NEET-PG 2012 Practice Questions

Q: Which circuit is specifically designed for anaesthesia in infants?

Ayres t piece. ***Ayres t piece*** - The **Ayres t piece (Jackson-Rees modification)** lacks a reservoir bag, which reduces **dead space** and resistance, making it ideal for infants with low tidal volumes. - Its simple design and **low resistance** minimize the work of breathing, crucial for neonates and infants. *Bains circuit* - The Bains circuit is a **modified Mapleson D system** often used in older children and adults. - It features a concentric design with a fresh gas flow lumen inside the expiratory limb, making it suitable for moderate to high fresh gas flows but less ideal for the very low tidal volumes of infants. *Magill circuit* - The Magill circuit is a **Mapleson A system**, most efficient for **spontaneous ventilation** in adults, requiring low fresh gas flows. - Its design with the APL valve near the patient leads to significant rebreathing if used with controlled ventilation or in infants due to their small tidal volumes. *Water's circuit* - The Water's circuit (also known as the **Mapleson E or F system**) is primarily used as an open-system mask for **spontaneous respiration**, often for induction or emergency situations. - It provides minimal control over ventilation and is generally not preferred for precise anesthesia management in any age group, especially not infants.

Q: Who is known for demonstrating the levels of ether anesthesia?

Guedel. ***Guedel*** - Arthur Guedel developed and refined the **stages and planes of ether anesthesia** based on clinical observations of respiratory patterns, eye signs, and muscle tone. - His classification system, known as the **Guedel stages**, provided a systematic approach to monitoring anesthetic depth, especially useful before the advent of modern anesthetic agents and monitoring equipment. *Morton* - **William T.G. Morton** is credited with the first successful public demonstration of sulfuric ether as a surgical anesthetic in 1846 during a tooth extraction. - While he pioneered the use of ether for anesthesia, he did not develop the classic stages of anesthetic depth. *Thompson* - There is no widely recognized historical figure named Thompson who is primarily known for defining the **levels or stages of ether anesthesia**. - This name is not associated with the primary discovery or classification of anesthetic depth. *None of the options* - This option is incorrect because **Guedel** is specifically known for his work in defining the stages of ether anesthesia. - Guedel's contributions were significant in standardizing anesthetic practice for many years.

Q: In which of the following conditions is a Barr body absent in females?

45 X0 genome. ***45 X0 genome*** - A Barr body is a **condensed, inactivated X chromosome** found in somatic cells of females with at least two X chromosomes. - Individuals with a **45 X0 genome** (Turner Syndrome) have only one X chromosome, therefore no Barr body is formed. *46 XX genome* - Individuals with a **46 XX genome** are typical females and will have one Barr body per somatic cell, as one of the two X chromosomes is inactivated. - This is the normal female karyotype. *47 XXX* - Individuals with a **47 XXX genome** (triple X syndrome) have two Barr bodies per somatic cell, as two of their three X chromosomes are inactivated. - The number of Barr bodies is typically one less than the number of X chromosomes. *None of the options* - This option is incorrect because the 45 X0 genome indeed leads to the absence of a Barr body in females. - There is a specific condition listed among the options where a Barr body is absent.

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: Selenium deficiency is seen in -

Keshan disease. ***Keshan disease*** - **Keshan disease** is a form of **cardiomyopathy** caused by **selenium deficiency**, particularly prevalent in regions with selenium-poor soil. - It presents with **heart failure**, arrhythmias, and cardiac enlargement. *Wilson disease* - **Wilson disease** is a disorder of **copper metabolism**, leading to excessive copper accumulation in organs, primarily the liver and brain. - It is not related to selenium deficiency. *Acrodermatitis enteropathica* - **Acrodermatitis enteropathica** is a genetic disorder of **zinc deficiency**, characterized by dermatitis, diarrhea, and alopecia. - It does not involve selenium deficiency. *None of the options* - This option is incorrect because Keshan disease is directly linked to selenium deficiency.

Q: Loss of intercellular cohesion between keratinocytes is referred to as?

Acantholysis. ***Acantholysis*** - This term specifically refers to the **loss of cohesion between keratinocytes** in the epidermis due to the breakdown of desmosomal attachments. - It is a hallmark feature of several **blistering skin diseases**, such as pemphigus. *Acanthosis* - This refers to the **thickening of the stratum spinosum** (prickle cell layer) of the epidermis, often due to an increase in the number of keratinocytes. - It is seen in conditions like **psoriasis** and seborrheic keratosis, but does not involve a loss of intercellular cohesion. *Keratinolysis* - This term describes the **breakdown or dissolution of keratin**, which is the primary structural protein of the epidermis. - While keratinocytes produce keratin, keratinolysis itself is not the specific term for loss of cohesion between these cells. *Spongiosis* - This is defined as **intercellular edema** (fluid accumulation) within the epidermis, especially prominent in the stratum spinosum. - It leads to the widening of intercellular spaces and stretching of desmosomes, but the cells generally remain attached, unlike in acantholysis.

Q: What is the initial drug of choice for ovarian cancer?

Cisplatin. ***Cisplatin*** - **Cisplatin** is a platinum-based chemotherapy drug that forms DNA adducts, leading to apoptosis and is a **first-line agent** for ovarian cancer. - Historically, it was the platinum agent of choice and is typically used in combination with a taxane (e.g., **paclitaxel**) for initial treatment of advanced disease. - **Note:** In current practice, **carboplatin** has largely replaced cisplatin as the preferred platinum agent due to better tolerability, less nephrotoxicity and neurotoxicity, and easier administration, while maintaining equivalent efficacy. - Among the options listed, **cisplatin remains the correct answer** as it is the only platinum-based first-line agent. *Doxorubicin* - **Doxorubicin** is an **anthracycline antibiotic** used in various cancers but is **not a first-line drug** for ovarian cancer. - It may be used in recurrent or platinum-resistant disease. - Its use is limited due to potential **cardiotoxicity**. *Ifosfamide* - **Ifosfamide** is an **alkylating agent** that is generally reserved for **recurrent** or refractory ovarian cancer. - It is associated with **hemorrhagic cystitis** (preventable with mesna) and neurotoxicity. - Not part of standard first-line treatment. *Methotrexate* - **Methotrexate** is an **antimetabolite** primarily used in other cancers like choriocarcinoma and is **not a standard treatment** for epithelial ovarian cancer. - It works by inhibiting dihydrofolate reductase, disrupting DNA synthesis. - Has no role in first-line ovarian cancer treatment.

Q: Which muscle flap is commonly used for autologous breast reconstruction after mastectomy?

Latissimus dorsi. ***Latissimus dorsi*** - The **latissimus dorsi** muscle is commonly used in **autologous breast reconstruction** due to its rich blood supply and ample tissue volume which can be transferred as a **pedicled flap** to the chest. - This flap includes muscle, skin, and subcutaneous fat, providing a good aesthetic outcome for **breast mound reconstruction** after mastectomy. *Deltopectoral* - The **deltopectoral flap** is primarily used for **head and neck reconstruction**, specifically for oral cavity and pharyngeal defects. - It involves muscle and skin from the **chest and shoulder region**, but its size and location make it less suitable for comprehensive breast reconstruction. *Serratus anterior* - The **serratus anterior** muscle is occasionally used as a **free flap** for small soft tissue defects, but it is not typically the first choice for large-volume breast reconstruction. - Its primary role is in **shoulder movement** and it does not provide sufficient tissue bulk for a complete breast mound. *Trapezius* - The **trapezius flap** is more commonly employed in **head and neck reconstruction** or for covering defects in the posterior shoulder region. - While it offers a good blood supply, its bulk and orientation are not ideal for **breast reconstruction**, which requires a more anterior and hemispheric shape.

Q: Most common organism causing infection after an open fracture?

Staphylococcus aureus. ***Staphylococcus aureus*** - *Staphylococcus aureus* is the **most common organism** causing infection in **open fractures**, accounting for 30-40% of cases. - It is present on **skin flora** and readily contaminates traumatic wounds, making it the predominant pathogen in the immediate post-injury period. - **Antibiotic prophylaxis** for open fractures (cephalosporins) primarily targets *S. aureus*, reflecting its clinical importance. - It causes both **early and late infections** in open fractures and is the leading cause of **post-traumatic osteomyelitis**. *Pseudomonas* - *Pseudomonas aeruginosa* can cause infections in open fractures but is **not the most common** organism. - More frequently seen in **Type III open fractures** with extensive soft tissue damage, **nosocomial infections**, or **delayed infections** after hospitalization. - Associated with **contaminated water exposure** and **chronic wounds** rather than being the primary pathogen in acute open fractures. *Klebsiella* - *Klebsiella* species are typically associated with **nosocomial infections**, particularly **urinary tract infections** and **pneumonia**. - Rarely the primary pathogen in acute open fracture infections. - May be seen in **hospital-acquired** infections in patients with prolonged hospitalization. *Gonococcus* - **Gonococcus** (*Neisseria gonorrhoeae*) is primarily associated with **sexually transmitted infections** and can cause **septic arthritis** through hematogenous spread. - It does **not** cause infections in open fractures as it is not found in the environment or on skin. - The mode of transmission is completely unrelated to trauma or wound contamination.

Question 1

Which circuit is specifically designed for anaesthesia in infants?

Accepted Answer

Ayres t piece

Answer

Bains circuit

Answer

Magill circuit

Answer

Water's circuit

Question 2

Who is known for demonstrating the levels of ether anesthesia?

Accepted Answer

Guedel

Answer

Morton

Answer

Thompson

Answer

None of the options

Question 3

In which of the following conditions is a Barr body absent in females?

Accepted Answer

45 X0 genome

Answer

46 XX genome

Answer

47 XXX

Answer

None of the options

Question 4

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 5

Selenium deficiency is seen in -

Accepted Answer

Keshan disease

Answer

Wilson disease

Answer

Acrodermatitis enteropathica

Answer

None of the options

Question 6

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 7

Loss of intercellular cohesion between keratinocytes is referred to as?

Accepted Answer

Acantholysis

Answer

Acanthosis

Answer

Keratinolysis

Answer

Spongiosis

Question 8

What is the initial drug of choice for ovarian cancer?

Accepted Answer

Cisplatin

Answer

Doxorubicin

Answer

Ifosfamide

Answer

Methotrexate

Question 9

Which muscle flap is commonly used for autologous breast reconstruction after mastectomy?

Accepted Answer

Latissimus dorsi

Answer

Deltopectoral

Answer

Serratus anterior

Answer

Trapezius

Question 10

Most common organism causing infection after an open fracture?

Accepted Answer

Staphylococcus aureus

Answer

Klebsiella

Answer

Pseudomonas

Answer

Gonococcus

NEET-PG 2012

Anesthesiology

Biochemistry

Dermatology

Obstetrics and Gynecology

Surgery