NEET-PG 2013 Practice Questions

Q: Which of the following is NOT a characteristic feature of systemic sclerosis?

Gottron's papules. ***Gottron's papules*** - **Gottron's papules** are pathognomonic for **dermatomyositis**, not systemic sclerosis. They are red, scaling papules found over the extensor surfaces of the metacarpophalangeal (MCP) and interphalangeal (IP) joints. - While both systemic sclerosis and dermatomyositis are connective tissue diseases, their distinct cutaneous manifestations aid in differentiation. *Acroosteolysis* - **Acroosteolysis** refers to the resorption of the distal phalanges, a common feature in systemic sclerosis, particularly in severe cases. - This symptom contributes to the characteristic digital abnormalities seen in the disease. *Calcinosis cutis* - **Calcinosis cutis** is the deposition of calcium in the skin and subcutaneous tissues, often seen in subsets of systemic sclerosis, especially the CREST syndrome. - It can manifest as firm, white-yellow nodules or plaques and contribute to skin breakdown. *Digital ulcers* - **Digital ulcers** are a frequent and debilitating complication of systemic sclerosis, resulting from severe **vasculopathy** [1] and **ischemia** [1]. - They are often painful and can lead to significant tissue loss and infection.

Q: Which of the following methods is used for prenatal diagnosis of Down Syndrome?

Karyotyping for chromosomal analysis. ***Karyotyping for chromosomal analysis*** - **Karyotyping** is the gold standard definitive diagnostic method for Down syndrome (trisomy 21) as it directly visualizes and counts all chromosomes, identifying the presence of an extra copy of chromosome 21. - This cytogenetic method provides a clear genetic diagnosis with 100% accuracy, confirming the chromosomal abnormality responsible for Down syndrome. - Karyotyping can be performed on cells obtained via amniocentesis or chorionic villus sampling (CVS). *Triple test for biomarker screening* - The **triple test** measures biochemical markers (alpha-fetoprotein, unconjugated estriol, and hCG) to assess the risk of Down syndrome, but it is a **screening tool**, not a diagnostic method. - It has a detection rate of approximately 69% with a 5% false-positive rate. - Abnormal results require confirmatory diagnostic testing with karyotyping or other chromosomal analysis methods. *Fetal ultrasonography for physical feature assessment* - Fetal ultrasonography can detect **soft markers** such as increased nuchal translucency, absent/hypoplastic nasal bone, echogenic intracardiac focus, or structural anomalies that raise suspicion for Down syndrome. - However, ultrasound findings are **not diagnostic** on their own and have limited sensitivity and specificity. - Positive findings necessitate genetic testing like karyotyping for definitive diagnosis. *Non-invasive prenatal testing (NIPT) for cell-free DNA analysis* - **NIPT** analyzes cell-free fetal DNA in maternal blood and has high sensitivity (>99%) and specificity (>99%) for detecting trisomy 21. - Despite its excellent screening performance, NIPT is still classified as a **screening test**, not a diagnostic test. - Positive NIPT results require confirmation with diagnostic testing (karyotyping) before making clinical decisions regarding the pregnancy.

Q: Which of the following is not a cause of exudative retinal detachment?

High myopia. ***High myopia*** - **High myopia** is a risk factor for **rhegmatogenous retinal detachment**, which is caused by a retinal break, not by fluid accumulation from a vascular or inflammatory process. - In rhegmatogenous detachment, vitreous fluid passes through the break into the subretinal space, separating the **neurosensory retina** from the **retinal pigment epithelium**. *Toxemia of pregnancy* - **Toxemia of pregnancy** (preeclampsia/eclampsia) can cause **exudative retinal detachment** due to choroidal ischemia and dysfunction of the retinal pigment epithelium, leading to fluid leakage. - The elevated **blood pressure** and systemic vascular changes impair choroidal perfusion, resulting in serous fluid accumulation beneath the retina. *Scleritis* - **Posterior scleritis** can lead to **exudative retinal detachment** by causing inflammation and edema of the choroid and sclera, which in turn compromises the integrity of the retinal pigment epithelium. - The inflammatory process increases vascular permeability, allowing fluid to leak into the subretinal space. *Central serous retinopathy* - **Central serous retinopathy** is a classic example of **exudative retinal detachment**, characterized by serous fluid accumulation under the macula. - This occurs due to dysfunction or a break in the **retinal pigment epithelium**, often associated with stress and corticosteroid use, leading to fluid leakage from the choroid.

Q: What is the drug of choice for treating intermediate uveitis?

Systemic steroids. ***Systemic steroids*** - **Systemic steroids** are the **drug of choice** for treating intermediate uveitis, especially when inflammation is significant or vision is threatened. - They effectively suppress the expansive **intraocular inflammation** typical of intermediate uveitis, which often involves the **vitreous** and **peripheral retina**. *Atropine* - **Atropine** is a **cycloplegic agent** primarily used to relieve ciliary spasm and prevent synechiae formation in anterior uveitis. - It does not address the underlying **inflammation** of intermediate uveitis, which is located more posteriorly. *Antibiotics* - **Antibiotics** are used to treat bacterial infections and are not indicated for **intermediate uveitis**, which is typically an **inflammatory** or **autoimmune disorder**. - They would be appropriate only if the uveitis were secondary to an **infectious cause**, which is not the primary characteristic of intermediate uveitis. *Topical steroids* - **Topical steroids** are effective for **anterior uveitis** but often fail to reach sufficient concentrations in the **vitreous** and **peripheral retina** to control the inflammation of intermediate uveitis. - **Intermediate uveitis** primarily affects the ciliary body, vitreous, and peripheral retina, requiring **systemic agents** for adequate therapeutic effect.

Q: Which type of supracondylar fracture of the femur is classified as extra-articular?

Type A. ***Type A*** - **Type A supracondylar fractures** are defined as those that do not involve the joint surface, making them **extra-articular**. - These fractures typically occur proximal to the condyles without extending into the knee articulation. *Type B* - **Type B supracondylar fractures** are considered **partial articular**, meaning they involve only a portion of the articular surface. - While they affect the joint, they are not completely intra-articular in nature. *Type C* - **Type C supracondylar fractures** are classified as **complete articular** fractures. - This type implies that the fracture line extends through the entire joint surface and separates the articular segment from the metaphysis. *Type D* - The classification of supracondylar femoral fractures generally uses A, B, and C types to denote extra-articular, partial articular, and complete articular involvement, respectively. - **Type D** is not a standard classification used to define an extra-articular supracondylar femoral fracture in common orthopedic systems like the Orthopaedic Trauma Association (OTA) classification.

Q: Hose pipe appearance of intestine is a feature of

Ulcerative colitis. ***Crohns disease*** - The **hose pipe appearance** of the intestine on imaging is due to **transmural inflammation** and **strictures**, characteristic of Crohn's disease [1]. - This feature indicates a **narrowed lumen** due to fibrosis, often affecting the small intestine or colon [1]. *Malabsorption syndrome* - This condition is primarily associated with **nutrient absorption issues**, not structural changes in the intestine. - It typically presents with **diarrhea**, **weight loss**, and **malnutrition**, lacking the characteristic imaging findings. *Ulcerative colitis* - Usually presents with **continuous lesions** confined to the colonic mucosa, leading to ulcers and inflammation but not a **hose pipe appearance**. - Symptoms include **bloody diarrhea** and **abdominal pain**, distinctly different from Crohn's disease. *Hirsprung disease* - A congenital condition causing **intestinal obstruction** due to the absence of ganglion cells, leading to **dilated proximal bowel** rather than a hose pipe appearance. - Typically presents in infants with **severe constipation** and **abdominal distension**, unrelated to imaging features seen in Crohn's disease. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 366-367.

Q: Which of the following is not typically associated with Treacher Collins syndrome?

Choanal atresia. Choanal atresia - While Treacher Collins syndrome involves various craniofacial anomalies, **choanal atresia** (blockage of the nasal airway) is **not a typical** or defining feature. - Choanal atresia is more commonly associated with conditions like **CHARGE syndrome** or isolated congenital defects. *Conductive deafness* - **Conductive deafness** is a common feature of Treacher Collins syndrome due to malformations of the **ossicles** and external ear structures. - The abnormal development of middle ear components prevents proper sound transmission, occurring in approximately **50% of cases**. *Cleft palate* - Although less frequent than other features, a **cleft palate** can occur in some individuals with Treacher Collins syndrome, especially in more severe cases. - It results from incomplete fusion of the palatal shelves during embryonic development, occurring in approximately **28-35% of cases**. *Mandibular hypoplasia* - **Mandibular hypoplasia** (underdevelopment of the jaw) is a **hallmark characteristic** of Treacher Collins syndrome, leading to a small chin and retrognathia. - This often contributes to feeding and breathing difficulties in affected individuals. *Malar hypoplasia* - **Malar hypoplasia** (underdevelopment of the cheekbones) is a **classic and defining feature** of Treacher Collins syndrome. - This results in flattened cheeks and contributes to the characteristic facial appearance of the condition.

Q: What is the primary use of the Balthazar scoring system?

Acute Pancreatitis. ***Acute Pancreatitis*** - The Balthazar score (also known as the **CT Severity Index** for pancreatitis) is primarily used to assess the severity of **acute pancreatitis** based on findings from a **CT scan**. - It evaluates pancreatic inflammation and necrosis, correlating with patient prognosis and the risk of complications. *Acute Appendicitis* - Acute appendicitis is typically diagnosed clinically, often with the help of the **Alvarado score** or imaging like ultrasound/CT, but not the Balthazar score. - The Balthazar score's focus on pancreatic changes is irrelevant to appendiceal inflammation. *Acute Cholecystitis* - Diagnosis of acute cholecystitis is based on clinical signs, lab tests, and imaging (ultrasound showing **gallbladder wall thickening**, pericholecystic fluid, or stones). - The Balthazar scoring system does not apply to the assessment of gallbladder inflammation. *Cholangitis* - Cholangitis is an infection of the bile ducts, diagnosed using the **Tokyo Guidelines**, which consider systemic inflammation, cholestasis, and imaging of biliary obstruction. - The Balthazar score is specific to pancreatic inflammation and does not provide information relevant to cholangitis.

Question 1

Which of the following is NOT a characteristic feature of systemic sclerosis?

Accepted Answer

Gottron's papules

Answer

Calcinosis cutis

Answer

Digital ulcers

Answer

Acroosteolysis

Question 2

Which of the following methods is used for prenatal diagnosis of Down Syndrome?

Accepted Answer

Karyotyping for chromosomal analysis

Answer

Non-invasive prenatal testing (NIPT) for cell-free DNA analysis

Answer

Triple test for biomarker screening

Answer

Fetal ultrasonography for physical feature assessment

Question 3

Which of the following is not a cause of exudative retinal detachment?

Accepted Answer

High myopia

Answer

Scleritis

Answer

Toxemia of pregnancy

Answer

Central serous retinopathy

Question 4

What is the drug of choice for treating intermediate uveitis?

Accepted Answer

Systemic steroids

Answer

Atropine

Answer

Antibiotics

Answer

Topical steroids

Question 5

What is the Essex-Lopresti lesion in the upper limb?

Accepted Answer

Comminuted radial head fracture with interosseous membrane disruption and DRUJ instability

Answer

Isolated radial head fracture without soft tissue involvement

Answer

Radial shaft

Answer

Radial shaft and radio-ulnar joint fracture

Question 6

Which type of supracondylar fracture of the femur is classified as extra-articular?

Accepted Answer

Type A

Answer

Type B

Answer

Type C

Answer

Type D

Question 7

Hose pipe appearance of intestine is a feature of

Accepted Answer

Ulcerative colitis

Answer

Malabsorption syndrome

Answer

Crohn's disease

Answer

Hirschsprung disease

Question 8

What is Reifenstein syndrome?

Accepted Answer

Partial androgen insensitivity syndrome due to receptor mutation.

Answer

Complete androgen insensitivity syndrome with female external genitalia

Answer

5-alpha reductase deficiency causing ambiguous genitalia

Answer

Gonadal dysgenesis with streak gonads

Question 9

Which of the following is not typically associated with Treacher Collins syndrome?

Accepted Answer

Choanal atresia

Answer

Conductive deafness

Answer

Cleft palate

Answer

Mandibular hypoplasia

Answer

Malar hypoplasia

Question 10

What is the primary use of the Balthazar scoring system?

Accepted Answer

Acute Pancreatitis

Answer

Acute Appendicitis

Answer

Acute Cholecystitis

Answer

Cholangitis

NEET-PG 2013

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Orthopaedics

Pathology

Psychiatry

Radiology