Section 1
-SECTION-1- GROUP-10
QUESTION-1:
A 19-year-old woman who is a college student is
brought to the clinic by her roommate because
she has been acting strangely during the past six
months. During the past month, the patient has
been describing how another person's thoughts
have been entering into her mind. The patient's
grades have been slipping, and she does not talk
as much as she did previously. The roommate
says that when the patient does talk, she strays
from the topic and is hard to follow. During the
interview, the patient says a television reporter
told her that the government had a special
message for her and she should listen to the radio
for further instructions. Which of the following
conditions is the most likely cause of this patient's
symptoms?
(A) Acute stress disorder
(B) Delusional disorder
(C) Schizoaffective disorder
(D) Schizophrenia
(E) Schizophreniform disorder
QUESTION2:
A 20-year-old woman who is a college student
comes to the health services center because she
has had symptoms of depression for the past
three months, since she was a victim of date rape
at a party. The patient says she was heavily
intoxicated when the incident occurred and has
little memory of the event, but she was
embarrassed and ashamed when she awoke at
the scene and realized what had happened. She
did not seek medical care at that time. The patient
says she has not told her friends about the
incident, and she has continued to attend classes
and work part time. However, she says she
ANSWER:
The correct answer is Option (D),
schizophrenia. The patient has
had classic symptoms of
schizophrenia for at least six
months, including hallucinations
(voices speaking to her), social
dysfunction affecting grades and
friendships, and disorganized
speech. Although her symptoms
meet the DSM criteria for the
condition.
ANSWER:
The correct answer is Option (E),
post-traumatic stress disorder.
The patient described meets the
criteria for post-traumatic stress
disorder, which include the
following: involvement in a
traumatic event, duration of
symptoms for more than one
month, and significant effect on
daily life due to depression,
anxiety, nightmares, and social
withdrawal.
constantly feels sad and anxious, has become
tearful and withdrawn, and has had difficulty
sleeping because of frightening nightmares. This
patient most likely has which of the following
psychiatric conditions?
(A) Acute stress disorder
(B) Adjustment disorder, unspecified
(C) Generalized anxiety disorder
(D) Major depressive disorder
(E) Post-traumatic stress disorder
Sec 1 - Group 5
Q1 Which of the following is NOT a
characteristic of borderline personality
disorder?
a. mood swings
b. ​hallucinations
c. impulsivity
d. identity problems
Q2)A 37-year-old man comes to the office
after he experienced what he says was a
nervous breakdown. The patient says that
after he recently declared bankruptcy,
losing his home and his business, he
became very depressed. During this time,
he began to hear voices telling him that
he was useless and should kill himself.
The patient says his symptoms stopped
after approximately one week. He has
had no similar episodes. Medical history
includes no psychiatric conditions.
Physical examination shows no
abnormalities, and results of laboratory
studies are within normal limits. Which of
the following is the most likely diagnosis?
(A) Borderline personality disorder
(B)​ Brief psychotic disorder
(C) Major depressive disorder with
Answer
B) hallucinations
According to DSM 5 criteria Essential
features of personality disorders using
this model include: impairment in
self-concept and interpersonal
relationships, inflexible traits causing
impairment in personal and social
situations, and pathological personality
traits.
Answer
B)brief psychotic disorder.
Essential features of brief psychotic
disorder include sudden onset of one or
more of the following symptoms:
● delusions, hallucinations,
disorganized speech, disorganized
behavior, and catatonia.
Brief psychotic disorder is also
characterized by duration of symptoms for
at least one day but less than one month
followed by return to premorbid level of
functioning. The disorder is not
associated with a medical condition or the
effect of illicit substances such as
hallucinogens.
psychotic features
(D) Schizophrenia
(E) Schizophreniform disorder

Section 1 - Group 17

Q1) ​A 24-year-old accountant believes Answer: The correct answer is​ D

angels have instructed him to embezzle (Schizophrenia).
from his company and give the money to
the poor. He believes the doctor who The best answer is schizophrenia
prescribed medication is under orders because the patient is being delusional.
from demons to poison him. The most
likely diagnosis for this man is?

A. Dissociative identity disorder

B. Obsessive-compulsive personality
disorder
C. Bipolar disorder
D. Schizophrenia

Q2) ​Refer to the figure. Which of the MRI Answer: The correct answer is​ B (1 and
images above are most likely to be scans 4)​.
of people with schizophrenia?
The majority of the findings seen with CT
scan can also be observed with an MRI.
Ventricular enlargement with cortical
atrophy (particularly in the frontal lobes) is
seen in patients with chronic
schizophrenia. Ventricular size has been
reported to increase with progression of
A. 1 and 2 the disease.
B. 1 and 4
C. 2 and 3
D. 3 and 4

Section 1 - Group 11

1.The DSM-5 diagnostic criteria for panic Answer: The correct answer is D.
disorder includes those mentioned below
EXCEPT​: 
​A, B, & C are characteristic of the
diagnostic criteria for panic disorder.
 A. Recurrent unexpected panic option D is characteristic of DSM-5
attacks. Diagnostic Criteria for Posttraumatic
Stress Disorder.
B. At least one of the attacks has
been followed by 1 month of
persistent concern and significant
maladaptive change in behaviour.

C. The neurological disturbance is

not attributed to the physiological
effects of a substance such as
drugs.

D. Exposure to actual or
threatened death, serious injury
or sexual injury, or sexual
violence.

2. What is the Sex ratio- female:male, for Answer:Correct answer is C.

panic disorder?
Females 2​: m
​ ales 1
A. 1:2
B. 2:3
C. 2:1
D. 1:1

SECTION 1 GROUP 1
Q1.​A 26-year-old man is brought to the
emergency department by his wife because of
bizarre and agitated behavior for the last 6
weeks. He thinks that the NSA is spying on
him and controlling his mind. His wife reports
that the patient has become withdrawn and at
times depressed for the past 3 months. He lost
his job because he stopped going to work 4
weeks ago. Since then, he has been working
on an invention that will block people from
being able to control his mind. Physical and
neurologic examinations show no
abnormalities. On mental status examination,
he is confused and suspicious with marked
psychomotor agitation. His speech is
disorganized and his affect is labile. Which of
the following is the most likely diagnosis?
A.Paranoid personality disorder
B.Delusional disorder
C.Schizophreniform disorder
D.Schizophrenia
Q2.​ A 38-year-old woman comes to the
physician for a 6-week history of sleeping
difficulties because she thinks that someone is
watching her through security cameras. Her
anxiety started 6 weeks ago when a security
camera was installed outside her house by the
police. Ever since, she has felt that she is
being monitored by security cameras
throughout the city. She avoids going outside
whenever possible and refuses to take the
subway. Whenever she needs to leave the
house she wears large hats or hooded
sweaters so that she cannot be recognized by
the cameras. As soon as she arrives at her
office or at home she feels safer. She was
recently promoted to the team manager of a
small advertising agency. She takes no
medications. On mental status examination,
she is alert, oriented, and shows normal range
of affect. Urine toxicology screening is
negative. The patient's symptoms are best
described as which of the following?
A.Delirium
Answer: C.Schizophreniform
disorder
Schizophreniform disorder is a
clinical diagnosis that is made using
the same diagnostic criteria as
schizophrenia. The main difference,
however, is the duration of the
disorder. Schizophreniform disorder
is diagnosed in patients who present
with delusions, hallucinations,
disorganized speech, and/or
negative symptoms that impair
social, occupational, and person
functioning and lasts for less than 6
months. If symptoms persist for > 6
months, the diagnosis must be
changed to schizophrenia. About
one-third of patients recover, while
the other two-thirds go on to develop
schizophrenia or schizoaffective
disorder.
Answer: C.Delusions
A delusion is a disturbance of
thought content that is characterized
by a fixed, false belief that is not
derived from the individual's cultural
or religious beliefs and cannot be
changed by reasoning. This patient
has a 6-week history of persecutory
delusions and delusions of reference
but functions normally at work and
has no other psychotic symptoms.
This is characteristic of delusional
disorder. Delusions can also occur in
patients with psychotic disorders
(e.g., schizophrenia, mood disorder
with psychotic features), and
substance use disorders. Other
types of delusions include delusions
of grandeur, delusions of control,
delusions of guilt, erotomanic
delusions, and somatic delusions.
B.Agoraphobia
C.Delusions
D.Derealization

SECTION 1 GROUP 12

A 20-year-old woman is brought to the ANS:

emergency room by her family because they
have been unable to get her to eat or drink
anything for the past 2 days. The patient,
although awake, is completely unresponsive
both vocally and nonverbally. She actively
resists any attempt to be moved. Her family
reports that during the previous 7 months
she became increasingly withdrawn, socially
isolated, and bizarre; often speaking to
people no one else could see. Which of the
following is the most likely diagnosis?
A. Schizoaffective disorder
B. Delusional disorder
C. Schizophreniform disorder
D. Catatonic schizophrenia
D. Catatonic schizophrenia
Catatonic schizophrenia is characterized
by marked psychomotor disturbances
including prolonged immobility, posturing,
extreme negativism (the patient actively
resists any attempts made to change his
or her position) or waxy flexibility (the
patient maintains the position in which he
or she is placed), mutism, echolalia
(repetition of words said by another
person), and echopraxia (repetition of
movements made by another person).
Periods of immobility and mutism can
alternate with periods of extreme agitation
(catatonic excitement).

Matthew was a 29 year old kind, generous, ANS:

extroverted, famous, industrious person. He B. Premorbid personality and
worked in a department store and was the functioning
breadwinner of his family. He was a
dependable and responsible worker as well
as a loyal and supportive friend to his peers
and very protective of his family members.
This description of Matthew is included in
what part of the psychiatric report?

A. General data
B. Premorbid personality and functioning
C. Past personal and social history
D. Family History
 SECTION 1 GROUP 15

Nestor, a 37-year old man was having fun Answer:

with his friends outside. They wanted to C. Withdrawal
buy alcoholic drinks but the stores are not
allowing them since there’s an alcohol
ban. He was beginning to experience
anxiety, nausea and shaky hands. This is
due to:

A. Tolerance
B. Abuse
C. Withdrawal
D. Addiction

Which of the following is ​NOT ​true about Answer:a

the criteria for alcohol withdrawal? D. The development of a reversible
substance-specific syn​drome due to
A. The symptoms are not due to a recent ingestion of (or exposure to) a
general medical condition and are substance.
not better accounted for by another
mental disorder. This is a general description for
B. The development of a substance intoxication.
substance-specific syndrome due to
the cessation of (or reduction in)
substance use that has been heavy
and prolonged.
C. The substance-specific syndrome
causes clinically signifi​cant distress
or impairment in social,
occupational, or other important
areas of functioning.
D. The development of a reversible
substance-specific syn​drome
due to recent ingestion of (or
exposure to) a substance.

SECTION 1 group 13

Two years after she was saved from her D) Posttraumatic stress disorder
burning house, a 32-year-old woman
continues to be distressed by recurrent
dreams and intrusive thoughts about
the event.
 a)Dissociative identity disorder
b)Obsessive-compulsive
disorder
c)Dissociative fugue
d) Posttraumatic stress disorder

What is the most important C.Duration

differentiating factor between acute
stress disorder and PTSD?

a.) Stressor
b.) Symptoms
c.) Duration
d.) Onset
 SECTION 1, GROUP 4

Q1​.What is the main difference between Answer : B

an individual diagnosed with bipolar I and Bipolar II disorder has never had a manic
bipolar II? episode , but in Bipolar I disorder has at
least one manic episode.
A. An individual diagnosed with bipolar I
has never had a hypomanic episode.An
individual diagnosed with bipolar II
disorder has had at least one manic
episode
B. An individual diagnosed with bipolar II
has never had a manic episode.An
individual diagnosed with bipolar I
disorder has had at least one manic
episode.
C. An individual diagnosed with bipolar II
has never had a hypomanic episode. An
individual diagnosed with bipolar I
disorder has had at least one hypomanic
episode.
D. An individual diagnosed with bipolar I
has never had a manic episode. An
individual diagnosed with bipolar II
disorder has had at least one manic
episode.

Q2. ​A 72-year-old man suffers a stroke Answer: D​ The anterior cerebral artery
with loss of motor functioning in the (ACA) territory is the area affected by this
left leg and, to a lesser extent, the left stroke. The ACA irrigates the medial
arm. He has abulia and his eyes and frontal lobes and therefore when affected
head seem preferentially deviated to causes preferential leg greater than arm
and face weakness contralateral to the
the right. His left arm is apraxia. His
side of the lesion. The destruction of the
head CT is shown below. The arterial nearby frontal eye fields causes loss of
territory involved is that of the: tonic opposition of the gaze to the
opposite side so the eyes will often be
A ​Right middle cerebral artery noted to look toward the side of the
B ​Right posterior cerebral artery lesion. Sphincteric incontinence is
C ​Right vertebral artery sometimes seen if the cortical bowel and
D ​Right anterior cerebral artery bladder areas are affected. Patients often
E ​Right posterior communicating suffer from abulia, a loss of will power or
artery the lack of ability to do things
independently. Bilateral ACA territory
damage can result in akinetic mutism.

SECTION 1 GROUP 3 

Q1. ​An 18 year old female was present to  Answer: B. Panic Attack 
the ER after collapsing on the stage at  Panic attacks are present with feelings 
her college. She mentioned that she  of intense fear, sometimes as if 
experienced an episode of trembling,  something terrible is about to happen 
dizziness, chest pains and feeling of  to the said person, along with other 
terror and sweating after being called  symptoms related to cardiac and 
on stage to give a speech. What is her  respiratory systems such as heart 
most likely diagnosis?  palpitation and shortness of breath or 
A. Agoraphobia   difficulty in breathing and is usually 
B. Panic Attack  triggered by a specific scenario.  
C. Depression  
D. Social Anxiety  

Q2. ​Bruce Wayne became consumed  Answer: A. Obsessive Compulsive 

with the need to clean up Gotham from  Disorder 
criminals and would not participate in  Behaviors that are obsessive enough or 
any other activities. All he did and  behaviors which are compulsive 
talked about was activities related to it  enough to eventually affect your quality 
and this behavior caused him to  of life are diagnosed as Obsessive 
completely distance from his social life  Compulsive Disorder.  
as well. Eventually his butler consulted 
him to a therapist who diagnosed him 
with: 
A. Obsessive Compulsive Disorder 
B. Bipolar Disorder 
C. Post Traumatic Stress Disorder 
D. Schizophrenia  

Section 1 Group 16

What are the core features of Major
Depressive Disorder (MDD)?
(1) depressed mood
(2) loss of interest or pleasure must be
present of at least 2 months
(3) Manic episodes
(4) Both A and B
Answer: Option. 1 depressed mood.
Other options are incorrect because
maniac episodes are not included in
depression. The loss of interest or
pleasure must be present for at least 2
weeks, and not months as mentioned in
the question.

A patient with a history of depressive Answer: b) Major depression with

symptoms, including problems with psychotic features.
concentration, sleep, appetite, and
symptoms of psychosis that started The features are best explained by MDD
after the mood disturbances may have: with psychotic features.

(1) schizoaffective disorder

(2) Major depression with psychotic
features
(3) MDD
(4) none of the above

Section 1 - Group 14
A 40 year old woman is brought to the
emergency room by the police after she
was found standing in the middle of the
road, naked, commanding the traffic to
stop. In the ER she is agitated and
restless, with pressured speech and
affect that alternates between euphoric
and irritable. Her father was contacted
and it was stated that this kind of
behaviour runs in the family. Which of the
following is the most likely diagnosis ?
A. Schizophrenia
B. Bipolar disorder, manic
C. Bipolar disorder, mixed state
D. Delirium
Answer: B. Bipolar disorder, manic
Mood elevation, mood lability, irritability,
expansive behavior, increased energy,
decreased need for sleep, lack of insight,
poor judgment, disinhibition, impulsivity
and pressured speech are characteristic
symptoms of elated acute mania. In more
severe cases, mood-congruent delusional
idealiations and hallucinations are also
present.

A 42-year-old man is referred to the office Answer: A: Avoidant

for mental health evaluation. The patient Avoidant personality disorder is
says he has a long-standing fear of characterized by fears of rejection,
criticism and rejection. He also has disapproval, and/or criticism;
feelings of inadequacy and refuses to try unwillingness to be involved with people
new activities because of his fear of unless assured of being liked; restraint in
embarrassment. The patient has held the intimate relationships; preoccupation with
same entry- level position at his social criticism or rejection; inhibition in
workplace for the past 11 years despite new situations because of feelings of
several opportunities for promotion. The inadequacy; and unwillingness to engage
patient is unmarried and has only had one in new activities because of possibility of
intimate relationship, which lasted only a embarrassment
few weeks. He has few friends other than
those in his model airplane club. Which of
the following personality disorders is the
most likely diagnosis?
A. Avoidant
B. Dependent
C. Paranoid
D. Schizoid

Section 1 - Group 9

Q1. ​A 17-year old girl had a depressed Answer: B, ​Because Patient has 6
mood with anhedonia, anergia, insomnia, definite symptoms from the DSM-5
and a decreased appetite with weight loss criteria for MDD (depressed mood
because her girlfriend broke up with her 2
weeks previously. She also has
decreased energy, suicidal ideation, and
mood-congruent auditory hallucinations.
Her mood and affect are dysphoric, and
she has noted an increase in her
irritability.
What is the most likely diagnosis
A. Cyclothymic disorder
B. Major depressive disorder
C. Bipolar disorder 1
D. Schizophrenia
Q2. ​Which of the following is correctly
paired in terms of the type of substance
and origin ?
A. Psilocybin : Peyote cactus
B. Ecstacy : THC
​C. Marijuana : Cannabis sativa
D. None of the above
Section 1 Group 7
Q1​.Mr.X, a survivor of world war II
berates his German neighbors who
moved in a week ago, believing that they
are “sent by. Hitler to eliminate him”. His
wife. X, who shares the same belief, set
the neighbor’s house on fire. The couple
are arrested and brought in for double
homicide. On further questioning and
psychiatric evaluation, it is found out that
ever since coming back from the war,
Mr.X has been going around beating up
Germans. His actions are fortified by his
wife’s support, which he got after a year
of her trying to convince him otherwise.
Now his wife and children also believe
the same as he does. His mental state
other than being mildly depressed is quite
everyday, markedly diminished
interest/pleasure in all activities nearly
everyday, significant weight loss,
psychomotor retardation, fatigue or loss
of energy nearly everyday, recurrent
thoughts of death) which persisted for
more than 2 weeks.
This is major depressive disorder, sever,
single episode with mood congruent
psychotic features (auditory features)
Answer C
Ans: D- Folie à deux, ​another name for
shared psychotic disorder is
characterized by transfer of delusions
from one person to another.
Unquestionable acceptance of the other
individual who has an earlier onset. Both
should be associated for a long time and
typically live together. It involves two
people usually, but may involve more
than two including entire families.
Persecutory beliefs are the most
common, but grandiose, religious and
somatic delusions may also occur.
normal, so is his wife’s.what is the most
likely diagnosis?

A. Schizophrenia
B. Erotomania
C. Delusional disorder, persecutory
type
D. Folie a deux

Q2. Vasanthi, 45 years, was brought to

casualty with abnormal movements which
included persistent deviation of neck to
right side one day before she was
prescribed Haloperidol 5 mgs three times
daily from the psychiatry OPD. She also
had an altercation with her husband
recently. Which of the following is the
most likely cause for her mptoms.
a) Acute drug dystonia
b) Conversion reaction
c) Acute psychosis
d) Cerebrovascular accident
ANS: A) Acute drug dystonia
0
An ​acute dystonic reaction is
characterized by involuntary contractions
of muscles of the extremities, face, neck,
abdomen, pelvis, or larynx in either
sustained or intermittent patterns that
lead to abnormal movements or postures.

Section 1 - Group 6

Q1)​ ​Dysthymia appears to be a milder ANS : b) Clinical Depression

form of:

a. bipolar disorder Depression ranges in seriousness from

b. clinical depression
c. schizophrenia
d. Munchausen syndrome
mild, temporary episodes of sadness to
severe persistent depression. Clinical
Depression is the more severe form of
depression, a constant sense of
hopelessness and despair is a sign of
clinical depression.

Q2) Physiological activity associated with
PTSD include all except :
A. decreased parasympathetic tone
B. elevated baseline heart rate
C. excessive sweating
D. increased circulating thyroxine
Section 1 - Group 8
JJ, an 18 year old, female trainee chef, is Answer:
brought to the hospital. About 2 months
ago following changes at work. She had
left the school late at time and while
crossing the street she was almost hit by
a motorbike. started to miss several
evenings each week and stopped
socializing Afraid of going out at night and
Dysthymia is a milder, but long-lasting
form of depression. It is a continuous
long-term (chronic) form of depression.
You may lose interest in normal daily
activities, feel hopeless, lack productivity,
and have low self-esteem and an overall
feeling of inadequacy.
ANS : D ) increased circulating
thyroxine
According to current conceptualizations,
PTSD is associated
with objective measures of physiological
arousal. This includes
elevated baselines heart rate,and
excessive sweating. Furthermore,
evidence from studies of baseline
cardiovascular activity revealed a positive
association between
heart rate and PTSD.
The finding of elevated baseline heart
rate activity is consistent
with the hypothesis of tonic sympathetic
nervous system arousal in PTSD.
Disturbance in autonomic nervous system
activity in individuals with PTSD is
characterized by increased
sympathetic and decreased
parasympathetic tone.There
is no change in blood level of thyroxine in
those with PTSD​.
B. PTSD
refused to cross the street alone. tells the
staff in the emergency room, she does
not wish to be seen in public because
she hates people looking at her.
Mental Status Examination :
appears to be restless and nervous about
her surroundings, She state that her
mood is “okay.”he is reluctant to talk and
keep saying okay to any questions.Affect
is congruent,
although flat. Her speech is of normal
rate, rhythm and tone.She denies any
suicidal thoughts or homicidal
ideations.
This patient most likely has which of the
following psychiatric conditions?

A. Schizophrenia
B. PTSD
C. Anxiety disorder
D. Acute stress disorder

A 25 year old male, the eldest among his Answer:

three siblings, belongs to a middle
socio-economic class. His parents and PTSD
close relatives reported the patient as
having been reserved and shy since
childhood, rarely initiated a conversation
or any activity and hesitant to talk to
others. Behavioural changes were noticed
by members of the family as he entered
adolescence, but were taken in a lighter
form and ignored. His irritable nature and
anti-social behaviour worsened over the
years and finally, had a violent bust out
on a minor financial issue of the family
with a neighbour.
No history of any complicated trauma,
alcohol and drug dependence, physical or
psychiatric illness of the mother during
pregnancy.
The mental status examination revealed
that the eye contact was not continuous
and he moved his eyes suspiciously and
furtively. He tried a little hard to change
the body postures and lethargic
movements of the limbs were also
noticed. Reduced quality of speech and
hesitant on expression of some of his
views and beliefs.
The dominant symptoms at the time of
admission and during his stay in the
health care centre were: suspicious
behaviour, delusions of reference and
persecution, auditory and olfactory
hallucination were also present, but were
rare. Loss of interest, irritability,
oversensitivity, lack of appetite and
insomnia also present.
The patient most likely to have which of
the following psychiatric conditions?
A. Depression
B. PTSD
C. Schizophrenia
D. Bipolar disorder

Section 1 - Group 2

Q. A 28-year-old man comes to the office Ans: E

because he has had severe restlessness,
anxiety, and generalized myalgia during
the past three days. The patient says he
has not slept for the past two days.
Physical examination shows dilation of
the pupils, excessive lacrimation,
diaphoresis, and piloerection. The most
likely cause of this patient's condition is
withdrawal of which of the following
substances?

(A) Cocaine
(B) Inhalants
(C) Methamphetamines
(D) Modafinil
(E) Opioids
Tim Sayer, 32 year old veteran soldier Ans: C
who have survived veteren from warzone
in vietnam. Tim's wife Tina upon his
arrival was very content, but as days
passed by he was not himself anymore.
He seems to be nervous, have
nightmares and would wake up
screaming, spends time all by himself and
avoids conversation. What may be the
diagnosis of Tim?

a. Bipolar disorder

b. Schizophrenia disorder

c. Post traumatic stress disorder

d. Eating disorder

Section 2

GROUP 5 (SECTION: 2)

Question 1; Answer 1;
K.V is a middle-aged man with schizoaffective
disorder, Over the course of his illness, K.V made C. CLOZAPINE is a
several suicide attempts. He consistently struggled dibenzodiazepine derivative
with treatment adherence, both due to impaired that possesses α-adrenergic
insight into his condition as well as a lack of blocking, antimuscarinic,
response to standard antipsychotic approaches. At antihistaminic, anti-serotonergic
times, he drank alcohol heavily. During a psychotic and sedative properties and is
episode, he attacked his mother with a knife when the most effective antipsychotic
she came to take him to a psychiatric appointment medication for
because he believed she and the CIA were treatment-resistant
conspiring against him. K.V was arrested and taken schizophrenia.
to jail.
While in jail, K.V was found incompetent to stand
trial due to his psychiatric illness and sent to the
state hospital in California to receive competency
restoration. After three years, it was determined that
K.V was unable to be restored due to repeated
decompensations of his illness and was sent back
to jail. In jail. He decompensated further and began
showing signs of catatonia, refusing food and
medications and becoming mute. After a particularly
severe episode, K.V was sent to a local hospital.
What would be the standard treatment for K.V at
this instance?
A. Paliperidone (Invega)
B. Aripiprazole (Abilify)
C. Clozapine
D. Bromperidol

Question 2; Answer 2;

Which of the following combinations is said to be Answer: A

Schizoaffective disorder?
A. Schizophrenia-Mood Disorder-Auditory
Hallucinations
B. Schizophrenia-Anxiety-Auditory
Hallucinations
C. Schizophrenia-Mood Disorder-Visual
Hallucinations
D. Schizophrenia-OCD-Tactile Hallucinations

GROUP 6 (SECTION - 2)

Question 1) Answer 1) ​ ​A) acute schizophrenia.

A previously healthy 20- year- old student
had been behaving in an odd way. At
times he appeared angry and told his
friends that he was being persecuted; at
other times he was seen to be laughing to
himself for
no apparent reason. For several months
he had seemed increasingly preoccupied
with his own thoughts. His academic work
had deteriorated. When interviewed,
he was restless, suspicious, and exhibited
odd mannerisms. He described hearing
voices commenting on his actions and
abusing him. He believed that the police
According to DSM5 common
features of acute schizophrenia, including
prominent persecutory delusions, with
accompanying hallucinations, gradual
social withdrawal and impaired
performance
at work, and the idea that other people
can read one’s thoughts. In appearance
and behaviour some patients with
acute schizophrenia are entirely normal.
Others seem changed, although not
always in a way that would immediately
point to psychosis. They may be
preoccupied
had conspired with his university teachers
to harm his brain and interfere with his
thoughts. He also suspected that they
could read his thoughts.what the most
likely diagnosis of this patient?
A) acute schizophrenia
B) chronic schizophrenia
C) delusion
D) brief psychotic disorder
E)bipolar I disorder with psychotic
features
Question 2)
Ms A, a 40-year-old married woman, had
a depressive symptoms began to appear
slowly, characterized by depressed mood,
irritability, diminished interest in her usual
activities, loss of appetite, weight loss,
lack of energy, poor concentration,
insomnia, and recurrent thoughts of
death, such as “It would be nice not being
alive.” These symptoms led to impaired
work and social functioning. Her mother
had a history of chronic depressive mood
disorder.
(A) Acute stress disorder
(B) Adjustment disorder, unspecified
(C) Generalized anxiety disorder
(D) Major depressive disorder
(E) Post-traumatic stress disorder
SECTION 2 GROUP 7
with their health, their appearance,
religion, or
other intense interests. Social withdrawal
often occurs— for example, spending a
long time in their room, perhaps lying
immobile on the bed. Some patients smile
or laugh without obvious reason. Some
appear to be constantly perplexed, while
others are restless and noisy, or show
sudden and unexpected variability of
behaviour.
The speech often reflects an underlying
thought disorder.
Answer 2) ​(D) Major depressive disorder
According to DSM5 - symptoms like
depressed mood, irritability, diminished
interest in her usual activities, loss of
appetite, weight loss, lack of energy, poor
concentration, insomnia, and recurrent
thoughts of death.
1. Thomas, 64 years old, married, A. Depression
and a retired sniper of the US
military. He started to suffer trauma B. PTSD
and flashbacks of his tours during
C. PTSD with substance abuse
his leave off from military duties.
His time served showed him the D. Severe Anxiety Disorder
horrors of war and death of many
people. Certain triggers in his
civilian life would cause flashbacks
of his time served. His emotions
became altered to the point that
even a dog playing with his son
would cause him to become
angered over fear of the dog
hurting his son. The symptoms
have lasted for close to a decade
between tours and his time on
leave. Has developed a drinking
problem to combat the issues he is
facing and relies on nicotine to
relieve stress.

2. 25-years house wife come to the A. ​Delusion

psychiatry outpatients department
complaining that her nose was longer
than usual. She felt that her husband
did not like her because of the
deformity and had developed
relationship with the neighboring girl.
Further she complained that people
made fun of her. It was not possible to
convince her that there was no
deformity. Her symptoms include:
B. Depersonalization
C. Depression
D. Hallucination
-Delusion is a disorder of thinking,
which is a firm, fixed, unshakable, and
held with strong conviction, irrespective
of sociocultural and educational
background. The content of it being
bizarre but not always.
 GROUP 8 (Section 2)
QUESTION 1:
A client with antisocial personality
disorder was admitted in a psychiatric unit
at the hospital. The newly admitted client
stole money from an elderly in the unit.
Which of the following is the most
appropriate for the doctor to say to the
patient?
a) “Why did you take the money?”
b) “Let’s talk about how you felt when
you took the money.”
c) “The consequences of stealing are
loss of privileges.”
d) “The elderly client is defenseless
against you”.
QUESTION 2:
A 19-year-old woman who is a college
student is brought to the clinic by her
roommate because she has been acting
strangely during the past six months.
During the past month, the patient has
been describing how another person's
thoughts have been entering into her
mind. The patient's grades have been
slipping, and she does not talk as much
as she did previously. The roommate
says that when the patient does talk, she
strays from the topic and is hard to follow.
During the interview, the patient says a
television reporter told her that the
government had a special message for
her and she should listen to the radio for
further instructions. Which of the following
conditions is the most likely cause of this
patient's symptoms?
(A) Acute stress disorder
(B) Delusional disorder
(C) Schizoaffective disorder
(D) Schizophrenia
ANSWER: (c)
The most appropriate response is to
reinforce the consequences of behavior
that disregard the rights of others. Option
A is incorrect because this client is likely
to rationalize and excuse the behavior.
Option B is also incorrect because the
nurse should not encourage the client to
provide excuses or explanations of
behaviors that are clearly against the
rules. A client with antisocial personality
disorder is unlikely to have compassion
for others and typically lacks respect for
the rights of others.
ANSWER: (D)
The patient has had classic symptoms of
schizophrenia for at least six months,
including hallucinations (voices speaking
to her), social dysfunction affecting
grades and friendships, and disorganized
speech. Although the patient is somewhat
young for schizophrenia (peak incidence
in women is between 25 and 35 years),
her symptoms meet the DSM criteria for
the condition
Option (A), acute stress disorder, is
incorrect because there is no evidence
that the patient has endured or witnessed
a traumatic event or expressed intense
fear, helplessness, or horror in response
to such an event.
Option (B), delusional disorder, is
incorrect because the patient’s delusions
are bizarre in nature
Option (C), schizoaffective disorder, is
plausible but can be ruled out based on
the fact that there is no evidence of
concurrent manic or depressive
symptoms during the schizophrenic
episode described
 GROUP 9 (Section 2)

Question 1: Answer: (A)

A 23-year-old man comes to the office The correct answer is Option (A),
because he has pain in his right hand. antisocial
The nurse says the patient was irritable personality disorder. Although the patient
and reluctant to answer many intake seems charming and ingratiating, he is
questions, and he refused to put onan aggressive and
examination gown. On questioning, the clearly exhibits disregard for social norms
patient is initially charming and glib, but and rights of others. These findings are
after he is characteristic
assured that the information he shares of antisocial personality disorder
will not be relayed to his probation officer,
he admits that he was involved in a
fistfight. He says proudly that "the other
guy is in a lot worse shape." This patient
most likely has which of the following
psychiatric conditions?
(A) Antisocial personality disorder
(B) Bipolar disorder, most recent episode
hypomanic
(C) Conduct disorder
(D) Oppositional defiant disorder
(E) Paranoid personality disorder

Question 2: Answer D
In Schizophrenia, paranoid behavior is One of the most common delusions in
characterized by which of the following? paranoid disorders is that of persecution.
A. Prominent delusions of a persecutory A chief contributing factor is an
or grandiose nature exaggerated tendency to self-reference
B. Exaggerated tendency to i.e., to systematically misinterpret
self-reference remarks, gestures, and acts of others as
C. Derision and contempt directed to intentional slights or as signs of derision
oneself and contempt directed at oneself.
D. All of the above

Group 13, Section B

Question 1: ​Posttraumatic stress
disorder (PTSD) differs from acute
stress disorder in that
A. acute stress disorder occurs
earlier than PTSD
B. PTSD is associated with at least
three dissociative symptoms
C. reexperiencing the trauma is not
found in acute stress disorder
D. avoidance of stimuli associated
with the trauma is only found in
PTSD
E. PTSD lasts less than 1 month
after a trauma
Answer: A
Acute stress disorder is a disorder that is similar to
posttraumatic stress disorder (PTSD), but acute
stress disorder occurs earlier than PTSD (within 4
weeks of the traumatic event) and remits within 2
days to 1 month after a trauma (not PTSD).
PTSD shows three domains of symptoms:
reexperiencing the trauma; avoiding stimuli
associated with the trauma; and experiencing
symptoms of increased autonomic arousal, such
as enhanced startle. Flashbacks, in which the
individual may act and feel as if the trauma is
recurring, represent a classic form of
reexperiencing. Other forms of reexperiencing
symptoms include distressing recollections or
dreams and either physiological or psychological
stress reactions on exposure to stimuli that are
linked to the trauma. Symptoms of avoidance
associated with PTSD include efforts to avoid
thoughts or activities related to trauma, anhedonia,
reduced capacity to remember events related to
trauma, blunted effect, feelings of detachment or
derealization, and a sense of a foreshortened
future. Symptoms of increased arousal include
insomnia, irritability, hypervigilance, and
exaggerated startle. The diagnosis of PTSD is only
made when symptoms persist for at least 1 month;
the diagnosis of acute stress disorder is made in
the interim.
Acute stress disorder is characterized by
reexperiencing, avoidance, and increased arousal,
similar to PTSD. Acute stress disorder (not PTSD)
is also associated with at least three dissociative
symptoms.
Question 2: ​You are asked to see a Answer: D The symptoms described are strongly
42-year-old male patient on a suggestive of delirium tremens. Such symptoms
surgical ward who had a major can arise in patients being admitted to the hospital
operation 2 days ago and is now for an operation and hence abstaining from
exhibiting bizarre behavior. He ex- alcohol. The clinical features are clouding of
presses fears that aliens are coming consciousness, difficulty sustaining attention,
to take him away and appears to be disorientation, autonomic hyperactivity with
responding to hallucinations. On tachycardia, excess sweating, and lability of blood
examination he is tremulous and pressure. Patients also have fleeting delusions
sweating but appears oriented and and hallucinations. The symptoms should resolve
denies any hallucinations. His with adequate treatment.
laboratory workup is subnormal with
increased MCV and GGT. What is
the most likely cause of his
symptoms?
A. Alcohol withdrawal
B. Schizophrenia
C. Severe depression
D. Delirium tremens
E. Alcoholic hallucinosis

Section 2 : Group 14

1. In the diagnosis of major depressive 5 or more symptoms that have been

disorder using the DSM 5 criteria, present during the same 2 week period
The patient must have
A. 3 or more symptoms that have been
present during the same 2 week
period
B. 5 or more symptoms that have been
present during the same 2 week
period
C. 2 or more symptoms that have
been present during the same 5
week period
D. None

2. A 25-years house wife came to the Delusion is a disorder of thinking,

psychiatry outpatients department which is a firm, fixed, unshakable,
complaining that her nose was and held with strong conviction,
 longer than usual. She felt that her irrespective of sociocultural and
husband did not like her because of educational background. The
the deformity and had developed a content of it being bizarre but not
relationship with the neighboring always.
girl. Further she complained that
people made fun of her. It was not
possible to convince her that there
was no deformity. Her symptoms
include:

A. Delusion

B. Depersonalization

C. Depression

D. Hallucination

Section 2, Group 10

Question 1: Answer:
(A) OCD
A 13-year-old boy learns in health class
that vomiting is an involuntary response
to illness. While watching the news with
his family one evening, he hears a story
about a young man who aspirates vomit
during his sleep and dies. He becomes
obsessed about getting ill and vomiting.
The boy shuns anyone who appears to be
sick at school. His friends wonder why he
isn’t talking to them. This boy carries
hand sanitizer everywhere he goes, and
avoids public restrooms. He won’t touch
food that he thinks might be contaminated
by germs. He avoids all the restaurants
that he used to enjoy with his family. The
boy’s parents worry about him.
What is the most likely diagnosis?
 (A) OCD
(B) Schizophrenia
(C) ASD
(D) Bipolar

Question 2: Answer:
Which of the following is accurate (D) The patient should be evaluated for
concerning the diagnostic criteria for symptoms of intrusion, negative
ASD? mood, dissociation, avoidance, and
(A) The individual must have directly arousal
experienced a traumatic event
(B) The duration of the disturbance
may be up to 3 months after the
traumatic event
(C) The disturbance need not cause
clinically significant distress in
social, occupational, or other
important areas of functioning
(D) The patient should be evaluated
for symptoms of intrusion,
negative mood, dissociation,
avoidance, and arousal

Section 2 Group-11

Question 1: Answer: C
What is ​NOT​ included in the DSM-5
Criteria for Major Depressive Disorder. Explanation: ​The DSM-5 Criteria for
A.) The symptoms cause clinically MDD states that there should not have
significant distress or impairment in been any episodes of mania or
social, occupational, or other important hypomania.
areas of functioning.
B.) The episode is not attributable to the
physiological effects of a substance or to
another medical condition.
C.) Presence of manic episode or a
hypomanic episode.
D.) The occurrence of the major
depressive episode is not better
explained by schizoaffective disorder,
schizophrenia, schizophreniform disorder,
delusional disorder, or other specified and
unspecified schizophrenia spectrum and
other psychotic disorders.

Question 2: Answer: B
In Schizophrenia psychotic symptoms
such as hallucinations delusions, Explanation:
disorganised speech and grossly Positive Symptoms: Characteristics of
disorganised or catatonic behaviours are psychotic symptoms which tend to reflect
known as: an excess or distortion of normal
a) Negative symptoms functions
b) Positive symptoms
c) Mediating symptoms
d) Catastrophic symptom

Section 2 Group 3

Questions Answers

James was a 38-year old, a veteran who A. PTSD

had returned from Afghanistan, where he The symptoms as well as the duration of
had served as an officer. He went to a disturbance (> 1month) is highly
mental health clinic complaining of suggestive of Post-Traumatic Stress
irritability and angry outbursts for about 2 disorder
months now. His symptoms involved
out-of-control rage when startled,
constant thoughts and memories of
death-related events, weekly vivid
nightmares of combat that caused trouble
sleeping, anxiety and a loss of interest in
hobbies he once enjoyed with friends.
In a recent visit to the doctor, he was
drifting off to sleep in the exam table.
When the a nurse tried to wake him up
gently, James leapt up, cursed and
threatened her — scaring both the nurse
and himself. What is the most likely
diagnosis?
A. PTSD
B. ASD
C. MDD
D. Adjustment Disoder

Symptoms of ASD are classified into 5 B. Intrusion, Negative Mood,

categories: Dissociative, Avoidance, Arousal
A. Intrusion, Positive Mood, Dissociative,
Avoidance, Arousal
B. Intrusion, Negative Mood, Dissociative,
Avoidance, Arousal
C. Intrusion, Negative Mood, Dissociative,
Avoidance, Mania

Section 2 Group 4

Question Answer

1. A 37-year-old man comes to the Option B

office after he experienced what ​Brief psychotic disorder. Essential
he says was a nervous features of brief psychotic disorder
breakdown. The patient says that include sudden onset of one or more of
after he recently declared the following symptoms: delusions,
bankruptcy, losing his home and hallucinations, disorganized speech,
his business, he became very disorganized behavior, and catatonia.
depressed. During this time, he Brief psychotic disorder is also
began to hear voices telling him characterized by duration of symptoms
that he was useless and should for at least one day but less than one
kill himself. The patient says his month followed by return to premorbid
symptoms stopped after level of functioning. The disorder is not
approximately one week. He has associated with a medical condition or
had no similar episodes. Medical the effect of illicit substances such as
history includes no psychiatric hallucinogens.
conditions. Physical examination
shows no abnormalities, and
results of laboratory studies are
within normal limits. Which of the
following is the most likely
diagnosis?
(A) Borderline personality disorder
(B) Brief psychotic disorder
(C) Major depressive disorder with
psychotic features
(D) Schizophrenia
(E) Schizophreniform disorder

2. A 16 year girl is taken to the Ans :LSD

hospital because the girl feels
she's "going insane." The girl Explanation:​Patients who consume
claims she was offered a white LSD may have a wide range of sensory
 tablet to take at a friend's party
several hours ago. She took the
pill and now She's agitated and
restless now and she believes
that she could fly. She also
states that she has
hallucinations that are visual,
auditory, and tactile. It is noted
that she has tachycardia,
tremors, hypertension, and
mydriasis on examination .
Which of the following
substances were most possibly
consumed by her?
A. LSD
B. Heroin
C.Ecstasy
D.Cocaine
Section 2 Group 15
Question
Q1. Posttraumatic stress disorder (PTSD)
differs from acute stress disorder in that
A. acute stress disorder occurs earlier
than PTSD
B. PTSD is associated with at least three
dissociative symptoms
C. reexperiencing the trauma is not found in
acute stress disorder
D. avoidance of stimuli associated with the
trauma is only found in PTSD
E. PTSD lasts less than 1 month after a
trauma
disturbances and may experience
tremors, hypertension, tachycardia,
mydriasis, hyperthermia, sweating, and
distorted vision due to the
sympathomimetic effects of these drugs.
Under the influence of these drugs it is
possible for Patients to accidentally
harm or kill themselves when they act
on their false beliefs (in this case, the
illusion that the patient can fly). If the
patient is not sure about which medicine
was administered, the sudden sensory
disturbances can be very alarming, and,
as in this case, patients can risk losing
their minds.
Answer
The answer is A
Acute stress disorder is a disorder that is
similar to posttraumatic stress disorder
(PTSD), but acute stress disorder occurs
earlier than PTSD (within 4 weeks of the
traumatic event) and remits within 2 days to 1
month after a trauma PTSD shows three
domains of symptoms: reexperiencing the
trauma; avoiding stimuli associated with the
trauma; and experiencing symptoms of
increased autonomic arousal, such as
enhanced startle. Flashbacks, in which the
individual may act and feel as if the trauma is
recurring, represent a classic form of
reexperiencing. Other forms of re
experiencing symptoms include distressing
recollections or dreams and either
 physiological or psychological stress
reactions on exposure to stimuli that are
linked to the trauma.

Q2. Which of the following physical The Answer is D,

symptoms are associated with Panic
attacks: Physical symptoms during a panic attack,
such as heart palpitations , sweating, chills,
A. Heart palpitations. trembling,hyperventilation ,weakness or
dizziness, tingly or numb hands, chest pain,
B. Illusions stomach pain, and nausea.

C. Hyperventilating

D. Both A and C

E. All of the above.

Section B Group 2

A 31-year-old local politician has a sudden Explanation :​ Answer: D .

onset of extreme anxiety, tremulousness, and
diaphoresis immediately before his first
scheduled appearance on national television,
and he is unable to go on the air. For the next
week he is paralyzed by fear each time he
faces an audience, and he cancels all of his
scheduled public appearances. Which of the
following is the most likely diagnosis?
(A) Acute stress disorder
(B) Adjustment disorder with anxious mood
(C) Panic disorder
(D) Social anxiety disorder (correct Answer)
(E) Specific phobia
This presentation is most suggestive of
social anxiety disorder. In this case,
exposure to public speaking precipitated
intense anxiety. Panic disorder is also
characterized by intense anxiety attacks;
however, there is no clear precipitant.
Specific phobia, situational type, is a less
likely diagnosis, because there is no specific
cause of the fear other than social exposure.
Acute stress disorder is characterized by the
presence of intrusive recollections and
emotional numbing that follow a life-
threatening event. Adjustment disorder with
anxious mood is characterized by an
adaptation problem that follows a
psychologic stressor, of which there is no
evidence in this case.

Which of the following brain imaging are not Answer C

accurate for diagnosis of panic disorder?
Structural brain imaging studies, such as
A. MRI - cortical atrophy in right temporal magnetic resonance imaging (MRI), in
lobe
B. PET - dysregulatiom of cerebral blood flow
C. MRI - cortical atrophy in frontal lobe
D. generalized cerebral vasoconstriction
E. Increased blood flow to basal ganglia
Section 2 Group 12
A middle-aged man is chronically
preoccupied with his health. For
many years he feared that his irregular
bowel functions meant he had cancer.
Now he is very worried about having a
serious heart disease, despite
his physician’s assurance that the
occasional “extra beats” he detects when
he checks his pulse are completely
benign. Which of the following is the
most likely diagnosis?
a. Somatization disorder
b. Hypochondriasis
c. Delusional disorder
d. Pain disorder
e. Conversion disorder
Which of the following
psychiatric diagnoses may develop in as
many as 25% of patients
informed of a positive HIV test?
a. Adjustment disorder with anxiety
b. PTSD
c. Bipolar disorder, manic
d. Panic disorder
patients with panic disorder have
implicated pathological involvement in the
temporal lobes. One MRI study reported
abnormalities, especially cortical atrophy in
the right temporal lobes of these patients.
Positron emission tomography (PET), have
implicated dysregulation of cerebral blood
flow. Specifically, anxiety disorders and
panic attacks are associated with cerebral
vasoconstriction, which may result in
central nervous system symptoms such as
dizziness and in peripheral nervous system
symptoms that may be induced by
hyperventilation and hypocapnia. Increased
blood flow to the basal ganglia has not been
noted in patients with panic disorder.
The answer is b.
Hypochondriasis is characterized by fear
of developing or having a serious
disease, based on the patient’s distorted
interpretation of normal physical
sensations or signs. The patient
continues to worry even though physical
examinations and diagnostic tests fail to
reveal any pathological process. The
fears do not have the absolute certainty of
delusions
The answer is A.
Patients receiving a positive HIV
test may need counseling for a wide
variety of symptoms, including anxiety
and depression, a syndrome like PTSD,
concern about minor physical
symptoms, and adjustment disorders, the
latter of which can occur in as
e. Hypochondriasis many as 25% of those given a positive
diagnosis.

Section 2 - Group 1

Which of the following questions is not Ans. c

productive in the early stages of a Questions asking “why”, early in the
psychiatric interview for a patient seekinginterview are often non-productive as
psychiatric help/consultation? patients often consult seeking an answer
to a “why” question themselves. In such
A) What caused you to come for a scenario patients could feel confused
consultation? and may bear an internal responsibility
B) When did you start hearing “their” and guilt for having mental issues.
voices? Furthermore, it may cause them to deem
C) Why do you feel anxious? psychiatric therapy or consultation
D) How often do you have such
useless
thoughts?

A 40-year-old man suffered from a heart ANS: D

attack under general anaesthesia. The T​he process of resuscitation is not
doctors in the operation theatre successfully considered to be traumatic in general and
resuscitated him. After recovery, he wants to doctor resuscitated him in his best interest.
sue the hospital for causing him
post-traumatic stress disorder (PTSD). He
claims the resuscitation process was
extremely traumatic. Which of the following
is the MOST IMPORTANT feature to
exclude the diagnosis of PTSD?

A. He does not have past history of PTSD

B. He has hidden agenda of suing the

hospital and tries to seek compensation.

C. He was under general anaesthesia and

he was not conscious during resuscitation.

D. ​The process of resuscitation is not

considered to be traumatic in general
and doctor resuscitated him in his best
interest.
E. He did not seek treatment from a
psychiatrist after the operation.