An 18-year-old boy came to the psychiatry clinic complaining of feeling strange and different from his normal self. He felt tense and anxious but could not identify the precise change. He was experiencing depersonalization.

1. QUIZ &
FEEDBACK
PHENOMENOLOGY
PSYCHIATRIC HISTORY & MSE

2. THIS PHENOMENA IS
BEST CALLED AS
An 18 year old boy came to the Psychiatry OPD with a
complaint of feeling changed from inside. He described
himself as feeling strange as if he is different from his
normal self. He was very tense and anxious yet could not
point out the precise change in him.
A. Delusional mood
B. Depersonalization
C. Autochthonous delusion
D. Over valued idea

3. DELUSION IS A DISORDER
OF
A. Thought
B. Perception
C. Insight
D. Cognition
E. Judgment

4. PERSEVERATION IS
A. Persistent and inappropriate repetition of the same
thoughts
B. When a patient feels very distressed about it
C. Characteristic of schizophrenia
D. Characteristic of obsessive compulsive disorder (OCD)
E. Relentless pursuit of one’s goal

5. LOOSENING OF ASSOCIATION IS
AN EXAMPLE OF
A. Formal thought disorder
B. Schneiderian first rank symptoms
C. Perseveration
D. Concrete thinking
E. Word salad

6. STATE THE FORMAL
THOUGHT DISORDER
"Many moldy mushrooms merge out of the
mildewy mud on Mondays."
"I heard the bell. Well, hell, then I fell."
"The next day when I'd be going out you
know, I took control, like uh, I put bleach on
my hair in California."

7. STATE THE FORMAL
THOUGHT DISORDER
Q: "What is your name?"
A: "Well, sometimes when people ask me that I have to think about
whether or not I will answer because some people think it's an odd
name even though I don't really because my mum gave it to me and I
think my dad helped but it's as good a name as any in my opinion, I
think it's a little weird to have the same name as two of my other
names, but the fact that I like it is a good thing... but yeah, it's Gordon."
"I own five cigars. I've been to Havana. She rose out of the water, in a
bikini."
Q: "Why do people comb their hair?"
A: "Because it makes a twirl in life, my box is broken help me blue
elephant. Isn't lettuce brave? I like electrons, hello please!"

8. STATE THE FORMAL
THOUGHT DISORDER
"I got so angry I picked up a dish and threw it at the geshinker."
"It's great to be here in Nevada, Nevada, Nevada, Nevada,
Nevada.“
Q: “Is your name Mary?"
A: "Yes."
Q: "Are you in the hospital?"
A: "Yes."
Q: "Are you a table?"
A: "Yes."

9. STATE THE FORMAL
THOUGHT DISORDER
“I’m not trying to make noise............I’m not trying to make sense
anymore. I’m trying to make dollars”
Interviewer, “What do you think about current political issues
like the energy crisis?”
Patient, “They're destroying too many cattle and oil just to make
soap. If we need soap when you can jump into a pool of water,
and then when you go to buy your gasoline, my folks always
thought they should get pop, but the best thing to get is motor
oil, and money.”
“I think I'll put on my hat, my hat, my hat, my hat.”

10. REGARDING CATATONIC
SYMPTOMS
Movement and speech ceases and the patient is unresponsive to
the spoken word or even to painful stimuli. There is usually also
the failure to take food or fluid.
The patient assumes a posture which is then maintained. This
might be a strange posture such as standing on one leg with the
arms out sideways in the middle of the front path.
A posture is maintained against the interviewer’s attempts to
move the limbs or the whole patient
The interviewer can change the position of the patient’s limbs,
and in the process the limbs feel to the interviewer as if they are
made of wax

11. DISORDER OF THOUGHT
CONTENT

12. QUIZ &
FEEDBACK
SCHIZOPHRENIA & OTHER PSYCHOTIC DISORDERS

13. All of the following are associated
with better prognosis in
schizophrenia, except
A. Late onset
B. Married
C. Negative symptoms
D. Acute onset

14. STATE THE DIAGNOSIS
Chris, a 44 year old woman, was arrested after harassing a local
television newscaster with telephone calls and letters asserting that he
had fathered, then absconded with her child. She denied any wish to
harm him but steadfastly pursued him with demands that he give her
“visitation rights” to “their” child. She said she understood that he
would be unable to marry her, or even to outwardly acknowledge his
love for her, because of his delicate public position.
There was no indication that the newscaster had ever had a
relationship with Chris, although evidence from her files and from her
apartment indicated that her fantasized relationship with him had
existed for several years. There was no indication of hallucinations,
disturbance of affect, significant Mood Disorder, or organic illness, and
the woman had never been treated for a psychiatric disorder.

15. SCHNEIDER’S FIRST RANK
SYMPTOMS (FRS)
A. Hearing thought spoken aloud
B. Hearing voices calling the patient’s name
C. Hallucination of running commentary
D. Somatic passivity
E. Persecutory delusion
F. Delusional perception
G. Waxy flexibility
H. Thought broadcast
I. ‘Made action’
J. Extracampine hallucination

16. PREDICTORS OF POOR
OUTCOME IN SCHIZOPHRENIA
A. Male
B. Married
C. Early age of onset
D. Family history of schizophrenia
E. Sudden onset
F. Abnormal premorbid personality
G. Co-morbid substance abuse
H. Mental retardation
I. Prominent mood symptoms
J. Prominent negative symptoms

17. BRIEF PSYCHOTIC
DISORDER
A. Sudden onset
B. Lasted 1 to 6 months
C. Confusion and labile mood is common
D. Three quarters will later on develop
schizophrenia
E. Functioning not grossly impaired and no bizarre
behaviour
F. Requires long-term antipsychotic tretment
G. Need to rule out substance use disorder

18. QUIZ &
FEEDBACK
NEUROLEPTICS
LIMBIC SYSTEM

19. REGARDING EXTRA
PYRAMIDAL SIDE-EFFECTS
A. Dry mouth
B. Hypotension
C. Weight gain
D. Akathisia
E. Blurred vision
F. Dystonia
G. Neuroleptic malignant
syndrome
H. Constipation
I. Retinitis
J. Parkinsonism
K. Urinary retention
L. Arrhythmia
M. Sialorrhea
N. Galactorrhea
O. Amenorhea
P. Diarrhea
Q. Dyskinesia
R. Jaundice
S. Skin discoloration

20. THE MOST LIKELY
DIAGNOSIS IS
A patient with acute psychosis, who is on haloperidol 20
mg/day for last 2 days, has an episode characterized by
tongue protrusion, oculogyric crisis, stiffness and
abnormal posture of limbs and trunk without loss of
consciousness for last 20 minutes before presenting to
casualty. This improved within a few minutes after
administration of diphenhydramine HCl.
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome

21. THE MOST LIKELY
DIAGNOSIS IS
A 30 year old man who was recently started on haloperidol 30
mg/day developed hyperpyrexia, muscle rigidity, akinesia,
mutism, sweating, tachycardia and increased blood
pressure. The investigations showed increased WBC count,
increased CPK. These is no history of any other drug intake
or any signs of infection.
A. Drug overdose
B. Neuroleptic malignant syndrome
C. Drug-induced Parkinsonism
D. Tardive dyskinesia

22. FUNCTIONS OF THE
LIMBIC SYSTEM
A. Memory
B. Reasoning
C. Reward
D. Emotion
E. Calculation
F. Sexual behavior
G. Expressive language function
H. Maternal behavior
I. Motor coordination

23. KLUVER-BUCY
SYNDROME
A. Inability to recognize common objects or understand
the meaning despite the fact that they could see
B. Need to examine their surroundings with their mouth
instead of their eyes
C. Obsessive urge to run around and touch everything
and place each found objects in their mouth
D. Increase sexual activity, hetero and homosexual acts,
masturbation
E. Decrease in fear

24. QUIZ &
FEEDBACK
NORMAL AND ABNORMAL BEHAVIOUR
BASIC CLASSIFICATION IN PSYCHIATRY

25. NORMALITY VS.
ABNORMALITY
In some cultures it is inappropriate to wear black to a funeral,
while in other wearing any color other than black is strange
Living in a state where you cannot emotionally connect to
anyone which causes physical strain
If it’s normal for a large population of people to laugh when
tickled this response can then be considered normal.
Schizophrenics may receive medications for the delusions they
experience

26. STRENGTHS OF CATEGORICAL
APPROACH INCLUDE
A. Reflects the “uniqueness” of each case
B. Helps professionals internationally
C. Considered to be “user friendly”
D. Richer and more detailed description
E. Enhances communication amongst health pro’s by providing
a “common language”
F. Helps reduce stigma because the person is not “labelled”
rather they gain a “profile of scores”
G. Takes into account wider range of a person’s symptoms &
characteristics

27. PSYCHOSIS
A. Are severe mental illness
B. Involve the total personality
C. Are manifested by anxiety or its derivatives
D. Are not accompanied by gross impairment of reality testing
E. Associated with bizarre behavior
F. Affect is usually normal
G. Exaggeration of normal experience
H. Insight is usually normal
I. Anxiety symptoms exclude psychosis

28. ORGANIC MENTAL
DISORDER
A. The term is currently being used in DSM-IV
B. Include cognitive disorders, conditions due
to a general medical condition and
substance related disorders
C. Psychosis is a features