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: What is the typical time between fertilization and implantation?

8 days. ***8 days*** - **Fertilization** typically occurs in the **fallopian tube**, and the resulting **zygote** then undergoes several cell divisions while migrating towards the uterus. - Implantation, the process by which the **blastocyst embeds into the uterine wall**, usually begins around day 6 post-fertilization and is completed by day 8-10. *2 days* - At 2 days post-fertilization, the embryo is typically in the **2-cell to 4-cell stage** and is still located within the fallopian tube, far from the implantation site. - This stage is too early for implantation to occur, as the embryo has not yet reached the **blastocyst stage** or the uterus. *14 days* - By 14 days post-fertilization, implantation would have long been completed, and the initial stages of **trophoblast development** and formation of the **placenta** would be underway. - This time frame represents a more advanced stage of pregnancy, whereas implantation is an early event. *16 days* - Sixteen days post-fertilization is well past the window for initial implantation; at this point, significant embryonic development has occurred, and the woman might even be experiencing early signs of **pregnancy**, such as a missed period. - Implantation is a much earlier process, concluding by day 10 at the latest.

Q: A pregnant woman with a known case of asthma is experiencing postpartum hemorrhage (PPH). Which drug is contraindicated?

Carboprost. ***Carboprost*** - **Carboprost** is a **prostaglandin F2-alpha analog** that causes strong uterine contractions but also leads to **bronchoconstriction** and increased airway resistance. - Due to its potent bronchoconstrictive effects, **carboprost** is **absolutely contraindicated in patients with asthma** as it can precipitate a severe asthmatic attack. *Methyl ergometrine* - **Methyl ergometrine** is an **ergot alkaloid** that causes sustained uterine contractions and is effective for PPH. - It is contraindicated in patients with **hypertension** or **pre-eclampsia** due to its vasoconstrictive properties, but not typically in asthma. *Misoprostol* - **Misoprostol** is a **prostaglandin E1 analog** used for PPH management, causing uterine contractions. - It is generally safe for use in patients with asthma as it does not have significant bronchoconstrictive side effects. *Oxytocin* - **Oxytocin** is a first-line uterotonic agent for PPH, working by causing rhythmic uterine contractions. - It is generally considered safe in patients with asthma and is not known to exacerbate respiratory conditions.

Q: In the image showing twin pregnancy where fetus A (first twin) is in breech presentation and fetus B (second twin) is in cephalic presentation, what is the recommended method of delivery for fetuses A and B respectively?

LSCS in both. ***LSCS in both*** - When the **first twin (Twin A) is in breech presentation**, current guidelines recommend **cesarean section (LSCS) for BOTH twins** - This avoids significant risks including **head entrapment**, **umbilical cord prolapse**, and **birth trauma** associated with vaginal breech delivery of the first twin - Once a cesarean section is performed for Twin A, delivering Twin B through the same uterine incision is **safer and standard practice** rather than attempting vaginal delivery - **ACOG guidelines** and the **Twin Birth Study (2013)** support cesarean delivery for both twins when Twin A is non-cephalic *LSCS, vaginal* - Delivering Twin A by cesarean section and then attempting **vaginal delivery of Twin B is NOT standard practice** and carries unnecessary risks - After opening the uterus for Twin A, delivering Twin B vaginally would leave an **unsutured uterine incision** with risks of hemorrhage and complications - This mixed approach is **not recommended** in modern obstetric practice *Vaginal, LSCS* - Attempting **vaginal breech delivery for Twin A** is associated with significantly higher risks of fetal morbidity and mortality - The sequence described (vaginal then LSCS) is illogical and not practiced clinically *Induce delivery in both* - **Induction of labor** refers to initiating contractions but does not address the **mode of delivery** (vaginal vs cesarean) - The **presentation of Twin A** is the primary determinant of delivery method, and breech presentation of the first twin is an indication for cesarean delivery regardless of induction

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 G2P1L1 woman with a history of previous cesarean section presents with complications related to the placenta. The image below shows the gross appearance of the uterus with abnormal placental attachment to the uterine wall. What is the most likely diagnosis?

Placenta accreta. ***Placenta accreta*** - This diagnosis is strongly suggested by the image showing the **placenta adhered directly to the myometrium**, without invading through the uterine muscular wall. - The history of a **previous cesarean section** is a significant risk factor for placenta accreta, as prior uterine surgery can alter endometrial integrity. *Placenta abruption* - This condition involves the **premature separation of the placenta** from the uterine wall after 20 weeks of gestation but before birth. - It is characterized by symptoms such as **abdominal pain**, **vaginal bleeding**, and **uterine tenderness**, which are not directly depicted by abnormal placental attachment in the image. *Placenta percreta* - This represents the most severe form of abnormal placental adherence, where the **chorionic villi invade through the entire uterine wall** and into adjacent organs like the bladder. - While it shares risk factors with accreta, the image showing attachment "to the uterine wall" rather than invasion *through* it makes percreta less likely. *Placenta previa* - In this condition, the **placenta implants over or near the internal cervical os**, potentially blocking the birth canal. - The image describes abnormal placental attachment *to the uterine wall*, not its position relative to the cervix, differentiating it from placenta previa.

Q: Identify the instrument shown in the image below:

Kielland. ***Kielland*** - Kielland forceps are distinguished by their **lack of pelvic curve** and the presence of a sliding lock mechanism designed for **rotation of the fetal head**. - They are primarily used for **rotational delivery** when the fetal head is in malposition, often in the mid-pelvis. *Simpson* - Simpson forceps have a distinct **cephalic curve** for grasping the fetal head and a **pelvic curve** to conform to the birth canal. - They are commonly used for **outlet and low-cavity deliveries** where minimal rotation is needed. *Wrigley* - Wrigley forceps are a type of **outlet forceps** with a very short shanks and blades, making them suitable only when the fetal head is on the **perineum**. - They are designed for situations where the head is already visible without separating the labia. *Pipers* - Pipers forceps are specifically designed for **delivery of the after-coming head in breech presentations**. - They feature a long, curved shank that allows placement from below the maternal pelvis to grasp the fetal head in this particular presentation.

Q: Which of the following is not a contraindication for External Cephalic Version (ECV)?

Primigravida. ***Primigravida*** - Being a **primigravida** (first pregnancy) is not a contraindication for ECV, though it might be associated with a slightly lower success rate compared to multiparous women due to a less pliable uterus. - While it may indicate a potentially more challenging ECV due to higher uterine tone, it does not preclude the procedure if other conditions are favorable. *Placenta previa* - **Placenta previa** is a contraindication because the manipulation of the uterus during ECV could dislodge the placenta, leading to **severe hemorrhage** and potential fetal compromise. - This condition involves the placenta covering the cervical opening, making any uterine intervention risky. *Twin pregnancy* - **Twin pregnancy** is a contraindication as ECV is generally not recommended in multiple gestations due to increased complexity and risk of complications. - The risk of **umbilical cord entanglement**, disruption of twin positioning, and potential harm to either fetus makes ECV unsafe in twin pregnancies. *PROM (Premature Rupture of Membranes)* - **Premature Rupture of Membranes (PROM)** is a contraindication due to the increased risk of uterine infection and **cord prolapse** during manipulation. - Once membranes are ruptured, the natural cushioning provided by the amniotic fluid is lost, making ECV potentially traumatic for both the mother and the fetus.

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

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 4

What is the typical time between fertilization and implantation?

Accepted Answer

8 days

Answer

2 days

Answer

14 days

Answer

16 days

Question 5

A pregnant woman with a known case of asthma is experiencing postpartum hemorrhage (PPH). Which drug is contraindicated?

Accepted Answer

Carboprost

Answer

Methyl ergometrine

Answer

Misoprostol

Answer

Oxytocin

Question 6

In the image showing twin pregnancy where fetus A (first twin) is in breech presentation and fetus B (second twin) is in cephalic presentation, what is the recommended method of delivery for fetuses A and B respectively?

Accepted Answer

LSCS in both

Answer

Vaginal, LSCS

Answer

Induce delivery in both

Answer

LSCS, vaginal

Question 7

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 8

A G2P1L1 woman with a history of previous cesarean section presents with complications related to the placenta. The image below shows the gross appearance of the uterus with abnormal placental attachment to the uterine wall. What is the most likely diagnosis?

Accepted Answer

Placenta accreta

Answer

Placenta abruption

Answer

Placenta percreta

Answer

Placenta previa

Question 9

Identify the instrument shown in the image below:

Accepted Answer

Kielland

Answer

Simpson

Answer

Wrigley

Answer

Pipers

Question 10

Which of the following is not a contraindication for External Cephalic Version (ECV)?

Accepted Answer

Primigravida

Answer

Placenta previa

Answer

Twin pregnancy

Answer

PROM (Premature Rupture of Membranes)

NEET-PG 2024

Anatomy

Biochemistry

OB/GYN

Obstetrics and Gynecology