IACAM Course “Module C” Assessment -Batch 3

Question 1 of 50

1. Question

2 point(s)

A 14-year-old boy presented with history of frequent stomach aches, difficulty falling asleep and restlessness. He was often preoccupied with trivial matters and would worry incessantly. Often, he sought reassurance from his parents and friends. At times, he would have pain in his chest associated with palpitations, racing pulse and feeling of breathlessness. What would you diagnose him as?

Panic Disorder
Conversion Disorder
Generalised Anxiety Disorder
d. Somatoform Disorder

Question 2 of 50

2. Question

2 point(s)

A 17-year-old adolescent was referred for abnormal behaviour. Parents noticed a decline in his scholastic performance over the past 2 years. For the last 10 months, he has not gone to school. He has locked himself inside his house and worries that the government is spying on him. He believes that his life is at risk because he is the only one who has got codes for a nuclear launch missile. He is sometimes restless and irritable, and his conversation is difficult to understand. What is the most probable diagnosis?

Early Onset Schizophrenia
Autism spectrum disorder
Delusional Disorder
Depression with psychotic features

Question 3 of 50

3. Question

2 point(s)

Punishment for failure to report a case of child sexual abuse is defined under which section in POCSO?

Section 19
Section 21
Section 22
Section 27

Question 4 of 50

4. Question

2 point(s)

Which is true about OCD in children?

Onset of symptoms is usually abrupt
Earlier age of onset (< 7 years) have a female preponderance
Content of symptoms remains consistent over time
Insight should be present to make diagnosis

Question 5 of 50

5. Question

2 point(s)

A 13-year-old adolescent was brought to the OPD by his mother. He presented with a 3-weeks history of sub-acute onset and progressive course of decreased need for sleep, increased talkativeness, increased demand for spicy food and sweets and expansive talks. He claimed to be a doctor and talked about being a very popular practitioner, said that he was a rich man, had a big car and a huge bungalow. From early childhood, he used to get complaints from his schoolteacher saying that he was naughty and troublesome in the class. He would often get into fights with other children and find it hard to wait for his turn when doing something. His mother reported that he had otherwise normal milestones. What are the comorbid disorders to be looked for in this patient?

Mania with ADHD
Mania with ODD
Mania with ASD
Mania with psychopathy

Question 6 of 50

6. Question

2 point(s)

Parallel play in children is best defined as:

When children play near each other with the same materials, but do not interact much.
When children interact together at an activity, doing similar things.
When children interact together in complementary ways.
When children play and interact intermittently at regular intervals.

Question 7 of 50

7. Question

2 point(s)

Which is true about pharmacotherapy of anxiety disorders in children?

Tricyclic antidepressants are effective
Benzodiazepines are the recommended first line treatment
Buspirone and beta-blockers have little evidence for efficacy
Antihistamines are effective for anxiety disorders in children

Question 8 of 50

8. Question

2 point(s)

A 16-year-old male was brought by his mother to OPD with complaints of abnormal behavior and fearfulness for one year. The parents reported that since early childhood, he was less communicative with his siblings and peers. He would not approach or make eye contact with guests at home and would start crying if his mother forced him to interact with any person who was not familiar to him. At home, he preferred activities that required the least participation from others. One year prior to presentation, without any apparent reason, the patient became disinterested in school and began watching programs with magical themes more frequently. The patient would become irritated if anyone tried to sit near him while he was watching television, which was unlike his previous behavior. Additionally, he appeared self-absorbed and was often seen smiling to himself and doing odd gestures in the air. He would sometimes say that he had magical powers, without any further elaboration. His was often irritable and would become angry without provocation, destroying household articles. What is the diagnosis?

Conduct Disorder confined to family context
Disruptive mood dysregulation disorder (DMDD)
Childhood onset mania
Schizotypal disorder

Question 9 of 50

9. Question

2 point(s)

Childhood onset schizophrenia is characterized by the following clinical features except:

Delusions are present in more than one half of children with schizophrenia.
Blunted or inappropriate affects appear almost universally in children with schizophrenia
Formal thought disorders, including loosening of associations and thought blocking, are common features among children with schizophrenia
Children with schizophrenia have severe poverty of speech content and are ambiguous in the way they refer to persons, objects, and events

Question 10 of 50

10. Question

2 point(s)

Which is true about treatment of anxiety disorders in children?

Psychotherapy has a faster onset of action compared to medication
Combined treatment is more effective than psychotherapy and medication given alone
Drug must be given as first line treatment
Giving psychotherapy alone increases the risk of relapses

Question 11 of 50

11. Question

2 point(s)

What is the most common type of hallucinations in early onset schizophrenia?

Visual
Auditory
Gustatory
Tactile

Question 12 of 50

12. Question

2 point(s)

Which is true about SSRI for OCD in children?

SSRIs have differential efficacy for OCD in children
Clomipramine is used as the first line treatment for OCD in children
Poor response to one SSRI does not predict nonresponse to other SSRIs
Augmentation with low dose of atypical antipsychotics is not effective

Question 13 of 50

13. Question

2 point(s)

Psychosis is commonly associated with injury of:

Temporal lobe
Parietal lobe
Occipital lobe
Cerebellum

Question 14 of 50

14. Question

2 point(s)

As per ICD-11 which of the following is correct regarding the diagnosis of depression?

Criteria for depressive disorders are different in children and adults
Delusions and hallucinations can be present in moderate depression
There are no specifiers for dysthymia in children
Hypersomnia has been removed as a requirement for the diagnosis of depression

Question 15 of 50

15. Question

2 point(s)

Higher rates of psychosis are associated with:

Adverse childhood events
Low socioeconomic status
Female gender
High intellectual functioning

Question 16 of 50

16. Question

2 point(s)

The following are considered to be etiological factors for depression in children, except:

Insecure attachment
Negative cognitive style
Underdeveloped mentalization
Neurotic traits

Question 17 of 50

17. Question

2 point(s)

Psychosis and autonomic instability can be seen in:

Pheochromocytoma
Bipolar affective disorder
NMDA receptor encephalitis
Wilson’s disease

Question 18 of 50

18. Question

2 point(s)

Which of the following is correct about childhood adversities?

Childhood adversities are more associated with childhood mood disorders compared to late onset mood disorder
Childhood adversities are associated mainly with traumatic stress syndromes and not with mood disorders
Emotional abuse is not associated with risk of depression
There is no association between temperament and depression.

Question 19 of 50

19. Question

2 point(s)

The following are indicators of bipolarity in children with depression except:

Positive family history of bipolar disorder
Psychomotor retardation
Insidious onset of symptoms
Mood-congruent psychotic symptoms

Question 20 of 50

20. Question

2 point(s)

These are helpful messages to parents or caregivers of a currently suicidal youth except:

“Suicidal thoughts and attempts are not uncommon in young people. In most of cases, this is an acute crisis that can be overcome in a few weeks with appropriate care”
“We are familiar with managing suicidal crises and will frankly discuss every step with you”
“As a first step we will formulate a contingency plan for you, your child and us”
“You should give your child space to work things out for himself/ herself”

Question 21 of 50

21. Question

2 point(s)

Which of the following is a diagnostic instrument for depression in children?

Beck Depression Inventory (BDI)
Patient Health Questionnaire – 9 (PHQ-9)
Strength and Difficulty Questionnaire (SDQ)
Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)

Question 22 of 50

22. Question

2 point(s)

The following are predictors of poor outcome in schizophrenia except:

Negative symptoms
Disorganisation
Very early onset
Positive symptoms

Question 23 of 50

23. Question

2 point(s)

What is the specific psychopharmacological treatment for suicidal youth?

Neuroleptics
SSRIs
Stimulants
There are no specific medications for suicidality

Question 24 of 50

24. Question

2 point(s)

Which of the following is considered important in diagnosing depressive disorder in children and adolescents?

Irritability due to poor frustration tolerance
Sad mood secondary to identity and intimacy issues in adolescents
School refusal
Pervasive depressed mood with loss of pleasure in previously pleasurable activities

Question 25 of 50

25. Question

2 point(s)

What is the percentage of exposure to a traumatic event in childhood/adolescences and lifetime percentage exposure to a traumatic event?

30 percent and 80 percent
80 percent and 90 percent
35 percent and 50 percent
60 percent and 80 percent

Question 26 of 50

26. Question

2 point(s)

Non-suicidal self-injury differs from a suicide attempt in that it:

Occurs predominantly in pre-pubertal youth
Does not have suicidal intent
Usually happens in a group context
Is more common in males

Question 27 of 50

27. Question

2 point(s)

Which of the following is correct about psychiatric comorbidities in children?

Psychiatric comorbidity is more common than medical comorbidity in children and adolescents with depression.
Medical disorders comorbidity occurs rarely in children and adolescents with depression.
Adverse childhood experiences do not impact the occurrence of comorbidity with depression.
When depression is comorbid with anxiety, depressive disorders predate anxiety disorders

Question 28 of 50

28. Question

2 point(s)

As per DSM-5 what is the minimum duration for the symptoms to be present, to diagnose PTSD:

More than 1 month for children above 6 years of age and more than 3 months for children below 6 years of age
More than 2 months for children above 6 years of age and more than 1 months for children below 6 years of age
More than 1 month for children above 6 years of age and more than 1 month for children below 6 years of age
More than 6 months for children above 6 years of age and more than 3 months for children below 6 years of age

Question 29 of 50

29. Question

2 point(s)

Which is true about Separation anxiety disorder in children?

It is the most common anxiety disorder in children less than 12 years of age
It is more common in girls
The symptoms should last at least 6 months for the diagnosis to be made
If separation anxiety disorder is present, a diagnosis of generalized anxiety disorder cannot be made

Question 30 of 50

30. Question

2 point(s)

Which of the following therapies has best evidence for treatment of depression in children?

Cognitive behavioural therapy
Family therapy
Narrative therapy
Play therapy

Question 31 of 50

31. Question

2 point(s)

Section 5 of POCSO defines:

Penetrative sexual assault
Aggravated penetrative sexual assault
Aggravated sexual assault
Punishment for sexual assault

Question 32 of 50

32. Question

2 point(s)

Which type of conversion phenomena is most common in adolescents in India?

Astasia-abasia
Paralysis
Pseudo seizures
Loss of voice

Question 33 of 50

33. Question

2 point(s)

The following medication have good evidential support for treatment of depression n children in adolescents except:

Fluoxetine
Sertraline
Paroxetine
Escitalopram

Question 34 of 50

34. Question

2 point(s)

Within how many hours of reporting of child sexual abuse should the victim be examined.

12 hours
24 hours
36 hours
48 hours

Question 35 of 50

35. Question

2 point(s)

Which of the following is true about secondary anxiety symptoms?

Avoidance is prominent
Good response to anti-anxiety medications
Predominance of physical symptoms of anxiety
Presence of significant stress

Question 36 of 50

36. Question

2 point(s)

Behavioural activation seen after SSRI administration in children is characterized by the following, except:

Appears in the first week after start of treatment
Appear after increase of dose
Appear after a few months
Behavioural activation decreases after switching SSRIs

Question 37 of 50

37. Question

2 point(s)

According to the WHO World Mental Health (WMH) Survey Initiative the most common childhood adversity is

Parental death
Family violence
Parental mental illness
Physical abuse

Question 38 of 50

38. Question

2 point(s)

The following are true about anxiety disorders in children except:

May manifest with behavioural symptoms
May not recognize their worry as excessive
May have other comorbid mental disorders
Psychosocial factors do not play an important role in childhood onset anxiety

Question 39 of 50

39. Question

2 point(s)

Which of the following is the medication of choice for bipolar depression in children.

Quetiapine
Lurasidone
Lithium
Olanzapine+fluoxetine

Question 40 of 50

40. Question

2 point(s)

All the following signs indicate possible emotional abuse, except:

Sudden speech disorder
Low self-esteem
Self-mutilation
Poor state of clothing

Question 41 of 50

41. Question

2 point(s)

Select the most appropriate statement for children with conversion disorder:

Common psychosocial factors include day to day problems
In prepubescent children, girls are more affected than boys
The type of conversion symptoms always remains the same
Most children have a long and chronic course of illness

Question 42 of 50

42. Question

2 point(s)

A 6-year-old boy presented with history of not making friends with other children. Further exploration revealed that he was not attached to his parents and spent most of his time playing alone. In addition, he shows repetitive head banging and hand wringing. It is also noted he gets agitated if his routines are changed. The likely diagnosis is:

Very Early Onset Schizophrenia
Autism Spectrum Disorder
Schizotaxia
Social anxiety disorder

Question 43 of 50

43. Question

2 point(s)

Which of the following is a scale to diagnose Psychopathy?

The static-99
PCL-R
SARA
SVR-20

Question 44 of 50

44. Question

2 point(s)

These factors are indicators of suicide risk in the family history, except:

Suicides and suicide attempts in family members
Paternal psychopathology
Unstable family relations and unresolved conflicts in the family
Low birth order in a large sibship

Question 45 of 50

45. Question

2 point(s)

The effect of media depictions of suicidal acts

Is called “Papageno” effect
Is called “Werther” effect
Is not known to affect suicide among adolescents
d. Is not known to be affected by the nature of reporting

Question 46 of 50

46. Question

2 point(s)

These are all characteristic of the “pre-suicidal syndrome” except:

Feelings of hopelessness, self-blame, of being alone and misunderstood
Inactivity and social withdrawal
Obsessive ruminations
Suicidal fantasies and planning

Question 47 of 50

47. Question

2 point(s)

These are all major psychopathological risk factors for suicide among adolescents except:

Severe major depressive disorder
Attention-deficit hyperactivity disorder
Feelings of hopelessness and worthlessness
Impulsive aggression

Question 48 of 50

48. Question

2 point(s)

These are all symptoms that may indicate acute suicide risk except:

Recent conduct symptoms
Recent social withdrawal
Intoxication (alcohol, drugs)
Distress following a break up

Question 49 of 50

49. Question

2 point(s)

Acute suicide risk is not affected by:

History of major psychiatric disorder present
Ability to form a therapeutic alliance with the clinician
Availability of social and family support
Being from a disadvantaged neighbourhood

Question 50 of 50

50. Question

2 point(s)

All these are helpful messages to a suicidal youth except:

“My main concern is your safety, and I will try to ensure that the best way I can”
“Don’t worry about these ideas, they go away with time”
“Almost every decision you make can be changed. However, death is final and irrevocable. It’s worth taking enough time to balance the pros and cons”
“I would like to know more about you”. Together we may get to understand the circumstances that placed you in this situation”