Organic psychiatry: general paresis: 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 · Organic psychiatry: general paresis

Sample item

A 45-year-old man has grandiose delusions, euphoria, tremor of the tongue and facial muscles, dysarthria and small irregular pupils that accommodate but do not react to light. Which is the diagnosis?

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

The answer and the reasoning

A. General paresis of the insane (neurosyphilis)

General paresis arises 10 to 20 years after syphilis infection, with dementia, grandiose delusions, tremor, dysarthria and Argyll Robertson pupils. CSF VDRL confirms the diagnosis and penicillin is the treatment. It must be considered in any new psychosis with neurological signs.

Option by option

  • A. General paresis of the insane (neurosyphilis) (correct)

    Correct. Grandiosity with Argyll Robertson pupils and tremor indicates general paresis.

  • B. Huntington disease

    Huntington disease shows chorea and a family history.

  • C. Wernicke encephalopathy

    Wernicke encephalopathy shows ophthalmoplegia, ataxia and confusion.

  • D. Mania in bipolar disorder

    Mania does not cause pupillary abnormalities and neurological signs.

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, General paresis of the insane (neurosyphilis). General paresis arises 10 to 20 years after syphilis infection, with dementia, grandiose delusions, tremor, dysarthria and Argyll Robertson pupils.

Why is "Huntington disease" not the answer?

Huntington disease shows chorea and a family history.

Why is "Wernicke encephalopathy" not the answer?

Wernicke encephalopathy shows ophthalmoplegia, ataxia and confusion.

Why is "Mania in bipolar disorder" not the answer?

Mania does not cause pupillary abnormalities and neurological signs.

What concept does this question test?

It tests Organic psychiatry: general paresis in Psychiatry. CSF VDRL confirms the diagnosis and penicillin is the treatment. It must be considered in any new psychosis with neurological signs.

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 Organic psychiatry: general paresis?

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.