Eating Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Eating Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Eating Disorders Indian Medical PG Question 1: Body dysmorphic disorder can be associated with all except
- A. Bulimia nervosa
- B. OCD
- C. Anxiety
- D. Mania (Correct Answer)
Eating Disorders Explanation: ***Mania***
- **Mania** is a state of elevated, expansive, or irritable mood that is distinct from the persistent preoccupation with perceived bodily defects seen in **body dysmorphic disorder (BDD)**.
- While agitation can occur in BDD, the core symptom profile of **mania**, including decreased need for sleep, grandiosity, and racing thoughts, is not a typical associated feature.
*Bulimia nervosa*
- **Bulimia nervosa** can co-occur with BDD, particularly when the perceived defects relate to body weight, shape, or specific body parts.
- Both disorders involve intense preoccupation with body image and often lead to harmful behaviors to attempt to "correct" perceived flaws.
*OCD*
- **Obsessive-compulsive disorder (OCD)** shares strong phenomenological similarities with BDD, including intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
- BDD is often conceptualized as part of the **OCD spectrum**, with both disorders involving obsessive thoughts and repetitive behaviors related to specific concerns.
*Anxiety*
- **Anxiety disorders** are highly comorbid with BDD, as individuals often experience significant distress, fear of judgment, and social avoidance due to their perceived flaws.
- The constant preoccupation and efforts to conceal or fix perceived defects can lead to chronic anxiety and panic attacks.
Eating Disorders Indian Medical PG Question 2: A young girl hospitalised with anorexia nervosa is on treatment. Even after taking adequate food according to the recommended diet plan for last 1 week, there is no gain in weight. What is the next step in management:
- A. Increase the caloric intake from 1500 kcal to 2000 kcal per day
- B. Increase fluid intake
- C. Increase the dose of anxiolytics
- D. Observe patient for 2 hours after meal (Correct Answer)
Eating Disorders Explanation: ***Observe patient for 2 hours after meal***
- Patients with **anorexia nervosa** often engage in compensatory behaviors like **purging** or extensive exercise, which would counteract the effects of increased caloric intake and lead to a lack of weight gain despite consuming an "adequate" diet.
- Observing the patient post-meal helps identify these behaviors and ensures that the ingested calories are actually being retained and utilized for weight restoration.
*Increase the caloric intake from 1500 kcal to 2000 kcal per day*
- Increasing caloric intake is a valid long-term strategy but is not the immediate next step when there's **no weight gain despite adequate intake**; the primary concern is identifying *why* the initial intake isn't leading to weight gain.
- Doing so without addressing potential compensatory behaviors might only increase patient distress or lead to more intense purging/exercise.
*Increase fluid intake*
- While adequate **hydration** is important, it does not directly address the issue of **lack of weight gain** in anorexia nervosa, which is fundamentally a caloric deficit problem.
- Increased fluid intake would not provide the necessary calories for weight restoration.
*Increase the dose of anxiolytics*
- Anxiolytics may help manage **anxiety** related to eating, but they do not directly promote **weight gain** or prevent compensatory behaviors.
- This step does not address the core issue of why the recommended diet is not leading to weight gain.
Eating Disorders Indian Medical PG Question 3: Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?
- A. Anorexia nervosa
- B. Bulimia nervosa (Correct Answer)
- C. Binge eating disorder
- D. Night eating syndrome
Eating Disorders Explanation: ***Bulimia nervosa***
- This disorder is characterized by recurrent episodes of **binge eating** followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise, while the individual generally maintains a **normal body weight**.
- The key differentiator from anorexia nervosa is the **normal weight** and the cyclical pattern of binging and compensatory behaviors.
- According to **DSM-5 criteria**, bulimia nervosa requires both binge eating episodes and inappropriate compensatory behaviors occurring at least once weekly for 3 months.
*Anorexia nervosa*
- This eating disorder is primarily characterized by an intense fear of gaining weight, leading to **severe restriction of food intake** and significantly **low body weight**.
- Individuals with anorexia nervosa do not maintain a normal weight; rather, their weight is often **below minimally normal** (BMI < 18.5 kg/m² in adults).
*Binge eating disorder*
- This disorder involves recurrent episodes of **binge eating**, defined as consuming an unusually large amount of food in a short period with a sense of loss of control, but it does **not involve recurrent compensatory behaviors** like purging.
- Individuals with binge eating disorder are often **overweight or obese**, contrasting with the normal weight seen in bulimia nervosa.
*Night eating syndrome*
- This disorder is characterized by recurrent episodes of **nighttime eating** (consuming food after evening meal or upon awakening from sleep) with full awareness.
- Unlike bulimia nervosa, it does **not involve binge eating** in the classic sense, and there are **no compensatory behaviors** like purging or excessive exercise.
- Individuals may maintain normal weight but the eating pattern is distinctly different from the binge-purge cycle.
Eating Disorders Indian Medical PG Question 4: Which of the following is the most likely explanation for the dental abnormalities in bulimia nervosa (BN)?
- A. self-induced vomiting (Correct Answer)
- B. excess cortisol levels
- C. osteoporotic changes
- D. self-induced physical trauma
Eating Disorders Explanation: ***self-induced vomiting***
- **Self-induced vomiting** leads to frequent exposure of teeth to highly acidic gastric contents, causing **dental erosion** (perimylolysis).
- This erosion typically affects the **lingual surfaces** of the maxillary anterior teeth and can lead to tooth sensitivity, discoloration, and loss of tooth structure.
*excess cortisol levels*
- While patients with BN can have elevated cortisol due to stress, this is not directly linked to **dental erosion** or other dental abnormalities.
- High cortisol primarily affects bone density, metabolism, and immune function, rather than directly damaging tooth enamel.
*osteoporotic changes*
- **Osteoporotic changes** can occur in BN due to nutritional deficiencies and hormonal imbalances, affecting bone density.
- However, osteoporosis primarily affects bone tissue throughout the body, not directly causing the characteristic **dental erosion** seen in BN.
*self-induced physical trauma*
- **Self-induced physical trauma** in BN refers to injuries from non-vomiting behaviors and would not explain the widespread **dental erosion** patterns.
- While some individuals might experience trauma from purging (e.g., calluses on knuckles), it does not account for the chemical damage to tooth enamel.
Eating Disorders Indian Medical PG Question 5: What is considered the most effective treatment for Borderline Personality Disorder?
- A. Combination of DBT and pharmacotherapy
- B. Cognitive Behavioural Therapy (CBT)
- C. Pharmacotherapy alone
- D. Dialectical Behaviour Therapy (DBT) (Correct Answer)
Eating Disorders Explanation: ***Dialectical Behaviour Therapy (DBT)***
- **DBT** is the **gold standard** and most evidence-based psychotherapy specifically developed for Borderline Personality Disorder
- Developed by **Marsha Linehan** specifically to target the core symptoms of BPD including emotional dysregulation, impulsivity, and interpersonal difficulties
- Combines **cognitive-behavioral techniques** with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills
- Has the **strongest research evidence** for reducing suicidal behavior, self-harm, and improving overall functioning in BPD patients
- Multiple RCTs demonstrate DBT's superiority in treating BPD compared to standard care
*Cognitive Behavioural Therapy (CBT)*
- While **CBT** is effective for many mental health conditions and can help with certain BPD symptoms, it was not specifically designed for BPD
- DBT is actually a specialized adaptation of CBT tailored for BPD, making it more targeted and effective for this specific condition
- Generic CBT may help with co-occurring conditions like depression or anxiety but lacks the comprehensive approach needed for core BPD features
*Combination of DBT and pharmacotherapy*
- This combination is clinically useful, especially when treating **co-morbid conditions** like depression, anxiety, or severe mood instability
- However, psychotherapy (particularly DBT) remains the **cornerstone** of BPD treatment, with medications serving an adjunctive role
- The question asks for the single most effective treatment, which is DBT alone
*Pharmacotherapy alone*
- **No medication** is FDA-approved specifically for BPD
- Pharmacotherapy may help manage specific symptoms (mood swings, impulsivity, brief psychotic episodes) but does not address the core **personality pathology**
- Generally not recommended as monotherapy for BPD; should always be combined with psychotherapy
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