NEET-PG 2018 Practice Questions

Q: The following cell type is seen in peripheral smear of a patient with membrane over the tonsils. All can be used in treatment except?

Acyclovir. ***Acyclovir*** - The image depicts an **atypical lymphocyte** (Downey cell), characteristic of **infectious mononucleosis**, commonly caused by the **Epstein-Barr virus (EBV)**. - Acyclovir is an **antiviral medication** primarily used for **herpes simplex virus (HSV)** and **varicella-zoster virus (VZV)** infections, and it is **not effective against EBV**. *Prednisolone* - **Corticosteroids** like prednisolone may be used in severe cases of infectious mononucleosis, especially when complications such as **airway obstruction** due to tonsillar hypertrophy, **hemolytic anemia**, or **thrombocytopenia** are present. - They help to **reduce inflammation** and suppress the immune response. *IVIG* - **Intravenous immunoglobulin (IVIG)** can be used in rare, severe, or complicated cases of infectious mononucleosis, particularly if there are significant **hematologic complications** (e.g., severe thrombocytopenia, severe hemolytic anemia) or in patients with **immunodeficiency**. - IVIG provides **passive immunity** and modulates the immune response. *Acetaminophen* - **Acetaminophen (paracetamol)** is a common **analgesic** and **antipyretic** used to manage symptomatic relief for fever, sore throat, and muscle aches associated with infectious mononucleosis. - It helps to **alleviate discomfort** and improve patient well-being during the acute phase of the illness.

Q: Which of the following is incorrect about the condition shown below?

Most common CT finding is intraventricular calcification. ***Most common CT finding is intraventricular calcification*** - This statement is **incorrect**. In neurocysticercosis, the most common CT finding is **parenchymal calcifications**, which represent the remnants of dead cysts, rather than intraventricular calcifications. - **Intraventricular calcifications** are possible but less frequent than parenchymal lesions and often arise from degenerating intraventricular cysts leading to obstructive hydrocephalus. *Most common presentation is partial seizures* - This statement is **correct**. **Partial seizures** (also known as focal seizures) are indeed the most common clinical presentation of neurocysticercosis, especially when **parenchymal cysts** are involved. - This is due to the cysts acting as a **focal irritant** within the cerebral cortex, leading to abnormal electrical activity. *Albendazole is given for 8 days* - This statement is **correct**. For neurocysticercosis, **Albendazole** is typically administered for a duration ranging from **8 days to 30 days**, depending on the number, location, and stage of the cysts. - The precise duration can vary based on clinical response and cyst resolution observed on follow-up imaging. *Steroids help in alleviating vasogenic oedema of ring enhancing lesion* - This statement is **correct**. **Corticosteroids**, such as dexamethasone, are frequently co-administered with anti-parasitic drugs like albendazole to manage the **inflammatory response** (vasogenic edema) caused by the dying parasites. - This edema often surrounds the **ring-enhancing lesions** seen on imaging and can exacerbate symptoms like seizures and headaches.

Q: The following organism is called:

Cestode. ***Cestode*** - The image displays a long, **segmented, ribbon-like worm**, which is characteristic morphology of a **tapeworm (cestode)**. - Cestodes typically possess a head (scolex) for attachment and a body composed of repeating segments called **proglottids**. *Nematode* - **Nematodes** are generally **unsegmented**, cylindrical, and elongated worms, often described as roundworms. - They lack the distinct proglottids and flattened, ribbon-like appearance seen in the image. *Trematode* - **Trematodes**, also known as flukes, are typically **leaf-shaped** and **unsegmented**. - They are much broader and flatter than the organism shown, and do not have the visible segmentation. *Annelid* - **Annelids** are segmented worms like earthworms and leeches, but they have a **cylindrical body** with visible external ring-like segments. - Unlike cestodes, annelids have a complete digestive system and lack the flat, ribbon-like morphology and internal proglottid structure characteristic of tapeworms.

Q: Which of the following life cycle is shown below?

Diphyllobothrium latum. ***Diphyllobothrium latum*** - The diagram clearly illustrates a life cycle involving **freshwater fish** as a second intermediate host, where **plerocercoid larvae** are found, and humans ingesting these fish. The presence of **procercoid** and **plerocercoid larvae** in the depicted stages is characteristic of *Diphyllobothrium latum*. - The description mentions that humans are infected by ingesting fish containing **plerocercoid larvae**, which become adults in the intestine and discharge eggs from **gravid proglottides**, which is consistent with the life cycle of the **fish tapeworm**. *Echinococcus granulosus* - This parasite's life cycle involves **dogs as definitive hosts** and **sheep or humans as intermediate hosts** developing **hydatid cysts**, which is distinctly different from the fish-involved cycle shown. - Infection occurs through ingestion of **eggs passed in dog feces**, and not through contaminated fish. *Taenia solium* - *Taenia solium* (pork tapeworm) involves **pigs as intermediate hosts** and humans as definitive hosts, or humans as intermediate hosts in the case of **cysticercosis**. - Its life cycle does not involve **fish** or the **plerocercoid/procercoid larval stages** as depicted. *Clonorchis sinensis* - While *Clonorchis sinensis* (Chinese liver fluke) also involves **freshwater fish** as an intermediate host, it is a **fluke, not a tapeworm**, and its larval stages are **cercariae** and **metacercariae**, not procercoid or plerocercoid larvae. - The adult worm primarily infects the **biliary ducts (liver)**, not maturing in the intestine with proglottids as shown for the tapeworm in the diagram.

Q: Which of the following life cycle is shown below?

Clonorchiasis. ***Clonorchiasis*** - The diagram displays metacercariae (infective stage) in freshwater fish being ingested by a human host, a defining characteristic of the Clonorchis sinensis life cycle. - The life cycle involves freshwater snails (first intermediate host) and freshwater fish (second intermediate host), which aligns with the image showing cercariae encysting in fish. *Diphylobothrium latum* - The infective stage for *Diphylobothrium latum* (fish tapeworm) is the **plerocercoid larva** in raw or undercooked freshwater fish, not metacercariae. - While it also involves freshwater fish, its larval forms and overall life cycle stages are distinct from what is depicted. *Echinococcus granulosus* - This parasite causes **hydatid disease** and has a life cycle involving canids (definitive host) and herbivores (intermediate host), with humans being accidental intermediate hosts. - The life cycle does not involve freshwater fish or metacercariae for human infection. *Tenia solium* - The human is the definitive host for **Taenia solium** (pork tapeworm), acquiring infection by ingesting undercooked pork containing **cysticerci**. - The intermediate host is pigs, and the life cycle does not involve freshwater fish or metacercariae.

Q: Which of the following parasite is shown below?

Echinococcus granulosus. ***Echinococcus granulosus*** - The image displays a **hydatid cyst**, characterized by its thick, laminated outer wall (ectocyst) and an inner germinal layer (endocyst) from which **brood capsules** and **protoscolices** (seen as invaginations) bud off. - This morphology is pathognomonic for **Echinococcus granulosus**, the causative agent of **cystic echinococcosis** (hydatid disease). *Cysticercosis cellulosae* - Cysts of *Cysticercus cellulosae* (larval stage of *Taenia solium*) typically appear as a fluid-filled bladder with a single **invaginated scolex** lacking the complex brood capsule arrangement seen in the image. - They also generally have a thinner cyst wall compared to *Echinococcus* cysts. *E. Histolytica* - *Entamoeba histolytica* is a **protozoan parasite** that causes amoebiasis, presenting as trophozoites or cysts; it does not form macroscopic cysts with complex internal structures like the one shown. - Amoebic abscesses are typically necrotic lesions, not true cysts with parasitic structures within. *Fasciola hepatica* - *Fasciola hepatica* is a **trematode (fluke)**, and its larval stages or adult worms do not form cysts with this characteristic morphology. - Liver flukes would appear as tissue sections of the flatworm itself in infected organs, not as a large, spherical cyst with internal budding structures.

Q: Which is correct of the parasite shown below?

$A=$ Dipylidium caninum, $B=$ Hymenolepis nana. ***A = Dipylidium caninum, B = Hymenolepis nana*** - Image A displays a **scolex with four prominent suckers and a rostellum armed with hooks**, which is characteristic of *Dipylidium caninum*. - Image B shows a **scolex with four suckers and a distinct retractable rostellum armed with a single circlet of hooks**, a key morphological feature of *Hymenolepis nana*. *A = Taenia solium, B = Taenia saginata* - *Taenia solium* scolex (pork tapeworm) typically has **four suckers and a rostellum with a double crown of hooks**, not the single retractile coronet seen in B. - *Taenia saginata* scolex (beef tapeworm) is **unarmed (lacks hooks)** and only possesses four suckers, which contradicts both images. *A = Taenia saginata, B = Taenia solium* - This option is incorrect because *Taenia saginata* is an **unarmed tapeworm**, meaning it lacks hooks, which are clearly visible in Image A. - *Taenia solium* has a **scolex with hooks**, but Image B's scolex with a single circlet of hooks is more consistent with *Hymenolepis nana*. *A = Hymenolepis nana, B = Dipylidium caninum* - The scolex in Image A possesses a **double-crown rostellum with hooks clustered in rows**, which is characteristic of *Dipylidium caninum*, not *Hymenolepis nana*. - The scolex in Image B with four suckers and a retractile rostellum with a single circlet of hooks is indicative of *Hymenolepis nana*, not *Dipylidium caninum*.

Q: Which of the following life cycles is shown below?

Hymenolepis nana. ***Hymenolepis nana*** - The image clearly depicts the life cycle of *Hymenolepis nana*, showing direct human infection from ingesting **fertile eggs**, leading to the development of an **oncosphere** and then a **cercocyst** within the human host before maturing into an adult tapeworm in the intestine. - The presence of an "alternative rodent host (rat, mouse) of minor importance" is a characteristic feature of *Hymenolepis nana*, which can infect both humans and rodents. *Echinococcus granulosus* - This parasite's life cycle involves **dogs (definitive host)** and **sheep/humans (intermediate hosts)**, where humans develop **hydatid cysts**, which is not shown here. - The depiction of an adult tapeworm developing directly in humans after ingestion of eggs, with a rodent as an alternative host, is inconsistent with *Echinococcus granulosus*. *Ascaris lumbricoides* - This is a **roundworm (nematode)**, not a tapeworm, and its life cycle involves **lung migration** of larvae before returning to the intestines to mature, which is not illustrated. - The image shows development from an oncosphere to a cercocyst and then to an adult tapeworm, which is specific to certain **cestodes**. *Toxocara canis* - This is another **roundworm** primarily affecting **dogs**, and humans become **incidental hosts** by ingesting embryonated eggs, leading to visceral larva migrans, where larvae migrate through tissues but do not develop into adult worms in the human intestine. - The illustrated life cycle details, particularly the formation of an oncosphere and cercocyst within the human leading to an adult tapeworm, are not indicative of *Toxocara canis*.

Q: Which of the following CNS lesions is shown below?

Neurocysticercosis. ***Neurocysticercosis*** - The top image displays multiple **cystic lesions** within the brain parenchyma, consistent with various stages of **neurocysticercosis**. - The bottom image shows an **egg of *Taenia solium***, the causative agent of cysticercosis, confirming the parasitic origin. *Cerebral toxoplasmosis* - This typically presents as **multiple ring-enhancing lesions**, often with a predilection for the **basal ganglia** in immunocompromised patients. - The pathological image shown here does not primarily depict ring-enhancing lesions but rather macroscopic cysts. *Cryptococcal meningitis* - While Cryptococcus can cause CNS lesions, they are usually **gelatinous pseudocysts** or **meningitis**, not the distinct cystic structures seen in the image. - The causative organism is a **fungus**, not a parasitic worm, so the associated egg image would be incorrect. *Hydatid cyst* - Hydatid cysts (caused by *Echinococcus granulosus*) are typically **solitary, large, well-defined cysts** with a characteristic laminated membrane. - The image shows **multiple, smaller cysts** and the egg is characteristic of *T. solium*, not *Echinococcus*.

Q: The life cycle shown in the image below is characteristic of which organism?

Schistosomiasis. ***Schistosomiasis*** - The image clearly depicts the characteristic **cercariae** penetrating human skin, with subsequent migration to the portal blood and maturation into adult worms in specific venous plexuses (e.g., rectum, liver, bladder). - The presence of **miracidia** hatching from eggs and infecting snails, followed by the release of cercariae from snails, is the hallmark life cycle of *Schistosoma* species. The eggs are shown in feces and urine, indicating different species of Schistosoma. *Paragonimus* - The life cycle of *Paragonimus* (lung flukes) involves ingestion of **undercooked crustaceans** (crabs or crayfish) containing metacercariae, not skin penetration by cercariae. - Adult worms typically reside in the **lungs**, and eggs are coughed up and swallowed or passed in feces, which is different from the venous system involvement shown. *Fasciolopsis buski* - *Fasciolopsis buski* (intestinal fluke) infection occurs through ingestion of **aquatic plants** contaminated with metacercariae. - The adult worms reside in the **small intestine**, and while eggs are passed in feces, the characteristic skin penetration by cercariae is absent in its life cycle. *Fasciola hepatica* - *Fasciola hepatica* (liver fluke) is acquired by ingesting **metacercariae** on aquatic vegetation, similar to *Fasciolopsis buski*. - Adult worms inhabit the **bile ducts** of the liver, and the life cycle does not involve skin penetration by cercariae as the mode of human infection.

Question 1

The following cell type is seen in peripheral smear of a patient with membrane over the tonsils. All can be used in treatment except?

Accepted Answer

Acyclovir

Answer

Prednisolone

Answer

IVIG

Answer

Acetaminophen

Question 2

Which of the following is incorrect about the condition shown below?

Accepted Answer

Most common CT finding is intraventricular calcification

Answer

Most common presentation is partial seizures

Answer

Albendazole is given for 8 days

Answer

Steroids help in alleviating vasogenic oedema of ring enhancing lesion

Question 3

The following organism is called:

Accepted Answer

Cestode

Answer

Nematode

Answer

Trematode

Answer

Annelid

Question 4

Which of the following life cycle is shown below?

Accepted Answer

Diphyllobothrium latum

Answer

Echinococcus granulosus

Answer

Taenia solium

Answer

Clonorchis sinensis

Question 5

Which of the following life cycle is shown below?

Accepted Answer

Clonorchiasis

Answer

Diphylobothrium latum

Answer

Echinococcus granulosus

Answer

Tenia solium

Question 6

Which of the following parasite is shown below?

Accepted Answer

Echinococcus granulosus

Answer

Cysticercosis cellulosae

Answer

E. Histolytica

Answer

Fasciola hepatica

Question 7

Which is correct of the parasite shown below?

Accepted Answer

$A=$ Dipylidium caninum, $B=$ Hymenolepis nana

Answer

A = Taenia saginata, B = Taenia solium

Answer

$A=$ Hymenolepis nana, $B=$ Dipylidium caninum

Answer

A = Taenia solium, B = Taenia saginata

Question 8

Which of the following life cycles is shown below?

Accepted Answer

Hymenolepis nana

Answer

Echinococcus granulosus

Answer

Ascaris lumbricoides

Answer

Toxocara canis

Question 9

Which of the following CNS lesions is shown below?

Accepted Answer

Neurocysticercosis

Answer

Cerebral toxoplasmosis

Answer

Cryptococcal meningitis

Answer

Hydatid cyst

Question 10

The life cycle shown in the image below is characteristic of which organism?

Accepted Answer

Schistosomiasis

Answer

Paragonimus

Answer

Fasciolopsis buski

Answer

Fasciola hepatica

NEET-PG 2018

Internal Medicine

Microbiology