NEET-PG 2013 Practice Questions

Q: In which condition are Haab's striae typically observed?

Buphthalmos. ***Buphthalmos*** - **Haab's striae** are characteristic linear tears in **Descemet's membrane** and endothelium caused by stretching of the globe in congenital glaucoma. - They are typically seen in **buphthalmos**, which is the enlargement of the eye due to increased intraocular pressure in infancy. *Keratoglobus* - This condition involves a **globular protrusion** of the entire cornea, making it uniformly thin and bulging, but does not typically feature Haab's striae. - It is a rare congenital anomaly, distinct from the corneal stretching and tears seen in buphthalmos. *Trachoma* - **Trachoma** is a chronic infectious conjunctivitis caused by *Chlamydia trachomatis* that leads to scarring of the conjunctiva and cornea, and can cause blindness. - It is characterized by conditions like **trichiasis** and corneal pannus, not Haab's striae. *Keratoconus* - **Keratoconus** is a progressive thinning and "cone-like" protrusion of the central cornea, which causes irregular astigmatism. - It is associated with **Vogt's striae** (vertical stress lines in the posterior stroma), not Haab's striae.

Q: All are major symptoms of sinusitis except?

Halitosis. ***Halitosis*** - While **halitosis** (bad breath) can be a symptom associated with sinusitis due to post-nasal drip and bacterial overgrowth, it is generally considered a **minor symptom** or a secondary effect rather than one of the primary, defining features. - Major symptoms focus on those directly caused by inflammation and obstruction of the sinuses. *Nasal blockage* - **Nasal blockage** or congestion is a cardinal symptom of sinusitis, resulting from inflammation and swelling of the nasal and sinus mucosa. - It often leads to difficulty breathing through the nose and contributes to a feeling of fullness. *Facial congestion* - **Facial congestion** or pressure is a key symptom of sinusitis, caused by the buildup of fluid and inflammation within the sinus cavities. - This symptom can manifest as pain or pressure around the eyes, cheeks, and forehead. *Anosmia* - **Anosmia**, or the loss of smell, is a significant symptom of sinusitis, particularly chronic sinusitis. - It occurs due to the inflammation and obstruction of the nasal passages, preventing odorants from reaching the olfactory receptors.

Q: Deep vein thrombosis most commonly occurs at which site?

Femoral vein. ***Femoral vein*** - The **femoral vein**, along with the **popliteal** and **iliac veins**, are the most common sites for **deep vein thrombosis (DVT)** in the lower extremities [1]. - Due to their size and the dynamics of blood flow in these regions, they are prone to clot formation, especially in the presence of **Virchow's triad**. *Subclavian vein* - While DVT can occur in the subclavian vein (an **upper extremity DVT**), it is less common than in the lower extremities [1]. - Upper extremity DVTs are often associated with **central venous catheters** or **thoracic outlet syndrome**. *External jugular vein* - **External jugular vein thrombosis** is rare and usually associated with local trauma, infection, or central line placement, not typically primary DVT [1]. - It is a superficial vein and not considered a common site for typical deep vein thrombosis. *Internal jugular vein* - **Internal jugular vein thrombosis** is also uncommon as a primary DVT and often secondary to neck infections, malignancies, or indwelling catheters [1]. - Like the subclavian vein, it's considered an upper extremity DVT site, but less frequent than lower extremity sites.

Q: Which of the following is a common finding in patients with Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)?

Normal BP. ***Normal BP*** - In SIADH, patients are typically **euvolemic** due to the primary issue being water retention rather than salt retention or frank dehydration [2]. - While hyponatremia occurs, the body's compensatory mechanisms usually prevent significant changes in blood pressure, maintaining it within the **normal range**. *Generalized edema* - Generalized edema is uncommon in SIADH because the excessive water retention is initially within the **intravascular compartment**, and the body attempts to excrete the additional volume of water [1]. - Although the patient is effectively retaining water, the osmolality is low, leading to fluid shifts rather than overt edema unless severe, protracted fluid overload occurs. *Ascites* - **Ascites**, which is the accumulation of fluid in the peritoneal cavity, is not a characteristic feature of SIADH [2]. - Ascites is more commonly associated with conditions like **liver cirrhosis**, heart failure, or malignancy. *Dry mucous membrane* - **Dry mucous membranes** are a sign of dehydration and fluid volume deficit. - In contrast, SIADH involves **fluid overload** (though euvolemic), making dry mucous membranes an unlikely finding [2].

Q: What is the primary clinical feature of Henoch-Schonlein purpura?

Skin rash characterized by palpable purpura. ***Skin rash characterized by palpable purpura*** - **Palpable purpura** is the hallmark cutaneous manifestation of **Henoch-Schonlein purpura (HSP)**, a small-vessel vasculitis [1]. - This rash typically appears on the **lower extremities and buttocks**, reflecting the deposition of IgA in vessel walls [1]. *Abdominal pain due to vasculitis* - While **abdominal pain** is a common feature of HSP due to gastrointestinal vasculitis, it is not considered the primary clinical feature [1]. - Gastrointestinal involvement can manifest with pain, bleeding, and intussusception, but the **skin rash** is more consistently present and diagnostic. *Joint pain associated with the condition* - **Arthralgia** or **arthritis** (joint pain) is seen in a significant number of HSP patients, particularly in the knees and ankles. - However, it is a secondary manifestation, and not the **defining primary sign** of the disease. *Kidney involvement in the disease* - **Renal involvement**, presenting as hematuria and proteinuria, occurs in about one-third of HSP cases and can lead to serious long-term complications. - Despite its significance for prognosis, **kidney disease** is a later and not universally present feature, making the rash the most critical initial diagnostic clue.

Q: Impotence is a feature of which of the following:

Multiple sclerosis. ***Multiple sclerosis*** - **Erectile dysfunction** (impotence) is a common symptom in men with multiple sclerosis, often resulting from **demyelination** in nerve pathways controlling sexual function [1], [2]. - MS can affect various neurological functions, leading to problems with **autonomic nervous system** control, sensation, and motor coordination, all of which can impact sexual health. *Poliomyelitis* - Poliomyelitis primarily affects the **anterior horn cells** of the spinal cord, leading to acute **flaccid paralysis** of muscles. - While it can cause muscle weakness and atrophy, it is not typically associated with chronic impotence or sexual dysfunction as a primary feature. *Amyotrophic lateral sclerosis* - ALS is a progressive neurodegenerative disease affecting **motor neurons**, leading to muscle weakness, atrophy, and spasticity. - It primarily impacts voluntary muscle movement and does not directly cause impotence, although the physical limitations and psychological stress can indirectly affect sexual function. *Meningitis* - Meningitis is an inflammation of the **meninges** (membranes surrounding the brain and spinal cord) caused by infection. - Its symptoms include headache, fever, and neck stiffness, and while severe cases can lead to neurological complications, impotence is not a typical direct consequence.

Q: In congenital dacryocystitis, the blockage occurs at?

Nasolacrimal duct. ***Nasolacrimal duct*** - **Congenital dacryocystitis** is primarily caused by an obstruction in the **nasolacrimal duct**, specifically at the **valve of Hasner** at its distal end near the inferior meatus. - This blockage prevents the proper drainage of tears into the nasal cavity, leading to tear overflow (epiphora), mucoid discharge, and potential secondary infection. - Present in approximately **5-6% of newborns**, with most cases resolving spontaneously by 12 months of age. *Punctum* - Congenital **punctal agenesis** is rare and not the typical site of obstruction in congenital dacryocystitis. - The puncta are usually patent in this condition. *Lacrimal canaliculi* - Obstruction of the **lacrimal canaliculi** is uncommon in congenital cases. - Canalicular obstruction is more often acquired (trauma, infection, medications). *Lacrimal sac* - The **lacrimal sac** itself is not the site of primary obstruction in congenital dacryocystitis. - The sac may become distended due to downstream obstruction at the nasolacrimal duct.

Q: What is the thinnest portion of the sclera?

Posterior to the rectus muscle insertion. ***Posterior to the rectus muscle insertion*** - The sclera is thinnest immediately **posterior to the insertion of the rectus muscles**, where it is about 0.3 mm thick. - This area is clinically relevant as it is a common site for globe rupture during trauma. *Anterior to the rectus muscle insertion* - The sclera is relatively thick in this region, measuring around **0.6 mm thick**. - It provides robust support and attachment for the rectus muscles. *At the posterior pole* - At the posterior pole, the sclera is the **thickest**, reaching about 1.0 mm, especially around the optic nerve. - This thickness is necessary to protect the delicate neural structures exiting the eye. *At the limbus* - The sclera-corneal junction, or **limbus**, has an intermediate thickness, around **0.8 mm**. - This area is critical for surgical procedures but is not the thinnest point.

Q: What is the most common type of shoulder dislocation?

Anterior. ***Anterior*** - **Anterior shoulder dislocations** account for more than 95% of all shoulder dislocations due to the anatomical vulnerability created by the lack of structural support anteriorly. - The **humeral head** displaces anteriorly and inferiorly relative to the glenoid, often resulting from **abduction and external rotation** forces. *Subcoracoid* - **Subcoracoid dislocation** is a specific type of **anterior dislocation** where the humeral head specifically lies inferior to the coracoid process. - While it is a common presentation of anterior dislocation, "anterior" refers to the broader category and hence is the more encompassing and correct answer. *Subclavicular* - **Subclavicular dislocation** is an even rarer type of **anterior dislocation** where the humeral head is displaced medially, lying inferior to the clavicle. - This is a much less common variant compared to general anterior dislocations. *Posterior* - **Posterior shoulder dislocations** are rare, accounting for only 2-4% of all shoulder dislocations. - They are typically associated with specific mechanisms like **seizures**, **electric shock**, or a fall on an adducted, internally rotated arm.

Q: What is the standard duration used to define apnea of prematurity?

20 sec. ***20 sec*** - Apnea of prematurity is defined as a cessation of breathing lasting **20 seconds or longer**, or a shorter pause in breathing accompanied by **bradycardia** (heart rate <100 bpm), **cyanosis**, or **pallor**. - This duration is crucial for determining the need for intervention and diagnosis in preterm infants. - The definition is standardized by the **American Academy of Pediatrics (AAP)** and is widely accepted in neonatal care. *Between 10 and 15 sec* - While pauses in breathing of this duration can be observed in preterm infants, they are usually considered **central periodic breathing** and not true apnea of prematurity unless accompanied by desaturation or bradycardia. - These shorter pauses are often considered benign, as significant physiological changes like bradycardia or cyanosis are less likely to occur. *More than 30 sec* - While a breathing cessation of more than 30 seconds certainly qualifies as apnea of prematurity, **20 seconds is the established minimum duration** for diagnosis. - Any apnea lasting longer than 20 seconds signifies a more severe event, indicating a greater risk to the infant. *Less than 10 sec* - Pauses in breathing lasting less than 10 seconds are generally considered **normal physiological variations** in both preterm and full-term infants. - These short pauses do not typically lead to significant oxygen desaturation or bradycardia and are not indicative of apnea of prematurity.

Question 1

In which condition are Haab's striae typically observed?

Accepted Answer

Buphthalmos

Answer

Keratoglobus

Answer

Trachoma

Answer

Keratoconus

Question 2

All are major symptoms of sinusitis except?

Accepted Answer

Halitosis

Answer

Nasal blockage

Answer

Facial congestion

Answer

Anosmia

Question 3

Deep vein thrombosis most commonly occurs at which site?

Accepted Answer

Femoral vein

Answer

Subclavian vein

Answer

External jugular vein

Answer

Internal jugular vein

Question 4

Which of the following is a common finding in patients with Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)?

Accepted Answer

Normal BP

Answer

Ascites

Answer

Generalized edema

Answer

Dry mucous membrane

Question 5

What is the primary clinical feature of Henoch-Schonlein purpura?

Accepted Answer

Skin rash characterized by palpable purpura

Answer

Abdominal pain due to vasculitis

Answer

Joint pain associated with the condition

Answer

Kidney involvement in the disease

Question 6

Impotence is a feature of which of the following:

Accepted Answer

Multiple sclerosis

Answer

Poliomyelitis

Answer

Amyotrophic lateral sclerosis

Answer

Meningitis

Question 7

In congenital dacryocystitis, the blockage occurs at?

Accepted Answer

Nasolacrimal duct

Answer

Punctum

Answer

Lacrimal canaliculi

Answer

Lacrimal sac

Question 8

What is the thinnest portion of the sclera?

Accepted Answer

Posterior to the rectus muscle insertion

Answer

Anterior to the rectus muscle insertion

Answer

At the posterior pole

Answer

At the limbus

Question 9

What is the most common type of shoulder dislocation?

Accepted Answer

Answer

Subcoracoid

Answer

Subclavicular

Answer

Posterior

Question 10

What is the standard duration used to define apnea of prematurity?

Accepted Answer

20 sec

Answer

Between 10 and 15 sec

Answer

More than 30 sec

Answer

Less than 10 sec

NEET-PG 2013

Dental

ENT

Internal Medicine

Ophthalmology

Orthopaedics

Pediatrics