NEET-PG 2023 Recall (PYQs) – Integrated Bullet-Note Compendium

Microbiology (Q 1-10)

  • Dengue – classical clinical triad & lab clues (Q1)
    • High-grade fever + arthralgia + extensive petechiae → capillary leak & thrombocytopenia.
    • Labs: Hb 9 g/dL9\,\text{g/dL} (hemoconcentration absent yet), WBC 9,000/mm39{,}000/\text{mm}^3, platelets 20,000/mm320{,}000/\text{mm}^3, prolonged bleeding time with normal clotting time = platelet dysfunction, not coagulation factor loss.
    • DDx ruled out: malaria (no hemolysis + normal BT/CT), scrub typhus (eschar), typhoid (rose spots, neutropenia).
    • Take-home: thrombocytopenia + petechiae + normal CT → think Dengue.

  • Trichomonas vaginalis pearls (Q2)
    • Pear-shaped, flagellated trophozoite; no cystic stage.
    • Exhibits characteristic “twitching / tumbling” motility on wet mount (true statement).
    • Cultivable in Diamond’s medium; sexually transmitted; causes strawberry cervix.

  • Leishmania tropica – cutaneous CL (Q3)
    • Desert Belt (West Rajasthan).
    • Ulcer with erythematous margin; biopsy shows Leishman-Donovan bodies (dark nucleus + bar-shaped kinetoplast).
    • Trypanosoma/Babesia blood parasites; Histoplasma → intracellular yeast.

  • Cytomegalovirus – “owl-eye” cells in urine (Q4)
    • Large basophilic intranuclear inclusions.
    • Congenital infection → sensorineural deafness, chorioretinitis.
    • Differs from EBV (Downey cells) & HSV (Cowdry A).

  • Clonorchis sinensis & cholangiocarcinoma (Q5)
    • Oriental liver fluke, encysts in intra-hepatic ducts.
    • Chronic infestation → biliary inflammation, pigment stones, carcinoma.

  • Pneumocystis jirovecii pneumonia (Q6)
    • HIV pt, non-productive cough, weight loss; sputum culture negative (doesn’t grow on routine fungal media).
    • Gomori methenamine silver → crescent/boat-shaped cysts with central dot.

  • Leptospirosis – MAT as investigation of choice (Q7)
    • Sewage worker triad: jaundice, conjunctival suffusion, hemorrhage (Weil disease).
    • Microscopic agglutination test = gold standard serology.

  • Rotavirus – stool Ag detection (Q8)
    • ELISA/latex agglutination for VP6 antigen; rapid & sensitive.

  • Plasmodium falciparum – HRP-2 positive (Q9)
    • HRP-2 based RDT detects histidine-rich protein-2 produced only by P. falciparum.
    • Vivax diagnosed by pLDH & aldolase kits.

  • Haemophilus influenzae meningitis (Q10)
    • Pleomorphic gram-negative coccobacilli; chocolate agar with X & V factors.
    • Satellitism around Staph. aureus (choice 3 – true).
    • Non-lactose fermenter on MacConkey.

Radiology (Q 12-13)

  • Cephalhematoma vs. subgaleal etc. (Q12)
    • Confined by suture lines; parietal swelling since birth; resolves spontaneously.
    • Subgaleal crosses sutures; encephalocele connects intracranially.

  • Putty Kidney – renal TB (Q13)
    • Autonephrectomised, dense calcification replacing renal outline; ster­ile pyuria.

Anatomy (Q 14-18)

  • Deep inguinal ring defect → fascia transversalis (Q14).
  • TMJ articular disc attachment – lateral pterygoid (Q15).
  • Histology slide showing glomerulus (Q16).
  • PDA due to 6th left aortic arch persistence (Q17).
  • Urachus → median umbilical ligament from allantois (marker 4) (Q18).

Biochemistry (Q 20-33)

  • γ\gamma-Glutamyl carboxylase needs factors II,VII,IX,XII, VII, IX, X & protein C/S (Vit K) (Q20).
  • Pellagra triad → Vit B3 (niacin) deficiency (Q21).
  • McArdle (Type V) – muscle glycogen phosphorylase defect; exercise-induced cramps, low lactate (Q22).
  • Polished rice → Thiamine deficiency; RBC transketolase ↑ after TPP (Q23).
  • Wernicke (confusion, ataxia, ophthalmoplegia) – acute thiamine lack in alcoholics (Q24).
  • Glycogen synthase deficiency – no hepatic glycogen, fasting hypoglycemia (Q25).
  • Wet beriberi – edema, cardiomegaly due to thiamine lack (Q26).
  • Alcohol → ↑NADH/NAD⁺ ratio → hyperuricemia & hyperlactatemia precipitating gout (Q27).
  • Acrodermatitis, poor wound healing → Zinc deficiency (Q28).
  • Scurvy due to defective collagen hydroxylation (Vit C) (Q29).
  • Low insulin:glucagon → hormone-sensitive lipase activation (Q30).
  • Black urine → alkaptonuria (homogentisate dioxygenase) (Q31).
  • Avidin from raw eggs binds biotin → dermatitis, alopecia (Q32).
  • **Cherry-red macula without hepatosplenomegaly → Tay–Sachs (Hexosaminidase-A) (Q33).

Ophthalmology (Q 34-38, 176-180)

  • Right homonymous hemianopia → lesion in left optic tract (Q34).
  • Immature senile cataract → phaco + IOL (Q35).
  • Limbal dermoid in child (Q36).
  • Kayser–Fleischer ring → order serum ceruloplasmin for Wilson (Q37).
  • Corneal ulcer diagnosis → fluorescein dye under cobalt-blue filter (Q38).
  • Astigmatism produces “conoid of Sturm” (retinoscopy image) (Q176).
  • Congenital glaucoma – buphthalmos, photophobia, tearing (Q179).
  • **Index myopia – nuclear cataract increases refractive index; pt removes near glasses (Q180).

Surgery (Selected high-yield: Q 39-47, 51, 58, 60, 62, 63, 65, 70, 72, 75, 84, 85, 88)

  • Penile verrucous Ca without nodes → partial penectomy with adequate margin (Q39).
  • IO (tibial) access for rapid fluid resuscitation (Q40).
  • Fournier gangrene → mixed aerobes & anaerobes; early debridement, broad ABX, HBOT may help (Q41).
  • APR – ligation of sup. rectal a. may injure hypogastric plexus → sympathetic retrograde ejaculation & bladder dysfn (Q42).
  • Keloid – extends beyond scar, pruritic (Q43).
  • Post-lap hernia repair thigh pain → lateral cutaneous nerve entrapment (Q44).
  • GCS: E2 V3 M4 = 9 (opens to pain, inappropriate words, withdraws) (Q45).
  • Hydatid cyst liver – due to Echinococcus; PAIR / surgery; serology (Q46).
  • High AFP >400 + chronic alcohol → hepatocellular carcinoma (Q47).
  • Chronic pancreatitis with dilated duct >7 mm → longitudinal pancreaticojejunostomy (Puestow) (Q51).
  • Acute aortic dissection – pulse/BP differential, mediastinal widening (Q58).
  • Small amoebic liver abscess 25 cc → metronidazole (medical) (Q60).
  • Subdural hematoma – crescent shape, weeks after trauma (Q62).
  • Necrotizing fasciitis (Meleney) – repeated debridement; HBOT useful (so statement ‘no role’ is false) (Q63).
  • Direct inguinal hernia – weakness of conjoint tendon/posterior wall (Q65).
  • Hand–arm vibration syndrome – prolonged use of drills → vasospasm (“white finger”) (Q70).
  • Rectal juvenile polyp hamartoma causing painless prolapse bleed (Q72).
  • Trophic (neuropathic) ulcer over pressure points (Q75).
  • CEAP C4a – eczema / pigmentation with varicose veins (Q84).
  • Subarachnoid hemorrhage – perform CT angiography / DSA; nimodipine after confirmation (Q85).
  • **Corrosive strictures with complete dysphagia – feeding jejunostomy first (Q88).

Pharmacology (Highlights Q 64, 66, 68, 71, 73-78, 140-143)

  • Oral candidiasis from ICS → clotrimazole troches (Q64).
  • PPH in asthmatic – avoid Carboprost (PGF2α) (bronchospasm) (Q66).
  • Omapatrilat inhibits both ACE & neprilysin (acts on RAAS & natriuretic path) (Q68).
  • Amiodarone → pulmonary fibrosis, weight gain, fatigue (Q71).
  • Aspirin overdose – alkalinize urine with NaHCO3\text{NaHCO}_3 (Q73).
  • Clonidine withdrawal → rebound hypertension due to receptor up-regulation (Q74).
  • Allopurinol – xanthine oxidase inhibitor, ↓uric acid synthesis (Q76).
  • Oprelvekin (IL-11) – thrombopoietic in chemo-induced thrombocytopenia (Q77).
  • Losartan additionally blocks TxA2 receptors – ↓platelet aggregation (true statement) (Q78).
  • Digoxin toxicity 4 mg/dL; wait two half-lives ≈ 80 h before restart (Q140).
  • Atropine infusion → decreased sweating → hyperthermia (Q141).
  • **Alteplase – tPA promotes plasmin-mediated fibrin degradation (Q143).

ENT (Q 55, 57, 59, 123, 126, 128)

  • Frontal mucocele – delayed proptosis post trauma (CT opacified sinus) (Q55).
  • Total laryngectomy stoma picture (Q57).
  • Rinne −ve at low freq, +ve at 1 kHz → 30-45 dB conductive loss (Q59).
  • Fossa of Rosenmüller marked in nasopharynx image (Q123).
  • Tracheostomy tube not for routine upper airway exam (Q126 false).
  • **Referred otalgia in tonsillitis via glossopharyngeal tympanic branch (Q128).

Physiology (Q 83, 86, 87, 90, 99, 104, 110)

  • Functional residual capacity labelled on spirogram (Q83).
  • Heat stroke → anhidrosis (so sweating absent; option 3 ‘sweating’ would NOT be seen) (Q86).
  • Renal clearance graph: A glucose (reabsorbed), B bicarbonate (partially), C inulin (GFR), D PAH (secreted) (Q87).
  • Refractory period is from B to D on nerve AP curve (Q90).
  • Preterm RDS – ↑surface tension, ↓compliance (Q99).
  • Hyperkalemia depolarizes RMP → less negative (more positive) (Q104).
  • **Myocardial plateau phase (point marked) due to slow prolonged Ca2+Ca^{2+} influx (Q110).

Medicine (Selected high-yield Q 93, 96, 98, 101, 106, 109, 111, 114, 134, 135, 136, 137, 138)

  • Holosystolic apex murmur radiation to axilla → mitral regurgitation (Q93).
  • Ankylosing spondylitis – bamboo spine, enthesitis, uveitis (Q96).
  • Thyroid storm with asthma → rate control by diltiazem (non-selective β-blockers contraindicated) (Q98).
  • Chronic HBV high load + ↑ALT → start Tenofovir >40>40 weeks (Q101).
  • Rest tremor, rigidity, flat affect → basal ganglia lesion (Q106).
  • HSV encephalitis – temporal lobe affinity (Q109).
  • Subacute combined degeneration – B12 lack → dorsal columns + CST loss (Q111).
  • Prominent ‘a’ wave + mid-diastolic murmur → tricuspid stenosis (Q114).
  • Tall peaked T & U wave from hyper-K? No; spironolactone → peaked T, prolonged PR (Q134).
  • Lewy bodies in cortex + visual hallucinations → Dementia with Lewy bodies (answer keyed Parkinson variant) (Q135).
  • Central diabetes insipidus post-hypophysectomy → lifelong DDAVP (Q136).
  • Pancoast tumour – apical lung mass, Horner & C8/T1 pain (Q137).
  • **Podagra with normal urate early – acute gout (monosodium urate crystals) (Q138).

Pediatrics (Key Q 112-118, 181-183, 186)

  • DKA with shock – ABC + NS 20 mL/kg, insulin after 1 h (ISPAD) (Q112).
  • Best growth marker – 25 cm length gain in 1st year (Q113).
  • Congenital rubella triad: cataract, PDA, deafness (Q115).
  • Cystic fibrosis – sweat chloride >60 mEq/L (Q118).
  • Measles – Koplik spots, cephalocaudal rash (Q119).
  • Bordetella pertussis
  • Laryngotracheobronchitis (croup) – steeple sign, biphasic stridor (Q181).
  • Biliary atresia – conjugated jaundice + clay stools, portal fibrosis (Q183).
  • **Congenital CMV – periventricular calcification, HSM, thrombocytopenia (Q186).

Pathology (Highlights Q 170-197)

  • Gaucher disease – glucocerebrosidase deficiency; crumpled tissue macrophages (Q170).
  • Letulle technique – en masse evisceration tongue to prostate (Q171).
  • HSV PCR most sensitive for CSF (Q173).
  • Yellow rhombic crystals with picric acid → Barberio test for semen (sexual assault) (Q175).
  • Hereditary spherocytosis confirmed by osmotic fragility (Q182).
  • Membranous nephropathy in Hep B – subepithelial spike & dome (Q188).
  • Hodgkin vs. Burkitt jaw mass t(8;14) starry-sky → Burkitt (Q185).
  • Spike & dome already covered.
  • AML-M3 (APML) t(15;17) with Auer rods, DIC risk (Q197).
  • Hemophilia A/B – factors VIII, IX deficiency cause deep bleeds (Q198).
  • **Asbestos exposure → malignant mesothelioma (Q199).

PSM & Public Health (Selected Q 116-133, 189, 192, 200)

  • Lathyrism – β\beta-ODAP (BOAA) from Lathyrus sativus causing spastic paraparesis (Q130).
  • qSOFA = SBP ≤100, RR ≥22, GCS
  • Tracking phenomenon – BP rank stability from childhood (Q120).
  • Retrospective cohort – aniline dye & bladder Ca study (Q117).
  • Grey kit for cervical erosion/PID (syndromic STI) (Q124).
  • RDA – intake meeting 97–98%97\text{–}98\% needs (Q200).
  • Sputum-negative TB suspect → order CBNAAT per NTEP (Q189).
  • **Infant mortality rate = sensitive index of health care (Q192).

Forensic Medicine (Q 166-175, 187, 190)

  • Datura poisoning – anticholinergic (dry hot skin, urinary retention); antidote physostigmine (Q166).
  • Viper bite – painful bleeding, local necrosis, incoagulable blood (Q190).
  • Post-mortem caloricity >37 °C in septicemia, tetanus, pontine hemorrhage (Q187).
  • Strychnine – spinal convulsions with opisthotonus, consciousness preserved (Q178).
  • **Section 314 IPC – death of mother by act with intent to cause miscarriage (Q184).

Miscellaneous High-Yield Nuggets

  • **Tissue plasminogen activator MOA – converts plasminogen → plasmin, ⇒\Rightarrow fibrinolysis.
  • **ASHA workers – behavior change, nutrition counselling for pregnant women (Q122).
  • **HPV vaccination advice to teen daughter of Ca-cervix pt (Q157).
  • **Hysteroscopy preferred in Asherman’s (intra-uterine adhesions) (Q145).
  • **OHSS – enlarged cystic ovaries after gonadotropin stimulation (Q154).
  • **Polyhydramnios – SFH > gestation, tense, muffled FHS (Q144).
  • **Ectopic <4 cm, hCG <5000, stable → single-dose MTX (Q153).