NEET-PG 2022 Practice Questions

Q: Which of the following statements is true regarding the telomerase theory of aging?

Decreased telomere length is associated with aging. ***Decreased telomere length is associated with aging*** - Telomeres are protective DNA-protein caps at chromosome ends that **shorten with each cell division** - Progressive telomere shortening triggers **cellular senescence** (Hayflick limit) and apoptosis - This mechanism directly contributes to aging and **age-related diseases** - The telomere theory of aging (Olovnikov hypothesis) states that telomere attrition is a primary driver of biological aging *Abnormal telomerase activation is associated with cancer* - **Telomerase is reactivated in ~85-90% of cancers**, enabling unlimited replicative potential - Normal adult somatic cells have low/absent telomerase activity - While telomerase can extend cellular lifespan, its aberrant activation leads to malignancy, not healthy aging *Telomere stability directly maintains chromosomal integrity* - Telomeres prevent chromosome degradation, end-to-end fusions, and DNA damage responses - This is a **protective function**, not the basis of the telomere theory of aging - The aging theory focuses on **consequences of telomere shortening**, not stability maintenance *Increased telomere length is associated with prolonged cellular lifespan* - Longer telomeres do correlate with younger biological age and extended replicative capacity - However, this describes the **inverse relationship** rather than the core aging theory - The telomere theory specifically explains aging through **progressive shortening**, not length extension

Q: Which of the following helps in the transport of fatty acids across the inner mitochondrial membrane?

Carnitine. ***Carnitine*** - **Carnitine** plays a crucial role in transporting long-chain fatty acids from the **cytosol** into the **mitochondrial matrix** for beta-oxidation. - It acts as a shuttling molecule, forming **acylcarnitine** which can cross the inner mitochondrial membrane via the **carnitine-acylcarnitine translocase**. *Acyl carrier protein* - **Acyl carrier protein (ACP)** is primarily involved in **fatty acid synthesis** in the cytoplasm, not in the transport of fatty acids into mitochondria for degradation. - It carries acyl groups during the elongation reactions of fatty acid synthesis. *Lecithin-cholesterol acyltransferase* - **Lecithin-cholesterol acyltransferase (LCAT)** is an enzyme found in plasma that catalyzes the formation of **cholesterol esters**, which are then transported by lipoproteins. - It is involved in **cholesterol metabolism** and reverse cholesterol transport, not in the mitochondrial transport of fatty acids. *Carnitine and albumin* - While **carnitine** is essential for mitochondrial fatty acid transport, **albumin** transports fatty acids in the blood plasma, from adipose tissue to other tissues. - Albumin does not transport fatty acids across the inner mitochondrial membrane; its role is extra-mitochondrial and related to systemic transport.

Q: What is the preferred method for removing a foreign body from the lung in children?

Rigid bronchoscopy. ***Rigid bronchoscopy*** - **Rigid bronchoscopy** is the preferred method for removing foreign bodies from the lung in children due to its ability to provide better air control, magnified viewing, and larger working channels for robust grasping tools. - It allows for complete ventilation control and isolation of the airway, which is crucial in children where airway obstruction can rapidly lead to respiratory compromise. *Chest x-ray* - A **chest x-ray** is a diagnostic tool used to identify the presence and location of a foreign body, but it is not a method for removal. - Many foreign bodies, especially non-radiopaque ones like food, may not be visible on an x-ray, making it unreliable for definitive diagnosis of presence or absence. *Flexible endoscopy* - While **flexible bronchoscopy** can be used for foreign body removal in some adults or specific situations, it is generally less effective and carries higher risks in children, especially for larger or lodged objects. - Its smaller working channels and less stable airway control make it less suitable for urgent and complete removal in the pediatric population. *Direct laryngoscopy* - **Direct laryngoscopy** is used to visualize the larynx and vocal cords, primarily to remove foreign bodies from the upper airway or intubate, but not typically for removal of foreign bodies lodged deep within the main bronchi or lungs. - It does not offer direct access or visualization of the lower bronchial tree where most aspirated foreign bodies in children tend to lodge.

Q: Identify the type of hymen.

Septate hymen. ***Septate hymen*** - The image clearly displays a **band of tissue** running across the hymenal opening, dividing it into two smaller openings, which is characteristic of a **septate hymen**. - This type of hymen can sometimes interfere with menstruation or intercourse and may require surgical correction. *Imperforate hymen* - An **imperforate hymen** completely covers the vaginal opening, with no perforations for menstrual flow. - This typically presents at menarche with **abdominal pain** and a bulging hymen due to retained menstrual blood (hematocolpos). *Semilunar hymen* - A **semilunar hymen** is incomplete, forming a crescent shape at the posterior aspect of the vaginal opening. - This is a common and normal variant, usually not causing any clinical issues. *Annular hymen* - An **annular hymen** is characterized by a circular opening in the center, encircled by hymenal tissue, appearing like a ring. - This is a common hymenal configuration and usually allows for normal menstrual flow.

Q: Which one of the following is an autosomal recessive disorder?

Cystic fibrosis. ***Cystic fibrosis*** - **Cystic fibrosis** is caused by mutations in the **CFTR gene**, leading to defective **chloride channel** function. - It is an **autosomal recessive disorder**, meaning an individual must inherit two copies of the mutated gene (one from each parent) to be affected. *Huntington's disease* - **Huntington's disease** is an **autosomal dominant disorder** caused by a mutation in the HTT gene. - Only one copy of the mutated gene is sufficient to cause the disease, resulting in progressive neurodegeneration. *Marfan syndrome* - **Marfan syndrome** is an **autosomal dominant disorder** affecting connective tissue, caused by mutations in the FBN1 gene. - It results in skeletal, ocular, and cardiovascular abnormalities due to defective **fibrillin-1**. *Neurofibromatosis type 1* - **Neurofibromatosis type 1** is an **autosomal dominant disorder** caused by mutations in the NF1 gene. - It is characterized by multiple neurofibromas, café-au-lait macules, and Lisch nodules.

Q: A female patient presents to you with a unilateral headache. It is associated with nausea, photophobia, and phonophobia. What is the drug of choice for acute management?

Sumatriptan. ***Sumatriptan*** - **Sumatriptan**, a **triptan**, is an effective abortive therapy for **acute migraine attacks** due to its selective serotonin 5-HT1B/1D receptor agonist action, leading to vasoconstriction and inhibition of neurogenic inflammation. - The symptoms described—**unilateral headache**, nausea, **photophobia**, and **phonophobia**—are classic features of migraine. *Flunarizine* - **Flunarizine** is a **calcium channel blocker** used for migraine **prophylaxis**, not for acute treatment. - It is typically prescribed for patients experiencing frequent or severe migraine attacks to reduce their incidence. *Propranolol* - **Propranolol** is a **beta-blocker** primarily used for migraine **prophylaxis**. - It helps prevent migraine attacks by modulating cerebral blood flow and neuronal excitability, but it is not effective for acute pain relief during an attack. *Topiramate* - **Topiramate** is an **antiepileptic drug** often used for migraine **prophylaxis**. - It works by various mechanisms, including altering neurotransmitter activity, but it does not provide acute symptomatic relief for an ongoing migraine attack.

Q: Which of the following is not seen in MEN 2B syndrome?

Parathyroid adenoma. ***Parathyroid adenoma*** - **Parathyroid adenomas**, leading to hyperparathyroidism, are characteristic of **MEN 2A syndrome**, not MEN 2B [1]. - While both MEN 2A and 2B involve mutations in the **RET proto-oncogene**, the specific clinical manifestations differ significantly. *Megacolon* - **Megacolon** (due to intestinal ganglioneuromatosis) is a recognized feature of **MEN 2B syndrome**. - This condition involves abnormal nerve ganglion cells in the intestine, leading to motility issues. *Mucosal neuroma* - **Mucosal neuromas** on the tongue, lips, and eyelids are a hallmark clinical sign of **MEN 2B syndrome**. - These benign growths are often one of the earliest and most recognizable features. *Marfanoid habitus* - **Marfanoid habitus**, characterized by a tall, slender build with long limbs and arachnodactyly, is a common physical finding in **MEN 2B syndrome**. - This connective tissue abnormality helps distinguish MEN 2B from other MEN syndromes.

Q: A pregnant patient, with a history of classical cesarean section in view of fetal growth retardation in the previous pregnancy, presents to you. She is currently at 35 weeks of gestation with breech presentation. What is the next step in management?

Cesarean section at 37 weeks. ***Cesarean section at 37 weeks*** - A history of **classical cesarean section** is an absolute contraindication to vaginal birth due to the high risk of **uterine rupture**. - Performing the cesarean section at 37 weeks, rather than waiting longer, minimizes the risk of spontaneous labor and rupture while ensuring fetal maturity. *Advice USG and visit after 2 weeks* - This option does not address the critical risk of **uterine rupture** due to the previous classical cesarean section. - Delaying definitive management by two weeks could increase the risk of spontaneous labor and associated complications. *Internal podalic version followed by vaginal delivery* - An **internal podalic version** is a procedure used to change fetal lie during labor, typically for the second twin, and it is **contraindicated** with a previous classical cesarean due to rupture risk. - Given the previous classical incision, a **vaginal delivery is unsafe** and should not be attempted. *External cephalic version at 36 weeks* - **External cephalic version (ECV)** is generally contraindicated in patients with a history of a **classical cesarean section** due to the increased risk of uterine rupture. - Even if successful, the patient would still require a cesarean section for delivery given the previous uterine scar.

Q: A woman with an obstetric score of G2P1 comes to the clinic at 14 weeks of gestation for her antenatal checkup. A uterine artery doppler was suggested by the doctor. What would it detect?

Risk of early-onset preeclampsia. **Risk of early-onset preeclampsia** - **Uterine artery Doppler** at 11-14 weeks of gestation is used to screen for **preeclampsia risk**, particularly **early-onset preeclampsia**, which is associated with impaired placental development. - An increased **pulsatility index (PI)** or presence of **bilateral notching** in the uterine arteries indicates high resistance to blood flow, suggesting a higher risk of developing this condition. *Risk of late-onset preeclampsia* - While uterine artery Doppler can indicate a general risk for preeclampsia, its predictive value is significantly lower for **late-onset preeclampsia** (after 34 weeks). - Late-onset preeclampsia often has different underlying causes, not solely related to abnormal **trophoblast invasion** detectable by early Doppler. *Risk of placenta accreta* - **Placenta accreta** is typically associated with previous **cesarean sections** or other uterine surgeries, leading to abnormal placental implantation. - It is diagnosed by the absence of a clear retroplacental hypoechoic zone and features such as **lacunae** on **ultrasound**, not primarily by uterine artery Doppler. *Fetal growth restriction risk* - Uterine artery Doppler at 11-14 weeks can offer some indication of **fetal growth restriction (FGR)** risk, particularly if severe and related to **placental insufficiency**. - However, the primary surveillance for FGR later in pregnancy often involves **umbilical artery Doppler** and fetal biometry, not solely early uterine artery Doppler.

Q: Which type of supracondylar fracture of the femur is classified as extra-articular?

Type A. ***Type A*** - **Type A supracondylar fractures** are defined as those that do not involve the joint surface, making them **extra-articular**. - These fractures typically occur proximal to the condyles without extending into the knee articulation. *Type B* - **Type B supracondylar fractures** are considered **partial articular**, meaning they involve only a portion of the articular surface. - While they affect the joint, they are not completely intra-articular in nature. *Type C* - **Type C supracondylar fractures** are classified as **complete articular** fractures. - This type implies that the fracture line extends through the entire joint surface and separates the articular segment from the metaphysis. *Type D* - The classification of supracondylar femoral fractures generally uses A, B, and C types to denote extra-articular, partial articular, and complete articular involvement, respectively. - **Type D** is not a standard classification used to define an extra-articular supracondylar femoral fracture in common orthopedic systems like the Orthopaedic Trauma Association (OTA) classification.

Question 1

Which of the following statements is true regarding the telomerase theory of aging?

Accepted Answer

Decreased telomere length is associated with aging

Answer

Abnormal telomerase activation is associated with cancer

Answer

Telomere stability directly maintains chromosomal integrity

Answer

Increased telomere length is associated with prolonged cellular lifespan

Question 2

Which of the following helps in the transport of fatty acids across the inner mitochondrial membrane?

Accepted Answer

Carnitine

Answer

Acyl carrier protein

Answer

Lecithin-cholesterol acyltransferase

Answer

Carnitine and albumin

Question 3

What is the preferred method for removing a foreign body from the lung in children?

Accepted Answer

Rigid bronchoscopy

Answer

Chest x-ray

Answer

Flexible endoscopy

Answer

Direct laryngoscopy

Question 4

Identify the type of hymen.

Accepted Answer

Septate hymen

Answer

Imperforate hymen

Answer

Semilunar hymen

Answer

Annular hymen

Question 5

Which one of the following is an autosomal recessive disorder?

Accepted Answer

Cystic fibrosis

Answer

Huntington's disease

Answer

Marfan syndrome

Answer

Neurofibromatosis type 1

Question 6

A female patient presents to you with a unilateral headache. It is associated with nausea, photophobia, and phonophobia. What is the drug of choice for acute management?

Accepted Answer

Sumatriptan

Answer

Flunarizine

Answer

Propranolol

Answer

Topiramate

Question 7

Which of the following is not seen in MEN 2B syndrome?

Accepted Answer

Parathyroid adenoma

Answer

Mucosal neuroma

Answer

Marfanoid habitus

Answer

Megacolon

Question 8

A pregnant patient, with a history of classical cesarean section in view of fetal growth retardation in the previous pregnancy, presents to you. She is currently at 35 weeks of gestation with breech presentation. What is the next step in management?

Accepted Answer

Cesarean section at 37 weeks

Answer

Advice USG and visit after 2 weeks

Answer

Internal podalic version followed by vaginal delivery

Answer

External cephalic version at 36 weeks

Question 9

A woman with an obstetric score of G2P1 comes to the clinic at 14 weeks of gestation for her antenatal checkup. A uterine artery doppler was suggested by the doctor. What would it detect?

Accepted Answer

Risk of early-onset preeclampsia

Answer

Risk of late-onset preeclampsia

Answer

Risk of placenta accreta

Answer

Fetal growth restriction risk

Question 10

Which type of supracondylar fracture of the femur is classified as extra-articular?

Accepted Answer

Type A

Answer

Type B

Answer

Type C

Answer

Type D

NEET-PG 2022

Biochemistry

ENT

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Orthopaedics