NEET-PG 2013 Practice Questions

Q: What is the PRIMARY application of capnography during patient monitoring?

Correct intubation. ***Correct intubation*** - Capnography is the **gold standard** for confirming **endotracheal tube (ETT) placement** by detecting carbon dioxide in exhaled breath. - A persistent waveform indicates the ETT is in the **trachea**, while absence suggests esophageal intubation. *Pulmonary embolism* - While capnography can show a **decrease in end-tidal CO2 (ETCO2)** due to increased dead space in pulmonary embolism, it is not its primary or most definitive diagnostic application. - Other diagnostic methods like CT pulmonary angiogram are preferred for confirming pulmonary embolism. *Adequate ventilation* - Capnography provides information about **ETCO2 levels**, which can indirectly reflect adequate ventilation by showing CO2 elimination. - However, it's more direct application is intubation confirmation, and other measures like **tidal volume** and **respiratory rate** are also crucial for assessing overall ventilation. *Significant metabolic change* - Capnography can show changes in CO2 production reflecting metabolic rate, such as in **hypermetabolic states** (e.g., fever, sepsis) or hypometabolic states. - While useful for monitoring trends, its primary role is not for diagnosing such changes but rather intubation confirmation.

Q: A 15cm hyperpigmented macule on an adolescent male undergoes changes such as coarseness, growth of hair & acne. Diagnosis is?

Becker nevus. ***Becker nevus*** - A Becker nevus is a **hyperpigmented patch** that typically appears during adolescence in males, often on the shoulder or upper trunk. - It characteristically becomes **hairy (hypertrichosis)**, more coarse, and can develop acne within the lesion, particularly during puberty due to androgen sensitivity. *Melanocytic nevus* - While melanocytic nevi are hyperpigmented, they generally do not show the characteristic changes of **coarseness, significant hair growth, or acne** within the lesion during adolescence. - They are typically stable in size and texture after initial development, with changes raising concern for **melanoma**. *Sebaceous nevus* - A sebaceous nevus is a **congenital lesion** often appearing as a yellowish-orange, waxy, or bumpy patch, usually on the scalp or face. - It does not typically present as a large, flat hyperpigmented macule that develops hair and acne in adolescence; instead, it may become verrucous or develop tumors in adulthood. *Sebaceous adenoma* - A sebaceous adenoma is a **benign tumor** of the sebaceous glands, usually appearing as a small, solitary, flesh-colored to yellowish papule or nodule, especially on the face. - It is not typically seen as a large, hyperpigmented macule that grows hair and acne over a broad area, as described in the question.

Q: What is the most likely diagnosis for a 15 mm hyperpigmented lesion on the shoulder that is enlarging and has hair growing from it?

Becker nevus. ***Correct: Becker nevus*** This diagnosis is supported by the description of a **hyperpigmented lesion** that is **enlarging** and has **hair growing from it**, typically appearing during adolescence or young adulthood. **Becker nevus** often presents as an **irregular, hyperpigmented patch**, usually on the shoulder or upper trunk, and is characteristically associated with **hypertrichosis** (increased terminal hair growth). The combination of location (shoulder), enlargement, and hair growth in a 15 mm lesion is classic for Becker nevus. *Incorrect: Melanocytic nevus* While **melanocytic nevi** are hyperpigmented, they typically do not continue to **enlarge significantly** after childhood and generally do not develop new onset **hypertrichosis** as a primary feature. The size (15 mm) and progressive growth combined with hair development are more characteristic of a Becker nevus than a common melanocytic nevus. *Incorrect: Sebaceous nevus* **Sebaceous nevi** are typically **yellow-orange to tan, waxy plaques**, often on the scalp or face, with a cobblestone or papillomatous texture. They are not primarily characterized by **hyperpigmentation** and terminal hair growth, but rather by sebaceous gland proliferation. *Incorrect: Comedo nevus* A **comedo nevus** presents as a linear or unilateral group of **dilated follicular openings** filled with keratinous material, resembling blackheads. It is not characterized by diffuse **hyperpigmentation** or the increased terminal hair growth described in this case.

Q: Brown macular pigmentation in malar area in a pregnant female is due to ?

Chloasma. ***Chloasma*** - **Chloasma**, also known as the **mask of pregnancy**, is characterized by **dark, irregular patches** of hyperpigmentation on the face, commonly in the malar areas. - It is caused by an increase in **estrogen and progesterone levels** during pregnancy, which stimulate melanin production. *Acanthosis nigricans* - This condition presents as **dark, velvety patches of skin**, typically in the body folds and creases, such as the neck, armpits, and groin. - It is often associated with **insulin resistance**, obesity, or underlying malignancies, not specifically pregnancy-induced facial pigmentation. *Urticaric pigmentosa* - This is a form of **mastocytosis** characterized by reddish-brown spots or patches that can **urticate (itch and swell)** when rubbed, a sign known as **Darier's sign**. - It results from an accumulation of **mast cells** in the skin and is not related to hormonal changes in pregnancy. *Acne rosacea* - **Acne rosacea** is a chronic inflammatory skin condition primarily affecting the face, causing **redness, flushing, visible blood vessels**, and sometimes bumps or pimples. - It is unrelated to hyperpigmentation and does not typically result in brown macular pigmentation.

Q: Intrauterine adhesions best seen by?

Hysteroscopy. ***Hysteroscopy*** - **Hysteroscopy** provides direct visualization of the uterine cavity, allowing for precise identification and characterization of **intrauterine adhesions (IUA)** or **Asherman's syndrome**. - It not only diagnoses IUAs but also allows for simultaneous treatment through **adhesiolysis**, making it the gold standard for both diagnosis and management. *Ultrasound* - While ultrasound can sometimes suggest the presence of adhesions through abnormal endometrial appearances or fluid collections, it is generally **not definitive** for diagnosing IUAs. - Its sensitivity is limited, especially for subtle or fine adhesions, and it often requires confirmation by other methods. *Computed Tomography* - **Computed Tomography (CT)** scans are generally **not used** for the diagnosis of intrauterine adhesions. - CT provides limited soft tissue contrast in the endometrial cavity and exposes the patient to **ionizing radiation**, without offering a clear advantage over other imaging modalities. *Magnetic Resonance Imaging* - **Magnetic Resonance Imaging (MRI)** can provide good soft tissue detail and may visualize severe adhesions, but it is **not as sensitive or specific** as hysteroscopy for detecting all types of IUAs. - MRI is more expensive and less accessible than hysteroscopy, and it does not allow for immediate therapeutic intervention.

Q: Hematuria in previous LSCS patient indicates -

Urinary tract infection. ***Urinary tract infection*** - Hematuria in a patient with a previous **LSCS** (Lower Segment Caesarean Section) is a common symptom of a **urinary tract infection (UTI)**, as pregnancy itself, and sometimes a previous C-section, can increase UTI risk. - While a previous LSCS might alter pelvic anatomy, a UTI is a more direct and common cause of hematuria in this scenario than other obstetrical complications. *Placenta previa* - **Placenta previa** primarily causes **painless vaginal bleeding** in the second or third trimester due to the placenta covering the cervical os, not hematuria directly from the urinary tract. - While bleeding might be significant, it originates from the uterus, not the bladder, and is typically bright red vaginal bleeding. *No significant findings* - **Hematuria** is a significant finding that warrants investigation, as it indicates blood in the urine and is never considered "no significant finding." - It could be a sign of various underlying conditions, ranging from benign to serious, necessitating evaluation. *Rupture uterus* - **Uterine rupture** is a catastrophic event in pregnancy, often presenting with **severe abdominal pain**, fetal distress, and significant **vaginal bleeding**, not isolated hematuria. - While it's a serious complication, the blood would primarily be from the uterus or internal hemorrhage, not directly in the urine.

Q: Radiological sign in case of Perthes disease?

Flattening of femoral head. ***Flattening of femoral head*** - **Flattening** and **fragmentation** of the femoral head are characteristic radiological findings in **early-stage** Perthes disease. - This flattening is a direct consequence of the **avascular necrosis** and subsequent **remodeling** of the femoral epiphysis. *Fragmentation of femoral head epiphysis* - While **fragmentation** is a key feature of Perthes disease, it's typically observed **after** the initial flattening and sclerosis in the avascular stage. - It represents the process of **resorption** and **revascularization** as the bone attempts to heal. *Lateral femoral head displacement* - **Lateral displacement** of the femoral head is a more common finding in conditions like **slipped capital femoral epiphysis (SCFE)**, where the epiphysis slips from the metaphysis. - In Perthes disease, the primary issue is the **necrosis and collapse** of the femoral head itself, rather than displacement from the neck. *Limited hip abduction* - **Limited hip abduction** is a clinical sign, not a radiological sign, and it is a common symptom in Perthes disease due to pain, inflammation, and deformity of the femoral head. - Radiological signs are visual abnormalities observed on imaging studies like X-rays.

Q: Which of the following is not a characteristic feature of personality disorders?

Ego dystonic symptoms. ***Ego dystonic symptoms*** - Personality disorders are characterized by **ego-syntonic** traits, meaning the individual perceives their thoughts, feelings, and behaviors as consistent with their self-image and acceptable. - **Ego-dystonic symptoms**, conversely, are experienced as alien, inconsistent with one's self-concept, and distressing (e.g., in OCD or major depressive disorder), which is **definitively NOT** a feature of personality disorders. - This is the key distinguishing feature: personality disorder traits are not perceived as problematic by the individual themselves (ego-syntonic), unlike neurotic disorders. *Starts in childhood.* - While personality traits and vulnerabilities may emerge in childhood, **formal diagnosis** of personality disorders is made in **late adolescence or early adulthood** (typically after age 18). - Per DSM-5 and ICD-11, the enduring pattern must be evident by early adulthood. - However, this option is less definitive as some underlying patterns do appear earlier, making "ego dystonic" the better answer. *Behavior is maladaptive.* - A **core diagnostic feature** of personality disorders is a pervasive pattern of **maladaptive behaviors** and inner experiences that deviate from cultural expectations. - These behaviors lead to distress, impairment in social, occupational, or other important areas of functioning. - This IS characteristic of personality disorders. *Disorder results in personal distress.* - Despite ego-syntonic symptoms, individuals with personality disorders frequently experience **significant personal distress**, often arising from consequences of their behaviors, interpersonal conflicts, or functional impairment. - This distress IS characteristic, though it may be indirect rather than from the symptoms themselves. - This IS a feature of personality disorders.

Q: What is the age range associated with the concrete operational stage in Piaget's theory of cognitive development?

7-11 years. ***7-11 years*** - This age range aligns with Piaget's **concrete operational stage**, during which children develop **logical thinking** about concrete events. - They begin to understand **conservation**, classification, and seriation. *2-6 years* - This range corresponds to the **preoperational stage**, characterized by **egocentrism** and reliance on intuition rather than logical reasoning. - Children in this stage have not yet mastered the concept of conservation. *5-10 years* - While it partially overlaps, this range is not the precise and commonly accepted period for the **concrete operational stage** in Piaget's theory. - The upper limit of 10 years excludes the latter portion of this cognitive stage. *10-15 years* - This age range predominantly represents the **formal operational stage**, where adolescents develop the ability for **abstract thought**, hypothetical reasoning, and systematic problem-solving. - This thinking is more advanced than the concrete operations.

Q: Barium swallow is used for -

Esophagus. ***Esophagus*** - A **barium swallow** specifically visualizes the **esophagus**, pharynx, and sometimes the early stomach. - It's used to identify abnormalities like **dysphagia**, strictures, **achalasia**, or tumors by coating the mucosal lining. *Colon* - The colon is typically examined using a **barium enema**, where barium sulfate is administered rectally. - This procedure is effective for visualizing the large intestine for conditions like **polyps**, diverticula, or inflammatory bowel disease. *Duodenum* - While a barium swallow may transiently show the **duodenum**, its primary target is the esophagus and stomach. - More detailed imaging of the duodenum often requires an **upper GI series (UGI)**, which is a broader study of the upper digestive tract. *Jejunum* - The jejunum is part of the small intestine and is best visualized through a **small bowel follow-through (SBFT)** procedure. - This involves ingesting barium and taking serial X-rays as it progresses through the small bowel, to detect conditions like **Crohn's disease** or obstructions.

Question 1

What is the PRIMARY application of capnography during patient monitoring?

Accepted Answer

Correct intubation

Answer

Pulmonary embolism

Answer

Adequate ventilation

Answer

Significant metabolic change

Question 2

A 15cm hyperpigmented macule on an adolescent male undergoes changes such as coarseness, growth of hair & acne. Diagnosis is?

Accepted Answer

Becker nevus

Answer

Melanocytic nevus

Answer

Sebaceous nevus

Answer

Sebaceous adenoma

Question 3

What is the most likely diagnosis for a 15 mm hyperpigmented lesion on the shoulder that is enlarging and has hair growing from it?

Accepted Answer

Becker nevus

Answer

Melanocytic nevus

Answer

Sebaceous nevus

Answer

Comedo nevus

Question 4

Brown macular pigmentation in malar area in a pregnant female is due to ?

Accepted Answer

Chloasma

Answer

Urticaric pigmentosa

Answer

Acanthosis nigricans

Answer

Acne rosacea

Question 5

Intrauterine adhesions best seen by?

Accepted Answer

Hysteroscopy

Answer

Ultrasound

Answer

Computed Tomography

Answer

Magnetic Resonance Imaging

Question 6

Hematuria in previous LSCS patient indicates -

Accepted Answer

Urinary tract infection

Answer

Placenta previa

Answer

No significant findings

Answer

Rupture uterus

Question 7

Radiological sign in case of Perthes disease?

Accepted Answer

Flattening of femoral head

Answer

Fragmentation of femoral head epiphysis

Answer

Lateral femoral head displacement

Answer

Limited hip abduction

Question 8

Which of the following is not a characteristic feature of personality disorders?

Accepted Answer

Ego dystonic symptoms

Answer

Starts in childhood.

Answer

Behavior is maladaptive.

Answer

Disorder results in personal distress.

Question 9

What is the age range associated with the concrete operational stage in Piaget's theory of cognitive development?

Accepted Answer

7-11 years

Answer

2-6 years

Answer

5-10 years

Answer

10-15 years

Question 10

Barium swallow is used for -

Accepted Answer

Esophagus

Answer

Colon

Answer

Duodenum

Answer

Jejunum

NEET-PG 2013

Anesthesiology

Dermatology

Obstetrics and Gynecology

Orthopaedics

Psychiatry

Radiology