Anxiety disorders: organic mimics: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety disorders: organic mimics

Sample item

A 35-year-old woman has episodic palpitations, headache, sweating and severe hypertension during attacks. Which investigation helps exclude an organic mimic of panic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Plasma or urinary metanephrines

Paroxysmal hypertension with headache, sweating and palpitations suggests phaeochromocytoma, which mimics panic attacks. Metanephrines confirm it. Thyrotoxicosis, hypoglycaemia, arrhythmias and substance effects are other mimics to consider.

Option by option

  • A. Plasma or urinary metanephrines (correct)

    Correct. Metanephrines screen for phaeochromocytoma.

  • B. Blood alcohol level

    Alcohol level does not explain paroxysmal hypertension.

  • C. Serum lithium level

    Lithium level is irrelevant without lithium use.

  • D. Antinuclear antibody titre

    ANA is used for autoimmune disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Plasma or urinary metanephrines. Paroxysmal hypertension with headache, sweating and palpitations suggests phaeochromocytoma, which mimics panic attacks.

Why is "Blood alcohol level" not the answer?

Alcohol level does not explain paroxysmal hypertension.

Why is "Serum lithium level" not the answer?

Lithium level is irrelevant without lithium use.

Why is "Antinuclear antibody titre" not the answer?

ANA is used for autoimmune disease.

What concept does this question test?

It tests Anxiety disorders: organic mimics in Psychiatry. Metanephrines confirm it. Thyrotoxicosis, hypoglycaemia, arrhythmias and substance effects are other mimics to consider.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety disorders: organic mimics?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.