NEET-PG 2013 Practice Questions

Q: Most common metal in contact allergic dermatitis is?

Nickel. ***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.

Q: Which type of ultraviolet radiation causes the most skin disorders?

UV-B. ***UV-B*** - **UV-B radiation** is a major cause of **sunburn** and directly damages DNA, leading to most **skin cancers** (basal cell carcinoma, squamous cell carcinoma, and melanoma). - It plays a significant role in photoaging and the development of most **skin disorders** related to sun exposure. *UV-A* - **UV-A radiation** penetrates deeper into the skin than UV-B and is primarily associated with **photoaging**, producing wrinkles and fine lines. - While it contributes to skin cancer development, its direct role in DNA damage and sunburn is less than that of UV-B. *UV-C* - **UV-C radiation** is the most damaging type of UV light, but it is almost entirely **absorbed by the Earth's ozone layer** and does not reach the Earth's surface. - Therefore, it does not typically cause skin disorders in humans under natural conditions. *None of the options* - This option is incorrect because **UV-B radiation** is well-established as a primary cause of numerous skin disorders, including most skin cancers and sunburn.

Q: Acute PID, the most common route of spread?

Ascending infection. ***Ascending infection*** - **Pelvic Inflammatory Disease (PID)** most commonly occurs when microorganisms from the **lower genital tract (vagina, cervix)** ascend into the upper genital tract (uterus, fallopian tubes, ovaries). - This upward spread leads to infection and inflammation of the endometrium (endometritis), fallopian tubes (salpingitis), and ovaries (oophoritis). *Descending* - A descending route of infection implies spread from an organ superior to the pelvis, which is not the typical mechanism for acute PID. - While infections can sometimes spread from adjacent structures, direct downward spread from non-genital organs is rare for primary PID. *Lymphatics* - While lymphatic spread can occur in some infections, it is not the primary or most common route for the initial onset of acute PID. - Lymphatic spread is more commonly associated with chronic or severe infections, or specific types of pelvic infections like tuberculosis. *Hematogenous* - Hematogenous spread involves pathogens traveling through the bloodstream to reach the pelvic organs. - This route is less common for typical acute PID but can be seen in cases of systemic infections or specific sexually transmitted infections like tuberculosis.

Q: In which part of the fallopian tube is there a high chance of rupture in a tubal pregnancy?

Isthmus. ***Isthmus*** - The **isthmus** is the narrowest and most muscular part of the fallopian tube. Due to its limited ability to stretch, an ectopic pregnancy here is highly prone to rupture **earlier** than in other segments (typically 6-8 weeks). - The **isthmic portion's** small lumen and thick muscular wall make rupture a rapid and common complication, often before significant fetal growth, giving it the **highest chance of rupture** when an ectopic pregnancy implants there. *Ampulla* - The **ampulla** is the most common site for ectopic pregnancies (approximately 70%) due to its wider lumen and being the usual site of fertilization. - However, rupture in the ampulla tends to occur **later** than in the isthmus (8-12 weeks) as it can accommodate the growing embryo for a longer period due to its greater distensibility. - While more ectopic pregnancies occur here in absolute numbers, each individual ampullary pregnancy has a **lower chance of rupture** compared to isthmic pregnancies. *Interstitial* - The **interstitial** (or cornual) part is the segment within the uterine wall, making it a rare site for ectopic pregnancies (2-4%). - Ruptures in the interstitial portion occur **latest** (12-16 weeks) but are often the most dangerous, leading to severe hemorrhage due to the surrounding vascularity of the uterus and proximity to uterine and ovarian arteries. *Fimbrial* - The **fimbrial** end is the portion closest to the ovary and is exceedingly rare for ectopic implantation. - Implantation near the fimbriae usually leads to an **"abdominal pregnancy"** if the embryo is extruded, or could result in early "tubal abortion" rather than a true rupture.

Q: What is the most common presenting feature of a complete mole?

Bleeding per vaginum. ***Bleeding per vaginum (Correct)*** - **Vaginal bleeding** in the first or early second trimester is the **most common presenting symptom** of a complete hydatidiform mole, occurring in approximately 80-90% of cases - This bleeding can vary in amount and color, often described as **prune juice-like** discharge with passage of grape-like vesicles in some cases - Typically presents between **6-16 weeks of gestation** as the most frequent initial clinical sign *Vomiting (Incorrect)* - While nausea and vomiting are common in normal pregnancies, this is **not the most common presenting feature** of a complete mole - Vomiting may occur but is less specific and typically occurs after or in conjunction with vaginal bleeding - When severe, it manifests as hyperemesis gravidarum (a separate entity) *Hyperemesis gravidarum (Incorrect)* - This condition, characterized by **severe, persistent nausea and vomiting**, is more prevalent in molar pregnancies due to **excessively high hCG levels** - Occurs in approximately **25-30% of complete moles**, making it a significant but not the most common presentation - It is a **consequence** of the molar pregnancy, often presenting **after** initial bleeding, and is not the most frequent first clinical sign *Amenorrhoea (Incorrect)* - **Amenorrhoea** (absence of menstruation) is a **universal symptom** of any pregnancy, including a molar pregnancy - While it indicates conception, it does **not differentiate** a molar pregnancy from a normal pregnancy or other causes of amenorrhoea - Therefore, it is not the most specific or common **presenting feature** that would lead to diagnosis of a molar pregnancy

Q: What is the most likely neurochemical change associated with schizophrenia?

Increased dopaminergic activity. ***Increased dopaminergic activity*** - The **dopamine hypothesis** of schizophrenia posits that the positive symptoms (hallucinations, delusions) are mainly due to **hyperactivity of dopamine D2 receptors** in the mesolimbic pathway. - Most **antipsychotic medications** work by blocking these D2 receptors, reducing dopaminergic transmission and alleviating symptoms. *Increased GABA activity* - **GABA (gamma-aminobutyric acid)** is the primary inhibitory neurotransmitter in the brain; *decreased* GABAergic activity has been implicated in schizophrenia, not increased. - A reduction in GABAergic interneurons can lead to **disinhibition** and contribute to cognitive deficits and positive symptoms. *Decreased dopaminergic activity* - While *decreased* dopamine activity in the **mesocortical pathway** (leading to the prefrontal cortex) is associated with the negative symptoms (e.g., avolition, anhedonia) and cognitive deficits of schizophrenia, the *primary* neurochemical change linked to the characteristic psychotic symptoms is an *increase* in mesolimbic dopamine. - Therefore, considering the overall presentation, **increased dopamine** is the most likely and direct answer. *Decreased norepinephrine activity* - Although **norepinephrine dysregulation** has been observed in schizophrenia, it is not considered the primary neurochemical change. - Changes in norepinephrine are often secondary or contribute to specific symptom clusters like **attention deficits** or mood disturbances rather than the core psychotic features.

Q: What is considered the most effective treatment for Borderline Personality Disorder?

Dialectical Behaviour Therapy (DBT). ***Dialectical Behaviour Therapy (DBT)*** - **DBT** is the **gold standard** and most evidence-based psychotherapy specifically developed for Borderline Personality Disorder - Developed by **Marsha Linehan** specifically to target the core symptoms of BPD including emotional dysregulation, impulsivity, and interpersonal difficulties - Combines **cognitive-behavioral techniques** with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills - Has the **strongest research evidence** for reducing suicidal behavior, self-harm, and improving overall functioning in BPD patients - Multiple RCTs demonstrate DBT's superiority in treating BPD compared to standard care *Cognitive Behavioural Therapy (CBT)* - While **CBT** is effective for many mental health conditions and can help with certain BPD symptoms, it was not specifically designed for BPD - DBT is actually a specialized adaptation of CBT tailored for BPD, making it more targeted and effective for this specific condition - Generic CBT may help with co-occurring conditions like depression or anxiety but lacks the comprehensive approach needed for core BPD features *Combination of DBT and pharmacotherapy* - This combination is clinically useful, especially when treating **co-morbid conditions** like depression, anxiety, or severe mood instability - However, psychotherapy (particularly DBT) remains the **cornerstone** of BPD treatment, with medications serving an adjunctive role - The question asks for the single most effective treatment, which is DBT alone *Pharmacotherapy alone* - **No medication** is FDA-approved specifically for BPD - Pharmacotherapy may help manage specific symptoms (mood swings, impulsivity, brief psychotic episodes) but does not address the core **personality pathology** - Generally not recommended as monotherapy for BPD; should always be combined with psychotherapy

Q: Which imaging modality is most effective in differentiating between epidermoid cyst and arachnoid cyst?

Magnetic Resonance Imaging (MRI). ***Magnetic Resonance Imaging (MRI)*** - **MRI** is superior for differentiating epidermoid and arachnoid cysts due to its excellent **soft tissue contrast** and ability to detect fluid signal characteristics. - **Diffusion-weighted imaging (DWI)**, a specific MRI sequence, is crucial; **epidermoid cysts** show high signal on DWI (diffusion restriction) due to their keratin content, while **arachnoid cysts** follow CSF signal on all sequences and do not restrict diffusion. *Ultrasound (USG)* - **Ultrasound** has limited utility for intracranial lesions in adults due to the bony skull, which prevents sound wave penetration. - It may be used in infants through the fontanelles but lacks the resolution and specific sequences needed to characterize these cysts. *Computed Tomography (CT) scan* - While a **CT scan** can identify these cysts as hypodense lesions, it lacks the detailed **tissue characterization** and signal patterns provided by MRI. - Both cysts would appear as **hypodense lesions**, making differentiation difficult based on density alone, especially after contrast administration. *Positron Emission Tomography (PET) scan* - A **PET scan** primarily assesses metabolic activity and would not effectively differentiate between benign **non-metabolic cysts** like epidermoid and arachnoid cysts. - It is more commonly used for detecting **malignancies** or assessing brain activity patterns, not for structural differentiation of fluid-filled lesions.

Q: What is the CT scan finding in a carotid cavernous sinus fistula?

Enlarged superior ophthalmic vein. ***Enlarged superior ophthalmic vein*** * A carotid cavernous sinus fistula (CCSF) causes **high-pressure arterial blood** to shunt into the **venous system** of the cavernous sinus. * This increased pressure leads to retrograde flow and congestion in the draining veins, most notably the **superior ophthalmic vein**, causing its dilation. *Enlarged inferior ophthalmic vein* * While the inferior ophthalmic vein can also be involved in some cases of CCSF, the **superior ophthalmic vein** is typically more prominent and consistently affected due to its primary drainage pathway. * The inferior ophthalmic vein is less frequently the primary or most notable imaging finding compared to the superior ophthalmic vein. *Enlarged superior ophthalmic artery* * A CCSF involves an abnormal connection between the **carotid artery** (an artery) and the **cavernous sinus** (a venous structure), leading to venous, not arterial, dilation. * Arteries in the orbital region, like the superior ophthalmic artery, would not typically enlarge as a direct result of increased venous pressure in the cavernous sinus. *Enlarged inferior ophthalmic artery* * Similar to the superior ophthalmic artery, the inferior ophthalmic artery is an **arterial structure** and would not enlarge due to a high-flow arteriovenous shunt within the cavernous sinus. * The pathological changes in CCSF are primarily observed in the **venous drainage pathways**.

Question 1

Most common metal in contact allergic dermatitis is?

Accepted Answer

Nickel

Answer

Gold

Answer

Silver

Answer

Aluminum

Question 2

Which type of ultraviolet radiation causes the most skin disorders?

Accepted Answer

UV-B

Answer

UV-A

Answer

UV-C

Answer

None of the options

Question 3

Acute PID, the most common route of spread?

Accepted Answer

Ascending infection

Answer

Descending

Answer

Lymphatics

Answer

Hematogenous

Question 4

What is the purpose of the Prague maneuver in obstetrics?

Accepted Answer

To deliver the head in breech presentation when the fetal back is posterior

Answer

To assess the fetal position in deep transverse arrest

Answer

To extract extended arms during delivery

Answer

To turn a fetus from breech to head-down position before labor

Question 5

In which part of the fallopian tube is there a high chance of rupture in a tubal pregnancy?

Accepted Answer

Isthmus

Answer

Interstitial

Answer

Fimbrial

Answer

Ampulla

Question 6

What is the most common presenting feature of a complete mole?

Accepted Answer

Bleeding per vaginum

Answer

Vomiting

Answer

Hyperemesis gravidarum

Answer

Amenorrhoea

Question 7

What is the most likely neurochemical change associated with schizophrenia?

Accepted Answer

Increased dopaminergic activity

Answer

Increased GABA activity

Answer

Decreased dopaminergic activity

Answer

Decreased norepinephrine activity

Question 8

What is considered the most effective treatment for Borderline Personality Disorder?

Accepted Answer

Dialectical Behaviour Therapy (DBT)

Answer

Combination of DBT and pharmacotherapy

Answer

Cognitive Behavioural Therapy (CBT)

Answer

Pharmacotherapy alone

Question 9

Which imaging modality is most effective in differentiating between epidermoid cyst and arachnoid cyst?

Accepted Answer

Magnetic Resonance Imaging (MRI)

Answer

Ultrasound (USG)

Answer

Computed Tomography (CT) scan

Answer

Positron Emission Tomography (PET) scan

Question 10

What is the CT scan finding in a carotid cavernous sinus fistula?

Accepted Answer

Enlarged superior ophthalmic vein

Answer

Enlarged inferior ophthalmic vein

Answer

Enlarged superior ophthalmic artery

Answer

Enlarged inferior ophthalmic artery

NEET-PG 2013

Dermatology

Obstetrics and Gynecology

Psychiatry

Radiology