NEET-PG 2013 Practice Questions

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: Marshall's triad is seen in:

Explosive injury. ***Explosive injury*** - Marshall's triad components, including **blast lung**, **abdominal hemorrhage**, and **tympanic membrane rupture**, are characteristic injuries of explosions, especially those involving pressure waves. - The triad highlights distinct patterns of organ damage caused by the high-energy transfer from blast forces. *Lightning injury* - Lightning injuries can cause diverse effects like **cardiac arrest**, **neurological damage**, and **burns**, but they do not typically present as Marshall's triad. - The primary mechanism is electrical, leading to distinct injury patterns different from blast trauma. *Gunshot injury* - Gunshot wounds create localized tissue damage along the projectile's path and a temporary cavity, but they do not cause generalized blast effects or the specific triad of Marshall. - The injury severity depends on the **caliber**, **velocity**, and **trajectory** of the bullet. *Drowning injury* - Drowning is characterized by **respiratory impairment** resulting from submersion or immersion in liquid, leading to **hypoxia** and multi-organ failure. - Its pathophysiology and presentation are entirely distinct from explosive trauma.

Q: Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?

Viper. ***Correct Answer: Viper*** - **Viper venom** contains **hemotoxic components** including **metalloproteinases** and **serine proteinases** that directly activate clotting factors - This leads to **consumptive coagulopathy** characterized by **thrombocytopenia**, **hypofibrinogenemia**, and prolonged coagulation times - Clinical manifestations include spontaneous **bleeding**, **ecchymoses**, **hemorrhage** at the bite site, and in severe cases, **disseminated intravascular coagulation (DIC)** - Viper envenomation is the **classic cause** of hematologic abnormalities among snake bites *Incorrect: Sea snake* - Sea snake venoms are primarily **neurotoxic** and **myotoxic**, causing paralysis and muscle damage - While they can cause **rhabdomyolysis** and subsequent **renal failure**, significant primary hematologic abnormalities are not their hallmark feature *Incorrect: Krait* - Krait venom is predominantly **neurotoxic**, leading to **flaccid paralysis** and **respiratory failure** - Does not typically cause the significant widespread **coagulopathies** seen with viper envenomation *Incorrect: Cobra* - Cobra venom primarily contains **neurotoxins** and **cytotoxins**, causing **paralysis**, **tissue necrosis**, and localized pain - While some cobras can cause minor local bleeding, they do not generally induce the severe and systemic **hematologic abnormalities** characteristic of viper bites

Q: Which of the following is used in the second-line management of strychnine poisoning?

Barbiturates. ***Barbiturates*** - As a **second-line treatment**, barbiturates like phenobarbital are used to control **refractory seizures** and muscle spasms in strychnine poisoning when benzodiazepines are insufficient. - They enhance the effect of **GABA**, leading to central nervous system depression and muscle relaxation. *Physostigmine* - This is an **acetylcholinesterase inhibitor** and is primarily used to reverse the anticholinergic effects of certain poisonings, not strychnine. - It would worsen seizures by increasing **acetylcholine**, which can cause tremors and convulsions. *Naloxone* - Naloxone is an **opioid antagonist** used to reverse opioid overdose, which presents with respiratory depression and pinpoint pupils. - It has no role in treating strychnine poisoning, which primarily causes **muscle spasms** and seizures. *Diazepam* - Diazepam, a **benzodiazepine**, is the **first-line treatment** for seizures and muscle spasms in strychnine poisoning. - It works by enhancing the effects of **GABA** at the GABA-A receptor, thereby reducing neuronal excitability.

Q: Contributory negligence is negligence due to:

Patient only. ***Patient only*** - **Contributory negligence** specifically refers to negligence on the part of the **plaintiff** (the patient) that contributed to their own injury. - This doctrine can reduce or bar recovery for damages if the patient's own actions played a role in causing the harm. *Doctor only* - This describes **medical malpractice**, where the healthcare provider's negligence directly causes harm to the patient. - While a doctor's negligence is a primary concern in healthcare, it doesn't align with the legal concept of *contributory* negligence, which attributes fault to the injured party. *Both doctor and patient* - This scenario relates to **comparative negligence**, a legal doctrine where fault is apportioned between multiple parties (e.g., doctor and patient). - Contributory negligence, in its strict form, implies the patient's negligence alone contributed significantly enough to preclude full recovery, rather than shared fault. *Hospital administrator and doctor* - This refers to negligence stemming from actions of the hospital administration (e.g., systemic failures, inadequate resources) and individual medical errors by the doctor. - While both can be liable for negligence, this does not represent the patient's own contribution to their injury, which is the core of contributory negligence.

Q: Stellate wound is produced with firearm in:

Contact shot. ***Contact shot*** - In a **contact shot**, gases and matter from the gun barrel are forced directly into the wound, causing the skin to stretch, tear, and burst outward, creating a **stellate or star-shaped wound**. - The hot gases and unburnt powder entering the wound create an exit for themselves, often leading to these characteristic irregular, radiating tears. *Close shot* - A close shot involves the skin being close to the muzzle but not directly touching, leading to a circular or oval wound with a surrounding area of **singeing**, **soot deposition**, and **powder tattooing**. - While there is gas effect, it's not as confined or forceful behind the skin as in a contact shot, thus not typically producing a stellate wound. *Distant shot* - A distant shot occurs when the muzzle is far enough from the target surface that only the **bullet strikes the skin**, leaving a relatively clean, circular or oval entry wound without significant singeing or tattooing. - The effects of gas and unburnt powder are not present at the wound site in a distant shot. *Range within 60 cm* - While a range within 60 cm (approximately 2 feet) can encompass close shots, it's a broad category and doesn't specifically define the conditions necessary for a stellate wound. - A stellate wound requires conditions more specific to a contact shot, where the muzzle is pressed against the skin.

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: 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.

Q: CAGE questionnaire is used in:

Alcohol dependence. ***Alcohol dependence*** - The **CAGE questionnaire** is a widely used screening tool for identifying potential **alcohol problems** and dependence. - The acronym CAGE stands for Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers, all related to drinking habits. *Opiate poisoning* - Screening for opiate use or poisoning typically involves asking about **drug use history**, conducting **urine drug screens**, and observing specific clinical signs like **pinpoint pupils** and **respiratory depression**. - The CAGE questionnaire is not designed to screen for opiate use. *Dhatura poisoning* - **Dhatura poisoning** is characterized by anticholinergic symptoms like **dilated pupils**, **dry mouth**, **tachycardia**, and **delirium**. - Diagnosis relies on clinical presentation and a history of exposure, not a specific questionnaire like CAGE. *Barbiturate poisoning* - **Barbiturate poisoning** presents with central nervous system depression, including **sedation**, **respiratory depression**, and **hypotension**. - Diagnosis involves a clinical assessment, history of barbiturate use, and toxicology screens, not the CAGE questionnaire.

Question 1

Sexual asphyxia is seen in cases of:

Accepted Answer

Masochism

Answer

Sadism

Answer

Voyeurism

Answer

Fetishism

Question 2

Marshall's triad is seen in:

Accepted Answer

Explosive injury

Answer

Lightning injury

Answer

Gunshot injury

Answer

Drowning injury

Question 3

Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?

Accepted Answer

Viper

Answer

Sea snake

Answer

Krait

Answer

Cobra

Question 4

Which of the following is used in the second-line management of strychnine poisoning?

Accepted Answer

Barbiturates

Answer

Physostigmine

Answer

Naloxone

Answer

Diazepam

Question 5

Contributory negligence is negligence due to:

Accepted Answer

Patient only

Answer

Doctor only

Answer

Both doctor and patient

Answer

Hospital administrator and doctor

Question 6

Stellate wound is produced with firearm in:

Accepted Answer

Contact shot

Answer

Close shot

Answer

Distant shot

Answer

Range within 60 cm

Question 7

Lendrum's stain is done for:

Accepted Answer

Amniotic fluid embolism

Answer

Air embolism

Answer

Pulmonary embolism

Answer

Fat embolism

Question 8

Classic tetrad of narcolepsy includes all, except:

Accepted Answer

Catalepsy

Answer

Hypnagogic hallucination

Answer

Sleep paralysis

Answer

Sleep attacks

Question 9

Term 'schizophrenia' was coined by:

Accepted Answer

Eugene Bleuler

Answer

Freud

Answer

Kraepelin

Answer

Schneider

Question 10

CAGE questionnaire is used in:

Accepted Answer

Alcohol dependence

Answer

Opiate poisoning

Answer

Dhatura poisoning

Answer

Barbiturate poisoning

NEET-PG 2013

Forensic Medicine

Pathology

Psychiatry