NEET-PG 2020 Practice Questions

Q: Admission rate bias is?

Berksonian bias. ***Berksonian bias*** - **Berksonian bias** is a form of selection bias, also known as **admission rate bias**, that occurs when different rates of admission to a hospital or clinical setting distort the association between diseases or between a disease and a risk factor. - This bias arises because the hospitalized population may not be representative of the general population, leading to spurious associations or masking real ones. *Reporting bias* - **Reporting bias** is a type of information bias where the outcome or exposure information is reported inaccurately, often due to social desirability or recall issues. - It does not specifically refer to distortions stemming from hospital admission rates. *Response bias* - **Response bias** occurs when participants in a study alter their answers or behavior from what is true due to factors like leading questions, social desirability, or acquiescence. - This is an issue related to data collection, not an unrepresentative study population due to hospital admission protocols. *None of the options* - Berksonian bias directly corresponds to the definition of admission rate bias, making this option incorrect.

Q: What is the target population for a Secondary Service Center as per the Vision 2020 initiative in India?

5 lac. ***5 lac*** - As per the **Vision 2020 initiative** (National Programme for Control of Blindness) in India, Secondary Service Centers are designed to cater to a target population of **500,000 (5 lac) individuals**. - This population size allows for efficient resource allocation and ensures comprehensive secondary-level eye care services, including cataract surgery and other specialist ophthalmological procedures, are accessible to a significant segment of the population. - Secondary Centers serve as referral units between Primary Centers and tertiary-level District Centers. *10000* - A target population of 10,000 is typically served by **Primary Vision Centers** or sub-centers, which provide basic eye screening and first-contact eye care. - Secondary Service Centers offer a broader range of specialized services that require a larger catchment area to be economically viable and effectively utilized. *50000* - A population of 50,000 is too small for a Secondary Service Center under the Vision 2020 framework. - This population size might be appropriate for enhanced Primary Care facilities, but Secondary Centers require a much larger demographic base to justify the specialized infrastructure and trained ophthalmologists necessary for comprehensive secondary eye care. *1 lac* - While 100,000 (1 lac) represents a substantial population, it is still **smaller than the intended target** for a Secondary Service Center under Vision 2020. - The centers are designed to serve **5 times this population** (5 lac), acting as major hubs for secondary eye care with surgical facilities and specialist services for multiple primary centers.

Q: A 30-year-old male presents with a one-week history of severe toothache, swelling in the floor of the mouth, and difficulty swallowing. What is the most likely diagnosis?

Ludwig's angina. ***Ludwig's angina*** - The combination of a recent **severe toothache** (suggesting odontogenic infection), **swelling in the floor of the mouth**, and **difficulty swallowing (dysphagia)** are classic signs of Ludwig's angina, a rapidly spreading cellulitis of the submandibular, sublingual, and submental spaces. - This condition is particularly dangerous due to its potential to cause **airway obstruction** if the swelling progresses posteriorly. *Acute parotitis* - Acute parotitis typically presents with swelling and pain primarily in the **parotid gland region**, often located anterior to the ear and extending to the angle of the jaw. - While it can cause pain and difficulty swallowing, swelling is not typically described as being predominantly in the **floor of the mouth**. *Angioneurotic edema* - Angioneurotic edema (or angioedema) is characterized by **rapid, localized swelling of subcutaneous or submucosal tissues**, often affecting the face, lips, tongue, and pharynx. - It usually lacks a preceding infectious etiology like a toothache and is typically attributed to allergic reactions or hereditary/acquired deficiencies in C1-esterase inhibitor. *Parapharyngeal abscess* - A parapharyngeal abscess is a deep neck infection located in the **parapharyngeal space** lateral to the pharynx, often presenting with fever, severe sore throat, and trismus (difficulty opening the mouth). - While it can cause dysphagia and neck swelling, the primary swelling location described in the **floor of the mouth** points away from a parapharyngeal abscess as the most likely diagnosis.

Q: In the context of civil negligence against a doctor, who bears the burden of proof?

Patient. ***Patient*** - In civil negligence cases, the **plaintiff** (the patient) always bears the **burden of proof** to demonstrate that the doctor was negligent. - The patient must establish the **four elements of negligence**: duty of care, breach of duty, causation, and damages. - This follows the fundamental legal principle: **"He who asserts must prove"** (*onus probandi*). *Judicial first-degree magistrate* - A **Judicial First-Class Magistrate (JFCM)** is a **criminal court** officer who handles criminal cases, not civil negligence suits. - Civil negligence cases against doctors are filed in **Civil Courts**, not before magistrates. - Magistrates do not bear the burden of proof; they adjudicate based on evidence presented by parties. *Police not below the level of sub-inspector* - This refers to **criminal negligence** cases under **Section 304A IPC** (causing death by rash or negligent act), not civil negligence. - In criminal cases, police (Sub-Inspector or above) investigate and the **State bears the burden of proof**, not the individual parties. - Civil negligence is a **tort**, handled separately from criminal proceedings. *Doctor* - The **doctor** (defendant) is the party against whom the negligence claim is made. - While the doctor must present evidence to **rebut** the patient's claims, they do not bear the **initial burden of proof** in civil cases. - The burden only shifts to the doctor if the doctrine of **res ipsa loquitur** applies (rare circumstances where negligence is self-evident).

Q: The patient is presenting with the deformity of the finger as shown. The PIP is involved but the DIP is spared

Rheumatoid arthritis. ***Rheumatoid arthritis*** - The image shows a **Boutonniere deformity**, characterized by **flexion of the PIP joint** and hyperextension of the DIP joint, which is classic for rheumatoid arthritis. - **Rheumatoid arthritis** typically affects the small joints of the hands and feet, particularly the **PIP joints and MCP joints**, sparing the DIP joints. *Osteoarthritis* - Osteoarthritis commonly involves the **DIP joints (Heberden's nodes)** and **PIP joints (Bouchard's nodes)**, but the depicted deformity (Boutonniere) is not typical. - It is primarily a degenerative joint disease, not inflammatory, and tends to spare the MCP joints until very late in the disease. *Psoriatic Arthritis* - Psoriatic arthritis often involves the **DIP joints and causes dactylitis (sausage digits)**, which is not clearly depicted, although Boutonniere can occur. - The key differentiator is usually the presence of **psoriasis skin lesions or nail changes**, which are not mentioned or visible in the image. *Ankylosing spondylitis* - This condition primarily affects the **axial skeleton**, particularly the **sacroiliac joints** and spine, leading to stiffness and pain. - While peripheral joint involvement can occur, it is generally not characterized by specific hand deformities like Boutonniere deformity.

Q: What is the diagnosis of a 55-year-old woman with chronic low backache?

Osteoporosis. ***Osteoporosis*** - The image shows **loss of bone density** and **vertebral compression fractures**, especially visible in the lumbar spine, which are characteristic findings in osteoporosis. - Osteoporosis is common in post-menopausal women, and **chronic low backache** is a frequent symptom due to microfractures or vertebral collapse. *Hurler's syndrome* - This is a lysosomal storage disease (mucopolysaccharidosis type I) that primarily affects **children** and presents with distinct **skeletal deformities** (dysostosis multiplex), facial features, and organ involvement. - It would not typically present as chronic low backache in a 55-year-old woman, and the radiological findings are not consistent with Hurler's syndrome. *Paget’s disease* - Paget's disease of bone involves abnormal bone remodeling, leading to **enlarged and weakened bones**, often with a characteristic **cotton wool appearance** on X-ray, which is not seen here. - While it can cause bone pain and affect the spine, the primary radiological features seen in this image are more consistent with generalized bone density loss and fractures rather than focal expansion and abnormal bone architecture. *Renal osteodystrophy* - This condition occurs in patients with **chronic kidney disease** and results from imbalances in calcium, phosphate, and parathyroid hormone. - Radiographic features include **osteosclerosis (rugger jersey spine)**, bone erosions, or osteomalacia, which are different from the generalized osteopenia and compression fractures observed in this X-ray.

Q: Which of the following criteria is used to assess the prognosis of liver conditions?

Child-Pugh score. ***Child-Pugh score*** - The **Child-Pugh score** is a widely used scoring system to assess the **prognosis of chronic liver disease**, primarily cirrhosis. - It categorizes patients into classes A, B, or C based on five clinical measures of liver function: **bilirubin**, **albumin**, **INR**, **ascites**, and **hepatic encephalopathy**. *Milan criteria* - The **Milan criteria** are used to select patients with **hepatocellular carcinoma (HCC)** for **liver transplantation**. - They are not a general prognostic tool for all liver conditions, but rather specific to HCC and transplant eligibility. *MELD score* - The **Model for End-Stage Liver Disease (MELD) score** is used to assess the **severity of chronic liver disease** and predict short-term survival. - It is primarily used for **prioritizing patients for liver transplantation**, not for general prognosis in all liver conditions, and includes bilirubin, creatinine, and INR. *Alvarado score* - The **Alvarado score** is a clinical scoring system used to assess the **likelihood of acute appendicitis**. - It is entirely unrelated to liver conditions and is not used for assessing liver prognosis.

Q: Identify the sleep stage marked in the EEG during the sleep-wake cycle?

REM sleep. ***REM sleep*** - The marked EEG pattern shows **low-amplitude, mixed-frequency waves** which are characteristic of REM sleep, often resembling an awake state. - This stage is associated with **rapid eye movements**, vivid dreams, and muscle atonias. *Stage 1 sleep* - Characterized by a transition from alpha waves to **theta waves**, which are slightly slower than alpha waves and have a higher amplitude than the waves shown. - This is the **lightest stage of sleep**, with the person easily aroused. *Stage 2 sleep* - Marked by the presence of **sleep spindles** (bursts of high-frequency waves) and **K-complexes** (large, slow waves), which are not visible in the image. - The background activity consists of **theta waves,** which are slower and higher amplitude than the waves present in the image. *Stage 3 sleep* - This is **deep non-REM sleep**, also known as slow-wave sleep, characterized by **delta waves** (high-amplitude, low-frequency waves). - The waves in the image are much faster and lower amplitude than delta waves characteristic of Stage 3 sleep.

Q: Identify the radiological sign of Ischemic colitis from the image provided.

Thumbprinting sign of Ischemic colitis. ***Thumbprinting sign of Ischemic colitis*** - The image displays prominent **indentations (thumbprinting)** along the bowel wall, especially in the descending colon (indicated by arrows). These indentations are caused by **edema** and **hemorrhage** in the submucosal layer due to ischemia. - This characteristic appearance on a barium enema or CT scan is a classic radiological sign highly suggestive of **ischemic colitis**. *Diverticulitis* - Diverticulitis typically presents with **saccular outpouchings** (diverticula) that become inflamed, potentially showing wall thickening or **pericolonic fat stranding**. - This image does not show typical diverticula or signs of severe inflammation associated with diverticulitis, but rather diffuse mucosal changes. *Appendicitis* - Appendicitis is characterized by inflammation of the **vermiform appendix**, typically seen as a **dilated**, non-compressible appendix with surrounding fat stranding in the right lower quadrant. - The radiological findings in the image are of the colon, not the appendix, and are inconsistent with acute appendicitis. *None of the options* - The image presents a clear and characteristic radiological sign that points to a specific diagnosis, making this option incorrect. - The presence of **thumbprinting** is a well-established indicator for ischemic colitis.

Q: What does a bluish-purple discoloration behind the mastoid indicate?

Battle sign. ***Battle sign*** - A **bluish-purple discoloration behind the mastoid** (postauricular ecchymosis) is a classic sign of a **basilar skull fracture**, particularly involving the middle cranial fossa. - This bruising is caused by the extravasation of blood from the fracture site into the soft tissues over the mastoid process. *Bezold abscess* - A Bezold abscess is a rare complication of **mastoiditis**, where infection erodes through the mastoid tip and spreads to the soft tissues of the neck. - It presents as a **painful swelling in the neck** and is typically not associated with a bluish-purple discoloration *behind* the mastoid unless there is significant necrotic tissue or a secondary hematoma, which is not the primary feature. *Both A and B* - These conditions represent distinct pathologies, one related to **trauma (Battle sign)** and the other to **infection (Bezold abscess)**. - While both involve the mastoid region, their underlying causes and typical presentations are different. *None of the options* - The image directly displays the characteristic bruising of a Battle sign, making this option incorrect. - The appearance is highly indicative of a specific medical condition.

Question 1

Admission rate bias is?

Accepted Answer

Berksonian bias

Answer

Reporting bias

Answer

Response bias

Answer

None of the options

Question 2

What is the target population for a Secondary Service Center as per the Vision 2020 initiative in India?

Accepted Answer

5 lac

Answer

10000

Answer

50000

Answer

1 lac

Question 3

A 30-year-old male presents with a one-week history of severe toothache, swelling in the floor of the mouth, and difficulty swallowing. What is the most likely diagnosis?

Accepted Answer

Ludwig's angina

Answer

Acute parotitis

Answer

Angioneurotic edema

Answer

Parapharyngeal abscess

Question 4

In the context of civil negligence against a doctor, who bears the burden of proof?

Accepted Answer

Patient

Answer

Judicial first-degree magistrate

Answer

Police not below the level of sub-inspector

Answer

Doctor

Question 5

The patient is presenting with the deformity of the finger as shown. The PIP is involved but the DIP is spared

Accepted Answer

Rheumatoid arthritis

Answer

Osteoarthritis

Answer

Psoriatic Arthritis

Answer

Ankylosing spondylitis

Question 6

What is the diagnosis of a 55-year-old woman with chronic low backache?

Accepted Answer

Osteoporosis

Answer

Hurler's syndrome

Answer

Paget’s disease

Answer

Renal osteodystrophy

Question 7

Which of the following criteria is used to assess the prognosis of liver conditions?

Accepted Answer

Child-Pugh score

Answer

Milan criteria

Answer

MELD score

Answer

Alvarado score

Question 8

Identify the sleep stage marked in the EEG during the sleep-wake cycle?

Accepted Answer

REM sleep

Answer

Stage 1 sleep

Answer

Stage 2 sleep

Answer

Stage 3 sleep

Question 9

Identify the radiological sign of Ischemic colitis from the image provided.

Accepted Answer

Thumbprinting sign of Ischemic colitis

Answer

Diverticulitis

Answer

Appendicitis

Answer

None of the options

Question 10

What does a bluish-purple discoloration behind the mastoid indicate?

Accepted Answer

Battle sign

Answer

Bezold abscess

Answer

Both A and B

Answer

None of the options

NEET-PG 2020

Community Medicine

Dental

Forensic Medicine

Internal Medicine

Physiology

Radiology

Surgery