MCQs (Psychiatry) part I

1- A 25 years old woman with a history of schizoaffective disorders, she did not sleep, irritable, spoke nonsense, want to run away. She was by the general doctor from the emergency unit. She is six weeks pregnant. Her BP: 120/80mmgh, pulse: 102/mn. The medical illness reveals no pathology noted. Which is the following medication need to be most urgently for the treatment?

2- A 33 years old woman with a history of schizoaffective disorders is referred for assessment the obstetric team. She has just giving birth to a healthy baby and wishes to breastfeed. They are seeking immediately advice regarding her medication and the risk of breast feeding. Which is of the following medications needs to be the most urgently treated?

3- A 35 years old man with a history of schizoaffective disorders comes with urinary retention. Which of the following medications is most likely to be responsible?

4- A 32 years old woman with a diagnosis of schizoaffective disorder being treated with clozapine was found to have mild neutropenia on routine blood investigation. Which of these psychotropic drug is the most likely to have a beneficial effect in correcting this patient’s neutropenia?

5- A 65 years old woman is referred for assessment the cardiology therapist. He has a history of unstable angina and has become depressed. Which of the following antidepressants would be the most suitable for treating this patient?

6- A 44 years old woman is attending for treatment of bipolar affective disorders. A routine blood investigation reveals a raised ALP and gamma GT. Which of the following drug is the most caused this abnormality?

7- A 50 years old woman with a diagnosis of bipolar affective disorder and epilepsy has been well maintained on sodium valproate. She recently has a relapse both illnesses after a second medication was introduced. Which of these medication is the most likely responsible for her relapse?

8- Which of following statements regarding lithium is most true?

9- Which of following scenarios is lithium least likely to be effective?

10- A 35 years old man on lithium for one year for the treatment of bipolar is brought to emergency by his family due to disorientation in his mental state. Following examination give the suspect lithium toxicity. Which of the following would be the most concern?

Senario 1- A 35-year-old man, married, 2 children, accountant with no previous psychiatric history is referred by his family physician for psychiatric evaluation. The physician found that he had mild hyperlipidemia. About 2 months ago, the man began to feel very blue, with a drop in his desire to play with his children and to compete in his usual volleyball. He reports that he has lost most of his libido and is having difficulty sleeping. 1- Which of the following is the most information needed?

Senario 1- A 35-year-old man, married, 2 children, accountant with no previous psychiatric history is referred by his family physician for psychiatric evaluation. The physician found that he had mild hyperlipidemia. About 2 months ago, the man began to feel very blue, with a drop in his desire to play with his children and to compete in his usual volleyball. He reports that he has lost most of his libido and is having difficulty sleeping. 2- Which of the following is the most likely diagnosis?

Senario 1- A 35-year-old man, married, 2 children, accountant with no previous psychiatric history is referred by his family physician for psychiatric evaluation. The physician found that he had mild hyperlipidemia. About 2 months ago, the man began to feel very blue, with a drop in his desire to play with his children and to compete in his usual volleyball. He reports that he has lost most of his libido and is having difficulty sleeping. 3- Which would be the most appropriate initial treatment for this patient?

Senario 2-Serena is 27 years old, accountancy. She complaints of head cold and poor quality sleep. He blood pressure is 105/ 75 mmgh, pouls is 96/ mn. Those symptoms are likely to be symptoms of:

1- Regarding central serotonergic neurotransmission, which of the following serotonin receptors is most likely to operate presynaptic?

2- Recent evidence suggests that at least some phobias is closely associated with the emotion of:

3- Individuals experience concerns about embarrassment and is afraid that others will judge them to be anxious, weak, “crazy”, or stupid. The emotional will be:

4- A 20 years old man comes with the symptoms of the emotional excessive checking his door most of the time. Which is the symptoms below could explain his emotional?

5- Anxiety disorder is the psychological response which could be biological explain as:

6- Anxiety disorder is biological change in GABA A receptor which can be explained as:

Senario 3- Mrs S is 40 years old, married, 2 children, teacher, from Kandal province. She comes to Psychiatric OPD alone and complains of palpitation, chestiness, cold extremities and fear of stay home alone but no symptoms of panic attacks with 6 months onset. BP= 120/75 mmhg, Pouls= 102/mn and Temperature=36.5 C: 1- What is the most important family’s information you need to explore:

Senario 3- Mrs S is 40 years old, married, 2 children, teacher, from Kandal province. She comes to Psychiatric OPD alone and complains of palpitation, chestiness, cold extremities and fear of stay home alone but no symptoms of panic attacks with 6 months onset. BP= 120/75 mmhg, Pouls= 102/mn and Temperature=36.5 C: What is the most important patient’s information you need to explore:

Senario 3- Mrs S is 40 years old, married, 2 children, teacher, from Kandal province. She comes to Psychiatric OPD alone and complains of palpitation, chestiness, cold extremities and fear of stay home alone but no symptoms of panic attacks with 6 months onset. BP= 120/75 mmhg, Pouls= 102/mn and Temperature=36.5 C: 1- What is the common symptoms you need to explore:

Senario 3- Mrs S is 40 years old, married, 2 children, teacher, from Kandal province. She comes to Psychiatric OPD alone and complains of palpitation, chestiness, cold extremities and fear of stay home alone but no symptoms of panic attacks with 6 months onset. BP= 120/75 mmhg, Pouls= 102/mn and Temperature=36.5 C: 1- What is the probably diagnosis of this patient:

Senario 4- Mr. A 22 years old, single, worker, from Kg Speu province, come at psychiatric OPD by feeling of fearfulness, woke up often at midnight with fearful feeling, difficulty to concentrate with daily work and palpitation. He noted those symptoms happen in several days after saw the serious traffic accident which some people died and continue around one months. BP= 110mmhg/ 70mmhg, Pouls= 92/mn and Temperature=37 C: 1- What is the most important symptoms you need to explore:

Senario 4- Mr. A 22 years old, single, worker, from Kg Speu province, come at psychiatric OPD by feeling of fearfulness, woke up often at midnight with fearful feeling, difficulty to concentrate with daily work and palpitation. He noted those symptoms happen in several days after saw the serious traffic accident which some people died and continue around one months. BP= 110mmhg/ 70mmhg, Pouls= 92/mn and Temperature=37 C: What is the main evidence that he has psychological problem

Senario 4- Mr. A 22 years old, single, worker, from Kg Speu province, come at psychiatric OPD by feeling of fearfulness, woke up often at midnight with fearful feeling, difficulty to concentrate with daily work and palpitation. He noted those symptoms happen in several days after saw the serious traffic accident which some people died and continue around one months. BP= 110mmhg/ 70mmhg, Pouls= 92/mn and Temperature=37 C: 1- What is the main symptoms for the psychiatric diagnosis :

Senario 4- Mr. A 22 years old, single, worker, from Kg Speu province, come at psychiatric OPD by feeling of fearfulness, woke up often at midnight with fearful feeling, difficulty to concentrate with daily work and palpitation. He noted those symptoms happen in several days after saw the serious traffic accident which some people died and continue around one months. BP= 110mmhg/ 70mmhg, Pouls= 92/mn and Temperature=37 C: 1- Which is the relevant psychological symptoms could be follow by the above event:

Senario 4- Mr. A 22 years old, single, worker, from Kg Speu province, come at psychiatric OPD by feeling of fearfulness, woke up often at midnight with fearful feeling, difficulty to concentrate with daily work and palpitation. He noted those symptoms happen in several days after saw the serious traffic accident which some people died and continue around one months. BP= 110mmhg/ 70mmhg, Pouls= 92/mn and Temperature=37 C: 1- What is the probably diagnosis of this patient:

Senario 5- A 18 female patient, student, lives in Phnom- Penh, come to Psychiatric OPD and complains of palpitation, fearful, difficulty falling asleep, trembling and feeling numbness, especially crossing the bridge. 1- What is the emotional response of this patient?

Senario 5- A 18 female patient, student, lives in Phnom- Penh, come to Psychiatric OPD and complains of palpitation, fearful, difficulty falling asleep, trembling and feeling numbness, especially crossing the bridge. 1- What is the probably diagnosis of this patient?

Senario 6- Mrs. B 36 years old, married, seller, lives in Kandal province come to emergency because of suddenly emotional disturbance for 2-3 times/ month, such as: perspiring, heart palpitation, difficulty to breath in (dyspnia), difficulty to control this emotion and fear of dying for around 4 weeks. She had BP= 130/80mmgh, Pouls= 102 /mn, other medical investigation reveal no abnormality related to the medical illness noted. 1- What are the additional important symptoms you need to explore:

Senario 6- Mrs. B 36 years old, married, seller, lives in Kandal province come to emergency because of suddenly emotional disturbance for 2-3 times/ month, such as: perspiring, heart palpitation, difficulty to breath in (dyspnia), difficulty to control this emotion and fear of dying for around 4 weeks. She had BP= 130/80mmgh, Pouls= 102 /mn, other medical investigation reveal no abnormality related to the medical illness noted. 1- What is the laboratory test you need to ask for:

Senario 6- Mrs. B 36 years old, married, seller, lives in Kandal province come to emergency because of suddenly emotional disturbance for 2-3 times/ month, such as: perspiring, heart palpitation, difficulty to breath in (dyspnia), difficulty to control this emotion and fear of dying for around 4 weeks. She had BP= 130/80mmgh, Pouls= 102 /mn, other medical investigation reveal no abnormality related to the medical illness noted. What is the common feature that the patient had those symptoms:

Senario 6- Mrs. B 36 years old, married, seller, lives in Kandal province come to emergency because of suddenly emotional disturbance for 2-3 times/ month, such as: perspiring, heart palpitation, difficulty to breath in (dyspnia), difficulty to control this emotion and fear of dying for around 4 weeks. She had BP= 130/80mmgh, Pouls= 102 /mn, other medical investigation reveal no abnormality related to the medical illness noted. 1- What is the probably diagnosis of this patient:

Senario 7- Patient SK 23 years old man, live in Kandal province, single, come to psychiatric OPD because of changing behavior such as concerned every things. Especially turned on the light, refrigerator, fan and other 2 -3 times before getting out home. His behavios happen for 2 months ago. 1- What is the problem of the psychological symptoms of SK?

Senario 7- Patient SK 23 years old man, live in Kandal province, single, come to psychiatric OPD because of changing behavior such as concerned every things. Especially turned on the light, refrigerator, fan and other 2 -3 times before getting out home. His behavios happen for 2 months ago. 1- What is the probably diagnosis of SK?

Senario 8- LB is a 18 years old female, single who comes to the psychiatric out patient department because she doesn’t want to participate in team activities and shows an extreme sensitive to rejection. She is shy and needs strong guarantees of uncritical acceptance. These issue have been worse for 1year. 1- What is the most striking aspect in the clinical interviews?

Senario 8- LB is a 18 years old female, single who comes to the psychiatric out patient department because she doesn’t want to participate in team activities and shows an extreme sensitive to rejection. She is shy and needs strong guarantees of uncritical acceptance. These issue have been worse for 1year. 1- What is a pervasive pattern of LB?

3- What is the feeling of LB?

Senario 8- LB is a 18 years old female, single who comes to the psychiatric out patient department because she doesn’t want to participate in team activities and shows an extreme sensitive to rejection. She is shy and needs strong guarantees of uncritical acceptance. These issue have been worse for 1year. 1- What is the most important history you need to explore?

Senario 8- LB is a 18 years old female, single who comes to the psychiatric out patient department because she doesn’t want to participate in team activities and shows an extreme sensitive to rejection. She is shy and needs strong guarantees of uncritical acceptance. These issue have been worse for 1year. 1- What is the most important patient’s information you need to explore?

1- A 7 years old boy cannot control his own sphincter. He cannot communicate effectively with his parents and family members even simple calculation. As a result, his parents do not allow him to go to school. Which below diagnosis should he be considered?

2- A 5 years old girl seems not sensitive to parent’s sound. She rarely gives eye contact and facial expression toward her parents and others family member. She is unable to perceive responses of other around her. These patterns of behavior have been noticing since she was 12 months old. Which below diagnosis should he be considered?

3- A 5 years old child is comfortable to write letter by left hand. Even though his mother tried to encourage him but it wasn’t successful. Which is the main intervention should be done?

4- A systematic change in the mental processes that underlie all learning and performance is:

1- A 9-year-old boy has had persisting difficulties in language and interpersonal relationships since the age of 2 years, and, although he can barely read, he is able to perform arithmetic calculations at the fifth-grade level. Which it is most likely diagnosis to be associated?

2- An 11-year-old girl has become uncharacteristically and markedly withdrawn in the past 8 months, staying in her room so that she can “talk to the ghosts in the attic.” which it is most likely diagnosis to be associated?

3- An 11-year-old girl has become markedly withdrawn in the past 8 months and has complained of persisting abdominal pain and constipation, for which no organic cause has been found. Which it is most likely diagnosis to be associated?

4- A6-year-old boy is reported by his kindergarten teacher to be easily distracted, impulsive, in need of continual supervision, but not hyperactive. Which it is most likely diagnosis to be associated?

5- A 3-year-old boy spends hours rocking in a chair or spinning the blades of a toy windmill; his parents say he never cries when he falls. Which it is most likely diagnosis to be associated?

6- After a mother and her young child are playing and interacting with each other as they so often do, the mother suddenly leaves. The observer witnesses the child crying and upset, and when the mother returns, the child will not let go of her. The child is said to be

Senario 9- A 5 years old child (preschool age), studies at school for 5 months was brought by his mother with learning problem. 1- Which is the following classroom scheduling practice would be developmentally appropriate for this child?

Senario 9- A 5 years old child (preschool age), studies at school for 5 months was brought by his mother with learning problem. 1- Which of the following is an example of a specific learning disability for this child?

Senario 9- A 5 years old child (preschool age), studies at school for 5 months was brought by his mother with learning problem. 1- Which of the following is an example of an intellectual disability for this child?