Dental
1 questionsWhat investigation uses dye to find out stones in the salivary gland?
NEET-PG 2013 - Dental NEET-PG Practice Questions and MCQs
Question 841: What investigation uses dye to find out stones in the salivary gland?
- A. MR angiography
- B. USG
- C. Breast imaging
- D. Sialography (Correct Answer)
Explanation: ***Sialography*** - **Sialography** is an imaging technique that involves injecting a **radiopaque dye** into the salivary ducts to visualize the internal structure and identify obstructions like stones (**sialoliths**). - This method allows for detailed imaging of the ductal system, revealing the exact location and size of stones or strictures. *Breast imaging* - **Breast imaging**, such as mammography or ultrasound of the breast, is used to detect abnormalities within the **breast tissue**. - It is completely unrelated to the diagnosis of salivary gland stones. *MR angiography* - **MR angiography (MRA)** is a type of MRI that specifically visualizes **blood vessels** and blood flow throughout the body. - It is used to detect vascular diseases, not obstructions in salivary glands. *USG* - **Ultrasound (USG)** can visualize salivary gland stones, but it does not typically involve the use of an injected dye for this purpose. - While useful for initial screening, **sialography** provides a more detailed view of the ductal system, especially smaller or more complex stones.
Internal Medicine
2 questionsWhich of the following is NOT a feature of Cushing's triad?
What are the key characteristics of Evans syndrome?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 841: Which of the following is NOT a feature of Cushing's triad?
- A. Hypertension
- B. Bradycardia
- C. Irregular breathing
- D. Hypotension (Correct Answer)
Explanation: ***Hypotension*** - Cushing's triad is an indicator of **increased intracranial pressure (ICP)** and classically presents with **hypertension**, not hypotension. - Hypotension would suggest a different problem, such as **spinal shock** or **hypovolemia**, which are not directly associated with Cushing's triad. *Bradycardia* - **Bradycardia** is a key component of Cushing's triad, resulting from vagal stimulation due to increased intracranial pressure. - This reflex reduces heart rate in an attempt to maintain cerebral perfusion. *Hypertension* - **Hypertension**, specifically a widened pulse pressure, is a cardinal feature of Cushing's triad, caused by systemic vasoconstriction to overcome increased ICP and maintain **cerebral perfusion pressure**. - It is a compensatory mechanism to push blood into the brain. *Irregular breathing* - **Irregular breathing patterns**, such as Cheyne-Stokes respiration or ataxic breathing, are characteristic of Cushing's triad, indicating brainstem compression [1]. - This irregular respiratory effort is due to direct pressure on the **respiratory centers** in the medulla [1].
Question 842: What are the key characteristics of Evans syndrome?
- A. Autoimmune hemolytic anemia and immune thrombocytopenia (Correct Answer)
- B. Low lymphocyte and red blood cell counts
- C. High platelet and lymphocyte counts
- D. A reduction in all blood cell types
Explanation: ***Autoimmune hemolytic anemia and immune thrombocytopenia*** - **Evans syndrome** is defined by the simultaneous or sequential occurrence of **autoimmune hemolytic anemia (AIHA)** and **immune thrombocytopenia (ITP)** [1], [2]. - Both conditions involve the immune system mistakenly attacking and destroying **red blood cells** and **platelets**, respectively [1], [2]. *Low lymphocyte and red blood cell counts* - While **red blood cell counts** are low in Evans syndrome due to AIHA, **lymphocyte counts** are not a defining characteristic; they can vary. - This option does not fully capture the dual autoimmune destruction of red blood cells and platelets specific to Evans syndrome. *High platelet and lymphocyte counts* - **Platelet counts** are **low** in Evans syndrome due to ITP, not high. - **Lymphocyte counts** are not characteristically high; a high count might suggest other conditions like leukemias or lymphomas. *A reduction in all blood cell types* - A reduction in all (red blood cells, white blood cells, and platelets) is known as **pancytopenia**, which is not the defining feature of Evans syndrome. - Evans syndrome specifically involves the destruction of **red blood cells** and **platelets**, but not necessarily all white blood cell types.
Radiology
1 questionsThe procedure of choice for the evaluation of aortic aneurysms is -
NEET-PG 2013 - Radiology NEET-PG Practice Questions and MCQs
Question 841: The procedure of choice for the evaluation of aortic aneurysms is -
- A. Computed tomography (Correct Answer)
- B. Magnetic resonance imaging
- C. Arteriography
- D. Ultrasonography
Explanation: ***Computed tomography*** - **Computed tomography (CT)** offers excellent spatial resolution and is the gold standard for diagnosing, staging, and pre-operative planning for aortic aneurysms. - It precisely measures aneurysm size, detects mural thrombus, assesses rupture risk, and evaluates the extent of involvement with surrounding structures. *Ultrasonography* - While useful for initial screening and serial monitoring of known abdominal aortic aneurysms due to its non-invasiveness and cost-effectiveness, its accuracy can be limited by **patient body habitus** and **bowel gas**. - It may not reliably visualize the entire aorta or accurately assess complex anatomy and rupture. *Magnetic resonance imaging* - **Magnetic resonance imaging (MRI)** provides detailed anatomical information and avoids radiation exposure, but it is typically more expensive and time-consuming than CT. - It is often reserved for patients with **renal insufficiency** where iodinated contrast is a concern or when evaluating specific tissue characteristics not well seen on CT. *Arteriography* - **Arteriography** (angiography) is an invasive procedure involving direct contrast injection, carrying risks such as arterial injury and nephrotoxicity. - While it can visualize the aortic lumen, it primarily shows the patent lumen and may **underestimate the true aneurysm size** due to mural thrombus. It is typically used for intervention planning or specific contexts rather than initial diagnosis.
Surgery
6 questionsTreatment for ileal obstruction due to roundworm infestation is
Among the following single parameters, malnutrition in surgical patients is best assessed by:
What is the most common site for carcinoid tumor?
Indication for sentinel node biopsy is:
Which one of the following is used as a preservative for packing catgut suture?
Which of the following nerves is commonly damaged during McBurney's incision?
NEET-PG 2013 - Surgery NEET-PG Practice Questions and MCQs
Question 841: Treatment for ileal obstruction due to roundworm infestation is
- A. Resection with end to end anastomosis
- B. Resection with side to side anastomosis
- C. Enterotomy, removal of worms and primary closure (Correct Answer)
- D. Diversion
Explanation: ***Enterotomy, removal of worms and primary closure*** - For **ileal obstruction** by **roundworms**, **surgical intervention** involves opening the affected bowel segment (**enterotomy**), carefully extracting the worm bolus, and then closing the incision primarily. - This approach is favored because the bowel itself is usually **healthy**, and the obstruction is purely mechanical from the worms. *Resection with end to end anastomosis* - This aggressive approach of **resecting** part of the bowel is generally **unnecessary** and **risky** when the bowel is otherwise healthy and viable, as is typical in roundworm obstruction. - It carries risks of **anastomotic leakage** and **short gut syndrome** if repeated resections are needed, making simple worm removal a preferable option. *Resection with side to side anastomosis* - Similar to end-to-end anastomosis, **resection** of the bowel is generally avoided unless there is **irreversible damage** or **ischemia** to the bowel, which is not the primary pathology in uncomplicated roundworm obstruction. - This method is more complex and less optimal than simply removing the obstruction, given the typically *healthy* nature of the bowel wall. *Diversion* - **Diversion** procedures, such as **stoma formation**, are generally reserved for situations with **perforation**, **gross contamination**, or complex obstructions where primary repair is considered unsafe or impossible. - In a straightforward ileal obstruction due to worms, the goal is to resolve the obstruction with minimal intervention to preserve bowel continuity.
Question 842: Among the following single parameters, malnutrition in surgical patients is best assessed by:
- A. Mid arm circumference (Correct Answer)
- B. Triceps skin fold thickness
- C. Hb level
- D. Serum albumin
Explanation: ***Mid arm circumference*** - **Mid-arm circumference (MAC)** is considered a reliable and easily measurable single parameter for assessing malnutrition, as it reflects both **muscle mass** and **subcutaneous fat**. - It is particularly useful in surgical patients where rapid and practical assessment of nutritional status is needed. *Serum albumin* - While **serum albumin** reflects visceral protein status, its levels can be significantly affected by **hydration status**, inflammation, and liver disease, making it less specific for malnutrition in acute surgical settings. - Due to its **long half-life**, serum albumin may not accurately reflect recent changes in nutritional status. *Hb level* - **Hemoglobin (Hb) levels** primarily assess anemia, which can be caused by various factors beyond malnutrition, such as blood loss or chronic disease. - Anemia does not directly measure or reflect overall protein-energy malnutrition. *Triceps skin fold thickness* - **Triceps skin fold thickness (TSFT)** measures subcutaneous fat stores but does not provide information about lean muscle mass or overall protein status. - Its measurement can be less accurate due to inter-observer variability and may not reflect comprehensive malnutrition as well as MAC.
Question 843: What is the most common site for carcinoid tumor?
- A. Lung
- B. Ileum (Correct Answer)
- C. Esophagus
- D. Appendix
Explanation: ***Ileum*** - The **ileum** is the most common site for carcinoid tumors, accounting for nearly **50%** of cases [1]. - Carcinoid tumors arise from **neuroendocrine cells** in the gastrointestinal tract, with the ileum being particularly common due to its abundant neuroendocrine tissue [1]. *Appendix* - While carcinoid tumors can occur in the **appendix**, they represent a smaller proportion compared to those found in the ileum. - Typical carcinoid tumors in the appendix are often **asymptomatic** and usually detected incidentally. *Lung* - Though lung carcinoids exist, they represent a different classification of carcinoid tumors, primarily occurring in the **bronchial tree** [2]. - They are less common than those in the gastrointestinal tract, particularly the ileum. *Esophagus* - Carcinoid tumors are rare in the **esophagus** and typically have different presentations compared to gastrointestinal carcinoids. - The esophagus is not a common site for carcinoid tumors, which are primarily found in the intestinal tract. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 780-781. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 727.
Question 844: Indication for sentinel node biopsy is:
- A. Palpable axillary lymph node
- B. Metastasis
- C. Mass > 5 cm
- D. Non-palpable axillary lymph node (Correct Answer)
Explanation: ***Non-palpable axillary lymph node*** - **Sentinel lymph node biopsy (SLNB)** is indicated when there is no clinical evidence of axillary lymph node involvement, meaning the nodes are **non-palpable**. - Its purpose is to identify micrometastases that would not be detectable by physical examination, staging the cancer more accurately and guiding further treatment. *Palpable axillary lymph node* - A **palpable axillary lymph node** suggests macroscopic nodal involvement, usually requiring a fine needle aspiration (FNA) or core needle biopsy for diagnosis. - If positive, these patients typically proceed directly to **axillary lymph node dissection (ALND)** rather than SLNB. *Mass > 5 cm* - The size of the primary tumor (e.g., > 5 cm) is a factor in staging but does not, in itself, preclude or indicate SLNB. - While larger tumors have a higher risk of nodal involvement, the decision for SLNB still hinges on the clinical status of the axilla (palpable vs. non-palpable nodes). *Metastasis* - If **distant metastasis** is confirmed, the focus shifts to palliative care and systemic treatment, making a regional staging procedure like SLNB less relevant or unnecessary. - SLNB is used for staging early-stage cancer to detect regional spread, not when widespread disease is already established.
Question 845: Which one of the following is used as a preservative for packing catgut suture?
- A. Colloidal iodine
- B. Glutaraldehyde
- C. Isopropyl alcohol (Correct Answer)
- D. Hydrogen peroxide
Explanation: ***Isopropyl alcohol*** - **Isopropyl alcohol** is commonly used as a preservative for **catgut sutures** due to its antiseptic and denaturing properties that prevent microbial growth and maintain the integrity of the biologic material. - It helps to keep the suture sterile and prevents degradation by enzymes or bacteria during storage. *Colloidal iodine* - **Colloidal iodine** is an antiseptic, but it is not typically used as a preservative for **catgut sutures**; it is more often used for skin preparation or wound disinfection. - Its reactivity and potential to stain or alter **suture material** make it less suitable for long-term preservation within the packaging. *Glutaraldehyde* - **Glutaraldehyde** is a potent disinfectant and sterilant, but it is generally too harsh for preserving **catgut sutures**; it can cause significant cross-linking and denaturation of proteins. - It is more commonly used for sterilizing heat-sensitive medical instruments like **endoscopes**, rather than for preserving **suture materials**. *Hydrogen peroxide* - **Hydrogen peroxide** is an oxidizing agent used as an antiseptic to clean wounds or as a sterilant, but it is not suitable for preserving **catgut sutures**. - Its oxidative action could degrade the **collagenous material** of the suture, compromising its strength and absorption properties.
Question 846: Which of the following nerves is commonly damaged during McBurney's incision?
- A. Subcostal nerve
- B. Iliohypogastric nerve (Correct Answer)
- C. 11th thoracic nerve
- D. 10th thoracic nerve
Explanation: ***Iliohypogastric nerve*** - The **iliohypogastric nerve** is most commonly injured during **McBurney's incision** due to its superficial position and transverse course at the level of the incision. - Damage can lead to **numbness** or altered sensation in the suprapubic region, and sometimes **weakness of the lower abdominal wall**. *Subcostal nerve* - The **subcostal nerve** (T12) runs inferior to the 12th rib and is generally superior to the typical site of a McBurney's incision. - Injury to this nerve is less common during this procedure compared to the iliohypogastric and ilioinguinal nerves. *10th thoracic nerve* - The **10th thoracic nerve** (T10) provides sensation around the umbilicus. - While it contributes to innervation of the abdominal wall, its location is typically well above the area of a standard McBurney's incision, making injury unlikely. *11th thoracic nerve* - The **11th thoracic nerve** (T11) innervates the abdominal wall and is located superior to the typical incision site for appendectomy. - Injury to T11 during a McBurney's incision is uncommon as the nerve's course lies cephalad to the surgical field.