NEET-PG 2015 Practice Questions

Q: During a postmortem examination of a young adult found with a faded tattoo, relatives mentioned that the tattoo was once visible. What is the best method to identify the tattoo?

Illuminate with ultraviolet (UV) light. ***Illuminate with ultraviolet (UV) light*** - **UV light** causes residual tattoo pigments, even faded ones, to **fluoresce**, making them visible again for identification. - This method is particularly effective for **older or faded tattoos** where the pigment has degraded or spread. *Use a spectrophotometer for analysis* - A spectrophotometer is used to measure the **intensity of light** as a function of wavelength, which is useful for **analyzing chemical components or color intensity**. - While it can analyze pigments, it is not the primary or most practical method for merely **identifying the presence and pattern of a faded tattoo** on skin, especially in a postmortem context. *Illuminate with ordinary light* - **Ordinary visible light** is typically insufficient to reveal tattoos that have significantly faded or been subjected to processes that obscure them. - If the tattoo is already faded to the point of being invisible to the naked eye, **ordinary light will not enhance its visibility** as it lacks the specific wavelengths needed to cause fluorescence. *Perform an X-ray examination* - **X-rays** are used to visualize dense structures like **bones and foreign bodies**, not for examining skin or pigments. - Tattoo pigments are generally **not radiopaque** and would not be visible on an X-ray film, rendering this method useless for tattoo identification.

Q: In which condition is sex reassignment surgery typically performed?

Gender dysphoria. ***Gender dysphoria*** - **Sex reassignment surgery** is primarily performed as part of the treatment for **gender dysphoria**, a condition where there is a marked incongruence between an individual's experienced/expressed gender and their assigned sex. - The surgery aims to align the individual's physical appearance with their **gender identity**, alleviating distress and improving quality of life. *Premature ejaculation* - This condition involves consistent or recurrent ejaculation with minimal sexual stimulation before, during, or shortly after penetration and before the person wishes it. - Treatment typically includes behavioral therapies, medication (e.g., SSRIs), and psychological counseling, not surgical intervention. *Erectile dysfunction* - **Erectile dysfunction** is the inability to achieve or maintain an erection firm enough for satisfactory sexual intercourse. - Treatments range from lifestyle changes and oral medications (e.g., PDE5 inhibitors) to vacuum devices, penile injections, and in some cases, penile implants, but not sex reassignment surgery. *Orgasmic dysfunction* - This condition refers to persistent or recurrent delay in, or absence of, orgasm following a normal phase of sexual excitement. - Management often involves psychological counseling, addressing underlying medical conditions, or adjusting medications; it does not involve sex reassignment surgery.

Q: Which of the following is not typically associated with dementia?

Alteration of consciousness. ***Alteration of consciousness*** - An **alteration of consciousness** is a hallmark feature of **delirium**, which is an acute confusional state, usually fluctuating. - **Dementia** is primarily characterized by a chronic, progressive decline in cognitive function with **clear consciousness**. *Forgetfulness* - **Forgetfulness**, particularly memory loss impacting daily life, is one of the **earliest and most common symptoms** of dementia. - This symptom progressively worsens, affecting short-term and eventually long-term memory. *Reduced personal care* - As dementia progresses, individuals often experience a decline in their ability to perform **activities of daily living (ADLs)**, including personal care. - This can manifest as forgetting to bathe, difficulty dressing, or neglecting personal hygiene due to cognitive impairment. *Loss of neurons in brain* - **Neurodegeneration**, characterized by the **loss of neurons** and synapses in the brain, is the underlying pathological basis of most types of dementia, such as Alzheimer's disease. - This neuronal loss leads to brain atrophy and the cognitive deficits seen in dementia.

Q: A girl exhibits aggressive behavior such as smashing and throwing objects and verbally abusing hospital staff. However, she shows a different demeanor towards a particular resident doctor. What could be the most likely diagnosis?

Borderline personality disorder. ***Borderline personality disorder*** - Patients with **borderline personality disorder** often exhibit **impulsivity**, intense mood swings, and a pattern of unstable interpersonal relationships, leading to aggressive outbursts. - Their unpredictable behavior and tendency to form intense, unstable attachments or a "favorite person" dynamic are characteristic, as seen in her differing demeanor towards a particular resident doctor. *Bipolar disorder* - While bipolar disorder involves **mood swings**, the behavioral patterns are typically characterized by distinct episodes of **mania** or hypomania and depression, with less emphasis on chronic interpersonal instability and aggression. - The aggression in bipolar disorder is often associated with the manic phase but lacks the consistent pattern of relationship instability and "favorite person" dynamic described. *Schizoaffective disorder* - This disorder involves a combination of **psychotic symptoms** (like delusions or hallucinations) and **mood symptoms** (like depression or mania), which are not explicitly described here as the primary issue. - The aggressive behavior is not primarily driven by psychosis, and the specific interpersonal dynamic with staff is more suggestive of a personality disorder. *Antisocial personality* - **Antisocial personality disorder** is characterized by a pervasive pattern of disregard for and violation of the **rights of others** and may include aggression, but it often involves a lack of empathy and manipulativeness rather than the intense emotional dysregulation and unstable interpersonal patterns seen in borderline personality. - While aggressive behavior is present, the specific description of verbally abusing staff while showing a "different demeanor" towards a particular doctor points away from the typical presentation of antisocial disregard for others.

Q: What is the most common cause of delirium?

Infection. ***Infection*** - **Infections**, particularly urinary tract infections (UTIs) or pneumonia, are a very common and often reversible cause of **delirium**, especially in elderly or immunocompromised patients [1]. - The systemic inflammatory response to infection can lead to neuroinflammation and direct effects on brain function, manifesting as acute changes in attention and cognition. *Liver failure* - While **liver failure** can cause **hepatic encephalopathy**, which presents with altered mental status, it typically has a more gradual onset and a different neurochemical profile than acute delirium caused by infection. - Hepatic encephalopathy is characterized by abnormal ammonia metabolism and often includes motor signs like **asterixis**, which are not universally present in delirium from infection. *Belladonna poisoning* - **Belladonna poisoning** (due to **anticholinergic toxicity**) can cause **delirium**, along with a constellation of symptoms like dilated pupils, dry mouth, and tachycardia. - However, it is a specific toxicological cause and not as broad or commonly encountered as infection as a general cause of new-onset delirium in hospitalized or elderly populations. *None of the options* - This option is incorrect because **infection** is indeed a very common and recognized cause of delirium [1].

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.

Question 1

During a postmortem examination of a young adult found with a faded tattoo, relatives mentioned that the tattoo was once visible. What is the best method to identify the tattoo?

Accepted Answer

Illuminate with ultraviolet (UV) light

Answer

Use a spectrophotometer for analysis

Answer

Illuminate with ordinary light

Answer

Perform an X-ray examination

Question 2

In which condition is sex reassignment surgery typically performed?

Accepted Answer

Gender dysphoria

Answer

Premature ejaculation

Answer

Erectile dysfunction

Answer

Orgasmic dysfunction

Question 3

Which of the following is not typically associated with dementia?

Accepted Answer

Alteration of consciousness

Answer

Reduced personal care

Answer

Loss of neurons in brain

Answer

Forgetfulness

Question 4

A girl exhibits aggressive behavior such as smashing and throwing objects and verbally abusing hospital staff. However, she shows a different demeanor towards a particular resident doctor. What could be the most likely diagnosis?

Accepted Answer

Borderline personality disorder

Answer

Bipolar disorder

Answer

Schizoaffective disorder

Answer

Antisocial personality

Question 5

What is the most common cause of delirium?

Accepted Answer

Infection

Answer

Liver failure

Answer

Belladonna poisoning

Answer

None of the options

Question 6

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 7

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 8

A patient inventing new words is a feature of?

Accepted Answer

Schizophrenia

Answer

Aphasia

Answer

Neurotic disorders

Answer

Obsessive-Compulsive Disorder (OCD)

Question 9

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

Accepted Answer

Schizophrenia

Answer

Depression

Answer

Mania

Answer

Delirium

Question 10

Loosening of association is an example of

Accepted Answer

Formal thought disorder

Answer

Concrete thinking

Answer

Schneider's first symptoms

Answer

Perseveration

NEET-PG 2015

Forensic Medicine

Psychiatry