NEET-PG 2012 — Psychiatry
24 Previous Year Questions with Answers & Explanations
What is the code for mental disorders in the ICD-10 classification?
According to the classical monoamine hypothesis of depression, deficiency of which of the following neurotransmitters is MOST commonly emphasized in modern antidepressant therapy?
In the context of understanding patient behavior and therapeutic relationships, what is the definition of social psychology?
Muttering delirium is seen with: NEET 13
What are the homes called where children are placed under the care of doctors and psychiatrists?
What is the most commonly abused drug in India?
Formication is primarily associated with which condition?
Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:
Which of the following factors is most commonly associated with suicidal tendencies?
What is the definition of phobia?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1: What is the code for mental disorders in the ICD-10 classification?
- A. E
- B. F (Correct Answer)
- C. P
- D. G
Explanation: ***F*** - In the **ICD-10 classification**, the chapter for **Mental and behavioural disorders** is designated by the letter **'F'**. - This chapter covers a wide range of conditions, from mental retardation to mood disorders and substance-related disorders. *E* - The letter **'E'** in ICD-10 is used for **Endocrine, nutritional and metabolic diseases**. - This category includes conditions like diabetes mellitus and thyroid disorders. *P* - The letter **'P'** in ICD-10 denotes **Certain conditions originating in the perinatal period**. - These are conditions that arise during the period around childbirth. *G* - The letter **'G'** in ICD-10 refers to **Diseases of the nervous system**. - This chapter includes conditions like epilepsy, Parkinson's disease, and stroke.
Question 2: According to the classical monoamine hypothesis of depression, deficiency of which of the following neurotransmitters is MOST commonly emphasized in modern antidepressant therapy?
- A. Serotonin (Correct Answer)
- B. Acetylcholine
- C. Dopamine
- D. GABA
Explanation: ***Serotonin*** - The **classical monoamine hypothesis** of depression posits deficiencies in monoamine neurotransmitters including **serotonin (5-HT), norepinephrine, and dopamine**. - Among these, **serotonin** is the **most commonly emphasized** in modern antidepressant therapy, given its central role in mood regulation, sleep, appetite, and cognition. - The majority of first-line antidepressants, such as **SSRIs (Selective Serotonin Reuptake Inhibitors)** and **SNRIs**, primarily target serotonergic pathways, reflecting its clinical importance. - **Clinical relevance**: Serotonin deficiency is associated with depressed mood, anxiety, sleep disturbances, and appetite changes. *Acetylcholine* - **Acetylcholine** is a neurotransmitter involved in cognitive function, memory, and muscle contraction. - It is **not a monoamine** and is not part of the classical monoamine hypothesis of depression. - Acetylcholine deficiency is primarily implicated in **Alzheimer's disease** and other cognitive disorders, not depression. *Dopamine* - **Dopamine** is one of the three monoamines implicated in the classical hypothesis and plays a role in pleasure, reward, motivation, and motor control. - Dopamine deficiency can contribute to symptoms of **anhedonia** (inability to feel pleasure) and lack of motivation in depression. - However, dopamine-targeting antidepressants (like bupropion) are less commonly used as first-line therapy compared to serotonergic agents, making serotonin the most emphasized in clinical practice. *GABA* - **GABA (gamma-aminobutyric acid)** is the primary **inhibitory neurotransmitter** in the central nervous system. - It is **not a monoamine** and is not part of the classical monoamine hypothesis of depression. - GABA dysfunction is primarily associated with **anxiety disorders, seizures, and insomnia**, not depression as per the classical hypothesis.
Question 3: In the context of understanding patient behavior and therapeutic relationships, what is the definition of social psychology?
- A. The study of human relationships and behavior in social contexts
- B. The examination of cultural influences on behavior
- C. A field that does not exist
- D. The study of how individuals think, feel, and behave in social situations (Correct Answer)
Explanation: ***The study of how individuals think, feel, and behave in social situations*** - **Social psychology** focuses on understanding how individual thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others. - This field examines topics like **social perception**, **attitude formation**, and **interpersonal relationships**, which are crucial for understanding therapeutic interactions. *The study of human relationships and behavior in social contexts* - While this option is close, it is a broader and less precise definition. Social psychology specifically focuses on the **individual's psychological processes** within social contexts. - This definition could also encompass fields like **sociology**, which studies groups and societies rather than the individual experience. *The examination of cultural influences on behavior* - This describes **cultural psychology** or **cross-cultural psychology**, which explicitly investigates the impact of culture on psychological processes. - While culture is a social context, social psychology's scope is broader, encompassing all forms of social influence, not just cultural ones. *A field that does not exist* - This statement is incorrect; **social psychology is a well-established and active field** within psychology. - It has a rich history and continues to contribute significantly to our understanding of human behavior and interactions.
Question 4: Muttering delirium is seen with: NEET 13
- A. Datura (Correct Answer)
- B. Castor oil plant
- C. Cocaine (stimulant)
- D. Monkshood (Aconitum)
Explanation: ***Datura*** - **Datura poisoning** is characterized by an **anticholinergic toxidrome**, which includes central nervous system effects like **muttering delirium, hallucinations**, and disorientation. - The patient exhibits features like **dilated pupils, dry mouth, flushed skin**, and **tachycardia** due to the blockage of muscarinic acetylcholine receptors. *Castor oil plant* - The **castor oil plant** contains **ricin**, a potent toxin that causes **gastrointestinal symptoms** (nausea, vomiting, abdominal pain, bloody diarrhea) and eventually multi-organ failure. - It does not typically cause the central nervous system effects like **muttering delirium** seen with Datura poisoning. *Cocaine (stimulant)* - **Cocaine** is a central nervous system stimulant that causes **euphoria, agitation, paranoia, dilated pupils**, and **tachycardia**. - While it can cause psychosis, the specific **muttering delirium** is not its hallmark presentation; instead, it is associated with a hyperadrenergic state. *Monkshood (Aconitum)* - **Monkshood** contains **aconitine**, a neurotoxin that primarily affects cardiac and neurological function, causing **paresthesias, muscle weakness, bradycardia**, and potentially fatal arrhythmias. - It does not typically cause the **muttering delirium** with features of an anticholinergic syndrome.
Question 5: What are the homes called where children are placed under the care of doctors and psychiatrists?
- A. Foster care homes
- B. Youth detention centers
- C. Child mental health clinics
- D. Residential treatment facilities (Correct Answer)
Explanation: ***Residential treatment facilities*** - These facilities provide structured, live-in therapeutic environments where children and adolescents receive comprehensive psychiatric and medical care. - They are staffed by a multidisciplinary team including **psychiatrists**, psychologists, social workers, and nurses. *Foster care homes* - Foster care involves placing children with temporary families, usually due to neglect or abuse, focusing on a family-like setting rather than intensive medical or psychiatric care. - While foster children may receive mental health services, the homes themselves are not clinical environments. *Youth detention centers* - These facilities are for children and adolescents who have committed crimes and are awaiting trial or serving sentences. - While mental health services may be provided, their primary purpose is correctional, not therapeutic. *Child mental health clinics* - These clinics offer outpatient services, including diagnosis, therapy, and medication management, but do not provide residential care. - Children attend appointments and then return home, unlike the live-in care provided in residential facilities.
Question 6: What is the most commonly abused drug in India?
- A. Heroin
- B. Amphetamine
- C. Cocaine
- D. Cannabis (Correct Answer)
Explanation: ***Cannabis*** - Cannabis (bhang, ganja, charas) is the **most commonly abused illicit drug in India** according to national surveys including the National Survey on Extent and Pattern of Substance Use. - It has **widespread social and cultural acceptance** in certain contexts, contributing to its higher prevalence across diverse populations. - Cannabis use is distributed across **all socioeconomic strata** and geographic regions, making it more prevalent than other illicit drugs. *Heroin* - While heroin is a **highly addictive opioid** with severe health consequences, its overall prevalence is **lower than cannabis** at the national level. - Heroin abuse is more concentrated in **specific regions** (northern states like Punjab, northeastern states) rather than being uniformly distributed. - The National Survey data shows opioid abuse (including heroin) affects a **smaller percentage** of the population compared to cannabis. *Amphetamine* - Amphetamines are **stimulant drugs** that are significantly less commonly abused in India compared to cannabis and opioids. - Their use is **highly localized** and represents a much smaller proportion of substance abuse cases. *Cocaine* - Cocaine is a **powerful stimulant** that is expensive and less accessible in India, making it one of the **least commonly abused** drugs. - Its use is typically limited to **affluent urban populations** and represents minimal prevalence in national substance abuse statistics.
Question 7: Formication is primarily associated with which condition?
- A. Acute amphetamine intoxication
- B. Alcohol withdrawal
- C. Cannabis poisoning
- D. Chronic use of amphetamine (Correct Answer)
Explanation: ***Chronic use of amphetamine*** - **Formication** (the sensation of insects crawling under the skin) is a classic symptom of **chronic amphetamine abuse**, often leading to excoriations due to scratching. - This **tactile hallucination** is part of the psychosis that can develop with prolonged high-dose amphetamine use. *Acute amphetamine intoxication* - While acute intoxication can cause psychosis and paranoia, **formication** is more strongly associated with the **chronic effects** and withdrawal of amphetamines. - Acute effects typically include euphoria, increased energy, and hypervigilance, rather than persistent tactile hallucinations. *Alcohol withdrawal* - **Alcohol withdrawal** can cause a range of symptoms including tremors, hallucinations (often visual or auditory), and seizures. - While some tactile disturbances can occur, **formication** is not a primary or characteristic symptom of alcohol withdrawal; **delirium tremens** often features visual or auditory hallucinations. *Cannabis poisoning* - **Cannabis poisoning** (or acute intoxication) typically presents with euphoria, altered perception of time, impaired coordination, and increased appetite. - It does not characteristically cause **formication** or other significant tactile hallucinations.
Question 8: Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:
- A. Chlorpromazine
- B. Haloperidol
- C. Diazepam
- D. Lithium carbonate (Correct Answer)
Explanation: **Lithium carbonate** - **Lithium** is a well-established and highly effective **mood stabilizer**, considered a first-line treatment for managing both **manic** and **depressive episodes** in bipolar disorder. - It helps prevent recurrent episodes and reduces the severity of mood swings, acting as a prophylactic agent. *Chlorpromazine* - **Chlorpromazine** is a **first-generation antipsychotic** that is primarily used to treat **schizophrenia** and other psychotic disorders. - While it can be used acutely to manage severe manic agitation, it is not a first-line agent for the long-term mood stabilization characteristic of bipolar disorder. *Haloperidol* - **Haloperidol** is another **first-generation antipsychotic** often used for acute treatment of **psychotic symptoms** or severe agitation, including in mania. - It is not a primary long-term mood stabilizer for bipolar disorder due to its side effect profile and lack of efficacy in preventing future mood episodes compared to lithium. *Diazepam* - **Diazepam** is a **benzodiazepine** primarily used for treating **anxiety**, muscle spasms, and acute seizures. - While it can help manage acute agitation and insomnia during a manic episode, it does not have mood-stabilizing properties and is not a long-term treatment for bipolar disorder.
Question 9: Which of the following factors is most commonly associated with suicidal tendencies?
- A. Female gender
- B. Severe depression (Correct Answer)
- C. Chronic illness
- D. Younger age group
Explanation: ***Severe depression*** - **Major depressive disorder** is the strongest and most common risk factor for suicidal ideation and attempts, significantly increasing suicidal tendencies [1]. - The profound **hopelessness**, **worthlessness**, and altered cognitive processing associated with severe depression contribute largely to suicidal thoughts [2]. - Depression is present in approximately **90%** of individuals who die by suicide. *Female gender* - While **females** have higher rates of **suicide attempts** and self-harm, **males** have a higher rate of completed suicides using more lethal methods. - Female gender alone is not the most common risk factor for suicidal tendencies compared to the profound impact of severe mental illness like depression [1]. *Chronic illness* - **Chronic medical conditions** can increase the risk of depression and subsequent suicidal ideation due to pain, functional limitations, and loss of independence [3]. - However, chronic illness is generally considered an **indirect risk factor**, often mediating its effect through the development of mental health disorders like depression [3]. *Younger age group* - Suicide is a leading cause of death in **adolescents and young adults**, highlighting significant concern in this demographic [1]. - While younger age is a risk factor, especially with concurrent mental health issues or stressors, it is not as universally predictive of suicidal tendencies as severe depression across all age groups [1].
Question 10: What is the definition of phobia?
- A. An intense, irrational fear that leads to avoidance (Correct Answer)
- B. Fear of specific objects or situations
- C. A type of anxiety disorder characterized by excessive fear
- D. A severe anxiety disorder characterized by irrational fear
Explanation: ***An intense, irrational fear that leads to avoidance*** - A phobia is primarily an **intense and persistent fear** reaction that is **irrational** in nature, meaning it is disproportionate to the actual danger posed by the object or situation. - This overwhelming fear invariably leads to **avoidance behavior**, where the individual actively tries to stay away from the feared stimulus. *Fear of specific objects or situations* - While phobias often involve specific objects or situations, this definition alone is insufficient as it doesn't capture the **intensity**, **irrationality**, or the **avoidance** component that are hallmarks of a true phobia. - Many people experience fear of specific things without it reaching the clinical threshold of a phobia, as long as it doesn't cause significant distress or impairment. *A type of anxiety disorder characterized by excessive fear* - This definition is broadly correct but is not the most precise or complete definition of a phobia itself. - While phobias are indeed a type of **anxiety disorder** and involve excessive fear, the key defining features of **irrationality** and **avoidance** are not explicitly stated, nor is the clear distinction from generalized anxiety. *A severe anxiety disorder characterized by irrational fear* - Similar to the previous option, this highlights the **irrational fear** and categorizes it as an **anxiety disorder**. - However, it omits the crucial element of **avoidance**, which is a defining diagnostic criterion and a hallmark behavioral response in phobias, and it also uses the broad term "severe" when the impact can vary.