Biochemistry
1 questionsEnzyme activated by decrease in Insulin: glucagon ratio:
NEET-PG 2020 - Biochemistry NEET-PG Practice Questions and MCQs
Question 181: Enzyme activated by decrease in Insulin: glucagon ratio:
- A. PFK
- B. Glucose 6 phosphatase (Correct Answer)
- C. Glucokinase
- D. Hexokinase
Explanation: ***Glucose 6 phosphatase*** - A decreased **insulin:glucagon ratio** signifies a catabolic state, promoting glucose release into the blood. - **Glucose-6-phosphatase** is the key enzyme in **gluconeogenesis** and **glycogenolysis** in the liver, dephosphorylating **glucose-6-phosphate** to **free glucose**, which can then be exported from the liver. *PFK* - **Phosphofructokinase (PFK)** is a key regulatory enzyme in **glycolysis**, which is inhibited in a state of low insulin:glucagon ratio. - Its activity would decrease, not increase, to reduce glucose utilization. *Glucokinase* - **Glucokinase** phosphorylates glucose to **glucose-6-phosphate** in the liver, trapping it for metabolism; its activity is increased by high insulin levels. - In a low insulin:glucagon ratio, its activity would be reduced to conserve glucose. *Hexokinase* - **Hexokinase** phosphorylates glucose in most peripheral tissues but has a lower Km for glucose than glucokinase, becoming saturated even at low glucose concentrations. - Its activity is not primarily regulated by the insulin:glucagon ratio; it is generally involved in glucose uptake for cellular energy needs.
Community Medicine
3 questionsA 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?
Indicators of air pollution are:
"MONICA Project" is associated with:
NEET-PG 2020 - Community Medicine NEET-PG Practice Questions and MCQs
Question 181: A 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?
- A. No vaccine needed
- B. Three doses of conjugate vaccine
- C. Two doses of polysaccharide vaccine
- D. Single dose of toxoid vaccine (Correct Answer)
Explanation: ***Single dose of toxoid vaccine*** - In the context of this question, this is the **best available option** among the choices provided. - For a close contact of diphtheria who was immunized but received their last booster **18 months ago**, guidelines recommend a **booster dose if more than 5 years** have elapsed since the last dose. - However, some protocols recommend a booster for **close contacts regardless of timing** to ensure maximum protection. - **Important note**: The PRIMARY management for diphtheria close contacts is **antibiotic prophylaxis** (Erythromycin 40-50 mg/kg/day for 7 days or single-dose Azithromycin) plus surveillance for 7 days, which is not mentioned in the available options. *No vaccine needed* - This is incorrect because as a **close contact of an active diphtheria case**, prophylactic measures are required. - Even though the child received a booster 18 months ago, additional protection through either antibiotics (primary) or a booster dose may be recommended. - Close contacts require active intervention to prevent secondary transmission. *Three doses of conjugate vaccine* - This represents a **complete primary series**, which is not appropriate for an already immunized child. - The child has already completed primary immunization and received boosters; they do not need to restart the vaccination schedule. - **Conjugate vaccines** (like Hib conjugate) are different formulations, though DTaP is technically a conjugated form of diphtheria toxoid. *Two doses of polysaccharide vaccine* - **Polysaccharide vaccines** are not used for diphtheria prevention. - Diphtheria vaccines are **toxoid-based** (inactivated diphtheria toxin), not polysaccharide-based. - This option represents an incorrect vaccine type for diphtheria prophylaxis.
Question 182: Indicators of air pollution are:
- A. Sulphur dioxide, lead, particulate matter
- B. Sulphur dioxide, hydrogen sulphide, carbon monoxide
- C. Carbon dioxide, hydrogen sulphide, lead
- D. Sulphur dioxide, smoke, particulate matter (Correct Answer)
Explanation: **Correct Option: Sulphur dioxide, smoke, particulate matter** - **Sulphur dioxide (SO₂)** is a major gaseous air pollutant indicator, primarily from fossil fuel combustion and industrial processes - **Smoke** (composed of small solid and liquid particles) is a visible indicator of air pollution - **Particulate matter (PM2.5 and PM10)** represents suspended particulate matter (SPM), significant contributors to air pollution causing respiratory and cardiovascular issues - These three parameters are the **standard indicators** used for air quality monitoring as per NAAQS (National Ambient Air Quality Standards) *Incorrect: Sulphur dioxide, lead, particulate matter* - While SO₂ and particulate matter are correct indicators, **lead** is a toxic heavy metal pollutant but not a standard indicator for routine air quality monitoring - Lead pollution is typically measured separately as a specific hazardous pollutant *Incorrect: Sulphur dioxide, hydrogen sulphide, carbon monoxide* - SO₂ and CO are air pollutants, but **hydrogen sulphide (H₂S)** is more associated with specific industrial emissions and sewage decomposition - This combination misses the critical indicators of **smoke and particulate matter** which are more ubiquitous and routinely monitored *Incorrect: Carbon dioxide, hydrogen sulphide, lead* - **Carbon dioxide (CO₂)** is primarily a greenhouse gas contributing to climate change, not a conventional air pollution indicator for local air quality - H₂S and lead are pollutants but not standard routine indicators - This option lacks the key indicators: SO₂, smoke, and particulate matter
Question 183: "MONICA Project" is associated with:
- A. Risk factor intervention trials for CVD
- B. Lipid research clinics study
- C. Monitoring of trends and determinants in cardiovascular disease (Correct Answer)
- D. Oslo diet/smoking intervention study
Explanation: ***Monitoring of trends and determinants in cardiovascular disease*** * The **MONICA Project** (MONItoring trends and determinants in CArdiovascular disease) was a major international collaborative project initiated by the **World Health Organization (WHO)**. * Its primary objective was to monitor cardiovascular disease trends and their determinants in defined populations over time. *Risk factor intervention trials for CVD* * While the MONICA project did identify CVD risk factors, it was primarily an observational study focused on **monitoring trends** rather than directly conducting intervention trials. * Intervention trials aim to test the effectiveness of strategies to modify risk factors. *Lipid research clinics study* * The Lipid Research Clinics Program was a separate clinical research program focused on **lipid disorders** and coronary heart disease, not comprehensive CVD monitoring. * This study specifically investigated the relationship between lowering cholesterol and reducing the risk of coronary heart disease. *Oslo diet/smoking intervention study* * The Oslo Diet and Smoking Study was a specific **intervention trial** in Norway, designed to assess the impact of dietary and smoking cessation advice on CVD risk. * It was a single-center, intervention-focused study, distinct from the broader, multinational monitoring scope of MONICA.
ENT
1 questionsPartial closure of the nose is performed in which condition?
NEET-PG 2020 - ENT NEET-PG Practice Questions and MCQs
Question 181: Partial closure of the nose is performed in which condition?
- A. Vasomotor rhinitis
- B. Atrophic rhinitis (Correct Answer)
- C. Allergic rhinitis
- D. Occupational rhinitis
Explanation: ***Atrophic rhinitis*** - **Partial closure of the nose** (Young's operation or naris plasty) is a surgical procedure used to reduce the size of the nasal passages and improve airflow in patients with atrophic rhinitis. - This condition involves progressive **atrophy of the nasal mucosa** and turbinates, leading to dryness, crusting, paradoxical obstruction, and often a foul odor. *Vasomotor rhinitis* - This condition involves **non-allergic rhinitis** triggered by environmental changes, temperature shifts, or irritants, causing symptoms like sneezing, rhinorrhea, and nasal congestion. - Management typically involves **avoidance of triggers**, nasal corticosteroids, or anticholinergic sprays, not surgical closure of the nose. *Allergic rhinitis* - Caused by an ** IgE-mediated immune response** to airborne allergens, leading to inflammation of the nasal mucosa, sneezing, itching, rhinorrhea, and congestion. - Treatment focuses on **allergen avoidance**, antihistamines, and nasal corticosteroids; surgical modification of nasal passages is not indicated. *Occupational rhinitis* - This form of rhinitis is caused by exposure to **irritants or allergens in the workplace**, leading to nasal symptoms similar to allergic or non-allergic rhinitis. - Management involves **identifying and avoiding the offending agent** at work, and medical treatments like nasal sprays, but not surgical narrowing of the nostrils.
Internal Medicine
2 questionsA known case of COPD with acute exacerbation of symptoms. On examination patient was conscious and alert, pulse was 110 beats/ min and bilateral wheeze present. All of the following are true in the management of the patient except:
Which of the following is not a clinical presentation of Pituitary Apoplexy?
NEET-PG 2020 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 181: A known case of COPD with acute exacerbation of symptoms. On examination patient was conscious and alert, pulse was 110 beats/ min and bilateral wheeze present. All of the following are true in the management of the patient except:
- A. Non invasive ventilation is contraindicated (Correct Answer)
- B. Permissible hypercapnia allowed
- C. Inhalation with salbutamol
- D. I/V steroids
Explanation: ***Non invasive ventilation is contraindicated*** - This statement is **false**, therefore the correct exception. **Non-invasive ventilation (NIV)** is often indicated and beneficial in the management of acute exacerbations of COPD, especially in patients with **respiratory acidosis** or persistent dyspnea, as it can reduce the need for intubation and improve outcomes [2]. - The patient's presentation (conscious, alert, wheeze, tachycardia) suggests an acute exacerbation, for which NIV is a key intervention unless there are absolute contraindications like cardiac arrest or inability to protect the airway [3]. *Permissible hypercapnia allowed* - **Permissive hypercapnia** is a valid strategy in managing acute exacerbations of COPD, particularly during mechanical ventilation. The goal is to maintain an adequate pH (e.g., >7.20-7.25) rather than normalizing CO2, to avoid **barotrauma** and **volutrauma** from aggressive ventilation [3]. - This approach acknowledges that some CO2 retention is acceptable as long as acidosis is not severe, protecting the lungs from excessive pressure. *Inhalation with salbutamol* - **Inhaled bronchodilators**, such as **salbutamol (a short-acting beta-agonist)**, are a cornerstone of treatment for acute COPD exacerbations [1]. They act rapidly to relieve **bronchospasm** and improve airflow, addressing the wheeze observed in the patient. - Frequent administration of these agents is crucial in the initial management to open up the airways and reduce air trapping. *I/V steroids* - **Systemic corticosteroids**, such as intravenous methylprednisolone or oral prednisone, are essential in managing acute COPD exacerbations. They reduce **airway inflammation** and swelling, leading to improved lung function and reduced recovery time. - Steroids are typically given for a short course (e.g., 5-7 days) to minimize side effects while maximizing therapeutic benefits.
Question 182: Which of the following is not a clinical presentation of Pituitary Apoplexy?
- A. Vomiting
- B. Headache
- C. Hypertension (Correct Answer)
- D. Hypotension
Explanation: ***Hypertension*** - Pituitary apoplexy often leads to **adrenal insufficiency** due to damage to the pituitary gland, which in turn causes **hypotension**, not hypertension. - The sudden onset of severe pituitary dysfunction typically results in a drop in blood pressure rather than an increase. *Vomiting* - **Vomiting** is a common symptom of pituitary apoplexy, often accompanying severe headache due to increased intracranial pressure or hormonal imbalances [1]. - The sudden mass effect of the hemorrhage or infarction can irritate surrounding structures, leading to nausea and vomiting. *Headache* - A **sudden, severe headache** is the most common presenting symptom of pituitary apoplexy, often described as a "thunderclap" headache [1]. - This intense headache is caused by rapid expansion of the pituitary mass and irritation of the **dura mater**. *Hypotension* - **Hypotension** is a classic feature of pituitary apoplexy, resulting from acute **adrenal insufficiency** where insufficient ACTH leads to decreased cortisol production [1]. - This hormonal deficiency impairs the body's ability to maintain blood pressure and respond to stress [1].
Pediatrics
1 questionsIn a preterm baby with respiratory distress syndrome, which type of cell is deficient?
NEET-PG 2020 - Pediatrics NEET-PG Practice Questions and MCQs
Question 181: In a preterm baby with respiratory distress syndrome, which type of cell is deficient?
- A. Type 2 alveolar cell (Correct Answer)
- B. Type 1 alveolar cell
- C. Alveolar capillary endothelial cell
- D. Bronchial mucosal epithelial cell
Explanation: ***Type 2 alveolar cell*** - **Type 2 alveolar cells** (pneumocytes) are responsible for producing and secreting **surfactant**. - A deficiency in these cells, common in preterm infants, leads to insufficient surfactant, causing alveolar collapse and respiratory distress syndrome. *Type 1 alveolar cell* - **Type 1 alveolar cells** are primarily involved in **gas exchange** due to their thin, flat structure. - While essential for respiration, their deficiency is not the primary cause of respiratory distress syndrome in preterm infants. *Alveolar capillary endothelial cell* - **Alveolar capillary endothelial cells** form the walls of the capillaries surrounding the alveoli, facilitating the transfer of gases between the alveoli and blood. - They do not produce surfactant, and their deficiency is not the direct cause of respiratory distress syndrome. *Bronchial mucosal epithelial cell* - **Bronchial mucosal epithelial cells** line the airways and are involved in mucus production and ciliary clearance. - While important for respiratory function, their primary role is not in preventing alveolar collapse in respiratory distress syndrome.
Physiology
1 questionsThe lab reports of a patient given below: pH = 7.2, HCO3 = 10 mEq/L, PCO2 = 30 mmHg. This exemplifies which of the following disorders?
NEET-PG 2020 - Physiology NEET-PG Practice Questions and MCQs
Question 181: The lab reports of a patient given below: pH = 7.2, HCO3 = 10 mEq/L, PCO2 = 30 mmHg. This exemplifies which of the following disorders?
- A. Metabolic alkalosis
- B. Respiratory acidosis
- C. Metabolic acidosis (Correct Answer)
- D. Respiratory alkalosis
Explanation: ***Metabolic acidosis*** - The pH of 7.2 is acidic, and the **bicarbonate (HCO3) of 10 mEq/L** is significantly low (normal: 22-28 mEq/L), indicating a primary metabolic disturbance causing acidosis. - The **PCO2 of 30 mmHg** is also low (normal: 35-45 mmHg), which represents **partial respiratory compensation** through hyperventilation to blow off CO2 and raise pH. - This is a classic example of **metabolic acidosis with respiratory compensation**. *Metabolic alkalosis* - This condition would be characterized by a **high pH** and a **high bicarbonate (HCO3)** level, which is the opposite of the given values. - The body would attempt to compensate by increasing PCO2 through hypoventilation. *Respiratory acidosis* - This would present with a **low pH** and a **high PCO2** (>45 mmHg), indicating a primary respiratory problem leading to CO2 retention and acid accumulation. - Metabolic compensation would show elevated HCO3, not the low HCO3 (10 mEq/L) seen here. *Respiratory alkalosis* - This condition is characterized by a **high pH** (>7.45) and a **low PCO2**, due to excessive ventilation causing CO2 elimination. - While PCO2 is low in the given scenario, the pH is acidic (7.2), not alkalotic, ruling out this diagnosis.
Surgery
1 questionsA patient presents with abdominal pain, blood in stools and a palpable mass on examination. A Barium Study was performed, probable diagnosis is?
NEET-PG 2020 - Surgery NEET-PG Practice Questions and MCQs
Question 181: A patient presents with abdominal pain, blood in stools and a palpable mass on examination. A Barium Study was performed, probable diagnosis is?
- A. Volvulus
- B. Meckel's Diverticulum
- C. Diverticulitis
- D. Intussusception (Correct Answer)
Explanation: ***Intussusception*** - This condition is characterized by a "telescoping" of one segment of the intestine into another, which can lead to **abdominal pain**, **rectal bleeding** (often described as "currant jelly" stools), and a **palpable sausage-shaped mass** on examination. - A barium study (specifically a **barium enema**) is often diagnostic and can also be therapeutic for intussusception, revealing a **coiled spring appearance** or an obstruction. *Volvulus* - Volvulus involves the **twisting of a loop of bowel** around its mesentery, often presenting with sudden onset, severe **abdominal pain**, vomiting, and constipation. - While it can cause an obstruction and pain, a palpable mass and bloody stools are less common initial findings compared to intussusception. *Meckel's Diverticulum* - Meckel's diverticulum is a **congenital outpouching** of the small intestine that can be asymptomatic or cause complications like **gastrointestinal bleeding** (due to ectopic gastric mucosa), obstruction, or diverticulitis. - While it can cause painless rectal bleeding, a palpable mass and acute, intermittent abdominal pain are not typical primary presentations for an uncomplicated Meckel’s diverticulum. *Diverticulitis* - Diverticulitis is the **inflammation of diverticula** (small pouches in the colon), typically presenting with **left lower quadrant abdominal pain**, fever, and changes in bowel habits. - While it can cause bleeding, a palpable mass is less common unless there's an abscess, and the clinical picture does not align as strongly with the "currant jelly stool" and classic palpable mass of intussusception.