NEET-PG 2013 Practice Questions

Q: Phase II block is seen with:

SCh infusion. ***SCh infusion*** - A **prolonged infusion or high dose** of succinylcholine (SCh) can lead to a **Phase II block**, a desensitizing block resembling that of a non-depolarizing neuromuscular blocker. - This occurs due to the **persistent presence of SCh** at the neuromuscular junction, which initially depolarizes the endplate (Phase I) but eventually leads to **receptor desensitization** and repolarization, preventing further muscle contraction. *Single dose SCh* - A **single bolus dose of succinylcholine** typically produces a **Phase I block**, characterized by initial muscle fasciculations followed by flaccid paralysis due to persistent depolarization of the motor endplate. - It resolves relatively quickly as **succinylcholine is rapidly hydrolyzed** by pseudocholinesterase, usually not leading to a prolonged desensitization characteristic of Phase II. *Mivacurium* - **Mivacurium** is an intermediate-acting, **non-depolarizing neuromuscular blocker**. - Its mechanism of action involves **competitively binding to nicotinic acetylcholine receptors** at the neuromuscular junction, thereby preventing acetylcholine from binding and initiating muscle contraction, which is fundamentally different from a Phase II block caused by prolonged depolarization. *None of the options* - This option is incorrect because **SCh infusion** is a recognized cause of Phase II block. - The phenomenon of Phase II block is a well-established pharmacological response to **excessive and prolonged exposure** to depolarizing neuromuscular blockers like succinylcholine.

Q: A person has lost his leg in an accident and is unable to walk. This condition is classified as -

Disability. ***Disability*** - The loss of a limb leading to inability to walk is classified as a **disability** because it significantly impairs a major life activity. - According to the **WHO International Classification of Functioning, Disability and Health (ICF)**, disability is an **umbrella term** encompassing impairments (loss of limb), activity limitations (inability to walk), and participation restrictions. - The scenario describes both an **impairment** (anatomical loss) and an **activity limitation** (functional consequence), which together constitute a **disability**. *Medical condition* - While the accident caused a medical condition (trauma, amputation), the term "medical condition" describes the **disease or injury state** itself, not its functional impact. - The question asks for the **classification** of the inability to walk, which is a functional consequence, not the primary medical diagnosis. *Physical limitation* - This is a **descriptive term** for restricted physical capacity but not a standard **classification** in public health terminology. - In the WHO ICF framework, this would fall under "activity limitation," which is a component of disability rather than a separate classification. *Mobility challenge* - This is a colloquial or lay term describing the **difficulty in moving** but lacks the specificity of formal medical classification. - While accurate descriptively, it does not represent the **standardized terminology** used in Community Medicine and rehabilitation frameworks.

Q: Ideal temperature for DPT storage?

4 to 8°C. ***4 to 8°C*** - The ideal temperature for DPT (diphtheria, pertussis, tetanus) vaccine storage is between **+2°C and +8°C** (or 35°F and 46°F), which is the standard refrigerator temperature range. - This temperature range is crucial for maintaining the **potency** and **efficacy** of the vaccine, preventing **degradation** due to excessive heat or cold. *Room temperature* - Storing DPT vaccines at **room temperature** (typically 20-25°C or 68-77°F) for extended periods can lead to a **loss of potency** as heat can degrade vaccine components. - While short-term excursions within this range might be permissible under specific conditions (e.g., during transport), it is not the ideal long-term storage solution. *0 to - 20°C* - DPT vaccines, particularly the **whole-cell pertussis (wP)** component, can be **damaged by freezing**. - Temperatures below 0°C can cause the **adjuvant** (usually aluminum salt) to separate, leading to a loss of efficacy and potential local reactions at the injection site. *None of the options* - This option is incorrect because **4 to 8°C** is indeed the established and recommended ideal storage temperature for DPT vaccines.

Q: Most basic level of Health Care System in India -

Primary health care. ***Primary health care*** - **Primary health care** is the first point of contact for individuals with the health system, providing essential and accessible healthcare services - In India, it is delivered through **sub-centers** (the most peripheral unit) and **primary health centers (PHCs)**, forming the **most basic and widespread layer** of the healthcare system - This represents the foundational level of care, focusing on preventive, promotive, and basic curative services *Secondary health care* - **Secondary health care** involves more specialized services, typically provided in district hospitals or community health centers (CHCs) - It serves as a referral point from primary care for patients requiring diagnostics, specialist consultations, or inpatient care - This is a **higher level of care** than primary, not the most basic level *Tertiary health care* - **Tertiary health care** offers highly specialized and advanced medical care, often involving complex procedures, specialized investigations, and management of rare or severe diseases - Provided in medical colleges, research institutes, and super-specialty hospitals - This represents the **highest and most advanced level** of the healthcare system, not the most basic *All are same* - This option is incorrect because the Indian healthcare system is structured in a **hierarchical manner** with distinct levels - Each level (primary, secondary, and tertiary) provides different services, varying in complexity, specialization, and accessibility - Primary care is clearly the most basic level, while secondary and tertiary represent progressively higher levels of specialization

Q: Which of the following is NOT a sign of somatic death?

Rigor mortis. ***Rigor mortis*** - **Rigor mortis** is a post-mortem change, occurring hours after death, characterized by muscle stiffening due to chemical changes after somatic death. - While it's a definitive sign of death, it is a secondary change occurring *after* the cessation of vital functions, not a primary sign of **somatic death** itself. *Cessation of respiration* - The complete and irreversible **cessation of respiration** (breathing) is a primary indicator of somatic death, as oxygen supply to tissues is halted. - This signifies the failure of the **respiratory system** to sustain life functions. *Cessation of heart* - The permanent **cessation of heart** function (cardiac arrest) is a fundamental sign of somatic death, leading to a lack of circulation and nutrient/oxygen delivery. - This marks the breakdown of the **circulatory system**, essential for maintaining life. *No response to external stimuli* - The absence of any **response to external stimuli**, including pain, light, and sound, indicates the complete loss of brain function and consciousness. - This signifies the irreversible failure of the **nervous system**, a key component of somatic death.

Q: Miscarriage due to medical negligence is seen under which IPC?

Sec 304A IPC. ***Sec 304A IPC*** - This section specifically deals with **causing death by negligence** (rash or negligent acts not amounting to culpable homicide). - **Medical negligence causing miscarriage** falls under this section as it involves an unintentional harm due to negligent medical practice. - This is the appropriate section when there is no voluntary intent to cause miscarriage, but harm results from professional negligence. *Sec 312 IPC* - This section deals with **voluntarily causing miscarriage**, requiring intentional/voluntary act. - It applies when a person **intentionally** causes a woman to miscarry (criminal abortion). - Medical **negligence** does not constitute a voluntary act in the legal sense, so Sec 312 does not apply to negligence cases. *Sec 310 IPC* - This section is related to **thuggee**, defining someone who habitually commits robbery or child-stealing by murder. - It has no relevance to medical negligence or miscarriage. *Sec 314 IPC* - This section deals with **death caused by an act done with intent to cause miscarriage**. - It applies when an intentional act to cause miscarriage results in the death of the woman. - This requires criminal intent, not negligence.

Q: Which immunoglobulin is known to be heat-labile?

IgM. ***IgM*** - **IgM** is known for its **heat lability** and is readily denatured at 56°C within a few minutes. - This characteristic is due to its **pentameric structure** held together by disulfide bonds and J chains, which are sensitive to thermal denaturation. - Heat lability of IgM is clinically important in complement fixation tests and other laboratory assays where heat inactivation is performed. - IgM is the first antibody produced in primary immune response and its heat sensitivity distinguishes it from other immunoglobulins. *IgA* - **IgA** exists in monomeric (serum) and dimeric (secretory) forms and shows moderate stability to heat. - Secretory IgA is relatively stable as it needs to function in harsh mucosal environments, though not as heat-resistant as IgG. - Does not exhibit the pronounced heat lability characteristic of IgM. *IgG* - **IgG** is the most stable immunoglobulin and is highly resistant to heat denaturation. - Can withstand temperatures up to 60-70°C without significant loss of activity. - Its monomeric structure with strong intramolecular bonds provides exceptional thermal stability. - Most abundant antibody in serum and has the longest half-life. *IgE* - **IgE** is actually quite stable to heat and can withstand 56°C for extended periods. - While it has a short half-life in serum (2-3 days), this is due to receptor binding rather than heat instability. - Important in type I hypersensitivity reactions and parasitic infections. - Does not show the characteristic heat lability that defines IgM.

Q: Glass vessels and syringes are best sterilised by -

Dry heat sterilization in a hot air oven. **Dry heat sterilization in a hot air oven** - **Dry heat sterilization** (160-180°C for 1-2 hours) is the **traditional and preferred method** for **glassware and glass syringes**. - **Hot air ovens** achieve sterilization by oxidative destruction and protein denaturation, leaving items completely **dry** and free from moisture. - **Advantages**: No corrosion, no rusting, items remain dry, ideal for **powders, oils, and glassware** that can withstand high temperatures. - **Note**: This question refers to **glass syringes** (historically used, now largely replaced by disposable plastic syringes which are pre-sterilized by radiation). *Steam sterilization in an autoclave* - **Autoclaving** uses **moist heat** (121°C at 15 psi for 15 minutes) and is highly effective for most medical instruments. - **Disadvantage for glassware**: Rapid temperature changes and steam exposure can cause **thermal shock, cracking, or etching** of delicate glassware. - Items emerge **wet** and require drying, which is undesirable for certain laboratory applications. - **Modern context**: Standard method for surgical instruments and heat-stable plastics. *Ethylene oxide sterilization* - **Ethylene oxide (ETO)** is a **low-temperature chemical sterilization** method (50-60°C) for heat-sensitive items. - Used for plastics, rubber, electronics, and endoscopes that cannot tolerate heat. - Requires **long exposure** (12-24 hours) and **aeration period** (up to 7 days) to remove toxic residues. - **Not preferred** for routine glassware sterilization when heat methods are suitable. *Radiation sterilization* - **Gamma radiation or electron beam** sterilization is used for **pre-packaged disposable medical devices**, pharmaceuticals, and plastic syringes. - Highly effective but **expensive** and requires specialized facilities. - Not practical for **routine laboratory glassware** sterilization in clinical or research settings.

Q: Who discovered the bacterium Treponema pallidum?

Fritz Schaudinn and Erich Hoffmann. ***Fritz Schaudinn and Erich Hoffmann*** - **Fritz Schaudinn** was a German zoologist, and **Erich Hoffmann** was a German dermatologist; they jointly discovered **Treponema pallidum** in **1905**. - Their discovery of the spirochete was a crucial step in understanding the etiology of **syphilis**. *Robert Koch* - **Robert Koch** is renowned for identifying the causative agents of **tuberculosis**, **cholera**, and **anthrax**. - He developed Koch's postulates, a fundamental set of criteria for establishing the causal relationship between a microbe and a disease. *Twort* - **Frederick Twort** was a British bacteriologist who is credited with the discovery of **bacteriophages** in **1915**. - His work involved examining transparent areas in bacterial cultures, leading to the identification of lytic viruses that infect bacteria. *Ellerman* - **Vilhelm Ellerman** was a Danish pathologist known for his work in **hematology** and **virology**. - Alongside **Olaf Bang**, he demonstrated that avian leukemia (erythroleukemia) could be transmitted by a filterable agent, indicating a viral etiology for some cancers.

Q: Which drug is primarily used in the treatment of breast cancer?

Tamoxifen. ***Tamoxifen*** - **Tamoxifen** is a **selective estrogen receptor modulator (SERM)** primarily used to treat and prevent **estrogen receptor (ER)-positive breast cancer**. - It works by blocking estrogen from binding to receptors in breast cancer cells, thereby inhibiting their growth. *Cyproterone* - **Cyproterone** is an **anti-androgen** and **progestogen** primarily used to treat conditions like **prostate cancer**, **acne**, and **hirsutism** in women. - Its main mechanism involves blocking androgen receptors and reducing androgen production, which is not the primary pathway for breast cancer. *Testosterone* - **Testosterone** is an **androgen** (male sex hormone) and is **not used** in the primary treatment of breast cancer. - In certain rare cases of severe metastatic breast cancer, androgens like high-dose testosterone have been historically used for palliation, but this is not standard therapy. *Chlorambucil* - **Chlorambucil** is an **alkylating agent** used primarily in the treatment of **chronic lymphocytic leukemia (CLL)** and certain **lymphomas**. - It works by interfering with DNA replication and transcription, but it is not a first-line or primary agent for breast cancer.

Question 1

Phase II block is seen with:

Accepted Answer

SCh infusion

Answer

Single dose SCh

Answer

Mivacurium

Answer

None of the options

Question 2

A person has lost his leg in an accident and is unable to walk. This condition is classified as -

Accepted Answer

Disability

Answer

Medical condition

Answer

Physical limitation

Answer

Mobility challenge

Question 3

Ideal temperature for DPT storage?

Accepted Answer

4 to 8°C

Answer

Room temperature

Answer

0 to - 20°C

Answer

None of the options

Question 4

Most basic level of Health Care System in India -

Accepted Answer

Primary health care

Answer

Secondary health care

Answer

Tertiary health care

Answer

All are same

Question 5

Which of the following is NOT a sign of somatic death?

Accepted Answer

Rigor mortis

Answer

Cessation of heart

Answer

No response to external stimuli

Answer

Cessation of respiration

Question 6

Miscarriage due to medical negligence is seen under which IPC?

Accepted Answer

Sec 304A IPC

Answer

Sec 310 IPC

Answer

Sec 312 IPC

Answer

Sec 314 IPC

Question 7

Which immunoglobulin is known to be heat-labile?

Accepted Answer

IgM

Answer

IgA

Answer

IgG

Answer

IgE

Question 8

Glass vessels and syringes are best sterilised by -

Accepted Answer

Dry heat sterilization in a hot air oven

Answer

Steam sterilization in an autoclave

Answer

Ethylene oxide sterilization

Answer

Radiation sterilization

Question 9

Who discovered the bacterium Treponema pallidum?

Accepted Answer

Fritz Schaudinn and Erich Hoffmann

Answer

Robert Koch

Answer

Twort

Answer

Ellerman

Question 10

Which drug is primarily used in the treatment of breast cancer?

Accepted Answer

Tamoxifen

Answer

Cyproterone

Answer

Testosterone

Answer

Chlorambucil

NEET-PG 2013

Anesthesiology

Community Medicine

Forensic Medicine

Microbiology

Pharmacology