Anatomy
1 questionsIn the case of a penile injury, which of the following structures prevents the extravasation of blood?
NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs
Question 861: In the case of a penile injury, which of the following structures prevents the extravasation of blood?
- A. Fascia of camper
- B. Fascia transversalis
- C. Buck's fascia (Correct Answer)
- D. None of the options
Explanation: ***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.
Pathology
1 questionsWhich of the following translocations is not associated with Down syndrome?
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 861: Which of the following translocations is not associated with Down syndrome?
- A. t(21;21)
- B. t(14;21)
- C. t(15;21)
- D. t(11;14) (Correct Answer)
Explanation: ***t (11: 14)*** - The **t(11;14) translocation** is commonly associated with **mantle cell lymphoma**, a B-cell non-Hodgkin lymphoma, and is not a cause of Down syndrome. - This translocation leads to the overexpression of the **cyclin D1 gene**, located on chromosome 11, which promotes cell growth and proliferation. *t (14; 21)* - This is a common **Robertsonian translocation** involving chromosomes 14 and 21, which results in an extra copy of chromosome 21 material [1]. - Individuals with this translocation can have **Down syndrome** because their cells end up with the equivalent of three copies of chromosome 21 [1]. *t (21; 21)* - This translocation is another type of **Robertsonian translocation** where two chromosome 21s fuse. - This specific translocation is rare and results in an extra copy of chromosome 21, leading to **Down syndrome** with a high recurrence risk in offspring. *t (15: 21)* - This is a **Robertsonian translocation** involving chromosomes 15 and 21, resulting in an extra copy of chromosome 21 material. - This translocation is a known cause of **Down syndrome** due to the dosage imbalance of genes on chromosome 21 [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 169-172.
Pediatrics
3 questionsAn XX baby presenting with male genitalia (penis and scrotum) is likely due to which of the following conditions?
What is the recommended CPR ratio for infants when performed by 2 rescuers?
Which of the following is a common symptom of neonatal lupus?
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 861: An XX baby presenting with male genitalia (penis and scrotum) is likely due to which of the following conditions?
- A. Turner syndrome
- B. None of the options
- C. Klinefelter syndrome
- D. High level of testosterone in maternal blood (Correct Answer)
Explanation: ***High level of testosterone in maternal blood*** - An **XX baby** (genetically female) presenting with **fully masculinized external genitalia** (penis and scrotum) indicates significant **androgen exposure** during the critical period of sexual differentiation (8-12 weeks of gestation). - While the most common cause is **congenital adrenal hyperplasia (CAH)** due to fetal androgen excess, **maternal sources of androgens** can also cause complete masculinization. - Maternal causes include **virilizing tumors** (e.g., luteoma of pregnancy, Krukenberg tumor, arrhenoblastoma), **exogenous androgen administration**, or **maternal CAH**. - High sustained maternal testosterone crosses the placenta and causes **virilization of female fetus**, which can range from clitoromegaly to complete male phenotype. - This is the **only medically correct option** among the choices given, though CAH (not listed) would be the most common cause overall. *Klinefelter syndrome* - **47, XXY karyotype** - genetically male due to presence of Y chromosome with SRY gene. - Presents as phenotypic male, not relevant to an **XX individual**. - Features include hypogonadism, infertility, tall stature, and gynecomastia. *Turner syndrome* - **45, X karyotype** - monosomy X, genetically and phenotypically female. - Presents with **female external genitalia**, streak gonads, short stature, webbed neck. - Cannot explain masculinized genitalia in any scenario. *None of the options* - This is incorrect because **high level of testosterone in maternal blood** is a documented cause of XX virilization with male phenotype, though less common than fetal CAH.
Question 862: What is the recommended CPR ratio for infants when performed by 2 rescuers?
- A. 15 : 2 (Correct Answer)
- B. 30 : 2
- C. 1 : 3
- D. 1 : 5
Explanation: ***15 : 2*** - For **infants and children**, when there are **two or more rescuers**, the recommended compression-to-ventilation ratio is **15 compressions to 2 breaths**. - This ratio provides a better balance between compressions and ventilations to optimize outcomes in pediatric cardiac arrest. *30 : 2* - The **30:2 ratio** is primarily recommended for **adult CPR**, or for **single rescuers** performing CPR on infants and children. - Using this ratio for two-rescuer infant CPR would likely lead to inadequate ventilation and potentially worse outcomes. *1 : 3* - A 1:3 ratio (1 compression to 3 breaths) is not a standard recommended ratio for CPR in any age group based on current guidelines. - This ratio would significantly prioritize ventilations over chest compressions, which is not ideal for maintaining circulation. *1 : 5* - A 1:5 ratio (1 compression to 5 breaths) is not a standard recommended ratio for CPR in any age group. - This ratio heavily emphasizes ventilations and would result in insufficient chest compressions, which are crucial for blood flow.
Question 863: Which of the following is a common symptom of neonatal lupus?
- A. All of the options
- B. Cutaneous lesion (Correct Answer)
- C. Thrombocytopenia
- D. Heart block
Explanation: ***Cutaneous lesion*** - **Cutaneous lesions** are the most common manifestation of neonatal lupus, typically appearing as an **annular erythematous rash** on the face and scalp. - These lesions often develop after exposure to **ultraviolet light** and usually resolve within 6 months as maternal autoantibodies clear from the infant's system. *Thrombocytopenia* - While **hematologic abnormalities** such as thrombocytopenia can occur in neonatal lupus, they are less common than cutaneous lesions. - **Thrombocytopenia** refers to a low platelet count, which can increase the risk of bleeding. *All of the options* - While all listed options (cutaneous lesions, thrombocytopenia, and heart block) can be features of neonatal lupus, **cutaneous lesions** are the most frequently observed symptom. - Choosing "All of the options" would imply equal commonality or presence of all in every case, which is not accurate. *Heart block* - **Congenital heart block** is a serious, but less common and often irreversible, manifestation of neonatal lupus, caused by maternal antibodies attacking the fetal cardiac conduction system. - It usually presents as **bradycardia** and may require a pacemaker, but it is not the most common symptom overall.
Radiology
1 questionsWhich of the following statements about hepatic adenoma is true?
NEET-PG 2012 - Radiology NEET-PG Practice Questions and MCQs
Question 861: Which of the following statements about hepatic adenoma is true?
- A. Associated with OCP use
- B. Common in young females (Correct Answer)
- C. Cold on isotope scan
- D. Typically malignant tumor
Explanation: ***Older females*** - Hepatic adenomas are primarily seen in **younger females** of childbearing age, often linked to **oral contraceptive pill (OCP)** usage [1]. - This statement is **incorrect** as hepatic adenomas are not typically associated with older females. *OCP use* - Hepatic adenomas are **strongly associated** with the **use of oral contraceptive pills**, especially in young women [1]. - They may regress or resolve after discontinuation of OCPs, indicating a clear relationship [1]. *Cold on isotope scan* - Hepatic adenomas generally appear as **hot lesions** on imaging, meaning they take up more radioisotope than surrounding liver tissue. - A "cold" appearance would be atypical and may suggest malignancy or other liver lesions. *Benign lesion* - Hepatic adenomas are classified as **benign tumors** [2][3], although they have risks of complications like **hemorrhage** or malignant transformation [3]. - Even though they are benign, they require careful monitoring depending on size and symptoms. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 874. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 398-399. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, pp. 874-875.
Surgery
4 questionsWhich muscle flap is commonly used for autologous breast reconstruction after mastectomy?
Which condition is commonly associated with complications arising from phimosis?
In the initial management of a hemodynamically unstable polytrauma patient, what is the recommended initial crystalloid bolus dose of Ringer's lactate for assessment and stabilization?
Most common congenital diaphragmatic hernia is:
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 861: Which muscle flap is commonly used for autologous breast reconstruction after mastectomy?
- A. Deltopectoral
- B. Serratus anterior
- C. Trapezius
- D. Latissimus dorsi (Correct Answer)
Explanation: ***Latissimus dorsi*** - The **latissimus dorsi** muscle is commonly used in **autologous breast reconstruction** due to its rich blood supply and ample tissue volume which can be transferred as a **pedicled flap** to the chest. - This flap includes muscle, skin, and subcutaneous fat, providing a good aesthetic outcome for **breast mound reconstruction** after mastectomy. *Deltopectoral* - The **deltopectoral flap** is primarily used for **head and neck reconstruction**, specifically for oral cavity and pharyngeal defects. - It involves muscle and skin from the **chest and shoulder region**, but its size and location make it less suitable for comprehensive breast reconstruction. *Serratus anterior* - The **serratus anterior** muscle is occasionally used as a **free flap** for small soft tissue defects, but it is not typically the first choice for large-volume breast reconstruction. - Its primary role is in **shoulder movement** and it does not provide sufficient tissue bulk for a complete breast mound. *Trapezius* - The **trapezius flap** is more commonly employed in **head and neck reconstruction** or for covering defects in the posterior shoulder region. - While it offers a good blood supply, its bulk and orientation are not ideal for **breast reconstruction**, which requires a more anterior and hemispheric shape.
Question 862: Which condition is commonly associated with complications arising from phimosis?
- A. Inability to retract the foreskin
- B. Inflammation of the glans and foreskin (Correct Answer)
- C. Urethral opening on the underside of the penis
- D. Narrowing of the urethral opening
Explanation: ***Inflammation of the glans and foreskin*** - **Phimosis** (the inability to retract the foreskin) can lead to poor hygiene under the foreskin, creating an environment for bacterial or fungal growth. - This often results in **balanitis** (inflammation of the glans) or **balanoposthitis** (inflammation of both the glans and foreskin) due to retained secretions and microorganisms. *Inability to retract the foreskin* - This is the **definition** of phimosis, not a complication arising from it. - While it is the primary characteristic, it directly describes the condition itself rather than a subsequent problem. *Urethral opening on the underside of the penis* - This condition is known as **hypospadias**, a congenital anomaly of the urethra. - Hypospadias is a developmental issue and is unrelated to phimosis or its complications. *Narrowing of the urethral opening* - This condition is called **meatal stenosis** and refers to the narrowing of the external opening of the urethra. - While it can cause urinary symptoms, it is a distinct condition and not a direct complication of phimosis, although severe phimosis might indirectly impact urinary hygiene.
Question 863: In the initial management of a hemodynamically unstable polytrauma patient, what is the recommended initial crystalloid bolus dose of Ringer's lactate for assessment and stabilization?
- A. 2000 ml Ringer's lactate bolus
- B. 1000 ml Ringer's lactate bolus, then regulated by clinical indicators (Correct Answer)
- C. 250 ml Ringer's lactate bolus
- D. 500 ml Ringer's lactate bolus, then regulated by clinical indicators
Explanation: ***1000 ml Ringer's lactate bolus, then regulated by clinical indicators*** - For **hemodynamically unstable** polytrauma patients, the initial recommended crystalloid bolus is typically **1 liter (1000 mL)** of Ringer's lactate. - This initial bolus allows for rapid assessment of the patient's response and guides subsequent fluid management based on **clinical indicators** such as blood pressure, heart rate, and urine output, avoiding over-resuscitation. *2000 ml Ringer's lactate bolus* - A **2000 ml bolus** is generally considered too large for an initial dose in trauma, as it can lead to **dilutional coagulopathy**, worsening hemorrhage, and **abnormal fluid shifts**, especially in cases where definitive hemorrhage control is not yet achieved. - Excessive fluid administration can lead to complications such as **abdominal compartment syndrome** and **acute respiratory distress syndrome (ARDS)**. *250 ml Ringer's lactate bolus* - A **250 ml bolus** is generally too small to effectively address **hemodynamic instability** in a polytrauma patient, offering insufficient volume to significantly improve circulation or organ perfusion. - While small boluses might be used in specific situations (e.g., small children or patients with cardiac comorbidities), this dose is not adequate for initial resuscitation in a severely unstable adult trauma patient. *500 ml Ringer's lactate bolus, then regulated by clinical indicators* - While **500 mL** is a common bolus size in other medical settings, it may be insufficient for the initial resuscitation of a **hemodynamically unstable adult polytrauma patient**. - Current trauma guidelines often recommend a larger initial bolus (e.g., 1000 mL) to gain a more immediate and measurable hemodynamic response for assessment.
Question 864: Most common congenital diaphragmatic hernia is:
- A. Bochdalek hernia (Correct Answer)
- B. Morgagni hernia
- C. None of the options
- D. Paraesophageal hernia
Explanation: ***Bochdalek hernia*** - This is the most common type of **congenital diaphragmatic hernia (CDH)**, accounting for approximately **95% of all CDH cases**. - It occurs due to a defect in the **posterolateral diaphragm** (pleuroperitoneal membrane), typically on the **left side**. - Presents in neonates with respiratory distress due to herniation of abdominal contents into the thorax. *Morgagni hernia* - This is a rare type of **congenital diaphragmatic hernia**, occurring through the **anterior retrosternal diaphragm** (foramen of Morgagni). - Accounts for only **2-5% of all CDH cases**, usually on the right side. - Often asymptomatic and diagnosed incidentally in adults. *Paraesophageal hernia* - This is an **acquired hiatal hernia** where part of the stomach herniates alongside the esophagus through the esophageal hiatus. - While **hiatal hernias are the most common diaphragmatic hernias overall**, they are **not congenital** and therefore not the answer to this question. - Seen commonly in older adults. *None of the options* - Incorrect, as **Bochdalek hernia** is definitively the most common congenital diaphragmatic hernia.