NEET-PG 2019 Practice Questions

Q: Identify the marked muscle ‘A’ in the diagram.

Extensor carpi radialis longus. ***Extensor carpi radialis longus*** - Muscle 'A' originates from the **lateral supracondylar ridge of the humerus** and inserts into the base of the second metacarpal, consistent with the **extensor carpi radialis longus (ECRL)**. - The ECRL is part of the **superficial layer** of the posterior compartment of the forearm, responsible for **extension and abduction of the wrist**. *Brachioradialis* - While the brachioradialis also originates from the lateral supracondylar ridge, it is typically more superficial and inserts onto the **styloid process of the radius**, not the metacarpals. - Its primary action is **flexion of the elbow**, rather than wrist extension, and its belly is more anterior relative to the ECRL in this view. *Flexor carpi radialis* - This muscle is located in the **anterior compartment of the forearm** and functions as a **wrist flexor and abductor**. - It originates from the medial epicondyle and inserts into the base of the second and third metacarpals, completely different from the muscle marked 'A'. *Extensor carpi ulnaris* - The extensor carpi ulnaris (ECU) is found on the **ulnar side of the posterior forearm**, originating from the lateral epicondyle and posterior ulna, and inserting into the base of the fifth metacarpal. - Its position is medial to the marked muscle 'A', and it functions to **extend and adduct the wrist**.

Q: A child presents with a rash in the neck folds as shown in the image. The area appears erythematous with satellite lesions and maceration. What is the most likely diagnosis?

Intertrigo. ***Intertrigo*** - The image shows a reddened, inflamed rash in skin folds (neck creases), which is characteristic of **intertrigo**. This condition results from skin-on-skin friction, moisture, and warmth. - The rash appears to have satellite lesions and a somewhat macerated appearance, which would be consistent with secondary fungal (e.g., Candida) or bacterial infection, common complications of intertrigo. *Heat rash* - **Heat rash (miliaria)** typically presents as small, itchy red bumps or clear blisters, often found in areas prone to sweating. - While it can occur in skin folds, the diffuse, raw-looking erythema and presence of potential satellite lesions shown in the image are less typical for simple heat rash. *Eczema* - **Eczema (atopic dermatitis)** is characterized by dry, itchy, inflamed skin, often with scaling, crusting, or lichenification during chronic stages. - While eczema can affect skin folds, the appearance in the image (intense redness, maceration, potential satellite lesions) is more suggestive of an irritant or infectious process like intertrigo rather than typical eczema. *Impetigo* - **Impetigo** is a bacterial skin infection characterized by honey-colored crusts, vesicles, or bullae, typically appearing anywhere on the body, especially around the nose and mouth. - The rash in the image lacks the characteristic honey-colored crusts or vesiculobullous lesions associated with impetigo.

Q: Identify the cardiac condition represented in the image.

Ventricular tachycardia. ***Ventricular tachycardia*** - The image displays a **wide, regular QRS complex tachycardia**, which is characteristic of **ventricular tachycardia (VT)**. - The QRS complexes are broad and bizarre, originating from an ectopic focus within the ventricles. *Atrial fibrillation* - **Atrial fibrillation** is characterized by an **irregularly irregular rhythm** with the absence of distinct P waves and varying R-R intervals. - The rhythm shown in the image is regular, which rules out atrial fibrillation. *Atrial flutter* - **Atrial flutter** typically presents with a "sawtooth" pattern of **flutter waves** in specific leads (e.g., II, III, aVF) and a regular or irregular ventricular response, often with a 2:1 or 3:1 block. - The image does not show these characteristic flutter waves. *Supraventricular tachycardia* - **Supraventricular tachycardia (SVT)** usually presents with a **narrow QRS complex** (unless there's an underlying bundle branch block) and a regular rhythm, originating from above the ventricles. - The QRS complexes in the image are wide, indicating a ventricular origin, not supraventricular.

Q: Day 20 of menstrual cycle falls under which phase?

Luteal phase. ***Luteal phase*** - The **luteal phase** typically starts after ovulation, around day 14, and lasts until menstruation begins, usually day 28 of a 28-day cycle. Therefore, **day 20 falls squarely within this phase**. - During this phase, the **corpus luteum** forms and produces **progesterone**, preparing the uterus for potential pregnancy. *Menstrual phase* - The **menstrual phase** is the period of shedding of the uterine lining, typically occurring from **day 1 to day 5** of the menstrual cycle. - Day 20 is well past this phase, during which bleeding and low hormone levels are characteristic. *Follicular phase* - The **follicular phase** starts on day 1 of menstruation and lasts until ovulation, usually around **day 13-14** in a 28-day cycle. - During this phase, follicles mature under the influence of **FSH** and **estrogen** levels rise. Day 20 is beyond this period. *Ovulation phase* - The **ovulation phase** is a short period, typically around **day 14** of a 28-day cycle, when the mature egg is released from the ovary. - This phase is brief and marks the transition from the follicular to the luteal phase, so day 20 is considerably after ovulation.

Q: The major contributor to amniotic fluid after 20 weeks of gestation is:

Fetal urine. ***Fetal urine*** - After **20 weeks of gestation**, the **fetal kidneys** are fully functional, and fetal urination becomes the primary source of amniotic fluid. - This contribution is crucial for the **volume of amniotic fluid** and plays a vital role in **fetal lung development** by allowing the fetus to "breathe" the fluid. *Ultrafiltrate of maternal plasma* - While an ultrafiltrate of maternal plasma contributes to the early amniotic fluid volume, its significance diminishes as the **fetal kidneys mature** past 20 weeks. - This source primarily provides water and dissolved solutes, but not a substantial volume. *Fluid from fetal lungs* - Fluid produced by the fetal lungs also contributes to amniotic fluid, but its volume is considerably smaller than that from **fetal urine**, especially after 20 weeks. - It mainly includes pulmonary surfactants and other specific proteins important for lung maturation. *Fetal skin* - Before **keratinization** of the fetal skin (around 20-22 weeks), the skin is permeable and allows for transepidermal fluid transport, contributing to amniotic fluid. - However, once **keratinization** is complete, the skin becomes impermeable, and its contribution to amniotic fluid becomes negligible.

Q: Which part of scaphoid fracture is most susceptible to avascular necrosis?

Proximal 1/3rd. ***Proximal 1/3rd*** - The **scaphoid bone** has a **retrograde blood supply**, meaning blood vessels enter distally and flow towards the proximal pole. - A fracture in the **proximal 1/3rd** can disrupt the blood supply to the **proximal fragment**, making it highly susceptible to **avascular necrosis**. *Distal 1/3rd* - Fractures in the **distal 1/3rd** of the scaphoid generally have a robust blood supply due to the entry of vessels from the distal pole. - While still requiring proper management, the risk of **avascular necrosis** is significantly lower compared to proximal fractures. *Middle 1/3rd* - Fractures in the **middle 1/3rd** (waist) of the scaphoid are common and can still compromise blood flow to the proximal segment, but the risk of **avascular necrosis** is intermediate. - The more proximal the fracture within the middle third, the higher the risk of **avascular necrosis**. *Scaphoid Tubercle* - The **scaphoid tubercle** is a distal projection of the scaphoid bone. - Fractures of the **scaphoid tubercle** are extra-articular and typically have an excellent blood supply; thus, they are at very low risk for **avascular necrosis**.

Q: Bimanual grip is seen at what age?

6 months. ***6 months*** - **Bimanual grip**, which involves using both hands to grasp an object, typically develops around **6 months of age**. - This milestone marks the ability to bring objects to the midline and use both hands cooperatively. *4 months* - At **4 months**, infants typically start to reach for objects with one hand but do not yet consistently demonstrate a coordinated **bimanual grip**. - They are more likely to swipe at objects or grasp with a **primitive palmar grasp** in one hand. *5 months* - While infants at **5 months** show increasing dexterity and may bring objects to the midline, a full, consistent **bimanual grip** is usually not yet firmly established. - They are moving towards this skill but have not fully mastered it. *7 months* - By **7 months**, infants have typically refined their grasping skills, including transferring objects from hand to hand and using a **bimanual grip**. - This age is usually past the initial emergence of this specific skill.

Q: Which of the following statements is true regarding delusional disorder?

Held with absolute conviction. ***Held with absolute conviction*** - This is the **BEST ANSWER** as it describes a **core diagnostic criterion** for delusions in delusional disorder per DSM-5/ICD-11. - Delusions are defined as **fixed, false beliefs held with absolute conviction** despite clear evidence to the contrary. - This unwavering certainty is what distinguishes delusions from overvalued ideas or normal beliefs. - This statement captures the fundamental **nature and defining characteristic** of the disorder itself. *More commonly occurs in middle to late adulthood* - This statement is **factually TRUE** - delusional disorder typically has onset between ages 40-55 (middle to late adulthood). - However, this describes **epidemiological data** (when it occurs), not a defining feature of the disorder. - While accurate, it is less fundamental than the absolute conviction which is a **diagnostic criterion**. *Often not amenable to reasoning* - This statement is also **factually TRUE** - patients with delusional disorder cannot be reasoned out of their false beliefs. - However, this is a **consequence** of the absolute conviction, not the primary defining feature. - The inability to respond to reasoning stems from the unwavering belief system. *Occurs at early age* - This is **FALSE** - delusional disorder is rare in early age. - Typical onset is in **middle to late adulthood** (ages 40-55), not childhood or adolescence. - Early onset would be atypical for this disorder.

Q: Identify the condition based on the provided image.

Callosal dysgenesis. ***Callosal dysgenesis*** - The image shows **colpocephaly**, characterized by **dilatation of the posterior horns** of the lateral ventricles and narrowing of the anterior horns. This is a classic MRI finding in callosal dysgenesis. - The absence or partial formation of the **corpus callosum** leads to a high-riding third ventricle and parallel lateral ventricles, which are often visualized alongside colpocephaly. *Dandy-Walker syndrome* - Characterized by a **cystic dilatation of the fourth ventricle** that fills the posterior fossa, leading to an upward displacement of the tentorium. - This condition involves agenesis or hypoplasia of the **cerebellar vermis**, which is not depicted in this image. *Aicardi syndrome* - Aicardi syndrome is characterized by the triad of **agenesis of the corpus callosum**, **chorioretinal lacunae**, and **infantile spasms**. - While it includes agenesis of the corpus callosum, the image alone does not provide evidence of the ocular or seizure components of Aicardi syndrome. *Septo-optic dysplasia* - This condition is defined by the **triad of optic nerve hypoplasia**, **pituitary hormone abnormalities**, and **midline brain defects**, specifically hypoplasia or absence of the septum pellucidum. - The image does not show features specific to optic nerve hypoplasia or the typical midline cysts or absent septum pellucidum characteristic of septo-optic dysplasia.

Question 1

Identify the marked muscle ‘A’ in the diagram.

Accepted Answer

Extensor carpi radialis longus

Answer

Brachioradialis

Answer

Flexor carpi radialis

Answer

Extensor carpi ulnaris

Question 2

A child presents with a rash in the neck folds as shown in the image. The area appears erythematous with satellite lesions and maceration. What is the most likely diagnosis?

Accepted Answer

Intertrigo

Answer

Heat rash

Answer

Eczema

Answer

Impetigo

Question 3

Identify the cardiac condition represented in the image.

Accepted Answer

Ventricular tachycardia

Answer

Atrial fibrillation

Answer

Atrial flutter

Answer

Supraventricular tachycardia

Question 4

Day 20 of menstrual cycle falls under which phase?

Accepted Answer

Luteal phase

Answer

Menstrual phase

Answer

Follicular phase

Answer

Ovulation phase

Question 5

The major contributor to amniotic fluid after 20 weeks of gestation is:

Accepted Answer

Fetal urine

Answer

Fetal skin

Answer

Ultrafiltrate of maternal plasma

Answer

Fluid from fetal lungs

Question 6

Which part of scaphoid fracture is most susceptible to avascular necrosis?

Accepted Answer

Proximal 1/3rd

Answer

Distal 1/3rd

Answer

Middle 1/3rd

Answer

Scaphoid Tubercle

Question 7

Which statement is incorrect about the pathology of the bone tumor?

Accepted Answer

Chemotherapy is the treatment of choice for all bone tumors.

Answer

Tumor has distinct margin

Answer

Tumor arises from epiphyseal to metaphyseal region

Answer

Eccentric lesion

Question 8

Bimanual grip is seen at what age?

Accepted Answer

6 months

Answer

5 months

Answer

7 months

Answer

4 months

Question 9

Which of the following statements is true regarding delusional disorder?

Accepted Answer

Held with absolute conviction

Answer

Occurs at early age

Answer

More commonly occurs in middle to late adulthood

Answer

Often not amenable to reasoning

Question 10

Identify the condition based on the provided image.

Accepted Answer

Callosal dysgenesis

Answer

Dandy-Walker syndrome

Answer

Aicardi syndrome

Answer

Septo-optic dysplasia

NEET-PG 2019

Anatomy

Dermatology

Internal Medicine

Obstetrics and Gynecology

Orthopaedics

Pathology

Pediatrics

Psychiatry

Radiology