Anatomy
1 questionsEmbryo gets implanted at what stage of development?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 1051: Embryo gets implanted at what stage of development?
- A. Two cell stage
- B. Four cell stage
- C. Morula
- D. Blastocyst (Correct Answer)
Explanation: Blastocyst - Implantation into the uterine wall occurs when the embryo has developed into a blastocyst, typically around day 6 post-fertilization [1]. - The blastocyst consists of an inner cell mass (which forms the embryo) and an outer layer called the trophoblast (which contributes to the placenta) [1]. Two cell stage - This stage occurs very early in development, usually within the first 24-30 hours after fertilization [1]. - At this point, the embryo is still in the fallopian tube and has not yet reached the uterus for implantation [1]. Four cell stage - The four-cell stage is also an early cleavage stage, occurring around 2 days post-fertilization [1]. - Like the two-cell stage, the embryo is still in transport through the fallopian tube and is not ready for implantation [1]. Morula - The morula is a solid ball of cells formed by cleavage, typically around day 3-4 post-fertilization [1]. - While it has moved closer to the uterus, it has not yet formed the distinct inner cell mass and trophoblast necessary for successful implantation [1].
Dermatology
1 questionsIn which of the following conditions is phototherapy, specifically ultraviolet light therapy, useful for treatment?
NEET-PG 2015 - Dermatology NEET-PG Practice Questions and MCQs
Question 1051: In which of the following conditions is phototherapy, specifically ultraviolet light therapy, useful for treatment?
- A. Psoriasis (Correct Answer)
- B. Tinea corporis
- C. Pemphigus
- D. PMLE
Explanation: ***Psoriasis*** - **Phototherapy** (narrowband UVB, broadband UVB, or PUVA) is a **well-established first-line treatment** for **moderate-to-severe psoriasis**. - It works by **suppressing overactive immune cells** in the skin, reducing inflammation and decreasing keratinocyte proliferation. - **Direct therapeutic effect** on active psoriatic lesions makes this the primary indication for phototherapy in dermatology. *Tinea corporis* - **Tinea corporis** is a **superficial fungal infection** (dermatophytosis) of the skin. - Requires **antifungal medications** (topical azoles or oral terbinafine/griseofulvin) for treatment. - **Phototherapy has no antifungal activity** and is not used for this condition. *Pemphigus* - **Pemphigus** is an **autoimmune blistering disease** with intraepidermal acantholysis. - Treatment requires **systemic immunosuppression** (corticosteroids, rituximab, azathioprine). - **Phototherapy is not indicated** and could potentially worsen the condition. *PMLE* - **Polymorphous light eruption (PMLE)** is a common **photosensitivity disorder**. - While **prophylactic photohardening** (gradual controlled UV exposure) can be used to build tolerance **before sun exposure season**, this is a **preventative desensitization strategy**, not treatment of active disease. - Unlike psoriasis, phototherapy does **not treat active PMLE lesions** and can trigger flares if not done properly. - The primary approach for active PMLE is **sun avoidance, sun protection, and topical corticosteroids**.
Obstetrics and Gynecology
8 questionsUterine height is greater than gestational age of the patient in a case of all except -
Following delivery, a tear involving the perineum and external anal sphincter with intact mucosa is classified as which grade?
Which of the following is NOT a cause of oligohydramnios?
Which of the following statements about chorionic villus sampling is false?
A 28-year-old primigravida with 32 weeks of gestation presents with profuse vaginal discharge since yesterday. She was advised USG, which showed a single live intrauterine gestational sac with FL and AC corresponding to the weeks of gestation and AFI as adequate. What is the diagnosis?
Poor prognostic factor for hydatidiform mole is -
Which of the following drugs is commonly used in the treatment of endometriosis?
What condition is diagnosed using the Amsel criteria?
NEET-PG 2015 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1051: Uterine height is greater than gestational age of the patient in a case of all except -
- A. Fibroid uterus
- B. Wrong dates
- C. Polyhydramnios
- D. IUGR (Correct Answer)
Explanation: ***IUGR*** - In **Intrauterine Growth Restriction (IUGR)**, the fetus is smaller than expected for gestational age, leading to a **fundal height** that measures less than the actual gestational age. - This condition is characterized by a **restricted growth rate** of the fetus, causing the uterine size to be disproportionately small. *Fibroid uterus* - The presence of **uterine fibroids** (leiomyomas) can increase the overall size of the uterus beyond what would be expected for a given gestational age. - These benign tumors add bulk to the uterine wall, leading to a **larger-than-expected uterine height**. *Wrong dates* - Incorrect estimation of the **Last Menstrual Period (LMP)** or date of conception can lead to a miscalculation of gestational age. - If the gestational age is **underestimated**, the actual uterine height will appear greater than the calculated gestational age. *Polyhydramnios* - **Polyhydramnios** is a condition characterized by an **excessive accumulation of amniotic fluid**, which distends the uterus. - Increased amniotic fluid volume leads to a significantly **larger uterine size** and a fundal height greater than the gestational age.
Question 1052: Following delivery, a tear involving the perineum and external anal sphincter with intact mucosa is classified as which grade?
- A. First degree
- B. Second degree
- C. Third degree (Correct Answer)
- D. Fourth degree
Explanation: ***Third degree*** - A third-degree perineal tear involves the **perineum** and the **external anal sphincter (EAS)**, either partially or completely, while the **anal mucosa remains intact**. - This classification is crucial for determining the necessary repair technique and predicting potential long-term complications related to **anal incontinence**. *First degree* - A first-degree tear involves only the **skin** of the perineum and the **vaginal mucosa**, without involving the underlying muscle. - These tears are typically superficial and may not even require suturing. *Second degree* - A second-degree tear involves the **perineal muscles** but does not extend to the anal sphincter. - It includes the vaginal mucosa, perineal skin, and muscles but spares the **external anal sphincter**. *Fourth degree* - A fourth-degree tear is the most severe, involving the **perineum**, **external anal sphincter**, and extending through the **anal mucosa**, exposing the rectal lumen. - These tears carry the highest risk of **fecal incontinence** and require meticulous surgical repair.
Question 1053: Which of the following is NOT a cause of oligohydramnios?
- A. Renal agenesis
- B. Amnion nodosum
- C. Chorioangioma (Correct Answer)
- D. IUGR
Explanation: ***Chorioangioma*** - A **chorioangioma** is a benign placental tumor that causes **polyhydramnios** (excess amniotic fluid), which is the **opposite** of oligohydramnios. - Large chorioangiomas lead to increased transudation from the tumor's vascular channels, fetal anemia, and high-output cardiac failure, resulting in increased fetal urine production. - This is clearly **NOT a cause** of oligohydramnios, making it the correct answer. *IUGR* - **Intrauterine growth restriction (IUGR)**, particularly with placental insufficiency, is a common cause of **oligohydramnios**. - Reduced placental perfusion leads to decreased **fetal renal blood flow** and diminished urine production. - Since fetal urine is the main source of amniotic fluid after 16 weeks, reduced output causes oligohydramnios. *Renal agenesis* - **Bilateral renal agenesis** (Potter syndrome) is a classic and severe cause of **oligohydramnios/anhydramnios**. - Complete absence of kidneys means **no fetal urine production**, eliminating the primary source of amniotic fluid in the second and third trimesters. - Results in severe oligohydramnios with associated pulmonary hypoplasia and Potter facies. *Amnion nodosum* - **Amnion nodosum** refers to small, grayish-yellow nodules on the fetal surface of the amnion, composed of aggregated fetal squamous epithelial cells and vernix. - These nodules are a **pathological finding** that occurs as a **consequence** of chronic oligohydramnios, not a cause. - They form due to prolonged contact between the fetal skin and amnion when amniotic fluid is severely reduced. - While technically "not a cause," it is strongly **associated with** oligohydramnios, whereas chorioangioma causes the opposite condition entirely.
Question 1054: Which of the following statements about chorionic villus sampling is false?
- A. Can cause limb deformities
- B. Is used for prenatal genetic diagnosis
- C. Villi are collected from chorion frondosum
- D. Is performed only in second trimester of pregnancy (Correct Answer)
Explanation: ***Is performed only in second trimester of pregnancy*** - This statement is false because **chorionic villus sampling (CVS)** is typically performed earlier in pregnancy, specifically during the **first trimester**, usually between 10 and 13 weeks of gestation. - Performing CVS only in the second trimester would negate one of its main advantages: providing earlier genetic diagnostic information than **amniocentesis**. *Is used for prenatal genetic diagnosis* - **CVS** is a primary method for **prenatal genetic diagnosis**, allowing for the detection of chromosomal abnormalities and genetic disorders. - It involves analyzing fetal cells obtained from the **chorionic villi**. *Villi are collected from chorion frondosum* - The sample for **CVS** is indeed collected from the **chorion frondosum**, which is the fetal part of the placenta containing numerous chorionic villi. - These villi are genetically identical to the fetus, making them suitable for **genetic analysis**. *Can cause limb deformities* - There is a recognized, albeit small, risk of **limb reduction defects** associated with CVS, particularly if performed very early in gestation (before 9-10 weeks). - This risk is part of the counseling provided to prospective parents considering the procedure.
Question 1055: A 28-year-old primigravida with 32 weeks of gestation presents with profuse vaginal discharge since yesterday. She was advised USG, which showed a single live intrauterine gestational sac with FL and AC corresponding to the weeks of gestation and AFI as adequate. What is the diagnosis?
- A. Candidiasis
- B. Trichomoniasis
- C. Normal vaginal discharge (Correct Answer)
- D. Preterm Premature Rupture of Membranes (PPROM)
Explanation: ***Normal vaginal discharge*** - Profuse vaginal discharge is a common and **physiological occurrence** in pregnancy due to increased estrogen levels and blood flow to the vagina. - The ultrasound findings of **adequate amniotic fluid index (AFI)** rule out rupture of membranes, and no other symptoms of infection are reported. *Preterm Premature Rupture of Membranes (PPROM)* - PPROM would present with a significant reduction in the **amniotic fluid index (AFI)** on ultrasound, which is noted as adequate in this case. - The discharge in PPROM is typically **amniotic fluid**, which is clear and watery, unlike mere profuse vaginal discharge. *Trichomoniasis* - This infection typically causes a **frothy, greenish-yellow discharge** with a foul odor, along with vulvar itching and irritation. - These characteristic symptoms are not mentioned in the patient's presentation. *Candidiasis* - Vaginal candidiasis usually presents with a **thick, white, cottage cheese-like discharge** accompanied by intense itching and burning. - The patient's description of discharge is simply "profuse," without these specific characteristics.
Question 1056: Poor prognostic factor for hydatidiform mole is -
- A. Prior molar pregnancy
- B. Metastasis to lung
- C. No prior chemotherapy
- D. WHO score > 8 (Correct Answer)
Explanation: ***WHO score > 8*** - A **WHO score > 8** (more specifically, WHO/FIGO score ≥7) indicates **high-risk gestational trophoblastic neoplasia (GTN)**, which is associated with a poor prognosis and requires multi-agent chemotherapy. - The WHO prognostic scoring system incorporates various factors: age, prior pregnancy outcome, antecedent pregnancy type, interval from index pregnancy, pre-treatment hCG level, largest tumor size, site of metastases, and number of metastases. - This is the **strongest poor prognostic indicator** among the options listed. *Prior molar pregnancy* - A **prior molar pregnancy** increases the *risk* of developing another molar pregnancy (recurrence risk ~1-2%), but it is **not a component of the WHO prognostic scoring system** and is not a poor prognostic factor for the outcome of current GTN. - The history affects surveillance requirements but doesn't dictate the difficulty of treating the current episode. *Metastasis to lung* - **Lung metastases** are actually among the **better prognostic sites** for metastatic GTN in the WHO scoring system. - Lung and vaginal metastases score only 1 point, whereas liver and brain metastases (true poor prognostic sites) score 4 points each. - While any metastasis indicates more advanced disease, isolated lung metastases generally have a *good prognosis* with appropriate chemotherapy, with cure rates >90%. *No prior chemotherapy* - The *absence* of **prior chemotherapy** is a **favorable prognostic factor**, not a poor one. - Patients who have *failed* prior chemotherapy or have received ≥2 drugs previously score 2-4 points in the WHO system, indicating worse prognosis. - No prior chemotherapy (scores 0 points) means better treatment response and outcomes.
Question 1057: Which of the following drugs is commonly used in the treatment of endometriosis?
- A. None of the above
- B. Letrozole
- C. Mifepristone
- D. Combined oral contraceptives (Correct Answer)
Explanation: ***Combined oral contraceptives*** - **Combined oral contraceptives (COCs)** are the **most commonly used first-line medical treatment** for endometriosis, as they suppress ovulation and reduce estrogen production, thereby reducing endometrial lesion growth. - They help manage **endometriosis-associated pain** by decreasing menstrual flow and uterine contractions. - COCs are widely prescribed due to their efficacy, safety profile, and additional contraceptive benefits. *Letrozole* - **Letrozole** is an aromatase inhibitor that reduces local estrogen production and has shown efficacy in treating endometriosis, particularly in refractory cases. - However, it is **not commonly used as first-line therapy** due to potential side effects (bone density concerns, teratogenicity) and is typically reserved for cases resistant to conventional hormonal therapy. - It may be used in combination with progestins for better outcomes. *Mifepristone* - **Mifepristone** is an antiprogestin primarily used for medical abortion or in the treatment of Cushing's syndrome. - It works by blocking **progesterone receptors** and is not a standard treatment for endometriosis. *None of the above* - This option is incorrect because **combined oral contraceptives** are the most widely accepted and commonly used treatment for endometriosis.
Question 1058: What condition is diagnosed using the Amsel criteria?
- A. Bacterial vaginosis (Correct Answer)
- B. Antiphospholipid antibody syndrome
- C. Ovarian ectopic pregnancy
- D. HELLP Syndrome
Explanation: ***Bacterial vaginosis*** - The **Amsel criteria** are specifically used for the clinical diagnosis of **bacterial vaginosis (BV)**. - The criteria include the presence of at least three of four findings: **homogeneous discharge**, **vaginal pH >4.5**, **positive whiff test**, and **clue cells** on microscopy. *Antiphospholipid antibody syndrome* - This syndrome is diagnosed based on **clinical criteria** (thrombosis, pregnancy morbidity) and the presence of persistent **antiphospholipid antibodies** (lupus anticoagulant, anti-cardiolipin, anti-β2-glycoprotein I antibodies). - It does not involve the use of the Amsel criteria. *Ovarian ectopic pregnancy* - Diagnosed primarily through **ultrasound imaging** showing a gestational sac or fetal heartbeat within the ovary, often accompanied by clinical symptoms like abdominal pain and vaginal bleeding. - This condition is not related to vaginal infections or the Amsel criteria. *HELLP Syndrome* - **HELLP syndrome** (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe obstetric complication usually occurring in pregnancy, diagnosed by **laboratory findings** of these specific abnormalities. - It is a systemic condition, not a vaginal infection, and does not use the Amsel criteria for diagnosis.