New MRCPsych Paper II Mock MCQ Papers
New MRCPsych Paper II Mock MCQ Papers
New MRCPsych Paper II Mock MCQ Papers
VELLINGIRI BADRAKALIMUTHU
MBBS, MRCPsych
Specialty Registrar in Old Age Psychiatry
PBL Tutor for CT1 and CT2 Psychiatry Trainees
Norfolk and Waveney Mental Health Foundation NHS Trust
Julian Hospital, Norwich
Foreword by
HUGO de WAAL
MD, FRCPsych
Lead Clinician for North Norfolk
Head of School, Postgraduate School of Psychiatry,
East of England Deanery
College Tutor, Norfolk and Waveney Psychiatric Training Scheme
Fellow, Higher Education Academy
CRC Press
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Foreword vi
Preface viii
About the author xi
About the references xii
Paper 1 1
Paper 2 47
Paper 3 93
Paper 4 137
Paper 5 183
Answers 227
Paper 1 227
Paper 2 228
Paper 3 229
Paper 4 230
Paper 5 231
Index 233
Foreword
There aren’t many books with a preface which contains an allusion to
E=MC2 and immediately go on to encourage a symbiotic relationship
with a mould-forming kitchen sink (no matter how readily recognis-
able the latter is to anyone who ever studied relativity at University, or
indeed anyone who ever revised for an exam). In fact, I would opine
there is only the one. It could be understood as symptomatic for the
breadth of Dr Badrakalimuthu’s second MRCPsych preparation work.
Once again tried and tested on the trainees in Norwich resulting in a
pass percentage that continues to be higher than the national average,
emphasising the completeness and thoroughness of the work.
This somewhat encyclopaedic feature immediately reminds one
of the life and times of the legendary Oliver Goldsmith, who posthu-
mously provided the motto to this book. Born in 1728 in Roscommon,
Ireland, Mr Goldsmith’s academic career started at the age of 16 at
Trinity College, Dublin. After graduation (it is not quite clear in what
topic of study) he became a tutor, but he was sacked after a quarrel.
He tried to emigrate to America, but missed his ship: not as easily
done as missing one’s flight from Heathrow. His next project, study-
ing law, was unwillingly shortened by gambling away the funds that
were meant to sustain him. Sometime later he shows up on a walking
tour through Flanders, having previously apparently studied medicine
in Edinburgh and possibly Leiden (Holland). He wound his way on
the roads as he did in academia, and meandered into Italy via France
and Switzerland, earning his keep by playing the flute. Returning to
London he blossomed into an author, playwright and poet and finally
reached a position of fame.
One of his earliest works was entitled Enquiry into the Present State
of Polite Learning (1759), in which he wrote:
Does the poet paint the absurdities of the vulgar, then he is low; does he
vi
FOREWORD
This brings us neatly to that lofty institution, which sets the curric-
ulum and exam questions you are assumed to be preparing for: you
may at times view those questions absurd to a degree, deemed lam-
entably absent by Goldsmith in ‘high life’. If so, it might be useful to
remind yourself that throughout your professional career the absurd-
ities of the vulgar are never thus: no matter what ‘station’ our patients
inhabit, the vulgar are never vulgar, their problems never absurd
and fools are few and far between. It could therefore be argued that,
whilst revising for the exam, your necessary obsession with the absurd
constitutes somewhat of a professional desensitisation: once you are
versant in the questions and answers contained in the Royal College’s
membership examinations, there won’t be much on the face of this
earth that would strike you as extraordinary, save perhaps your own
experience of having passed them.
A final remark: Goldsmith’s literary fame brought him wealth and
reputation, but his carelessness, intemperance and gambling habit
brought him down and he died penniless, broken in health and mind,
in 1774. Perhaps he would have benefited from familiarity with those
professional competencies in our College’s curriculum, which tran-
scend knowledge, are not easily tested in exams, but will prove vital
in you successfully meandering through your professional career,
whether you play the flute or not.
vii
Preface
Having taken the first step towards successfully passing Paper II, your
focus should be on finding answers to the most complex and difficult
questions that you might expect in its exam. This book provides you
with that and more, but first I would like to answer (for a change)
some of the questions that trainees have often asked me.
viii
PREFACE
● epidemiology
● neuroscience
● psychopharmacology
ix
PREFACE
Vellingiri Badrakalimuthu
August 2009
x
About the author
Having completed the MBBS at Coimbatore Medical College, India,
in 2002, Vellingiri trained in psychiatry at the Institute of Mental
Health, Chennai, India. His first appointment in the UK was at the
Maudsley Hospital, after which he took up a post as Senior House
Officer on the Solent Rotation. He became a Member of the Royal
College of Psychiatrists in 2007.
He has research publications to his credit and has been commis-
sioned by Advances in Psychiatric Treatment and RCPsych-CPD
Online for various projects. He has been shortlisted for the Advance
Trainee of the Year Award (2009) by the Royal College of Psychiatrists.
He is currently a registrar in Old Age Psychiatry and PBL tutor for
CT1 and CT2 trainees. He is also studying for a Masters degree in
Neuroscience at the Institute of Psychiatry, London.
xi
About the references
JOURNALS
Advances in Psychiatric Treatment (2006, 2007, 2008 and 2009) (APT)
British Journal of Psychiatry (2006, 2007 and 2008) (BJP)
BOOKS
Hodges JR. Cognitive Assessment for Clinicians. Oxford: Oxford
University Press; 2007. (CA)
Longstaff A. Instant Notes in Neuroscience (BIOS Instant Notes).
Abingdon: Taylor & Francis; 2005. (N)
McGuffin P, Owen M, Gottesman I. Psychiatric Genetics and Genomics.
Oxford: Oxford University Press; 2004. (PG)
Morgan G, Butler S. Seminars in Basic Neurosciences. 1993; www.
rcpsych.ac.uk/pdf/semBasNeuro_prelims.pdf (SBN)
Patestas M, Gartner LP. A Textbook of Neuroanatomy. Oxford: Wiley-
Blackwell; 2006. (TN)
Sadock B, Kaplan H, Sadock V. Synopsis of Psychiatry. Behavioural
Sciences/Clinical Psychiatry (10 e). Philadelphia, PA: Lippincott
Williams & Wilkins; 2007. (KS)
Scott AIF. The ECT Handbook (2e): The Third Report of the Royal College
of Psychiatrists’ Special Committee on ECT. London: Royal College
of Psychiatrists; 2004. (ECT)
WEBSITES
www.nice.org.uk
www.rcpsych.ac.uk
xii
To Hugo and Daphne
1
NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 1
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PAPER 1
5
NEW MRCPsych PAPER II MOCK MCQ PAPERS
13. The Zurich criteria for hypomania include all of the following
except:
a. The absence of a past history of mania
b. At least 3 of the 7 symptoms of hypomania according to
DSM-IV
c. Euphoria, irritability or over-activity
d. Experience of negative consequences of hypomanic periods
e. Hypomanic symptoms with a duration of at least 1 day (APT
2006)
6
PAPER 1
7
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8
PAPER 1
9
NEW MRCPsych PAPER II MOCK MCQ PAPERS
10
PAPER 1
27. All of the following statements about steroids and mental illness
are true except:
a. Depression is associated with withdrawing from steroids
b. During steroid use, people score lower on schizoid
personality traits
c. The risk of developing psychotic symptoms may be related
to high-dose testosterone
d. Self-reported aggression may be the only sign of steroid
misuse
e. Steroid users have been shown to have a higher prevalence
of cluster B personality traits (APT 2006)
11
NEW MRCPsych PAPER II MOCK MCQ PAPERS
29. All of the following are NICE recommendations for the use of
antidepressants in bipolar disorder except:
a. Anyone under the age of 30 years should be reviewed within
1 week for suicidal ideation
b. If the patient does not respond to three adequate trials of
antidepressants, you should consider referral to a clinician
with special interest
c. Lamotrigine can be used routinely to treat depressive
episodes in bipolar type 1 disorder
d. Venlafaxine is less associated with discontinuation symptoms
than are SSRIs
e. When the symptoms have been less severe for at least
8 weeks, the discontinuing of antidepressants should be
considered (www.nice.org.uk)
12
PAPER 1
13
NEW MRCPsych PAPER II MOCK MCQ PAPERS
34. The cranial nerve that arises between pyramids and olives is:
a. VIII
b. IX
c. X
d. XI
e. XII (TN)
37. All of the following are correct with regard to the composition of
cerebrospinal fluid except:
a. Calcium concentration is 1.0–1.4 mmol/L
b. Magnesium concentration is 0.8–1.3 mmol/L
c. pH is 7.3
d. Potassium concentration is 2.0–2.8 mmol/L
e. Protein – almost none (TN)
14
PAPER 1
38. All of the following statements about the corticospinal tract are
true except:
a. Fibres terminating in the ventral motor horn of the spinal
cord are involved in muscle contraction
b. Fibres that do not decussate form the anterior corticospinal
tract
c. It passes through the posterior limb of the internal capsule
near its genu
d. It passes through the posterior half of the posterior limb of
the internal capsule
e. It passes through the upper third of the crux cerebri (TN)
15
NEW MRCPsych PAPER II MOCK MCQ PAPERS
43. Which of the following is the only cranial nerve to send central
processes of some of its first-order neurons to synapse directly in
the cerebellum?
a. III
b. V
c. VII
d. VIII
e. XI (TN)
44. The carotid sinus reflex would be lost in a lesion involving which
of the following?
a. The inferior ganglion of glossopharyngeal nerve
b. The jugular ganglion of vagus nerve
c. The otic ganglion of glossopharyngeal nerve
d. The superior ganglion of glossopharyngeal nerve
e. The superior ganglion of vagus nerve (TN)
16
PAPER 1
46. In which of the following are the cell bodies of rods and cones
present?
a. Ganglion cell layer
b. Inner nuclear layer
c. Outer nuclear layer
d. Optic nerve fibre layer
e. Rod and cone layer (TN)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
49. All of the following statements about the cortex are true except:
a. Broca’s area consists of supramarginal gyrus
b. The dorsolateral prefrontal cortex functions in working
memory
c. The secondary auditory cortical areas are connected with
Wernicke’s area
d. The somaesthetic association area is located in the superior
parietal lobule
e. Tertiary visual areas include the middle temporal area of the
cortex (TN)
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PAPER 1
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PAPER 1
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61. All of the following statements about Balint’s syndrome are true
except:
a. It involves a lesion of angular gyrus
b. There is an inability to reach for visual targets
c. There is an inability to point at visual targets
d. Simultagnosia is a feature
e. Symptoms include an inability to direct voluntary eye
movements to visual targets (CA)
22
PAPER 1
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PAPER 1
69. All of the following statements about cranial tumours are true
except:
a. Anterior falx meningiomas may present with the frontal lobe
syndrome
b. Limbic encephalitis can be a non-metastatic complication of
systemic malignant disease
c. Malignant tumours are more common in the anterior
pituitary than in the posterior pituitary
d. Meningiomas commonly originate from the arachnoid cells
of leptomeninges
e. Metastases are usually from carcinomas of the lung (SBN)
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PAPER 1
27
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78. All of the following statements about the genetics of autism are
true except:
a. The candidate gene for autism is the 5HT transporter gene
b. The concordance rate among MZ twins has ranged from
36% to 90%
c. A LOD score of 2.53 is reported in a region on chromosome
7q
d. The relative increased risk to siblings of those with classic
autism is between 10 and 20
e. Tuberous sclerosis occurs in less than 5% of those with
autism (PG)
28
PAPER 1
29
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PAPER 1
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PAPER 1
94. Which of the following genes has been implicated in learning and
memory in the disease model of schizophrenia?
a. COMT
b. DISC1
c. Dysbindin
d. Neuregulin
e. PRODH (BJP 2006)
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PAPER 1
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102. All of the following statements about panic disorder are true
except:
a. In acute-phase treatment, combined treatment is superior to
antidepressant treatment
b. Beyond its acute phase, combined treatment is superior to
antidepressant treatment
c. Beyond its acute phase, combined treatment is superior to
psychotherapy
d. The evidence for cognitive–behavioural therapy is most
conclusive
e. Pharmacotherapy is associated with significant relapse rates
even when patients are maintained on adequate doses of
antidepressants (BJP 2006)
36
PAPER 1
104. All of the following statements about fMRI are true except:
a. fMRI shows that the neural circuit for lexical categories
involves the left anterior temporal lobe
b. fMRI shows that the area activated upon listening to speech
is also activated during auditory hallucinations in people
with schizophrenia
c. fMRI shows that patients with dyslexia show a failure to
activate Wernicke’s area
d. It gives specific information about neuronal metabolism
e. It works on the principle of detecting the levels of
oxygenation in blood (KS)
105. All of the following statements about adult ADHD are true
except:
a. About 65% of those with ADHD fulfil the criteria for partial
remission at the age of 25 years
b. ADHD symptoms are continuously distributed throughout
the population
c. ADHD symptoms show an age-dependent decline
d. Adults with ADHD respond to stimulants
e. Longitudinal studies show that ADHD and antisocial
behaviour start simultaneously (BJP 2007)
106. All of the following statements about the treatment and outcomes
of eating disorders among adolescents are true except:
a. High expressed emotion is associated with poor outcomes
b. Inpatient treatment predicts poor outcomes
c. Only about 50% of adolescents adhere to inpatient
treatment
d. There is RCT evidence for family treatment for anorexia in
adolescents
e. Those receiving lengthy inpatient treatment that results in
their regaining normal weight continue to maintain their
weight at 1-year follow-up (BJP 2007)
37
NEW MRCPsych PAPER II MOCK MCQ PAPERS
107. All of the following statements about depression and MI are true
except:
a. An ENRICHD study showed that the improvement in
depression observed at 6 months following CBT was
sustained at 30 months
b. Post-MI depression is associated with a 2- to 2.5-fold
increase in mortality
c. Sertraline is a safe drug to use in post-MI patients
d. The somatic symptoms of depression are associated with a
poor prognosis in post-MI patients
e. CBT has no effect on the risk of all-cause mortality in MI
patients with depression (BJP 2007)
108. Which of the following is an agent that binds to the same recep-
tor as an agonist for that receptor, but produces the opposite
pharmacological effect?
a. Antagonist
b. Full agonist
c. Inverse agonist
d. Mixed agonist
e. Partial agonist (KS)
38
PAPER 1
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
114. All of the following statements about vagus stimulation are true
except:
a. The acute response to vagus stimulation in resistant
depression is notably low
b. It has been found to be effective in the treatment of resistant
epilepsy
c. The leads from the device are connected to the thoracic
vagus
d. The procedure involves the subcutaneous implantation of a
pacemaker-like device
e. Vocal cord palsy has been reported to be an adverse effect of
the procedure (BJP 2006)
40
PAPER 1
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118. All of the following are good prognostic factors for brief psychotic
disorder except:
a. Affective symptoms
b. Confusion during onset
c. Insidious onset
d. Little affective blunting
e. Severe precipitating stressor (KS)
42
PAPER 1
122. Beliefs about oneself, the world and the future are referred to as:
a. Cognitive distortion
b. The cognitive triad
c. Learned helplessness
d. Schema
e. Psychodynamic hierarchies (KS)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
123. The forming of conclusions based on too little and too narrow
experience is referred to as:
a. Arbitrary inference
b. Magnification and minimisation
c. Oversimplification
d. Personalisation
e. Specific abstraction (KS)
125. All of the following statements about the course of major depress-
ive disorder are true except:
a. Around 5–10% of patients with an initial diagnosis of
depression develop a manic episode 6 to 10 years after initial
diagnosis
b. Late onset is associated with antisocial personality disorder
c. A major depressive disorder is usually preceded by a
premorbid personality disorder
d. Over a 20-year period the mean number of episodes is
between five and six
e. Untreated episodes last for about 6 to 13 months (KS)
44
PAPER 1
127. For which of the following is the use of projection and splitting
as defence mechanisms specifically unsuitable?
a. Brief focal psychotherapy
b. Psychoanalytic psychotherapy
c. Short-term anxiety-provoking psychotherapy
d. Short-term dynamic psychotherapy
e. Time-limited psychotherapy (KS)
45
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2
Paper 2
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
6. With regard to the assessment tools for use with patients with
cannabis misuse and psychosis, which of the following statements
is true?
a. The Addiction Severity Index does not include psychiatric
problems
b. Patients with schizotypal personality disorder report fewer
unpleasant after-effects on the Cannabis Experiences
Questionnaire
c. The Psychiatric Research Interview for Substance and
Mental Disorders takes less time to complete than scheduled
interviews
d. The Stages of Change Readiness and Treatment Eagerness
Scale is a 15-item self-report measure
e. The Substance Use Scale for Psychosis can be used to
explore patients’ reasons for using drugs (APT 2008)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
11. Which of the following statements about the genetic and develop-
mental aspects of schizophrenia is true?
a. Clinical symptoms in first-degree relatives of patients with
schizophrenia are restricted to positive ones
b. Most people with schizophrenia have an onset in late
adolescence or adulthood
c. Older children without thought disorders tend to score
higher on thought-disorder indices than younger children
d. Schizotaxia is apparent in 10% of first-degree relatives of
people with schizophrenia
e. An underlying vulnerability to disorders in the schizophrenia
spectrum begins to manifest with positive symptoms
(APT 2007)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
13. The client factors that are suitable for long-term psychodynamic
psychotherapy include all of the following except:
a. Treatment-resistant psychosis
b. The presence of previous severe disruption to personality
development
c. The presence of a lack of consistent problem focus
d. The presence of unhelpful team reactions that have become
obstacles to offering care
e. Willingness to take responsibility for addressing problems
(APT 2008)
52
PAPER 2
17. The risk factors for suicide among patients with multiple sclerosis
include all of the following except:
a. Female gender
b. Past history of depression
c. Social isolation
d. Substance misuse
e. Young age of onset (APT 2006)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
22. All of the following statements about the treatment of PTSD are
true except:
a. According to NICE, paroxetine is a second-line treatment
for PTSD
b. Augmentation with olanzapine can be considered for
treatment-resistant PTSD
c. Mirtazapine in the treatment of PTSD is associated with
weight loss
d. NICE guidelines recommend that treatment should be
considered for at least 1 year
e. Sertraline is indicated for the treatment of PTSD (APT
2007)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
27. Mrs Taylor presents with dizziness, double vision and difficulty
in communication. The diagnosis is:
a. Acoustic neuroma
b. Benign paroxysmal positional vertigo
c. Labyrinthitis
d. Meniere’s disease
e. Vertebrobasilar insufficiency (TN)
28. All of the following statements about treatment with ECT are
true except:
a. Adverse psychological reactions are rare
b. It produces deficits in autobiographical and impersonal
memory
c. The extent of retrograde amnesia is not significantly
correlated with the degree of therapeutic improvement
d. Midazolam is contraindicated for patients who are agitated
in the recovery phase from ECT
e. Its mortality risk is 1 per 10 000 patients (ECT)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
30. All of the following statements about ECT procedure are correct
except:
a. The extent of eventual improvement is associated with the
improvement seen during the first few treatments
b. In bilateral ECT, the initial treatment dose should be at least
100% more than that of the seizure threshold
c. In unilateral ECT, the initial treatment dose should be at
least 200% more than that of the seizure threshold
d. The optimal technique for using unilateral ECT for mania
has not been established
e. The initial dose for male patients receiving unilateral ECT is
10% (ECT)
31. The tests of attention and concentration include all of the follow-
ing except:
a. The components of the Test of Everyday Attention
b. The Corsi block-tapping span
c. The Paused Auditory Serial Addition Test
d. The reverse-digit span
e. A timed test involving star cancellation (CA)
58
PAPER 2
34. All of the following statements about the brain’s blood supply are
true except:
a. All of the arteries that supply the brain are paired except for
the basilar artery
b. The carotid artery is flanked by the oculomotor and optic
nerves
c. The brain receives 750 mL of blood per minute
d. The brain’s large vessels are thin-walled
e. A loss of blood supply for 10 to 15 seconds results in loss of
consciousness (TN)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
38. All of the following statements about efferent fibres from the
striatum are true except:
a. Fibres originate from the caudate nucleus
b. The striatonigral pathway uses substance P
c. The striatonigral fibres use acetylcholine
d. The striatopallidal fibres to the external segment use
enkephalin
e. The striatopallidal fibres use glutamate as a neurotransmitter
(TN)
40. All of the following matches with regard to the neurons in the
basal ganglia are true except:
a. Intrastriatal interneurons – acetylcholinergic neurons that
are inhibited by dopaminergic neurons
b. Neuropeptide-releasing neurons – release GABA and
enkephalin from the same neuron
c. Pars compacta – neurons releasing dopamine have an
excitatory effect on the GABA-ergic neurons that project to
the lateral segment of the globus pallidus
d. Striatum – principally composed of GABA-releasing neurons
e. Subthalamic nucleus – gives rise to glutamate-releasing
neurons (TN)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
45. All of the following statements about auditory pathways are true
except:
a. First-order neurons are bipolar
b. Fibres from the posteroventral cochlear nucleus terminate in
the ventral nucleus of the lateral lemniscus
c. Hair-receptor cells stimulate the peripheral process of first-
order neurons
d. Inferior olivary nuclei are involved in processing sound
frequency
e. The sound attenuation reflex involves the motor nucleus of
the trigeminal nerve (TN)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
47. All of the following statements about nystagmus are true except:
a. Extensive damage at the pontomedullary junction causes
rotator nystagmus
b. Horizontal nystagmus is normal
c. The normal duration of post-rotatory nystagmus during a
rotation test is half a minute
d. Spontaneous nystagmus indicates a lesion affecting the
vestibular nuclei
e. Vertical nystagmus results from damage to the inferior
vestibular nucleus (TN)
64
PAPER 2
52. All of the following statements about the middle cerebral artery
are true except:
a. An infarction of its more posterior branches is associated
with visual agnosias
b. It supplies both Broca’s and Wernicke’s areas
c. It does not supply a narrow territory close to the sagittal
fissure
d. It supplies the medial surface of the brain
e. It forms part of the circle of Willis (SBN)
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NEW MRCPsych PAPER II MOCK MCQ PAPERS
66
PAPER 2
58. Mr Bainbridge presents with a head injury, and you want to detect
and measure the severity of visual neglect involved. Which of the
following is the recommended test?
a. The Behavioural Assessment of the Dysexecutive Syndrome
b. The Behavioural Inattention Test
c. The Delis–Kaplan Executive Function Syndrome
d. The National Adult Reading Test
e. Raven’s Progressive Matrices (CA)
67
NEW MRCPsych PAPER II MOCK MCQ PAPERS
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PAPER 2
64. All of the following statements about neural-tube defects are true
except:
a. Fetal ultrasound and amniotic fluid assay can identify 90% of
defects in vivo
b. Closure of the neural tube occurs within 18 to 26 days after
the formation of the zygote
c. In anencephaly, cerebral hemispheres fail to develop with
exposure to diencephalon
d. Minor neural-tube defects are present in less than 1% of the
population without neurological deficits
e. The recurrence rate for spina bifida in a second baby is 1 in
20 (SBN)
69
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PAPER 2
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PAPER 2
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PAPER 2
75
NEW MRCPsych PAPER II MOCK MCQ PAPERS
76
PAPER 2
77
NEW MRCPsych PAPER II MOCK MCQ PAPERS
78
PAPER 2
79
NEW MRCPsych PAPER II MOCK MCQ PAPERS
80
PAPER 2
101. All of the following statements about CBT are true except:
a. A 12-week comprehensive treatment programme consisting
of CBT, body awareness therapy and graded exercise is more
effective than antidepressant therapy in chronic fatigue
syndrome
b. According to the Nottingham Study of Neurotic Disorder,
cognitive therapy and self-help were more effective for
depressed people with comorbid personality disorder than
for people without personality disorder
c. CBT with a problem-solving component has a positive effect
on self-harm
d. People with a personality disorder who respond to cognitive
therapy show sustained responses
e. Schema-focused therapy has been found to reduce self-harm
in patients with borderline personality disorder (BJP 2008)
81
NEW MRCPsych PAPER II MOCK MCQ PAPERS
82
PAPER 2
83
NEW MRCPsych PAPER II MOCK MCQ PAPERS
84
PAPER 2
85
NEW MRCPsych PAPER II MOCK MCQ PAPERS
114. All of the following are risk factors for self-reported psychotic
symptoms among the general population except:
a. Harmful pattern of drinking
b. Living in an urban area
c. More adverse life events
d. Having a small primary support group
e. Smoking tobacco (BJP 2006)
115. All of the following statements about the risk factors for psychi-
atric illnesses among women from low-income countries are true
except:
a. Being married
b. Living in a relatively large household
c. Poverty
d. Reporting chronic physical illnesses
e. Use of tobacco (BJP 2006)
116. The risk factors for severe postpartum psychosis include all of the
following except:
a. Caesarean section
b. Delivery complications
c. Delivering a female baby
d. Multiparity
e. Having a relatively shorter gestation period (BJP 2006)
86
PAPER 2
87
NEW MRCPsych PAPER II MOCK MCQ PAPERS
88
PAPER 2
125. All of the following are the patient variables most suited for inter-
personal therapy except:
a. A focused dispute with a partner or significant other
b. A modest to moderate need for direction and guidance
c. Pragmatic thinking
d. Responsiveness to environmental manipulation
e. Social or communication problems (KS)
89
NEW MRCPsych PAPER II MOCK MCQ PAPERS
128. Which of the following is the process during which the group
leader formulates the meaning or significance of a patient’s resist-
ance?
a. Acceptance
b. Consensual validation
c. Identification
d. Interpretation
e. Reality testing (KS)
90
PAPER 2
91
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Paper 3
93
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94
PAPER 3
95
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96
PAPER 3
11. All of the following are tasks that could be used to measure every-
day memory functioning in patients receiving ECT except:
a. The Autobiographical Memory Index
b. The Everyday Memory Interview
c. The nine-point mood rating scale
d. The landmark location task
e. The virtual map task (APT 2007)
97
NEW MRCPsych PAPER II MOCK MCQ PAPERS
13. MRI evidence suggests that patients with multiple sclerosis who
exhibit mania with psychotic symptoms have plaques in:
a. The dorso-lateral frontal cortex
b. The non-dominant parietal lobe
c. The orbitofrontal cortex
d. The pre-frontal cortex
e. The temporal horn (APT 2006)
14. All of the following drugs have been used for the treatment of
pathological laughing and crying in multiple sclerosis except:
a. Amantadine
b. Amitryptyline
c. Carbamazepine
d. Fluoxetine
e. Levodopa (APT 2006)
15. The drug for which there is evidence with regard to treating cog-
nitive impairment in multiple sclerosis is:
a. Donepezil
b. Galantamine
c. Memantine
d. Rivastigmine
e. None of the above (APT 2006)
98
PAPER 3
18. All of the following statements about PTSD are correct except:
a. A genetic factor has been shown to account for 34% of cases
of PTSD
b. High levels of neuropeptide Y have been found in combat
veterans with PTSD
c. Increased levels of corticotrophin-releasing hormone are
found in the CSF of patients with PTSD
d. Numbing is strongly associated with chronicity
e. The prevalence of PTSD among people directly affected by
terrorism is between 12% and 16% (APT 2007)
99
NEW MRCPsych PAPER II MOCK MCQ PAPERS
100
PAPER 3
101
NEW MRCPsych PAPER II MOCK MCQ PAPERS
23. All of the following statements about the management of falls are
true except:
a. According to the Cochrane Review, multifactor risk
assessment is one of the effective factors for the management
of falls
b. Cardiogenic syncope is more likely to be fatal than
neurogenic syncope
c. Fludrocortisone is used as an option in the management of
postural hypotension when non-pharmacological measures
fail
d. One of the aims of the NSF is to provide advice on
prevention through a specialised falls service
e. There is robust evidence supporting the use of hip
protectors to prevent fractures in community populations
(www.psychiatrycpd.co.uk)
25. All of the following matches with regard to ECT and age are cor-
rect except:
a. Adult – posterior beta
b. Adult – anterior alpha
c. Infant – low amplitude
d. Old age – decrease in delta
e. 2–6 years – mature rhythms (SBN)
102
PAPER 3
28. Which of the following does the neural basis of phonology in-
volve?
a. The anterior temporal lobe
b. Broca’s area
c. The inferior temporal lobe
d. The left anterior hemisphere
e. The left superior temporal lobe (CA)
103
NEW MRCPsych PAPER II MOCK MCQ PAPERS
104
PAPER 3
36. Which of the following receptors sends nerve fibres through the
anterolateral system?
a. Free nerve endings
b. Merkel’s tactile discs
c. Meissner’s corpuscles
d. Pacinian corpuscles
e. Peritrichial nerve endings (TN)
105
NEW MRCPsych PAPER II MOCK MCQ PAPERS
41. All of the following statements about the lobes of the cerebellum
are true except:
a. The anterior lobe is the spinocerebellum
b. The flocculonodular lobe consists of the pontocerebellum
c. The posterior lobe is also known as the neocerebellum
d. The posterior lobe is involved with non-stereotype skilled
movement
e. The vermis is part of the anterior lobe (TN)
106
PAPER 3
42. The efferent fibres that pass through the superior cerebellar ped-
uncle include all of the following except:
a. The cerebelloreticular fibres
b. The dentatorubrothalamic pathway
c. The fastigiothalamic tract
d. The fastigiovestibular tract
e. The interpositorubrothalamic pathway (TN)
44. All of the following statements about the limbic system are true
except:
a. The dentate gyrus is part of the archicortex
b. The hippocampus forms a prominence on the lateral wall of
the inferior horn of the lateral ventricle
c. The output target of the hippocampus includes the
mammillary body
d. The subcallosal gyri form a part of it
e. The polymorphic layer of the hippocampus consists of
interneurons (TN)
107
NEW MRCPsych PAPER II MOCK MCQ PAPERS
46. The production of oxytocin and ADH is under the control of:
a. The preoptic nucleus
b. The medial preoptic nucleus
c. The lateral preoptic nucleus
d. The suprachiasmatic nucleus
e. The supraoptic nucleus (TN)
108
PAPER 3
109
NEW MRCPsych PAPER II MOCK MCQ PAPERS
110
PAPER 3
111
NEW MRCPsych PAPER II MOCK MCQ PAPERS
112
PAPER 3
63. All of the following are tests of the frontal lobe except:
a. The Benton Verbal Fluency Test
b. The Benton Visual Retention Test
c. The Halstead Category Test
d. The Trail Making Test
e. The Wisconsin Card Sorting Test (SBN)
113
NEW MRCPsych PAPER II MOCK MCQ PAPERS
64. Which of the following is a specific test for spatial dyslexia and
dyscalculia?
a. The arithmetic scale of the Luria–Nebraska Battery
b. The Rey Complex Figure
c. The Left–Right Disorientation Test
d. The Speech Sound Perception Test
e. The Trail Making Test (SBN)
65. All of the following statements about head injuries are true
except:
a. The Galveston Orientation and Memory Test is a specific
test of post-traumatic amnesia
b. Neuropsychological assessment has a sensitivity of 90–95%
c. The prognostic value of post-traumatic amnesia is most
closely seen in closed and blunt head injuries
d. Retrograde amnesia is a reliable index of the severity of brain
damage but not of its prognosis
e. Retrograde amnesia results from lacerations to the frontal
and temporal regions (SBN)
114
PAPER 3
115
NEW MRCPsych PAPER II MOCK MCQ PAPERS
116
PAPER 3
76. All of the following statements about evoked potentials are true
except:
a. As measured by auditory evoked potentials, cochlear but not
brainstem lesions alter early waves
b. In multiple sclerosis there is a delay in onset of P100
c. In myoclonic epilepsy there is a low-amplitude evoked action
potential
d. Leukodystrophies produce delayed evoked potentials
e. The pathological nature of somatosensory evoked potential
seen in multiple sclerosis is due to degeneration of axon
from the first-order neuron (SBN)
117
NEW MRCPsych PAPER II MOCK MCQ PAPERS
78. Linkage studies have implicated all of the following loci in schizo-
phrenia except:
a. 1q21-q22
b. 6p24-22
c. 6q
d. 8p22-21
e. 21q11 (PG)
118
PAPER 3
81. All of the following statements about alcohol misuse are true
except:
a. The A1 allele of Taq1 polymorphism close to the DRD2
gene is associated with alcohol dependence
b. The ALDH2 responsible for acetaldehyde oxidation maps to
chromosome 12q24.2
c. At intoxicating levels, ADH4 may account for up to 40% of
ethanol oxidation
d. Cytochrome P450IIEI is inhibited by ethanol consumption
e. The GABAAβ2 gene on chromosome 2 has been implicated
in alcohol dependence (PG)
119
NEW MRCPsych PAPER II MOCK MCQ PAPERS
82. The following genes have been implicated in the opiate response
in mouse models. All of them have been correctly matched except
for:
a. DAT – increased reward response
b. GluR-A – reduced tolerance
c. Mu opioid – physical dependence
d. Nociceptin receptor – loss of tolerance
e. SubP – increase in withdrawal (PG)
84. Which of the following is a drug that shows agonist activity at the
μ-receptor and antagonist activity at the κ-receptor?
a. Buprenorphine
b. Nalorphine
c. Naltrexone
d. Naloxone
e. Pentazocine (N)
85. Which of the following is a drug that shows agonist activity at the
δ- and κ-receptors and antagonistic activity at the μ-receptor?
a. Buprenorphine
b. Nalorphine
c. Naltrexone
d. Naloxone
e. Pentazocine (N)
120
PAPER 3
121
NEW MRCPsych PAPER II MOCK MCQ PAPERS
92. The most common genotype associated with type III hyperlipi-
daemia is:
a. ApoE1
b. ApoE2
c. ApoE3
d. ApoE4
e. ApoE5 (PG)
122
PAPER 3
94. All of the following statements about the course of affective dis-
order are true except:
a. Agoraphobia without panic disorder lacks evidence for
influencing course
b. Anxiety disorders present during relative euthymia predict a
worse prognosis
c. Current comorbid anxiety disorder is associated with a risk
of earlier relapse
d. A longer time period since the resolution of a previous
episode predicts subsyndromal symptoms in recurrent
unipolar depression
e. Social anxiety disorder is associated with poor outcomes of
bipolar disorder (BJP 2006)
123
NEW MRCPsych PAPER II MOCK MCQ PAPERS
97. All of the following statements about debriefing are true except:
a. Debriefing in people with high baseline levels of arousal
increases their likelihood of developing PTSD
b. Emotional ventilation debriefing is safer than educational
debriefing
c. Psychoeducation provided as part of debriefing may increase
awareness of stress symptoms
d. There is no empirical evidence to support single-session
debriefing for anxiety
e. There is evidence for adverse effects of debriefing for PTSD
(BJP 2006)
124
PAPER 3
99. All of the following statements about affective disorders are true
except:
a. Family therapy is neither more nor less effective than crisis
management for bipolar disorder
b. Group psychoeducation as an adjunct to pharmacological
therapy may be effective for relapse prevention in bipolar
disorder
c. Internet-delivered brief CBT may be effective in the
treatment of depression
d. Male gender and depression are associated with self-harm in
first-episode psychosis
e. Progressive severity of depressive episodes is dependent on
the patient’s age at the onset of the disorder (BJP 2008)
125
NEW MRCPsych PAPER II MOCK MCQ PAPERS
126
PAPER 3
127
NEW MRCPsych PAPER II MOCK MCQ PAPERS
128
PAPER 3
111. All of the following statements about flumazenil are true except:
a. It can reverse the effects of zaleplon
b. It can precipitate seizures
c. It does not reverse the effects of opioids
d. It should be used only once at a dosage of 2 mg
e. Sedation can return in up to 3% of people who are treated
with flumazenil (KS)
129
NEW MRCPsych PAPER II MOCK MCQ PAPERS
115. All of the following statements about lithium are true except:
a. About 50% of patients with bipolar disorder are prescribed
lithium
b. Glomerular dysfunction is more common than tubular
dysfunction
c. It reduces the lethality of suicide attempts
d. It is retained in monotherapy for much longer than other
mood stabilisers
e. Treatment adherence is a strong predictor of suicidal
behaviour (KS)
130
PAPER 3
131
NEW MRCPsych PAPER II MOCK MCQ PAPERS
119. All of the following statements about the role of amines in affect-
ive disorders are true except:
a. Cholinergic agonists can exacerbate the symptoms of
depression
b. A correlation exists between the down-regulation of
β-adrenergic receptors and the clinical antidepressant
response
c. The D1-receptor may be hypoactive in depression
d. GABA-receptors are upregulated by antidepressants
e. The platelets of people with suicidal impulses have a high
concentration of serotonin uptake sites (KS)
132
PAPER 3
133
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134
PAPER 3
135
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Paper 4
137
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138
PAPER 4
139
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140
PAPER 4
11. For which of the following herbal remedies does evidence exist
for its effectiveness in treating anxiety?
a. Ginkgo biloba
b. Lavandula angustifolia
c. Melissa officinalis
d. Piper methysticum
e. Valeriana officinalis (APT 2007)
141
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142
PAPER 4
143
NEW MRCPsych PAPER II MOCK MCQ PAPERS
144
PAPER 4
145
NEW MRCPsych PAPER II MOCK MCQ PAPERS
22. All of the following statements about smoking are true except:
a. Approximately 50% of smokers with mental illness in the
UK have shown a desire to quit smoking
b. High rates of smoking are significantly associated with an
increased risk of other smoking-related illnesses in people
with mental illness
c. People whose mental illness has remitted are at no greater
risk of subsequent smoking than people with active disorders
d. People with mental illness are three times more likely to
smoke than the general population
e. Smoking increases the risk of mental illness even after
correcting for major risk indicators of a mental disorder
(APT 2008)
24. With which of the following changes in EEG are negative symp-
toms in schizophrenia correlated?
a. Decreased alpha activity
b. Increased beta activity
c. Increased delta wave
d. Low mean alpha frequency
e. Paroxysmal activity (SBN)
146
PAPER 4
147
NEW MRCPsych PAPER II MOCK MCQ PAPERS
30. With which of the following fibre types does the fusimotor to
intrafusal fibres of muscle spindles function match?
a. Aβ afferent
b. Aδ afferent
c. C afferent
d. Aα efferent
e. Aγ efferent (TN)
148
PAPER 4
34. All of the following statements about the vibration sense are true
except:
a. Decussation is in the medial lemniscus
b. The cell bodies of first-order neurons are located in the
dorsal root ganglion
c. The cell bodies of second-order neurons are located in the
dorsal horn
d. The VPL nucleus of the thalamus hosts the cell bodies of
third-order neurons
e. Third-order neurons terminate in the postcentral gyrus
(TN)
149
NEW MRCPsych PAPER II MOCK MCQ PAPERS
150
PAPER 4
38. Which of the following are the afferent fibres that pass through
the inferior cerebellar peduncle?
a. The anterior spinocerebellar tract
b. The ceruleocerebellar fibres
c. The rubrocerebellar fibres
d. The tectocerebellar fibres
e. The trigeminocerebellar fibres (TN)
151
NEW MRCPsych PAPER II MOCK MCQ PAPERS
152
PAPER 4
153
NEW MRCPsych PAPER II MOCK MCQ PAPERS
154
PAPER 4
155
NEW MRCPsych PAPER II MOCK MCQ PAPERS
56. All of the following statements about peptides are true except:
a. CCKA is involved in emotional behaviour
b. CRH stimulates locus firing
c. Injections of CRH produce decreased appetite
d. TRH is three amino acids long
e. Two different types of CCK receptors have been identified
(SBN)
156
PAPER 4
157
NEW MRCPsych PAPER II MOCK MCQ PAPERS
61. An EEG shows a 2/s spike and wave form in a person with a clin-
ical history of absences. The diagnosis is:
a. Benign rolandic epilepsy
b. Creutzfeldt–Jacob disease
c. Huntington’s disease
d. Lennox–Gastaut syndrome
e. Temporal-lobe epilepsy (SBN)
64. All of the following are clinical scales of the Standardised Luria–
Nebraska Battery except:
a. Expressive speech
b. Motor
c. Power
d. Receptive speech
e. Rhythm (SBN)
158
PAPER 4
65. All of the following statements about the timing of the course of
events occurring after an occlusion of a cerebral vessel are true
except:
a. Less than 12 hours – no microscopic or macroscopic changes
by conventional methods
b. 12 to 24 hours – increasing swelling of damaged area with
normal staining of the brain
c. 1 to 3 days – inflammatory cell response
d. 1 to 2 weeks – astrocytosis
e. Months or years – tissue destruction with remaining
astrocytic scar or cavity formation (SBN)
159
NEW MRCPsych PAPER II MOCK MCQ PAPERS
68. In the intermediate lobe of the pituitary, all of the following are
derived from pro-opiomelanocortin except:
a. α-Melanocyte-stimulating hormone
b. Adrenocorticotrophic hormone
c. β-Endorphin
d. γ-Lipotrophin
e. Corticotrophin-like intermediate lobe peptide (SBN)
160
PAPER 4
161
NEW MRCPsych PAPER II MOCK MCQ PAPERS
162
PAPER 4
79. The following genes have been implicated in the cocaine response
in mouse models. They have all been correctly matched except
for:
a. 5-HT1B – increased locomotor activity
b. DRDR1 – increased locomotor activity
c. GABAA Ab3 – increased locomotor activity
d. Retinoic acid receptors – blunted response
e. NAChR beta2 – reduced conditioned place preference (PG)
163
NEW MRCPsych PAPER II MOCK MCQ PAPERS
81. Which of the following statements about the ionic receptor family
is true?
a. Benzodiazepine prolongs the length of time for which the
chloride channel is open
b. The binding site on nAChR is the β-subunit
c. GABAA subunits do not share homology with nAChR
d. The GluR1 subunit of AMPA receptors stimulates the
growth of dendritic spines on the cortical pyramidal cells
e. NMDA receptors favour calcium permeation (N)
83. All of the following statements about DNA are true except:
a. Adenine is always paired with thymine
b. DNA polymerisation occurs in a 5′ to 3′ direction
c. The human genome consists of 3.3 × 10 9 bases
d. Transcription involves the formation of RNA from a DNA
template
e. Around 30% of the bases encode proteins (PG)
164
PAPER 4
165
NEW MRCPsych PAPER II MOCK MCQ PAPERS
88. All of the following statements about the 5-HTTLPR gene and
depression are true except:
a. The 5-HTTLPR gene has been associated with neuroticism
b. Significant interactions take place between the 5-HTTLPR
gene and environmental risk among adolescent women but
not adolescent men
c. The ‘l’ allele increases vulnerability to adverse events
d. The ‘s’ allele reduces the transcriptional efficiency of the
serotonin promoter
e. There is no direct relationship between the 5-HTTLPR
gene and the onset of depression (BJP 2006)
166
PAPER 4
167
NEW MRCPsych PAPER II MOCK MCQ PAPERS
168
PAPER 4
169
NEW MRCPsych PAPER II MOCK MCQ PAPERS
170
PAPER 4
99. Lesions of the dominant parietal lobe cause all of the following
except:
a. Acalculia
b. Apperceptive visual agnosia
c. Agraphia
d. Finger agnosia
e. Right–left disorientation (KS)
100. All of the following are derived from the telencephalon except the:
a. Amygdala
b. Cerebral cortex
c. Hippocampus
d. Striatum
e. Thalamus (KS)
171
NEW MRCPsych PAPER II MOCK MCQ PAPERS
102. All of the following statements about action potentials are true
except:
a. Activation of K+ channels results in hyperpolarisation
b. The duration of an action potential in a neuron is 0.1–2 msec
c. E Cl− = −81 mV
d. E Na+ = 97 mV
e. The spike threshold of a neuron is approximately −55 mV
(KS)
172
PAPER 4
173
NEW MRCPsych PAPER II MOCK MCQ PAPERS
111. All of the following are excellent candidate genes for schizophre-
nia except:
a. COMT
b. DISC 1
c. GRM 3
d. 5-HTTLPR
e. NRG 1 (KS)
174
PAPER 4
113. All of the following statements about migration are true except:
a. Excluding African-Caribbean people, in the UK the risk of
bipolar disorder among migrants is reduced to insignificant
levels
b. The mean relative risk of any mood disorder among
migrants does not depend on the relative risk among the
African-Caribbean population
c. The mean risk of developing bipolar disorder among
migrants is 2.47
d. The relative risk of developing schizophrenia in people with
a family history of migration is 2.9
e. White people with bipolar disorder present more often with
hypomanic symptoms than do others (BJP 2007)
175
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176
PAPER 4
177
NEW MRCPsych PAPER II MOCK MCQ PAPERS
178
PAPER 4
179
NEW MRCPsych PAPER II MOCK MCQ PAPERS
125. What is the term used for the requirement that the patient must
tell everything that comes into their head?
a. Analyst as mirror
b. The fundamental rule
c. The principle of evenly suspended attention
d. The rule of abstinence
e. Transference (KS)
128. What is the term used for having patients direct their attention
to specific bodily areas and hear themselves think certain phrases
that reflect a relaxed state?
a. Adaptation of progressive muscular relaxation
b. Applied relaxation
c. Applied tension
d. Autogenic therapy
e. Biofeedback (KS)
180
PAPER 4
129. What is the term used for the step of applied relaxation in which
patients relax just before entering the target situation, and stay in
the situation for 10 to 15 minutes?
a. Application training
b. Cue-controlled relaxation
c. Differential relaxation
d. Progressive relaxation
e. Release-only relaxation (KS)
130. What is the term used for the technique in which patients act out
real-life problems under a therapist’s observation or direction?
a. Assertiveness training
b. Behaviour rehearsal
c. Psychodrama
d. Social skills training
e. Therapeutic graded exposure (KS)
181
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Paper 5
183
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4. Mrs Bentley is being considered for CBT for OCD. All of the
following aspects are related to her treatment except:
a. Combining actual and imagined exposure is superior to
actual exposure alone
b. The degree of family involvement is an area to be covered in
the assessment
c. In response prevention, patients are never forced to stop a
compulsion
d. The Obsessive-Compulsive Inventory is an objectively rated
tool
e. Prolonged exposure and response-prevention sessions with
frequent homework will result in symptom reduction (APT
2007)
184
PAPER 5
6. Mrs Schmidt is being considered for CBT for OCD. The psy-
chologist in your team wants to know from your assessment the
factors for her prognosis. The poor prognostic factors include all
of the following except:
a. Comorbid schizoid personality
b. Expressed hostility from family members
c. Hoarding
d. Overvalued ideation
e. Severe avoidance (APT 2007)
7. All of the following statements about CBT for paranoia are true
except:
a. Clinicians need to be flexible with regard to the length of the
sessions
b. The evidence is strongest for negative symptoms such as
apathy
c. It is an exploratory approach
d. It reduces recovery time for acute psychosis
e. Self-help includes testing out suspicious thoughts (APT
2006)
185
NEW MRCPsych PAPER II MOCK MCQ PAPERS
10. The herbal remedy that interacts with levodopa to produce extra-
pyramidal symptoms is:
a. Evening primrose oil
b. Kava
c. Maidenhair tree
d. St John’s Wort
e. Valerian (APT 2007)
11. Which of the following is the symptom with the highest fre-
quency among core manic symptoms in hypomania?
a. Decreased sleep
b. Disinhibition
c. Increased activity
d. Increased plans or ideas
e. Increased talkativeness (APT 2006)
186
PAPER 5
14. All of the following associations between stroke and mood dis-
order are true except:
a. Antidepressants are effective in treating emotionalism
irrespective of a diagnosis of depression
b. Bromocriptine aggravates apathy following a stroke
c. The standardised mortality rate from suicide following a
stroke increases by threefold
d. There is more evidence of lability of mood in mood
disorders associated with a stroke
e. Tricyclic antidepressants are more effective than SSRIs
(APT 2006)
187
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188
PAPER 5
189
NEW MRCPsych PAPER II MOCK MCQ PAPERS
190
PAPER 5
25. According to the NICE guidelines for OCD, all of the following
statements are true except:
a. Therapists need to advise patients that there is no
convincing evidence for the effectiveness of psychoanalysis
b. Therapists need to consider giving cognitive therapy in
addition to exposure and response prevention, to enhance
long-term symptom reduction
c. Therapists need to consider cognitive therapy for patients
who refuse to engage in exposure and response prevention
d. Therapists need to consider using rewards for motivation
e. Therapists need to discourage patients’ families from using
exposure and response prevention should new symptoms
emerge (www.nice.org.uk)
191
NEW MRCPsych PAPER II MOCK MCQ PAPERS
27. All of the following statements about the NICE guidelines for
bipolar affective disorder are true except:
a. If a patient is taking an antidepressant at the onset of manic
symptoms, that antidepressant should not be stopped
abruptly
b. If antipsychotics are ineffective in the treatment of mania,
augmenting them with valproate should be considered
c. The guidelines recommend olanzapine for long-term
treatment
d. Patients should not routinely continue antidepressants as a
long-term treatment
e. Risperidone is licensed for the acute treatment of mania
(www.nice.org.uk)
192
PAPER 5
29. All of the following are parts of the limbic lobe except the:
a. Cingulate gyrus
b. Parahippocampal gyrus
c. Paraolfactory gyrus
d. Precuneus
e. Preterminal gyrus (TN)
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36. In which of the following are the pyramidal cells that contribute
to the corticospinal and corticobulbar tracts situated?
a. Layer I
b. Layer II
c. Layer III
d. Layer IV
e. Layer V (TN)
194
PAPER 5
37. All of the following statements about the premotor cortex are true
except:
a. Its key function is in the planning phase of motor activity
b. It involves area 6
c. It is on the lateral aspect of the frontal lobe
d. Once an intended activity begins, its activity continues to
increase
e. Its principal function is the control of axial and proximal
limb musculature (TN)
195
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42. All of the following statements about the taste pathway are true
except:
a. The anterior two-thirds of the tongue are supplied by the
facial nerve
b. The fibres from the ventroposteromedial nucleus end in the
parietal operculum
c. The nodose ganglion receives the fibres from the posterior
third of the tongue
d. Some fibres from the solitary nucleus pass to the
parabrachial nucleus
e. Taste fibres pass through the posterior limb of the internal
capsule (TN)
196
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44. All of the following statements about the cell layers of the neo-
cortex are true except:
a. The external granular layer consists mainly of stellate cells
b. The internal pyramidal layer is the source of the majority of
the corticofugal fibres
c. Layer IV is the main efferent station of the cerebral cortex
d. The pyramidal cell axons of the external pyramidal layer are
the principal source of the corticocortical fibres
e. The most numerous cells in the plexiform layer are the
horizontal cells of Cajal (TN)
197
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46. All of the following statements about the internal capsule are true
except:
a. Its anterior limb includes corticothalamic radiations
b. Its genu transmits corticobulbar fibres
c. It has sub- and retrolenticular limbs
d. Its posterior limb is between the head of the caudate nucleus
and the lentiform nucleus
e. Its retrolenticular limb carries visual information (TN)
47. All of the following statements about the motor cortex are true
except:
a. Part of the precentral gyrus controlling the movements of
the tongue is located at its inferior aspect
b. The premotor cortex receives fibres from the cerebellum
through the ventral lateral nucleus of the thalamus
c. Its primary motor area corresponds to Brodmann’s area 4
d. Its secondary motor cortex is localised exclusively to the
frontal lobe
e. Its supplementary motor area receives input from the basal
ganglia (TN)
198
PAPER 5
49. All of the following statements about cell membranes are true
except:
a. They behave as if there were pores
b. They are permeable to large molecules
c. They are permeable to lipophilic substances
d. They are permeable to water
e. They are selectively permeable to ions (SBN)
51. The fibres with the fastest conduction velocity are the:
a. Aα fibres
b. Aβ fibres
c. Aγ fibres
d. Aδ fibres
e. C fibres (SBN)
199
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200
PAPER 5
201
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202
PAPER 5
203
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204
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70. All of the following are associated with insulin resistance except:
a. Acanthosis nigricans
b. Hypertriglyceridaemia
c. Lipodystrophy
d. Polycystic ovaries
e. Testicular feminisation (SBN)
205
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73. All of the following statements about fragile X syndrome are true
except:
a. It is associated with a loss of expression of the FMR2 gene
b. It is associated with attentional difficulties and hyperactivity
c. It is the single commonest known inherited cause of mental
retardation
d. Its mutation involves CGG repeats within the first exon of
the FMR1 gene
e. The rate of fragile X syndrome is higher among children
with autism than among those with a learning disability (PG)
206
PAPER 5
207
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79. All of the following statements about inhibitory amino acids are
true except:
a. Cerebellar Purkinje cells use GABA as a neurotransmitter
b. GABA is synthesised from glutamate by glutamic acid
decarboxylase
c. The glycine receptor is activated by strychnine
d. The Renshaw cells of the spinal cord use glycine as a
neurotransmitter
e. Vigabatrin inhibits the catabolism of GABA to succinic
semialdehyde (N)
208
PAPER 5
80. All of the following statements about dopamine are true except:
a. Around 80% of all dopaminergic neurons are found in the
substantia nigra
b. Aldehyde dehydrogenase metabolises dopamine to
homovanillic acid
c. The amacrine cells of the retina use dopamine as a
neurotransmitter
d. Dopaminergic neurons are unmyelinated
e. The hydroxylation of tyrosine is the rate-limiting step in the
synthesis of dopamine (N)
209
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84. The mechanism by which the variation in the rate at which a gene
is expressed can be inherited in the absence of a change in the
primary DNA sequence is called:
a. Anticipation
b. Epigenetic inheritance
c. A frame-shift mutation
d. A trinucleotide repeat
e. Uniparental isodisomy (PG)
210
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211
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212
PAPER 5
92. All of the following statements about CBT are true except:
a. Adjunctive CBT is only of benefit to people who have had
fewer than 12 episodes of bipolar affective disorder
b. A long-term study of the use of CBT for treating comorbid
schizophrenia and substance misuse found that it had no
effect on the percentage of days of abstinence
c. CBT can reduce interpersonal difficulty among people at
high risk for psychosis
d. CBT is effective for problems associated with amphetamine
use
e. A reduction in compliance with command hallucination
with a reduction in voice activity occurs following CBT for
psychosis (BJP 2006)
213
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214
PAPER 5
97. All of the following statements about group therapies are true
except:
a. Group CBT has a significant impact on schizophrenia
relapse rates
b. Group CBT reduces feelings of hopelessness in patients with
schizophrenia
c. Group CBT reduces low self-esteem among patients with
schizophrenia
d. Group IPT has a significant effect on depression, which is
maintained at 6-month follow-up
e. Group psychoeducational interventions offered to women in
primary care reduce depressive symptoms (BJP 2006)
215
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98. All of the following statements about a synapse are true except:
a. Changes in the structure of synapses are mediated by growth
factors
b. Conjoint synapses have both electrical and chemical
characteristics
c. Nitric oxide, but not carbon monoxide, acts as a
neurotransmitter in a synapse
d. The propagation of an action potential along an axon is an
all-or-nothing phenomenon
e. The synaptic compartment represents less than 1% of the
brain (KS)
216
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103. EEGs show increased alpha activity with the use of which of the
following?
a. Alcohol
b. Barbiturates
c. Caffeine
d. Opioids
e. Nicotine (KS)
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218
PAPER 5
109. All of the following factors are associated with a good prognosis
in schizophrenia except:
a. Symptoms of depressive disorder
b. A family history of mood disorders
c. A history of assaultiveness
d. Being married
e. Having positive symptoms (KS)
219
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111. All of the following are risk factors for suicide among inpatients
with common mental illnesses except:
a. Involvement with the police
b. Previous suicidal behaviour
c. The presence of hallucinations
d. Suffering a recent bereavement
e. Engaging in violence against property (BJP 2006)
112. All of the following are risk factors for suicide among patients
discharged from hospital care except:
a. A lack of continuity of care
b. The lack of a social network
c. Suicidal ideation prior to discharge
d. Unemployment
e. An unplanned discharge (BJP 2006)
220
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221
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116. Mr Bainbridge presents with a belief that his wife can assume the
guise of strangers. This is called:
a. Capgras syndrome
b. Delusional intermetamorphosis
c. Folie impose
d. Fregoli’s phenomenon
e. Illusion de sosies (KS)
222
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121. The term used to describe the frustration of the emotional needs
and wishes that patients may have in relation to the analyst is:
a. Analyst as mirror
b. Counter-transference
c. The principle of evenly suspended attention
d. The rule of abstinence
e. Transference (KS)
223
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224
PAPER 5
225
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226
Answers
Paper 1
1. d 2. e 3. e 4. a 5. c 6. a 7. e
8. e 9. d 10. b 11. c 12. a 13. a 14. e
15. c 16. e 17. d 18. c 19. a 20. e 21. b
22. b 23. e 24. a 25. c 26. b 27. b 28. e
29. d 30. a 31. e 32. c 33. a 34. e 35. c
36. d 37. d 38. e 39. c 40. e 41. b 42. a
43. d 44. a 45. a 46. c 47. a 48. d 49. a
50. c 51. c 52. a 53. a 54. e 55. c 56. d
57. a 58. e 59. d 60. d 61. a 62. c 63. e
64. b 65. b 66. c 67. a 68. d 69. c 70. e
71. e 72. a 73. b 74. e 75. a 76. c 77. d
78. d 79. c 80. c 81. e 82. e 83. a 84. d
85. c 86. c 87. b 88. e 89. a 90. c 91. d
92. d 93. a 94. e 95. b 96. b 97. a 98. b
99. d 100. c 101. d 102. c 103. c 104. d 105. e
106. e 107. a 108. c 109. a 110. b 111. b 112. a
113. c 114. c 115. d 116. c 117. d 118. c 119. e
120. c 121. b 122. b 123. c 124. c 125. c 126. b
127. d 128. e 129. d 130. d
227
NEW MRCPsych PAPER II MOCK MCQ PAPERS
Paper 2
1. c 2. d 3. b 4. e 5. e 6. e 7. b
8. e 9. e 10. a 11. b 12. e 13. e 14. b
15. d 16. b 17. a 18. a 19. b 20. e 21. e
22. c 23. a 24. a 25. c 26. c 27. e 28. d
29. d 30. b 31. b 32. a 33. e 34. a 35. e
36. d 37. b 38. e 39. e 40. c 41. e 42. e
43. e 44. b 45. d 46. b 47. e 48. b 49. a
50. a 51. c 52. c 53. b 54. e 55. d 56. c
57. e 58. b 59. d 60. c 61. e 62. d 63. b
64. d 65. c 66. e 67. a 68. a 69. a 70. a
71. d 72. b 73. d 74. e 75. e 76. b 77. a
78. e 79. c 80. c 81. d 82. c 83. a 84. d
85. b 86. c 87. a 88. e 89. a 90. a 91. e
92. c 93. e 94. a 95. d 96. a 97. b 98. a
99. a 100. b 101. b 102. b 103. e 104. b 105. b
106. e 107. e 108. d 109. e 110. e 111. c 112. b
113. a 114. b 115. b 116. d 117. a 118. c 119. c
120. a 121. b 122. b 123. d 124. a 125. c 126. c
127. e 128. d 129. d 130. c
228
ANSWERS
Paper 3
1. a 2. e 3. c 4. d 5. b 6. c 7. e
8. a 9. e 10. e 11. a 12. d 13. e 14. c
15. a 16. a 17. a 18. b 19. e 20. b 21. d
22. d 23. e 24. d 25. c 26. e 27. b 28. e
29. b 30. b 31. d 32. e 33. a 34. e 35. d
36. a 37. a 38. e 39. d 40. c 41. b 42. a
43. d 44. b 45. c 46. e 47. e 48. d 49. c
50. a 51. b 52. e 53. e 54. b 55. e 56. d
57. c 58. c 59. e 60. e 61. c 62. e 63. b
64. a 65. d 66. d 67. a 68. d 69. a 70. b
71. e 72. c 73. b 74. c 75. d 76. c 77. a
78. e 79. c 80. b 81. d 82. e 83. c 84. a
85. e 86. a 87. d 88. e 89. c 90. c 91. b
92. b 93. d 94. d 95. b 96. d 97. b 98. a
99. e 100. e 101. b 102. d 103. d 104. a 105. e
106. e 107. b 108. e 109. d 110. d 111. d 112. a
113. b 114. a 115. b 116. b 117. c 118. d 119. e
120. b 121. a 122. a 123. d 124. b 125. d 126. a
127. d 128. b 129. c 130. e
229
NEW MRCPsych PAPER II MOCK MCQ PAPERS
Paper 4
1. d 2. c 3. a 4. c 5. b 6. c 7. d
8. d 9. c 10. e 11. d 12. b 13. c 14. c
15. c 16. c 17. e 18. a 19. e 20. c 21. b
22. d 23. d 24. c 25. e 26. c 27. e 28. c
29. d 30. e 31. a 32. b 33. c 34. c 35. b
36. c 37. d 38. e 39. c 40. a 41. b 42. c
43. d 44. e 45. a 46. a 47. b 48. e 49. c
50. e 51. e 52. d 53. a 54. d 55. b 56. a
57. a 58. e 59. d 60. d 61. d 62. b 63. c
64. c 65. b 66. e 67. e 68. b 69. e 70. b
71. d 72. e 73. b 74. b 75. b 76. e 77. d
78. d 79. b 80. b 81. e 82. d 83. e 84. a
85. b 86. c 87. b 88. c 89. b 90. e 91. d
92. b 93. d 94. e 95. a 96. c 97. a 98. c
99. b 100. e 101. c 102. d 103. c 104. c 105. b
106. d 107. d 108. b 109. b 110. b 111. d 112. d
113. e 114. e 115. b 116. e 117. d 118. b 119. e
120. e 121. c 122. e 123. b 124. a 125. b 126. d
127. e 128. d 129. a 130. b
230
ANSWERS
Paper 5
1. a 2. b 3. c 4. d 5. c 6. a 7. b
8. a 9. a 10. b 11. c 12. b 13. b 14. b
15. e 16. b 17. a 18. b 19. b 20. b 21. d
22. d 23. a 24. d 25. e 26. e 27. a 28. e
29. d 30. c 31. a 32. a 33. a 34. c 35. e
36. e 37. d 38. b 39. a 40. b 41. b 42. c
43. e 44. c 45. e 46. d 47. d 48. d 49. b
50. a 51. a 52. b 53. b 54. c 55. c 56. c
57. d 58. d 59. c 60. e 61. b 62. c 63. c
64. d 65. a 66. e 67. e 68. d 69. c 70. e
71. e 72. b 73. e 74. e 75. e 76. b 77. c
78. c 79. c 80. b 81. e 82. d 83. d 84. b
85. b 86. b 87. b 88. e 89. b 90. d 91. d
92. e 93. e 94. b 95. a 96. d 97. a 98. c
99. d 100. e 101. e 102. a 103. e 104. c 105. c
106. e 107. e 108. b 109. c 110. b 111. c 112. b
113. e 114. c 115. b 116. d 117. b 118. d 119. b
120. c 121. d 122. b 123. a 124. a 125. e 126. d
127. b 128. a 129. c 130. c
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