NEET-PG 2015 Practice Questions

Q: Most common location of ectopic salivary gland is -

Cervical lymph nodes. Cervical lymph nodes - **Ectopic salivary gland tissue** is most frequently found within or adjacent to **cervical periparotid lymph nodes**. - This is thought to be due to inclusion of salivary gland anlage within lymph nodes during embryological development. *Anterior mediastinum* - While ectopic tissues can occur in the mediastinum, **salivary gland tissue** is not a common finding there. - The **mediastinum** is more commonly associated with ectopic **thymic** or **thyroid** tissue. *Posterior triangle* - The **posterior triangle of the neck** is a common site for various neck masses , but **ectopic salivary gland tissue** is rare in this location. - Masses here are more typically **lymphadenopathy**, **brachial cleft cysts**, or **fibromas**. *Parathyroid gland* - The **parathyroid glands** are endocrine glands located near or within the thyroid, and are not typically associated with containing **ectopic salivary gland tissue**. - Their embryological development is distinct from that of salivary glands.

Q: Which of the following statements about drug-induced SLE is NOT true?

Anti-histone antibodies are negative. ***Anti-histone antibodies are negative*** - **Anti-histone antibodies** are actually positive in approximately **95% of drug-induced SLE** cases, making this statement false. - The presence of **anti-histone antibodies** is a hallmark diagnostic feature that helps distinguish drug-induced lupus from other forms of lupus. *CNS involvement not common* - **Central nervous system manifestations** are indeed rare in drug-induced lupus, unlike idiopathic SLE. - This accurately reflects a key differentiating feature, as **neuropsychiatric symptoms** are uncommon in drug-induced variants. *Female:Male = 1:1* - Drug-induced SLE shows **equal gender distribution** (1:1 ratio), contrasting with idiopathic SLE's female predominance. - This lack of **gender predilection** is a characteristic feature that distinguishes it from systemic lupus erythematosus. *Renal involvement not common* - **Renal manifestations** are rare in drug-induced lupus erythematosus, making this statement accurate. - This absence of **lupus nephritis** helps differentiate it from idiopathic SLE, where kidney involvement is frequent and severe.

Q: What does a motor score of 4 on the Glasgow Coma Scale indicate?

Withdrawal or flexion to pain. A motor score of 4 on the **Glasgow Coma Scale (GCS)** signifies that the patient **withdraws or flexes their limb** away from a painful stimulus. - This response indicates a degree of purposeful movement but is not considered localization to the pain. *Decerebrate posturing* - This represents a GCS motor score of **2**, characterized by **extension and internal rotation of the arms** and extension of the legs in response to pain [1]. - It suggests severe damage to the **brainstem**, specifically below the red nucleus [1]. *Decorticate posturing* - This corresponds to a GCS motor score of **3**, where the patient exhibits **flexion and adduction of the arms** with extension of the legs to painful stimuli [1]. - It often indicates damage to the **corticospinal tracts** above the red nucleus [1]. *Localizes to pain* - This is a GCS motor score of **5**, where the patient **moves their hand beyond the chin** attempting to remove the painful stimulus. - It indicates a higher level of conscious response and purposeful movement compared to withdrawal.

Q: Pseudoclaudication is caused by

Lumbar canal stenosis. ***Lumbar canal stenosis*** - **Pseudoclaudication**, also known as **neurogenic claudication**, is a characteristic symptom of **lumbar canal stenosis**. - It is caused by **compression of spinal nerve roots** in the lumbar spine, leading to pain, numbness, or weakness in the legs, often exacerbated by standing or walking and relieved by sitting or stooping forward [1]. *Femoral Artery stenosis* - **Femoral artery stenosis** causes **vascular claudication**, which is pain in the leg muscles due to insufficient blood flow during exercise [2]. - Unlike pseudoclaudication, vascular claudication is typically relieved by rest and is not influenced by spinal position [2]. *Popliteal Artery stenosis* - **Popliteal artery stenosis** also leads to **vascular claudication**, presenting as calf pain during walking due to reduced blood supply to the distal leg [2]. - This condition is related to **peripheral artery disease**, distinct from neurological compression [2]. *Radial Artery stenosis* - **Radial artery stenosis** typically affects blood flow to the **hand and forearm**, potentially causing symptoms of ischemia in those areas. - It is not associated with leg pain or claudication.

Q: Oxygen consumption increases in pregnancy by

20%. ***20%*** - During **pregnancy**, the maternal **metabolic rate increases** to support fetal growth and the physiological changes occurring in the mother's body. - This increased metabolic demand leads to a **rise in oxygen consumption** by approximately 20% compared to the non-pregnant state. *10%* - A 10% increase is an **underestimation** of the physiological change in oxygen consumption during pregnancy. - The demands of supporting a growing fetus and increased maternal tissue mass require a more substantial metabolic adjustment. *30%* - While oxygen consumption does increase significantly, a 30% rise is generally considered an **overestimation** of the average increase. - The typical physiological adaptation usually falls within the 15-25% range. *40%* - A 40% increase in oxygen consumption would represent an **extreme physiological demand** that is not typically observed during an uncomplicated pregnancy. - Such a drastic increase might indicate underlying pathology rather than normal adaptation.

Q: Supraomohyoid dissection is a type of?

Selective neck dissection. ***Selective neck dissection*** - **Supraomohyoid dissection** specifically refers to a type of selective neck dissection, characterized by the removal of lymph node levels **I, II, and III**. - This procedure is commonly performed for early-stage oral cavity cancers due to their typical lymphatic spread patterns. *Modified radical neck dissection* - This dissection preserves one or more **non-lymphatic structures** (e.g., sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve) that are typically removed in a radical neck dissection. - It involves a broader range of lymph node levels (typically **I-V**) compared to a supraomohyoid dissection. *Radical neck dissection* - This is a more extensive procedure involving the removal of all lymph node groups (levels **I-V**), along with the **sternocleidomastoid muscle**, **internal jugular vein**, and **spinal accessory nerve**. - It is reserved for advanced neck disease due to its significant morbidity. *Posterolateral dissection* - **Posterolateral neck dissection** is a term not commonly used within the standard classification of neck dissections (radical, modified radical, selective). - Lymphatic dissection is typically categorized based on anatomical levels rather than a general directional term like posterolateral.

Q: A 45-year-old female underwent a modified radical mastectomy with axillary clearance for breast cancer. Post-surgery, she is unable to lift her arm above her head. Which nerve is most likely to be injured?

Long thoracic nerve of Bell. ***Long thoracic nerve of Bell*** - Injury to the **long thoracic nerve** (nerve to the serratus anterior) leads to **paralysis of the serratus anterior muscle**. - This muscle is crucial for **upward rotation and protraction of the scapula**, which is essential for arm elevation above the head and preventing **'winging' of the scapula**. *Intercostobrachial nerve* - Injury to the **intercostobrachial nerve** typically causes **sensory loss** or numbness in the medial upper arm. - It does not primarily affect motor function or the ability to lift the arm. *Nerve to latissimus Dorsi* - The **thoracodorsal nerve** innervates the **latissimus dorsi muscle**, which is involved in adduction, extension, and internal rotation of the arm. - Injury to this nerve would impair these movements but not directly prevent arm elevation above the head. *Lateral Pectoral nerve* - The **lateral pectoral nerve** supplies the **pectoralis major muscle**, primarily its clavicular head. - Injury would weaken adduction and flexion of the arm, but the inability to lift the arm above the head strongly points to serratus anterior dysfunction.

Q: Which of the following statements about Hirschsprung disease is incorrect?

The non-peristaltic affected segment is dilated. ***The non-peristaltic affected segment is dilated*** - In Hirschsprung disease, the **aganglionic segment** is typically **constricted** and **narrow**, not dilated, due to continuous contraction without relaxation. - The healthy colon proximal to the affected segment becomes dilated due to the obstruction caused by the constricted, aganglionic segment. *Absence of Ganglion cells in the involved segment* - This statement is **correct**. Hirschsprung disease is fundamentally characterized by the **absence of intramural ganglion cells** (Meissner and Auerbach plexuses) in a segment of the distal colon. - This aganglionosis results in a failure of relaxation and normal peristalsis in the affected bowel segment. *Swenson, Duhamel, and Soave are surgical procedures for this condition* - This statement is **correct**. These are the classic and most common **pull-through surgical procedures** used to treat Hirschsprung disease. - They involve resecting the aganglionic segment and pulling the normal, ganglionated bowel down to the anus. *Mainly presents in infancy* - This statement is **correct**. Hirschsprung disease is primarily a **congenital condition** and is typically diagnosed in newborns and infants. - Common presenting symptoms include **failure to pass meconium** within the first 24-48 hours of life, abdominal distension, and bilious vomiting.

Q: Which of the following statements about Branchial cysts is true:

Most common site is lateral neck. ***Most common site is lateral neck*** - **Branchial cleft cysts** typically present as a mass in the **lateral neck**, anterior to the sternocleidomastoid muscle. - They are congenital anomalies resulting from incomplete obliteration of the branchial clefts during embryonic development. *50-70% are seen in lungs* - This statement is incorrect; branchial cysts are **cervical anomalous masses** arising from the branchial apparatus, not primarily found in the lungs. - Lung lesions are more commonly associated with congenital pulmonary airway malformations or bronchogenic cysts, which differ in origin. *They are premalignant lesions* - Branchial cysts are generally **benign lesions** and do not typically transform into malignancy. - While rare cases of carcinoma arising within a branchial cleft cyst have been reported, they are not considered routinely premalignant. *Infection is uncommon in branchial cysts* - Conversely, infection is a **common complication** of branchial cysts, often leading to sudden enlargement, pain, and erythema. - The presence of internal fluid and epithelial lining makes them susceptible to bacterial colonization and subsequent abscess formation.

Question 1

Most common location of ectopic salivary gland is -

Accepted Answer

Cervical lymph nodes

Answer

Posterior triangle

Answer

Parathyroid gland

Answer

Anterior mediastinum

Question 2

Which of the following statements about drug-induced SLE is NOT true?

Accepted Answer

Anti-histone antibodies are negative

Answer

CNS involvement not common

Answer

Female:Male = 1:1

Answer

Renal involvement not common

Question 3

What does a motor score of 4 on the Glasgow Coma Scale indicate?

Accepted Answer

Withdrawal or flexion to pain

Answer

Decorticate posturing

Answer

Decerebrate posturing

Answer

Localizes to pain

Question 4

Pseudoclaudication is caused by

Accepted Answer

Lumbar canal stenosis

Answer

Femoral Artery stenosis

Answer

Popliteal Artery stenosis

Answer

Radial Artery stenosis

Question 5

A patient undergoing a minor surgical procedure is given lignocaine injection. Assertion: Local anaesthetics act by blocking nerve conduction. Reason: Small fibers and non-myelinated fibers are blocked more easily than large myelinated fibers.

Accepted Answer

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

Answer

Assertion is false, but Reason is true

Answer

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

Answer

Assertion is true, but Reason is false

Question 6

Oxygen consumption increases in pregnancy by

Accepted Answer

20%

Answer

10%

Answer

30%

Answer

40%

Question 7

Supraomohyoid dissection is a type of?

Accepted Answer

Selective neck dissection

Answer

Modified radical neck dissection

Answer

Radical neck dissection

Answer

Posterolateral dissection

Question 8

A 45-year-old female underwent a modified radical mastectomy with axillary clearance for breast cancer. Post-surgery, she is unable to lift her arm above her head. Which nerve is most likely to be injured?

Accepted Answer

Long thoracic nerve of Bell

Answer

Intercostobrachial nerve

Answer

Nerve to latissimus Dorsi

Answer

Lateral Pectoral nerve

Question 9

Which of the following statements about Hirschsprung disease is incorrect?

Accepted Answer

The non-peristaltic affected segment is dilated

Answer

Absence of ganglion cells in the involved segment

Answer

Mainly presents in infancy

Answer

Swenson, Duhamel, and Soave are surgical procedures for this condition

Question 10

Which of the following statements about Branchial cysts is true:

Accepted Answer

Most common site is lateral neck

Answer

50-70% are seen in lungs

Answer

They are premalignant lesions

Answer

Infection is uncommon in branchial cysts

NEET-PG 2015

Anatomy

Internal Medicine

Pharmacology

Physiology

Surgery