Which of the following is NOT a symptom of mild dehydration?
Which of the following statements about polio is false?
If a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
Site for injection of cell culture rabies vaccine-
Which of the following symptoms is commonly associated with giardiasis?
Which of the following is true about Hepatitis A virus?
Waterhouse-Friderichsen syndrome is seen in:
Most common site for hydatid cyst
Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?
Who coined the term 'cafe coronary'?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 41: Which of the following is NOT a symptom of mild dehydration?
- A. Thirst
- B. Restlessness
- C. Dry tongue
- D. Normal BP (Correct Answer)
Explanation: ***Normal BP*** - In **mild dehydration**, the body's compensatory mechanisms, such as increased heart rate and vasoconstriction, typically manage to maintain a **normal blood pressure**. [1] - A significant drop in **blood pressure** (hypotension) is usually indicative of **moderate to severe dehydration**, where these compensatory mechanisms begin to fail. [2] *Thirst* - **Thirst** is one of the **earliest and most reliable** indicators of dehydration, as the body signals a need for fluid intake. [3] - It arises in response to increased plasma osmolality and decreased blood volume, both occurring even in **mild dehydration**. [3] *Restlessness* - **Restlessness** can be an early sign of discomfort and altered mental status associated with **mild dehydration**, particularly in infants and young children. - As the body struggles to maintain fluid balance, individuals may experience irritability and general unease. *Dry tongue* - A **dry tongue** and **dry sticky mucous membranes** are common signs of mild to moderate dehydration. - This symptom results from reduced salivary production due to decreased fluid volume in the body.
Question 42: Which of the following statements about polio is false?
- A. 99% non paralytic
- B. Aseptic meningitis
- C. Flaccid paralysis
- D. Increased tendon reflexes (Correct Answer)
Explanation: ***Increased tendon reflexes*** - Polio causes **lower motor neuron damage**, specifically to the anterior horn cells of the spinal cord [1]. - This damage leads to **flaccid paralysis** and **decreased or absent deep tendon reflexes**, not increased reflexes [3]. *99% non paralytic* - The vast majority of poliovirus infections (approximately 95-99%) are **asymptomatic** or cause only mild, non-specific symptoms. - Only a small percentage of infected individuals develop the more severe paralytic form of the disease. *Flaccid paralysis* - Poliovirus directly attacks and destroys **motor neurons** in the anterior horn of the spinal cord [1]. - This damage results in **muscle weakness** and loss of muscle tone, leading to **flaccid paralysis** [3]. *Aseptic meningitis* - About 1-5% of poliovirus infections can manifest as **aseptic meningitis**, characterized by symptoms like fever, headache, neck stiffness, and vomiting without bacterial infection [2]. - This form of meningitis is typically **self-limiting** and does not lead to paralysis [2].
Question 43: If a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
- A. Grade 0
- B. Grade I
- C. Grade II (Correct Answer)
- D. Grade III
Explanation: A **claw hand** deformity, characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, indicates a significant and **visible disability** but the affected part is still functional to a limited degree. In the context of leprosy, this observable and permanent deformity falls under **Grade II** on the WHO disability grading scale, signifying a clear and established disability. This grade indicates **no disability** or deformity related to leprosy. A patient with a claw hand has an obvious physical deformity and functional impairment, thus not fitting this classification. This grade refers to a **detectable impairment** but **no visible deformity**. A claw hand is a clearly visible deformity, making Grade I an inappropriate classification. While Grades are typically 0, I, and II in the WHO disability grading for leprosy, some classifications might refer to severe, non-functional deformities as higher grades. However, Grade II adequately captures **visible and significant deformities** like a claw hand, and a Grade III is not a standard or commonly used classification for a claw hand in leprosy in the WHO system.
Question 44: Site for injection of cell culture rabies vaccine-
- A. Gluteus
- B. Subcutaneous
- C. Deltoid (Correct Answer)
- D. Anterior abdominal wall
Explanation: Deltoid - The **deltoid muscle** is the recommended site for intramuscular injection of cell culture rabies vaccine due to its size and accessibility [1]. - Intramuscular administration in this area ensures optimal vaccine absorption and immunogenicity [1]. Gluteus - The **gluteus muscle** is not the preferred site for rabies vaccine due to the risk of injecting into fat, which can lead to reduced immune response [1]. - Additionally, there is a higher risk of **sciatic nerve injury** with gluteal injections. Subcutaneous - **Subcutaneous administration** is not the standard route for cell culture rabies vaccines as it can lead to slower absorption and potentially a less robust immune response. - This route is typically reserved for specific vaccine types or in situations where intramuscular injection is contraindicated. Anterior abdominal wall - The **anterior abdominal wall** is an unsuitable site for intramuscular injection of rabies vaccine. - This area is primarily used for **subcutaneous injections** (e.g., insulin) and lacks sufficient muscle mass for effective intramuscular vaccine delivery.
Question 45: Which of the following symptoms is commonly associated with giardiasis?
- A. Steatorrhea and flatulence (Correct Answer)
- B. All of the options
- C. Nausea and vomiting
- D. Abdominal pain
Explanation: ***Steatorrhea and flatulence*** - **Giardiasis** is an intestinal infection caused by the parasite *Giardia lamblia*, leading to malabsorption and characteristic symptoms [1]. - The parasite attaches to the intestinal lining, interfering with fat absorption, which results in **steatorrhea** (fatty, foul-smelling stools) and increased gas production causing **flatulence** [1]. *Nausea and vomiting* - While **nausea** can occur in giardiasis, **vomiting** is less common as a primary or dominant symptom. - These symptoms are more characteristic of other gastrointestinal infections like **viral gastroenteritis**. *Abdominal pain* - **Abdominal pain** is a general symptom that can occur with many gastrointestinal issues, including giardiasis [1]. - However, it's not as specific or as clinically defining for giardiasis as **steatorrhea** and **flatulence**, which are direct consequences of the parasite's impact on fat absorption. *All of the options* - Although some patients with giardiasis may experience nausea and abdominal pain, **steatorrhea** and **flatulence** are the most direct and specific indicators of the malabsorption caused by *Giardia lamblia* [1]. - Choosing "all of the above" would imply that all listed symptoms are equally common and specific, which is not the case for giardiasis.
Question 46: Which of the following is true about Hepatitis A virus?
- A. Causes chronic hepatitis
- B. Helps HDV replication
- C. Causes cirrhosis
- D. Common cause of hepatitis in children (Correct Answer)
Explanation: ***Common cause of hepatitis in children*** - **Hepatitis A virus (HAV)** infection is often acquired in childhood, particularly in areas with poor sanitation, and many infections are **asymptomatic** or mild in children [1]. - Due to their developing immune systems and often exposure in daycare or school settings, children are a highly susceptible population for HAV transmission [1]. *Causes cirrhosis* - **HAV infection** is an **acute self-limiting illness** and typically does not lead to chronic liver disease or cirrhosis [1]. - **Cirrhosis** is primarily associated with chronic viral hepatitis (e.g., HBV, HCV), alcohol-related liver disease, or certain autoimmune conditions. *Helps HDV replication* - **Hepatitis D virus (HDV)** is a **defective virus** that requires the presence of **Hepatitis B virus (HBV)** surface antigen (HBsAg) for its replication and assembly [1]. - **HAV** has no role in the replication or pathogenesis of **HDV** [1]. *Causes chronic hepatitis* - **HAV infection** results in an **acute inflammatory response** in the liver that resolves spontaneously in most cases [1]. - Unlike **HBV** and **HCV**, **HAV** does not establish a persistent infection and, therefore, does not cause chronic hepatitis [1].
Question 47: Waterhouse-Friderichsen syndrome is seen in:
- A. Neisseria meningitidis (Correct Answer)
- B. Yersinia
- C. Pseudomonas
- D. Pneumococci
Explanation: ***Neisseria meningitidis*** - **Waterhouse-Friderichsen syndrome** is a severe complication of **meningococcal sepsis**, predominantly caused by *Neisseria meningitidis* [1]. - It is characterized by **adrenal gland hemorrhage**, leading to acute adrenal insufficiency, hemorrhagic skin rash, and shock [1]. *Pseudomonas* - While *Pseudomonas aeruginosa* can cause severe infections, including sepsis, it is **not typically associated** with Waterhouse-Friderichsen syndrome. - *Pseudomonas* infections often lead to **ecthyma gangrenosum** in immunocompromised patients, a different dermatological manifestation. *Yersinia* - *Yersinia* species can cause various infections, such as **yersiniosis** (gastroenteritis) and **plague** (*Yersinia pestis*). - These infections do not commonly present with the distinct features of **adrenal hemorrhage** and **fulminant sepsis** seen in Waterhouse-Friderichsen syndrome. *Pneumococci* - *Streptococcus pneumoniae* (**pneumococci**) is a common cause of **meningitis** and **sepsis**, especially in children and the elderly. - Although it can lead to severe bloodstream infections, it is **rarely specifically linked** to the adrenal hemorrhage syndrome known as Waterhouse-Friderichsen syndrome.
Question 48: Most common site for hydatid cyst
- A. Lung
- B. Liver (Correct Answer)
- C. Brain
- D. Kidney
Explanation: ***Liver*** - The **liver** is the most common site for hydatid cysts, accounting for approximately **60-70%** of cases [1]. - It often leads to **biliary obstruction** and liver dysfunction, highlighting its impact on the organ. *Kidney* - Hydatid cysts in the **kidney** are rare and account for a small percentage of cases (around **2-5%**). - Symptoms are often nonspecific, including **flank pain** or hematuria, which are not primary concerns. *Brain* - While the **brain** can be affected, it is not a common site; CNS involvement occurs in only **1-2%** of hydatid disease cases. - Symptoms are related to increased intracranial pressure or focal neurological deficits, not typical for hydatid cysts. *Lung* - The **lung** is another site for hydatid cysts but accounts for about **10-20%** of cases. - Presentation may include **cough** and chest pain, making it less common compared to liver involvement.
Question 49: Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?
- A. Deep-seated
- B. Pleomorphic (Correct Answer)
- C. Centrifugal
- D. Multilocular
Explanation: ***Pleomorphic*** - The rash of **chickenpox** is **pleomorphic**, meaning lesions at various stages of development (macules, papules, vesicles, scabs) are present simultaneously in the same body area. - In contrast, a **smallpox** rash is **monomorphic**, with all lesions in a given area appearing at the same stage of development. *Centrifugal* - A **centrifugal distribution** (lesions more concentrated on the face and extremities) is characteristic of **smallpox**. - **Chickenpox** typically has a **centripetal distribution**, with lesions more concentrated on the trunk. *Deep-seated* - **Smallpox** lesions are described as **deep-seated** and feel like "shot under the skin," often associated with significant scarring. - **Chickenpox** lesions are superficial and less likely to cause scarring unless secondarily infected. *Multilocular* - **Smallpox** vesicles and pustules are typically **multilocular**, meaning they have internal septations and do not collapse when punctured. - **Chickenpox** vesicles are unilocular, appearing as a single compartment, and collapse when punctured.
Question 50: Who coined the term 'cafe coronary'?
- A. Roger Haugen (Correct Answer)
- B. J. Morton
- C. Neil Markson
- D. M. Hoppefield
Explanation: ***Roger Haugen*** - Dr. Roger Haugen is widely credited with coining the term "**cafe coronary**" in 1966. - He described cases of sudden death during meals that mimicked myocardial infarction but were caused by **choking on food** [1]. *J. Morton* - While J. Morton was a physician and made contributions to medical literature, he is **not associated** with coining the term "cafe coronary." - His work focused on other areas of medicine, not specifically on choking incidents. *Neil Markson* - Neil Markson is **not recognized** in medical history for coining the term "cafe coronary." - This name does not commonly appear in the context of the history of this medical term. *M. Hoppefield* - M. Hoppefield is **not attributed** to coining the term "cafe coronary." - There is no historical information linking this individual to the origin of this specific medical phrase.