NEET PG High Yield Questions for Medicine

To do well in the NEET PG exam, you need a smart study plan focusing on important topics. This blog provides a list of key questions in Medicine that are likely to be on the exam. By studying these questions and their explanations, you'll improve your understanding of Medicine concepts and feel more prepared and confident for the exam.

1. A 40-year-old patient presents with painless rectal bleeding. Proctoscopy is performed to investigate the source of bleeding, revealing internal hemorrhoids. Which of the following statements accurately describes Grade III internal hemorrhoids?

A. Only visible on proctoscopy

B. Veins prolapsing during defecation and show spontaneous reduction

C. Veins prolapse out during defecation and reduce only on digital repositioning

D. Veins prolapse out during defecation and do not reduce on digital repositioning

Correct Option C - Veins prolapse out during defecation and reduce only on digital repositioning:

In the grading system for internal hemorrhoids:

• Grade I: Veins are visible on proctoscopy.
• Grade II: Veins prolapse out, with spontaneous reduction.
• Grade III: Veins prolapse out, and they can be manually repositioned successfully.
• Grade IV: Veins prolapse out, and digital repositioning fails.

Incorrect Options:

Options A, B, and D: Are for grades I, II, and IV, respectively. 

2. Using the image below, identify the condition and mark the option that is not its causative factor.

A. Amyloidosis

B. Focal segmental glomerulosclerosis

C. Para-proteinuria

D. Membrano-glomerulonephritis

Correct Option C - Para-proteinuria is the odd option here:

• The image shows frothy and yellow-colored urine with proteinuria(turns yellow on-air exposure
• Albumin excretion rate (AER) /Urinary albumin creatinine (UAC) ratio is >3500 mg /gm = Nephrotic Range proteinuria
• Paraproteinuria, seen in multiple myeloma is more commonly associated with ‘severely increased albuminuria’ rather than nephrotic range proteinuria. Patients with multiple myeloma who develop nephrotic range proteinuria usually have a coexisting disorder such as amyloidosis.
• Note - The urine dipstick test is good at picking up the presence of negatively charged proteins such as albumin, but is not effective when it comes to picking up positively charged paraproteins. Hence, Urine dipstick might be falsely negative in patients with multiple myeloma.

Incorrect Options: Eliminated by the explanation of the above option

Options A, B, and D -  Are associated with nephrotic range proteinuria.

3. A 68-year-old male with a history of COPD presents to the ER with palpitations, shortness of breath, and dizziness. He is on long-term theophylline therapy. His heart rate is 120 beats per minute, blood pressure is 100/80 mmHg, respiratory rate is 24 breaths per minute, and SpO2 is 92% on room air. An electrocardiogram is performed, which is shown below:

Which of the following statements are true about the treatment of this condition?

A. DC shock is the preferred treatment of choice

B. Amiodarone cannot be given as a long term treatment modality

C. Verapamil acts on SA node and stabilizes the heart rate

D. Metoprolol when given causes stabilization of the membrane

Correct Option B- Amiodarone cannot be given as a long-term treatment modality:

• The combination of an irregular rhythm with varying P-wave morphologies in a patient on theophylline therapy for COPD is consistent with the diagnosis of Multifocal Atrial Tachycardia (MAT).
• Amiodarone, a class III antiarrhythmic medication with a membrane-stabilizing effect, can be recommended for the treatment of MAT. However, its potential for toxicity limits its use as a long-term treatment option.

Incorrect Options: 

Option A-DC shock is the preferred treatment of choice: DC shock is not the preferred treatment for Multifocal Atrial Tachycardia (MAT) because it is ineffective in the presence of theophylline toxicity and does not provide long-term benefit.

Option C- Verapamil acts on SA node and stabilizes the heart rate: Verapamil primarily acts on the AV node, not the SA node, and is not the preferred medication for managing MAT.Option D- Metoprolol when given causes stabilization of the membrane: Metoprolol works by blocking adrenaline's effects on the heart, but it does not directly stabilize the membrane. It is used to manage heart rate and symptoms in MAT.

4. A 60-year-old man with hypertension is complaining of feeling dizzy with palpitations and breathlessness. The blood pressure was 70/40 mm Hg and became unrecordable while ECG was being recorded, carotid pulse was also not detectable. What should be the first step in the management of this patient?

A. IV Amiodarone 150mg

B. IV Lasix 40mg

C. Defibrillation

D. Cardioversion

Correct Option C- Defibrillation:

The ECG shows broad QRS complex tachycardia called Monomorphic ventricular tachycardia.

• Since the blood pressure of the patient is crashing→ defibrillation needs to be done.
• since this monomorphic ventricular tachycardia (VT) is without a pulse, the first-line treatment is immediate defibrillation. This involves delivering a high-energy electric shock to the heart to terminate the arrhythmia and restore normal rhythm.

Incorrect Options:

Option A- IV Amiodarone 150 mg:

• IV Amiodarone is the drug of choice for monomorphic ventricular tachycardia if heart disease is present. However, since the patient is hemodynamically unstable at this moment, the first step in management should be to achieve hemodynamic stability.

Option B- IV Lasix 40 mg:

• IV Lasix is given in patients with left ventricular failure resulting in symptoms of volume overload, e.g. pulmonary edema causing shortness of breath, cough, and exertional fatigue.

Option D- Cardioversion:

• It is done in supraventricular tachycardia and is synchronous with the peak of R wave / carotid pulsations. 

5. Using the image below, Guess the diagnosis in this neonate and pick the option with the investigation of choice.

A. Double-contrast barium enema technique

B. Omnipaque contrast enema technique

C. Gastrograffin enema

D. Barium meal follow-through

Correct Option C- Gastrograffin enema:

• Meconium ileus-is the likely diagnosis. It which is one of the manifestation of cystic fibrosis
• Abdominal distension & delayed Passage of meconium(Normal < 48 hours)
• Investigation of choice: GASTROGRAFFIN enema
• Treatment of choice: GASTROGRAFFIN ENEMA
• As it Softens the stool

Incorrect Options:

Option A- Double-contrast barium enema technique:

Option B- Omnipaque contrast enema technique:

Option D- Barium meal follow-through:

Refer to the above explanations

Also Read: NEET PG Previous Year Question Papers of Last 6 Years

6. A 14-year-old male patient who has been having persistent coughing and difficulty breathing for the past 2 months attends the OPD. On chest auscultation, wheezing is present. Blood cell counts, serum electrolyte levels, and chest x-ray is normal. A sputum examination was done, showing the following finding. What is the most likely diagnosis?

A. Tuberculous cavity

B. Asthma

C. Chronic bronchitis

D. Bronchiectasis

Correct Option: B - Asthma:

• The patient presentation is most consistent with asthma
• Curschmann’s spirals refer to the spiral-shaped mucus plugs from the subepithelial mucous gland ducts of the bronchi, seen in the airways of asthmatics
• They are often seen in association with Creola bodies and Charcot-Leyden crystals

Incorrect Options:

Options : A, C and D - They are not associated with Curschmann's spirals on sputum examination

7. What cardiac manifestation is least likely manifested in a 50-year-old female patient presented to the cardiology clinic with complaints of chest pain and shortness of breath.Upon examination, you notice that her nose appears pinched, and her lips are tightly approximated. Additionally, her facial expression seems diminished , you also note the presence of a pericardial friction rub and the following as shown in the image?

A. Dilated cardiomyopathy

B. Sick sinus syndrome

C. Pericarditis

D. Diastolic malfunction of the heart

Correct Option A - Dilated cardiomyopathy:

• Systemic sclerosis can lead to various cardiac manifestations however it does not manifest Dilated cardiomyopathy.

Incorrect Options:

Option B, C and D are associated with systemic scleroderma

8. A patient has presented to the clinic after experiencing a stroke. He is having difficulty processing simple calculations, has impaired writing, and is unable to name individual fingers. Additionally, he is unable to distinguish between the examiner's right and left arm. What is his likely diagnosis?

A. Charles Bonnet syndrome

B. Cotard's syndrome

C. Korsakoff's syndrome

D. Gerstmann’s Syndrome

Correct Option:

Option D- Gerstmann’s Syndrome:

Gerstmann’s Syndrome is characterized by a constellation of symptoms including:

• Difficulty processing simple calculations (acalculia)
• Impaired writing ability (dysgraphia)
• Difficulty distinguishing between fingers (finger anomia)
• Inability to distinguish between right and left sides of the body (right-left disorientation).

These symptoms typically result from damage to the dominant parietal lobe of the brain, often due to a stroke or other neurological conditions.

Incorrect Options:

Option A - Charles Bonnet syndrome:

• Charles Bonnet Syndrome (CBS) is a medical condition that causes complex visual hallucinations along with visual field loss or visual acuity loss. This disease affects people with visual impairment or vision loss, and the pathways leading to CBS can involve any part of the visual pathway, including the brain, optic nerve, or eyes.

Option B - Cotard's syndrome:

• Cotard’s syndrome is a series of delusions where one believes they have lost organs, blood, body parts, their soul or are dead.

Option C - Korsakoff's syndrome:

• Korsakoff's syndrome is a memory disorder caused by vitamin B1 deficiency and alcoholism. It damages nerve cells, supporting cells in the brain and spinal cord, and the memory center of the brain.
• Symptoms include amnesia, tremors, coma, disorientation, and vision problems.

9. Percussion is a method of tapping body parts with fingers, hands, or small instruments as part of a physical examination. It is done to determine: The size, consistency, and borders of body organs. Which one of the following statements is TRUE regarding the clinical sign being elicited in the given picture?

A. This test helps to detect ascites

B. This test is for eliciting shifting dullness

C. The hand on the midline below the umbilicus will feel the vibrations in patients with ascites

D. All of the above statements are true

Option A: This test helps to detect ascites

The above picture shows the method of percussion for the abdominal examination.

• One technique for evaluating ascites is an assessment of shifting dullness.
• In the ascitic abdomen, gas-filled bowel loops float to the top while the ascitic fluid falls to the dependent portion of the abdomen. As a result, percussion notes are tympanitic over the bowel loops and dull over the surrounding fluid.
• With the patient lying on his back, map out these areas of dullness and tympany. Then, ask the patient to roll on his side and re-percuss. The ascites and, thus, dullness shift to the side the patient is lying on, while the tympanitic area shifts to the top.

Option B: This test is for eliciting shifting dullness

Shifting Dullness:

1. This manoeuvre is performed with the patient supine.
2. Percuss across the abdomen as for flank dullness, with the point of transition from tympany to dullness noted.
3. The patient then is rolled on his/her side away from the examiner, and percussion from the umbilicus to the flank area is repeated.
4. Positive test: When ascites are present, the area of dullness will shift to the dependent site. The area of the tympany will shift toward the top.

Option C: The hand on the midline below the umbilicus will feel the vibrations in patients with ascites

• In palpating the abdomen, one should first gently examine the abdominal wall with the fingertips. This will demonstrate the crunching feeling of crepitus of the abdominal wall, a sign of gas or fluid within the subcutaneous tissues. In addition, it will demonstrate any irregularities of the abdominal wall (such as lipomas or hernias) and give some idea as to areas of tenderness.
• Deep palpation of the abdomen is performed by placing a flat hand on the abdominal wall and applying firm, steady pressure. It may be helpful to use two-handed palpation, particularly in evaluating a mass.
• Here the upper hand is used to exert pressure, while the lower hand is used to feel. One should start deep palpation in the quadrant directly opposite any area of pain and carefully examine each quadrant. At each costal margin, it is helpful to have the patient inspired deeply to aid in the palpation of the liver, gallbladder, and spleen.

Option D: All of the above statements are true

• All statements are not true for this picture.

10. An obese male patient who is a known case of diabetes has presented with OPD with increased serum ferritin levels. Upon further investigations, it is found that he is a case of Non- alcoholic fatty liver disease. Which of the following is the most common cause of Non- alcoholic fatty liver disease?

1. Reye syndrome
2. Syndrome-X
3. Cardiac syndrome-X
4. Pregnancy

Option B: Syndrome-X

• A condition marked by extra fat around the abdomen, high levels of blood glucose (sugar) when not eating, high levels of triglycerides (a type of fat) in the blood, low levels of high-density lipoproteins (a type of protein that carries fats) in the blood, and high blood pressure.
• Also known as Metabolic syndrome is most commonly associated with NAFLD
• Abnormalities associates Syndrome X:
  • Impaired fasting plasma glucose concentration
  • Impaired glucose tolerance
  • Increase plasma uric acid concentration
  • Decrease renal uric acid concentration
  • Increase plasma triglyceride concentration
  • Increase renal sodium retention
  • Increase blood pressure
  • Polycystic ovary syndrome

Option A: Reye syndrome

• Reye's syndrome is a very rare disorder that can cause serious liver and brain damage. If it's not treated promptly, it may lead to permanent brain injury or death.
• Reye's syndrome mainly affects children and young adults under 20 years of age.

Option C: Cardiac syndrome-X

• Cardiac syndrome X (CSX) is characterized by typical or atypical anginal chest pain with no evidence of significant coronary vascular abnormalities visualized on an angiogram. It is viewed as a type of ischemic heart disease with occurrence most prevalent in perimenopausal and postmenopausal females. To avoid the high morbidity and complications associated with this condition requires prompt diagnosis and treatment. This activity reviews the evaluation and treatment of CSX and highlights the role of the interprofessional team in evaluating and treating patients with this condition

Objectives:

• Review the pathogenesis of cardiac syndrome X.
• Describe the treatment modalities of cardiac syndrome X.
• Identify the complications of cardiac syndrome X.
• Summarize interprofessional team strategies for improving care coordination and patient education in treating patients with cardiac syndrome X and improving outcomes.

Option D: Pregnancy

• The 5 pregnancy-related liver disorders—are acute fatty liver of pregnancy (AFLP), HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), pre-eclamptic liver dysfunction, intrahepatic cholestasis of pregnancy (ICP) and hyperemesis gravidarum—occur in different gestational time periods. This review focuses on these pregnancy-related liver disorders.

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