Dermatology
6 questionsBrown macular pigmentation in malar area in a pregnant female is due to ?
Which of the following causes non-cicatricial alopecia?
Which of the following conditions does NOT cause nail pitting?
A 25-year-old patient presents with chronic itchy, erythematous skin lesions on the flexural areas that have been recurring since childhood. The patient has a family history of asthma. Which of the following is the most important diagnostic criterion for the most likely diagnosis?
Most common metal in contact allergic dermatitis is?
The Grattage test is used to diagnose which of the following conditions?
NEET-PG 2013 - Dermatology NEET-PG Practice Questions and MCQs
Question 1331: Brown macular pigmentation in malar area in a pregnant female is due to ?
- A. Chloasma (Correct Answer)
- B. Urticaric pigmentosa
- C. Acanthosis nigricans
- D. Acne rosacea
Explanation: ***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.
Question 1332: Which of the following causes non-cicatricial alopecia?
- A. Tinea capitis
- B. SLE
- C. Alopecia areata
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - **Tinea capitis**, **SLE** (Systemic Lupus Erythematosus), and **Alopecia areata** all can cause **non-cicatricial alopecia**. - **Non-cicatricial alopecia** refers to hair loss where the hair follicle is not permanently destroyed, and hair regrowth is possible, leaving no scarring. *Tinea capitis* - This is a **fungal infection** of the scalp that causes hair shafts to break, leading to patches of hair loss. - While it can lead to inflammation, it typically does not cause permanent destruction of the hair follicle unless severe and untreated, thus being predominantly **non-cicatricial**. *SLE* - Hair loss in **SLE** can occur due to various mechanisms, including diffuse thinning, patchy alopecia, or the characteristic "**lupus hair**" (fragile hairs around the hairline). - This type of hair loss is usually **non-scarring** and reversible, although discoid lupus erythematosus often causes scarring alopecia. *Alopecia areata* - This is an **autoimmune condition** characterized by patchy, sudden hair loss on the scalp or other body parts. - The hair follicles are attacked by the immune system but are not destroyed, making the condition largely **non-cicatricial** and potentially reversible.
Question 1333: Which of the following conditions does NOT cause nail pitting?
- A. Lichen planus
- B. Fungal infection
- C. Pityriasis Rosea (Correct Answer)
- D. Psoriasis
Explanation: ***Pityriasis Rosea*** - This condition primarily affects the **skin**, causing a distinctive rash of oval, pinkish-red patches, often preceded by a **herald patch**. - It characteristically spares the **nails**, meaning nail pitting is not a feature of pityriasis rosea. - Nail changes are not associated with this self-limiting dermatosis. *Lichen planus* - **Nail lichen planus** can cause various nail changes, including **pitting**, longitudinal ridging, pterygium formation, and thinning of the nail plate. - It is an inflammatory condition affecting the skin, hair, nails, and mucous membranes. - Nail involvement occurs in approximately 10% of patients with cutaneous lichen planus. *Psoriasis* - **Nail psoriasis** is common, affecting up to 50% of patients with psoriasis, and **pitting is the most characteristic nail finding**. - Pitting appears as small punctate depressions on the nail surface due to defects in the proximal nail matrix. - Other nail changes include onycholysis (oil drop sign), subungual hyperkeratosis, and salmon patches. *Fungal infection* - **Onychomycosis** (fungal nail infection) typically causes **thickening, discoloration, onycholysis, and crumbling** of the nail. - **True nail pitting is NOT a characteristic feature** of fungal infections, as pitting results from defects in the proximal nail matrix, not fungal invasion. - Fungal infections affect the nail plate and bed differently, causing destruction rather than the punctate depressions seen in pitting.
Question 1334: A 25-year-old patient presents with chronic itchy, erythematous skin lesions on the flexural areas that have been recurring since childhood. The patient has a family history of asthma. Which of the following is the most important diagnostic criterion for the most likely diagnosis?
- A. Personal or family history of atopy
- B. Elevated serum IgE levels
- C. Early age of onset (before 2 years)
- D. Chronic pruritic eczema with typical morphology and distribution (Correct Answer)
Explanation: ***Chronic pruritic eczema with typical morphology and distribution*** - The patient presents with **chronic**, **itchy**, **erythematous lesions** on the **flexural areas** (e.g., antecubital and popliteal fossae), characteristic of **atopic dermatitis** (eczema). - The **recurrence since childhood** and the typical distribution represent the **major diagnostic criteria** based on clinical morphology and distribution. - **Clinical presentation with typical morphology** is the **primary diagnostic criterion** according to Hanifin and Rajka criteria. *Elevated serum IgE levels* - While **elevated serum IgE** is often associated with atopic dermatitis, it is a **minor criterion** and a **laboratory finding**, not a primary diagnostic feature. - It reflects an **atopic predisposition**, but **clinical morphology and distribution** remain the most important diagnostic factors. *Personal or family history of atopy* - A **family history of asthma** (an atopic condition) is a **minor criterion** that supports the diagnosis of atopic dermatitis. - However, this is a **predisposing/supporting factor**, not as important as the characteristic clinical morphology and distribution. *Early age of onset (before 2 years)* - While atopic dermatitis often begins in **infancy or early childhood**, this is a **minor criterion** in the diagnostic framework. - The question states symptoms **recurring since childhood** but onset timing is less diagnostically important than the characteristic **clinical presentation** with typical morphology and distribution.
Question 1335: Most common metal in contact allergic dermatitis is?
- A. Gold
- B. Silver
- C. Aluminum
- D. Nickel (Correct Answer)
Explanation: ***Nickel*** - **Nickel** is the most frequent cause of **metal-induced contact allergic dermatitis**, affecting a significant portion of the population. - It is commonly found in jewelry, belt buckles, buttons, and other everyday metallic objects. *Gold* - **Gold allergy** can occur but is much less common than nickel allergy. - Reactions typically arise from jewelry and may involve **allergic contact dermatitis**. *Silver* - **Silver allergy** is quite rare and often due to impurities or alloys rather than pure silver itself. - Pure silver is generally considered **hypoallergenic**. *Aluminum* - **Aluminum** is generally not a common cause of **allergic contact dermatitis**. - While it can be an irritant in some products (e.g., antiperspirants), true allergic reactions are infrequent.
Question 1336: The Grattage test is used to diagnose which of the following conditions?
- A. Tinea capitis
- B. Lichen planus
- C. Pemphigus vulgaris
- D. Psoriasis (Correct Answer)
Explanation: ***Psoriasis*** - The **Grattage test** (candle grease sign) involves **scraping the psoriatic lesion** to reveal characteristic features - First reveals **fine, silvery-white scales** resembling candle wax - Further scraping exposes **pinpoint bleeding points** (**Auspitz sign**) due to exposure of dilated capillaries in dermal papillae - This combination is **pathognomonic for psoriasis** and helps differentiate it from other scaly dermatoses *Tinea capitis* - A **fungal infection of the scalp** caused by dermatophytes - Diagnosed by **KOH mount** (showing fungal hyphae), **fungal culture**, and sometimes **Wood's lamp examination** - The Grattage test is not used for diagnosing fungal infections *Lichen planus* - Characterized by **purplish, polygonal, flat-topped, pruritic papules and plaques** - Surface shows **Wickham's striae** (fine white lines) - Diagnosis is **clinical**, supported by **skin biopsy** showing band-like lymphocytic infiltrate and sawtooth rete ridges - The Grattage test is not applicable *Pemphigus vulgaris* - A severe **autoimmune blistering disorder** with **suprabasal acantholysis** - Presents with **flaccid bullae** that rupture easily, leaving erosions - Diagnosed by **skin biopsy**, **direct immunofluorescence** (intercellular IgG and C3 deposits), and **Nikolsky's sign** (positive) - The Grattage test is not used for bullous disorders
Internal Medicine
1 questionsA female patient presents with hirsutism, amenorrhea, and obesity. What is the most likely diagnosis?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1331: A female patient presents with hirsutism, amenorrhea, and obesity. What is the most likely diagnosis?
- A. Androgen-secreting ovarian tumor
- B. Congenital adrenal hyperplasia
- C. Cushing's syndrome
- D. Polycystic Ovary Syndrome (PCOS) (Correct Answer)
Explanation: ***Polycystic Ovary Syndrome (PCOS)*** - **Hirsutism**, **amenorrhea** (or oligomenorrhea), and **obesity** are classic clinical features of PCOS, reflecting hyperandrogenism and insulin resistance [2]. - PCOS is a diagnosis of exclusion and involves chronic anovulation and polycystic ovaries on ultrasound [3], though these are not explicitly mentioned, the constellation of symptoms strongly points to it. *Androgen-secreting ovarian tumor* - While it can cause **hirsutism** and **amenorrhea**, the onset is typically **rapid** and severe, with very high androgen levels, and obesity is not a primary feature. - Ovarian tumors are generally less common than PCOS and may present with a palpable mass or specific imaging findings. *Congenital adrenal hyperplasia* - This genetic condition often presents in childhood or adolescence with varying degrees of **virilization** and menstrual irregularities due to enzyme deficiencies in cortisol synthesis [1]. - While it causes **hirsutism** and potentially **amenorrhea**, obesity is not a direct consequence, and the patient's age of presentation and specific symptom pattern are less typical for adult-onset CAH in this context. *Cushing's syndrome* - Characterized by **central obesity**, **moon facies**, **buffalo hump**, **striae**, and proximal muscle weakness due to chronic glucocorticoid excess. - Although it can cause **menstrual irregularities** and mild **hirsutism** [2], the overall clinical picture including the absence of other specific Cushingoid features makes it less likely than PCOS.
Obstetrics and Gynecology
3 questionsA patient presents with a history of vaginal prolapse and a painful ulcer on the prolapsed tissue. What is the most likely diagnosis?
What is the most common presenting symptom of TB endometritis?
What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?
NEET-PG 2013 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1331: A patient presents with a history of vaginal prolapse and a painful ulcer on the prolapsed tissue. What is the most likely diagnosis?
- A. Carcinoma
- B. Pressure erosion
- C. Syphilis
- D. Decubitus ulcer (Correct Answer)
Explanation: ***Decubitus ulcer*** - A **decubitus ulcer** (pressure sore) is the most likely diagnosis when a patient with a **vaginal prolapse** develops a **painful ulcer** on the prolapsed tissue due to chronic pressure and friction. - The prolapsed tissue is often exposed to constant irritation and lack of proper blood supply, making it susceptible to ulceration. *Carcinoma* - While possible, carcinoma typically presents as a **non-healing lesion** with irregular borders and induration, and is often *not immediately painful* in its early stages. - A definitive diagnosis of carcinoma requires **biopsy and histopathological examination**. *Pressure erosion* - This term is a general description of tissue damage from pressure and can be a precursor to a decubitus ulcer, but **decubitus ulcer** specifically denotes the developed lesion. - It describes the *mechanism of injury* rather than the specific, fully formed ulcer. *Syphilis* - Syphilis causes a **chancre**, which is typically a *painless ulcer* with indurated borders. - It is a sexually transmitted infection, and while it could cause an ulcer, the context of a **vaginal prolapse** points more strongly to a localized pressure injury.
Question 1332: What is the most common presenting symptom of TB endometritis?
- A. Amenorrhoea
- B. Vaginal discharge
- C. Abdominal pain
- D. Infertility (Correct Answer)
Explanation: ***Infertility*** - **Infertility** is the most common presenting symptom of **tuberculosis (TB) endometritis**, particularly secondary infertility. - The infection leads to inflammation and scarring of the endometrium and fallopian tubes, impairing implantation and ovum transport. *Abdominal pain* - While **abdominal pain** can occur in TB endometritis, it is typically a less frequent or prominent presenting symptom compared to infertility. - Pain often arises from pelvic inflammation or adhesions but is not the cardinal complaint that prompts diagnosis. *Amenorrhoea* - **Amenorrhea** (absence of menstruation) can be a symptom, especially in advanced cases where there is significant destruction of the endometrium. - It is, however, less common than infertility as the initial presenting symptom. *Vaginal discharge* - **Vaginal discharge** is an uncommon symptom of TB endometritis. - When present, it is often non-specific and not characteristic enough to suggest TB as the underlying cause.
Question 1333: What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?
- A. 10mg
- B. 20mg
- C. 200mg (Correct Answer)
- D. 100mg
Explanation: ***200mg*** - The standard dose of **mifepristone** for medical termination of pregnancy (MTP) is **200mg orally**. - This dose is typically followed 24-48 hours later by a **prostaglandin analog** (e.g., misoprostol) to complete the termination process. *10mg* - This dose is significantly lower than the recommended therapeutic dose for medical abortion. - Such a low dose would likely be **ineffective** in achieving termination. *20 mg* - This dose is also much lower than the standard therapeutic recommendation. - It would not adequately block progesterone receptors to initiate the termination process effectively. *100mg* - While closer to the standard dose, 100mg is still considered **sub-therapeutic** for many individuals undergoing medical abortion. - A lower efficacy rate would be expected compared to the 200mg dose.