NEET-PG 2015 Practice Questions

Q: Which condition has the maximum relative risk attributed to obesity?

DM. ***DM*** - Obesity is a major risk factor for Type 2 Diabetes Mellitus (T2DM), with a **relative risk often exceeding 3-7 times that of normal-weight individuals**, and even higher for severe obesity. - The link is primarily due to **insulin resistance** caused by increased adipose tissue. *Hypertension* - Obesity significantly increases the risk of hypertension, with a relative risk typically in the range of **2 to 3 times higher** than normal-weight individuals. - The mechanisms involve increased **blood volume**, **sympathetic nervous system activity**, and **renal sodium reabsorption**. *CHD* - Obesity is a strong independent risk factor for Coronary Heart Disease (CHD), contributing to a relative risk of approximately **1.5 to 2.5 times higher** than normal weight. - It often acts by exacerbating other risk factors like **hypertension**, **dyslipidemia**, and **diabetes**. *Cancer* - Obesity is linked to various cancers, including endometrial, esophageal adenocarcinoma, renal cell, and breast cancer in postmenopausal women, with relative risks typically ranging from **1.2 to 2 times higher** for specific cancers. - The pathways include **chronic inflammation**, altered **hormone levels** (e.g., estrogen), and **insulin-like growth factor signaling**.

Q: According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?

Should have at least 1 child. ***Should have at least 1 child*** - The 2014 guidelines **removed the previous requirement** for a specific number of children, focusing instead on **informed consent** and **voluntary decision-making**. - The emphasis is now on the client's **autonomous choice**, regardless of their parity. - Having at least one child is **NOT an eligibility criterion** under the revised guidelines. *Age of at least 22 years* - While there is a minimum age requirement (legally 21 years, though some guidelines mention 22 years), this IS a valid eligibility criterion. - The age criterion ensures that individuals are mature enough to make an **informed and irreversible decision** about permanent contraception. - Younger individuals may be at higher risk of **regret** following sterilization. *Being unmarried* - Marital status is **NOT a barrier** to female sterilization under the 2014 guidelines. - Unmarried individuals have the same right to choose this method of contraception based on **informed consent**. - The decision for sterilization rests solely with the individual, irrespective of their **relationship status**. *Partner is not sterilized* - Partner's sterilization status is **NOT a determining factor** for female sterilization eligibility. - The decision is based on the **individual's choice**, health status, and desire for permanent contraception. - The eligibility criteria focus on the client's **informed consent** and understanding of the procedure, not on the partner's reproductive history.

Q: Which state has the lowest Infant Mortality Rate (IMR) in India?

Kerala. ***Kerala*** - Kerala consistently has achieved the **lowest Infant Mortality Rate (IMR)** in India, demonstrating significant progress in public health and maternal-child care. - This is primarily attributed to its robust **healthcare infrastructure**, high literacy rates, and effective implementation of health programs. *Maharashtra* - While Maharashtra has made progress in reducing IMR, its rate remains **higher than Kerala's**, reflecting varying healthcare access and quality across the state. - There are regional disparities in health outcomes, despite significant economic development. *Tamil Nadu* - Tamil Nadu has a commendable healthcare system and has significantly reduced its IMR over the years, yet it **does not consistently achieve the lowest rate** when compared to Kerala. - Its focus on **universal healthcare access** and nutrition programs has been instrumental in its improvements. *Uttar Pradesh* - Uttar Pradesh typically reports one of the **highest Infant Mortality Rates (IMR)** in India, due to challenges such as limited access to healthcare, malnutrition, and poor sanitation. - Significant efforts are underway to improve maternal and child health indicators, but the state still lags behind the national average and other states like Kerala.

Q: What is the primary function of glaucoma drainage devices?

Drain aqueous humour to an external device. **Drain aqueous humour to an external device** - Glaucoma drainage devices create an artificial outflow pathway, channeling excess **aqueous humour** from the anterior chamber to an external reservoir (usually under the conjunctiva) to lower intraocular pressure. - This bypasses the compromised natural drainage system, preventing further damage to the **optic nerve**. *Drain aqueous humour to the posterior segment* - Glaucoma drainage devices are designed to drain aqueous humour from the **anterior segment** (specifically the anterior chamber) of the eye, not the posterior segment. - The posterior segment primarily contains the **vitreous humour**, and drainage to this area is not the intended mechanism for IOP reduction. *Open the trabeculae mechanically* - Glaucoma drainage devices do not mechanically open the **trabecular meshwork**; this is the mechanism of action for procedures like goniotomy or trabeculoplasty. - These devices create an entirely new drainage pathway, bypassing the dysfunctional trabecular meshwork. *Reduce the aqueous secretion by compressing the ciliary epithelium* - Reducing aqueous humour secretion is the mechanism of action for medications like **beta-blockers** or **carbonic anhydrase inhibitors**, which act on the **ciliary epithelium**. - Glaucoma drainage devices focus on increasing outflow, not on reducing the production of aqueous humour.

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 condition are miotics the treatment of choice for?

Open-angle glaucoma. ***Open-angle glaucoma*** - Miotics, such as **pilocarpine**, are a classical treatment option for **primary open-angle glaucoma (POAG)**. - They work by **contracting the ciliary muscle**, which opens up the **trabecular meshwork** and increases aqueous humor outflow. - This results in **reduction of intraocular pressure (IOP)**, the primary goal in glaucoma management. - Though less commonly used today due to side effects (brow ache, miosis affecting vision), they remain effective and are particularly useful in patients who cannot tolerate other medications. *Angle closure glaucoma* - Miotics are **contraindicated in acute angle-closure glaucoma** as they can worsen pupillary block during the acute attack. - The initial treatment involves **IOP-lowering agents, systemic medications, and laser iridotomy**, not miotics. - Miotics may have a limited role in chronic angle closure after definitive treatment, but they are NOT the treatment of choice. *Buphthalmos* - This refers to **enlargement of the eyeball** in infants due to congenital glaucoma. - Management primarily involves **surgical intervention** (goniotomy, trabeculotomy) to address the developmental anomalies of the drainage angle. - Medical management alone, including miotics, is insufficient. *Sympathetic ophthalmia* - A rare **bilateral granulomatous panuveitis** following penetrating trauma or surgery to one eye. - Treated with **corticosteroids and immunosuppressive agents**. - Miotics have no role in managing this inflammatory condition.

Q: Descemet membrane breach is seen in ?

Congenital glaucoma (Buphthalmos). ***Congenital glaucoma (Buphthalmos)*** - In **congenital glaucoma**, increased intraocular pressure (IOP) in infancy stretches the developing eye, leading to enlargement (buphthalmos) and **Descemet membrane breaches** or ruptures. - These ruptures appear as fine, parallel, or branching lines on the posterior corneal surface, known as **Haab's striae**, which are characteristic signs of this condition. *Angle closure glaucoma* - This condition involves a sudden rise in IOP due to physical obstruction of the **aqueous humor outflow** and does not typically cause Descemet membrane breaks. - Clinical signs include **corneal edema** due to endothelial dysfunction, but not membrane breaches. *Acute Iridocyclitis* - **Acute iridocyclitis** is an inflammatory condition of the iris and ciliary body, primarily causing cells and flare in the anterior chamber. - It does not directly lead to **Descemet membrane breaches** or structural damage like stretching of the cornea. *Subconjunctival hemorrhage* - This condition is characterized by **bleeding under the conjunctiva** and is typically due to ruptured conjunctival blood vessels. - It is a superficial condition that does not involve the cornea or the Descemet membrane.

Q: Where is the newborn care corner located?

Labour room. ***Labour room*** - A **newborn care corner** is an essential facility located in the **labour room** to provide immediate care, resuscitation, and stabilization for newborns right after birth. - This setup ensures that critical interventions like **drying**, **warming**, **suctioning**, and initiation of **ventilation** can be performed promptly, improving neonatal outcomes. *NICU* - The **NICU (Neonatal Intensive Care Unit)** is for sick or premature newborns requiring intensive medical care, not the initial care at birth for all newborns. - While newborns from the labour room may be transferred to the NICU if they require specialized care, the initial care corner is distinct. *OPD* - **OPD (Outpatient Department)** is for patients seeking consultation without admission, and is not equipped or intended for immediate newborn care. - Newborns are brought to OPD for follow-up visits or routine check-ups much later, not immediately after birth. *Wards side room* - A **ward side room** is part of a general hospital ward, usually for inpatient care, and is not specifically designed or staffed for the initial, immediate care of a newborn at the moment of delivery. - While mothers and newborns may be transferred to a ward side room after stabilization, it's not where delivery and immediate postnatal care occur.

Question 1

Which condition has the maximum relative risk attributed to obesity?

Accepted Answer

DM

Answer

Hypertension

Answer

CHD

Answer

Cancer

Question 2

According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?

Accepted Answer

Should have at least 1 child

Answer

Partner is not sterilized

Answer

Being unmarried

Answer

Age of at least 22 years

Question 3

Which state has the lowest Infant Mortality Rate (IMR) in India?

Accepted Answer

Kerala

Answer

Maharashtra

Answer

Tamil Nadu

Answer

Uttar Pradesh

Question 4

What does the Gross Reproduction Rate (GRR) measure?

Accepted Answer

Number of female children a woman would have during her reproductive years, assuming no mortality

Answer

Number of total children a woman would have during her reproductive years (both male and female), assuming no mortality

Answer

Number of live births per 1000 women in a given year

Answer

Number of male children a woman would have during her reproductive years, assuming no mortality

Question 5

What does the term 'Total Communication' refer to in the context of deaf education?

Accepted Answer

Using all available communication methods to educate a deaf child.

Answer

Utilizing various communication methods for advertising purposes.

Answer

Employing multiple communication methods for educational purposes in schools.

Answer

Engaging various communication methods for community involvement.

Question 6

What is the primary function of glaucoma drainage devices?

Accepted Answer

Drain aqueous humour to an external device

Answer

Drain aqueous humour to the posterior segment

Answer

Open the trabeculae mechanically

Answer

Reduce the aqueous secretion by compressing the ciliary epithelium

Question 7

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 8

What condition are miotics the treatment of choice for?

Accepted Answer

Open-angle glaucoma

Answer

Angle closure glaucoma

Answer

Buphthalmos

Answer

Sympathetic ophthalmia

Question 9

Descemet membrane breach is seen in ?

Accepted Answer

Congenital glaucoma (Buphthalmos)

Answer

Angle closure glaucoma

Answer

Acute Iridocyclitis

Answer

Subconjunctival hemorrhage

Question 10

Where is the newborn care corner located?

Accepted Answer

Labour room

Answer

NICU

Answer

OPD

Answer

Wards side room

NEET-PG 2015

Community Medicine

ENT

Ophthalmology

Pediatrics