Psychiatry

MCQ 3.327

A 28-year-old investment banker presents for advice and treatment of persistent premature ejaculation which he
attributes to fatigue from his job and his new relationship. WOTF would be the approach for his long-term benefit?

A. Interview him with his partner.

B. Teach him relaxation exercises.
C. Instruct him in the use of penile squeeze techniques.
D. Prescribe sildenafil (Viagra®) one hour before attempting intercourse.
E. Prescribe low dose clomipramine.

MCQ 3.328

A 21-year-old medical student presents with a one-week history of increasing arousal and hypervigilance. He reports
that he is God and describes ‘believing’ this when he first put on a white coat three weeks ago. This abnormal belief
is an example of WOTF?

A. An illusion.
B. A hallucination.
C. A passivity phenomenon.
D. A delusional perception.
E. Thought insertion.

MCQ 3.329

A 42-year-old academic has sought help from you for alcohol abuse. The most striking feature is his lack of emotional
warmth and rapport. He tells you he has never married and has no friends, but is devoted to his work as a research
economist. His only interest is playing fantasy games and chess on his home computer. He describes himself as
introspective and self-sufficient, and has always been aloof and ill at ease with people, even his family of origin.
WOTF is the most likely disorder of his personality?

A. Antisocial.
B. Schizotypal.
C. Schizoid.
D. Avoidant.
E. Paranoid.

MCQ 3.330

As part of the mental state assessment of cognitive function, patients may be asked to subtract seven from 100
sequentially (‘serial seven’). This ‘serial sevens’ test is primarily a test of WOTF?

A. Registration.
B. Digit span.
C. Concentration.
D. Abstract thinking.
E. Memory.
MCQ 3.331

A 32-year-old woman presents seeking counselling after the news agency in which she works was robbed by a man
with a knife who threatened her and a customer. She is now anxious and hypervigilant and her sleep has become
disrupted by nightmares of the incident. She is adamant that she does not want medication but asks about the
outcome of the counselling. WOTF would be the ultimate goal of her crisis intervention counselling?

A. To bring about a life-long change in her personality.

B. To restore her to her pre-crisis level of functioning.
C. To promote a cathartic retelling of her experience.
D. To facilitate her subsequent referral for long-term psychotherapy.
E. To provide emotional support during natural healing in response to stress.

MCQ 3.332

A 24-year-old fashion model and minor celebrity presents after having used cocaine at a party a few days ago. She
has been ‘high’ and appears euphoric, elevated hyperactive and restless. Her urinary drug screen is negative. She
insists that this is just an exaggeration of her normal self and that she is usually quite emotional, with short-lived
highs and lows, tantrums and tears, which is corroborated by her partner. She is quite concerned about her physical
appearance and demands a mirror so that she can ‘look right’ during your interview and touch up her face with
make-up and lipstick before she speaks with you. During the interview, she is disinhibited and flirtatious, flatters you
with compliments and asks you out on a date. Her mental status examination is otherwise normal. WOTF is the most
likely dx?

A. Cocaine intoxication
B. Undisclosed ecstasy usage
C. Histrionic PD
D. Cyclothymia
E. Hypomania

MCQ 3.333

You have been visited in your general practive by a pharmaceutical company representative accompanied by a
researcher from the local univerity’s department of clinical pharmacology. They request that you recommend and
refer patients from your general practice with insomnia who would be considered for a trial of a new non-
benzodiazepine hyponotic. WOTF is essential for your agreement?

A. Clarifying the sample size and the number needed to treat.

B. Establishing the known side effect profile of the drug from earlier clinical trials.
C. Verifying that the study has approval from a Human Research Ethics Committee.
D. Ensuring that your patients receive adequate financial compensation for their participation.
E. Insisting that you have co-authorship of any scientific papers that may result from the study.

MCQ 3.334

A 72-year-old woman has been brought to the ED after falling in the street and fracturing her wrist. At the time she
was carrying a large number of plastic bags filled with assorted rubbish, decaying food scraps, sugar sachets, used
teabags, newpapers and discarded advertising brochures. She was dirty and unkempt, but was neither delirious,
demented nor thought disordered. She admitted that she also saves abandoned cats and keeps at least a dozen at
home. Her daughter arrived and confirmed that her mother’s hoards rubbish and bric-a-brac at home and her living
conditions are filthy and squalid. The name of the syndrome which describes this domestic state and her clinical
picture are WOTF?

A. Charles Bonnet.
B. Ekbom.
 C. Cotard.
D. Diogenes.
E. Briquet.

MCQ 3.335

A clinical assessment of a 30-year-old woman shows a 15-year-history of fluctuating bulimia nervosa. WOTF would
be the least likely to be found on PE?

A. Swollen salivary glands.

B. Dental decay.
C. Calloused knuckles.
D. Hirsutism.
E. Amenorrhoea.

MCQ 3.336

A 28-year-old ballet dancer presents with a sprained ankl.e She has been appearing as part of the corps-de-ballet in a
nationally touring company and has had to perform six times a week since the ballet season began two months ago.
She tells you that for the last three months she has engaged in sel-induced vomiting several times a day, partly out of
performance anxiety and partly to control her body weight. Her sprained ankle was the result of orsening fatigue
contributing to a fall during a performance. After effective treatment of her ankle injury, WOTF would be the most
appropriate initial investigation?

A. Liver function tests including serum albumin.

B. Serum electrolytes and creatinine.
C. FBC and serum iron.
D. Thyroid function tests.
E. Fasting glucose level.

MCQ 3.337

A 20-year-old female elite athlete on a sports scholarship has presented for assessment after collapsing in the gym
during a workout. One of the trainers who accompanied her says that he is concerned that she is over-training and
over-exercising and that this is not the first time that she has fainted during a gym workout. As part of a mental state
assessment of this woman, WOTF is the most likely abnormality in her cognitive content?

A. Thoughts about suicide.

B. Fears of losing control.
C. Obsessions about cleanliness.
D. Concerns about her weight and shape.
E. Infatuation with a fellow student.

MCQ 3.338

A 48-year-old man has chronic low back pain as a result of lifting heavy boxes at work four years previously. He is
now not working and is on a pension having had a disability insurance claim settled. A magnetic resonance scan has
confirmed a low lumbar disc prolapse without neurocompression. He complains that paracetamol two tablets (each
500mg) on an ‘as needed’ basis up to four times a day is not sufficient to alleviate his pain. WOTF is the most
appropriate next step in his pain management?

A. Add amitriptyline 150mg daily.

B. Add buprenorphine (Norspan®) patches weekly.
C. Change to aspirin ‘as needed’.
D. Change to regular paracetamol.
E. Change to a regular nonsteroidal anti-inflammatory analgesic.
MCQ 3.339

In evaluating the characteristics of a screening test for a psychiatric disorder, it is important to know of the
prevalence of the disorder in the sample population. If the prevalence is low, WOTF statements about sensitivity,
specificity, positive and negative predictive power and reliability is correct?

A. Sensitivity will be lower.

B. Specificity will be higher.
C. Positive predictive power will be lower.
D. Reliability will be higher.
E. Negative predictive power will be unchanged.

MCQ 3.340

A 36-year-old woman is 150cm tall and weighs 45kg. Her body mass index (BMI) is WOTF?

A. 12.5
B. 15.0
C. 20.0
D. 30.0
E. 33.3