NEET-PG 2013 Practice Questions

Q: What is the condition characterized by the hypertrophy of sebaceous glands?

Sebaceous hyperplasia. ***Sebaceous hyperplasia*** - This condition is characterized by the **enlargement (hypertrophy)** of normal sebaceous glands, often appearing as yellowish-white papules with a central umbilication. - It commonly occurs on the **face of older adults**, particularly on the forehead and cheeks, and is a benign condition. *Rhinosporidiosis* - This is a **chronic granulomatous disease** caused by the fungus *Rhinosporidium seeberi*, primarily affecting the **mucous membranes** of the nose and nasopharynx. - It presents as **friable, polypoidal masses** with a characteristic "strawberry-like" appearance due to small white spots (sporangia), not sebaceous gland hypertrophy. *Tubercular infection* - A tubercular infection, particularly cutaneous tuberculosis, can manifest in various forms, including **lupus vulgaris**, scrofuloderma, or tuberculosis cutis verrucosa. - These presentations involve **granulomatous inflammation** and tissue destruction, not isolated hypertrophy of sebaceous glands. *Nasopharyngeal angiofibroma* - This is a **rare, benign, highly vascular tumor** that originates in the nasopharynx, predominantly affecting adolescent males. - It typically presents with symptoms like **epistaxis** and **nasal obstruction**, and is composed of fibrous and vascular tissue, not sebaceous glands.

Q: Which of the following statements about Grisel syndrome is false?

A neurosurgeon is never needed.. ***A neurosurgeon is never needed.*** - This statement is false because severe cases of **Grisel syndrome** may require surgical intervention, necessitating consultation with a **neurosurgeon**. - Surgical management, such as **cervical fusion**, may be indicated in cases of irreducible subluxation or neurological compromise. *It can occur after adenoidectomy.* - This statement is true; **Grisel syndrome** is a rare complication that may occur following **adenoidectomy** or other head and neck surgeries. - The postulated mechanism involves inflammation spreading from the pharynx to the alar and transverse ligaments, leading to **atlantoaxial subluxation**. *It involves inflammation of cervical spine ligaments.* - This statement is true; **Grisel syndrome** is characterized by non-traumatic **atlantoaxial subluxation** resulting from inflammatory laxity of the cervical ligaments. - Specifically, the **transverse and alar ligaments** become inflamed and weakened, leading to instability between the atlas (C1) and axis (C2). *Conservative treatment is the first-line approach in most cases.* - This statement is true; initial management of **Grisel syndrome** typically involves conservative measures such as **neck immobilization**, pain control, and muscle relaxants. - Early diagnosis and conservative treatment are crucial to prevent progression and potential neurological complications.

Q: In which condition do symptoms improve with crying?

Choanal atresia. ***Choanal atresia*** - In **bilateral choanal atresia**, a newborn is unable to breathe through the nose due to a bony or membranous obstruction. Symptoms like **cyanosis** worsen with feeding and improve with crying because crying involves **mouth breathing**, which bypasses the nasal obstruction. - This condition is a **medical emergency** as newborns are obligate nasal breathers, and immediate intervention (e.g., oral airway, surgical repair) is often required. *Tetralogy of Fallot* - This congenital heart defect can lead to **cyanotic spells** (hypercyanotic or "tet" spells), which are characterized by increased cyanosis, tachypnea, and irritability. These spells are often precipitated by activities that increase right-to-left shunting, and **crying can worsen them** rather than improve them due to increased systemic oxygen demand and vascular resistance. - Management often involves positioning (knee-chest) and medications to reduce pulmonary vascular resistance or increase systemic vascular resistance, to alleviate shunting. *Bronchial asthma* - **Crying is a common trigger for asthma attacks** in children, as it can induce bronchoconstriction due to hyperventilation and airway irritation. Symptoms typically worsen with crying, leading to **wheezing, coughing, and shortness of breath**. - Asthma is characterized by **reversible airway obstruction** and airway hyperresponsiveness, and its symptoms do not improve with crying. *None of the options* - This option is incorrect because **choanal atresia** is a condition where symptoms (specifically cyanosis) do improve with crying due to the switch from nasal to mouth breathing.

Q: In which condition is the Schwartze sign observed?

Otosclerosis. ***Otosclerosis*** - The **Schwartze sign** is a reddish blush seen through the tympanic membrane, indicative of increased vascularity over the promontory. - It is a classic clinical finding in **active otosclerosis**, distinguishing it from inactive forms. *Glomus Jugulare* - This is a highly **vascular tumor** of the middle ear and mastoid, often presenting with pulsating tinnitus and hearing loss. - While vascularity is present, it manifests as a **reddish-blue mass behind the tympanic membrane**, not the diffuse blush characteristic of Schwartze sign. *Meniere's disease* - Characterized by episodes of **vertigo, fluctuating hearing loss, tinnitus**, and aural fullness due to endolymphatic hydrops. - It does not present with any specific otoscopic findings like the Schwartze sign. *Acoustic neuroma* - This is a **benign tumor of the vestibulocochlear nerve (CN VIII)**, typically causing progressive unilateral sensorineural hearing loss, tinnitus, and balance issues. - It does not produce any visible changes on otoscopy and therefore lacks the Schwartze sign.

Q: What condition is associated with Lemierre's syndrome?

Thrombophlebitis of IJV. ***Thrombophlebitis of IJV*** - **Lemierre's syndrome** is classically defined as **septic thrombophlebitis of the internal jugular vein (IJV)** following an oropharyngeal infection [1]. - The infection, most commonly caused by *Fusobacterium necrophorum*, spreads from the pharynx to the parapharyngeal space, leading to IJV inflammation and thrombosis [1]. *Carotid sinus aneurysm* - A **carotid sinus aneurysm** is an abnormal focal dilation of the carotid sinus, often associated with atherosclerosis or connective tissue disorders. - It is not directly linked to the pathogenesis or complications of **Lemierre's syndrome**. *Traumatic occlusion of IJV* - **Traumatic occlusion of the IJV** results from direct injury to the neck, leading to vessel compression or damage. - While it affects the IJV, it does not involve the septic thrombophlebitis or preceding oropharyngeal infection characteristic of **Lemierre's syndrome**. *Any of the above* - This option is incorrect because **Lemierre's syndrome** is specifically associated with **septic thrombophlebitis of the IJV**, not with other unrelated vascular conditions affecting the neck.

Q: Extraintestinal manifestations of Inflammatory bowel disease include all of the following, Except:

Osteoarthritis. ***Osteoarthritis*** - **Osteoarthritis** is a **degenerative joint disease** caused by wear and tear on cartilage, and it is **not** an extraintestinal manifestation of IBD [3]. - While patients with IBD can develop osteoarthritis, it does not share the same **pathophysiological link** to the inflammatory process of IBD as other extraintestinal manifestations. *Uveitis* - **Uveitis** is an inflammation of the **uvea** (middle layer of the eye) and is a well-recognized ocular extraintestinal manifestation of IBD [2]. - It can cause eye pain, redness, and blurred vision, and its severity may correlate with IBD disease activity. *Sclerosing cholangitis* - **Primary sclerosing cholangitis (PSC)** is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the **bile ducts**, and it is strongly associated with **ulcerative colitis** [1]. - It often progresses to **cirrhosis** and liver failure and is a significant extraintestinal manifestation. *Skin nodules* - **Erythema nodosum** and **pyoderma gangrenosum** are common cutaneous extraintestinal manifestations of IBD, often presenting as **painful red nodules** or ulcers on the skin [2]. - These skin conditions are thought to be immune-mediated and often parallel the activity of the underlying inflammatory bowel disease.

Q: Torsades de pointes is seen in all except

Hyponatremia. ***Hyponatremia*** - **Hyponatremia** (low sodium levels) primarily affects neuronal function and can lead to neurological symptoms like seizures and altered mental status [1]. - It does not directly cause **QT prolongation** or **Torsades de Pointes (TdP)**, which are typically associated with electrolyte imbalances affecting cardiac repolarization. *Hypocalcemia* - **Hypocalcemia** (low calcium levels) can prolong the **QT interval** on an electrocardiogram. - Prolongation of the QT interval increases the risk of developing **Torsades de Pointes**, a life-threatening polymorphic ventricular tachycardia [2]. *Hypomagnesemia* - **Hypomagnesemia** (low magnesium levels) is a common cause and aggravator of **Torsades de Pointes**. - Magnesium plays a crucial role in cardiac ion channel function, and its deficiency can lead to significant **QT prolongation** and ventricular arrhythmias. *Hypokalemia* - **Hypokalemia** (low potassium levels) can prolong the **QT interval** and increase the risk of developing ventricular arrhythmias, including **Torsades de Pointes** [1]. - Potassium channels are essential for cardiac repolarization, and their dysfunction due to low potassium can destabilize myocardial electrical activity [1].

Q: Madelung's deformity is characterized by an abnormality in which bone?

Distal radius. ***Distal radius*** - **Madelung's deformity** is primarily characterized by a **malformation of the distal radius**, specifically the physis (growth plate). - This leads to abnormal growth, causing the **radius to shorten and bow** dorsally, resulting in a prominent distal ulna. *Humerus* - The **humerus** is the bone of the upper arm, and abnormalities of this bone are not characteristic of Madelung's deformity. - Conditions affecting the humerus typically involve the shoulder or elbow joint, distinct from the wrist pathology seen in Madelung's. *Proximal ulna* - The **proximal ulna** forms part of the elbow joint, and while the ulna can be affected, the primary abnormality in Madelung's is in the radius. - While the ulna may appear prominent, this is secondary to the radial deformity, not a primary issue of the proximal ulna. *Carpals* - The **carpal bones** are located in the wrist, distal to the radius and ulna, and are not the primary site of deformity in Madelung's. - While wrist motion may be affected, the underlying cause is the abnormal growth of the distal radius, which can then impact carpal alignment.

Q: Which of the following statements about Kernicterus is TRUE?

Kernicterus is due to Unconjugated Hyperbilirubinemia. ***Kernicterus is due to Unconjugated Hyperbilirubinemia*** - **Kernicterus** is a rare but severe neurological condition caused by **high levels of unconjugated bilirubin** in a newborn's blood. - **Unconjugated bilirubin** is lipophilic and can cross the **blood-brain barrier**, particularly when levels are excessively high or the barrier is compromised. *Prematurity is the primary cause of Kernicterus* - **Prematurity** is a **major risk factor** for kernicterus, as premature infants have immature livers, reduced albumin binding sites, and a less developed blood-brain barrier. - However, the primary cause is the **unconjugated hyperbilirubinemia** itself, which can occur in both term and preterm infants, though it is more common and severe in prematures. *Yellowish staining occurs primarily in the Cerebellum in Kernicterus* - While kernicterus does affect the **cerebellum**, the **primary and most characteristic sites** of bilirubin deposition are the **basal ganglia**, hippocampus, and brainstem nuclei. - The **basal ganglia** are the predominant target, not the cerebellum, making this statement anatomically incorrect. *Kernicterus is not associated with increased morbidity.* - Kernicterus is associated with **significant morbidity** and can lead to permanent neurological damage, including **cerebral palsy**, hearing loss, intellectual disabilities, and gaze abnormalities. - It is a medical emergency that requires prompt diagnosis and treatment to prevent long-term neurological sequelae.

Q: At what month does a baby typically sit in the tripod position?

6 months. **6 months** - Around **6 months** of age, infants typically develop sufficient **head control** and **trunk strength** to sit unsupported, often using their hands for balance in a **tripod position**. - This developmental milestone is crucial for further motor development, enabling improved visual exploration and hand use. *5 months* - At **5 months**, infants can usually **roll over** and support themselves on their forearms, but generally lack the **trunk stability** for unsupported sitting. - While they might briefly sit with support, the sustained **tripod position** is typically not achieved until later. *8 months* - By **8 months**, most infants can sit **unsupported for extended periods** and often begin to **crawl** or pull themselves to stand. - The tripod position is usually a precursor to fully unsupported sitting, which is well-established by this age. *9 months* - At **9 months**, infants are typically highly mobile, often **crawling**, **cruising** (walking while holding onto furniture), and sitting completely **independently** without needing hand support. - The need for a tripod position for stability would indicate a **developmental delay** at this age.

Question 1

What is the condition characterized by the hypertrophy of sebaceous glands?

Accepted Answer

Sebaceous hyperplasia

Answer

Rhinosporidiosis

Answer

Tubercular infection

Answer

Nasopharyngeal angiofibroma

Question 2

Which of the following statements about Grisel syndrome is false?

Accepted Answer

A neurosurgeon is never needed.

Answer

It can occur after adenoidectomy.

Answer

It involves inflammation of cervical spine ligaments.

Answer

Conservative treatment is the first-line approach in most cases.

Question 3

In which condition do symptoms improve with crying?

Accepted Answer

Choanal atresia

Answer

Tetralogy of Fallot

Answer

Bronchial asthma

Answer

None of the options

Question 4

In which condition is the Schwartze sign observed?

Accepted Answer

Otosclerosis

Answer

Glomus Jugulare

Answer

Acoustic neuroma

Answer

Meniere's disease

Question 5

What condition is associated with Lemierre's syndrome?

Accepted Answer

Thrombophlebitis of IJV

Answer

Carotid sinus aneurysm

Answer

Traumatic occlusion of IJV

Answer

Any of the above

Question 6

Extraintestinal manifestations of Inflammatory bowel disease include all of the following, Except:

Accepted Answer

Osteoarthritis

Answer

Sclerosing cholangitis

Answer

Skin nodules

Answer

Uveitis

Question 7

Torsades de pointes is seen in all except

Accepted Answer

Hyponatremia

Answer

Hypomagnesemia

Answer

Hypokalemia

Answer

Hypocalcemia

Question 8

Madelung's deformity is characterized by an abnormality in which bone?

Accepted Answer

Distal radius

Answer

Humerus

Answer

Proximal ulna

Answer

Carpals

Question 9

Which of the following statements about Kernicterus is TRUE?

Accepted Answer

Kernicterus is due to Unconjugated Hyperbilirubinemia

Answer

Prematurity is the primary cause of Kernicterus

Answer

Kernicterus is not associated with increased morbidity.

Answer

Yellowish staining occurs primarily in the Cerebellum in Kernicterus

Question 10

At what month does a baby typically sit in the tripod position?

Accepted Answer

6 months

Answer

9 months

Answer

8 months

Answer

5 months

NEET-PG 2013

Dermatology

ENT

Internal Medicine

Orthopaedics

Pediatrics