NEET-PG 2022 Practice Questions

Q: The structure marked A in the image below gives rise to which of the following structures?

Falciform ligament. ***Falciform ligament*** - The structure marked 'A' represents the **ventral mesentery** in the embryonic stage, which connects the primitive gut tube to the anterior body wall. - The **falciform ligament** develops from the ventral mesentery, specifically in the region of the liver, and connects the liver to the anterior abdominal wall and diaphragm. *Gastrosplenic ligament* - This ligament is derived from the **dorsal mesentery**, not the ventral mesentery. - It connects the greater curvature of the stomach to the hilum of the spleen. *Lienorenal ligament* - Also derived from the **dorsal mesentery**, connecting the left kidney to the spleen. - This structure is not formed from the ventral mesentery which is indicated by 'A'. *Gastrophrenic ligament* - This ligament is part of the **dorsal mesentery** and connects the stomach to the diaphragm. - It is not a derivative of the ventral mesentery.

Q: Identify the mask used for patients requiring high concentrations of oxygen.

Non-rebreathing mask. ***Non-rebreathing mask*** - The **non-rebreathing mask** delivers the **highest concentration of oxygen** (FiO2 60-90%) among standard oxygen masks due to a one-way valve that prevents exhaled air from returning to the reservoir bag and ensures only pure oxygen is inhaled. - It is identifiable by the **reservoir bag** which fills with oxygen and one-way valves. *Hudson mask* - The **Hudson mask**, also known as a simple face mask, delivers a **moderate concentration of oxygen (FiO2 35-50%)** and does not have the reservoir bag or one-way valves seen in the image. - It is used for patients requiring a higher oxygen concentration than nasal cannulae, but less than a non-rebreather. *Nebulizer* - A **nebulizer** is a device used to administer medication in the form of a **mist**, typically for respiratory conditions, not primarily for administering high concentrations of oxygen. - While it can be oxygen-driven, its primary function is drug delivery, not oxygen concentration. *Venturi mask* - The **Venturi mask** delivers **precise and consistent concentrations of oxygen (FiO2 24-60%)** through interchangeable jets, which are not visible in the depicted mask. - It is used when precise control over oxygen delivery is crucial, such as in patients with **COPD**.

Q: Identify the type of hymen.

Septate hymen. ***Septate hymen*** - The image clearly displays a **band of tissue** running across the hymenal opening, dividing it into two smaller openings, which is characteristic of a **septate hymen**. - This type of hymen can sometimes interfere with menstruation or intercourse and may require surgical correction. *Imperforate hymen* - An **imperforate hymen** completely covers the vaginal opening, with no perforations for menstrual flow. - This typically presents at menarche with **abdominal pain** and a bulging hymen due to retained menstrual blood (hematocolpos). *Semilunar hymen* - A **semilunar hymen** is incomplete, forming a crescent shape at the posterior aspect of the vaginal opening. - This is a common and normal variant, usually not causing any clinical issues. *Annular hymen* - An **annular hymen** is characterized by a circular opening in the center, encircled by hymenal tissue, appearing like a ring. - This is a common hymenal configuration and usually allows for normal menstrual flow.

Q: A patient presents with complaints of hair loss and behavioral changes noted by his wife. Upon examination, the doctor observes a loss of eyebrows. After further assessment, including an examination of the nails, what type of poisoning is suspected in this case?

Thallium. ***Thallium*** - **Thallium poisoning** characteristically presents with **hair loss (alopecia)**, including loss of eyebrows, and **neurological symptoms** such as behavioral changes. - It also causes nail changes like **Mees' lines** and is known for its **neurotoxic effects**. *Arsenic* - **Arsenic poisoning** primarily causes **gastrointestinal symptoms** (nausea, vomiting, diarrhea), **skin lesions** (hyperpigmentation, hyperkeratosis), and **neuropathy**. - While it can cause nail changes (Mees' lines), significant alopecia and loss of eyebrows are less prominent compared to thallium. *Mercury* - **Mercury poisoning** often leads to **neurological symptoms** (tremors, ataxia, irritability), kidney damage, and **gingivostomatitis**. - Hair loss and loss of eyebrows are not typical or prominent features of mercury toxicity. *Lead* - **Lead poisoning** is associated with **neurodevelopmental deficits** in children, **peripheral neuropathy**, **abdominal pain (lead colic)**, and **anemia**. - Alopecia and loss of eyebrows are not characteristic symptoms of lead toxicity.

Q: Which of the following is not seen in MEN 2B syndrome?

Parathyroid adenoma. ***Parathyroid adenoma*** - **Parathyroid adenomas**, leading to hyperparathyroidism, are characteristic of **MEN 2A syndrome**, not MEN 2B [1]. - While both MEN 2A and 2B involve mutations in the **RET proto-oncogene**, the specific clinical manifestations differ significantly. *Megacolon* - **Megacolon** (due to intestinal ganglioneuromatosis) is a recognized feature of **MEN 2B syndrome**. - This condition involves abnormal nerve ganglion cells in the intestine, leading to motility issues. *Mucosal neuroma* - **Mucosal neuromas** on the tongue, lips, and eyelids are a hallmark clinical sign of **MEN 2B syndrome**. - These benign growths are often one of the earliest and most recognizable features. *Marfanoid habitus* - **Marfanoid habitus**, characterized by a tall, slender build with long limbs and arachnodactyly, is a common physical finding in **MEN 2B syndrome**. - This connective tissue abnormality helps distinguish MEN 2B from other MEN syndromes.

Q: A patient with a history of chronic liver disease presents with abdominal distension, jaundice, and pruritis. Ascitic fluid analysis revealed a neutrophil count >650 per cubic mm. What is the most likely diagnosis?

Spontaneous bacterial peritonitis. ***Spontaneous bacterial peritonitis*** - The combination of **chronic liver disease**, **ascites**, and a significantly elevated ascitic fluid **neutrophil count (>250 cells/mm³ is diagnostic)**, in this case, >650 cells/mm³, is highly indicative of spontaneous bacterial peritonitis (SBP). - SBP is a common and serious complication in patients with **cirrhosis** and ascites, characterized by bacterial infection of ascitic fluid without an obvious source. *Malignant ascites* - While malignant ascites can occur in chronic liver disease (e.g., from hepatocellular carcinoma), the ascitic fluid analysis would typically show **cytology positive for malignant cells** and often a **low neutrophil count** unless secondarily infected. - The primary differentiator here is the very high neutrophil count suggesting an acute inflammatory/infectious process. *Tubercular ascites* - Tubercular ascites might present with ascites and abdominal distension, but the ascitic fluid analysis usually shows a **lymphocytic predominance** (high lymphocyte count) rather than a high neutrophil count. - Diagnosis typically involves **adenosine deaminase (ADA) levels**, acid-fast bacilli smear, or culture of ascitic fluid. *Intestinal obstruction* - Intestinal obstruction primarily causes **abdominal pain, distension, nausea, vomiting**, and constipation, with a clinical picture distinct from SBP. - While it can lead to ascites in rare cases (e.g., from bowel ischemia or perforation), the ascitic fluid would not characteristically show such a high neutrophil count unless there was associated perforation and peritonitis.

Q: Which of the following is NOT an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Uterine malformation. ***Uterine malformation*** - While a **uterine malformation** can make IUD placement difficult or increase the risk of expulsion, it is generally considered a **relative contraindication**, not an absolute one. - The decision to place an IUD in such cases depends on the specific type of malformation and the experience of the clinician. *Pregnancy* - **Pregnancy** is an **absolute contraindication** because an IUD offers no protection against pregnancy in an already conceived state and can lead to complications such as miscarriage or ectopic pregnancy if inserted. - Inserting an IUD into a pregnant uterus can cause significant harm to both the mother and the fetus. *Active pelvic infection* - An **active pelvic infection** (e.g., **pelvic inflammatory disease, cervicitis**) is an **absolute contraindication** due to the risk of exacerbating the infection and spreading it further into the uterus and fallopian tubes. - IUD insertion during an active infection can lead to severe complications. *Known allergy to IUD components* - A **known allergy** to any component of the IUD (e.g., copper, plastic) is an **absolute contraindication** to avoid severe allergic reactions. - Allergic reactions can range from localized irritation to systemic responses.

Q: A 24 year old lactating female with an 18 month old child comes with a history of irregular, heavy bleeding seeking contraceptive advice. Which is the contraceptive of choice?

Progestin-only pill. ***Progestin-only pill*** - The **progestin-only pill (POP)** is the contraceptive of choice for lactating women because it does not affect **breast milk supply** or composition. - It works by thickening cervical mucus and thinning the **endometrium**, which can help reduce heavy bleeding and provide effective contraception. *Copper IUD* - While the **copper IUD** is a highly effective contraceptive, it is known to potentially increase **menstrual bleeding** and cramping. - Given the patient's history of **heavy bleeding**, a copper IUD might worsen her symptoms. *Progestin-only injection* - **Progestin-only injections** like DMPA are highly effective and safe for lactating women, but they can cause **irregular bleeding patterns** initially and are associated with a slower return to fertility. - While an option, the **progestin-only pill** offers more immediate control over menstrual patterns and easier discontinuation if side effects are problematic. *Combined oral contraceptive pill* - **Combined oral contraceptive pills (COCs)** contain both estrogen and progestin. Estrogen can negatively impact **milk production** and may not be suitable for breastfeeding mothers, especially in the first 6 months postpartum. - COCs are generally avoided in lactating women until breastfeeding is well-established or after 6 months to prevent interference with **lactation**.

Question 1

The structure marked A in the image below gives rise to which of the following structures?

Accepted Answer

Falciform ligament

Answer

Lienorenal ligament

Answer

Gastrophrenic ligament

Answer

Gastrosplenic ligament

Question 2

Identify the mask used for patients requiring high concentrations of oxygen.

Accepted Answer

Non-rebreathing mask

Answer

Hudson mask

Answer

Nebulizer

Answer

Venturi mask

Question 3

Identify the type of hymen.

Accepted Answer

Septate hymen

Answer

Imperforate hymen

Answer

Semilunar hymen

Answer

Annular hymen

Question 4

A patient presents with complaints of hair loss and behavioral changes noted by his wife. Upon examination, the doctor observes a loss of eyebrows. After further assessment, including an examination of the nails, what type of poisoning is suspected in this case?

Accepted Answer

Thallium

Answer

Arsenic

Answer

Mercury

Answer

Lead

Question 5

Which of the following is not seen in MEN 2B syndrome?

Accepted Answer

Parathyroid adenoma

Answer

Mucosal neuroma

Answer

Marfanoid habitus

Answer

Megacolon

Question 6

A patient with a history of chronic liver disease presents with abdominal distension, jaundice,    and pruritis. Ascitic fluid analysis revealed a neutrophil count >650 per cubic mm. What is the    most likely diagnosis?

Accepted Answer

Spontaneous bacterial peritonitis

Answer

Malignant ascites

Answer

Tubercular ascites

Answer

Intestinal obstruction

Question 7

Which of the following is NOT an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Accepted Answer

Uterine malformation

Answer

Pregnancy

Answer

Active pelvic infection

Answer

Known allergy to IUD components

Question 8

A primigravida presents to the labor room at 40 weeks of gestation with lower abdominal pain.    She has been in labor for 3 hours. Which of the following will determine if she is in active    labor?

Accepted Answer

Cervical dilatation of 6 cm or more with regular contractions

Answer

Fetal head 5/5 palpable on abdominal examination

Answer

Two contractions lasting for 10 seconds in 10 minutes

Answer

Rupture of membranes

Question 9

A 24 year old lactating female with an 18 month old child comes with a history of irregular,    heavy bleeding seeking contraceptive advice. Which is the contraceptive of choice?

Accepted Answer

Progestin-only pill

Answer

Copper IUD

Answer

Progestin-only injection

Answer

Combined oral contraceptive pill

Question 10

An RTA patient presented to the emergency department with severe pain in the ankle. An X-ray was performed, given below. What is the best next step in management?

Accepted Answer

Neurovascular Assessment and Closed reduction with slab application

Answer

Neurovascular Assessment and Closed reduction with cast application

Answer

Neurovascular Assessment and Immediate surgery

Answer

Neurovascular Assessment and Immediate open reduction

NEET-PG 2022

Anatomy

Anesthesiology

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Orthopaedics