NEET-PG 2015 Practice Questions

Q: Embryo gets implanted at what stage of development?

Blastocyst. Blastocyst - Implantation into the uterine wall occurs when the embryo has developed into a blastocyst, typically around day 6 post-fertilization [1]. - The blastocyst consists of an inner cell mass (which forms the embryo) and an outer layer called the trophoblast (which contributes to the placenta) [1]. Two cell stage - This stage occurs very early in development, usually within the first 24-30 hours after fertilization [1]. - At this point, the embryo is still in the fallopian tube and has not yet reached the uterus for implantation [1]. Four cell stage - The four-cell stage is also an early cleavage stage, occurring around 2 days post-fertilization [1]. - Like the two-cell stage, the embryo is still in transport through the fallopian tube and is not ready for implantation [1]. Morula - The morula is a solid ball of cells formed by cleavage, typically around day 3-4 post-fertilization [1]. - While it has moved closer to the uterus, it has not yet formed the distinct inner cell mass and trophoblast necessary for successful implantation [1].

Q: Which of the following is NOT a manifestation of vitamin E deficiency?

Autonomic dysfunction. ***Autonomic dysfunction*** - **Autonomic dysfunction** is not typically associated with vitamin E deficiency. Instead, it is commonly seen in conditions like **diabetes mellitus**, Parkinson's disease, or certain inherited neuropathies. - Vitamin E primarily acts as an **antioxidant** and is crucial for neurological and red blood cell health. *Hemolytic anemia* - Vitamin E is an **antioxidant** that protects red blood cell membranes from **oxidative damage**. - Its deficiency can lead to increased fragility and **hemolysis** of red blood cells, resulting in hemolytic anemia, particularly in premature infants. *Posterior column abnormalities* - Vitamin E deficiency can cause **neurological dysfunction** due to oxidative damage to neuronal membranes. - This often manifests as degeneration of the **posterior columns** of the spinal cord, leading to impaired proprioception and vibratory sensation. *Cerebellar ataxia* - The **cerebellum** is highly susceptible to oxidative stress, and vitamin E deficiency can lead to damage in this area. - This damage results in **ataxia**, characterized by impaired coordination, balance, and gait disturbances.

Q: What is the normal range for maximum phonation time in healthy adults?

30-35 seconds. ***30-35 seconds*** - The **maximum phonation time (MPT)** is a measure of the longest period a person can sustain a vowel sound on a single breath. - A healthy adult typically has an MPT in the range of **30-35 seconds**, reflecting good respiratory and phonatory control. *8-12 seconds* - This range is generally considered **below normal** for a healthy adult and may indicate compromised **respiratory support** or **laryngeal function**. - A short MPT could be a sign of **vocal fold pathology** or **reduced breath support**. *15-25 seconds* - While better than 8-12 seconds, this range is still often considered **slightly lower than optimal** for healthy adults. - It might suggest subtle inefficiencies in **breath control** or **vocal fold coaptation**, though it's not severely pathological. *40-45 seconds* - An MPT in this range is **unusually long** and exceeds the typical normal values for most healthy adults. - While seemingly good, excessively long MPTs are not standard and might suggest unusual respiratory capacity or an outlier measurement.

Q: Which of the following methods is not used for managing shoulder dystocia?

Hegar's maneuver. *McRobert's maneuver* - This maneuver is a common first-line intervention for shoulder dystocia, involving sharp **flexion of the mother's hips** back towards her abdomen to flatten the sacrum and rotate the symphysis pubis anteriorly. - It works by increasing the functional diameter of the **pelvic outlet**, potentially dislodging the anterior shoulder. ***Hegar's maneuver*** - **Hegar's sign** is a clinical finding related to early pregnancy, indicating the **softening of the lower uterine segment** (isthmus) upon bimanual examination. - It is a diagnostic sign of pregnancy and **not a method used to resolve shoulder dystocia**. *Zavanelli maneuver* - The **Zavanelli maneuver** is a last-resort intervention for shoulder dystocia, involving the **replacement of the fetal head into the uterus** followed by immediate delivery via **cesarean section**. - This is a highly invasive procedure with significant risks to both mother and fetus, used when other maneuvers have failed. *Wood's maneuver* - **Wood's maneuver** involves **rotating the fetal shoulders** by applying pressure to the posterior aspect of the anterior shoulder or the anterior aspect of the posterior shoulder to achieve a corkscrew effect. - This rotation can help dislodge an impacted shoulder or facilitate its passage under the symphysis pubis.

Q: A child presented to an orthopaedic clinic with a limp. The surgeon suspected him to have a fixed flexion deformity of the hip. Which test should the surgeon perform to confirm his finding?

Thomas test. ***Thomas test*** - The **Thomas test** is specifically designed to detect a **fixed flexion deformity of the hip**, where the hip cannot fully extend. - During the test, the patient's hip is flexed to flatten the lumbar spine, and if the contralateral leg then rises off the table, it indicates a fixed flexion deformity. *Trendelenburg's test* - The **Trendelenburg's test** assesses the strength and function of the **hip abductor muscles**, primarily the gluteus medius. - A positive result indicates weakness of the abductors on the standing leg, causing the pelvis to drop on the unsupported side, which is unrelated to fixed flexion deformity. *Nelaton's test* - **Nelaton's test** is used to determine the relative position of the **greater trochanter** in relation to the **ischial tuberosity** and **anterior superior iliac spine (ASIS)**, primarily in cases of hip dislocation or fracture. - It would not specifically identify a fixed flexion deformity of the hip joint itself. *Telescoping test* - The **telescoping test** is used to evaluate for hip instability, particularly in infants with **developmental dysplasia of the hip (DDH)**. - It involves applying axial pressure to the femur while moving the hip, assessing for abnormal movement of the femoral head within the acetabulum, and does not directly detect fixed flexion deformity.

Q: Which of the following statements about cross-matching of blood is false?

Donor serum is tested against recipient packed cells. ***Donor serum is tested against recipient packed cells*** - This statement is **FALSE** and describes a **minor crossmatch**, which is rarely performed in modern transfusion practice. - The minor crossmatch tests donor antibodies against recipient cells, but this is not standard practice because donor plasma is significantly diluted during transfusion, making clinically significant reactions rare. - Modern blood banking focuses on the **major crossmatch** as the critical safety measure. *Recipient serum is tested against donor packed cells* - This statement is **TRUE** and accurately describes the **major crossmatch**, which is the standard and most critical pre-transfusion compatibility test. - The major crossmatch detects antibodies in the recipient's serum that could react with donor red blood cell antigens, preventing potentially fatal hemolytic transfusion reactions. *Mandatory in all cases except emergency* - This statement is **TRUE**. Crossmatching is mandatory for safe transfusion practice. - In life-threatening emergencies where delay could be fatal, uncrossmatched O-negative (universal donor) blood may be given, but this is a rare exception. *Involves visible agglutination* - This statement is **TRUE**. A positive crossmatch indicating incompatibility is identified by **visible agglutination** or **hemolysis**. - These visible reactions occur when recipient antibodies bind to donor red blood cell antigens, signaling that transfusion would cause a severe reaction.

Q: Which of the following statements about hypernephroma is true?

Not radiosensitive. ***Radiosensitive*** - Hypernephroma, or renal cell carcinoma, is typically resistant to **radiation therapy**, making this statement false. - It is generally treated with **surgery** and targeted therapies rather than radiation. *Usually adenocarcinoma* - Hypernephroma is indeed a type of **adenocarcinoma**, as it originates from the renal tubular epithelium [1]. - It is the most common form of **kidney cancer**, supporting this as a true statement. *May present with rapidly developing varicocele* - Rapidly developing **varicocele** can occur due to **renal vein obstruction** associated with renal tumors [2], so this statement is true. - Varicocele is a recognized clinical feature in renal cell carcinoma due to its anatomical relationships. *Arise from cortex usually from pre existing adenoma* - Hypernephroma does arise from the **renal cortex**, often from pre-existing renal adenomas or other lesions. - This establishes its origin, making the statement accurate. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 959-961. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 492-493.

Q: A 3-month-old child presents with indrawing of the chest and a respiratory rate of 52 breaths per minute. This condition can be classified as:

Respiratory distress. ***Respiratory distress*** - **Indrawing of the chest** is a classic sign of increased work of breathing, indicating the child is struggling to oxygenate. - A respiratory rate of **52 breaths per minute in a 3-month-old** is significantly elevated and, combined with indrawing, points to respiratory distress. - According to **WHO IMCI guidelines**, chest indrawing in a child with fast breathing is classified as **pneumonia/respiratory distress** requiring immediate treatment. *SIRS* - **Systemic Inflammatory Response Syndrome (SIRS)** criteria are typically more comprehensive and include fever or hypothermia, tachycardia, tachypnea, and abnormal white blood cell count. - While tachypnea is present, the other defining features of SIRS are not fully met by the information provided, nor does indrawing directly classify as SIRS. *Tachypnoea* - **Tachypnoea** refers specifically to an elevated respiratory rate, which is present (52 breaths per minute). - However, the presence of **chest indrawing** indicates more than just rapid breathing; it signifies significant respiratory effort and compromise. - The classification must capture both the elevated rate and the increased work of breathing. *ARDS* - **Acute Respiratory Distress Syndrome (ARDS)** is a severe form of lung injury characterized by widespread inflammation, hypoxemia, and bilateral infiltrates on chest imaging. - While respiratory distress is a feature of ARDS, the given information is insufficient to diagnose ARDS, which requires specific criteria relating to oxygenation and radiological findings.

Q: All of the following are clinical features suggestive of tracheoesophageal fistula except -

Fever. ***Fever*** - **Fever is NOT a primary clinical feature** of tracheoesophageal fistula (TEF) itself. - While fever might occur as a **complication** if aspiration pneumonia develops, it is not a direct presenting sign of TEF. - The classic presentation of TEF occurs in **newborns within hours of birth** and involves the "3 Cs" - not fever. *Choking and Coughing* - Part of the classic **"3 Cs" triad** (Choking, Coughing, Cyanosis) of TEF presentation. - Occurs during the **first feeding attempt** when milk enters the trachea through the abnormal fistulous connection. - This is a **cardinal diagnostic feature** that should immediately raise suspicion for TEF. *Regurgitation* - **Immediate regurgitation** of feeds is characteristic, especially in TEF with esophageal atresia (most common type - Type C). - The **blind-ending proximal esophageal pouch** prevents normal passage of saliva and feeds, causing regurgitation. - Often accompanied by **excessive drooling and frothy secretions** from the mouth and nose. *Cyanosis* - The third component of the **"3 Cs" triad** and a key clinical feature. - Results from **aspiration of feeds or saliva** into the trachea and lungs, causing acute respiratory distress. - May also occur from **laryngospasm** as a protective reflex when fluid enters the airway.

Q: Most common site of colorectal carcinoma?

Sigmoid Colon. ***Sigmoid Colon*** - The **sigmoid colon** is the most common site for colorectal carcinoma, accounting for approximately **25%** of all cases. - This higher incidence is potentially due to its role in stool storage, leading to longer contact time with potential carcinogens. *Rectum* - While the rectum is a common site, it accounts for about **15-20%** of colorectal cancers, making it less frequent than the sigmoid colon. - Rectal cancers often present with **hematochezia** and changes in bowel habits. *Ascending Colon* - The **ascending colon** is less frequently affected, around **10-15%** of cases. - Tumors here are often associated with **iron deficiency anemia** due to chronic blood loss. *Descending Colon* - The **descending colon** is also less commonly affected, making up approximately **5-10%** of colorectal cancers. - Tumors in this segment may present with **obstruction** due to the narrower lumen.

Question 1

Embryo gets implanted at what stage of development?

Accepted Answer

Blastocyst

Answer

Two cell stage

Answer

Four cell stage

Answer

Morula

Question 2

Which of the following is NOT a manifestation of vitamin E deficiency?

Accepted Answer

Autonomic dysfunction

Answer

Posterior column abnormalities

Answer

Cerebellar ataxia

Answer

Hemolytic anemia

Question 3

What is the normal range for maximum phonation time in healthy adults?

Accepted Answer

30-35 seconds

Answer

15-25 seconds

Answer

40-45 seconds

Answer

8-12 seconds

Question 4

Which of the following methods is not used for managing shoulder dystocia?

Accepted Answer

Hegar's maneuver

Answer

Zavanelli maneuver

Answer

Wood's maneuver

Answer

McRobert's maneuver

Question 5

A child presented to an orthopaedic clinic with a limp. The surgeon suspected him to have a fixed flexion deformity of the hip. Which test should the surgeon perform to confirm his finding?

Accepted Answer

Thomas test

Answer

Trendelenburgs test

Answer

Telescoping test

Answer

Nelaton's test

Question 6

Which of the following statements about cross-matching of blood is false?

Accepted Answer

Donor serum is tested against recipient packed cells

Answer

Mandatory in all cases except emergency

Answer

Involves visible agglutination

Answer

Recipient serum is tested against donor packed cells

Question 7

Which of the following statements about hypernephroma is true?

Accepted Answer

Not radiosensitive

Answer

May present with rapidly developing varicocele

Answer

Usually an adenocarcinoma

Answer

Arises from the cortex, usually from a pre-existing adenoma

Question 8

A 3-month-old child presents with indrawing of the chest and a respiratory rate of 52 breaths per minute. This condition can be classified as:

Accepted Answer

Respiratory distress

Answer

SIRS

Answer

Tachypnoea

Answer

ARDS

Question 9

All of the following are clinical features suggestive of tracheoesophageal fistula except -

Accepted Answer

Fever

Answer

Choking and Coughing

Answer

Regurgitation

Answer

Cyanosis

Question 10

Most common site of colorectal carcinoma?

Accepted Answer

Sigmoid Colon

Answer

Ascending Colon

Answer

Descending Colon

Answer

Rectum

NEET-PG 2015

Anatomy

Biochemistry

ENT

Obstetrics and Gynecology

Orthopaedics

Pathology

Pediatrics

Surgery