NEET-SS Medicine 2024

Subject: Gastroenterology
Topic: Liver Transplantation
Subtopic: Post-Transplant Infections
Question Number: 1
Question Type: Clinical question

Question:
 A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?

Options:
 A) Endoscopy and mucosal biopsy
 B) Start fungals
 C) Increase immunosuppression
 D) Observation and supportive care

Correct Answer: A) Endoscopy and mucosal biopsy

Subject: Infectious Diseases
Topic: Dengue Fever
Subtopic: Complications and Secondary Infections
Question Number: 2
Question Type: Clinical question

Question:
A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?

Options:
 A) Serum ferritin
 B) Triglycerides
 C) Bone marrow study
 D) All of the above

Correct Answer: D) All of the above

Subject: Gastroenterology
Topic: Hepatitis C Virus (HCV) Infection
Subtopic: Disease Progression Factors
Question Number: 3
Question Type: Non-clinical question

Question:
A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?

Options:
A) Old age
B) HCV RNA titers
C) Chronic alcohol use
D) Long-term chronic HCV infection

Correct Answer: B) HCV RNA titers

Subject: Infectious Diseases
Topic: Rabies and Opportunistic Infections
Subtopic: Post-Exposure Management and Fungal Infections
Question Number: 4
Question Type: Clinical question

Question:
A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?

Options:
A) Immunoglobulin alone
B) ARV 0-3 days
C) ARV 0-3-7-14-28 days
D) ARV 0-7-28 days

Correct Answer: B) ARV 0-3 days

Subject: Infectious Diseases
Topic: Fungal Infections in Immunocompromised Hosts
Subtopic: Post-Chemotherapy Complications
Question Number: 5
Question Type: Clinical question

Question:
A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC < 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?

Options:
 A) Hepatosplenic candidiasis
 B) Typhlitis
 C) Bacterial liver abscess
 D) CMV hepatitis

Correct Answer: A) Hepatosplenic candidiasis

Subject: Infectious Diseases
Topic: Viral Infections
Subtopic: Mumps and Its Complications
Question Number: 6
Question Type: Clinical question

Question:
A 22-year-old man presents with testicular pain and swelling 5 days after an episode of parotid gland enlargement and fever. Ultrasound confirms orchitis. He reports that he was not vaccinated in childhood. Which of the following statements regarding mumps orchitis is true?

Options:
 A) Subfertility occurs in 30-80%
 B) Vaccination provides lifelong immunity
 C) Parotitis lasts 3-12 months
 D) Meningitis is unlikely

Correct Answer: A) Subfertility occurs in 30-80%

Subject: Gastroenterology
Topic: Malabsorption Syndromes
Subtopic: Infectious Causes
Question Number: 7
Question Type: Clinical question

Question:
A 45-year-old man presents with chronic diarrhea, significant weight loss, and arthralgia. Endoscopic biopsy of the small intestine reveals numerous foamy macrophages in the lamina propria that stain positive with Periodic Acid–Schiff (PAS). What is the most likely diagnosis?

Options:
 A) Tropical sprue
 B) Celiac disease
 C) Whipple’s disease
 D) Giardia infection

Correct Answer: C) Whipple’s disease

Subject: Infectious Diseases
Topic: HIV-Related Neurological Disorders
Subtopic: Intracerebral Lesions in AIDS
Question Number: 8

Question Type: Clinical question

Question:
A 38-year-old HIV-positive man with a CD4 count of 38 presents with fever and generalized tonic-clonic seizures. MRI brain reveals two ring-enhancing subcortical lesions without any specific differentiating features. What is the most likely diagnosis?

Options:
 A) Toxoplasmosis
 B) Tuberculosis
 C) Neurocysticercosis
 D) Primary CNS lymphoma

Correct Answer: A) Toxoplasmosis

Subject: Gastroenterology
Topic: Liver Abscess
Subtopic: Antimicrobial Therapy
Question Number: 9
Question Type: Non-clinical question

Question:
 What is the drug of choice in the treatment of liver abscess?

Options:
 A) Metronidazole
 B) Azithromycin
 C) Drainage
 D) Needle aspiration

Correct Answer: A) Metronidazole

Subject: Pharmacology
Topic: Antimicrobial Agents
Subtopic: Aminoglycosides – Pharmacokinetics and Dosing
Question Number: 10
Question Type: Non-clinical question

Question:
Understanding the pharmacokinetics of Amikacin is important because it helps clinicians to:

Options:
 A) Give once daily
 B) Give twice daily
 C) Give thrice daily
 D) Given only in combination

Correct Answer: A) Give once daily

Subject: Rheumatology
Topic: Reactive Arthritis
Subtopic: Reiter’s Syndrome
Question Number: 11
Question Type: Clinical question

Question:
What is the most common cause of reactive arthritis in a patient with diarrhea and dysuria?

Options:
 A) Treponema pallidum
 B) Mycoplasma
 C) Salmonella
 D) Streptococcus

Correct Answer: C) Salmonella

Subject: Infectious Diseases
Topic: Diphtheria
Subtopic: Neurological Complications
Question Number: 12
Question Type: Clinical question

Question:
A 7-year-old unvaccinated child presented with a history of sore throat and fever 3 weeks ago. The child now develops nasal regurgitation of fluids, facial deviation, and tongue weakness with numbness. On examination, there is palatal paralysis and a nasal twang to the voice. What is the most likely diagnosis?

Options:
 A) Diphtheria
 B) CMV
 C) Guillain-Barré syndrome (GBS)
 D) Quincy abscess

Correct Answer: A) Diphtheria

Subject: Infectious Diseases
Topic: HIV and Antiretroviral Therapy
Subtopic: Drug-Induced Toxicities
Question Number: 13
Question Type: Clinical question

Question:
A 42-year-old HIV-positive patient on antiretroviral therapy with stavudine presents with progressive motor weakness, tingling in the limbs, hepatomegaly, and metabolic acidosis. Laboratory evaluation shows elevated serum lactate levels, and neurological examination reveals large fiber sensory loss. What is the most likely diagnosis?

Options:
 A) Toxic neuropathy
 B) HIV neuropathy
 C) HIV myelopathy
 D) Neuromuscular disorder

Correct Answer: B) HIV neuropathy

Subject: Neurology
Topic: Central Nervous System Infections
Subtopic: Bacterial Meningitis
Question Number: 14
Question Type: Clinical question

Question:
A 60-year-old man presents with high-grade fever, headache, neck stiffness, and altered sensorium. Cerebrospinal fluid (CSF) examination is pending, but clinical findings are highly suggestive of bacterial meningitis. Which empirical antibiotic regimen should be started immediately?

Options:
 A) Ampicillin
 B) Ampicillin + Vancomycin
 C) Ampicillin + Vancomycin + Ceftriaxone
 D) Ampicillin + Cefotaxime

Correct Answer: C) Ampicillin + Vancomycin + Ceftriaxone

Subject: Microbiology
Topic: Antimicrobial Resistance
Subtopic: Mechanisms of Drug Resistance
Question Number: 15
Question Type: Clinical question

Question:
A 45-year-old man on antitubercular therapy is found to have a rifampicin-resistant strain of Mycobacterium tuberculosis on GeneXpert testing. Which of the following best explains the mechanism of resistance?

Options:
 A) Inactivating enzymes
 B) Activating enzymes
 C) Altered target enzymes
 D) Efflux of drug

Correct Answer: C) Altered target enzymes

Subject: Infectious Diseases
Topic: Leishmaniasis
Subtopic: Diagnostic Investigations
Question Number: 16
Question Type: Non-clinical question

Question:
A 35-year-old man from Bihar presents with prolonged fever, weight loss, and hepatosplenomegaly. Laboratory findings show pancytopenia. Which of the following is considered the gold standard investigation for confirming the diagnosis of leishmaniasis?

Options:
 A) Bone marrow biopsy to demonstrate amastigotes
 B) Blood culture
 C) rK-39
 D) PCR

Correct Answer: A) Bone marrow biopsy to demonstrate amastigotes

Subject: Medicine
Topic: Urinary Tract Infections in Pregnancy
Subtopic: Asymptomatic Bacteriuria
Question Number: 17
Question Type: Clinical question

Question:
A 28-year-old pregnant woman in her first trimester undergoes routine antenatal evaluation. Urine culture reveals >100,000 CFU/mL of E. coli, but she remains asymptomatic. What is the most appropriate next step in management?

Options:
 A) Screening in first trimester and management accordingly
 B) Management/antibiotics only if symptomatic
 C) Screening in third trimester and treat only if positive
 D) Treat only in third trimester

Correct Answer: A) Screening in first trimester and management accordingly

Subject: Medicine
Topic: Diverticular Disease
Subtopic: Complicated Diverticulitis
Question Number: 18
Question Type: Clinical question

Question:
A 58-year-old man presents with left lower quadrant pain, low-grade fever, and leukocytosis. CT abdomen shows diverticulitis with a small pericolic abscess. What is the first step in management?

Options:
 A) IV antibiotics
 B) CT-guided drainage
 C) Surgical resection
 D) Conservative management only

Correct Answer: A) IV antibiotics

Subject: Medicine
Topic: Febrile Neutropenia
Subtopic: Microbiological Etiology
Question Number: 19
Question Type: Non-clinical question

Question:
A 48-year-old man undergoing chemotherapy for acute myeloid leukemia presents with high-grade fever, chills, and hypotension. Laboratory tests show an absolute neutrophil count (ANC) of 300 cells/mm³. Blood cultures are pending. Which of the following organisms is most commonly responsible for sepsis in patients with febrile neutropenia?

Options:
 A) Escherichia coli
 B) Streptococcus pneumoniae
 C) Pseudomonas aeruginosa
 D) Enterococcus

Correct Answer: C) Pseudomonas aeruginosa

Subject: Infectious Diseases
Topic: Febrile Neutropenia
Subtopic: Empirical Therapy
Question Number: 20
Question Type: Clinical question

Question:
 A 45-year-old patient with acute myeloid leukemia undergoing chemotherapy develops high-grade fever with chills and a total leukocyte count of 400 cells/mm³. Blood pressure is stable, but the patient has mucositis and no localizing source of infection. Which of the following is the most appropriate empirical antibiotic regimen to start?

Options:
 A) Meropenem
 B) Ceftriaxone
 C) Piperacillin-tazobactam + Gentamicin
 D) Vancomycin alone

Correct Answer: C) Piperacillin-tazobactam + Gentamicin

Subject: Neurology
Topic: Multiple Sclerosis
Subtopic: Disease-Modifying Therapy in Pregnancy Planning
Question Number: 21
Question Type: Clinical question

Question:
A 32-year-old woman with relapsing-remitting multiple sclerosis presents with a positive Lhermitte sign indicating cervical cord involvement. She has low JC virus antibody titers and wishes to conceive in the future. Which of the following disease-modifying therapies is most appropriate for her?

Options:
 A) Fingolimod
 B) Interferon gamma
 C) Natalizumab
 D) Teriflunomide

Correct Answer: C) Natalizumab

Subject: Gastroenterology
Topic: Viral Hepatitis
Subtopic: Hepatitis E in Pregnancy
Question Number: 22
Question Type: Clinical question

Question:
A 28-year-old woman in her third trimester presents with jaundice, malaise, and elevated liver enzymes. Serology confirms Hepatitis E infection. Which of the following statements regarding Hepatitis E infection in pregnancy is true?

Options:
 A) Acute liver failure (ALF) is more severe in the 1st trimester than in the 3rd trimester
 B) ALF is more common in pregnancy than in non-pregnant state
 C) Chronic liver disease is more common in pregnancy
 D) It is the most common cause of ALF worldwide

Correct Answer: B) ALF is more in pregnancy than in the non-pregnant state

Subject: Gastroenterology
Topic: Liver Transplantation
Subtopic: Contraindications
Question Number: 23
Question Type: Clinical question

Question:
A 48-year-old male with acute hepatic failure is being evaluated for liver transplantation. His urine test shows ethylene glycol positivity. Which of the following constitutes an absolute contraindication to liver transplantation?

Options:
 A) HIV infection
 B) Urine ethylene glycol positive
 C) Coronary artery disease with EF 40%
 D) Coronary artery disease with 85% stenosis

Correct Answer: B) Urine ethylene glycol positive

Subject: Gastroenterology
Topic: Wilson’s Disease
Subtopic: Diagnostic Evaluation
Question Number: 24
Question Type: Clinical question

Question:
A 22-year-old male presents with progressive tremors, slurred speech, and personality changes over the past few months. On examination, he has mild hepatomegaly, dysarthria, and a brownish ring around the cornea visible on slit-lamp examination (Kayser–Fleischer ring). Laboratory evaluation shows mildly elevated liver enzymes. Which of the following is the definitive diagnostic test for Wilson’s disease?

Options:
 A) Hepatic copper content
 B) Serum copper
 C) Urine copper
 D) Serum ceruloplasmin

Correct Answer: A) Hepatic copper content

Subject: Gastroenterology
Topic: Cirrhosis
Subtopic: Diagnostic Approach
Question Number: 25
Question Type: Clinical question

Question:
A 52-year-old man with long-standing alcohol use presents with jaundice and mild ascites. Laboratory tests show total bilirubin of 4.8 mg/dL, AST 48 U/L, ALT 45 U/L, and INR 1.8. Viral hepatitis serology is negative, and ultrasound shows a coarse echotexture liver with features of portal hypertension. What is the most appropriate method to determine the cause of cirrhosis in this patient?

Options:
 A) Liver elastography
 B) Transjugular biopsy
 C) Percutaneous biopsy
 D) FNAC liver

Correct Answer: B) Trans jugular biopsy

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