NEET-PG 2013 - Psychiatry PYQs Practice Questions

Q: Among which of the following conditions is suicide risk highest?

Depression. ***Depression*** - **Major depressive disorder** is the psychiatric condition most frequently associated with **suicide**, accounting for a large percentage of completed suicides. - The presence of severe depression, especially with features like **hopelessness**, **agitation**, and **prior suicide attempts**, significantly elevate the risk. *Alcohol dependence* - While **alcohol dependence** is a significant risk factor for suicide, it often co-occurs with mood disorders like depression; alcohol can exacerbate suicidal ideation and impulsivity. - It is an important comorbidity, but **major depression** alone has a higher prevalence in suicide statistics than alcohol dependence as a primary factor. *Dementia* - **Dementia** generally poses a lower risk of completed suicide compared to mood disorders, as cognitive decline can impair the ability to plan and execute such acts. - Early stages of dementia, particularly when insight into cognitive decline is preserved, may carry some risk, but it is not the highest risk condition overall. *Schizophrenia* - Individuals with **schizophrenia** have a significantly elevated risk of suicide compared to the general population, often due to factors like **command hallucinations**, hopelessness, and adverse effects of medication. - However, **depression** remains the leading psychiatric diagnosis associated with suicide completions. [Practice more Psychiatry PYQs on OnCourse]

Q: What is the total score in the Mini Mental Status Examination (MMSE)?

30. ***Correct: 30*** - The **Mini Mental State Examination (MMSE)** is a 30-point questionnaire used to screen for **cognitive impairment** and monitor changes in cognitive function over time. - The score is calculated by summing points for correct responses across various cognitive domains such as **orientation**, **attention**, **memory**, **language**, and **visuospatial skills**. - This is the **maximum total score** achievable on the MMSE. *Incorrect: 25* - A score of 25 in the MMSE is significantly below the maximum, and depending on age and education, it often suggests **mild cognitive impairment** or early **dementia**. - While 25 is a possible score a patient can achieve, it is not the **maximum total score** for the examination itself. *Incorrect: 32* - The MMSE is standardized to have a maximum score of **30**, so 32 is higher than the possible range for this particular cognitive assessment tool. - No domain in the MMSE allows for a score that would lead to a total of 32 points. *Incorrect: 35* - Like 32, a score of 35 is beyond the **maximum achievable score** on the MMSE. - This indicates a misunderstanding of the MMSE's scoring rubric, as the highest possible score is **30 points**. [Practice more Psychiatry PYQs on OnCourse]

Q: Doppelganger is a term used to describe which medical phenomenon?

Feeling of double of oneself. ***Feeling of double of oneself*** - **Doppelganger** (also called **autoscopy** or **heautoscopy**) refers to the experience of seeing or sensing one's own double or duplicate - This is the **correct definition** of the term doppelganger in medical terminology - Associated with **neurological conditions** (temporal lobe epilepsy, brain lesions, migraine) and **psychiatric conditions** (schizophrenia, dissociative states) - The person perceives their duplicate as a separate entity, which may appear visually or be sensed as a presence *Shadow following person* - This is not a recognized medical or psychiatric phenomenon - Does not describe the autoscopic experience of seeing one's own double - Not related to the definition of doppelganger *Identification of stranger as familiar* - This more closely describes **Fregoli delusion**, where a person believes that different people are actually a single person in disguise - Could also relate to other delusional misidentification syndromes - **Not doppelganger**, which specifically involves seeing one's own double, not misidentifying others - Note: **Capgras syndrome** is the opposite—believing a familiar person has been replaced by an imposter *None of the options* - Incorrect because "Feeling of double of oneself" accurately describes the doppelganger phenomenon [Practice more Psychiatry PYQs on OnCourse]

Q: What deficiency may contribute to relapse in a patient who has experienced remission with selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs)?

Folate. ***Folate*** - **Folate (vitamin B9) deficiency** is strongly linked to depression and is a well-established cause of relapse in patients treated with antidepressants. - Folate plays a crucial role in the **one-carbon metabolism pathway**, which is essential for the synthesis of monoamine neurotransmitters including **serotonin, norepinephrine, and dopamine**. - Studies show that **low folate levels** are associated with poor response to SSRIs and TCAs, and folate supplementation can improve antidepressant efficacy. - Approximately **30% of depressed patients** have folate deficiency, making it a clinically significant factor in treatment resistance and relapse. *Cobalamin* - **Cobalamin (vitamin B12)** deficiency can cause neuropsychiatric symptoms including depression and cognitive impairment. - While B12 is important for myelin formation and neurotransmitter synthesis, it is less specifically implicated in antidepressant relapse compared to folate. - B12 deficiency more commonly presents with **cognitive and neurological symptoms** rather than pure mood symptoms. *Pyridoxine* - **Pyridoxine (vitamin B6)** is a cofactor in neurotransmitter synthesis, including serotonin and dopamine. - While B6 deficiency can contribute to mood disturbances, it is not commonly implicated as a primary cause of relapse in antidepressant-treated depression. *Ascorbate* - **Ascorbate (vitamin C)** is an antioxidant with some role in neurotransmitter metabolism. - Severe vitamin C deficiency (scurvy) can have psychiatric manifestations, but it is not typically associated with relapse in patients treated with SSRIs or TCAs. [Practice more Psychiatry PYQs on OnCourse]

Question 1

A person presents to the outpatient department with tremors and visual hallucinations after a 2-day history of alcohol cessation. What is the diagnosis?

Accepted Answer

Delirium tremens

Answer

Korsakoff’s psychosis

Answer

Wernicke encephalopathy

Answer

Alcoholic hallucinosis

Question 2

Among which of the following conditions is suicide risk highest?

Accepted Answer

Depression

Answer

Alcohol dependence

Answer

Dementia

Answer

Schizophrenia

Question 3

What is the total score in the Mini Mental Status Examination (MMSE)?

Accepted Answer

30

Answer

25

Answer

32

Answer

35

Question 4

Doppelganger is a term used to describe which medical phenomenon?

Accepted Answer

Feeling of double of oneself

Answer

Shadow following person

Answer

Identification of stranger as familiar

Answer

None of the options

Question 5

What deficiency may contribute to relapse in a patient who has experienced remission with selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs)?

Accepted Answer

Folate

Answer

Pyridoxine

Answer

Cobalamin

Answer

Ascorbate

Question 6

Muttering delirium is seen with: NEET 13

Accepted Answer

Datura

Answer

Castor oil plant

Answer

Cocaine (stimulant)

Answer

Monkshood (Aconitum)

Question 7

What is the term for the salivation of a dog in response to a bell after it has been conditioned with food?

Accepted Answer

Conditioned reflex

Answer

Reinforcement

Answer

Habituation

Answer

Innate reflex

Question 8

Which of the following develop first during dependence of a substance ?

Accepted Answer

Psychological dependence

Answer

Tolerance

Answer

Physical dependence

Answer

Withdrawal symptoms

Question 9

In psychiatric assessment, which term refers to a temporary and subjective judgment or viewpoint expressed by a patient regarding their condition or treatment?

Accepted Answer

Opinion

Answer

Belief

Answer

Practice

Answer

Attitude

Question 10

Which of the following is an antipsychotic drug?

Accepted Answer

Flupenthixol

Answer

Rasagiline

Answer

Clobazam

Answer

Divalproex

NEET-PG 2013 — Psychiatry