Catatonia: 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 · Catatonia

Sample item

A 25-year-old woman is mute, holds an odd posture for hours and resists passive movement, with waxy flexibility. She has refused food for two days. What is the most appropriate initial treatment?

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

The answer and the reasoning

A. Intravenous or intramuscular lorazepam

Catatonia responds rapidly to benzodiazepines, and a lorazepam challenge is both diagnostic and therapeutic. ECT is used if there is no response or the course is malignant. Antipsychotics can worsen catatonia and precipitate neuroleptic malignant syndrome.

Option by option

  • A. Intravenous or intramuscular lorazepam (correct)

    Correct. Benzodiazepines such as lorazepam are first-line for catatonia.

  • B. Oral imipramine

    Tricyclic antidepressants do not treat catatonia and add anticholinergic and cardiac risks.

  • C. Oral lithium carbonate

    Lithium has no role in the acute management of catatonia.

  • D. High-dose haloperidol injection

    Antipsychotics may worsen catatonia and carry a risk of neuroleptic malignant syndrome.

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.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Intravenous or intramuscular lorazepam. Catatonia responds rapidly to benzodiazepines, and a lorazepam challenge is both diagnostic and therapeutic.

Why is "Oral imipramine" not the answer?

Tricyclic antidepressants do not treat catatonia and add anticholinergic and cardiac risks.

Why is "Oral lithium carbonate" not the answer?

Lithium has no role in the acute management of catatonia.

Why is "High-dose haloperidol injection" not the answer?

Antipsychotics may worsen catatonia and carry a risk of neuroleptic malignant syndrome.

What concept does this question test?

It tests Catatonia in Psychiatry. ECT is used if there is no response or the course is malignant. Antipsychotics can worsen catatonia and precipitate neuroleptic malignant syndrome.

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 Catatonia?

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.