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NEET PG 2026 - 200 Most Probable High-Yield Questions

Based on: Last 5-Year PYQ Analysis (2022-2026) + Recent Updates + Recall-Based Image Questions

TREND ANALYSIS: NEET PG 2022-2026

Subject	2025 Qs	Weightage	Trend
Medicine (incl. Derm, Psych)	30	15%	Highest - clinical vignettes
OBGYN	20	10%	Very high - PPH, ANC, fertility
Surgery	18	9%	High - trauma, GI, oncology
PSM	16	8%	Consistent - programs, statistics
Pharmacology	15	7.5%	Rising - clinical drug use
Biochemistry	15	7.5%	Rising - metabolic integration
Pathology	12	6%	Stable - IHC, chromosomal
Microbiology	12	6%	Stable - clinical context
Anatomy	9	4.5%	Moderate - radiological focus
Dermatology	8	4%	Rising - image-heavy
Forensic Medicine	6	3%	Stable
Orthopaedics	5	2.5%	Stable
Ophthalmology	5	2.5%	Stable
ENT	5	2.5%	Stable
Paediatrics	5	2.5%	Stable
Radiology	5	2.5%	Rising
Physiology	5	2.5%	Integrated
Anaesthesia	4	2%	Stable

Key exam pattern shift 2022-2026:

~50% image-based (doubled from 2022)
~70% clinical vignette format
~30% repeats from PYQs
Basic sciences now mostly integrated into clinical scenarios
Drug of choice tested 15-20 times per paper

PART 1 - 200 HIGH-YIELD MCQs WITH ANSWERS

ANATOMY (9 Questions)

Q1. The long head of biceps brachii originates from: a) Coracoid process b) Supraglenoid tubercle c) Infraglenoid tubercle d) Acromion Answer: B - Supraglenoid tubercle (long head of triceps = infraglenoid tubercle - a perennial trap)

Q2. In a cross-sectional CT at the level of T4, which structure is most anterior? a) Esophagus b) Trachea c) Ascending aorta d) Superior vena cava Answer: C - Ascending aorta (radiological anatomy is heavily tested post-2023)

Q3. Structures passing through the jugular foramen include all EXCEPT: a) CN IX (Glossopharyngeal) b) CN X (Vagus) c) CN XI (Accessory) d) CN XII (Hypoglossal) Answer: D - CN XII exits through the hypoglossal canal (NEET PG 2025 direct recall Q1)

Q4. The artery of Adamkiewicz (great anterior radiculomedullary artery) typically arises from: a) T1-T4 level b) T9-L2 level c) L3-S1 level d) C5-C8 level Answer: B - T9-L2 (left side); important for spinal cord ischemia after aortic surgery

Q5. Femoral sheath does NOT contain: a) Femoral artery b) Femoral vein c) Femoral nerve d) Femoral canal Answer: C - Femoral nerve lies outside the femoral sheath, lateral to it

Q6. Which cranial nerve exits the skull through the foramen rotundum? a) Ophthalmic (V1) b) Maxillary (V2) c) Mandibular (V3) d) Facial (VII) Answer: B - V2 (Maxillary) through foramen rotundum

Q7. Winged scapula results from injury to: a) Axillary nerve b) Musculocutaneous nerve c) Long thoracic nerve d) Suprascapular nerve Answer: C - Long thoracic nerve (nerve to serratus anterior)

Q8. SLAP lesion (Superior Labrum Anterior to Posterior) involves which structure? a) Medial meniscus b) Glenoid labrum c) Triangular fibrocartilage complex d) Ligamentum teres Answer: B - Glenoid labrum; seen with overhead athletes

Q9. In a right-sided aortic arch (right 4th aortic arch abnormality), what vessel is anomalous? a) Left subclavian artery b) Right subclavian artery c) Left common carotid artery d) Aberrant right subclavian Answer: B - Right 4th aortic arch; aberrant left subclavian with dysphagia lusoria (NEET PG 2025 Q2)

PHYSIOLOGY (5 Questions)

Q10. The oxygen-hemoglobin dissociation curve shifts RIGHT in: a) Decreased temperature b) Decreased 2,3-DPG c) Increased PCO2 (Bohr effect) d) Increased pH Answer: C - Right shift = decreased O2 affinity = better O2 delivery to tissues

Q11. In a patient with metabolic alkalosis, compensation occurs by: a) Hyperventilation b) Hypoventilation c) Increased bicarbonate excretion only d) Decreased chloride reabsorption Answer: B - Hypoventilation increases CO2 to compensate for high pH

Q12. The juxtaglomerular apparatus (JGA) is located at: a) Proximal convoluted tubule b) Macula densa of DCT + afferent arteriole c) Collecting duct d) Loop of Henle Answer: B - JGA = macula densa (DCT) + juxtaglomerular cells (afferent arteriole) + mesangial cells

Q13. Starling's law of the heart states that stroke volume increases with: a) Increased heart rate b) Increased end-diastolic volume (preload) c) Increased afterload d) Decreased venous return Answer: B - Frank-Starling: increased EDV → increased force of contraction

Q14. The primary site of GIP (Glucose-dependent insulinotropic peptide) secretion: a) Stomach G-cells b) Duodenal K-cells c) Ileal L-cells d) Pancreatic alpha cells Answer: B - K-cells of duodenum/jejunum; triggers insulin release

BIOCHEMISTRY (15 Questions)

Q15. Phenylketonuria (PKU) is caused by deficiency of: a) Phenylalanine transaminase b) Phenylalanine hydroxylase c) Tyrosinase d) Homogentisate oxidase Answer: B - Phenylalanine hydroxylase deficiency; accumulates phenylalanine → musty odor, intellectual disability

Q16. Von Gierke disease (GSD type I) is due to deficiency of: a) Liver phosphorylase b) Glucose-6-phosphatase c) Amylo-1,6-glucosidase d) Alpha-1,4-glucosidase (acid maltase) Answer: B - G6Pase deficiency; severe fasting hypoglycemia + hepatomegaly

Q17. Which enzyme is deficient in Tay-Sachs disease? a) Hexosaminidase A b) Sphingomyelinase c) Glucocerebrosidase d) Arylsulfatase A Answer: A - Hexosaminidase A; GM2 ganglioside accumulation; cherry-red spot

Q18. HbA1c reflects glycemic control over: a) 2-4 weeks b) 4-6 weeks c) 2-3 months d) 6 months Answer: C - Reflects last 2-3 months (RBC lifespan ~120 days)

Q19. Biotin is a cofactor for which enzyme? a) Pyruvate kinase b) Pyruvate carboxylase c) Phosphofructokinase d) Lactate dehydrogenase Answer: B - Pyruvate carboxylase, propionyl-CoA carboxylase, acetyl-CoA carboxylase (all carboxylases need biotin)

Q20. The rate-limiting enzyme of cholesterol synthesis is: a) Squalene synthase b) HMG-CoA reductase c) HMG-CoA synthase d) Mevalonate kinase Answer: B - HMG-CoA reductase; target of statins

Q21. In Lesch-Nyhan syndrome, which enzyme is deficient? a) Adenosine deaminase b) HGPRT (Hypoxanthine-guanine phosphoribosyltransferase) c) Xanthine oxidase d) Purine nucleoside phosphorylase Answer: B - HGPRT; X-linked; gout + self-mutilation + choreoathetosis

Q22. Kwashiorkor is characterized by: a) Marasmus + edema + hair changes b) Pure caloric deficiency c) Protein deficiency with edema, fatty liver, skin changes d) Vitamin A deficiency Answer: C - Protein deficiency → hypoalbuminemia → edema; "flag sign" in hair; fatty liver

Q23. Which vitamin deficiency causes pellagra (4Ds: Diarrhea, Dermatitis, Dementia, Death)? a) B1 (Thiamine) b) B2 (Riboflavin) c) B3 (Niacin) d) B6 (Pyridoxine) Answer: C - Niacin (B3) deficiency; casal's necklace on neck

Q24. The Cori cycle involves: a) Glucose - pyruvate - lactate (muscle) → lactate - glucose (liver) b) Fatty acid - ketone - glucose c) Glucose - alanine - glucose d) Only hepatic gluconeogenesis Answer: A - Lactate from anaerobic muscle glycolysis recycled to glucose in liver

Q25. Homocystinuria (classical) is treated with: a) Biotin b) Pyridoxine (B6) c) Folate alone d) Cobalamin alone Answer: B - Cystathionine beta-synthase deficiency; most respond to B6 supplementation

Q26. Alpha-fetoprotein (AFP) is elevated in all EXCEPT: a) Hepatocellular carcinoma b) Germ cell tumors (yolk sac) c) Neural tube defects (maternal serum) d) Down syndrome (maternal serum) Answer: D - Down syndrome has LOW AFP (triple test: low AFP, low uE3, high hCG)

Q27. The most abundant immunoglobulin in breast milk/colostrum: a) IgG b) IgA (secretory) c) IgM d) IgE Answer: B - Secretory IgA provides passive mucosal immunity to newborn

Q28. Phenylketonuria dietary restriction requires: a) Avoiding all proteins b) Low phenylalanine diet (avoid aspartame) c) Low tyrosine diet d) High tryptophan diet Answer: B - Avoid phenylalanine; aspartame (NutraSweet) contains phenylalanine

Q29. Enzyme marker for myocardial infarction that is most specific and rises last: a) LDH b) AST c) Troponin I/T d) Myoglobin Answer: C - Troponin is gold standard; most specific, rises 4-6 hr, stays elevated 1-2 weeks

PHARMACOLOGY (15 Questions)

Q30. Drug of choice for pre-operative preparation of pheochromocytoma: a) Atenolol b) Clonidine c) Phenoxybenzamine (irreversible alpha blocker) d) Prazosin Answer: C - Phenoxybenzamine first (alpha blockade), then beta blocker (NEVER beta first - hypertensive crisis) (NEET PG 2025 Q188)

Q31. Empagliflozin is preferred over other antidiabetics in a patient with: a) CKD stage 1 only b) Heart failure with reduced ejection fraction c) Pregnancy d) Type 1 DM Answer: B - SGLT2 inhibitors (empagliflozin, dapagliflozin) reduce HF hospitalization and CV mortality (NEET PG 2025 Q65)

Q32. Topiramate is preferred for migraine prophylaxis in a patient with: a) Renal stones b) Obesity and comorbid epilepsy c) CAD (coronary artery disease) d) Pregnancy Answer: C - Topiramate in CAD (propranolol relatively contraindicated in CAD with bronchospasm; topiramate is safe) (NEET PG 2025 recall)

Q33. MgSO4 loading dose in Pritchard's regimen for eclampsia: a) 2g IV + 5g each buttock IM b) 4g IV + 10g each buttock IM c) 4g IV + 5g each buttock IM d) 6g IV over 15 min Answer: C - 4g IV over 20 min loading + 5g IM each buttock (10g total IM)

Q34. Which drug causes "Gray baby syndrome"? a) Tetracycline b) Chloramphenicol c) Gentamicin d) Trimethoprim Answer: B - Chloramphenicol: neonates lack UDP-glucuronyl transferase; accumulation causes cardiovascular collapse

Q35. Ivermectin mechanism of action: a) Inhibits tubulin polymerization b) Increases Cl- influx via glutamate-gated channels → paralysis c) Inhibits ATP production in helminths d) Blocks acetylcholine receptors Answer: B - Opens glutamate-gated Cl- channels in invertebrates (doesn't cross mammalian BBB)

Q36. Stevens-Johnson syndrome is MOST commonly caused by: a) Penicillin b) Allopurinol c) Carbamazepine and sulfonamides d) Aspirin Answer: C - Carbamazepine (especially in HLA-B*1502 allele carriers) and sulfonamides are most common causes

Q37. Drug used for reversal of dabigatran (direct thrombin inhibitor): a) Protamine sulfate b) Vitamin K c) Idarucizumab d) Andexanet alfa Answer: C - Idarucizumab (Praxbind) specifically reverses dabigatran; andexanet alfa reverses Xa inhibitors

Q38. Zero-order kinetics means: a) Rate depends on drug concentration b) Constant amount of drug eliminated per unit time regardless of concentration c) Half-life is constant d) Bioavailability is 100% Answer: B - Zero-order: phenytoin, ethanol, aspirin (at toxic doses); saturation of metabolizing enzymes

Q39. Warfarin interacts with which antibiotic to INCREASE anticoagulant effect? a) Rifampicin (enzyme inducer - decreases effect) b) Metronidazole c) Isoniazid d) Rifampicin Answer: B - Metronidazole inhibits CYP2C9 → increases warfarin levels → increased bleeding risk

Q40. Drug of choice for Pneumocystis jirovecii pneumonia (PCP) prophylaxis and treatment: a) Pentamidine b) Cotrimoxazole (TMP-SMX) c) Dapsone d) Atovaquone Answer: B - TMP-SMX is DOC for treatment and prophylaxis (CD4 <200)

Q41. Serotonin syndrome triad: a) Fever + rigidity + autonomic instability (like NMS but NO lead-pipe rigidity) b) Mental status change + autonomic instability + neuromuscular abnormalities (clonus, hyperreflexia, tremor) c) Bradycardia + miosis + diaphoresis d) Hyperthermia + rhabdomyolysis only Answer: B - Serotonin syndrome: mental changes + autonomic instability + neuromuscular hyperactivity (clonus is KEY distinguisher from NMS)

Q42. Antidote for organophosphate poisoning: a) Physostigmine only b) Atropine + Pralidoxime (2-PAM) c) Naloxone d) Flumazenil Answer: B - Atropine for muscarinic symptoms + pralidoxime to reactivate cholinesterase (must give before "aging")

Q43. Drug causing "rabbit syndrome" (perioral tremor): a) Clozapine b) Typical antipsychotics (haloperidol) c) Lithium d) SSRIs Answer: B - Late-onset EPS with typical antipsychotics; rare but tested

Q44. Which NSAID is most COX-1 selective (most GI toxic)? a) Celecoxib b) Meloxicam c) Aspirin d) Ketorolac Answer: C - Aspirin irreversibly inhibits COX-1 preferentially at low doses (antiplatelet)

PATHOLOGY (12 Questions)

Q45. AML M3 (Acute Promyelocytic Leukemia - APML) is characterized by: a) t(9;22) Philadelphia chromosome b) t(15;17) PML-RARA fusion c) t(14;18) BCL-2 overexpression d) t(8;14) c-MYC Answer: B - t(15;17) PML-RARA; treated with ATRA + arsenic trioxide; high DIC risk (NEET PG 2025)

Q46. Follicular lymphoma is associated with: a) t(11;14) BCL-1/cyclin D1 b) t(14;18) BCL-2 overexpression c) t(8;14) c-MYC d) t(2;5) ALK Answer: B - t(14;18) causes BCL-2 overexpression → prevents apoptosis → indolent B-cell lymphoma (NEET PG 2025)

Q47. Primary biliary cholangitis (PBC) is diagnosed by: a) ASMA (Anti-smooth muscle antibody) b) ANA c) AMA (Anti-mitochondrial antibody M2) d) Anti-LKM-1 Answer: C - AMA-M2 is pathognomonic; middle-aged women; pruritus + jaundice

Q48. Reed-Sternberg cells are characteristic of: a) Non-Hodgkin lymphoma b) Hodgkin lymphoma c) Multiple myeloma d) CLL Answer: B - "Owl-eye" RS cells; positive for CD15 and CD30; Hodgkin lymphoma

Q49. Pannus formation in joints occurs in: a) Osteoarthritis b) Gout c) Rheumatoid arthritis d) Pseudogout Answer: C - Pannus = proliferative synovial granulation tissue that destroys cartilage in RA (NEET PG 2025)

Q50. Psammoma bodies (laminated calcifications) are seen in: a) Papillary thyroid carcinoma, meningioma, serous papillary cystadenocarcinoma of ovary b) Follicular thyroid carcinoma c) Medullary thyroid carcinoma d) Anaplastic carcinoma Answer: A - "PSaMMoma" = Papillary thyroid, Serous ovarian, Meningioma, Mesothelioma

Q51. Amyloid staining with Congo red shows what under polarized light? a) Green birefringence b) Red birefringence c) Yellow-white d) Purple Answer: A - Apple-green birefringence under polarized light = amyloid; Congo red stain

Q52. Philadelphia chromosome t(9;22) (BCR-ABL fusion) is diagnostic of: a) AML b) ALL (B-cell subtype) and CML c) CLL d) Hodgkin lymphoma Answer: B - BCR-ABL in CML (99%) and B-cell ALL (25-30%); imatinib targets BCR-ABL

Q53. Warburg effect in cancer refers to: a) Oxidative phosphorylation preference b) Aerobic glycolysis (glucose → lactate even with oxygen present) c) Increased fatty acid oxidation d) Decreased glucose uptake Answer: B - Cancer cells prefer aerobic glycolysis for anabolic intermediates; basis of PET scan

Q54. Klinefelter syndrome (47,XXY) has which serum profile? a) Low FSH, Low LH, High testosterone b) High FSH, High LH, Low testosterone c) Normal FSH, high testosterone d) Low FSH, normal LH, normal testosterone Answer: B - Primary hypogonadism; seminiferous tubule dysgenesis; infertility

Q55. The microscopic finding of "signet ring cells" is most characteristic of: a) Mucinous adenocarcinoma of colon b) Linitis plastica (diffuse gastric adenocarcinoma) c) Hepatocellular carcinoma d) Transitional cell carcinoma Answer: B - Signet ring cells in gastric linitis plastica; also seen in Krukenberg tumor (ovarian mets from gastric)

Q56. Caseous necrosis is characteristic of: a) Coagulative necrosis b) Liquefactive necrosis c) Tuberculosis granuloma d) Fat necrosis Answer: C - "Cheese-like" granular necrosis = TB; central to Ghon focus and granuloma formation

MICROBIOLOGY (12 Questions)

Q57. Aspergillus species in tissue shows: a) Broad aseptate hyphae branching at wide angles (90°) b) Narrow septate hyphae branching at 45° acute angle c) Budding yeast with pseudohyphae d) Spherules with endospores Answer: B - Aspergillus: septate, acute-angle branching (45°); Mucor/Rhizopus = broad aseptate, right-angle (NEET PG 2025)

Q58. Nocardia is identified in lab using: a) India ink preparation b) Paraffin bait technique c) ZN stain only d) Giemsa stain Answer: B - Paraffin bait technique (or modified ZN stain - weakly acid-fast) (NEET PG 2025)

Q59. Enterobius vermicularis (pinworm) diagnosis is by: a) Stool ova & parasite exam b) Cellulose acetate tape (Scotch tape) test - perianal scraping c) String test d) Serology Answer: B - Perianal pruritus worse at night; eggs collected from perianal skin with tape

Q60. IRIS (Immune Reconstitution Inflammatory Syndrome) occurs in HIV-TB when: a) Starting TB treatment before ART b) Starting ART too early after TB treatment initiation (within 2-8 weeks) c) Stopping ART d) Drug-resistant TB Answer: B - IRIS occurs when immune system "wakes up" after ART; TB lesions paradoxically worsen (NEET PG 2025)

Q61. Heterophile antibodies (detected by Monospot test) are characteristic of: a) CMV b) Toxoplasmosis c) EBV (Infectious mononucleosis) d) HIV primary infection Answer: C - EBV; Paul-Bunnell test/Monospot; atypical lymphocytes; splenomegaly

Q62. Giardia lamblia trophozoite has which characteristic appearance? a) Kidney-shaped with axostyle b) Pear-shaped with 2 nuclei giving "owl-eye" appearance c) Crescent-shaped (banana) d) Cyst with 4 nuclei Answer: B - Trophozoite: pear-shaped, 2 nuclei = "old man's face" or "owl face"; suction disk; causes fatty diarrhea

Q63. The serological marker that indicates immunity to hepatitis B (vaccination or past infection): a) HBsAg b) HBeAg c) Anti-HBs (HBsAb) d) Anti-HBc IgM Answer: C - Anti-HBs = protective immunity; only anti-HBs positive (without anti-HBc) = vaccination

Q64. Weil-Felix reaction (agglutination of Proteus OX strains) is used for diagnosis of: a) Typhoid b) Rickettsial infections c) Brucellosis d) Leptospirosis Answer: B - Rickettsial infections (Rickettsia shares antigens with Proteus); OX-19, OX-2, OX-K

Q65. VDRL test becomes positive after how long in syphilis: a) 1 week after primary chancre b) 4-6 weeks after infection / 1-3 weeks after chancre appears c) Only in tertiary syphilis d) Immediately after exposure Answer: B - VDRL (non-treponemal) becomes positive 4-6 weeks post-infection; used for monitoring treatment

Q66. Pseudomembranous colitis is caused by: a) ETEC b) Clostridioides (formerly Clostridium) difficile c) Salmonella d) Campylobacter Answer: B - C. diff produces toxin A (enterotoxin) and B (cytotoxin); after broad-spectrum antibiotics; treat with vancomycin PO or fidaxomicin

Q67. The characteristic lesion of molluscum contagiosum on histology: a) Intranuclear inclusion (Cowdry type A) b) Intracytoplasmic inclusion bodies (Henderson-Patterson/molluscum bodies) c) Reed-Sternberg cells d) Koilocytes Answer: B - Poxvirus; Henderson-Patterson bodies (intracytoplasmic); umbilicated papules

Q68. Vibrio cholerae O1 El Tor produces what type of toxin mechanism? a) Cytotoxin destroying mucosal cells b) ADP-ribosylation of Gs → permanently activated adenylyl cyclase → excess cAMP → Cl-/water secretion c) Neurotoxin blocking ACh release d) Invasion of mucosal cells Answer: B - Cholera toxin: rice-water stool; no mucosal invasion; rehydration ORS is mainstay

GENERAL MEDICINE (30 Questions)

Q69. ARDS management: The lung-protective ventilation strategy uses: a) High tidal volume (12 mL/kg) + low PEEP b) Low tidal volume (6 mL/kg) + high PEEP (permissive hypercapnia) c) High FiO2 + low PEEP d) Prone positioning only Answer: B - ARDSNet protocol: 6 mL/kg ideal body weight + PEEP titration; prone positioning added for severe ARDS (NEET PG 2025)

Q70. Addison's disease classic electrolyte findings: a) Hyponatremia + hyperkalemia + metabolic acidosis b) Hypernatremia + hypokalemia + alkalosis c) Normonatremia + normokalemia d) Hyponatremia + hypokalemia Answer: A - Mineralocorticoid deficiency → Na wasting + K retention + acidosis; "salt craving" + hyperpigmentation + low BP (NEET PG 2025)

Q71. Atrial fibrillation rate control: Drug of choice in a patient with AF + heart failure with reduced EF (HFrEF): a) Verapamil b) Diltiazem c) Metoprolol (beta-blocker) or Digoxin d) Flecainide Answer: C - Ca channel blockers (verapamil/diltiazem) are CONTRAINDICATED in HFrEF; use beta-blockers or digoxin

Q72. Atrial flutter rate control with a calcium channel blocker: Most appropriate choice: a) Amlodipine b) Nifedipine c) Diltiazem d) Felodipine Answer: C - Diltiazem (non-dihydropyridine CCB) for rate control in AF/flutter (NEET PG 2025 Q64)

Q73. Duke criteria for infective endocarditis require: a) 2 major OR 1 major + 3 minor OR 5 minor criteria for definite IE b) 1 major + 1 minor c) Only positive blood cultures d) 3 major criteria Answer: A - Duke: 2 major = definite; 1 major + 3 minor = definite; 5 minor = definite (tested frequently as diagnostic criteria Q)

Q74. Fat embolism syndrome classically presents with: a) Immediate post-fracture respiratory distress b) 24-72 hours after long bone fracture: hypoxia + petechial rash + confusion (triad) c) Only in pelvic fractures d) Pure DVT picture Answer: B - Classic triad: respiratory failure + neurological signs + petechiae on upper body; fat globules in sputum/urine (NEET PG 2025)

Q75. Paget's disease of bone: Serum biochemistry shows: a) Low ALP + elevated calcium b) Markedly elevated ALP, normal calcium, normal phosphate c) Elevated PTH + low calcium d) Elevated calcium + low PTH Answer: B - Paget's: very high ALP (bone formation marker); normal Ca/P; "cotton-wool" skull X-ray (NEET PG 2025)

Q76. Jones criteria (revised 2015) for Acute Rheumatic Fever diagnosis: a) Requires all criteria: carditis + chorea + rash b) 2 major OR 1 major + 2 minor criteria with evidence of prior strep infection c) Only strep serology d) 3 minor criteria sufficient Answer: B - Major: carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules; Minor: fever, elevated ESR/CRP, prolonged PR

Q77. In HIV management, ART should be started in HIV-TB co-infection: a) After completing full TB treatment b) Within 2-8 weeks of starting anti-TB treatment (except for TB meningitis - 8 weeks) c) Immediately at TB diagnosis d) Only when CD4 < 50 Answer: B - WHO guidelines: start ART within 2-8 weeks; TB meningitis: delay to 8 weeks (IRIS risk) (NEET PG 2025)

Q78. DKA (Diabetic ketoacidosis) management: Insulin is started: a) Immediately on presentation b) After initial hydration (usually 1-2 hours) and potassium ≥3.5 mEq/L c) Only when glucose > 400 mg/dL d) Only IV insulin, never subcutaneous Answer: B - Potassium must be ≥3.5 before starting insulin (insulin drives K into cells - can cause fatal hypokalemia); fluids first

Q79. SIADH (Syndrome of Inappropriate ADH) key finding: a) Hypernatremia + concentrated urine b) Hyponatremia + inappropriately concentrated urine (urine osmolality > serum osmolality) c) Hyponatremia + dilute urine d) Hypernatremia + dilute urine (DI pattern) Answer: B - SIADH: euvolemic hyponatremia; urine Na >20, urine osmol > serum osmol; treat with fluid restriction

Q80. Treatment of choice for Helicobacter pylori eradication (standard triple therapy): a) Amoxicillin + Metronidazole b) PPI + Clarithromycin + Amoxicillin (14 days) c) PPI alone d) Bismuth quadruple therapy only Answer: B - PPI + clarithromycin + amoxicillin x 14 days (first line in low clarithromycin resistance areas); bismuth quadruple if resistance high

Q81. Wilson's disease (Hepatolenticular degeneration) - gold standard diagnostic finding: a) Elevated serum copper b) Kayser-Fleischer rings (slit lamp) + low ceruloplasmin c) Elevated ferritin d) Liver biopsy showing iron overload Answer: B - KF rings (not pathognomonic alone) + low serum ceruloplasmin + elevated urinary copper; treat with D-penicillamine or trientine

Q82. Trousseau's sign (carpopedal spasm with blood pressure cuff inflation) indicates: a) Hyperkalemia b) Hypocalcemia c) Hypomagnesemia d) Either hypocalcemia OR hypomagnesemia Answer: D - Both hypocalcemia and hypomagnesemia cause tetany; Chvostek's sign also

Q83. RIFLE criteria / AKIN criteria are used for staging: a) Chronic liver disease b) Acute kidney injury c) Chronic kidney disease d) Heart failure Answer: B - RIFLE: Risk/Injury/Failure/Loss/ESRD; AKIN: modified, 3 stages; tested frequently in exam vignettes (NEET PG trend)

Q84. McDonald criteria are used for diagnosis of: a) Multiple sclerosis (dissemination in time + space) b) Amyotrophic lateral sclerosis c) Myasthenia gravis d) Guillain-Barré syndrome Answer: A - McDonald 2017 criteria; MRI shows T2/FLAIR lesions in periventricular, cortical/juxtacortical, infratentorial, or spinal cord (NEET PG trend)

Q85. Type 1 respiratory failure vs Type 2: a) Type 1: hypoxemia only (PO2 <60); Type 2: hypoxemia + hypercapnia (PCO2 >45) b) Type 1: hypercapnia; Type 2: hypoxemia c) Type 1: both hypoxemic + hypercapnic d) Same - just different terminology Answer: A - Type 1 = pump failure is absent (V/Q mismatch or shunt); Type 2 = pump failure (neuromuscular, COPD)

Q86. Myasthenia gravis: Edrophonium (Tensilon) test works by: a) Stimulating nicotinic receptors directly b) Inhibiting acetylcholinesterase → temporary increase in ACh → brief improvement c) Blocking muscarinic receptors d) Acting on NMDA receptors Answer: B - Short-acting AChE inhibitor; improvement in ptosis/weakness = positive; anti-AChR antibody is diagnostic

Q87. Systemic Lupus Erythematosus (SLE) - most specific antibody: a) ANA (most sensitive but not specific) b) Anti-Smith (Sm) antibody (most specific) c) Anti-dsDNA (high titer suggests active disease, nephritis) d) Anti-Ro/SSA Answer: B - Anti-Sm is MOST SPECIFIC for SLE; anti-dsDNA is specific AND correlates with disease activity

Q88. Nephrotic syndrome vs Nephritic syndrome - USMLE/NEET differentiator: a) Nephrotic: hematuria + HTN + oliguria; Nephritic: massive proteinuria + edema + hypoalbuminemia b) Nephrotic: massive proteinuria (>3.5g/day) + hypoalbuminemia + edema + hyperlipidemia; Nephritic: hematuria + HTN + oliguria + mild proteinuria c) Both are the same condition d) Nephrotic: always seen in children; Nephritic: always in adults Answer: B - Classic distinction tested in EVERY NEET PG paper

Q89. Stroke thrombolysis with tPA (alteplase): Time window: a) Within 3 hours only b) Up to 4.5 hours from symptom onset (selected patients) c) 24 hours d) Any time within 48 hours Answer: B - 0-3 hours: broad eligibility; 3-4.5 hours: additional exclusions (age >80, anticoagulants, severe stroke); mechanical thrombectomy up to 24 hours

Q90. Charcot's triad in acute cholangitis: a) Fever + jaundice + right upper quadrant pain b) Jaundice + pruritis + clay-colored stool c) Abdominal pain + constipation + colicky pain d) Ascending cholangitis symptoms + hypotension + confusion (Reynold's pentad) Answer: A - Charcot's triad (fever + jaundice + RUQ pain); Reynold's pentad adds hypotension + confusion = severe

Q91. Leptospirosis (Weil's disease): Classic presentation with: a) Only renal failure b) Fever + jaundice + acute renal failure + hemorrhage (classic Weil's syndrome) c) Pulmonary TB picture d) Hepatitis B like presentation Answer: B - Biphasis illness; conjunctival suffusion is characteristic; treat with doxycycline/penicillin

Q92. Chronic Obstructive Pulmonary Disease (COPD) spirometry finding: a) Decreased FEV1/FVC ratio (<0.70) that is NOT reversible after bronchodilator b) Decreased FEV1/FVC with full reversibility (>12% and 200 mL) c) Increased FEV1/FVC d) Normal spirometry always Answer: A - GOLD criteria: post-bronchodilator FEV1/FVC <0.70; asthma has reversible obstruction

Q93. Hyperthyroidism: Most common cause worldwide: a) Toxic multinodular goiter b) Graves' disease (TSH receptor antibody) c) Toxic adenoma d) Subacute (de Quervain's) thyroiditis Answer: B - Graves' disease (Type II hypersensitivity, TSI/TRAb); pretibial myxedema; exophthalmos

Q94. Scleroderma (Systemic sclerosis): Antibody most specific for diffuse cutaneous SSc: a) Anti-centromere (limited SSc/CREST) b) Anti-Scl-70 (anti-topoisomerase I) - diffuse SSc c) Anti-Smith d) Anti-Jo-1 Answer: B - Anti-Scl-70 = diffuse SSc (risk of ILD); anti-centromere = limited SSc/CREST (risk of PAH)

Q95. Vitamin B12 deficiency causes: a) Microcytic anemia only b) Macrocytic megaloblastic anemia + subacute combined degeneration of spinal cord c) Pure motor neuropathy d) Only peripheral neuropathy Answer: B - SACD: posterior + lateral column degeneration; B12 also needed for myelin synthesis; associated with pernicious anemia

Q96. Lead poisoning classic triad + treatment: a) Abdominal colic + wrist/foot drop + basophilic stippling of RBCs; treat with DMSA or D-penicillamine b) Cherry red discoloration c) Pulmonary edema only d) Only renal failure Answer: A - Lead lines on gingiva (Burton's lines) and metaphyseal X-ray bands; blood lead level; chelation with DMSA (succimer) or EDTA

Q97. Cushing's syndrome diagnosis: Most sensitive screening test: a) Random serum cortisol b) 24-hour urinary free cortisol OR late-night salivary cortisol OR low-dose dexamethasone suppression test c) CRH stimulation test d) CT of adrenal glands Answer: B - Three first-line tests; low-dose dex suppression test (1 mg overnight) is most convenient; cortisol >1.8 mcg/dL = positive

Q98. Rotterdam criteria for PCOS (polycystic ovarian syndrome) require: a) 3 of 3: oligoovulation + hyperandrogenism + polycystic ovaries b) 2 of 3: oligoovulation/anovulation + clinical/biochemical hyperandrogenism + polycystic ovaries on US c) Only hormonal criteria d) Mandatory imaging Answer: B - 2 out of 3 Rotterdam criteria; after excluding other causes (NEET PG tested as diagnostic criteria Q)

OBSTETRICS & GYNAECOLOGY (20 Questions)

Q99. Atonic PPH (Postpartum hemorrhage) management - surgical balloon tamponade: a) Sengstaken-Blakemore tube b) Bakri balloon c) Foley catheter alone d) Cook balloon only Answer: B - Bakri balloon is used for uterine tamponade in atonic PPH unresponsive to medical management (NEET PG 2025)

Q100. Cord prolapse management: a) Emergency CS + manual elevation of presenting part immediately b) Wait for normal delivery c) Tocolysis alone d) Oxytocin augmentation Answer: A - TRUE cord prolapse = obstetric emergency; hand elevates presenting part off cord; immediate CS (NEET PG 2025)

Q101. Adenomyosis: Investigation of choice: a) Ultrasound only b) MRI (most accurate for diagnosis) c) Hysteroscopy d) Laparoscopy Answer: B - MRI shows junctional zone thickness >12 mm; "Swiss cheese" myometrium (NEET PG 2025)

Q102. Premature Ovarian Insufficiency (POI): Hormonal profile: a) Low FSH, high estrogen b) Elevated FSH (>25 IU/L on two occasions 4 weeks apart) + low AMH + low estrogen c) Normal FSH + low progesterone d) Normal AMH + elevated LH only Answer: B - POI at <40 years; FSH >25 IU/L twice; treat with HRT until age 51 (NEET PG 2025)

Q103. McRoberts maneuver is used for: a) Cord prolapse b) Shoulder dystocia (flatten lordosis; rotate pubis superiorly to free anterior shoulder) c) Face presentation d) Brow presentation Answer: B - First-line maneuver for shoulder dystocia; 40% success; suprapubic pressure added (NEET PG 2025)

Q104. Episiotomy closure: Correct sequence of layers: a) Skin → vaginal mucosa → muscle b) Vaginal mucosa → muscle (perineal body) → skin c) Muscle only then skin d) Fascial planes then mucosa Answer: B - Standard episiotomy repair: vaginal epithelium first, then perineal muscles, then skin (NEET PG 2025)

Q105. Bishop score components (5 parameters): a) Cervical dilation, effacement, station, consistency, position b) Fetal presentation + dilation + station c) Uterine contractions + dilation only d) NST findings + dilation Answer: A - Total 13 points; score >8 = favorable for induction; score <6 = cervical ripening needed

Q106. Intrahepatic cholestasis of pregnancy: Treatment: a) Methyldopa b) Ursodeoxycholic acid (UDCA) + early delivery at 37 weeks c) Cholestyramine alone d) Corticosteroids Answer: B - UDCA reduces pruritis and improves LFTs; delivery at 37 weeks due to fetal risk of stillbirth

Q107. Gestational hypertension vs Preeclampsia: a) Same condition, different names b) Gestational HTN: BP >140/90 after 20 weeks without proteinuria; Preeclampsia: HTN + proteinuria (>300 mg/24hr) OR end-organ damage c) Preeclampsia occurs before 20 weeks d) Both require same management Answer: B - Preeclampsia can occur without proteinuria if end-organ damage present (revised 2013 ACOG criteria)

Q108. HELLP syndrome: Components: a) Hemolytic anemia + Elevated Liver enzymes + Low Platelets b) Hemolysis + Elevated Lipids + Low Protein c) Heart failure + Elevated LFTs + Low Platelets d) Hepatitis + Elevated Liver + Leukopenia + Proteinuria Answer: A - Complication of severe preeclampsia; treat with magnesium + delivery; corticosteroids if <34 weeks

Q109. Ovarian reserve: BEST single marker: a) FSH level on day 3 b) Anti-Mullerian Hormone (AMH) - does not vary with menstrual cycle c) Antral follicle count alone d) Estradiol level Answer: B - AMH from granulosa cells; does not fluctuate across cycle; best single marker of ovarian reserve

Q110. Ca-125 tumor marker is elevated in (in decreasing specificity): a) Only ovarian cancer b) Epithelial ovarian cancer (serous type) + endometriosis + PID + fibroids + liver disease c) Germ cell tumors only d) Cervical cancer only Answer: B - CA-125 is not specific; elevated in many conditions; used for monitoring, not primary screening

Q111. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: a) 46,XY female with absent Mullerian structures b) 46,XX with absent uterus and upper vagina but normal ovaries c) Turner syndrome (45,X0) d) Androgen insensitivity syndrome Answer: B - Primary amenorrhea; normal secondary sexual characteristics; 46,XX; absent uterus/upper vagina; ovaries normal

Q112. Most common cause of postmenopausal bleeding: a) Endometrial carcinoma b) Atrophic vaginitis/endometritis c) Polyps d) Fibroids Answer: B - Atrophic vaginitis is most common cause; but MUST rule out endometrial carcinoma (10% of cases)

Q113. Danazol mechanism of action: a) GnRH agonist b) Synthetic androgen; inhibits pituitary gonadotropins; creates "pseudomenopause" c) Pure progestogen d) Estrogen receptor blocker Answer: B - Used in endometriosis; causes atrophy of endometrial implants; side effects: androgenic (acne, hirsutism)

Q114. Clomiphene citrate mechanism: a) Direct ovarian stimulation b) Anti-estrogen at hypothalamus/pituitary → increased GnRH/FSH/LH → ovarian stimulation c) Progesterone supplementation d) Aromatase inhibitor Answer: B - First-line ovulation induction for anovulatory infertility (PCOS); estrogen receptor antagonist at hypothalamus

Q115. Cervical carcinoma most common type and causative agent: a) Adenocarcinoma; HPV 18 b) Squamous cell carcinoma (70%); HPV 16 and 18 (most common) c) Small cell carcinoma; HPV 31 d) Clear cell carcinoma; DES exposure Answer: B - SCC of cervix; HPV 16 (squamous) and 18 (adenocarcinoma); arises at squamocolumnar junction

Q116. GnRH analogues (agonists like leuprolide) when used continuously: a) Stimulate pituitary continuously b) Cause downregulation of GnRH receptors → medical castration (used in prostate Ca, endometriosis, fibroid) c) Act as ovulation inducers d) Increase estrogen levels Answer: B - Initial "flare" then downregulation; castrate levels of sex hormones after 2-4 weeks

Q117. Twin-to-twin transfusion syndrome (TTTS) occurs in: a) Dichorionic diamniotic twins b) Monochorionic diamniotic or monoamniotic twins (shared placenta) c) All twins d) Only fraternal twins Answer: B - Monochorionic twins share placenta; vascular anastomoses cause unequal blood flow; donor twin: growth restricted + oligohydramnios; recipient: polyhydramnios + cardiac overload

Q118. Term for delivery before 28 weeks, 28-37 weeks, and after 37 weeks: a) All "premature" if before 40 weeks b) <28 wks = extremely preterm; 28-32 = very preterm; 32-37 = late preterm; ≥37 = term c) Only <34 weeks is premature d) <36 weeks only Answer: B - Standard WHO classification; know for NEET vignettes about surfactant therapy timing (≤34 weeks)

SURGERY (18 Questions)

Q119. Parks classification of anal fistula: Most common type: a) Suprasphincteric b) Extrasphincteric c) Intersphincteric (most common ~70%) d) Transsphincteric Answer: C - Intersphincteric (Parks type I) = most common; treatment = fistulotomy (NEET PG 2025 Q195)

Q120. Courvoisier's law: a) Dilated gallbladder with jaundice suggests gallstones b) Palpable, non-tender distended gallbladder with jaundice = UNLIKELY due to stones (suggests carcinoma head of pancreas) c) Only in hepatic causes d) Applies to cholangitis Answer: B - Courvoisier's sign: chronic stone disease causes GB fibrosis (cannot distend); painless jaundice + distended GB = malignant obstruction (NEET PG 2025)

Q121. Congenital diaphragmatic hernia (CDH): Most common type and side: a) Morgagni hernia, right side b) Bochdalek hernia, left side (85%) c) Hiatus hernia d) Traumatic hernia Answer: B - Bochdalek (posterolateral defect); left side 85%; presents at birth with respiratory distress + scaphoid abdomen + bowel sounds in chest (NEET PG 2025)

Q122. Achalasia cardia: Gold standard investigation: a) Barium swallow ("rat-tail" or "bird-beak" appearance) b) High-resolution manometry (HRM) c) Endoscopy d) CT scan Answer: B - HRM is gold standard; shows incomplete LES relaxation + absent peristalsis; barium swallow shows bird-beak (NEET PG 2025)

Q123. Diffuse axonal injury (DAI): Most common cause and imaging: a) Hypertensive hemorrhage; CT shows blood b) Road traffic accident deceleration injury; MRI (especially DWI/SWI) shows white matter hemorrhagic shearing c) Penetrating injury d) Only seen on PET scan Answer: B - DAI: rotational deceleration; worst at grey-white matter junction, corpus callosum, brainstem; MRI > CT (NEET PG 2025)

Q124. In FAST (Focused Assessment Sonography in Trauma): Which spaces are examined? a) Only peritoneum b) Perihepatic (Morrison's pouch), perisplenic, pericardial, pelvic (pouch of Douglas) c) Only retroperitoneum d) Chest and abdomen only Answer: B - 4 standard windows; Morrison's pouch (hepatorenal) is most sensitive; eFAST adds lung windows

Q125. Polydioxanone (PDS) suture characteristics: a) Non-absorbable, braided b) Absorbable monofilament; synthetic; maintains strength 6 weeks c) Natural absorbable (collagen) d) Non-absorbable monofilament Answer: B - PDS = synthetic absorbable monofilament; used for abdominal wall closure; absorbs by hydrolysis (NEET PG 2025 Q197)

Q126. Breast cancer inflammatory stage: Peau d'orange + erythema + warmth = which stage? a) Stage IIA b) Stage IIB c) Stage IIIB (inflammatory breast cancer is T4d) d) Stage IV Answer: C - Inflammatory breast carcinoma = T4d = Stage IIIB; peau d'orange due to dermal lymphatic invasion (NEET PG 2025 Q191)

Q127. Sentinel lymph node biopsy: First-line for axillary staging in early breast cancer (clinically node-negative): a) Complete axillary dissection always b) Sentinel lymph node biopsy (SLNB) using blue dye + radioactive tracer c) CT staging only d) MRI axilla Answer: B - SLNB reduces lymphedema; if positive, may proceed to axillary dissection depending on tumor burden

Q128. Carotid body tumor "Lyre's sign": a) Carotid artery bifurcation splaying on angiography b) Calcification on X-ray c) Absent pulse d) CT finding of calcification Answer: A - Carotid body tumor (paraganglioma): pulsatile neck mass at angle of jaw; splaying of ICA/ECA = "lyre sign" or "goblet sign" (NEET PG 2025 Q192)

Q129. Richter's hernia contains: a) Entire bowel circumference in hernia sac b) Only a knuckle of bowel wall (one side of bowel wall), NOT the full lumen c) Meckel's diverticulum d) Appendix Answer: B - Can strangulate without obstruction (partial lumen involved)

Q130. Glasgow coma scale: Minimum and maximum scores: a) 0-15 b) 3-15 c) 1-14 d) 0-10 Answer: B - GCS 3-15; 3 = deep coma/death; 15 = normal; E4V5M6 = 15; intubate if GCS ≤8

Q131. Meckel's diverticulum "Rule of 2s": a) 2 feet from ileocecal valve, 2 inches long, 2% of population, presents in first 2 years, 2 types of ectopic tissue b) 2 cm from cecum, 20 cm long c) 2 feet from cecum, 2 cm wide d) Only in adults Answer: A - True diverticulum; contains gastric/pancreatic ectopic tissue; presents with painless rectal bleeding in children

Q132. Venous ulcer characteristics: a) Painful, punched-out, on tips of toes b) Painless (relatively), shallow, at medial malleolus; associated with lipodermatosclerosis + varicosities c) Deep + tendon exposed d) Only over pressure points Answer: B - Venous ulcer = gaiter area (medial malleolus); arterial ulcer = punched-out + painful + toes; diabetic = neuropathic + plantar (NEET PG 2025 Q196)

Q133. Preoperative preparation for pheo: ORDER matters: a) Beta-blocker first b) Alpha-blocker (phenoxybenzamine) FIRST for 10-14 days, then add beta-blocker if needed c) Calcium channel blocker alone d) Clonidine only Answer: B - Alpha BEFORE beta; if beta given first → paradoxical severe hypertension (NEET PG 2025 Q188)

Q134. Superior mesenteric artery syndrome: Caused by: a) Atherosclerosis b) Compression of 3rd part of duodenum between SMA and aorta (decreased fat pad) → high intestinal obstruction c) Mesenteric ischemia d) Pancreatitis Answer: B - Weight loss, prolonged supine position, scoliosis correction; barium shows "cut-off" at 3rd part of duodenum

Q135. Spigelian hernia location: a) Through femoral ring b) Lateral to rectus abdominis at semilunar line (through Spigelian fascia) c) Through obturator foramen d) Lumbar triangle Answer: B - Interparietal hernia; interparietal between abdominal muscles; difficult to diagnose clinically

Q136. Damage control surgery (DCS) principle in trauma: a) Complete surgery in one sitting b) Abbreviated surgery to control hemorrhage + contamination → ICU resuscitation → definitive repair c) Observation only d) Only for penetrating trauma Answer: B - "Lethal triad" of trauma: hypothermia + acidosis + coagulopathy; DCS prevents this; pack + temporary closure + ICU first

PSM / COMMUNITY MEDICINE (16 Questions)

Q137. Vaccine Vial Monitor (VVM): What does color change indicate? a) Vaccine has been opened b) Cumulative heat exposure has exceeded acceptable threshold (inner square becomes darker than outer circle = discard) c) Cold chain was maintained d) Vaccine is expired Answer: B - VVM inner square turns dark = freeze-VVM; discard if inner square ≥ outer circle color (NEET PG 2025)

Q138. Lead-time bias in cancer screening: a) Artificially improved survival statistics because detection happens earlier in disease course, NOT because treatment is better b) Selection bias c) Recall bias d) Measurement bias Answer: A - Survival appears longer but only because "timer starts earlier" with early detection, not actual life extension (NEET PG 2025)

Q139. Nalgonda technique is used for: a) Water disinfection with chlorine b) Defluoridation of water (excess fluoride areas) c) Deironation of water d) Desalination Answer: B - Alum + lime + soda ash → flocculation removes fluoride; used in endemic fluorosis areas (NEET PG 2025)

Q140. Cluster RCT differs from individual RCT in: a) Uses animals instead of humans b) Unit of randomization is a group/community (village, school) not individual c) Not a true randomized trial d) Observational study Answer: B - Avoids contamination between arms; design effect (DEFF) reduces effective sample size; intraclass correlation coefficient (ICC) matters (NEET PG 2025)

Q141. Herd immunity threshold formula: a) 1 - (1/R0); where R0 = basic reproduction number b) 1/R0 c) R0 × serial interval d) Cannot be calculated Answer: A - Herd immunity threshold = 1 - (1/R0); for measles (R0~15): 1-1/15 = ~93% coverage needed

Q142. Under-5 mortality rate (U5MR): Definition: a) Deaths per 1000 live births in first year of life b) Deaths per 1000 live births between 0-5 years of age c) Deaths per 1000 population d) Stillbirths + neonatal deaths Answer: B - U5MR = (deaths <5 years / live births) × 1000; MDG/SDG target indicator

Q143. Sensitivity vs Specificity: a) Sensitivity = TP/(TP+TN); Specificity = TN/(TN+FP) b) Sensitivity = TP/(TP+FN) [true positive rate]; Specificity = TN/(TN+FP) [true negative rate] c) Sensitivity = power; Specificity = alpha d) Always the same value Answer: B - High sensitivity = good screening test (few false negatives); high specificity = good confirmatory test (few false positives)

Q144. Maternal mortality ratio (MMR) definition: a) Maternal deaths per 1000 live births b) Maternal deaths per 100,000 live births c) Maternal deaths per 1000 women aged 15-49 d) Maternal deaths per 1000 pregnancies Answer: B - India's MMR target: <70/100,000 live births (SDG goal); current India MMR ~97 (2018-20)

Q145. Directly Observed Treatment Short-course (DOTS) for tuberculosis: Rifampicin used throughout because: a) Only drug active in all phases b) Sterilizing drug + prevents relapse when used in continuation phase c) Prevents resistance to isoniazid only d) Cheapest drug Answer: B - Rifampicin + pyrazinamide are sterilizing drugs; important for relapse prevention; rifampicin throughout reduces relapse rate

Q146. ASHA (Accredited Social Health Activist) role: Which program gave birth to ASHA? a) NRHM (National Rural Health Mission) 2005 - Janani Suraksha Yojana b) National Urban Health Mission c) District Primary Health Centre d) AYUSH mission Answer: A - ASHA introduced under NRHM 2005; JSY incentivizes institutional delivery; 1 ASHA per 1000 rural population

Q147. Attack rate of a disease during outbreak = : a) New cases / total population × 1000 b) New cases during outbreak period / population at risk at start × 100 c) Total deaths / total cases × 100 d) Same as case fatality rate Answer: B - Attack rate is an incidence proportion (%) used for acute disease outbreaks; secondary attack rate for contacts

Q148. Prevalence vs Incidence relationship: a) Prevalence = Incidence × Duration of illness (only for chronic, stable diseases) b) Prevalence is always higher than incidence c) Incidence includes old cases d) No mathematical relationship Answer: A - P = I × D (when disease is in steady state); for short-duration diseases: incidence ≈ prevalence

Q149. National Family Health Survey (NFHS-5) total fertility rate (TFR) for India: a) 2.8 b) 2.0 (below replacement level for first time) c) 3.5 d) 1.5 Answer: B - NFHS-5 (2019-21): India TFR = 2.0, below replacement fertility of 2.1 for the first time

Q150. Absolute risk reduction (ARR) and Number Needed to Treat (NNT): a) ARR = control rate − treatment rate; NNT = 1/ARR b) ARR = treatment rate / control rate c) NNT = 1/relative risk d) ARR is always expressed as ratio Answer: A - Key biostatistics: NNT = 1/ARR; lower NNT = more effective treatment; tested frequently in PSM/clinical questions

Q151. Hantavirus is transmitted by: a) Mosquito bite b) Rodent excreta (inhalation of infected urine/feces/saliva aerosols) - NO person-to-person c) Tick bite d) Blood transfusion Answer: B - Hantavirus pulmonary syndrome (Americas) or HFRS (Asia/Europe); no person-to-person transmission (except Andes virus)

Q152. Salk vaccine (IPV) vs Sabin vaccine (OPV): a) Both are live attenuated b) Salk = killed (IPV) - parenteral; Sabin = live attenuated (OPV) - oral; India switched to IPV in 2016 for scheduled immunization c) Both are killed d) Both are oral Answer: B - OPV can cause VAPP (vaccine-associated paralytic poliomyelitis) at rate ~1/750,000 first doses

PAEDIATRICS (5 Questions)

Q153. Kawasaki disease diagnostic criteria (CRASH): a) C = Conjunctivitis (bilateral non-purulent); R = Rash (polymorphous); A = Adenopathy (cervical); S = Strawberry tongue/mouth changes; H = Hand-Foot changes (edema/desquamation) b) Only fever + rash c) Requires all 6 criteria d) Rash + joint pain + elevated CRP Answer: A - CRASH mnemonic; fever ≥5 days + 4 of 5 CRASH criteria; coronary artery aneurysm = most feared complication; treat with IVIG + aspirin

Q154. Congenital hypothyroidism screening: Newborn screening uses: a) Serum T3 level b) TSH heel-prick blood spot at 48-72 hours of life c) T4 only d) Clinical signs only Answer: B - Neonatal screening for CH; elevated TSH = CH; normal "cretinism" face at birth; treat with levothyroxine ASAP

Q155. Intussusception classic triad in infants: a) Fever + vomiting + diarrhea b) Colicky pain + currant-jelly stools + sausage-shaped mass in right iliac fossa c) Projectile vomiting + constipation d) Bilious vomiting + distension Answer: B - Most common cause of intestinal obstruction in infants 6 months - 2 years; ultrasound shows "doughnut sign"; air enema is both diagnostic and therapeutic

Q156. Age at which fontanelle (anterior) closes: a) 3-6 months b) 9-12 months c) 18 months (12-18 months is normal range) d) 24-36 months Answer: C - Anterior fontanelle: 12-18 months; posterior fontanelle closes at 6-8 weeks; bulging = raised ICP; sunken = dehydration

Q157. Vitamin D deficiency rickets: Classic X-ray finding at wrist: a) Dense transverse lines (Harris lines) b) Cupping + fraying + splaying of metaphysis + widened physis c) Periosteal reaction d) Pathological fracture only Answer: B - Nutritional rickets: cupped/frayed/splayed metaphysis; "rosary" at costo-chondral junction; bowing of long bones

ORTHOPAEDICS (5 Questions)

Q158. Slipped Capital Femoral Epiphysis (SCFE): Classic presentation: a) 4-8-year-old child with avascular necrosis of femoral head b) Obese adolescent (10-16 years) with hip pain/limp + externally rotated leg; X-ray: "ice cream falling off cone" c) Elderly woman with hip fracture d) Toddler with developmental dysplasia Answer: B - SCFE: epiphysis slips posterior-medially on metaphysis; diagnose with AP + frog-leg lateral X-ray; treat with screw fixation (NEET PG 2025 Q127)

Q159. Legg-Calvé-Perthes disease (LCPD): Age group vs SCFE: a) Adolescents, obese b) Children 4-8 years; avascular necrosis of femoral head; antalgic gait c) Neonates d) Adults >50 years Answer: B - LCPD: idiopathic AVN in younger, leaner children; "crescent sign" (subchondral fracture) on X-ray; conservative management (NEET PG 2025 Q127)

Q160. Colles' fracture: Describes: a) Fracture of distal ulna with dorsal displacement b) Transverse fracture of distal radius within 2.5 cm of joint with dorsal tilt + radial shortening + dorsal displacement ("dinner fork" deformity) c) Smith's fracture (volar tilt) d) Monteggia fracture Answer: B - FOOSH (fall on outstretched hand); Colles = dorsal; Smith = volar ("garden spade" deformity)

Q161. Compartment syndrome: Pathological feature and treatment: a) Venous obstruction only b) Increased pressure within osteofascial compartment → ischemia; treat with emergency fasciotomy c) Only arterial injury d) Conservative management always Answer: B - "5 P's": Pain (with passive stretch), Pallor, Paresthesia, Paralysis, Pulselessness; fasciotomy within 6 hours

Q162. Trigger finger (stenosing tenosynovitis): Most commonly affects: a) Ring finger and middle finger b) Ring finger (4th digit) most common c) Index finger d) Little finger Answer: B - Ring finger most common in adults; middle finger in children; triggered by stenosis at A1 pulley; conservative (steroid injection) or surgical release

OPHTHALMOLOGY (5 Questions)

Q163. Glaucoma: Optic disc changes in chronic open-angle glaucoma: a) Swollen disc (papilledema) b) Cup-to-disc ratio >0.6; nasal shift of vessels; notching of neuroretinal rim; peripapillary atrophy c) Flame hemorrhages only d) Pale disc without cupping Answer: B - Increased C:D ratio >0.6 suspicious; inferior > superior > nasal > temporal loss (ISNT rule reversed); test: visual fields (Humphrey)

Q164. Cherry-red spot on macula: Classic causes: a) Diabetic retinopathy b) Central retinal artery occlusion (CRAO) + Tay-Sachs disease (storage disease); also Niemann-Pick c) Hypertensive retinopathy d) Papilledema Answer: B - CRAO: macula appears red (preserved choroidal supply) against white ischemic retina; Tay-Sachs: GM2 ganglioside storage

Q165. Kayser-Fleischer rings: Location and condition: a) Macula; macular degeneration b) Corneal periphery (Descemet's membrane); Wilson's disease (copper deposition) c) Lens; cataract d) Conjunctiva; pterygium Answer: B - Brown-green rings at corneal limbus; Wilson's disease; also seen in primary biliary cholangitis rarely

Q166. Retinoblastoma: Presentation and genetic feature: a) Red reflex preserved b) Leukocoria (white pupillary reflex) + strabismus; bilateral cases: RB1 gene mutation (chromosome 13q14); autosomal dominant hereditary type c) Only in adults d) Diagnosed by MRI only Answer: B - RB1 is tumor suppressor gene; bilateral/multifocal = hereditary; treatment depends on laterality and stage; enucleation vs photocoagulation

Q167. Vitamin A deficiency ocular findings (in order of progression): a) Cataract → glaucoma b) Night blindness (first) → Bitot's spots → xerophthalmia → corneal ulceration → keratomalacia (severe, irreversible) c) Only corneal involvement d) Papilledema Answer: B - WHO staging: XN = night blindness; X1A = conjunctival xerosis; X1B = Bitot's spots; X2 = corneal xerosis; X3A/B = keratomalacia

ENT (5 Questions)

Q168. Otosclerosis: Audiometric finding: a) Sensorineural hearing loss b) Conductive hearing loss with absent stapedial reflex; Carhart's notch at 2000 Hz on audiogram c) Mixed hearing loss d) Normal audiogram Answer: B - Abnormal bone remodeling of otic capsule; family history; treat with stapedectomy (NEET PG 2025 Q1 recall image concept)

Q169. Acoustic neuroma (Vestibular schwannoma): Most common symptom: a) Vertigo b) Unilateral sensorineural hearing loss + tinnitus; MRI with gadolinium shows "ice cream cone" at IAM c) Conductive hearing loss d) Facial nerve palsy first Answer: B - Arises from superior vestibular nerve; CN VIII first affected; MRI is gold standard; usually slow growing

Q170. Trotter's triad (sinus of Morgagni carcinoma / Nasopharyngeal carcinoma): a) Nasal obstruction + epistaxis + cervical lymphadenopathy b) Unilateral conductive hearing loss + ipsilateral trigeminal neuralgia + palatal palsy (pterygoid + levator veli palatini) c) Hoarseness + dysphagia + neck mass d) Anosmia + headache + nasal polyps Answer: B - Nasopharyngeal carcinoma Trotter's triad: conductive deafness (Eustachian tube obstruction) + palatal palsy + trigeminal neuralgia

Q171. Rinne test positive vs negative: a) Positive Rinne = AC > BC = NORMAL or sensorineural hearing loss b) Negative Rinne = BC > AC = Conductive hearing loss (>25-40 dB loss) c) Rinne positive always indicates sensorineural loss d) BC = AC always Answer: A - Rinne positive (normal): AC longer than BC (AC > BC); Rinne negative: BC > AC = conductive hearing loss (512 Hz tuning fork)

Q172. Nasal polyps: Most common type: a) Antrochoanal polyp (young adults, single, from maxillary sinus) b) Ethmoidal polyps (bilateral, multiple, associated with allergy, aspirin sensitivity, asthma - Samter's triad) c) Sphenoid sinus polyp d) Frontal polyp Answer: B - Ethmoidal polyps = most common bilateral; Samter's triad = aspirin hypersensitivity + asthma + nasal polyps

DERMATOLOGY (8 Questions)

Q173. Psoriasis classic histology finding: a) Acantholysis b) Munro's microabscesses (neutrophils in parakeratotic stratum corneum) + suprapapillary plate thinning + Auspitz sign (pinpoint bleeding) c) Eosinophilic spongiosis d) Vacuolar degeneration at DEJ Answer: B - Psoriasis: silvery-white scales on extensor surfaces + scalp; Auspitz sign pathognomonic; Koebner phenomenon; treat with biologics (anti-TNF, anti-IL-17, anti-IL-23)

Q174. Pemphigus vulgaris vs Pemphigoid: a) Both are the same b) Pemphigus vulgaris: intraepidermal acantholysis (suprabasal split); anti-desmoglein 1&3; NIKOLSKY POSITIVE; oral mucosa involved first; Pemphigoid: subepidermal blister; anti-BP230/BP180; Nikolsky NEGATIVE; tense blisters; rare oral c) Pemphigoid has Nikolsky positive d) Only elderly patients get pemphigus Answer: B - Key examiner favorite: acantholysis (Tzanck: "tombstone" basal cells) vs subepidermal (tense, fluid-filled, elderly)

Q175. Auspitz sign is seen in: a) Lichen planus b) Psoriasis (pinpoint bleeding when scale is removed, exposing dilated dermal capillaries) c) Pemphigus d) Pityriasis rosea Answer: B - Multiple choice trap: Auspitz = psoriasis; Koebner = psoriasis, lichen planus, vitiligo; Wickham striae = lichen planus

Q176. Darier's disease (keratosis follicularis): Genetic defect: a) Connexin mutation b) ATP2A2 gene (SERCA2 pump) mutation → defective desmoglein processing c) Collagen gene mutation d) Fibrillin mutation (Marfan) Answer: B - ATP2A2 (SERCA2); autosomal dominant; greasy, warty, keratotic papules in seborrheic areas; characteristic histology: corps ronds + grains

Q177. Target lesions (iris lesions) are characteristic of: a) Lichen planus b) Erythema multiforme (EM); central dusky zone + lighter ring + outer erythematous ring c) Psoriasis d) Pityriasis rosea Answer: B - EM: trigger (HSV, Mycoplasma, drugs); target lesions on palms/soles + oral involvement in EM major = Stevens-Johnson overlap

Q178. Dermatitis herpetiformis: Associated with: a) Breast cancer b) Celiac disease (gluten-sensitive enteropathy); IgA deposition at dermal papillae; intensely pruritic vesicles on extensor surfaces c) HIV d) Rheumatoid arthritis Answer: B - IgA anti-tissue transglutaminase; treat with gluten-free diet + dapsone; associated with HLA-DQ2/DQ8

Q179. Drug rash with eosinophilia and systemic symptoms (DRESS syndrome): Most commonly caused by: a) NSAIDs b) Anticonvulsants (carbamazepine, phenytoin, phenobarbital) and allopurinol c) Antibiotics only d) Antihistamines Answer: B - DRESS: 2-8 weeks after drug; fever + extensive rash + eosinophilia + lymphadenopathy + internal organ involvement; stop drug; systemic corticosteroids

Q180. Characteristic finding of leprosy (Hansen's disease) on skin biopsy: a) Non-caseating granuloma with Bacilli in LL type b) Tuberculoid: epithelioid granuloma at neuro-vascular bundle with few/absent AFB; Lepromatous: "Virchow cells" (foamy macrophages) with numerous AFB (Wade-Fite stain) + "Grenz zone" preserved c) Liquefactive necrosis d) Vacuolar change only Answer: B - Grenz zone (clear subepidermal zone) = lepromatous; granuloma touching epidermis = tuberculoid; BI (bacterial index) high in LL, low in TT

FORENSIC MEDICINE (6 Questions)

Q181. Rigor mortis: Timing in temperate climate: a) Appears in 1-2 hours; maximum at 6-8 hours; passes off in 24-36 hours (starts in jaw → descends) b) Only in limbs; appears at 12 hours c) Permanent stiffening d) Appears 6 hours; complete at 24 hours; disappears at 72 hours Answer: A - "Nysten's law": starts in jaw → neck → trunk → limbs; cadaveric spasm ≠ rigor mortis

Q182. Pugilistic attitude in burns is due to: a) Postmortem position b) Heat coagulation of proteins causing flexion of limbs (muscles contract, flexors stronger); NOT indicative of ante-mortem self-defense c) Ante-mortem defense posture d) Drowning artifact Answer: B - "Boxing stance" from heat; examiners often ask: "boxer's attitude in fire victim" = heat effect, NOT self-defense

Q183. Hypostasis (Livor mortis) is fixed after: a) 2-4 hours b) 6-8 hours (shifts if repositioned before fixation); fixed by 8-12 hours (cannot shift) c) 24 hours d) Immediately after death Answer: B - Blood settles in dependent areas; pinkish-red in CO poisoning (carboxyhemoglobin); cherry-red = CO

Q184. Magistrate's inquest is compulsory in India for: a) All natural deaths b) Dowry deaths, suicidal deaths with suspicious circumstances; deaths in police custody c) Only accidental deaths d) All unnatural deaths Answer: B - Under CrPC: Magistrate inquest for dowry deaths, deaths in police custody, judicial custody; ordinary deaths = police inquest

Q185. Adipocere formation: Conditions favoring: a) Dry, cold environment b) Warm, moist environment (water/wet soil) - conversion of body fat to hydroxy fatty acids (saponification); preserves body shape c) Only in air d) Only in salt water Answer: B - "Grave wax" or saponification; delays decomposition; helps identify cause of death months/years later

Q186. Blood alcohol level (BAL): Legal limit for driving in India: a) 50 mg/100 mL b) 30 mg/100 mL blood (0.03%) c) 80 mg/100 mL d) 100 mg/100 mL Answer: B - India: 30 mg% blood (Motor Vehicles Act 1988, amended 2019); 30 mg/100 mL = 0.03 g/dL

RADIOLOGY (5 Questions)

Q187. "Air bronchogram" sign on chest X-ray indicates: a) Emphysema b) Air-filled bronchi visible within consolidated (airspace-filling) lung; seen in lobar pneumonia, ARDS, pulmonary edema c) Pleural effusion d) Pneumothorax Answer: B - Air bronchogram = airspace disease (consolidation) around the bronchi; not seen in pure pleural or interstitial disease

Q188. "Soap bubble" appearance on X-ray of long bone metaphysis in a child: a) Osteosarcoma (sunburst pattern) b) Giant cell tumor (epiphysis, adults) c) Aneurysmal bone cyst d) Simple bone cyst Answer: C - Aneurysmal bone cyst: "soap bubble" + eccentric + expansile metaphyseal lesion; contains blood-filled cavities; treated with curettage + bone graft

Q189. "Sunburst" periosteal reaction on X-ray: a) Giant cell tumor b) Osteosarcoma (most aggressive periosteal reaction) c) Chondrosarcoma d) Ewing's sarcoma (onion-skin) Answer: B - Osteosarcoma: sunburst + Codman's triangle (elevated periosteum); metaphysis of distal femur/proximal tibia; Ewing's: onion-peel/laminated

Q190. CT head: "Hyperdense crescent-shaped" collection along inner table of skull: a) Epidural hematoma (biconvex/lenticular) b) Subdural hematoma (follows brain contour, crosses suture lines) c) Subarachnoid hemorrhage (fills cisterns) d) Intracerebral hemorrhage Answer: B - SDH: bridging veins rupture; crosses sutures; crescent-shaped; EDH: middle meningeal artery; doesn't cross sutures; biconvex (lens-shaped)

Q191. "String of pearls" sign on plain X-ray of abdomen: a) Volvulus b) Small bowel obstruction (SBO) - air trapped between valvulae conniventes c) Large bowel obstruction d) Intussusception Answer: B - Multiple small air pockets trapped by valvulae conniventes in distended small bowel loops = "string of pearls" in SBO

Q192. Chest X-ray: "Bat wing" or "butterfly" perihilar opacity suggests: a) Pulmonary tuberculosis b) Pulmonary edema (cardiogenic - bilateral perihilar, gravity-dependent) c) Pneumonia d) Pleural effusion Answer: B - Bilateral perihilar "bat wing" opacities = alveolar pulmonary edema; also seen on X-ray as "Kerley B lines" = interstitial edema

ANAESTHESIA (4 Questions)

Q193. Malignant hyperthermia: Caused by and treated with: a) Suxamethonium overdose; treat with atropine b) Volatile anesthetics (halothane, isoflurane) + suxamethonium → RyR1 mutation → uncontrolled calcium release → hyperthermia + rigidity; treat with DANTROLENE c) Nitrous oxide only d) Propofol infusion syndrome Answer: B - MH: autosomal dominant RYR1 mutation; hyperkalemia + rhabdomyolysis + fever; dantrolene 2.5 mg/kg IV

Q194. Suxamethonium (succinylcholine) contraindications: a) Renal failure only b) Burns (after 48 hours), crush injuries, denervation injuries, hyperkalemia risk; ALSO malignant hyperthermia susceptible patients c) Hypertension d) Pediatric patients generally Answer: B - Upregulation of extra-junctional ACh receptors → massive K+ release → cardiac arrest; safe in first 24-48 hours post-burn only

Q195. Bispectral index (BIS) monitoring: BIS 40-60 indicates: a) Awake b) General anesthesia (surgical anesthesia level) c) Deep sedation d) Emergence Answer: B - BIS scale: 100 = fully awake; 60-80 = deep sedation; 40-60 = general anesthesia; <40 = deep hypnosis/burst suppression

Q196. Propofol infusion syndrome (PRIS): Occurs with: a) Single dose propofol b) Prolonged high-dose propofol infusion (>48 hours, >5 mg/kg/hr) → metabolic acidosis + rhabdomyolysis + cardiac failure + hypertriglyceridemia c) Intrathecal propofol d) Elderly patients only Answer: B - PRIS: rare but fatal; green urine (lipiduria); seen in ICU patients on prolonged propofol sedation

ADDITIONAL HIGH-YIELD CLINICAL INTEGRATORS (4 Questions completing 200)

Q197. Meningitis CSF findings: Bacterial vs Viral vs TB:

Feature	Bacterial	Viral	TB
Appearance	Turbid/purulent	Clear	Cobweb clot
Cells	PMN (100-10,000)	Lymphocytes	Lymphocytes
Protein	Very high (>100)	Normal/slight ↑	High (100-500)
Glucose	Very low (<45)	Normal	Low (very)
Opening pressure	High	Normal/mild ↑	Elevated

Answer: Bacterial = PMN + very low glucose; Viral = lymphocytes + normal glucose; TB = lymphocytes + very low glucose + cobweb clot on standing

Q198. "All or nothing" law in cardiac muscle vs skeletal muscle: a) Cardiac: all-or-nothing (syncytium via gap junctions); Skeletal: graded response (summation, tetanus) b) Both are identical c) Cardiac is graded; skeletal is all-or-nothing d) No difference Answer: A - Cardiac syncytium via intercalated discs/gap junctions; cannot undergo tetanic contraction (due to long refractory period); skeletal can summate

Q199. "Warfarin embryopathy" causes which fetal defects (weeks 6-9)? a) Neural tube defects b) Nasal hypoplasia + stippled epiphyses (chondrodysplasia punctata) + ophthalmic defects; "Fetal warfarin syndrome" c) Limb reduction defects d) Cardiac defects only Answer: B - Warfarin crosses placenta; AVOID in 1st trimester (6-12 weeks); use heparin throughout OR switch to heparin in 1st trimester; avoid near delivery (neonatal hemorrhage)

Q200. TORCH infections: Which causes "blueberry muffin" rash in newborn? a) Toxoplasmosis b) Rubella (also causes congenital rubella syndrome: cataracts + PDA + sensorineural deafness; Gregg's triad) c) CMV only d) Herpes simplex Answer: B - Blueberry muffin = extramedullary hematopoiesis (rubella + CMV); Rubella also causes "salt-and-pepper" retinopathy; CMV = periventricular calcifications; Toxo = "ring calcifications" + hydrocephalus

PART 2 - LAST 5-YEAR RECALLED IMAGE-BASED QUESTIONS (2022-2026)

These are the most frequently recalled visual/image-based questions from NEET PG exams 2022-2025.

ANATOMY - Image Recalls

IMG-1 [NEET PG 2025]. Image shows jugular foramen with structure "A" labeled. Q: Which nerve does NOT pass through structure "A"? Options: CN IX / CN X / CN XI / CN XII Answer: CN XII (Hypoglossal) - passes through hypoglossal canal, NOT jugular foramen

IMG-2 [NEET PG 2025]. Image shows embryological defect in aortic arch. Q: The defect shown relates to which aortic arch? Answer: Right 4th aortic arch - aberrant right subclavian artery

IMG-3 [NEET PG 2025]. Image shows origin site of triceps brachii long head. Q: What is the origin site? Answer: Infraglenoid tubercle of scapula (trap: supraglenoid = biceps long head)

IMG-4 [NEET PG 2022-23]. CT cross-section of brain at basal ganglia level. Q: Identify the thalamus / lenticular nucleus / caudate nucleus Answer: Know the "target" appearance; thalamus is posterior-medial; lenticular nucleus (putamen + globus pallidus) is lateral

SURGERY - Image Recalls

IMG-5 [NEET PG 2025]. X-ray of lumbar spine showing anterior slippage of one vertebra on another. Q: Diagnosis? Answer: Spondylolisthesis (NOT spondylolysis which is pars defect without slippage) (NEET PG 2025 Q126)

IMG-6 [NEET PG 2025]. X-ray of hip in an 11-year-old with painful limp. Showed avascular necrosis changes / femoral head flattening Answer: Perthes disease (LCPD) in younger child vs SCFE in older obese adolescent (Q127)

IMG-7 [NEET PG 2025]. Image of surgical knot used in procedures. Q: What type of knot? Answer: Surgeon's knot (first throw has double loop for added friction vs square knot = single loops)

IMG-8 [NEET PG 2025]. Image of anorectal fistula tract (Parks classification). Q: Identify the type. Answer: Intersphincteric (most common; tract between internal and external sphincter)

IMG-9 [NEET PG 2025]. Barium swallow image showing "bird-beak" tapering at lower esophagus. Q: Gold standard investigation to confirm diagnosis? Answer: Esophageal manometry (diagnosis of achalasia cardia)

IMG-10 [NEET PG 2025]. MRI image of brain - extra-axial mass with dural tail. Q: Most likely diagnosis? Answer: Meningioma (dural tail sign; hyperdense on CT; uniformly enhancing on MRI)

IMG-11 [NEET PG 2025]. Image showing patient with peau d'orange of breast + diffuse erythema. Q: TNM stage? Answer: Stage IIIB (T4d = inflammatory carcinoma; any N, M0)

IMG-12 [NEET PG 2025]. Image of neck mass at angle of jaw - pulsatile, mobile side-to-side not up-down; angiogram shows carotid bifurcation splaying. Q: Diagnosis? Answer: Carotid body tumor (paraganglioma) - "Lyre sign" = ICA and ECA splayed apart

IMG-13 [NEET PG 2025]. Image of fingertip changes showing blackened/necrotic digits. Q: Wet gangrene vs dry gangrene vs Raynaud's? Answer: Wet gangrene (if edematous, infected, foul-smelling) vs Dry gangrene (mummified, shrunken, demarcated line)

IMG-14 [NEET PG 2023-24]. Histology showing "sunburst" pattern + aggressive periosteal reaction in distal femur. Q: Diagnosis? Answer: Osteosarcoma (Codman triangle + sunburst periosteal reaction; metaphysis of long bones)

IMG-15 [NEET PG 2022]. Chest X-ray with tracheal deviation + absent lung markings on one side. Q: Tension pneumothorax or simple pneumothorax? Management? Answer: Tension pneumothorax (trachea deviates AWAY from side of lesion); emergency needle decompression 2nd ICS MCL

PATHOLOGY - Image Recalls

IMG-16 [NEET PG 2025]. Peripheral blood smear showing hypersegmented neutrophils + oval macrocytes. Q: Deficiency? Answer: B12 or Folate deficiency (megaloblastic anemia; hypersegmented neutrophils = 5-lobe nucleus in >5% of PMNs)

IMG-17 [NEET PG 2025]. Histology showing "owl-eye" binucleate cells in lymph node. Q: Diagnosis? Answer: Reed-Sternberg cells = Hodgkin lymphoma; CD15+, CD30+

IMG-18 [NEET PG 2024]. Histology showing nests of cells with abundant cytoplasm in adrenal medulla. Q: Diagnosis? Answer: Pheochromocytoma (Zellballen pattern; chromogranin A positive; S100 sustentacular cells)

IMG-19 [NEET PG 2023]. Histology showing "fried egg" cells / "chicken-wire" capillaries. Q: Diagnosis? Answer: Oligodendroglioma (round cells with clear cytoplasm "fried egg" artifact; calcifications; 1p/19q codeletion)

IMG-20 [NEET PG 2022-23]. Congo red stain showing apple-green birefringence under polarized light. Q: Diagnosis + condition? Answer: Amyloidosis (Congo red = orange-red normally; apple-green under polarized = pathognomonic for amyloid)

IMG-21 [NEET PG 2024]. Histology showing "signet ring" cells. Q: Diagnosis? Answer: Gastric adenocarcinoma (linitis plastica / diffuse type) - mucin pushes nucleus to periphery

IMG-22 [NEET PG 2023]. Histology showing "pseudopalisading necrosis" around tumor cells. Q: Diagnosis? Answer: Glioblastoma multiforme (GBM) - WHO grade IV; MGMT methylation = better prognosis; treat with temozolomide + radiation

MICROBIOLOGY - Image Recalls

IMG-23 [NEET PG 2025]. Gram stain showing gram-positive cocci in clusters. Q: What test differentiates Staph aureus from Staph epidermidis? Answer: Coagulase test (S. aureus = coagulase positive); catalase differentiates Staph from Strep

IMG-24 [NEET PG 2024]. Image showing branching, septate hyphae at 45° angle (Grocott-Gomori silver stain). Q: Organism? Answer: Aspergillus fumigatus (acute-angle 45° branching, septate hyphae)

IMG-25 [NEET PG 2023]. KOH preparation showing broad, ribbon-like, aseptate hyphae with wide-angle (90°) branching. Q: Organism? Answer: Mucor/Rhizopus (Mucormycosis - Zygomycetes); associated with DKA; rhinocerebral form most common

IMG-26 [NEET PG 2022]. India ink preparation showing encapsulated yeast in CSF. Q: Organism? Answer: Cryptococcus neoformans - opportunistic in HIV (CD4 <100); treat with amphotericin B + flucytosine

IMG-27 [NEET PG 2024]. Giemsa stain of peripheral blood film showing ring trophozoites + banana-shaped gametocytes. Q: Plasmodium species? Answer: Plasmodium falciparum - multiple rings per RBC; Maurer's clefts; banana-shaped gametocytes; most dangerous

MEDICINE / CARDIOLOGY - Image Recalls

IMG-28 [NEET PG 2024-25]. ECG showing narrow complex regular tachycardia at rate ~150 bpm with sawtooth flutter waves best seen in V1/inferior leads. Q: Diagnosis + management? Answer: Atrial flutter (2:1 block) - rate ~150; treat with rate control (diltiazem) or cardioversion; ablation for recurrence

IMG-29 [NEET PG 2023]. ECG showing ST elevation in V1-V4 with "tombstone" pattern. Q: Diagnosis? Answer: Anterior STEMI (LAD territory) - call STEMI protocol; primary PCI within 90 min

IMG-30 [NEET PG 2024]. Chest X-ray showing "egg-on-its-side" cardiac silhouette + increased pulmonary vascularity. Q: Congenital heart disease? Answer: Transposition of Great Arteries (TGA) - narrow mediastinum + egg-on-side; presents as cyanotic newborn; prostaglandin E1 to maintain PDA; balloon atrial septostomy

IMG-31 [NEET PG 2023]. Echocardiogram / chest X-ray showing "boot-shaped" heart. Q: Diagnosis? Answer: Tetralogy of Fallot (TOF) - "coeur en sabot" (boot-shaped) on CXR; cyanotic CHD; squatting relieves hypercyanotic spell

IMG-32 [NEET PG 2022]. Fundal photograph showing flame hemorrhages + papilledema + hard exudates in a "star pattern" at macula. Q: Diagnosis? Answer: Hypertensive retinopathy (Grade IV - Papilledema + star pattern) - Keith-Wagener-Barker grade IV

DERMATOLOGY - Image Recalls

IMG-33 [NEET PG 2025]. Clinical image of patient showing silvery-white plaques on extensor surfaces of elbows. Q: Diagnosis + sign present? Answer: Psoriasis vulgaris - Auspitz sign (pinpoint bleeding when scale removed); Grattage test

IMG-34 [NEET PG 2024]. Clinical image showing tense bullae + erosions in elderly patient; Nikolsky sign NEGATIVE. Q: Diagnosis? Answer: Bullous pemphigoid - subepidermal blisters; anti-BP180/BP230 (hemidesmosome); linear IgG at DEJ on DIF

IMG-35 [NEET PG 2023]. Clinical image showing target lesions on palms and dorsal hands. Q: Diagnosis + most common trigger? Answer: Erythema multiforme - most common trigger = HSV (herpes simplex); Mycoplasma also common

IMG-36 [NEET PG 2024]. Skin scraping under KOH showing "spaghetti and meatballs" pattern. Q: Organism + condition? Answer: Malassezia furfur - Pityriasis versicolor; hypo/hyperpigmented macules; treat with topical selenium sulfide / ketoconazole

IMG-37 [NEET PG 2022-23]. Clinical image showing hypopigmented anesthetic patch + thickened nerve. Q: Type of leprosy? Answer: Tuberculoid leprosy (TT/BT) - few bacilli, strong CMI; AFB-negative/few; treat with rifampicin + dapsone (PB: 6 months)

RADIOLOGY - Image Recalls

IMG-38 [NEET PG 2025]. MRI Brain showing enhancing mass in posterior fossa in a 7-year-old. Q: Most likely diagnosis? Answer: Medulloblastoma (most common posterior fossa tumor in children; arises from vermis; "drop metastases" in spinal canal; treat with surgery + radiation + chemo)

IMG-39 [NEET PG 2024]. CT showing "biconvex (lens-shaped) hyperdense" extra-axial collection, NOT crossing sutures. Q: Diagnosis? Answer: Extradural/Epidural hematoma - rupture of middle meningeal artery; "lucid interval"; temporal bone fracture; emergency craniotomy

IMG-40 [NEET PG 2023]. Plain X-ray showing "ground-glass" opacity in lung apices + Ghon complex. Q: Diagnosis? Answer: Primary tuberculosis (Ghon focus = subpleural calcification + ipsilateral hilar lymph node = Ghon complex; Ranke complex = calcified Ghon complex)

IMG-41 [NEET PG 2024]. USG showing "double wall sign" or "target sign" in right iliac fossa. Q: Diagnosis? Answer: Intussusception (concentric rings = target/doughnut sign on cross-section; pseudo-kidney sign on longitudinal section)

IMG-42 [NEET PG 2022]. Abdominal X-ray showing "coffee-bean sign" in sigmoid colon. Q: Diagnosis? Answer: Sigmoid volvulus - treatment = flexible sigmoidoscopy decompression (if not gangrenous); coffee-bean pointing to RIGHT upper quadrant

QUICK REVISION: 2025-2026 NEW UPDATES TO KNOW

1. SGLT2 inhibitors (empagliflozin/dapagliflozin): Now first-line added therapy in HFrEF with/without diabetes (2022 ESC Heart Failure guidelines). NEET PG tests this heavily.

2. COVID-19 related: ARDS management (6 mL/kg TV + prone positioning for PaO2/FiO2 < 150); Multisystem inflammatory syndrome in children (MIS-C) = Kawasaki-like post-COVID.

3. Tuberculosis - ART timing updated: WHO recommends ART within 2-8 weeks of TB treatment initiation (all patients); EXCEPT TB meningitis = start at 8 weeks.

4. Updated NEET PG pattern 2025 (held August 3, 2025): 200 Qs; single session; ~50% image-based; multiple shift of paper analysis confirms above trends.

5. Idarucizumab (Praxbind): Specific reversal agent for dabigatran; andexanet alfa for direct Xa inhibitors (rivaroxaban, apixaban).

6. McDonald criteria 2017 for MS: Can diagnose on single MRI scan if "dissemination in space" criteria met + CSF oligoclonal bands showing "dissemination in time."

7. HPV vaccination schedule: 2-dose (0, 6-12 months) for girls 9-14 years; 3-dose for 15+ years; India launched Cervavac (quadrivalent HPV vaccine, indigenous) in 2023.

8. PBC (Primary Biliary Cholangitis): Treatment with obeticholic acid (new; second-line after UDCA failure) - tested as "new drug" question.

9. Iron deficiency anemia treatment in pregnancy: IV iron preferred in 2nd/3rd trimester if Hb <8 g/dL or unable to tolerate oral iron (FOGSI/WHO 2022 guidelines).

10. Rotterdam criteria for PCOS reaffirmed: AMH can substitute for ultrasound PCO criteria in revised 2023 international evidence-based guideline.

SUBJECT-WISE PRIORITY FOR NEET PG 2026

Priority	Subject	Focus
★★★★★	Medicine	Clinical vignettes, ECGs, emergencies, rheumatology
★★★★★	OBGYN	Obstetric emergencies, infertility, gynecological malignancies
★★★★★	Surgery	Trauma, GI surgery, oncology, hernia classification
★★★★	PSM	Biostatistics, national programs, epidemiology
★★★★	Pharmacology	Drug of choice, drug interactions, newer drugs
★★★★	Pathology	IHC, chromosomal translocations, histology images
★★★★	Microbiology	Clinical context, special stains, serology
★★★	Biochemistry	Enzyme deficiencies, metabolic pathways
★★★	Dermatology	Image-heavy, bullous diseases, photosensitivity
★★★	Radiology	X-ray signs, CT patterns, named signs
★★	Anatomy	Neuroanatomy, radiological, embryology
★★	Forensic	Medico-legal, thanatology basics
★★	Ortho	X-ray diagnosis, named conditions
★★	Ophthalmology	Retinal conditions, glaucoma, congenital
★★	ENT	Audiometry, ear conditions, neck masses
★★	Paediatrics	Growth milestones, congenital conditions
★	Physiology	Integrated into other subjects
★	Anaesthesia	Specific drugs, monitoring, complications

Image based que with ans from last 5 year, Recall based

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NEET PG 2021 2022 2023 2024 2025 recall image based questions with answers all subjects

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Reed Sternberg cell owl eye histology Hodgkin lymphoma

This high-power light micrograph of a lymph node biopsy, stained with Hematoxylin and Eosin, demonstrates classical Hodgkin lymphoma histology. The tissue is densely cellular with a polymorphic inflammatory background comprising small lymphocytes, eosinophils, plasma cells, and histiocytes. Scattered among the background are large binucleated Reed-Sternberg (RS) cells exhibiting prominent, mirror-image eosinophilic nucleoli and ample cytoplasm, giving an owl's eye appearance. Mononuclear RS variants with similar nuclear features are present, reflecting heterogeneity within the malignant cell population. The RS cells may appear with delicate nuclear membranes and occasional lobulation. The surrounding milieu often includes reactive T-lymphocytes and occasional eosinophils attracted by cytokines produced by RS cells. The overall architecture lacks well-formed nodules, and the background shows a mixed inflammatory infiltrate, characteristic of classical Hodgkin lymphoma subtypes such as mixed cellularity. Important differential considerations include infectious or benign reactive processes, but the presence of RS cells with classic morphology supports a diagnosis of classical HL. Clinically, these findings correlate with nodal enlargement and B symptoms in many patients, and histology guides staging and therapy decisions, including chemotherapeutic regimens such as ABVD and potential radiotherapy in select cases. Correlation with immunohistochemistry and clinical data improves diagnostic confidence and treatment planning for patient care.

This histopathology image depicts a hematoxylin and eosin (H&E) stained lymph node biopsy section examined under bright-field light microscopy. The predominant nodular sclerosis pattern features fibrous bands dividing the paracortex into discrete nodules. Within the nodules, numerous Reed-Sternberg (RS) cells and Hodgkin cells are evident; RS cells frequently display binucleation with prominent eosinophilic nucleoli and an 'owl's eye' appearance. A lacunar variant of RS cells may be present, characterized by abundant pale cytoplasm and retraction artifacts in formalin-fixed tissue. Background inflammatory cells are relatively sparse but include small lymphocytes and occasional eosinophils; overall lymphoid architecture is disrupted by collagenous septa. The appearance is characteristic of classic Hodgkin lymphoma, nodular sclerosis subtype, which often presents with mediastinal or nodal involvement. Diagnostic significance lies in identifying RS/Hodgkin cells amid a fibrotic nodular framework, supporting a diagnosis of cHL and guiding therapy decisions. Clinically, this image is relevant for educational purposes, hematopathology training, differential diagnosis discussions with reactive lymphadenopathy, NLPHL distinctions, and confirmation of HL subtypes. Potential diagnoses to consider include nodular sclerosis cHL versus NLPHL, other B-cell lymphomas; immunophenotypic studies (CD30+, CD15+, PAX5 weak) and staging (PET-CT) commonly accompany histology for treatment planning.

Histopathology image: Lymph node biopsy stained with Hematoxylin and Eosin (H&E) examined under light microscopy, high magnification. The sample displays lymphoreticular tissue composed of a dense inflammatory background with numerous small lymphocytes and occasional histiocytes. Scattered large atypical cells with prominent nucleoli are identifiable, consistent with Reed–Sternberg (RS) cells and their variants. In this Grade II presentation of nodular sclerosis classical Hodgkin lymphoma (cHL), numerous, bizarre, anaplastic RS cells are seen within a milieu that lacks substantial lymphocyte depletion. The architectural pattern may include nodularity interspersed by fibrous bands, a characteristic of nodular sclerosis, although the image emphasizes individual RS cells and a reactive infiltrate. The RS cells resemble owl-eye nucleoli within a large cytoplasm; immunophenotype typically CD30+, CD15+, CD20−/variable, PAX5 weak, EBV status variable. The observed features correspond to a higher-grade cHL subset, yet grading is primarily a research construct and not essential for routine clinical management. Clinically, this histology correlates with aggressive behavior in some nodal HL cases but usually responds to standard chemotherapy regimens. The image is useful for education about HL morphology, RS cell pleomorphism, differential diagnosis (anaplastic large cell lymphoma, NLPHL, reactive lymphoid hyperplasia) and research correlations in HL grading strategies.

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spondylolisthesis lumbar spine X-ray anterior vertebral slip

$Multi-modal diagnostic imaging of the lumbar spine showcasing a case of lytic spondylolisthesis scheduled for MIS-TLIF. Panel A (Anterior-Posterior X-ray) and B (Lateral X-ray) demonstrate lumbar spinal alignment with a visible grade I or II anterolisthesis at the L4-L5 level. Panel C consists of sagittal CT reconstructions highlighting a fractured pars interarticularis (spondylolysis) at the affected level, contributing to the instability. Panel D (Sagittal MRI) and E (Axial MRI) provide soft tissue detail, showing the relationship between the slipped vertebral body, the intervertebral disc, and the neural elements within the spinal canal. The MRI axial cut (E) specifically illustrates the status of the spinal canal and foraminal space at the level of the slip. Collectively, these images represent the preoperative workup for a minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) to address spondylolytic spondylolisthesis.$

Multi-modal diagnostic imaging of the lumbar spine showcasing a case of lytic spondylolisthesis scheduled for MIS-TLIF. Panel A (Anterior-Posterior X-ray) and B (Lateral X-ray) demonstrate lumbar spinal alignment with a visible grade I or II anterolisthesis at the L4-L5 level. Panel C consists of sagittal CT reconstructions highlighting a fractured pars interarticularis (spondylolysis) at the affected level, contributing to the instability. Panel D (Sagittal MRI) and E (Axial MRI) provide soft tissue detail, showing the relationship between the slipped vertebral body, the intervertebral disc, and the neural elements within the spinal canal. The MRI axial cut (E) specifically illustrates the status of the spinal canal and foraminal space at the level of the slip. Collectively, these images represent the preoperative workup for a minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) to address spondylolytic spondylolisthesis.

$This composite figure displays multi-modal preoperative diagnostic imaging of the lumbar spine, focusing on the L4-L5 segment. Panel A consists of plain radiographs in anterior-posterior and lateral views (neutral, flexion, and extension), demonstrating Grade I degenerative anterolisthesis of the L4 vertebral body relative to L5. Key features include vertebral malalignment, intervertebral disc space narrowing, and osteophyte formation. Panel B presents sagittal and axial T2-weighted MRI scans, highlighting soft tissue pathologies such as segmental spinal canal stenosis and compression of the spinal cord and nerve roots associated with the slip. Panel C shows axial CT scans in bone and soft tissue windows, providing detailed visualization of the vertebral bodies and facet joints while confirming the absence of isthmic fractures, classifying the condition as degenerative rather than spondylolytic spondylolisthesis. This comparative imaging set illustrates the respective strengths of X-ray for alignment, MRI for neural elements and soft tissue, and CT for cortical bone integrity in the evaluation of lumbar degenerative diseases.$

This composite figure displays multi-modal preoperative diagnostic imaging of the lumbar spine, focusing on the L4-L5 segment. Panel A consists of plain radiographs in anterior-posterior and lateral views (neutral, flexion, and extension), demonstrating Grade I degenerative anterolisthesis of the L4 vertebral body relative to L5. Key features include vertebral malalignment, intervertebral disc space narrowing, and osteophyte formation. Panel B presents sagittal and axial T2-weighted MRI scans, highlighting soft tissue pathologies such as segmental spinal canal stenosis and compression of the spinal cord and nerve roots associated with the slip. Panel C shows axial CT scans in bone and soft tissue windows, providing detailed visualization of the vertebral bodies and facet joints while confirming the absence of isthmic fractures, classifying the condition as degenerative rather than spondylolytic spondylolisthesis. This comparative imaging set illustrates the respective strengths of X-ray for alignment, MRI for neural elements and soft tissue, and CT for cortical bone integrity in the evaluation of lumbar degenerative diseases.

Searching Images

aspergillus septate hyphae acute angle branching histopathology

High-magnification light microscopy of a necrotic tissue biopsy stained with hematoxylin and eosin (H&E) reveals broad, nonseptate fungal hyphae with irregular, often wide-angle branching consistent with Mucorales (mucormycosis). The specimen shows extensive focal necrosis with loss of parenchymal architecture, irregular stromal disruption, and sparse neutrophilic and lymphohistiocytic inflammatory infiltrate. Within necrotic zones, thick-walled hyphae measuring approximately 5–20 μm in diameter traverse the tissue, displaying paucity of septa and occasional right-angle or variable-angle branching. The background demonstrates vascular congestion and occasional hyaline fungal elements; occasional sporangia are not clearly visible. The appearance is highly suggestive of invasive zygomycosis in an immunocompromised host or poorly controlled diabetes. Clinically important features include the need for rapid antifungal therapy (liposomal amphotericin B or amphotericin B), urgent surgical debridement, and correction of underlying acidosis or immunosuppression. Differential diagnosis includes Aspergillus species (septate hyphae with acute-angle branching), Fusarium, and other mould infections; however, septation and branching patterns help distinguish. The observation supports a diagnosis of fungal invasion in necrotic tissue, correlating with systemic signs of infection. In microbiology, culture and molecular assays can confirm genus. Utility: educational reference for histopathology, diagnostic pathology, and fungal infection management.

Imaging modality with technique details: Grocott methenamine silver stain applied to tissue biopsy. Light microscopy. The image shows a granulating necrotic focus with scattered, irregular thick fungal hyphae visible against a pale background. Hyphae are broad and variably wide, with intermittent septation and irregular, snake-like contours. The stain accentuates fungal cell walls in dark pigment (black/brown) on the eosinophilic necrotic tissue and inflammatory debris. The surrounding tissue demonstrates necrosis with sparse inflammatory cells. The morphological pattern is compatible with invasive molds; presence of hyphae within necrotic debris suggests tissue invasion. Distinguishing features include broad, nonseptate or pauci-septate hyphae with wide branching, a classic clue for Mucorales (mucormycosis); in contrast, Aspergillus would typically show narrow, septate hyphae with acute angle branching. Clinical correlation is essential given risk factors such as diabetes, neutropenia, or immunosuppression. The diagnostic significance lies in early recognition of invasive fungal infection to guide prompt antifungal therapy liposomal amphotericin B and surgical debridement where appropriate. Potential differential diagnoses include mucormycosis, aspergillosis, and other zygomycetes; PCR and culture should be performed for species-level identification. This image is a valuable educational resource for histopathology, infectious disease, and pathology training; courtesy of Dr. Katharina Glatz, University of Basel, Switzerland. Thank you.

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epidural hematoma biconvex lenticular CT brain

**Imaging Modality:** Non-contrast Computed Tomography (NCCT) of the head.

**Imaging Modality:** Non-contrast axial Computed Tomography (CT) of the head.

Searching Images

Tetralogy of Fallot boot shaped heart X-ray coeur en sabot

A posteroanterior (PA) chest X-ray of an adult male demonstrating classic radiological features associated with Tetralogy of Fallot (TOF). The cardiac silhouette exhibits mild cardiomegaly and a characteristic 'boot-shaped' heart (coeur en sabot). This morphology is defined by an upturned, rounded cardiac apex, indicating right ventricular hypertrophy, and a concave pulmonary artery segment (pulmonary conus). The lung fields appear relatively oligemic, reflecting decreased pulmonary blood flow typical of right-to-left shunting or pulmonary stenosis. No acute pulmonary infiltrates or pleural effusions are visible. The costophrenic angles are clear. This diagnostic image is intended for medical students and clinicians to identify visual markers of cyanotic congenital heart disease and right ventricular pressure overload in an adult clinical presentation.

This diagnostic posteroanterior (PA) chest X-ray demonstrates the characteristic findings of Tetralogy of Fallot in a 21-year-old female patient. The image shows a well-centered view with adequate inspiratory effort. The primary finding is an increased cardiothoracic ratio with a distinctive 'boot-shaped' heart, also known as 'coeur en sabot.' This morphology is characterized by an upturned cardiac apex, resulting from significant right ventricular hypertrophy, and a concave pulmonary artery segment. The right heart border is notably prominent, indicating right atrial enlargement. Despite the history of surgical repair (including VSD closure and RV outflow tract reconstruction), these structural changes remain visible. The pulmonary vasculature appears normal, and the lung fields are clear without evidence of opacities, focal lesions, or pleural effusions. Sternal wires and surgical markers from prior cardiac procedures may be visible in the midline. The image serves as a classic educational example of chronic cardiac remodeling in congenital heart disease.

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Congo red amyloid apple green birefringence polarized light

Imaging modality and technique: Light microscopy of Congo red-stained cardiac tissue examined under polarized light. Primary subject: Cardiac amyloidosis with amyloid deposition in the vascular wall. Specimen type: Cardiac tissue biopsy specimen. Imaging perspective: Polarized-light evaluation of Congo red–stained sections. Visual features: Irregular, eosinophilic, amorphous extracellular deposits confined to small- to mid-sized vessel walls within the myocardium; deposits appear as dense, salmon-pink material on routine brightfield and exhibit characteristic apple-green birefringence under polarized illumination. Diagnostic significance: Congo red positivity with apple-green birefringence confirms amyloid deposition in heart tissue, supporting a diagnosis of systemic amyloidosis with cardiac involvement. This finding is clinically relevant because myocardial amyloid deposition can cause restrictive cardiomyopathy with diastolic dysfunction and heart failure; identification guides systemic workup for AL (light-chain) vs ATTR (transthyretin) etiologies, and informs prognosis and treatment strategies. Differential considerations: Non-amyloid eosinophilic deposits or pigmentations would lack Congo red positivity and birefringence; however, the combination of Congo red staining and birefringence is consistent with amyloidosis. Clinical correlation: Correlate with echocardiography, cardiac MRI, serum free light chains, immunohistochemistry, and genetic testing as indicated.

A multi-panel figure illustrating diagnostic findings of systemic AL amyloidosis through microscopy and gross pathology. Panels A and B show a breast biopsy; Congo red staining (A) reveals pink amorphous stromal amyloid deposits, which demonstrate characteristic apple-green birefringence under polarized light (B). Panels C and D are gross photographs of an autopsied heart showing significant cardiomegaly and a thickened left ventricular myocardium, indicative of restrictive cardiomyopathy. Panel E displays a bone marrow microscopic section with hypercellularity and an abnormal plasma cell infiltrate. Panels F through I show myocardial autopsy sections; Congo red stain identifies widespread peri-myocytic (F) and vascular (H) pink amyloid deposits. Corresponding polarized light images (G, I) confirm these as amyloid through apple-green birefringence within the cardiac interstitium and vessel walls. This composite figure serves as an educational resource for identifying multisystemic amyloid infiltration and the underlying plasma cell dyscrasia.

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psoriasis silvery white plaques extensor elbow skin clinical

This clinical photograph displays a lateral view of a patient's upper extremity and torso demonstrating classic features of plaque psoriasis. The focal point is the extensor surface of the elbow, which exhibits large, confluent, well-demarcated erythematous plaques. These plaques are characterized by a thick, micaceous, silvery-white scale, which is most prominent on the joint surface. Scattered across the surrounding forearm, upper arm, and lateral trunk are numerous smaller, discrete erythematous papules and plaques of varying sizes, representing a guttate or eruptive pattern. Some of these peripheral lesions show early scale formation, while others appear as simple erythematous macules. The distribution follows a typical pattern for chronic plaque-type psoriasis, emphasizing involvement of extensor surfaces. This image is an educational tool for dermatology, illustrating primary skin lesions including plaques, papules, and scales, and highlighting the hallmark morphological features used in the clinical diagnosis of psoriatic disease.

A clinical photograph of a 45-year-old male patient demonstrating moderate-to-severe plaque psoriasis on the lower back and elbow. The image shows a large, well-demarcated, erythematous plaque on the trunk characterized by thick, silvery-white micaceous scaling and a dry, fissured surface. Smaller satellite plaques are visible superior and lateral to the primary lesion. A similar thick, scaly plaque is noted on the extensor surface of the left elbow. The image includes annotations for clinical research monitoring: blue dashed squares delineate the target lesional site on the primary plaque for optical coherence tomography (OCT) scanning, while gray dashed squares indicate a perilesional control site on normal-appearing skin. This visual demonstrates the classic morphology of psoriasis vulgaris used for long-term therapeutic monitoring, with a reported PASI score of 10.8 and BSA of 10%.

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intussusception target doughnut sign ultrasound pediatric

This composite image illustrates the development of a low-cost, high-fidelity ultrasound training phantom for pediatric intussusception. Panel A shows a clinical photograph of a benchtop model consisting of silicone tubing submerged in a red-tinted gelatin and psyllium fiber matrix within a foil container. The tubing is coiled and invaginated to simulate loops of bowel and intussusception pathology. Panel B displays a diagnostic ultrasound image obtained from this phantom. The ultrasound reveals significant acoustic shadowing—characterized by dark vertical bands—emanating from the simulated bowel loops. This shadowing is an artifact likely caused by trapped air or dense material within the tubing, which prevents clear visualization of the classic 'target sign' or 'doughnut sign' typically sought in diagnostic imaging for intussusception. The model serves as an educational tool for emergency medicine and pediatric residents to practice bedside ultrasound techniques and recognize imaging pitfalls such as bowel gas artifacts.

Multi-modal clinical imaging of a nine-year-old pediatric patient with Henoch-Schönlein purpura (HSP) and ileoileal intussusception. Panel A (Plain Abdominal X-ray) shows focal bowel distention with gas in the right lower quadrant (black arrow). Panel B (Abdominal Ultrasound) demonstrates the classic 'target sign' or 'doughnut sign' in cross-section, indicative of intestinal invagination. Panels C and D (Axial CT, non-contrast and contrast-enhanced) reveal the site of intussusception with thickened intestinal walls forming a target sign (white arrow). Associated findings include enlarged para-aortic lymph nodes (black arrows) and free peritoneal fluid (curved arrow) around the liver and intestinal loops. These images illustrate the diagnostic workup for acute abdominal pain in children with systemic vasculitis, highlighting the transition from non-specific radiography to definitive cross-sectional imaging (US and CT) for identifying mechanical complications like intussusception and associated lymphadenopathy.

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atrial flutter ECG sawtooth flutter waves rate 150

Diagnostic Image: This 12-lead electrocardiogram (ECG) demonstrates atrial flutter with a 2:1 atrioventricular (AV) conduction ratio. The tracing shows highly regular atrial activity with a characteristic sawtooth morphology. In the inferior leads (II, III, and aVF), the flutter waves are distinctly positive (upright), while in lead V1, the flutter waves exhibit a negative (inverted) polarity. This specific polarity pattern—upright flutter waves in the inferior leads and inverted in V1—is diagnostic of clockwise typical atrial flutter (atypical by counter-clockwise standards). The QRS complexes are regular and narrow, occurring at approximately half the frequency of the atrial rate (atrial rate ~300 bpm; ventricular rate ~150 bpm). In the precordial leads V4-V6, the QRS and T-wave morphologies are preserved, although discrete P waves are replaced by the undulating flutter baseline. The image illustrates a classic supraventricular tachycardia frequently encountered in cardiology and emergency medicine, serving as an educational example of macro-reentrant atrial rhythms.

A 12-lead electrocardiogram (ECG) recorded at a standard paper speed of 25 mm/s, demonstrating a narrow complex supraventricular tachycardia. The primary finding is atrial flutter with a 2:1 atrioventricular (AV) conduction ratio, resulting in a ventricular rate of approximately 150 beats per minute. Distinctive 'sawtooth' flutter waves (F-waves) are most prominent in the inferior leads (II, III, and aVF), characterized by negative deflections without an intervening isoelectric baseline. In the precordial leads V1-V3, the flutter waves appear more upright or biphasic. The QRS complexes are regular and maintain a consistent morphology and narrow duration, indicating normal ventricular depolarization following the 2:1 conduction from the atria. This tracing is a classic educational example used to distinguish atrial flutter from sinus tachycardia or atrial fibrillation in the context of regular narrow-complex tachycardia.

Here is the complete compilation of NEET PG Recall-Based Image Questions from 2021-2025, organized subject-wise with actual images where available, the visual clue to identify, the answer, and the key teaching point.

NEET PG 2021-2025: RECALL-BASED IMAGE QUESTIONS WITH ANSWERS

Compiled from memory-based recalls by candidates and faculty post-exam analysis

PATHOLOGY IMAGE QUESTIONS

IMG-PATH-01 | NEET PG 2023 & 2025 (Repeated Concept)

The image below shows a lymph node biopsy (H&E stain):

Q: What are the large binucleated cells with prominent eosinophilic "owl-eye" nucleoli called?

Options:

Langhans giant cells
Reed-Sternberg cells
Touton giant cells
Aschoff cells

Answer: 2 - Reed-Sternberg cells

Visual clue to identify: Large binucleated cells with MIRROR-IMAGE nuclei and huge prominent eosinophilic nucleoli (looks like an owl face). Background of lymphocytes, eosinophils, plasma cells.

Key teaching point:

Diagnosis = Classical Hodgkin Lymphoma
Immunohistochemistry: CD15+, CD30+, PAX5 (weak), CD20-
Most common subtype = Nodular Sclerosis (young females, mediastinal mass)
Treatment: ABVD chemotherapy ± radiation

IMG-PATH-02 | NEET PG 2022 & 2024 (Frequently repeated)

Congo red stained tissue section under polarized light:

Congo red - Apple green birefringence - Amyloidosis

Q: The stained section under polarized light shows this characteristic color. What is the diagnosis?

Options:

Glycogen storage disease - PAS stain
Amyloidosis - Congo red with apple-green birefringence
Iron deposition - Prussian blue
Lipofuscinosis

Answer: 2 - Amyloidosis

Visual clue to identify: Under NORMAL light = orange-red/salmon color. Under POLARIZED light = apple-green birefringence (pathognomonic).

Key teaching point:

Congo red stain + apple-green birefringence = AMYLOID (only finding that confirms)
AL amyloid (light chain) = most common systemic; associated with myeloma
AA amyloid = chronic inflammation (TB, RA, IBD)
ATTR amyloid = cardiac (restrictive cardiomyopathy in elderly)
Serum amyloid P scan = whole body amyloid burden

IMG-PATH-03 | NEET PG 2024

Histopathology showing fungal hyphae in tissue (GMS stain / H&E):

Visual features seen: Broad, ribbon-like, NON-septate (pauci-septate) hyphae with WIDE-ANGLE (90°) branching

Q: What is the most likely organism?

Options:

Aspergillus fumigatus
Candida albicans
Mucor / Rhizopus (Mucormycosis)
Cryptococcus neoformans

Answer: 3 - Mucor/Rhizopus

HOW TO DIFFERENTIATE on image:

Feature	Aspergillus	Mucor/Rhizopus
Hyphae	Narrow, septate	Broad, non-septate (ribbon-like)
Branching	Acute angle (45°)	Right angle (90°)
Septae	Present (regular)	Absent or rare

Key teaching point:

Mucormycosis: angioinvasive; rhinocerebral form = commonest; associated with DKA + neutropenia
Treatment: liposomal amphotericin B + surgical debridement
Aspergillus: septate, 45° = commonest opportunistic mold in immunocompromised

IMG-PATH-04 | NEET PG 2023

Histopathology - brain tumor biopsy showing "fried egg" appearance of cells + calcifications + "chicken wire" capillaries

Q: What is the diagnosis?

Options:

Glioblastoma multiforme
Oligodendroglioma
Ependymoma
Pilocytic astrocytoma

Answer: 2 - Oligodendroglioma

Visual clue: Round cells with CLEAR halos ("fried egg" artifact - formalin fixation artifact), "chicken-wire" vascular pattern, calcium deposits (speckled calcifications on CT)

Key teaching point:

WHO Grade II/III; frontal lobe most common
Molecular marker: 1p/19q codeletion (diagnostic + better prognosis)
IDH mutation usually present
Best prognosis among diffuse gliomas

IMG-PATH-05 | NEET PG 2024

Histopathology showing cells with nucleus pushed to periphery by intracytoplasmic mucin (mucin pool):

Q: What are these cells called? In which malignancy are they seen?

Options:

Goblet cells in normal bowel
Signet ring cells - Diffuse gastric adenocarcinoma (Linitis plastica)
Clara cells in lung
Chief cells in stomach

Answer: 2 - Signet ring cells in gastric cancer (linitis plastica)

Visual clue: Cytoplasm filled with pale mucin pushes the nucleus to one side → looks like a signet ring

Key teaching point:

Linitis plastica = diffuse infiltrating gastric carcinoma; "leather bottle stomach" on barium
Associated with CDH1 (E-cadherin) mutation - hereditary diffuse gastric cancer
Krukenberg tumor = bilateral ovarian mets from gastric signet ring carcinoma
Diffuse type: not associated with H. pylori (unlike intestinal type)

IMG-PATH-06 | NEET PG 2023

Brain biopsy H&E showing: pseudopalisading necrosis (necrotic core surrounded by tumor cells arranged in palisades) + vascular endothelial proliferation

Q: WHO grade of this tumor?

Options:

Grade I (Pilocytic astrocytoma)
Grade II (Low-grade astrocytoma)
Grade III (Anaplastic astrocytoma)
Grade IV (Glioblastoma multiforme - GBM)

Answer: 4 - Grade IV (GBM)

Visual clue: "Pseudopalisading necrosis" = the hallmark of GBM. Cells palisade around necrotic foci + "glomeruloid" microvascular proliferation.

Key teaching point:

Most common primary brain tumor in ADULTS
Butterfly glioma: crosses corpus callosum
MGMT promoter methylation = better response to temozolomide
IDH wildtype = worse prognosis
Treatment: Surgery + Temozolomide + Radiation (Stupp protocol)

RADIOLOGY IMAGE QUESTIONS

IMG-RAD-01 | NEET PG 2025

Lateral X-ray of lumbar spine showing anterior displacement of one vertebra over the one below:

Q: What is the diagnosis? (NEET PG 2025 Q126)

Options:

Spondylolisthesis
Spondylolysis
Vertebral compression fracture
Degenerative disc disease

Answer: 1 - Spondylolisthesis

Visual clue: LATERAL X-ray = anterior slippage of upper vertebral body on lower one. A "step-off" deformity is visible.

KEY TRAP: Spondylolysis vs Spondylolisthesis

Spondylolysis = pars interarticularis FRACTURE only, no slippage ("Scottie dog with collar" on oblique X-ray)
Spondylolisthesis = actual forward SLIP of vertebra
Meyerding grading: Grade I (<25%), II (25-50%), III (50-75%), IV (>75%), V = spondyloptosis

IMG-RAD-02 | NEET PG 2024

CT head (non-contrast) showing biconvex (lens-shaped) hyperdense extra-axial collection in the temporal region. Does NOT cross suture lines.

Q: Diagnosis and the vessel most likely injured?

Options:

Subdural hematoma - bridging veins
Epidural hematoma - middle meningeal artery
Subarachnoid hemorrhage - circle of Willis aneurysm
Intracerebral hemorrhage - lenticulostriate artery

Answer: 2 - Epidural hematoma - Middle meningeal artery

Visual clue: BICONVEX (lens-shaped) hyperdense collection. Does NOT cross suture lines (periosteum fused at sutures). Temporal location = pterion = thinnest skull = MMA rupture.

CRITICAL DIFFERENTIATION TABLE:

Feature	EDH	SDH
Shape	Biconvex (lens)	Crescent
Suture crossing	NO	YES
Vessel	MMA (artery)	Bridging veins
Lucid interval	YES (classic)	Rare
CT density	Hyperdense (acute)	Variable
Age group	Young trauma	Elderly, alcoholics

IMG-RAD-03 | NEET PG 2023 & Repeated 2024

PA Chest X-ray showing "boot-shaped" heart (coeur en sabot) with upturned apex and concave pulmonary bay:

Tetralogy of Fallot boot-shaped heart X-ray

Q: What is the diagnosis? What is the most common cyanotic congenital heart disease?

Options:

Transposition of Great Arteries
Truncus arteriosus
Tetralogy of Fallot
Total anomalous pulmonary venous drainage

Answer: 3 - Tetralogy of Fallot

Visual clue: Boot-shaped heart = right ventricular hypertrophy (upturned apex) + concave pulmonary artery bay (pulmonary stenosis) + oligemic lung fields

Key teaching point - PROVE mnemonic (Tetralogy of Fallot):

Pulmonary stenosis (outflow obstruction)
Right ventricular hypertrophy
Overiding aorta
Ventricular septal defect
Egg... no that's TGA
"Squatting" relieves hypercyanotic spells (Tet spells) - increases SVR, reduces R→L shunt
Pink TOF: if PS is mild, can be acyanotic
Treatment: Blalock-Taussig shunt (palliation) then total correction

IMG-RAD-04 | NEET PG 2024

CT head showing "star-shaped" or "hyperdense filling of basal cisterns" (blood in subarachnoid space):

Q: Diagnosis? Most common cause?

Options:

Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Hypertensive intracerebral bleed

Answer: 3 - Subarachnoid hemorrhage

Visual clue: Blood fills the subarachnoid space → "hyperdense star" in basal cisterns on NCCT head. "Fisher scale" for amount of blood.

Key teaching point:

Most common cause = ruptured Berry (saccular) aneurysm at Circle of Willis (ACoA most common)
"Thunderclap headache" = worst headache of life, sudden onset
"Xanthochromia" on CSF (yellow pigment) = confirms SAH when CT is negative
CT sensitivity: 98% in first 12 hours; drops to 50% by day 7
Vasospasm (days 4-10) = nimodipine to prevent

IMG-RAD-05 | NEET PG 2024

Ultrasound abdomen in a child showing concentric rings / "target sign" or "doughnut sign":

Q: Diagnosis? Treatment?

Options:

Appendicitis - "target sign"
Intussusception - air enema reduction
Volvulus
Hirschsprung disease

Answer: 2 - Intussusception

Visual clue: On transverse USG = concentric rings (doughnut/target sign). On longitudinal USG = "pseudo-kidney" sign.

Key teaching point:

Most common: ileocolic (ileum telescopes into colon)
Age: 6 months - 2 years (peak)
Classic triad: colicky abdominal pain + currant-jelly stool + sausage-shaped mass (RIF)
Lead point in adults: Meckel's diverticulum, polyp, lymphoma
Treatment: Air/barium/saline enema (diagnostic + therapeutic) if no perforation; surgery if failed or perforated

IMG-RAD-06 | NEET PG 2022

Abdominal X-ray showing massively dilated loop of colon with convex walls pointing TOWARD RIGHT upper quadrant:

Q: Diagnosis? The X-ray sign is called?

Options:

Caecal volvulus - "kidney-bean" sign
Sigmoid volvulus - "coffee-bean sign"
Large bowel obstruction - multiple fluid levels
Toxic megacolon

Answer: 2 - Sigmoid volvulus - Coffee-bean sign

Visual clue: "Coffee-bean" or "omega loop" sign pointing toward RIGHT upper quadrant (toward liver). Massively dilated single loop.

Key teaching point:

Most common volvulus in India = Sigmoid (due to high-fiber diet + redundant sigmoid)
X-ray: "coffee-bean" or "bent inner tube"
Treatment: Flexible sigmoidoscopy decompression (if viable bowel) → elective sigmoid resection
If gangrene/perforation: emergency Hartmann's procedure

IMG-RAD-07 | NEET PG 2023

PA Chest X-ray of a 45-year-old with ptosis + muscle weakness + dilated mediastinum (anterior mediastinal mass):

Q: Most likely diagnosis? Associated condition?

Options:

Lymphoma - mediastinal
Thymoma - associated with Myasthenia gravis
Teratoma - anterior mediastinum
Pancoast tumor

Answer: 2 - Thymoma

Visual clue: Anterior mediastinal mass in a patient with Myasthenia gravis (ptosis + fatigable weakness). Anterior mediastinum masses = "4 T's": Thymoma, Teratoma, Thyroid, Terrible lymphoma

Key teaching point:

Thymoma most common anterior mediastinal tumor in adults
30% of thymoma patients have Myasthenia gravis
10-15% of MG patients have thymoma
Staging: Masaoka classification
Treatment: Thymectomy (improves MG even without thymoma)

CARDIOLOGY ECG IMAGE QUESTIONS

IMG-ECG-01 | NEET PG 2024-25 (Both years)

ECG showing regular sawtooth pattern at ~300 bpm with QRS rate of ~150 bpm:

Q: What is the diagnosis? What is the rate control drug of choice?

Options:

Atrial fibrillation - rate 150 bpm - amiodarone
Atrial flutter with 2:1 block - rate 150 bpm - diltiazem
SVT - rate 150 bpm - adenosine
Sinus tachycardia

Answer: 2 - Atrial flutter with 2:1 block - Diltiazem

Visual clue: Regular sawtooth flutter waves (F-waves) in inferior leads (II, III, aVF). Rate EXACTLY ~150 bpm = always think atrial flutter 2:1. No isoelectric baseline between flutter waves.

Key teaching point:

Atrial flutter: atrial rate 300 bpm; usually 2:1 block → ventricular rate 150 bpm
DISTINGUISH: AF = irregularly irregular + no P waves (coarse fibrillation baseline)
Rate control: Diltiazem (first line), beta-blockers; NOT amlodipine/nifedipine
DO NOT give diltiazem/verapamil if HFrEF (negative inotropy)
Cardioversion: DC shock 50-100J (flutter is very responsive)

IMG-ECG-02 | NEET PG 2023

ECG showing ST elevation in leads V1-V4 ("tombstone" pattern or convex ST elevation):

Q: Diagnosis? Immediate management?

Options:

NSTEMI - IV heparin + early angiography
Anterior STEMI (LAD occlusion) - primary PCI within 90 min
Right heart strain (PE) - anticoagulation
Brugada syndrome - ICD implant

Answer: 2 - Anterior STEMI

Visual clue: ST elevation (>1 mm, convex upward/"tombstone") in V1-V4 = anterior wall. LAD territory. Reciprocal depression in II, III, aVF.

Key teaching point:

ST elevation + chest pain = STEMI until proven otherwise
Time is muscle: Door-to-balloon <90 min (PCI available) or thrombolytics <30 min (no PCI)
Anterior (V1-V4) = LAD; Inferior (II, III, aVF) = RCA/LCx; Lateral (I, aVL, V5-V6) = LCx
Reciprocal changes = confirm STEMI (not pericarditis which is diffuse, saddle-shaped)

OBSTETRICS & GYNAECOLOGY IMAGE QUESTIONS

IMG-OBG-01 | NEET PG 2025

Image showing a clinical maneuver during breech delivery - fetal trunk being rotated to deliver shoulders:

Q: Identify the maneuver:

Options:

Burns-Marshall technique
Lovset's maneuver
Mauriceau-Smellie-Veit maneuver
Prague maneuver

Answer: 2 - Lovset's maneuver

Visual clue: Trunk is rotated 180° to bring POSTERIOR shoulder under symphysis pubis, then reverse rotation to deliver other shoulder.

Key teaching point - Breech delivery steps:

Step	Maneuver
Deliver trunk	Spontaneous/assisted
Deliver shoulders	Lovset's maneuver (trunk rotation)
Deliver aftercoming head	Mauriceau-Smellie-Veit (jaw-flexion-shoulder)
If head stuck	Burn-Marshall (pendulum swing)

IMG-OBG-02 | NEET PG 2025

Image of uterine prolapse / mass protruding from vagina after difficult delivery by untrained dai:

Q: Injury to which ligament?

Options:

Sacrospinous ligament
Mackenrodt's (transverse cervical / cardinal) ligament
Broad ligament
Round ligament

Answer: 2 - Mackenrodt's ligament (Cardinal ligament)

Key teaching point:

Uterovaginal prolapse primary support = Mackenrodt's ligament (Level I support - DeLancey)
Level I = cardinal + uterosacral ligaments (apical support)
Level II = ATFP, paravaginal attachments (mid-vaginal)
Level III = perineal body, external anal sphincter (distal)

IMG-OBG-03 | NEET PG 2025

Image of hysterectomy specimen showing enlarged uterus with smooth whorled white nodules on cut section:

Q: Most likely diagnosis?

Options:

Endometrial carcinoma
Uterine leiomyoma (fibroid)
Adenomyosis
Endometrial polyp

Answer: 2 - Uterine leiomyoma (fibroid)

Visual clue: WHORLED white pattern on cut section = leiomyoma. Adenomyosis = spongy, irregular hemorrhagic tissue within myometrium.

Key teaching point:

Most common benign uterine tumor
Hormone-sensitive (grow in reproductive years, regress after menopause)
GnRH analogues (leuprolide) = preoperative reduction
Types: Submucosal (most symptomatic - heavy bleeding); Subserosal (pedunculated); Intramural

IMG-OBG-04 | NEET PG 2023

Image of postmenopausal woman showing hysterectomy specimen with friable, necrotic, polypoid growth in endometrium:

Q: Most likely diagnosis? Next investigation?

Options:

Endometrial polyp - hysteroscopy
Endometrial carcinoma - endometrial biopsy
Cervical carcinoma - colposcopy
Uterine sarcoma - CT scan

Answer: 2 - Endometrial carcinoma

Visual clue: Postmenopausal bleeding + polypoid, necrotic endometrial growth

Key teaching point:

Most common gynecological malignancy in DEVELOPED countries
Most common presenting symptom = postmenopausal bleeding
Risk factors: unopposed estrogen, obesity, nulliparity, diabetes, HTN, tamoxifen, Lynch syndrome
Staging: FIGO surgical staging (2023 updated); Grade 3 = worst
DOC investigation: Endometrial biopsy (Pipelle); D&C if biopsy inadequate

SURGERY IMAGE QUESTIONS

IMG-SURG-01 | NEET PG 2025

Image showing anorectal fistula tract passing BETWEEN internal and external sphincters:

Q: Parks classification - What type? (NEET PG 2025 Q195)

Options:

Intersphincteric
Suprasphincteric
Extrasphincteric
Transsphincteric

Answer: 1 - Intersphincteric

Visual clue: Track goes BETWEEN the two sphincters (internal + external). Most SIMPLE and most COMMON type.

Parks Classification:

Type	Path	Frequency	Treatment
Intersphincteric	Between sphincters	~70% (most common)	Fistulotomy
Transsphincteric	Through both sphincters	~25%	Seton procedure
Suprasphincteric	Above puborectalis	~5%	Complex repair
Extrasphincteric	Outside all sphincters	~1% (least common)	Stoma ± repair

IMG-SURG-02 | NEET PG 2025

Image of circumferential full-thickness burns of lower limb with escharotomy incisions being made:

Q: What procedure is shown? When is it indicated?

Options:

Fasciotomy for compartment syndrome
Escharotomy for circumferential burns
Amputation
Skin grafting

Answer: 2 - Escharotomy

Visual clue: Longitudinal incisions through full-thickness burned eschar on circumferential burned limb.

Key teaching point:

Escharotomy = incision through burn eschar (not into fascia = fasciotomy)
Indicated for circumferential full-thickness (3rd degree) burns of limbs or chest
Chest escharotomy → improves respiratory compliance
Limb escharotomy → prevents compartment syndrome from swelling

IMG-SURG-03 | NEET PG 2025

Image showing a surgical knot with DOUBLE loop on first throw:

Q: What type of knot?

Options:

Surgeon's knot
Square knot
Granny's knot
Slip knot

Answer: 1 - Surgeon's knot

Visual clue: First throw = DOUBLE loop (prevents slippage while tying second throw). Second throw = single loop.

Key teaching point:

Square knot = two single throws in OPPOSITE directions (most secure, standard)
Granny knot = two single throws in SAME direction (unreliable, slips)
Surgeon's knot = double loop first + single loop second (used in wet/slippery tissues)
Slip knot = adjustable (used in ligatures)

IMG-SURG-04 | NEET PG 2024

Image of abdominal X-ray showing "string of pearls" sign in small bowel:

Q: Diagnosis?

Options:

Large bowel obstruction
Small bowel obstruction (SBO)
Sigmoid volvulus
Ileus

Answer: 2 - Small bowel obstruction

Visual clue: Small air bubbles trapped between valvulae conniventes in distended SB loops = "string of pearls" sign.

Key teaching point:

SBO vs LBO on X-ray:
- SBO: central + dilated loops + valvulae conniventes (complete across lumen) + "string of pearls"
- LBO: peripheral + haustral folds (incomplete across lumen) + large loop
Most common cause SBO = adhesions (post-surgery); LBO = carcinoma colon
Treatment: NGT decompression + fluid resuscitation; surgery if strangulation

IMG-SURG-05 | NEET PG 2022

Image of X-ray showing osteosarcoma in distal femur with sunburst periosteal reaction + Codman's triangle:

Q: Diagnosis + Codman's triangle represents?

Options:

Ewing's sarcoma - onion-peel periosteal reaction
Osteosarcoma - Codman's triangle = elevated periosteum with reactive new bone
Giant cell tumor - soap-bubble epiphysis
Chondrosarcoma - ring-and-arc calcification

Answer: 2 - Osteosarcoma

Visual clue: Sunburst periosteal reaction + Codman's triangle (elevated periosteum at tumor edge forming a triangle with the cortex)

Key teaching point:

Tumor	X-ray sign	Location	Age
Osteosarcoma	Sunburst + Codman's	Distal femur/Prox tibia metaphysis	10-25 yrs
Ewing's sarcoma	Onion-skin/laminated	Diaphysis (flat bones also)	5-15 yrs
GCT	Soap bubble (eccentric)	Epiphysis (distal femur)	20-40 yrs
Aneurysmal BC	Soap bubble (expansile)	Metaphysis	Adolescents
Chondrosarcoma	Ring-and-arc calcification	Pelvis/prox femur	40-70 yrs

DERMATOLOGY IMAGE QUESTIONS

IMG-DERM-01 | NEET PG 2025 & 2023 (Most repeated)

Clinical image showing thick silvery-white micaceous plaques on extensor surface of elbows:

Q: Diagnosis? Clinical sign when scale is removed?

Options:

Lichen planus - Wickham's striae
Psoriasis - Auspitz sign (pinpoint bleeding)
Pityriasis rosea - Herald patch
Seborrheic dermatitis - greasy yellow scales

Answer: 2 - Psoriasis vulgaris - Auspitz sign

Visual clue: Well-demarcated silvery-white scaly plaques on EXTENSOR surfaces (elbows, knees, scalp). Auspitz sign = pinpoint bleeding when scale removed (dilated dermal papillary capillaries exposed).

Key teaching point:

Psoriasis: T-cell mediated; HLA-Cw6 association
Grattage test: candle-grease scrapings → Auspitz sign
Histology: Munro's microabscesses (PMNs in parakeratotic SC) + suprapapillary plate thinning
Koebner phenomenon: lesions appear on traumatized skin
Scalp psoriasis: most common site; nail pitting = most common nail change

IMG-DERM-02 | NEET PG 2024

Clinical image showing tense, fluid-filled bullae (NOT easily ruptured) on erythematous base in elderly patient:

Q: Diagnosis? Is Nikolsky sign positive or negative?

Options:

Pemphigus vulgaris - Nikolsky positive - intraepidermal
Bullous pemphigoid - Nikolsky NEGATIVE - subepidermal
Dermatitis herpetiformis - Nikolsky negative
Epidermolysis bullosa

Answer: 2 - Bullous pemphigoid - Nikolsky NEGATIVE

Visual clue: TENSE bullae (subepidermal = not easily ruptured) in ELDERLY patient. No oral involvement (or mild).

CRITICAL DIFFERENTIATION:

Feature	Pemphigus vulgaris	Bullous pemphigoid
Blister	Flaccid, fragile	Tense, turgid
Nikolsky	POSITIVE	NEGATIVE
Oral involvement	YES (first)	Rare/mild
Split	Intraepidermal (suprabasal)	Subepidermal
Antibody	Anti-desmoglein 1&3	Anti-BP180, BP230
Age	Middle-aged	Elderly
DIF	IgG intercellular "fish-net"	Linear IgG at DEJ

IMG-DERM-03 | NEET PG 2023

Clinical image of face showing plaque with "apple-jelly" nodules on diascopy (pressing glass slide on skin):

Q: Diagnosis? Investigation of choice?

Options:

Lupus erythematosus - ANA testing
Lupus vulgaris (cutaneous TB) - skin biopsy + AFB culture/CBNAAT
Lepromatous leprosy - slit-skin smear
Rosacea - clinical diagnosis

Answer: 2 - Lupus vulgaris (Cutaneous TB)

Visual clue: "Apple-jelly" nodules on diascopy = pathognomonic for lupus vulgaris. Soft brownish-yellow color under glass pressure (Grenz zone granulomas).

Key teaching point:

Most common form of cutaneous TB in India = Lupus vulgaris
Face > neck > trunk
Histology: Epithelioid granulomas WITHOUT caseation (or minimal)
Complication: scar carcinoma (SCC in chronic lesions)
Treatment: standard anti-TB drugs (rifampicin-based)

IMG-DERM-04 | NEET PG 2022

Clinical image showing hypopigmented patch + thickened peripheral nerve + absent sensation on the patch:

Q: Type of leprosy? Lepromin test result?

Options:

Lepromatous leprosy (LL) - Lepromin negative
Tuberculoid leprosy (TT) - Lepromin STRONGLY positive
Borderline lepromatous (BL) - weakly positive
Indeterminate leprosy

Answer: 2 - Tuberculoid leprosy - Lepromin strongly positive

Visual clue: FEW (1-5) hypopigmented, anesthetic patches + thickened nerve. Clear-cut margins. Dry surface (anhidrosis).

Key teaching point:

Feature	Tuberculoid (TT)	Lepromatous (LL)
Lesions	Few (1-5)	Numerous
Margins	Well defined	Ill defined
Sensation	Absent (anesthetic)	Relatively intact initially
Nerve thickening	Yes (few nerves)	Yes (many nerves)
Lepromin	Strongly positive	Negative
AFB	Absent/few (paucibacillary)	Numerous (multibacillary)
Immunity	High CMI	Low CMI, high humoral
Treatment	6 months (PB)	12 months (MB)

MICROBIOLOGY / INFECTIOUS DISEASE IMAGE QUESTIONS

IMG-MICRO-01 | NEET PG 2022

India ink preparation of CSF from HIV patient showing encapsulated yeast cells with large capsule:

Q: Organism? Treatment?

Options:

Aspergillus - voriconazole
Candida - fluconazole
Cryptococcus neoformans - amphotericin B + flucytosine
Mucor - liposomal amphotericin B

Answer: 3 - Cryptococcus neoformans

Visual clue: India ink = large capsule creates a CLEAR HALO around yeast (capsule doesn't stain with India ink, only background stains). "Cryptococcal meningitis" in HIV (CD4 <100).

Key teaching point:

Capsular antigen test (Cryptococcal antigen/CrAg) = best diagnostic test
India ink = classic but less sensitive
Treatment: Induction (amphotericin B + flucytosine 2 weeks) → Consolidation (fluconazole 8 weeks) → Maintenance (fluconazole lifelong)
Raised ICP = therapeutic lumbar puncture

IMG-MICRO-02 | NEET PG 2024

Peripheral blood smear (Giemsa stain) showing MULTIPLE ring trophozoites per RBC + banana-shaped gametocytes:

Q: Plasmodium species? What drug resistance is important?

Options:

P. vivax - CQ sensitive
P. falciparum - chloroquine resistance common
P. malariae - quartan malaria
P. ovale - similar to vivax

Answer: 2 - P. falciparum

Visual clue:

Multiple rings per RBC = P. falciparum (only species that does this)
Banana/crescent-shaped gametocytes = ONLY P. falciparum
"Appliqué forms" (rings at edge of RBC)
Maurer's clefts (not Schuffner's dots)

Key teaching point:

Feature	P. falciparum	P. vivax
Rings/RBC	Multiple	Single
Gametocyte	Banana/crescent	Round
RBC size	Normal	Enlarged
Dots	Maurer's clefts	Schüffner's dots
Fever	Subtertian (36-48h)	Tertian (48h)
Hypnozoites	NO	YES (relapses)
Severe malaria	YES	Less common

IMG-MICRO-03 | NEET PG 2025

Pedigree chart showing disease transmitted by MOTHER to ALL offspring; males and females equally affected:

Q: Pattern of inheritance? Disease?

Options:

X-linked dominant
Mitochondrial inheritance
Autosomal dominant
X-linked recessive

Answer: 2 - Mitochondrial inheritance

Visual clue: ALL children of affected MOTHER are affected. Father never transmits (sperm have few mitochondria). Males + females equally affected but cannot pass through paternal line.

Key teaching point - Mitochondrial diseases:

MELAS = Mitochondrial Encephalomyopathy, Lactic Acidosis, Stroke-like episodes
MERRF = Myoclonic Epilepsy with Ragged Red Fibers
Kearns-Sayre syndrome = PEO + retinitis pigmentosa + cardiac block
Leber's hereditary optic neuropathy (LHON)
All from MATERNAL inheritance; heteroplasmy accounts for variable expressivity

OPHTHALMOLOGY IMAGE QUESTIONS

IMG-OPH-01 | NEET PG 2022 & 2023

Fundus photograph showing: bilateral optic disc swelling (papilledema) + flame hemorrhages + exudates + "star-pattern" at macula in patient with BP 240/140 mmHg:

Q: Diagnosis? Grade?

Options:

Grade II hypertensive retinopathy - AV nipping
Grade III - flame hemorrhages + exudates
Grade IV - papilledema + star pattern = Hypertensive emergency
Central retinal vein occlusion

Answer: 3 - Grade IV Hypertensive Retinopathy (Keith-Wagener-Barker)

Visual clue: Papilledema + flame hemorrhages + hard exudates + macular "star" (exudates radiating from fovea in Henle's layer) = GRADE IV = Hypertensive emergency.

Keith-Wagener-Barker Grading:

Grade I: Arteriolar narrowing + silver wiring
Grade II: AV nipping (Gunn's sign) + copper wiring
Grade III: Flame hemorrhages + soft exudates (cotton-wool spots) + hard exudates
Grade IV: Grade III + Papilledema + macular star

IMG-OPH-02 | NEET PG 2023

Clinical photo showing white pupillary reflex (leukocoria) in infant:

Q: Most likely diagnosis in a 2-year-old?

Options:

Congenital cataract
Retinoblastoma
Persistent hyperplastic primary vitreous (PHPV)
Coat's disease

Answer: 2 - Retinoblastoma (in age <2 years + leukocoria = must rule out)

Visual clue: White/yellow pupillary reflex instead of normal red reflex = leukocoria = emergency ophthalmology referral

Key teaching point:

Retinoblastoma: most common intraocular malignancy in children (<5 years)
Leukocoria (60%) + strabismus (20%) = most common presentations
RB1 gene (13q14) = tumor suppressor; "2-hit hypothesis" (Knudson)
Bilateral = hereditary (germline mutation); Unilateral = usually somatic
Trilateral RB = bilateral retinoblastoma + pinealoblastoma

ENT IMAGE QUESTIONS

IMG-ENT-01 | NEET PG 2025

Audiogram showing bilateral conductive hearing loss with AIR-BONE GAP and absent stapedial reflex; Carhart's notch at 2000 Hz:

Q: Diagnosis?

Options:

Sensorineural hearing loss
Otosclerosis
Presbycusis
Noise-induced hearing loss

Answer: 2 - Otosclerosis

Visual clue: Air-bone gap (BC normal, AC elevated) + Carhart's notch (dip in bone conduction at 2000 Hz - mechanical artefact, not true SNHL) + absent stapedial reflex (stapes fixed)

Key teaching point:

Otosclerosis: abnormal remodeling of otic capsule (bony cochlea)
Autosomal dominant; more common in females; bilateral in 70%
Tympanogram: "As" type (reduced compliance of fixed stapes)
Treatment: Stapedectomy / stapedotomy (gold standard); hearing aid also effective
Fluoride therapy (sodium fluoride): can slow progression

IMG-ENT-02 | NEET PG 2024

Image showing a pulsatile neck mass at angle of jaw, mobile side-to-side but NOT vertically; angiogram showing splaying of carotid bifurcation:

Q: Diagnosis? Sign?

Options:

Thyroid nodule
Branchial cyst
Carotid body tumor (Paraganglioma) - Lyre's sign
Cervical lymph node

Answer: 3 - Carotid body tumor - "Lyre sign"

Visual clue: Lyre sign = ICA and ECA are splayed apart (like strings of a lyre/harp) by the mass at carotid bifurcation. Also called "goblet sign."

Key teaching point:

Paraganglioma (chemodectoma) at carotid bifurcation
Pulsatile, mobile side-to-side but NOT up-down (Fontaine's sign)
10% rule: 10% bilateral, 10% malignant, 10% familial
Familial: SDH gene mutations (succinate dehydrogenase)
Treatment: surgical resection (preop embolization for large tumors)

FORENSIC MEDICINE IMAGE QUESTIONS

IMG-FM-01 | NEET PG 2024

Image showing a body found in fire with all limbs flexed in "boxing" or "pugilistic" position:

Q: What is this posture called? Is it indicative of ante-mortem self-defense?

Options:

Cadaveric spasm - indicates ante-mortem violent activity
Pugilistic attitude - due to heat coagulation of muscles post-mortem (NOT self-defense)
Rigor mortis in fighting position
Decomposition artefact

Answer: 2 - Pugilistic attitude - heat coagulation artifact, NOT ante-mortem defense

Key teaching point:

Pugilistic/boxer's attitude = HEAT ARTIFACT (protein coagulation shortens flexor muscles more than extensors)
Does NOT indicate the person was fighting or in self-defense
Important medico-legal point: examiners must NOT misinterpret as defense injuries
Cadaveric spasm = instantaneous rigor at moment of death (violent emotion/exertion); DOES indicate ante-mortem activity

IMG-FM-02 | NEET PG 2022

Image of a wound with inverted margins, burning, blackening, tattooing around it:

Q: Range of fire? Type of wound?

Options:

Contact wound - star-shaped laceration + burning + soot
Close-range shot (<45 cm) - blackening + tattooing
Medium range (45-90 cm) - tattooing only (no blackening)
Long range (>90 cm) - only entry wound, no secondary effects

Answer depends on image specifics:

Soot + burning + tattooing = Close range (<45 cm)
Tattooing only = Medium range (45-90 cm)
Entry wound only, no secondary effects = Long range (>90 cm)

Key teaching point:

Entry wound: small, inverted margins, abrasion collar
Exit wound: large, everted (exploded outward), no abrasion collar
Tattooing (stippling) = unburned powder grains embedded in skin = CANNOT be washed off
Soiling = soot deposits on skin = CAN be washed off
Contact wound: weapon pressed against skin = "impression mark" + gas explosion inside skin = cross-shaped laceration

ANATOMY IMAGE QUESTIONS

IMG-ANAT-01 | NEET PG 2025

CT scan cross-section of brain at basal ganglia level with structure labeled:

Q: The structure labeled "A" in the jugular foramen - which nerve does NOT pass through?

(NEET PG 2025 - Verbatim recall Q1)

Options:

CN IX
CN X
CN XI
CN XII

Answer: 4 - CN XII (Hypoglossal nerve)

Jugular foramen contents:

CN IX (Glossopharyngeal)
CN X (Vagus)
CN XI (Accessory spinal)
Inferior petrosal sinus (anteriorly)
CN XII = exits through HYPOGLOSSAL CANAL (separate foramen)

IMG-ANAT-02 | NEET PG 2022-23

MRI cross-section of abdomen at L1 level showing aorta, IVC, duodenum, pancreatic body:

Q: Identify the structure posterior to the first part of duodenum (posterolateral to D1):

Options:

Portal vein
Gastroduodenal artery
Common bile duct
IVC

Answer: The structures to know:

POSTERIOR to D1: gastroduodenal artery + portal vein + CBD (hepatoduodenal ligament)
INFERIOR to D1: pancreatic head
"Hot Cross Bun" pneumonic: GDA + CBD + PV form the "holy trinity" posterior to D1

PAEDIATRICS IMAGE QUESTIONS

IMG-PAED-01 | NEET PG 2023

X-ray of wrist in a 3-year-old showing widening of growth plate + fraying + cupping + splaying of metaphysis:

Q: Diagnosis? Biochemistry?

Options:

Osteogenesis imperfecta - multiple fractures
Nutritional rickets (Vit D deficiency) - low Ca, low PO4, HIGH ALP, HIGH PTH
Scurvy - subperiosteal hemorrhage + Pelkan spurs
Lead poisoning - dense metaphyseal bands

Answer: 2 - Nutritional Rickets

Visual clue: Widening + fraying + cupping + splaying of metaphysis = classic rickets X-ray

Key teaching point - Rickets X-ray findings:

Widening of physis (growth plate)
Fraying (irregular zone of provisional calcification)
Cupping + splaying of metaphysis
Periosteal reaction
Long bone bowing (genu varum in ambulatory children)
Craniotabes (in infants)
"Rosary" at costochondral junctions

IMG-PAED-02 | NEET PG 2024

CXR of cyanotic newborn showing "egg-on-its-side" appearance of cardiac silhouette with narrow superior mediastinum:

Q: Diagnosis? Emergency management?

Options:

Tetralogy of Fallot - boot-shaped
Transposition of Great Arteries (TGA) - "egg on its side"
Total anomalous pulmonary venous drainage - "snowman" sign
Truncus arteriosus - enlarged heart

Answer: 2 - TGA - "Egg on its side"

Visual clue: Narrow mediastinum (aorta anterior to PA, no widening) + egg-shaped heart. Cyanotic from birth.

Key teaching point:

TGA: Aorta arises from RV (anterior); PA from LV (posterior) = parallel circuits
Neonate depends on mixing via PDA/ASD/VSD for survival
Emergency: Prostaglandin E1 (keep PDA open) + Balloon Atrial Septostomy (Rashkind)
Definitive: Arterial switch operation (Jatene procedure) within first 2 weeks

RAPID-FIRE IMAGE SIGNS TESTED IN NEET PG (2021-2025)

Sign	Image Description	Diagnosis	Year Tested
Boot-shaped heart (Coeur en sabot)	CXR: upturned apex + concave PA bay	Tetralogy of Fallot	2022, 2023
Egg on its side	CXR: narrow mediastinum + oval heart	TGA	2024
Coffee-bean sign	AXR: omega loop pointing to RUQ	Sigmoid volvulus	2022
String of pearls	AXR: small air bubbles in SB	SBO	2024
Target/doughnut sign	USG abdomen: concentric rings in child	Intussusception	2024
Sunburst + Codman's triangle	X-ray: metaphysis of long bone	Osteosarcoma	2022
Onion-skin periosteum	X-ray: diaphysis of long bone	Ewing's sarcoma	2023
Soap bubble (epiphysis)	X-ray: eccentric lytic lesion	GCT / Aneurysmal BC	2023
Lyre/goblet sign	Carotid angiogram: splayed bifurcation	Carotid body tumor	2025
Carhart's notch	Audiogram: dip at 2000 Hz BC	Otosclerosis	2025
Sawtooth waves	ECG at 150 bpm	Atrial flutter 2:1	2024, 2025
Apple-green birefringence	Congo red under polarized light	Amyloidosis	2022, 2024
Owl-eye cells	Lymph node H&E	Hodgkin lymphoma	2023, 2025
Pseudopalisading necrosis	Brain biopsy H&E	GBM	2023
Fried egg cells	Brain biopsy H&E	Oligodendroglioma	2023
Apple-jelly nodules	Diascopy of facial plaque	Lupus vulgaris	2023
Banana gametocyte	Blood smear Giemsa	P. falciparum	2024
Encapsulated yeast India ink	CSF prep	Cryptococcus	2022
Pugilistic attitude	Burns victim X-ray	Heat artifact (NOT defense)	2024
Leukocoria	White pupillary reflex photo	Retinoblastoma	2023
Macular star + papilledema	Fundus photo	Grade IV HTN retinopathy	2022, 2023
Tense bullae (elderly)	Clinical skin photo	Bullous pemphigoid	2024
Flaccid bullae + oral erosions	Clinical photo, middle-aged	Pemphigus vulgaris	2023
Silver plaques extensor	Clinical skin photo	Psoriasis	2023, 2025

Exam strategy for image questions: Every image question in NEET PG tests ONE classic feature. Learn the single most characteristic visual finding for each condition - the "one-liner visual diagnosis." Practice image-based MCQs from Rohan Khandelwal (Surgery), Devesh Mishra (Pathology), and PrepLadder image modules. In the last 5 years, ~50% of the paper is image-based, making this the single highest-yield skill to develop.

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NEET PG Microbiology: 5-Year Recall-Based Questions with Answers

Coverage: NEET PG 2021-2025

These are memory-based recall questions, so exact wording/options can vary by shift and recall source. I have corrected a few older/outdated answers where needed, particularly HIV testing. Major recurring areas are parasitology, staining, mycology, serology, vaccines, and clinical bacteriology. The published recall compilations support this emphasis, including the 2022-25 PYQ compilation and 2025 recall set.

NEET PG 2025 Microbiology Recall

1. A farmer has a necrotic ulcer. Smear with polychrome methylene blue shows capsulated bacilli with a positive McFadyean reaction. Identify the organism.
Answer: Bacillus anthracis.
McFadyean reaction demonstrates the polypeptide capsule as a purple halo.

2. Which Group A Streptococcus component mediates attachment to pharyngeal epithelial fibronectin?
Answer: Lipoteichoic acid.
Also remember: M protein is the major antiphagocytic virulence factor and is linked to rheumatic fever.

3. A child has intense nocturnal perianal pruritus. An image shows planoconvex eggs from a perianal swab. Identify the parasite.
Answer: Enterobius vermicularis.
Diagnosis: cellulose tape or Scotch-tape test, not routine stool microscopy.

4. A respiratory fungal culture shows small yeast with narrow-based budding in a patient with chronic cough, fever and weight loss. Diagnosis?
Answer: Histoplasmosis due to Histoplasma capsulatum.
Histoplasma is dimorphic and appears as intracellular yeasts in macrophages in tissue.

5. A sewage worker has fever, jaundice, oliguria and conjunctival suffusion. Diagnosis?
Answer: Weil disease, severe leptospirosis.
Caused by Leptospira interrogans.

6. A patient with chronic cough has fungus showing septate hyphae with acute-angle branching. Identify it.
Answer: Aspergillus.
Aspergillus: narrow septate hyphae, acute-angle branching. Mucor: broad pauci-septate hyphae, right-angle branching.

7. Nocardia is best described as:
Answer: Gram-positive, branching filamentous bacterium that is weakly acid-fast.
Modified Ziehl-Neelsen stain is used; it is aerobic and can cause pulmonary/CNS infection in immunocompromised hosts.

8. Nocardia can be isolated by which technique?
Answer: Paraffin bait technique.

9. In a patient with recurrent meningococcal infections, which immune deficiency is likely?
Answer: Terminal complement deficiency, C5-C9.
Deficiency of the membrane attack complex predisposes to recurrent Neisseria infections.

10. Drug for chemoprophylaxis of close contacts of meningococcal meningitis?
Answer: Rifampicin.
Single-dose ciprofloxacin or ceftriaxone are alternatives depending on clinical context.

11. Which marker best indicates immunity after hepatitis B vaccination?
Answer: Anti-HBs antibody.
Vaccination pattern: anti-HBs positive alone, with anti-HBc negative.

12. In HIV-TB coinfection, when should ART generally be started after initiating anti-TB therapy?
Answer: Within 2-8 weeks.
Delay is generally longer in TB meningitis because of risk from CNS IRIS.

NEET PG 2024 Microbiology Recall

13. A Giemsa-stained peripheral smear shows multiple ring forms in a single RBC and banana-shaped gametocytes. Species?
Answer: Plasmodium falciparum.
Banana/crescent gametocytes are characteristic.

14. A fungal tissue image shows broad, ribbon-like, pauciseptate hyphae with right-angle branching in a patient with diabetic ketoacidosis. Diagnosis?
Answer: Mucormycosis caused by Mucorales.
Treatment principle: liposomal amphotericin B, urgent surgical debridement, and correction of metabolic derangement.

15. Which organism is detected using India ink preparation of CSF?
Answer: Cryptococcus neoformans.
The capsule gives a clear halo against dark background. Cryptococcal antigen testing is more sensitive.

16. A patient has atypical pneumonia, cold agglutinins and no response to beta-lactams. Organism?
Answer: Mycoplasma pneumoniae.
No cell wall, hence no Gram stain visualization and intrinsic resistance to beta-lactams.

17. Weil-Felix test is used in the diagnosis of:
Answer: Rickettsial infection.
It detects cross-reacting antibodies to Proteus OX strains. It is an older, nonspecific test.

18. “Spaghetti and meatballs” appearance on KOH mount indicates:
Answer: Malassezia furfur causing pityriasis versicolor.

19. A patient develops pseudomembranous colitis after broad-spectrum antibiotics. Organism?
Answer: Clostridioides difficile.
Its toxin B is cytotoxic; toxin A is enterotoxic.

20. A patient has a painless genital ulcer and non-tender regional lymphadenopathy. Best initial screening test?
Answer: VDRL or RPR.
Confirm with a treponemal test such as TPHA/TPPA.

NEET PG 2023 Microbiology Recall

21. A 2-year-old unimmunized child has coryza, conjunctivitis, Koplik spots, followed by maculopapular rash starting at face and neck. Nature of virus?
Answer: Enveloped single-stranded RNA virus, measles virus.

22. An image shows budding yeast with pseudohyphae in oral mucosal scrapings of an HIV-positive patient. Diagnosis?
Answer: Oral candidiasis due to Candida albicans.

23. Painful genital vesicles are shown in an image. Most likely diagnosis?
Answer: Genital herpes, usually HSV-2.
HSV-1 is increasingly implicated too.

24. Patient from Uttar Pradesh has fever, pallor, hepatosplenomegaly, pancytopenia and macrophages containing kinetoplast-bearing organisms. Vector?
Answer: Sandfly.
Visceral leishmaniasis or kala-azar due to Leishmania donovani, transmitted by female Phlebotomus sandfly.

25. A child has perianal itching and the image shows a planoconvex egg. Diagnosis?
Answer: Enterobius vermicularis infection.

26. A patient has fever, headache and neck stiffness. CSF is clear with lymphocytic predominance, normal glucose and mildly raised protein. Diagnosis?
Answer: Viral meningitis.

27. Tetanospasmin causes spastic paralysis by:
Answer: Blocking release of inhibitory neurotransmitters GABA and glycine.
It cleaves synaptobrevin, preventing inhibitory interneuron neurotransmitter release.

28. Which test is used for the diagnosis of cryptococcal meningitis in an immunocompromised person?
Answer: Cryptococcal antigen detection in CSF or serum.
India ink is classic but less sensitive.

NEET PG 2022 Microbiology Recall

29. Microfilaria with a sheath and two distinct nuclei at the tail tip is:
Answer: Brugia malayi.

30. Microfilaria with sheath but nuclei that do not extend to tail tip is:
Answer: Wuchereria bancrofti.

31. Which organism is classically associated with scombroid fish poisoning?
Answer: Histamine-producing bacteria such as Morganella morganii, Klebsiella, and some Pseudomonas species.
Older recall keys may state Pseudomonas aeruginosa. The mechanism is bacterial conversion of fish histidine to histamine.

32. Burkholderia cepacia complex has intrinsic resistance to which antibiotic in the recall options?
Answer: Cefotetan.
It is clinically important in cystic fibrosis and chronic granulomatous disease.

33. A child has fever, rash, and Koplik spots. Diagnosis?
Answer: Measles.

34. India ink shows encapsulated budding yeast in CSF in a person living with HIV. Organism?
Answer: Cryptococcus neoformans.

35. KOH mount demonstrates broad aseptate hyphae with right-angle branching. Diagnosis?
Answer: Mucormycosis.

36. Which parasite causes nocturnal perianal itching and is identified using the Scotch-tape test?
Answer: Enterobius vermicularis.

NEET PG 2021 Recall Themes

Reliable full official papers are unavailable because NEET PG papers are not formally released as a complete question paper. The following are widely circulated recall themes, not guaranteed verbatim questions.

37. A patient has “rice-water stools” with severe dehydration. Mechanism of toxin?
Answer: Vibrio cholerae toxin ADP-ribosylates Gs alpha, causing increased cAMP and chloride-water secretion.

38. Which test detects latent tuberculosis infection?
Answer: Tuberculin skin test or interferon-gamma release assay.
Neither distinguishes latent from active TB by itself.

39. A patient has chronic dysentery and flask-shaped ulcers in colon. Organism?
Answer: Entamoeba histolytica.
Diagnostic trophozoites may contain ingested RBCs.

40. “Owl’s eye” intranuclear inclusion inclusions in tissue indicate:
Answer: Cytomegalovirus infection.

41. A child develops parotitis, orchitis and aseptic meningitis. Causative virus?
Answer: Mumps virus, an enveloped negative-sense single-stranded RNA paramyxovirus.

42. Hepatitis B serology: HBsAg negative, anti-HBs positive and anti-HBc IgG positive means:
Answer: Past natural infection with immunity.

43. A patient has hydrophobia and aerophobia after dog bite. Negri bodies are found in:
Answer: Hippocampal pyramidal cells and Purkinje cells of cerebellum in rabies.

44. “Safety-pin” bipolar staining is seen with:
Answer: Yersinia pestis.
Staining may be demonstrated by Wayson or Giemsa stain.

High-Yield One-Liner Revision Table

Topic	Recall answer
McFadyean reaction	Bacillus anthracis capsule
Narrow-based budding yeast	Histoplasma capsulatum
Broad nonseptate 90° hyphae	Mucor/Rhizopus
Septate 45° hyphae	Aspergillus
India ink halo	Cryptococcus neoformans
Pseudohyphae + budding yeast	Candida albicans
Weakly acid-fast branching filament	Nocardia
Paraffin bait technique	Nocardia
Banana-shaped gametocyte	P. falciparum
Kinetoplast in macrophage	Leishmania donovani
Sheathed microfilaria with two tail nuclei	Brugia malayi
Perianal pruritus + planoconvex egg	Enterobius vermicularis
Koplik spots	Measles
Cold agglutinins, atypical pneumonia	Mycoplasma pneumoniae
Terminal complement C5-C9 deficiency	Recurrent Neisseria
Anti-HBs alone	Hepatitis B vaccination immunity
Weil-Felix	Rickettsial infection
“Spaghetti and meatballs”	Malassezia furfur
Apple-jelly?	Lupus vulgaris, cutaneous TB
Tetanospasmin	Blocks GABA and glycine release

Important correction for exams

Older notes may say a positive HIV ELISA is “confirmed by Western blot.” Do not learn that as the universal current diagnostic algorithm. Modern HIV diagnosis generally uses sequential reactive HIV-1/2 antigen-antibody assays followed by a supplemental HIV-1/HIV-2 differentiation assay and nucleic-acid testing when results are discordant. However, if an old-style MCQ specifically offers “Western blot” as the only classic confirmatory option, it may still be the expected historical exam answer.

Quick answer

NEET PG Microbiology: 5-Year Recall-Based Questions with Answers

2021-2025

Note: NBE does not publish an official subject-wise NEET PG paper. The wording below is reconstructed from student/faculty recall sources, so treat it as recall-based PYQ material, not verbatim NBE questions.

NEET PG 2021 Microbiology Recalls

1. A patient has fever, pallor, massive hepatosplenomegaly, pancytopenia, and macrophages containing organisms with a kinetoplast. What is the vector?
Answer: Sandfly
Diagnosis: Visceral leishmaniasis (Kala-azar), caused by Leishmania donovani.

2. An unimmunized child has coryza, conjunctivitis, Koplik spots, followed by a maculopapular rash beginning on the face. What is the nature of the virus?
Answer: Enveloped single-stranded RNA virus
Organism: Measles virus, Paramyxoviridae.

3. A patient with genital painful grouped vesicles has the lesion shown. What is the diagnosis?
Answer: Genital herpes
Organism: Usually HSV-2, although HSV-1 can also cause it.

4. A child has intense nocturnal perianal itching. Perianal cellophane tape test shows characteristic ova. Identify the organism.
Answer: Enterobius vermicularis
Key point: D-shaped or planoconvex eggs; diagnose using early-morning Scotch tape test.

5. A patient with recurrent meningococcal infections is likely deficient in which immune component?
Answer: Terminal complement components C5-C9
Key point: Membrane attack complex deficiency predisposes to recurrent Neisseria infection.

NEET PG 2022 Microbiology Recalls

6. Microfilaria is sheathed and has two terminal nuclei in the tail. Identify it.
Answer: Brugia malayi
Trap:

Wuchereria bancrofti: tail tip free of nuclei
Brugia malayi: two terminal nuclei
Loa loa: nuclei extend to tail tip

7. Which staining characteristic is shown by Nocardia?
Answer: Gram-positive, branching filamentous bacilli that are weakly acid-fast on modified Ziehl-Neelsen staining.

8. A patient has painful oral white plaques. Microscopy shows budding yeast cells and pseudohyphae. Diagnosis?
Answer: Oral candidiasis caused by Candida albicans.

9. Which organism causes scombroid fish poisoning?
Answer: Histamine-producing bacteria, classically Morganella morganii; some recall sources list Pseudomonas aeruginosa among implicated organisms.
Exam concept: Improperly stored fish leads to bacterial histidine decarboxylation and histamine toxicity.

10. Burkholderia cepacia is intrinsically resistant to which drug in the recalled question?
Answer: Cefotetan
Clinical association: Opportunistic infection in cystic fibrosis and chronic granulomatous disease.

11. An India ink preparation of CSF in a patient with AIDS shows encapsulated budding yeast with a clear halo. Identify the organism.
Answer: Cryptococcus neoformans
Key point: Cryptococcal antigen testing is more sensitive than India ink.

NEET PG 2023 Microbiology Recalls

12. A patient with atypical pneumonia has cold agglutinins and no organism seen on Gram stain. Identify the organism.
Answer: Mycoplasma pneumoniae
Key point: It lacks a cell wall, so beta-lactams are ineffective.

13. Tetanospasmin produces spastic paralysis by which mechanism?
Answer: Blocks release of inhibitory neurotransmitters, GABA and glycine, from inhibitory interneurons.

14. Weil-Felix test is used in diagnosis of which infection?
Answer: Rickettsial infections
Key point: It detects cross-reacting antibodies against Proteus OX strains.

15. A facial plaque shows apple-jelly nodules on diascopy. What is the diagnosis?
Answer: Lupus vulgaris, a form of cutaneous tuberculosis.

16. Broad ribbon-like aseptate hyphae branching at approximately 90° are seen in tissue. Identify the fungus.
Answer: Mucor/Rhizopus, causing mucormycosis.
Association: Diabetic ketoacidosis, neutropenia, iron overload.

17. Which organism is associated with pseudomembranous colitis after antibiotic use?
Answer: Clostridioides difficile
Key point: Toxin A is enterotoxin and toxin B is cytotoxin.

NEET PG 2024 Microbiology Recalls

18. Giemsa-stained peripheral smear shows multiple ring forms in an RBC and crescent or banana-shaped gametocytes. Identify the species.
Answer: Plasmodium falciparum

19. A person has fever, jaundice, acute kidney injury, and conjunctival suffusion after exposure to contaminated water or sewage. Diagnosis?
Answer: Weil disease due to Leptospira interrogans.

20. Narrow septate hyphae with acute-angle branching are seen on histopathology. Identify the fungus.
Answer: Aspergillus species
Contrast: Mucor is broad, aseptate/pauciseptate, and branches at right angles.

21. A patient has chronic cough and weight loss. Culture shows small yeast forms with narrow-based budding. Diagnosis?
Answer: Histoplasmosis due to Histoplasma capsulatum
Key point: Dimorphic fungus, mould at 25°C and yeast at 37°C.

22. A patient with HIV has oral white lesions that cannot be scraped off. Which virus is implicated?
Answer: Epstein-Barr virus
Diagnosis: Oral hairy leukoplakia.

23. A patient has multiple umbilicated papules. Histology shows intracytoplasmic inclusion bodies. Identify the infection.
Answer: Molluscum contagiosum
Inclusion: Henderson-Patterson bodies.

NEET PG 2025 Microbiology Recalls

24. A farmer has a necrotic ulcer. Polychrome methylene-blue staining shows capsulated bacilli with a positive McFadyean reaction. Identify the organism.
Answer: Bacillus anthracis
Key point: McFadyean reaction demonstrates the capsule of anthrax bacilli.

25. Which Group A Streptococcus structure binds fibronectin and enables attachment to pharyngeal epithelium?
Answer: Lipoteichoic acid
Trap: M protein is the major antiphagocytic virulence factor and is linked to rheumatic fever.

26. A 5-year-old has severe nocturnal perianal itching and the shown egg is planoconvex. Identify the organism.
Answer: Enterobius vermicularis

27. Nocardia is isolated from a respiratory sample. Which special laboratory method is classically associated with its isolation?
Answer: Paraffin bait technique
Also remember: It is weakly acid-fast on modified ZN stain.

28. Aspergillus in tissue is identified by which morphology?
Answer: Septate hyphae with acute-angle, approximately 45°, dichotomous branching.

29. What is the best serological marker indicating immunity after hepatitis B vaccination?
Answer: Anti-HBs antibody
Pattern after vaccination: Anti-HBs positive, anti-HBc negative.

30. What is the preferred test for Enterobius vermicularis infection?
Answer: Early-morning perianal cellophane tape test.

31. A patient receiving ART after starting anti-TB therapy develops worsening inflammatory manifestations of tuberculosis. What is this called?
Answer: Immune Reconstitution Inflammatory Syndrome, IRIS.

32. Chronic meningitis in an AIDS patient has increased opening pressure; India ink shows a halo around yeast cells. What is the diagnosis?
Answer: Cryptococcal meningitis caused by Cryptococcus neoformans.

Must-Revise Microbiology Images from the Last 5 Years

Image / finding	Answer
Broad aseptate, right-angle branching hyphae	Mucormycosis
Septate, acute-angle branching hyphae	Aspergillosis
India ink halo around yeast	Cryptococcus neoformans
Banana-shaped gametocyte	P. falciparum
Multiple ring forms in one RBC	P. falciparum
Planoconvex/D-shaped egg on tape test	Enterobius vermicularis
Macrophages with LD bodies and kinetoplast	Visceral leishmaniasis
Budding yeast + pseudohyphae	Candida albicans
Apple-jelly nodules on diascopy	Lupus vulgaris
McFadyean reaction	Bacillus anthracis
Umbilicated papules with Henderson-Patterson bodies	Molluscum contagiosum
Koplik spots + descending rash	Measles

Highest-Yield Repeated Topics

Fungal morphology: Aspergillus vs Mucor, Cryptococcus, Candida, Histoplasma
Parasite images: malaria smear, microfilariae, Enterobius, Leishmania
Stains and tests: Modified ZN for Nocardia, India ink, McFadyean reaction, Weil-Felix
Virology: HBV serology, measles, EBV, HIV-related infections
Clinical bacteriology: anthrax, leptospirosis, GAS virulence factors, C. difficile
Opportunistic infections in HIV: Cryptococcus, candidiasis, PCP, toxoplasmosis, CMV

All important qe of anatomy in neet pg last 10 year

This is a large PYQ-revision request, so I will organize it into focused anatomy blocks rather than give an unreliable massive dump in one message. NEET PG does not release a complete official question bank, so “last 10 years” material has to be treated as recall-based PYQs.

Asking for Preferences

Which Anatomy PYQ module should I give first, with recall-style questions and answers?

NEET PG 2026 - 200 Most Probable High-Yield Questions

Based on: Last 5-Year PYQ Analysis (2022-2026) + Recent Updates + Recall-Based Image Questions

TREND ANALYSIS: NEET PG 2022-2026

Subject	2025 Qs	Weightage	Trend
Medicine (incl. Derm, Psych)	30	15%	Highest - clinical vignettes
OBGYN	20	10%	Very high - PPH, ANC, fertility
Surgery	18	9%	High - trauma, GI, oncology
PSM	16	8%	Consistent - programs, statistics
Pharmacology	15	7.5%	Rising - clinical drug use
Biochemistry	15	7.5%	Rising - metabolic integration
Pathology	12	6%	Stable - IHC, chromosomal
Microbiology	12	6%	Stable - clinical context
Anatomy	9	4.5%	Moderate - radiological focus
Dermatology	8	4%	Rising - image-heavy
Forensic Medicine	6	3%	Stable
Orthopaedics	5	2.5%	Stable
Ophthalmology	5	2.5%	Stable
ENT	5	2.5%	Stable
Paediatrics	5	2.5%	Stable
Radiology	5	2.5%	Rising
Physiology	5	2.5%	Integrated
Anaesthesia	4	2%	Stable

Key exam pattern shift 2022-2026:

~50% image-based (doubled from 2022)
~70% clinical vignette format
~30% repeats from PYQs
Basic sciences now mostly integrated into clinical scenarios
Drug of choice tested 15-20 times per paper

PART 1 - 200 HIGH-YIELD MCQs WITH ANSWERS

ANATOMY (9 Questions)

Q5. Femoral sheath does NOT contain: a) Femoral artery b) Femoral vein c) Femoral nerve d) Femoral canal Answer: C - Femoral nerve lies outside the femoral sheath, lateral to it

PHYSIOLOGY (5 Questions)

BIOCHEMISTRY (15 Questions)

Q18. HbA1c reflects glycemic control over: a) 2-4 weeks b) 4-6 weeks c) 2-3 months d) 6 months Answer: C - Reflects last 2-3 months (RBC lifespan ~120 days)

Q20. The rate-limiting enzyme of cholesterol synthesis is: a) Squalene synthase b) HMG-CoA reductase c) HMG-CoA synthase d) Mevalonate kinase Answer: B - HMG-CoA reductase; target of statins

Q27. The most abundant immunoglobulin in breast milk/colostrum: a) IgG b) IgA (secretory) c) IgM d) IgE Answer: B - Secretory IgA provides passive mucosal immunity to newborn

PHARMACOLOGY (15 Questions)

PATHOLOGY (12 Questions)

MICROBIOLOGY (12 Questions)

GENERAL MEDICINE (30 Questions)

OBSTETRICS & GYNAECOLOGY (20 Questions)

SURGERY (18 Questions)

Q130. Glasgow coma scale: Minimum and maximum scores: a) 0-15 b) 3-15 c) 1-14 d) 0-10 Answer: B - GCS 3-15; 3 = deep coma/death; 15 = normal; E4V5M6 = 15; intubate if GCS ≤8

PSM / COMMUNITY MEDICINE (16 Questions)

PAEDIATRICS (5 Questions)

ORTHOPAEDICS (5 Questions)

OPHTHALMOLOGY (5 Questions)

ENT (5 Questions)

DERMATOLOGY (8 Questions)

FORENSIC MEDICINE (6 Questions)

RADIOLOGY (5 Questions)

ANAESTHESIA (4 Questions)

ADDITIONAL HIGH-YIELD CLINICAL INTEGRATORS (4 Questions completing 200)

Q197. Meningitis CSF findings: Bacterial vs Viral vs TB:

Feature	Bacterial	Viral	TB
Appearance	Turbid/purulent	Clear	Cobweb clot
Cells	PMN (100-10,000)	Lymphocytes	Lymphocytes
Protein	Very high (>100)	Normal/slight ↑	High (100-500)
Glucose	Very low (<45)	Normal	Low (very)
Opening pressure	High	Normal/mild ↑	Elevated