Anxiety Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Anxiety Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Anxiety Disorders Indian Medical PG Question 1: A 19-year-old man working as a driver comes to Psychiatrist with excessive anxiety and fear. He reports that every time he drives over a bump in the road, he is convinced that he has accidentally run over a small child. He has to pull over and check underneath his car for blood and retrace his driving route to look for any injured children. As a result, he is always late for work. He also has intrusive thoughts about stabbing his coworkers. He prays to try to erase these thoughts from his mind, but this rarely helps. First-line pharmacological treatment of this patient's condition primarily affects which of the following neurotransmitters?
- A. Dopamine
- B. Serotonin (Correct Answer)
- C. Norepinephrine
- D. Acetylcholine
Anxiety Disorders Explanation: ***Serotonin***
- The described symptoms (obsessive thoughts about harming others, compulsive checking, and attempts to neutralize thoughts with prayer) are highly characteristic of **Obsessive-Compulsive Disorder (OCD)**.
- **Selective Serotonin Reuptake Inhibitors (SSRIs)** are the first-line pharmacological treatment for OCD, and they work by increasing the availability of serotonin in the synaptic cleft.
*Dopamine*
- Dopamine dysregulation is primarily implicated in disorders such as **schizophrenia** and **Parkinson's disease**, and to some extent in ADHD and addiction.
- While dopamine may play a role in some aspects of OCD, typical first-line treatments do not primarily target dopamine.
*Norepinephrine*
- Norepinephrine is largely involved in the **fight-or-flight response**, attention, and arousal, and is a target for treating depression and anxiety disorders with SNRIs.
- While some antidepressants that affect norepinephrine may be used if SSRIs are ineffective, they are not considered the primary neurotransmitter target for first-line OCD treatment.
*Acetylcholine*
- Acetylcholine is crucial for **muscle contraction**, learning, and memory, and imbalances are associated with conditions like **Alzheimer's disease** and myasthenia gravis.
- It is not a primary target for the pharmacological treatment of OCD.
Anxiety Disorders Indian Medical PG Question 2: Which of the following disorders is classified under somatic symptom and related disorders in the DSM-5?
- A. Post-Traumatic Stress Disorder (PTSD)
- B. Phobic disorders (e.g., social anxiety disorder)
- C. Conversion disorder (functional neurological symptom disorder) (Correct Answer)
- D. Obsessive-Compulsive Disorder (OCD)
Anxiety Disorders Explanation: ***Conversion disorder (functional neurological symptom disorder)***
- **Conversion disorder** is characterized by neurological symptoms (e.g., paralysis, blindness) that are **incompatible with recognized neurological or medical conditions**, yet are not intentionally produced.
- It falls under **somatic symptom and related disorders** because the primary features are physical symptoms causing distress or functional impairment, rather than being malingered or feigned.
*Phobic disorders (e.g., social anxiety disorder)*
- **Phobic disorders** are classified under **anxiety disorders** in the DSM-5, not somatic symptom and related disorders.
- They are primarily characterized by **intense, irrational fears** of specific objects or situations, leading to avoidance rather than prominent physical symptoms without a medical cause.
*Post-Traumatic Stress Disorder (PTSD)*
- **PTSD** is classified under **trauma- and stressor-related disorders** in the DSM-5, distinguished by symptoms developing after exposure to a traumatic event.
- Its core features include **intrusive memories, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity**, rather than unexplained physical symptoms.
*Obsessive-Compulsive Disorder (OCD)*
- **OCD** is classified under **obsessive-compulsive and related disorders** in the DSM-5.
- It is primarily characterized by the presence of **obsessions (recurrent, intrusive thoughts)** and/or **compulsions (repetitive behaviors or mental acts)**, which are distinct from somatic symptoms.
Anxiety Disorders Indian Medical PG Question 3: What is the treatment of choice for acute panic attacks?
- A. Tricyclic antidepressants (TCAs)
- B. Monoamine oxidase inhibitors (MAOIs)
- C. Barbiturates
- D. Benzodiazepines (Correct Answer)
Anxiety Disorders Explanation: ***Correct: Benzodiazepines***
- Benzodiazepines are the **treatment of choice for acute panic attacks** due to their **rapid onset of action** (within minutes)
- They work by enhancing **GABA-A receptor** activity, providing immediate anxiolytic effects
- Commonly used agents include **alprazolam, lorazepam, and clonazepam**
- While effective acutely, they are not recommended for long-term management due to dependence risk
*Incorrect: Tricyclic antidepressants (TCAs)*
- TCAs are effective for **long-term prophylaxis** of panic disorder, not acute attacks
- They have a **delayed onset of action** (2-4 weeks), making them unsuitable for immediate relief
- Significant **anticholinergic effects** and potential cardiotoxicity limit their use
*Incorrect: Monoamine oxidase inhibitors (MAOIs)*
- MAOIs can be effective for panic disorder but are reserved for **treatment-resistant cases**
- **Delayed onset of action** (several weeks) makes them inappropriate for acute attacks
- Require **dietary restrictions** and have risk of hypertensive crisis with tyramine-containing foods
*Incorrect: Barbiturates*
- Largely **obsolete** in psychiatric practice, replaced by safer benzodiazepines
- **Narrow therapeutic index** with high risk of overdose and respiratory depression
- Greater potential for dependence and withdrawal complications
- No role in modern management of panic attacks
Anxiety Disorders Indian Medical PG Question 4: A patient with a history of RTA before 2 months presents with complaints of dreams of accidents. He is able to visualize the same scene whenever he visits the place. Hence is afraid to go back to the accident site. Identify the type of disorder that he might be suffering from?
- A. PTSD (Correct Answer)
- B. Anxiety disorder
- C. Obsessive-Compulsive Disorder (OCD)
- D. Adjustment disorder
Anxiety Disorders Explanation: ***PTSD***
- The patient's symptoms, including **recurrent dreams** of the accident, **intrusive memories** triggered by the accident site, and **avoidance** of the location, are classic diagnostic criteria for **Post-Traumatic Stress Disorder (PTSD)**.
- PTSD often develops after exposure to a **traumatic event** like a car accident, with symptoms lasting for more than one month.
*Anxiety disorder*
- While anxiety is a prominent feature of PTSD, **Generalized Anxiety Disorder** typically involves excessive worry about everyday events rather than a specific traumatic incident.
- Other anxiety disorders like **panic disorder** involve sudden, intense fear without the specific re-experiencing and avoidance symptoms seen here.
*Obsessive-Compulsive Disorder (OCD)*
- OCD is characterized by repetitive, unwanted thoughts (**obsessions**) and ritualistic behaviors (**compulsions**) performed to reduce anxiety, which are not described in this patient's presentation.
- The patient's distress stems from a past trauma, not from obsessions or compulsions.
*Adjustment disorder*
- An adjustment disorder occurs in response to a **stressor**, but the symptoms are typically less severe and do not include the full constellation of **re-experiencing, avoidance, and hyperarousal** seen in PTSD.
- An adjustment disorder resolves within 6 months of the stressor or its consequences, however, the persistence and nature of the symptoms here point to a more severe trauma-related condition.
Anxiety Disorders Indian Medical PG Question 5: Which of the following is the most prevalent psychiatric disorder in the general population?
- A. Schizophrenia
- B. Mania
- C. Anxiety disorder (Correct Answer)
- D. Depression
Anxiety Disorders Explanation: ***Anxiety disorder***
- **Anxiety disorders** are collectively the most prevalent psychiatric disorders in the general population, affecting approximately **10-30% of individuals** during their lifetime.
- This category includes **specific phobias, social anxiety disorder, panic disorder, generalized anxiety disorder, and others**, which together have the highest prevalence among all psychiatric conditions.
- Epidemiological studies consistently show that **anxiety disorders surpass depression** in terms of overall prevalence in community samples.
*Depression*
- **Major depressive disorder** is highly prevalent (lifetime prevalence approximately 10-15%) and is the **leading cause of disability worldwide**.
- While extremely common and clinically significant, it is slightly less prevalent than anxiety disorders when considering community-based epidemiological data.
- Depression often occurs **co-morbidly with anxiety disorders**, further emphasizing the importance of both conditions.
*Schizophrenia*
- **Schizophrenia** is a severe chronic mental illness with a much lower prevalence, affecting approximately **0.3-0.7%** of the general population.
- Despite its significant impact on affected individuals and families, its overall prevalence is relatively low compared to mood and anxiety disorders.
*Mania*
- **Mania** is a mood state characteristic of **bipolar disorder**, which has a prevalence of approximately **1-2%** of the population.
- This is considerably lower than the prevalence of both anxiety disorders and major depressive disorder.
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