NEET-PG 2012 Practice Questions

Q: Which of the following statements about spider telangiectasia is false?

More common in males. ***More common in males*** - This statement is **FALSE** because spider telangiectasias (spider nevi/spider angiomas) are more commonly observed in **females**, often due to hormonal influences like **estrogen**. - They are frequently associated with conditions such as **pregnancy**, **oral contraceptive use**, or **chronic liver disease**, highlighting a female predominance. - The estrogen-dependent nature explains their higher prevalence in women of reproductive age. *Can be caused by trauma* - This statement is **TRUE** in a broader sense, though classical spider telangiectasias are primarily hormonally-mediated rather than traumatic. - While **simple telangiectasias** can develop after localized trauma or repeated pressure, spider telangiectasias have a characteristic morphology (central arteriole with radiating vessels) and are typically associated with **estrogen excess** or **liver disease**. - For exam purposes, this is considered a true statement as telangiectatic vessels can be influenced by local factors. *Light therapy for treatment* - This statement is **TRUE**. **Laser therapy**, specifically **pulsed dye laser (PDL)** or **intense pulsed light (IPL)**, is the most effective treatment for spider telangiectasias. - The laser selectively targets **hemoglobin** in the dilated vessels, causing photocoagulation and vessel obliteration, leading to excellent cosmetic results. *May be associated with liver disease* - This statement is **TRUE**. Spider telangiectasias are a well-recognized cutaneous manifestation of **chronic liver disease**, especially **cirrhosis**. - Impaired hepatic function leads to decreased **estrogen metabolism** (hyperestrogenemia), contributing to the development of these vascular lesions. - They are one of the stigmata of chronic liver disease, along with palmar erythema and gynecomastia.

Q: Loss of intercellular cohesion between keratinocytes is referred to as?

Acantholysis. ***Acantholysis*** - This term specifically refers to the **loss of cohesion between keratinocytes** in the epidermis due to the breakdown of desmosomal attachments. - It is a hallmark feature of several **blistering skin diseases**, such as pemphigus. *Acanthosis* - This refers to the **thickening of the stratum spinosum** (prickle cell layer) of the epidermis, often due to an increase in the number of keratinocytes. - It is seen in conditions like **psoriasis** and seborrheic keratosis, but does not involve a loss of intercellular cohesion. *Keratinolysis* - This term describes the **breakdown or dissolution of keratin**, which is the primary structural protein of the epidermis. - While keratinocytes produce keratin, keratinolysis itself is not the specific term for loss of cohesion between these cells. *Spongiosis* - This is defined as **intercellular edema** (fluid accumulation) within the epidermis, especially prominent in the stratum spinosum. - It leads to the widening of intercellular spaces and stretching of desmosomes, but the cells generally remain attached, unlike in acantholysis.

Q: Which of the following is a recognized method for the delivery of the after-coming head of a breech?

Mauriceau-Smellie-Veit maneuver. ***Mauriceau-Smellie-Veit maneuver*** - The **Mauriceau-Smellie-Veit maneuver** is the **gold standard** and most widely recognized method for delivering the after-coming head in breech delivery. - The technique involves the accoucheur placing the **index and middle fingers over the maxilla** (malar eminence) to flex the fetal head, while the fetal body rests on the forearm. - An assistant applies **suprapubic pressure** to maintain flexion of the fetal head. - This method provides excellent **control of the fetal head** and maintains proper flexion to prevent extension and facilitate safe delivery. *Burns and Marshall method* - The **Burns-Marshall method** is also a recognized technique for assisted breech delivery, but it is typically used when the body delivers spontaneously. - This method involves holding the fetal feet and allowing the baby to hang by its own weight, promoting flexion, then sweeping the baby upward over the maternal abdomen. - While valid, it is generally considered an **alternative** to the Mauriceau-Smellie-Veit maneuver rather than the primary method. *Forceps method* - **Piper forceps** are specifically designed for the after-coming head and are a recognized method, particularly when manual methods fail or in cases of **fetal distress**. - However, forceps application requires specific expertise and may not be the first-line approach in all settings. - When used appropriately, forceps provide controlled delivery and protect the fetal head. *Malar flexion and shoulder traction* - This is **not a recognized standard method** as described. - While malar pressure is used in the Mauriceau-Smellie-Veit maneuver, **shoulder traction** is dangerous and can cause **brachial plexus injury**, **Erb's palsy**, or **spinal cord damage**. - Traction should never be applied to the shoulders during breech delivery.

Q: What is the treatment for uterine prolapse in nulliparous women?

Manchester operation. ***Manchester operation*** - This procedure is sometimes considered for **nulliparous women** with uterine prolapse, particularly if combined with cervical elongation. - It involves **amputation of the cervix** and support of the cardinal ligaments, which can address the prolapse while preserving uterine function. *Sling used involving rectus sheath* - A sling using the rectus sheath is typically employed for **stress urinary incontinence**, not primarily for uterine prolapse. - While it supports the urethra and bladder neck, it does not directly address the descent of the uterus. *Anterior colporrhaphy* - This procedure repairs a **cystocele** (prolapse of the bladder into the vagina) by tightening the anterior vaginal wall. - It does not directly manage **uterine prolapse** itself, though a cystocele can coexist with uterine descent. *Posterior colporrhaphy* - This surgical repair targets a **rectocele** (prolapse of the rectum into the vagina) by tightening the posterior vaginal wall. - Similar to anterior colporrhaphy, it addresses a specific vaginal wall defect rather than the **uterine position**.

Q: Palmer sign is related to ?

Uterine contractions palpable through rectum during labor. ***Uterine contractions palpable through rectum during labor*** - **Palmer sign** refers to the palpation of **uterine contractions** through the rectum, particularly during the early stages of labor or even in simulated labor pains. - This sign is an indicator used to assess uterine activity, especially when vaginal examination might be less informative or desired. *Softening of the cervix during pregnancy* - This describes **Goodell's sign**, which is caused by increased vascularity and edema of the cervix during early pregnancy. - While an important sign of pregnancy, it is not referred to as Palmer sign. *Bluish discoloration of cervix and vagina* - This phenomenon is known as **Chadwick's sign**, resulting from increased blood flow to the reproductive organs during pregnancy. - It is an early indication of pregnancy but distinct from the uterine contraction palpation. *Increased pulsations in uterine arteries* - This is known as **Osiander’s sign** or **uterine souffle**, characterized by a soft blowing sound over the uterus due to increased blood flow through the uterine arteries. - It is a vascular sign of pregnancy and not related to uterine contractions felt rectally.

Q: Decidual reaction is due to which hormone?

Progesterone. ***Progesterone*** - The **decidual reaction** is a specific uterine stromal cell differentiation process that prepares the endometrium for **implantation and pregnancy maintenance**. - This process is primarily induced and maintained by **progesterone**, which causes stromal cells to enlarge, accumulate glycogen and lipids, and secrete various factors essential for embryonic development. *Estrogen* - Estrogen plays a crucial role in the **proliferation of the endometrium** during the follicular phase, building up the uterine lining. - While estrogen is essential, it acts in conjunction with progesterone; progesterone is the **primary hormone** responsible for the decidualization process itself. *LH* - Luteinizing hormone (LH) is responsible for triggering **ovulation** and stimulating the corpus luteum to produce progesterone. - LH's direct role is not in the decidual reaction of the endometrium but rather in the **ovarian events** that lead to the production of the hormones that cause decidualization. *FSH* - Follicle-stimulating hormone (FSH) is vital for the growth and maturation of **ovarian follicles** and **estrogen production**. - FSH does not directly induce the decidual reaction but facilitates the production of estrogen, which then contributes to endometrial proliferation, a precursor to progesterone's decidualizing effect.

Q: What is the maximum cumulative dose of isotretinoin for acne treatment?

120-150 mg/kg. ***120-150 mg/kg*** - The goal of **isotretinoin cumulative dosing** is to achieve long-term remission and reduce the risk of relapse. - A cumulative dose in the range of **120-150 mg/kg** has been shown to optimize treatment outcomes for severe or recalcitrant acne. *30-60 mg/kg* - This range is typically considered too low to achieve the optimal **cumulative dose** for sustained remission in severe acne. - Doses within this range might be used in some cases for milder forms of acne or in patients with significant side effects, but not as the standard maximum. *60-90 mg/kg* - While this is closer to an effective cumulative dose, it still often falls short of the recommended range for maximizing the long-term efficacy and reducing relapse rates in patients with severe forms of acne. - Studies suggest that higher cumulative doses correlate with better treatment success and fewer recurrences. *90-120 mg/kg* - This range is often considered a minimal target for a **cumulative dose**, especially at the higher end of the range (120 mg/kg). - While effective for many patients, aiming for the upper end (120-150 mg/kg) often provides a more robust and durable response, particularly in more severe or nodular acne.

Q: All of the following are correct about ketamine, EXCEPT which of the following?

It is a potent bronchoconstrictor. ***It is a potent bronchoconstrictor*** - **Ketamine** is known for its **bronchodilatory properties**, making it a suitable anesthetic for patients with asthma or reactive airway disease, rather than a bronchoconstrictor [1]. - Its ability to relax bronchial smooth muscle is mediated, in part, by its indirect sympathetic stimulation and direct effects on airways. *It functionally "dissociates" the thalamus* - Ketamine's mechanism of action involves **N-methyl-D-aspartate (NMDA) receptor antagonism**, which leads to a "dissociative" state [2]. - This results in a functional separation between the **thalamoneocortical** and **limbic systems**, explaining its unique anesthetic effects. *It increases arterial blood pressure* - Ketamine typically causes an **increase in heart rate** and **arterial blood pressure** due to its sympathomimetic effects. - This is achieved through the release of **endogenous catecholamines**, which stimulate the cardiovascular system. *It inhibits polysynaptic reflexes in the spinal cord* - Ketamine acts as a powerful **analgesic** by inhibiting ascending **polysynaptic reflexes** in the spinal cord. - This contributes to its ability to provide profound **pain relief** separate from its anesthetic effects [2].

Q: Which drug is commonly used for outpatient department (OPD) analgesia?

Paracetamol. ***Paracetamol*** - It is a widely used and generally **safe analgesic** and antipyretic often prescribed for mild to moderate pain in an outpatient setting. - Its favorable side effect profile and availability as an **over-the-counter (OTC)** medication make it a first-choice drug for many common pain conditions. *Diclofenac* - While it is an effective NSAID used for pain and inflammation, its use can be associated with **gastrointestinal side effects** like ulcers and bleeding, as well as cardiovascular risks. - It is often reserved for more significant inflammatory pain or when other analgesics are insufficient, and may require more careful monitoring in an outpatient setting. *Ibuprofen* - Similar to diclofenac, Ibuprofen is an **NSAID** which is effective for pain and inflammation. However, it also carries risks of **gastrointestinal irritation** and renal side effects, especially with prolonged use or in certain patient populations. - While available OTC, its use for routine outpatient analgesia may be less preferred than paracetamol in some cases due to its GI and renal side effect profile. *Tramadol* - Tramadol is a **central acting opioid analgesic** with a higher potential for side effects such as nausea, dizziness, constipation, and the risk of dependence or abuse. - It is typically reserved for moderate to severe pain that is not adequately managed by non-opioid analgesics, and its prescription often involves more stringent monitoring than paracetamol.

Q: Which of the following techniques uses piezoelectric crystals?

Ultrasonography. ***Ultrasonography*** - **Piezoelectric crystals** are the core component of **ultrasound transducers**, which generate and detect ultrasonic waves. - These crystals convert electrical energy into mechanical vibrations (sound waves) and vice-versa, allowing for the creation of images. *NMR imaging* - **NMR imaging** (Nuclear Magnetic Resonance, now commonly known as **MRI**) uses strong magnetic fields and **radiofrequency pulses** to generate images. - It relies on the magnetic properties of atomic nuclei, particularly hydrogen, rather than piezoelectric effects. *X-ray diffraction* - **X-ray diffraction** is a technique used to study the atomic and molecular structure of materials, and it involves the interaction of **X-rays** with the electron clouds of atoms. - It does not involve piezoelectric crystals; instead, it uses an X-ray source and a detector to measure diffracted X-rays. *Xeroradiography* - **Xeroradiography** is an older imaging technique that used **xerographic plates** coated with a photoconductive material (like selenium) to capture X-ray images. - It relies on electrostatic charges and dry development rather than piezoelectric crystals to produce images.

Question 1

Which of the following statements about spider telangiectasia is false?

Accepted Answer

More common in males

Answer

Light therapy for treatment

Answer

May be associated with liver disease

Answer

Can be caused by trauma

Question 2

Loss of intercellular cohesion between keratinocytes is referred to as?

Accepted Answer

Acantholysis

Answer

Acanthosis

Answer

Keratinolysis

Answer

Spongiosis

Question 3

Which of the following is a recognized method for the delivery of the after-coming head of a breech?

Accepted Answer

Mauriceau-Smellie-Veit maneuver

Answer

Burns and Marshall method

Answer

Malar flexion and shoulder traction

Answer

Forceps method

Question 4

What is the treatment for uterine prolapse in nulliparous women?

Accepted Answer

Manchester operation

Answer

Anterior colporrhaphy

Answer

Posterior colporrhaphy

Answer

Sling used involving rectus sheath

Question 5

Palmer sign is related to ?

Accepted Answer

Uterine contractions palpable through rectum during labor

Answer

Increased pulsations in uterine arteries

Answer

Bluish discoloration of cervix and vagina

Answer

Softening of the cervix during pregnancy

Question 6

Decidual reaction is due to which hormone?

Accepted Answer

Progesterone

Answer

Estrogen

Answer

LH

Answer

FSH

Question 7

What is the maximum cumulative dose of isotretinoin for acne treatment?

Accepted Answer

120-150 mg/kg

Answer

30-60 mg/kg

Answer

60-90 mg/kg

Answer

90-120 mg/kg

Question 8

All of the following are correct about ketamine, EXCEPT which of the following?

Accepted Answer

It is a potent bronchoconstrictor

Answer

It increases arterial blood pressure

Answer

It inhibits polysynaptic reflexes in the spinal cord

Answer

It functionally "dissociates" the thalamus

Question 9

Which drug is commonly used for outpatient department (OPD) analgesia?

Accepted Answer

Paracetamol

Answer

Diclofenac

Answer

Ibuprofen

Answer

Tramadol

Question 10

Which of the following techniques uses piezoelectric crystals?

Accepted Answer

Ultrasonography

Answer

NMR imaging

Answer

X-ray diffraction

Answer

Xeroradiography

NEET-PG 2012

Dermatology

Obstetrics and Gynecology

Pharmacology

Radiology