NEET-PG 2013 Practice Questions

Q: Which of the following viral diseases is least commonly reported in India?

Lassa fever. ***Lassa fever*** - **Lassa fever** is endemic to West Africa, with the **multimammate rat** being its primary reservoir. - Cases of Lassa fever are **extremely rare** in India, primarily limited to travel-related instances due to the geographical distribution of the disease and its vector. *Japanese B encephalitis* - **Japanese B encephalitis (JBE)** is a significant public health concern in India, particularly in endemic regions. - It is a mosquito-borne viral disease, and **vaccination programs** are ongoing to control its spread. *KFD* - **Kyasanur Forest Disease (KFD)** is an endemic viral hemorrhagic fever primarily found in the **Karnataka state of India**. - It is transmitted by **ticks**, making it a regionally significant but recognized viral disease within India. *Dengue* - **Dengue** is one of the most commonly reported and widespread viral diseases in India. - It is a **mosquito-borne** illness with frequent outbreaks occurring across various parts of the country.

Q: According to the immunization schedule, how many doses of influenza vaccine should children under 9 years of age receiving the vaccine for the first time typically receive?

2 doses at 4 weeks interval. ***2 doses at 4 weeks interval*** - Children **under 9 years of age** receiving the influenza vaccine for the **first time** require **two doses** administered at least **4 weeks (28 days) apart**. - This two-dose priming schedule is essential to ensure adequate immune response and protection against circulating influenza strains. - This recommendation is consistent across **IAP (Indian Academy of Pediatrics)** and **CDC guidelines**. - Children 9 years and older, and younger children who have been previously vaccinated, require only **1 dose annually**. *3 doses at 4 weeks interval* - The standard protocol for influenza vaccination does **not involve three doses**. - A three-dose schedule is typically seen with vaccines like **Hepatitis B**, **DTaP**, or **Hib**, but not for influenza. *2 doses at 4 weeks interval with a booster dose for high-risk children* - While high-risk children (chronic lung disease, heart disease, immunocompromised) are priority groups for influenza vaccination, the schedule remains **two initial doses** for first-time recipients under 9 years. - There is **no additional booster dose** beyond the two-dose series within the same influenza season, even for high-risk children. - Subsequent years require only **1 dose annually**. *None of the options* - This is incorrect as the standard recommendation is clearly established in immunization guidelines. - The **two-dose schedule at 4-week intervals** for first-time recipients under 9 years is well-documented by IAP and international guidelines.

Q: In the context of disease screening, which type of lead time is most beneficial for effective screening?

Long lead time is beneficial for screening. ***Long lead time is beneficial for screening*** - **Long lead time** provides a greater window of opportunity between disease detection by screening and clinical symptom onset - This extended asymptomatic detectable phase allows for **early intervention** when treatments are most effective - Longer lead time correlates with improved prognosis and potential prevention of severe outcomes - Essential criterion for effective screening programs per **Wilson-Jungner criteria** *Short lead time* - Limited time between disease detectability and clinical symptoms - Reduces screening effectiveness as disease progresses rapidly - Minimal opportunity for beneficial early intervention *Both short and long lead times are beneficial* - Only **long lead time** is beneficial for screening programs - Short lead time actually limits screening effectiveness - Screening benefit is directly proportional to duration of asymptomatic detectable phase *Lead time has no impact on screening effectiveness* - **Lead time is crucial** for determining screening program effectiveness - Directly impacts the window for early detection and intervention - Without adequate lead time, screening loses its preventive value

Q: Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?

Pleomorphic. ***Pleomorphic*** - The rash of **chickenpox** is **pleomorphic**, meaning lesions at various stages of development (macules, papules, vesicles, scabs) are present simultaneously in the same body area. - In contrast, a **smallpox** rash is **monomorphic**, with all lesions in a given area appearing at the same stage of development. *Centrifugal* - A **centrifugal distribution** (lesions more concentrated on the face and extremities) is characteristic of **smallpox**. - **Chickenpox** typically has a **centripetal distribution**, with lesions more concentrated on the trunk. *Deep-seated* - **Smallpox** lesions are described as **deep-seated** and feel like "shot under the skin," often associated with significant scarring. - **Chickenpox** lesions are superficial and less likely to cause scarring unless secondarily infected. *Multilocular* - **Smallpox** vesicles and pustules are typically **multilocular**, meaning they have internal septations and do not collapse when punctured. - **Chickenpox** vesicles are unilocular, appearing as a single compartment, and collapse when punctured.

Q: In blast injury, which organ is most likely to be damaged first?

Tympanic membrane. ***Tympanic membrane*** - The **tympanic membrane** is the most sensitive organ to the pressure waves generated by a blast, often rupturing even with relatively low blast overpressures. - Its thin, delicate structure and direct exposure to external air pressure make it highly vulnerable to barotrauma. *Gastrointestinal tract* - While the **gastrointestinal tract** can be damaged by blast waves, especially air-filled organs, this typically occurs after the tympanic membrane is affected. - Damage often includes hemorrhage, perforation, and mesenteric injury. *Liver* - The **liver** is a solid organ and is less susceptible to initial blast injury compared to air-filled structures. - Damage to the liver usually results from secondary mechanisms like blunt trauma from displacement or impact against other structures. *Lung* - **Blast lung** is a serious injury characterized by pulmonary contusions, hemorrhage, and edema, but it generally requires higher blast overpressure than tympanic membrane rupture. - The air-filled nature of the lungs makes them susceptible, but the tympanic membrane almost always fails first.

Q: Who coined the term 'cafe coronary'?

Roger Haugen. ***Roger Haugen*** - Dr. Roger Haugen is widely credited with coining the term "**cafe coronary**" in 1966. - He described cases of sudden death during meals that mimicked myocardial infarction but were caused by **choking on food** [1]. *J. Morton* - While J. Morton was a physician and made contributions to medical literature, he is **not associated** with coining the term "cafe coronary." - His work focused on other areas of medicine, not specifically on choking incidents. *Neil Markson* - Neil Markson is **not recognized** in medical history for coining the term "cafe coronary." - This name does not commonly appear in the context of the history of this medical term. *M. Hoppefield* - M. Hoppefield is **not attributed** to coining the term "cafe coronary." - There is no historical information linking this individual to the origin of this specific medical phrase.

Q: Pseudomonas is which type of bacteria?

Aerobic. ***Aerobic*** - **Pseudomonas aeruginosa** is a classic example of an **aerobic bacterium**, meaning it requires oxygen for growth and metabolism. - Its ability to thrive in aerobic environments contributes to its prevalence in hospital settings and its capacity to cause a wide range of infections. *Anaerobic* - Anaerobic bacteria grow in the absence of oxygen and often die in its presence. **Pseudomonas** does not exhibit this characteristic. - Examples of anaerobic bacteria include *Clostridium* species. *Microaerophilic* - Microaerophilic bacteria require oxygen but only in low concentrations (5-10%), higher concentrations are inhibitory. - **Pseudomonas** grows optimally in atmospheric oxygen levels, not restricted to low concentrations. *Obligate anaerobe* - Obligate anaerobes are severely inhibited or killed by oxygen. - This is the opposite of **Pseudomonas**, which strictly requires oxygen for survival.

Q: Pneumococcal vaccine is prepared from ?

Capsular polysaccharide. ***Capsular polysaccharide*** - The **polysaccharide capsule** of *Streptococcus pneumoniae* is the primary virulence factor, protecting the bacteria from phagocytosis. - Vaccines, such as **PCV13** (pneumococcal conjugate vaccine) and **PPSV23** (pneumococcal polysaccharide vaccine), are designed targeting these capsular polysaccharides to elicit a protective immune response. *Cell surface antigen* - While bacteria possess various **cell surface antigens**, not all are immunogenic or provide protective immunity as effectively as the capsular polysaccharides for *S. pneumoniae*. - For pneumococcus, the **capsule** is the most critical surface component for vaccine development due to its role in virulence and serotype specificity. *From exotoxin* - *S. pneumoniae* primarily causes disease through its **polysaccharide capsule** and other bacterial components, not through the production of an **exotoxin** that would be targeted by a vaccine. - Vaccines developed from exotoxins (e.g., diphtheria or tetanus toxoids) target specific toxins, which is not the mechanism for pneumococcal vaccines. *From M protein* - **M protein** is a major virulence factor for *Streptococcus pyogenes* (Group A Strep), not *Streptococcus pneumoniae*. - Vaccines targeting M protein are associated with **Group A Streptococcus** infections, for protection against diseases like rheumatic fever.

Q: Which anticoagulant is used when blood is sent for blood culture?

SPS. ***SPS*** - **SPS (Sodium Polyanethol Sulfonate)** is the preferred anticoagulant for blood cultures because it inhibits phagocytosis and complement activation, allowing microorganisms to survive and grow. - It also neutralizes the bactericidal effect of aminoglycoside antibiotics, which might be present in the patient's blood. *Sodium citrate* - **Sodium citrate** works by binding to calcium ions, preventing blood coagulation, and is typically used for coagulation studies. - It is not suitable for blood cultures as it does not have the anti-phagocytic or antibiotic-neutralizing properties of SPS. *EDTA* - **EDTA (Ethylenediaminetetraacetic acid)** is a strong chelator of calcium and is primarily used for hematology tests like complete blood counts (CBC) as it preserves cell morphology. - It can be toxic to some bacteria and would inhibit microbial growth, making it unsuitable for blood cultures. *Oxalate* - Various **oxalates** (e.g., potassium oxalate) also act as anticoagulants by precipitating calcium, and are commonly found in tubes for glucose testing when combined with a glycolytic inhibitor. - Oxalates are generally unsuitable for blood cultures because they can inhibit the growth of certain microorganisms.

Q: Most common organ involved in air blast injury is?

Ear drum. ***Ear drum*** - The **tympanic membrane (eardrum)** is highly sensitive to changes in pressure, making it the most vulnerable and frequently injured organ during **air blast events**. - Its delicate structure can easily rupture due to the sudden, immense pressure wave. *Stomach* - While blast injuries can affect the gastrointestinal tract, causing conditions like **bowel perforation**, the stomach is less commonly and directly impacted than the eardrum. - Gastrointestinal injury usually results from a combination of **blast waves** and secondary effects like **fragmentation**. *Eye* - Eye injuries from blasts often involve **foreign bodies**, **ocular trauma**, or **thermal burns**, but direct **barotrauma** to the eye itself is less common than eardrum rupture. - The eye is somewhat protected by the bony orbit, offering a degree of shielding from direct blast effects. *Lung* - **Blast lung injury** is a serious, life-threatening condition involving pulmonary contusions, hemorrhage, and rupture of alveoli. - While significant, it is generally considered less frequent than eardrum perforation in overall blast injury cases.

Question 1

Which of the following viral diseases is least commonly reported in India?

Accepted Answer

Lassa fever

Answer

Japanese B encephalitis

Answer

KFD

Answer

Dengue

Question 2

According to the immunization schedule, how many doses of influenza vaccine should children under 9 years of age receiving the vaccine for the first time typically receive?

Accepted Answer

2 doses at 4 weeks interval

Answer

2 doses at 4 weeks interval with a booster dose for high-risk children

Answer

3 doses at 4 weeks interval

Answer

None of the options

Question 3

In the context of disease screening, which type of lead time is most beneficial for effective screening?

Accepted Answer

Long lead time is beneficial for screening

Answer

Short lead time

Answer

Both short and long lead times are beneficial

Answer

Lead time has no impact on screening effectiveness

Question 4

Which of the following characteristics can be used to differentiate the rash of chickenpox from the rash of smallpox?

Accepted Answer

Pleomorphic

Answer

Deep-seated

Answer

Centrifugal

Answer

Multilocular

Question 5

In blast injury, which organ is most likely to be damaged first?

Accepted Answer

Tympanic membrane

Answer

Liver

Answer

Lung

Answer

Gastrointestinal tract

Question 6

Who coined the term 'cafe coronary'?

Accepted Answer

Roger Haugen

Answer

J. Morton

Answer

Neil Markson

Answer

M. Hoppefield

Question 7

Pseudomonas is which type of bacteria?

Accepted Answer

Aerobic

Answer

Anaerobic

Answer

Microaerophilic

Answer

Obligate anaerobe

Question 8

Pneumococcal vaccine is prepared from ?

Accepted Answer

Capsular polysaccharide

Answer

Cell surface antigen

Answer

Exotoxin

Answer

M protein

Question 9

Which anticoagulant is used when blood is sent for blood culture?

Accepted Answer

SPS

Answer

Sodium citrate

Answer

EDTA

Answer

Oxalate

Question 10

Most common organ involved in air blast injury is?

Accepted Answer

Ear drum

Answer

Stomach

Answer

Eye

Answer

Lung

NEET-PG 2013

Community Medicine

Forensic Medicine

Microbiology

Surgery