NEET-PG 2024 Practice Questions

Q: At what age does maximum brain growth occur?

6 months. ***6 months*** - **Brain growth** is most rapid during the early postnatal period, with the brain reaching almost **50% of its adult size by 6 months of age**. - This period involves rapid **synaptogenesis** and myelination, crucial for early cognitive and motor development. *1 year* - While significant **brain growth** continues, the peak rate of increase in brain volume has typically passed by 1 year. - At this age, the brain has reached approximately **75% of its adult size**. *2 years* - By 2 years, the brain is about **80% of its adult size**, indicating ongoing but slower growth compared to the first year. - This period is more characterized by refinement of neural circuits rather than rapid volumetric expansion. *3 years* - At 3 years, the brain has attained around **90% of its adult size**, though important developmental changes continue. - The rate of **neural development** at this stage largely focuses on strengthening existing connections and pruning less used ones. *5 years* - By 5 years, the brain has reached approximately **90-95% of its adult size**, with growth significantly slower than in earlier years. - Development at this age focuses primarily on **synaptic pruning** and refinement of neural networks rather than volumetric growth.

Q: The Image shows the growth curve of different organs with age. Identify A in the graph

Brain Growth. ***Brain Growth*** - This graph shows a rapid increase in size during early childhood, reaching near-adult proportions by age 5-6, which is characteristic of **brain development**. - The brain undergoes significant myelinization and neuronal growth in the first few years of life, reflected in this steep curve. *Somatic Growth* - **Somatic growth** (body as a whole) generally follows a more gradual S-shaped curve, with two major growth spurts: one in infancy and another during puberty. - It does not plateau as early as curve A, but continues to increase significantly through adolescence. *Lymphoid Growth* - **Lymphoid tissues** (e.g., thymus, lymph nodes) show a unique growth pattern, peaking in size around 10-12 years of age and then involuting or decreasing in size during adolescence. - This pattern is distinctly different from curve A, which continuously increases and plateaus. *Gonadal Growth* - **Gonadal growth** (reproductive organs) typically shows minimal growth during childhood, with a pronounced and rapid increase in size starting at puberty (around 10-14 years of age). - This growth pattern is a later and more delayed surge compared to what is depicted in curve A. *Reproductive Growth* - **Reproductive growth** follows essentially the same pattern as gonadal growth, with minimal development during childhood and rapid acceleration during puberty. - Like gonadal tissues, reproductive organs show their major growth spurt much later than the early plateau seen in curve A.

Q: The flexion point in ventouse (vacuum) delivery is located at:

3 cm anterior to the posterior fontanelle. ***3 cm anterior to the posterior fontanelle*** - This is the **correct location of the flexion point** (also described as approximately 6 cm posterior to the anterior fontanelle along the sagittal suture). - This position optimizes the **flexion-traction axis** during vacuum extraction, ensuring that the fetal head descends through the birth canal in the most favorable attitude with maximum flexion. - Correct placement of the vacuum cup at this site provides a **mechanical advantage**, leveraging the natural pivot point of the fetal head for effective delivery and bringing the **occiput** down first. *3 cm posterior to the anterior fontanelle* - This location is **too far anterior**, only 3 cm from the anterior fontanelle, and does not correspond to the true flexion point. - Placing the cup here would result in **suboptimal flexion** and poor mechanical advantage during traction. - This may lead to **cup slippage**, increased rate of failed vacuum delivery, and potential scalp injury. *6 cm anterior to the posterior fontanelle* - Since the distance between fontanelles is approximately 9 cm, this position would be equivalent to 3 cm posterior to the anterior fontanelle (too anterior). - This is **not the correct flexion point** and would result in the same problems as placing the cup too far anterior. *Midway between the anterior and posterior fontanelle* - While this location (approximately 4.5 cm from either fontanelle) might seem intuitive, it does not precisely correspond to the optimal **flexion point** for vacuum extraction. - The true flexion point is slightly more posterior, at **3 cm anterior to the posterior fontanelle**, which optimizes the mechanism of labor.

Q: A 3-year-old child presents to the OPD with a history of recurrent urinary tract infections, poor urinary stream, and difficulty voiding. The radiological image is shown below. What is the most appropriate management?

Endoscopic ablation. ***Endoscopic ablation*** - The image shows a distended bladder with a dilated, elongated posterior urethra and a narrow stream of contrast beyond the bladder neck, characteristic findings of **posterior urethral valves (PUV)**. - **Endoscopic ablation (incision or fulguration)** of the valves is the definitive treatment for PUV to relieve obstruction and prevent further kidney damage. - This is the **gold standard primary treatment** for PUV in children who are large enough to undergo the procedure safely. *Dilation of urethra* - **Dilation** is generally ineffective because PUV are folds of tissue that require incision rather than simple stretching. - This approach does not address the underlying anatomical obstruction caused by the valves and could potentially cause damage to the urethra. *Dilation of urethra and bladder* - **Dilation of the urethra** is not an effective treatment for PUV. The bladder is already dilated due to the obstruction, and further dilation would not resolve the issue. - This approach would not remove the obstruction and could worsen bladder function or lead to further complications like reflux. *Conservative* - **Conservative management** with watchful waiting is not appropriate for PUV, as untreated obstruction can lead to progressive and irreversible kidney damage, bladder dysfunction, and recurrent UTIs. - Timely intervention is crucial to preserve renal function and improve long-term outcomes in boys with PUV. *Vesicostomy* - **Vesicostomy** (temporary bladder diversion) is reserved for specific scenarios such as neonates or very young infants too small for safe endoscopic ablation, severe hydronephrosis with renal failure, or failed primary ablation. - In this **3-year-old child**, endoscopic ablation is preferred as the primary definitive treatment rather than temporary diversion, which would require a second procedure later.

Q: An unimmunized 5 -year-old child presents to the OPD with a white membranous layer on the throat upon inspection. The child's brother is immunized. What is the first step in management?

Diphtheria antitoxin. ***Diphtheria antitoxin*** - The presence of a **white membranous layer** on the **throat** in an **unimmunized child**, along with the high contagiousness (brother's immunization is relevant to exposure), strongly suggests **diphtheria**. - **Diphtheria antitoxin (DAT)** is the crucial first-line treatment to neutralize the **exotoxin** produced by *Corynebacterium diphtheriae*, which is responsible for the severe systemic effects. - Antitoxin must be administered **immediately** without waiting for culture confirmation, as it only neutralizes unbound toxin. *Diphtheria toxoid* - **Diphtheria toxoid** is used for **active immunization** (vaccination) to prevent diphtheria, not for emergency treatment of an active infection. - Administering toxoid during an acute infection would not rapidly neutralize the circulating toxin. *Penicillin* - **Penicillin** (or erythromycin) is used to **eradicate the bacteria** (*Corynebacterium diphtheriae*) from the patient's throat and prevent further toxin production and transmission. - While important for source control, it does not neutralize the pre-formed toxin, which is the immediate threat to life. - Antibiotics should be given **after** antitoxin administration. *Isolation and supportive care* - **Isolation** is essential to prevent transmission, but it does not treat the patient's infection. - **Supportive care** is also crucial, but it addresses symptoms rather than the underlying cause or the effects of the toxin. *Tracheostomy* - **Tracheostomy** may be required later for airway obstruction if the membrane extends to the larynx or causes significant respiratory compromise. - However, it is **not the first step** in management; securing airway patency comes after antitoxin administration unless there is immediate life-threatening airway obstruction. - The priority is neutralizing the toxin to prevent further membrane formation and systemic complications.

Q: A 6-week-old baby is brought in by the mother with complaints of vomiting. An X-ray shows a single bubble appearance. What is the most likely diagnosis?

Congenital hypertrophic pyloric stenosis (CHPS). ***Congenital hypertrophic pyloric stenosis (CHPS)*** - The **single bubble appearance** observed in the X-ray, along with vomiting in a 6-week-old, is characteristic of an obstruction at the gastric outlet due to **pyloric stenosis**. The "bubble" represents the dilated stomach. - Infants with CHPS typically present with **non-bilious projectile vomiting** around 3-6 weeks of age, often accompanied by good appetite. *Duodenal atresia* - This condition classically presents with a **"double bubble" sign** on X-ray, representing dilation of the stomach and the proximal duodenum. - Vomiting is usually **bilious** and occurs earlier, often from birth. *Annular pancreas* - Annular pancreas can cause duodenal obstruction, leading to a **"double bubble" sign** similar to duodenal atresia. - The presentation would also be earlier, typically with **bilious vomiting** from birth or shortly thereafter. *Jejunal atresia* - Jejunal atresia would result in **multiple dilated loops of small bowel** proximal to the obstruction with air-fluid levels, rather than a single bubble. - The vomiting would be **bilious** and abdominal distension would be more prominent. *Malrotation with midgut volvulus* - This presents with **bilious vomiting** and can occur at any age, though commonly in the first few weeks of life. - X-ray findings include a **"corkscrew" or "whirl" sign** on contrast studies, or a gasless abdomen if complete obstruction occurs. - Unlike the single bubble of pyloric stenosis, malrotation typically shows abnormal bowel gas patterns or a paucity of gas in the abdomen.

Question 1

At what age does maximum brain growth occur?

Accepted Answer

6 months

Answer

1 year

Answer

2 years

Answer

3 years

Answer

5 years

Question 2

The Image shows the growth curve of different organs with age. Identify A in the graph

Accepted Answer

Brain Growth

Answer

Somatic Growth

Answer

Lymphoid Growth

Answer

Gonadal Growth

Answer

Reproductive Growth

Question 3

An infant presents with vomiting after feeding. Benedict's test was positive for a non-glucose reducing substance. What is the most likely diagnosis?

Accepted Answer

Galactosemia due to GAL-1-P Uridyl Transferase enzyme deficiency

Answer

Fructosuria due to Fructokinase deficiency

Answer

Hereditary fructose intolerance due to Aldolase B deficiency

Answer

Primary lactose intolerance

Answer

Glycogen storage disease due to Glucose-6-phosphatase deficiency

Question 4

Which disease will show the mode of inheritance depicted in this pedigree?

Accepted Answer

Achondroplasia

Answer

Prader-Willi syndrome

Answer

Wilson disease

Answer

Wiskott-Aldrich syndrome

Answer

Hemophilia A

Question 5

A mother brings her 14 -year-old mentally retarded son to the OPD, who is suffering from joint pain and has an irresistible urge to bite his fingers and lips. His serum uric acid level was found to be elevated. What is the disorder?

Accepted Answer

Lesch-Nyhan syndrome

Answer

Xanthine oxidase deficiency

Answer

CPS II defect

Answer

Thymidylate synthetase

Answer

Von Gierke disease

Question 6

The flexion point in ventouse (vacuum) delivery is located at:

Accepted Answer

3 cm anterior to the posterior fontanelle

Answer

3 cm posterior to the anterior fontanelle

Answer

6 cm anterior to the posterior fontanelle

Answer

Midway between the anterior and posterior fontanelle

Question 7

A 3-year-old child presents to the OPD with a history of recurrent urinary tract infections, poor urinary stream, and difficulty voiding. The radiological image is shown below. What is the most appropriate management?

Accepted Answer

Endoscopic ablation

Answer

Dilation of urethra

Answer

Dilation of urethra and bladder

Answer

Conservative

Answer

Vesicostomy

Question 8

An unimmunized 5 -year-old child presents to the OPD with a white membranous layer on the throat upon inspection. The child's brother is immunized. What is the first step in management?

Accepted Answer

Diphtheria antitoxin

Answer

Diphtheria toxoid

Answer

Penicillin

Answer

Isolation and supportive care

Answer

Tracheostomy

Question 9

An unimmunized 5 -year-old child presents to the OPD with a white membranous layer on inspection, suggesting diphtheria. What is the appropriate prophylaxis for a 2 -year-old contact who has completed their vaccination?

Accepted Answer

Penicillin

Answer

No prophylaxis needed

Answer

Toxoid

Answer

Immunoglobulins

Answer

Erythromycin

Question 10

A 6-week-old baby is brought in by the mother with complaints of vomiting. An X-ray shows a single bubble appearance. What is the most likely diagnosis?

Accepted Answer

Congenital hypertrophic pyloric stenosis (CHPS)

Answer

Duodenal atresia

Answer

Annular pancreas

Answer

Jejunal atresia

Answer

Malrotation with midgut volvulus

NEET-PG 2024

Anatomy

Biochemistry

Obstetrics and Gynecology

Pediatrics