Consultation-Liaison Psychiatry Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Consultation-Liaison Psychiatry. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Consultation-Liaison Psychiatry Indian Medical PG Question 1: Which of the following is a validated screening tool for alcohol use disorder?
- A. AUDIT
- B. CAGE questionnaire
- C. SADQ
- D. All of the options (Correct Answer)
Consultation-Liaison Psychiatry Explanation: ***CAGE questionnaire and AUDIT***
- Both **CAGE** and **AUDIT** are widely validated screening tools specifically designed for alcohol use disorder [1].
- **CAGE** is a brief 4-item tool focusing on **C**ut down, **A**nnoyed, **G**uilty, and **E**ye-opener - ideal for quick screening in clinical settings [1].
- **AUDIT** (Alcohol Use Disorders Identification Test) is a comprehensive 10-item tool assessing consumption patterns, drinking behaviors, and alcohol-related problems.
- AUDIT is considered the **gold standard** for screening and can assess risk levels and severity.
*Why not SADQ alone?*
- **SADQ** (Severity of Alcohol Dependence Questionnaire) is primarily a **severity assessment tool**, not a screening tool.
- It is a 20-item instrument used to measure the **degree of alcohol dependence** in individuals already identified with alcohol problems.
- While valuable for treatment planning, SADQ is more detailed and designed for assessment rather than initial screening [1].
- However, all three tools are validated and used in alcohol use disorder evaluation - CAGE and AUDIT for screening, SADQ for severity assessment.
Consultation-Liaison Psychiatry Indian Medical PG Question 2: Which of the following will have an organic cause?
- A. Schizophrenia
- B. Delirium (Correct Answer)
- C. Anxiety
- D. Obsessive compulsive disorder
Consultation-Liaison Psychiatry Explanation: ***Delirium***
- Delirium is an **acute, fluctuating disturbance of consciousness** and cognition that is directly caused by a **medical condition**, substance intoxication/withdrawal, or medication side effect [1], [2], [3].
- It always has an **underlying organic etiology** such as infection, metabolic derangements, drug toxicity, or neurological disorders [1], [2].
*Schizophrenia*
- Schizophrenia is a **chronic psychiatric disorder** characterized by psychosis (hallucinations, delusions), disorganized thinking, and negative symptoms.
- While it has a neurobiological basis, it is considered a **primary mental illness** and not typically caused by an acute, identifiable organic illness in the way delirium is.
*Anxiety*
- Anxiety disorders are characterized by excessive worry, fear, and physical symptoms of arousal. They are considered **primary mental health conditions**.
- Although stress can precipitate anxiety, it is not primarily due to a **specific acute organic cause** that resolves with treatment of that cause.
*Obsessive compulsive disorder*
- Obsessive-compulsive disorder (OCD) is an anxiety-related disorder characterized by **recurrent, intrusive thoughts (obsessions)** and repetitive behaviors (compulsions) aimed at reducing distress.
- Like other primary mental health conditions, it has a neurobiological basis but is not classified as having an **acute organic cause** in the medical sense.
Consultation-Liaison Psychiatry Indian Medical PG Question 3: A 41 year old married female presented with headache for the last 6 months. She had several consultations. All her investigations were found to be within normal limits. She still insists that there is something wrong in her head and seeks another consultation. The most likely diagnosis is:
- A. Illness Anxiety Disorder (Correct Answer)
- B. Phobia
- C. Psychogenic headache
- D. Depression
Consultation-Liaison Psychiatry Explanation: ***Illness Anxiety Disorder***
- This patient exhibits persistent **preoccupation with having a serious illness** despite **repeated medical evaluations** showing no underlying pathology.
- She continues to **seek multiple consultations**, demonstrating **excessive health-related behaviors** characteristic of health anxiety.
- Despite reassurance and normal investigations, she **insists something is wrong**, which is the core feature of this disorder.
- Note: The presence of headache doesn't exclude this diagnosis; the key is the **disproportionate anxiety and health-seeking behavior** relative to the symptom.
*Phobia*
- Phobias involve an **intense, irrational fear** of a specific object or situation (e.g., agoraphobia, social phobia).
- The patient's concern is about having an illness and physical symptoms, not a fear of a specific trigger or situation.
*Psychogenic headache*
- This is a **symptom description**, not a psychiatric disorder diagnosis.
- While the headache may have psychological factors, the question asks for the **disorder** that best explains the overall clinical picture.
- The primary pathology here is the **persistent health anxiety and reassurance-seeking behavior**, not just the headache itself.
*Depression*
- Although **depression can present with somatic symptoms** like headaches, the **core features of major depression** are not mentioned (e.g., persistent low mood, anhedonia, sleep/appetite changes, hopelessness).
- The patient's **preoccupation with having a disease** despite medical reassurance is more characteristic of Illness Anxiety Disorder than depression alone.
Consultation-Liaison Psychiatry Indian Medical PG Question 4: What does Consultation-liaison (C-L) psychiatry involve?
- A. Suicidal tendency in psychiatric patients
- B. Suicidal tendency in medically ill
- C. Medical illness of psychiatric patients
- D. Psychiatric illness in medically ill (Correct Answer)
Consultation-Liaison Psychiatry Explanation: ***Psychiatric illness in medically ill***
- Consultation-liaison (C-L) psychiatry focuses on the **diagnosis** and **management** of mental health conditions that arise in individuals with co-occurring medical illnesses.
- It involves close collaboration between psychiatrists and other medical teams to address the psychological impact of physical disease and optimize overall patient care.
- This is the **core definition** of C-L psychiatry—psychiatric complications in the context of primary medical illness.
*Suicidal tendency in psychiatric patients*
- While suicide risk assessment is a crucial part of general psychiatry, this option is too broad as it doesn't emphasize the unique context of C-L psychiatry.
- C-L psychiatry specifically addresses psychiatric issues in the context of patients with existing **medical conditions**, not general psychiatric patients.
*Suicidal tendency in medically ill*
- This is a significant aspect of C-L psychiatry, as medically ill patients may experience **depression** and **distress** leading to suicidal ideation.
- However, C-L psychiatry encompasses a **broader range** of psychiatric illnesses in medically ill patients, not just suicidal tendencies—this option is too narrow.
*Medical illness of psychiatric patients*
- This describes a situation where a patient with a primary psychiatric diagnosis develops a medical illness, which is the **reverse** of the typical C-L psychiatry focus.
- While this bidirectional care is also relevant, the core concept of C-L psychiatry is addressing **psychiatric complications** that emerge in the context of a primary medical illness in medical/surgical settings.
Consultation-Liaison Psychiatry Indian Medical PG Question 5: F00 in ICD denotes
- A. mood disorders
- B. organic disorders (Correct Answer)
- C. substance use
- D. psychosis
Consultation-Liaison Psychiatry Explanation: ***Organic disorders - CORRECT***
- **F00-F09** in the **International Classification of Diseases (ICD-10)** Chapter V (Mental and behavioural disorders) specifically denotes **organic, including symptomatic, mental disorders**
- These disorders are characterized by brain disease, brain injury, or other insult leading to **cerebral dysfunction**
- **F00** specifically refers to **Dementia in Alzheimer's disease**
*Mood disorders - Incorrect*
- Mood disorders are classified under codes **F30-F39** in ICD-10
- This category includes conditions like bipolar affective disorder, depressive episodes, and recurrent depressive disorders
*Substance use - Incorrect*
- Mental and behavioral disorders due to psychoactive substance use are classified under codes **F10-F19** in ICD-10
- This section covers disorders resulting from the use of alcohol, opioids, cannabis, sedatives, hypnotics, and other substances
*Psychosis - Incorrect*
- Specific psychotic disorders like schizophrenia are classified under codes **F20-F29** in ICD-10
- Psychosis can be a symptom of various mental disorders, including some organic conditions
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