FPSC NO : 51 MCQs on SCHIZOPHRENIA Submission DEADLINE :

FPSC NO : 51 MCQs on SCHIZOPHRENIA Submission DEADLINE : 9 APRIL 2013 12 NOON INSTRUCTIONS • To submit answers to the following multiple choice questions, you are required to log on to the College On-line Portal (www.cfps2online.org). • Attempt ALL the following multiple choice questions. • There is only ONE correct answer for each question. • The answers should be submitted to the College of Family Physicians Singapore via the College On-line Portal before the submission deadline stated above. 1. The first psychotic episode of schizophrenia is often preceded by a prodromal phase lasting weeks or even years. which of the following symptoms is NOT consistent with the prodromal phase? (A) Delusions. (B) Sleep disturbance. (C) Poor concentration. (D) Irritability. (E) Anxiety. 2. About the symptoms that may be present in a patient with schizophrenia, which of the following symptoms is LEAST LIKELY to be present? (A) Hallucinations. (B) Delusions. (C) Alogia. (D) Grandiosity. (E) Anhedonia. 3. About the age of onset of schizophrenia in men, which of the following is CORRECT? (A) 10 – 20 years. (B) 15 – 25 years. (C) 20 – 30 years. (D) 25 – 35 years. (E) 30 – 40 years. 4. The genetic vulnerability in schizophrenia arises from a complex combination of multiple genes of small effect. which of the following lifetime risk of schizophrenia is CORRECT? (A) 25% for a child with patients who do not have the disorder. (B) 13% for a child with one parent with schizophrenia. (C) 30% for a child with both parents with schizophrenia. (D) 60% for a child with a monozygotic twin with schizophrenia. (E) The genetic vulnerability is too small to be of predictive value. 5. with regards to the longitudinal course of schizophrenia, what is proportion of patients will have a good outcome? (A) Less than 10%. (B) Less than 20% (C) Less than 30% (D) Less than 40%. (E) Less than 50%. 6. The Global Assessment of Functioning (GAF) score is used to assess the level of functioning. what is the GAF score that defines recovery in schizophrenia? (A) 45 or more. (B) 50 or more. (C) 55 or more. (D) 60 or more. (E) 65 or more. 7. In the Singapore EPIP, patients rated their satisfaction with the service provided by EPIP on the Client Satisfaction Questionnaire 8 (CSQ-8). At the end of 2 years what was the proportion of patients who rated the level of satisfaction as “good or better” (A) 78.9% (B) 84.9% (C) 88.9% (D) 94.9% (E) 98.9% 8. The concept of early intervention for psychosis resulted in several intervention sites being set up across the world. which of the following matching of programme and site is CORRECT? (A) Early Assessment Service for Young People with Early Psychosis Programme – Norway. (B) TIPS – Hong Kong. The Singapore Family phySician Vol39no1Jan-mar 2013:35 MCQS on SCHIZOPHRENIA 15. A proportion of patients with schizophrenia have (D) The Prevention and Early Psychosis Program for Psychosis co-morbid psychiatric or medical conditions. what (C) Lambeth Early Onset (LEO) Service – London. (PEPP) – Calgary. is the prevalence? (E) Early Psychosis Program – Ontario. (A) More than 30% (B) More than 40% (C) More than 50% (D) More than 60% (E) More than 70% 9. The five most disabling conditions suffered by mankind are matched with their ranked order. which of the matching is CORRECT? (A) First – Dementia (B) Second – Quadriplegia (C) Third – Psychosis. (D) Fourth – Paraplegia (E) Fifth – Blindness. 10. Between April 2007 and March 2011, EPIP screened 1293 individuals and accepted 815 into the programme. what is the biggest referral source of such individuals? (A) Counsellor from welfare organization or school. (B) Police or Court. (C) General Practice or Polyclinic. (D) Hospital. (E) Relatives, friends or self. 11. Schizophrenia is a complex, disabling psychiatric disorder. what is its worldwide prevalence rate? (A) 1% (B) 2% (C) 4% (D) 6% (E) 8% 12.Bipolar disorder with psychotic features is a differential diagnosis of schizophrenia. which of the following supports a diagnosis of Bipolar disorder? (A) Rapid onset and family history of affective disorder. (B) Hallucinations. (C) Paranoia. (D) Disorganised speech. (E) Low energy. 16. what does the acronym GPPP stand for in the context of the collaboration between family doctors and the Institute of Mental Health in Singapore? (A) General Practitioner-Patient Project. (B) Generalist-Psychiatrist-Patient Partnership. (C) GP Partnership Programme. (D) General Practitioners’ Psychosis Project. (E) Generalist-Patient Psychosis Programme. 17.The GPPP is a collaboration for the care and management of patients with mental illness in the community. what is the type of patients managed in this collaboration? (A) Socially isolated patients. (B) High risk patients. (C) Unemployed patients. (D) Financially needy patients. (E) Stable patients. 18. About the patients suitable to be referred to family doctors in the GPPP, which of the following inclusion criteria is CORRECT? (A) Patients not hospitalized within the last 6 months. (B) Patients requiring the same maintenance medications for the last 6 weeks. (C) Patients who are unemployed. (D) Patients who cannot afford expensive consultation fees. (E) Patients staying alone. 19. About the patients suitable to be referred to family doctors in the GPPP, which of the following IS NOT an exclusion criteria? (A) Olanzapine prescription. (B) Disruptive personality disorder. (C) Substance use. (D) Formal psychotherapy. (E) Benzodiazepine-only prescription. 20. About the satisfaction with the GPPP collaboration, what is the level of patient satisfaction in the 2011 survey? (A) 58.1% (B) 62,1% (C) 78.6% (D) 82.1% (E) 98.6% 13. Mental changes can medications. which of the medications and the mental changes is CORRECTLY paired? (A) Corticosteroids and depression. (B) Antidepressants and insomnia. (C) Beta-blockers and mania. (D) Anticholinergics and somnolence. (E) Levodopa and hallucinations. 14. A schizoid personality disorder shares a common clinical feature with schizophrenia. what is it? (A) Anhedonia. (B) Asociality. (C) Alogia. (D) Avolition. (E) Delusional. occur with prescribed heterogeneous, and The Singapore Family phySician Vol39no1Jan-mar 2013:36 21. One of the problems of schizophrenia is the high rate of relapse of psychotic symptoms. what is the proportion of patients who may relapse within a year of being hospitalized? (A) Up to 20%. (B) Up to 25%. (C) Up to 30%. (D) Up to 35%. (E) Up to 40%. 22. Treatment resistant schizophrenia is defined as little or no symptomatic response to at least 2 antipsychotic trials of treatment at therapeutic dose range and adequate trial of treatment duration. What is defined as adequate treatment duration? (A) At least 4 weeks. (B) At least 6 weeks. (C) At least 8 weeks. (D) At least 10 weeks. (E) At least 12 weeks. 23. In a patient with proven treatment resistant schizophrenia, what is the drug of choice? (A) Aripiprazole. (B) Haloperidol. (C) Olanzapine. (D) Respiridone. (E) Clozapine. 24. Early recognition of an impending relapse helps in early treatment and avoidance of hospitalization. which of the following is an early symptom? (A) Hallucinations. (B) Delusions. (C) Difficulty concentrating. (D) Asociality. (E) Anhedonia. 25.About relapse in schizophrenia, identification of triggers is important. which of the following is the LEAST LIKELY trigger? (A) Cocaine use. (B) Alcohol use. (C) Cannabis use. (D) Low expressed emotion of caregivers. (E) Alcohol usage. 26. Antipsychotics used in treatment of schizophrenia are heterogeneous compounds. They nevertheless share a common effect that is efficacious. What is that? (A) They all block 5-HT2A neuroreceptors (B) They all block D2 dopamine neuroreceptors. (C) They all block M1 muscarinic neuroreceptors. (D) They all block alpha1-adrenergic neuroreceptors. (E) They all block H1 histamine neuroreceptors. typical antipsychotics or First generation extrapyramidal symptom of MCQS on SCHIZOPHRENIA 27. The antipsychotics are divided by potency into high, intermediate and low. which of the following has low potency? (A) Thioridazine. (B) Haloperidol. (C) Perphenazine. (D) Trifluoperazine. (E) Fluphenazine. 28. In a patient with osteoporosis, an antipsychotic that does not raise prolactin levels is desired. which of the following antipsychotic will therefore be a good choice? (A) Thiothixene. (B) Aripiprazole. (C) Respiridone. (D) Chlopromazine. (E) Thioridazine. 29. A patient with schizophrenia has a BMI of 29. which of the following antipsychotics will be a good choice? (A) Haloperidol. (B) Quetiapine. (C) Olanzapine. (D) Zoprasidone. (E) Clozapine. 30. Akathisia is an antipsychotic therapy. Apart from dose reduction, which of the following medications helps to ameliorate this adverse effect? (A) Benzodiazepine. (B) Vitamin D. (C) Propranolol. (D) Baclofen. (E) Dandrolene. The Singapore Family phySician Vol39no1Jan-mar 2013:37

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