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Psychiatry Question Bank – 11 Multiple Choice Questions on “Child Psychiatry”

1. Which of the following is not seen in a hyperkinetic child?

A. Aggressive outbursts

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B. Decreased attention span

C. Left-to-right disorientation

D. Soft neurological signs

It is a common disorder in school age children (3%). These occur before the age of 7 years. Males are more common. The characteristic clinical features are:

1. Poor attention span with distractibility

2. Hyperactivity

3. Impulsivity

2. An 11-year-old child was found to be very restless and hyperactive in the classroom, making it difficult for the other students to concentrate. He ran a round the class all day long and could not sit in one place for a long time. He got very agitated when the toy in his hand was taken away. The most likely diagnosis is:

A. Autism

B. Attention deficit hyperactivity disorder

C. Conduct disorder

D. Depressive disorder Treatment for ADHD is

1. Stimulant medications

Dextro amphetamine (10-40 mg/day)

Methylphenidate (10-60 mg/day)

Magnesium pemoline (37.5-115 mg/day)

2. Behaviour therapy

3. Counseling and supportive psychotherapy

3. True about infantile autism includes:

A. Profound impairment of the child’s ability to relate to people including parents

B. Speech is delayed and onset occurs before the age of 2 1/2 years

C. Tranquilizing medication is useful to control aggressive and self-mutilating outbursts

D. All of the above

Cannabis – most active ingredient is Delta-9-tetra hydro cannabinol. Cannabis produces very mild physical dependence withdrawal syndrome characterized by fine tremors, irritability, restlessness, nervous, insomnia, decreased appetite, and craving.

This syndrome begins within a few hours stopping cannabis and lasts for 4 to 5 days. Cannabis often leads to splitting of consciousness in acute intoxication perceptual disturbances like depersonalization, hallucinations, synesthesias occur. Flash back also does occur.

Complications of cannabis use include:

1. Transient or short lasting psychiatric disorders

2. Amotivational syndrome

3. Hemp insanity and cannabis psychosis.

4. Hyperkinetic disorder is characterized by all of the fol­lowing, except:

A. Hyperactivity

B. Hallucinations

C. Impulsivity

D. Distractibility

Hyperkinetic disorder also called as attention deficits disorder, minimal brain deficit (MBD), strass syndrome, etc. Occurs in 3 percent of school age children, males 6 to 8 times > females. Onset is usually by 7 yrs of age. There are 4 clinical types.

1. Attention deficit disorder with hyperactivity – features – poor attention span with distractibility, hyperactivity, impulsivity.

2. Attention deficit disorder without hyperactivity.

3. Residual type – past history of ADD + with the presence of a few residual features in adulthood.

4. Hyperkinetic disorder with conduct disorder. Diagnosis is by teacher’s school report, parent’s report, and clinical examination. About 80 percent of patients improve on their own by puberty. 15-20 percent may have persistent symptoms even in adulthood. Impulsivity and inattention are the most common residual features after puberty.

Treatment: 1. Pharmacotherapy

1. Stimulant medication – dextro amphetamine, methylphenidate, magnesium Pemoline with a response rate of 90 percent.

ii. Others-imipramine and thioridazine. Barbiturates are contraindicated.

2. Behavior therapy

3. Counseling and supportive psychotherapy.

5. Coprolalia is found in:

A. alcoholic intoxication

B. Tourette’s syndrome

C. Mania

D. Delirium

Also seen are simple and complex motor tics.

6. Autistic disorder is due to lesion in the following:

A. Occipital lobe

B. Temporal lobe

C. Partial lobe

D. Corpus callosum

7. One of the following is used to test IQ:

A. Eysenck personality

B. Ink blot test

C. Sentence completion

D. Binet-Stanford test Other Intelligence tests

Binet-Kamath test

WISC

Bhatia’s battery

Raven’s progressive matrices

8. A 5-year old boy presents with nocturnal enuresis. Which of the following should the doctor not advice?

A. Reserves to the mother

B. Medications

C. Toilet training of the boy was faulty

D. It will be used by itself

Therapeutic measures in enuresis are: 1. restriction of fluid intake, 2. Bladder training 3. Conditions devices, 4. Pharmacotherapy – imipramine.

9. A child with a history of anoxic injury at the time of birth is not interested in the surroundings and games that other children play. This verbal and language communication is impaired. This speech is repetitive stereotyped and idiosyncratic. This activities and interests are limited and he becomes aggressive and nervous if interfered with. The most likely diagnosis is: (AIIMS-2001)

A. Autistic disorder

B. ADHD

C. Tempest tantrums

D. Hyperactive child

10. A child with poor performance at school has been re­ported by the teacher for disturbing the other students and constantly leaving his bench. He is suffering from:

A. Autism

B. Attention-deficit hyperactivity disorder

C. Mental retardation

D. Conduct disorder

11. The most common form of a learning disorder is:

A. Difficulty in spelling words

B. Difficulty in arithmetic tasks

C. A writing disorder

D. A reading disorder

E. None of the above.

Answer

1.C 2.B 3.D 4.B 5.B 6.B 7.D 8.D 9.A 10.B 11.D

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