NEET-PG 2015 Practice Questions

Q: Which of the following statements about development milestones at 6 months of age is incorrect?

Pincer grasp. ***Pincer grasp*** - The **pincer grasp** (using the index finger and thumb to pick up small objects) typically develops much later, usually around **9-12 months** of age. - At 6 months, infants are usually developing a **palmar grasp** or raking motion, not the fine motor control required for a pincer grasp. - This milestone is **NOT expected at 6 months**, making this the incorrect statement. *Watching self in mirror* - By 6 months, infants typically show **interest in their own reflection** and will watch themselves in a mirror, often smiling or vocalizing at the image. - This is a normal social-emotional milestone at this age. *Sitting in tripod position* - Many 6-month-old infants are able to sit with support, and often begin to sit independently for short periods, frequently using their arms for stability in a **tripod position**. - This is a common and expected gross motor milestone at this age. *Monosyllable sounds* - Around 6 months, infants commonly start to produce **monosyllable sounds** like "ba-ba," "da-da," or "ma-ma," as part of their early babbling. - This is a normal and expected language development milestone.

Q: At what age do children typically begin to use past and present tense in their speech?

30 Months. ***30 Months*** - Around 30 months (2.5 years), children typically begin to comprehend and produce **simple past and present tense forms**. - This stage reflects an increased understanding of **time concepts** and more complex grammatical structures. *1 Year* - At 1 year, children are usually at the **single-word stage**, using vocabulary like 'mama' or 'dada'. - They are primarily focused on **naming objects and people**, with little to no grasp of verb tenses. *2 Years* - By 2 years, children are generally using **two-word phrases** and beginning to combine words into simple sentences. - While they are expanding their vocabulary, consistent use of distinct past and present tenses is still developing. *18 Months* - Children at 18 months are typically expanding their **single-word vocabulary** and may be starting to use two-word combinations. - Their language is still focused on immediate needs and objects, without the grammatical complexity of verb tenses.

Q: Which of the following is NOT a milestone typically expected at 1 year of age?

Walking upstairs independently. ***Walking upstairs independently*** - **Walking upstairs independently** is a gross motor skill that typically develops much later, around **24-36 months of age**, as it requires advanced balance, coordination, and bilateral leg strength. - At 1 year, an infant might be able to *pull to stand*, *cruise* (walk while holding onto furniture), or take a few independent steps, but independent stair climbing is well beyond their developmental capacity. *Playing a simple ball game* - By 1 year, many infants can participate in simple interactive games like rolling a ball back and forth, demonstrating early **social reciprocity and motor coordination**. - This activity involves basic object manipulation and understanding of turn-taking, which are typical **social-adaptive milestones** at this age. *Using 2 words that are meaningful* - Most 1-year-olds can say 1-2 meaningful words besides "mama" and "dada" (e.g., "ball", "dog", "bye"), showing emerging **expressive language skills**. - This milestone is indicative of vocabulary development and the child's ability to associate words with objects or actions. *Spontaneous scribbling* - Around 12 months, children typically make **imitative scribbles** when shown how to use a crayon, demonstrating early **fine motor control**. - While some advanced 1-year-olds may begin spontaneous scribbling, this skill is more consistently achieved around **15-18 months**, making it an age-appropriate milestone for most infants at 1 year. - The key distinction is that at 1 year, scribbling is usually *prompted* rather than truly spontaneous.

Q: At what age does stranger anxiety typically develop in infants?

7 months. ***7 months*** - **Stranger anxiety** typically emerges around **6-8 months** of age, peaking around 9-12 months. - This developmental stage reflects the infant's growing ability to distinguish between familiar and unfamiliar faces and their developing **attachment to primary caregivers**. *3 months* - At 3 months, infants are typically in an earlier stage of social development, primarily focusing on **recognizing primary caregivers** and showing social smiles. - They generally do not exhibit stranger anxiety, as their cognitive and emotional development has not yet reached that milestone. *4 months* - While 4-month-olds are becoming more socially aware and responsive, their **object permanence** and ability to differentiate strangers from familiar faces is still developing. - Therefore, definitive stranger anxiety is typically not observed at this age. *11 months* - By 11 months, stranger anxiety has already developed and is usually **at its peak**, as infants at this age have a well-established sense of who their primary caregivers are. - While stranger anxiety is very prominent at this age, it is not when it typically **develops** (initial emergence), but rather when it is most pronounced.

Q: What is the average weight gain of the neonate per day after the initial weight loss period?

25-30 g. ***25-30 g*** - After the initial physiological weight loss (typically 5-10% of birth weight in the first few days), healthy term neonates should gain approximately **25-30 grams per day**. - This consistent weight gain indicates adequate feeding and healthy development in the first month of life. *5-10 g* - This range is too low for the average daily weight gain after the initial weight loss period. - A gain of only **5-10 g per day** would suggest inadequate feeding or an underlying medical issue. *50-60 g* - This rate of weight gain is typically seen in **older infants** (e.g., 2-3 months of age) or in cases of catch-up growth, not usually in the immediate neonatal period after initial weight loss. - While rapid growth can occur, 50-60 g/day is above the average for a neonate. *100-150 g* - This is an **excessively high** rate of daily weight gain for a neonate. - Such rapid weight gain is not typical and could potentially indicate measurement error or an unusual metabolic state.

Q: What is the most common cause of pneumonia in early onset sepsis in neonates?

Group B streptococcus. ***Group B streptococcus*** - **Group B Streptococcus (GBS)** is the leading cause of **early-onset sepsis** and pneumonia in neonates, typically acquired during passage through the birth canal. - Maternal GBS colonization is a significant risk factor, and GBS can cause **severe respiratory distress** in affected newborns. *H influenzae* - **_Haemophilus influenzae_** is a more common cause of **late-onset sepsis** or pneumonia in infants and children, rather than early-onset neonatal disease. - While it can cause neonatal infections, it is much less frequent than GBS in the early-onset period. *Coagulase positive staph aureus* - **_Staphylococcus aureus_** is a common cause of **nosocomial infections** or late-onset sepsis in neonates, particularly in ventilated or catheterized infants. - It is not the most common pathogen for community-acquired **early-onset neonatal pneumonia**. *Listeria* - **_Listeria monocytogenes_** can cause severe neonatal sepsis and pneumonia, often associated with maternal consumption of contaminated food. - While it is a significant pathogen, it is less common overall than GBS as a cause of early-onset neonatal pneumonia in most regions.

Q: All of the following are medical uses of erythropoietin except?

Megaloblastic Anemia. ***Megaloblastic Anemia*** - Megaloblastic anemia is caused by **vitamin B12 or folate deficiency**, which impairs DNA synthesis and leads to the production of large, immature red blood cells. - Treatment involves supplementing the deficient vitamin (B12 or folate), as erythropoietin does not address the underlying cause of impaired red blood cell maturation. *Treatment of anaemia associated with renal disease* - **Erythropoietin** is primarily produced by the kidneys, and chronic kidney disease often leads to decreased erythropoietin production, resulting in anemia. - Administering exogenous erythropoietin stimulates red blood cell production, making it a critical treatment for **anemia of chronic kidney disease**. *Chemotherapy induced anemia* - Chemotherapy can suppress bone marrow function, leading to **decreased red blood cell production** and subsequent anemia. - Erythropoietin-stimulating agents can be used to mitigate this side effect by **stimulating erythropoiesis** in the bone marrow. *Specific cases of anemia associated with Crohn's disease.* - Anemia in Crohn's disease can have multiple causes, including iron deficiency from blood loss, malabsorption of vitamins, and **anemia of chronic disease**. - Erythropoietin may be considered in cases where the anemia is primarily due to **inflammation-induced suppression of erythropoiesis** or decreased erythropoietin response, particularly if other treatments are ineffective.

Q: What is the primary change in fetal circulation that occurs at birth?

Closure of the foramen ovale. ***Closure of the foramen ovale*** - The **foramen ovale** undergoes functional closure within minutes of birth, making it the **primary immediate circulatory change** - At birth, the first breath causes **dramatic decrease in pulmonary vascular resistance** and **increased pulmonary blood flow**, which raises **left atrial pressure** - Simultaneously, umbilical cord clamping **increases systemic vascular resistance** and **decreases right atrial pressure** (loss of placental return) - This **pressure gradient reversal** (left atrial pressure > right atrial pressure) causes the **septum primum** to be pushed against the **septum secundum**, achieving functional closure - This immediately separates the systemic and pulmonary circulations, which is the **most critical primary change** in transitioning from fetal to neonatal circulation *Closure of the patent ductus arteriosus* - The **ductus arteriosus** undergoes **functional closure over 10-15 hours** after birth, followed by **anatomical closure over 2-3 weeks** - Closure occurs due to increased arterial oxygen tension and decreased prostaglandin E2 levels, causing smooth muscle constriction - While important, this is a **secondary change** that occurs more gradually compared to the immediate foramen ovale closure *Closure of the ductus venosus* - The **ductus venosus** closes functionally within 3-7 days as umbilical venous flow ceases - This redirects portal blood through the liver but does not directly impact the critical pulmonary-systemic circulation separation *Increased activity of the right ventricle* - After birth, the **left ventricle** becomes dominant as it pumps against higher systemic vascular resistance - The right ventricle actually experiences **decreased afterload** due to falling pulmonary vascular resistance - This is a consequence of, not the primary change in, the circulatory transition

Q: What is the IQ range associated with borderline intellectual functioning?

70 - 80. ***70 - 80*** - The IQ range of **70-80** (or sometimes 70-85, depending on the classification system) is typically defined as **borderline intellectual functioning**. - Individuals in this range may have some difficulties with **adaptive skills** and academic performance, but they do not meet the criteria for intellectual disability. *50 - 69* - An IQ range of **50-69** is generally classified as **mild intellectual disability**. - Individuals in this range often require significant support to achieve academic and occupational independence. *20 - 49* - An IQ range of **20-49** is categorized as **moderate intellectual disability**. - People in this range typically need substantial support in daily living activities and adaptive functioning. *0 - 20* - An IQ range of **0-20** (or sometimes 0-19) indicates **severe or profound intellectual disability**. - Individuals with IQs in this range require full-time care and supervision due to significant impairments in adaptive functioning.

Q: Which type of surgical suture is known to cause the most tissue reaction?

Silk. ***Silk*** - Silk is a **natural, braided, non-absorbable suture** that is known to elicit a significant **inflammatory reaction** due to its natural protein composition and braided structure. - While it was historically used for its good handling properties, its high tissue reactivity makes it less ideal for situations where minimal scarring or inflammation is desired. - **Silk causes the most tissue reaction** among commonly used sutures. *Plain Catgut* - Plain catgut is a **natural, absorbable suture** derived from purified collagen of animal intestines, causing a moderate to high tissue reaction. - However, its absorption by enzymatic hydrolysis is relatively rapid, limiting the duration of the inflammatory response compared to non-absorbable natural materials like silk. *Polydiaxonone* - Polydiaxonone (PDS) is a **synthetic, monofilament, absorbable suture** known for causing a relatively **low tissue reaction**. - Its slow absorption profile and monofilament structure contribute to its minimal inflammatory response, making it suitable for tissues requiring prolonged support. *Chromic Catgut* - Chromic catgut is a treated form of plain catgut that has been coated with chromium salts, which prolong its absorption time and reduce its tissue reactivity compared to plain catgut. - Although it is still a natural, absorbable suture, its tissue reaction is **less than both plain catgut and silk**, but greater than synthetic monofilament sutures like PDS.

Question 1

Which of the following statements about development milestones at 6 months of age is incorrect?

Accepted Answer

Pincer grasp

Answer

Watching self in mirror

Answer

Sitting in tripod position

Answer

Monosyllable sounds

Question 2

At what age do children typically begin to use past and present tense in their speech?

Accepted Answer

30 Months

Answer

18 Months

Answer

1 Year

Answer

2 Years

Question 3

Which of the following is NOT a milestone typically expected at 1 year of age?

Accepted Answer

Walking upstairs independently

Answer

Playing a simple ball game

Answer

Using 2 words that are meaningful

Answer

Spontaneous scribbling

Question 4

At what age does stranger anxiety typically develop in infants?

Accepted Answer

7 months

Answer

3 months

Answer

4 months

Answer

11 months

Question 5

What is the average weight gain of the neonate per day after the initial weight loss period?

Accepted Answer

25-30 g

Answer

5-10 g

Answer

50-60 g

Answer

100-150 g

Question 6

What is the most common cause of pneumonia in early onset sepsis in neonates?

Accepted Answer

Group B streptococcus

Answer

H influenzae

Answer

Coagulase positive staph aureus

Answer

Listeria

Question 7

All of the following are medical uses of erythropoietin except?

Accepted Answer

Megaloblastic Anemia

Answer

Treatment of anaemia associated with renal disease

Answer

Chemotherapy induced anemia

Answer

Specific cases of anemia associated with Crohn's disease.

Question 8

What is the primary change in fetal circulation that occurs at birth?

Accepted Answer

Closure of the foramen ovale

Answer

Closure of the ductus venosus

Answer

Increased activity of the right ventricle

Answer

Closure of the patent ductus arteriosus

Question 9

What is the IQ range associated with borderline intellectual functioning?

Accepted Answer

70 - 80

Answer

0 - 20

Answer

50 - 69

Answer

20 - 49

Question 10

Which type of surgical suture is known to cause the most tissue reaction?

Accepted Answer

Silk

Answer

Plain Catgut

Answer

Polydiaxonone

Answer

Chromic catgut

NEET-PG 2015

Pediatrics

Pharmacology

Physiology

Psychiatry

Surgery