Controversy 1:

All of the following are common etiologies of delirium except:
a) Hyperthyroidism
b) Hypothyroidism
c) Hyperparathyroidism
d) Hypoparathyroidism


Difficult to say what was the answer considered by the examiner.

As per three sources – Kaplan’s Synopsis, Uptodate and Lishman’s Organic Psychiatry all the 4 can cause Delirium. Hence, best to avoid answering this question.

Controversy 2:

OCD is a disorder of :
a) Thought form
b) Thought stream
c) Thought possession
d) Thought content


Difficult to say what was the source the examiner would have considered.

OCD is possession of thought disorder, as per psychopathology books. As per Kaplan, it is given as content disorder. So, it is debatable based on the source. I shall go with POSSESSION, as per FISH psychopathology book.

Controversy: 3

A 26-year-old patient female presents with the history of excessive cheerfulness, increase activity levels, excessive talking, lack of sleep for the last 10 days. Which of the following drugs would best treat this patient ?

A. Lithium
B. Carbamazepine
C. Lorazepam
D. Haloperidol


Current guidelines recommend antipsychotics as first line treatment of acute mania.

The possible reason this question might be marked by some guides as Lithium is because, the source might referring to older management strategies. This is assumed because Haloperidol is given as choice. May be the guide updates the question at sometime, the answer would change to antipsychotic.

Controversy: 4

In Alzheimer’s disease (AD) which of the following is not seen:


Alzheimer Disease is a neurodegenerative disease, which can affect many areas of brain over a period of time. Hence, all the 4 components mentioned can be seen in Alzheimer disease.

If you have to choose one answer out of the 4, then go for Acalculia. The reason being Kaplan and Sadock in the whole chapter on neurocognitive disorders does not speak about acalculia. Moreover there is a line in Kaplan and Sadock quoted as “The cortical dementias occur in dementia of the Alzheimer type, Creutzfeldt–Jakob disease (CJD), and Pick disease, which frequently manifests aphasia, agnosia, and apraxia”.

Controversy: 5

The Digit Repetition Test is used to assess
Immediate Memory


Digit Span Test can check for attention, concentration and immediate memory components.
Serial subtraction test can check for attention, concentration and immediate memory components.

Cognitive components do overlap and hence the confusion in some Qbanks/resources.

In MMSE, serial subtraction test is used to assess attention. Hence, good to consider attention as answer for serial subtraction test.

Immediate memory is assessed in various intelligence by doing the digit repetition test. Hence, for immediate memory it is good to consider digit repetition test.