Anatomy
1 questionsWhich bones form the floor of the nasal cavity in children?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 1001: Which bones form the floor of the nasal cavity in children?
- A. Nasal bone and maxilla
- B. Vomer and ethmoid
- C. Palatine process of the maxilla and horizontal plate of the palatine bone (Correct Answer)
- D. Nasal crest of maxilla and palatine process of maxilla
Explanation: ***Palatine process of the maxilla and horizontal plate of the palatine bone*** - These two bones form the **hard palate**, which also serves as the **floor of the nasal cavity**. - The **palatine process of the maxilla** forms the anterior two-thirds, while the **horizontal plate of the palatine bone** forms the posterior one-third of the hard palate. *Vomer and ethmoid* - The **vomer** and part of the **ethmoid bone** (specifically the perpendicular plate) contribute to the **nasal septum**, which divides the nasal cavity. - They do not form the floor of the nasal cavity. *Nasal bone and maxilla* - The **nasal bones** form the **bridge of the nose** and part of the roof of the nasal cavity anteriorly. - While the **maxilla** contributes to the floor via its palatine process, the nasal bones do not. *Nasal crest of maxilla and palatine process of maxilla* - The **palatine process of the maxilla** does form part of the floor of the nasal cavity. - However, the **nasal crest of the maxilla** is part of the vomer's articulation and is involved in the septum, not the primary floor structure.
Community Medicine
1 questionsJapanese encephalitis vaccine in routine schedule is given in how many doses -
NEET-PG 2015 - Community Medicine NEET-PG Practice Questions and MCQs
Question 1001: Japanese encephalitis vaccine in routine schedule is given in how many doses -
- A. Two doses (at 9-12 months and 15-18 months) (Correct Answer)
- B. Single dose vaccine
- C. Three doses 1 month apart followed by a booster if needed
- D. Three doses with the second dose 1 month and 3rd dose 6 months after the first dose
Explanation: ***Two doses (at 9-12 months and 15-18 months)*** - The **routine JE vaccination schedule in India** as per NTAGI and IAP recommendations involves **two doses**. - **First dose** is given at **9-12 months** of age. - **Second dose** is administered at **15-18 months** (or up to 24 months), approximately **6-12 months after the first dose**. - This provides adequate long-term protection against Japanese encephalitis in endemic areas. *Single dose vaccine* - A single dose does **not provide adequate long-lasting protection** against Japanese encephalitis. - The **immune response** from a single dose is insufficient for routine immunization. - Two doses are required to ensure protective antibody levels. *Three doses 1 month apart followed by a booster if needed* - This schedule is **not part of the routine immunization program** for JE in India. - The standard routine schedule involves **only 2 primary doses**, not three. - Rapid three-dose schedules may be used in specific outbreak situations but not for routine immunization. *Three doses with the second dose 1 month and 3rd dose 6 months after the first dose* - This three-dose schedule is **not the routine JE vaccination schedule** in India. - This may be confused with schedules for other vaccines or older JE vaccine protocols. - The current **routine schedule requires only 2 doses** at specified age intervals.
Dermatology
1 questionsWhat condition is suggested by eyelid papules and a hoarse cry in a child?
NEET-PG 2015 - Dermatology NEET-PG Practice Questions and MCQs
Question 1001: What condition is suggested by eyelid papules and a hoarse cry in a child?
- A. Croup
- B. Lipoid proteinosis (Correct Answer)
- C. Acrodermatitis enteropathica
- D. Congenital syphilis
Explanation: ***Lipoid proteinosis*** - This condition is characterized by **hoarseness from infancy** due to deposition in the vocal cords and characteristic **beaded papules on the eyelids** (moniliform blepharosis). - Also known as **Urbach-Wiethe disease**, it is a rare autosomal recessive disorder resulting from mutations in the **ECM1 gene**, leading to abnormal deposition of hyaline material in various tissues. *Croup* - Croup typically presents with a **barking cough** and **stridor**, often following a viral upper respiratory infection. - It does not cause eyelid papules or chronic hoarseness from infancy, but rather acute respiratory distress. *Acrodermatitis enteropathica* - This is a rare autosomal recessive disorder of **zinc malabsorption**, leading to a classic triad of **dermatitis**, **diarrhea**, and **alopecia**. - It does not involve eyelid papules or hoarseness as primary features. *Congenital syphilis* - Congenital syphilis can cause a wide range of manifestations, including skin rashes, bone abnormalities, and rhinitis ("snuffles"), but eyelid papules and chronic hoarseness are not typical presenting features. - Diagnosis is usually confirmed by serological tests for syphilis.
Internal Medicine
3 questionsWhich of the following is used to decrease the duration and severity of acute diarrhea?
Reduced osmolarity ORS does not contain which of the following ions?
Therapeutic phlebotomy is not done in which of the following conditions?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1001: Which of the following is used to decrease the duration and severity of acute diarrhea?
- A. Zn (Correct Answer)
- B. Mg
- C. Fe
- D. Ca
Explanation: ***Zn*** - **Zinc supplementation** has been shown to reduce the **duration** and **severity** of acute diarrhea, particularly in children in developing countries [1]. - It plays a crucial role in **immune function** and **intestinal integrity**, which helps in recovery from diarrheal episodes [1]. *Mg* - **Magnesium** is an essential mineral, but it is not directly used to decrease the duration or severity of acute diarrhea. - In fact, high doses of magnesium can act as a **laxative** and may worsen diarrhea. *Fe* - **Iron** is vital for red blood cell formation and oxygen transport, but it does not directly impact the duration or severity of acute diarrhea. - Iron supplementation is primarily used to treat **anemia**. *Ca* - **Calcium** is important for bone health and various metabolic processes, but it is not a primary intervention for reducing the duration or severity of acute diarrhea. - While sometimes used for mild digestive issues, it does not have the same evidence base as zinc for acute diarrhea.
Question 1002: Reduced osmolarity ORS does not contain which of the following ions?
- A. Sodium
- B. Potassium
- C. Lactate (Correct Answer)
- D. Citrate
Explanation: ***Lactate*** - The **reduced osmolarity ORS** formulation replaced **bicarbonate** with **citrate** and does not contain lactate. - **Citrate** is preferred over lactate / bicarbonate due to its stability, longer shelf life, and ease of dissolution. *Sodium* - **Sodium** is a crucial component of ORS, as it is co-transported with glucose into enterocytes, facilitating water absorption through **solvent drag**. - Reduced osmolarity ORS has a **lower sodium concentration** (75 mEq/L) compared to standard ORS (90 mEq/L) to minimize hypernatremia risk and enhance water absorption. *Potassium* - **Potassium** is included in ORS to replace intestinal losses, as **diarrhea** leads to significant potassium depletion. - Maintaining adequate **potassium levels** is essential for normal cellular function and preventing hypokalemia-related complications. *Citrate* - **Citrate** is a component of ORS that serves as an **alkalinizing agent** to correct metabolic acidosis often associated with dehydration in diarrheal diseases. - It also enhances the absorption of sodium and water in the intestine.
Question 1003: Therapeutic phlebotomy is not done in which of the following conditions?
- A. CML (Correct Answer)
- B. Polycythemia vera
- C. Hemochromatosis
- D. Porphyria cutanea tarda
Explanation: CML - **Chronic Myeloid Leukemia (CML)** is typically treated with targeted therapies like **Tyrosine Kinase Inhibitors** (e.g., Imatinib), not phlebotomy [1]. - Therapeutic phlebotomy is ineffective in managing the **hypercellularity** or symptoms associated with this condition compared to other conditions [1]. *Polycythemia vera* - Therapeutic phlebotomy is a key treatment in **Polycythemia vera** to reduce **hyperviscosity** symptoms. - This condition features increased red blood cell mass, which is directly addressed by phlebotomy. *Hemochromatosis* - In **Hemochromatosis**, phlebotomy is employed to lower **iron overload** by removing excess iron from the body. - This reduces the risk of complications such as **liver cirrhosis** and **diabetes** associated with iron excess. *Porphyria cutanea tarda* - Therapeutic phlebotomy is sometimes used in cases of **Porphyria cutanea tarda** to manage iron levels as a potential precipitating factor [2]. - It helps alleviate symptoms and prevent complications associated with **photosensitivity** and skin lesions [2].
Pediatrics
4 questionsWhich of the following statements about shock in children is correct?
At what rate should dopamine be administered for inotropic support in a severely dehydrated child?
Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?
Most common site for bone marrow aspiration in neonates is -
NEET-PG 2015 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1001: Which of the following statements about shock in children is correct?
- A. Tachycardia is a sensitive indicator of shock in children. (Correct Answer)
- B. Mottling of extremities is an early sign of shock.
- C. Confusion and stupor are early signs of shock.
- D. Respiratory rate is a more sensitive indicator of shock than heart rate.
Explanation: ***Tachycardia is a sensitive indicator of shock in children.*** - **Tachycardia** is often the first and most reliable sign of **compensated shock** in children, as their cardiovascular system initially maintains cardiac output by increasing heart rate. - Children have a remarkable ability to compensate for significant fluid loss, and an elevated heart rate helps maintain **perfusion** before blood pressure drops. *Mottling of extremities is an early sign of shock.* - **Mottling** of extremities is typically a sign of **decompensated shock** and indicates significant vasoconstriction and poor tissue perfusion. - It is a **late sign** that suggests the child's compensatory mechanisms are failing. *Confusion and stupor are early signs of shock.* - **Altered mental status**, such as confusion or stupor, usually indicates **severe shock** and reduced cerebral perfusion. - These are generally **late signs** of shock, appearing after initial compensatory mechanisms have failed. *Respiratory rate is a more sensitive indicator of shock than heart rate.* - While **tachypnea** can be present in shock due to metabolic acidosis or compensatory mechanisms, **tachycardia** is a more consistently sensitive and earlier indicator of circulatory compromise. - Respiratory changes can also be influenced by other factors like pain, fever, or respiratory illness, making heart rate a more specific initial marker for shock.
Question 1002: At what rate should dopamine be administered for inotropic support in a severely dehydrated child?
- A. 0.1-0.5 microgram/kg/min
- B. 1-5 microgram/kg/min (Correct Answer)
- C. 1-5 mg/kg/min
- D. 10-15 mg/kg/min
Explanation: ***1-5 microgram/kg/min*** - This dosage range of **dopamine** primarily targets **beta-1 adrenergic receptors**, leading to **increased myocardial contractility** (inotropic effect) and improved cardiac output. - It is appropriate for managing **hypotension** and poor perfusion in a severely dehydrated child after initial **fluid resuscitation** has been attempted but was insufficient. *0.1-0.5 microgram/kg/min* - This very low dose range of dopamine primarily stimulates **dopaminergic receptors** in the renal and mesenteric vascular beds. - Its main effect is **vasodilation** in these areas, which increases blood flow to the kidneys and gut, but it provides minimal to no **inotropic support**. *1-5 mg/kg/min* - This dosage is significantly too high, as it is in milligrams rather than micrograms. - Administering dopamine at this rate would lead to severe **toxicity**, including profound **tachycardia**, ventricular arrhythmias, and extreme **vasoconstriction**. *10-15 mg/kg/min* - This dopamine dosage is also excessively high, again due to being in milligrams per minute rather than micrograms per minute. - Such a dose would be **lethal**, causing catastrophic cardiovascular collapse due to overwhelming **alpha-adrenergic stimulation** and severe arrhythmias.
Question 1003: Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?
- A. Detection of IgG
- B. ZN staining
- C. Detection of IgM (Correct Answer)
- D. FTA-ABS test
Explanation: ***Detection of IgM*** - The presence of **IgM antibodies** in a newborn suggests active infection because maternal IgM does not cross the placenta. - This indicates the newborn's immune system has produced its own antibodies in response to *Treponema pallidum* infection. *Detection of IgG* - **Maternal IgG antibodies can cross the placenta**, so detecting IgG in a newborn does not differentiate between passive transfer from the mother and active newborn infection. - While total IgG might be elevated due to infection, specific IgM is a more reliable indicator of active congenital syphilis. *ZN staining* - **Ziehl-Neelsen (ZN) staining** is used to identify **acid-fast bacteria**, such as *Mycobacterium tuberculosis*, not spirochetes like *Treponema pallidum*. - *Treponema pallidum* is typically visualized using darkfield microscopy or silver stains due to its thin, helical shape. *FTA-ABS test* - The **Fluorescent Treponemal Antibody Absorption (FTA-ABS)** test detects specific antibodies against *Treponema pallidum* but primarily measures IgG, which can be maternally transferred. - While it confirms exposure, an IgM-specific FTA-ABS would be more definitive for congenital syphilis, but the general FTA-ABS test alone is not sufficient to diagnose active infection in a newborn.
Question 1004: Most common site for bone marrow aspiration in neonates is -
- A. Anterior superior iliac crest
- B. Posterior superior iliac crest
- C. Sternum
- D. Anteromedial tibia (Correct Answer)
Explanation: ***Anteromedial tibia*** - The **anteromedial tibia** is the preferred site in neonates due to its relatively **large marrow cavity**, superficial location, and reduced risk of vital organ injury. - This site is easily accessible and provides a good yield of marrow cells, making it suitable for diagnostic purposes in newborns. *Anterior superior iliac crest* - While a common site for bone marrow aspiration in older children and adults, the **anterior superior iliac crest** can be more challenging and poses a greater risk in neonates due to their smaller bone structures. - The iliac crest offers less bony prominence and a thinner cortex in neonates, increasing the difficulty of the procedure and potential for sampling error. *Posterior superior iliac crest* - The **posterior superior iliac crest** is another common site in older children and adults but is generally avoided in neonates due to the difficulty in positioning and the risk of damaging vital structures in the vicinity. - It requires prone positioning and offers less superficial bone, making it a less practical and safe choice for neonates compared to the tibia. *Sternum* - **Sternal aspiration** is generally contraindicated in neonates and young children due to the thinness of the sternal bone and proximity to vital structures like the heart and great vessels. - There is a high risk of **perforation** of the sternum and injury to underlying organs, making this site unsafe for bone marrow aspiration in this age group.