Biochemistry
1 questionsEnzyme activated by decrease in Insulin: glucagon ratio:
NEET-PG 2023 - Biochemistry NEET-PG Practice Questions and MCQs
Question 111: 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.
ENT
1 questionsA 50-year-old smoker presents with hoarseness, dysphagia, and weight loss. Flexible laryngoscopy shows a mass on the vocal cords. What is the next best step?
NEET-PG 2023 - ENT NEET-PG Practice Questions and MCQs
Question 111: A 50-year-old smoker presents with hoarseness, dysphagia, and weight loss. Flexible laryngoscopy shows a mass on the vocal cords. What is the next best step?
- A. Direct laryngoscopy with biopsy (Correct Answer)
- B. MRI of neck
- C. CT scan of neck
- D. Radiotherapy
Explanation: ***Direct laryngoscopy with biopsy*** - A definitive diagnosis of a vocal cord mass requires **histological examination** to rule out malignancy, especially given the patient's risk factors (age, smoking) and symptoms (hoarseness, dysphagia, weight loss). - **Direct laryngoscopy** allows for a thorough, magnified view of the mass and precise biopsy collection, which is superior to flexible laryngoscopy alone for definitive diagnosis and staging. *MRI of neck* - While MRI can provide excellent soft tissue detail for **staging** a known malignancy, it cannot provide a **histological diagnosis**. - It would typically be performed after a biopsy confirms malignancy to assess the extent of the tumor and potential spread. *CT scan of neck* - A CT scan is useful for evaluating **bony involvement**, lymph node status, and tumor extension for **staging purposes**, but it is not a diagnostic tool for identifying the specific type of tissue or cell pathology. - Like MRI, a CT scan would generally follow a biopsy confirming malignancy. *Radiotherapy* - **Radiotherapy** is a treatment modality for laryngeal cancer, not a diagnostic step. - Initiating treatment without a definitive histological diagnosis of malignancy would be inappropriate and potentially harmful.
Forensic Medicine
2 questionsIn which condition is postmortem caloricity observed?
Method of autopsy in which organs of various systems are removed en masse:
NEET-PG 2023 - Forensic Medicine NEET-PG Practice Questions and MCQs
Question 111: In which condition is postmortem caloricity observed?
- A. Septicemia (Correct Answer)
- B. Massive hemorrhage
- C. Cyanide poisoning
- D. Corrosive poisoning
Explanation: ***Septicemia*** - **Postmortem caloricity** (a rise in body temperature after death) is a characteristic finding in cases of **septicemia** due to ongoing bacterial activity and metabolic processes that continue for a short period post-mortem. - The bacterial activity in septicemia continues to generate heat, leading to a transient increase in core body temperature before it eventually falls to ambient levels. - **Note:** Other conditions causing postmortem caloricity include heat stroke, cholera, tetanus, and certain poisonings (e.g., strychnine), but among the given options, **septicemia is the correct answer**. *Massive hemorrhage* - **Massive hemorrhage** typically causes a significant drop in body temperature before death due to volume loss and circulatory collapse, and this hypothermia usually continues after death. - It does not involve conditions that would lead to a postmortem rise in temperature; rather, it promotes **algor mortis** (cooling of the body). *Cyanide poisoning* - **Cyanide poisoning** inhibits cellular respiration and energy production, leading to rapid tissue anoxia and cellular death. - It does not involve a process that would generate heat post-mortem; instead, it causes rapid cessation of metabolic heat production and normal cooling follows. *Corrosive poisoning* - **Corrosive poisoning** causes local tissue damage and systemic effects that can lead to shock and hypothermia, but it does not generally cause postmortem caloricity. - The primary effects are on tissue destruction and organ failure, which would not result in postmortem heat generation.
Question 112: Method of autopsy in which organs of various systems are removed en masse:
- A. Lettulle (Correct Answer)
- B. Virchow
- C. Rokitansky
- D. Ghon
Explanation: ***Lettulle*** - The **Lettulle method** (or en masse method) involves the removal of organs in large blocks or as a single unit, which helps preserve anatomical relationships. - This technique is particularly useful for studying the **interrelationships between organs** and the spread of disease involving multiple systems. *Virchow* - The **Virchow method** involves the individual removal of each organ, which allows for detailed examination of each organ separately. - This method is straightforward but can disrupt the **anatomical relationships** between organs. *Rokitansky* - The **Rokitansky method** involves *in situ* dissection of organs, with the organs remaining largely in the body during dissection. - This technique is valued for maintaining the **topographical integrity** of organ systems within the body cavity. *Ghon* - The **Ghon method** is a modified block dissection method, focusing on the removal of specific organ blocks. - This often includes the **thoracic and abdominal organs** together, maintaining their anatomical connections.
Internal Medicine
2 questionsA patient presents with severe abdominal pain and jaundice. Imaging reveals calcified cysts in the liver, and serological testing is positive for Echinococcus. What is a potential complication of this infection?
Which of the following is not the component of qSOFA?
NEET-PG 2023 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 111: A patient presents with severe abdominal pain and jaundice. Imaging reveals calcified cysts in the liver, and serological testing is positive for Echinococcus. What is a potential complication of this infection?
- A. Portal hypertension due to cyst compression
- B. Rupture of cysts leading to anaphylactic shock
- C. No significant complications
- D. Secondary bacterial infection of cysts (Correct Answer)
Explanation: ***Secondary bacterial infection of cysts*** - **Hydatid cysts** can become secondarily infected, typically after rupture or surgical manipulation, leading to an **abscess formation** within the liver. - This complication can present with features like fever, worsening abdominal pain, and an elevated **white blood cell count**, distinct from the initial presentation. *Rupture of cysts leading to anaphylactic shock* - While rupture of **hydatid cysts** can lead to **anaphylactic shock** due to the release of hydatid fluid, it is not the *most common immediate complication* or the scenario implied by abdominal pain and jaundice. - **Anaphylaxis** implies a rapid, severe systemic allergic reaction, which is a life-threatening acute event. *Portal hypertension due to cyst compression* - While large cysts can compress structures, significant **portal hypertension** due to direct compression of the portal vein by **hydatid cysts** is rare. - More commonly, portal hypertension is a complication of advanced **cirrhosis**, not typically direct cyst compression in the early stages described. *No significant complications* - **Echinococcosis** (hydatid disease) is a serious parasitic infection that almost always leads to significant morbidity if left untreated. - Cysts grow over time and inevitably cause **organ dysfunction**, pain, obstruction, or other complications.
Question 112: Which of the following is not the component of qSOFA?
- A. Respiratory rate >22/min
- B. Altered mental status
- C. Unequally dilated pupils (Correct Answer)
- D. Systolic BP<100 mmHg
Explanation: ***Unequally dilated pupils*** - **Unequally dilated pupils** are not a component of the **qSOFA** score. This finding can be indicative of neurological issues such as increased **intracranial pressure** or **uncal herniation**, but not directly part of the sepsis screening tool [1]. - The qSOFA score focuses on easily obtainable clinical signs to rapidly identify patients at risk for poor outcomes from **sepsis**. *Respiratory rate >22/min* - A **respiratory rate greater than 22 breaths per minute** is one of the three criteria for the **qSOFA** score, indicating significant physiological stress. - This elevated respiratory rate suggests an increased work of breathing, often due to **metabolic acidosis** or **systemic inflammation** associated with sepsis. *Altered mental status* - **Altered mental status** (e.g., Glasgow Coma Scale score less than 15) is a core component of the **qSOFA** score [1]. - This sign reflects **cerebral hypoperfusion** or **encephalopathy** due to the systemic effects of sepsis [1]. *Systolic BP<100 mmHg* - A **systolic blood pressure less than 100 mmHg** is another key criterion of the **qSOFA** score. - This indicates **hypotension** and suggests inadequate tissue perfusion, a critical sign of **circulatory dysfunction** in sepsis [1].
Obstetrics and Gynecology
1 questionsAs per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?
NEET-PG 2023 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 111: As per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?
- A. 25 years
- B. 21 years
- C. 30 years (Correct Answer)
- D. 18 years
Explanation: ***30 years*** - **Indian guidelines** from the **Ministry of Health & Family Welfare (MoHFW)** and the **Indian Council of Medical Research (ICMR)** recommend initiating cervical cancer screening at **age 30 years** or within 3 years of first sexual contact. - The recommended screening methods in India include **VIA (Visual Inspection with Acetic Acid)**, **HPV DNA testing**, or **Pap smear**, performed every 5 years until age 65. - This approach is tailored to the **Indian healthcare setting** and resource availability. *21 years* - This is the recommended screening age according to **US guidelines (ACOG/USPSTF)**, not Indian guidelines. - While appropriate for the US context, Indian guidelines start screening later at age 30, considering **epidemiological data**, **disease prevalence**, and **healthcare infrastructure** specific to India. *25 years* - Some **European countries** and the **UK** recommend starting screening at age 25. - This is **not the recommended age** for cervical cancer screening according to Indian national guidelines. - In India, screening typically begins at age 30 years. *18 years* - Initiating cervical cancer screening at age 18 is **not recommended** by any major international or Indian guidelines. - Screening before age 21 (in US guidelines) or 30 (in Indian guidelines) often leads to **unnecessary procedures and anxiety**, as **HPV infections** and mild dysplasias in adolescents usually resolve spontaneously.
Ophthalmology
1 questionsIn a child presenting unilateral watering and photophobia which of the following is the least likely disorder?
NEET-PG 2023 - Ophthalmology NEET-PG Practice Questions and MCQs
Question 111: In a child presenting unilateral watering and photophobia which of the following is the least likely disorder?
- A. Congenital entropion
- B. Congenital glaucoma
- C. Congenital NLDO (Correct Answer)
- D. Congenital dacryocystitis
Explanation: **Congenital NLDO** - **Congenital nasolacrimal duct obstruction (NLDO)** typically presents with **unilateral watering** (epiphora) due to blockage of tear drainage. - While it causes watering, **photophobia** is not a characteristic symptom of isolated NLDO, making it less likely given the combined presentation. *Congenital entropion* - **Congenital entropion** involves the inward turning of the eyelid margin, causing eyelashes to rub against the cornea. - This irritation can lead to **unilateral watering** and **photophobia** due to corneal abrasion and discomfort. *Congenital glaucoma* - **Congenital glaucoma** is characterized by elevated intraocular pressure, which can cause corneal edema and stretching. - These changes commonly result in **unilateral watering** (epiphora) and marked **photophobia**, often accompanied by **buphthalmos** (enlarged eye). *Congenital dacryocystitis* - **Congenital dacryocystitis** is an infection of the lacrimal sac, often secondary to NLDO. - It presents with **unilateral watering**, discharge, and inflammation of the lacrimal sac, and the associated irritation can induce **photophobia**.
Physiology
1 questionsAbsolute refractoriness of a neuron is due to?
NEET-PG 2023 - Physiology NEET-PG Practice Questions and MCQs
Question 111: Absolute refractoriness of a neuron is due to?
- A. Hyperpolarization of Cl channels
- B. Opening of rectifier K+ channels
- C. Closure of activated Na channels
- D. Inactivation of Na channels (Correct Answer)
Explanation: ***Inactivation of Na channels*** - During the **absolute refractory period**, voltage-gated **Na+ channels** enter an inactivated state, making them unresponsive to further stimulation. - This inactivation prevents another action potential from being generated, regardless of the stimulus intensity, ensuring unidirectional propagation. *Hyperpolarization of Cl channels* - While **Cl- channels** can cause hyperpolarization, this typically leads to **inhibition** rather than absolute refractoriness. - Their activity doesn't directly prevent the generation of a new action potential by blocking Na+ channel function. *Opening of rectifier K+ channels* - The opening of **rectifier K+ channels** is involved in **repolarization** and the **relative refractory period**, by increasing K+ efflux. - While it contributes to making the neuron less excitable, it doesn't cause the absolute inability to fire associated with Na+ channel inactivation. *Closure of activated Na channels* - The **closure of activated Na+ channels** occurs as part of the repolarization process, but the critical mechanism for absolute refractoriness is their transition into an **inactivated state**, not simply closure. - **Inactivation** locks the channels in a non-responsive configuration, whereas simple closure would allow them to reopen quickly with sufficient depolarization.
Psychiatry
1 questionsA 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?
NEET-PG 2023 - Psychiatry NEET-PG Practice Questions and MCQs
Question 111: A 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?
- A. Generalized anxiety disorder
- B. Panic disorder (Correct Answer)
- C. Social anxiety disorder
- D. Obsessive-compulsive disorder
Explanation: ***Panic disorder*** - The presentation of recurrent, unexpected **panic attacks** characterized by sudden episodes of intense fear, palpitations, sweating, and a fear of losing control is classic for **panic disorder**. - These episodes often manifest with physical symptoms that mimic a medical emergency, leading to significant distress and avoidance behaviors. *Generalized anxiety disorder* - This condition involves **persistent and excessive worry** about various life circumstances for at least six months, rather than discrete, intense episodes of fear. - While physical symptoms like restlessness and fatigue can occur, they are generally less acute and not as severe as the sudden "fight-or-flight" response seen in panic attacks. *Social anxiety disorder* - This disorder is characterized by marked fear or anxiety about **social situations** where the individual might be scrutinized by others. - While it can involve symptoms like palpitations and sweating in social contexts, it doesn't typically present with unexpected attacks unrelated to social performance. *Obsessive-compulsive disorder* - This disorder is defined by the presence of **obsessions** (recurrent and persistent thoughts, urges, or images) and/or **compulsions** (repetitive behaviors or mental acts) that the individual feels driven to perform. - The symptoms described—palpitations, sweating, and fear of losing control—are not typical primary manifestations of OCD, which focuses on specific obsessions and compulsions.