Diagnosis of PCOS | NEET Based MCQ

Which of the following serum value is not in favour of diagnosis of PCOS-?

A. Elevated LH, ratio of LH/FSH is >3; 1
B. Reversible oestradiol : oestrone ratio
C. Reduced SHBG level
D. Reduced serum insulin level

Ans. D. Reduced serum insulin level .investigation for PCOS include- Ultrasonography ; various serum values ; laparoscopy.

The serum values in PCOS are-

·  LH level is elevated  and/or ratio of LH:FSH is > 3:1

·  Reversible oestradiol:oestrone ratio- The oestrone level is markedly elevateD.

·  SHBG level is reduceD.

·  Androstenedione level is elevated.

·  Serum testosterone and DHEA may be marginally ElevateD.

·  Raised serum insulin level (insulin resistance) or the ratio of fasting glucose: fasting insulin is < 4.5

Drug contraindicated during breast feeding | NEET Based MCQ

Which of the following drug is contraindicated during breast feeding:-

A. Warfarin 
B. Sumatriptan
C. Bromocriptine 
D. Glucocorticoids

Ans. C. Drugs which are contraindicated during breast feeding are bromocriptine  (suppresses latation), cocaine, phencyclidine, lithium, anticancer drugs (cyclophosphamide, cyclosporine, doxorubicin) methotrexate, phenindione and radioactive iodine and other radiolabelled elements. Warfarin, Sumatriptan and Glucocorticoids can be given safely during this period.

Conditions contraindicated for vacuum extractions | NEET Based MCQ

Conditions which are relatively contraindicated for vacuum extractions are all; except:

A. Face presentation 
B. Extreme prematurity
C. Fetal coagulopathies
D. None of the above

Ans. D. Vacuum extraction (vantouse) has the theorectical advantages over forceps. Which includes avoidance of insertion of space occupying steel blades within the vagina, the ability to otate the fetal head without impinging upon maternal soft tissues and less intracranial pressure duting traction. Thje indications and prerequisite for use of vacuum extrations are same as for forceps delivery. The relative contraindication are (1) face or other nonvertex presentation (2) extreme premautrity (3) fetal coagulopthies (4) known macrosomia (5) following recent scalp blood sampling.

CAD predisposing factors | PGI Nov 2017 Preparations MCQ

CAD predisposing factors 

A. Homocysteinemia 
B. ↓ L Lipoprotein B 
C. ↓ Fibrinogen 
D. ↓ HDL 
E. ↓ plasminogen activator inhibitors 1

Answer. A. Homocystenimia ; (B) ↓ Fibrinogen; (E) ↓ Plasminagen activator

• LDL also called β-lipoprotein is most directly related to CAD.

• HDL also called α-lipoprotein is inversely related to CAD.

• VLDL also called prebeta is associated with premature atherosclerosis. It is strongly associated with

peripheral vascular disease (Intermittent claudication)

• Plasminogen activator inhibitor -1 causes

— Venous thrombosis

— Tail vein thrombosis

— Hind, foot oedema :

• Certain genotypes of PAT-I gene appear to co-related with increased coronary risk.

• Homocysteinemia is associated with coronary artery disease.

• Several makers of hemostatic and thrombotic function in addition to homocysteine level characteristics

event such as MI and stroke

— The markers are

  level of plasminogen activator inhibitor-i,

— Plasma fibrinogen.

— C—Reactive protein

• Infection causing coronary heart disease and atherosclerosis

— Herpes

— Cytomegalo virus

— Chlamydia pneumonia; 

Nephrotic syndrome | PGI Nov 2017 Preparations MCQ

Nephrotic syndrome is characterised by 

A. Proteinuria 
B. Hyperlipidemia 
C. Oedema 
D. Haematuria 
E. Lipiduria

Answer. A. Proteinuria ; (B) Hyperipidemia ; (C) Oedema ; (E) Lipiduria :

The nephrotic syndrome is characterised by

— Massive proteinuria, with daily loss of 3.5 gm or more protein.

— Hypoalbuminemia with plasma albumin levels less than 3 gm/dl.

— Generalised oedema

Hyperlipidemia and lipiduria.

• Thrombotic and thromboembolic complications are common in nephrotic syndrome due to loss of anticoagulant factor (e.g: antithrombin III)

• Haematuria is seen in nephritic syndrome.

Treatment of partner is required in all infections except | PGI Nov 2017 Preparations MCQ

Treatment of partner is required in all infections except 

A. Candida 
B. Herpes 
C. Trichomonas 
D. Gardnerella
E. HSV 2 infection

Answer.D. Gardnerella

• Treatment of partners recquired in

— Candidiasis

— Herpes genitalis

—Trichomoniasis

— HSV 2 infection

• Treatment of male partners with metronidazole does not prevent recurrence of bacterial vaginosis.

Chlamydia causes | PGI Nov 2017 Preparations MCQ

Chlamydia causes 

A. Infertility 
B. Pneumothorax 
C. Pelvic Inflamatorydisease 
D. Cong. malformation in fetus
E. Miscarriage

Answer. A. Infertility; (C) Pelvic Inflamatory disease :

* Chlamydiacauses infertility due to tubal scaring.

• It causes pelvic inflammatory disease by ascending intraluminal spread from low

genital tract.

* It causes upper respiratory infections pneumonitis. 

• Infection during pregnancy associated with premature delivery and postpartum

endometritis. 

Loud pulmonary component of second heart sound | NEET Based MCQ

Loud pulmonary component of second heart sound is heard in :

A. Pulmonary hypertension
B. TOF
C. Eisenmenger syndrome 
D. Pulmonary stenosis

Ans. (A) Pulmonary hypertension

In pulmonary hypertension, P₂ is loud, and splitting of the second heart sound may be diminished, normal, or accentuated, depending on the cause of the pulmonary hypertension, the pulmonary vascular resistance, and the presence or absence of right ventricular decompensation. Loud P₂: Pulmonary hypertension

Loud A₂: Systemic hypertension  ; Aortitis ; Aortic aneurysm

ARDS | NEET Based MCQ

Which of the following findings is virtually always seen in a patient with ARDS ?

A. A small localized mass on chest x-ray 
B. Reduced lung compliance 
C. Normal oxygenation with impaired minute ventilation 
D. Increased arterial Pco2

The answer is B

Adult respira­tory distress syndrome (ARDS, "wet lung") be­gins with a disruption of capillary integrity, which leads to extravasation of fluid, fibrin, and protein into the alveoli. As a result, the lungs become wet and stiff (i.e., noncom­pliant). This condition is characterized by se­vere hypoxia caused by extreme ventila­tion-perfusion (V/Q) imbalance and shunting of blood in the fluid-filled areas of the lung. Clinical features include progressive tachyp­nea; patchy, diffuse, fluffy infiltrates on chest x-ray; increased minute ventilation; and de­creased lung volumes. There usually is an ab­sence of specific physical findings.

Drug clinically interacting with ribosomes | PGI Nov 2017 Preparations MCQ

Drug clinically interacting with ribosomes to interfere with translation in bacteria 

A. Tetracycline 
B. Erythromycin 
C. Puromycin
D. Oligomycin
E. None

. Answer. A. Teracycline ; (B) Erythromycin :

• The process of translation is divided into :

— Initiation 

 — Elongation

— Termination.

, Streptomycin binds to the 30 S sub-units and distorts its structure, interfering with the initiation of protein synthesis.

• Tetracyclines interact with small ribosomal sub-units blocking access of the amino-acyl t-RNA to the m-RNA ribosome complex.

• Puromycin, chloramphenicol inhibits elongation.

• Clindamycin Erythromycin bind irreversibly to a site of 50S submit of the bacterial ribosome and inhibit translation. Though puromycin inhibits translation , it does not interfere with ribosomes

Pseudomonas | PGI Nov 2017 Preparations MCQ

Drugs effective against pseudomonas include :

A. Cefazoline. 
B. Ceftazidine
C. Piperacillin 
D. Cefuroxime.
E. Cefotaxime

Answer. B. Ceftazidime ; (C) Piperacillin

• Anti-pseudomonal penicillins

- Piperacillin/Tazobactum

- Mezlocillin

- Ticarcillin/Clavulunate

• Anti-pseudomonal cephalosporins

- Ceftazidime

- Cefoperazone

- Cefepime

• Other anti-pseudomonals are :

- Tobramycin, Gentamycin, amikacin

-Imipenem/cilastatin, Meropenem

- Aztreonam                                           

- Polymyxin B

 - Ciprofloxacin, Levofloxacin.

-  Colistin 

Visceral Leishmaniasis | PGI Nov 2017 Preparations MCQ

All of the following are true regarding Visceral Leishmaniasis except-

A. Caused by L. tropica
B. Post-leishmaniasis dermatitis is common 
C. Antimonials are useful drugs 
D. Diagnosed by blood smear 
E. Vector is phlebotomussergenti

Answer. A. Caused by L. tropica ; (B) Post-leishmaniasis dermatitis is common ; (E) Vector is phlebotomus sergenti.

— Visceral -leishmaniasis or kala-azar is caused by Leishmania donovani.

— The vector for Kala-azar is sandfly.

Different species of sandfly transmit different diseases;

• Phlebotomus argentipes — Kala-azar

• Phlebotomus papatasi — Sandfly fever, oriental sore

• Phlebotomus sergenti — Oriental sore

• S. punjabensis — Sand fly fever

• Post Kala-azar dermal leishmanisis is a type of ulcerative cuntaneous lesion prevalent in endemic areas of India.

— Develops in about l0 of Kala-azar patients.

— Develops after one or two yrs after completion of antimonial treatment for original disease.

— It is appear when visceral infection disappear but cutanous infection persists.

— It has been found in spontaneously cured Kala-azar patients also :

Besides face , lesions appear on extensor surface of limbs, sides and back of the trunk.

• Definite diagnosis of leishmaniasis requires demonstration of parasite. Thin blood smear or histologic section is required to identify amastigotes of the parasite. 

Hand Washing | PGI Nov 2017 Preparations MCQ

Which of the following can be reliably used for hand washing?

A. Chlorhexidine 
B. Isopropyl alcohol 
C. Lysol 
D. Cresol 
E. Glutaraldehyde

Answer. A. Chlorhexidine ; (B) Isopropyl alcochol ; (C) Lysol ; (D) Cresol

• Chlorhexidine, Isopropyl alcohol (preferred), iodine, ethyl alcohol are effective skin

disinfectants

• Glutaraldehyde is a skin irritant

• Lysol is 50% emulsion (soapy) of cresol. It is used for disinfection of utensils, excreta and for washing

hands.

• Sodium hypochlorite solution is unstable and too irritant to be used as antiseptic though

chlorine and its compounds like hypochloride are used to disinfect water, food, dairy products etc.

Dienes phenomena | PGI Nov 2017 Preparations MCQ

Dienes phenomena is seen with 

A. Proteus mirabilis 
B. Klebsiella 
C. Proteus vulgaris 
D.Providentia
E. Morganella

Answer. A. Proteus mirabilis ; (C) Proteus vulgaris

o By the help of Dienes phenomenon, swarming can be used to recognize identical strain of Proteus.

— Strains isolated from a suspected episode of hospital infection are spot inoculated around the edge of a culture plate with one strain in the centre; seven strains per plate is appropriate. Identical strains will shows no line of demarcation at the edges of swarming area. Serological bacterial and phage type can also be employed by the characterized strain.

Note: Dienes method of staining is done to see the character of the colony of Mycoplasma.

— The colony of Mycoplasma appears as ‘fried eggs appearance

— Danysz phenomenon: If to a given amount of antitoxin, the equivalent amount of toxin was added all at once the mixture remained non toxic. If same amount is added in two or more installments at the intervals of 15 minutes or more, the resultant mixture is toxic. This paradoxical occurrence is called danysz phenomenon. It is due to ability of toxins and antitoxin to combine with more than its equivalent of antitoxin, leaving insufficient anitoxin behind to neutralize the toxin added subsequently.

Trans-placental spread | PGI Nov 2017 Preparations MCQ

Trans-placental spread is least with?

A. HBV 
B. Rubella
C. HSV 
D. HIV
E. None of the above

Answer. C. HSV.

“The acquisition of genital herpes during pregnancy is associated with spontaneous abortion, prematurity, and congenital and neonatal herpes. A recent cohort study of pregnant women without evidence of previous herpes infection demonstrated that ~2% of the women acquired a new herpes infection during the pregnancy. Approximately 60% of the newly infected women had no clinical symptoms. Infection occurred equally in all three trimesters. If herpes seroconversion occurred early in pregnancy, the risk of transmission to the newborn was very low. In women who acquired genital herpes shortly before delivery, the risk of transmission was high. The risk of active genital herpes lesions at term can be reduced by prescribing acyclovir for the last 4 weeks of pregnancy to women who have had their first episode of genital herpes during the pregnancy.

Herpesvirus infection in the newborn can be devastating. Disseminated neonatal herpes carries with it high mortality and morbidity rates from CNS involvement. It is recommended that pregnant women with active genital herpes lesions at the time of presentation in labor be delivered by cesarean section

Parasites penetrating through skin | PGI Nov 2017 Preparations MCQ

Parasites penetrating through skin for entry into the body are 

A. Ankylostoma duodenale 
B. Strongyloides 
C. Round worm 
D. Trichuris trichura 
E. D. Medinensis

Answer. A. Ankylostoma duodenale ; (B) Strongyloides :

Mode of infestation by nematodes

1. By ingestion of:

• Embryonated eggs contaminated in food and drink as in A. Lumbricoides, E. Vermicularis, T. trichura

• Growing embryos in intermediate host (Cyclops) as in D. Medinensis.

• Encysted embryos in infected pig flesh as in T. spiralis.

2. By penetration of skin — Filariform larvae through skin as in A duodenale, Necator americanus.

3. By blood sucking insects as in Filaria

4. By inhalation of dust containing embryonated egg. as A. Lumbricoides, E.Vermicularis 

The earliest radiological finding in Rickets |

The earliest radiological finding in Rickets is?

A. Narrowing or absence of the normal zone of calcification 
B. Widening and lengthening of the growth plate 
C. Splaying and cupping of the metaphyses 
D. Bowing of legs

Ans. B.                                                                                                                  

 Widening and lengthening of the growth plate
KEY IMAGING FEATURES OF RICKETS
• Widening of the physis (growth plate)
• Irregular metaphyseal margins (ill-defined zone of
provisional calcification)
• Splaying and cupping of the metaphyses and
costochondral junctions (rachitic rosary)
• Bowing of the extremities
• Osteopenia
• Findings typical of osteomalacia.
The normal ordered maturation and mineralization of cartilage cells becomes disrupted. This occurs predominantly in
the hypertrophic zone, where the number of chondrocytes is seen to increase and the normal columnar formation of
the cells is lost. There is a continued building up of cells, resulting in the earliest radiographic finding of rickets— widening and lengthening of the growth plate. 

Radiological feature of small intestinal obstruction | NEET Based MCQ

The most characteristic radiological feature of small intestinal obstruction is; 

A. featureless abdomen 
B. stepladder pattern 
C. concertina effect 
D. prominent valvulae conniventes

Ans.D. (prominent valvulae conniventes)
Small bowel obstruction
Mechanical small bowel obstruction normally causes small bowel dilatation, with an accumulation of both gas and fluid and a reduction in caliber of the large bowel.
 Diagnosis of small-bowel obstruction can be made on plain abdominal radiographs in 60—70% of patients. The distal ileum is the site of small bowel obstruction in most patients with normal or equivocal plain abdominal radiographs.

Metabolic bone disease | PGI Nov 2017 Preparations MCQ

Metabolic bone disease is caused by excess intake of all of the following vitamins except 

A. A 
B. B 
C. C 
D. D 
E. E

Answer. B. C; E .

• Vitamin-A, intoxication leads to demineralization of bone, hypercalcemia, hyperostosis

• Vitamin- D, intoxication leads to hypercalcemia and hyperphosphatemia.

• High doses of Vit. E (> 800 mg/d) may reduce platelet aggregation and interfere with Vit. K metabolism

• Vit. C toxicity results in

-  kidney stones especially in pre-existing renal disease since Vit. C is metabolised to OXALATE.

- Induction of hemolysis in G-6 PD deficient patients.

- Ealse negative guaiac test.

- Interference with test for urinary glucose.

• Deficiency of Vit. C leads impaired bone growth.

True about nitric oxide | PGI Nov 2017 Preparations MCQ

True about nitric oxide is all except 

A. Free radical 
B. Vasodilator 
C. Oxidizing agent 
D. Catalyst 
E. Platelet aggregator

. Answer. E. Platelet aggregator.

• Nitric oxide is a gas synthesized by endothelial cells previously known as endothelial derived relaxing

Factor (EDRF), causes vasodilatation. It stimulates guanyl cyclase.

•NO has very short half life (3-4 sec.) as in tissues it reacts with oxygen and superoxide producing peroxynitrite which decomposes to form highly reactive 0H radical.

Importances of Nitric oxide    • Vasodilator, important in regulation of BP    • Involved inn penile erection.    • Neurotransmitter in brain and peripheral autonomic nervous system.    • Role in long- term potentiation.    • Role in neurotoxicity    • Low level of NO involved in causation of pyloric spasm in infantile                  hypertrophic pyloric stenosis.    • May have role in relaxation of skeletal muscle.    • May constitute part of primitive immune system    • Inhibitis adhesion, activation, and aggregation of platelets.

Ribozymes | PGI Nov 2017 Preparations MCQ

Ribozymes is/are 

A. Splicing of heterogenous RNA (hnRNA) to form mRNA 
B. Splicing of polypeptide chain and mRNA 
C. Transcription of mRNA 
D. Recognition of codons in introns 
E. RNA polymerase

Answer. A. Splicing of heterogenous RNA to form mRNA ; (D) Recognition of codons in intron

• Ribozymes are RNA molecules with intrinsic catalytic activity, meeting all the criteria for enzymes definition. These generally involve transesterification reactions, and ultimately hydrolysis of phosphodiester bonds in RNA molecules and most concerned with RNA metabolism (splicing and endoribonuclease). These reactions are facilitated by free-OH groups e.g. on guanosyl residues. Examples Sn RNAs, rRNA.

(i) Intron splicing events essential for conversion of pm. mRNA to mature RNAs in eukaryotes. Introns don’t code for protein primary transcript while exons codes for proteins are spliced together to form mature mRNA. Small nuclear RNAs (snRNAs) in association with small nuclear ribonucleoprotein particles (snRNPs) facilitate splicing arid thus act as enzyme.

(ii) In eukaryotic protein synthesis during elongation of polypeptide chain ribozymes (rRNA) involved. The formation Of peptide bonds is catalyzed by peptidyl transferase, an activity intrinsic to 23S rRNA

found in 50S ribosomal subunit.

• Heterogeneous RNA (hnRNA) are precursor of mRNA. They are synthesized in nucleus of 75% of hnRNA are degraded in nucleus only 25% of hnRNA forms precussor of mRNA (pre-mRNA). Splicing of hnRNA forms mRNA pre-mRNA is converted to mRNA.

• Glycine is converted to serine addition of a methylene group from N5, N’° methylene tetrahydrofolate

Glycine Tetrahydrofolate N5N’° methylene Serine tetrahydrofolate 

Commonest allergic manifestation of tuberculosis | NEET Based MCQ

Commonest allergic manifestation of tuberculosis is 

A. Phlyctenular conjunctivitis 
B. Koeppe’s nodule 
C. Retinopathy 
D. Scleritis


Ans. B. (Koeppe’s nodule)                                                                           
Explanation: In Tuberculosis, multiple, small, milliary palpebral conjunctival ulcers, follicular conjunctivitis, gelatinous excrescences in the fornix resembling a cock’s comb, a pedunculated polyp-like growth or a tuberculoma-like nodule at the limbus.

Painless loss of vision | NEET Based MCQ

A young adult male presented with sudden painless loss of vision. He recovered spontaneously within 3 months. What can be the most probable cause of blindness? 

A. Central serous retinopathy 
B. Macular hole 
C. Myopic crescent 
D. Vitreous hemorrhage



Ans. A. (Central serous retinopathy)                                                                             
Explanation: Central serous retinopathy condition occurs in young males as sudden blurring of vision accompanied by a positive scotoma and metamorphopsia. The visual acuity is correctable by convex lenses and returns to normal within 3—6 months in most cases. 

Result of acclimatization | PGI Nov 2017 Preparations MCQ

All of the following occur as a result of acclimatization. except :

A. Polycythemia
B. Vasodilation in pulmonary vessel 
C. Increased diffusion capacity of lung 
D. Increase in pulmonary ventilation
E. Decrease in pulmonary ventilation

Answer. B. Vasodilation in pulmonary vessel ; (E) Decrease in pulmonary ventilation

Acclimatization refers to change in body tissues in response to long term exposure to hypoxia (i.e. at high attitude for days, weeks or years)

1. ­Great increase in pulmonary ventilation.

2. ­in RBC - polycythemia

3. Increased diffusion capacity of lungs

4. Pulmonary HT - due to vaso constriction in pulmonary vessels.

5. Capillary density increases in skeletal & cardiac muscle.

6. Increased ability of cell to use O₂, despite low pO₂.