NEET-PG-2018-Question-Paper-With-Solutions

Embryology & Development

Branchial arch nerves: $\text{Neural crest derivatives}$ .
Hard palate: keratinised epithelium + sub-mucosa + minor glands.
Vocal-cord tensor: $\text{Cricothyroid (SLN)}$ .
Ureteric bud: outgrowth of mesonephric duct.
Sibson’s fascia: thickening over lung apex – attaches to inner border 1st rib.
BMI lethal: $13\;\text{kg/m}^2$ (men).
Prosopagnosia = inability to recognise familiar faces.
Brown-Séquard: $\text{CL loss pain/temp}$ + $\text{IL motor}$ .
Va/Q $=\infty$ → ventilated / un-perfused (no gas exchange).
C-wave: bulging tricuspid in $\text{iso-vol contraction}$ .
Alpha waves: $8-13\;\text{Hz}$ seen relaxed, eyes closed.
Counter-current: no $\text{Na}^{+}$ outflow in thin ascending limb.

Anatomy – Miscellaneous

Iliolumbar lig: upper band to iliac crest; lower to sacrum; supports lumbosacral joint.
Neuro-retinal rim (ISNT): thinnest $\text{Temporal}$ .
Round lig keeps uterus anteverted.

Histology / Pathology

Weber syn: CL hemiplegia + IL III nerve palsy; NOT anterior cerebral peduncle.
Lateral medullary (PICA) occlusion.
Broca area: pars opercularis & triangularis (inf frontal gyrus).
Acute tonsillitis → glossopharyngeal nerve.
Aortic hiatus (T12): aorta, azygos, thoracic duct (not vagus).
Myasthenia gravis: auto-Abs block $\text{AChR}$ .
IgG C3b = main opsonin; Bernard-Soulier → $\text{GpIb}$ defect; PTEN → Cowden.
TRALI within $6\;\text{h}$ transfusion.
PNH: loss CD55/59.
Stellate granuloma: cat-scratch disease.
Flipped LDH 1>2 ⇒ MI.
Anaplasia = lack of differentiation.
Prolactinoma likely if PRL >200\,\text{ng/mL}.
Ammonium urate stones – laxative abuse.
Dactylitis – sickle cell.

Biochemistry & Molecular

Tyrosinosis: fumarylacetoacetate hydrolase deficiency.
Lesch-Nyhan: $\text{HGPRT}$ def.
Trimethylaminuria: $\text{FMO3}$ def.
Galactosemia: $\text{G1P uridyl-transferase}$ .
FA synthesis end product: palmitate.
DNA Pol I: mainly repair; not essential for bacterial replication.
Chaperones assist protein folding.
VMA ↑ in pheochromocytoma; HIAA ↑ in carcinoid.
Warthin-Finkeldey cells – measles.
Fishy odour with riboflavin def.

Pharmacology

Amphotericin B targets fungal cell membrane (ergosterol).
Emtricitabine: anti-HIV & anti-HBV.
Resistant rheumatic chorea → valproate.
pKa=pH ⇒ 50 % ionised.
Hydrocortisone physio dose: $10\,\text{mg/kg/day}$ .
Colchicine: microtubule inhibitor – blocks neutrophil migration.
Basiliximab: IL-2 R (CD25) antagonist.
Pirenzepine (M1) for peptic ulcer.
Risperidone → ↑ prolactin.
Metyrapone inhibits $11\beta$ -hydroxylase.
Prasugrel: pro-drug P2Y12 blocker.
Quinidine → QT prolongation / torsades.
Sacubitril: neprilysin inhibitor.
Niacin contra DM (raises glucose).
Endothelin via $\text{cGMP}$ pathway.
Tizanidine: central $\alpha_2$ muscle relaxant.
Apixaban: direct $\text{Xa}$ inhibitor.
Anaerobes intrinsically resist aminoglycosides.
Vancomycin = bactericidal; others listed bacteriostatic.
Senna → melanosis coli.
Catheter UTI + pneumonia → BL/β-lactamase inhibitor.
Mycoplasma resistant to β-lactams.
Tadalafil contraindicated with nitrates/vasodilators.
ACLS VF alt to epi: high-dose vasopressin.

Microbiology & Immunology

MR vaccine campaign: 9 mo – <15 y; India launched; replaces measles shot.
Aortic graft infection → Pseudomonas histamine fish poisoning.
Trimethoprim-sulfamethoxazole effective vs B. cepacia.
Shingles – VZV; urea breath test – H. pylori.
Hyperacute rejection: minutes (ABO mis-match).
HBsAg = Australia antigen.
Orbital mucor/aspergillus in DKA – Aspergillus common.
Sabin-Feldman dye test – toxoplasmosis.
Acute haemorrhagic conjunctivitis: Enterovirus 70.
Echinococcus granulosus definitive host = dog.
Actinomyces: sulphur granules.
IGRA uses whole blood.

Physiology

BMI lethal 13 men.
Hypovolemic shock: renal afferent constriction.
Glucose intestinal absorption by facilitated diffusion.
IGF-1 secreted by liver.
Ventilation–perfusion extremes: Va/Q 0 or ∞ no exchange.

Medicine (Cardio, Resp, Renal)

Very severe COPD (GOLD IV): \text{FEV1}<30\% + FEV1/FVC <70%.
Liddle syndrome: HTN + hypoK alkalosis.
Takotsubo cardiomyopathy = stunned myocardium post-stress.
Alternative shock drug VF: vasopressin.
ABI falsely ↑ in calcified arteries.
Sac aneurysm surgery threshold: abdominal aorta ≥ $5.5\,\text{ cm}$ .
AICD indications: VF, low EF, Brugada.

Surgery & Trauma

Parkland: $4 \times wt \times \%TBSA$ – give half first 8 h.
Posthumous child = born after father’s death.
Ectopic trigger for tracheostomy: airway FB obstruction.
CRVO → “100-day (neovascular) glaucoma”.
Intussusception US target; pyloric stenosis mass best felt during feed.
Fasciotomy cuts: skin + subcut + superficial + deep fascia.
Crohn: skip lesions; rectum often spared.
Pancreatitis chronic: alcohol 70%.
Fem-pop bypass best graft: PTFE stent-graft.

Obstetrics & Gynaecology

Mission Indradhanush excludes JE vaccine.
Four live vaccines interval $4\,\text{weeks}$ .
Quadruple screen: 15-20 weeks.
Fetal lungs: dexamethasone.
Shoulder dystocia sequence: after McRoberts → suprapubic pressure.
True hermaphroditism karyotype $46\,XX$ (ovotestis).
Acute fatty liver in 3rd trimester.
Fetoplacental circ. day 20-22.
Intrapartum epidural preferred in severe pre-eclampsia.
Preeclampsia antihypertensives: labetalol, hydralazine, methyldopa (not atenolol).

Paediatrics

TRALI within 6 h.
Aplastic crisis in sickle cell from Parvovirus B19.
Cutis marmorata: cold exposure.
Parkland calc: example 40% burns 50 kg → $4$ L first 8 h.

Community & Forensic

CPT (couple protection) ≥60 % to reach NRR 1.
Factory Act: < 14 y not employed; 48 h/week.
M’Naghten rule: IPC $84$ .
Sibson fascia covers lung apex
Locard: theory of exchange.

Radiology & Imaging

MRI: Vein of Galen malformation.
HSG unicornuate uterus: asymmetric banana cavity.
CT descending aortic dissection.
XR “pepper-pot” skull: Paget.
Struvite = $\text{MgNH}<em>4PO</em>4$ stones.

ENT & Ophthalmology

Severe conjunctivitis: Neisseria.
Auditory brainstem implant electrode: lateral recess 4th