Anesthesiology
3 questionsWhich circuit is specifically designed for anaesthesia in infants?
Fast induction and recovery is seen in?
Which of the following statements about halothane is false?
NEET-PG 2012 - Anesthesiology NEET-PG Practice Questions and MCQs
Question 1091: Which circuit is specifically designed for anaesthesia in infants?
- A. Bains circuit
- B. Magill circuit
- C. Ayres t piece (Correct Answer)
- D. Water's circuit
Explanation: ***Ayres t piece*** - The **Ayres t piece (Jackson-Rees modification)** lacks a reservoir bag, which reduces **dead space** and resistance, making it ideal for infants with low tidal volumes. - Its simple design and **low resistance** minimize the work of breathing, crucial for neonates and infants. *Bains circuit* - The Bains circuit is a **modified Mapleson D system** often used in older children and adults. - It features a concentric design with a fresh gas flow lumen inside the expiratory limb, making it suitable for moderate to high fresh gas flows but less ideal for the very low tidal volumes of infants. *Magill circuit* - The Magill circuit is a **Mapleson A system**, most efficient for **spontaneous ventilation** in adults, requiring low fresh gas flows. - Its design with the APL valve near the patient leads to significant rebreathing if used with controlled ventilation or in infants due to their small tidal volumes. *Water's circuit* - The Water's circuit (also known as the **Mapleson E or F system**) is primarily used as an open-system mask for **spontaneous respiration**, often for induction or emergency situations. - It provides minimal control over ventilation and is generally not preferred for precise anesthesia management in any age group, especially not infants.
Question 1092: Fast induction and recovery is seen in?
- A. N2O (Correct Answer)
- B. Methoxyflurane
- C. Ether
- D. Halothane
Explanation: ***N2O*** - **Nitrous oxide (N2O)** has a very **low blood-gas partition coefficient**, meaning it rapidly equilibrates between the alveolar gas and blood. - This rapid equilibration leads to a **fast onset of anesthetic action** (induction) and quick elimination from the body (recovery). *methoxyflurane* - **Methoxyflurane** has a **high blood-gas partition coefficient**, which means it has high solubility in blood. - This high solubility leads to **slow induction and prolonged recovery** as more anesthetic needs to be dissolved and then eliminated from the blood. *ether* - **Diethyl ether** also has a relatively **high blood-gas partition coefficient**, resulting in slow induction and recovery. - Its high solubility in blood and tissues means it takes longer to achieve and then dissipate its anesthetic effect. *halothane* - **Halothane** has a **moderate blood-gas partition coefficient**, leading to a slower induction and recovery compared to N2O. - While faster than methoxyflurane or ether, its solubility is still significant enough to delay its onset and offset.
Question 1093: Which of the following statements about halothane is false?
- A. Volatile liquid with sweet odour
- B. Constricts bronchii (Correct Answer)
- C. Causes malignant hyperthermia
- D. Sensitises heart to adrenaline
Explanation: ***Constricts bronchii*** - Halothane is a **bronchodilator** that relaxes bronchial smooth muscle, making it useful in patients with asthma or COPD. - The statement that it constricts bronchi is **false**. *Volatile liquid with sweet odour* - **Halothane** is a **volatile liquid** and is known for its characteristic **sweet, non-pungent odour**. - This property makes it well-tolerated during induction of anesthesia, particularly in pediatric patients. *Sensitises heart to adrenaline* - Halothane **sensitizes the myocardium** to the effects of **catecholamines**, including adrenaline (epinephrine). - This can lead to the development of **cardiac arrhythmias**, especially ventricular arrhythmias, when adrenaline is administered or endogenous levels are high. *Causes malignant hyperthermia* - Halothane is a potent trigger for **malignant hyperthermia**, a rare but life-threatening pharmacogenetic disorder. - This condition is characterized by a rapid and severe increase in body temperature, muscle rigidity, and metabolic derangements due to uncontrolled release of calcium from the sarcoplasmic reticulum.
Dermatology
1 questionsWhich of the following is not a feature of dermatomyositis?
NEET-PG 2012 - Dermatology NEET-PG Practice Questions and MCQs
Question 1091: Which of the following is not a feature of dermatomyositis?
- A. Salmon Patch (Correct Answer)
- B. Periungual telangiectasias
- C. Gottron's patch
- D. Mechanic's hands
Explanation: ***Salmon Patch*** - A **salmon patch** (also known as a nevus simplex or stork bite) is a common, benign vascular birthmark that presents as a flat, red or pink patch. - It is **not associated with dermatomyositis** and has no pathogenic link to the condition. *Gottron's patch* - **Gottron's patches** are a classic cutaneous manifestation of dermatomyositis, characterized by erythematous, violaceous, or dusky red papules or plaques over the **extensor surfaces of the metacarpophalangeal and interphalangeal joints**. - Their presence is highly suggestive of dermatomyositis, often preceding or co-occurring with muscle weakness. *Periungual telangiectasias* - **Periungual telangiectasias** are dilated capillaries around the nail folds and are a common skin manifestation of dermatomyositis. - They represent small vessel vasculopathy, a histological feature, and suggest microvascular damage often seen in systemic connective tissue diseases like dermatomyositis. *Mechanic's hands* - **Mechanic's hands** are a cutaneous feature seen in dermatomyositis (and other inflammatory myopathies like antisynthetase syndrome). - They are characterized by **hyperkeratosis**, fissuring, and scaling of the skin, particularly on the lateral and palmar aspects of the fingers, resembling the hands of a manual laborer.
Orthopaedics
1 questionsAfter chronic use of steroids severe pain in right hip with immobility is due to
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1091: After chronic use of steroids severe pain in right hip with immobility is due to
- A. Avascular necrosis (Correct Answer)
- B. Perthes disease
- C. Hip dislocation
- D. Osteoarthritis
Explanation: ***Avascular necrosis*** - Chronic **steroid use** is a major risk factor for avascular necrosis (AVN), particularly affecting the **femoral head** of the hip. - Reduced blood supply leads to bone death, resulting in severe pain and impaired mobility. *Perthes disease* - This is a condition of idiopathic **avascular necrosis of the femoral head** occurring in **children**, primarily between ages 4-10. - It is not associated with steroid use and typically presents in a different age group. *Hip dislocation* - Hip dislocation presents with **acute, severe pain** and an inability to bear weight or move the hip, often due to significant trauma. - While it causes immobility, it is an **acute traumatic event** rather than a chronic consequence of steroid use. *Osteoarthritis* - Osteoarthritis is a degenerative joint disease characterized by **cartilage breakdown** and joint pain that typically **worsens with activity** and improves with rest. - While chronic hip pain can be due to osteoarthritis, its direct link to steroid use for severe pain and immobility as described is less prominent than AVN.
Pharmacology
1 questionsMidazolam does not cause which of the following?
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1091: Midazolam does not cause which of the following?
- A. Anterograde amnesia
- B. Decreased cardiovascular effects as compared to propofol
- C. Causes tachyphylaxis during high dose infusions
- D. Retrograde amnesia (Correct Answer)
Explanation: ***Retrograde amnesia*** - Midazolam, a benzodiazepine, primarily causes **anterograde amnesia** [2], meaning patients have difficulty forming new memories after drug administration. - It does not significantly affect memories formed **before drug administration** (retrograde amnesia). *Anterograde amnesia* - Midazolam is well-known for its ability to induce **anterograde amnesia**, which is often a desirable effect in procedural sedation [2]. - This effect helps patients forget unpleasant or painful procedures performed while under its influence. *Causes tachyphylaxis during high dose infusions* - Prolonged or high-dose infusions of midazolam can lead to **tachyphylaxis**, requiring increased doses to achieve the same effect [1]. - This phenomenon is due to the **down-regulation or desensitization of GABA-A receptors** with continuous stimulation. *Decreased cardiovascular effects as compared to propofol* - Midazolam generally causes **less pronounced cardiovascular depression** (e.g., hypotension) compared to propofol, especially in standard sedative doses [1]. - This makes midazolam a safer option for sedation in some patients with **fragile cardiovascular statuses**.
Psychiatry
3 questionsWhich of the following diseases has the maximum Disability-Adjusted Life Years (DALY) loss?
Which of the following is a negative symptom of schizophrenia?
What type of therapy is desensitization commonly classified as?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1091: Which of the following diseases has the maximum Disability-Adjusted Life Years (DALY) loss?
- A. Schizophrenia (Mental Disorder)
- B. Bipolar depression (Bipolar Disorder)
- C. Mania (Bipolar Disorder Episode)
- D. Unipolar depression (Major Depressive Disorder) (Correct Answer)
Explanation: ***Unipolar depression (Major Depressive Disorder)*** - **Major Depressive Disorder (MDD)** is considered a leading cause of **disability worldwide**, contributing significantly to DALYs due to its high prevalence, chronicity, and disabling nature. - The long-term impact on daily functioning, productivity, and overall quality of life makes it the mental disorder with the largest burden of disease. *Schizophrenia (Mental Disorder)* - While **schizophrenia** causes severe disability and is highly impactful on individuals and society, its prevalence is lower than that of unipolar depression. - The DALY burden for schizophrenia is substantial, but **unipolar depression** affects a much larger proportion of the global population. *Bipolar depression (Bipolar Disorder)* - **Bipolar disorder (depressive episodes)** also contributes significantly to disability, but it is less prevalent than unipolar depression. - Although the depressive phases are often more severe than unipolar depression, the overall DALYs are lower due to its **comparatively lower incidence**. *Mania (Bipolar Disorder Episode)* - **Mania**, a component of bipolar disorder, can cause significant impairment during an episode but is typically **episodic** and less frequent than depressive states in bipolar disorder. - The DALYs attributed to manic episodes alone are generally lower than the overall burden of persistent depressive states found in unipolar depression.
Question 1092: Which of the following is a negative symptom of schizophrenia?
- A. Hallucination
- B. Delusion
- C. Motor hyperactivity
- D. Alogia (poverty of speech) (Correct Answer)
Explanation: ***Alogia (poverty of speech)*** - **Alogia** refers to a reduction in the **fluency and productivity of speech**, which is a classic **negative symptom** of schizophrenia indicating a *loss* or *absence* of normal functions. - Negative symptoms are characterized by deficits in normal emotional responses or other thought processes. *Hallucination* - **Hallucinations** are perceptual experiences that occur in the absence of an external stimulus, most commonly **auditory** in schizophrenia. - They are considered **positive symptoms** because they represent an *addition* or *distortion* of normal functions. *Delusion* - A **delusion** is a fixed, false belief that is not amenable to change in light of conflicting evidence, such as **persecutory** or **grandiose delusions**. - Delusions are also categorized as **positive symptoms** as they involve an *exaggeration* or *distortion* of normal thought content. *Motor hyperactivity* - **Motor hyperactivity** involves excessive or uncontrolled body movements and is not a typical symptom of schizophrenia. - While schizophrenia can involve **psychomotor agitation**, this is distinct from generalized hyperactivity and is not a core negative symptom.
Question 1093: What type of therapy is desensitization commonly classified as?
- A. Psychotherapy
- B. Psychoanalysis
- C. Behavioral therapy (Correct Answer)
- D. Not applicable
Explanation: ***Behavioral therapy*** - Desensitization techniques, such as **systematic desensitization**, are a cornerstone of **behavioral therapy** due to their focus on changing learned dysfunctional responses. - This approach aims to reduce anxiety or phobic reactions by gradually exposing individuals to feared stimuli in a controlled manner. *Psychotherapy* - This is a very **broad category** that encompasses many types of talking therapies, including behavioral therapy. - While desensitization is a *type* of psychotherapy, **behavioral therapy** is a more specific and accurate classification. *Psychoanalysis* - This therapeutic approach, developed by Sigmund Freud, focuses on uncovering **unconscious conflicts** and past experiences, often through techniques like **free association** and dream analysis. - Desensitization does not primarily deal with unconscious drives or early childhood experiences as its core mechanism. *Not applicable* - This option is incorrect because desensitization is a well-established and recognized therapeutic technique that fits within a standard classification of psychotherapies. - It clearly has a defined application and theoretical framework.
Radiology
1 questions"Sunray appearance" on X-rays is suggestive of:
NEET-PG 2012 - Radiology NEET-PG Practice Questions and MCQs
Question 1091: "Sunray appearance" on X-rays is suggestive of:
- A. A metastatic tumour in the bone
- B. An Osteogenic sarcoma (Correct Answer)
- C. An Ewing's sarcoma
- D. A type of bone cancer that can show various radiographic appearances
Explanation: ***An Osteogenic sarcoma*** - The **"sunray appearance" (or sunburst)** on X-rays is a classic radiographic finding pathognomonic for **osteosarcoma**, especially in adults and adolescents. - This appearance is due to the **periosteal new bone formation** that grows perpendicular to the bone surface, creating a radiating spicule pattern. *A type of bone cancer that can show various radiographic appearances* - While true that bone cancers can show various appearances, the "sunray appearance" is specific enough to strongly point to a particular type, rather than just a general category. - This option is too broad and does not provide the most precise diagnosis indicated by the specific radiographic sign. *A metastatic tumour in the bone* - Metastatic bone lesions typically present with **lytic (bone destruction)** or **blastic (bone formation)** patterns, or a mixed pattern, but rarely produce the periosteal "sunray" appearance. - The characteristic radiographic finding for metastasis would often involve multiple lesions and different periosteal reactions, such as an **onion skin appearance** in some aggressive cases, but not typically sunray. *An Ewing's sarcoma* - Ewing's sarcoma commonly presents with an **"onion skin" periosteal reaction** due to multiple layers of new bone formation. - While both are primary bone tumors, the radiographic findings are distinctly different, allowing for differentiation.