Substance use: 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 · Substance use

Sample item

A man who uses heroin is admitted and has had no drug for twelve hours. He is fully oriented but has yawning, watering eyes, a running nose, dilated pupils, piloerection, muscle aches and diarrhoea. What is the most likely diagnosis?

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

The answer and the reasoning

C. Opioid withdrawal

Opioid withdrawal is unpleasant but rarely life-threatening, with autonomic over-activity (lacrimation, rhinorrhoea, piloerection, diarrhoea) and mydriasis, with a clear sensorium. Treatment includes opioid substitution or a tapered regimen and clonidine for autonomic symptoms.

Option by option

  • A. Alcohol withdrawal delirium

    Alcohol withdrawal delirium shows disorientation, hallucinations and coarse tremor.

  • B. Cocaine intoxication

    Cocaine intoxication causes euphoria, agitation and tachycardia rather than yawning, rhinorrhoea and myalgia.

  • C. Opioid withdrawal (correct)

    Correct. Clear sensorium with these autonomic and mucosal features marks opioid withdrawal.

  • D. Opioid intoxication

    Opioid intoxication causes pinpoint pupils, sedation and respiratory depression.

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 C, Opioid withdrawal. Opioid withdrawal is unpleasant but rarely life-threatening, with autonomic over-activity (lacrimation, rhinorrhoea, piloerection, diarrhoea) and mydriasis, with a clear sensorium.

Why is "Alcohol withdrawal delirium" not the answer?

Alcohol withdrawal delirium shows disorientation, hallucinations and coarse tremor.

Why is "Cocaine intoxication" not the answer?

Cocaine intoxication causes euphoria, agitation and tachycardia rather than yawning, rhinorrhoea and myalgia.

Why is "Opioid intoxication" not the answer?

Opioid intoxication causes pinpoint pupils, sedation and respiratory depression.

What concept does this question test?

It tests Substance use in Psychiatry. Treatment includes opioid substitution or a tapered regimen and clonidine for autonomic symptoms.

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 Substance use?

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.