MRCPSYCH
PAPER A2 MOCK
EXAMINATION 1:
QUESTIONS
GET THROUGH MRCPSYCH PAPER A2:
MOCK EXAMINATION
Total number of questions: 184 (124 MCQs, 60 EMIs)
Total time provided: 180 minutes
Question 1
A 30-year-old male, a patient with antisocial personality traits, has been admitted
to the inpatient psychiatric ward. The nurses are now complaining much about
the difficulties with managing him. They are angry with him and want him to be
transferred. Which of the following psychological process is occurring?
a. Transference
b. Countertransference
c. Displacement
d. Reaction formation
e. Sublimation
Question 2
Based on epidemiological studies in the United Kingdom, which of the following is
known to be the most common methodology of committing suicide?
a. Analgesic overdose
b. Antidepressant overdose
c. Antipsychotic overdose
d. Hanging
e. Drowning
Question 3
In which of the following inherited genetic conditions would dietary restriction
and close monitoring of dietary habits be of use in terms of management?
a. Down’s syndrome
b. Hunter’s syndrome
c. Lesch–Nyhan syndrome
d. Prader–Willi syndrome
e. Turner’s syndrome
1
, Question 4
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
A 25-year-old male has tried two antipsychotic medications, but both of them did
not help him with his symptoms. The team has recommended and started him
on clozapine, with which he has not experienced much improvement still. He is
currently on clozapine 400 mg ON. Based on the guidelines, which one of the
following could be used to help him with his symptoms?
a. Continue clozapine treatment but titrate the medication to 1000 mg/day, as he
is treatment resistant.
b. Continue clozapine treatment but titrate the medication to a maximum of
900 mg/day, as he is treatment resistant.
c. Consider commencement of intramuscular depot.
d. Consider adding lithium to augment the effects of the drug.
e. Consider adding omega-3 fatty acids to enhance the effectiveness of clozapine.
Question 5
A 28-year-old male was admitted to the emergency department following a
collapse at the shopping mall. A routine CT brain was performed, and the
radiologist reported marked atrophy of the caudate nucleus. Which of the
following clinical diagnoses would be the most appropriate?
a. Alzheimer’s dementia
b. Frontotemporal dementia
c. Huntington’s disease
d. Lewy body dementia
e. Parkinsonism-related dementia
Question 6
Based on your understanding about psychotherapy, which of the following
statements about interpersonal therapy is incorrect?
a. It is focused much on the earlier childhood events that the client has
undergone.
b. It usually lasts for 16 sessions.
c. It involves dealing with grief.
d. It involves dealing with role transition.
e. It involves dealing with deficits in interpersonal relationships.
Question 7
A medical student wonders which of the following anxiety disorders would have
the earliest age of onset. The correct answer would be
a. Obsessive-compulsive disorder
b. Generalized anxiety disorder
c. Panic disorder
d. Specific phobia
e. Social phobia
Question 8
Which of the following statements about the aetiology of autism is incorrect?
a. The heritability of autism is around 50%.
b. The male to female ratio is around 4:1.
2
, c. Genetic causative factors might include a positive family history of
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
schizophrenia like psychosis or affective disorder.
d. Maternal use of sodium valproate might cause autism.
e. Perinatal injuries and antenatal infections are aetiological factors that are
responsible for the development of autism.
Question 9
It is known that some genetic disorders are caused by mutations that have occurred
in the body cells and are inherited to the next generation. Which particular type of
genetic mutation would not have an impact on the next generation?
a. Frameshift mutation
b. Missense mutation
c. Nonsense mutation
d. Polymorphic mutation
e. Somatic mutation
Question 10
In order for the transcribed RNA to be processed for translation, which of the
following must happen first?
a. The introns must be separated first.
b. There must be methylation happening to the start end of the transcribed RNA.
c. There must be methylation happening to the tail end of the transcribed RNA.
d. There must be the splicing of the cap of the transcribed RNA.
e. There must be splicing and methylation of the cap of the transcribed RNA.
Question 11
Which of the following therapies would be the most effective for a patient with
obsessive-compulsive disorder, whose main fears are that of contamination and
compulsions are that of repeated washing?
a. Exposure and response prevention
b. Flooding
c. Cognitive analytical therapy
d. Rational emotive behavioural therapy
e. Interpersonal therapy
Question 12
A 28-year-old female just had a recent first episode of schizophrenia and she
has been concordant with her medications since discharge. Her mother is
worried about the long-term side effects of the medication and wanted to know
for how long pharmacological treatment should be continued. The correct
answer would be
a. For 3 months
b. For 6 months
c. For at least 1 year
d. For more than 2 years
e. For life
3
, Question 13
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
In which of the following conditions would there be the presence of eosinophilic
inclusion with high amyloid content in the cingulated gyrus?
a. Alzheimer’s disease
b. Frontotemporal dementia
c. Vascular dementia
d. Lewy body dementia
e. Parkinsonism dementia
Question 14
A 22-year-old male would like to have some help with regards to his alcohol
addiction issues. He has read about ‘disulfiram’ and is wondering how this
medication can help him. What is the mechanism of action of the drug?
a. It is an aversive agent which inhibits aldehyde dehydrogenase 2 (ALDH2), thus
leading to acetaldehyde accumulation after drinking alcohol.
b. It works as a GABA agonist and glutamate antagonist.
c. It inactivates the N-methyl-d-aspartate (NMDA) receptors and helps to
prevent calcium influx.
d. It is an opioid antagonist.
e. It is a dopamine antagonist.
Question 15
For a patient with OCD, whose main obsessions are that of fears of contamination
and main compulsions are that of repeated washing, which of the following
correctly describes how exposure and response prevention would help?
a. Therapist telling the patient to keep using deep breathing when she is anxious
b. Therapist challenging the automatic thoughts of the patient
c. Therapist telling the patient to intentionally touch something contaminated,
but preventing her from doing her usual compulsion
d. Therapist gradually limiting the number of times the patient is allowed to
perform the compulsion
e. Therapist advising the patient to consider other forms of distractions when she
is compelled to perform her compulsions
Question 16
Genetic studies have identified that trinucleotide repeat expansions are responsible
for the following genetic disorder:
a. Down’s syndrome
b. Fragile X syndrome
c. Lewy body dementia
d. Rett syndrome
e. Turner syndrome
Question 17
A 27-year-old female has bipolar disorder and is currently on treatment. She
presented to the emergency department with the following symptoms: nausea,
diarrhoea and coarse tremors. She claimed that she has just seen her GP last week
4
PAPER A2 MOCK
EXAMINATION 1:
QUESTIONS
GET THROUGH MRCPSYCH PAPER A2:
MOCK EXAMINATION
Total number of questions: 184 (124 MCQs, 60 EMIs)
Total time provided: 180 minutes
Question 1
A 30-year-old male, a patient with antisocial personality traits, has been admitted
to the inpatient psychiatric ward. The nurses are now complaining much about
the difficulties with managing him. They are angry with him and want him to be
transferred. Which of the following psychological process is occurring?
a. Transference
b. Countertransference
c. Displacement
d. Reaction formation
e. Sublimation
Question 2
Based on epidemiological studies in the United Kingdom, which of the following is
known to be the most common methodology of committing suicide?
a. Analgesic overdose
b. Antidepressant overdose
c. Antipsychotic overdose
d. Hanging
e. Drowning
Question 3
In which of the following inherited genetic conditions would dietary restriction
and close monitoring of dietary habits be of use in terms of management?
a. Down’s syndrome
b. Hunter’s syndrome
c. Lesch–Nyhan syndrome
d. Prader–Willi syndrome
e. Turner’s syndrome
1
, Question 4
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
A 25-year-old male has tried two antipsychotic medications, but both of them did
not help him with his symptoms. The team has recommended and started him
on clozapine, with which he has not experienced much improvement still. He is
currently on clozapine 400 mg ON. Based on the guidelines, which one of the
following could be used to help him with his symptoms?
a. Continue clozapine treatment but titrate the medication to 1000 mg/day, as he
is treatment resistant.
b. Continue clozapine treatment but titrate the medication to a maximum of
900 mg/day, as he is treatment resistant.
c. Consider commencement of intramuscular depot.
d. Consider adding lithium to augment the effects of the drug.
e. Consider adding omega-3 fatty acids to enhance the effectiveness of clozapine.
Question 5
A 28-year-old male was admitted to the emergency department following a
collapse at the shopping mall. A routine CT brain was performed, and the
radiologist reported marked atrophy of the caudate nucleus. Which of the
following clinical diagnoses would be the most appropriate?
a. Alzheimer’s dementia
b. Frontotemporal dementia
c. Huntington’s disease
d. Lewy body dementia
e. Parkinsonism-related dementia
Question 6
Based on your understanding about psychotherapy, which of the following
statements about interpersonal therapy is incorrect?
a. It is focused much on the earlier childhood events that the client has
undergone.
b. It usually lasts for 16 sessions.
c. It involves dealing with grief.
d. It involves dealing with role transition.
e. It involves dealing with deficits in interpersonal relationships.
Question 7
A medical student wonders which of the following anxiety disorders would have
the earliest age of onset. The correct answer would be
a. Obsessive-compulsive disorder
b. Generalized anxiety disorder
c. Panic disorder
d. Specific phobia
e. Social phobia
Question 8
Which of the following statements about the aetiology of autism is incorrect?
a. The heritability of autism is around 50%.
b. The male to female ratio is around 4:1.
2
, c. Genetic causative factors might include a positive family history of
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
schizophrenia like psychosis or affective disorder.
d. Maternal use of sodium valproate might cause autism.
e. Perinatal injuries and antenatal infections are aetiological factors that are
responsible for the development of autism.
Question 9
It is known that some genetic disorders are caused by mutations that have occurred
in the body cells and are inherited to the next generation. Which particular type of
genetic mutation would not have an impact on the next generation?
a. Frameshift mutation
b. Missense mutation
c. Nonsense mutation
d. Polymorphic mutation
e. Somatic mutation
Question 10
In order for the transcribed RNA to be processed for translation, which of the
following must happen first?
a. The introns must be separated first.
b. There must be methylation happening to the start end of the transcribed RNA.
c. There must be methylation happening to the tail end of the transcribed RNA.
d. There must be the splicing of the cap of the transcribed RNA.
e. There must be splicing and methylation of the cap of the transcribed RNA.
Question 11
Which of the following therapies would be the most effective for a patient with
obsessive-compulsive disorder, whose main fears are that of contamination and
compulsions are that of repeated washing?
a. Exposure and response prevention
b. Flooding
c. Cognitive analytical therapy
d. Rational emotive behavioural therapy
e. Interpersonal therapy
Question 12
A 28-year-old female just had a recent first episode of schizophrenia and she
has been concordant with her medications since discharge. Her mother is
worried about the long-term side effects of the medication and wanted to know
for how long pharmacological treatment should be continued. The correct
answer would be
a. For 3 months
b. For 6 months
c. For at least 1 year
d. For more than 2 years
e. For life
3
, Question 13
MRCPSYCH PAPER A2 MOCK EXAMINATION 1: QUESTIONS
In which of the following conditions would there be the presence of eosinophilic
inclusion with high amyloid content in the cingulated gyrus?
a. Alzheimer’s disease
b. Frontotemporal dementia
c. Vascular dementia
d. Lewy body dementia
e. Parkinsonism dementia
Question 14
A 22-year-old male would like to have some help with regards to his alcohol
addiction issues. He has read about ‘disulfiram’ and is wondering how this
medication can help him. What is the mechanism of action of the drug?
a. It is an aversive agent which inhibits aldehyde dehydrogenase 2 (ALDH2), thus
leading to acetaldehyde accumulation after drinking alcohol.
b. It works as a GABA agonist and glutamate antagonist.
c. It inactivates the N-methyl-d-aspartate (NMDA) receptors and helps to
prevent calcium influx.
d. It is an opioid antagonist.
e. It is a dopamine antagonist.
Question 15
For a patient with OCD, whose main obsessions are that of fears of contamination
and main compulsions are that of repeated washing, which of the following
correctly describes how exposure and response prevention would help?
a. Therapist telling the patient to keep using deep breathing when she is anxious
b. Therapist challenging the automatic thoughts of the patient
c. Therapist telling the patient to intentionally touch something contaminated,
but preventing her from doing her usual compulsion
d. Therapist gradually limiting the number of times the patient is allowed to
perform the compulsion
e. Therapist advising the patient to consider other forms of distractions when she
is compelled to perform her compulsions
Question 16
Genetic studies have identified that trinucleotide repeat expansions are responsible
for the following genetic disorder:
a. Down’s syndrome
b. Fragile X syndrome
c. Lewy body dementia
d. Rett syndrome
e. Turner syndrome
Question 17
A 27-year-old female has bipolar disorder and is currently on treatment. She
presented to the emergency department with the following symptoms: nausea,
diarrhoea and coarse tremors. She claimed that she has just seen her GP last week
4
