Practice Paper of NEET PG: Important Questions of PSYCHIATRY

The Important Questions of Psychiatry for NEET PG exam:

1. Treatment of alcohol dependence is by all except?
A. Disulfiram
B. Naltrexone
C. Flumazenil
D. Acamprosate

Correct answer : C. Flumazenil

Flumazenil is a benzodiazepine antagonist. It is not used for the treatment of alcohol dependence.

PHARMACOLOGICAL TREATMENT OF ALCOHOL DEPENDENCE

  • Benzodiazepines – treatment of alcohol withdrawal symptoms
  • Disulfiram – aversion therapy
  • Naltrexone, acamprosate – anticraving drugs

 

2. 40 year old female came to the OPD with complaints of with depressed mood, insomnia, loss of appetite and lack of interest in surroundings for the past 1 year. These symptoms appeared after loss in a business deal 1 year ago. Which is correct regarding the management?
A. Selective Serotonin Reuptake Inhibitors (SSRI’s) are the most effective drugs
B. Antidepressants should be given based on the side effect profile
C. No treatment is required as it is due to loss in a business deal
D. Combination therapy with 2 or more antidepressants

Correct answer : B. Antidepressants should be given based on the side effect profile

The history is characteristic of depressive disorder. Antidepressant drugs are to be given. But there are no ideal antidepressants. The treatment should be based on the side effect profile of the drugs.

 

3. Drug used for treatment of nocturnal enuresis is?

A. Trazodone
B. Imipramine
C. Chlorpromazine
D. Sertraline

Correct answer : B. Imipramine

TREATMENT OF NOCTURNAL ENURESIS

  • Enuresis alarm systems are the preferred treatment for children with nocturnal enuresis.
    • These detect the moisture of urine when there is nocturnal enuresis.
    • An alarm is triggered which wakes up the child.
    • These systems are of 3 types – wearable alarms, wireless alarms and pad type alarms.
    • Alarm systems are also have the least relapse rate among the various modalities of treatment.
  • Motivational therapy
    • The child is rewarded for keeping dry at night. But punishment for bedwetting is discouraged.
    • There is limited evidence to support the efficacy of this approach.
  • Drug therapy
    • Pharmacological treatment for nocturnal enuresis is reserved for cases which do not respond to treatment with enuresis alarms.
    • Desmopressin in the preferred drug. It is given at night to reduce urine production during sleep.
    • Tricyclic antidepressants like imipramine can also be used. But use is limited due to side effects.

 

4. Most common cause of premature death in schizophrenia is?

A. Drug toxicity
B. Nosocomial infection
C. Homicide
D. Suicide

Correct answer : D. Suicide

PREMATURE DEATH IN SCHIZOPHRENIA

  • Life expectancy of patients with schizophrenia is decreased by approximately 15 to 25 years.
  • Suicide is the most important cause of premature death in patients with schizophrenia.
  • There is a 20 fold increased risk of suicide compared to the general population.
  • Suicide attempts may occur without warning or expression of intent.
  • Cancer is the second most frequent cause of mortality in schizophrenics.
  • The rates of metabolic syndrome and cardiovascular disorders are also increased.

 

5. Which is not a cognitive dysfunction?

A. Overgeneralization

B. Thought block

C. Catastrophic thinking

D. Arbitrary inference

Correct answer : B. Thought block

Cognitive dysfunction refers to the errors in the processing of information in the thought process. Thought block is an error in the continuity of thought.

6. Which of the following is seen associated with alcoholic paranoia ?

A. Drowsiness

B. Delusions

C. Hallucinations

D. Impulsiveness

Correct answer : B. Delusions

  • Alcoholic paranoia is an alcohol induced psychotic disorder
  • It is characterised by delusions (mostly of persecution / jealousy / reference)
  • Auditory hallucinations may also be seen

 

7. All are features of autistic disorders except ?

A. Stereotypic movements

B. Impairment of social interaction

C. Visual impairment

D. Delay in speech development

Correct answer : C. Visual impairment

Autistic disorders are characterised by:

  • Impairement of social interaction
  • Disorder of communication and language (as in delayed development of speech)
  • Stereotypic movements

Visual impairment is not seen in autism.

 

8. Somatic passivity is seen in?

A. Depression

B. Hypomania

C. Body dysmorphic disorder

D. Paranoid Schizophrenia

Correct answer : D. Paranoid Schizophrenia

Somatic passivity is a Schneiderian first rank of Schizophrenia.

 

9. An 18 year old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be to:
A. Leave him as normal adolescent problem
B. Rule out depression
C. Rule out migraine
D. Rule out an oppositional defiant disorder

Correct answer : B. Rule out depression

The given features are not something that may be considered as normal adolescent problem. Also the headache described here cannot be classified under migraine. Oppositional defiant disorder often presents at a younger age. Hence it is necessary to rule out depression.

 

10. A 25 year old female presents with 2 year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them along with medications. She is most likely to benefit from which of the following therapies?
A. Exposure and response prevention
B. Systematic desensitization
C. Assertiveness training
D. Sensate focusing

Correct answer : A. Exposure and response prevention

The history is suggestive of Obsessive Compulsive Disorder. The first line of treatment is Exposure and response prevention

 

11. An 18 year old boy came to the Psychiatry OPD with a complaint of feeling changed from inside. He described himself as feeling strange as if he is different from his normal self. He was very tense and anxious yet could not point out the precise change in him. This phenomena is best called as:
A. Delusional mood
B. Depersonalization
C. Autochthonous delusion
D. Over valued idea

Correct answer : B. Depersonalization

The given history is the classical description of depersonalization.

 

12. One of the following usually differentiates hysterical symptoms from hypochondriacal symptoms:
A. Symptoms do not normally reflect understandable physiological or pathological mechanism
B. Physcial symptoms are prominent which are not explained by organic factors
C. Personality traits are significant
D. Symptoms run a chronic course

Correct answer : A. Symptoms do not normally reflect understandable physiological or pathological mechanism

Hysteria (Conversion disroder) is a condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.

Hypochondria is a belief that physical symptoms are signs of a serious illness, even when there is no medical evidence to support the presence of an illness.

 

13. Perseveration is:
A. Persistent and inappropriate repetition of the same thoughts
B. When a patient feels very distressed about it
C. Characteristic of schizophrenia
D. Characteristic of obsessive compulsive disorder (OCD)

Correct answer : A. Persistent and inappropriate repetition of the same thoughts

Perseveration is seen in schizophrenia

 

14. Rivastigmine and Donepezil are drugs used predominantly in the management of:
A. Depression
B. Dissociation
C. Delusions
D. Dementia

Correct answer : D. Dementia

Rivastigmine and Donepezil are cholinergic stimulators. They are used in the treatment of Alzheimer’s disease – the most common cause of dementia.

 

15. Bright light treatment has been found to be most effective in treatment of:
A. Anorexia nervosa
B. Seasonal affective disorder
C. Schizophrenia
D. Obsessive compulsive disorder

Correct answer : B. Seasonal affective disorder

Seasonal affective disorder refers to episodes of depression that occur every year during autumn or winter. Symptoms improve in spring and summer.

16. Mutism and akinesis in a person, who appears awake and even alert, is best described as:
A. Twilight state
B. Oneiroid state
C. Stupor
D. Delirium

Correct answer : C. Stupor

 

17. Intense nihilism, somatization and agitation in old age are the hallmark symptoms of:
A. Involutional melancholia
B. Atypical depression
C. Somatized depression
D. Depressive stupor

Correct answer :A. Involutional melancholia

 

18. All of the following are associated with better prognosis in schizophrenia, except:
A. Late onset
B. Married
C. Negative symptoms
D. Acute onset

Correct answer :C. Negative symptoms

 

19. Loosening of association is an example of:
A. Formal thought disorder
B. Schneiderian first rank symptoms
C. Perseveration
D. Concrete thinking

Correct answer :A. Formal thought disorder

 

20. 5-HIAA is a metabolite of:
A. Serotonin
B. Dopamine
C. Epinephrine
D. Histamine

Correct answer : A. Serotonin

5-HIAA is a metabolite of Serotonin.

 

21. A middle aged person reported to Psychiatric OPD with the complaints of the fear of leaving home, fear of travelling alone and fear of being in a crowd. He develops marked anxiety with palpitations and swelling if he is in these situations. He often avoids public transport to go to his place of work. The most likely diagnosis is:
A. Generalised anxiety disorder
B. Schizophrenia
C. Personality disorder
D. Agoraphobia

Correct answer : D. Agoraphobia

 

22. A patient with acute psychosis, who is on haloperidol 20 mg/day for last 2 days, has an episode characterized by tongue protrusion, oculogyric crisis, stiffness and abnormal posture of limbs and trunk without loss of consciousness for last 20 minutes before presenting to casualty. This improved within a few minutes after administration of diphenhydramine HCl. The most likely diagnosis is:
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome

Correct answer : A.  Acute dystonia

 

23. A 30 year old man who was recently started on haloperidol 30 mg/day developed hyperpyrexia, muscle rigidity, akinesia, mutism, sweating, tachycardia and increased blood pressure. The investigations showed increased WBC count, increased creatinine phophokinase. These is no history of any other drug intake or any signs of  infection. The most likely diagnosis is:
A. Drug overdose
B. Neuroleptic malignant syndrome
C. Drug induced Parkinsonism
D. Tardive dyskinesia

Correct answer : B. Neuroleptic malignant syndrome

 

24. The following is not an atypical antipsychotic
A. Thioridazine
B. Clozapine
C. Olanzapine
D. Resperidone

Correct answer : A. Thioridazine

 

25. The drug which is used for long term maintenance in opioid addiction :
A. Naloxone
B. Nalorphine
C. Butarphenol
D. Methadone

Correct answer : D. Methadone

26. Most common substance abuse in India is :
A. Tobacco
B. Cannabis
C. Alcohol
D. Heroin

Correct answer : A. Tobacco

Explanation:

Most common substance abuse in India – Tobacco (see statistics below)
Most common substance abuse in the world – ?? Probably tobacco (According to WHO statistics, there is an estimated 1.1 billion tobacco users in the world – corresponds to 1/3 of people above 15 years of age)
Most common illicit substance abuse in India – Cannabis (see statistics below)
Most common illicit substance abuse in the world – Cannabis (see statistics below)
National Household Survey of Drug and Alcohol Abuse in India  – Estimated users: (2001)
  • Tobacco – 162 million
  • Alcohol – 62 million
  • Cannabis – 9 million
  • Opiates – 2.5 lakh
Cannabis is by far the most widely cultivated, trafficked and abused illicit drug. About 147 million people, 2.5% of the world population, consume cannabis (annual prevalence) compared with 0.2% consuming cocaine and 0.2% consuming opiates.

 

27. Naltrexone is used in opioid addiction because
A. To treat withdrawl symptoms
B. To treat overdose of opioids
C. Prevent relapse
D. Has addiction potential

Correct answer : C. Prevent relapse

 

28. The drug of choice for obsessive compulsive disorder
A. lmpiramine
B. Fluoxetine
C. Chlorpromazine
D. Benzodiazepine

Correct answer : B. Fluoxetine

 

29. Delusion is a disorder of:
A. Thought
B. Perception
C. Insight
D. Cognition

Correct answer : Thought

 

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