NEET-PG 2012 Practice Questions

Q: Which vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?

Thiamine. ***Thiamine*** - **Thiamine** (Vitamin B1) deficiency is extremely common in chronic alcoholics due to **poor dietary intake**, impaired absorption, and increased excretion. - Deficiency can lead to serious neurological complications like **Wernicke-Korsakoff syndrome**, characterized by confusion, ataxia, and ophthalmoplegia. *Pyridoxine* - **Pyridoxine** (Vitamin B6) deficiency can occur in alcoholics, but it is less common and less clinically significant than thiamine deficiency. - While it can manifest as peripheral neuropathy or **sideroblastic anemia**, it is not the most common or critical deficiency in this population. *Riboflavin* - **Riboflavin** (Vitamin B2) deficiency can also be seen in chronic alcoholics due to poor nutrition. - Symptoms like **cheilosis** and **angular stomatitis** are mild compared to the severe neurological consequences of thiamine deficiency. *Niacin* - **Niacin** (Vitamin B3) deficiency, known as **pellagra**, is rare in developed countries but can occur in severe malnutrition, including in some alcoholics. - Pellagra presents with the "3 Ds": **dermatitis**, **diarrhea**, and **dementia**, but it is generally less prevalent than thiamine deficiency in alcohol use disorders.

Q: Which of the following is associated with macrosomia?

Gestational diabetes mellitus. ***Gestational diabetes mellitus*** - **Gestational diabetes mellitus (GDM)** is a common cause of macrosomia because high maternal glucose levels lead to increased fetal insulin production, which promotes growth and fat deposition. - The **hyperglycemic environment** in GDM stimulates fetal overgrowth, resulting in larger-than-average babies. *Hypothyroidism* - **Maternal hypothyroidism** is typically associated with **fetal growth restriction** and lower birth weight, not macrosomia. - Undiagnosed or poorly controlled hypothyroidism can lead to complications such as **preterm labor** and **preeclampsia**, but not increased fetal size. *None of the options* - This option is incorrect because **gestational diabetes mellitus** is directly associated with macrosomia. - There is a clear and well-documented link between maternal hyperglycemia and increased fetal growth. *Maternal anemia* - **Maternal anemia**, especially severe anemia, is generally associated with an **increased risk of fetal growth restriction** and **low birth weight**. - Anemia limits oxygen and nutrient delivery to the fetus, thereby hindering optimal growth.

Q: What is a Pulled Elbow?

Partial dislocation of the radial head. ***Partial dislocation of the radial head*** - A pulled elbow, also known as **nursemaid's elbow**, specifically refers to a **subluxation of the radial head** from the annular ligament. - This injury typically occurs in young children when their arm is suddenly pulled or jerked, causing the **radial head** to slip out of the **annular ligament**. *Complete separation of the elbow joint* - A complete separation of the elbow joint would involve a **full dislocation** of the humeroulnar or humeroradial joints, a much more severe injury than a pulled elbow. - This would present with more significant deformity and instability compared to the subtle presentation of a pulled elbow. *Subluxation of proximal radio ulnar joint* - While the injury involves the radius and ulna, the specific subluxation in a pulled elbow is that of the **radial head** at the **humero-radial joint**, not primarily the proximal radio-ulnar joint itself. - The focus is on the annular ligament's integrity around the radial head, rather than direct forces acting on the proximal radio-ulnar articulation. *No injury present* - A pulled elbow is a recognized and common **pediatric orthopedic injury** requiring intervention to reduce the radial head. - The child will typically present with pain, refusal to use the affected arm, and a characteristic holding posture.

Q: Proximal humerus fracture which has maximum chances of avascular necrosis

Four part. ***Four part fracture*** - A **four-part proximal humerus fracture** typically involves displacement of the humeral head, greater tuberosity, lesser tuberosity, and humeral shaft. - This extensive displacement significantly disrupts the **blood supply** to the humeral head, specifically the **arcuate artery** and its branches, leading to a high risk of **avascular necrosis**. *One part fracture* - A **one-part fracture** indicates that the fracture fragments are minimally displaced (<1 cm or <45° angulation). - The **blood supply** to the humeral head remains largely intact, resulting in a very low risk of avascular necrosis. *Two part fracture* - A **two-part fracture** involves displacement of one major fragment (e.g., surgical neck or tuberosity) from the humeral head. - While there is some disruption, the overall risk of **avascular necrosis** is lower compared to more complex fractures. *Three part fracture* - A **three-part fracture** involves separate displacement of the humeral head and two tuberosities. - This fracture pattern causes more significant disruption to the **vascularity** of the humeral head than two-part fractures but generally less than four-part fractures.

Q: What is the recommended rate for blood transfusion in neonates?

1-5 ml/min. ***1-5 ml/min*** - The recommended rate for blood transfusion in neonates is **1-5 ml/min** to prevent **circulatory overload** and other complications. - Slower rates are crucial for neonates due to their limited cardiovascular reserves and smaller blood volume. *5-10 ml/min* - This rate is generally **too fast** for routine neonatal blood transfusions, increasing the risk of **fluid overload** and **cardiac strain**. - Rapid administration can lead to complications such as **necrotizing enterocolitis (NEC)** or **respiratory distress**. *10-15 ml/min* - Administering blood at this rate in neonates is **contraindicated** due to the high risk of **cardiovascular compromise**. - It could quickly overwhelm the neonate's circulatory system, leading to severe adverse events. *15-20 ml/min* - This rate is significantly **too rapid** for any neonatal blood transfusion and would almost certainly result in **severe volume overload** and potential cardiac arrest. - Such high rates are only rarely considered in extreme emergency situations, like massive hemorrhage with specific considerations and monitoring.

Q: Upper segment to lower segment ratio in a 3-year-old child is:

1.3:1. ***1.3:1*** - At birth, the upper segment to lower segment ratio is around **1.7:1**, indicating proportionally longer trunks. - By the age of **3 years**, this ratio typically decreases to approximately **1.3:1** as the lower limbs grow more rapidly. *1.2:1* - This ratio is typically observed in **older children** or young adults, as lower limb growth catches up further. - A ratio of 1.2:1 would suggest more **proportional body segments** than expected for a 3-year-old child. *1.4:1* - This ratio is closer to that of a **younger infant** or toddler, as the lower segments are still relatively shorter. - A 3-year-old would generally have experienced more **lower limb growth**, reducing this ratio further. *1.6:1* - This ratio is characteristic of a **newborn or very young infant**, where the upper body and head are significantly larger relative to the legs. - It would be **abnormal** for a 3-year-old to still have such a high ratio, indicating a disproportional growth pattern.

Q: Most commonly abused opioid -

Diacetylmorphine. ***Diacetylmorphine*** - **Diacetylmorphine**, commonly known as **heroin**, is synthetically derived from **morphine** but is significantly more potent and lipid-soluble, allowing it to cross the **blood-brain barrier** rapidly [1, 3]. - Its rapid onset of action and intense euphoric effects contribute to its high potential for **abuse** and addiction, making it one of the most commonly abused opioids globally, particularly through intravenous injection [1]. *Morphine* - While **morphine** is a potent opioid and has a high potential for abuse, it is often prescribed in clinical settings for severe pain. - Its slower onset and less intense "rush" compared to **heroin** make it less frequently the **primary opioid of abuse** in illicit street drug markets [1]. *Oxycodone* - **Oxycodone** is a highly abused prescription opioid, especially in the form of controlled-release formulations like **OxyContin**, but its abuse is primarily linked to prescription drug diversion rather than being the most common illicitly manufactured opioid of abuse. - While it contributes significantly to the opioid crisis, **heroin** (diacetylmorphine) remains the most commonly abused opioid in the illicit market due to its widespread availability and potency [1]. *Buprenorphine* - **Buprenorphine** is a **partial opioid agonist** used in the treatment of opioid dependence (opioid replacement therapy) due to its ceiling effect on respiratory depression and ability to block the effects of other opioids. - Although it can be abused, particularly in combination with naloxone (Suboxone) via intravenous injection, its primary role is in **medication-assisted treatment**, making it less commonly abused as a standalone illicit opioid compared to **heroin**.

Q: Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:

Lithium carbonate. **Lithium carbonate** - **Lithium** is a well-established and highly effective **mood stabilizer**, considered a first-line treatment for managing both **manic** and **depressive episodes** in bipolar disorder. - It helps prevent recurrent episodes and reduces the severity of mood swings, acting as a prophylactic agent. *Chlorpromazine* - **Chlorpromazine** is a **first-generation antipsychotic** that is primarily used to treat **schizophrenia** and other psychotic disorders. - While it can be used acutely to manage severe manic agitation, it is not a first-line agent for the long-term mood stabilization characteristic of bipolar disorder. *Haloperidol* - **Haloperidol** is another **first-generation antipsychotic** often used for acute treatment of **psychotic symptoms** or severe agitation, including in mania. - It is not a primary long-term mood stabilizer for bipolar disorder due to its side effect profile and lack of efficacy in preventing future mood episodes compared to lithium. *Diazepam* - **Diazepam** is a **benzodiazepine** primarily used for treating **anxiety**, muscle spasms, and acute seizures. - While it can help manage acute agitation and insomnia during a manic episode, it does not have mood-stabilizing properties and is not a long-term treatment for bipolar disorder.

Q: What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?

Obsession. ***Obsession*** - An **obsession** is defined by the presence of **recurrent and persistent thoughts, urges, or images** that are experienced as intrusive and unwanted, causing significant anxiety or distress. - These thoughts are often recognized as products of one's own mind, and individuals typically attempt to ignore, suppress, or neutralize them. *Phobia* - A **phobia** is an intense, irrational fear of a specific object or situation that poses little or no actual danger. - Unlike obsessions, phobias are typically related to external stimuli and do not primarily involve intrusive thoughts. *Compulsion* - A **compulsion** is a repetitive behavior (e.g., hand washing, checking) or mental act (e.g., praying, counting) that an individual feels driven to perform in response to an obsession. - Compulsions are often aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation. *Anxiety* - **Anxiety** is a general term for a feeling of worry, nervousness, or unease, typically about an event or something with an uncertain outcome. - While obsessions cause anxiety, "anxiety" itself is a broad emotional state, not specifically the intrusive thoughts described.

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 vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?

Accepted Answer

Thiamine

Answer

Pyridoxine

Answer

Riboflavin

Answer

Niacin

Question 2

Which of the following is associated with macrosomia?

Accepted Answer

Gestational diabetes mellitus

Answer

None of the options

Answer

Hypothyroidism

Answer

Maternal anemia

Question 3

What is a Pulled Elbow?

Accepted Answer

Partial dislocation of the radial head

Answer

Subluxation of proximal radio ulnar joint

Answer

Complete separation of the elbow joint

Answer

No injury present

Question 4

Proximal humerus fracture which has maximum chances of avascular necrosis

Accepted Answer

Four part

Answer

One part

Answer

Two part

Answer

Three part

Question 5

What is the recommended rate for blood transfusion in neonates?

Accepted Answer

1-5 ml/min

Answer

10-15 ml/min

Answer

15-20 ml/min

Answer

5-10 ml/min

Question 6

Upper segment to lower segment ratio in a 3-year-old child is:

Accepted Answer

1.3:1

Answer

1.2:1

Answer

1.4:1

Answer

1.6:1

Question 7

Most commonly abused opioid -

Accepted Answer

Diacetylmorphine

Answer

Morphine

Answer

Oxycodone

Answer

Buprenorphine

Question 8

Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:

Accepted Answer

Lithium carbonate

Answer

Chlorpromazine

Answer

Haloperidol

Answer

Diazepam

Question 9

What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?

Accepted Answer

Obsession

Answer

Phobia

Answer

Compulsion

Answer

Anxiety

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

Biochemistry

Obstetrics and Gynecology

Orthopaedics

Pediatrics

Pharmacology

Psychiatry

Surgery