NEET-PG 2015 Practice Questions

Q: Cephalic index is calculated as

Biparietal Diameter / Occipitofrontal Diameter. ***Biparietal Diameter / Occipitofrontal Diameter*** - The **cephalic index** is a measure used in **craniometry** to describe the shape of the skull, calculated by dividing the maximum **biparietal diameter** (width) by the maximum **occipitofrontal diameter** (length) and multiplying by 100. [1] - This ratio helps classify head shapes into **brachycephalic** (short, wide), **mesocephalic** (medium), and **dolichocephalic** (long, narrow). *Biparietal Diameter / Head Circumference* - This ratio is not the standard definition for the **cephalic index**; head circumference is a measure of overall head size, not its proportional shape in terms of width to length. - While both parameters are used in fetal biometry, their ratio does not define the **cephalic index**. *Head Circumference / Femur Length* - This ratio is completely unrelated to the **cephalic index**. - **Head circumference** estimates head size, and **femur length** estimates fetal long bone growth, both used for gestational age assessment, but not for skull shape. *Occipitofrontal Diameter / Biparietal Diameter* - This formula represents the inverse of the **cephalic index**, which would yield a different and non-standard index for skull shape. - The traditional and medically recognized formula for the **cephalic index** places the **biparietal diameter** in the numerator.

Q: Which is the most common tumor leading to death in adults?

Lung cancer. ***Lung cancer*** - **Lung cancer** is the most common cause of cancer-related death in both men and women worldwide [1], [2]. - Its high mortality is attributed to its aggressive nature, late diagnosis, and limited treatment options for advanced stages [3]. *Prostate cancer* - While **prostate cancer** is very common in men, it typically has a slower progression and a relatively high survival rate compared to lung cancer. - Early detection through screening often leads to successful treatment and a good prognosis. *Colorectal cancer* - **Colorectal cancer** is a significant cause of cancer mortality but ranks behind lung cancer in overall deaths [2]. - Improved screening methods like colonoscopies allow for early detection and removal of precancerous polyps, reducing mortality. *Leukemia* - **Leukemia** refers to cancers of the blood and bone marrow, and while serious, they are less common causes of cancer death than solid tumors like lung, colorectal, or prostate cancer [2]. - Advances in chemotherapy, stem cell transplantation, and targeted therapies have significantly improved survival rates for many types of leukemia.

Q: A man working in a hot environment and consuming large amounts of water without replacing salts is likely to develop -

Heat cramps. ***Heat cramps*** - **Heat cramps** are painful, involuntary muscle spasms that occur during or after strenuous activity in a hot environment, especially when there is excessive sweating and **inadequate salt replacement**. - The consumption of **large amounts of water** without replacing electrolytes further dilutes the remaining electrolytes, exacerbating the problem. *Heat hyperpyrexia* - **Heat hyperpyrexia** is characterized by a very high core body temperature (typically >106°F or 41.1°C) without central nervous system dysfunction [1]. - While it involves extreme heat exposure, the primary problem described (muscle cramps due to fluid and **electrolyte imbalance**) is not hyperpyrexia itself but a milder heat illness. *Heat stroke* - **Heat stroke** is a severe, life-threatening condition involving a dangerously elevated body temperature (>104°F or 40°C) along with **central nervous system dysfunction** (e.g., altered mental status, seizures) [1], [2]. - Although strenuous activity and heat exposure contribute, the predominant symptoms described are muscle cramps, not the systemic collapse characteristic of heat stroke. *Heat encephalopathy* - **Heat encephalopathy** refers to the neurological manifestations of severe heat illness, particularly **heat stroke**, involving altered mental status, confusion, and possibly seizures. - While heat cramps are a form of heat illness, they primarily involve muscle symptoms and do not typically include direct brain dysfunction as the primary feature.

Q: Which serum level is increased in premature ovarian failure?

Serum FSH. ***Serum FSH*** - In **premature ovarian failure**, the ovaries fail to produce sufficient estrogen and inhibin, leading to a loss of negative feedback on the pituitary gland. - This lack of negative feedback results in continuously **elevated levels of FSH** as the pituitary tries to stimulate the non-responsive ovaries. *Serum Inhibin* - **Inhibin** is a hormone produced by ovarian granulosa cells, which normally inhibits FSH secretion. - In premature ovarian failure, due to ovarian dysfunction, **inhibin levels are typically decreased**, not increased. *Serum Estradiol* - **Estradiol** is the primary estrogen produced by the ovaries. - In premature ovarian failure, the ovaries are failing, resulting in **decreased production of estrogen/estradiol**. *Serum Progesterone* - **Progesterone** is primarily produced after ovulation by the corpus luteum. - In premature ovarian failure, ovulation is impaired or absent, leading to **low or undetectable progesterone levels**.

Q: The Salter Harris classification is used for classifying which type of injuries?

Fractures involving the physis in children. ***Fractures involving the physis in children*** - The **Salter-Harris classification system** is specifically designed for classifying fractures that involve the **growth plate (physis)** in children. - This system helps predict the risk of **growth disturbance** and guides treatment decisions based on the fracture pattern. *Soft tissue injuries in pediatric patients* - The Salter-Harris classification does not apply to **soft tissue injuries** like sprains or strains. - Soft tissue injuries are assessed using different classification systems or descriptive terms. *Long bone fractures without growth plate involvement* - Fractures in children that do not involve the growth plate are classified using descriptive terms, such as **transverse**, **oblique**, or **spiral fractures**, or other systems like the **AO pediatric classification**, not Salter-Harris. - The Salter-Harris system is unique to physis involvement. *Joint dislocations in pediatric orthopedics* - **Joint dislocations** involve the displacement of bones at a joint and are classified by the direction of displacement (e.g., anterior, posterior). - They do not involve a fracture of the growth plate itself, so the Salter-Harris system is not applicable.

Q: During performing a total hip replacement, the surgeon found destruction of the articular cartilage and multiple wedge-shaped subchondral depressions. What is this called?

Osteonecrosis. ***Osteonecrosis*** - **Osteonecrosis**, also known as **avascular necrosis**, is characterized by the death of bone tissue due to a lack of blood supply, which leads to the collapse of the subchondral bone and articular cartilage destruction. - The description of **wedge-shaped subchondral depressions** and **articular cartilage destruction** is highly indicative of osteonecrosis, especially in the context of advanced hip joint pathology requiring total hip replacement. *Osteolysis* - **Osteolysis** refers to the active resorption of bone, often seen around implants in prosthetic joints due to wear particles, leading to bone loss. - While it involves bone destruction, it typically presents as diffuse bone loss rather than specific wedge-shaped subchondral depressions. *Osteomyelitis* - **Osteomyelitis** is an infection of the bone or bone marrow, often leading to bone destruction, but it is primarily characterized by inflammation and pus formation. - The presented scenario does not mention signs of infection (e.g., fever, pus, inflammation) but focuses purely on structural destruction consistent with vascular compromise. *Osteogenesis* - **Osteogenesis** is the process of bone formation or development. - This term describes the creation of bone tissue and is the opposite of bone destruction, making it an incorrect answer for a condition involving cartilage and bone deterioration.

Q: Further investigation is essential in a newborn with which of the following conditions?

Lens opacity. ***Lens opacity*** - A **lens opacity** in a newborn suggests congenital **cataracts**, which can lead to permanent vision impairment if not identified and treated early. - **Investigation is essential** to identify underlying causes such as **TORCH infections** (Toxoplasmosis, Rubella, CMV, HSV), **metabolic disorders** (galactosemia, Lowe syndrome), **genetic syndromes**, or **chromosomal abnormalities**. - Early detection and management are crucial to prevent **amblyopia** (lazy eye) and optimize visual development during the **critical period** of visual maturation. - Investigations include: TORCH titers, urine for reducing substances, metabolic screening, and genetic evaluation. *Erythema toxicum* - This is a common, **benign newborn rash** characterized by blotchy red macules and papules with central vesicles or pustules. - It typically resolves spontaneously within days to a few weeks and requires **no specific investigation or treatment**. *Vaginal bleed* - A small amount of **vaginal bleeding** in female newborns is usually due to the temporary withdrawal of maternal hormones (e.g., estrogen) after birth. - This is a **physiologic response** and generally self-resolves, requiring no further investigation unless excessive or prolonged. *Subconjunctival hemorrhage* - This occurs due to the rupture of tiny blood vessels in the eye during the birthing process, often associated with **vaginal delivery**. - It is a **benign condition** that resolves on its own within a couple of weeks and does not affect vision.

Q: Which of the following statements about cephalhematoma is correct?

It is hemorrhage between the skull and periosteum. ***It is hemorrhage between the skull and periosteum*** - A **cephalhematoma** is defined as a collection of blood between the **periosteum** and the underlying **skull bone** (subperiosteal). - Its boundaries are limited by the suture lines because the periosteum is firmly attached at these junctions, preventing blood from crossing. *It is hemorrhage within the subcutaneous tissue around the skull* - This description corresponds to a **caput succedaneum**, which involves **edema and hemorrhage** in the subcutaneous tissue, rather than between the skull and periosteum. - Unlike a cephalhematoma, a **caput succedaneum** can cross suture lines and is typically present at birth. *It is type of subdural hemorrhage* - A **subdural hemorrhage** involves bleeding between the **dura mater** and the **arachnoid mater** within the cranial vault. - This type of hemorrhage is a **neurological emergency** and is distinct from a cephalhematoma, which is an external scalp injury. *It is subperiosteal bleeding in the skull* - While this statement is technically correct (subperiosteal means under the periosteum), the **standard definition** specifically states "between the periosteum and the skull bone." - The distinction is important: **subperiosteal** could theoretically include bleeding within the periosteum itself, whereas the precise location is in the **potential space** between periosteum and bone. - Option A is more precise and is the preferred medical definition.

Q: Vacuum assisted closure is contraindicated in which of the following conditions -

Large amount of necrotic tissue with eschar. ***Large amount of necrotic tissue with eschar*** - The presence of a large amount of **necrotic tissue** and **eschar** is a contraindication for VAC therapy because it prevents effective contact between the foam and viable tissue, impairing wound healing. - Eschar acts as a physical barrier, trapping bacteria and hindering the proper function of negative pressure by preventing uniform pressure distribution and fluid removal from the wound bed. *Chronic osteomyelitis* - While chronic osteomyelitis can be challenging, VAC therapy can sometimes be used as an **adjunctive treatment** after surgical debridement to manage the wound and promote granulation tissue formation. - It helps in controlling infection and closing the wound by removing exudates, reducing edema, and improving blood flow. *Abdominal wound* - VAC therapy is commonly used for **abdominal wounds**, especially after damage control surgery or in cases of open abdomen management. - It facilitates closure by promoting granulation, reducing edema, and protecting the abdominal contents. *Surgical wound dehiscence* - **Surgical wound dehiscence** is a common indication for VAC therapy, as it helps to manage the open wound, promote granulation tissue, and prepare the wound for eventual secondary closure or grafting. - VAC therapy reduces surgical site infections, removes exudates, and enhances tissue perfusion, leading to better wound healing outcomes.

Question 1

Cephalic index is calculated as

Accepted Answer

Biparietal Diameter / Occipitofrontal Diameter

Answer

Biparietal Diameter / Head Circumference

Answer

Head Circumference / Femur Length

Answer

Occipitofrontal Diameter / Biparietal Diameter

Question 2

Which is the most common tumor leading to death in adults?

Accepted Answer

Lung cancer

Answer

Prostate cancer

Answer

Colorectal cancer

Answer

Leukemia

Question 3

A man working in a hot environment and consuming large amounts of water without replacing salts is likely to develop -

Accepted Answer

Heat cramps

Answer

Heat hyperpyrexia

Answer

Heat stroke

Answer

Heat encephalopathy

Question 4

Which serum level is increased in premature ovarian failure?

Accepted Answer

Serum FSH

Answer

Serum Inhibin

Answer

Serum Estradiol

Answer

Serum Progesterone

Question 5

The Salter Harris classification is used for classifying which type of injuries?

Accepted Answer

Fractures involving the physis in children

Answer

Soft tissue injuries in pediatric patients

Answer

Long bone fractures without growth plate involvement

Answer

Joint dislocations in pediatric orthopedics

Question 6

During performing a total hip replacement, the surgeon found destruction of the articular cartilage and multiple wedge-shaped subchondral depressions. What is this called?

Accepted Answer

Osteonecrosis

Answer

Osteolysis

Answer

Osteomyelitis

Answer

Osteogenesis

Question 7

Further investigation is essential in a newborn with which of the following conditions?

Accepted Answer

Lens opacity

Answer

Vaginal bleed

Answer

Subconjunctival hemorrhage

Answer

Erythema toxicum

Question 8

Which of the following statements about cephalhematoma is correct?

Accepted Answer

It is hemorrhage between the skull and periosteum

Answer

It is hemorrhage within the subcutaneous tissue around the skull

Answer

It is type of subdural hemorrhage

Answer

It is subperiosteal bleeding in the skull

Question 9

Which of the following characteristics is most accurate about Boerhaave syndrome?

Accepted Answer

Most common site is left posterolateral aspect 3 - 5 cms above the gastroesophageal junction

Answer

Most cases follow a bout of heavy eating or drinking

Answer

Perforation of the esophagus due to barotrauma

Answer

Sudden severe chest pain is an early manifestation

Question 10

Vacuum assisted closure is contraindicated in which of the following conditions -

Accepted Answer

Large amount of necrotic tissue with eschar

Answer

Chronic osteomyelitis

Answer

Abdominal wound

Answer

Surgical wound dehiscence

NEET-PG 2015

Anatomy

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Pediatrics

Surgery