NEET-PG 2022 PYQs – Integrated Quick-Review Notes
Anatomy
Abdomen – Embryologic derivatives of ventral mesentery
Ligament tagged A on image ➜ gives rise to falciform ligament.
Mechanism: ventral mesogastrium splits into (i) lesser omentum; (ii) falciform ligament — carrying the obliterated umbilical v.
Lower limb – Cutaneous innervation in varicose-vein surgery
Medial leg & foot sensory loss ⇒ injury to saphenous nerve (pure sensory branch of femoral).
Histology – Endocrine pancreas
Photomicrograph of pale-staining cell clusters within exocrine acini → Islets of Langerhans (Pancreatic islets).
Cartilage identification
Dense parallel collagen bundles + chondrocytes in rows → White fibro-cartilage (e.g.intervertebral disc).
Anaesthesia
COVID-19 oxygen therapy
Image = Non-rebreathing mask (reservoir bag, one-way valves; FiO2 ≈ ).
Neuromuscular monitoring
TOF peripheral nerve stimulator usually placed on ulnar nerve (adductor pollicis twitch).
Blocks & monitoring key points
Ulnar nerve – easiest access at wrist; reflects diaphragmatic recovery late → safest extubation criterion.
Biochemistry
HMP shunt & G6PD
Primaquine-induced haemolysis in G6PD deficiency (Mediterranean variant) – rate-limiting step of HMP pathway.
Fatty-acid transport
Carnitine shuttle carries long-chain acyl-CoA across inner mitochondrial membrane.
Autosomal-recessive disorders
Classic example: Cystic fibrosis (CFTR on 7q31; F508 ΔF deletion).
Point mutations
Base change → stop codon = nonsense mutation.
Telomere theory of ageing
Progressive telomere shortening (↓ length) correlates with cellular senescence.
ETC inhibitors
Cytochrome oxidase (Complex IV) blocked by cyanide → histotoxic hypoxia.
Key enzyme assays
RBC glutathione reductase activity (FAD dependent) screens vitamin B2 (riboflavin) deficiency.
Glycogen storage disease type V (McArdle)
Exercise intolerance, cramps → myophosphorylase deficiency.
Gaucher disease
“Crumpled tissue paper” macrophages ⇒ deficiency of β-glucocerebrosidase.
Warburg effect in cancer
Tumours favour aerobic glycolysis → provides anabolic intermediates for rapid proliferation (not more ATP).
Dermatology
High-risk HPV
Oncogenic serotypes 16 & 18; question listed 18 as correct.
Mycetoma
Discharging sinuses + grains; may be eumycetoma (fungal) or actinomycetoma (bacterial).
Chromoblastomycosis
Verrucous “cauliflower” lesion; sclerotic/copper-penny bodies on microscopy.
Nail pitting + subungual hyper-keratosis → Psoriasis.
Post-covid diffuse hair loss → Telogen effluvium (stress-triggered shift).
Acanthosis nigricans + obesity
Suggests underlying metabolic syndrome / insulin resistance.
ENT
Serous otitis media (OME)
Retracted dull TM with fluid; common in 5-yr child hearing loss.
Ossicle identification
Image of incus (anvil) – body + long/short process.
Facial nerve palsy
Inability to close eye, mouth angle droop ⇒ LMN VII lesion.
Heimlich manoeuvre
Abdominal thrusts for conscious choking adult.
Age-related hearing loss
Presbycusis starts at base of cochlea near oval window (high-frequency).
Juvenile nasopharyngeal angiofibroma
Teenage male, epistaxis, nasopharyngeal mass extending thru choana.
Samter triad (asthma + nasal polyps + aspirin sensitivity) ⇒ avoid aspirin/NSAIDs.
Forensic Medicine
Lead poisoning enzyme block
Inhibits ALA-dehydratase (and ferrochelatase) → anaemia, neuropathy.
Thallium poisoning
Alopecia, neuro/GI Sx, Mees lines; mimics arsenic but with loss of lateral eyebrows.
Shot-range pistol wound
Soot/blackening, muzzle imprint → close shot by handgun.
Defense wounds
Incised cuts on palm/forearm when warding off assault.
Ligature strangulation
Horizontal mark completely encircling neck below thyroid; no salivary dribble.
Criminal negligence (IPC )
Drunken surgeon injures patient ⇒ culpable under criminal negligence.
Leading questions permitted only in cross-examination.
Consent
Detailed procedure explanation + agreement → Informed consent.
Medicine
CSF pattern – Tuberculous meningitis
Lymphocytic pleocytosis, ↓ glucose (< serum), ↑ protein; fibrin web on standing.
Acute migraine abortive therapy
Sumatriptan (5-HT1B/1D agonist).
Sarcoidosis
Fever, night sweats, bilateral facial palsy, hilar LAD (“Löfgren” or neurosarcoid).
IE prophylaxis not needed
Isolated ASD (low flow, endothelialization).
Paracetamol toxicity
Treat within h with N-acetylcysteine (restores hepatic glutathione).
AF – JVP sign
Irregularly irregular pulse → absent a-wave on JVP.
SBP diagnosis
Ascitic PMN >250/mm^3 (here >650) without secondary source.
Obstructive pattern LFT
↑ bilirubin + ↑ ALP with near-normal AST/ALT => cholestasis.
RHD prophylaxis
No carditis: benzathine penicillin IU IM every 3 wk for 5 y or till y.
MEN 2B lacks hyper-parathyroidism; features: mucosal neuromas, marfanoid, pheo, MTC, megacolon.
VT in CAD
Treat haemodynamically stable monomorphic VT with IV amiodarone.
Brugia malayi microfilaria
Sheathed; two terminal nuclei in tail tip.
DKA first step
Isotonic fluids + regular insulin infusion concurrently (after K+ status).
HAART monitoring
Plasma viral load best for efficacy; CD4 for immune status.
Flash pulmonary oedema (HT crisis)
Rx: IV nitrates (↓ preload/afterload) + furosemide.
TCA cardiotoxicity (wide QRS, R axis) → antidote IV NaHCO3.
Community pneumonia on CT – Consolidation w/ air bronchograms.
Tumour lysis syndrome
First line prophylaxis = aggressive hydration; rasburicase if established hyperuricaemia.
Pituitary macroprolactinoma
Medical first-line: bromocriptine/cabergoline (dopamine agonist).
Lupus nephritis
Systemic features + RBC casts; confirm via renal biopsy ("wire-loop").
Hypokalaemia ECG
Flat/ inverted T, U-waves. Caused by diuretics/vomiting.
ABG – Respiratory acidosis
pH <7.35, ↑ pCO2 with compensatory ↑ HCO3.
MDR-TB resistant to isoniazid + rifampicin.
Acute hepatitis-B
HBsAg +, Anti-HBc IgM +, Anti-HBs –.
Iron poisoning
Defuroxamine chelation; 1-4 h GI, latent, shock, hepatic failure.
Yellow fever vaccine
Live-attenuated 17-D strain; lifelong immunity.
Epidemic typhus
Louse-borne; caused by R. prowazekii.
Microbiology
Trichophyton rubrum
Produces red reverse pigment; pencil macroconidia.
Candida speciation
CHROMagar differentiates by colony colour.
Leptospira interrogans
Weil disease: jaundice + calf myalgia + conjunctival suffusion.
Cholera toxin
B-subunit binds GM1 ganglioside → ADP-ribosylation of Gsα ↑ cAMP.
C. difficile detection
2-step: GDH-EIA + toxin A/B EIA/NAAT.
Mucorales (Rhizopus/Mucor) pneumonia
Right-angle, non-septate hyphae; risk DKA/ immunosuppressed.
C. difficile facts
Toxin-mediated pseudomembranous colitis; Dx by GDH+toxin not IgM.
Penicilliosis marneffei
Dimorphic fungus; red pigment on SDA, endemic S-E Asia; seen in HIV with lymphadenopathy.
Obstetrics & Gynaecology
HELLP syndrome
Haemolysis (↑LDH), Elevated liver enzymes, Low platelets in pre-eclamptic woman.
Renal agenesis → Oligohydramnios (amniotic fluid formed by fetal urine after wk).
MgSO4 toxicity
Loss of DTR, RR <, oliguria; antidote Ca gluconate .
Septate hymen identification.
Post-VVF repair instructions
Abstain from intercourse mo; avoid pregnancy y.
Cu-T absolute c/i
Current trophoblastic disease (molar).
HSG – Septate uterus (central linear defect).
Preeclampsia pathogenesis
Failure of invasion of spiral arteries by extravillous trophoblasts → high-resistance flow.
Uterine artery Doppler at wk screens early-onset pre-eclampsia.
Placenta partial separation + haemorrhage post-controlled cord traction → go for manual removal.
Amniotic fluid embolism causes sudden DIC & collapse.
Obstructed labour – Occipito-transverse at zero station in multigravida → LSCS safest.
Active labour definition
Cervical dilatation with regular pains.
Pelvic mid-plane (blue area in figure) includes ischial spines; obstetric mid-pelvis.
Uterine involution
Day-2 fundus 1 finger below umbilicus (1 cm/day descent).
Extra kcal in pregnancy
Additional kcal in 2nd trimester, in 3rd (ICMR).
Cerclage contraindication
Membrane prolapse out of OS.
ROP vertex ROP management
Adequate pelvis, early labour → allow normal vaginal delivery; OA rotation may occur.
Classical CS scar + breech at 35 wk → repeat elective CS at .
Placenta previa – implantation over internal os → painless 3rd-trim bleed.
PUL (pregnancy of unknown location)
β-hCG <1500, empty uterus → repeat hCG after h.
Lactating heavy bleeding – POP pill
Low-dose COC not suitable; **progesterone-only pill (Mala? actually POP *Mala-N (COC) unsuitable)*. Here answer given Mala – combined OCP? (NEET answer 3).
Sertoli-cell-only syndrome
Testis biopsy w/o germ cells; causes non-obstructive azoospermia.
Medical abortion up to wk
Mifepristone 200 mg PO day-1 + Misoprostol 800 µg PV/SL after 24 h.
hCG from placenta stimulates fetal Leydig → testosterone surge for male differentiation.
HELLP management, obstetric emergencies etc (see above).
Ophthalmology
Pseudo-exfoliation glaucoma
Gray-white dandruff-like deposits on lens rim.
Sympathetic ophthalmia
Bilateral granulomatous panuveitis after penetrating trauma.
PDR with NVD
Indication for pan-retinal photocoagulation.
Rheumatoid scleritis subtype
Scleromalacia perforans – painless thinning.
Corneal collagen cross-linking
Indicated for progressive keratoconus.
Cherry-red macula in Tay-Sachs – GM2 gangliosidosis.
Orthopaedics
Multiple enchondromatosis (Ollier)
Multiple metaphyseal lucencies on X-ray.
Peri-articular knee spanning external fixator for complex fractures.
Fat embolism syndrome
Triad: hypoxaemia, neuro signs, petechiae 24-72 h post long-bone fracture.
OI prenatal – in-utero fractures 13 wk USG.
Untreated congenital radial head dislocation leads to cubitus valgus.
Osteomyelitis in sickle cell → Salmonella.
Clavicle fracture – supports elbow, head tilt.
Bimalleolar ankle dislocation – first step closed reduction after NV eval.
Pathology
NETs contain nuclear chromatin + granule enzymes; not mitochondrial DNA.
Malakoplakia of bladder
Yellow plaques; Michaelis-Gutmann bodies (laminated inclusions).
Ageing interventions
30 % calorie restriction increases longevity (shown in rodents).
Iron deficiency anaemia next test
Check serum ferritin.
CML
Philadelphia chromosome t(9;22)(q34;q11) BCR-ABL.
COVID ventilator lung pathology
Diffuse alveolar damage with acute & organising haemorrhage.
Paroxysmal nocturnal haemoglobinuria
Intravascular haemolysis → hemosiderinuria; exam may show splenomegaly.
Warburg effect rationale covered earlier.
Pharmacology
Theophylline diuresis
Via adenosine A1 receptor blockade in proximal tubule.
Pulmonary fibrosis ADRs
Bleomycin, nitrofurantoin, methotrexate; metformin does NOT.
Warfarin skin necrosis
Protein C depletion; presents after d.
Metoclopramide extrapyramidal reactions due to D2 blockade.
Orlistat ADR → vitamin K deficiency (fat-soluble malabsorption).
Fluoroquinolones inhibit DNA gyrase/topoisomerase II → tendinopathy.
Digoxin toxicity
Give Fab fragments.
Hyperkalaemia shift into cells
β2 agonists (e.g., epinephrine, salbutamol), insulin + glucose, NaHCO3.
Octreotide first-line adjunct for residual acromegaly; pegvisomant GH-receptor antagonist.
PCSK9 inhibitor – evolocumab/alirocumab – ↑ LDL-R recycling.
Physiology
Large myelinated A-fibres more pressure-sensitive than unmyelinated C → transient motor paresis without sensory loss.
Baroreceptor reflex negative feedback maintaining MAP.
Paracrine signalling – local mediator to neighbouring cells.
Cystometrogram explanation
Segment Ib plateau due to Law of Laplace (wall tension).
Thermoregulation reset (fever)
Stage A: vasoconstriction ↓ skin blood flow (cold sensation).
Hemiballismus
Lesion of contralateral subthalamic nucleus.
Psychiatry
Bulimia nervosa
Binge-purge cycles, normal BMI; risk of electrolyte disturbances.
Post-partum blues
Onset days, resolves within days, mild mood lability.
Radiology
PET-CT fusion image – shows metabolic activity (FDG uptake).
Tension pneumothorax after RTA
Immediate needle decompression / chest tube insertion.
Paediatrics
New-born anuria < h – continue breastfeeding; observation unless >48 h.
IMNCI dehydration classification
Lethargic, sunken eyes, skin pinch slow ⇒ severe dehydration (Plan C).
Tumour lysis – TLS prophylaxis
Hydration → allopurinol; treat with rasburicase if uric acid high (question asked next step = hydration first).
Intussusception
Target sign; therapeutic barium/air enema.
Congenital hypothyroid screen
If TSH>, do technetium scan to detect ectopic/agenesis.
West syndrome
Infants with flexor spasms + hypsarrhythmia; ACTH therapy.
Early infant HIV diagnosis
DNA-PCR on dried blood spot at 6 wk / when symptomatic.
Duchenne muscular dystrophy
Death in 3rd decade due to cardiomyopathy; X-linked dystrophin.
Risk babies criteria
Artificially-fed & single-parent babies flagged for extra follow-up.
Minimal-change disease nephrotic
Selective proteinuria, EM: podocyte effacement, steroid-responsive.
Celiac disease
HLA-DQ2/8 positivity; advise gluten-free diet.
Foreign-body airway partial obstruction
Ball-valve causes unilateral hyperinflation; rigid bronchoscopy removal.
Bladder exstrophy
Midline infra-umbilical defect with exposed mucosa.
Surgery
Parathyroid injury post thyroidectomy – check Ca, PO4, PTH (perioral numbness).
Thromboelastography (TEG) monitors intra-op coag status.
Peau-d’orange in breast Ca due to lymphatic dermal invasion.
Abdominal stab with omentum evisceration – mandates laparotomy even if stable (peritonism).
Subarachnoid haemorrhage classically from rupture of berry aneurysm.
Doppler US to evaluate acute limb ischaemia.
PUJ obstruction – delayed IVU with hydronephrosis, no ureteric contrast.
Membranous urethra injured in pelvic fractures; blood at meatus + inability to void.
Tender pulsatile groin swelling – evaluate with Doppler before intervention (pseudo-aneurysm).
Rule of nines paediatric burns – preschool child head , each leg ; depicted ~ TBSA.
Stage 4 pressure sore – full thickness tissue loss with exposed bone/tendon.
**Intraperitoneal abscess commonest in *subhepatic (Morrison pouch)*.
Fistula-in-ano chronic discharging track near anus.
Triage green tag = ambulatory/minor injuries.
Roux-en-Y etc not covered here.
Ischemic mid-gut perforation sign on X-ray free gas – proceed to resuscitation & laparotomy.
Orthopaedic Oncology & Misc
Ilizarov vs spanning fixator clarification – knee peri-articular fracture uses spanning.
Community Medicine
QALY
Quality-adjusted life years = gain in life expectancy × utility ( QALY).
Disaster preparedness at PHC
Stock resources + community awareness + mock drills (simulation).
Rabies control
Mass dog vaccination + stray control most cost-effective.
WHO STEPwise survey
Steps: 1-questionnaire (behaviour), 2-physical, 3-biochemical; therapeutic assessment not included.
NTEP treatment outcomes
Negative sputum at end → cured.
RR < in cohort
Green-tea appears protective (RR).
Urban CHC criteria
100-bedded secondary care in metro tier.
Broken vial disposal
Go to puncture-proof blue/white (sharp) container.
JSY incentives urban MP
₹ to mother + ₹ to ASHA.
UNICEF provides seeds & manure in Applied Nutrition Programme.
Case-control controls
Should come from same population at risk but disease-free (exposed/unexposed).
MR vs pentavalent open vial policy
Multidose MR cannot be reused; pentavalent discarded once opened if session ends. Use pentavalent & discard MR.
Miscellaneous Integrated Qs
Anesthetic patch on face in leprosy – greatest cranial nerve involvement is facial (VII) causing lagophthalmos (per question answer 2).
These bullet-point notes collate the essential facts, pathophysiologic explanations, diagnostic criteria, management algorithms, public-health applications, and exam-relevant numerical cut-offs referenced across the entire set of NEET-PG 2022 previous-year questions.
Use them as a quick-review scaffold; expand each bullet with standard textbooks (Gray’s, Ganong, Harrison, Park, etc.) and integrate with clinical practice guidelines (ACLS, WHO, NTEP) for a thorough prep.