Psychotic disorders: first psychosis with seizures in India: 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 · Psychotic disorders: first psychosis with seizures in India

Sample item

A 26-year-old farmer from a village where pigs roam freely has had two generalised seizures in the last month, followed by three weeks of hearing voices and suspiciousness. Vital signs and general examination are normal. What is the best next investigation?

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

The answer and the reasoning

A. Contrast MRI of the brain

New seizures with psychosis in a person from an endemic setting need neuroimaging before a primary psychotic disorder is assumed, as neurocysticercosis and other structural or infective lesions are common causes. Organic work-up is also indicated by atypical features such as seizures.

Option by option

  • A. Contrast MRI of the brain (correct)

    Correct. Imaging can reveal cystic or calcified brain lesions that cause both seizures and psychosis.

  • B. Nerve conduction study

    Nerve conduction studies assess peripheral nerves, and have no bearing on seizures with psychosis.

  • C. Serum ceruloplasmin

    Ceruloplasmin tests for Wilson disease, which does not usually present with seizures and voices at this age without other signs.

  • D. Polysomnography

    Polysomnography evaluates sleep disorders and is not the investigation for new-onset seizures.

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, Contrast MRI of the brain. New seizures with psychosis in a person from an endemic setting need neuroimaging before a primary psychotic disorder is assumed, as neurocysticercosis and other structural or infective lesions are common causes.

Why is "Nerve conduction study" not the answer?

Nerve conduction studies assess peripheral nerves, and have no bearing on seizures with psychosis.

Why is "Serum ceruloplasmin" not the answer?

Ceruloplasmin tests for Wilson disease, which does not usually present with seizures and voices at this age without other signs.

Why is "Polysomnography" not the answer?

Polysomnography evaluates sleep disorders and is not the investigation for new-onset seizures.

What concept does this question test?

It tests Psychotic disorders: first psychosis with seizures in India in Psychiatry. Organic work-up is also indicated by atypical features such as seizures.

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 Psychotic disorders: first psychosis with seizures in India?

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.