NEET-PG 2022 — Psychiatry

Q: A woman, who is 4 days postpartum, presented with tearfulness, mood swings, and occasional insomnia. What is the likely diagnosis?

Postpartum blues. ***Postpartum blues*** - This condition presents with mild, transient symptoms like **tearfulness**, **mood swings**, and **insomnia** typically peaking around **4-5 days postpartum** and resolving within two weeks. - It is a very common, self-limiting condition impacting up to 80% of new mothers, attributed to drastic **hormonal shifts** post-delivery. *Postpartum depression* - Symptoms are similar to postpartum blues but are more **severe**, last longer (typically **beyond two weeks**), and significantly impair functioning. - It often includes feelings of **hopelessness**, pervasive sadness, loss of pleasure, and sometimes thoughts of harming oneself or the baby. *Postpartum psychosis* - This is a severe psychiatric emergency characterized by **hallucinations**, delusions, disorganized thinking, and bizarre behavior, usually within the first 2-3 weeks postpartum. - It is a rare condition requiring **urgent medical intervention** due to the high risk of harm to mother and baby. *Postpartum anxiety* - While anxiety can co-occur with postpartum blues or depression, primary postpartum anxiety specifically involves excessive and **uncontrollable worry** or fear, often about the baby's health or safety. - It does not typically present with the prominent **tearfulness** and **mood swings** characteristic of blues or depression. [Practice more Psychiatry PYQs on OnCourse]

Q: 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?

Bulimia nervosa. ***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. [Practice more Psychiatry PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

A woman, who is 4 days postpartum, presented with tearfulness, mood swings, and occasional insomnia. What is the likely diagnosis?

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?

NEET-PG 2022 - Psychiatry NEET-PG Practice Questions and MCQs

Question 1: A woman, who is 4 days postpartum, presented with tearfulness, mood swings, and occasional insomnia. What is the likely diagnosis?

A. Postpartum depression
B. Postpartum blues (Correct Answer)
C. Postpartum psychosis
D. Postpartum anxiety

Explanation: ***Postpartum blues*** - This condition presents with mild, transient symptoms like **tearfulness**, **mood swings**, and **insomnia** typically peaking around **4-5 days postpartum** and resolving within two weeks. - It is a very common, self-limiting condition impacting up to 80% of new mothers, attributed to drastic **hormonal shifts** post-delivery. *Postpartum depression* - Symptoms are similar to postpartum blues but are more **severe**, last longer (typically **beyond two weeks**), and significantly impair functioning. - It often includes feelings of **hopelessness**, pervasive sadness, loss of pleasure, and sometimes thoughts of harming oneself or the baby. *Postpartum psychosis* - This is a severe psychiatric emergency characterized by **hallucinations**, delusions, disorganized thinking, and bizarre behavior, usually within the first 2-3 weeks postpartum. - It is a rare condition requiring **urgent medical intervention** due to the high risk of harm to mother and baby. *Postpartum anxiety* - While anxiety can co-occur with postpartum blues or depression, primary postpartum anxiety specifically involves excessive and **uncontrollable worry** or fear, often about the baby's health or safety. - It does not typically present with the prominent **tearfulness** and **mood swings** characteristic of blues or depression.

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

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.