Sleep-Wake Disorders — MCQs

An 11-year-old boy is brought to the physician with a complaint that he gets up at night and while sleeping, he walks around the house for a few minutes before returning to bed. When his parents try to wake him up, he is confused and disoriented. Which of the following is the most appropriate treatment for him?

Q82

What is the term for a persistent lack of sexual desire or arousal?

Q83

What is the term used to describe increased sexual desire in males?

Sleep-Wake Disorders Indian Medical PG Practice Questions and MCQs

Question 81: An 11-year-old boy is brought to the physician with a complaint that he gets up at night and while sleeping, he walks around the house for a few minutes before returning to bed. When his parents try to wake him up, he is confused and disoriented. Which of the following is the most appropriate treatment for him?

A. Tell the parents to maintain a safe environment and monitor the patient's symptoms (Correct Answer)
B. Start the patient on a low dose of a tricyclic antidepressant
C. Tell the parents that the child would benefit from cognitive behavioral therapy
D. Start the patient on a low dose of benzodiazepines at night

Explanation: ***Tell the parents to maintain a safe environment and monitor the patient's symptoms*** - This presentation describes **sleepwalking** (somnambulism), a **NREM sleep arousal disorder** common in children, which typically resolves spontaneously as the child matures. - The primary management involves ensuring the child's **safety** during episodes (e.g., locking windows/doors) and observing symptom progression, with active pharmacologic treatment often unnecessary unless episodes are frequent, dangerous, or significantly disruptive. *Start the patient on a low dose of a tricyclic antidepressant* - **Tricyclic antidepressants** are generally not indicated as first-line treatment for uncomplicated sleepwalking in children due to potential side effects and the self-limiting nature of the condition. - While sometimes used in severe cases, the potential for side effects outweighs the benefits in mild to moderate presentations. *Tell the parents that the child would benefit from cognitive behavioral therapy* - **Cognitive behavioral therapy (CBT)** is more commonly used for sleep disorders like insomnia or anxiety-related sleep issues, rather than isolated sleepwalking episodes in children. - While it may address underlying stressors, it is not the initial or primary treatment for managing the physical act of sleepwalking. *Start the patient on a low dose of benzodiazepines at night* - **Benzodiazepines** can be used in some severe cases of sleepwalking to suppress NREM sleep arousal, but they are not a first-line treatment, especially in children, due to potential side effects such as **sedation**, **tolerance**, and **dependence**. - Their use is typically reserved for cases where sleepwalking poses significant danger and non-pharmacological interventions have failed.

Question 82: What is the term for a persistent lack of sexual desire or arousal?

A. Female Orgasmic Disorder
B. Genito-Pelvic Pain/Penetration Disorder
C. Male Erectile Disorder
D. Hypoactive Sexual Desire Disorder (HSDD) (Correct Answer)

Explanation: ***Hypoactive Sexual Desire Disorder (HSDD)*** - **HSDD** is characterized by a persistent or recurrent deficiency or absence of **sexual fantasies** and desire for **sexual activity**. - This diagnosis specifically addresses the **lack of desire or arousal**, differentiating it from other sexual dysfunctions. *Female Orgasmic Disorder* - This disorder is marked by significant difficulty, delay, or absence of **orgasm** following sufficient sexual stimulation and arousal. - While it impacts sexual experience, it does not primarily involve a lack of **desire or arousal**. *Genito-Pelvic Pain/Penetration Disorder* - This condition is defined by persistent difficulties with vaginal penetration, marked by **genito-pelvic pain**, fear/anxiety about pain, and/or tensing of pelvic floor muscles. - It focuses on **pain and physical barriers** to sexual activity, not explicitly on desire. *Male Erectile Disorder* - This disorder involves a consistent inability to attain and/or maintain an adequate **erection** until the completion of sexual activity. - While it affects a male's ability to engage in sexual activity, the primary issue is **erectile function**, not necessarily a lack of sexual desire.

Question 83: What is the term used to describe increased sexual desire in males?

A. Nymphomania
B. Satyriasis (Correct Answer)
C. Frigidity
D. Fetishism

Explanation: ***Satyriasis*** - **Satyriasis** is the term used to describe **excessive or uncontrollable sexual desire in men**. - It refers to a compulsive need for sexual activity, often leading to distress or functional impairment. *Nymphomania* - **Nymphomania** is the term for **excessive sexual desire in women**, not men. - While analogous, it specifically applies to the female gender. *Frigidity* - **Frigidity** typically refers to a **lack of sexual desire or arousal**, primarily in women. - It is the opposite of increased sexual desire and is not gender-specific to men. *Fetishism* - **Fetishism** involves sexual arousal derived from an **unusual focus on a non-genital object or body part**. - It describes a specific sexual preference, not an overall increase in sexual desire.

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