NEET-PG 2015 Practice Questions

Q: All of the following are features of a nasal foreign body except:

Nasal polyps. ***Nasal polyps*** - While chronic inflammation can lead to nasal polyps, they are **not a direct or acute feature** of a nasal foreign body. - Nasal foreign bodies typically present with more immediate and obstructive symptoms rather than polyp formation. *Epistaxis* - A nasal foreign body can **irritate and traumatize the delicate nasal mucosa**, leading to bleeding. - This is a common symptom, especially if the foreign body is sharp or has been in place for some time. *Nasal obstruction* - The presence of any object in the nasal cavity will inevitably cause some degree of **physical blockage of airflow**. - This is one of the most common presenting symptoms, particularly in children. *Foul smelling discharge* - If a foreign body remains in the nasal cavity for an extended period, it can lead to **stasis of secretions and secondary bacterial infection**. - This infection often results in a **purulent, unilateral, and foul-smelling discharge**.

Q: Which of the following is the MOST SIGNIFICANT modifiable predisposing factor for arterial thrombosis?

Cigarette smoking. ***Cigarette smoking*** - **Cigarette smoking** is a major modifiable risk factor for **atherosclerosis** and arterial thrombosis, primarily by promoting endothelial dysfunction, inflammation, and hypercoagulability. [1] - It damages the **endothelium**, leading to plaque formation and increasing the risk of **thrombotic events** such as myocardial infarction and stroke. [1] *Antiphospholipid syndrome* - This is an **autoimmune disorder** causing recurrent arterial and venous thromboses, but it is not a modifiable lifestyle factor. - While it dramatically increases thrombosis risk, therapeutic management focuses on anticoagulation rather than lifestyle modification. *Hyperlipidemia* - **Hyperlipidemia**, particularly elevated LDL cholesterol, is a significant risk factor for **atherosclerosis**, which can lead to thrombosis. [1] - However, while modifiable through diet and medication, its immediate thrombotic impact is often mediated through chronic plaque formation, whereas smoking has more direct prothrombotic effects on endothelium and platelet function. *Homocystinuria* - This is a rare, inherited **metabolic disorder** causing elevated homocysteine levels, leading to severe premature atherosclerosis and **thrombotic disease**. - It is a genetic condition and therefore not a modifiable risk factor in the same way as lifestyle choices.

Q: What is the cause of perihepatic fibrosis in Fitz-Hugh-Curtis syndrome?

Pelvic Inflammatory Disease. ***Pelvic Inflammatory Disease*** - Fitz-Hugh-Curtis syndrome is a complication of **Pelvic Inflammatory Disease (PID)**, where infection spreads from the pelvic organs to the liver capsule [1]. - The inflammation leads to **perihepatic fibrosis** and adhesions, often described as "violin string" adhesions [1]. *Bile Duct Injury* - **Bile duct injury** can cause inflammation and fibrosis of the liver, but it typically affects the intrahepatic or extrahepatic bile ducts directly, rather than the liver capsule. - This condition is often associated with surgical procedures or gallstones, and not directly linked to PID. *Chronic Alcoholism* - **Chronic alcoholism** is a well-known cause of liver fibrosis and cirrhosis, but it specifically damages hepatocytes and leads to diffuse scarring of the liver parenchyma. - It does not primarily cause localized perihepatic fibrosis in the manner seen in Fitz-Hugh-Curtis syndrome. *Viral Hepatitis* - **Viral hepatitis** (e.g., Hepatitis B or C) causes diffuse inflammation and fibrosis throughout the liver, leading to cirrhosis over time. - It does not typically result in the characteristic localized perihepatic adhesions of Fitz-Hugh-Curtis syndrome, which is an ascendant infection.

Q: Blount's disease is associated with all of the following, except:

Genu recurvatum (hyperextension of the knee). ***Genu recurvatum (hyperextension of the knee)*** - Blount's disease is primarily characterized by **genu varum** (bowing of the legs) due to abnormal growth of the proximal tibia. - **Genu recurvatum** is not a typical feature or associated deformity of Blount's disease. *Genu varum (tibia vara)* - This is the **hallmark deformity** of Blount's disease, involving an inward bowing of the leg predominantly at the knee. - It results from a growth disturbance in the **medial portion of the proximal tibial physis**. *External tibial torsion (can occur in some cases)* - While less common than internal torsion, **external tibial torsion** can sometimes be a secondary or associated deformitry in complex cases of Blount's disease, especially with progressive bowing. - It involves an outward twisting of the tibia relative to the femur. *Internal tibial torsion (common in Blount's disease)* - **Internal tibial torsion** is a frequently observed deformity in patients with Blount's disease. - It results in an inward rotation of the lower leg, contributing to the overall malalignment alongside the genu varum.

Q: What was the first oral direct thrombin inhibitor to be developed and approved for clinical use?

Ximelagatran. ***Ximelagatran*** - **Ximelagatran** was the **first oral direct thrombin inhibitor** to be developed and approved for clinical use. - Despite its initial approval, it was later withdrawn due to concerns about **drug-induced liver injury**. *Indraparinux* - **Indraparinux** is a **synthetic heparin analog** and an **indirect Factor Xa inhibitor**, not a direct thrombin inhibitor. - It was developed as a long-acting anticoagulant but did not achieve widespread clinical adoption. *Dabigatran* - **Dabigatran** is currently a widely used **oral direct thrombin inhibitor**, but it was approved **after ximelagatran**. - It is often cited as the first of the modern non-vitamin K antagonist oral anticoagulants (**NOACs**) to be widely marketed, but not the very first to be developed and approved for clinical use. *Fondaparinux* - **Fondaparinux** is a synthetic **selective Factor Xa inhibitor**, structurally similar to the antithrombin-binding region of heparin. - It works indirectly by enhancing antithrombin's activity against Factor Xa, and is not a direct thrombin inhibitor.

Q: Which of the following antidiabetic drugs is NOT an insulin secretagogue?

Pramlintide. ***Pramlintide*** - **Pramlintide** is an **amylin analog** which delays gastric emptying, suppresses glucagon secretion, and promotes satiety, thereby reducing postprandial glucose. It is **not an insulin secretagogue**. - Its mechanism of action is distinct from drugs that directly stimulate insulin release from pancreatic beta cells. - **This is the correct answer** as pramlintide has no role in enhancing insulin secretion. *Exenatide* - **Exenatide** is a **glucagon-like peptide-1 (GLP-1) receptor agonist** that enhances **glucose-dependent** insulin secretion. - Unlike traditional insulin secretagogues (sulfonylureas and glinides), GLP-1 agonists work through the **incretin effect** and only stimulate insulin release when glucose levels are elevated. - In strict pharmacological classification, GLP-1 agonists are **incretin mimetics**, not traditional insulin secretagogues, as they do not cause insulin release independent of glucose levels. - However, they do enhance insulin secretion in a physiological manner. *Glinides* - **Glinides**, such as repaglinide and nateglinide, are **insulin secretagogues** that stimulate rapid and short-lived insulin release from pancreatic beta cells. - They bind to the **sulfonylurea receptor** on beta cells, leading to membrane depolarization and insulin exocytosis. - Unlike GLP-1 agonists, glinides can cause insulin release **regardless of glucose levels**. *Sulfonylureas* - **Sulfonylureas**, such as glyburide and glipizide, are **insulin secretagogues** that stimulate insulin secretion by binding to the sulfonylurea receptor on pancreatic beta cells. - This binding leads to **closure of ATP-sensitive potassium channels**, membrane depolarization, and subsequent insulin release, regardless of blood glucose levels. - This glucose-independent action increases the risk of hypoglycemia compared to incretin-based therapies.

Q: Through which of the following means of transport is folic acid absorbed in the proximal jejunum?

Both active and passive transport. ***Both active and passive transport*** - **Folic acid** absorption in the **proximal jejunum** occurs through **both active and passive mechanisms**. - At **low physiological concentrations**, an **active carrier-mediated transport** system is primarily responsible, while at **higher concentrations** (e.g., from supplements), **passive diffusion** also plays a significant role. *Facilitated diffusion* - While a type of passive transport, **facilitated diffusion** alone does not fully encompass the entirety of folic acid absorption, especially at low concentrations. - It relies on a **concentration gradient** and **carrier proteins** but does not require metabolic energy. *Active transport* - **Active transport** is crucial for absorbing folic acid when its concentration is low in the gut lumen. - This process requires **energy** and specific **carrier proteins**, like the **reduced folate carrier (RFC)**, to transport folate against a concentration gradient. *Passive transport* - **Passive transport**, specifically **simple diffusion**, contributes to folic acid absorption but primarily at **high lumen concentrations**, such as after taking large doses of supplements. - It occurs down a **concentration gradient** and does not require energy or specific carriers.

Q: Characteristic hallucination of schizophrenia is -

Auditory hallucinations giving running commentary. **Auditory hallucinations giving running commentary** - **Third-person auditory hallucinations**, such as *running commentaries* or *voices discussing the patient in the third person*, are considered highly characteristic of **schizophrenia**, particularly a **first-rank symptom**. - These types of hallucinations are distinct from simple voices and often involve multiple voices or a narrative describing the patient's actions or thoughts. *Auditory hallucinations commanding the patient* - While *command hallucinations* can occur in **schizophrenia**, they are not considered as diagnostically characteristic as *third-person commentaries or discussions*. - *Command hallucinations* can also be seen in other psychiatric conditions, including **bipolar disorder** and **severe depression**. *Auditory hallucinations criticizing the patient* - *Critical or pejorative hallucinations* can be present in **schizophrenia**, but they are not as specific to the diagnosis as third-person voices. - These types of hallucinations can also be a feature of **mood disorders** with psychotic features. *Auditory hallucinations talking to patient* - *Second-person auditory hallucinations* where voices speak directly *to* the patient are common in many psychotic disorders, including **schizophrenia**. - However, they lack the specific classic feature of *third-person commentary* or discussion, which is more indicative of **schizophrenia**.

Q: Characterized by chronic, multiple tics, what is the condition?

Tourette's syndrome. ***Tourette's syndrome*** - This syndrome is defined by **multiple motor tics** and at least one **vocal tic** that persist for more than one year. - Tics in Tourette's syndrome are typically **sudden**, rapid, recurrent, nonrhythmic **movements** or vocalizations. *Parkinson's disease* - Characterized by **tremor at rest**, **bradykinesia**, **rigidity**, and postural instability. - While it involves movement disorders, it does not typically present with the characteristic tics seen in Tourette's. *Wilson's disease* - An **autosomal recessive disorder** causing excessive copper accumulation in the liver, brain, and other organs. - Manifestations include **hepatic dysfunction**, neurologic symptoms like **tremor** and **dystonia**, and **Kayser-Fleischer rings**, not tics. *Shy-Drager syndrome* - This is an older term for **multiple system atrophy (MSA)**, a progressive neurodegenerative disorder. - It primarily affects the **autonomic nervous system**, leading to **orthostatic hypotension**, cerebellar ataxia, and parkinsonism, but not tics.

Question 1

All of the following are features of a nasal foreign body except:

Accepted Answer

Nasal polyps

Answer

Epistaxis

Answer

Nasal obstruction

Answer

Foul smelling discharge

Question 2

Which of the following is the MOST SIGNIFICANT modifiable predisposing factor for arterial thrombosis?

Accepted Answer

Cigarette smoking

Answer

Antiphospholipid syndrome

Answer

Hyperlipidemia

Answer

Homocystinuria

Question 3

What is the cause of perihepatic fibrosis in Fitz-Hugh-Curtis syndrome?

Accepted Answer

Pelvic Inflammatory Disease

Answer

Bile Duct Injury

Answer

Chronic Alcoholism

Answer

Viral Hepatitis

Question 4

What is a reverse hypopyon?

Accepted Answer

Collection of emulsified silicone oil in the anterior chamber

Answer

Collection of pus in the vitreous

Answer

Abscess in the orbit

Answer

Seen in corneal ulcer close to being ruptured

Question 5

Blount's disease is associated with all of the following, except:

Accepted Answer

Genu recurvatum (hyperextension of the knee)

Answer

External tibial torsion (can occur in some cases)

Answer

Genu varum (tibia vara)

Answer

Internal tibial torsion (common in Blount's disease)

Question 6

What was the first oral direct thrombin inhibitor to be developed and approved for clinical use?

Accepted Answer

Ximelagatran

Answer

Indraparinux

Answer

Fondaparinux

Answer

Dabigatran

Question 7

Which of the following antidiabetic drugs is NOT an insulin secretagogue?

Accepted Answer

Pramlintide

Answer

Glinides

Answer

Exenatide

Answer

Sulfonylureas

Question 8

Through which of the following means of transport is folic acid absorbed in the proximal jejunum?

Accepted Answer

Both active and passive transport

Answer

Facilitated diffusion

Answer

Active transport

Answer

Passive transport

Question 9

Characteristic hallucination of schizophrenia is -

Accepted Answer

Auditory hallucinations giving running commentary

Answer

Auditory hallucinations criticizing the patient

Answer

Auditory hallucinations talking to patient

Answer

Auditory hallucinations commanding the patient

Question 10

Characterized by chronic, multiple tics, what is the condition?

Accepted Answer

Tourette's syndrome

Answer

Parkinson's disease

Answer

Wilson's disease

Answer

Shy-Drager syndrome

NEET-PG 2015

ENT

Internal Medicine

Ophthalmology

Orthopaedics

Pharmacology

Physiology

Psychiatry