NEET-PG 2018 Practice Questions

Q: The online software used to monitor TB control program under RNTCP is:

NIKSHAY. ***Correct Answer: NIKSHAY*** - **NIKSHAY** is the official **web-based patient management system** for monitoring the TB control program under the **Revised National Tuberculosis Control Programme (RNTCP)**, now known as the National Tuberculosis Elimination Programme (NTEP) - It serves as a comprehensive platform for **real-time case notification, treatment monitoring, and tracking of patient outcomes** - Enables **digital recording** of TB patient details, treatment regimens, and follow-up information across India *Incorrect: NIRBHAI* - This is not a recognized software platform associated with RNTCP or TB control monitoring - No official government health program uses this name for TB surveillance *Incorrect: e-DOTS* - While **DOTS (Directly Observed Treatment, Short-course)** is the core treatment strategy for TB, e-DOTS is not the comprehensive online monitoring software - e-DOTS may refer to electronic recording of DOTS adherence, but **NIKSHAY** is the overarching national platform *Incorrect: NISCHAY* - This is not a recognized software platform for RNTCP monitoring - Does not correspond to any official TB control initiative in India

Q: All of the following characteristic patterns seen in Brown-Sequard syndrome; except:-

Ipsilateral loss of pain and temperature. ***Ipsilateral loss of pain and temperature*** - Brown-Sequard syndrome results from **hemitransverse spinal cord lesion**, leading to distinct sensory and motor deficits on only one side of the body [1]. - Pain and temperature pathways (spinothalamic tracts) **decussate (cross over)** in the spinal cord upon entry, so a lesion on one side causes **contralateral** loss of these sensations [2]. *Contralateral loss of pain and temperature* - This is a **characteristic finding** in Brown-Sequard syndrome, as the spinothalamic tracts (carrying pain and temperature) cross over at the level of the spinal cord [2]. - A lesion on one side of the spinal cord therefore results in the loss of these sensations on the **opposite side of the body below the level of the lesion** [1]. *Ipsilateral weakness* - This is a **characteristic finding** in Brown-Sequard syndrome due to the involvement of the **corticospinal tracts** (responsible for motor function) [1]. - These tracts primarily descend **uncrossed** in the spinal cord, so a lesion on one side causes weakness on the **same side of the body below the level of the lesion**. *Ipsilateral loss of position and vibration* - This is a **characteristic finding** in Brown-Sequard syndrome because the **dorsal columns** (medial lemniscal pathway), responsible for fine touch, proprioception, and vibration, ascend **ipsilaterally (uncrossed)** in the spinal cord [2]. - A lesion on one side of the spinal cord therefore results in the loss of these sensations on the **same side of the body below the level of the lesion** [1].

Q: A newborn male baby presents with congestive heart failure. On examination, there are enlarged fontanelles, a loud cranial bruit, and the following radiological finding. What is the most likely diagnosis?

Vein of Galen malformation. ***Vein of Galen malformation*** - The imaging displays a massively dilated **vein of Galen**, indicating a **Vein of Galen malformation (VOGM)**. - VOGM creates a large **arteriovenous shunt**, leading to high-output **congestive heart failure** and often presenting with prominent **cranial bruits** and **macrocephaly** (enlarged fontanelles). *Pneumocephalus* - This condition involves the presence of **air within the intracranial cavity**, commonly due to trauma, surgery, or infection. - It would not explain the **congestive heart failure** or the vascular malformation seen on the imaging. *Crouzon syndrome* - This is a form of **craniosynostosis** characterized by abnormalities in skull and facial bone development, including **midfacial hypoplasia** and **proptosis**. - While it can involve enlarged fontanelles due to hydrocephalus, it does not typically cause **congestive heart failure** or a **cranial bruit** from a vascular malformation. *Dandy-Walker syndrome* - This congenital brain malformation involves agenesis or hypoplasia of the **cerebellar vermis** and cystic dilation of the **fourth ventricle**, often leading to hydrocephalus. - While it can cause enlarged fontanelles, it does not typically lead to **congestive heart failure** or a **cranial bruit**, nor does it present with the characteristic vascular lesion seen in the image.

Q: A 16-year-old girl comes to you with primary amenorrhea; on evaluation there is absent breast development, she has a normal stature, her FSH and LH levels are found to be high and she has a karyotype of 46XX. What is the probable diagnosis?

Gonadal dysgenesis. ***Gonadal dysgenesis*** - **Primary amenorrhea** with **absent breast development** and **high FSH/LH** (hypergonadotropic hypogonadism) in a **46,XX individual** with **normal stature** points to **46,XX gonadal dysgenesis** (pure gonadal dysgenesis). - In this condition, the gonads fail to develop properly despite a normal female karyotype, leading to non-functional streak ovaries that fail to produce estrogen, hence the lack of secondary sexual characteristics and elevated gonadotropins due to lack of negative feedback. - Unlike Turner syndrome, patients have normal stature and a normal 46,XX karyotype. *Testicular feminizing syndrome* - Individuals with **complete androgen insensitivity syndrome (CAIS)**, formerly called testicular feminizing syndrome, have a **46,XY karyotype** and develop external female characteristics due to complete androgen resistance. - They present with **primary amenorrhea** but typically have **well-developed breasts** (from peripheral aromatization of testosterone to estrogen) and a blind-ending vagina, which contradicts the absent breast development in this case. *Turner syndrome* - Characterized by a **45,X karyotype** (or variants with mosaicism) and typically presents with **short stature**, primary amenorrhea, and gonadal dysgenesis. - While it causes **primary amenorrhea** and **absent breast development** with high FSH/LH, the **normal stature** and **46,XX karyotype** in this patient rule out Turner syndrome. *Kallmann syndrome* - This condition is characterized by **hypogonadotropic hypogonadism** associated with **anosmia or hyposmia** due to defective GnRH secretion. - Patients present with **low FSH and LH levels**, which contradicts the **high gonadotropin levels** seen in this case.

Q: Which of the following is true about factor V leiden mutation?

Factor V becomes resistant to cleavage by protein C. **Factor V becomes resistant to cleavage by protein C** - The **Factor V Leiden mutation** involves a substitution in the Factor V gene, rendering the **activated Factor V (FVa)** resistant to inactivation by **activated protein C (APC)** [1]. - This resistance leads to prolonged activity of FVa, which is a cofactor in the formation of thrombin, thereby increasing the risk of **thrombosis** [1]. *Increased bleeding tendency* - The Factor V Leiden mutation leads to a **hypercoagulable state**, which means an **increased tendency to form blood clots**, not an increased bleeding tendency [1]. - Bleeding disorders are typically associated with deficiencies or dysfunctions in clotting factors or platelets that impair clot formation. *Deficiency of factor V* - The Factor V Leiden mutation is a **gain-of-function mutation** that results in a modified, more active Factor V, not a deficiency of Factor V [1]. - Deficiency of Factor V (known as **parahemophilia**) is a rare bleeding disorder. *Arginine to glycine substitution* - The Factor V Leiden mutation specifically involves a single nucleotide polymorphism leading to an **arginine to glutamine substitution at position 506** (Arg506Gln) in the Factor V protein [1]. - This specific amino acid change alters the cleavage site for activated protein C, making it less effective at inactivating Factor V [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, pp. 133-134.

Q: Which of the following is the most common epithelial tumor of the stomach?

Gastric adenocarcinoma. ***Gastric adenocarcinoma*** - This is the **most common** malignant epithelial tumor of the stomach, accounting for over 90% of all gastric cancers [1], [2]. - It arises from the **glandular epithelial cells** lining the stomach [1]. *GIST* - **Gastrointestinal Stromal Tumors (GISTs)** are mesenchymal tumors, originating from the interstitial cells of Cajal, not epithelial cells [2]. - While they are common **non-epithelial** tumors of the stomach, they are far less frequent than gastric adenocarcinoma [2]. *Sarcoma* - **Sarcomas** are rare **mesenchymal tumors** of the stomach, arising from connective tissues like muscle or fat, not epithelial cells. - They constitute a very small percentage of gastric malignancies. *Carcinoid tumor* - **Carcinoid tumors** are **neuroendocrine tumors** that originate from enterochromaffin-like cells in the stomach. - While they are epithelial in origin, they are much less common than gastric adenocarcinoma. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 779. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 354-355.

Q: High tracheostomy is NOT done in:-

Laryngeal carcinoma. ***Laryngeal carcinoma*** - High tracheostomy is **contraindicated** in laryngeal carcinoma due to risk of **stomal recurrence** and tumor seeding at the tracheostomy site. - It can contaminate the **surgical field** and compromise oncological principles, making future surgical resection more complex. *Laryngomalacia* - High tracheostomy **is indicated** in severe laryngomalacia when there is significant **respiratory distress** or failure to thrive. - It bypasses the **collapsing supraglottic structures** and provides a secure airway above the level of obstruction. *Vocal cord palsy* - High tracheostomy **may be performed** in bilateral vocal cord palsy causing severe **airway obstruction** and stridor. - It provides immediate airway relief while preserving options for future **vocal cord procedures** or reinnervation surgeries. *Subglottic stenosis* - High tracheostomy **is appropriate** in subglottic stenosis as it places the stoma **above the level of stenosis**. - It allows for **staged surgical repair** of the stenotic segment while maintaining airway patency during reconstruction procedures.

Q: Falsely elevated ankle brachial index is used for evaluation of?

Calcified vessels. A falsely elevated **ankle-brachial index (ABI)**, often >1.3, indicates that the **ankle arteries are non-compressible** due to calcification [1]. This calcification is common in conditions like **diabetes** and **end-stage renal disease**, where the vessels become stiff and resist compression, leading to inaccurate pressure readings [1].

Question 1

True statement about vitamin K is?

Accepted Answer

Vitamin K affects bone health by activating proteins that bind calcium

Answer

Vitamin K is needed for action of clotting factor 8

Answer

Vitamin K deficiency leads to DVT

Answer

Vitamin K is water soluble

Question 2

The online software used to monitor TB control program under RNTCP is:

Accepted Answer

NIKSHAY

Answer

NIRBHAI

Answer

e-DOTS

Answer

NISCHAY

Question 3

All of the following characteristic patterns seen in Brown-Sequard syndrome; except:-

Accepted Answer

Ipsilateral loss of pain and temperature

Answer

Contralateral loss of pain and temperature

Answer

Ipsilateral weakness

Answer

Ipsilateral loss of position and vibration

Question 4

A newborn male baby presents with congestive heart failure. On examination, there are enlarged fontanelles, a loud cranial bruit, and the following radiological finding. What is the most likely diagnosis?

Accepted Answer

Vein of Galen malformation

Answer

Pneumocephalus

Answer

Crouzon syndrome

Answer

Dandy walker syndrome

Question 5

A 16-year-old girl comes to you with primary amenorrhea; on evaluation there is absent breast development, she has a normal stature, her FSH and LH levels are found to be high and she has a karyotype of 46XX. What is the probable diagnosis?

Accepted Answer

Gonadal dysgenesis

Answer

Testicular feminizing syndrome

Answer

Turner syndrome

Answer

Kallmann syndrome

Question 6

Which of the following is true about factor V leiden mutation?

Accepted Answer

Factor V becomes resistant to cleavage by protein C

Answer

Increased bleeding tendency

Answer

Deficiency of factor V

Answer

Arginine to glutamine substitution

Question 7

Which of the following is the most common epithelial tumor of the stomach?

Accepted Answer

Gastric adenocarcinoma

Answer

GIST

Answer

Sarcoma

Answer

Carcinoid tumor

Question 8

Mechanism of action of d-tubocurarine is:

Accepted Answer

Competitive, nondepolarizing block at the Nm cholinergic receptor

Answer

Noncompetitive, depolarizing block at the Nm cholinergic receptor

Answer

Non-competitive, nondepolarizing block at the Nm cholinergic receptor

Answer

Competitive, depolarizing block at the Nm cholinergic receptor

Question 9

High tracheostomy is NOT done in:-

Accepted Answer

Laryngeal carcinoma

Answer

Vocal cord palsy

Answer

Subglottic stenosis

Answer

Laryngomalacia

Question 10

Falsely elevated ankle brachial index is used for evaluation of?

Accepted Answer

Calcified vessels

Answer

Deep vein thrombosis

Answer

Acute limb ischemia

Answer

Chronic venous insufficiency

NEET-PG 2018

Biochemistry

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Pathology

Pharmacology

Surgery