Biochemistry
1 questionsA child presents with developmental delay and coarse facial features. Enzyme assay reveals a deficiency of α-L-iduronidase. Which of the following substances is most likely to accumulate in this condition?
NEET-PG 2025 - Biochemistry NEET-PG Practice Questions and MCQs
Question 111: A child presents with developmental delay and coarse facial features. Enzyme assay reveals a deficiency of α-L-iduronidase. Which of the following substances is most likely to accumulate in this condition?
- A. Only Dermatan sulfate
- B. Heparan sulfate + Chondroitin sulfate
- C. Dermatan sulfate + Chondroitin sulfate
- D. Dermatan sulfate + Heparan sulfate (Correct Answer)
Explanation: ***Dermatan sulfate + Heparan sulfate*** - The presenting features of developmental delay and **coarse facial features** point towards a Mucopolysaccharidosis (MPS). - A deficiency of **α-L-iduronidase** is diagnostic of **MPS Type I (Hurler syndrome)**, which leads to the accumulation of **Dermatan sulfate** and **Heparan sulfate**. *Dermatan sulfate + Chondroitin sulfate* - While **Dermatan sulfate** accumulates in MPS I, **Chondroitin sulfate** accumulation is characteristic of **MPS IV (Morquio syndrome)**, which has different clinical features (skeletal dysplasia, normal intelligence). - This combination does not correctly represent the primary storage products of **MPS I**. *Only Dermatan sulfate* - Both **MPS I (Hurler syndrome)** and **MPS II (Hunter syndrome)** result in accumulation of **both Dermatan sulfate AND Heparan sulfate**, not dermatan sulfate alone. - Listing dermatan sulfate alone is incomplete and does not accurately reflect the biochemical defect in **α-L-iduronidase deficiency**. *Heparan sulfate + Chondroitin sulfate* - **Heparan sulfate** does accumulate in MPS I, but the co-accumulation is with **Dermatan sulfate**, not Chondroitin sulfate. - **Chondroitin sulfate** accumulation is characteristic of **MPS IV (Morquio syndrome)**, which involves different enzyme deficiencies.
Community Medicine
1 questionsWhich of the following vials, as shown in the image, can be used for administering vaccines?
NEET-PG 2025 - Community Medicine NEET-PG Practice Questions and MCQs
Question 111: Which of the following vials, as shown in the image, can be used for administering vaccines?
- A. Only 1
- B. 1,2,3,4
- C. 2,4
- D. 1,2 (Correct Answer)
Explanation: ***Correct: 1,2*** - Vials 1 and 2 show the inner square of the **Vaccine Vial Monitor (VVM)** is lighter than the outer circle, indicating that the vaccine has **not been damaged by heat** and is **safe for administration** (VVM Stages 1 and 2). - The VVM is designed to change color permanently upon exposure to heat, signaling irreversible thermal damage. - According to WHO guidelines, vaccines are usable as long as the inner square is **lighter than the outer ring**. *Incorrect: Only 1* - While Vial 1 (inner square much lighter than the ring) is clearly usable (VVM Stage 1), this option incorrectly excludes Vial 2. - Vial 2 is also **usable** as the inner square is still lighter than the outer ring (VVM Stage 2). - Vaccines remain usable until the inner square reaches the same color intensity as the outer ring. *Incorrect: 1,2,3,4* - Vials 3 and 4 must be **discarded** because their VVMs indicate heat exposure has darkened the inner square. - A vaccine is considered spoilt and unusable if the inner square is the **same color as or darker** than the outer circle. - Including all vials would risk administering heat-damaged vaccines. *Incorrect: 2,4* - Vial 4 is **unusable and must be discarded** because its inner square is clearly much **darker than the outer ring** (VVM Stage 4). - This option incorrectly includes an unusable vial and excludes Vial 1, which is clearly usable.
Internal Medicine
1 questionsThe pedigree diagram of a family is shown below. Affected individuals present with progressive external ophthalmoplegia, pigmentary retinopathy, and cardiac conduction defects. Based on the pedigree and clinical features, what is the most likely diagnosis?
NEET-PG 2025 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 111: The pedigree diagram of a family is shown below. Affected individuals present with progressive external ophthalmoplegia, pigmentary retinopathy, and cardiac conduction defects. Based on the pedigree and clinical features, what is the most likely diagnosis?
- A. Duchenne Muscular Dystrophy
- B. Kearns-Sayre Syndrome (Correct Answer)
- C. Friedreich Ataxia
- D. Myotonic Dystrophy
Explanation: ***Kearns-Sayre Syndrome*** * Kearns-Sayre Syndrome (KSS) is a **mitochondrial disorder** caused by large-scale deletions in **mtDNA** (mtDNA deletion syndrome). * The classic triad of KSS is **progressive external ophthalmoplegia (PEO)**, **pigmentary retinopathy**, and onset before age 20, often associated with **cardiac conduction defects** and cerebellar ataxia, matching the clinical presentation. *Duchenne Muscular Dystrophy* * DMD is an **X-linked recessive** disorder, which would show mother-to-son transmission, but not father-to-son transmission. The pedigree shows affected males having affected children (both male and female), inconsistent with X-linked inheritance. * The primary features are **progressive proximal muscle weakness** and Gower's sign, not the characteristic ophthalmoplegia, retinopathy, and heart block of KSS. *Friedreich Ataxia* * Friedreich ataxia is an **autosomal recessive** disorder, which would typically skip generations and mainly present in siblings of unaffected parents. This is inconsistent with the clear mother-to-child transmission seen in the pedigree. * The key features are **ataxia**, **dysarthria**, and **loss of vibratory sense**, not primarily ophthalmoplegia and pigmentary retinopathy. *Myotonic Dystrophy* * Myotonic dystrophy (DM1) is an **autosomal dominant** disorder, consistent with the vertical transmission, but the genetic defect is an **unstable trinucleotide repeat (CTG)**. While it can involve **cardiac conduction defects**, the primary clinical feature is **myotonia** (inability to quickly relax muscles) and facial weakness. * The absence of myotonia and the distinct presentation of PEO and pigmentary retinopathy make KSS a better fit than myotonic dystrophy.
Obstetrics and Gynecology
1 questionsIn a woman with a regular 28-day menstrual cycle, which of the following best describes the typical hormonal profile during days 21 to 25 of the cycle?
NEET-PG 2025 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 111: In a woman with a regular 28-day menstrual cycle, which of the following best describes the typical hormonal profile during days 21 to 25 of the cycle?
- A. Low estrogen, high progesterone, high LH and FSH
- B. High estrogen, high progesterone (Correct Answer)
- C. Low estrogen, low progesterone, low LH and FSH
- D. Low estrogen, high progesterone, low LH and FSH
Explanation: ***High estrogen, high progesterone*** - Days 21 to 25 fall within the **mid-to-late luteal phase** of a 28-day cycle, which is dominated by the corpus luteum. - The corpus luteum secretes large amounts of **progesterone** (peak luteal levels) and **moderate-to-high levels of estrogen** (secondary luteal peak). - Both hormones exert **negative feedback** on the hypothalamus and pituitary, leading to suppressed **LH and FSH** levels. - This combination of high progesterone with moderately elevated estrogen is characteristic of a functional corpus luteum during the mid-luteal phase. *Low estrogen, high progesterone, low LH and FSH* - While **LH and FSH** are correctly low due to negative feedback, and **progesterone** is high, describing estrogen as "low" is inaccurate for days 21–25. - During the mid-luteal phase, the corpus luteum produces a **secondary estrogen peak** that is moderate-to-high, not low. - Low estrogen would only occur if the corpus luteum had already regressed, which happens closer to menstruation (days 26–28). *Low estrogen, high progesterone, high LH and FSH* - High levels of **LH and FSH** occur only during the **LH surge** around day 14 (ovulation) or during the **menstrual/early follicular phase** when steroid hormones are low. - The combination of **high progesterone** and **high gonadotropins** does not occur normally in the menstrual cycle, as progesterone and estrogen suppress LH and FSH through negative feedback. *Low estrogen, low progesterone, low LH and FSH* - This hormonal profile is characteristic of the **late follicular phase** before the LH surge, or the very end of the luteal phase when the corpus luteum regresses. - During days 21–25, the **corpus luteum** is still fully functional, maintaining high levels of **progesterone** and moderate-to-high levels of **estrogen**.
Pediatrics
3 questionsA 6-month-old infant presents with recurrent infections and failure to thrive. Laboratory investigations reveal a deficiency of adenosine deaminase (ADA). Which of the following immunodeficiency disorders is most likely associated?
An HIV-positive mother with a viral load of 1200 copies/mL delivers a baby. What is the most appropriate antiretroviral prophylaxis for the newborn?
A 3-year-old child is brought to the emergency room with a generalized seizure following a high-grade fever. What is the first-line drug of choice for seizure control in this acute febrile setting?
NEET-PG 2025 - Pediatrics NEET-PG Practice Questions and MCQs
Question 111: A 6-month-old infant presents with recurrent infections and failure to thrive. Laboratory investigations reveal a deficiency of adenosine deaminase (ADA). Which of the following immunodeficiency disorders is most likely associated?
- A. Hypogammaglobulinemia
- B. Wiskott-Aldrich Syndrome
- C. Severe Combined Immunodeficiency (SCID) (Correct Answer)
- D. DiGeorge Syndrome
Explanation: ***Severe Combined Immunodeficiency (SCID)*** - **Adenosine deaminase (ADA) deficiency** is a classic autosomal recessive cause of SCID, resulting in accumulation of toxic metabolites like **dATP**. - These toxic metabolites destroy both **T and B lymphocytes**, leading to profound lymphopenia and the severe clinical picture of recurrent infections and **failure to thrive**. *Hypogammaglobulinemia* - This term generally refers to primary **B-cell intrinsic defects** leading to reduced antibody levels (e.g., X-linked agammaglobulinemia or CVID). - While it causes recurrent infections, the underlying genetic defect is specific to B-cell development or function, not **ADA deficiency** affecting both T and B cells profoundly. *DiGeorge Syndrome* - This syndrome is caused by a defect in the 3rd and 4th pharyngeal pouches, often due to **22q11 microdeletion**, resulting in **thymic aplasia** (T-cell deficiency). - Clinical presentation involves the triad of T-cell defect, **cardiac anomalies** (conotruncal defects), and **hypocalcemia** (parathyroid hypoplasia), not ADA deficiency. *Wiskott-Aldrich Syndrome* - This is an X-linked disorder defined by the classic triad of **eczema**, immunodeficiency, and **thrombocytopenia** (small platelets). - The mutation affects the **WASP gene**, leading to defective cytoskeleton function in hematopoietic cells, which is unrelated to ADA enzymatic deficiency.
Question 112: An HIV-positive mother with a viral load of 1200 copies/mL delivers a baby. What is the most appropriate antiretroviral prophylaxis for the newborn?
- A. Nevirapine + Zidovudine for 6 weeks (Correct Answer)
- B. Zidovudine for 4 weeks
- C. Nevirapine for 6 weeks
- D. Nevirapine for 12 weeks
Explanation: ***Nevirapine + Zidovudine for 6 weeks*** - This combination is the recommended regimen for **high-risk newborns** in resource-limited settings, defined by a maternal viral load (MVL) greater than 1000 copies/mL or if maternal treatment was **suboptimal/absent**. - The dual prophylaxis provides comprehensive coverage to minimize the risk of **mother-to-child transmission (MTCT)**, which is elevated due to the high viral load (1200 copies/mL). *Nevirapine for 6 weeks* - **Nevirapine monotherapy** is reserved for **low-risk newborns** (MVL < 1000 copies/mL) or when the mother received adequate **antiretroviral therapy (ART)**. - Given the MVL of 1200 copies/mL, the risk is high, making dual therapy necessary. *Nevirapine for 12 weeks* - Extended NVP prophylaxis (12 weeks) is sometimes used if the infant is **breastfed and at high risk**, but current standard guidelines for non-breastfed infants with this MVL recommend 6 weeks of dual therapy. - **Duration of 12 weeks** is typically not the initial prophylaxis choice for a non-breastfed infant born to a mother with a high viral load. *Zidovudine for 4 weeks* - **Zidovudine monotherapy** for 4 weeks is considered inadequate given the mother's high viral load of **1200 copies/mL**. - This regimen (4 weeks of ZDV) is primarily reserved for **low-risk newborns** in settings where dual therapy is not feasible, or for term infants born to mothers with **fully suppressed viral loads** who received continuous ART.
Question 113: A 3-year-old child is brought to the emergency room with a generalized seizure following a high-grade fever. What is the first-line drug of choice for seizure control in this acute febrile setting?
- A. Valproate
- B. Doxycycline / Amoxicillin
- C. Diazepam (Correct Answer)
- D. Fosphenytoin
Explanation: ***Diazepam*** - **Benzodiazepines** like Diazepam and Lorazepam are the preferred first-line agents for aborting acute seizures, including **febrile seizures**, due to their rapid onset of action. - They potentiate the inhibitory effects of **GABA** (gamma-aminobutyric acid), quickly halting seizure activity. *Valproate* - Valproate is a broad-spectrum **antiepileptic drug (AED)** used for maintenance therapy, not typically the first choice for acute seizure termination in the emergency setting. - While effective, its onset of action is slower compared to rapid-acting benzodiazepines for emergency control. *Fosphenytoin* - Fosphenytoin is a **prodrug** of Phenytoin, typically reserved for status epilepticus or when benzodiazepines fail, as it lacks the rapid action required for immediate seizure control. - Its use is associated with potential side effects like **cardiac rhythm disturbance** and is generally second or third line. *Doxycycline / Amoxicillin* - These are **antibiotics** (Doxycycline is preferred for atypical pneumonia/tick-borne diseases; Amoxicillin for common bacterial infections) and have absolutely **no role** in the acute control of seizures. - This question relates to seizure management, not the empirical treatment of the fever's underlying infection.
Radiology
2 questionsA 24-hour-old baby with severe respiratory distress was admitted to the ICU. A chest X-ray of the neonate is given. What is the most probable diagnosis?
A 30-year-old male patient presents to OPD with complaints of recurrent headache and nausea, MRI of brain shown below. What is the diagnosis?
NEET-PG 2025 - Radiology NEET-PG Practice Questions and MCQs
Question 111: A 24-hour-old baby with severe respiratory distress was admitted to the ICU. A chest X-ray of the neonate is given. What is the most probable diagnosis?
- A. Congenital lobar emphysema
- B. Congenital Pulmonary Airway Malformation (CPAM)
- C. Neonatal pneumonia
- D. Congenital Diaphragmatic Hernia (CDH) (Correct Answer)
Explanation: ***Congenital Diaphragmatic Hernia (CDH)*** - The image shows loops of **gas-filled bowel** (multiple curvilinear lucencies) in the left hemithorax, confirming the presence of abdominal contents in the chest cavity, which is pathognomonic for **CDH** (most commonly through the **Bochdalek defect**). - There is significant **mediastinal shift** to the right, leading to compression of the right lung (pulmonary hypoplasia) and severe respiratory distress in the neonate. *Congenital Pulmonary Airway Malformation (CPAM)* - CPAM (previously CCAM) usually presents as a **mass of cysts** (Type 1 is large cysts, Type 2 is small cysts) within the lung parenchyma, which are not typically associated with gas-filled loops of bowel extending from the abdomen. - While CPAM can cause mediastinal shift, the defining feature in CDH is the presence of **abdominal viscera** above the diaphragm, which is clearly visible. *Congenital lobar emphysema* - This condition involves **hyperinflation** of one or more lobes (most commonly the upper lobes) due to air trapping, resulting in an abnormally large, radiolucent lobe on X-ray. - It would show a large area of hyperlucency and possible collapse of adjacent lung tissue but would **not show intestinal loops** in the chest cavity. *Neonatal pneumonia* - Neonatal pneumonia typically presents with generalized or focal **opacification/consolidation** (white patches) rather than distinct, gas-filled cystic appearances resembling bowel loops. - While pneumonia causes respiratory distress, it does **not cause the mediastinal shift** or the visualization of abdominal organs in the chest seen here.
Question 112: A 30-year-old male patient presents to OPD with complaints of recurrent headache and nausea, MRI of brain shown below. What is the diagnosis?
- A. Meningioma (Correct Answer)
- B. Glioma
- C. Pilocytic astrocytoma
- D. Ependymoma
Explanation: ***Meningioma*** - The MRI displays a classic **extra-axial mass** (meaning outside the brain parenchyma) arising from the convexity dura. - Key imaging features supporting this diagnosis are the **well-circumscribed, lobulated shape** and the **intense, homogenous enhancement** post-contrast. *Glioma* - Gliomas, such as **Glioblastoma Multiforme (GBM)**, are **intra-axial tumors** (arising within the brain tissue) and typically have irregular, infiltrating margins. - High-grade gliomas commonly show **ring enhancement** with central necrosis, which is not characteristic of the lesion depicted. *Ependymoma* - Ependymomas are typically found within the **ventricular system** (especially the fourth ventricle in adults, or lateral ventricles in children) or the spinal cord. - They are **intra-axial** tumors (ventricular location being the defining feature) and rarely present as extra-axial convexity lesions. *Pilocytic astrocytoma* - This tumor is predominantly seen in children and adolescents, often located in the **cerebellum** or along the optic pathways, usually presenting as an **intra-axial** tumor. - Radiologically, it typically appears as a large **cyst with an enhancing mural nodule**, which differs significantly from the solid, extra-axial lesion shown.
Surgery
1 questionsA 56-year-old man presents with the following pathology shown in the image, which of the following is correct?
NEET-PG 2025 - Surgery NEET-PG Practice Questions and MCQs
Question 111: A 56-year-old man presents with the following pathology shown in the image, which of the following is correct?
- A. Sclerotherapy is the best treatment
- B. Telangiectasia is rare
- C. No possibility of venous ulcer
- D. Lipodermatosclerosis/eczema can occur (Correct Answer)
Explanation: ***Lipodermatosclerosis/eczema can occurs*** - The image suggests features of **chronic venous insufficiency (CVI)**, including skin discoloration (hyperpigmentation/hemosiderin deposition) and induration, which are classic features leading to **lipodermatosclerosis** and **venous eczema** (C4 changes in CEAP classification). - Lipodermatosclerosis involves inflammation and fibrosis of the skin and subcutaneous fat in the gaiter area due to prolonged **venous hypertension**. *Sclerotherapy is the best treatment* - Sclerotherapy is typically indicated for **small varicose veins** or **telangiectasias**. - For CVI causing advanced skin changes (like lipodermatosclerosis), the best initial treatment is usually **compression therapy** and addressing the source of reflux (e.g., endovenous ablation). *Telangiectasia is rare* - **Telangiectasias** (spider veins) are very common in patients with CVI and often represent the earliest visible sign of **venous disease** (C1 in CEAP classification). - The presence of more advanced skin changes (like those shown) indicates significant venous hypertension, often accompanied by microcirculatory changes including telangiectasia. *No possibility of venous ulcer* - The changes seen (hyperpigmentation and probable underlying induration/atrophy) are stages C4/C5 of the CEAP classification, which are **immediate precursors** to or associated with **venous leg ulcers** (C6). - Venous hypertension is the underlying cause for both the skin changes and the development of **venous ulcers**, making the possibility very real in this patient.