Community Medicine
4 questionsWhich of the following reflects a key health initiative promoted by the Colombo Plan?
In a 10-year-old school child, which of the following vaccines is given as a part of the school immunization program?
A construction worker came to the OPD complaining of white fingers. He has been working in the cement and concrete industry and has been working on heavy machinery drills, wood, and furniture polishing for 20 years. What is the most likely etiology for this condition?
Which of the following is the sensitive indicator to assess the availability, utilization, and effectiveness of healthcare in a community?
NEET-PG 2023 - Community Medicine NEET-PG Practice Questions and MCQs
Question 61: Which of the following reflects a key health initiative promoted by the Colombo Plan?
- A. Promoting cobalt therapy initiatives for cancer treatment
- B. Strengthening human resources for healthcare (Correct Answer)
- C. Establishing treatment facilities for various diseases
- D. Support for diagnostic imaging technology in healthcare
Explanation: ***Strengthening human resources for healthcare*** - The Colombo Plan primarily focused on **technical cooperation** and **human resource development** in developing member countries - This included providing **fellowships** for training doctors, nurses, and other health professionals, and sending experts to assist in health education and infrastructure - The core mandate was **capacity building** through training and expertise, enabling countries to develop sustainable healthcare systems *Establishing treatment facilities for various diseases* - While improved health outcomes often lead to better facilities, the core mandate of the Colombo Plan was **capacity building** rather than direct construction or funding of treatment centers - The focus was on equipping local professionals to manage and develop their own health systems *Promoting cobalt therapy initiatives for cancer treatment* - While cancer treatment is crucial, cobalt therapy initiatives were not a primary or defining feature of the Colombo Plan's health strategy - The plan emphasized a broader approach to **healthcare infrastructure** and **human capital development** across multiple health domains *Support for diagnostic imaging technology in healthcare* - Support for specific technologies like diagnostic imaging was less prominent than the overarching goal of **human resource development** - The plan's emphasis was on foundational **training and expertise** across various health sectors rather than targeted equipment provision
Question 62: In a 10-year-old school child, which of the following vaccines is given as a part of the school immunization program?
- A. Measles vaccine
- B. Rotavirus vaccine
- C. TT/Td vaccine (Correct Answer)
- D. Hepatitis B vaccine
Explanation: ***TT/Td vaccine*** - The **tetanus toxoid (TT)** or **tetanus and diphtheria (Td) vaccine** is commonly administered to school-aged children as a booster to maintain immunity against these diseases. - This is part of many national immunization programs, including those in schools, to ensure continued protection beyond early childhood vaccinations. *Measles vaccine* - The **measles vaccine (MMR)** is typically given at 9-12 months and a second dose around 4-6 years of age, much earlier than 10 years. - While essential, it's usually completed before a child reaches the age of 10 for primary vaccination. *Rotavirus vaccine* - The **rotavirus vaccine** is administered to infants, usually before 6 months of age, to protect against severe rotavirus gastroenteritis. - It is not part of school immunization programs for 10-year-olds. *Hepatitis B vaccine* - The **Hepatitis B vaccine** is typically given at birth and completed during infancy, with a series of doses before 1 year of age. - While crucial for early protection, it is not a routine vaccination for 10-year-olds within a school immunization program unless for catch-up reasons.
Question 63: A construction worker came to the OPD complaining of white fingers. He has been working in the cement and concrete industry and has been working on heavy machinery drills, wood, and furniture polishing for 20 years. What is the most likely etiology for this condition?
- A. Candidal infection of the fingers due to continuous exposure to water
- B. Exposure to thinners and paints
- C. Continuous exposure to cement and concrete
- D. Continuous exposure to drills and machines (Correct Answer)
Explanation: ***Continuous exposure to drills and machines*** - The use of **heavy machinery drills** subjects the hands to **vibration**, which is a well-known cause of **Raynaud's phenomenon**, presenting as "white fingers" due to **vasospasm**. - This condition, often referred to as **vibration white finger**, is a common occupational hazard for workers using vibratory tools over long periods. *Candidal infection of the fingers due to continuous exposure to water* - While prolonged exposure to moisture can cause **Candidal infections** (e.g., paronychia), this typically presents as **redness, swelling, and pain** around the nails or skin, not the characteristic "white fingers" of Raynaud's. - White fingers due to candidiasis are not a primary manifestation and lack the **vasospastic component** seen with vibration exposure. *Exposure to thinners and paints* - Exposure to chemicals like **thinners and paints** can cause **irritant or allergic contact dermatitis**, leading to redness, itching, and skin lesions. - However, direct exposure to these substances is not typically associated with the sudden, episodic **blanching of fingers** characteristic of Raynaud's phenomenon. *Continuous exposure to cement and concrete* - **Cement and concrete** exposure often leads to **irritant or allergic contact dermatitis** due to the alkaline nature of cement, causing dryness, cracking, and eczema. - This type of exposure does not directly cause the **vasospastic episodes** that result in "white fingers."
Question 64: Which of the following is the sensitive indicator to assess the availability, utilization, and effectiveness of healthcare in a community?
- A. Infant mortality rate (Correct Answer)
- B. Maternal mortality rate
- C. Immunization coverage
- D. Disability-adjusted life years
Explanation: ***Infant mortality rate*** - The **infant mortality rate (IMR)** is widely considered a sensitive indicator of a community's health status, including access to and quality of healthcare, nutrition, and environmental conditions. - A high IMR often reflects inadequate maternal and child health services, poor sanitation, and socioeconomic disparities within a population. *Maternal mortality rate* - While a critical indicator of the health system's ability to provide safe pregnancy and childbirth services, the **maternal mortality rate (MMR)** specifically reflects women's health during gestation and postpartum. - It does not encompass the broader spectrum of health determinants that affect infants, such as postnatal care, nutrition, and infectious disease control, as comprehensively as IMR. *Immunization coverage* - **Immunization coverage** is an excellent indicator of the reach and effectiveness of preventive health services for infectious diseases. - However, it is a specific measure of program implementation, not a comprehensive indicator of overall healthcare availability, utilization, or effectiveness across all health domains. *Disability-adjusted life years* - **Disability-adjusted life years (DALYs)** measure the total healthy life years lost due to premature mortality and disability from specific diseases and injuries. - While a valuable concept for burden of disease analysis, DALYs are a complex measure of population health outcome, rather than a direct and sensitive indicator of the operational aspects of healthcare like availability and utilization.
Internal Medicine
3 questionsA farmer was sleeping in the field, and he felt a sting on his leg. He saw something moving away quickly. He then got drowsy and was taken to the hospital. He developed pain around the site and continued to bleed profusely from the wound site. The wound became red with blisters. Which of the following is the most likely cause?
A 30-year-old male is found to be positive for HBsAg and HBeAg and is diagnosed with chronic hepatitis B. The patient's viral load is 2 × 10^5 IU/mL and ALT is elevated (2× upper limit of normal). What is the appropriate management in this patient?
A patient hailing from Delhi presents with fever, arthralgia, and extensive petechial rash for 3 days. Lab investigations revealed a hemoglobin of 9 g/ dL, a white blood cell count of 9000 cells/mm3, a platelet count of 20000 cells/mm3, and a prolonged bleeding time. The clotting time was normal. What is the most likely diagnosis?
NEET-PG 2023 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 61: A farmer was sleeping in the field, and he felt a sting on his leg. He saw something moving away quickly. He then got drowsy and was taken to the hospital. He developed pain around the site and continued to bleed profusely from the wound site. The wound became red with blisters. Which of the following is the most likely cause?
- A. Viper bite (Correct Answer)
- B. Cobra bite
- C. Wasp sting
- D. Scorpion sting
Explanation: ***Viper bite*** - **Viper venom** is predominantly **hemotoxic**, causing local tissue damage (pain, redness, blistering, bleeding) and systemic effects like **coagulopathy**, leading to profuse bleeding [1]. - The rapid onset of drowsiness, local pain, bleeding, and blistering are classic signs of **viper envenomation** [1]. *Cobra bite* - **Cobra venom** is primarily **neurotoxic**, leading to **flaccid paralysis**, ptosis, and respiratory failure, rather than significant local tissue destruction or profuse bleeding [1]. - While local swelling and pain may occur, extensive blistering and significant bleeding are less characteristic compared to viper bites [1]. *Wasp sting* - A **wasp sting** causes localized pain, swelling, and redness, and may lead to an **anaphylactic reaction** in sensitive individuals [2]. - It does not typically cause profuse, prolonged bleeding or extensive blistering at the wound site as seen here [2]. *Scorpion sting* - **Scorpion stings** typically cause intense localized pain, paresthesias, and sometimes systemic symptoms like hypertension, tachycardia, and neurological effects [3]. - They do not typically cause widespread **hemorrhagic symptoms** or significant local blistering and extensive bleeding as described [3].
Question 62: A 30-year-old male is found to be positive for HBsAg and HBeAg and is diagnosed with chronic hepatitis B. The patient's viral load is 2 × 10^5 IU/mL and ALT is elevated (2× upper limit of normal). What is the appropriate management in this patient?
- A. Combined pegylated interferon with lamivudine
- B. Pegylated interferon
- C. Lamivudine
- D. Tenofovir (Correct Answer)
Explanation: Tenofovir - This patient presents with chronic hepatitis B (HBsAg positive for >6 months), evidence of active viral replication (HBeAg positive, high viral load), and liver inflammation (elevated ALT). [3] This signifies chronic active hepatitis B, requiring treatment. [1] - Tenofovir is a highly potent nucleotide analog with a high barrier to resistance, making it a first-line treatment for chronic hepatitis B. *Lamivudine* - While an antiviral for HBV, lamivudine has a low genetic barrier to resistance, meaning resistance mutations can rapidly develop, reducing its long-term efficacy. - Due to the high risk of resistance, lamivudine is generally not recommended as a first-line monotherapy for treatment-naive patients with chronic hepatitis B, especially with a high viral load. *Pegylated interferon* - Pegylated interferon is an option for chronic hepatitis B, but it causes significant side effects (e.g., fatigue, depression, bone marrow suppression) and is usually administered by injection. [2] - Its efficacy in achieving sustained HBeAg seroconversion or HBsAg loss can be variable, and it is often reserved for patients who prefer a finite course of treatment and can tolerate the side effects, or for those without advanced liver disease. [2] *Combined pegylated interferon with lamivudine* - There is no significant evidence that combining pegylated interferon with lamivudine offers superior efficacy compared to monotherapy with a potent nucleos(t)ide analog like tenofovir or entecavir. - This combination would increase the side effect burden from interferon and still carry the risk of lamivudine resistance without substantial added benefit.
Question 63: A patient hailing from Delhi presents with fever, arthralgia, and extensive petechial rash for 3 days. Lab investigations revealed a hemoglobin of 9 g/ dL, a white blood cell count of 9000 cells/mm3, a platelet count of 20000 cells/mm3, and a prolonged bleeding time. The clotting time was normal. What is the most likely diagnosis?
- A. Dengue (Correct Answer)
- B. Malaria
- C. Scrub typhus
- D. Typhoid
Explanation: Dengue - The combination of **fever, arthralgia, extensive petechial rash**, and severe **thrombocytopenia** (platelet count 20,000/mm³) with **prolonged bleeding time** is highly characteristic of severe dengue infection, especially in an endemic area like Delhi [1]. - While leukocytosis (WBC 9000/mm³) is not typical for dengue (usually causes leukopenia), the other features strongly point to dengue hemorrhagic fever [1]. *Malaria* - Typically presents with **intermittent high fever**, chills, and sweats. While it can cause some thrombocytopenia and anemia, the **extensive petechial rash** is not a characteristic feature. - **Thrombocytopenia** in malaria is usually milder than observed here, and prolonged bleeding time is less common [2]. *Scrub typhus* - Caused by Orientia tsutsugamushi, it is characterized by **fever, headache, myalgia, and a characteristic eschar** (necrotic ulcer) at the bite site, which is not mentioned. - While it can cause rash and some thrombocytopenia, the **petechial rash** and such severe thrombocytopenia with prolonged bleeding time are less typical. *Typhoid* - Presents with **sustained high fever**, headache, bradycardia, and sometimes a **rose spot rash** (maculopapular), which is different from a petechial rash. - Typhoid typically causes **leukopenia** and can lead to gastrointestinal complications like intestinal bleeding, but severe thrombocytopenia and extensive petechiae are not common presenting features.
Obstetrics and Gynecology
1 questionsA primigravida presents to you with anemia early in her pregnancy. She is 7 weeks pregnant as seen on ultrasound. Her hemoglobin level is 9 g/dL. When should the iron supplements be started for her?
NEET-PG 2023 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 61: A primigravida presents to you with anemia early in her pregnancy. She is 7 weeks pregnant as seen on ultrasound. Her hemoglobin level is 9 g/dL. When should the iron supplements be started for her?
- A. 8 to 10 weeks
- B. Immediately upon diagnosis (Correct Answer)
- C. After 14 weeks
- D. After 20 weeks
Explanation: ***Correct Option: Immediately upon diagnosis*** - **Iron deficiency anemia** in pregnancy (Hb <11 g/dL in first trimester) should be addressed promptly to prevent adverse maternal and fetal outcomes - Initiating treatment at 7 weeks ensures sustained **iron stores** throughout pregnancy - WHO and ACOG guidelines recommend **immediate supplementation** when anemia is diagnosed during antenatal screening - Early treatment prevents worsening due to physiological plasma volume expansion in second trimester *Incorrect Option: 8 to 10 weeks* - Delaying treatment for 1-3 weeks after diagnosis at 7 weeks is not justified medically - Any delay in treatment allows anemia to worsen and depletes maternal iron stores - Recommended practice is **immediate supplementation** if hemoglobin count is less than 11 g/dL during first two antenatal visits *Incorrect Option: After 14 weeks* - Waiting until second trimester (after 14 weeks) would allow the **anemia to worsen**, making it harder to correct before physiological drop in hemoglobin due to plasma volume expansion - Fetal development, particularly **neurological development**, is rapid in first trimester and iron is crucial during this period - Delaying 7 weeks after diagnosis risks maternal complications and suboptimal fetal development *Incorrect Option: After 20 weeks* - Starting supplementation this late (13 weeks after diagnosis) would result in severe maternal iron deficiency - Significant **fetal iron demands** increase by third trimester, making it difficult to replete maternal stores if supplementation starts this late - **Severe anemia** poses risks such as **preterm birth**, low birth weight, and **postpartum hemorrhage**
Pediatrics
1 questionsA child presents with a fever and a rash. Urine examination showed cells with owl's eye appearance. What is the most likely diagnosis?
NEET-PG 2023 - Pediatrics NEET-PG Practice Questions and MCQs
Question 61: A child presents with a fever and a rash. Urine examination showed cells with owl's eye appearance. What is the most likely diagnosis?
- A. Herpes simplex virus infection
- B. Toxoplasmosis caused by Toxoplasma gondii
- C. Cytomegalovirus (CMV) infection (Correct Answer)
- D. Infectious mononucleosis caused by Epstein-Barr virus
Explanation: ***Cytomegalovirus (CMV) infection*** - The presence of cells with an **owl's eye appearance** in urine sediment is a classic histological hallmark of **CMV infection**. - CMV can cause a variety of symptoms in children, including **fever and rash**, making this the most likely diagnosis. *Herpes simplex virus infection* - HSV causes characteristic **vesicular lesions** on mucocutaneous surfaces, often associated with fever. - While HSV can cause systemic illness, it does not typically present with **owl's eye inclusions** in urine cells. *Toxoplasmosis caused by Toxoplasma gondii* - **Toxoplasmosis** can cause fever and rash, especially in congenital infections or immunocompromised individuals. - However, it does not lead to **owl's eye inclusions** in urinary cells, which are pathognomonic for CMV. *Infectious mononucleosis caused by Epstein-Barr virus* - **Infectious mononucleosis** commonly presents with fever, fatigue, and lymphadenopathy, sometimes with a rash. - **Epstein-Barr virus (EBV)** infection does not produce cells with an **owl's eye appearance** in the urine; that is specific to CMV.
Surgery
1 questionsA 23-year-old male patient presents with midline swelling in the neck. The swelling moves with deglutition and protrusion of the tongue. What is the likely diagnosis?
NEET-PG 2023 - Surgery NEET-PG Practice Questions and MCQs
Question 61: A 23-year-old male patient presents with midline swelling in the neck. The swelling moves with deglutition and protrusion of the tongue. What is the likely diagnosis?
- A. Brachial cyst
- B. Thyroglossal cyst (Correct Answer)
- C. Plunging ranula
- D. Dermoid cyst
Explanation: ***Thyroglossal cyst*** - A **thyroglossal cyst** is a congenital anomaly that arises from the persistent **thyroglossal duct**, a remnant of the thyroid's embryologic descent. - Its classic diagnostic feature is its movement with **deglutition** (due to attachment to the hyoid bone, which moves during swallowing) and **protrusion of the tongue** (as the thyroglossal duct is connected to the base of the tongue). *Brachial cyst* - A **brachial cyst** is a congenital neck mass that typically presents as a lateral neck swelling, often located along the anterior border of the **sternocleidomastoid muscle**. - Unlike a thyroglossal cyst, it does not typically move with **deglutition** or **tongue protrusion**. *Plunging ranula* - A **plunging ranula** is a type of mucocele that arises from the **sublingual gland** and extends below the mylohyoid muscle into the neck. - It presents as a cervical mass but is typically located in the floor of the mouth or submandibular region and does not move with **deglutition** or **tongue protrusion**. *Dermoid cyst* - A **dermoid cyst** is a congenital cyst that can occur anywhere on the body, including the head and neck, often presenting as a painless mass. - It arises from sequestered embryonic ectoderm and mesoderm, containing skin appendages, but it does not move with **deglutition** or **tongue protrusion**.