Anatomy
1 questionsWhich muscle originates from 1st pharyngeal arch?
NEET-PG 2019 - Anatomy NEET-PG Practice Questions and MCQs
Question 181: Which muscle originates from 1st pharyngeal arch?
- A. Posterior belly of digastric
- B. Buccinator
- C. Masseter (Correct Answer)
- D. Stylopharyngeus
Explanation: ***Masseter*** - The **masseter muscle** is a strong muscle of mastication that originates from the **first pharyngeal arch**. - Muscles derived from the first pharyngeal arch are innervated by the **trigeminal nerve (CN V)**, which also innervates the masseter. *Posterior belly of digastric* - The **posterior belly of the digastric muscle** originates from the **second pharyngeal arch**. - It is innervated by the **facial nerve (CN VII)**, which is associated with the second pharyngeal arch. *Buccinator* - The **buccinator muscle** is a muscle of facial expression that also originates from the **second pharyngeal arch**. - Like other muscles of facial expression, it is innervated by the **facial nerve (CN VII)**. *Stylopharyngeus* - The **stylopharyngeus muscle** originates from the **third pharyngeal arch**. - It is innervated by the **glossopharyngeal nerve (CN IX)**, which is associated with the third pharyngeal arch.
Internal Medicine
3 questionsPolyuria in adults is commonly defined as urine output exceeding:
Patient with ascending paralysis, areflexia and sphincter sparing is seen in?
Not an AIDS defining illness?
NEET-PG 2019 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 181: Polyuria in adults is commonly defined as urine output exceeding:
- A. 50 ml/ kg / day
- B. 30 ml / Kg/ day
- C. 60 ml/ kg / day
- D. 40 ml / Kg/ day (Correct Answer)
Explanation: ***40 ml / Kg/ day*** - **Polyuria** is clinically defined as urine output exceeding 3 liters per 24 hours (L/day) in adults. - Converting this to a weight-based measurement for an average 75 kg adult, 3 L/day equates to approximately **40 ml/kg/day**. *50 ml/ kg / day* - This value represents a significantly higher urine output than the standard clinical definition of **polyuria**, making it an unlikely threshold. - While excessive, it would indicate a more severe and less common degree of diuresis, not the general definition. *30 ml / Kg/ day* - This value is below the typical threshold for **polyuria** and is closer to what might be considered normal or slightly elevated urine output. - Normal urine output is typically between **0.5-1 ml/kg/hour**, which translates to 12-24 ml/kg/day. *60 ml/ kg / day* - This is a substantially high urine output, indicating a profound level of **diuresis**, well beyond the standard definition of polyuria. - While possible in extreme cases, it is not the common cutoff used for defining polyuria.
Question 182: Patient with ascending paralysis, areflexia and sphincter sparing is seen in?
- A. G.B.S (Correct Answer)
- B. Botulinism
- C. Snake bite
- D. Polio
Explanation: **G.B.S** - **Guillain-Barré Syndrome (GBS)** is characterized by **ascending paralysis** and **areflexia**, meaning loss of deep tendon reflexes [1]. - **Sphincter sparing** is also typical in GBS, differentiating it from other causes of paralysis where autonomic involvement can lead to bladder and bowel dysfunction [1]. *Botulism* - Botulism typically presents with **descending paralysis**, weakness starting in the cranial nerves and progressing downwards. - While it causes significant muscle weakness and can lead to **areflexia**, the pattern of paralysis (descending vs. ascending) and the presence of prominent cranial nerve involvement help distinguish it. *Snake bite* - Neurotoxic snake bites can cause **flaccid paralysis** and **areflexia**, but the paralysis often starts at the site of the bite or affects cranial nerves preferentially before generalized ascending paralysis. - The history of a **snake bite** and presence of **local envenomation signs** (swelling, pain) would also be prominent. *Polio* - Polio primarily causes **asymmetric flaccid paralysis** and **areflexia**, due to the destruction of anterior horn cells in the spinal cord. - Unlike GBS, polio does not typically present with an ascending pattern affecting both sides symmetrically and often involves sensory sparing.
Question 183: Not an AIDS defining illness?
- A. Progressive multifocal leukoencephalopathy
- B. Lymphoma of brain < 60 years of age
- C. Extrapulmonary Cryptococcosis
- D. Tertiary Syphilis (Correct Answer)
Explanation: ***Tertiary Syphilis*** - While a serious late-stage manifestation of **syphilis**, it is not specifically listed as an **AIDS-defining illness** by the CDC, although HIV-positive individuals may be more susceptible to its complications [1]. - **Neurosyphilis**, a form of tertiary syphilis affecting the central nervous system, is also not an AIDS-defining condition on its own, unlike some other opportunistic infections [1]. *Progressive multifocal leukoencephalopathy (PML)* - PML, caused by the **JC virus**, is an **AIDS-defining illness** characterized by the progressive destruction of myelin in the brain, leading to severe neurological deficits. - It occurs almost exclusively in individuals with severe **immunodeficiency**, such as those with untreated HIV infection. *Lymphoma of brain < 60 years of age* - **Primary central nervous system (CNS) lymphoma** in individuals with HIV, especially those under 60 years of age, is an **AIDS-defining condition** [2]. - Its occurrence is strongly linked to severe immunosuppression in HIV-infected patients [2]. *Extrapulmonary Cryptococcosis* - **Cryptococcosis**, when it affects sites outside the lungs (e.g., **cryptococcal meningitis**), is an **AIDS-defining illness**. - This fungal infection is a common opportunistic infection in individuals with advanced HIV disease.
Microbiology
1 questionsCaspase involved in activation of IL-1 is which of the following?
NEET-PG 2019 - Microbiology NEET-PG Practice Questions and MCQs
Question 181: Caspase involved in activation of IL-1 is which of the following?
- A. Caspase 5
- B. Caspase 1 (Correct Answer)
- C. Caspase 8
- D. Caspase 3
Explanation: ***Caspase 1*** - **Caspase 1** (also known as interleukin-1 beta converting enzyme or ICE) is the primary caspase responsible for the proteolytic cleavage and activation of pro-IL-1β and pro-IL-18 into their mature, active forms. - This activation occurs within the **inflammasome complex**, a multiprotein oligomer that assembles in response to various pathogens and danger signals. *Caspase 5* - While **Caspase 5** is an inflammatory caspase, similar to Caspase 1, it primarily functions in the direct activation of pro-IL-1β in certain contexts, particularly in response to *Gram-negative bacteria* through the non-canonical inflammasome. - However, **Caspase 1** is the canonical and most well-known activator of IL-1 in the classical inflammasome pathway. *Caspase 8* - **Caspase 8** is a key **initiator caspase** in the extrinsic pathway of apoptosis, activated by death receptors like Fas and TNF receptors. - Its primary role is in **apoptotic signaling** and it is not directly involved in the proteolytic activation of IL-1. *Caspase 3* - **Caspase 3** is a major **effector caspase** in both the intrinsic and extrinsic pathways of apoptosis. - It executes apoptosis by cleaving numerous cellular substrates and is not directly involved in the **processing of cytokines** like IL-1.
Obstetrics and Gynecology
1 questionsA lady primigravida developed fluctuant painful mass of breast and fever after 14 days of delivery. Preferred treatment option is:-
NEET-PG 2019 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 181: A lady primigravida developed fluctuant painful mass of breast and fever after 14 days of delivery. Preferred treatment option is:-
- A. Incision and drainage (Correct Answer)
- B. Analgesics and continue breast feeding
- C. Antipyretic
- D. Stop lactation
Explanation: ***Incision and drainage*** - A **fluctuant, painful mass** in the breast combined with **fever** 14 days postpartum strongly indicates a **breast abscess**, which requires surgical drainage as the definitive treatment. - **I&D removes the pus collection** and is the preferred treatment for an established abscess, usually combined with **appropriate antibiotics** (though the primary intervention is drainage). - After drainage, breastfeeding can typically be **continued from the unaffected breast** while the affected side heals. *Analgesics and continue breast feeding* - While analgesics can relieve pain and continuing breastfeeding is appropriate for **simple mastitis**, these measures are **insufficient for an established abscess** with a fluctuant collection. - An abscess requires drainage; conservative management alone will not resolve a loculated pus collection. *Antipyretic* - An antipyretic will help reduce the **fever symptomatically**, but it does not address the underlying **purulent collection or infection**. - It would only mask symptoms without treating the cause, potentially delaying appropriate surgical intervention. *Stop lactation* - Stopping lactation abruptly can lead to **breast engorgement** and may worsen milk stasis, potentially complicating the infection. - While temporary cessation from the affected breast during acute infection might be considered, outright stopping lactation is **not the preferred primary treatment** for an abscess and may interfere with recovery.
Pediatrics
1 questionsCongenital Rubella Syndrome includes all except
NEET-PG 2019 - Pediatrics NEET-PG Practice Questions and MCQs
Question 181: Congenital Rubella Syndrome includes all except
- A. SN deafness
- B. Cataract
- C. VSD
- D. Intracerebral hemorrhage (Correct Answer)
Explanation: ***Intracerebral hemorrhage*** - This is not a typical manifestation of **Congenital Rubella Syndrome** (CRS). Symptoms of CRS primarily include sensory, cardiac, and ocular defects, not bleeding into the brain. *SN deafness* - **Sensorineural (SN) deafness** is a very common and characteristic symptom of **Congenital Rubella Syndrome**, often bilateral, due to damage to the organ of Corti. - It is one of the classic triad of manifestations of CRS. *Cataract* - **Cataracts** (clouding of the lens) are a prominent ocular defect in CRS, often leading to significant vision impairment or blindness. - Ocular defects like cataracts and **microphthalmia** are part of the classic clinical picture. *VSD* - **Ventricular Septal Defect (VSD)** is a common cardiac anomaly seen in CRS, caused by rubella virus infection during heart development. - Other common cardiac defects include **Patent Ductus Arteriosus (PDA)** and **Pulmonary Artery Stenosis**.
Pharmacology
2 questionsWhich of the following is a contraindication to the use of Beta Blockers:
Reason for preferring Cisatracurium over Atracurium is:-
NEET-PG 2019 - Pharmacology NEET-PG Practice Questions and MCQs
Question 181: Which of the following is a contraindication to the use of Beta Blockers:
- A. Severe asthma with bronchospasm (Correct Answer)
- B. Thyroid storm
- C. Glaucoma
- D. AV nodal reentrant tachycardia (AVNRT)
Explanation: ***Severe asthma with bronchospasm*** - Beta-blockers, especially **non-selective ones**, can block beta-2 receptors in the lungs, leading to **bronchoconstriction** and worsening asthma symptoms. - This can precipitate a severe **asthma attack** and respiratory distress, making it an **absolute contraindication**. - Even cardioselective beta-blockers should be avoided in severe asthma. *Thyroid storm* - Beta-blockers are often used in **thyroid storm** to manage hyperadrenergic symptoms like **tachycardia** and **tremors**. - Propranolol also has the added benefit of inhibiting peripheral conversion of T4 to T3. - They are not contraindicated but rather an important part of treatment. *Glaucoma* - Topical beta-blockers (e.g., timolol) are commonly used to treat **glaucoma** by **reducing aqueous humor production**, thereby lowering intraocular pressure. - Oral beta-blockers also have this effect and are not contraindicated in glaucoma. *AV nodal reentrant tachycardia (AVNRT)* - Beta-blockers are frequently used in the management of **AVNRT** by slowing AV nodal conduction. - They are effective in both acute termination and prophylaxis of AVNRT episodes. - **Note:** Beta-blockers ARE contraindicated in **atrial fibrillation with Wolff-Parkinson-White syndrome** (pre-excited AF), as blocking the AV node can preferentially conduct through the accessory pathway, potentially causing ventricular fibrillation.
Question 182: Reason for preferring Cisatracurium over Atracurium is:-
- A. Faster acting than Atracurium
- B. Shorter action than Atracurium
- C. Lesser provocation of histamine release (Correct Answer)
- D. Does not undergo Hoffman elimination
Explanation: ***Lesser provocation of histamine release*** - **Cisatracurium** is preferred over atracurium primarily due to its significantly **lower potential to induce histamine release**, leading to fewer cardiovascular side effects like hypotension and tachycardia. - This property makes cisatracurium a **safer option** for patients prone to hemodynamic instability or allergic reactions. *Faster acting than Atracurium* - Both atracurium and cisatracurium are **intermediate-acting** neuromuscular blockers, and their onset times are quite similar, with cisatracurium sometimes having a slightly *slower* onset. - The difference in onset time is **not clinically significant** enough to be a primary reason for preference. *Shorter action than Atracurium* - **Cisatracurium** has a slightly **longer duration of action** compared to atracurium, although both are considered intermediate-acting drugs. - Therefore, a shorter duration of action is **not a reason for its preference**; instead, it might even be a slight disadvantage in certain clinical scenarios requiring rapid reversal. *Does not undergo Hoffman elimination* - Both atracurium and cisatracurium undergo **Hoffman elimination** (non-enzymatic degradation) and ester hydrolysis, which allows for their use in patients with renal or hepatic dysfunction. - This is a shared characteristic, not a distinguishing factor that makes cisatracurium superior, and cisatracurium actually relies *more* heavily on Hoffman elimination.
Surgery
1 questionsMost commonly used approach for retrosternal goitre:-
NEET-PG 2019 - Surgery NEET-PG Practice Questions and MCQs
Question 181: Most commonly used approach for retrosternal goitre:-
- A. Transthoracic second intercostal space
- B. Axillary approach
- C. Trans-sternal through anterior mediastinum
- D. Transcervical (Correct Answer)
Explanation: ***Transcervical*** - The transcervical approach is the **most common and preferred method** for resecting retrosternal goitres, as the majority can be delivered through the **thoracic inlet**. - This approach minimizes morbidity and avoids the need for a **sternotomy** in most cases. *Transthoracic second intercostal space* - This approach is typically reserved for **mediastinal masses** or procedures requiring direct access to the **pleural cavity**, which is generally not necessary for retrosternal goitres. - It would involve a more invasive incision than typically required for a goitre that can be delivered transcervically. *Axillary approach* - The axillary approach is primarily used for **lymph node dissection** in breast cancer or for certain **thoracoscopic procedures**, not for accessing the thyroid gland for retrosternal goitre removal. - Its anatomical location does not provide adequate exposure to the **cervical and mediastinal structures** involved in a retrosternal goitre. *Trans-sternal through anterior mediastinum* - A trans-sternal approach (sternotomy) is a **major surgical procedure** typically reserved for very large, irreducible retrosternal goitres that have significant **mediastinal extension** or are adherent to surrounding structures. - It is avoided whenever possible due to increased morbidity and longer recovery compared to the transcervical approach, making it less commonly used overall.