Dermatology
4 questionsWhat is the most common trigger associated with erythema multiforme?
The Grattage test is used to diagnose which of the following conditions?
Lines of Blaschko are related to?
Acantholysis is not seen in:
NEET-PG 2013 - Dermatology NEET-PG Practice Questions and MCQs
Question 1381: What is the most common trigger associated with erythema multiforme?
- A. Herpes simplex (Correct Answer)
- B. Mycoplasma pneumoniae
- C. TB
- D. Drugs
Explanation: ***Herpes simplex*** - **Herpes simplex virus (HSV)** is the most common precipitating factor for **erythema multiforme**, accounting for **50-60% of identifiable cases**, particularly the recurrent form. - The rash typically appears **10-14 days after an HSV outbreak**, suggesting an immune-mediated reaction. - **HSV-1** is more commonly implicated than HSV-2. *Mycoplasma pneumoniae* - **Mycoplasma pneumoniae** is the **second most common infectious trigger** for erythema multiforme, especially in children and young adults. - EM associated with Mycoplasma typically occurs during or after respiratory infection. - However, it is still less common than HSV as a trigger. *TB* - **Tuberculosis (TB)** is not typically associated with erythema multiforme. - While other infections can trigger erythema multiforme, TB is rarely implicated. *Drugs* - **Drug reactions** are a recognized cause of erythema multiforme, but they are less common than HSV infection as a trigger. - Certain medications like **sulfonamides, anticonvulsants, NSAIDs, and penicillins** are among the drugs that can induce erythema multiforme.
Question 1382: The Grattage test is used to diagnose which of the following conditions?
- A. Tinea capitis
- B. Lichen planus
- C. Pemphigus vulgaris
- D. Psoriasis (Correct Answer)
Explanation: ***Psoriasis*** - The **Grattage test** (candle grease sign) involves **scraping the psoriatic lesion** to reveal characteristic features - First reveals **fine, silvery-white scales** resembling candle wax - Further scraping exposes **pinpoint bleeding points** (**Auspitz sign**) due to exposure of dilated capillaries in dermal papillae - This combination is **pathognomonic for psoriasis** and helps differentiate it from other scaly dermatoses *Tinea capitis* - A **fungal infection of the scalp** caused by dermatophytes - Diagnosed by **KOH mount** (showing fungal hyphae), **fungal culture**, and sometimes **Wood's lamp examination** - The Grattage test is not used for diagnosing fungal infections *Lichen planus* - Characterized by **purplish, polygonal, flat-topped, pruritic papules and plaques** - Surface shows **Wickham's striae** (fine white lines) - Diagnosis is **clinical**, supported by **skin biopsy** showing band-like lymphocytic infiltrate and sawtooth rete ridges - The Grattage test is not applicable *Pemphigus vulgaris* - A severe **autoimmune blistering disorder** with **suprabasal acantholysis** - Presents with **flaccid bullae** that rupture easily, leaving erosions - Diagnosed by **skin biopsy**, **direct immunofluorescence** (intercellular IgG and C3 deposits), and **Nikolsky's sign** (positive) - The Grattage test is not used for bullous disorders
Question 1383: Lines of Blaschko are related to?
- A. Keratinocytes (Correct Answer)
- B. Blood vessels
- C. Nerves
- D. Bones
Explanation: ***Keratinocytes*** - **Lines of Blaschko** represent the migratory pathways of embryonic cells, primarily **keratinocytes**, in the skin. - These lines are not visible under normal conditions but become apparent in various **genetic skin disorders** where abnormal cells follow these specific patterns. *Blood vessels* - While blood vessels are extensively present in the skin, they do not follow the specific **migratory patterns** described by the Lines of Blaschko. - Their arrangement is more related to **vascular networks** and anatomical supply rather than embryonic cell migration. *Nerves* - **Nerves** in the skin have specific distributions, often following dermatomal patterns, which are distinct from the **Lines of Blaschko**. - Nerve distribution is related to their segmental origin from the **spinal cord**, not the migratory paths of epidermal cells. *Bones* - **Bones** are part of the skeletal system and are not found in the skin, making them unrelated to the **Lines of Blaschko**. - These lines describe epidermal cell migration, which is a feature of the **integumentary system**.
Question 1384: Acantholysis is not seen in:
- A. Lichen planus (Correct Answer)
- B. Dermatitis herpetiformis
- C. Hailey-Hailey disease
- D. Bullous pemphigoid
Explanation: ***Lichen planus*** - **Lichen planus** is a **non-blistering inflammatory dermatosis** where **acantholysis is completely absent** as it is not a blistering disorder. - Characterized by **acanthosis** (epidermal thickening), **hyperkeratosis**, **wedge-shaped hypergranulosis**, and a **band-like lymphocytic infiltrate** at the dermo-epidermal junction. - The pathology involves **basal cell liquefaction** and inflammation, not loss of keratinocyte cohesion. - **Most appropriate answer** as lichen planus is fundamentally a non-blistering condition, unlike the other options which are blistering diseases. *Bullous pemphigoid* - A **subepidermal bullous disease** where blister formation occurs *below* the epidermis at the **dermo-epidermal junction**. - Autoantibodies target **BP180 and BP230** antigens in **hemidesmosomes**, causing separation between epidermis and dermis. - **No acantholysis** is present as keratinocytes within the epidermis remain cohesive; the split is subepidermal. - Also a correct answer, but less optimal than lichen planus as it is still a blistering disease. *Dermatitis herpetiformis* - A **subepidermal blistering disease** associated with **celiac disease** and characterized by intensely pruritic papulovesicles. - Features **neutrophilic microabscesses** in dermal papillae and granular **IgA deposits** at the dermo-epidermal junction. - **No acantholysis** as blister formation is subepidermal due to immune complex deposition, not loss of keratinocyte adhesion. - Also technically correct, but lichen planus remains the best answer. *Hailey-Hailey disease* - **INCORRECT:** This condition is characterized by **suprabasal acantholysis**, making it a classic example where acantholysis IS present. - Also known as **familial benign chronic pemphigus**, caused by mutation in **ATP2C1 gene** affecting calcium regulation. - Leads to chronic, relapsing blistering and erosions in **intertriginous areas** (axillae, groin). - **Acantholysis is the defining histological feature**, producing a "dilapidated brick wall" appearance.
Obstetrics and Gynecology
1 questionsAt which gestational week does the maximum volume of amniotic fluid occur?
NEET-PG 2013 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1381: At which gestational week does the maximum volume of amniotic fluid occur?
- A. 32 weeks
- B. 34 weeks
- C. 36 weeks (Correct Answer)
- D. 40 weeks
Explanation: ***36 weeks*** - The volume of **amniotic fluid** gradually increases during pregnancy, reaching its **peak** around **36 weeks** of gestation. - After 36 weeks, the volume of amniotic fluid typically begins to **decrease** as the pregnancy approaches term. *32 weeks* - At 32 weeks, the amniotic fluid volume is still **increasing** and has not yet reached its maximum level. - The fetus is actively growing and contributing to fluid production, but the peak is still several weeks away. *34 weeks* - Although significant, the amniotic fluid volume at 34 weeks has not yet reached its **maximum**. - The volume will continue to rise for another two weeks before plateauing and then declining. *40 weeks* - By 40 weeks, a normal-term pregnancy, the volume of amniotic fluid has typically **decreased** from its peak at 36 weeks. - A declining amniotic fluid volume (oligohydramnios) can be a concern at term if it's too low.
Orthopaedics
3 questionsWhat splint is used in CTEV after correction?
Von-Rosen's sign is positive in which of the following conditions?
Most common nerve injured in fracture of medial epicondyle of humerus is:
NEET-PG 2013 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1381: What splint is used in CTEV after correction?
- A. Bohler-Brown splint
- B. Thomas splint
- C. Dennis Brown splint (Correct Answer)
- D. None of the options
Explanation: ***Dennis Brown splint*** - The **Dennis Brown splint** is specifically designed for maintaining the correction of **clubfoot (CTEV)** in infants to prevent recurrence. - It consists of a bar connecting two shoes that hold the feet in an **external rotation** and **abduction** position. *Bohler-Brown splint* - The **Bohler-Brown splint** is primarily used for the management of **tibial shaft fractures**. - It is a **traction splint** designed to maintain alignment and length of the fractured bone. *Thomas splint* - The **Thomas splint** is typically used for **femoral shaft fractures** to provide traction and reduce muscle spasm. - It is not indicated for the long-term management of clubfoot. *None of the options* - This option is incorrect as the **Dennis Brown splint** is a well-established and a primary splint used for CTEV after correction.
Question 1382: Von-Rosen's sign is positive in which of the following conditions?
- A. Perthe's disease
- B. SCFE
- C. CTEV
- D. Developmental Dysplasia of the Hip (DDH) (Correct Answer)
Explanation: ***Developmental Dysplasia of the Hip (DDH)*** - **Von-Rosen's sign** is a clinical test used to detect **instability or dislocation** of the hip in newborns, a hallmark of DDH. - The test involves placing the infant **supine with hips flexed to 90 degrees**, then **externally rotating and abducting** the hips while applying gentle longitudinal traction; positive if abduction is limited to **less than 60 degrees**. *Perthe's disease* - This condition involves **avascular necrosis of the femoral head** in children, typically presenting with a limp and hip pain, not congenital instability. - Diagnosis is usually made by X-rays showing **sclerosis and fragmentation** of the femoral head, not by Von-Rosen's sign. *SCFE* - **Slipped Capital Femoral Epiphysis (SCFE)** is a condition where the femoral head epiphysis displaces from the femoral neck, common in adolescents. - Patients typically present with **hip or knee pain** and a characteristic external rotation of the affected limb, which is not detected by Von-Rosen's sign. *CTEV* - **Congenital Talipes Equinovarus (CTEV)**, or **clubfoot**, is a deformity of the foot and ankle, involving plantarflexion and inversion. - This condition affects the foot, not the hip, rendering tests for hip instability like Von-Rosen's sign irrelevant.
Question 1383: Most common nerve injured in fracture of medial epicondyle of humerus is:
- A. Radial nerve
- B. Ulnar nerve (Correct Answer)
- C. Median nerve
- D. Musculocutaneous nerve
Explanation: ***Ulnar nerve*** - The **ulnar nerve** runs directly behind the **medial epicondyle** of the humerus in a groove called the **cubital tunnel**, making it highly vulnerable to injury during fractures of this bony prominence. - Injury to the ulnar nerve at this location can cause symptoms like **numbness and tingling** in the **little finger and half of the ring finger**, **weakness in certain hand muscles**, and eventually a **"claw hand" deformity**. *Radial nerve* - The **radial nerve** courses along the posterior aspect of the humerus in the **spiral groove** and is more commonly injured with **mid-shaft humeral fractures**. - Injury typically results in **wrist drop** and **sensory loss over the dorsum of the hand**. *Median nerve* - The **median nerve** travels more anteriorly in the arm and forearm and is most commonly injured with **supracondylar fractures of the humerus** or **carpal tunnel syndrome** at the wrist. - Damage leads to **ape hand deformity** and sensory deficits over the **thumb, index, middle, and radial half of the ring finger**. *Musculocutaneous nerve* - The **musculocutaneous nerve** innervates the biceps brachii and brachialis muscles and provides sensation to the lateral forearm; it is **less commonly injured in elbow fractures**. - Injury would primarily affect **elbow flexion** and **sensation over the lateral forearm**, which is not the typical presentation for medial epicondyle fractures.
Pharmacology
1 questionsDepot preparations are administered by ?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1381: Depot preparations are administered by ?
- A. Subcutaneous route
- B. Intravenous route
- C. Intramuscular route
- D. Both subcutaneous and intramuscular route (Correct Answer)
Explanation: ***Both subcutaneous and intramuscular route*** - **Depot preparations** are designed for **sustained release** of medication over an extended period - This is achieved by forming a 'depot' in the tissue, often facilitated by a viscous vehicle or sparingly soluble form of the drug - Both **subcutaneous** and **intramuscular** tissues can sustain depot formulations effectively - **SC depot examples:** Insulin glargine, contraceptive implants (Nexplanon), leuprolide acetate - **IM depot examples:** Haloperidol decanoate, medroxyprogesterone acetate (Depo-Provera), paliperidone palmitate, long-acting risperidone *Subcutaneous route* - While some **depot preparations** are administered **subcutaneously**, it is not the *only* route for all depot formulations - The **subcutaneous tissue** offers relatively low blood flow, suitable for slow absorption - Alone, this option is incomplete as many depot preparations require IM administration *Intramuscular route* - Many **depot preparations** are given **intramuscularly** due to the muscle tissue's vascularity and tissue volume - The **muscle tissue** provides an excellent site for drug reservoir formation - Alone, this option is incomplete as some depot preparations are given subcutaneously *Intravenous route* - **Intravenous administration** is used for immediate and rapid drug delivery directly into the bloodstream - This route is **unsuitable for depot preparations** which require sustained release over time - No 'depot' can be formed with IV route as the drug is immediately diluted and distributed throughout the body
Radiology
1 questionsRadiological sign in case of Perthes disease?
NEET-PG 2013 - Radiology NEET-PG Practice Questions and MCQs
Question 1381: Radiological sign in case of Perthes disease?
- A. Flattening of femoral head (Correct Answer)
- B. Fragmentation of femoral head epiphysis
- C. Lateral femoral head displacement
- D. Limited hip abduction
Explanation: ***Flattening of femoral head*** - **Flattening** and **fragmentation** of the femoral head are characteristic radiological findings in **early-stage** Perthes disease. - This flattening is a direct consequence of the **avascular necrosis** and subsequent **remodeling** of the femoral epiphysis. *Fragmentation of femoral head epiphysis* - While **fragmentation** is a key feature of Perthes disease, it's typically observed **after** the initial flattening and sclerosis in the avascular stage. - It represents the process of **resorption** and **revascularization** as the bone attempts to heal. *Lateral femoral head displacement* - **Lateral displacement** of the femoral head is a more common finding in conditions like **slipped capital femoral epiphysis (SCFE)**, where the epiphysis slips from the metaphysis. - In Perthes disease, the primary issue is the **necrosis and collapse** of the femoral head itself, rather than displacement from the neck. *Limited hip abduction* - **Limited hip abduction** is a clinical sign, not a radiological sign, and it is a common symptom in Perthes disease due to pain, inflammation, and deformity of the femoral head. - Radiological signs are visual abnormalities observed on imaging studies like X-rays.