Anatomy
2 questionsWhich nerve passes through the structure shown? (Recent NEET Pattern 2019)
Identify the structure shown below. (Recent NEET Pattern 2019)
NEET-PG 2019 - Anatomy NEET-PG Practice Questions and MCQs
Question 281: Which nerve passes through the structure shown? (Recent NEET Pattern 2019)
- A. Inferior alveolar nerve (Correct Answer)
- B. Lingual nerve
- C. Buccal nerve
- D. Hypoglossal nerve
Explanation: ***Inferior alveolar nerve*** - The image points to the **mandibular foramen**, an opening on the medial surface of the mandibular ramus. - The **inferior alveolar nerve** enters the mandible through this foramen to supply sensation to the mandibular teeth. *Lingual nerve* - The **lingual nerve** typically runs anterior to the inferior alveolar nerve in the infratemporal fossa but does not pass through the mandibular foramen. - It supplies general sensation and taste to the anterior two-thirds of the tongue. *Buccal nerve* - The **buccal nerve** passes between the two heads of the lateral pterygoid muscle and supplies sensation to the buccal mucosa and gingiva, not traveling within the mandible. - It arises from the anterior division of the mandibular nerve. *Hypoglossal nerve* - The **hypoglossal nerve (CN XII)** is a motor nerve for the tongue muscles and is located entirely outside the mandible. - It exits the skull through the hypoglossal canal and runs in the neck and floor of the mouth.
Question 282: Identify the structure shown below. (Recent NEET Pattern 2019)
- A. Fornix (Correct Answer)
- B. Corpus callosum
- C. Pineal gland
- D. Splenium
- E. Septum pellucidum
Explanation: ***Fornix*** - The arrow points to a C-shaped bundle of **nerve fibers** in the brain that acts as the primary efferent (output) pathway of the **hippocampus**, a crucial structure for memory. - It is located inferior to the corpus callosum and its position in the image is consistent with the anatomical location of the fornix. *Corpus callosum* - The corpus callosum is a large, **C-shaped nerve fiber bundle** located beneath the cerebral cortex in the longitudinal fissure, connecting the left and right cerebral hemispheres. - While visible in the image, the arrow specifically indicates the structure immediately beneath it, which is the fornix, not the corpus callosum itself. *Pineal gland* - The **pineal gland** is a small endocrine gland located in the epithalamus, near the center of the brain, behind the thalamus. - Its position is medial and inferior to the structure indicated by the arrow. *Splenium* - The **splenium** is the posterior, thicker part of the **corpus callosum**, forming its most caudal end. - The arrow points to a more anterior and inferior structure than the splenium. *Septum pellucidum* - The **septum pellucidum** is a thin, vertical membrane separating the anterior horns of the left and right lateral ventricles. - It is located superior and anterior to the fornix, positioned between the corpus callosum above and the fornix below, which is different from the structure indicated by the arrow.
Dermatology
3 questionsWhat is the diagnosis of the lesion visible in neck folds of this child?
In a patient with the following lesion on scalp, what changes are seen in the nails?
The following image shows
NEET-PG 2019 - Dermatology NEET-PG Practice Questions and MCQs
Question 281: What is the diagnosis of the lesion visible in neck folds of this child?
- A. SSSS
- B. Intertriginous candida (Correct Answer)
- C. Impetigo
- D. Ecthyma
Explanation: ***Intertriginous candida*** - The image shows **erythema, scaling, and white satellite lesions** in a skin fold, which is characteristic of candidal intertrigo. - This condition thrives in **warm, moist environments** like neck folds of infants, often presenting with burning and itching. *SSSS* - **Staphylococcal Scalded Skin Syndrome (SSSS)** is characterized by widespread **erythema and superficial blistering**, leading to skin peeling, which is not seen here. - It usually involves a more diffuse rash and often has a **positive Nikolsky sign**, unlike the localized lesion shown. *Impetigo* - **Impetigo** typically presents with **honey-colored crusts** and is caused by bacterial infection, primarily *Staphylococcus aureus* or *Streptococcus pyogenes*. - While it can occur in skin folds, the characteristic white, cheesy appearance and satellite lesions seen in the image are not typical of impetigo. *Ecthyma* - **Ecthyma** is a more severe, ulcerative form of impetigo, characterized by **punched-out ulcers with adherent crusts** that extend into the dermis. - The lesion in the image does not show the deep ulceration or dense, dark crusts associated with ecthyma.
Question 282: In a patient with the following lesion on scalp, what changes are seen in the nails?
- A. Azure nails
- B. Dorsal pterygium of nails
- C. Pitting of nails (Correct Answer)
- D. Yellow nail discolouration
Explanation: ***Pitting of nails*** - The image shows a patch of **alopecia areata** on the scalp. **Nail pitting** is the most common and characteristic nail change associated with alopecia areata, occurring in **10-66% of cases**. - Pitting appears as small depressions or **"ice-pick" marks** on the nail surface, resulting from defective nail matrix keratinization. - Other nail changes in alopecia areata include **trachyonychia (rough nails), red spotted lunulae, onycholysis**, and **Beau's lines**. *Dorsal pterygium of nails* - **Dorsal pterygium** occurs when the proximal nail fold fuses with and extends over the nail plate, creating a wing-like scar. - This is classically associated with **lichen planus, trauma, burns, vasculitis**, and **graft-versus-host disease** — **NOT alopecia areata**. - It can lead to permanent nail dystrophy or nail loss. *Azure nails* - **Azure nails** (blue nails) are typically associated with **Wilson's disease** (copper accumulation) or **minocycline use**, not alopecia areata. - They represent a blue-gray discoloration of the nail bed or lunula. *Yellow nail discolouration* - **Yellow nail syndrome** is a rare condition characterized by slow-growing, thickened, yellow nails, often associated with **lymphedema** and **respiratory problems** (pleural effusions, chronic bronchitis). - It is not linked to alopecia areata.
Question 283: The following image shows
- A. Dermoid cyst
- B. Sebaceous cyst
- C. Neurofibroma
- D. Encephalocele (Correct Answer)
Explanation: ***Encephalocele*** - The image shows a **protrusion (sac) on the scalp** of a child, suggesting a congenital defect where brain tissue and/or meninges herniate through a defect in the skull. This is characteristic of an **encephalocele**. - **Encephaloceles** often present as a skin-covered or membranous sac, typically found along the midline of the skull, as depicted in the image. *Dermoid cyst* - A dermoid cyst is a **benign tumor** that contains mature skin structures like hair follicles and sebaceous glands. - While they can occur on the scalp, they are typically **smaller, firmer, and do not communicate with the intracranial cavity**, unlike the large, soft-appearing protrusion in the image. *Sebaceous cyst* - A sebaceous cyst, or epidermoid cyst, is a **closed sac under the skin** filled with keratin and fatty material. - These are generally **firm, mobile, and do not represent a herniation of intracranial contents**, making them unlikely given the size and appearance of the lesion. *Neurofibroma* - A neurofibroma is a **benign tumor of nerve sheath cells** that can manifest as a skin lesion or subcutaneous nodule. - While they can vary in size, they usually appear as soft, fleshy growths and are **not associated with a skull defect or herniation of brain tissue**, which is the defining feature of the lesion shown.
General Medicine
1 questionsDrug of choice for following infection (as shown in image) in a HIV patient: (NEET Pattern 2019)
NEET-PG 2019 - General Medicine NEET-PG Practice Questions and MCQs
Question 281: Drug of choice for following infection (as shown in image) in a HIV patient: (NEET Pattern 2019)
- A. INH+ Rifampicin
- B. Cotrimoxazole (Correct Answer)
- C. Doxycycline
- D. Azithromycin
Explanation: ***Cotrimoxazole*** - The image shows numerous **dark-stained cysts** and **trophozoites** within lung tissue, characteristic of **Pneumocystis jirovecii pneumonia (PCP)**, a common opportunistic infection in HIV patients. - **Cotrimoxazole (trimethoprim-sulfamethoxazole)** is the drug of choice for the treatment and prophylaxis of PCP. *INH + Rifampicin* - This combination is used for the treatment of **tuberculosis**, characterized by **acid-fast bacilli** and granulomas, which are not seen in this image. - While TB is common in HIV patients, the morphology in the image is not consistent with Mycobacterium tuberculosis. *Doxycycline* - Doxycycline is a broad-spectrum antibiotic used for various bacterial infections, including atypical pneumonia, but it is not effective against **Pneumocystis jirovecii.** - It is also used for malaria prophylaxis and Rickettsial infections. *Azithromycin* - Azithromycin is an antibiotic primarily effective against atypical bacteria like **Mycoplasma** and **Chlamydia**, and it is used for **MAC (Mycobacterium avium complex)** prophylaxis in advanced HIV. - It has no role in the treatment of Pneumocystis jirovecii pneumonia.
Microbiology
2 questionsThe following culture medium is used for the isolation of: (NEET Pattern 2019)
CSF gram stain of a child suffering with meningitis is shown below. What is the causative agent? (NEET Pattern 2019)
NEET-PG 2019 - Microbiology NEET-PG Practice Questions and MCQs
Question 281: The following culture medium is used for the isolation of: (NEET Pattern 2019)
- A. Listeria
- B. Legionella (Correct Answer)
- C. Escherichia
- D. Campylobacter
Explanation: ***Legionella*** - The image displays growth on **buffered charcoal yeast extract (BCYE) agar**, which is the selective medium for the isolation of *Legionella* species. - *Legionella* requires **L-cysteine** and **iron salts** for growth, which are provided in BCYE agar, making it distinctively well-suited for its isolation. *Listeria* - *Listeria* species are typically isolated on selective media such as Oxford agar or PALCAM agar, which contain **antibiotics** and **chromogenic substrates** to differentiate them from other bacteria. - While *Listeria* can grow on general purpose media, BCYE agar is not the primary selective medium for its isolation. *Escherichia* - **Escherichia coli** is a common fecal coliform that grows readily on various non-selective media like blood agar and selective/differential media such as MacConkey agar (lactose fermenter with pink colonies) or eosin methylene blue (EMB) agar (green metallic sheen colonies). - BCYE agar is not a standard medium for *Escherichia* isolation, as it lacks the necessary components for its optimal differentiation and growth. *Campylobacter* - **Campylobacter** species are **microaerophilic** and require specialized selective media like **Campy-BAP (Campylobacter Blood Agar Plate)**, Skirrow's medium, or CCDA (cefoperazone charcoal deoxycholate agar). - These media contain antibiotics to inhibit normal flora and are incubated in a microaerophilic atmosphere; BCYE agar is not used for *Campylobacter* isolation.
Question 282: CSF gram stain of a child suffering with meningitis is shown below. What is the causative agent? (NEET Pattern 2019)
- A. Streptococcus pneumoniae
- B. H. influenzae (Correct Answer)
- C. Klebsiella pneumoniae
- D. Staphylococcus aureus
Explanation: ***H. Influenzae*** - The image shows **Gram-negative rods or coccobacillary forms**, which are characteristic of *Haemophilus influenzae*. - *H. influenzae* is a common cause of **bacterial meningitis** in children, particularly before the widespread use of vaccines. *Streptococcus pneumoniae* - This bacterium would appear as **Gram-positive cocci** in pairs or short chains, which is not consistent with the image. - *Streptococcus pneumoniae* is also a common cause of meningitis but has a distinct morphological appearance. *Klebsiella pneumonia* - While *Klebsiella pneumoniae* is a Gram-negative rod, it is typically a larger, more plump rod, and less commonly a cause of **pediatric meningitis** compared to *H. influenzae*. - The morphology in the image, particularly the coccobacillary appearance, is more typical of *Haemophilus*. *Staphylococcus aureus* - This bacterium would appear as **Gram-positive cocci** in grape-like clusters, which clearly differs from the Gram-negative rods/coccobacillary forms seen in the image. - *Staphylococcus aureus* can cause meningitis, especially in cases of head trauma or neurosurgery, but its morphology is distinct.
Ophthalmology
1 questionsIdentify the instrument? (NEET Pattern 2019)
NEET-PG 2019 - Ophthalmology NEET-PG Practice Questions and MCQs
Question 281: Identify the instrument? (NEET Pattern 2019)
- A. Maddox rod (Correct Answer)
- B. Maddox wing
- C. Red green glasses
- D. Bagolini's striated glasses
Explanation: ***Maddox rod*** - The image displays a **Maddox rod**, characterized by a series of parallel, high-plus cylinders (rods) typically embedded in a red plastic disk with a handle. - This instrument is used to dissociate the eyes and convert a point source of light into a **line of light**, which is crucial for detecting and measuring heterophorias (latent deviations) and heterotropias (manifest deviations). *Maddox wing* - The **Maddox wing** is a different device used for measuring horizontal and vertical phorias at near. It consists of a septal plate that separates the visual fields of the two eyes, allowing the patient to see a set of scales with one eye and an arrow with the other. - It does not have the characteristic red parallel rods seen in the image. *Red green glasses* - **Red-green glasses** (or red-green anaglyph glasses) are used in various vision tests, such as stereopsis testing or some forms of vision therapy. - They selectively filter light, allowing one eye to see through a red filter and the other through a green filter, which is distinct from the multiple parallel rods shown. *Bagolini's striated glasses* - **Bagolini's striated glasses** are nearly plano lenses with very fine striations, designed to cause minimal disruption to vision while creating a streak of light from a point source. - They are primarily used to assess the presence and type of anomalous retinal correspondence and gross diplopia, and they do not have the prominent red rods as depicted.
Pathology
1 questionsA 12-year-old boy develops multiple lumps in the skin. Biopsy of the lumps is shown below. What is the probable causative agent? (NEET Pattern 2019)
NEET-PG 2019 - Pathology NEET-PG Practice Questions and MCQs
Question 281: A 12-year-old boy develops multiple lumps in the skin. Biopsy of the lumps is shown below. What is the probable causative agent? (NEET Pattern 2019)
- A. Cysticercus cellulosae (Correct Answer)
- B. Cysticercus bovis
- C. Echinococcus granulosus
- D. Hymenolepis Nana
- E. Echinococcus multilocularis
Explanation: ***Cysticercus cellulosae*** - The presence of multiple lumps in the skin, particularly in a child, is highly suggestive of **subcutaneous cysticercosis** [1]. - **_Cysticercus cellulosae_** is the larval stage of **_Taenia solium_** (pork tapeworm), which commonly encysts in subcutaneous tissues, muscles, and the brain in humans [1]. *Cysticercus bovis* - **_Cysticercus bovis_** is the larval stage of **_Taenia saginata_** (beef tapeworm). - It primarily infects cattle and is not a common cause of subcutaneous lumps in humans. *Echinococcus granulosus* - **_Echinococcus granulosus_** causes **hydatid disease**, forming large cysts primarily in the liver and lungs [1]. - While it can form cysts in other organs, it typically presents as large, solitary cysts rather than multiple small subcutaneous lumps. *Hymenolepis Nana* - **_Hymenolepis nana_** is the **dwarf tapeworm** and is the most common cestode infection in humans. - It is an intestinal parasite and does not form cysts or lumps in the skin. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 403-405.