NEET-PG 2013 - Psychiatry Practice Questions

Q: In stupor catatonia, all are seen except -

Agitation. ***Agitation*** - **Stuporous catatonia** is characterized by a significant reduction or absence of motor activity and responsiveness, making **agitation**—increased motor activity—an unlikely feature. - In such a state, the patient is typically rigid, immobile, and unresponsive to external stimuli, which is the antithesis of agitation. *Catalepsy* - **Catalepsy** refers to a trance-like state with a loss of voluntary motion and active posturing, where the limbs maintain any position in which they are placed (waxy flexibility). - This is a hallmark feature of **catatonic stupor**, indicating a profound disturbance in motor control. *Mutism* - **Mutism** is the absence or profound reduction of speech, which is a common and defining feature of **catatonic stupor**. - Patients in a stuporous state typically do not speak or respond verbally to questions or commands. *Akinesia* - **Akinesia** is the absence of movement, or pronounced difficulty in initiating voluntary movements, which is a key component of **catatonic stupor**. - Patients exhibit severe motor retardation, often appearing frozen or rigid.

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 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: 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: Visual hallucinations are typically seen in all of the following conditions except?

Depression. **Depression** - While other forms of hallucinations can occur in severe depression with psychotic features (e.g., auditory), **visual hallucinations are rare**. - **Mood-congruent delusions** are more common in psychotic depression than visual hallucinations. *Delirium* - **Visual hallucinations** are a hallmark symptom of delirium, often described as polymorphic and vivid. - They are typically accompanied by **fluctuating consciousness** and cognitive impairment. *Schizophrenia* - Although **auditory hallucinations** are more common, visual hallucinations can occur in schizophrenia, particularly in advanced or severe cases. - These hallucinations are often well-formed, frequent, and can be **persecutory** or **bizarre** in nature. *Alcohol withdrawal* - **Alcohol withdrawal delirium** (delirium tremens) is characterized by prominent **visual hallucinations**, tactile hallucinations, and autonomic instability. - These hallucinations can be terrifying and are due to **CNS hyperexcitability**.

Q: Which of the following can cause delirium?

All of the options. ***All of the options*** - **Delirium** is an acute, fluctuating disturbance in attention and cognition, often with altered consciousness, and can be caused by a wide range of factors. - **Hypoxia**, **barbiturate** use, and **alcohol withdrawal** are all well-established causes of delirium. *Hypoxia* - **Cerebral hypoxia**, or insufficient oxygen supply to the brain, directly impairs neuronal function, leading to acute confusion and altered mental status characteristic of delirium. - Conditions like severe respiratory failure, heart failure, or anemia can precipitate hypoxia and subsequent delirium. *Barbiturates* - **Barbiturates** are central nervous system depressants that can cause sedation, confusion, and cognitive impairment, especially in overdose or in susceptible individuals. - While they typically induce sedation, paradoxical excitement or severe cognitive dysfunction consistent with delirium can occur. *Alcohol withdrawal* - **Alcohol withdrawal** can lead to a severe form of delirium known as *delirium tremens*, characterized by extreme confusion, hallucinations, tremors, and autonomic instability. - The rapid cessation of chronic alcohol intake disrupts neurochemical balance, leading to hyperexcitability and delirium.

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 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.

Q: Which of the following is not a feature of psychosis?

Preserved contact with reality. ***Preserved contact with reality*** - Psychosis is fundamentally characterized by a **loss of contact with reality**, making this option a defining non-feature of the condition. - Individuals experiencing psychosis often have profound difficulties distinguishing between what is real and what is not. *Loss of insight* - **Lack of insight** into one's own mental illness is a hallmark feature of psychosis, meaning the affected individual may not recognize their thoughts or perceptions as abnormal. - This symptom contributes to the difficulty in engaging individuals with psychosis in treatment. *Presence of delusions* - **Delusions** are fixed, false beliefs that are resistant to reason or evidence, and they are a core positive symptom of psychosis. - These beliefs are often bizarre and can significantly impair an individual's functioning and perception of reality. *Personality disturbances* - While not a primary diagnostic criterion, **personality disturbances** can be associated with psychotic disorders. - Changes in personality, mood, and behavior may occur as a result of the psychotic experience or the underlying illness.

Q: Which of the following statements is NOT true about type 1 schizophrenia?

It has a poor prognosis.. ***It has a poor prognosis.*** - This statement is **NOT true** about type 1 schizophrenia, making it the correct answer to this question. - Type 1 schizophrenia is generally associated with a **better prognosis** and good response to antipsychotic medication. - It is characterized by the prominence of **positive symptoms**, which tend to be more responsive to treatment. *It is an acute illness.* - This statement is **TRUE** about type 1 schizophrenia, so it is not the answer. - Type 1 schizophrenia is often characterized by an **acute onset** of symptoms, particularly positive symptoms. - This acute presentation differentiates it from type 2, which typically has a more insidious onset. *Intellect is usually maintained.* - This statement is **TRUE** about type 1 schizophrenia, so it is not the answer. - In type 1 schizophrenia, **cognitive function**, including intellect, is usually better preserved compared to type 2 schizophrenia. - While some cognitive deficits may occur, they are generally less severe and less pervasive than in type 2. *It is characterized by negative symptoms.* - This statement is **FALSE** about type 1 schizophrenia, but it is not the best answer because the prognosis statement is more definitively incorrect. - Type 1 schizophrenia is primarily characterized by the predominance of **positive symptoms**, such as hallucinations, delusions, and disorganized thought. - **Negative symptoms** (e.g., apathy, anhedonia, alogia, blunted affect) are the hallmark of type 2 schizophrenia.

Question 1

In stupor catatonia, all are seen except -

Accepted Answer

Agitation

Answer

Mutism

Answer

Akinesia

Answer

Catalepsy

Question 2

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 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

Waxy flexibility is a feature of ?

Accepted Answer

Catatonia

Answer

Echolalia

Answer

Stereotypy

Answer

Mannerisms

Question 5

Visual hallucinations are typically seen in all of the following conditions except?

Accepted Answer

Depression

Answer

Schizophrenia

Answer

Alcohol withdrawal

Answer

Delirium

Question 6

Which of the following can cause delirium?

Accepted Answer

All of the options

Answer

Hypoxia

Answer

Barbiturates

Answer

Alcohol withdrawal

Question 7

Who coined the term 'psychiatry'?

Accepted Answer

Johann Reil

Answer

Moral

Answer

Bleuler

Answer

Pinel

Question 8

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

Question 9

Which of the following is not a feature of psychosis?

Accepted Answer

Preserved contact with reality

Answer

Loss of insight

Answer

Personality disturbances

Answer

Presence of delusions

Question 10

Which of the following statements is NOT true about type 1 schizophrenia?

Accepted Answer

It has a poor prognosis.

Answer

Intellect is usually maintained.

Answer

It is an acute illness.

Answer

It is characterized by negative symptoms.

NEET-PG 2013 — Psychiatry