Anesthesiology
3 questionsWhich of the following is NOT a contraindication for spinal anaesthesia?
What is the critical temperature of Nitrous Oxide (N2O)?
Cocaine was first used as a local anesthetic by?
NEET-PG 2012 - Anesthesiology NEET-PG Practice Questions and MCQs
Question 951: Which of the following is NOT a contraindication for spinal anaesthesia?
- A. Raised intracranial tension
- B. Bleeding disorder
- C. Hypertension (Correct Answer)
- D. Infection at injection site
Explanation: ***Hypertension*** - While **severe uncontrolled hypertension** may necessitate blood pressure stabilization before surgery, **mild to moderate hypertension** is not an absolute contraindication for spinal anesthesia. - In fact, spinal anesthesia can sometimes be beneficial in hypertensive patients due to its **vasodilatory effects**, which may help lower blood pressure. *Bleeding disorder* - A **bleeding disorder** (e.g., thrombocytopenia, coagulopathy) is a **major contraindication** due to the high risk of **epidural or spinal hematoma** formation. - A hematoma can lead to **spinal cord compression** and irreversible neurological damage. *Raised intracranial tension* - **Raised intracranial tension (ICT)** is a **strict contraindication** because the drop in cerebrospinal fluid (CSF) pressure during spinal anesthesia can worsen the pressure gradient across the foramen magnum. - This can precipitate **herniation of the brainstem** and lead to catastrophic neurological injury or death. *Infection at injection site* - The presence of an **infection at the injection site** is an absolute contraindication as it poses a significant risk of introducing bacteria into the **subarachnoid space**. - This can lead to serious complications such as **meningitis** or a **spinal abscess**.
Question 952: What is the critical temperature of Nitrous Oxide (N2O)?
- A. -118°C
- B. -36°C
- C. -30°C
- D. -36.5°C (Correct Answer)
Explanation: **-36.5°C** - The **critical temperature** of **nitrous oxide (N2O)** is **36.5°C**, which is the temperature above which it cannot be liquefied by pressure alone. - This value is important for understanding the **physical state** and safe handling of N2O, as deviations can lead to phase changes or storage issues. *-118°C* - This temperature is significantly lower than the actual critical temperature of N2O and is incorrect. - This value might be related to the **boiling point of other gases** but not the critical temperature of N2O. *-36°C* - While close, **-36°C** is not the precise critical temperature for nitrous oxide. - This small difference can be significant in contexts requiring **exact physical properties** of gases. *-30°C* - This temperature is incorrect and is higher than the actual critical temperature of N2O. - At this temperature, N2O would still behave as a **liquefiable gas** under sufficient pressure, indicating it is below its critical point.
Question 953: Cocaine was first used as a local anesthetic by?
- A. Holmer Wells
- B. Morton
- C. Carl Koller (Correct Answer)
- D. None of the options
Explanation: ***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**.
Biochemistry
1 questionsWhich vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?
NEET-PG 2012 - Biochemistry NEET-PG Practice Questions and MCQs
Question 951: Which vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?
- A. Pyridoxine
- B. Thiamine (Correct Answer)
- C. Riboflavin
- D. Niacin
Explanation: ***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.
Internal Medicine
1 questionsWhich of the following statements about lepromatous leprosy is true?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 951: Which of the following statements about lepromatous leprosy is true?
- A. Thickened peripheral nerves are a common feature.
- B. Erythema nodosum leprosum occurs in less than 50% of cases.
- C. The lepromin test is usually negative or weakly positive.
- D. Lepromatous leprosy typically presents with multiple cutaneous lesions. (Correct Answer)
Explanation: ***Lepromatous leprosy typically presents with multiple cutaneous lesions.*** - Lepromatous leprosy is characterized by **widespread skin involvement**, often manifesting as numerous, symmetrically distributed nodules, plaques, and macules [1]. - The high bacterial load in lepromatous leprosy leads to extensive skin infiltration due to the host's ineffective cellular immune response. *Thickened peripheral nerves are a common feature.* - While nerve thickening can occur in lepromatous leprosy, it is a **more prominent and early feature** of **tuberculoid leprosy** due to a more robust granulomatous inflammatory response within the nerve [2]. - In lepromatous leprosy, nerve damage is often more diffuse and less demarcated, leading to **insidious nerve loss** rather than clearly palpable thickening. *Erythema nodosum leprosum occurs in less than 50% of cases.* - **Erythema nodosum leprosum (ENL)** is a common type 2 leprosy reaction associated with lepromatous leprosy, estimated to occur in **approximately 30-50% of untreated patients** [1]. - It results from an immune complex deposition and is triggered by changes in bacillary load or drug therapy, and it is observed within the stated percentage range. *The lepromin test is usually negative or weakly positive.* - The lepromin test assesses **cell-mediated immunity** to *Mycobacterium leprae* antigens. - In lepromatous leprosy patients, there is a **deficient cell-mediated immune response**, making the lepromin test typically **negative**, indicating anergy.
Pharmacology
3 questionsWhat is the effect of adding epinephrine to lignocaine (a local anesthetic)?
Which of the following is the prototypical sympathomimetic agent with both alpha and beta-adrenergic activity?
Most commonly abused opioid -
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 951: What is the effect of adding epinephrine to lignocaine (a local anesthetic)?
- A. Increases distribution of local anesthetic
- B. Decreases absorption of local anesthetic (Correct Answer)
- C. Decreases duration of local anesthetic
- D. Increases metabolism of local anesthetic
Explanation: ***Decreases absorption of local anesthetic*** - Epinephrine causes **vasoconstriction** at the site of injection, which reduces the rate at which the local anesthetic is absorbed into the systemic circulation. - This slower absorption leads to a **higher concentration of the anesthetic** at the nerve fibers, prolonging its effect and reducing systemic toxicity. - This is the primary mechanism by which epinephrine enhances local anesthetic efficacy. *Increases distribution of local anesthetic* - The primary effect of epinephrine is to **localize the anesthetic** by reducing its systemic distribution. - This localization is achieved through **vasoconstriction**, which keeps the drug at the desired site rather than allowing it to distribute widely. *Decreases duration of local anesthetic* - By slowing absorption, epinephrine effectively **increases the duration of action** of the local anesthetic. - The anesthetic remains at the site of action for a longer period, providing **extended pain relief**. *Increases metabolism of local anesthetic* - Epinephrine does not directly affect the **metabolic rate** of local anesthetics. - The primary mechanism of metabolism for amides like lignocaine is in the **liver** by cytochrome P450 enzymes.
Question 952: Which of the following is the prototypical sympathomimetic agent with both alpha and beta-adrenergic activity?
- A. Epinephrine (Correct Answer)
- B. Isoproterenol
- C. Norepinephrine
- D. Dopamine
Explanation: ***Epinephrine*** - Epinephrine (adrenaline) is a potent direct-acting **sympathomimetic** that stimulates both **alpha and beta-adrenergic receptors**. - Its diverse effects on the cardiovascular, respiratory, and other systems make it the prototypical agent for demonstrating both receptor activities. *Norepinephrine* - While norepinephrine (noradrenaline) also acts on **alpha and beta-1 receptors**, its affinity for **beta-2 receptors** is significantly lower than epinephrine. - This results in a predominant effect on **vasoconstriction** and cardiac contractility rather than bronchodilation or peripheral vasodilation. *Isoproterenol* - Isoproterenol is a **non-selective beta-adrenergic agonist**, meaning it primarily stimulates **beta-1 and beta-2 receptors**. - It has minimal or no activity at **alpha-adrenergic receptors**, differentiating it from epinephrine's mixed activity. *Dopamine* - Dopamine's effects are **dose-dependent**; at low doses, it primarily stimulates **dopamine receptors** and at moderate doses, it activates **beta-1 receptors**. - At high doses, it can stimulate **alpha-adrenergic receptors**, but its primary and distinguishing characteristic is its agonism at **dopamine receptors**, which epinephrine does not share.
Question 953: Most commonly abused opioid -
- A. Morphine
- B. Diacetylmorphine (Correct Answer)
- C. Oxycodone
- D. Buprenorphine
Explanation: ***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**.
Psychiatry
1 questionsWhat term describes repetitive, intrusive thoughts that cause significant distress or anxiety?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 951: What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?
- A. Phobia
- B. Obsession (Correct Answer)
- C. Compulsion
- D. Anxiety
Explanation: ***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.
Radiology
1 questionsThe most appropriate first-line imaging modality to detect adrenal metastasis due to bronchogenic carcinoma is:
NEET-PG 2012 - Radiology NEET-PG Practice Questions and MCQs
Question 951: The most appropriate first-line imaging modality to detect adrenal metastasis due to bronchogenic carcinoma is:
- A. PET scan
- B. MRI of the abdomen
- C. Adrenal radionuclide scan
- D. Contrast Enhanced CT abdomen (Correct Answer)
Explanation: **Contrast Enhanced CT abdomen** - **Contrast-enhanced CT abdomen** is generally considered the most sensitive and cost-effective imaging modality for detecting **adrenal metastases**. - It allows for detailed visualization of adrenal gland morphology, including size, shape, and enhancement patterns, which can help differentiate benign from malignant lesions. *PET scan* - While **PET (Positron Emission Tomography) scans** are highly sensitive for detecting metabolically active metastatic disease, they are often used as a secondary imaging modality to characterize indeterminate lesions found on CT or MRI. - **PET scans** can have false positives in benign adrenal tumors (e.g., adenomas rich in fat) and are less readily available or higher in cost for initial screening compared to CT. *MRI of the abdomen* - **MRI of the abdomen** can be very useful for further characterization of adrenal masses, especially for distinguishing between lipid-rich adenomas and metastases. - However, for initial detection, especially in the context of screening for distant metastases from bronchogenic carcinoma, **CT is generally preferred due to its wider availability, speed, and lower cost**. *Adrenal radionuclide scan* - **Adrenal radionuclide scans** (e.g., using MIBG or iodocholesterol) are primarily used for functional imaging of adrenal glands, typically to detect specific types of tumors like pheochromocytomas or aldosteronomas. - These scans are **not sensitive for detecting adrenal metastases** from bronchogenic carcinoma, as the metastatic lesions do not typically exhibit the specific uptake patterns targeted by these radiotracers.