Trauma and Stress-Related Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Trauma and Stress-Related Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Trauma and Stress-Related Disorders Indian Medical PG Question 1: Which of the following is not done in the primary survey of trauma?
- A. Intubation
- B. NCCT head (Correct Answer)
- C. ICD drainage
- D. CXR
Trauma and Stress-Related Disorders Explanation: ***NCCT head***
- A **Non-Contrast CT (NCCT) head** is typically performed during the **secondary survey** once the patient is hemodynamically stable and life-threatening conditions have been addressed.
- The primary survey focuses on immediate **life-saving interventions** for airway, breathing, circulation, disability, and exposure.
*Intubation*
- **Intubation** is a critical intervention during the primary survey, specifically under the **'A' (Airway)** component, to establish and secure a patent airway in a compromised patient.
- Failure to establish an airway can rapidly lead to **hypoxia** and death.
*ICD drainage*
- **Intercostal drain (ICD) drainage** is an urgent intervention in the primary survey, falling under **'B' (Breathing)**, to manage conditions like **tension pneumothorax** or massive hemothorax.
- These conditions can severely compromise ventilation and circulation, requiring immediate relief.
*CXR*
- A **Chest X-ray (CXR)** is a rapid and essential diagnostic tool in the primary survey, also under **'B' (Breathing)**, to identify life-threatening thoracic injuries such as pneumothorax, hemothorax, or mediastinal shift.
- It provides quick information crucial for immediate management decisions.
Trauma and Stress-Related Disorders Indian Medical PG Question 2: Therapeutic exposure is a form of_______ therapy.
- A. Behavioural (Correct Answer)
- B. Supportive
- C. Cognitive
- D. Psychoanalytical
Trauma and Stress-Related Disorders Explanation: ***Behavioural***
- **Therapeutic exposure** is a core technique in **behavioral therapy**, particularly in the treatment of anxiety disorders, phobias, and PTSD.
- It involves **gradually confronting feared objects, situations, or thoughts** to reduce anxiety and avoidance behaviors through processes like **habituation** and **extinction**.
*Supportive*
- **Supportive therapy** focuses on providing **empathy, encouragement, and practical advice** to help individuals cope with stressors and improve their functioning.
- While it can involve discussing difficult situations, it does not typically involve **direct, structured exposure** to feared stimuli.
*Cognitive*
- **Cognitive therapy** primarily targets **maladaptive thought patterns** and beliefs, aiming to identify and restructure them.
- While insights gained in cognitive therapy can support exposure work, **exposure itself is a behavioral technique**, not a cognitive one.
*Psychoanalytical*
- **Psychoanalytical therapy** explores **unconscious conflicts, early childhood experiences, and defense mechanisms** to gain insight into present psychological difficulties.
- This approach relies heavily on **free association, dream analysis, and transference**, rather than direct exposure methods.
Trauma and Stress-Related Disorders Indian Medical PG Question 3: In trauma, which of the following hormones is/are increased?
a) Epinephrine
b) ACTH
c) Glucagon
d) Parathormone
- A. bc
- B. acd
- C. bcd
- D. abc (Correct Answer)
Trauma and Stress-Related Disorders Explanation: ***abc***
- Trauma is a significant stressor that triggers the release of **epinephrine** (a), **ACTH** (b), and **glucagon** (c) as part of the body's **fight-or-flight response** and metabolic adaptation.
- **Epinephrine** increases heart rate, blood pressure, and mobilizes energy stores; **ACTH** stimulates cortisol release to manage stress and inflammation; **glucagon** mobilizes glucose to provide energy for tissues.
- **Parathormone** (d) is NOT significantly increased in acute trauma as it primarily regulates calcium homeostasis, not the acute stress response.
*bc*
- This option is incomplete as **epinephrine** (a) is also significantly increased during trauma due to the activation of the sympathetic nervous system.
- While **ACTH** and **glucagon** are elevated, failing to include epinephrine underestimates the full hormonal response to trauma.
*acd*
- This option incorrectly includes **parathormone** (d) as a primary hormone elevated in acute trauma. While calcium regulation is important, parathormone's immediate increase is not a hallmark of the acute stress response.
- It also omits **ACTH** (b), which is a key hormone in the stress axis response.
*bcd*
- This option incorrectly includes **parathormone** (d) which does not typically show a significant immediate increase during acute trauma.
- It also omits **epinephrine** (a), a crucial component of the acute stress response mediated by sympathetic activation.
Trauma and Stress-Related Disorders Indian Medical PG Question 4: A 1st year medical student presents with recurrent episodes of choking sensation, breathlessness, intense sweating along with feeling of impending doom. Usually the episodes occur prior to exams. What is the most likely diagnosis?
- A. Panic attack (Correct Answer)
- B. Acute stress disorder
- C. Generalised anxiety disorder
- D. Phobia
Trauma and Stress-Related Disorders Explanation: ***Panic attack (Panic Disorder)***
- The sudden onset of intense fear or discomfort, along with symptoms like **choking sensation**, **breathlessness**, **sweating**, and **feeling of impending doom**, are characteristic of a **panic attack**.
- The **recurrent episodes** occurring prior to exams indicate **Panic Disorder**, which is defined by recurrent unexpected panic attacks followed by persistent concern about future attacks.
- The situational trigger (exams) suggests a pattern consistent with panic disorder, where attacks may be situationally predisposed.
*Acute stress disorder*
- This condition occurs within **one month of exposure to a traumatic event** and involves dissociative symptoms, intrusions, avoidance, and arousal symptoms.
- The patient describes recurrent episodes tied to exams, not a single acute traumatic event with subsequent stress response.
*Generalised anxiety disorder*
- Characterized by excessive and **uncontrollable worry** about various events or activities for **at least six months**.
- While anxiety is present, the sudden, intense, **episodic nature** of symptoms with a distinct "feeling of impending doom" points away from the chronic, pervasive worry of GAD.
- GAD presents with chronic anxiety rather than discrete panic episodes.
*Phobia*
- A phobia is an **irrational and intense fear** of a specific object or situation (e.g., specific phobia) or social situations (social anxiety disorder).
- While exam-related anxiety can be severe, the description points to a **full-blown panic response** with multiple autonomic symptoms (choking, breathlessness, sweating) and psychological distress (impending doom).
- Unlike a phobia where avoidance is the primary feature, this patient experiences discrete panic episodes with characteristic somatic symptoms.
Trauma and Stress-Related Disorders Indian Medical PG Question 5: To diagnose post-traumatic stress disorder, the symptoms should persist for more than ______
- A. 1 month (Correct Answer)
- B. 2 days
- C. 3 months
- D. 6 months
Trauma and Stress-Related Disorders Explanation: ***1 month***
- According to the **DSM-5 criteria**, for a diagnosis of **Post-Traumatic Stress Disorder (PTSD)**, the symptoms must persist for **more than one month**.
- If symptoms last for less than one month, but meet other criteria, the diagnosis is typically **Acute Stress Disorder**.
*2 days*
- Symptoms lasting only **2 days** following a traumatic event are too short for a diagnosis of PTSD.
- Such a brief duration may align with an **acute stress reaction**, which is a normal response to trauma and usually resolves quickly.
*3 months*
- While symptoms lasting **3 months** would certainly qualify for PTSD in terms of duration, this is not the minimum duration required.
- The **minimum duration** for PTSD diagnosis is specifically defined as more than one month.
*6 months*
- Symptoms persisting for **6 months** or longer clearly meet the duration criteria for PTSD, but this is not the minimal period.
- Setting the minimum at 6 months would lead to **underdiagnosis** of PTSD in individuals whose symptoms are significant and disabling after one month but before six months.
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