Biochemistry
1 questionsAmino acid required for conversion of norepinephrine to epinephrine:-
NEET-PG 2019 - Biochemistry NEET-PG Practice Questions and MCQs
Question 191: Amino acid required for conversion of norepinephrine to epinephrine:-
- A. Lysine
- B. Tryptophan
- C. Methionine (Correct Answer)
- D. Phenylalanine
Explanation: ***Methionine*** - **Norepinephrine** is converted to **epinephrine** by the enzyme **phenylethanolamine N-methyltransferase (PNMT)**. - This enzyme uses **S-adenosylmethionine (SAM)** as a **methyl donor**, which is derived from methionine. *Lysine* - **Lysine** is an essential amino acid primarily involved in **protein synthesis**, **calcium absorption**, and the production of **carnitine**. - It does not directly participate in the methylation reaction converting norepinephrine to epinephrine. *Tryptophan* - **Tryptophan** is a precursor for **serotonin** and **niacin** synthesis. - It is not involved in the catecholamine synthesis pathway from norepinephrine to epinephrine. *Phenylalanine* - **Phenylalanine** is the initial amino acid in the **catecholamine synthesis pathway**, being converted to **tyrosine**, then to DOPA, dopamine, and norepinephrine. - While it's crucial for the synthesis *up to* norepinephrine, it is not directly involved in the *conversion of norepinephrine to epinephrine*.
Community Medicine
1 questionsContact isolation is done for:
NEET-PG 2019 - Community Medicine NEET-PG Practice Questions and MCQs
Question 191: Contact isolation is done for:
- A. Mumps
- B. MRSA (Correct Answer)
- C. Diphtheria
- D. Typhoid
Explanation: ***MRSA*** - **Methicillin-resistant *Staphylococcus aureus* (MRSA)** is transmitted primarily through direct contact with infected patients or contaminated environmental surfaces, necessitating **contact isolation** measures. - These measures include the use of **gloves and gowns** upon entering the patient's room to prevent spread. *Mumps* - Mumps is a viral infection primarily transmitted via **respiratory droplets**, requiring **droplet isolation** rather than contact isolation. - The virus spreads through coughing and sneezing, necessitating measures like wearing a surgical mask. *Diphtheria* - Diphtheria, caused by *Corynebacterium diphtheriae*, is spread through **respiratory droplets** from close contact with an infected person, requiring **droplet isolation**. - This typically involves wearing a mask and sometimes eye protection. *Typhoid* - Typhoid fever is a **fecal-oral disease** caused by *Salmonella Typhi*, transmitted through contaminated food and water. - While proper hand hygiene is crucial, it generally does not require specific isolation precautions beyond **standard precautions** in a hospital setting for most patients.
Dermatology
1 questionsA 26-year-old female patient presented with oral ulcers, sensitivity to light and rash over the malar area of the face sparing the nasolabial folds of both sides. Which of the following is most characteristic of this condition?
NEET-PG 2019 - Dermatology NEET-PG Practice Questions and MCQs
Question 191: A 26-year-old female patient presented with oral ulcers, sensitivity to light and rash over the malar area of the face sparing the nasolabial folds of both sides. Which of the following is most characteristic of this condition?
- A. Butterfly rash sparing the nasolabial folds (Correct Answer)
- B. Heliotrope rash on upper eyelid, bilateral hilar lymphadenopathy
- C. Port-wine stain with CNS malformations
- D. Silvery scales or plaques
Explanation: ***Butterfly rash sparing the nasolabial folds*** - The patient's presentation with oral ulcers, sensitivity to light (photosensitivity), and a rash over the malar area **sparing the nasolabial folds** is highly characteristic of **Systemic Lupus Erythematosus (SLE)**, a condition where a butterfly rash is a hallmark. - This specific distribution of the malar rash is a key diagnostic feature differentiating it from other facial rashes. *Heliotrope rash on upper eyelid, bilateral hilar lymphadenopathy* - A **heliotrope rash** on the upper eyelids is characteristic of **dermatomyositis**, which also presents with muscle weakness, not typically oral ulcers or a malar rash. - **Bilateral hilar lymphadenopathy** is a classic finding in **sarcoidosis**, a granulomatous disease, not directly related to the patient's symptoms. *Port-wine stain, CNS malformations: seen in Sturge-Weber syndrome* - A **port-wine stain** (nevus flammeus) is a congenital capillary malformation, often on the face, and is a principal feature of **Sturge-Weber syndrome**, which involves CNS malformations and seizures. - This condition has no association with oral ulcers, photosensitivity, or the described malar rash. *Silvery scales or plaques: seen in psoriasis* - **Silvery scales or plaques** are the characteristic dermatological lesions of **psoriasis**, a chronic inflammatory skin condition. - Psoriasis typically presents with well-demarcated erythematous plaques and is not associated with oral ulcers, photosensitivity, or a lupus-specific malar rash.
Internal Medicine
2 questionsWhich of the following is not an AIDS defining illness?
Which of the following is the best treatment for refractory ITP?
NEET-PG 2019 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 191: Which of the following is not an AIDS defining illness?
- A. Cervical cancer
- B. Hodgkin's lymphoma (Correct Answer)
- C. Primary CNS lymphoma
- D. Kaposi sarcoma
Explanation: ***Hodgkin's lymphoma*** - While patients with HIV are at an increased risk of developing **Hodgkin's lymphoma**, it is not officially classified as an **AIDS-defining illness** by the CDC [3]. - AIDS-defining conditions primarily include certain opportunistic infections and specific malignancies [4]. *Cervical cancer* - **Invasive cervical cancer** is an AIDS-defining illness in HIV-positive women, indicating severe immunosuppression [4]. - This is because HIV infection can accelerate or worsen the progression of **HPV-related cervical dysplasia** to invasive cancer [4]. *Primary CNS lymphoma* - **Primary CNS lymphoma** (brain lymphoma) is an AIDS-defining illness, particularly when associated with **Epstein-Barr virus** [2]. - Its presence indicates a significant degree of **immunodeficiency** in HIV-infected individuals. *Kaposi sarcoma* - **Kaposi sarcoma** is a well-known and common AIDS-defining malignancy, caused by **Human Herpesvirus 8 (HHV-8)** [1]. - It presents as vascular lesions on the skin, mucous membranes, internal organs, and lymph nodes [1].
Question 192: Which of the following is the best treatment for refractory ITP?
- A. Platelet transfusion
- B. Azathioprine
- C. Prednisolone
- D. Splenectomy (Correct Answer)
Explanation: ***Splenectomy*** - **Splenectomy** is considered the most effective treatment for **refractory immune thrombocytopenic purpura (ITP)**, especially in patients who have failed multiple lines of medical therapy [1]. - The spleen is the primary site of **platelet destruction** and **antibody production** against platelets in ITP, so its removal can lead to a sustained increase in platelet count [1]. *Platelet transfusion* - While platelet transfusions can temporarily increase platelet counts, they are generally reserved for **acute, life-threatening bleeding** in ITP, not as a definitive treatment for refractory cases. - Transfused platelets are rapidly destroyed by the same **autoantibodies** that target endogenous platelets, making their effect short-lived. *Azathioprine* - **Azathioprine** is an **immunosuppressant** that can be used in ITP, but it is typically a **second-line** or **third-line agent** and its response takes time [1]. - It is not considered the "best" treatment for refractory ITP compared to splenectomy, which offers a more immediate and often sustained response [1]. *Prednisolone* - **Prednisolone** (corticosteroids) is often the **first-line treatment** for ITP due to its rapid immunosuppressive effects. - However, for **refractory ITP** (meaning it has not responded adequately to initial treatments), corticosteroids alone are usually insufficient to achieve long-term remission [1].
Orthopaedics
1 questions12 years male came with swelling of lower end tibia which is surrounded by rim of reactive bone. What is most likely diagnosis?
NEET-PG 2019 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 191: 12 years male came with swelling of lower end tibia which is surrounded by rim of reactive bone. What is most likely diagnosis?
- A. GCT
- B. Hyper PTH
- C. Brodie's Abscess (Correct Answer)
- D. Osteomyelitis
Explanation: ***Brodie's Abscess*** - A **Brodie's abscess** is a subacute or chronic osteomyelitis characterized by a localized bone abscess, typically with a surrounding **sclerotic rim of reactive bone**. - It often occurs in the **metaphysis of long bones** (like the lower end of the tibia) in children and adolescents, presenting with localized pain and swelling. *GCT* - **Giant cell tumor (GCT)** typically occurs in **skeletally mature adults** (20-40 years old) and is a lytic lesion often found in the **epiphysis** of long bones, rarely with a distinct sclerotic rim. - GCTs are generally more aggressive and demonstrate a **soap-bubble appearance** with cortical expansion rather than a thick reactive bone rim. *Hyper PTH* - **Hyperparathyroidism** causes bone changes such as **osteopenia**, **subperiosteal bone resorption**, especially in the phalanges, and **brown tumors** (lytic lesions). - It does not typically present as a localized lesion with a **sclerotic rim of reactive bone** in a child. *Osteomyelitis* - While chronic osteomyelitis can involve local bone destruction and reactive bone formation, a **Brodie's abscess** is a specific, well-circumscribed form of **subacute osteomyelitis**. - Acute osteomyelitis presents with more diffuse systemic symptoms (fever, malaise) and less defined reactive bone in its early stages compared to the distinct **sclerotic rim** seen in a Brodie's abscess.
Pharmacology
1 questionsWhich of the following drugs is used for smoking cessation?
NEET-PG 2019 - Pharmacology NEET-PG Practice Questions and MCQs
Question 191: Which of the following drugs is used for smoking cessation?
- A. Gabapentin
- B. Acamprosate
- C. Nalmefene
- D. Varenicline (Correct Answer)
Explanation: ***Varenicline*** - **Varenicline** is a **partial agonist** at the **α4β2 nicotinic acetylcholine receptor**, reducing cravings and withdrawal symptoms while decreasing the rewarding effects of nicotine [2]. - It is a first-line pharmacotherapy for **smoking cessation**, often initiated a week before the target quit date. *Gabapentin* - **Gabapentin** is primarily an **anticonvulsant** and is also used to treat **neuropathic pain**. - It is not indicated for **smoking cessation** and acts by modulating **GABAergic neurotransmission**, unrelated to nicotine dependence. *Acamprosate* - **Acamprosate** is used to maintain **abstinence from alcohol** in patients with alcohol dependence. - Its mechanism involves restoring the balance between **excitation and inhibition** in the brain, which is not directly applicable to nicotine dependence. *Nalmefene* - **Nalmefene** is an **opioid system modulator** used for reducing **alcohol consumption** in adults with alcohol dependence [1]. - It acts as an **opioid receptor antagonist**, a mechanism distinct from the neurotransmitter systems involved in nicotine addiction [1].
Psychiatry
2 questionsWhich of the following conditions is characterized by intense depression and misery?
What is the typical IQ range for males affected with Fragile X syndrome?
NEET-PG 2019 - Psychiatry NEET-PG Practice Questions and MCQs
Question 191: Which of the following conditions is characterized by intense depression and misery?
- A. Schizophrenia
- B. Major depressive disorder (Correct Answer)
- C. Mania
- D. Melancholia
Explanation: ***Major depressive disorder*** - This condition is primarily defined by a period of at least two weeks of **depressed mood** or **loss of interest or pleasure** (anhedonia). - Patients often experience profound **feelings of sadness, hopelessness, and misery**, along with other symptoms like changes in sleep, appetite, energy, and concentration. - **MDD is the primary diagnostic category** for conditions characterized by intense depression and misery. *Schizophrenia* - Schizophrenia is characterized by **psychotic symptoms** such as hallucinations, delusions, disorganized thought, and negative symptoms. - While people with schizophrenia might experience periods of low mood, the primary defining features are not intense depression and misery, but rather a **break from reality**. *Mania* - Mania is characterized by an **elevated or irritable mood**, increased energy, and hyperactivity, which are the opposite of depression. - Symptoms include **racing thoughts, decreased need for sleep, grandiosity, and impulsive behavior**, not intense depression. *Melancholia* - Melancholia is a **specifier for major depressive disorder**, not a standalone condition in DSM-5/ICD-11. - While melancholia describes a **particularly severe form** of depression with profound despondency, it is a **subtype or qualifier** applied to MDD, not a separate diagnostic entity. - **The question asks for a "condition"** - MDD is the primary condition, while melancholic features describe characteristics within that condition.
Question 192: What is the typical IQ range for males affected with Fragile X syndrome?
- A. IQ range of 20-40
- B. IQ range of 60-80 (Correct Answer)
- C. IQ range of 80-100
- D. Normal IQ range (90-110)
- E. IQ range of 50-70
Explanation: **IQ range of 60-80** - Males affected with **Fragile X syndrome** typically experience **moderate intellectual disability**, corresponding to an IQ range of 60-80. - This range indicates significant cognitive impairment, yet usually allows for some level of independent living and vocational skills with support. *IQ range of 20-40* - An IQ range of 20-40 represents **severe intellectual disability**, which is less common for the typical presentation of Fragile X syndrome in males. - While some individuals with Fragile X may fall into this range, it is not considered the most typical or average outcome. *IQ range of 50-70* - An IQ range of 50-70 represents **mild to moderate intellectual disability**, which overlaps with but is generally slightly lower than the most typical presentation. - While many males with Fragile X syndrome may score in this range, the typical range cited in literature extends slightly higher to 60-80. *IQ range of 80-100* - An IQ range of 80-100 is considered **borderline to low-average intelligence**, which is generally higher than the typical impact of Fragile X syndrome on male cognitive function. - This range is not indicative of the moderate intellectual disability characteristic of the syndrome. *Normal IQ range (90-110)* - A **normal IQ range (90-110)** is inconsistent with the diagnosis of Fragile X syndrome, which is a leading cause of inherited intellectual disability. - While females with Fragile X may have a wider range of IQs, including normal intelligence, males are typically more severely affected.
Surgery
1 questionsWhich of the following best describes a degloving injury?
NEET-PG 2019 - Surgery NEET-PG Practice Questions and MCQs
Question 191: Which of the following best describes a degloving injury?
- A. Separation of only the skin layer
- B. Separation of skin and subcutaneous tissue without fascia involvement
- C. Exposure of tendons without skin and fascia separation
- D. Separation of skin, subcutaneous tissue, and fascia with tendon exposure (Correct Answer)
Explanation: ***Separation of skin, subcutaneous tissue, and fascia with tendon exposure*** - A **degloving injury** is characterized by the avulsion of skin, subcutaneous tissue, and fascia from the underlying muscle and connective tissue due to **shearing forces**. - This extensive separation often exposes deeper structures like **tendons**, bones, or neurovascular bundles in severe cases, though tendon exposure is not universally present in all degloving injuries. - The key feature is the **separation of multiple tissue layers** including fascia, which distinguishes it from superficial injuries. - Can be **open** (complete skin avulsion) or **closed** (Morel-Lavallée lesion with intact skin but underlying separation). *Separation of only the skin layer* - This description is incomplete as a degloving injury involves deeper layers beyond just the epidermal and dermal skin layers. - Simple skin separation or abrasion does not involve the extensive avulsion of **subcutaneous tissue and fascia** seen in degloving. *Separation of skin and subcutaneous tissue without fascia involvement* - While degloving involves skin and subcutaneous tissue separation, the crucial element of **fascia involvement** is missing from this description. - The tearing and separation at the **fascial plane** is key to the classification of a true degloving injury, distinguishing it from less severe avulsion injuries. *Exposure of tendons without skin and fascia separation* - Tendon exposure without concomitant skin and fascia separation would typically describe an **open wound** or deep laceration, not a degloving injury. - A degloving injury's hallmark is the **shearing force** that detaches extensive layers of soft tissue from their underlying attachments, not isolated tendon exposure.