NEET-PG 2012 Practice Questions

Q: The inducing agent of choice in shock -

Ketamine. **Ketamine** * **Ketamine** is preferred in shock due to its sympathomimetic properties, which maintain or increase blood pressure and heart rate, thus preserving **cardiovascular stability**. * It also has minimal respiratory depression and bronchodilatory effects, making it safer for patients with compromised respiratory function. * The cardiovascular stimulating effects of ketamine helps maintain haemodynamic stability in shocked patients. It maintains cerebral autoregulation and perfusion of vital organs. *Isoflurane* * **Isoflurane** is an inhaled anesthetic that typically causes **dose-dependent myocardial depression** and **vasodilation**, which can worsen hypotension in a shock state. * It can significantly decrease systemic vascular resistance, thereby exacerbating the already compromised cardiovascular status of a shock patient. *Desflurane* * **Desflurane** is an inhaled anesthetic known for its rapid onset and offset but can cause a **significant increase in heart rate and blood pressure** upon rapid concentration changes, which may be detrimental in an unstable patient. * Like isoflurane, it also causes dose-dependent peripheral vasodilation and myocardial depression, which can worsen hypotension in patients in shock. *Thiopentone* * **Thiopentone** is a barbiturate that causes significant **myocardial depression** and **peripheral vasodilation**, leading to a substantial drop in blood pressure. * Its use in shock would further compromise cardiovascular stability and is generally contraindicated due to its potent hemodynamic depressant effects.

Q: The arthropod vector BEST KNOWN for transovarian transmission of multiple pathogens is -

Ticks. ***Ticks*** - Ticks are well-known for their diverse modes of pathogen transmission, including **transovarian transmission**, where pathogens are passed from an infected female tick to her offspring through the eggs. - This mechanism is crucial for the maintenance and spread of several tick-borne diseases, such as **Rocky Mountain spotted fever (caused by *Rickettsia rickettsii*)** and **Babesiosis** (caused by *Babesia* species). *Fleas* - Fleas are primarily known for transmitting pathogens such as *Yersinia pestis* (causing **plague**) and *Rickettsia typhi* (causing **murine typhus**) through their bites, but transovarian transmission is not their primary mode. - They typically transmit pathogens through **regurgitation** during feeding or by their **feces** being rubbed into the bite wound. *Sandfly* - Sandflies are vectors for diseases like **leishmaniasis**, caused by parasitic protozoa of the genus *Leishmania*. - They transmit these pathogens through **saliva** during blood meals, but transovarian transmission is not a significant feature of their lifecycle. *Mosquitoes* - Mosquitoes are vectors for a wide range of diseases, including **malaria**, **dengue**, **Zika**, and **West Nile virus**, primarily through the **injection of saliva** during blood feeding. - While some arboviruses can exhibit transovarian transmission in mosquitoes, it is not as prominent or broadly impactful across multiple pathogens as it is in ticks.

Q: The population norm for a trained health aide is:

1000. ***1000*** - According to public health guidelines, a single **trained health aide** is typically designated to serve a population of approximately **1,000 individuals**. - This staffing level allows for effective outreach, basic health services, and community engagement in primary healthcare. *5000* - A population of **5,000** would generally require multiple health aides or a more comprehensive primary health unit with a larger staff. - This ratio is too high for a single health aide to provide adequate care and coverage. *100000* - A population of **100,000** is far too large for a single trained health aide to manage, requiring an extensive healthcare system with numerous professionals. - This number represents a district or sub-district level population, not the responsibility of one aide. *30000* - Serving **30,000** people would be an impossible task for one health aide, as it far exceeds the standard allocation for community-level health services. - This population size usually necessitates a full-fledged primary health center or hospital.

Q: The primary indication for enucleation in pediatric patients is:

Retinoblastoma. ***Retinoblastoma*** - **Retinoblastoma** is a malignant tumor of the retina commonly seen in children, and **enucleation** (surgical removal of the eye) is frequently the primary treatment to prevent tumor spread and save the child's life. - The decision for enucleation is based on the tumor's size, location, and potential for dissemination, especially when other globe-sparing therapies are not feasible or fail. *Panophthalmitis* - **Panophthalmitis** is a severe infection involving all coats of the eye and orbital tissues, which can be managed with aggressive antibiotic therapy. - While enucleation might be a last resort in cases of uncontrolled infection and severe pain, it is not the primary indication, especially in pediatric patients where globe salvage is often attempted first. *Acute congestive glaucoma* - **Acute congestive glaucoma** involves a sudden, severe increase in intraocular pressure, causing pain and vision loss, but it is primarily managed with medical and surgical interventions to lower pressure. - Enucleation is not a standard treatment for acute glaucoma unless the eye is blind, painful, and unresponsive to all other treatments, and it is rarely the primary indication in children. *None of the options* - This option is incorrect because **retinoblastoma** is a well-established and common primary indication for enucleation in pediatric patients due to its life-threatening nature.

Q: Police inquest is NOT required in:

Natural death due to disease in elderly person at home. ***Natural death due to disease in elderly person at home*** - Police inquest is **NOT required** for natural deaths occurring at home with a known medical condition - A registered medical practitioner who has been attending the deceased can issue a death certificate - No suspicion of foul play or unnatural circumstances exists - This is the only scenario among the options where police involvement is not mandated *Death in police custody* - Police inquest is **absolutely required** under **Section 176 CrPC** (mandatory magisterial inquiry) - Custodial deaths are considered highly sensitive and require thorough investigation - Ensures accountability and rules out torture, negligence, or human rights violations - Automatic judicial oversight is mandated by law *Suicide* - Police inquest is **required** as suicide is classified as an **unnatural death** - Investigation needed to confirm manner of death and rule out homicide - Section 174 CrPC mandates police investigation for all unnatural deaths - Documentation required for legal and insurance purposes *Murder* - Police inquest is **absolutely required** as murder is a **criminal homicide** - Section 174 CrPC mandates immediate police investigation - Crime scene examination, evidence collection, and suspect identification are essential - Forms the basis for criminal prosecution under IPC Section 302

Q: Which of the following provide protection against malaria except

PNH. ***PNH*** - **Paroxysmal nocturnal hemoglobinuria (PNH)** is a rare, acquired clonal disorder of hematopoietic stem cells characterized by complement-mediated hemolysis. - It does not offer any known protective advantage against malaria infection; in fact, chronic hemolysis could potentially complicate malaria diagnosis or management. *Thalassemia* - Individuals with **thalassemia traits (heterozygotes)**, particularly alpha-thalassemia, have red blood cells that are more resistant to malarial parasite invasion and growth [1]. - This protection is thought to arise from altered red cell morphology, reduced parasite multiplication, and enhanced clearance of infected cells. *Sickle cell anemia* - The **heterozygous state (sickle cell trait)** provides significant protection against severe malaria, as the altered hemoglobin S in red blood cells inhibits parasite growth and promotes early clearance of infected cells [1], [2]. - Although the homozygous state (sickle cell anemia) can be severe, even carriers benefit from reduced malaria susceptibility. *Duffy blood group* - Absence of the **Duffy antigen on red blood cells**, common in West African populations, provides complete protection against infection with **Plasmodium vivax** malaria. - The Duffy antigen receptor is essential for *P. vivax* to invade human red blood cells.

Q: Classical cesarean section is specifically indicated in which of the following conditions?

Cervical cancer involving lower uterine segment. ***Cervical cancer involving lower uterine segment*** - A classical cesarean section, involving a **vertical incision into the upper uterine segment**, allows for delivery of the fetus without disturbing the cancerous cervix and lower uterine segment. - This approach minimizes the risk of **tumor dissemination** and excessive bleeding, which would be high with a low transverse incision. *Transverse lie with back down* - A **low transverse cesarean section** is generally preferred for a transverse lie presentation as it aligns better with the uterine architecture and is associated with fewer future uterine rupture risks. - A classical incision is typically reserved for extreme cases of transverse lie (e.g., morbidly obese patient making access difficult or fetal anomaly) or when the **lower uterine segment is not adequately formed**. *Placenta previa with anterior placenta accreta* - This condition typically necessitates a **low transverse cesarean section**, often combined with a **hysterectomy**, due to the abnormal placental adherence to the anterior lower uterine segment. - A classical incision would likely lead to **significant hemorrhage** and may not effectively manage the adherent placenta. *Previous two cesarean sections* - While a previous cesarean section increases the risk of uterine rupture in subsequent pregnancies, it does not automatically indicate a classical cesarean section for the third delivery. - A repeat **low transverse cesarean section** is usually performed as it carries a lower risk of rupture in future pregnancies compared to a classical incision scar.

Q: A child with fever with abdominal cramps & pus in stools, causative organism is ?

EAEC. ***EAEC (Enteroaggregative E. coli)*** - Among the E. coli strains listed, EAEC is the answer for this question, though **this is an atypical presentation**. - EAEC classically causes **persistent watery diarrhea** (>14 days) in children, often with **low-grade fever** and **abdominal pain**. - While EAEC primarily causes non-bloody diarrhea, it can occasionally produce **mucoid stools** with inflammatory cells due to mucosal inflammation from biofilm formation. - **Note:** The classic organism for fever + cramps + pus in stools would be **Shigella**, **Campylobacter**, or **EIEC (Enteroinvasive E. coli)** - not listed here. *EHEC (Enterohemorrhagic E. coli)* - EHEC (O157:H7) causes **hemorrhagic colitis** with bloody diarrhea due to **Shiga toxins**. - Can lead to **hemolytic uremic syndrome (HUS)** in children. - Characterized by **blood** rather than pus in stools, distinguishing it from typical dysentery. *ETEC (Enterotoxigenic E. coli)* - Most common cause of **traveler's diarrhea** and watery diarrhea in developing countries. - Produces **heat-labile (LT)** and **heat-stable (ST)** enterotoxins causing secretory diarrhea. - Results in profuse **watery stools without inflammation, blood, or pus**. *EPEC (Enteropathogenic E. coli)* - Leading cause of infantile diarrhea in developing countries. - Causes **attaching and effacing** lesions on intestinal mucosa. - Results in **watery diarrhea without significant inflammatory cells or pus** in stools.

Q: The longest half life is that of:

Uranium. ***Uranium*** - **Uranium-238**, a common isotope, has an incredibly long half-life of approximately **4.468 billion years**, which is comparable to the age of the Earth. - This extremely long half-life is due to its slow **alpha decay**, making it a very stable radioactive element. *Radon* - **Radon-222** has a relatively short half-life of about **3.8 days**. - Its short half-life makes it a significant indoor air pollutant as it rapidly decays into other radioactive isotopes. *Cesium* - **Cesium-137**, a product of nuclear fission, has a half-life of approximately **30 years**. - While longer than radon, its half-life is much shorter compared to uranium, meaning it decays significantly faster. *Radium* - **Radium-226**, a decay product of uranium, has a half-life of approximately **1,600 years**. - Although much longer than radon and cesium, it is still orders of magnitude shorter than the half-life of uranium-238.

Question 1

The inducing agent of choice in shock -

Accepted Answer

Ketamine

Answer

Isoflurane

Answer

Desflurane

Answer

Thiopentone

Question 2

The arthropod vector BEST KNOWN for transovarian transmission of multiple pathogens is -

Accepted Answer

Ticks

Answer

Fleas

Answer

Sandfly

Answer

Mosquitoes

Question 3

The population norm for a trained health aide is:

Accepted Answer

1000

Answer

5000

Answer

100000

Answer

30000

Question 4

The primary indication for enucleation in pediatric patients is:

Accepted Answer

Retinoblastoma

Answer

Panophthalmitis

Answer

Acute congestive glaucoma

Answer

None of the options

Question 5

In forensic examination of gunshot wounds, which of the following is NOT typically found in contact wounds from shotgun discharge?

Accepted Answer

Beveling of bone at exit wound

Answer

Stippling pattern around entry wound

Answer

Powder burns on skin surface

Answer

Muzzle imprint on contact wound

Question 6

Police inquest is NOT required in:

Accepted Answer

Natural death due to disease in elderly person at home

Answer

Suicide

Answer

Murder

Answer

Death in police custody

Question 7

Which of the following provide protection against malaria except

Accepted Answer

PNH

Answer

Thalassemia

Answer

Sickle cell anemia

Answer

Duffy blood group

Question 8

Classical cesarean section is specifically indicated in which of the following conditions?

Accepted Answer

Cervical cancer involving lower uterine segment

Answer

Transverse lie with back down

Answer

Placenta previa with anterior placenta accreta

Answer

Previous two cesarean sections

Question 9

A child with fever with abdominal cramps & pus in stools, causative organism is ?

Accepted Answer

EAEC

Answer

EHEC

Answer

ETEC

Answer

EPEC

Question 10

The longest half life is that of:

Accepted Answer

Uranium

Answer

Radon

Answer

Cesium

Answer

Radium

NEET-PG 2012

Anesthesiology

Community Medicine

Dental

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pediatrics

Radiology