NEET-PG 2022 - Internal Medicine Practice Questions

Q: A 40-year-old male presented with fever, cough with expectoration and shoness of breath, mild confusion for 1 week. Patient gave history of shower in a public washroom 10 days back. Patient also repoed some episodes of diarrhoea. Sputum sample was taken. And gram staining and direct fluorescent antibody test were done. CT Scan Which of the following lab findings would be most commonly found: -

Hyponatremia. ***Hyponatremia*** - **Legionella pneumonia** often causes syndrome of inappropriate antidiuretic hormone (SIADH) secretion, leading to **dilutional hyponatremia**. - **Gastrointestinal symptoms** like diarrhea, commonly associated with *Legionella* infection, can also contribute to electrolyte imbalances via fluid loss. *Hypocalcemia* - While electrolyte abnormalities can occur, **hypocalcemia** is not a classic or most common finding specifically associated with *Legionella* pneumonia. - It is more typically seen in conditions like **sepsis** or **acute pancreatitis**, which present differently. *Hypernatremia* - **Hypernatremia** indicates a deficit of total body water relative to total body sodium, which is less common in *Legionella* pneumonia, where **SIADH** typically leads to water retention. - Dehydration can cause hypernatremia, but the overall clinical picture of *Legionella* pneumonia and associated GI symptoms usually doesn't lead to this severe imbalance. *Hypercalcemia* - **Hypercalcemia** is a rare finding in acute infections and is generally not associated with *Legionella* pneumonia. - It is more characteristic of conditions like **malignancy** or **hyperparathyroidism**.

Q: A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Substantia Nigra. ***Substantia Nigra*** - A lesion in the **substantia nigra** leads to a deficiency of **dopamine**, which is characteristic of **Parkinson's disease** [1]. - Symptoms like **continuous tremor (resting tremor)**, **postural instability (tendency to fall)**, rigidity, and bradykinesia are hallmark features of Parkinson's disease, linked to substantia nigra degeneration [1], [2]. *Putamen* - While the putamen is part of the basal ganglia and involved in motor control, its primary lesion is not typically associated with the classic triad of **Parkinsonian symptoms** (tremor, rigidity, bradykinesia) [1]. - Lesions here might instead contribute to involuntary movements like **dystonia** or **chorea**, which are not described. *Globus pallidus* - The globus pallidus is involved in regulating voluntary movement, and lesions here can cause various movement disorders, including **dystonia**, **chorea**, or **hemiballismus** [2]. - However, isolated pallidal lesions are less commonly the primary cause of the specific combination of **resting tremor** and **falls** seen in Parkinson's. *Caudate nucleus* - The caudate nucleus plays a crucial role in cognitive and motor functions and is primarily affected in diseases like **Huntington's disease**, leading to **chorea** and cognitive decline [2]. - Lesions in the caudate nucleus do not typically present with a **continuous tremor** and **tendency to fall** as the predominant symptoms.

Question 1

A 40-year-old male presented with fever, cough with expectoration and shoness of breath, mild confusion for 1 week. Patient gave history of shower in a public washroom 10 days back. Patient also repoed some episodes of diarrhoea. Sputum sample was taken. And gram staining and direct fluorescent antibody test were done. CT Scan Which of the following lab findings would be most commonly found: -

Accepted Answer

Hyponatremia

Answer

Hypocalcemia

Answer

Hypernatremia

Answer

Hypercalcemia

Question 2

A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Accepted Answer

Substantia Nigra

Answer

Putamen

Answer

Globus pallidus

Answer

Caudate nucleus

NEET-PG 2022 — Internal Medicine