01 Mar A 60-year-old women, suffers from arterial hypertension about 15 years. After the second stroke she complains in unexplained decrease of mood, severity of concentration of attention and

Variante 1

       1. A 60-year-old women, suffers from arterial hypertension about 15 years. After the second stroke she complains in unexplained decrease of mood, severity of concentration of attention and forgets to close  entrance door, does not remember the events of the past day. On the CT section there are postinfarction changes in the posterior frontal cortical areas. What is the most likely diagnosis of the patient? 

A.Vascular Dementia.    B. Alzheimer's Disease.    C. Hentington's Disease.      D. Pick Disease.       E. Dissociative amnesia. 

        2. A 25-year-old man, states that for the last month he has noticed  the people treat him wrong, become suspiciously and contemplate something against him. He can hear threatening voices in his head. Some time later the patient realized that the voice belonged to his brother. What syndrome is most likely? 

A. Delirious syndrome.    B. Paranoid syndrome.   C. Paranoiac syndrome.   D. Phobic syndrome.   E. Paraphrenic syndrome.        3. Patient D., aged 27, feel an extremely unpleasant sensation of burning in the abdonmen without any real basis. Somatically: no pathology. What symptom is most likely?

A. Tactile hallucinations.     B. Senestopathies.     C. Hyperaesthesia.     D. Delusion ideas.     E. Visceral hallucinations.  

        4. The patient of 34 years old suffers from anxious disorder with panic attacks about two years. She was treated by psychotherapist. Partial remission was achieved. She interrupted psychotherapy in connection with a move to another city. Soon, the condition became worse considerably, felt almost permanent anxiety, panic attacks  to 5-6 times per day, accompanied by strong palpitations, shortness of breath, cold sweat, fear of death. What group of medications is most appropriate for treatment ? 

A. Cardiotonics.   B. Sedative neuroleptics.  C. Neuroleptic of antipsychotic action. D. Lithium.  E. Antidepressants.         5. The patient was 24 years old by the nature of the emotionally labile, after her divorce from her husband complains of irritability, palpitations, a sense of disruption and stabbing pains in the heart, general weakness. Objective: hyperhidrosis of palms, pulse – 72-78/hv, labile, the heart – without pathology. ECG normal. What is the most likely syndrome? 

A. Depressive syndrome. B. Hyperhondrical syndrome.  C. Asthenic syndrome.  D. Phobic syndrome.  E. Hysterical syndrome.         6. A 37-year-old patient P. takes treatment at the mental hospital. He does not talk to anybody, does not react to the current events. All the time he stays in the bed in the same pose with his head raised of the pillow. The expression of his face is exalted. The patient demonstrates active negativism. The emotional and the pupil’s reactions to any pain are absent. What is the most likely syndrome? 

A. Delirium.        B. Catatonic.        C. Hebiphrenic.         D. Apathoabulic.        E. Maniacal syndrome.       7. Patient 34 years old 3 years ago, suffered a head injury, while studying at the university occasionally used the hashish. Within 2 months there were "insertion" and "withdrawal" of thoughts, their transfer, raving outside influence, pertaining to his thoughts. Somatic condition without pathology. What is the most likely diagnosis of the patient? 

A. Catatonic schizophrenia.    B. Paranoid schizophrenia.    C. Simple schizophrenia.   D. Undeffirential schizohrenia. E. Scizoaffective disorder. 

      8.A 53-year-old patient developed tiredness, headaches, irritation, superficial sleep, hypersensitivity to loud sounds, impossibility to concentrate, depressed mood after changing her job. What of medication should be prescribed?

    A. Carbamazepine.      B. Risperidone.       C. Amitriptyline.        D. Lorazepame.        E. Fluoxetine.       9. A 30-year-old patient, speaks quickly. His emotional level is increased. He considers himself to be a man of genius with an extremely high intellectual level. He states that he understood the sense of life on the basis of his philosophic meditation. The patient considers that his intellect to be  God’s gift. For many years he has been talking with God. Of late the patient has begun to consider himself to be much more intelligent than God. What is the most likely syndrome? 

      A. Delirium.        B. Catatonic.        C. Hebiphrenic.         D. Apathoabulic.        E. Maniacal syndrome.

    10. A 39-year-old married ex-nurse was reffered by her general practice doctor to psychiatric outpation clinic with a 6-month history of depressed mood. She was a slim woman of medium height who had been suffering from tearfulness, lack of energy, anhedonia, reduced appetite and weight loss. She was suffering from initial insomnia of 1-2 hours but there was no erly morning wakening. She had also noticed that her menstrual cycle, which was normally regular, had stopped 3 month ago. Prior to referral her physical condition had been extensively invesigated by an endocrinologist and all test had proved negative. Although the patient was suffering from depressed mood, she denied having suicidal thoughts. Her husband confirmed that she had never seriously considered suicide. What is the most likely diagnosis? 

  A. Mild depressive episode.        B. Moderate depressive episode.   C. Severe depressive episode without psychotic simptoms.   D. Severe depressive episode with psychotic simptoms.   E. Reccurente depressive disorder.

   11. A 7 – year-old student became inattentive several times during lessons, began to smack his lips. During short "absence" did not respond to his name. Falling and seizures were not observed at that time. The mother noticed such phenomena and before, but did not attach significance to them, considering that a child was thoughtful. What is the most likely diagnosis? 

   A. Jackon’s partial seizure.   B. Generalized myoclonic seizures.  C. Adversivny attack.  D. Complex partial seizure.

   E. Absence seizures. 

   12. A student, 22 years old, after not passed the exam, started to complain of foreign body sensation, like a lump in the throat, difficulty swallowing. Fixed on it, restricts herself in a meal, tearful, seeking to attract attention, demonstrative. Easily amenable to psychotherapeutic suggestion. Which is psychiatric diagnosis of this patient? 

   A.  Hypochondriac disorder.  B. Dissociative disorder. C. Depressive episode. D. Obsessive disorder.  E. Schizophrenia.

   13. Patient K., 45 years. The state has changed in the evening after a 3-day binge: he became uneasy, ran around the apartment, talking to himself. Seen: disoriented in time and place. Properly called his name, age. Frightened looks around. Suddenly he jumped up and ran down the hall, shouting: "The devil came, beware!" What group of medications is most appropriate for treatment? 

     A. Tranquilizers.       B. Nootropics.     C. Neuroleptics.     D. Mood stabilize.    E. Antidepressante.

   14. Patient M., aged 40, after uncompleted suicide demonstrated disturbance of memory on events before the incident. Determine the type of amnesia:

     A. Retrograde ;        B. Anterograde;          C. Progressive;       D. Anteroretrograde;         E. Fixation. 

   15.  Patient U., aged 34, answers the question about his first seizure: “It happened in spring. I got up early, washed, got shaved. I was cooking breakfast. For breakfast I like fried eggs. I like to eat very much…” What kind of thinking disturbance?

     A. Incoherent thinking;     B. Retarded thinking;    C. Non-consinuos thinking;    D. Circumstantion;      E. Mentism

   16. A 16-year-old man. Over the past year gradually changed behavior: he was to isolate himself, lost interest in friends, learning. He became indifferent to his family, was gratuitously rude, himself spoke or laughed. At question is answered formally correct. He considers himself quite healthy, but a little tired. What type of schizophrenia should be diagnosed?

     A. Simple.          B. Paranoid.            C. Catatonic.       D. Hebephrenic.         E. Residual. 

   17. A man of 40 years able to solve the problem of cancer and AIDS by handing out money to strangers. Choose the most correct diagnosis?  

      A. Maniacal episode.    B. Depressive episode.    C. Cyclotymia.   D. Catatonis schizophrenia. E. Bibolar affective disorder.

   18. Patient of 68 years old, an employee. The disturbance of memory began about two years ago: became forgetful at work and home, unable to cope with official duties. Gradually  began to forget the names of relatives, names of objects, became helpless, speech was impaired. Lost the skills of writing, reading, caring for himself. With computer-tomographic study: atrophy of the cerebral cortex of large hemispheres . What syndrome is most likely? 

    A. Psychoorganic syndrome.     B. Korsakoff’s amnestic syndrome.     C. Dementia.      D. Mental retardation. 

    E. Neurasthenic syndrome.

   19. A 23-year-old man admitted to the psychiatric hospital stated that he had been upset for at least a year owing to the fact, that he had been hearning voices when he was no his own and when there were no obvious causes. He would typically hear two male voices who would talk to each other about him and who would also sometimes comment on his actions. He had “realized” that the voices were the result of his being spied on by security agents, who were plotting to kill him. What is the leading psychopathological symptome? 

    A. Impirative hallucinations.   B. Simple hallucinations.   C. Antogonistic hallucinations.  D. Functional hallucinations.

    E. Comment hallucinations.

20. A fragment of the patient’s speech: “Not knowing that I was ill, I made no attemp to understand what was happening, but felt that there was some overwhelming significance in all of this, produced either by God or Satan…”.The walk of a stranger on the street could be a “sign” to me which I must interpret. Every face in the windows of a passing street car would be engraved on my mind, all of them concentrating on me and trying to pass me some sort of message. What is the leading psychopathological symptome?

   A. Symbolic thinking.   B. Loosening of association.    C. Flight of ideas.    D. Circumstantial thinking.   E. Thought blocking.

21. The patient in the somatic hospital and fever developed psychomotor agitation. He tried to run for office, believed that the walls of a water leak, and on the floor running rats, cockroaches, etc. He declared that he was in a hostel, "learned" friends. In the place and time is not oriented, in his personality is oriented correctly. After the introduction of sedative medication to sleep. In the morning kept the remembrance of the state. What is the diagnosis of the patient? 

   A. Organic delirium.  B. Organic amnestic syndrome.   C. Vascular dementia.  D. Organic delusion disorder. 

   E. Organic hallucinosis.

22. A 17-year-old patient’s father states that his son suffers from lack of appetite (a weight loss by 7 kg), insomnia and worsens progress in his studies. The patient’s activity and mood decreased. He says that he can not cope with his studies and will not be able to study at the vocational school. The patient says that sometimes melancholy was extremely high and he cried and had thoughts that he would be able not defend himself and there was no way-out but nothing had happened. What of medication should be prescribed?

    A. Diazepame.    B. Magnesium sulfate.    C. Oxybutyrate sodium.     D. Chlorpromazine.       E. Thiopental sodium.

23. A 30-year-old patient P. takes treatment at the mental hospital. He does not talk to anybody, does not react to the current events. All the time he stays in the bed in the same pose with his head raised of the pillow. The expression of his face is exalted. The patient demonstrates active negativism. The emotional and the pupil’s reactions to any pain are absent. What type of schizophrenia should be diagnosed?

   A. Simple.        B. Paranoid.          C. Catatonic.          D. Hebephrenic.        E. Residual.

24. Patient M., aged 60, is admitted to a mental hospital by Ambulance. He does not consider himself to be a mentally ill person. He states that everything is his wife’s made up show in order to receive her lovers. He says that he has repeatedly noticed his wife giving signals to her lovers: for this purpose she puts flowers in the window-sill, hangs blinds in the kitchen and opens the windows. He demands being discharged from the mental hospital to find his wife with her lover while she is not waiting for the patient. The patient suffers from: 

    A. Overvalued ideas.          B. Delusion.           C. Forced ideas.             D. Illusion.               E. Confabulation. 

25. Female of 60 years old, suffers from arterial hypertension about 15 years. After the second stroke she complains in unexplained decrease of mood, severity of concentration of attention and forgets to close  entrance door, does not remember the events of the past day. On the CT section there are postinfarction changes in the posterior frontal cortical areas. What is the most likely diagnosis of the patient? 

    A.Vascular Dementia.     B. Alzheimer's Disease.   C. Hentington's Disease.    D. Pick Disease.     E. Dissociative Amnesia.

Answers:

1. A

2. C

3. E

4. E

5. A

6. B

7. B

8. C

9. E

10. B

11. A

12. C

13. D

14. A

15. C

16. D

17. A

18. C

19. A

20. A

21. E

22. A

23. C

24. B

25. A