Last 5 year PYQs in Psychiatry  for NEET PG

Q1. Which of the following drug abuses can lead to the symptoms described by a 25-year-old male patient, who complains of a sensation resembling insects crawling beneath his skin, and has presented to the clinic?

1. Cannabis
2. Cocaine
3. Amphetamine
4. Alcohol

Ans. 2) Cocaine

• Cocaine abuse can lead to the development of a condition called "formication," which is the sensation of insects crawling under the skin. This phenomenon is also known as "coke bugs" or "cocaine bugs." Cocaine is a powerful stimulant drug that affects the central nervous system. It increases the levels of dopamine, a neurotransmitter associated with pleasure and reward, in the brain.
• The sensation of formication is a common side effect of cocaine abuse and is believed to be related to the drug's stimulant effects on the nervous system. The exact mechanism of how cocaine causes this sensation is not fully understood, but it is thought to involve alterations in the brain's perception and processing of sensory information.

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Q2. What is the most probable diagnosis for a 60-year-old man who is grieving the loss of his wife and expressing guilt, believing his intestines have deteriorated and that he deserves to be imprisoned? He also reports persistent sadness and a lack of interest in daily activities since his wife's passing.

1. Normal grief reaction
2. Psychotic depression
3. Delusional disorder
4. Schizophrenia

Ans. 2) Psychotic depression

• Psychotic depression, also known as a major depressive disorder with psychotic features, is a subtype of depression characterized by the presence of psychotic symptoms alongside depressive symptoms. It is a severe form of depression that can involve delusions, hallucinations, or both.
• In the given scenario, the patient is experiencing feelings of guilt and responsibility for his wife's death, which are indicative of depressive symptoms. Additionally, he has developed delusions of his intestines being rotten and feeling deserving of imprisonment, suggesting the presence of psychotic symptoms. These delusions are not based on reality and are consistent with the features of psychotic depression.

Q3. What is the preferred treatment option for postpartum blues?

1. Fluoxetine
2. Cognitive behavioral therapy
3. Lithium carbonate
4. Support and Education

Ans. 4) Support and Education

• Postpartum blues, also known as "baby blues," is a common condition that affects many women after childbirth. It is characterized by mild mood swings, tearfulness, irritability, and emotional lability. These symptoms typically appear within the first few days after delivery and resolve spontaneously within a few weeks.
• Support and education are the mainstays of treatment for postpartum blues. This involves providing reassurance, empathy, and understanding to the woman experiencing the condition. . Education about postpartum blues and its self-limiting nature can help alleviate anxiety and promote an understanding of the normal emotional changes that occur during the postpartum period.

Q4. What medication is typically prescribed to treat the condition experienced by a 25-year-old woman who complains of a sensation resembling creepy crawling in her legs? This symptom is more pronounced at night and hinders her ability to sleep. However, she finds relief by either engaging in walking or moving her legs.

1. Gabapentin
2. Pramipexole
3. Vitamin B12
4. Iron tablets

Ans. 1) Gabapentin

• The symptoms described by the patient are consistent with restless legs syndrome (RLS), a neurological disorder characterized by uncomfortable sensations in the legs, usually accompanied by an irresistible urge to move them. The symptoms are typically worse during periods of rest or inactivity, such as when sitting or lying down, and are relieved by movement, such as walking or stretching.
• Gabapentin is one of the medications commonly used to treat restless legs syndrome. It is an anticonvulsant and analgesic drug that can help alleviate sensory symptoms and improve sleep quality in individuals with RLS. It works by affecting the transmission of certain neurotransmitters in the brain, reducing abnormal electrical activity, and calming overactive nerve signals.

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Q5. What is the most probable diagnosis for a first-year MBBS student who presents at the OPD with intermittent episodes of intense sweating and a sensation of imminent danger, commonly experienced before her examinations?

1. Panic disorder
2. Conversion disorder
3. Social anxiety disorder
4. Generalized anxiety disorder

Ans. 1) Panic disorder

• Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks. Panic attacks are sudden episodes of intense fear or discomfort that reach a peak within minutes. They are often accompanied by physical symptoms such as sweating, trembling, heart palpitations, shortness of breath, chest pain, and a feeling of impending doom.
• In the given scenario, the student experiences intermittent episodes of a feeling of impending doom accompanied by intense perspiration, particularly prior to exams. These symptoms are consistent with panic attacks, which commonly occur in situations that provoke anxiety or fear, such as exams or stressful events.

Q6. What is the term used to describe the occurrence when a therapist experiences a combination of conscious and unconscious emotions towards their patient during psychotherapy?

1. Countertransference
2. Transference
3. Dissociation
4. Preoccupation

Ans. 1)  Countertransference

• Countertransference occurs when a therapist unintentionally transfers their personal feelings and experiences onto their patient during therapy. Ideally, therapists are expected to remain calm and unbiased, avoiding interference from their emotions and history. However, countertransference can lead to therapists having mixed conscious and unconscious feelings toward their patients.

Q7. A patient stopped alcohol consumption for 3 days and presented with irritability, disorientation, paranoid delusions, agitation, visual hallucinations, and altered sensorium. What is the likely diagnosis in this case?

1. Delirium tremens
2. Wernicke’s encephalopathy
3. Korsakoff psychosis
4. Alcohol-induced psychosis

Ans. 1) Delirium tremens

• Delirium tremens is a serious condition that can be extremely dangerous and even fatal. It occurs during alcohol withdrawal. Confusion, intense physical reactions, visual hallucinations, motor agitation, disorientation, paranoid delusions, and altered sensorium characterize it.

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Q8. In this scenario, what is the type of learning demonstrated when a teacher showed her students the proper handwashing technique and they subsequently practiced it both at school and home?

1. Cognitive
2. Psychomotor
3. Affective
4. Affective and cognitive

Ans. 2) Psychomotor

• Psychomotor learning involves acquiring physical skills and coordination through practice and repetition, such as the steps of handwashing demonstrated by the teacher and performed by the students.

Q9. Which one of the options below represents a formal thought disorder?

1. Obsession
2. Derailment
3. Delusion
4. Thought insertion

Ans. 2) Derailment

• Derailment, also known as loosening of associations or thought disorder, is a symptom commonly associated with certain psychiatric conditions, such as schizophrenia or bipolar disorder. It refers to a disruption in the normal flow of thought processes, resulting in the individual's speech or thoughts becoming tangential or incoherent.

Q10. What is the probable diagnosis for a 16-year-old girl who exhibits symptoms such as excessive familiarity, rapid flow of thoughts, heightened mood, heightened sexual desire, and experiencing pseudohallucinations?

1. Mania
2. Hypomania
3. Cyclothymia
4. Schizomania

Ans. 1) Mania

• Mania is a mood disorder characterized by a distinct period of abnormally elevated, expansive, or irritable mood and increased energy or activity levels. The symptoms mentioned, such as overfamiliarity, flight of ideas, elevated mood, increased sexual desire, and pseudohallucination, are consistent with the manic episode seen in bipolar disorder.
• Mania is a period of at least 1 week where a person's behavior drastically changes and affects their functioning.
• Individuals experiencing mania engage in heightened goal-directed activity and may show psychomotor agitation.
• Mania is a characteristic of Bipolar I disorder.

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Q11. Under the Mental Healthcare Act 2017, what is the longest duration for which an individual can voluntarily admit themselves for mental health treatment?

1. 48 hours
2. 7 days
3. 30 days
4. 90 days

Ans. 3) 30 days

• Under the Mental Healthcare Act 2017, a person with a mental illness has the right to seek voluntary admission to a mental health establishment for treatment. Voluntary admission means that the individual willingly seeks admission and agrees to receive treatment.
• According to the Act, the maximum period of voluntary self-admission is 30 days. During this period, the person can receive treatment and care in the mental health establishment. After the initial period of 30 days, if further treatment is required, the individual has the option to continue the admission on a voluntary basis, subject to periodic review and renewal.

​Q12.  Please determine the sleep stage based on the red-highlighted EEG findings.​

1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4

Ans. 4) Stage 4

• The EEG findings of sawtooth waves indicate the presence of slow-wave sleep (SWS), which is typically observed in Stage 4 of the sleep cycle. Stage 4 is characterized by the presence of deep, restorative sleep with synchronized slow-wave activity on the EEG.

Q13. What diagnosis according to DSM-V would be appropriate for a middle-aged female patient who has been experiencing symptoms such as loss of interest in daily activities, weight loss, insomnia, and persistent sadness for a period of six months? Additionally, she reports a single incident of hearing a voice instructing her to commit suicide.

1. Major depressive disorder with psychotic features
2. Schizophrenia
3. Schizoaffective disorder
4. Delusional disorder

Ans. 1) Major depressive disorder with psychotic features

• Based on the information provided, the patient is experiencing symptoms of both depression and psychosis. The presence of symptoms such as loss of interest, weight loss, insomnia, and sadness for six months indicates a depressive episode. Additionally, the patient's report of hearing a voice that ordered her to kill herself suggests the presence of psychotic symptoms.

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Q14. What could be the likely diagnosis for a 16-year-old girl who experiences strong food cravings and engages in excessive eating followed by self-induced vomiting?

1. Anorexia nervosa
2. Bulimia nervosa
3. Atypical depression
4. Binge eating disorder

Ans. 2) Bulimia nervosa

• Bulimia nervosa is characterized by recurrent episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting, laxative use, or excessive exercise.
• Individuals with bulimia nervosa often have a normal body weight or maybe slightly overweight, and they tend to have a preoccupation with their body shape and weight.
• The key features are:
  • Strong food cravings
  • Episodes of excessive eating (binge eating)
  • Engaging in behaviors to prevent weight gain (e.g., self-induced vomiting)

Q15. What is the probable diagnosis for a woman who is 4 days postpartum and experiencing tearfulness, mood swings, and occasional insomnia?

1. Postpartum depression
2. Postpartum blues
3. Postpartum psychosis
4. Postpartum anxiety

Ans. 2) Postpartum blues

• The symptoms of tearfulness, occasional insomnia, and mood swings in a woman who is 4 days postpartum indicate the diagnosis of postpartum blues. Postpartum blues, also known as "baby blues," is a common condition that affects up to 80% of women after giving birth. It is a mild and self-limiting condition characterized by symptoms such as mood swings, tearfulness, anxiety, irritability, and sleep disturbances. The symptoms usually appear within the first few days after delivery and resolve within a week or two without requiring any treatment.

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Q16. Which drug listed below is utilized as an agent for smoking cessation?

1. Busulfan
2. Acamprosate
3. Varenicline
4. Gabapentin

Ans. 3) Varenicline

• Varenicline is a medication used as an antismoking agent. It works by targeting nicotine receptors in the brain, reducing the pleasurable effects of smoking and decreasing nicotine withdrawal symptoms. Varenicline is commonly prescribed to individuals who want to quit smoking or tobacco use.

Q17. Which of the following statements about somnambulism is incorrect?

1. Disorder of sleep arousal
2. Person will have full consciousness
3. Usually, terminates in awakening followed by confusion
4. There may be neurological condition associated

Ans. 2) Person will have full consciousness

• Somnambulism, also known as sleepwalking, is a parasomnia disorder characterized by complex motor behaviors and actions during sleep. During an episode of somnambulism, individuals are in a state of partial arousal from sleep, and their consciousness is typically impaired or altered.

Q18. Which one of the options does not contribute as a risk factor for delusional disorder?

1. Recent immigration
2. Social isolation
3. Family history
4. Young age

Ans. 4) Young age

• Delusional disorder is a psychiatric condition characterized by the presence of persistent delusions without significant impairment in other cognitive functions. Delusions are fixed, false beliefs that are maintained despite evidence to the contrary. While various factors can contribute to the development of delusional disorder, young age is not considered a significant risk factor.

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Q19. Premature ejaculation is a disorder of which phase of the normal sexual cycle?

1. Desire
2. Arousal
3. Orgasm
4. Pain

Ans. 3) Orgasm

• Premature ejaculation is a disorder that occurs during the orgasm phase of the normal sexual cycle. It is characterized by the persistent or recurrent ejaculation that happens before or shortly after the initiation of sexual activity, often with minimal stimulation. This results in an inability to delay ejaculation and causes distress or interpersonal difficulties.

Q20. Confusion assessment test is used in:

1. Delirium
2. Dementia
3. Schizophrenia
4. Depression

Ans. 1) Delirium 

• Confusion Assessment Test (CAM) is primarily used for the assessment and diagnosis of delirium. Delirium is a state of acute confusion and changes in cognition that often occurs in older adults, particularly those who are hospitalized or have underlying medical conditions. The CAM is a validated screening tool that helps healthcare professionals identify the presence of delirium and distinguish it from other cognitive disorders or psychiatric conditions.

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