Biochemistry
1 questionsWhat is the effect of moderate alcohol consumption on lipid profiles in dyslipidemia?
NEET-PG 2013 - Biochemistry NEET-PG Practice Questions and MCQs
Question 961: What is the effect of moderate alcohol consumption on lipid profiles in dyslipidemia?
- A. Decreased HDL levels
- B. Increased HDL levels (Correct Answer)
- C. Increased triglyceride levels
- D. Decreased LDL levels
Explanation: ***Increased HDL levels*** - Moderate alcohol consumption is known to **increase high-density lipoprotein (HDL) cholesterol levels**, which is often considered beneficial for cardiovascular health. - This effect is thought to be mediated by alcohol's influence on **hepatic lipoprotein metabolism**, leading to enhanced HDL production and reduced catabolism. *Decreased HDL levels* - This is incorrect, as multiple studies have consistently shown that **moderate alcohol consumption** tends to elevate, rather than decrease, HDL cholesterol. - Low HDL levels are associated with increased cardiovascular risk, making this effect an undesirable outcome that is not typical of moderate drinking. *Increased triglyceride levels* - While heavy or chronic alcohol consumption can lead to **increased triglyceride levels**, moderate intake typically has a neutral or only slightly elevated effect, if any, often overshadowed by the HDL increase. - Significant hypertriglyceridemia is a concern with **excessive alcohol use**, not usually with moderate consumption in healthy individuals. *Decreased LDL levels* - Moderate alcohol consumption generally has **little to no significant effect** on **low-density lipoprotein (LDL) cholesterol levels**, often referred to as "bad" cholesterol. - While HDL increases are observed, alcohol does not effectively lower LDL, which is a primary target in the management of dyslipidemia.
Internal Medicine
6 questionsIsolated painful third nerve palsy is a feature of aneurysms of:
In Wilson's disease, copper deposition primarily occurs in which part of the brain?
Genitourinary complication of ulcerative colitis
A diabetic patient presents with sensory involvement, tingling, numbness, ankle swelling, and absence of pain. What is the most likely diagnosis?
Which of the following is a sign of Bartter's syndrome?
Use of spironolactone in liver cirrhosis is
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 961: Isolated painful third nerve palsy is a feature of aneurysms of:
- A. Aneurysm of the posterior communicating artery (Correct Answer)
- B. Aneurysm of the anterior communicating artery
- C. Aneurysm of the vertebrobasillary artery
- D. Aneurysm of the ophthalmic artery
Explanation: ***Aneurysm of the posterior communicating artery*** - An aneurysm of the **posterior communicating artery (PCOM)** can compress the ipsilateral **oculomotor nerve (CN III)** as it exits the brainstem. - This compression typically affects the **superficial parasympathetic fibers** first, leading to a **dilated pupil** (mydriasis) along with ophthalmoplegia and ptosis, making the third nerve palsy "painful" and "isolated" without other focal neurological deficits. *Aneurysm of the anterior communicating artery* - Aneurysms of the **anterior communicating artery (ACoM)** are more commonly associated with **subarachnoid hemorrhage** and can cause **visual field defects** or **frontal lobe dysfunction**, but generally not isolated CN III palsy. - While rupture can lead to various neurological deficits, isolated painful third nerve palsy due to ACoM aneurysm is atypical. *Aneurysm of the vertebrobasillary artery* - Aneurysms in the **vertebrobasillar system** typically present with symptoms related to **brainstem compression** or ischemia, such as cranial nerve palsies beyond the third nerve, ataxia, or motor/sensory deficits. - Isolated third nerve palsy is an uncommon presentation for vertebrobasilar aneurysms compared to PCOM aneurysms. *Aneurysm of the ophthalmic artery* - **Ophthalmic artery aneurysms** are usually **intraorbital** and can cause **visual loss** due to direct compression of the **optic nerve (CN II)** or orbital structures. - They are less likely to cause isolated painful third nerve palsy, as the third nerve's course is generally not directly compromised by ophthalmic artery aneurysms.
Question 962: In Wilson's disease, copper deposition primarily occurs in which part of the brain?
- A. Basal ganglia (Correct Answer)
- B. Cerebellum
- C. Pons
- D. Medulla
Explanation: ***Basal ganglia*** - The **basal ganglia**, particularly the **putamen** and **globus pallidus**, are the most common sites for copper deposition in the brain in Wilson's disease [1]. - This deposition leads to **neurological symptoms** such as dystonia [2], tremor, and dysarthria. *Pons* - While copper can accumulate in various brain regions, the **pons** is not a primary or characteristic site of significant copper deposition. - Neurological symptoms associated with pontine damage are not typical presenting features of Wilson's disease. *Cerebellum* - The **cerebellum** can show some copper accumulation in advanced stages, but it is not the primary site. - Cerebellar signs like **ataxia** can occur in Wilson's disease, but usually secondary to more widespread pathology rather than primary cerebellar copper deposition. *Medulla* - The **medulla oblongata** is generally spared from significant copper deposition in Wilson's disease. - Involvement of the medulla would typically manifest with severe autonomic or brainstem dysfunction, which is not a hallmark of early Wilson's disease.
Question 963: Genitourinary complication of ulcerative colitis
- A. Urinary calculi (Correct Answer)
- B. Pyelonephritis
- C. Urethritis
- D. Cystitis
Explanation: ***Urinary calculi*** - Patients with ulcerative colitis are at an increased risk of developing **urinary calculi** due to several factors, including chronic dehydration, malabsorption of fats leading to increased oxalate absorption (enteric hyperoxaluria), and altered urine composition. - The inflammatory process and potential for surgical interventions (e.g., colectomy with ileostomy) can further predispose individuals to kidney stone formation. *Cystitis* - While cystitis (bladder inflammation) can occur in the general population, it is not considered a specific or significantly elevated genitourinary complication directly linked to the pathogenesis of ulcerative colitis itself. - It results primarily from bacterial infection, and there is no direct evidence suggesting UC patients have a higher intrinsic risk compared to the general population. *Pyelonephritis* - Pyelonephritis (kidney infection) is not a direct or common complication of ulcerative colitis. - It is typically caused by bacterial ascent from the lower urinary tract and is not specifically promoted by the inflammatory processes or metabolic changes associated with UC. *Urethritis* - Urethritis (inflammation of the urethra) is primarily associated with sexually transmitted infections or irritation and is not a recognized genitourinary complication directly caused by ulcerative colitis. - There is no increased incidence of urethritis in UC patients compared to the general population.
Question 964: A diabetic patient presents with sensory involvement, tingling, numbness, ankle swelling, and absence of pain. What is the most likely diagnosis?
- A. Charcot's joint (Correct Answer)
- B. Gout
- C. Rheumatoid arthritis
- D. Ankylosing spondylitis
Explanation: ***Charcot's joint*** - This condition is characterized by **neuropathic arthropathy**, resulting from nerve damage (often due to **diabetes**), leading to sensory involvement, **numbness**, and **absence of pain** [1]. - The loss of protective sensation and repeated microtrauma contribute to joint destruction, often manifesting as **swelling** and deformity, particularly in the feet and ankles [1]. *Gout* - Gout typically presents with sudden, severe episodes of **pain**, redness, and swelling in a single joint, most commonly the **big toe**. - It is caused by **uric acid crystal deposition** and is not primarily associated with sensory deficits or chronic painless swelling. *Rheumatoid arthritis* - This is a **chronic autoimmune** inflammatory disease primarily affecting the **small joints** of the hands and feet symmetrically, causing pain, stiffness, and swelling. - It does not typically present with sensory neuropathy or painless joint destruction in the way described. *Ankylosing spondylitis* - This is a **chronic inflammatory disease** primarily affecting the **spine and sacroiliac joints**, causing progressive stiffness and pain that improves with activity. - It is not associated with peripheral joint neuropathy, numbness, or painless ankle swelling [1].
Question 965: Which of the following is a sign of Bartter's syndrome?
- A. High potassium levels
- B. Acidic blood
- C. Low potassium levels (Correct Answer)
- D. High sodium levels
Explanation: ***Low potassium levels*** * Bartter's syndrome is characterized by **renal salt wasting** and subsequent volume depletion, which activates the **renin-angiotensin-aldosterone system** [1]. * This leads to increased aldosterone levels, causing increased potassium secretion in the collecting ducts, resulting in **hypokalemia** [2]. *High potassium levels* * **Hyperkalemia** is not a feature of Bartter's syndrome; instead, it is marked by persistent potassium loss [1]. * Conditions causing hyperkalemia typically involve impaired renal potassium excretion or increased potassium release from cells. *Acidic blood* * Bartter's syndrome usually presents with **metabolic alkalosis** due to hydrogen ion loss in the urine, not acidic blood [2]. * Acidic blood (**acidemia**) would imply a state of respiratory or metabolic acidosis. *High sodium levels* * Bartter's syndrome primarily involves **renal salt wasting**, leading to **normal or low sodium levels** rather than high sodium levels. * High sodium levels (**hypernatremia**) are usually due to inadequate water intake or excessive water loss.
Question 966: Use of spironolactone in liver cirrhosis is
- A. Decrease edema (Correct Answer)
- B. May improve liver function indirectly
- C. May decrease afterload
- D. May decrease intravascular volume
Explanation: ***Decrease edema*** - Spironolactone is an **aldosterone antagonist** that blocks the effects of aldosterone, which is often elevated in liver cirrhosis. - By antagonizing aldosterone, spironolactone promotes **sodium and water excretion**, directly leading to a reduction in **ascites and peripheral edema** [1]. *May improve liver function indirectly* - While spironolactone manages complications of liver cirrhosis, it does **not directly improve liver function** or reverse liver damage. - Its primary role is in **symptom management**, particularly fluid retention, not in healing the underlying liver disease. *May decrease afterload* - Spironolactone's primary action is on the **kidneys** to promote diuresis; it is **not a vasodilator** and therefore does not directly decrease cardiac afterload. - Any effect on systemic vascular resistance would be minimal and secondary to volume changes rather than a direct vasodilatory property. *May decrease intravascular volume* - Spironolactone **decreases total body sodium and water**, leading to a reduction in extravascular fluid (edema and ascites) [1]. - While it decreases the total amount of fluid in the body, its main effect is on **extravascular volume**, and it's chosen over loop diuretics in cirrhosis to prevent **excessive intravascular depletion** which can worsen renal function.
Pathology
1 questionsWhat is a watershed infarct in the brain?
NEET-PG 2013 - Pathology NEET-PG Practice Questions and MCQs
Question 961: What is a watershed infarct in the brain?
- A. Occurs in the border zones between major arteries (Correct Answer)
- B. Occurs in the areas supplied by only one artery
- C. Occurs in the terminal portion of main arteries
- D. Occurs only in areas with complete arterial occlusion
Explanation: ***Occurs in the border zones between major arteries*** - A **watershed infarct** or **border zone infarct** arises in areas where the **perfusion** from two different arterial territories meets [1]. - These areas are particularly vulnerable to ischemia during periods of **systemic hypoperfusion**, as blood flow is lowest at the "watershed" of these overlapping supply zones [1]. *Occurs in the areas supplied by only one artery* - Infarcts in areas supplied by only one artery are typically seen in **lacunar strokes**, affecting **deep penetrating arteries** and not necessarily watershed areas [2]. - These are often due to occlusion of a single, small perforating artery, leading to a **discrete, localized lesion**. *Occurs only in areas with complete arterial occlusion* - Watershed infarcts result from **systemic hypoperfusion** rather than complete arterial occlusion [1]. - They occur when global reduction in cerebral blood flow affects the **most vulnerable border zones**, even without complete vessel occlusion. - Complete arterial occlusions typically cause **territorial infarcts** in the distribution of that specific artery. *Occurs in the terminal portion of main arteries* - Infarcts in the terminal portions of main arteries are more consistent with **embolic or thrombotic events** directly occluding that specific artery. - A watershed infarct is distinct as it results from a **global reduction in cerebral blood flow**, affecting the *most distal* and *least well-perfused regions*. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 150-151. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1266-1268.
Pharmacology
1 questionsWhich of the following drugs is useful in acute attack of gout ?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 961: Which of the following drugs is useful in acute attack of gout ?
- A. Furosemide
- B. Sulfinpyrazone
- C. Allopurinol
- D. Piroxicam (Correct Answer)
Explanation: ***Piroxicam*** - **Piroxicam** is a **non-steroidal anti-inflammatory drug (NSAID)**, which are the first-line treatment for acute gout attacks. - NSAIDs work by inhibiting **prostaglandin synthesis**, thereby reducing inflammation and pain associated with the acute crystal-induced arthritis. *Furosemide* - **Furosemide** is a loop diuretic that can **raise uric acid levels** by increasing reabsorption in the renal tubules. - Therefore, it would exacerbate **gout** and is contraindicated during an acute attack. *Sulfinpyrazone* - **Sulfinpyrazone** is a **uricosuric agent** used for chronic gout management to increase uric acid excretion. - It is **not used for acute attacks** as it can precipitate or worsen an attack by mobilizing uric acid crystals. *Allopurinol* - **Allopurinol** is a **xanthine oxidase inhibitor** used for long-term management of hyperuricemia and chronic gout. - Starting allopurinol during an **acute attack** can worsen or prolong the attack by causing rapid changes in serum uric acid levels.
Physiology
1 questionsResult of liquorice ingestion
NEET-PG 2013 - Physiology NEET-PG Practice Questions and MCQs
Question 961: Result of liquorice ingestion
- A. Hyperkalemic alkalosis
- B. Hypokalemic acidosis
- C. Hypernatremic acidosis
- D. Hypokalemic alkalosis (Correct Answer)
Explanation: ***Hypokalemic alkalosis*** - **Licorice** contains **glycyrrhizic acid**, which inhibits **11β-hydroxysteroid dehydrogenase** in the kidneys, preventing the conversion of cortisol to inactive cortisone. - This leads to increased cortisol acting on **mineralocorticoid receptors**, mimicking **aldosterone excess**, resulting in **sodium reabsorption**, **potassium excretion** (hypokalemia), and **hydrogen ion excretion** (metabolic alkalosis). *Hyperkalemic alkalosis* - This option is incorrect because licorice ingestion leads to **hypokalemia** due to increased potassium excretion, not hyperkalemia. - While it does cause alkalosis, the associated potassium imbalance is the opposite of this choice. *Hypokalemic acidosis* - This option is incorrect because licorice ingestion causes a **metabolic alkalosis** due to increased hydrogen ion excretion, not acidosis. - Although it correctly identifies hypokalemia, the acid-base disturbance is wrong. *Hypernatremic acidosis* - This option is incorrect as licorice ingestion initially causes **sodium and water retention** (which can lead to hypernatremia in severe cases, but is not the primary driver of the acid-base), but primarily leads to **metabolic alkalosis**, not acidosis. - The combination of hypernatremia and acidosis is not characteristic of licorice toxicity.