Anatomy
3 questionsWhere is Schatzki's Ring present?
Through which meatus is a nasal puncture typically performed?
Which structure prevents spread of infection from middle ear to brain?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 1001: Where is Schatzki's Ring present?
- A. Upper end of trachea
- B. Lower end of esophagus (Correct Answer)
- C. Upper end of esophagus
- D. Lower end of trachea
Explanation: ***Lower end of esophagus*** - **Schatzki's Ring** is a localized narrowing that can occur at the **gastroesophageal junction**, specifically at the squamocolumnar junction. - This ring is a common cause of intermittent **dysphagia** for solid foods. [2] *Upper end of trachea* - The upper end of the trachea is the **larynx** or a region just below it, which is anatomically distinct from the esophagus. - Constrictions in this area are generally unrelated to Schatzki's Ring and typically involve conditions like **subglottic stenosis**. *Upper end of esophagus* - The upper end of the esophagus contains the **upper esophageal sphincter** (UES), which is a muscular structure. [3] - While strictures can occur here, they are not referred to as Schatzki's Ring. *Lower end of trachea* - The lower end of the trachea **bifurcates into the bronchi** and is part of the respiratory system. [1] - Anatomically, it is separate from the esophagus, and issues here would be related to respiratory conditions, not Schatzki's Ring.
Question 1002: Through which meatus is a nasal puncture typically performed?
- A. Superior meatus
- B. Middle meatus
- C. Inferior meatus (Correct Answer)
- D. Sphenoethmoidal recess
Explanation: ---Inferior meatus--- - A nasal puncture for **maxillary sinus irrigation** is typically performed through the **inferior meatus** because it provides direct access to the floor of the nasal cavity and the passage to the maxillary sinus. - The floor of the **inferior meatus** is the thinnest part of the lateral nasal wall, making it an ideal entry point for procedures into the maxillary sinus. *Superior meatus* - The **superior meatus** is associated with the drainage of the **posterior ethmoid cells** and the **sphenoid sinus**. - Puncturing here would not provide access for maxillary sinus irrigation and could risk damage to the **cribriform plate**. *Middle meatus* - The **middle meatus** is where the **maxillary**, **frontal**, and **anterior ethmoid sinuses** primarily drain. - While related to the maxillary sinus, it is not the preferred site for a puncture for irrigation, as it is more complex and less direct than the inferior meatus. *Sphenoethmoidal recess* - The **sphenoethmoidal recess** is located superior to the superior concha and is the drainage site for the **sphenoid sinus**. - This area is too high and posterior to be relevant for a puncture aimed at the **maxillary sinus**.
Question 1003: Which structure prevents spread of infection from middle ear to brain?
- A. Tegmen tympani (Correct Answer)
- B. Cribriform plate
- C. Fundus tympani
- D. Petrous apex
Explanation: ***Tegmen tympani*** - The **tegmen tympani** is a thin plate of bone forming the roof of the middle ear cavity, separating it from the **middle cranial fossa** and the brain. - Its primary function is to act as a **bony barrier**, preventing upward spread of infection from the middle ear space into the intracranial cavity. *Cribriform plate* - The **cribriform plate** is part of the ethmoid bone, located in the anterior cranial fossa, and is perforated by the **olfactory nerves**. - It does not form a boundary to the middle ear cavity and is not involved in preventing infection spread from the middle ear. *Fundus tympani* - This term is not a standard anatomical landmark. The **floor of the tympanic cavity**, or **fundus tympani**, separates the middle ear from the **internal jugular vein**. - It does not prevent the spread of infection to the brain but rather to structures below the middle ear. *Petrous apex* - The **petrous apex** is the very tip of the petrous part of the temporal bone, which houses the cochlea and vestibule. - While part of the temporal bone, it is not the direct barrier between the middle ear cavity and the brain; its involvement in infection spread is typically due to **petrous apexitis**, a distinct complication.
ENT
5 questionsAll are absolute indications of tonsillectomy except which of the following?
Early tonsillectomy is not done in?
Which objective test is most effective for examining adenoids?
Mucoperichondrial flap in septoplasty is made on?
Rosen's incision is used for which surgical procedure?
NEET-PG 2013 - ENT NEET-PG Practice Questions and MCQs
Question 1001: All are absolute indications of tonsillectomy except which of the following?
- A. Peritonsillar abscess
- B. Tonsils causing obstructive sleep apnea
- C. Chronic tonsillitis (Correct Answer)
- D. Suspicious malignancy
Explanation: ***Chronic tonsillitis*** - **Chronic tonsillitis** is a **relative indication** for tonsillectomy, not an **absolute indication**. - It becomes an indication based on frequency criteria (e.g., Paradise criteria: ≥7 episodes in 1 year, ≥5 episodes per year for 2 years, or ≥3 episodes per year for 3 years). - Absolute indications involve conditions requiring urgent surgical intervention. *Suspicious malignancy* - Suspected **malignancy** is an **absolute indication** for tonsillectomy to obtain tissue for histopathological diagnosis. - Early diagnosis and treatment of tonsillar malignancy is critical for patient outcomes. *Peritonsillar abscess* - **Peritonsillar abscess** (quinsy) is typically managed with needle aspiration or incision & drainage plus antibiotics, NOT immediate tonsillectomy. - Acute tonsillectomy during active infection ("hot tonsillectomy") is generally **contraindicated** due to increased bleeding risk and surgical complications. - **Recurrent peritonsillar abscess** may warrant **interval tonsillectomy** (4-6 weeks after resolution) as a **relative indication**, not an absolute one. *Tonsils causing obstructive sleep apnea* - **Obstructive sleep apnea (OSA)** caused by tonsillar hypertrophy is an **absolute indication** for tonsillectomy, particularly in children. - Untreated OSA can lead to serious complications including failure to thrive, cor pulmonale, developmental delays, and neurocognitive problems.
Question 1002: Early tonsillectomy is not done in?
- A. Peritonsillar abscess
- B. Thyroid storm (Correct Answer)
- C. Rheumatic fever
- D. Suspected malignancy
Explanation: ***Thyroid storm*** - **Thyroid storm** is a life-threatening medical emergency caused by exaggerated hyperthyroidism, requiring immediate medical stabilization to control hormone levels and systemic effects. - Early tonsillectomy is **contraindicated** in this scenario because it would add significant surgical stress and anesthetic risks to an already critically unstable patient. *Peritonsillar abscess* - A **quinsy tonsillectomy** (abscess tonsillectomy) is often performed acutely, especially if drainage is difficult or if it's the first episode, to resolve the abscess and remove the infected tissue. - This procedure can be done in the acute phase of a peritonsillar abscess to relieve symptoms and reduce the risk of recurrence. *Rheumatic fever* - Patients with recurrent **acute tonsillitis** who are at risk of developing **rheumatic fever** are strong candidates for tonsillectomy to prevent further streptococcal infections and subsequent autoimmune complications. - Tonsillectomy is considered a prophylactic intervention in cases of recurrent strep throat leading to rheumatic fever. *Suspected malignancy* - If tonsillar asymmetry or other signs raise suspicion of **tonsillar malignancy**, prompt tonsillectomy is often performed for **diagnostic biopsy** and initial tumor removal. - Early surgical intervention is crucial for diagnosing and staging potential tonsil cancer, which can guide subsequent treatment.
Question 1003: Which objective test is most effective for examining adenoids?
- A. Posterior rhinoscopy (Correct Answer)
- B. Anterior rhinoscopy
- C. Manual palpation
- D. None of the options
Explanation: ***Posterior rhinoscopy*** - This method allows for **direct visualization of the nasopharynx** where the adenoids are located, using a post-nasal mirror or flexible endoscope. - It provides an **objective assessment** of adenoid size, extent, and any associated obstruction by direct observation. - Among the clinical examination methods listed, this is the most effective for **visualizing adenoid tissue** and assessing hypertrophy. - In modern practice, flexible nasopharyngoscopy has largely replaced mirror examination, but posterior rhinoscopy remains the principle of direct nasopharyngeal visualization. *Anterior rhinoscopy* - This technique examines the **anterior nasal cavity**, nasal septum, and inferior turbinates. - It **cannot visualize the nasopharynx** where adenoids are located due to anatomical limitations. - Useful for anterior nasal pathology but inadequate for adenoid assessment. *Manual palpation* - This is a **subjective, not objective** method that relies on examiner's tactile sensation. - Highly uncomfortable for children, causing gagging and distress. - Carries risks of trauma, bleeding, and infection. - Does not provide measurable or reproducible data, hence not considered an objective test. - Largely abandoned in modern practice due to these limitations. *None of the options* - Incorrect because **posterior rhinoscopy is a recognized objective clinical examination** for adenoids. - It allows direct visualization which can be documented and is superior to subjective methods like palpation. - While radiological methods (lateral neck X-ray) also provide objective data, among the examination techniques listed, posterior rhinoscopy is the correct answer.
Question 1004: Mucoperichondrial flap in septoplasty is made on?
- A. Alar cartilage
- B. Septal cartilage (Correct Answer)
- C. Maxillary spine
- D. Sphenoid spine
Explanation: ***Septal cartilage*** - A mucoperichondrial flap is meticulously raised on the **septal cartilage** during septoplasty to access and correct deviations of the nasal septum. - This flap preserves the **perichondrium** and overlying mucosa, which is crucial for nutrient supply and healing of the septal cartilage. *Alar cartilage* - The alar cartilage forms the **lower lateral aspect** of the nose and is not involved in creating a mucoperichondrial flap for septal correction. - Procedures involving alar cartilage typically address **nasal tip projection** or alar rim deformities. *Maxillary spine* - The maxillary spine is a **bony prominence** at the anterior nasal floor and forms part of the underlying support for the septum. - While it can sometimes be a site of septal deviation, a mucoperichondrial flap is not primarily raised over the maxillary spine itself. *Sphenoid spine* - The sphenoid spine is a **bony projection** found on the sphenoid bone, located deep within the cranial base, posterior to the nasal cavity. - It is anatomically distant from the nasal septum and has no role in septoplasty or mucoperichondrial flap creation for septal surgical access.
Question 1005: Rosen's incision is used for which surgical procedure?
- A. Septoplasty
- B. Stapedectomy (Correct Answer)
- C. Tonsillectomy
- D. Tympanoplasty
Explanation: ***Stapedectomy*** - **Rosen's incision** is a **curved incision in the posterior ear canal** specifically used for **stapedectomy** surgery. - This incision provides excellent exposure of the **middle ear** and particularly the **stapes footplate** for otosclerosis surgery. - The incision extends from approximately **6 o'clock to 12 o'clock** position in the posterior canal, allowing the tympanomeatal flap to be elevated. *Tympanoplasty* - **Tympanoplasty** (repair of perforated tympanic membrane) can use various incisions including **permeatal**, **endaural**, or **postauricular** approaches. - While transmeatal approaches are used, they are not specifically termed "Rosen's incision," which is reserved for stapes surgery. *Septoplasty* - **Septoplasty** is a nasal procedure for correcting a deviated septum using incisions like **hemitransfixion** or **Killian's incision**. - This procedure involves the **nasal septum**, not the ear canal. *Tonsillectomy* - **Tonsillectomy** is performed entirely through an **oral approach** for removal of palatine tonsils. - No external or ear canal incisions are involved.
Psychiatry
1 questionsWhich of the following is not typically associated with Treacher Collins syndrome?
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1001: Which of the following is not typically associated with Treacher Collins syndrome?
- A. Conductive deafness
- B. Cleft palate
- C. Mandibular hypoplasia
- D. Choanal atresia (Correct Answer)
- E. Malar hypoplasia
Explanation: Choanal atresia - While Treacher Collins syndrome involves various craniofacial anomalies, **choanal atresia** (blockage of the nasal airway) is **not a typical** or defining feature. - Choanal atresia is more commonly associated with conditions like **CHARGE syndrome** or isolated congenital defects. *Conductive deafness* - **Conductive deafness** is a common feature of Treacher Collins syndrome due to malformations of the **ossicles** and external ear structures. - The abnormal development of middle ear components prevents proper sound transmission, occurring in approximately **50% of cases**. *Cleft palate* - Although less frequent than other features, a **cleft palate** can occur in some individuals with Treacher Collins syndrome, especially in more severe cases. - It results from incomplete fusion of the palatal shelves during embryonic development, occurring in approximately **28-35% of cases**. *Mandibular hypoplasia* - **Mandibular hypoplasia** (underdevelopment of the jaw) is a **hallmark characteristic** of Treacher Collins syndrome, leading to a small chin and retrognathia. - This often contributes to feeding and breathing difficulties in affected individuals. *Malar hypoplasia* - **Malar hypoplasia** (underdevelopment of the cheekbones) is a **classic and defining feature** of Treacher Collins syndrome. - This results in flattened cheeks and contributes to the characteristic facial appearance of the condition.
Radiology
1 questionsWhat is the best imaging view for assessing the nasal bone in X-ray?
NEET-PG 2013 - Radiology NEET-PG Practice Questions and MCQs
Question 1001: What is the best imaging view for assessing the nasal bone in X-ray?
- A. Lateral (Correct Answer)
- B. Towne's
- C. Submentovertical
- D. Caldwell
Explanation: ***Lateral*** - The **lateral view** provides a clear profile of the nasal bones, allowing for the best assessment of fractures, displacement, and angulation. - It visualizes the nasal bone in relation to other facial structures, which is crucial for treatment planning. *Towne's* - The **Towne's view** is primarily used to visualize the **occipital bone** and the **foramen magnum**, not the nasal bones. - It projects the petrous pyramids inferiorly, which would obstruct the view of the nasal region. *Caldwell* - The **Caldwell view** is primarily used to assess the **frontal sinuses**, **ethmoid sinuses**, and **orbits**. - While it offers some visualization of the nasal region, it does not provide the detailed lateral projection needed for optimal nasal bone assessment. *Submentovertical* - The **submentovertical view** (also known as the **basal view**) is primarily used to visualize the **base of the skull**, **sphenoid sinuses**, and **zygomatic arches**. - This view does not offer a direct or clear projection of the nasal bones themselves.