Internal Medicine
2 questionsWhich of the following is associated with WPW syndrome?
Which of the following is a symptom of protein deficiency?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 901: Which of the following is associated with WPW syndrome?
- A. Ebstein anomaly (Correct Answer)
- B. TOF
- C. VSD
- D. TAPVC
Explanation: ***Ebstein anomaly*** - **Ebstein anomaly** is a congenital heart defect characterized by apical displacement of the septal and posterior leaflets of the tricuspid valve, which is strongly associated with **Wolff-Parkinson-White (WPW) syndrome.** - WPW syndrome, involving an **accessory pathway** that bypasses the AV node [1], is found in 5-25% of patients with Ebstein anomaly, predisposing them to re-entrant tachycardias [3]. *TOF* - **Tetralogy of Fallot (TOF)** is a complex cyanotic congenital heart defect that includes four main features: VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy [2]. - There is no direct or strong association between TOF and WPW syndrome. *VSD* - A **Ventricular Septal Defect (VSD)** is a common congenital heart defect where there is an opening in the interventricular septum, allowing blood to flow between the ventricles [4]. - While VSDs can occur with other cardiac anomalies, there is no specific or frequent association with WPW syndrome. *TAPVC* - **Total Anomalous Pulmonary Venous Connection (TAPVC)** is a rare congenital heart defect where all four pulmonary veins connect to the systemic venous circulation instead of the left atrium. - This condition does not have a recognized association with WPW syndrome.
Question 902: Which of the following is a symptom of protein deficiency?
- A. Cherry like skin
- B. Flaky paint like skin (Correct Answer)
- C. Glossitis
- D. Nail change
Explanation: ***Flaky paint like skin*** - This dermatological manifestation, known as **"flaky paint" dermatosis** or **crazy pavement dermatosis**, is a classic sign of **severe protein-energy malnutrition** (PEM), particularly **kwashiorkor**. - It results from **altered skin keratinization** and **desquamation** due to inadequate protein synthesis, leading to patches of hyperpigmentation and peeling skin that resemble peeling paint. *Glossitis* - **Glossitis**, or inflammation of the tongue, is primarily associated with deficiencies of **B vitamins** (especially B12, folate, niacin, and riboflavin) and **iron deficiency**. - While protein deficiency can broadly affect cell turnover, glossitis is not a primary or specific symptom directly attributable to it. *Nail change* - Various **nail changes** can indicate nutritional deficiencies, but they are more commonly linked to deficiencies in **iron** (e.g., koilonychia or "spoon nails"), **zinc** (e.g., Beau's lines, white spots), or certain **vitamins**. - While chronic malnutrition can impact nail health, there isn't a specific, characteristic nail change solely indicative of protein deficiency. *Cherry like skin* - "Cherry-like skin" is not a recognized dermatological symptom associated with any specific nutritional deficiency in medical literature. - Skin manifestations like **cherry angiomas** are benign vascular proliferations and are generally not linked to nutritional status.
Pediatrics
6 questionsAcrodermatitis enteropathica is associated with a deficiency of which of the following?
Which of the following is NOT a characteristic of caput succedaneum?
In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?
The most common cause of meningitis in children aged 5 yrs is-
What is the APGAR score for a baby that grimaces in response to stimulation?
Most common syndrome associated with A-V canal defect -
NEET-PG 2013 - Pediatrics NEET-PG Practice Questions and MCQs
Question 901: Acrodermatitis enteropathica is associated with a deficiency of which of the following?
- A. Zinc (Correct Answer)
- B. Manganese
- C. Copper
- D. Selenium
Explanation: ***Zinc*** - Acrodermatitis enteropathica is a rare, inherited metabolic disorder characterized by a **deficiency in zinc absorption** or utilization. - Clinical manifestations include a characteristic **periorificial and acral dermatitis**, alopecia, and diarrhea, all of which respond dramatically to zinc supplementation. *Manganese* - Manganese is a trace element essential for various enzyme functions, but its deficiency does not cause acrodermatitis enteropathica. - Deficiency symptoms include impaired growth, skeletal abnormalities, and reproductive problems. *Copper* - Copper deficiency can lead to anemia, neutropenia, and neurological problems, but it is not associated with acrodermatitis enteropathica. - Conditions like Menkes disease involve problems with copper transport and metabolism. *Selenium* - Selenium deficiency can contribute to Keshan disease (cardiomyopathy) and impaired immune function. - It is not directly linked to the dermatological and gastrointestinal symptoms seen in acrodermatitis enteropathica.
Question 902: Which of the following is NOT a characteristic of caput succedaneum?
- A. Crosses the suture line
- B. Crosses midline
- C. It does not disappear within 2-3 days (Correct Answer)
- D. It is a diffuse edematous swelling of the soft tissues of the scalp
Explanation: ***It does not disappear within 2-3 days*** - Caput succedaneum is a benign condition that typically resolves within **2 to 3 days** after birth as the edema is reabsorbed. - Therefore, a characteristic of caput succedaneum is that it *does* disappear relatively quickly, making the statement that it "does not disappear within 2-3 days" incorrect. *Crosses midline* - Caput succedaneum is a **diffuse swelling** that extends across the scalp and is **not limited by anatomical boundaries** like the midline of the skull. - This characteristic helps differentiate it from a **cephalohematoma**, which is typically confined to one side of the head. *Crosses the suture line* - The edema of caput succedaneum is in the **soft tissues superficial to the periosteum**, allowing it to **cross the suture lines** of the skull. - This is a key differentiating feature from a **cephalohematoma**, which is a subperiosteal hemorrhage and therefore confined by suture lines. *It is a diffuse edematous swelling of the soft tissues of the scalp* - This statement accurately describes caput succedaneum as a **collection of serosanguineous fluid** and **edema** in the most superficial layers of the scalp. - It results from pressure on the fetal scalp during labor, leading to **venous congestion** and extravasation of fluid.
Question 903: In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?
- A. Acrodermatitis enteropathica (Correct Answer)
- B. Pellagra
- C. Riboflavin deficiency
- D. Kwashiorkor
Explanation: ***Acrodermatitis enteropathica*** - This condition is a **zinc deficiency** syndrome, which can be either inherited or acquired. - It presents with a classic triad of **diarrhoea**, **dermatitis** (often periorificial and acral with moist, crusted lesions), and **alopecia**. - The **perianal moist crust** is a characteristic finding of the periorificial dermatitis seen in this condition. *Pellagra* - Pellagra is caused by **niacin (Vitamin B3) deficiency** and is characterized by the "4 D's": **dermatitis** (often sun-exposed areas), **diarrhoea**, **dementia**, and eventually death. - The dermatitis of pellagra is typically **symmetrical, hyperpigmented, and photosensitive**, not moist perianal crusts, differentiating it from the presented case. *Riboflavin deficiency* - **Riboflavin deficiency** typically manifests as **cheilosis**, angular stomatitis, glossitis, and seborrheic dermatitis, but not specifically perianal moist crusts with diarrhoea. - While it can affect mucous membranes, the specific perianal presentation with diarrhoea points away from this diagnosis. *Kwashiorkor* - **Kwashiorkor** is a form of protein-energy malnutrition that can present with **diarrhoea** and skin changes (flaky paint dermatosis, hypopigmentation). - However, the skin changes are typically **desquamating** and affect dependent areas, not the characteristic **moist, crusted periorificial lesions** seen in zinc deficiency. - Kwashiorkor also typically presents with **edema**, which is not mentioned in this case.
Question 904: The most common cause of meningitis in children aged 5 yrs is-
- A. Staphylococcus
- B. E.coli
- C. H. influenzae
- D. S. pneumoniae (Correct Answer)
Explanation: ***S. pneumoniae*** - **_Streptococcus pneumoniae_** (Pneumococcus) is the **most common cause of bacterial meningitis** in children aged 5 years and older, as well as in adults. - Widespread vaccination has reduced its incidence but it remains a significant pathogen. *H. influenzae* - **_Haemophilus influenzae_ type b (Hib)** was a major cause of meningitis in young children, but its incidence has **drastically decreased** due to the routine **Hib vaccine**. - Without vaccination, it would still be a significant cause in this age group, but with high vaccine coverage, it is less common than _S. pneumoniae_. *Staphylococcus* - **_Staphylococcus aureus_** and other staphylococcal species are **less common causes of meningitis** in otherwise healthy children. - They are more typically associated with meningitis following **neurosurgery**, trauma, or in immunocompromised patients. *E.coli* - **_Escherichia coli_** is a common cause of **neonatal meningitis** (in infants less than 3 months old), often acquired during passage through the birth canal. - It is **rarely a cause of meningitis** in children aged 5 years.
Question 905: What is the APGAR score for a baby that grimaces in response to stimulation?
- A. 0
- B. 1 (Correct Answer)
- C. 2
- D. 3
Explanation: ***1*** - A score of **1** is given for **grimace** in response to stimulation, indicating some reflex irritability but not a vigorous cry or sneeze. - This response shows a minimal protective reflex, suggesting the baby is not completely flaccid but also not optimally responsive. - The APGAR scoring for reflex irritability ranges from 0 to 2, with grimacing specifically scoring **1 point**. *0* - A score of **0** for reflex irritability is reserved for **no response** or **complete absence** of reflexes. - This would indicate a severely depressed neurological state, unlike the grimace observed. *2* - A score of **2** for reflex irritability is given for a **vigorous cry**, **sneeze**, **cough**, or **active withdrawal** from stimulation. - A grimace is a less robust response than these, thus not warranting a score of 2. *3* - The APGAR scoring system uses a **0-2 scale** for each of the five components (Appearance, Pulse, Grimace, Activity, Respiration). - The maximum score for any single component is **2**, making 3 an invalid score. - Total APGAR scores range from 0-10, but individual components never exceed 2.
Question 906: Most common syndrome associated with A-V canal defect -
- A. Klinefelter syndrome
- B. Down syndrome (Correct Answer)
- C. Turner syndrome
- D. Marfan syndrome
Explanation: ***Down syndrome*** - **Down syndrome (Trisomy 21)** is the most common syndrome associated with **atrioventricular (AV) canal defects** (endocardial cushion defects) - Occurs in approximately **40-50% of individuals with Down syndrome**, making it the hallmark cardiac anomaly in this condition - AV canal defects range from partial to complete defects involving atrial and ventricular septa and AV valves *Klinefelter syndrome* - **Klinefelter syndrome (47,XXY)** is not characteristically associated with AV canal defects - May have **mitral valve prolapse** or **aortic root dilation**, but AV canal defects are not a typical feature *Turner syndrome* - **Turner syndrome (45,X)** has distinct cardiovascular associations including **coarctation of the aorta** and **bicuspid aortic valve** - AV canal defects are **not** characteristic of Turner syndrome *Marfan syndrome* - **Marfan syndrome** is a connective tissue disorder with **aortic root dilation**, **aortic aneurysms**, and **mitral valve prolapse** - **AV canal defects are not a feature** of Marfan syndrome
Pharmacology
1 questionsWhich prostaglandin inhibitor is used in the treatment of patent ductus arteriosus (PDA)?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 901: Which prostaglandin inhibitor is used in the treatment of patent ductus arteriosus (PDA)?
- A. PGE-2
- B. Misoprostol
- C. Indomethacin (Correct Answer)
- D. Dinoprostone
Explanation: ***Indomethacin*** - **Indomethacin** is a non-steroidal anti-inflammatory drug (**NSAID**) that inhibits **prostaglandin synthesis**, particularly **prostaglandin E2 (PGE2)**. - **PGE2** helps keep the **ductus arteriosus** open in utero; by inhibiting its production, indomethacin facilitates the closure of a **patent ductus arteriosus (PDA)** in neonates. *Misoprostol* - **Misoprostol** is a **prostaglandin E1 (PGE1) analog** and is used to induce labor, treat gastric ulcers, and for medical abortions. - It would work to **maintain** rather than close the **ductus arteriosus** if used in a neonate with a heart defect requiring patency. *Dinoprostone* - **Dinoprostone** is a **prostaglandin E2 analog** used for cervical ripening and labor induction. - It is not used for closing a **PDA**; its prostaglandin agonistic action would likely keep the **ductus arteriosus open**. *PGE-2* - **Prostaglandin E2 (PGE2)** is a naturally occurring prostaglandin that helps maintain the patency of the **ductus arteriosus** in the fetus. - Administering **PGE2** would keep the **ductus arteriosus open**, which is the opposite of the desired effect when treating a **PDA**.
Surgery
1 questionsHead & face burn in infant accounts for what percentage of total body surface area?
NEET-PG 2013 - Surgery NEET-PG Practice Questions and MCQs
Question 901: Head & face burn in infant accounts for what percentage of total body surface area?
- A. 15%
- B. 18% (Correct Answer)
- C. 12%
- D. 32%
Explanation: ***18%*** - In infants, the **Rule of Nines** is modified due to their proportionally larger head and smaller lower extremities compared to adults. - The head and face in an infant account for a larger percentage of the **total body surface area (TBSA)**, specifically 18%. *15%* - This percentage is inaccurate for an infant's head and face when calculating **TBSA** using the modified Rule of Nines. - While some areas might be 15% in adults, an infant's head is proportionally larger. *12%* - This percentage significantly **underestimates** the body surface area of an infant's head and face. - Using this value would lead to an incorrect assessment of **burn size** and potential under-resuscitation. *32%* - This percentage far **overestimates** the surface area of an infant's head and face. - Such a high value would result in an incorrect assessment of **burn severity** and potentially lead to over-resuscitation.