NEET-PG 2019 Practice Questions

Q: The marked area in the image is supplied by which dermatome?

T10. ***T10*** - The **umbilicus** (navel) is a crucial anatomical landmark for dermatome mapping. - The area around the umbilicus is consistently innervated by the **T10 dermatome**. *T8* - The **T8 dermatome** is located higher on the abdomen, typically around the **xiphoid process**. - It would be too superior to supply the umbilical region. *T9* - The **T9 dermatome** is situated between T8 and T10, above the umbilicus. - It generally covers the region just **above the navel**, but not the navel itself. *T11* - The **T11 dermatome** is located below the umbilicus, closer to the **inguinal region**. - It would be too inferior to innervate the umbilical area.

Q: Which of the following is the most common method used to know depth of anaesthesia?

BIS. ***BIS*** - The **BIS (Bispectral Index) monitor** is the most common and widely utilized objective method for assessing the depth of anesthesia by analyzing brain electrical activity. - It provides a numerical value, typically from 0 to 100, where lower numbers indicate deeper anesthetic states, aiming for a range of 40-60 during general anesthesia. *Oesophageal contractility* - While esophageal motility can be affected by anesthetic depth, it is **not a standard or common method** for monitoring anesthesia during surgery. - Its measurement is invasive and not directly correlated with cortical brain activity, which is the primary target of most general anesthetics. *Depressed responses* - **Clinical signs of depressed responses** (e.g., lack of purposeful movement, stable vital signs) are important, but they are subjective and less reliable for accurately measuring anesthetic depth, especially in paralyzed patients. - These signs can be influenced by various factors unrelated to anesthetic depth, such as neuromuscular blockade or hypothermia. *Hypotension* - **Hypotension** is a common side effect of general anesthesia, but it is an indicator of the *hemodynamic effects* of anesthetics, not a direct or reliable measure of their depth. - Hypotension can be caused by many factors other than anesthetic depth, such as blood loss, hypovolemia, or cardiac dysfunction, making it a non-specific indicator.

Q: What condition is likely to be present in the child shown in the image, whose mother has asthma?

Atopic dermatitis. ***Atopic dermatitis*** - The image shows an infant with **red, scaly, and irritated skin**, particularly on the cheeks and around the mouth, consistent with the characteristic presentation of **atopic dermatitis (eczema)** in infants. - Atopic dermatitis often occurs in individuals with a family history of **atopy**, which includes conditions like **asthma**, allergic rhinitis, and food allergies; a mother with asthma significantly increases the child's risk. *SLE* - **Systemic lupus erythematosus (SLE)** is a **chronic autoimmune inflammatory disease** that rarely presents in infancy with such prominent skin findings, especially without other systemic symptoms. - Skin manifestations of SLE typically include a **malar (butterfly) rash** or **discoid lesions**, which are different from the diffuse eczematous rash seen here. *Erythema* - **Erythema** simply refers to **redness of the skin** caused by inflammation or dilation of blood capillaries. - While the infant's skin is erythematous, erythema is a **symptom**, not a specific diagnosis, and does not fully describe the scaly, papular nature of the rash or the underlying condition. *TEN* - **Toxic epidermal necrolysis (TEN)** is a **severe, life-threatening skin condition** characterized by widespread epidermal detachment, forming large blisters and skin sloughing, often triggered by medications. - The skin lesions in the image do not show the extensive blistering and denudation characteristic of TEN, and a history of an asthmatic mother is not a risk factor for TEN.

Q: Patient presents with pruritus of the interdigital spaces of the left hand as shown in the image. Identify the condition.

Sarcoptes scabiei. ***Sarcoptes scabiei*** - The image shows **papules and excoriations** in the **interdigital spaces**, a classic presentation of **scabies**. Patients typically experience **intense pruritus**, especially at night. - The presence of **burrows**, which are linear or serpiginous tracks, further supports this diagnosis, as these are created by the female mite tunneling into the epidermis. *Dermatitis herpetiformis* - This condition is characterized by **intensely pruritic, symmetrically grouped vesicles and bullae** on extensor surfaces, such as elbows, knees, and buttocks, not primarily interdigital spaces. - It is strongly associated with **celiac disease** and typically responds to a gluten-free diet and dapsone. *Xerotic dermatitis* - **Xerotic dermatitis**, also known as **eczema craquelé** or **winter itch**, is characterized by **dry, fissured skin** that resembles cracked porcelain, often exacerbated by dry weather. - While it causes pruritus, it does not typically present with the papules and burrows seen in scabies, nor is it confined to interdigital spaces in this manner. *Erythema multiforme* - **Erythema multiforme** is an acute, self-limiting inflammatory skin condition characterized by **target lesions** (concentric rings of erythema and edema) and often involves mucous membranes. - It is often triggered by infections (e.g., herpes simplex virus) or drugs and does not primarily present with pruritic papules in interdigital areas.

Q: A child with history of fever, photosensitivity, rash sparing nasolabial fold presents to OP. Identify the condition?

SLE. ***SLE*** - The combination of **fever**, **photosensitivity**, and a **rash sparing the nasolabial folds** (malar rash or butterfly rash) is highly characteristic of Systemic Lupus Erythematosus (SLE). - Childhood-onset SLE can present with similar mucocutaneous and systemic features as adult-onset disease. *Polymorphous light eruption* - This condition is primarily characterized by **photosensitive skin lesions** but typically does not involve systemic symptoms like fever. - While it presents with rash in sun-exposed areas, it generally lacks the distinct malar rash appearance and systemic involvement seen in SLE. *Discoid lupus* - Discoid lupus is a form of **cutaneous lupus** characterized by chronic, scaly, disfiguring plaques, often on the face and scalp. - It usually **lacks systemic symptoms** like fever and does not present as a widespread malar rash sparing nasal folds. *Skin tuberculosis* - Skin tuberculosis (lupus vulgaris or scrofuloderma) presents with **nodular, plaque-like lesions** or cold abscesses, often with ulceration and scarring. - It is not typically associated with **photosensitivity** or a malar rash, and fever, if present, is usually due to systemic Mycobacterium infection.

Q: Which of the following statements about conjunctival lesions is NOT true?

Surgery is treatment of choice. ***Surgery is treatment of choice*** - While surgery can be used to treat conjunctival lesions, it is not always the **treatment of choice**, especially for smaller, asymptomatic lesions like **pinguecula** which may only require observation and lubrication. - Many conjunctival lesions, such as uncomplicated **pterygium** or **pinguecula**, are managed conservatively unless they cause significant symptoms, vision impairment, or cosmetic concerns. *Arise from any part of conjunctiva* - **Conjunctival lesions** can indeed arise from various parts of the conjunctiva, including the palpebral, bulbar, and forniceal conjunctiva. - For example, **pterygium** typically arises from the bulbar conjunctiva, while **pinguecula** also originates in the bulbar conjunctiva, specifically in the interpalpebral fissure. *Can cause Astigmatism* - Larger **conjunctival lesions**, particularly a **pterygium** that encroaches onto the cornea, can induce or alter astigmatism. - The growth of the lesion can change the **curvature of the cornea**, leading to optical distortion and astigmatism. *UV exposure is risk factor* - **Ultraviolet (UV) light exposure** is a well-established risk factor for the development of many conjunctival lesions, including **pterygium** and **pinguecula**. - Chronic UV exposure leads to **elastotic degeneration** of the conjunctival collagen and is thought to play a key role in the pathogenesis of these growths.

Q: Most characteristic cardiovascular defect seen in Rubella-

Patent ductus arteriosus. ***Patent ductus arteriosus*** - **Patent ductus arteriosus (PDA)** is the most characteristic cardiovascular defect associated with congenital rubella syndrome [1]. - The rubella virus can interfere with the normal closure of the **ductus arteriosus** during fetal development [1]. *Coarctation of the aorta* - **Coarctation of the aorta** is a narrowing of the aorta and is not typically linked to congenital rubella syndrome [1]. - It is often associated with syndromes like **Turner syndrome** or bicuspid aortic valve, which are not mentioned here [1]. *Ventricular septal defect* - **Ventricular septal defects (VSDs)** are common congenital heart defects, but they are not specifically characteristic of congenital rubella [1]. - VSDs are more frequently associated with conditions like **Down syndrome** or can occur in isolation [1]. *Pulmonary artery stenosis* - While **pulmonary artery stenosis** can occur as a congenital heart defect, it is less commonly the primary cardiovascular manifestation of congenital rubella syndrome. - **Peripheral pulmonary artery stenosis** can be seen in rubella, but PDA is the most characteristic overarching defect [1].

Q: What should be the correct treatment for a 14-year-old child with newly diagnosed Juvenile Rheumatoid Arthritis?

DMARDs with a short course of steroids. ***DMARDs with a short course of steroids*** - For **newly diagnosed rheumatoid arthritis** in children (juvenile idiopathic arthritis), the primary goal is to **control inflammation** and prevent joint damage with **disease-modifying antirheumatic drugs (DMARDs)**. - A **short course of corticosteroids** is often used as a **bridging therapy** to rapidly reduce inflammation while the DMARDs take effect. - This approach ensures **early aggressive treatment** to prevent joint damage while minimizing long-term steroid exposure. *Incorrect: Only NSAIDs* - **NSAIDs** alone provide **symptomatic relief** but do not alter the course of the disease or prevent joint damage in rheumatoid arthritis. - Relying solely on NSAIDs can lead to **progressive joint erosion** and functional impairment. *Incorrect: DMARDs after initial treatment with NSAIDs* - While NSAIDs can be used for initial symptom control, delaying **DMARD initiation** is generally not recommended as it allows for continued joint inflammation and potential damage. - Early and aggressive treatment with DMARDs is crucial for **optimizing long-term outcomes** and preserving joint function. *Incorrect: Monotherapy with TNF inhibitors* - **TNF inhibitors** are potent **biologic DMARDs** and are typically considered for patients who have **failed conventional DMARDs** (e.g., methotrexate). - They are not usually the **first-line monotherapy** for treatment-naive rheumatoid arthritis due to their cost, potential side effects, and the availability of other effective options. *Incorrect: Long-term high-dose corticosteroid therapy* - **Prolonged corticosteroid use** at high doses is associated with significant side effects including growth suppression, osteoporosis, increased infection risk, and cushingoid features. - While steroids are useful as **bridging therapy** for a short duration, long-term high-dose use is avoided in pediatric patients whenever possible.

Q: A blood grouping test shows clumping with Anti-A serum, clumping with Anti-B serum, and no clumping in the control. What blood group does this indicate?

AB. ***AB*** - The results show **clumping with both Anti-A and Anti-B serum**, indicating the presence of both A and B antigens on the red blood cells. - The absence of clumping in the control confirms that the **agglutination with Anti-A and Anti-B is due to specific antigen-antibody reactions**, not nonspecific agglutination. - Blood group AB individuals have both A and B antigens on their RBCs and no anti-A or anti-B antibodies in their serum. *A* - Blood group A would show **clumping with Anti-A serum only** and no clumping with Anti-B serum. - This is incorrect because the sample shows clumping with both antisera. *B* - Blood group B would show **clumping with Anti-B serum only** and no clumping with Anti-A serum. - This is incorrect because the sample shows clumping with both antisera. *O* - Blood group O would show **no clumping with either Anti-A or Anti-B serum**, as it lacks both A and B antigens. - This is incorrect because the sample clearly shows clumping with both Anti-A and Anti-B sera.

Q: A female patient presented with recurrent urinary tract infections. What is the most probable diagnosis based on the imaging findings?

Ureterocele. ***Ureterocele*** - The imaging shows a rounded, radiolucent filling defect within the **contrast-filled bladder**, which is characteristic of a **ureterocele**. This is often associated with recurrent UTIs due to obstruction and stasis. - A ureterocele is a **congenital dilation** of the terminal part of the ureter as it enters the bladder, causing a cystic protrusion into the bladder lumen. *Congenital megaureter* - A congenital megaureter would appear as a **diffusely dilated ureter** throughout its course, often extending from the renal pelvis, rather than a localized cystic structure within the bladder. - While it can cause recurrent UTIs, the specific bladder filling defect seen here is not typical for an isolated megaureter. *Urinary stones* - Urinary stones would typically appear as **radiopaque foci** of varying size, depending on their composition, within the collecting system or bladder. - They do not typically present as a smooth, rounded filling defect within a contrast-filled bladder. *Ureteral duplication* - Ureteral duplication involves two separate ureters draining a single kidney, which often have their own separate openings into the bladder or meet before entering. - While it can be associated with UTIs (especially with reflux or ectopia), the primary finding on imaging would be the presence of **two distinct ureters**, not an intravesical cystic structure.

Question 1

The marked area in the image is supplied by which dermatome?

Accepted Answer

T10

Answer

T8

Answer

T9

Answer

T11

Question 2

Which of the following is the most common method used to know depth of anaesthesia?

Accepted Answer

BIS

Answer

Oesophageal contractility

Answer

Depressed responses

Answer

Hypotension

Question 3

What condition is likely to be present in the child shown in the image, whose mother has asthma?

Accepted Answer

Atopic dermatitis

Answer

SLE

Answer

Erythema

Answer

TEN

Question 4

Patient presents with pruritus of the interdigital spaces of the left hand as shown in the image. Identify the condition.

Accepted Answer

Sarcoptes scabiei

Answer

Dermatitis herpetiformis

Answer

Xerotic dermatitis

Answer

Erythema multiforme

Question 5

A child with history of fever, photosensitivity, rash sparing nasolabial fold presents to OP. Identify the condition?

Accepted Answer

SLE

Answer

Polymorphous light eruption

Answer

Discoid lupus

Answer

Skin tuberculosis

Question 6

Which of the following statements about conjunctival lesions is NOT true?

Accepted Answer

Surgery is treatment of choice

Answer

Arise from any part of conjunctiva

Answer

Can cause Astigmatism

Answer

UV exposure is risk factor

Question 7

Most characteristic cardiovascular defect seen in Rubella-

Accepted Answer

Patent ductus arteriosus

Answer

Coarctation of the aorta

Answer

Ventricular septal defect

Answer

Pulmonary artery stenosis

Question 8

What should be the correct treatment for a 14-year-old child with newly diagnosed Juvenile Rheumatoid Arthritis?

Accepted Answer

DMARDs with a short course of steroids

Answer

Only NSAIDs

Answer

DMARDs after initial treatment with NSAIDs

Answer

Monotherapy with TNF inhibitors

Answer

Long-term high-dose corticosteroid therapy

Question 9

A blood grouping test shows clumping with Anti-A serum, clumping with Anti-B serum, and no clumping in the control. What blood group does this indicate?

Accepted Answer

AB

Answer

A

Answer

B

Answer

O

Question 10

A female patient presented with recurrent urinary tract infections. What is the most probable diagnosis based on the imaging findings?

Accepted Answer

Ureterocele

Answer

Congenital megaureter

Answer

Urinary stones

Answer

Ureteral duplication

NEET-PG 2019

Anatomy

Anesthesiology

Dermatology

Internal Medicine

Ophthalmology

Pediatrics

Physiology

Radiology