NEET-PG 2023 Practice Questions

Q: In HIV patients, Kaposi's sarcoma is most likely caused by which of the following?

Virus. ***Virus*** - The image likely depicts **Kaposi's sarcoma**, a common lesion in HIV patients, which is caused by **Human Herpesvirus 8 (HHV-8)**. - Other viral infections like **Herpes Simplex Virus (HSV)** can also cause mucocutaneous lesions in immunocompromised individuals. *Bacteria* - While HIV patients are susceptible to bacterial infections (e.g., **Staphylococcus aureus** causing skin abscesses), the described lesion type is not characteristic of common bacterial skin infections. - Bacterial lesions often present as pustules, cellulitis, or ulcers with purulent discharge, which differ from typical Kaposi's sarcoma. *Parasite* - Parasitic infections can occur in HIV patients (e.g., **scabies** or **leishmaniasis**), but these typically present with different dermatological features like intensely itchy papules or nodular ulcerative lesions. - Lesions caused by parasites do not usually manifest as the violaceous, nodular, or plaque-like appearances seen in Kaposi's sarcoma. *Fungus* - Fungal infections in HIV patients can cause skin lesions (e.g., **candidiasis** with oral thrush or esophagitis, or **cryptococcosis** with molluscum-like lesions). - However, the morphology of these fungal lesions generally differs from the classic appearance of Kaposi's sarcoma or other common viral lesions in HIV.

Q: Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Intravenous sodium bicarbonate. ***Intravenous sodium bicarbonate*** - While it can drive potassium into cells, its effect is often **delayed and unreliable** in acute, dangerous hyperkalemia, especially without concurrent acidosis. - Its efficacy is most pronounced when hyperkalemia is associated with **metabolic acidosis**, which is not always the primary driving factor of dangerous hyperkalemia. *Calcium chloride injection* - This is a **first-line treatment** for dangerous hyperkalemia, as it **stabilizes the cardiac membrane** by antagonizing the direct effects of potassium on myocardial excitability [1]. - It does not lower serum potassium levels but **protects the heart** from life-threatening arrhythmias, buying time for other therapies to reduce potassium [1]. *Beta-2 agonist (Salbutamol)* - **Beta-2 agonists** like salbutamol are effective in shifting potassium **intracellularly**, thereby lowering serum potassium levels. - This effect is mediated by stimulating the **Na+/K+-ATPase pump** on cell membranes. *Dialysis (Hemodialysis)* - **Hemodialysis** is the **most effective and rapid** method for removing excess potassium from the body, especially in cases of severe or refractory hyperkalemia. - It provides definitive treatment by directly **filtering potassium** from the blood, and is often considered when other measures fail or in patients with kidney failure.

Q: Koplik spots are seen in?

Measles. ***Measles*** - **Koplik spots** are pathognomonic rash that appears as small, white spots with a bluish-white center on an erythematous base on the **buccal mucosa** opposite the second molars. - They typically appear 2-3 days before the onset of the characteristic maculopapular rash, during the **prodromal phase** of measles (rubeola). *Rubella* - Rubella, or **German measles**, presents with a milder rash, **lymphadenopathy**, and mild fever. - It does not cause Koplik spots; instead, **Forchheimer spots** (petechiae on the soft palate) may be seen, but these are less specific. *Mumps* - Mumps is characterized primarily by **parotitis** (swelling of the salivary glands), fever, and headache. - It does not present with Koplik spots or any characteristic oral mucosal lesions. *Varicella* - Varicella, or **chickenpox**, is characterized by a **vesicular rash** that progresses from macules to papules to vesicles to crusts, appearing in crops. - It does not involve Koplik spots; the rash is typically generalized and pruritic.

Question 1

In HIV patients, Kaposi's sarcoma is most likely caused by which of the following?

Accepted Answer

Virus

Answer

Bacteria

Answer

Parasite

Answer

Fungus

Question 2

Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Accepted Answer

Intravenous sodium bicarbonate

Answer

Calcium chloride injection

Answer

Beta-2 agonist (Salbutamol)

Answer

Dialysis (Hemodialysis)

Question 3

Koplik spots are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Mumps

Answer

Varicella

NEET-PG 2023

Internal Medicine

Pediatrics