NEET-PG 2020 Practice Questions

Q: Female, on maize as a staple diet. History of diarrhoea and lesion in the neck region. This is due to deficiency of which of the following?

Niacin. ***Niacin*** * The constellation of **diarrhea**, **dermatitis** (neck lesion, often a "Casal's necklace"), and the exclusive reliance on a **maize staple diet** is highly characteristic of **pellagra**, which is caused by a **niacin (vitamin B3) deficiency**. * Maize contains niacin in a bound form (niacytin) that is largely **unbioavailable** unless treated with alkali (e.g., historical limewater soaking in some cultures). *Pyridoxine* * Deficiency of **pyridoxine (vitamin B6)** can lead to symptoms such as **skin inflammation (seborrheic dermatitis)**, **glossitis**, **cheilosis**, and neurological issues like **peripheral neuropathy** or **seizures**. * It does not typically present with the classic **diarrhea** and **dermatitis** pattern associated with pellagra in the context of a maize-based diet. *Thiamine* * **Thiamine (vitamin B1) deficiency** is associated with **beriberi**, characterized by cardiovascular symptoms (**wet beriberi** with edema and heart failure) or neurological symptoms (**dry beriberi** with neuropathy and muscle wasting). * It does not cause the specific dermatological lesion on the neck or the triad of symptoms (dermatitis, diarrhea, and dementia) seen with niacin deficiency. *Zinc* * **Zinc deficiency** can manifest as **dermatitis (acrodermatitis enteropathica)**, **diarrhea**, **impaired immune function**, and **poor wound healing** or **growth retardation**. * While it can cause skin lesions and diarrhea, the distinct **photosensitive dermatosis** on the neck and the strong association with a maize staple diet specifically point away from zinc deficiency and towards pellagra.

Q: Liquid chemical waste is discarded in:

Yellow bag. ***Yellow bag*** - **Liquid chemical waste** including laboratory reagents, disinfectants, and expired chemicals must be segregated and collected in a **yellow bag or container** as per **Bio-Medical Waste Management Rules, 2016 (India)**. - Yellow bags are designated for **infectious and hazardous waste** including chemical waste, expired medicines, and anatomical waste. - This ensures proper handling through **incineration or chemical treatment** to prevent environmental contamination. *Red bag* - **Red bags** are used for **contaminated waste (recyclable)** including items contaminated with blood or body fluids that are not highly infectious. - This includes tubing, bottles, intravenous sets, and catheters that can be autoclaved and recycled. - Red bag waste undergoes **autoclaving/microwaving** followed by shredding before disposal. *White bag* - **White or translucent puncture-proof containers** are designated for **sharps waste** including needles, syringes, scalpels, and blades. - These containers prevent needlestick injuries and ensure safe handling of sharp objects. - Not suitable for liquid chemical waste which requires yellow bag disposal. *Blue bag* - **Blue/white puncture-proof containers** are used for **sharps including metallic body implants** and glassware that may cause injury. - In the Indian BMW system, blue and white containers serve similar purposes for sharps waste. - Not designated for liquid chemical waste, which belongs in yellow bags.

Q: Tuberculous otitis media of the middle ear has all of the following except:-

Painful otorrhea is seen. ***Painful otorrhea is seen*** - **Tuberculous otitis media** is often characterized by **painless otorrhea**, making painful otorrhea an unlikely finding. - The absence of pain is attributed to the **insidious** and slow-growing nature of the infection, which often delays diagnosis. *Multiple perforations are seen* - **Multiple tympanic membrane perforations** are a classic sign of tuberculous otitis media, differentiating it from other chronic otitis media forms. - These perforations are often **small and non-healing**, contributing to persistent discharge. *Pale granulomas are seen* - The presence of **pale granulomas** in the middle ear is a histological hallmark of tuberculosis, reflecting the characteristic **caseating granulomatous inflammation**. - These granulomas can lead to **ossicular erosion** and subsequent conductive hearing loss. *ATT should be started* - **Anti-tubercular treatment (ATT)** is the definitive therapy for tuberculous otitis media, targeting the underlying Mycobacterium tuberculosis infection. - Early initiation of ATT is crucial to prevent further **destruction** of middle ear structures and hearing loss.

Q: A 26 year old female after her delivery develops features of headache, nausea, visual complaints, fatigue. What is the most probable diagnosis?

Sheehan's syndrome. ***Sheehan's syndrome*** - This syndrome is caused by **ischemic necrosis of the pituitary gland** due to severe postpartum hemorrhage or hypovolemic shock, leading to **pituitary dysfunction** [1]. - Symptoms like **headache, nausea, visual complaints, and fatigue** are consistent with panhypopituitarism developing after delivery, often presenting in the postpartum period due to the large, vulnerable pregnancy-enlarged pituitary [1]. *Waterhouse-Friderichsen syndrome* - This is a rare, life-threatening condition caused by overwhelming **bacterial infection (often meningococcal)**, leading to **adrenal gland hemorrhage** and acute adrenal insufficiency. - It presents with rapid onset of fever, petechial rash, hypotension, and shock, which are not described in the patient's symptoms. *Hyperprolactinemia* - While hyperprolactinemia can cause headaches and visual disturbances (if due to a pituitary tumor) [1], it typically presents with **galactorrhea**, **amenorrhea**, or **oligomenorrhea**, and is not directly linked to the postpartum period unless caused by a new or existing pituitary adenoma. - It does not account for the widespread pituitary failure implied by the patient's general fatigue and other symptoms after delivery, which is more characteristic of Sheehan's [2]. *Pituitary adenoma* - A pituitary adenoma can cause headaches, visual disturbances (due to **mass effect on the optic chiasm**) [1], and hormone deficiencies or excesses, but its onset is not specifically tied to the postpartum period like Sheehan's syndrome. - While it's a possibility for these symptoms, the history of recent delivery strongly points to Sheehan's syndrome over a newly symptomatic or pre-existing pituitary adenoma without specific features like galactorrhea or Cushing's symptoms that would hint at a specific type of adenoma.

Q: Superantigen is produced by which of the following?

Streptococcus pyogenes. ***Streptococcus pyogenes*** - *Streptococcus pyogenes* produces **superantigens** such as **streptococcal pyrogenic exotoxins (SPE-A, SPE-B, SPE-C)**. - These superantigens cause massive non-specific T-cell activation, leading to **toxic shock syndrome** and **scarlet fever**. - Superantigens bypass normal antigen processing by directly binding MHC class II molecules to T-cell receptors. *Clostridium perfringens* - *Clostridium perfringens* primarily produces **alpha-toxin** (phospholipase C) and other toxins causing **gas gangrene** and **food poisoning**. - It does not produce superantigens. *Vibrio cholerae* - *Vibrio cholerae* produces **cholera toxin**, an **enterotoxin** that causes massive fluid secretion in the intestine, leading to profuse watery diarrhea. - Cholera toxin is not a superantigen; it acts by activating adenylate cyclase through ADP-ribosylation. *Staphylococcus epidermidis* - *Staphylococcus epidermidis* is a common skin commensal that can cause infections related to **medical devices** and **biofilm formation**. - Unlike *Staphylococcus aureus* (which produces TSST-1 and enterotoxins), *S. epidermidis* does not produce superantigens.

Q: The depicted instrument (Fallopian ring applicator) is used in which procedure?

Tubectomy (Female Sterilisation). ***Tubectomy (Female Sterilisation)*** - The **Fallopian ring applicator** is a specialized instrument designed for applying **Silastic bands** (Fallopian rings) to the fallopian tubes. - This procedure, known as **laparoscopic tubal ligation** or **female sterilization**, involves occluding the fallopian tubes to prevent the union of sperm and egg. *Punch Biopsy* - A **punch biopsy** uses a circular blade to remove a core of tissue, primarily for **skin or mucosal lesions**. - The instruments involved are a **punch biopsy tool**, forceps, and scissors, which are distinctly different from an applicator. *Bone marrow biopsy set* - A **bone marrow biopsy set** typically includes a specialized needle (e.g., Jamshidi needle) for aspirations and biopsies from the **iliac crest**. - These instruments are designed for obtaining samples from bone and marrow, not for occluding tubular structures. *Trocar and cannula (used for general laparoscopy)* - A **trocar and cannula** system is used to create an access port into a body cavity for **laparoscopic surgery**. - While it facilitates the entry for instruments like the Fallopian ring applicator, it is a general entry tool and not the specific instrument depicted for the tubectomy itself.

Q: A 5-year-old unvaccinated child presents to the OPD with fever, red eyes, and a maculopapular rash. What is the most likely complication associated with this condition?

Pneumonia. ***Pneumonia*** - **Pneumonia** is the **most common and most likely complication of measles**, occurring in approximately **1-6% of measles cases** - The clinical presentation of **fever, red eyes (conjunctivitis), and maculopapular rash** in an **unvaccinated child** is classic for **measles (rubeola)** - Pneumonia may be due to **direct viral pneumonitis** from measles virus or **secondary bacterial infection** (most commonly *Streptococcus pneumoniae*, *Staphylococcus aureus*, or *Haemophilus influenzae*) - It is a major cause of **measles-related mortality**, particularly in young children and immunocompromised individuals *Acute myocarditis* - **Acute myocarditis** is an extremely rare complication of measles - While myocardial involvement can theoretically occur with severe viral infections, it is **not a recognized characteristic or common complication** of measles - This is not the most likely complication when compared to pneumonia, otitis media, or diarrhea *Acute nephritis* - **Acute nephritis** is not a characteristic complication of measles - It is more commonly associated with **post-streptococcal glomerulonephritis** following Group A Streptococcus infection - Kidney involvement in measles is not a well-documented or common complication *Acute orchitis* - **Acute orchitis** is a recognized complication of **mumps** virus infection, particularly in post-pubertal males (occurring in 20-30% of infected males) - It is **not associated with measles infection** - This is a classic distractor testing knowledge of viral exanthems and their specific complications

Q: Which of the following drugs act by inhibiting DNA replication?

6-Mercaptopurine. ***6-Mercaptopurine*** - This drug is a **purine analog** that acts as an **antimetabolite**, directly interfering with the **synthesis of purine nucleotides** required for DNA replication. - By inhibiting enzymes like **PRPP amidotransferase** and getting incorporated into DNA as a fraudulent nucleotide, it blocks the **de novo synthesis** pathway, preventing normal DNA replication. - This represents **direct inhibition of DNA synthesis** at the nucleotide building block level. *Mitomycin C* - This agent is an **alkylating agent** that **cross-links DNA** strands, causing DNA damage that prevents strand separation. - While it does prevent DNA replication, its mechanism is through **DNA damage and structural disruption** rather than inhibition of the DNA synthesis machinery itself. - It acts by damaging already-formed DNA rather than preventing new DNA synthesis. *Actinomycin D* - Actinomycin D is an **intercalating agent** that inserts itself between DNA base pairs, primarily **inhibiting RNA synthesis** by blocking RNA polymerase movement. - While it binds to DNA, its primary therapeutic action is on **transcription (RNA synthesis)**, not direct inhibition of DNA replication. *Asparaginase* - Asparaginase is an enzyme that **depletes asparagine** from the blood, which is an essential amino acid for certain cancer cells (e.g., leukemic cells). - Its mechanism is to starve cancer cells of asparagine, leading to **inhibition of protein synthesis**, not DNA replication.

Q: Radiation Dose Monitoring in Occupational Workers is done by

TLD Badge. ***TLD Badge (used for monitoring radiation exposure)*** - **Thermoluminescent Dosimeter (TLD) badges** are widely used for monitoring an individual's exposure to ionizing radiation over time. - They work by storing energy from radiation exposure and releasing it as **light when heated**, which is then measured to calculate the accumulated dose. *Collimators (used to shape radiation beams)* - **Collimators** are devices used in radiation therapy and diagnostic imaging to **restrict and shape the radiation beam**, ensuring it only targets the intended area. - They do not measure or monitor the dose received by an individual, but rather **control the spatial distribution** of the radiation. *Grid (used to reduce scatter in imaging)* - An **anti-scatter grid** is placed between the patient and the image receptor in radiography to **absorb scattered radiation**, which degrades image quality. - While essential for image quality, grids do not directly measure or monitor the radiation dose received by an occupational worker. *Linear Accelerator (used for delivering radiation therapy)* - A **linear accelerator (linac)** is a machine used to deliver **external beam radiation treatment** for cancer. - It generates high-energy X-rays or electrons, but it is a **source of radiation** for treatment, not a device for monitoring occupational exposure.

Question 1

Female, on maize as a staple diet. History of diarrhoea and lesion in the neck region. This is due to deficiency of which of the following?

Accepted Answer

Niacin

Answer

Pyridoxine

Answer

Thiamine

Answer

Zinc

Question 2

Liquid chemical waste is discarded in:

Accepted Answer

Yellow bag

Answer

Red bag

Answer

White bag

Answer

Blue bag

Question 3

Tuberculous otitis media of the middle ear has all of the following except:-

Accepted Answer

Painful otorrhea is seen

Answer

Multiple perforations are seen

Answer

Pale granulomas are seen

Answer

ATT should be started

Question 4

A 26 year old female after her delivery develops features of headache, nausea, visual complaints, fatigue. What is the most probable diagnosis?

Accepted Answer

Sheehan's syndrome

Answer

Waterhouse-Friderichsen syndrome

Answer

Hyperprolactinemia

Answer

Pituitary adenoma

Question 5

Superantigen is produced by which of the following?

Accepted Answer

Streptococcus pyogenes

Answer

Clostridium perfringens

Answer

Vibrio cholerae

Answer

Staphylococcus epidermidis

Question 6

The depicted instrument (Fallopian ring applicator) is used in which procedure?

Accepted Answer

Tubectomy (Female Sterilisation)

Answer

Punch Biopsy

Answer

Bone marrow biopsy set

Answer

Trocar and cannula (used for general laparoscopy)

Question 7

A 5-year-old unvaccinated child presents to the OPD with fever, red eyes, and a maculopapular rash. What is the most likely complication associated with this condition?

Accepted Answer

Pneumonia

Answer

Acute myocarditis

Answer

Acute nephritis

Answer

Acute orchitis

Question 8

Which of the following drugs act by inhibiting DNA replication?

Accepted Answer

6-Mercaptopurine

Answer

Mitomycin C

Answer

Actinomycin D

Answer

Asparaginase

Question 9

Radiation Dose Monitoring in Occupational Workers is done by

Accepted Answer

TLD Badge

Answer

Collimators

Answer

Grid

Answer

Linear Accelerator

Question 10

Which of the following is a FALSE statement regarding radiation?

Accepted Answer

Small blood vessels are relatively resistant to radiation compared to other tissues

Answer

GI mucosa is one of the most radiosensitive tissues in the body

Answer

Rapidly dividing cells are highly sensitive to Radiation

Answer

The intensity of Radiation is inversely proportional to the square of distance from the source

NEET-PG 2020

Biochemistry

Community Medicine

ENT

Internal Medicine

Microbiology

Obstetrics and Gynecology

Pediatrics

Pharmacology

Radiology