NEET-PG 2015 Practice Questions

Q: What is the primary benefit of screening for diseases?

Early detection of diseases. ***Early detection of diseases*** - This is the **primary benefit** and defining purpose of **screening programs** in public health. - Screening identifies diseases in their **presymptomatic or early stage** when individuals are apparently healthy, allowing for intervention before clinical symptoms appear. - According to epidemiological principles, the goal of screening is to detect disease **earlier than it would be found through routine clinical practice**. - Early detection enables better prognosis through **lead time** and **length time bias** advantages. *Timely treatment of identified conditions* - While treatment is the **ultimate goal** of healthcare, it is not specific to screening—treatment occurs whether disease is found through screening or clinical presentation. - Treatment is the **consequence** of early detection, not the primary benefit of the screening process itself. - The unique value of screening lies in **detection**, not treatment per se. *Providing support for patients after diagnosis* - **Patient support** is an important aspect of healthcare but is not the purpose of screening programs. - This is **post-diagnostic care**, which follows after the screening process has identified cases. *Identifying all potential cases of a disease* - **Screening tests** cannot identify all cases due to inherent limitations in **sensitivity** and **specificity**. - Screening aims to identify a significant proportion of cases in a population, accepting that some will be missed (**false negatives**) and some healthy individuals may test positive (**false positives**).

Q: In Caldwell Luc operation, the approach is through the?

Opening of maxillary antrum through gingivolabial approach. ***Opening of maxillary antrum through gingivolabial approach*** - The **Caldwell-Luc operation** involves creating a surgical window in the anterior wall of the **maxillary sinus** via an incision in the **gingivolabial sulcus** (also called sublabial sulcus). - This **open surgical approach** through the canine fossa provides direct access to the antrum for removal of pathology, foreign bodies, or drainage of chronic infections. - The incision is made above the canine tooth, and the anterior wall of the maxilla is fenestrated. *Transnasal endoscopic approach through the middle meatus* - This describes **functional endoscopic sinus surgery (FESS)**, which is a minimally invasive endoscopic technique, not the traditional open Caldwell-Luc procedure. - While FESS accesses the maxillary sinus through the natural ostium or by creating a middle meatal antrostomy, it is a fundamentally different approach. - Caldwell-Luc is an **extranasal, open approach**, whereas FESS is an **intranasal, endoscopic approach**. *Through the sphenopalatine recess for maxillary sinus access* - The **sphenopalatine recess** is primarily associated with endoscopic approaches to the sphenoid sinus or procedures involving the **pterygopalatine fossa**, not the Caldwell-Luc approach. - This approach does not involve breaching the anterior wall of the maxillary sinus through the canine fossa. *Accessing the maxillary sinus via superior meatus* - The **superior meatus** is not used for accessing the maxillary sinus in any standard surgical approach. - The natural ostium of the maxillary sinus opens into the **middle meatus**, not the superior meatus. - The superior meatus drains the posterior ethmoid cells, not the maxillary sinus.

Q: What is the causative agent of trench fever?

Bartonella quintana. ***Bartonella quintana*** - **Trench fever** is a **rickettsial-like illness** primarily transmitted by the human body louse. - The causative agent is the bacterium **Bartonella quintana**, which causes recurrent fever, headache, and body pains. *Q-fever* - Q-fever is caused by the bacterium **Coxiella burnetii** and is typically transmitted through airborne exposure to contaminated aerosols from infected animals. - It presents with fever, headache, and atypical pneumonia, and is not associated with human body lice. *Boutonneuse fever* - This fever is caused by **Rickettsia conorii**, transmitted by the **brown dog tick**. - Characterized by a **maculopapular rash** and an **eschar (tache noire)** at the site of the tick bite. *Indian tick typhus* - This is a form of spotted fever group rickettsiosis caused by **Rickettsia conorii subspecies indica**, transmitted by ticks [1]. - It presents with fever, rash, and an eschar, similar to boutonneuse fever, but is specified for the Indian subcontinent [1].

Q: Digitalis is used in mitral stenosis to control the ventricular rate when the patient develops which condition?

Atrial fibrillation. ***Atrial fibrillation*** - **Digitalis** (digoxin) is effective in **slowing the ventricular rate** in atrial fibrillation by increasing vagal tone and prolonging the refractory period of the AV node. - In **mitral stenosis**, an uncontrolled rapid ventricular rate due to atrial fibrillation can significantly reduce cardiac output and worsen symptoms. *Right ventricular failure* - While digitalis can improve contractility, its primary role in **RV failure** is not rate control; diuretics and afterload reduction are more commonly used. - A patient with isolated right ventricular failure due to mitral stenosis would not directly benefit from digitalis for rate control. *Acute pulmonary edema* - **Acute pulmonary edema** requires rapid diuresis, oxygen, and vasodilators to reduce preload and afterload. - Digitalis has a slower onset of action and is not the first-line treatment for acute pulmonary edema, especially if the cause is not related to a rapid ventricular rate. *Myocarditis* - **Myocarditis** is an inflammation of the heart muscle, and digitalis is generally avoided due to concerns about potentially worsening arrhythmias and myocardial damage in an inflamed heart. - Treatment for myocarditis focuses on supportive care and addressing the underlying cause, not rate control with digitalis unless specific arrhythmias develop.

Q: IgM appears in fetus at what gestational age -

20 weeks. ***20 weeks*** - The fetal immune system begins to develop around **20 weeks of gestation**, at which point the fetus starts producing its own **IgM antibodies**. - **IgM** is the first antibody isotype produced by the developing fetal **B lymphocytes** and is important for early immune responses. *10 weeks* - While some components of the immune system may start to differentiate earlier, **IgM production** at a functional level is not yet established at **10 weeks of gestation**. - At this early stage, the fetal immune system is still primarily in its **developmental phase**, with major organogenesis occurring. *30 weeks* - By **30 weeks**, the fetus has already been producing IgM for several weeks, and the immune system is more mature, capable of a more robust **antibody response**. - While **IgG** levels are significantly increasing due to maternal transfer at this stage, **IgM production** began earlier. *at birth* - At birth, a neonate has circulating **IgM antibodies**, which are indicative of prior fetal immune activation and are measurable in umbilical cord blood. - However, the initial production of **fetal IgM** occurs much earlier in gestation, not at the time of birth.

Q: Which of the following imaging modalities is most appropriate for initial evaluation of suspected acute appendicitis in a young adult patient?

Ultrasound. ***Ultrasound*** - **First-line imaging modality** for suspected acute appendicitis in young adults, especially in children, pregnant women, and young females - **Advantages:** No ionizing radiation, readily available, cost-effective, can be performed at bedside - **High specificity** (>90%) when positive findings are present - **Graded compression technique** helps visualize the appendix and assess for periappendiceal inflammation - **Limitations:** Operator-dependent, may be difficult in obese patients or with overlying bowel gas *CT scan (Contrast-enhanced)* - **Most sensitive imaging modality** (sensitivity >95%) for acute appendicitis - Considered when ultrasound is inconclusive or technically difficult - **Gold standard** in adults, especially in obese patients - Provides excellent visualization of the appendix and complications (perforation, abscess) - However, involves **ionizing radiation**, making it less ideal as first-line in young patients *MRI* - **Preferred in pregnant women** when ultrasound is inconclusive - No ionizing radiation exposure - High accuracy but **limited availability**, longer scan time, and higher cost - Not typically used as first-line imaging in non-pregnant young adults *Plain radiography (X-ray)* - **Limited role** in diagnosing acute appendicitis - Non-specific findings; may show fecalith, loss of psoas shadow, or signs of perforation - Cannot reliably visualize the appendix - **Not recommended** as initial imaging for suspected appendicitis

Question 1

What is the primary benefit of screening for diseases?

Accepted Answer

Early detection of diseases

Answer

Providing support for patients after diagnosis

Answer

Identifying all potential cases of a disease

Answer

Timely treatment of identified conditions

Question 2

What does the Gross Reproduction Rate (GRR) measure?

Accepted Answer

Number of female children a woman would have during her reproductive years, assuming no mortality

Answer

Number of total children a woman would have during her reproductive years (both male and female), assuming no mortality

Answer

Number of live births per 1000 women in a given year

Answer

Number of male children a woman would have during her reproductive years, assuming no mortality

Question 3

What is the definition of Population Attributable Risk?

Accepted Answer

The difference between incidence in population and incidence in non-exposed.

Answer

The difference between incidence in population and incidence in exposed.

Answer

The difference between incidence in population and incidence in non-exposed compared with incidence in exposed.

Answer

The difference between incidence in exposed and incidence in non-exposed.

Question 4

In Caldwell Luc operation, the approach is through the?

Accepted Answer

Opening of maxillary antrum through gingivolabial approach

Answer

Transnasal endoscopic approach through the middle meatus

Answer

Through the sphenopalatine recess for maxillary sinus access

Answer

Accessing the maxillary sinus via superior meatus

Question 5

What is the causative agent of trench fever?

Accepted Answer

Bartonella quintana

Answer

Q-fever

Answer

Boutonneuse fever

Answer

Indian tick typhus

Question 6

Digitalis is used in mitral stenosis to control the ventricular rate when the patient develops which condition?

Accepted Answer

Atrial fibrillation

Answer

Right ventricular failure

Answer

Acute pulmonary edema

Answer

Myocarditis

Question 7

IgM appears in fetus at what gestational age -

Accepted Answer

20 weeks

Answer

10 weeks

Answer

30 weeks

Answer

at birth

Question 8

What is regular astigmatism?

Accepted Answer

Astigmatism where the principal meridians are at a 90-degree angle to each other

Answer

Astigmatism in which the principal meridians are parallel

Answer

Asymptomatic astigmatism

Answer

Astigmatism as a result of cataract surgery

Question 9

What is the key pathophysiological difference between acid and alkali injuries in terms of tissue necrosis?

Accepted Answer

Alkali injuries cause liquefactive necrosis

Answer

Acid injuries cause coagulative necrosis

Answer

Alkali injuries lead to deeper tissue damage

Answer

Acid injuries are less severe than alkali injuries

Question 10

Which of the following imaging modalities is most appropriate for initial evaluation of suspected acute appendicitis in a young adult patient?

Accepted Answer

Ultrasound

Answer

CT scan (Contrast-enhanced)

Answer

Plain radiography (X-ray)

Answer

MRI

NEET-PG 2015

Community Medicine

ENT

Internal Medicine

Microbiology

Ophthalmology

Pathology

Radiology