MRCPsych Exam Practice:
Classification
(all are past MCQs used in the exams)
Dr Gareth Thomas (Consultant Psychiatrist for Older People)
September 2014
1.
Which of the following can be a discriminating symptom
when making a clinical diagnosis?
A.
Poor concentration
B.
Psychomotor retardation
C.
Thought withdrawal
D.
Anhedonia
E.
Panic attacks
1.
Which of the following can be a discriminating symptom
when making a clinical diagnosis?
A.
Poor concentration
B.
Psychomotor retardation
C.
Thought withdrawal
D.
Anhedonia
E.
Panic attacks
Explanation
• Thought withdrawal is the delusion that
thoughts have been taken out of the patient's
mind
• Other symptoms may be associated with
other conditions, but thought withdrawal is
associated with schizophrenia only
• This is one of Schneider's first rank symptoms
for schizophrenia (read)
• These form the basis for the ICD10 criteria
for Schizophrenia (read)
• This is also a ‘positive symptom’ (read)
2
A 35 year old man has low mood, poor energy levels,
anhedonia with associated loss of appetite, poor sleep and
reduced libido. What is the severity of his depression?
A.
Mild
B.
Moderate
C.
Severe
D.
Dysthymia
E.
No depression
2
A 35 year old man has low mood, poor energy levels,
anhedonia with associated loss of appetite, poor sleep and
reduced libido. What is the severity of his depression?
A.
Mild
B.
Moderate
C.
Severe
D.
Dysthymia
E.
No depression
Explanation
•
•
•
•
Duration of at least 2 weeks
Depressed mood, loss of interest and enjoyment and reduced
energy are the core symptoms
Other symptoms
– Reduced concentration and attention
– Reduced self-esteem and self-confidence
– Ideas of guilt and unworthiness
– Bleak and pessimistic views of the future
– Ideas or acts of self-harm or suicide
– Disturbed sleep
– Diminished appetite
Severity
– Mild 2-3 symptoms
– Moderate > 4
– Severe > 6
3.
Which of the following subtypes of schizophrenia is
classified in DSM, not ICD?
A.
Hebephrenic schizophrenia
B.
Paranoid schizophrenia
C.
Undifferentiated schizophrenia
D.
Disorganised schizophrenia
E.
Catatonic schizophrenia
3.
Which of the following subtypes of schizophrenia is
classified in DSM, not ICD?
A.
Hebephrenic schizophrenia
B.
Paranoid schizophrenia
C.
Undifferentiated schizophrenia
D.
Disorganised schizophrenia
E.
Catatonic schizophrenia
Explanation
4.
The following is true regarding persistent delusional
disorder according to ICD-10?
A.
Delusions of more than 3 months duration
B.
Delusions incongruent to mood
C.
No hallucinations
D.
Single theme of delusions only
E.
Identifiable preceding stressor
4.
The following is true regarding persistent delusional
disorder according to ICD-10?
A.
Delusions of more than 3 months duration
B.
Delusions incongruent to mood
C.
No hallucinations
D.
Single theme of delusions only
E.
Identifiable preceding stressor
Explanation
• Persistent delusional disorder is
characterised by a persistent delusion(s)
• Transient auditory and visual
hallucinations may occur but not as clear
as in Schizophrenia
• No blunting of affect
• There is no necessity to have an
identifiable stressor
• DSM-IV specifies that symptoms should
have been present for at least 1 month
• ICD-10 specifies at least 3 months
5.
A 40 year old woman had an episode of depression four
years ago. For the last four weeks, she is low in mood,
socially isolative and fears leaving the house in case she
has a panic attack. She is tearful and not sleeping well. The
most likely diagnosis is:
A.
Panic disorder
B.
Agoraphobia
C.
Depression
D.
Anxiety
E.
Dysthymia
5.
A 40 year old woman had an episode of depression four
years ago. For the last four weeks, she is low in mood,
socially isolative and fears leaving the house in case she
has a panic attack. She is tearful and not sleeping well. The
most likely diagnosis is:
A.
Panic disorder
B.
Agoraphobia
C.
Depression
D.
Anxiety
E.
Dysthymia
Explanation
• In the exams, Depression almost always the
answer if given the choice between
Depression and Anxiety
Any questions?
Thanks.