Anatomy
1 questionsHard palate contains:
NEET-PG 2018 - Anatomy NEET-PG Practice Questions and MCQs
Question 131: Hard palate contains:
- A. Keratinised, submucosa, minor salivary gland (Correct Answer)
- B. Keratinised, absent submucosal layer, minor salivary gland
- C. Non keratinised, submucosal layer, minor salivary gland
- D. Non keratinised, absent submucosa, minor salivary gland
Explanation: ***Keratinised, submucosa, minor salivary gland*** - The oral epithelium of the **hard palate** is predominantly **keratinized stratified squamous epithelium**, which provides protection against mechanical stress during mastication. - The hard palate has a **unique structure**: in the **median raphe and anterior region**, the mucosa is directly attached to periosteum (mucoperiosteum with no submucosa), but in the **anterolateral and posterolateral regions**, a **submucosa IS present** containing **minor salivary glands** (predominantly mucous type). - Since the question asks what the hard palate "contains," and it DOES contain submucosa in the lateral regions where glands are located, this is the correct answer. *Keratinised, absent submucosal layer, minor salivary gland* - While it is true that the **submucosa is absent in the midline/anterior region** of the hard palate, this option is incorrect because the hard palate DOES contain submucosa in the **lateral and posterior regions** where the **minor salivary glands** are located. - The presence of glands requires underlying submucosa for their placement. *Non keratinised, submucosal layer, minor salivary gland* - The hard palate is primarily covered by **keratinized epithelium**, not non-keratinized epithelium, which makes this option incorrect. - Non-keratinized epithelium is typically found in areas like the **soft palate, buccal mucosa, and ventral tongue** where less mechanical stress occurs. *Non keratinised, absent submucosa, minor salivary gland* - This option is incorrect on both counts: the epithelium is **keratinized** (not non-keratinized) and the **submucosa is present** in lateral/posterior regions where glands are located. - This combination does not accurately describe any region of the hard palate.
Internal Medicine
1 questionsWhat is a potential cause of cardiogenic shock other than myocardial infarction (MI)?
NEET-PG 2018 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 131: What is a potential cause of cardiogenic shock other than myocardial infarction (MI)?
- A. Acute mitral regurgitation (Correct Answer)
- B. Ventricular septal rupture
- C. Isolated right ventricular shock
- D. None of the options
Explanation: ***Acute mitral regurgitation*** - **Acute mitral regurgitation** is a severe form of valvular heart disease where the mitral valve fails to close properly, leading to a sudden backflow of blood into the left atrium during systole. [1] - This significantly reduces **forward cardiac output** and increases left atrial pressure, which can rapidly lead to pulmonary edema and cardiogenic shock, even in the absence of MI. [1] *Ventricular septal rupture* - While a **ventricular septal rupture** can cause cardiogenic shock, it is typically a **complication of myocardial infarction**, meaning it would fall under MI as the underlying cause. [2] - This condition involves a hole in the septum separating the ventricles, leading to a shunt and increased workload on the right ventricle, causing cardiogenic shock. *Isolated right ventricular shock* - **Isolated right ventricular shock** is often caused by conditions like a **massive pulmonary embolism** or a right ventricular infarction. [2] - While it can lead to shock, it is distinct from general cardiogenic shock which often implies left ventricular dysfunction or severe myocardial compromise, and the question asks for a cause *other than* MI, which can cause right ventricular shock. *None of the options* - This option is incorrect because **acute mitral regurgitation** is a distinct and significant cause of cardiogenic shock, independent of MI. [1]
Microbiology
1 questionsUrea breath test is used for diagnosis of:
NEET-PG 2018 - Microbiology NEET-PG Practice Questions and MCQs
Question 131: Urea breath test is used for diagnosis of:
- A. H. pylori (Correct Answer)
- B. E. coli
- C. Lactobacillus
- D. Campylobacter jejuni
Explanation: ***H. pylori*** - The **urea breath test** is a common and accurate non-invasive method to detect current **Helicobacter pylori** infection. - H. pylori produces the enzyme **urease**, which breaks down ingested urea into ammonia and carbon dioxide, which is then exhaled and measured. *Campylobacter jejuni* - **Campylobacter jejuni** is a common cause of **bacterial gastroenteritis** and typically diagnosed via **stool culture**. - It does not possess the **urease** enzyme, so a urea breath test would not be positive. *E.coli* - **E. coli** is a diverse group of bacteria, some strains causing gastrointestinal illness, but it is not associated with **urease production** for diagnostic purposes. - Diagnosis for diarrheagenic E. coli strains usually involves **stool culture** and specific toxin assays. *Lactobacillus* - **Lactobacillus** are beneficial bacteria commonly found in the gut and are not typically associated with pathogenic infections requiring a **urea breath test**. - They do not produce the **urease** enzyme in quantities relevant for this diagnostic test.
Pathology
1 questionsIn Rheumatoid arthritis, which type of cells are prominently present ?
NEET-PG 2018 - Pathology NEET-PG Practice Questions and MCQs
Question 131: In Rheumatoid arthritis, which type of cells are prominently present ?
- A. B cells
- B. T cells
- C. Macrophages (Correct Answer)
- D. Dendritic cells
Explanation: ***Macrophages*** - **Macrophages** are abundant in the inflamed synovial tissue of patients with **rheumatoid arthritis**, contributing significantly to inflammation and joint destruction [1]. - They produce various **pro-inflammatory cytokines** (e.g., TNF-̑, IL-1, IL-6) and enzymes that degrade cartilage and bone. *B cells* - While **B cells** play a role in **rheumatoid arthritis** by producing autoantibodies like **rheumatoid factor (RF)**, they are not the most prominently present immune cell type in the synovium compared to macrophages [2]. - Their presence is often concentrated in lymphocytic aggregates within the synovium [1]. *T cells* - **T cells**, particularly **CD4+ helper T cells**, are important in orchestrating the immune response in **rheumatoid arthritis** and are found in the inflamed synovium [2]. - However, **macrophages** are generally more numerous and critical for the sustained inflammatory destruction. *Dendritic cells* - **Dendritic cells** are **antigen-presenting cells** that initiate and shape immune responses in **rheumatoid arthritis**. - While present in the synovium, their numbers are generally lower than those of **macrophages** and **T cells**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Osteoarticular And Connective Tissue Disease, pp. 677-678. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, pp. 1212-1214.
Pharmacology
1 questionsAnaerobes are resistant intrinsically against which of the following?
NEET-PG 2018 - Pharmacology NEET-PG Practice Questions and MCQs
Question 131: Anaerobes are resistant intrinsically against which of the following?
- A. Aminoglycosides (Correct Answer)
- B. Azithromycin
- C. Metronidazole
- D. Beta lactam antibiotics
Explanation: ***Aminoglycosides*** - **Aminoglycosides** require an **oxygen-dependent transport system** to enter bacterial cells. [3] - Since **anaerobes** thrive in low-oxygen environments, this transport system is inactive, making them intrinsically resistant to aminoglycosides. [3] *Azithromycin* - **Azithromycin** (a macrolide) inhibits protein synthesis by binding to the 50S ribosomal subunit. - Many anaerobes are susceptible to **azithromycin**, making it an effective treatment for certain anaerobic infections. *Metronidazole* - **Metronidazole** is a potent prodrug that requires reduction by **anaerobic metabolism** to become active. [1], [2] - Its mechanism of action involves creating **cytotoxic free radicals** that damage DNA, making it highly effective against most anaerobes. [2] *Beta lactam antibiotics* - **Beta-lactam antibiotics**, such as **penicillins** and **cephalosporins**, interfere with bacterial cell wall synthesis. - While some anaerobes are susceptible, others have developed resistance mechanisms like producing **beta-lactamase enzymes**, but they are not intrinsically resistant across the board. [4]
Psychiatry
1 questionsWhat is the current preferred term for the condition previously known as mental retardation?
NEET-PG 2018 - Psychiatry NEET-PG Practice Questions and MCQs
Question 131: What is the current preferred term for the condition previously known as mental retardation?
- A. Feeble Mindedness
- B. Madness
- C. Intellectual disability (Correct Answer)
- D. Mentally unstable
Explanation: ***Correct: Intellectual disability*** - This term was adopted to replace "mental retardation" due to its less stigmatizing nature and its focus on **cognitive and adaptive functioning** - It emphasizes the need for supports and services to help individuals achieve their potential, rather than simply labeling a deficit - Officially adopted in **DSM-5 (2013)** and mandated by **Rosa's Law (2010)** in federal terminology *Incorrect: Feeble Mindedness* - This is an **outdated and derogatory term** that was used historically to describe individuals with cognitive impairments - Its use has been discontinued due to its negative and dehumanizing connotations *Incorrect: Madness* - This term typically refers to severe **mental illness** or **psychosis**, not intellectual impairment - It is an informal and often stigmatizing term that is not used in clinical or diagnostic contexts for intellectual functioning *Incorrect: Mentally unstable* - This term is often used to describe individuals experiencing **fluctuations in mood**, **behavior**, or **thought processes**, usually associated with mental health conditions - It does not specifically refer to global cognitive deficits or intellectual functioning
Radiology
1 questionsWhat type of lesions in the skull calvarium can be identified on this X-ray?
NEET-PG 2018 - Radiology NEET-PG Practice Questions and MCQs
Question 131: What type of lesions in the skull calvarium can be identified on this X-ray?
- A. Brain metastases (Correct Answer)
- B. Multiple myeloma
- C. Osteosarcoma
- D. Osteomyelitis
Explanation: ***Brain metastases (Skull metastases)*** - The image shows multiple **lytic lesions** in the skull calvarium, which are characteristic of metastatic disease that has spread to bone - Metastases from primary cancers (lung, breast, kidney, thyroid, prostate) commonly involve the skull and appear as **punched-out or moth-eaten lytic lesions** - While plain X-rays cannot visualize brain parenchyma, they can detect **bony destruction** caused by metastatic deposits in the skull - These appear as well-defined osteolytic lesions without sclerotic margins *Multiple myeloma* - Multiple myeloma typically presents with **multiple punched-out lytic lesions** in the skull that can appear very similar to metastases - However, multiple myeloma is a **primary bone marrow malignancy** rather than metastatic disease - Key differentiator: myeloma lesions are usually more uniform in size and distribution - Clinical context (monoclonal protein, anemia, renal dysfunction) helps distinguish from metastases *Osteosarcoma* - Osteosarcoma is a **primary bone tumor** that usually causes a mixture of lytic and blastic (bone-forming) lesions - Typically presents with **sunburst or spiculated periosteal reaction** and soft tissue mass - Usually occurs as a **solitary aggressive lesion** in younger patients, not multiple scattered lesions - Rarely occurs in the skull compared to long bones *Osteomyelitis* - Osteomyelitis is an **infection of the bone** that causes bone destruction and reactive new bone formation - Shows features of **bone destruction, periosteal reaction**, and possibly sequestra (dead bone fragments) - Typically presents as a **focal process** with surrounding inflammatory changes - Does not produce the multiple discrete lytic lesions pattern seen in metastatic disease
Surgery
3 questionsWhich of the following statements about the management of haematomas is NOT correct?
What is the most common indication for performing a tracheostomy?
Which is the best investigation for carcinoma of the head of pancreas?
NEET-PG 2018 - Surgery NEET-PG Practice Questions and MCQs
Question 131: Which of the following statements about the management of haematomas is NOT correct?
- A. Haematoma must be operated. (Correct Answer)
- B. Some haematomas require surgical intervention.
- C. GCS assessment is helpful in prognosis.
- D. CT scan is the investigation of choice for acute haemorrhage.
Explanation: ***Haematoma must be operated.*** - This statement is **incorrect** because not all hematomas require surgical intervention. - The decision to operate depends on **size**, **location**, **neurological status**, **mass effect**, and rate of expansion. - Small, asymptomatic hematomas can be managed **conservatively** with serial imaging and close neurological monitoring. - Absolute statements like "must be operated" are incorrect in clinical practice where individualized management is essential. *Some haematomas require surgical intervention.* - This statement is **correct** - many hematomas necessitate surgical evacuation. - Indications for surgery include: **significant mass effect**, **midline shift >5mm**, **neurological deterioration**, **large volume** (>30mL for SDH, >50mL for ICH), or **posterior fossa hematomas** causing brainstem compression. - Surgical intervention aims to relieve intracranial pressure and prevent secondary brain injury. *GCS assessment is helpful in prognosis.* - This statement is **correct** - the **Glasgow Coma Scale (GCS)** is a critical prognostic tool. - GCS is used to assess severity of neurological injury and predict outcomes in head trauma patients. - Lower GCS scores (≤8) indicate severe injury with poorer prognosis, while higher scores suggest better outcomes. - GCS also guides management decisions including need for intubation and intensive monitoring. *CT scan is the investigation of choice for acute haemorrhage.* - This statement is **correct** - **Non-contrast CT (NCCT)** is the gold standard for acute intracranial hemorrhage. - CT is rapid, widely available, and highly sensitive for detecting acute blood. - It helps identify location, size, mass effect, and associated injuries like skull fractures. - MRI has limited role in acute settings but is useful for subacute/chronic hemorrhage and detecting diffuse axonal injury.
Question 132: What is the most common indication for performing a tracheostomy?
- A. Severe obstructive sleep apnea
- B. Tracheal stenosis
- C. Vocal cord paralysis
- D. Prolonged mechanical ventilation (Correct Answer)
Explanation: ***Prolonged mechanical ventilation*** - Maintaining an **endotracheal tube** for an extended period carries risks like **tracheal injury**, **vocal cord damage**, and difficulty with oral intake. - A tracheostomy provides a more comfortable and stable airway for **long-term respiratory support**, facilitates weaning from the ventilator, and reduces the risk of **ventilator-associated pneumonia**. *Severe obstructive sleep apnea* - While tracheostomy can effectively treat severe OSA by bypassing the upper airway obstruction, it is generally considered a **last resort** after less invasive treatments have failed. - The most common initial treatments for OSA include **CPAP**, weight loss, and oral appliances. *Tracheal stenosis* - Tracheal stenosis itself is a **structural narrowing** of the trachea that may or may not require tracheostomy, depending on its severity and location. - While a tracheostomy can bypass a severe stenosis, surgical repair of the trachea is often the definitive treatment for **severe tracheal stenosis**. *Vocal cord paralysis* - Unilateral vocal cord paralysis typically causes **hoarseness** and may not always necessitate a tracheostomy. - Bilateral vocal cord paralysis can lead to **airway obstruction**, but intervention usually involves vocal cord lateralization procedures or, in severe cases, a tracheostomy for airway patency.
Question 133: Which is the best investigation for carcinoma of the head of pancreas?
- A. Transduodenal/transperitoneal sampling
- B. Guided biopsy
- C. ERCP
- D. EUS (Correct Answer)
Explanation: ***EUS*** - **Endoscopic ultrasound (EUS)** provides the highest resolution imaging of the pancreas and allows for **fine-needle aspiration (FNA)** of suspicious lesions, offering definitive tissue diagnosis. - Its ability to visualize small, early-stage tumors and regional lymph nodes makes it the **most accurate method for diagnosis and staging** of pancreatic head carcinoma. *Guided biopsy* - While a biopsy is necessary for definitive diagnosis, 'guided biopsy' is a broad term that doesn't specify the highly effective EUS guidance. - Other biopsy methods that are not guided by EUS may be less accurate and carry higher risks for pancreatic lesions. *ERCP* - **Endoscopic retrograde cholangiopancreatography (ERCP)** is primarily a therapeutic procedure used for **biliary drainage** in cases of obstruction caused by pancreatic head tumors. - Although it can visualize ductal abnormalities and allow brush cytology, it is **less sensitive for direct tumor visualization** and tissue acquisition compared to EUS-FNA. *Transduodenal/transperitoneal sampling* - These are **invasive surgical approaches** for obtaining tissue samples, typically reserved when less invasive methods like EUS-FNA are unsuccessful or when intraoperative confirmation is needed. - They carry **higher risks** and are not considered the "best investigation" for initial diagnosis due to their invasiveness and potential for complications.