NEET-PG 2019 Practice Questions

Q: Which nerve supplies the area marked as ‘Area B’ in the image?

Radial nerve. ***Radial nerve*** - Area B represents the sensory distribution of the **radial nerve**, specifically its superficial branch. - The radial nerve provides sensory innervation to the **dorsal (back) aspect of the hand** over the radial (lateral) side, including the thumb, index, middle, and radial half of the ring finger up to the proximal interphalangeal joints. - The superficial branch of the radial nerve also innervates the **anatomical snuffbox** and the radial side of the dorsum of the hand. - **Note:** The radial nerve does NOT supply the palmar surface of the hand; its sensory distribution is limited to the dorsal aspect. *Ulnar nerve* - The ulnar nerve provides sensory innervation to the **medial 1.5 fingers** (little finger and ulnar half of ring finger) on both palmar and dorsal aspects. - It also supplies the **hypothenar eminence** and medial portion of the palm and dorsal hand. - This distribution corresponds to **Area C** in the image, not Area B. *Median nerve* - The median nerve provides sensory innervation to the **lateral 3.5 fingers** (thumb, index, middle, and radial half of ring finger) on the **palmar surface**. - It also supplies the **palmar aspect** of these digits and the **nail beds (dorsal tips)** of the same fingers. - This distribution corresponds to **Area A** in the image, not Area B. *Posterior interosseous nerve* - The **posterior interosseous nerve (PIN)** is a **motor branch** of the radial nerve with no cutaneous sensory distribution. - It supplies the extensor muscles of the posterior forearm compartment. - It does not provide sensory innervation to the skin of the hand.

Q: Which research method is most appropriate for studying the progression of a disease over time?

Cohort Study. ***Cohort Study*** - A **cohort study** observes a group of individuals over a period of time, allowing researchers to track the **natural progression of a disease** from exposure through onset and various stages. - This design is ideal for investigating the **incidence** of disease and identifying risk factors over time. *Cross sectional study* - A **cross-sectional study** assesses exposure and outcome at a **single point in time**, providing a snapshot. - It cannot establish temporality or observe disease progression, as it does not follow individuals over time. *Randomized Control Trials* - **Randomized controlled trials (RCTs)** are primarily designed to evaluate the **effectiveness of interventions** or treatments by comparing outcomes between an experimental group and a control group. - While they follow participants over time, their main goal is not to study the natural progression of an untreated disease. *Interventional Studies* - **Interventional studies** involve manipulating an exposure or treatment to observe its effect, often to test a hypothesis about a causal relationship. - While they track outcomes over time, their focus is on the impact of the intervention rather than the natural history or progression of a disease without intervention.

Q: A 6-year-old boy presents with fever and chills, cough, rapid breathing, difficulty breathing, and chest pain. A culture from a respiratory sample shows Gram-positive bacteria. What is the most likely organism causing this infection?

Streptococcus pneumoniae. ***Streptococcus pneumoniae*** - This clinical picture describes typical symptoms of **pneumonia** in a child, including fever, cough, rapid and difficult breathing, and chest pain. - **_Streptococcus pneumoniae_** is the most common bacterial cause of community-acquired pneumonia in children. The respiratory sample showing gram-positive bacteria further supports this. *Staphylococcus aureus* - While **_Staphylococcus aureus_** can cause pneumonia, it is less common than _Streptococcus pneumoniae_ in community-acquired cases in healthy children and often associated with more severe, necrotizing forms or post-viral infections. - While it is a **Gram-positive bacterium**, its clinical presentation would not be the most likely first choice for typical pneumonia symptoms in this age group. *Propionibacterium acnes* - **_Propionibacterium acnes_** (now *Cutibacterium acnes*) is primarily associated with **acne vulgaris** and, less commonly, opportunistic infections related to implanted devices or some rare soft tissue infections. - It is not a typical cause of primary respiratory infections like pneumonia. *Streptococcus pyogenes* - **_Streptococcus pyogenes_** (Group A Streptococcus) is known for causing **pharyngitis** (strep throat), skin infections (impetigo, cellulitis), and scarlet fever. - While it can rarely cause pneumonia, it is not a common cause, and the constellation of symptoms points more strongly to _Streptococcus pneumoniae_.

Q: What is the presenting diameter of a fully flexed head?

Suboccipito-bregmatic diameter. ***Suboccipito-bregmatic diameter*** - This diameter measures from the **nape of the neck** (**suboccipital region**) to the **anterior fontanelle** (**bregma**), which is the smallest presenting diameter of the fetal head when it is in **full flexion**. - A fully flexed head presents the smallest and most favorable diameter for vaginal birth, allowing for optimal passage through the birth canal. *Suboccipito-frontal diameter* - This diameter is measured from the **nape of the neck to the center of the forehead**, indicating a less flexed head than the suboccipito-bregmatic diameter. - While it represents some flexion, it is not the ideal presenting diameter for a fully flexed head and is larger than the suboccipito-bregmatic diameter. *Occipito-frontal diameter* - This diameter is measured from the **occipital protuberance to the forehead**, representing a **deflexed** or **partially flexed** head. - This presentation is less favorable for vaginal delivery as it is a larger diameter than either the suboccipito-bregmatic or suboccipito-frontal diameters. *Biparietal diameter* - This diameter measures the **widest transverse diameter of the fetal head**, between the two parietal eminences. - While clinically important for assessing head size and growth, it is **not a presenting longitudinal diameter** that describes the leading part of the fetal head during engagement and descent.

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 is the most common ocular finding in myasthenia gravis?

Ptosis. ***Ptosis*** - **Ptosis**, or drooping of the eyelid, is the most common ocular manifestation of **myasthenia gravis**, affecting a large majority of patients. - It results from **weakness of the levator palpebrae superioris muscle**, which is responsible for lifting the eyelid. *Lagophthalmos* - **Lagophthalmos** is the inability to close the eyelids completely, often due to facial nerve palsy or severe proptosis. - While it can lead to exposure keratopathy, it is **not a primary or common finding** in myasthenia gravis. *Proptosis* - **Proptosis** (or exophthalmos) is the forward bulging of the eyeball, most commonly associated with **Graves' ophthalmopathy**. - It is **not a feature of myasthenia gravis**, which typically involves muscle weakness, not orbital mass effects. *Enophthalmos* - **Enophthalmos** refers to the posterior displacement of the eyeball within the orbit, often seen in conditions like **orbital fractures** or Horner's syndrome. - It is **not associated with the neuromuscular dysfunction** characteristic of myasthenia gravis.

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: A 2-year-old boy weighing 12 kg is diagnosed with vitamin A deficiency. What is the recommended oral dose of vitamin A for him?

200,000 I.U.. ***200,000 I.U.*** - According to **WHO guidelines**, for children aged **12 months and older** with vitamin A deficiency, the recommended oral dose is **200,000 I.U.** - This dose is given immediately upon diagnosis, repeated the next day, and a third dose is given 2-4 weeks later. - Since this child is **2 years old**, he falls into the ≥12 months category requiring 200,000 I.U. *100,000 I.U.* - A dose of **100,000 I.U.** is recommended for infants aged **6-11 months** with vitamin A deficiency. - This child is 2 years old, making 100,000 I.U. an insufficient dose for his age group. *50,000 I.U.* - A dose of **50,000 I.U.** is recommended for infants **younger than 6 months** diagnosed with vitamin A deficiency. - This dose is too low for a 2-year-old child. *150,000 I.U.* - **150,000 I.U.** is not a standard WHO-recommended dose for vitamin A deficiency treatment in any pediatric age group. - This is an incorrect dosing option.

Q: The Confusion Assessment Method (CAM) is used for which of the following?

Delirium. ***Delirium*** - The Confusion Assessment Method (CAM) is a widely used and highly sensitive and specific tool for the rapid identification of **delirium**. - It assesses for acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. *Schizophrenia* - Schizophrenia is a chronic mental health disorder primarily characterized by **psychosis**, including hallucinations, delusions, and disorganized thought. - While patients with schizophrenia can experience cognitive difficulties, specialized scales like the Positive and Negative Syndrome Scale (PANSS) are used, not the CAM. *Dementia* - Dementia is a gradual and progressive decline in cognitive function, including memory, thinking, and reasoning, severe enough to interfere with daily life. - Tools like the mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA) are used for screening and assessing dementia, not the CAM. *Depression* - Depression is a mood disorder characterized by persistent sadness, loss of interest, and other emotional and physical symptoms. - Assessment tools like the Hamilton Depression Rating Scale (HDRS) or Patient Health Questionnaire-9 (PHQ-9) are used for depression.

Q: Most common type of gallstone is?

Pure cholesterol stones. ***Mixed stones*** - Mixed gallstones, typically composed of **cholesterol** and **pigment**, are the most prevalent type, accounting for about 70-80% of cases [1]. - They are often associated with **biliary stasis** and **inflammation**, contributing to their formation. *Pigment stones* - Pigment stones are less common, usually representing about 10-20% of gallstones [1]. They are primarily formed from **bilirubin** and are associated with conditions causing **hemolysis**. - They may lead to **complications**, but their overall incidence is lower compared to mixed stones. *Calcium bilirubinate* - These stones are a type of **pigment stone**, formed in conditions like chronic hemolytic anemia, but they are relatively rare overall [1]. - They specifically result from **excess bilirubin**, unlike the mixed stones' composition which includes **cholesterol**. *Pure cholesterol stones* - Pure cholesterol stones occur in about 10-15% of cases, developing primarily due to **supersaturation of cholesterol** in bile. - They are less common than mixed stones and typically present as **large, yellowish stones** in the gallbladder.

Question 1

Which nerve supplies the area marked as ‘Area B’ in the image?

Accepted Answer

Radial nerve

Answer

Ulnar nerve

Answer

Median nerve

Answer

Posterior interosseous nerve

Question 2

Which research method is most appropriate for studying the progression of a disease over time?

Accepted Answer

Cohort Study

Answer

Cross sectional study

Answer

Randomized Control Trials

Answer

Interventional Studies

Question 3

A 6-year-old boy presents with fever and chills, cough, rapid breathing, difficulty breathing, and chest pain. A culture from a respiratory sample shows Gram-positive bacteria. What is the most likely organism causing this infection?

Accepted Answer

Streptococcus pneumoniae

Answer

Streptococcus pyogenes

Answer

Staphylococcus aureus

Answer

Propionibacterium acnes

Question 4

What is the presenting diameter of a fully flexed head?

Accepted Answer

Suboccipito-bregmatic diameter

Answer

Suboccipito-frontal diameter

Answer

Occipito-frontal diameter

Answer

Biparietal diameter

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 is the most common ocular finding in myasthenia gravis?

Accepted Answer

Ptosis

Answer

Lagophthalmos

Answer

Proptosis

Answer

Enophthalmos

Question 7

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 8

A 2-year-old boy weighing 12 kg is diagnosed with vitamin A deficiency. What is the recommended oral dose of vitamin A for him?

Accepted Answer

200,000 I.U.

Answer

50,000 I.U.

Answer

100,000 I.U.

Answer

150,000 I.U.

Question 9

The Confusion Assessment Method (CAM) is used for which of the following?

Accepted Answer

Delirium

Answer

Schizophrenia

Answer

Dementia

Answer

Depression

Question 10

Most common type of gallstone is?

Accepted Answer

Pure cholesterol stones

Answer

Pigment stones

Answer

Calcium bilirubinate

Answer

Mixed stones

NEET-PG 2019

Anatomy

Community Medicine

Microbiology

Obstetrics and Gynecology

Ophthalmology

Orthopaedics

Pediatrics

Psychiatry

Surgery