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Psychiatry Question Bank – 38 Multiple Choice Questions on “Organic Mental Disorders”

1. The psychological disorder most commonly associated with myxoedema is:

A. Mania

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B. Depression

C. Phobia

D. Paranoid feeling

Others include

Apathy, lethargy, memory impairment, slows tuning, poor attention span, paranoid ideations, dementia (myxoedema madness).

2. Disorientation occurs in:

A. Organic brain syndrome

B. Schizophrenia

C. Depression

D. Mania

Disorientation is common in delirium.

3. All the following are true about dementia, except:

A. Clouding of the consciousness is common

B. Is often irreversible

C. Hallucinations are not common

D. Nootropics play a limited role

4. A reversible cause of dementia is:

A. Multi-infarct

B. Senile dementia

C. Postencephalitis

D. Huntington’s chorea

Reversible causes of dementia are:

Drug induced toxin

Endocrine causes

Metabolic causes

Epilepsies

Nutritional causes/neoplasm

Trauma induced

Infections

Arterial malformations

5. The best test for organic brain syndrome is:

A. Rorschach test

B. Thematic apperception test

C. Sentence completion test

D. Bender-gestalt test

Bender gestalt is used most frequently with adults as a screening device for signs of organic dysfunction.

Testing memory:

1. Weschler memory scale (1938, Lauretta Bender)

2. Benton visual retention test (sensitive for short term memory loss).

Reasoning, concept formation, and problem solving:

1. Wisconsin card sorting test.

Intelligence testing:

1. Alfred binet (1905) test IQ = MA/CA X 100

2. Weschler adult intelligence scale

3. Weschler intelligence scale for children

4. Weschler preschool and primary scale of intelligence.

Objective personality Assessment:

1. Minnesota multiphasic personality inventing (MMPI).

Projective personality Assessment:

1. Rorscharch test – scoring is done based on,

Location

Determinants

Content

Popularity

Form level

2. Thematic apperception test (TAT) (Mary and Morgan)

3. Sentence completion test (SCT)

4. Word-association technique (Carl Gustav Jung)

5. Draw a person test (Machover).

6. A 50-year-old man complains of slowness of movements, postural instability, tremor, rigidity, and memory loss. The diagnosis is:

A. Parkinsonism

B. Multi-infarct dementia

C. Alzheimer’s disease

D. Thyrotoxicosis

7. A patient presents with impaired consciousness, fragmen­tary delusions, visual hallucinations, and hyperactivity. The diagnosis is:

A. Dementia

B. Delirium

C. Paranoid psychosis

D. Schizophrenia

Delirium:

Disturbance of consciousness and a change in cognition that develops over a short time. Acute confusion with diurnal variations does occur. Dementia: Characterized by several cognitive deficits including impaired memory.

Amnesia:

Impaired memory without other cognitive impairments.

Mini mental states examination (MMSE) questionnaire: Practical method for grading the cognitive state of patients consists of orientation, registration, attention and calculation, construction and language tests which comprises of naming, repetition, comprehension reading, and performing command. Maximum score is 30.

A score of less than 25 suggests impairment.

8. A patient with pneumonia for 5 days ceases to recognize the doctor and staff, complains of scorpions attacking him and is in altered sensorium. This condition is known as:

A. Delirium

B. Dementia

C. Schizophrenia

D. Acute paranoia

9. Chandu, a 32-year-old, presents with acute abdominal pain and vomiting. He also complains of some psychiat­ric diagnosis is:

A. Hysteria

B. Hypothyroidism

C. Hyperthyroidism

D. Intermittent porphyria

10. A patient presented with a short-lasting episode of be­havioral changes which include agitation and a dream­like state with thrashing movements of his limbs. He does not recall any of these episodes and there is no precipitating factor likely. The most likely diagnosis is:

A. Schizophrenia

B. Temporal lobe epilepsy

C. Panic episodes

D. Dissociation disorder

11. Delusions are seen in all the following, except:

A. Depression

B. Delirium

C. Mania

D. Compulsive disorders

12. The following is suggestive of an organic cause of the behavioral symptoms:

A. Prominent visual hallucinations

B. Auditory hallucinations

C. Delusions of fruit

D. Formal thought disorder

13. Signs of organic brain damage are evident on:

A. Bender gestalt test

B. Rorschach test

C. sentence completion test

D. Thematic apperception test

Thematic Apperception Test, Rorschach, and sentence completion tests are for projective personality assessment tests. Others include word association technique; draw a person test, etc.

14. Dementia is a clinical feature of the following:

A. Hypothyroidism

B. Hyperthyroidism

C. Hypoparathyroidism

D. Hyperparathyroidism

Dementia in a chronic organic mental disorder characterized by impairment of intellectual function, memory impairment, deterioration of personality with lack of personal care, emotional liability, catastrophic reaction, thought abnormalities, disorientation in time, place and person, urinary and fecal incontinence.

Some important causes of dementia include:

1. Parenchymatous brain disease: – Alzheimer’s disease, pick’s disease, Parkinson’s disease, Huntington’s chorea, steel Richardson syndrome.

2. Vascular dementia – Multi-infarct dementia, sub­cortical vascular dementia.

3. Toxic dementias – Bromide intoxication, drugs heavy metals, alcohol, carbon monoxide analysis, anticonvulsants, benzodiazepines, psychotropic drugs.

4. Metabolic dementias – Chronic hepatic or ureic encephalopathy, dialysis dementia, Wilson’s diseases.

5. Endocrine causes – Thyroid, parathyroid, pituitary, adrenal dysfunction.

6. Deficiency dimensions – Pernicious anemia pellagra folic acid deficiency, thiamine deficiency.

7. Dementias due to injections – Creutzfeldt Jacob diseases, neurosyphilis, chronic meningitis, viral encephalitis, AIDS dementia, other HIV related disorders, subacute scalding panencephalitis.

8. Neoplastic dementias – Neoplasms and other intra cranial space occupying lesion.

9. Traumatic dementias – Chronic subdural hematoma, head injury.

10. Hydrocephalic dementia – Normal pressure hydrocephalus.

Of these hypothyroid is one of the most important treatable and reversible causes of dementia, second only to toxic dementias. It accounts for less than l per cent of dementias. Clinical diagnosis is difficult & hence laboratory tests have to be resorted for correct diagnosis.

15. Condition tertiary to anxiety neurosis is seen in:

A. Hypothyroidism

B. Hyperthyroidism

C. Hypopitutirism

D. Cushing’s syndrome

16. Fluctuating level of consciousness is seen in:

A. Hysteria

B. Delirium

C. Dementia

D. Mania

Other fealties of delirium:

Alteration of sleep-wake cycle

Sun downing

Visual hallucinations

Illusions

Disturbed orientation

17. Reversible dementia is a feature of:

A. Alzheimer’s disease

B. Pick’s disease

C. Multi infarct dementia

D. Hypothyroidism

Also remember – most common cause of dementia – Alzheimer’s disease. 2nd most common cause – multi infarct dementia

18. Peptic ulcers are uncommon in:

A. Alcoholics

B. Obsessive compulsive

C. Schizophrenics

D. Depressives

19. Mini mental scale in psychiatry interview is:

A. No point cognitive test

B. Psychiatric

C. Dose related in psychiatric interview

D. 30 point cognitive test

Mild dementia 20-24. Moderate – 11-19 Severe – 0-10.

20. Reversible dementia is characteristically seen in:

A. Distemper’s diseases

B. Hypothyroidism

C. BSE

D. Pill’s disease

Hypothyroidism accounts for less than 1 percent of dementias.

21. Dementia pugilistica is seen in:

A. Punch-drunk syndrome

B. Alcoholism

C. Alzheimer’s diseases

D. Senile dementia

22. The most common cause of dementia is:

A. Alzheimer’s disease

B. Encephalitis

C. Neuro syphilis

D. Alcoholism

70 percent of all cases of Dementia.

23. Lucid interval is seen in:

A. Encephalitis

B. Insanity

C. Wernicke’s encephalopathy

D. Tertiary syphilis

24. Psychiatric manifestation is seen in all of the following, except:

A. Acute cuter militant porphyries’

B. Secondary syphilis

C. Hypothyroidism

D. Hyperthyroidism

25. Parkinsonism most commonly presents with:

A. Mania B. Schizophrenia

C. Phobia D. Depression

26. Among the following, visual hallucination is most com­monly seen in:

A. Temporal lobe epilepsy

B. Schizophrenia

C. Delirium

D. Amphetamine toxicity

27. Subcortical dementia is seen in all, except:

A. Alzheimer’s disease

B. Huntington’s chorea

C. Parkinsonism

D. Wilson’s diseases

Causes of subcortical dementia are-Huntington’s chorea, Parkinson’s, Progressive supranuclear palsy, Wilson’s disease.

28. All findings are seen in Petit mal epilepsy, except:

A. No tonic-Clonic phase

B. Transient loss of consciousness

C. Ethosuximide is the drug of choice

D. Non-specific EEG pattern.

29. Anxiety is a common symptom of all of the following, except:

A. Hypoglycemia

B. Hypothyroidism

C. Pheochromocytoma

D. Porphyria

Hypothyroidism, hypoglycemia and Pheochromo­cytoma can manifest as anxiety.

30. The commonest psychological feature of AIDS is:

A. Mania

B. Depression

C. Suicidal tendency

D. Violence.

31. All the following are true about delirium, except:

A. Clear Consciousness

B. Disorientation

C. Sun downing

D. Marked perceptual disturbance

32. All of the following are true about dementia, except:

A. Memory impairment

B. Altered sensorium

C. Depressed mood

D. Loss of neurons in brain matter

33. A characteristic of sub cortical dementia is:

A. Memory loss

B. Dyslexia

C. Aphasia

D. Tactile Agnosia

34. Receptive aphasia disorder increasing with age is com­monly associated with:

A. Conversion disorder

B. Attention deficit disorder

C. Phenylketonuria

D. Down syndrome

35. Biochemical etiology of Alzheimer’s relates to:

A. Serotonins

B. Dopamine

C. Acetylcholine

D. GABA

Degradation of Acetylcholine and thereby a reduction of its concentration is seen in Alzheimer’s dementia.

36. The occurrence of which of the following symptoms would allow differentiation between delirium and dementia?

A. An impaired judgment

B. A memory deficit

C. An impaired consciousness

D. An impaired process of thinking

E. Disorientation

37. In the absence of auditory hallucinations visual or tac­tile hallucinations are in favors of are of the following conditions:

A. Conversion disorder

B. Panic disorder

C. Manic disorders

D. Organic brain syndrome

38. All of the following are subtests of a verbal Wechsler scale, except:

A. Arithmetic

B. Digit-span

C. Vocabulary

D. Picture arrangement

Verbal scale has seven subjects. Picture arrangement is a subject in performance scale.

Answer

1.A 2.A 3.C 4.C 5.D 6.A 7.B 8.A 9.D 10.B 11.B 12.A 13.A 14.A 15.B 16.B 17.D 18.C 19.D 20.B 21.A 22.A 23.A 24.B 25.D 26.C 27.A 28.D 29.D 30.B 31.A 32.B 33.A 34.D 35.C 36.C 37.D 38.D

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