NEET-PG 2023 Practice Questions

Q: All the following nerves are involved in entrapment neuropathy except -

Femoral nerve. ***Femoral nerve*** - While the femoral nerve can be injured, it is **uncommonly involved** in entrapment neuropathy compared to other nerves. - Entrapment of the femoral nerve is rare and typically occurs in the **pelvis** or **inguinal region**, often due to trauma or mass effect. *Median nerve* - The median nerve is classically involved in **carpal tunnel syndrome**, where it is compressed at the wrist [1], [2]. - Symptoms include pain, numbness, and tingling in the thumb, index, middle, and radial half of the ring finger [1]. *Ulnar nerve* - The ulnar nerve is commonly entrapped at the **cubital tunnel** (elbow) or the **Guyon's canal** (wrist) [1]. - This leads to symptoms such as numbness and weakness in the small finger and ulnar half of the ring finger [1]. *Lateral cutaneous nerve of thigh* - This nerve is frequently entrapped as it passes under the **inguinal ligament**, causing **meralgia paresthetica**. - Symptoms include burning pain and numbness on the lateral aspect of the thigh.

Q: Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Intravenous sodium bicarbonate. ***Intravenous sodium bicarbonate*** - While it can drive potassium into cells, its effect is often **delayed and unreliable** in acute, dangerous hyperkalemia, especially without concurrent acidosis. - Its efficacy is most pronounced when hyperkalemia is associated with **metabolic acidosis**, which is not always the primary driving factor of dangerous hyperkalemia. *Calcium chloride injection* - This is a **first-line treatment** for dangerous hyperkalemia, as it **stabilizes the cardiac membrane** by antagonizing the direct effects of potassium on myocardial excitability [1]. - It does not lower serum potassium levels but **protects the heart** from life-threatening arrhythmias, buying time for other therapies to reduce potassium [1]. *Beta-2 agonist (Salbutamol)* - **Beta-2 agonists** like salbutamol are effective in shifting potassium **intracellularly**, thereby lowering serum potassium levels. - This effect is mediated by stimulating the **Na+/K+-ATPase pump** on cell membranes. *Dialysis (Hemodialysis)* - **Hemodialysis** is the **most effective and rapid** method for removing excess potassium from the body, especially in cases of severe or refractory hyperkalemia. - It provides definitive treatment by directly **filtering potassium** from the blood, and is often considered when other measures fail or in patients with kidney failure.

Q: In HIV patients, Kaposi's sarcoma is most likely caused by which of the following?

Virus. ***Virus*** - The image likely depicts **Kaposi's sarcoma**, a common lesion in HIV patients, which is caused by **Human Herpesvirus 8 (HHV-8)**. - Other viral infections like **Herpes Simplex Virus (HSV)** can also cause mucocutaneous lesions in immunocompromised individuals. *Bacteria* - While HIV patients are susceptible to bacterial infections (e.g., **Staphylococcus aureus** causing skin abscesses), the described lesion type is not characteristic of common bacterial skin infections. - Bacterial lesions often present as pustules, cellulitis, or ulcers with purulent discharge, which differ from typical Kaposi's sarcoma. *Parasite* - Parasitic infections can occur in HIV patients (e.g., **scabies** or **leishmaniasis**), but these typically present with different dermatological features like intensely itchy papules or nodular ulcerative lesions. - Lesions caused by parasites do not usually manifest as the violaceous, nodular, or plaque-like appearances seen in Kaposi's sarcoma. *Fungus* - Fungal infections in HIV patients can cause skin lesions (e.g., **candidiasis** with oral thrush or esophagitis, or **cryptococcosis** with molluscum-like lesions). - However, the morphology of these fungal lesions generally differs from the classic appearance of Kaposi's sarcoma or other common viral lesions in HIV.

Q: A child 10 yrs of age presents with a mass on his left thigh. The mass seems to be arising from the diaphysis of the femur and involving the soft tissue of the thigh. The child is having fever also. Give your most probable diagnosis -

Ewing's sarcoma. ***Ewing's sarcoma*** - **Ewing's sarcoma** commonly presents in children and adolescents, often involving the **diaphysis of long bones** like the femur. - The presence of a **soft tissue mass** and **fever** are characteristic systemic symptoms due to its aggressive nature and rapid growth. *Osteosarcoma* - While it is a common pediatric bone tumor, **osteosarcoma** typically arises in the **metaphysis** of long bones, not the diaphysis. - Systemic symptoms like fever are less common at presentation compared to Ewing's sarcoma unless there's significant metastatic disease. *Chondrosarcoma* - **Chondrosarcoma** is a malignant tumor of cartilage that usually affects older adults and rarely occurs in children. - It typically affects the **pelvis, shoulder, or long bones**, but a fever and involvement of the soft tissue with a diaphyseal origin are less classic presentation. *Malignant fibrous histiocytoma* - **Malignant fibrous histiocytoma** (now often termed undifferentiated pleomorphic sarcoma) is a tumor of adulthood, primarily affecting individuals over 40 years of age. - While it can involve deep soft tissues and bone, it is an extremely rare diagnosis in a 10-year-old child.

Q: Koplik spots are seen in?

Measles. ***Measles*** - **Koplik spots** are pathognomonic rash that appears as small, white spots with a bluish-white center on an erythematous base on the **buccal mucosa** opposite the second molars. - They typically appear 2-3 days before the onset of the characteristic maculopapular rash, during the **prodromal phase** of measles (rubeola). *Rubella* - Rubella, or **German measles**, presents with a milder rash, **lymphadenopathy**, and mild fever. - It does not cause Koplik spots; instead, **Forchheimer spots** (petechiae on the soft palate) may be seen, but these are less specific. *Mumps* - Mumps is characterized primarily by **parotitis** (swelling of the salivary glands), fever, and headache. - It does not present with Koplik spots or any characteristic oral mucosal lesions. *Varicella* - Varicella, or **chickenpox**, is characterized by a **vesicular rash** that progresses from macules to papules to vesicles to crusts, appearing in crops. - It does not involve Koplik spots; the rash is typically generalized and pruritic.

Question 1

All the following nerves are involved in entrapment neuropathy except -

Accepted Answer

Femoral nerve

Answer

Median nerve

Answer

Ulnar nerve

Answer

Lateral cutaneous nerve of thigh

Question 2

Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Accepted Answer

Intravenous sodium bicarbonate

Answer

Calcium chloride injection

Answer

Beta-2 agonist (Salbutamol)

Answer

Dialysis (Hemodialysis)

Question 3

In HIV patients, Kaposi's sarcoma is most likely caused by which of the following?

Accepted Answer

Virus

Answer

Bacteria

Answer

Parasite

Answer

Fungus

Question 4

A child 10 yrs of age presents with a mass on his left thigh. The mass seems to be arising from the diaphysis of the femur and involving the soft tissue of the thigh. The child is having fever also. Give your most probable diagnosis -

Accepted Answer

Ewing's sarcoma

Answer

Osteosarcoma

Answer

Chondrosarcoma

Answer

Malignant fibrous histiocytoma

Question 5

Koplik spots are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Mumps

Answer

Varicella

NEET-PG 2023

Internal Medicine

Microbiology

Orthopaedics

Pediatrics