NEET-PG 2012 Practice Questions

Q: In which of the following conditions is a Barr body absent in females?

45 X0 genome. ***45 X0 genome*** - A Barr body is a **condensed, inactivated X chromosome** found in somatic cells of females with at least two X chromosomes. - Individuals with a **45 X0 genome** (Turner Syndrome) have only one X chromosome, therefore no Barr body is formed. *46 XX genome* - Individuals with a **46 XX genome** are typical females and will have one Barr body per somatic cell, as one of the two X chromosomes is inactivated. - This is the normal female karyotype. *47 XXX* - Individuals with a **47 XXX genome** (triple X syndrome) have two Barr bodies per somatic cell, as two of their three X chromosomes are inactivated. - The number of Barr bodies is typically one less than the number of X chromosomes. *None of the options* - This option is incorrect because the 45 X0 genome indeed leads to the absence of a Barr body in females. - There is a specific condition listed among the options where a Barr body is absent.

Q: Which of the following statements about Sickle Cell Anemia is FALSE?

Patients usually present before the age of 6 months. ***Patients usually present before the age of 6 months*** - This statement is **FALSE** because sickle cell anemia patients typically become symptomatic **after 6 months of age**, when **fetal hemoglobin (HbF)** levels decline. - **HbF is protective** against sickling, so symptoms like **dactylitis** and **splenic sequestration** usually manifest once HbF is replaced by HbS. *There is a positive correlation between HBS and polymerization of HBS* - This statement is **TRUE** as higher levels of **hemoglobin S (HbS)** lead to increased **polymerization** and sickling of red blood cells. - The **polymerization of deoxygenated HbS** is the primary pathophysiologic mechanism causing vaso-occlusive crises and hemolysis. *Recurrent infections is the most common cause of death* - This statement is **TRUE**, particularly in children with sickle cell anemia due to **functional asplenia** from repeated splenic infarctions. - **Splenic dysfunction** impairs clearance of **encapsulated bacteria**, increasing risk of severe infections like **pneumococcal sepsis** and **meningitis**. *Patients require frequent blood transfusions* - This statement is **TRUE** as **chronic transfusion therapy** is a standard treatment for managing severe complications and preventing stroke. - Transfusions help **suppress HbS production**, dilute existing sickle cells, and reduce the frequency of **vaso-occlusive crises**.

Q: Which of the following diseases is NOT associated with Anti-Neutrophil Cytoplasmic Antibodies (ANCA)?

Henoch schonlein purpura. ***Henoch schonlein purpura*** - **Henoch-Schönlein purpura (HSP)** is not associated with **ANCA**; it primarily involves IgA deposition [1]. - Commonly presents with **purpura**, **abdominal pain**, and **glomerulonephritis**, differentiating it from ANCA-associated vasculitides [1]. *Wegener's granulomatosis* - **Wegener's granulomatosis**, now known as **Granulomatosis with polyangiitis**, is strongly associated with **c-ANCA** and anti-PR3 antibodies. - It typically presents with **respiratory** and **renal symptoms** due to vasculitis [2]. *Microscopic PAN* - **Microscopic polyangiitis (PAN)** is associated with **p-ANCA** and myeloperoxidase (MPO) antibodies. - It leads to **glomerulonephritis** and **pulmonary hemorrhage**, indicating its vasculitic nature. *Churg Strauss syndrome* - **Churg-Strauss syndrome**, or **Eosinophilic Granulomatosis with Polyangiitis**, is associated with **p-ANCA** and perinuclear staining [1]. - Often presents with **asthma**, **eosinophilia**, and systemic vasculitis affecting multiple organs [1].

Q: Hypophosphatemia is seen in:

Hyperparathyroidism. ***Hyperparathyroidism*** - In **primary hyperparathyroidism**, the excess **parathyroid hormone (PTH)** leads to increased phosphate excretion by the kidneys [1], [4]. - This results in **hypophosphatemia** as the body attempts to maintain **calcium-phosphate balance**, often at the expense of phosphate levels [1]. *Hyperthyroidism* - While hyperthyroidism can affect **bone metabolism**, it is typically associated with **normal or slightly elevated phosphate levels**, not hypophosphatemia [3]. - The main electrolyte disturbances are usually related to **calcium** (e.g., hypercalcemia) due to increased bone turnover [3]. *Hypoparathyroidism* - **Hypoparathyroidism** is characterized by **low or absent PTH**, leading to decreased renal phosphate excretion. - This results in **hyperphosphatemia**, along with **hypocalcemia** [2]. *Pseudohypoparathyroidism* - In **pseudohypoparathyroidism**, there is **PTH resistance** at target tissues, even with high or normal PTH levels [2]. - This leads to symptoms resembling hypoparathyroidism, including **hyperphosphatemia** and **hypocalcemia** [2].

Q: A pregnant woman is diagnosed with Graves' disease. The most appropriate therapy for her would be:

Propylthiouracil oral. ***Propylthiouracil oral*** - **Propylthiouracil (PTU)** is the preferred antithyroid drug during the **first trimester** of pregnancy due to a lower risk of teratogenicity compared to methimazole/carbimazole [1]. - It works by inhibiting both the synthesis of thyroid hormones and the peripheral conversion of **T4 to T3**. *Radioiodine therapy* - **Radioactive iodine** is absolutely contraindicated in pregnancy as it can cross the placenta and cause **fetal hypothyroidism or athyreosis**. - It leads to permanent destruction of the thyroid gland and is not suitable for a temporary condition in a pregnant woman. *Total thyroidectomy* - While thyroidectomy can be considered for Graves' disease in pregnancy, it is generally reserved for cases where antithyroid drugs are not tolerated or ineffective, or for very large goiters causing compressive symptoms. - It carries risks associated with **surgery and anesthesia** during pregnancy, and requires **lifelong thyroid hormone replacement**. *Carbimazole parenteral* - **Carbimazole** (which is metabolized to methimazole) is generally avoided in the **first trimester** due to an increased risk of teratogenicity, particularly **aplasia cutis**, omphalocele, and choanal atresia [1]. - While it can be used in the second and third trimesters, **PTU is preferred in the first trimester**, and carbimazole is not typically administered parenterally.

Q: Most common bacterial cause of acute parotitis -

Staphylococcus Aureus. ***Staphylococcus Aureus*** - **_Staphylococcus aureus_** is the most frequent bacterial pathogen isolated in cases of **acute bacterial parotitis**. [2] - It often causes ascending infection from the oral cavity, leading to inflammation and suppuration of the parotid gland. [1] *Streptococcus Pneumonia* - While **_Streptococcus pneumoniae_** can cause various infections, it is not the primary cause of acute bacterial parotitis. - Its infections more commonly manifest as **pneumonia**, otitis media, or meningitis. *Klebsiella* - **_Klebsiella_** species are typically associated with **nosocomial infections**, particularly urinary tract infections and pneumonia. - They are a relatively uncommon cause of acute parotitis compared to _S. aureus_. *Streptococcus Viridans* - **_Streptococcus viridans_** group bacteria are common commensal organisms of the oral cavity and are often implicated in **dental caries** and **endocarditis**. - They are not a usual cause of acute bacterial parotitis.

Q: In the context of blunt trauma affecting the entire body, what is the estimated daily nitrogen loss in grams due to protein metabolism?

Approximately 35 grams. ***Approximately 35 grams*** - In **severe trauma**, such as blunt trauma affecting the entire body, the body undergoes a significant stress response leading to marked **protein catabolism**. Approximately **35 grams of nitrogen** can be lost daily under such conditions. - This represents a highly catabolic state where muscle protein is broken down to provide amino acids for energy and synthesis of acute-phase proteins, impacting overall nitrogen balance. *Approximately 45 grams* - While severe trauma does lead to substantial nitrogen loss, **45 grams** would typically indicate an even more extreme or prolonged catabolic state, which is less common in the initial stages of post-trauma protein metabolism than 35 grams. - Such a high nitrogen loss might be seen in very extensive burns or sepsis, which are different clinical contexts. *Approximately 55 grams* - A daily nitrogen loss of **55 grams** is beyond what is commonly observed even in severe, whole-body blunt trauma. This level of catabolism would likely be unsustainable or indicative of a rare, super-catabolic condition. - This magnitude of protein breakdown would lead to rapid and severe muscle wasting and organ dysfunction if sustained. *Approximately 65 grams* - Losing **65 grams of nitrogen** per day is an exceptionally high rate of protein catabolism, rarely, if ever, observed in blunt trauma alone. - This level of protein breakdown would represent a profound and life-threatening metabolic derangement, far exceeding typical post-trauma responses.

Q: Parrot beak appearance is seen in which of the following conditions?

Volvulus. ***Volvulus*** - A **parrot beak** appearance, or bird's beak sign, is characteristic of a **volvulus** on barium enema or CT imaging, representing the twisted lumen of the bowel. - This finding indicates a **torsion** of a segment of the bowel, which can lead to obstruction and ischemia. *Intussusception* - Intussusception typically presents with a **"target sign"** or **"donut sign"** on ultrasound, indicating concentric layers of bowel within bowel. - The classic presentation is a **"currant jelly stool"** and a palpable **sausage-shaped mass**. *Rectal atresia* - Rectal atresia involves a **complete blockage** or absence of the rectum, preventing passage of stool. - Imaging typically shows a **dilated colon** proximal to the atretic segment, without a specific "parrot beak" appearance. *CA colon* - Colon cancer (CA colon) appears as a **filling defect** or an **"apple core" lesion** on barium enema due to tumoral constriction. - It does not present with a "parrot beak" sign, which is indicative of a twisted bowel segment.

Q: The term 'raspberry tumor' is most commonly associated with which of the following conditions?

Umbilical granuloma. ***Umbilical granuloma*** - An **umbilical granuloma** is a common condition in newborns, presenting as a soft, red, moist growth at the umbilicus after the umbilical cord detaches. - Its characteristic appearance, resembling a small red berry, has led to the descriptive term "**raspberry tumor**." *Umbilical fistula* - An **umbilical fistula** is an abnormal connection that can occur between the intestine or bladder and the umbilicus, leading to the discharge of stool or urine from the umbilicus. - It does not present as a fleshy, raspberry-like growth, but rather as an opening with discharge. *Meckel’s diverticulum* - **Meckel's diverticulum** is a remnant of the **vitelline duct**, typically found on the anti-mesenteric border of the ileum, and is a congenital anomaly of the small intestine. - It is an internal structure and does not manifest externally at the umbilicus as a "raspberry tumor." *Umbilical adenoma* - An **umbilical adenoma** is a rare tumor of the umbilicus, often a remnant of the **vitelline duct** or **urachus**, which can present as a reddish mass. - While it can be a reddish mass, the specific term "raspberry tumor" is not commonly associated with umbilical adenoma but rather with umbilical granuloma due to its very distinct granular appearance.

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.

Question 1

In which of the following conditions is a Barr body absent in females?

Accepted Answer

45 X0 genome

Answer

46 XX genome

Answer

47 XXX

Answer

None of the options

Question 2

Which of the following statements about Sickle Cell Anemia is FALSE?

Accepted Answer

Patients usually present before the age of 6 months

Answer

There is a positive correlation between HBS and polymerization of HBS

Answer

Recurrent infections is the most common cause of death

Answer

Patients require frequent blood transfusions

Question 3

Which of the following diseases is NOT associated with Anti-Neutrophil Cytoplasmic Antibodies (ANCA)?

Accepted Answer

Henoch schonlein purpura

Answer

Wegener's granulomatosis

Answer

Microscopic PAN

Answer

Churg Strauss syndrome

Question 4

Hypophosphatemia is seen in:

Accepted Answer

Hyperparathyroidism

Answer

Hyperthyroidism

Answer

Hypoparathyroidism

Answer

Pseudohypoparathyroidism

Question 5

A pregnant woman is diagnosed with Graves' disease. The most appropriate therapy for her would be:

Accepted Answer

Propylthiouracil oral

Answer

Radioiodine therapy

Answer

Total thyroidectomy

Answer

Carbimazole parenteral

Question 6

Most common bacterial cause of acute parotitis -

Accepted Answer

Staphylococcus Aureus

Answer

Klebsiella

Answer

Streptococcus Viridans

Answer

Streptococcus Pneumoniae

Question 7

In the context of blunt trauma affecting the entire body, what is the estimated daily nitrogen loss in grams due to protein metabolism?

Accepted Answer

Approximately 35 grams

Answer

Approximately 45 grams

Answer

Approximately 55 grams

Answer

Approximately 65 grams

Question 8

Parrot beak appearance is seen in which of the following conditions?

Accepted Answer

Volvulus

Answer

Rectal atresia

Answer

CA colon

Answer

Intussusception

Question 9

The term 'raspberry tumor' is most commonly associated with which of the following conditions?

Accepted Answer

Umbilical granuloma

Answer

Umbilical fistula

Answer

Meckel’s diverticulum

Answer

Umbilical adenoma

Question 10

Best gas used for creating pneumoperitoneum at laparoscopy is:

Accepted Answer

CO2

Answer

N2

Answer

N2O

Answer

O2

NEET-PG 2012

Biochemistry

Internal Medicine

Microbiology

Physiology

Radiology

Surgery