I85PREP
⌘ K
Arab Board Psychiatry Part 1 study materials
Arab Board Psychiatry Part 1 study resources

Arab Board Psychiatry Part 1 practice questions

One question at a time. Build your Arab Board Psychiatry Part 1 understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which neurotransmitter is synthesised by the rate-limiting enzyme tyrosine hydroxylase?

  1. Dopamine Correct answer.
  2. Serotonin
  3. Acetylcholine
  4. GABA

Explanation

Catecholamines are built from tyrosine; tyrosine hydroxylase converts tyrosine to L-DOPA and is the rate-limiting step, with dopamine as the first catecholamine product. Acetylcholine, serotonin and GABA arise from entirely different precursors.

Question 2Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

The principal inhibitory neurotransmitter in the adult mammalian central nervous system is:

  1. Substance P
  2. Dopamine
  3. GABA Correct answer.
  4. Glutamate

Explanation

GABA is the dominant inhibitory transmitter, acting largely through GABA-A chloride channels and GABA-B G-protein-coupled receptors. Glutamate is the main excitatory transmitter, while dopamine and substance P are modulatory or peptidergic.

Question 3Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Degeneration of dopaminergic neurons in the substantia nigra pars compacta is the pathological hallmark of:

  1. Alzheimer disease
  2. Huntington disease
  3. Parkinson disease Correct answer.
  4. Multiple sclerosis

Explanation

Loss of nigrostriatal dopamine neurons produces the classic motor triad of Parkinson disease. Huntington disease involves striatal degeneration, Alzheimer disease cortical pathology, and multiple sclerosis demyelination.

Question 4Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

The antipsychotic action of most first-generation drugs is attributed mainly to blockade of which receptor?

  1. GABA-A receptors
  2. 5-HT2A serotonin receptors
  3. D2 dopamine receptors Correct answer.
  4. H1 histamine receptors

Explanation

Typical antipsychotics act chiefly as D2 dopamine receptor antagonists in mesolimbic pathways, which correlates with antipsychotic potency. 5-HT2A blockade is more characteristic of atypicals, while H1 and GABA-A effects do not mediate antipsychotic efficacy.

Question 5Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which enzyme is inhibited by monoamine oxidase inhibitors?

  1. Catechol-O-methyltransferase
  2. Tryptophan hydroxylase
  3. Monoamine oxidase Correct answer.
  4. Acetylcholinesterase

Explanation

MAOIs block monoamine oxidase, the enzyme that degrades noradrenaline, dopamine and serotonin, thereby raising synaptic monoamine levels. The other enzymes have distinct roles in catabolism or synthesis.

Question 6Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Lithium is most appropriately monitored by measuring:

  1. Erythrocyte lithium content
  2. Salivary lithium concentration
  3. Serum lithium concentration 12 hours after the last dose Correct answer.
  4. Urinary lithium excretion

Explanation

Therapeutic drug monitoring for lithium uses a serum level drawn about 12 hours post-dose to reflect steady-state trough concentrations. Other matrices are not standard for routine monitoring.

Question 7Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

In a case-control genetic study, an odds ratio of 1.0 for a candidate allele indicates:

  1. Insufficient data to interpret
  2. Strong association with the disorder
  3. Protective effect against the disorder
  4. No association with the disorder Correct answer.

Explanation

An odds ratio of 1.0 means the odds of exposure are identical in cases and controls, i.e. no association. Values above 1 suggest risk and below 1 suggest protection.

Question 8Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Benzodiazepines produce their anxiolytic effect by:

  1. Increasing the frequency of GABA-A channel opening Correct answer.
  2. Directly opening chloride channels
  3. Blocking presynaptic GABA release
  4. Inhibiting GABA transaminase

Explanation

Benzodiazepines are positive allosteric modulators that increase the frequency of GABA-A chloride channel opening in the presence of GABA. Barbiturates prolong channel opening duration, and neither class opens channels directly.

Question 9Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which cranial nerve nucleus provides parasympathetic innervation to the salivary glands and also receives fibres mediating taste from the anterior tongue?

  1. Facial nerve nucleus Correct answer.
  2. Oculomotor nucleus
  3. Trigeminal motor nucleus
  4. Hypoglossal nucleus

Explanation

The facial nerve carries parasympathetic fibres to the submandibular and sublingual glands via the superior salivatory nucleus and taste fibres from the anterior two-thirds of the tongue via the chorda tympani. The other nuclei serve motor or oculomotor functions.

Question 10Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Long-term potentiation in the hippocampus is most dependent on which receptor?

  1. Alpha-1 adrenergic receptor
  2. GABA-B receptor
  3. NMDA receptor Correct answer.
  4. Muscarinic M2 receptor

Explanation

NMDA receptor activation allows calcium influx that triggers the synaptic changes underlying long-term potentiation, a cellular model of learning. The other receptors do not provide the coincidence detection required.

Question 11Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A patient on fluoxetine develops agitation, tremor and hyperthermia after taking tramadol. The most likely mechanism is:

  1. Excess serotonergic activity Correct answer.
  2. Cholinergic overactivity
  3. GABA-A potentiation
  4. Dopamine D2 blockade

Explanation

Combining an SSRI with a serotonergic agent such as tramadol can precipitate serotonin syndrome through excessive synaptic serotonin. The features described are characteristic of that syndrome rather than of dopamine blockade or cholinergic excess.

Question 12Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Clozapine requires regular blood monitoring primarily to detect:

  1. Hypothyroidism
  2. Hyponatraemia
  3. Hypercalcaemia
  4. Agranulocytosis Correct answer.

Explanation

Clozapine carries a well-established risk of neutropenia and agranulocytosis, so full blood counts are mandatory at defined intervals. Electrolyte and thyroid disturbances are not the reason for mandatory monitoring.

Question 13Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A tricyclic antidepressant overdose most characteristically produces which ECG change?

  1. Prominent U waves
  2. Widened QRS complex Correct answer.
  3. Shortened PR interval
  4. Prolonged QT interval with flat T waves

Explanation

Tricyclics block cardiac sodium channels, slowing depolarisation and widening the QRS complex, which predicts arrhythmia risk. QT prolongation and U waves are more typical of other drug or electrolyte disturbances.

Question 14Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

The inheritance pattern of Huntington disease is:

  1. Autosomal recessive
  2. X-linked dominant
  3. Mitochondrial
  4. Autosomal dominant Correct answer.

Explanation

Huntington disease is caused by a CAG repeat expansion in the HTT gene and follows autosomal dominant inheritance with high penetrance. Its pattern is not recessive, X-linked or mitochondrial.

Question 15Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A 30-year-old presents with hyperphagia, weight gain and hypersomnolence after a hypothalamic insult. Which structure is most implicated?

  1. Amygdala
  2. Hippocampus
  3. Ventromedial hypothalamus Correct answer.
  4. Lateral hypothalamus

Explanation

The ventromedial hypothalamus mediates satiety, so its damage produces hyperphagia and obesity. The lateral hypothalamus instead drives feeding, and the amygdala and hippocampus serve emotional and memory functions.

Question 16Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement best describes the mechanism of action of selective serotonin reuptake inhibitors?

  1. They inhibit monoamine oxidase type A
  2. They directly stimulate postsynaptic serotonin receptors
  3. They block presynaptic serotonin reuptake transporters Correct answer.
  4. They deplete presynaptic serotonin stores

Explanation

SSRIs inhibit the serotonin transporter, increasing extracellular serotonin and enhancing serotonergic transmission over time. They do not act as direct receptor agonists or as MAO inhibitors.

Question 17Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A drug that blocks muscarinic receptors is most likely to cause which adverse effect?

  1. Bradycardia
  2. Urinary retention Correct answer.
  3. Diarrhoea
  4. Miosis

Explanation

Antimuscarinic blockade relaxes the detrusor muscle and impairs bladder emptying, producing urinary retention. The other listed effects reflect cholinergic excess rather than blockade.

Question 18Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

The mesolimbic dopamine pathway projects primarily from the ventral tegmental area to which structure?

  1. Substantia nigra
  2. Nucleus accumbens Correct answer.
  3. Cerebellum
  4. Medulla oblongata

Explanation

The mesolimbic pathway carries dopamine from the ventral tegmental area to the nucleus accumbens and is implicated in reward and psychosis. The substantia nigra belongs to the nigrostriatal pathway.

Question 19Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which of the following best describes the phenomenon of tachyphylaxis with repeated drug administration?

  1. An exaggerated response to a first dose
  2. Increased drug accumulation due to impaired clearance
  3. An immune-mediated reaction to a drug
  4. A rapid decrease in response after repeated dosing Correct answer.

Explanation

Tachyphylaxis is a rapid loss of responsiveness on repeated dosing, often due to receptor desensitisation or transmitter depletion. It differs from allergy, first-dose hypersensitivity and pharmacokinetic accumulation.

Question 20Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A 45-year-old on haloperidol develops rigidity, tremor and fever with raised creatine kinase. The most likely diagnosis is:

  1. Acute dystonic reaction
  2. Neuroleptic malignant syndrome Correct answer.
  3. Anticholinergic toxicity
  4. Serotonin syndrome

Explanation

Neuroleptic malignant syndrome follows dopamine blockade and presents with rigidity, hyperthermia, autonomic instability and elevated creatine kinase. Serotonin syndrome instead shows hyperreflexia and clonus.

Question 21Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement about the blood-brain barrier is correct?

  1. It is formed by fenestrated capillary endothelium
  2. It freely permits large hydrophilic molecules
  3. It is formed by tight junctions between capillary endothelial cells Correct answer.
  4. It is absent in the area postrema

Explanation

The blood-brain barrier depends on tight junctions between brain capillary endothelial cells supported by astrocyte end-feet, restricting paracellular movement. Circumventricular organs such as the area postrema are specialised exceptions, not evidence of general absence.

Question 22Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

In a randomised trial, a drug reduces relapse from 40% to 30%. The absolute risk reduction is:

  1. 33%
  2. 75%
  3. 10% Correct answer.
  4. 25%

Explanation

Absolute risk reduction is the simple difference between event rates, 40% minus 30%, giving 10%. The relative risk reduction is 25%, and the number needed to treat is the reciprocal of the absolute reduction.

Question 23Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which receptor type is a ligand-gated ion channel that mediates fast excitatory synaptic transmission?

  1. Muscarinic M1 receptor
  2. GABA-B receptor
  3. D2 dopamine receptor
  4. AMPA receptor Correct answer.

Explanation

AMPA receptors are ionotropic glutamate receptors responsible for fast excitatory transmission. GABA-B, muscarinic and dopamine receptors are all G-protein-coupled metabotropic receptors.

Question 24Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A patient with a lesion of the right parietal lobe is most likely to show which deficit?

  1. Right-sided homonymous hemianopia
  2. Aphasia
  3. Left-sided hemispatial neglect Correct answer.
  4. Ideomotor apraxia of the right hand

Explanation

The right parietal lobe attends to the contralateral left hemispace, so right-sided lesions commonly cause left hemispatial neglect. Homonymous hemianopia and aphasia localise to other regions.

Question 25Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which pharmacokinetic change in older adults most increases the risk of drug accumulation?

  1. Reduced renal clearance Correct answer.
  2. Increased serum albumin
  3. Decreased body fat proportion
  4. Increased hepatic blood flow

Explanation

Glomerular filtration declines with age, reducing clearance of renally excreted drugs and prolonging half-life. Hepatic flow and albumin tend to fall, and body fat proportion tends to rise.

Question 26Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

The nigrostriatal dopamine pathway originates in which midbrain structure?

  1. Locus coeruleus
  2. Substantia nigra pars compacta Correct answer.
  3. Ventral tegmental area
  4. Raphe nuclei

Explanation

The nigrostriatal tract arises from dopaminergic neurons of the substantia nigra pars compacta and projects to the dorsal striatum, forming part of the basal ganglia motor circuit. Its degeneration produces the motor features of Parkinson disease.

Question 27Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which enzyme is the rate-limiting step in the synthesis of catecholamines?

  1. Dopamine beta-hydroxylase
  2. Tyrosine hydroxylase Correct answer.
  3. Catechol-O-methyltransferase
  4. Dopa decarboxylase

Explanation

Tyrosine hydroxylase converts tyrosine to L-DOPA and is the rate-limiting enzyme of catecholamine biosynthesis; it is regulated by end-product feedback. Subsequent steps proceed rapidly once L-DOPA is formed.

Question 28Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A person with a first-degree relative affected by schizophrenia has an approximate lifetime risk of developing the disorder of about:

  1. 1%
  2. 45%
  3. 10% Correct answer.
  4. 3%

Explanation

The general population risk is about 1%, rising to roughly 10% in first-degree relatives of an affected person, which illustrates substantial but incomplete heritability. Risk rises further with greater genetic sharing such as monozygotic twins.

Question 29Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement about the inheritance of fragile X syndrome is correct?

  1. It follows autosomal dominant inheritance
  2. It affects males and females with equal severity
  3. It is caused by expansion of a CGG repeat on the X chromosome Correct answer.
  4. It results from deletion of chromosome 22q11

Explanation

Fragile X syndrome results from expansion of a trinucleotide CGG repeat in the FMR1 gene on the X chromosome. Because it is X-linked, males are typically more severely affected than females.

Question 30Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which second messenger is generated by activation of a Gq-coupled receptor such as the alpha-1 adrenergic receptor?

  1. Adenosine triphosphate
  2. Cyclic AMP
  3. Inositol trisphosphate Correct answer.
  4. Cyclic GMP

Explanation

Gq-coupled receptors activate phospholipase C, which cleaves phosphatidylinositol bisphosphate into inositol trisphosphate and diacylglycerol, mobilising intracellular calcium. Cyclic AMP is generated downstream of Gs or Gi coupling instead.

Question 31Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A patient taking a monoamine oxidase inhibitor eats aged cheese and develops severe occipital headache, hypertension and sweating. Which mechanism best explains this reaction?

  1. Direct blockade of alpha-1 adrenergic receptors
  2. Reduced gut absorption of the drug
  3. Accumulation of tyramine with displacement of stored noradrenaline Correct answer.
  4. Increased hepatic metabolism of the inhibitor

Explanation

MAO inhibitors block breakdown of dietary tyramine, which then enters adrenergic nerve terminals and displaces stored noradrenaline, producing a hypertensive crisis. This is the classic cheese reaction.

Question 32Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A patient with bipolar disorder on lithium develops coarse tremor, ataxia and confusion after starting a thiazide diuretic. Which mechanism best explains this?

  1. Thiazides increase renal lithium reabsorption Correct answer.
  2. Thiazides block lithium entry into the brain
  3. Thiazides increase lithium clearance
  4. Thiazides induce hepatic enzymes that activate lithium

Explanation

Thiazide diuretics cause sodium depletion, and the kidney compensates by increasing proximal tubular reabsorption of lithium, raising serum levels toward toxicity. Loop diuretics and osmotic diuretics have a different effect on lithium handling.

Question 33Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement about the mechanism of action of typical antipsychotic drugs is most accurate?

  1. They inhibit monoamine oxidase type B
  2. They act primarily as serotonin 5-HT2A agonists
  3. They block dopamine D2 receptors in mesolimbic pathways Correct answer.
  4. They potentiate GABA-A receptor currents

Explanation

Typical antipsychotics produce their antipsychotic effect mainly through D2 receptor blockade in mesolimbic circuits, while nigrostriatal blockade explains extrapyramidal effects. Serotonin antagonism is characteristic of atypical agents.

Question 34Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A patient stable on warfarin starts fluoxetine. Which pharmacokinetic interaction is most likely?

  1. Fluoxetine displaces warfarin from albumin without affecting INR
  2. Fluoxetine inhibits CYP2C9 and raises INR Correct answer.
  3. Fluoxetine induces CYP2C9 and lowers INR
  4. Fluoxetine increases renal warfarin excretion

Explanation

Fluoxetine inhibits CYP2C9, the enzyme metabolising S-warfarin, so warfarin levels and INR rise, increasing bleeding risk. Close INR monitoring is needed when such combinations are unavoidable.

Question 35Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement about the mechanism of action of valproate is correct?

  1. It is a selective GABA-A receptor antagonist
  2. It blocks voltage-gated sodium channels and increases GABA availability Correct answer.
  3. It inhibits serotonin reuptake selectively
  4. It acts mainly by blocking dopamine D2 receptors

Explanation

Valproate limits sustained repetitive neuronal firing through sodium channel blockade and also raises GABA levels, giving it broad-spectrum antimanic and anticonvulsant activity. It is not a receptor antagonist or reuptake inhibitor.

Question 36Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which change in drug handling with ageing most increases the risk of accumulation of water-soluble drugs such as lithium?

  1. Increased lean body mass
  2. Reduced glomerular filtration rate Correct answer.
  3. Increased hepatic blood flow
  4. Increased serum albumin

Explanation

Glomerular filtration declines with age, so renally cleared drugs accumulate unless doses are adjusted. Lithium is entirely renally excreted, making this particularly important.

Question 37Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

A lesion of the left optic nerve just anterior to the chiasm produces which visual field defect?

  1. Bitemporal hemianopia
  2. Total blindness of the left eye Correct answer.
  3. Left homonymous hemianopia
  4. Right homonymous hemianopia

Explanation

The optic nerve carries all fibres from the ipsilateral retina, so a prechiasmal lesion causes monocular blindness on the same side. Chiasmal lesions produce bitemporal defects and retrochiasmal lesions produce homonymous defects.

Question 38Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which finding is most characteristic of a lesion in Wernicke's area?

  1. Non-fluent speech with preserved comprehension
  2. Fluent speech with impaired comprehension Correct answer.
  3. Loss of ability to write despite normal speech
  4. Inability to repeat sentences with otherwise normal speech

Explanation

Wernicke's area in the posterior superior temporal gyrus mediates language comprehension; lesions cause fluent but meaningless speech with poor comprehension and impaired repetition. Broca's area lesions instead produce non-fluent output.

Question 39Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

In a twin study, concordance for a disorder is 60% in monozygotic and 20% in dizygotic pairs. Which conclusion is best supported?

  1. The disorder follows simple Mendelian inheritance
  2. The disorder is entirely environmental
  3. Heritability is approximately zero
  4. Genetic factors contribute substantially to liability Correct answer.

Explanation

A markedly higher concordance in monozygotic than dizygotic twins indicates a substantial genetic contribution, since both types share environments to a similar degree. Concordance below 100% in monozygotic pairs also shows that non-genetic factors matter.

Question 40Basic Sciences Relevant to Psychiatry (neuroanatomy, neurophysiology, neurochemistry, genetics, psychopharmacology)

Which statement about the mechanism of action of buspirone is correct?

  1. It is a full agonist at GABA-A receptors
  2. It is a partial agonist at serotonin 5-HT1A receptors Correct answer.
  3. It blocks histamine H1 receptors
  4. It inhibits noradrenaline reuptake

Explanation

Buspirone acts as a partial agonist at 5-HT1A receptors, with delayed anxiolytic onset and no cross-tolerance with benzodiazepines. It does not act through GABA or histamine receptors.

Question 41Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

During a mental state examination, a patient reports hearing voices that comment on his actions in the third person. This phenomenon is best classified as which type of hallucination?

  1. Gustatory hallucination
  2. Tactile hallucination
  3. Auditory verbal hallucination Correct answer.
  4. Visual hallucination

Explanation

Hallucinations are percepts without an external stimulus and are classified by the sensory modality involved. Voices, including third-person commenting voices, are auditory verbal hallucinations.

Question 42Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

A patient firmly believes that strangers on the street are plotting to kill him, despite no evidence, and this belief is unshakeable. This is best described as which type of delusion?

  1. Erotomanic delusion
  2. Nihilistic delusion
  3. Grandiose delusion
  4. Persecutory delusion Correct answer.

Explanation

A delusion is a fixed false belief held with conviction despite contrary evidence. Beliefs that others intend harm are persecutory (paranoid) delusions.

Question 43Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

Which term describes a patient's inability to recognize that he is ill despite clear evidence of a psychotic disorder?

  1. Anosognosia Correct answer.
  2. Avolition
  3. Apathy
  4. Alexithymia

Explanation

Anosognosia is impaired awareness of one's own illness, common in psychotic and some neurological disorders. Apathy and avolition refer to reduced motivation, not illness awareness.

Question 44Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

In the mental state examination, a patient's speech is described as jumping from one topic to another with loose associations between ideas. This is best termed which of the following?

  1. Mutism
  2. Flight of ideas Correct answer.
  3. Echolalia
  4. Perseveration

Explanation

Flight of ideas is rapid, pressured speech with loose but discernible associations between successive ideas, typically seen in mania. Perseveration and echolalia are different speech phenomena.

Question 45Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

A patient sits motionless in an odd posture for an hour and resists passive movement of his limbs. This finding is best described as which of the following?

  1. Catalepsy with rigidity Correct answer.
  2. Tardive dyskinesia
  3. Tremor
  4. Akathisia

Explanation

Catalepsy is maintenance of a posture against gravity, often with waxy flexibility, and is a catatonic sign. Akathisia is motor restlessness, while tardive dyskinesia involves involuntary movements.

Question 46Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

Which of the following is the standard multiaxial classification system formerly used by the American Psychiatric Association that has now been replaced by a single-axis diagnostic manual?

  1. DSM-IV Correct answer.
  2. ICD-11
  3. ICD-10
  4. DSM-5

Explanation

DSM-IV used a multiaxial system with five axes, which was abandoned in DSM-5 in favour of a single diagnostic listing. ICD systems did not use the same five-axis framework.

Question 47Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

A patient describes feeling that his thoughts are being removed by an external force and that his actions are controlled by others. These experiences are best classified as which type of phenomenon?

  1. Compulsions
  2. Obsessions
  3. Phobias
  4. Passivity phenomena Correct answer.

Explanation

Passivity phenomena (made phenomena) are experiences that one's thoughts, feelings, or actions are controlled by an external agency. Obsessions and compulsions are intrusive phenomena of anxiety disorders.

Question 48Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

Which of the following best describes the purpose of the mental state examination?

  1. To determine the patient's genetic risk only
  2. To record a cross-sectional description of the patient's current psychological functioning Correct answer.
  3. To establish a lifelong personality profile
  4. To replace the psychiatric history

Explanation

The mental state examination is a structured, cross-sectional description of appearance, behaviour, mood, thought, perception, cognition, and insight at the time of assessment. It complements rather than replaces the longitudinal history.

Question 49Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

A patient being assessed for depression reports that he no longer enjoys activities that he previously found pleasurable. This symptom is best termed which of the following?

  1. Dysphoria
  2. Anergia
  3. Diurnal variation
  4. Anhedonia Correct answer.

Explanation

Anhedonia is loss of interest or pleasure in normally enjoyable activities and is a core symptom of depression. Dysphoria refers to low mood, and anergia to loss of energy.

Question 50Psychopathology and Psychiatric Assessment (clinical interview, mental state examination, classification systems)

A patient reports that he can hear his own thoughts spoken aloud just after thinking them. This phenomenon is best described as which of the following?

  1. Thought echo Correct answer.
  2. Thought broadcasting
  3. Thought insertion
  4. Thought blocking

Explanation

Thought echo (gedankenlautwerden) is hearing one's thoughts spoken aloud, a first-rank phenomenon. Thought insertion is the experience that thoughts are placed into one's mind by others.