NEET-PG 2023 Practice Questions

Q: Which vitamin deficiency is most commonly associated with rickets in children?

Vitamin D. ***Vitamin D*** - **Vitamin D** plays a crucial role in the absorption of **calcium** and **phosphate**, which are essential for proper **bone mineralization**. - A deficiency leads to impaired mineralization of newly formed bone matrix, resulting in soft, weak bones characteristic of **rickets** in children and **osteomalacia** in adults. *Vitamin A* - **Vitamin A** is primarily involved in **vision**, immune function, and cell growth and differentiation. - While essential for health, its deficiency is not directly linked to the skeletal deformities seen in rickets. *Vitamin C* - **Vitamin C** is vital for **collagen synthesis**, a key component of connective tissues, skin, and bone matrix. - Its deficiency causes **scurvy**, characterized by bleeding gums, poor wound healing, and joint pain, not the bone deformities of rickets. *Vitamin K* - **Vitamin K** is essential for **blood coagulation** and plays a role in bone metabolism through the carboxylation of certain bone proteins like **osteocalcin**. - However, its deficiency primarily leads to bleeding disorders and does not cause rickets.

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: Which of the following is a known risk factor for cholangiocarcinoma?

Clonorchis sinensis infestation. ***Clonorchis sinensis infestation*** - **Clonorchis sinensis**, also known as the Chinese liver fluke, is a well-established and significant risk factor for the development of **cholangiocarcinoma**. - Chronic inflammation and irritation of the bile ducts caused by the parasite are believed to promote malignant transformation. *Giardia lamblia (intestinal protozoa) infection* - **Giardia lamblia** is a common intestinal parasite causing giardiasis, characterized by diarrhea and malabsorption. - While it affects the gastrointestinal tract, there is **no known association** between *Giardia* infection and an increased risk of cholangiocarcinoma. *Paragonimus westermani infestation* - **Paragonimus westermani** is a lung fluke that primarily causes paragonimiasis, affecting the lungs and leading to cough and hemoptysis. - This parasite is not associated with direct bile duct inflammation or an increased risk of **cholangiocarcinoma**. *Ascaris lumbricoides (roundworm) infection* - **Ascaris lumbricoides** is a large intestinal roundworm that can cause intestinal obstruction or nutrient deficiencies. - Although it can occasionally migrate into the biliary tree, it is **not considered a risk factor** for cholangiocarcinoma [1].

Q: A patient presents with fever and jaundice after repairing sewers. What is the most appropriate test to diagnose the infection in this patient?

Microscopic agglutination test. ***Microscopic agglutination test*** - The patient's presentation (fever, jaundice, history of repairing sewers) is highly suggestive of **leptospirosis** [1]. The **Microscopic Agglutination Test (MAT)** is considered the gold standard for diagnosing leptospirosis, as it directly detects antibodies against *Leptospira* serovars [1]. - MAT provides **serovar-specific results** and is highly sensitive and specific, especially when acute and convalescent phase sera are tested [1]. *Weil Felix test* - The Weil-Felix test is used to diagnose **rickettsial infections**, not leptospirosis. - It detects antibodies that cross-react with antigens of certain *Proteus* species. *Paul Bunnell test* - The Paul-Bunnell test is used to detect **heterophile antibodies** associated with **infectious mononucleosis** (Epstein-Barr virus infection). - This test is not relevant for diagnosing bacterial infections like leptospirosis. *Microimmunofluorescence test* - The microimmunofluorescence (MIF) test is primarily used for the diagnosis of **chlamydial infections** and sometimes for rickettsial diseases. - While an antibody-detection test, it is not the standard or preferred method for diagnosing leptospirosis.

Q: A lady on treatment for infertility developed ascites, abdominal pain, and dyspnea. An ultrasound (USG) of the patient was done. What will be the diagnosis?

Ovarian Hyperstimulation Syndrome (OHSS). ***Ovarian Hyperstimulation Syndrome (OHSS)*** - The clinical presentation of infertility treatment followed by **ascites, abdominal pain, and dyspnea** is highly suggestive of OHSS. The ultrasound image shows **enlarged ovaries with multiple follicular cysts**, which is characteristic of severe OHSS. - OHSS is a potentially serious complication of **ovarian stimulation** during infertility treatment, where excessive ovarian response leads to systemic changes from increased vascular permeability. *Theca lutein cysts* - These cysts typically develop due to **excessive stimulation by hCG**, often seen with gestational trophoblastic disease or multiple pregnancies. - While they can be large and multiple, they are not typically associated with the rapid onset of severe systemic symptoms like **ascites and dyspnea** in the context of infertility treatment directly. *Mucinous cystadenoma* - This is a type of **benign ovarian tumor** that can grow very large and cause abdominal distension, but it is not typically associated with infertility treatment or the acute systemic symptoms of ascites and dyspnea as seen here. - Imaging would typically show a **multilocular cyst with internal septations**, not the numerous small follicular cysts seen in the image. *Polycystic Ovary Syndrome (PCOS)* - PCOS is a common cause of infertility, characterized by **anovulation, hyperandrogenism, and polycystic ovaries** on ultrasound (multiple small follicles in a string-of-pearls pattern). - While the ultrasound shares some similarities with multiple follicles, PCOS does not cause the acute symptoms of **ascites, abdominal pain, and dyspnea** that are directly linked to the rapid onset of severe OHSS.

Q: A 29-year-old primigravida presents at 36 weeks of gestation with a transverse lie. What is the recommended management?

Schedule cesarean delivery. ***Schedule cesarean delivery*** - A persistent **transverse lie** at 36 weeks makes vaginal delivery impossible and requires definitive management. - **Cesarean delivery** is the definitive and safest option for ensuring maternal and fetal well-being when the transverse lie persists. - While external cephalic version may be attempted first, if unsuccessful, contraindicated, or the lie remains transverse near term, cesarean section is mandatory. - Attempting vaginal delivery with transverse lie risks **cord prolapse**, **uterine rupture**, and **obstructed labor**. *Induce labor* - Inducing labor with a transverse lie is **absolutely contraindicated** due to impossibility of vaginal delivery. - The fetal shoulder or arm would present first, preventing engagement and causing **obstructed labor**. - High risk of **cord prolapse**, **uterine rupture**, and severe maternal-fetal complications. *Perform amniotomy* - **Amniotomy** (artificial rupture of membranes) with a transverse lie is extremely dangerous and contraindicated. - Significantly increases the risk of **cord prolapse** as membranes rupture without an engaged presenting part. - Would necessitate immediate cesarean delivery in emergency conditions, worsening outcomes. *Attempt external cephalic version* - While **external cephalic version (ECV)** can be attempted for transverse lie at 36-37 weeks, it has lower success rates (30-50%) compared to breech presentation. - However, the question asks for "recommended management" which refers to the **definitive management plan** - cesarean delivery remains the final recommendation when transverse lie persists. - ECV may be offered as an option to avoid cesarean, but has risks including **placental abruption**, **fetal distress**, and **failure** requiring cesarean anyway. - At 36 weeks with persistent transverse lie, planning for cesarean delivery is the safest definitive approach.

Q: Which of the following ocular findings is not associated with diabetes?

Blepharophimosis. ***Blepharophimosis*** - This is a **congenital disorder** characterized by small palpebral fissures, ptosis, and epicanthus inversus, which is **not associated with diabetes**. - It is a **developmental anomaly** of the eyelids, with no known link to metabolic conditions like diabetes. *Retinopathy* - **Diabetic retinopathy** is a common and serious complication of diabetes, caused by damage to the blood vessels in the retina. - It can lead to vision loss if not managed, and is directly linked to **poor glycemic control**. *Early senile cataract* - Diabetes is a significant risk factor for the **earlier development and progression of cataracts**, including senile cataracts. - High blood sugar levels can cause changes in the lens, leading to **opacification** and impaired vision. *Neovascular glaucoma* - This severe form of **secondary glaucoma** is often a complication of advanced **diabetic retinopathy**. - Ischemia in the retina triggers the growth of **new blood vessels** on the iris and in the angle of the eye, obstructing aqueous outflow and raising intraocular pressure.

Q: Which of the following is NOT a side effect of amiodarone?

Tachycardia. ***Tachycardia*** - **Amiodarone** is an antiarrhythmic drug primarily used to treat and prevent **tachyarrhythmias**, meaning it generally slows down heart rate and is not associated with causing tachycardia. - Its main effect is to prolong the **refractory period** in myocardial cells, which helps to stabilize abnormal heart rhythms, rather than inducing them. *Pulmonary fibrosis* - **Amiodarone** is well-known for its potential to cause **pulmonary toxicity**, including **interstitial lung disease** and **pulmonary fibrosis**, which can be severe and even fatal. - This side effect is thought to be dose-dependent and can manifest as shortness of breath and cough, requiring careful monitoring. *Corneal microdeposits* - **Corneal microdeposits**, often described as **whorl keratopathy** or **cornea verticillata**, are a very common and usually benign side effect of **amiodarone**. - These deposits typically do not affect vision but can cause blurred vision or halos around lights in some patients. *Photosensitivity* - **Photosensitivity** is a common dermatological side effect of **amiodarone**, leading to an exaggerated sunburn reaction or a grayish-blue skin discoloration in sun-exposed areas. - Patients are advised to use **sunscreen** and protective clothing while on **amiodarone** to minimize this risk.

Q: What is the most likely diagnosis for the parotid mass with mixed consistency shown in the image?

Pleomorphic adenoma. ***Pleomorphic adenoma*** - The **mixed consistency** of the parotid mass indicates a **benign tumor**, predominantly of epithelial and mesenchymal origin, typical of pleomorphic adenomas. - This type of tumor is usually **pain-free** and can exhibit a **soft** and **firm** texture on examination [1]. *Sebaceous cyst* - Typically presents as a **smooth, fluctuant nodule** and usually has a **firm consistency** rather than mixed. - Generally not seen as a parotid mass; usually found on the skin in areas with sebaceous glands. *Dermoid cyst* - Generally presents as a **well-defined, soft, and mobile mass**, not commonly associated with mixed consistency. - Often contains **keratin** and has a more homogenous consistency rather than the mixed characteristics of pleomorphic adenoma. *All* - As not all options are suitable for the description of a **mixed consistency parotid mass**, this option is incorrect. - Only **pleomorphic adenoma** aligns with the specific clinical presentation detailed in the question [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 751-753.

Question 1

Which vitamin deficiency is most commonly associated with rickets in children?

Accepted Answer

Vitamin D

Answer

Vitamin A

Answer

Vitamin C

Answer

Vitamin K

Question 2

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

Accepted Answer

Lateral pterygoid

Answer

Buccinator

Answer

Masseter

Answer

Temporalis

Question 3

Which of the following is a known risk factor for cholangiocarcinoma?

Accepted Answer

Clonorchis sinensis infestation

Answer

Giardia lamblia (intestinal protozoa) infection

Answer

Ascaris lumbricoides (roundworm) infection

Answer

Paragonimus westermani infestation

Question 4

A patient presents with fever and jaundice after repairing sewers. What is the most appropriate test to diagnose the infection in this patient?

Accepted Answer

Microscopic agglutination test

Answer

Weil Felix test

Answer

Paul Bunnell test

Answer

Microimmunofluorescence test

Question 5

A lady on treatment for infertility developed ascites, abdominal pain, and dyspnea. An ultrasound (USG) of the patient was done. What will be the diagnosis?

Accepted Answer

Ovarian Hyperstimulation Syndrome (OHSS)

Answer

Theca lutein cysts

Answer

Mucinous cystadenoma

Answer

Polycystic Ovary Syndrome (PCOS)

Question 6

A 29-year-old primigravida presents at 36 weeks of gestation with a transverse lie. What is the recommended management?

Accepted Answer

Schedule cesarean delivery

Answer

Induce labor

Answer

Perform amniotomy

Answer

Attempt external cephalic version

Question 7

Which of the following ocular findings is not associated with diabetes?

Accepted Answer

Blepharophimosis

Answer

Retinopathy

Answer

Early senile cataract

Answer

Neovascular glaucoma

Question 8

Which of the following is NOT a side effect of amiodarone?

Accepted Answer

Tachycardia

Answer

Corneal microdeposits

Answer

Photosensitivity

Answer

Pulmonary fibrosis

Question 9

What is the most likely diagnosis for the parotid mass with mixed consistency shown in the image?

Accepted Answer

Pleomorphic adenoma

Answer

Sebaceous cyst

Answer

Dermoid cyst

Answer

None of the options

Question 10

In a patient with esophageal cancer and dysphagia affecting liquid intake, what is the most appropriate intervention to ensure nutritional support?

Accepted Answer

Placement of a percutaneous endoscopic gastrostomy tube

Answer

Total parenteral nutrition

Answer

Nasogastric tube feeding

Answer

Esophageal stent placement

NEET-PG 2023

Biochemistry

Dental

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Pharmacology

Surgery