NEET-PG 2015 Practice Questions

Q: Foot drop occurs due to the involvement of:

Common peroneal nerve palsy. ***Common peroneal nerve palsy*** - The **common peroneal nerve** (also known as the common fibular nerve) innervates the muscles responsible for **dorsiflexion** and eversion of the foot (tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus longus and brevis). - Damage to this nerve leads to weakness or paralysis of these muscles, resulting in **foot drop**, which is the most common neurological cause. - The nerve is vulnerable at the **neck of the fibula** where it is superficial and can be compressed or injured. *Sciatic nerve* - The **sciatic nerve** divides into the tibial and common peroneal nerves. - Proximal sciatic nerve injury can cause foot drop, but it would also cause additional deficits including hamstring weakness, loss of ankle plantarflexion, and sensory loss over a wider distribution. - Isolated foot drop typically indicates **common peroneal nerve** injury, not sciatic nerve injury. *Direct injury to the dorsiflexors* - Direct trauma to the **dorsiflexor muscles** (tibialis anterior, extensor hallucis longus, extensor digitorum longus) can mechanically impair dorsiflexion. - However, the term "foot drop" typically refers to **neurological causes** rather than direct muscle injury, making common peroneal nerve palsy the more specific answer. *Obturator nerve* - The **obturator nerve** innervates the **adductor muscles of the thigh** (adductor longus, adductor brevis, adductor magnus, gracilis). - It does not innervate any muscles responsible for dorsiflexion of the foot and therefore **cannot cause foot drop**.

Q: Group of 4-8 experts talking in front of a large group of audience is known as:

Panel discussion. ***Panel discussion*** - A **panel discussion** involves a small group of experts (4-8) presenting their views and discussing a specific topic in front of a larger audience. - The format typically includes an initial presentation by each panelist, followed by a moderated discussion among the panelists and sometimes questions from the audience. *Symposium* - A **symposium** is a formal meeting at which several experts or specialists deliver short presentations on a particular subject. - While it involves experts, it typically consists of a series of individual presentations rather than an interactive discussion among the presenters. *Workshop* - A **workshop** is a training or educational meeting where participants engage in intensive discussion and activity on a particular subject or project. - The primary focus is on hands-on learning and skill development for the attendees, not primarily on experts talking to an audience. *Seminar* - A **seminar** is a meeting or conference for discussion or training, usually involving a small group of students or professionals. - It often involves a leader or speaker presenting information, followed by discussion, but it is typically smaller and more interactive than a large expert panel.

Q: A girl about to marry has comedonal acne. Drug to treat such a case is:

Retinoids. ***Retinoids*** - **Topical retinoids** (e.g., tretinoin, adapalene) are the gold standard for comedonal acne as they normalize **follicular keratinization** and prevent microcomedone formation. - Being **Category C in pregnancy**, topical retinoids require **contraception counseling** for women of childbearing age but are still first-line treatment with proper precautions. *Benzoyl peroxide* - **Benzoyl peroxide** has mild comedolytic properties but is primarily effective for **inflammatory acne** due to its antimicrobial action against *Cutibacterium acnes*. - Less effective than retinoids for purely **comedonal acne** as it doesn't address the core pathology of abnormal keratinization. *Estrogen* - **Hormonal therapy** with estrogen-containing contraceptives reduces sebum production by suppressing androgens but takes **3-6 months** to show effects. - More suitable for **hormonal acne** with inflammatory lesions rather than purely comedonal acne, and not first-line for this presentation. *Topical antibiotic* - **Topical antibiotics** (clindamycin, erythromycin) target bacterial overgrowth and inflammation but have limited efficacy in **non-inflammatory comedonal acne**. - Risk of **bacterial resistance** when used alone, and they don't address the underlying hyperkeratinization that causes comedone formation.

Q: Maculae cerulea is seen in ?

Pediculosis pubis. ***Pediculosis pubis*** - **Maculae ceruleae** (blue spots) are **pathognomonic** for pubic louse (*Pthirus pubis*) infestation. - These characteristic **bluish-gray macules** are typically found on the trunk, thighs, and lower abdomen. - They result from the **anticoagulant in louse saliva** converting hemoglobin to biliverdin at feeding sites, causing localized hemorrhage and pigment deposition. - This is a **classic diagnostic feature** of pediculosis pubis. *Pediculosis hominis corporis* - Body louse infestation causes **pruritus** and **excoriations**, typically along clothing lines (waistband, collar). - **Maculae ceruleae** are not a feature of body louse infestation. *Pediculosis capitis* - Head lice infestation presents with **scalp pruritus**, **nits on hair shafts**, and excoriations. - **Maculae ceruleae** do not occur with head lice. *Scabies* - Caused by *Sarcoptes scabiei* mite burrowing in the stratum corneum. - Presents with **burrows**, **papules**, **vesicles**, and intense **nocturnal pruritus**. - **Maculae ceruleae** are NOT associated with scabies infestation.

Q: Hennebert's sign is a false positive fistula test when there is no evidence of middle ear disease causing a fistula of the horizontal semicircular canal. It is seen in?

Meniere’s disease. ***Meniere's disease*** - **Hennebert's sign** is a *false-positive fistula test* resulting from a hypermobile footplate or saccule, or a fibrous band between the stapes footplate and the utricle due to otolithic *hydrops*. - It indicates that changes in external ear canal pressure cause **nystagmus** and **vertigo** due to inner ear fluid displacement, even without a true fistula. - This is the **most common** cause of Hennebert's sign in clinical practice. *Congenital syphilis* - Congenital syphilis can also present with Hennebert's sign as a false-positive fistula test due to inner ear involvement. - However, the question context specifies Hennebert's sign in the absence of middle ear disease, making Meniere's disease the more typical answer. - Other features include **sensorineural hearing loss**, **vestibular dysfunction**, **interstitial keratitis**, and **Hutchinson's teeth**. *Cholesteatoma* - A cholesteatoma often erodes bone, leading to a **true fistula** in the horizontal semicircular canal, especially its lateral aspect. - This would result in a *true positive fistula test* rather than a false positive associated with Hennebert's sign. *Stapedectomy* - A stapedectomy is a surgical procedure to treat otosclerosis, involving the removal of the stapes and insertion of a prosthesis. - While it can lead to complications such as perilymph fistula, it is not directly associated with Hennebert's sign as a *pre-existing condition* causing a false-positive fistula test in the absence of middle ear disease.

Q: Which of the following is a feature of crush syndrome -

Myoglobinuria. Myoglobinuria - **Myoglobinuria** is a hallmark of crush syndrome, resulting from the massive release of **myoglobin** from damaged muscle cells into the bloodstream [2]. - This excess myoglobin can precipitate in the renal tubules, leading to **acute kidney injury (AKI)** [1]. *Hypophosphatemia* - Crush syndrome typically results in **hyperphosphatemia**, not hypophosphatemia, due to the release of intracellular phosphate from damaged muscular cells. - The elevated phosphate levels contribute to reciprocal **hypocalcemia** through precipitation. *Hypokalemia* - Crush syndrome is characterized by **hyperkalemia**, caused by the release of intracellular potassium from damaged muscle cells. - **Hyperkalemia** is a significant and life-threatening complication due to its potential for cardiac arrhythmias. *Hypercalcemia* - Crush syndrome typically presents with **hypocalcemia** due to the precipitation of calcium with released phosphate and fatty acids. - Initial **hypocalcemia** may later be followed by **hypercalcemia** during the recovery phase, especially in those with renal failure, but hypocalcemia is more acute.

Q: Hebra nose is caused by:

Frisch bacillus. ***Frisch bacillus*** - **Frisch bacillus**, also known as *Klebsiella rhinoscleromatis*, is the causative agent of **rhinoscleroma**, which often presents as a condition causing tumor-like growths in the nose, leading to the characteristic "Hebra nose." - **Hebra nose** refers to the chronic, deforming nasal lesion associated with late stages of **rhinoscleroma**, characterized by hardening and widening of the nose. *C. diphtheriae* - *Corynebacterium diphtheriae* causes **diphtheria**, primarily affecting the respiratory tract and skin. - It forms a **pseudomembrane** in the throat and can lead to systemic complications due to toxin production, but it does not cause Hebra nose. *Pseudomonas* - *Pseudomonas aeruginosa* is an opportunistic pathogen commonly causing **nosocomial infections**, such as pneumonia, urinary tract infections, and wound infections. - While it can cause various infections, it is not associated with the specific nasal deformity known as Hebra nose. *Staph aureus* - *Staphylococcus aureus* is a common bacterium causing a wide range of infections, including **skin infections** (e.g., boils, cellulitis), **pneumonia**, and **sepsis**. - Although it can cause nasal colonization and local infections, it does not cause the chronic, deforming condition known as Hebra nose.

Q: Pilocarpine is used in all of the following except:

Malignant Glaucoma. ***Malignant Glaucoma*** - **Pilocarpine** is contraindicated in **malignant glaucoma** because it can worsen the condition by causing **ciliary body edema** and anterior displacement of the lens-iris diaphragm. - This form of glaucoma requires treatment aimed at posterior displacement of the lens-iris diaphragm, often involving **cycloplegics**, **hyperosmotic agents**, or surgical interventions. *Primary, Open Angle Glaucoma* - **Pilocarpine** is an effective **miotic agent** that increases aqueous humor outflow through the **trabecular meshwork**, thereby lowering intraocular pressure. - It can be used as a treatment for **primary open-angle glaucoma**, although it is less commonly used due to its side effects and the availability of better-tolerated medications. *Acute Angle Closure Glaucoma* - **Pilocarpine** is typically used in the management of **acute angle-closure glaucoma** after the intraocular pressure has been acutely lowered by other agents. - It works by inducing **miosis**, which pulls the iris away from the **trabecular meshwork**, opening the angle and facilitating aqueous outflow. *Chronic Synechial Angle Closure Glaucoma* - In **chronic synechial angle-closure glaucoma**, **pilocarpine** can be used to break or prevent the formation of new **peripheral anterior synechiae** by constricting the pupil. - However, its effectiveness is limited if extensive synechiae have already formed, as these physically block the outflow pathway.

Q: True about rotavirus vaccine:

Given orally. ***Given orally*** - Rotavirus vaccines are **live attenuated vaccines** administered orally to stimulate localized immunity in the gastrointestinal tract. - This oral route is crucial for inducing **mucosal immunity**, which is important for protection against rotavirus infection. *Killed vaccine* - The rotavirus vaccine is an **attenuated live vaccine**, meaning it contains weakened forms of the virus, not killed ones. - Live attenuated vaccines generally provide a **stronger and longer-lasting immune response** compared to killed vaccines. *Should be given before 5 years* - The rotavirus vaccine series is recommended to be completed in **infancy**, typically before 8 months of age, depending on the specific vaccine brand and schedule. - Giving the vaccine at too old an age increases the (still very small) risk of **intussusception** and a lack of efficacy. *Given subcutaneous* - Rotavirus vaccines are administered by the **oral route**, not subcutaneously. - The **subcutaneous route** is used for various other vaccines, but not for rotavirus.

Q: Not true about gas gangrene:

Cl perfringens produce heat-labile spores. ***Cl perfringens produce heat-labile spores*** - *Clostridium perfringens* spores are, in fact, **heat-resistant**, allowing them to survive harsh conditions and subsequently germinate into vegetative cells causing infection. - This heat resistance is a crucial factor in food poisoning outbreaks and wound infections, as spores can survive cooking temperatures. *Metronidazole is the drug of choice* - While metronidazole can be used as an adjunct, **penicillin G** is generally the primary antibiotic of choice for gas gangrene, often in combination with other agents like clindamycin. - **Surgical debridement** and **hyperbaric oxygen therapy** are also critical components of treatment, as antibiotics alone are often insufficient. *Most common cause is Cl perfringens* - **_Clostridium perfringens_** is indeed the most frequent cause of gas gangrene (clostridial myonecrosis), accounting for approximately 80-95% of cases. - This bacterium produces potent **exotoxins** that cause rapid tissue destruction and gas formation, leading to the characteristic symptoms. *Extensive necrosis of muscles* - Gas gangrene is characterized by **rapid and extensive necrosis of muscle tissue**, which is caused by the potent toxins produced by clostridial species, particularly alpha-toxin. - This muscle destruction leads to systemic toxicity, pain, and the production of gas within the tissues.

Question 1

Foot drop occurs due to the involvement of:

Accepted Answer

Common peroneal nerve palsy

Answer

Obturator nerve

Answer

Sciatic nerve

Answer

Direct injury to the dorsiflexors

Question 2

Group of 4-8 experts talking in front of a large group of audience is known as:

Accepted Answer

Panel discussion

Answer

Symposium

Answer

Workshop

Answer

Seminar

Question 3

A girl about to marry has comedonal acne. Drug to treat such a case is:

Accepted Answer

Retinoids

Answer

Topical antibiotic

Answer

Estrogen

Answer

Benzoyl peroxide

Question 4

Maculae cerulea is seen in ?

Accepted Answer

Pediculosis pubis

Answer

Pediculosis hominis corporis

Answer

Scabies

Answer

Pediculosis capitis

Question 5

Hennebert's sign is a false positive fistula test when there is no evidence of middle ear disease causing a fistula of the horizontal semicircular canal. It is seen in?

Accepted Answer

Meniere’s disease

Answer

Congenital syphilis

Answer

Cholesteatoma

Answer

Stapedectomy

Question 6

Which of the following is a feature of crush syndrome -

Accepted Answer

Myoglobinuria

Answer

Hypophosphatemia

Answer

Hypokalemia

Answer

Hypercalcemia

Question 7

Hebra nose is caused by:

Accepted Answer

Frisch bacillus

Answer

C. diphtheriae

Answer

Pseudomonas

Answer

Staph aureus

Question 8

Pilocarpine is used in all of the following except:

Accepted Answer

Malignant Glaucoma

Answer

Primary, Open Angle Glaucoma

Answer

Acute Angle Closure Glaucoma

Answer

Chronic Synechial Angle Closure Glaucoma

Question 9

True about rotavirus vaccine:

Accepted Answer

Given orally

Answer

Killed vaccine

Answer

Should be given before 5 years

Answer

Given subcutaneous

Question 10

Not true about gas gangrene:

Accepted Answer

Cl perfringens produce heat-labile spores

Answer

Metronidazole is the drug of choice

Answer

Most common cause is Cl perfringens

Answer

Extensive necrosis of muscles

NEET-PG 2015

Anatomy

Community Medicine

Dermatology

ENT

Internal Medicine

Microbiology

Pharmacology

Surgery