NEET-PG 2012

Q: A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

Apical lymph nodes. ***Apical lymph nodes*** - The **apical lymph nodes** are located **medial** to the **medial border of the pectoralis minor muscle**, at the apex of the axilla (Level III) [2]. - Since the removal was restricted to nodes **lateral** to the medial edge of the pectoralis minor, the apical nodes would **not be removed**. - These nodes receive lymph from all other axillary node groups and drain into the subclavian lymphatic trunk. *Central lymph nodes* - **Central lymph nodes** are located **posterior to (deep to)** the pectoralis minor muscle, within the axillary fat (Level II) [1]. - They lie between the medial and lateral borders of the pectoralis minor and are generally considered to be **lateral** to the medial edge of the pectoralis minor, so they would be removed in this dissection. *Lateral lymph nodes* - **Lateral (humeral) lymph nodes** are found along the **lateral border** of the axilla, following the axillary vein (Level I) [1]. - These nodes drain the majority of the upper limb and are clearly **lateral** to the pectoralis minor muscle, so hese would be included in the dissection. *Pectoral lymph nodes* - **Pectoral (anterior) lymph nodes** lie along the **lower border** of the pectoralis minor muscle and the lateral thoracic vessels (Level I). - They receive lymph from the anterior and lateral thoracic walls and much of the breast. - These nodes are located **lateral** to the medial edge of the pectoralis minor and would be removed as part of the surgical procedure. [Practice more NEET-PG 2012 questions on OnCourse]

Q: Deltoid ligament is attached to all, except which structure?

Medial cuneiform. ***Medial cuneiform*** - The **deltoid ligament** is located on the **medial side of the ankle** and primarily connects the **tibia** to several tarsal bones. It does not attach to the medial cuneiform. - The **medial cuneiform** is a midfoot bone primarily involved in the **tarsometatarsal joint** and is not a direct attachment site for the deltoid ligament. *Medial malleolus* - The **medial malleolus**, the distal end of the **tibia**, serves as the **proximal attachment point** for all four parts of the deltoid ligament. - This strong connection is crucial for **stabilizing the ankle joint** medially. *Navicular bone* - The **tibionavicular part** of the deltoid ligament attaches to the **tuberosity of the navicular bone**. - This attachment helps **limit excessive abduction** and **eversion** of the foot. *Sustentaculum tali* - The **tibiocalcaneal part** of the deltoid ligament attaches to the **sustentaculum tali** on the calcaneus. - This attachment provides significant stability to the **subtalar joint**. [Practice more NEET-PG 2012 questions on OnCourse]

Q: Which of the following is NOT a key intervention implemented under the Reproductive and Child Health (RCH) programme?

Management of hypertension. ***Management of hypertension*** - While important for overall health, the **management of non-communicable diseases (NCDs)** like hypertension is not a primary, direct focus of the **Reproductive and Child Health (RCH) programme**. - RCH programs primarily target interventions related to women's reproductive health, safe motherhood, and child survival. *Immunization* - **Immunization** is a cornerstone intervention of the RCH program, crucial for preventing major childhood diseases and improving child survival rates. - It directly contributes to reducing **infant and child mortality** by protecting against vaccine-preventable diseases. *ORS therapy* - **Oral Rehydration Solution (ORS) therapy** is a key intervention within the RCH program aimed at reducing child mortality due to diarrheal diseases. - It is effective in treating **dehydration** caused by diarrhea, a common cause of death in young children. *Vitamin A supplementation* - **Vitamin A supplementation** is an essential RCH intervention, particularly for children, to prevent **vitamin A deficiency**. - It plays a vital role in **boosting immunity**, preventing blindness, and reducing the severity of common childhood infections. [Practice more NEET-PG 2012 questions on OnCourse]

Q: Haemoglobin F is raised in which condition?

Juvenile chronic myeloid leukemia. ***Juvenile chronic myeloid leukemia*** - This condition is characterized by a high proportion of **fetal hemoglobin (HbF)**, often exceeding 50%, alongside other typical myeloproliferative features. - The elevated HbF is a distinguishing feature of **juvenile CML** from adult CML, which typically presents with normal or only slightly elevated HbF levels. *Beta-thalassemia major* - While patients with **beta-thalassemia major** can have elevated HbF, it is typically in response to a severe deficiency in beta-globin chain production, leading to compensatory gamma-chain synthesis. - However, the primary genetic defect lies in the beta-globin genes, and the HbF increase is usually not as universally high or definitive as in HPFH or juvenile CML. *Sickle cell disease* - Patients with **sickle cell disease** can have variable levels of HbF, and higher levels are associated with a milder disease course [1]. - HbF acts as a protective factor by inhibiting hemoglobin S polymerization, but the presence of high HbF is not a diagnostic marker in the same way it is for HPFH or juvenile CML [1]. *Hereditary persistence of fetal hemoglobin (HPFH)* - This is a benign condition characterized by the **continued production of high levels of HbF into adulthood** due to genetic mutations that prevent the normal developmental switch from gamma-globin to beta-globin synthesis. - While it features significantly raised HbF, HPFH is typically **asymptomatic** and does not present with the myeloproliferative features seen in juvenile CML. [Practice more NEET-PG 2012 questions on OnCourse]

Q: Which of the following statements about Streptococcus is false?

Group A Streptococcus is catalase positive. ***Group A Streptococcus is catalase positive*** - This statement is false because all species of **Streptococcus**, including Group A Streptococcus (GAS), are **catalase-negative**. - The absence of the **catalase enzyme** is a key differentiating feature between streptococci and staphylococci, which are catalase-positive. *Group B causes neonatal meningitis* - **Group B Streptococcus (GBS)**, or *Streptococcus agalactiae*, is a well-known cause of **neonatal meningitis** and sepsis. - Infants can acquire GBS during passage through the birth canal from a colonized mother, leading to severe infections. *Group B lives in female genital tract* - GBS is a common commensal organism found in the **lower gastrointestinal** and **female genital tracts** of up to 30% of healthy women. - Its presence in the female genital tract poses a risk for transmission to neonates during childbirth. *Classification by Lancefield based on carbohydrate antigen* - The **Lancefield grouping system** classifies streptococci based on the presence of specific **carbohydrate antigens** in their cell walls. - This serological classification, developed by Rebecca Lancefield, divides streptococci into groups A, B, C, D, F, and G, which helps in identifying different species and their associated pathologies. [Practice more NEET-PG 2012 questions on OnCourse]

1213 Previous Year Questions with Answers & Explanations

1213

Questions

Subjects

Anatomy

2 questions

A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

Deltoid ligament is attached to all, except which structure?

NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs

Question 1: A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

A. Central lymph nodes
B. Lateral lymph nodes
C. Pectoral lymph nodes
D. Apical lymph nodes (Correct Answer)

Explanation: ***Apical lymph nodes*** - The **apical lymph nodes** are located **medial** to the **medial border of the pectoralis minor muscle**, at the apex of the axilla (Level III) [2]. - Since the removal was restricted to nodes **lateral** to the medial edge of the pectoralis minor, the apical nodes would **not be removed**. - These nodes receive lymph from all other axillary node groups and drain into the subclavian lymphatic trunk. *Central lymph nodes* - **Central lymph nodes** are located **posterior to (deep to)** the pectoralis minor muscle, within the axillary fat (Level II) [1]. - They lie between the medial and lateral borders of the pectoralis minor and are generally considered to be **lateral** to the medial edge of the pectoralis minor, so they would be removed in this dissection. *Lateral lymph nodes* - **Lateral (humeral) lymph nodes** are found along the **lateral border** of the axilla, following the axillary vein (Level I) [1]. - These nodes drain the majority of the upper limb and are clearly **lateral** to the pectoralis minor muscle, so hese would be included in the dissection. *Pectoral lymph nodes* - **Pectoral (anterior) lymph nodes** lie along the **lower border** of the pectoralis minor muscle and the lateral thoracic vessels (Level I). - They receive lymph from the anterior and lateral thoracic walls and much of the breast. - These nodes are located **lateral** to the medial edge of the pectoralis minor and would be removed as part of the surgical procedure.

Question 2: Deltoid ligament is attached to all, except which structure?

A. Sustentaculum tali
B. Medial cuneiform (Correct Answer)
C. Navicular bone
D. Medial malleolus

Explanation: ***Medial cuneiform*** - The **deltoid ligament** is located on the **medial side of the ankle** and primarily connects the **tibia** to several tarsal bones. It does not attach to the medial cuneiform. - The **medial cuneiform** is a midfoot bone primarily involved in the **tarsometatarsal joint** and is not a direct attachment site for the deltoid ligament. *Medial malleolus* - The **medial malleolus**, the distal end of the **tibia**, serves as the **proximal attachment point** for all four parts of the deltoid ligament. - This strong connection is crucial for **stabilizing the ankle joint** medially. *Navicular bone* - The **tibionavicular part** of the deltoid ligament attaches to the **tuberosity of the navicular bone**. - This attachment helps **limit excessive abduction** and **eversion** of the foot. *Sustentaculum tali* - The **tibiocalcaneal part** of the deltoid ligament attaches to the **sustentaculum tali** on the calcaneus. - This attachment provides significant stability to the **subtalar joint**.

Community Medicine

1 questions

Which of the following is NOT a key intervention implemented under the Reproductive and Child Health (RCH) programme?

Internal Medicine

1 questions

Haemoglobin F is raised in which condition?

Microbiology

2 questions

Which of the following statements about Streptococcus is false?

Which of the following statements is true regarding Wuchereria bancrofti?

NEET-PG 2012 - Microbiology NEET-PG Practice Questions and MCQs

Question 1: Which of the following statements about Streptococcus is false?

A. Group A Streptococcus is catalase positive (Correct Answer)
B. Group B causes neonatal meningitis
C. Group B lives in female genital tract
D. Classification by Lancefield based on carbohydrate antigen

Explanation: ***Group A Streptococcus is catalase positive*** - This statement is false because all species of **Streptococcus**, including Group A Streptococcus (GAS), are **catalase-negative**. - The absence of the **catalase enzyme** is a key differentiating feature between streptococci and staphylococci, which are catalase-positive. *Group B causes neonatal meningitis* - **Group B Streptococcus (GBS)**, or *Streptococcus agalactiae*, is a well-known cause of **neonatal meningitis** and sepsis. - Infants can acquire GBS during passage through the birth canal from a colonized mother, leading to severe infections. *Group B lives in female genital tract* - GBS is a common commensal organism found in the **lower gastrointestinal** and **female genital tracts** of up to 30% of healthy women. - Its presence in the female genital tract poses a risk for transmission to neonates during childbirth. *Classification by Lancefield based on carbohydrate antigen* - The **Lancefield grouping system** classifies streptococci based on the presence of specific **carbohydrate antigens** in their cell walls. - This serological classification, developed by Rebecca Lancefield, divides streptococci into groups A, B, C, D, F, and G, which helps in identifying different species and their associated pathologies.

Question 2: Which of the following statements is true regarding Wuchereria bancrofti?

A. Unsheathed
B. Tail tip free from nuclei (Correct Answer)
C. Non-periodic
D. None of the options

Explanation: ***Tail tip free from nuclei*** - The **microfilariae** of *Wuchereria bancrofti* are characterized by a **clean tail tip**, meaning there are no nuclei extending into the very end of the tail. - This feature is crucial for differentiating it from other microfilariae like *Brugia malayi*, which has two distinct nuclei in its tail tip. *Unsheathed* - *Wuchereria bancrofti* microfilariae are **sheathed**, meaning they retain an egg envelope as a loose covering. - An unsheathed microfilaria, like that of *Onchocerca volvulus*, lacks this outer covering. *Non-periodic* - *Wuchereria bancrofti* exhibits **nocturnal periodicity**, meaning its microfilariae are most abundant in the peripheral blood during the night. - Non-periodic microfilariae are found in the blood at any time of day, as seen with *Loa loa*. *None of the options* - This statement is incorrect because "Tail tip free from nuclei" is a true characteristic of *Wuchereria bancrofti* microfilariae.

Obstetrics and Gynecology

1 questions

IUCD lasting for 10 years is a:

Pathology

2 questions

Malignancy in pheochromocytoma is indicated by:

Renal papillary necrosis is almost always associated with one of the following conditions:

NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs

Question 1: Malignancy in pheochromocytoma is indicated by:

A. Mitotic figures
B. Capsular invasion
C. Metastasis (Correct Answer)
D. Vascular invasion

Explanation: ***Metastasis*** - The definitive criterion for diagnosing **malignancy in pheochromocytoma** is the presence of **metastatic disease**, meaning tumor cells have spread to sites where chromaffin tissue is not normally found. - The distinction between benign and malignant pheochromocytomas often cannot be made based on histological features alone. *Mitotic figures* - While increased **mitotic activity** can be a feature indicating aggressive tumor behavior, it is not a standalone definitive criterion for malignancy in pheochromocytoma. - Benign pheochromocytomas can occasionally show mitotic figures, and their presence alone does not confirm malignancy. *Capsular invasion* - **Capsular invasion** suggests an aggressive tumor but is not a definitive indicator of malignancy in pheochromocytoma. - Tumors that exhibit capsular invasion without distant spread are still considered to have uncertain malignant potential rather than overt malignancy. *Vascular invasion* - Similar to capsular invasion, **vascular invasion** indicates an increased risk of metastasis but is not a conclusive sign of malignancy. - The presence of tumor cells within blood vessels raises suspicion, but true malignancy is only confirmed by the presence of distant metastases.

Question 2: Renal papillary necrosis is almost always associated with one of the following conditions:

A. Diabetes-mellitus
B. Analgesic-nephropathy (Correct Answer)
C. Chronic pyelonephritis
D. Post streptococcal GN

Explanation: ***Analgesic-nephropathy*** - Chronic use of certain analgesics (especially **phenacetin**, aspirin, and NSAIDs) can lead to **ischemia** and damage to the renal papillae, causing **papillary necrosis**. - This condition is considered the **classic** cause of renal papillary necrosis and is the most frequently emphasized in medical education. - Analgesic nephropathy shows a very **strong and direct association** with papillary necrosis as a hallmark feature. *Diabetes-mellitus* - **Diabetes mellitus** is actually one of the **most common causes** of renal papillary necrosis in clinical practice, particularly when complicated by **infection** or **ischemia** [1]. - While clinically very common, it causes papillary necrosis through multiple mechanisms and is often associated with coexisting factors like **pyelonephritis** [1], [2] or NSAID use. - In the context of "almost always associated," analgesic nephropathy has a more direct and consistent association. *Chronic pyelonephritis* - **Chronic pyelonephritis** involves recurrent bacterial infections of the kidney parenchyma and can lead to scarring and kidney damage. - While it is indeed a recognized cause of **papillary necrosis** (part of the POSTCARDS mnemonic), it is not as consistently associated as analgesic nephropathy [2]. *Post streptococcal GN* - **Post-streptococcal glomerulonephritis (PSGN)** is an immune-mediated inflammatory kidney disease that typically follows a **streptococcal infection**. - It primarily affects the **glomeruli** and does **not** cause necrosis of the renal papillae, making this option incorrect. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 543-544. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 937-940.

Psychiatry

1 questions

What is the code for mental disorders in the ICD-10 classification?