NEET-PG 2022 Practice Questions

Q: Identify the type of cartilage shown in the image.

Fibrocartilage. ***Fibrocartilage*** - The image displays **chondrocytes** arranged in rows between bundles of **collagen fibers**, characteristic of fibrocartilage. This structure provides high tensile strength and shock absorption. - Unlike other cartilage types, fibrocartilage lacks a distinct perichondrium and is found in structures requiring extreme strength, such as intervertebral discs and menisci. *Hyaline cartilage* - Hyaline cartilage has an amorphous, **glassy matrix** with chondrocytes typically arranged in small groups (isogenous groups) within lacunae, without prominent collagen bundles. - It is found in articular surfaces, tracheal rings, and the costal cartilages, providing smooth, low-friction surfaces. *Elastic cartilage* - Elastic cartilage is characterized by a high concentration of **elastic fibers** within its matrix, giving it flexibility and resilience. - Chondrocytes are typically scattered and the matrix stains darker due to the elastic fibers, which are not apparent in the image. *Dense connective tissue* - While dense connective tissue contains abundant **collagen fibers**, it lacks chondrocytes in lacunae, instead containing fibroblasts. - The presence of chondrocytes in the image confirms this is cartilage, not dense connective tissue.

Q: Identify the mask used for patients requiring high concentrations of oxygen.

Non-rebreathing mask. ***Non-rebreathing mask*** - The **non-rebreathing mask** delivers the **highest concentration of oxygen** (FiO2 60-90%) among standard oxygen masks due to a one-way valve that prevents exhaled air from returning to the reservoir bag and ensures only pure oxygen is inhaled. - It is identifiable by the **reservoir bag** which fills with oxygen and one-way valves. *Hudson mask* - The **Hudson mask**, also known as a simple face mask, delivers a **moderate concentration of oxygen (FiO2 35-50%)** and does not have the reservoir bag or one-way valves seen in the image. - It is used for patients requiring a higher oxygen concentration than nasal cannulae, but less than a non-rebreather. *Nebulizer* - A **nebulizer** is a device used to administer medication in the form of a **mist**, typically for respiratory conditions, not primarily for administering high concentrations of oxygen. - While it can be oxygen-driven, its primary function is drug delivery, not oxygen concentration. *Venturi mask* - The **Venturi mask** delivers **precise and consistent concentrations of oxygen (FiO2 24-60%)** through interchangeable jets, which are not visible in the depicted mask. - It is used when precise control over oxygen delivery is crucial, such as in patients with **COPD**.

Q: A patient presents with complaints of hair loss and behavioral changes noted by his wife. Upon examination, the doctor observes a loss of eyebrows. After further assessment, including an examination of the nails, what type of poisoning is suspected in this case?

Thallium. ***Thallium*** - **Thallium poisoning** characteristically presents with **hair loss (alopecia)**, including loss of eyebrows, and **neurological symptoms** such as behavioral changes. - It also causes nail changes like **Mees' lines** and is known for its **neurotoxic effects**. *Arsenic* - **Arsenic poisoning** primarily causes **gastrointestinal symptoms** (nausea, vomiting, diarrhea), **skin lesions** (hyperpigmentation, hyperkeratosis), and **neuropathy**. - While it can cause nail changes (Mees' lines), significant alopecia and loss of eyebrows are less prominent compared to thallium. *Mercury* - **Mercury poisoning** often leads to **neurological symptoms** (tremors, ataxia, irritability), kidney damage, and **gingivostomatitis**. - Hair loss and loss of eyebrows are not typical or prominent features of mercury toxicity. *Lead* - **Lead poisoning** is associated with **neurodevelopmental deficits** in children, **peripheral neuropathy**, **abdominal pain (lead colic)**, and **anemia**. - Alopecia and loss of eyebrows are not characteristic symptoms of lead toxicity.

Q: Which of the following is not seen in MEN 2B syndrome?

Parathyroid adenoma. ***Parathyroid adenoma*** - **Parathyroid adenomas**, leading to hyperparathyroidism, are characteristic of **MEN 2A syndrome**, not MEN 2B [1]. - While both MEN 2A and 2B involve mutations in the **RET proto-oncogene**, the specific clinical manifestations differ significantly. *Megacolon* - **Megacolon** (due to intestinal ganglioneuromatosis) is a recognized feature of **MEN 2B syndrome**. - This condition involves abnormal nerve ganglion cells in the intestine, leading to motility issues. *Mucosal neuroma* - **Mucosal neuromas** on the tongue, lips, and eyelids are a hallmark clinical sign of **MEN 2B syndrome**. - These benign growths are often one of the earliest and most recognizable features. *Marfanoid habitus* - **Marfanoid habitus**, characterized by a tall, slender build with long limbs and arachnodactyly, is a common physical finding in **MEN 2B syndrome**. - This connective tissue abnormality helps distinguish MEN 2B from other MEN syndromes.

Q: A patient presents to you with fever, night sweats, ptosis, and bilateral facial nerve palsy. Investigations showed leukocytosis and bilateral hilar lymphadenopathy. Which of the following is the most likely diagnosis?

Sarcoidosis. ***Sarcoidosis*** - The combination of **fever**, **night sweats**, **bilateral facial nerve palsy**, **ptosis**, and **bilateral hilar lymphadenopathy** is highly suggestive of **neurosarcoidosis** manifesting as Heerfordt's syndrome (uveoparotid fever) [1]. - **Leukocytosis** is a non-specific finding but can be present due to inflammatory processes in sarcoidosis. *Tuberculosis* - While tuberculosis can cause **fever**, **night sweats**, and **hilar lymphadenopathy** [2] [3], it is less likely to present with **bilateral facial nerve palsy** and **ptosis** simultaneously. - Pulmonary tuberculosis often shows specific patterns like **apical infiltrates** or cavitations, rather than solely bilateral hilar lymphadenopathy, especially without other classic symptoms like productive cough. *Lymphoma* - Lymphoma can cause **fever**, **night sweats**, and **lymphadenopathy** (including hilar) [4]. - However, **bilateral facial nerve palsy** and **ptosis** are not typical primary manifestations of lymphoma and would require other evidence of direct mass effect or widespread infiltration. *Hypersensitive pneumonitis* - This condition is characterized by **inflammation of the lung alveoli** and small airways due to repeated exposure to inhaled antigens, leading to symptoms like cough, dyspnea, and fever. - It typically does **not cause neurological symptoms** such as facial nerve palsy or ptosis, nor is it prominently associated with hilar lymphadenopathy.

Q: Which of the following is NOT an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Uterine malformation. ***Uterine malformation*** - While a **uterine malformation** can make IUD placement difficult or increase the risk of expulsion, it is generally considered a **relative contraindication**, not an absolute one. - The decision to place an IUD in such cases depends on the specific type of malformation and the experience of the clinician. *Pregnancy* - **Pregnancy** is an **absolute contraindication** because an IUD offers no protection against pregnancy in an already conceived state and can lead to complications such as miscarriage or ectopic pregnancy if inserted. - Inserting an IUD into a pregnant uterus can cause significant harm to both the mother and the fetus. *Active pelvic infection* - An **active pelvic infection** (e.g., **pelvic inflammatory disease, cervicitis**) is an **absolute contraindication** due to the risk of exacerbating the infection and spreading it further into the uterus and fallopian tubes. - IUD insertion during an active infection can lead to severe complications. *Known allergy to IUD components* - A **known allergy** to any component of the IUD (e.g., copper, plastic) is an **absolute contraindication** to avoid severe allergic reactions. - Allergic reactions can range from localized irritation to systemic responses.

Q: A 65-year-old male presents with blurred vision and a history of cataract surgery. Upon examination, fluffy white deposits are noted on the anterior lens capsule. What is the most likely diagnosis?

Pseudoexfoliation syndrome. ***Pseudoexfoliation syndrome*** - The description of **fluffy white deposits on the anterior lens capsule** in an older patient with blurred vision and a history of cataract surgery is highly characteristic of **pseudoexfoliation syndrome**. - This condition is caused by the abnormal production and accumulation of an **extracellular fibrillar material**, which can also affect the iris, ciliary body, and trabecular meshwork, potentially leading to **glaucoma** and lens subluxation. *Intraocular foreign body* - An intraocular foreign body would typically present with a history of **trauma** and might be visible as a distinct object, rather than diffuse fluffy deposits. - While it can cause inflammation and vision changes, its appearance is not consistent with the described findings. *Ocular trauma* - Ocular trauma would typically have an associated history of injury and could present with various signs like hyphema, iritis, or retinal detachment, but not specifically this type of **fluffy white deposit** on the lens. - While it can lead to vision issues, the specific clinical findings do not point towards acute or chronic sequelae of trauma as the primary diagnosis. *Vossius ring* - A **Vossius ring** is a deposition of iris pigment on the anterior lens capsule, forming a circular ring corresponding to the pupil margin at the time of blunt trauma. - It would appear as a **pigmented ring**, not fluffy white deposits, and is directly linked to a history of blunt trauma.

Q: A patient presents to the emergency department with a history of ingestion of ten tablets of paracetamol. He has developed oliguria and liver function tests show deranged values. In the context of paracetamol overdose, which of the following can be used in the management of this condition?

N-acetylcysteine. **Correct: N-acetylcysteine** - **N-acetylcysteine (NAC)** is the specific antidote for **paracetamol overdose**, working by replenishing **glutathione** stores in the liver. - Replenishing **glutathione** helps detoxify the toxic metabolite **N-acetyl-p-benzoquinone imine (NAPQI)**, preventing further **hepatic damage** and facilitating recovery in cases of **liver failure** and potential **renal damage** (oliguria). - Most effective when given within **8 hours** of ingestion, but remains beneficial even with **established hepatotoxicity** (as in this case with deranged LFTs). *Incorrect: Dopamine* - **Dopamine** is a **vasopressor** primarily used to increase **blood pressure** and **cardiac output** in conditions like **shock**. - While it might be used to support circulation in severe overdose complications, it does not directly treat the **paracetamol toxicity** itself. *Incorrect: Ursodeoxycholic acid* - **Ursodeoxycholic acid (UDCA)** is a **cholagogue** used in the management of **cholestatic liver diseases** (e.g., primary biliary cholangitis) by improving bile flow. - It has no role in the direct management of **acute liver failure** due to **paracetamol overdose**. *Incorrect: Furosemide* - **Furosemide** is a **loop diuretic** used to increase **urine output** in conditions like **fluid overload** or **heart failure**. - While **oliguria** is present, it is often a sign of **acute kidney injury** requiring supportive care, and furosemide would not address the underlying **toxic mechanism** of paracetamol.

Question 1

Identify the type of cartilage shown in the image.

Accepted Answer

Fibrocartilage

Answer

Hyaline cartilage

Answer

Elastic cartilage

Answer

Dense connective tissue

Question 2

Identify the mask used for patients requiring high concentrations of oxygen.

Accepted Answer

Non-rebreathing mask

Answer

Hudson mask

Answer

Nebulizer

Answer

Venturi mask

Question 3

A patient presents with complaints of hair loss and behavioral changes noted by his wife. Upon examination, the doctor observes a loss of eyebrows. After further assessment, including an examination of the nails, what type of poisoning is suspected in this case?

Accepted Answer

Thallium

Answer

Arsenic

Answer

Mercury

Answer

Lead

Question 4

Which of the following is not seen in MEN 2B syndrome?

Accepted Answer

Parathyroid adenoma

Answer

Mucosal neuroma

Answer

Marfanoid habitus

Answer

Megacolon

Question 5

A patient presents to you with fever, night sweats, ptosis, and bilateral facial nerve palsy.    Investigations showed leukocytosis and bilateral hilar lymphadenopathy. Which of the    following is the most likely diagnosis?

Accepted Answer

Sarcoidosis

Answer

Tuberculosis

Answer

Lymphoma

Answer

Hypersensitive pneumonitis

Question 6

Which of the following is NOT an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Accepted Answer

Uterine malformation

Answer

Pregnancy

Answer

Active pelvic infection

Answer

Known allergy to IUD components

Question 7

A 65-year-old male presents with blurred vision and a history of cataract surgery. Upon examination, fluffy white deposits are noted on the anterior lens capsule. What is the most likely diagnosis?

Accepted Answer

Pseudoexfoliation syndrome

Answer

Intraocular foreign body

Answer

Ocular trauma

Answer

Vossius ring

Question 8

An RTA patient presented to the emergency department with severe pain in the ankle. An X-ray was performed, given below. What is the best next step in management?

Accepted Answer

Neurovascular Assessment and Closed reduction with slab application

Answer

Neurovascular Assessment and Closed reduction with cast application

Answer

Neurovascular Assessment and Immediate surgery

Answer

Neurovascular Assessment and Immediate open reduction

Question 9

An 11-year-old child with a history of streptococcal pharyngitis presents you with fever and arthralgia. There is no past history of rheumatic heart disease or features of carditis or valvular disease. How often is 600,000 IU of benzathine penicillin recommended for prophylaxis of rheumatic heart disease?

Accepted Answer

Once in three weeks for 5 years or till the age of 18, whichever is longer

Answer

Immediately

Answer

Thrice weekly lifelong

Answer

Once in three weeks for 10 years or till the age of 25, whichever is longer

Question 10

A patient presents to the emergency department with a history of ingestion of ten tablets of paracetamol. He has developed oliguria and liver function tests show deranged values. In the context of paracetamol overdose, which of the following can be used in the management of this condition?

Accepted Answer

N-acetylcysteine

Answer

Dopamine

Answer

Ursodeoxycholic acid

Answer

Furosemide

NEET-PG 2022

Anatomy

Anesthesiology

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Orthopaedics

Pediatrics

Pharmacology