Questions: MCQs
For each question, select one answer option.
HISTORY AND MENTAL STATE EXAMINATION
1. During an assessment interview, the clinician asked a 23-year-old man questions such as, ‘What did your mother say when your father said this to your brother?’. Which interview technique is used in this case?
A Closed question B Circular question C Direct question D Open question E Put-down question
2. During a therapy session of a family consisting of the couple, two daughters and a son, the son had been quiet and said very little, if anything. On the other hand, the couple and their daughters tended to fill the silence by saying almost anything, or having a silly laugh. The therapist then asked the couple, ‘If your son spoke now what might he say?’. Which interview technique is used in this case?
A Facilitation
B Hypothetical question C Interpretation D Positive reinforcement E ‘Run-on’ questioning
3. A 21-year-old man told his doctor that Jesus spoke to him whenever he started his motorbike and stopped talking to him whenever he switched the engine off. He found this very distressing and confusing, so could not use his motorbike to go to work. Which of the following explains this experience?
A Affective illusion B Anxious foreboding C Extracampine hallucination D Functional hallucination E Kinaesthetic hallucination
4. A 37-year-old single American man informed his doctor that, whenever he saw President Obama on television, he got sharp pains in his right leg. He was convinced that President Obama was controlling him through the television. Which of the following can explain this man’s experience?
A Hemisomatognosis B Hyperschemazia
C Hyposchemazia D Paraschemazia E Reflex hallucination
5. A 61-year-old business executive had an exploratory laparotomy 5 days ago. He told the nurses that he saw tiny pink elephants and white tigers dancing outside the windowsills. He has a history of alcohol dependence. Which of the following explains his experience?
A Hypnagogic hallucinations B Hypnopompic hallucinations C Lilliputian hallucinations D Paraschemazia
E Pareidolia
6. Which of the following is an example of a closed question?
A ‘Have you been sleeping well?’
B ‘How are your sleep and appetite?’
C ‘So, do I understand this correctly that … ?'
D ‘What brought you to the emergency department today?’
E ‘You were not sleeping at that time?’
7. What does the three-stage command in the mini-mental state examination (MMSE) test?
A Concentration B Delayed recall C Language naming D Language understanding E Verbal fluency
8. A 48-year-old married man was concerned that he might be developing Parkinson’s disease.
Which of the following clinical features is diagnostic?
A A 10- to 12-Hz resting tremor B Board-like muscular rigidity C Exaggerated arm swinging D Facial hypomimia E Macrographia
9. Which of the following is the most appropriate and quickest assessment test for performance IQ?
A MMSE
B National adult reading test C Raven’s progressive matrices D Stanford–Binet scale
E Wechsler adult intelligence scale IV
10. Which of the following statements about Addenbrooke’s cognitive examination is correct?
A Possible outcomes include delirium, dementia and depression with psychotic symptoms B Scores of < 82 predict dementia with 100% specificity
C Scores of < 82 predict dementia with 100% sensitivity D Scores of < 90 predict dementia with 100% sensitivity E The MMSE should be conducted separately
11. Which of the following is assessed by the clock-drawing test?
A Attention B Comprehension
C Concentration D Insight
E Orientation to time and person
12. You are assessing the language function in a 50-year-old man with a history of cerebrovascular accident. He says ‘litter for letter’. What is this an example of?
A Nominal aphasia B Phonemic paraphasia C Semantic deficit D Semantic paraphasia E Superordinate response
13. Which of the following is a non-verbal test for semantic memory?
A Boston naming test B Cactus and camel test C Category fluency test D Similarities test
E Word-to-picture matching
14. Which of the following can be assessed by the word stem completion task?
A Declarative memory B Episodic memory
C Priming
D Semantic memory E Working memory
15. Which of the following lobe functions is assessed by the Iowa gambling test assess?
A Frontal lobe B Left parietal lobe C Left temporal lobe D Right parietal lobe E Right temporal lobe
16. A 31-year-old man presented with a spinal injury. On examination, you diagnosed that he had spastic paralysis of the lower limbs. You tested his sensations and found that he had sensation above the umbilicus. Where is the spinal cord lesion?
A C4 B L3 C S1 D T4 E T10
17. Which of the following is present in the Brown–Séquard syndrome with a right-sided lesion?
A Decreased reflexes on the right B Left hemiplegia of the arm and leg C Left monoplegia
D Loss of pain and temperature sensation on the left side E Loss of proprioception and vibration sense on the left side
18. A 33-year-old man was hit on his head during a fight. He was suspected of having an extradural haematoma. Which of the following signs is the first indication of raised intracranial pressure causing compression of cranial nerve III?
A Constriction of the ipsilateral pupil
B Dilatation of the ipsilateral pupil
C Ipsilateral eyeball abducted and directed slightly inferiorly D Ipsilateral ptosis
E Ipsilateral slowness of the pupillary response
19. A 55-year-old man diagnosed with hypothyroidism complained that he had an aching pain in his right hand with paraesthesia, occurring mainly at night. Which sign are you most likely to elicit?
A Ability to oppose the thumb B Loss of pronation of the forearm C No sensory loss over the palm D Sensory loss over the little finger E Wasting of the thenar muscles
20. A 70-year-old woman presented with hearing loss and tinnitus. Investigations led to a diagnosis of acoustic neuroma. You examine the patient’s cranial nerves. What sign are you most likely to elicit?
A Facial hyperaesthesia B Facial weakness C Impaired gag reflex D Intact corneal reflex E Ptosis
ASSESSMENT
21. You were called to assess an 83-year-old man who was found wandering by the police. During the MMSE, you asked him to remember three objects but he was unable to repeat them after 1 minute. Which type of memory deficit has been elicited?
A Anterograde memory B Declarative memory C Episodic memory D Retrograde memory E Working memory
22. A 79-year-old widow with Alzheimer’s disease attended the day hospital regularly. She continued enjoying knitting, which she used to do before developing her condition. Which of her memories remains intact?
A Declarative memory B Episodic memory C Procedural memory D Retrograde memory E Semantic memory
23. A 31-year-old man was unconscious for 1 week after a road traffic accident. On examination, he had no memory for any events for a period of 2 weeks before the accident. What type of memory loss does this refer to?
A Anterograde memory B Episodic memory C Retrograde memory D Semantic memory E Working memory
24. A 23-year-old man with schizophrenia presented with complaints of visual hallucinations, restlessness and marked thirst. On examination, he was agitated and had a raised body temperature, dilated pupils, dry mouth and urinary retention. Which of the following is most likely to account for this clinical presentation?
A Antimuscarinic intoxication B Benzodiazepine withdrawal C Catatonia
D Cocaine withdrawal E Opioid intoxication
25. Which of the following single-photon emission computed tomography (SPECT) scan reports is characteristic of Alzheimer’s disease?
A Increased perfusion in the frontal lobes B Increased perfusion in the lateral temporal lobes C Increased perfusion in the parietal lobes D Reduced perfusion in the occipital lobes
E Reduced perfusion in the posterior temporal lobes
26. Which of the following tests is used to assess executive function?
A Adaptive behaviour scales B Goldstein object sorting test C Hayling’s sentence completion test D MMSE
E Rey–Osterrieth complex figure test
27. Which of the following is a specific test for frontal lobe dysfunction?
A Cognitive estimates test B Digit-span task
C Raven’s progressive matrices D Repertory grid test
E Wechsler memory scale