Eating and sleep disorders: augmentation in restless legs syndrome: 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 · Eating and sleep disorders: augmentation in restless legs syndrome

Sample item

A woman with restless legs syndrome has taken pramipexole for two years. Symptoms now begin in mid-afternoon, are more intense and have spread to the arms. What is this phenomenon called?

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

The answer and the reasoning

A. Augmentation

Long-term dopamine agonist or levodopa therapy can cause augmentation: symptoms start earlier in the day, intensify and spread to other body parts. Management is to reduce or stop the dopamine agonist and use an alpha-2-delta ligand, and to check iron stores.

Option by option

  • A. Augmentation (correct)

    Correct. Earlier onset, greater intensity and spread define augmentation.

  • B. Rebound withdrawal after missed doses

    Rebound occurs in the early morning after the drug wears off, without spread to the arms.

  • C. Tardive dyskinesia

    Tardive dyskinesia consists of involuntary orofacial movements after dopamine blockade.

  • D. Neuroleptic-induced akathisia

    Akathisia follows dopamine-blocking drugs, and she is on a dopamine agonist.

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, Augmentation. Long-term dopamine agonist or levodopa therapy can cause augmentation: symptoms start earlier in the day, intensify and spread to other body parts.

Why is "Rebound withdrawal after missed doses" not the answer?

Rebound occurs in the early morning after the drug wears off, without spread to the arms.

Why is "Tardive dyskinesia" not the answer?

Tardive dyskinesia consists of involuntary orofacial movements after dopamine blockade.

Why is "Neuroleptic-induced akathisia" not the answer?

Akathisia follows dopamine-blocking drugs, and she is on a dopamine agonist.

What concept does this question test?

It tests Eating and sleep disorders: augmentation in restless legs syndrome in Psychiatry. Management is to reduce or stop the dopamine agonist and use an alpha-2-delta ligand, and to check iron stores.

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 Eating and sleep disorders: augmentation in restless legs syndrome?

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.