NEET-PG 2013 - Psychiatry Practice Questions

Q: Which neurological condition is commonly associated with Alice in Wonderland Syndrome?

Epileptic seizures. ***Epileptic seizures*** - **Alice in Wonderland Syndrome (AIWS)**, characterized by distortions of visual perception, body image, and sense of time, is often reported as an **aura or part of focal epileptic seizures**, particularly those originating in the temporal or parietal lobes. - The **transient and episodic nature** of AIWS symptoms aligns well with the paroxysmal electrical activity seen in epilepsy. *Subacute sclerosing panencephalitis (SSPE)* - **SSPE** is a rare, fatal brain disorder caused by a persistent **measles virus infection**, primarily affecting children and young adults. - While it causes progressive neurological deterioration, including cognitive decline, motor dysfunction, and seizures, **Alice in Wonderland Syndrome** is not a characteristic or commonly associated symptom. *Cerebral hemorrhage* - A **cerebral hemorrhage** involves bleeding within the brain tissue, leading to acute neurological deficits depending on the location and size of the bleed. - Although it can cause a variety of symptoms, such as headache, weakness, and altered consciousness, **Alice in Wonderland Syndrome** is not a typical manifestation of acute hemorrhage. *Multiple sclerosis* - **Multiple sclerosis (MS)** is a chronic autoimmune disease affecting the central nervous system, leading to demyelination and neurological symptoms. - Common symptoms involve motor, sensory, visual, and cognitive deficits, but **Alice in Wonderland Syndrome** is not a recognized or common neurological manifestation of MS.

Q: Which of the following is NOT considered one of Bleuler's fundamental symptoms of schizophrenia?

Delusions. ***Delusions*** - **Delusions** are considered a **first-rank symptom** of schizophrenia according to Schneider, but not one of Bleuler's fundamental "4 A's". - Bleuler classified delusions as **accessory symptoms**, which are variable and not always present, unlike fundamental symptoms. *Loosening of associations* - This is one of Bleuler's **"4 A's"**, representing a disturbance in the logical flow of thought, leading to incoherent speech and fractured thinking. - Bleuler saw this as a core cognitive dysfunction in schizophrenia. *Affect disturbances* - This refers to **inappropriate affect** (e.g., laughing at a funeral) or **blunted/flattened affect**, which is another of Bleuler's "4 A's." - It signifies a disruption in the normal experience and expression of emotions. *Autism* - Bleuler's term **"autism"** (or autismus) refers to a pathological self-preoccupation, withdrawal from social interaction, and an immersion in one's own internal world. - This is also one of Bleuler's **"4 A's"**, highlighting a foundational disturbance in social engagement.

Q: Which type of delusion is primarily associated with Cotard's syndrome?

Nihilistic delusions. ***Nihilistic delusions*** - **Cotard's syndrome** is characterized by beliefs of **non-existence**, such as the patient being dead, not existing, or having lost their organs, which are typical of **nihilistic delusions**. - These delusions can also extend to the belief that the world or parts of it no longer exist. *Persecutory delusions* - These involve the belief that one is being **harassed, tricked, spied upon, or conspired against**, which is not the primary feature of Cotard's syndrome. - While they can co-occur with other psychiatric conditions, **persecutory themes** are distinct from the non-existence themes of Cotard's. *Religious delusions* - These delusions focus on **religious or spiritual themes**, such as believing one is a prophet or has a special relationship with a deity. - They are not a core component of Cotard's syndrome, which centers on themes of **death and non-existence**. *Hypochondriacal delusions* - These involve a preoccupation with the belief that one has a **serious, undiagnosed medical condition**, despite medical reassurance. - While Cotard's syndrome can involve bodily concerns, the belief in **non-existence of organs** or death goes beyond typical hypochondriacal fears of illness.

Q: Who coined the term 'psychiatry'?

Johann Reil. ***Johann Reil*** - The term "**psychiatry**" (Psychiatrie) was coined by the German physician **Johann Christian Reil** in **1808**. - Reil introduced the term in his work to advocate for a more **humane and medical approach** to mental illness, moving away from purely custodial care. *Moral* - While Reil's efforts were part of a broader movement towards **moral treatment** of the mentally ill, "moral" itself is not the specific context in which the term was coined. - **Moral treatment** emphasized humane care, occupational therapy, and a therapeutic environment, contributing to the development of psychiatry but not coining the word. *Bleuler* - **Eugen Bleuler** is known for coining the term "**schizophrenia**" in the early 20th century. - He significantly contributed to the understanding of psychotic disorders but did not coin the broader term "psychiatry." *Pinel* - **Philippe Pinel** was a French physician who was an instrumental figure in the **humanitarian reform** of mental asylum care in the late 18th century. - He is famous for **unshackling patients** at Bicêtre and Salpêtrière asylums, but he did not coin the term "psychiatry."

Q: Which of the following statements about hallucinations is true?

Perceived as real but without an external stimulus. ***Perceived as real but without an external stimulus*** - Hallucinations are defined by the perception of sensory experiences (e.g., seeing, hearing, feeling) that **feel real to the individual** but have **no corresponding external stimulus**. - This fundamental characteristic distinguishes them from other perceptual distortions like illusions. *There is misinterpretation of external stimulus* - This describes an **illusion**, where an actual external stimulus is misinterpreted (e.g., seeing a coat in the dark and believing it's a person). - Hallucinations occur in the **absence of any external stimulus**, making this statement incorrect for defining hallucinations. *Can be controlled by voluntary effort* - Hallucinations, being involuntary sensory experiences, are generally **not amenable to conscious control** or suppression by the individual experiencing them. - The lack of voluntary control is a key feature distinguishing them from imagination or fantasy. *Always indicates severe mental illness* - While often associated with severe mental illnesses like **schizophrenia**, hallucinations can also occur due to various other causes, including **substance intoxication or withdrawal**, neurological conditions (e.g., delirium, Parkinson's disease), or even during periods of extreme fatigue or stress. - Therefore, stating they *always* indicate severe mental illness is inaccurate.

Q: Which of the following is true regarding the treatment of cocaine withdrawal symptoms?

No specific drug. ***No specific drug*** - Currently, there is **no FDA-approved pharmacotherapy** for the treatment of cocaine withdrawal symptoms or for preventing relapse in cocaine dependence. - Management primarily focuses on **supportive care**, **psychotherapy** (cognitive behavioral therapy, contingency management), and addressing **co-occurring mental health disorders**. - Unlike alcohol or opioid withdrawal, cocaine withdrawal is not life-threatening and does not require specific medication. *Fluoxetine* - Fluoxetine is a **selective serotonin reuptake inhibitor (SSRI)** primarily used to treat depression and anxiety disorders. - While depression can be a symptom of cocaine withdrawal, fluoxetine has **not been shown to be effective** for reducing cocaine use or treating cocaine withdrawal specifically. - Multiple clinical trials have failed to demonstrate benefit for cocaine dependence treatment. *Antidepressants* - While various antidepressants (including desipramine, bupropion) have been investigated, there is **no strong evidence** to support their routine use as primary treatment for cocaine withdrawal or dependence. - Their effectiveness in this context is **limited and inconsistent** across studies. - They may be used to treat **co-occurring depressive disorders** but not as primary cocaine withdrawal treatment. *Benzodiazepines* - Benzodiazepines are primarily used to manage **acute anxiety and seizures** during withdrawal from GABAergic substances like **alcohol and sedatives**. - They are generally **not recommended** for cocaine withdrawal as cocaine withdrawal does not cause seizures or dangerous autonomic instability. - May be used only for **severe agitation** or **co-occurring alcohol withdrawal**, but carry their own dependence potential and do not address cocaine withdrawal itself.

Q: Which of the following is considered a poor prognostic factor for schizophrenia?

Poor premorbid adjustment. **Poor premorbid adjustment** - **Poor premorbid adjustment**, indicated by difficulties in social, academic, or occupational functioning before the onset of psychosis, is a consistent predictor of a worse outcome in schizophrenia. - This suggests a more pervasive and entrenched neurodevelopmental vulnerability impacting the individual's ability to cope and integrate socially. *Blunted affect (negative symptom)* - While **blunted affect** is a negative symptom often associated with poorer outcomes than positive symptoms, it is typically considered a *symptom* of the illness rather than a primary prognostic *factor* like premorbid adjustment. - Its presence contributes to disability, but it is not as strong an independent prognostic indicator as the life trajectory prior to illness onset. *Male sex (generally poorer prognosis)* - **Male sex** is generally associated with an **earlier age of onset** and often a **more severe course** of schizophrenia. - However, compared to significant functional impairment before disease onset, it is not as strong an individual predictor of overall long-term prognosis. *Presence of depression (often associated with better outcomes)* - The **presence of depressive symptoms** in schizophrenia is often associated with a **better prognosis**. - This is because depressive features can sometimes indicate a more preserved capacity for emotional experience and insight, which can align with higher functioning.

Q: Waxy flexibility is a feature of ?

Catatonia. ***Catatonia*** - **Waxy flexibility** (or catalepsy) is a classic symptom of **catatonia**, where an individual's limbs can be **placed in any position by the examiner and remain in that position for an extended period**, as if molded from wax. - It reflects a severe psychomotor disturbance, often seen in conditions like **schizophrenia** or **mood disorders** with catatonic features. *Echolalia* - **Echolalia** refers to the **involuntary repetition of another person's spoken words**, typically without understanding. - It is a symptom of thought disorder or communication difficulties, not a state of motor rigidity. *Stereotypy* - **Stereotypy** involves **repetitive, seemingly purposeless movements or utterances** (e.g., body rocking, hand flapping). - While repetitive, it does not involve maintaining a fixed posture imposed by another, as seen in waxy flexibility. *Mannerisms* - **Mannerisms** are **habitual, idiosyncratic gestures or behaviors** that may appear odd but are often voluntary and goal-directed (e.g., an exaggerated bow before speaking). - They are distinct from the involuntary, often rigid, posturing characteristic of waxy flexibility.

Q: Psychoanalysis was started by?

Sigmund Freud. ***Sigmund Freud*** - **Sigmund Freud** is widely recognized as the founder of **psychoanalysis**. - He developed theories on the **unconscious mind**, **psychosexual development**, and the use of techniques like **free association** and dream analysis. *Eugen Bleuler* - **Eugen Bleuler** was a Swiss psychiatrist who coined the term "**schizophrenia**." - While influential in psychiatry, his work was primarily focused on **descriptive psychopathology**, not the founding of psychoanalysis. *Carl Jung* - **Carl Jung** was a student of Freud who later diverged to develop his own school of thought called **analytical psychology**. - His contributions include concepts like the **collective unconscious**, archetypes, and psychological types. *Erik Erikson* - **Erik Erikson** was a developmental psychologist and psychoanalyst known for his theory of **psychosocial development**. - He expanded on Freud's work by focusing on the influence of social factors and the **lifespan stages** on personality development.

Q: Which of the following is NOT a diagnostic criterion for drug dependence?

Early completion of tasks. ***Early completion of tasks*** - This is not a recognized diagnostic criterion for **drug dependence (substance use disorder)** according to standardized diagnostic manuals like the DSM-5. - While it might reflect an individual's productivity or efficiency, it has no direct link to the compulsive drug-seeking and use behaviors characteristic of dependence. *Tolerance* - **Tolerance** is a core criterion, defined as a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of the substance. - This indicates a physiological adaptation to the presence of the drug. *Withdrawal symptoms* - **Withdrawal symptoms** refer to the characteristic physiological and psychological symptoms that occur when a person stops or reduces their use of a substance after prolonged or heavy use. - The presence of a withdrawal syndrome or taking the substance (or a closely related one) to relieve or avoid withdrawal symptoms is a key diagnostic indicator. *Taking substance in larger amounts than intended* - This criterion reflects the **impaired control** over substance use, where the individual uses the substance more often or in larger quantities than they initially intended. - It demonstrates a loss of conscious regulation over drug intake, which is a hallmark of substance dependence.

Question 1

Which neurological condition is commonly associated with Alice in Wonderland Syndrome?

Accepted Answer

Epileptic seizures

Answer

Subacute sclerosing panencephalitis (SSPE)

Answer

Cerebral hemorrhage

Answer

Multiple sclerosis

Question 2

Which of the following is NOT considered one of Bleuler's fundamental symptoms of schizophrenia?

Accepted Answer

Delusions

Answer

Loosening of associations

Answer

Affect disturbances

Answer

Autism

Question 3

Which type of delusion is primarily associated with Cotard's syndrome?

Accepted Answer

Nihilistic delusions

Answer

Persecutory delusions

Answer

Religious delusions

Answer

Hypochondriacal delusions

Question 4

Who coined the term 'psychiatry'?

Accepted Answer

Johann Reil

Answer

Moral

Answer

Bleuler

Answer

Pinel

Question 5

Which of the following statements about hallucinations is true?

Accepted Answer

Perceived as real but without an external stimulus

Answer

There is misinterpretation of external stimulus

Answer

Can be controlled by voluntary effort

Answer

Always indicates severe mental illness

Question 6

Which of the following is true regarding the treatment of cocaine withdrawal symptoms?

Accepted Answer

No specific drug

Answer

Fluoxetine

Answer

Antidepressants

Answer

Benzodiazepines

Question 7

Which of the following is considered a poor prognostic factor for schizophrenia?

Accepted Answer

Poor premorbid adjustment

Answer

Male sex

Answer

Presence of depression

Answer

Blunted affect

Question 8

Waxy flexibility is a feature of ?

Accepted Answer

Catatonia

Answer

Echolalia

Answer

Stereotypy

Answer

Mannerisms

Question 9

Psychoanalysis was started by?

Accepted Answer

Sigmund Freud

Answer

Eugen Bleuler

Answer

Carl Jung

Answer

Erik Erikson

Question 10

Which of the following is NOT a diagnostic criterion for drug dependence?

Accepted Answer

Early completion of tasks

Answer

Taking substance in larger amounts than intended

Answer

Tolerance

Answer

Withdrawal symptoms

NEET-PG 2013 — Psychiatry