Organic mental disorders: neuropsychiatric lupus: 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 mental disorders: neuropsychiatric lupus

Sample item

A 24-year-old woman develops a malar rash, joint pains and oral ulcers over two months, and then sudden psychosis with a generalised seizure. Which investigation best supports the likely diagnosis?

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

The answer and the reasoning

B. Antinuclear antibody with anti-double-stranded DNA

Neuropsychiatric lupus can present with psychosis, seizures, mood disturbance or cognitive change, and the rash, arthritis and ulcers suggest systemic lupus. Antinuclear antibody and anti-dsDNA support the diagnosis, and corticosteroid treatment itself can also cause psychosis later.

Option by option

  • A. Serum ceruloplasmin

    Ceruloplasmin tests for Wilson disease, which lacks a malar rash and arthritis.

  • B. Antinuclear antibody with anti-double-stranded DNA (correct)

    Correct. ANA and anti-dsDNA support systemic lupus as the cause.

  • C. Serum TSH

    TSH detects thyroid disease, which does not explain a malar rash with oral ulcers.

  • D. VDRL test of serum

    VDRL screens for syphilis, which may cause psychosis but not this combination of rash, arthritis and ulcers.

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 B, Antinuclear antibody with anti-double-stranded DNA. Neuropsychiatric lupus can present with psychosis, seizures, mood disturbance or cognitive change, and the rash, arthritis and ulcers suggest systemic lupus.

Why is "Serum ceruloplasmin" not the answer?

Ceruloplasmin tests for Wilson disease, which lacks a malar rash and arthritis.

Why is "Serum TSH" not the answer?

TSH detects thyroid disease, which does not explain a malar rash with oral ulcers.

Why is "VDRL test of serum" not the answer?

VDRL screens for syphilis, which may cause psychosis but not this combination of rash, arthritis and ulcers.

What concept does this question test?

It tests Organic mental disorders: neuropsychiatric lupus in Psychiatry. Antinuclear antibody and anti-dsDNA support the diagnosis, and corticosteroid treatment itself can also cause psychosis later.

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 Organic mental disorders: neuropsychiatric lupus?

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.