Medical mimics: acute intermittent porphyria: 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 · Medical mimics: acute intermittent porphyria

Sample item

A young woman has recurrent episodes of severe abdominal pain, anxiety, hallucinations and dark urine after a barbiturate. The most probable underlying disease is:

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

The answer and the reasoning

D. Acute intermittent porphyria

Acute intermittent porphyria presents with abdominal pain, neuropsychiatric symptoms and port-wine urine, precipitated by drugs such as barbiturates and sulphonamides. Diagnosis is by urinary porphobilinogen, and treatment includes haem arginate and glucose.

Option by option

  • A. Hyperthyroidism

    Hyperthyroidism does not produce dark urine.

  • B. Wilson disease

    Wilson disease causes liver and neurological disease with KF rings.

  • C. Schizophrenia

    Schizophrenia does not explain the abdominal pain and urine change.

  • D. Acute intermittent porphyria (correct)

    Correct. Abdominal pain, psychiatric features and dark urine after barbiturates indicate AIP.

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 D, Acute intermittent porphyria. Acute intermittent porphyria presents with abdominal pain, neuropsychiatric symptoms and port-wine urine, precipitated by drugs such as barbiturates and sulphonamides.

Why is "Hyperthyroidism" not the answer?

Hyperthyroidism does not produce dark urine.

Why is "Wilson disease" not the answer?

Wilson disease causes liver and neurological disease with KF rings.

Why is "Schizophrenia" not the answer?

Schizophrenia does not explain the abdominal pain and urine change.

What concept does this question test?

It tests Medical mimics: acute intermittent porphyria in Psychiatry. Diagnosis is by urinary porphobilinogen, and treatment includes haem arginate and glucose.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Medical mimics: acute intermittent porphyria?

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.