NEET-PG 2013

1544 Questions — Page 98 of 155

Anatomy

3 questions

Q971

Which of the following statements is true regarding the anatomy of the external nose?

Q972

Which of the following arteries does NOT contribute to Little's area?

Q973

Posterior epistaxis occurs from:

NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs

Question 971: Which of the following statements is true regarding the anatomy of the external nose?

A. The lower one-third is primarily cartilaginous. (Correct Answer)
B. The upper two-thirds is entirely bony.
C. The lateral aspect has only a single cartilage.
D. The external nose is supported by two nasal bones.

Explanation: ***The lower one-third is primarily cartilaginous.*** - The **lower one-third** of the external nose, including the nasal tip and alae, is predominantly supported by **alar cartilages** (lower lateral cartilages) and other minor cartilages, giving it flexibility. - This cartilaginous structure allows for movement and shaping of the nostrils. - This statement is **anatomically accurate and complete**. *The upper two-thirds is entirely bony.* - This is **incorrect**. - The **upper one-third** is bony (nasal bones and frontal process of maxilla). - The **middle one-third** is primarily **cartilaginous** (upper lateral cartilages). - Therefore, the upper two-thirds consists of **both bone and cartilage**, not entirely bone. *The lateral aspect has only a single cartilage.* - This is **incorrect**. - The lateral aspect contains **multiple cartilages**: upper lateral cartilages, lower lateral (alar) cartilages, and accessory cartilages. - The presence of multiple cartilages provides structural support and flexibility. *The external nose is supported by two nasal bones.* - This is **incomplete and misleading**. - While two **nasal bones** do form the superior bony bridge (upper one-third), the external nose is also supported by: - Frontal process of the maxilla - Upper and lower lateral cartilages - Septal cartilage - Stating only the nasal bones ignores the majority of nasal support structures.

Question 972: Which of the following arteries does NOT contribute to Little's area?

A. Sphenopalatine artery
B. Posterior Ethmoidal artery (Correct Answer)
C. Greater palatine artery
D. Anterior Ethmoidal artery

Explanation: Posterior Ethmoidal artery - The posterior ethmoidal artery primarily supplies the posterior ethmoidal cells and part of the sphenoid sinus, but it does not contribute to the vascular plexus in Little's area. - Little's area, also known as Kiesselbach's plexus, is formed by anastomoses of several arteries on the anterior nasal septum. Sphenopalatine artery - The sphenopalatine artery, a terminal branch of the maxillary artery, is a major contributor to Little's area through its septal branch. - It supplies a significant portion of the nasal septum and is frequently involved in posterior epistaxis. Greater palatine artery - The greater palatine artery, a branch of the descending palatine artery (from the maxillary artery), enters the nasal cavity through the incisive canal and contributes to Little's area on the nasal septum. - It primarily supplies the hard palate and then anastomoses with other vessels in the anterior nasal septum. Anterior Ethmoidal artery - The anterior ethmoidal artery, a branch of the ophthalmic artery, is a key contributor to Little's area. - It supplies the anterior and middle ethmoidal cells and also contributes to the blood supply of the dura mater.

Question 973: Posterior epistaxis occurs from:

A. Kiesselbach's plexus
B. Sphenopalatine artery
C. Little's area
D. Woodruff's plexus (Correct Answer)

Explanation: ***Woodruff's plexus*** - **Woodruff's plexus** is a collection of large, often friable veins located on the **posterior aspect of the lateral wall of the nasal cavity**, making it the most common anatomical site for **posterior epistaxis**. - Bleeding from this plexus is typically more severe and difficult to control than anterior epistaxis due to the larger vessel size and posterior location. - Located in the **posterolateral nasal cavity** near the posterior end of the inferior turbinate. *Kiesselbach's plexus* - **Kiesselbach's plexus** (also known as Little's area) is located on the **anterior nasal septum** and is the most common site for **anterior epistaxis**. - This is an anastomotic network of vessels from multiple arterial sources in the anterior nasal cavity. - Bleeding from this plexus is usually less severe and often responds to local pressure or cauterization. *Sphenopalatine artery* - The **sphenopalatine artery** is the terminal branch of the maxillary artery and is the primary arterial supply to the posterior nasal cavity. - While it supplies the area where posterior epistaxis occurs, the venous **Woodruff's plexus** is the specific anatomical structure most commonly associated with posterior epistaxis. - The sphenopalatine artery may require ligation or embolization in severe posterior epistaxis cases. *Little's area* - **Little's area** is another name for **Kiesselbach's plexus** and is located on the **anterior nasal septum**, primarily responsible for anterior epistaxis. - This area is highly vascularized by anastomoses of the anterior ethmoidal, sphenopalatine, greater palatine, superior labial, and septal branches of arteries. - Prone to bleeding from minor trauma, digital manipulation, or mucosal dryness.

Dermatology

2 questions

Q971

Which of the following statements is true about rhinophyma?

Q972

What is the condition characterized by the hypertrophy of sebaceous glands?

NEET-PG 2013 - Dermatology NEET-PG Practice Questions and MCQs

Question 971: Which of the following statements is true about rhinophyma?

A. Premalignant
B. Common in alcoholics
C. Acne rosacea (Correct Answer)
D. Fungal etiology

Explanation: ***Acne rosacea*** - **Rhinophyma** is a severe form of **acne rosacea**, characterized by sebaceous gland hypertrophy and connective tissue hyperplasia on the nose. - It specifically represents the **phymatous subtype** of rosacea, which involves thickening of the skin. *Premalignant* - Rhinophyma itself is generally **not considered premalignant** to skin cancer. - While skin cancers like **basal cell carcinoma** can rarely occur within rhinophyma, the condition itself does not inherently transform into malignancy. *Common in alcoholics* - This is a **common misconception**; while often associated with heavy alcohol use, there is no direct causal link. - The development of rhinophyma is primarily driven by the underlying pathogenesis of **rosacea**, not alcohol consumption. *Fungal etiology* - Rhinophyma is primarily an inflammatory skin condition, not caused by **fungal infection**. - Its etiology is complex, involving genetics, environmental triggers, and vascular dysregulation, but **microbial involvement** is typically bacterial (e.g., Demodex mites) rather than fungal.

Question 972: What is the condition characterized by the hypertrophy of sebaceous glands?

A. Rhinosporidiosis
B. Tubercular infection
C. Sebaceous hyperplasia (Correct Answer)
D. Nasopharyngeal angiofibroma

Explanation: ***Sebaceous hyperplasia*** - This condition is characterized by the **enlargement (hypertrophy)** of normal sebaceous glands, often appearing as yellowish-white papules with a central umbilication. - It commonly occurs on the **face of older adults**, particularly on the forehead and cheeks, and is a benign condition. *Rhinosporidiosis* - This is a **chronic granulomatous disease** caused by the fungus *Rhinosporidium seeberi*, primarily affecting the **mucous membranes** of the nose and nasopharynx. - It presents as **friable, polypoidal masses** with a characteristic "strawberry-like" appearance due to small white spots (sporangia), not sebaceous gland hypertrophy. *Tubercular infection* - A tubercular infection, particularly cutaneous tuberculosis, can manifest in various forms, including **lupus vulgaris**, scrofuloderma, or tuberculosis cutis verrucosa. - These presentations involve **granulomatous inflammation** and tissue destruction, not isolated hypertrophy of sebaceous glands. *Nasopharyngeal angiofibroma* - This is a **rare, benign, highly vascular tumor** that originates in the nasopharynx, predominantly affecting adolescent males. - It typically presents with symptoms like **epistaxis** and **nasal obstruction**, and is composed of fibrous and vascular tissue, not sebaceous glands.

ENT

4 questions

Q971

What is not true about the use of intranasal steroids in nasal polyposis?

Q972

Which of the following statements about Rhinoscleroma is false?

Q973

Which of the following is a predisposing factor for nasal myiasis?

Q974

In which condition is mulberry nasal mucosa typically observed?

NEET-PG 2013 - ENT NEET-PG Practice Questions and MCQs

Question 971: What is not true about the use of intranasal steroids in nasal polyposis?

A. Effective in all types of nasal polyps (Correct Answer)
B. May cause nasal irritation
C. Reduce recurrence
D. Most effective in eosinophilically predominant polyps

Explanation: ***Effective in all types of nasal polyps*** - Intranasal steroids are primarily effective in nasal polyps with an **eosinophilic inflammatory component**, which is the most common type. - They are **not effective in all types** - efficacy is significantly reduced in polyps with **neutrophilic inflammation** or those related to conditions like **cystic fibrosis**, reflecting different underlying pathologies. - This statement is **FALSE**, making it the correct answer to this negation question. *May cause nasal irritation* - **Nasal irritation**, including **burning, stinging**, or **dryness**, is a common local side effect associated with the use of intranasal steroids. - Other local side effects can include **epistaxis** (nosebleeds) and mucosal atrophy, though less common. - This statement is **TRUE**. *Reduce recurrence* - **Intranasal steroids** are crucial in **reducing the recurrence** of nasal polyps after surgical removal. - Their anti-inflammatory action helps to **control the underlying inflammation** that contributes to polyp formation. - This statement is **TRUE**. *Most effective in eosinophilically predominant polyps* - Intranasal steroids primarily target the **eosinophilic inflammatory pathway**, which is characteristic of the majority of **chronic rhinosinusitis with nasal polyps (CRSwNP)**. - While they have **maximal efficacy** in eosinophilic polyps, they may have limited benefit in mixed inflammatory patterns. - Their efficacy is significantly reduced in polyps that are predominantly **neutrophilic** or associated with systemic conditions like **cystic fibrosis**, as these involve different inflammatory mechanisms. - This statement is **TRUE**.

Question 972: Which of the following statements about Rhinoscleroma is false?

A. Woody nose
B. Mikulicz cells
C. More common in tropical regions (Correct Answer)
D. Caused by bacteria

Explanation: ***More common in tropical regions*** - While rhinoscleroma is endemic in certain regions, it is more commonly found in **temperate and subtropical climates**, particularly in Eastern Europe, Central and South America, and parts of Africa and Asia, rather than exclusively tropical areas. - The prevalence is linked to socioeconomic factors and poor hygiene rather than strictly temperature-based climate zones. *Mikulicz cells* - The presence of **Mikulicz cells** is a characteristic histopathological feature of rhinoscleroma. - These are large macrophages with a clear, foamy cytoplasm containing numerous bacilli, which are pathognomonic for the disease. *Woody nose* - **Woody nose** (or "saddle nose" deformity in late stages) is a clinical feature associated with the advanced stages of rhinoscleroma. - The disease causes chronic inflammation and granuloma formation, leading to firm, indurated infiltrates that can result in this characteristic nasal deformity. *Caused by bacteria* - Rhinoscleroma is indeed caused by the bacterium **_Klebsiella rhinoscleromatis_**, a gram-negative rod. - It is an infectious disease primarily affecting the upper respiratory tract.

Question 973: Which of the following is a predisposing factor for nasal myiasis?

A. Allergic rhinitis
B. Vasomotor rhinitis
C. Atrophic rhinitis (Correct Answer)
D. Rhinitis medicamentosa

Explanation: ***Atrophic rhinitis*** - **Atrophic rhinitis** leads to thinning and drying of the nasal mucosa, creating a favorable environment for **fly larvae (maggots)** to infest. - The **crusting and foul odor** associated with atrophic rhinitis can attract flies, making the nasal cavity susceptible to myiasis. *Allergic rhinitis* - Characterized by **inflammation and watery discharge** due to allergen exposure. It does not create the tissue damage or conducive environment for myiasis. - While it causes nasal symptoms, it generally **does not involve tissue necrosis** or open lesions that would attract flies for oviposition. *Vasomotor rhinitis* - Involves **non-allergic triggers** causing nasal congestion, sneezing, and runny nose, often due to autonomic nervous system dysfunction. - There is **no tissue destruction or mucosal atrophy** that would predispose to myiasis. *Rhinitis medicamentosa* - Results from **overuse of topical decongestant sprays**, leading to rebound congestion and chronic inflammation. - While it causes nasal irritation, it does **not typically involve the extensive mucosal damage or open wounds** that attract flies for myiasis.

Question 974: In which condition is mulberry nasal mucosa typically observed?

A. Lupus vulgaris (Correct Answer)
B. Vasomotor rhinitis
C. Atrophic rhinitis
D. Allergic rhinitis

Explanation: ***Lupus vulgaris*** - **Mulberry nasal mucosa** is a **pathognomonic finding** in **lupus vulgaris**, a form of cutaneous tuberculosis affecting the nasal mucosa. - The mucosa shows characteristic **reddish-brown, soft nodules** that resemble mulberries, with a typical **apple-jelly appearance on diascopy**. - Lesions are **persistent, slowly progressive**, and may cause destruction of the nasal cartilage if untreated. *Vasomotor rhinitis* - **Vasomotor rhinitis** (non-allergic rhinitis) presents with **pale, bluish, or boggy nasal mucosa**, not the mulberry appearance. - Caused by **autonomic nervous system dysregulation**, leading to nasal congestion and rhinorrhea triggered by non-allergic stimuli. - The mucosal changes are **diffusely edematous** rather than nodular. *Atrophic rhinitis* - **Atrophic rhinitis** involves progressive atrophy of the nasal mucosa and underlying bone. - Mucosa appears **pale, dry, smooth, and shiny** with thick crusts (ozena in secondary form). - Wide nasal cavities with paradoxical nasal obstruction, **not mulberry-like nodular changes**. *Allergic rhinitis* - **Allergic rhinitis** typically shows **pale, edematous, bluish-gray mucosa** with watery discharge. - Caused by **IgE-mediated hypersensitivity** to environmental allergens. - Mucosa may appear **boggy but not nodular or mulberry-like**.

Internal Medicine

1 questions

Q971

All are seen in Samters triad except?