Emergency Psychiatry Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Emergency Psychiatry. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Emergency Psychiatry Indian Medical PG Question 1: Which of the following will have an organic cause?
- A. Schizophrenia
- B. Delirium (Correct Answer)
- C. Anxiety
- D. Obsessive compulsive disorder
Emergency 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.
Emergency Psychiatry Indian Medical PG Question 2: All are related to criminal responsibility of insane except -
- A. Res ipsa loquitur (Correct Answer)
- B. Currens rule
- C. Durham rule
- D. McNaughten rule
Emergency Psychiatry Explanation: ***Res ipsa loquitur***
- This legal doctrine means "the thing speaks for itself" and is used in **tort law** to infer **negligence** when the facts demonstrate no other reasonable explanation.
- It is a principle of civil law concerning **causation of injury** and has no direct application to the criminal responsibility or insanity defense.
*Currens rule*
- The Currens Rule (also known as the American Law Institute or ALI test) states that a person is not responsible for criminal conduct if, at the time of such conduct, as a result of **mental disease or defect**, they lacked substantial capacity either to appreciate the criminality of their conduct or to conform their conduct to the requirements of law.
- This rule is a standard for determining **legal insanity** in criminal cases.
*Durham rule*
- The Durham rule (or "product test") states that an accused is not criminally responsible if their unlawful act was the **product of mental disease or defect**.
- This rule focuses on a causal link between the mental illness and the crime, being a standard for **legal insanity**.
*McNaughten rule*
- The McNaughten rule states that for a defense of insanity to be established, it must be clearly proved that, at the time of committing the act, the party accused was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know he was doing what was wrong.
- This is a foundational legal test for **criminal insanity** in many common law jurisdictions.
Emergency Psychiatry 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)
Emergency Psychiatry 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
Emergency Psychiatry Indian Medical PG Question 4: Best therapy suited to teach daily life skill to a mentally challenged child:
- A. Contingency management (Correct Answer)
- B. Cognitive reconstruction
- C. Self instruction
- D. CBT (Cognitive behavior therapy)
Emergency Psychiatry Explanation: ***Contingency management***
- This therapy involves consistently **rewarding desired behaviors** and withholding rewards for undesirable ones, which is highly effective for teaching new skills to individuals with intellectual disabilities.
- It uses principles of **operant conditioning** to shape behavior through positive reinforcement, making it suitable for acquiring daily living skills.
*Cognitive reconstruction*
- This technique focuses on identifying and changing **maladaptive thought patterns**, which typically requires a higher level of cognitive function.
- It is generally not the primary or most effective approach for teaching concrete daily life skills to individuals with significant **cognitive limitations**.
*Self instruction*
- This involves teaching individuals to guide their own behavior using **internal verbal cues** or self-talk.
- While beneficial for some, it often requires a certain degree of **abstract thinking** and memory, making it less suitable as a standalone method for those with profound cognitive challenges in acquiring basic skills.
*CBT (Cognitive behavior therapy)*
- CBT integrates cognitive and behavioral strategies to address emotional and behavioral problems by modifying **thoughts, feelings, and behaviors**.
- While beneficial for a range of psychological issues, its emphasis on **cognitive restructuring** makes it less directly applicable or the most effective first-line therapy for teaching concrete, functional daily living skills to mentally challenged children.
Emergency Psychiatry Indian Medical PG Question 5: Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
- A. Social support
- B. Screening family members (Correct Answer)
- C. Human rights
- D. Communication regarding care and treatment
Emergency Psychiatry Explanation: ***Screening family members***
- The Mental Health Act 2017 focuses on the **rights, treatment, and support of individuals with mental illness**, not routine screening of their family members.
- The Act does not contain provisions mandating **screening of asymptomatic family members**, though family history may be relevant for clinical assessment.
- This is **not a provision** outlined in the Act based on WHO guidelines.
*Human rights*
- The Act is explicitly grounded in the **protection and promotion of human rights** for persons with mental illness (Chapter I).
- Ensures care with **dignity, respect, and freedom from discrimination** as core principles.
- Aligns with WHO's mental health action plan and human rights framework.
*Communication regarding care and treatment*
- **Section 4** emphasizes the right to information and **informed consent** for all treatment decisions.
- Patients must receive clear communication about their **diagnosis, treatment options, and care plans**.
- Includes provisions for **advance directives** and involvement in treatment decisions.
*Social support*
- **Chapter V** addresses rehabilitation and community-based services, emphasizing the role of **social support systems**.
- Promotes **community integration** and access to social resources for recovery.
- Recognizes family and community support as essential for long-term mental health management.
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