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Post Graduate Medical Diploma (Part-I)

Diploma in Psychological Medicine (DPM) Signatures of Candidate
Paper-I
(Multiple Choice Questions)
MODEL PAPER Roll No.

Total Marks: 100

Time Allowed: 2 hours

Instructions:
i. Read the instructions on the MCQ Response Form carefully.
ii. Attempt all questions.
iii. Question Paper to be returned along with MCQ Response Form.
iv. Candidates are strictly prohibited to give any identification mark except
Roll No. & Signatures in the specified column only.

Q.1 Midbrain develops from:

a) Ectoderm. d) Metencephalon.
b) Endoderm. e) Telencephalon.
c) Mesoderm.

Q.2 You have seen a patient who is presenting with signs of meningial irritation. You have decided to
examine his CSF. While doing a lumber puncture, CSF is taken from:
a) Extradural space. d) Subarachnoid space.
b) Subdural space. e) Central canal of spinal cord.
c) Lateral ventricle.

Q.3 Cerebral aqueduct is situated in:

a) Cerebral hemisphere. d) Hypophysis.
b) Forebrain. e) Mesencephalon.
c) Hindbrain.

Q.4 Neurotransmitter secreted at the pr eganglionic fibres of sympathetic nervous system is

a) Adrenaline. d) Serotonine.
b) Nor adrenaline. e) Dopamine.
c) Acetylcholine.

Q.5 You have seen a child who developed Poliomyelitis. Which part of spinal cord is affected?
a) Anterior gray horn. d) Fasciculus cuneatus.
b) Posterior gray horn. e) Substantia gelatinosa.
c) Fasciculus gracilis.

Q.6 Gracile and cuneate tubercles are seen on the surface of:
a) Pons. d) Cerebellum.
b) Medulla oblongata. e) Spinal cord.
c) Cerebrum.

Q.7 Tegmentum is a part of:

a) Spinal cord. d) Mid brain.
b) Medulla oblongata. e) Thalamus.
c) Pons.

Q.8 You have seen a patient who has a CT scan report showing a tumour in cerebellum. Which of the
following symptoms suggests involvement of cerebellum:
a) Blindness. d) Dysdiadochokinesis.
b) Aphasia. e) Alexithymia.
c) Mental retardation.

Q.9 Facial colliculus is found in which part of fourth ventricle?

a) Roof. d) Posterior wall.
b) Right lateral wall. e) Floor.
c) Left lateral wall.

Q.10 You have seen a patient who developed extra pyramidal symptoms after taking haloperidol. Which
pathway is affected?
a) Nigrostriatal. d) Cortico limbic.
b) Tuberoinfundibular. e) Spinothalamic.
c) Hypothalamo hypophysial.
(Continued)
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Q.11 Substantia nigra is situated in

a) Thalamus. d) Midbrain.
b) Hypo thalamus. e) Cerebellum.
c) Basal ganglia.

Q.12 A patient presents with features of Wernicke’s encephalopathy. Pathology is most likely in:
a) Spinal cord. d) Cerebellum.
b) Mid brain. e) Pons.
c) Diencephalon.

Q.13 Lateral geniculate body is a part of:

a) Spinal cord. d) Thalamus.
b) Medulla oblongata. e) Hypothalamus.
c) Pons.

Q.14 Following contains commissural fibres:

a) Internal capsule. d) Spinocerebellar tract.
b) Corpus callosum. e) Posterior horn.
c) Medial geniculate body.

Q.15 You have seen a patient who cannot speak. If lesion is in Broca’s area of speech, where is it
situated?
a) Superior frontal gyrus. d) Post central gyrus.
b) Inferior frontal gyrus. e) Inferior temporal gyrus.
c) Pre central gyrus.

Q.16 Third and fourth ventricles are connected through:

a) Cerebral aqueduct. d) Foramen of Luschka.
b) Central canal. e) Foramen of Magendie.
c) Interventricular foramina.

Q.17 Para sympathetic fibres from eye are present in which cranial nerve
a) First. d) Fourth.
b) Second. e) Fifth.
c) Third.

Q.18 Amygdala is structurally related to:

a) Spinal cord. d) Limbic system.
b) Pons. e) Hypophysis cerebri.
c) Medulla oblongata.

Q.19 Which of the following cranial nerve controls the lateral movement of eyeball
a) Olfactory. d) Trigeminal.
b) Optic. e) Abducent.
c) Occulomotor.

Q.20 Basilar artery is formed by the union of two:

a) Anterior cerebral arteries. d) Posterior cerebral arteries.
b) Vertebral arteries. e) Anterior spinal arteries.
c) Posterior communicating arteries.

Q.21 What proportion of all sensory information is discarded by the brain as irrelevant and
unimportant?
a) Less than 40%. d) 80% to 99%.
b) 40% to 59%. e) More than 99%.
c) 60% to 79%.

Q.22 You have seen a patient who has presented with intense anxiety. You have prescribed 5 mgs of
diazepam three times a day. Which of the following neurotransmitter system is facilitated by
diazepam for its anxiolytic effect?
a) Acetylcholine. d) GABA.
b) Epinephrine. e) Dopamine.
c) Nor epinephrine.

Q.23 You saw a patient of depression and prescribed 20 mgs of fluoxetine per day. It will inhibit
re-uptake of Serotonine from synaptic cleft. What is the width of synaptic cleft?
a) 20 to 30 micrometers. d) 20 to 30 angstroms.
b) 200 to 300 micrometers. e) 200 to 300 angstroms.
c) 20 to 30 millimetres.

Q.24 You have seen a patient who is complaining of severe headache. Which type of sensory receptors
are involved in pain sensations:
a) Nociceptors. d) Chemo receptors.
b) Thermo receptors. e) Electromagnetic receptors.
c) Mechanoreceptors.
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Q.25 A patient brings to you a report sa ying that his dorsal column of spinal cord is affected. Dorsal
column transmits following sensations
a) Pain. d) Tickle and itch.
b) Temperature. e) Sexual sensations.
c) Position sensations from the joints .

Q.26 Which of the following is found in the brain’s opiate system?

a) Morphine. d) Codeine.
b) Endorphin. e) Buperinorphine.
c) Pethidine.

Q.27 Nor epinephrine is synthesised from

a) Dopamine. d) GABA.
b) Epinephrine. e) Acetylcholine.
c) Serotonine.

Q.28 You have advised dexamethasone suppression test in a depressed patient. You measure cortisol
level. Cortisol is secreted from
a) Pituitary gland. d) Thyroid gland.
b) Adrenal medulla. e) Hypothalamus.
c) Adrenal cortex.

Q.29 You have seen a patient suffering from narcolepsy. Sleep and wakefulness are controlled by which
part of brain?
a) Cerebral cortex. d) Hypothalamus.
b) Reticular activating system. e) Internal capsule.
c) Limbic system.

Q.30 You have prescribed procyclidine to a patient who had glaucoma. What is normal intraocular
pressure?
a) 45 mm Hg. d) 15 mmHg.
b) 35 mm Hg. e) 05 mm Hg.
c) 25 mm Hg.

Q.31 Inhibitory cells situated in spinal cord are known as:

a) Renshaw cells. d) Purkinje cells.
b) Golgi cells. e) Dorsal root ganglia.
c) GABA cells.

Q.32 Primary motor cortex lies in:

a) Post central gyrus. d) Broca’s area .
b) Pre central gyrus. e) Area 17 of cerebral cortex.
c) Temporal lobe.

Q.33 Which part of brain prevents overshooting of movements?

a) Cerebral cortex. d) Basal ganglia.
b) Thalamus. e) Spinal cord.
c) Cerebellum.

Q.34 The major area for language comprehension in cerebral cortex is also known as
a) Korsakoff’s area. d) Wernicke’s area.
b) Parkinson’s area. e) Auditory area.
c) Broca’s area.

Q.35 You have seen a patient whose immediate memory is normal but short-term memory is deranged.
The part of brain involved in consolidation of memory is:
a) Thalamus. d) Corpus callosum.
b) Putamin. e) Hippocampus.
c) Globus Pallidus.

Q.36 A neurologist refers a patient to you. His MRI scan shows loss of neurons in cerebellum. Loss of
the deep cerebellar nuclei commonly causes:
a) Clasp knife rigidity. d) Hypertonia.
b) Cog wheel rigidity. e) Hypotonia.
c) Ankle clonus.

Q.37 You have seen a patient whose CT scan shows a brain tumour and his temperature regulatory
system is affected. Which part of brain controls the temperature regulation?
a) Tuberous cinerium. d) Preoptic area of hypothalamus.
b) Mammilary bodies. e) Infundibulum.
c) Para ventricular area of hypothalamus.

(Continued)
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Q.38 Reward and punishment centres are located in which part of brain
a) Spinal cord. d) Cerebral cortex.
b) Brain stem. e) Reticular activating system.
c) Limbic system.

Q.39 A patient comes to you with history of fits. His EEG shows theta waves. Frequency of theta waves
is:
a) Less than 3.5 cycles per second. d) 14 to 21 cycles per second.
b) 4 to 7 cycles per second. e) More than 21 cycles per second.
c) 8 to 13 cycles per second.

Q.40 You have seen a patient who suffers from schizophreni a. You have prescribed typical anti
psychotics, which blocks α-adrenergic receptors. Blockage of α-adrenergic receptors causes:
a) Vaso dilatation. d) Tachycardia.
b) Vaso constriction. e) Alexithymia.
c) Pupil dilatation.

Q.41 The characteristic transmission in synapse is:

a) There is one-way conduction. d) There are several axons in a neurone.
b) Transmission occurs both ways. e) Mitochondria store the neurotransmitter in
c) Transmission is mainly electrical. pre synaptic terminals.

Q.42 You have seen a patient who is complaining of memory loss. Long-term memory requires
prolonged changes in neurone, which is achieved by:
a) Opening ion channels in postsynaptic d) Creating action potential at neuromuscular
neurone. junction.
b) Activating a second messenger chemical e) Making changes in the DNA .
system in the post synaptic neurone.
c) Activating a second messenger chemical
system in the pre synaptic neurone.

Q.43 Excitation of neurone occurs by

a) Opening of chloride ion channels through d) Increased positive charge out side the
the receptor molecule. postsynaptic cell.
b) Increase in the conductance of potassium e) Increased negative charge inside the
ions through the receptor. postsynaptic neurone.
c) Opening of sodium channels into the
interior of the postsynaptic cell.

Q.44 You have seen a 25 years old patient who suffers from schizophrenia. You have prescribed
haloperidol, which is dopamine antagonist. Which of the following is an inhibitory
neurotransmitter?
a) Acetylcholine. d) Glycine.
b) Epinephrine. e) 5HT.
c) Nor epinephrine.

Q.45 Resting membrane potential of the neuronal soma in spinal cord is about:
a) + 35 millivolts. d) —35 millivolts.
b) + 65 millivolts. e) —65 millivolts.
c) +95 millivolts.

Q.46 In excitatory postsynaptic potential:

a) There is no change in membrane potential. d) Membrane potential becomes more
b) Membrane potential becomes less positive. negative.
c) Membrane potential becomes more e) Membrane potential becomes less
positive. negative.

Q.47 In case of pre synaptic inhibition neurotransmitter involved is usually:

a) Dopamine. d) GABA.
b) Acetylcholine. e) Cytochrome p 450.
c) 5HT.

Q.48 When the summated post synaptic potential is excitatory but has not risen high enough to reach
the threshold for excitation, neurone is said to be:
a) Blocked. d) Fired.
b) Inhibited. e) Disinhibited.
c) Facilitated.

Q.49 You have seen a patient suffering from epilepsy. Epileptic fit usually lasts for less than a minute.
Most likely mechanism explaining the short duration of fit is:
a) Facilitation of synaptic transmission. d) Disinhibition of synaptic transmission.
b) Fatigue of synaptic transmission. e) Blocking of synaptic transmission.
c) Excitation of synaptic transmission.
(Continued)
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Q.50 You have seen a patient who is hyperventilating as a result of intense anxiety. It results in:
a) Increased neuronal excitability. d) No change in neuronal activity.
b) Decreased neuronal excitability . e) Respiratory acidosis.
c) Blocking of neuronal activity.

Q.51 When you administer ECT; thiopentone sodium is used as an anaesthetic. It causes:
a) Decreased neuronal excitability . d) Metabolic acidosis.
b) Increased neuronal excitability. e) Respiratory alkalosis.
c) Decrease in the convulsion threshold.

Q.52 Synaptic delay is for:

a) 0.05 milliseconds. d) 50 milliseconds.
b) 0.5 milliseconds. e) 500 milliseconds.
c) 5 milliseconds.

Q.53 Mechanoreceptors are found in:

a) Retina. d) Hypothalamus.
b) Internal ear. e) Spinal cord.
c) Skin.

Q.54 Maximum amplitude of most sensory receptor potential is about

a) 0.1 millivolts. d) 100 millivolts.
b) 1 millivolts. e) 1000 millivolts.
c) 10 millivolts.

Q.55 Receptors adapt at a different rate. Which type of sensory receptors takes longest time for
adaptation?
a) Pacinian corpuscle. d) Auditory receptors.
b) Mechano receptors. e) Pain receptors.
c) Visual receptors.

Q.56 You have seen a 65 years old patient who has presented with memory loss and personality
change. If amyloid plaques are present in his brain, most likely diagnosis is:
a) Addison’s disease. d) Korsakoff’s psychosis.
b) Kluver Bucy syndrome . e) Alzheimer’s disease.
c) Wernicke’s encephalopathy.

Q.57 Acetylcholine is meta bolised by the enzyme

a) Catachol O methyl transferase . d) Acetyl cholinesterase.
b) Choline acetyl transferase. e) Acetylcholine dehydrogenase.
c) Monoamine oxidase.

Q.58 You have seen a patient with symptoms of episodic anxiety. After investigations he is found to
have pheochromocytoma. In adrenal medulla 80% of catecholamines are in the form of
a) Dopamine. d) Aldosterone.
b) Nor epinephrine. e) Cortisol.
c) Epinephrine.

Q.59 In adrenal medulla, nor epinephrine is converted to epinephrine by the process of:
a) Hydroxylation. d) Acetylation.
b) Methylation. e) Oxidation.
c) Decarboxylation.

Q.60 You have prescribed procyclidine to a patient who developed extra pyramidal symptoms after
taking haloperidol. Postganglionic neurones of para sympathetic system act on which receptors
a) Muscrinic. d) Beta.
b) Nicotinic. e) D-2.
c) Alpha.

Q.61 You have seen a patient complaining of anxiety. He suffers from bronchial asthma as well. You are
thinking about prescribing β-blocker, Propranolol. Bronchodilatation is caused by stimulation of
which receptor?
a) Beta 2. d) D 2.
b) Beta 1. e) 5HT 2.
c) Alpha 1.

Q.62 Sympathetic fibres to most sweat glands are:

a) Adrenergic. d) Histaminergic.
b) Cholinergic. e) Serotonergic.
c) Dopaminergic.

(Continued)
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Q.63 You have seen a patient whose CT scan shows a tumour of pituitary gland. Which hormone is
secreted from posterior pituitary?
a) ACTH. d) ADH.
b) FSH. e) MSH.
c) LH.

Q.64 You have seen a patient who has been diagnosed as having tumour in hypothalamus. Inhibitory
factor is secreted from hypothalamus to act on pituitary for which hormone of the pituitary?
a) Oxytocine. d) Growth hormone.
b) Anti diuretic hormone. e) Prolactin.
c) Leutinising hormone.

Q.65 Neurotransmitter acting on the tubero infundibular system is:

a) Serotonine. d) Nor epinephrine.
b) Acetylcholine. e) Dopamine.
c) Epinephrine.

Q.66 You have been asked to develop a programme of token economy for rehabilitation of patients
suffering from schizophrenia. This is theoretically derived from:
a) Cognitive learning. d) Psychoanalysis.
b) Operant conditioning. e) Supportive psychotherapy.
c) Classical conditioning.

Q.67 You have seen a 45 years old male who has been consuming excessive amount of alcohol for the
last several years. He suffers from Korsakoff’s psychosis. Most common type of memory loss in
this disorder is:
a) Short term memory. d) Immediate memory.
b) Long-term memory. e) Remote memory.
c) Digit span.

Q.68 Which of the following is a secondary reinforcer?

a) Food. d) Sex.
b) Water. e) Alcohol.
c) Money.

Q.69 You want to decrease unwanted behaviour of an individual. Which of the following would decrease
unwanted behaviour?
a) Positive reinforcement d) Punishment
b) Negative reinforcement e) Partial reinforcement
c) Intermittent reinforcement

Q.70 Language based memory is known as:

a) Episodic memory. d) Confabulation.
b) Perceptual memory. e) Semantic memory.
c) Encoded memory.

Q.71 A patient presents to you with history of needle phobia. According to theories of learning it can be
explained be st by:
a) Avoidance learning d) Extinction.
b) Observational learning e) Mono amine theory.
c) Psychoanalysis

Q.72 Thinking which is highly private and may use symbols with very personal meanings is known as:
a) Divergent thinking. d) Abstract thinking.
b) Autistic thinking. e) Directed thinking.
c) Concrete thinking.

Q.73 According to Maslow’s hierarchy of needs, lowest needs level is:

a) Self actualisation. d) Esteem needs.
b) Safety needs. e) Love needs.
c) Biological needs.

Q.74 Which theory states that felt emotion and bodily responses are independent events?
a) Watson-Crick theory. d) Cannon-Bard theory.
b) Schachter-Singer theory. e) Yerkes-Dodson theory.
c) James-Lang theory.

Q.75 Who did experiments using electric shocks to study the phenomenon of obedience?
a) Bower. d) Milner.
b) Caldwell. e) Milgram.
c) Miller.
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Q.76 You have seen a child who is exhibiting features of animism, egocentricism, authoritarian morality
and pre causal logic. According to Piaget’s theory of cognitive development, what is the likely age
of the child?
a) Less than 2 years. d) 12 to 16 years.
b) 2 to 7 years. e) More than 16 years.
c) 7 to 12 years.

Q.77 You have sent your patient to psychologist for assessment of intelligence. Result is in the form of
percentile score. Which test has been most likely administered?
a) WAIS. d) Stanford Binet test.
b) WISC . e) Ravens progressive Matrices.
c) WISC -R.

Q.78 You sent a patient to psychologist for IQ assessment. Result says that his score lies at 30th
percentile. What does it mean?
a) Patient is of average intelligence. d) Patient is severely mentally retarded.
b) Patient is mildly mentally retarded. e) Patient is profoundly mentally retarded.
c) Patient is moderately mentally retarded.

Q.79 You have sent a patient for IQ assessment. Report says that his score is within 2 standard
deviations of the mean. If mean is 100 what is the value for one standard deviation?
a) 5. d) 20.
b) 10. e) 25.
c) 15.

Q.80 You want to assess the personality of a patient. You have decided to use a projective test. Which
of the following is a projective test to assess personality
a) MMPI. d) Thematic apperception test.
b) Personality assessment schedule. e) The 16 personality factor (16PF)
c) Maudsley personality inventory. questionnaire.

Q.81 You have received a report of assessment of personality of a patient. It mentions dimensions of
introversion, extraversion and high or low neuroticism. Who developed a personality test
mentioning these characteristics?
a) Eysenck. d) Henderson.
b) Freud. e) Kraepelin.
c) Schneider.

Q.82 You have seen a patient suffering from obsessive compulsive disorder. According to Freud which
component of personality is very strong?
a) Ego. d) Preconscious.
b) Super ego. e) Unconscious.
c) ID.

Q.83 We use the term inferiority complex in our daily life. Who coined this term initially?
a) Freud. d) Horney.
b) Jung. e) Schneider.
c) Adler.

Q.84 Which of the following defence mechanism is most useful considering its consequences:
a) Projection. d) Sublimation.
b) Reaction formation. e) Rationalisation.
c) Repression.

Q.85 Which of the following defence mechanism is used in psychosis

a) Rationalisation d) Regression
b) Displacement e) Projection
c) Intellectualisation

Q.86 Following is a measure of central tendency

a) Mode. d) Analysis of variance.
b) Standard deviation. e) Range.
c) Variance.

Q.87 You are planning a research to compare a new anti depressant with a placebo. Your null
hypothesis would be:
a) Anti depressant is better than placebo. d) Results will be null and void.
b) There is no difference between e) Results are statistically significant.
antidepressant and placebo.
c) Placebo is better than antidepressant.

(Continued)
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Q.88 You are planning a research and you want that every member of population should have an equal
chance of being selected in the sample. This sampling is known as:
a) Stratified sampling. d) Convenient sampling.
b) Snowball sampling. e) Consecutive sampling.
c) Random sampling.

Q.89 You are doing a research on schizophrenia. For a chronic disorder like schizophrenia
a) Incidence is more than prevalence. d) Prevalence is more than incidence.
b) Yearly inception rate is more than point e) Incidence and prevalence are equal.
prevalence.
c) Prevalence means number of new cases.
Q.90 If p value is less than 5% it means
a) Results are statistically significant. d) Null hypothesis is true.
b) Results are clinically significant. e) Results are not valid.
c) There is type I error.
Q.91 You have referred a patient for counseling. It is best practice:
a) To avoid giving direct advice to clients . d) That clinical psychologist should do it.
b) To write down everything discussed. e) To have sessions every week.
c) To take the fee before the session.
Q.92 You should take consent from the patient before treatment. This is according to the ethical
principle of:
a) Justice. d) Honesty.
b) Autonomy. e) Humility.
c) Good Samaritan.

Q.93 Confidentiality may be broken in following circumstance:

a) Patient refuses to pay the fee. c) Relatives request for it.
b) Head of your department orders you to do d) Patient has died.
it. e) Court orders you to do it.
Q.94 When patient does not have the capacity to decide about the treatment you should:
a) Ask for second opinion. d) Work in the best interest of the patient.
b) Not treat the patient. e) Seek permission from relatives.
c) Refer the patient to some one else.

Q.95 Following is a relatively culture free IQ test:

a) WAIS. d) Stanford Binet test.
b) WISC . e) Mini mental state.
c) Ravens progressive Matrices.

Q.96 A young woman of Azad Kashmir is in psychological distress after being badly injured in
earthquake. One of her distant uncles has also been killed in the disaster. She is most likely to be
in a state of:
a) Developmental crisis. d) Economic crisis.
b) Situational crisis. e) Social crisis.
c) Family crisis.
Q.97 An 18 years old girl with a dissociative (hysterical) disorder is admitted in psychiatry ward. A few
days later she insists on repeated examination by a young male doctor. Most likely she has
developed a state called:
a) Rapport. d) Transference.
b) Dependence. e) Learning.
c) Confidence.
Q.98 After physical examination and investigation a 42 years old businessman has been told that he has
advanced carcinoma of liver. After 2 hours the doctor on his revisit observes that he is completely
relaxed and happy. The patient is most likely exhibiting:
a) Strong nerves. d) Tolerance.
b) Patience. e) Hiding the anxiety consciously.
c) Denial.
Q.99 A 20 years old girl presents to a doctor with amne sia. She has failed in recent examination. There
is no organic cause for amnesia. She probably has:
a) Fear. d) Shock.
b) Confusion. e) Dissociation.
c) Frustration.

Q.100 The most stressful event for a 55 years old government servant according to Holmes and Rahe is:
a) Death of spouse. d) Marriage of his son.
b) Retirement. e) Accidental injury.
c) Robbery at home.