Do you ever hear voices commenting on what you are doing?’ This question is usually asked to ascertain the presence of which one of the following?

A. Bleuler’s primary symptoms

B. Schneider’s first-rank symptoms

C. Command hallucinations

D. Catatonic symptoms of schizophrenia

E. Negative symptoms of schizophrenia

Assessment of insight is an integral part of mental state examination in psychiatric practice.Regarding insight, which of the following statements is true?

A. Patients with schizophrenia will never have insight into their illness

B. OCD being a neurosis, insight is always intact

C. Intellectual insight is present when patients’ awareness and understanding of their symptoms lead to a change in behaviour

D. Intellectual insight is the highest level of insight

E. Loss of insight is similar to the concept of anosognosia in neurological illness

A patient with schizophrenia vividly describes how Martians are ‘reverse freezing’ earth to produce global warming. He stops to ask what you think about this. Choose the best response.

A. This is a fantastic theory. But I want to know more about this. Tell me, have you ever seen these Martians?

B. This seems possible but there is no proof for all this. Tell me, have you ever seen these Martians?

C. This cannot be true. Martians do not exist. Tell me, have you ever seen these Martians?

D. Tell me, have you ever seen these Martians?

E. What I think is not so important. I want to know more about what you think of this. Tell me, have you ever seen these Martians?

احس يجي هلشيء

A patient looks dishevelled, with unkempt hair and dirty, unwashed clothes.

Self neglect is commonly noted in all of the following EXCEPT

A. Alcoholism

B. Chronic schizophrenia

C. Depression

D. Dementia

E. Social phobia

. A 57-year-old lady with many previous hospitalizations is brought by police to casualty. She is wearing full make-up, green lipstick, shiny green nail polish, and green jewellery. She asks everyone at the admission unit to call her Ms Green. Which of the following diagnoses is most consistent with the above presentation?

A. Mania

B. Depression

C. Panic attacks

D. Obsessive compulsive disorder

E. Learning disability

. A 33-year-old man attending an out-patient clinic turns towards his left and spits out, muttering unintelligibly. He does this act at least three times in half an hour and appears very guarded.This gesture is suggestive of which of the following?

A. Depression

B. Suicidal thinking

C. Low self esteem

D. Responding to hallucination

E. Acute confusion

Nihilistic delusions will be congruent with which of the following findings of mental state examination?

A. Depression

B. Mania

C. Depersonalization

D. Grandiose delusion

E. None of the above

An 18-year-old male, recently started on a medication, presents to the A and E department with slow, long-sustained, contorting, involuntary movements and postures involving proximal limb and axial muscles. Which of the following medications is most likely to cause the above presentation?

A. Propranolol

B. Diazepam

C. Risperidone

D. Procyclidine

E. Sertraline

A man admitted to the psychiatric intensive care unit with a manic episode, received 10 mg of haloperidol intramuscularly as he had turned violent. He became unresponsive shortly afterwards. On examination, there is evidence of confusion, labile BP, hyperthermia, rigidity, and dysphagia. What is the most important differential diagnosis?

A. Acute dystonia

B. Neuroleptic malignant syndrome

C. Tardive dyskinesia

D. Akathisia

E. Parkinsonism