NEET-PG 2020 Practice Questions

Q: Which absorbs least water?

Cellulose. ***Cellulose*** - **Cellulose** is a **polysaccharide** with strong **intermolecular hydrogen bonding** between its linear chains. - These strong bonds form a highly ordered, crystalline structure that makes it **insoluble in water** and resistant to water absorption. *Mucilage* - **Mucilage** consists of **polysaccharides** that have a high capacity to absorb water, forming a slimy, gelatinous mass. - This property is due to its highly branched structure and abundance of **hydroxyl groups**, which readily form hydrogen bonds with water. *Pectin* - **Pectin** is a complex **polysaccharide** found in plant cell walls, known for its ability to absorb significant amounts of water. - It forms **gels** with water, a property widely utilized in food production. *Gums* - **Gums** are a diverse group of **polysaccharides** that are highly soluble in water and have an excellent capacity for water absorption. - They tend to form **viscous solutions** or gels when mixed with water.

Q: In the court of law, the act of a witness giving false evidence after taking an oath is punishable under:

193 IPC. ***193 IPC*** - **Section 193 of the Indian Penal Code (IPC)** specifically deals with the punishment for giving **false evidence** in a judicial proceeding. - This section outlines that any person who intentionally gives false evidence in any stage of a judicial proceeding, or fabricates false evidence for the purpose of being used in any stage of a judicial proceeding, shall be punished. *192 IPC* - **Section 192 IPC** defines what constitutes **"fabricating false evidence."** - While fabricating false evidence is a prerequisite for some offenses related to false evidence, Section 192 itself defines the act, but does not prescribe the punishment for giving false evidence after taking an oath in court. *191 IPC* - **Section 191 IPC** defines what constitutes **"giving false evidence."** - It explains that consciously making a statement which is false, and which a person either knows or believes to be false, or does not believe to be true, while legally bound by oath or by any express provision of law to state the truth, is considered giving false evidence, but does not prescribe the punishment. *197 IPC* - **Section 197 IPC** deals with **issuing or signing a false certificate**, not the act of a witness giving false evidence under oath in court. - This section punishes someone who issues or signs any certificate required by law, knowing or believing it to be false, in any material point.

Q: What is the Child-Pugh class for a patient who has a serum bilirubin of 2.5 mg/dL, serum albumin of 3 g/dL, INR of 2, mild ascites, but no encephalopathy?

Child-Pugh Class B. ***Child-Pugh Class B*** - A serum bilirubin of **2.5 mg/dL** (2 points), serum albumin of **3 g/dL** (2 points), INR of **2** (2 points), and mild ascites (2 points), with no encephalopathy (1 point), sums up to a total of 9 points, which falls into the range for **Child-Pugh Class B** (7-9 points) [1]. - This class indicates **moderate hepatic dysfunction** and is characterized by a higher risk of complications and mortality compared to Class A. *Child-Pugh Class A* - This class is assigned for a total score of **5-6 points**, indicating **well-compensated hepatic disease**. - The patient's total score of 9 points exceeds the threshold for Class A, suggesting more significant liver impairment. *Child-Pugh Class D* - There is no Child-Pugh Class D; the classification system only includes classes A, B, and C. - This option is therefore incorrect based on the established Child-Pugh scoring system. *Child-Pugh Class C* - This class corresponds to a total score of **10-15 points**, indicative of **severe hepatic decompensation**. - The patient's calculated score of 9 points is below the minimum required for Child-Pugh Class C.

Q: Which of the following is associated with pauci-immune glomerulonephritis?

Granulomatosis with polyangiitis (GPA). ***Granulomatosis with polyangiitis (GPA)*** - **Pauci-immune glomerulonephritis** is characterized by the absence or scarcity of immune complex deposits in the glomeruli. - This is typical of **ANCA-associated vasculitides**, such as GPA (formerly Wegener's granulomatosis), which cause severe necrotising glomerulonephritis with few immune deposits [1]. *Anti-GBM glomerulonephritis* - This condition is characterized by **linear deposition of anti-GBM antibodies** along the glomerular basement membrane, making it an **immune complex-mediated disease**, not pauci-immune [1]. - It involves autoantibodies attacking the **collagen type IV** in the GBM. *SLE nephritis* - Systemic lupus erythematosus (SLE) nephritis is a classic example of **immune complex-mediated glomerulonephritis**, with abundant immune deposits containing immunoglobulins and complement [1]. - The pathology often shows **full-house immunofluorescence** with IgG, IgA, IgM, C3, and C1q. *IgA nephropathy* - This is characterized by prominent **mesangial deposition of IgA immune complexes**, which is clearly an immune complex-mediated process [1]. - While it can present with different histological patterns, the presence of **IgA deposition** means it is not pauci-immune [1].

Q: A 24-year-old woman who had a home delivery 2 weeks ago now presents with a complete perineal tear. What is the next line of management?

Repair after 3 months. ***Repair after 3 months*** - Delayed repair, typically after **3 to 6 months**, allows for resolution of **inflammation**, re-epithelialization of the wound edges, and softening of the scar tissue. - This timing optimizes conditions for successful surgical reconstruction by minimizing the risk of **infection** and promoting better tissue healing. *Repair after 3 weeks* - Repairing a complete perineal tear at this stage is too early as the tissue is still highly **inflamed** and prone to **infection** and **dehiscence**. - The wound bed would not have sufficiently healed or softened, making surgical repair more challenging and increasing the likelihood of poor outcomes. *Repair after 6 months* - Waiting for 6 months to repair a complete perineal tear is generally considered too long, as the tissues may become excessively **fibrotic** and less amenable to successful reconstruction. - While sometimes necessary in complex cases, waiting this long can lead to prolonged discomfort and functional issues for the patient. *Repair immediately* - Immediate repair of a complete perineal tear that was missed or inadequately repaired at the time of delivery is typically not recommended several weeks postpartum due to significant **edema**, **inflammation**, and potential for **infection**. - Immediate repair is usually performed **at the time of delivery** if the tear is recognized, not two weeks later.

Q: Microscopic examination of the reperfused myocardium is likely to have which of the following findings?

Contraction band necrosis. ***Contraction band necrosis*** - This lesion is characteristic of **reperfusion injury**, resulting from the reintroduction of **calcium** into ischemic cells, causing hypercontraction of sarcomeres [1]. - The bands represent irreversibly contracted sarcomeres and are a hallmark of cell death in the setting of restored blood flow [1]. *Neutrophilic infiltration* - While present in myocardial infarction, **neutrophilic infiltration** primarily begins hours after injury and is part of the inflammatory response to necrotic tissue, not a specific marker of reperfusion itself [2]. - It's a general feature of **acute inflammation** and necrosis but doesn't specifically distinguish reperfused myocardium from non-reperfused ischemic injury in the acute phase [2]. *Waviness of fibres* - **Waviness of fibers** is an early microscopic change in **ischemic myocardium**; it's due to the stretching of dead or dying muscle fibers adjacent to healthy, contracting fibers [2]. - This finding is typically seen within the first few hours of ischemia, before significant reperfusion injury is evident. *Cardiac myocyte swelling* - **Cardiac myocyte swelling** (cellular edema) is an early and non-specific sign of **ischemic injury** due to the failure of ion pumps, leading to intracellular accumulation of water [2]. - While present in ischemia, it's not a unique characteristic of reperfusion injury; reperfusion leads to more specific changes like contraction band necrosis [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 554-556. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, p. 552.

Q: A patient with pH of 7, pCO2 of 30 mmHg and Bicarbonate levels of 10 meq. What is the acid base abnormality?

Metabolic Acidosis. ***Metabolic Acidosis*** - The pH is 7, which is severely **acidotic** (normal range 7.35-7.45). This indicates an acid-base disorder where the body is too acidic. - The **bicarbonate level is 10 mEq/L** (normal range 22-26 mEq/L), which is significantly low, directly contributing to the acidosis and pointing towards a metabolic origin. *Respiratory alkalosis* - This condition involves an **elevated pH** (alkalosis) due to a primary decrease in pCO2. - In this case, the pH is acidic, not alkaline. *Metabolic alkalosis* - This condition involves an **elevated pH** (alkalosis) due to a primary increase in bicarbonate levels. - Here, the pH is acidic and bicarbonate is low, directly contradicting metabolic alkalosis. *Respiratory Acidosis* - This condition involves a **decreased pH** (acidosis) due to a primary increase in pCO2. - Although the pH is acidotic, the pCO2 is 30 mmHg (normal range 35-45 mmHg), which is low, indicating a respiratory compensation rather than the primary cause.

Q: On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:

30 days. ***30 days*** - As per the **Mental Healthcare Act, 2017**, under **Section 89 (Independent Admission)**, a person can be admitted independently for a **maximum period of 30 days**. - After 30 days, the person must either be discharged or the admission must be converted to voluntary or involuntary admission with appropriate procedures. - This provision allows for independent treatment-seeking without requiring a caregiver's involvement initially. *48 hours* - **48 hours** is not related to voluntary or independent admission duration. - This timeframe relates to the period within which a voluntary patient must be discharged after they request to leave (unless there are grounds for involuntary admission). *60 days* - **60 days** is not specified in the Mental Healthcare Act, 2017 for any category of admission. - This is neither the duration for voluntary, independent, nor involuntary admission procedures. *90 days* - **90 days** is not the correct maximum period for voluntary or independent admission. - While voluntary admission can continue indefinitely with ongoing consent, **independent admission** specifically has a **30-day limit** as per Section 89 of the Act.

Q: Magnan's symptom is seen in:

Cocaine. ***Cocaine*** - **Magnan's symptom**, also known as **formication**, is a tactile hallucination where an individual perceives insects crawling under their skin, commonly associated with chronic cocaine use. - This symptom is a manifestation of **cocaine-induced psychosis** or severe intoxication, leading to paranoid delusions and abnormal sensory experiences. *Datura* - **Datura** intoxication primarily causes anticholinergic effects, such as **dry mouth**, **dilated pupils**, confusion, and visual hallucinations, but not typically Magnan's symptom. - The hallucinations associated with Datura are often described as vivid and florid, but distinct from the tactile formication seen with cocaine. *Cannabis* - **Cannabis** use can induce altered perceptions, euphoria, anxiety, and sometimes paranoia, but it is not typically associated with tactile hallucinations like Magnan's symptom. - While high doses can lead to psychotic-like symptoms, **formication** is not a characteristic feature of cannabis intoxication. *Opium* - **Opium** and other opioids primarily cause central nervous system depression, leading to euphoria, sedation, pinpoint pupils, and respiratory depression. - Opioid use is not linked to tactile hallucinations such as **formication** or Magnan's symptom.

Q: Not a landmark of facial nerve identification in parotid surgery:

Inferior belly of omohyoid. ***Inferior belly of omohyoid*** - The **inferior belly of the omohyoid muscle** is located in the anterior triangle of the neck and is not a surgical landmark for the facial nerve during parotidectomy. - Its anatomical position is too far inferior and anterior to the parotid gland and facial nerve trunk to be useful for facial nerve identification. *Peripheral branches* - While careful dissection of **peripheral branches** is crucial for preserving facial nerve function, they are typically identified *after* locating the main trunk, not as primary landmarks for initially finding the nerve. - Direct identification of peripheral branches first is challenging and carries a higher risk of injury without prior identification of the main trunk or its primary divisions. *Post belly of digastric* - The **posterior belly of the digastric muscle** serves as a vital deep landmark for locating the facial nerve trunk. - The facial nerve typically passes superior to and deep to the posterior belly of the digastric muscle, providing a reliable point of reference for approaching the nerve. *Tragal pointer* - The **tragal pointer**, referring to the anterior surface of the cartilaginous tragus, is a superficial landmark used to approximate the location of the facial nerve trunk. - The facial nerve's main trunk typically emerges from the stylomastoid foramen, which is positioned anterior and inferior to the tragus, making it a useful starting point for surgical dissection.

Question 1

Which absorbs least water?

Accepted Answer

Cellulose

Answer

Mucilage

Answer

Pectin

Answer

Gums

Question 2

In the court of law, the act of a witness giving false evidence after taking an oath is punishable under:

Accepted Answer

193 IPC

Answer

191 IPC

Answer

192 IPC

Answer

197 IPC

Question 3

What is the Child-Pugh class for a patient who has a serum bilirubin of 2.5 mg/dL, serum albumin of 3 g/dL, INR of 2, mild ascites, but no encephalopathy?

Accepted Answer

Child-Pugh Class B

Answer

Child-Pugh Class A

Answer

Child-Pugh Class D

Answer

Child-Pugh Class C

Question 4

Which of the following is associated with pauci-immune glomerulonephritis?

Accepted Answer

Granulomatosis with polyangiitis (GPA)

Answer

Anti-GBM glomerulonephritis

Answer

SLE nephritis

Answer

IgA nephropathy

Question 5

A 24-year-old woman who had a home delivery 2 weeks ago now presents with a complete perineal tear. What is the next line of management?

Accepted Answer

Repair after 3 months

Answer

Repair after 3 weeks

Answer

Repair after 6 months

Answer

Repair immediately

Question 6

Microscopic examination of the reperfused myocardium is likely to have which of the following findings?

Accepted Answer

Contraction band necrosis

Answer

Neutrophilic infiltration

Answer

Cardiac myocyte swelling

Answer

Waviness of fibers

Question 7

A patient with pH of 7, pCO2 of 30 mmHg and Bicarbonate levels of 10 meq. What is the acid base abnormality?

Accepted Answer

Metabolic Acidosis

Answer

Respiratory alkalosis

Answer

Metabolic alkalosis

Answer

Respiratory Acidosis

Question 8

On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:

Accepted Answer

30 days

Answer

48 hours

Answer

60 days

Answer

90 days

Question 9

Magnan's symptom is seen in:

Accepted Answer

Cocaine

Answer

Datura

Answer

Cannabis

Answer

Opium

Question 10

Not a landmark of facial nerve identification in parotid surgery:

Accepted Answer

Inferior belly of omohyoid

Answer

Peripheral branches

Answer

Post belly of digastric

Answer

Tragal pointer

NEET-PG 2020

Biochemistry

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pathology

Physiology

Psychiatry

Surgery