Psychiatric Assessment and Diagnosis Practice Questions

Q: In conversion disorder, which of the following is typically NOT found?

Jealousy. **Explanation:** **Conversion Disorder (Functional Neurological Symptom Disorder)** is characterized by the presence of one or more symptoms of altered voluntary motor or sensory function that are incompatible with recognized neurological or medical conditions. **Why Jealousy is the correct answer:** Jealousy is an **emotional state or a symptom of a delusional disorder** (e.g., Othello syndrome), not a physical manifestation of neurological dysfunction. Conversion disorder specifically involves "converting" psychological distress into **physical (somatic) symptoms** affecting the motor or sensory systems. Therefore, jealousy does not fit the diagnostic criteria for conversion disorder. **Analysis of Incorrect Options:** * **B. Paralysis:** This is a common motor symptom in conversion disorder. Patients may present with hemiplegia or monoplegia that does not follow anatomical nerve distributions. * **C. Anesthesia:** Sensory loss (anesthesia or paresthesia) is a hallmark feature. A classic example is "glove and stocking" anesthesia, which does not correspond to dermatomal patterns. * **D. Abnormal gait:** Motor coordination issues, such as **Astasia-abasia** (a wild, staggering gait where the patient rarely falls), are frequently observed. **NEET-PG High-Yield Pearls:** * **La Belle Indifférence:** A classic (though not pathognomonic) feature where the patient shows a surprising lack of concern regarding their severe disability. * **Primary Gain:** Internal conflict is kept out of awareness (anxiety is reduced). * **Secondary Gain:** External benefits are derived from being sick (e.g., attention, avoiding work). * **Identification:** The patient may unconsciously mimic the symptoms of a deceased or ill loved one. * **Treatment:** Physical therapy and Cognitive Behavioral Therapy (CBT) are first-line; pharmacotherapy is used only for comorbid anxiety or depression.

Q: The patient's thoughts seem to be associated more by sound and rhyme than by meaning. This phenomenon is known as:

Clang association. **Explanation:** The correct answer is **Clang association**. This is a formal thought disorder where the patient’s speech is governed by the **sounds of words (phonetics)** rather than their conceptual meaning. This typically manifests as rhyming, punning, or alliteration (e.g., "I am the king, ring, wing, sing"). It is most commonly associated with the **manic phase of Bipolar Disorder** and occasionally Schizophrenia. **Analysis of Incorrect Options:** * **A. Flight of ideas:** This involves a rapid succession of thoughts where the connection between ideas is maintained but shifts quickly based on chance associations or distracting stimuli. While it can include clang associations, the term specifically refers to the *speed* and *flow* of thoughts. * **B. Perseveration:** This is the inappropriate persistence or repetition of a specific response (word, phrase, or gesture) to different questions or stimuli, even after the initial stimulus is removed. It is often a sign of organic brain disease or Catatonia. * **C. Circumstantiality:** The patient provides excessive, unnecessary detail and tedious "parenthetical" remarks before eventually reaching the point or answering the original question. **Clinical Pearls for NEET-PG:** * **Clang Association** is a hallmark of **Mania**. * **Neologism:** Coining new words that have meaning only to the patient (common in Schizophrenia). * **Word Salad (Incoherence):** A complete breakdown of syntax where words are strung together without any logical connection. * **Thought Blocking:** A sudden interruption in the train of thought before an idea is completed; pathognomonic for **Schizophrenia**.

Q: The Wechsler test is used to assess which of the following?

Intelligence. **Explanation:** The **Wechsler Scales** are the gold standard instruments used globally for the assessment of **Intelligence (Option D)**. Developed by David Wechsler, these tests move away from the traditional "Mental Age" concept, instead using the **Deviation IQ**, which compares an individual's performance to the average performance of their age-matched peers. There are three primary versions tailored to different age groups: 1. **WPPSI:** Wechsler Preschool and Primary Scale of Intelligence (ages 2.5–7 years). 2. **WISC:** Wechsler Intelligence Scale for Children (ages 6–16 years). 3. **WAIS:** Wechsler Adult Intelligence Scale (ages 16–90 years). **Analysis of Incorrect Options:** * **Memory (Option A):** While the Wechsler scales include subtests for working memory (like Digit Span), memory is primarily assessed using the **Wechsler Memory Scale (WMS)** or the PGI Memory Scale, not the standard intelligence test. * **Orientation (Option B):** This is a component of the **Mini-Mental State Examination (MMSE)** or a bedside Mental Status Examination (MSE), used to screen for delirium or dementia. * **Speech (Option C):** Speech and language are evaluated through clinical observation or specific neuropsychological batteries (e.g., Boston Diagnostic Aphasia Examination) rather than IQ tests. **High-Yield Clinical Pearls for NEET-PG:** * **Mean IQ:** The mean score for Wechsler tests is **100** with a Standard Deviation (SD) of **15**. * **Intellectual Disability (ID):** Defined as an IQ score below **70** (2 SDs below the mean) along with deficits in adaptive functioning. * **Bhatia’s Battery:** A common Indian performance test for intelligence often asked in exams. * **Raven’s Progressive Matrices:** A popular non-verbal, culture-fair test of intelligence.

Q: An IQ value between 90-109 is considered to belong to which category?

Normal. ### Explanation The Intelligence Quotient (IQ) is a standardized measure of cognitive ability, calculated as (Mental Age / Chronological Age) × 100. According to the classification originally proposed by Terman and widely used in clinical psychiatry, an **IQ of 90–109 is classified as Average or Normal**. This range encompasses approximately 50% of the general population. #### Analysis of Options: * **C. Normal (Correct):** This range (90–109) represents the median of the bell curve in intelligence testing. * **A. Imbecile (Incorrect):** This is an obsolete term for **Moderate Intellectual Disability**, corresponding to an IQ range of **35–49**. * **B. Moron (Incorrect):** This is an obsolete term for **Mild Intellectual Disability**, corresponding to an IQ range of **50–70**. In modern ICD-11/DSM-5 terminology, these terms are replaced by "Intellectual Development Disorder." * **D. Near Genius (Incorrect):** This category (often termed "Very Superior") typically refers to an IQ score of **140 and above**. #### High-Yield Clinical Pearls for NEET-PG: * **Borderline Intelligence:** IQ range of **70–79**. * **Dull Normal:** IQ range of **80–89**. * **Intellectual Disability (ID) Cut-off:** An IQ below **70**, accompanied by deficits in adaptive functioning. * **Classification of ID (ICD-10):** * **Mild:** 50–69 (Educable) * **Moderate:** 35–49 (Trainable) * **Severe:** 20–34 (Dependent) * **Profound:** < 20 (Life support) * **The Flynn Effect:** The observed rise in average IQ scores over generations, necessitating periodic re-norming of tests.

Q: Phantom limb is an example of a disorder of which of the following?

Perception. **Explanation:** **Phantom limb** is a phenomenon where a patient continues to experience sensations (such as pain, itching, or movement) in a limb that has been surgically removed or lost. It is classified as a **disorder of perception** because it involves a sensory experience in the absence of an external stimulus. 1. **Why Perception is Correct:** Perception is the process of interpreting sensory information. In phantom limb, the brain’s cortical homunculus (the somatosensory map) continues to receive or generate signals as if the limb were still present. This "false" sensory experience—occurring without a peripheral object—makes it a type of **hallucination** (specifically, a somatic or tactile hallucination), which is a primary disorder of perception. 2. **Why Other Options are Incorrect:** * **Thought:** Disorders of thought involve disturbances in the flow, form, or content of ideas (e.g., delusions, loosening of associations). Phantom limb is a sensory experience, not a belief or a logic error. * **Cognition:** Cognitive disorders involve deficits in memory, orientation, attention, or executive function (e.g., Dementia, Delirium). While the brain is involved, phantom limb does not represent a loss of intellectual faculty. **High-Yield Clinical Pearls for NEET-PG:** * **Phantom Limb vs. Stump Pain:** Phantom limb is the sensation of the missing part; stump pain is localized pain at the site of the surgical scar. * **Mirror Box Therapy:** This is a high-yield treatment modality used to "trick" the brain into reorganizing the cortical map to reduce phantom pain. * **Cortical Reorganization:** The underlying pathophysiology is the neuroplastic reorganization of the primary somatosensory cortex.

Q: Which of the following is known as Munchausen Syndrome?

Factitious Disorder. **Explanation:** **Munchausen Syndrome** is the historical and most severe form of **Factitious Disorder** (specifically Factitious Disorder Imposed on Self). In this condition, a patient intentionally produces, feigns, or exaggerates physical or psychological symptoms. Unlike malingering, the primary motivation is not external gain (like money or avoiding work) but rather the **"sick role"**—the desire for medical attention, sympathy, and care. Patients often undergo invasive procedures and move from hospital to hospital ("hospital hopping"). **Analysis of Incorrect Options:** * **B. Mood Disorder:** These are characterized by disturbances in emotional state (e.g., Depression or Bipolar Disorder) and do not involve the intentional fabrication of symptoms for psychological gain. * **C. Somatoform Disorder:** In these disorders (now largely classified as Somatic Symptom Disorder), the patient experiences genuine distress from physical symptoms that are **not** intentionally produced. The symptoms are unconscious and involuntary. * **D. PTSD:** This is a stressor-related disorder following exposure to a traumatic event; it involves flashbacks and hyperarousal, not the falsification of illness. **High-Yield Clinical Pearls for NEET-PG:** * **Munchausen by Proxy:** Now termed "Factitious Disorder Imposed on Another," where a caregiver (usually a mother) fabricates illness in a child. This is a form of child abuse. * **Key Differentiator:** In **Factitious Disorder**, the motive is internal (the sick role). In **Malingering**, the motive is external (secondary gain). * **Common Presentation:** Patients often have extensive medical knowledge and surgical scars ("gridiron abdomen").

Q: Which of the following is not a disorder of the form of thought?

Thought block. ### Explanation In psychiatry, thought disorders are classified into four main categories: **Stream/Flow, Form, Content, and Possession.** Understanding this distinction is crucial for NEET-PG. **1. Why "Thought Block" is the correct answer:** Thought block is a disorder of the **Stream (or Flow)** of thought. It is the sudden, involuntary cessation of the train of thought before a concept is completed. The patient suddenly stops speaking and, after a silence, often cannot recall what they were saying or starts a new topic. **2. Why the other options are incorrect:** Options A, B, and D are all disorders of the **Form of thought** (Formal Thought Disorder). This refers to how ideas are linked together: * **Loosening of Association (Option D):** A lack of logical connection between sequential thoughts; the hallmark of schizophrenia. * **Derailment (Option A):** Often used interchangeably with loosening of association, where the patient "slides off the track" onto another unrelated topic. * **Tangentiality (Option B):** The patient replies to a question in an oblique or irrelevant manner, never reaching the original goal or point. --- ### High-Yield Clinical Pearls for NEET-PG: * **Disorder of Content:** Includes **Delusions**, obsessions, and phobias. * **Disorder of Possession:** Includes **Thought Insertion, Withdrawal, and Broadcasting** (Schneiderian First Rank Symptoms). * **Neologism:** Coining new words with private meanings; also a disorder of **Form**. * **Circumstantiality:** The patient includes excessive unnecessary detail but eventually returns to the point (unlike tangentiality). This is a disorder of **Stream/Flow**. * **Flight of Ideas:** Rapid shifting of ideas with some connection (often phonetic or "clang association"); seen in **Mania**. This is a disorder of **Stream/Flow**.

Q: A false belief, unexplained by reality and shared by a number of people, is termed as what?

Mass hysteria. **Explanation:** The correct answer is **Mass Hysteria** (also known as Epidemic Hysteria or Mass Psychogenic Illness). **1. Why Mass Hysteria is correct:** Mass hysteria refers to the rapid spread of illness signs and symptoms affecting a group of people, originating from a shared nervous system disturbance. The key feature in this question is the **shared nature** of the false belief. Unlike a typical delusion which is idiosyncratic (private to the individual), mass hysteria involves a collective "group-think" where a false belief or perceived threat is accepted and acted upon by multiple people simultaneously, often triggered by stress or anxiety. **2. Why the other options are incorrect:** * **Illusion (A):** This is a misinterpretation of a real external sensory stimulus (e.g., mistaking a rope for a snake). It is a disorder of perception, not belief. * **Delusion (B):** While a delusion is a fixed false belief, it is defined as being **not shared** by others of the same common cultural or social background. If a belief is shared by a large group, it is generally excluded from the definition of a clinical delusion. * **Obsession (C):** These are recurrent, persistent, and intrusive thoughts, images, or urges that the individual recognizes as their own but finds distressing. They are not "beliefs" accepted as reality. **Clinical Pearls for NEET-PG:** * **Folie à deux (Shared Psychotic Disorder):** A delusion shared by only two people (usually closely related). If it involves more, it is *Folie à plusieurs*. * **Delusion Definition:** Fixed, false belief, not amenable to change in light of conflicting evidence, and **not consistent** with the patient’s educational, cultural, and social background. * **Mass Hysteria** often presents with physical symptoms (fainting, tremors) without an organic cause in a school or workplace setting.

Question 1

In conversion disorder, which of the following is typically NOT found?

Accepted Answer

Jealousy

Answer

Paralysis

Answer

Anesthesia

Answer

Abnormal gait

Question 2

The patient's thoughts seem to be associated more by sound and rhyme than by meaning. This phenomenon is known as:

Accepted Answer

Clang association

Answer

Flight of ideas

Answer

Perseveration

Answer

Circumstantiality

Question 3

The Wechsler test is used to assess which of the following?

Accepted Answer

Intelligence

Answer

Memory

Answer

Orientation

Answer

Speech

Question 4

Which of the following signs is not characteristic of conversion disorder?

Accepted Answer

Cogwheel rigidity

Answer

Astasia-abasia

Answer

Hemianesthesia of the body at the midline

Answer

Normal reflexes

Question 5

An IQ value between 90-109 is considered to belong to which category?

Accepted Answer

Normal

Answer

Imbecile

Answer

Moron

Answer

Near Genius

Question 6

A homosexual person feels that they are imposed by a female body and has persistent discomfort with their sex. What is the diagnosis?

Accepted Answer

Gender dysphoria

Answer

Transvestism

Answer

Voyeurism

Answer

Paraphilias

Question 7

Phantom limb is an example of a disorder of which of the following?

Accepted Answer

Perception

Answer

Thought

Answer

Cognition

Answer

None of the above

Question 8

Which of the following is known as Munchausen Syndrome?

Accepted Answer

Factitious Disorder

Answer

Mood Disorder

Answer

Somatoform Disorder

Answer

PTSD

Question 9

Which of the following is not a disorder of the form of thought?

Accepted Answer

Thought block

Answer

Derailment

Answer

Tangentiality

Answer

Loosening of association

Question 10

A false belief, unexplained by reality and shared by a number of people, is termed as what?

Accepted Answer

Mass hysteria

Answer

Illusion

Answer

Delusion

Answer

Obsession

Psychiatric Assessment and Diagnosis — MCQs

Psychiatric Assessment and Diagnosis — MCQs

On this page

Practice by Chapter

Want unlimited practice?