Consultation-Liaison Psychiatry Practice Questions

Q: Depression is most commonly seen in patients suffering from which of the following cancers?

Pancreatic cancer. **Explanation:** The association between **Pancreatic Cancer** and **Depression** is a classic high-yield concept in Consultation-Liaison Psychiatry. **Why Pancreatic Cancer is the Correct Answer:** Pancreatic cancer has the highest prevalence of depression among all malignancies (estimated between 30-50%). Crucially, depression in these patients often presents as a **prodromal symptom**, appearing months before the physical diagnosis of the tumor. The underlying mechanism is believed to be **paraneoplastic** in nature, involving the release of pro-inflammatory cytokines (like IL-6 and TNF-alpha) and alterations in the kynurenine pathway, which depletes serotonin levels even before significant tumor burden or cachexia occurs. **Analysis of Incorrect Options:** * **A. Brain Cancer:** While brain tumors (especially frontal lobe lesions) can cause personality changes and mood symptoms, the statistical prevalence of clinical depression is lower than in pancreatic cancer. * **C. Lung Cancer:** Depression is common in lung cancer due to high symptom burden and smoking-related comorbidities, but it typically follows the diagnosis rather than preceding it as a biological prodrome. * **D. Kidney Cancer:** While chronic illness increases the risk of adjustment disorders, there is no specific biological or statistical link making it the "most common" compared to pancreatic malignancy. **NEET-PG High-Yield Pearls:** * **Prodromal Depression:** If an elderly patient presents with new-onset depression and unexplained weight loss, always screen for occult pancreatic malignancy. * **Cytokine Theory:** Depression in cancer is not just a psychological reaction; it is often a biological manifestation of systemic inflammation. * **Treatment:** SSRIs remain the first-line treatment, but Mirtazapine is often preferred in cancer patients to help with insomnia and appetite stimulation.

Q: Consultation-Liaison psychiatry involves diagnosing which of the following?

Psychiatric illness in medically ill patients. **Explanation:** **Consultation-Liaison (C-L) Psychiatry**, also known as Psychosomatic Medicine, is a specialized sub-discipline that serves as the bridge between psychiatry and other medical/surgical specialties. **1. Why Option A is Correct:** The primary role of a C-L psychiatrist is to diagnose and manage **psychiatric illnesses occurring in patients hospitalized for medical, surgical, or obstetric conditions**. These patients are often in general hospital wards (e.g., ICU, Oncology, or Cardiology) where their physical illness either triggers, exacerbates, or coexists with a mental disorder (such as Delirium, Depression due to chronic illness, or Adjustment Disorder). **2. Why the Other Options are Incorrect:** * **Option B:** While psychiatrists must be aware of physical health, the primary focus of the *C-L service* is the psychiatric complication of the medical patient, not the primary medical diagnosis of a psychiatric inpatient. * **Options C & D:** While assessing suicidality is a critical skill in psychiatry, it is a specific clinical task rather than the defining scope of the C-L specialty. C-L psychiatry covers a much broader range of conditions, including delirium, capacity assessments, and somatoform disorders. **High-Yield Clinical Pearls for NEET-PG:** * **Most Common Referral:** The most frequent reason for a C-L consultation in a general hospital is **Delirium** (Acute Confusional State). * **Common Scenarios:** Managing post-MI depression, neuropsychiatric symptoms in SLE, or psychological distress in terminal cancer patients. * **Key Function:** It involves two components—**Consultation** (providing expert opinion on a specific patient) and **Liaison** (improving the communication and mental health skills of the non-psychiatric medical staff).

Question 1

Depression is most commonly seen in patients suffering from which of the following cancers?

Accepted Answer

Pancreatic cancer

Answer

Brain cancer

Answer

Lung cancer

Answer

Kidney cancer

Question 2

Type D personality is recently found to be at risk of developing which of the following?

Accepted Answer

Coronary artery disease

Answer

Depression

Answer

Schizophrenia

Answer

Mania

Question 3

A 20-year-old female presents with complaints of nausea, vomiting, and pain in her legs. Her physical examination and laboratory investigations are normal. What is the most probable diagnosis?

Accepted Answer

Somatoform pain disorder

Answer

Generalized anxiety disorder

Answer

Conversion disorder

Answer

Somatization disorder

Question 4

A postoperative male client with diabetes mellitus reports impotence and expresses concern about its effect on his marriage. In planning this client's care, what is the most appropriate intervention?

Accepted Answer

Suggest referral to a sex counselor or other appropriate professional.

Answer

Encourage the client to ask questions about personal sexuality.

Answer

Provide time for privacy.

Answer

Provide support for the spouse or significant other.

Question 5

Consultation-Liaison psychiatry involves diagnosing which of the following?

Accepted Answer

Psychiatric illness in medically ill patients

Answer

Medical illness in psychiatric patients

Answer

Suicidal tendency in psychiatric patients

Answer

Suicidal tendency in medically ill patients

Question 6

Astasia-abasia is seen in patients with which of the following disorders?

Accepted Answer

Conversion disorder

Answer

Illness anxiety disorder

Answer

Somatic symptom disorder

Answer

Depression

Question 7

When assessing a patient’s needs for psychologic support after the patient has been diagnosed with stage I cancer of the colon, which question by the nurse will provide the most information?

Accepted Answer

Can you tell me what has been helpful to you in the past when coping with stressful events?

Answer

How long ago were you diagnosed with this cancer?

Answer

Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?

Answer

How do you feel about having a possibly terminal illness?

Question 8

A 16-year-old female presents with recurrent abdominal pain, but biochemical assays and ultrasound of the abdomen are normal. After waking up from sleep, she suddenly complains of loss of vision in both eyes. An ophthalmologist finds nothing on examination. This condition is most probably due to:

Accepted Answer

Malingering

Answer

Bilateral optic neuritis

Answer

Posterior cerebellar artery infarct

Answer

Occipital hemorrhage

Question 9

Persistent preoccupation with serious illness and normal body function is called?

Accepted Answer

Hypochondriasis

Answer

Obsession

Answer

Somatization

Answer

Conversion disorder

Question 10

A 35-year-old male with pre-morbid anxious traits and heavy smoking believes he has suffered from lung carcinoma for a year. No significant clinical findings are detected on examination, and relevant investigations are unremarkable. He continues to hold this belief despite evidence to the contrary, having spent considerable money, time, and energy on undue investigations. What is the most likely diagnosis?

Accepted Answer

Hypochondriacal disorder

Answer

Carcinoma lung

Answer

Delusional disorder

Answer

Malingering

Consultation-Liaison Psychiatry — MCQs

Consultation-Liaison Psychiatry — MCQs

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