NEET-PG 2013 Practice Questions

Q: What is the primary clinical use of Sugammadex in anesthesia?

Reversal of NM blockers. ***Reversal of NM blockers*** - **Sugammadex** is a modified gamma-cyclodextrin that specifically encapsulates steroidal **neuromuscular blocking agents (NMBAs)** like **rocuronium** and **vecuronium**. - This encapsulation rapidly inactivates the NMBAs, leading to a dose-dependent and swift **reversal of neuromuscular blockade**. *Organophosphate poisoning* - Organophosphate poisoning is treated with **atropine** to block muscarinic effects and **pralidoxime** to reactivate inhibited acetylcholinesterase. - Sugammadex has no role in antagonizing the effects of **organophosphates** or regenerating acetylcholinesterase. *Treatment of local anaesthetic poisoning* - Local anesthetic systemic toxicity (LAST) is primarily managed with supportive care, including airway management, and the administration of **lipid emulsion therapy**. - Sugammadex does not bind to local anesthetics and therefore has no efficacy in treating local anesthetic poisoning. *Treatment of central anticholinergic syndrome* - Central anticholinergic syndrome is typically treated with **physostigmine**, an acetylcholinesterase inhibitor that can cross the blood-brain barrier. - Sugammadex is not an anticholinergic antagonist and does not affect the central nervous system to reverse anticholinergic effects.

Q: Which anaesthetic agent has maximum MAC ?

Nitrous Oxide (N2O). ***Nitrous Oxide (N2O)*** - **Nitrous Oxide** has the highest **minimum alveolar concentration (MAC)** of all commonly used inhalational anesthetics, approximately 104%. - A high MAC indicates **low potency**, meaning that a large concentration is required to achieve anesthetic effects. *Ether* - **Ether** has a MAC of about 1.92%, which is significantly lower than that of Nitrous Oxide. - Its use has largely been replaced due to its flammability, slow induction, and recovery times. *Methoxyfluorane* - **Methoxyfluorane** is known for having a very low MAC, around 0.16%, making it the most potent inhalational anesthetic. - Due to its high potency and significant nephrotoxicity, its use is now very limited. *Halothane* - **Halothane** has a MAC of approximately 0.75%. - While it was a widely used inhalational anesthetic, it has largely been replaced due to concerns about **halothane hepatitis** and arrhythmogenicity.

Q: What was the target reduction in child mortality rates set by the Millennium Development Goals (MDGs) between 1990 and 2015?

Two-thirds. ***Two-thirds*** - The **Millennium Development Goal 4 (MDG 4)** specifically aimed to **reduce child mortality by two-thirds** among children under five years old between 1990 and 2015. - This target focused on improving maternal and child health outcomes globally. *Half* - Reducing child mortality by half was not the specific target set by MDG 4 for the 1990-2015 period. - While improvements were sought, the ambition was a more substantial reduction. *One-fourth* - A reduction of one-fourth would have been a significantly lower target than what was ultimately set and pursued by the MDGs. - The goals were designed to be ambitious yet achievable. *One-third* - Reducing child mortality by one-third falls short of the actual target established by the MDGs. - The international community aimed for a greater impact on child survival rates.

Q: How many segments of RNA does the Influenza virus have?

8 segments of single-stranded RNA. ***8 segments of single-stranded RNA*** - The **Influenza virus** is characterized by its segmented genome, which consists of **eight distinct negative-sense single-stranded RNA (ssRNA)** molecules. - This segmentation is crucial for its high mutation rate and ability to undergo **antigenic shift** and **antigenic drift**, leading to new strains. *5 segments of single-stranded RNA* - This option is incorrect because the Influenza virus specifically has **eight segments**, not five. - While it is a single-stranded RNA virus, the number of segments is a key characteristic. *8 segments of double-stranded DNA* - This option is incorrect as Influenza is an **RNA virus**, not a DNA virus, and its genetic material is single-stranded, not double-stranded. - No known influenza viruses have a **double-stranded DNA genome**. *8 segments of single-stranded DNA* - This option is incorrect because Influenza is an **RNA virus**, not a DNA virus. - Its genetic material is composed of **RNA**, specifically negative-sense single-stranded RNA.

Q: Which of the following is the most potent topical corticosteroid?

Clobetasol propionate. ***Clobetasol propionate*** - **Clobetasol propionate** is recognized as one of the most potent **Class I topical corticosteroids**, used for severe inflammatory skin conditions. - Its high potency allows for effective suppression of severe inflammation and pruritus, but also carries a greater risk of **adverse effects** with prolonged use. *Triamcinolone acetonide* - **Triamcinolone acetonide** is a **medium-potency** topical corticosteroid (Class IV-V), less potent than clobetasol propionate. - It is commonly used for moderate inflammatory skin conditions, such as eczema and psoriasis, but not for severe cases requiring maximum potency. *Hydrocortisone acetate* - **Hydrocortisone acetate** is a **low-potency** topical corticosteroid (Class VII), making it the least potent option listed. - It's often used for mild inflammatory conditions, sensitive areas like the face, or for less severe conditions requiring minimal corticosteroid strength. *Betamethasone valerate* - **Betamethasone valerate** is a **medium-to-high potency** topical corticosteroid (Class III-V), placing it among stronger corticosteroids but still less potent than clobetasol propionate. - It is effective for moderate to severe inflammatory skin conditions but does not reach the highest level of potency demonstrated by clobetasol.

Q: Which of the following is a benzylisoquinoline muscle relaxant?

Doxacurium. ***Doxacurium*** - **Doxacurium** is a long-acting, non-depolarizing neuromuscular blocker classified as a **benzylisoquinoline** compound [1]. - These agents are known for their minimal cardiovascular effects and lack of histamine release in therapeutic doses [1]. *Vecuronium* - **Vecuronium** is an **aminosteroid** non-depolarizing neuromuscular blocker [2]. - It is known for its intermediate duration of action and minimal cardiovascular effects [1]. *Rocuronium* - **Rocuronium** is also an **aminosteroid** non-depolarizing neuromuscular blocker [2]. - It has a rapid onset of action, making it suitable for rapid sequence intubation, and can be reversed by **sugammadex**. *Pancuronium* - **Pancuronium** is an **aminosteroid** non-depolarizing neuromuscular blocker with a long duration of action [1]. - It is associated with a vagolytic effect that can cause an increase in **heart rate** and **blood pressure** [1].

Q: Which medication increases insulin secretion from beta cells?

Repaglinide. ***Repaglinide*** - This medication is a **meglitinide analog** that stimulates **insulin release** from pancreatic beta cells by closing ATP-sensitive potassium channels. - Its fast onset and short duration of action make it particularly useful for controlling **postprandial glucose** excursions. *Metformin* - This medication primarily works by **decreasing hepatic glucose production** and improving insulin sensitivity in peripheral tissues. - It does **not directly stimulate insulin secretion** from beta cells; thus, it carries a lower risk of hypoglycemia compared to sulfonylureas or meglitinides. *Pramlintide* - This is an **amylin analog** that works by slowing gastric emptying, suppressing postprandial glucagon secretion, and increasing satiety. - It is an **injectable medication** used as an adjunct to insulin therapy and does not directly enhance insulin secretion from beta cells. *Pioglitazone* - This drug is a **thiazolidinedione** that improves insulin sensitivity in target tissues (e.g., muscle, fat, liver) by activating **peroxisome proliferator-activated receptor-gamma (PPAR-γ)**. - While it improves the body's response to insulin, it does **not directly stimulate insulin secretion** from the beta cells.

Q: What serious side effect may lead to the discontinuation of felbamate?

Aplastic anemia. ***Aplastic anemia*** - Felbamate is known to cause **aplastic anemia**, a severe and life-threatening condition where the **bone marrow stops producing enough new blood cells**. - Felbamate carries a **black box warning** for both aplastic anemia and **hepatotoxicity (severe liver failure)**, which are the two most serious adverse effects leading to discontinuation. - Due to this significant risk, felbamate is reserved for severe, refractory epilepsy cases, and patients require **regular monitoring** of blood counts and liver function tests. *Renal impairment* - While some medications can cause renal impairment, **felbamate is not primarily associated** with this side effect to the extent of requiring discontinuation. - Its metabolism and excretion are predominantly **hepatic (liver)**, and renal effects are less common or severe. *Gastrointestinal disorder* - Gastrointestinal side effects like nausea or vomiting are **common with many medications**, including felbamate, but are generally **mild and manageable**, rarely leading to discontinuation. - These effects are usually **dose-dependent** and can often be mitigated with supportive care. *Seizures* - Felbamate is an **antiepileptic drug (AED)**, so it is used to treat seizures, not cause them. - If a patient experiences seizures while on felbamate, it usually indicates **inadequate treatment response** or seizure exacerbation, rather than a direct side effect necessitating discontinuation for toxicity.

Q: Which of the following statements about sitagliptin is false?

Cannot be used orally. ***Cannot be used orally*** - This statement is **false** because **sitagliptin** is an **oral medication** approved for the treatment of type 2 diabetes mellitus. - As a **DPP-4 inhibitor**, it is designed to be taken by mouth to increase incretin hormone levels. *Used in type II diabetes mellitus* - This statement is **true** as **sitagliptin** is a commonly prescribed **oral antidiabetic drug** for the management of type 2 diabetes. - It works by inhibiting the enzyme **dipeptidyl peptidase-4 (DPP-4)**, which increases levels of **GLP-1** and **GIP** to enhance insulin secretion and reduce glucagon secretion. *Used in combination with other oral hypoglycemic agents* - This statement is **true** as **sitagliptin** is often used as **add-on therapy** with other oral hypoglycemic agents like **metformin** or a **sulfonylurea** when monotherapy is insufficient. - This combination approach helps achieve better glycemic control by targeting different mechanisms of action. *All of the above statements are true* - This statement is **false** because the first statement "Cannot be used orally" is incorrect. - Since sitagliptin is indeed an oral medication, not all the above statements are true, making this option incorrect.

Q: What is a potential risk associated with the use of thiazolidinediones in the treatment of type 2 diabetes?

Heart failure. ***Heart failure*** - Thiazolidinediones (TZDs), such as **pioglitazone** and **rosiglitazone**, can cause **fluid retention** and **volume expansion**, which may precipitate or worsen congestive heart failure. - This risk is higher in patients with pre-existing cardiac conditions and is a significant concern for these drugs. *Pulmonary fibrosis* - **Pulmonary fibrosis** is not a known or common adverse effect associated with thiazolidinedione use. - This condition is typically linked to certain other medications (e.g., **amiodarone**, **methotrexate**) or systemic diseases. *Myocarditis* - **Myocarditis**, inflammation of the heart muscle, is not a recognized side effect of thiazolidinediones. - Myocarditis is more commonly caused by viral infections, autoimmune diseases, or hypersensitivity reactions to certain drugs, but not TZDs. *Renal dysfunction* - While TZDs can cause fluid retention, they do not directly cause **renal dysfunction** or damage the kidneys. - In fact, some studies suggest they may have renoprotective effects due to reduced proteinuria, although fluid balance needs careful monitoring in patients with impaired renal function.

Question 1

What is the primary clinical use of Sugammadex in anesthesia?

Accepted Answer

Reversal of NM blockers

Answer

Organophosphate poisoning

Answer

Treatment of local anaesthetic poisoning

Answer

Treatment of central anticholinergic syndrome

Question 2

Which anaesthetic agent has maximum MAC ?

Accepted Answer

Nitrous Oxide (N2O)

Answer

Ether

Answer

Methoxyfluorane

Answer

Halothane

Question 3

What was the target reduction in child mortality rates set by the Millennium Development Goals (MDGs) between 1990 and 2015?

Accepted Answer

Two-thirds

Answer

Half

Answer

One-fourth

Answer

One-third

Question 4

How many segments of RNA does the Influenza virus have?

Accepted Answer

8 segments of single-stranded RNA

Answer

5 segments of single-stranded RNA

Answer

8 segments of double-stranded DNA

Answer

8 segments of single-stranded DNA

Question 5

Which of the following is the most potent topical corticosteroid?

Accepted Answer

Clobetasol propionate

Answer

Triamcinolone acetonide

Answer

Hydrocortisone acetate

Answer

Betamethasone valerate

Question 6

Which of the following is a benzylisoquinoline muscle relaxant?

Accepted Answer

Doxacurium

Answer

Rocuronium

Answer

Pancuronium

Answer

Vecuronium

Question 7

Which medication increases insulin secretion from beta cells?

Accepted Answer

Repaglinide

Answer

Metformin

Answer

Pioglitazone

Answer

Pramlintide

Question 8

What serious side effect may lead to the discontinuation of felbamate?

Accepted Answer

Aplastic anemia

Answer

Seizures

Answer

Renal impairment

Answer

Gastrointestinal disorder

Question 9

Which of the following statements about sitagliptin is false?

Accepted Answer

Cannot be used orally

Answer

Used in type II diabetes mellitus

Answer

Used in combination with other oral hypoglycemic agents

Answer

All of the above statements are true

Question 10

What is a potential risk associated with the use of thiazolidinediones in the treatment of type 2 diabetes?

Accepted Answer

Heart failure

Answer

Pulmonary fibrosis

Answer

Myocarditis

Answer

Renal dysfunction

NEET-PG 2013

Anesthesiology

Community Medicine

Microbiology

Pharmacology