1. Which of the following is not seen in mania? A.

Delusion of grandeur B. Elation C. Pressure of speech D. Disorientation Criteria for manic episode: Persistently elevated, expansive or irritable mood lasting at least 1 week. During this period 3 or more/ 4 or more (if mood is irritable) of the following is to be present significantly: 1.

Grandiosity 2. Decreased need for sleep 3. Pressure need for sleep 4. Pressure to keep talking 5. Flight of ideas 6. Distractibility 7. Increase in goal directed activity 8. Excessive involvement in pleasurable activities measured important in socio-occupational functioning no organic basis should explain the illness.

2. The commonest psychiatric disorder is: A. Dementia B Schizophrenia C. Paranoia D. Depression 3.

Endogenous depression is characterized by all of the fol­lowing, except: A. Paranoid feeling B. Third person hallucination C. Guilt psychosis D.

Loss of self-esteem 4. The neurotransmitters involved in depression are: A. GABA and dopamine B. Serotonin and norepinephrine C. Dopamine and serotonin D. GABA and norepinephrine Of the biogenic amines, norepinephrine and serotonin are the 2 neurotransmitters most implicated in the pathophysiology of mood disorders. 5.

The drug of choice for depression in an old person is: A. Fluoxetine B. Buspirone C. Amitryptilline D. Imipramine 6. Delusions of nihilism and early morning insomnia are seen in: A. Major depression B.

Schizophrenia C. Mania D. Personality disorder 7. The most common age group for depression is: A. Middle-aged men B. Middle-aged females C. Young girls D.

Children Life time prevalence is 15 percent, as high as 25 percent for women 8. A period of normalcy is seen between two psychotic epi­sodes in: A. Schizophrenia B. Manic depressive psychosis C. Alcoholism D.

Depression 9. A 20-year-old man has presented with increase alcohol consumption and sexual indulgence, irritability, lack of sleep, and not feeling fatigued even in prolonged peri­ods of activity. All these changes are present for past 3 weeks.

The most likely diagnosis is: A. Alcohol dependence B. Schizophrenia C. Mania D.

impulse control disorder Increased libido, irritable mood, decreased need for sleep, excessive psychomotor activity characterize manic episode in this case. 10. Ms.

B, a 27-year-old nurse had extracurricular interest in trekking and painting. She broke up relationship with her boy friend. Two months later she lost interest in her hob­bies and was convinced that she would not be able to work pain. She thought life was not worth living and has consumed 60 tablets of phenobarbitone to end her life. She is most likely suffering from: A. Adjustment disorder B. Conversion disorder C.

Depressive disorder D. Post-traumatic stress disorder Loss of interest Feeling of worthlessness Death wishes Poor functioning one is suggestive of a depressive episode. 11. Major depression is most commonly associated with: A. Poverty B. Major accident C. Prolonged physical illness D. Death of loved person 12.

A person initially presenting with an episode of mania is classified as: A. Unipolar B. Bipolar C.

Affective disorder D. Personality disorder Bipolar I disorder: Single manic episode and a specific type of recurrent episode. Bipolar II disorder: It is characterized by depressive episodes and hypomanic episodes during the course of the disorder. Unipolar disorder: Depressive episode only. 13. Mania is a: A. Obsessive disorder B. Mood disorder C.

Neurotic disorder D. Psychological disorder Mood is a sustained and province emotional response which colors the whole psychic life. According to ICD ten mood disorders are classified as: 1. manic episode, 2. Depressive episode, 3. bipolar mood (affective) disorder, 4. Recurrent depressive disorders, 5. Persistent mood disorder (including cyclothymia and dysthymia), 6.

Other mood disorders (including mixed affective episode and recurrent brief depressive disorder). 14. Mania is associated with the following, except: A. Euphoria B. Good humour C.

Physical overactivity D. Thought disorders 15. Which of the following is not seen in mania? A.

Delusions of grandeur B. Elation C. Pressure of speech D. Disorientation Disorientation occurs in delirium. 16. Atypical depression is characterized by all of the follow­ing, except: A. Increased libido B.

Weight gain C. Ravenous appetite D. Hypersonic Weight gain, appetite Hypersonic – reverse vegetative, features. 17. Dysthymia is: A.

Chronic mild depression B. Personality disorder C. Bipolar depression D. Chronic severe depression Duration criteria for dysthymia – 2 years This category does not require the presence of stress as a precipitation factor. Average age of onset is late third decade more common in females. 18. Depression is a. an: A.

Affective disorder B. Organic disorder C. Mood disorder D. Dissociate disorder Affective disorder form is a misnomer In ICD – ten mood disorder classification: 1) Manic episode 2) depressive episode 3) Bipolar mood 4) recurrent depressive disorder 5) persistent mood disorders 6) other mood disorders. 19. Profound mood disturbance is seen with: A. Schizophrenia B.

Psychosomatic illness C. Depression and mania D. Affective disorders Depression and mania are mood disorders where a pervasive and profound mood disturbance is mandatory to make a diagnosis. 20. Somatic symptoms of depression include all, except: A. Feelings of guilt B. Reduced interest C.

Insomnia D. Weight change Somatic symptoms (syndrome – melancholic symptoms, vegetative symptoms): Early morning awakening Diurnal variation Significant decrease in appetite or weight Pervasive loss of interest and loss of reactivity. 21. Which one of the following disturbances is the basic de­fect seen in mania? A. Elation B. Ideas of reference C. Coining of new jokes D. Delusions of grandiosity 22.

Depression is not caused by: A. Metronome B. Methyldopa C. Reserpine D. Oral contraceptives Drugs which can cause depression are: reserpine, clonidine, methyldopa, OC pills, Propranolol, anti cancer drugs. 23. The following are feelings of cyclothymic personality ex­cept: A. Mood swings B.

Excessive planning C. Spending sprees D. Mood incongruent delusions Persistent instability of mood between mild depression and mild elation is seen in cyclothymiacs. 24. Mania depressive psychosis is associated with: A. Jules Falter B. Sigmund Freud C.

Emil Kraeplin D. KL Kahlbaum He also described dementia praecox. According to Kraeplin MDP has an episodic course and good prognosis. 25. Which drug is not useful in acute mania? A. Diazepam B. Clonazepam C. ECT D.

Chlordane Drugs used in acute manic episode – mood stabilizers: antipsychotic and Clonazepam. 26. Acute mania with mood disturbance is: A. Feature of the following B. Borderline disorder C. Cyclothymiacs disorder D.

Paranoid disorder Duration criteria for cyclothymia – 2 years It is classified as a persistent mood disorder. 27. Mood disorder is seen in: A. Hysterical state B. Borderline personality state C. Paranoid state D.

Schizoid state Affective instability is commonly seen in borderline personality disorders. 28. Drug that is known to produce manic like syndrome in­clude all expect: A. Amphetamine B. Corticosteroids C. Tricyclic antidepressant D. Reserpine Reserpine induces depression Whereas amphetamine causes schizophrenics – like pictures Corticosteroids and TCA’s can induce mania. 25 D 26 C 27 B 28 D 29.

Features of depression include all, except: A. Depressed mood B. Loss of appetite C. Hyperactivity D. Suicidal ideas Depressed mood is the first among them, loss of appetite and suicidal ideas are associated symptoms, hyperactivity is unusual (it may occur in elderly). 30.

Which of the following is least likely to cause serious depression as a side effect of long-term use? A. Reserpine B. Propranolol C. INH D.

None of the above 31. Which of the following drugs is used for maintenance of MDP? A. Chlorpromazine B. Carbamazepine C. Haloperidol D.

Amphetamine Carbamazepine is a mood stabilizer used for maintenance therapy of MDP. 32. All the following drugs are used in prophylaxis of MDP, except: A. Sodium Valproate B. Carbamazepine C. Lithium D. Haloperidol Drugs used in bipolar MDP prophylaxis are lithium, carbamazepine, sodium valproate, oxcarbamazepine and lamotrigine.

33. The family members of a 56-year-old man reports that he has become increasingly irritable, sleepless, has started spending large amounts of money, and shows increased sexual behavior. The most probable cause could be: A. Mania B.

Psychosexual developmental disorder C. Impulse control disorder D. Obsessive-compulsive neurosis Irritable mood, reduced sleep, overspending, and distributed are features of mania 34. A 36-year-old female presents with no interest in any­thing, a nihilistic attitude, and a sad appearance with suicidal ideas and plans. The most appropriate man­agement is: A. Antidepressants B.

Behavior therapy C. ECT D. Aminophyline The patient is having severe depression and suicidal risk. In this case the first choice of management is ECT. 35.

A 55-year-old lady presented with decreased sleep and appetite and thoughts of spiritualism. She donates money and property and talks about God. Her husband died few days back and she has increased psychomotor activity. She is most likely suffering from: A. PTSD B. Mania episodes C. Brief reaction D. Depression 36.

The most common cause of mood congruent delusion is: A. Obsessive-compulsive neurosis B. Schizophrenia C. Dementia D.

Mania Mood congruence refers to occurrence of psychiatry symptoms in keeping with mood state. 37. Pseudodementia is commonly seen in: A. Hysteria B.

Depression C. Mania D. Anxiety neurosis Frequent Complaints about memory loss Patient gives “Don’t know” answers for most of questions. Answer1.D 2.D 3.B 4.B 5.A 6.A 7.B 8.B 9.C 10.C 11.B 12.B 13.B 14.B 15.D 16.A 17.A 18.C 19.C 20.A 21.A 22.A 23.A 24.C 25.D 26.C 27.B 28.D 29.C 30.C 31.B 32.D 33.A 34.C 35.B 36.D 37.B