NEET-PG 2023 Practice Questions

Q: A family consumes only polished rice. Which of the following combinations of vitamin deficiency and enzymatic defect will be present in this family?

Thiamine-transketolase. ***Thiamine-transketolase*** - Consumption of **polished rice** is a classic cause of **thiamine (vitamin B1) deficiency** because the polishing process removes the outer layers of the grain where thiamine is abundant. - **Transketolase** is a key enzyme in the **pentose phosphate pathway** that requires thiamine pyrophosphate (TPP) as a cofactor, making its activity a reliable indicator of thiamine status. *Riboflavin-glutathione reductase* - **Glutathione reductase** activity is indeed used to assess **riboflavin (vitamin B2) status**, as it requires FAD (a derivative of riboflavin) as a cofactor. - However, **riboflavin deficiency** is not characteristically associated with consumption of polished rice. *Thiamine-transaminase* - While this option correctly identifies **thiamine**, the associated enzyme, **transaminase**, is incorrect in this context. - **Transaminases** are primarily dependent on **pyridoxal phosphate (vitamin B6)** as a cofactor, not thiamine. *Riboflavin-transketolase* - This option incorrectly combines **riboflavin deficiency** with the enzyme **transketolase**. - As mentioned, **transketolase** activity is specifically used to assess **thiamine status**, not riboflavin status.

Q: Which of the following best describes the concept of 'Years of Potential Life Lost' (YPLL)?

Years lost due to premature mortality. ***Correct Answer: Years lost due to premature mortality*** - **Years of Potential Life Lost (YPLL)** is a measure of premature mortality, calculated by subtracting the age at death from a predetermined standard age (e.g., 75 or 65 years) - It quantifies the **societal and economic impact** of deaths occurring before a statistically expected lifespan, giving more weight to deaths at younger ages - YPLL emphasizes the burden of **early deaths** on society, making it particularly useful for prioritizing public health interventions *Incorrect: Years lost due to illness or morbidity* - This concept describes the **burden of living with illness**, not necessarily dying prematurely - While related to health outcomes, it is distinct from YPLL, which specifically focuses on the impact of **death** *Incorrect: Years lost due to disability* - This is a component of **Disability-Adjusted Life Years (DALYs)**, specifically the **Years Lived with Disability (YLD)** component - It does not directly account for **mortality**, but rather the impact of non-fatal health outcomes - YLD measures the burden of living with health conditions, not years lost to premature death *Incorrect: Years lost due to poor health quality* - This is a broad term that can encompass various aspects of health - While related to the overall societal health burden, it is not a specific, standardized metric like YPLL - YPLL has a precise definition and calculation method focused exclusively on **premature death**

Q: Which muscle is attached to the disc of the temporomandibular joint?

Lateral pterygoid. ***Lateral pterygoid*** - The superior head of the **lateral pterygoid muscle** inserts directly into the **articular disc** and the neck of the condyle, playing a crucial role in the movement and stability of the TMJ. - Its contraction pulls the disc and condyle forward during mouth opening and protrusion. *Buccinator* - The buccinator muscle forms the **muscular portion of the cheek** and is primarily involved in smiling, whistling, and preventing food from accumulating between the teeth and cheeks. - It does not have any direct attachment to the temporomandibular joint or its disc, as it is located superficially and anteriorly to the joint. *Masseter* - The masseter is a powerful muscle that **elevates the mandible** (closes the mouth) and assists in protrusion. - While it is a muscle of mastication and originates from the zygomatic arch and inserts into the lateral surface of the ramus and angle of the mandible, it **does not attach to the articular disc** of the TMJ. *Temporalis* - The temporalis muscle is responsible for **elevating and retracting the mandible** (closing the mouth). - It originates from the temporal fossa and inserts into the coronoid process and anterior border of the ramus of the mandible, with **no direct attachment to the TMJ disc**.

Q: A female patient presents with hearing loss. Rinne test results show Rinne negative at 256 Hz and 512 Hz, while Rinne positive at 1024 Hz. Based on these findings, what is the expected air conduction and bone conduction gap?

15-30 dB. ***15-30 dB*** - The pattern of **Rinne negative at 256 Hz and 512 Hz** combined with **Rinne positive at 1024 Hz** is characteristic of a **mild to moderate conductive hearing loss** with an air-bone gap in the **15-30 dB range**. - In this range, the conductive component is sufficient to cause Rinne negativity at lower frequencies where bone conduction is more efficient, but at higher frequencies (1024 Hz), the gap narrows and air conduction becomes relatively better, resulting in a positive Rinne test. - This frequency-dependent pattern indicates the air-bone gap is **closing at higher frequencies**, typical of mild conductive losses. *30-45 dB* - An air-bone gap of **30-45 dB** represents a **moderate conductive hearing loss** where Rinne test would remain **negative across all frequencies** including 1024 Hz. - At this magnitude of conductive loss, bone conduction would still significantly exceed air conduction even at higher frequencies. - The transition to Rinne positive at 1024 Hz would NOT occur with this degree of hearing loss. *45-60 dB* - This represents a **moderate-severe conductive hearing loss** with a substantial air-bone gap. - Rinne test would be **strongly negative across all tested frequencies** without exception. - The large gap would prevent any frequency from showing air conduction superiority. *>60 dB* - This indicates a **severe to profound conductive hearing loss** with a very large air-bone gap. - Rinne test would be **markedly negative at all frequencies**, with bone conduction dramatically exceeding air conduction. - Air conduction may be barely perceptible or absent at this level of loss.

Q: A patient comes with abdominal pain, jaundice, and portal hypertension. Anastomosis between which of the following veins is seen?

Esophageal veins and left gastric veins. ***Esophageal veins and left gastric veins*** - This anastomosis is crucial in **portal hypertension**, as increased pressure in the **portal venous system** (e.g., due to liver cirrhosis) causes blood to back up into the **systemic venous circulation** through these collateral vessels. - This shunting creates **esophageal varices**, which can rupture and lead to life-threatening **upper gastrointestinal bleeding**, commonly presenting with **jaundice** and **abdominal pain** in liver disease. *Left colic vein and middle colic veins* - Both the left colic and middle colic veins are tributaries of the **inferior mesenteric vein** and **superior mesenteric vein**, respectively, and are part of the **portal system**. - While they form an anastomosis (via the **marginal artery of Drummond**), this connection is within the portal system and does not typically serve as a portosystemic shunt to decompress portal hypertension in the way esophageal varices do. *Superior rectal and phrenic veins* - The **superior rectal vein** drains into the **inferior mesenteric vein** (part of the portal system), and the **phrenic veins** drain into the **inferior vena cava** (part of the systemic system). - There is no direct significant portosystemic anastomosis between these two veins that would be clinically relevant in portal hypertension. *Sigmoid and superior rectal veins* - Both the **sigmoid veins** and the **superior rectal vein** are part of the **inferior mesenteric venous system**, which drains into the **portal circulation**. - While there are anastomoses between these veins within the mesenteric circulation, they are not a direct portosystemic shunt used to relieve pressure in portal hypertension causing the described symptoms.

Q: A patient comes to the casualty with a severe headache. His BP was found to be 160/100 mmHg. CT scan revealed a subarachnoid hemorrhage. What is the next best step in the management of this patient?

Angiography. ***Angiography*** - Following the diagnosis of **subarachnoid hemorrhage (SAH)** by CT scan, **cerebral angiography** is the next crucial step to identify the source of bleeding. - This procedure helps locate and characterize the **aneurysm** or other vascular malformations, which is essential for planning definitive treatment. *Nimodipine* - **Nimodipine** is a calcium channel blocker used to prevent and treat **vasospasm**, a common complication after SAH. - While important in SAH management, it is typically initiated after the source of bleeding has been identified and secured, or as an adjunct immediately after diagnosis, but not the *next best step* before identifying the source. *Surgery* - **Surgical clipping** or **endovascular coiling** are definitive treatments for ruptured aneurysms after SAH. - However, surgery is performed *after* the aneurysm has been identified and localized through angiography, making angiography the prerequisite next step. *Fibrinolytic therapy* - **Fibrinolytic therapy** is used to dissolve blood clots in conditions like ischemic stroke or myocardial infarction. - It is **contraindicated** in hemorrhagic stroke, including subarachnoid hemorrhage, as it would worsen the bleeding.

Q: In your STI clinic, standardized treatment kits are available for different conditions based on clinical presentation and likely pathogens. A 22-year-old female comes to the STI clinic with minimal vaginal discharge. On speculum examination, erosions are seen on the cervix. Which of the following treatment kit should be given to this patient?

Grey. ***Grey*** - A grey kit is indicated for **vaginal discharge** with associated **cervical erosions**, suggesting a treatable bacterial STI like gonorrhea or chlamydia. This kit typically contains antibiotics effective against these pathogens. - The presence of **minimal vaginal discharge** combined with **cervical erosions** points towards cervicitis, for which the grey kit is specifically designed. *Green* - The green kit is typically for the treatment of **vaginal discharge** without specific signs of cervicitis, often targeting common causes like **bacterial vaginosis** or **trichomoniasis**. - It would not specifically address the **cervical erosions** seen in this patient, which are more indicative of cervicitis. *Red* - The red kit is generally used for the treatment of **genital ulcers**, which are typically caused by **herpes simplex virus** or **syphilis**. - While there are erosions, the primary complaint is discharge, and erosions are not typically the sole indicator for a "genital ulcer" kit. *Yellow* - The yellow kit is often designated for **urethral discharge** in males, addressing conditions like **gonorrhea** or **chlamydia** when presenting as urethritis. - This patient is female and presents with **vaginal discharge** and **cervical erosions**, making the yellow kit inappropriate.

Q: A 5-year-old child was admitted to the hospital for a prolapsing rectal mass and painless rectal bleeding. Histopathological examination reveals enlarged and inflamed glands filled with mucin. What is the likely diagnosis?

Juvenile polyp (Hamartoma). ***Juvenile polyp (Hamartoma)*** - **Juvenile polyps** are the most common cause of rectal bleeding in children, often presenting as a **prolapsing rectal mass** and **painless bleeding**. - Histologically, they are characterized by **enlarged, inflamed glands filled with mucin**, consistent with a hamartomatous origin. *Adenoma (precancerous lesion in adults)* - While adenomas can cause rectal bleeding and prolapse, they are typically found in **adults** and are considered **precancerous lesions** [1]. - The patient's young age (5-year-old) makes an adenoma highly unlikely [1]. *Carcinoma (malignant tumor, rare in children)* - **Colorectal carcinoma** is exceedingly **rare in children** and usually presents with more aggressive symptoms than painless bleeding, such as weight loss or anemia [2]. - The histological description of inflamed, mucin-filled glands is not typical for carcinoma [2]. *Choristoma (benign growth of normal tissue in an abnormal location)* - A **choristoma** is a benign growth of normal tissue in an abnormal location, but it does not typically present as a rectal mass or cause rectal bleeding. - The microscopic findings of enlarged and inflamed glands filled with mucin are not characteristic of a choristoma. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 371-372. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 821-822.

Q: A patient with recurrent gout attacks was started on a drug that inhibits uric acid synthesis. His symptoms were reduced after therapy. Which drug was he started on?

Allopurinol. ***Allopurinol*** - **Allopurinol** is a **xanthine oxidase inhibitor** that effectively reduces uric acid synthesis by blocking the enzyme responsible for converting hypoxanthine and xanthine to uric acid. - It is a cornerstone therapy for preventing recurrent gout attacks in patients with **hyperuricemia**. *Probenecid* - **Probenecid** is a **uricosuric agent** that increases the excretion of uric acid in the urine, rather than inhibiting its synthesis. - It works by inhibiting the reabsorption of uric acid in the renal tubules. *Colchicine* - **Colchicine** is an **anti-inflammatory agent** primarily used to treat acute gout flares and prevent future attacks by disrupting microtubule function and inhibiting neutrophil migration. - It does not affect uric acid synthesis or excretion. *Diclofenac* - **Diclofenac** is a **non-steroidal anti-inflammatory drug (NSAID)** used to manage the pain and inflammation associated with acute gout attacks. - It works by inhibiting prostaglandin synthesis and has no effect on uric acid levels.

Question 1

A family consumes only polished rice. Which of the following combinations of vitamin deficiency and enzymatic defect will be present in this family?

Accepted Answer

Thiamine-transketolase

Answer

Riboflavin-glutathione reductase

Answer

Thiamine-transaminase

Answer

Riboflavin-transketolase

Question 2

Which of the following best describes the concept of 'Years of Potential Life Lost' (YPLL)?

Accepted Answer

Years lost due to premature mortality

Answer

Years lost due to illness or morbidity

Answer

Years lost due to disability

Answer

Years lost due to poor health quality

Question 3

Which muscle is attached to the disc of the temporomandibular joint?

Accepted Answer

Lateral pterygoid

Answer

Buccinator

Answer

Masseter

Answer

Temporalis

Question 4

A female patient presents with hearing loss. Rinne test results show Rinne negative at 256 Hz and 512 Hz, while Rinne positive at 1024 Hz. Based on these findings, what is the expected air conduction and bone conduction gap?

Accepted Answer

15-30 dB

Answer

30-45 dB

Answer

45-60 dB

Answer

>60 dB

Question 5

A patient comes with abdominal pain, jaundice, and portal hypertension. Anastomosis    between which of the following veins is seen?

Accepted Answer

Esophageal veins and left gastric veins

Answer

Left colic vein and middle colic veins

Answer

Superior rectal and phrenic veins

Answer

Sigmoid and superior rectal veins

Question 6

A patient comes to the casualty with a severe headache. His BP was found to be 160/100    mmHg. CT scan revealed a subarachnoid hemorrhage. What is the next best step in the    management of this patient?

Accepted Answer

Angiography

Answer

Nimodipine

Answer

Surgery

Answer

Fibrinolytic therapy

Question 7

In your STI clinic, standardized treatment kits are available for different conditions based on clinical presentation and likely pathogens. A 22-year-old female comes to the STI clinic with minimal vaginal discharge. On speculum examination, erosions are seen on the cervix. Which of the following treatment kit should be given to this patient?

Accepted Answer

Grey

Answer

Green

Answer

Red

Answer

Yellow

Question 8

A 5-year-old child was admitted to the hospital for a prolapsing rectal mass and painless rectal bleeding. Histopathological examination reveals enlarged and inflamed glands filled with mucin. What is the likely diagnosis?

Accepted Answer

Juvenile polyp (Hamartoma)

Answer

Adenoma (precancerous lesion in adults)

Answer

Carcinoma (malignant tumor, rare in children)

Answer

Choristoma (benign growth of normal tissue in an abnormal location)

Question 9

A patient with recurrent gout attacks was started on a drug that inhibits uric acid synthesis. His symptoms were reduced after therapy. Which drug was he started on?

Accepted Answer

Allopurinol

Answer

Probenecid

Answer

Colchicine

Answer

Diclofenac

Question 10

A woman with endometrial carcinoma is undergoing radiotherapy. Which of the following statements about radiation therapy is true?

Accepted Answer

Intensity is inversely proportional to the square of the distance from the source.

Answer

Small intestinal mucosa is radioresistant.

Answer

Rapidly proliferating cells are radioresistant.

Answer

Small blood vessels are radioresistant.

NEET-PG 2023

Biochemistry

Community Medicine

Dental

ENT

Internal Medicine

Obstetrics and Gynecology

Pathology

Pharmacology

Radiology