NEET-PG 2015 Practice Questions

Q: Japanese encephalitis vaccine in routine schedule is given in how many doses -

Two doses (at 9-12 months and 15-18 months). ***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.

Q: Reduced osmolarity ORS does not contain which of the following ions?

Lactate. ***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.

Q: What condition is suggested by eyelid papules and a hoarse cry in a child?

Lipoid proteinosis. ***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.

Q: Which of the following is NOT part of the classic triad of normal pressure hydrocephalus?

Headache. ***Headache*** - Headache is **not a typical symptom** of normal pressure hydrocephalus (NPH) and is generally absent, differentiating NPH from other forms of hydrocephalus. - While headaches can occur in other brain conditions, they are **not part of the classic diagnostic triad** for NPH. *Dementia* - **Cognitive impairment**, often manifesting as **subcortical dementia** with executive dysfunction and memory problems, is a core feature of NPH [1]. - This symptom typically progresses and can be a significant cause of disability in affected individuals. *Gait disturbance* - An **ataxic gait** or "magnetic gait" (difficulty lifting feet off the floor) is often the **earliest and most prominent symptom** in NPH. - It significantly impacts mobility and balance, contributing to falls. *Urinary incontinence* - **Urinary urgency and incontinence**, often appearing later than gait disturbance but earlier than dementia, is the third component of the classic triad [1]. - This symptom results from the pressure effects on the **sacral micturition centers** [1].

Q: Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?

Detection of IgM. ***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.

Q: Medulloblastoma arises exclusively from the cells of

Immature embryonal cells. ***Immature embryonal cells*** - **Medulloblastoma** is a malignant **embryonal tumor** of the cerebellum, exclusively arising from primitive neuroectodermal cells. - These tumors are thought to originate from remnants of the **external granular layer** of the cerebellum or other primitive neuroectodermal cells. *Ependymal cells* - Tumors arising from **ependymal cells** are called **ependymomas**, which typically occur within the ventricles of the brain or spinal cord. - Ependymomas have distinct histological features and clinical behavior compared to medulloblastomas. *Neurons* - Tumors primarily composed of neurons or with significant neuronal differentiation include **gangliogliomas** and **central neurocytomas**. - **Medulloblastomas** largely consist of undifferentiated, small round cells with minimal evidence of neuronal maturation. *Spindle-shaped cells* - **Spindle-shaped cells** are characteristic of various tumor types, including some **gliomas** (e.g., pilocytic astrocytoma) or mesenchymal tumors. - While some medulloblastoma variants can show desmoplastic features, the hallmark cell type is a small, round, blue embryonal cell.

Q: At what rate should dopamine be administered for inotropic support in a severely dehydrated child?

1-5 microgram/kg/min. ***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.

Q: Which of the following is used to decrease the duration and severity of acute diarrhea?

Zn. ***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.

Q: Most common site for bone marrow aspiration in neonates is -

Anteromedial tibia. ***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.

Question 1

Which bones form the floor of the nasal cavity in children?

Accepted Answer

Palatine process of the maxilla and horizontal plate of the palatine bone

Answer

Nasal bone and maxilla

Answer

Vomer and ethmoid

Answer

Nasal crest of maxilla and palatine process of maxilla

Question 2

Japanese encephalitis vaccine in routine schedule is given in how many doses -

Accepted Answer

Two doses (at 9-12 months and 15-18 months)

Answer

Single dose vaccine

Answer

Three doses 1 month apart followed by a booster if needed

Answer

Three doses with the second dose 1 month and 3rd dose 6 months after the first dose

Question 3

Reduced osmolarity ORS does not contain which of the following ions?

Accepted Answer

Lactate

Answer

Sodium

Answer

Potassium

Answer

Citrate

Question 4

What condition is suggested by eyelid papules and a hoarse cry in a child?

Accepted Answer

Lipoid proteinosis

Answer

Croup

Answer

Acrodermatitis enteropathica

Answer

Congenital syphilis

Question 5

Which of the following is NOT part of the classic triad of normal pressure hydrocephalus?

Accepted Answer

Headache

Answer

Dementia

Answer

Gait disturbance

Answer

Urinary incontinence

Question 6

Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?

Accepted Answer

Detection of IgM

Answer

Detection of IgG

Answer

ZN staining

Answer

FTA-ABS test

Question 7

Medulloblastoma arises exclusively from the cells of

Accepted Answer

Immature embryonal cells

Answer

Ependymal cells

Answer

Neurons

Answer

Spindle-shaped cells

Question 8

At what rate should dopamine be administered for inotropic support in a severely dehydrated child?

Accepted Answer

1-5 microgram/kg/min

Answer

0.1-0.5 microgram/kg/min

Answer

1-5 mg/kg/min

Answer

10-15 mg/kg/min

Question 9

Which of the following is used to decrease the duration and severity of acute diarrhea?

Accepted Answer

Zn

Answer

Mg

Answer

Fe

Answer

Ca

Question 10

Most common site for bone marrow aspiration in neonates is -

Accepted Answer

Anteromedial tibia

Answer

Anterior superior iliac crest

Answer

Posterior superior iliac crest

Answer

Sternum

NEET-PG 2015

Anatomy

Community Medicine

Dermatology

Internal Medicine

Microbiology

Pathology

Pediatrics