NEET-PG 2012 Practice Questions

Q: Which vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?

Thiamine. ***Thiamine*** - **Thiamine** (Vitamin B1) deficiency is extremely common in chronic alcoholics due to **poor dietary intake**, impaired absorption, and increased excretion. - Deficiency can lead to serious neurological complications like **Wernicke-Korsakoff syndrome**, characterized by confusion, ataxia, and ophthalmoplegia. *Pyridoxine* - **Pyridoxine** (Vitamin B6) deficiency can occur in alcoholics, but it is less common and less clinically significant than thiamine deficiency. - While it can manifest as peripheral neuropathy or **sideroblastic anemia**, it is not the most common or critical deficiency in this population. *Riboflavin* - **Riboflavin** (Vitamin B2) deficiency can also be seen in chronic alcoholics due to poor nutrition. - Symptoms like **cheilosis** and **angular stomatitis** are mild compared to the severe neurological consequences of thiamine deficiency. *Niacin* - **Niacin** (Vitamin B3) deficiency, known as **pellagra**, is rare in developed countries but can occur in severe malnutrition, including in some alcoholics. - Pellagra presents with the "3 Ds": **dermatitis**, **diarrhea**, and **dementia**, but it is generally less prevalent than thiamine deficiency in alcohol use disorders.

Q: What is the maximum cumulative dose of isotretinoin for acne treatment?

120-150 mg/kg. ***120-150 mg/kg*** - The goal of **isotretinoin cumulative dosing** is to achieve long-term remission and reduce the risk of relapse. - A cumulative dose in the range of **120-150 mg/kg** has been shown to optimize treatment outcomes for severe or recalcitrant acne. *30-60 mg/kg* - This range is typically considered too low to achieve the optimal **cumulative dose** for sustained remission in severe acne. - Doses within this range might be used in some cases for milder forms of acne or in patients with significant side effects, but not as the standard maximum. *60-90 mg/kg* - While this is closer to an effective cumulative dose, it still often falls short of the recommended range for maximizing the long-term efficacy and reducing relapse rates in patients with severe forms of acne. - Studies suggest that higher cumulative doses correlate with better treatment success and fewer recurrences. *90-120 mg/kg* - This range is often considered a minimal target for a **cumulative dose**, especially at the higher end of the range (120 mg/kg). - While effective for many patients, aiming for the upper end (120-150 mg/kg) often provides a more robust and durable response, particularly in more severe or nodular acne.

Q: Loss of intercellular cohesion between keratinocytes is referred to as?

Acantholysis. ***Acantholysis*** - This term specifically refers to the **loss of cohesion between keratinocytes** in the epidermis due to the breakdown of desmosomal attachments. - It is a hallmark feature of several **blistering skin diseases**, such as pemphigus. *Acanthosis* - This refers to the **thickening of the stratum spinosum** (prickle cell layer) of the epidermis, often due to an increase in the number of keratinocytes. - It is seen in conditions like **psoriasis** and seborrheic keratosis, but does not involve a loss of intercellular cohesion. *Keratinolysis* - This term describes the **breakdown or dissolution of keratin**, which is the primary structural protein of the epidermis. - While keratinocytes produce keratin, keratinolysis itself is not the specific term for loss of cohesion between these cells. *Spongiosis* - This is defined as **intercellular edema** (fluid accumulation) within the epidermis, especially prominent in the stratum spinosum. - It leads to the widening of intercellular spaces and stretching of desmosomes, but the cells generally remain attached, unlike in acantholysis.

Q: Which of the following statements about spider telangiectasia is false?

More common in males. ***More common in males*** - This statement is **FALSE** because spider telangiectasias (spider nevi/spider angiomas) are more commonly observed in **females**, often due to hormonal influences like **estrogen**. - They are frequently associated with conditions such as **pregnancy**, **oral contraceptive use**, or **chronic liver disease**, highlighting a female predominance. - The estrogen-dependent nature explains their higher prevalence in women of reproductive age. *Can be caused by trauma* - This statement is **TRUE** in a broader sense, though classical spider telangiectasias are primarily hormonally-mediated rather than traumatic. - While **simple telangiectasias** can develop after localized trauma or repeated pressure, spider telangiectasias have a characteristic morphology (central arteriole with radiating vessels) and are typically associated with **estrogen excess** or **liver disease**. - For exam purposes, this is considered a true statement as telangiectatic vessels can be influenced by local factors. *Light therapy for treatment* - This statement is **TRUE**. **Laser therapy**, specifically **pulsed dye laser (PDL)** or **intense pulsed light (IPL)**, is the most effective treatment for spider telangiectasias. - The laser selectively targets **hemoglobin** in the dilated vessels, causing photocoagulation and vessel obliteration, leading to excellent cosmetic results. *May be associated with liver disease* - This statement is **TRUE**. Spider telangiectasias are a well-recognized cutaneous manifestation of **chronic liver disease**, especially **cirrhosis**. - Impaired hepatic function leads to decreased **estrogen metabolism** (hyperestrogenemia), contributing to the development of these vascular lesions. - They are one of the stigmata of chronic liver disease, along with palmar erythema and gynecomastia.

Q: Most commonly abused opioid -

Diacetylmorphine. ***Diacetylmorphine*** - **Diacetylmorphine**, commonly known as **heroin**, is synthetically derived from **morphine** but is significantly more potent and lipid-soluble, allowing it to cross the **blood-brain barrier** rapidly [1, 3]. - Its rapid onset of action and intense euphoric effects contribute to its high potential for **abuse** and addiction, making it one of the most commonly abused opioids globally, particularly through intravenous injection [1]. *Morphine* - While **morphine** is a potent opioid and has a high potential for abuse, it is often prescribed in clinical settings for severe pain. - Its slower onset and less intense "rush" compared to **heroin** make it less frequently the **primary opioid of abuse** in illicit street drug markets [1]. *Oxycodone* - **Oxycodone** is a highly abused prescription opioid, especially in the form of controlled-release formulations like **OxyContin**, but its abuse is primarily linked to prescription drug diversion rather than being the most common illicitly manufactured opioid of abuse. - While it contributes significantly to the opioid crisis, **heroin** (diacetylmorphine) remains the most commonly abused opioid in the illicit market due to its widespread availability and potency [1]. *Buprenorphine* - **Buprenorphine** is a **partial opioid agonist** used in the treatment of opioid dependence (opioid replacement therapy) due to its ceiling effect on respiratory depression and ability to block the effects of other opioids. - Although it can be abused, particularly in combination with naloxone (Suboxone) via intravenous injection, its primary role is in **medication-assisted treatment**, making it less commonly abused as a standalone illicit opioid compared to **heroin**.

Q: Which drug is commonly used for outpatient department (OPD) analgesia?

Paracetamol. ***Paracetamol*** - It is a widely used and generally **safe analgesic** and antipyretic often prescribed for mild to moderate pain in an outpatient setting. - Its favorable side effect profile and availability as an **over-the-counter (OTC)** medication make it a first-choice drug for many common pain conditions. *Diclofenac* - While it is an effective NSAID used for pain and inflammation, its use can be associated with **gastrointestinal side effects** like ulcers and bleeding, as well as cardiovascular risks. - It is often reserved for more significant inflammatory pain or when other analgesics are insufficient, and may require more careful monitoring in an outpatient setting. *Ibuprofen* - Similar to diclofenac, Ibuprofen is an **NSAID** which is effective for pain and inflammation. However, it also carries risks of **gastrointestinal irritation** and renal side effects, especially with prolonged use or in certain patient populations. - While available OTC, its use for routine outpatient analgesia may be less preferred than paracetamol in some cases due to its GI and renal side effect profile. *Tramadol* - Tramadol is a **central acting opioid analgesic** with a higher potential for side effects such as nausea, dizziness, constipation, and the risk of dependence or abuse. - It is typically reserved for moderate to severe pain that is not adequately managed by non-opioid analgesics, and its prescription often involves more stringent monitoring than paracetamol.

Q: All of the following are correct about ketamine, EXCEPT which of the following?

It is a potent bronchoconstrictor. ***It is a potent bronchoconstrictor*** - **Ketamine** is known for its **bronchodilatory properties**, making it a suitable anesthetic for patients with asthma or reactive airway disease, rather than a bronchoconstrictor [1]. - Its ability to relax bronchial smooth muscle is mediated, in part, by its indirect sympathetic stimulation and direct effects on airways. *It functionally "dissociates" the thalamus* - Ketamine's mechanism of action involves **N-methyl-D-aspartate (NMDA) receptor antagonism**, which leads to a "dissociative" state [2]. - This results in a functional separation between the **thalamoneocortical** and **limbic systems**, explaining its unique anesthetic effects. *It increases arterial blood pressure* - Ketamine typically causes an **increase in heart rate** and **arterial blood pressure** due to its sympathomimetic effects. - This is achieved through the release of **endogenous catecholamines**, which stimulate the cardiovascular system. *It inhibits polysynaptic reflexes in the spinal cord* - Ketamine acts as a powerful **analgesic** by inhibiting ascending **polysynaptic reflexes** in the spinal cord. - This contributes to its ability to provide profound **pain relief** separate from its anesthetic effects [2].

Q: What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?

Obsession. ***Obsession*** - An **obsession** is defined by the presence of **recurrent and persistent thoughts, urges, or images** that are experienced as intrusive and unwanted, causing significant anxiety or distress. - These thoughts are often recognized as products of one's own mind, and individuals typically attempt to ignore, suppress, or neutralize them. *Phobia* - A **phobia** is an intense, irrational fear of a specific object or situation that poses little or no actual danger. - Unlike obsessions, phobias are typically related to external stimuli and do not primarily involve intrusive thoughts. *Compulsion* - A **compulsion** is a repetitive behavior (e.g., hand washing, checking) or mental act (e.g., praying, counting) that an individual feels driven to perform in response to an obsession. - Compulsions are often aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation. *Anxiety* - **Anxiety** is a general term for a feeling of worry, nervousness, or unease, typically about an event or something with an uncertain outcome. - While obsessions cause anxiety, "anxiety" itself is a broad emotional state, not specifically the intrusive thoughts described.

Q: Rim sign in IVP is seen in

Hydronephrosis. ***Hydronephrosis*** - The **rim sign** in IVP (Intravenous Pyelography) refers to the opacification of the renal parenchyma surrounding a dilated pelvicalyceal system, forming a "rim" of contrast. - This sign is characteristic of acute obstruction leading to **hydronephrosis**, where the contrast accumulates in the compressed renal tissue and then slowly excretes into the dilated collecting system, outlining it. *Chronic Pyelonephritis* - Characterized by **focal cortical thinning**, scarring, and clubbing of the calyces, not a rim sign. - The kidney may appear small and irregularly outlined on IVP due to **parenchymal loss**. *Renal Cell Carcinoma* - Often presents as a **mass lesion** that distorts the collecting system, but typically does not cause a rim sign. - May show vascularity on imaging and can cause direct invasion or displacement of renal structures. *Polycystic Kidney Disease* - Involves multiple **cysts** of varying sizes throughout both kidneys, leading to significant renal enlargement and distortion of the collecting system. - The appearance is typically described as a "Swiss cheese" or "moth-eaten" pattern due to the numerous cysts, not a rim sign.

Q: Which of the following techniques uses piezoelectric crystals?

Ultrasonography. ***Ultrasonography*** - **Piezoelectric crystals** are the core component of **ultrasound transducers**, which generate and detect ultrasonic waves. - These crystals convert electrical energy into mechanical vibrations (sound waves) and vice-versa, allowing for the creation of images. *NMR imaging* - **NMR imaging** (Nuclear Magnetic Resonance, now commonly known as **MRI**) uses strong magnetic fields and **radiofrequency pulses** to generate images. - It relies on the magnetic properties of atomic nuclei, particularly hydrogen, rather than piezoelectric effects. *X-ray diffraction* - **X-ray diffraction** is a technique used to study the atomic and molecular structure of materials, and it involves the interaction of **X-rays** with the electron clouds of atoms. - It does not involve piezoelectric crystals; instead, it uses an X-ray source and a detector to measure diffracted X-rays. *Xeroradiography* - **Xeroradiography** is an older imaging technique that used **xerographic plates** coated with a photoconductive material (like selenium) to capture X-ray images. - It relies on electrostatic charges and dry development rather than piezoelectric crystals to produce images.

Question 1

Which vitamin deficiency is most commonly associated with chronic alcohol consumption and may require supplementation in alcohol use disorders?

Accepted Answer

Thiamine

Answer

Pyridoxine

Answer

Riboflavin

Answer

Niacin

Question 2

What is the maximum cumulative dose of isotretinoin for acne treatment?

Accepted Answer

120-150 mg/kg

Answer

30-60 mg/kg

Answer

60-90 mg/kg

Answer

90-120 mg/kg

Question 3

Loss of intercellular cohesion between keratinocytes is referred to as?

Accepted Answer

Acantholysis

Answer

Acanthosis

Answer

Keratinolysis

Answer

Spongiosis

Question 4

Which of the following statements about spider telangiectasia is false?

Accepted Answer

More common in males

Answer

Light therapy for treatment

Answer

May be associated with liver disease

Answer

Can be caused by trauma

Question 5

Most commonly abused opioid -

Accepted Answer

Diacetylmorphine

Answer

Morphine

Answer

Oxycodone

Answer

Buprenorphine

Question 6

Which drug is commonly used for outpatient department (OPD) analgesia?

Accepted Answer

Paracetamol

Answer

Diclofenac

Answer

Ibuprofen

Answer

Tramadol

Question 7

All of the following are correct about ketamine, EXCEPT which of the following?

Accepted Answer

It is a potent bronchoconstrictor

Answer

It increases arterial blood pressure

Answer

It inhibits polysynaptic reflexes in the spinal cord

Answer

It functionally "dissociates" the thalamus

Question 8

What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?

Accepted Answer

Obsession

Answer

Phobia

Answer

Compulsion

Answer

Anxiety

Question 9

Rim sign in IVP is seen in

Accepted Answer

Hydronephrosis

Answer

Chronic Pyelonephritis

Answer

Renal Cell Carcinoma

Answer

Polycystic Kidney Disease

Question 10

Which of the following techniques uses piezoelectric crystals?

Accepted Answer

Ultrasonography

Answer

NMR imaging

Answer

X-ray diffraction

Answer

Xeroradiography

NEET-PG 2012

Biochemistry

Dermatology

Pharmacology

Psychiatry

Radiology