Exam set
25 of 25 items · 30 min budget · seed 1 · 1005 available in scope
Deliberate practice, not a test. Work through the set at your own pace; nothing is timed server-side, scored, or recorded. The budget is guidance only.
1. Explain · Morbid Anxiety Description
Explain why organic neurasthenia is considered a distinct subtype of morbid anxiety rather than simply an alternative label for the same thing.
2. Explain · Experience of Multiple Personalities Description
Explain why the experience of multiple personalities requires careful, thorough differentiation from other conditions before being accepted as the diagnosis.
3. Apply · Anxious Personality Disorder Application
A woman describes intense fear specifically and only when required to eat in front of others or speak at meetings, but is otherwise socially confident, has a wide circle of established friends, and does not describe any generalised low self-worth. Before revealing the answer: is this anxious (avoidant) personality disorder?
4. Explain · La Belle Indifférence Description
Explain why la belle indifference is not simply a more dramatic form of denial.
5. Discriminate · Disturbance of the Continuity of Self vs Disturbance of the Immediate Awareness of Self-Unity Discrimination
A patient describes a disturbed sense of who they are. Before revealing the answer, decide what distinguishes a disturbance of the continuity of self from a disturbance of self-unity.
6. Elicit · Occupational Delirium Elicitation
You suspect a confused patient shows occupational delirium. Before revealing the answer, decide how you would assess for this.
7. Discriminate · Paraschemazia vs Somatoparaphrenia Discrimination
A patient describes an unusual, distressing change in how a body part feels. Before revealing the answer, decide what distinguishes paraschemazia from somatoparaphrenia.
8. Apply · Ganser Syndrome Application
A fully alert, oriented patient consistently gives approximate wrong answers to simple questions, with an amused, facetious manner, but shows no clouding of consciousness, disorientation, or hallucinations at any point. Before revealing the answer: is this Ganser syndrome?
9. Explain · Psychomotor Retardation Description
A patient's family reports she now takes far longer to complete everyday tasks than she used to, though she denies feeling unusually tired. Why is comparing her current pace against her own previous baseline more useful than asking about tiredness alone?
10. Elicit · Movement Disorders Associated with Antipsychotic Medication Elicitation
You are reviewing a patient recently started on antipsychotic medication and want to screen for a subtle movement disorder that might not be obvious just from watching them. Which single question is most appropriate to ask?
11. Discriminate · Obstruction (Blocking) vs Psychomotor Retardation Discrimination
A patient's movements are slowed or hindered. Before revealing the answer, decide what distinguishes obstruction from psychomotor retardation.
12. Explain · Thought Alienation Description
Explain why the three sub-types of thought alienation — insertion, withdrawal, and broadcasting — are described as varying by the 'direction' of the felt interference.
13. Apply · Inhibition (Slowing) of Thinking Application
Mid-sentence, describing his weekend, a patient suddenly stops speaking entirely, looking momentarily blank, and afterward cannot recall what he had been about to say, though his speech had been at a completely normal pace right up until that moment. Before revealing the answer: is this inhibition of thinking?
14. Discriminate · Depressive Pseudodementia vs Amnestic State Discrimination
One patient develops broad difficulty with memory, concentration, and everyday tasks alongside a severe, unmistakable low mood, is acutely distressed by her own decline, and recovers her cognitive function almost completely once the depression is treated. A second patient, following a head injury with no mood disturbance at all, cannot learn or recall any new information from the day of the injury onward, while his other cognitive abilities, immediate recall, and memories from before the injury all remain intact. Are both of these best understood as depressive pseudodementia?
15. Recognise · Morbid Anxiety Recognition
A patient describes a pervasive, sustained state of anxiety present most of the time for months, persisting regardless of what is actually happening in her life, and significantly impairing her ability to work or socialise. What is this?
16. Recognise · Circumstantiality Recognition
Asked a simple question about when his symptoms began, a man gives a long, detailed, meandering account full of unnecessary tangents, and each time you try to redirect him he briefly returns to the point before digressing again. Eventually, several minutes later, he does answer the original question. What is this?
17. Apply · Demoralization Application
A woman managing a difficult, prolonged legal dispute over several years describes feeling worn down and doubtful she can see it through, but remains actively engaged with her hobbies, her friendships, and her work, describing her low feeling as entirely about the legal situation itself. Before revealing the answer: is this most likely a depressive illness?
18. Apply · Somatisation Application
A man recently diagnosed with a terminal illness continues to make detailed plans for events years in the future, insisting to his family that the diagnosis must be a mistake, and shows no physical symptoms or complaints related to depression at all. Before revealing the answer: is this somatisation?
19. Discriminate · Body Image Disturbance vs Nihilistic Delusion Discrimination
A patient describes an abnormal experience involving part of their body. Before revealing the answer, decide what distinguishes body image disturbance from a nihilistic delusion.
20. Apply · Hemispatial Neglect Application
A patient following a stroke fails to recognise her own left arm as belonging to her, insisting it belongs to someone else, but she readily notices and responds normally to objects, food, and people on her left side more generally. Before revealing the answer: is this hemispatial neglect?
21. Apply · Primary Delusion Application
A woman with several weeks of severe depressed mood and profound guilt develops a fixed belief that she has committed a terrible unforgivable sin and deserves to be punished. Before revealing the answer: is this a primary or secondary delusion?
22. Apply · Extended Suicide Application
A father with severe, delusional depressive illness, believing his family faces certain financial ruin and that this is entirely his fault, expresses a plan to end his own life alone, with no mention of harming his children. Before revealing the answer: does this meet the pattern of extended suicide?
23. Elicit · Affective Incontinence Elicitation
You suspect a patient may show affective incontinence. Before revealing the answer, decide how you would assess for this.
24. Discriminate · Catatonic Speech Disturbance vs Talking Past the Point (Vorbeireden) Discrimination
A patient's speech sounds unusual. Before revealing the answer, decide what distinguishes catatonic speech disturbance from talking past the point.
25. Apply · Distortion of Recognition Application
A patient with schizophrenia has, over several weeks, developed a fixed, elaborated conviction that her neighbour has been replaced by a physically identical impostor, maintained despite all reassurance. Before revealing the answer: is this an ordinary distortion of recognition?