NEET-PG 2015 Practice Questions

Q: Which of the following is not a feature of ethmoidal polyp?

Commonly found as a single polyp. ***Commonly found as a single polyp*** - **Ethmoidal polyps** are typically **multiple** and bilateral, originating from the ethmoid sinuses. - They rarely present as a single, isolated polyp, which is more characteristic of antrochoanal polyps. - This is the key distinguishing feature that makes this statement INCORRECT. *Common in adults* - **Ethmoidal polyps** are indeed **more prevalent in adults** than in children. - Peak incidence occurs between 30-50 years of age. - Their incidence tends to increase with age, often associated with chronic rhinosinusitis. *Commonly bilateral* - **Ethmoidal polyps** almost invariably present as **bilateral polyps**, involving both sides of the nasal cavity. - This bilateral nature is a key differentiating feature from antrochoanal polyps, which are typically unilateral. - Bilateral presentation is one of the hallmark characteristics of ethmoidal polyps. *Associated with chronic rhinosinusitis* - **Ethmoidal polyps** are strongly associated with **chronic rhinosinusitis with nasal polyposis (CRSwNP)**. - They arise from chronic mucosal inflammation of the ethmoid sinuses. - Often associated with conditions like aspirin-exacerbated respiratory disease (AERD/Samter's triad) and non-allergic eosinophilic inflammation.

Q: All of the following are treatments for multiple bilateral ethmoidal polyps except which of the following?

Caldwell Luc Surgery. ***Caldwell Luc Surgery*** - This procedure accesses the **maxillary sinus** through an incision in the gingivobuccal sulcus, primarily used for maxillary sinus pathology. - It is **not the primary treatment** for ethmoidal polyps, which are located in the ethmoid sinuses. *Intranasal ethmoidectomy* - This is a common and effective surgical approach to remove ethmoidal polyps, involving access through the **nostrils**. - It allows for direct visualization and removal of polyps within the ethmoid labyrinth. *Extranasal ethmoidectomy* - This surgical approach involves an external incision (e.g., Lynch-Howarth incision) to access the ethmoid sinuses. - It is typically reserved for **extensive or complicated ethmoid disease** or in cases where intranasal approaches are insufficient. *Functional endoscopic sinus surgery* - This is the **gold standard** for treating chronic rhinosinusitis with polyps, including ethmoidal polyps. - It uses an endoscope to visualize and remove polyps while preserving healthy mucosa and restoring normal sinus drainage and ventilation.

Q: Thrombocythemia is characterized by an elevated platelet count.

Elevated platelet count. Elevated platelet count - Thrombocythemia is a condition specifically defined by an abnormally high number of platelets (thrombocytes) in the blood [2]. - This elevated count can lead to issues with both bleeding and clotting [2]. Low platelets - Low platelets, also known as thrombocytopenia, is the opposite of thrombocythemia [1]. - This condition is associated with an increased risk of bleeding [1]. Neutrophilia - Neutrophilia refers to an elevated count of neutrophils, a type of white blood cell, which is typically seen in bacterial infections. - It does not directly describe the platelet count. Monocytosis - Monocytosis indicates an increase in monocytes, another type of white blood cell, often seen in chronic infections or inflammatory conditions. - This term is unrelated to platelet levels.

Q: In a patient with COPD, what is the best management option?

Quit smoking. ***Quit smoking*** - **Smoking cessation** is the single most effective intervention for slowing the progression of **COPD** and improving lung function [1]. - It reduces exacerbation rates and improves overall mortality, making it the cornerstone of management [1]. *Bronchodilators* - **Bronchodilators** (e.g., beta-agonists, anticholinergics) are crucial for symptomatic relief by opening airways, but they do not alter the disease progression [1]. - While essential for managing symptoms, they are not the "best" in terms of modifying the disease course. *Low flow oxygen* - **Oxygen therapy** is indicated for patients with **severe hypoxemia** (PaO2 < 55 mmHg or SaO2 < 88%) to improve survival and quality of life [2]. - It is a supportive treatment for advanced disease and does not prevent or slow the progression of COPD itself. *Mucolytics* - **Mucolytics** may be used in some patients with COPD and chronic productive cough to reduce sputum viscosity and improve clearance. - Their benefit is primarily symptomatic, and they do not have a significant impact on disease progression or mortality.

Q: Murmur heard in aortic stenosis

Right 2nd intercostal, high pitch systolic ejection murmur. ***Right 2nd intercostal, high pitch systolic ejection murmur*** - The murmur of **aortic stenosis** is classically heard loudest at the **right second intercostal space** (aortic area) due to turbulent flow through the stenosed aortic valve. - It is a **high-pitched, systolic ejection murmur** with a crescendo-decrescendo pattern, often radiating to the carotid arteries [2]. *Apex, low pitch murmur associated with mitral valve issues* - A murmur heard at the **apex** that is low-pitched typically suggests **mitral stenosis**, which is a diastolic rumble, not an aortic stenosis murmur [1]. - This option refers to characteristics associated with **mitral valve disease**, not aortic stenosis. *Pan-systolic murmur, high pitch murmur associated with mitral regurgitation* - A **pan-systolic murmur** is characteristic of conditions like **mitral regurgitation** or tricuspid regurgitation, where blood flows throughout the entire systole [3]. - While it can be high-pitched, its pan-systolic nature and association with mitral regurgitation make it distinct from aortic stenosis. *Left Sternal area, murmur indicating mitral regurgitation* - Murmurs heard primarily at the **left sternal area** can indicate various conditions, but this option specifically points to **mitral regurgitation**. - **Mitral regurgitation** is better heard at the apex and usually radiates to the axilla, and the description does not fit the typical presentation of aortic stenosis [3].

Q: Which of the following is not a recognized transmission route for amoebiasis?

Vector transmission. ***Vector transmission*** - Amoebiasis, caused by *Entamoeba histolytica*, is primarily an **intestinal infection** transmitted through the **fecal-oral route**. - Its life cycle **does not involve any arthropod vector** (e.g., mosquito, tick, fly) for transmission. - This is the **only route among the options that is definitively NOT recognized** for amoebiasis transmission. *Sexual transmission* - Amoebiasis **can be transmitted** through **oral-anal sexual contact**, particularly documented in men who have sex with men (MSM). - This represents an **indirect fecal-oral transmission** route and is a recognized mode of spread. *Blood and blood products* - While *E. histolytica* can disseminate to cause **amoebic liver abscesses** and rarely systemic disease, transmission via blood transfusion is **extremely rare and not well-documented**. - However, theoretically possible in cases of parasitemia during invasive disease. - Unlike vector transmission, this cannot be definitively ruled out as "not recognized." *Fecal-oral route* - This is the **primary and most important transmission route** for amoebiasis. - Infection occurs through ingestion of **cysts** from contaminated food, water, or through direct person-to-person contact with poor hand hygiene.

Q: Most common route of nosocomial infection [Hospital-acquired infection]?

Direct contact. **Direct contact** - **Direct contact** with colonized or infected patients is the predominant mode of transmission for many common nosocomial pathogens like **MRSA** and **VRE**. - This often involves healthcare workers' hands becoming contaminated and then touching other patients. *Droplet transmission* - Involves the transmission of infectious agents through **respiratory droplets** produced during coughing, sneezing, or talking. - While significant for some infections (e.g., influenza, pertussis), it is not the most common route overall for nosocomial infections. *Indirect contact* - Occurs when an infectious agent is transferred via a **contaminated intermediate object** or person. - Although important (e.g., contaminated medical devices), it is generally less frequent than direct patient-to-patient transmission. *Vehicle transmission* - Involves transmission through **contaminated inanimate vehicles** like food, water, medications, or surgical instruments. - While outbreaks can occur via this route (e.g., contaminated endoscopes), it is not the most common day-to-day transmission mechanism in hospitals.

Q: Which of the following does not stimulate active immunity?

Transplacental antibody transfer in newborn. ***Transplacental antibody transfer in newborn*** - This is a form of **passive immunity**, where pre-formed **antibodies from the mother** are transferred to the newborn, providing immediate but temporary protection. - It does not involve the newborn's own immune system generating an immune response or creating **memory cells**. *Subclinical infection* - Even without overt symptoms, a **natural infection** exposes the immune system to pathogens, triggering an active immune response and generating **memory cells**. - This leads to **long-term immunity** against future exposures to the same pathogen. *Clinical infection* - A **symptomatic natural infection** involves the immune system actively responding to the pathogen, producing antibodies and **memory cells**. - This process is the basis of **naturally acquired active immunity** and provides durable protection. *Vaccination* - Vaccines contain weakened or inactive forms of pathogens, or their components, which stimulate the immune system to produce **antibodies** and **memory cells** without causing disease. - This is an example of **artificially acquired active immunity**, providing long-lasting protection.

Q: Haptens are immunogenic when they covalently bind to which type of carrier?

Protein carrier. ***Protein carrier*** - Haptens are small molecules that are **antigenic** but not **immunogenic** on their own; they acquire immunogenicity when covalently bound to a larger carrier molecule. - **Proteins** are highly effective carriers because their complex structures and multiple epitopes can induce strong T-cell help, which is crucial for a robust antibody response against the hapten. *Lipid carrier* - While some lipids can be antigenic (e.g., glycolipids), they generally do not serve as effective carriers for haptens to induce a strong adaptive immune response, especially T-cell-dependent responses. - **Lipids** are less likely to be processed and presented by MHC molecules in a way that generates potent helper T-cell activation. *Polysaccharide carrier* - Some polysaccharides can be immunogenic themselves (e.g., bacterial capsular polysaccharides) and can induce T-cell-independent antibody responses. - However, for haptens to become immunogenic and induce a **T-cell-dependent antibody response**, a protein carrier is typically required. *None of the above carrier* - This option is incorrect because haptens do require a carrier to become immunogenic, and specific types of carriers are more effective than others. - The type of carrier chosen significantly impacts the **strength and nature of the immune response** to the hapten.

Q: Which of the following is NOT a feature of CHARGE syndrome?

Esophageal Atresia. ***Esophageal Atresia*** - While other **tracheoesophageal abnormalities** can occur in CHARGE syndrome, **esophageal atresia** is not typically considered one of the core diagnostic criteria. - The acronym CHARGE stands for a specific set of features, and esophageal atresia is not directly included, unlike **choanal atresia**. *Eye Coloboma* - **Coloboma** of the eye, particularly the iris or retina, is a **major diagnostic feature** of CHARGE syndrome. - This congenital malformation results from incomplete closure of the **choroid fissure** during development. *Congenital heart disease* - Various types of **congenital heart defects**, such as **tetralogy of Fallot** or an **atresia of the aortic valve**, are common in CHARGE syndrome. - These cardiac anomalies are a **major diagnostic criterion** and significantly impact patient management. *Choanal Atresia* - **Choanal atresia** represents the "A" in the CHARGE acronym and is a **major diagnostic criterion**. - This condition involves blockage of the nasal passages and is one of the most characteristic features of the syndrome. *Urinary tract defects* - **Genital and urinary abnormalities** are frequently observed in individuals with CHARGE syndrome. - These can include **hypoplastic genitalia** and **kidney abnormalities**, classifying as a **minor diagnostic feature**.

Question 1

Which of the following is not a feature of ethmoidal polyp?

Accepted Answer

Commonly found as a single polyp

Answer

Common in adults

Answer

Commonly bilateral

Answer

Associated with chronic rhinosinusitis

Question 2

All of the following are treatments for multiple bilateral ethmoidal polyps except which of the following?

Accepted Answer

Caldwell Luc Surgery

Answer

Intranasal ethmoidectomy

Answer

Extranasal ethmoidectomy

Answer

Functional endoscopic sinus surgery

Question 3

Thrombocythemia is characterized by an elevated platelet count.

Accepted Answer

Elevated platelet count

Answer

Low platelets

Answer

Neutrophilia

Answer

Monocytosis

Question 4

In a patient with COPD, what is the best management option?

Accepted Answer

Quit smoking

Answer

Bronchodilators

Answer

Low flow oxygen

Answer

Mucolytics

Question 5

Murmur heard in aortic stenosis

Accepted Answer

Right 2nd intercostal, high pitch systolic ejection murmur

Answer

Apex, low pitch murmur associated with mitral valve issues

Answer

Pan-systolic murmur, high pitch murmur associated with mitral regurgitation

Answer

Left Sternal area, murmur indicating mitral regurgitation

Question 6

Which of the following is not a recognized transmission route for amoebiasis?

Accepted Answer

Vector transmission

Answer

Sexual transmission

Answer

Blood and blood products

Answer

Fecal-oral route

Question 7

Most common route of nosocomial infection [Hospital-acquired infection]?

Accepted Answer

Direct contact

Answer

Droplet transmission

Answer

Indirect contact

Answer

Vehicle transmission

Question 8

Which of the following does not stimulate active immunity?

Accepted Answer

Transplacental antibody transfer in newborn

Answer

Clinical infection

Answer

Vaccination

Answer

Subclinical infection

Question 9

Haptens are immunogenic when they covalently bind to which type of carrier?

Accepted Answer

Protein carrier

Answer

Lipid carrier

Answer

Polysaccharide carrier

Answer

None of the above carrier

Question 10

Which of the following is NOT a feature of CHARGE syndrome?

Accepted Answer

Esophageal Atresia

Answer

Congenital heart disease

Answer

Urinary tract defects

Answer

Eye Coloboma

Answer

Choanal Atresia

NEET-PG 2015

ENT

Internal Medicine

Microbiology

Psychiatry