NEET-PG 2019 Practice Questions

Q: Which nerve supplies the area marked as ‘Area B’ in the image?

Radial nerve. ***Radial nerve*** - Area B represents the sensory distribution of the **radial nerve**, specifically its superficial branch. - The radial nerve provides sensory innervation to the **dorsal (back) aspect of the hand** over the radial (lateral) side, including the thumb, index, middle, and radial half of the ring finger up to the proximal interphalangeal joints. - The superficial branch of the radial nerve also innervates the **anatomical snuffbox** and the radial side of the dorsum of the hand. - **Note:** The radial nerve does NOT supply the palmar surface of the hand; its sensory distribution is limited to the dorsal aspect. *Ulnar nerve* - The ulnar nerve provides sensory innervation to the **medial 1.5 fingers** (little finger and ulnar half of ring finger) on both palmar and dorsal aspects. - It also supplies the **hypothenar eminence** and medial portion of the palm and dorsal hand. - This distribution corresponds to **Area C** in the image, not Area B. *Median nerve* - The median nerve provides sensory innervation to the **lateral 3.5 fingers** (thumb, index, middle, and radial half of ring finger) on the **palmar surface**. - It also supplies the **palmar aspect** of these digits and the **nail beds (dorsal tips)** of the same fingers. - This distribution corresponds to **Area A** in the image, not Area B. *Posterior interosseous nerve* - The **posterior interosseous nerve (PIN)** is a **motor branch** of the radial nerve with no cutaneous sensory distribution. - It supplies the extensor muscles of the posterior forearm compartment. - It does not provide sensory innervation to the skin of the hand.

Q: All of the following are examples of Dietary fibre except for which of the following?

Starch. ***Correct: Starch*** - **Starch** is a **polysaccharide** that serves as a **storage carbohydrate** in plants and is readily digestible by human enzymes, breaking down into glucose. - While it's a carbohydrate found in plant foods, it does not fit the definition of dietary fibre which is generally resistant to human digestive enzymes. *Incorrect: Pectin* - **Pectin** is a type of **soluble dietary fibre** found in fruits, particularly apples and citrus. - It forms a gel in water, contributing to satiety and helping to **lower cholesterol** and **regulate blood sugar**. *Incorrect: Lignin* - **Lignin** is a **non-carbohydrate dietary fibre** that provides structural support in plants. - It is an **insoluble fibre** and is resistant to breakdown by digestive enzymes, aiding in bulk formation in stool. *Incorrect: Cellulose* - **Cellulose** is a major component of **plant cell walls** and is a type of **insoluble dietary fibre**. - It adds bulk to stool, promoting regularity and preventing constipation.

Q: Which of the following is not an epidemiological indicator?

None of the options. ***None of the options*** - All listed options—**ABER (Annual Blood Examination Rate)**, **Annual parasite index**, and **Annual falciparum incidence**—are indeed widely recognized and utilized **epidemiological indicators**, particularly in the context of malaria surveillance and control. - As such, there is no option presented that is *not* an epidemiological indicator. *ABER* - **ABER (Annual Blood Examination Rate)** is an epidemiological indicator used to assess the annual number of blood smears examined per 1000 population. - It helps to measure the **intensity of surveillance** and case detection efforts in a given area for diseases like malaria. *Annual parasite index* - The **Annual Parasite Index (API)** is an epidemiological indicator that measures the number of confirmed malaria cases per 1000 population per year. - It is crucial for assessing **malaria endemicity** and the burden of the disease in a specific region. *Annual falciparum incidence* - **Annual falciparum incidence** is an epidemiological indicator specifically tracking the number of *Plasmodium falciparum* malaria cases per 1000 population per year. - This indicator is essential for monitoring the **severity and transmission of the most dangerous form of malaria**.

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.

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

Single positive culture of Coxiella burnetii. ***Single positive culture of Coxiella burnetii*** - A single positive blood culture for **Coxiella burnetii** or **anti-phase I IgG antibody titer > 1:800** is considered a major criterion for infective endocarditis due to its highly pathogenic nature in this context [1], [2]. - This organism is a known cause of **culture-negative endocarditis**, and specific serology or molecular tests are often required for diagnosis [1]. *Single positive culture of Corynebacterium species* - **Corynebacterium species** are often considered **contaminants** in blood cultures, especially *Corynebacterium jeikeium*, and typically require multiple positive cultures, often from different sites, to be considered significant pathogens for infective endocarditis [2]. - A single positive culture of these organisms alone is generally insufficient to meet major diagnostic criteria for endocarditis [2]. *Both HACEK and Coxiella cultures* - While both **HACEK organisms** and **Coxiella burnetii** can cause endocarditis, the combination of both is not a specific major criterion in itself. - The diagnostic criteria address each organism individually [2]. *Single positive culture of HACEK group* - **HACEK organisms** (**H**aemophilus, **A**ggregatibacter, **C**ardiobacterium, **E**ikenella, **K**ingella) are well-known causes of endocarditis, but usually require **two separate positive blood cultures** for infective endocarditis major criteria [2]. - A single positive culture of a HACEK organism is typically classified as a minor criterion unless other supporting evidence is present.

Q: A 6-year-old boy presents with fever and chills, cough, rapid breathing, difficulty breathing, and chest pain. A culture from a respiratory sample shows Gram-positive bacteria. What is the most likely organism causing this infection?

Streptococcus pneumoniae. ***Streptococcus pneumoniae*** - This clinical picture describes typical symptoms of **pneumonia** in a child, including fever, cough, rapid and difficult breathing, and chest pain. - **_Streptococcus pneumoniae_** is the most common bacterial cause of community-acquired pneumonia in children. The respiratory sample showing gram-positive bacteria further supports this. *Staphylococcus aureus* - While **_Staphylococcus aureus_** can cause pneumonia, it is less common than _Streptococcus pneumoniae_ in community-acquired cases in healthy children and often associated with more severe, necrotizing forms or post-viral infections. - While it is a **Gram-positive bacterium**, its clinical presentation would not be the most likely first choice for typical pneumonia symptoms in this age group. *Propionibacterium acnes* - **_Propionibacterium acnes_** (now *Cutibacterium acnes*) is primarily associated with **acne vulgaris** and, less commonly, opportunistic infections related to implanted devices or some rare soft tissue infections. - It is not a typical cause of primary respiratory infections like pneumonia. *Streptococcus pyogenes* - **_Streptococcus pyogenes_** (Group A Streptococcus) is known for causing **pharyngitis** (strep throat), skin infections (impetigo, cellulitis), and scarlet fever. - While it can rarely cause pneumonia, it is not a common cause, and the constellation of symptoms points more strongly to _Streptococcus pneumoniae_.

Q: What is the causative organism for the condition depicted in the image?

Staphylococci. ***Staphylococci*** - The image shows **impetigo** with **crusted lesions**, consistent with **_Staphylococcus aureus_** infection. - **Staphylococcus aureus** is a major causative organism of impetigo, particularly **bullous impetigo**, and commonly produces the characteristic **honey-colored crusts** seen in non-bullous forms as well. - This superficial bacterial skin infection is highly contagious and responds well to topical or systemic antibiotics. *Candidal infection* - **Candidal infections** (e.g., candidiasis) typically present as **erythematous patches** with satellite lesions, or white plaques in mucosal areas, which is not consistent with the image. - This fungal infection is often seen in immunocompromised individuals or in warm, moist skin folds, not as crusted superficial lesions. *Streptococcus* - While **_Streptococcus pyogenes_** can also cause impetigo (especially non-bullous impetigo), the clinical presentation in the image is most consistent with **staphylococcal infection**. - Streptococcal infections may present similarly but can also cause other conditions like cellulitis or erysipelas with distinct features. *Actinomycetes* - **Actinomycosis** is a rare, chronic bacterial infection that forms **abscesses and sinus tracts**, often with "sulfur granules," which is distinct from the superficial skin lesions shown. - This infection usually involves deeper tissues and presents as a chronic, indolent infection, unlike the acute superficial presentation of impetigo.

Q: Which of the following treatments is used for vulvar atrophy and itching?

Estrogen ointment. ***Estrogen ointment*** * **Estrogen ointment** is the primary treatment for vulvar atrophy and itching because it directly addresses the underlying cause of these symptoms, which is the decline in estrogen levels after **menopause**. * By restoring estrogen to the vulvar tissues, it helps to **thicken the epithelium**, improve blood flow, and increase lubrication, thereby alleviating dryness, itching, and discomfort. *Antihistamines* * **Antihistamines** are used to treat allergic reactions and reduce itching associated with conditions like hives or insect bites, but they do not address the hormonal deficiency causing vulvar atrophy. * While they might temporarily relieve some itching, they do not treat the underlying **tissue thinning** and dryness characteristic of vulvar atrophy. *Tamoxifen* * **Tamoxifen** is a selective estrogen receptor modulator (SERM) primarily used in the treatment and prevention of breast cancer, as it blocks estrogen's effects in breast tissue. * However, in vulvovaginal tissues, **tamoxifen can actually worsen atrophy and dryness** due to its anti-estrogenic effects, making it an inappropriate treatment for vulvar atrophy. *None of the options* * This option is incorrect because **estrogen ointment** is a well-established and effective treatment specifically designed to address vulvar atrophy and associated itching, by restoring estrogen levels to the affected tissues.

Q: Which part of scaphoid fracture is most susceptible to avascular necrosis?

Proximal 1/3rd. ***Proximal 1/3rd*** - The **scaphoid bone** has a **retrograde blood supply**, meaning blood vessels enter distally and flow towards the proximal pole. - A fracture in the **proximal 1/3rd** can disrupt the blood supply to the **proximal fragment**, making it highly susceptible to **avascular necrosis**. *Distal 1/3rd* - Fractures in the **distal 1/3rd** of the scaphoid generally have a robust blood supply due to the entry of vessels from the distal pole. - While still requiring proper management, the risk of **avascular necrosis** is significantly lower compared to proximal fractures. *Middle 1/3rd* - Fractures in the **middle 1/3rd** (waist) of the scaphoid are common and can still compromise blood flow to the proximal segment, but the risk of **avascular necrosis** is intermediate. - The more proximal the fracture within the middle third, the higher the risk of **avascular necrosis**. *Scaphoid Tubercle* - The **scaphoid tubercle** is a distal projection of the scaphoid bone. - Fractures of the **scaphoid tubercle** are extra-articular and typically have an excellent blood supply; thus, they are at very low risk for **avascular necrosis**.

Q: The Confusion Assessment Method (CAM) is used for which of the following?

Delirium. ***Delirium*** - The Confusion Assessment Method (CAM) is a widely used and highly sensitive and specific tool for the rapid identification of **delirium**. - It assesses for acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. *Schizophrenia* - Schizophrenia is a chronic mental health disorder primarily characterized by **psychosis**, including hallucinations, delusions, and disorganized thought. - While patients with schizophrenia can experience cognitive difficulties, specialized scales like the Positive and Negative Syndrome Scale (PANSS) are used, not the CAM. *Dementia* - Dementia is a gradual and progressive decline in cognitive function, including memory, thinking, and reasoning, severe enough to interfere with daily life. - Tools like the mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA) are used for screening and assessing dementia, not the CAM. *Depression* - Depression is a mood disorder characterized by persistent sadness, loss of interest, and other emotional and physical symptoms. - Assessment tools like the Hamilton Depression Rating Scale (HDRS) or Patient Health Questionnaire-9 (PHQ-9) are used for depression.

Question 1

Which nerve supplies the area marked as ‘Area B’ in the image?

Accepted Answer

Radial nerve

Answer

Ulnar nerve

Answer

Median nerve

Answer

Posterior interosseous nerve

Question 2

All of the following are examples of Dietary fibre except for which of the following?

Accepted Answer

Starch

Answer

Pectin

Answer

Lignin

Answer

Cellulose

Question 3

Which of the following is not an epidemiological indicator?

Accepted Answer

None of the options

Answer

ABER

Answer

Annual falciparum incidence

Answer

Annual parasite index

Question 4

Which type of cardiomyopathy is associated with alcohol abuse?

Accepted Answer

Dilated cardiomyopathy

Answer

Hypertrophic cardiomyopathy

Answer

Pericarditis

Answer

Myocarditis

Question 5

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 6

A 6-year-old boy presents with fever and chills, cough, rapid breathing, difficulty breathing, and chest pain. A culture from a respiratory sample shows Gram-positive bacteria. What is the most likely organism causing this infection?

Accepted Answer

Streptococcus pneumoniae

Answer

Streptococcus pyogenes

Answer

Staphylococcus aureus

Answer

Propionibacterium acnes

Question 7

What is the causative organism for the condition depicted in the image?

Accepted Answer

Staphylococci

Answer

Candidal infection

Answer

Streptococcus

Answer

Actinomycetes

Question 8

Which of the following treatments is used for vulvar atrophy and itching?

Accepted Answer

Estrogen ointment

Answer

Antihistamines

Answer

Tamoxifen

Answer

None of the options

Question 9

Which part of scaphoid fracture is most susceptible to avascular necrosis?

Accepted Answer

Proximal 1/3rd

Answer

Distal 1/3rd

Answer

Middle 1/3rd

Answer

Scaphoid Tubercle

Question 10

The Confusion Assessment Method (CAM) is used for which of the following?

Accepted Answer

Delirium

Answer

Schizophrenia

Answer

Dementia

Answer

Depression

NEET-PG 2019

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Microbiology

Obstetrics and Gynecology

Orthopaedics

Psychiatry