Community Medicine
2 questionsAs per the Sustainable Development Goals, what is the target for Maternal Mortality Ratio (MMR)?
Blood bags are disposed of in
NEET-PG 2020 - Community Medicine NEET-PG Practice Questions and MCQs
Question 81: As per the Sustainable Development Goals, what is the target for Maternal Mortality Ratio (MMR)?
- A. < 70 per 100,000 live births (Correct Answer)
- B. < 100 per 100,000 live births
- C. < 7 per 1,000 live births
- D. < 10 per 1,000 live births
Explanation: ***< 70 per 100,000 live births*** - **Sustainable Development Goal (SDG) 3.1** specifically targets reducing the global maternal mortality ratio to less than **70 per 100,000 live births** by 2030. - This target aims to address the significant disparities in maternal mortality rates observed across different regions and countries. *< 100 per 100,000 live births* - While this represents an improvement over current global averages, it is **not the specific target set by SDG 3.1** for maternal mortality. - The SDGs establish a more ambitious threshold to ensure greater progress in maternal health outcomes. *< 7 per 1,000 live births* - This value is equivalent to **700 per 100,000 live births**, which is significantly higher than the SDG target and represents a **much higher maternal mortality rate**. - This option reflects a misunderstanding of the scale and denominator used for maternal mortality ratios in the SDGs. *< 10 per 1,000 live births* - This value is equivalent to **1,000 per 100,000 live births**, which is also **significantly higher than the SDG target**. - This option shows a similar misconception regarding the magnitude and proper reporting of maternal mortality ratios.
Question 82: Blood bags are disposed of in
- A. Yellow bag (Correct Answer)
- B. Black bag
- C. Red bag
- D. White bag
Explanation: ***Yellow bag*** - **Yellow bags** are designated for **infectious waste** including items contaminated with **blood and body fluids** according to **Bio-Medical Waste Management Rules, 2016**. - **Blood bags** (both used and expired) are specifically categorized under **soiled waste** requiring disposal in **yellow bags**. - This waste is either incinerated or subjected to plasma pyrolysis to eliminate **bloodborne pathogens**. *Red bag* - **Red bags** are used for **contaminated recyclable waste** such as tubing, catheters, IV sets (without needles), and gloves. - While red bags handle contaminated items, they are meant for waste that can potentially be recycled after appropriate treatment, **not for blood bags**. *Black bag* - **Black bags** are designated for **general non-infectious waste** (municipal solid waste) such as paper, packaging materials, and food waste. - Disposing blood bags in black bags would violate **biomedical waste management regulations** and pose serious **infection control risks**. *White bag* - **White bags/containers** are puncture-proof containers used for **sharp waste** including needles, scalpels, and broken glass. - Blood bags are not classified as sharps and require different disposal methods due to their **infectious liquid content**.
Forensic Medicine
1 questionsWhat poison will you detect in the skeleton even after decomposition
NEET-PG 2020 - Forensic Medicine NEET-PG Practice Questions and MCQs
Question 81: What poison will you detect in the skeleton even after decomposition
- A. Lead
- B. Arsenic (Correct Answer)
- C. Mercury
- D. Cadmium
Explanation: ***Arsenic*** - **Arsenic** has a high affinity for **keratin-rich tissues** like hair, nails, and skin, and also gets incorporated into bones. - Its presence in the skeleton and other tissues can be detected long after death, even in cases of **emaciation** or advanced decomposition. *Lead* - **Lead** primarily accumulates in **bones** due to its chemical similarity to calcium, where it can reside for decades. - While detectable in the skeleton, arsenic is often considered in forensic toxicology when looking for poisons in highly decayed remains due to its long-term persistence in various tissues. *Mercury* - **Organic mercury** forms, like **methylmercury**, primarily accumulate in the **brain and kidneys**, and to a lesser extent in hair and nails. - While some inorganic forms can be found in bone, its persistence and detectability in the skeleton after significant decomposition are generally less prominent than arsenic. *Cadmium* - **Cadmium** preferentially accumulates in the **kidneys and liver**, with a smaller proportion stored in bones. - While it can be detected in bone, its persistence in decayed remains and diagnostic significance as a poison in the skeleton is not as universal as arsenic.
Internal Medicine
1 questionsEsophageal manometry was performed - it revealed panesophageal pressurization with distal contractile integrity as >450mm Hg pressure in the body. What will be the diagnosis?
NEET-PG 2020 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 81: Esophageal manometry was performed - it revealed panesophageal pressurization with distal contractile integrity as >450mm Hg pressure in the body. What will be the diagnosis?
- A. Type 2 achalasia
- B. Type 3 achalasia (Correct Answer)
- C. Jackhammer esophagus
- D. Type 1 achalasia (classic achalasia)
Explanation: The diagnosis is Type 3 achalasia. This condition is characterized by panesophageal pressurization, indicating diffuse, simultaneous contractions throughout the esophagus. The high distal contractile integrity (>450 mmHg pressure) further supports Type 3 achalasia, which involves significant spastic contractions. In contrast, while high-resolution manometry allows for the accurate classification of these motility abnormalities [1], other types present differently. Type 1 achalasia (classic achalasia) is marked by failed esophageal peristalsis and absent or minimal esophageal pressurization [1]. The primary characteristic is incomplete or absent lower esophageal sphincter (LES) relaxation, not hypercontractility [1]. Type 2 achalasia is identified by esophageal panesophageal pressurization (simultaneous contractions), but with normal to high contractile pressures, not the extremely high values seen here. Jackhammer esophagus involves hypercontractility (distal contractile integral >8000 mmHg·cm·s) and is characterized by rapid, repetitive, and fragmented contractions, rather than the diffuse panesophageal pressurization and spasticity typical of Type 3 achalasia [2].
Obstetrics and Gynecology
2 questionsA 36-week pregnant lady with previous twin delivery. What is the Obstetric score?
Which distension medium is used for hysteroscopy with bipolar cautery?
NEET-PG 2020 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 81: A 36-week pregnant lady with previous twin delivery. What is the Obstetric score?
- A. G2P1 (Correct Answer)
- B. G2P2
- C. G3P2
- D. G3P3
Explanation: ***G2P1*** - **Gravida (G)** refers to the total number of pregnancies, including the current one, so the current pregnancy (1) plus the previous twin delivery (1) equals **G2**. - **Parity (P)** refers to the number of times a woman has given birth to a fetus (or fetuses) beyond 20 weeks gestation, irrespective of whether the baby was born alive or is now living. A **twin delivery counts as one parity event** because it was one pregnancy that resulted in a delivery. *G2P2* - This option incorrectly counts the twin delivery as two separate parity events, whereas **parity is counted per pregnancy event** resulting in live birth or stillbirth beyond 20 weeks. - While G2 is correct (current pregnancy + previous pregnancy), P2 incorrectly implies two separate delivery events. *G3P2* - This option correctly identifies the parity as P2, but incorrectly states the gravida as G3. - **Gravida is 2** (current pregnancy + previous twin pregnancy), not 3. *G3P3* - This option is incorrect for both gravida and parity. - The patient has had **two pregnancies** (G2) and **one delivery event** (P1).
Question 82: Which distension medium is used for hysteroscopy with bipolar cautery?
- A. NS (Correct Answer)
- B. Glycine
- C. Carbon Dioxide
- D. Dextran 70
Explanation: ***NS*** - **Normal Saline (NS)** is an **electrolyte-containing solution** (0.9% NaCl) and is thus safe to use with **bipolar electrosurgery** because it does not conduct current across the tissue but only between the two poles of the instrument. - Its isotonicity minimizes fluid shifts and its clear nature allows for good visualization. *Glycine* - **Glycine** is a **non-electrolyte solution** that is used with **monopolar electrosurgery**, as it does not conduct electrical current to the patient but only through the active electrode. - Using it with bipolar devices is unnecessary and can lead to complications such as **dilutional hyponatremia** and **hyperammonemia** if significant intravascular absorption occurs. *Carbon Dioxide* - **Carbon dioxide** is used as a distension medium for **diagnostic hysteroscopy** because of its lack of risk for fluid overload and clear visualization. - It is **contraindicated with electrosurgery** because of the risk of **gas embolism** and its potential for impaired visualization with significant bleeding. *Dextran 70* - **Dextran 70** is a **high-viscosity, non-electrolyte solution** primarily used for diagnostic hysteroscopy when blood or mucus obscures the view. - It is **contraindicated for electrosurgery** due to its non-conductive nature and the risk of **anaphylactic reactions** and **pulmonary edema** from volume expansion.
Physiology
2 questionsA 33-year-old man presents with a 5-week history of calf pain, swelling, and low-grade fever. Serum levels of creatinine kinase are elevated. A muscle biopsy reveals numerous eosinophils and he also has peripheral blood eosinophilia. Which of the following interleukins is primarily responsible for the increase in eosinophils in this patient?
What is the reflex in which there is inhibition of gastric emptying when there is acid and hypertonic solution in the duodenum?
NEET-PG 2020 - Physiology NEET-PG Practice Questions and MCQs
Question 81: A 33-year-old man presents with a 5-week history of calf pain, swelling, and low-grade fever. Serum levels of creatinine kinase are elevated. A muscle biopsy reveals numerous eosinophils and he also has peripheral blood eosinophilia. Which of the following interleukins is primarily responsible for the increase in eosinophils in this patient?
- A. IL-4
- B. IL-5 (Correct Answer)
- C. IL-6
- D. IL-2
Explanation: ***IL-5*** - **Interleukin-5 (IL-5)** is the **most potent and direct cytokine** responsible for the **differentiation, maturation, activation, and survival of eosinophils**. - IL-5 is produced primarily by **Th2 cells**, mast cells, and eosinophils themselves, and acts directly on eosinophil progenitors in the bone marrow. - In this patient with eosinophilic myositis (likely parasitic infection such as trichinosis), **IL-5 is the primary mediator** of the peripheral blood eosinophilia and tissue eosinophil infiltration. - **Clinical correlation:** Anti-IL-5 therapies (mepolizumab, reslizumab) are used to treat hypereosinophilic conditions, confirming IL-5's central role. *IL-4* - **Interleukin-4 (IL-4)** is produced by Th2 cells and mast cells and promotes the **differentiation of naive T cells into Th2 cells**. - While IL-4 initiates the Th2 immune response that eventually leads to IL-5 production, it does **not directly stimulate eosinophil production or recruitment**. - IL-4 is more involved in IgE class switching and allergic inflammation rather than direct eosinophil regulation. *IL-6* - **Interleukin-6 (IL-6)** is a pleiotropic cytokine involved in the **acute phase response**, inflammation, and hematopoiesis. - While it has broad effects on immune cells, it is **not primarily responsible** for eosinophil production or recruitment. - Elevated in many inflammatory conditions but not specific for eosinophilia. *IL-2* - **Interleukin-2 (IL-2)** is primarily involved in the **proliferation and differentiation of T lymphocytes** and activation of natural killer (NK) cells. - It plays no significant direct role in eosinophil production or recruitment. - More important for T cell-mediated immunity rather than eosinophilic responses.
Question 82: What is the reflex in which there is inhibition of gastric emptying when there is acid and hypertonic solution in the duodenum?
- A. Enterogastric (Correct Answer)
- B. Gastroileal
- C. Gastrocolic
- D. Myenteric
Explanation: ***Enterogastric*** - The **enterogastric reflex** is initiated when the duodenum detects the presence of acid and hypertonic solutions, signifying that the chyme is not yet ready for further digestion and absorption. - This reflex inhibits **gastric emptying** to allow more time for the stomach to process its contents and for the duodenum to neutralize the acid and dilute the hypertonic solution. *Gastroileal* - The **gastroileal reflex** increases motility in the ileum when the stomach is distended, facilitating the movement of chyme into the large intestine. - This reflex does not primarily involve the inhibition of gastric emptying due to duodenal contents. *Gastrocolic* - The **gastrocolic reflex** increases the motility of the colon in response to the stretching of the stomach by food. - Its main function is to prepare the large intestine for upcoming chyme and does not directly inhibit gastric emptying. *Myenteric* - The **myenteric plexus** (Auerbach's plexus) is a network of neurons located between the longitudinal and circular layers of the muscularis propria throughout the gastrointestinal tract. - While it plays a crucial role in controlling gut motility and is involved in numerous reflexes, it refers to a neural plexus rather than a specific reflex mechanism for inhibiting gastric emptying due to duodenal stimuli.
Surgery
2 questionsWhich statement about retrosternal goiter is correct?
A pregnant female had meconium-stained liquor and underwent emergency LSCS. A few days later, her condition deteriorated, and an ultrasound showed edematous bowels. What is the most likely cause of her condition?
NEET-PG 2020 - Surgery NEET-PG Practice Questions and MCQs
Question 81: Which statement about retrosternal goiter is correct?
- A. Surgery should be avoided in all cases.
- B. CT chest is recommended for evaluation of retrosternal goiter. (Correct Answer)
- C. All patients require surgical intervention.
- D. Blood supply primarily comes from the thyroid arteries.
Explanation: ***CT chest is recommended for evaluation of retrosternal goiter.*** * A **CT chest** provides detailed imaging of the goiter's extent, its relationship to surrounding structures (trachea, esophagus, great vessels), and helps in surgical planning. * It can identify potential complications like **tracheal compression** or involvement of the superior mediastinum, which are crucial for management decisions. *All patients require surgical intervention.* * Surgical intervention is not universally required; it depends on the **size of the goiter**, presence and severity of compressive symptoms, and malignancy suspicion. * Small, asymptomatic retrosternal goiters may be managed conservatively with **monitoring**. *Blood supply primarily comes from the thyroid arteries.* * While the initial development of the goiter is from the thyroid gland, as it extends into the mediastinum, it can develop additional **blood supply from mediastinal vessels**. * This dual blood supply, sometimes including branches from the internal mammary or subclavian arteries, can make surgical ligation more complex. *Surgery should be avoided in all cases.* * Surgery is often necessary, especially in cases with **compressive symptoms** such as dyspnea, dysphagia, or stridor, or if there is concern for malignancy. * **Retrosternal goiters** can grow large and cause significant morbidity or even mortality due to airway obstruction, making surgery a vital treatment option.
Question 82: A pregnant female had meconium-stained liquor and underwent emergency LSCS. A few days later, her condition deteriorated, and an ultrasound showed edematous bowels. What is the most likely cause of her condition?
- A. Adhesive intestinal obstruction
- B. Intra-abdominal abscess
- C. Paralytic ileus (Correct Answer)
- D. Intestinal perforation
Explanation: ***Paralytic ileus*** - **Paralytic ileus**, often called **postoperative ileus**, is a common complication after abdominal surgeries like **LSCS**, especially when associated with complications like meconium-stained liquor. - The combination of **meconium-stained liquor** (indicating fetal distress/inflammation) and **emergency LSCS** increases the risk for a prolonged inflammatory response post-surgery, leading to intestinal paralysis and **edematous bowels**. - Ultrasound findings of **edematous bowels** without signs of mechanical obstruction support this diagnosis. *Adhesive intestinal obstruction* - **Adhesive intestinal obstruction** usually occurs later, weeks to years after surgery, as **adhesions** form and contract. - While possible, it is less likely to present acutely a "few days later" after an initial surgery compared to **paralytic ileus**. *Intra-abdominal abscess* - An **intra-abdominal abscess** would typically cause localized pain, fever, and signs of infection with more focal findings on imaging. - The primary observation of **edematous bowels** points more directly to diffuse bowel dysfunction rather than a localized collection. *Intestinal perforation* - **Intestinal perforation** would present with acute peritonitis, free fluid/air on imaging, severe abdominal pain, and signs of sepsis. - While edematous bowels can be present, the clinical picture would be more dramatic with peritoneal signs rather than the subacute deterioration described here.