Eating Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Eating Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Eating Disorders Indian Medical PG Question 1: A young lady presents with a history of repeated episodes of overeating followed by purging using laxatives. She is probably suffering from -
- A. Binge eating disorder
- B. Schizophrenia
- C. Anorexia nervosa
- D. Bulimia nervosa (Correct Answer)
Eating Disorders Explanation: ***Bulimia nervosa***
- This condition is characterized by recurrent episodes of **binge eating** followed by inappropriate compensatory behaviors like **purging (e.g., laxative use)**, self-induced vomiting, excessive exercise, or fasting.
- The patient's presentation of repeated overeating followed by purging with laxatives directly aligns with the diagnostic criteria for **bulimia nervosa**.
*Binge eating disorder*
- While it involves recurrent episodes of **binge eating**, it **does not include** the regular use of inappropriate compensatory behaviors such as purging.
- Individuals with binge eating disorder typically experience significant distress about their binging but do not attempt to undo the caloric intake.
*Schizophrenia*
- This is a severe mental disorder characterized by **distortions in thinking, perception, emotions, language, sense of self, and behavior**, such as hallucinations and delusions.
- It is a **psychotic disorder** and does not involve specific eating patterns or purging behaviors.
*Anorexia nervosa*
- This eating disorder is characterized by a persistent restriction of energy intake leading to a **significantly low body weight**, an intense **fear of gaining weight**, and a distorted body image.
- Although some individuals with anorexia nervosa may engage in binge-purging type behavior, the primary defining feature is **significantly low body weight**, which is not mentioned in the patient's presentation.
Eating Disorders Indian Medical PG Question 2: Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?
- A. Anorexia nervosa
- B. Bulimia nervosa (Correct Answer)
- C. Binge eating disorder
- D. Night eating syndrome
Eating Disorders Explanation: ***Bulimia nervosa***
- This disorder is characterized by recurrent episodes of **binge eating** followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise, while the individual generally maintains a **normal body weight**.
- The key differentiator from anorexia nervosa is the **normal weight** and the cyclical pattern of binging and compensatory behaviors.
- According to **DSM-5 criteria**, bulimia nervosa requires both binge eating episodes and inappropriate compensatory behaviors occurring at least once weekly for 3 months.
*Anorexia nervosa*
- This eating disorder is primarily characterized by an intense fear of gaining weight, leading to **severe restriction of food intake** and significantly **low body weight**.
- Individuals with anorexia nervosa do not maintain a normal weight; rather, their weight is often **below minimally normal** (BMI < 18.5 kg/m² in adults).
*Binge eating disorder*
- This disorder involves recurrent episodes of **binge eating**, defined as consuming an unusually large amount of food in a short period with a sense of loss of control, but it does **not involve recurrent compensatory behaviors** like purging.
- Individuals with binge eating disorder are often **overweight or obese**, contrasting with the normal weight seen in bulimia nervosa.
*Night eating syndrome*
- This disorder is characterized by recurrent episodes of **nighttime eating** (consuming food after evening meal or upon awakening from sleep) with full awareness.
- Unlike bulimia nervosa, it does **not involve binge eating** in the classic sense, and there are **no compensatory behaviors** like purging or excessive exercise.
- Individuals may maintain normal weight but the eating pattern is distinctly different from the binge-purge cycle.
Eating Disorders Indian Medical PG Question 3: Which of the following conditions is characterised by episodes of excessive and uncontrolled eating?
- A. Bulimia nervosa (Correct Answer)
- B. Body dysmorphobia
- C. Anorexia nervosa
- D. All of the options
Eating Disorders Explanation: **Bulimia nervosa**
- This condition is characterized by recurrent episodes of **binge eating**, which involve consuming an unusually large amount of food in a short period and feeling a lack of control over eating during the episode.
- These episodes are followed by inappropriate compensatory behaviors to prevent weight gain, such as **self-induced vomiting**, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
*Body dysmorphobia*
- This is a mental disorder characterized by a persistent and intrusive preoccupation with an imagined or slight defect in one's **physical appearance**.
- It does not involve episodes of excessive and uncontrolled eating, but rather focuses on perceived flaws that are often unnoticeable to others.
*Anorexia nervosa*
- This eating disorder is characterized by an intense fear of gaining weight and a **distorted body image**, leading to severe restriction of food intake.
- While there may be episodes of binge eating in a subtype of anorexia nervosa (binge-eating/purging type), the primary characteristic is a persistent restriction of energy intake leading to a significantly low body weight.
*All of the options*
- This is incorrect as only bulimia nervosa is primarily characterized by episodes of excessive and uncontrolled eating.
- The other conditions listed do not fit this description.
Eating Disorders Indian Medical PG Question 4: True about anorexia nervosa is all except ?
- A. Amenorrhea starts before severe loss of weight
- B. More common in females than males
- C. Self-induced vomiting
- D. Binge eating is common (Correct Answer)
Eating Disorders Explanation: ***Binge eating is common***
- **Binge eating** is NOT common in all cases of anorexia nervosa
- It occurs only in the **binge-eating/purging subtype**, which represents approximately **50% of cases**
- The **restricting subtype** (the other ~50%) does NOT involve binge eating episodes
- Characterizing binge eating as "common" in anorexia nervosa overall is **inaccurate** and misleading
*Amenorrhea starts before severe loss of weight*
- This statement is **TRUE** - amenorrhea can and often does occur **before or concurrently** with significant weight loss in anorexia nervosa
- **Hypothalamic-pituitary-gonadal axis dysfunction** occurs early in the disease process
- Studies demonstrate that **hormonal changes** leading to amenorrhea can precede marked weight loss
- DSM-5 removed amenorrhea as a required diagnostic criterion partly due to variable timing
*More common in females than males*
- **TRUE** - Anorexia nervosa has significantly higher prevalence in **females** compared to males
- Female-to-male ratio is approximately **10:1**
- This gender disparity is consistent across various populations
*Self-induced vomiting*
- **TRUE** - Self-induced vomiting is a common compensatory behavior in the **binge-eating/purging subtype** of anorexia nervosa
- Used to prevent weight gain and maintain control over body weight
- Represents a purging behavior alongside laxative/diuretic abuse and excessive exercise
Eating Disorders Indian Medical PG Question 5: In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?
- A. Acrodermatitis enteropathica (Correct Answer)
- B. Pellagra
- C. Riboflavin deficiency
- D. Kwashiorkor
Eating Disorders Explanation: ***Acrodermatitis enteropathica***
- This condition is a **zinc deficiency** syndrome, which can be either inherited or acquired.
- It presents with a classic triad of **diarrhoea**, **dermatitis** (often periorificial and acral with moist, crusted lesions), and **alopecia**.
- The **perianal moist crust** is a characteristic finding of the periorificial dermatitis seen in this condition.
*Pellagra*
- Pellagra is caused by **niacin (Vitamin B3) deficiency** and is characterized by the "4 D's": **dermatitis** (often sun-exposed areas), **diarrhoea**, **dementia**, and eventually death.
- The dermatitis of pellagra is typically **symmetrical, hyperpigmented, and photosensitive**, not moist perianal crusts, differentiating it from the presented case.
*Riboflavin deficiency*
- **Riboflavin deficiency** typically manifests as **cheilosis**, angular stomatitis, glossitis, and seborrheic dermatitis, but not specifically perianal moist crusts with diarrhoea.
- While it can affect mucous membranes, the specific perianal presentation with diarrhoea points away from this diagnosis.
*Kwashiorkor*
- **Kwashiorkor** is a form of protein-energy malnutrition that can present with **diarrhoea** and skin changes (flaky paint dermatosis, hypopigmentation).
- However, the skin changes are typically **desquamating** and affect dependent areas, not the characteristic **moist, crusted periorificial lesions** seen in zinc deficiency.
- Kwashiorkor also typically presents with **edema**, which is not mentioned in this case.
Eating Disorders Indian Medical PG Question 6: Which is true about an infant with failure to thrive and the following findings?
- A. Hypokalemia
- B. Metabolic alkalosis
- C. Increased urinary sodium (Correct Answer)
- D. Increased cortisol
Eating Disorders Explanation: ***Increased urinary sodium***
- This image displays an infant with **ambiguous genitalia**, specifically severe clitoromegaly. This is a classic presentation of **congenital adrenal hyperplasia (CAH)** due to **21-hydroxylase deficiency**.
- In salt-wasting CAH, deficient **aldosterone** production leads to **renal sodium loss**, resulting in increased urinary sodium, **hyponatremia**, and **hypotension**, contributing to failure to thrive.
*Hypokalemia*
- **Hypokalemia** is not typically seen in salt-wasting CAH; rather, **hyperkalemia** is more common due to the lack of aldosterone's mineralocorticoid effect, which normally promotes potassium excretion.
- The absence of aldosterone causes sodium to be excreted and potassium to be retained.
*Metabolic alkalosis*
- **Metabolic alkalosis** is not characteristic of salt-wasting CAH; instead, these infants often develop **metabolic acidosis** due to the loss of sodium bicarbonate and impaired acid excretion.
- The primary electrolyte disturbance points towards acidosis, not alkalosis.
*Increased cortisol*
- In 21-hydroxylase deficiency, the enzyme responsible for converting precursors to **cortisol** and aldosterone is deficient, leading to **decreased cortisol** production.
- The adrenal glands instead shunt precursors towards androgen synthesis, causing **adrenal hyperplasia** and the virilization seen in the image.
Eating Disorders Indian Medical PG Question 7: Severe hypothermia in a neonate is defined by a temperature below which of the following?
- A. < 35 °C
- B. < 34 °C
- C. < 33 °C
- D. < 32 °C (Correct Answer)
Eating Disorders Explanation: ***< 32 °C***
- Severe hypothermia in neonates is defined by a body temperature falling below **32 °C** according to WHO classification.
- This level of hypothermia is associated with significant physiological compromise including bradycardia, hypoglycemia, metabolic acidosis, and coagulopathy.
- Requires immediate and aggressive warming interventions with continuous monitoring of vital signs and blood glucose.
*< 35 °C*
- A temperature below 35 °C falls into the **moderate hypothermia** range (32-35.9°C) in neonates, not mild.
- While serious and requiring active warming, it is not classified as severe hypothermia.
- May present with lethargy, poor feeding, and peripheral vasoconstriction.
*< 34 °C*
- A temperature below 34 °C is also within the **moderate hypothermia** category.
- More concerning than temperatures closer to 35°C but does not meet the threshold for severe hypothermia.
- Requires active warming and close monitoring but typically less aggressive than severe hypothermia management.
*< 33 °C*
- A temperature below 33 °C remains in the **moderate hypothermia** range, approaching the severe threshold.
- While clinically significant, the WHO classification defines severe hypothermia specifically as <32°C.
- The distinction is important for determining the urgency and intensity of warming protocols.
Eating Disorders Indian Medical PG Question 8: Costochondral junction swelling is seen in which of the following conditions?
- A. Scurvy
- B. Rickets
- C. Chondrodystrophy
- D. All of the above (Correct Answer)
Eating Disorders Explanation: **Explanation:**
Swelling of the costochondral junctions, clinically referred to as a "rosary," is a classic physical finding in pediatric medicine. While most commonly associated with Rickets, it occurs in several distinct pathologies due to different underlying mechanisms.
1. **Rickets (Rachitic Rosary):** This is the most common cause. It occurs due to the failure of osteoid mineralization, leading to an overgrowth of cartilaginous tissue and uncalcified osteoid at the growth plate. The swelling is typically **painless, rounded, and knobby.**
2. **Scurvy (Scorbutic Rosary):** Vitamin C deficiency leads to defective collagen synthesis and failure of osteoid formation. This results in the "subluxation" of the sternum backward, creating a sharp, **step-off deformity** at the costochondral junction. Unlike Rickets, the scorbutic rosary is often **exquisitely tender.**
3. **Chondrodystrophy (e.g., Achondroplasia):** In various skeletal dysplasias, abnormal endochondral ossification leads to a compensatory enlargement of the costochondral junctions.
**Clinical Pearls for NEET-PG:**
* **Rachitic Rosary:** Described as "knobby" or "bead-like."
* **Scorbutic Rosary:** Described as "sharp," "angular," or "step-off."
* **Harrison’s Sulcus:** A horizontal groove along the lower border of the thorax (at the insertion of the diaphragm), seen in chronic Rickets.
* **Differential Diagnosis:** Always consider **Leukemia** if costochondral swelling is accompanied by bone pain and systemic symptoms.
Since all three conditions listed can present with enlargement of the costochondral junctions, **Option D** is the correct answer.
Eating Disorders Indian Medical PG Question 9: Flag sign and flaky paint dermatitis are characteristically seen in which condition?
- A. Kwashiorkor (Correct Answer)
- B. Marasmus
- C. Pellagra
- D. Nutritional dwarfism
Eating Disorders Explanation: **Explanation:**
**Kwashiorkor** is a form of severe acute malnutrition (SAM) characterized by a relative deficiency of protein despite adequate or near-adequate caloric intake.
* **Flaky Paint Dermatitis (Crazy Paving Dermatosis):** This is the hallmark skin lesion of Kwashiorkor. It begins as erythematous patches that become hyperpigmented and dry. These patches then crack and peel off, resembling old, peeling paint, leaving behind pale or raw skin.
* **Flag Sign:** This refers to alternating bands of light (depigmented) and dark (normal) hair. The light bands represent periods of poor protein intake (reduced melanin synthesis), while dark bands represent periods of improved nutrition.
**Why other options are incorrect:**
* **Marasmus:** Caused by a total deficiency of all nutrients (calories and protein). It is characterized by severe muscle wasting, "baggy pants" appearance (loss of gluteal fat), and an "old man" facies, but lacks the edema and specific skin/hair changes of Kwashiorkor.
* **Pellagra:** Caused by Niacin (Vitamin B3) deficiency. It presents with the "3 Ds" (Dermatitis, Diarrhea, Dementia). The dermatitis is typically photosensitive (Casal’s necklace) and does not show the "flaky paint" morphology.
* **Nutritional Dwarfism:** Refers to children with chronic malnutrition who are stunted (low height-for-age) but have normal weight-for-height proportions.
**High-Yield Clinical Pearls for NEET-PG:**
* **Edema:** The essential diagnostic feature of Kwashiorkor (due to hypoalbuminemia).
* **Psychological changes:** Children with Kwashiorkor are typically apathetic and irritable, whereas marasmic children are often hungry/alert.
* **Fatty Liver:** Common in Kwashiorkor due to decreased synthesis of Apolipoprotein B-100, leading to impaired VLDL export.
Eating Disorders Indian Medical PG Question 10: Milk is deficient in which of the following?
- A. Iron and Vitamin C (Correct Answer)
- B. Iron and Vitamin A
- C. Phosphorus and Vitamin C
- D. Phosphorus and Vitamin A
Eating Disorders Explanation: **Explanation:**
Milk, particularly cow’s milk, is often described as a "near-complete food," but it has two significant nutritional deficits: **Iron and Vitamin C**.
1. **Why Iron and Vitamin C are deficient:**
* **Iron:** Milk contains very low concentrations of iron. Furthermore, the bioavailability of iron in cow's milk is poor compared to breast milk. Prolonged exclusive breastfeeding beyond six months or early introduction of cow's milk can lead to **Iron Deficiency Anemia (IDA)**.
* **Vitamin C (Ascorbic Acid):** Vitamin C is heat-labile and is largely destroyed during the pasteurization or boiling of milk. Since infants require Vitamin C for collagen synthesis and iron absorption, a diet solely based on cow's milk can lead to **Scurvy**.
2. **Analysis of Incorrect Options:**
* **Vitamin A:** Milk (especially whole milk) is a good source of fat-soluble vitamins, including Vitamin A.
* **Phosphorus:** Milk is very rich in phosphorus. In fact, the high phosphorus content in cow's milk (compared to human milk) can lead to hypocalcemic tetany in neonates because the high phosphorus load inhibits calcium absorption.
3. **NEET-PG High-Yield Pearls:**
* **Goat Milk:** Specifically deficient in **Folate** (Vitamin B9), leading to megaloblastic anemia.
* **Breast Milk vs. Cow Milk:** While both are low in iron, 50% of iron in breast milk is absorbed compared to only 10% in cow's milk.
* **Cow's Milk Protein Allergy (CMPA):** A common cause of occult GI blood loss in infants, further exacerbating iron deficiency.
* **Vitamin D:** Milk is also naturally low in Vitamin D, which is why supplementation is recommended for all breastfed infants from birth.
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