NEET-PG 2013 Practice Questions

Q: In Veau classification for cleft lip and palate, Type IV denotes

Bilateral cleft lip and palate. ***Bilateral cleft lip and palate*** - Veau Type IV specifically classifies cases involving a **bilateral complete cleft of both the lip and the palate**. - This is the most severe form in the Veau classification system, indicating involvement of both sides of the primary and secondary palates. *Bilateral cleft palate only* - The Veau classification primarily focuses on cleft lip and palate, not isolated palatal clefts without lip involvement. - An isolated bilateral cleft palate is not directly classified as Type IV; rather, Veau Type IV includes lip involvement. *Bilateral cleft lip only* - Veau Type IV encompasses both lip and palatal involvement, not just a bilateral cleft lip alone. - A bilateral cleft lip without a concomitant cleft palate would be classified differently within the system (e.g., Veau Type III if affecting the entire primary palate bilaterally without complete secondary palate involvement). *No cleft* - The Veau classification system is designed to categorize the presence and extent of cleft deformities, not the absence of a cleft. - This option is contrary to the purpose of a classification system for anomalies.

Q: Minamata disease is caused by toxicity of:

Mercury. ***Mercury (Correct Answer)*** - Minamata disease is a severe neurological syndrome caused by **mercury poisoning**, specifically from the consumption of fish and shellfish contaminated with **methylmercury**. - The disease was first identified in Minamata Bay, Japan, resulting from the release of industrial wastewater containing methylmercury. - **Clinical features** include: ataxia, dysarthria, constriction of visual fields, sensory disturbances, and in severe cases, convulsions and death. *Arsenic (Incorrect)* - **Arsenic poisoning** is associated with symptoms like **garlic breath**, skin lesions (hyperkeratosis, Raindrop pigmentation), and neurological damage, but it does not cause Minamata disease. - Exposure typically occurs through contaminated water or occupational settings. *Antimony (Incorrect)* - **Antimony toxicity** can manifest with symptoms such as nausea, vomiting, cardiac arrhythmias, and skin inflammation. - It is not linked to the distinct neurological syndrome known as Minamata disease. *Lead (Incorrect)* - **Lead toxicity** (plumbism) primarily affects the nervous system, kidneys, and hematopoietic system, leading to symptoms like **abdominal pain**, **wrist drop/foot drop**, and anemia. - While it causes neurological damage, it has a different clinical presentation and is not associated with Minamata disease.

Q: The common cause of subarachnoid hemorrhage is:

Aneurysm. ***Aneurysm*** - Aneurysms, particularly **saccular** or **berry aneurysms**, are the most frequent cause of **spontaneous subarachnoid hemorrhage (SAH)**, accounting for about 80-85% of cases [2]. - The sudden rupture of an intracranial aneurysm leads to blood spilling into the **subarachnoid space**, causing characteristic symptoms like a "thunderclap headache" [1]. *Arterio-venous malformation* - While AV malformations (AVMs) can cause SAH, they are a less common cause than aneurysms, accounting for approximately 5-10% of cases. - AVMs are abnormal direct connections between arteries and veins that bypass the capillary system and can rupture, leading to SAH or intraparenchymal hemorrhage. *Cavernous angioma* - Cavernous angiomas are abnormal clusters of dilated, thin-walled capillaries that can lead to hemorrhage, but they primarily cause **intraparenchymal hemorrhage** rather than SAH. - They are much less likely to result in diffuse bleeding into the subarachnoid space compared to ruptured aneurysms. *Hypertension* - Hypertension is a significant risk factor for the formation and rupture of aneurysms [1], but it is not a direct cause of SAH itself in the same way an aneurysm rupture is. - While uncontrolled hypertension is often associated with **intracerebral hemorrhage** (bleeding within the brain tissue), its direct role in causing SAH is usually secondary to an underlying vascular abnormality like an aneurysm.

Q: Polyopia/diplopia is seen in which type of cataract?

Cortical cataract. ***Cortical cataract*** - **Cortical cataracts** cause spokes or vacuoles that refract light in multiple directions, leading to **polyopia** or **diplopia**. - The irregular opacities disrupt the light path, causing the brain to perceive **multiple images**. *Nuclear cataract* - **Nuclear cataracts** primarily affect central vision and cause **myopic shift**, not typically polyopia or diplopia. - They cause **blurry vision** and difficulty seeing in dim light as the lens nucleus hardens and yellows. *Posterior subcapsular cataract* - **Posterior subcapsular cataracts** are characterized by glare and difficulty with reading, mainly affecting near vision. - They form at the back of the lens, close to the nodal point, causing earlier onset of **visual symptoms** with less impact on polyopia. *Anterior polar cataract* - **Anterior polar cataracts** are usually small, well-demarcated opacities at the front of the lens that typically do not cause significant visual impairment. - They rarely cause **polyopia** unless they are very large or dense, which is uncommon.

Q: In senile nuclear cataract what type of myopia is seen?

Index myopia. **Index myopia** - **Senile nuclear cataract** involves opacification and hardening of the lens nucleus, which increases the **refractive index** of the lens. - This results in a stronger refractive power of the eye, causing light to focus in front of the retina, characteristic of **myopia**. *Curvature myopia* - Occurs when there is an increase in the **curvature of the cornea** or lens, leading to increased refractive power. - While lens curvature can change, the primary mechanism in nuclear cataracts is refractive index change, not solely curvature. *Axial myopia* - Arises from an **elongation of the eyeball**, making the axial length too long relative to the refractive power. - This is a structural change in the eye's shape, not directly caused by changes within the lens itself due to cataract. *Lenticular myopia* - This term is a broader category that refers to myopia caused by changes in the lens, which **index myopia** falls under. - However, "index myopia" is more specific and accurately describes the underlying mechanism in senile nuclear cataracts.

Q: "Bread-crumb" appearance is seen in ?

Complicated cataracts. ***Complicated cataracts*** - A "bread-crumb" appearance, specifically referring to small, refractile opacities in the posterior capsule, is a characteristic finding in **complicated cataracts**. - These cataracts often develop due to chronic intraocular diseases such as **uveitis**, **retinal detachment**, or **intraocular tumors**, leading to secondary lens changes. *Cataract due to diabetes* - Diabetic cataracts typically present as "snowflake" opacities in younger patients or accelerated nuclear/cortical sclerosis in older patients, not a "bread-crumb" appearance. - They are often associated with poor glycemic control and metabolic changes affecting lens hydration and protein structure. *Cataract due to CMV infection* - Cataracts associated with **cytomegalovirus (CMV) infection** are more common in congenital infections and can manifest as varying degrees of lens opacification, but "bread-crumb" is not a typical description. - Congenital CMV can cause a spectrum of ocular abnormalities, including microphthalmia, chorioretinitis, and optic atrophy, in addition to cataracts. *Cataract due to Toxoplasmosis* - **Toxoplasmosis** primarily causes **chorioretinitis**, especially in congenital cases, with lens involvement being less common and not typically described as having a "bread-crumb" appearance. - If a cataract develops, it's usually secondary to inflammation or direct lens invasion, but the characteristic morphology differs.

Q: What is the drug of choice for the treatment of kala-azar?

Liposomal Amphotericin B. ***Liposomal Amphotericin B*** - It is currently considered the **drug of choice** for treating **visceral leishmaniasis (kala-azar)** due to its high efficacy and better tolerability profile compared to conventional amphotericin B. - The **liposomal formulation** allows for targeted delivery to macrophages, where *Leishmania* parasites reside, reducing systemic toxicity. *Amphotericin B* - While effective against *Leishmania*, conventional **Amphotericin B deoxycholate** is associated with significant **nephrotoxicity** and other severe side effects. - It is generally reserved for cases where liposomal amphotericin B is unavailable or as an alternative in specific clinical situations. *Quinine* - **Quinine** is an **antimalarial drug** primarily used for the treatment of *Plasmodium falciparum* malaria. - It has no significant efficacy against *Leishmania* species, which are the causative agents of kala-azar. *Paromomycin* - **Paromomycin** is an **aminoglycoside antibiotic** that can be used as an alternative treatment for visceral leishmaniasis, especially in combination therapies. - Although effective, it is generally not considered the first-line **drug of choice** globally, and its efficacy can vary by region.

Q: Metabolic change in severe vomiting is

Metabolic alkalosis due to loss of gastric acid. **Metabolic alkalosis due to loss of gastric acid** - Severe vomiting leads to the loss of **hydrochloric acid (HCl)** from the stomach, causing an increase in plasma bicarbonate and subsequently **metabolic alkalosis** [1], [3]. - This condition is often accompanied by **hypokalemia** due to renal compensation and increased aldosterone activity [1]. *Respiratory alkalosis due to hyperventilation* - **Hyperventilation** causes a decrease in arterial partial pressure of carbon dioxide (PaCO2), leading to **respiratory alkalosis** [2]. - While vomiting can sometimes cause mild hyperventilation due to discomfort, the primary metabolic derangement from severe vomiting is related to acid loss, not CO2 expulsion [4]. *Hyperkalemia due to renal dysfunction* - **Hyperkalemia** is an elevated potassium level, typically associated with **renal failure** or certain medications. - In severe vomiting, the loss of gastric fluid and subsequent fluid shifts tend to cause **hypokalemia** as the kidneys try to conserve hydrogen and excrete potassium [1]. *Metabolic acidosis due to renal failure* - **Metabolic acidosis** is characterized by a decrease in blood pH and bicarbonate, often caused by the accumulation of acids or loss of bicarbonate [3]. - **Renal failure** is a common cause of metabolic acidosis due to impaired acid excretion, which is not the primary issue in severe vomiting.

Q: Which of the following is not a typical symptom of Duchenne Muscular Dystrophy (DMD)?

Tenderness in muscles. ***Tenderness in muscles*** - **Muscle tenderness** and pain are **not typical primary symptoms** of Duchenne Muscular Dystrophy (DMD); the disease is characterized by progressive muscle weakness without significant pain. - While some discomfort might arise from muscle spasms or joint issues, widespread tenderness is characteristic of inflammatory conditions, not DMD. *Muscle pseudo hypertrophy* - **Pseudohypertrophy**, particularly in the calves, is a **hallmark sign** of DMD, caused by the replacement of muscle tissue with fat and connective tissue, making the muscles appear larger but weaker. - This symptom reflects the underlying muscle degeneration in DMD. *Muscle weakness* - **Progressive muscle weakness** is the defining characteristic of DMD, typically starting in the proximal muscles and leading to significant functional impairment. - This weakness is due to the lack of **dystrophin**, which is crucial for muscle fiber integrity. *Cardiomyopathy* - **Cardiomyopathy** is a **common and serious complication** of DMD, affecting nearly all patients by adolescence or early adulthood due to the absence of dystrophin in cardiac muscle. - It often manifests as **dilated cardiomyopathy**, contributing significantly to morbidity and mortality. *Gower's sign* - **Gower's sign** is a **classic clinical manifestation** of DMD, where the child uses their hands to "walk up" their legs when rising from the floor due to proximal muscle weakness. - This sign typically appears early in the disease course and is a key diagnostic indicator.

Q: Which of the following is an example of a clean surgery?

Hernia surgery. ***Hernia surgery*** - **Clean surgeries** involve no entry into hollow viscera (e.g., gastrointestinal, genitourinary, or respiratory tract) and are characterized by **no inflammation** or infection. Hernia repair typically fits this description. - The risk of **surgical site infection** (SSI) is usually less than 2% in clean cases, making it a benchmark for surgical infection control. *Gastric surgery* - This involves entry into the **gastrointestinal tract**, which is considered a **contaminated** or **clean-contaminated** procedure due to the presence of bacteria. - The risk of infection is higher than in clean surgeries, often requiring prophylactic antibiotics. *Cholecystectomy* - This procedure involves the **gallbladder**, which is part of the biliary system, often considered a **clean-contaminated** wound if bile spills or if there's no evidence of active infection. - If performed for **acute cholecystitis** (inflammation/infection), it would be classified as **contaminated** or **dirty**. *Rectal surgery* - This involves the **rectum**, which is part of the lower **gastrointestinal tract** and contains a high bacterial load. - Procedures involving the rectum are classified as **contaminated** or **dirty** due to the high risk of bacterial contamination.

Question 1

In Veau classification for cleft lip and palate, Type IV denotes

Accepted Answer

Bilateral cleft lip and palate

Answer

Bilateral cleft palate only

Answer

Bilateral cleft lip only

Answer

No cleft

Question 2

Minamata disease is caused by toxicity of:

Accepted Answer

Mercury

Answer

Arsenic

Answer

Antimony

Answer

Lead

Question 3

The common cause of subarachnoid hemorrhage is:

Accepted Answer

Aneurysm

Answer

Arterio-venous malformation

Answer

Cavernous angioma

Answer

Hypertension

Question 4

Polyopia/diplopia is seen in which type of cataract?

Accepted Answer

Cortical cataract

Answer

Nuclear cataract

Answer

Posterior subcapsular cataract

Answer

Anterior polar cataract

Question 5

In senile nuclear cataract what type of myopia is seen?

Accepted Answer

Index myopia

Answer

Curvature myopia

Answer

Axial myopia

Answer

Lenticular myopia

Question 6

"Bread-crumb" appearance is seen in ?

Accepted Answer

Complicated cataracts

Answer

Cataract due to CMV infection

Answer

Cataract due to diabetes

Answer

Cataract due to Toxoplasmosis

Question 7

What is the drug of choice for the treatment of kala-azar?

Accepted Answer

Liposomal Amphotericin B

Answer

Amphotericin B

Answer

Quinine

Answer

Paromomycin

Question 8

Metabolic change in severe vomiting is

Accepted Answer

Metabolic alkalosis due to loss of gastric acid

Answer

Respiratory alkalosis due to hyperventilation

Answer

Hyperkalemia due to renal dysfunction

Answer

Metabolic acidosis due to renal failure

Question 9

Which of the following is not a typical symptom of Duchenne Muscular Dystrophy (DMD)?

Accepted Answer

Tenderness in muscles

Answer

Muscle pseudo hypertrophy

Answer

Muscle weakness

Answer

Cardiomyopathy

Answer

Gower's sign

Question 10

Which of the following is an example of a clean surgery?

Accepted Answer

Hernia surgery

Answer

Cholecystectomy

Answer

Rectal surgery

Answer

Gastric surgery

NEET-PG 2013

Dental

Forensic Medicine

Internal Medicine

Ophthalmology

Pharmacology

Physiology

Psychiatry

Surgery