NEET-PG 2015 Practice Questions

Q: Which part of the bone is considered the most vascular zone?

Metaphysis. ***Metaphysis*** - The metaphysis is the most **vascular** part of the bone, containing numerous blood vessels that supply the growing bone. - This high vascularity makes it a common site for **osteomyelitis** and bone tumors due to the abundant blood supply [1]. *Diaphysis* - The diaphysis is the **shaft** or central part of a long bone, primarily composed of **compact bone** [2]. - While it has blood supply through nutrient arteries, its vascularity is less dense compared to the metaphysis. *Epiphysis* - The epiphysis is the **end portion** of a long bone, typically covered by articular cartilage. - It receives its blood supply from periarticular vessels, but is less vascular than the metaphysis, especially in mature bone. *Medullary Cavity* - The medullary cavity is the central cavity of bone shafts where **bone marrow** is stored [2]. - While it contains hematopoietic stem cells and a rich blood supply, the surrounding bone tissue of the metaphysis itself is considered more vascular in terms of nutrient delivery and growth.

Q: All of the following are true about Gout, except which of the following?

Occurs more in females. ***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**.

Q: The window of implantation occurs at which of the following time periods after fertilization?

6-10 days. ***6-10 days*** - The uterus is most receptive to implantation during the **"window of implantation,"** which occurs roughly **6 to 10 days post-fertilization**, coinciding with the mid-luteal phase. - During this period, the **endometrial lining** undergoes specific changes, guided by hormonal signals from **progesterone**, making it optimal for the blastocyst to attach. *12 days* - While implantation can still occur, the **peak receptivity window** is generally considered to be narrower, between 6 and 10 days. - By day 12, changes in the **endometrial environment** may start to reduce the likelihood of successful implantation. *12 weeks* - **12 weeks** refer to the end of the first trimester of pregnancy and is far too late for the initial implantation event. - Implantation must have occurred much earlier for a viable pregnancy at this stage. *6 weeks* - **6 weeks** refers to an established pregnancy, at which point implantation would have occurred several weeks prior. - The process of implantation is completed within the first two weeks post-fertilization.

Q: All of the following are true regarding the application of POP Cast except -

It is anhydrous Calcium phosphate. ***It is anhydrous Calcium phosphate*** - **Plaster of Paris (POP)** is chemically **calcium sulfate hemihydrate** (CaSO₄·½H₂O), not anhydrous calcium phosphate. - Adding water to calcium sulfate hemihydrate causes an exothermic reaction, forming **calcium sulfate dihydrate**, which is the hardened cast. *Putting the Plaster roll in warm water hastens setting time* - **Warm water** increases the rate of the chemical reaction that causes POP to set, thus **hastening the setting time**. - While it speeds up setting, excessively hot water can lead to a cast that sets too quickly or becomes brittle. *It can be applied in presence of extreme swelling* - Applying a non-flexible POP cast in the presence of **extreme swelling** is contraindicated because swelling will rapidly resolve, making the cast loose and ineffective. - Furthermore, if swelling increases unexpectedly under a tight cast, it can lead to dangerous **compartment syndrome**. *Gangrene is known complication of a tight plaster cast* - A **tight plaster cast** can compromise blood supply to the limb by compressing arteries and veins, potentially leading to **ischemia**. - Prolonged ischemia due to a tight cast can cause **tissue necrosis** and ultimately **gangrene** if not identified and treated promptly.

Q: Which of the following is true regarding precocious puberty:

Sexual maturity is attained early. ***Sexual maturity is attained early*** - **Precocious puberty** is defined by the development of secondary sexual characteristics significantly earlier than the average age. - This early onset of puberty means that affected individuals reach **sexual maturity** at a younger chronological age. *Mental function is increased* - Precocious puberty does not inherently lead to an increase in **mental function** or cognitive abilities. - While hormonal changes can influence mood and behavior, they do not enhance intelligence. *Reproductive function is absent* - Precocious puberty implies the premature activation of the **hypothalamic-pituitary-gonadal axis**, leading to the appearance of secondary sexual characteristics and, in many cases, the potential for **reproductive function**. - Girls, for example, can experience early menarche and boys can produce sperm, meaning fertility is not absent but rather accelerated. *Body proportions remain unchanged* - Precocious puberty often results in changes in **body proportions**, particularly due to the early closure of epiphyseal plates. - Although there is an initial growth spurt, the premature fusion of growth plates can lead to a shorter-than-average adult height.

Q: What is the drug of choice (DOC) for the treatment of subacute sclerosing panencephalitis (SSPE)?

Inosine pranobex. ***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.

Q: What is the primary treatment indication of folic acid?

Treatment of megaloblastic anemia. ***Treatment of megaloblastic anemia*** - Folic acid is essential for **DNA synthesis** and cell division, and its deficiency leads to impaired red blood cell maturation, causing **megaloblastic anemia**. - Supplementation with folic acid effectively reverses the hematological abnormalities in **folate-deficient megaloblastic anemia**. *Prevention of neural tube defects in pregnancy* - While folic acid is crucial for preventing **neural tube defects** (NTDs), this is a **prophylactic** rather than a primary therapeutic use. - The focus of this question is on the *primary therapeutic* use, implying treatment of an existing condition. *Management of hemoglobinopathies* - Hemoglobinopathies like **sickle cell anemia** or **thalassemia** are genetic disorders affecting hemoglobin structure or production, not primarily due to folic acid deficiency. - Folic acid may be given to these patients to support increased red blood cell turnover, but it does not address the underlying genetic defect. *None of the above* - This option is incorrect because folic acid has a clear primary therapeutic role in treating **megaloblastic anemia**.

Q: What is the IQ range associated with borderline intellectual functioning?

70 - 80. ***70 - 80*** - The IQ range of **70-80** (or sometimes 70-85, depending on the classification system) is typically defined as **borderline intellectual functioning**. - Individuals in this range may have some difficulties with **adaptive skills** and academic performance, but they do not meet the criteria for intellectual disability. *50 - 69* - An IQ range of **50-69** is generally classified as **mild intellectual disability**. - Individuals in this range often require significant support to achieve academic and occupational independence. *20 - 49* - An IQ range of **20-49** is categorized as **moderate intellectual disability**. - People in this range typically need substantial support in daily living activities and adaptive functioning. *0 - 20* - An IQ range of **0-20** (or sometimes 0-19) indicates **severe or profound intellectual disability**. - Individuals with IQs in this range require full-time care and supervision due to significant impairments in adaptive functioning.

Q: What is the primary indication for the Nigro Regimen?

Anal Carcinoma. ***Anal Carcinoma*** - The **Nigro Regimen** is a standard treatment protocol involving concurrent **chemotherapy** (5-fluorouracil and mitomycin C) and **radiation therapy** for anal carcinoma. - Its primary goal is to achieve **organ preservation** and avoid the need for abdominoperineal resection, which would result in a permanent colostomy. *Rectal Carcinoma* - Treatment for **rectal carcinoma** often involves surgery (e.g., low anterior resection), radiation, and chemotherapy, but the specific **Nigro Regimen** is not the primary protocol. - While some chemotherapy drugs might overlap, the combined regimen and indications are distinct. *Sigmoid Colon Carcinoma* - **Sigmoid colon carcinoma** is typically treated primarily with **surgical resection**, often followed by adjuvant chemotherapy based on staging. - The Nigro Regimen is specifically designed for tumors in the **anal canal**, not the more proximal colon. *Duodenal Carcinoma* - **Duodenal carcinoma** is a rare gastrointestinal cancer usually managed with surgical resection, such as a **Whipple procedure**, and sometimes adjuvant chemotherapy. - This type of cancer is anatomically and etiologically distinct from anal carcinoma, making the Nigro Regimen irrelevant.

Q: What is the most important presenting feature of periampullary carcinoma?

Jaundice. ***Jaundice*** - **Painless obstructive jaundice** is the hallmark symptom, occurring early due to the tumor's proximity to the common bile duct. - The obstruction of bile flow leads to the accumulation of **bilirubin**, causing yellow discoloration of the skin and eyes. *Abdominal Pain* - While **abdominal pain** can occur, it is often a later symptom and is less specific than jaundice for early diagnosis. - Pain typically arises from tumor growth, invasion of surrounding structures, or pancreatic involvement. *Unintentional Weight Loss* - **Unintentional weight loss** is a common constitutional symptom of many advanced malignancies, including periampullary carcinoma. - However, it usually manifests at a later stage and is not the initial, specific presenting feature that prompts investigation. *Palpable Abdominal Mass* - A **palpable abdominal mass** is rare in early periampullary carcinoma, as these tumors are typically small and deeply seated. - Its presence usually indicates advanced disease with significant tumor burden or metastasis.

Question 1

Which part of the bone is considered the most vascular zone?

Accepted Answer

Metaphysis

Answer

Diaphysis

Answer

Epiphysis

Answer

Medullary Cavity

Question 2

All of the following are true about Gout, except which of the following?

Accepted Answer

Occurs more in females

Answer

Can be precipitated by pyrazinamide

Answer

Birefringent crystals are present in the joint

Answer

Occurs due to accumulation of urate crystals in joint

Question 3

The window of implantation occurs at which of the following time periods after fertilization?

Accepted Answer

6-10 days

Answer

12 days

Answer

12 weeks

Answer

6 weeks

Question 4

All of the following are true regarding the application of POP Cast except -

Accepted Answer

It is anhydrous Calcium phosphate

Answer

It can be applied in presence of extreme swelling

Answer

Gangrene is known complication of a tight plaster cast

Answer

Putting the Plaster roll in warm water hastens setting time

Question 5

Which of the following is true regarding precocious puberty:

Accepted Answer

Sexual maturity is attained early

Answer

Mental function is increased

Answer

Reproductive function is absent

Answer

Body proportions remain unchanged

Question 6

What is the drug of choice (DOC) for the treatment of subacute sclerosing panencephalitis (SSPE)?

Accepted Answer

Inosine pranobex

Answer

Abacavir

Answer

Glatiramer

Answer

Interferon

Question 7

What is the primary treatment indication of folic acid?

Accepted Answer

Treatment of megaloblastic anemia

Answer

Prevention of neural tube defects in pregnancy

Answer

Management of hemoglobinopathies

Answer

None of the above

Question 8

What is the IQ range associated with borderline intellectual functioning?

Accepted Answer

70 - 80

Answer

0 - 20

Answer

50 - 69

Answer

20 - 49

Question 9

What is the primary indication for the Nigro Regimen?

Accepted Answer

Anal Carcinoma

Answer

Rectal Carcinoma

Answer

Sigmoid Colon Carcinoma

Answer

Duodenal Carcinoma

Question 10

What is the most important presenting feature of periampullary carcinoma?

Accepted Answer

Jaundice

Answer

Abdominal Pain

Answer

Unintentional Weight Loss

Answer

Palpable Abdominal Mass

NEET-PG 2015

Anatomy

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Pediatrics

Pharmacology

Psychiatry

Surgery