NEET-PG 2022 Practice Questions

Q: The structure marked A in the image below gives rise to which of the following structures?

Falciform ligament. ***Falciform ligament*** - The structure marked 'A' represents the **ventral mesentery** in the embryonic stage, which connects the primitive gut tube to the anterior body wall. - The **falciform ligament** develops from the ventral mesentery, specifically in the region of the liver, and connects the liver to the anterior abdominal wall and diaphragm. *Gastrosplenic ligament* - This ligament is derived from the **dorsal mesentery**, not the ventral mesentery. - It connects the greater curvature of the stomach to the hilum of the spleen. *Lienorenal ligament* - Also derived from the **dorsal mesentery**, connecting the left kidney to the spleen. - This structure is not formed from the ventral mesentery which is indicated by 'A'. *Gastrophrenic ligament* - This ligament is part of the **dorsal mesentery** and connects the stomach to the diaphragm. - It is not a derivative of the ventral mesentery.

Q: Which of the following statements is true regarding the telomerase theory of aging?

Decreased telomere length is associated with aging. ***Decreased telomere length is associated with aging*** - Telomeres are protective DNA-protein caps at chromosome ends that **shorten with each cell division** - Progressive telomere shortening triggers **cellular senescence** (Hayflick limit) and apoptosis - This mechanism directly contributes to aging and **age-related diseases** - The telomere theory of aging (Olovnikov hypothesis) states that telomere attrition is a primary driver of biological aging *Abnormal telomerase activation is associated with cancer* - **Telomerase is reactivated in ~85-90% of cancers**, enabling unlimited replicative potential - Normal adult somatic cells have low/absent telomerase activity - While telomerase can extend cellular lifespan, its aberrant activation leads to malignancy, not healthy aging *Telomere stability directly maintains chromosomal integrity* - Telomeres prevent chromosome degradation, end-to-end fusions, and DNA damage responses - This is a **protective function**, not the basis of the telomere theory of aging - The aging theory focuses on **consequences of telomere shortening**, not stability maintenance *Increased telomere length is associated with prolonged cellular lifespan* - Longer telomeres do correlate with younger biological age and extended replicative capacity - However, this describes the **inverse relationship** rather than the core aging theory - The telomere theory specifically explains aging through **progressive shortening**, not length extension

Q: A patient presents to you with an irregularly irregular pulse of 120/minutes and a pulse deficit of 20. Which of the following would be the jugular venous pressure (JVP) finding?

Absent a wave. ***Absent a wave*** - An **irregularly irregular pulse** with a **pulse deficit** strongly suggests **atrial fibrillation (AF)**. - In AF, the atria quiver chaotically instead of contracting effectively, leading to the **absence of a coordinated atrial contraction** and thus an **absent 'a' wave** in the JVP. *Normal JVP* - A normal JVP would show a regular **'a' wave** corresponding to normal atrial contraction. - This is inconsistent with the **irregularly irregular pulse** and **pulse deficit** seen in the patient, which points to a significant atrial arrhythmia. *Cannon a wave* - A **cannon 'a' wave** results from the right atrium contracting against a closed tricuspid valve, leading to a large, prominent wave in the JVP. - This is typically seen in conditions like **complete heart block** or **ventricular tachycardia with AV dissociation**, not atrial fibrillation. *Raised JVP with normal waveform* - A raised JVP with a normal waveform indicates increased right atrial pressure but preserves the normal sequence of atrial contraction and relaxation. - This could be due to conditions like **right heart failure** or **volume overload**, but would still show the presence of an 'a' wave, which is absent in atrial fibrillation.

Q: A 24 year old lactating female with an 18 month old child comes with a history of irregular, heavy bleeding seeking contraceptive advice. Which is the contraceptive of choice?

Progestin-only pill. ***Progestin-only pill*** - The **progestin-only pill (POP)** is the contraceptive of choice for lactating women because it does not affect **breast milk supply** or composition. - It works by thickening cervical mucus and thinning the **endometrium**, which can help reduce heavy bleeding and provide effective contraception. *Copper IUD* - While the **copper IUD** is a highly effective contraceptive, it is known to potentially increase **menstrual bleeding** and cramping. - Given the patient's history of **heavy bleeding**, a copper IUD might worsen her symptoms. *Progestin-only injection* - **Progestin-only injections** like DMPA are highly effective and safe for lactating women, but they can cause **irregular bleeding patterns** initially and are associated with a slower return to fertility. - While an option, the **progestin-only pill** offers more immediate control over menstrual patterns and easier discontinuation if side effects are problematic. *Combined oral contraceptive pill* - **Combined oral contraceptive pills (COCs)** contain both estrogen and progestin. Estrogen can negatively impact **milk production** and may not be suitable for breastfeeding mothers, especially in the first 6 months postpartum. - COCs are generally avoided in lactating women until breastfeeding is well-established or after 6 months to prevent interference with **lactation**.

Q: A 65-year-old male presents with blurred vision and a history of cataract surgery. Upon examination, fluffy white deposits are noted on the anterior lens capsule. What is the most likely diagnosis?

Pseudoexfoliation syndrome. ***Pseudoexfoliation syndrome*** - The description of **fluffy white deposits on the anterior lens capsule** in an older patient with blurred vision and a history of cataract surgery is highly characteristic of **pseudoexfoliation syndrome**. - This condition is caused by the abnormal production and accumulation of an **extracellular fibrillar material**, which can also affect the iris, ciliary body, and trabecular meshwork, potentially leading to **glaucoma** and lens subluxation. *Intraocular foreign body* - An intraocular foreign body would typically present with a history of **trauma** and might be visible as a distinct object, rather than diffuse fluffy deposits. - While it can cause inflammation and vision changes, its appearance is not consistent with the described findings. *Ocular trauma* - Ocular trauma would typically have an associated history of injury and could present with various signs like hyphema, iritis, or retinal detachment, but not specifically this type of **fluffy white deposit** on the lens. - While it can lead to vision issues, the specific clinical findings do not point towards acute or chronic sequelae of trauma as the primary diagnosis. *Vossius ring* - A **Vossius ring** is a deposition of iris pigment on the anterior lens capsule, forming a circular ring corresponding to the pupil margin at the time of blunt trauma. - It would appear as a **pigmented ring**, not fluffy white deposits, and is directly linked to a history of blunt trauma.

Q: All of the following statements are true regarding neutrophil extracellular trapping (NET) except for which of the following?

Mitochondrial DNA is seen. ***Mitochondrial DNA is seen*** - NETs (Neutrophil Extracellular Traps) are made primarily of **nuclear chromatin**, not mitochondrial DNA [2]. - The main purpose of NETs is to trap and kill pathogens, focusing on **nuclear genetic material** rather than mitochondrial components. *It is detected in blood during sepsis* - NETs can indeed be found in the **circulation during sepsis**, serving as a defense mechanism against infections. - Their presence in blood indicates an **active immune response**, particularly in severe systemic infections. *It is produced in response to bacterial infection* - NET formation is a known response to **bacterial infections**, as neutrophils deploy them to capture and neutralize pathogens. - This process helps in controlling infections, showcasing the importance of NETs in **innate immunity**. *It is chromatin with antibacterial enzymes* - NETs consist primarily of **decondensed chromatin**, embedded with **antimicrobial proteins** and enzymes to combat pathogens [1][2]. - This characteristic underscores their role in targeting and eliminating invading microorganisms effectively. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 91-92. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 92-93.

Q: A 59-year-old lady presents with a progressive, painless lump in the breast. What is the cause of the skin change associated with breast cancer?

Infiltration of subdermal lymphatics. ***Infiltration of subdermal lymphatics*** - The skin change described often refers to **peau d'orange**, which is caused by the **blockage of superficial lymphatic vessels** by tumor cells [1]. - This lymphatic obstruction leads to **edema** and dimpling of the skin, resembling an orange peel [1]. *Infiltration of the lactiferous duct* - While cancer can arise in or infiltrate lactiferous ducts, this primarily causes symptoms like **nipple discharge**, inversion, or a palpable mass. - It does not directly explain the specific **skin dimpling** or **peau d'orange** appearance. *Involvement of Cooper's ligament* - Involvement of **Cooper's ligaments** (suspensory ligaments of the breast) can cause skin dimpling or retraction [1]. - However, the image depicts widespread **peau d'orange**, which is more commonly associated with lymphatic involvement than direct ligamentous retraction [1]. *Spread of the tumor to the anterior chest wall* - Tumor extension to the **anterior chest wall** signifies advanced disease and can cause **fixation of the breast** to underlying structures or skin ulceration [2]. - This typically results in **immobility of the breast** or an ulcerated lesion, not the widespread edematous and dimpled appearance of **peau d'orange**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 453-454. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 456-457.

Question 1

The structure marked A in the image below gives rise to which of the following structures?

Accepted Answer

Falciform ligament

Answer

Lienorenal ligament

Answer

Gastrophrenic ligament

Answer

Gastrosplenic ligament

Question 2

Which of the following statements is true regarding the telomerase theory of aging?

Accepted Answer

Decreased telomere length is associated with aging

Answer

Abnormal telomerase activation is associated with cancer

Answer

Telomere stability directly maintains chromosomal integrity

Answer

Increased telomere length is associated with prolonged cellular lifespan

Question 3

You are working in a primary health center (PHC) situated in a high seismic zone. Which of the following actions should you take as part of preparedness for an emergency?

Accepted Answer

Conduct a simulation for the disaster and assess the response.

Answer

Ensure all financial and other resources are available for disaster preparedness.

Answer

Increase public awareness through campaigns and loudspeakers.

Answer

Follow instructions given over the phone or radio by higher officials.

Question 4

A patient presents to you with an irregularly irregular pulse of 120/minutes and a pulse deficit    of 20. Which of the following would be the jugular venous pressure (JVP) finding?

Accepted Answer

Absent a wave

Answer

Normal JVP

Answer

Cannon a wave

Answer

Raised JVP with normal waveform

Question 5

A 24 year old lactating female with an 18 month old child comes with a history of irregular,    heavy bleeding seeking contraceptive advice. Which is the contraceptive of choice?

Accepted Answer

Progestin-only pill

Answer

Copper IUD

Answer

Progestin-only injection

Answer

Combined oral contraceptive pill

Question 6

A 65-year-old male presents with blurred vision and a history of cataract surgery. Upon examination, fluffy white deposits are noted on the anterior lens capsule. What is the most likely diagnosis?

Accepted Answer

Pseudoexfoliation syndrome

Answer

Intraocular foreign body

Answer

Ocular trauma

Answer

Vossius ring

Question 7

An RTA patient presented to the emergency department with severe pain in the ankle. An X-ray was performed, given below. What is the best next step in management?

Accepted Answer

Neurovascular Assessment and Closed reduction with slab application

Answer

Neurovascular Assessment and Closed reduction with cast application

Answer

Neurovascular Assessment and Immediate surgery

Answer

Neurovascular Assessment and Immediate open reduction

Question 8

All of the following statements are true regarding neutrophil extracellular trapping (NET) except for which of the following?

Accepted Answer

Mitochondrial DNA is seen

Answer

It is detected in blood during sepsis

Answer

It is chromatin with antibacterial enzymes

Answer

It is produced in response to bacterial infection

Question 9

An 11-year-old child with a history of streptococcal pharyngitis presents you with fever and arthralgia. There is no past history of rheumatic heart disease or features of carditis or valvular disease. How often is 600,000 IU of benzathine penicillin recommended for prophylaxis of rheumatic heart disease?

Accepted Answer

Once in three weeks for 5 years or till the age of 18, whichever is longer

Answer

Immediately

Answer

Thrice weekly lifelong

Answer

Once in three weeks for 10 years or till the age of 25, whichever is longer

Question 10

A 59-year-old lady presents with a progressive, painless lump in the breast. What is the cause of the skin change associated with breast cancer?

Accepted Answer

Infiltration of subdermal lymphatics

Answer

Infiltration of the lactiferous duct

Answer

Involvement of Cooper’s ligament

Answer

Spread of the tumor to the anterior chest wall

NEET-PG 2022

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Orthopaedics

Pathology

Pediatrics

Surgery