NEET-PG 2012 Practice Questions

Q: Which of the following is not classified as a special incidence rate?

Standardized mortality rate. ***Standardized mortality rate*** - This is a measure used to compare **mortality rates** between different populations, adjusting for age or other confounding factors. - It is a **standardized mortality measure**, not an incidence rate, and therefore not classified as a special incidence rate. - Special incidence rates measure the occurrence of **new cases** in specific circumstances, whereas SMR is a **comparative mortality metric**. *Attack rate* - The **attack rate** is a classic **special incidence rate** used to describe the proportion of people in a population who became ill during an **epidemic or outbreak**. - It is specifically calculated during a **short, well-defined period**, often relevant to foodborne illnesses or infectious disease outbreaks. *Secondary attack rate* - The **secondary attack rate** is a **special incidence rate** that measures the proportion of susceptible people who develop a disease after being exposed to a **primary case** within a defined population (e.g., household contacts). - It quantifies the **spread of an infectious agent** within a closed population after its introduction. *Hospital admission rate* - This is a **health service utilization indicator** that measures hospital admissions in a population during a specified period. - It is **not classified as a special incidence rate** in standard epidemiological teaching, as it reflects healthcare utilization rather than disease occurrence in outbreak situations.

Q: Which is the main vector of Dengue?

A. aegypti. ***A. aegypti*** - **Aedes aegypti** is the primary vector responsible for transmitting the **Dengue virus** to humans. - It is a **day-biting mosquito** found predominantly in tropical and subtropical regions. *Culex* - **Culex mosquitoes** are known vectors for diseases like **Japanese encephalitis**, **West Nile virus**, and **filariasis**. - They are generally **night-biting** and do not play a significant role in Dengue transmission. *Anopheles* - **Anopheles mosquitoes** are the primary vectors for **malaria** in humans. - They are not associated with the transmission of the Dengue virus. *Aedes scutellaris* - While part of the **Aedes genus**, **Aedes scutellaris** is a secondary vector for Dengue in the **Pacific region**. - The main vector for Dengue globally remains **Aedes aegypti**, followed by **Aedes albopictus** in some regions.

Q: Which of the following sources provides the highest yield and most reliable samples for DNA fingerprinting?

Blood. ***Blood*** - **Blood** provides a high concentration of **nucleated cells** (e.g., white blood cells), yielding abundant and high-quality DNA. - The DNA obtained from blood is typically well-preserved and less prone to degradation or contamination compared to other sources. *Saliva* - While saliva contains DNA from **buccal epithelial cells** and white blood cells, its DNA yield can be lower and more variable due to mucous and bacterial contamination. - DNA from saliva may be more subject to degradation, especially if not collected and stored properly. *Tooth* - **Teeth** can be a good source of DNA, particularly from the **pulp**, but extraction can be challenging and destructive. - The DNA yield varies depending on the tooth's condition and the extraction method, and it is generally reserved for situations where other sources are unavailable or severely degraded. *Buccal mucosa* - **Buccal mucosa** swabs are a common and non-invasive source of DNA from **epithelial cells**. - While suitable for many applications, the DNA yield can be lower than blood, and the sample may be more susceptible to surface contamination.

Q: HIV post exposure prophylaxis should be started within?

72 hrs. ***72 hrs*** - **Post-exposure prophylaxis (PEP)** aims to prevent HIV infection after potential exposure and should ideally be initiated as soon as possible, but no later than **72 hours** after exposure [1]. - Starting PEP within this window significantly increases its effectiveness in preventing HIV seroconversion. *1-2 hrs* - While initiating PEP as soon as possible is crucial, stating it must be within **1-2 hours** can be misleading as the window of effectiveness extends beyond this. - This timeframe might be an ideal, but not the absolute crucial limit for efficacy. *14 hrs* - This timeframe is **too restrictive** for the recommended window for PEP initiation. - Missing the opportunity within **14 hours** does not negate the effectiveness of PEP if started within the broader 72-hour window. *18 hrs* - Similar to **14 hours**, **18 hours** is an unnecessarily strict limit for PEP initiation. - Guidelines universally support starting PEP up to **72 hours** post-exposure for optimal benefit [1].

Q: Which organism can be isolated from stool & sputum?

Paragonimus. ***Paragonimus*** - *Paragonimus* species, particularly *P. westermani* (the **lung fluke**), are known to infest the lungs, leading to symptoms like **cough** and **sputum production**, where their eggs can be found. - While residing in the lungs, eggs can be swallowed, passed through the gastrointestinal tract, and subsequently found in **stool samples**. *Fasciola* - *Fasciola hepatica* (the **sheep liver fluke**) primarily infects the **liver and biliary ducts**. - Its eggs are typically found in **stool samples** but not in sputum, as it does not infest the respiratory tract. *Clonorchis* - *Clonorchis sinensis* (the **Chinese liver fluke**) also primarily inhabits the **bile ducts** of the liver. - Similar to *Fasciola*, its eggs are excreted in **feces** and are not found in sputum. *P. carinii* - *Pneumocystis jirovecii* (formerly *Pneumocystis carinii*) is a **fungus** that causes **pneumonia** (PCP) in immunocompromised individuals. - It is exclusively found in the **lungs** and identified in respiratory specimens like sputum or bronchoalveolar lavage, not in stool.

Q: What is the primary function of the Nef gene in HIV?

Enhancing viral pathogenesis. ***Enhancing viral pathogenesis*** - The **Nef protein** is critical for efficient viral replication and disease progression in HIV-infected individuals, significantly increasing **viral load** and contributing to immune evasion. - It achieves this by downregulating **CD4** and **MHC class I** molecules on the surface of infected cells, thereby preventing immune recognition and increasing viral infectivity. *Enhancing the expression of host genes* - While Nef interacts with various host proteins, its primary function is not to globally enhance the expression of host genes but rather to modulate specific host pathways to favor viral replication. - Instead, Nef often leads to **downregulation** of specific host proteins important for immune response, such as CD4 and MHC class I. *Decreasing viral replication* - Nef's role is to **increase**, not decrease, viral replication and spread within the host. - Viruses lacking a functional Nef gene show **attenuated replication** in vivo and often reduced pathogenicity. *Promoting host cell apoptosis* - While Nef can influence cellular processes, its direct and primary function is not to promote host cell apoptosis. - In fact, Nef can sometimes prevent early apoptosis of infected cells, allowing more time for virus production and release, thereby contributing to viral persistence.

Q: Which component is considered the central part of the complement pathway?

C3 (complement component 3). ***C3*** - **C3** is considered the central component because all three major pathways of complement activation (classical, alternative, and lectin) converge at the point of **C3 activation**. - Its cleavage product, **C3b**, is crucial for opsonization, formation of the C5 convertase, and initiating the assembly of the **membrane attack complex (MAC)**. *C1 (complement component 1)* - **C1** is the initial component of the **classical complement pathway** but does not play a direct role in the alternative or lectin pathways. - Its primary function is to bind to **antibody-antigen complexes** or directly to pathogens to activate C4 and C2. *C2 (complement component 2)* - **C2** is a component of the **classical** and **lectin pathways**, acting as a substrate for C1s and MASP to form the C3 convertase. - It is not involved in the initial activation of the **alternative pathway**. *C5 (complement component 5)* - **C5** is activated downstream of C3 and is a key component in the formation of the **membrane attack complex (MAC)**. - While critical for pathogen lysis, its activation is dependent on the prior cleavage of **C3** into C3b.

Q: Which of the following is not typically screened for in blood donations?

Epstein-Barr Virus (EBV). ***Epstein-Barr Virus (EBV)*** ✓ - EBV is **NOT routinely screened** for in blood donations in India and most countries - While EBV is a common virus (>90% adults are seropositive), it is **not considered a major transfusion-transmitted infection** - The virus is primarily transmitted through saliva; transfusion-associated EBV transmission is **extremely rare and usually not clinically significant** in immunocompetent recipients - Risk-benefit analysis does not support routine screening due to **high prevalence, low clinical impact, and cost considerations** - EBV screening may only be considered for specific recipients (e.g., severely immunocompromised patients) *HIV* - **Routinely screened** in all blood donations worldwide - Screening includes HIV-1 and HIV-2 antibodies and/or HIV antigen/RNA testing - Transfusion-transmitted HIV causes AIDS with severe consequences - Mandatory screening under the Drugs and Cosmetics Act in India *HBV* - **Routinely screened** in all blood donations - Screening includes HBsAg (Hepatitis B surface antigen) testing, and often anti-HBc or HBV DNA - Can cause acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma - Mandatory screening in India and globally *HCV* - **Routinely screened** in all blood donations - Screening includes anti-HCV antibodies and/or HCV RNA (nucleic acid testing) - Major cause of chronic hepatitis, cirrhosis, and liver cancer - Mandatory screening under blood safety regulations

Q: Extrapyramidal syndrome-like side effects are seen in which of the following medications?

Haloperidol. ***Haloperidol*** - **Haloperidol** is a **typical antipsychotic** known for its potent **dopamine D2 receptor blockade**. - This strong blockade in the **nigrostriatal pathway** often leads to **extrapyramidal symptoms (EPS)** such as dystonia, akathisia, and parkinsonism. *Clozapine* - **Clozapine** is an **atypical antipsychotic** that has a lower propensity for causing **extrapyramidal symptoms (EPS)** due to its weaker D2 receptor antagonism and potent serotonin 5-HT2A receptor blockade. - While it can cause other severe side effects, such as **agranulocytosis** and **myocarditis**, EPS are less common compared to typical antipsychotics. *Tetracycline* - **Tetracycline** is an **antibiotic** primarily used to treat bacterial infections. - Its mechanism of action involves inhibiting bacterial protein synthesis, and it is not associated with **neurological side effects** like **extrapyramidal symptoms**. *Ketoconazole* - **Ketoconazole** is an **antifungal medication** that works by inhibiting ergosterol synthesis in fungi. - It is known for potential **hepatotoxicity** and **endocrine dysfunction**, but not for causing **extrapyramidal symptoms**.

Q: Which of the following is an intermediate-acting insulin?

NPH insulin. ***NPH insulin*** - **NPH (Neutral Protamine Hagedorn) insulin** is characterized by its intermediate duration of action, typically peaking in 4-12 hours and lasting up to 24 hours [1]. - This intermediate profile is achieved by combining insulin with **protamine**, which slows its absorption from the subcutaneous injection site [1]. *Insulin lispro* - **Insulin lispro** is a **rapid-acting insulin** analog, designed to act very quickly after injection, typically within 15-30 minutes [1, 2]. - Its quick onset and short duration make it suitable for dosing **immediately before meals** to control post-prandial glucose levels [1]. *Regular insulin* - **Regular insulin** is a **short-acting insulin**, with an onset of action around 30-60 minutes and a peak effect typically within 2-4 hours. - It is often administered **30 minutes before meals** and can also be used intravenously in acute situations like diabetic ketoacidosis. *Insulin glargine* - **Insulin glargine** is a **long-acting insulin** analog, providing a prolonged and relatively peakless effect over 24 hours [1, 2]. - Its primary role is to provide **basal insulin coverage**, mimicking the body's continuous background insulin production [1, 2].

Question 1

Which of the following is not classified as a special incidence rate?

Accepted Answer

Standardized mortality rate

Answer

Attack rate

Answer

Secondary attack rate

Answer

Hospital admission rate

Question 2

Which is the main vector of Dengue?

Accepted Answer

A. aegypti

Answer

Culex

Answer

Anopheles

Answer

Aedes scutellaris

Question 3

Which of the following sources provides the highest yield and most reliable samples for DNA fingerprinting?

Accepted Answer

Blood

Answer

Saliva

Answer

Tooth

Answer

Buccal mucosa

Question 4

HIV post exposure prophylaxis should be started within?

Accepted Answer

72 hrs

Answer

1-2 hrs

Answer

14 hrs

Answer

18 hrs

Question 5

Which organism can be isolated from stool & sputum?

Accepted Answer

Paragonimus

Answer

Fasciola

Answer

P. carinii

Answer

Clonorchis

Question 6

What is the primary function of the Nef gene in HIV?

Accepted Answer

Enhancing viral pathogenesis

Answer

Enhancing the expression of host genes

Answer

Decreasing viral replication

Answer

Promoting host cell apoptosis

Question 7

Which component is considered the central part of the complement pathway?

Accepted Answer

C3 (complement component 3)

Answer

C1 (complement component 1)

Answer

C2 (complement component 2)

Answer

C5 (complement component 5)

Question 8

Which of the following is not typically screened for in blood donations?

Accepted Answer

Epstein-Barr Virus (EBV)

Answer

HIV

Answer

HBV

Answer

HCV

Question 9

Extrapyramidal syndrome-like side effects are seen in which of the following medications?

Accepted Answer

Haloperidol

Answer

Clozapine

Answer

Tetracycline

Answer

Ketoconazole

Question 10

Which of the following is an intermediate-acting insulin?

Accepted Answer

NPH insulin

Answer

Insulin lispro

Answer

Insulin glargine

Answer

Regular insulin

NEET-PG 2012

Community Medicine

Forensic Medicine

Internal Medicine

Microbiology

Pathology

Pharmacology