NEET-PG 2012 Practice Questions

Q: What vitamin is significantly absent in breast milk?

Vitamin K. ***Vitamin K*** - Breast milk contains **critically low amounts** of **vitamin K** (approximately 2-5 μg/L), making it the **most significantly absent** vitamin in breast milk. - Newborns are at high risk for **Vitamin K deficiency bleeding (VKDB)**, which can be life-threatening. - This deficiency is so critical that **prophylactic vitamin K injection** is routinely administered to **all newborns** at birth to prevent hemorrhagic disease. - Vitamin K is essential for the synthesis of **clotting factors II, VII, IX, and X** in the liver. *Vitamin D* - While breast milk does contain **some vitamin D**, the levels are often **insufficient** to meet the infant's daily requirements (contains ~25-78 IU/L; infant needs 400 IU/day). - However, it is **present in measurable amounts**, unlike vitamin K which is nearly absent. - Infants are recommended to receive **vitamin D supplementation** starting soon after birth, especially if the mother has low vitamin D levels or limited **sun exposure**. *Vitamin C* - **Breast milk** contains adequate amounts of **vitamin C** (40-50 mg/L), which is sufficient for the infant's needs. - Maternal diet typically provides enough vitamin C to ensure its presence in breast milk. *Vitamin A* - Breast milk is a **good source** of **vitamin A**, particularly in the form of **beta-carotene** and retinol. - Vitamin A levels in breast milk are adequate for infant **vision development** and **immune function**.

Q: Which organization among the following is specifically mandated to work on reproductive health and family planning globally?

UNFPA. ***UNFPA*** - The **United Nations Population Fund (UNFPA)** is the lead UN agency for delivering a world where every pregnancy is wanted, every birth is safe, and every young person's potential is fulfilled. - Its mandate specifically focuses on **sexual and reproductive health (SRH)**, family planning, and maternal health worldwide. *UNICEF* - The **United Nations Children's Fund (UNICEF)** focuses on providing humanitarian and developmental aid to children worldwide, prioritizing their health, education, and protection. - While it addresses child health, its primary mandate is not exclusive to reproductive health or family planning. *ILO* - The **International Labour Organization (ILO)** is a United Nations agency whose mandate is to advance social and economic justice by establishing international labor standards. - Its work focuses on labor rights, decent work, and social protection, not reproductive health. *WHO* - The **World Health Organization (WHO)** works broadly on all aspects of global health including infectious diseases, non-communicable diseases, health systems, and emergency response. - While WHO does work on reproductive health, it is not specifically mandated exclusively for reproductive health and family planning like UNFPA.

Q: At what level is Kit B (basic emergency obstetric care supplies/ASHA kit/immunization supplies) provided in the healthcare system?

Sub-center. ***Sub-center*** - **Kit B** is designed for use at the **Sub-center level** within the Indian healthcare system, specifically for **ASHA workers** and other grassroots healthcare providers. - It contains essential supplies for **basic emergency obstetric care**, as well as items for **immunization** and other primary healthcare needs in the community. *PHC* - **Primary Healthcare Centers (PHCs)** are a higher level of care compared to sub-centers and typically have more extensive facilities and a wider range of services. - While PHCs do offer obstetric care and immunization, **Kit B** itself is primarily intended for the more peripheral sub-center operations. *CHC* - **Community Healthcare Centers (CHCs)** serve as referral units for 4-5 PHCs and provide specialist services, including basic surgical and obstetric care. - The level of care and supplies at a CHC is far more comprehensive than what is contained in **Kit B**, which targets basic community-level interventions. *FRU level* - **First Referral Units (FRUs)** are typically equipped to handle all obstetric emergencies, including Caesarean sections and blood transfusions. - The scope of services at an FRU is significantly advanced, requiring a much broader inventory of medical supplies and equipment than what is found in **Kit B**.

Q: What is the correct order of application of reagents in the complete Gram staining procedure?

Gentian violet → Iodine → Alcohol/Acetone → Safranin. **Gentian violet → Iodine → Alcohol/Acetone → Safranin** - **Gentian violet** (or crystal violet) is the **primary stain** that colors all cells purple. - **Iodine** acts as a **mordant**, forming a crystal violet-iodine complex within the cell walls. - **Alcohol/Acetone** is the **decolorizer**, washing out the primary stain from Gram-negative cells but not from Gram-positive cells. - Finally, **Safranin** is the **counterstain** that stains decolorized Gram-negative cells pink or red. *Iodine → Gentian violet → Alcohol/Acetone → Safranin* - **Iodine** is a mordant and needs a primary stain (like gentian violet) to bind to and form a complex; applying it first would not effectively stain the cells. - The correct sequence requires the primary stain to be applied before the mordant can fix it. *Safranin → Gentian violet → Iodine → Alcohol/Acetone* - **Safranin** is a counterstain and should be applied last to stain the decolorized Gram-negative cells, not as the first reagent. - Applying reagents out of order would lead to incorrect staining results, as **safranin** is meant to provide contrast after decolorization. *Gentian violet → Alcohol/Acetone → Iodine → Safranin* - **Alcohol/Acetone** (decolorizer) is applied too early in this sequence; it should be used after the mordant (iodine) has formed a complex with the primary stain. - Applying the decolorizer before the mordant would prevent the formation of the crystal violet-iodine complex, leading to incorrect differentiation between Gram-positive and Gram-negative bacteria.

Q: The 'headlight in fog' appearance is seen in which condition?

Toxoplasmosis. ***Toxoplasmosis*** - The "headlight in fog" appearance is a classic description of **chorioretinitis** caused by **congenital toxoplasmosis**. - It refers to an old, healed **retinal scar** (headlight) surrounded by active inflammation and **vitreous haze** (fog). *Syphilis* - Ocular syphilis can cause various presentations, including uveitis, retinitis, and optic neuropathy, but it does **not typically** present with the specific "headlight in fog" appearance. - Ocular lesions are often more diffuse or involve distinct **gummatous lesions**. *Toxocara* - Ocular toxocariasis often presents as a **granuloma** (either peripheral or macular) or as **endophthalmitis**, but not the characteristic "headlight in fog" pattern. - The lesions are usually a result of a direct larval migration and subsequent inflammatory reaction. *Herpes* - Herpes simplex virus (HSV) or varicella-zoster virus (VZV) can cause **acute retinal necrosis** (ARN) or progressive outer retinal necrosis (PORN), presenting with widespread retinal whitening and vascular occlusion. - These conditions have distinct appearances, generally **lacking the central scar** with surrounding active inflammation seen in "headlight in fog."

Q: What is the most common cause of anterior uveitis?

Idiopathic. ***Idiopathic*** - In a significant proportion of cases of **anterior uveitis**, a specific cause cannot be identified, leading to a diagnosis of idiopathic uveitis. - This highlights the multifactorial nature of the condition, where various triggers or underlying predispositions may not always be evident. *CMV* - **Cytomegalovirus (CMV)** typically causes a **posterior uveitis** or **retinitis**, especially in immunocompromised individuals. - While CMV can rarely cause anterior uveitis, it is not the most common cause. *Toxoplasma* - **Toxoplasmosis** is a frequent cause of **posterior uveitis** or **chorioretinitis**, characterized by focal necrotic lesions in the retina. - It is not a common cause of isolated anterior uveitis, although anterior chamber inflammation can occur secondary to posterior disease. *Ankylosing spondylitis* - **Ankylosing spondylitis** is a well-known systemic condition associated with **acute anterior uveitis**. - However, while a significant association exists, it is not the single most common cause when considering all cases of anterior uveitis, many of which remain idiopathic.

Q: What visual disturbance is caused by an optic tract lesion?

Contralateral homonymous hemianopsia. ***Contralateral homonymous hemianopsia*** - An **optic tract lesion** interrupts the nerve fibers originating from the contralateral nasal retina and the ipsilateral temporal retina, leading to **vision loss in the contralateral visual field** of both eyes. - This results in a defect where the patient cannot see objects on the **opposite side** of the body from the lesion. *Marcus Gunn pupil* - A **Marcus Gunn pupil**, also known as an **afferent pupillary defect**, indicates asymmetric disease of the **retina** or **optic nerve**, not specifically the optic tract. - It is characterized by paradoxical dilation of the affected pupil when light is swung from the unaffected to the affected eye. *Bilateral blindness* - **Bilateral blindness** typically results from severe damage to both **optic nerves**, the **optic chiasm**, or extensive bilateral lesions in the visual cortex. - An optic tract lesion affects only one side of the visual pathway posterior to the chiasm, thus not causing complete bilateral vision loss. *Ipsilateral homonymous hemianopsia* - **Ipsilateral homonymous hemianopsia** is not a standard neurological visual field defect. Visual field defects are usually described relative to the lesion side as contralateral or ipsilateral based on the specific anatomical location. - An optic tract lesion always produces a **contralateral homonymous hemianopsia** because optic tract fibers cross at the optic chiasm.

Q: Most common cause of bilateral optic atrophy is:

Nutritional deficiency (B12/folate). ***Nutritional deficiency (B12/folate)*** - **Nutritional optic neuropathy** due to deficiencies in B vitamins (especially B12, thiamine) and folate is a common cause of bilateral optic atrophy, particularly in **developing countries** and in populations with **malnutrition or chronic alcoholism**. - These deficiencies impair the **metabolism of retinal ganglion cells** and their axons, leading to symmetric bilateral optic nerve degeneration. - The condition is often **reversible in early stages** with appropriate supplementation. - **Note:** The "most common" cause varies by geographic location, population, and clinical setting. *Hereditary optic neuropathy* - **Leber's hereditary optic neuropathy (LHON)** and **autosomal dominant optic atrophy (ADOA)** are major causes of bilateral optic atrophy, especially in **younger patients**. - LHON typically presents in young males (15-35 years) with **sequential bilateral visual loss**. - These are among the **most common inherited optic neuropathies** and should always be considered in bilateral cases. *Intracranial tumor* - Intracranial tumors typically cause **unilateral optic atrophy** due to direct compression of one optic nerve. - **Bilateral optic atrophy** can occur with **chiasmal or suprasellar tumors** (pituitary adenomas, craniopharyngiomas) but is less common. - Usually presents with **visual field defects** (bitemporal hemianopia) before significant atrophy develops. *Toxic optic neuropathy* - **Toxic optic neuropathies** result from exposure to substances such as **methanol, ethambutol, tobacco-alcohol amblyopia**, or isoniazid. - Can cause bilateral symmetric optic atrophy but are **exposure-dependent** and less prevalent in general population. - **Tobacco-alcohol amblyopia** may overlap with nutritional deficiency.

Q: Tadpole cells, comma-shaped cells on histopathology are seen in -

Rhabdomyosarcoma. ***Rhabdomyosarcoma*** - **Tadpole cells** and **comma-shaped cells** are characteristic histological features of **rhabdomyosarcoma**, representing primitive mesenchymal cells differentiating towards skeletal muscle. - These cells are often pleomorphic, with eccentric nuclei and fibrillar eosinophilic cytoplasm, giving them their distinctive shapes. *Trichoepithelioma* - This is a benign adnexal tumor of follicular differentiation, characterized by nests of **basaloid cells**, **horn cysts**, and rudimentary hair structures. - It does not typically feature tadpole or comma-shaped cells. *Histiocytoma* - A **benign fibrous histiocytoma** (dermatofibroma) is composed of fibroblasts and histiocytes forming storiform patterns. - **Malignant fibrous histiocytoma** (now often reclassified as undifferentiated pleomorphic sarcoma) features pleomorphic spindle cells and giant cells, but not specifically tadpole or comma-shaped cells. *Leiomyosarcoma* - This is a malignant tumor of **smooth muscle origin**, characterized by spindle cells with blunt-ended nuclei, arranged in fascicles. - It lacks the tadpole or comma-shaped cells seen in rhabdomyosarcoma.

Q: Which of the following statements about Conivaptan is correct?

It is a vasopressin antagonist.. ***It is a vasopressin antagonist.*** * **Conivaptan** is a non-peptide, dual **vasopressin V1A and V2 receptor antagonist**, meaning it blocks the action of vasopressin. * By blocking vasopressin, it promotes **aquaresis** (excretion of solute-free water), which is beneficial in conditions like **hyponatremia**. * *It selectively acts on V2 receptors.* * **Conivaptan** is a **dual antagonist**, blocking both **V1A and V2 receptors**, not just V2. * **Tolvaptan**, in contrast, is a selective **V2 receptor antagonist**. * *It is administered orally.* * **Conivaptan** is typically administered intravenously, particularly in hospital settings for acute hyponatremia. * **Tolvaptan** is the orally administered vasopressin antagonist. * *All of the options.* * Since Conivaptan is not selectively acting on V2 receptors and is not administered orally, this option is incorrect.

Question 1

What vitamin is significantly absent in breast milk?

Accepted Answer

Vitamin K

Answer

Vitamin D

Answer

Vitamin C

Answer

Vitamin A

Question 2

Which organization among the following is specifically mandated to work on reproductive health and family planning globally?

Accepted Answer

UNFPA

Answer

UNICEF

Answer

ILO

Answer

WHO

Question 3

At what level is Kit B (basic emergency obstetric care supplies/ASHA kit/immunization supplies) provided in the healthcare system?

Accepted Answer

Sub-center

Answer

PHC

Answer

CHC

Answer

FRU level

Question 4

What is the correct order of application of reagents in the complete Gram staining procedure?

Accepted Answer

Gentian violet → Iodine → Alcohol/Acetone → Safranin

Answer

Iodine → Gentian violet → Alcohol/Acetone → Safranin

Answer

Safranin → Gentian violet → Iodine → Alcohol/Acetone

Answer

Gentian violet → Alcohol/Acetone → Iodine → Safranin

Question 5

The 'headlight in fog' appearance is seen in which condition?

Accepted Answer

Toxoplasmosis

Answer

Syphilis

Answer

Toxocara

Answer

Herpes

Question 6

What is the most common cause of anterior uveitis?

Accepted Answer

Idiopathic

Answer

CMV

Answer

Toxoplasma

Answer

Ankylosing spondylitis

Question 7

What visual disturbance is caused by an optic tract lesion?

Accepted Answer

Contralateral homonymous hemianopsia

Answer

Marcus Gunn pupil

Answer

Bilateral blindness

Answer

Ipsilateral homonymous hemianopsia

Question 8

Most common cause of bilateral optic atrophy is:

Accepted Answer

Nutritional deficiency (B12/folate)

Answer

Intracranial tumor

Answer

Hereditary optic neuropathy

Answer

Toxic optic neuropathy

Question 9

Tadpole cells, comma-shaped cells on histopathology are seen in -

Accepted Answer

Rhabdomyosarcoma

Answer

Trichoepithelioma

Answer

Histiocytoma

Answer

Leiomyosarcoma

Question 10

Which of the following statements about Conivaptan is correct?

Accepted Answer

It is a vasopressin antagonist.

Answer

It selectively acts on V2 receptors.

Answer

It is administered orally.

Answer

All of the options.

NEET-PG 2012

Biochemistry

Community Medicine

Microbiology

Ophthalmology

Pathology

Pharmacology