NEET-PG 2019 - Internal Medicine PYQs Practice Questions

Q: Which syndrome is associated with posterior inferior cerebellar artery thrombosis?

Wallenberg syndrome. No specific references from the provided list reached the relevance threshold (score >= 7) to be cited in the explanation. The original text remains unchanged. ***Wallenberg syndrome*** - Also known as **lateral medullary syndrome**, it is caused by **thrombosis of the posterior inferior cerebellar artery (PICA)** or its branches. - Symptoms include ipsilateral **ataxia**, **vertigo**, **nystagmus**, dysphagia, and contralateral loss of pain and temperature sensation. *Medial medullary syndrome* - This syndrome results from occlusion of the **anterior spinal artery** and paramedian branches of the **vertebral artery**. - Clinical features include contralateral **hemiparesis**, ipsilateral **tongue deviation**, and loss of position and vibration sensation. *Inferior alternating syndrome* - This is another name for **medial medullary syndrome**, caused by a lesion in the **medulla oblongata**. - It is characterized by ipsilateral cranial nerve signs and contralateral long tract signs, differentiating it from Wallenberg syndrome. *Dejerine syndrome* - Also known as **medial medullary syndrome**, it is linked to occlusion of the **anterior spinal artery**. - Symptoms primarily involve the **pyramidal tract**, **medial lemniscus**, and **hypoglossal nerve**. [Practice more Internal Medicine PYQs on OnCourse]

Q: Calcitonin levels increased in

Medullary thyroid carcinoma. Medullary thyroid carcinoma - Calcitonin is a hormone produced by the parafollicular C cells of the thyroid gland. - Medullary thyroid carcinoma is a neuroendocrine tumor arising from these C cells, leading to excessive and unregulated calcitonin production. Hyperparathyroidism - This condition involves increased production of parathyroid hormone (PTH), which acts to increase serum calcium levels [2]. - Calcitonin secretion is typically decreased or normal in hyperparathyroidism, as calcitonin works to lower serum calcium. Hypoparathyroidism - This condition is characterized by insufficient production of parathyroid hormone (PTH), leading to low serum calcium levels [1]. - Calcitonin levels are generally unaffected or may even be slightly decreased in response to the low calcium, as its primary role is to lower calcium. Cushing Syndrome - Cushing Syndrome is caused by prolonged exposure to high levels of cortisol, a glucocorticoid. - While cortisol can affect bone metabolism, it does not directly impact calcitonin production or secretion, which is primarily regulated by serum calcium levels and C-cell activity. [Practice more Internal Medicine PYQs on OnCourse]

Q: What does a decreased FEV1/FVC ratio typically indicate in pulmonary function tests?

Obstructive lung disease. ***Obstructive lung disease*** - A decreased **FEV1/FVC ratio** indicates that the amount of air forcefully exhaled in one second (FEV1) is disproportionately low compared to the total forced vital capacity (FVC) [1]. This is a hallmark of **airflow limitation**, distinguishing obstructive lung diseases. - This pattern suggests a problem with **airway narrowing** or obstruction, making it difficult to exhale air quickly, which is characteristic of conditions like **COPD** (emphysema, chronic bronchitis) or **asthma** [1]. *Normal pulmonary function* - In normal pulmonary function, the **FEV1/FVC ratio** would be within the expected reference range, typically **above 70%** (or 0.7) for adults [1]. - A low ratio explicitly indicates a deviation from normal airflow dynamics, not a state of healthy lung function. *Restrictive lung disease* - **Restrictive lung diseases** are characterized by a **reduced total lung volume** (decreased FVC), but the FEV1/FVC ratio is typically **normal or even increased**. - This is because the airways are generally not obstructed; instead, the problem lies with the lungs' inability to expand fully, leading to a proportional reduction in FEV1 and FVC. *Both obstructive and restrictive lung disease* - While it is possible to have both conditions, a **decreased FEV1/FVC ratio** primarily points to an **obstructive pattern**. - A definitive diagnosis of both would require further interpretation of other PFT parameters such as **total lung capacity (TLC)**, which would be normal or increased in obstruction and reduced in restriction. [Practice more Internal Medicine PYQs on OnCourse]

Q: Which of the following exocrine glandular ducts are not obstructed in cystic fibrosis?

Sweat gland. ***Sweat gland*** - In cystic fibrosis, the **CFTR protein** in sweat glands is defective, leading to **impaired chloride reabsorption** and excessively salty sweat [1]. - This defect causes dysfunctional sweat production but **does not result in obstruction** of the sweat gland ducts, which continue to secrete. *Pancreas* - The **exocrine pancreatic ducts** are frequently obstructed in cystic fibrosis due to the production of **thick, sticky mucus**. - This obstruction leads to maldigestion and **pancreatic insufficiency**, requiring enzyme replacement therapy. *Lung* - **Bronchial ducts** and airways in the lungs are severely affected by the accumulation of **viscous mucus**, leading to chronic obstruction [1]. - This obstruction impairs mucociliary clearance, making patients susceptible to recurrent **pulmonary infections** and progressive lung damage [1], [2]. *None of the options* - This option is incorrect because sweat glands are indeed not obstructed, making option C the appropriate answer. [Practice more Internal Medicine PYQs on OnCourse]

Q: Which type of cardiomyopathy is associated with alcohol abuse?

Dilated cardiomyopathy. ### Dilated cardiomyopathy - Chronic **alcohol abuse** is a well-established cause of **dilated cardiomyopathy**, leading to weakening and enlargement of the ventricles [1]. - This condition results in impaired systolic function and can cause **heart failure** [1]. *Hypertrophic cardiomyopathy* - This condition is primarily characterized by **pathological thickening of the heart muscle**, often genetic, and is not directly caused by alcohol abuse. - It leads to issues with relaxation and filling of the heart, rather than dilation and weakness. *Pericarditis* - **Pericarditis** is the inflammation of the sac surrounding the heart (pericardium), most commonly caused by viral infections, autoimmune diseases, or injury. - It is not directly linked to alcohol abuse as a primary cause. *Myocarditis* - **Myocarditis** is the inflammation of the heart muscle, often triggered by viral infections, autoimmune reactions, or certain medications. - While heavy alcohol use can weaken the heart, myocarditis is primarily an inflammatory process not directly caused by alcohol. [Practice more Internal Medicine PYQs on OnCourse]

Question 1

Which syndrome is associated with posterior inferior cerebellar artery thrombosis?

Accepted Answer

Wallenberg syndrome

Answer

Medial medullary syndrome

Answer

Inferior alternating syndrome

Answer

Dejerine syndrome

Question 2

Calcitonin levels increased in

Accepted Answer

Medullary thyroid carcinoma

Answer

Hypoparathyroidism

Answer

Cushing Syndrome

Answer

Hyperparathyroidism

Question 3

What does a decreased FEV1/FVC ratio typically indicate in pulmonary function tests?

Accepted Answer

Obstructive lung disease

Answer

Normal pulmonary function

Answer

Restrictive lung disease

Answer

Both obstructive and restrictive lung disease

Question 4

Which of the following exocrine glandular ducts are not obstructed in cystic fibrosis?

Accepted Answer

Sweat gland

Answer

Pancreas

Answer

Lung

Answer

None of the options

Question 5

Which type of cardiomyopathy is associated with alcohol abuse?

Accepted Answer

Dilated cardiomyopathy

Answer

Hypertrophic cardiomyopathy

Answer

Pericarditis

Answer

Myocarditis

Question 6

What are the essential major blood culture criteria for diagnosing infective endocarditis?

Accepted Answer

Single positive culture of Coxiella burnetii

Answer

Single positive culture of Corynebacterium species

Answer

Both HACEK and Coxiella cultures

Answer

Single positive culture of HACEK group

Question 7

Which of the following statements about deep venous thrombosis (DVT) is incorrect?

Accepted Answer

Mostly bilateral

Answer

Most common clinically presents as pain and tenderness in calf

Answer

Some cases may directly present as pulmonary thromboembolism

Answer

Clinical assessment highly reliable

Question 8

Identify the cardiac condition represented in the image.

Accepted Answer

Ventricular tachycardia

Answer

Atrial fibrillation

Answer

Atrial flutter

Answer

Supraventricular tachycardia

Question 9

A female patient of 26 years, presents with oral ulcers, photosensitivity and skin malar rash in face sparing the nasolabial folds of both side.

Accepted Answer

SLE

Answer

Sturge weber syndrome

Answer

Dermatitis

Answer

Psoriasis

Question 10

In which condition are solitary lytic lesions typically seen?

Accepted Answer

Multiple myeloma

Answer

Atherosclerosis

Answer

Mitral stenosis

Answer

Osteosarcoma

NEET-PG 2019 — Internal Medicine