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A 21 year old man has been brought to A&E after his family found him with a knife cutting his head, to try remove a brain implant he believes the FBI put in to read his thoughts. He is also worried that they are putting thoughts into his head. When speaking to him he mentions that even when his family aren’t there he can hear them saying negative things about him. Which neurotransmitter is most likely to be increased in his brain?

a. Dopamine


c. Glutamate

d. Norepinephrine

e. Serotonin


A 19 year old man is brought in by police after being in a fight which started over a man bumping into him. He has a police record with multiple fights, often over insignificant things. Despite breaking the other man’s nose he states he has done nothing wrong and states no feelings of guilt. What personality disorder is most likely here?

a. Anxious

b. Emotionally unstable

c. Dissocial

d. Histrionic

e. Schizoid


Which of the following is not controlled by the hypothalamus?

a. Circadian rhythm

b. Drinking behaviour

c. Feeding behaviour

d. Reward

e. Sexual behaviour


A 21 year old male without any previous medical problems presents to clinic. A mental state examination is undertaken. His appearance and behaviour includes lots of bright colourful clothes, featuring wellington boots despite it being dry and sunny. He is socially disinhibited, asking the clinician personal questions. His mood appears low and he is agitated. His speech is fast when answering questions, but there is no spontaneous speech. Concerning thoughts, these include the belief that the government are using drones to put thoughts into his head. He is experiencing auditory hallucinations, specifically third person commentary on his actions. He has poor concentration and is easily distractible whilst he is not aware that he has any problem. From the mental state examination, what is the most likely diagnosis?

a. Bipolar disorder

b. Mania

c. Obsessive compulsive disorder

d. Paranoid personality disorder

e. Schizophrenia


A 33 year old woman has come to the GP after a 2 month history of low mood with tiredness. She can’t sleep and then wake up early in the morning. She states a lack of interest in work as well as her ballroom dancing which she used to go to weekly. Her husband is worried that she isn’t eating much and has lost weight since she has no appetite. What neurotransmitter is most likely low in her brain?

a. Dopamine


c. Glutamate

d. Norepinephrine

e. Serotonin


A 35 year old woman has presented with a ‘funny turn’ in the supermarket. She was doing her shopping when all of a sudden she became aware of her heart beating and it was beating faster. She started to breathe faster and became dizzy and sweaty. She has never had this happen before and no past medical history. What is the likely cause?

a. Agoraphobia

b. Generalised anxiety disorder

c. Obsessive compulsive disorder

d. Panic attack

e. Social phobia


An 87 year old man is brought to the GP by his daughter. She is worried that for the last 7 months he has been having problems with his memory. It started off just forgetting little things but he is now forgetting names of old friends and occasionally leaving the front door unlocked or the oven on. He has a past medical history of COPD. There are no neurological signs present but he does ask why he is at the GP multiple times in the consultation. What is the most likely diagnosis?

a. Alzheimer’s dementia

b. Delirium

c. Frontotemporal dementia

d. Lewy body dementia

e. Vascular dementia.


A 24 year old man has been to his GP about the medication for his depression. Despite trying multiple medication there has been little success and now a TCA has been decided to be used. Which of these is not a possible side effect of TCA?

a. Cheese effect

b. Constipation

c. Dry mouth

d. Postural hypotension

e. Weight gain


A 23 year old woman presents to clinic with the following mental state exam. • Appearance and behaviour: tearful, unkempt with poor personal hygiene. Avoiding eye contact • Speech: slow and monotonous • Mood: subjectively and objectively low • Thought: decreased speed of thoughts • Perceptual abnormalities: auditory hallucinations occasionally which just saying short negative comments • Cognitive function: not impaired • Insight: isn’t aware of any problem. What is the most likely cause of the above presentation?

a. Anxious personality disorder

b. Bipolar disorder

c. Depression

d. Emotionally unstable personality disorder

e. Generalised anxiety disorder


From the following mental state examination pick the most likely diagnosis for a 19 year old woman who has no past medical problems. • Appearance and behaviour: normal behaviour and appearance apart from multiple, superficial self-harm scars • Speech: normal speed, tone and volume • Mood: varied constantly throughout, with very sudden changes from low to high • Thought: has lots of negative ideas about self-image and some thoughts of self-harm • Perception: normal • Cognition: normal • Insight: fails to see a problem

a. Depression

b. Emotionally unstable personality disorder

c. Generalised anxiety disorder

d. Histrionic personality disorder

e. Mania