NEET-PG 2017 Practice Questions

Q: Which of the following is correct about ear speculum insertion?

Pinna : upward, backward and laterally; Tragus: forward. ***Pinna : upward, backward and laterally; Tragus: forward*** - To properly visualize the **tympanic membrane** and ear canal in adults, the **pinna** (auricle) should be gently pulled **upward, backward, and laterally**. This maneuver helps to straighten the **ear canal**. - The **tragus** should be gently pushed **forward** to stabilize the ear and facilitate speculum insertion, minimizing discomfort [1]. *Pinna : downward, backward and laterally; Tragus: forward* - Pulling the **pinna downward** is typically recommended for **children** to straighten their ear canal. - Doing so in adults may not adequately straighten the **ear canal**, hindering visualization. *Pinna : upward, backward and medially; Tragus: forward* - While pulling the pinna **upward and backward** is correct, pulling it **medially** would likely obstruct the view or cause discomfort. - The goal is to open the **ear canal** for better visualization [1]. *Pinna : upward, forward and laterally ; Tragus: forward* - Pulling the pinna **forward** would likely curl the helix and obstruct the **external auditory canal**, making it difficult to insert the speculum. - The correct direction is **backward** to align the cartilaginous and bony parts of the canal [1].

Q: The electrode of the hearing implant shown below is placed in:

Scala tympani. ***Scala tympani*** - The electrode array of a cochlear implant is typically inserted into the **scala tympani** to deliver electrical stimulation directly to the auditory nerve fibers. - This placement avoids damage to the delicate **organ of Corti** located in the scala media. *Scala vestibuli* - The scala vestibuli is separated from the scala media by **Reissner's membrane** and contains perilymph. - Inserting the electrode here is not the standard approach and could potentially damage the **cochlear duct**. *Scala media* - The scala media (cochlear duct) contains the **organ of Corti** and endolymph, which is crucial for natural hearing. - Placing an electrode here would likely **destroy the hair cells** and organ of Corti, preventing any residual natural hearing. *Tectorial membrane* - The tectorial membrane lies above the hair cells within the **scala media** and is essential for converting mechanical vibrations into electrical signals in natural hearing. - This membrane is not a fluid-filled space and is too delicate and structurally integral for electrode insertion.

Q: Which of the following hearing aid or implant is shown below?

Cochlear implant. ***Cochlear implant*** - The image clearly shows an **electrode array** inserted into the **cochlea**, bypassing damaged hair cells and directly stimulating the auditory nerve. - This is characteristic of a **cochlear implant**, which is used for individuals with severe to profound sensorineural hearing loss. *Brainstem auditory implant* - A **brainstem auditory implant** (BAI) electrode is placed on the **cochlear nucleus** in the brainstem, not the cochlea itself. - BAIs are typically used for conditions where the auditory nerve is damaged or absent, such as in cases of **neurofibromatosis type 2** with bilateral acoustic neuromas. *Bone anchored hearing aid* - A **bone-anchored hearing aid** (BAHA) works by transmitting sound vibrations directly to the cochlea via bone conduction, typically through a surgically implanted post or magnet in the **skull bone**. - The image does not depict an external processor or bone conduction mechanism, but rather an internal electrode within the inner ear. *In the canal hearing aid* - An **in-the-canal (ITC) hearing aid** is an external device that sits within the ear canal and amplifies sound acoustically. - The image shows an **invasive internal device** implanted into the cochlea, which is distinct from a non-invasive, external ITC hearing aid.

Q: All are used for the treatment of the condition shown below except:

Canthoplasty. ***Canthoplasty*** - The image depicts **trichiasis**, a condition where eyelashes grow inwards and rub against the cornea. Canthoplasty is a surgical procedure that **modifies the outer or inner canthus of the eye** (the corners) and is not primarily used to address misdirected eyelashes. - Canthoplasty is typically performed for conditions like **ectropion** or **entropion** to correct eyelid position, or for cosmetic purposes, not for direct removal or redirection of individual eyelashes. *Electrolysis* - **Electrolysis** is a common and effective method for treating trichiasis by destroying the hair follicle with an electric current, preventing regrowth. - This procedure targets individual misdirected eyelashes, providing a long-term solution. *Electrodiathermy* - **Electrodiathermy** (also known as diathermy) uses high-frequency electrical currents to generate heat, which can be applied to destroy hair follicles, similar to electrolysis. - It is an effective treatment for permanent removal of eyelashes in cases of trichiasis. *Cryotherapy* - **Cryotherapy** involves freezing the eyelash follicles to destroy them, preventing further abnormal growth. - This technique is another viable option for the permanent removal of eyelashes in trichiasis and can be applied to a group of misdirected lashes.

Q: A 30-year-old woman presents with painful eye swelling. Based on the clinical photograph shown, the most likely diagnosis is:

Acute dacryocystitis. ***Acute dacryocystitis*** - The image shows a **painful, erythematous, and swollen area** at the medial canthus below the **medial palpebral ligament**, characteristic of acute inflammation of the lacrimal sac. - This condition results from **obstruction of the nasolacrimal duct**, leading to bacterial infection and abscess formation in the lacrimal sac. *Lacrimal gland carcinoma* - This condition typically presents as a **slow-growing mass** in the upper outer quadrant of the orbit, often causing **proptosis and displacement** of the globe, rather than acute inflammation at the medial canthus. - While it can be painful, the **acute inflammatory signs** and specific location seen in the image are not typical of lacrimal gland carcinoma. *Orbital cellulitis* - Orbital cellulitis involves inflammation and infection of the **orbital tissues posterior to the orbital septum**, causing generalized swelling of the eyelids, proptosis, pain with eye movements, and potentially vision loss. - The localized swelling near the medial canthus with obvious inflammatory signs is more consistent with a dacryocystitis, whereas orbital cellulitis would involve a broader area of swelling and often more systemic symptoms. *Hordeolum externum* - A hordeolum externum, or stye, is an acute **localized infection of a hair follicle or sebaceous gland** (gland of Zeis or Moll) along the eyelid margin. - The swelling seen in the image is much larger and more medially located, involving the lacrimal sac area, rather than being confined to the eyelid margin.

Q: A patient presents with itching in eyes with redness of eyelids. What is correct about the image shown below? (Recent NEET Pattern 2016-17)

Blepharitis. ***Blepharitis*** - The image shows **redness** and **inflammation of the eyelid margins**, often accompanied by scales or crusts at the base of the eyelashes. This is characteristic of blepharitis. - The history of **itching** and **redness of eyelids** further supports the diagnosis, as these are common symptoms of blepharitis, an immune-mediated inflammation. *Trichiasis* - This condition involves **misdirected eyelashes** that grow inwards and rub against the surface of the eye. - While it can cause irritation, the primary feature in the image is inflammation and crusting of the eyelid margin, not just misdirected lashes. *Blepharospasm* - **Blepharospasm** is an involuntary, repetitive, bilateral twitching or forceful closure of the eyelids. - This is a neurological condition affecting eyelid movement and is not depicted by the visible inflammation in the image. *Distichiasis* - **Distichiasis** is a rare condition where there is an extra row of eyelashes growing from the meibomian gland openings on the eyelid margin. - The image does not show an extra row of lashes; instead, it indicates inflammation and debris along the existing lash line.

Q: What is correct about the composition of fluid in the area marked as $X$ ?

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L. ***Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L*** - The area marked 'X' represents the **scala media** in the cochlear cross-section, which contains **endolymph**. - Endolymph has a unique ionic composition with **high potassium concentration** (150 mEq/L) and **low sodium concentration** (3 mEq/L), similar to intracellular fluid. *Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L* - This composition represents **perilymph**, found in the **scala vestibuli** and **scala tympani**, not in the scala media. - Perilymph has high Na+ and low K+ concentrations, resembling **cerebrospinal fluid** and extracellular fluid. *Na = 150 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The **potassium level of 30 mEq/L** is intermediate and doesn't match any physiological cochlear fluid composition. - This value is too high for perilymph (normally 3 mEq/L) and too low for endolymph (normally 150 mEq/L). *Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The **sodium concentration of 50 mEq/L** is abnormally low for any extracellular fluid compartment. - Neither the Na+ nor K+ values correspond to the known ionic gradients essential for **cochlear hair cell function**.

Q: What is correct about the composition of fluid in the area marked as X?

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L. ***Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L*** - The area marked as X points to the **endolymph** within the scala media of the cochlea, which has a unique high **potassium concentration** (~150 mEq/L) and low **sodium concentration** (~3 mEq/L). - This composition is maintained by the **stria vascularis** and is essential for proper **hair cell function** and hearing transduction. - The high K⁺/low Na⁺ ratio creates the **endocochlear potential** (+80 mV) necessary for cochlear amplification. *Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L* - This represents typical **extracellular fluid** or **perilymph** composition with high sodium and low potassium, which is the opposite of endolymph. - The **perilymph** is found in the scala vestibuli and scala tympani, not in the area marked as X (scala media). *Na = 152 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The sodium level is too high and potassium too low to represent **endolymph**, which requires an extreme K⁺/Na⁺ gradient for proper cochlear function. - These intermediate values don't match any specific **cochlear fluid compartment** and would not support normal hearing. *Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - Both sodium and potassium levels are insufficient to create the **electrochemical gradient** necessary for cochlear hair cell depolarization. - These values don't correspond to either **endolymph** or **perilymph** compositions found in the inner ear.

Q: The image given below shows stapedial reflex. What does ' $X$ ' denote?

Superior olivary complex. ***Superior olivary complex*** - The image depicts the neural pathway for the **stapedial reflex**, where sound input from the cochlea is processed, and the signal travels to the superior olivary complex. - From the superior olivary complex (labeled 'X'), signals project to the **facial nerve nucleus**, which then innervates the **stapedius muscle** to contract and dampen sound. *Medial geniculate body* - The medial geniculate body is part of the **thalamus** and is involved in processing auditory information before it reaches the auditory cortex. - It is a more rostral structure in the auditory pathway and is not directly involved in the brainstem reflex arc of the stapedius reflex at the labeled point 'X'. *Superior colliculus* - The superior colliculus is primarily involved in **visual reflexes** and directing gaze towards salient stimuli. - Although it has some multimodal sensory integration, it is not a key relay in the auditory pathway for the stapedial reflex. *Lateral lemniscus* - The lateral lemniscus is an **ascending auditory pathway** in the brainstem, carrying information from the cochlear nuclei and superior olivary complex to higher centers like the inferior colliculus. - While it carries auditory signals, "X" represents a more specific processing center (superior olivary complex) that integrates bilateral auditory input and projects to motor nuclei for acoustic reflexes.

Question 1

All are correct about the part marked as $X$ and $Y$ except:

Accepted Answer

$X$ is utricle and has anterior upward slope of 30 degrees

Answer

$Y$ is ductus reuniens

Answer

$Y$ connects utricle to cochlear duct

Answer

$X$ is utricle and receives 5 openings of three semicircular canals

Question 2

Which of the following is correct about ear speculum insertion?

Accepted Answer

Pinna : upward, backward and laterally; Tragus: forward

Answer

Pinna : downward, backward and laterally; Tragus: forward

Answer

Pinna : upward, backward and medially; Tragus: forward

Answer

Pinna : upward, forward and laterally ; Tragus: forward

Question 3

The electrode of the hearing implant shown below is placed in:

Accepted Answer

Scala tympani

Answer

Scala vestibuli

Answer

Scala media

Answer

Tectorial membrane

Question 4

Which of the following hearing aid or implant is shown below?

Accepted Answer

Cochlear implant

Answer

Brainstem auditory implant

Answer

Bone anchored hearing aid

Answer

In the canal hearing aid

Question 5

All are used for the treatment of the condition shown below except:

Accepted Answer

Canthoplasty

Answer

Electrolysis

Answer

Electrodiathermy

Answer

Cryotherapy

Question 6

A 30-year-old woman presents with painful eye swelling. Based on the clinical photograph shown, the most likely diagnosis is:

Accepted Answer

Acute dacryocystitis

Answer

Lacrimal gland carcinoma

Answer

Orbital cellulitis

Answer

Hordeolum externum

Question 7

A patient presents with itching in eyes with redness of eyelids. What is correct about the image shown below? (Recent NEET Pattern 2016-17)

Accepted Answer

Blepharitis

Answer

Trichiasis

Answer

Blepharospasm

Answer

Distichiasis

Question 8

What is correct about the composition of fluid in the area marked as $X$ ?

Accepted Answer

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L

Answer

Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Question 9

What is correct about the composition of fluid in the area marked as X?

Accepted Answer

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L

Answer

Na = 152 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Answer

Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Question 10

The image given below shows stapedial reflex. What does ' $X$ ' denote?

Accepted Answer

Superior olivary complex

Answer

Medial geniculate body

Answer

Superior colliculus

Answer

Lateral lemniscus

NEET-PG 2017

Anatomy

ENT

Ophthalmology

Physiology