Biochemistry
1 questionsDermatitis may be a clinical manifestation of deficiency states of all of the following nutrients except -
NEET-PG 2015 - Biochemistry NEET-PG Practice Questions and MCQs
Question 991: Dermatitis may be a clinical manifestation of deficiency states of all of the following nutrients except -
- A. Biotin
- B. Niacin
- C. Pyridoxine
- D. Thiamine (Correct Answer)
Explanation: ***Thiamine*** - A deficiency in **thiamine (vitamin B1)** primarily affects the nervous and cardiovascular systems, leading to conditions like **beriberi**, characterized by neuropathy, heart failure, and Wernicke-Korsakoff syndrome. - Dermatitis is **not a typical or direct clinical manifestation** of thiamine deficiency. *Biotin* - **Biotin (vitamin B7)** deficiency can cause **dermatitis**, often described as a scaly, erythematous rash around the eyes, nose, and mouth. - Hair loss (**alopecia**) and **neurological symptoms** are also associated with biotin deficiency. *Niacin* - **Niacin (vitamin B3)** deficiency leads to **pellagra**, classically presenting with the "3 Ds": **dermatitis**, **diarrhea**, and **dementia**. - The dermatitis in pellagra is typically symmetrical and photosensitive, affecting sun-exposed areas. *Pyridoxine* - **Pyridoxine (vitamin B6)** deficiency can result in **seborrheic dermatitis-like rash**, especially around the eyes, nose, and mouth. - Other symptoms include **glossitis**, **cheilosis**, and **neurological disturbances** like peripheral neuropathy.
Dermatology
1 questionsIn which part of the body are lesions of Kaposi sarcoma most commonly seen?
NEET-PG 2015 - Dermatology NEET-PG Practice Questions and MCQs
Question 991: In which part of the body are lesions of Kaposi sarcoma most commonly seen?
- A. Upper extremities
- B. Lower extremities (Correct Answer)
- C. Torso
- D. Head and neck
Explanation: ***Lower extremities*** - Kaposi sarcoma lesions most frequently appear on the **skin of the lower extremities**, especially the feet and ankles. - This predilection is thought to be due to increased **venous stasis** or other local factors. *Upper extremities* - While Kaposi sarcoma can affect the upper extremities, it is a **less common primary site** compared to the lower limbs. - Lesions here are more likely to appear as the disease **progresses or disseminates**. *Torso* - Kaposi sarcoma lesions can occur on the torso, particularly on the **trunk**, but it is not the most common initial presentation. - Visceral involvement of the **gastrointestinal tract** and lungs can often present without skin lesions on the torso. *Head and neck* - Lesions of Kaposi sarcoma can appear on the head and neck, especially on the **face and oral cavity**, particularly in classic Kaposi sarcoma or in individuals with advanced immunosuppression. - However, this is still **less frequent** than involvement of the lower extremities.
Internal Medicine
5 questionsMost common acute complication of dialysis is
What is the most common cause of death in patients with advanced cancer?
All of the following are true about Gout, except which of the following?
Most common organism associated with reactive arthritis is:
In long standing rheumatoid arthritis, which condition is commonly observed?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 991: Most common acute complication of dialysis is
- A. Hypotension (Correct Answer)
- B. Bleeding
- C. Dementia
- D. Muscle cramps
Explanation: ***Hypotension*** - **Intradialytic hypotension** is the most common acute complication, occurring in 15-30% of dialysis sessions. - It is often caused by rapid removal of fluid (ultrafiltration), leading to a significant drop in blood pressure [1]. *Bleeding* - While bleeding can occur due to **anticoagulation** used during dialysis or as a complication of vascular access, it is less common than hypotension. - It is not considered the most frequent acute complication of the dialysis procedure itself. *Dementia* - **Dementia** is a chronic neurological condition that is not an acute complication directly attributable to a single dialysis session. - It can be a long-term comorbidity in patients with end-stage renal disease (ESRD), but not an immediate side effect. *Muscle cramps* - **Muscle cramps** are a relatively common acute complication during or immediately after dialysis, affecting about 5-20% of patients. - However, their frequency is generally lower than that of intradialytic hypotension [1].
Question 992: What is the most common cause of death in patients with advanced cancer?
- A. Bleeding
- B. Infection (Correct Answer)
- C. Respiratory failure
- D. Renal failure
Explanation: ***Infection*** - **Immunosuppression** from cancer itself and its treatments (e.g., chemotherapy, radiation) significantly increases susceptibility to infections. - Many patients with advanced cancer die from **sepsis** or opportunistic infections due to their weakened immune systems [1]. *Bleeding* - While bleeding can be a significant complication in advanced cancer (e.g., from tumor erosion, thrombocytopenia), it is less common as a direct cause of death compared to infection. - Life-threatening hemorrhages are typically managed, and other factors often contribute to mortality. *Respiratory failure* - **Respiratory failure** can occur due to **lung metastases**, direct tumor invasion, or complications like pneumonia in advanced cancer patients. - However, the underlying cause of such pneumonia or decline is often infectious or a result of systemic weakness. *Renal failure* - **Renal failure** can be caused by tumor obstruction of the urinary tract, **nephrotoxic chemotherapy**, or paraneoplastic syndromes. - Although serious, it is not the most frequent immediate cause of death in the broad population of advanced cancer patients.
Question 993: All of the following are true about Gout, except which of the following?
- A. Can be precipitated by pyrazinamide
- B. Birefringent crystals are present in the joint
- C. Occurs due to accumulation of urate crystals in joint
- D. Occurs more in females (Correct Answer)
Explanation: ***Occurs more in females*** - **Gout** is more prevalent in **males** than in females, especially before menopause, due to hormonal differences and lifestyle factors. - After menopause, the incidence in females increases but generally remains lower than in males. *Occurs due to accumulation of urate crystals in joint* - **Gout** is precisely characterized by the **deposition of monosodium urate crystals** in joints and surrounding tissues, leading to inflammation [1], [2]. - This accumulation is a direct consequence of **hyperuricemia**, either from overproduction or underexcretion of uric acid [2], [3]. *Can be precipitated by pyrazinamide* - **Pyrazinamide** is an anti-tuberculosis drug known to **inhibit uric acid excretion** by the kidneys. - This leads to **hyperuricemia**, thereby increasing the risk of acute gout attacks. *Birefringent crystals are present in the joint* - Microscopic examination of **synovial fluid** from a gouty joint reveals **needle-shaped, negatively birefringent crystals** of monosodium urate [1], [4]. - This finding is a definitive diagnostic criterion for **gout**.
Question 994: Most common organism associated with reactive arthritis is:
- A. Staphylococcus
- B. Shigella
- C. Chlamydia (Correct Answer)
- D. Yersinia
Explanation: ***Chlamydia*** - **Chlamydia trachomatis** is a commonly identified pathogen causing **genitourinary infections** that can trigger reactive arthritis [1]. - The organism itself is not present in the joint, but its antigens trigger an immune response leading to sterile arthritis [1]. *Staphylococcus* - **Staphylococcus aureus** is a common cause of septic arthritis, which involves direct bacterial invasion of the joint. - Reactive arthritis is a **sterile arthritis** triggered by an infection elsewhere, not directly caused by staphylococcal joint infection. *Shigella* - While **Shigella** is a known enteric pathogen that can trigger reactive arthritis, it is less commonly associated with the condition globally compared to Chlamydia [1]. - Reactive arthritis often follows episodes of **dysentery** caused by Shigella species [1]. *Yersinia* - **Yersinia enterocolitica** is another enteric bacterium that can induce reactive arthritis, typically after **gastrointestinal infections**. - Its prevalence as a trigger for reactive arthritis is generally lower than that of Chlamydia.
Question 995: In long standing rheumatoid arthritis, which condition is commonly observed?
- A. Milk alkali syndrome
- B. Nephrolithiasis
- C. Paradoxical aciduria
- D. Secondary amyloidosis (Correct Answer)
Explanation: ***Secondary amyloidosis*** - Chronic inflammation in **rheumatoid arthritis** can lead to the production and deposition of **amyloid A protein**, which is the hallmark of secondary (AA) amyloidosis [1]. - **Secondary amyloidosis** can affect various organs, including the kidneys, heart, and gastrointestinal tract, leading to organ dysfunction [1]. *Milk alkali syndrome* - This condition is caused by excessive intake of **calcium** and absorbable alkali, resulting in **hypercalcemia** and **metabolic alkalosis**. - It is not directly associated with the chronic inflammatory process of rheumatoid arthritis. *Nephrolithiasis* - **Kidney stones** (nephrolithiasis) are often associated with genetic predispositions, dietary factors, and certain metabolic conditions like **hypercalciuria** or **hyperoxaluria**. - There is no direct causal link between **rheumatoid arthritis** and an increased risk of common types of kidney stones. *Paradoxical aciduria* - This condition is characterized by the excretion of acidic urine in the presence of **metabolic alkalosis**, typically due to **volume depletion** and **hypokalemia**. - While it reflects a disturbance in acid-base balance and renal function, it is not a direct or commonly observed complication of long-standing rheumatoid arthritis itself.
Pharmacology
2 questionsWhat is the drug of choice (DOC) for the treatment of subacute sclerosing panencephalitis (SSPE)?
Which vitamin/nutrient toxicity is associated with excessive sweating?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 991: What is the drug of choice (DOC) for the treatment of subacute sclerosing panencephalitis (SSPE)?
- A. Abacavir
- B. Inosine pranobex (Correct Answer)
- C. Glatiramer
- D. Interferon
Explanation: ***Inosine pranobex*** - **Inosine pranobex (Isoprinosine)** is considered the **oral drug of choice** for treating **subacute sclerosing panencephalitis (SSPE)**, particularly in the early stages, as it has shown success in delaying disease progression. - This drug works by **modulating the immune system** and enhancing T-cell function, which helps control the persistent measles virus infection in the CNS. - **Note:** Best outcomes are achieved when inosine pranobex is combined with **intrathecal/intraventricular interferon-alpha**, but as a single oral agent, inosine pranobex is the primary choice. *Abacavir* - **Abacavir** is an **antiretroviral drug (NRTI)** used in the treatment of **HIV infection**. - It inhibits reverse transcriptase and has **no role** in treating measles virus-induced SSPE. *Glatiramer* - **Glatiramer acetate** is an **immunomodulatory drug** used in **multiple sclerosis (MS)**. - It works by mimicking **myelin basic protein** to reduce immune attacks on myelin, but is **not effective** against viral infections like SSPE. *Interferon* - **Interferon-alpha** (particularly **intrathecal/intraventricular** administration) has been used in **SSPE** as **combination therapy** with inosine pranobex, showing improved outcomes. - However, when given systemically alone, it has **significant side effects** and **variable efficacy**. - As a single answer option without specifying the route, **inosine pranobex** is preferred as the primary oral DOC.
Question 992: Which vitamin/nutrient toxicity is associated with excessive sweating?
- A. Choline (Correct Answer)
- B. Biotin
- C. Folic acid
- D. Niacin (Vitamin B3)
Explanation: ***Choline*** - **Excessive sweating** is a recognized symptom of choline toxicity, often accompanied by a **fishy body odor**, hypotension, and gastrointestinal distress. - Choline plays a role in various metabolic pathways, and high doses can overwhelm these systems, leading to adverse effects. *Biotin* - **Biotin toxicity** is extremely rare, even at very high doses; there are no well-documented cases of adverse effects from excessive intake. - Symptoms like excessive sweating are not associated with biotin overdose. *Folic acid* - While high doses of **folic acid** can mask a **vitamin B12 deficiency**, side effects like gastrointestinal upset or sleep disturbances are rare. - Excessive sweating is **not a characteristic symptom** of folic acid toxicity. *Niacin (Vitamin B3)* - High doses of niacin, especially its nicotinic acid form, are well-known to cause **flushing, itching, and liver toxicity**. - While skin effects are common with niacin toxicity, **excessive sweating** as a primary symptom is not typically reported.
Psychiatry
1 questionsIn Alzheimer's disease (AD), which of the following is NOT commonly seen in early stages?
NEET-PG 2015 - Psychiatry NEET-PG Practice Questions and MCQs
Question 991: In Alzheimer's disease (AD), which of the following is NOT commonly seen in early stages?
- A. Apraxia
- B. Aphasia
- C. Agnosia
- D. Acalculia (Correct Answer)
Explanation: ***Acalculia*** - **Acalculia**, the inability to perform mathematical calculations, is generally **not an early feature** of Alzheimer's disease. - It typically emerges in **middle-to-late stages** as parietal lobe involvement progresses. - Early AD primarily affects **episodic memory, orientation, and mild language difficulties** before significantly impairing complex cognitive tasks like calculation. *Aphasia* - **Mild anomia** (word-finding difficulty) and naming problems are **common early symptoms** of Alzheimer's disease. - Patients often struggle with spontaneous speech and may use circumlocutions to compensate. - This reflects early involvement of temporal-parietal language areas. *Agnosia* - **Agnosia** (inability to recognize objects, faces, or sounds despite intact sensory function) typically appears in **middle-to-late stages**, not early AD. - Early AD is characterized by memory loss and mild language problems, with agnosia developing later as cortical atrophy progresses. - However, among the later features listed, aphasia is clearly the earliest. *Apraxia* - **Apraxia** (inability to perform learned motor tasks despite intact motor function) is a **middle-stage feature**, not an early manifestation. - Early AD patients retain the ability to perform routine motor tasks; apraxia develops as the disease progresses and involves premotor and parietal cortices. - Like agnosia, this is not an early feature.