ENT
1 questionsA patient presents with fever and dysphagia. An image shows a tonsil that is pushed medially. What is the most likely diagnosis?
NEET-PG 2020 - ENT NEET-PG Practice Questions and MCQs
Question 101: A patient presents with fever and dysphagia. An image shows a tonsil that is pushed medially. What is the most likely diagnosis?
- A. Parapharyngeal abscess
- B. Retropharyngeal abscess
- C. Peritonsillar abscess (Correct Answer)
- D. Ludwig's angina
Explanation: ***Peritonsillar abscess*** - The image clearly shows **unilateral bulging** of the soft palate and displacement of the tonsil medially, consistent with a peritonsillar abscess. - Patients typically present with **fever**, **dysphagia**, severe sore throat, and a "hot potato" voice. *Parapharyngeal abscess* - A parapharyngeal abscess involves the **deep neck spaces** lateral to the pharynx, often presenting with neck swelling, trismus, and systemic symptoms. - While it can cause pharyngeal bulging, the classic **medial displacement of the tonsil** is more indicative of a peritonsillar abscess. *Retropharyngeal abscess* - This involves the space behind the posterior pharyngeal wall, usually presenting with **dysphagia**, **neck stiffness**, and fever. - Imaging would reveal a **prevertebral soft tissue swelling**, not primarily a medially displaced tonsil. *Ludwig's angina* - Ludwig's angina is a **rapidly spreading cellulitis** of the submandibular and sublingual spaces, typically arising from an odontogenic infection. - It presents with **woody induration** of the neck and floor of the mouth, elevation of the tongue, and potential airway compromise, but not primarily a medially displaced tonsil.
Internal Medicine
3 questionsA Patient falls down often with behavioral change and enuresis. What is the condition associated with him?
In trochlear palsy, which specific eye movement is lost?
A female patient has been on lithium for bipolar disorder for 6 months. After fasting for several days due to religious reasons, she presents with seizures, tremors, confusion, and weakness. What is the most appropriate investigation to diagnose her condition?
NEET-PG 2020 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 101: A Patient falls down often with behavioral change and enuresis. What is the condition associated with him?
- A. Normal pressure hydrocephalus (NPH) (Correct Answer)
- B. Parkinson's disease (PD)
- C. Alzheimer's disease (AD)
- D. Frontotemporal dementia (FTD)
Explanation: ***Normal pressure hydrocephalus (NPH)*** - NPH is characterized by the classic triad of symptoms: **gait disturbance** (leading to falls), **dementia/behavioral changes**, and **urinary incontinence** (enuresis) [1]. - These symptoms arise from the accumulation of cerebrospinal fluid (CSF) in the brain's ventricles without a corresponding increase in intracranial pressure [2]. *Parkinson's disease (PD)* - While PD causes **gait instability** and falls, its primary symptoms include **bradykinesia**, **rigidity**, and **resting tremor**, which are not mentioned. - Behavioral changes can occur later in the disease, but **enuresis** is not a hallmark symptom. *Alzheimer's disease (AD)* - AD primarily presents with **progressive memory loss** and cognitive decline, not gait disturbances or enuresis as early or prominent features. - Falls usually occur much later due to advanced cognitive impairment and not as an initial triad component. *Frontotemporal dementia (FTD)* - FTD is characterized by early and prominent **behavioral and personality changes** or language difficulties. - While falls can occur due to executive dysfunction, **gait disturbance** and **enuresis** as part of a triad are not typical presenting features.
Question 102: In trochlear palsy, which specific eye movement is lost?
- A. Upward gaze
- B. Lateral movement of the eye
- C. Downward gaze and inward rotation of the eye (Correct Answer)
- D. Facial expressions
Explanation: ***Downward gaze and inward rotation of the eye*** - Trochlear palsy affects the **superior oblique muscle**, which is primarily responsible for **downward gaze** and **intorsion** (inward rotation) of the eye, particularly when the eye is adducted. - Patients often present with **vertical diplopia** and a **head tilt** away from the affected side to compensate for the eye misalignment. *Upward gaze* - Upward gaze is primarily mediated by the **superior rectus muscle** (innervated by the oculomotor nerve) and the **inferior oblique muscle** (also oculomotor nerve). - Trochlear nerve palsy does not directly impair the muscles responsible for moving the eye upwards. *Lateral movement of the eye* - **Lateral movement** (abduction) of the eye is controlled by the **lateral rectus muscle**, which is innervated by the **abducens nerve (CN VI)**. - A loss of lateral movement would indicate an abducens nerve palsy, not a trochlear nerve palsy. *Facial expressions* - **Facial expressions** are controlled by the muscles of facial expression, which are innervated by the **facial nerve (CN VII)**. - This is unrelated to the cranial nerves involved in eye movement.
Question 103: A female patient has been on lithium for bipolar disorder for 6 months. After fasting for several days due to religious reasons, she presents with seizures, tremors, confusion, and weakness. What is the most appropriate investigation to diagnose her condition?
- A. Serum electrolytes
- B. Serum lithium levels (Correct Answer)
- C. ECG
- D. MRI
Explanation: **Serum lithium levels** - The patient's symptoms (seizures, tremors, confusion, weakness) are classic for **lithium toxicity**. - **Fasting** can lead to dehydration and electrolyte imbalance, which can increase lithium concentrations and toxicity [1]. *Serum electrolytes* - While **electrolyte imbalances** can occur with fasting and contribute to symptoms, measuring serum electrolytes alone will not directly diagnose lithium toxicity. - Electrolyte disturbances might be a predisposing factor or a concomitant issue, but not the primary diagnostic test for lithium toxicity itself [1]. *ECG* - An **ECG** can reveal cardiac effects of lithium toxicity, such as T-wave flattening or inversion, but it is not the most appropriate direct diagnostic test for the condition itself. - ECG changes are secondary manifestations and may not always be present or specific. *MRI* - While an **MRI** of the brain might be considered to rule out other causes of neurological symptoms like a stroke or brain lesion, it is not the initial or most appropriate investigation for suspected lithium toxicity. - The clinical picture strongly points to a pharmacological cause, making laboratory tests more relevant first-line diagnostics than imaging.
Obstetrics and Gynecology
2 questionsWhat is the best treatment option for a septate uterus?
What will be the Hysterosalpingogram (HSG) finding?
NEET-PG 2020 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 101: What is the best treatment option for a septate uterus?
- A. Tompkins Metroplasty
- B. Jones metroplasty
- C. Strassmann metroplasty
- D. Transcervical hysteroscopic resection of the septum (Correct Answer)
Explanation: ***Transcervical hysteroscopic resection of the septum*** - This procedure involves using a **hysteroscope** to visualize and resect the **fibrous or muscular septum** that divides the uterine cavity, restoring a normal uterine shape. - It is considered the gold standard due to its **minimally invasive nature**, effectiveness in improving reproductive outcomes, and lower risk of complications compared to abdominal approaches. *Tompkins Metroplasty* - This is an **abdominal surgical procedure** primarily used for the repair of a **bicornuate uterus**, not typically for a septate uterus. - It involves resecting the uterine fundus to create a single uterine cavity, which is more invasive than hysteroscopic septum resection. *Jones metroplasty* - This procedure is also an **abdominal approach** used for the surgical correction of a **bicornuate uterus**, not a septate uterus. - It involves excising the septal portion and approximating the uterine walls. *Strassmann metroplasty* - This is another **abdominal surgical technique** that is primarily indicated for the repair of a **bicornuate or didelphys uterus**, where a large defect needs to be corrected. - It involves reconstructing the uterus through a fundal incision, which is significantly more invasive than hysteroscopic septal resection for a septate uterus.
Question 102: What will be the Hysterosalpingogram (HSG) finding?
- A. Hydrosalpinx (Correct Answer)
- B. Cornual block
- C. Normal findings
- D. Bicornuate uterus
Explanation: ***Hydrosalpinx*** - The image, likely a hysterosalpingogram (HSG), shows a **dilated and fluid-filled fallopian tube** with no spillage of contrast into the peritoneal cavity, which is characteristic of hydrosalpinx. - The **contrast media fills the tubal lumen** but is unable to egress, indicating distal tubal obstruction and fluid accumulation. *Cornual block* - A cornual block would present as **obstruction at the uterine ostium** of the fallopian tube, preventing contrast from entering the tubal lumen. - In this image, contrast has clearly entered and dilated the fallopian tube, ruling out a cornual block. *Normal findings* - Normal HSG findings would show **patent fallopian tubes** with free spill of contrast into the peritoneal cavity. - The visible **dilation** and **lack of spill** in the image are distinctly abnormal. *Bicornuate uterus* - A bicornuate uterus is a **congenital uterine anomaly** characterized by two separate uterine horns. - While the uterus appears somewhat irregular, the dominant feature is the dilated fallopian tube, which is not a hallmark of a bicornuate uterus.
Pediatrics
1 questionsWhat is the most serious complication of measles?
NEET-PG 2020 - Pediatrics NEET-PG Practice Questions and MCQs
Question 101: What is the most serious complication of measles?
- A. Croup
- B. Otitis media
- C. Meningo-encephalitis
- D. Pneumonia (Correct Answer)
Explanation: ***Pneumonia*** - **Pneumonia**, particularly **giant cell pneumonia**, is the most common cause of **measles-related deaths** in young children. - It results from the **direct viral infection** of the lungs or a **secondary bacterial superinfection**. *Croup* - **Croup (laryngotracheobronchitis)** can be a complication of measles, but it is typically **less severe** and **less life-threatening** than pneumonia. - It primarily affects the **upper airways**, causing a barking cough and stridor. *Meningo-encephalitis* - **Meningo-encephalitis** is a serious, albeit **less common**, complication of measles, occurring in approximately 1 in 1,000 cases. - While potentially fatal or leading to neurological sequelae, it is **outranked by pneumonia** in terms of overall mortality attributed to measles. *Otitis media* - **Otitis media** (middle ear infection) is a common complication of measles, but it is generally **not life-threatening**. - It usually responds well to **antibiotic treatment** and rarely leads to severe outcomes.
Pharmacology
1 questionsA patient on lithium therapy developed hypertension and was started on a thiazide diuretic. After a few days, he developed coarse tremors and other symptoms suggestive of lithium toxicity. What is the probable mechanism of interaction between thiazide diuretics and lithium?
NEET-PG 2020 - Pharmacology NEET-PG Practice Questions and MCQs
Question 101: A patient on lithium therapy developed hypertension and was started on a thiazide diuretic. After a few days, he developed coarse tremors and other symptoms suggestive of lithium toxicity. What is the probable mechanism of interaction between thiazide diuretics and lithium?
- A. Thiazide increases the tubular reabsorption of lithium (Correct Answer)
- B. Thiazide inhibits the metabolism of lithium
- C. Thiazides act as an add-on drug to lithium
- D. None of the above
Explanation: ***Thiazide increases the tubular reabsorption of lithium*** - Thiazide diuretics cause a decrease in sodium reabsorption in the distal convoluted tubule, leading to increased sodium excretion in urine. - The kidneys, in an attempt to conserve sodium, increase reabsorption in the proximal tubule. Because **lithium** is reabsorbed similarly to sodium in the proximal tubule, this increased reabsorption also affects lithium, leading to a rise in its plasma concentration and toxicity. *Thiazide inhibits the metabolism of lithium* - Lithium is primarily excreted by the kidneys and is not significantly metabolized in the body. - Thiazide diuretics do not affect enzyme systems responsible for drug metabolism. *Thiazides act as an add on the drug to lithium* - This statement is vague and does not explain a mechanism of interaction leading to toxicity. - While both drugs might be prescribed concurrently for different conditions, "add on" does not describe a pharmacological interaction causing altered drug levels. *None of the above* - This option is incorrect because a clear and well-understood mechanism for the interaction between thiazide diuretics and lithium exists.
Physiology
1 questionsAmong the following, prolactin secretion is maximum:
NEET-PG 2020 - Physiology NEET-PG Practice Questions and MCQs
Question 101: Among the following, prolactin secretion is maximum:
- A. During REM sleep
- B. After 2 hours of running
- C. 24 hrs after delivery (Correct Answer)
- D. 24 hours after ovulation
Explanation: ***Correct: 24 hrs after delivery*** - Prolactin levels are highest in the initial **24 hours postpartum**, especially during and after **breastfeeding sessions**, which act as a powerful stimulus for prolactin release. - This peak prolactin level is crucial for initiating and maintaining **lactation** following childbirth. - The postpartum prolactin surge represents the **maximum physiological level** of this hormone under normal circumstances. *Incorrect: During REM sleep* - While prolactin secretion does exhibit a **circadian rhythm** with nocturnal peaks, the highest levels do not specifically occur during **REM sleep**; rather, they are elevated throughout the sleep cycle. - Though prolactin does rise during sleep, the magnitudes are **not comparable** to the surges seen postpartum or after intense suckling. *Incorrect: After 2 hours of running* - Exercise, particularly prolonged and intense physical activity, can cause a transient increase in prolactin levels due to **stress response** and hormonal changes. - However, this exercise-induced increase is generally **modest** compared to the physiological surge observed after delivery. *Incorrect: 24 hours after ovulation* - Prolactin levels show a slight increase during the **luteal phase** of the menstrual cycle, which follows ovulation, primarily due to rising progesterone levels. - This elevation is significantly **lower** than the dramatic rise seen immediately postpartum needed for milk production.
Radiology
1 questionsThe chest radiograph shown below is from a 25-year-old male patient presenting with hypertension. The image demonstrates bilateral inferior rib notching. What is the most likely diagnosis?
NEET-PG 2020 - Radiology NEET-PG Practice Questions and MCQs
Question 101: The chest radiograph shown below is from a 25-year-old male patient presenting with hypertension. The image demonstrates bilateral inferior rib notching. What is the most likely diagnosis?
- A. Tetralogy of Fallot
- B. Ebstein's Anomaly
- C. TAPVC
- D. Coarctation of Aorta (Correct Answer)
Explanation: ***Coarctation of Aorta*** - The chest radiograph shows findings consistent with **rib notching**, which is a classic sign of coarctation of the aorta due to increased collateral circulation through intercostal arteries. - The history of **hypertension** in a male patient, especially if presenting at a younger age or with differential blood pressures between upper and lower extremities, strongly suggests coarctation of the aorta. *Tetralogy of Fallot* - Characterized by a **boot-shaped heart** due to right ventricular hypertrophy and pulmonary outflow obstruction. - Would typically present with **cyanosis** and decreased pulmonary vascular markings, not rib notching or isolated hypertension. *Ebstein's Anomaly* - Involves apical displacement of the **tricuspid valve**, leading to atrialization of the right ventricle and severe tricuspid regurgitation. - Chest X-rays often show **severe cardiomegaly** (huge heart due to right atrial enlargement) and decreased pulmonary vascularity, which are not depicted here. *TAPVC* - Total anomalous pulmonary venous connection (TAPVC) involves all pulmonary veins draining into the systemic circulation. - The classic chest X-ray finding for supracardiac TAPVC is a **"snowman" or "figure of 8" sign** due to dilated anomalous vessels and superior vena cava, which is absent in this image.