MCQ’s

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 ❖Introduction to Neuropsychiatric disorders:
1 By definition, a cognitive disorder cannot be caused by
A) a medical disease.
B) substance intoxication or withdrawal.
C) a psychiatric disorder.
D) an infection.

2 Cognitive disorders were formerly referred to as

A) thought disorders.
B) organic brain disorders.
C) amnestic disorders.
D) multi-infarct disorders.

3 Which of the following is not a common deficit that occurs in

dementia?
A) amnesia
B) alogia
C) apraxia
D) aphasia

4 In dementia, which of the following terms refers to an inability to

recognize objects or people?
A) apraxia
B) alogia
C) agnosia
D) aphasia

5 The most common cause of dementia is

A) head injury.
B) Alzheimer's disease.
C) cerebrovascular disease.
D) HIV.

6 In Alzheimer's disease, plaques are particularly common in the

A) hippocampus.
B) hypothalamus.
C) brainstem.
D) thalamus.

7 On which of the following chromosomes is there a genetic

abnormality that is associated with an increased risk of late-onset
Alzheimer's disease?
A) chromosome 4
B) chromosome 14
C) chromosome 19
D) chromosome 21

8 On which of the following chromosomes is there a genetic

abnormality that may be responsible for about 80% of early-onset
Alzheimer's disease?
A) chromosome 4
B) chromosome 14
C) chromosome 19
D) chromosome 21

9 Which of the following is not associated with an increased risk of

developing dementia following a stroke?
A) a previous history of strokes
B) a higher level of education
C) diabetes
D) older age

10 Parkinson's disease results from the death of neurons that

produce
A) serotonin
B) acetylcholine
C) dopamine
D) norepinephrine

11 Which of the following is not a symptom of Parkinson's disease?

A) early memory loss
B) tremors
C) muscle rigidity
D) an inability to initiate movement
12 Which of the following medical conditions can produce a mild
neurocognitive disorder and mild impairments in social/occupational
functioning?
A) Parkinson's disease
B) Huntington's disease
C) Creutzfeldt-Jakob disease
D) HIV

13 The nun study by Snowdon et al. (1996) showed that

A) religious people are more likely to experience dementia.
B) people with greater linguistic skills early in life were less likely to develop Alzheimer's
disease later in late.
C) better-educated people are more likely to become demented because they have more
abilities to lose once dementia takes hold.
D) people with low levels of education are less likely to be diagnosed with Alzheimer's
disease than people with higher levels of education.

14 Korsakoff's syndrome is an amnestic disorder caused by damage

to the __________.
A) cerebral cortex
B) amygdala
C) hippocampus
D) thalamus

15 A disturbance of consciousness caused by a medical condition

that develops over a very short period of time and is characterized
by a change in cognition (such as a memory deficit or disorientation)
and a reduction in the ability to focus, shift, or sustain attention, is
known as
A) Alzheimer's disease.
B) Korsakoff's syndrome.
C) delirium.
D) HIV-associated dementia.
16 Dementia occurs:
A) only in people over 60 years of age.
B) in 2-5% of people over age 65.
C) more often in men than in women.
D) in 80% of people over age 85.

17 Which of the following would not be considered to reflect a deficit

in executive functioning?
A) interpreting the proverb, "People who live in glass houses shouldn't throw stones" to
mean, "People don't want their windows broken"
B) failing to recognize objects or people
C) difficulty planning how to carry out a sequence of actions
D) trouble stopping oneself from engaging in a behavior

18 All of the following are pathological brain changes that occur in

Alzheimer's disease except:
A) neurofibrillary tangles.
B) loss of dendrites.
C) shrunken ventricles.
D) extensive cell death.

19 The most common causes of closed head injuries are:

A) gunshot wounds.
B) falls.
C) motor vehicle accidents.
D) blows to the head during violent assaults.

20 Which of the following disorders is transmitted by a single

dominant gene?
A) Huntington's disease
B) Parkinson's disease
C) Alzheimer's disease
D) Pick's disease
ANSWERS:

1.C
2.B
3.B
4.C
5.B
6.A
7.C
8.B
9.B
10.C
11.A
12.D
13.B
14.D
15.C
16.B
17.B
18.C
19.E
20.A

FOR MORE QUESTIONS:

Dementia
Delirium

❖Depressive disorders:
1. Ms. Nouf is a 28-year-old single woman works as a teacher. She has a
five-week history of low mood, chest tightness, poor appetite,
disturbed sleep, excessive guilt feelings, and loss of interest in her
social activities. Her father has a history of depression.
What is Ms. Nouf's condition?
She has MDE, which can be a presentation of MDD, Bipolar I or Bipolar II disorders.
So,this means MDE≠MDD.

How you would proceed in such a case?

Take a detailed past psychiatric history especially previous manic, mixed, or depressive
episodes.
Why is it essential to take detailed past psychiatric history?
Not only to reach a proper diagnosis , but also to treat her properly. If she had previous
manic or mixed episodes and you treat her with antidepressants without careful
observation she may swing into a manic or a mixed episode with serious behavioral
problems.

A 28-year-old female reports that, for more days than not over the past
3 years, she has felt "down" and, at times, "mildly depressed." Over this
period, she also endorses feeling fatigued, difficulty concentrating, and
often sleeping more than in the past. The patient denies any manic or
hypomanic periods and also reports that she did not have any periods
of extreme worsening of her depressed mood beyond that described
above. She also denies any suicidal ideation. What is the minimum
amount of time this patient must exhibit these symptoms in order to
meet the diagnostic criteria for dysthymia?
1. 2 months
2. 6 months
3. 1 year
4. 2 years
Answer is 4

A 44 year-old woman with severe depression is about to initiate a

therapy that has a common side effect of amnesia. What therapy is she
likely to be starting?
1. Electroconvulsive therapy
2. Sertraline
3. Propofol
4. Alprazolam
5. Psychotherapy
Answer is 1

A 27-year-old female presents to your office for a check up. The patient
is currently on paroxetine, though denies depressive symptoms for the
last 6 months. She has had 2 episodes of major depression. How do you
proceed with this patient?
1. Discontinue paroxetine today
2. Continue for another 6 months, and if symptom free, discontinue paroxetine
3. Continue for another 12 months, and if symptom free, discontinue paroxetine
4. Continue for another 3 years, and if symptom free, discontinue paroxetine
5. Continue paroxetine indefinitely.
Answer is 5 ​because :The patient in this vignette is currently in remission on SSRI
therapy. With a history of 2 (or greater) depressive episodes, therapy should be
continued indefinitely​.

A 56-year-old hypertensive man on antihypertensive medications was

referred to psychiatry clinic for evaluation of loss of pleasure, poor
erection, poor appetite, and disturbed sleep. The most appropriate
management step:
A. Start him on paroxetine 50 mg.
B. Investigate him for hypothyroidism.
C. Review side effects of his medications.
D. Add Propranolol to his medications.
Answer is C

Which episode is occur when there is more than 1 week of elevated,

expansive, or irritable mood ?
A. ​Major depressive episode
B. Manic episode
C. Mixed episode
D. Hypomanic episode
Answer is B
A 28-year-old woman is following up with her primary care physician
for treatment of depression. Three months ago she was diagnosed with
a first episode of major depressive disorder and was started on
sertraline at that time. She now reports significant improvement in her
symptoms for the last month. She denies any difficulty sleeping or
difficulty tolerating the medication. She is exercising regularly and
enjoying her work as an attorney. She wants to know how much longer
she should continue treatment with sertraline. Which of the following
is the appropriate course of management?
1. She can now stop treatment.
2. She should continue treatment for an additional 3 months.
3. She should continue treatment for an additional 5 months.
4. She should continue treatment for an additional 11 months.
5. She should continue lifetime treatment.
Answer is 3

A 67-year-old man presents to general medical clinic with a chief

complaint of fatigue. He also reports poor concentration and a general
sense of hopelessness. He denies any other symptoms. He feels as if
these symptoms will never go away as they have been present for the
past three years. His vital signs are within normal limits and a physical
exam is unremarkable. A laboratory workup reveals that he is
euthyroid. What is the most likely diagnosis?
1. Cyclothymia
2. Major Depressive Disorder
3. Double Depression
4. Dysthymia
5. Bipolar Disorder
Answer is 4

A 77-year-old woman presents to general medical clinic with a chief

complaint of a depressed mood. She reports that she has been unable to
sleep regularly for ten days. During this time, she has no interest in
knitting or reading, two of her favorite hobbies. She feels guilty that she
has not been able to improve her mood. She denies any suicidal
ideations. Which of the following is true regarding the diagnosis of
major depressive disorder in this patient?
1. Sufficient duration of symptoms, but does not have the required number of symptoms
2. Insufficient duration of symptoms, but does have appropriate number of symptoms
3. Sufficient duration and number of symptoms
4. Insufficient duration and number of symptoms
5. The patient could not meet criteria for this disease without suicidal ideation
Answer is 4

Anxiety disorders are considered as part of mood disorders in the

modern classification:
A. True
 B. False
Answer is B

Which one of the depressive disorders is more in children ?

A. Disruptive Mood Dysregulation Disorder
B. Premenstrual Dysphoric Disorder
C. Major Depressive Disorder
D. Persistent Depressive Disorder
Answer is A

All of the following diseases can contribute to depression, EXCEPT:

A. SLE.
B. Astrocytoma.
C. Parkinson's disease.
D. Otitis media.
Answer is D

The most effective treatment for dysthymic disorder is the (CBT):

A. True.
B. False.
Answer is A

❖Schizophrenia:
1-What is the mainstay treatment of schizophrenia?
A) ECT
B) hospitalization
C) antipsychotic medication
D) antidepressants medication
Answer :B
2-which one of these drugs considered a -Conventional, (1st
generation) drug ?
A. Risperidone
B. Clozapine
C. Olanzapine
D. haloperidol
Answer : D
3- the Exact etiology of schizophrenia is ?
A.Unknown
B.Mutation of gene
C.Social problems
D.All
Answer : A

4- schizophrenia probably involves . . .

A.multiple neurotransmitter system abnormalities
B.Decrease Glutamate
C.Decrease Dopamine
D.Both b & c
Answer : A

5- in a mental status examination, we should pay attention to :

A. Appearance & behavior
B. Cognitive functioning
C. Perceptual disturbances
D. All of the above
Answer : D
6- Which statement of the following is FALSE ?
A) There is only a single clinical sign or symptom that is pathognomonic for
schizophrenia.
B) Patient's history & mental status examination are essential for diagnosis.
C) Premorbid history includes schizoid or schizotypal personalities
D) Premorbid history includes few friends & exclusion of social activities.
Answer : A
A 26-year-old male presents with 'voices in my head." The patient was
well until 8 months ago when he began to hear voices of two men
plotting to kill him. His fear of being killed has resulted in his missing
multiple days of work, and he was recently fired. On physical exam he
is disheveled and has incoherent, disorganized speech. Which of the
following findings would you NOT expect to see on head CT?
1. Decreased cerebellar mass
2. Increased ventricular size
3. Decreased cerebral mass
4. Decreased hippocampal mass
5. Decreased temporal mass

Answer is:1 , ​This patient has schizophrenia. Patients with schizophrenia do NOT have
decreased cerebellar mass, though they may have increased ventricular size, and decreased
cerebral, hippocampal and temporal masses.

​A 17-year-old patient with a past medical history of recent marijuana

use presents to her primary care physician for a routine check-up.
Although the patient has been well-groomed on past visits, the patient
is noticeably disheveled, with a strong odor and dirty clothes. When
asked why she has come to the office, she responds, "I just returned
from the moon." During follow-up questions, she seems distracted,
often stopping in the middle of a sentence. Which of the following is
most likely to denote a poor prognosis in this patient?
1. Mostly positive symptoms
2. Early age of onset
3. An absence of a family history
4. Recent use of marijuana

Answer is:2 ,​The first psychotic break in men with schizophrenia typically occurs by age 25 or
earlier. A poor prognosis is associated with earlier age of onset (which is associated with a male
gender), a positive family history, and mostly negative symptoms.