given by ?
a) Eugene Bleuler

b) William Harvey

c) Robert Macinoff

d) Eden Speroff

Correct Answer - A
Ans. A. Eugene Bleuler
Extracampine hallucinations
The term extracampine is indebted to Latin words extra - outside
and campaneus - field.
It was introduced in or shortly before 1903 by Swiss Psychiatrist
Eugene Bleuler to denote a hallucination that is experienced by
affected individual as being outside the range of normal perception.
152. Hypomimia is ?
a) Decreased ability to copy

b) Decreased execution

c) Deficit of expression by gesture

d) Deficit of fluent speech

Correct Answer - C
Ans. C. Deficit of expression by gesture
Hypomimia
Hypomimia or amimia is a deficit or absence of expression by
gesture or mimicry.
This is usually most obvious as a lack of facial expressive mobility
(mask - like facies).
This is a feature of frontal subcortical disease.
153. Serial 7 substraction is used to test ?
a) Working memory

b) Long term memory

c) Mathematical ability

d) Recall power

Correct Answer - A
Ans. A. Working memory
Serial sevens substraction test
Serial sevens, counting down from one hundred by sevens, is a
clinical test used to test mental function; for example, to help assess
mental status after possible head injury or in suspected cases of
dementia.
This well-known test, in active documented use since at least
l944,was adopted as part of the mini-mental state examination.
The test is also used in determining when a patient is becoming
unconscious under anaesthetic, for example prior to major dental
surgery.
154. Which of the following are sections of
mental state examination?
a) Mood and affect

b) Speech and language

c) Cognition

d) All the above

Correct Answer - D
Ans. D. All the above
155. Obsessive attention by an individual
towards another person is called ?
a) Stalking

b) Percieving

c) Following

d) Pressurizing

Correct Answer - A
Ans. A. Stalking
Stalking
Stalking is unwanted or obsessive attention by an individual or group
toward another Person.
Stalking behaviors are related to harassment and intimidation and
may include following the victim in person or monitoring them.
The word stalking is used, with some differing meanings, in
psychology and psychiatry and also in some legal jurisdictions as a
term for a criminal offense.
156. Most common of all psychiatric
disorders are -
a) Anxiety disorder

b) Schizophrenia

c) Depression

d) Mania

Correct Answer - A
Ans. A. Anxiety disorder
Most common psychiatric disorder > Anxiety disorders.
2d most common psychiatric disorder > Depression.
157. Patient wants to scratch for itching in his
amputated limb is an example of ?
a) Illusion

b) Pseudohallucination

c) Phantom limb hallucination

d) Autoscopy hallucination

Correct Answer - C
Ans. C. Phantom limb hallucination
Phantom limb hallucination - The person feels his body parts intact
in their respective places even after they are lost through amputation
or injury.
In the question given patient feels itching in the amputated limb and
tries to scratch the limb. Thus it is an example of phantom limb
hallucination.
158. Myxedema madness includes ?
a) Auditory hallucinations and paranoia

b) Visual hallucinations and depression

c) Auditory hallucinations and depression

d) Paranoia and depression

Correct Answer - A
Ans. A. Auditory hallucinations and paranoia
Psychiatric disorders in hypothyroidism
These include depressed mood, apathy, impaired memory and other
cognitive defects.
Hypothyroidism can contribute to the development of treatment
refractory depression.
Myxedema madness consisting of auditory hallucinations and
paranoia is seen in some Patients.
159. APACHE II does not include ?
a) Acute physiology score

b) Age

c) Sex

d) Chronic health evaluation

Correct Answer - C
Ans. C. Sex
Acute physiology and chronic health evaluation
Knaus et al (1981) introduced the first the Acute Physiology and
Chronic Health Evaluation (APACHE) model in 1981 and revised it
to APACHE II in 1985. APACHE III was presented in 1991 but as the
regression analysis modelling is not in the public domain its uptake
has been slow.
APACHE II is made up of four basic comPonents:
1) Acute physiology score;
2) Chronic health evaluation;
3) Age;
4) Urgency of admission to critical care
160. SSRIs should be carefully used in the
young for the management of depression
due to increase in?
a) Nihilism ideation

b) Guilt ideation

c) Suicidal ideation

d) Envious ideation

Correct Answer - C
Ans. C. Suicidal ideation
In 2003, th UK Medicine and Health Care products regulatory
agency concluded that all SSNs, with the exception of fluoxetine,
were contraindicated in the treatment of depression in young people
due to increase in suicidal ideation and dubious efficacy.
161. If a person is asked, "what will he do if
he sees a house on fire"?, Then what is
being tested in that person ?
a) Social judgement

b) Test judgement

c) Response judgement

d) None of the above

Correct Answer - B
AnS. B. Test judgement
Judgement
It is the ability to assess a situation correctly and act appropriately
within that situation'
Social judgement: is observed during the hospital stay and during
the interview session. It includes evaluation of personal judgement.
Test Judgement: is assessed by asking the patient what he would
do in certain test situations like - house on fire, man lying on road.
It is rated as good/ intact normal or poor/ impaired/abnormal'
 162. Illusion is a disorder of ?
a) Thought

b) Perception

c) Affect

d) Emotion

Correct Answer - B
Ans, B. Perception
Disorders of perception
1. Altered perception - Sensory distortion (micropsia, hyeracusis),
Illusion.
2. False perception - Hallucination.
 163. Rope seen as snake is an example of -
a) Illusion

b) Hallucination

c) Delusion

d) Pseudohallucination

Correct Answer - A
Ans. A. Illusion
llusions are altered perception in which a real eternal object is
combined with imagery to produce false internal percept.
In simple words, illusion is misinterpretation of an actual sensory
input.
For example: -
1. Hearing once name in a train whistle:- Train whistle is a real eternal
stimulus, which is perceived as once name (false internal percept).
2. Mistaking a stick or rope for snake in dark room:- Stick is a real
external object, which is perceived falsely as snake.
164. Woman firmly and persistently feels her
husband is cheating on her and she
disapproves to accePt any proof given in
the husbands support' The other family
members do not supportherbelief. This is
anexample of-
a) Illusion

b) Delusion

c) Hallucination

d) Perversion

Correct Answer - B
Ans. B. Delusion
In the question given the woman has a false unshakable belief that
her husband is cheating on her and she disapproves all her relatives
and proofs in support of her husband.
Thus this is an example of delusion.
165. Withdrawal of which of the following
causes piloerecton?
a) Morphine

b) Cannabis

c) Smoking

d) Alcohol

Correct Answer - A
Ans. A. Morphine
Manifestations of morphine withdrawal
Lacrimation
Anxiety & fear
Sweating
Restlessness r
Yawning
Gooseflash (Piloerection).
166. Schizotypal personality belongs to which
cluster of personality disorders?
a) A

b) B

c) C

d) D

Correct Answer - A
Ans. A. A
Cluster A: Paranoid, Schizoid, Schizotypal.
Cluster B: Antisocial (Dissocial), Histrionic, Narcissistic, Borderline.
Cluster C: Anxious (avoidant), Dependent, obsessive - compulsive
(anankastic).
167. Cardinal feature of antisocial personality
-
a) Violation of rules of society

b) Attention - seeking behavior

c) Unstable interpersonal relationship

d) Grandiose behaviour

Correct Answer - A
Ans. A. Violation of rules of society
The essential features of antisocial personality disorder are a
disregard for and violation of the rights of the other and the rules of
the society.
168.
Which personality disorder/s can be a part of
autistic sPectrum of disorders?
a) Schizoid

b) Schizotypical

c) Borderline

d) All the above

Correct Answer - D
Ans. D. All the above
Following personality disorders can be diagnosed later in life in
patients with childhood autistic spectrum of disorders: Borderline,
Obsessive compulsive, narcissitic, paranoid, schizotypical and,
avoidant, personality.
169. Patients who are grandiose and require
admiration from others has which type of
personality?
a) Narcissistic

b) Histrionic

c) Borderline

d) Antisocial

Correct Answer - A
Ans. A. Narcissistic
Grandiosity and admiration from others are feature of Narcissistic
personality disorder.
170. Max duration of time spent is in NREM
stage?
a) I

b) II

c) III

d) IV

Correct Answer - B
Ans, B. II
REM sleep occupies 20-30% of total sleep and NREM sleep ocupies
60-70% (state I: 5-70%, stage II : 40-50%, stage III & IV : 15_20%)
171. Spouse jealousy is a feature of ?
a) Othello syndrome

b) Chronic alcoholism

c) Stockholm syndrome

d) Clerambault's syndrome

Correct Answer - A
Ans. A. Othello syndrome
Othello Syndrome:
When the content of delusions is predominantly jealousy (infidelity)
involving the spouse, person feels an unreasonable fear that a
partner has been unfaithful, is presently unfaithful, or plans to be
unfaithful, it is called as Othello Syndrome or conjugal paranoia.
Elaborate steps are taken to prevent the spouse to go outside
(Locks the spouse, not allowing her to go outside).
172. All of the following are true about
pseudohalluci​nations except ?
a) Arises in inner subjective self

b) Patient describes the sensations being perceived by mind eye

c) Are under voluntary control

d) Distressing flashback of PTSD is a n example

Correct Answer - C
Ans.C. Are under voluntary control
Pseudohallucination
Pseudohallucination is a perceptual experience, which differs from a
hallucination in that it appears to arise in the inner subjective space,
not through one of the external sensory organs.
Patients tend to describe these sensations as being perceived with
the 'inner eye' or 'mind eye' (or ear).
However, like true hallucinations pseudohallucinations are not under
voluntary control.
Example include: Distressing flashbacks in post-traumatic stress
disorder or the recently bereaved widow waking up to briefly 'see'
her husband sitting at the foot of the bed,
173. Delirium is defined as ?
a) Acute onset of disturbed consciousness

b) Chronic onset of disturbed consciousness

c) Progressive generalized impairment of intellectual functions and

d) Disorientation without clouding of consciousness

Correct Answer - A
Ans. A. Acute onset of disturbed consciousness
Delirium is defined by the acute onset of fluctuating cognitive
impairment and a disturbance of consciousness.
It is also referred to as acute confusional state or acute organic brain
syndrome.
 174. All the following drugs are used to
prevent relapse and maintain abstinence
in cases of alcohol withdrawal except ?
a) Disulfiram

b) Acamprosate

c) Naltrexone

d) Propranolol

Correct Answer - D
Ans. D. Propranolol
Detoxification (treatment of withdrawal):- BZDs are the drugs of
choice, e.g. chlordiazepoxiile (Id choice), Diazepam (2nd choice).
Maintenance after detoxification (to prevent relapse and
maintenance of abstinence):-
1. Aversive agent (ileferent agents):- Disulfiram, CCC, metronidazole,
Natrafezole.
2. Anticraving agent: - Naltrexone, Acamprosate, fluoxetine,
Topiramate, Nalmefene.
175. Which is the most common type of
persistent delusional disorder ?
a) Delusion of persecution

b) Somatic delusion

c) Delusion of jealousy

d) Delusion of grandeur

Correct Answer - A
Ans. A. Delusion of persecution
Delusion of persecution is the most common type of persistent
delusional disorder.
176. Dysthymia is ?
a) Chronic depression

b) Chronic mania

c) Bipolar disorder

d) Personality disorder

Correct Answer - A
Ans. A. Chronic depression
Persistent depressive disorder (Dysthymia)
Depression may run a chronic course over years with fluctuation of
mood interposed with symptom free intervals (less than 2 months).
If symptoms persist for more than 2 years, they are referred to as
persistent depressive disorder or dysthymia.
177. Bipolar II disorder includes ?
a) Cyclothymic disorder

b) Dysthymia

c) Single maniac episode

d) Major depression and hypomania

Correct Answer - D
Ans. D. Major depression and hypomania
Bipolar II: One or more major depressive episodes together with at
least 1 hypomanic episode.
 178. Psychotic patient on antipsychotic drugs
develops torticollis within 4 days of
therapy. what is the treatment?
a) Central anticholinergic

b) Peripheral anticholinergic

c) Beta blocker

d) Dantrolene

Correct Answer - A
Ans. A. Central anticholinergic
This is a case of drug induced muscular dystonia, which is treated
by central anticholinergic.
Drug of choice for antipsychotic induced extrapyramidal side effects
1. Acute muscular dystonia -+ Central anticholinergic
2. Akathisia - Beta blocker
3. Parkinsonism - Central anticholinergic.
4. Neuroleptic malignant syndrome - Dantrolene
5. Tardive dyskinesia → Terabenazine (TBZ)
179. Eugene Blueler's 4As include following
except ?
a) Autism

b) Affect

c) Anhedonia

d) Association

Correct Answer - C
Ans. C. Anhedonia
Bleuler's 4 'As' are: (l) Ambivalence (2) Autism; (3) Affect
disturbances (inappropriate affect); and (4) Association disturbances
(loosening of association, thought disorder).
180. Appetite for nonnutritive substances is
called ?
a) Pica

b) Apprepritant

c) Bulimia

d) Bolean

Correct Answer - A
Ans. A. Pica
Pica is characterized by an appetite for substances that are largely
non-nutritive, such as paper, clay, metal, chalk, soil, glass, or sand.
181. Bad trip is seen with ?
a) Cocaine

b) Cannabis

c) LSD

d) Heroin

Correct Answer - C
Ans. C. LSD
Acute panic reaction with loss of control on onself, called Bad trip, is
characteristic of LSD or otJrer hallocinogens.
182. Antipsychotic drug causing retinal
pigment disorder is?
a) Thiaoridazine

b) Clozapine

c) Chlorpromazine

d) None of the above

Correct Answer - A
Ans. A. Thiaoridazine
Blue pigmentation of skin, corneal and lenticular opacities, retinal
degenration can occur with thioridazine.
183. Antipsychotic drug with least extra
pyramidal symptoms?
a) Pimozide

b) Thioridazone

c) Clozapine

d) Flupromazine

Correct Answer - C
Ans. C. Clozapine
Antipsychotics with no extrapyramidal side effects clozapine,
aripiprazole, quetiapine.
Amongst typical antipsychotics, thioridazone has least extrapyramial
side effects.
184. Following is true about alcoholic
dependence syndrome except -
a) No tolerance

b) Withdrawal symptoms

c) CAGE questionnaire

d) Physical dependence

Correct Answer - A
Ans. A. No tolerance
Alcohol dependence has following criteria:- (i) Tolerance; (ii)
Withdrawal symptoms; (iii) Taken in larger amount or longer
duration; (iv) Persistent craving (desire) to take alcohol; (v) A great
deal of time spent to obtain alcohol or to use it; (vi) Neglect of other
activities (social, occupational); and (vii) Continued use despite clear
evidence of overtly harmful consequences.
The CAGE questionnaire is a tool used to assess individuals for
potential alcohol problems, including dependence.
Alcohol produces both physical as well as psychological
dependence.
185. DSM IV criterion for depression is?
a) 1 week

b) 2 weeks

c) 3 weeks

d) 4 weeks

Correct Answer - B
Ans. B. 2 weeks
For the diagnosis of minor depression 2-4 and for major depression
> 5 DSM IV symptoms are required for at least for a two week
period.
186. The clinical effects of the antidepressant
drugs is mainly based on ?
a) Change in neurotransmitter receptor sensitivity

b) Decreased level of neurotransmitters

c) Change in efficacy of neurotransmitters

d) None of the above

Correct Answer - A
Ans. A. Change in neurotransmitter receptor sensitivity
Temporal correlation of clinical effects with changes in receptor
sensitivity has given rise to hypothesis that changes in
neurotransmitter receptor sensitivity may actually mediate the
clinical effects of antidepressant drugs.
These clinical effects include not only antidepressant and anxiolytic
actions but also the development of tolerance to the acute side
effects of antidepressant drugs.
187. Theory of human motivation was given
by ?
a) Pavlov

b) Abraham Maslow

c) Alios Alzheimer

d) Aaron Beck

Correct Answer - B
Ans. B. Abraham Maslow
Maslords hierarchy of needs is a theory in psyehslag proposed by
Abraham Maslow in his 1943 paper.
"A Theory Of Human Motivation" in Psychological Review.
Maslow subsequently extended to include his observations of
humans innate curiosity'.
His theories parallel many other theories of human developmental
psychology, some of which focus on describing the stages of growth
in humans.
Maslow used the terms "physiological", "safety', "beloftingness" and
love, esteem, self-actualization", and "self-transcendence" to
describe the pattern that human motivations generally have through.
188. Mechanism of action of duloxetine is ?
a) Selective Inhibition of serotonin reuptake

b) Selective inhibition of nor-epinephrine reuptake

c) Selective inhibition of both serotonin and nor-epinephrine

d) None of the above

Correct Answer - C
Ans. C. Selective inhibition of both serotonin and nor-
epinephrine reuptake
Duloxetine, is a drug classified under serotonin-norepinephrine
reuptake inhibitors (sNRJs).
At lower doses it is more prominent serotonin reuptake inhibitor.
Whereas at higher doses it is more prominent inhibitor of nor-
epinephrine reuptake.
It has minimal dopamine agonist action.
189. Medical treatment for paraphillia
includes ?
a) SSRIs

b) Benzodiazepines

c) Opioids

d) Barbiturates

Correct Answer - A
Ans. A. SSRIs
Medical treatment for paraphillia -
Antidepressants, such as lithium and various selective serotonin
reuptake inhibitors (SSRIs)
Long-acting gonadotropin-releasing hormones (ie, medical
castration), such as leuprolide acetate and triptorelin
Antiandrogens (to lower sex drive)' such as
medroxyprogesteroneacetate (10 mgqt2hr, with the dosage doubled
every3 days to a maximum of 200 mg/day, then maintained for I
month and adjusted as necessary).
Phenothiazines, such as fluphenazine
Mood stabilizers
190. Husband having suspicion that his wife
is having affair with another man,
diagnosis is ?
a) Illusion

b) Delusion

c) Hallucination

d) Delirium

Correct Answer - B
Ans. B. Delusion
A delusion is false, firm (unshakeable) beliefthat is not accepted by
other members of patient's culture and society.
Above is an example of delusion of infedility (morbid jealousy,
othello syndrome) i.e-. False belief that one’s lover has been
unfaithful.
191. Causes of neuroregression in a child can
be all except ?
a) Wilson's disease

b) Vitamin B12 deficiency

c) ADHD

d) Ataxia telengiectasia

Correct Answer - C
Ans. C. ADHD
Causes of neuroregression
Inherited
A. GreY matter involvement-
With visceromegaly :- Niemann pick disease, Sandholf disease
(GM2), sialidosis, Goucherdisease, Mucopolyschharidoses (MPS)
Without visceromegaly :- TaySach Disease, Rett syndrome, Menke’s
kinky hair disease
B. White matter involvement:-
Leukodystrophies :- Metachromatic leukodystrophy, Krebbe's
disease, Adrenoleukodytrophy, Alexander disease, Cannavan
disease .
Acquired/Demyelinating:-
Multiplesclerosis,schilder'sdisease,Devicdisease
C. Basal ganglia involvement - Wilson’s disease, Dystonia muscular
deformans, Huntington's disease
D. Spinocerebeller :- Friedrich's ataxia, Ataxia telengiectasis
E. Acquired
Infections:- SSPE, progressive rubella syndrome, HIV
Metabolic:Chronicleadpoisoning,Hypothyoidism,VitB12&Edeficienry,Drugs(anticonv
192. A 25 year old male believes that his
penis is decreasing in size everyday and
one day it will disappear one day and he
will die. Diagnosis is ?
a) Obsession

b) Somatization

c) Hypochondriasis

d) Delusion disorder

Correct Answer - D
Ans. D. Delusion disorder
Description given in the question is of Koro syndrome, a delusional
disorder.
Koro syndrome
Koro is a culture-specific syndrome delusional disorder in which an
individual has an overpowering belief that one’s genitalia are
retracting and will disappear, despite the lack of any true
longstanding changes to the genitals.
Koro is also known as shrinking penis. The syndrome is commonly
known as genital retraction syndrome.
193. Haloperidol induced extarpyramidal side
effects are treated by ?
a) Benzodiazepines

b) Barbiturates

c) Anticholinergic drugs

d) SSRIs

Correct Answer - C
Ans. C. Anticholinergic drugs
Commonly used medications for extra-pyramidal symptoms are
anticholinergic agents such as Benztropine, Diphenhydramine and
trihexyphenidyl.
Another common course of treatment includes dopamine agonist
agents such as pramipexole.
 194. Most common substance of abuse in
India ?
a) Cannabis

b) Tobacco

c) Alcohol

d) Opium

Correct Answer - B
Ans.B. Tobacco
National Household Survey of Drug and Alcohol Abuse in India
– Estimated users: (2001)
1. Tobacco - 162 million.
2. Alcohol - 62 million
3. Cannabis - 9 million.
4. Opiates - 2.5 lakh
195. In Neuroleptic malignant syndrome,
cause of death is ?
a) Respiratory failure

b) Liver failure

c) Drug toxicity

d) None of the above

Correct Answer - A
Ans. A. Respiratory failure
Causes of death in NMS
Respiratory failure
Renal failure
Pneumonia
Thromboembolism
Cardiac failure
 196. Drug with no mood stabilizing property
is -
a) Lithium

b) Lamotrigine

c) Imipramine

d) Carbamazepine

Correct Answer - C
Ans. C. Imipramine
The 5 individual drugs that can be used as mood stabilizers
are:
1. Lithium
2. CarbamazePine
3. Lamotrigine
4. Valproate
5. Asenapine
197. Sex reassignment surgery is done in ?
a) Gender identity disorder

b) Premature ejaculation

c) Erectile dysfunction

d) Orgasmic dysfunction

Correct Answer - A
Ans. A. Gender identity disorder
Many persons with gender identity disorder have sought sex-
reassignment surgery, that is, physical change that is constant with
their cross sexual identity.
198. Modafinil is used for the treatment of ?
a) Narcolepsy

b) Sexual dysfunction

c) Depression

d) Anxiety

Correct Answer - A
Ans. A. Narcolepsy
Modafinil is a wakefulness-promoting agent (or eugeroic) used for
treatment of disorders such as narcolepsy,shift work sleep disorder,
and excessive daytime sleepiness associated with obstructive sleep
apnea'
199. A girl with bad behavior like smashing
and throwing objects was admitted in the
hospital. There also she was behaving
very badly with staff & abusing nurses.
But she behaves very well with a one
very good looking resident doctor.
Diagnosis is?
a) Bipolar disorder

b) Schizoaffective disorder

c) Borderline personality disorder

d) Antisocial personality

Correct Answer - D
Ans. D. Antisocial personality
Antisocial (Dissocial) personality disorder
The essential features of antisocial personality disorder are a
disregard for and violation of the rights of the other and the ruIes of
the society.
It is characterized by repeated violation of the law and rules of the
society (drug abuse); physical aggressiveness; Reckless disregard
for safety of self or others; consistent irresponsibility in work and
family environment and lack of remorse.
This disorder is synonymous with previously used terms like
psychopath or sociopath.
200. All of the following are associated
increased REM latency, except ?
a) First night effect

b) SSRIs

c) Narcolepsy

d) Restless leg syndrome

Correct Answer - C
Ans. C. Narcolepsy
Increased REM latency -
PTSD
Restless leg syndrome.
First night effect
SSRI’s
TCA’s
Ethanol
Lithium
201. Sign of oppositionalism in a young child
is due to?
a) Mental retardation

b) Organic mental disorder

c) Mental distress

d) All of the above

Correct Answer - C
Ans. C. Mental distress
“Oppositionalism, temper tantrums and breath holding spells are not
unusual during 1st years of life and are age typical expression of
frustration and anger”
202. Trichophagia is characterized by?
a) Compulsive pulling of hair

b) Compulsive eating of hair

c) Compulsive shopping

d) Compulsive stealing

Correct Answer - B
Ans. B. Compulsive eating of hair
Trichophagia is compulsive eating of hair and is usually associated
with trichotillomania i.e. compulsive pulling of hair.
203. MC cause of delirium ?
a) Infection

b) Liver failure

c) Belladonna poisoning

d) None of the above

Correct Answer - A
Ans. A. Infection
Infection is one of the most common causes of delirium.
204. General paralysis of insane is associated
with ?
a) Neurosyphillis

b) Alzheimer's disease

c) Parkinson's disease

d) None of the above

Correct Answer - A
Ans, A. Neurosyphillis
General paresis, also known as general paralysis ofthe insane or
paralytic dementia, is a severe neuropsychiatric disorder, classified
as an organic mental disorder and caused by the chronic
meningoencephalitis that leads to cerebral atrophy in late-
stagesyphilis.
Degenerative changes are associated primarily with the frontal and
temporal lobar cortex-
General paralysis of the Insane (GPI) is progressive deterioration of
the whole mental and physical personality.
Symptoms included exaggeratedkneejerk, Iack ofreaction ofthe
pupils to light, an inabilityto pay attention, a'clouding'of
consciousness, poor short-term memory, tremulous voice, reflex
disturbances, and retinal anomalies' and diminished skin sensation.
Patients were often recognizable by their striking 'delusions of
grandeur”
205. Jamais vu is -
a) Illusion that what one is hearing, one has heard previously

b) A unfamiliar thought regarded as repetition of a previous

c) Unfamiliar situations or events feel strangely familiar

d) Feeling of strangeness to familiar situation

Correct Answer - D
Ans. D. Feeling of strangeness to familiar situation
famais vu :- A feeling of strangeness to familiar situations or events.
206. Conventional drug used in the treatment
of delirium is?
a) Haloperidol

b) Lithium

c) SSRIs

d) Morphine

Correct Answer - A
Ans. A. Haloperidol
Drugs used for delirium:
Typical antipsychotics: - Haloperidol (Doc), Thioridazine,
chlorpromazine.
Atypical antipsychotics: - Risperidone, quetiapine, olanzapine.
Benzndiazepines (for delirium tremens): - Chlordiazepoxide,
Diazepam, Lorazepam, Clonazepam.
 207. Characteristic hallucination of
schizophrenia is
a) Auditory hallucinations commanding the patient

b) Auditory hallucinations giving running commentary

c) Auditory hallucinations criticizing the patient

d) Auditory hallucinations talking to patient

Correct Answer - B
Ans. B. Auditory hallucinations giving running commentary
Third-person hallucinations, e.g. voices heard arguing, commenting
or discussing the patient or giving a running commentary on one's
action; are characteristic of schizophrenia.
In schizophrenia auditory hallucinations are the most common
type of hallucinations.
1. First-person hallucination:- Audible self-thoughts
2. Second person hallucination:- Voices address the person directly or
commanding one's action and
3. Third-person hallucinations:- voices heard arguing, commenting or
discussing the patient or giving a running commentary on his action
or thought. Only the "third person hallucinations' are characteristic of
schizophrenia.
208. Which of the following typical
antipsychotic drug is not available in
depot form ?
a) Haloperidol

b) Risperidone

c) Olanzapine

d) Chlorpromazine

Correct Answer - D
Ans. D. Chlorpromazine
Antipsychotic drugs with depot preparations are risperidone,
poliperidone, halopetidol, fluphenazine, flupenthixol, zuclopenthixol,
olannpine, clozapine, imipramine and quetiapine.
209. Self mutilation is a feature of ?
a) Von-Gogh syndrome

b) Catatonic schizophrenia

c) Paranoid schizophrenia

d) None of the above

Correct Answer - A
Ans. A. Von-Gogh syndrome
Dramatic self-mutilation occurring in schizophrenia has also been
called Von-Gogh syndrome'
210. A patient inventing new words, is a
feature of ?
a) Neurosis

b) Schizophrenia

c) OCD

d) Von-Gogh syndrome

Correct Answer - B
Ans B. Schizophrenia
Neologism: - New words or condensations of several words that are
not readily understood by others.
Neologism is seen in schizophrenia and organic brain syndrome.
211. True about flumazenil is ?
a) Can be used in barbiturate poisoning

b) Specific antidote for opiate overdose

c) Can be used in benzodiazepine overdose

d) All of the above

Correct Answer - C
Ans. C. Can be used in benzodiazepine overdose
Fumazenil is an imidazobenzodiazepine derivative and a potent
benzodiazepine recePtor antagonist that competitively inhibits the
activity at the benzodiazepine recognition site on the GABA
benzodiazepine receptor complex thereby reversing the effects of
benzodiazepine on the central nervous system.
Flumazenil does not antagonize the central nervous system effects
of drugs affecting GABA-ergic neurons by means other than the
benzodiazepine receptor (including ethanol, barbiturates, or general
anesthetics) and does not reverse the effects of opioids.
212. Increased dopamine levels are
associated ?
a) Depression

b) Mania

c) Delirium

d) Schizophrenia

Correct Answer - D
Ans. D. Schizophrenia
Dopamine hypothesis is the most accepted hypothesis for
schizophrenia.
There is hyperactivity of dopaminergic system.
Other neurotransmitters involved are : - Increased serotonin,
Decreased GABA, variable change (Increased or decreased)
glutamate, and increased norepinephrine.
213. Tourette syndrome is a type of ?
a) Tic disorder

b) Mental retardation disorder

c) Seizure disorder

d) None of the above

Correct Answer - A
Ans. A. Tic disorder
Tourette syndrome (also called Tourette's syndrome, Tourette's
disorder, Gilles de la Tourette syndrome, GTS or, more commonly,
simply Tourette's or TS) is an inherited neuropsychiatric disorder
with onset in childhood, characterized by multiple physical (motor)
tics and at least one vocal (phonic) tic.
Average onset between the ages of 3 and 9 years.
Males are affected about three to four times more often than
females.
Common associations are ADHD and OCD.
214. Treatment of choice for acute panic
attacks is ?
a) Barbiturates

b) Benzodiazepines

c) TCAs

d) MAO inhibitors

Correct Answer - B
Ans. B. Benzodiazepines
DOC for Panic disorders - SSRI’s
DOC for acute panic attack - Benzodiazepines.
215. Characterized by chronic, multiple tics ?
a) Parkinson's disease

b) Wilson's disease

c) Shy-Drager syndrome

d) Tourette's syndrome

Correct Answer - D
Ans. D. Tourette's syndrome
Tourette syndrome (also called Tourette's syndrome, Tourette's
disorder, Gilles de la Tourette syndrome, GTS or, more commonly,
simply Tourette's or TS) is an inherited neuropsychiatric disorder
with onset in childhood, characterized by multiple physical (motor)
tics and at least one vocal (phonic) tic.
216. Which of the following is not true about
sleep ?
a) REM sleep comes earlier than NREM sleep

b) REM sleep is also called paradoxical sleep

c) Sleep walking comes in NREM sleep

d) Dreams come in REM sleep

Correct Answer - A
Ans. A. REM sleep comes earlier than NREM sleep
The NREM (with its four stages) and REM sleep repeat several
times a night in cyclic manner, 4-6 times depending on the length of
sleep.
A typical cycle starts with stage I of the NREM sleep which is
followed by second, third and fourth stages.
REM sleep occupies 20-30% of total sleep and NREM sleep
occupies 60-70% (Stage I occupies 5- 10%; Stage 2 occupies 40-
50% ;Stage 3 occupies 15-20%
217. Gamma waves of REM sleep in sleep
cycle are associated with ?
a) Intense attention

b) Subconscious thinking

c) Deep subconscious thinking

d) Deep sleep

Correct Answer - A
Ans. A. Intense attention
Beta and gamma waves (20-80Hz) occur spontaneously during
REM sleep and waking and are evoked by intense attention,
conditioned responses, tasks requiring fine movements and sensory
stimulus
 218. Drug not used in prophylaxis of MD P ?
a) Haloperidol

b) Lithium

c) Carbamazepine

d) Valproate

Correct Answer - A
Ans. A. Haloperidol
Prophylactic treatment for bipolar disorder:
1. Lithium (drugof choice)
2. Carbamazepine
3. Valproate
4. Other drugs which can be used are topiramate, Lamotrigine, atypical
antipsychotics (artpiprazale, olanzapine,quetiapine, risperidone,
Clozapine) and Gabapentin.
219. Behavioral therapy is done in ?
a) Schizophrenia

b) Agoraphobia

c) Delirium

d) Neurotic depression

Correct Answer - B
Ans. B. Agoraphobia
Most important use of behavioral therapy - Phobia & OCD.
Other users are - Other anxiety disorders (including panic), Eating
disorders, Autism, ADHD, some personality disorder, sexual
dysfunctions, depression.
 220. Feature associated with mania is ?
a) Neologism

b) Perseveration

c) Echolalia

d) Flights of ideas

Correct Answer - D
Ans. D. Flights of ideas
Diagnostic criteria for mania
Three or more of the following for at least 1 week:-
1. Inflated selfvesteem or grandiosity
2. Decreased need for sleep
3. Overtalkativeness
4. Flightofvideas
5. Distractibility
6. Psychomotor agitation or Increased goal directed activities
7. Excessive involvement in pleasurable activities
221. Eating disorder with normal weight is?
a) Anorexia nervosa

b) Bulimia nervosa

c) Binge eating disorder

d) None of the above

Correct Answer - B
Ans. B. Bulimia nervosa
Anorexia nervosa - Under weight
Bulimia nervosa - Normal Weight
Binge eating disorder - Over weight.
222. Phototherapy is used in the treatment of
?
a) Anorexia nervosa

b) Seasonal affective disorder

c) Schizophrenia

d) Obsessive compulsive disorder

Correct Answer - B
Ans. B. Seasonal affective disorder
Phototherapy is primarily indicated in the treatment of seasonal
depressions.
In addition to seasonal depression, the other major indication for
phototherapy may be in sleep disorders.
223. Binge eating disorder is characterized by
?
a) Normal weight

b) Weight loss

c) Obesity

d) Self induced vomiting

Correct Answer - C
Ans. C. Obesity
Binge eating disorder (BED) is characterized by insatiable cravings
that can occur any time day or night, usually secretive, and filled with
shame.
There are no comPensatory mechanisms associated with the binge
to get rid of calories, so individulas with BED are more likely to be
overweight or obese, while patients with bulimia nervosa may be
underweight, normal weight.
224. Tricyclic antidepressants have all of the
following actions except ?
a) Anticholinergic action

b) MAO inhibition

c) Block 5-HT or NE reuptake

d) Causes sedation

Correct Answer - B
Ans- B. MAO inhibition
Tricyclic antidepressants (TCAS) are either NA + 5HT reuptake
inhibitors (e.g. - Imipramine,
Amitriptyline) or predominantly NA reuptake inhibitors (e.g.
Desipramine, nortriptyline).
TCAs are not MAO inhibitors.
Adverse effects of TCFs are : anticholinergic side effects, sedatior,
mental confusion, weakness, increase appetite & weight gain,
sweating & fine tremor, postural hypotension and cardiac
arrhythmia.
225. Which of the following is a feature of
opioid withdrawal?
a) Tremors

b) Goose flesh

c) Dry nose and mouth

d) Constipation

Correct Answer - B
Ans. B. Goose flesh
Manifestations of morphine withdrawal -
Lacrimation
Sweating
Yawning
Gooseflash(Piloerection)
Mydriasis
Anxiety & fear
Restlessness
Insomnia
Abdominal colic
Diarrhea
Dehydration
Hypertension
Palpitation
Rapid weight loss
226. Patient and Psychotherapis, both
participate actively in?
a) Psychoanalysis

b) Psychoanalytic psychotherapy

c) Psycodynamic psychotherapy

d) All of the above

Correct Answer - B
Ans. B. Psychoanalytic psychotherapy
Psychoanalytic (psychodynamic) psychotherapy is a much more
direct from of psychonalysis.
The patient and therapist sit face to face.
However therapist usually talks quite a lot, compared to silence in
psychoanalysis.
Treatment is an interactive process between the patient and
therapist.
227. The maximum DALY loss is for the
following disease -
a) Schizophrenia

b) Unipolar depression

c) Bipolar depression

d) Mania

Correct Answer - B
Ans. B. Unipolar depression
Amongst the psychiatric disorders maximum DALY loss is caused by
major depression.
228. Etheromanias refer to ?
a) Acute psychosis post ether anaesthesia

b) Ether addiction

c) Excessive ether use drug anaesthesia

d) None

Correct Answer - B
Ans, B. Ether addiction
Ether addiction or etheromania is the addiction to inhalation or
drinking of diethyl ether.
229. The term "Dementia precox" was coined
by ?
a) Freud

b) Bleuler

c) Kraepelin

d) Schneider

Correct Answer - C
Ans. C. Kraepelin
230. The term 'id' was coined by ?
a) Freud

b) Skinner

c) Wayker

d) Blueler

Correct Answer - A
Ans, A. Freud
Structural theory of mind(theid, ego and superego) was given by
sigmund freud.
231. Subcortical dementia is seen in all
except ?
a) Parkinsonism

b) Alzheimer's disease

c) Wilson's disease

d) Huntingtons chorea

Correct Answer - B
Ans.B. Alzheimer's disease
Subcortical dementia is seen in parkinsonism, Huntington's disease,
wilson's disease, progressive supranuclear palsy, idiopathic basal
ganglion calcification (Fahr's disease), thalamic lesions, multiple
sclerosis, HIV associated dementia and multisYstem atroPhY.
Alzheimer's disease causes cortical dementia.
232. Formication is seen with ?
a) Acute amphetamine intoxication

b) Chronic use of amhetamine

c) Alcohol withdrawal

d) Cannabis poisoning

Correct Answer - B
Ans. B. Chronic use of amhetamine
Magnan’s syndrome (also called formication) is seen in chronic
cocaine and chronic amphetamine abuse.
233. Hangover following alcohol consumption
can be treated with ?
a) Pyridoxine

b) Thiamine

c) Riboflavin

d) Niacin

Correct Answer - B
ANs. B. Thiamine
Thiamine helps prevent the buildup of glutarate in the brain, which
may be associated with part of the headache associated with
hangover.
234. Most commonly abused opioid -
a) Morphine

b) Diacetylmorphine

c) Oxycodine

d) Bupremorphine

Correct Answer - B
Ans, B. Diacetylmorphine
Diacetylmorphine (heroin) is the most commonly abused opioid.
235. Hallucinations are produced by?
a) Amphetamine

b) Morphine

c) Paraxetine

d) Chlorpromazine

Correct Answer - A
Ans, A. Amphetamine
Amphetamine psychosis mimic paranoid schizophrenia. There may
be deleusions and hallucinations.
236. Anxiety is ?
a) Neurosis

b) Psychosis

c) Personality disorder

d) None

Correct Answer - A
Ans., A. Neurosis
Important neurotic disorders are Anxiety disorders (Panic), Phobia
(Phobic anxiety disorder), obsessive compulsive Disorder &
Dissociative conversion disorder.
237. In depressions, there is deficiency of ?
a) 5-HT

b) Acetylcholine

c) Dopamine

d) GABA

Correct Answer - A
Ans. A. 5-HT
Depression = Decrease in serotonin and norepinephrine.
Serotonin is the most imPortant neurotransmitter in depression.
Mania= Increased of norepipherine.
238. The aminoacid derived neurotransmitter
used for treating depression is ?
a) Serotonine

b) Histamine

c) acetylcholine

d) none

Correct Answer - A
Ans. A. Serotonine
The three main neurotransmitters involved in depression are
dopamine, norepinephrine and serotonin (s-HT).
When brain Ievels of one or more neurotransmitter are low or
unbalanced, depression can result. Generally, antidepressant drugs
work by increasing production or decreasing the breakdown of one
or more of these neurotransmitters.
239. Repetitive times work doing for
premonition of ?
a) Obscession

b) Compulsion

c) Anxiety

d) None

Correct Answer - B
Ans. B. Compulsion
Repetitive irresistable thoughts > Obsession.
Repetitive purposeful behavior (work doing) > compulsion.
240. Derelation & depersonalisation seen in
which type of disorder ?
a) Dissociative disorder

b) Personality disorders

c) Mania

d) None

Correct Answer - A
Ans. A. Dissociative disorder
241. Schizoid personality disorder all are
seen except?
a) Aloof & detached

b) Prone to fantasy

c) Suspicious

d) Introspective

Correct Answer - C
Ans. C. Suspicious
Suspiciousness is seen in paranoid personality disorder.
242. Narcolepsy is due to abnormality in ?
a) Hypothalamus

b) Neocortex

c) Cerebellum

d) Medulla oblongata

Correct Answer - A
Ans. A. Hypothalamus
Narcolepsy is unique in that those who suffer from it tyPicaly fall
almost instantaneously into REM sleep.
It is thought that narcolepsy is caused by a malfunctioning of the
hypothalamus in brain.
243. Max duration of time spent is in NREM
stage ?
a) I

b) II

c) III

d) IV

Correct Answer - B
Ans. B. II
244. NREM Sleep true is ?
a) Teeth grinding

b) Narcolepsy

c) Nightmares

d) Sleep paralysis

Correct Answer - A
Ans. A. Teeth grinding
Slow wave sleep (stage 3 & 4 of NREM sleep) disorders r Sleep
walking (somnambulism), night terror (sleep terror or
pavornocturnus), Nocturnal enuresis, Bruxism (teeth grinning), and
sleep talking (somniloquy).
REM sleep events/disorder:- Nightmares, nocturnal penile
tumescence, Narcolepsy.
245. Bruxism is ?
a) Walking during sleep

b) Nocturnal enuresis

c) Grinding of teeth during sleep

d) Sleep apnoea

Correct Answer - C
Ans. C. Grinding of teeth during sleep
246. Narcolepsy, not true ?
a) Cataplexy

b) Sleep architecture normal

c) Loss of muscle tone

d) Hallucination

Correct Answer - B
Ans. B. Sleep architecture normal
There is disturbed REM sleep.
Cataplexy (sudden loss of muscle tone) is the most common
accessory symPtom.
There may be hallucinations.
247. How to differentiate between
psychological and organic erectile
dysfunction ?
a) Nocturnal penile tumescence

b) PIPE therapy

c) Sildenafil induced erection

d) Squeeze technique

Correct Answer - A
Ans. A. Nocturnal penile tumescence
One of the important method to distinguish psychogenic impotence
from organic imPotence is nocturnal penile tumsescence & early
morning erection which are preserved in psychogenic impotence but
not in organic cause of impotence.
248. Desensitization is a type of ?
a) Psychotherapy

b) Psychoanalysis

c) Behavioral therapy

d) None

Correct Answer - C
Ans.C. Behavioral therapy
Types of behavioral therapy are : - Systemic desensitization,
therapeutic graded exPosure, exPosure & response prevention,
flooding, aversion therapy, and operant conditioning.
249. Stimulant drug is given to child for ?
a) Conduct disorder

b) Speech developmental disorder

c) Pervasive disorder

d) ADHD

Correct Answer - D
Ans.D. ADHD
Stimulants (like methylphenidate, dextramphetamine) are the drugs
of choice for ADHD.
250. Klein levin syndrome ?
a) Insomnia

b) Anxiety

c) Depression

d) Hypersomnia

Correct Answer - D
Ans. D. Hypersomnia
Kleine levin syadrome or sleeping beauty syndrome is a neurological
disorder of recurring periods of excessive amounts of sleeping and
eating.
251. According to recent rounds by DSM what
code is given to psychiatric diseases in
ICD 10 ?
a) E

b) F

c) P

d) G

Correct Answer - B
Ans. B. F
ICD -10 is WHO classification for all diseases and health problems
(and not only psychiatric disorders).
ICD-10 uses alpha numeric code made of an alphabet à in contrast
DSM-IV uses numerical coding) à 'F' is for mental disorders.
There are l0 main categories denoted by digits 0 to 9.
252. Which of the following is the poor
prognostic factor for OCD?
a) Magical thinking

b) Dirt contamination

c) Pathological doubt

d) Hoarding

Correct Answer - B
Ans: B. Dirt contamination.
OCD - Clinical features & symptoms:
Contamination – Most common obsession.
Obsession of contamination → compulsive avoiding of contaminated
objects → excessive cleaning --> inability to leave there homes (due
to germs fear, shame & disgust from feces, urine, dust & germs).
Pathological doubt – 2nd most common.
Obsession of doubt → compulsive checking → most danger of
violence → forgetting to turn off the stove, or not locking the
door, some patient can travel back home several times.
Obsession of self-doubt → feeling guilty about issues
Intrusive thoughts – 3rd most common.
Intrusive obsessional thoughts without compulsion (repetitive
sexual or aggressive acts, patients obsessed of there thoughts,
may think that they suppose to report them to the police or to
make a confession to the priest .
Symmetry – 4th most common.
Need for symmetry of precision → compulsion of slowness, patient
can take an hour to eat a meal or shave their faces.
253. Semen squeeze
a) Erectile dysfunction

b) Premature ejaculation

c) Retrograde ejaculation

d) Antegrade ejaculation

Correct Answer - B
Answer: B- Premature Ejaculation
Squeeze Technique:
Variation of the Masters and Johnson method.
As a man approaches climax, either he or his partner squeezes the
tip of the penis just below the head of the penis as he approaches
the point of climax.
Pressure is held there until the sensation of impending orgasm
diminishes.
This pressure can even be held until there is some reduction in
erection.
The process can then be started over again so that over time a man
prolongs the time period until he reaches ejaculation.
Useful to treat cases of premature ejaculation
254. A patient with a history of RTA before 2
months presents with complaints of
dreams of accidents. He is able to
visualize the same scene whenever he
visits the place. Hence is afraid to go
back to the accident site. Identify the
type of disorder that he might be
suffering from?
a) Adjustment disorder

b) PTSD

c) Anxiety disorder

d) OCD

Correct Answer - B
Answer: B - Post-traumatic Stress disorder
Post-traumatic stress disorder, basically a type of anxiety
disorder
Though it shares features with other anxiety disorders, has its own
specific characteristics in presentation.
Criteria 1:
Etiologically significant trauma should be present to be classified
under this condition.
Criteria 2:
“Intentionality” or “aboutness”, an important factor in PTSD.
PTSD concerns with memory intrusion of past stressors into present.
Nightmares, flashbacks, or reliving experiences should be related to
the past experience.
Criteria 3:
Avoid a stimulus or activity that provokes the memory of past event.
255. Freud’s theory of dream includes all
except:
a) Displacement

b) Condensation

c) Symbolisation

d) Correlation

Correct Answer - D
Answer: -D - Correlation
Sigmund Freud theory of dream:
Dream work involves the process of condensation, displacement,
and secondary elaboration.
Concept of unconscious mind:
Primary assumption of Freudian theory is that the unconscious mind
governs behavior to a greater degree than people suspect.
Goal of psychoanalysis is to make the unconscious, conscious.
Theory of dream:
Freud theory of dream elaborates the state of unconscious mind with
respect to dream interpretation,
Process involved include condensation, displacement, and
secondary elaboration.
Displacement takes place when we transform the person or object
we are really concerned about to someone else.
The process of condensation is the joining of two or more
ideas/images into one.
256. Expression and consequent release of
previously repressed emotion is called
as
a) Regression

b) Dissociation

c) Abreaction

d) All of the above

Correct Answer - C
Answer: C - Abreaction
The expression and consequent release of a previously repressed
emotion, achieved through reliving the experience that caused it.
Done typically through
Hypnosis
Suggestion
257. All are habit disorder except
a) Nail biting

b) Thumb sucking

c) Temper tantrum

d) Tics

Correct Answer - C
Answer: C- Temper tantrum
Definition:
Habit disorder is a term used to describe several related disorders
linked by the presence of repetitive and relatively stable behaviour
that seem to occur beyond the awareness of the person performing
the behaviour.
The first group of habit disorder includes “Tic Disorder”
Tics are involuntary movements, sounds, or words that are sudden,
rapid, recurrent and non-rhythmic”
In addition to TD’s, body-focussed behaviours,
Recurrent hair pulling - Trichotillomania (TTM)
Skin picking (SP)
Nail biting , are included within habit disorders.
Head banging, rocking of body, teeth grinding & thumb sucking
are repetitive disorders.
Seen in children between age group of 6 months to 2 years.
Benign & self-limited.
The movements serve a means of tension discharging in children.
As children become older, they learn to inhibit some of their rhythmic
patterns.
Undue attention by parents can lead to aggravation of these
problems.
258. New name of mental retardation
according to American Association of
Mental Retardation
a) Feeble Mindedness

b) Madness

c) Intellectual disability

d) Mentally unstable

Correct Answer - C
Answer: C - Intellectual disability
Intellectual disability (ID), also known as general learning disability,
Mental retardation (MR), is a generalized neurodevelopmental
disorder characterized by significantly impaired intellectual and
adaptive functioning.
259. Now-a-days Down syndrome Is referred
to as.
a) Submental disorder

b) Oligophrenia

c) Madness

d) Mentally unstable

Correct Answer - A
Answer: A - Submental disorder
Majority of children with Down syndrome function in mild to
moderate range of mental retardation.
Down syndrome / Trisomy 21 -
Genetic disorder caused by presence of all or part of a third copy
ofchromosome 21.
Typically associated with physical growth delays, characteristic facial
features and mild to moderate intellectual disability.
260. A 55 years aged chronic alcoholic male,
presented with irrelevant talks, tremor
and sweating. He had his last drink 3
days back. What will the probable
diagnosis?
a) Delirium tremens

b) Korsakoff psychosis

c) Post-Acute withdrawal syndrome

d) Discontinuation syndrome

Correct Answer - A
Answer: A - Delirium Tremens
The description of symptoms is related to the condition “Delirium
Tremens”
Delirium Tremens / Alcohol Withdrawal Delirium (AWD):
Most severe form of ethanol withdrawal manifested by,
Altered mental status (Global confusion)
Autonomic hyperactivity (Sympathetic overdrive)
Mechanism:
Alcohol abuse affects neurotransmitter systems in brain mainly by,
Loss of GABA inhibitory mechanism - Reduces chloride ion
influx.
Alcohol acts as NMDA receptor antagonist - Withdrawal increases
the excitatory neurotransmitter.
The clinical manifestations of ethanol withdrawal are combination
effects of GABA & NMDA receptor activity.
Thus causing tremors, diaphoresis, tachycardia, anxiety & in
severe cases Seizure.
261. What differentiates delirium from
dementia?
a) Confusion

b) Difficulty in communicating

c) Hallucination

d) Sudden change

Correct Answer - D
Answer: D. Sudden change
Delirium
Also called the acute confusional state, delirium is a medical
condition that results in confusion and other disruptions in thinking
and behavior, including changes in perception, attention, mood and
activity level.
In dementia, changes in memory and intellect are slowly evident
over months or years. Delirium is a more abrupt confusion, emerging
over days or weeks, and represents a suddenchange from the
person’s previous course of dementia. Thinking becomes more
disorganized, and maintaining a coherent conversation may not be
possible.
The hallmark separating delirium from underlying dementia is
inattention. The individual simply cannot focus on one idea or task.
262. Most common DRUG causing
dependence?
a) Cannabis

b) Cocaine

c) Heroin

d) Amphetamine

Correct Answer - A
ANS - A.Cannabis
Cannabis- 9 million users,192 million users(Acc. To WHO Drug
report 2018)
Heroin (opioid derivative) -2.5 lakh users
It is estimated that 275 million people used illicit drugs, such as
cannabis, amphetamines, opioids, and cocaine, in 2016 which
translates into an annual prevalence of illicit drug use of 5.6%.
Cannabis is most used with 192 million users. Some 31 million
people who use drugs suffer from drug use disorders.-(WHO Drug
report 2018)
Ref: ARVIND ARORA review of psychiatry p:64, WHO Drug
report(2018)
263. MBBS student she was choking with
dyspnea, chest tightness, anxiety and an
impending sense of doom on
examination all systemic conditions were
found normal, then she went to
psychiatry. What is the probable
diagnosis of the condition?
a) Panic disorder

b) Depression

c) Epilepsy

d) Asthma

Correct Answer - A
ANS - A. Panic disorder
Panic disorder-severe anxiety with choking, chest pain and
palpitations.
Depression- low mood and lost interest in activities
Epilepsy-neurological disorder with whole-body fatigue and muscle
spasms
An asthma-respiratory disorder associated with symptoms of cough,
wheezing, etc
Ref: ARVIND ARORA review of psychiatry p:131
264. A patient with depression was given
Imipramine for 2 weeks. Relatives
noticed increased excitement, colourful
clothes, increased talking. What is the
next step in management?
a) Antipsychotic with Imipramine continued

b) Discontinue Imipramine and start Valproate

c) Continue Imipramine alone

d) Manage with Valproate alone

Correct Answer - A
ANS-A. Antipsychotic with Imipramine continued
The condition from which the patient above is suffering is a bipolar
disorder which includes both depression and mania.
So in order to treat both antidepressant i.e imipramine is continued
along with an antipsychotic such as phenothiazines, thioxanthenes,
etc.
Antipsychotic or valproate alone cannot reduce the depression and
Imipramine alone cannot reduce the mania.
Ref: ARVIND ARORA review of psychiatry p.no:111
265. A Patient falls down often with
behavioral change and enuresis. What is
the condition associated with him?
a) Frontotemporal dementia

b) Normal pressure hydrocephalus

c) Parkinson's disease

d) Alzheimer's disease

Correct Answer - B
Ans- B. Normal pressure hydrocephalus
Frontotemporal dementia - Associated with poor behavioral control,
decision making, and language.
Normal-pressure hydrocephalus - Associated with gait disturbance,
behavioural change, enuresis, and dementia.
Parkinson’s disease - Associated with tremor and muscular stiffness
Alzheimer’s disease-Associated mainly with memory loss and
confusion
Ref: Normal Pressure Hydrocephalus By Michael J. Fritsch,
Uwe Kehler, Ullrich Meier P .16; Oxford textbook of neurological
surgery by Adel Helmy P.94
266. A Patient with depressive symptoms for
6 months and associated with
auditory hallucinations for 2 weeks. What
is the probable diagnosis of the
condition?
a) Psychotic depression

b) Schizoaffective disorder

c) Mania depressive illness

d) Schizophrenia

Correct Answer - A
Ans- A. Psychotic depression
Psychotic depression- Depression along with psychotic symptoms
such as hallucinations, delusions, etc.
Schizoaffective disorder-Symptoms of schizophrenia and mood
disturbances occur together.
Mania depressive illness - Mania depression along with psychotic
symptoms.
Schizophrenia includes all the symptoms of schizophrenia
Ref: Arvind Arora review of Psychiatry page. 103