NEET-PG 2015 Practice Questions

Q: Which study design is most effective for investigating rare adverse effects of a drug?

Case-control study. ***Case-control study*** - This design starts by identifying individuals with the **rare adverse effect (cases)** and a control group without the effect to look back for exposure to the drug. - It is efficient for studying rare outcomes because it doesn't require following a large population for a long time to observe few events. *Cohort study* - A **cohort study** follows a group of individuals exposed and unexposed to a drug forward in time to observe outcomes. - While good for common outcomes, it would require an **extremely large sample size** and a long follow-up period to observe rare adverse drug effects. *Cross-sectional study* - A **cross-sectional study** assesses exposure and outcome simultaneously at a single point in time. - This design is suitable for determining **prevalence** but cannot establish temporal relationships between drug exposure and rare adverse effects, nor is it efficient for rare outcomes. *Clinical trial/experimental study* - **Clinical trials** are primarily designed to test the efficacy and safety of new interventions, usually focusing on common adverse effects. - They are generally **not powered** or long enough to detect rare adverse events, as such events would occur in very few participants, if any.

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 the context of ventricular tachycardia, what do extra systoles appear as on an electrocardiogram (ECG)?

QRS complex. ***QRS complex*** - Extra systoles, particularly **premature ventricular contractions (PVCs)**, originate in the ventricles and result in a **wide and bizarre QRS complex** on an ECG [2]. - The QRS complex represents **ventricular depolarization**, and in ventricular tachycardia, the *ventricular activity* dominates the ECG tracing [2]. *P wave* - The **P wave** represents **atrial depolarization** and is typically either absent or dissociated from the QRS complex in ventricular tachycardia [1], [2]. - Its presence or absence helps differentiate supraventricular from ventricular arrhythmias. *T wave* - The **T wave** represents **ventricular repolarization**, which typically follows the QRS complex [1]. - While it will be present, it often appears abnormal or discordant in ventricular tachycardia due to the altered ventricular depolarization. *R wave* - The **R wave** is part of the QRS complex, specifically the first positive deflection. - While an R wave is present within the QRS complex of an extrasystole, referring to the entire **QRS complex** is more accurate as it encompasses the complete ventricular depolarization in an abnormal morphology.

Q: What is the primary clinical application of the Rockall score?

Upper GI bleeding. ***Upper GI bleeding*** - The **Rockall score** is a clinical risk assessment tool specifically designed to predict **re-bleeding** and **mortality** in patients admitted with **acute upper gastrointestinal bleeding** [1]. - It uses clinical parameters (age, shock, comorbidities) and endoscopic findings (diagnosis, stigmata of recent hemorrhage) to stratify risk [1]. *Lower GI bleeding* - The Rockall score is **not validated** for assessing risk in **lower gastrointestinal bleeding**, which has different etiologies and clinical courses. - Other scoring systems, like the **Blatchford score** or **Glasgow-Blatchford score**, might be used for initial risk assessment in GI bleeding, but Rockall is specific to upper GI [1]. *Hepatic encephalopathy* - **Hepatic encephalopathy** is a neuropsychiatric complication of liver cirrhosis, for which the Rockall score has **no diagnostic or prognostic utility**. - Its assessment involves grading the severity of neurological symptoms and identifying precipitating factors. *IBD* - Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic inflammatory condition of the GI tract. - The Rockall score is **irrelevant** in the assessment or management of **IBD**, which uses specific disease activity indices.

Q: Which of the following statements is true regarding amoebic liver abscess?

Mostly involving the right lobe of the liver.. ***Mostly involving the right lobe of the liver*** - The **right lobe** of the liver is the most common site for an amoebic liver abscess due to its larger size and preferential blood flow from the portal venous system, which drains the intestines where *Entamoeba histolytica* resides. - The **superior mesenteric vein**, draining the cecum and ascending colon (common sites for amebiasis), primarily feeds the right hepatic lobe. *May rupture into the pleural cavity* - While rupture can occur, the **peritoneal cavity** is a more common site of rupture for amoebic liver abscesses. - Rupture into the pleural cavity or lung is less frequent but can lead to **empyema** or **bronchopleural fistula** [1]. *For asymptomatic luminal carriers, metronidazole is the drug of choice* - **Metronidazole** is effective against invasive amoebiasis (like liver abscess or dysentery) but is not the drug of choice for asymptomatic luminal carriers. - For **asymptomatic luminal carriers**, **luminal amebicides** such as **paromomycin** or **diloxanide furoate** are used to eradicate cysts from the intestine [1]. *Multiple abscesses is less common than a single abscess* - **A single amoebic liver abscess** is more common than multiple abscesses [1]. - Multiple abscesses are typically seen in disseminated disease or immunocompromised individuals, though even then a solitary lesion is more frequent.

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: All are true about anaerobic infections except:

Exudates and swabs are ideal for culture. ***Exudates and swabs are ideal for culture.*** - **Swabs exposed to air** are generally **not ideal** for anaerobic culture because oxygen exposure can kill obligate anaerobes, leading to false-negative results. - Optimal anaerobic specimen collection requires techniques that **minimize oxygen exposure**, such as aspirates or tissue biopsies placed in anaerobic transport media. *Most infections are endogenous* - Anaerobic infections commonly arise from **one's own commensal flora**, which becomes pathogenic under specific conditions like tissue damage or impaired blood supply. - These bacteria are part of the normal microbiota of various body sites, including the gastrointestinal tract, oral cavity, and skin. *Specimen for UTI is suprapubic aspiration* - For **suspected anaerobic urinary tract infections (UTIs)**, suprapubic aspiration is considered the gold standard for specimen collection. - This method bypasses potential contamination from urethral flora and ensures a sterile, oxygen-free sample for accurate anaerobic culture. *They are found normally on skin and GIT* - **Anaerobic bacteria** are a significant component of the normal flora of the **skin and gastrointestinal tract (GIT)**, as well as the oral cavity and genitourinary tract. - Their presence in these sites is crucial for maintaining normal physiological functions and preventing the overgrowth of pathogens.

Q: What is the causative agent of Izumi fever?

Yersinia pseudotuberculosis. ***Yersinia pseudotuberculosis*** - Izumi fever (also called **Far East scarlet-like fever**) is caused by Yersinia pseudotuberculosis, particularly referring to outbreaks that occurred in Japan. - This infection presents with **fever, abdominal pain, and a scarlet fever-like rash**, often mimicking appendicitis due to mesenteric lymphadenitis. - Y. pseudotuberculosis is transmitted through **contaminated food and water**, and the Izumi fever variant is characterized by systemic manifestations including erythema and desquamation. *Yersinia enterocolitica* - While this is a closely related species that also causes **gastroenteritis and mesenteric adenitis**, it is NOT the causative agent of Izumi fever. - Y. enterocolitica typically presents with diarrhea, abdominal pain, and fever, but lacks the distinctive scarlet fever-like rash seen in Izumi fever. *Pseudomonas aeruginosa* - This bacterium is an **opportunistic pathogen** often associated with nosocomial infections, especially in immunocompromised individuals. - It causes **pneumonia**, urinary tract infections, and wound infections, but not Izumi fever. *Pasteurella multocida* - This bacterium is common in the **respiratory tracts of animals**, especially cats and dogs, and is a frequent cause of wound infections from animal bites or scratches. - It typically causes localized cellulitis, abscesses, and occasionally severe infections like meningitis or osteomyelitis, not Izumi fever.

Q: Which of the following is not a standard treatment for myopia?

Holmium laser thermoplasty. ***Holmium laser thermoplasty*** - This procedure was explored for the treatment of **hyperopia**, not myopia, as it aims to steepen the cornea to increase its refractive power. - It involves using a holmium laser to apply heat to the peripheral cornea, causing **collagen shrinkage** and steepening, which is the opposite of what is needed for myopia correction. *LASIK* - **LASIK (Laser-Assisted in Situ Keratomileusis)** is a common and effective surgical procedure for correcting myopia by reshaping the cornea to reduce its refractive power. - It involves creating a **corneal flap** and using an excimer laser to remove tissue from the underlying stromal bed. *Phakic intraocular lens* - **Phakic intraocular lenses (IOLs)** are implanted into the eye without removing the natural lens and are a standard treatment for moderate to high myopia, especially in patients not suitable for LASIK. - They work by adding refractive power to the eye, allowing light to focus correctly on the retina. *Radial Keratotomy* - **Radial Keratotomy (RK)** was an early surgical procedure for myopia, involving making radial incisions in the cornea to flatten it and reduce its refractive power. - Although largely replaced by LASIK due to its unpredictable outcomes and potential for glare and night vision problems, it was historically a standard treatment for myopia.

Q: Irresistible sexual desire is known as:

Hypersexuality. ***Hypersexuality*** - This term describes an **unusually high or frequent sexual drive** or activity in either males or females that causes significant distress or impairment. - While "satyriasis" was historically used for males, **hypersexuality** is the current, more inclusive and clinically recognized term for excessive sexual desire. *Nymphomania* - This term specifically refers to **excessive sexual desire in a female**. - It is an older, often pathologizing term and is generally replaced by terms like **hypersexuality** or **compulsive sexual behavior**. *Tribadism* - This refers to a specific sexual practice between **women involving friction** of the vulva or clitoris. - It describes a *sexual act*, not an overwhelming sexual desire. *Sadism* - This is a paraphilia characterized by deriving **sexual pleasure from inflicting pain or humiliation on others**. - It describes a *preference for a certain type of sexual activity* rather than an irresistible or excessive general sexual desire.

Question 1

Which study design is most effective for investigating rare adverse effects of a drug?

Accepted Answer

Case-control study

Answer

Cohort study

Answer

Cross-sectional study

Answer

Clinical trial/experimental study

Question 2

Thrombocythemia is characterized by an elevated platelet count.

Accepted Answer

Elevated platelet count

Answer

Low platelets

Answer

Neutrophilia

Answer

Monocytosis

Question 3

In the context of ventricular tachycardia, what do extra systoles appear as on an electrocardiogram (ECG)?

Accepted Answer

QRS complex

Answer

P wave

Answer

T wave

Answer

R wave

Question 4

What is the primary clinical application of the Rockall score?

Accepted Answer

Upper GI bleeding

Answer

Lower GI bleeding

Answer

Hepatic encephalopathy

Answer

IBD

Question 5

Which of the following statements is true regarding amoebic liver abscess?

Accepted Answer

Mostly involving the right lobe of the liver.

Answer

May rupture into the pleural cavity.

Answer

For asymptomatic luminal carriers, metronidazole is the drug of choice.

Answer

Multiple abscesses is less common than a single abscess.

Question 6

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

Accepted Answer

Direct contact

Answer

Droplet transmission

Answer

Indirect contact

Answer

Vehicle transmission

Question 7

All are true about anaerobic infections except:

Accepted Answer

Exudates and swabs are ideal for culture

Answer

Specimen for UTI is suprapubic aspiration

Answer

They are found normally on skin and GIT

Answer

Most infections are endogenous

Question 8

What is the causative agent of Izumi fever?

Accepted Answer

Yersinia pseudotuberculosis

Answer

Yersinia enterocolitica

Answer

Pseudomonas aeruginosa

Answer

Pasteurella multocida

Question 9

Which of the following is not a standard treatment for myopia?

Accepted Answer

Holmium laser thermoplasty

Answer

Phakic intraocular lens

Answer

Radial Keratotomy

Answer

LASIK

Question 10

Irresistible sexual desire is known as:

Accepted Answer

Hypersexuality

Answer

Nymphomania

Answer

Tribadism

Answer

Sadism

NEET-PG 2015

Community Medicine

Internal Medicine

Microbiology

Ophthalmology

Psychiatry