NEET-PG 2020 Practice Questions

Q: In the following X-ray of the wrist, what is the exact age of the child?

6 years. ***6 years*** - The appearance of **ossification centers** in the carpals and epiphysis of long bones of the hand and wrist indicates a bone age of approximately 6 years. Key markers for this age include the presence of **capitate, hamate, triquetrum, lunate, scaphoid, and trapezium** ossification centers, as well as the initial appearance of the **distal radial epiphysis** and **epiphyses of phalanges and metacarpals**. - Specifically, the **trapezium** and **scaphoid** ossification centers are typically visible by 5-6 years, and the **distal radial epiphysis** has started to ossify but the **distal ulna epiphysis** is not yet visible, which is characteristic of the 6-year-old child. *2 years* - At 2 years of age, fewer **carpal bones** would be ossified, typically only the capitate and hamate, and possibly the triquetrum. - The **epiphyses** of the distal radius and ulna and many of the phalanges and metacarpals would be less developed or not yet visible. *8 years* - By 8 years, the **distal ulna epiphysis** would typically be visible, and the **trapezoid** would also be ossified, which is not clearly evident yet in this image. - The carpal bones present are consistent with a younger age than 8 years. *9 years* - At 9 years, all **carpal ossification centers** (capitate, hamate, triquetrum, lunate, scaphoid, trapezium, trapezoid, and pisiform) would generally be present, with the pisiform appearing around 9-12 years. - The image lacks the full complement of carpal bones consistently seen at 9 years, especially the **pisiform** and a distinctly visible **trapezoid**.

Q: Ochronosis is due to the accumulation of?

Homogentisic acid. ***Homogentisic acid (Correct)*** - **Ochronosis** is a rare genetic disorder characterized by the accumulation of **homogentisic acid** in connective tissues. - This accumulation results from a deficiency of the enzyme **homogentisate 1,2-dioxygenase**, which is crucial in the catabolism of tyrosine and phenylalanine. - Clinically presents with dark pigmentation of cartilage, sclera, and other connective tissues. *Alkapton (Incorrect)* - While **alkaptonuria** is the disease caused by homogentisic acid accumulation, **alkapton** itself is not the substance that accumulates in tissues in ochronosis. - **Alkapton** refers to the dark-colored urine observed in patients with alkaptonuria, which is due to the oxidation of homogentisic acid in the urine. *Xanthurenate (Incorrect)* - **Xanthurenate** is an intermediate in the metabolism of tryptophan, and its accumulation is associated with certain vitamin B6 deficiencies. - It is not involved in the pathogenesis of ochronosis or alkaptonuria. *Glyoxylate (Incorrect)* - **Glyoxylate** is a metabolic intermediate involved in various pathways, including carbohydrate and amino acid metabolism. - Accumulation of glyoxylate is associated with **primary hyperoxaluria type 1**, but not with ochronosis.

Q: Which of the following is an example of prospective screening?

Neonate for thyroid diseases. ***Neonate for thyroid diseases*** - **Prospective/Mass screening** involves screening an **entire population or specific subgroup** before symptoms appear for early detection and intervention - **Neonatal screening for congenital hypothyroidism** is performed universally on all newborns to identify and treat the condition early, preventing severe developmental disabilities and intellectual impairment - This represents **true population-wide screening** applied systematically to every member of the birth cohort *Immigrant screening* - This is **selective screening** targeting a specific high-risk group rather than universal population screening - Primary goal is to **control disease transmission** and identify conditions posing public health risks upon entry - Not applied to the general population systematically *Pap smear for 45-year female* - This is an example of **organized screening** for cervical cancer in a specific age group - While valuable for secondary prevention, it targets women within defined age ranges (typically 21-65 years) - Not universal across all age groups like neonatal screening *Diabetes mellitus for 40-year male* - This represents **opportunistic or selective screening** based on age and risk factors - Not a universal population-wide program applied systematically to everyone - Typically done as part of routine health checks for at-risk individuals

Q: Relatives of a patient told during postmortem examination that the person had a tattoo - which was now invisible. How to identify?

Examine the Lymph node. ***Examine the Lymph node*** - Tattoo ink particles are **phagocytosed** by macrophages and subsequently transported to and deposited in the regional **lymph nodes**. - Even if a tattoo is no longer visible on the skin due to decomposition or other factors, the pigment can often still be found in the associated **lymph nodes upon histological examination**. *Spectrophotometer* - A spectrophotometer is used to **measure the absorption or transmission of light** by a sample, which could identify pigments in a *prepared tissue sample*. - However, it would not be the **primary method for initial detection of an invisible tattoo** within a body as it requires a specific tissue sample containing the pigment to work, and would not help in locating the tattoo's original site or the presence of pigment in regional lymph nodes. *Ordinary light* - Ordinary light is suitable for examining **visible surface features** or visible tattoos. - If a tattoo is already described as **invisible**, ordinary light will not reveal its presence, as the pigments are either degraded, covered, or too deep to be seen. *X-ray* - X-rays are primarily used to visualize **bone or dense structures** and can detect foreign bodies that are radiopaque (like some metals). - Tattoo pigments are generally **not sufficiently radiopaque** to be visible on X-ray, making this method ineffective for detecting tattoos.

Q: A patient presents with painful blisters around the angle of the mouth. What is the most likely pathogen responsible for this condition?

Herpes Simplex Virus. ***Herpes Simplex Virus*** - The image shows a cluster of **small, painful vesicles** on an erythematous base around the mouth, characteristic of **herpes labialis** or cold sores. - HSV-1 is the primary cause of oral herpes, which typically presents with these recurrent painful blister outbreaks. *Coxsackievirus* - Coxsackievirus typically causes **Hand, Foot, and Mouth Disease**, characterized by oral lesions (herpangina) and a rash on the hands and feet. - The painful blisters are usually in the **posterior oral cavity** (soft palate, tonsillar pillars) and are not typically perioral in the depicted clustered vesicular pattern. *Varicella-Zoster Virus* - VZV causes **chickenpox** (widespread vesicular rash) and **shingles** (painful, dermatomal vesicular rash). - While it causes vesicles, they would present as either widespread and generalized or in a unilateral, **dermatomal distribution**, which is not consistent with the perioral presentation shown. *Epstein-Barr Virus* - EBV is primarily known for causing **infectious mononucleosis**, which can lead to fatigue, fever, and lymphadenopathy, and sometimes oral manifestations like palatal petechiae or oral hairy leukoplakia. - It does not typically cause the **painful vesicular lesions** around the mouth as depicted.

Q: A mother brought her 16-year-old daughter to Gynaecology OPD with a complaint of not attaining menarche. She gives a history of cyclic abdominal pain. On further examination, a midline abdominal swelling is seen. Per rectal examination reveals a bulging mass in the vagina. Which of the following conditions is most likely responsible for these findings?

Imperforate hymen. ***Imperforate hymen*** - An **imperforate hymen** obstructs the outflow of menstrual blood, leading to its accumulation in the vagina (**hematocolpos**) and uterus (**hematometra**), causing **cyclic abdominal pain** and a bulging mass (due to accumulated blood) in the vagina. - The patient presents with **primary amenorrhea** (not having attained menarche) and cyclical abdominal pain caused by the inability of menstrual blood to exit the body. *Transverse vaginal septum* - A **transverse vaginal septum** can also cause primary amenorrhea and cyclic abdominal pain due to obstruction of menstrual flow. However, it is a less common cause than an imperforate hymen. - While it can lead to hematocolpos, the characteristic bulging mass on per rectal examination is more strongly associated with an imperforate hymen presenting at the vaginal introitus. *Vaginal agenesis* - **Vaginal agenesis** (complete absence of the vagina) would present with primary amenorrhea, but there would be no cyclic abdominal pain if the uterus is also absent or rudimentary. If a uterus is present, there would be no accumulation of blood in the vagina or a bulging mass per rectum as there is no vaginal canal. - This condition is typically associated with a rudimentary or absent uterus, leading to an inability to menstruate rather than obstructed flow. *Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome* - **MRKH syndrome** is characterized by congenital aplasia of the uterus and the upper two-thirds of the vagina, with normal ovaries and external genitalia. - Patients present with **primary amenorrhea** but typically do not experience **cyclic abdominal pain** or a bulging vaginal mass because there is no functional uterus to produce menstrual blood or a vaginal canal for blood accumulation.

Q: 25-year-old man presents for a routine physical examination. The patient is tall and on examination, he was found to have an early diastolic murmur. His family pedigree is given below (image attached). Which of the following is the mode of inheritance by which the disease is likely to be transmitted?

Autosomal Dominant. ***Autosomal Dominant*** - The pedigree shows that the disease appears in every generation, and affected individuals have at least one affected parent (e.g., I-1 passes it to II-1, II-5, II-8). This pattern is characteristic of **dominant inheritance**. - Both males and females are affected, and affected fathers can pass the trait to their sons (e.g., I-1 to II-1), ruling out X-linked inheritance and supporting an **autosomal dominant** mode. *Autosomal Recessive* - In autosomal recessive inheritance, affected individuals typically have **unaffected parents** (who are carriers), and the disease often skips generations. This is not observed in the provided pedigree. - While both males and females can be affected, the presence of affected individuals in every generation and vertical transmission makes recessive inheritance unlikely. *X-Linked Recessive* - X-linked recessive disorders typically show more affected males than females, and affected fathers **cannot pass the trait to their sons**. The pedigree clearly shows affected females and father-to-son transmission (I-1 to II-1 and potentially II-8 to III-6), ruling out this pattern. - Also, all daughters of an affected father would be carriers, and some an affected mother would have affected offspring. *X-Linked Dominant* - In X-linked dominant inheritance, all daughters of an affected father would be affected, and there is no male-to-male transmission. - The pedigree shows instances where affected fathers (like I-1) have unaffected daughters (e.g., II-2, II-4, II-6, II-7), and affected mothers (II-5, II-8) have unaffected children, which contradicts X-linked dominant inheritance.

Q: Where does meiosis occur in human females?

In the adult ovary. ***In the adult ovary*** - **Meiosis I** in oocytes starts during fetal development but arrests in prophase I. It resumes and completes in the **adult ovary** just before ovulation in response to hormonal signals. - **Meiosis II** begins after the completion of Meiosis I and arrests in metaphase II. It is only completed upon **fertilization** by a sperm, also occurring within the adult reproductive tract. *At birth in the ovary* - At birth, female ovaries contain primary oocytes that have entered **meiosis I** but are arrested in prophase I; actual meiotic divisions promoting maturation do not occur at this stage. - The completion of meiosis I and the initiation of meiosis II are processes that are **post-puberty** and occur in response to hormonal changes leading to ovulation. *In the adult testis* - The testis is the male gonad, and it is the site of **spermatogenesis**, the process of sperm production involving meiosis in males. - **Oogenesis**, the formation of female gametes, occurs exclusively in the **ovaries** of females. *In the prepubertal testis* - In the prepubertal testis, spermatogenesis has not yet begun, and thus **meiosis does not occur** at this stage in males. - Meiosis in males usually begins during **puberty** under the influence of hormones like testosterone.

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: The Barium Swallow examination shows a filling defect in the esophagus. What is the most probable diagnosis?

Esophageal Carcinoma. ***Esophageal Carcinoma*** - A filling defect on a barium swallow study, especially with irregular borders and luminal narrowing, is highly suggestive of an **esophageal carcinoma**. - The image appears to show an **irregular, obstructing lesion** that displaces the barium column, characteristic of a mass. *Esophageal Ring* - An esophageal ring, such as a **Schatzki ring**, typically presents as a thin, circumferential narrowing of the distal esophagus, forming a smooth, shelf-like indentation, which is not seen here. - Esophageal rings usually cause **intermittent dysphagia** to solids but do not present as a large, irregular filling defect. *Esophageal Tear* - An esophageal tear (e.g., **Mallory-Weiss tear**) is a mucosal laceration that would present with **hematemesis** and would typically appear as a linear defect or streak on a barium swallow if visible, not a filling defect. - A tear is not usually associated with a persistent mass effect or irregular luminal obstruction seen in the image. *Achalasia Cardia* - **Achalasia** is characterized by the failure of the lower esophageal sphincter to relax and **absent peristalsis** in the esophageal body, leading to a classic "bird's beak" or "rat tail" appearance on barium swallow due to distal narrowing and proximal dilation. - While it causes luminal narrowing, it does not typically present as an irregular filling defect within the lumen, but rather as a smooth tapering of the distal esophagus.

Question 1

In the following X-ray of the wrist, what is the exact age of the child?

Accepted Answer

6 years

Answer

2 years

Answer

8 years

Answer

9 years

Question 2

Ochronosis is due to the accumulation of?

Accepted Answer

Homogentisic acid

Answer

Alkapton

Answer

Xanthurenate

Answer

Glyoxylate

Question 3

Which of the following is an example of prospective screening?

Accepted Answer

Neonate for thyroid diseases

Answer

Immigrant screening

Answer

Pap smear for 45-year female

Answer

Diabetes mellitus for 40-year male

Question 4

Relatives of a patient told during postmortem examination that the person had a tattoo - which was now invisible. How to identify?

Accepted Answer

Examine the Lymph node

Answer

Spectrophotometer

Answer

Ordinary light

Answer

X-ray

Question 5

A patient presents with painful blisters around the angle of the mouth. What is the most likely pathogen responsible for this condition?

Accepted Answer

Herpes Simplex Virus

Answer

Coxsackievirus

Answer

Varicella-Zoster Virus

Answer

Epstein-Barr Virus

Question 6

A mother brought her 16-year-old daughter to Gynaecology OPD with a complaint of not attaining menarche. She gives a history of cyclic abdominal pain. On further examination, a midline abdominal swelling is seen. Per rectal examination reveals a bulging mass in the vagina. Which of the following conditions is most likely responsible for these findings?

Accepted Answer

Imperforate hymen

Answer

Vaginal agenesis

Answer

Transverse vaginal septum

Answer

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome

Question 7

25-year-old man presents for a routine physical examination. The patient is tall and on examination, he was found to have an early diastolic murmur. His family pedigree is given below (image attached). Which of the following is the mode of inheritance by which the disease is likely to be transmitted?

Accepted Answer

Autosomal Dominant

Answer

Autosomal Recessive

Answer

X-Linked Recessive

Answer

X-Linked Dominant

Question 8

Where does meiosis occur in human females?

Accepted Answer

In the adult ovary

Answer

At birth in the ovary

Answer

In the adult testis

Answer

In the prepubertal testis

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

The Barium Swallow examination shows a filling defect in the esophagus. What is the most probable diagnosis?

Accepted Answer

Esophageal Carcinoma

Answer

Esophageal Ring

Answer

Esophageal Tear

Answer

Achalasia Cardia

NEET-PG 2020

Anatomy

Biochemistry

Community Medicine

Forensic Medicine

Microbiology

Obstetrics and Gynecology

Pathology

Physiology

Radiology