PAPER-4
DECEMBER 2020 JUNE 2020
1) What are the changes implicated in the New Mental Health Act 1) 1. Write the different types of admission as per the Mental Health
for the admission and treatment of psychiatric patients in Care Act,2017. How do you assess the capacity to make mental
teaching Institutions/Medical Colleges.5+5 healthcare and treatment decisions as part of this Act? 6+4
2) What are the major psychiatric problems surfaced in persons due 2) Role of Vitamin D in psychiatry.10
to the Corona Pandemic and how can they be managed?5+5 3) Discuss the clinical features for erectile dysfunction. What are various
3) Which cannabis derivatives are used for medicinal purpose? pharmacological treatments for erectile dysfunction and their
Discuss each derivative, with indications.4+6 common side effects?4+(4+2)
4) Recent advances in the management in OCD. 4) Write briefly the pros and cons of newer long acting antipsychotics.
5) Describe at least 3 newer Antipsychotics. Write a note on Write the dosing schedule and side effects of olanzapine pamoate.
Cariprazine.6+4 5) What is palliative care? Describe the role of psychiatrist in palliative
6) Describe at least 3 newer Antidepressants. Write a note on care? 3+7
Levomilnacipran.6+4 6) What is black box warning? Discuss the black box warnings in relation
7) Discuss advantages of Depot Antipsychotics. Compare to various psychotropic medications. 2+8
advantages/disadvantages of First Generation Depot 7) Discuss the challenges to mental health during a pandemic. How
Antipsychotics with Second Generation Depot Antipsychotics.4+6 would you meet these challenges? 5+5
8) What is Teleconsultation in Psychiatry? Discuss its indications and 8) Role of Mobile Apps in psychiatry.10
limitations.2+(4+4) 9) What are clinical practice guidelines? Discuss advantages and
9) What is Internet Gaming Disorder? Discuss its features and disadvantages of using these guidelines in clinical practice.
management.2+(4+4) 10) What is cyber bullying? Discuss various factors leading to cyber
10) Discuss the age-wise challenges of mental health of children bullying and its management.
during pandemic and how to manage them.
DECEMBER 2019 JUNE 2019
11) Discuss new antidepressants. Write a note on Vortioxetine. 11) Discuss the benefits given by the Government of India to persons
12) Write about tobacco withdrawal and recent advances in the with intellectual disability.
treatment of tobacco use disorders. 12) Discuss the role of psychiatrist in renal transplant unit.
13) Role of PET scan in evaluation of neuropsychiatric disorders with 13) What are the various sexual side-effects of antipsychotic drugs?
specific use of pharmacological and neuropsychological probes. Discuss their management.
14) What is deep brain stimulation? Write its role and outcome in 14) What is informed consent? What are its components? Discuss its
treatment of depression. relevance in patients with psychiatric disorders as compared to other
15) Write clinical features of tardive dyskinesia(TD). Write about disorders.
Deuterated tetrabenazine and Valbenazine in management of TD. 15) What is double blind drug trial? What is double blind double dummy
16) Write advantage of long acting antipsychotics. Describe the drug trial? How are they different from other clinical drug trails?
procedure of giving depot antipsychotic. Write note on 16) What is the association of schizophrenia and criminal acts?
paliperidone palmitate depot. 17) What are functional somatic symptoms? Enumerate various
17) Role of glutamate and NMDA receptors in psychiatry. medical functional syndromes and discuss one of these in brief.
18) Write about role of rTMS in psychiatric disorders and its 18) What are the various subtypes of vascular dementia? What are main
advantages over ECT. clinical features and risk factors associated with vascular dementia?
19) Write about the role of ketamine in depression - mechanism of 19) What are the clinical features of idiopathic REM sleep behavior
action, side effects and caution. disorder? What is their association with other disorders?
20) What is amotivation in Schizophrenia? Discuss its management. 20) What is multisensory therapy? Explain its application in at least two
psychiatric disorders.
DECEMBER 2018
21) What is rTMS and describe its principles? Critically review with JUNE 2018
evidence its role in the management of various psychiatric 21) What is palliative care? Discuss role of psychiatrist in palliative
disorders.1+(2+7) care.2+8
22) Etiology, clinical features and management of narcolepsy.2+4+4 22) Clinical features, comorbidity and treatment of hoarding
23) Mention some auto immune disorders with their neuro- disorder.4+3+3
psychiatric manifestations. Discuss neuro-psychiatric 23) Core and associated behavioral symptoms seen in autism spectrum
manifestations of SLE and its management. 2+(4+4) disorder.4+6
24) What is “brain- gut axis? What is probiotics? What is the probable 24) What is transcranial direct current stimulation? Discuss its
role of probiotics in preventing depression? 2+2+6 mechanism of action and role in psychiatric disorders. 3+(4+3)
25) What is Vortioxetine? Discuss about indications and mechanism of 25) What are inhalants? Discuss clinical presentation and
action of Vortioxetine.2+(3+5) management of inhalant use disorder.2+(4+4)
26) What is “Treatment Resistant Schizophrenia”? Write about 26) What is mentalization based therapy? How does it differ from
common side effects of Clozapine. What is the management of mindfulness? Briefly discuss its role in psychiatric disorders.2+4+4
clozapine Resistant Schizophrenia?3+3+4 27) What is personalised medication? Discuss its principles and
27) Describe the aims and scope of Human Brain Project & Human application in psychiatry. 2+(4+4)
Connectome Project. What could be its implication for future 28) Write briefly about the etiology of tardive dyskinesia. Discuss its
classification in Psychiatry? (4+4)+2 pharmacological management in relation to recently approved
PAPER-4 Page 1
clozapine Resistant Schizophrenia?3+3+4 27) What is personalised medication? Discuss its principles and
27) Describe the aims and scope of Human Brain Project & Human application in psychiatry. 2+(4+4)
Connectome Project. What could be its implication for future 28) Write briefly about the etiology of tardive dyskinesia. Discuss its
classification in Psychiatry? (4+4)+2 pharmacological management in relation to recently approved
28) What is Bio-feedback? Name the types and indications of Bio- drugs for its management.4+6
feedback in Psychiatry. 3+(3+4) 29) Assessment and certification of specific learning disability in India.
29) What is Gender Identity Disorder? Discuss the indication of sex 30) Define human rights. What are different rights of persons with mental
reassignment surgery. Briefly describe the role of psychiatrist in illness as per Mental Health Care Act, 2017.
the team. 3+3+4
30) Write an essay on RDoC. Review its merits and demerits. Describe JUNE 2017
its possible role in future classification. 31) a) What are the salient features of Mental Health Care Act?
b) Critical comment about advanced directives. 7+3
DECEMBER 2017 32) a) What are different psychiatric issues related with pregnancy?
31) What is epigenesis? Describe briefly the basic principles of b) Management of post partum psychosis.5+5
family studies, twin studies and adoption studies.3+(3+2+2) 33) What is stress diathesis model, and its implications in causation and
32) Define normality. Discuss the functional perspectives and prevention of psychiatric disorders? 3+7
different psycho analytic concepts of normality 2+(4+4) 34) Influence of migration and urbanization on mental health.5+5
33) What are pharmacogenomics and pharmacogenetics? 35) a) What is malingering?
What is relevance of pharmacogenetics in psychiatry?(2+2)+6 b) Challenges faced by psychiatrist in its diagnosis and management.
34) What are neuro fibrillary tangles? What are their 36) a) Management of deliberate self harm (DSH).
components? Name the sites in brain where they can be b) What is current legal status of suicide in light of Mental Health Care
seen. What is their clinical significance? 2+2+3+3 Act?
35) What is action potential? Describe the process with help of 37) a) Enumerate various screening tools for psychosis.
a diagram. How does action potential translate into b) Explain any two of them in brief 4+6
chemical neuro-transmission? 38) a) Define insomnia disorder.
36) Discuss the current status regarding definition, clinical b) How would you evaluate and treat a case of primary insomnia
features, comorbidity and management of body dysmorphic disorder? 1+(4+5)
disorders.2+3+2+3 39) a) What is obsession?
37) What is type A personality and its relationship with b) Non pharmacological management of OCD (Obssessive
cardiovascular disorders? How do you assess and manage it?2,5,3 Compulsive Disorder). 2+8
38) What are the risks of HIV patients for psychiatric 40) a) What is rTMS and its principle?
morbidity? Describe the psychiatric syndromes associated b) Its role in management of various psychiatric disorders.
with HIV and their assessment and management.2+(4+2+2)
39) What do you understand by Positron Emission Tomography (PET) JUNE 2016
and Single Photon Emission Computed Tomography (SPECT)? 41) a) What are animal research models in Psychiatry?
What are the applications of PET and SPECT in neuropsychiatric b) Animal models for anxiety disorders. 3+7
research? What are their clinical indications? 3+4+3 42) a) Classify the types of headaches.
40) What are endorphins? How are they produced in human body? b) Acute and prophylactic management of migraine. 4+(3+3)
What function do they perform? What is their clinical 43) a) Cardiac toxicity of psychotropic drugs.
significance? b) Assessment needed prior to start of anti-psychotics. 5+5
44) a) What are soft neurological signs?
DECEMBER 2016 b) Role of soft neurological signs in Psychiatry.3+7
41) What is metabolic syndrome? Give its relationship and 45) Recent advances in neurobiology of Schizophrenia with regard to
significance with antipsychotic drugs.5+5 neurotransmitters, structural and electrophysiological research.3+4+3
42) What are the advantages of MRI over SPECT? What is the role 46) a) Changes made in classification of substance use disorders in DSM-5.
of SPECT in psychiatry? 4+6 b) Critically review the changes.6+4
43) a) Categorical v/s dimensional approach in classification. 47) a) What are core symptoms of autism spectrum disorder?
b) Classificatory approach adopted by DSM-5. 6+4 b) Write the different physical and associated behavioral symptoms
44) a) Salient features of Mental Health Care Bill. that may occur in autism spectrum disorder.3+(3+4)
b) What are its advantages over its predecessor mental health 7+3 48) a) What is multidisciplinary team in relation to mental health?
45) What is stigma in psychiatry? As a psychiatrist, how can you b) Role of psychiatrist in public and community psychiatry
help to reduce and combat stigma in psychiatry. 3+7 multidisciplinary teams.3+7
46) What is Evidence-Based Medicine? What are the key skills 49) a) What is hoarding disorder?
required for the evidence based practice and what are the various b) Clinical features, co-morbidities and treatment of hoarding disorder.
methods of its practice? 2+(4+4) 50) a) What are the recommendations for pharmacological management
47) a) What is pharmacogenetics? of treatment resistant schizophrenia?
b) Its current concept and possible future use with reference to b) Side effects of clozapine and their management.
psychiatry.2+(4+4)
48) a) What is the current understanding of relationship between JUNE 2015
personality disorders and other mental disorders? 51) a) Bio-psycho-social model of schizophrenia.
b) Nosological status of Schizotypal personality disorder in ICD- b) Recent advances in genetics in aetiology of schizophrenia.5+5
10 and DSM-IV.6+4 52) a) Aetiology of depression in the background of Beck’s cognitive
49) a) What is culture? psychology.
b) Role of culture in psychiatry.2+8 b) “Mindfulness” therapy recently being practiced in depression.6+4
50) What are neurodevelopmental disorders? What are the reasons 53) a) NMDA (N methyl D aspartate) receptors.
for including ADHD in this category? b) Role of NMDA receptors in psychiatric illness. 4+6
PAPER-4 Page 2
10 and DSM-IV.6+4 52) a) Aetiology of depression in the background of Beck’s cognitive
49) a) What is culture? psychology.
b) Role of culture in psychiatry.2+8 b) “Mindfulness” therapy recently being practiced in depression.6+4
50) What are neurodevelopmental disorders? What are the reasons 53) a) NMDA (N methyl D aspartate) receptors.
for including ADHD in this category? b) Role of NMDA receptors in psychiatric illness. 4+6
54) a) Circadian rhythm.
DECEMBER 2015 b) Neuro-physiology of supra-chiasmatic nucleus.
51) a) What is Vagus-Nerve Stimulation (VNS)? c) Relevance of few psychiatric disorders of circadian rhythm.3+3+4
b) Its mechanism of action & relevance in Psychiatry. 55) a) Physiological mechanism of fMRI.
52) a) What are cognitive functions? b) Relevance of fMRI in various behavioral disorders.5+5
b) Assessment of cognitive functions with emphasis on tests 56) a) Manifestations of adult ADHD.
used in India. b) How does it differ from childhood ADHD? 5+5
53) a) What is Emotional Intelligence? 57) a) Difference between Death & Dying.
b) Its relevance in Psychiatry. b) Stages of Death & Dying by Elizabeth Kϋhler Ross. 5+5
54) a) Enumerate Newer Animal Research Studies in Psychiatry. 58) a) Modern day psycho-surgery.
b) Relevance of Animal Research in Psychiatry.4+6 b) Evaluating a patient with OCD for psycho-surgery. 5+5
55) a) Psychiatric aspects of renal transplantation. 59) a) Compliance in psychiatric practice.
b) Principles of assessment of donor and recipient in renal b) Causes of poor compliance.
transplantation.5+5 c) Newer modalities of treatment available to improve compliance in
56) a) Psycho-social aspects of adoption. schizophrenia. 3+3+4
b) Role of mental health professionals for adoption.5+5 60) a) Psycho-neuro-endocrinology.
57) a) Psychiatric aspects of infanticide. b) Relevance to causation of depression on the basis of psychoneuro-
b) Legal implications & prevention of infanticide.5+5 endocrinology.
58) a) What are pharmacogenomics & pharmacogenetics?
b) Relevance of pharmacogenomics in Psychiatry.4+6 JUNE 2014
59) a) Recent advances in assessment of psychiatric disorders. 61) What is Global Burden of Disease? Discuss contribution of mental
b) Recent advances in psychotropic drug developments.5+5 disorders to global burden and its significance.
60) a) What is Psycho-neuro-immunology? 62) What is social stigma? Discuss its causes and management in relation
b) Its relevance in Psychiatry. to Psychiatry.
63) What is functional imaging? Enumerate different types of functional
DECEMBER 2014 imaging. Discuss in brief the role of functional imaging in Psychiatry.
61) What is rTMS? Describe its role in management of specific 64) What is transcranial magnetic brain stimulation? Discuss briefly its
psychiatric disorders.10 mechanism and indications in Psychiatry.
62) Describe the provisions of proposed Mental Health Care Bill 65) What is public mental health? Discuss its scope and significance in low
which differ from the existing MHA, 1987. and middle income countries.
63) How does the diagnosis of schizophrenia differ between DSM- IV 66) What is evidence based medicine? How is it being practiced in India?
and DSM 5? Discuss briefly its limitations.
64) Describe the role of cultural factors in diagnosis and management 67) What is glutamate? Discuss its role in psychiatric disorders.
of major mental disorders. ’ 68) Write a critical evaluation of role of typical antipsychotics in
65) Describe the role of medications in management of Autism. management of schizophrenia in current practice.
66) What is motivation? How will you test it? Describe principles of 69) Who are different non-medical mental health professionals? Discuss
motivation enhancement therapy. briefly their role in mental health care.
67) What is pharmacogenetics? Describe its role in medical disorders 70) What is metabolic syndrome? Discuss its relevance in Psychiatry.
with examples.
68) What are the principles of rehabilitation in modern psychiatric
practice?
69) Discuss the techniques, applications and limitations of EEG in
Psychiatry.
70) What drugs, under NDPS Act, are preferred for palliative care?
What are the risks of their free use?
DECEMBER 2013
71) What is Chronic Fatigue Syndrome (CFS)? What are its psychiatric
correlates? How will you treat a lady suffering from CFS? 2+4+4
72) Describe the role of clozapine in treatment of schizophrenia, its
risks and benefits.
73) Describe clinical presentation, nosological status and
management of premenstrual dysphoric disorder.
74) What is somatic symptom disorder? Describe clinical features and
management of somatic symptom disorder.
75) Describe the role of physical exercise in the treatment of
psychiatric disorders.
76) Name various stages of the sexual response cycle. Describe very
briefly the disorders associated with different stages.
77) Describe the various models describing etiology of conversion
disorder.
PAPER-4 Page 3
disorder.
78) What are the diagnostic features of generalized anxiety disorder?
Describe its course and prognosis?
79) What are the theoretical principles guiding dialectical behavior
therapy (DBT)? Describe the components of DBT.
80) Define dementia. Describe different modalities of management of
cognitive impairment in Alzheimer’s dementia.
DECEMBER 2012
81) Discuss the etiology and risk factors for suicide. Briefly discuss the
management of a suicidal patient.
82) Discuss the clinical features and management of
atypical depression.
83) Discuss the prognostic factors and various outcomes
of schizophrenia.
84) Discuss the assessment and management of treatment
resistant depression.
85) What is systemic desensitization? Describe its
principles, components and applications.
86) What are the causes of lithium toxicity? Discuss the features of
lithium toxicity according to the serum levels and the treatment of
lithium toxicity.
87) What is agoraphobia? Describe briefly its prevalence,
comparative nosology and management outline.
88) What is conversion disorder? Describe briefly the
development of the concept in terms of history and its current
nosological status.
89) Discuss the cognitive - behavioral therapy (CBT) for
anxiety disorders.
90) Discuss the role of r-TMS (Repetitive Transcranial
Magnetic Stimulation) in management of psychiatric disorders.
DECEMBER 2011
91) Discuss briefly the different techniques used in the psychosocial
treatment of schizophrenia.
92) Define treatment resistant obsessive compulsive disorder and
discuss its management.
93) Discuss the biological basis of panic disorder. 10
94) What is group therapy? Write its principle components and types.
95) What is serotonin withdrawal syndrome and write its
management?
96) What is dissociative amnesia? Write in brief about its clinical
presentation, etiology and management.
97) What is akathisia? Discuss its etiology and treatment.
98) Enumerate various paraphilias and write any one in detail
99) Write about somatoform pain disorder and its management.
100) What are atypical antipsychotic drugs? Name some of the atypical
anti-psychotics effective in negative symptoms of schizophrenia.
What are their common side effects and their management?
PAPER-4 Page 4
