NEET-PG 2012 Practice Questions

Q: Raindrop pigmentation is caused by?

Arsenic. ***Arsenic*** - Chronic **arsenic** exposure can lead to characteristic skin manifestations, including **raindrop pigmentation**, which appears as small, scattered hypopigmented macules surrounded by hyperpigmented skin, particularly on the trunk and extremities. - This pigmentation is a result of altered **melanin distribution** and **keratinocyte damage** due to arsenic toxicity. *Clofazimine* - **Clofazimine** is an anti-leprosy drug that can cause **reddish-brown to bluish-black skin discoloration**, which is a diffuse pigmentation, not "raindrop" in nature. - The pigmentation associated with clofazimine is due to drug deposition in tissues and is usually reversible. *Dapsone* - **Dapsone** is primarily known for causing **methemoglobinemia** and **hemolytic anemia**, especially in patients with G6PD deficiency. - While it can cause some dermatological side effects, **pigmentation** is not a characteristic feature, and it does not produce a "raindrop" pattern. *Minocycline* - **Minocycline** can cause various types of pigmentation, including **blue-gray discoloration** in scars, shins, and mucous membranes, as well as diffuse brown pigmentation. - However, the pigmentation caused by minocycline is typically diffuse or localized to specific areas, and it does not present as "raindrop pigmentation."

Q: The odour of cyanide is similar to?

Bitter almond. ***Bitter almond*** - The classic description of **cyanide odor** is that of **bitter almonds**. This specific scent is a key indicator during forensic investigations or in cases of suspected poisoning. - However, not everyone can detect this smell due to a **genetic trait** that affects the ability to perceive it. *Rotten egg* - A **rotten egg** odor is characteristic of **hydrogen sulfide (H2S)**, a highly toxic gas. - This gas is often produced by the decomposition of organic matter and does not indicate cyanide exposure. *Fish* - A **fishy odor** is typically associated with compounds like **amines**, such as **trimethylamine**, which are found in decomposing fish or certain medical conditions like **trimethylaminuria**. - This smell is distinct from the bitter almond scent of cyanide. *Fruity* - A **fruity odor** can be associated with various substances, including **ketones** in conditions like **diabetic ketoacidosis** or certain **volatile organic compounds**. - This scent is not characteristic of cyanide poisoning.

Q: What is the effect of strychnos nux vomica poisoning on a patient's consciousness?

Remains conscious throughout the poisoning. ***Remains conscious throughout the poisoning*** - Patients poisoned with **strychnine** (from *Strychnos nux vomica*) typically remain **fully conscious** and aware of their surroundings, even during severe convulsions. - This preservation of consciousness amidst intense muscular spasms is a **distinguishing and agonizing feature** of strychnine poisoning. *Becomes unconscious within an hour* - This statement is generally incorrect for strychnine poisoning, as the prominent feature is maintained consciousness alongside **neurological excitability**. - Loss of consciousness is not a **primary or direct effect** of strychnine, though severe complications could indirectly affect it. *Becomes unconscious only in severe cases* - While extreme metabolic derangements or secondary complications (e.g., severe hypoxia from prolonged seizures) might eventually lead to altered consciousness, the **direct pharmacological action** of strychnine does not cause unconsciousness. - The patient remains conscious even through the most severe and life-threatening **tetanic spasms**. *Becomes unconscious immediately after exposure* - Strychnine primarily acts as an **antagonist to glycine receptors** in the spinal cord and brainstem, leading to exaggerated reflexes and muscle overactivity, not immediate unconsciousness. - The onset of symptoms, including muscular spasms, typically occurs within **15-30 minutes** of exposure, with consciousness generally preserved.

Q: What is the correct order of application of reagents in the complete Gram staining procedure?

Gentian violet → Iodine → Alcohol/Acetone → Safranin. **Gentian violet → Iodine → Alcohol/Acetone → Safranin** - **Gentian violet** (or crystal violet) is the **primary stain** that colors all cells purple. - **Iodine** acts as a **mordant**, forming a crystal violet-iodine complex within the cell walls. - **Alcohol/Acetone** is the **decolorizer**, washing out the primary stain from Gram-negative cells but not from Gram-positive cells. - Finally, **Safranin** is the **counterstain** that stains decolorized Gram-negative cells pink or red. *Iodine → Gentian violet → Alcohol/Acetone → Safranin* - **Iodine** is a mordant and needs a primary stain (like gentian violet) to bind to and form a complex; applying it first would not effectively stain the cells. - The correct sequence requires the primary stain to be applied before the mordant can fix it. *Safranin → Gentian violet → Iodine → Alcohol/Acetone* - **Safranin** is a counterstain and should be applied last to stain the decolorized Gram-negative cells, not as the first reagent. - Applying reagents out of order would lead to incorrect staining results, as **safranin** is meant to provide contrast after decolorization. *Gentian violet → Alcohol/Acetone → Iodine → Safranin* - **Alcohol/Acetone** (decolorizer) is applied too early in this sequence; it should be used after the mordant (iodine) has formed a complex with the primary stain. - Applying the decolorizer before the mordant would prevent the formation of the crystal violet-iodine complex, leading to incorrect differentiation between Gram-positive and Gram-negative bacteria.

Q: What is the iodine content percentage in amiodarone?

20 - 40%. ***20 - 40%*** - **Amiodarone** is highly lipophilic and contains a significant amount of **iodine**, typically comprising around **37.5%** of its molecular weight. - This high iodine content is responsible for many of its **adverse effects**, particularly those related to thyroid dysfunction. *10 - 20%* - This range is too low; the actual iodine content in **amiodarone** is considerably higher, making it a prominent feature of the drug's chemical structure. - A lower iodine percentage would likely result in fewer **thyroid-related side effects**. *40 - 60%* - While amiodarone has a high iodine content, 40-60% is slightly above the generally accepted range. - Iodine constitutes a substantial but not an overwhelming majority of the drug's molecular mass. *60 - 80%* - This range is significantly higher than the actual iodine content in **amiodarone**. - Such a high percentage would imply an even greater propensity for **iodine-induced adverse effects**.

Q: Which of the following medications is known to cause increased renin levels with prolonged use?

Enalapril. ***Enalapril*** - **Enalapril** is an **ACE inhibitor** which blocks the conversion of angiotensin I to angiotensin II, leading to decreased levels of angiotensin II [1]. - Reduced angiotensin II levels remove the **negative feedback** on renin release from the juxtaglomerular cells, thus increasing renin secretion [1], [2]. *Clonidine* - Clonidine is a **central alpha-2 adrenergic agonist** that reduces sympathetic outflow from the central nervous system. - This reduction in sympathetic activity leads to a **decrease in renin release**, as sympathetic stimulation normally promotes renin secretion [3]. *Methyldopa* - Methyldopa is a **central alpha-2 adrenergic agonist** that works similarly to clonidine by reducing sympathetic tone. - It consequently causes a **decrease in plasma renin activity** due to reduced sympathetic stimulation of the juxtaglomerular apparatus [3]. *Propranolol* - Propranolol is a **non-selective beta-blocker** that blocks beta-1 receptors in the juxtaglomerular cells of the kidney. - This blockade **inhibits the release of renin** stimulated by sympathetic activity, leading to reduced renin levels [3].

Q: Which of the following is NOT caused by Prostaglandin E2 (PGE2)?

None of the options. ***None of the options*** - All three listed effects (water retention, uterine contraction, and flushing) **ARE caused by Prostaglandin E2 (PGE2)**, making this the correct answer to the question asking what is NOT caused by PGE2. - Since PGE2 actually causes all the listed effects, "None of the options" is the accurate response. *Water retention* - PGE2 **stimulates ADH (vasopressin) release** from the posterior pituitary gland. - PGE2 also **enhances ADH action** on renal collecting ducts, promoting water reabsorption. - While PGE2 has complex renal effects including natriuresis, its net effect includes **promoting water retention** through the ADH mechanism. - This is an important effect of PGE2 on fluid balance. *Uterine contraction* - PGE2 is a **potent stimulator of uterine smooth muscle contraction**. - It is used clinically for **labor induction** and **cervical ripening** (dinoprostone). - PGE2 plays a crucial role in **parturition** and is involved in **dysmenorrhea**. *Flushing* - PGE2 causes **peripheral vasodilation**, particularly in cutaneous blood vessels. - This vasodilatory effect leads to **increased skin blood flow**, manifesting as **flushing** and warmth. - This is commonly seen as part of the **inflammatory response** and contributes to erythema.

Q: What is the antidote for Ethylene Glycol?

Fomepizole. ***Fomepizole*** - **Fomepizole** is the primary and preferred antidote for ethylene glycol poisoning, as it competitively inhibits **alcohol dehydrogenase**, the enzyme responsible for metabolizing ethylene glycol into its toxic metabolites. - By blocking this enzyme, fomepizole prevents the formation of harmful compounds like **glycolic acid** and **oxalic acid**, which cause metabolic acidosis and kidney damage. - **Ethanol** is an alternative antidote that works by the same mechanism (competitive inhibition of alcohol dehydrogenase) and can be used when fomepizole is unavailable, though fomepizole is preferred due to better safety profile and easier dosing. *Barbiturate* - **Barbiturates** are a class of psychoactive drugs that act as central nervous system depressants, primarily used for sedation, anesthesia, and seizure control. - They have no role in neutralizing or metabolizing ethylene glycol or its toxic byproducts. *Acetylcysteine* - Acetylcysteine is an antidote primarily used for **acetaminophen (paracetamol) overdose**, where it replenishes glutathione stores and detoxifies its toxic metabolite, **NAPQI**. - It does not have any direct antidotal effect against ethylene glycol or its metabolites. *Ferric chloride* - **Ferric chloride** is a chemical compound used in various industrial processes, water treatment, and as a laboratory reagent. - It is highly corrosive and toxic if ingested, but it is not used as an antidote for any type of poisoning, including ethylene glycol.

Q: Which of the following actions is NOT recommended when dealing with a patient who has been bitten by a snake?

Local incision. ***Local incision*** - Making an incision at the bite site can **worsen tissue damage**, increase the risk of infection, and does not effectively remove venom. - This practice is **outdated** and potentially harmful, as venom spreads rapidly through the lymphatic system rather than being localized in a way that incision can help. - **Local incision is NOT recommended** and is a contraindicated first-aid measure. *Immobilization of the affected limb* - Immobilizing the bitten limb helps **slow the spread of venom** through the lymphatic system. - This is a **recommended first-aid measure**, especially for neurotoxic snakebites, and should be done by keeping the limb at or below heart level. - Proper immobilization involves splinting the limb without restricting blood flow. *Reassurance* - Overt fear and anxiety can lead to symptoms like **tachycardia** and **hypertension**, which can exacerbate the effects of the venom. - **Calming the patient** helps reduce the physiological stress response, which is crucial as panic can worsen the clinical picture. - Reassurance is a **recommended supportive measure**. *Clean with soap and water* - Cleaning the wound helps remove surface venom and **reduce the risk of secondary bacterial infection**. - This is a **recommended basic first-aid measure** that promotes wound hygiene without interfering with venom management.

Question 1

Raindrop pigmentation is caused by?

Accepted Answer

Arsenic

Answer

Dapsone

Answer

Minocycline

Answer

Clofazimine

Question 2

The odour of cyanide is similar to?

Accepted Answer

Bitter almond

Answer

Rotten egg

Answer

Fish

Answer

Fruity

Question 3

What is the effect of strychnos nux vomica poisoning on a patient's consciousness?

Accepted Answer

Remains conscious throughout the poisoning

Answer

Becomes unconscious within an hour

Answer

Becomes unconscious only in severe cases

Answer

Becomes unconscious immediately after exposure

Question 4

What is the correct order of application of reagents in the complete Gram staining procedure?

Accepted Answer

Gentian violet → Iodine → Alcohol/Acetone → Safranin

Answer

Iodine → Gentian violet → Alcohol/Acetone → Safranin

Answer

Safranin → Gentian violet → Iodine → Alcohol/Acetone

Answer

Gentian violet → Alcohol/Acetone → Iodine → Safranin

Question 5

Which of the following statements about Haemophilus influenzae is true?

Accepted Answer

Encapsulated strains are the most common cause of severe H. influenzae diseases

Answer

It is not capsulated

Answer

Invasive strain causes severe diseases but is less common than non-invasive strains

Answer

Typically grown on chocolate agar in CO2-enriched environment but not clinically relevant to severe diseases

Question 6

What is the iodine content percentage in amiodarone?

Accepted Answer

20 - 40%

Answer

10 - 20%

Answer

40 - 60%

Answer

60 - 80%

Question 7

Which of the following medications is known to cause increased renin levels with prolonged use?

Accepted Answer

Enalapril

Answer

Clonidine

Answer

Methyldopa

Answer

Propranolol

Question 8

Which of the following is NOT caused by Prostaglandin E2 (PGE2)?

Accepted Answer

None of the options

Answer

Water retention

Answer

Flushing

Answer

Uterine contraction

Question 9

What is the antidote for Ethylene Glycol?

Accepted Answer

Fomepizole

Answer

Barbiturate

Answer

Acetylcysteine

Answer

Ferric chloride

Question 10

Which of the following actions is NOT recommended when dealing with a patient who has been bitten by a snake?

Accepted Answer

Local incision

Answer

Reassurance

Answer

Immobilization of the affected limb

Answer

Clean with soap and water

NEET-PG 2012

Dermatology

Forensic Medicine

Microbiology

Pharmacology

Surgery