NEET-PG 2013 Practice Questions

Q: What is the effect of moderate alcohol consumption on lipid profiles in dyslipidemia?

Increased HDL levels. ***Increased HDL levels*** - Moderate alcohol consumption is known to **increase high-density lipoprotein (HDL) cholesterol levels**, which is often considered beneficial for cardiovascular health. - This effect is thought to be mediated by alcohol's influence on **hepatic lipoprotein metabolism**, leading to enhanced HDL production and reduced catabolism. *Decreased HDL levels* - This is incorrect, as multiple studies have consistently shown that **moderate alcohol consumption** tends to elevate, rather than decrease, HDL cholesterol. - Low HDL levels are associated with increased cardiovascular risk, making this effect an undesirable outcome that is not typical of moderate drinking. *Increased triglyceride levels* - While heavy or chronic alcohol consumption can lead to **increased triglyceride levels**, moderate intake typically has a neutral or only slightly elevated effect, if any, often overshadowed by the HDL increase. - Significant hypertriglyceridemia is a concern with **excessive alcohol use**, not usually with moderate consumption in healthy individuals. *Decreased LDL levels* - Moderate alcohol consumption generally has **little to no significant effect** on **low-density lipoprotein (LDL) cholesterol levels**, often referred to as "bad" cholesterol. - While HDL increases are observed, alcohol does not effectively lower LDL, which is a primary target in the management of dyslipidemia.

Q: What is the treatment of choice for a post-operative abscess?

Image guided aspiration. ***Image-guided aspiration*** - This is often the **first-line treatment** for a post-operative abscess, especially if it is well-localized. - It involves **draining the pus** under imaging guidance, relieving pressure and removing the infectious material. *Hydration* - While important for overall patient management, especially in cases of infection or sepsis, **hydration alone does not treat an abscess**. - It is a supportive measure but does not address the **localized collection of pus**. *IV antibiotics* - Antibiotics are typically indicated as an **adjunct to drainage**, especially in cases of systemic infection or cellulitis. - However, **antibiotics alone are often insufficient** to resolve an abscess as they have difficulty penetrating the necrotic core and thick capsule. *Reexploration* - **Surgical reexploration** is a more invasive option usually reserved for abscesses that are **large, multiloculated, not amenable to percutaneous drainage**, or when initial drainage attempts fail. - It carries greater risks and is not the initial treatment of choice for every post-operative abscess.

Q: What is the recommended time frame for completing a blood transfusion after initiation?

1-4 hours. ***1-4 hours*** - This timeframe is recommended to **minimize the risk of bacterial growth** in the blood product, as bacteria can multiply quickly at room temperature. - Completing the transfusion within 4 hours also reduces the likelihood of **red blood cell degeneration** and loss of efficacy. *3-6 hours* - This period extends beyond the recommended maximum of 4 hours, increasing the risk of **bacterial proliferation** in the blood product. - Prolonged infusion times can also lead to a **decrease in the viability and function** of transfused cells. *4-8 hours* - Transfusing over 4-8 hours significantly elevates the risk of **bacterial contamination** and potential septic reactions. - The extended duration compromises the **quality and safety** of the blood product. *8-12 hours* - This timeframe is unacceptably long for a blood transfusion, posing a **critical risk of severe bacterial growth** and infection. - Blood products should not be administered beyond 4 hours due to the rapid decline in **cell integrity and increased adverse reaction potential**.

Q: The earliest change noticed in hypertensive retinopathy is:

Arteriolar spasm. ***Arteriolar spasm*** - **Arteriolar spasm** is the **earliest functional change** and is characterized by increased vascular tone in response to elevated blood pressure. - This spasm is a dynamic process and often leads to **narrowing of the retinal arterioles**, which can be observed during fundoscopic examination. *Soft exudate* - **Soft exudates**, also known as **cotton wool spots**, represent areas of **ischemic retinal nerve fiber layer** damage due to obstruction of precapillary arterioles. - These are typically seen in later stages of hypertensive retinopathy, indicating more significant vascular damage and ischemia. *Venospasm* - **Venospasm**, or narrowing of retinal veins, is **not a primary or early finding** in hypertensive retinopathy. - While venous changes like tortuosity can occur, arterial changes dominate the early pathogenesis. *Hard exudate* - **Hard exudates** are yellow-white deposits of **lipid and protein** that leak from damaged capillaries, often indicative of chronic retinal edema and incompetent blood-retinal barrier. - These usually appear in **more advanced stages** of hypertensive retinopathy and are not considered the earliest change.

Q: All the following are true of craniopharyngioma except:

Present in sella or infra-sellar location. ***Present in sella or infra-sellar location*** - Craniopharyngiomas are typically located in the **suprasellar region**, above the **sella turcica**, where they can compress the optic chiasm. - While they can extend into the sella, their primary location is rarely exclusively intrasellar or infrasellar. *Derived from Rathke's pouch* - This statement is true; craniopharyngiomas arise from remnants of **Rathke's pouch**, the embryonic precursor of the anterior pituitary gland. - This origin explains their characteristic location near the pituitary stalk and third ventricle. *Contains epithelial cells* - This statement is true as **craniopharyngiomas** are benign **epithelial tumors**, specifically adamantinomatous or papillary types. - They are composed of stratified squamous epithelium, often with calcifications and cystic components. *Causes visual disturbances* - This statement is true because the **suprasellar location** of a craniopharyngioma often leads to compression of the **optic chiasm**, resulting in characteristic visual field deficits like bitemporal hemianopsia. - Visual disturbances are a common presenting symptom due to their proximity to the visual pathways.

Q: Tear drop sign is seen in?

Blow out fracture. ***Blow out fracture*** - The **tear drop sign** on imaging (often CT scan) is characteristic of an **orbital blow-out fracture**, indicating herniation of orbital contents (fat, muscle) into the maxillary sinus. - This fracture typically involves the **orbital floor** or medial wall, often caused by a blunt force trauma to the eye. *Fracture zygomatic arch* - A fracture of the zygomatic arch is often associated with a **flattening of the malar prominence** rather than a "tear drop" sign. - It might lead to restricted jaw movement if the arch impinges on the coronoid process. *Fracture maxilla* - Maxillary fractures (e.g., Le Fort fractures) involve the midface bones and cause **facial deformity**, malocclusion, and mobility of the maxilla. - The tear drop sign is not a primary diagnostic feature of maxillary fractures. *Fracture mandible* - Mandibular fractures present with pain, swelling, and **malocclusion** of the teeth. - Imaging would reveal a break in the mandible, not a tear drop sign associated with orbital contents.

Q: In which of the following conditions is ERCP not indicated?

Proximal cholangiocarcinoma. ***Proximal cholangiocarcinoma*** - For **proximal/hilar cholangiocarcinoma** (Klatskin tumors at the **hepatic hilum**), **PTBD (Percutaneous Transhepatic Biliary Drainage)** is generally preferred over ERCP for biliary drainage. - The **high location** of these tumors makes endoscopic access difficult, with lower success rates and higher risk of complications like **cholangitis** and incomplete drainage. - **ERCP may fail** to adequately drain both hepatic ducts in bifurcation tumors, making PTBD the more reliable first-line approach. *Hepatic porta tumor* - **Hepatic porta tumors** involving the bile ducts are anatomically similar to **proximal cholangiocarcinoma**. - While ERCP can occasionally be attempted for porta hepatis lesions, **PTBD is often preferred** for high biliary obstructions due to better access to intrahepatic ducts. - The distinction is subtle, but **proximal cholangiocarcinoma** specifically refers to Klatskin tumors where ERCP has the **highest failure rate** and PTBD is most strongly preferred. *Distal CBD tumor* - **ERCP is the preferred modality** for **distal CBD tumors** to provide **biliary drainage**, tissue sampling (biopsy), and stent placement to relieve obstruction. - Direct endoscopic access to the distal common bile duct makes ERCP highly effective for diagnosis and palliation in this region. *Gallstone pancreatitis* - **ERCP is indicated** in **gallstone pancreatitis** when there is evidence of **cholangitis** or persistent **biliary obstruction** (e.g., rising liver enzymes, imaging showing retained stone in the CBD). - It allows for **therapeutic removal of impacted stones** from the common bile duct, preventing further pancreatic inflammation and complications.

Q: Most common site for anal fissure is

6 O'clock. ***6 O'clock*** - The **posterior midline (6 o'clock position)** is the most common site for anal fissures, accounting for approximately **90% of all cases**. - This location is prone to tearing due to relatively **poor blood supply** and increased **mechanical stress** during defecation. - The posterior midline is the least supported part of the anal canal by the external anal sphincter. - **Note**: The **anterior midline (12 o'clock position)** is the second most common site, occurring in **10-25% of women** but rarely in men. *3 O'clock* - The **3 o'clock position (right lateral)** is an infrequent site for anal fissures. - Fissures in this location, especially if *lateral*, may suggest an underlying systemic disease such as **Crohn's disease**, **tuberculosis**, **HIV**, or **malignancy**. - Atypical fissures warrant thorough investigation. *2 O'clock* - The **2 o'clock position (anterior-lateral)** is not typically associated with anal fissures. - Similar to other atypical sites, a fissure here warrants investigation for secondary causes. - Consider inflammatory bowel disease or other pathological conditions. *10 O'clock* - The **10 o'clock position (left lateral)** is also a less common site for anal fissures compared to the posterior midline. - Fissures in lateral positions should raise suspicion for other conditions, such as **inflammatory bowel disease**, **tuberculosis**, **HIV**, or **malignancy**.

Question 1

What is the effect of moderate alcohol consumption on lipid profiles in dyslipidemia?

Accepted Answer

Increased HDL levels

Answer

Decreased HDL levels

Answer

Increased triglyceride levels

Answer

Decreased LDL levels

Question 2

What is the treatment of choice for a post-operative abscess?

Accepted Answer

Image guided aspiration

Answer

Hydration

Answer

IV antibiotics

Answer

Reexploration

Question 3

What is the recommended time frame for completing a blood transfusion after initiation?

Accepted Answer

1-4 hours

Answer

3-6 hours

Answer

4-8 hours

Answer

8-12 hours

Question 4

The earliest change noticed in hypertensive retinopathy is:

Accepted Answer

Arteriolar spasm

Answer

Soft exudate

Answer

Venospasm

Answer

Hard exudate

Question 5

What is the characteristic feature of Barton's fracture?

Accepted Answer

Intra-articular fracture of the distal end radius with carpal bone subluxation and joint involvement

Answer

Extra-articular fracture of the distal end radius

Answer

Intra-articular fracture of the distal end radius without carpal bone subluxation

Answer

Intra-articular fracture of the distal end radius with carpal bone subluxation

Question 6

All the following are true of craniopharyngioma except:

Accepted Answer

Present in sella or infra-sellar location

Answer

Derived from Rathke's pouch

Answer

Contains epithelial cells

Answer

Causes visual disturbances

Question 7

Tear drop sign is seen in?

Accepted Answer

Blow out fracture

Answer

Fracture zygomatic arch

Answer

Fracture maxilla

Answer

Fracture mandible

Question 8

Which fracture pattern is classified as a Le Fort I fracture?

Accepted Answer

Horizontal fracture of the maxilla separating teeth from upper jaw

Answer

Pyramidal fracture involving maxilla and nasal bones

Answer

Complete craniofacial separation involving the upper face

Answer

Isolated nasal bone fracture

Question 9

In which of the following conditions is ERCP not indicated?

Accepted Answer

Proximal cholangiocarcinoma

Answer

Distal CBD tumor

Answer

Hepatic porta tumor

Answer

Gall stone pancreatitis

Question 10

Most common site for anal fissure is

Accepted Answer

6 O'clock

Answer

3 O'clock

Answer

2 O'clock

Answer

10 O'clock

NEET-PG 2013

Biochemistry

Dental

Internal Medicine

Ophthalmology

Orthopaedics

Pathology

Radiology

Surgery