NEET-PG 2013 Practice Questions

Q: The inducing agent of choice in shock -

Ketamine. **Ketamine** * **Ketamine** is preferred in shock due to its sympathomimetic properties, which maintain or increase blood pressure and heart rate, thus preserving **cardiovascular stability**. * It also has minimal respiratory depression and bronchodilatory effects, making it safer for patients with compromised respiratory function. * The cardiovascular stimulating effects of ketamine helps maintain haemodynamic stability in shocked patients. It maintains cerebral autoregulation and perfusion of vital organs. *Isoflurane* * **Isoflurane** is an inhaled anesthetic that typically causes **dose-dependent myocardial depression** and **vasodilation**, which can worsen hypotension in a shock state. * It can significantly decrease systemic vascular resistance, thereby exacerbating the already compromised cardiovascular status of a shock patient. *Desflurane* * **Desflurane** is an inhaled anesthetic known for its rapid onset and offset but can cause a **significant increase in heart rate and blood pressure** upon rapid concentration changes, which may be detrimental in an unstable patient. * Like isoflurane, it also causes dose-dependent peripheral vasodilation and myocardial depression, which can worsen hypotension in patients in shock. *Thiopentone* * **Thiopentone** is a barbiturate that causes significant **myocardial depression** and **peripheral vasodilation**, leading to a substantial drop in blood pressure. * Its use in shock would further compromise cardiovascular stability and is generally contraindicated due to its potent hemodynamic depressant effects.

Q: Tuberculin test is positive in general population (immunocompetent individuals with no specific risk factors) if induration is?

>10mm. >10mm - For **immunocompetent** individuals without specific risk factors, a tuberculin skin test (TST) induration of **≥10 mm** is considered positive. - This threshold indicates a likely **exposure to Mycobacterium tuberculosis** and a cellular immune response. *>7mm* - This is not a standard threshold for a positive TST in any risk group. - TST interpretation is based on specific **induration sizes** corresponding to different risk factors. *>5mm* - An induration of **≥5 mm** is considered positive for individuals with compromised immunity, those in close contact with active TB cases, or those with fibrotic changes on chest X-ray. - This lower threshold is used for **high-risk groups** due to their increased susceptibility to developing active tuberculosis. *>2mm* - An induration of **≥2 mm** is not typically used as a positive threshold for the tuberculin test in any established guidelines. - Such a small induration is generally considered **negative** or clinically insignificant.

Q: Wood's lamp has a wavelength of –

360 nm. ***360 nm*** - A **Wood's lamp** emits **long-wave ultraviolet (UV-A) light**, which is typically in the range of 320 to 450 nm. - The precise wavelength of **360 nm** is the most common and effective for dermatological diagnostic applications, allowing visualization of specific fluorescence patterns. *320 nm* - While 320 nm falls within the UV-A spectrum, it is at the lower end and less characteristic of the peak emission wavelength used in Wood's lamps for diagnostic purposes. - Using this lower wavelength might result in less pronounced or absent fluorescence for some conditions. *300 nm* - A wavelength of 300 nm is in the **UV-B spectrum** which is primarily used for therapeutic purposes like **phototherapy for psoriasis**, not for diagnostic fluorescence with a Wood's lamp. - UV-B light has different biological effects and is too short to elicit the characteristic fluorescence observed with a Wood's lamp. *250 nm* - This wavelength falls into the **UV-C spectrum**, which is **germicidal** and harmful to human tissue. - UV-C light is not used in Wood's lamps for diagnostic purposes due to its damaging properties and inability to produce the desired fluorescence.

Q: Trismus is commonly seen in

Quinsy. ***Quinsy*** - **Quinsy (peritonsillar abscess)** is the **most common cause of trismus** among pharyngeal infections. - Trismus occurs due to **inflammation and reflex spasm of the pterygoid muscles** adjacent to the abscess. - The severe pain and swelling in the peritonsillar region directly limit **mandibular movement**, making it difficult or impossible to open the mouth. - **Trismus is one of the cardinal clinical features** of quinsy. *Parapharyngeal abscess* - A **parapharyngeal abscess** can also cause trismus due to direct inflammation and irritation of the muscles of mastication. - However, it is **less common than quinsy** and typically presents with other prominent symptoms like **neck swelling**, lateral pharyngeal bulging, and internal carotid artery involvement risk. *Ludwig's angina* - While Ludwig's angina is a severe infection of the **submandibular and sublingual spaces**, trismus is **less common** and less pronounced compared to peritonsillar abscess. - The primary concern in Ludwig's angina is **airway obstruction** due to tongue elevation and "bull neck" swelling, not typically severe trismus. *Retropharyngeal abscess* - A **retropharyngeal abscess** is located behind the pharynx and typically manifests with **dysphagia**, **odynophagia**, **neck stiffness**, and respiratory distress. - While indirect muscle spasm can occur, **trismus is not a characteristic or common symptom** of retropharyngeal abscess, which primarily affects swallowing and neck mobility.

Q: Incest is defined as sexual intercourse between which individuals?

Closely related individuals. ***Closely related individuals*** - **Incest** refers to sexual intercourse between individuals who are considered too **closely related** by lineage or kinship to marry each other legally. - The definition of "closely related" varies across cultures and legal systems but generally includes **immediate family members** such as parents, children, and siblings. *Individuals other than spouse* - This definition describes **adultery** or **extramarital affairs**, which are distinct from incest. - While both involve sexual acts outside of legally or socially accepted norms, they differ significantly in the relationship between the involved parties. *Humans and animals* - This describes **bestiality** or **zoophilia**, which is a form of sexual activity involving humans and animals. - This is a separate and distinct concept from incest, which specifically concerns sexual relations between humans within a prohibited degree of kinship. *Unrelated individuals of same gender* - This describes **homosexual** sexual acts between adults, which are not inherently illegal or considered incestuous. - Incest is defined specifically by the **familial relationship** between the individuals, not their gender or lack of marital ties.

Q: Tensile strength of a wound becomes normal after:

Never. ***Never*** - A healed wound, even after complete maturation, only achieves about **80% of the original tissue's tensile strength** - The process of scar formation involves the realignment of collagen fibers and increased cross-linking, but it can **never perfectly replicate** the pre-injury tissue architecture and strength - This is a fundamental principle of wound healing - scar tissue is structurally different from normal tissue *6 months* - By 6 months, a wound's tensile strength has typically reached its **maximum potential** of approximately 80%, but this is still less than 100% of the original tissue's strength - This period marks the end of the significant remodeling phase, where collagen fibers are reorganized and strengthened *4 months* - At 4 months, the wound is still undergoing substantial **remodeling and strengthening**, achieving approximately 70-80% of eventual tensile strength - While considerable strength is gained by this time, further improvements continue for several more months *6 weeks* - At 6 weeks, the wound has achieved about **50-70% of its eventual tensile strength** - This stage is characterized by increased collagen deposition and cross-linking, making the wound clinically strong, but it is far from its maximum or normal strength

Q: All are used in the treatment of nocturnal enuresis except?

Voiding of urine before sleeping. ***Voiding of urine before sleeping*** - **Voiding before sleep** is a **general hygiene measure and preventive advice** rather than a specific therapeutic intervention for nocturnal enuresis. - While it may reduce bladder volume at bedtime, it does **not address the underlying pathophysiology** of nocturnal enuresis (arousal deficit, nocturnal polyuria, or detrusor overactivity). - It is **routine advice** given to all children, not a targeted treatment modality for curing enuresis. *Imipramine* - **Imipramine**, a tricyclic antidepressant, is an established **pharmacological treatment** for nocturnal enuresis. - Its mechanisms include: **anticholinergic effects** (increasing bladder capacity and functional bladder capacity), **alpha-adrenergic effects** (increasing bladder outlet resistance), and **antidiuretic effects**. - Typical dosing: **25-50 mg at bedtime**, with success rates of 40-60%. *Alarm setup* - **Bed-wetting alarms** are the **first-line behavioral therapy** with the highest long-term cure rates (60-70% success). - Works through **classical conditioning**: the alarm triggers when moisture is detected, training the child to either wake to void or develop nocturnal bladder control. - Requires **8-12 weeks** of consistent use and has the lowest relapse rates among treatments. *Maintenance of calendar of day night wetting* - **Voiding diary/calendar** is an essential **behavioral intervention** for monitoring and managing nocturnal enuresis. - Helps identify patterns, track treatment progress, and provides **positive reinforcement** through visual feedback. - Part of comprehensive behavioral management alongside fluid restriction and scheduled voiding during daytime.

Q: Which is not used in status epilepticus?

Metformin. ***Metformin*** - **Metformin** is an **oral hypoglycemic agent** used to treat **type 2 diabetes mellitus** and has no role in the management of seizures or status epilepticus. - Its primary mechanism involves decreasing **hepatic glucose production** and improving **insulin sensitivity**. *Lorazepam* - **Lorazepam** is a first-line treatment for **status epilepticus** due to its rapid onset of action and efficacy in terminating seizures. - It enhances the effect of **GABA** (gamma-aminobutyric acid) at the GABA-A receptor, leading to neuronal hyperpolarization and reduced excitability. *Phenytoin* - **Phenytoin** is a common second-line agent used in status epilepticus, administered after benzodiazepines, to maintain seizure control. - It works by blocking **voltage-gated sodium channels**, thereby stabilizing neuronal membranes and preventing repetitive firing. *Phenobarbitone* - **Phenobarbitone** (phenobarbital) is an effective antiepileptic drug, often considered as a second or third-line agent in status epilepticus, especially when other treatments fail. - It acts primarily by enhancing the activity of **GABA** at the GABA-A receptor, similar to benzodiazepines, but with a longer duration of action.

Q: Pagophagia involves eating

Ice. ***Ice*** - **Pagophagia** is a specific form of **pica**, characterized by a compulsive desire to consume **ice**, ice chips, or iced drinks. - It is often associated with **iron-deficiency anemia**, though the exact mechanism for this craving is unclear. *Sand* - The compulsive consumption of **sand** is known as **geophagy**, which is another form of pica. - This behavior is distinct from pagophagia and is not specifically linked to ice consumption. *Salt* - An excessive craving for **salt**, while sometimes indicative of an underlying condition (e.g., adrenal insufficiency), is not referred to as pagophagia. - **Pagophagia** specifically refers to the consumption of ice. *Clay* - The ingestion of **clay** is a specific type of **geophagy**, similar to eating sand. - It is a different form of pica and does not describe the selective craving for and consumption of ice.

Q: Sistrunk operation is for:

Thyroglossal cyst. ***Thyroglossal cyst*** - The **Sistrunk operation** is the definitive surgical procedure for the removal of a **thyroglossal duct cyst**. - This procedure involves excising the cyst along with the central portion of the **hyoid bone** and a core of muscle from the posterior aspect of the hyoid to the foramen cecum to prevent recurrence. *Thyroglossal fistula* - A **thyroglossal fistula** is a complication of a thyroglossal cyst that has ruptured or been surgically incised, leading to a persistent tract to the skin. - While a Sistrunk operation may be performed for a fistula, it is primarily indicated for the *cyst* itself to prevent both recurrence of the cyst and subsequent fistula formation. *Branchial fistula* - A **branchial fistula** is a congenital anomaly resulting from incomplete closure of the branchial arches during embryonic development, leading to an abnormal tract between the neck and the pharynx or skin. - Surgical excision of a branchial fistula is a different procedure from the Sistrunk operation, as its anatomical location and developmental origin are distinct from those of a thyroglossal cyst. *Branchial cyst* - A **branchial cyst** is a congenital neck mass arising from remnants of the branchial arches, typically presenting as a painless, soft, movable lump in the lateral neck. - While also a congenital neck cyst requiring surgical excision, the surgical approach for a branchial cyst does not involve the hyoid bone in the same manner as the Sistrunk operation due to its different embryological origin and location.

Question 1

The inducing agent of choice in shock -

Accepted Answer

Ketamine

Answer

Isoflurane

Answer

Desflurane

Answer

Thiopentone

Question 2

Tuberculin test is positive in general population (immunocompetent individuals with no specific risk factors) if induration is?

Accepted Answer

>10mm

Answer

>7mm

Answer

>5mm

Answer

>2mm

Question 3

Wood's lamp has a wavelength of –

Accepted Answer

360 nm

Answer

320 nm

Answer

300 nm

Answer

250 nm

Question 4

Trismus is commonly seen in

Accepted Answer

Quinsy

Answer

Ludwig's angina

Answer

Parapharyngeal abscess

Answer

Retropharyngeal abscess

Question 5

Incest is defined as sexual intercourse between which individuals?

Accepted Answer

Closely related individuals

Answer

Individuals other than spouse

Answer

Humans and animals

Answer

Unrelated individuals of same gender

Question 6

Tensile strength of a wound becomes normal after:

Accepted Answer

Never

Answer

6 months

Answer

4 months

Answer

6 weeks

Question 7

All are used in the treatment of nocturnal enuresis except?

Accepted Answer

Voiding of urine before sleeping

Answer

Imipramine

Answer

Alarm setup

Answer

Maintenance of calendar of day night wetting

Question 8

Which is not used in status epilepticus?

Accepted Answer

Metformin

Answer

Lorazepam

Answer

Phenytoin

Answer

Phenobarbitone

Question 9

Pagophagia involves eating

Accepted Answer

Ice

Answer

Sand

Answer

Salt

Answer

Clay

Question 10

Sistrunk operation is for:

Accepted Answer

Thyroglossal cyst

Answer

Thyroglossal fistula

Answer

Branchial fistula

Answer

Branchial cyst

NEET-PG 2013

Anesthesiology

Community Medicine

Dermatology

ENT

Forensic Medicine

Pathology

Pediatrics

Pharmacology

Psychiatry

Surgery