Mutism and akinesis in a person who appears awake and even alert is best described as:
Q512
What is the term used in neuropsychology to describe the phenomenon where an individual persistently and inappropriately repeats the same thoughts or actions?
Q513
What is the code for mental disorders in the ICD-10 classification?
Q514
Which of the following disorders does not typically involve auditory hallucinations?
Psychiatric Assessment and Diagnosis Indian Medical PG Practice Questions and MCQs
Question 511: Mutism and akinesis in a person who appears awake and even alert is best described as:
A. Stupor (unresponsive state)
B. Oneroid state (hallucinations and vivid dreams)
C. Delirium (fluctuating consciousness and agitation)
D. Akinetic mutism (Correct Answer)
Explanation: ***Akinetic mutism***
- This condition is characterized by **mutism (inability to speak)** and **akinesis (lack of voluntary movement)**, despite the patient appearing awake and alert with preserved consciousness.
- It results from lesions in specific brain regions, such as the **anterior cingulate gyrus** or bilateral paramedian thalamic nuclei, which *disconnect* motivation from motor output.
*Stupor (unresponsive state)*
- Stupor is a state of **unresponsiveness** from which the patient can be aroused only by vigorous and repeated noxious stimuli.
- Unlike akinetic mutism, individuals in stupor are **not considered awake or alert** and have significantly impaired consciousness.
*Oneroid state (hallucinations and vivid dreams)*
- An oneroid state involves a dream-like state with **vivid hallucinations**, illusions, and disoriented behavior, often associated with a clouding of consciousness.
- While there may be motor disturbances, the primary feature is the **dream-like perceptual experience**, which differs from the *mutism* and *akinesis* of an otherwise alert person.
*Delirium (fluctuating consciousness and agitation)*
- Delirium is an acute state of **fluctuating consciousness**, disorientation, and often includes agitation, inattention, and cognitive impairment.
- The key features are the **acute onset** and *fluctuating nature* of consciousness and cognitive deficits, which is distinct from the persistent mutism and akinesis in an alert individual seen in akinetic mutism.
Question 512: What is the term used in neuropsychology to describe the phenomenon where an individual persistently and inappropriately repeats the same thoughts or actions?
A. Obsessions
B. Perseveration (Correct Answer)
C. Thought blocking
D. Rumination
Explanation: ***Perseveration, characterized by repetitive and inappropriate thoughts or actions.***
- **Perseveration** is a core executive dysfunction symptom, where an individual repeatedly responds with the same answer or behavior despite changing situations or instructions.
- It often indicates **frontal lobe dysfunction** due to conditions like stroke, traumatic brain injury, or neurodegenerative diseases.
*Thought blocking, commonly seen in schizophrenia.*
- **Thought blocking** refers to an abrupt interruption in the flow of thoughts, where the person stops speaking mid-sentence and then, after a brief pause, cannot recall what they were saying.
- It is a **thought disorder** symptom associated with conditions like **schizophrenia**, not persistent repetition.
*Obsessions, a hallmark of obsessive-compulsive disorder (OCD).*
- **Obsessions** are intrusive, unwanted, and recurrent thoughts, images, or urges that cause distress and anxiety, but they are typically *internal mental experiences* rather than repetitive outward actions in this context.
- While they are repetitive, they are specifically linked to the **anxiety-driven cycle of OCD** and are distinct from the executive dysfunction seen in perseveration.
*Rumination, often associated with mood disorders.*
- **Rumination** involves repetitive and passive dwelling on the causes, meanings, and consequences of negative thoughts and feelings, often seen in **depression**.
- It is a **cognitive process** focused on internal contemplation of distress, rather than a motor or behavioral repetition in response to a task.
Question 513: What is the code for mental disorders in the ICD-10 classification?
A. E
B. F (Correct Answer)
C. P
D. G
Explanation: ***F***
- In the **ICD-10 classification**, the chapter for **Mental and behavioural disorders** is designated by the letter **'F'**.
- This chapter covers a wide range of conditions, from mental retardation to mood disorders and substance-related disorders.
*E*
- The letter **'E'** in ICD-10 is used for **Endocrine, nutritional and metabolic diseases**.
- This category includes conditions like diabetes mellitus and thyroid disorders.
*P*
- The letter **'P'** in ICD-10 denotes **Certain conditions originating in the perinatal period**.
- These are conditions that arise during the period around childbirth.
*G*
- The letter **'G'** in ICD-10 refers to **Diseases of the nervous system**.
- This chapter includes conditions like epilepsy, Parkinson's disease, and stroke.
Question 514: Which of the following disorders does not typically involve auditory hallucinations?
A. Schizophrenia
B. Acute and transient psychotic disorder
C. Delirium tremens
D. Panic disorder (Correct Answer)
Explanation: ***Panic disorder***
- While individuals experiencing panic attacks may feel **derealization** or **depersonalization**, they do not typically manifest **auditory hallucinations**.
- Panic disorder is characterized by sudden, intense episodes of fear accompanied by **physical symptoms** like palpitations, shortness of breath, and chest pain, without perceptual disturbances.
*Schizophrenia*
- **Auditory hallucinations** are a hallmark symptom of schizophrenia, often involving voices commenting, conversing, or commanding.
- These are considered **positive symptoms** and are crucial for diagnosis.
*Acute and transient psychotic disorder*
- This disorder is characterized by the **sudden onset of psychotic symptoms**, including **auditory hallucinations**, delusions, and disorganized speech or behavior.
- The symptoms are often severe but resolve within a short period, typically less than one month.
*Delirium tremens*
- This is a severe form of **alcohol withdrawal** that commonly causes significant **auditory**, visual, and tactile hallucinations.
- The hallucinations are often vivid and distressing, distinguishing it from other withdrawal symptoms.
