Anatomy
1 questionsA person inhaled a peanut two days ago and is now unable to cough it out. Where is the possible location?
NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs
Question 941: A person inhaled a peanut two days ago and is now unable to cough it out. Where is the possible location?
- A. Right superior lobe
- B. Right lower lobe (Correct Answer)
- C. Left lower lobe
- D. Right middle lobe
Explanation: ***Right lower lobe*** - Due to the **angle** of the right main bronchus, which is less acute than the left, aspirated foreign bodies, like a peanut, tend to preferentially enter the **right bronchial tree**. - Within the right lung, foreign bodies are most commonly found in the **right lower lobe** because its **bronchus is the most direct continuation** of the right main bronchus, especially in an upright position. *Right superior lobe* - While material can go into the right lung, the **right upper lobe bronchus** branches off at a more acute angle, making aspiration into this lobe less common than into the lower lobes when a person is in an upright or semi-recumbent position. - Aspiration into the superior lobes is more common with specific body positions or in cases of massive aspiration. *Right middle lobe* - The **right middle lobe bronchus** is smaller and branches off at an angle that is less favorable for direct aspiration compared to the right lower lobe. - Aspiration to this lobe is less frequent than to the lower lobes. *Left lower lobe* - The **left main bronchus** is narrower and branches off at a much more acute angle from the trachea compared to the right main bronchus. - This anatomical difference makes aspiration into the left lung, including the **left lower lobe**, significantly less common than into the right lung.
Pathology
1 questionsWhich of the following is the most common type of tongue cancer?
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 941: Which of the following is the most common type of tongue cancer?
- A. Lymphoma
- B. Squamous cell carcinoma (Correct Answer)
- C. Adenocarcinoma
- D. Basal cell carcinoma
Explanation: ***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.
Pediatrics
6 questionsWhat are the first-line disease-modifying treatments for Guillain-Barre Syndrome (GBS) in a child?
Opsoclonus-myoclonus is a phenomenon seen in:
Best treatment for nocturnal enuresis is
In Precocious puberty, the age limit for girls is?
A 30-week preterm neonate is admitted to NICU immediately after birth. Which of the following complications is MOST directly related to surfactant deficiency?
What is the primary reason for low glucose levels in premature infants?
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 941: What are the first-line disease-modifying treatments for Guillain-Barre Syndrome (GBS) in a child?
- A. Intravenous Immunoglobulin (IV Ig) and Plasmapheresis (Correct Answer)
- B. Intravenous Immunoglobulin (IV Ig) alone
- C. Mechanical Ventilation alone
- D. Plasmapheresis
Explanation: ***Intravenous Immunoglobulin (IV Ig) and Plasmapheresis*** - Both **IV Ig** and **plasmapheresis** are equally effective first-line disease-modifying treatments for GBS in children - **IV Ig** works by neutralizing pathogenic antibodies and modulating the immune response - **Plasmapheresis** removes circulating antibodies and inflammatory mediators from the plasma - Both treatments reduce the severity and duration of paralysis and accelerate recovery - They are equally effective with **no significant difference in outcomes**; choice depends on availability, contraindications, and patient factors *Intravenous Immunoglobulin (IV Ig) alone* - While IV Ig is indeed a first-line treatment, it is not the only one - The question asks for treatments (plural), and plasmapheresis is equally effective *Mechanical Ventilation alone* - This is a **supportive measure** for respiratory failure, not a disease-modifying treatment - About 20-30% of GBS patients require mechanical ventilation due to respiratory muscle weakness - It manages complications but does not treat the underlying immune-mediated neuropathy *Plasmapheresis alone* - While plasmapheresis is indeed a first-line treatment, it is not the only one - The question asks for treatments (plural), and IV Ig is equally effective
Question 942: Opsoclonus-myoclonus is a phenomenon seen in:
- A. Wilms' tumor
- B. Meningioma
- C. Cortical tuberculoma
- D. Neuroblastoma (Correct Answer)
Explanation: ***Neuroblastoma*** - **Opsoclonus-myoclonus syndrome (OMS)** is a rare paraneoplastic neurological disorder primarily associated with childhood neuroblastoma. - It is characterized by rapid, irregular eye movements (**opsoclonus**), brief, involuntary muscle jerks (**myoclonus**), ataxia, and irritability. *Wilm's tumor* - Wilms' tumor (nephroblastoma) is a kidney tumor of childhood and is not typically associated with opsoclonus-myoclonus syndrome. - While it is also a pediatric cancer, its paraneoplastic manifestations are different and do not include OMS. *Meningioma* - Meningiomas are typically slow-growing tumors arising from the meninges in adults, and are not associated with opsoclonus-myoclonus. - Paraneoplastic syndromes are rare with meningiomas, and OMS is not one of them. *Cortical tuberculoma* - A cortical tuberculoma is a granulomatous lesion in the brain caused by Mycobacterium tuberculosis, often seen in individuals with tuberculosis. - While it can cause neurological symptoms like seizures, headaches, and focal deficits, it does not cause opsoclonus-myoclonus syndrome.
Question 943: Best treatment for nocturnal enuresis is
- A. Positive reinforcement
- B. Punishment
- C. Bed alarm (Correct Answer)
- D. Desmopressin
Explanation: ***Bed alarm*** - **Bed alarms** are considered the most effective long-term treatment for nocturnal enuresis by conditioning the child to wake up to a full bladder. - This method has a high success rate and a lower relapse rate compared to pharmacological treatments. *Positive reinforcement* - While helpful for building confidence and encouraging adherence to treatment, **positive reinforcement** alone is generally not sufficient to cure nocturnal enuresis. - It works best as an adjunct to other established treatments, like bed alarms, to motivate the child. *Punishment* - **Punishment** is not an effective or appropriate treatment for nocturnal enuresis and can be psychologically harmful to the child. - Enuresis is an involuntary condition, and punishment can lead to increased stress, anxiety, and shame, potentially worsening the problem. *Desmopressin* - **Desmopressin** (DDAVP) is a synthetic analog of antidiuretic hormone and can reduce urine production at night, offering a short-term solution. - It is effective in reducing the frequency of wet nights but has a higher relapse rate once discontinued, and it does not cure the underlying problem like a bed alarm does.
Question 944: In Precocious puberty, the age limit for girls is?
- A. 8 years (Correct Answer)
- B. 10 years
- C. 9 years
- D. 11 years
Explanation: ***8 years*** - Precocious puberty is defined clinically by the development of secondary sexual characteristics in girls before the age of **8 years old**. - This age cut-off is based on population studies and clinical consensus to identify children needing further evaluation for underlying causes. *10 years* - This age is generally considered within the **normal range** for the onset of puberty, not precocious. - Pubertal development typically begins between ages 8 and 13 in girls. *9 years* - While close to the precocious threshold, **9 years** is still considered within the typical window for the onset of puberty. - The established clinical definition for precocious puberty in girls is explicitly _before_ the age of 8. *11 years* - This age is well within the **normal range** for pubertal onset and progression in girls. - Development of secondary sexual characteristics at this age would not be considered precocious.
Question 945: A 30-week preterm neonate is admitted to NICU immediately after birth. Which of the following complications is MOST directly related to surfactant deficiency?
- A. Increased risk of intraventricular hemorrhage
- B. Increased risk of respiratory distress syndrome (Correct Answer)
- C. Increased risk of hypothermia
- D. Increased risk of hypoglycemia
Explanation: ***Increased risk of respiratory distress syndrome*** - RDS is **most directly caused by surfactant deficiency** in preterm infants, as surfactant production begins around 24-28 weeks and becomes adequate only by 34-36 weeks of gestation. - Surfactant reduces **surface tension in alveoli**, preventing alveolar collapse during expiration. Without adequate surfactant, there is diffuse atelectasis and impaired gas exchange. - Clinical features include **tachypnea, grunting, intercostal retractions, and cyanosis** typically appearing within the first few hours of life. - Chest X-ray shows characteristic **ground-glass appearance with air bronchograms**. *Increased risk of hypothermia* - While preterm infants are indeed at risk for hypothermia due to **large surface area-to-body mass ratio, reduced brown fat, and immature thermoregulation**, this is not directly related to surfactant deficiency. - Hypothermia is primarily related to **thermal regulation mechanisms** rather than lung maturity. *Increased risk of hypoglycemia* - Preterm babies have **limited glycogen stores and immature gluconeogenesis**, increasing hypoglycemia risk. - However, this is related to **metabolic and hepatic immaturity**, not surfactant deficiency. *Increased risk of intraventricular hemorrhage* - Preterm infants are at risk for IVH due to **fragile germinal matrix capillaries and fluctuating cerebral blood flow**. - This is a **neurovascular complication**, not directly related to surfactant deficiency, though severe RDS with hypoxia can be a contributing factor.
Question 946: What is the primary reason for low glucose levels in premature infants?
- A. Decreased glycogen stores (Correct Answer)
- B. Increased brain to body ratio
- C. Decreased action of pyruvate carboxylase
- D. None of the options
Explanation: ***Decreased glycogen stores*** - Premature infants have undeveloped livers, leading to significantly **reduced glycogen reserves** at birth compared to full-term infants. - These limited stores are rapidly depleted within hours after birth, leaving the infant vulnerable to **hypoglycemia** as they cannot maintain glucose homeostasis. *Increased brain to body ratio* - While premature infants do have a relatively **larger brain-to-body ratio**, this primarily increases their glucose utilization, rather than causing low glucose directly. - The increased glucose demand is an exacerbating factor for hypoglycemia, but the fundamental issue remains the lack of available glucose to meet this demand. *Decreased action of pyruvate carboxylase* - **Pyruvate carboxylase** is an enzyme crucial for **gluconeogenesis**, the process of synthesizing glucose from non-carbohydrate precursors. - While immature hepatic enzyme systems in premature infants can contribute to impaired gluconeogenesis, the primary and most immediate reason for initial low glucose levels is the lack of stored glycogen. *None of the options* - Given that a specific and significant reason for low glucose levels in premature infants is clearly identified (decreased glycogen stores), this option is incorrect.
Pharmacology
1 questionsWhat is the correct sequence of medication administration for pre-operative prophylaxis in pheochromocytoma?
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 941: What is the correct sequence of medication administration for pre-operative prophylaxis in pheochromocytoma?
- A. Beta blockade followed by alpha blockade
- B. Simultaneous alpha and beta blockade
- C. Alpha blockade followed by beta blockade (Correct Answer)
- D. Alpha blockade only
Explanation: ***Alpha blockade followed by beta blockade*** - **Alpha blockade** should always be initiated first to control **hypertension** and prevent a **hypertensive crisis** during surgery. This is critical because pheochromocytoma causes excessive catecholamine release, leading to profound vasoconstriction. - **Beta blockade** is then added only after adequate alpha blockade has been achieved to control **tachycardia** and arrhythmias, preventing **unopposed alpha-adrenergic stimulation** which could paradoxically worsen hypertension. *Simultaneous alpha and beta blockade* - Administering both simultaneously is dangerous because **beta blockade** can mask the effects of inadequate alpha blockade. - This can lead to **unopposed alpha-adrenergic stimulation** after beta blockade, causing severe **vasoconstriction** and hypertensive crisis. *Beta blockade followed by alpha blockade* - Initiating with **beta blockade** without prior **alpha blockade** is absolutely contraindicated in pheochromocytoma. - This can lead to severe and potentially fatal **hypertension** due to **unopposed alpha-adrenergic stimulation** as beta blockade prevents vasodilation. *Alpha blockade only* - While essential for initial management, **alpha blockade alone** might not fully control all symptoms, especially **tachycardia** and **arrhythmias** caused by high circulating catecholamine levels. - Adding a **beta blocker** after achieving adequate alpha blockade helps in controlling these cardiac effects, optimizing patient preparation for surgery.
Surgery
1 questionsWhich of the following hernias has the highest risk of strangulation?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 941: Which of the following hernias has the highest risk of strangulation?
- A. Indirect
- B. Spigelian (Correct Answer)
- C. Direct
- D. Incisional
Explanation: ***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.