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: 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: At which gestational week does the maximum volume of amniotic fluid occur?

36 weeks. ***36 weeks*** - The volume of **amniotic fluid** gradually increases during pregnancy, reaching its **peak** around **36 weeks** of gestation. - After 36 weeks, the volume of amniotic fluid typically begins to **decrease** as the pregnancy approaches term. *32 weeks* - At 32 weeks, the amniotic fluid volume is still **increasing** and has not yet reached its maximum level. - The fetus is actively growing and contributing to fluid production, but the peak is still several weeks away. *34 weeks* - Although significant, the amniotic fluid volume at 34 weeks has not yet reached its **maximum**. - The volume will continue to rise for another two weeks before plateauing and then declining. *40 weeks* - By 40 weeks, a normal-term pregnancy, the volume of amniotic fluid has typically **decreased** from its peak at 36 weeks. - A declining amniotic fluid volume (oligohydramnios) can be a concern at term if it's too low.

Q: Windswept deformity is seen in which condition?

Rickets. ***Rickets*** - **Windswept deformity** is characterized by bilateral knee deformities where one knee is in **valgus** and the other is in **varus**. - This condition is caused by a deficiency in **vitamin D**, **calcium**, or **phosphate**, leading to improper bone mineralization and subsequent bone deformities. *Rheumatoid Arthritis* - Rheumatoid arthritis is a **chronic autoimmune inflammatory disease** primarily affecting the synovial joints. - While it can cause joint deformities, they typically involve symmetric joint swelling, pain, and stiffness, with characteristic deformities like **ulnar deviation** or **swan-neck deformities**, rather than windswept deformity. *Hyperparathyroidism* - Hyperparathyroidism leads to excessive production of **parathyroid hormone**, which causes increased bone resorption and elevated blood calcium levels. - It can result in bone fragility, **osteitis fibrosa cystica**, and kidney stones, but it does not cause specific windswept deformity. *Scurvy* - Scurvy results from a severe deficiency of **vitamin C**, which is essential for collagen synthesis. - It presents with symptoms like bleeding gums, poor wound healing, and perifollicular hemorrhages, but it does not typically cause windswept deformity of the knees.

Q: Most common site of myositis ossificans ?

Quadriceps/Thigh. ***Quadriceps/Thigh*** - The **quadriceps and thigh** muscles are frequently affected due to their common involvement in sports injuries and trauma. - This region is prone to **hematoma formation** after contusions, which can predispose to ectopic bone formation. *Shoulder* - While the shoulder can be affected by myositis ossificans, it is **less common** than the quadriceps. - Traumatic myositis ossificans in the shoulder typically involves the **deltoid muscle**. *Wrist* - Myositis ossificans of the **wrist is rare** and usually occurs after severe trauma or crush injuries. - The small muscle mass and limited direct trauma to the wrist muscles make it an **unlikely primary site**. *Elbow* - Myositis ossificans can occur around the elbow, particularly in the **brachialis muscle**, often following dislocations or fractures. - However, the elbow is still **less commonly affected overall** compared to the large muscle groups of the thigh.

Q: Depot preparations are administered by ?

Both subcutaneous and intramuscular route. ***Both subcutaneous and intramuscular route*** - **Depot preparations** are designed for **sustained release** of medication over an extended period - This is achieved by forming a 'depot' in the tissue, often facilitated by a viscous vehicle or sparingly soluble form of the drug - Both **subcutaneous** and **intramuscular** tissues can sustain depot formulations effectively - **SC depot examples:** Insulin glargine, contraceptive implants (Nexplanon), leuprolide acetate - **IM depot examples:** Haloperidol decanoate, medroxyprogesterone acetate (Depo-Provera), paliperidone palmitate, long-acting risperidone *Subcutaneous route* - While some **depot preparations** are administered **subcutaneously**, it is not the *only* route for all depot formulations - The **subcutaneous tissue** offers relatively low blood flow, suitable for slow absorption - Alone, this option is incomplete as many depot preparations require IM administration *Intramuscular route* - Many **depot preparations** are given **intramuscularly** due to the muscle tissue's vascularity and tissue volume - The **muscle tissue** provides an excellent site for drug reservoir formation - Alone, this option is incomplete as some depot preparations are given subcutaneously *Intravenous route* - **Intravenous administration** is used for immediate and rapid drug delivery directly into the bloodstream - This route is **unsuitable for depot preparations** which require sustained release over time - No 'depot' can be formed with IV route as the drug is immediately diluted and distributed throughout the body

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: Flooding is a psychological treatment modality used in which of the following?

Phobia. ***Phobia*** - **Flooding** is a specific type of **exposure therapy** that involves immediate and intense exposure to the feared object or situation for a prolonged period, without the possibility of escape. - This technique is primarily used to overcome **phobias** and other **anxiety disorders** by breaking the association between the feared stimulus and the anxiety response. *Depression* - Treatment for **depression** typically involves a combination of **pharmacotherapy** (antidepressants) and **psychotherapy**, such as cognitive-behavioral therapy (CBT) or interpersonal therapy. - While exposure techniques exist for some aspects of depression (e.g., social anxiety in depressive contexts), **flooding** is not a primary or standalone treatment modality for core depressive symptoms. *Mania* - **Mania**, a characteristic feature of **bipolar disorder**, is primarily treated with **mood stabilizers** (e.g., lithium, valproate) and sometimes antipsychotics. - Psychological interventions focus on **psychoeducation**, symptom monitoring, and adherence to medication, rather than exposure-based therapies like flooding. *Schizophrenia* - The primary treatment for **schizophrenia** involves **antipsychotic medications** to manage psychotic symptoms like hallucinations and delusions. - Psychological therapies, such as **cognitive-behavioral therapy for psychosis (CBTp)** and **family therapy**, aim to improve coping skills, reduce distress, and enhance social functioning, but **flooding** is not an appropriate or effective treatment.

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

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 5

At which gestational week does the maximum volume of amniotic fluid occur?

Accepted Answer

36 weeks

Answer

32 weeks

Answer

34 weeks

Answer

40 weeks

Question 6

Windswept deformity is seen in which condition?

Accepted Answer

Rickets

Answer

Hyperparathyroidism

Answer

Scurvy

Answer

Rheumatoid Arthritis

Question 7

Most common site of myositis ossificans ?

Accepted Answer

Quadriceps/Thigh

Answer

Shoulder

Answer

Wrist

Answer

Elbow

Question 8

Depot preparations are administered by ?

Accepted Answer

Both subcutaneous and intramuscular route

Answer

Subcutaneous route

Answer

Intravenous route

Answer

Intramuscular route

Question 9

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 10

Flooding is a psychological treatment modality used in which of the following?

Accepted Answer

Phobia

Answer

Depression

Answer

Mania

Answer

Schizophrenia

NEET-PG 2013

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Pharmacology

Psychiatry