Which type of delusion is primarily associated with Cotard's syndrome?
Waxy flexibility is a feature of ?
Visual hallucinations are typically seen in all of the following conditions except?
Which of the following can cause delirium?
Which of the following is NOT a diagnostic criterion for drug dependence?
Which of the following is true regarding the treatment of cocaine withdrawal symptoms?
Which of the following is NOT a symptom of nicotine withdrawal?
Which of the following conditions does not typically involve delusions?
Which of the following is not a feature of psychosis?
Which of the following is NOT a feature of neurosis?
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 41: Which type of delusion is primarily associated with Cotard's syndrome?
- A. Persecutory delusions
- B. Religious delusions
- C. Nihilistic delusions (Correct Answer)
- D. Hypochondriacal delusions
Explanation: ***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.
Question 42: Waxy flexibility is a feature of ?
- A. Catatonia (Correct Answer)
- B. Echolalia
- C. Stereotypy
- D. Mannerisms
Explanation: ***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.
Question 43: Visual hallucinations are typically seen in all of the following conditions except?
- A. Schizophrenia
- B. Alcohol withdrawal
- C. Delirium
- D. Depression (Correct Answer)
Explanation: **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**.
Question 44: Which of the following can cause delirium?
- A. Hypoxia
- B. Barbiturates
- C. Alcohol withdrawal
- D. All of the options (Correct Answer)
Explanation: ***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.
Question 45: Which of the following is NOT a diagnostic criterion for drug dependence?
- A. Taking substance in larger amounts than intended
- B. Tolerance
- C. Withdrawal symptoms
- D. Early completion of tasks (Correct Answer)
Explanation: ***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 46: Which of the following is true regarding the treatment of cocaine withdrawal symptoms?
- A. Fluoxetine
- B. Antidepressants
- C. No specific drug (Correct Answer)
- D. Benzodiazepines
Explanation: ***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.
Question 47: Which of the following is NOT a symptom of nicotine withdrawal?
- A. Anxiety
- B. Increased heart rate (Correct Answer)
- C. Hyperhidrosis
- D. Weight gain
Explanation: ***Increased heart rate*** - **Increased heart rate** is NOT a symptom of nicotine withdrawal; rather, it is associated with **active nicotine use** due to nicotine's stimulant effects on the sympathetic nervous system. - During **nicotine withdrawal**, the heart rate typically **decreases or normalizes** as the body adjusts to the absence of nicotine's cardiovascular stimulation. - Nicotine acts as a sympathomimetic agent, causing tachycardia during use, but withdrawal does not produce increased heart rate. *Anxiety* - **Anxiety** is one of the most common and prominent symptoms of **nicotine withdrawal**. - As nicotine affects neurotransmitter systems (particularly dopamine, norepinephrine, and serotonin), cessation leads to neurochemical imbalances manifesting as anxiety, irritability, and restlessness. - This symptom typically peaks within the first week of cessation. *Hyperhidrosis* - **Hyperhidrosis** (excessive sweating) is actually a recognized symptom of **nicotine withdrawal**. - Increased sweating can occur as part of the autonomic nervous system dysregulation during the withdrawal period. - This is included among the physical withdrawal symptoms in standard diagnostic criteria. *Weight gain* - **Weight gain** is a well-documented and common consequence of **nicotine withdrawal**. - This occurs due to increased appetite, decreased metabolic rate (as nicotine's metabolic-enhancing effects cease), and behavioral substitution of smoking with eating. - Average weight gain is approximately 4-5 kg in the months following cessation.
Question 48: Which of the following conditions does not typically involve delusions?
- A. Delirium
- B. Alcohol withdrawal
- C. OCD (Correct Answer)
- D. Schizophrenia
Explanation: ***OCD*** - **Obsessive-compulsive disorder** is characterized by recurrent, intrusive **thoughts (obsessions)** and repetitive **behaviors (compulsions)**, which the individual typically recognizes as irrational. - While patients with severe OCD may have **poor insight**, they generally do not experience **delusions**, which are fixed, false beliefs held despite evidence to the contrary. *Delirium* - **Delirium** is an acute, fluctuating disturbance of consciousness resulting from medical conditions or substance intoxication/withdrawal, often accompanied by **psychotic symptoms** including **delusions** and **hallucinations**. - The rapid onset and global cognitive impairment make **delusions** a common feature. *Schizophrenia* - **Schizophrenia** is a severe mental disorder characterized by **psychotic symptoms**, with **delusions** being one of the hallmark positive symptoms. - These **delusions** often include **persecutory**, **grandiose**, or **somatic themes**, among others. *Alcohol withdrawal* - Severe **alcohol withdrawal** can lead to **delirium tremens (DTs)**, which is associated with **psychotic symptoms** such as **delusions** and vivid **hallucinations** (often visual or tactile). - These **delusions** are often **persecutory** or referential in nature and contribute to the patient's fear and agitation.
Question 49: Which of the following is not a feature of psychosis?
- A. Loss of insight
- B. Preserved contact with reality (Correct Answer)
- C. Personality disturbances
- D. Presence of delusions
Explanation: ***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.
Question 50: Which of the following is NOT a feature of neurosis?
- A. Symptoms cause subjective distress
- B. Contact with reality preserved
- C. Personality disturbances (Correct Answer)
- D. Insight is maintained
Explanation: ***Personality disturbances*** - While neurosis can cause significant distress and impact functioning, it does not typically involve **fundamental alterations in personality structure or identity**. - **Personality disorders**, not neuroses, are characterized by deeply ingrained, inflexible, and maladaptive patterns of perceiving, thinking, and behaving that deviate markedly from cultural expectations. *Symptoms cause subjective distress* - A core characteristic of neurosis is that the individual experiences significant **emotional suffering** and discomfort due to their symptoms, such as anxiety, phobias, or obsessions. - This **subjective distress** is often a primary motivator for seeking treatment. *Contact with reality preserved* - Individuals with neurosis maintain their ability to **distinguish between internal experiences and external reality**, unlike in psychosis where this distinction is lost. - They may understand that their fears or anxieties are irrational, but they are unable to control them. *Insight is maintained* - People with neurosis generally have some level of **awareness** that they have a problem or that their symptoms are unreasonable or excessive. - This **insight** allows them to recognize the need for help and engage in therapeutic processes.