Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Cognitive-Behavioral Therapy for Eating Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 1: Diagnostic criteria for Bulimia nervosa are all EXCEPT
- A. Lack of control over eating behaviour
- B. Self induced vomiting
- C. Presence of other psychiatric disorders (Correct Answer)
- D. Binge eating
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Presence of other psychiatric disorders***
- While psychiatric comorbidities like depression, anxiety, and substance abuse are **extremely common** in individuals with bulimia nervosa, they are **not a diagnostic criterion** for the disorder.
- The DSM-5 diagnosis of bulimia nervosa focuses specifically on **eating behaviors** (binge eating), **compensatory mechanisms** (purging/non-purging), and the impact on self-evaluation, not on the presence of co-occurring mental health conditions.
- This is the correct answer as it is **NOT** a diagnostic criterion.
*Lack of control over eating behaviour*
- This is a **core diagnostic criterion** of bulimia nervosa.
- Individuals must experience a sense of **lack of control** over eating during binge episodes (feeling unable to stop eating or control what or how much they are eating).
- This feeling of loss of control during binges is essential for diagnosis.
*Self induced vomiting*
- This is a **diagnostic criterion** as one of the inappropriate compensatory behaviors used to prevent weight gain after binge eating.
- Other compensatory behaviors include misuse of laxatives, diuretics, enemas, fasting, or excessive exercise.
- At least one type of compensatory behavior must occur regularly (average of once weekly for 3 months).
*Binge eating*
- This is a **fundamental diagnostic criterion** involving eating an amount of food that is definitely larger than what most people would eat in a similar period under similar circumstances.
- Must occur in a discrete time period (e.g., within any 2-hour period) with a sense of lack of control.
- Binge episodes must occur, on average, at least once a week for 3 months for diagnosis.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 2: A 16-year-old girl has intense cravings for food and consumes large amounts of it, followed by purging behaviors. What is the most likely diagnosis?
- A. Anorexia nervosa
- B. Bulimia nervosa (Correct Answer)
- C. Major depressive disorder
- D. Binge eating disorder
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Bulimia nervosa***
- **Bulimia nervosa** is characterized by recurrent episodes of **binge eating** (consuming large amounts of food with a sense of lack of control), followed by inappropriate **compensatory behaviors** such as self-induced vomiting, laxative abuse, or excessive exercise.
- The patient's presentation of "intense cravings for food," consuming "large amounts," and "purging behaviors" directly aligns with DSM-5 diagnostic criteria for bulimia nervosa.
- Peak onset is typically in **adolescence and early adulthood**, and it is more common in females.
*Anorexia nervosa*
- **Anorexia nervosa** is primarily characterized by **restriction of energy intake** leading to significantly low body weight, intense fear of gaining weight, and disturbance in body image.
- While the binge-eating/purging subtype of anorexia exists, the defining feature is **persistent restriction** and significantly **low body weight**, which is not mentioned in this clinical scenario.
*Major depressive disorder*
- **Depression** is a mood disorder with persistent sadness, anhedonia, and neurovegetative symptoms.
- While depression commonly co-occurs with eating disorders and may cause appetite changes, the specific cyclical pattern of **binge eating followed by compensatory purging** is not a characteristic feature of depression itself.
*Binge eating disorder*
- **Binge eating disorder** involves recurrent episodes of consuming large amounts of food with a sense of lack of control, accompanied by marked distress.
- The key distinguishing feature is the **absence of regular compensatory behaviors** (purging, excessive exercise, fasting) that are present in bulimia nervosa.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 3: Best therapy suited to teach daily life skills to a child with intellectual disability:
- A. Applied Behavior Analysis (ABA) (Correct Answer)
- B. Cognitive Behavioral Therapy (CBT)
- C. Social skills training
- D. Self-instructional training
Cognitive-Behavioral Therapy for Eating Disorders Explanation: **Applied Behavior Analysis (ABA)**
- **ABA** is a highly structured, evidence-based therapy that focuses on teaching specific skills by breaking them down into smaller steps and using **positive reinforcement**.
- It is particularly effective for children with intellectual disabilities in acquiring **adaptive daily living skills**, communication, and social behaviors.
*Cognitive Behavioral Therapy (CBT)*
- **CBT** primarily targets changing negative thought patterns and behaviors, requiring a level of abstract reasoning that may be challenging for children with significant intellectual disabilities.
- While it can be adapted, its core methods rely on cognitive processes that might not be the most direct approach for teaching basic daily life skills to a mentally challenged child.
*Social skills training*
- **Social skills training** focuses specifically on improving social interactions and communication within social contexts.
- While important for overall development, it is a subcomponent of broader skill development and may not directly address all aspects of **daily living skills** in a comprehensive manner.
*Self-instructional training*
- **Self-instructional training** involves teaching individuals to guide themselves through tasks using internal speech or self-talk, which relies on a child's ability to internalize and follow complex verbal instructions.
- This approach might be too cognitively demanding for a child with significant developmental delays when the primary goal is mastering basic, functional daily life skills.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 4: Bulimia nervosa is treated with
- A. Clozapine
- B. Reserpine
- C. Pimozide
- D. Escitalopram (Correct Answer)
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Escitalopram***
- **SSRIs** like escitalopram are considered first-line pharmacological treatment for **bulimia nervosa**, especially when combined with **psychotherapy**.
- They help reduce the frequency of **binge-eating** and **purging** episodes by modulating serotonin levels.
*Clozapine*
- This is an **atypical antipsychotic** primarily used for **treatment-resistant schizophrenia**.
- It has significant side effects, including **agranulocytosis**, and is not indicated for eating disorders.
*Reserpine*
- An **antihypertensive** and **antipsychotic** drug that depletes catecholamines and serotonin from central neurons.
- Due to its severe side effects, including **depression** and **parkinsonism**, it is rarely used today and not for eating disorders.
*Pimozide*
- A **first-generation antipsychotic** specifically approved for treating **Tourette's syndrome** but sometimes used off-label for severe tics.
- It is not indicated for the treatment of bulimia nervosa and may carry significant **cardiac side effects**.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 5: 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)
Cognitive-Behavioral Therapy for 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.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 6: A young girl hospitalised with anorexia nervosa is on treatment. Even after taking adequate food according to the recommended diet plan for last 1 week, there is no gain in weight. What is the next step in management:
- A. Increase the caloric intake from 1500 kcal to 2000 kcal per day
- B. Increase fluid intake
- C. Increase the dose of anxiolytics
- D. Observe patient for 2 hours after meal (Correct Answer)
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Observe patient for 2 hours after meal***
- Patients with **anorexia nervosa** often engage in compensatory behaviors like **purging** or extensive exercise, which would counteract the effects of increased caloric intake and lead to a lack of weight gain despite consuming an "adequate" diet.
- Observing the patient post-meal helps identify these behaviors and ensures that the ingested calories are actually being retained and utilized for weight restoration.
*Increase the caloric intake from 1500 kcal to 2000 kcal per day*
- Increasing caloric intake is a valid long-term strategy but is not the immediate next step when there's **no weight gain despite adequate intake**; the primary concern is identifying *why* the initial intake isn't leading to weight gain.
- Doing so without addressing potential compensatory behaviors might only increase patient distress or lead to more intense purging/exercise.
*Increase fluid intake*
- While adequate **hydration** is important, it does not directly address the issue of **lack of weight gain** in anorexia nervosa, which is fundamentally a caloric deficit problem.
- Increased fluid intake would not provide the necessary calories for weight restoration.
*Increase the dose of anxiolytics*
- Anxiolytics may help manage **anxiety** related to eating, but they do not directly promote **weight gain** or prevent compensatory behaviors.
- This step does not address the core issue of why the recommended diet is not leading to weight gain.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 7: Management of a violent patient in psychiatry includes all except:
- A. CBT (Correct Answer)
- B. Haloperidol
- C. ECT
- D. BZD
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***CBT***
- **Cognitive Behavioral Therapy (CBT)** is a long-term psychological intervention aimed at changing maladaptive thought patterns and behaviors. It is **not suitable for immediate management** of an acutely violent patient.
- While CBT can be beneficial for aggression management in a stable patient, it requires patient cooperation, cognitive engagement, and time, which are not available during a **violent psychiatric emergency**.
*Haloperidol*
- **Haloperidol** is a potent typical antipsychotic frequently used in acute settings for rapid tranquilization of violent or severely agitated patients.
- It is effective in reducing **psychosis-related agitation** and can be administered **intramuscularly** for quick onset of action.
- Often used in combination with benzodiazepines for optimal control of acute violence.
*ECT*
- **Electroconvulsive Therapy (ECT)** may be considered in **severe, treatment-resistant cases** of violence associated with conditions like uncontrolled mania, catatonic excitement, or psychotic depression when pharmacological interventions have failed.
- While not used for immediate acute management due to logistical requirements (consent, anesthesia, specialized setup), it can be an effective option for severe psychiatric conditions with persistent violence.
- It works by inducing a brief controlled seizure, which can rapidly alleviate severe symptoms.
*BZD*
- **Benzodiazepines (BZDs)** like lorazepam or diazepam are **first-line agents** in the acute management of violent or agitated patients due to their rapid anxiolytic, sedative, and muscle relaxant properties.
- They are particularly useful for **calming acute agitation** and are often combined with antipsychotics for rapid tranquilization.
- Can be administered intramuscularly or intravenously for quick action in psychiatric emergencies.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 8: Which of the following is FALSE regarding Anorexia Nervosa:
- A. Decreased appetite (Correct Answer)
- B. Body image distortion
- C. Vigor exceeding physical ill being
- D. Weight loss
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Decreased appetite***
- Patients with anorexia nervosa typically experience **increased hunger** and **preoccupation with food**, despite efforts to restrict intake, rather than a decreased appetite.
- The sensation of hunger often intensifies due to severe caloric restriction, making the statement "decreased appetite" false.
*Body image distortion*
- This is a core diagnostic criterion of anorexia nervosa, where individuals perceive themselves as **overweight** even when they are severely underweight.
- The distorted body image drives their relentless pursuit of thinness and fear of weight gain.
*Vigor exceeding physical ill being*
- Patients with anorexia nervosa often display surprising **energy and hyperactivity** despite severe physical debilitation and malnutrition.
- This "vigor" can be a mechanism to burn calories, suppress hunger, or avoid rest, exceeding what would be expected given their poor health status.
*Weight loss*
- **Significant weight loss** or failure to gain weight during growth is a defining characteristic of anorexia nervosa.
- This weight loss is intentionally achieved through severe dietary restriction, excessive exercise, or purging behaviors.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 9: Laser uvulopalatoplasty is indicated for which of the following conditions?
- A. Obstructive sleep apnea (Correct Answer)
- B. Pharyngotonsillitis
- C. Cleft palate
- D. Stammering
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***Obstructive sleep apnea***
- **Laser uvulopalatoplasty (LUP)** is a surgical procedure that reshapes the **uvula** and **soft palate** to enlarge the airway in patients with **obstructive sleep apnea (OSA)**.
- OSA is characterized by repetitive episodes of upper airway obstruction during sleep, leading to snoring, daytime sleepiness, and other health issues.
*Pharyngotonsillitis*
- This condition involves inflammation of the **pharynx** and **tonsils**, usually caused by bacterial or viral infections.
- Treatment typically involves antibiotics for bacterial infections or symptomatic relief for viral infections, not surgical reshaping of the palate.
*Cleft palate*
- **Cleft palate** is a congenital birth defect where the roof of the mouth does not fully close during fetal development.
- The primary treatment involves **surgical repair** to close the opening, which is a different procedure from LUP and focuses on reconstructing normal anatomy.
*Stammering*
- **Stammering** is a **speech disorder** characterized by disruptions in fluency, such as repetitions, prolongations, or blocks in speech.
- It is managed through **speech therapy** and behavioral interventions, and is unrelated to airway obstruction or surgical procedures on the palate.
Cognitive-Behavioral Therapy for Eating Disorders Indian Medical PG Question 10: Which of the following is not a known cause of neuroregression in children?
- A. Vitamin B12 deficiency
- B. Ataxia telangiectasia
- C. ADHD (Correct Answer)
- D. Wilson's disease
Cognitive-Behavioral Therapy for Eating Disorders Explanation: ***ADHD***
- **Attention-deficit/hyperactivity disorder (ADHD)** is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. It is **not** a cause of neuroregression.
- While ADHD can impact cognitive and behavioral functioning, it does not involve a loss of previously acquired developmental milestones or skills.
*Wilson's disease*
- **Wilson's disease** is an inherited disorder that causes **copper accumulation** in organs, particularly the liver and brain.
- Neurological symptoms, including **neuroregression**, can occur due to copper toxicity in the central nervous system.
*Vitamin B12 deficiency*
- **Vitamin B12 deficiency** can lead to neurological complications such as **subacute combined degeneration** of the spinal cord and peripheral neuropathy.
- In children, severe or prolonged deficiency can impair brain development and lead to **developmental regression**.
*Ataxia telangiectasia*
- **Ataxia telangiectasia** is a rare, neurodegenerative, inherited disease that affects multiple body systems.
- It is characterized by progressive **cerebellar ataxia**, leading to **neuroregression** and intellectual disability over time.
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