NEET-PG 2013 - Internal Medicine Practice Questions

Q: What is the BMI range that defines preobesity?

25-29.9. ***25-29.9*** - A **Body Mass Index (BMI)** between 25 and 29.9 kg/m² is classified as **overweight** [1] or **preobesity**. - This range indicates an increased risk of developing various health problems associated with higher body weight [1]. *18.5-24.9* - This BMI range is considered **normal weight**, which is generally ideal for health [1]. - Individuals within this range typically have the lowest risk of weight-related health complications [1]. *30-34.9* - A BMI in this range is classified as **obesity class I** [1]. - This category indicates a significantly increased risk of developing co-morbidities such as type 2 diabetes and cardiovascular disease [1]. *35-39.9* - This BMI range represents **obesity class II** (severe obesity) [1]. - Individuals in this category face a high risk of serious health issues and often require more aggressive intervention strategies [1].

Q: Which of the following symptoms is commonly associated with giardiasis?

Steatorrhea and flatulence. ***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.

Q: Most common site for hydatid cyst

Liver. ***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.

Q: Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?

Pleomorphic. ***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.

Q: Which of the following statements about polio is false?

Increased tendon reflexes. ***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].

Q: Which of the following is NOT a symptom of mild dehydration?

Normal BP. ***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.

Q: Site for injection of cell culture rabies vaccine-

Deltoid. 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.

Q: Which of the following conditions is least commonly associated with Pneumocystis carinii in AIDS?

Otic polypoid mass. ***Otic polypoid mass*** - While *Pneumocystis jirovecii* (formerly *carinii*) can cause **extrapulmonary disease** in immunocompromised patients, an **otic polypoid mass** is an extremely rare and atypical presentation. - Extrapulmonary manifestations usually involve organs with rich vascular supply, but ear involvement in this form is not a characteristic feature. *Pneumonia* - **Pneumocystis pneumonia (PCP)** is the **most common opportunistic infection** and AIDS-defining illness caused by *Pneumocystis jirovecii* in individuals with AIDS [1]. - It typically manifests as **fever, cough, and dyspnea** with characteristic imaging findings [1]. *Ophthalmic choroid lesion* - **Choroid lesions** due to *Pneumocystis jirovecii* are a recognized, albeit less common, **extrapulmonary manifestation** in immunocompromised patients, particularly those with AIDS. - These lesions are usually **asymptomatic** and discovered incidentally on funduscopic examination. *Meningitis* - Although *Pneumocystis jirovecii* causing **meningitis** is rare, it has been reported in severely immunocompromised individuals with AIDS, often as part of disseminated disease. - Central nervous system involvement signifies **widespread dissemination** and advanced immunosuppression.

Q: Waterhouse-Friderichsen syndrome is seen in:

Neisseria meningitidis. ***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.

Q: Which of the following is true about Hepatitis A virus?

Common cause of hepatitis in children. ***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 1

What is the BMI range that defines preobesity?

Accepted Answer

25-29.9

Answer

18.5-24.9

Answer

30-34.9

Answer

35-39.9

Question 2

Which of the following symptoms is commonly associated with giardiasis?

Accepted Answer

Steatorrhea and flatulence

Answer

All of the options

Answer

Nausea and vomiting

Answer

Abdominal pain

Question 3

Most common site for hydatid cyst

Accepted Answer

Liver

Answer

Lung

Answer

Brain

Answer

Kidney

Question 4

Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?

Accepted Answer

Pleomorphic

Answer

Deep-seated

Answer

Centrifugal

Answer

Multilocular

Question 5

Which of the following statements about polio is false?

Accepted Answer

Increased tendon reflexes

Answer

99% non paralytic

Answer

Aseptic meningitis

Answer

Flaccid paralysis

Question 6

Which of the following is NOT a symptom of mild dehydration?

Accepted Answer

Normal BP

Answer

Thirst

Answer

Restlessness

Answer

Dry tongue

Question 7

Site for injection of cell culture rabies vaccine-

Accepted Answer

Deltoid

Answer

Gluteus

Answer

Subcutaneous

Answer

Anterior abdominal wall

Question 8

Which of the following conditions is least commonly associated with Pneumocystis carinii in AIDS?

Accepted Answer

Otic polypoid mass

Answer

Meningitis

Answer

Pneumonia

Answer

Ophthalmic choroid lesion

Question 9

Waterhouse-Friderichsen syndrome is seen in:

Accepted Answer

Neisseria meningitidis

Answer

Yersinia

Answer

Pseudomonas

Answer

Pneumococci

Question 10

Which of the following is true about Hepatitis A virus?

Accepted Answer

Common cause of hepatitis in children

Answer

Causes chronic hepatitis

Answer

Helps HDV replication

Answer

Causes cirrhosis

NEET-PG 2013 — Internal Medicine