Biochemistry
1 questionsWhich organelle is primarily affected in Fabry's disease?
NEET-PG 2012 - Biochemistry NEET-PG Practice Questions and MCQs
Question 961: Which organelle is primarily affected in Fabry's disease?
- A. Endoplasmic Reticulum
- B. Lysosome (Correct Answer)
- C. Golgi apparatus
- D. Cell membrane
Explanation: ***Lysosome*** - Fabry's disease is a **lysosomal storage disorder** caused by a deficiency of the enzyme **alpha-galactosidase A**. - This enzyme deficiency leads to the accumulation of **globotriaosylceramide (Gb3)** within lysosomes in various cells throughout the body. *Endoplasmic Reticulum* - The **endoplasmic reticulum** is involved in protein synthesis and folding, and lipid metabolism. - While cellular stress from Gb3 accumulation can indirectly affect the ER, it is not the primary organelle involved in the storage of the accumulated substrate in Fabry's disease. *Golgi apparatus* - The **Golgi apparatus** modifies, sorts, and packages proteins and lipids. - It is not the site of primary pathology or substrate accumulation in lysosomal storage diseases. *Cell membrane* - The **cell membrane** regulates passage of substances into and out of the cell. - While lysosomal dysfunction can ultimately impact overall cell function, the cell membrane itself is not the organelle where the undigested substrate accumulates in Fabry's disease.
Internal Medicine
2 questionsWhich of the following statements is MOST accurate regarding herpes encephalitis?
What is the most characteristic cerebrospinal fluid (CSF) finding in viral meningitis?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 961: Which of the following statements is MOST accurate regarding herpes encephalitis?
- A. Focal neurological symptoms are common.
- B. EEG findings are nonspecific and not diagnostic.
- C. The temporal lobe is commonly involved. (Correct Answer)
- D. MRI is a key diagnostic tool.
Explanation: ***The temporal lobe is commonly involved.*** - **Herpes simplex encephalitis (HSE)** characteristically targets the **temporal lobes** [1] and **orbitofrontal cortex**, leading to specific neurological deficits. - This predilection for the temporal lobes often results in symptoms such as **aphasia**, **seizures**, and **memory disturbances** [1]. *Focal neurological symptoms are common.* - While focal neurological symptoms such as **aphasia**, **hemiparesis**, and **seizures** are indeed common in HSE [1], this statement is less specific than the involvement of the temporal lobe. - The **localization** of the infection to the temporal lobes explains why these focal symptoms are so prevalent [1]. *MRI is a key diagnostic tool.* - **MRI findings**, particularly **T2-weighted** and **FLAIR sequences**, showing **edema** and **hemorrhage** in the temporal lobes and insular cortex, are highly suggestive of HSE. - However, the most definitive diagnostic tool remains the detection of **HSV DNA** in the **cerebrospinal fluid (CSF)** via **PCR**. *EEG findings are nonspecific and not diagnostic.* - **EEG** in HSE often shows **periodic lateralizing epileptiform discharges (PLEDs)** or **focal slowing** primarily over the temporal lobes, which are highly suggestive, although not entirely diagnostic on their own. - These findings can help guide further investigation and support a clinical diagnosis in conjunction with other tests.
Question 962: What is the most characteristic cerebrospinal fluid (CSF) finding in viral meningitis?
- A. Lymphocytic pleocytosis in CSF (Correct Answer)
- B. WBC count typically less than 1000/mL
- C. Glucose levels normal or slightly decreased
- D. Protein levels normal or slightly increased
Explanation: ***Lymphocytic pleocytosis in CSF*** - **Lymphocytic pleocytosis**, meaning an increase in lymphocytes in the CSF, is the hallmark of **viral meningitis**, reflecting the immune response to the viral pathogen. [1] - While other CSF parameters can be altered, the presence of predominantly lymphocytes is the most reliable distinguishing feature from bacterial meningitis. [1] *WBC count typically less than 1000/mL* - This statement is generally true for viral meningitis, as the **WBC count** is usually lower than in bacterial meningitis. - However, it is not the *most characteristic* finding because bacterial meningitis can sometimes present with a WBC count under 1000/mL, especially early in the disease, and the *predominance* of lymphocytes is more specific to viral infection. *Glucose levels normal or slightly decreased* - **Normal glucose levels** are typical in viral meningitis, but they can be slightly decreased in a minority of cases. - This finding is not as characteristic as lymphocytic pleocytosis because significantly decreased glucose levels are more indicative of **bacterial or fungal meningitis**. *Protein levels normal or slightly increased* - **Protein levels** in viral meningitis are often normal or mildly elevated, usually not exceeding **100-150 mg/dL**. - While consistent with viral meningitis, this finding is less specific than lymphocytic pleocytosis, as protein levels can also be elevated in other conditions, including early bacterial meningitis.
Obstetrics and Gynecology
1 questionsWhat is the definitive management for adenomyosis?
NEET-PG 2012 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 961: What is the definitive management for adenomyosis?
- A. Endometrial ablation.
- B. Hysterectomy (surgical removal of the uterus). (Correct Answer)
- C. Hormonal therapy (e.g., Danazol) for temporary symptom relief.
- D. Hormonal therapy (e.g., GnRH analogue) for temporary symptom relief.
Explanation: ***Hysterectomy (surgical removal of the uterus)*** - This is considered the **definitive management** for adenomyosis because it completely removes the uterine tissue where the ectopic endometrial glands are found. - Hysterectomy effectively eliminates the source of symptoms such as **heavy menstrual bleeding** and **pelvic pain** by removing the uterus entirely. *Endometrial ablation* - Endometrial ablation involves destroying the **lining of the uterus** and is primarily used for heavy menstrual bleeding. - It is **ineffective for adenomyosis** since the endometrial tissue is embedded deep within the myometrium and is not fully reached by ablation. *Hormonal therapy (e.g., Danazol) for temporary symptom relief* - **Danazol** (an androgen derivative) can suppress ovarian function and reduce symptoms of adenomyosis by shrinking endometrial tissue. - However, its effects are **temporary**, and symptoms typically return upon cessation of treatment, making it not a definitive solution. *Hormonal therapy (e.g., GNRH analogue) for temporary symptom relief* - **GnRH analogues** induce a temporary menopausal state, which can significantly reduce symptoms by inhibiting estrogen production, leading to atrophy of the adenomyotic tissue. - This treatment is also **temporary**, and symptoms often recur once the medication is stopped; it's often used as a bridge to surgery or for women nearing menopause.
Orthopaedics
2 questionsWhich of the following is NOT a symptom of carpal tunnel syndrome?
Commonest ligament injured in ankle injury ?
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 961: Which of the following is NOT a symptom of carpal tunnel syndrome?
- A. Phalen's sign
- B. Pain & paraesthesia of wrist
- C. Tinel sign
- D. Ulnar nerve dysfunction (Correct Answer)
Explanation: ***Ulnar nerve dysfunction*** - Carpal tunnel syndrome specifically involves compression of the **median nerve**, not the ulnar nerve. - Symptoms related to the median nerve include numbness and tingling in the **thumb, index, middle, and radial half of the ring finger**, along with **thenar muscle wasting**. *Tinel sign* - The **Tinel sign** is a common physical examination finding in carpal tunnel syndrome, elicited by tapping over the **median nerve** at the wrist. - A positive sign involves tingling or electric shock-like sensations in the **median nerve distribution**. *Phalen's sign* - **Phalen's sign** is another classic physical maneuver used to diagnose carpal tunnel syndrome, where exaggerated wrist flexion for 60 seconds reproduces symptoms. - This maneuver increases pressure within the **carpal tunnel**, exacerbating median nerve compression. *Pain & paraesthesia of wrist* - **Pain and paraesthesia (numbness and tingling)** in the wrist and hand are hallmark symptoms of carpal tunnel syndrome. - These symptoms are often worse at night or with repetitive hand movements, reflecting **median nerve irritation**.
Question 962: Commonest ligament injured in ankle injury ?
- A. Anterior talofibular ligament (Correct Answer)
- B. Calcaneofibular ligament
- C. Posterior talofibular ligament
- D. Spring ligament
Explanation: ***Anterior talofibular ligament*** - The **anterior talofibular ligament (ATFL)** is the **most frequently injured ligament** in ankle sprains because it is the weakest and most commonly stretched during **inversion injuries**. - Its position makes it vulnerable during movements where the foot rolls inward, a common mechanism for ankle sprains. *Calcaneofibular ligament* - The **calcaneofibular ligament (CFL)** is stronger than the ATFL and is typically injured with more severe inversion forces, often in conjunction with ATFL rupture. - While it plays a crucial role in ankle stability, it is not the *most* commonly injured ligament. *Posterior talofibular ligament* - The **posterior talofibular ligament (PTFL)** is the strongest of the lateral ankle ligaments and is rarely injured in isolated ankle sprains. - Its injury usually signifies a **severe ankle sprain** with significant talar displacement or dislocation. *Spring ligament* - The **spring ligament**, also known as the **plantar calcaneonavicular ligament**, is located on the medial side of the foot and supports the medial longitudinal arch. - It is not directly involved in typical ankle sprains, which primarily affect the lateral collateral ligaments.
Pathology
1 questionsThe immunoglobulin most commonly involved in Multiple Myeloma is:
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 961: The immunoglobulin most commonly involved in Multiple Myeloma is:
- A. IgG (Correct Answer)
- B. IgM
- C. IgA
- D. IgD
Explanation: ***IgG*** - In Multiple Myeloma, the most commonly involved immunoglobulin is **IgG**, which is often produced in excess by malignant plasma cells [1][2]. - The presence of **monoclonal IgG** in serum is a key indicator of this malignancy, evident in diagnostic tests like serum protein electrophoresis. *IgM* - While **elevated IgM** levels can occur in other conditions like Waldenström's macroglobulinemia, it is not typically associated with Multiple Myeloma [2]. - IgM is produced by a different type of plasma cell and does not reflect the classic presentation of Multiple Myeloma. *IgA* - Although **IgA** can be involved in some cases of Multiple Myeloma, it is much less common than IgG [1][2]. - Patients with predominately **IgA Multiple Myeloma** are relatively rare compared to those with IgG. *IgD* - **IgD** myeloma is a very rare type of Multiple Myeloma, accounting for less than 2% of cases [1][2]. - It is not typically associated with the classic symptoms and conditions that characterize the more common IgG or IgA forms. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 608-609. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 616-617.
Pediatrics
2 questionsWhich of the following cancers has the highest cure rate?
What is the most common cause of conjugated hyperbilirubinemia in infants?
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 961: Which of the following cancers has the highest cure rate?
- A. Wilm's Tumor
- B. Retinoblastoma (Correct Answer)
- C. Rhabdomyosarcoma
- D. All of the options
Explanation: ***Retinoblastoma*** - This **childhood eye cancer** has an excellent prognosis, with a reported cure rate of **over 95%** when diagnosed early and treated promptly. - Treatment options like **chemotherapy**, **radiation**, **laser therapy**, and **enucleation** contribute to its high survival rate. *Wilm's Tumor* - While **Wilm's tumor** (nephroblastoma) also has a high cure rate in children, typically **around 90%**, it is slightly lower than that of retinoblastoma. - It is a **kidney cancer** primarily affecting children and is highly responsive to treatment. *Rhabdomyosarcoma* - The cure rate for **rhabdomyosarcoma**, a rare and aggressive cancer of the soft tissues, varies significantly based on factors like **tumor location**, **stage**, and **histology**. - Overall survival rates are generally lower than for retinoblastoma and Wilm's tumor, often ranging from **60-70%**. *All of the options* - This option is incorrect because while all three cancers listed have good prognoses, **retinoblastoma** specifically stands out with the highest cure rate among them. - The cure rates for Wilm's tumor and rhabdomyosarcoma, while good, are not as high as that for retinoblastoma.
Question 962: What is the most common cause of conjugated hyperbilirubinemia in infants?
- A. Rotor syndrome
- B. Crigler Najjar syndrome
- C. Dubin-Johnson syndrome
- D. Biliary atresia (Correct Answer)
Explanation: ***Rotor syndrome*** - Characterized by **conjugated hyperbilirubinemia** due to a defect in hepatic uptake and storage of bilirubin [1]. - This condition can lead to elevated levels of **direct (conjugated) bilirubin** without significant liver damage. *Crigler Najjar* - This condition primarily causes **unconjugated hyperbilirubinemia** due to a deficiency of the enzyme **uridine diphosphate glucuronyl transferase** [1]. - It typically presents with **kernicterus** in newborns rather than conjugated bilirubin elevation. *Breast milk jaundice* - Mainly leads to **unconjugated hyperbilirubinemia** due to substances in breast milk that inhibit bilirubin conjugation. - Generally occurs in **breastfed infants** after the first week of life, not presenting with increased conjugated bilirubin. *Gilbert syndrome* - This syndrome is associated with **unconjugated hyperbilirubinemia** due to a genetic defect in bilirubin conjugation [1]. - Typically benign, it does not cause **increased conjugated bilirubin** levels as seen in Rotor syndrome. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 860.
Pharmacology
1 questionsWhich of the following substances is known to cause predominantly sensory neuropathy?
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 961: Which of the following substances is known to cause predominantly sensory neuropathy?
- A. Pyridoxine excess
- B. Suramin
- C. Cisplatin (Correct Answer)
- D. Vincristine
Explanation: ***Cisplatin*** - **Cisplatin** is a platinum-based chemotherapy drug well-known for causing **dose-dependent peripheral neuropathy**, primarily affecting sensory neurons. - Patients often present with **numbness**, **tingling**, and **loss of proprioception** in a glove-and-stocking distribution. - This is the **most characteristic** drug for **predominantly sensory neuropathy** among chemotherapeutic agents. *Pyridoxine excess* - While **pyridoxine (vitamin B6) excess** can cause sensory neuropathy, it is less commonly observed as a primary cause compared to cisplatin in the context of drug-induced neuropathies. - High doses of pyridoxine can lead to **dorsal root ganglionopathy**, affecting sensory nerve fibers. *Suramin* - **Suramin** is an anthelmintic agent primarily used for treating sleeping sickness, and it is known to cause a variety of side effects, including **renal toxicity** and **neurological symptoms**. - While neurological side effects can occur, they are not typically characterized as a **predominantly sensory neuropathy** in the same way as cisplatin. *Vincristine* - **Vincristine** is a vinca alkaloid chemotherapy agent that causes peripheral neuropathy. - However, vincristine typically causes **mixed motor and sensory neuropathy** with prominent motor involvement (foot drop, wrist drop). - This differs from cisplatin's **predominantly sensory** presentation.