NEET-PG 2013 Practice Questions

Q: Which one of the tissues putrefies late?

Prostate. ***Prostate*** - The **prostate** is a glandular organ that contains a significant amount of **fibrinous connective tissue**, which is less susceptible to rapid decomposition. - Its relatively **acidic internal environment** also contributes to slower bacterial proliferation and, therefore, delayed putrefaction compared to other organs. *Liver* - The **liver** is rich in **parenchymal cells** and blood, making it a good substrate for bacterial growth and enzymatic degradation leading to early putrefaction. - Its metabolic activity continues shortly after death, releasing enzymes that contribute to **autolysis** and subsequent putrefaction. *Brain* - The **brain** has a high **water and lipid content**, which makes it highly susceptible to rapid autolysis, particularly by its own lysosomal enzymes. - It also has a rich blood supply, providing ample nutrients for **anaerobic bacteria**, accelerating decomposition. *Stomach* - The **stomach** contains a high concentration of **digestive enzymes** (e.g., pepsin, hydrochloric acid) which, post-mortem, contribute to rapid autolysis of its own tissues. - The presence of food contents and abundant bacteria within the stomach lumen further accelerates the process of **putrefaction**.

Q: Dilated pupil with coma is seen in which poisoning?

Dhatura. ***Dhatura*** - **Dhatura poisoning** is characterized by an **anticholinergic toxidrome**, leading to symptoms like **dilated pupils (mydriasis)**, dry mouth, flushed skin, tachycardia, and altered mental status progressing to coma. - The dilated pupils are a direct result of the **muscarinic receptor blockade** in the eye, preventing parasympathetic innervation. *Opium* - **Opium poisoning** typically causes **pinpoint pupils (miosis)**, respiratory depression, and central nervous system depression leading to coma. - This effect is due to the **opioid agonists** stimulating mu-opioid receptors. *Mushroom* - Mushroom poisoning can present with various toxidromes depending on the species; however, some muscarine-containing species can cause **miosis** (pinpoint pupils), salivation, and bradycardia, while others may cause delirium or hepatic failure. - **Dilated pupils** are not a characteristic feature of the more common deadly mushroom poisonings that lead to coma. *Pilocarpine* - **Pilocarpine** is a **direct cholinergic agonist** that stimulates muscarinic receptors and typically causes **miosis (constricted pupils)**, increased secretions, and bradycardia. - It would not lead to dilated pupils or coma in the manner described.

Q: Concealment of birth is punishable under:

Sec. 318 IPC. ***Sec. 318 IPC*** - This section of the **Indian Penal Code (IPC)** specifically deals with the **concealment of birth by secret disposal of dead body**. - It punishes anyone who, by **secretly burying or otherwise disposing of the dead body of a child**, endeavors to conceal the birth of the child. *Sec. 320 IPC* - This section defines **"grievous hurt"** under the IPC. - It lists various types of injuries that constitute grievous hurt, such as **emasculation**, permanent privation of sight or hearing, fracture or dislocation of a bone, etc., and is unrelated to concealment of birth. *Sec. 317 IPC* - This section pertains to the **exposure and abandonment of a child under twelve years** of age by a parent or person having care of it. - While it deals with offenses against a child, it specifically addresses abandonment rather than the concealment of a dead body after birth. *Sec. 312 IPC* - This section addresses **causing miscarriage**. - It punishes anyone who voluntarily causes a woman with child to miscarry, which is distinct from the act of concealing a birth by disposing of a dead child's body.

Q: Sexual asphyxia is seen in cases of:

Masochism. ***Masochism*** - **Sexual asphyxia** (also known as autoerotic asphyxiation or hypoxyphilia) is a dangerous practice where an individual intentionally reduces oxygen supply to the brain during sexual activity to enhance sexual arousal through cerebral hypoxia. - This practice is associated with **sexual masochism disorder**, where sexual gratification is derived from experiencing pain, suffering, or potentially life-threatening situations. - The oxygen deprivation creates a sense of euphoria and heightened arousal, but carries significant risk of accidental death. - This is considered a particularly dangerous form of masochistic sexual behavior. *Sadism* - **Sexual sadism disorder** involves deriving sexual pleasure from inflicting pain, suffering, or humiliation on others. - The focus is on causing distress to another person, whereas sexual asphyxia is typically self-inflicted (autoerotic) or involves the practitioner being the one deprived of oxygen. *Voyeurism* - **Voyeuristic disorder** refers to obtaining sexual pleasure from secretly observing unsuspecting individuals who are naked, disrobing, or engaging in sexual activity. - It does not involve any form of physical risk, asphyxia, or oxygen deprivation. *Fetishism* - **Fetishistic disorder** is a paraphilia where sexual arousal and gratification are primarily associated with inanimate objects (e.g., shoes, underwear) or specific non-genital body parts. - This condition does not involve asphyxiation; the focus is on a particular object or body part as the source of sexual pleasure.

Q: What disease is associated with ascitic fluid SAAG < 1.1?

Peritoneal carcinomatosis. Peritoneal carcinomatosis - A serum-ascites albumin gradient (SAAG) less than 1.1 g/dL indicates that the ascites is not due to portal hypertension [1]. - In peritoneal carcinomatosis, the malignant cells in the peritoneum disrupt the normal fluid exchange, leading to fluid accumulation that is low in albumin relative to serum [1]. Liver failure - Liver failure, especially when leading to cirrhosis, is typically associated with portal hypertension and a SAAG ≥ 1.1 g/dL [1]. - The high SAAG reflects the increased hydrostatic pressure in the hepatic sinusoids, forcing fluid low in protein into the peritoneal cavity [1]. Portal vein thrombosis - Portal vein thrombosis causes portal hypertension and would therefore be associated with a high SAAG (≥ 1.1 g/dL) [1]. - The obstruction of the portal vein leads to increased sinusoidal hydrostatic pressure, similar to other causes of portal hypertension [1]. Tuberculosis peritonitis - Tuberculosis peritonitis is an inflammatory condition that can cause ascites, but it is typically associated with a SAAG < 1.1 g/dL [1]. - This is because the inflammatory process in the peritoneum allows for the leakage of albumin into the ascitic fluid, diminishing the gradient [1].

Q: Lendrum's stain is done for:

Amniotic fluid embolism. ***Amniotic fluid embolism*** - **Lendrum's stain** (MSB - Martius Scarlet Blue) is specifically used to identify **fibrin**, **mucin**, and **squamous cells** in the pulmonary vasculature, which are characteristic findings in amniotic fluid embolism. [1] - This stain excellently demonstrates **fibrin** (stains red) and helps visualize components of amniotic fluid that embolize to the mother's lungs, leading to a severe, often fatal, obstetric emergency. [1] - Lendrum's method is particularly valuable in forensic pathology and autopsy diagnosis of this condition. *Air embolism* - Air embolism diagnosis relies on identifying **air bubbles** in the cardiovascular system, often confirmed by imaging studies or direct visualization during autopsy. [1] - Special stains are not typically used for direct detection of air in tissue sections. *Pulmonary embolism* - Pulmonary embolism, typically caused by a **blood clot**, is diagnosed by identifying **fibrin** and **red blood cells** within pulmonary arteries, often with stains like hematoxylin and eosin (H&E). [1] - While Lendrum's stain can demonstrate fibrin, it is specifically employed when amniotic fluid embolism is suspected, not for routine thromboembolic disease. *Fat embolism* - **Fat embolism** is diagnosed by demonstrating **fat globules** in the pulmonary microvasculature using **fat stains** like **Oil Red O** or **Sudan Black**, usually on frozen sections. - Lendrum's stain does not specifically highlight fat emboli. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 322-324.

Q: True about MDMA:

Ecstasy is another name for it. Ecstasy is another name for it - MDMA (3,4-methylenedioxymethamphetamine) is widely known by its street name, Ecstasy [1]. - This name refers to its profound empathogenic effects and sense of well-being it often induces. It is a cocaine congener - MDMA is an amphetamine derivative and acts primarily on serotonin, dopamine, and norepinephrine systems, distinct from cocaine's primary action as a reuptake inhibitor [1], [2]. - While both MDMA and cocaine are stimulants, their chemical structures and primary mechanisms of action are different; MDMA is a substituted amphetamine [1]. Methadone is used to treat withdrawal symptoms - Methadone is an opioid agonist primarily used in the management of opioid dependence and withdrawal symptoms [3]. - MDMA withdrawal symptoms are typically managed with supportive care, focusing on symptom relief and psychological support, as there is no specific pharmacological treatment like methadone for MDMA withdrawal [3]. Causes parkinsonism like syndrome - While MDMA can cause neurotoxicity, particularly affecting serotonergic neurons, it is not typically associated with a direct parkinsonism-like syndrome [2]. - Parkinsonism is primarily linked to dopaminergic system damage, often seen with certain neuroleptics or drugs like MPTP, not MDMA.

Q: Voyeurism is also known as:

Scoptophilia. ***Scoptophilia*** - **Scoptophilia** is another term for **voyeurism**, defined as deriving sexual pleasure from secretly watching others. - This paraphilia involves observing unsuspecting individuals, often unclothed or engaging in sexual activity. *Frotteurism* - **Frotteurism** involves obtaining sexual gratification by **rubbing** against or touching a non-consenting person in a public place. - Unlike voyeurism, it requires direct physical contact rather than just observation. *Eonism* - **Eonism** refers to **transvestism**, a condition where individuals derive sexual gratification from wearing clothes of the opposite sex. - It is distinct from voyeurism, which is about observation, not cross-dressing. *Onanism* - **Onanism** is historically and generally used to refer to **masturbation** or coitus interruptus (withdrawal method). - It does not involve observing others like voyeurism, but rather self-stimulation or a specific form of contraception.

Q: Classic tetrad of narcolepsy includes all, except:

Catalepsy. ***Catalepsy*** - Catalepsy refers to a **waxy flexibility** and maintenance of postures seen in **catatonia** (a psychiatric condition). - It is **NOT** part of the classic tetrad of narcolepsy. - The classic tetrad includes **cataplexy** (not catalepsy), which is sudden muscle weakness triggered by strong emotions, along with excessive daytime sleepiness, sleep paralysis, and hypnagogic/hypnopompic hallucinations. *Hypnagogic hallucination* - Vivid, often frightening, dream-like experiences that occur while **falling asleep** (hypnagogic) or upon awakening (hypnopompic). - This is a recognized component of the **classic tetrad of narcolepsy**. *Sleep paralysis* - Temporary inability to move or speak upon **waking up or falling asleep**. - One of the four key symptoms forming the **classic tetrad of narcolepsy**. *Sleep attacks* - Sudden, irresistible urges to sleep that can occur at any time, often without warning. - **Excessive daytime sleepiness** leading to these attacks is a core feature and part of the **classic tetrad of narcolepsy**.

Q: Term 'schizophrenia' was coined by:

Eugene Bleuler. ***Eugene Bleuler*** - The Swiss psychiatrist **Eugene Bleuler** was the first to use the term "schizophrenia" in **1908**, replacing **Kraepelin's** term **dementia praecox**. - He coined the term from Greek roots: "schizein" (to split) and "phren" (mind), referring to the **splitting of mental functions**. *Freud* - **Sigmund Freud** is known as the founder of **psychoanalysis** and developed theories on the unconscious mind, defense mechanisms, and psychosexual development. - While influential in psychiatry, he did not coin the term "schizophrenia." *Kraepelin* - **Emil Kraepelin** was a German psychiatrist who developed a classification system for mental disorders and described what he called **"dementia praecox,"** which is now largely equivalent to schizophrenia. - He systematized the understanding of the disorder but did not coin the term "schizophrenia" itself. *Schneider* - **Kurt Schneider** was a German psychiatrist known for his concept of **"first-rank symptoms"** of schizophrenia, which are considered highly characteristic of the disorder. - His contributions were significant in diagnosing schizophrenia, but he did not originate the term.

Question 1

Which one of the tissues putrefies late?

Accepted Answer

Prostate

Answer

Liver

Answer

Brain

Answer

Stomach

Question 2

Dilated pupil with coma is seen in which poisoning?

Accepted Answer

Dhatura

Answer

Opium

Answer

Mushroom

Answer

Pilocarpine

Question 3

Concealment of birth is punishable under:

Accepted Answer

Sec. 318 IPC

Answer

Sec. 320 IPC

Answer

Sec. 317 IPC

Answer

Sec. 312 IPC

Question 4

Sexual asphyxia is seen in cases of:

Accepted Answer

Masochism

Answer

Sadism

Answer

Voyeurism

Answer

Fetishism

Question 5

What disease is associated with ascitic fluid SAAG < 1.1?

Accepted Answer

Peritoneal carcinomatosis

Answer

Liver failure

Answer

Portal vein thrombosis

Answer

Tuberculosis peritonitis

Question 6

Lendrum's stain is done for:

Accepted Answer

Amniotic fluid embolism

Answer

Air embolism

Answer

Pulmonary embolism

Answer

Fat embolism

Question 7

True about MDMA:

Accepted Answer

Ecstasy is another name for it

Answer

It is a cocaine congener

Answer

Methadone is used to treat withdrawal symptoms

Answer

Causes parkinsonism like syndrome

Question 8

Voyeurism is also known as:

Accepted Answer

Scoptophilia

Answer

Frotteurism

Answer

Eonism

Answer

Onanism

Question 9

Classic tetrad of narcolepsy includes all, except:

Accepted Answer

Catalepsy

Answer

Hypnagogic hallucination

Answer

Sleep paralysis

Answer

Sleep attacks

Question 10

Term 'schizophrenia' was coined by:

Accepted Answer

Eugene Bleuler

Answer

Freud

Answer

Kraepelin

Answer

Schneider

NEET-PG 2013

Forensic Medicine

Internal Medicine

Pathology

Pharmacology

Psychiatry