NEET-PG 2024 Practice Questions

Q: What is the pressure required to open the device shown in the image?

30–40 cm H₂O. ***30–40 cm H₂O*** - This pressure range is generally required to open the **Pop-Off Valve** (Pressure Relief Valve) in an Ambu bag (Bag-Valve-Mask) to prevent **barotrauma** to the patient's lungs. - The Pop-Off Valve is a safety feature that vents excess pressure to minimize the risk of **pneumothorax** or other lung injuries during manual ventilation. *10–20 cm H₂O* - This pressure range is typically within the normal ventilatory pressure used for gently inflating the lungs, not specifically for opening the **safety valve**. - While it's a safe pressure for ventilation, it's usually too low to activate the **overpressure relief mechanism** of the Pop-Off Valve. *10–20 mm H₂O* - This unit of millimeters of water (mm H₂O) is incorrect for standard ventilatory pressure measurements in this context; centimeters of water (cm H₂O) is the standard. - Furthermore, the magnitude is too low to represent the pressure required to open a **safety release valve** on a BVM. *30–40 mm H₂O* - Similar to the previous option, the unit of **millimeters of water (mm H₂O)** is not the standard measurement for this type of pressure in respiratory care. - While the numeric value is appropriate for safety valve activation, the ** गलत इकाई ** (wrong unit) makes this option incorrect.

Q: In demographic transition analysis, what does the difference between birth rates and death rates represent when plotting demographic changes over time?

Natural increase. ***Natural increase*** - **Natural increase** is specifically defined as the difference between the **birth rate** and the **death rate** in a population. - When plotted over time in demographic transition models, this difference visually represents the **population growth** or decline due to births and deaths alone, excluding migration. *Birth rate* - The **birth rate** is the number of live births per 1,000 people in a given year. - It is only one component of the calculation for natural increase, not the difference itself. *Death rate* - The **death rate** is the number of deaths per 1,000 people in a given year. - It is another component used to calculate natural increase but does not represent the difference between the two rates. *Growth Rate* - The **growth rate** of a population usually includes the effects of both **natural increase** (births minus deaths) and **net migration** (immigration minus emigration). - While natural increase contributes to the overall growth rate, it specifically refers to the growth stemming only from births and deaths, without considering migration.

Q: A patient presents with conductive hearing loss, pulsatile tinnitus and a positive Phelps sign. Using the CT scan provided, identify the condition.

Glomus jugulare. ***Glomus jugulare*** - This diagnosis aligns with the presence of **conductive hearing loss**, **pulsatile tinnitus**, and a **positive Phelps sign**, which indicate a highly vascular tumor in the jugular foramen. - While exact details of the CT scan are difficult to discern from the provided image, the clinical context strongly points towards a **glomus jugulare tumor**, known for its characteristic bone erosion around the jugular bulb seen on imaging. *Glomus tympanicum* - This typically presents with **pulsatile tinnitus** and **conductive hearing loss**, but is usually observed as a red mass behind an intact tympanic membrane, arising from the **promontory** within the middle ear space. - It would not typically cause a **Phelps sign**, which specifically relates to erosion of the jugular foramen region. *Acoustic neuroma* - An acoustic neuroma (vestibular schwannoma) causes **sensorineural hearing loss**, often unilateral, not conductive, along with **tinnitus** (usually non-pulsatile) and **balance issues**. - It arises from the vestibular nerve within the **internal auditory canal** and cerebellopontine angle, and does not cause a Phelps sign. *Otosclerosis* - Otosclerosis is characterized by **conductive hearing loss** due to abnormal bone growth fixing the stapes in the oval window, but it does not cause **pulsatile tinnitus** or involve a **positive Phelps sign**. - The disease involves the **otic capsule** and typically does not present with a tumorous mass visible on CT in the jugular foramen area.

Q: A 35-year-old male from a rural village in South Asia is admitted to the hospital with a 5-day history of high-grade fever, severe headache, and progressive breathlessness. His family reports that he has become increasingly disoriented over the past 48 hours, with episodes of confusion and drowsiness. Upon examination, the patient is febrile with a temperature of 39°C (102.2°F), tachypneic with a respiratory rate of 30 breaths per minute, and is displaying signs of altered mental status, including lethargy and difficulty following commands. His oxygen saturation is 92% on room air. There are no signs of a rash or bleeding. What is the diagnosis?

NIPAH. ***NIPAH*** - The combination of **rapidly progressive encephalitis** (disorientation, confusion, lethargy), **respiratory distress** (breathlessness, tachypnea, reduced O2 saturation), and **geographical context** (rural South Asia) strongly points towards NIPAH virus infection. - **Bats** (specifically fruit bats) are the natural reservoir for NIPAH virus, and exposure to bat secretions or contaminated food can lead to outbreaks, especially in rural areas where the image suggests bats are present. - The **distinctive combination of severe respiratory and neurological symptoms** with rapid progression is characteristic of NIPAH. *Ebola* - Ebola typically presents with **hemorrhagic fever**, characterized by severe bleeding (both internal and external), which is not described in the patient's symptoms. - While it causes high fever and altered mental status, the **prominent respiratory symptoms and lack of bleeding** make Ebola less likely. *Zika* - Zika virus infection is usually **mild or asymptomatic** and primarily transmitted by mosquitoes. - While encephalitis can occur in rare cases, the **severe respiratory distress and rapid progression of neurological symptoms** described are not typical for Zika. *Malaria* - Malaria is characterized by **cyclic fevers, chills, and sweats**, and can cause severe symptoms like cerebral malaria leading to altered mental status. - However, the patient's **pronounced respiratory symptoms and rapid onset of encephalitis without typical cyclic fever patterns** make malaria a less fitting diagnosis than NIPAH. *Japanese Encephalitis* - Japanese Encephalitis is endemic in South Asia and does cause **encephalitis with altered mental status**. - However, **prominent respiratory distress and breathlessness** are not typical features of Japanese Encephalitis, which primarily affects the central nervous system. - The **rapid progression with severe respiratory involvement** points more toward NIPAH than Japanese Encephalitis.

Q: A patient presents with genital grouped vesicles, as shown in the image. What is the most likely causative organism?

Herpes simplex virus. ***Herpes*** - The image shows **grouped vesicles** on an erythematous base, which is the classic presentation of **genital herpes** caused by the **Herpes simplex virus (HSV)**. - These lesions are typically painful and can recur, indicating a viral etiology. *Haemophilus* - *Haemophilus ducreyi* causes **chancroid**, which presents as **painful genital ulcers** with ragged borders and often associated with inguinal lymphadenopathy. - It does not present as grouped vesicles. *Klebsiella* - *Klebsiella granulomatis* causes **donovanosis (granuloma inguinale)**, characterized by progressive, **painless ulcerative lesions** that are highly vascular and bleed easily. - This organism does not cause vesicular lesions. *Treponema* - *Treponema pallidum* causes **syphilis**, which in its primary stage presents as a **painless chancre** (a solitary ulcer) or in secondary stage as a diffuse rash. - It does not cause grouped vesicles.

Q: A G2P1L1 woman with a history of previous cesarean section presents with complications related to the placenta. The image below shows the gross appearance of the uterus. What is the most likely diagnosis?

Placenta accreta. ***Placenta accreta*** - A previous **cesarean section** is a strong risk factor for placenta accreta, as it can lead to scarring and defects in the uterine wall, allowing the placenta to implant too deeply. - The image suggests a placenta that is **firmly adhered and possibly invasive** into the uterine wall, making separation difficult, which is characteristic of accreta due to the absence of a proper decidual layer. *Uterine inversion* - This condition involves the **fundus of the uterus collapsing inward** or turning inside out, which is a clinical event during postpartum and not a morphological feature visible in a resected specimen like this. - The image shows an attached placenta within a uterine specimen, not an inverted uterus. *Placental abruption* - Placental abruption is the **premature separation of the placenta** from the uterine wall before delivery, often leading to retroplacental hemorrhage. - While it's a serious complication, the image does not show evidence of a separated placenta or a large retroplacental clot; instead, it depicts an abnormally adherent placenta. *Placenta previa* - Placenta previa occurs when the **placenta implants over the cervical os**, which would be diagnosed prenatally based on its location in the uterus. - The image does not provide information about the placental location relative to the cervix, but rather illustrates the manner of placental attachment.

Q: Identify the instrument shown in the image below: ![img-52.jpeg](img-52.jpeg)

Wrigley. ***Wrigley*** - The image depicts short-bladed forceps with a pelvic curve that is characteristic of Wrigley's forceps. - Wrigley's forceps are designed for **outlet or low-cavity forceps deliveries** where the fetal head is already visible or very low in the birth canal. *Kielland* - Kielland forceps have a very slight pelvic curve or are straight, and they lack a cephalic curve, which is distinct from the instrument shown. - They are primarily used for **rotational deliveries** and can be applied to the fetal head in various positions. *Pipers* - Piper's forceps have very long, curved shanks and are specifically designed for **delivery of the after-coming head in breech presentations**. - The instrument in the image does not show the characteristic long shanks of Piper's forceps. *Simpson* - Simpson's forceps have a prominent **pelvic curve** and a **cephalic curve** with blades that are longer than those depicted in the image. - They are commonly used for **mid-cavity deliveries** when rotation is not the primary concern.

Q: Based on the educational diagram showing different degrees of perineal tears, which degree involves only the perineal skin and vaginal mucosa without affecting the underlying muscle?

1st degree. ***1st degree*** - Involves only the **perineal skin** and **vaginal mucosa** without affecting underlying muscle tissue. - The **pelvic floor muscles (PFM)** remain completely intact, making this the most superficial type of perineal tear. *2nd degree* - Extends deeper to involve the **perineal muscles** including the pelvic floor muscles, but spares the anal sphincter. - Requires **muscle repair** in addition to skin closure, making it more complex than 1st degree tears. *3rd degree* - Involves the **anal sphincter complex** (external and/or internal anal sphincter) extending toward the anus. - Requires specialized **sphincter reconstruction** to prevent future fecal incontinence complications. *4th degree* - The most severe tear extending through the **anal sphincter** and into the **rectal mucosa**. - Requires **multilayer repair** including rectal mucosa, sphincter complex, and perineal tissues to restore anatomy.

Q: Identify the condition shown in the given X-ray: ![img-63.jpeg](img-63.jpeg)

Osgood-Schlatter disease. ***Osgood-Schlatter disease*** - The X-ray shows fragmentation and irregularity of the **tibial tuberosity**, which is characteristic of Osgood-Schlatter disease. - This condition typically affects adolescents undergoing rapid growth spurts and presents with **pain and swelling** at the tibial tuberosity. *Tibial tuberosity fracture* - This usually involves a **clear fracture line** and displacement of the tibial tuberosity. - It is typically caused by a **sudden, forceful contraction** of the quadriceps muscle. *Lateral epicondyle of femur* - The X-ray shows changes at the **tibial tuberosity**, not the lateral epicondyle of the femur. - The lateral epicondyle is located at the **distal end of the femur**, near the knee joint. *Gerdy's tubercle fracture* - Gerdy's tubercle is the insertion point of the **iliotibial band** on the lateral aspect of the proximal tibia. - Fractures here are **rare** and would present differently on X-ray compared to the observed tibial tuberosity changes.

Q: A 34-year-old female presented with low hemoglobin, platelet count of 25,000 / mm³, raised PT and APTT. The image shows a peripheral smear. Which of the following fusion genes is affected?

PML-RARA. ***PML-RARA*** - The image shows **promyelocytes** with prominent granules and **Auer rods** (indicated by the arrow), which are characteristic of Acute Promyelocytic Leukemia (APL). [1] - APL is strongly associated with the **t(15;17)** translocation, leading to the **PML-RARA** fusion gene. The patient’s clinical presentation of pancytopenia (low hemoglobin, low platelet count) and prolonged PT/APTT leading to **DIC**, is highly consistent with APL. [1] *RUNX1-RUNX1T1* - This fusion gene is associated with **Acute Myeloid Leukemia (AML) M2** (AML with maturation), often due to t(8;21) translocation. [1] - While it is a type of AML, the peripheral smear and clinical features are more specific to APL, not AML M2. *INV 16* - Inversion 16, denoted as **inv(16)(p13q22)**, is associated with an AML subtype that typically presents with **myelomonocytic differentiation** and **abnormal eosinophils** in the bone marrow. [1] - The image and clinical findings do not suggest myelomonocytic morphology or the presence of abnormal eosinophils, making APL a more likely diagnosis. *IGH-NSD2* - This fusion gene is characteristic of **Multiple Myeloma**, a plasma cell malignancy. - Multiple myeloma would present with plasma cell proliferation, bone lesions, and hypercalcemia, which differ significantly from the acute leukemia presentation seen here. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 620-622.

Question 1

What is the pressure required to open the device shown in the image?

Accepted Answer

30–40 cm H₂O

Answer

10–20 cm H₂O

Answer

10–20 mm H₂O

Answer

30–40 mm H₂O

Question 2

In demographic transition analysis, what does the difference between birth rates and death rates represent when plotting demographic changes over time?

Accepted Answer

Natural increase

Answer

Birth rate

Answer

Death rate

Answer

Growth Rate

Question 3

A patient presents with conductive hearing loss, pulsatile tinnitus and a positive Phelps sign. Using the CT scan provided, identify the condition.

Accepted Answer

Glomus jugulare

Answer

Glomus tympanicum

Answer

Acoustic neuroma

Answer

Otosclerosis

Question 4

A 35-year-old male from a rural village in South Asia is admitted to the hospital with a 5-day history of high-grade fever, severe headache, and progressive breathlessness. His family reports that he has become increasingly disoriented over the past 48 hours, with episodes of confusion and drowsiness. Upon examination, the patient is febrile with a temperature of 39°C (102.2°F), tachypneic with a respiratory rate of 30 breaths per minute, and is displaying signs of altered mental status, including lethargy and difficulty following commands. His oxygen saturation is 92% on room air. There are no signs of a rash or bleeding. What is the diagnosis?

Accepted Answer

NIPAH

Answer

Ebola

Answer

Zika

Answer

Malaria

Answer

Japanese Encephalitis

Question 5

A patient presents with genital grouped vesicles, as shown in the image. What is the most likely causative organism?

Accepted Answer

Herpes simplex virus

Answer

Haemophilus

Answer

Klebsiella

Answer

Treponema

Question 6

A G2P1L1 woman with a history of previous cesarean section presents with complications related to the placenta. The image below shows the gross appearance of the uterus. What is the most likely diagnosis?

Accepted Answer

Placenta accreta

Answer

Uterine inversion

Answer

Placental abruption

Answer

Placenta previa

Question 7

Identify the instrument shown in the image below:
![img-52.jpeg](img-52.jpeg)

Accepted Answer

Wrigley

Answer

Kielland

Answer

Pipers

Answer

Simpson

Question 8

Based on the educational diagram showing different degrees of perineal tears, which degree involves only the perineal skin and vaginal mucosa without affecting the underlying muscle?

Accepted Answer

1st degree

Answer

2nd degree

Answer

3rd degree

Answer

4th degree

Question 9

Identify the condition shown in the given X-ray:
![img-63.jpeg](img-63.jpeg)

Accepted Answer

Osgood-Schlatter disease

Answer

Lateral epicondyle of femur

Answer

Tibial tuberosity fracture

Answer

Gerdy's tubercle fracture

Question 10

A 34-year-old female presented with low hemoglobin, platelet count of 25,000 / mm³, raised PT and APTT. The image shows a peripheral smear. Which of the following fusion genes is affected?

Accepted Answer

PML-RARA

Answer

RUNX1-RUNX1T1

Answer

INV 16

Answer

IGH-NSD2

NEET-PG 2024

Anesthesiology

Community Medicine

ENT

Internal Medicine

Microbiology

Obstetrics and Gynecology

Orthopaedics

Pathology