Forensic Medicine
1 questionsWhat is the first external sign of decomposition of a dead body?
NEET-PG 2012 - Forensic Medicine NEET-PG Practice Questions and MCQs
Question 731: What is the first external sign of decomposition of a dead body?
- A. Decomposition of liver and intestine
- B. Greenish discolouration over right iliac fossa (Correct Answer)
- C. Greenish discolouration over dependent parts
- D. Blood stained froth from mouth
Explanation: ***Greenish discolouration over right iliac fossa*** - The **first external sign of decomposition** is typically a **greenish discoloration** that appears over the **right iliac fossa**. - This occurs due to the breakdown of **hemoglobin** by bacteria, particularly *Clostridium perfringens*, in the **cecum**, which is located in this region. - It typically appears **12-24 hours after death** under normal environmental conditions. *Decomposition of liver and intestine* - While internal organs like the liver and intestine do decompose, their decomposition is an **internal process** and not the **first external sign**. - Internal putrefaction precedes external signs but is not visually observable from the exterior initially. *Greenish discolouration over dependent parts* - Greenish discolouration over dependent parts represents a **later stage of decomposition** when putrefactive changes spread throughout the body. - This occurs after the initial greenish discoloration in the right iliac fossa as bacterial action and gases spread from the intestines to other body regions. - This is NOT the first external sign but rather a progression of decomposition. *Blood stained froth from mouth* - **Blood-stained froth from the mouth** can be seen in various conditions, such as **drowning**, **pulmonary edema**, or certain types of poisoning, but it is not related to decomposition. - This finding is more indicative of the cause of death or agonal/perimortem changes rather than postmortem decomposition.
Microbiology
1 questionsUnsegmented eggs are in which parasite?
NEET-PG 2012 - Microbiology NEET-PG Practice Questions and MCQs
Question 731: Unsegmented eggs are in which parasite?
- A. Ancylostoma
- B. Necator americanus
- C. Dracunculus
- D. Trichuris trichiura (Correct Answer)
Explanation: ***Trichuris trichiura*** - *Trichuris trichiura* (whipworm) eggs are typically **unembryonated** or **unsegmented** when passed in feces. - Upon defecation, the eggs require a period of **development in soil** to become infective. *Ancylostoma* - **Hookworm (Ancylostoma)** eggs are typically **segmented** (possessing a 2-8 cell stage) when passed in feces. - They develop into **rhabditiform larvae** in the soil. *Necator americanus* - **Hookworm (Necator americanus)** eggs are also typically **segmented** (possessing a 2-8 cell stage) when passed in feces. - Like *Ancylostoma*, they require further development in soil to become infective. *Dracunculus* - *Dracunculus medinensis* (Guinea worm) does not lay eggs; instead, it releases **larvae** from the skin blister of the host into water. - The larvae are then ingested by **cyclops** (copepods) to continue their life cycle.
Obstetrics and Gynecology
1 questionsWhich of the following is not a recognized risk factor for endometrial carcinoma?
NEET-PG 2012 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 731: Which of the following is not a recognized risk factor for endometrial carcinoma?
- A. Infertility
- B. Obesity
- C. Smoking (Correct Answer)
- D. Tamoxifen
Explanation: ***Smoking*** - Smoking is generally not considered a risk factor for endometrial carcinoma; in fact, some studies suggest it may paradoxically **decrease risk** by altering estrogen metabolism. - While smoking is a known risk factor for many cancers, its effect on **estrogen-dependent cancers** like endometrial cancer is complex and often opposite to that of other cancers. *Obesity* - Obesity is a significant risk factor due to the increased peripheral conversion of **androgens to estrogens** in adipose tissue, leading to unopposed estrogen stimulation of the endometrium. - This **elevated estrogen exposure** promotes endometrial hyperplasia and increases the risk of malignant transformation. *Infertility* - Infertility, particularly anovulatory infertility, is often associated with **unopposed estrogen exposure** due to a lack of progesterone production. - This hormonal imbalance can lead to endometrial hyperplasia and an increased risk of developing endometrial cancer. *Tamoxifen* - Tamoxifen, a **selective estrogen receptor modulator (SERM)**, acts as an estrogen antagonist in breast tissue but as an estrogen agonist in the endometrium. - This estrogenic effect on the endometrium can lead to **endometrial hyperplasia** and increase the risk of endometrial cancer, particularly when used long-term.
Pathology
1 questionsGlomus tumor is seen in -
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 731: Glomus tumor is seen in -
- A. Rare locations such as retroperitoneum
- B. Long bones and vertebrae
- C. Proximal portion of digits (less common site)
- D. Distal portion of digits (Correct Answer)
Explanation: ***Distal portion of digits*** - **Glomus tumors** are most commonly found in the **distal extremities**, especially the **subungual region** (under the nail) of the fingers and toes. - This location accounts for over 75% of all glomus tumors, where they originate from specialized **neuromyoarterial glomus bodies** involved in thermoregulation. - The classic clinical triad includes **paroxysmal pain, point tenderness, and cold sensitivity**. *Rare locations such as retroperitoneum* - While glomus tumors can occur in unusual sites, the **retroperitoneum** is an exceptionally rare location for primary glomus tumors. - Extradigital glomus tumors account for approximately 25% of cases and can occur in various soft tissue sites. *Long bones and vertebrae* - Glomus tumors do not typically arise in **bone tissue** as they originate from glomus bodies in soft tissue. - Bone involvement, when present, is usually secondary due to pressure erosion from an adjacent soft tissue tumor rather than primary bone origin. *Proximal portion of digits (less common site)* - While glomus tumors can occasionally be found in less common digital locations, the **proximal portion of digits** is significantly less frequent than the distal, and particularly the subungual, region. - Their primary association remains with the **distal phalanx** and nail bed.
Pharmacology
6 questionsWhat is the iodine content percentage in amiodarone?
Which of the following medications is known to cause increased renin levels with prolonged use?
Which of the following is NOT caused by Prostaglandin E2 (PGE2)?
Extrapyramidal syndrome-like side effects are seen in which of the following medications?
Which of the following is a selective progesterone receptor modulator?
Finasteride is classified as a:
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 731: What is the iodine content percentage in amiodarone?
- A. 10 - 20%
- B. 20 - 40% (Correct Answer)
- C. 40 - 60%
- D. 60 - 80%
Explanation: ***20 - 40%*** - **Amiodarone** is highly lipophilic and contains a significant amount of **iodine**, typically comprising around **37.5%** of its molecular weight. - This high iodine content is responsible for many of its **adverse effects**, particularly those related to thyroid dysfunction. *10 - 20%* - This range is too low; the actual iodine content in **amiodarone** is considerably higher, making it a prominent feature of the drug's chemical structure. - A lower iodine percentage would likely result in fewer **thyroid-related side effects**. *40 - 60%* - While amiodarone has a high iodine content, 40-60% is slightly above the generally accepted range. - Iodine constitutes a substantial but not an overwhelming majority of the drug's molecular mass. *60 - 80%* - This range is significantly higher than the actual iodine content in **amiodarone**. - Such a high percentage would imply an even greater propensity for **iodine-induced adverse effects**.
Question 732: Which of the following medications is known to cause increased renin levels with prolonged use?
- A. Clonidine
- B. Enalapril (Correct Answer)
- C. Methyldopa
- D. Propranolol
Explanation: ***Enalapril*** - **Enalapril** is an **ACE inhibitor** which blocks the conversion of angiotensin I to angiotensin II, leading to decreased levels of angiotensin II [1]. - Reduced angiotensin II levels remove the **negative feedback** on renin release from the juxtaglomerular cells, thus increasing renin secretion [1], [2]. *Clonidine* - Clonidine is a **central alpha-2 adrenergic agonist** that reduces sympathetic outflow from the central nervous system. - This reduction in sympathetic activity leads to a **decrease in renin release**, as sympathetic stimulation normally promotes renin secretion [3]. *Methyldopa* - Methyldopa is a **central alpha-2 adrenergic agonist** that works similarly to clonidine by reducing sympathetic tone. - It consequently causes a **decrease in plasma renin activity** due to reduced sympathetic stimulation of the juxtaglomerular apparatus [3]. *Propranolol* - Propranolol is a **non-selective beta-blocker** that blocks beta-1 receptors in the juxtaglomerular cells of the kidney. - This blockade **inhibits the release of renin** stimulated by sympathetic activity, leading to reduced renin levels [3].
Question 733: Which of the following is NOT caused by Prostaglandin E2 (PGE2)?
- A. None of the options (Correct Answer)
- B. Water retention
- C. Flushing
- D. Uterine contraction
Explanation: ***None of the options*** - All three listed effects (water retention, uterine contraction, and flushing) **ARE caused by Prostaglandin E2 (PGE2)**, making this the correct answer to the question asking what is NOT caused by PGE2. - Since PGE2 actually causes all the listed effects, "None of the options" is the accurate response. *Water retention* - PGE2 **stimulates ADH (vasopressin) release** from the posterior pituitary gland. - PGE2 also **enhances ADH action** on renal collecting ducts, promoting water reabsorption. - While PGE2 has complex renal effects including natriuresis, its net effect includes **promoting water retention** through the ADH mechanism. - This is an important effect of PGE2 on fluid balance. *Uterine contraction* - PGE2 is a **potent stimulator of uterine smooth muscle contraction**. - It is used clinically for **labor induction** and **cervical ripening** (dinoprostone). - PGE2 plays a crucial role in **parturition** and is involved in **dysmenorrhea**. *Flushing* - PGE2 causes **peripheral vasodilation**, particularly in cutaneous blood vessels. - This vasodilatory effect leads to **increased skin blood flow**, manifesting as **flushing** and warmth. - This is commonly seen as part of the **inflammatory response** and contributes to erythema.
Question 734: Extrapyramidal syndrome-like side effects are seen in which of the following medications?
- A. Haloperidol (Correct Answer)
- B. Clozapine
- C. Tetracycline
- D. Ketoconazole
Explanation: ***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**.
Question 735: Which of the following is a selective progesterone receptor modulator?
- A. Onapristone
- B. Ulipristal (Correct Answer)
- C. Nomegestrol
- D. Toremifene
Explanation: ***Ulipristal*** - **Ulipristal acetate** is a **selective progesterone receptor modulator (SPRM)** that acts as a progesterone receptor agonist/antagonist. - It is primarily used for **emergency contraception** and for the pre-operative treatment of **uterine fibroids**. *Onapristone* - **Onapristone** is an **antiprogestin** and a **progesterone receptor antagonist**, not a selective modulator. - It has been primarily investigated for its potential role in **breast cancer** treatment but is not approved for general clinical use. *Nomegestrol* - **Nomegestrol** is a **synthetic progestin** used in hormonal contraception. - It functions as a **progesterone receptor agonist** and does not exhibit selective modulation properties. *Toremifene* - **Toremifene** is a **selective estrogen receptor modulator (SERM)**, not a progesterone receptor modulator. - It is used in the treatment of **estrogen receptor-positive metastatic breast cancer** in postmenopausal women.
Question 736: Finasteride is classified as a:
- A. 5-alpha reductase inhibitor (Correct Answer)
- B. Phosphodiesterase inhibitor
- C. Alpha-1 blocker
- D. Androgen receptor antagonist
Explanation: ### ***5-alpha reductase inhibitor*** - **Finasteride** specifically inhibits the enzyme **5-alpha reductase**, preventing the conversion of **testosterone** to **dihydrotestosterone (DHT)** [2], [4]. - This reduction in DHT is clinically useful for treating conditions like **benign prostatic hyperplasia (BPH)** and **androgenetic alopecia** [4]. ### *Phosphodiesterase inhibitor* - **Phosphodiesterase inhibitors** (e.g., sildenafil) typically work by increasing levels of **cyclic GMP**, leading to **vasodilation** and are used for **erectile dysfunction** [3]. - Their mechanism of action is distinct from finasteride's effect on **hormone metabolism**. ### *Alpha-1 blocker* - **Alpha-1 blockers** (e.g., tamsulosin) primarily relax **smooth muscle** in the prostate and bladder neck, improving **urine flow** in BPH [3], [5]. - They act on **adrenergic receptors** and do not affect **hormone synthesis** or **metabolism** [3]. ### *Androgen receptor antagonist* - **Androgen receptor antagonists** (e.g., flutamide) directly block the binding of **androgens** (like testosterone and DHT) to their receptors [1], [4]. - While they also affect androgen action, their mechanism is different from finasteride's **enzyme inhibition** [4].