PSYCHIATRY

Evals 1

TOPICS:
• Thought Disorders – Dr. Briguela
• Psychosomatic Disorders and Consultation-Liaison Psychiatry – Dr. Marinas
• Psychiatric Interview of the Medically Ill – Dr. Chua
• Mood Disorders and Managing Suicide – Dr. Abala
• Classification in Psychiatry and Psychological First Aid – Dr. Santos

QUESTIONS RATIONALIZATION

THOUGHT DISORDERS

1. A caregiver intends to begin treatment of his ANSWER: A

schizophrenic patient with a conventional
antipsychotic but has not selected a Conventional Antipsychotics can be Low potency or High potency but
particular agent yet. Which of the following with the same MOA of Dopamine Receptor Antagonist
is most true about conventional
antipsychotic? For side effects:
High potency- can have Extrapyramidal symptoms
A. They are very similar in therapeutic Low potency- can have sedation and hypotension. It can also be
profile but differ in side effect profile. cardiotoxic and has anticholinergic adverse effects
B. They are very similar in both therapeutic
and side effect profile
C. They differ in the therapeutic profile but
are similar in the side effect profile.
D. They differ in both therapeutic and side
effect profile.

2. True of Delusional Disorder: ANSWER: C

A. Delusions are fragmented Delusional Disorder:

B. Duration of 6 months Criterion A: presence of non bizarre delusion of one month
C. Delusions are no bizarre
D. Has auditory hallucinations Non bizarre delusions is about situations that occur in real life as being
followed, infected and loved at a distance have to do with phenomena
that although not real are possible

3. In Schizophrenia, ANSWER: B

A. The simplest formulation is that there is Processs of elimination tayo:

too little dopaminergic activity in A- WRONG. Researchers believe that many of the symptoms of
Schizophrenia. schizophrenia are a result of excess of dopamine in the brain
B. In 20th century, researchers had no C- only causes NEGATIVE symptoms
significant basis for neuropathology of D- Alterations in the GABA neurotransmitter system are found in
Schizophrenia. clinical and basic neuroscience schizophrenia studies as well as
C. Current hypothesis posits serotonin in animal models and may be involved in the pathophysiology of
excess cause both positive and negative schizophrenia
symptoms in Schizophrenia.
D. GABA, inhibitory amino acid
neurotransmitter, has not been
 implicated in pathophysiology of
Schizophrenia.

4. Ela is 25 y/o, female, married, overseas ANSWER: D

contract worker, was sent home because of
observed change in behavior in Dubai. She
cried most of the time, also became talkative and
suspicious to her room mates. At home, she
was restless, sleepless and lacked appetite to
eat. She was brought to a herbolario who gave
her “Thorazine” (Chlorpromazine) which afforded
very little help. She stopped the medication and
symptoms persisted until on its second month,
hence, she was brought to a psychiatrist. What
is your finding?
Patient’s symptoms:
- 2 months
- Restless and talkative
- Restless, sleepless and lacked of appetite to eat
Symptoms more than 1 month but less than 6 months, distinguished
by its difference in duration, the total duration including prodromal,
active, and residual phase - Criterion A of DSM 5 is same as in
schizophrenia

A. Brief Psychotic Disorder

B. Schizophrenia
C. Schizoaffective
D. Schizophreniform Disorder

5. Which among the following is not a negative ANSWER: C

symptom?
NEGATIVE SYMPTOMS:
A. Asocial - Diminished emotional expression; reduction in pleasure; 5As
B. Avolition • Avolition – reduced motivation
C. Euthymic Affect • Alogia – reduced speech output
D. Alogia • Anhedonia – decreased ability to experienced pleasure
• Asocial – lack of interest in social interaction
• Flat Affect

Positive Symptoms are:

• Delusions
• Hallucinations
• Distortions or exaggerations in language and
communication
• Disorganized speech
• Disorganized behavior
• Catatonic behavior
• Agitation

6. Which among the symptoms show ANSWER: C

Disorganized Thinking?
Disorganized (formerly Hebephrenic)
A. Waxy flexibility - Marked regression to primitive, disinhibited or unorganized
B. Mutism behavior
C. Tangentiality - Absence of symptoms that meet criteria for catatonic
D. Agitation - Occur before age 25
- Signs observed: incongruous grim/grimacing, behavior is silly
- Incoherence marked looseness of association (can be a
sign of Tangentiality), and pronounce thought disorder

*Tangentiality- tends to digress readily from one topic under

discussion to other topics that arise in the course of associations

7. A mental disorder that is with marked by ANSWER: B

hallucination and delusion, less obvious
symptoms are social isolation or withdrawal, and Definition lifted directly from definition of Dr. Briguela (Kaplan and
unusual speech. Saddock’s)

A. Neurosis Psychosis vs. Neurosis

B. Psychosis - Psychosis – derailment or disturbance in reality testing
C. Personality Disorder - Neurotic – patient has contact with reality; alam nila yung
D. ADHD nangyayari sa paligid but the patient experiences severe
anxiety, phobia, trauma/PTSD, OCD. They do not experience
delusions or hallucinations which can be found in psychosis

8. Which of the following is NOT a goal in ANSWER: B

treatment during the Acute Phase of
Schizophrenia?
A. Reduced severity of psychosis
B. Induced harm (mauling the patient for
agitated behavior)
C. Develop alliance with patient
D. Give supportive therapy
GOALS OF TREATMENT (FOR ACUTE PHASE)
1. Prevent harm
2. Control disturbed behavior
3. Reduced severity of psychosis and associated signs
4. Effect a rapid return to the best level of functioning
5. Develop alliance with patients and family
6. Formulate short and long term treatment plans

9. Case of R.B., a 20 year old, Filipino man, ANSWER: B & C

who was brought to the ER by campus security
guard of his university. He refused to leave a Process of elimination tayo:
classroom after randomly walking into a A- Depressed mood has symptoms of prolonged sadness or
lecture hall and shouting to the audience. unexplained crying spells and significant changes in appetite and
His sister said that he had quit seeing his friends sleep patterns.
and spent most of his time lying in bed B- as evidenced by randomly walking into a lecture hall and shouting
staring at the ceiling. She also explained that to the audience and etc. (refer to bold statements
she repeatedly saw him mumbling quietly to C- He loudly insisted that all of the hospital’s food was poisoned
himself and noted that he would sometimes, D- hallucination not present
at night, stand on the roof of their home. On
examination in the ER, R.B. became enraged
when the staff brought him dinner. He loudly
insisted that all of the hospital’s food was
poisoned and that he would only drink a specific
type of bottled water. What important sign and
symptom did you find relevant? (2 answers)

A. Depressed mood
B. Disorganized behavior
C. Suspiciousness
D. Hallucination

10. Psychiatric co-morbidity is a risk factor and ANSWER: C

has serious effects on:
Cannot find exact ratio :(
A. Coronary Artery Disease
B. Diabetes Mellitus Psychosis can be a symptom of Alzheimer's disease, but it is a
C. Alzheimer’s Disease defining clinical feature in other types of dementia, including
D. All of the above Parkinson's disease related dementia and dementia with Lewy bodies

About 36 per cent of people with Alzheimer's are thought to have

delusions and 18 per cent have hallucinations

PSYCHOSOMATIC DISORDERS & CONSULTATION-LIAISON PSYCHIATRY

11. Evaluation process of the medically ill ANSWER: D

involves:

A. Focus on medical history and context of
physical health care
B. Physical and neurological examination
C. Patient’s concept of stress, personality
traits and coping strategies
D. All of the above
12. A patient with End Stage Renal Disease, on
chronic hemodialysis, was referred for
psychiatric evaluation and management.
Assessment revealed that the patient had Major
Depressive Disorder. Plan of management
would involve:
A. Prescribing an antidepressant to
address the symptoms of depression
B. Psychotherapy only because of possible
side effects and drug-drug interactions
C. Reassuring patient that this is part of his
illness reaction
D. Informing the attending physician that
nothing more can be done
13. A patient comes in for consult due to
palpitations, cold sweats, disturbed sleep and a
feeling of restlessness. The patient has been
cleared by Endocrinology and Cardiology
services. His relatives are complaining that the
patient is just imagining everything. Part of your
treatment planning will involve:
A. Requesting for a FT3, FT4, TSH
B. 2D Echo to rule out Mitral Valve
Prolapse
C. Prescribing an antidepressant
D. Berating the relatives for not being
supportive enough to the patient
14. Part of the treatment process in medically ill
patients involve:
A. Psychopharmacology
B. Harnessing the support system of the
patient and setting realistic expectations
C. Coordinating with the referring physician
D. All of the above
Psychosomatic medicine: evaluation process
● Standard Psychiatric Assessment (History/MSE)
○ Past medical history, family history, developmental
and personal history
● Physical and neurological examination
● Gain an understanding of the patient’s experience of his or her
illness – becomes the central focus
● Concepts of stress, personality traits, coping strategies
and defense mechanisms
● Laboratory and ancillary procedures
● Synthesize all those, and do a comprehensive report
● Coordinate with the referring physician, or with the patient’s
primary care physician
ANSWER: A
Past-E hahahahahahaha but i’ll try?
Rule out C and D because depression is not a normal reaction and we
can and should do something about it
Observational studies as well as small trials suggest that certain
serotonin-selective reuptake inhibitors may be safe to use in patients
with advanced CKD and ESRD.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258342/
Therefore, there are still antidepressants you can use for the patient.
ANSWER: C
Remember that most psych conditions are diagnoses of exclusion so
you first have to rule out medical causes. BUT the question said
“cleared by endo and cardio” so that rules out A and B.
Rule out D kasi hello bakit mo papagalitan yung relatives anong
karapatan mo. The better thing to do would be to talk to the relatives,
explain the situation, and explore why they’re not being supportive
(e.g. family therapy)
So that leaves us with C
ANSWER: D
Treatment used in psychosomatic medicine
● Psychopharmacology
○ Targeting active symptoms
○ Side-effect profile
○ Drug-drug interactions
● Psychotherapy
○ Coping strategies
● Psychosocial interventions
○ Harnessing support system
○ Realistic expectations
And because it’s a medically ill patient, you have to coordinate with
 the referring physician.

15. A patient comes to the ER complaining of ANSWER: C

poor sleep and requesting for Midazolam,
claiming it has been prescribed to him before Past-E ulit hehehehehehehe
and that no other medication can help him sleep.
You would suspect that this patient has: Key phrase: “no other medication can help him sleep”
Rule out A and B because other medications can work with those
A. Sleep Disorder secondary to Anxiety
B. Primary insomnia Malingering is the fabricating of symptoms of mental or physical
C. Substance use disorder disorders for a variety of reasons such as financial compensation
D. Malingering (often tied to fraud); avoiding school, work or military service; obtaining
drugs; or as a mitigating factor for sentencing in criminal cases.

Rule out D because the patient is really experiencing symptoms

In this case, the insomnia is a withdrawal symptom.

16. A 42 year old female comes in for consult ANSWER: A

due to headache, chest pain, abdominal pain
and body weakness. She has been unable to Somatic symptom disorder
function for the past 8 months due to this and is ● Presence of one or more somatic symptoms that are
constantly at the hospital. Most likely diagnosis distressing or result in significant disruption of daily life
would be: ● Excessive thoughts, feelings, or behaviors related to the
somatic symptoms
A. Somatic Symptom Disorder ● Disproportionate and persistent thoughts about the
B. Illness Anxiety Disorder seriousness of one’s illness
C. Conversion Disorder ● Persistently high level of anxiety about health or symptoms
D. Pain Disorder ● Excessive time and energy are devoted to these symptoms

Illness anxiety disorder

● Preoccupation with having or acquiring a serious illness
(hypochondriasis)
● Somatic symptoms are not present, or if present, are only mild
in intensity. If another medical condition is present, the
preoccupation is excessive/ disproportionate
● High level of anxiety about health
● Performs excessive health-related disorders

Conversion disorder (Functional neurological symptom disorder)

● Symptom of deficits that affect voluntary motor or sensory
functions
● Caused by psychological factors because illness is preceded
by conflicts or other stressors

Pain disorder
● Presence of, or focus on, pain in one or more body sites and
is sufficiently severe to come to clinical attention
● Psychological factors are necessary in the genesis, severity or
maintenance of the pain, which causes significant distress,
impairment, or both
● Focus on the psychological factors and impairment caused by
the pain

Shortcuts:
Somatic symptom - (+) symptoms na iba-iba, no organic cause
Illness anxiety - (-) symptoms, preoccupied with having a disease
Conversion disorder - (+) symptoms affecting motor and sensory
function, neuro tests normal, does not follow normal nerve distribution
 Pain disorder - (+) pain, no organic cause

17. Good prognostic factors for Conversion ANSWER: B

Disorder include, EXCEPT:
Good prognosis:
A. Acute onset ● acute onset
B. Tremors and seizures ● presence of clear
C. Paralysis, aphonia and blindness ● identifiable stressors
D. Above average intelligence ● short interval between onset and institution of treatment
● above average intelligence
● paralysis, aphonia, blindness

Poor prognosis:
● tremors and seizures

18. In this Somatoform Disorder, the patient ANSWER: B

believes that he/she has a serious disease:
See ratio for number 16
A. Somatic Symptom Disorder
B. Illness Anxiety Disorder
C. Conversion Disorder
D. Pain Disorder

19. La belle indifference is commonly seen in: ANSWER: C

A. Somatic Symptom Disorder La belle indifference

B. Illness Anxiety Disorder - a naive, inappropriate lack of emotion or concern for the perceptions
C. Conversion Disorder by others of one's disability, typically seen in persons with conversion
D. Pain Disorder hysteria.

20. This type of Stress Management training ANSWER: C

involves making the patient aware of
maladaptive thoughts, beliefs and expectations: Stress Management training
● Self-observation
A. Hypnosis ○ Daily diary format
B. Cognitive restructuring ○ How they respond to stress/ challenges each day
C. Cognitive behavioral skills training ○ Stressful events that precipitate signs/ symptoms
D. Biofeedback ● Cognitive restructuring
○ Awareness of maladaptive thoughts, beliefs and
expectations
● Relaxation training
● Time management
● Problem-solving
○ Applying solutions to problem situations

P.S. It’s not C because that involves behaviors, too

21. A 40 year old female, married, employed ANSWER: D

part-time in airline company, was referred by
Gastroenterologist for evaluation and
management. The patient complains that she
has diarrhea everyday, and is distressed that
despite a negative stool exam, a gastroscopy
and antibiotic therapy, her doctor is unable to
find a disease/disorder. She admits to feeling
anxious and depressed almost everyday, and
worries that her case is hopeless. She also
From Kaplan:
“a person with a diagnosis of a major depressive episode also
experiences at least four symptoms from a list that
includes changes in appetite and weight, changes in sleep and
activity, lack of energy, feelings of guilt, problems thinking and
making
decisions, and recurring thoughts of death or suicide”
admits to having poor appetite, disturbed sleep
and has lost interest in most of her activities.
She denies hearing any voices or having any
paranoid thoughts. You would consider the
following diagnosis/es:

A. Functional Diarrhea
B. Peptic Ulcer Disease
C. Major Depressive Disorder
D. A&C

22. In the case above, you would consider ANSWER: B

asking for the following diagnostic test:
Can’t find the exact ratio. Pero to rule out na rin other diseases that
A. Thyroid function test you’re considering, order mo na lahat! Yas.
B. Complete battery of psychological tests
C. Cranial CT Scan
D. EEG

23. Based on your diagnosis, your treatment ANSWER: B

plan would then include:
For Illness Anxiety Disorder (diagnosis of the above case):
A. More antibiotic therapy Pharmacotherapy and psychotherapy ang treatment!
B. Pharmacotherapy (antidepressant) and
psychotherapy
C. Telling the patient that it’s all in her head
D. Diet modification

24. This disorder is characterized by an ANSWER: D

intention to deceive and may result in strong
negative countertransference from the attending From Kaplan: “The disorders are a form of repetitional compulsion,
physician/s: repeating the basic conflict of needing and seeking acceptance and
love while expecting that they will not be forthcoming. Hence, the
A. Somatic Symptom Disorder patient transforms the physicians and staff
B. Illness Anxiety Disorder members into rejecting parents.”
C. Conversion Disorder
D. Factitious Disorder

25. Characteristic of Consultation-Liaison ANSWER: A

Psychiatry, EXCEPT:

A. Deals with reservation & biases of the

consultation
B. Patient does not generally initiate
referral
C. Encounters clinical issues not usually
seen in out-patient settings
D. Identify mental disorders and
psychological responses to physical
illness
PSYCHIATRIC INTERVIEW OF THE MEDICALLY ILL

26. Elements of the psychiatric interview of the ANSWER: D

medically ill:
CLARIFICATION OF THE CONSULTEE-STATED VS
A. Clarification of the reason for referral CONSULTANT-ASSESSED REASONS FOR REFERRAL
B. Review of the medical chart for pertinent ● The overt reason expressed for the need for consultation may
medical factors be incomplete, or a request may be made for the assessment
C. Description of the behavior noted by the of one problem when another more serious problem is
medical staff unrecognized
D. All of the above ● Direct contact with the individual who initiated the request is
beneficial for obtaining exact information about the patient’s
behavior, which may not appear in the record

ASSESSMENT FOR THE EXTENT THE PATIENT’S PSYCHIATRIC

DISTURBANCE IS CAUSED BY THE MEDICAL/SURGICAL
ILLNESS
● The medical chart must be reviewed for pertinent medical
factors that could contribute to the patient’s current state
● Attention must be given to the description of the mental status
and the behavior noted by the medical staff
● Assessment for the adequacy of pain management

27. Pain assessment and management, ANSWER: C

EXCEPT:
GENERAL PRINCIPLES OF PAIN ASSESSMENT & MANAGEMENT
A. Diagnostic work-up for pain complaints ● Obtaining information about the pain complaint
B. Awareness of how anxiety may ● Awareness of how pain contributes to specific illnesses
contribute to acute pain and depression ● Awareness of how psychiatric disorders and symptoms
to chronic pain contribute to pain complaints and vice versa
C. Exaggerated complaints and/or ● Detailed assessment of all analgesics and adjuvant
abnormal behaviors are often associated medications
with pain disorder ● It is crucial to have an understanding of the factors that
D. Understand how pain contributes to a contribute to undertreatment of pain, the appropriate
specific illness diagnostic work-up for pain complaints, and the elements of

28. Cognitive error which may increase the risk
of depression in patients with physical pain:
A. Wishful thinking
B. Personalization
C. Over-solicitous response to problems
D. All of the above
29. True regarding evaluation of the medically ill
patient’s character style:
A. Based solely on information obtained
from the history of present illness
B. Reaction to illness is influenced by an
existing personality disorder
C. Understanding of the factors that
contribute to under treatment of pain
D. All of the above
30. Included in the medical-psychiatric history of ANSWER: C
a medically ill patient, EXCEPT:
Medical-Psychiatric History
A. Patient’s medication list and recent
changes in medication
B. Subtle disturbances in cognition
C. Patient’s perspective of how he/she
should be managed
D. None of the above
MOOD DISORDERS & MANAGING SUICIDE
31. Norepinephrine has a complicated
relationship to Serotonin. It may act as a
_______ of serotonin release at alpha 1
receptors at the somatodendritic area while
acting as a ______ at alpha 2 receptors.
A. Accelerator; Accelerator
B. Accelerator; Brake
C. Brake; Accelerator
D. Brake; Brake
32. Several circuits and areas of the brain are
thought to correlate to the different symptoms
seen in mood disorders. Patients manifesting
with psychomotor changes and general fatigue
are thought to dysfunctions in these areas of the
integrated, multimodal assessment and management of
patients in pain
ANSWER: B
Personalization
● Is a distortion where a person believes that everything others
do or say is some kind of direct, personal reaction to the
person. They may also see themselves as the cause of some
unhealthy external event that they were not responsible for.
Or digest nalang. Past e naman hahaha
ANSWER: B
EVALUATION OF THE PATIENT’S CHARACTER STYLE
● Information from several domains (eg. developmental history,
social history, occupational history) must be integrated to form
a dynamic life narrative leading up to the current illness
● Medical illness, surgery and the many stresses of
hospitalization are managed differently by individuals with
different character styles or DSM-IV Axis II personality
disorders
● Understanding how character influences the experience of
physical illness is critical for explaining abnormal patient
behaviors, emotions and demands
● Assessment for the extent the patient’s psychiatric disturbance
is caused by the medical/surgical illness
● Assessment for the extent the psychiatric disturbance is
caused by medication or substance abuse
● Assessment for disturbance in cognition
● Assessment of psychiatric symptomatology and behavior
○ The patient’s perspective of possible precipitating,
exacerbating, or resolving factors is most pertinent
ANSWER: B
Norepinephrine regulates serotonin release. It does this by acting as a
BRAKE on serotonin release at alpha 2 receptors on axon terminals
and as an ACCELERATOR of serotonin release at alpha 1 receptors
at the somatodendritic area.
ANSWER: A
CNS:

A. Prefrontal Cortex, Nucleus Accumbens,

Striatum, Cerebellum, Spinal Cord
B. Prefrontal Cortex, Thalamus, Basal
Forebrain, Cerebellum, Nucleus
Accumbens, Striatum
C. Prefrontal Cortex, Hypothalamus,
Striatum, Nucleus Accumbens, Spinal
Cord
D. Prefrontal Cortex, Cerebellum, Striatum,
Basal Forebrain, Spinal Cord

33. Depression and Mania share which of the ANSWER: D

following symptoms:
Psychomotor acceleration and grandiosity = mania
A. Psychomotor acceleration Low self-esteem = depression
B. Low self-esteem
C. Grandiosity Angry outbursts lasting over several days, during both manic episodes
D. Anger and agitated states of depression are typical in BPD. Also. according
to Freud, depression is basically anger turned inward.

34. A hypomanic episode differs from a manic ANSWER: B

episode in that the hypomanic episode:
A manic episode is a distinct period of an abnormally and persistently
A. Last at least 1 week elevated, expansive, or irritable mood lasting for at least 1 week or
B. Lack psychotic features less if a patient must be hospitalized.
C. Causes greater impairment
D. Has increased speech production A hypomanic episode lasts at least 4 days
and is similar to a manic episode except that it is not sufficiently
severe to cause impairment in social or occupational functioning,
and no psychotic features are present.

Both mania and hypomania are associated

with inflated self-esteem, a decreased need for sleep, distractibility,
great physical and mental activity, and overinvolvement in pleasurable
behavior

35. Functionality in each brain region may be ANSWER: A

associated with a different constellation of
symptoms in mania. Patients manifesting with
racing thoughts may be experiencing dysfunction
in which areas:

A. Prefrontal Cortex, Nucleus Accumbens

B. Hypothalamus, Striatum
C. Basal forebrain, Amygdala
D. Hypothalamus, Cerebellum
36. Ben, who has been diagnosed with Bipolar ANSWER: D
Depression, has started to experience numerous
auditory hallucinations. These hallucinations Mood-Congruent Psychotic features
involve his father, Han, calling him worthless and - Delusions or hallucinations whose content is entirely
commanding him to kill himself. For the past 2 consistent with the typical manic or depressive themes
weeks, he has also started to experience racing
thoughts, a decreased need for sleep, increased with Mixed features
energy and elevated mood. These psychotic - When an individual’s mood fluctuates rapidly, he or she meets
symptoms are an example of: diagnostic criteria for both manic and major depressive
episodes for at least one week. Individuals with Mixed
A. Mood-Congruent Atypical Psychotic Features may be agitated, have difficulty sleeping,
Features demonstrate changes in appetite and experience psychosis or
B. Mood-Congruent Psychotic Features suicidal ideation.
C. Mood-Incongruent Psychotic Features,
with anxious distress
D. Mood-Congruent Psychotic Features,
with Mixed features

37. Persistent Depressive Disorder differs from ANSWER: B

Major Depressive Disorder because in PDD:
Depression is episodic; has a high-grade chronicity; onset is usually
A. Depression is episodic late in life = MDD
B. The symptoms outnumber the signs
C. The onset is usually late in life Manic episodes are not common in MDD and PDD
D. Manic episodes are common
E. Has a high-grade chronicity

38. Which of the following epidemiological data ANSWER: D

is TRUE in Bipolar I Disorder:
- Manic episodes are more common in men
A. Women are more likely to experience - Depressive episodes are more common in women
manic episodes - When manic episodes occur in women, they are more likely
B. Men are more likely to experience mixed than men to present a mixed picture
episodes - Women also have a higher rate of being rapid cyclers
C. Men are more likely to experience
depressive episodes
D. Women are more likely to be rapid
cyclers

39. For an adult patient to be diagnosed as ANSWER: D

suffering from Cyclothymic Disorder, s/he must
have been symptomatic for at least 2 years with
symptom-free periods not lasting more than:

A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks

40. For a patient who frequently consumes food ANSWER: D

rich in tyramine, which mood medication would
you AVOID? Recall.

A. Selective Serotonin Reuptake Inhibitors

(SSRI’s)
B. Atypical Antipsychotic (AP’s)
C. Antiepileptic Drugs (AED’s)
D. Monoamine Oxidase inhibitor (MAOI’s)

41. The most common precipitant for a suicide ANSWER: C

attempt in the Philippines (from 1974-2005)
is/are:

A. Sexual dysfunction
B. Chronic Illness
C. Relational Problems
D. Substance Abuse

42. Luke has come to the ER of his own free ANSWER: B

will, stating that he has been feeling very
depressed the past month. He is not intoxicated
or under the influence of any substance, has not
attempted to harm himself but has entertained
several specific ideas without acting on them.
On further assessment, you discover he has
been seeing a Psychiatrist, who has always
reminded Luke to go to the ER whenever he
feels seriously suicidal. Luke’s risk for suicide
may be classified as:

A. Low
B. Moderate
C. High
- Memorize mo to frenny, important slide!
D. Extreme

43. Which of the following factors is likely to ANSWER: A

increase the suicide risk of Luke?

A. Male
 B. Celibate
C. Lives with his twin sister
D. Employed

44. An example of deliberate self-harm (also ANSWER: B

known as nonsuicidal self-injury):

A. Ingesting enough paracetamol to exceed

the LD50
B. Cutting oneself on the
stomach/thighs/other areas that cannot
be publicly seen]
C. A poorly educated person ingesting
three bottles of vitamin tablets
D. Shooting oneself in the head with a
firearm

45. Brendol has been asking several friends ANSWER: C

where he could purchase bottles of cyanide. He
has also already written a 5 page long letter that
he refuses to let anyone see. He may be
classified under which level of risk of suicide?

A. Low
B. Moderate
C. High
D. Not suicidal

PSYCHIATRIC INTERVIEW OF THE MEDICALLY ILL

46. Purpose of the Mental Status Examination in ANSWER: C

the medically ill patient:
The purpose of the mental status examination for the medically ill is to
A. To obtain information about how pain elicit the patient’s capacity to understand and cope with the illness and
contributes to the illness to make decisions about care
B. To address feeling of unattended
suffering and helplessness
C. To elicit the patient’s capacity to
understand the illness
D. To form a dynamic life narrative leading
up to the current illness
47. Particularly important technique in obtaining
a psychiatric history in a medically ill patient:
A. Introduce questions about the areas
described in the outline of the history
and mental status examination
B. Use close-ended questions
C. Facilitation of the patient’s narrative
D. Obtain information from other sources
ANSWER: C
● The practice of narrative medicine involves an ability to
acknowledge, absorb, interpret and act on the stories and
struggles of others.
● Narratives are facilitated by authentic, compassionate, and
genuine engagement

CLASSIFICATION IN PSYCHIATRY & PSYCHOLOGICAL FIRST AID

48. What is included in Psychological First Aid? ANSWER: D

A. Professional counseling
B. Searching for meaning in the midst of
disaster
C. Highly encouraging people to talk of
their experience
D. Helping people to address basic needs
such as food and water

49. What are the PFA action principles? ANSWER: B

Refer to no. 48
A. Look, Learn and Go
B. Look, Listen and Link
C. Stop, Look and Listen
D. Live, Dream and Believe

50. Good communication skills in PFA include: ANSWER: D

A. Always say that they should not feel Familiarize mo medyo common sense lang :)
sorry for themselves
B. Give information in the most details and
technical approach
C. Talk about worse scenarios that they
could have been through
D. Acknowledge how they are feeling and
acknowledge any important event they
 share

51. Organic Psychiatric Disorder with ANSWER: D

manifestation of cognitive impairment:
Digest!
A. Characterized by changes in brain tissue
function
B. Caused by a specific agent that leads to
structural change
C. Caused by psychoactive substances
that lead to impaired judgment &
intellectual functions
D. All of the above are correct

52. Psychiatric Disorders are arranged into ANSWER: D

categories:
From trans!
 A. According to shared characteristics
B. Based on etiology or pathophysiology
C. Based on clusters of signs and
symptoms
D. All of the above are correct
Psychiatric Disorders are arranged into categories according to
- Shared characteristics
- Based on etiology and pathophysiology
- Based on clusters of signs and symptoms

53. Schizophrenia Spectrum and Other ANSWER: A

Psychotic Disorders include:
Schizophrenia Spectrum and other Psychotic disorders
A. Delusional Disorder - DELUSIONAL DISORDER
B. Brief Manic Disorder - Schizophrenia
C. Acute Stress Disorder - Schizoaffective disorder
D. Communication Disorder - Schizophreniform disorder
- Shared psychotic disorder
- Brief Psychotic Disorder
- Substance/medication induced Psychotic Disorder
- Psychotic disorder due to another medical condition
- Catatonia

54. Bipolar and Related Disorders include: ANSWER: A

A. Cyclothymic Disorder Bipolar and Related Disorder

B. Schizoaffective Disorder - Bipolar I Disorder
C. Persistent Depressive Disorder - Bipolar II Disorder
D. Intermittent Explosive Disorder - CYCLOTHYMIC DISORDER
- Bipolar Disorder due to another medical condition
- Substance/Medication induced Bipolar disorder

55. Somatic Symptom and Related Disorders ANSWER: A

include:

A. Illness Anxiety Disorder

B. Schizophreniform Disorder
C. Dissociative Identity Disorder
D. Trichotillomania

Special thanks to the PSYCH RATIO TEAM 😊 (Alexis de las Alas, Russell Flores, Sha Tablada, Gylle Lanzar, Janina Alcos,
Kryschelle Cantos, Allen Kamantigue and Sirenz Ramos)