NEET-PG 2012 Practice Questions

Q: Which of the following cannot be given by epidural anaesthesia?

Remifentanil. ***Remifentanil*** - **Remifentanil** is specifically designed for **intravenous administration** and is rapidly metabolized by plasma esterases, making it unsuitable for epidural use. - Due to its short half-life and rapid metabolism, epidural administration would provide inconsistent and fleeting analgesia, and its breakdown products are not inert in the epidural space, potentially causing **neurotoxicity**. *Morphine* - **Morphine** is a commonly used opioid for **epidural analgesia** due to its hydrophilicity, allowing for prolonged action in the cerebrospinal fluid. - It provides effective **postoperative pain relief** and has a relatively slow onset but long duration of action when administered epidurally. *Alfentanil* - **Alfentanil** is a synthetic opioid that has been used for **epidural analgesia**, though less commonly than fentanyl or sufentanil, sometimes in conjunction with local anesthetics. - It has a faster onset and shorter duration of action compared to morphine, but still provides effective **analgesia** when administered epidurally. *Fentanyl* - **Fentanyl** is a widely used lipophilic opioid for **epidural analgesia**, often combined with local anesthetics, for both surgical and obstetric pain. - Its lipophilicity allows for rapid absorption and a relatively quick onset of action, providing effective **segmental analgesia**.

Q: In which context can helium replace nitrogen as a diluent gas in oxygen mixtures?

None of the options. **None of the options** - This question implies that helium might replace *another noble gas* as a diluent, but the correct application is for helium to replace **nitrogen** in oxygen mixtures, particularly in **diving applications**. This question likely has a flaw in its premise if expecting one of the noble gases listed to be the 'replacement' for nitrogen, as helium *is* the replacement. - Helium is used instead of nitrogen in diving gases (**trimix, heliox**) for deep dives because it is less narcotic than nitrogen under pressure, reducing the risk of **nitrogen narcosis**. *Argon* - **Argon** is denser than nitrogen and has a higher narcotic potential at depth, making it unsuitable as a replacement for nitrogen in diving gases. - It is sometimes used during **dry suit inflation** for insulation due to its low thermal conductivity, but not as a breathing gas diluent. *Xenon* - **Xenon** is a potent anesthetic agent, even at atmospheric pressure, due to its high lipid solubility. - Its use as a diluent would cause severe **narcosis** and render a diver unconscious, making it entirely inappropriate for diving mixtures. *Helium* - While helium is indeed the gas that replaces nitrogen as a diluent in oxygen mixtures for deep diving, it being listed as an option here suggests a misunderstanding of the question's phrasing. The question is asking for **in which context** helium can replace nitrogen, not asking to identify helium itself as the replacement. - Given the other options are noble gases that *cannot* replace nitrogen in this context, "None of the options" is the most accurate answer if the question implies picking from the provided list for a replacement *for helium* or a suitable *alternative* to helium, which isn't the case here.

Q: What is the most reliable indicator to prevent esophageal intubation?

Measurement of CO2 in exhaled air (EtCO2).. ***Measurement of CO2 in exhaled air (EtCO2)*** - The presence of **carbon dioxide** in exhaled air confirms tracheal intubation as the esophagus does not contain CO2. - This method provides a **real-time**, objective assessment of tube placement that is highly reliable because even small amounts of CO2 are detected. *Oxygen saturation on pulse oximeter* - This indicator measures **oxygenation**, which can remain adequate for several minutes after esophageal intubation due to pre-oxygenation. - A **delayed drop in saturation** might indicate esophageal intubation, but it's not immediate and therefore not the most reliable early indicator. *Direct visualization of passing tube beneath vocal cords* - While helpful, **direct visualization** can sometimes be misleading due to difficult airways or poor visibility, where the tube might appear to pass correctly but enter the esophagus. - This method is **operator-dependent** and its reliability can vary based on the intubator's experience and the patient's anatomy. *Auscultation over chest* - **Auscultation** can detect breath sounds; however, sounds can be transmitted from the stomach or surrounding tissues, leading to false positives. - It is also very difficult to reliably distinguish between **esophageal and tracheal sounds**, especially in noisy environments or with inexperienced personnel, making it less reliable than EtCO2.

Q: Which of the following is not associated with subcortical dementia?

Alzheimer's disease. ***Alzheimer's disease*** - Alzheimer's disease is primarily a **cortical dementia**, characterized by global cognitive decline, specifically affecting memory, language, and executive functions. - It involves the accumulation of **amyloid plaques** and **neurofibrillary tangles** predominantly in the cerebral cortex. *Parkinsonism* - Parkinsonism, particularly Parkinson's disease dementia, is a common cause of **subcortical dementia**. - It presents with prominent **motor symptoms** (bradykinesia, rigidity, tremor) along with cognitive impairment affecting executive function and attention. *Wilson's disease* - Wilson's disease is a genetic disorder leading to **copper accumulation**, which can cause significant damage to the basal ganglia and other subcortical structures. - This often results in a **subcortical dementia** characterized by motor symptoms, psychiatric disturbances, and cognitive decline. *Huntington's chorea* - Huntington's chorea is a neurodegenerative genetic disorder primarily affecting the **basal ganglia**, a key subcortical structure. - It is a classic example of **subcortical dementia**, presenting with characteristic choreiform movements, psychiatric disturbances, and cognitive impairment.

Q: Which condition is associated with exclusively fetal blood loss?

Vasa previa. ***Vasa previa*** - Vasa previa occurs when **fetal blood vessels** from the umbilical cord traverse the membranes over the cervical os, underneath the fetal presenting part. - Rupture of these unprotected vessels, which can happen during labor or membrane rupture, leads to **exclusively fetal blood loss**, posing a high risk of fetal exsanguination and death. *Placenta praevia* - This condition involves the **placenta implanting low** in the uterus, potentially covering the internal cervical os. - Bleeding in placenta previa is typically **maternal** in origin, resulting from the detachment of the placenta from the uterine wall as the cervix dilates. *Polyhydramnios* - Polyhydramnios is characterized by an **excessive amount of amniotic fluid**. - It is not directly associated with antepartum or intrapartum bleeding, but rather with conditions that affect fetal swallowing or urination, such as **fetal gastrointestinal anomalies** or maternal diabetes. *Oligohydramnios* - Oligohydramnios refers to an **insufficient amount of amniotic fluid**. - While it can be associated with various fetal and maternal complications, such as **renal agenesis** or premature rupture of membranes, it does not typically cause blood loss.

Q: What is a common complication of joint tuberculosis?

Fibrous ankylosis. ***Fibrous ankylosis*** - Joint tuberculosis commonly leads to **fibrous ankylosis** due to chronic inflammation and destruction of articular cartilage, promoting the formation of fibrous tissue that limits joint movement. - This complication results from the body's attempt to heal the persistent inflammatory process, creating a stiff and immoveable joint. *Bony ankylosis* - While possible in severe, long-standing cases, **bony ankylosis** (fusion of bones) is less common in joint tuberculosis than fibrous ankylosis. - It typically occurs in diseases like **ankylosing spondylitis** or advanced rheumatoid arthritis, where new bone formation bridges joint spaces. *Normal healing* - **Normal healing** with full restoration of joint function is rare in untreated or late-diagnosed joint tuberculosis due to the destructive nature of the infection. - The disease often causes significant damage to cartilage and bone, precluding complete recovery without sequelae. *None of the options* - This option is incorrect because **fibrous ankylosis** is a well-recognized and frequent complication of joint tuberculosis. - The chronic inflammatory response and tissue destruction inherent to the disease make complications highly probable.

Q: In elbow, osteochondritis usually involves

Capitulum. ***Capitulum*** - The **capitulum** of the humerus is the most common site for **osteochondritis dissecans (OCD)** in the elbow, especially in throwing athletes and gymnasts. - This condition involves an avascular necrosis of the subchondral bone leading to a detachment of a cartilage fragment. *Olecranon* - The **olecranon** is part of the ulna and is more commonly affected by **stress fractures** or **bursitis**, not typically osteochondritis. - While it articulates with the trochlea, it does not bear the primary compressive forces that lead to osteochondritis in the same way the capitulum does. *Trochlea* - The **trochlea** of the humerus articulates with the trochlear notch of the ulna and is less frequently involved in primary osteochondritis compared to the capitulum. - Pathologies here are more likely related to **instability** or **fractures**. *Radial head* - The **radial head** articulates with the capitulum and is more prone to **fractures** or degenerative changes like **osteoarthritis**. - While it can be affected by **osteochondral lesions**, the capitulum is the classic site for elbow osteochondritis dissecans.

Q: What is the term for a persistent preoccupation with serious illness despite having no or only mild symptoms?

Illness anxiety disorder. ***Illness anxiety disorder*** - This condition is characterized by a **preoccupation with having or acquiring a serious illness** despite having few or no somatic symptoms. - Individuals with illness anxiety disorder engage in **excessive health-related behaviors** (e.g., repeated checking) or maladaptive avoidance (e.g., avoiding doctor appointments). *Somatic symptom disorder* - Involves **distressing somatic symptoms** that result in significant disruption of daily life, with excessive thoughts or behaviors related to the symptoms. - The focus is on the **symptoms themselves**, rather than the fear of a specific undiagnosed illness. *Conversion disorder* - Features neurological symptoms (e.g., weakness, paralysis, seizures) that are **incompatible with recognized neurological or medical conditions**. - There is a **lack of voluntary control** over the symptoms, and they are not intentionally feigned. *Body dysmorphic disorder* - Characterized by a **preoccupation with perceived flaws** or defects in physical appearance that are not observable or appear slight to others. - This preoccupation leads to **repetitive behaviors** (e.g., mirror checking) or mental acts (e.g., comparing oneself to others).

Q: Which of the following is NOT a characteristic feature of somatization disorder?

Rejection of the sick role. ***Rejection of the sick role*** - Patients with somatization disorder (now classified under **somatic symptom disorder** in DSM-5) characteristically **embrace the sick role**, not reject it - They actively seek medical attention, present with multiple chronic physical symptoms, express significant distress, and often become preoccupied with their perceived illnesses - This adoption of the sick role is a key behavioral pattern distinguishing somatization disorder from malingering or factitious disorder *Absence of pseudo-neurological symptoms* - This is incorrect because **pseudo-neurological (conversion) symptoms** are characteristic features of somatization disorder - Examples include paralysis, blindness, seizures, sensory loss, aphonia, and loss of coordination - These symptoms resemble neurological conditions but lack organic pathology *Absence of pain symptoms* - This is incorrect because **pain symptoms** are among the most common presentations in somatization disorder - Patients typically report pain in multiple sites: headaches, back pain, joint pain, chest pain, abdominal pain - Pain complaints are often one of the primary reasons these patients seek medical care *Lack of sexual symptoms* - This is incorrect because **sexual and reproductive symptoms** are frequently reported in somatization disorder - Examples include sexual indifference, erectile dysfunction, dyspareunia, irregular menses, excessive menstrual bleeding, and vomiting throughout pregnancy - These contribute to the widespread and varied somatic complaints characteristic of the disorder

Q: What is the most reliable diagnostic tool to differentiate between psychological and organic erectile dysfunction?

Nocturnal penile tumescence. ***Nocturnal penile tumescence*** - This diagnostic tool assesses whether a man experiences erections during sleep, which are naturally occurring physiological events. The presence of normal nocturnal erections indicates intact **neurovascular pathways** necessary for erection, suggesting that any daytime erectile dysfunction is likely due to **psychological factors** [2]. - Conversely, the absence of nocturnal erections points towards an **organic cause** for erectile dysfunction, as the physiological mechanism itself is impaired [1]. *Squeeze technique* - The squeeze technique is a behavioral therapy used to treat **premature ejaculation**, not erectile dysfunction. It involves stopping stimulation at the point of impending ejaculation and applying pressure to the glans to reduce arousal. - This technique does not provide any diagnostic information regarding the underlying cause (psychological vs. organic) of erectile dysfunction. *Sildenafil induced erection* - While sildenafil (Viagra) can induce an erection in many men with erectile dysfunction, its response does not reliably differentiate between psychological and organic causes. Sildenafil works by enhancing the effects of **nitric oxide**, leading to increased blood flow to the penis. - Both men with psychological erectile dysfunction and some with organic causes (e.g., mild vascular compromise) may respond to sildenafil, so a positive response does not rule out an **organic etiology**. *PIPE therapy* - "PIPE therapy" is not a recognized medical or diagnostic term for erectile dysfunction. It may be a typo or a misnomer. - Therefore, it does not serve as a diagnostic tool for differentiating between psychological and organic causes of erectile dysfunction.

Question 1

Which of the following cannot be given by epidural anaesthesia?

Accepted Answer

Remifentanil

Answer

Morphine

Answer

Alfentanil

Answer

Fentanyl

Question 2

In which context can helium replace nitrogen as a diluent gas in oxygen mixtures?

Accepted Answer

None of the options

Answer

Argon

Answer

Xenon

Answer

Helium

Question 3

What is the most reliable indicator to prevent esophageal intubation?

Accepted Answer

Measurement of CO2 in exhaled air (EtCO2).

Answer

Oxygen saturation on pulse oximeter

Answer

Direct visualization of passing tube beneath vocal cords

Answer

Auscultation over chest

Question 4

Which of the following is not associated with subcortical dementia?

Accepted Answer

Alzheimer's disease

Answer

Wilson's disease

Answer

Huntington's chorea

Answer

Parkinsonism

Question 5

Which condition is associated with exclusively fetal blood loss?

Accepted Answer

Vasa previa

Answer

Placenta praevia

Answer

Polyhydramnios

Answer

Oligohydramnios

Question 6

What is a common complication of joint tuberculosis?

Accepted Answer

Fibrous ankylosis

Answer

Bony ankylosis

Answer

Normal healing

Answer

None of the options

Question 7

In elbow, osteochondritis usually involves

Accepted Answer

Capitulum

Answer

Olecranon

Answer

Trochlea

Answer

Radial head

Question 8

What is the term for a persistent preoccupation with serious illness despite having no or only mild symptoms?

Accepted Answer

Illness anxiety disorder

Answer

Somatic symptom disorder

Answer

Conversion disorder

Answer

Body dysmorphic disorder

Question 9

Which of the following is NOT a characteristic feature of somatization disorder?

Accepted Answer

Rejection of the sick role

Answer

Absence of pseudo neurological symptoms

Answer

Absence of pain symptoms

Answer

Lack of sexual symptoms

Question 10

What is the most reliable diagnostic tool to differentiate between psychological and organic erectile dysfunction?

Accepted Answer

Nocturnal penile tumescence

Answer

PIPE therapy

Answer

Sildenafil induced erection

Answer

Squeeze technique

NEET-PG 2012

Anesthesiology

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Psychiatry

Surgery