Biochemistry
2 questionsDietary deficiency of which vitamin is considered extremely rare?
Which of the following is NOT a manifestation of vitamin E deficiency?
NEET-PG 2015 - Biochemistry NEET-PG Practice Questions and MCQs
Question 1111: Dietary deficiency of which vitamin is considered extremely rare?
- A. Thiamine
- B. Vitamin B6
- C. Vitamin E (Correct Answer)
- D. Vitamin D
Explanation: ***Vitamin E*** - **Vitamin E deficiency** is exceptionally rare because it is a **fat-soluble vitamin** stored in the body and is widely available in many common foods. - Symptoms of deficiency, when they do occur, are usually seen in individuals with severe **malabsorption syndromes** or genetic abnormalities affecting its metabolism. *Vitamin B6* - **Vitamin B6 deficiency** can occur, especially in individuals with **alcoholism**, those taking certain medications, or with certain chronic diseases. - It can manifest with neurological symptoms, such as **neuropathy** and **seizures**, as well as dermatological issues. *Thiamine* - **Thiamine (Vitamin B1) deficiency** is a known problem in regions with poor nutrition and in chronic alcoholics. - It leads to conditions like **beriberi** (wet and dry) and **Wernicke-Korsakoff syndrome**, affecting the cardiovascular and nervous systems. *Vitamin D* - **Vitamin D deficiency** is common globally, particularly in populations with limited sun exposure or inadequate dietary intake. - It can cause **rickets** in children and **osteomalacia** in adults, impacting bone health.
Question 1112: Which of the following is NOT a manifestation of vitamin E deficiency?
- A. Posterior column abnormalities
- B. Cerebellar ataxia
- C. Hemolytic anemia
- D. Autonomic dysfunction (Correct Answer)
Explanation: ***Autonomic dysfunction*** - **Autonomic dysfunction** is not typically associated with vitamin E deficiency. Instead, it is commonly seen in conditions like **diabetes mellitus**, Parkinson's disease, or certain inherited neuropathies. - Vitamin E primarily acts as an **antioxidant** and is crucial for neurological and red blood cell health. *Hemolytic anemia* - Vitamin E is an **antioxidant** that protects red blood cell membranes from **oxidative damage**. - Its deficiency can lead to increased fragility and **hemolysis** of red blood cells, resulting in hemolytic anemia, particularly in premature infants. *Posterior column abnormalities* - Vitamin E deficiency can cause **neurological dysfunction** due to oxidative damage to neuronal membranes. - This often manifests as degeneration of the **posterior columns** of the spinal cord, leading to impaired proprioception and vibratory sensation. *Cerebellar ataxia* - The **cerebellum** is highly susceptible to oxidative stress, and vitamin E deficiency can lead to damage in this area. - This damage results in **ataxia**, characterized by impaired coordination, balance, and gait disturbances.
Internal Medicine
5 questionsWhich condition is associated with Streptococcus bovis infection?
In which condition is Chvostek's sign typically observed?
Blood transfusion associated acute lung injury occurs due to -
In a patient presenting with a painful swollen joint and a history of high uric acid levels, which condition is most likely indicated by this clinical presentation?
Which of the following is not associated with Carney's triad?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1111: Which condition is associated with Streptococcus bovis infection?
- A. Colorectal cancer (Correct Answer)
- B. Chronic lymphocytic leukemia (CLL)
- C. Hairy cell leukemia (HCL)
- D. Multiple myeloma (MM)
Explanation: ***Colorectal cancer*** - *Streptococcus gallolyticus* (formerly known as *Streptococcus bovis* biotype I) infection, particularly **bacteremia** or **endocarditis**, has a strong association with underlying **colorectal cancer**. - It is hypothesized that the bacteria may play a role in **tumorigenesis** or that the cancerous lesions provide an entry point for the bacteria into the bloodstream. *Chronic lymphocytic leukemia (CLL)* - While patients with CLL are **immunocompromised** and prone to infections, there is no specific association between *Streptococcus bovis* and CLL. - Infections in CLL patients are typically due to encapsulated bacteria, such as *Streptococcus pneumoniae* or *Haemophilus influenzae*. *Hairy cell leukemia (HCL)* - Patients with HCL often experience **immunosuppression** due to neutropenia and monocytopenia, leading to increased susceptibility to infections. - However, there is no direct or specific link between *Streptococcus bovis* infection and HCL itself. *Multiple myeloma (MM)* - Patients with multiple myeloma have **impaired humoral immunity** and are at risk for infections, especially from encapsulated bacteria. - There is no established specific association between *Streptococcus bovis* infection and multiple myeloma.
Question 1112: In which condition is Chvostek's sign typically observed?
- A. Hypercalcemia
- B. Hypoparathyroidism (Correct Answer)
- C. Insulinoma
- D. Diabetes mellitus
Explanation: Hypoparathyroidism - **Chvostek's sign** is a clinical manifestation of **hypocalcemia**, which is a hallmark of hypoparathyroidism [1]. - It involves a twitch of facial muscles elicited by tapping the **facial nerve** anterior to the ear. Hypercalcemia - **Hypercalcemia** is the opposite of hypocalcemia and would not cause increased neuromuscular excitability [2]. - Patients with hypercalcemia might experience symptoms like **fatigue**, **constipation**, and **bone pain** [2]. Insulinoma - An **insulinoma** is a tumor that produces excessive insulin, leading to **hypoglycemia**, not issues with calcium balance. - Symptoms are primarily related to low blood sugar, such as **confusion** and **tachycardia**. Diabetes mellitus - **Diabetes mellitus** is a metabolic disorder characterized by **high blood glucose levels** due to insulin deficiency or resistance. - It is not directly associated with calcium imbalances that would cause Chvostek's sign.
Question 1113: Blood transfusion associated acute lung injury occurs due to -
- A. Nosocomial infections
- B. Auto-immune disorder
- C. Genetic susceptibility
- D. HLA-mediated reaction (Correct Answer)
Explanation: ***HLA-mediated reaction*** - Transfusion-related acute lung injury (TRALI) is primarily caused by **antibodies** in the donor plasma (usually anti-HLA or anti-HNA antibodies) reacting with the recipient's **neutrophils** [1]. - This interaction leads to neutrophil activation and sequestration in the pulmonary vasculature, causing **endothelial damage** and increased capillary permeability [1]. *Nosocomial infections* - Nosocomial infections are **hospital-acquired infections** and are not a direct cause of TRALI. - While infections can lead to lung injury, the mechanism of TRALI is distinct and immunologically mediated by donor antibodies. *Auto-immune disorder* - An autoimmune disorder involves the body's immune system attacking its own tissues, which is not the primary mechanism of TRALI. - TRALI is an **alloimmune reaction** where donor antibodies react with host antigens, rather than a pre-existing autoimmune condition. *Genetic susceptibility* - While genetic factors might sometimes play a role in an individual's general inflammatory response or susceptibility to certain conditions, they are **not the direct or primary cause** of TRALI. - The acute lung injury in TRALI is triggered by specific **antibody-antigen interactions** during the transfusion.
Question 1114: In a patient presenting with a painful swollen joint and a history of high uric acid levels, which condition is most likely indicated by this clinical presentation?
- A. Gout (Correct Answer)
- B. Ankylosing spondylitis
- C. Osteoarthritis
- D. Rheumatoid arthritis
Explanation: ***Gout*** - **Gout** is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often the **big toe** [1],[2]. - A history of **high uric acid levels** (hyperuricemia) is a primary risk factor, as it leads to the formation of **uric acid crystals** in the joint [1],[3]. *Ankylosing spondylitis* - This condition is a chronic inflammatory disease primarily affecting the **spine and sacroiliac joints**, causing stiffness and pain, especially in the morning. - It is not directly associated with **high uric acid levels** or generally presenting as an acute, single swollen joint attack. *Osteoarthritis* - **Osteoarthritis** is a degenerative joint disease characterized by the breakdown of cartilage over time, leading to pain and stiffness, especially with activity. - While it can cause joint swelling, it is typically a gradual process, not an acute, intensely painful attack, and is not linked to **uric acid levels**. *Rheumatoid arthritis* - **Rheumatoid arthritis** is an autoimmune disease causing chronic inflammation, primarily affecting multiple small joints symmetrically. - It presents with prolonged morning stiffness and is not directly caused by **high uric acid levels**, nor is its typical presentation an acute monoarthritis.
Question 1115: 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.
Pathology
1 questionsAlzheimer type II astrocytes are seen in which condition?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 1111: Alzheimer type II astrocytes are seen in which condition?
- A. Hepatic encephalopathy (Correct Answer)
- B. Parkinsonism
- C. Alzheimer's
- D. Binswanger disease
Explanation: ***Hepatic encephalopathy*** - **Alzheimer type II astrocytes** are characteristic histological findings in cases of **hepatic encephalopathy**, reflecting the brain's response to elevated ammonia levels. - These astrocytes show enlarged, pale nuclei with prominent nucleoli and marginal chromatin, indicating cellular stress from metabolic dysfunction in the setting of liver failure. *Alzheimer's* - Alzheimer's disease is characterized by the presence of **neurofibrillary tangles** (tau protein) and **amyloid plaques** (beta-amyloid protein), not Alzheimer type II astrocytes. - Astrocytes in Alzheimer's disease may show reactive changes, but they do not typically manifest as the specific "Alzheimer type II" morphology. *Parkinsonism* - Parkinsonism is primarily characterized by the degeneration of **dopaminergic neurons** in the substantia nigra and the presence of **Lewy bodies** (alpha-synuclein aggregates). - While glial cells (astrocytes and microglia) do play a role in neuroinflammation in Parkinson's, they do not exhibit the specific Alzheimer type II astrocytic change. *Binswanger disease* - Binswanger disease is a form of **vascular dementia** characterized by diffuse white matter lesions due to chronic ischemia and damage to small cerebral blood vessels. - The pathology primarily involves demyelination and axonal loss in the white matter, with reactive gliosis, but not the specific changes seen in Alzheimer type II astrocytes.
Pediatrics
1 questionsPolyarticular onset JRA involves more than how many joints?
NEET-PG 2015 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1111: Polyarticular onset JRA involves more than how many joints?
- A. 5
- B. 3
- C. 4 (Correct Answer)
- D. 6
Explanation: ***4*** - **Polyarticular onset Juvenile Rheumatoid Arthritis (JRA)**, now often referred to as **Juvenile Idiopathic Arthritis (JIA)**, is defined by the involvement of **five or more joints** within the first six months of the disease. Therefore, "more than 4" correctly describes this threshold. - This subtype of JIA accounts for approximately 30% of all JIA cases and can be further classified into rheumatoid factor-positive and rheumatoid factor-negative forms. *3* - Involvement of **fewer than five joints** (i.e., four or fewer) within the first six months would classify the disease as **oligoarticular JIA**, a distinct and often milder subtype. - Oligoarticular JIA is the most common subtype and often affects large joints like the knees. *5* - While **five or more joints** is the diagnostic criterion for polyarticular JIA, stating "more than 5" would be incorrect as exactly five joints already falls within the polyarticular definition. - The threshold is **equal to or greater than five joints**, not strictly exceeding five. *6* - Specifying "more than 6" joints would exclude cases where 5 or 6 joints are involved, which are still considered polyarticular JIA. - The key diagnostic number is **five**, meaning "more than 4" encompasses the correct definition.
Pharmacology
1 questionsWhich of the following medications is primarily used to decrease serum triglycerides?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1111: Which of the following medications is primarily used to decrease serum triglycerides?
- A. Fibrates (Correct Answer)
- B. Ezetimibe
- C. Niacin
- D. Statin
Explanation: ***Fibrates*** - Fibrates, such as **gemfibrozil** and **fenofibrate**, are primarily used to activate **PPAR-alpha**, leading to increased lipoprotein lipase activity and reduced hepatic triglyceride synthesis. - This effectively lowers **serum triglyceride levels** by 20-50% and can also increase HDL cholesterol. *Statin* - Statins primarily inhibit **HMG-CoA reductase**, the rate-limiting enzyme in cholesterol synthesis, which makes them highly effective at lowering **LDL cholesterol**. - While they can cause a modest reduction in triglycerides (10-30%), this is not their primary mechanism or indication. *Ezetimibe* - Ezetimibe works by inhibiting the absorption of **cholesterol** at the brush border of the small intestine, thereby lowering **LDL cholesterol**. - It has minimal effect on **triglyceride levels** and is not indicated for primary triglyceride reduction. *Niacin* - Niacin, or **nicotinic acid**, reduces the liver's production of VLDL (which contains triglycerides) and LDL, and also increases HDL cholesterol. - While it can significantly lower triglycerides, its use is often limited by bothersome side effects such as **flushing** and itchiness, making fibrates generally preferred for primary triglyceride lowering due to better tolerability.