BEHAVIORAL SCIENCES – PAST QUESTIONS (2007-19)

(Compiled by Shahroze Ahmed, N-66, Nishtar Medical University)

SECTION A

Non-pharmacological Interventions (NPIs) In Clinical Practice

Communication Skills

1.
a) What are non-pharmacological interventions? (2)
b) Explain in detail the communication skills needed for effective communication with a
patient. (3) [Supple 2018 held in 2019]
2.
a) What are non-pharmacological interventions? (4)
b) Explain in detail the communication skills needed for effective communication with a
patient. (5) [Supple 2017 held in 2018]

3. A medical student was interviewing a patient (suffering from headache and frequent attacks
for the last six months) in the center of the ward in the presence of other people and
patients. [Annual 2017]
a) What important step has the medical student left for effective communication? (2)
b) What other factor come into your mind which can obstruct the effective communication
in such situations? (7)

4. Professor of psychiatry was listening to you when you are interviewing a patient. He pointed
out some important deterrents to listening. Briefly highlight some important deterrent to
listening. [Supple 2013]

5. A politician comes to you and requests you to highlight important Do’s of public speaking.
What will you guide him not to do while delivering speech in a jalsa? [Supple 2013]

Counselling

1. A 30 years old woman comes to you with some issue regarding her personal life. She is at
the verge of a divorce with her husband and is in dilemma of what to do.
a) What do you mean by the term counselling? (2)
b) What are the aims of counselling session? (3)
 c) What are the various don’ts of counselling? (4)
[Annual 2018]

Informational Care

1.
a) What is informational care? How will you give informational care to a patient with newly
diagnosed tuberculosis? (4)
b) What are the seven (7) important questions that are required to be answered by you? (5)
[Annual 2017]

Breaking Bad News

1. A couple presents to a hospital because the wife is expecting a baby. Attending doctor
discovers that the baby has disability in his legs. [Supple held in 2015]
a) After breaking the bad news to the parents, what reaction should the doctor expect?
b) What psychosocial issues can be faced by this child with disability?

Conflict Resolution

1. You as a doctor have come across a situation where there is a huge fight between one of
your colleagues and an attendant of an admitted patient. [Supple held in 2019]
a) What is the current situation referred to as? (2)
b) What are the steps of resolving it? (7)

2.
a) You are head of department and your registrar got in fight with house officer. How will
you resolve with this conflict? (5)
b) What are the common causes of conflict at your hospital? (4)
[Supple held in 2018]

3. A young girl is admitted in ward in a severe depressed state with suicidal ideas. Ward staff
complains that patient’s mother is not ready to leave the patient alone inspite of their
counselling. The lady is very demanding, uncooperative and aggressive. How will you handle
the situation? (5) [Annual 2017]

4. Young doctors in the emergency room have gone on a strike and stopped the emergency
services. You have been asked to negotiate with them on behalf of hospital administration
to resolve the situation. What important guidelines will you keep in mind while planning for
this conflict resolution? [Supple 2016 held in 2017]
5. A patient in emergency expires; his relatives came and start shouting and arguing with you.
How can you manage your anger? [Supple 2013]

6. A heavy rush of dengue fever is expected in emergency departments of hospitals in this

session. You are to train students and doctors in dealing with verbal abuse. What are the
important areas you will highlight and talk and explain to them? [Supple 2013]

SECTION B
1. You have been hired for a job where you are required to assess professionalism in medical
doctors. Describe in detail the desired professional skills and attitudes that a professional
doctor should have. (9) [Annual 2018]

Guiding Principles of Medical Ethics

1. Enumerate four pillars of medical ethics. (2) [Annual 2018]

2. What are the pillars of medical ethics? (4) [Supple held in 2018]

Common Ethical Issues in Medical Practice

1. A patient having shifting pain in abdomen from umbilical region to right lower quadrant.
Surgeon diagnosed it as appendicitis and advised operation for the problem. You are asked
to take his consent. Define consent and its types. (5) [Supple held in 2018]

2. A young female visited to your clinic and requested you to get information about mental
health issues of her fiancé who is under your treatment for the last three years.
a) As a physician, how will your respond? (2)
b) In which conditions confidentiality can be breached? (5)
[Annual 2018]

3. You are going to start pharmacological treatment in a psychotic patient. You are asked to
take informed consent from the patient.
a) What are the various types of consent?
b) What are the components of informed consent?
[Annual 2016]
4. A final year medical student comes to you and wants to get information about her fiancé
who is under your treatment for last one year.
a) How will you deal with her?
b) In what situations confidentiality can be breached?
[Annual 2014]

5. A 20-year old illiterate man having pulmonary tuberculosis and admitted in medical ward is
advised to continue with anti-tuberculosis treatment on discharge. The man is worried
about his illness. What kind of information you will provide to him? [Annual 2014]

Common Ethical Dilemmas in a Health Professional’s Life

1. One of your regular patients came to you with a very expensive gift as a token of gratitude
for his full recovery from a severe illness. He insisted that the gift should be accepted. As a
medical professional:
a) What you should do and how should you deal with the situation?
b) What is the ethical dilemma involved in this case?
[Annual 2015]

Rights and Responsibilities of Patients and Doctors

1. A young girl admitted in ward in a severe depressed state with suicidal ideas. Ward staff
complained that patient’s mother is not ready to leave the patient alone in spite of their
counseling. The lady is very demanding, uncooperative and aggressive. What are patient’s
responsibilities in a hospital setting? (4) [Annual 2017]

Psychological Reactions in Doctor-Patient Relationship

1. A young doctor working in a ward discovers that a young female patient has developed a
liking of him because she refuses to see any other doctor and calls him repeatedly.
a) What is the phenomenon called?
b) How should the doctor handle it?
c) What are other hazards in doctor-patient relationship?
[Supple held in 2015]
SECTION C
Learning

1. When a child starts going to school, he learns a number of new things from parents. A
couple comes to you to complain that their child is uncomfortable. How will you teach them
the principles of reinforcements in behavior modification? [Supple 2013]

2. A 9-year-old boy wets his bed every night. He feels embarrassed and ashamed. His parents
are concerned and worried.
a) Using the principles of learning, how this case can be managed?
b) What are schedules of reinforcement in operant conditioning and which one is best?
[Annual 2014]
3.
a) Define operant conditioning. Enlist important principles used in our daily life.
b) Your friend has a bad habit of scratching skin around the nails and hands. How can you
help him in leaving that habit using operant conditioning technique?
[Annual 2015]

Metacognition

1. A 12 years old came in psychiatry OPD with difficulties in studies and recent decline in grades.
Boy reports recent change to English medium school and difficulty in science subjects. What
metacognition strategies may help him to improve his learning? [Annual 2018]

Motivation

1.
a) Draw Maslow’s pyramid of hierarchical needs.
b) Why did Maslow propose a pyramid of needs instead of a square or some other shape?
c) In hospital, who is responsible for each step?
[Annual 2013]

Intelligence

1.
a) What is meant by the term emotional intelligence? (2)
b) Explain the components of emotional intelligence. (7)
[Supple held in 2019]
2.
a) What is emotional intelligence? Enlist is components.
b) How can we improve our emotional intelligence during daily life activities?
[Annual 2015]

3. You have to deliver a lecture in civil services academy and are asked to talk about emotional
intelligence. How will you cover this topic? Briefly highlight the important components of
this topic. [Supple 2013]

Personality Development

1.
a) A 29 years old Mr., X has a habit of smoking since many years. He also admitted of biting
his nails in times of stress. He has had a difficult childhood. According to Sigmund Freud,
which stage of psychosexual development is this patient stuck in? (2)
b) Explain in detail stages of psychosexual development according to Sigmund Freud. (7)
[Supple held in 2019]

2. A young boy of school-going age is referred from school for not taking part in group
activities, poor attention in class and laziness since his migration from another city. On
examination, he shows inferiority and inadequacy. [Annual 2017]
a) Which stage of development he is facing problems, according to Erik-Erikson’s theory of
psychosocial development? (4)
b) Which further stages will be affected? (5)

3. A 30 years old male is brought to you by his family and reported he is overly rigid and
obsessional. He became easily distressed if his orderliness or timetable is disturbed.
a) Identify the stage of psychodynamic theory at which he is fixed.
b) Enlist stages of psychodynamic theory.
[Annual 2016]

4. The head of an institution is very fond of his deputy because of the perfection in his work,
punctuality and orderliness.
a) Which personality traits does the deputy probably have?
b) Enlist other personality disorders of this trait.
c) What is the difference between having a personality disorder and a personality trait?
[Annual 2013]
5. How fixation to a stage leads to abnormalities in the adulthood. Give examples and explain
using Freud’s principles of psychosexual development. [Supple 2013]

Memory

1. A first-year medical student is facing difficulty in remembering his anatomy lessons he come
to you for advice. Explain to him in detail the techniques he can use to improve his memory
and learning skills. (9) [Supple held in 2019]

2.
a) A student of first year MBBS come to you and complains of poor memory. What
suggestions you will give to improve his memory? (5)
b) What are the types of long memory? (4)
[Supple held in 2018]
3. What is the traditional three-stage model of memory? Describe & explain. [Supple 2013]

Sleep

1.
a) A young female presented to you with sleep disturbance. What will you communicate
her about sleep hygiene? (4)
b) What are the stages of sleep? (5)
[Supple held in 2018]

2. A 40-year-old executive comes to you with the problem of difficulty in falling asleep. He
gives history of tossing and turning in bed for an hour or two before he can finally go to
sleep. He says that he wakes up repeatedly during night and does not feel fresh in the
morning. On examination there is no evidence of any psychiatric or medical illness. How will
you manage him in terms of general principles of sleep hygiene? [Annual 2014]

3. A 33-year-old banker comes to you with complaints of irritability, lack of concentration and
disturbed sleep for the last few days. He is not willing to take medication for sleep
disturbance. What suggestions you would like to give the patient? Elaborate. [Annual 2013]
SECTION D

Sociology and Health

1. You come across a patient with poor treatment outcomes. Despite correct diagnosis and
medicine, you find out erratic intake of doses and poor following of instructions.
a) What is this called? (2)
b) How can it be corrected? (7)
[Annual 2016]

2. A local NGO is planning to run a campaign on spreading awareness about psychiatric

diseases. What points from the Health Belief Model should its members take into account?
(9) [Supple held in 2017]

Anthropology and Health

1. What is the influence of socio-cultural factors on therapeutics? [Annual 2013]

2. Give some suggestions to understand culture. [Supple 2013]

3. Two middle aged men are admitted in a hospital having liver disease. One of them is
illiterate but has strong religious beliefs but the other is educated with regular religious
practices.
a) Which one of them has better prognosis and why?
b) What should be the attitude of doctor while treating the patient in such scenario?
[Supple 2015]

SECTION E

Psychosocial Aspects of Health and Disease

1. An English and Mathematics teacher are talking in the staff room after their intelligence
intermediate class performs badly in their subjects. The English teacher says the class was
disinterested in her subject while her colleague comments that her subject was too
difficult. [Annual 2013]
a) Which defense mechanism is the English teacher using?
b) Which defense mechanism is the Mathematics teacher using?
 c) According to Freud from which part of the mind do defense mechanisms arise?
d) Define altruism, sublimation and suppression.

Common Psychiatric Disorders in General Health Settings

1. A 23-year-old female is brought to you with multiple somatic complaints for two years but
all her lab reports are consistently normal and there has been no response to systematic
treatment from medical specialist.
a) What will be the differential diagnosis? (3)
b) What is the management guideline? (6)
[Supple held in 2017]
2. A young educated unemployed person came to you with self-inflicted wounds on both
arms. He also has history of suicide in family. His family members are worried about him as
he is the only son.
a) What are the risk factors for suicide in this person?
b) What are the protective factors that play against suicide?
[Annual 2015]

3. A 60-year-old man reports that when he lies on to sleep, there is an uncomfortable

sensation in his legs. He has to move them frequently resulting in insomnia. He feels jerky
movements in legs.
a) What is the diagnosis?
b) What is the etiology?
c) Name treatment options.
[Supple 2015]

4. A 65-year-old man tells his doctor that his family members want to poison him. He hears
voices that tell him to shift his house. Family members report that he lost his way to home.
He claims seeing insects.
a) What is the diagnosis?
b) How to examine him clinically?
c) Name treatment options.
[Supple 2015]

5. As life becomes more and more stressful, suicide is becoming more and more prevalent in
Pakistan. What are the factors which can be considered protective against suicide?
[Annual 2013]
Psychosocial aspects of Gender and Sexuality

1. An 18-year-old female presents in the OPD and complains of having a wish that she was a
man. She has short hair and is dressed up like men. By looking at her, there is no sign of
femininity seen in her. She says she feels like a male trapped in a female body and wishes
she was a male.
a) What problem is she undergoing? (4)
b) What will be your management approach? (5)
[Annual 2018, Annual 2017]

Psychosocial Aspects of Pain

1. A 35-year-old female with herniated disc has been suffering from back pain for past two
years. To help control her pain, she takes opiate based medication daily.
a) She is at high risk of developing which disorder?
b) Describe the psychological management of pain in this patient.
[Supple held in 2017]

Psychotrauma

1. A 30-year-old man witnessed an incident robbery at his home. Later, he became fearful and
could not sleep at all. Enlist the psychological reactions a person experiences when he
encounters a trauma. [Annual 2016]

Stress and its Management

1. A 28 years old banker comes with the complaints of muscle pain, fatigue and irritability for
last few days. He informs that his job is too stressful for him and does not want medications.
a) What stress management tips will you give to him? (5)
b) Write down points of progressive muscle relaxation. (4)
[Annual 2016]

2. An entrepreneur has a very tough routine with long hours and excessive workload. Currently
he is further stressed out due to the death of his business partner who was also his very
close friend.
a) What kind of emotional manifestations of stress are expected in this case?
b) What psychological interventions would you suggest for him?
[Annual 2014]