NEET-PG 2013 - Psychiatry Practice Questions

Q: Prognosis of schizophrenia is best, if:

Acute onset. ***Acute onset*** - An **acute onset** of schizophrenia is associated with a better prognosis, as it often indicates a more favorable response to treatment and less pervasive deterioration of daily functioning. - This typically suggests that the individual had a relatively intact baseline level of functioning before the emergence of psychotic symptoms. *Negative symptoms* - The presence of prominent **negative symptoms** (e.g., avolition, anhedonia, alogia) is usually associated with a poorer prognosis in schizophrenia. - Negative symptoms are generally harder to treat and often lead to greater functional impairment and disability. *Insidious onset* - An **insidious onset** of schizophrenia, where symptoms develop gradually over time, is typically linked to a poorer prognosis. - This often implies more severe and persistent neurodevelopmental abnormalities and a less robust response to interventions. *Family history is positive* - A **positive family history** of schizophrenia indicates a higher genetic predisposition but does not directly predict the individual's prognosis. - While genetics play a role in susceptibility, the course and outcome of the illness are influenced by many other factors, including symptom presentation and treatment adherence.

Q: An IQ of 40 corresponds to which level of intellectual disability?

Moderate. ***Moderate*** - An **IQ score between 35 and 49** is classified as moderate intellectual disability. - Individuals with moderate intellectual disability often require **supervision** but can develop some communication and self-care skills. *Mild* - **IQ scores between 50 and 69** are indicative of mild intellectual disability. - Individuals with mild intellectual disability can often achieve academic skills up to a **sixth-grade level** and live independently with support. *Profound* - **IQ scores below 20** signify profound intellectual disability. - Individuals with profound intellectual disability require **intensive support** for all activities of daily living and have minimal communication skills. *Severe* - **IQ scores between 20 and 34** fall into the severe intellectual disability category. - Individuals with severe intellectual disability have significant **impairments in adaptive functioning** and require substantial support for self-care and communication.

Q: Severe mental retardation is:

20-35. ***20-35*** - A **score between 20-35** indicates **severe mental retardation**, where individuals typically have very limited communication skills and require extensive support in daily living activities. - This range is associated with significant cognitive impairment that often necessitates full-time supervision. *<20* - An **IQ score below 20** signifies **profound mental retardation**, indicating extremely limited intellectual functioning and severe developmental delays. - Individuals in this category generally have very minimal capacity for self-care or communication. *35-50* - This IQ range reflects **moderate mental retardation**, where individuals can often develop some basic communication and self-care skills, but still require significant support. - They may live semi-independently with supervision, but struggle with academic and complex social tasks. *50-70* - An **IQ score between 50-70** is classified as **mild mental retardation**, which is the most common form. - Individuals often achieve academic skills up to a 6th-grade level and can live independently with appropriate support.

Q: Erotomania is seen in:

Delusional disorder. ***Delusional disorder*** - Erotomania (De Clérambault's syndrome) is **classically a subtype of delusional disorder** known as **erotomanic type** in DSM-5. - Characterized by a **non-bizarre delusion** that another person, usually of higher social status, is in love with the individual. - The delusion persists despite clear evidence to the contrary and is the **primary psychiatric diagnosis** for erotomania. - Patients may engage in behaviors like following, attempting contact, or surveillance of the object of their delusion. *Bipolar mania* - While **psychotic features can occur** in severe manic episodes, they typically involve **grandiose delusions** about one's own abilities, power, wealth, or special identity. - Erotomania is **not a characteristic or common psychotic feature** of bipolar mania. - Manic psychosis more commonly presents with mood-congruent grandiose delusions rather than erotomanic delusions. *Obsessive compulsive disorder* - Characterized by **obsessions** (intrusive, unwanted thoughts) and **compulsions** (repetitive behaviors performed to reduce anxiety). - These thoughts are **ego-dystonic** and recognized as excessive or irrational by the patient. - Erotomania is a **fixed delusional belief** without insight, fundamentally different from OCD phenomenology. *Mania without psychotic features* - By definition involves elevated mood, increased energy, and decreased need for sleep **without delusions or hallucinations**. - Erotomania is a **delusional belief**, indicating presence of psychotic features. - This diagnosis would exclude any presentation with erotomanic delusions.

Q: Mental Health Care Act of India was passed in the year:

2017. ***2017*** - The **Mental Health Care Act of India** was specifically enacted in **2017**, introducing a comprehensive rights-based approach to mental healthcare. - This act replaced the outdated **Mental Health Act 1987** and focuses on protecting the rights of persons with mental illness while ensuring quality care. *1948* - This year marks the **Universal Declaration of Human Rights** globally, but no mental health legislation was enacted in India. - India's mental health framework was still governed by the colonial-era **Indian Lunacy Act of 1912** during this period. *2007* - No significant mental health legislation was passed in India during this year. - The **Mental Health Act 1987** remained in effect, and the new Mental Health Care Act was still a decade away. *1987* - The **Mental Health Act 1987** (without "Care" in the title) was passed in this year, not the Mental Health Care Act. - This act provided the legal framework for mental health services but lacked the comprehensive **rights-based approach** later introduced in 2017.

Q: Type of schizophrenia with intellectual disability:

Pfropf schizophrenia. ***Pfropf schizophrenia*** - **Pfropf schizophrenia** is a historical term specifically used to describe a form of schizophrenia that develops in individuals with **pre-existing intellectual disability** (formerly termed mental retardation). - The term "Pfropf" is derived from German, meaning "grafted" or "engrafted," referring to schizophrenia being "grafted onto" pre-existing intellectual disability. - This term distinguishes it from other types of schizophrenia where intellectual disability is not a primary defining characteristic. - While this classification is largely historical (modern DSM-5 has removed schizophrenia subtypes), it remains relevant for older examination questions. *Catatonic schizophrenia* - Characterized primarily by prominent **psychomotor disturbances**, which can include stupor, catalepsy, waxy flexibility, mutism, and negativism. - While intellectual disability might coexist, it is not a defining feature of the catatonic subtype itself. *Paranoid schizophrenia* - Marked by the prominence of **delusions**, typically persecutory or grandiose, and **auditory hallucinations**. - Intellectual disability is not a core diagnostic criterion or a defining characteristic of this subtype. *Hebephrenic schizophrenia* - Also known as **disorganized schizophrenia**, this type is characterized by marked **disorganization of thought processes**, flat or inappropriate affect, and bizarre behavior. - While it often presents early and can lead to significant functional impairment, intellectual disability is not a defining feature; rather, the primary disturbance is in thought and emotion.

Q: All are first rank symptoms of schizophrenia, except:

Perplexity. ***Perplexity*** - **Perplexity** is a state of severe confusion, bewilderment, or puzzlement, which can be seen in various psychiatric conditions but is not specifically classified as a **first-rank symptom of schizophrenia** by Kurt Schneider. - While it may be present in schizophrenia, it is a non-specific symptom, meaning it can occur in conditions other than schizophrenia. *Audible thoughts* - **Audible thoughts** (Gedankenlautwerden in German) refers to the patient hearing their own thoughts spoken aloud, often as if by another voice. - This is considered a **first-rank symptom** as described by Kurt Schneider, highly indicative of schizophrenia. *Thought broadcasting* - **Thought broadcasting** is the delusional belief that one's thoughts are escaping from their mind and are somehow accessible to others. - This symptom is also a **first-rank symptom** of schizophrenia according to Schneider's criteria. *Voice arguing or discussing or both* - **Voices arguing or discussing** are a specific type of auditory hallucination where two or more voices are perceived to be talking to each other, often about the patient. - This phenomenon is considered a classic **first-rank symptom** of schizophrenia.

Q: Quod hanc means:

Impotent towards a particular woman. ***Impotent towards a particular woman*** - The Latin phrase "**Quod hanc**" translates to "towards this woman." - In a medical or medico-legal context, particularly when discussing impotence or fertility, it refers to a situation where a man is **impotent only in relation to a specific woman** or partner, but not with others. [1] *Impotent due to psychological factors* - While psychological factors can cause situational impotence, "Quod hanc" specifically describes an impotence directed **"towards this woman,"** rather than broadly psychological. - This option is broader than the precise meaning of the Latin phrase, which highlights the **specificity of the partner**. *Impotent due to physical factors* - "Quod hanc" has no direct implication about the underlying cause being physical; it solely points to the **target of the impotence**. - Physical impotence would generally mean an inability to achieve erection with **any partner**, which contradicts the specific nature implied by "hanc." *Impotent in specific situations* - This is a general term for **situational impotence**, which could include performance anxiety or stress. [1] - "Quod hanc" is a **more specific sub-category** of situational impotence, precisely indicating that the impotence is directed at "this woman."

Question 1

Prognosis of schizophrenia is best, if:

Accepted Answer

Acute onset

Answer

Negative symptoms

Answer

Insidious onset

Answer

Family history is positive

Question 2

An IQ of 40 corresponds to which level of intellectual disability?

Accepted Answer

Moderate

Answer

Mild

Answer

Profound

Answer

Severe

Question 3

Anxiety is best described as:

Accepted Answer

Excessive worry and emotional distress without loss of reality (Anxiety disorder)

Answer

A specific fear leading to avoidance behavior (Phobic disorder)

Answer

A mental disorder with delusions or hallucinations (Psychosis)

Answer

Enduring maladaptive personality traits (Personality disorder)

Question 4

Frotteurism is:

Accepted Answer

Sexual gratification by rubbing against a non-consenting person

Answer

Sexual practice involving three people

Answer

Sexual pleasure in watching people getting undressed

Answer

Sexual pleasure obtained by witnessing urination

Question 5

Severe mental retardation is:

Accepted Answer

20-35

Answer

<20

Answer

35-50

Answer

50-70

Question 6

Erotomania is seen in:

Accepted Answer

Delusional disorder

Answer

Obsessive compulsive disorder

Answer

Bipolar mania

Answer

Mania without psychotic features

Question 7

Mental Health Care Act of India was passed in the year:

Accepted Answer

2017

Answer

1948

Answer

2007

Answer

1987

Question 8

Type of schizophrenia with intellectual disability:

Accepted Answer

Pfropf schizophrenia

Answer

Catatonic schizophrenia

Answer

Paranoid schizophrenia

Answer

Hebephrenic schizophrenia

Question 9

All are first rank symptoms of schizophrenia, except:

Accepted Answer

Perplexity

Answer

Audible thoughts

Answer

Thought broadcasting

Answer

Voice arguing or discussing or both

Question 10

Quod hanc means:

Accepted Answer

Impotent towards a particular woman

Answer

Impotent due to psychological factors

Answer

Impotent due to physical factors

Answer

Impotent in specific situations

NEET-PG 2013 — Psychiatry