Biochemistry
1 questionsSelenium deficiency is seen in -
NEET-PG 2012 - Biochemistry NEET-PG Practice Questions and MCQs
Question 951: Selenium deficiency is seen in -
- A. Keshan disease (Correct Answer)
- B. Wilson disease
- C. Acrodermatitis enteropathica
- D. None of the options
Explanation: ***Keshan disease*** - **Keshan disease** is a form of **cardiomyopathy** caused by **selenium deficiency**, particularly prevalent in regions with selenium-poor soil. - It presents with **heart failure**, arrhythmias, and cardiac enlargement. *Wilson disease* - **Wilson disease** is a disorder of **copper metabolism**, leading to excessive copper accumulation in organs, primarily the liver and brain. - It is not related to selenium deficiency. *Acrodermatitis enteropathica* - **Acrodermatitis enteropathica** is a genetic disorder of **zinc deficiency**, characterized by dermatitis, diarrhea, and alopecia. - It does not involve selenium deficiency. *None of the options* - This option is incorrect because Keshan disease is directly linked to selenium deficiency.
Dental
2 questionsWhat is the first permanent tooth to erupt?
Which of the following conditions is NOT associated with delayed dentition?
NEET-PG 2012 - Dental NEET-PG Practice Questions and MCQs
Question 951: What is the first permanent tooth to erupt?
- A. First premolar
- B. Second premolar
- C. First molar (Correct Answer)
- D. Second molar
Explanation: ***First molar*** - The **first molars** are typically the first permanent teeth to erupt, usually around **6 years of age**. - They erupt distal to the primary second molars and are not preceded by primary teeth, making them crucial for establishing the **occlusion**. *First premolar* - **First premolars** typically erupt later, between **10 and 11 years of age**, replacing the primary first molars. - Their eruption is part of the **exchange of primary teeth** for permanent successors. *Second premolar* - The **second premolars** erupt even later, usually between **11 and 12 years of age**, replacing the primary second molars. - They are also involved in the **replacement of primary teeth**, not the initial permanent eruption. *Second molar* - **Second molars** erupt much later than the first molars, typically between **11 and 13 years of age**, distal to the first molars. - They are part of the **later stages of permanent dentition development**.
Question 952: Which of the following conditions is NOT associated with delayed dentition?
- A. Down syndrome
- B. Cystic fibrosis (Correct Answer)
- C. Congenital hypothyroidism
- D. Rickets
Explanation: ***Cystic fibrosis*** - **Cystic fibrosis** primarily affects exocrine glands, leading to issues in the respiratory and digestive systems, and does not directly impact tooth development or eruption timing. - While patients with cystic fibrosis may have other oral health concerns due to medications or nutritional deficiencies, **delayed dentition** is not a characteristic feature of the condition itself. *Down syndrome* - Children with **Down syndrome** often experience generalized developmental delays, including delayed eruption of both primary and permanent teeth. - Other common oral manifestations in Down syndrome include **microdontia**, **taurodontism**, and a higher incidence of **periodontal disease**. *Congenital hypothyroidism* - **Congenital hypothyroidism** is associated with significant developmental delays, including skeletal maturation and delayed tooth eruption. - The reduced metabolic rate due to thyroid hormone deficiency impacts bone and tooth development. *Rickets* - **Rickets**, caused by a deficiency in vitamin D, calcium, or phosphate, leads to inadequate mineralization of bone and cartilage, which can affect tooth development and eruption. - Oral manifestations of rickets include **delayed tooth eruption**, enamel hypoplasia, and a higher susceptibility to dental caries.
Orthopaedics
1 questionsTardy ulnar nerve palsy is specifically associated with which type of fracture?
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 951: Tardy ulnar nerve palsy is specifically associated with which type of fracture?
- A. Lateral condyle fracture of the humerus (Correct Answer)
- B. Medial condyle fracture of the humerus
- C. Fracture of the humeral shaft
- D. Fracture of the radial shaft
Explanation: ***Lateral condyle fracture of the humerus*** - This fracture, especially in children, can lead to **cubitus valgus deformity** as a long-term complication if it heals incorrectly. - The resulting **valgus angulation** at the elbow abnormally stretches the ulnar nerve behind the medial epicondyle, causing **tardy ulnar nerve palsy** years after the initial injury. *Medial condyle fracture of the humerus* - While close to the ulnar nerve, medial condyle fractures are more likely to cause **immediate nerve damage** due to direct impingement, rather than delayed or "tardy" palsy from chronic stretching. - Complications typically involve varus deformity, which does not commonly stretch the ulnar nerve in the same manner as valgus. *Fracture of the humeral shaft* - This type of fracture is more commonly associated with **radial nerve injury** (e.g., wrist drop), especially in fractures of the mid-shaft. - It does not typically lead to long-term deformities at the elbow that would cause **delayed ulnar nerve compression**. *Fracture of the radial shaft* - Radial shaft fractures (e.g., Monteggia, Galeazzi) primarily affect the **radial nerve** or the **posterior interosseous nerve**. - They do not directly involve the elbow joint in a manner that would cause **tardy ulnar nerve palsy**.
Pathology
1 questionsWhat is the most common cerebellar tumor in children?
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 951: What is the most common cerebellar tumor in children?
- A. Ependymoma
- B. Medulloblastoma (Correct Answer)
- C. PNET
- D. Astrocytoma
Explanation: ***Medulloblastoma*** - **Medulloblastoma** is the most common **malignant** cerebellar tumor in children, accounting for about 20% of all childhood brain tumors [2]. - In the context of this question, medulloblastoma is considered the "most common cerebellar tumor" as it is the most frequently encountered **malignant** tumor requiring aggressive treatment. - These tumors arise from neuroectodermal cells in the cerebellum and are typically **highly aggressive**, often spreading through the cerebrospinal fluid (CSF) pathways [1], [2]. - Peak incidence is between 5-9 years of age, with a male predominance [1]. *Astrocytoma* - **Cerebellar pilocytic astrocytomas** are actually the most common **benign** cerebellar tumor in children and represent a significant portion of all cerebellar tumors [1]. - However, in competitive exam contexts, when asking about "most common cerebellar tumor," the question typically refers to **malignant tumors**, where medulloblastoma takes precedence. - **Pilocytic astrocytomas** are usually low-grade (WHO Grade I) and have an excellent prognosis, often presenting as cystic lesions with a mural nodule. *Ependymoma* - **Ependymomas** are the third most common posterior fossa tumor in children (after medulloblastoma and pilocytic astrocytoma). - They typically arise from the ependymal lining of the **fourth ventricle**, making them cerebellar-adjacent rather than primarily cerebellar tumors [3], [4]. - They account for about 10% of pediatric brain tumors and have an intermediate prognosis. *PNET* - **PNET (Primitive Neuroectodermal Tumor)** is a historical term that has largely been replaced by more specific classifications in the current WHO CNS tumor classification. - Medulloblastoma was previously classified as a type of PNET, but is now recognized as a distinct entity. - The term PNET is now rarely used in modern neuropathology practice, having been superseded by molecular and genetic classification systems. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 725-726. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1314-1315. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 726-727. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1312-1313.
Pediatrics
4 questionsWhat is the treatment of choice for a 5-year-old child with bedwetting?
What is the minimum weight gain recommended for a malnourished child during the catch-up growth phase of nutritional rehabilitation?
In children, which of the following is a key diagnostic sign of congestive heart failure (CHF)?
Treatment of simple febrile convulsion is based on
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 951: What is the treatment of choice for a 5-year-old child with bedwetting?
- A. No treatment
- B. Motivational therapy (Correct Answer)
- C. Imipramine
- D. Desmopressin
Explanation: ***Motivational therapy*** - This is the **first-line active treatment** for **primary nocturnal enuresis** in children, involving encouragement, positive reinforcement (star charts), rewards, and education about bladder control. - It focuses on **behavioral strategies** and can be highly effective with parental involvement. - When intervention is pursued at age 5, motivational therapy is preferred over pharmacological options due to safety and effectiveness. *No treatment* - At age 5, **watchful waiting with reassurance** is often appropriate since nocturnal enuresis is common at this age (affects 15-20% of 5-year-olds) and has a **spontaneous resolution rate of 15% per year**. - However, when the question asks for "treatment of choice," it implies active intervention rather than observation alone. - Active behavioral therapy is preferred when bedwetting causes distress or affects the child's self-esteem. *Imipramine* - **Imipramine** is a **tricyclic antidepressant** with anticholinergic effects that can reduce bladder contractions, but it has significant side effects including **cardiac arrhythmias** and is **not first-line treatment**. - It is typically reserved for children ≥7 years after behavioral interventions fail, due to its potential adverse effects and high relapse rate after discontinuation. *Desmopressin* - **Desmopressin** is an **antidiuretic hormone analog** that reduces urine production overnight. - While effective, it is typically reserved for children ≥6 years who are unresponsive to behavioral therapy or for **short-term situational use** (e.g., sleepovers, camps). - Side effects include potential **hyponatremia** and high relapse rate after discontinuation.
Question 952: What is the minimum weight gain recommended for a malnourished child during the catch-up growth phase of nutritional rehabilitation?
- A. 5 gm/kg/day (Correct Answer)
- B. 10 gm/kg/day
- C. 15 gm/kg/day
- D. 20 gm/kg/day
Explanation: ***Correct: 5 gm/kg/day*** - According to **WHO guidelines** for management of severe acute malnutrition and **IAP recommendations**, the **minimum acceptable weight gain** during the catch-up growth phase is **5 gm/kg/day**. - This represents the **threshold for adequate nutritional rehabilitation** - gains below this indicate inadequate recovery and require reassessment of the feeding protocol. - Weight gain of 5 gm/kg/day or more indicates that the child is responding to treatment. *Incorrect: 10 gm/kg/day* - A weight gain of **10 gm/kg/day** represents **good/satisfactory catch-up growth**, not the minimum requirement. - This is considered an **optimal target** rather than the minimum acceptable threshold. - While desirable, the question specifically asks for the minimum recommendation, which is 5 gm/kg/day. *Incorrect: 15 gm/kg/day* - A weight gain of **15 gm/kg/day** reflects **excellent catch-up growth** and is at the higher end of optimal targets. - This exceeds both the minimum requirement and the good target. - While indicating very successful rehabilitation, it is not the minimum recommendation. *Incorrect: 20 gm/kg/day* - A weight gain of **20 gm/kg/day** is an **exceptionally high rate** rarely achieved in clinical practice. - While theoretically possible with intensive feeding protocols, this far exceeds the minimum requirement. - Such high rates may require monitoring for refeeding syndrome and metabolic complications.
Question 953: In children, which of the following is a key diagnostic sign of congestive heart failure (CHF)?
- A. Pedal edema
- B. Raised JVP
- C. Basal crepitations
- D. Hepatomegaly (Correct Answer)
Explanation: ***Hepatomegaly*** - In children, **hepatomegaly** is a crucial indicator of **right-sided heart failure** due to congestion of the hepatic venous system. - The liver is a compressible organ and can accommodate a significant increase in blood volume, causing it to enlarge considerably before other signs of **venous congestion** become apparent. *Raised JVP* - **Raised jugular venous pressure (JVP)** is often difficult to assess reliably in infants and young children due to their short necks and uncooperative nature. - While present in older children with CHF, it is not considered as sensitive or specific as other signs in younger pediatric patients. *Pedal edema* - **Pedal edema** is less common in pediatric CHF compared to adults, particularly in infants and toddlers. - Their shorter hydrostatic columns and tendency to spend more time supine make dependent edema less prominent. *Basal crepitations* - **Basal crepitations** (rales) indicate **pulmonary edema**, which is a sign of **left-sided heart failure**. - While a part of CHF, **hepatomegaly** is a more consistent and often earlier sign that can be detected across different forms of pediatric CHF (right or left-sided).
Question 954: Treatment of simple febrile convulsion is based on
- A. Control of fever (Correct Answer)
- B. Rectal diazepam
- C. CSF finding
- D. Blood reports
Explanation: ***Control of fever*** - Among the given options, **control of fever** is the most appropriate answer as it represents the **immediate supportive care** for a child with a simple febrile seizure. - Management includes using antipyretics like **paracetamol** or **ibuprofen** to reduce fever and improve comfort. - **Important note:** While fever control is good supportive care, evidence shows that antipyretics do **NOT prevent recurrence** of febrile seizures. The actual cornerstone of management is **reassurance and parental education**. - According to AAP guidelines, simple febrile seizures are benign, self-limited events that require no specific anticonvulsant treatment. *Rectal diazepam* - **Rectal diazepam** is used for **acute termination** of prolonged seizures (>5 minutes) or as rescue therapy for recurrent episodes. - It is NOT indicated for routine management of simple febrile seizures, which typically last <15 minutes and resolve spontaneously. - May be prescribed for home use in select cases with recurrent seizures. *CSF finding* - **CSF analysis** is a **diagnostic procedure**, not a treatment basis. - It is indicated only when there is clinical suspicion of meningitis or meningoencephalitis (e.g., altered sensorium, meningeal signs, complex seizure features). - NOT routinely required for simple febrile seizures in well-appearing children. *Blood reports* - **Blood investigations** are diagnostic, not treatment-guiding for simple febrile seizures. - They may be considered to identify the source of fever or rule out electrolyte abnormalities, but are not the basis of seizure management itself. - Simple febrile seizures do not require routine laboratory workup.
Surgery
1 questionsWhat is the most common complication associated with carpal tunnel release surgery?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 951: What is the most common complication associated with carpal tunnel release surgery?
- A. Malunion
- B. Avascular necrosis
- C. Finger stiffness (Correct Answer)
- D. Rupture of EPL tendon
Explanation: ***Finger stiffness*** - Among the options listed, **finger stiffness** is the most recognized complication of carpal tunnel release surgery. - **Post-operative pain, swelling, and scar tissue formation** can lead to reduced range of motion in the digits. - Patients may develop stiffness due to **immobilization**, **scar adhesions**, or apprehension in mobilizing the hand after surgery. - **Note:** In clinical practice, **pillar pain** (pain at the thenar and hypothenar eminences) is actually the most common complication (10-30% of cases), but it is not among the options provided. *Malunion* - **Malunion** refers to improper healing of a fractured bone. - Carpal tunnel release involves dividing the **transverse carpal ligament** (flexor retinaculum), which is a **soft tissue procedure**. - No bone is cut or fractured, so malunion is not relevant to this surgery. *Avascular necrosis* - **Avascular necrosis (AVN)** is bone death due to interrupted blood supply. - AVN affects bones with precarious blood supply (femoral head, scaphoid, lunate in Kienböck's disease). - Carpal tunnel release does not involve bone manipulation and **AVN is not a recognized complication** of this procedure. *Rupture of EPL tendon* - **Extensor Pollicis Longus (EPL) tendon rupture** is classically associated with **distal radius fractures** or inflammatory arthritis. - EPL runs through the **third dorsal compartment** and is anatomically distant from the carpal tunnel (volar wrist). - While median nerve injury is a rare but serious complication of carpal tunnel release, **EPL rupture is not associated** with this surgery.