Feedback: MRCPsych Paper A - June 2016

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On 7/28/2016 at 08:42, pankaj sheoran said:

Utilitarian moral theory

... is correct :)

Many thanks to this.

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On 6/24/2016 at 11:09, MONA NAZ said:

hi, these are the questions i remember. there were pretty similar to these.  


1, The annual incidence of tardive dyskinesia in patients with chronic schizophrenia who are on any antipsychotic treatment is




Select one:





5% 10%

The correct answer is: 0.03


According to the CATIE study of patients with schizophrenia, the number of patients meeting criteria for metabolic syndrome ranges between what percentages?


2, Select one:












3, The upper normal QTc level in female subjects is


Select one:


440 ms


450 ms


500 ms




420 ms


4, Which of the following drugs have a half-life of 3 days?


Select one:












5, Which of the following is a localising sign for frontal lesions?


Select one:


Postural headache






Olfactory disturbances 




6, National adult reading test is used to assess


Select one:


Visuospatial ability


Premorbid intelligence 


Attentional bias


Nonverbal intelligence


Frontal lobe functions


7, On routine examination of eyes, accommodation reflexes were present but pupils were small irregular with absent light reflexes. This type of pupil is called 


Select one:


Marcus Gunn pupil


Senile pupil




Kayser-Fleischer pupil


Argyll Robertson pupils 


8, The gene implicated in Huntington's disease is present on the chromosome


More than 35 repeats


Less than 35 repast


 Which of the following is associated with narcolepsy?


9.  callous-unemotional traits


A, schizoid personality


B, schizotypal


C, pwersonality


10, Huntingtonis causedby


A,  AD


B, AR,


C, x link recessive


D, x link dominant






6th nerve pelsy


5th nerve


7th nerve


12, The somatodendritic inhibition of 5-HT release is regulated by


Select one:


5-HT1A receptors 


5-HT3 receptors


5-HT4 receptors


5-HT5 receptors


5-HT2 receptors


13, Which of the following is the precursor of Dopamine


L tyrosine


L tryphtophane


Acetyal co




5 hydroxybyt


14, patient admitted to hospital he had previous stroke 2 years ago . How will we differentiate


A, Bilateral weakness in both limbs


B, Muscle wasting in left limb.


C, Facial droop.




15, Prion protein found I prion nucleus


Venlafaxine to mirtazapine in a patient who has developed severe gastrointestinal intolerance.


..Withdraw, wait for five weeks and then start the second drugWithdraw,

Fluoxetine to tranylcypromine due to the inefficacy of the former.


.Withdraw, wait for five weeks 


An investigator is interested in calculating the risk of illness within families among first, second and third degree relatives and compare the rates with the established risk in the general population.






16, Rey-Osterrieth complex figure test is one of the non verbal memory tests. Here the subject is first asked to copy a complex geometric figure and then to draw from memory after an interval of 30 minutes. The recall is impaired in patients with dementia and amnesic syndrome. 


17, Stroop test, inhibition


18, Neuroleptic malignant syndrome (NMS) is associated with a mortality rate of


Select one:












19, Mr.Z is a 25 year old gentleman being treated for first episode schizophrenia. He was initially started on Risperidone 2mgs daily which was subsequently increased to 4mgs by week 4. Difficulty in breating and saying that he will swallow his tongue.


Select one:


acute dystonia




20, The antidepressant most associated with QTc prolongation is


Select one:












21, inpatient on a psychiatric ward. He has a history of psychotic depression and is on combination treatment with antipsychotics and antidepressants. He appears slightly flushed, with dry mouth, dry skin, feeling hot, and confused. He is exhibiting features of


Select one:


SSRI discontinuation syndrome


Neuroleptic malignant syndrome


Idiopathic parkinsonism


Anticholinergic syndrome 


Serotonin syndrome


22, Which drug increases the risk of bleeding in patients on SSRIs?


Select one:












23, The mechanism of action of Varenicline is


Select one:


Alpha-2, beta-4, nicotinic acetylcholine receptor partial agonist


Alpha-2, beta-2, nicotinic acetylcholine receptor partial agonist


Alpha-4, beta-2, nicotinic acetylcholine receptor partial antagonist


Alpha-4, beta-2, nicotinic acetylcholine receptor partial agonist 


Alpha-2, beta-4, nicotinic acetylcholine receptor partial antagonist


24, Aripiprazole has an elimination half life of


Select one:


3.5 hours


2 hours


12 hours


24 hours


75 hours 


25. Drugs not effected by P450


26, In pregnancy effect of


Reduce  kidney function


reduce liver function


reduce fat


reduce Gut absorption


need more dose of iv medication


26, D2 receptors


Ans , pre and post receptor


27, Transcriptome is a


Select one:


Statistical test


Type of plasmid


Collection of expressed m-RNA


Positional cloning


Stretch of DNA 


28, Which of the following areas of the brain does not lack blood brain barrier?


Select one:


Median eminence


Posterior pituitary


Area postrema


Subfornical organ


Anterior pituitary 


29, Phencyclidine –




30, chose most relevant


Ans, Glycine most distributed in brain


31, Which area of the brain is implicated with recognition of faces?


Select one:




Fusiform gyrus 


31, The receptors which have both pre and postsynaptic presence are


Select one:


5-HT2C receptors


D2 receptors 


D1 receptors


D5 receptors


5-HT1A receptors




Your answer is correct.


D2-like receptors (D-2, D-3 and D-4) have both pre-synaptic and post-synaptic inhibitory effect. 


D1 like receptors (D1 and D5) have only postsynaptic inhibition effect.




32, EEG  4-8 = theta


33, A patient has chronic schizophrenia and is on clozapine therapy. If you want to try augmentation, which one should be avoided?


Select one:




Sodium valproate








33, Pt have risk of congenital disease more  ?


Mother using Smoking,




34, In WAIS, hold tests are vocabulary, can relatively




object assembly


picture completion.


35, The term used for purpose to identify locus of a gene on the chromosome by studying the extent to which it, co-segregates with a marker gene is called as;


Select one:




Physical mapping


Association studies


Linkage analysis 


Polymerase chain reaction


36, The metabotropic receptors are coupled to


Select one:


Ligand non-dependent regulators of nuclear transcription


G proteins 


Ligand dependent regulators of nuclear transcription


Proteins that have intrinsic enzyme activity


Ligand gated channels


37, The neurotransmitter which is most widely distributed in the brain is


Select one:












38, Which of the following neuroimaging finding is most suggestive of new variant CJD?


Select one:


Occipital hypoperfusion on HMPAO- SPECT


Activation of primary auditory cortex on functional MRI


Impaired dorsolateral cortex function


Medial temporal atrophy on structural MRI scan


Increased signal in the pulvinar nucleus of thalamus bilaterally 


39, Wife started on Risperidone now she is Kicking in bed










40, shock-like sensations are seen in SSRI discontinuation syndrome.


One among the following is not a feature of serotonin syndrome


Select one:






Myoclonic Jerks


Electric shock like sensations 


Autonomic instability


41, A 67-year-old gentleman has been on treatment for depression. He went to the local beach for sunbathing on a summer day afternoon and presented to A and E complaining of nausea, dizziness and leg cramps.


Select one:












42, What is the main risk involved in treating a patient with combination of clozapine and carbamazepine?


Select one:


Neuroleptic malignant syndrome


Diabetes mellitus






Weight gain


43, With Agomalation check








44, Which of the following agents exert an allosteric action on the nicotinic receptors?


Select one:












45, It does not affect hepatic cytochrome P450 enzymes.


Reboxetine i





46, Which of the following is hydroxylated as one of the steps in dopamine synthesis?




In Huntington's disease, there are increased CAG repeats. Normal repeat lengths range from about 7 to 28 triplets. Individuals with 29-35 triplets will not develop HD but may pass an expanded allele to an offspring, while individuals with 40 or more triplets will develop HD

wrong question as option were repeated twice


47, The technique used to assemble correct DNA fragments from a gene library into a continuous overlapping stretch, which will contain genes of interests is;


Select one:


Physical mapping 


Polymerase chain reaction


Association studies




Linkage analysis


48, Which neuroglial cells act as scavenger cells at the sites of CNS injury?


Select one:


Schwann cells




Satellite cells




Ependymal cells














50, The mechanism of action of Memantine is


Select one:


Non competitive NMDA receptor agonist


Non competitive NMDA receptor antagonist 


Competitive NMDA receptor antagonist


Competitive NMDA receptor agonist


Acetylcholinesterase inhibitor


51, When swapping MAOIs to SSRIs, what is the optimum wash out period?


Select one:


Minimum 2 days is essential


Minimum 5 days is essential


Minimum 2 months is essential


Minimum 2 weeks is essential 


Minimum 5 weeks is essential


52, A psychologist is performing neuropsychological testing in a 45 year old man. Which one of the following is a test of set shifting?


Select one:


Wechsler memory scale


Ravens progressive matrices


Boston naming test


Wisconsin Card sorting test




53, Copying intersecting pentagons  which test is used


constructional praxis


54, Which of the following accounts for spongiform appearance in CJD?


Select one:


Accumulation of prion proteins


Neuronal vacuolation 


Trapped air in parenchymal cells


Neuronal loss


Neurophil loss


 54, Korsakoff's syndrome correlates best with the presence of lesions in the dorsomedial thalamus. But lesions in the mammillary bodies, the mammillothalamic tract and the anterior thalamus may be more relevant to memory dysfunction than lesions in the medial dorsal nucleus of the thalamus. 


55, Prosopagnosics cannot recognise familiar faces.  (fusiform gyrus). 


56, Astrocytes are the most numerous of all three types of glial cells. These are star-shaped cells that enable nutrition of neurons, breakdown of some neurotransmitters, and maintaining the blood-brain barrier


57, Ependymal cells are a particular type of glia that cover the ventricles and enable CSF circulation.


58, A 27-year-old woman suffers from depression and is on Amitriptyline. She develops infectious diarrhoea and collapses. ECG shows polymorphic ventricular tachycardia. What feature could be seen in her ECG recorded prior to developing tachycardia?


Answer 2Choose...P waves absent before every QRSP-R interval of 100 msP-R interval of 280 msP-R interval of 500 msCorrected QT of 510 msDiffuse ST elevation with saddle formationR-R interval of 500 msProlonged QRS intervalR-R interval of 1500msCorrected QT of 440 ms


60, Saddle shape in pericarditis and other option ?





A 33-year-old gentleman was started on trifluoperazine five days ago. He is now complaining of tremors, stiffness and inability to initiate body movement.


Answer 3Choose...AkathisiaCerebellar ataxiaHyponatraemiaSerotonin syndromeSIADHNeuroleptic malignant syndromeParkinsonismTardive dyskinesiaAcute dystoniaCholinergic rebound syndrome


62, A 36-year-old woman treated on fluoxetine and phenelzine for her depression has now developed diarrhoea, excessive sweating and myoclonus.


Answer 1Choose...HyponatraemiaParkinsonismAcute dystoniaSerotonin syndromeAntidepressant discontinuation syndromeNeuroleptic malignant syndromeCholinergic rebound syndromeCerebellar ataxiaTardive dyskinesia


A 76-year-old gentleman admitted to hospital is on paroxetine for more than five years. He has not taken his antidepressant medication for last five days. He has developed flu-like symptoms, paresthesias and complains of electric shock-like sensations


Answer 2Choose...Hyponatraemia





A 25-year-old gentleman with an acute episode of psychosis was started on trifluoperazine 3 days ago. He has now developed a high fever, rigidity, profuse sweating and confusion.


Answer 1Choose...ParkinsonismTardive dyskinesiaCerebellar ataxiaSerotonin syndromeSIADHHyponatraemiaCholinergic rebound syndromeAcute dystoniaNeuroleptic malignant syndromeAkathisia






63, associated with Gamblers






64,  Cause of nausea


Answer 3Choose...Serotonin 5HT3 activation







65, X link reassess picture




66, Hardy-Weinberg equilibrium? 



67, Which of the following conditions is an example of aneuploidy?


Select one:




Huntington's disease


Absence seizures




Down's syndrome 








68, enome-wide association studies are based on linkage disequilibrium (LD), using several hundred thousand marker single nucleotide polymorphisms or SNPs.


The correct answer is: Single nucleotide polymorphisms




70, Unfavourable lyonisation of X chromosome






71, Which memory is independent of time and place








Episodic memory is


Episodic memory 


72, Only see some things area of brain affected


Tunnel vision effected brain


? post cerebral region 


73, A 25-year-old man sustains a severe head injury in a motor cycle race event. On recovery, he is noted to have grasp reflex, poor judgement and impaired reasoning with impulsivity. Which of the following tests is highly likely to be abnormal?


Select one:


Wisconsin card sorting test 


Wechsler adult intelligence scale IQ score


Paragraph retention test


Wechsler memory scale


National adult reading test


74, Which of the following is a true statement concerning human HIV disease?


Select one:


Psychosis is the most common HIV related psychiatric problem.


CSF viral load is the best predictor of HIV related CNS disease.


HIV cross the blood brain barrier using macrophages 


CD4 count is the better indicator for severity than viral load


HIV does not cause programmed cell death of neurons




I75, n which of the following conditions both balloon cells and Hirano bodies are seen?


Select one:


Alzheimer's disease


HSE encephalitis






Pick's disease 


76, Mr. Y presents to the emergency department with a history of apathy and weight loss. On further investigations, he has hyponatraemia and hyperkalemia. What is his possible diagnosis?


Select one:


Acute porphyria


Cushing's syndrome


Cohn's syndrome


Diabetes insipidus


Addison's disease 


77,  Mrs. X is an 83-year-old lady who has been diagnosed with early stages of Alzheimer's disease. The brain region, which could show prominent changes, is;


Select one:


Prefrontal cortex


Entorhinal cortex 


Superior temporal gyrus


Caudate nucleus


Prefrontal cortex


78, Which one of the following structures is involved in the visual pathway? Chose 2 options


Select one:


Medial geniculate body


Heschl's gyrus


Inferior Colliculus


Lateral geniculate body 






79, Which of the following disorders is characterised by a predominant presence of triphasic waves in EEG?


 Hepatic encephalopathy






80,  deficits in new learning  area of brain involve






Drugs worse the schizoprinic hallocinations ? LSD




Pregabalin is a 3-isobutyl derivative of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) that functions as a calcium channel blocker.[1




Clozapine don’t work on


? Glutamte receptor


Risk factors for TD-Older patients, females, patients with organic brain damage and patients with affective disorders, and those who have had acute EPSEs (Extra pyramidal side effects) early on treatment.






82, Bipolar time


A, 2 days


2, week


3 months


4, 6 months




83, Which of the following is not a feature of Kubler-Ross model of grief?




Select one:


Agitation Correct










84, Which of the following is a characteristic feature of schizoid personality disorder?


Select one:


Labile affect


Insensitivity to prevailing social norms 


Highly sensitive and intolerability to setbacks


Poor frustration tolerance


Rigidity and stubbornness


85, fECG shown 


Ant MI




85,  mode of retrieval after showing 2 list to patient to identify similar


Flow recall






86, Select one: child burn hand and never went near to stove


Positive reinforcement


Classical conditioning 




Negative reinforcement






87, Autonomy, beneficience, non-maleficinece in medical ethics are described as


Select one:












88, A 4-year-old child , my teddy is sleeping , got pain, Which of the following features is she exhibiting?


Select one:


Semiotic thinking


Lack of conservation








89, achieving 'conservation'.


Select one:


Formal operational


Operational stage






Concrete operational 


99, According to Erik Erikson, between the ages of 8, the crisis to be resolved is


Select one:


Autonomy vs shame


Initiative vs guilt


Industry vs inferiority 


Trust vs mistrust


Identity vs role confusion


100, A psychologist takes a 31 year old patient with significant fear of heights to the top of a 21 storey-building. Which of the following behavioural technique is he employing?




Select one:


Relaxation training




Flooding Correct




In vitro flooding




101, Star chart is based on the principles of


Select one:


Avoidance conditioning


Classical conditioning


Operant conditioning 


Higher order conditioning


Trace conditioning


102, LSD also produces visual hallucinations in pt with schizophrenia


103, In MMSE, intersecting pentagons primarily assesses which of the following functions?


Select one:




Constructional praxis 




Copying skills


Visual retention


104, A child was told to finish homework tasks before he can play outside. This is based on


Select one:


Reciprocal inhibition


Classical conditioning


Cognitive mapping


Premack's principle 


Operant conditioning


105, A family has got a new dog. A 3 year old child in the family is afraid of dogs and would stay in the same room with the dog only if he could sit on his mother's lap and had his favourite ice cream. Select the learning theory principle employed here


Select one:


Avoidance learning




Operant conditioning


Reciprocal inhibition 


Classical conditioning


106, A 40 year old man has chest pain and dizziness. His bloods and ECG are normal. He is advised to take medications, fat restricted diet, exercise. This is called 


Select one:


Illness behaviour 




Sick role


Worried well




107, Semantic memory is not tagged to the time of learning but involves factual recalls.




108, The modification of memories in terms of one's general attitude is called 


Select one:


False memory syndrome


Semantic memory


Repressed memory


Flashbulb memory


Retrospective falsification 


108, A 59-year-old man played Lotto consistently with the desire to win big one day. He has won small amounts of money on certain occasions. What is the reinforcement schedule demonstrated by his behaviour?




Variable ratio






109, hich of the following increases the effectiveness of a persuasive communication?


Select one:


Mass media communication


High intensity urging


A credible communicator 


High receiver intelligence


High cognitive dissonance




110, "The individual behaviour of group members is less important than that of the whole group". What is this concept called?


Select one:


Group think






Risky shift phenomenon






111, Which of the following can reduce groupthink?


To tell members to keep information secret and hide from other group members.




112, A 12-year-old girl is called by names at her school after her dad's admission at the local psychiatric hospital. This is called


Select one:


NIMBY opposition


Self stigma




Courtesy stigma 




113, The right action is the one that has the best foreseeable consequences and not duty. This is called;


Select one:


Engel's model


Utilitarian moral theory 


Paternalistic model


Hammurabi code


Oath of Hippocrates




114, NHS employees are paid every month irrespective of targets achieved or competitive performance.


 Fixed interval reinforcement




Mr. Z is shown a list of words. He is then shown an another list of words and asked which of those appeared on the first list



116, Language is slower to develop in


Select one:


Both parent is deaf and not communicating




Big thanks



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