Dermatology
5 questionsWhich of the following causes non-cicatricial alopecia?
Brown macular pigmentation in malar area in a pregnant female is due to ?
Lines of Blaschko are related to?
Characteristic of chronic eczema?
A 40 year old male reported with recurrent episodes of oral ulcers, large areas of denuded skin and flaccid vesiculo-bullous eruptions. Which is the most important bedside investigation helpful in establishing the diagnosis -
NEET-PG 2013 - Dermatology NEET-PG Practice Questions and MCQs
Question 1201: Which of the following causes non-cicatricial alopecia?
- A. Tinea capitis
- B. SLE
- C. Alopecia areata
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - **Tinea capitis**, **SLE** (Systemic Lupus Erythematosus), and **Alopecia areata** all can cause **non-cicatricial alopecia**. - **Non-cicatricial alopecia** refers to hair loss where the hair follicle is not permanently destroyed, and hair regrowth is possible, leaving no scarring. *Tinea capitis* - This is a **fungal infection** of the scalp that causes hair shafts to break, leading to patches of hair loss. - While it can lead to inflammation, it typically does not cause permanent destruction of the hair follicle unless severe and untreated, thus being predominantly **non-cicatricial**. *SLE* - Hair loss in **SLE** can occur due to various mechanisms, including diffuse thinning, patchy alopecia, or the characteristic "**lupus hair**" (fragile hairs around the hairline). - This type of hair loss is usually **non-scarring** and reversible, although discoid lupus erythematosus often causes scarring alopecia. *Alopecia areata* - This is an **autoimmune condition** characterized by patchy, sudden hair loss on the scalp or other body parts. - The hair follicles are attacked by the immune system but are not destroyed, making the condition largely **non-cicatricial** and potentially reversible.
Question 1202: Brown macular pigmentation in malar area in a pregnant female is due to ?
- A. Chloasma (Correct Answer)
- B. Urticaric pigmentosa
- C. Acanthosis nigricans
- D. Acne rosacea
Explanation: ***Chloasma*** - **Chloasma**, also known as the **mask of pregnancy**, is characterized by **dark, irregular patches** of hyperpigmentation on the face, commonly in the malar areas. - It is caused by an increase in **estrogen and progesterone levels** during pregnancy, which stimulate melanin production. *Acanthosis nigricans* - This condition presents as **dark, velvety patches of skin**, typically in the body folds and creases, such as the neck, armpits, and groin. - It is often associated with **insulin resistance**, obesity, or underlying malignancies, not specifically pregnancy-induced facial pigmentation. *Urticaric pigmentosa* - This is a form of **mastocytosis** characterized by reddish-brown spots or patches that can **urticate (itch and swell)** when rubbed, a sign known as **Darier's sign**. - It results from an accumulation of **mast cells** in the skin and is not related to hormonal changes in pregnancy. *Acne rosacea* - **Acne rosacea** is a chronic inflammatory skin condition primarily affecting the face, causing **redness, flushing, visible blood vessels**, and sometimes bumps or pimples. - It is unrelated to hyperpigmentation and does not typically result in brown macular pigmentation.
Question 1203: Lines of Blaschko are related to?
- A. Keratinocytes (Correct Answer)
- B. Blood vessels
- C. Nerves
- D. Bones
Explanation: ***Keratinocytes*** - **Lines of Blaschko** represent the migratory pathways of embryonic cells, primarily **keratinocytes**, in the skin. - These lines are not visible under normal conditions but become apparent in various **genetic skin disorders** where abnormal cells follow these specific patterns. *Blood vessels* - While blood vessels are extensively present in the skin, they do not follow the specific **migratory patterns** described by the Lines of Blaschko. - Their arrangement is more related to **vascular networks** and anatomical supply rather than embryonic cell migration. *Nerves* - **Nerves** in the skin have specific distributions, often following dermatomal patterns, which are distinct from the **Lines of Blaschko**. - Nerve distribution is related to their segmental origin from the **spinal cord**, not the migratory paths of epidermal cells. *Bones* - **Bones** are part of the skeletal system and are not found in the skin, making them unrelated to the **Lines of Blaschko**. - These lines describe epidermal cell migration, which is a feature of the **integumentary system**.
Question 1204: Characteristic of chronic eczema?
- A. Erythema
- B. Induration
- C. Lichenification (Correct Answer)
- D. Edema
Explanation: ***Lichenification*** - **Lichenification** is a hallmark of chronic eczema, characterized by thickening of the epidermis with exaggerated skin markings due to persistent rubbing or scratching. - This response reflects the long-term inflammatory and reparative processes in chronically affected skin. *Erythema* - **Erythema**, or redness, is a common finding in both acute and chronic inflammatory skin conditions, including acute eczema, but is not specifically characteristic of chronicity. - While present, it does not distinguish chronic from acute phases as definitively as other features. *Induration* - **Induration** refers to hardening or firmness of the skin, often due to inflammation or infection, and while it can be present in chronic eczema, it's a more general sign and not as specific as lichenification. - It might also suggest other conditions like cellulitis or deep tissue involvement. *Edema* - **Edema**, or swelling, is more prominent in the acute phase of eczema due to vasodilation and increased vascular permeability leading to fluid extravasation. - While some edema can persist, it's a less defining feature of chronic eczema compared to the epidermal changes observed in lichenification.
Question 1205: A 40 year old male reported with recurrent episodes of oral ulcers, large areas of denuded skin and flaccid vesiculo-bullous eruptions. Which is the most important bedside investigation helpful in establishing the diagnosis -
- A. Tzanck smear from the floor of bulla (Correct Answer)
- B. Gram staining of blister fluid
- C. Culture and sensitivity of blister fluid
- D. Skin biopsy with immunofluorescence
Explanation: ***Tzanck smear from the floor of bulla*** - A Tzanck smear from the floor of a bulla will reveal **acantholytic cells** (rounded keratinocytes that have lost their intercellular connections), which are characteristic of pemphigus, consistent with recurrent oral ulcers, denuded skin, and flaccid vesiculobullous eruptions. - This **bedside test** provides a rapid diagnosis by demonstrating the cytological features of acantholysis, differentiating it from other blistering disorders. *Gram staining of blister fluid* - This test is primarily used to identify **bacterial infections** and would show the morphology and Gram-staining characteristics of any bacteria present. - It would not provide information about the **acantholysis** or autoimmune nature of the blistering condition described. *Culture and sensitivity of blister fluid* - This investigation identifies **specific bacterial pathogens** and their antibiotic susceptibilities, which is useful for treating bacterial infections. - It would not help in diagnosing **autoimmune blistering diseases** like pemphigus, where bacteria are not the primary cause of the lesions. *Skin biopsy with immunofluorescence* - While a **skin biopsy with direct immunofluorescence** is the gold standard for confirming pemphigus by detecting autoantibodies, it is an **invasive procedure** requiring laboratory processing and is not considered a rapid bedside investigation. - The question specifically asks for the "most important **bed-side investigation**" helpful in establishing the diagnosis rapidly.
Internal Medicine
1 questionsWhat is the treatment for Trichomonas vaginalis?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1201: What is the treatment for Trichomonas vaginalis?
- A. Metronidazole (Correct Answer)
- B. Azithromycin
- C. Ciprofloxacin
- D. None of the options
Explanation: ***Metronidazole*** - **Metronidazole** is the **first-line drug** for treating *Trichomonas vaginalis* infection. - It is effective against this **anaerobic protozoan** and can be administered as a single dose or a 7-day course. *Azithromycin* - **Azithromycin** is a **macrolide antibiotic** primarily used to treat bacterial infections, such as **chlamydia** or certain **respiratory tract infections**. - It is **not effective** against *Trichomonas vaginalis*, which is a parasitic protozoan. *Ciprofloxacin* - **Ciprofloxacin** is a **fluoroquinolone antibiotic** used for bacterial infections, especially **urinary tract infections** and complicated **gastrointestinal infections**. - It has **no activity** against *Trichomonas vaginalis*. *None of the options* - This option is incorrect because **Metronidazole** is a highly effective and widely accepted treatment for *Trichomonas vaginalis* infections.
Obstetrics and Gynecology
3 questionsWhich organism causes puerperal sepsis?
A young sexually active female presents with intense pruritus and watery discharge. What is the most likely causative organism?
What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?
NEET-PG 2013 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1201: Which organism causes puerperal sepsis?
- A. Group A beta hemolytic streptococci (Correct Answer)
- B. CMV
- C. Toxoplasma gondii
- D. Group B beta hemolytic streptococci
Explanation: ***Group A beta hemolytic streptococci*** - **Group A Streptococcus (GAS)**, specifically *Streptococcus pyogenes*, is the **classic and most important cause of puerperal sepsis** (puerperal fever). - Historically, GAS was responsible for devastating epidemics of puerperal fever in maternity wards before the introduction of antiseptic practices by Ignaz Semmelweis. - GAS causes severe, rapidly progressive postpartum infections with **high morbidity and mortality** if untreated. - Clinically presents with fever, severe uterine tenderness, and can progress to **toxic shock syndrome** and septicemia. *Group B beta hemolytic streptococci* - **Group B Streptococcus (GBS)**, *Streptococcus agalactiae*, can cause postpartum endometritis and maternal infections. - However, GBS is **more commonly associated with neonatal sepsis** rather than being the primary cause of classic puerperal sepsis. - While it can colonize the genital tract and cause infection, it is not the historical or most severe cause of puerperal fever. *CMV* - **Cytomegalovirus (CMV)** is a viral infection that causes congenital infections when transmitted in utero. - It is not a bacterial cause of **puerperal sepsis**, which is primarily a bacterial postpartum infection. *Toxoplasma gondii* - **Toxoplasma gondii** is a parasite causing toxoplasmosis, which can lead to congenital abnormalities. - It is not associated with **puerperal sepsis**, which is a bacterial infection of the postpartum period.
Question 1202: A young sexually active female presents with intense pruritus and watery discharge. What is the most likely causative organism?
- A. Chlamydia trachomatis
- B. Candida albicans
- C. Gardnerella vaginalis
- D. Trichomonas vaginalis (Correct Answer)
Explanation: ***Trichomonas vaginalis*** - **Trichomoniasis** commonly presents with **intense vulvovaginal pruritus**, a **frothy, greenish-yellow discharge**, and sometimes a **strawberry cervix**. - It is a **sexually transmitted infection (STI)** caused by a flagellated protozoan. *Candida vaginitis* - Typically causes severe **pruritus**, **dysuria**, and a **thick, white, curd-like discharge**, often without the watery characteristic. - Known as a **yeast infection**, it is caused by an overgrowth of *Candida* species. *Gardnerella vaginalis* - Associated with **bacterial vaginosis**, which presents with a **thin, grayish-white discharge** and a **fishy odor**, especially after intercourse, but usually less intense pruritus. - It's characterized by an imbalance of vaginal flora rather than being a true STI in the same sense as trichomoniasis. *Chlamydia trachomatis* - Often causes **asymptomatic infections** or symptoms such as **mucopurulent discharge**, **dysuria**, or **post-coital bleeding**, but usually **not intense pruritus** or watery discharge. - It is a **bacterial STI** known for causing cervicitis and pelvic inflammatory disease.
Question 1203: What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?
- A. 10mg
- B. 20mg
- C. 200mg (Correct Answer)
- D. 100mg
Explanation: ***200mg*** - The standard dose of **mifepristone** for medical termination of pregnancy (MTP) is **200mg orally**. - This dose is typically followed 24-48 hours later by a **prostaglandin analog** (e.g., misoprostol) to complete the termination process. *10mg* - This dose is significantly lower than the recommended therapeutic dose for medical abortion. - Such a low dose would likely be **ineffective** in achieving termination. *20 mg* - This dose is also much lower than the standard therapeutic recommendation. - It would not adequately block progesterone receptors to initiate the termination process effectively. *100mg* - While closer to the standard dose, 100mg is still considered **sub-therapeutic** for many individuals undergoing medical abortion. - A lower efficacy rate would be expected compared to the 200mg dose.
Pathology
1 questionsWhich layer of the epidermis is primarily involved in spongiosis?
NEET-PG 2013 - Pathology NEET-PG Practice Questions and MCQs
Question 1201: Which layer of the epidermis is primarily involved in spongiosis?
- A. Stratum basale
- B. Stratum corneum
- C. Stratum granulosum
- D. Stratum spinosum (Correct Answer)
Explanation: ***Stratum spinosum*** - **Spongiosis** is characterized by **intercellular edema** (fluid accumulation between cells) within the epidermis [1], primarily affecting the **stratum spinosum** [2]. - The cells of the stratum spinosum, known as **keratinocytes**, become separated by this edema, giving the tissue a "spongy" appearance on histology due to the preservation of **desmosomal attachments**. *Stratum basale* - The **stratum basale** is the deepest layer of the epidermis, responsible for **cell proliferation** and attachment to the basement membrane. - While edema can affect all epidermal layers in severe cases, spongiosis specifically refers to the intercellular edema most prominent in the stratum spinosum [2]. *Stratum corneum* - The **stratum corneum** is the outermost layer of the epidermis, composed of dead, flattened **keratinocytes** that provide a protective barrier. - Edema in this layer is less common and would not be described as spongiosis, which implies living cells with preserved intercellular junctions. *Stratum granulosum* - The **stratum granulosum** lies above the stratum spinosum and is characterized by cells containing **keratohyalin granules**. - While it can be affected by intercellular edema, the most pronounced and characteristic spongiosis occurs in the stratum spinosum where cells are still actively synthesizing keratin and have strong desmosomal connections [2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, p. 636. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, p. 1166.