General MCQs for CT1 traineescomposite neuropsychiatry and

psychopathology MCQs

John O’Donovan

MCQs

History of psychiatry • Pinel treated the marquis de sade • Napoleon’s legal code stipulates that

“no crime exist… if existed in a state of dementia”

• Pinel and Esquirol were empirical in outlook

• Morel is associated with the degeneration theory

• In 19th century Germany there was an intellectual conflict between the mentalists and the somatists

• Griesinger was the original German neuropsychiatrist

History of psychiatry• Cullen=neurosis • Bleuler developed the term

schizophrenia • Griesinger believed that psychoses

were one disorder• 1854 Falret described “folie circulaire”• French psychiatrists particularly

resented the concept of schizophrenia• First ICD was 1855• ICD 8 was the first of relevance to

psychiatry• DSM 3 is “operationalized”

MCQs 2

Schizohprenia• Delusions in schizophrenia are

internally inconsistent• Third person auditory hallucinations

are the most specific sign for schizophrenia

• Over 70% of schizophrenic patients show at least one first rank symptom

• Second person auditory hallucinations are a first rank symptom

• Schizophrenic thought disorder shows metonyms

Schizophrenia• Schneider’s first rank sympoms

are atheoretical • Delusional mood is a first rank

symptom• Hebephrenic schizophrenia is

characterised by absence of disorganisation

• Alogia is common in the early stages of schizophrenia

• Catatonia is most commonly due to schizophrenia

MCQs

Capgras Syndrome• Is one of the DMIS• Also known as “illusion de sosies”• Is most commonly seen in

schizophrenia • Is an example of a primary

delusion• May be associated with lesions of

the fusiform gyrus• The core belief is that an impostor

has replaced someone close to the patient and looks identical or near identical

DMIS• The Fregoli syndrome is associated

with a big red nose • Is a belief one or more individuals

have altered their appearances to resemble famillar people

• Can be associated with intermetamorphosis rather then hypermetamorphosis

• DMIS contain four different types including Capgras, Fregoli, intermetamorphosis and the syndrome of subjective doubles

• Has a prevalence of 1: million

MCQs

Cotard’s syndrome• Is the delusion of negation • Exists in different forms • Is always accompanied by

depression • May be a chronic state • Is the most delusional of the

delusions

Schizophrenic thought disorder

• Does not occur in VLOSLP(very late onset schizophrenic like psychosis)

• Is easily distinguished from a perisylivan stroke

• Is associated with derailment • Tangentiality • Loss of goal • Knight’s move thinking• Prolixity

MCQs

Valproate • Causes tremor • Commonly causes hirsuitism • Is the drug of choice for JME• Was discovered by chance

as a solvent• is particularly likely to cause

a rash when used concurrently with topiramate

Lithium• Can cause hyperthyroidism • Levels of 1.9mEq are

therapeutic • Levels should be taken just

before dosing • May cause cranial diabetes

insipidus • Is metabolised slowly in the

liver

MCQs

Causes of light-near dissociation

• Ventral midbrain syndrome • Holmes-Adie Syndrome • Balint Syndrome • Optic neuritis • Third nerve compressive

palsy secondary to PICA aneurysm

Syringobulbia• May cause anosmia • May cause opthalmoplegia • May cause a pseudobulbar

affect • Classically causes slow wave

jerks and rotatory nystagmus

MCQs

A left frontal stroke• Will classically cause a weak

right leg more so then right arm

• May produce a fluent dysphasia

• May cause deviation of the eyes to the left visual field

• Will have a better prognosis then a right frontal stroke

• May cause agraphia

Non dominant temporal lesions

• Are not good for a violinist • Are not good for writers• May cause strange smells• Are the classical site for

strokes causing a manic presentation

• May be silent neurologically • Are associated with left

hemianopsia