NEET-PG 2015 Practice Questions

Q: Which area in the spleen is considered *primarily* thymus-dependent?

Periarteriolar lymphoid sheath (PALS). ***Periarteriolar lymphoid sheath (PALS)*** - PALS is the **T-cell zone** of splenic white pulp, containing predominantly **T-lymphocytes** arranged around central arterioles. [2] - This area is **thymus-dependent** as it houses mature T cells that have undergone thymic selection and education, making it the primary thymus-dependent area of the spleen. [1] *Mantle layer* - The mantle layer consists of **naïve B lymphocytes** that surround the germinal center within splenic follicles. - This area is **thymus-independent** and primarily involved in **B-cell responses** to antigens. *Malpighian corpuscle* - Also known as **splenic follicles** or white pulp, this area primarily functions as **B-cell aggregation zones**. - While containing both B and T cell areas, it's predominantly **thymus-independent** with its main role being B-cell activation and antibody production. *None of the options* - This option is incorrect because PALS clearly represents the primary **thymus-dependent area** in the spleen. - The spleen definitively contains thymus-dependent zones where **T-cell activation** and proliferation occur, specifically the PALS. [1]

Q: Which of the following statements about alcoholic hepatitis is false?

SGPT is raised > SGOT. ***SGPT is raised > SGOT*** - In **alcoholic hepatitis**, the ratio of **AST (SGOT)** to **ALT (SGPT)** is typically **2:1 or higher**, meaning SGOT is usually significantly higher than SGPT. - This is because alcohol depletes **pyridoxal phosphate**, a cofactor for ALT, leading to relatively lower ALT levels. *Gamma glutamyl transferase is raised* - **Gamma-glutamyl transferase (GGT)** is frequently elevated in **alcoholic liver disease**, including alcoholic hepatitis [1]. - It serves as a sensitive marker for **biliary tract injury** and **alcohol consumption** [1]. *SGOT is raised > SGPT* - This statement is **true** for alcoholic hepatitis, as the **AST (SGOT)** to **ALT (SGPT)** ratio is typically **2:1 or greater**. - The disproportionately high AST is a characteristic feature reflecting the **mitochondrial damage** caused by alcohol within hepatocytes [2]. *Alkaline phosphatase is raised* - **Alkaline phosphatase (ALP)** can be elevated in alcoholic hepatitis, although usually to a lesser extent than in obstructive jaundice [1]. - Its elevation often reflects superimposed **cholestasis** or **biliary inflammation** [1].

Q: Which of the following symptoms is least likely to be associated with hyponatremia?

Myalgia. Myalgia - While muscle cramps can occur with electrolyte imbalances, generalized myalgia (muscle pain) is not a typical or primary symptom of hyponatremia. - Hyponatremia primarily affects neurological function due to osmotic shifts in the brain. anorexia - Anorexia (loss of appetite) is a common, non-specific symptom of many metabolic disturbances, including hyponatremia, and often accompanies nausea and vomiting. - It arises from the general malaise and gastrointestinal upset associated with the condition. Convulsions - Convulsions are a severe neurological symptom of acute and profound hyponatremia, resulting from cerebral edema and increased intracranial pressure [1]. - This occurs when the brain swells due to the osmotic shift of water into brain cells. Drowsiness - Drowsiness is a frequent neurological manifestation of hyponatremia, indicative of altered mental status [1]. - It reflects impaired brain function due to the osmotic disturbances and potential cerebral edema [1].

Q: Which of the following is NOT a criterion for the diagnosis of Primary Hyperaldosteronism?

Hyperkalemia. Primary hyperaldosteronism is typically characterized by **hypokalemia** due to excessive aldosterone-mediated potassium excretion in the urine, not hyperkalemia [1]. Hyperkalemia would suggest other conditions, such as **adrenal insufficiency** or kidney disease, rather than primary hyperaldosteronism [2]. *Diastolic Hypertension without edema* - **Diastolic hypertension** is a common presentation of primary hyperaldosteronism due to increased **sodium and water retention**, leading to expanded extracellular volume. - The absence of significant edema is also common, as the body often develops an **"escape phenomenon"** where natriuresis occurs despite high aldosterone, preventing overt fluid overload [3]. *Low Plasma Renin Activity* - In primary hyperaldosteronism, the high aldosterone levels **suppress renin secretion** through negative feedback mechanisms. - Therefore, a **low plasma renin activity** (PRA) or plasma renin concentration (PRC) is a key diagnostic feature [4]. *Hyperaldosteronism which is not suppressed by volume expansion* - Normally, volume expansion would suppress aldosterone secretion. However, in primary hyperaldosteronism, aldosterone production is **autonomous** and remains elevated even after volume expansion. - This lack of suppression is a critical diagnostic criterion, often assessed through various **confirmatory tests** like saline infusion or oral sodium loading.

Q: Trypanosoma cruzi is transmitted by which of the following?

Reduviid bug. ***Reduviid bug*** - *Trypanosoma cruzi*, the causative agent of **Chagas disease**, is primarily transmitted to humans through the feces of infected **reduviid bugs**, also known as **kissing bugs**. - The bug typically bites a person, often around the face, and then defecates near the bite wound, allowing the parasite to enter when the person scratches or rubs the area. *Tse tse fly* - The **tsetse fly** is the vector for **African trypanosomiasis** (sleeping sickness), caused by *Trypanosoma brucei*. - This fly is geographically restricted to sub-Saharan Africa, whereas *Trypanosoma cruzi* is prevalent in the Americas. *Culex mosquito* - **Culex mosquitoes** are known vectors for various diseases, including **West Nile virus**, **Japanese encephalitis**, and **filariasis**. - They are not involved in the transmission of *Trypanosoma cruzi*. *Sand fly* - **Sand flies** transmit **Leishmaniasis**, a parasitic disease caused by various species of *Leishmania*. - They are also responsible for transmitting **Bartonellosis** and some types of **Arboviruses**, but not Chagas disease.

Q: What is the most sensitive test for diagnosing syphilis?

FTA-ABS. ***FTA-ABS*** - The **fluorescent treponemal antibody absorption (FTA-ABS)** test is a treponemal test that is highly sensitive (>95%) and specific for detecting antibodies to *Treponema pallidum*. - It was traditionally considered the gold standard confirmatory test and is often used to confirm positive screening results. - It detects antibodies early in infection and remains positive for life, even after successful treatment. - **Note:** Modern treponemal tests like TP-PA have comparable sensitivity, but FTA-ABS remains widely recognized in clinical practice. *VDRL* - The **Venereal Disease Research Laboratory (VDRL)** test is a non-treponemal test that measures antibodies to cardiolipin, a lipid released from damaged host cells and *T. pallidum*. - While useful for screening and monitoring treatment response (titers decrease with successful treatment), it is less sensitive than treponemal tests, especially in early primary and late/tertiary syphilis. - Can yield false positives in various conditions (pregnancy, autoimmune diseases, infections). *TP-PA* - The **Treponema pallidum particle agglutination (TP-PA)** test is a highly sensitive and specific treponemal test that detects antibodies to *T. pallidum*. - It has sensitivity comparable to FTA-ABS (>95%) and is increasingly preferred in modern laboratories due to easier performance and objective reading. - Like other treponemal tests, it remains positive for life. *RPR* - The **rapid plasma reagin (RPR)** test is a non-treponemal test similar to VDRL, detecting antibodies to cardiolipin. - It is commonly used for screening due to ease of use and ability to monitor treatment response through quantitative titers. - Like VDRL, it has lower sensitivity compared to treponemal tests and can produce false positives.

Q: Unilateral frontal blisters with upper lid edema and conjunctivitis is seen in?

Herpes Zoster Ophthalmicus. ***Herpes Zoster Ophthalmicus*** - This condition is characterized by a **unilateral vesicular rash** (blisters) in the **trigeminal dermatome (V1)**, which includes the forehead and upper eyelid, along with significant **lid edema** and **conjunctivitis**. - **Hutchinson's sign** (lesions on the tip, side, or root of the nose) indicates a high risk of ocular involvement due to the nasociliary nerve innervation. *Acanthamoeba Keratitis* - This is an **amoebic infection** of the cornea typically associated with **contact lens wear** and often presents with severe pain and a **ring infiltrate** in the cornea. - It does not typically present with unilateral frontal blisters or significant lid edema. *Herpes Simplex* - Herpes simplex typically causes **recurrent corneal ulcers** (dendritic or geographic) and sometimes blepharitis, but not the widespread **unilateral frontal blisters** seen in the trigeminal distribution. - While it can cause conjunctivitis and lid edema, the pattern of skin lesions is the key differentiator. *Neuroparalytic Keratitis* - This condition results from **trigeminal nerve damage**, leading to corneal anesthesia and subsequent **trophic corneal ulceration**. - It presents primarily with **corneal findings** (epithelial defects, ulcers) due to impaired sensation and tear film stability, not initial vesicular skin lesions or prominent lid edema.

Q: All of the following are complications of traumatic hyphema except which of the following?

Corneal Ulcer. ***Corneal Ulcer*** - A **corneal ulcer** is typically caused by infection, trauma, or exposure keratitis and is not a direct complication of blood in the anterior chamber from a **traumatic hyphema**. - While prolonged elevation of **intraocular pressure** from hyphema could theoretically impair corneal health, a direct ulcer is not a typical or primary complication. *Rebleeding* - **Rebleeding** is a common and serious complication of hyphema, usually occurring 2-7 days after the initial injury. - It often results in a more significant bleed and carries a higher risk of complications such as **elevated intraocular pressure** and **blood staining of the cornea**. *Pupillary Block* - **Pupillary block** can occur if the amount of blood from the hyphema prevents the flow of aqueous humor from the posterior to the anterior chamber. - This blockage leads to a buildup of **aqueous humor** in the posterior chamber, causing the iris to bow forward and potentially precipitating **acute angle-closure glaucoma**. *Posterior synechiae* - **Posterior synechiae** can develop due to inflammation (uveitis) associated with the hyphema, where the iris adheres to the anterior lens capsule. - This complication can lead to **irregular pupil shape**, **pupillary block glaucoma**, or other visual disturbances.

Q: Which is a hormone dependent liver tumor?

Adenoma. ***Adenoma*** - Hepatic adenomas are **hormone-dependent tumors** commonly associated with conditions like **oral contraceptive use** and are influenced by estrogen [1]. - These tumors can present as **benign liver masses**, but they have a risk of hemorrhage and malignant transformation [1]. *Hepatocellular carcinoma* - This is a **malignant tumor** of the liver primarily associated with cirrhosis and chronic liver disease, not directly hormone-dependent. - Risk factors include **viral hepatitis** and **alcohol exposure**, rather than hormonal influences. *Hemangioma* - Liver hemangiomas are **vascular lesions** that are usually asymptomatic and are **not hormone-dependent**. - They are the most common benign liver tumors, often discovered incidentally during imaging. *Hemangiopericytoma* - A rare tumor, hemangiopericytoma originates from **pericytes** around blood vessels and is not specifically associated with liver tissue or hormones. - It can arise in various organs but lacks the dependency on hormones seen in hepatic adenomas. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 874.

Q: Miracle fruit is used to change the taste from?

Sour to Sweet. ***Sour to Sweet*** - The **miracle fruit** (Synsepalum dulcificum) contains a glycoprotein called **miraculin**. - Miraculin binds to taste receptors on the tongue and modifies their perception, making **sour foods taste sweet**. *Sour to Bitter* - The primary effect of miracle fruit is to convert **sour tastes into sweet tastes**, not bitter ones. - No known natural compound consistently changes sour perception to bitter. *Bitter to Sweet* - While miraculin makes sour foods sweet, it does not typically convert **bitter tastes into sweet sensations**. - Bitter taste perception involves different receptor pathways that are not significantly altered by miraculin. *Salty to Sweet* - Miracle fruit primarily targets **sour taste receptors**. - It does not have a significant effect on altering the perception of **salty tastes to sweet**.

Question 1

Which area in the spleen is considered *primarily* thymus-dependent?

Accepted Answer

Periarteriolar lymphoid sheath (PALS)

Answer

Mantle layer

Answer

Malpighian corpuscle

Answer

None of the options

Question 2

Which of the following statements about alcoholic hepatitis is false?

Accepted Answer

SGPT is raised > SGOT

Answer

Gamma glutamyl transferase is raised

Answer

Alkaline phosphatase is raised

Answer

SGOT is raised > SGPT

Question 3

Which of the following symptoms is least likely to be associated with hyponatremia?

Accepted Answer

Myalgia

Answer

anorexia

Answer

Drowsiness

Answer

Convulsions

Question 4

Which of the following is NOT a criterion for the diagnosis of Primary Hyperaldosteronism?

Accepted Answer

Hyperkalemia

Answer

Diastolic Hypertension without edema

Answer

Low Plasma Renin Activity

Answer

Hyperaldosteronism which is not suppressed by volume expansion

Question 5

Trypanosoma cruzi is transmitted by which of the following?

Accepted Answer

Reduviid bug

Answer

Tse tse fly

Answer

Culex mosquito

Answer

Sand fly

Question 6

What is the most sensitive test for diagnosing syphilis?

Accepted Answer

FTA-ABS

Answer

VDRL

Answer

RPR

Answer

TP-PA

Question 7

Unilateral frontal blisters with upper lid edema and conjunctivitis is seen in?

Accepted Answer

Herpes Zoster Ophthalmicus

Answer

Herpes Simplex

Answer

Neuroparalytic Keratitis

Answer

Acanthamoeba Keratitis

Question 8

All of the following are complications of traumatic hyphema except which of the following?

Accepted Answer

Corneal Ulcer

Answer

Pupillary Block

Answer

Posterior synechiae

Answer

Rebleeding

Question 9

Which is a hormone dependent liver tumor?

Accepted Answer

Adenoma

Answer

Hemangioma

Answer

Hepatocellular carcinoma

Answer

Hemangiopericytoma

Question 10

Miracle fruit is used to change the taste from?

Accepted Answer

Sour to Sweet

Answer

Sour to Bitter

Answer

Bitter to Sweet

Answer

Salty to Sweet

NEET-PG 2015

Anatomy

Internal Medicine

Microbiology

Ophthalmology

Pathology

Physiology