Psychiatry

Topic-wise Questions
1. Identify the Neurologist shown in Photograph 3. Identify the Chart used in Psychiatry as given in
the Photograph

/e
,3
20
on

a. Eugene Bleuer
ot

b. Cloninger
a. First ranks symptoms of Schizophrenia
c. Sigmund Freud
Ph

b. Wechsler classes of IQ level

d. Jellinek
c. Stages of Psychosexual development
Ans. d. MMSE

1. c 2. Maximum score of test shown in Photograph is 

2. b  [Recent Question 2013]
3. c 4. Physician shown in the Photograph is known as
4. b Father of ………………

a. Psychiatry
b. Psychosomatic medicine
a. 13 b. 30 c. Psychotherapy
c. 47 d. 55 d. Mental Health

Explanations of the questions are given at the end of the subject

 History and General Principles of Psychiatry 669

PSYCHIATRY
5. Symbol used in Pedigree analysis (Photograph) is 8. Psychiatrist shown in Photograph coined the term
used to represent

a. Consanguineous mating
b. Divorce
c. Monozygotic twins a. Psychiatry b. Dementia praecox
d. Dizygotic twins c. Psychoanalysis d. Free principle

9. Identify the Psychiatrist shown in Photograph

 [Recent Question 2014]
6. Symbol shown in Photograph is related to ………
disorder

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,3
20
on

a. Cloninger b. Jellinek
c. Eugene Bleuer d. Sigmund Freud
ot
Ph

10. Symbol used in Pedigree analysis (Photograph) is

used to represent
a. Alcoholism b. Depression Ans.
c. Substance use disorders d. Autism 5. b
6. d
7. b
8. b
9. c
7. Identify psychiatrist shown in Photograph  10. c
 [Recent Question 2014] a. Male heterozygote b. Female heterozygote
11. c
c. Sex unknown d. Death

11. Symbol used in Pedigree analysis (Photograph) is

used to represent

a. Eugene Bleuer b. Emil Kraepelin

c. Freud d. Cloninger a. Normal female b. Deceased female
c. Adopted female d. None of the above

Explanations of the questions are given at the end of the subject

 670 History and General Principles of Psychiatry/ Psychiatric Disorders
PHOTON 20

12. 
Instrument shown in Photograph is used for 15. Identify the Child Psychiatric disorder as shown
diagnosis of in Photograph

a. Dyscalculia b. Dysphasia
c. Dyslexia d. Echolalia

a. Seizures b. Panic disorder

c. Sleep disorders d. Dementia
16. 
Fear of Situation shown in the Photograph is
known as
13. Identify the Behavioral syndrome as shown in
Photograph [Recent Question 2013]

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,3
20
on
ot
Ph

a. Anorexia nervosa a. Xenophobia b. Sitophobia

Ans. c. Algophobia d. Ichthyophobia
b. Bulimia nervosa
12. b c. Obesity
13. b d. Binge-eating disorder
14. c
15. c 17. 
Fear of Situation shown in the Photograph is
16. b known as
17. b 14. 
Fear of Situation shown in the Photograph is
known as [Recent Question 2012]

a. Xenophobia b. Algophobia a. Xenophobia b. Heliophobia

c. Anthophobia d. Claustrophobia c. Iatrophobia d. Hypnophobia

Explanations of the questions are given at the end of the subject

 Psychiatric Disorders 671

PSYCHIATRY
18. Diagnose the Underlying Skin disorder shown in 22. 
Disorder in which a person develops sexual
the Photograph [Recent Question 2012] arousal with object shown in Photograph

a. Traction alopecia b. Trichotillomania

c. Telogen effluvium d. Hirsutism
a. Sexual masochism b. Voyeurism
19. Identify the Child Psychiatric disorder as shown c. Frotteurism d. Fetischism
in Photograph

23. 
Identify disorder of childhood shown in

/e
Photograph

a. Dyscalculia b. Dysphasia
,3
c. Dyspraxia d. Echolalia
20

20. 
Delusion of Doubles (Photograph) is
characteristic of [Recent Question 2013]
on
ot
Ph

a. Tourette syndrome b. ADHD Ans.

c. Dyslexia d. Autism 18. b
19. a
a. Xenophobia b. Cotard syndrome 20. c
c. Capgras syndrome d. Othello syndrome 24. Identify fear shown in Photograph 21. b
22. d
[Recent Question 2013]
23. a
21. Identify Obsession seen in a Patient shown in 24. c
Photograph

a. Checkers b. Washers a. Agoraphobia b. Acrophobia

c. Cleaners d. None c. Claustrophobia d. Xenophobia

Explanations of the questions are given at the end of the subject

 672 Psychiatric Disorders
PHOTON 20

25. 
Fear of Situation shown in the Photograph is 28. 
Identify type of Schizophrenia shown in
known as  Recent Question 2014] Photograph [Recent Question 2013]

a. Oneiroid schizophrenia
b. Van Gogh syndrome
c. Paranoid schizophrenia
d. Hebrephrenic schizophrenia
a. Xenophobia b. Algophobia
c. Acrophobia d. Claustrophobia

/e
29. Impulse disorder associated with Photograph is

26. Identify the Mental health disorder shown in the

Photograph
,3
20
on
ot
Ph

a. Cyclothymia a. Kleptomania b. Trichotitillomania

b. Dysthymia c. Onychophagia d. Pyromania
Ans. c. Bipolar mood disorder
25. c d. Recurrent depressive disorder
26. c 30. Identify Paraphilia shown in Photograph
27. d
28. b 27. 
Identify Bleuler’s symptom of Schizophrenia
29. d shown in Photograph
30. d

a. Autism b. Affect disturbance a. Sadism b. Exhibitionism

c. Association disorder d. Ambivalence c. Sexual masochism d. Frotteurism

Explanations of the questions are given at the end of the subject

 Psychiatric Disorders 673

PSYCHIATRY
31. Identify Paraphilia shown in Photograph 34. 
Identify the Treatment technique of Sexual
disorder shown in Photograph

a. Sensate focus technique

b. Master’s & Johnson’s technique
a. Sadism b. Voyeurism c. Squeeze technique
c. Sexual masochism d. Frotteurism d. Dual-sex therapy

/e
32. 
Identify peculiar Syndrome as shown in 35. 
Identify Defence mechanism shown in
Photograph ,3 Photograph  [Recent Question 2012]
20
on
ot
Ph

a. Xenophobia b. Cotard syndrome a. Repression b. Projection Ans.

c. Capgras syndrome d. Othello syndrome c. Denial d. Distortion
31. b
32. d
33. a
33. Identify Syndrome as shown in Photograph 36. Identify Syndrome as shown in Photograph 34. c
 [Recent Question 2013] 35. b
36. c

a. Fregoli Syndrome
b. Cotard syndrome
c. Capgras syndrome a. Ganser’s Syndrome b. Cotard syndrome
d. Clerambaults’ syndrome c. Dissociative fugue d. Possession hysteria

Explanations of the questions are given at the end of the subject

 674 Psychiatric Disorders
PHOTON 20

37. Identify delusion shown in Photograph 40. Countries shown in Photograph constitute zone

known as [Recent Question 2014]

a. Nihilistic b. Doubles
c. Persecution d. Religious a. Golden crescent b. Golden triangle
c. Golden trap d. Bermuda triangle

38. Countries shown in Photograph constitute 

 [Recent Question 2013] 41. 
Identify personality disorder shown in

/e
Photograph
,3
20
on
ot
Ph

a. Borderline b. Anxious
Ans. c. Narcissistic d. Dependent
37. c a. Golden crescent
38. b b. Golden triangle
39. c c. Golden trap 42. Identify Syndrome as shown in Photograph
40. a d. Bermuda triangle
41. c
42. d

39. Identify specific Paraphilia shown in Photograph

a. Xenophobia
b. Cotard syndrome
a. Sadism b. Voyeurism c. Capgras syndrome
c. Paedophilia d. Frotteurism d. Clerambaults’ syndrome

Explanations of the questions are given at the end of the subject

 Psychiatric Disorders/Substance use Disorders 675

PSYCHIATRY
43. Personality disorder shown in Photograph 46. Most Severe Withdrawal syndrome of Dependence
shown in Photograph is

a. Histrionic b. Anxious a. Delirium tremens b. Alcoholic seizures

c. Narcissistic d. Avoidant c. Alcoholic hallucinosis d. Vomiting

44. Opioid shown in Photograph act mainly via ……… 47. Substitution therapy in Dependence of Substance

/e
receptors [Recent Question 2013] Use (Photograph) is
,3
20
on
ot
Ph

Ans.
a. mu b. kappa a. LAAM b. Naltrexone 43. a
c. delta d. sigma c. Methadone d. Clonidine 44. a
45. b
46. a
47. c
45. 
Anonymous group represented by Symbol 48. Dried leaves, flowering shoots and cut tops of the 48. b
(Photograph) is for [Recent Question 2014] Plant (Photograph) provide

a. Tobacco b. Alcohol a. Charas b. Bhang

c. Cannabis d. Cocaine c. Ganja d. Hash oil

Explanations of the questions are given at the end of the subject

 676 Substance use Disorders
PHOTON 20

49. Deterrent agents used for Substance shown in 52. Dipsomania (Photograph) is present in ………..
Photograph include all EXCEPT species of Jellinek alcohol dependence

a. Beta b. Gamma
a. Disulfiram
c. Delta d. Epsilon
b. Citrate calcium carbide
c. Acamprosate
d. Metronidazole

/e
53. Drug shown in Photograph is used as a Modality
of  [Recent Question 2012]

50. 
Method of Substance use shown in Figure is
,3
mainly used for
20
on
ot
Ph

a. Opioid substitution therapy

b. Smoking cessation agent
Ans. c. Alcohol deterrent agent
d. DOC for depression
49. c
50. d
51. d
a. Ganja b. Bhang
52. d 54. Plant shown in Photograph is used for production
c. Charas d. Cocaine
53. c of which recreational drug?
54. b

51. Body fluid level of Substance Use at which Coma

occur ….. [Recent Question 2013]

a. 50-100 mg% b. 100-200 mg% a. Cocaine b. Opium

c. 200-300 mg% d. >350 mg% c. LSD d. Amphetamine

Explanations of the questions are given at the end of the subject

 Substance use Disorders/Psychiatric Treatment 677

PSYCHIATRY
55. Plant shown in Photograph is used for production 58. Indication for Treatment shown in Photograph
of which recreational drug?

a. Cocaine b. Cannabis a. Mild depression

c. LSD d. Heroin b. Severe depression
c. Severe refractory depression with suicidal ten-
dency
d. Depression during Pregnancy
56. ‘Flash backs’ as shown in Photograph are seen in

/e
,3 59. Peripheral blood smear condition mainly occur
due to exposure to
20
on
ot
Ph

a. LSD b. Cocaine Ans.

c. Opiate d. Amphetamine
55. a
56. a
a. Thioridazine b. Haloperidol 57. d
57. 
Laboratory marker of Condition shown in c. Chlorpromazine d. Clozapine 58. c
Photograph include 59. d
60. c
60. MC Antipsychotic drugs leading to Side-effect of
shown in Photograph

a. Gamma glutamyl transferase

b. Mean corpuscular volume
c. Alkaline phosphatase a. Haloperidol b. Chlorpromazine
d. All of the above c. Thioridazine d. Clozapine

Explanations of the questions are given at the end of the subject

 678 Psychiatric Treatment
PHOTON 20

61. ECG changes and Tachycardia are seen maximum 64. Skin changes shown in Photograph occur due to
with which Antidepressant drug? exposure to

a. Amitriptyline
b. Fluoxetine
c. Trazodone
d. Doxepin

62. 
Prolongation of Segment shown in ECG
Photograph occur due to a. Thioridazine
b. Haloperidol

/e
c. Chlorpromazine
d. Clozapine
,3
20

65. Skin changes shown in Photograph occur due to

exposure to
on

a. Thioridazine
b. Haloperidol
c. Chlorpromazine
ot

d. Clozapine
Ph

63. Changes in Retina s shown in Photograph occur

Ans.
due to
61. a
62. a
63. a
64. c
65. c

a. Thioridazine
b. Haloperidol
c. Chlorpromazine
a. Thioridazine b. Haloperidol d. Clozapine
c. Chlorpromazine d. Clozapine

Total Qs: 65, Topic-wise Qs: 65

Answers & Explanations
1. Ans. (c)  Sigmund Freud 4. Ans. (b)  Psychosomatic medicine
[Ref. Kaplan & Sadock, 11/e p15] [Ref. Niraj Ahuja, 7/e p242]

CONTRIBUTIONS OF SIGMUND FREUD (1856-1939) •• Alexander, Franz (1891-1964) (Photograph) is sometimes

(PHOTOGRAPH) known as Father of psychosomatic medicine
•• Founding Father of Psychoanalysis •• He proposed that specific psychosomatic illnesses are
•• Theory of Psychosexual development associated with specific conflicts
•• Id, Ego, Superego
5. Ans. (b)  Divorce
•• Dram interpretation
•• Free association [Ref. Kaplan & Sadock, 11/e p74]
•• A pedigree analysis is conducted in multi generations of the
families
Topper’s edge..................................................
•• Symbols used in pedigree analysis:
•• Eugene Bleuer: “Cardinal symptoms” of schizophrenia.

2. Ans. (b)  30
[Ref. Kaplan & Sadock, 11/e p233]

MINI-MENTAL STATUS EXAMINATION (PHOTOGRAPH)

•• Description: A sensitive, valid and reliable 30-point

/e
questionnaire that is used extensively in clinical and
research settings to measure cognitive impairment including ,3
orientation, attention, memory, construction, & language
•• Scoring pattern:
ƒƒ Highest score: Score 30
20
ƒƒ Normal cognition: Score > 27
ƒƒ MMSE Test components: [Mnemonic: COOLAR3]
on

Category Possible points

Complex commands 6
ot

Orientation to time 5
Orientation to place 5
Ph

6. Ans. (d)  Autism

Language 2
[Ref. Postgraduate Psychiatry by Vyas & Ahuja, 3/e, p. 968, 969]
Attention and calculation 5
AUTISM
Recall 3 •• A neurodevelopmental disorder characterized by impaired
Registration 3 communication & social interaction & repetitive behavior
Repetition 1 •• Autism symbol (Photograph):
ƒƒ The puzzle pattern of the ribbon reflects the complexity
of the autism spectrum
3. Ans. (c)  Stages of Psychosexual development ƒƒ The different colors and shapes represent the diversity of
[Ref. Niraj Ahuja, 7/e p207, 208] the people and families living with the condition
ƒƒ The brightness of the ribbon signals hope that through
•• Freud enunciated his theory of infantile sexuality & described
increased awareness of autism, and through early
the psychosexual stages of development (Photograph)
intervention and access to appropriate services/supports,
•• According to Freud, children’s pleasure-seeking urges
people with autism will lead full lives able to interact with
(governed by the id) are focused on a different area of the
the world on the own terms
body, called an erogenous zone, at each of the five stages of
development 7. Ans. (b)  Emil Kraepelin
ƒƒ Phase I. Oral Phase(Birth-1½ years)
ƒƒ Phase II. Anal Phase (1-3 years) [Ref. Kaplan & Sadock, 11/e p300, 15]
ƒƒ Phase III. Phallic/ Oedipal Phase (3-5 years) •• Kraepelin (Photograph) translated “Demence precoce”
ƒƒ Phase IV. Latency Phase (5-12 years) into “Dementia precox”, a term that emphasized cognition
ƒƒ Phase V. Genital Phase (12 years – later) (dementia) & early onset (precox) of the disorder
 680 Answers & Explanations
PHOTON 20
Topper’s edge..................................................
•• Eugene Bleuler coined the term Schizophrenia, which
replaced dementia precox
•• Sigmund Freud is a Founder of Classic Psychoanalysis
•• Claude Robert Cloninger, M.D. (born April 4, 1944) is an
American psychiatrist and geneticist noted for his research
on the biological, psychological, social, and spiritual
foundation of both mental health and mental illness
8. Ans. (b)  Dementia praecox
[Ref. Kaplan & Sadock, 11/e p300]
DEMENTIA PRAECOX
•• A term coined by Morel in to describe those psychoses
(“vesania’’) with a poor prognosis, i.e., those ending in
deterioration (dementia) and incurability
•• Kraepelin (Photograph) translated “Demence precoce”
into “Dementia precox”, a term that emphasized cognition
(dementia) & early onset (precox) of the disorder
9. Ans. (c)  Eugene Bleuer
[Ref. Kaplan & Sadock, 11/e p15]
•• Eugene Bleuer (Photograph) described “Cardinal symptoms”
of schizophrenia.
20
10. Ans. (c)  Sex unknown
[Ref. Kaplan & Sadock, 11/e p74]
on
11. Ans. (c)  Adopted female
ot
[Ref. Kaplan & Sadock, 11/e p74]
Ph
12. Ans. (b)  Panic disorder
[Ref. Kaplan & Sadock, 11/e p392]
•• An acute attack of anxiety accompanied by feelings of
impending doom is know as panic disorder
•• DSM-5 criteria of panic disorder include 13 features out
of which should have palpitation, pounding of heart or
accelerated heart rate, sweating, sensations of SOB etc.
•• Hence patients of panic attack should under go ECG to rule
out other medical conditions
Topper’s edge..................................................
•• Holter monitoring (Photograph) is a continuous 24- or 48-
hour ECG recording to evaluate the type and amount of
irregular heartbeats during regular activities, exercise and
sleep
13. Ans. (b)  Bulimia nervosa (Feature: Self-induced vomiting)
[Ref. Niraj Ahuja, 7/e p144]
BULIMIA NERVOSA
•• An eating disorder characterized by patients have intense
fear of becoming obese, persistent preoccupation with
eating, & an irresistible craving for food
•• There are episodes of overeating in which large amount of
food is consumed within a short period of time
•• Counter effects include: Self induced vomiting
(Photograph), purgative abuse, periods of starvation, use of
drugs such as appetite suppressants
14. Ans. (c)  Anthophobia
[Ref. Kaplan & Sadock, 11/e p1408, 1409, 1418]
•• Anthophobia: An abnormal and persistent fear of flowers
(Photograph)
Topper’s edge..................................................
•• Xenophobia: Abnormal fear of strangers
•• Algophobia: Dread of pain
•• Claustrophobia: Abnormal fear of closed places
/e
15. Ans. (c) Dyslexia (Features: Developmental reading
,3
disorder, Impaired writing and spelling)
[Ref. Kaplan & Sadock, 11/e p1411]
•• Dyslexia: Specific learning disability syndrome involving an
impairment of previously acquired ability to read and write
(Photograph); unrelated to person’s intelligence
Topper’s edge..................................................
•• Dyscalculia: Difficulty in performing calculations
•• Dysphasia: Difficulty in comprehending oral language or in
trying to express verbal language
•• Echolalia: Psychopathological repeating of words or phrases
of one person by another, tends to be repetitive & persistent.
Seen in schizophrenia, especially in catatonic types
16. Ans. (b)  Sitophobia
[Ref. Niraj Ahuja, 7/e p142]
ANOREXIA NERVOSA
•• Loss of appetite amounting to a disgust or distaste for food
and a fear of gaining weight
•• Patient has intense concerns about the body habitus and a
phobia about being overweight or gaining weight
•• Its an body-image disturbance (Photograph)
•• Decreased appetite resulting from food aversion is known
as Sitophobia
17. Ans. (b)  Heliophobia
[Ref. Kaplan & Sadock, 11/e p1418]
•• Heliophobia: Fear of sunlight (Photograph)
 Answers & Explanations
Topper’s edge..................................................
•• Xenophobia: Abnormal fear of strangers
•• Iatrophobia: Fear of going to doctor or doctors.
•• Hypnophobia: Fear of sleep or being hypnotized
18. Ans. (b)  Trichotillomania
[Ref. Kaplan & Sadock, 11/e p431]
TRICHOTILLOMANIA (COMPULSIVE-HAIR PULLING)
•• A hair pulling disorder (Photograph) characterized by hair
pulling leading to variable hair loss that may be visible to others
•• Example of habit & impulse control disorder
•• Management of impulse control disorder includes Aversion
therapy, CBT (cognitive behavior therapy), individual
psychotherapy occasionally pharmacotherapy
19. Ans. (a)  Dyscalculia
[Ref. Kaplan & Sadock, 11/e p1411]
•• Dyscalculia: Difficulty in performing calculations
(Photograph)
Topper’s edge..................................................
20
•• Dysphasia: Difficulty in comprehending oral language or in
trying to express verbal language
•• Dysprexia: Developmental coordination disorder (DCD),
on
also known as developmental dyspraxia or quite simply
dyspraxia, is a chronic neurological disorder beginning in
childhood that can affect planning of movements and co-
ot
ordination as a result of brain messages not being accurately
transmitted to the body
Ph
•• Echolalia: Psychopathological repeating of words or phrases
of one person by another, tends to be repetitive & persistent;
Seen in schizophrenia, especially in catatonic types
20. Ans. (c)  Capgras syndrome
[Ref. Kaplan & Sadock, 11/e p335, 336, 1418 & Niraj Ahuja, 7/e p84]
•• Capgras syndrome: Delusion in Capgras syndrome is
the belief that a familiar person has been replaced by an
imposter (Photograph)
Topper’s edge..................................................
•• Cotard syndrome or Nihilistic delusion: patients in this
syndrome complains of having lost not only possession,
status & strength but also their heart, intestines, blood
•• Xenophobia: Abnormal fear of strangers
•• Othello syndrome: when the content of delusion is
predominantly jealousy (infidelity) involving spouse, it is
called as Othello syndrome or Conjugal paranoia
21. Ans. (b)  Washers
[Ref. Niraj Ahuja, 7/e p95, 96]
681
WASHERS
PSYCHIATRY
•• MC type of Obsessive compulsive disorders
ƒƒ Obsession is of contamination of dirt, germs, body
excretions
ƒƒ Compulsion is washing of hands or whole body,
repeatedly many times a day (Photograph)
•• It usually spreads on to washing clothes, washing bathroom,
bedroom, door knobs & personal articles, gradually
•• The person tries to avoid contamination but is unable to, so
washing becomes ritual
Topper’s edge..................................................
CHECKERS
•• Person has multiple doubts
•• Compulsion is checking repeatedly to remove doubt
22. Ans. (d)  Fetischism
[Ref. Niraj Ahuja, 7/e p125, 126]
•• Fetishism: In fetishism, the sexual arousal occurs either
/e
solely or predominantly with a non living object, which is
usually intimately associated with the human body
,3 •• The Fetish objects may include gloves, shoes, bras,
underpants, stockings etc.
Topper’s edge..................................................
•• Sexual Masochism: This is just reverse of sexual sadism;
here the person is aroused by physical or psychological
humiliation, suffering or injury inflicted on self by others
ƒƒ Sexual masochism & sexual sadism are classified as
sadomasochism in ICD-10
•• Voyeurism: This is persistent or recurrent tendency to
observe unsuspecting persons (usually of other sex) naked,
disrobing or engaged in sexual activity
•• Frotteurism: This is persistent or recurrent involvement in
the act of touching & rubbing against an unsuspecting, non
consenting person (usually of other sex)
•• Paedophilia: Is a persistent or recurrent involvement of
an adult (age>16 years & at least 5 years older than child)
in a sexual activity with pre-pubertal children, either
heterosexual or homosexual
23. Ans. (a)  Tourette syndrome
[Ref. Niraj Ahuja, 7/e p168]
TIC DISORDER
•• Presence of tics, tic is an abnormal involuntary movement
(AIM) which occurs suddenly, repetitively, rapidly & is
purposeless in nature
•• Tourette’s disorder is typically characterized by multiple
motor, vocal tics, duration of more than 1 year
24. Ans. (c)  Claustrophobia
[Ref. Kaplan & Sadock, 11/e p1418]
•• Claustrophobia: Abnormal fear of closed places
(Photograph)
 682 Answers & Explanations
PHOTON 20
Topper’s edge..................................................
•• Acrophobia: Fear of heights
•• Xenophobia: Fear of strangers
•• Agoraphobia: Agoraphobia is an anxiety disorder that
often develops after one or more panic attacks; symptoms
include fear and avoidance of places and situations that
might cause feelings of panic, entrapment, helplessness or
embarrassment
25. Ans. (c)  Acrophobia
[Ref. Kaplan & Sadock, 11/e p1418]
•• Acrophobia: Fear of heights
Topper’s edge..................................................
•• Algophobia: An abnormal and persistent fear of pain that is
far more powerful than that of a normal person
26. Ans. (c)  Bipolar mood disorder
[Ref. Niraj Ahuja, 7/e p73]
•• Photograph on the plate depicts clinical picture of bipolar
disorder
•• This disorder is earlier known as manic depressive psychosis
20
(MDP), is characterized by recurrent episodes of mania and
depression in same patient in different times
on
27. Ans. (d)  Ambivalence
[Ref. Niraj Ahuja, 7/e p246]
ot
•• Ambivalence: Inability to decide for or against, due to co-
existence of two opposing impulses for the same thing at the
Ph
same time in the same person (Photograph)
Topper’s edge..................................................
•• Affect: The outward expression of the immediate experience
of an emotion at given time
28. Ans. (b)  Van Gogh syndrome
[Ref. Niraj Ahuja, 7/e p60, 61]
VON GOGH SYNDROME (PHOTOGRAPH)
•• Dramatic self-mutilation
•• Occurring in schizophrenia has been called as von Gogh
syndrome, after the name of the famous painter Vincent van
gogh who has cut ear at the active phase of illness
Topper’s edge..................................................
•• Oneiroid schizophrenia: An acute onset, clouding of
consciousness, disorientation, dream-like state, and
perceptual disturbances with rapid shifting.
•• Pfropf schizophrenia: Schizophrenia occurring in presence of
mental retardation.
29. Ans. (d)  Pyromania (Impulse: To start/ set up fire)
[Ref. Niraj Ahuja, 7/e p119]
PYROMANIA (PHOTOGRAPH)
•• Pathological fire-setting
•• Characterized by two or more acts of fire setting without an
apparent motive
•• There is an intense urge to set fire to objects, with a feeling
of tension before the act & a sense of relief afterwards
30. Ans. (d)  Frotteurism
[Ref. Niraj Ahuja, 7/e p125, 126]
•• Frotteurism: This is persistent or recurrent involvement in
the act of touching & rubbing against an unsuspecting, non
consenting person (usually of other sex) (Photograph)
31. Ans. (b)  Voyeurism
[Ref. Niraj Ahuja, 7/e p125, 126]
•• VOYEURISM (Photograph)
•• This is persistent or recurrent tendency to observe
/e
unsuspecting persons (usually of other sex) naked, disrobing
,3 or engaged in sexual activity.
•• Practice of spying on others’ intimate life
32. Ans. (d)  Othello syndrome
[Ref. Niraj Ahuja, 7/e p84]
•• Othello syndrome: When the content of delusion is predom-
inantly jealousy (infidelity) involving spouse (Photograph),
it is called as Othello syndrome or Conjugal paranoia.
33. Ans. (a)  Fregoli Syndrome
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e p469]
FREGOLI SYNDROME
•• The belief is that certain unfamiliar person or people may in
reality be another familiar in disguise, in order to influence
the behavior (Photograph)
•• Delusion of Doubles
Topper’s edge..................................................
•• Fregoli’s syndrome is described as ‘hyperidentificaton’
where as Capgras syndrome is ‘hypoidentification’
34. Ans. (c)  Squeeze technique
[Ref. Niraj Ahuja, 7/e p131]
SQUEEZE TECHNIQUE
•• Semen’s technique
•• Used in treatment of premature ejaculation
•• Female partner is asked to manually stimulate the penis
causing erection
•• When the male partner experiences “ejaculatory
inevitability”, the female partner “squeezes” the penis on the
coronal ridge thus delaying ejaculation (Photograph)
 Answers & Explanations 683

35. Ans. (b)  Projection •• Golden crescent indicates illicit opium production areas

PSYCHIATRY
•• India, surrounded on both sides by infamous routes of illicit
[Ref. Kaplan & Sadock, 11/e p161] transport (Iran-Afghanistan-Pakistan) called as Golden
PROJECTION crescent (Photograph)
•• Perceiving & reacting to unacceptable inner impulses
41. Ans. (c)  Narcissistic
& their derivatives as thought they were outside the self
(Photograph) [Ref. Kaplan & Sadock, 11/e p752]
•• On a psychotic level, this takes the form of frank delusions
NARCISSISTIC PERSONALITY DISORDER
about external reality, usually persecutory, includes both •• Characterized by heightened sense of self importance,
perception of one’s own feelings & those of another with lack of empathy, and grandiose feelings of uniqueness
subsequent acting on perception, impulses may derive from (Photograph)
id or super ego •• Excessive excessively preoccupied with personal adequacy,
power, prestige & beauty
36. Ans. (c)  Dissociative fugue
•• Underneath however, their self-esteem is fragile &
[Ref. Kaplan & Sadock, 11/e p295] vulnerable to even minor criticism
DISSOCIATIVE FUGUE 42. Ans. (d)  Clerambaults’ syndrome
•• Characterized by sudden travel away from home associated
[Ref. Kaplan & Sadock, 11/e p334]
with partial or complete memory loss about one’s identity
(Photograph) “DE CLERAMBAULT SYNDROME” OR “PSYCHOSE

/e
•• Person suddenly, without planning or warning, travels far PASSIONELLE” ,
from home or work and leaves behind a past life •• Patient has the delusional convection that other person,

37. Ans. (c)  Persecution (Feature:)

,3 usually of higher status, is in love with him or her
(Photograph)
•• A person’s delusional belief that person is in love with
20
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e, p226]
another and love is reciprocated
DELUSION OF PERSECUTION •• Usually seen in Erotomania
•• False & irrational beliefs that they are being cheated, harassed,
on

poisoned, or conspired against them (Photograph) 43. Ans. (a)  Histrionic

•• Peron’s false belief that others are conspiring to harm/ kill [Ref. Niraj Ahuja, 7/e p116]
him
ot

HISTRIONIC PERSONALITY
38. Ans. (b)  Golden triangle •• Features include self-dramatization & exaggerated
Ph

expression of emotions (Photograph), suggestibility,

[Ref. Kaplan & Sadock, 11/e p660 & Niraj Ahuja, 7/e p43]
shallow and labile affectivity, continual attention seeking
•• Golden triangle indicates illicit opium production areas attitude, inappropriate seductiveness, and over concern
•• India, surrounded on both sides by infamous routes of illicit with physical attractiveness
transport (Burma-Thailand-Laos) namely Golden Triangle
(Photograph) 44. Ans. (a)  mu
[Ref. Kaplan & Sadock, 11/e p1367]
39. Ans. (c)  Paedophilia
•• Morphine (Photograph) is a prototype opioid acts by
[Ref. Niraj Ahuja, 7/e p125, 126] agonistic activity on mu receptors. Opioids commonly
•• Paedophilia: Is a persistent or recurrent involvement of cause delirium & hallucinations
an adult (age>16 years & atleast 5 years older than child)
in a sexual activity with prepubertal children, either 45. Ans. (b)  Alcohol
heterosexual or homosexual (Photograph) [Ref. Kaplan & Sadock, 11/e p1274]

SOBRIETY CIRCLE & TRIANGLE SYMBOL

Topper’s edge..................................................
•• Protection of Children from Sexual Offences Act (POCSO Act)
2012 was formulated in India to effectively address sexual
abuse and sexual exploitation of children
40. Ans. (a)  Golden crescent
[Ref. Kaplan & Sadock, 11/e p660 & Niraj Ahuja, 7/e p43]
(PHOTOGRAPH)
•• Symbol used by Alcoholics Anonymous
•• The equilateral triangle represents the three-part answer
- unity, recovery and service - to a three-part disease -
physical, mental and spiritual, while the circle represents
wholeness or oneness
ƒƒ The body should be triangular, stable, the mind circular,
open
 684 Answers & Explanations

ƒƒThe triangle represents the means for generation of good •• Can be administered orally, intranasal, by smoking (free
PHOTON 20

energy, and is the most stable physical posture
•• The circle symbolizes serenity and perfection, and the
source of unlimited potential
•• Together they represent the perfect union of mind and body
46. Ans. (a)  Delirium tremens
[Ref. Kaplan & Sadock, 11/e p1410)
•• Acute & sometimes fatal reaction to withdrawal from
alcohol (Photograph), usually occurring 72 to 96 hours
after cessation of heavy drinking; distinctive features are
marked autonomic hyperactivity, usually accompanied
with tremors, hallucinations, illusions & delusions called as
alcohol withdrawal with perceptual disturbance
basing) or parenteral, depending on preparation available
•• Snorting (Photograph): Inhale (the powdered form of an
illegal drug, especially cocaine) through the nose
•• A typical pattern of “Cocaine runs” (binges), followed by
cocaine “Crashes”
Topper’s edge..................................................
•• Sometimes cocaine is used in combinations with opiates like
heroine called as “Speed ball”
51. Ans. (d)  >350 mg%
[Ref. Niraj Ahuja, 6/e p40]

47. Ans. (c)  Methadone ALCOHOL INTOXICATION (PHOTOGRAPH)

[Ref. Kaplan & Sadock, 11/e p664] Blood level of Signs of intoxication
•• Methadone is a synthetic narcotic that substitutes for heroin alcohol
& can be taken orally 150-200 mg% CNS depression (after brief excitation)
•• Methadone can be used to control withdrawal symptoms of Increased reaction time, slow thinking, poor

/e
opioid (Photograph) use motor control
,3 Dysarthria, ataxia, poor motor control
48. Ans. (b)  Bhang Uninhibited behaviour
Amnesia/ black-outs
[Ref. Niraj Ahuja, 7/e p45]
20
300-450 mg% Drowsiness
•• Cannabis (Photograph) is derived from the hemp plant, Respiratory depression
cannabis sativa, which has several varieties Coma
•• Cannabis: Grass, hash or hashish, marihuana
400-800 mg% Death
on

•• Pistillate form of female plant is more important in cannabis

production
52. Ans. (d)  Epsilon
ot

[Ref. Niraj Ahuja, 7/e p35, 36]

Topper’s edge..................................................
Ph

•• According to Jellinek, there are five species of alcohol

CANNABIS PREPARATIONS
•• Hashish/ Charas: Resinous exudate from flowering tops of
cultivated plants
•• Ganja: Small leaves and inflorescence of highly cultivated
plants
•• Bhang: Dried leaves, flowering shoots, cut tops of
uncultivated plants
•• Hash oil: Lipid soluble plant extract
49. Ans. (c)  Acamprosate
[Ref. Niraj Ahuja, 7/e p42]
•• Acamprosate (the calcium salt of N-acetyl-homotaurinate)
interacts with NMDA receptor mediated glutamatergic
neurotransmission in the various brain regions & reduces
calcium influx through the voltage operated channels
•• Acamprosate, Naltrexone & SSRI’s are used as anti craving
agents in alcohol dependency (Photograph)
dependence (Photograph) on the basis of patterns of use
ƒƒ Alpha: Excessive & inappropriate drinking to relieve
physical/emotional pain, no loss of control, ability to
abstain present
ƒƒ Beta: Excessive & inappropriate drinking, physical
complications (eg., cirrhosis, gastritis & neuritis) due
to cultural drinking patterns & poor nutrition; No
dependency
ƒƒ Gamma: Also called as Malignant alcoholism. progressive
course physical dependence with tolerance & withdrawal
symptoms; Psychological dependence, with inability to
control drinking
ƒƒ Delta: Tolerance, inability to abstain, withdrawal
symptoms, social disruption is minimal, the amount of
alcohol consumed can be controlled
ƒƒ Epsilon: Dipsomania (compulsive-drinking), spree-
drinking

50. Ans. (d)  Cocaine 53. Ans. (c)  Alcohol deterrent agent
[Ref. Niraj Ahuja, 7/e p46,47] [Ref. Niraj Ahuja, 7/e p39]

COCAINE ALCOHOL DETERRENT AGENTS

•• An alkaloid derived from Coca Bush, Erythroxylum Coca •• Sulfonylureas
•• Street name: Crack •• Cephalosporins
 Answers & Explanations 685
•• Metronidazole 59. Ans. (d)  Clozapine

PSYCHIATRY
•• Calcium citrate carbide
•• Animal charcoal [Ref. Niraj Ahuja, 7/e p66]
•• Griseofulvin •• Clozapine, atypical antipsychotic available in the Indian
•• Disulfiram (Photograph) market
•• Copranusatramentarius •• It is an effective drug but can cause agranulocytosis
(Photograph) & seizures as side effects, used with caution
Mnemonic with regular WBC, neutrophil count
Sachin Can Make Cricket A Great Deadly Contest] 60. Ans. (c)  Thioridazine
[Ref. Kaplan & Sadock, 11/e p284]
54. Ans. (b)  Opium
THIORIDAZINE
[Ref. Niraj Ahuja, 7/e p42, 43] •• Impaired vision can occur with the high doses (over 800 mg
•• Dried exudate obtained from unripe seed capsules of per day)
Papaver somniferum (Photograph) has been used & abused •• Can also cause pigmentary retinopathy, mydriasis
•• Most important dependence producing derivatives are (Photograph)
Morphine & Heroine
•• Plant shown in color plate is Papaver somniferum 61. Ans. (a)  Amitriptyline
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e p1368]
55. Ans. (a)  Cocaine
•• CVS adverse effects of Amitriptyline (Tryptomer) are

/e
[Ref. Niraj Ahuja, 7/e p46,47] postural hypotension, dizziness, hypertension, sinus
•• Cocaine is an alkaloid derived from Coca Bush, ,3 tachycardia, premature atrial or ventricular beats, anti
Erythroxylum Coca (Photograph) arrhythmic effect, myocardial depression, pedal edema,
ST-segment depression, T-wave flattened or inverted, QRS-
20
56. Ans. (a)  LSD prolongation
[Ref. Niraj Ahuja, 7/e p49, 50] 62. Ans. (a)  Thioridazine
LSD – LYSERGIC ACID DIETHYLAMIDE
on

[Ref. Kaplan & Sadock, 11/e p274]

•• A powerful hallucinogen
•• Thioridazine has been associated with QTc interval in a
•• It is related to psychedelic compounds found in morning
dose related manner
ot

glory seeds •• Prolongation of the QTc interval (Photograph) has been

•• A common pattern of LSD use is “trip” (occasional use
associated with Torsade’s de pointes arrhythmias
Ph

followed by a long period of abstinence)

•• Acute LSD intoxication presents with an acute panic 63. Ans. (a)  Thioridazine
reaction, known as “bad trip”
•• Sometimes, there is a spontaneous recurrence of the LSD [Ref. Kaplan & Sadock, 11/e p284]
use experience in a drug free state described as “flash backs” •• Thioridazine impaired vision can occur with the high doses
(Photograph) (over 800mg per day) can also cause pigmentary retinopathy
•• No withdrawal syndrome has been described with LSD (Photograph)

57. Ans. (d)  All of the above
[Ref: Kaplan & sadock’s-synopsis of psychiatry, 11/e, p621]
•• Laboratory markers for alcohol dependence (Photograph)
are GGT, Mean corpuscular volume, Alkaline phosphatase
58. Ans. (c)  Severe refractory depression with suicidal tendency
[Ref. Niraj Ahuja, 7/e p77]
64. Ans. (c)  Chlorpromazine
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e p1343]
•• Common side effects: Sedation, hypotension, EPS, anticho-
linergic side effects, galactorrhea, amenorrhea, impaired
ejaculation, tachycardia, cardiac arrhythmias, mydriasis,
weight gain, jaundice, agranulocytosis, seizures, photosen-
sitivity (Photograph)

INDICATIONS FOR ECT (PHOTOGRAPH) IN 65. Ans. (c) Chlorpromazine (Change shown: Blue-grey
DEPRESSION metallic discoloration of skin)
•• Severe depression with suicidal risk
[Ref: Vyas & Ahuja Postgraduate psychiatry, 3/e p1343]
•• Severe depression with stupor, severe psychomotor
retardation or somatic syndrome •• Long-term chlorpromazine use is associated with blue-gray
•• Severe treatment refractory depression discoloration of skin areas exposed to sunlight
•• Delusional depression •• The skin changes often begin with a tan or golden brown
•• Presence of significant antidepressant side effects or color and progress to such colors as slate gray, metallic blue,
intolerance to drugs and purple