NEET-PG 2012 Practice Questions

Q: Which of the following is used for the diagnosis of asthma?

FEV1. ***FEV1*** - **Forced expiratory volume in 1 second (FEV1)** is the gold standard spirometric parameter for asthma diagnosis - Key diagnostic criteria include: - Reduced **FEV1/FVC ratio** (<0.70 or <0.75-0.80 in adults) - **Bronchodilator reversibility**: ≥12% and ≥200 mL increase in FEV1 after inhaled short-acting β2-agonist - This reversibility distinguishes asthma from fixed obstructive diseases like COPD - Serial **peak expiratory flow (PEF)** monitoring can also demonstrate variability characteristic of asthma *Measurement of tidal volume* - **Tidal volume** measures the amount of air inhaled or exhaled during normal breathing (typically ~500 mL at rest) - Not a diagnostic parameter for asthma as it doesn't assess **airway obstruction** or **hyperresponsiveness** - May be reduced during acute exacerbations but lacks specificity for asthma diagnosis *End expiratory flow rate* - Not a standard diagnostic parameter for asthma - While **mid-expiratory flow rates** (FEF25-75%) and **peak expiratory flow (PEF)** are assessed, **FEV1** remains the primary diagnostic measure - FEV1 provides better reproducibility and standardization for diagnosis *Total lung capacity* - **Total lung capacity (TLC)** represents total lung volume after maximal inhalation - May be normal or increased in asthma due to **air trapping** and hyperinflation - Not used as a primary diagnostic criterion as asthma diagnosis focuses on demonstrating **reversible airflow limitation**, not lung volumes

Q: Kussmaul's sign is classically described in:

Chronic inflammatory heart condition. ***Chronic inflammatory heart condition*** - **Kussmaul's sign**, characterized by a paradoxical rise in **jugular venous pressure (JVP)** during inspiration, is classically seen in conditions like **constrictive pericarditis** [1], which is often a chronic inflammatory heart condition. - This sign reflects the heart's inability to accommodate increased venous return during inspiration due to a rigid, fibrotic pericardium [1]. *Acute cardiac compression* - **Cardiac tamponade** [3], a form of acute cardiac compression, typically presents with **pulsus paradoxus** and muffled heart sounds, not Kussmaul's sign. - While it involves elevated JVP, the paradoxical inspiratory rise is less common compared to constrictive pericarditis. *Acute myocardial damage* - **Acute myocardial infarction** [2] or myocarditis, leading to acute myocardial damage, primarily causes symptoms related to reduced cardiac output and arrhythmias, such as chest pain or dyspnea. - Kussmaul's sign is not a typical feature of acute myocardial damage because the pericardium is usually not rigid or constricting. *Chronic ventricular stiffening* - Conditions involving **chronic ventricular stiffening**, such as **restrictive cardiomyopathy**, can mimic some features of constrictive pericarditis, including elevated JVP and sometimes Kussmaul's sign. - However, the classic description and most prominent cases of Kussmaul's sign are associated with external compression from a diseased pericardium rather than intrinsic myocardial stiffness, although differentiation can be challenging.

Q: Oculoorogenital ulcers are associated with which of the following conditions?

Behcet's disease. ***Behcet's disease*** - This condition is characterized by **recurrent oral and genital ulcers**, along with **ocular inflammation** (e.g., uveitis), perfectly matching the "Oculoorogenital ulcers" description. - It is a **chronic, relapsing inflammatory disease** of unknown etiology involving vasculitis affecting various organ systems. *Lichen planus* - This is a chronic inflammatory condition affecting the **skin, hair, nails, and mucous membranes**. - While it can cause oral lesions, it typically presents as **purple, polygonal, pruritic papules** on the skin and does not cause genital ulcers or significant ocular involvement like Behcet's. *Systemic lupus erythematosus (SLE)* - SLE is a **systemic autoimmune disease** with diverse manifestations, including skin rashes, arthritis, and internal organ involvement. - Oral ulcers can occur, but **genital ulcers and severe ocular inflammation** as a prominent triad are not typical diagnostic features of SLE. *Psoriasis* - This is a common **chronic inflammatory skin disease** characterized by well-demarcated erythematous plaques with silvery scales. - Psoriasis primarily affects the skin and joints, and **does not typically present with oral, genital, or ocular ulcers** as described.

Q: What is the treatment of choice for Bartholin's cyst?

Marsupialization. ***Marsupialization*** - This procedure involves incising the cyst, draining its contents, and then everting and suturing the edges of the cyst wall to the surrounding skin, creating a permanent-draining pouch. - **Marsupialization** is the treatment of choice because it prevents recurrence by allowing continuous drainage of mucus, unlike simple incision and drainage. *Excision* - Complete surgical excision of the Bartholin's gland or cyst is a more invasive procedure and is typically reserved for cases of **recurrent cysts** after marsupialization or suspected malignancy. - It carries a higher risk of bleeding and infection compared to marsupialization, and can lead to **vaginal dryness** due to loss of glandular secretions. *Antibiotic therapy* - Antibiotics are primarily used if the Bartholin's gland becomes **infected**, leading to an **abscess**, or if there is surrounding cellulitis. - They do not address the underlying blockage of the duct and will not resolve a Bartholin's cyst, which is a collection of mucus due to duct obstruction. *Cyst drainage* - Simple incision and drainage (I&D) provides temporary relief by emptying the cyst contents but has a **high recurrence rate** because the duct often re-occludes. - While it may be used as an initial temporizing measure, it is not the definitive treatment for preventing future episodes of Bartholin's cysts.

Q: Which of the following is NOT a symptom of carpal tunnel syndrome?

Ulnar nerve dysfunction. ***Ulnar nerve dysfunction*** - Carpal tunnel syndrome specifically involves compression of the **median nerve**, not the ulnar nerve. - Symptoms related to the median nerve include numbness and tingling in the **thumb, index, middle, and radial half of the ring finger**, along with **thenar muscle wasting**. *Tinel sign* - The **Tinel sign** is a common physical examination finding in carpal tunnel syndrome, elicited by tapping over the **median nerve** at the wrist. - A positive sign involves tingling or electric shock-like sensations in the **median nerve distribution**. *Phalen's sign* - **Phalen's sign** is another classic physical maneuver used to diagnose carpal tunnel syndrome, where exaggerated wrist flexion for 60 seconds reproduces symptoms. - This maneuver increases pressure within the **carpal tunnel**, exacerbating median nerve compression. *Pain & paraesthesia of wrist* - **Pain and paraesthesia (numbness and tingling)** in the wrist and hand are hallmark symptoms of carpal tunnel syndrome. - These symptoms are often worse at night or with repetitive hand movements, reflecting **median nerve irritation**.

Q: What is the primary reason for early stabilization of a femur shaft fracture?

To prevent fat embolism syndrome and systemic complications. ***To prevent fat embolism syndrome and systemic complications*** - Early stabilization of femur shaft fractures significantly **reduces the incidence of fat embolism syndrome (FES)**. Fat emboli released from the bone marrow can travel to the lungs and brain, causing severe respiratory distress and neurological deficits. - By stabilizing the fracture, the **release of fat globules is minimized**, thereby preventing FES and associated systemic complications such as acute respiratory distress syndrome (ARDS) and adult respiratory distress syndrome (ADRS). *To prevent significant blood loss.* - While femur fractures can cause significant blood loss, the primary reason for early stabilization is not solely to prevent it but to reduce complications. **Blood loss is a direct consequence**, but FES poses a greater immediate threat to life. - Furthermore, **blood loss can often be managed initially by other means**, such as fluid resuscitation and direct pressure, while FES requires prompt reduction of fracture movement. *To reduce pain and discomfort.* - Reducing pain and discomfort is an important benefit of stabilization, but it is **not the primary life-saving reason** for early intervention. Analgesics and proper splinting can also address pain. - The focus on early stabilization goes beyond symptomatic relief to actively prevent **potentially fatal systemic complications**. *To facilitate quicker healing.* - While stability is crucial for proper healing, **early stabilization primarily addresses acute, life-threatening complications** rather than long-term healing rates. Optimal healing depends on many factors, including blood supply and infection control, not solely on initial stabilization. - **Quicker healing is a secondary benefit**; the immediate priority is to prevent acute morbidity and mortality associated with the fracture.

Q: Which of the following translocations is not associated with Down syndrome?

t(11;14). ***t (11: 14)*** - The **t(11;14) translocation** is commonly associated with **mantle cell lymphoma**, a B-cell non-Hodgkin lymphoma, and is not a cause of Down syndrome. - This translocation leads to the overexpression of the **cyclin D1 gene**, located on chromosome 11, which promotes cell growth and proliferation. *t (14; 21)* - This is a common **Robertsonian translocation** involving chromosomes 14 and 21, which results in an extra copy of chromosome 21 material [1]. - Individuals with this translocation can have **Down syndrome** because their cells end up with the equivalent of three copies of chromosome 21 [1]. *t (21; 21)* - This translocation is another type of **Robertsonian translocation** where two chromosome 21s fuse. - This specific translocation is rare and results in an extra copy of chromosome 21, leading to **Down syndrome** with a high recurrence risk in offspring. *t (15: 21)* - This is a **Robertsonian translocation** involving chromosomes 15 and 21, resulting in an extra copy of chromosome 21 material. - This translocation is a known cause of **Down syndrome** due to the dosage imbalance of genes on chromosome 21 [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 169-172.

Q: Opsoclonus-myoclonus is a phenomenon seen in:

Neuroblastoma. ***Neuroblastoma*** - **Opsoclonus-myoclonus syndrome (OMS)** is a rare paraneoplastic neurological disorder primarily associated with childhood neuroblastoma. - It is characterized by rapid, irregular eye movements (**opsoclonus**), brief, involuntary muscle jerks (**myoclonus**), ataxia, and irritability. *Wilm's tumor* - Wilms' tumor (nephroblastoma) is a kidney tumor of childhood and is not typically associated with opsoclonus-myoclonus syndrome. - While it is also a pediatric cancer, its paraneoplastic manifestations are different and do not include OMS. *Meningioma* - Meningiomas are typically slow-growing tumors arising from the meninges in adults, and are not associated with opsoclonus-myoclonus. - Paraneoplastic syndromes are rare with meningiomas, and OMS is not one of them. *Cortical tuberculoma* - A cortical tuberculoma is a granulomatous lesion in the brain caused by Mycobacterium tuberculosis, often seen in individuals with tuberculosis. - While it can cause neurological symptoms like seizures, headaches, and focal deficits, it does not cause opsoclonus-myoclonus syndrome.

Q: Which of the following is not a characteristic of schizoid personality disorder?

Suspicious. ***Suspicious*** - **Suspiciousness** and mistrust of others are core features of **paranoid personality disorder**, not schizoid personality disorder. - Individuals with schizoid personality disorder are typically apathetic towards others rather than actively distrustful. *Aloof & detached* - Individuals with schizoid personality disorder are characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression. - They often appear emotionally cold and indifferent to praise or criticism, indicating their aloof nature. *Prone to fantasy* - People with schizoid personality disorder frequently engage in **excessive daydreaming** and imaginative fantasy as an escape from reality. - This tendency is a coping mechanism for their limited social interaction and emotional expression. *Introspective* - Schizoid individuals tend to be **preoccupied with their inner world** and thoughts, often to the exclusion of external social interactions. - Their introspective nature contributes to their social withdrawal and isolation.

Q: In Congenital Diaphragmatic Hernia (CDH), the most commonly associated anomaly affects the

Congenital heart defects. ***Congenital heart defects*** - **Congenital diaphragmatic hernia (CDH)** is frequently associated with other congenital anomalies. - **Cardiac malformations** are the most common co-occurring defects, affecting a significant proportion of CDH patients. *Anomalies of the urinary tract* - While **urogenital anomalies** can occur with CDH, they are less prevalent than congenital heart defects. - These typically include conditions like **renal agenesis** or **hydronephrosis**. *Anomalies of the skull* - **Skull anomalies** are not a primary or common association with congenital diaphragmatic hernia. - Genetic syndromes associated with both CDH and skull anomalies are relatively rare. *Craniofacial anomalies* - **Craniofacial anomalies**, such as **cleft lip/palate**, can occur with CDH but are less common than cardiac anomalies. - These are often seen within the context of specific genetic syndromes.

Question 1

Which of the following is used for the diagnosis of asthma?

Accepted Answer

FEV1

Answer

Measurement of tidal volume

Answer

End expiratory flow rate

Answer

Total lung capacity

Question 2

Kussmaul's sign is classically described in:

Accepted Answer

Chronic inflammatory heart condition

Answer

Acute myocardial damage

Answer

Acute cardiac compression

Answer

Chronic ventricular stiffening

Question 3

Oculoorogenital ulcers are associated with which of the following conditions?

Accepted Answer

Behcet's disease

Answer

Lichen planus

Answer

Systemic lupus erythematosus (SLE)

Answer

Psoriasis

Question 4

What is the treatment of choice for Bartholin's cyst?

Accepted Answer

Marsupialization

Answer

Excision

Answer

Antibiotic therapy

Answer

Cyst drainage

Question 5

Which of the following is NOT a symptom of carpal tunnel syndrome?

Accepted Answer

Ulnar nerve dysfunction

Answer

Phalen's sign

Answer

Pain & paraesthesia of wrist

Answer

Tinel sign

Question 6

What is the primary reason for early stabilization of a femur shaft fracture?

Accepted Answer

To prevent fat embolism syndrome and systemic complications

Answer

To prevent significant blood loss.

Answer

To reduce pain and discomfort.

Answer

To facilitate quicker healing.

Question 7

Which of the following translocations is not associated with Down syndrome?

Accepted Answer

t(11;14)

Answer

t(21;21)

Answer

t(14;21)

Answer

t(15;21)

Question 8

Opsoclonus-myoclonus is a phenomenon seen in:

Accepted Answer

Neuroblastoma

Answer

Wilms' tumor

Answer

Meningioma

Answer

Cortical tuberculoma

Question 9

Which of the following is not a characteristic of schizoid personality disorder?

Accepted Answer

Suspicious

Answer

Prone to fantasy

Answer

Introspective

Answer

Aloof & detached

Question 10

In Congenital Diaphragmatic Hernia (CDH), the most commonly associated anomaly affects the

Accepted Answer

Congenital heart defects

Answer

Anomalies of the urinary tract

Answer

Anomalies of the skull

Answer

Craniofacial anomalies

NEET-PG 2012

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Pathology

Pediatrics

Psychiatry

Surgery