INI-CET 2026 - Psychiatry PYQs Practice Questions

Q: A 45-year-old recently divorced alcoholic expresses suicidal ideation. What is the next best step?

Hospitalization and safety measures. ***Hospitalization and safety measures*** - In the setting of **suicidal ideation** combined with high-risk factors like **alcohol abuse** and a recent **major life stressor** (divorce), the immediate clinical priority is ensuring patient safety. - **Inpatient psychiatric admission** is the standard of care for acute risk to prevent self-harm, allowing for stabilization and a thorough risk assessment in a controlled environment. *Cognitive Behavioral Therapy and weekly outpatient visits* - While **Cognitive Behavioral Therapy (CBT)** is an effective long-term treatment for mood disorders, it is insufficient for an acute crisis where there is an imminent risk of self-harm. - **Outpatient management** is contraindicated when a patient expresses active suicidal ideation, as it does not provide the 24-hour supervision necessary to protect the patient. *Start antidepressant therapy* - **Antidepressant therapy** typically takes weeks to reach therapeutic efficacy and does not address the immediate, life-threatening danger posed by suicidal ideation. - Initiating medication without first ensuring the patient's **acute physical safety** through hospitalization neglects the primary management goal in psychiatric emergencies. *Monitor for recurrence* - This approach is dangerously passive and inappropriate for a patient presenting with active **suicidal ideation**, which requires immediate intervention. - **Active monitoring** is a component of long-term care, but it fails to address the immediate crisis or the patient's current potential to act on suicidal impulses. [Practice more Psychiatry PYQs on OnCourse]

Q: Which of the following drugs is classified as a novel antidepressant?

Vilazodone. ***Vilazodone*** - Classified as a **serotonin partial agonist-reuptake inhibitor (SPARI)**, it combines **SSRI** activity with **5-HT1A receptor partial agonism**. - Its unique mechanism of action contributes to its status as a **novel antidepressant**, often associated with a lower incidence of sexual side effects compared to traditional SSRIs. *Trazodone* - This is an older **serotonin antagonist and reuptake inhibitor (SARI)**, primarily utilized today at lower doses for its **sedative-hypnotic properties** rather than as a first-line antidepressant. - It is not classified as a novel antidepressant due to its chemical structure and established long-term history of clinical use. *Blonanserin* - This is an **atypical antipsychotic** drug, not an antidepressant, primarily used for the treatment of **schizophrenia**. - It functions as a **dopamine D2 and serotonin 5-HT2A receptor antagonist**. *Etizolam* - This is a **thienodiazepine derivative**, structurally related to **benzodiazepines**, primarily used for its **anxiolytic**, hypnotic, and anticonvulsant effects. - It acts as a **GABA-A receptor positive allosteric modulator** and has no primary antidepressant classification. [Practice more Psychiatry PYQs on OnCourse]

Q: A patient with chronic alcoholism presents with severe memory problems. Which of the following features is most characteristic of Korsakoff syndrome?

Inability to form new memories (anterograde amnesia). ***Inability to form new memories (anterograde amnesia)*** - Korsakoff syndrome is a chronic neuropsychiatric condition characterized by severe **anterograde amnesia**, where patients have a profound inability to form new memories. - It is frequently associated with **confabulation**, a process where patients fill in memory gaps with fabricated information, often due to damage in the **diencephalon** (specifically the **mediodorsal nucleus of the thalamus** and **mammillary bodies**). *Loss of personal identity* - This feature is characteristic of **dissociative amnesia**, a psychological condition typically triggered by trauma or severe stress. - Korsakoff syndrome specifically affects episodic and declarative memory but does not usually compromise the patient's core sense of self or identity. *Impairment of unconscious (implicit) memory* - Implicit memory (such as procedural memory for skills) remains largely **preserved** in patients with Korsakoff syndrome. - The deficit in this condition is primarily limited to **explicit memory** (declarative memory), distinguishing it from other neurodegenerative dementias. *Confusion, unsteady gait, and eye movement paralysis* - This describes the **classic triad** of **Wernicke encephalopathy** (confusion, ataxia, ophthalmoplegia), which is the acute, reversible precursor to Korsakoff syndrome. - While the conditions are related, the triad specifically represents the **acute phase** rather than the chronic amnestic syndrome of Korsakoff. [Practice more Psychiatry PYQs on OnCourse]

Question 1

Which statement correctly describes classical conditioning?

Accepted Answer

Conditioned stimulus triggers a conditioned response after learning

Answer

Association between conditioned stimulus and conditioned response

Answer

Association between unconditioned stimulus and unconditioned response

Answer

Unconditioned stimulus produces conditioned response after learning

Question 2

Which instruction is correct for a patient using nicotine replacement therapy?

Accepted Answer

Patient should avoid liquids like tea or coffee 15 minutes before using gum or lozenge

Answer

Gums are more effective than lozenges

Answer

Correct timing of doses

Answer

Proper storage of nicotine products

Question 3

A 45-year-old recently divorced alcoholic expresses suicidal ideation. What is the next best
step?

Accepted Answer

Hospitalization and safety measures

Answer

Cognitive Behavioral Therapy and weekly outpatient visits

Answer

Start antidepressant therapy

Answer

Monitor for recurrence

Question 4

Which of the following drugs is classified as a novel antidepressant?

Accepted Answer

Vilazodone

Answer

Trazodone

Answer

Blonanserin

Answer

Etizolam

Question 5

A patient with chronic alcoholism presents with severe memory problems. Which of the
following features is most characteristic of Korsakoff syndrome?

Accepted Answer

Inability to form new memories (anterograde amnesia)

Answer

Loss of personal identity

Answer

Impairment of unconscious (implicit) memory

Answer

Confusion, unsteady gait, and eye movement paralysis

Question 6

An elderly patient dies, and autopsy reveals neuritic plaques in the brain. What is the most likely
diagnosis?

Accepted Answer

Alzheimer’s disease

Answer

Parkinson’s disease

Answer

Creutzfeldt-Jakob disease

Answer

Huntington’s disease

INI-CET 2026 — Psychiatry