NEET-PG 2015 Practice Questions

Q: What is the most common form of leptospirosis?

Anicteric form. ***Anicteric form*** - The **anicteric form** accounts for about 90% of all leptospirosis cases, presenting with milder, flu-like symptoms without jaundice. - Patients typically experience **fever, headache, myalgia**, and conjunctival suffusion during the initial septicemic phase [1], followed by an immune phase that can involve meningitis or uveitis [1]. *Icteric form* - The **icteric form** (Weil's disease) is a severe manifestation, characterized by jaundice, renal failure, and hemorrhage, occurring in a minority of cases (5-10%). - Although more severe and often life-threatening, it is **less common** than the anicteric presentation [1]. *Hepatorenal form* - This term describes the severe complications of leptospirosis, including **liver and kidney dysfunction**, specifically associated with Weil's disease. - While a critical aspect of severe leptospirosis, it is a description of the organ involvement rather than a distinct common form of the disease. *Weil's disease* - **Weil's disease** is the most severe and potentially fatal form of leptospirosis, characterized by **jaundice, renal failure, hemorrhage, and myocarditis**. - It is a severe subset of the icteric form, making it a very serious but **uncommon variant** of the overall disease.

Q: Draughtsman colonies are seen with:

Pneumococci. ***Pneumococci*** - **Draughtsman colonies** (or **draughtsman-like colonies**) are a characteristic morphological feature observed when *Streptococcus pneumoniae* (pneumococci) grows on certain agar media, such as blood agar. - This appearance is due to the **central umbilication or depression** of the colony caused by autolytic enzymes that break down the bacterial cells in the center as the colony matures. *Anthrax* - Colonies of *Bacillus anthracis* are typically described as **"Medusa head" colonies**, characterized by swirling projections at the periphery. - They are generally **non-hemolytic** on blood agar, distinguishing them from other *Bacillus* species. *Pertussis* - *Bordetella pertussis* colonies are characteristic on **Bordet-Gengou agar**, appearing as small, glistening, pearl-like, or "mercury droplet" colonies. - This distinct morphology is crucial for its identification in laboratory cultures. *Yersinia* - *Yersinia pestis* (which causes plague) colonies on blood agar at 28°C often show a **"fried egg" appearance** over several days, with a dark center and lighter periphery. - Other *Yersinia* species like *Y. enterocolitica* can show a **bull's-eye pattern** on CIN (Cefsulodin-Irgasan-Novobiocin) agar.

Q: Naegler's reaction is due to:

Lecithinase. ***Lecithinase*** - The **Naegler reaction** is a bacterial identification test used to detect the production of **lecithinase** (also known as alpha-toxin) by certain bacteria, particularly *Clostridium perfringens*. - This enzyme hydrolyzes **lecithin** (a lipid found in egg yolk), resulting in a visible opaque precipitate around the bacterial colonies on egg yolk agar. *Coagulase* - **Coagulase** is an enzyme produced by some bacteria (e.g., *Staphylococcus aureus*) that causes the coagulation of blood plasma. - While it is an important virulence factor, it is not involved in the **Naegler reaction**. *Hyaluronidase* - **Hyaluronidase** is an enzyme that breaks down **hyaluronic acid**, a component of connective tissue, facilitating the spread of bacteria. - It is often referred to as a **spreading factor** but is not detected by the **Naegler reaction**. *None of the options* - This option is incorrect because **Lecithinase** is directly responsible for the **Naegler reaction**.

Q: Disruption of which of the following oropharyngeal commensals predisposes to candidiasis?

Streptococcus. ***Streptococcus*** - **Streptococcus** species, particularly *S. sanguinis* and *S. mitis*, are major commensals in the oral cavity that **inhibit the growth of *Candida albicans*** through competition for nutrients and production of antimicrobial substances. - Disruption of this normal **streptococcal flora**, often by broad-spectrum antibiotics, creates an environment where *Candida albicans* can proliferate, leading to candidiasis. *Staphylococcus* - **Staphylococcus** species are primarily skin and nasal commensals; while *S. aureus* can be found in the oral cavity, it is not a primary competitor against *Candida* in the same way as streptococci. - Their presence or absence is not typically a direct predisposing factor for oral candidiasis compared to the dominant streptococcal flora. *Lactobacillus* - **Lactobacillus** species are common in the gastrointestinal tract and vagina, where they maintain an acidic environment that inhibits pathogen growth; however, they are less dominant in the oropharynx as a defense against *Candida*. - While beneficial for overall host health, their disruption in the oral cavity does not typically precipitate candidiasis as directly as that of the **streptococcal flora**. *Hemophilus influenzae* - *Haemophilus influenzae* is a common inhabitant of the **upper respiratory tract** and can be an opportunistic pathogen, but it is not known to have a significant role in directly inhibiting *Candida* growth in the oropharynx. - Its presence or absence in the commensal flora in the oral cavity does not typically influence the development of candidiasis.

Q: Listeria escapes from phagosomes (phagolysosomes) due to:

beta-hemolysin. ***beta-hemolysin*** - *Listeria monocytogenes* produces **listeriolysin O (LLO)**, a **beta-hemolysin**, which is a pore-forming toxin that lyses the phagosomal membrane. - This allows the bacteria to escape into the host cell cytoplasm, thus **avoiding destruction** by lysosomal enzymes and neutralizing the microbicidal environment. *Caspases* - **Caspases** are a family of proteases that play essential roles in programmed cell death (apoptosis) and inflammation. - While bacteria can manipulate host cell apoptosis, caspases themselves are **host enzymes** and do not directly confer resistance to phagosome destruction. *Cell membrane adhesion molecules* - **Adhesion molecules** facilitate bacterial attachment to host cells and internalisation, but they do not directly provide a mechanism for **escaping the phagosome** once internalised. - Examples include internalins, which are involved in bacterial entry into cells. *Opacity associated protein (OAP)* - **Opacity associated proteins (OAPs)** are primarily associated with *Neisseria gonorrhoeae* and are involved in adherence to host cells and evasion of the immune response. - They are not a mechanism for **phagosomal escape** or directly related to *Listeria's* intracellular survival.

Q: Which bacteria can grow even in the presence of antiseptics?

Pseudomonas. ***Pseudomonas*** - **Pseudomonas aeruginosa** is unique among common bacteria in its ability to not just survive but actually **grow in the presence of antiseptics**. - It can multiply in **quaternary ammonium compounds**, **chlorhexidine solutions**, and even **distilled water** due to minimal nutritional requirements. - Resistance mechanisms include **efflux pumps**, **biofilm formation**, and **low outer membrane permeability** that exclude many antiseptic agents. - This characteristic makes it a notorious cause of **hospital-acquired infections** and contaminant of disinfectant solutions. *Staphylococcus* - While some strains like **MRSA (methicillin-resistant Staphylococcus aureus)** are resistant to many antibiotics, they are generally **susceptible to common antiseptics**. - Standard antiseptics like alcohols, iodophors, and chlorhexidine effectively kill Staphylococcus species. *Streptococcus* - **Streptococcus species** are generally **susceptible to most common antiseptics and disinfectants**. - They are known for causing infections like strep throat and cellulitis but do not exhibit antiseptic resistance. *E. coli* - **Escherichia coli** is typically **susceptible to standard antiseptic agents**. - While some strains can be antibiotic-resistant, their resistance mechanisms do not generally extend to antiseptics, unlike **Pseudomonas**.

Q: Which of the following statements about anthrax toxin is false?

Inhibits protein synthesis. ***Inhibits protein synthesis*** - Anthrax toxin, specifically the **lethal factor (LF)**, is a **zinc-dependent metalloprotease** that cleaves and inactivates **mitogen-activated protein kinase kinase (MAPKKs)**, leading to cell death, not directly inhibiting protein synthesis. - The **edema factor (EF)** component of the toxin is an **adenylate cyclase** that increases **intracellular cyclic AMP (cAMP)**, which also does not directly inhibit protein synthesis. *Has three components* - Anthrax toxin is indeed composed of three distinct proteins: **protective antigen (PA)**, **edema factor (EF)**, and **lethal factor (LF)**. - PA is necessary for EF and LF to enter host cells, while EF causes edema and LF is responsible for cytotoxicity. *Increase cAMP* - The **edema factor (EF)** component of anthrax toxin is a **calmodulin-dependent adenylate cyclase**. - Once inside the cell, EF converts **ATP to cyclic AMP (cAMP)**, leading to increased intracellular cAMP levels, which disrupts water homeostasis and causes edema. *Coded by plasmid* - The genes encoding the anthrax toxin components (PA, EF, and LF) are located on a large plasmid known as **pXO1**. - This plasmid, along with another plasmid (pXO2) carrying genes for the capsule, is crucial for the full virulence of *Bacillus anthracis*.

Q: Which tumor is characterized by the presence of cells that resemble tennis rackets?

Langerhans cell histiocytosis. ***Langerhans cell histiocytosis*** - This condition is characterized by **Birbeck granules** within the Langerhans cells, which have a distinctive **tennis racket-like appearance** on electron microscopy. - The cells are also positive for **CD1a** and **S-100** immunohistochemical markers. *Sarcoma botyroides* - This is a subtype of **embryonal rhabdomyosarcoma** typically found in mucosal sites, presenting as a polypoid, grape-like mass. - Its histology shows small, undifferentiated cells with primitive skeletal muscle differentiation, but **not tennis racket-shaped cells**. *Vaginal adenocarcinoma* - This is a rare malignancy of the vagina, often associated with **diethylstilbestrol (DES) exposure** in utero, presenting as glands. - The cells show glandular differentiation and produce mucin, but **lack Birbeck granules**. *Seminoma* - This is a germ cell tumor of the testis characterized by large, uniform cells with clear cytoplasm and prominent nucleoli, divided into lobules by fibrous septa containing lymphocytes. - There are **no tennis racket-shaped cells** or Birbeck granules associated with seminoma.

Q: What is the average survival time of a person without food and water under normal conditions?

3 to 5 days. ***3 to 5 days*** - When deprived of **both food and water**, the human body can typically survive for **3 to 5 days** under normal conditions. - **Water is the critical limiting factor** - while the body can tolerate food deprivation for weeks, lack of water becomes life-threatening within days. - Water is essential for cellular metabolism, temperature regulation, waste elimination, and cardiovascular function. *1 to 3 days* - This represents the **absolute minimum survival time** without water, particularly under harsh environmental conditions (heat, physical exertion, humidity). - However, under normal/average conditions, most individuals can survive slightly longer than this range. *10 to 12 days* - This duration is **not possible** without water, even with optimal conditions. - This timeframe is more consistent with survival **without food but WITH water**, which can extend to 3-4 weeks or more. *5 to 10 days* - While exceptional cases might approach 5-7 days without water in cool, resting conditions with low metabolic demands, **10 days is physiologically implausible**. - Severe dehydration typically causes death by day 5-7 maximum, with most succumbing earlier.

Question 1

What is the significance of the term 'Corona mortis' in human anatomy?

Accepted Answer

Anastomosis between obturator and inferior epigastric vessels

Answer

Anastomosis between superior and inferior gluteal arteries

Answer

A ligament connecting the pubic symphysis

Answer

A nerve crossing the pelvic brim

Question 2

What is the most common form of leptospirosis?

Accepted Answer

Anicteric form

Answer

Icteric form

Answer

Hepatorenal form

Answer

Weil's disease

Question 3

Draughtsman colonies are seen with:

Accepted Answer

Pneumococci

Answer

Anthrax

Answer

Pertussis

Answer

Yersinia

Question 4

Naegler's reaction is due to:

Accepted Answer

Lecithinase

Answer

Coagulase

Answer

Hyaluronidase

Answer

None of the options

Question 5

Disruption of which of the following oropharyngeal commensals predisposes to candidiasis?

Accepted Answer

Streptococcus

Answer

Staphylococcus

Answer

Lactobacillus

Answer

Haemophilus influenzae

Question 6

Listeria escapes from phagosomes (phagolysosomes) due to:

Accepted Answer

beta-hemolysin

Answer

Opacity associated protein (OAP)

Answer

Caspases

Answer

Cell membrane adhesion molecules

Question 7

Which bacteria can grow even in the presence of antiseptics?

Accepted Answer

Pseudomonas

Answer

Staphylococcus

Answer

Streptococcus

Answer

E. coli

Question 8

Which of the following statements about anthrax toxin is false?

Accepted Answer

Inhibits protein synthesis

Answer

Increase cAMP

Answer

Has three components

Answer

Coded by plasmid

Question 9

Which tumor is characterized by the presence of cells that resemble tennis rackets?

Accepted Answer

Langerhans cell histiocytosis

Answer

Seminoma

Answer

Vaginal adenocarcinoma

Answer

Sarcoma botyroides

Question 10

What is the average survival time of a person without food and water under normal conditions?

Accepted Answer

3 to 5 days

Answer

10 to 12 days

Answer

1 to 3 days

Answer

5 to 10 days

NEET-PG 2015

Anatomy

Internal Medicine

Microbiology

Pathology

Physiology