NEET-PG 2012 Practice Questions

Q: What is the role of iodized salt in the iodine deficiency control programme?

Primary prevention of iodine deficiency. ***Primary prevention of iodine deficiency*** - **Iodized salt** is a population-wide strategy to ensure adequate **iodine intake** in communities, preventing deficiency before it even occurs. - It aims to maintain normal **thyroid hormone** production and prevent disorders like **goiter** and **cretinism** in healthy individuals. *Secondary prevention of iodine deficiency* - **Secondary prevention** focuses on early diagnosis and prompt treatment in individuals already showing signs of a disease to prevent progression. - While screening for **iodine deficiency disorders (IDD)** might be secondary prevention, the universal use of iodized salt is not targeted at already deficient individuals but at the entire population. *Tertiary prevention of iodine deficiency* - **Tertiary prevention** involves managing existing conditions to prevent complications, reduce disability, and improve quality of life after a disease has manifested. - This would involve treating conditions like **severe hypothyroidism** or **cretinism** that result from prolonged iodine deficiency, for which **iodized salt** is not a direct treatment but a preventative measure. *Not applicable* - This option is incorrect as **iodized salt** plays a crucial and well-established role in public health for controlling **iodine deficiency**. - The scientific evidence and public health initiatives globally highlight its significant applicability in preventing **iodine deficiency disorders**.

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 agency monitors air quality in India?

Central pollution control board. ***Central pollution control board*** - The **Central Pollution Control Board (CPCB)** is responsible for setting standards and monitoring air quality across India. - It works under the **Ministry of Environment, Forest and Climate Change (MoEFCC)**. *Central air quality board* - There is **no specific agency** or board named "Central Air Quality Board" in India. - Air quality monitoring falls under the broader mandate of pollution control. *Central public works dept* - The **Central Public Works Department (CPWD)** is primarily involved in the construction and maintenance of government buildings and infrastructure. - It does **not have a mandate** for environmental monitoring like air quality. *None of the options* - This option is incorrect because the **Central Pollution Control Board** is the correct agency responsible for air quality monitoring. - There is a specific statutory organization fulfilling this role.

Q: In which of the following diseases is mass vaccination considered ineffective?

Tetanus. ***Correct: Tetanus*** - Mass vaccination is considered **ineffective** for tetanus because it is **not a communicable disease** transmitted person-to-person - Tetanus is caused by **Clostridium tetani** spores present in soil and environment - Since there is **no herd immunity** benefit, vaccinating large populations simultaneously does not break any chain of transmission - **Individual immunization** with tetanus toxoid is highly effective for personal protection, but this is different from mass vaccination strategies used for communicable diseases - The focus for tetanus prevention is on **universal immunization** and **wound management**, not mass campaigns *Incorrect: Measles* - Mass vaccination for measles is **highly effective** due to its person-to-person transmission - Achieving high vaccination coverage (>95%) provides **herd immunity** and can lead to **elimination** - The **MMR vaccine** is a cornerstone of mass immunization programs worldwide *Incorrect: Polio* - Mass vaccination campaigns (Pulse Polio) have been **extremely effective** in nearly eradicating polio globally - The disease spreads through the fecal-oral route, making mass vaccination crucial for breaking transmission chains - Both **OPV** and **IPV** provide individual and community protection through herd immunity *Incorrect: None of the options* - This is incorrect because tetanus is a clear example where mass vaccination strategy is ineffective due to lack of person-to-person transmission

Q: Which of the following is the mechanism of action of tetanospasmin ?

Inhibition of release of GABA and glycine. ***Inhibition of release of GABA and glycine*** - **Tetanospasmin** is a potent neurotoxin produced by *Clostridium tetani* that acts by blocking the release of inhibitory neurotransmitters, specifically **GABA (gamma-aminobutyric acid)** and **glycine**, from presynaptic terminals in the spinal cord and brainstem. - This inhibition leads to **uncontrolled muscle spasms**, rigidity, and convulsions, characteristic of tetanus, due to the lack of inhibitory signals to motor neurons. *Inhibition of Ach release from synapse* - This mechanism is characteristic of **botulinum toxin** (produced by *Clostridium botulinum*), not tetanospasmin. - Botulinum toxin inhibits the release of **acetylcholine (ACh)** at the neuromuscular junction, leading to flaccid paralysis. *Inhibition of protein synthesis* - This mechanism is associated with toxins like **diphtheria toxin** and **exotoxin A** from *Pseudomonas aeruginosa*. - These toxins inactivate elongation factor-2 (EF-2), thereby blocking protein synthesis and causing cell death. *Activation of adenylyl cyclase* - Toxins such as **cholera toxin** and **pertussis toxin** act by activating adenylyl cyclase, leading to an increase in intracellular cAMP levels. - This mechanism causes effects like severe diarrhea in cholera and respiratory symptoms in whooping cough.

Q: Orphan Annie nuclei are characteristic of which of the following?

Papillary thyroid carcinoma. ***Papillary carcinoma thyroid***[1][2] - Characterized by **Orphan Annie nuclei**[1], which are large and round with a clear or empty appearance due to the presence of intranuclear cytoplasmic inclusions[1]. - Often associated with **thyroid follicular structures** and is the most common type of thyroid cancer[2]. *Meningioma* - Typically presents with **dural-based tumors** and does not exhibit Orphan Annie nuclei. - Histologically, it may demonstrate **whorled patterns** or calcifications instead. *Carcinoma pituitary* - Involves **adenomatous changes** in the pituitary gland but does not demonstrate the characteristic Orphan Annie nuclei. - More commonly shows **varied cellular morphology** depending on the type of secretory cells (e.g., prolactin, ACTH). *Paraganglioma* - Derived from **neuroendocrine cells**, and presents with **zellballen pattern** rather than Orphan Annie nuclei. - Often shows **chromaffin cells** and is typically associated with catecholamine secretion. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, p. 1099. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 429-430.

Q: What is the name of the mumps vaccine?

Jeryl Lynn. ***Jeryl Lynn*** - The **Jeryl Lynn strain** is a widely used and highly effective **live attenuated mumps vaccine virus** found in many combined MMR (measles, mumps, rubella) vaccines. - It was developed by **Maurice Hilleman** and is known for its **low reactogenicity** and good safety profile. *Edmonston-Zagreb* - The **Edmonston-Zagreb strain** is a specific type of **live attenuated measles vaccine virus**, not mumps. - It is used in some combinations of the **MMR vaccine** but is distinct from the mumps component. *Schwarz* - The **Schwarz strain** is another variant of **live attenuated measles vaccine virus**, primarily distinguished by its passage history. - Like Edmonston-Zagreb, it targets **measles prevention** and is not used for mumps. *Moraten* - The **Moraten strain** is a specific **live attenuated measles vaccine virus** that is derived from the **Edmonston B strain**. - It is one of the most common measles vaccine strains, also used in **MMR vaccines**, but it does not protect against mumps.

Q: As per RNTCP guidelines, Multi drug resistance (MDR) TB is defined as resistance to:

Rifampicin and isoniazid. ***Rifampicin and isoniazid*** - According to **RNTCP guidelines** (now NTEP), **MDR-TB** is specifically defined as tuberculosis that is resistant to at least both **rifampicin** and **isoniazid**. - These two drugs are the **most potent first-line anti-TB medications**, and resistance to both significantly complicates treatment. *Rifampicin* - While resistance to **rifampicin alone** is a serious concern, it is classified as **rifampicin-resistant TB (RR-TB)**, not full **MDR-TB**. - **MDR-TB** requires resistance to at least two key first-line drugs. *Rifampicin, isoniazid and ethambutol* - Resistance to **rifampicin**, **isoniazid**, and **ethambutol** would be a form of **MDR-TB** (as it includes resistance to rifampicin and isoniazid), but it is a more extensive form of resistance. - The minimum definition of **MDR-TB** focuses on the two most crucial first-line drugs. *None of the above* - This option is incorrect because there is a specific definition for **MDR-TB** that aligns with one of the provided choices. - The guidelines clearly define **MDR-TB** based on resistance to specific drugs.

Q: What are the homes called where children are placed under the care of doctors and psychiatrists?

Residential treatment facilities. ***Residential treatment facilities*** - These facilities provide structured, live-in therapeutic environments where children and adolescents receive comprehensive psychiatric and medical care. - They are staffed by a multidisciplinary team including **psychiatrists**, psychologists, social workers, and nurses. *Foster care homes* - Foster care involves placing children with temporary families, usually due to neglect or abuse, focusing on a family-like setting rather than intensive medical or psychiatric care. - While foster children may receive mental health services, the homes themselves are not clinical environments. *Youth detention centers* - These facilities are for children and adolescents who have committed crimes and are awaiting trial or serving sentences. - While mental health services may be provided, their primary purpose is correctional, not therapeutic. *Child mental health clinics* - These clinics offer outpatient services, including diagnosis, therapy, and medication management, but do not provide residential care. - Children attend appointments and then return home, unlike the live-in care provided in residential facilities.

Question 1

What is the role of iodized salt in the iodine deficiency control programme?

Accepted Answer

Primary prevention of iodine deficiency

Answer

Secondary prevention of iodine deficiency

Answer

Tertiary prevention of iodine deficiency

Answer

Not applicable

Question 2

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 3

What does the net reproduction rate indicate?

Accepted Answer

Average number of daughters a newborn girl will have during her lifetime

Answer

Number of live births per 1000 mid-year population

Answer

Number of live births per 1000 women of child bearing age

Answer

None of the options

Question 4

Which agency monitors air quality in India?

Accepted Answer

Central pollution control board

Answer

None of the above

Answer

Central air quality board

Answer

Central public works dept

Question 5

In which of the following diseases is mass vaccination considered ineffective?

Accepted Answer

Tetanus

Answer

None of the options

Answer

Measles

Answer

Polio

Question 6

Which of the following is the mechanism of action of tetanospasmin ?

Accepted Answer

Inhibition of release of GABA and glycine

Answer

Inhibition of Ach release from synapse

Answer

Inhibition of protein synthesis

Answer

Activation of adenylyl cyclase

Question 7

Orphan Annie nuclei are characteristic of which of the following?

Accepted Answer

Papillary thyroid carcinoma

Answer

Paraganglioma with Zellballen pattern

Answer

Meningioma with psammoma bodies

Answer

Pituitary adenoma with atypical nuclei

Question 8

What is the name of the mumps vaccine?

Accepted Answer

Jeryl Lynn

Answer

Moraten

Answer

Edmonston-Zagreb

Answer

Schwarz

Question 9

As per RNTCP guidelines, Multi drug resistance (MDR) TB is defined as resistance to:

Accepted Answer

Rifampicin and isoniazid

Answer

Rifampicin

Answer

Rifampicin, isoniazid and ethambutol

Answer

None of the above

Question 10

What are the homes called where children are placed under the care of doctors and psychiatrists?

Accepted Answer

Residential treatment facilities

Answer

Foster care homes

Answer

Youth detention centers

Answer

Child mental health clinics

NEET-PG 2012

Community Medicine

Microbiology

Pathology

Pharmacology

Psychiatry