UKZN Schoolof Medicine-Psychiatry Past Paper With Answers & Explanation

5)Police use form 22
6) Tarasoff case - psych doc should
a get informed consent before invol admission

b report illegal activity of patient to police
c report sexual activity of patients under 21yo to parents
d inform potential victim of a violent MHCU
7) antipsychotics cause gynaecosmastia via

A mesocortical
B mesolimbic
C nigrostriatal
D tuberoinfundibular
8) Psychotic patients who develop EPSE on risperidone should be changed to

Clozapine
Haloperidol
Clopixol
Fluanxol
9) Psychotic patients who present with insomnia should be put on

Chlorpromazine
Haloperidol
Clopixol
11) 18 year old first year male medical student who came in the top 10 for matric now presents with "weird
behavior": social isolation, talking to himself an believes that aliens have inserted thoughts into his mind.
Protector factors for schizophrenia include
- age
- male
- premorbid occupational functioning
- social isolation
12) After being initiated on haloperidol for a few weeks he was prescribed Orphenadrine 50mg BD.
Which neuroleptic induced side effect is he more likely to have:
- acute dystonia
- akathisia
- Parkinsonism
- tardive dyskinesia
13) 35 year old male ward counsellor believes that the hawks are after him and trying to poison his food for
a year. He only eats tinned food that he opens himself. He has had one experience of auditory
hallucinations. It worries him and makes him sad. Likely diagnosis:
- delusional disorder
- schizophrenia
- MDD with psych features
- schizoaffective
14) A 34 year old schizophrenic patient presents to outpatient clinic. He is very happy because he says the
news presenter sends him special messages on the news every night. This is called
- delusions of reference
- loosening of associations
- grandiose delusions
- illusions
15) A 45 year old male patient presents with an 8 month history of low mood, anhedonia, lack of
concentration, insomnia etc. He has more recently been having mood congruent auditory hallucinations.
This is his first episode. He has smoked cannabis since age 14. He is HIV positive on treatment since 4
years ago. VL negligible. Most likely diagnosis
- depressive disorder with psychotic features due to HIV
- major depressive disorder with psychotic features
- schizoaffective, depressive episode
- substance induced mood disorder
16) what is the period that MDD is managed for

a. 18 months
b. 24 months
c. 6 months.
d. 6 weeks.
17. features of MDD and 2 previous suicidal attempts, what is the management of choice.
a. citalopram
b. clomipramine.
c. clonidine.
d. chlorpromazine.
18. 3 weeks post partum mother with thoughts of killing baby and hallucinations.
a. brief psychotic disorder.]
b. delirium.
c. MDD
d. post partum blues.
19. Side effects of fluoxetine

A. Dizziness? (not sure about this option)
B. Agitation
C. Seizures
D. Hypotension
20. 50 year old female. Presents with depression, helplessness, hopelessness, vegetative symptoms. 1
year duration.
For the past 3 weeks now, hearing voices commanding her to kill herself.
Past history of hypomanic episode
Most appropriate treatment would be:
A. Mood stabilizer and antidepressant
B. Mood stabilizer and antipsychotic
C. Mood stabilizer and anxiolytic
D. Antidepressant and antipsychotic
21. Which of the following symptoms are most likely to be “manic episode”?
A. Insomnia, easily distracted, aggressive

B. Elevated mood, inflated self-esteem, flight of ideas
C. Grandiose delusions, auditory hallucinations, aggression
D. Talkative, aggression, agitation?
22. 29 yo with MDD symptoms, previous 2 episodes of mania few years ago, had been well out of
medication for the past two years.
Which medication would you give?
A. Sodium valproate
B. Fluoxetine
C. Citalopram
D. Imipramine
23. 24 year old pregnant female with mania
A. Lithium carbonate
B. Sodium valproate
C. Lamotrigine
D. Olanzapine
24. A 34 year old female with mania, decision is to start her on lithium. Consultant asks you to do a
“work up” but the hospital is in a severe financial constraint. Decide on which tests to do for now:
A. U&E, Folate
B. U&E, TFT
C. LFT, TFT
D. LFT, RPR
25. Mr NM referred to a psych clinic, says will never go out again because it makes her feel “crazy”. Is
worried about the occurrence of one of the episodes where she experiences difficulty breathing,
sweating, dizziness, and feeling like she is going to die. It has already occurred 3 times before on
different occasions 3 months ago. No history of use of illicit drugs and medical tests normal.
First line treatment:
A. Clomipramine
B. Fluoxetine
C. Lorazepam
D. Clonazepam
31. 75 requiring full time care, diabetic and hypertensive, cva 10 years ago. Now confused,
incoherent and illogical. All vitals are normal.
a. major neurocog due to vascular dx.
b. minor neurocog due to vascular dx.
c. acute delerioum.
d. persisitent delirium.
32. 65 y/o previous MI, known hypertension. Presenting with depressive symptoms. MMSE 28/30. All
investigations normal.
a. fluoxetine.
b.flupenthixol.
c.amitriptilline.
d. clozapine.
33. 67 year old male with history of ischemic heart disease and hypertension presenting with
decreased memory and concentration. All tests are normal and MSE score is 28/30.
What treatment should he be started on?
a. Fluoxetine
b. Flupenthixol
c. Amitryptilline
d. ?
34. Farmer with a Major neurocognitive condition is murdered. Autopsy shows brain with
neurofibillary tangle and amyloid deposit.
What neurocognitive disease did he have?
a. Alzheimer's
b. Huntington's
c. HIV
D. Hypertension
41) causes of ROH withdrawal delirium:
Niacin, diazepam or disulfuram
42) Man in casualty presents with feeling of ants crawling on him, tremors and raised BP:
ROH withdrawal, ROH intoxication, ROH induced psychosis or ROH persistent amnesia
43) man with Rasta hairstyl. which “product”is not natural:
Cannabis, cocaine, LSD, opium
44) lady has overwhelming problems. Divorce papers, father passed away and diagnosed with cancer.
Therapy she needs is:
Psychoanalytical
Psychodynamic
Supportive
Insight orientation
45) 21yo presents with binge eating and using laxatives for 3 weeks. She has distorted body image and
BMI=17
Anorexia
Bulimia
Binge eating disorder
Unspecified eating disorder
48. A young librarian has always beem very shy since childhood. She longs to have friends but She is
always afraid that she will not "fit in". She keeps to herself and thinks that she is not competent.
What is the likely diagnosis
A. Schizoid personality disorder
B. Avoidant personality disorder
C. Schizotypical personality disorder
D. Obsessive compulsive disorder
49. A 43 year old woman presents with multiple, unexplained, physical complaints. All routine tests
prove negative. Her symptoms are difficult to explain anatomically and physiologically. The symptoms
cause her to feel very distressed.
What is the likely diagnosis?
A. Generalized anxiety disorder
B. Malingering
C. Somatic symptom disorder
D. Fictitious disorder
50. A 34 year old woman is being interviewed for a job as a bank teller. During the interview she gives
long complicated answers with many unnecessary explanations before correctly answering the
questions.
What term is used to describe this form of thought?
A. Tangential
B. Circumstantial
C. Loosening of association
D. Flight of ideas.

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5)Police use form 22

6) Tarasoff case - psych doc should

a get informed consent before invol admission

7) antipsychotics cause gynaecosmastia via

8) Psychotic patients who develop EPSE on risperidone should be changed to

9) Psychotic patients who present with insomnia should be put on

16) what is the period that MDD is managed for

19. Side effects of fluoxetine

A. Insomnia, easily distracted, aggressive

Which medication would you give?

23. 24 year old pregnant female with mania

First line treatment:

a. major neurocog due to vascular dx.

b. minor neurocog due to vascular dx.

What treatment should he be started on?

What neurocognitive disease did he have?

What is the likely diagnosis

A. Schizoid personality disorder

B. Avoidant personality disorder

C. Schizotypical personality disorder

D. Obsessive compulsive disorder

What is the likely diagnosis?

A. Generalized anxiety disorder

C. Somatic symptom disorder

What term is used to describe this form of thought?

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