Forensic Medicine
3 questionsFor autopsy, stomach is opened through -
Tache noire de la sclera is a postmortem finding related to which of the following?
What is defined as a negative autopsy?
NEET-PG 2015 - Forensic Medicine NEET-PG Practice Questions and MCQs
Question 471: For autopsy, stomach is opened through -
- A. Lesser sac
- B. Greater sac
- C. Greater curvature (Correct Answer)
- D. Lesser curvature
Explanation: ***Greater curvature*** - Opening the stomach along the **greater curvature** allows for a complete and unobstructed view of the entire gastric mucosa. - This approach minimizes damage to the medically significant **lesser curvature**, which is important for identifying conditions like ulcers or tumors that often occur in that region. *Lesser sac* - The **lesser sac** is a peritoneal cavity space behind the stomach, not an anatomical part of the stomach itself to be opened. - Accessing the stomach via the lesser sac is not a surgical approach for opening the gastric lumen. *Greater sac* - The **greater sac** is the main peritoneal cavity, referring to the general abdominal space, not a specific part of the stomach wall. - This option describes a general anatomical area rather than a specific incision line for the stomach. *Lesser curvature* - Opening the stomach along the **lesser curvature** is generally avoided in autopsy. - This area is prone to various pathologies like ulcers and gastric cancer, and incising it would disrupt potential diagnostic findings.
Question 472: Tache noire de la sclera is a postmortem finding related to which of the following?
- A. The eye (Correct Answer)
- B. Muscle tissue
- C. Hair follicles
- D. Skin
Explanation: ***The eye*** - **Tache noire de la sclera** is a postmortem phenomenon characterized by a **black spot on the sclera**, resulting from the drying out of the globe after death. - This finding is important in **forensic pathology** as it can help in estimating the postmortem interval if the eyes are open. *Muscle tissue* - Postmortem changes in muscle tissue include **rigor mortis** (stiffening of muscles) and **livor mortis** (discoloration of skin due to blood pooling), neither of which are described as "tache noire de la sclera." - These changes relate to muscle biochemistry and gravity, not specific changes to the sclera. *Hair follicles* - Hair follicles are not associated with "tache noire de la sclera." Postmortem changes related to hair would involve **hair growth assessment** or decomposition changes affecting the scalp. - The phenomenon described is specific to ocular structures. *Skin* - While skin shows prominent postmortem changes such as **livor mortis**, **marbling**, and **decomposition**, these are distinct from tache noire de la sclera. - Tache noire specifically refers to the **drying and darkening of the exposed sclera**, not cutaneous changes.
Question 473: What is defined as a negative autopsy?
- A. Cause is apparent on gross examination but not on histopathological examination.
- B. Gross findings are minimal.
- C. Cause is apparent on gross examination but not found due to constraints on the part of the doctor.
- D. No cause of death is found after both gross and histopathological examination. (Correct Answer)
Explanation: ***No cause of death is found after both gross and histopathological examination.*** - A **negative autopsy** is declared when comprehensive examination, including both macroscopic (gross) and microscopic (histopathological) assessment, fails to identify a definitive **cause of death**. - This outcome can be due to various reasons, such as death from **functional disturbances** (e.g., arrhythmias, metabolic imbalances) or processes not evident morphologically. *Cause is apparent on gross examination but not on histopathological examination.* - This scenario describes situations where a cause might be evident visually (e.g., a large hemorrhage) but further microscopic investigation is still needed for confirmation or detailed understanding. - It does not align with a "negative" autopsy, as a cause has already been *grossly identified*. *Gross findings are minimal.* - While minimal gross findings might precede a negative autopsy, this statement alone is insufficient to define it. - A negative autopsy specifically requires the absence of a cause of death even after subsequent **histopathological examination**. *Cause is apparent on gross examination but not found due to constraints on the part of the doctor.* - This option refers to a failure in diagnostic process due to external factors or limitations by the examiner, not an inherent lack of discernible cause. - It suggests a missed diagnosis, not that a cause could not be found through comprehensive investigation.
Internal Medicine
1 questionsWhich of the following is a cause of post-transplantation hypertension? I. Rejection II. Cyclosporine nephrotoxicity III. Renal transplant artery stenosis (RTAS) IV. Recurrent disease in the allograft. Select the correct option.
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 471: Which of the following is a cause of post-transplantation hypertension? I. Rejection II. Cyclosporine nephrotoxicity III. Renal transplant artery stenosis (RTAS) IV. Recurrent disease in the allograft. Select the correct option.
- A. None of the above are correct causes.
- B. I, II, and IV are correct causes.
- C. I and III are correct causes.
- D. All of the options are correct causes of post-transplantation hypertension. (Correct Answer)
Explanation: ***All of the options are correct causes of post-transplantation hypertension.*** - Post-transplantation hypertension often has a multifactorial etiology, with **rejection**, **cyclosporine nephrotoxicity**, **renal transplant artery stenosis (RTAS)**, and **recurrent disease in the allograft** all being significant contributors. - Each of these conditions can lead to mechanisms that elevate blood pressure, such as **renal ischemia**, activation of the **renin-angiotensin system**, and inflammatory responses affecting renal function. *I, II, and IV are correct causes.* - This option is incorrect because it excludes **renal transplant artery stenosis (RTAS)** (III), which is a well-established cause of secondary hypertension in transplant recipients due to reduced blood flow to the allograft. - **RTAS** activates the renin-angiotensin-aldosterone system (RAAS), leading to **vasoconstriction** and **sodium retention**, contributing to hypertension. *I and III are correct causes.* - This option is incorrect as it omits other crucial causes like **cyclosporine nephrotoxicity** (II) and **recurrent disease in the allograft** (IV), both of which are documented contributors to post-transplantation hypertension. - **Cyclosporine nephrotoxicity** causes afferent arteriolar vasoconstriction and glomerulosclerosis, directly increasing blood pressure. *None of the above are correct causes.* - This option is incorrect because **rejection**, **cyclosporine nephrotoxicity**, **renal transplant artery stenosis (RTAS)**, and **recurrent disease in the allograft** are all recognized and significant causes of post-transplantation hypertension. - Each condition has distinct pathological mechanisms that contribute to **elevated blood pressure** in transplant recipients.
Microbiology
1 questionsBacteria most commonly involved in bowel decomposition after death is?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 471: Bacteria most commonly involved in bowel decomposition after death is?
- A. Streptococcus pyogenes
- B. Pseudomonas aeruginosa
- C. Clostridium perfringens (Correct Answer)
- D. Escherichia coli
Explanation: ***Clostridium perfringens*** - This bacterium is a ubiquitous **anaerobe** in the gut and is known for its rapid proliferation after death, producing gases that contribute to **bloating and decomposition**. - It is a primary cause of **gas gangrene** in living individuals, reflecting its tissue-destructive capabilities, which extend to post-mortem changes. - Produces large amounts of **hydrogen and CO2**, making it the most significant contributor to post-mortem gas formation and putrefaction. *Streptococcus pyogenes* - While a significant pathogen in life, causing conditions like **strep throat** and **necrotizing fasciitis**, it is not the primary agent of putrefaction. - Its role in post-mortem decomposition is generally less prominent compared to anaerobic gut flora. *Pseudomonas aeruginosa* - This bacterium is an opportunistic pathogen often associated with infections in immunocompromised individuals or in healthcare settings. - It is not typically identified as the most common or primary bacterium involved in the initial stages of post-mortem **bowel decomposition**, though it can be present in later stages. *Escherichia coli* - While *E. coli* is abundant in the bowel and participates in post-mortem decomposition, it is not the **most common** agent responsible for gas production and tissue decomposition. - *Clostridium perfringens* proliferates more rapidly and produces significantly more gas, making it the predominant bacterium in bowel putrefaction.
Pharmacology
5 questionsIn patients undergoing INH therapy, which group is least likely to develop neuropathy?
Which of the following drugs is not used for the treatment of H. Pylori?
Which of the following is the longest acting carbapenem?
Which of the following conditions is not associated with an increased risk of neuropathy caused by Isoniazid (INH)?
Idoxuridine is used for treatment of?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 471: In patients undergoing INH therapy, which group is least likely to develop neuropathy?
- A. Having malnutrition
- B. Alcoholics
- C. Fast acetylators (Correct Answer)
- D. Vitamin B complex deficiency
Explanation: ***Fast acetylators*** - **Fast acetylators** metabolize INH more quickly, leading to lower systemic drug levels and thus a reduced risk of adverse effects like neuropathy. - Neuropathy associated with INH is primarily due to **pyridoxine (vitamin B6) depletion**, which is less pronounced if the drug is rapidly cleared. *Having malnutrition* - **Malnutrition** often involves deficiencies in essential vitamins, including vitamin B6, which is crucial for preventing INH-induced neuropathy. - Patients with poor nutritional status are at a **higher risk** of developing neuropathy during INH therapy due to pre-existing vitamin B6 depletion. *Alcoholics* - **Alcoholism** is strongly associated with deficiencies in various B vitamins, particularly **pyridoxine (vitamin B6)**, due to poor diet and impaired absorption. - This pre-existing deficiency makes alcoholics **highly susceptible** to INH-induced neuropathy. *Vitamin B complex deficiency* - A **deficiency in vitamin B complex**, especially pyridoxine (B6), is a known risk factor for INH-induced neuropathy. - Isoniazid interferes with **pyridoxine metabolism**, and those with pre-existing deficiency are more vulnerable to this adverse effect.
Question 472: Which of the following drugs is not used for the treatment of H. Pylori?
- A. Bismuth
- B. Domperidone (Correct Answer)
- C. Clarithromycin
- D. Amoxicillin
Explanation: ***Correct: Domperidone*** - Domperidone is a **prokinetic drug** used to treat nausea, vomiting, and gastric motility disorders, but it has **no direct antibacterial activity** against *H. pylori*. - It works by blocking **dopamine receptors** in the chemoreceptor trigger zone and peripherally. - Therefore, it is **NOT used for *H. pylori* eradication**. *Incorrect: Bismuth* - **Bismuth subsalicylate** is a key component of **quadruple therapy** for *H. pylori* eradication, particularly in cases of antibiotic resistance or treatment failure. - It has **bactericidal effects** against *H. pylori*, disrupts its cell wall, and inhibits its adherence to the gastric mucosa. *Incorrect: Amoxicillin* - **Amoxicillin** is a penicillin-class antibiotic commonly used in various *H. pylori* eradication regimens, including **triple therapy**. - It acts by **inhibiting bacterial cell wall synthesis**, leading to bacterial lysis. *Incorrect: Clarithromycin* - **Clarithromycin** is a macrolide antibiotic frequently included in standard **triple therapy** for *H. pylori* eradication. - It inhibits **bacterial protein synthesis** by binding to the 50S ribosomal subunit.
Question 473: Which of the following is the longest acting carbapenem?
- A. Imipenem
- B. Meropenem
- C. Doripenem
- D. Ertapenem (Correct Answer)
Explanation: ***Ertapenem*** - **Ertapenem** has the **longest half-life** among the carbapenems, allowing for once-daily dosing. - Its prolonged action is due to its **chemical structure**, which provides high protein binding and reduced renal clearance compared to other carbapenems. *Imipenem* - **Imipenem** has a **relatively short half-life** and requires co-administration with cilastatin to prevent its renal metabolism by dehydropeptidase-1. - Its short duration of action necessitates **frequent dosing**, typically every 6 to 8 hours. *Meropenem* - **Meropenem** has a **shorter half-life** than ertapenem, generally requiring dosing every 8 hours. - Although it does not require cilastatin, its pharmacokinetic profile is not as extended as ertapenem's. *Doripenem* - **Doripenem** also has a **shorter half-life** than ertapenem, necessitating administration every 8 hours. - Its spectrum of activity is similar to meropenem, but it does not offer the same extended duration of action.
Question 474: Which of the following conditions is not associated with an increased risk of neuropathy caused by Isoniazid (INH)?
- A. Uremia
- B. Diabetes mellitus
- C. Poor nutrition
- D. Hyperthyroidism (Correct Answer)
Explanation: ***Hyperthyroidism*** - **Hyperthyroidism** is not typically associated with an increased risk of isoniazid-induced neuropathy. The neuropathy due to INH is primarily linked to **pyridoxine (vitamin B6) deficiency**. - While hyperthyroidism can cause its own set of neurological symptoms, it does not directly impair pyridoxine metabolism or exacerbate INH's neurotoxic effects. *Uremia* - **Uremia** (renal failure) can increase the risk of INH-induced neuropathy due to impaired drug excretion, leading to higher plasma concentrations of INH and its metabolites. - Patients with uremia often have compromised nutritional status and may experience vitamin deficiencies, further contributing to pyridoxine depletion. *Diabetes mellitus* - **Diabetes mellitus** is a significant risk factor for INH-induced neuropathy because it is an independent cause of **peripheral neuropathy** itself, making patients more susceptible to additional nerve damage. - Diabetic patients may also have altered pyridoxine metabolism or suboptimal nutritional intake, predisposing them to INH toxicity. *Poor nutrition* - **Poor nutrition**, particularly malabsorption or inadequate dietary intake, directly contributes to **pyridoxine (vitamin B6) deficiency**. - Isoniazid's mechanism of neurotoxicity involves interfering with pyridoxine metabolism, so pre-existing deficiency significantly increases the risk of neuropathy.
Question 475: Idoxuridine is used for treatment of?
- A. Influenza
- B. RSV
- C. HSV (Correct Answer)
- D. HIV
Explanation: ***HSV*** - **Idoxuridine** is a **pyrimidine analog** that inhibits viral DNA synthesis, making it effective against **herpes simplex virus (HSV)** infections, particularly **herpes keratitis** (ophthalmic use). - Its mechanism involves being incorporated into viral DNA, leading to errors in replication and transcription. - It is applied **topically** for ocular HSV infections due to systemic toxicity concerns. *Influenza* - **Idoxuridine** is not active against **influenza viruses**. - **Antiviral drugs** like **oseltamivir** or **zanamivir** are typically used for influenza treatment. *RSV* - **Idoxuridine** is not indicated for the treatment of **respiratory syncytial virus (RSV)**. - **Ribavirin** is the primary antiviral agent used for severe RSV infections, especially in immunocompromised patients. *HIV* - **Idoxuridine** has no significant activity against **human immunodeficiency virus (HIV)**. - **Antiretroviral therapy (ART)**, a combination of drugs targeting various stages of the HIV life cycle, is used for HIV treatment.