APRIL 2017 Previous (solved) Paper IMM

Q11 A 45-year male patient with several years history of mental illness was seen replying to some person abusing him when nobody was around. At the same time, he also reports that he can see a young girl skipping a rope behind his back. During the conversation, he recalled events related to his father's accidental death & burial that occurred two months back but was mostly smiling while mentioning it. He was convinced that his wife is not faithful to him and is having an illicit relationship with one of his friends, although no evidence suggesting, this is available. During his assessment, he was found constantly imitating the actions performed by his doctor and believed that a cart carrying armed personnel will land in his room by making a hole in the roof and will take away all his valuables to another planet.


Name the psychological disturbances present in phenomenological terms.


Q12 Outline the neurobiology of neglect and abuse in childhood. Enumerate psychological consequences.


Q13 A 6-year-old boy has been brought to the ER with multiple bruises on face black eye and lacerated upper lip. His father reported that the boy fell from the stairs a week ago. The casualty medical officer suspected physical abuse and called you. How would you assess factors predicting the risk of abuse?


Q14 You have been asked to examine a 7 years old boy with a history of low birth weight, developmental delays, and soft hyperextensible joints.


What other findings will you look for in this case?
What two psychometric instruments would you like to use?
What would be the finding in psychometric testing?


Q15 A young man married a year ago has been referred to you with impotence
Enlist the areas you will explore in the sexual history of this patient.


Q16 A 25-year male, married six months back, presented with depressed mood, irritability, poor sleep and irregular on his job. He believed that his wife has illicit relations and is always searching for proof.
What are the provisional diagnoses?
What risk factors would you look for in personal history?
What informational care is essential to be passed on to the attendant of this patient prior to discharge?


Q17. A dermatologist has referred A 32 years old shopkeeper for psychiatric evaluation for disorientation and impaired memory. Dermatologist noted vesicles and bullae on extremities that were symmetrical and bilateral on sun-exposed part and stomatitis. His wife reported he had reduced his physical and mental stamina, become agitated and depressed often and vomiting and diarrhoea for the fast three months.


What relevant mental state examination finding would you look for?
What is the most likely diagnosis?
What will be your management in this case?


Q19 According to standard guidelines, what is the status of clozapine administration in case of pregnancy, lactation, epilepsy, and Diabetes mellitus?










Q20 The obstetric team has requested you to give an opinion on pharmacological management of a pregnant woman who has developed depressive episode in her first trimester of pregnancy. Answer the following questions as per the recommendation of Maudsley guidelines:




Enlist three safer antidepressant choices.


If she:


Uses lithium, what anomaly could occur?


Requires a mood stabiliser, which one you would advise?


Develops psychotic features. What three antipsychotics would you offer?


Require psychotropic drugs in the postpartum period, what antidepressant, antipsychotic and anxiolytic (one drug from each group) which you would advise?