UPSC-CMS 2025 - Psychiatry PYQs Practice Questions

Q: The 4AT is a screening tool for detection of delirium. Which THREE of the following parameters listed below are included in the 4AT tool? I. Alertness II. Apnoea III. Abbreviated Mental Test (AMT4) IV. Attention Select the correct answer using the code given below:

I, III and IV. ***I, III and IV*** - The 4AT screening tool specifically includes **Alertness**, **AMT4 (Abbreviated Mental Test)**, and **Attention** as key parameters for detecting delirium. - The **AMT4** component assesses **cognitive function**, while **Alertness** and **Attention** evaluate the patient's state of consciousness and focus. *I, II and IV* - This option incorrectly includes **Apnoea**. While apnoea is a significant medical condition, it is not a direct parameter in the **4AT delirium screening tool**. - The 4AT focuses on cognitive and neurological signs of delirium, not respiratory patterns. *I, II and III* - This option also incorrectly includes **Apnoea** as one of the parameters in the 4AT tool. - The 4AT is designed to assess **delirium**, which primarily manifests through altered mental status, rather than respiratory issues. *II, III and IV* - This option is incorrect as it includes **Apnoea** and omits **Alertness**, which is a fundamental component of the **4AT delirium screening tool**. - **Alertness** is crucial for evaluating the patient's level of consciousness, a primary sign of delirium. [Practice more Psychiatry PYQs on OnCourse]

Q: Specific genetic conditions account for a proportion of Autism Spectrum Disorder (ASD) cases. Which of the following are known to be associated with ASD ? I. Tuberous sclerosis II. Fragile X syndrome III. Prader-Willi syndrome IV. Patau syndrome Select the correct answer using the code given below :

I and II. ***I and II*** - Both **Tuberous sclerosis** and **Fragile X syndrome** are well-established genetic conditions with a strong association with Autism Spectrum Disorder (ASD). - Tuberous Sclerosis Complex (TSC) is a genetic disorder that causes **benign tumors** to grow in the brain and other organs, and approximately **40-50% of individuals with TSC also have ASD**. Fragile X syndrome is the **most common inherited cause of intellectual disability** and a leading known **single-gene cause of ASD**, with about **25-50% of affected males** meeting the diagnostic criteria for ASD. *I and III* - While Tuberous sclerosis is strongly associated with ASD, **Prader-Willi syndrome** has a less consistent and well-defined relationship with ASD despite some overlapping behavioral features. - Prader-Willi syndrome is characterized by **hyperphagia (insatiable appetite)**, intellectual disability, and behavioral problems, but the autistic-like features may represent a behavioral phenocopy rather than true ASD. *II and III* - **Fragile X syndrome** is strongly associated with ASD, but **Prader-Willi syndrome** is not considered a primary or well-established genetic cause of ASD. - While intellectual disability and behavioral difficulties can be present in both, their underlying genetic mechanisms and core features differ significantly regarding ASD classification. *I and IV* - **Tuberous sclerosis** is clearly linked to ASD, but **Patau syndrome (Trisomy 13)** is not associated with ASD. - Patau syndrome is a severe chromosomal disorder characterized by **multiple congenital abnormalities** and **profound developmental delays**, often leading to early mortality. The severe nature of the condition and high infant mortality rate preclude typical ASD presentation. [Practice more Psychiatry PYQs on OnCourse]

Q: Which of the following medications may be used in a child diagnosed with Attention Deficit Hyperactivity Disorder? I. Carbamazepine II. Methylphenidate III. Atomoxetine IV. Clonazepam Select the correct answer using the code given below :

II and III. ***II and III*** - **Methylphenidate** is a first-line **CNS stimulant** that increases dopamine and norepinephrine in the prefrontal cortex, improving attention and reducing hyperactivity/impulsivity - **Atomoxetine** is a **selective norepinephrine reuptake inhibitor (SNRI)**, FDA-approved as a non-stimulant alternative for ADHD management - Both medications are **evidence-based treatments** for ADHD in children with proven efficacy in controlled trials *I and III* - **Carbamazepine** is an anticonvulsant used for epilepsy and bipolar disorder, **not indicated for ADHD** - While Atomoxetine is correct, pairing it with Carbamazepine makes this option incorrect *I and IV* - **Carbamazepine** has no role in ADHD management - **Clonazepam** is a benzodiazepine used for anxiety and seizures, **contraindicated in ADHD** as it causes sedation and may worsen attention deficits *II and IV* - While Methylphenidate is a core ADHD medication, **Clonazepam is inappropriate** for ADHD treatment - Benzodiazepines can impair cognitive function and exacerbate attention problems in ADHD patients [Practice more Psychiatry PYQs on OnCourse]

Q: Which one of the following is correct regarding postpartum psychosis?

Recurrence rate in subsequent pregnancy is 60-70 %.. ***Recurrence rate in subsequent pregnancy is 60-70%.*** - Postpartum psychosis carries a **high recurrence risk**, making subsequent pregnancies a concern for women with a history of the condition. - This high recurrence rate (ranging from 50-80% across studies) underscores the importance of close monitoring and prophylactic treatment in future pregnancies. *Electro convulsive therapy is the first treatment of choice.* - **ECT** is considered for severe cases of postpartum psychosis, particularly when there is rapid deterioration, severe suicidality, or catatonia, rather than being the first-line treatment. - Initial management typically involves a combination of **antipsychotics and mood stabilizers**, often in an inpatient setting for safety. *There is often no family history of psychosis.* - A **family history of psychosis**, especially bipolar disorder or schizophrenia, is a **significant risk factor** for postpartum psychosis. - Genetic predisposition plays a substantial role, making this statement incorrect—family history is commonly present. *Its onset is usually within 4 days of delivery.* - While postpartum psychosis has a **rapid onset**, stating "usually within 4 days" is too restrictive. - The condition typically manifests within the **first 2-4 weeks after delivery**, with approximately **50% of cases occurring within the first week** and peak incidence in the first 2 weeks. - This makes the 4-day timeframe an underestimate of the typical onset window. [Practice more Psychiatry PYQs on OnCourse]

Q: Which among the following are defence mechanisms adopted when an individual is faced with problems or failures? I. Rationalization II. Regression III. Projection IV. Replacement Select the correct answer using the code given below :

I, II and III. ***I, II and III*** - **Rationalization**, **Regression**, and **Projection** are all classic defense mechanisms described in psychoanalytic theory. - These mechanisms are unconscious strategies used by the **ego** to reduce anxiety and protect the self from unacceptable thoughts or feelings, particularly when an individual faces problems or failures. *I, III and IV* - This option correctly identifies Rationalization and Projection, but incorrectly includes **Replacement**. - While "replacement" might refer to a form of **displacement** in some contexts, it is not a standard, recognized defense mechanism in the classic psychoanalytic framework. *I, II and IV* - This option correctly identifies Rationalization and Regression, but incorrectly includes **Replacement**. - **Replacement** is not a standard defense mechanism; instead, individuals might experience **displacement** where feelings are redirected to a safer target. *II, III and IV* - This option includes Regression and Projection, but misses **Rationalization** while incorrectly including **Replacement**. - **Rationalization** is a very common defense mechanism involving creating logical but false justifications for actions or beliefs. [Practice more Psychiatry PYQs on OnCourse]

Question 1

The 4AT is a screening tool for detection of delirium. Which THREE of the following parameters listed below are included in the 4AT tool?
I. Alertness
II. Apnoea
III. Abbreviated Mental Test (AMT4)
IV. Attention

Select the correct answer using the code given below:

Accepted Answer

I, III and IV

Answer

I, II and IV

Answer

I, II and III

Answer

II, III and IV

Question 2

Specific genetic conditions account for a proportion of Autism Spectrum Disorder (ASD) cases. Which of the following are known to be associated with ASD ?
I. Tuberous sclerosis
II. Fragile X syndrome
III. Prader-Willi syndrome
IV. Patau syndrome

Select the correct answer using the code given below :

Accepted Answer

I and II

Answer

I and III

Answer

II and III

Answer

I and IV

Question 3

Which of the following medications may be used in a child diagnosed with Attention Deficit Hyperactivity Disorder?
I. Carbamazepine
II. Methylphenidate
III. Atomoxetine
IV. Clonazepam

Select the correct answer using the code given below :

Accepted Answer

II and III

Answer

I and III

Answer

I and IV

Answer

II and IV

Question 4

Which one of the following is correct regarding postpartum psychosis?

Accepted Answer

Recurrence rate in subsequent pregnancy is 60-70 %.

Answer

Electro convulsive therapy is the first treatment of choice.

Answer

There is often no family history of psychosis.

Answer

Its onset is usually within 4 days of delivery.

Question 5

Which among the following are defence mechanisms adopted when an individual is faced with problems or failures?
I. Rationalization
II. Regression
III. Projection
IV. Replacement

Select the correct answer using the code given below :

Accepted Answer

I, II and III

Answer

I, III and IV

Answer

I, II and IV

Answer

II, III and IV

UPSC-CMS 2025 — Psychiatry