NEET-PG 2023 Practice Questions

Q: Enzyme activated by decrease in Insulin: glucagon ratio:

Glucose 6 phosphatase. ***Glucose 6 phosphatase*** - A decreased **insulin:glucagon ratio** signifies a catabolic state, promoting glucose release into the blood. - **Glucose-6-phosphatase** is the key enzyme in **gluconeogenesis** and **glycogenolysis** in the liver, dephosphorylating **glucose-6-phosphate** to **free glucose**, which can then be exported from the liver. *PFK* - **Phosphofructokinase (PFK)** is a key regulatory enzyme in **glycolysis**, which is inhibited in a state of low insulin:glucagon ratio. - Its activity would decrease, not increase, to reduce glucose utilization. *Glucokinase* - **Glucokinase** phosphorylates glucose to **glucose-6-phosphate** in the liver, trapping it for metabolism; its activity is increased by high insulin levels. - In a low insulin:glucagon ratio, its activity would be reduced to conserve glucose. *Hexokinase* - **Hexokinase** phosphorylates glucose in most peripheral tissues but has a lower Km for glucose than glucokinase, becoming saturated even at low glucose concentrations. - Its activity is not primarily regulated by the insulin:glucagon ratio; it is generally involved in glucose uptake for cellular energy needs.

Q: A 50-year-old smoker presents with hoarseness, dysphagia, and weight loss. Flexible laryngoscopy shows a mass on the vocal cords. What is the next best step?

Direct laryngoscopy with biopsy. ***Direct laryngoscopy with biopsy*** - A definitive diagnosis of a vocal cord mass requires **histological examination** to rule out malignancy, especially given the patient's risk factors (age, smoking) and symptoms (hoarseness, dysphagia, weight loss). - **Direct laryngoscopy** allows for a thorough, magnified view of the mass and precise biopsy collection, which is superior to flexible laryngoscopy alone for definitive diagnosis and staging. *MRI of neck* - While MRI can provide excellent soft tissue detail for **staging** a known malignancy, it cannot provide a **histological diagnosis**. - It would typically be performed after a biopsy confirms malignancy to assess the extent of the tumor and potential spread. *CT scan of neck* - A CT scan is useful for evaluating **bony involvement**, lymph node status, and tumor extension for **staging purposes**, but it is not a diagnostic tool for identifying the specific type of tissue or cell pathology. - Like MRI, a CT scan would generally follow a biopsy confirming malignancy. *Radiotherapy* - **Radiotherapy** is a treatment modality for laryngeal cancer, not a diagnostic step. - Initiating treatment without a definitive histological diagnosis of malignancy would be inappropriate and potentially harmful.

Q: In which condition is postmortem caloricity observed?

Septicemia. ***Septicemia*** - **Postmortem caloricity** (a rise in body temperature after death) is a characteristic finding in cases of **septicemia** due to ongoing bacterial activity and metabolic processes that continue for a short period post-mortem. - The bacterial activity in septicemia continues to generate heat, leading to a transient increase in core body temperature before it eventually falls to ambient levels. - **Note:** Other conditions causing postmortem caloricity include heat stroke, cholera, tetanus, and certain poisonings (e.g., strychnine), but among the given options, **septicemia is the correct answer**. *Massive hemorrhage* - **Massive hemorrhage** typically causes a significant drop in body temperature before death due to volume loss and circulatory collapse, and this hypothermia usually continues after death. - It does not involve conditions that would lead to a postmortem rise in temperature; rather, it promotes **algor mortis** (cooling of the body). *Cyanide poisoning* - **Cyanide poisoning** inhibits cellular respiration and energy production, leading to rapid tissue anoxia and cellular death. - It does not involve a process that would generate heat post-mortem; instead, it causes rapid cessation of metabolic heat production and normal cooling follows. *Corrosive poisoning* - **Corrosive poisoning** causes local tissue damage and systemic effects that can lead to shock and hypothermia, but it does not generally cause postmortem caloricity. - The primary effects are on tissue destruction and organ failure, which would not result in postmortem heat generation.

Q: Method of autopsy in which organs of various systems are removed en masse:

Lettulle. ***Lettulle*** - The **Lettulle method** (or en masse method) involves the removal of organs in large blocks or as a single unit, which helps preserve anatomical relationships. - This technique is particularly useful for studying the **interrelationships between organs** and the spread of disease involving multiple systems. *Virchow* - The **Virchow method** involves the individual removal of each organ, which allows for detailed examination of each organ separately. - This method is straightforward but can disrupt the **anatomical relationships** between organs. *Rokitansky* - The **Rokitansky method** involves *in situ* dissection of organs, with the organs remaining largely in the body during dissection. - This technique is valued for maintaining the **topographical integrity** of organ systems within the body cavity. *Ghon* - The **Ghon method** is a modified block dissection method, focusing on the removal of specific organ blocks. - This often includes the **thoracic and abdominal organs** together, maintaining their anatomical connections.

Q: A patient presents with severe abdominal pain and jaundice. Imaging reveals calcified cysts in the liver, and serological testing is positive for Echinococcus. What is a potential complication of this infection?

Secondary bacterial infection of cysts. ***Secondary bacterial infection of cysts*** - **Hydatid cysts** can become secondarily infected, typically after rupture or surgical manipulation, leading to an **abscess formation** within the liver. - This complication can present with features like fever, worsening abdominal pain, and an elevated **white blood cell count**, distinct from the initial presentation. *Rupture of cysts leading to anaphylactic shock* - While rupture of **hydatid cysts** can lead to **anaphylactic shock** due to the release of hydatid fluid, it is not the *most common immediate complication* or the scenario implied by abdominal pain and jaundice. - **Anaphylaxis** implies a rapid, severe systemic allergic reaction, which is a life-threatening acute event. *Portal hypertension due to cyst compression* - While large cysts can compress structures, significant **portal hypertension** due to direct compression of the portal vein by **hydatid cysts** is rare. - More commonly, portal hypertension is a complication of advanced **cirrhosis**, not typically direct cyst compression in the early stages described. *No significant complications* - **Echinococcosis** (hydatid disease) is a serious parasitic infection that almost always leads to significant morbidity if left untreated. - Cysts grow over time and inevitably cause **organ dysfunction**, pain, obstruction, or other complications.

Q: Which of the following is not the component of qSOFA?

Unequally dilated pupils. ***Unequally dilated pupils*** - **Unequally dilated pupils** are not a component of the **qSOFA** score. This finding can be indicative of neurological issues such as increased **intracranial pressure** or **uncal herniation**, but not directly part of the sepsis screening tool [1]. - The qSOFA score focuses on easily obtainable clinical signs to rapidly identify patients at risk for poor outcomes from **sepsis**. *Respiratory rate >22/min* - A **respiratory rate greater than 22 breaths per minute** is one of the three criteria for the **qSOFA** score, indicating significant physiological stress. - This elevated respiratory rate suggests an increased work of breathing, often due to **metabolic acidosis** or **systemic inflammation** associated with sepsis. *Altered mental status* - **Altered mental status** (e.g., Glasgow Coma Scale score less than 15) is a core component of the **qSOFA** score [1]. - This sign reflects **cerebral hypoperfusion** or **encephalopathy** due to the systemic effects of sepsis [1]. *Systolic BP<100 mmHg* - A **systolic blood pressure less than 100 mmHg** is another key criterion of the **qSOFA** score. - This indicates **hypotension** and suggests inadequate tissue perfusion, a critical sign of **circulatory dysfunction** in sepsis [1].

Q: As per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?

30 years. ***30 years*** - **Indian guidelines** from the **Ministry of Health & Family Welfare (MoHFW)** and the **Indian Council of Medical Research (ICMR)** recommend initiating cervical cancer screening at **age 30 years** or within 3 years of first sexual contact. - The recommended screening methods in India include **VIA (Visual Inspection with Acetic Acid)**, **HPV DNA testing**, or **Pap smear**, performed every 5 years until age 65. - This approach is tailored to the **Indian healthcare setting** and resource availability. *21 years* - This is the recommended screening age according to **US guidelines (ACOG/USPSTF)**, not Indian guidelines. - While appropriate for the US context, Indian guidelines start screening later at age 30, considering **epidemiological data**, **disease prevalence**, and **healthcare infrastructure** specific to India. *25 years* - Some **European countries** and the **UK** recommend starting screening at age 25. - This is **not the recommended age** for cervical cancer screening according to Indian national guidelines. - In India, screening typically begins at age 30 years. *18 years* - Initiating cervical cancer screening at age 18 is **not recommended** by any major international or Indian guidelines. - Screening before age 21 (in US guidelines) or 30 (in Indian guidelines) often leads to **unnecessary procedures and anxiety**, as **HPV infections** and mild dysplasias in adolescents usually resolve spontaneously.

Q: In a child presenting unilateral watering and photophobia which of the following is the least likely disorder?

Congenital NLDO. **Congenital NLDO** - **Congenital nasolacrimal duct obstruction (NLDO)** typically presents with **unilateral watering** (epiphora) due to blockage of tear drainage. - While it causes watering, **photophobia** is not a characteristic symptom of isolated NLDO, making it less likely given the combined presentation. *Congenital entropion* - **Congenital entropion** involves the inward turning of the eyelid margin, causing eyelashes to rub against the cornea. - This irritation can lead to **unilateral watering** and **photophobia** due to corneal abrasion and discomfort. *Congenital glaucoma* - **Congenital glaucoma** is characterized by elevated intraocular pressure, which can cause corneal edema and stretching. - These changes commonly result in **unilateral watering** (epiphora) and marked **photophobia**, often accompanied by **buphthalmos** (enlarged eye). *Congenital dacryocystitis* - **Congenital dacryocystitis** is an infection of the lacrimal sac, often secondary to NLDO. - It presents with **unilateral watering**, discharge, and inflammation of the lacrimal sac, and the associated irritation can induce **photophobia**.

Q: Absolute refractoriness of a neuron is due to?

Inactivation of Na channels. ***Inactivation of Na channels*** - During the **absolute refractory period**, voltage-gated **Na+ channels** enter an inactivated state, making them unresponsive to further stimulation. - This inactivation prevents another action potential from being generated, regardless of the stimulus intensity, ensuring unidirectional propagation. *Hyperpolarization of Cl channels* - While **Cl- channels** can cause hyperpolarization, this typically leads to **inhibition** rather than absolute refractoriness. - Their activity doesn't directly prevent the generation of a new action potential by blocking Na+ channel function. *Opening of rectifier K+ channels* - The opening of **rectifier K+ channels** is involved in **repolarization** and the **relative refractory period**, by increasing K+ efflux. - While it contributes to making the neuron less excitable, it doesn't cause the absolute inability to fire associated with Na+ channel inactivation. *Closure of activated Na channels* - The **closure of activated Na+ channels** occurs as part of the repolarization process, but the critical mechanism for absolute refractoriness is their transition into an **inactivated state**, not simply closure. - **Inactivation** locks the channels in a non-responsive configuration, whereas simple closure would allow them to reopen quickly with sufficient depolarization.

Q: A 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?

Panic disorder. ***Panic disorder*** - The presentation of recurrent, unexpected **panic attacks** characterized by sudden episodes of intense fear, palpitations, sweating, and a fear of losing control is classic for **panic disorder**. - These episodes often manifest with physical symptoms that mimic a medical emergency, leading to significant distress and avoidance behaviors. *Generalized anxiety disorder* - This condition involves **persistent and excessive worry** about various life circumstances for at least six months, rather than discrete, intense episodes of fear. - While physical symptoms like restlessness and fatigue can occur, they are generally less acute and not as severe as the sudden "fight-or-flight" response seen in panic attacks. *Social anxiety disorder* - This disorder is characterized by marked fear or anxiety about **social situations** where the individual might be scrutinized by others. - While it can involve symptoms like palpitations and sweating in social contexts, it doesn't typically present with unexpected attacks unrelated to social performance. *Obsessive-compulsive disorder* - This disorder is defined by the presence of **obsessions** (recurrent and persistent thoughts, urges, or images) and/or **compulsions** (repetitive behaviors or mental acts) that the individual feels driven to perform. - The symptoms described—palpitations, sweating, and fear of losing control—are not typical primary manifestations of OCD, which focuses on specific obsessions and compulsions.

Question 1

Enzyme activated by decrease in Insulin: glucagon ratio:

Accepted Answer

Glucose 6 phosphatase

Answer

PFK

Answer

Glucokinase

Answer

Hexokinase

Question 2

A 50-year-old smoker presents with hoarseness, dysphagia, and weight loss. Flexible laryngoscopy shows a mass on the vocal cords. What is the next best step?

Accepted Answer

Direct laryngoscopy with biopsy

Answer

MRI of neck

Answer

CT scan of neck

Answer

Radiotherapy

Question 3

In which condition is postmortem caloricity observed?

Accepted Answer

Septicemia

Answer

Massive hemorrhage

Answer

Cyanide poisoning

Answer

Corrosive poisoning

Question 4

Method of autopsy in which organs of various systems are removed en masse:

Accepted Answer

Lettulle

Answer

Virchow

Answer

Rokitansky

Answer

Ghon

Question 5

A patient presents with severe abdominal pain and jaundice. Imaging reveals calcified cysts in the liver, and serological testing is positive for Echinococcus. What is a potential complication of this infection?

Accepted Answer

Secondary bacterial infection of cysts

Answer

Portal hypertension due to cyst compression

Answer

Rupture of cysts leading to anaphylactic shock

Answer

No significant complications

Question 6

Which of the following is not the component of qSOFA?

Accepted Answer

Unequally dilated pupils

Answer

Respiratory rate >22/min

Answer

Altered mental status

Answer

Systolic BP<100 mmHg

Question 7

As per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?

Accepted Answer

30 years

Answer

25 years

Answer

21 years

Answer

18 years

Question 8

In a child presenting unilateral watering and photophobia which of the following is the least likely disorder?

Accepted Answer

Congenital NLDO

Answer

Congenital entropion

Answer

Congenital glaucoma

Answer

Congenital dacryocystitis

Question 9

Absolute refractoriness of a neuron is due to?

Accepted Answer

Inactivation of Na channels

Answer

Hyperpolarization of Cl channels

Answer

Opening of rectifier K+ channels

Answer

Closure of activated Na channels

Question 10

A 45-year-old male presents with recurrent episodes of palpitations, sweating, and a fear of losing control. He has been experiencing these episodes for the past six months. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Generalized anxiety disorder

Answer

Social anxiety disorder

Answer

Obsessive-compulsive disorder

NEET-PG 2023

Biochemistry

ENT

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Physiology

Psychiatry