First and Second Psychiatry Rotation

First and Second Psychiatry Rotation  Essay Questions: 1) A patient with schizophrenia. What are the main points to tell to his family 2) What is the management of Alcohol dependence? 3) What are the risks associated with depression?  MCQ 1) Abrupt Withdrawal of one of the following drugs causes seizures: (apparently benzodiazepine withdrawal) Answer : Lorazepam 2) Obsessive - compulsive Disorder patients Have the following characteristics Except: a)Intrusive b)Ego-Dystonic c)Resisted D) Delusional Answer : Delusional (not a feature of OCD) 3) A schizophrenic patient want to be pregnant , What is the choice that her son will have Schizophrenia : Answer : 12% 4) One of the following is Wrong about Anxiety disorder : A) Behavioral therapy used in Anxiety disorder B) more common in higher socioeconomic groups C) Anxiety prevalence rate Answer : Anxiety prevalence rate is 10% 5) One of the following is true about Impulse control disorder : A) Kleptomania is a criminal behavior B) Adults are more committed to Pyromania C) Serotonin dysregulation may be a cause D) Trichotillomania is more common in males Answer : I think (serotonin dysregualtion may be a cause) 6) Which of the following is true about adjustment disorder : A) a rare mental disorder B)Usually following a catastrophic Traumatic events C)Onset of symptoms within 3 months following trauma exposure D)Rarely seen in children or adolescent E)Conduct abnormalities are infrequent presenting feature in children 7) what is true about Bipolar disease : Answer : lithium is the main long term treatment 8) About schizophrenia : Answer : Hospitalization indicated when the patient refuse to eat or drink 9) Which of the following unlikely to be a diagnostic feature of dementia A)Impaired memory B)Fluctuating level of Consciousness C) Impaired digit span D) Difficulty dressing E)Difficulty in finding home Answer : Fluctuating level of consciousness (not a diagnostic feature of dementia) 10) All of the following are true about suicide , Except : A) Depression is associated with high rates of suicides B)Suicide is more common among men than women C)Suicide is associated with living alone D) Mild Dementia is a risk factor for suicide E)The elderly is less successful in his or her attempt at suicide Answer: The elderly is less successful in his or her attempt at suicide (false about suicide) 11) one of the following is a common side effect of SSRI's : A) Hypotension B) Dystonia C & D other SE of Antipsychotics E)Nausea Answer : Nausea (Common side effect of SSRI) 12) One of the following is a Paraphilia : Answer : Voyerurism **************** 13) A 23 year old male consulted his doctor about recurrent short episodes of depression . The doctor prescribed Fluoxetine. After 3 weeks of regular daily use of the drug the patient started to display overactivity,aggressiveness,Overtalkativness, overspending of money and started to take alcohol in exess. The most likely underying reason for the recent development was that the doctor missed to make the diagnosis of : A)Schizophrenia B)Antisocial personality disorder C) Alcohol abuse D)Bipolar disorder E)Delirium Answer : Bipolar diorder 14) A 30 year old male arrested several times during the last year by police because of driving offences. Screeing the blood reveaked alcohol in large concentration but no other substances . He gave a history of infrequent heavy drinking during weekends followed by problems with family and neighbors. After 2 weeks of quitting alcohol he displayed no withdrawal symptoms . The most appropriate diagnosis is : A) Alcohol intoxication B) Alcohol dependance C) Alcohol tolerance D)Alcohol abuse E) Alcohol Blackout Answer : Alcohol abuse 15) One of the following drugs is Antipsychotic : A) Quetiapine Rest of choices are Antidepressants Answer:Queriapine 16) one of the following is true about personality disorders : A) We can diagnose personality disorder before age 18 B) Most of the personality disorders remit after age 40 Answer : ..... 17) A 65 year old woman who has been a known patient of depression for years is brought to emergency room in a state of confusion. She was recently prescribed diazepam by her physician. On examination she is confused, distracted and has a trouble conversing. She is agitated and is disoriented in space and time. According to the attendant, she was fine a few hours ago and has never suffered a similar episode. which of the following is the most likely diagnosis : A) Dementia B) Delirium C)Schizophrenia D)Epilepsy E)Bipolar disorder Answer: Delirium 18) one of the following is true : A)Sexual identity is the self identification of gender B) Gender Identity is the Biologic identification of gender C)Gender identity usually develops by age 3 Answer : Gender Identity develops by age 3 19) what is the most appropriate statement to describe Delusion : A) False belief amenable to reasoning B) Thought content disorder C) Misinterpretation of external stimuli Answer :Thought content disorder 20) an easy question about doctor-patient relationship (I don't remember the answers) 21) All of the following is true except : Answer: stigmatisation for psychiatric illnesses occur in developing countries only 22) Depersonalization is : Answer :Feeling of unreal self 23) All of the following occurs in Narcolepsy except : A)Catalpexy B)Sleep paralysis C) Partial seizures Answer : Partial seizures (Does not occur in narcolepsy) 24) one of the following is cluster A personality disorders : A) Schizoid MCQ’s 25) Wrong about dementia = fluctuations of concentration 26) Wrong about insomnia = 2 episodes per month for diagnosis 27) Most potent on D2: Haloperidol 28) One of the following regarding suicide is wrong:  It's the 3rd leading cause of death **  Mild dementia is a risk factor 29) Indication for admission bipolar patient = not eat or drink 30) All of the following is true except : stigmatization for psychiatric illnesses occur in developing countries only 31) One of the following drugs cause seizures if withdrawn : Diazepam 32) When giving lithium for treatment you would do what test : Serum cortisol Serum creatinine ** (follow up when taking lithium) EEG 33) Social phobia is one of the following : Fearing of strangers in open places Fearing of negative evaluation ** 34) indication for hospitalization (in bipolar) : a pt who is not eating or drinking 35) Wrong about ECT: it’s always a 2nd line of treatment 36) Not given to an elderly with dementia : TCA 37) What’s wrong: kleptomania is criminal behavior 38) Risk of schizophrenia in fetus with a pregnant woman? 12% 39) What is depersonalization: Feeling of unreal self 40) How do anxiety disorders affect a pts life? ‫او بما معناه‬ 41) What is affect: Objective assessment elicited by the doctor 42) Not associated with narcolepsy? Night seizures 43) A pts came to the doctor with depression , he was given an antidepressent then a few weeks later he came again with euphoria , agitation ( cant remember exactly but they are symptoms of mania ) what’s the diagnosis? Bipolar 44) A 65 year old women appeared to be confused at the ER .. She has been prescribed benzodiazepines .. This is her first episode what's this Dementia Delirium ** 45) A manifestation on Neuroleptic Malignant Syndrome : leukocytosis 46) A patient is known to drink alcohol and have had high levels in his blood . His drinking led to family problems .. When they cut his drinking he had no withdrawal symptoms what is this called : Alcohol dependence Alcohol abuse ** Alcohol intoxication 47) Delusion =false fixed thought 48) Social phobia=fear of negative evaluation 49) About schizophrenia =it common in winter 50) What drug causes dryness of mouth : Imipramine (TCA) 51) In cases of recurrent manic attacks you can add what drug carbamazepine 52) For life time treatment of bipolar depression we use : Valproate ** Tca Ssri Combination of B and c 53) Drug that not use in Alzheimer disease = tricyclic 54) Not a side effect of an antipsychotics : hypotonia Mention 5 good prognostic factors for schizophrenia Mention the personalities included in cluster B Third Psychiatry Rotation 13/9-8/10  Multiple Choice Questions: 1) A patient has been hearing voices talking about him over the last three weeks and he can't see them, which psychopathology: Answer : Disorders of Perception. 2) A patient when asked about his level of education, talked about his school, his friends and concluded by saying, " that was the end of my schooling". Which demonstrates his answer: Answer :Circumstantiality 3) Increasing the amount of Heroin to achieve the same initial effect: Answer: Tolerance 4) Occurs in REM sleep: Answer: Loss of muscle tone 5) Which is antipsychotic: Answer: Quetiapine 6) A student who is afraid to give seminars as he is sensitive to negative evaluation, most likely diagnosis is: Answer: Social phobia 7) Definition of Delusions: Answer: False belief that is held despite evidence of contrary 8) A patient presented to ER with severe respiratory depression, on physical examination he is unresponsive with a tattoo over a large area of his body, also there are needle marks on his forearm. Which drug is the most likely involved? Answer: Heroin ( Doctor Radwan concluded that a large tattoo is sign of personality disorder or a substance abuse, and as the patient presented with severe respiratory depression that is a sign of heroin abuse ) 9) A patient admitted after an RTA, was conscious and became confused after a few hours as he started wandering in the ward thinking he is home. The diagnosis: Answer: Delirium 10) A sign of seriousness of suicidal attempt: Answer: Suicidal note ( A suicidal note means a planned suicidal attempt ) 11) Hallucination is a disorder of: Answer: Perception 12) Gender identity is normally established at age : Answer : 3 years ( 36 months ) 13) True about psychotherapy: Answer: it aims at improving client function 14) A behavior therapy technique : Answer: modeling 15) Pyromania is : Answer: Impulse to set fire 16) Characteristic of Paranoid personality disorder : Answer: Mistrust 17) Sign to alert the physician about the possibility of alcohol dependence: Answer: Peripheral neuropathy 18) Cause of reversible dementia: Answer: Alcohol induced type 19) Drug causes highest mortality among users : Answer: Heroin 20) Rate of transmitting schizophrenia to the offspring of a schizophrenia mother: Answer: 12% 21) Which brain system is correlated in schizophrenia: Answer: Dopaminergic system 22) Another question about the features of REM sleep: Answer: Maximal loss of muscle tone 23) Associated with anorexia nervosa: Answer: Amenorrhea 24) Most important in delirium management: Answer: Searching for underlying cause 25) True depression: Answer: Physical symptoms are common presentation 26) True about Doctor-Patient relationship: Answer: Medical schools should nurture patient centered relationship 27) Recurrent short episodes of depression that was treated. Three weeks late the patient started having symptoms of mania, diagnosis: Answer: Bipolar disorder 28) True about adjustment disorder: Answer: Onset of symptoms within 3 months after trauma exposure 29) True about schizophrenia: Answer: Dopamine over activity is thought to be the cause 30) Cluster A personality disorder: Answer: Schizo, Paranoid Cluster B (His Nar Anti Border) Histrionic, Antisocial, Borderline, Narcissistic  Essay Questions: of Third group : 1) Give brief description about bipolar mood disorder and its management. 2) Write the good prognostic factors in schizophrenia. 3) List the symptoms of panic attack.