Dental
1 questionsIn which of the following causes of oral ulcers are auto-antibodies not seen?
NEET-PG 2015 - Dental NEET-PG Practice Questions and MCQs
Question 1021: In which of the following causes of oral ulcers are auto-antibodies not seen?
- A. Behcet disease (Correct Answer)
- B. SLE
- C. Pemphigus
- D. Celiac disease
Explanation: ***Behcet disease*** - Behcet disease is characterized by **recurrent oral and genital ulcers**, along with **eye lesions**, but it does not involve autoantibody formation. - The underlying mechanism is believed to be **immune dysregulation** rather than autoimmunity, making it distinctive. *Celiac disease* - In Celiac disease, **anti-tissue transglutaminase** antibodies are present, which are involved in the body's response to gluten. - Oral ulcers associated with Celiac are often related to nutrient deficiencies, particularly **iron and folate**. *SLE* - Systemic lupus erythematosus (SLE) is marked by various autoantibodies, including **antinuclear antibodies (ANA)** [1]. - Oral ulcers can occur in SLE, and these are a manifestation of its **autoimmune nature** [1]. *Pemphigus* - Pemphigus is characterized by the presence of **autoantibodies** against desmogleins, leading to **blistering** and ulcer formation. - Oral ulcers are common in this condition due to the **disruption of mucosal integrity** caused by the autoimmune response. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, p. 226.
Internal Medicine
5 questionsWhich of the following is not associated with Carney's triad?
Which of the following conditions is least likely to cause multiple painful ulcers on the tongue?
Which fluid is ideally given for a patient experiencing dehydration?
What is the appropriate fluid management in the case of an intracerebral hemorrhage?
Which of the following statements about drug-induced SLE is NOT true?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1021: Which of the following is not associated with Carney's triad?
- A. Atrial myxoma (Correct Answer)
- B. GIST
- C. Chondroma
- D. Paraganglioma
Explanation: ***Atrial myxoma*** - Atriomyxoma is not part of **Carney's triad**, which primarily includes **paraganglioma**, **chondroma**, and **gastrointestinal stromal tumors (GIST)**. - Carney's triad is a rare genetic condition associated with **multiple neoplasms**, and atrial myxomas are cardiac tumors, not part of this triad. *Paraganglioma* - Paragangliomas are tumors derived from **neuroendocrine cells**, and they are one of the key components of **Carney's triad**. - They typically arise in **chromaffin tissue**, which is involved in catecholamine secretion. *Chondroma* - Chondromas are benign tumors of **cartilage**, also recognized as a component of **Carney's triad**. - They are often found in the **bones** or soft tissues, but they are part of the neoplasms associated with this condition. *GIST* - Gastrointestinal stromal tumors (GISTs) are significant neoplasms linked to **Carney's triad**, arising from **interstitial cells of Cajal** in the GI tract. - They are characterized by specific mutations and can be a source of gastrointestinal symptoms in affected individuals.
Question 1022: Which of the following conditions is least likely to cause multiple painful ulcers on the tongue?
- A. TB
- B. Herpes
- C. Behcet disease
- D. Sarcoidosis (Correct Answer)
Explanation: ***Sarcoidosis*** - While sarcoidosis can affect any organ, **oral involvement is rare** and typically presents as **nodules, plaques, or generalized swelling**, not usually multiple painful ulcers on the tongue. - The lesions, when they occur, are often **painless** and appear as submucosal nodules, red patches, or diffuse swelling. *TB* - Oral tuberculosis can present as **multiple painful ulcers** on the tongue, often with a **granulomatous appearance** mimicking squamous cell carcinoma. - These ulcers are typically **irregular, undermined, and persistent**, often associated with pulmonary TB. *Herpes* - **Herpes simplex virus (HSV)** infection, particularly primary herpetic gingivostomatitis, commonly causes **multiple painful ulcers** on the tongue, gums, and other oral mucosa. - These ulcers begin as vesicles that **rupture to form painful erosions** and are a classic presentation of oral herpes. *Behcet disease* - **Oral aphthous ulcers** are a hallmark feature of Behcet disease, commonly presenting as **multiple, recurrent, painful ulcers** on the tongue and other oral mucosal surfaces. - These ulcers are clinically indistinguishable from common aphthous stomatitis but are more frequent and often associated with genital ulcers, skin lesions, and ocular inflammation.
Question 1023: Which fluid is ideally given for a patient experiencing dehydration?
- A. Plasma
- B. Normal Saline (Correct Answer)
- C. Blood
- D. 5% dextrose
Explanation: ***Normal Saline*** - **Normal saline (0.9% sodium chloride)** is an **isotonic solution** that effectively increases **extracellular fluid volume**, making it ideal for treating **dehydration** and hypovolemia [1]. - It closely mimics the **osmolality of plasma** and stays predominantly in the intravascular space, helping to restore circulating volume [1]. *Plasma* - **Plasma** is primarily used for **coagulation factor deficiencies** or volume expansion in cases of severe **hypoproteinemia**, not routine dehydration. - It contains **proteins and clotting factors** that are not typically needed for simple dehydration and carries risks of **allergic reactions and transfusion-related acute lung injury (TRALI)**. *Blood* - **Blood transfusions** are indicated for patients with **significant anemia** or **acute blood loss**, not for generalized dehydration. - Using blood for dehydration would be inappropriate due to risks such as **transfusion reactions**, **infections**, and **iron overload**. *5% dextrose* - **5% dextrose in water (D5W)** is an **isotonic solution initially**, but once the dextrose is metabolized, it becomes **hypotonic**, causing free water to shift into the cells [1]. - While it provides some free water, it is not ideal for primary rehydration in cases of significant volume depletion due to its lack of electrolytes and potential for causing **hyponatremia** if given in large quantities [1].
Question 1024: What is the appropriate fluid management in the case of an intracerebral hemorrhage?
- A. Normal saline (Correct Answer)
- B. Colloids
- C. Blood transfusion
- D. Hypertonic fluids
Explanation: **Normal saline** - **Normal saline (0.9% NaCl)** is the preferred fluid for volume maintenance in patients with **intracerebral hemorrhage (ICH)** as it is an isotonic crystalloid. - It helps maintain an adequate **cerebral perfusion pressure (CPP)** and avoids hypotonic effects that could worsen cerebral edema. *Colloids* - **Colloids** are generally avoided in ICH as they can potentially **increase intracranial pressure (ICP)** due to their osmotic effects within the damaged blood-brain barrier. - They are also associated with **increased risk of cerebral edema** and poor neurological outcomes in stroke patients. *Blood transfusion* - **Blood transfusions** are indicated only in cases of significant **anemia** (typically hemoglobin < 7-8 g/dL) or active bleeding where oxygen delivery to the brain is compromised. - Routine blood transfusion without clear indication is not part of standard fluid management for ICH and carries risks. *Hypertonic fluids* - **Hypertonic saline (e.g., 3% NaCl)** or **mannitol** are used specifically for the acute management of **elevated intracranial pressure (ICP)**, not for routine fluid maintenance. - While they improve cerebral perfusion by reducing brain edema, their continuous use as maintenance fluid can lead to severe electrolyte imbalances and dehydration.
Question 1025: Which of the following statements about drug-induced SLE is NOT true?
- A. Female: Male ratio=1:9 (Correct Answer)
- B. CNS involvement not common
- C. Renal involvement not common
- D. Anti-histone antibodies are negative
Explanation: ***Female: Male ratio=1:9*** - Drug-induced lupus erythematosus (DILE) typically has no significant **gender predilection**, unlike idiopathic SLE which has a marked female predominance (9:1 female: male ratio) [1]. - This statement is incorrect because the male:female ratio is closer to 1:1, or even male predominance, making the given ratio of 1:9 (female:male) false. *Anti-histone antibodies are negative* - **Anti-histone antibodies** are positive in 95% of patients with drug-induced lupus, making this statement incorrect. - The presence of anti-histone antibodies is a hallmark diagnostic feature of drug-induced lupus. *CNS involvement not common* - **Central nervous system (CNS) manifestations** are indeed uncommon in drug-induced lupus erythematosus. - This statement accurately reflects a key differentiating feature from idiopathic systemic lupus erythematosus (SLE), where CNS involvement can be significant [1]. *Renal involvement not common* - **Renal involvement** is rare in drug-induced lupus erythematosus. - This statement is true and helps distinguish drug-induced lupus from idiopathic SLE, where renal disease (lupus nephritis) is a frequent and serious complication [1].
Pathology
2 questionsWhich of the following statements about cross-matching of blood is false?
What is the number of Barr bodies present in Klinefelter's syndrome?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 1021: Which of the following statements about cross-matching of blood is false?
- A. Mandatory in all cases except emergency
- B. Involves visible agglutination
- C. Recipient serum is tested against donor packed cells
- D. Donor serum is tested against recipient packed cells (Correct Answer)
Explanation: ***Donor serum is tested against recipient packed cells*** - This statement is **FALSE** and describes a **minor crossmatch**, which is rarely performed in modern transfusion practice. - The minor crossmatch tests donor antibodies against recipient cells, but this is not standard practice because donor plasma is significantly diluted during transfusion, making clinically significant reactions rare. - Modern blood banking focuses on the **major crossmatch** as the critical safety measure. *Recipient serum is tested against donor packed cells* - This statement is **TRUE** and accurately describes the **major crossmatch**, which is the standard and most critical pre-transfusion compatibility test. - The major crossmatch detects antibodies in the recipient's serum that could react with donor red blood cell antigens, preventing potentially fatal hemolytic transfusion reactions. *Mandatory in all cases except emergency* - This statement is **TRUE**. Crossmatching is mandatory for safe transfusion practice. - In life-threatening emergencies where delay could be fatal, uncrossmatched O-negative (universal donor) blood may be given, but this is a rare exception. *Involves visible agglutination* - This statement is **TRUE**. A positive crossmatch indicating incompatibility is identified by **visible agglutination** or **hemolysis**. - These visible reactions occur when recipient antibodies bind to donor red blood cell antigens, signaling that transfusion would cause a severe reaction.
Question 1022: What is the number of Barr bodies present in Klinefelter's syndrome?
- A. 0
- B. 1 (Correct Answer)
- C. 2
- D. 3
Explanation: ***1*** - **Klinefelter's syndrome** typically has a 47,XXY karyotype, meaning there are two X chromosomes [1]. - The number of Barr bodies is calculated as **N-1**, where N is the total number of X chromosomes. In this case, 2-1 = **1 Barr body** [1]. - This follows the principle that one X chromosome remains active while additional X chromosomes are inactivated [1]. *0* - **No Barr bodies** are found in individuals with a normal male karyotype (46,XY) or in Turner syndrome (45,XO), neither of which describes Klinefelter's syndrome [1]. - The presence of at least one Barr body indicates the presence of at least two X chromosomes. *2* - **Two Barr bodies** would be indicative of a karyotype with three X chromosomes (e.g., 47,XXX syndrome or Triple X syndrome), which is not Klinefelter's syndrome. - This calculation follows the N-1 rule: 3 X chromosomes - 1 = 2 Barr bodies. *3* - **Three Barr bodies** would correspond to a karyotype with four X chromosomes (e.g., 48,XXXX), which is an even rarer sex chromosome aneuploidy not associated with Klinefelter's syndrome. - The N-1 rule applies: 4 X chromosomes - 1 = 3 Barr bodies. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 173-174.
Pharmacology
1 questionsWhich of the following methods can reduce flushing caused by niacin?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1021: Which of the following methods can reduce flushing caused by niacin?
- A. All of the options (Correct Answer)
- B. Tachyphylaxis
- C. Laropiprant
- D. Premedication with aspirin
Explanation: ***All of the options*** - **All three methods** (tachyphylaxis, laropiprant, and premedication with aspirin) are effective strategies for reducing niacin-induced flushing. - This demonstrates that multiple pharmacological and physiological approaches can mitigate this common side effect of niacin therapy. **Why each method works:** **Tachyphylaxis:** - Refers to the rapid decrease in response to a drug after repeated administration - With continued niacin use, tolerance develops and flushing intensity decreases over time - This is a natural adaptive response, though not an immediate solution for initial flushing episodes **Laropiprant:** - A selective antagonist of the **prostaglandin D2 receptor 1 (DP1)** - Specifically developed to reduce niacin-induced flushing by blocking prostaglandin D2-mediated vasodilation - Was marketed in combination with niacin (though later withdrawn due to other safety concerns) **Premedication with aspirin:** - **Aspirin** or other NSAIDs taken approximately 30 minutes before niacin administration - Reduces flushing by inhibiting **prostaglandin synthesis**, particularly prostaglandin D2 - Prostaglandins are key mediators of the cutaneous vasodilation that causes flushing
Surgery
1 questionsWhat is the best management for a human bite?
NEET-PG 2015 - Surgery NEET-PG Practice Questions and MCQs
Question 1021: What is the best management for a human bite?
- A. Ampicillin plus sulbactam (Correct Answer)
- B. Clindamycin plus TMP-SMX
- C. Fluoroquinolone
- D. Doxycycline
Explanation: ***Ampicillin plus sulbactam*** - This combination is effective against the common **aerobic and anaerobic bacteria** found in human bite wounds, including **Eikenella corrodens** and oral streptococci. - The sulbactam component provides **beta-lactamase inhibition**, which is crucial as many oral bacteria produce these enzymes, rendering ampicillin alone ineffective. *Clindamycin plus TMP-SMX* - While clindamycin covers many anaerobes, it has **poor activity against Eikenella corrodens**, a key pathogen in human bites. - **TMP-SMX (trimethoprim-sulfamethoxazole)** also lacks reliable coverage against many oral anaerobes and Eikenella. *Fluoroquinolone* - **Fluoroquinolones** generally have good Gram-negative coverage but often possess **limited activity against oral anaerobes and streptococci** relevant to human bites. - There is a **growing concern for resistance** with fluoroquinolone monotherapy in these types of infections. *Doxycycline* - Doxycycline has a broad spectrum but is **not the first-line choice for human bites** due to inconsistent activity against common oral anaerobes and Eikenella corrodens. - It may be considered in specific cases, but **empiric coverage needs to be broader** for initial management of these **polymicrobial infections**.