NEET-PG 2015 Practice Questions

Q: Which of the following actions is NOT associated with tricyclic antidepressants?

MAO inhibition. ***MAO inhibition*** - Tricyclic antidepressants (TCAs) primarily exert their effects by inhibiting the reuptake of **norepinephrine** and **serotonin**, not by inhibiting monoamine oxidase (MAO). - **MAO inhibitors** are a distinct class of antidepressants with a different mechanism of action and side effect profile. *Anticholinergic action* - Many TCAs have significant **anticholinergic effects**, blocking muscarinic receptors and leading to side effects like dry mouth, constipation, and blurred vision. - These effects contribute to the **adverse event profile** of TCAs, especially in elderly patients. *Block 5-HT or NE reuptake* - The primary mechanism of action of TCAs involves the **inhibition of serotonin (5-HT)** and **norepinephrine (NE) reuptake** into presynaptic neurons. - This action increases the concentration of these neurotransmitters in the **synaptic cleft**, thereby potentiating their effects. *Causes sedation* - TCAs frequently cause **sedation**, particularly the more histaminergic ones (e.g., amitriptyline, doxepin), due to their **histamine H1 receptor antagonism**. - This side effect can be beneficial for patients with insomnia but can be problematic for daytime functioning.

Q: Gamma waves of REM sleep are associated with?

Subconscious processing. ***Subconscious processing*** - **Gamma waves (30-100 Hz)** during **REM sleep** represent high-frequency neural oscillations associated with **complex cognitive processing** occurring below the level of conscious awareness. - These waves reflect **integration of neural activity** across different brain regions, facilitating information processing and neural plasticity during sleep. - The term encompasses the underlying **neural mechanisms** that support dream generation and memory consolidation processes. *Dream consciousness and memory consolidation* - While **gamma waves** do correlate with dreaming and memory processes during **REM sleep**, these represent the **experiential and functional outcomes** rather than the primary neurophysiological association. - Dream consciousness is a **manifestation** of the underlying subconscious processing, not the direct association with gamma wave activity itself. *Deep subconscious processing* - The term "deep subconscious" is **non-specific** and lacks precise neurophysiological definition in the context of gamma wave activity. - While directionally correct, this option uses imprecise terminology compared to the more accurate "subconscious processing." *Non-REM sleep* - **Gamma waves** are characteristic of **waking states** and **REM sleep**, not non-REM sleep stages. - **Non-REM sleep** (stages N1, N2, N3) is dominated by **slower wave activity** including theta waves (stage N1), sleep spindles and K-complexes (stage N2), and delta waves (stage N3/deep sleep).

Q: What does the term 'jamais vu' refer to?

The feeling of strangeness in a familiar situation. ***The feeling of strangeness in a familiar situation*** - **Jamais vu** describes the opposite of déjà vu; it is the experience of encountering something familiar—a person, place, or word—but feeling that it is **unfamiliar or strange**. - This phenomenon can sometimes be a symptom associated with certain neurological conditions like **temporal lobe epilepsy**. *A thought that feels familiar but is actually new* - This describes a sensation closer to **cryptomnesia** or a "false familiarity," where a new idea is mistakenly believed to be an original thought. - Jamais vu specifically relates to the **perception of external reality** or recognition of known entities, not the familiarity of internal thoughts. *A situation that feels familiar but is actually new* - This is the definition of **déjà vu**, not jamais vu. Déjà vu involves experiencing a new event or situation as if it has happened before. - **Déjà vu** translates to "already seen," directly contrasting with the "never seen" sensation of jamais vu. *An illusion where one feels they have heard something before* - This is a specific type of **déjà vu** known as **déjà entendu** ("already heard"). - Jamais vu involves the *loss of familiarity* with something known, rather than the *false familiarity* with something new.

Q: Which of the following conditions is most commonly associated with self-mutilation?

Borderline personality disorder. **_Borderline personality disorder_** - **Self-mutilation** (e.g., cutting, burning) is a common coping mechanism in **borderline personality disorder (BPD)**, used to relieve intense emotional pain or a sense of emptiness. - This behavior is often associated with the characteristic **emotional dysregulation**, **impulsivity**, and unstable interpersonal relationships seen in BPD. - Self-mutilation is included as a diagnostic criterion in DSM-5 for BPD. *Catatonic schizophrenia* - This subtype of schizophrenia is characterized by profound disturbances in psychomotor behavior, such as **immobility**, **mutism**, **posturing**, or **excessive, purposeless motor activity**. - While individuals with catatonia may injure themselves during periods of extreme agitation or impulsivity, **self-mutilation** is not a primary or defining feature of catatonic schizophrenia. *Paranoid schizophrenia* - This type of schizophrenia is dominated by **delusions** (often persecutory or grandiose) and **auditory hallucinations**. - While individuals with paranoid schizophrenia may engage in self-harm if driven by delusional beliefs or command hallucinations, **self-mutilation** as a primary coping mechanism is not a hallmark characteristic of this disorder. *None of the options* - This option is incorrect because **borderline personality disorder** is strongly and specifically associated with self-mutilation.

Q: A patient inventing new words is a feature of?

Schizophrenia. ***Schizophrenia*** - The invention of new words, known as **neologisms**, is a characteristic symptom of **thought disorder** in schizophrenia. - These words often have personal meaning to the patient but are unintelligible to others, reflecting disturbed communication. *Neurotic disorders* - These disorders, such as anxiety and phobias, primarily involve **distress and maladaptive coping mechanisms** but do not typically feature neologisms. - **Thought content** may be ruminative or anxious, but not disorganized to the extent of inventing new words. *Aphasia* - Aphasia is a **language disorder caused by brain damage** (e.g., stroke), resulting in difficulty with language production or comprehension. - While it can involve word-finding difficulties or paraphasias (word substitutions), it is distinctly different from the deliberate invention of new, non-existent words seen in psychosis. *Obsessive-Compulsive Disorder (OCD)* - OCD is characterized by **recurrent, intrusive thoughts (obsessions)** and repetitive behaviors (compulsions). - It does not involve thought disorganization or the creation of neologisms; language remains structured, though often focused on obsessive themes.

Q: Increased dopamine levels are associated with which of the following conditions?

Schizophrenia. ***Schizophrenia*** - The **dopamine hypothesis of schizophrenia** is the most well-established association with increased dopamine levels, particularly in the **mesolimbic pathway**, which contributes to positive symptoms such as **hallucinations** and **delusions**. - Antipsychotic medications, which are **dopamine D2 receptor antagonists**, effectively reduce these positive symptoms by blocking dopamine activity. - This is the **classic and primary answer** when considering increased dopamine levels in psychiatry. *Depression* - Depression is primarily associated with **decreased levels of monoamines**, including **serotonin**, **norepinephrine**, and **dopamine**. - Treatments for depression often aim to increase these neurotransmitter levels, not related to dopamine excess. *Mania* - Mania, a hallmark of **bipolar disorder**, is associated with **increased dopamine activity** along with elevated **norepinephrine** and **serotonin** levels. - While mania does involve dopamine elevation, **schizophrenia** remains the **primary and most established** condition associated with the dopamine hypothesis in psychiatric literature. - The distinction is that schizophrenia's pathophysiology is more centrally and specifically linked to dopamine dysregulation. *Delirium* - Delirium is a state of **acute brain failure** characterized by a fluctuating course and disturbances in attention and cognition. - While neurotransmitter imbalances, including dopamine, **acetylcholine deficiency**, and GABA alterations, can contribute to delirium, it is not primarily defined by increased dopamine as the main pathophysiological mechanism.

Q: Loosening of association is an example of

Formal thought disorder. ***Formal thought disorder*** - **Loosening of association** is a classic symptom of **formal thought disorder**, where thoughts become disconnected, fragmented, or illogical. - It reflects a disturbance in the **structure and flow of thought**, leading to disorganized speech. *Schneider's first symptoms* - **Schneider's first-rank symptoms** are specific psychotic experiences (e.g., thought insertion, auditory hallucinations commenting on actions) that are highly suggestive of schizophrenia but do not include loosening of association as a primary symptom. - While sometimes seen in schizophrenia, loosening of association is a broader concept of thought disorganization rather than a first-rank symptom itself. *Perseveration* - **Perseveration** involves the **inappropriate repetition of words, phrases, or ideas**, even when the topic has changed. - While a form of thought disorder, it is distinct from the general disconnectedness seen in loosening of association. *Concrete thinking* - **Concrete thinking** is the **inability to comprehend abstract concepts or metaphors**, interpreting them literally. - This is a disorder of **thought content or style**, but not directly related to the disorganized flow of thought characterized by loosening of association.

Q: What is the treatment of choice for acute panic attacks?

Benzodiazepines. ***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

Q: In which of the following conditions is behavioral therapy most commonly utilized?

Agoraphobia. ***Agoraphobia*** - **Behavioral therapy**, particularly **exposure therapy**, is the **gold standard and first-line treatment** for agoraphobia. - It involves **systematic desensitization** and gradual exposure to feared situations (e.g., crowded places, public transport, open spaces). - This approach directly reduces **avoidance behaviors** and anxiety responses, making it the most commonly utilized behavioral intervention among these conditions. *Schizophrenia* - While behavioral interventions can be part of a comprehensive treatment plan, **pharmacotherapy** (antipsychotics) is the cornerstone for managing positive and negative symptoms. - Behavioral approaches often focus on **social skills training** and vocational rehabilitation, not primary symptom reduction. *Delirium* - The primary management for delirium involves identifying and treating the **underlying medical cause** and providing supportive care. - Behavioral therapy is generally not indicated as this condition is an **acute organic brain syndrome** requiring medical management. *Neurotic depression* - This term is largely outdated; current diagnostic manuals use terms like **persistent depressive disorder (dysthymia)** or **major depressive disorder**. - While behavioral activation is a component of CBT for depression, the primary treatments are **cognitive behavioral therapy (CBT)** and/or **pharmacotherapy** (antidepressants), rather than purely behavioral therapy.

Q: Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?

Bulimia nervosa. ***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.

Question 1

Which of the following actions is NOT associated with tricyclic antidepressants?

Accepted Answer

MAO inhibition

Answer

Block 5-HT or NE reuptake

Answer

Anticholinergic action

Answer

Causes sedation

Question 2

Gamma waves of REM sleep are associated with?

Accepted Answer

Subconscious processing

Answer

Dream consciousness and memory consolidation

Answer

Deep subconscious processing

Answer

Non-REM sleep

Question 3

What does the term 'jamais vu' refer to?

Accepted Answer

The feeling of strangeness in a familiar situation

Answer

A thought that feels familiar but is actually new

Answer

A situation that feels familiar but is actually new

Answer

An illusion where one feels they have heard something before

Question 4

Which of the following conditions is most commonly associated with self-mutilation?

Accepted Answer

Borderline personality disorder

Answer

Catatonic schizophrenia

Answer

Paranoid schizophrenia

Answer

None of the options

Question 5

A patient inventing new words is a feature of?

Accepted Answer

Schizophrenia

Answer

Aphasia

Answer

Neurotic disorders

Answer

Obsessive-Compulsive Disorder (OCD)

Question 6

Increased dopamine levels are associated with which of the following conditions?

Accepted Answer

Schizophrenia

Answer

Depression

Answer

Mania

Answer

Delirium

Question 7

Loosening of association is an example of

Accepted Answer

Formal thought disorder

Answer

Concrete thinking

Answer

Schneider's first symptoms

Answer

Perseveration

Question 8

What is the treatment of choice for acute panic attacks?

Accepted Answer

Benzodiazepines

Answer

Tricyclic antidepressants (TCAs)

Answer

Monoamine oxidase inhibitors (MAOIs)

Answer

Barbiturates

Question 9

In which of the following conditions is behavioral therapy most commonly utilized?

Accepted Answer

Agoraphobia

Answer

Schizophrenia

Answer

Delirium

Answer

Neurotic depression

Question 10

Which eating disorder is characterized by episodes of binge eating while maintaining a normal weight?

Accepted Answer

Bulimia nervosa

Answer

Anorexia nervosa

Answer

Binge eating disorder

Answer

Night eating syndrome

NEET-PG 2015

Pharmacology

Physiology

Psychiatry