Intermediate Module (Psychiatry)---Paper II----------September 29, 2010.
Time Allowed = 3 Hours
Q.1 A 35 year old, married lady, presented with H/O inability to complete house-hold chance in time, excessive thinking about trivial matters, and feels that a disaster will strike, if she did not give a hundred rupees every day to a beggar. Her husband informed that she hides kitchen knives because she had doubts that she may hurt her children.
a) What is this behavior called in phenomenological terms?
b) What further inquires will you make to establish the psychopathological basis of this presentation?
c) List four clinical disorders that can present with such a phenomenon.
Q.2 A 25 year old male was brought by his family at a medical emergency with history of opium overdose.
a) What clinical features do you expect in this case?
b) How will you manage this case?
Q.3 A female teacher approaches you with her husband who is suffering from schizophrenia. She seeks counseling on the risk of schizophrenia in her children.
Keeping in mind the genetic studies on the subject how will you explain the risk to her off springs?
Q.4 You have been asked to deliver a talk to the nursing staff in your ward on “Factors associated with dangerousness and violent behavior in psychiatry wards”.
What will be the salient features of your talk?
Q.5 A 30-year-old female patient is receiving 4 mg of risperidone medication. After a few days she reports that milk is coming out of her nipples.
a) What specific Lab tests would you request for?
b) What could be the pathophysiological basis of this clinical situation?
c) Suggest the changes that you will make in medication.
Q.6 A 55 years old businessman who has been recently diagnosed as Alzheimer’s disease is brought by his wife to your clinic.
a) What information will you give about the nature and prognosis disease to the family?
b) What advice you will give to make best use of patients existing capabilities?
c) Name any four medicines that patient is likely to benefit from.
Q.7 A student nurse asked you at the end of your lecture, “why there is a need for patients to have six to eight hours of sleep every day”.
a) Write down a response based on the physiological basis of sleep and its role as biological function.
b) List four normal physiological conditions that can cause disturbed sleep.
Q.8 A 45 years old female patient of schizophrenia taking olanzapine 10 mg daily for the last one year was admitted in medical ward for complaints of burning feet, excessive urination and 10 kg of weight gain during last two months.
a) What will be your diagnoses?
b) What specific Lab tests would you request for?
c) What will be your treatment plan?
Q.9 A 25 year old pregnant lady is admitted from emergency with one day H/O weakness of her right leg. She has past H/O admission with C/O blindness in one eye. To rule out organic causes plan to advice CT scan or MRI, besides other investigations.
a) Which of the two (CT brain or MRI brain) will you prefer in this case and why.
b) What are the basic differences in these techniques? Identify their merits and demerits.
Q.10 The consultant has asked you to take informed consent from the relatives of a chronic schizophrenic to start clozapine treatment.
What information will you provide about clozapine?
