NEET-PG 2015 Practice Questions

Q: According to the ICDS scheme, what is the recommended population range for establishing one Anganwadi centre in rural areas?

400-800 (Rural). ***400-800 (Rural)*** - The **Integrated Child Development Services (ICDS)** scheme recommends one Anganwadi centre for a population of **400-800** in **rural areas**. - This is the **standard population norm** as per ICDS guidelines for establishing Anganwadi centres in typical rural settings. - This ensures adequate coverage and accessibility of ICDS services (nutrition, immunization, health check-ups, and preschool education) for mothers and children. *700-1000 (Urban)* - This population range (**700-1000**) is the standard norm for **urban areas**, not rural areas. - Urban areas have higher population density, hence a slightly larger population range is used per Anganwadi centre. - The question specifically asks about **rural areas**, making this option incorrect. *300-800 (Hilly/Tribal areas)* - This range (**300-800**) is designated for **hilly, difficult terrain, or specific tribal areas** where geographical challenges and scattered populations require lower population norms. - While this includes rural characteristics, it represents **special category areas**, not standard rural areas as asked in the question. *1000-1500 (Urban high density)* - A population target of **1000-1500** would be too high even for standard urban norms and doesn't align with official ICDS guidelines. - This is not applicable to **rural areas** as specified in the question.

Q: Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

2. ***2 (Minimum acceptable among given options)*** - The **Rideal-Walker coefficient** measures disinfectant efficacy relative to phenol as the standard reference - A coefficient of **2** means the disinfectant is **twice as effective** as phenol against test organisms (*Salmonella typhi* and *Staphylococcus aureus*) - While higher coefficients are preferred for highly infectious materials like cholera stool, **2 represents the minimum acceptable threshold** among the given options that still provides reasonable disinfection efficacy - Standard practice recommends disinfectants with RW coefficient ≥5 for cholera stool, but among the choices provided, 2 is the lowest that meets basic acceptability criteria *4 (Better choice but not the minimum)* - A coefficient of **4** means the disinfectant is **four times more effective** than phenol - This provides **more robust disinfection** and would be preferred over a coefficient of 2 - However, the question specifically asks for the **minimum acceptable** value, not the optimal value - Among the options, this is not the minimum *7 (Highly effective)* - A coefficient of **7** indicates the disinfectant is **seven times more potent** than phenol - This represents **very good disinfection efficacy** and exceeds minimum requirements - This is well above the minimum acceptable threshold *10 (Excellent efficacy)* - A coefficient of **10** means the disinfectant is **ten times more effective** than phenol - This represents **excellent disinfection power** with a very high safety margin - While ideal for high-risk situations, this far exceeds the minimum acceptable requirement

Q: What is the recommended therapeutic supplementation of iron and folic acid for adults with deficiency?

100 mg iron, 500 mcg folic acid. ***100 mg iron, 500 mcg folic acid*** - For adults with **iron deficiency anemia**, the therapeutic dose of elemental iron is typically **100-200 mg daily**, commonly given as ferrous sulfate 325 mg (containing ~65 mg elemental iron) 2-3 times daily. **100 mg is an appropriate therapeutic dose**. - For **folic acid deficiency**, the standard therapeutic dose is **1-5 mg (1000-5000 mcg) daily** for treating established deficiency. However, **500 mcg (0.5 mg)** represents a minimal therapeutic/high prophylactic dose that may be used in milder deficiencies or as initial supplementation. Among the given options, this is the most appropriate combination. *20 mg iron, 500 mcg folic acid* - **20 mg of iron** is grossly insufficient for therapeutic supplementation in iron deficiency anemia and would fail to correct the anemia adequately. - While 500 mcg folic acid has some therapeutic value, the **iron dose is far too low** for treatment. *40 mg iron, 250 mcg folic acid* - **40 mg of iron** is a prophylactic dose (used in pregnancy or prevention) but is **insufficient for therapeutic correction** of established iron deficiency anemia. - **250 mcg of folic acid** is also a prophylactic dose and inadequate for treating established deficiency. *100 mg iron, 100 mcg folic acid* - **100 mg of iron** is an appropriate therapeutic dose for treating **iron deficiency anemia**. - However, **100 mcg of folic acid** is purely a maintenance/prophylactic dose found in multivitamins and is **grossly insufficient** for treating established folic acid deficiency.

Q: Which one of the following is not an early complication of acute myocardial infarction?

Dressler's syndrome. ***Dressler's syndrome*** - **Dressler's syndrome** (post-myocardial infarction syndrome) is a **late complication** of acute myocardial infarction, typically occurring weeks to months after the event. - It is an **immune-mediated pericarditis**, characterized by chest pain, fever, and pericardial effusion, but is not seen immediately following an MI. *Papillary muscle dysfunction* - **Papillary muscle dysfunction** or rupture can occur as an **early complication** due to ischemia and necrosis of the muscle, leading to **mitral regurgitation** [1]. - This usually manifests within hours to days of the infarct, especially in **inferior MIs** affecting the posterior papillary muscle. *Ventricular septal defect* - A **ventricular septal defect (VSD)** is an **early mechanical complication** resulting from necrosis and rupture of the interventricular septum. - It typically presents within the **first week** after an MI, causing a new **holosystolic murmur** and signs of heart failure. *Pericarditis* - **Early pericarditis** (within a few days of MI) results from inflammation overlying the necrotic myocardial tissue [1]. - It presents with **pleuritic chest pain** that improves with leaning forward and a **pericardial friction rub**, and is distinct from Dressler's syndrome.

Q: Which of the following conditions is a direct indication for initiating dialysis?

Severe hyperkalemia. ### Severe hyperkalemia - **Severe hyperkalemia** (potassium levels typically >6.5 mEq/L or rapidly rising, especially with ECG changes) is an immediate life-threatening indication for dialysis when conservative measures fail or are insufficient [1]. - Dialysis effectively removes **excess potassium** from the blood, preventing fatal cardiac arrhythmias. *Severe metabolic acidosis* - While **severe metabolic acidosis** (pH <7.1-7.2) can be an indication, it is often managed first with bicarbonate administration and is typically not a stand-alone **direct** *emergency* indication for dialysis unless accompanied by other severe features or resistance to medical therapy. - The decision to dialyze for acidosis often depends on the underlying cause, degree of renal failure, and response to initial management [2]. *Fluid overload* - **Fluid overload** is a common complication of kidney failure, but it becomes a *direct* indication for dialysis when it is **refractory to diuretic therapy** and causes life-threatening symptoms such as **pulmonary edema** [2]. - Without such refractory state and immediate danger, fluid overload itself is not always an *immediate* trigger for dialysis compared to severe hyperkalemia. *Acute kidney injury* - **Acute kidney injury** (AKI) is the underlying *condition* that can lead to indications for dialysis, but AKI itself is not a *direct indication* for dialysis. - Dialysis is initiated for the *complications* of AKI, such as refractory hyperkalemia, severe metabolic acidosis, or fluid overload, rather than the diagnosis of AKI alone [2].

Q: Duroziez's sign is associated with which of the following conditions?

Aortic Regurgitation. ***Aortic Regurgitation*** - **Duroziez's sign** is a characteristic **systolic and diastolic bruit** heard over the femoral artery, indicative of significant **aortic regurgitation**. [1], [2] - This sign occurs due to the rapid antegrade and retrograde flow of blood during systole and diastole, respectively, caused by the incompetent aortic valve. [2] *Tricuspid Regurgitation* - **Tricuspid regurgitation** is primarily associated with **holosystolic murmur** best heard at the left lower sternal border, often increasing with inspiration (Carvallo's sign). - It does not produce arterial bruits like Duroziez's sign. *Pericardial effusion* - **Pericardial effusion** is characterized by the accumulation of fluid in the pericardial sac, which can lead to distant heart sounds, **pulsus paradoxus**, and electrical alternans on ECG. - It does not involve vascular bruits in peripheral arteries. *Mitral Stenosis* - **Mitral stenosis** classically presents with a **diastolic rumble** and an **opening snap**, typically heard at the apex. - It is a left-sided heart valve condition that does not cause peripheral arterial bruits.

Q: Which of the following statements about Chromobacterium violaceum is false?

Normal flora in human. **This question asks for the FALSE statement about *Chromobacterium violaceum*.** ***Normal flora in human*** ✓ (FALSE STATEMENT - This is the correct answer) - *Chromobacterium violaceum* is **not considered normal flora** in humans. It is an environmental bacterium typically found in **soil and water** in tropical and subtropical regions. - Its presence in humans usually signifies a serious **opportunistic infection**, often resulting from exposure to contaminated environments. - Since this statement is FALSE, this is the correct answer. *Gram negative* (TRUE statement) - *Chromobacterium violaceum* is indeed a **Gram-negative bacterium**. This characteristic is crucial for its identification and determining appropriate antibiotic treatment. - Like other Gram-negative bacteria, it possesses an **outer membrane** containing lipopolysaccharide (LPS). *Causes cellulitis* (TRUE statement) - *Chromobacterium violaceum* can cause severe infections in humans, including **cellulitis**, often following skin breaches like cuts or abrasions. - The infections are frequently aggressive and can lead to systemic disease such as **sepsis and abscess formation**. *Produces violet-colored pigment* (TRUE statement) - *Chromobacterium violaceum* is notable for producing **violacein**, a distinctive **violet-colored pigment**. - This pigment production is a key identifying feature on culture media and is associated with some of its pathogenic properties.

Q: After taking MMR live vaccine, conception should not occur within ?

4 weeks. ***4 weeks*** - The **MMR (measles, mumps, and rubella) vaccine** is a **live attenuated vaccine**, meaning it contains weakened forms of the viruses. - To minimize any theoretical risk of congenital rubella syndrome, women are advised to **avoid conception for at least 4 weeks** (or one month) after receiving the MMR vaccine. *2 weeks* - This period is generally considered too short for ensuring the complete clearance of the attenuated live virus from the woman's system before conception. - The standard recommendation for live attenuated vaccines like MMR is typically longer due to potential, though rare, viral transmission risks to the fetus. *8 weeks* - While a longer waiting period like 8 weeks would certainly be safe, it is **not the minimum recommended duration** by public health guidelines. - Waiting 4 weeks (one month) is sufficient and a more practical guideline for most women planning conception. *10 weeks* - This duration is significantly longer than the standard recommendation and is not necessary to ensure safety after an MMR vaccination. - The 4-week guideline balances safety with practicality for reproductive planning.

Q: What is the cause of glaucoma in retinoblastoma?

Neovascularisation. ***Neovascularisation*** - Retinoblastoma leads to **neovascularization of the iris (NVI)** and **angle structures** due to tumor necrosis, ischemia, and release of **angiogenic factors (VEGF)**. - The **neovascular membrane** grows over and obstructs the **trabecular meshwork** and anterior chamber angle, causing **secondary neovascular glaucoma**. - This is the **most characteristic and common mechanism** of glaucoma in advanced retinoblastoma. - Neovascular glaucoma in retinoblastoma is typically **refractory to medical treatment** and indicates poor prognosis. *Blockage of trabecular network* - While tumor cells can directly seed into the anterior chamber and block the trabecular meshwork, this mechanism is **less common** than neovascularization. - This option is also **less specific** as it doesn't identify the underlying pathophysiological process (neovascularization) that is characteristic of retinoblastoma-associated glaucoma. - Direct trabecular blockage by tumor cells typically occurs in advanced disease and often coexists with neovascularization. *Mass effect of the tumour* - The tumor mass itself rarely causes glaucoma through direct mechanical compression of outflow pathways. - Retinoblastoma causes glaucoma primarily through **secondary mechanisms** such as inflammation, neovascularization, or cellular seeding, not simple bulk effect. - Massive tumors may cause angle closure, but this is uncommon compared to neovascular mechanisms. *Lysis of the lens* - **Phacolytic glaucoma** from lens protein leakage is rare in retinoblastoma. - While lens damage can occur with advanced tumors, it is **not a typical or characteristic cause** of glaucoma in retinoblastoma. - The primary mechanisms involve the **tumor-angle-trabecular meshwork axis**, not lens pathology.

Q: What is the most common etiopathogenetic cause of glaucoma?

Decreased outflow. ***Decreased outflow*** - The most common cause of glaucoma is an **obstruction** or inefficiency in the drainage of **aqueous humor** from the eye, leading to its accumulation. - This reduced outflow results in an increase in **intraocular pressure (IOP)**, which damages the optic nerve. *Raised pressure in episcleral veins* - While elevated episcleral venous pressure can contribute to increased IOP and glaucoma, it is a **less common primary etiopathogenetic mechanism** compared to impaired outflow facility. - Conditions like **Sturge-Weber syndrome** or an **arteriovenous fistula** can cause this, but they are not the typical presentation of primary open-angle glaucoma. *Increased formation of aqueous humour* - An increase in the production of **aqueous humor** is rarely the primary cause of glaucoma. - The eye's regulatory mechanisms usually compensate, or if overproduction occurs, it is an **anatomical issue**, not an outflow issue. *Increased scleral outflow* - Increased **scleral outflow** (also known as uveoscleral outflow, which is a non-conventional drainage pathway) would actually lead to a **decrease** in intraocular pressure, not an increase. - This mechanism is often targeted by certain glaucoma medications (e.g., **prostaglandin analogues**) to lower IOP by facilitating drainage.

Question 1

According to the ICDS scheme, what is the recommended population range for establishing one Anganwadi centre in rural areas?

Accepted Answer

400-800 (Rural)

Answer

700-1000 (Urban)

Answer

1000-1500 (Urban high density)

Answer

300-800 (Hilly/Tribal areas)

Question 2

Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

Accepted Answer

2

Answer

4

Answer

10

Answer

7

Question 3

What is the recommended therapeutic supplementation of iron and folic acid for adults with deficiency?

Accepted Answer

100 mg iron, 500 mcg folic acid

Answer

20 mg iron, 500 mcg folic acid

Answer

40 mg iron, 250 mcg folic acid

Answer

100 mg iron, 100 mcg folic acid

Question 4

Which one of the following is not an early complication of acute myocardial infarction?

Accepted Answer

Dressler's syndrome

Answer

Pericarditis

Answer

Papillary muscle dysfunction

Answer

Ventricular septal defect

Question 5

Which of the following conditions is a direct indication for initiating dialysis?

Accepted Answer

Severe hyperkalemia

Answer

Severe metabolic acidosis

Answer

Fluid overload

Answer

Acute kidney injury

Question 6

Duroziez's sign is associated with which of the following conditions?

Accepted Answer

Aortic Regurgitation

Answer

Pericardial effusion

Answer

Tricuspid Regurgitation

Answer

Mitral Stenosis

Question 7

Which of the following statements about Chromobacterium violaceum is false?

Accepted Answer

Normal flora in human

Answer

Gram negative

Answer

Causes cellulitis

Answer

Produces violet-colored pigment

Question 8

After taking MMR live vaccine, conception should not occur within ?

Accepted Answer

4 weeks

Answer

8 weeks

Answer

2 weeks

Answer

10 weeks

Question 9

What is the cause of glaucoma in retinoblastoma?

Accepted Answer

Neovascularisation

Answer

Mass effect of the tumour

Answer

Blockage of trabecular network

Answer

Lysis of the lens

Question 10

What is the most common etiopathogenetic cause of glaucoma?

Accepted Answer

Decreased outflow

Answer

Raised pressure in episcleral veins

Answer

Increased formation of aqueous humour

Answer

Increased scleral outflow

NEET-PG 2015

Community Medicine

Internal Medicine

Microbiology

Obstetrics and Gynecology

Ophthalmology