Question 1
A patient believes that insignificant remarks and events in their environment have a personal meaning directed at them. This false belief is best described as which of the following?
A) Delusion of Grandiosity B) Delusion of Reference C) Thought Broadcasting D) Thought Insertion E) Nihilistic Delusion
Answer
B) Delusion of Reference
Explanation: Source defines Delusion of Reference as "A false belief that insignificant remarks, events, persons, or objects in one’s environment have personal meaning."
Question 2
A 30-year-old woman presents with multiple physical symptoms including abdominal pain, headache, shortness of breath, unsteadiness, palpitations, and numbness of lower limbs, which have been present for several months. Extensive investigations including ECG, X-ray, neurological examinations, and abdominal ultrasounds all show normal findings. She refuses to accept reassurance or negative test results. What is the most likely diagnosis?
A) Hypochondrial disorder B) Conversion disorder C) Malingering D) Munchausen’s syndrome E) Somatisation disorder
Answer
E) Somatisation disorder
Explanation: Source defines Somatisation disorder by "Multiple physical SYMPTOMS" and states the mnemonic "SoMatisation = So Many symptoms and investigations with no physical cause". Source adds that the "Patient refuses to accept reassurance or negative test results" and provides an example matching this scenario.
Question 3
A patient presents with a persistent belief in the presence of a serious underlying disease, such as cancer or HIV, despite multiple negative test results and reassurance from doctors. This description is most consistent with which condition?
A) Somatisation disorder B) Conversion disorder C) Hypochondrial disorder D) Factitious disorder E) Delusion of reference
Answer
C) Hypochondrial disorder
Explanation: Source defines Hypochondrial disorder as a "Persistent belief in the presence of an underlying SERIOUS DISEASE, e.g. Cancer, HIV". Source states that the "Patient again refuses to accept reassurance or negative test results" and provides examples of believing a benign lump is cancer or a minor headache is a brain tumour. Source repeats this definition and feature.
Question 4
A woman frequently presents to the hospital complaining of abdominal pain and bloody stools. She brings stool samples from home, which show blood, but is unable to produce a sample at the hospital. Her lab tests from hospital samples are normal. She has multiple surgical scars and insists on more investigations despite normal findings. What is the most likely condition?