A 78-year-old woman presents with a progressive decline in daily activity. She gives a history of convulsions and visual hallucinations. She does not talk to anyone and keeps looking at the sky. Pathological examination shows the presence of Lewy bodies within the neurons. What is the most probable diagnosis?
Q2
A woman, who is 4 days postpartum, presented with tearfulness, mood swings, and occasional insomnia. What is the likely diagnosis?
Q3
A 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?
NEET-PG 2023 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1: A 78-year-old woman presents with a progressive decline in daily activity. She gives a history of convulsions and visual hallucinations. She does not talk to anyone and keeps looking at the sky. Pathological examination shows the presence of Lewy bodies within the neurons. What is the most probable diagnosis?
A. Prion disease
B. Huntington's disease
C. Lewy body dementia (Correct Answer)
D. Alzheimer's disease
Explanation: ***Lewy body dementia***
- The presence of **progressive cognitive decline**, **visual hallucinations**, and **convulsions** in an elderly patient is highly indicative of Lewy body dementia.
- The definitive pathological finding of **Lewy bodies** within neurons confirms the diagnosis.
*Prion disease*
- Characterized by rapidly progressive dementia, **myoclonus**, and cerebellar ataxia, without typical visual hallucinations or convulsions.
- Pathological examination typically shows **spongiform changes** and accumulation of abnormal prion protein, not Lewy bodies.
*Huntington's disease*
- Presents with a classic triad of **motor dysfunction** (chorea), psychiatric symptoms, and cognitive decline, typically with an earlier onset (30-50 years).
- It is an inherited neurodegenerative disorder, and its pathology involves neuronal loss in the striatum, without Lewy bodies.
*Alzheimer's disease*
- The most common cause of dementia, characterized by **memory impairment** as an early and prominent feature.
- Pathological findings include **amyloid plaques** and **neurofibrillary tangles**, not Lewy bodies, and visual hallucinations are less common or occur later in the disease.
Question 2: 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 3: A 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Panic disorder (Correct Answer)
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Explanation: ***Panic disorder***
- The presentation of recurrent, unexpected **panic attacks** characterized by sudden episodes of intense fear, palpitations, sweating, and a fear of losing control is classic for **panic disorder**.
- These episodes often manifest with physical symptoms that mimic a medical emergency, leading to significant distress and avoidance behaviors.
*Generalized anxiety disorder*
- This condition involves **persistent and excessive worry** about various life circumstances for at least six months, rather than discrete, intense episodes of fear.
- While physical symptoms like restlessness and fatigue can occur, they are generally less acute and not as severe as the sudden "fight-or-flight" response seen in panic attacks.
*Social anxiety disorder*
- This disorder is characterized by marked fear or anxiety about **social situations** where the individual might be scrutinized by others.
- While it can involve symptoms like palpitations and sweating in social contexts, it doesn't typically present with unexpected attacks unrelated to social performance.
*Obsessive-compulsive disorder*
- This disorder is defined by the presence of **obsessions** (recurrent and persistent thoughts, urges, or images) and/or **compulsions** (repetitive behaviors or mental acts) that the individual feels driven to perform.
- The symptoms described—palpitations, sweating, and fear of losing control—are not typical primary manifestations of OCD, which focuses on specific obsessions and compulsions.