Anesthesiology
1 questionsWhat does the image of the Capnograph depict?
NEET-PG 2020 - Anesthesiology NEET-PG Practice Questions and MCQs
Question 91: What does the image of the Capnograph depict?
- A. Capnograph during inspiration
- B. Capnograph showing inspiration with cardiac oscillations
- C. Capnograph during expiration
- D. Capnograph indicating spontaneous respiration (Correct Answer)
Explanation: ***Capnograph indicating spontaneous respiration*** - The characteristic dip in the **EtCO2 waveform** during the plateau phase (phaselll) is indicative of a breath taken by the individual which is a classic finding of **spontaneous respiration**. This dip is because when a patient takes a breath in, fresh gas with no CO2 is pulled into the sampling line momentarily decreasing the measured CO2. - This pattern is often referred to as a "**curare cleft**" or "**respiratory indentation**," and it signifies incomplete paralysis or return of spontaneous breathing. *Capnograph during inspiration* - During normal inspiration, there is no CO2 in the inhaled air, so the capnograph reading would theoretically drop to **zero** or near-zero, not exhibit a waveform with a plateau. - The baseline of the capnograph reflects inspiration, which should be flat (zero CO2). *Capnograph showing inspiration with cardiac oscillations* - Cardiac oscillations typically appear as **small rhythmic fluctuations** on the baseline or the expiratory plateau, synchronized with the heartbeat. - These oscillations are usually much smaller and do not present as distinct, sharp dips within the expiratory plateau as seen in the image. *Capnograph during expiration* - During a normal expiration, the capnograph waveform rises from a baseline of zero (phase I, **dead space ventilation**) to a plateau (phase III, **alveolar gas emptying**) with a peak value, before returning to baseline during inspiration. - While the image shows expiration with a plateau, the key feature of the dip during the plateau is more specific to spontaneous respiration than just general expiration.
Biochemistry
1 questionsAddition of which Amino Acid will increase UV absorption
NEET-PG 2020 - Biochemistry NEET-PG Practice Questions and MCQs
Question 91: Addition of which Amino Acid will increase UV absorption
- A. Tryptophan (Correct Answer)
- B. Leucine
- C. Proline
- D. Arginine
Explanation: ***Tryptophan*** - **Tryptophan** contains an **indole ring** with a conjugated pi system responsible for strong **UV light absorption** at approximately **280 nm**. - Its unique aromatic structure allows it to absorb UV light, making it a key amino acid for protein quantification using **spectrophotometry**. *Leucine* - **Leucine** is an **aliphatic amino acid** with a non-polar side chain and lacks chromophores. - It does not significantly absorb UV light in the typical range used for protein analysis. *Proline* - **Proline** is an **imino acid** with a unique cyclic structure, but it lacks aromatic rings or conjugated double bonds. - It does not absorb UV light significantly at wavelengths above 230 nm. *Arginine* - **Arginine** is a **basic amino acid** with a guanidinium group, but this functional group does not contribute to UV absorption in the 280 nm range. - Its presence does not enhance the UV absorbance of proteins.
Community Medicine
1 questionsIn which of the following methods of management is the benefit measured in natural units?
NEET-PG 2020 - Community Medicine NEET-PG Practice Questions and MCQs
Question 91: In which of the following methods of management is the benefit measured in natural units?
- A. Network analysis
- B. Cost-benefit analysis
- C. Program budgeting system
- D. Cost-effectiveness analysis (Correct Answer)
Explanation: ***Cost-effectiveness analysis*** - In **cost-effectiveness analysis**, the benefits of a healthcare intervention are measured in **natural units** (e.g., lives saved, years of life gained, cases cured, reduction in symptoms). - This method compares the costs of different interventions to achieve a specific health outcome, expressed in a non-monetary unit. *Network analysis* - **Network analysis** is a project management technique used to plan and control complex projects, often for scheduling tasks and identifying critical paths. - Its primary focus is on task dependencies and timelines, not on measuring benefits of management interventions in natural units. *Cost-benefit analysis* - In **cost-benefit analysis**, both the costs and the benefits of an intervention are converted into **monetary units**. - This allows for a comparison where a project is deemed beneficial if its monetary benefits outweigh its monetary costs. *Program budgeting system* - A **program budgeting system** is a financial planning and management tool that links expenditures to the achievement of specific program objectives. - While it focuses on resource allocation and outcomes, it does not primarily measure benefits in natural health units.
Obstetrics and Gynecology
1 questionsA sexually active female presenting with profuse frothy foul-smelling discharge with intense itching. Strawberry cervix revealed on examination. What will be the diagnosis?
NEET-PG 2020 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 91: A sexually active female presenting with profuse frothy foul-smelling discharge with intense itching. Strawberry cervix revealed on examination. What will be the diagnosis?
- A. Trichomonas vaginalis (Correct Answer)
- B. Bacterial vaginosis
- C. Candidiasis
- D. None of the options
Explanation: **Trichomonas vaginalis** - The classic presentation of **profuse, frothy, foul-smelling vaginal discharge** with **intense itching** and the presence of a **strawberry cervix** are highly characteristic of a *Trichomonas vaginalis* infection. - *Trichomonas vaginalis* is a **motile protozoan** and a common sexually transmitted infection. *Bacterial vaginosis* - While bacterial vaginosis (BV) causes a **foul-smelling discharge** (often described as "fishy"), it is typically **thin and grayish-white**, not frothy, and does not cause a strawberry cervix. - BV is caused by an **overgrowth of anaerobic bacteria** and a decrease in lactobacilli, leading to an elevated vaginal pH. *Candidiasis* - Candidiasis (yeast infection) presents with a **thick, white, "cottage cheese-like" discharge** and intense itching, but the discharge is usually odorless and it does not cause a frothy discharge or strawberry cervix. - It is caused by an **overgrowth of *Candida* species**, primarily *Candida albicans*, and is not typically sexually transmitted. *None of the options* - Given the classic constellation of symptoms and definitive signs, a specific diagnosis can be made, making this option incorrect.
Pathology
2 questionsHBsAg is based on which principle
A 30-year-old male presents with swelling around the knee joint. Histopathological examination reveals many giant cells interspersed with mononuclear cells. What is the most likely diagnosis?
NEET-PG 2020 - Pathology NEET-PG Practice Questions and MCQs
Question 91: HBsAg is based on which principle
- A. Chemiluminescence
- B. Immunofluorescence
- C. Immunochromatography assays
- D. ELISA (Correct Answer)
Explanation: ***ELISA*** - **Enzyme-linked immunosorbent assay (ELISA)** is a widely used laboratory test to detect and quantify antigens (like HBsAg) or antibodies in a sample. - It involves an enzyme-linked antibody that reacts with a substrate to produce a detectable signal, making it highly sensitive and specific for **HBsAg detection**. *Immunochromatography assays* - These are typically **rapid diagnostic tests (RDTs)** that provide quick qualitative results, often used for point-of-care testing. - While they can detect HBsAg, they generally have lower sensitivity and specificity compared to ELISA. *Chemiluminescence* - This is a detection method used in some immunoassays where a chemical reaction emits light, often providing higher sensitivity than colorimetric detection. - While it can be incorporated into HBsAg testing platforms, it is a *detection principle* rather than the primary assay principle like ELISA itself. *Immunofluorescence* - This technique uses **fluorescently labeled antibodies** to visualize antigens in cells or tissues under a fluorescence microscope [1]. - It is used for localization and identification of antigens, but not typically the primary method for routine quantitative HBsAg serology [1]. **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. 259-260.
Question 92: A 30-year-old male presents with swelling around the knee joint. Histopathological examination reveals many giant cells interspersed with mononuclear cells. What is the most likely diagnosis?
- A. Osteosarcoma
- B. Ewing's sarcoma
- C. Giant cell tumour (Correct Answer)
- D. Chondrosarcoma
Explanation: ***Giant cell tumour*** - The presence of **giant cells** interspersed with **mononuclear cells** in the histopathological examination is characteristic of giant cell tumors [1], often found around the **knee joint** [1]. - Typically occurs in **young adults** and is associated with **subarticular bone lesions** that cause joint swelling [1]. *Osteosarcoma* - Generally presents with **extensive bone destruction** and **persistent pain**, along with a mass, not primarily giant cell formation. - Commonly involves individuals aged **10-20 years**, making it less likely in a 30-year-old male. *Ewing's sarcoma* - Characterized by **small round blue cells** on histology, often with **more aggressive behavior** and less prominent giant cells. - Typically affects the **pelvis** and **long bones**, rather than directly around the knee joint. *Chondrosarcoma* - Primarily characterized by **cartilage formation** with no prominent giant cells, often leading to a confusing diagnosis in imaging. - Usually occurs in **older adults** and does not typically present with predominant giant cells in histopathology. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, pp. 1205-1206.
Pharmacology
2 questionsWhich of the following drugs can be given in patients of primary pulmonary hypertension?
A patient diagnosed with Rheumatoid arthritis was on medications. After 2 years, he developed a blurring vision and was found to have corneal opacity. Which drug is most likely to cause this?
NEET-PG 2020 - Pharmacology NEET-PG Practice Questions and MCQs
Question 91: Which of the following drugs can be given in patients of primary pulmonary hypertension?
- A. Icatibant
- B. Bosentan (Correct Answer)
- C. Sodium nitroprusside
- D. Labetalol
Explanation: ***Bosentan*** - **Bosentan** is an **endothelin receptor antagonist** that blocks the vasoconstrictive and proliferative effects of endothelin-1, a key mediator in the pathogenesis of **pulmonary hypertension**. - It is an FDA-approved medication specifically used for the treatment of **pulmonary arterial hypertension (PAH)**, improving exercise capacity and delaying clinical worsening. *Icatibant* - **Icatibant** is a **bradykinin B2 receptor antagonist** used in the treatment of **hereditary angioedema**. - It has no known role or efficacy in the management of **primary pulmonary hypertension**. *Labetalol* - **Labetalol** is a **beta-blocker** with **alpha-1 adrenergic blocking activity** used primarily for systemic **hypertension** and **hypertensive emergencies**. - Beta-blockers are generally **contraindicated** in pulmonary hypertension as they can worsen right heart function and lead to clinical deterioration. *Sodium nitroprusside* - **Sodium nitroprusside** is a **direct arterial and venous vasodilator** used in hypertensive crises and severe heart failure by reducing both preload and afterload. - While it can lower systemic blood pressure, its use in pulmonary hypertension is **limited** due to the risk of **systemic hypotension** and the lack of selective pulmonary vasodilation compared to other agents.
Question 92: A patient diagnosed with Rheumatoid arthritis was on medications. After 2 years, he developed a blurring vision and was found to have corneal opacity. Which drug is most likely to cause this?
- A. Sulfasalazine
- B. Leflunomide
- C. Chloroquine (Correct Answer)
- D. Methotrexate
Explanation: ***Chloroquine*** - **Chloroquine (and hydroxychloroquine)** can accumulate in the **cornea**, leading to **corneal opacity** (vortex keratopathy or cornea verticillata) and **retinopathy**, manifesting as blurring vision. - While corneal changes are usually reversible upon discontinuation, the retinal toxicity, particularly **maculopathy** (bull's eye maculopathy), can be permanent and severe. *Sulfasalazine* - Common side effects include **gastrointestinal upset**, headache, skin rash, and **bone marrow suppression**. - It is not typically associated with **corneal opacity** or significant ocular toxicity. *Leflunomide* - Known for side effects such as **hepatotoxicity**, gastrointestinal issues (diarrhea), **alopecia**, and **hypertension**. - **Ocular side effects** like corneal opacity are not characteristic of leflunomide use. *Methotrexate* - Primary side effects include **bone marrow suppression**, **hepatotoxicity**, **mucositis**, and **pulmonary fibrosis**. - Although it can cause ocular side effects like **conjunctivitis**, it is not a common cause of **corneal opacity**.
Physiology
1 questionsWhat is the reflex in which there is inhibition of gastric emptying when there is acid and hypertonic solution in the duodenum?
NEET-PG 2020 - Physiology NEET-PG Practice Questions and MCQs
Question 91: What is the reflex in which there is inhibition of gastric emptying when there is acid and hypertonic solution in the duodenum?
- A. Enterogastric (Correct Answer)
- B. Gastroileal
- C. Gastrocolic
- D. Myenteric
Explanation: ***Enterogastric*** - The **enterogastric reflex** is initiated when the duodenum detects the presence of acid and hypertonic solutions, signifying that the chyme is not yet ready for further digestion and absorption. - This reflex inhibits **gastric emptying** to allow more time for the stomach to process its contents and for the duodenum to neutralize the acid and dilute the hypertonic solution. *Gastroileal* - The **gastroileal reflex** increases motility in the ileum when the stomach is distended, facilitating the movement of chyme into the large intestine. - This reflex does not primarily involve the inhibition of gastric emptying due to duodenal contents. *Gastrocolic* - The **gastrocolic reflex** increases the motility of the colon in response to the stretching of the stomach by food. - Its main function is to prepare the large intestine for upcoming chyme and does not directly inhibit gastric emptying. *Myenteric* - The **myenteric plexus** (Auerbach's plexus) is a network of neurons located between the longitudinal and circular layers of the muscularis propria throughout the gastrointestinal tract. - While it plays a crucial role in controlling gut motility and is involved in numerous reflexes, it refers to a neural plexus rather than a specific reflex mechanism for inhibiting gastric emptying due to duodenal stimuli.
Surgery
1 questionsWhich statement about retrosternal goiter is correct?
NEET-PG 2020 - Surgery NEET-PG Practice Questions and MCQs
Question 91: Which statement about retrosternal goiter is correct?
- A. Surgery should be avoided in all cases.
- B. CT chest is recommended for evaluation of retrosternal goiter. (Correct Answer)
- C. All patients require surgical intervention.
- D. Blood supply primarily comes from the thyroid arteries.
Explanation: ***CT chest is recommended for evaluation of retrosternal goiter.*** * A **CT chest** provides detailed imaging of the goiter's extent, its relationship to surrounding structures (trachea, esophagus, great vessels), and helps in surgical planning. * It can identify potential complications like **tracheal compression** or involvement of the superior mediastinum, which are crucial for management decisions. *All patients require surgical intervention.* * Surgical intervention is not universally required; it depends on the **size of the goiter**, presence and severity of compressive symptoms, and malignancy suspicion. * Small, asymptomatic retrosternal goiters may be managed conservatively with **monitoring**. *Blood supply primarily comes from the thyroid arteries.* * While the initial development of the goiter is from the thyroid gland, as it extends into the mediastinum, it can develop additional **blood supply from mediastinal vessels**. * This dual blood supply, sometimes including branches from the internal mammary or subclavian arteries, can make surgical ligation more complex. *Surgery should be avoided in all cases.* * Surgery is often necessary, especially in cases with **compressive symptoms** such as dyspnea, dysphagia, or stridor, or if there is concern for malignancy. * **Retrosternal goiters** can grow large and cause significant morbidity or even mortality due to airway obstruction, making surgery a vital treatment option.