Pharmacology
4 questionsWhich of the following actions is NOT associated with tricyclic antidepressants?
Which of the following statements about flumazenil is correct?
Which of the following typical antipsychotic drugs is least commonly used in depot form?
Modafinil is primarily used for the treatment of which of the following conditions?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1301: Which of the following actions is NOT associated with tricyclic antidepressants?
- A. Block 5-HT or NE reuptake
- B. Anticholinergic action
- C. MAO inhibition (Correct Answer)
- D. Causes sedation
Explanation: ***MAO inhibition*** - Tricyclic antidepressants (TCAs) primarily exert their effects by inhibiting the reuptake of **norepinephrine** and **serotonin**, not by inhibiting monoamine oxidase (MAO). - **MAO inhibitors** are a distinct class of antidepressants with a different mechanism of action and side effect profile. *Anticholinergic action* - Many TCAs have significant **anticholinergic effects**, blocking muscarinic receptors and leading to side effects like dry mouth, constipation, and blurred vision. - These effects contribute to the **adverse event profile** of TCAs, especially in elderly patients. *Block 5-HT or NE reuptake* - The primary mechanism of action of TCAs involves the **inhibition of serotonin (5-HT)** and **norepinephrine (NE) reuptake** into presynaptic neurons. - This action increases the concentration of these neurotransmitters in the **synaptic cleft**, thereby potentiating their effects. *Causes sedation* - TCAs frequently cause **sedation**, particularly the more histaminergic ones (e.g., amitriptyline, doxepin), due to their **histamine H1 receptor antagonism**. - This side effect can be beneficial for patients with insomnia but can be problematic for daytime functioning.
Question 1302: Which of the following statements about flumazenil is correct?
- A. Can be used in barbiturate poisoning
- B. Specific antidote for opiate overdose
- C. Can be used in benzodiazepine overdose (Correct Answer)
- D. None of the options
Explanation: ***Can be used in benzodiazepine overdose*** - **Flumazenil** is a **competitive antagonist** at the **GABA-A receptor**, specifically designed to reverse the effects of **benzodiazepines**. - It binds to the same receptor site as benzodiazepines, effectively blocking their sedative and anxiolytic actions, making it useful in emergent overdose situations. *Can be used in barbiturate poisoning* - **Flumazenil** is **ineffective** in **barbiturate overdose** because barbiturates bind to a different site on the GABA-A receptor than benzodiazepines. - Barbiturates enhance **GABAergic activity** through a distinct mechanism, which flumazenil does not antagonize. *Specific antidote for opiate overdose* - The **specific antidote for opiate overdose** is **naloxone**, which acts as an opioid receptor antagonist. - **Flumazenil** has **no affinity** for opioid receptors and thus no role in reversing opiate toxicity. *None of the options* - This option is incorrect because **flumazenil** is indeed used for **benzodiazepine overdose**, as described above. - Its specific mechanism of action targets benzodiazepine-induced central nervous system depression.
Question 1303: Which of the following typical antipsychotic drugs is least commonly used in depot form?
- A. Haloperidol
- B. Fluphenazine
- C. Chlorpromazine (Correct Answer)
- D. Trifluoperazine
Explanation: ***Chlorpromazine*** - Chlorpromazine is a **typical antipsychotic** that is **NOT available in depot form** for clinical use. - It is available only in **oral** and **short-acting injectable** formulations, making it the **least commonly used in depot form** among the options listed. - Its high sedative properties, orthostatic hypotension risk, and pharmacokinetic profile make it unsuitable for long-acting depot formulation. *Haloperidol* - **Haloperidol decanoate** is one of the **most widely used depot formulations** of typical antipsychotics. - Administered intramuscularly every **3-4 weeks**, it is highly effective for **long-term maintenance treatment** in schizophrenia. - Its favorable pharmacokinetic profile makes it ideal for depot preparation. *Fluphenazine* - **Fluphenazine decanoate** and **fluphenazine enanthate** are **well-established depot preparations** with decades of clinical use. - These formulations allow for dosing every **2-4 weeks**, significantly improving **medication adherence** in chronic psychotic disorders. - Fluphenazine depot is a first-line option for long-acting injectable antipsychotic therapy. *Trifluoperazine* - Trifluoperazine is primarily available and used as an **oral medication** for maintenance therapy. - While some limited depot formulations have been reported in older literature, they are **not commonly used in clinical practice**. - However, it is still more available in depot form than chlorpromazine, which has essentially **no depot use**.
Question 1304: Modafinil is primarily used for the treatment of which of the following conditions?
- A. Narcolepsy (Correct Answer)
- B. Sexual dysfunction
- C. Depression
- D. Anxiety
Explanation: ***Narcolepsy*** - **Modafinil** is a **eugeroic** (wakefulness-promoting agent) specifically approved and widely used for the treatment of excessive daytime sleepiness associated with **narcolepsy**. - Its mechanism involves increasing **dopamine** and **norepinephrine** levels, and modulating **orexin** pathways, promoting alertness without significant psychomotor stimulation. *Sexual dysfunction* - While sometimes explored off-label for certain types of sexual dysfunction, **modafinil** is not a primary or approved treatment for this condition. - Primary treatments for sexual dysfunction often involve specific medications like **PDE5 inhibitors** or hormone therapy, depending on the cause. *Depression* - **Modafinil** is not a primary antidepressant, although it can be used as an **adjunctive therapy** in some cases to combat residual fatigue or hypersomnia associated with depression. - Standard treatment for depression involves **selective serotonin reuptake inhibitors (SSRIs)**, **serotonin-norepinephrine reuptake inhibitors (SNRIs)**, or other classes of antidepressants. *Anxiety* - **Modafinil** is a stimulant-like drug and can sometimes **exacerbate anxiety** in susceptible individuals due to its catecholaminergic effects. - Primary treatments for anxiety disorders include **selective serotonin reuptake inhibitors (SSRIs)**, **benzodiazepines** (for acute relief), and psychotherapy.
Psychiatry
6 questionsWhich eating disorder is characterized by episodes of binge eating while maintaining a normal weight?
Which of the following is a common feature associated with mania?
What type of disorder is Tourette syndrome?
Which first-line conventional drug is commonly used in the treatment of delirium?
What is the PRIMARY psychological cause of oppositional behavior in young children?
Which of the following conditions is NOT typically associated with increased REM latency?
NEET-PG 2015 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1301: 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
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.
Question 1302: Which of the following is a common feature associated with mania?
- A. Neologism
- B. Perseveration
- C. Echolalia
- D. Flights of ideas (Correct Answer)
Explanation: ***Flights of ideas*** - A **flight of ideas** is characterized by a rapid, continuous, pressured flow of talk with abrupt changes from one topic to another, usually based on understandable associations or plays on words, which is a hallmark feature of **mania**. - This symptom reflects the accelerated thinking and heightened energy typical of a **manic episode**. *Neologism* - **Neologisms** are newly coined words or phrases, often without meaning to others, which are more commonly associated with thought disorders like **schizophrenia**. - While patients with mania can have pressured speech, the formation of nonsensical new words is not a primary or common feature of the condition. *Perseveration* - **Perseveration** involves the persistent repetition of a word, phrase, or gesture despite the absence of a stimulus or the appropriateness of the repetition, often seen in **cognitive disorders** or **schizophrenia**. - It differs from the rapidly shifting topics in a flight of ideas, where new thoughts are constantly being generated rather than a single thought being repeated. *Echolalia* - **Echolalia** is the automatic repetition of vocalizations made by another person, which is mainly observed in conditions such as **autism spectrum disorder** or **Tourette's syndrome**. - This symptom involves imitation rather than the spontaneous generation of accelerated speech and thoughts characteristic of mania.
Question 1303: What type of disorder is Tourette syndrome?
- A. Tic disorder (Correct Answer)
- B. Intellectual disability
- C. Seizure disorder
- D. None of the options
Explanation: ***Tic disorder*** - Tourette syndrome is defined by the presence of both **multiple motor tics** and at least one **vocal tic** for more than one year. - Tics are sudden, rapid, recurrent, non-rhythmic motor movements or vocalizations. - Classified under **Neurodevelopmental Disorders** in DSM-5 and **Tic disorders** in ICD-11. *Intellectual disability* - Intellectual disability (previously termed mental retardation) is characterized by significant limitations both in **intellectual functioning** and in **adaptive behavior**. - While co-occurring conditions are common with Tourette syndrome, intellectual disability is **not a defining characteristic** of the syndrome itself. - Tourette syndrome is a **tic disorder**, not an intellectual disability. *Seizure disorder* - Seizure disorders (**epilepsy**) are neurological conditions characterized by recurrent, unprovoked seizures, which are abnormal electrical activities in the brain. - Tics and seizures are **distinct neurological phenomena** with different pathophysiology. - Tourette syndrome is **not a type of seizure disorder**, though they may occasionally co-occur. *None of the options* - This option is incorrect because Tourette syndrome is indeed a well-defined type of **tic disorder**, as recognized by DSM-5 and ICD-11 diagnostic criteria. - The correct classification is clearly established in psychiatric nosology.
Question 1304: Which first-line conventional drug is commonly used in the treatment of delirium?
- A. Haloperidol (Correct Answer)
- B. Lithium carbonate
- C. Opioids
- D. Selective Serotonin Reuptake Inhibitors (SSRIs)
Explanation: ***Haloperidol*** - **Haloperidol** is a first-generation antipsychotic widely considered the **first-line conventional drug** for managing **agitation and psychotic symptoms** in delirium (particularly in the context of this 2015 exam). - Its efficacy in controlling these symptoms promptly, coupled with its availability in oral, intramuscular, and intravenous forms, makes it a preferred choice, especially in acute settings. - **Note:** Current evidence (post-2018) emphasizes non-pharmacological interventions first, with antipsychotics reserved for severe agitation when non-pharmacological measures fail. *Lithium carbonate* - **Lithium carbonate** is primarily used as a **mood stabilizer** for bipolar disorder, not for acute management of delirium. - It has a narrow therapeutic window and requires **careful monitoring of blood levels** to prevent toxicity, making it unsuitable for acute delirium management. *Opioids* - **Opioids** are mainly used for **pain management** and can actually **exacerbate delirium** due to their sedative and central nervous system depressant effects. - They are not indicated for treating the core symptoms of delirium, such as disorientation, fluctuating consciousness, or psychotic features. *Selective Serotonin Reuptake Inhibitors (SSRIs)* - **SSRIs** are primarily used for the treatment of **depression and anxiety disorders**, and their therapeutic effects take several weeks to manifest. - They are not effective for the immediate management of acute delirium and may even **worsen confusion or agitation** in some delirious patients.
Question 1305: What is the PRIMARY psychological cause of oppositional behavior in young children?
- A. Emotional distress (Correct Answer)
- B. Genetic predisposition
- C. Intellectual disability
- D. Neurological disorder
Explanation: ***Emotional distress*** - **Emotional distress**, such as anxiety, fear, sadness, or frustration, is a primary driver of oppositional behavior as children may lack the verbal or emotional regulation skills to express these feelings constructively. - Children often express their internal emotional struggles through externalizing behaviors like opposition, defiance, and irritability as a form of **maladaptive coping**. *Intellectual disability* - While children with an **intellectual disability** may exhibit oppositional behavior, it is not the primary psychological cause across all young children. - In such cases, oppositional behaviors might stem from difficulties understanding expectations, communication challenges, or a lack of coping strategies rather than being the direct psychological root of the opposition itself. *Neurological disorder* - Certain **neurological disorders** (e.g., ADHD) can contribute to behaviors that appear oppositional due to challenges with impulsivity or attention, but they are not the primary psychological cause of oppositional behavior in general. - The oppositional behavior in these cases is more a consequence of the unique cognitive and executive function challenges associated with the disorder, rather than a direct psychological state of distress. *Genetic predisposition* - **Genetic predisposition** can influence temperament and vulnerability to certain mental health conditions, thereby indirectly contributing to oppositional behavior. - However, genetics do not directly cause oppositional behavior; rather, they interact with environmental factors and a child's psychological state to either mitigate or exacerbate such behaviors.
Question 1306: Which of the following conditions is NOT typically associated with increased REM latency?
- A. First night effect
- B. SSRIs
- C. Restless leg syndrome
- D. Narcolepsy (Correct Answer)
Explanation: ***Narcolepsy*** - **Narcolepsy** is characterized by pathologically **decreased REM latency**, not increased. - Patients typically enter REM sleep within **15 minutes** of sleep onset (normal is 60-90 minutes). - **Sleep-onset REM periods (SOREMPs)** are a diagnostic hallmark of narcolepsy, seen on multiple sleep latency testing (MSLT). - Since narcolepsy is associated with *decreased* REM latency, it is definitively **NOT associated with increased REM latency**, making it the correct answer to this negation question. *First night effect* - The **first-night effect** refers to sleep disruption and increased REM latency during the first night of polysomnography in an unfamiliar environment. - This is a well-documented phenomenon that **increases REM latency** due to environmental stress and arousal. *SSRIs* - **Selective serotonin reuptake inhibitors (SSRIs)** significantly suppress REM sleep, leading to **increased REM latency** and decreased total REM sleep time. - This effect is mediated by increased serotonin, which inhibits cholinergic neurons involved in REM sleep generation. - SSRIs can increase REM latency by 30-90 minutes beyond normal values. *Restless leg syndrome* - **Restless leg syndrome (RLS)** primarily causes difficulty initiating sleep and sleep fragmentation due to uncomfortable leg sensations. - While RLS disrupts sleep architecture, its effect on REM latency is **variable and inconsistent** - some studies show minimal impact, while chronic sleep deprivation from RLS may actually decrease REM latency during rebound sleep. - However, RLS is not as clearly and consistently dissociated from increased REM latency as narcolepsy is.