Gt 12 Neet Pg

Question 1

Bal swasthta karyakram- 4 D’s???

Answer 1

Birth defects
Developmental delay
Deficiency
Disability

Not diagnostic services

For birth to 18yrs- to reduce morbidity and mortality

Question 2

SLE vegetations
And others

Answer 2

SLE- libmannsacks- small- medium sized on either side
IE- large friable on cusps
RHD- small warty along the line of closure
Non bacterial thrombotic endocarditis- small,single/multiple along line of closure

Question 3

Warfarin moa andcomplications; treatment of complications

Answer 3

MOA- inhibit vitamin k epoxide reductase- inhibit VIT k dependant clothing factors- 2,7,9, 10, protein C and S
Complication-
① warfarin induced skin necrosis- stop warfarin and start another anticoagulant like heparin + vit k
② purple toe syndrome
③ Fetal warfarin syndrome

Question 4

Murmur comes after lubb and before dubb.. Caused by

Answer 4

Lub- s1- closure of mv & tv- start of systole
Dubb- s 2- closure of semi-lunar values
Murmur b/n lubb & dubb - systolic murmur-MR & AS
Murmur during diastole - MS & AR

Question 5

Patient with heart disease presents to emergency with computing blurring of vision, greenish tinge over objects.. what is the Durg causing this complication and serum electrolyte changes due to this drug

Answer 5

Greenish yellow tinge means xanthopsia, ventricular arythemia in heart pt- digitalis toxicity
Digoxin inhibit Na K+ ATPase- reducing sodium influx - serum electrolyte complication would be hyperkalemia, also calcium accumulates inside cell

Treatment - lignocaine

Question 6

Joint pain, diffuse rash, lethargy in a patient who is being treated for tb.. What drug causes this and due to inhibition of which enzyme?-

Answer 6

The condition is drug induced lupus - caused by isoniazid
* due to reduced activity of N-acetyl transferase 2
Drug induced lupus -
Ship drugs
Sulphonamides
Hydralazine
Isoniazid
Procainamide

Ship drugs metabolised by acetylation

Question 7

Reflexes before birth in child

Answer 7

Palmar grasp- starts 28th week of gestation — ends 2-3 months postnatal
Rooting reflex— 32 week of ga — 1 month postnatal
Moro— 35-36 week of GA— 5-6 month postnatal
Tonic neck reflex— 35-36 month ha— 3-4 month postnatal

Question 8

Acanthosis Nigricans treatment

Answer 8

First line - topical retinoids
Second line - topical keratolytics-salicylic acid
Third line- oral isotretinoin

Question 9

Pt exercise at high altitude what are the changes occur to him with respect to 2,3 BPG and oxygen dissociation curve

Answer 9

Exercise @ High altitude require more oxygen
At high altitude there is low po2.. The chemoreceptors increase ventilation
↓
Leads to co2 elimination
↓
Increase pH ( respiratory alkalosis)
↓
Compensatory metabolic acidosis occurs

• No. oxygen in muscle, all pyruvic acid converted into lactic acid, leads to fatigue

*to release more o2 , there is increase in 1,3BPG and 2,3 BPG, right shift of oxygen dissociation curve

• increase in erythropoietin due to hypoxia

Question 10

Pt with palpable breast swelling
Histo pathology shows - dyscohesive infiltrating tumor cells and signet ring cells with intracytoplasmic mucin droplets
Immunohistochemistry shows luminal group

Likely diagnosis??

Answer 10

Invasive lobular carcinoma

ER +be her2 -ve
CDH 1 gene loss of function - No e-cadherin - dyscohesive tumour cells

Question 11

Why saline solution preferred over dextrose for kick administration in hypokalaemia

Answer 11

Dextrose induce insulin which worsens hypokalemic

Question 12

Other tests used as alternatives for babinsky sign??

Answer 12

Gordon sign- squeezing calf - extension of great toe - abnormal
Chaddok’s - stroking skin below lateral malleolus
Oppenheim’s - stocking of tibial surface

+ve babinsky in UMN lesions

Question 13

Provocative tests of thoracic outlet syndrome

Answer 13

Adsons test
Halstead test
Wright test
Roos hyperabduction test

Question 14

Ecoli strains
1. ETEC
2. EIEC
3.EHEC
4.EPEC
Mention their pathogenesis

Answer 14

1. ETEC- travelers diarrhoea-
   LT toxin- increase CAMP
   ST toxin- increase CGMP
2. EIEC - invades interstitial epithelial cells- resembles shigellosis
   3.EHEC - shiga like toxin
   4.EPEC- infantile diarrhoea, adherent and effacement of microvilli
3. EAEC- persistent diarrhoea- stacked brick pattern

Question 15

Scoliosis defined on which angle
Types of splints used in scoliosis

Answer 15

Scoliosis- cobb’s angle >10 degree

Types of splints
1. Milwaukee brace- cervico- thorasic - lumbar- sacral orthosis
2. Boston brace- thoracic lumbo sacral orthosis
3. Charleston bending brace- thoracic lumbo sacral orthosis
4. SOMI- cervico thorasic orthosis

Question 16

Post menopausal bleeding + elevated oestrogen
Probable cause ??

Answer 16

Ovarian malignancy most likely

Granulosa cell tumour, Thecoma - from granulosa cells and theca cells- produce oestrogen

Question 17

Marbling is an external sign of??

Answer 17

Putrefaction

Question 18

Sequence of structures that would be visualised anterior to posterior in normal angle width on gonioscopy

A. Schwalbes line
B. scleral spur
C. Trabecular mesh work
D. Anterior part of ciliary body

Answer 18

A, C, B, D

Question 19

Fish odour syndrome?
Vitamin which helps in alleviate his symptoms??

Answer 19

Fish odour syndrome- trimethylaminuria
VIT. B2 / riboflavin improves the pt. Symptoms

Question 20

Characteristic X-ray finding in meconium aspiration syndrome

Answer 20

Patchy infiltrates a coarse streaking

Question 21

Radiological features of
1. Congenital diaphragmatic hernia
2. Respiratory distress syndrome

Answer 21

1. Congenital diaphragmatic hernia- bowel loops in thorax, mediastinal shift
2. Respiratory distress syndrome- air bronchogram, ground glass opacities symmetric, low lung volume

Question 22

What are the anterior and posterior layers covering the lower third of rectum

Answer 22

Ant- DENONVILLIERS’ fascia
Post- waldeyers fascia - develop from presacral fascia- and divides retro rectal space into superior and inferior compartments

Rectal proper fascia- covers mesorectum

Question 23

Pt with metabolic condition present with progressive shoulder pain with painful restriction of abduction and restriction with normal xray
What is the condition of
What do u access

Answer 23

Diagnosis frozen shoulder
Can be idiopathic, or d/t DM
So Should access HbA1C

Question 24

5yr boy presented with well defined mass with irregular borders and involving adjacent orbit. Biopsy showed small round cells +ve four reskin

Diagnosis and origin of tumour???

Answer 24

Diagnosis- rabdomyosarcoma
Origin from - striated muscle

They rapidly increase in size involving adjacent structures and also +ve for desmin
Most specific- myoglobulin

Question 25

Which neuromuscular blocking drug is not reversed by sugammadex ( antidote for NMD)

Answer 25

Mivacurium