NEET-PG 2024 Practice Questions

Q: A patient does not understand the meaning of the doctor's words. What type of barrier does this represent?

Linguistic. ***Linguistic*** - This barrier occurs when there is a **lack of shared language** or when an individual does not understand the specific **vocabulary or jargon** being used. - In a medical context, this often manifests as a patient not understanding complex medical terms or explanations. *Cultural* - This barrier arises from differences in **beliefs, values, customs, or social norms** between individuals. - It would involve misunderstandings based on cultural perspectives rather than the literal meaning of words themselves. *Psychological* - This type of barrier relates to the emotional or mental state of the individuals involved, such as **anxiety, fear, or a lack of attention**. - While emotional factors can affect understanding, the core issue described here is specifically about the comprehension of words. *Environmental* - This barrier refers to **physical distractions or unsuitable surroundings** that hinder effective communication. - Examples include noise, inadequate privacy, or uncomfortable settings, which are not suggested by the patient's inability to understand the doctor's words. *Physical* - This barrier involves **sensory impairments** such as hearing loss, visual deficits, or speech difficulties. - While physical impairments can affect communication, the scenario describes comprehension of word meaning rather than sensory limitations.

Q: A patient with homocystinuria presents with ectopia lentis (dislocation of the lens). Which vitamin should be supplemented?

Vitamin B6. ***Vitamin B6*** - Many cases of **homocystinuria** are due to a deficiency in **cystathionine beta-synthase (CBS)**, an enzyme that requires **pyridoxal phosphate (active B6)** as a cofactor. - Supplementing with **high doses of vitamin B6** can significantly improve outcomes in patients with **B6-responsive homocystinuria** by increasing residual CBS enzyme activity. *Vitamin B12* - While vitamin B12 (cobalamin) is a cofactor for **methionine synthase**, an enzyme involved in homocysteine metabolism, it is not the primary treatment for **homocystinuria due to CBS deficiency**. - B12 deficiency can lead to increased homocysteine levels, but B12 supplementation alone will not address the underlying enzyme defect in most cases of homocystinuria. *Thiamine* - **Thiamine (Vitamin B1)** is essential for carbohydrate metabolism and nerve function, but it has no direct role in the metabolic pathway involved in homocystinuria. - Thiamine deficiency causes **beriberi** and **Wernicke-Korsakoff syndrome**, symptoms distinctly different from homocystinuria. *Vitamin B9 (Folate)* - **Folate** is a cofactor for **methionine synthase**, working alongside vitamin B12 to convert homocysteine back to methionine. - While folate deficiency can contribute to hyperhomocysteinemia, it is not the primary therapeutic intervention for homocystinuria caused by **CBS deficiency**. *Vitamin C* - **Vitamin C (ascorbic acid)** is important for collagen synthesis and acts as an antioxidant, but it has no role in homocysteine metabolism or the treatment of homocystinuria. - Vitamin C deficiency causes **scurvy**, which presents with bleeding gums, petechiae, and poor wound healing—completely unrelated to homocystinuria.

Q: A study recorded the survival times (in months) of 8 patients diagnosed with pancreatic cancer who received a new chemotherapy regimen. The survival times were: 2, 3, 4, 4, 5, 6, 7, 8 months. What is the median survival time for these patients?

4.5. ***4.5*** - The given survival times are already ordered: 2, 3, 4, 4, 5, 6, 7, 8. - Since there is an **even number of observations (n=8)**, the median is the average of the two middle values, which are the 4th and 5th values. (4 + 5) / 2 = **4.5**. *3.5* - This value would result from incorrectly averaging the 3rd and 4th observations (3 + 4) / 2 = 3.5. - This error occurs when miscounting the middle positions in an even-numbered dataset. *4.0* - This value represents the **fourth observation** in the ordered list, not the true median for an even number of data points. - While it is one of the middle values, the median for an even dataset requires averaging the two middle-most values. *5.0* - This value represents the **fifth observation** in the ordered list, not the true median for an even number of data points. - It would be the median if the dataset contained an odd number of observations and 5 was the middle term. *5.5* - This value would be the mean of 5 and 6, which are the 5th and 6th values, not the correct middle values. - This calculation does not represent the correct methodology for finding the median in this dataset.

Q: Which of the following diseases has the largest submerged portion in the iceberg model of disease?

Influenza. **The Iceberg Model of Disease** represents the concept that for many diseases, only a small portion of cases (the "tip" above water) are clinically apparent and reported, while a much larger portion (the "submerged" part) consists of asymptomatic, subclinical, or undiagnosed cases. ***Influenza*** - Has the **largest submerged portion** among the given options, with **50-75% of infections being asymptomatic or mild** and going undiagnosed - High transmissibility and varied clinical presentation contribute to significant hidden burden - Only severe cases requiring hospitalization typically get reported, representing just the "tip of the iceberg" - Classic example of diseases with large subclinical-to-clinical ratio *Chickenpox* - Most cases are **clinically apparent** with characteristic vesicular rash - Asymptomatic infections are rare due to distinctive clinical features - High visibility of cases reduces the submerged portion significantly *Tetanus* - **Severe, acute neurological condition** with distinct clinical manifestations (trismus, risus sardonicus, opisthotonus) - Almost all cases are diagnosed due to dramatic presentation - Virtually no submerged portion - what exists clinically is recognized *Rabies* - **Nearly uniformly fatal** once symptoms appear, making all symptomatic cases clinically evident - No asymptomatic or mild phase after symptom onset - Minimal to no submerged portion in the iceberg model

Q: A patient presents with eye ache and difficulty in vision after watching a movie. What will be the first line of management?

Mannitol with Pilocarpine. ***Mannitol with Pilocarpine*** - This combination is appropriate for **acute angle-closure glaucoma (AACG)**, which can be triggered by pupillary dilation (e.g., in a dark movie theater). **Mannitol** is an osmotic diuretic that rapidly reduces intraocular pressure. - **Pilocarpine** is a miotic agent that constricts the pupil, pulling the iris away from the trabecular meshwork and opening the drainage angle to facilitate aqueous humor outflow. *Mannitol with Moxifloxacin* - While mannitol helps with intraocular pressure, **Moxifloxacin is an antibiotic** used to treat bacterial infections. - There is no indication of an ocular infection in this scenario, so an antibiotic would not be the first-line treatment for sudden eye pain and vision difficulty after watching a movie. *Mannitol with Atropine* - Adding **Atropine, a cycloplegic agent**, would cause further pupillary dilation, which would worsen acute angle-closure glaucoma and increase intraocular pressure. - Atropine is contraindicated in AACG and would exacerbate the patient's condition. *Mannitol with lubricating eye drops* - While mannitol helps with intraocular pressure, **lubricating eye drops** are used for dry eyes or surface irritation, not for acute angle-closure glaucoma. - Lubricating drops do not address the underlying pathology of increased intraocular pressure due to angle closure.

Q: A patient presents with sudden painful diminution of vision, difficulty looking in light (photophobia), and circumcorneal congestion with hypopyon. What is the most likely diagnosis?

Acute anterior uveitis. ***Acute anterior uveitis*** - The constellation of **sudden painful diminution of vision**, **photophobia**, **circumcorneal congestion**, and **hypopyon** (pus in the anterior chamber, visible as a whitish fluid level in the image) is highly characteristic of acute anterior uveitis. - This condition involves inflammation of the iris and ciliary body, leading to these severe symptoms and signs. *Acute conjunctivitis* - Characterized by **redness**, **itching**, and **discharge**, but typically lacks significant pain, photophobia, or vision loss. - Hypopyon is not a feature of acute conjunctivitis; the congestion is diffuse and not pericorneal. *Episcleritis* - Presents with **localized redness** and mild discomfort, but generally without pain, photophobia, or vision changes. - Episcleritis does not typically involve the anterior chamber with hypopyon. *Acute congestive glaucoma* - Involves severe eye pain, blurred vision, ciliary congestion, and often a **fixed, mid-dilated pupil** due to acutely elevated intraocular pressure. - While it shares some symptoms like pain, photophobia, and blurred vision, **hypopyon is not a typical finding** in acute congestive glaucoma, which differentiates it from uveitis.

Q: A patient presents with a nodular swelling near the limbus, which does not blanch with topical vasoconstrictors and recurs after treatment. Based on the image and clinical presentation, what is the most probable diagnosis?

Scleritis with rheumatoid arthritis. ***Scleritis with rheumatoid arthritis*** - The image shows **deep, violaceous conjunctival injection** with surrounding edema and a nodular appearance near the limbus, consistent with **nodular scleritis**. Scleritis is inflammation of the sclera, often characterized by severe pain and association with systemic autoimmune diseases like **rheumatoid arthritis**, which can cause destructive lesions and recurrence. - The characteristic **deep vessel engorgement that does not blanch with phenylephrine** and the history of recurrence further support scleritis. *Episcleritis with rheumatoid arthritis* - Episcleritis presents with a **more superficial, bright red injection** involving the episclera, which generally **blanches with topical phenylephrine** and is less painful than scleritis. - While episcleritis can be associated with rheumatoid arthritis, the clinical features described (nodular swelling, deep injection) are more typical of scleritis. *Pinguecula* - A pinguecula is a **yellowish patch or bump** on the conjunctiva, typically on the nasal side of the eye, that is **not inflamed** unless irritated. - It consists of **degenerated collagen fibers** and elastic tissue, and does not present with the diffuse, deep vascular injection seen in the image. *Dry eye* - Dry eye is characterized by **ocular dryness, irritation, and sometimes a foreign body sensation**, but it typically causes **diffuse conjunctival hyperemia** rather than a localized, nodular, deep inflammation with surrounding edema as shown. - While dry eye can be associated with autoimmune diseases, its appearance is not consistent with the depicted nodular lesion.

Q: A baby presents with hydrocephalus, intracranial calcifications, and chorioretinitis. What is the most probable diagnosis?

Toxoplasmosis. **Toxoplasmosis** - The classic triad of **hydrocephalus**, **intracranial calcifications**, and **chorioretinitis** is highly characteristic of congenital toxoplasmosis. - These findings result from the parasite's invasive nature and predilection for the central nervous system and eyes of the developing fetus. - Calcifications in toxoplasmosis are typically **diffuse and scattered** throughout the brain parenchyma. *Syphilis* - Congenital syphilis typically presents with **rhinitis**, **skin rash**, **hepatosplenomegaly**, and **bone abnormalities** (e.g., periostitis, saber shins). - While neurological complications can occur, the specific triad of hydrocephalus, intracranial calcifications, and chorioretinitis is not characteristic. *Cytomegalovirus (CMV) infection* - Congenital CMV can cause **periventricular calcifications** (not diffuse calcifications), **microcephaly**, and **sensorineural hearing loss**. - While chorioretinitis can occur, hydrocephalus is less frequent, and the calcification pattern differs from toxoplasmosis (CMV shows periventricular pattern vs. diffuse in toxoplasmosis). *Rubella* - Congenital rubella syndrome is known for causing the classic triad of **cataracts**, **sensorineural hearing loss**, and **congenital heart defects** (e.g., patent ductus arteriosus, pulmonary artery stenosis). - Intracranial calcifications and hydrocephalus are not typical presentations of congenital rubella. *Herpes Simplex Virus (HSV) infection* - Neonatal HSV typically presents with **vesicular skin lesions**, **encephalitis**, and **disseminated disease** affecting liver and lungs. - While HSV can cause encephalitis with brain involvement, the classic triad of hydrocephalus, diffuse intracranial calcifications, and chorioretinitis is not characteristic of HSV infection.

Q: A mother delivers in a rural area under the guidance of a skilled care attendant. Which of the following statements is incorrect regarding the care provided by the skilled care attendant at birth?

Bathe the baby with warm water. ***Bathe the baby with warm water*** - **Delaying the first bath** for at least 6-24 hours after birth is recommended to prevent **hypothermia** and promote **skin-to-skin contact** for bonding and breastfeeding. - Early bathing can remove **vernix caseosa**, which provides natural antimicrobial protection and moisturization to the newborn's skin. *Start breastfeeding as early as possible* - **Early initiation of breastfeeding**, ideally within the first hour of birth, is crucial for both mother and baby. - It promotes **uterine contractions** to prevent **postpartum hemorrhage** and provides the newborn with **colostrum**, rich in antibodies. *Cover the baby's head and body* - Covering the newborn's head and body is essential to prevent **heat loss** and maintain a stable **body temperature**, immediately after birth. - Newborns are highly susceptible to **hypothermia** due to their large surface area to mass ratio and immature thermoregulation. *Clear the eyes with a sterile swab* - Clearing the newborn's eyes with a sterile swab is a standard part of immediate newborn care to remove any **mucus or blood** that might have entered during delivery. - This helps prevent **ophthalmia neonatorum**, especially if the mother has an infection like gonorrhea or chlamydia. *Dry the baby thoroughly and stimulate breathing* - **Drying the baby immediately** after birth is a critical first step in newborn resuscitation and care. - It helps prevent **hypothermia** and provides **tactile stimulation** to initiate breathing and crying, which is essential for transitioning from fetal to neonatal circulation.

Question 1

A patient does not understand the meaning of the doctor's words. What type of barrier does this represent?

Accepted Answer

Linguistic

Answer

Cultural

Answer

Psychological

Answer

Environmental

Answer

Physical

Question 2

A patient with homocystinuria presents with ectopia lentis (dislocation of the lens). Which vitamin should be supplemented?

Accepted Answer

Vitamin B6

Answer

Vitamin B12

Answer

Thiamine

Answer

Vitamin B9 (Folate)

Answer

Vitamin C

Question 3

A study recorded the survival times (in months) of 8 patients diagnosed with pancreatic cancer who received a new chemotherapy regimen. The survival times were: 2, 3, 4, 4, 5, 6, 7, 8 months. What is the median survival time for these patients?

Accepted Answer

4.5

Answer

4.0

Answer

5.0

Answer

5.5

Answer

3.5

Question 4

Which of the following diseases has the largest submerged portion in the iceberg model of disease?

Accepted Answer

Influenza

Answer

Chickenpox

Answer

Tetanus

Answer

Rabies

Question 5

A patient presents with eye ache and difficulty in vision after watching a movie. What will be the first line of management?

Accepted Answer

Mannitol with Pilocarpine

Answer

Mannitol with Moxifloxacin

Answer

Mannitol with Atropine

Answer

Mannitol with lubricating eye drops

Question 6

A patient presents with sudden painful diminution of vision, difficulty looking in light (photophobia), and circumcorneal congestion with hypopyon. What is the most likely diagnosis?

Accepted Answer

Acute anterior uveitis

Answer

Acute conjunctivitis

Answer

Episcleritis

Answer

Acute congestive glaucoma

Question 7

A patient presents with a nodular swelling near the limbus, which does not blanch with topical vasoconstrictors and recurs after treatment. Based on the image and clinical presentation, what is the most probable diagnosis?

Accepted Answer

Scleritis with rheumatoid arthritis

Answer

Episcleritis with rheumatoid arthritis

Answer

Pinguecula

Answer

Dry eye

Question 8

A child presenting with leukocoria has an intraocular mass. Microscopic examination shows rosettes with scanty cytoplasm and positive synaptophysin. What is the most likely diagnosis?

Accepted Answer

Retinoblastoma

Answer

Medulloblastoma

Answer

Neuroblastoma

Answer

Ependymoma

Question 9

A baby presents with hydrocephalus, intracranial calcifications, and chorioretinitis. What is the most probable diagnosis?

Accepted Answer

Toxoplasmosis

Answer

Syphilis

Answer

Cytomegalovirus (CMV) infection

Answer

Rubella

Answer

Herpes Simplex Virus (HSV) infection

Question 10

A mother delivers in a rural area under the guidance of a skilled care attendant. Which of the following statements is incorrect regarding the care provided by the skilled care attendant at birth?

Accepted Answer

Bathe the baby with warm water

Answer

Start breastfeeding as early as possible

Answer

Cover the baby's head and body

Answer

Clear the eyes with a sterile swab

Answer

Dry the baby thoroughly and stimulate breathing

NEET-PG 2024

Behavioral Science

Biochemistry

Biostatistics

Community Medicine

Ophthalmology

Pathology

Pediatrics