NEET-PG 2015 Practice Questions

Q: Which state has the lowest Infant Mortality Rate (IMR) in India?

Kerala. ***Kerala*** - Kerala consistently has achieved the **lowest Infant Mortality Rate (IMR)** in India, demonstrating significant progress in public health and maternal-child care. - This is primarily attributed to its robust **healthcare infrastructure**, high literacy rates, and effective implementation of health programs. *Maharashtra* - While Maharashtra has made progress in reducing IMR, its rate remains **higher than Kerala's**, reflecting varying healthcare access and quality across the state. - There are regional disparities in health outcomes, despite significant economic development. *Tamil Nadu* - Tamil Nadu has a commendable healthcare system and has significantly reduced its IMR over the years, yet it **does not consistently achieve the lowest rate** when compared to Kerala. - Its focus on **universal healthcare access** and nutrition programs has been instrumental in its improvements. *Uttar Pradesh* - Uttar Pradesh typically reports one of the **highest Infant Mortality Rates (IMR)** in India, due to challenges such as limited access to healthcare, malnutrition, and poor sanitation. - Significant efforts are underway to improve maternal and child health indicators, but the state still lags behind the national average and other states like Kerala.

Q: Immunity starts after how many days of yellow fever vaccination ?

7-10 days. ***Correct: 7-10 days*** - The **onset of immunity** after yellow fever vaccination typically occurs within **7-10 days** for most individuals. - This period is crucial for the body to develop a protective immune response, which is why travelers are advised to get vaccinated at least **10 days before potential exposure** as per WHO guidelines. - Approximately **95% of vaccinees** develop protective immunity by day 10. *Incorrect: 2-3 weeks* - While immunity continues to strengthen over this period, **initial protective immunity** is established earlier, typically by 7-10 days. - This option represents a slightly delayed timetable for the initial establishment of immunity. *Incorrect: 4-5 weeks* - This duration is significantly longer than the time required for the initial protective immunity to develop after yellow fever vaccination. - At this point, robust and **long-lasting immunity** would generally be established, but it's not when immunity "starts." *Incorrect: 2-3 months* - This timeframe is far too long for the *start* of immunity following yellow fever vaccination. - By this point, immunity is not only well-established but also **lifelong** (the vaccine provides protection for life after a single dose).

Q: Arsenic poisoning presents with symptoms mimicking which condition?

Cholera. ***Cholera*** - **Acute arsenic poisoning** often presents with severe **gastrointestinal symptoms** such as profuse watery diarrhea and vomiting, which can lead to rapid dehydration and shock, mimicking **cholera**. - Both conditions cause significant **fluid and electrolyte loss**, leading to similar clinical presentations in their acute phases. *Dhatura poisoning* - Dhatura poisoning primarily affects the **central nervous system** and presents with **anticholinergic symptoms** such as dry mouth, dilated pupils, blurred vision, delirium, and tachycardia. - This symptom profile differs significantly from the profuse gastrointestinal distress seen in acute arsenic poisoning. *Barbiturates poisoning* - Barbiturate poisoning causes **central nervous system depression**, leading to drowsiness, ataxia, reduced reflexes, and eventual respiratory depression. - These neurological symptoms are distinct from the severe gastrointestinal and dehydrative features of acute arsenic poisoning. *Morphine poisoning* - Morphine poisoning is characterized by the **opioid triad**: pinpoint pupils, respiratory depression, and depressed mental status (coma). - While it can cause some gastrointestinal symptoms like constipation, it does not typically present with the severe watery diarrhea and vomiting that mimic cholera.

Q: Multiple drug resistance is transferred through -

Conjugation. ***Conjugation*** - Conjugation is a primary mechanism for the spread of **antibiotic resistance genes** among bacteria, including those responsible for multiple drug resistance. - It involves the direct transfer of **plasmids** (which often carry resistance genes) from one bacterial cell to another through a pilus. *Transduction* - Transduction is the process where bacteria acquire foreign DNA, including resistance genes, via a **bacteriophage (virus)**. - While it can transfer resistance, conjugation is a more common and clinically significant route for **multidrug resistance** spread. *Transformation* - Transformation involves the uptake of **naked DNA** from the environment by a bacterial cell. - While bacteria can acquire resistance genes this way, it is less efficient for widespread, rapid transfer of **multiple resistance traits** compared to conjugation. *Mutation* - Mutation refers to a change in the bacterial organism's own DNA, which can lead to the development of **drug resistance**. - However, mutation explains the *origin* of resistance in a single bacterium, not the *transfer* of resistance genes (especially multiple resistance) between different bacteria.

Q: Dalrymple's sign of ocular Graves' disease refers to which of the following?

Retraction of the upper lid. ***Retraction of the upper lid*** - **Dalrymple's sign** specifically refers to the **wide-eyed stare** seen in **Graves' ophthalmopathy** due to **retraction of the upper eyelid**. - This symptom is caused by sympathetic overactivity of the **levator palpebrae superioris muscle**. *Lid lag* - **Lid lag (Graefe's sign)** is a different ocular sign where the **upper eyelid lags behind the globe** on downward gaze. - While also seen in **Graves' disease**, it is distinct from constant upper lid retraction. *Proptosis* - **Proptosis**, or **exophthalmos**, is the **forward protrusion of the eyeball** from the orbit. - This is a common feature of **Graves' ophthalmopathy**, but it is not what Dalrymple's sign refers to. *Convergence insufficiency* - **Convergence insufficiency (Moebius sign)** refers to the **inability to maintain convergence** during near vision. - While this can occur in **thyroid eye disease**, it is not Dalrymple's sign.

Q: What is the primary function of glaucoma drainage devices?

Drain aqueous humour to an external device. **Drain aqueous humour to an external device** - Glaucoma drainage devices create an artificial outflow pathway, channeling excess **aqueous humour** from the anterior chamber to an external reservoir (usually under the conjunctiva) to lower intraocular pressure. - This bypasses the compromised natural drainage system, preventing further damage to the **optic nerve**. *Drain aqueous humour to the posterior segment* - Glaucoma drainage devices are designed to drain aqueous humour from the **anterior segment** (specifically the anterior chamber) of the eye, not the posterior segment. - The posterior segment primarily contains the **vitreous humour**, and drainage to this area is not the intended mechanism for IOP reduction. *Open the trabeculae mechanically* - Glaucoma drainage devices do not mechanically open the **trabecular meshwork**; this is the mechanism of action for procedures like goniotomy or trabeculoplasty. - These devices create an entirely new drainage pathway, bypassing the dysfunctional trabecular meshwork. *Reduce the aqueous secretion by compressing the ciliary epithelium* - Reducing aqueous humour secretion is the mechanism of action for medications like **beta-blockers** or **carbonic anhydrase inhibitors**, which act on the **ciliary epithelium**. - Glaucoma drainage devices focus on increasing outflow, not on reducing the production of aqueous humour.

Q: All of the following are true for retinopathy of prematurity except which of the following?

End result is bilateral blindness. ***End result is bilateral blindness*** - While retinopathy of prematurity (ROP) can lead to severe vision loss or blindness, it is not always a bilateral end result, especially with early diagnosis and treatment. The severity can vary between eyes, and some cases resolve spontaneously. - Modern screening and intervention strategies, such as laser photocoagulation or anti-VEGF injections, are often successful in preventing complete blindness in one or both eyes. *Due to hypoxia there occurs neovascularization followed by fibroproliferation* - This statement accurately describes the pathogenesis of ROP. The initial phase involves delayed normal retinal vascularization, followed by a proliferative phase characterized by **neovascularization** in response to hypoxia in the avascular retina. - These new, abnormal vessels are fragile and prone to bleeding, and their associated **fibrovascular proliferation** can lead to retinal detachment. *Blindness can be prevented by early diagnosis and ablation of vascular premature retina with cryotherapy or photocoagulation* - This is a true statement. **Early diagnosis** through ophthalmologic screening of premature infants is crucial, and treatments like **laser photocoagulation** or **cryotherapy** are effective in ablating the avascular peripheral retina to halt the progression of abnormal vessel growth. - These interventions reduce the hypoxic drive that fuels neovascularization, thereby preventing severe retinal detachment and subsequent blindness. *Occurs in premature infants due to abnormal retinal blood vessel development.* - This statement is correct. ROP is a disease primarily affecting **premature infants** because their retinal blood vessels have not completed development by the time of birth. - Postnatal factors, including oxygen fluctuations and low birth weight, further disrupt this critical development, leading to **abnormal vascularization**.

Q: 1mm change in axial length of the eyeball would change the refracting power of the eye by?

3D. ***3D*** - A 1mm change in the **axial length** of the eyeball leads to an approximate **3 diopter (D) change** in the refractive power of the eye. - This relationship is crucial for understanding **refractive errors** like myopia (if the eyeball is too long) or hyperopia (if it's too short). *1D* - A 1D change in refractive power corresponds to a much larger change in the **focal length** of the eye, not typically 1mm in axial length. - This value is too small to reflect the significant impact of a 1mm axial length alteration on the eye's focusing ability. *2D* - While a direct relationship exists, 2D is an **underestimation** of the actual refractive change caused by a 1mm alteration in axial length. - This value would imply a less sensitive optical system than the human eye. *4D* - A 4D change would represent an **overestimation** of the refractive power change for a 1mm alteration in axial length. - Such a high value is generally seen with more substantial anatomical variations or surgical interventions.

Q: Primary complex of M bovis involves:

Tonsil and intestine. ***Tonsil and intestine*** - *Mycobacterium bovis* is primarily transmitted through **consumption of contaminated milk and dairy products**, making the **alimentary tract** the main route of infection - The primary complex (Ghon complex) involves the **initial site of infection plus regional lymph nodes** - In alimentary tuberculosis, the organisms enter through the **intestinal mucosa** (Peyer's patches) or **tonsillar tissue**, creating foci with associated mesenteric or cervical lymphadenopathy - Both tonsils and intestines are part of the **alimentary system**, representing the typical primary complex for M. bovis in humans *Tonsil and lung* - This incorrectly combines **two different routes of entry** (alimentary and respiratory) - A primary complex involves a **single portal of entry**, not multiple unrelated organ systems - While M. bovis can rarely cause pulmonary TB through inhalation, this would create a separate lung + hilar node complex, not a combined tonsil-lung complex *Tonsil and skin* - **Skin involvement** requires direct inoculation through cuts or abrasions and does not form a primary complex with tonsillar infection - These represent different portals of entry and would not occur together as a primary complex *Skin and Intestine* - **Skin infection** by M. bovis is rare and requires occupational exposure with direct inoculation (e.g., veterinarians, butchers) - This incorrectly pairs two different routes of infection that would not form a single primary complex

Q: All of the following are indications for tracheostomy except ?

Superior laryngeal nerve palsy. ***Superior laryngeal nerve palsy*** - While superior laryngeal nerve palsy can cause **hoarseness** and **dysphagia** due to impaired laryngeal sensation and cricothyroid muscle function, it typically does not directly lead to **airway obstruction** requiring a tracheostomy. - The primary concern with this condition is often **aspiration risk**, which is usually managed through compensatory swallowing techniques or dietary modifications, not surgical airway establishment. *Coma after head injury* - Patients in a **prolonged coma** or with severe **neurological impairment** often lose their protective airway reflexes (e.g., cough, gag reflex), increasing the risk of **aspiration** and making **pulmonary toilet** difficult. - A tracheostomy provides a secure, long-term airway for **ventilatory support**, suctioning, and protection against aspiration in these patients. *Maxillofacial injury* - Severe **maxillofacial trauma** can cause significant **airway obstruction** due to edema, hemorrhage, or anatomical disruption of the upper airway structures. - In such cases, a tracheostomy may be necessary to bypass the obstructed area and establish a **stable airway** for respiration. *Bilateral abductor palsy* - **Bilateral abductor palsy** results in failed abduction of both vocal cords, leading to a fixed, adducted position of the vocal cords that can cause severe or complete **airway obstruction**. - This condition is a direct and urgent indication for tracheostomy to ensure an **open airway**.

Question 1

Which state has the lowest Infant Mortality Rate (IMR) in India?

Accepted Answer

Kerala

Answer

Maharashtra

Answer

Tamil Nadu

Answer

Uttar Pradesh

Question 2

Immunity starts after how many days of yellow fever vaccination ?

Accepted Answer

7-10 days

Answer

2-3 weeks

Answer

4-5 weeks

Answer

2-3 months

Question 3

Arsenic poisoning presents with symptoms mimicking which condition?

Accepted Answer

Cholera

Answer

Dhatura poisoning

Answer

Morphine poisoning

Answer

Barbiturates poisoning

Question 4

Multiple drug resistance is transferred through -

Accepted Answer

Conjugation

Answer

Transduction

Answer

Transformation

Answer

Mutation

Question 5

Dalrymple's sign of ocular Graves' disease refers to which of the following?

Accepted Answer

Retraction of the upper lid

Answer

Lid lag

Answer

Proptosis

Answer

Convergence insufficiency

Question 6

What is the primary function of glaucoma drainage devices?

Accepted Answer

Drain aqueous humour to an external device

Answer

Drain aqueous humour to the posterior segment

Answer

Open the trabeculae mechanically

Answer

Reduce the aqueous secretion by compressing the ciliary epithelium

Question 7

All of the following are true for retinopathy of prematurity except which of the following?

Accepted Answer

End result is bilateral blindness

Answer

Due to hypoxia there occurs neovascularization followed by fibroproliferation

Answer

Occurs in premature infants due to abnormal retinal blood vessel development.

Answer

Blindness can be prevented by early diagnosis and ablation of avascular peripheral retina with cryotherapy or photocoagulation

Question 8

1mm change in axial length of the eyeball would change the refracting power of the eye by?

Accepted Answer

3D

Answer

1D

Answer

2D

Answer

4D

Question 9

Primary complex of M bovis involves:

Accepted Answer

Tonsil and intestine

Answer

Tonsil and skin

Answer

Tonsil and lung

Answer

Skin and Intestine

Question 10

All of the following are indications for tracheostomy except ?

Accepted Answer

Superior laryngeal nerve palsy

Answer

Coma after head injury

Answer

Maxillofacial injury

Answer

Bilateral abductor palsy

NEET-PG 2015

Community Medicine

Forensic Medicine

Microbiology

Ophthalmology

Pathology

Surgery