NEET-PG 2013 Practice Questions

Q: Antiserum is available for passive immunization against ?

Rabies. ***Rabies*** - **Antiserum** (or rabies immune globulin, RIG) provides immediate **passive immunity** against rabies, neutralizing the virus before the body can mount an active immune response. - It is administered in conjunction with the **rabies vaccine** for post-exposure prophylaxis, especially in severe exposures. *Typhoid* - **Typhoid fever** is primarily prevented through vaccination (active immunization) and improved sanitation. - There is no routinely available antiserum for **passive immunization** against *Salmonella typhi* infection. *Measles* - **Measles** is prevented through active immunization with the MMR (measles, mumps, rubella) vaccine. - While immune globulin can be used for passive protection in exposed, immunocompromised individuals, it's not commonly referred to as "antiserum" in the same context as rabies. *Mumps* - **Mumps** is prevented by active immunization with the MMR vaccine. - Similar to measles, there is no commonly used specific antiserum for **passive immunity** against mumps in the clinical setting.

Q: Most commonly used tuning fork in ear examination?

512 Hz. ***512 Hz*** - The **512 Hz tuning fork** is the most commonly recommended and used for auditory tests like **Rinne** and **Weber** because its vibratory decay is slow enough to allow adequate testing, and it falls within the **speech frequency range**. - Its frequency is optimal for assessing both **bone conduction** and **air conduction** without introducing confusing overtones or being too low to be felt as a vibration rather than heard as a tone. *128 Hz* - A **128 Hz tuning fork** produces a strong vibratory sensation and is primarily used for **neurological examinations** to test **vibration sense**, not typically for ear examinations. - Its low frequency can be easily perceived as a **tactile vibration** through bone, making it less ideal for purely auditory assessment. *256 Hz* - While it falls within the audible range, a **256 Hz tuning fork** is less commonly used than 512 Hz for standard hearing tests. - Its vibratory tone may have a faster decay and might not provide as clear a distinction for **bone conduction** as the 512 Hz fork. *1024 Hz* - A **1024 Hz tuning fork** is a higher frequency tone, which may decay too quickly for accurate **Rinne and Weber tests**, especially when assessing subtle differences in hearing. - While audible, its higher pitch can be less representative of the critical **speech frequencies** typically evaluated in basic hearing screenings.

Q: In blast injury, which organ is most likely to be damaged first?

Tympanic membrane. ***Tympanic membrane*** - The **tympanic membrane** is the most sensitive organ to the pressure waves generated by a blast, often rupturing even with relatively low blast overpressures. - Its thin, delicate structure and direct exposure to external air pressure make it highly vulnerable to barotrauma. *Gastrointestinal tract* - While the **gastrointestinal tract** can be damaged by blast waves, especially air-filled organs, this typically occurs after the tympanic membrane is affected. - Damage often includes hemorrhage, perforation, and mesenteric injury. *Liver* - The **liver** is a solid organ and is less susceptible to initial blast injury compared to air-filled structures. - Damage to the liver usually results from secondary mechanisms like blunt trauma from displacement or impact against other structures. *Lung* - **Blast lung** is a serious injury characterized by pulmonary contusions, hemorrhage, and edema, but it generally requires higher blast overpressure than tympanic membrane rupture. - The air-filled nature of the lungs makes them susceptible, but the tympanic membrane almost always fails first.

Q: Which of the following statements about the Consumer Protection Act is NOT accurate or NOT specifically mentioned in the Act?

Consumer complaints are resolved within 3-6 months.. ***Consumer complaints are resolved within 3-6 months.*** - While the Act aims for **expeditious resolution**, it does not specify a rigid 3-6 month timeframe for consumer complaint resolution. - The actual time taken can vary significantly depending on the **complexity of the case** and the **caseload of the consumer forums**. *The Act was passed in 1986.* - The **Consumer Protection Act (COPRA)** in India was indeed enacted in the year **1986**. - This statement is factually accurate regarding the **historical context** of the Act. *ESI hospitals are specifically excluded.* - The **Supreme Court of India** has ruled that services provided by **Employment State Insurance (ESI) hospitals** and other government hospitals for free are generally excluded from the purview of the Consumer Protection Act. - This exclusion is based on the premise that these services are not rendered as part of a **"contract of service"** for consideration. *Consumers have the right to safety.* - The **Consumer Protection Act** explicitly grants consumers several rights, including the **right to be protected against marketing of goods and services which are hazardous to life and property**. - This fundamental right ensures that consumers receive **safe products and services**.

Q: Which immunoglobulin is primarily secreted by the intestine?

IgA. **IgA** - **Secretory IgA** is the dominant immunoglobulin in mucosal secretions, including those of the intestine. - It plays a crucial role in providing **local immunity** by preventing microbial adherence and neutralizing toxins on mucosal surfaces. *IgG* - **IgG** is the most abundant immunoglobulin in serum and plays a major role in systemic immunity, including opsonization and complement activation. - While some IgG is found in secretions, it is not the primary immunoglobulin secreted by the intestine. *IgM* - **IgM** is a pentameric immunoglobulin, primarily found in blood and lymph, where it is very effective in activating the complement system and agglutinating antigens. - Although it can be found at mucosal surfaces in small amounts, it is not the principal secreted antibody in the intestine. *IgD* - **IgD** is primarily found on the surface of naive B lymphocytes, where it functions as a B cell receptor. - Its role in secreted form is minimal, and it is not significantly secreted into the intestine or other bodily fluids.

Q: Which of the following medications is known to cause peripheral neuropathy?

Vincristine. ***Vincristine*** - **Vincristine** is a **vinca alkaloid chemotherapeutic agent** that is **notorious** for causing **peripheral neuropathy** as its **dose-limiting toxicity**. - It interferes with **microtubule function** during mitosis, leading to **axonal damage** and predominantly **sensorimotor neuropathy**. - Peripheral neuropathy occurs in **virtually all patients** receiving vincristine and typically manifests as **distal paresthesias**, **loss of deep tendon reflexes**, and **motor weakness**. - This is the **most characteristic adverse effect** of vincristine. *Paclitaxel* - **Paclitaxel** is a **taxane chemotherapeutic agent** that also causes **peripheral neuropathy** as a significant adverse effect. - It stabilizes **microtubules**, preventing their depolymerization, leading to neurotoxicity. - While peripheral neuropathy is common with paclitaxel, it shares prominence with other major toxicities like **myelosuppression** and **hypersensitivity reactions**. *Sulfonamide* - **Sulfonamide antibiotics** are primarily associated with **hypersensitivity reactions**, **crystalluria**, **skin rashes**, and **hematologic abnormalities**. - Peripheral neuropathy is not a recognized or common adverse effect of sulfonamides. *Amiodarone* - **Amiodarone** is an **antiarrhythmic drug** with multiple adverse effects including **pulmonary fibrosis**, **thyroid dysfunction**, **corneal deposits**, and **hepatotoxicity**. - While rare cases of **peripheral neuropathy** have been reported, it is **not a characteristic or common adverse effect** of amiodarone.

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 serious side effect may lead to the discontinuation of felbamate?

Aplastic anemia. ***Aplastic anemia*** - Felbamate is known to cause **aplastic anemia**, a severe and life-threatening condition where the **bone marrow stops producing enough new blood cells**. - Felbamate carries a **black box warning** for both aplastic anemia and **hepatotoxicity (severe liver failure)**, which are the two most serious adverse effects leading to discontinuation. - Due to this significant risk, felbamate is reserved for severe, refractory epilepsy cases, and patients require **regular monitoring** of blood counts and liver function tests. *Renal impairment* - While some medications can cause renal impairment, **felbamate is not primarily associated** with this side effect to the extent of requiring discontinuation. - Its metabolism and excretion are predominantly **hepatic (liver)**, and renal effects are less common or severe. *Gastrointestinal disorder* - Gastrointestinal side effects like nausea or vomiting are **common with many medications**, including felbamate, but are generally **mild and manageable**, rarely leading to discontinuation. - These effects are usually **dose-dependent** and can often be mitigated with supportive care. *Seizures* - Felbamate is an **antiepileptic drug (AED)**, so it is used to treat seizures, not cause them. - If a patient experiences seizures while on felbamate, it usually indicates **inadequate treatment response** or seizure exacerbation, rather than a direct side effect necessitating discontinuation for toxicity.

Q: Which of the following statements about lamotrigine is correct?

Has a half-life of approximately 24 hours.. ***Has a half-life of approximately 24 hours.*** - Lamotrigine's **half-life** is typically around **24 to 33 hours** in adults, which allows for once or twice-daily dosing. - This relatively long half-life is advantageous for maintaining **stable plasma concentrations** and improving patient adherence. *Is the first choice for absence seizures.* - **Ethosuximide** or **valproate** are generally considered first-line treatments for **absence seizures**. - Lamotrigine is not the preferred initial therapy due to its **slower titration** and occasional lack of efficacy in this seizure type. *Is not significantly metabolized in the liver.* - Lamotrigine is **significantly metabolized** in the liver, primarily through **glucuronidation** by the **UGT1A4 enzyme**. - This hepatic metabolism explains many of its **drug interactions**, particularly with other antiepileptic drugs affecting UGT enzymes. *Has decreased efficacy in treating depressive episodes.* - Lamotrigine is known for its **mood-stabilizing properties** and is effective in treating and preventing **depressive episodes**, particularly in **bipolar disorder**. - Its efficacy in depression is a key distinguishing feature, making it a valuable option for patients with comorbid mood disorders.

Question 1

Antiserum is available for passive immunization against ?

Accepted Answer

Rabies

Answer

Typhoid

Answer

Mumps

Answer

Measles

Question 2

Most commonly used tuning fork in ear examination?

Accepted Answer

512 Hz

Answer

128 Hz

Answer

256 Hz

Answer

1024 Hz

Question 3

In blast injury, which organ is most likely to be damaged first?

Accepted Answer

Tympanic membrane

Answer

Liver

Answer

Lung

Answer

Gastrointestinal tract

Question 4

Which of the following statements about the Consumer Protection Act is NOT accurate or NOT specifically mentioned in the Act?

Accepted Answer

Consumer complaints are resolved within 3-6 months.

Answer

The Act was passed in 1986.

Answer

Consumers have the right to safety.

Answer

ESI hospitals are specifically excluded.

Question 5

Which immunoglobulin is primarily secreted by the intestine?

Accepted Answer

IgA

Answer

IgG

Answer

IgM

Answer

IgD

Question 6

Which of the following medications is known to cause peripheral neuropathy?

Accepted Answer

Vincristine

Answer

Sulfonamide

Answer

Amiodarone

Answer

Paclitaxel

Question 7

What are the primary mechanisms behind cardiac toxicity associated with Tricyclic antidepressants?

Accepted Answer

Both norepinephrine reuptake inhibition and anticholinergic effects on the heart

Answer

Norepinephrine reuptake inhibition only

Answer

Anticholinergic effects on the heart

Answer

Direct membrane stabilizing effects only

Question 8

Which of the following anticoagulants is given orally?

Accepted Answer

Rivaroxaban

Answer

Argatraban

Answer

Alteplase

Answer

Fondaparinux

Question 9

What serious side effect may lead to the discontinuation of felbamate?

Accepted Answer

Aplastic anemia

Answer

Seizures

Answer

Renal impairment

Answer

Gastrointestinal disorder

Question 10

Which of the following statements about lamotrigine is correct?

Accepted Answer

Has a half-life of approximately 24 hours.

Answer

Is the first choice for absence seizures.

Answer

Is not significantly metabolized in the liver.

Answer

Has decreased efficacy in treating depressive episodes.

NEET-PG 2013

Community Medicine

ENT

Forensic Medicine

Microbiology

Pharmacology