C. Rationalization

D. Reaction formation

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E. Projection

2. The most accepted hypothesis explaining the biological basis for schizophrenia is:

A. The transmethylation hypothesis

B. The double bind hypothesis

C. The serotonin hypothesis

D. The dopamine hypothesis

E. The endogenous opiate hypothesis

3. A disorientation to time is characteristic of:

A. Korsakoff’s syndrome

B. An acute schizophrenia episode

C. Hypomania

D. Depressive psychosis

E. Agoraphobia

4. It is advisable during a child’s upbringing to:

A. Clearly indicate the rules for the child

B. Overlook any destructive behavior

C. Praise the child for any improvements of behaviour; well-behaved children should be praised with privileges

D. All of the above

E. None of the above

5. In attempting to teach a child to accomplish a new task one must:

A. Reinforce the child immediately f611owing completion of the task

B. Reinforce the child, with a slight delay, following completion of the task

C. Reinforce the child, after a marked delay, following completion of the task

6. When a 5-year-old child “throws a fit”. He/she is usually punished but at times the child gets what he/she wants. These fits are most likely to:

A. Become less frequent

B. Gradually cease

C. Become continuous

7. If praise, attention, and warm affection fail to act as means of reinforcement in a young schoolchild:

A. Physical punishment should be introduced

B. The child should be warned

C. Alternative means of reinforcement should be intro­duced, such as praising the child with chocolate and toys.

8. To properly develop a good behavior in a child, it is ad­visable to:

A. Punish the child

B. Reward the child

C. Both of the above

D. None of the above

9. Criticizing any undesirable behavior of a child, it is ad­visable to:

A. The best way to eliminate the undesirable behavior

B. The best way to reinforce the undesirable behavior

C. Neither of the above

10. In attempting to reinforce the behavior of a child, it is advisable to:

A. Punish the child

B. Reward the child

C. Both of the above

D. None of the above

11. Punishment is effective if:

A. It does not generate aversion towards the punishing person

B. It does not result in an escape reaction

C. It decrease the necessary of further punishment

D. It does not reinforce an aggressive behavior

E. All of the above

12. Punishment is effective if it is applied:

A. Immediately

B. With a slight delay

C. With marked delay

D. None of the above

13. In the following example, the best way to reinforce a child’s behavior is to tell him/her:

1. “Go to bed, I’ll tell you a tale!”

2. “I’ll bet you if you don’t go straight to bed!”

3. “I’m happy that you’ve put your pyjamas on!”

4. “If don’t go to bed, you can’t have breakfast in the morning!”

A. Answers 1, 2, and 3 are correct

B. Answers 1 and 3 are correct

C. Answers 2 and 4 are correct

D. All of the above

14. Which of the following statements concerning the prog­nosis of homosexually in males is correct?

A. Dreams of heterosexual activity are indicative of a better prognosis

B. The prognosis is independent of the patient’s age at the beginning of therapy

C. The prognosis is independent of any childhood experiences with the other sex

D. All of the above

E. None of the above

15. The frequency of suicide is highest in:

A. Manic-depressive illnesses

B. Schizophrenia

C. Senile depressive reactions

D. Psychotic depressive reactions

E. None of the above

16. Important mechanisms in the development of the “ego” include:

A. Condensation

B. Rationalization

C. Defense

D. Identification

17. Thumb sucking:

A. Usually ceases by the first year of age

B. May normally be observed during sleep until the age of 3

C. Is physiologically present during the first few months of life

D. Is observed in 20 percent of children above the age of 6

E. All of the above

18. The proportion of suicides which have already been pre­ceded by earlier suicide attempts is:

A. 10 percent

B. 20 percent

C. 50 percent

D. 60 percent

E. 100 percent s

19. The most common form of a learning disorder is:

A. Difficulty in spelling words

B. Difficulty in arithmetic tasks

C. A writing disorder

D. A reading disorder

E. None of the above

20. Contraindications to lithium administration include:

A. An administration in combination with chlorpromazine (Thorazine)

B. The presence of the symptoms of schizophrenia

C. Any occurrence of the symptoms of schizophrenia

D. The presence of depression

E. An administration in combination with imipramine (tofranil)

21. “Suggestion” as a form of a psychotherapy is used in:

A. Conversion disorder

B. Child psychiatry

C. Patients with a low IQ

D. All of the above

E. None of the above

22. Perception without corresponding environmental stimuli is:

A. A hallucination

B. An illusion

C. A delusion

D. Derealization

E. Depersonalization

23. The occurrence of which of the following symptoms would allow differentiation between delirium and dementia?

A. An impaired judgement

B. A memory consciousness

C. An impaired process of thinking

D. Disorientation

24. A loss of remote memory is a typical symptom of de­lirium tremens:

A. Delirium

B. Senile dementia

C. Schizophrenia

D. Korsakoff’s syndromes

E. Hysteria

25. Disorders characterized by delusions include all of the following, except

A. Affective disorders

B. Organic mental disorders

C. Paranoid disorders

D. Personality disorders

E. Schizophrenia disorders

26. Early in the psychiatric interview, it is important for the physician to:

A. Inform the patient of the fee

B. Obtain details of any past psychiatric illness

C. Let patients talk about what is bothering them

D. Obtain information about the patient’s mood

E. Record the family history

27. A typical exhibitionist:

A. Projects repressed homosexual impulses

B. Is impotent

C. Experiences loneliness and shame

D. Is older than 50

E. Is schizophrenia

28. Factors determining an adult’s gender identity include:

A. Parental attitudes about the patient’s sex during childhood

B. The availability of sexual partners

C. Endocrine factors

D. The external genitals

E. The sex chromosomes

29. Which of the following symptoms is least characteristic for schizophrenia?

A. Autistic thinking

B. Bizarre delusions

C. Hypnogogic hallucinations

D. Neologisms

E. Thought blocking

30. Physical processes involved in the development of the “superego” include all the following, except:

A. Identification

B. Internalization

C. Introjections

D. Isolation

E. Idealization

31. A “projection” mechanism is most characteristic for which of the following personality disorders?

A. An anancastic personality

B. A schizoid personality

C. A hypomanic personality

D. A paranoid personality

E. An antisocial personality

32. Procrastination, scorning the efforts or others, forgetting appointments, duties and obligations are all examples of:

A. Splitting

B. Projection

C. Regression

D. Acting out

E. Passive aggression

33. Anxiety is a common symptom of all the following con­ditions, except:

A. Hypoglycemia

B. Hypothyroidism

C. Pheochromocytoma

D. Porphyria

E. Hypocalcemia

34. The mortality rate of anorexia nervosa is:

A. Less than 1 percent

B. 5 to 15 percent

C. 20 to 30 percent

D. 35 percent

E. 50 percent

35. A “borderline personality disorder” is characterized by all of the following symptoms, except:

A. Impulsivity and an unpredictable behaviour

B. Identity disturbances

C. Mood instability

D. Withdrawal from social activity

E. Recurrent suicidal gestures and short psychotic episodes

36. A ratio of those who visited a physician within 6 months preceding their death by suicide compared to the total number of suicides is:

A. 40 percent of all suicides

B. 50 percent of all suicides

C. 60 percent of all suicides

D. 70 percent of all suicides

E. 80 percent of all suicides

37. A 56-year-old male presents with symptoms of irritability and disinterest in his daily activities. At times, he is con­fused and forgetful. His gait is unsteady. The deep ten­don reflexes are diminished. He frequently experiences tingling in his legs. The most likely diagnosis is:

A. Hypothyroidism

B. A cerebellar tumor

C. Multiple sclerosis

D. A vitamin B12 deficiency

E. Presenile dementia

38. Bleuler’s symptoms of schizophrenia (the four A’s) include all of the following except:

A. Ambivalence

B. Affective flattening

C. Apathy

D. Autism

E. Loose associations

39. A 25-year-old patient complains of hearing voices speak­ing about him and threatening him. The patient regards them as real and suffers from them. The most likely di­agnosis is:

A. Schizophrenia

B. Alcoholic hallucinations

C. Dementia

D. Hysteria

E. Debility

40. The most frequent cause of retarded development is:

A. Psychological factors

B. Hypothyroidism

C. The fetal alcohol syndrome

D. Constitutional factors

E. Addison’s diseases

41. Personality disorders are almost always:

A. Manifested during adolescence

B. Worse in old age

C. Free of genetic-biologic influences

D. Associated with good occupational functioning

E. Seen intermittently during adult life

42. A 23-year-old women complains of becoming occasion­ally anxious these occurrences are associated with ta­chycardia and excessive sweating. The condition usu­ally develops in the morning. Which of the following tests has to be performed urgently?

A. Thyroid function tests

B. Toxicological screening

C. Determination of the serum sodium level

D. Determination of the blood glucose level

E. Determination of the serum ammonia level

43. Typically, the iatrogenic psychic problems of heart dis­ease patients are caused by:

A. Negligence of the patient’s compliance

B. Excessive physical activity, as in overcompensation

C. Sustained rehabilitation and disability

D. Reaction formation

E. Suicidal ideation

44. Patients suffering from which of the following disorders are most likely to be concerned with their diseases?

A. Hypochondriasis

B. The different phobias

C. Conversion neurosis

D. Somatization syndrome (Briquet’s syndrome)

E. Aggravation

45. Symptoms of mania include all of the following, except:

A. Rapid speech

B. Creativity

C. Expansiveness

D. Homicidal ideation

E. Paranoid delusions

46. A middle-aged waited was admitted to the psychiatric ward in a drunken state. While in the ward his behavior became bizarre and he gradually became disoriented to place and time. He sometimes acted as if he was taking orders or serving dishes. On examination he usu­ally misinterpreted the antecedents and circumstances of his admission. He was unable to recall his answers to simple questions after few minutes. He denies any hal­lucinations or delusions. The patients have had no prior psychiatric disorders. His relatives haven’t found any­thing extraordinary about his behaviour. The most likely diagnosis is:

A. Alcohol withdrawal syndrome (delirium tremens)

B. Acute paranoid schizophrenia

C. Alcoholic hallucination

D. Alcohol amnesic syndrome (Korsakoff’s syndrome)

E. Manic phase (of bipolar disorder)

47. The most severe symptom of a diffuse organic mental syndrome is:

A. A lose of remote memory

B. Emotional incontinence

C. Dementia

D. Confusion

E. Intent

48. The clinical course of affective disorders is character­ized by:

A. Clinic relapsing episodes

B. A slow progression

C. A slow progression occasionally manifested by periods of acute relapses

D. Acute relapses

E. Dementia

49. The psychotherapy of schizophrenic patients includes all of the following, except:

A. A warm, open relationship aiming to promote the patient’s self esteem and education the patient about his/her disease

B. A supportive psychotherapy that focuses on resolving the problems of the patient’s in his/her everyday life

C. Setting limits on the patient’s behaviour, including the consequences of his/her violent actions.

D. Encouraging socialisation in order to build more extensive social relationships

E. Encouraging the patients to express his/her anger hostility as much as possible in the therapeutic relationship in order to reduce the intensity of these emotions outside the consulting office

50. Neurotransmitters believed to have a role in the patho­physiology of schizophrenia include all of the following, except:

A. Dopamine

B. Prostaglandin EL

C. Ascorbic acid

D. Norepinephrine

E. Serotonin

51. According to the DSM-III-R, the principle diagnostic dif­ference between schizophrenia and a schizophreniform disorder is:

A. The time of onset of the psychotic symptoms

B. The duration of the disorder

C. The nature and variability of the psychotic symptoms

D. The presence or absence of the precipitating stressor

E. The premorbid personality

52. Which of the following symptoms of schizophrenia is most likely to be acutely responsive to treatment with medi­cation and other inpatient treatment methods?

A. Auditory hallucination

B. Apathy

C. Poverty of thought content

D. Anhedonia

E. Withdrawal from social relationships

53. A 25-year-old female was brought to the hospital ward by ambulance upon examination she was febrile, con­fused, and a bizarre posture was observed. The results of blood and cerebrospinal fluid tests were normal; the patient was diagnosed as schizophrenic and is currently on chlorpromazine (Hibernal). Which is the most likely cause of her current symptoms?

A. An acute dystonic reaction

B. Akathisia

C. Tardive dyskinesia

D. A malignant neuroleptic syndrome

E. An allergic reaction to chlorpromazine

54. Statements which are characteristic for the various psychotherapeutic methods include all of the following, except:

A. These methods aim to relieve anxiety and to improve social integration

B. The theories concerning the application of the methods are specific for each of the psychiatric disorders

C. These focus on childhood events and experiences

D. Impulsiveness and resistance develop between the physician and the patient.

E. These methods all have a therapeutic aim and elicit a learning process in the patient.

55. Which of the following tests is important for the differen­tial diagnosis of organic and psychogenic impotence?

A. Monitoring of the serum gonadotropin levels over 24 hours

B. Night-time erections

C. Projective tests

D. Monitoring of any alternations in the testosterone levels

56. Negative symptoms of schizophrenia include all of the following, except

A. Flat affect

B. Auditory hallucinations

C. Lack of motivation and initiative

D. Anhedonia

E. Poverty of though content

57. A person who laughs one minute and cries the next with­out any clear stimulus is said to have:

A. A flat affect

B. Euphoria

C. A labile mood

D. A labile affect

E. Parathymia

58. Hallucinations are symptoms of:

A. Mood disorders

B. Mental disorders

C. Thought disorders abnormal perception

D. Disorders of concentration

E. Single choice questions

59. Delusion is characterized by all of the following state­ments, except:

A. Delusion is a belief that does not correspond to the experiences of the individual

B. Delusions are common symptoms of schizophrenia

C. Delusions are possible symptoms of affective disorders

D. Delusions may be symptoms of an organic mental disorder

E. Delusions may be eliminated by logical explanations

60. Which of the following is the most common cause of the cessation of sexual activity in married couples?

A. Aging

B. Marital discord

C. Physical illness

D. Cultural prohibition

E. Depression

61. Someone who exhibits pathological jealousy, is suspi­cious about being tricked, and is concerned about hidden, meanings is demonstrating signs of:

A. A schizoid personality

B. A paranoid personality

C. An antisocial personality

D. A narcissistic personality

E. None of the above

62. A shop assistant who steals goods and explains it as a compensation for his low salary is using which of the following defense mechanisms?

A. Intellectualization

B. Overcompensation

C. Rationalization

D. Substitution

E. Destruction

63. A young man develops an irrepressible urge to wash his hair several times a day which he explains as a means of protection against infection from others. He assures everyone that he feels well but he becomes extremely anxious if he cannot wash his hair. The most probable diagnosis is:

A. Automatism

B. Compulsive personality disorder

C. Hypochondriacs

D. Compulsive thoughts

E. Phobia

64. Unconscious emotions generated by a physician during psychotherapy are best described by the term:

A. Projection

B. Impulse transmission

C. Acting out

D. Identification

E. Introjections

65. A 25-year-old women who has extramarital affairs fears that her physician disapproves strongly of her behavior. The represents which of the following defense mecha­nisms?

A. Denial

B. Repression

C. Reaction formation

D. Isolation

E. Projection

66. Which of the conditions listed below is most commonly associated with a violent behavior?

A. A XYY chromosome anomaly

B. A low level of intelligence

C. An XO chromosome anomaly

D. Epilepsy

E. None of the above

67. A 15-year-old girl presents to the emergency room with severe weight loss. On examination she is cachectic, bradycardic, and hypotensive. The first course of action should be to:

A. Determine the family dynamics

B. Administer a high-protein and carbohydrate diet

C. Draw blood for a serum electrolyte determination and then start intravenous feeding

D. Arrange to have the patient admitted to the psychiatric ward

E. Prepare for electroconvulsive therapy

68. Based on the results of psychiatric epidemiological stud­ies, the most common psychiatric disorder among the general population is:

A. Depression

B. Schizophrenia

C. Alcoholism

D. Phobias

E. Dementia

69. The ratio of psychiatric disturbances among patients who seek evolution for somatic diseases is:

A. 10 percent

B. 20 percent

C. 33 percent

D. 50 percent

E. 90 percent

70. A 21-year-old women who presents with depressive symp­toms in December reports a similar episode during late autumn. The most likely mechanism of her depression involves:

A. Noradrenergic hyperactivity

B. Diminished serotonergic activity

C. Alterations in the diurnal rhythm

D. The deterioration of family relationships

E. None of the above

71. A 40-year-old woman developed delusions during the past year that her husband was having an affair with her sis­ter. She denies any hallucinations. Her emotions and her behavior correspond to the contents of the delusion. The most likely diagnosis is:

A. Acute paranoid disorder

B. Folie a deu (induced mental disorder)

C. Paranoid schizophrenia

D. Schizophrenia form disorder with a paranoid character

72. Statements characteristic for the epidemiology of mood disorders include all of the following, except.

A. The lifelong risk for bipolar disorders is 1 percent

B. Depression may be manifested at any age

C. Dysthymia (neurotic depression) is commonly associated with organic and psychiatric disorders

D. Depression is more frequently diagnosed in men than in women the risk for a major mood disorder is higher among family members of a diseased individual than among the general population

73. A 20-year-old man is admitted to the hospital. He developed hallucinations and delusions of persecution three weeks ago. He is currently agitated. Possible diagnosis, based on the DSM-III-R, includes all of the following, except:

A. Brief reactive psychosis

B. Organic mental disorder

C. Borderline personality disorder

D. Schizophrenia

E. Schizophreniform disorder

74. The most important reason for monitoring the serum lithium level is:

A. To check on the patient’s compliance

B. Because the toxic dose is very close to the therapeutic level

C. Because lithium is rapidly excreted from the body

D. Because lithium is a salt, rather than a drug

E. None of the above

75. Which of the following types of delusions is least likely to be present in an affective disorder?

A. Delusions of grandeur

B. Nihilistic delusions

C. Delusions of poverty

D. Hypochondriac delusions

E. Thought withdrawal

76. The psychosocial rehabilitation of schizophrenic patients includes all of the following, except

A. The improvement of communicative skills

B. The improvement of everyday activities such as cleaning the house, preparing a meal, and manage­ment of financial duties

C. Education in a new job in order to re-enter the workforce

D. Encouragement to somehow contribute to controlling the affliction

E. A new and refreshing activity in order to promote well-being and health in the patients

77. Dementia is characterized by all of the following symp­toms, except:

A. A gradual decline in cognitive functions (memory, orientation, abstraction)

B. Aphasia, alexia, or agraphia

C. Alterations in behavior (egocentrism, apathy)

D. A sudden decline in intellectual functions after a cerebrovascular accident

E. A decline in mental functions associated with focal neurological symptoms.

78. Catatonic motor disorder is best defined as:

A. A marked hyperactivity which is commonly violent and aimless

B. A generalised muscle rigidity

C. Stupor or mutism, without an organic cause

D. A severe psychomotor disturbance with cannot be attributed to an organic cause

79. Drugs contraindicated in acute alcohol intoxication in­clude all of the following, except:

A. Diazepam (Seduxen)

B. Phenobarbital (Sevenal)

C. Disulfiram (Anticol, Antaethyl)

D. Glunethimide (Noxyron)

E. Haloperidol

80. Common complications of alcoholism include:

A. Cerebral damage

B. Gastritis

C. Suicide

D. Polyneuropathy

E. All of the above

81. Alzheimer’s disease can be diagnosed by which of the following methods?

A. Computerized tomography

B. EEG

C. Laboratory tests

D. Lumbar puncture

E. Clinical judgement

82. Organic mental syndromes include all of the following, except.

A. Delirium

B. Dementia amnestic syndromes

C. Paranoid disorders

D. Organic hallucinations

83. Diseases that lead to mental retardation and require genetitt counseling include all of the following, except:

A. Tay-Sachs disease

B. Galactosemia

C. Phenylketonuria

D. Down’s syndrome

E. Cerebral Paralysis (Little’s desease)

84. The aim of methadone maintenance during the treat­ment of addiction is:

A. To detoxify the patient and then gradually withdraw the opiates

B. To treat the underlying psychological causes

C. To satisfy the “drug-hunger” of the addict in order to make it possible for him to deal with other aspects of his life

D. To use methadone as an opiate antagonists every questions incomplete statement has only one answer in the following combinations:

E. If the answers 1, 2 and 3 are true

F. If the answers 1 and 3 are true

G. If the answers 2 and 4 are true

H. If all the four answers are true

85. Symptoms of a perception disorder include:

A. Hallucination

B. Depersonalization

C. Illusion

D. Preservation

86. Psychological defense mechanisms are functions of the ego and:

A. Protect the self from anxiety

B. Are mobilized unconsciously

C. May be maladaptive

D. Usually require psychotherapy

87. Sleep patterns characteristic for major (endogenous) depression include:

A. Frequent nightmares followed by awakening

B. Waking up too early

C. A marked prolongation of the 3rd and 4th phases (delta phase) of sleep

D. A markedly decreased ratio of the REM phases

88. Mourning is characterized by:

A. Ideas of death

B. Weight loss

C. Insomnia

D. A duration of 2 to 6 months

89. Functions of the ego include:

A. The regulation of intrapsychic conflicts

B. The regulation of instincts

C. Reality testing

D. Developing relationships with objects

90. A complete psychic evolution should include inquiries about any:

A. Suicidal gestures

B. Homicidal ideas

C. Delusional thinking

D. Hallucinations

E. All of the above

91. Which of the following has an etiologic role in anorexia nervosa?

A. Cultural influences

B. Hypothalamic-pituitary abnormalities

C. Parental over-regulation

D. Schizophrenia

92. A 35-year-old man complains of hearing voices at night, telling him that he is a bad and guilty person. Having no other available information, which of the following con­ditions would you consider?

A. Schizophreniform

B. Personality disorder

C. Hypnagogic hallucinations

D. Organic hallucination

E. Depression psychosis

93. An agitated 24-year-old man is brought to the emergency room hand-cuffed by the police. He was found wander­ing along the main street in a confuse state. The patient does not speak and appears to be anxious. The first steps in managing this patient include:

A. Taking a history from the police

B. Having the policeman remove the handcuffs

C. Trying to talk to the patient about his impulse control

D. Administering 5 mg of haloperidol intramuscularly

94. Characteristics of a conversion (histrionic) disorder include:

A. Mimicking an organic disease

B. Expression of a psychological conflict

C. Seeking other people’s attention in order to gain their support

D. The patient’s ability to control his/her symptoms voluntarily

95. A 24-year-old man, wearing a white robe, claims to be a prophet. He wanders in the streets preaching about the end of the world. His speech in circumstantial, and he is very anxious. Select the most likely diagnosis:

A. Antisocial personality disorder

B. Schizophrenia

C. Paranoid personality disorder

D. Schizophreniform disorder

96. Patients one of the key combination

A. No sense of humor

B. An awareness of power and rank

C. They are proud about being objective

D. Excessive vanity and concern about their appearance

97. Factors indicative of a better prognosis in schizophrenia and Schizophreniform disorder include:

A. A low level of distress at the time of the symptoms

B. The lack of the precipitating stressor before the onset

C. A schizoid premorbid personality

D. The first psychotic episode occurs after the age of 35

98. Correct statements about an antisocial personality disor­der include:

A. It is identical to criminal behaviour

B. It is the male counterpart of a histrionic disorder

C. It can be controlled with antiandrogens

D. The EEG reveals cortical immaturity in this condition

99. Which of the following statements concerning suicide are correct?

A. The ratio of suicides with a fatal outcome decreases with age

B. Women die from suicide more often than men

C. A suicide can reliably be predicted by certain clinical features

D. A conversation with the patient about his / her ideals of suicide may protect the patient from being a potential victim

100. Psychotropic drugs that can cause addiction include:

A. Benzodiazepines

B. Amphetamines

C. Meprobamate

D. Butyrophenones

Answers

1.C 2.D 3.A 4.D 5.A 6.C 7.C 8.B 9.B 10.B 11.E 12.A 13.B14.A 15.C 16.D 17.E 18.D 19.D 20.B 21.D 22.A 23.C 24.D 25.D 26.C 27.C 28.A 29.C 30.D 31.D 32.E33.B 34.B 35.D 36.E 37.D 38.C 39.B 40.A 41.A 42.D 43.C 44.A 45.B 46.D 47.NO 48.A 49.E 50.C 51.B 52.A 53.D 54.C 55.C 56.B 57.D 58.D 59.E 60.B 61.B 62.C 63.B 64.B 65.E 66.B 67.C 68.C 69.C 70.C 71.C 72.D 73.D 74.D 75.E 76.C 77.B 78.C 79.E 80.E 81.E 82.D 83.E 84.C 85.A 86.A 87.C 88.E 89.A 90.E 91.A 92.E 93.B 94.A 95.C 96.A 97.D 98.D 99.D 100.A

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