Anatomy
1 questionsWhich arteries supply the talus?
NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs
Question 1031: Which arteries supply the talus?
- A. Peroneal artery
- B. Posterior tibial artery
- C. Anterior tibial artery
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - The **talus** has a tenuous blood supply due to its limited muscular attachments, receiving contributions from multiple surrounding arteries to ensure adequate perfusion. - The **anterior tibial artery**, **posterior tibial artery**, and **peroneal artery** all contribute branches that form an anastomotic network around the talus. *Anterior tibial artery* - The **anterior tibial artery** contributes blood supply to the talus primarily through its **dorsal pedis branch** and ascending branches that supply the neck and head of the talus. - Its major role is in supplying the **anterior and superior talar surfaces**. *Posterior tibial artery* - The **posterior tibial artery** is a significant source of blood supply, particularly to the body and posterior aspect of the talus, via branches like the **artery of the tarsal canal** and the **deltoid branch**. - Its branches contribute to the **posterior talar artery network** which is crucial for the central part of the talus. *Peroneal artery* - The **peroneal artery** provides blood supply to the lateral and posterior parts of the talus through its **communicating branch** and perforating branches. - It contributes to the **tarsal artery network**, ensuring collateral circulation to the talus.
Microbiology
1 questionsAcute Infective Endocarditis with abscess formation is most commonly associated with
NEET-PG 2012 - Microbiology NEET-PG Practice Questions and MCQs
Question 1031: Acute Infective Endocarditis with abscess formation is most commonly associated with
- A. Listeria
- B. Staphylococcus (Correct Answer)
- C. Streptococcus
- D. Enterococcus
Explanation: ***Staphylococcus*** - **_Staphylococcus aureus_** is the most common cause of **acute infective endocarditis (AIE)** and is particularly virulent, leading to rapid valve destruction and **abscess formation**. - Its ability to adhere to damaged endothelium and produce various toxins contributes to its high pathogenicity and propensity for complicated infections. *Listeria* - **_Listeria monocytogenes_** is a gram-positive rod known to cause meningitis and gastrointestinal infections, especially in immunocompromised individuals. - While it can rarely cause endocarditis, it is not typically associated with the majority of AIE cases or abscess formation. *Streptococcus* - **_Streptococcus_ species**, particularly **_Viridans streptococci_**, are commonly associated with **subacute infective endocarditis (SIE)** on previously damaged valves. - They generally cause a more indolent course and are less frequently linked to rapid valve destruction or abscess formation compared to _Staphylococcus aureus_. *Enterococcus* - **_Enterococcus_ species** are a common cause of endocarditis, especially in older patients, those with healthcare-associated infections, or urinary tract procedures. - While they can cause serious infections, **_Staphylococcus aureus_** remains the predominant pathogen for acute infective endocarditis with abscess formation.
Obstetrics and Gynecology
1 questionsNuchal translucency is used in
NEET-PG 2012 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1031: Nuchal translucency is used in
- A. Head scan
- B. MRI neck
- C. ANC USG (Correct Answer)
- D. Anthropometry
Explanation: ***ANC USG*** - **Nuchal translucency** measurement is a key component of the **first-trimester antenatal ultrasound** (ANC USG). - It helps in screening for chromosomal abnormalities like **Down syndrome (Trisomy 21)** and certain cardiac defects. *Head scan* - A head scan (e.g., CT or MRI of the head) is used to evaluate the **brain** and **skull** for conditions like tumors, strokes, or trauma. - It is not routinely used for fetal screening or nuchal translucency assessment. *MRI neck* - **MRI of the neck** is employed to visualize soft tissues, blood vessels, and bones in the neck region. - Its primary use is in diagnosing conditions like cervical disc herniations, spinal cord compression, or neck masses, not for fetal screening. *Anthropometry* - **Anthropometry** involves the measurement of the human body, such as height, weight, and limb circumference. - While general measurements are taken during pregnancy, anthropometry specifically does not refer to the assessment of nuchal translucency.
Orthopaedics
1 questionsTreatment of choice for displaced fracture neck femur in a 40 years old female
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1031: Treatment of choice for displaced fracture neck femur in a 40 years old female
- A. None of the options
- B. Bipolar hemiarthroplasty
- C. Multiple screw fixation (Correct Answer)
- D. THR
Explanation: ***Multiple screw fixation*** - For a **displaced femoral neck fracture** in a younger patient (40 years old), **internal fixation** with multiple screws is generally the preferred treatment to preserve the native **femoral head**. - This approach aims to achieve **anatomical reduction** and stable fixation, allowing for bone healing and a better long-term functional outcome in active individuals. *Bipolar hemiarthroplasty* - This procedure is typically reserved for older, less active patients with **displaced femoral neck fractures**, particularly those with pre-existing conditions that might limit their longevity or activity level. - While it replaces the femoral head, it does not preserve the native joint, which is a less desirable outcome in a 40-year-old. *THR* - **Total hip replacement** is usually considered for older patients, or younger patients with **pre-existing arthritis** or failed internal fixation, due to concerns about the prosthesis's longevity and potential future revisions. - In a 40-year-old, the goal is typically to preserve the native joint if possible, unless there are other complicating factors. *None of the options* - Internal fixation with multiple screws is a well-established and appropriate treatment for a displaced femoral neck fracture in a 40-year-old patient. - Therefore, one of the provided options is indeed the correct treatment choice for this specific scenario.
Pediatrics
4 questionsDouble aortic arch is associated with which syndrome?
A 3-month-old infant presents with an abdominal palpable mass and non-bilious vomiting. What is the most likely diagnosis?
What is the PRIMARY pathophysiological mechanism underlying the most common cause of neonatal hyperbilirubinemia?
Most common site of extramedullary relapse of ALL in a 6-year-old boy is
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1031: Double aortic arch is associated with which syndrome?
- A. DiGeorge syndrome (Correct Answer)
- B. CATCH 22 syndrome
- C. Shprintzen syndrome
- D. None of the options
Explanation: ***DiGeorge syndrome*** - **DiGeorge syndrome** is caused by a **22q11.2 deletion** affecting the development of the third and fourth pharyngeal pouches, leading to **thymic hypoplasia**, **parathyroid hypoplasia**, and **cardiac anomalies**. - Common cardiac defects include **interrupted aortic arch type B**, **truncus arteriosus**, **tetralogy of Fallot**, and **VSD**. - **Double aortic arch** can occur in 22q11.2 deletion syndrome, though it is less common than other cardiac anomalies; however, among the syndromes listed, this represents the most appropriate association. - The question tests recognition that various cardiac arch anomalies, including double aortic arch, may be seen in this genetic syndrome. *CATCH 22 syndrome* - This is an **acronym** for DiGeorge syndrome: **C**ardiac defects, **A**bnormal facies, **T**hymic hypoplasia, **C**left palate, **H**ypocalcemia, and **22q11 deletion**. - It is **essentially the same condition** as DiGeorge syndrome, just using different nomenclature. - While technically correct, "DiGeorge syndrome" is the more standard medical terminology currently used. *Shprintzen syndrome* - **Shprintzen syndrome** (also called **velocardiofacial syndrome or VCFS**) is caused by the **same 22q11.2 deletion** as DiGeorge syndrome. - It represents a **phenotypic variant within the 22q11.2 deletion syndrome spectrum**, with more emphasis on palatal and facial features. - Since it shares the same genetic basis, it can also present with similar cardiac anomalies, but "DiGeorge syndrome" is the more commonly recognized term for this genetic disorder. *None of the options* - This is incorrect because the three syndromes listed above (DiGeorge, CATCH 22, and Shprintzen) all refer to **22q11.2 deletion syndrome** or its variants, which can be associated with various cardiac anomalies including double aortic arch. - Among the listed options, **DiGeorge syndrome** is the most appropriate and widely recognized answer.
Question 1032: A 3-month-old infant presents with an abdominal palpable mass and non-bilious vomiting. What is the most likely diagnosis?
- A. Hypertrophic pyloric stenosis (Correct Answer)
- B. Tracheoesophageal fistula
- C. Duodenal atresia
- D. Intussusception
Explanation: ***Hypertrophic pyloric stenosis*** - The classic presentation includes **projectile non-bilious vomiting** and a palpable **olive-shaped mass** in the epigastrium of an infant typically between 3 weeks and 6 months of age. - The vomiting is non-bilious because the obstruction is proximal to the ampulla of Vater. *Intussusception* - While it can present with an **abdominal mass** and vomiting, the vomiting is often **bilious** and the classic stool is **'currant jelly'**, which is not mentioned here. - It usually presents with sudden onset of severe, **colicky abdominal pain** and occurs more commonly in slightly older infants (6-12 months). *Tracheoesophageal fistula* - This condition presents at birth with symptoms such as **choking, coughing**, and **cyanosis** during feeding. - It usually causes respiratory distress and feeding difficulties from the first days of life, not a palpable abdominal mass and non-bilious vomiting at 3 months. *Duodenal atresia* - This is a congenital obstruction that typically presents with **bilious vomiting** (as the obstruction is distal to the ampulla of Vater) within the first 24-48 hours of life. - Imaging usually shows a **“double bubble” sign** on abdominal X-ray, and an abdominal mass is not typically palpable.
Question 1033: What is the PRIMARY pathophysiological mechanism underlying the most common cause of neonatal hyperbilirubinemia?
- A. Inefficient erythropoiesis
- B. Immature liver enzyme (Correct Answer)
- C. RBC hemolysis
- D. Decreased bilirubin excretion
Explanation: ***Immature liver enzyme*** - The most common cause of neonatal hyperbilirubinemia is **physiological jaundice**, and its PRIMARY pathophysiological mechanism is **immature hepatic conjugation** due to deficiency of **UDP-glucuronosyltransferase (UGT1A1)**. - While neonates do produce more bilirubin from RBC breakdown, the **rate-limiting step** is the liver's inability to conjugate unconjugated bilirubin efficiently for excretion. - This immaturity causes accumulation of unconjugated bilirubin, which peaks at **3-5 days of life** and resolves as the enzyme system matures by **7-10 days**. - Key clinical feature: **Unconjugated (indirect) hyperbilirubinemia** in an otherwise healthy term neonate. *RBC hemolysis* - Neonates do have a **shorter RBC lifespan** (70-90 days vs. 120 days in adults) and higher hematocrit, leading to increased bilirubin production (~2-3 times adult rate). - However, this is a **contributory factor**, not the primary mechanism—a normal liver can handle this load easily. - **Pathological hemolysis** (ABO/Rh incompatibility, G6PD deficiency, spherocytosis) causes jaundice through a different mechanism with earlier onset (<24 hours) and more severe hyperbilirubinemia. *Inefficient erythropoiesis* - Ineffective erythropoiesis (abnormal RBC production with intramedullary destruction) is seen in conditions like **thalassemia** and **megaloblastic anemia**. - This can contribute to increased bilirubin load but is not the mechanism in physiological jaundice. - In neonates, erythropoiesis is typically transitioning from fetal to adult hemoglobin but is not pathologically inefficient. *Decreased bilirubin excretion* - Decreased excretion of **conjugated bilirubin** occurs in **cholestatic conditions** (biliary atresia, neonatal hepatitis, choledochal cyst). - This results in **direct (conjugated) hyperbilirubinemia**, not the indirect hyperbilirubinemia seen in physiological jaundice. - While neonates do have relatively decreased enterohepatic circulation clearance, the primary bottleneck is conjugation, not excretion.
Question 1034: Most common site of extramedullary relapse of ALL in a 6-year-old boy is
- A. Testes
- B. Liver
- C. CNS (Central Nervous System) (Correct Answer)
- D. Lung
Explanation: ***CNS (Central Nervous System)*** - The **central nervous system** is the **most common site of extramedullary relapse** in pediatric acute lymphoblastic leukemia (ALL), accounting for the majority of extramedullary relapses. - CNS is an immunologically privileged sanctuary site where chemotherapy penetration is limited due to the blood-brain barrier. - CNS relapse presents with symptoms like headache, vomiting, cranial nerve palsies, or signs of increased intracranial pressure and requires intrathecal chemotherapy and cranial irradiation. - Prophylactic CNS therapy is a standard component of ALL treatment protocols to prevent CNS relapse. *Testes* - **Testes** are the **second most common** site of extramedullary relapse and the most common **solid organ** site in boys with ALL. - Like the CNS, testes are immunologically privileged sites with limited chemotherapy penetration. - Testicular relapse presents as painless testicular enlargement (unilateral or bilateral) and requires testicular radiation plus systemic therapy intensification. *Liver* - While **hepatic infiltration** can occur in ALL, the liver is not a common site for **isolated extramedullary relapse**. - Hepatic involvement typically indicates widespread systemic disease rather than a primary relapse site. *Lung* - **Pulmonary involvement** in ALL is rare as an isolated extramedullary relapse site. - Lung findings in ALL patients are more commonly due to infection, leukostasis in hyperleukocytosis, or disseminated disease.
Psychiatry
2 questionsFormication is primarily associated with which condition?
What is the definition of phobia?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1031: Formication is primarily associated with which condition?
- A. Acute amphetamine intoxication
- B. Alcohol withdrawal
- C. Cannabis poisoning
- D. Chronic use of amphetamine (Correct Answer)
Explanation: ***Chronic use of amphetamine*** - **Formication** (the sensation of insects crawling under the skin) is a classic symptom of **chronic amphetamine abuse**, often leading to excoriations due to scratching. - This **tactile hallucination** is part of the psychosis that can develop with prolonged high-dose amphetamine use. *Acute amphetamine intoxication* - While acute intoxication can cause psychosis and paranoia, **formication** is more strongly associated with the **chronic effects** and withdrawal of amphetamines. - Acute effects typically include euphoria, increased energy, and hypervigilance, rather than persistent tactile hallucinations. *Alcohol withdrawal* - **Alcohol withdrawal** can cause a range of symptoms including tremors, hallucinations (often visual or auditory), and seizures. - While some tactile disturbances can occur, **formication** is not a primary or characteristic symptom of alcohol withdrawal; **delirium tremens** often features visual or auditory hallucinations. *Cannabis poisoning* - **Cannabis poisoning** (or acute intoxication) typically presents with euphoria, altered perception of time, impaired coordination, and increased appetite. - It does not characteristically cause **formication** or other significant tactile hallucinations.
Question 1032: What is the definition of phobia?
- A. An intense, irrational fear that leads to avoidance (Correct Answer)
- B. Fear of specific objects or situations
- C. A type of anxiety disorder characterized by excessive fear
- D. A severe anxiety disorder characterized by irrational fear
Explanation: ***An intense, irrational fear that leads to avoidance*** - A phobia is primarily an **intense and persistent fear** reaction that is **irrational** in nature, meaning it is disproportionate to the actual danger posed by the object or situation. - This overwhelming fear invariably leads to **avoidance behavior**, where the individual actively tries to stay away from the feared stimulus. *Fear of specific objects or situations* - While phobias often involve specific objects or situations, this definition alone is insufficient as it doesn't capture the **intensity**, **irrationality**, or the **avoidance** component that are hallmarks of a true phobia. - Many people experience fear of specific things without it reaching the clinical threshold of a phobia, as long as it doesn't cause significant distress or impairment. *A type of anxiety disorder characterized by excessive fear* - This definition is broadly correct but is not the most precise or complete definition of a phobia itself. - While phobias are indeed a type of **anxiety disorder** and involve excessive fear, the key defining features of **irrationality** and **avoidance** are not explicitly stated, nor is the clear distinction from generalized anxiety. *A severe anxiety disorder characterized by irrational fear* - Similar to the previous option, this highlights the **irrational fear** and categorizes it as an **anxiety disorder**. - However, it omits the crucial element of **avoidance**, which is a defining diagnostic criterion and a hallmark behavioral response in phobias, and it also uses the broad term "severe" when the impact can vary.