NEET-PG 2012 Practice Questions

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: In a severely anaemic pregnant patient presenting with cardiac failure, what is the most appropriate choice of transfusion?

Exchange transfusion. ***Exchange transfusion*** - In **severe anaemia with cardiac failure**, exchange transfusion simultaneously **removes** and **replaces** blood volume, correcting anaemia without **net volume increase** that could worsen cardiac failure. - This procedure is the **safest option** as it avoids **fluid overload** while effectively improving **oxygen-carrying capacity** in cardiac-compromised pregnant patients. *Platelets* - **Platelets** are indicated for **thrombocytopenia** or **platelet dysfunction** to prevent bleeding, not for correcting anaemia. - They provide no benefit for **oxygen transport** or the underlying cause of cardiac failure in this anaemic patient. *Packed cells* - **Packed red blood cells** still add **net volume** to circulation, which can precipitate **pulmonary edema** and worsen cardiac failure despite slower infusion. - Even with **diuretics**, the risk of **fluid overload** remains significant in patients with pre-existing cardiac compromise. *Whole blood* - **Whole blood** contains **plasma volume** that significantly increases circulatory load, making it particularly dangerous in cardiac failure. - The large **volume expansion** can rapidly lead to **congestive heart failure** and **pulmonary edema** in already compromised patients.

Q: What is the minimum weight gain recommended for a malnourished child during the catch-up growth phase of nutritional rehabilitation?

5 gm/kg/day. ***Correct: 5 gm/kg/day*** - According to **WHO guidelines** for management of severe acute malnutrition and **IAP recommendations**, the **minimum acceptable weight gain** during the catch-up growth phase is **5 gm/kg/day**. - This represents the **threshold for adequate nutritional rehabilitation** - gains below this indicate inadequate recovery and require reassessment of the feeding protocol. - Weight gain of 5 gm/kg/day or more indicates that the child is responding to treatment. *Incorrect: 10 gm/kg/day* - A weight gain of **10 gm/kg/day** represents **good/satisfactory catch-up growth**, not the minimum requirement. - This is considered an **optimal target** rather than the minimum acceptable threshold. - While desirable, the question specifically asks for the minimum recommendation, which is 5 gm/kg/day. *Incorrect: 15 gm/kg/day* - A weight gain of **15 gm/kg/day** reflects **excellent catch-up growth** and is at the higher end of optimal targets. - This exceeds both the minimum requirement and the good target. - While indicating very successful rehabilitation, it is not the minimum recommendation. *Incorrect: 20 gm/kg/day* - A weight gain of **20 gm/kg/day** is an **exceptionally high rate** rarely achieved in clinical practice. - While theoretically possible with intensive feeding protocols, this far exceeds the minimum requirement. - Such high rates may require monitoring for refeeding syndrome and metabolic complications.

Q: What is the correct dose of i.v. adrenaline in term infants during neonatal resuscitation?

0.1-0.3 ml/kg in 1:10,000. ***0.1-0.3 ml/kg in 1:10,000*** - The recommended intravenous adrenaline dose for neonatal resuscitation is **0.01-0.03 mg/kg** using a **1:10,000 solution (0.1 mg/mL)**. - Volume calculation: 0.01-0.03 mg/kg ÷ 0.1 mg/mL = **0.1-0.3 mL/kg**. - This is the standard dose as per **NRP (Neonatal Resuscitation Program)** and **AHA guidelines** [2]. - The 1:10,000 concentration is safer for IV/umbilical venous catheter administration in neonates. *0.01-0.03 ml/kg in 1:1,000* - This volume is far too low for a 1:1,000 solution. - Would deliver only 0.01-0.03 mg total (not per kg), resulting in a **sub-therapeutic dose**. - The 1:1,000 concentration contains 1 mg/mL, which is **10 times more concentrated** than the recommended dilution. *0.3-0.5 ml/kg in 1:10,000* - This volume would deliver 0.03-0.05 mg/kg, which **exceeds the recommended maximum** of 0.03 mg/kg. - Higher doses can cause **severe adverse effects** including hypertension, arrhythmias, decreased myocardial function, and compromised coronary perfusion. - Not recommended as the standard initial dose. *0.03-0.05 ml/kg in 1:1,000* - The 1:1,000 concentration (1 mg/mL) is **too concentrated for IV use** in neonates [1]. - This volume would deliver 0.03-0.05 mg/kg from a highly concentrated solution, increasing risk of **severe cardiovascular complications**. - The 1:1,000 solution is reserved for **endotracheal administration** (at higher volumes of 0.5-1 mL/kg), not IV route.

Q: Which of the following is not a definite use for Prostaglandin E2 (PGE2)?

Keeps patency of PDA. ***Keeps patency of PDA*** - **Prostaglandin E1 (PGE1)**, not PGE2, is used to maintain the patency of the **ductus arteriosus** in neonates with certain congenital heart defects. - PGE1 causes **vascular smooth muscle relaxation**, preventing closure of the ductus arteriosus. *Contraception* - **PGE2 analogs** are used in various forms of contraception, including emergency contraception and for cervical ripening before elective abortion. - They act by inducing **uterine contractions** and can interfere with implantation or facilitate expulsion of a fertilized egg. *Induces labour* - **PGE2 (dinoprostone)** is commonly used clinically to induce labor by promoting **cervical ripening** and stimulating **uterine contractions**. - It is administered as a vaginal gel or insert to prepare the cervix for delivery. *Therapeutic abortion* - **PGE2 analogs** are used to induce therapeutic abortion, particularly in the second trimester, by causing powerful **uterine contractions** that lead to the expulsion of the fetus. - They are often used in combination with other agents to enhance their efficacy.

Q: Tetany is seen in

Respiratory alkalosis. ***Respiratory alkalosis*** - **Respiratory alkalosis** is caused by **hyperventilation**, which leads to a decrease in arterial partial pressure of carbon dioxide (**PaCO2**). - This decrease in PaCO2 causes an increase in pH (alkalemia) and a shift in the albumin-bound calcium equilibrium, reducing the amount of **ionized calcium** in the blood, leading to symptoms of **hypocalcemia** such as tetany. *Respiratory acidosis* - **Respiratory acidosis** is characterized by an increase in PaCO2 and a decrease in pH due to inadequate ventilation, which would not typically cause tetany. - In fact, the acidosis would tend to increase **ionized calcium** levels, thereby counteracting any tendency towards symptoms of hypocalcemia. *Metabolic acidosis* - **Metabolic acidosis** involves a decrease in bicarbonate concentration and pH, often due to conditions like diabetic ketoacidosis or lactic acidosis. - Similar to respiratory acidosis, the acidic environment of **metabolic acidosis** tends to increase **ionized calcium** levels, making tetany unlikely. *Hyperkalemia* - **Hyperkalemia** refers to elevated potassium levels in the blood, which primarily affects cardiac and neuromuscular function. - While it can cause muscle weakness and cardiac arrhythmias, it does not directly lead to **tetany**, which is a sign of **hypocalcemia**.

Q: Formication is primarily associated with which condition?

Chronic use of amphetamine. ***Chronic use of amphetamine*** - **Formication** (the sensation of insects crawling under the skin) is a classic symptom of **chronic amphetamine abuse**, often leading to excoriations due to scratching. - This **tactile hallucination** is part of the psychosis that can develop with prolonged high-dose amphetamine use. *Acute amphetamine intoxication* - While acute intoxication can cause psychosis and paranoia, **formication** is more strongly associated with the **chronic effects** and withdrawal of amphetamines. - Acute effects typically include euphoria, increased energy, and hypervigilance, rather than persistent tactile hallucinations. *Alcohol withdrawal* - **Alcohol withdrawal** can cause a range of symptoms including tremors, hallucinations (often visual or auditory), and seizures. - While some tactile disturbances can occur, **formication** is not a primary or characteristic symptom of alcohol withdrawal; **delirium tremens** often features visual or auditory hallucinations. *Cannabis poisoning* - **Cannabis poisoning** (or acute intoxication) typically presents with euphoria, altered perception of time, impaired coordination, and increased appetite. - It does not characteristically cause **formication** or other significant tactile hallucinations.

Q: What type of therapy is desensitization commonly classified as?

Behavioral therapy. ***Behavioral therapy*** - Desensitization techniques, such as **systematic desensitization**, are a cornerstone of **behavioral therapy** due to their focus on changing learned dysfunctional responses. - This approach aims to reduce anxiety or phobic reactions by gradually exposing individuals to feared stimuli in a controlled manner. *Psychotherapy* - This is a very **broad category** that encompasses many types of talking therapies, including behavioral therapy. - While desensitization is a *type* of psychotherapy, **behavioral therapy** is a more specific and accurate classification. *Psychoanalysis* - This therapeutic approach, developed by Sigmund Freud, focuses on uncovering **unconscious conflicts** and past experiences, often through techniques like **free association** and dream analysis. - Desensitization does not primarily deal with unconscious drives or early childhood experiences as its core mechanism. *Not applicable* - This option is incorrect because desensitization is a well-established and recognized therapeutic technique that fits within a standard classification of psychotherapies. - It clearly has a defined application and theoretical framework.

Q: In a patient with acute cholecystitis, referred pain to the shoulder is known as

Boas' sign. ***Boas' sign*** - **Boas' sign** refers to the presence of hyperesthesia below the right scapula, which can also manifest as referred pain to the **right shoulder** or back [1]. - This symptom in acute cholecystitis is due to the **irritation** of the **phrenic nerve**, which shares sensory pathways with the shoulder region. *Murphy's sign* - **Murphy's sign** is elicited by asking the patient to exhale, then placing the examiner's hand below the costal margin on the right mid-clavicular line, and then asking the patient to inhale deeply [1]. - A positive sign is indicated by a sudden cessation of inspiration due to pain, which is specific for **acute cholecystitis** and not referred shoulder pain [1]. *Gray Turner sign* - The **Gray Turner sign** involves ecchymosis or discoloration of the flanks. - It is a severe indicator of **retroperitoneal hemorrhage**, often associated with acute pancreatitis, not cholecystitis [2]. *Cullen's sign* - **Cullen's sign** presents as periumbilical ecchymosis or discoloration around the navel. - This sign is also indicative of **retroperitoneal hemorrhage**, typically seen in serious conditions like ruptured ectopic pregnancy or acute pancreatitis.

Question 1

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 2

In a severely anaemic pregnant patient presenting with cardiac failure, what is the most appropriate choice of transfusion?

Accepted Answer

Exchange transfusion

Answer

Platelets

Answer

Packed cells

Answer

Whole blood

Question 3

What is the most common cerebellar tumor in children?

Accepted Answer

Medulloblastoma

Answer

Ependymoma

Answer

PNET

Answer

Astrocytoma

Question 4

What is the minimum weight gain recommended for a malnourished child during the catch-up growth phase of nutritional rehabilitation?

Accepted Answer

5 gm/kg/day

Answer

10 gm/kg/day

Answer

15 gm/kg/day

Answer

20 gm/kg/day

Question 5

What is the correct dose of i.v. adrenaline in term infants during neonatal resuscitation?

Accepted Answer

0.1-0.3 ml/kg in 1:10,000

Answer

0.03-0.05 ml/kg in 1:1,000

Answer

0.01-0.03 ml/kg in 1:1,000

Answer

0.3-0.5 ml/kg in 1:10,000

Question 6

Which of the following is not a definite use for Prostaglandin E2 (PGE2)?

Accepted Answer

Keeps patency of PDA

Answer

Induces labour

Answer

Contraception

Answer

Therapeutic abortion

Question 7

Tetany is seen in

Accepted Answer

Respiratory alkalosis

Answer

Respiratory acidosis

Answer

Metabolic acidosis

Answer

Hyperkalemia

Question 8

Formication is primarily associated with which condition?

Accepted Answer

Chronic use of amphetamine

Answer

Acute amphetamine intoxication

Answer

Alcohol withdrawal

Answer

Cannabis poisoning

Question 9

What type of therapy is desensitization commonly classified as?

Accepted Answer

Behavioral therapy

Answer

Psychotherapy

Answer

Psychoanalysis

Answer

Not applicable

Question 10

In a patient with acute cholecystitis, referred pain to the shoulder is known as

Accepted Answer

Boas' sign

Answer

Murphy's sign

Answer

Gray Turner sign

Answer

Cullen's sign

NEET-PG 2012

Dermatology

Obstetrics and Gynecology

Pathology

Pediatrics

Pharmacology

Physiology

Psychiatry

Surgery