Psychiatry Question Quality Review
Executive Summary
This review covers 100 candidate (non-gold) questions sampled from a Psychiatry pool of 4,716 items, benchmarked against 6 gold-standard items and 12 recent PYQs. The overall picture is one of a pool that is factually mostly intact but structurally weak and heavily skewed toward low-order recall. The Blooms distribution is the most immediate structural problem: 41 of the 100 candidate questions sit at Blooms Level 1, and 49 at Level 2, leaving only 10 items at Levels 3–5 combined. The benchmark and PYQ sets, by contrast, include meaningful proportions of Levels 3 and 4 items with clinical vignettes and applied reasoning. The candidate pool is therefore systematically under-challenging relative to the exam standard.
Beyond the Blooms skew, the reviewed set shows five operationally distinct problem types: a small but serious cluster of factually unsafe or ambiguous items that require immediate attention; a wrong-topic placement problem (sexual dysfunction questions filed under Sleep-Wake Disorders); a large body of low-value, trivia-level recall items that add no discriminatory power; a repetition problem concentrated in opioid withdrawal and a few other high-frequency topics; and a meaningful group of items where the underlying concept is exam-relevant but the execution is too weak to use as written. Broken delivery is present in at least one item (a corrupted special character in a stem). No items in this sample appear to belong to a completely different subject.
Headline numbers from the reviewed set:
| Issue Category | Approximate Count | Recommended Action |
|---|---|---|
| Wrong Key or Factually Unsafe | 6 | Disable or urgent fix |
| Wrong Topic Placement | 2 | Refile |
| Broken Delivery | 1 | Fix |
| Low-Value But Correct | ~35 | Disable (most); selective keep |
| Repetitive / Duplicative | ~8 | Disable duplicates |
| Worthwhile Concept, Weak Execution | ~18 | Fix |
What Good Looks Like
The benchmark and PYQ items establish a clear quality bar. The best items in the gold set share several properties that are almost entirely absent from the weak candidate questions.
Clinical vignette with a reasoning demand. The conversion disorder PYQ (beb15713) presents a 14-year-old with sudden blindness, la belle indifférence, and a recent bereavement, then asks a non-obvious epidemiological fact about sex distribution in children versus adults. The candidate must first identify the diagnosis from the vignette, then apply a second layer of knowledge. The valproate teratogenicity PYQ (66163e7c) embeds the pharmacological question inside a pregnancy-planning scenario, forcing the candidate to integrate clinical context with drug safety data. The CAPD PYQ (ace984cb) requires the candidate to distinguish a specific neurodevelopmental diagnosis from malingering and sensorineural loss using audiological findings.
Distractors that are plausible and instructive. In the Korsakoff PYQ (19fd06f6), option A describes Wernicke's encephalopathy triad, option C incorrectly implicates implicit memory, and option D introduces a plausible-sounding but wrong feature. Each wrong option tests a specific misconception. In the risperidone off-label use PYQ (4c970ced), the correct answer is the FDA-approved indication, which is the counterintuitive choice — a genuine knowledge trap.
Appropriate Blooms level for the concept. The autistic thinking benchmark item (a050f160) is Blooms 3: the candidate reads a patient's verbatim statement and must classify the thought abnormality. The ASD core criterion benchmark (7daf29e4) is Blooms 3 because "impaired imagination" and "language developmental delay" are plausible distractors that require understanding of DSM-5 restructuring. Even the simpler benchmark items (e.g., b93efd5a on flumazenil) use the "except" format to test a specific misconception — that flumazenil is used for alcohol dependence — rather than asking a bare definitional question.
What the weak candidate items lack: Most candidate items ask a single-fact question with a transparent correct answer and implausible distractors. They do not require the candidate to reason, apply, or discriminate between closely related concepts. They would not distinguish a prepared candidate from one who has read a single paragraph on the topic.
Main Issue Categories
1. Wrong Key or Factually Unsafe
Why this pattern is bad. A wrong key is the most serious quality failure in a question bank. It directly harms candidates who know the correct answer and are penalised for it, and it undermines trust in the platform. Factually ambiguous items — where the stated correct answer is defensible but a competing answer is equally or more defensible by current standard references — carry the same operational risk.
How it shows up. In this sample, the problem appears as: (a) a key that contradicts standard textbook consensus; (b) a key that is correct for one classification system but wrong for another, with no system specified; (c) a stem that contains a logical or structural error that makes the key untenable.
Affected items:
ebdf085c — "Delusion is a disorder of: Cognition (correct)" This directly contradicts item 5ec77b96 in the same sample, which marks "Belief" as the correct answer to an almost identical question. Standard psychiatric psychopathology (Fish's Clinical Psychopathology, Sims' Symptoms in the Mind) classifies delusion as a disorder of the content of thought / belief, not cognition per se. Cognition is a broader category that includes memory, attention, and executive function. The two items cannot both be correct as keyed. One has a wrong key; both are unsafe to run simultaneously. Disable ebdf085c; review 5ec77b96 for accuracy and keep only one.
88290d39 — "Catatonia is most commonly seen with: Depression (correct)" This is factually contested. While DSM-5 acknowledges catatonia as a specifier across mood and psychotic disorders, and some epidemiological data suggest mood disorders (including depression) account for a plurality of catatonia cases, the standard Indian PG teaching (Ahuja's Textbook of Psychiatry, Kaplan & Sadock) consistently presents catatonic schizophrenia as the prototypical association. The question stem does not specify a classification system or epidemiological context. A candidate who answers "Schizophrenia" based on standard teaching will be marked wrong. This is a factually unsafe key in the Indian PG context. Disable or rewrite with a more defensible key and a referenced source.
914545f3 — "Duration required for diagnosis of acute and transient psychosis: 2 weeks (correct)" ICD-10 specifies that acute and transient psychotic disorders have an onset within 2 weeks (acute onset criterion), but the duration criterion for the episode itself is up to 1 month (for acute polymorphic psychotic disorder without symptoms of schizophrenia) or up to 3 months (with schizophrenia symptoms). The question asks for "duration required for diagnosis," which is ambiguous between onset criterion and episode duration. The answer "2 weeks" corresponds to the onset criterion, not the diagnostic duration. This is likely to confuse candidates and may be keyed to the wrong parameter. Item 5cd566cb in the same sample asks "time interval between onset of acute and persistent psychotic disease" and keys "1 month," which is a different but related concept. The two items together create a confusing and potentially contradictory cluster. Disable 914545f3; fix 5cd566cb with a clearer stem.
1fc42046 — Catatonia "except" question with duplicate option Options A and D are both "Echolalia." This is a structural error that also makes the question logically broken: if echolalia appears twice, the "except" logic is violated regardless of which option the candidate selects. The correct answer is keyed as "Grandiosity" (option B), which is defensible, but the duplicate option makes the item undeliverable. Disable immediately; concept can be rewritten cleanly.
940025cc — "Which is NOT classified as an anxiety disorder? None of the above (correct)" The use of "None of the above" as the correct answer in a "NOT" question creates a double-negative logical trap that is pedagogically indefensible. The question is asking which of the listed disorders is not an anxiety disorder; if the answer is "none of the above," it means all three listed options (GAD, panic disorder, social phobia) are anxiety disorders, which is correct — but the question format is so convoluted that it tests reading comprehension rather than psychiatric knowledge. Additionally, under DSM-5, social phobia (social anxiety disorder) is classified under anxiety disorders, so the premise is correct, but the format is broken. Disable; the concept does not need a question of this type.
2fe090ba — "La belle indifférence is seen in: Conversion disorder (correct)" — topic misfiled as Mood Disorders The key is correct, but the topic assignment is wrong (see Category 2 below). Additionally, the stem contains a corrupted character rendering: "La belle indiff\neverence" — the special character é has been broken into a line-break artifact. This is both a broken delivery issue and a wrong-topic issue. Fix character encoding and refile to Trauma and Stress-Related Disorders or Somatic Symptom Disorders.
2. Wrong Subject or Wrong Topic Placement
Why this pattern is bad. Incorrect topic placement degrades topic-level analytics, disrupts adaptive learning sequences, and causes candidates to encounter questions in the wrong study context. It also inflates or deflates apparent coverage of specific topics.
How it shows up. In this sample, the problem is not cross-subject contamination (no Psychiatry questions appear to belong to Medicine or Surgery) but intra-subject topic misfiling. Two distinct patterns are observed: sexual dysfunction questions filed under Sleep-Wake Disorders, and a conversion disorder question filed under Mood Disorders.
Affected items:
8bff6ef8 — "Squeeze technique for premature ejaculation" filed under Sleep-Wake Disorders Premature ejaculation is a sexual dysfunction, not a sleep-wake disorder. DSM-5 places it under Sexual Dysfunctions (Chapter on Sexual Dysfunctions). The correct topic in this bank's taxonomy would be Sexual Dysfunctions or, if that topic does not exist as a standalone, Psychiatric Assessment and Diagnosis or a general Psychiatry topic. Refile to Sexual Dysfunctions or equivalent topic.
35527748 — "DSM-5 definition of premature ejaculation" filed under Sleep-Wake Disorders Same misfiling as above. Both items on premature ejaculation are in the wrong topic. Refile.
2fe090ba — "La belle indifférence in conversion disorder" filed under Mood Disorders Conversion disorder is classified under Somatic Symptom and Related Disorders (DSM-5) or Dissociative/Conversion Disorders (ICD-10). It has no primary relationship to mood disorders. Refile to Trauma and Stress-Related Disorders or create/use a Somatic Symptom Disorders topic.
3. Broken Delivery
Why this pattern is bad. A broken stem or malformed option means the question cannot be delivered to a candidate in a usable form. Even if the underlying concept is sound, the item is non-functional until repaired.
How it shows up. In this sample, one confirmed broken delivery item is present, and one item has a structural option duplication that also constitutes broken delivery.
Affected items:
2fe090ba — Corrupted special character in stem The stem reads "La belle indiff\neverence" — the accented character é has been replaced with a line-break escape sequence, rendering the term unrecognisable. This is a character encoding failure. Fix the encoding; the concept is valid.
1fc42046 — Duplicate option (Echolalia appears as both option A and option D) As noted in Category 1, this is simultaneously a broken delivery issue and a factual/structural issue. The item cannot be scored fairly. Disable.
4. Low-Value But Correct (Too Simple, Low-Yield, Trivia-Heavy, Weak Exam Relevance)
Why this pattern is bad. Questions at this level do not discriminate between prepared and unprepared candidates at the PG entrance level. They inflate the apparent size of the question bank without adding assessment value. They also crowd out higher-quality items in daily plans and mock tests, reducing the overall challenge level of the platform. The benchmark and PYQ sets demonstrate that even Blooms 1 items can be made non-trivial by choosing a specific misconception to test (e.g., flumazenil for alcohol dependence, risperidone off-label use). The items in this category do not do that — they ask questions whose answers are immediately obvious to any candidate who has opened a psychiatry textbook.
How it shows up. The pattern appears repeatedly across multiple topics. Common signatures: single-word answer questions ("Freud is known for: Psychoanalysis"), bare definitional questions ("Hallucination is a disorder of: Perception"), eponym-to-concept mapping with no clinical context ("Emile Durkheim is linked with: Suicide"), and questions where three of the four options are absurd distractors that no PG candidate would select.
Affected items (representative, not exhaustive):
08d0c3b7 — "Freud is known for: Psychoanalysis" This is a question a first-year MBBS student could answer without any study. The distractors (Flooding, Counselling, Cognitive therapy) are not plausible for Freud. No discriminatory value. Disable.
4acf8be8 — "Hallucination is a disorder of: Perception" Bare definitional recall. No clinical context, no reasoning demand. The concept is important but this format adds nothing. Disable; the concept is better tested by the benchmark item a050f160 or a vignette-based item.
ad409c50 — "What term describes the defense mechanism where individuals refuse to accept reality? Denial" The distractors ("Risk-reduction behavior," "Cognitive restructuring," "Reality distortion") are not psychiatric terms in any standard classification. A candidate who has never studied psychiatry could answer this by elimination. Disable.
82d15cac — "Emile Durkheim is linked with: Suicide" Pure eponym recall. The templateMembership shows this item has been placed in sociology quizzes, which confirms it is not functioning as a psychiatry PG item. Disable from Psychiatry pool.
105f291c — "Acrophobia is a fear of: Heights" This is general vocabulary, not psychiatric knowledge. The distractors (Snakes, Cats, Death) are not plausible phobia confusors. Disable.
fad04715 — "A disease occurring before 65 years is termed: Presenile" Single-word definitional recall with no clinical application. Disable.
6db667bf — "Mania is best described as: A mood disorder" The question is so broad that it tests nothing specific. Any candidate who has heard the word "mania" can answer this. Disable.
88635fa9 — "Which investigation is used to diagnose sleep disturbances? Polysomnography" The distractors include "Orthography" (a term from linguistics/printing, not medicine), which signals that the item was not carefully constructed. Disable.
2c878a01 — "Which is not a derivative of cannabis? Heroin" This is general pharmacology trivia at the level of a lay person. No clinical reasoning required. Disable.
53d0744b — "Yawning is a feature of which withdrawal? Opioid withdrawal" While the fact is correct and clinically relevant, this is a single-symptom recall question with no discriminatory challenge. The concept is better tested in the context of a withdrawal syndrome comparison or a clinical vignette. Disable; concept covered better elsewhere.
92a3eea0 — "Other name for anankastic personality disorder: OCPD" Pure nomenclature recall. No clinical application. Disable.
b64d34fd — "IQ level in profound mental retardation: Below 20-25" Bare numerical recall. The concept is exam-relevant but this format is too simple. Disable; replace with a vignette asking about management or associated features.
98b65e86 — "What are homes called where children are placed under doctors and psychiatrists? Residential treatment facilities" This question tests administrative terminology at a level below what any PG exam would ask. The PYQ tag (NEET-PG-2012) suggests it may have appeared in an old exam, but the concept has no current exam relevance. Disable.
7aaea47f — "Which bedside test is primarily used to assess mental status? MMSE" The distractors (GCS, MMPI, WAIS) are not plausible bedside mental status tests in the same category. No discriminatory value. Disable.
ed404daf — "Primary characteristic of narcolepsy: Excessive daytime sleepiness" The distractors (sleep walking, sleep talking, sleep terrors) are parasomnias, not features of narcolepsy. Any candidate who knows the word "narcolepsy" can answer this. Disable.
5add798d — "ICD-10 duration for mania: 1 week" The fact is correct and exam-relevant, but the format (four duration options in 1-week increments) is a pure recall item with no reasoning demand. The concept is better tested in a clinical scenario. Disable; concept can be incorporated into a vignette.
cdea6d89 — "Minimum duration for hypomania: 4 days" Same issue as above. Pure duration recall. Disable.
750dbba3 — "Most common receptor for typical antipsychotics: D2" Correct and exam-relevant, but the format is too simple. The concept is better tested by asking about the mechanism of EPS, or by a clinical scenario involving antipsychotic side effects. Disable; concept covered by better items.
f2ea90e0 — "Acamprosate is used for: Maintenance therapy of alcohol abstinence" The distractors (Cough, Rickets, Thrombolysis) are absurd. No discriminatory value. Disable.
2ac7552e — "Which is true regarding defense mechanisms? All of the above" "All of the above" as the correct answer to a question about defense mechanisms is a low-quality format. The three sub-options (unconscious processes, abolish anxiety, resolve internal conflicts) are individually correct but the question tests nothing specific. Disable.
cb282137 — "Non-memory cognitive symptoms in Alzheimer's: All of the options (Aphasia, Apraxia, Agnosia)" "All of the options" as the correct answer is a weak format. The question is also trivially easy — the three A's of Alzheimer's are among the most commonly memorised facts in psychiatry. Disable.
5. Repetitive or Duplicative Coverage
Why this pattern is bad. Duplicate or near-duplicate items waste slots in daily plans and mock tests, give candidates a false sense of breadth, and reduce the effective size of the usable question pool. When the same fact is tested by multiple items with slightly different wording, the weaker versions should be removed to preserve the stronger one.
How it shows up. In this sample, the most concentrated repetition is in opioid withdrawal features, where at least four items test overlapping content. There is also duplication in the "delusion" definition cluster and the "multiple personalities = dissociative disorder" cluster.
Affected items:
Opioid withdrawal cluster: 9d23acb0, ededea74, d45cf77e, 2cefed9f, 0455d808 Five items in the reviewed set test features of opioid withdrawal. The key facts tested are: miosis is a feature of intoxication not withdrawal (9d23acb0, ededea74); hallucinations are not a feature of opioid withdrawal (d45cf77e); vomiting is a feature (2cefed9f); constipation is not a withdrawal feature (0455d808). While these are distinct facts, the density of coverage in a single topic is disproportionate. Items 9d23acb0 and ededea74 are near-duplicates (both ask about miosis in opioid withdrawal, both key miosis as the "not a feature" answer). Disable ededea74 as the weaker duplicate; keep 9d23acb0 or d45cf77e as the stronger item; review 2cefed9f and 0455d808 for retention based on difficulty and format quality.
Delusion definition cluster: 5ec77b96, ebdf085c As noted in Category 1, these two items ask essentially the same question ("delusion is a disorder of...") with different correct answers (Belief vs. Cognition). They cannot coexist. Disable ebdf085c (wrong key); keep 5ec77b96 after verifying the key.
Multiple personalities = dissociative disorder: ef3f1166, ce0feee2 Items ef3f1166 and ce0feee2 are near-identical in stem and options. Both describe "a person with multiple distinct personalities" and key "Dissociative disorder." The wording differs by one phrase. Disable ce0feee2 as the duplicate; keep ef3f1166.
Acamprosate cluster: 15be5d68, f2ea90e0 Item 15be5d68 asks which anticraving agent acts as an NMDA antagonist (answer: Acamprosate). Item f2ea90e0 asks what acamprosate is used for (answer: alcohol abstinence maintenance). These are not identical but test the same drug from two angles. Item 15be5d68 is the higher-quality item (mechanism-based). Disable f2ea90e0 (trivial distractors); keep 15be5d68.
ECT cluster: b8420163, be710592 Item b8420163 asks for treatment of choice in depression with suicidal tendencies (ECT). Item be710592 asks where ECT is most effective (severe depression). These are near-duplicates testing the same clinical fact. Keep b8420163 (more specific clinical scenario); disable be710592 (too broad).
6. Worthwhile Concept, Weak Execution
Why this pattern is bad. These items test concepts that appear in PYQs and benchmark items, meaning the topic is genuinely exam-relevant. However, the stem, options, or clinical framing is too weak to function as a quality item. Discarding these entirely would leave gaps in topic coverage; fixing them is the right disposition. The fix required is usually: add a clinical vignette, replace implausible distractors with plausible near-miss options, or specify the classification system being used.
How it shows up. Bare definitional questions on high-yield topics, "except" questions with weak distractors, and clinical vignettes that are too telegraphic to require reasoning.
Affected items:
62fc056e — "Patient with altered consciousness, tremors, visual hallucinations: Delirium tremens" The concept (DT vs. Wernicke's vs. Korsakoff's) is high-yield and appears in PYQs. However, the stem omits the most important contextual detail: the history of alcohol use and the timing of last drink. Without that, the question is ambiguous — altered consciousness + tremors + visual hallucinations could be DT, but also Wernicke's or another cause of delirium. Adding "72 hours after stopping alcohol in a chronic drinker" would make this a clean, high-yield vignette. Fix: add alcohol history and timing to stem; distractors are acceptable.
55cbe234 — "52-year-old with delirium, visual hallucinations of 'little snakes': Delirium" The concept is correct and the vignette is reasonable, but the stem explicitly states "no history of substance abuse," which rules out DT, and then offers DT-like distractors. The question is testing delirium recognition, which is appropriate, but the distractor set (Schizophrenia, Dementia, Depression with psychotic features) is too easy — a candidate who knows only that delirium has fluctuating consciousness and visual hallucinations will answer correctly without needing to distinguish delirium from DT. The item would be stronger if it included a distractor of "Wernicke's encephalopathy" or "Lewy body dementia" to force a more precise differential. Fix: improve distractor quality.
9c281c31 — "Social phobia vignette" The concept is appropriate and the vignette is functional, but "Avoidant personality" as a distractor is the most important differential for social phobia and is correctly included. However, "Schizophrenia" is an implausible distractor that no PG candidate would select. Replacing it with "Agoraphobia" or "Specific phobia" would make the item more discriminating. Fix: replace Schizophrenia distractor with a more plausible anxiety-spectrum option.
06090980 — "41-year-old woman with somatic symptoms, denies sadness: Major depression" This is a well-constructed vignette testing masked/somatic depression, which is a high-yield concept. The distractors (Somatoform pain disorder, Somatization disorder, Dissociative disorder) are plausible. The item is close to benchmark quality. The only weakness is that the stem does not specify duration of symptoms relative to diagnostic criteria. Minor fix: add duration context (e.g., "for the past 6 months") to anchor the diagnosis.
38806502 — "Treatment-resistant schizophrenia: Switch to clozapine" This is a high-yield clinical reasoning item (Blooms 4) with a good vignette. The distractors are plausible. The item is close to keep-as-is quality. The only concern is the "TELEGRAM" tag, which suggests uncertain provenance. Keep after provenance verification; no content fix needed.
38fad2af — "EPS on risperidone: Add benztropine" Similar to above — good clinical vignette, appropriate Blooms level, plausible distractors. The "TELEGRAM" tag again raises provenance questions. Keep after provenance verification.
aace60bc — "NMS on phenothiazines: Neuroleptic malignant syndrome" The vignette is functional and the concept is high-yield. However, "Malignant hyperthermia" as a distractor is the most important differential and is correctly included. The item would be stronger if the stem specified that the patient is not under general anaesthesia (to make the MH distractor more challenging). Minor fix: add context to make MH distractor more plausible.
fd06a0f3 — "Hypochondriasis vignette" The vignette is well-constructed and the concept is exam-relevant. However, the stem uses the ICD-10 term "Hypochondriasis" as the correct answer, while DSM-5 uses "Illness Anxiety Disorder." For a PG exam that tests both systems, the question should specify which classification is being used, or the options should include both terms. Fix: specify ICD-10 or DSM-5 in the stem.
d197344a — "Intense depression without apparent cause: Melancholia" The concept is correct (melancholia = endogenous depression without precipitant), but the distractor "Major depressive disorder" is problematic — melancholia is a specifier within MDD in DSM-5, not a separate entity. A candidate who knows DSM-5 well might argue that MDD is also correct. The question needs a stem that makes the distinction clearer, or the distractor should be changed. Fix: revise distractor or add classification context.
24d4356f — "Drug of choice for Mixed Depressive-Manic episodes: Lithium" The concept is exam-relevant but the key is debatable. Current guidelines (NICE, BAP) suggest valproate or atypical antipsychotics are often preferred for mixed states, and lithium's role is less clear-cut. The question as written may reflect older teaching. Fix: verify against current Indian PG standard references (Ahuja, Kaplan & Sadock); if Lithium is the accepted answer in the Indian PG context, add a reference anchor in the explanation.
63f65ce2 — "Personality disorders associated with bipolar disorder except: Antisocial" The concept is interesting and the format is appropriate, but the evidence base for this question is weak — the association between specific personality disorders and bipolar disorder is not a standard exam topic with a clear consensus answer. The key (Antisocial as the exception) is not well-supported by a single authoritative source. Fix: verify key against a specific reference; if not supportable, disable.
bf365f4b — "Maximum clinical assessment period for initial psychiatric evaluation: 30 days" This question appears in multiple templates including "Family Medicine Mega Quiz," suggesting it may be a medico-legal or administrative question rather than a clinical psychiatry question. The concept (30-day assessment period under the Mental Healthcare Act 2017) is India-specific and exam-relevant for INICET/NEET-PG. However, the stem is vague ("typical maximum clinical assessment period") and does not anchor to the MHA 2017 or any specific context. Fix: rewrite stem to explicitly reference the Mental Healthcare Act 2017 and the context of involuntary admission assessment.
1377232a — "Narcolepsy false statement: Typically presents in second decade" The key states that presentation in the second decade is false, implying narcolepsy typically presents in the first or third decade. This is factually contested — narcolepsy most commonly presents in the second decade (adolescence/early adulthood), with a peak around 15–25 years. The key appears to be wrong. Urgent review: if the key is wrong, this item moves to Category 1 (Wrong Key). Disable pending fact-check.
f384b972 — "Drug of choice for GAD: Buspirone" The key is defensible in older Indian PG teaching, but current international guidelines (NICE, BAP) recommend SSRIs/SNRIs as first-line for GAD, with buspirone as a second-line option. The question is tagged as a PYQ (NEET-PG-2013), which explains the older answer. For current exam preparation, this item may mislead candidates. Fix: update stem to specify "non-benzodiazepine anxiolytic of choice" or "drug of choice as per older classification," or add a note in the explanation about current guidelines.
Prioritization
The following priority tiers are recommended for the content operations team.
Priority 1 — Immediate action (within current sprint): Wrong key, broken delivery, factually unsafe
These items are live risks. Any candidate who encounters them may be scored incorrectly or receive misinformation.
| Question ID | Issue | Action |
|---|---|---|
| ebdf085c | Wrong key (Cognition vs. Belief conflict with 5ec77b96) | Disable |
| 5ec77b96 | Paired conflict item | Verify key; keep only if correct |
| 88290d39 | Factually unsafe key (Catatonia most common in Depression) | Disable |
| 1fc42046 | Duplicate option + broken logic | Disable |
| 940025cc | Double-negative "None of the above" format | Disable |
| 2fe090ba | Broken character encoding + wrong topic | Fix encoding; refile |
| 1377232a | Likely wrong key (narcolepsy onset decade) | Urgent fact-check; disable if wrong |
| 914545f3 | Ambiguous key (onset vs. duration criterion) | Disable |
Priority 2 — Next sprint: Wrong topic placement
| Question ID | Issue | Action |
|---|---|---|
| 8bff6ef8 | Sexual dysfunction in Sleep-Wake Disorders | Refile |
| 35527748 | Sexual dysfunction in Sleep-Wake Disorders | Refile |
| 2fe090ba | Conversion disorder in Mood Disorders | Refile (also Priority 1 for encoding) |
Priority 3 — Batch processing: Low-value and duplicate items
These items can be processed in a single batch disable operation. They do not require individual review beyond confirming the concept is covered by a higher-quality item elsewhere in the pool.
Disable candidates (low-value): 08d0c3b7, 4acf8be8, ad409c50, 82d15cac, 105f291c, fad04715, 6db667bf, 88635fa9, 2c878a01, 53d0744b, 92a3eea0, b64d34fd, 98b65e86, 7aaea47f, ed404daf, 5add798d, cdea6d89, 750dbba3, f2ea90e0, 2ac7552e, cb282137, 39f2ea38, b71f5d81, aedf117f.
Disable candidates (duplicates): ededea74 (duplicate of 9d23acb0), ce0feee2 (duplicate of ef3f1166), be710592 (duplicate of b8420163).
Priority 4 — Fix queue: Worthwhile concepts needing rewrite
These items should be queued for content writer revision. Each requires a specific, bounded fix as described in Category 6.
Fix queue: 62fc056e, 55cbe234, 9c281c31, 06090980, aace60bc, fd06a0f3, d197344a, 24d4356f, 63f65ce2, bf365f4b, f384b972.
Example Keep / Fix / Disable Calls
The following table provides concrete, actionable disposition calls for a representative cross-section of the reviewed items.
| Question ID | Topic | Disposition | Rationale |
|---|---|---|---|
| 38806502 | Psychotic Disorders | Keep (after provenance check) | High-yield clinical vignette, Blooms 4, correct key, plausible distractors. Treatment-resistant schizophrenia → clozapine is a core exam concept. |
| 38fad2af | Psychopharmacology | Keep (after provenance check) | EPS management vignette, Blooms 4, correct key. Benztropine for drug-induced parkinsonism is a standard exam topic. |
| 06090980 | Mood Disorders | Fix | Excellent concept (somatic/masked depression), good distractors, but needs duration context added to stem to anchor the diagnosis. Minor edit only. |
| 8e8eef4b | Child and Adolescent Psychiatry | Keep | ABA for intellectual disability daily skills — correct, Blooms 3, plausible distractors (CBT, social skills training). Exam-relevant. |
| d45cf77e | Substance Use Disorders | Keep | Hallucinations not a feature of opioid withdrawal — correct key, Blooms 4 rating, PYQ tag. Tests a specific misconception. |
| 91adb813 | Psychotic Disorders | Keep | Poor premorbid adjustment as poor prognostic factor — PYQ, Blooms 5, correct key. High-yield. |
| 62fc056e | Substance Use Disorders | Fix | DT concept is high-yield but stem lacks alcohol history and timing. Add "72 hours after last drink in a chronic alcohol user" to make the vignette clinically anchored. |
| 9c281c31 | Anxiety Disorders | Fix | Social phobia vignette is functional but Schizophrenia distractor is implausible. Replace with Agoraphobia or Specific phobia. |
| fd06a0f3 | Psychiatric Assessment and Diagnosis | Fix | Hypochondriasis vignette is well-constructed but needs classification system specified (ICD-10 vs. DSM-5 Illness Anxiety Disorder). |
| bf365f4b | Psychiatric Assessment and Diagnosis | Fix | 30-day assessment period is India-specific and exam-relevant (MHA 2017) but stem is vague. Rewrite to explicitly reference the Act and involuntary admission context. |
| ebdf085c | Psychiatric Assessment and Diagnosis | Disable | Wrong key (Cognition vs. Belief); conflicts with 5ec77b96. Factually unsafe. |
| 88290d39 | Psychotic Disorders | Disable | Factually unsafe key in Indian PG context (catatonia most common in depression). Standard teaching associates catatonia with schizophrenia. |
| 1fc42046 | Psychotic Disorders | Disable | Duplicate option (Echolalia × 2) makes item undeliverable and logically broken. |
| 08d0c3b7 | Psychotherapies | Disable | "Freud is known for Psychoanalysis" — trivial, no discriminatory value, implausible distractors. |
| 82d15cac | Introduction to Psychiatry | Disable | Durkheim/suicide eponym recall. Placed in sociology quizzes; no PG psychiatry exam value. |
| 105f291c | Personality Disorders | Disable | Acrophobia = fear of heights. General vocabulary, not psychiatric knowledge. Wrong topic (Personality Disorders). |
| ededea74 | Substance Use Disorders | Disable | Near-duplicate of 9d23acb0 (both test miosis in opioid withdrawal). Weaker of the pair. |
| ce0feee2 | Psychiatric Assessment and Diagnosis | Disable | Near-duplicate of ef3f1166 (both: multiple personalities = dissociative disorder). |
| 940025cc | Anxiety Disorders | Disable | Double-negative "None of the above" format is logically broken and tests reading comprehension rather than psychiatric knowledge. |
| 1377232a | Sleep-Wake Disorders | Disable (pending fact-check) | Key states narcolepsy does NOT typically present in second decade — likely factually wrong. Urgent review required. |
| 8bff6ef8 | Sleep-Wake Disorders | Refile to Sexual Dysfunctions | Squeeze technique for premature ejaculation is not a sleep-wake disorder topic. |
| 35527748 | Sleep-Wake Disorders | Refile to Sexual Dysfunctions | DSM-5 definition of premature ejaculation is not a sleep-wake disorder topic. |