NEET-PG 2018 Practice Questions

Q: Testicular artery is a branch of -

Abdominal aorta. ***Abdominal aorta*** - The **testicular arteries**, also known as **gonadal arteries**, originate directly from the anterior aspect of the **abdominal aorta**. - They typically arise just inferior to the **renal arteries** at the level of the second lumbar vertebra (L2) and descend to supply the testes. *Common iliac artery* - The common iliac artery is a terminal branch of the **abdominal aorta**, but it gives rise to the internal and external iliac arteries, not directly the testicular artery. [2] - It bifurcates at the level of the sacroiliac joint. [3] *External iliac artery* - The external iliac artery primarily supplies the **lower limb** and gives off the inferior epigastric and deep circumflex iliac arteries. [1] - It does not directly provide branches to the testes. *Internal iliac artery* - The internal iliac artery primarily supplies the **pelvic organs**, gluteal region, and perineum. - While it has numerous branches, none of them are the main gonadal arteries; it contributes to the blood supply of the reproductive organs through other smaller branches. [3]

Q: WHO global target for prevention and control of non communicable diseases by 2025 is to decrease the prevalence of raised blood pressure (hypertension) by

25%. ***25%*** - The World Health Organization (WHO) set a **global target** to achieve a **25% relative reduction** in the prevalence of **raised blood pressure (hypertension)** by 2025 (compared to 2010 baseline). - This target is part of the **WHO Global Action Plan for NCDs** and the Global Monitoring Framework to combat **non-communicable diseases (NCDs)**. *75%* - A 75% reduction in hypertension prevalence is an **unrealistically ambitious** target given current global health challenges and interventions. - While significant reductions are desired, the evidence-based target set by WHO is a more achievable 25% reduction. *90%* - A 90% reduction is not one of the specifically stated **WHO global targets** for hypertension by 2025. - Such a drastic reduction would require unprecedented public health interventions and is not supported by current evidence. *55%* - 55% is not a recognized **WHO target** for the prevention and control of hypertension by 2025. - The established global target from the WHO NCD Global Monitoring Framework specifically focuses on a **25% relative reduction**.

Q: Which of the following conditions is most commonly associated with cryoglobulinemia?

Hepatitis c. No relevant references were found in the provided sources to support the connection between Hepatitis C and cryoglobulinemia. The available text discusses taste physiology, Lambert-Eaton Myasthenic Syndrome (LEMS), and administrative frontmatter (author bios and prefaces), which are not relevant to the clinical question regarding cryoglobulinemia associations. ***Hepatitis C*** - **Hepatitis C virus (HCV)** infection is the most common cause of **mixed cryoglobulinemia**, particularly Type II and Type III. - HCV-associated cryoglobulinemia often presents with **purpura, arthralgia, and glomerulonephritis**. *Ovarian cancer* - While certain cancers can be associated with paraneoplastic syndromes, **ovarian cancer** is not a common cause of cryoglobulinemia. - Cryoglobulinemia associated with malignancies is typically seen with **hematologic cancers** rather than solid tumors like ovarian cancer. *Diabetes* - **Diabetes mellitus** is a metabolic disorder primarily affecting glucose regulation and is not directly linked to the formation of cryoglobulins. - There is no established common association between diabetes and cryoglobulinemia. *Leukemia* - Although some **hematologic malignancies** like multiple myeloma or Waldenström's macroglobulinemia can be associated with cryoglobulinemia (Type I), **leukemia** is not the most common cause overall. - The most prevalent association for mixed cryoglobulinemia remains **chronic infections**, specifically Hepatitis C.

Q: Which of the following is seen in Rheumatoid Arthritis?

All of the above. ***All of the above*** - **Rheumatoid arthritis** is an autoimmune disease characterized by chronic inflammation that can affect various body systems, and the presence of **Rheumatoid Factor (RF)**, **Anti-Cyclic Citrullinated Peptide (Anti-CCP) antibodies**, and a **higher risk of extra-articular manifestations** are all characteristic features [1]. - While RF and anti-CCP are diagnostic markers, extra-articular manifestations highlight the systemic nature of the disease, affecting organs beyond the joints. *Presence of Rheumatoid Factor (RF)* - While many patients with **rheumatoid arthritis** test positive for **RF**, it is not specific to RA and can be seen in other conditions, such as systemic lupus erythematosus, Sjögren's syndrome, and chronic infections [1]. - Approximately 20% of RA patients are seronegative for RF. *Presence of Anti-CCP antibodies* - **Anti-CCP antibodies** are highly specific for **rheumatoid arthritis** and often appear early in the disease course, making them a valuable diagnostic and prognostic marker [1]. - Their presence is strongly associated with an erosive disease course. *Higher risk of extra-articular manifestations* - **Extra-articular manifestations** of **rheumatoid arthritis** indicate systemic involvement and can include rheumatoid nodules, vasculitis, pleuritis, pericarditis, scleritis, and Felty's syndrome [1]. - The presence of these manifestations often correlates with more severe disease and a poorer prognosis [1].

Q: Most common catheter-related bloodstream infection is due to:

Coagulase-negative Staphylococci (CoNS). ***Coagulase-negative Staphylococci (CoNS)*** - **Coagulase-negative Staphylococci (CoNS)**, particularly *Staphylococcus epidermidis*, are the most common cause of **catheter-related bloodstream infections (CRBSIs)** due to their ability to form **biofilms** on catheter surfaces. - Their ubiquity on the skin, combined with their capacity for **adherence** and **biofilm production**, facilitates their entry and proliferation within the catheter lumen. *Candida species* - While *Candida species* (e.g., *Candida albicans*) are significant causes of CRBSIs, especially in **immunocompromised** patients or those on **broad-spectrum antibiotics**, they are less common overall than CoNS. - Risk factors for *Candida* CRBSIs include prolonged hospitalization, total parenteral nutrition, and **central venous catheters**. *Gram-negative bacilli* - **Gram-negative bacilli** (e.g., *Klebsiella pneumoniae*, *Escherichia coli*, *Pseudomonas aeruginosa*) are important pathogens in CRBSIs, often associated with **severe sepsis** and higher mortality rates. - However, their overall incidence in catheter-induced infections is lower than that of CoNS, though they are more prevalent in certain hospital units like **ICUs**. *Staphylococcus aureus (S. aureus)* - **Staphylococcus aureus** causes clinically significant CRBSIs, often leading to more severe infections, including **endocarditis** and **septic emboli**, than CoNS. - While *S. aureus* infections are serious, CoNS remain the most frequently isolated organism in all CRBSI cases, partly due to the high carriage rate of *S. epidermidis* on human skin.

Q: In uterine prolapse, how do you assess if a pessary ring is properly in place?

If not expelled after increased abdominal pressure. ***If not expelled after increased abdominal pressure*** - A properly fitted pessary should remain in place even with increased **intra-abdominal pressure**, such as during coughing, straining, or Valsalva maneuvers, indicating stable support for the uterus. - This assesses the pessary's ability to mechanically support the **pelvic organs** and prevent prolapse recurrence during daily activities. *If Bleeding does not occur* - While bleeding after pessary insertion can indicate trauma or irritation, the absence of bleeding alone does not confirm proper fit or efficacy in preventing **prolapse**. - Bleeding can occur due to various reasons, and it is not a direct measure of the pessary's ability to maintain its position or provide support. *If patient feels discomfort* - Discomfort can indicate either an improperly fitted pessary (too large causing pressure, or too small causing rubbing) or an initial adjustment period. - However, the absence of discomfort does not guarantee the pessary will stay in place during activities that increase **abdominal pressure**, which is crucial for prolapse management. *None of the options* - This option is incorrect because the ability of the pessary to remain in place during increased abdominal pressure is a key indicator of its proper fit and effectiveness.

Q: A 40-year-old immunocompromised patient presents with complaints of dysphagia. UGI endoscopy shows multiple ulcers in distal esophagus. Biopsy was performed and histopathology is shown below. Diagnosis is:

CMV esophagitis. ***CMV esophagitis*** - The image shows a classic "owl's eye" inclusion, which is a characteristic cytopathic effect of **Cytomegalovirus (CMV)** infection. - CMV esophagitis typically causes large, linear ulcers in the distal esophagus of **immunocompromised patients**, matching the patient's presentation. *Candida esophagitis* - This condition presents with white plaques and fuzzy exudates on endoscopy, and biopsy reveals **yeast and pseudohyphae**, which are not seen in the image. - While it occurs in immunocompromised patients, the microscopic findings are distinct from those of CMV. *Herpes esophagitis* - Herpes esophagitis is characterized by multiple, small, punched-out ulcers and microscopic findings of **Cowdry A inclusions** and **multinucleated giant cells**. - The "owl's eye" inclusion seen in the image is not typical for herpes simplex virus infection. *Barrett's esophagus* - Barrett's esophagus is a metaplastic change in the esophageal lining where **squamous epithelium** is replaced by **columnar epithelium with goblet cells**, usually due to chronic GERD. - It does not involve viral inclusions or ulcerations in the manner described in the clinical vignette or depicted in the image.

Q: A 50-year-old lady with thyroid swelling underwent total thyroidectomy. The gross specimen and histopathological slide is shown below. Diagnosis is:

Medullary carcinoma of thyroid. ***Medullary carcinoma of thyroid*** - The gross specimen of medullary carcinoma often shows a **firm, grey-white, ill-defined mass**, which can be seen in the provided image. - Histopathologically, it is characterized by nests or cords of **polygonal or spindle cells** with **amyloid deposition** in the stroma, which stains positive with Congo red. *Hashimoto thyroiditis* - Grossly, Hashimoto thyroiditis typically presents as a **diffusely enlarged, firm, pale gland**, not a discrete mass. - Histologically, it is characterized by **lymphocytic infiltration**, **germinal centers**, and **Hurthle cell change**, without amyloid deposition or the specific cellular architecture of medullary carcinoma. *Follicular carcinoma* - Grossly, follicular carcinoma often appears as a **solitary, well-circumscribed nodule** with a fibrous capsule, which may show areas of hemorrhage or necrosis [1]. - Histologically, the diagnosis of follicular carcinoma relies on evidence of **capsular and/or vascular invasion** by follicular cells, which is not the primary feature suggested by the image [1]. *Anaplastic carcinoma* - Grossly, anaplastic carcinoma is typically a **rapidly growing, large, invasive mass** that often extends beyond the thyroid capsule [2]. - Histologically, it is characterized by highly **pleomorphic, bizarre giant cells** and/or spindle cells with frequent mitoses and necrosis, lacking the specific features of medullary carcinoma [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1100-1101. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1101-1102.

Q: What is the mechanism of action of colchicine in acute gout?

Inhibition of leukocyte migration and phagocytosis. ***Inhibition of leukocyte migration and phagocytosis*** - Colchicine primarily exerts its anti-inflammatory effect in acute gout by **binding to tubulin**, which inhibits microtubule polymerization. - This action disrupts essential cellular functions in inflammatory cells, particularly **neutrophils**, thereby reducing their migration to inflamed sites and their ability to phagocytose uric acid crystals. *Renal disease involving interstitial tissues* - This option describes a potential complication or manifestation of gout, such as **urate nephropathy**, rather than the mechanism of action of colchicine. - Colchicine does not directly target or treat pre-existing renal interstitial tissue disease as its primary mechanism for acute gout relief. *Uric acid nephrolithiasis* - This condition involves the formation of **kidney stones from uric acid** and is a consequence of chronic hyperuricemia. - Colchicine is not used to acutely treat or prevent the formation of uric acid kidney stones; its role is in managing the inflammatory arthritis of gout. *Deficiency of enzyme Xanthine oxidase* - **Xanthine oxidase** is an enzyme involved in the production of uric acid, and its inhibition (e.g., by allopurinol or febuxostat) is a strategy to lower uric acid levels in the blood. - Colchicine does not affect xanthine oxidase activity; it works downstream by modulating the inflammatory response to uric acid crystals.

Q: Which of the following feature differentiates delirium from dementia?

Acute confusional state. ***Acute confusional state*** - Delirium is characterized by an **acute or subacute onset** of fluctuating attention and cognition, indicating a sudden and often reversible change in mental status. - This contrasts sharply with dementia, which typically involves a **gradual and progressive decline** over months to years. *Progressive memory impairment* - This is a hallmark feature of **dementia**, where memory loss gradually worsens over time as the disease progresses. - While memory can be impaired in delirium, its onset is acute and severe memory impairment typically only occurs in cases of **severe delirium**, not as a primary defining feature. *Visual or auditory hallucinations* - While hallucinations can occur in both delirium and dementia, they are more **prominent and vivid** in delirium, often fluctuating and contributing to the acute confusional state. - In dementia, hallucinations are usually less frequent and tend to be **more persistent**, but not typically as variable as in delirium. *Impaired communication due to cognitive decline* - Both conditions can cause difficulty with communication due to cognitive deficits, but in dementia, this impairment is **gradual and pervasive**, reflecting a chronic decline in language and executive function. - In delirium, communication difficulties arise from the **acute disturbance of attention** and can fluctuate significantly depending on the patient's level of arousal and confusion.

Question 1

Testicular artery is a branch of -

Accepted Answer

Abdominal aorta

Answer

Common iliac artery

Answer

External iliac artery

Answer

Internal iliac artery

Question 2

WHO global target for prevention and control of non communicable diseases by 2025 is to decrease the prevalence of raised blood pressure (hypertension) by

Accepted Answer

25%

Answer

75%

Answer

90%

Answer

55%

Question 3

Which of the following conditions is most commonly associated with cryoglobulinemia?

Accepted Answer

Hepatitis c

Answer

Ovarian cancer

Answer

Diabetes

Answer

Leukemia

Question 4

Which of the following is seen in Rheumatoid Arthritis?

Accepted Answer

All of the above

Answer

Presence of Rheumatoid Factor (RF)

Answer

Presence of Anti-CCP antibodies

Answer

Higher risk of extra-articular manifestations

Question 5

Most common catheter-related bloodstream infection is due to:

Accepted Answer

Coagulase-negative Staphylococci (CoNS)

Answer

Candida species

Answer

Gram-negative bacilli

Answer

Staphylococcus aureus (S. aureus)

Question 6

In uterine prolapse, how do you assess if a pessary ring is properly in place?

Accepted Answer

If not expelled after increased abdominal pressure

Answer

If Bleeding does not occur

Answer

If patient feels discomfort

Answer

None of the options

Question 7

A 40-year-old immunocompromised patient presents with complaints of dysphagia. UGI endoscopy shows multiple ulcers in distal esophagus. Biopsy was performed and histopathology is shown below. Diagnosis is:

Accepted Answer

CMV esophagitis

Answer

Candida esophagitis

Answer

Herpes esophagitis

Answer

Barrett's esophagus

Question 8

A 50-year-old lady with thyroid swelling underwent total thyroidectomy. The gross specimen and histopathological slide is shown below. Diagnosis is:

Accepted Answer

Medullary carcinoma of thyroid

Answer

Hashimoto thyroiditis

Answer

Follicular carcinoma

Answer

Anaplastic carcinoma

Answer

Papillary carcinoma

Question 9

What is the mechanism of action of colchicine in acute gout?

Accepted Answer

Inhibition of leukocyte migration and phagocytosis

Answer

Renal disease involving interstitial tissues

Answer

Uric acid nephrolithiasis

Answer

Deficiency of enzyme Xanthine oxidase

Question 10

Which of the following feature differentiates delirium from dementia?

Accepted Answer

Acute confusional state

Answer

Progressive memory impairment

Answer

Visual or auditory hallucinations

Answer

Impaired communication due to cognitive decline

NEET-PG 2018

Anatomy

Community Medicine

Internal Medicine

Microbiology

Obstetrics and Gynecology

Pathology

Pharmacology

Psychiatry