What is the BMI range that defines preobesity?
Which of the following is NOT a symptom of mild dehydration?
Which of the following is true about Hepatitis A virus?
Which of the following statements about polio is false?
If a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
Waterhouse-Friderichsen syndrome is seen in:
Which of the following conditions is least commonly associated with Pneumocystis carinii in AIDS?
Most common site for hydatid cyst
Pseudomembranous colitis, all are true except:
Which of the following symptoms is commonly associated with giardiasis?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 41: What is the BMI range that defines preobesity?
- A. 18.5-24.9
- B. 30-34.9
- C. 35-39.9
- D. 25-29.9 (Correct Answer)
Explanation: ***25-29.9*** - A **Body Mass Index (BMI)** between 25 and 29.9 kg/m² is classified as **overweight** [1] or **preobesity**. - This range indicates an increased risk of developing various health problems associated with higher body weight [1]. *18.5-24.9* - This BMI range is considered **normal weight**, which is generally ideal for health [1]. - Individuals within this range typically have the lowest risk of weight-related health complications [1]. *30-34.9* - A BMI in this range is classified as **obesity class I** [1]. - This category indicates a significantly increased risk of developing co-morbidities such as type 2 diabetes and cardiovascular disease [1]. *35-39.9* - This BMI range represents **obesity class II** (severe obesity) [1]. - Individuals in this category face a high risk of serious health issues and often require more aggressive intervention strategies [1].
Question 42: Which of the following is NOT a symptom of mild dehydration?
- A. Thirst
- B. Restlessness
- C. Dry tongue
- D. Normal BP (Correct Answer)
Explanation: ***Normal BP*** - In **mild dehydration**, the body's compensatory mechanisms, such as increased heart rate and vasoconstriction, typically manage to maintain a **normal blood pressure**. [1] - A significant drop in **blood pressure** (hypotension) is usually indicative of **moderate to severe dehydration**, where these compensatory mechanisms begin to fail. [2] *Thirst* - **Thirst** is one of the **earliest and most reliable** indicators of dehydration, as the body signals a need for fluid intake. [3] - It arises in response to increased plasma osmolality and decreased blood volume, both occurring even in **mild dehydration**. [3] *Restlessness* - **Restlessness** can be an early sign of discomfort and altered mental status associated with **mild dehydration**, particularly in infants and young children. - As the body struggles to maintain fluid balance, individuals may experience irritability and general unease. *Dry tongue* - A **dry tongue** and **dry sticky mucous membranes** are common signs of mild to moderate dehydration. - This symptom results from reduced salivary production due to decreased fluid volume in the body.
Question 43: Which of the following is true about Hepatitis A virus?
- A. Causes chronic hepatitis
- B. Helps HDV replication
- C. Causes cirrhosis
- D. Common cause of hepatitis in children (Correct Answer)
Explanation: ***Common cause of hepatitis in children*** - **Hepatitis A virus (HAV)** infection is often acquired in childhood, particularly in areas with poor sanitation, and many infections are **asymptomatic** or mild in children [1]. - Due to their developing immune systems and often exposure in daycare or school settings, children are a highly susceptible population for HAV transmission [1]. *Causes cirrhosis* - **HAV infection** is an **acute self-limiting illness** and typically does not lead to chronic liver disease or cirrhosis [1]. - **Cirrhosis** is primarily associated with chronic viral hepatitis (e.g., HBV, HCV), alcohol-related liver disease, or certain autoimmune conditions. *Helps HDV replication* - **Hepatitis D virus (HDV)** is a **defective virus** that requires the presence of **Hepatitis B virus (HBV)** surface antigen (HBsAg) for its replication and assembly [1]. - **HAV** has no role in the replication or pathogenesis of **HDV** [1]. *Causes chronic hepatitis* - **HAV infection** results in an **acute inflammatory response** in the liver that resolves spontaneously in most cases [1]. - Unlike **HBV** and **HCV**, **HAV** does not establish a persistent infection and, therefore, does not cause chronic hepatitis [1].
Question 44: Which of the following statements about polio is false?
- A. 99% non paralytic
- B. Aseptic meningitis
- C. Flaccid paralysis
- D. Increased tendon reflexes (Correct Answer)
Explanation: ***Increased tendon reflexes*** - Polio causes **lower motor neuron damage**, specifically to the anterior horn cells of the spinal cord [1]. - This damage leads to **flaccid paralysis** and **decreased or absent deep tendon reflexes**, not increased reflexes [3]. *99% non paralytic* - The vast majority of poliovirus infections (approximately 95-99%) are **asymptomatic** or cause only mild, non-specific symptoms. - Only a small percentage of infected individuals develop the more severe paralytic form of the disease. *Flaccid paralysis* - Poliovirus directly attacks and destroys **motor neurons** in the anterior horn of the spinal cord [1]. - This damage results in **muscle weakness** and loss of muscle tone, leading to **flaccid paralysis** [3]. *Aseptic meningitis* - About 1-5% of poliovirus infections can manifest as **aseptic meningitis**, characterized by symptoms like fever, headache, neck stiffness, and vomiting without bacterial infection [2]. - This form of meningitis is typically **self-limiting** and does not lead to paralysis [2].
Question 45: If a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
- A. Grade 0
- B. Grade I
- C. Grade II (Correct Answer)
- D. Grade III
Explanation: A **claw hand** deformity, characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, indicates a significant and **visible disability** but the affected part is still functional to a limited degree. In the context of leprosy, this observable and permanent deformity falls under **Grade II** on the WHO disability grading scale, signifying a clear and established disability. This grade indicates **no disability** or deformity related to leprosy. A patient with a claw hand has an obvious physical deformity and functional impairment, thus not fitting this classification. This grade refers to a **detectable impairment** but **no visible deformity**. A claw hand is a clearly visible deformity, making Grade I an inappropriate classification. While Grades are typically 0, I, and II in the WHO disability grading for leprosy, some classifications might refer to severe, non-functional deformities as higher grades. However, Grade II adequately captures **visible and significant deformities** like a claw hand, and a Grade III is not a standard or commonly used classification for a claw hand in leprosy in the WHO system.
Question 46: Waterhouse-Friderichsen syndrome is seen in:
- A. Neisseria meningitidis (Correct Answer)
- B. Yersinia
- C. Pseudomonas
- D. Pneumococci
Explanation: ***Neisseria meningitidis*** - **Waterhouse-Friderichsen syndrome** is a severe complication of **meningococcal sepsis**, predominantly caused by *Neisseria meningitidis* [1]. - It is characterized by **adrenal gland hemorrhage**, leading to acute adrenal insufficiency, hemorrhagic skin rash, and shock [1]. *Pseudomonas* - While *Pseudomonas aeruginosa* can cause severe infections, including sepsis, it is **not typically associated** with Waterhouse-Friderichsen syndrome. - *Pseudomonas* infections often lead to **ecthyma gangrenosum** in immunocompromised patients, a different dermatological manifestation. *Yersinia* - *Yersinia* species can cause various infections, such as **yersiniosis** (gastroenteritis) and **plague** (*Yersinia pestis*). - These infections do not commonly present with the distinct features of **adrenal hemorrhage** and **fulminant sepsis** seen in Waterhouse-Friderichsen syndrome. *Pneumococci* - *Streptococcus pneumoniae* (**pneumococci**) is a common cause of **meningitis** and **sepsis**, especially in children and the elderly. - Although it can lead to severe bloodstream infections, it is **rarely specifically linked** to the adrenal hemorrhage syndrome known as Waterhouse-Friderichsen syndrome.
Question 47: Which of the following conditions is least commonly associated with Pneumocystis carinii in AIDS?
- A. Meningitis
- B. Otic polypoid mass (Correct Answer)
- C. Pneumonia
- D. Ophthalmic choroid lesion
Explanation: ***Otic polypoid mass*** - While *Pneumocystis jirovecii* (formerly *carinii*) can cause **extrapulmonary disease** in immunocompromised patients, an **otic polypoid mass** is an extremely rare and atypical presentation. - Extrapulmonary manifestations usually involve organs with rich vascular supply, but ear involvement in this form is not a characteristic feature. *Pneumonia* - **Pneumocystis pneumonia (PCP)** is the **most common opportunistic infection** and AIDS-defining illness caused by *Pneumocystis jirovecii* in individuals with AIDS [1]. - It typically manifests as **fever, cough, and dyspnea** with characteristic imaging findings [1]. *Ophthalmic choroid lesion* - **Choroid lesions** due to *Pneumocystis jirovecii* are a recognized, albeit less common, **extrapulmonary manifestation** in immunocompromised patients, particularly those with AIDS. - These lesions are usually **asymptomatic** and discovered incidentally on funduscopic examination. *Meningitis* - Although *Pneumocystis jirovecii* causing **meningitis** is rare, it has been reported in severely immunocompromised individuals with AIDS, often as part of disseminated disease. - Central nervous system involvement signifies **widespread dissemination** and advanced immunosuppression.
Question 48: Most common site for hydatid cyst
- A. Lung
- B. Liver (Correct Answer)
- C. Brain
- D. Kidney
Explanation: ***Liver*** - The **liver** is the most common site for hydatid cysts, accounting for approximately **60-70%** of cases [1]. - It often leads to **biliary obstruction** and liver dysfunction, highlighting its impact on the organ. *Kidney* - Hydatid cysts in the **kidney** are rare and account for a small percentage of cases (around **2-5%**). - Symptoms are often nonspecific, including **flank pain** or hematuria, which are not primary concerns. *Brain* - While the **brain** can be affected, it is not a common site; CNS involvement occurs in only **1-2%** of hydatid disease cases. - Symptoms are related to increased intracranial pressure or focal neurological deficits, not typical for hydatid cysts. *Lung* - The **lung** is another site for hydatid cysts but accounts for about **10-20%** of cases. - Presentation may include **cough** and chest pain, making it less common compared to liver involvement.
Question 49: Pseudomembranous colitis, all are true except:
- A. Blood in stools is a common feature (Correct Answer)
- B. Toxin A is responsible for clinical manifestation
- C. Summit lesions are early histopathological findings
- D. Toxin B is responsible for clinical manifestation
Explanation: ***Blood in stools is a common feature*** - While diarrhea is a hallmark of **pseudomembranous colitis**, **bloody stools** are uncommon and, if present, suggest severe disease or an alternative diagnosis [1]. - The typical presentation involves **watery diarrhea**, abdominal cramps, and fever, not usually overt bleeding [1]. *Toxin A is responsible for clinical manifestation* - **Toxin A (TcdA)** is one of the primary exotoxins produced by *Clostridioides difficile* and contributes significantly to the **inflammation** and fluid secretion seen in pseudomembranous colitis. - It acts as an **enterotoxin**, causing fluid secretion and mucosal damage in the colon [1]. *Summit lesions are early histopathological findings* - **Summit lesions**, also known as "summit pseudomembranes" or **"volcano lesions"**, refer to characteristic histological findings where inflammatory exudates effuse from the tips of damaged crypts. - These are typical early findings in pseudomembranous colitis, demonstrating the focal nature of the **mucosal injury**. *Toxin B is responsible for clinical manifestation* - **Toxin B (TcdB)** is another key exotoxin produced by *Clostridioides difficile*, and it is considered even more **cytotoxic** than Toxin A [1]. - It causes significant **cell damage** and **apoptosis**, playing a crucial role in the development of the pseudomembranes and clinical symptoms [1].
Question 50: Which of the following symptoms is commonly associated with giardiasis?
- A. Steatorrhea and flatulence (Correct Answer)
- B. All of the options
- C. Nausea and vomiting
- D. Abdominal pain
Explanation: ***Steatorrhea and flatulence*** - **Giardiasis** is an intestinal infection caused by the parasite *Giardia lamblia*, leading to malabsorption and characteristic symptoms [1]. - The parasite attaches to the intestinal lining, interfering with fat absorption, which results in **steatorrhea** (fatty, foul-smelling stools) and increased gas production causing **flatulence** [1]. *Nausea and vomiting* - While **nausea** can occur in giardiasis, **vomiting** is less common as a primary or dominant symptom. - These symptoms are more characteristic of other gastrointestinal infections like **viral gastroenteritis**. *Abdominal pain* - **Abdominal pain** is a general symptom that can occur with many gastrointestinal issues, including giardiasis [1]. - However, it's not as specific or as clinically defining for giardiasis as **steatorrhea** and **flatulence**, which are direct consequences of the parasite's impact on fat absorption. *All of the options* - Although some patients with giardiasis may experience nausea and abdominal pain, **steatorrhea** and **flatulence** are the most direct and specific indicators of the malabsorption caused by *Giardia lamblia* [1]. - Choosing "all of the above" would imply that all listed symptoms are equally common and specific, which is not the case for giardiasis.