EXAM OF

MEDICAL PSYCHOLOGY AND

MEDICAL COMMUNICATION
PRE-REQUISITES
Attendance at the practicals (+ recovery of missed practicals)
Passing grade at the practical exam

THE EXAM CAN BE TAKEN JUST ONCE IN THE

JANUARY-FEBRUARY SESSION !
GRADE < 5 = SEPTEMBER

ABSENT = SEPTEMBER

EXAM FOR IMPROVING THE GRADE (pre-req.: fulfilling the conditions)

PAPERS ARE GRADED ANONYMOUSLY.

Grading system = announced in advance.
REFERENCES:
published on Classroom at the beginning of the semester
+ content of performed courses;
+ content of performed practicals.

RULES:
- mobile phones turned off;
- black or blue pen;
- a photo ID (student card, passport).

RESULTS:
- will be published on Classroom in a maximum of two working days;
- they can be appealed only ONCE;
- the students‘ representative will send the list of students who wish to
appeal within 24 hours from the date of publication of the results;
- the answer to the appeal will be published on Classroom in a maximum
of two working days and is final (it cannot be appealed once again).
FORMAT
45 simple choice questions
(“pick a single letter out of five”)
SAMPLE OF EXAM QUESTIONS
WITH ANNOTATED ANSWERS

Image by storyset on Freepik

1. Psychosomatic disorders (PSd) are:

A. emotional states of short duration;

B. organic diseases;
C. irreversible diseases;
D. acute and generally totally reversible changes of
physiological processes, as a result of emotions;
E. the somato-psychological loop of a disease.

Correct answer: D.
PSd are a special type of physiological changes, in which emotions have an
essential etiopathogenic role. They are not organic diseases and they are not
irreversible. They are not psychological, but somatic (they are NOT emotions,
but derive from them; they are NOT psychiatric symptoms, such as anxiety or
depression).
2. Which statement is true about the placebo effect?

A. if the patient is suggestible, the placebo effect occurs more easily;

B. if the doctor is a good psychologist, it is more difficult for the placebo
effect to occur;
C. the taste of the placebo preparation can never influence its onset;
D. the placebo effect occurs if the placebo preparation is administered
while sleeping;
E. none of the above options (A...D) is true.

Correct answer: A.
The appearance of the placebo effect is largely conditioned by the
suggestibility of the patient. A good doctor-patient relationship favors its
appearance. The taste of the placebo preparation can favor its appearance,
if it is in line with the patient's preferences. Being conditioned by
suggestibility, which is related to being awake, the placebo effect cannot
occur during sleep.
3. Eustress:

A. can be described as the state of happiness occasioned by the

exposure to an event that has a happy ending;
B. is more frequent than distress;
C. is correlated with an increased secretion of cortisol;
D. is never associated to an increased risk to health;
E. Is typically long-lasting.

Correct answer: A.
The variant A corresponds to the definition of eustress. Eustress is not more
common than distress and does not correlate with an increased secretion of
cortisol, but of endorphins. Although it is generally a sanogenetic factor,
occasionally it can be associated with health risks, especially cardiovascular
ones (via the increased secretion of adrenaline / noradrenaline). Being a rather
random event (like a pleasant surprise), it is typically short-lasting.
4. Paranoid personality type:

A. has a bad opinion of himself;

B. is an insecure person;
C. is not a rigid person;
D. may have a bad relationship with the doctor (for example, they
suspect the doctor of bad intentions);
E. none of the above options (A...D) is true.

Correct answer: D.
The paranoid personality type has a good opinion of himself ("I'm ok, you're
not ok"). He generally has firm convictions and often displays a rigid
behavior. In the therapeutic relationship, he has negative or reduced
transference, often suspecting the doctor of bad intentions and trying to
impose his views. He tends to be non- or hypocompliant.
5. Denial:

A. is very useful in the long term, facilitating the person's adjustment to

stressful situations;
B. can act as a "buffer" coping mechanism in intensely traumatic and
unexpected situations;
C. is more common in adulthood;
D. is more common in men than in women;
E. is the same thing with repression.

Correct answer: B.
Denial has only a short-term value, facilitating adjustment to unexpected
traumatic circumstances. No gender or age asymmetry was found in terms of
denial. Repression is different from denial, in that the person who represses
admits the existence of an unpleasant situation that he does not want to talk
about and that he does not want to think about, this being painful. Oppositely,
a person in denial does not admit the existence of the respective situation.
6. The Theory of Reasoned Action) is focused on:

A. the risk-benefit balance;

B. the group norms;
C. the stages of change;
D. the control exercised by the patient during the therapy;
E. the control received by the patient during the therapy.

Correct answer: B.
The risk-benefit balance is characteristic to the HBM model, the stages of
change – to the model with the same name, and the control exercised /
received by the patient during the therapy – to the TPB model.
7. The histrionic (hysterical) personality type:

A. generally has very little or no transference;

B. has low suggestibility;
C. requires detailed, well-argued explanations from the doctor;
D. may have affective ambivalence towards the doctor;
E. none of the options above - (A...D) - is true.

Correct answer: D.
The hysterical personality type most often has exaggerated transference. Its
suggestibility is increased, being able to be both a victim of informational
contagion and an inducer of it. The well-argued explanations from the doctor
are not as well received as those with heightened emotional content, even the
latter are more superficial. Affective ambivalence is a real risk in this patient,
especially if the doctor does not meet his expectations (generally exag-
gerated).
8. In Seligman's learned helplessness experiment, the threatening
stimulus:

A. is progressive in intensity;
B. eventually leads to exhaustion;
C. is constant in intensity, but increases in frequency of daily
administration;
D. does not represent a vital threat;
E. none of the options above - (A...D) - is true.

Correct answer: B.
In Seligman's experiment the stimulus represents a vital threat. It is not
progressive in intensity or frequency of daily administration, but unpredictable. It
finally leads to exhaustion, which is generally irreversible (“learned helplessness
– hopelessness”).
9. Empathy:

A. is the same thing as sympathy;

B. requires an effort to perceive the feelings of others, to imagine
the reasons that were the basis of their development and to mirror
one's own feelings in them;
C. is not related to emotional intelligence;
D. can edify oneself without relating to others;
E. none of the options above - (A…D) - is true.

Correct answer: B.
Empathy is not the same thing as sympathy (it represents the ability to imagine
the feelings and thoughts of others, without going as far as identifying with
them). It requires a conscious effort and repeated communication exercises with
other people. It is related to the broader concept of "emotional intelligence",
being an attitude illustrating it.
10. What is the meaning of the term „frustration”?

A. the situation when the patient has suicidal tendencies;

B. the situation when an individual is mentally overwhelmed by stimuli;
C. the situation when a patient wants less than his possibilities;
D. the situation in which there is a barrier between the individual and his
goal which cannot be overcome;
E. none of the options above - (A…D) - is true.

Correct answer: D.
Frustration is not typically associated with suicide, but with the inability to
achieve goals. It's not the same as being overloaded (overwhelmed by stimuli).
Most people describe it as a barrier which they cannot be overcome.
11. The technique in which the doctor says two or three
sentences that condense the information provided by the patient
is called:

A. paraphrasing;
B. clarification;
C. summarizing;
D. reflection;
E. none of the options above - (A…D) - is true.

Correct answer: C.
Paraphrasing is not equivalent to condensing, but to saying the same things
communicated by the patient, using other words. Clarification and reflection
do not necessarily involve condensing the information reported by the
patient.
12. The superego has the role of:

A. moral consciousness;
B. coordinator of mental life in normal people;
C. facilitator for the satisfaction of aggressive instincts;
D. facilitator for the pursuit of pleasure;
E. a mediator between Self and Ego.

Correct answer: A.
In Freud's conception, the Superego plays the role of moral consciousness.
Normally, it does not represent the coordinator of mental life, or a mediator
between Self and Ego. The role of coordinator of mental life is played, in
normal people, by the Ego.
The Superego does not facilitate the satisfaction of aggressive instincts or
the pursuit of pleasure (the Self has the key role in this).
13. Which statement is true regarding the communication with the patient?

A. a well-conducted anamnesis excludes the possibility of non-compliance;

B. the doctor's tendency to judge the patient increases the patient’s trust in
therapy;
C. the doctors should not pay attention to their own non-verbal language, so
that they are not distracted from the explanations they have to provide;
D. active listening can increase treatment compliance;
E. the patient's trust in the doctor depends exclusively on the doctor's
technical competence.

Correct answer: D.
A well-conducted anamnesis does not exclude the possibility of non-compliance.
The patient's trust can be decreased by the doctor's tendency to judge him and by
the lack of attention given by the doctor to his own non-verbal language (which can
thus come into contradiction with the verbal language). Active listening can
increase treatment compliance, being part of the four basic qualities needed by a
doctor (along with empathy, assertiveness and cultural competence). Trust in the
doctor is based not only on the doctor's technical competence, but also on his
relational skills.
14. The following statement is true about communication skills:

A. empathy is not useful in the intensive care unit (ICU);

B. interrupting the patient when they relate details about illness
is a proof of active listening skills;
C. empathy involves trying to understand what the patient feels;
D. summarizing what the patient says is equivalent to empathy;
E. none of the options above - (A…D) - is true.

Correct answer: C.
Empathy is useful in all specialties and especially in those where suffering is
higher (e.g., ICU). Interrupting the patient is not an indicator of active
listening, even more so in situations where the patient provides details related
to his illness. Summarizing is an interview technique, but it does not
necessarily reflect empathy, but active listening (the patient has the
confirmation that he was listened to).
15. In relation to the characteristics of the participants and the situation,
"coherent" communication is one a kind of communication in which:
A. the communicators can express themselves spontaneously, and the
content of the communication is appropriate to the situation;
B. one of the communicators (or both) is not authentic, however the
content of the communication is appropriate to the situation;
C. both communicators are authentic, however the content of the
communication is not appropriate to the situation;
D. none of the communicators is authentic, and the content of the
communication is not appropriate to the situation;
E. none of the options above - (A…D) - is true.

Correct answer: A.
Option B corresponds to adapted communication, option C to incongruent
communication, and option D to inadequate communication.
16. In order to be efficient, the suggestions used in hypnosis need:

A. to be as elaborate as possible;
B. to be precise;
C. to contain negations;
D. to have previously been administered while sleeping;
E. none of the options above - (A…D) - is true.

Correct answer: B.
The suggestions used in hypnosis must be simple, precise and contain no
negations. Their administration must be performed in the trance state (not
in sleep).
17. A person with an assertive communication style:

A. expresses own wishes with confidence;

B. is able to say "no" in a calm way;
C. maintains visual contact with the interlocutor;
D. shows respect for others;
E. all the options above are true.

Correct answer: E.
Assertiveness is characterized by all the qualities provided by options A-D.
18. From a psychological point of view, what does the term
"transference" mean?

A. the feelings that a patient develops towards the doctor, during therapy;
B. the feelings that the doctor develops towards the patient, during
therapy;
C. moving the patient from one department to another, in the hospital;
D. moving the patient from hospital care to home care;
E. moving the patient from home care to hospital care.

Correct answer: A.
Option B corresponds to the notion of counter-transference. Options C-
E describe administrative issues.
19. Which of the following is an example of an open-ended question
formulated appropriately for the relative of a patient brought to the
Emergency Room, complaining with abdominal pain due to a chronic
illness?

A. "So, where does it hurts more, in the top of the chest or lower?"
B. "Don't you know that this is a chronic disease that causes pain?"
C. "What concerned you the most about the patient's condition?"
D. "Aha, so he forgot to take his medication again?"
E. "Quick, tell me briefly: why do you think it hurts?".

Correct answer: C.
A true open-ended question is only option C. Option A is a close-ended
question. Variants B and D are close-ended questions, that indirectly
communicate blame towards the relative (B) or the patient (D). Option
E only mimics an open-ended question, because the doctor makes it
very clear that he wants a quick and short answer.
20. Regarding depression, one of the following statements is FALSE:

A. can be influenced by the quality of the doctor-patient relationship;

B. is sometimes not apparent (“masked depression”);
C. cannot influence treatment adherence;
D. can be surrounded by somatic symptoms;
E. can sometimes be better managed in a multidisciplinary team.

Correct answer: C.
Adherence to treatment is typically low in depressed patients, because they
do not have the energy to start / continue treatment, they have feelings of
guilt and they do not have the pleasure of healing (they have generalized
anhedonia). Related to options A, B, D, E: depression can be influenced by
the quality of the doctor-patient relationship; it is sometimes masked; it can
be surrounded by somatic symptoms; it can sometimes be better managed
in a multidisciplinary team (i.e. when a somatic disease is associated,
together with the specialist doctor; when endogenous and exogenous
causes are associated, in a psychologist-psychiatrist team).
GOOD LUCK!

‫بالتوفيق‬ Καλη επιτυχια! ‫בהצלחה‬

Bonne chance! Viel Erfolg!

¡Buena suerte! Buona fortuna! Удачи!

‫ موفق باشید‬Onnea! Boa sorte! Lykke til!

Lycka till! Iyi şanslar! BAFTĂ!