NEET-PG 2020 Practice Questions

Q: The patient is presenting with pain around the base of the thumb. Which tendons are likely involved?

APL & EPB. ***APL & EPB*** - Pain around the base of the thumb, especially with movement, is characteristic of De Quervain's tenosynovitis [1]. This condition involves the **abductor pollicis longus (APL)** and **extensor pollicis brevis (EPB)** tendons [1]. - These two tendons share a common synovial sheath as they pass through the first dorsal compartment of the wrist, making them susceptible to inflammation and friction [1]. *APB & EPL* - **APB (Abductor Pollicis Brevis)** is an intrinsic hand muscle found in the thenar eminence, primarily involved in thumb abduction, and is not typically associated with De Quervain's tenosynovitis. - **EPL (Extensor Pollicis Longus)** is part of the third dorsal compartment and its tendon crosses over the other thumb tendons, and is not inflamed in De Quervain's tenosynovitis. *APB & EPB* - As mentioned, **APB (Abductor Pollicis Brevis)** is an intrinsic hand muscle, not involved in De Quervain's tenosynovitis. - While **EPB (Extensor Pollicis Brevis)** is involved, its combination with APB incorrectly identifies the primary tendons affected in the first dorsal compartment. *APL & EPL* - **APL (Abductor Pollicis Longus)** is one of the correct tendons involved. - **EPL (Extensor Pollicis Longus)** belongs to the third dorsal compartment of the wrist and is not typically affected in De Quervain's tenosynovitis, differentiating it from the tendons in the first dorsal compartment [1].

Q: In trochlear palsy, which specific eye movement is lost?

Downward gaze and inward rotation of the eye. ***Downward gaze and inward rotation of the eye*** - Trochlear palsy affects the **superior oblique muscle**, which is primarily responsible for **downward gaze** and **intorsion** (inward rotation) of the eye, particularly when the eye is adducted. - Patients often present with **vertical diplopia** and a **head tilt** away from the affected side to compensate for the eye misalignment. *Upward gaze* - Upward gaze is primarily mediated by the **superior rectus muscle** (innervated by the oculomotor nerve) and the **inferior oblique muscle** (also oculomotor nerve). - Trochlear nerve palsy does not directly impair the muscles responsible for moving the eye upwards. *Lateral movement of the eye* - **Lateral movement** (abduction) of the eye is controlled by the **lateral rectus muscle**, which is innervated by the **abducens nerve (CN VI)**. - A loss of lateral movement would indicate an abducens nerve palsy, not a trochlear nerve palsy. *Facial expressions* - **Facial expressions** are controlled by the muscles of facial expression, which are innervated by the **facial nerve (CN VII)**. - This is unrelated to the cranial nerves involved in eye movement.

Q: Identify the type of joint in the image provided.

Synovial joint. ***Synovial joint*** - The image depicts a **costovertebral joint**, which connects a rib to a thoracic vertebra. These joints are **diarthrotic**, meaning they are freely movable, characteristic of synovial joints. - Synovial joints are characterized by the presence of a **synovial cavity**, articular cartilage, an articular capsule, and synovial fluid, allowing for a wide range of motion. *Syndesmosis* - A syndesmosis is a type of **fibrous joint** where two bones are joined by a ligament or a membrane, allowing for very limited movement, such as the distal tibiofibular joint. - This definition does not match the image, which shows a joint designed for movement between the rib and vertebra. *Synarthrosis* - Synarthrosis is a classification for **immovable joints**, such as sutures in the skull. - The costovertebral joints, as shown, allow for movement during respiration and are therefore not synarthrotic. *Symphysis* - A symphysis is a type of **cartilaginous joint** where bones are joined by **fibrocartilage**, allowing for slight movement. Examples include the pubic symphysis or intervertebral discs. - The costovertebral joint shown in the image is a synovial articulation, not a cartilaginous joint.

Q: The image shows a highlighted region on the dorsal aspect of the hand (anatomical snuffbox). Which of the following anatomical structures form the boundaries or floor of this region?

All of the above anatomical structures.. ***All of the above anatomical structures.*** - The image highlights the **anatomical snuffbox**, a triangular depression on the radial dorsal aspect of the hand. Its boundaries are formed by the tendons of the **extensor pollicis longus muscle** (ulnar side), and the **abductor pollicis longus** and **extensor pollicis brevis muscles** (radial side). - The **styloid process of the radius** forms the floor of the anatomical snuffbox along with the scaphoid and trapezium bones. All the options listed are key anatomical features associated with this region. *Extensor pollicis longus muscle.* - This muscle forms the **ulnar (medial) border** of the anatomical snuffbox. - Its tendon can be palpated during **thumb extension** and contributes to the overall structure of the highlighted area. *Abductor pollicis longus muscle.* - This muscle, along with the extensor pollicis brevis, forms the **radial (lateral) border** of the anatomical snuffbox. - Its tendon is visible and palpable on the radial side of the highlighted region when the thumb is abducted. *Styloid process of the radius.* - This bony prominence is located at the **distal end of the radius** on the radial side of the wrist. - It forms part of the **proximal floor** of the anatomical snuffbox, contributing to its definition.

Q: Blood bags are disposed of in

Yellow bag. ***Yellow bag*** - **Yellow bags** are designated for **infectious waste** including items contaminated with **blood and body fluids** according to **Bio-Medical Waste Management Rules, 2016**. - **Blood bags** (both used and expired) are specifically categorized under **soiled waste** requiring disposal in **yellow bags**. - This waste is either incinerated or subjected to plasma pyrolysis to eliminate **bloodborne pathogens**. *Red bag* - **Red bags** are used for **contaminated recyclable waste** such as tubing, catheters, IV sets (without needles), and gloves. - While red bags handle contaminated items, they are meant for waste that can potentially be recycled after appropriate treatment, **not for blood bags**. *Black bag* - **Black bags** are designated for **general non-infectious waste** (municipal solid waste) such as paper, packaging materials, and food waste. - Disposing blood bags in black bags would violate **biomedical waste management regulations** and pose serious **infection control risks**. *White bag* - **White bags/containers** are puncture-proof containers used for **sharp waste** including needles, scalpels, and broken glass. - Blood bags are not classified as sharps and require different disposal methods due to their **infectious liquid content**.

Q: Identify the condition causing this infection on the upper arm

Tinea corporis (body ringworm). ***Tinea corporis (body ringworm)*** - This lesion, depicted on the upper arm, is characteristic of **tinea corporis** due to its **annular, erythematous, and scaly border with central clearing**. - The term "corporis" refers to the **body surface**, excluding the scalp, hands, feet, groin, and nails. *Tinea capitis (scalp ringworm)* - Tinea capitis specifically affects the **scalp** and can present with scaling, hair loss, and inflammation. - The image clearly shows a lesion on the **upper arm**, not the scalp. *Tinea cruris (jock itch)* - Tinea cruris is a fungal infection found in the **groin area**, often extending to the inner thighs and buttocks. - The location of the lesion in the image, on the **upper arm**, rules out tinea cruris. *Tinea manus (hand ringworm)* - Tinea manus affects the **hands**, typically causing dryness, scaling, and sometimes blister formation on the palms or between the fingers. - The lesion in the image is located on the **upper arm**, not the hand.

Q: Which antibody is not transmitted from mother to baby?

IgA antibodies. ***IgA antibodies*** - While IgA is found in breast milk and provides **passive immunity** to the infant's gastrointestinal tract, it is **not transferred across the placenta** to the fetus. - This antibody has a larger molecular structure and is primarily involved in **mucosal immunity**, making it unsuitable for transplacental transfer. *Diphtheria IgG antibodies* - **IgG antibodies**, including those for diphtheria, are actively transported across the **placenta** from mother to fetus during the third trimester. - This transfer provides the newborn with **passive immunity** against diphtheria during the first few months of life. *Tetanus IgG antibodies* - Similar to diphtheria IgG, **tetanus IgG antibodies** are efficiently transported across the **placenta** from mother to baby. - This offers crucial **passive protection** against tetanus, particularly important after birth. *Measles IgG antibodies* - **Measles IgG antibodies** from a vaccinated or previously infected mother cross the **placenta** to the fetus. - This maternal transfer provides temporary **passive immunity** to the newborn against measles.

Q: Esotropia is common in

Hypermetropia. ***Hypermetropia*** - **Esotropia**, or inward turning of the eye, is common in **hypermetropia** (farsightedness) due to the accommodative effort required to focus. - In hypermetropia, **excessive accommodation** is needed to see clearly at all distances, especially for **near vision**. - This constant **accommodative effort** stimulates convergence through the **accommodation-convergence reflex**, predisposing to **accommodative esotropia**, particularly in children. *Myopia* - **Myopia** (nearsightedness) is typically associated with **exotropia** (outward turning of the eye). - This is because myopic individuals exert less accommodative effort for near vision, reducing the stimulus for convergence and potentially leading to divergence of the eyes. *Emmetropia* - **Emmetropia** describes an eye with **no refractive error**, where light focuses perfectly on the retina without accommodation for distance. - Individuals with emmetropia generally have **orthophoria** (proper alignment of the eyes) and are less prone to strabismus like esotropia unless an underlying muscle imbalance is present. *Astigmatism* - **Astigmatism** is an optical defect in which the eye does not focus light evenly onto the retina, causing blurred vision at any distance. - While it can be associated with other refractive errors, **astigmatism itself is not directly or commonly associated with esotropia**.

Q: A person was given a muscle relaxant that competitively blocks nicotinic receptors. Which of the following drugs is used for reversal of muscle relaxation after surgery?

Neostigmine. ***Neostigmine*** - **Neostigmine** is an **acetylcholinesterase inhibitor** that increases the amount of acetylcholine at the neuromuscular junction, thereby overcoming the competitive block at nicotinic receptors [1], [4]. - This increase in acetylcholine effectively reverses the paralysis caused by **nondepolarizing muscle relaxants**, making it useful for post-surgical recovery [2]. *Carbachol* - **Carbachol** is a **direct-acting cholinergic agonist** that stimulates both muscarinic and nicotinic receptors and is not typically used for reversing competitive neuromuscular blockade. - Its primary use is for glaucoma and to stimulate the bladder or bowels, not to counteract muscle relaxants. *Succinylcholine* - **Succinylcholine** is a **depolarizing muscle relaxant** and would prolong, rather than reverse, muscle blockade if administered after a competitive blocker [3]. - It works by initially causing depolarization and then preventing further muscle contraction, leading to paralysis. *Physostigmine* - **Physostigmine** is an **acetylcholinesterase inhibitor** that crosses the blood-brain barrier, making it more suitable for treating central anticholinergic toxicity rather than peripheral neuromuscular blockade. - While it inhibits acetylcholinesterase, its central effects and potential for seizures limit its use for reversing surgical muscle relaxation.

Q: Patient with pulmonary fibrosis. Which antiarrhythmic drug is contraindicated?

Amiodarone. Amiodarone - **Amiodarone** is contraindicated in patients with pulmonary fibrosis due to its well-known and potentially severe pulmonary toxicity, which can exacerbate existing lung conditions or induce new ones like **interstitial lung disease**. Dose-related pulmonary toxicity is the most important adverse effect, and potentially fatal pulmonary fibrosis can be observed even at low doses [1]. - Its long half-life means that its toxic effects, including **pulmonary toxicity**, can persist for an extended period even after discontinuation [1], [2]. *Flecainide* - **Flecainide** is a Class IC antiarrhythmic drug primarily associated with cardiac side effects and is generally not contraindicated in patients with pulmonary fibrosis. - Its main risks include **proarrhythmia**, especially in patients with structural heart disease, but not pulmonary issues [3]. *IV ibutilide* - **IV ibutilide** is a Class III antiarrhythmic agent used for rapid conversion of atrial fibrillation/flutter and is not specifically contraindicated in pulmonary fibrosis. - Its primary concern is the risk of **QT prolongation** and **Torsades de Pointes**, rather than pulmonary complications. *Lidocaine* - **Lidocaine** is a Class IB antiarrhythmic typically used for ventricular arrhythmias, especially in the setting of acute myocardial infarction. It is not contraindicated in pulmonary fibrosis. - Its main side effects are **neurological (e.g., seizures, paresthesias)** at higher doses, not pulmonary complications.

Question 1

The patient is presenting with pain around the base of the thumb. Which tendons are likely involved?

Accepted Answer

APL & EPB

Answer

APB & EPL

Answer

APB & EPB

Answer

APL & EPL

Question 2

In trochlear palsy, which specific eye movement is lost?

Accepted Answer

Downward gaze and inward rotation of the eye

Answer

Upward gaze

Answer

Lateral movement of the eye

Answer

Facial expressions

Question 3

Identify the type of joint in the image provided.

Accepted Answer

Synovial joint

Answer

Syndesmosis

Answer

Synarthrosis

Answer

Symphysis

Question 4

The image shows a highlighted region on the dorsal aspect of the hand (anatomical snuffbox). Which of the following anatomical structures form the boundaries or floor of this region?

Accepted Answer

All of the above anatomical structures.

Answer

Abductor pollicis longus muscle.

Answer

Styloid process of the radius.

Answer

Extensor pollicis longus muscle.

Question 5

Blood bags are disposed of in

Accepted Answer

Yellow bag

Answer

Black bag

Answer

Red bag

Answer

White bag

Question 6

Identify the condition causing this infection on the upper arm

Accepted Answer

Tinea corporis (body ringworm)

Answer

Tinea capitis (scalp ringworm)

Answer

Tinea cruris (jock itch)

Answer

Tinea manus (hand ringworm)

Question 7

Which antibody is not transmitted from mother to baby?

Accepted Answer

IgA antibodies

Answer

Tetanus IgG antibodies

Answer

Diphtheria IgG antibodies

Answer

Measles IgG antibodies

Question 8

Esotropia is common in

Accepted Answer

Hypermetropia

Answer

Myopia

Answer

Emmetropia

Answer

Astigmatism

Question 9

A person was given a muscle relaxant that competitively blocks nicotinic receptors. Which of the following drugs is used for reversal of muscle relaxation after surgery?

Accepted Answer

Neostigmine

Answer

Carbachol

Answer

Succinylcholine

Answer

Physostigmine

Question 10

Patient with pulmonary fibrosis. Which antiarrhythmic drug is contraindicated?

Accepted Answer

Amiodarone

Answer

Flecainide

Answer

Lidocaine

Answer

IV ibutilide

NEET-PG 2020

Anatomy

Community Medicine

Dermatology

Microbiology

Ophthalmology

Pharmacology