PLAB Psychiatry & Mental Health 3

Question 1

A 62-year-old presents with a 2-year history of progressive memory loss, getting lost in familiar areas, and personality changes. MMSE score is 18/30. What is the most likely diagnosis?

Accepted Answer

Alzheimer's disease

Answer

Delirium

Answer

Vascular dementia

Answer

Frontotemporal dementia

Question 2

Which mood stabilizer requires regular monitoring of serum levels, renal function, and thyroid function due to its narrow therapeutic index?

Accepted Answer

Lithium

Answer

Sodium valproate

Answer

Lamotrigine

Answer

Carbamazepine

Question 3

A 30-year-old experiences recurrent unexpected episodes of intense fear with palpitations, shortness of breath, sweating, and a feeling of impending doom, each lasting about 10 minutes. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Agoraphobia

Answer

Social anxiety disorder

Question 4

A 16-year-old girl with a BMI of 15.5 presents with severe caloric restriction, intense fear of weight gain, and distorted body image. What is the most appropriate initial management priority?

Accepted Answer

Medical stabilization and inpatient nutritional rehabilitation

Answer

Outpatient CBT alone

Answer

Initiate fluoxetine

Answer

Family-based therapy alone

Question 5

Which extrapyramidal side effect of antipsychotics typically appears within hours to days of starting treatment and presents with involuntary muscle spasms?

Accepted Answer

Acute dystonia

Answer

Tardive dyskinesia

Answer

Metabolic syndrome

Answer

Akathisia

Question 6

A 45-year-old with depression is found hoarding large quantities of medication at home and expresses hopelessness, stating his family would be better off without him. What is the most appropriate immediate action?

Accepted Answer

Urgent crisis assessment and consider inpatient admission

Answer

Schedule outpatient CBT next week

Answer

Increase the antidepressant dose

Answer

Advise the patient to call a helpline if needed

Question 7

A 28-year-old has recurrent 4-day episodes of elevated mood, increased energy, decreased sleep, and heightened productivity that do not cause severe impairment or require hospitalization. He also has a history of major depressive episodes. What is the most likely diagnosis?

Accepted Answer

Bipolar II disorder

Answer

Bipolar I disorder

Answer

Cyclothymia

Answer

Major depressive disorder with mixed features