NEET-PG 2017 Practice Questions

Q: Which is correct sequence of handwashing technique?

A → B → C. ***A → B → C*** - Follows the **WHO 6-step handwashing protocol** progression from **palm-to-palm with fingers interlaced** (step 3) to **backs of fingers against opposing palm** (step 4) to **rotational thumb rubbing** (step 5). - This sequence ensures **systematic cleaning** of all hand surfaces, moving from basic interdigital spaces to more complex finger positions before focusing on the thumb. *A → C → B* - Skips the **backs of fingers cleaning** (step 4) before proceeding to **thumb cleaning**, disrupting the systematic progression. - **Thumb cleaning** should come after thorough **interdigital cleaning** to ensure complete coverage of all finger surfaces. *B → A → C* - Begins with **backs of fingers to opposing palm**, which requires **fingers interlocked**, before completing basic **palm-to-palm interlacing**. - This reverses the **WHO protocol** by attempting advanced finger positioning before establishing proper **interdigital contact**. *C → B → A* - Starts with **thumb cleaning** before addressing **interdigital spaces**, completely reversing the systematic approach. - **Thumb cleaning** should be performed after **thorough finger and palm cleaning** to prevent recontamination of cleaned areas.

Q: All are true about bacteria shown in the smear of pus below, except:

Most strains are inhibited in presence of 5 % NaCl. The image shows **Gram-positive cocci** arranged in clusters, which is characteristic of *Staphylococcus aureus*. Many pus cells (neutrophils) are also seen, indicating an inflammatory response, consistent with a bacterial infection. ***Most strains are inhibited in presence of 5 % NaCl*** - *Staphylococcus aureus* is known to be **halophilic**, meaning it **grows well** in the presence of high salt concentrations (e.g., 7.5% NaCl), which distinguishes it from many other bacteria. - Therefore, the statement that it is 'inhibited in the presence of 5% NaCl' is **incorrect**. *Produce black colonies on potassium tellurite blood agar* - *Staphylococcus aureus* **reduces tellurite** to metallic tellurium, resulting in the production of **black colonies** on potassium tellurite blood agar. - This is a characteristic feature used in the identification of *Staphylococcus aureus*, particularly on media like Baird-Parker agar. *Liquefy gelatin* - *Staphylococcus aureus* produces the enzyme **gelatinase**, which **hydrolyzes gelatin**, causing it to liquefy. - This is a biochemical characteristic used to differentiate *Staphylococcus aureus* from certain other staphylococcal species. *Seen in Job syndrome* - **Job syndrome** (Hyper-IgE syndrome) is characterized by recurrent severe **Staphylococcal infections** of the skin and lungs. - Patients with Job syndrome have impaired neutrophil chemotaxis and elevated IgE levels, making them highly susceptible to *Staphylococcus aureus* infections.

Q: Which of the following toxins will produce the condition shown below?

ETA and ETB. ***ETA and ETB*** - The image shows a child with widespread **blistering and epidermal exfoliation**, characteristic of **Staphylococcal Scalded Skin Syndrome (SSSS)**. - SSSS is caused by **exfoliative toxins A (ETA)** and **exfoliative toxins B (ETB)** produced by *Staphylococcus aureus*, which target **desmoglein-1** in the stratum granulosum, leading to intraepidermal cleavage and skin peeling. *Leukocidin* - **Leukocidin** is a cytotoxin produced by *Staphylococcus aureus* that targets and destroys **leukocytes**, particularly neutrophils and macrophages. - It does not directly cause the widespread epidermal blistering and exfoliation seen in the image. *TSST-1* - **Toxic Shock Syndrome Toxin-1 (TSST-1)** is a superantigen produced by *Staphylococcus aureus* that causes **Toxic Shock Syndrome**, characterized by fever, rash, hypotension, and multi-organ failure. - While it can manifest with a diffuse erythematous rash followed by desquamation, it does not typically cause the prominent blistering and extensive epidermal peeling seen in the image. *Serum opacity factor* - **Serum opacity factor** is an enzyme produced by some strains of **Group A Streptococcus** (not *Staphylococcus aureus*) that degrades serum lipoproteins. - It is associated with **rheumatic fever** and **acute glomerulonephritis** but plays no direct role in skin blistering or exfoliation.

Q: All are true about the bacteria shown in the figure except:

Urease positive. ***Urease positive*** - The image depicts **Corynebacterium diphtheriae**, characterized by **metachromatic granules** and its bacillary (rod) shape, often showing V or L formations. - *Corynebacterium diphtheriae* is **urease negative**, not positive, making this statement false and the correct answer to this "except" question. *Pyrazinamidase test positive* - *Corynebacterium diphtheriae* is **pyrazinamidase positive**, an important biochemical characteristic used in its identification. - This enzyme activity distinguishes it from other *Corynebacterium* species like *C. pseudodiphtheriticum* and *C. ulcerans*. *C. gravis has daisy head colony* - The **mitis** and **gravis** biotypes are distinct strains of *Corynebacterium diphtheriae*, with *C. gravis* characterized by its distinctive **"daisy head" colony morphology** on tellurite medium. - This irregular growth pattern is a known characteristic feature of *C. diphtheriae* biotype gravis. *Heat labile toxin has affinity for myocardium* - The **diphtheria toxin** produced by *C. diphtheriae* is indeed **heat-labile** and has strong affinity for various tissues, particularly the **myocardium** and nerve cells. - This tissue affinity leads to serious complications such as **myocarditis** and neurological deficits in diphtheria patients.

Q: All the following statements regarding this image are true except: (Recent NEET Pattern 2016-17)

This is a soft tissue tumor. ***This is a soft tissue tumor*** - The image shows a swelling over the olecranon process, which is characteristic of **olecranon bursitis**. This condition is an **inflammation of the bursa**, not a soft tissue tumor. - A tumor implies an abnormal growth of tissue that can be benign or malignant, which is not depicted here; the swelling is related to fluid accumulation within a bursa. *This condition could result from student's elbow* - **Student's elbow** is another name for olecranon bursitis, which is the condition depicted in the image. - This common term refers to the inflammation of the olecranon bursa, often caused by **repetitive pressure or trauma** to the elbow, such as leaning on it for extended periods while studying. *It is secondary to trauma* - **Trauma**, especially repetitive minor trauma or a single significant impact, is a very common cause of olecranon bursitis due to injury to the bursa. - This trauma can lead to inflammation and fluid accumulation within the bursa, causing the characteristic swelling. *This condition is due to inflammation of the sub-cutaneous fat* - The condition shown is **olecranon bursitis**, which is an inflammation of the **olecranon bursa**. - The olecranon bursa is a fluid-filled sac that lies between the skin and the olecranon process of the ulna to reduce friction, and its inflammation is distinct from inflammation of the subcutaneous fat (panniculitis).

Q: What is the grade of fracture according to Garden's classification?

Grade III. ***Grade III*** - This image shows a **complete displaced fracture** of the femoral neck, but with the **distal fragment in valgus** position, which corresponds to Garden Grade III. - In Garden Grade III, the fracture is **complete and displaced**, but there is still some **engagement** of the fracture surfaces, leading to the valgus alignment of the head on the shaft. *Grade I* - Garden Grade I refers to an **incomplete impacted valgus fracture** of the femoral neck. - The fracture line is visible, but there is no displacement, and the head is tilted into a valgus position relative to the neck. *Grade II* - Garden Grade II describes a **complete but non-displaced fracture** of the femoral neck. - The fracture line extends across the entire neck, but the fragments remain in anatomical alignment without angulation or displacement. *Grade IV* - Garden Grade IV is characterized by a **complete and fully displaced fracture** of the femoral neck, with the **femoral head completely separated** from the shaft and in a neutral or varus position. - There is a complete loss of contact and alignment between the femoral head and the shaft, indicating significant instability.

Q: A sportsman presented to you after injury during practice exercise. You performed the test given in the image, and it came out as positive. What is the diagnosis?

Anterior cruciate ligament tear. ***Anterior cruciate ligament tear*** - The image depicts the **Lachman test**, a highly sensitive and specific clinical test for **ACL integrity**. - A positive Lachman test, characterized by *increased anterior tibial translation* and a *soft or absent endpoint*, confirms an **ACL tear**. *Posterior cruciate ligament tear* - A PCL tear is identified by tests like the **posterior drawer test** or **posterior sag sign**, which show *posterior tibial translation*. - The test shown in the image specifically assesses **anterior stability**, not posterior. *Medial meniscus tear* - Medial meniscus tears are typically diagnosed with tests like **McMurray's test** or **Apley's grind test**, which involve *rotation* and *compression* of the knee. - While a crucial knee structure, the meniscus does not primarily contribute to **anterior-posterior stability** in the way the ACL does. *Medial collateral ligament tear* - An MCL tear is detected by applying a **valgus stress** to the knee at various degrees of flexion. - This tear presents with *medial joint line pain* and *instability to valgus stress*, which is not assessed by the depicted test.

Q: Which of the following spine deformities is seen in the image?

Gibbus. ***Gibbus*** - A **gibbus deformity** is a sharply angular posterior projection of a vertebral segment, caused by the collapse of one or more vertebral bodies. - Most commonly due to **Pott's disease (spinal tuberculosis)**, where vertebral body destruction leads to a focal, acute-angle hump. - The image clearly shows a **localized, sharp posterior angulation** in the thoracic spine, which is characteristic of a gibbus. *Kyphosis* - **Kyphosis** refers to an exaggerated **posterior curvature** of the thoracic spine, producing a "rounded back." - While a gibbus is technically a severe form of kyphosis, kyphosis alone describes a more **generalized, smooth curve** — not the focal, angular hump seen in the image. *Lordosis* - **Lordosis** describes an **anterior (forward) curvature** of the lumbar spine, often called "swayback." - This is not seen in the image, which displays a prominent **posterior** projection, not an anterior one. *Scoliosis* - **Scoliosis** is a **lateral (side-to-side) curvature** of the spine, seen as a deviation when viewed from behind. - The image shows a deformity in the **sagittal plane** (anterior-posterior), not the coronal plane, ruling out scoliosis.

Q: Comment on the diagnosis of the presentation shown below:

Unicameral bone cyst. ***Unicameral bone cyst*** - This X-ray shows a **well-defined, lytic lesion** in the proximal humerus, consistent with a unicameral bone cyst, often presenting in the **metaphysis** of long bones in children and adolescents. - The lesion has a **thin, sclerotic rim** and shows **no significant periosteal reaction** or soft tissue mass, which are classic features. *Aneurysmal bone cyst* - While also a lytic lesion, an aneurysmal bone cyst typically appears more **expansile** and **multiloculated**, often with a **"soap bubble" appearance**. - It usually has a **thicker, more irregular rim** and can present with faster growth or more aggressive features than a unicameral bone cyst. *Osteoblastoma* - Osteoblastomas are typically **osteoblastic (bone-forming)** tumors, which would appear more **sclerotic** or mixed lytic-sclerotic on X-ray, rather than a purely lytic lesion like the one shown. - They commonly affect the **spine or long bones**, but their radiographic appearance of predominant bone formation is not seen here. *Osteoclastoma* - Osteoclastomas, also known as **giant cell tumors of bone**, are usually found in the **epiphysis** of long bones in mature skeletons, which is a different location than observed. - They are typically **aggressive lytic lesions** with poorly defined margins and can extend to the articular surface, which is not characteristic of the well-demarcated lesion in the image.

Q: A 20-year-old college girl presents with pain in the upper part of tibia especially after dance classes. The pain has increased to a level that she cannot practice for forthcoming college festival. X-ray of the lower leg shows:

Osteoblastoma. ***Osteoblastoma*** - On X-ray, osteoblastomas commonly appear as a **lytic lesion** with a **sclerotic rim**, often larger than 2 cm, which can be seen in the provided image. The pain in the **tibia** that worsens with activity and affects a young individual is also consistent with the presentation of osteoblastoma. - This benign bone tumor is known to cause significant localized pain and can be found in the **metaphysis or diaphysis** of long bones like the tibia. *Osteosarcoma* - Osteosarcoma is a **highly aggressive malignant bone tumor** that typically presents with a **"sunburst" or "Codman's triangle"** appearance and areas of amorphous calcification (osteoid matrix) on X-ray, which are not clearly evidenced here. - While it can occur in young adults and cause pain, the radiographic findings are more indicative of a benign lytic lesion. *Chondrosarcoma* - Chondrosarcoma is a **malignant cartilaginous tumor** often characterized by **"rings and arcs"** or **popcorn-like calcifications** within a lytic lesion on X-ray, typical of cartilage matrix. - While it can cause pain, its radiographic features are distinct from those observed. *Pigmented villonodular synovitis* - This is a **benign proliferative disorder of the synovium** affecting joints or bursae, not primarily the bone itself. - It would typically demonstrate **erosions** and **soft tissue masses** within a joint on imaging, not a lytic bone lesion as shown.

Question 1

Which is correct sequence of handwashing technique?

Accepted Answer

A → B → C

Answer

A → C → B

Answer

B → A → C

Answer

C → B → A

Question 2

All are true about bacteria shown in the smear of pus below, except:

Accepted Answer

Most strains are inhibited in presence of 5 % NaCl

Answer

Produce black colonies on potassium tellurite blood agar

Answer

Liquefy gelatin

Answer

Seen in Job syndrome

Question 3

Which of the following toxins will produce the condition shown below?

Accepted Answer

ETA and ETB

Answer

Leukocidin

Answer

TSST-1

Answer

Serum opacity factor

Question 4

All are true about the bacteria shown in the figure except:

Accepted Answer

Urease positive

Answer

Pyrazinamidase test positive

Answer

C. gravis has daisy head colony

Answer

Heat labile toxin has affinity for myocardium

Question 5

All the following statements regarding this image are true except: (Recent NEET Pattern 2016-17)

Accepted Answer

This is a soft tissue tumor

Answer

This condition could result from student's elbow

Answer

It is secondary to trauma

Answer

This condition is due to inflammation of the sub-cutaneous fat

Question 6

What is the grade of fracture according to Garden's classification?

Accepted Answer

Grade III

Answer

Grade I

Answer

Grade II

Answer

Grade IV

Question 7

A sportsman presented to you after injury during practice exercise. You performed the test given in the image, and it came out as positive. What is the diagnosis?

Accepted Answer

Anterior cruciate ligament tear

Answer

Posterior cruciate ligament tear

Answer

Medial meniscus tear

Answer

Medial collateral ligament tear

Question 8

Which of the following spine deformities is seen in the image?

Accepted Answer

Gibbus

Answer

Kyphosis

Answer

Lordosis

Answer

Scoliosis

Question 9

Comment on the diagnosis of the presentation shown below:

Accepted Answer

Unicameral bone cyst

Answer

Aneurysmal bone cyst

Answer

Osteoblastoma

Answer

Osteoclastoma

Question 10

A 20-year-old college girl presents with pain in the upper part of tibia especially after dance classes. The pain has increased to a level that she cannot practice for forthcoming college festival. X-ray of the lower leg shows:

Accepted Answer

Osteoblastoma

Answer

Osteosarcoma

Answer

Chondrosarcoma

Answer

Pigmented villonodular synovitis

NEET-PG 2017

Microbiology

Orthopaedics