NEET-PG 2012 Practice Questions

Q: The commonest site of aspiration of a foreign body in the supine position is into the:

Right lower lobe superior segment. ***Right lower lobe superior segment*** - When an individual is in the **supine position**, the most dependent portion of the lung (where gravity would pull aspirated material) is the **superior segment of the right lower lobe**. - This anatomical orientation, combined with the **wider and more vertical right main bronchus**, increases the likelihood of aspirated foreign bodies entering and settling in this specific segment. - The superior segment of the right lower lobe is **posteriorly located** and becomes the most dependent when lying supine. *Right upper lobe apical* - While the right upper lobe is on the favored side for aspiration due to the anatomy of the main bronchi, the **apical segment** is not the most dependent in the supine position. - Aspiration into the apical segment is generally less common than into more dependent segments when lying flat. *Left basal* - The **left main bronchus** is narrower and takes a more acute angle compared to the right, making aspiration into the left lung less common. - Even if aspiration were to occur in the left lung, the **basal segments** are not the most dependent in the supine position. *Right middle lobe medial segment* - The medial segment of the middle lobe is **not as posteriorly positioned** as the superior segment of the right lower lobe in the supine position. - While aspiration can occur into the middle lobe, it is **less common** than into the superior segment of the right lower lobe when supine due to the anatomical positioning and gravity effects.

Q: In the case of a penile injury, which of the following structures prevents the extravasation of blood?

Buck's fascia. ***Buck's fascia*** - **Buck's fascia** is a strong, fibrous sheath that surrounds the **corpora cavernosa** and **corpus spongiosum**, acting as a confining layer. - In cases of **penile injury**, such as a penile fracture, rupture of the tunica albuginea leads to bleeding [1]. Buck's fascia contains this extravasated blood, preventing its spread beyond the penis and resulting in a characteristic **"eggplant" deformity** [1]. *Fascia of Camper* - The **fascia of Camper** is the superficial fatty layer of the anterior abdominal wall's superficial fascia. - It is continuous with the superficial perineal fascia but does not directly cover the erectile tissues of the penis. *Fascia transversalis* - The **fascia transversalis** is a deep fascia lining the inner aspect of the anterior abdominal wall, beneath the transversus abdominis muscle. - It plays a role in forming the posterior wall of the inguinal canal and is not directly involved in containing blood within the penis after an injury. *None of the options* - This option is incorrect because Buck's fascia specifically fulfills the function described, isolating blood within the penile shaft.

Q: Which of the following is NOT a feature of atopic dermatitis?

Darier’s Sign. ***Darier's Sign*** - **Darier's sign** is characteristic of **urticaria pigmentosa** (cutaneous mastocytosis), where rubbing a skin lesion causes the formation of an urticarial wheal due to mast cell degranulation - It is **not associated** with the pathogenesis or clinical presentation of **atopic dermatitis** *Dennie-Morgan fold* - **Dennie-Morgan folds** are extra folds or lines in the skin just below the lower eyelids - They are a common clinical sign observed in patients with **atopic dermatitis**, often linked to chronic inflammation and allergic reactions affecting the skin around the eyes *Hertoghe's sign* - **Hertoghe's sign** refers to the thinning or absence of the lateral third of the eyebrows - This sign is often seen in individuals with **atopic dermatitis**, as well as in other conditions like hypothyroidism *Hyperlinearity of palms* - **Hyperlinearity of palms** refers to the exaggerated creases and lines on the palms of the hands - This is a common **stigmata of atopy** and is frequently observed in patients with **atopic dermatitis**, reflecting the underlying predisposition to skin dryness and altered epidermal barrier function

Q: What is the investigation of choice in postmenopausal bleeding?

Ultrasound. ***Ultrasound*** - An initial **transvaginal ultrasound** is the investigation of choice to assess the endometrial thickness in postmenopausal bleeding. An endometrial thickness of >4-5mm often warrants further investigation. - It helps in **ruling out endometrial pathologies** like hyperplasia, polyps, or carcinoma. *PAP smear* - A **PAP smear** is a screening test for cervical cancer, not typically used to investigate postmenopausal bleeding originating from the uterus. - While it can detect some endometrial cells, it is **not sensitive** or specific enough to diagnose the cause of postmenopausal bleeding. *Laparoscopy* - **Laparoscopy** is a surgical procedure used to visualize pelvic organs and is generally employed for diagnosing and treating conditions like endometriosis, ovarian cysts, or ectopic pregnancies. - It is **not the initial investigation** for postmenopausal bleeding and is too invasive for primary diagnosis unless other methods have failed or a specific pathology is suspected. *Fractional curettage* - **Fractional curettage** involves scraping the lining of the cervix and uterus to obtain tissue samples for histological examination. - While it can be diagnostic for endometrial pathology, it is typically performed **after an initial ultrasound** has identified increased endometrial thickness or other suspicious findings, and less commonly as a standalone initial investigation.

Q: Which of the following is a recognized method for the delivery of the after-coming head of a breech?

Mauriceau-Smellie-Veit maneuver. ***Mauriceau-Smellie-Veit maneuver*** - The **Mauriceau-Smellie-Veit maneuver** is the **gold standard** and most widely recognized method for delivering the after-coming head in breech delivery. - The technique involves the accoucheur placing the **index and middle fingers over the maxilla** (malar eminence) to flex the fetal head, while the fetal body rests on the forearm. - An assistant applies **suprapubic pressure** to maintain flexion of the fetal head. - This method provides excellent **control of the fetal head** and maintains proper flexion to prevent extension and facilitate safe delivery. *Burns and Marshall method* - The **Burns-Marshall method** is also a recognized technique for assisted breech delivery, but it is typically used when the body delivers spontaneously. - This method involves holding the fetal feet and allowing the baby to hang by its own weight, promoting flexion, then sweeping the baby upward over the maternal abdomen. - While valid, it is generally considered an **alternative** to the Mauriceau-Smellie-Veit maneuver rather than the primary method. *Forceps method* - **Piper forceps** are specifically designed for the after-coming head and are a recognized method, particularly when manual methods fail or in cases of **fetal distress**. - However, forceps application requires specific expertise and may not be the first-line approach in all settings. - When used appropriately, forceps provide controlled delivery and protect the fetal head. *Malar flexion and shoulder traction* - This is **not a recognized standard method** as described. - While malar pressure is used in the Mauriceau-Smellie-Veit maneuver, **shoulder traction** is dangerous and can cause **brachial plexus injury**, **Erb's palsy**, or **spinal cord damage**. - Traction should never be applied to the shoulders during breech delivery.

Q: Nuchal translucency is used in

ANC USG. ***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.

Q: Which of the following is the most common type of tongue cancer?

Squamous cell carcinoma. ***Adenocarcinoma most common*** - The most common type of tongue cancer is **squamous cell carcinoma (SCC)**, not adenocarcinoma [1]. - Adenocarcinomas are less frequently associated with the tongue compared to SCC, which constitutes the majority of cases. *Tobacco is the cause* - Tobacco use is indeed a **significant risk factor** for various head and neck cancers, including tongue cancer [1]. - Smoking and smokeless tobacco are linked to increased incidence and severity of **squamous cell carcinoma** on the tongue [1]. *Deep cervical lymph nodes not involved* - Tongue cancers often metastasize to **deep cervical lymph nodes**, particularly in advanced stages. - Involvement of lymph nodes is a common feature that can affect prognosis and treatment strategies. *Lateral surface involved* - The **lateral surface** of the tongue is a common site for cancerous lesions, especially in cases related to tobacco use. - Tumors might also arise from other surfaces, but lateral involvement is characteristic of **squamous cell carcinoma**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 738-739.

Q: What is the recommended rate for blood transfusion in neonates?

1-5 ml/min. ***1-5 ml/min*** - The recommended rate for blood transfusion in neonates is **1-5 ml/min** to prevent **circulatory overload** and other complications. - Slower rates are crucial for neonates due to their limited cardiovascular reserves and smaller blood volume. *5-10 ml/min* - This rate is generally **too fast** for routine neonatal blood transfusions, increasing the risk of **fluid overload** and **cardiac strain**. - Rapid administration can lead to complications such as **necrotizing enterocolitis (NEC)** or **respiratory distress**. *10-15 ml/min* - Administering blood at this rate in neonates is **contraindicated** due to the high risk of **cardiovascular compromise**. - It could quickly overwhelm the neonate's circulatory system, leading to severe adverse events. *15-20 ml/min* - This rate is significantly **too rapid** for any neonatal blood transfusion and would almost certainly result in **severe volume overload** and potential cardiac arrest. - Such high rates are only rarely considered in extreme emergency situations, like massive hemorrhage with specific considerations and monitoring.

Q: Which of the following hernias has the highest risk of strangulation?

Spigelian. ***Spigelian*** - **Spigelian hernias** occur through a defect in the **Spigelian aponeurosis** (between the semilunar line and lateral border of rectus abdominis), typically inferior to the arcuate line. - They have a **high risk of strangulation (20-25%)** due to their **narrow fascial defect** and tendency to become incarcerated through the layers of the abdominal wall. - The hernia often becomes **interparietal** (between muscle layers), making it difficult to detect clinically, which increases the risk of delayed presentation and strangulation. *Indirect* - **Indirect inguinal hernias** pass through the **deep inguinal ring** and follow the inguinal canal, potentially entering the scrotum. - While they do have a narrow neck that can cause strangulation, their **strangulation risk is moderate (~10-15%)**, lower than Spigelian hernias. - They are the most common type of hernia but not the highest risk for strangulation among these options. *Direct* - **Direct inguinal hernias** protrude through **Hesselbach's triangle** in the posterior wall of the inguinal canal. - They have a **broad-based neck**, making strangulation relatively uncommon (~5%). - The wider defect allows easier reduction and less constriction of contents. *Incisional* - **Incisional hernias** develop at previous surgical incision sites due to fascial weakness or inadequate healing. - While they can incarcerate, they typically have a **wider neck** and **lower strangulation risk** compared to Spigelian or indirect inguinal hernias. - Risk varies with defect size, but generally not the highest among common hernia types.

Question 1

The commonest site of aspiration of a foreign body in the supine position is into the:

Accepted Answer

Right lower lobe superior segment

Answer

Right upper lobe apical

Answer

Left basal

Answer

Right middle lobe medial segment

Question 2

In the case of a penile injury, which of the following structures prevents the extravasation of blood?

Accepted Answer

Buck's fascia

Answer

Fascia of camper

Answer

Fascia transversalis

Answer

None of the options

Question 3

Which of the following is NOT a feature of atopic dermatitis?

Accepted Answer

Darier’s Sign

Answer

Dennie-Morgan fold

Answer

Hyperlinearity of palms

Answer

Hertoghe’s sign

Question 4

What is the investigation of choice in postmenopausal bleeding?

Accepted Answer

Ultrasound

Answer

PAP smear

Answer

Laparoscopy

Answer

Fractional curettage

Question 5

Which of the following is a recognized method for the delivery of the after-coming head of a breech?

Accepted Answer

Mauriceau-Smellie-Veit maneuver

Answer

Burns and Marshall method

Answer

Malar flexion and shoulder traction

Answer

Forceps method

Question 6

Nuchal translucency is used in

Accepted Answer

ANC USG

Answer

Head scan

Answer

MRI neck

Answer

Anthropometry

Question 7

Which of the following is the most common type of tongue cancer?

Accepted Answer

Squamous cell carcinoma

Answer

Lymphoma

Answer

Adenocarcinoma

Answer

Basal cell carcinoma

Question 8

What is the recommended rate for blood transfusion in neonates?

Accepted Answer

1-5 ml/min

Answer

10-15 ml/min

Answer

15-20 ml/min

Answer

5-10 ml/min

Question 9

What is the best skin disinfectant for central line insertion?

Accepted Answer

Chlorhexidine

Answer

Alcohol

Answer

Cetrimide

Answer

Povidone iodine

Question 10

Which of the following hernias has the highest risk of strangulation?

Accepted Answer

Spigelian

Answer

Indirect

Answer

Direct

Answer

Incisional

NEET-PG 2012

Anatomy

Dermatology

Obstetrics and Gynecology

Pathology

Pediatrics

Pharmacology

Surgery