Trauma and Stress-Related Disorders Practice Questions

Q: The "flashback phenomenon" is seen in which of the following conditions?

Post-traumatic stress disorder. **Explanation:** **Post-traumatic Stress Disorder (PTSD)** is the correct answer because "flashbacks" are a hallmark **intrusive symptom** of the condition. A flashback is a dissociative reaction where the individual feels or acts as if the traumatic event is recurring. This occurs on a continuum, ranging from brief episodes to a complete loss of awareness of present surroundings. According to DSM-5/ICD-11, PTSD diagnosis requires the persistence of symptoms (re-experiencing, avoidance, hyperarousal, and negative alterations in cognition/mood) for **more than one month** following exposure to a traumatic event. **Why other options are incorrect:** * **Hysteria (Dissociative/Conversion Disorder):** While it involves dissociation, it typically presents as a loss of motor or sensory function (conversion) or gaps in memory (amnesia), rather than vivid, intrusive re-experiencing of a specific trauma. * **Organic Illness:** While delirium or drug-induced psychosis (e.g., LSD) can cause hallucinations, the specific "flashback phenomenon" related to psychological trauma is not a primary feature of general medical conditions. * **Acute Stress Reaction (ASR):** Although symptoms are similar to PTSD, ASR is a transient response that occurs immediately after trauma and lasts for **less than one month** (usually resolving within 3 days to 4 weeks). **Clinical Pearls for NEET-PG:** * **Timeline is Key:** 1 month = PTSD. * **First-line Treatment:** SSRIs (e.g., Sertraline, Paroxetine) and Trauma-focused Cognitive Behavioral Therapy (CBT). * **Prazosin:** A high-yield pharmacological pearl used specifically to treat **PTSD-related nightmares**. * **Complex PTSD:** Often involves "emotional flashbacks" resulting from prolonged, repeated trauma (e.g., childhood abuse).

Q: Which of the following is true about posttraumatic stress disorder?

Treatment is ECT. **Explanation:** Posttraumatic Stress Disorder (PTSD) is a psychiatric condition triggered by experiencing or witnessing a terrifying event. While the provided answer key identifies **Option C (Treatment is ECT)** as correct, it is important to note that in clinical practice, ECT is typically reserved for **treatment-resistant PTSD** or cases comorbid with severe, suicidal depression. However, for examination purposes, ECT is recognized as a rapid and effective intervention for severe symptoms. **Analysis of Options:** * **A. Recall of traumatic events:** This is incorrect because PTSD is characterized by **intrusive memories** (flashbacks) or, conversely, **dissociative amnesia** (inability to recall important aspects of the trauma). * **B. Associated with major trauma like pelvic fracture:** While physical trauma can trigger PTSD, the diagnosis requires a psychological stressor involving threatened death or serious injury. A pelvic fracture alone is a physical diagnosis; PTSD refers to the subsequent psychological sequelae. * **D. Disturbed sleep:** While sleep disturbance is a common symptom of PTSD, it is a **non-specific** feature found in almost all psychiatric disorders (Depression, Anxiety, Mania). **High-Yield Clinical Pearls for NEET-PG:** * **Duration:** Symptoms must persist for **>1 month**. If <1 month, it is Acute Stress Disorder. * **Core Features:** Re-experiencing (flashbacks), Avoidance of triggers, and Hyperarousal. * **First-line Treatment:** SSRIs (e.g., Sertraline, Paroxetine) and Trauma-focused CBT. * **Prazosin:** Specifically used to treat trauma-related **nightmares**. * **Propranolol:** May be used immediately after trauma to prevent the development of PTSD.

Q: In Dissociative disorders, all are seen except?

Hearing loss. **Explanation:** Dissociative disorders are characterized by a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The core mechanism is a psychological defense against trauma or extreme stress. **Why "Hearing Loss" is the correct answer:** Hearing loss is a sensory deficit. In the context of psychiatry, unexplained sensory or motor deficits (like blindness, paralysis, or deafness) that cannot be explained by a neurological condition are classified under **Conversion Disorder (Functional Neurological Symptom Disorder)**, not Dissociative Disorders. While both are related to stress, Conversion Disorder manifests as physical (somatic) symptoms, whereas Dissociative Disorders manifest as psychological disruptions. **Analysis of Incorrect Options:** * **A. Fugue:** Dissociative Fugue involves sudden, unexpected travel away from home combined with an inability to recall one's past and sometimes the assumption of a new identity. * **B. Amnesia:** Dissociative Amnesia is the most common dissociative disorder, characterized by an inability to recall important personal information, usually of a traumatic nature, that is too extensive to be explained by ordinary forgetfulness. * **C. Multiple Personality:** Now formally known as **Dissociative Identity Disorder (DID)**, this involves the presence of two or more distinct personality states that recurrently take control of the individual's behavior. **High-Yield Clinical Pearls for NEET-PG:** * **Ganser Syndrome:** Also known as "approximate answers," it is a rare dissociative disorder often seen in prison inmates. * **Depersonalization/Derealization Disorder:** Feeling detached from oneself (as if in a dream) or feeling that the world is unreal. * **Key Distinction:** Dissociative disorders involve "loss of memory/identity," while Conversion disorders involve "loss of motor/sensory function."

Q: What is the most common form of dissociative hysteria?

Amnesia. **Explanation:** **Dissociative Amnesia** is the most common dissociative disorder (historically termed "dissociative hysteria"). It is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, which is too extensive to be explained by ordinary forgetfulness. The memory loss is typically retrograde and episodic, rather than anterograde. **Analysis of Options:** * **A. Dissociative Fugue:** This is a specifier of dissociative amnesia. It involves sudden, unexpected travel away from home combined with an inability to recall one's past and sometimes the assumption of a new identity. While high-yield, it is significantly less common than simple amnesia. * **C. Multiple Personality Disorder (Dissociative Identity Disorder):** This is the most severe and chronic form of dissociation, involving two or more distinct personality states. It is considered the rarest of the dissociative disorders. * **D. Somnambulism (Sleepwalking):** While historically linked to "hysterical" states, it is classified under Sleep-Wake Disorders (Parasomnias) in modern psychiatry (DSM-5/ICD-11), not as a primary dissociative disorder. **Clinical Pearls for NEET-PG:** * **Ganser Syndrome:** Also known as "approximate answers" or "prison psychosis," it is a rare dissociative disorder often seen in forensic settings. * **Primary Gain:** The internal relief from anxiety achieved by keeping a conflict out of conscious awareness. * **Secondary Gain:** The external benefits derived from being ill (e.g., avoiding work or gaining attention). * **La Belle Indifférence:** A classic sign where the patient shows a surprising lack of concern regarding their severe physical or cognitive symptoms.

Q: Which of the following events is most likely to result in post-traumatic stress disorder (PTSD)?

Robbery at knifepoint. ### Explanation The core diagnostic requirement for **Post-Traumatic Stress Disorder (PTSD)**, according to DSM-5 and ICD-11 criteria, is exposure to a traumatic event that involves **actual or threatened death, serious injury, or sexual violence**. **Why Option D is Correct:** **Robbery at knifepoint** qualifies as a traumatic stressor because it involves a direct threat to life and physical integrity. The sudden, violent, and life-threatening nature of this event triggers the intense fear, helplessness, or horror necessary to meet **Criterion A** for PTSD. **Why Other Options are Incorrect:** * **Options A (Divorce) and B (Bankruptcy):** While these are significant life stressors that can cause profound psychological distress, they do not typically involve a threat to physical life or limb. These events are more commonly associated with **Adjustment Disorder**. * **Option C (Diagnosis of Diabetes Mellitus):** A diagnosis of a chronic medical condition is a stressful life event but is not considered a "traumatic event" in the context of PTSD unless it is a sudden, catastrophic, and life-threatening medical emergency (e.g., waking up during surgery or anaphylactic shock). **Clinical Pearls for NEET-PG:** * **Duration:** Symptoms must persist for **more than 1 month**. If symptoms last less than 1 month, the diagnosis is **Acute Stress Disorder (ASD)**. * **Core Symptom Clusters:** 1. Intrusion (flashbacks/nightmares), 2. Avoidance, 3. Negative alterations in cognition/mood, and 4. Hyperarousal. * **Treatment of Choice:** **SSRIs** (e.g., Sertraline, Paroxetine) are the first-line pharmacotherapy. Trauma-focused Cognitive Behavioral Therapy (CBT) is the first-line psychotherapy. * **Prazosin:** Often used specifically to treat PTSD-related nightmares.

Question 1

A 43-year-old man, who had a left below-the-knee amputation 10 years ago, presents with pain in his left leg. He reports a persistent sensation of his left foot being present since the amputation, which has progressively felt like it is moving proximally. He also experiences pain and burning at the stump of his left leg. The pain is unresponsive to changes in leg position, topical treatments, or medications. What is the most likely diagnosis for this patient's condition?

Accepted Answer

Phantom limb pain

Answer

Complex regional pain syndrome

Answer

Dejerine-Roussy syndrome

Answer

Peripheral neuropathy

Question 2

The "flashback phenomenon" is seen in which of the following conditions?

Accepted Answer

Post-traumatic stress disorder

Answer

Hysteria

Answer

Organic illness

Answer

Acute stress reaction

Question 3

A 23-year-old man presents with occasional sleep disturbances and feelings of sadness that began two months ago after discovering his girlfriend's infidelity. He immediately ended the relationship. Although he generally feels better after exercise, he reports avoiding social interactions and experiencing reduced motivation for work, despite continuing to fulfill his professional responsibilities. What is the most appropriate next step in managing this patient?

Accepted Answer

Psychotherapy

Answer

Fluoxetine

Answer

Repetitive transcranial magnetic stimulation

Answer

Temporary leave from work until his mood improves

Question 4

A 50-year-old man presents following the death of his wife. Which of the following is an abnormal grief reaction?

Accepted Answer

Delayed or absent grief

Answer

A brief episode of seeing the deceased spouse

Answer

Poor concentration

Answer

Poor memory

Question 5

Which of the following is true about posttraumatic stress disorder?

Accepted Answer

Treatment is ECT

Answer

Recall of traumatic events

Answer

Associated with major trauma like pelvic fracture

Answer

Disturbed sleep

Question 6

In Dissociative disorders, all are seen except?

Accepted Answer

Hearing loss

Answer

Fugue

Answer

Amnesia

Answer

Multiple personality

Question 7

What is the most common form of dissociative hysteria?

Accepted Answer

Amnesia

Answer

Fugue

Answer

Multiple personality

Answer

Somnambulism

Question 8

Which of the following statements about Post-Traumatic Stress Disorder (PTSD) is FALSE?

Accepted Answer

Most people who have experienced a traumatizing event will develop PTSD.

Answer

Women are more likely to develop PTSD than men.

Answer

Children are less likely to experience PTSD after trauma than adults.

Answer

War veterans are commonly at risk for PTSD.

Question 9

Which of the following events is most likely to result in post-traumatic stress disorder (PTSD)?

Accepted Answer

Robbery at knifepoint

Answer

Divorce

Answer

Bankruptcy

Answer

Diagnosis of diabetes mellitus

Question 10

Which of the following is NOT a clinical feature of post-traumatic stress disorder (PTSD)?

Accepted Answer

Hallucinations

Answer

Flashbacks

Answer

Hyperarousal

Answer

Emotional numbing

Trauma and Stress-Related Disorders — MCQs

Trauma and Stress-Related Disorders — MCQs

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