NEET-PG 2013 Practice Questions

Q: What anatomical structure is formed after the obliteration of the umbilical vein?

Round ligament of the liver (ligamentum teres). ***Round ligament of the liver (ligamentum teres)*** - The **umbilical vein** carries oxygenated blood from the placenta to the fetus during development [1]. - After birth, the umbilical vein obliterates and forms the **round ligament of the liver**, also known as the **ligamentum teres hepatis**. *Ligamentum venosum* - This structure is the obliterated remnant of the **ductus venosus**, which shunted blood from the umbilical vein to the inferior vena cava, bypassing the fetal liver [1]. - It is located in a fissure on the posterior surface of the liver, separate from the round ligament. *Ligamentum arteriosum* - This ligament is the remnant of the **ductus arteriosus**, a fetal blood vessel connecting the pulmonary artery to the aorta. - Its obliteration allows blood to flow through the lungs after birth. *Medial umbilical ligament* - This ligament is formed from the obliterated **umbilical arteries**, which carry deoxygenated blood from the fetus back to the placenta. - There are two medial umbilical ligaments, one from each umbilical artery.

Q: Which of the following is the nodal centre for disaster management at the district level in India?

District Collector's office. ***District Collector's office*** - The **District Collector (Deputy Commissioner/District Magistrate)** is the **chairperson of the District Disaster Management Authority (DDMA)** as per the Disaster Management Act, 2005. - The District Collector's office serves as the **nodal centre for all disaster management activities** at the district level, with overall administrative and operational responsibility. - The District Collector coordinates all disaster preparedness, response, relief, and rehabilitation activities in the district. *Emergency Operations Center (EOC)* - The **EOC** is a **functional/operational unit** that assists in disaster coordination and information management. - It serves as a support mechanism for the District Collector but is **not the nodal agency itself**. - The EOC operates under the administrative framework of the District Disaster Management Authority. *PHC* - A **Primary Health Centre (PHC)** is the first point of contact for healthcare in rural areas. - Its role in disasters is limited to providing initial medical aid and supporting community health needs. - It is not an administrative or coordinating body for overall disaster management. *CHC* - A **Community Health Centre (CHC)** provides secondary healthcare services and acts as a referral center for PHCs. - While important for medical response during disasters, it has no administrative role in disaster management coordination.

Q: Immersion syndrome is also known as?

Hydrocution. ***Hydrocution*** - **Immersion syndrome**, or hydrocution, is a sudden death that occurs immediately upon immersion in cold water. - It is believed to be caused by a **vasovagal reflex** triggered by the sudden temperature change, leading to cardiac arrest. *Wet drowning* - This term refers to conventional drowning where an individual inhales water, leading to respiratory compromise and death. - It is characterized by the presence of **fluid in the lungs**, which is not the primary mechanism in immersion syndrome. *Dry drowning* - **Dry drowning** occurs when water does not enter the lungs; instead, the glottis spasms and closes, preventing air and water from entering. - This leads to suffocation, often hours after the initial water exposure, and is distinct from the immediate cardiac event of immersion syndrome. *Secondary drowning* - **Secondary drowning**, or delayed drowning, refers to complications that arise hours or days after a near-drowning incident due to inhaled water causing pulmonary edema. - It involves a delayed physiological response rather than an immediate reflex.

Q: Maximum density of microfilariae in blood is reported to be between -

11 pm to 2 am. ***11 pm to 2 am*** - This period aligns with the **nocturnal periodicity** of *Wuchereria bancrofti* and *Brugia malayi* microfilariae, which are the most common causes of filariasis. - The microfilariae migrate to the **peripheral circulation** during these hours, making it the optimal time for blood smear collection for diagnosis. *9 pm to 11 pm* - While still within the active period for microfilarial migration, the **peak density** is generally observed slightly later. - Blood drawn during this time might show microfilariae, but in lower concentrations compared to the peak. *8 pm to 10 pm* - This timing is generally a little too early to consistently capture the **highest microfilarial load** in nocturnal periodic infections. - The microfilariae are still in the process of migrating from deeper tissues to the peripheral blood. *2 am to 5 am* - By this time, the microfilarial density in the peripheral blood of **nocturnal periodic species** usually starts to decline. - While some microfilariae may still be present, the count would likely be lower than during the earlier peak hours.

Q: What is Hydroxyethyl starch?

Plasma expander. ***Plasma expander*** - **Hydroxyethyl starch** is a **colloid solution** used intravenously to increase plasma volume and maintain oncotic pressure. - It is often used in situations of **hypovolemia** or shock to support circulation. *Vasodilator* - A **vasodilator** is a medication that widens blood vessels, typically used to lower blood pressure or improve blood flow. - Hydroxyethyl starch does not directly cause **vasodilation** as its primary mechanism of action. *Inotrope* - An **inotrope** is an agent that alters the force or energy of muscular contractions, mainly affecting the heart's contractility. - Hydroxyethyl starch has no direct effect on **myocardial contractility**. *Diuretic* - A **diuretic** is a substance that promotes increased production of urine, thereby increasing the excretion of water from the body. - While fluid administration can temporarily increase urine output, hydroxyethyl starch is not classified as a **diuretic agent** itself.

Q: What conditions is Metformin primarily used to treat?

Both Type 2 Diabetes and Polycystic Ovary Syndrome (PCOS). ***Both Type 2 Diabetes and Polycystic Ovary Syndrome (PCOS)*** - **Metformin** is a first-line treatment for **Type 2 Diabetes** due to its ability to decrease hepatic glucose production and improve insulin sensitivity [1], [2]. - It is also commonly used off-label for **PCOS** to improve insulin resistance, ovulation, and reduce androgen levels. *Only Type 2 Diabetes* - While Metformin is a cornerstone for **Type 2 Diabetes** treatment, stating "only" is incorrect as it has other significant therapeutic uses [2]. - Its benefits extend beyond diabetes management, particularly in conditions involving **insulin resistance**. *Only Polycystic Ovary Syndrome (PCOS)* - Metformin is used in **PCOS**, but it is not the sole condition it treats, and its primary indication remains **Type 2 Diabetes** [2]. - This option incorrectly limits its application to just one condition, overlooking its major role in diabetes. *Pregnancy Induced Hypertension* - **Metformin** is not indicated for the treatment of **pregnancy-induced hypertension** (gestational hypertension). - Treatment for pregnancy-induced hypertension typically involves medications like **labetalol**, **methyldopa**, or **nifedipine**, with delivery being the definitive management for severe cases.

Q: Which of the following anticoagulants is given orally?

Rivaroxaban. ***Rivaroxaban*** - Rivaroxaban is a **direct oral anticoagulant (DOAC)** that specifically inhibits **Factor Xa**. - It is administered orally and does not require routine coagulation monitoring. *Argatraban* - Argatroban is a **direct thrombin inhibitor (DTI)** primarily used intravenously, especially in patients with **heparin-induced thrombocytopenia (HIT)**. - It is not an orally administered anticoagulant. *Alteplase* - Alteplase is a **thrombolytic agent** (clot buster), not an anticoagulant, that works by converting **plasminogen to plasmin**. - It is administered intravenously to dissolve existing clots. *Fondaparinux* - Fondaparinux is a **synthetic pentasaccharide** that selectively inhibits **Factor Xa** by binding to antithrombin. - It is administered **subcutaneously**, not orally.

Q: What is the most serious side effect associated with Raltegravir?

Rhabdomyolysis. ***Rhabdomyolysis*** - Raltegravir, an **integrase strand transfer inhibitor (INSTI)**, can cause muscle-related side effects, including **rhabdomyolysis** and **myopathy**. [2] - Patients may present with muscle pain, weakness, and elevated **creatine kinase (CK)** levels. *Headache* - While headache can be a general side effect of many medications, it is not a **distinguishing or severe adverse effect commonly associated with Raltegravir** that would require specific monitoring. - Other more prominent side effects are typically prioritized in counseling and monitoring for this drug. *Hyperglycemia* - **Hyperglycemia** is not a commonly reported or significant side effect of Raltegravir. - While some antiretrovirals, particularly certain **protease inhibitors (PIs)** and **nucleoside reverse transcriptase inhibitors (NRTIs)**, are associated with altered glucose metabolism, INSTIs like Raltegravir generally have a more favorable metabolic profile. [1] *Hypertension* - Hypertension is generally **not a recognized or common side effect** of Raltegravir. - Cardiovascular events and hypertension are more frequently associated with other classes of antiretroviral drugs or as comorbidities in HIV-positive patients, rather than directly with INSTIs.

Q: Most clinically significant side effect of topiramate requiring immediate medical attention?

Visual impairment. ***Visual impairment*** - Topiramate can cause **acute angle-closure glaucoma**, a medical emergency that typically occurs within the **first month of therapy**. - Mechanism: Topiramate causes **ciliary body swelling** and **uveal effusion**, leading to anterior rotation of the iris-lens diaphragm and angle closure. - Clinical presentation: Rapid-onset **blurred vision**, **eye pain**, **headache**, **redness**, and may progress to permanent vision loss if untreated. - Management: **Immediate discontinuation** of topiramate and urgent **ophthalmology referral** for intraocular pressure management. *Weight loss* - Weight loss is a common and often desired side effect of topiramate, related to its effect on **appetite suppression** and enhanced satiety. - While it can be significant, it does not typically require immediate medical attention unless it becomes excessive or leads to nutritional deficiencies. - This side effect is sometimes therapeutically exploited in migraine prophylaxis. *Insomnia* - Insomnia is a known side effect of topiramate and can impact quality of life but is generally not life-threatening or an immediate medical emergency. - Management often involves adjusting the dosage, timing of administration (dosing earlier in the day), or prescribing sleep aids. *Hemolysis* - Hemolysis is **not a recognized side effect** of topiramate. - Topiramate is not known to directly cause the destruction of red blood cells. - Other serious side effects of topiramate include metabolic acidosis, kidney stones, and cognitive impairment, but not hemolysis.

Q: Mode of excretion of cyclophosphamide is?

Kidney. ***Kidney*** - Cyclophosphamide is a **prodrug** that undergoes metabolism in the liver to its active forms. However, both the parent drug and its active metabolites are primarily **excreted renally**. [1] - Renal excretion means that patients with **renal impairment** may require dose adjustments to prevent drug accumulation and increased toxicity. [3] *Lung* - The lungs are primarily involved in **gas exchange** and the elimination of volatile substances, not non-volatile drugs like cyclophosphamide. - While some drugs can be excreted to a minor extent via the lungs, it is not the primary route for **cyclophosphamide**. *Liver* - The liver is the primary site of **metabolism** for cyclophosphamide, where it is converted into active cytotoxic metabolites. [1], [2] - While metabolites are formed here, the liver is not the main organ for the final **elimination** (excretion) of the drug or its metabolites from the body. *Skin* - The skin's role in drug excretion is generally minimal, mainly involving substances excreted in **sweat**, and is not a significant route for cyclophosphamide. - Excretion via the skin is typically very limited for most drugs and does not play a major role in the elimination of **chemotherapeutic agents** like cyclophosphamide.

Question 1

What anatomical structure is formed after the obliteration of the umbilical vein?

Accepted Answer

Round ligament of the liver (ligamentum teres)

Answer

Ligamentum venosum

Answer

Ligamentum arteriosum

Answer

Medial umbilical ligament

Question 2

Which of the following is the nodal centre for disaster management at the district level in India?

Accepted Answer

District Collector's office

Answer

PHC

Answer

Emergency Operations Center (EOC)

Answer

CHC

Question 3

Immersion syndrome is also known as?

Accepted Answer

Hydrocution

Answer

Wet drowning

Answer

Dry drowning

Answer

Secondary drowning

Question 4

Maximum density of microfilariae in blood is reported to be between -

Accepted Answer

11 pm to 2 am

Answer

9 pm to 11 pm

Answer

8 pm to 10 pm

Answer

2 am to 5 am

Question 5

What is Hydroxyethyl starch?

Accepted Answer

Plasma expander

Answer

Vasodilator

Answer

Inotrope

Answer

Diuretic

Question 6

What conditions is Metformin primarily used to treat?

Accepted Answer

Both Type 2 Diabetes and Polycystic Ovary Syndrome (PCOS)

Answer

Only Type 2 Diabetes

Answer

Only Polycystic Ovary Syndrome (PCOS)

Answer

Pregnancy Induced Hypertension

Question 7

Which of the following anticoagulants is given orally?

Accepted Answer

Rivaroxaban

Answer

Argatraban

Answer

Alteplase

Answer

Fondaparinux

Question 8

What is the most serious side effect associated with Raltegravir?

Accepted Answer

Rhabdomyolysis

Answer

Hyperglycemia

Answer

Hypertension

Answer

Headache

Question 9

Most clinically significant side effect of topiramate requiring immediate medical attention?

Accepted Answer

Visual impairment

Answer

Weight loss

Answer

Insomnia

Answer

Hemolysis

Question 10

Mode of excretion of cyclophosphamide is?

Accepted Answer

Kidney

Answer

Lung

Answer

Liver

Answer

Skin

NEET-PG 2013

Anatomy

Community Medicine

Forensic Medicine

Microbiology

Pharmacology