Indication for induction of labor | NEET Based MCQ

Which of the following clinical conditions is not an indication for induction of labor?

A. Intrauterine fetal demise 
B. Severe preeclampsia at 36 weeks
C. Complete placenta previa 
D. Chorioamnionitis

The answer is C. Placenta previa is a contraindication to labor because the placenta is ahead of the presenting part covering the cervix and vaginal delivery would result in hemorrhage.Intrauterine fetal demise, preeclampsia, chorioamnionitis, are all indications to induce labor.

Dunlop's traction | NEET Based MCQ

Dunlop's traction is a type of traction used for correcting 

A. Supracondylar fracture elbow 
B. Cervical spinal injuries 
C. Femoral shaft fractures 
D. Calcaneal fracture

The answer is A.

 Supracondylar fracture elbow Dunlop's traction is used in the management of supra condylar fractures of the humerus in children. The method is particularly useful if flexion causes a circulatory embarrassment. 

Agnes hunt traction | NEET Based MCQ

Agnes hunt traction is used fo correction of 

A. Torticollis 
B. Gunstock deform' 
C. Mild flexion deformity at the hip 
D. Atlanto axial dislocation.

The answer is.C.

Mild flexion deformity at the hip This traction technique is used to correct a mild flexion deformity at the hip joint. In this technique the unaffected hip and knee are flexed and encased in a single hip spica, the affected hip is subjected to skin traction which rests in a Thomas splint. 

M/C site of cholangio CA | NEET Based MCQ

M/C site of cholangio CA:

A. intrahepatic 
B. Distal biliary tract
C. Hilum 
D. Multifoca

The answer is C. Hilum

Risk factor for cholangio carcinoma

·        Primary sclerosing cholangitis

·        Choledochal cyst

·        Ulcerative colitis

·        Clonorchissinensis injection

·       Chronic typhoid carries

2/3^rdof cholangio carcinoma are located at hepatic duct bifurcation here they are called as KLATSKIN's tumours

M/C type is adenocarcinoma

•Painless jaundice is the most common presentation

Placenta Previa | NEET Based MCQ

Which of the following statements concerning placenta previa is true?

A. Its incidence decreases with maternal age
B. The initial hemorrhage is usually painless and rarely fatal 
C. Its incidence is unaffected by parity
D. Management no longer includes a double setup

The answer is b. The initial hemorrhage in placenta previa is usually painless and rarely fatal. If the fetus is premature and if hemorrhaging is not severe, vaginal examination of a woman suspected of having placenta previa frequently can be delayed until 37 weeks gestation; this delay in the potentially hazardous examination reduces the risk of prematurity, which is often associated with placenta previa. Vaginal examination, when needed to determine whether a low- lying placenta is covering the internal os of the cervix, should be performed in an operating room fully prepared for an emergency cesarean section. Increasing maternal age and multiparity are associated with a higher incidence of placenta previa.

CLIP staging systems | NEET Based MCQ

CLIP staging systems is used for classification for which of the following disease? 

A. CA colon 
B. Hepatoma
C. Wilson's disease
D. Ulcerative colitis

The answer is B. Hepatoma

Table: Clip Staging Systems for Hepatocellular Carcinoma
CLIP Classification
	Points
Variables	0	1	2
1.Tumor number	Single	Multiple	-
Hepatic replacement by tumor (%)	<50	<50	>50
2.Child – pugh score	A	B	C
3. Fetoprotein level (ng/ml)	<400	<400	-
4. Portal vein thrombosis (CT)	No	Yes	-
CLIP STAGES (Score = sum of points) : CLIP 0,0 Points; CLIP 1, 1 point ; CLIP 2, 2 points; CLIP 3, 3 Points

Watery Diarrhea | NEET Based MCQ

Which of the following pathogens are associated with watery diarrhea after an incubation period of 8 to 14 hours?

A. Rotavirus and Norwalk virus
B. Shigella and Salmonella
C. S. aureus and Bacillus cereus
D. Bacillus cereus and Clostridium perfringens

The answer is d Bacillus cereus and Clostridium perfringens

Bacillus cereus strains can produce two different toxins: a heat stable toxin that can lead to an illness after 2 to 7 hours and a heat-labile toxin that causes disease manifestations 8 to 14 hours after ingestion. The syndrome of Clostridium perfringens diarrhea usually occurs 8 to 14 hours after ingestion of the preformed toxin.

Fat-soluble vitamins, compared with their water soluble counterparts | NEET Based MCQ

Fat-soluble vitamins, compared with their water soluble counterparts.Generally have a greater potential toxicity for because they are 

A. Administeicd in larger doses 
B. Avidly stored by the body 
C. Capable ot dissolving membrane phospholinids
D. Involved in more essential metabolic pathways

The answer is  B

Fat soluble vitamins, especially A and D, can be stored in massive amounts and hence, have a potential for serious toxicities. Water soluble vitamins are easily excreted by the kidney and accumulation to toxic levels is much less common. Conversely, inadequate dietary intake will lead to manifestations of deficiency relatively faster.

If annual growth rate of population is 1.2% | NEET Based MCQ

If annual growth rate of population is 1.2%, the population is likely to get doubled in:

A. 18—20 years 
B. 20—23 years 
C. 28—35 years 
D. 47 — 50 years

The answer is D

    

Rate	Annual GR %	Yrs required
Stationary	No growth	-
Slow growth	0.5	>139
Moderate growth	0.5-1	139-70
Rapid growth	1-1.5	70-47
Very rapid growth	1.5-2	47-35
Explosive growth	2-2.5	35-28
Explosive growth	3-3.5	23-20
Explosive growth	3.5-4	20-18

Features of splenic rupture on plain X —ray abdomen | NEET Based MCQ

All of the following are features of splenic rupture on plain X —ray abdomen, EXCEPT: 

A. Obliteration of psoas shadow 
B. Obliteration of splenic outline 
C. Obliteration of colonic air bubble 
D. Elevation of the lefthemidiaphragm.

The Answer is C

• Features of splenic rupture on plain X-ray abdomen:

1.     Obliteration of splenic outline.

2.     Obliteration of the psoas shadow.

3.     Fracture oflower ribs ofleft side.

4.     Free fluid between gas-filled intestinal coils.

5.     Elevation of the left hemidiaphragm. Indentation of the gastric air bubble 

5% dextrose in 0.9% saline | NEET Based MCQ

Which of the following is a correct statement regarding 5% dextrose in 0.9% saline? 

A. It contains the same concentration of sodium ions asplasma 
B. It can be given in large quantities without seriously affecting acid-base balance 
C. It is isosmotic with plasma 
D. It may cause a dilutional acidosis

The answer is D. It may cause a dilutional acidosis

Isotonic saline solutions contain 154 meq of both sodium and chloride ions. Each ion is in a substantially higher concentration than is found in the normal serum (Na = 142 meqCl 103 meq. When isotonic solutions are given in large quantities, they overload the kidney's ability to excrete chloride ion, which results in a dilutional acidosis.They also may intensify pre existing acidosis by reducing the base bicarbonate acid ratio in the body Isotonic saline solutions are particularly useful in hyponatremic or hypochloremic states and whenever a tendency to metabolic alkalosis is present, as occurs with significant nasogastric suction losses or vomiting.

Administration of lactated Ringer's solution is appropriate for replacements gastrointestinal losses and correcting extracellular fluid deficits. Containing 130 meq sodium lactated Ringer's is. hyposmolar with respect to sodium and provides approximately 150 mL of free water with each liter given. Although this is ordinarily not a significant load, in some clinical condition - it can be. Lactated Ringer's is sufficiently physiological to enable administration of large amounts without significantly affecting the body's acid-base balance. It is worth noting that both isotonic saline and lactated. Ringer's are acidic with respect to the plasma: 0.9% NaC1/5% dextrose has a pH of 4.5 while lactated Ringer's has a pH of 6.5. 

Wireless capsule endoscopy | NEET Based MCQ

Wireless capsule endoscopy is done to visualize which of the following condition? 

A. Esophageal varices 
B. Gastric carcinoma 
C. Crohn's disease 
D. Ulcerative colitis

The answer is C. Crohn's disease

Wireless capsule endoscopy (WCE) allows direct visualization of the entire small-bowel mucosa. The diagnostic yield of detecting lesions suggestive of active CD is higher with WCE than CT enterography or small-bowel series. WCE cannot be used in the setting of a small-bowel stricture. Capsule retention occurs in <1 % of patients with suspected CD, but retention rates of 4--6% are seen in patients with established CD. 

Human papillomavirus | NEET Based MCQ

Human papillomavirus is most commonly associated with 

A. Rectal polypsb. 
B. Prostate cancer
C. Condylomaacuminatumd. 
D. Hepatic carcinoma

The answer is : C

Papillomavirus infects the skin or mucosa and causes benign tumors. The lesion is termed condylomaacuminatum. These tumors may undergo malignant conversion and become squamous cell carcinomas. Classification of the human papillomavirus is done by DNA hybridization, and to date 46 types have been recognized. Some types, such as 16 and 18 are more frequently associated with carcinoma, while others, such as 6 and 11, are associated with benign tumors or warts.

Rupture of the internal vertebral venous plexus | NEET Based MCQ

Rupture of the internal vertebral venous plexus results in an accumulation of blood in which of the following spaces 

A. Space deep to the pia mater 
B. Space between the arachnoid and duramater
C. Space between duramater and periosteum of vertebra 
D. Space between the arachnoid and pia mater

The answer is .C.

In the spine, the epidural space is the space outside the tough membrane called the dura mater, and within the spinal canal, which is formed by the surrounding vertebrae. Adherent to the inside of the dura is a much thinner and more fragile membrane, the arachnoid mater. Enclosed within the arachnoid is the subarachnoid space, which contains the cerebrospinal fluid, and the spinal cord.

Anterior division of internal iliacartery include | NEET Based MCQ

The branches of anterior division of internal iliacartery include all except 

A. lnternalpudendal
B. Superior gluteal
C. Uterined. 
D. Obturator

The answer is B.

• Internal iliac artery arises at the bifurcation of the common iliac, artery, Opposite the lumbosacral joint (L5/S1 intervertebral disc)
Division Branch

Posterior Iliac artery

·  Superior gluteal artery

·  Iliolumbar artery

·  Lateral sacral arteries

Anterior Iliac Artery- about 8 branches

·  Obturator artery (occasionally from inferior epigastric artery)

·  Inferior gluteal artery

·  Umbilical artery, which later persist as superior vesical artery (remaining artery becomes medial umbilical ligament).

·  Uterine artery (females) or deferential artery (males) Vaginal artery (females, can also arise from uterine artery) or inferior vesical artery (males)

·  Middle rectal artery 

·  Internal pudendal artery

·  Artery of the perineum

·  Accessory obturator artery: The obturator artery sometimes arises from the main stem or from the posterior trunk of the internal iliac, or it may spring from the superior gluteal artery; occasionally it arises from the external iliac. 

Lassa fever, influenza A and B, and respiratory syncytial virus (RSV) | NEET Based MCQ

Which of the following antiviral agents is a purine nucleoside analogue that has shown promise with Lassa fever, influenza A and B, and respiratory syncytial virus (RSV).

A. Amantadine 
B. Rimantadine
C. Vidarabine 
D. Ribavirin

The answer is: D

 As an intravenous agent, ribavirin is effective against Lassa fever in the first week of onset of the disease. It may also be administered as an aerosol that is quite useful in infants with RSV. Unlike amantadine, which is efficacious only with influenza A, ribavirin has activity against both influenza A and B if administered by aerosol in the first 24 h of onset.

HIV – positive patient with a viral load of 750.000 copies of HIV RNA/ml | NEET Based MCQ

HIV – positive patient with a viral load of 750.000 copies of HIV RNA/ml and a total CD4 count of 50 is at an increased risk for a number of infectious diseases. For which of the following diseases the paitent has no added risk than an immune complete host?

A. Pneumocystic pneumonia 
B. Mycobacterial diseas
C. Kaposi’s sarcomad. 
D. Pneumococcal pneumonia

The answer is: D

A low CD4 count does not predict progression to AIDS but does indicate increased chance of opportunistic infection such as those listed. Kaposi’s sarcoma, which has been linked to herpesvirustyp 8, pneumocystis, and mycobacterial disease are three of the most prevalent opportunistic infections.  While HIV-positive patients contract pneumococcal pneumonia, they are probably at no more risk than the general population, as protection against pneumococcal disease is linked to the presence of anticapsular antibody.

Merkel cell carcinoma | NEET Based MCQ

Merkel cell carcinoma is due to 

A. Cytokeratin: 7 
B. Cytokeratin: 19 
C. Cytokeratin: 20 
D. Cytokeratin: 18

The answer is C. Cytokeratin 20:

•   Merkel cell carcinoma (MCC) [trabecular carcinoma, small cell carcinoma of the skin, primary cutaneous neuroendocrine carcinoma] is a rare, aggressive, primary skin cancer exhibiting neuroendocrine differentiation.

•   The histogenesis of MCC is controversial. Possible cells of origin include the epidermal MC, a dermal MC equivalent, a neural-crest-derived cell of the amine precursor uptake and decarboxylation (APUD) system, and a residual epidermal stem cell.

•   Cytogenetic abnormalities are present in 30-47% of MCCs. The most frequent change is loss of heterozygosity due to translocations or deletions of chromosome 1; specifically, 2 distinct regions in the most distal band 1 p36 on the short arm of chromosome 1 are implicated in MCC. Similar abnormalities near this site occur in several neuro cystic tumors, including melanoma, neuroblastoma, and pheochromocytoma. Other abnormalities described in MCC include losses at chromosomes 3, 13, and 22 and partial trisomy 01 chromosomes 1, 11, 18, and X. Unlike neuroendocrine (small cell) carcinoma of the lung, gene amplifications are rare in cutaneous MCC.

•   Cytokeratin 20 is expressed in a dot like paranuclear or crescentic pattern; other low molecular weight (MW) cytokeratin antibodies (E.g., CAM5.2, MNF116), white less specific, react in a similar localization pattern.

•   Electron microscopic findings are characteristic, revealing a lobulated nucleus that may contain rodlets. The cytoplasm is electron-lucent and contains a prominent Golgiapparatus and numerous ribosomes. Intermediate filaments are numerous and often assume a parallel or whorled arrangement near the nucleus, accounting for the dot like pattern of cytokeratin distribution visualized by immunohistochemistry. Desmosomes may be present. Most diagnostic is the dense core granule (80-120 mn in diameter), the source and the locus of the neuroendocrine peptides. 

Chromosome analysis of the fetus | NEET Based MCQ

All of the following can be used to determine a chromosome analysis of the fetus except

A. Amniocentesis 
B. Chorionic villus sampling
C. Percutaneous umbilical blood sampling (PUBS)
D. Fetal umbilical Doppler velocimetry

The answer is D

Fetal tissue for chromosome analysis can be obtained via amniocentesis, chorionic villus sampling (CVS), percutaneousumbilical blood sampling, or direct biopsy of fetal muscle or skin. Amnio- centesis involves obtaining a sample of amniotic fluid, which contains fetal fibroblasts. Chorionic villus sampling involves taking a biopsy of the placenta. In the case of PUBS, the umbilical vein is punctured under direct ultrasound guidance near the placental origin and blood is obtained for genetic analysis. Doppler velocimetry is an ultrasound technique used to examine blood flow through the umbilical artery. IUGR has been associated with abnormal umbilical artery Doppler velocimetry. Therefore, this technique is used with other modalities such as BPP and NSTS to monitor fetal wellbeing.