Internal Medicine
3 questionsWhat is the preferred test for confirming H. pylori eradication?
Distal renal tubular acidosis is associated with:
Tall T waves on ECG are seen in:
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1021: What is the preferred test for confirming H. pylori eradication?
- A. Urease breath test (Correct Answer)
- B. Culture
- C. Serological test
- D. Biopsy urease test
Explanation: ***Urease breath test*** - The **urea breath test** is highly sensitive and specific for detecting active *H. pylori* infection and its eradication by measuring radioactive or non-radioactive labeled carbon dioxide released from metabolizing urea. - It is a non-invasive test preferred after treatment to confirm eradication, as it directly detects bacterial urease activity. *Culture* - **Culture** requires an invasive endoscopic biopsy, is expensive, and takes several days to yield results; therefore, it is not the preferred method for routine eradication confirmation. - While it offers the advantage of **antibiotic susceptibility testing**, its invasiveness and turnaround time make it less practical for post-treatment assessment. *Serological test* - **Serological tests** (blood tests for antibodies) remain positive for **H. pylori antibodies** for extended periods even after successful eradication, rendering them unsuitable for confirming eradication. - These tests primarily indicate past exposure rather than current, active infection. *Biopsy urease test* - A **biopsy urease test** involves an invasive endoscopy to obtain a tissue sample, which is then tested for urease activity. - Although useful for initial diagnosis, its invasiveness makes it less preferred for confirming eradication compared to the non-invasive breath test.
Question 1022: Distal renal tubular acidosis is associated with:
- A. Hypocitraturia
- B. Oxalate stones
- C. Calcium stones (Correct Answer)
- D. Uric acid stones
Explanation: ***Calcium stones*** - Distal renal tubular acidosis (Type 1 RTA) causes metabolic acidosis due to impaired distal tubular **hydrogen ion secretion**. - This leads to **increased urinary calcium excretion** (hypercalciuria) and decreased urinary citrate, creating an environment favorable for the formation of **calcium phosphate renal stones**. *Oxalate stones* - While oxalate is a component of some calcium stones (calcium oxalate), **primary hyperoxaluria** or dietary excess of oxalate are the main causes, not directly distal RTA. - Distal RTA specifically promotes **calcium phosphate stone formation** due to pH changes and hypercalciuria. *Hypocitraturia* - **Hypocitraturia** is indeed a feature of distal RTA as the kidney attempts to excrete acid by reabsorbing citrate, making the urine less inhibitory to stone formation. - However, the most direct and common clinically observed consequence in stone formation is the development of **calcium stones**, as hypocitraturia combined with hypercalciuria facilitates their formation. *Uric acid stones* - **Uric acid stones** typically form in persistently **acidic urine** and are associated with conditions like gout or myeloproliferative disorders. - While distal RTA results in systemic acidosis, the urine pH in distal RTA is typically **alkaline or inappropriately neutral**, which does not favor uric acid stone formation.
Question 1023: Tall T waves on ECG are seen in:
- A. Hyperkalemia (Correct Answer)
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypocalcemia
Explanation: ***Hyperkalemia*** - **Tall, peaked T waves** are a hallmark ECG finding in early to moderate **hyperkalemia**, reflecting altered repolarization due to elevated extracellular potassium [1]. - As potassium levels rise further, other ECG changes may include a **prolonged PR interval**, **widened QRS complex**, and ultimately a **sine wave pattern**, leading to ventricular arrhythmias [1]. *Hypokalemia* - This condition is typically associated with **flattened or inverted T waves**, prominent **U waves**, and a **prolonged QT interval** on the ECG [1]. - The ECG changes in hypokalemia reflect delayed repolarization and increased myocardial instability [1]. *Hypercalcemia* - **Hypercalcemia** is characterized by a **shortened QT interval** on the ECG due to accelerated ventricular repolarization. - T waves, if affected, are usually not tall or peaked but may be wider or slightly less prominent. *Hypocalcemia* - **Hypocalcemia** typically leads to a **prolonged QT interval** on the ECG, primarily due to a lengthened ST segment. - While it can manifest with various T wave morphologies, it does not typically cause the characteristic tall, peaked T waves seen in hyperkalemia.
Ophthalmology
2 questionsColoboma, most common site?
Expulsive hemorrhage in cataract surgery is from?
NEET-PG 2012 - Ophthalmology NEET-PG Practice Questions and MCQs
Question 1021: Coloboma, most common site?
- A. Superotemporal
- B. Inferonasal (Correct Answer)
- C. Inferotemporal
- D. Superonasal
Explanation: ***Inferonasal*** - This is the **most common site** for coloboma because it corresponds to the location of the **fetal optic fissure** (choroidal fissure) during development. - Coloboma results from the **incomplete closure** of the fetal optic fissure, which normally occurs around the fifth to seventh week of gestation. *Superotemporal* - While coloboma can occur in various locations, the **superotemporal quadrant** is not the typical site. - Colobomas are usually found in areas consistent with the path of the optic fissure. *Inferotemporal* - This location is less common for colobomas compared to the inferonasal region. - The inferotemporal region does not align with the usual embryological fusion line of the optic fissure. *Superonasal* - Colobomas in the **superonasal quadrant** are rare. - This area is typically unaffected because it is not part of the fetal optic fissure's normal closure pathway.
Question 1022: Expulsive hemorrhage in cataract surgery is from?
- A. Vortex vein
- B. Choroidal vein
- C. Ciliary artery (Correct Answer)
- D. None of the options
Explanation: ***Ciliary artery*** - Expulsive hemorrhage is a rare but devastating complication, typically resulting from the rupture of a **posterior ciliary artery** within the choroid. - This arterial rupture leads to a sudden, massive increase in intraocular pressure and extrusion of intraocular contents. *Vortex vein* - **Vortex veins** drain the choroid, and while their rupture could lead to hemorrhage, it is less likely to cause the highly pressurized, expulsive nature of a choroidal hemorrhage. - Hemorrhage from a vortex vein is generally less severe and less rapid in onset compared to arterial bleeding. *Choroidal vein* - **Choroidal veins** are part of the venous drainage system; bleeding from these vessels would typically be lower pressure and less likely to cause an expulsive hemorrhage. - Venous bleeds are generally slower and do not generate the rapid, violent pressure increase characteristic of expulsive hemorrhage. *None of the options* - This option is incorrect because the rupture of a ciliary artery is the direct cause of expulsive hemorrhage. - The other options are incorrect for the reasons stated above.
Pediatrics
5 questionsA baby is born at 27 weeks of gestation and required mechanical ventilation for 4 weeks and CPAP for 1 week. He was maintained on room air subsequently. Based on the new definition of Bronchopulmonary Dysplasia (BPD), and assuming he remained on room air at 36 weeks post-menstrual age, what is the most appropriate classification of his condition?
Which of the following statements is true regarding anemia of prematurity?
Diarrhoea in a child of 12 months, dose of Zinc is?
At what age do children typically begin to say short sentences of 4-5 words?
Which of the following is a common symptom of neonatal lupus?
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1021: A baby is born at 27 weeks of gestation and required mechanical ventilation for 4 weeks and CPAP for 1 week. He was maintained on room air subsequently. Based on the new definition of Bronchopulmonary Dysplasia (BPD), and assuming he remained on room air at 36 weeks post-menstrual age, what is the most appropriate classification of his condition?
- A. Mild BPD (Correct Answer)
- B. Moderate BPD
- C. Severe BPD
- D. No BPD
Explanation: ***Mild BPD*** - The infant required respiratory support (ventilation and CPAP) for an extended period (5 weeks total, far exceeding the 28-day oxygen requirement for BPD diagnosis). - Being on **room air at 36 weeks post-menstrual age** despite prior prolonged support classifies his condition as mild BPD according to the diagnostic criteria. - For infants born <32 weeks gestation, mild BPD is defined as needing oxygen for ≥28 days but breathing room air at 36 weeks PMA. *Moderate BPD* - Moderate BPD would be diagnosed if the infant still required **less than 30% oxygen (FiO2 0.22-0.29) at 36 weeks post-menstrual age**. - This infant was on room air (FiO2 0.21), indicating less severe lung disease than moderate BPD. *Severe BPD* - Severe BPD involves the ongoing need for **30% or greater oxygen (FiO2 ≥0.30)** and/or positive pressure support (CPAP/ventilator) at 36 weeks post-menstrual age. - This infant did not meet these criteria, as he was on room air without any support. *No BPD* - No BPD would require **less than 28 days of oxygen/respiratory support** during the neonatal period. - This infant required mechanical ventilation for 4 weeks and CPAP for 1 week (total 5 weeks = 35 days), clearly exceeding the 28-day threshold for BPD diagnosis. - Despite being stable on room air at 36 weeks PMA, the prolonged earlier support establishes the diagnosis of BPD (mild severity).
Question 1022: Which of the following statements is true regarding anemia of prematurity?
- A. Low reticulocyte response (Correct Answer)
- B. Hemoglobin level <10 gm/dL
- C. 10 ml/kg packed cell transfusion
- D. Microcytic hypochromic type
Explanation: ***Low reticulocyte response*** - Anemia of prematurity results from several factors, including a **blunted erythropoietin response** to anemia, **shortened red blood cell lifespan**, and **rapid growth with increased blood volume requirements**. - The combination of these factors leads to **insufficient red blood cell production** by the bone marrow, reflected by a **low reticulocyte count** despite anemia. - This low reticulocyte response is a **key diagnostic feature** distinguishing it from hemolytic anemias. *Hemoglobin level <10 gm/dL* - While premature infants with anemia of prematurity develop low hemoglobin, a specific cutoff of **<10 gm/dL is not universally definitive** for diagnosis. - Hemoglobin nadirs vary based on **gestational age** (more premature = lower nadir) and occur at different postnatal ages. - Transfusion thresholds are determined by **clinical stability and symptoms**, not just a single Hb value. *10 ml/kg packed cell transfusion* - This describes a **treatment intervention**, not a characteristic of the disease itself. - Transfusion volume is typically **10-15 ml/kg** when indicated, but the decision to transfuse depends on gestational age, postnatal age, clinical stability, and symptoms like apnea or bradycardia. - This is **not a defining feature** of anemia of prematurity. *Microcytic hypochromic type* - Anemia of prematurity is typically **normocytic, normochromic**, not microcytic hypochromic. - **Microcytic hypochromic** anemia suggests **iron deficiency**, which is a different condition. - The red cells in anemia of prematurity have **normal size (MCV) and normal hemoglobin content** per cell.
Question 1023: Diarrhoea in a child of 12 months, dose of Zinc is?
- A. 1 mg / 10 - 14 day
- B. 10 mg / 10 - 14 day
- C. 20 mg / 10 - 14 day (Correct Answer)
- D. 15 mg / 10 - 14 day
Explanation: **20 mg / 10 - 14 day** - For children aged **12 months and older**, the recommended dose of zinc for acute diarrhea is **20 mg** once daily for **10 to 14 days**. - This dosage helps reduce the severity and duration of diarrheal episodes and prevents future occurrences. *1 mg / 10 - 14 day* - This dosage is **too low** and would be ineffective in treating or preventing the future incidence of diarrhea in a 12-month-old child. - Subtherapeutic doses will not provide the necessary micronutrient support during diarrheal illness. *10 mg / 10 - 14 day* - This is the recommended dose for children **under 6 months of age**, not for a 12-month-old child. - While it's a correct dosage for a different age group, it is an insufficient dose for a 12-month-old. *15 mg / 10 - 14 day* - This dose is **not the standard recommendation** by major health organizations like WHO or UNICEF for any age group for treating diarrhea. - It falls between the standard dosages and may not provide optimal benefit.
Question 1024: At what age do children typically begin to say short sentences of 4-5 words?
- A. 2 years
- B. 3 years
- C. 4 years (Correct Answer)
- D. 5 years
Explanation: ***4 years*** - By this age, children typically have a vocabulary of **1,500-2,500 words** and can construct sentences of **4-5 words**, demonstrating improved grammatical structure and complexity. - They can also tell simple stories and use pronouns and plurals correctly. *2 years* - Children at this age typically combine **two to three words** into short phrases, such as "more milk" or "daddy go." - Their vocabulary usually consists of about **50-200 words**, not enough for 4-5 word sentences. *3 years* - Three-year-olds usually speak in **three- to four-word sentences**, such as "I want big cookie." - Their vocabulary is typically around **900-1,000 words**, but they are still developing the complexity needed for consistent 4-5 word sentences. *5 years* - By age five, children can typically speak in much **longer and more complex sentences** (5-6+ words) and are mastering grammar rules. - They can comprehend and communicate more nuanced ideas, surpassing the milestone of 4-5 word sentences.
Question 1025: Which of the following is a common symptom of neonatal lupus?
- A. All of the options
- B. Cutaneous lesion (Correct Answer)
- C. Thrombocytopenia
- D. Heart block
Explanation: ***Cutaneous lesion*** - **Cutaneous lesions** are the most common manifestation of neonatal lupus, typically appearing as an **annular erythematous rash** on the face and scalp. - These lesions often develop after exposure to **ultraviolet light** and usually resolve within 6 months as maternal autoantibodies clear from the infant's system. *Thrombocytopenia* - While **hematologic abnormalities** such as thrombocytopenia can occur in neonatal lupus, they are less common than cutaneous lesions. - **Thrombocytopenia** refers to a low platelet count, which can increase the risk of bleeding. *All of the options* - While all listed options (cutaneous lesions, thrombocytopenia, and heart block) can be features of neonatal lupus, **cutaneous lesions** are the most frequently observed symptom. - Choosing "All of the options" would imply equal commonality or presence of all in every case, which is not accurate. *Heart block* - **Congenital heart block** is a serious, but less common and often irreversible, manifestation of neonatal lupus, caused by maternal antibodies attacking the fetal cardiac conduction system. - It usually presents as **bradycardia** and may require a pacemaker, but it is not the most common symptom overall.