NEET-PG 2013 Practice Questions

Q: Circuit of choice for controlled ventilation ?

Type D. **Type D** - The **Type D circuit** (also known as the **Bain circuit** or a modified Mapleson D circuit) is highly efficient for **controlled ventilation** due to its fresh gas flow entering near the patient, effectively sweeping away exhaled gases. - Its design maintains a relatively constant **expiratory resistance**, making it suitable for precise control of ventilation parameters. *Magill circuit* - The **Magill circuit** (Mapleson A) is efficient for **spontaneous ventilation** but requires a high fresh gas flow to prevent rebreathing during controlled ventilation. - During controlled ventilation, a high minute volume is required to flush out expired gases efficiently, which can be wasteful of anesthetic agents. *Type C* - The **Type C circuit** (Mapleson C circuit) is a simple system useful for **resuscitation** and short procedures but is inefficient for prolonged controlled ventilation. - It has a high resistance to gas flow and a tendency for significant rebreathing during both spontaneous and controlled breathing, leading to high CO2 levels. *Type E* - The **Type E circuit** (Mapleson E circuit) is a basic T-piece system, primarily used for **spontaneous breathing in infants and children**. - It lacks a reservoir bag and adjustable pressure limiting valve, making it unsuitable for controlling ventilation effectively in adults.

Q: The Grattage test is used to diagnose which of the following conditions?

Psoriasis. ***Psoriasis*** - The **Grattage test** (candle grease sign) involves **scraping the psoriatic lesion** to reveal characteristic features - First reveals **fine, silvery-white scales** resembling candle wax - Further scraping exposes **pinpoint bleeding points** (**Auspitz sign**) due to exposure of dilated capillaries in dermal papillae - This combination is **pathognomonic for psoriasis** and helps differentiate it from other scaly dermatoses *Tinea capitis* - A **fungal infection of the scalp** caused by dermatophytes - Diagnosed by **KOH mount** (showing fungal hyphae), **fungal culture**, and sometimes **Wood's lamp examination** - The Grattage test is not used for diagnosing fungal infections *Lichen planus* - Characterized by **purplish, polygonal, flat-topped, pruritic papules and plaques** - Surface shows **Wickham's striae** (fine white lines) - Diagnosis is **clinical**, supported by **skin biopsy** showing band-like lymphocytic infiltrate and sawtooth rete ridges - The Grattage test is not applicable *Pemphigus vulgaris* - A severe **autoimmune blistering disorder** with **suprabasal acantholysis** - Presents with **flaccid bullae** that rupture easily, leaving erosions - Diagnosed by **skin biopsy**, **direct immunofluorescence** (intercellular IgG and C3 deposits), and **Nikolsky's sign** (positive) - The Grattage test is not used for bullous disorders

Q: Which organism causes puerperal sepsis?

Group A beta hemolytic streptococci. ***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.

Q: Red degeneration of fibroid is seen in which of the following?

Mid pregnancy. ***Mid pregnancy*** - **Red degeneration**, or **carneous degeneration**, is most common during the **second and third trimesters of pregnancy** due to increased metabolic demands of the growing fibroid outstripping its blood supply. - The rapid growth leads to **ischemia**, hemorrhage, and necrosis within the fibroid, causing acute abdominal pain. *Early pregnancy* - While fibroids can grow in early pregnancy, **red degeneration** is less common as the uterine blood supply is generally still adequate to meet the fibroid's metabolic needs. - Other forms of degeneration, like **hyaline degeneration**, are more frequently observed in non-pregnant or early pregnant states. *Puerperium* - In the puerperium, fibroids typically undergo **regression** rather than degeneration, as the hormonal stimulation (estrogen and progesterone) that promoted their growth significantly decreases. - The uterus involutes rapidly, and fibroids often shrink. *Nulliparous women* - Nulliparous women can have fibroids and experience various forms of degeneration, but **red degeneration** specifically is rare outside of pregnancy. - Degeneration in nulliparous women is more commonly **hyaline** or **cystic** degeneration.

Q: Which of the following is the most common genital infection in pregnancy?

Vaginal candidiasis. ***Vaginal candidiasis*** - **Vaginal candidiasis**, commonly known as a yeast infection, is the **most frequent genital infection** during pregnancy due to hormonal changes that alter the vaginal microenvironment. - Pregnancy increases susceptibility through **elevated estrogen levels**, **increased vaginal glycogen**, and **altered vaginal pH**. - While generally not harmful to the fetus, it can cause significant maternal discomfort with symptoms like **itching**, burning, and a **thick, white, cottage cheese-like discharge**. *Gonorrhea* - Gonorrhea is a **sexually transmitted infection (STI)** that, although possible, is not the most common genital infection in pregnancy. - It carries a risk of serious complications for both mother and infant, including **preterm birth**, **chorioamnionitis**, and **neonatal conjunctivitis** (ophthalmia neonatorum). *Chlamydia* - Chlamydia is another **STI** that can occur during pregnancy but is not as common as candidiasis. - Untreated chlamydia can lead to **preterm rupture of membranes**, **preterm labor**, and **postpartum endometritis** in the mother, and **conjunctivitis** or **pneumonia** in the newborn. *Bacterial vaginosis* - Bacterial vaginosis (BV) is a common vaginal infection caused by an **imbalance in normal vaginal flora**, with overgrowth of anaerobic bacteria. - While BV is the most common vaginal infection in **non-pregnant women**, vaginal candidiasis is more frequently encountered during pregnancy due to hormonal changes. - BV in pregnancy is associated with increased risk of **preterm birth**, **preterm rupture of membranes**, and **postpartum endometritis**, making screening and treatment important.

Q: What is the most common malignant tumor of the skeletal system?

Metastasis. ***Metastasis*** - **Skeletal metastasis** is overwhelmingly the most common malignant tumor involving bone, as many primary cancers (e.g., breast, prostate, lung) frequently spread to bone [1]. - While not originating in the bone, these metastatic deposits are malignant neoplasms within the skeletal system, making them the most prevalent. *Multiple myeloma* - This is a **primary malignancy of plasma cells** that arises in the bone marrow, causing destructive bone lesions. - It is the most common **primary malignant bone tumor** in adults, but still less common than metastatic disease. *Osteosarcoma* - This is the most common **primary malignant bone tumor** in **children and adolescents**, primarily affecting long bones [2]. - While a significant primary bone cancer, its incidence is lower than that of metastatic bone disease across all age groups [1]. *Chondrosarcoma* - This is a malignant tumor of **cartilage-forming cells** and is the second most common primary bone cancer in adults, after multiple myeloma [3]. - It is much less common than metastatic disease and osteosarcoma [1], [3]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Osteoarticular And Connective Tissue Disease, pp. 671-672. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, p. 1202. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, p. 1204.

Q: Which personality disorder is commonly associated with bipolar disorder?

Borderline Personality Disorder. ***Borderline Personality Disorder*** - **Borderline Personality Disorder (BPD)** and **bipolar disorder** share overlapping symptoms such as mood instability, impulsivity, and relational difficulties. - Due to these shared features, there is a high comorbidity rate, and distinguishing between the two can be challenging, often requiring careful assessment of symptom origins and patterns. *Obsessive-Compulsive Personality Disorder* - **Obsessive-Compulsive Personality Disorder (OCPD)** is characterized by a preoccupation with orderliness, perfectionism, and control. - While an individual can have both, OCPD does not typically share the prominent **mood instability** or **impulsivity** that are core to bipolar disorder. *Narcissistic Personality Disorder* - **Narcissistic Personality Disorder (NPD)** involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy, often presenting with inflated self-esteem or sense of superiority. - While **grandiosity** can be seen in manic phases of bipolar disorder, the chronic and pervasive nature of NPD, particularly the lack of empathy, differs from the episodic mood extremes of bipolar disorder. *Antisocial Personality Disorder* - **Antisocial Personality Disorder (ASPD)** is characterized by a disregard for and violation of the rights of others, often involving deception, impulsivity, and criminal behavior. - While **impulsivity** and **reckless behavior** can occur during manic episodes in bipolar disorder, ASPD's core features are a pervasive pattern of deceitfulness and lack of remorse, which are not primary symptoms of bipolar disorder.

Q: Which neurotransmitter is believed to be increased in mania?

Increased dopamine. ***Increased dopamine*** - **Dopamine** is the primary neurotransmitter implicated in the pathophysiology of mania according to the **dopaminergic hypothesis** of mood disorders. - Increased dopaminergic activity in the **mesolimbic and mesocortical pathways** contributes to the core symptoms of mania including **euphoria**, **increased goal-directed activity**, **reduced need for sleep**, **psychosis**, and **impulsivity**. - Evidence includes: response to dopamine antagonists (antipsychotics) in treating mania, and dopamine agonists can precipitate manic episodes. - Studies using neuroimaging and CSF analysis support elevated dopamine activity during manic episodes. *Increased norepinephrine* - While norepinephrine is also increased in mania and contributes to **arousal**, **attention**, and **energy levels**, it is considered a secondary or contributory mechanism rather than the primary pathophysiological change. - The **catecholamine hypothesis** suggests both dopamine and norepinephrine are elevated, but dopamine plays the more central role in the characteristic manic symptoms. *Decreased dopamine* - Decreased dopamine is associated with **depression**, **Parkinson's disease**, and **negative symptoms of schizophrenia**, not mania. - Low dopamine leads to reduced motivation, anhedonia, psychomotor retardation, and lack of energy—the opposite of manic presentation. *Decreased norepinephrine* - Decreased norepinephrine is linked to **depressive states**, characterized by low energy, poor concentration, and reduced arousal. - This is directly contrary to the hyperarousal, excessive energy, and heightened activity seen in mania.

Q: Frequency of ultrasound waves in USG -

>2 MHz. ***>2 MHz*** - Medical diagnostic ultrasound typically uses frequencies in the **range of 2-15 MHz**, with some applications extending from 1-20 MHz. - Frequencies **above 2 MHz** are considered the standard for diagnostic ultrasonography, providing adequate **spatial resolution** and tissue penetration for imaging internal structures. - **Frequency selection** depends on the application: - **2-5 MHz**: Deep structures (abdominal, obstetric imaging) - better penetration - **5-10 MHz**: Vascular studies, cardiac imaging - **7-15 MHz**: Superficial structures (thyroid, breast, musculoskeletal) - better resolution - Higher frequencies provide better resolution but less penetration; the choice represents a trade-off based on clinical needs. *2000 Hz* - This frequency (2 kHz) falls within the **audible range** for humans (20 Hz to 20 kHz). - Such low frequencies would not provide the necessary **spatial resolution** for diagnostic imaging and lack the characteristics needed for medical ultrasound. *5000 Hz* - At 5 kHz, this is still within the **audible frequency range**. - These frequencies are far too low for medical ultrasound imaging, which requires **megahertz frequencies** to generate diagnostically useful images with adequate detail. * 20 kHz), are generally **below the diagnostic range** for most clinical applications. - Although lower frequencies offer better tissue penetration, frequencies below 2 MHz provide **insufficient spatial resolution** for standard diagnostic medical imaging.

Question 1

Circuit of choice for controlled ventilation ?

Accepted Answer

Type D

Answer

Magill circuit

Answer

Type C

Answer

Type E

Question 2

The Grattage test is used to diagnose which of the following conditions?

Accepted Answer

Psoriasis

Answer

Tinea capitis

Answer

Lichen planus

Answer

Pemphigus vulgaris

Question 3

Which organism causes puerperal sepsis?

Accepted Answer

Group A beta hemolytic streptococci

Answer

CMV

Answer

Toxoplasma gondii

Answer

Group B beta hemolytic streptococci

Question 4

Red degeneration of fibroid is seen in which of the following?

Accepted Answer

Mid pregnancy

Answer

Early pregnancy

Answer

Nulliparous women

Answer

Puerperium

Question 5

Which of the following statements about gestational diabetes mellitus (GDM) is true?

Accepted Answer

Gestational diabetes mellitus is first recognized during pregnancy.

Answer

It is always associated with a previous history of IUGR.

Answer

There is no recurrence of GDM in future pregnancies.

Answer

There is no risk of developing overt diabetes in the future.

Question 6

Which of the following is the most common genital infection in pregnancy?

Accepted Answer

Vaginal candidiasis

Answer

Gonorrhea

Answer

Chlamydia

Answer

Bacterial vaginosis

Question 7

What is the most common malignant tumor of the skeletal system?

Accepted Answer

Metastasis

Answer

Chondrosarcoma

Answer

Multiple myeloma

Answer

Osteosarcoma

Question 8

Which personality disorder is commonly associated with bipolar disorder?

Accepted Answer

Borderline Personality Disorder

Answer

Narcissistic Personality Disorder

Answer

Obsessive-Compulsive Personality Disorder

Answer

Antisocial Personality Disorder

Question 9

Which neurotransmitter is believed to be increased in mania?

Accepted Answer

Increased dopamine

Answer

Decreased dopamine

Answer

Increased norepinephrine

Answer

Decreased norepinephrine

Question 10

Frequency of ultrasound waves in USG -

Accepted Answer

>2 MHz

Answer

2000 Hz

Answer

5000 Hz

Answer

< 2 MHz

NEET-PG 2013

Anesthesiology

Dermatology

Microbiology

Obstetrics and Gynecology

Pathology

Psychiatry

Radiology