NEET-PG 2013 Practice Questions

Q: What is the primary clinical use of Sugammadex in anesthesia?

Reversal of NM blockers. ***Reversal of NM blockers*** - **Sugammadex** is a modified gamma-cyclodextrin that specifically encapsulates steroidal **neuromuscular blocking agents (NMBAs)** like **rocuronium** and **vecuronium**. - This encapsulation rapidly inactivates the NMBAs, leading to a dose-dependent and swift **reversal of neuromuscular blockade**. *Organophosphate poisoning* - Organophosphate poisoning is treated with **atropine** to block muscarinic effects and **pralidoxime** to reactivate inhibited acetylcholinesterase. - Sugammadex has no role in antagonizing the effects of **organophosphates** or regenerating acetylcholinesterase. *Treatment of local anaesthetic poisoning* - Local anesthetic systemic toxicity (LAST) is primarily managed with supportive care, including airway management, and the administration of **lipid emulsion therapy**. - Sugammadex does not bind to local anesthetics and therefore has no efficacy in treating local anesthetic poisoning. *Treatment of central anticholinergic syndrome* - Central anticholinergic syndrome is typically treated with **physostigmine**, an acetylcholinesterase inhibitor that can cross the blood-brain barrier. - Sugammadex is not an anticholinergic antagonist and does not affect the central nervous system to reverse anticholinergic effects.

Q: Which of the following is a key criterion for a prudent diet?

Saturated fats < 10% of total energy. ***Saturated fats < 10% of total energy*** - Limiting **saturated fat intake** to less than 10% of total energy is a key recommendation for a prudent diet to reduce the risk of **cardiovascular disease**. - High intake of saturated fats can increase **LDL cholesterol** ("bad" cholesterol), contributing to **atherosclerosis**. *Fat intake 35-40% of total energy* - This range is generally considered **too high** for a healthy diet, as excessive fat intake can lead to **obesity** and increased risk of chronic diseases. - A more prudent range for total fat intake is typically around **20-35% of total energy**. *Dietary cholesterol < 300 mg/1000Kcal per day* - While limiting dietary cholesterol was historically a key recommendation, current guidelines emphasize reducing **saturated and trans fats** more strongly than dietary cholesterol itself due to its limited impact on blood cholesterol for most people. - The limit of **300 mg/day** for dietary cholesterol is an older guideline; many newer recommendations do not specify an upper limit for dietary cholesterol for healthy individuals. *Salt intake <10 g/day* - This statement indicates a salt intake of less than 10 grams per day, which is still **higher** than the generally recommended upper limit for a prudent diet. - Current guidelines suggest limiting **sodium intake** to less than 2300 mg (approximately 5.8g of salt) per day, with an ideal limit of less than 1500 mg (approximately 3.8g of salt) for most adults to manage **blood pressure**.

Q: Which of the following is the primary component of the AFP (Acute Flaccid Paralysis) case definition used in polio surveillance?

Onset of acute flaccid paralysis. ***Onset of acute flaccid paralysis*** - The primary component of the **AFP case definition** for polio surveillance is the acute onset of **flaccid paralysis** in a child under 15 years, or paralytic illness in a person of any age when polio is suspected. - This definition is crucial for identifying all potential cases of polio, regardless of the cause, to ensure thorough investigation and prevent outbreaks. *Stool specimen positive for poliovirus* - A positive stool specimen for poliovirus is a **laboratory confirmation** of polio infection, but it is not the primary component of the initial case definition. - The AFP case definition aims for **high sensitivity** to capture all possible cases for investigation, even before laboratory results are available. *Presence of residual paralysis after 60 days* - Residual paralysis after 60 days is an important indicator for **classifying a confirmed polio case** and understanding the long-term impact. - However, it is a **follow-up criterion** used after the initial detection of AFP, not the primary component that triggers the initial surveillance. *All of the above* - While laboratory confirmation and residual paralysis provide further information about a case, the **initial identification relies specifically on the clinical presentation** of acute flaccid paralysis. - The broad clinical definition ensures that no potential polio case is missed, initiating an immediate public health response.

Q: Bullous myringitis is caused by?

Mycoplasma pneumoniae. ***Mycoplasma pneumoniae*** - **Bullous myringitis** is characterized by the formation of **blisters** (bullae) on the **tympanic membrane**, which is a classic presentation associated with *Mycoplasma pneumoniae* infection. - While other bacteria can cause otitis media, *Mycoplasma pneumoniae* has a strong association with the development of **hemorrhagic bullae** on the eardrum. *Streptococcus pneumoniae* - This bacterium is the **most common cause** of **acute otitis media (AOM)**, but it typically presents with inflammation and bulging of the tympanic membrane **without** the characteristic bullae. - While it can cause severe ear infections, its typical presentation does not involve the **blister formation** seen in bullous myringitis. *Haemophilus influenzae* - This is another **common bacterial cause** of **acute otitis media**, especially in children, often leading to bulging and redness of the eardrum. - Similar to *Streptococcus pneumoniae*, it is not typically associated with the development of **bullae** on the tympanic membrane. *Candida* - **Candida** species are **fungi** and are a cause of **otitis externa** (ear canal infection) or, less commonly, **chronic otitis media**, particularly in immunocompromised individuals. - Fungal infections of the ear, including Candida, do **not** typically cause the characteristic **bullous myringitis** presentation.

Q: The outer covering of diatoms is made of?

Silica. ***Correct: Silica*** - The cell walls of diatoms are primarily composed of **hydrated amorphous silica (SiO2·nH2O)**. - This rigid, intricate outer covering is known as a **frustule**, which provides structural support and protection. - Diatoms are uniquely characterized by their intricate silica cell walls, making them easily identifiable under microscopy. *Incorrect: Magnesium* - **Magnesium (Mg)** is an important metal and a component of chlorophyll, essential for photosynthesis. - While diatoms do contain magnesium for metabolic processes, it is not the primary structural component of their outer covering. *Incorrect: Hydrocarbons* - **Hydrocarbons** are organic compounds consisting entirely of hydrogen and carbon, commonly found in fossil fuels. - Diatom cell walls are inorganic (mineral-based), not organic hydrocarbon structures. *Incorrect: None of the options* - This option is incorrect because **silica** is listed among the options and is the correct answer. - Diatom frustules are definitively composed of silica.

Q: Which anticoagulant is used when blood is sent for blood culture?

SPS. ***SPS*** - **SPS (Sodium Polyanethol Sulfonate)** is the preferred anticoagulant for blood cultures because it inhibits phagocytosis and complement activation, allowing microorganisms to survive and grow. - It also neutralizes the bactericidal effect of aminoglycoside antibiotics, which might be present in the patient's blood. *Sodium citrate* - **Sodium citrate** works by binding to calcium ions, preventing blood coagulation, and is typically used for coagulation studies. - It is not suitable for blood cultures as it does not have the anti-phagocytic or antibiotic-neutralizing properties of SPS. *EDTA* - **EDTA (Ethylenediaminetetraacetic acid)** is a strong chelator of calcium and is primarily used for hematology tests like complete blood counts (CBC) as it preserves cell morphology. - It can be toxic to some bacteria and would inhibit microbial growth, making it unsuitable for blood cultures. *Oxalate* - Various **oxalates** (e.g., potassium oxalate) also act as anticoagulants by precipitating calcium, and are commonly found in tubes for glucose testing when combined with a glycolytic inhibitor. - Oxalates are generally unsuitable for blood cultures because they can inhibit the growth of certain microorganisms.

Q: Which of the following is an intermediate level disinfectant?

Hypochlorite. ***Hypochlorite*** - **Hypochlorite** (e.g., sodium hypochlorite, bleach) is an effective **intermediate-level disinfectant** commonly used for surface disinfection and water purification. - It works by **oxidizing cellular components** and disrupting membrane function in microorganisms, effective against a wide range of bacteria, viruses, and some fungi. *2% glutaraldehyde* - **2% glutaraldehyde** is a **high-level disinfectant** and **sterilant** often used for heat-sensitive medical equipment like endoscopes. - It is effective against bacterial spores, mycobacteria, fungi, and viruses, which exceeds the scope of intermediate-level disinfection. *Ethylene oxide* - **Ethylene oxide** is a **gaseous sterilant** used for heat-sensitive and moisture-sensitive medical devices, making it a high-level modality. - It works by **alkylating proteins and nucleic acids**, effectively killing all forms of microbial life, including spores. *None of the options* - This option is incorrect because **Hypochlorite** is indeed an intermediate-level disinfectant. - The classification of disinfectants is based on their ability to kill different types of microorganisms, with hypochlorite falling squarely into the intermediate category.

Q: Which of the antithyroid drugs inhibits iodine trapping?

Thiocyanates. ***Thiocyanates*** - **Thiocyanates** are competitive inhibitors of the **sodium-iodide symporter (NIS)**, which is responsible for actively transporting iodide into thyroid follicular cells (iodine trapping) [1]. - By blocking NIS, thiocyanates prevent the thyroid gland from accumulating iodide, thereby inhibiting thyroid hormone synthesis [1]. *Radioactive iodine* - **Radioactive iodine (RAI)** primarily works by being taken up by thyroid cells and emitting **beta particles**, which destroy the thyroid tissue [3]. - It does not inhibit iodine trapping, but rather uses the trapping mechanism to concentrate in the thyroid and exert its destructive effect [3]. *Iodides* - **Iodides** (e.g., Lugol's solution) paradoxically inhibit organification and hormone release from the thyroid gland, an effect known as the **Wolff-Chaikoff effect** [2]. - They also decrease the vascularity and size of the thyroid gland, making them useful in preparing patients for thyroidectomy, but do not directly inhibit iodine trapping [2]. *Methimazole* - **Methimazole** is a **thionamide** drug that primarily inhibits the enzyme **thyroid peroxidase**. - This prevents the **organification of iodide** (incorporation of iodine into tyrosine residues) and the **coupling of iodotyrosines** (forming T3 and T4), not the initial trapping of iodine.

Q: What is the best drug for control of acute esophageal variceal bleeding?

Octreotide. ***Octreotide*** - **Octreotide** is a somatostatin analog that causes **splanchnic vasoconstriction**, reducing portal venous inflow and pressure, which is crucial in controlling **esophageal variceal bleeding**. - Its mechanism involves inhibiting the release of **vasodilatory hormones** like glucagon, leading to a decrease in portal pressure without significant systemic side effects. *Vasopressin* - **Vasopressin** is a potent vasoconstrictor that can reduce portal pressure but has significant systemic side effects such as **myocardial ischemia** and **bowel ischemia** due to widespread vasoconstriction. - It is generally no longer considered the first-line pharmacological treatment for variceal bleeding due to its **adverse effect profile**. *GnRH* - **GnRH** (Gonadotropin-releasing hormone) plays a role in regulating the reproductive system by controlling the release of FSH and LH from the pituitary. - It has **no direct role** in the management or control of esophageal bleeding. *Propranolol* - **Propranolol** is a non-selective beta-blocker primarily used for **prophylaxis** of variceal bleeding by reducing portal pressure chronically. - It works by reducing cardiac output and causing splanchnic vasoconstriction, but it is **not used for acute control** of active bleeding.

Q: Aminophylline inhibits which of the following enzymes?

Phosphodiesterase. ***Phosphodiesterase*** - **Aminophylline** is a methylxanthine derivative that primarily acts as a **phosphodiesterase (PDE) inhibitor** [1], [2]. - By inhibiting PDE, aminophylline increases intracellular levels of **cAMP** and **cGMP**, leading to **bronchodilation** and other effects [2], [3]. *MAO* - **MAO (monoamine oxidase)** inhibitors are antidepressants that prevent the breakdown of neurotransmitters like serotonin, norepinephrine, and dopamine. - Aminophylline does not significantly inhibit MAO. *Alcohol dehydrogenase* - **Alcohol dehydrogenase** is an enzyme responsible for metabolizing alcohol (ethanol) in the liver. - Aminophylline has no direct inhibitory effect on alcohol dehydrogenase. *Cytochrome P450* - **Cytochrome P450 (CYP450)** enzymes are a group of enzymes primarily involved in the metabolism of drugs and other xenobiotics in the liver [4]. - While aminophylline (and its active metabolite theophylline) can be metabolized by and *affect* certain **CYP450** isoenzymes (e.g., CYP1A2), it does not act as a general inhibitor of the entire CYP450 system; its primary therapeutic action is not through CYP450 inhibition.

Question 1

What is the primary clinical use of Sugammadex in anesthesia?

Accepted Answer

Reversal of NM blockers

Answer

Organophosphate poisoning

Answer

Treatment of local anaesthetic poisoning

Answer

Treatment of central anticholinergic syndrome

Question 2

Which of the following is a key criterion for a prudent diet?

Accepted Answer

Saturated fats < 10% of total energy

Answer

Fat intake 35-40% of total energy

Answer

Dietary cholesterol < 300 mg/1000Kcal per day

Answer

Salt intake <10 g/day

Question 3

Which of the following is the primary component of the AFP (Acute Flaccid Paralysis) case definition used in polio surveillance?

Accepted Answer

Onset of acute flaccid paralysis

Answer

All of the above

Answer

Stool specimen positive for poliovirus

Answer

Presence of residual paralysis after 60 days

Question 4

Bullous myringitis is caused by?

Accepted Answer

Mycoplasma pneumoniae

Answer

Haemophilus influenzae

Answer

Candida

Answer

Streptococcus pneumoniae

Question 5

The outer covering of diatoms is made of?

Accepted Answer

Silica

Answer

Magnesium

Answer

Hydrocarbons

Answer

None of the options

Question 6

Which anticoagulant is used when blood is sent for blood culture?

Accepted Answer

SPS

Answer

Sodium citrate

Answer

EDTA

Answer

Oxalate

Question 7

Which of the following is an intermediate level disinfectant?

Accepted Answer

Hypochlorite

Answer

Ethylene oxide

Answer

2% glutaraldehyde

Answer

None of the options

Question 8

Which of the antithyroid drugs inhibits iodine trapping?

Accepted Answer

Thiocyanates

Answer

Radioactive iodine

Answer

Iodides

Answer

Methimazole

Question 9

What is the best drug for control of acute esophageal variceal bleeding?

Accepted Answer

Octreotide

Answer

Vasopressin

Answer

GnRH

Answer

Propranolol

Question 10

Aminophylline inhibits which of the following enzymes?

Accepted Answer

Phosphodiesterase

Answer

MAO

Answer

Alcohol dehydrogenase

Answer

Cytochrome P450

NEET-PG 2013

Anesthesiology

Community Medicine

ENT

Forensic Medicine

Microbiology

Pharmacology