Nonalcoholic Steatohepatitis | NEET Based MCQ

Which is associated with nonalcoholic steatohepatitis?

A. Amiodarone therapy 
B. Thin body habitus
C. Phenytoin sodium therapy 
D. Right hemicolectomy

Ans: (A) Amiodarone therapy

Nonalcoholic steatohepatitis is often associated with obe­sity, diabetes mellitus, intravenous hyperali­mentation, jejunoileal bypass surgery, and drugs such as amiodarone. The liver is fatty on biopsy, and Mallory bodies are occasion­ally noted. Laboratory examination may re­veal a two- to fourfold increase in transami­nase levels. Initially thought to be a benign condition, prolonged steatohepatitis may lead to cirrhosis. Treatment consists of reducing risk factors; for example, loss of 10% of body weight has been associated with a marked im­provement of transaminase levels in obese patients.

Malabsorptive syndrome | NEET Based MCQ

Which finding is di¬agnostic for malabsorptive syndrome?

A. Prominent villi on small intestine biopsy 
B. 3 g of D-xylose in a 5-hour urine collection
C. High carotene level with normal vitamin A intake
D. 4 g of fat on a 72-hour fecal fat collection

Ans. (B) 3 g of D-xylose in a 5-hour urine collection

After a 25-g oral dose of xylose, a 5-hour urine col­lection should contain at least 5 g of D-xylose. The finding of less than 4-5 g of D-xylose in the stool is indicative of malabsorption syn­drome. Flat villi with inflammatory cell infiltra­tion on small bowel biopsy are characterized by celiac disease. The serum carotene level is a reflection of vitamin A metabolism. Because vitamin A is a fat-soluble vitamin, a low serum carotene level with normal vitamin A intake may be useful in screening for fat mal­absorption. A positive Sudan stain is indica­tive of an underlying malabsorptive process. However, the gold standard test for fat malab­sorption is a 72-hour stool collection for fecal fat. The coefficient of fat absorption in the small intestine is 7%. As a result, a patient consuming a 100-g fat diet should have no more than 7 g of fat in the stool each day; more than 7 g of fat would be consistent with a malabsorption syndrome.

HACEK | NEET Based MCQ

HACEK is NOT related to 

A. Hemophilus aphrophilus 
B. Acinetobacter baumannii 
C. Cardiobacterium hominis 
D. Eikenella corrodens

Ans. B. (Acinetobacter baumannii)
Explanation
HACEK
This refers to a group of fastidious slow-growing bacteria, normally resident in mouth, which can sometimes cause severe infections, particularly endocarditis. This group includes the following:
• Haemophilus species (H. parainfluenzae, H. aphrophilus, and H. paraphrophilus)
• Actinobacillus actinomycetemcomitans
• Cardiobacterium hominis
• Eikenella corrodens
• Kin gella kingae
Characteristic features
• Blood culture from HACEK patients takes 7—30 days to become positive.
• Antibiotic-sensitivity tests are essential for effective therapy as drug resistance is very common.
• 3% of the cases of infective endocarditis are attributable to HACEK organisms.
• Embolization is common; prevalence of major emboli is 28—60 percent.
• Strains producing β-lactamase may not be identified accurately.
• The cure rate for HACEK prosthetic valve endocarditis appears to be high.
• Haemophilus species accounts for half of the cases.
• Mycotic aneurysm and congestive heart failure are frequent.

Anteroposterior diameter of the inlet | NEET Based MCQ

A pelvis characterized by an anteroposterior diameter of the inlet greater than the transverse diameter is classified as

A. Gynecoid 
B. Android
C. Anthropoid 
D. Platypelloid

Ans.C.               

By tradition, pelvis are classified as belonging to one of four major groups. The gynecoid pelvis is the classic female pelvis with a posterior sagittal diameter of the inlet only slightly shorter than the anterior sagittal diameter. In the android pelvis, the posterior sagittal diameter at the inlet is much shorter than the anterior sagittal diameter, limiting the use of the posterior space by the fetal head. In the anthropoid pelvis, the anteroposterior (AP) diameter of the inlet is greater than the transverse diameter, resulting in an oval with large sacrosciatic notches and convergent side walls. Ischial spines are likely to be prominent. The platypelloid pelvis is flattened with a short AP and wide transverse diameter. Wide sacrosciatic notches are common. The pelvis of most women do not fall into a pure type and are blends of one or more of the above types.

Contraindications to IUCD are | PGI Nov 2017 Preparations MCQ

Contraindications to IUCD are 

A. Pelvic infl. disease (PID) 
B. Congenital uterine abnormality 
C. Liver disease 
D. DM 
E. Heart disease

Ans. (A) Pelvic infl. disease(PID) ; (B)Congenital uterine abnormality ; (D)DM
(E)Heart disease :
• Contra indication of IUCD
- Suspected pregnancy
- Pelvic inflammatory disease; lower genital tract infection.
- Presence of fibroid.
- Menorrhagia and dysmenorrhea.
-- Severely anaemic.
- Distortion of the shape of uterine cavity as in fibroid or congenital malformation (there is difficulty in insertion and contraceptive).
- DM which are not controlled.
- Heart disease.
- Suspicious carcinoma cervix with abnormal cytology.
- Previous ectopic pregnancy.
- Scared uterus to be cautious.
--  Preferrably avoid in unmarried nulliparous..

Raised beta-HCG levels | PGI Nov 2017 Preparations MCQ

Raised beta-HCG levels are seen in 

A. DM 
B. Preeclampsia 
C. Ectopic pregnancy 
D. Rh. incompatibility 
E. Down synd.

Ans. (E) Downs synd :
• High levels of beta HCG seen is
— Multiple pregnancy.
— Hydatidiform mole or
— Choriocarcinoma and relatively high in pregnancy with down’s syndrome.
• In ectopic pregnancy —* lower concentration of βhCG as compared to that of uterine pregnancy.

True about endometrial carcinoma | PGI Nov 2017 Preparations MCQ

True about endometrial carcinoma 

A. Predisposed by DM, hypertension & obesity 
B. Adenosquamous type is commonest 
C. Commonly associated with Ca. cervix 
D. Common age group affected is between 20--40 yrs
E. All are false.

Ans.  (A) Predisposed by DM hypertension & obesity:
• Endometrial carcinoma is predisposed by Diabetes, hypertension, obesity.
• Endometrial carcinoma is a carcinoma of perimenopausal age group, after the age of 50 years.
• High estrogen level in body are associated with endometrial carcinoma. 

X-ray feature of spondylisthesis | PGI Nov 2017 Preparations MCQ

X-ray feature of spondylisthesis 

A. Sunbrust appearance 
B. Scot’ dog 
C. Napolian hat’ 
D. Hairy rope sign 
E. Hat on the hook deformity.

Ans.  (B) Scot dog. :
• In spndylolisthesis, X-ray shows the forward shift of upper part of the spinal column on stable vertebra below, elongation of the arch or defects may he seen. The gap in the pars interventricularis is best seen in the oblique views.
• In AP view, superior surface of slipped vertebral body may be seen.
• In oblique view, pars interventricularis better seen where it is likened to a collar around the ‘neck’ of an illustory ‘dog’ i.e. Scot dog.
In this case, the break in the pars is seen in the lateral X-ray.

Oblique view shows that on one side there is defect but on the other the break has healed with elongation of the pars.

Painful lymphadenopathy | PGI Nov 2017 Preparations MCQ

Painful lymphadenopathy is seen in: 

A. Donovanosis 
B. Syphilis 
C. Chancroid 
D. Herpes simplex 
E. Gonorrhaea

Ans. (C) Chancroid (D)Herpes Simplex :
• The lymph nodes are painful in both acute and chronic lymphadenitis acute leukemia, but are painless in syphillis, lymphosarcoma, secondary carcinoma, lymphoma etc.
• Chancroid (Soft chancre)is caused by Haemophilus Ducreyi, has an IP of 3-5 days is characterised by painful, non indurated ulcer and painful lymphadenopathy. Ito test is done here.
• Donovanosis or granuloma inguinale is caused by calymmatobacterium granulomatis, has an IP of 1-4 wks in characterised by one or more subcutaneous nodules that erode through skin to produce ulcer, granulomatous sharply defined painless leson. The genitalia are involved in 90% of cases and genital swelling, particularly of the labia, is a common feature and occasionally progresses to psuedoelephastiasis. Lymphadeopathy is not seen and pseudobubos are seen.

• In syphilis, painless, indurated papule formed that may turn to ulcer and painless, firm, shotty, discrete lymphadenophthy is seen.
• In herpes infection, painful papule is formed that ulcerate in 3-6 days. Tender inguinal lymphadenopathy dysuria, urethral and vaginal discharge are local Sx.
•In Gonorrhea, lymphadenopathy is not found.
In lymphogranuloma venerum after the genital lesion has healed, painful matted suppurative lymphadenopathy occurs. Multiple sinus tracts, Groove’s sign.Elephantiasis 

USG features of fetal death | PGI Nov 2017 Preparations MCQ

USG features of fetal death are-

A. Halo’ sign of head 
B. Heart beat absent 
C. Spalding sign 
D. Hegar’s sign
E. Goodle’s sign


Ans. (B) Heart beat absent :
Fetal signs of IUD on ultrasound
— Lack of all fetal motions
— Oligohydramnios, callapsed bones
•X-rayfindings
— Spalding sign (overriding of scalp bones)
—Rohetts sign.(Gas in heart, great vessels detected as early in 12 hrs. after death)
— Hyperflexion of spine
— Crowding of ribs
between. 6-10 wks. of pregnancy

Mycobacterium causing skin ulcer | PGI Nov 2017 Preparations MCQ

Mycobacterium causing skin ulcer 

A. M. Smegmatis 
B. M. Scrofulaceum 
C. M. Ulcerans 
D. M. fortuitum 
E. M. Marinum

Ans. (C) M. ulcerans ; (E) M. Marinum:
• M. Ulcerans produces a toxin that produces the characteristic skin lesion (Buruli ulcer) Among the mycobacterium species, M. ulceràns only produces toxin.
• M. marinum causes tuberculosis in fish and amphibia. Human infection originates from contaminated swimming pools or fish tanks. The lesion, heginningas a papule and breaking down to form an indolent ulcer, so it is known as “swimming pool granuloma”.

M. Scrofulaceum may cause scrofula (cervical adenitis) in children. 

Yaws | NEET Based MCQ

All of the following are true regarding Yaws EXCEPT 

A. Caused by Treponema subtype T. pertenue
B. It cross reacts with antibody titer of syphilis
C. Transmitted sexually
D. Common in children

Ans. C. (Transmitted sexually)
• Yaws is a chronic disease that is usually acquired in childhood and is caused by T.pertenue. It is also known as Pian, framboesia, or bouba.
• The disease is characterized by the development of one or several primary lesions (called the ‘mother yaws’) followed by the appearance of multiple disseminated skin lesions.
• Early lesions may persist for many months, are infectious, usually recur several times within the early years of infection.
• Manifestations are destructive and can involve skin, bone, etc.
• The infection is transmitted by direct contact with infectious lesions.
• Children with open lesions and without clothing are most likely to transmit infection during play or in group.
• Incubation period is 3—4 weeks.
• Lesion begins as a papule, usually on an extremity, (particularly during moist warm weather) to become papular (“raspberry- like” thus the name “framboesia”) lymphadenopathy develops, and the lesion usually heals within six months.
• A generalized secondary eruption, accompanied by generalized lymphadenopathy, appears either concurrent or following the primary lesion, may take several forms, papular, or papillomatous, and may become secondarily infected with other bacteria.
• Painful papillomatous lesions on the soles result in a painful crab like gait (“crab yaws”)
• Periostitis may result in nocturnal bone pain and poiy dactylitis.
• All early skin infections and cutaneous relapses are common during the first five years.
• Late yaws is recognized in 10% of untreated patients manifested by gummas of the skin and long bones, hyperkeratosis of palms and soles, osteitis and periostitis, and hydrarthrosis.
• Lesions are characteristically very destructive and destruction of the nose, maxilla, palate, and pharynx is termed as gangosa and is similar to the destructive lesions seen in leprosy and leishmaniasis

Water soluble vitamin | NEET Based MCQ

Water soluble vitamin is 

A. Vitamin K 
B. Folic acid
C. Vitamin A 
D. Tocopherol

Ans. B. (Folic acid)

Explanation
• “Folic acid is a hematopoietic water soluble vitamin”.

• Water-soluble vitamins differ from fat-soluble vitamins in several respects. Most arereadily excreted once their concentration surpasses the renal threshold. Thus toxicities are rare. Deficiencies of these vitamins occur relatively quickly on an inadequate diet.

• Their metabolic stores are labile and depletion can often occur in a matter of weeks or months. Since the water-soluble vitamins are coenzymes for many common biochemical reactions, it is often possible to assay vitamin status by measuring one or more enzyme activities in isolated red blood cells.

• These assays are especially useful if one measures the endogenous activity and the stimulated activity following addition of the active coenzyme derived from that vitamin. 

Phosphorylase B in the muscle | NEET Based MCQ

Phosphorylase B in the muscle is normally kept in inhibited state by which one of the following? 

A. ATP 
B. AMP 
C. Ca2 
D. Glucose

Ans. B. (AMP)

Explanation
Muscle Phosphorylase: This exists in an active ‘a’ form and an inactive ‘b’ form. Phosphorylase is a dimmer containing two identical subunits and occurs tightly bound to glycogen granules; ‘a’ is the phosphorylated form and ‘b’ the dephosphorylated form.

• Phosphorylation requires ATP and occurs at the —OH groups of serine in each subunit of the ‘b’ form to produce the ‘a’ form. This phosphorylation is brought about by the enzyme phosphorylase kinase. In presence of AM the muscle phosphorylase remains in inactive form.

• Presence of Ca2 leads to activation of phosphorylase kinase which leads to subsequent activation of muscle glycogen phosphorylase. 

Hazards of incomplete descent of a single testes | PGI Nov 2017 Preparations MCQ

Hazards of incomplete descent of a single testes are

A. Sterility 
B. Pain
C. Torsion 
D. Epididymo-orchitis
E. Increased liability to malignant disease.

Ans. B,C,D,E

These include Sterility in bilateral cases (especially intra-abdominaltestes)

Pain as a result of trauma, Associated inguinal hernia, Torsion

Epididymo-orchitis

Atrophy of an inguinal testis

Increased liability to malignant disease

Atherosclerosis | NEET Based MCQ

Atherosclerosis does not commonly involve which of the following blood vessels? 

A. Abdominal aorta 
B. Vessels of Circle of Willis 
C. Coronary arterics 
D. Vessels of upper extremities

Ans. D.

                                                                                                                  
Atherosclerosis:
• Atherosclerosis of the coronary arteries commonly causes myocardial infarction) and angina pectoris. In the coronary circulation, for example, the proximal left anterior descending coronary artery
• Atherosclerosis of the arteries supplying the central nervous system frequently provokes strokes.

Hydropic swelling of the cell | NEET Based MCQ

Hydropic swelling of the cell is characterized by all the following except 

A. increased number of cytoplasmic organelles
B. dilatation of cisternae of endoplasmic reticulum
C. impairment of cellular volume regulation
D. influx of sodium into the cell


Ans. A. Except for A, all the answers describe changes that typically occur during hydropic swelling. The volume of the cell increases because of an influx of sodium and water into the cytoplasm. The number of cytoplasmic organelles remains the same.

Biondi ring tangles | NEET Based MCQ

Biondi ring tangles are seen in 

A. Lateral ventricle 
B. Cerebral cortex 
C. Lining of the choroid plexus 
D. Cerebellum

Ans. C. (Lining of the choroid plexus)

Explanation
• Biondi ring tangles are intracellular inclusions found in epithelial cells of choroid plexus cells of Alzheimers disease/aging brains

• They are homogenous globules covered with a thin layer of amyloid fibrils

• By electron microscopy these tangles are made of tightly packed bundles of long filaments with diameter around 10 nm that are morphologically distinct

• Pathological changes in choroid plexus in Alzheimer’s disease

1. Epithelial atrophy (↓cell size by 1/3)

2. Biondi ring tangles

3. Lipofuchsin vacuoles

4. Basement membrane thickening (3-fold t)

5. Stromal fibrosis

6. IgG and 1gM depositions 

Carpal bones | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following carpal bones is prone for anterior dislocation? 

A. Lunate 
B. Capitate 
C. Scaphoid 
D. Trapezium

Ans. A. Lunate.

The 8 carpal bones are arranged in 2 rows.
• The proximal row, which contains the scaphoid, lunate, triquetrum, and pisiform, articulates
with the radius and triangular cartilage to form the carpus.
• The distal row contains the trapezium, trapezoid, capitate, and harnate.
• The ulnar nerve runs deep to the flexor carpus ulnaris tendon through the canal of Guyon.
• The median nerve lies between the flexor carpus radiaJis and the palmaris longus tendon in
the carpal tunnel. Blood is supplied via the radial and ulnar arteries, which form the dorsal
palmar arch.
• The scaphoid bone receives its blood supply from the distal part of this arch, which is prone
to injury. (especially Avascular Necrosis). The scaphoid is usually fractured secondary to
hyperextension of the wrist, often from falls onto the outstretched hand.
• Carpal bone dislocation is usually the result of extreme flexion or extension injuries of the
wrist. The type of dislocation or fracture-dislocation produced by these mechanisms depends
on the direction and intensity of the acting force or the position of the hand in relation to the
forearm at the moment of impact. The integrity of the lurate-capitate relationship is the most
crucial factor in all dislocations of the wrist.Lunate is the bone most commonly to undergo
dislocation and dislocation of lunate can cause median nerve injury.

Coracoid process | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Coracoid process is a ________________type of epiphysis 

A. Pressure 
B. Traction 
C. Atavistic 
D. Aberrant

Ans. B. atavistic

Type of EPIPHYSIS

PRESSURE EPIPHYSIS	1. Articular 2. Takes part in transmission of weight EXAMPLES: Head of femur Lower end of Fibula
TRACTION EPIPHYSIS	1. Non articular 2. Does not take part in transmission of weight 3. Provide attachment to one or more tendons which exert traction on epiphysis EXAMPLES: Tubercles of humerus Trochanters of femur  Mastoid process
ATAVISTIC EPIPHYSIS	1. Phylogenetically an independent bone which in man becomes fused to another bone. EXAMPLE: Coracoid process of Scapula Os Trigonum
ABERRANT EPIPHYSIS	EXAMPLES: Ephysis of head of first metacarpal Epiphysis at the base of other metacarpal bones

Neurotransmitter | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Neurotransmitter responsible for second pain is

A. Glycine 
B. Glutamate
C. Substance P 
D. Ach
E. ATP

Ans. B, C

Activation of C fibres release a combination of glutamate & substance P is responsible for Second pain(slow pain or protopathic pain)

PARAMETER	HUMAN MILK	COW MILK
Bacterial contamination	None	Likely
Anti infective substances	Antibodies, leukocytes, lactoferrin, bifidus factor, others [MCQ]	Not active
Protein	1%	4%
Casein	0.5%	4%
Amino acids: Cysteine Taurine	Enough for growing brain and taurine is enough for retina and bile acid conjugation [MCQ]	Not enough
Fat (total)	4%	4%
Linoleic acid(essential)	Enough for growing brain	Not enough
Cholesterol	Enough	Not enough
Lipase to digest fat	Present	None
LACTOSE	7% [MCQ]	3-4%
Sodium	Correct amount – 6.5	Too much – 25
Chloride	Correct amount – 12	Too much – 29
Potassium	Correct amount – 14	Too much - 35
Calcium	350(correct amount	1400 (too much)

]