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Question 1
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A 40-year-old male is experiencing difficulty walking of standing normally. He presents to the Emergency department and is observed swaying from side to side, almost falling before recovering. What is the specific name for this condition?
Your Answer: Hypochondriasis
Correct Answer: Blocq's disease
Explanation:Blocq’s disease, also known as astasia-abasia, is a conversion symptom characterized by an abnormal gait that is not indicative of any organic lesion. Hypochondriasis is excessive worry about having a serious illness despite the absence of a medical condition. Malingering involves fabricating symptoms for secondary gain, while somatization is a chronic condition with multiple physical complaints for which no physical cause can be found and is associated with frequent medical contact.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 2
Correct
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A 32-year-old teacher has been referred by the doctor with persistent feelings of sadness. She now describes experiencing a sense of disconnection and feels like she is watching herself in a surreal state. What is the most probable diagnosis?
Your Answer: Depersonalisation
Explanation:Depersonalisation is classified as a neurotic disorder in the ICD-10 and is characterized by feelings of detachment of distance from one’s own experiences and emotions. Derealisation, on the other hand, is a perceptual phenomenon in which the external world seems unreal. Dissociative fugue is a dissociative state that can lead to wandering and getting lost in another location. Hypochondriasis is a condition in which an individual excessively worries about having a serious illness, despite no evidence of a medical condition. Finally, somatisation is a chronic condition in which multiple physical complaints are present across various systems, but no physical cause can be identified, leading to frequent medical visits.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 3
Incorrect
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While on a weekend pass to visit his family, a middle-aged man with bipolar disorder destroys his sister's car.
When asked about his behavior, he explains that he saw a black cat cross his path and knew he had to destroy something to ward off bad luck.
What is this an instance of?Your Answer: Delusion of reference
Correct Answer: Delusional percept
Explanation:Delusional perceptions involve attaching a delusional meaning to an accurate perception, which can feel like a significant realization. This differs from interpreting accurate perceptions in a way that aligns with pre-existing delusions. These perceptions are considered a primary symptom.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 4
Incorrect
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A 72-year-old male reports feeling distressed after hearing his deceased wife's voice in his head, asking him to come join her. He clarifies that he heard it internally and not as an external sound. What type of perceptual abnormality is reflected in his experience?
Your Answer: Hypnopompic hallucinations
Correct Answer: Pseudohallucinations
Explanation:– Pseudohallucinations are figurative and not real
– They are located in the inner subjective space
– Auditory hallucinations are concrete, tangible, and real
– They are located in the outside objective space
– Autoscopy is the experience of seeing oneself
– Reflex hallucination is where a stimulus in one modality produces hallucination in another modality
– Hypnopompic hallucinations occur when waking up from sleep. -
This question is part of the following fields:
- Descriptive Psychopathology
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Question 5
Incorrect
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You encounter a 30-year-old patient in the Emergency department who reports experiencing intense visual hallucinations while listening to music. How would you characterize this symptom?
Your Answer: Écho de la pensée
Correct Answer: Reflex hallucinations
Explanation:Types of Hallucinations
Reflex hallucinations occur when a stimulus in one sensory modality leads to hallucinations in another sensory modality. Autoscopy is the experience of seeing one’s own body projected into external space, typically in front of oneself. Extracampine hallucinations are those that occur outside of an individual’s sensory fields. Écho de la pensée refers to the experience of hearing voices that repeat one’s thoughts immediately after thinking them. Functional hallucinations occur when an external stimulus triggers hallucinations that are experienced simultaneously and in the same modality as the initial stimulus.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 6
Incorrect
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What is the definition of volitional passivity?
Your Answer: The patient is aware of an alien presence inserting thoughts into his mind
Correct Answer: The patient is aware of someone controlling his actions as though he were a robot
Explanation:All of the options describe passivity phenomena, which are first rank symptoms. Passivity of volition involves feeling like one’s actions are controlled by someone else. Passivity of impulse is experiencing an urge that originates outside oneself. Thought insertion is the awareness of an alien presence inserting thoughts into one’s mind, which may be accompanied by visceral hallucinations. Somatic passivity is the feeling that someone is controlling things inside one’s body. Passivity of affect involves feeling emotions that originate outside oneself, which is different from incongruity of blunting of affect.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 7
Incorrect
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What is an example of the young women's behavior on the ward?
Your Answer: Delusional memory
Correct Answer: Delusional mood/atmosphere
Explanation:Typically, when a delusion arises, the patient feels a sense of relief from the preceding anxiety and tension. The delusional atmosphere is the perception that something is amiss, while the delusional mood refers to the accompanying feelings of anxiety and tension.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 8
Incorrect
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A man observes the image of an elderly man in the patterns of his coffee grounds. What is the term for this perceptual anomaly?
Your Answer: Autoscopic hallucination
Correct Answer: Pareidolic illusion
Explanation:Pareidolic illusions are vivid illusions that can occur from indistinct stimuli, such as seeing a face in the clouds. These illusions are a result of fantasy and vivid visual imagery and can intensify with concentration. Affect illusions arise from a particular mood state and disappear with concentration. Autoscopic hallucinations involve seeing oneself, such as in an out-of-body experience. Charles Bonnet syndrome is a type of hallucination that occurs in elderly people with reduced visual acuity. Complete illusions occur in the context of inattention, where an incomplete stimulus is perceived as complete. For more information, refer to Casey PR and Kelly B’s book, Fish’s Clinical Psychopathology: Signs and Symptoms in Psychiatry.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 9
Incorrect
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What is the accurate information about neurasthenia?
Your Answer: Psychosis is a cardinal feature
Correct Answer: It is still retained as a category in ICD-10 classification
Explanation:In 1869, George Miller Beard introduced the term ‘neurasthenia’ in an article published in the Boston Medical and Surgical Journal. He described anxiety as a key symptom of this condition, which he defined as a lack of nerve force. However, later interpretations of neurasthenia focused more on a state of fatigue and irritability rather than anxiety. While some classification systems have omitted neurasthenia, it remains a commonly used diagnosis in many countries and is still included as a category in ICD-10.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 10
Incorrect
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A 30-year-old male experienced the sudden death of his spouse. Within a week, he arrived at the Emergency department with an inability to speak at a normal volume and could only communicate in hushed tones.
What is the most probable cause of his symptoms?Your Answer:
Correct Answer: Aphonia
Explanation:Speech disturbances can be caused by organic of psychogenic disorders. In this case, the patient is experiencing dissociative aphonia, which is a conversion disorder where psychological stress is converted into physical symptoms. Aphonia is the loss of ability to vocalize, resulting in whispered speech, and can also occur in organic disorders. Dysphonia is a speech impairment characterized by hoarseness but without complete loss of function. Echolalia is the automatic repetition of words of parts of sentences spoken in the presence of the person. Logoclonia is a condition where the patient may get stuck on a particular word, resulting in spasmodic repetition of syllables of words. Stuttering is a speech disorder characterized by involuntary repetitions, prolongations, of blocks in speech flow, resulting in silent pauses of difficulty producing sounds.
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This question is part of the following fields:
- Descriptive Psychopathology
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