NEET-PG 2022 Practice Questions

Q: Which of the following agencies is primarily responsible for supporting school feeding programs globally?

WFP. ***WFP (World Food Programme)*** - **WFP** is the **primary UN agency** responsible for supporting **school feeding programs globally**, operating in over 60 countries and providing meals to millions of schoolchildren. - WFP's school feeding programs are the world's largest safety net initiative, combining hunger relief with education support, and are a **flagship program** of the organization. - The agency focuses specifically on food assistance and hunger, making school feeding programs a core component of their mission to achieve Zero Hunger. *UNICEF* - **UNICEF** does support child nutrition and welfare programs, including some school-based nutrition initiatives, but it is **not the primary agency** for school feeding programs. - UNICEF's broader mandate focuses on child rights, health, education, and protection, with nutrition being one component rather than the specialized focus that WFP has on food assistance. - UNICEF often **collaborates with WFP** on school feeding initiatives rather than leading them independently. *UNDP* - The **UNDP** (United Nations Development Programme) focuses on sustainable development, poverty alleviation, and resilient societies. - While food security is part of development goals, UNDP does not directly implement or primarily fund school feeding programs compared to WFP. *WHO* - The **WHO** (World Health Organization) is the leading international authority on public health, focusing on disease prevention, health standards, and health policy. - While WHO provides guidance on nutritional standards and healthy diets for children, it does **not implement or fund school feeding programs** - this operational role belongs to WFP.

Q: A 45-year-old patient complained of pain on one side of the neck. She is afraid of eating food as it worsens the pain. An ultrasound of the salivary glands is shown below. What is the most likely diagnosis?

Sialolithiasis. ***Sialolithiasis*** - The ultrasound image shows an **echogenic focus** with clear **posterior acoustic shadowing** within the salivary gland, which is characteristic of a salivary gland stone. - The patient's symptoms of **pain on one side of the neck** and **worsening pain with eating** (likely due to salivary stimulation) are classic for **sialolithiasis**, as the stone obstructs salivary flow. *Salivary gland foreign body* - While a foreign body could present with similar pain, it would typically appear as a distinct object on ultrasound, but its echogenicity and shading characteristics might differ depending on the material. - The history of a foreign body ingestion or insertion would be crucial, which is not mentioned here. *Cervical lymphadenopathy* - **Lymph nodes** on ultrasound typically appear as oval-shaped structures with a **hypoechoic cortex** and an **echogenic hilum**; they do not usually show significant acoustic shadowing unless calcified. - While cervical lymphadenopathy can cause neck pain, it is not typically exacerbated by eating in the same way an obstructed salivary gland would be. *Osteoma of the floor of the mouth* - An **osteoma** is a **benign bone tumor** that would present as a very **dense, highly echogenic mass** with severe posterior acoustic shadowing on ultrasound, originating from bony structures. - While an osteoma could cause pain, its location (floor of the mouth) and nature would not typically explain pain worsening specifically with eating due to salivary gland obstruction.

Q: Based on the provided wound characteristics, identify the type of firearm used and the estimated range of the shot.

Pistol, close shot. ***Pistol, close shot*** - The wound shows **soot deposition (blackening/fouling)** around the entry point, which is characteristic of a **close shot** fired within the **flame distance** (~8 cm). - **Close shots** produce both **soot blackening** and **powder tattooing (stippling)**, distinguishing them from near shots which show only tattooing. *Shotgun, intermediate range* - Shotgun wounds at intermediate range produce **multiple scattered pellet wounds** with a **dispersed pattern**, not a single entry wound. - There would be **no soot or powder burns** at intermediate range due to the greater distance. *Shotgun, close range* - Close range shotgun wounds create **large, ragged wounds** with **extensive tissue destruction** due to the **shot column** and **wadding impact**. - The wound pattern would be **much larger and more irregular** than the single projectile entry seen here. *Pistol, near shot* - **Near shots** (3-24 inches) show **powder tattooing only** without any **soot deposition** or blackening around the wound. - The presence of **soot blackening** in this image rules out a near shot classification.

Q: A female patient presented with fatigue and a history of piles. Routine complete blood count analysis showed hemoglobin of 9 g/dL, MCV 60fL, and RBC count of 5.2 million. A peripheral smear is provided. Which of the following is the next best investigation after the smear for this patient?

Serum ferritin levels. ***Serum ferritin levels*** - The **low hemoglobin** and **low MCV (microcytic anemia)** indicate a likely iron deficiency, commonly assessed by serum ferritin levels [1]. - The patient's **history of piles** suggests possible gastrointestinal bleeding, further pointing to the need for iron studies. *Serum folate levels* - Typically evaluated in cases of **macrocytic anemia**, which is not indicated here due to a **low MCV**. - Folate deficiency leads to larger, immature red cells, contrasting the findings of microcytic anemia in this patient. *Serum homocysteine levels* - While elevated levels can indicate **vitamin B12 or folate deficiency**, they are not specific for iron deficiency anemia. - The current presentation does not suggest deficiencies of B12 or folate, making this test less relevant. *HbA2 levels* - Useful in diagnosing **beta-thalassemia**, but not indicated in the context of evident **microcytic anemia** and fatigue without hemolysis or family history [1]. - The patient's profile does not align with thalassemia, thus making this investigation unnecessary. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 590-591.

Q: A patient diagnosed to be HIV-positive was started on highly active antiretroviral therapy (HAART). Which of the following can be used to monitor treatment efficacy?

Viral load. ***Viral load*** - **Viral load** (HIV RNA copies per milliliter of plasma) is the most direct and sensitive measure of HAART efficacy, as it indicates the amount of actively replicating virus [1]. - A successful HAART regimen aims to reduce the **viral load** to undetectable levels, signaling effective suppression of viral replication [1]. *CD4+ T cell count* - While important for monitoring immune status and disease progression, **CD4+ T cell count** changes more slowly than viral load [1]. - An increase in **CD4+ T cell count** is a positive sign of immune reconstitution but is a lagging indicator of immediate treatment efficacy [1]. *p24 antigen* - **p24 antigen** is a core structural protein of HIV, primarily detectable early in acute infection and in advanced stages when viral replication is very high. - It is generally not used for routine monitoring of HAART efficacy in chronic HIV infection because its levels fluctuate and become undetectable as the immune system produces antibodies. *Viral serotype* - **Viral serotype** refers to the specific strain or subtype of HIV (e.g., HIV-1 vs. HIV-2, or different clades within HIV-1). - It is determined at diagnosis to understand the specific virus but does not change significantly during the course of treatment and is not used to monitor HAART efficacy.

Q: A female patient presents with complaints of thick white vaginal secretions. Which of the following can be used to identify the likely species of the causative agent?

CHROMagar. ***CHROMagar*** - **CHROMagar Candida** is a differential and selective medium used for the isolation and presumptive identification of common yeast species, including *Candida albicans*, *Candida tropicalis*, and *Candida glabrata*, based on chromogenic reactions. - Different *Candida* species produce distinct colonies of varying colors on this medium, aiding in their **presumptive identification** directly from patient samples like vaginal secretions. *Birdseed agar* - This medium (also known as Staib's medium or Niger seed agar) is primarily used for the isolation and identification of **Cryptococcus neoformans**, which produces dark brown to black colonies due to its phenoloxidase activity. - While it's a fungal growth medium, it is not optimized for distinguishing common *Candida* species responsible for vaginal candidiasis. *Brain heart infusion agar* - **Brain heart infusion (BHI) agar** is a general-purpose, enriched non-selective medium used for the cultivation of a wide variety of fastidious bacteria, yeasts, and molds. - It does not contain differential components that would allow for the specific identification or differentiation of *Candida* species based on colony color or morphology. *Sabouraud dextrose agar* - **Sabouraud dextrose agar (SDA)** is a selective medium primarily used for the isolation and cultivation of pathogenic and nonpathogenic fungi, including yeasts and molds. - While *Candida* species will grow well on SDA, it does not provide differential characteristics (like distinct colony colors) to allow for the presumptive identification and differentiation of various *Candida* species.

Q: A 16-year-old girl has intense cravings for food and consumes large amounts of it, followed by purging behaviors. What is the most likely diagnosis?

Bulimia nervosa. ***Bulimia nervosa*** - **Bulimia nervosa** is characterized by recurrent episodes of **binge eating** (consuming large amounts of food with a sense of lack of control), followed by inappropriate **compensatory behaviors** such as self-induced vomiting, laxative abuse, or excessive exercise. - The patient's presentation of "intense cravings for food," consuming "large amounts," and "purging behaviors" directly aligns with DSM-5 diagnostic criteria for bulimia nervosa. - Peak onset is typically in **adolescence and early adulthood**, and it is more common in females. *Anorexia nervosa* - **Anorexia nervosa** is primarily characterized by **restriction of energy intake** leading to significantly low body weight, intense fear of gaining weight, and disturbance in body image. - While the binge-eating/purging subtype of anorexia exists, the defining feature is **persistent restriction** and significantly **low body weight**, which is not mentioned in this clinical scenario. *Major depressive disorder* - **Depression** is a mood disorder with persistent sadness, anhedonia, and neurovegetative symptoms. - While depression commonly co-occurs with eating disorders and may cause appetite changes, the specific cyclical pattern of **binge eating followed by compensatory purging** is not a characteristic feature of depression itself. *Binge eating disorder* - **Binge eating disorder** involves recurrent episodes of consuming large amounts of food with a sense of lack of control, accompanied by marked distress. - The key distinguishing feature is the **absence of regular compensatory behaviors** (purging, excessive exercise, fasting) that are present in bulimia nervosa.

Q: A delayed intravenous urogram of a patient is given below. What is the likely diagnosis?

Pelviureteric junction obstruction. ***Pelviureteric junction obstruction*** - The image shows marked **dilatation of the renal pelvis and calyces** on the right side, with a relatively abrupt narrowing at the junction of the pelvis and ureter. - The delayed nature of the urogram suggests **impaired drainage** of contrast from the renal pelvis, accumulating proximal to the obstruction. *Putty kidney* - A "putty kidney" (or **autonecrotic kidney**) refers to a chronic, severely diseased kidney, often seen in end-stage **renal tuberculosis**, that has become calcified and non-functional. - This image demonstrates active contrast excretion and pelvicalyceal dilatation, not a calcified, non-functional organ. *Staghorn calculus* - A staghorn calculus is a **large, branched kidney stone** that occupies a significant portion of the renal collecting system. - While it can cause hydronephrosis, the image does not show a dense, radiopaque calculus filling the collecting system. *Cystic kidney* - **Cystic kidneys**, such as in polycystic kidney disease, are characterized by multiple fluid-filled sacs within the kidney parenchyma. - The image depicts dilatation of the collecting system, not diffuse cystic changes throughout the renal parenchyma.

Q: Identify the most common site of an intraperitoneal abscess.

Pelvis (Pouch of Douglas). ***Pelvis (Pouch of Douglas)*** - The **Pouch of Douglas** (rectouterine or rectovesical pouch) is the **most common site** for intraperitoneal abscesses. - It is the **most dependent (lowest) part** of the peritoneal cavity in both upright and supine positions, allowing gravity to facilitate collection of infected fluid. - Commonly results from **perforated appendicitis**, **diverticulitis**, **gynecological infections** (PID, tubo-ovarian abscess), or any source of peritoneal contamination where infected material flows downward. - **Clinical significance**: Pelvic abscesses can be drained via transrectal or transvaginal approaches, making them accessible for percutaneous drainage. *Subhepatic* - The **subhepatic space** (Morison's pouch on the right) is a **common but not the most common** site for intraperitoneal abscesses. - More specifically associated with **cholecystitis**, **perforated duodenal ulcers**, or hepatobiliary surgery complications. - While dependent in the supine position, it is less dependent than the pelvis in the upright position. *Suprahepatic* - Abscesses in the **suprahepatic space** are relatively uncommon. - May occur from direct extension of liver abscesses or as complications of upper abdominal surgery. - The presence of peritoneal attachments limits widespread fluid collection in this area. *Left subphrenic space* - The **left subphrenic space** is less commonly involved than the pelvis or right subphrenic spaces. - Typically arises from complications of **splenic injury**, **pancreatitis**, **gastric perforations**, or post-splenectomy infections.

Question 1

Which of the following agencies is primarily responsible for supporting school feeding programs globally?

Accepted Answer

WFP

Answer

UNDP

Answer

UNICEF

Answer

WHO

Question 2

A 45-year-old patient complained of pain on one side of the neck. She is afraid of eating food as it worsens the pain. An ultrasound of the salivary glands is shown below. What is the most likely diagnosis?

Accepted Answer

Sialolithiasis

Answer

Salivary gland foreign body

Answer

Cervical lymphadenopathy

Answer

Osteoma of the floor of the mouth

Question 3

Based on the provided wound characteristics, identify the type of firearm used and the estimated range of the shot.

Accepted Answer

Pistol, close shot

Answer

Shotgun, intermediate range

Answer

Shotgun, close range

Answer

Pistol, near shot

Question 4

A woman with recurrent diarrhea is prescribed a broad-spectrum antibiotic. Which of the following statements is not true regarding Clostridium difficile infection?

Accepted Answer

IgM assay is used to confirm the diagnosis of Clostridium difficile infection.

Answer

Pseudomembrane is a layer of inflammatory debris

Answer

Oral fidaxomicin is used for treatment

Answer

It is toxin mediated

Question 5

A female patient presented with fatigue and a history of piles. Routine complete blood count analysis showed hemoglobin of 9 g/dL, MCV 60fL, and RBC count of 5.2 million. A peripheral smear is provided. Which of the following is the next best investigation after the smear for this patient?

Accepted Answer

Serum ferritin levels

Answer

HbA2 levels

Answer

Serum folate levels

Answer

Serum homocysteine levels

Question 6

A patient diagnosed to be HIV-positive was started on highly active antiretroviral therapy (HAART). Which of the following can be used to monitor treatment efficacy?

Accepted Answer

Viral load

Answer

CD4+ T cell count

Answer

p24 antigen

Answer

Viral serotype

Question 7

A female patient presents with complaints of thick white vaginal secretions. Which of the following can be used to identify the likely species of the causative agent?

Accepted Answer

CHROMagar

Answer

Brain heart infusion agar

Answer

Sabouraud dextrose agar

Answer

Birdseed agar

Question 8

A 16-year-old girl has intense cravings for food and consumes large amounts of it, followed by purging behaviors. What is the most likely diagnosis?

Accepted Answer

Bulimia nervosa

Answer

Anorexia nervosa

Answer

Major depressive disorder

Answer

Binge eating disorder

Question 9

A delayed intravenous urogram of a patient is given below. What is the likely diagnosis?

Accepted Answer

Pelviureteric junction obstruction

Answer

Putty kidney

Answer

Staghorn calculus

Answer

Cystic kidney

Question 10

Identify the most common site of an intraperitoneal abscess.

Accepted Answer

Pelvis (Pouch of Douglas)

Answer

Suprahepatic

Answer

Left subphrenic space

Answer

Subhepatic

NEET-PG 2022

Community Medicine

ENT

Forensic Medicine

Internal Medicine

Microbiology

Psychiatry

Radiology

Surgery