NEET-PG 2012 Practice Questions

Q: Stages of anesthesia were established by

Diethyl ether. ***Diethyl ether** - The classic stages of anesthesia (analgesia, excitement, surgical anesthesia, medullary depression) were originally described in relation to the administration of **diethyl ether**. - Its slow onset and prolonged half-life allowed for the clear observation and definition of these distinct stages. *Nitrous oxide* - This gaseous anesthetic has a rapid onset and offset, making it difficult to clearly delineate all four classical stages with its use. - It is often used as an adjunct to other anesthetics rather than as a sole agent for prolonged surgical anesthesia. *Halothane* - Halothane is a potent volatile anesthetic that became popular after ether, but its use also does not typically involve the clear, step-wise progression through all four anesthetic stages as seen with ether. - It was one of the first widely used inhaled anesthetics that largely replaced ether due to better patient control and fewer side effects. *Chloroform* - Chloroform was another early anesthetic but was associated with significant cardiac and hepatic toxicity, leading to its limited use and eventual discontinuation. - While it induced anesthesia, the clear staging of anesthetic depth was primarily established and standardized using diethyl ether.

Q: Which condition is associated with calcification of the intervertebral disc?

Alkaptonuria. ***Alkaptonuria*** - **Alkaptonuria** is a rare autosomal recessive disorder characterized by a deficiency of the enzyme **homogentisate 1,2-dioxygenase**, leading to the accumulation of **homogentisic acid**. - This accumulation results in the deposition of a **dark pigment (ochre pigment)** in connective tissues, including the intervertebral discs, causing **calcification (ochronosis)** and early degenerative arthritis. *Gout* - **Gout** is caused by the deposition of **monosodium urate crystals** in joints and soft tissues, leading to inflammation and pain [1]. - While it can affect various joints, it does not typically cause **calcification of intervertebral discs**; rather, it can form tophi in periarticular soft tissues [1]. *Rheumatoid* - **Rheumatoid arthritis** is a chronic autoimmune inflammatory disease primarily affecting the **synovial lining of joints**, leading to joint destruction and deformity. - It does not involve the **calcification of intervertebral discs**; spinal involvement is usually restricted to the cervical spine, particularly the atlantoaxial joint. *Psoriasis* - **Psoriasis** is a chronic inflammatory skin condition, which in some cases can be associated with **psoriatic arthritis**, an inflammatory arthritis. - Psoriatic arthritis primarily affects peripheral joints, the sacroiliac joints, and the spine, but it does not cause **calcification of the intervertebral discs** as seen in alkaptonuria.

Q: Corkscrew esophagus is seen in which of the following conditions ?

Diffuse esophagus spasm. ***Diffuse esophagus spasm*** - **Corkscrew esophagus** is a classic radiographic finding in **diffuse esophageal spasm (DES)**, indicating multiple simultaneous, non-peristaltic contractions. [1] - This condition is characterized by **uncoordinated esophageal contractions** that can lead to chest pain and dysphagia. [1] *Scleroderma* - Scleroderma typically causes **hypomotility** or aperistalsis in the esophagus, especially in the distal two-thirds, rather than a corkscrew appearance. [1] - It results from progressive **fibrosis and atrophy of the smooth muscle**, leading to esophageal dilation and reflux symptoms. [1] *Achalasia cardia* - Achalasia is defined by the **failure of the lower esophageal sphincter (LES) to relax** and loss of peristalsis in the esophageal body, leading to a "bird-beak" appearance on barium swallow. [2] - It features a **dilated esophagus** proximally to the tight LES, not multiple indentations. [2] *Carcinoma esophagus* - Esophageal carcinoma usually presents as a **focal stricture**, mass, or irregular lumen on imaging, often causing dysphagia that is progressive. - It does not typically cause the diffuse, segmental contractions characteristic of a corkscrew esophagus.

Q: Derealization and depersonalization are symptoms of which type of disorder?

Dissociative disorder. ***Dissociative disorder*** - **Derealization** involves experiencing the outside world as unreal or dreamlike - **Depersonalization** is the experience of feeling detached from one's own body or mental processes - These are hallmark symptoms of **dissociative disorders**, specifically depersonalization-derealization disorder in DSM-5 *Personality disorders* - Characterized by enduring, maladaptive patterns of inner experience and behavior - While some personality disorders (e.g., **borderline personality disorder**) may display transient dissociative symptoms under stress, derealization and depersonalization are not core diagnostic features *Mania* - A state of abnormally elevated mood and energy, involving **racing thoughts**, **decreased need for sleep**, and **impulsive behavior** - Does not typically involve consistent derealization or depersonalization as core features *Anxiety disorders* - Depersonalization can occur transiently during **panic attacks** or severe anxiety - However, when derealization and depersonalization are the primary, persistent symptoms, they indicate a **dissociative disorder** rather than an anxiety disorder

Q: Which of the following is a recognized type of anxiety disorder?

Panic Disorder. ***Panic Disorder*** - **Panic disorder** is a recognized **anxiety disorder** characterized by recurrent unexpected **panic attacks** - sudden episodes of intense fear accompanied by physical symptoms like heart palpitations, shortness of breath, chest pain, dizziness, and trembling. - It involves persistent worry about having more attacks (anticipatory anxiety) and maladaptive behavioral changes to avoid situations where attacks might occur. - Classified under **Anxiety Disorders** in DSM-5 and ICD-11. *Major Depressive Disorder* - **Major Depressive Disorder (MDD)** is a **mood disorder**, not an anxiety disorder. - Characterized by persistent depressed mood, loss of interest or pleasure (anhedonia), changes in appetite/sleep, fatigue, feelings of worthlessness, and potential suicidal ideation. - Classified under **Depressive Disorders** in DSM-5, distinct from anxiety disorders, though anxiety symptoms may co-occur. *Bipolar Disorder* - **Bipolar disorder** is a **mood disorder**, not an anxiety disorder. - Characterized by significant mood swings including episodes of mania/hypomania (elevated, expansive, or irritable mood with increased energy) and depression. - Classified under **Bipolar and Related Disorders** in DSM-5, distinct from anxiety disorders. *Schizophrenia* - **Schizophrenia** is a **psychotic disorder**, not an anxiety disorder. - Characterized by disturbances in thought, perception, emotions, and behavior, including hallucinations, delusions, disorganized thinking, and negative symptoms. - Classified under **Schizophrenia Spectrum and Other Psychotic Disorders** in DSM-5, distinct from anxiety disorders.

Q: What does the term 'etheromania' refer to?

Ether addiction. ***Ether addiction*** - **Etheromania** specifically refers to the compulsive use and dependence on **ether** for its psychoactive effects. - This term was historically used to describe individuals who developed a significant **addiction** to ether. - The suffix "-mania" in psychiatric terminology often denotes an obsessive or compulsive behavior pattern related to a specific substance. *Acute psychosis following ether anesthesia* - While ether anesthesia can sometimes lead to transient psychomotor agitation or emergence delirium, **acute psychosis** is not the primary definition of etheromania. - Etheromania describes a long-term pattern of **addictive behavior**, not an acute post-anesthesia complication. *Excessive use of ether as an anesthetic* - This describes a medical application of ether, albeit potentially misused, but does not primarily denote the **addictive state** of the person using it. - **Etheromania** focuses on the individual's psychological and physiological dependence, not merely the quantity used for medical purposes. *Delirium tremens from ether withdrawal* - Delirium tremens is specifically associated with **alcohol withdrawal**, not ether withdrawal. - While ether withdrawal can cause symptoms, the term **etheromania** refers to the addiction itself, not withdrawal complications.

Q: HU is a measure of

CT. ***Correct Answer: CT*** - HU stands for **Hounsfield Units**, a standardized quantitative scale used exclusively in **computed tomography (CT)** to describe the **radiodensity** of tissues based on **X-ray attenuation**. - On this scale, **water is assigned 0 HU**, air is -1000 HU, and dense bone can be +1000 HU or more. - This allows objective measurement and comparison of tissue densities across different CT scanners and examinations. *Incorrect: MRI* - **Magnetic Resonance Imaging (MRI)** does not use Hounsfield Units. - MRI signal intensity is based on the **magnetic properties of tissues** and local hydrogen proton density, not X-ray attenuation. *Incorrect: PET* - **Positron Emission Tomography (PET)** measures the metabolic activity of cells using **radioactive tracers**. - Its output is typically quantified in **Standardized Uptake Value (SUV)**, not Hounsfield Units. *Incorrect: USG* - **Ultrasound (USG)** imaging uses sound waves to create images of internal body structures. - It measures the **acoustic impedance** of tissues and displays findings in terms of echogenicity, not Hounsfield Units.

Q: Investigation of choice for screening of proximal internal carotid artery stenosis is :

Doppler ultrasound (USG). ***Doppler ultrasound (USG)*** - **Doppler ultrasound** is the investigation of choice for screening carotid artery stenosis due to its **non-invasive nature**, widespread availability, and cost-effectiveness. It provides excellent anatomical information and hemodynamics, including **blood flow velocity** and presence of **plaque**. - It can effectively estimate the degree of **stenosis** based on flow characteristics and is safe for serial monitoring. *CT angiography* - **CT angiography** provides detailed anatomical imaging of the carotid arteries but involves **ionizing radiation** and **iodinated contrast agents**, making it less suitable for routine screening, especially in patients with renal impairment or contrast allergies. - While it offers higher resolution for certain plaque characteristics, it’s typically reserved for cases where ultrasound findings are inconclusive or for surgical planning. *Magnetic resonance imaging (MRI)* - **MRI** and **MR angiography (MRA)** can visualize carotid stenosis without ionizing radiation but are more expensive and time-consuming than ultrasound, and can be limited by artifacts from patient movement. - Patients with **claustrophobia** or **metallic implants** may not be suitable for MRI, making it less ideal for general screening. *Digital subtraction angiography (DSA)* - **Digital subtraction angiography (DSA)** is the **gold standard** for diagnosing carotid stenosis as it provides the most detailed and accurate images of the arterial lumen. However, it is an **invasive procedure** associated with risks such as stroke, arterial dissection, contrast nephropathy, and radiation exposure. - Due to its invasiveness and potential complications, DSA is typically reserved for cases with **discordant non-invasive findings** or prior to intervention rather than as a primary screening tool.

Q: Rat tail appearance in contrast radiography is seen in?

Achalasia cardia. ***Correct: Achalasia cardia*** - The **"rat tail" or "bird's beak" sign** is the classic radiological appearance of **achalasia cardia** on barium swallow study - Shows **smooth, symmetrical, tapered narrowing** of the distal esophagus with proximal esophageal dilatation - Due to **failure of the lower esophageal sphincter (LES) to relax**, causing functional obstruction - The smooth tapering distinguishes it from irregular narrowing seen in malignancy *Incorrect: Carcinoma esophagus* - Esophageal carcinoma shows **"shouldered lesion"** or **"apple core" appearance** - Characterized by **irregular, shelf-like margins** with abrupt transition - Narrowing is **asymmetric and irregular**, not the smooth tapering of rat tail sign - May show mucosal destruction and filling defects *Incorrect: Plummer-Vinson syndrome* - Shows **postcricoid web** in the upper esophagus on barium swallow - Associated with iron deficiency anemia, glossitis, and increased risk of esophageal cancer - Presents as a thin, web-like membrane rather than distal narrowing *Incorrect: Diffuse esophageal spasms* - Shows **"corkscrew esophagus"** or **"rosary bead" appearance** on barium swallow - Multiple, **simultaneous, non-peristaltic contractions** create segmented appearance - Dynamic finding with normal segments between contractions - Represents uncoordinated muscular activity, not fixed narrowing

Q: Which of the following is a nonionic dye used in medical imaging?

Iohexol. ***Iohexol*** - **Iohexol** is a widely used **nonionic, low-osmolality contrast medium** in various medical imaging procedures. - Nonionic contrast agents generally have a **lower incidence of adverse reactions** compared to ionic agents due to their reduced osmolality. *Iothalamate* - **Iothalamate** is an **ionic, high-osmolality contrast medium**. - High-osmolality ionic agents are associated with a **higher risk of adverse events**, such as anaphylactoid reactions and nephrotoxicity. *Ioxaglate* - **Ioxaglate** is an **ionic dimer**, often described as a "monoacidic dimer," which gives it **lower osmolality** than traditional ionic monomers, but it is still fundamentally ionic. - While it has a better safety profile than older ionic monomers, it still differs structurally and functionally from true nonionic agents like iohexol. *None of the options* - This option is incorrect because **Iohexol** is indeed a nonionic dye used in medical imaging, fitting the description.

Question 1

Stages of anesthesia were established by

Accepted Answer

Diethyl ether

Answer

Nitrous oxide

Answer

Halothane

Answer

Chloroform

Question 2

Which condition is associated with calcification of the intervertebral disc?

Accepted Answer

Alkaptonuria

Answer

Gout

Answer

Rheumatoid

Answer

Psoriasis

Question 3

Corkscrew esophagus is seen in which of the following conditions ?

Accepted Answer

Diffuse esophagus spasm

Answer

Scleroderma

Answer

Achalasia cardia

Answer

Carcinoma esophagus

Question 4

Derealization and depersonalization are symptoms of which type of disorder?

Accepted Answer

Dissociative disorder

Answer

Personality disorders

Answer

Mania

Answer

Anxiety disorders

Question 5

Which of the following is a recognized type of anxiety disorder?

Accepted Answer

Panic Disorder

Answer

Bipolar Disorder

Answer

Major Depressive Disorder

Answer

Schizophrenia

Question 6

What does the term 'etheromania' refer to?

Accepted Answer

Ether addiction

Answer

Acute psychosis following ether anesthesia

Answer

Excessive use of ether as an anesthetic

Answer

Delirium tremens from ether withdrawal

Question 7

HU is a measure of

Accepted Answer

CT

Answer

MRI

Answer

PET

Answer

USG

Question 8

Investigation of choice for screening of proximal internal carotid artery stenosis is :

Accepted Answer

Doppler ultrasound (USG)

Answer

CT angiography

Answer

Magnetic resonance imaging (MRI)

Answer

Digital subtraction angiography (DSA)

Question 9

Rat tail appearance in contrast radiography is seen in?

Accepted Answer

Achalasia cardia

Answer

Carcinoma esophagus

Answer

Plummer-Vinson syndrome

Answer

Diffuse esophageal spasms

Question 10

Which of the following is a nonionic dye used in medical imaging?

Accepted Answer

Iohexol

Answer

Iothalamate

Answer

Ioxaglate

Answer

None of the options

NEET-PG 2012

Anesthesiology

Internal Medicine

Psychiatry

Radiology