NEET-PG 2012 Practice Questions

Q: Cocaine was first used as a local anesthetic by?

Carl Koller. ***Carl Koller*** - **Carl Koller** (1857-1944), an Austrian ophthalmologist, is credited with the first clinical use of cocaine as a local anesthetic in 1884. - He demonstrated its efficacy for topical anesthesia in eye surgery, revolutionizing surgical practices. *Holmer Wells* - **Horace Wells** (not Holmer) was an American dentist who pioneered the use of **nitrous oxide** as an anesthetic in dentistry in the 1840s, preceding Koller's work with cocaine. - His contributions were focused on general anesthesia for pain relief during tooth extractions. *Morton* - **William T.G. Morton** was another American dentist who famously demonstrated the use of **ether** as a surgical anesthetic in 1846. - His work popularized surgical anesthesia, but it was not related to cocaine as a local anesthetic. *None of the options* - This option is incorrect because Carl Koller is historically recognized as the pioneer for the clinical use of **cocaine as a local anesthetic**.

Q: Which of the following is the MOST characteristic feature of skin tags (acrochordons)?

They are typically pedunculated.. ***They are typically pedunculated.*** - **Skin tags (acrochordons)** are benign soft tissue tumors characterized by their **pedunculated morphology** - they are attached to the skin by a narrow stalk or pedicle. - This **pedunculated appearance** is the **most characteristic** and **defining feature** that distinguishes them from other benign skin lesions. - They are typically **soft, flesh-colored or hyperpigmented**, and range from 1-5 mm in size. *They commonly occur on the neck and axilla.* - While **skin tags** frequently occur in areas of friction such as the neck, axilla, eyelids, groin, and inframammary folds, this **location is not specific**. - Many other skin conditions also favor these sites, so location alone is not a characteristic diagnostic feature. *They are associated with seborrhoeic keratosis.* - There is **no established clinical association** between skin tags and seborrheic keratoses. - Both are common **benign skin growths** in adults but represent different pathological entities with different clinical appearances. *They have malignant potential.* - This is **incorrect**. Skin tags are **benign fibrous polyps** with **no malignant potential**. - They do not require removal unless symptomatic or for cosmetic reasons.

Q: What type of cell are Tzanck cells commonly associated with in skin conditions?

Keratinocyte. ***Keratinocyte*** - **Tzanck cells** are **acantholytic keratinocytes** characterized by loss of intercellular connections, resulting in rounded cells with **large nuclei** and **perinuclear halos**. - They are classically seen in **pemphigus vulgaris** and other acantholytic disorders on **Tzanck smear** preparation. - The Tzanck smear is a simple bedside diagnostic test where the base of a blister is scraped and examined microscopically after staining. *Fibroblast* - **Fibroblasts** are mesenchymal cells in the **dermis** that produce **collagen** and extracellular matrix components. - They are not epithelial cells and do not undergo acantholysis to form Tzanck cells. *Neutrophil* - **Neutrophils** are polymorphonuclear leukocytes involved in acute inflammatory responses and fighting bacterial infections. - They may infiltrate skin lesions but do not transform into Tzanck cells, which are specifically altered keratinocytes. *Lymphocyte* - **Lymphocytes** (T cells and B cells) are immune cells involved in **adaptive immunity**. - They are not the cell type from which Tzanck cells originate; Tzanck cells are acantholytic epidermal keratinocytes.

Q: 6 year old son of pregnant woman is suffering from chicken pox. Which of the following is given to pregnant woman?

Only immunoglobulin. ***Only immunoglobulin*** - Giving **immunoglobulin** to a pregnant woman exposed to **chickenpox** provides immediate passive immunity, which is crucial as she is at risk of infection from her child. - This is particularly important because chickenpox during pregnancy can lead to severe maternal disease and congenital varicella syndrome in the fetus. *Acyclovir + immunoglobulin* - **Acyclovir** is an antiviral that treats active varicella infection but is not typically given prophylactically in combination with immunoglobulin for exposure unless the woman is already immunocompromised or develops symptoms. - The primary goal for exposed pregnant women is preventing infection through passive immunity, not immediately treating a potential infection. *Vaccination* - **Varicella vaccine** is a live attenuated vaccine and is **contraindicated** during pregnancy due to the theoretical risk of fetal infection. - It is used for pre-conception immunity or post-exposure prophylaxis in non-pregnant individuals if given within a short window, but not for pregnant women. *Acyclovir* - **Acyclovir** is an antiviral medicine used to treat active chickenpox infections, not to prevent infection immediately after exposure. - It would be considered if the pregnant woman develops symptoms of chickenpox, but not as a primary prophylactic measure in this scenario.

Q: Which of the following drugs is not commonly used for menorrhagia?

Clomiphene. ***Clomiphene*** - **Clomiphene citrate** is a selective estrogen receptor modulator used primarily to **induce ovulation** in women with infertility, not to treat menorrhagia. - Its mechanism involves blocking estrogen receptors in the hypothalamus, leading to increased release of **gonadotropins (FSH and LH)**. - It has no role in the management of heavy menstrual bleeding. *Methergin* - **Methergine (methylergonovine)** is an ergot alkaloid that causes sustained uterine contractions. - It is primarily used for **postpartum hemorrhage** and control of bleeding after abortions (acute obstetric bleeding). - While it can control acute uterine bleeding, it is **not used for chronic menorrhagia management** due to its side effects and availability of better alternatives. - It is an acute intervention, not a treatment for cyclic heavy menstrual bleeding. *GnRH* - **GnRH agonists** (e.g., leuprolide) are used to treat menorrhagia by inducing a **hypoestrogenic state**, which leads to endometrial atrophy and reduced menstrual bleeding. - They are often used as a temporary measure before surgery or for short-term management due to potential side effects like **hot flashes and bone loss**. *NSAIDS* - **Nonsteroidal anti-inflammatory drugs (NSAIDs)**, such as ibuprofen or naproxen, reduce prostaglandin production, which can decrease **menstrual blood loss** by affecting uterine contractility and vasoconstriction. - They are a common first-line treatment for menorrhagia, especially when associated with **painful periods (dysmenorrhea)**.

Q: Which drug is known to cause placental abruption?

Cocaine. **Cocaine** - **Cocaine** use during pregnancy is strongly associated with an increased risk of **placental abruption** due to its vasoconstrictive effects on uterine blood vessels. - Its potent **vasoconstrictive properties** lead to uterine ischemia and contractions, which can cause the placenta to detach prematurely from the uterine wall. *Methadone* - While methadone use during pregnancy is associated with risks such as **neonatal abstinence syndrome**, it is not a primary cause of **placental abruption**. - It is often used as a maintenance therapy for opioid-dependent pregnant women to avoid the fluctuating levels of illicit drug use, which can have more severe consequences. *Amphetamine* - Amphetamine use can lead to adverse pregnancy outcomes like **preterm birth** and **low birth weight** due to its stimulant effects. - Although it causes vasoconstriction, its association with **placental abruption** is less direct and less pronounced compared to cocaine. *Fluoxetine* - Fluoxetine, an **SSRI antidepressant**, generally has a relatively safe profile in pregnancy, although some studies suggest a small increased risk of persistent **pulmonary hypertension** in neonates. - It is not known to be a cause of **placental abruption**.

Q: Which of the following statements about Hegar's sign is false?

Present in 2/3rd of cases. ***Present in 2/3rd of cases*** - This statement is **FALSE** and is the correct answer to this question. - Hegar's sign, while a classic sign of pregnancy, is not consistently present in 2/3rds of cases with such statistical certainty. - Its detectability varies significantly depending on **gestational age** (optimal 6-12 weeks), **uterine position** (retroverted uterus makes it harder), **examiner experience**, and **patient body habitus**. - This specific "2/3rd" frequency claim lacks strong evidence-based support in obstetric literature. *Bimanual palpation method* - This statement is TRUE. - **Hegar's sign** is elicited by **bimanual pelvic examination** where one hand is placed on the abdomen and the other in the vagina to palpate the softening and compressibility of the **lower uterine segment** (isthmus). - The examiner feels the cervix and uterine fundus separately with the soft isthmus compressed between the examining fingers. *Difficult in obese* - This statement is TRUE. - **Obesity** makes any deep abdominal or pelvic palpation more challenging due to increased adipose tissue. - The **softening of the lower uterine segment** is harder to appreciate, reducing the sensitivity of detecting Hegar's sign in obese patients. *Can be done at 14 weeks* - This statement is technically TRUE but represents suboptimal timing. - **Hegar's sign** is most reliably detectable between the **6th and 12th weeks of gestation**. - At **14 weeks**, while the examination can still be performed, the uterus has grown significantly and risen into the abdomen, making the lower uterine segment less compressible and the sign much less prominent or absent. - The statement doesn't claim it's "optimal" at 14 weeks, only that it "can be done," which is technically accurate even if clinically impractical.

Q: In pregnancy, plasma volume increase is maximum at what gestational age?

30 wks. ***30 wks*** - **Plasma volume** typically reaches its maximum expansion around **30-34 weeks of gestation**, increasing by approximately 40-50% compared to pre-pregnancy levels. - This increase is crucial for supporting the **fetoplacental unit**, enhancing nutrient delivery, and protecting against supine hypotension. *10 wks* - At **10 weeks**, the increase in plasma volume is still modest, with significant expansion primarily occurring in the **second trimester**. - Most of the rapid expansion begins after the **first trimester**, around the 12-week mark. *20 wks* - While plasma volume is significantly increasing by **20 weeks**, it has not yet reached its peak. - The continuous expansion continues through the **third trimester** before stabilizing. *25 wks* - At **25 weeks**, plasma volume is substantially elevated, but the maximum expansion is usually observed a few weeks later. - The peak is generally in the **early third trimester**, around 30-34 weeks.

Q: In a 5-month pregnant female, which of the following statements regarding physiological changes is true?

80-90% have soft systolic murmur. ***80-90% have soft systolic murmur*** - The **increased blood volume** and **cardiac output** during pregnancy lead to increased flow across the aortic and pulmonic valves, often resulting in a **physiological systolic ejection murmur**. - This murmur is typically heard best at the **left sternal border** and usually resolves after delivery. *Cardiac output is reduced* - **Cardiac output actually increases** significantly during pregnancy, typically by 30-50%, to meet the metabolic demands of the fetus and placenta. - This increase is due to both an **increase in heart rate** and **stroke volume**. *Systemic vascular resistance is increased* - **Systemic vascular resistance (SVR) decreases** during pregnancy, primarily due to the **vasodilating effects of progesterone** and the creation of a **low-resistance placental circulation**. - The drop in SVR contributes to the physiological **decrease in blood pressure** often observed in mid-pregnancy. *Increase in CVP* - **Central venous pressure (CVP) typically remains unchanged or slightly decreases** during normal pregnancy. - While blood volume increases, the accompanying **vasodilation and decreased SVR** usually prevent a significant rise in CVP.

Question 1

Cocaine was first used as a local anesthetic by?

Accepted Answer

Carl Koller

Answer

Holmer Wells

Answer

Morton

Answer

None of the options

Question 2

Which of the following is the MOST characteristic feature of skin tags (acrochordons)?

Accepted Answer

They are typically pedunculated.

Answer

They commonly occur on the neck and axilla.

Answer

They have malignant potential.

Answer

They are associated with seborrhoeic keratosis.

Question 3

What type of cell are Tzanck cells commonly associated with in skin conditions?

Accepted Answer

Keratinocyte

Answer

Neutrophil

Answer

Lymphocyte

Answer

Fibroblast

Question 4

Which of the following statements about lepromatous leprosy is true?

Accepted Answer

Lepromatous leprosy typically presents with multiple cutaneous lesions.

Answer

Thickened peripheral nerves are a common feature.

Answer

Erythema nodosum leprosum occurs in less than 50% of cases.

Answer

The lepromin test is usually negative or weakly positive.

Question 5

6 year old son of pregnant woman is suffering from chicken pox. Which of the following is given to pregnant woman?

Accepted Answer

Only immunoglobulin

Answer

Acyclovir + immunoglobulin

Answer

Vaccination

Answer

Acyclovir

Question 6

Which of the following drugs is not commonly used for menorrhagia?

Accepted Answer

Clomiphene

Answer

GnRH

Answer

NSAIDS

Answer

Methergin

Question 7

Which drug is known to cause placental abruption?

Accepted Answer

Cocaine

Answer

Amphetamine

Answer

Fluoxetine

Answer

Methadone

Question 8

Which of the following statements about Hegar's sign is false?

Accepted Answer

Present in 2/3rd of cases

Answer

Bimanual palpation method

Answer

Difficult in obese

Answer

Can be done at 14 weeks

Question 9

In pregnancy, plasma volume increase is maximum at what gestational age?

Accepted Answer

30 wks

Answer

10 wks

Answer

20 wks

Answer

25 wks

Question 10

In a 5-month pregnant female, which of the following statements regarding physiological changes is true?

Accepted Answer

80-90% have soft systolic murmur

Answer

Cardiac output is reduced

Answer

Systemic vascular resistance is increased

Answer

Increase in CVP

NEET-PG 2012

Anesthesiology

Dermatology

Obstetrics and Gynecology