NEET-PG 2022 Practice Questions

Q: A 70-year-old male patient presents with high-frequency hearing loss. It was noted that the basilar membrane was affected. Which of the following structures lies near the affected structure?

Stria vascularis. ***Stria vascularis*** - The **stria vascularis** is a highly vascularized epithelial layer located on the lateral wall of the **scala media**, directly adjacent to the **basilar membrane**. - It is crucial for maintaining the high potassium concentration in the **endolymph** which is essential for the function of hair cells in the **organ of Corti** and thus hearing [2]. *Modiolus* - The **modiolus** is the central, conical bony pillar of the cochlea, around which the cochlear duct spirals. - While it houses the **spiral ganglion** and auditory nerve fibers, it is structurally distinct from and not immediately adjacent to the basilar membrane. *Helicotrema* - The **helicotrema** is the small opening at the apex of the cochlea where the **scala vestibuli** and **scala tympani** communicate [1]. - It is located at the very end of the cochlea, far from the main vibratory portion of the basilar membrane responsible for high-frequency sounds. *Oval window* - The **oval window** is the opening in the bony labyrinth into which the **stapes** footplate fits, transmitting vibrations from the middle ear to the inner ear [2]. - While critical for hearing, it is located at the base of the cochlea and is not an immediate neighbor of the basilar membrane in the context of its function in sound transduction within the cochlear duct.

Q: A young patient started to take a weight loss medication that acts by inhibiting fat absorption from food. After a few weeks, she developed easy bruising and increased menstrual bleeding. Deficiency of which of the following vitamins is responsible for her condition?

Vitamin K. ***Vitamin K*** - The patient is taking a **weight-loss medication** that **inhibits fat absorption**, leading to a deficiency in **fat-soluble vitamins**, including vitamin K. - **Vitamin K** is crucial for the synthesis of **coagulation factors** (II, VII, IX, X), and its deficiency leads to impaired clotting, manifesting as **easy bruising** and **increased menstrual bleeding**. *Vitamin E* - While vitamin E is a fat-soluble vitamin, its deficiency typically causes **neurological dysfunction** and **hemolytic anemia**, not bleeding diathesis. - Although malabsorption of vitamin E can occur with fat malabsorption, it does not directly explain the bleeding symptoms observed. *Vitamin B6* - Vitamin B6 is a **water-soluble vitamin**, so its absorption would not be directly affected by a medication inhibiting fat absorption. - Its deficiency can cause **neuropathy**, **dermatitis**, and **anemia**, but not increased bleeding. *Vitamin D* - Vitamin D is a **fat-soluble vitamin** whose deficiency is associated with **bone disorders** like **osteomalacia** and **rickets**, not bleeding. - While its absorption would be impacted by the medication, its deficiency would not cause easy bruising or increased menstrual bleeding.

Q: A male patient diagnosed with tuberculosis took complete treatment. Sputum examination was done after the completion of the intensive and the continuation phases. It was found to be negative. What is the status of the patient?

Cured. ***Cured*** - A patient is declared **cured** if they have completed the full course of treatment and have achieved **two negative sputum smear results**, with one at the end of the intensive phase and another at the completion of the treatment [1]. - This indicates that the **infection has been eradicated**, and the patient is no longer infectious. *Treatment completed* - This status applies when a patient has **completed the full treatment course** but does not have documented sputum smear results that meet the criteria for "cured." - While treatment was completed, the **bacteriological status is not confirmed** in the same way as for a cured patient. *Lost to follow up* - This term describes a patient who was **enrolled in treatment but was interrupted** for a specific period (e.g., two consecutive months or more) and their outcome cannot be determined. - They **ceased to attend follow-up appointments** and their treatment completion or success is unknown. *Treatment failed* - This status is assigned when a patient remains **sputum smear-positive at the end of the intensive phase** or at the end of the treatment, or if they initially converted to negative but later became positive again [1]. - It signifies that the **treatment regimen was ineffective** in eradicating the infection.

Q: A woman presents to you with fever, arthralgia, ulcers, fatigue for the past six months, and new-onset hematuria. Urine examination reveals RBC casts and proteinuria. What is the likely diagnosis?

Lupus nephritis. ***Lupus nephritis*** - The combination of **fever, arthralgia, oral ulcers, and fatigue** lasting for six months is highly suggestive of **systemic lupus erythematosus (SLE)** [1]. - The new-onset **hematuria, proteinuria, and RBC casts** indicate **glomerulonephritis**, which is a common and serious renal manifestation of SLE, known as lupus nephritis [2]. *Acute interstitial nephritis* - Characterized by acute kidney injury, often following exposure to **medications** (e.g., NSAIDs, antibiotics) or infections. - Typically presents with sterile pyuria, eosinophilia, and white cell casts, not hemorrhagic urine and RBC casts. *Poststreptococcal glomerulonephritis* - Occurs **1-3 weeks after a streptococcal infection** (e.g., pharyngitis, impetigo) and presents with acute nephritic syndrome. - While it causes hematuria and proteinuria, the prolonged systemic symptoms (arthralgia, ulcers, fatigue) and the absence of a recent streptococcal infection make it less likely. *IgA nephropathy* - Often presents with **recurrent episodes of gross hematuria**, usually developing within days of an upper respiratory tract infection. - It does not typically present with the broad array of systemic symptoms like chronic fever, arthralgia, and oral ulcers seen in this patient.

Q: A patient with diabetes mellitus for the past 5 years presents with vomiting and abdominal pain. She is non-compliant with medication and appears dehydrated. Investigations revealed a blood sugar value of 500 mg/dl and the presence of ketone bodies. What is the next best step in management of this patient?

Intravenous fluids with regular insulin. Detailed management of diabetic ketoacidosis (DKA) requires both fluid resuscitation and insulin therapy. ***Intravenous fluids with regular insulin*** - The patient presents with classic signs of **diabetic ketoacidosis (DKA)**: hyperglycemia (blood sugar 500 mg/dl), ketone bodies, dehydration, and a history of diabetes non-compliance [1]. - Initial management for DKA involves aggressive **intravenous fluid resuscitation** to correct dehydration and then **intravenous regular insulin** to lower blood glucose and resolve ketosis [2]. *Intravenous fluids with long-acting insulin* - While fluids are essential, **long-acting insulin** is not appropriate for the acute management of DKA because its slow onset of action makes it inefficient for rapidly correcting hyperglycemia and ketosis. - **Regular insulin** is preferred as it has a quicker onset and shorter duration, allowing for more precise titration in an acute setting [2]. *Intravenous fluids* - Although crucial for correcting **dehydration** and improving renal perfusion, fluids alone will not address the underlying **insulin deficiency** and **ketosis** that define DKA. - Without insulin, the body will continue to produce ketones, exacerbating acidosis [3]. *Intravenous insulin* - Giving intravenous insulin without prior or concomitant **fluid resuscitation** can be dangerous, as it can worsen **hypovolemia** and potentially lead to circulatory collapse by shifting glucose and potassium into cells. - It is critical to first restore **circulating volume** before initiating insulin therapy [2].

Q: A middle-aged male patient presents with protrusion of the chin, excessive sweating, impaired glucose tolerance, and enlargement of hands and feet. Which of the following is a growth hormone receptor antagonist used to treat this condition?

Pegvisomant. ***Pegvisomant*** - **Pegvisomant** is a **growth hormone receptor antagonist** that binds to growth hormone receptors, preventing endogenous growth hormone from signaling and reducing IGF-1 levels. - It is specifically used in the treatment of **acromegaly**, a condition characterized by excessive growth hormone secretion, which aligns with the patient's symptoms of chin protrusion, excessive sweating, impaired glucose tolerance, and enlarged hands and feet. *Octreotide* - **Octreotide** is a **somatostatin analog** that works by inhibiting growth hormone secretion from the pituitary gland. - While used in acromegaly, it is not a growth hormone receptor antagonist, but rather reduces the production of growth hormone itself. *Cabergoline* - **Cabergoline** is a **dopamine agonist** primarily used to treat hyperprolactinemia by inhibiting prolactin secretion. - It can sometimes be used in acromegaly for patients with co-secretion of prolactin or those who are sensitive to its effects on growth hormone, but it is not a direct growth hormone receptor antagonist. *Olcegepant* - **Olcegepant** is a **calcitonin gene-related peptide (CGRP) receptor antagonist** developed for the treatment of migraine. - It has no known therapeutic role in the management of acromegaly or growth hormone-related disorders.

Q: A woman presenting with symptoms of urinary tract infection was prescribed a drug that causes tendon rupture and arthropathy. What is the mechanism of action of the drug?

DNA gyrase inhibition. ***DNA gyrase inhibition*** - The description of a drug causing **tendon rupture** and **arthropathy** in the context of a urinary tract infection (UTI) suggests a **fluoroquinolone**. - Fluoroquinolones exert their bactericidal effect by inhibiting **bacterial DNA gyrase** (also known as topoisomerase II) and **topoisomerase IV**, thereby preventing DNA replication and repair. *Ribosomal inhibition* - This mechanism is characteristic of antibiotics like **aminoglycosides**, **tetracyclines**, and **macrolides**. - While some of these can treat UTIs, they are not typically associated with **tendon rupture** or **arthropathy** as major side effects. *Cell wall synthesis* - This is the mechanism of action for **beta-lactam antibiotics** (e.g., penicillins, cephalosporins) and **vancomycin**. - These drugs are common for UTIs but do not cause **tendon rupture** or **arthropathy**. *Inhibition of folic acid synthesis* - This mechanism is used by **sulfonamides** and **trimethoprim**, often combined as trimethoprim-sulfamethoxazole. - While effective for UTIs, these drugs are not known to cause **tendon rupture** or **arthropathy**.

Question 1

A 70-year-old male patient presents with high-frequency hearing loss. It was noted that the basilar membrane was affected. Which of the following structures lies near the affected structure?

Accepted Answer

Stria vascularis

Answer

Modiolus

Answer

Helicotrema

Answer

Oval window

Question 2

A young patient started to take a weight loss medication that acts by inhibiting fat absorption from food. After a few weeks, she developed easy bruising and increased menstrual bleeding. Deficiency of which of the following vitamins is responsible for her condition?

Accepted Answer

Vitamin K

Answer

Vitamin E

Answer

Vitamin B6

Answer

Vitamin D

Question 3

A male patient diagnosed with tuberculosis took complete treatment. Sputum examination was done after the completion of the intensive and the continuation phases. It was found to be negative. What is the status of the patient?

Accepted Answer

Cured

Answer

Treatment completed

Answer

Lost to follow up

Answer

Treatment failed

Question 4

You are working in a primary health center (PHC) situated in a high seismic zone. Which of the following actions should you take as part of preparedness for an emergency?

Accepted Answer

Conduct a simulation for the disaster and assess the response.

Answer

Ensure all financial and other resources are available for disaster preparedness.

Answer

Increase public awareness through campaigns and loudspeakers.

Answer

Follow instructions given over the phone or radio by higher officials.

Question 5

A woman presents to you with fever, arthralgia, ulcers, fatigue for the past six months, and    new-onset hematuria. Urine examination reveals RBC casts and proteinuria. What is the likely    diagnosis?

Accepted Answer

Lupus nephritis

Answer

Acute interstitial nephritis

Answer

Poststreptococcal glomerulonephritis

Answer

IgA nephropathy

Question 6

A patient with diabetes mellitus for the past 5 years presents with vomiting and abdominal pain. She is non-compliant with medication and appears dehydrated. Investigations revealed a blood sugar value of 500 mg/dl and the presence of ketone bodies. What is the next best step in management of this patient?

Accepted Answer

Intravenous fluids with regular insulin

Answer

Intravenous fluids

Answer

Intravenous insulin

Answer

Intravenous fluids with long-acting insulin

Question 7

An 8-year old child has difficulty walking and getting up from a squatting position. A muscle    biopsy was done and is as shown in the image. Which of the following is true about this    condition?

Accepted Answer

Death occurs in the 3rd decade for certain types of muscular dystrophy.

Answer

Previous history of viral prodrome

Answer

It is a mitochondrial storage disorder

Answer

Early treatment has excellent prognosis

Question 8

A middle-aged male patient presents with protrusion of the chin, excessive sweating, impaired glucose tolerance, and enlargement of hands and feet. Which of the following is a growth hormone receptor antagonist used to treat this condition?

Accepted Answer

Pegvisomant

Answer

Olcegepant

Answer

Cabergoline

Answer

Octreotide

Question 9

A woman presenting with symptoms of urinary tract infection was prescribed a drug that    causes tendon rupture and arthropathy. What is the mechanism of action of the drug?

Accepted Answer

DNA gyrase inhibition

Answer

Ribosomal inhibition

Answer

Cell wall synthesis

Answer

Inhibition of folic acid synthesis

Question 10

Which of the following statements is true regarding the given cystometrogram?

Accepted Answer

Segment Ib reflects the bladder's ability to accommodate increasing volume without a significant rise in pressure.

Answer

Micturition occurs in segment II; failure to micturate is not characteristic of this segment.

Answer

Segment Ia represents the initial phase of bladder filling, not residual urine.

Answer

The dotted line represents a reference point, not the occurrence of micturition.

NEET-PG 2022

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Pediatrics

Pharmacology

Physiology