NEET-PG 2012 Practice Questions

Q: Stages of anesthesia were established by

Diethyl ether. ***Diethyl ether** - The classic stages of anesthesia (analgesia, excitement, surgical anesthesia, medullary depression) were originally described in relation to the administration of **diethyl ether**. - Its slow onset and prolonged half-life allowed for the clear observation and definition of these distinct stages. *Nitrous oxide* - This gaseous anesthetic has a rapid onset and offset, making it difficult to clearly delineate all four classical stages with its use. - It is often used as an adjunct to other anesthetics rather than as a sole agent for prolonged surgical anesthesia. *Halothane* - Halothane is a potent volatile anesthetic that became popular after ether, but its use also does not typically involve the clear, step-wise progression through all four anesthetic stages as seen with ether. - It was one of the first widely used inhaled anesthetics that largely replaced ether due to better patient control and fewer side effects. *Chloroform* - Chloroform was another early anesthetic but was associated with significant cardiac and hepatic toxicity, leading to its limited use and eventual discontinuation. - While it induced anesthesia, the clear staging of anesthetic depth was primarily established and standardized using diethyl ether.

Q: Antibodies most commonly seen in drug induced lupus are:

Antihistone Antibodies. ***Antihistone Antibodies*** - **Antihistone antibodies** are the most common laboratory finding, present in 95% of patients with **drug-induced lupus erythematosus (DIL)**. - This type of lupus is often triggered by medications such as **procainamide**, **hydralazine**, and **isoniazid**. *Anti ds DNA Antibodies* - **Anti-double-stranded DNA (dsDNA) antibodies** are highly specific for **systemic lupus erythematosus (SLE)**, particularly severe cases, but are rarely seen in DIL. - High titers of anti-dsDNA often correlate with **lupus nephritis** and disease activity. *Anti Sm Antibodies* - **Anti-Sm antibodies** are highly specific for **SLE**, sometimes associated with neuropsychiatric manifestations, but are rarely identified in drug-induced lupus. - Their presence helps to confirm the diagnosis of SLE but not DIL. *Anti-Ro Antibodies* - **Anti-Ro (SSA) antibodies** are most commonly associated with **Sjögren's syndrome** and **neonatal lupus**, and can be seen in a subset of SLE patients, especially those with photosensitivity. - While they can be present in some forms of SLE, they are not the hallmark autoantibody for drug-induced lupus.

Q: What is the maximum gestational age (from LMP) for performing medical termination of early pregnancy using mifepristone and misoprostol?

7 weeks. ***7 weeks (49 days)*** - Medical termination of pregnancy using **mifepristone and misoprostol** is most effective up to **49 days (7 weeks) of gestation** from the first day of the last menstrual period (LMP). - This is the **FDA-approved and WHO-recommended timeframe** for medical abortion with optimal efficacy (95-98% success rate). - The **MTP Act in India** allows medical methods up to **63 days (9 weeks)**, but 49 days represents the timeframe with highest efficacy and lowest complication rates. - Beyond this period, success rates decline and surgical methods may be more appropriate. *21 days* - This is only **3 weeks of gestation**, far too early and restrictive for medical abortion guidelines. - Most women wouldn't have confirmed pregnancy by this time. - This is not aligned with any standard medical abortion protocol. *4 weeks* - At **4 weeks gestation**, pregnancy has just been missed (around time of expected period). - This is too restrictive and not the maximum allowable timeframe for medical abortion. - Medical abortion can safely be performed well beyond this point. *14 days* - This is only **2 weeks of gestation** (around the time of ovulation in a typical cycle). - Pregnancy cannot even be reliably detected at this point. - This timeframe has no relevance to medical abortion guidelines.

Q: All of the following are used for treatment of *H. pylori*, except:

Gentamicin. ***Gentamicin*** - **Gentamicin** is an **aminoglycoside antibiotic** primarily used for severe Gram-negative bacterial infections and is **not effective** against *H. pylori*. - Its mechanism of action and **toxicity profile** (ototoxicity, nephrotoxicity) make it unsuitable for typical *H. pylori* eradication regimens. *Clarithromycin* - **Clarithromycin** is a **macrolide antibiotic** frequently used in **triple therapy regimens** for *H. pylori* eradication. - It works by **inhibiting bacterial protein synthesis**, significantly contributing to the eradication of the bacteria. *Metronidazole* - **Metronidazole** is an **antibiotic** and **antiprotozoal agent** commonly included in *H. pylori* **quadruple therapy** or when penicillin allergies are present. - It acts by forming **cytotoxic compounds** that disrupt bacterial DNA, making it effective against anaerobic and microaerophilic bacteria like *H. pylori*. *Amoxicillin* - **Amoxicillin** is a **beta-lactam antibiotic** that is a cornerstone of many *H. pylori* **eradication regimens**, particularly in standard triple therapy. - It works by **inhibiting bacterial cell wall synthesis**, leading to bacterial lysis.

Q: Derealization and depersonalization are symptoms of which type of disorder?

Dissociative disorder. ***Dissociative disorder*** - **Derealization** involves experiencing the outside world as unreal or dreamlike - **Depersonalization** is the experience of feeling detached from one's own body or mental processes - These are hallmark symptoms of **dissociative disorders**, specifically depersonalization-derealization disorder in DSM-5 *Personality disorders* - Characterized by enduring, maladaptive patterns of inner experience and behavior - While some personality disorders (e.g., **borderline personality disorder**) may display transient dissociative symptoms under stress, derealization and depersonalization are not core diagnostic features *Mania* - A state of abnormally elevated mood and energy, involving **racing thoughts**, **decreased need for sleep**, and **impulsive behavior** - Does not typically involve consistent derealization or depersonalization as core features *Anxiety disorders* - Depersonalization can occur transiently during **panic attacks** or severe anxiety - However, when derealization and depersonalization are the primary, persistent symptoms, they indicate a **dissociative disorder** rather than an anxiety disorder

Q: Which of the following features is used to identify the colon on an X-ray?

Haustra. ***Haustra (Correct Answer)*** - **Haustra** are sacculations or pouches of the colon created by the uneven contraction of the **taeniae coli** - They are THE characteristic feature that helps distinguish the large bowel from the small bowel on an X-ray - These indentations typically do **not cross the entire width** of the bowel lumen, unlike the valvulae conniventes of the small intestine - Haustra appear as incomplete septations on plain radiographs *Valvulae conniventes (Incorrect)* - **Valvulae conniventes** (also known as plicae circulares) are large, circular folds of the **small intestine** mucosa that project into the lumen - They extend **completely across the lumen** of the small bowel, making them easily distinguishable from haustra which only partially traverse the colon - This is a feature of small bowel, not colon *String of beads sign (Incorrect)* - The "**string of beads sign**" is a **pathological radiographic finding** associated with small bowel obstruction - It refers to multiple small, gas-filled loops of small bowel stacked on top of each other, often with small pockets of fluid or air trapped between the folds, resembling beads on a string - This is not a normal anatomical feature used to identify the colon *More number of loops (Incorrect)* - The number of loops is **not a primary distinguishing feature** between the large and small bowel on an X-ray - While the small intestine generally has more convolutions or loops than the colon, this is a **less reliable and specific sign** compared to the presence of haustra - Haustra remain the gold standard feature for colon identification

Q: Rat tail appearance in contrast radiography is seen in?

Achalasia cardia. ***Correct: Achalasia cardia*** - The **"rat tail" or "bird's beak" sign** is the classic radiological appearance of **achalasia cardia** on barium swallow study - Shows **smooth, symmetrical, tapered narrowing** of the distal esophagus with proximal esophageal dilatation - Due to **failure of the lower esophageal sphincter (LES) to relax**, causing functional obstruction - The smooth tapering distinguishes it from irregular narrowing seen in malignancy *Incorrect: Carcinoma esophagus* - Esophageal carcinoma shows **"shouldered lesion"** or **"apple core" appearance** - Characterized by **irregular, shelf-like margins** with abrupt transition - Narrowing is **asymmetric and irregular**, not the smooth tapering of rat tail sign - May show mucosal destruction and filling defects *Incorrect: Plummer-Vinson syndrome* - Shows **postcricoid web** in the upper esophagus on barium swallow - Associated with iron deficiency anemia, glossitis, and increased risk of esophageal cancer - Presents as a thin, web-like membrane rather than distal narrowing *Incorrect: Diffuse esophageal spasms* - Shows **"corkscrew esophagus"** or **"rosary bead" appearance** on barium swallow - Multiple, **simultaneous, non-peristaltic contractions** create segmented appearance - Dynamic finding with normal segments between contractions - Represents uncoordinated muscular activity, not fixed narrowing

Q: Best gas used for creating pneumoperitoneum at laparoscopy is:

CO2. ***CO2*** - **Carbon dioxide** is rapidly absorbed and expelled by the respiratory system, minimizing the risk of **gas embolism**. - It is **non-flammable**, which is crucial in a surgical environment where electrosurgical devices are often used. - CO2 is **highly soluble in blood**, allowing rapid clearance if venous absorption occurs. *N2* - **Nitrogen** is not ideal for pneumoperitoneum as its poor solubility in blood leads to a significant risk of **gas embolism**. - **Increased nitrogen pockets** can create complications that make it a poor choice. *O2* - **Oxygen** poses a significant **fire hazard** in the presence of electrosurgical instruments. - It **supports combustion**, making the surgical field dangerous when using electrocautery or laser devices. *N2O* - **Nitrous oxide** supports **combustion**, making it unsafe for use with electrosurgical devices. - It can also diffuse into **bowel loops**, causing distension and obstructing visibility, which is undesirable during laparoscopy.

Q: Ogilvie's syndrome most commonly involves

Cecum and right hemicolon. ***Cecum and right hemicolon*** - Ogilvie's syndrome, also known as acute colonic pseudo-obstruction, primarily affects the **large bowel**. - It most commonly presents with significant dilation of the **cecum and right hemicolon** due to impaired autonomic innervation *Stomach* - The stomach is not typically involved in Ogilvie's syndrome. Conditions affecting the stomach might include **gastroparesis** or **pyloric obstruction**, which have different pathophysiologies. - Ogilvie's syndrome is a disorder of **colonic motility**, not gastric motility. *Gallbladder* - The gallbladder is an organ of the **biliary system** and is not directly affected by Ogilvie's syndrome. - Conditions like **cholecystitis** or **cholelithiasis** involve the gallbladder but are unrelated to acute colonic pseudo-obstruction. *Small intestine* - While pseudo-obstruction can sometimes affect the small intestine (chronic intestinal pseudo-obstruction), Ogilvie's syndrome specifically refers to **acute colonic pseudo-obstruction**. - **Small bowel obstruction** caused by mechanical blockages is a distinct condition with different diagnostic features and management.

Question 1

Stages of anesthesia were established by

Accepted Answer

Diethyl ether

Answer

Nitrous oxide

Answer

Halothane

Answer

Chloroform

Question 2

Thrombotic thrombocytopenic purpura is a syndrome characterized by which of the following?

Accepted Answer

Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever

Answer

Thrombocytopenia, anemia, neurological abnormalities, progressive hepatic failure and fever

Answer

Thrombocytopenia, normal anemia, neurological abnormalities, progressive renal failure and fever

Answer

Thrombocytopenia, anemia, no neurological abnormalities, progressive renal failure and fever

Question 3

Antibodies most commonly seen in drug induced lupus are:

Accepted Answer

Antihistone Antibodies

Answer

Anti ds DNA Antibodies

Answer

Anti Sm Antibodies

Answer

Anti-Ro Antibodies

Question 4

What is the maximum gestational age (from LMP) for performing medical termination of early pregnancy using mifepristone and misoprostol?

Accepted Answer

7 weeks

Answer

21 days

Answer

4 weeks

Answer

14 days

Question 5

All of the following are used for treatment of *H. pylori*, except:

Accepted Answer

Gentamicin

Answer

Metronidazole

Answer

Amoxicillin

Answer

Clarithromycin

Question 6

Derealization and depersonalization are symptoms of which type of disorder?

Accepted Answer

Dissociative disorder

Answer

Personality disorders

Answer

Mania

Answer

Anxiety disorders

Question 7

Which of the following features is used to identify the colon on an X-ray?

Accepted Answer

Haustra

Answer

Valvulae conniventes

Answer

String of beads sign

Answer

More number of loops

Question 8

Rat tail appearance in contrast radiography is seen in?

Accepted Answer

Achalasia cardia

Answer

Carcinoma esophagus

Answer

Plummer-Vinson syndrome

Answer

Diffuse esophageal spasms

Question 9

Best gas used for creating pneumoperitoneum at laparoscopy is:

Accepted Answer

CO2

Answer

N2

Answer

N2O

Answer

O2

Question 10

Ogilvie's syndrome most commonly involves

Accepted Answer

Cecum and right hemicolon

Answer

Stomach

Answer

Gallbladder

Answer

Small intestine

NEET-PG 2012

Anesthesiology

Internal Medicine

Obstetrics and Gynecology

Pharmacology

Psychiatry

Radiology

Surgery