NEET-PG 2021 Practice Questions

Q: A 50-year-old male presents with backache, morning stiffness, red eye, and ankle swelling. Based on the X-ray provided, what is the most likely diagnosis?

Ankylosing Spondylitis. ***Ankylosing Spondylitis*** - The X-ray likely shows features of **sacroiliitis** (joint space narrowing, sclerosis, erosion) and possibly **vertebral fusion**, consistent with ankylosing spondylitis. The clinical presentation of **backache, morning stiffness, red eye (uveitis), and ankle swelling (enthesitis)** are classic extra-articular manifestations and peripheral arthritis of ankylosing spondylitis. - X-ray findings like **bamboo spine** (late stage), syndesmophytes, and erosions of the sacroiliac joints are characteristic of this seronegative spondyloarthropathy. *Paget's Disease* - Paget's disease is characterized by disorganized bone remodeling, leading to bone enlargement, deformity, and increased density or lysis. It typically does not present with **sacroiliitis** or widespread **ankylosis**. - Clinical features usually include **bone pain**, **bone deformities**, and potentially **nerve compression**, which are not the primary symptoms described. *Healed TB spine* - Healed TB spine (Pott's disease) would typically show bone destruction, collapse of vertebral bodies, **kyphosis**, and often calcified abscesses. - While backache can occur, the presence of **red eye** and **ankle swelling** are not characteristic of spinal tuberculosis. *Osteopetrosis* - Osteopetrosis is a rare genetic disorder characterized by **increased bone density** due to defective osteoclast function, leading to abnormally thick and brittle bones. - The X-ray would show **generalized sclerosis** (diffuse increased bone density) throughout the skeleton, which is not the primary finding indicated by the clinical context of sacroiliitis and joint fusion.

Q: A mother brings her daughter with short stature, webbed neck, and other physical features. What is the most likely finding on ultrasound?

Streak ovaries with small uterus. ***Streak ovaries with small uterus*** - The constellation of **short stature** and **webbed neck** is highly suggestive of **Turner syndrome (45,X0)**. - A characteristic feature of Turner syndrome is **gonadal dysgenesis**, which manifests as **streak ovaries** and a **small uterus** due to the absence of normal ovarian development. *Hepatomegaly with altered echotexture* - This finding is more indicative of **liver disease** or metabolic disorders, which are not primary features of Turner syndrome. - While Turner syndrome can be associated with various health issues, **hepatomegaly** is not a common or defining ultrasonographic finding. *Echo showing tricuspid stenosis* - **Cardiac abnormalities** are common in Turner syndrome, but the most frequent ones are **bicuspid aortic valve** and **coarctation of the aorta**, not typically **tricuspid stenosis**. - **Tricuspid stenosis** is a rare congenital heart defect and not specifically associated with Turner syndrome. *Single kidney* - **Renal anomalies**, such as a **horseshoe kidney** or **renal agenesis**, can occur in Turner syndrome. - However, the description of **single kidney** is less specific than **streak ovaries** in identifying the most likely finding given the presented clinical features of short stature and webbed neck.

Q: A patient with infertility has an ultrasound (USG) suggestive of a uterine anomaly. Which of the following is the best method to confirm the diagnosis?

Hysteroscopy + Laparoscopy. ***Hysteroscopy + Laparoscopy*** - This combination allows for a comprehensive evaluation: **hysteroscopy** visualizes the uterine cavity to confirm the type of anomaly (e.g., septum), while **laparoscopy** assesses the external uterine contour and overall pelvic anatomy. - It is considered the **gold standard** for diagnosing complex uterine anomalies as it provides the most detailed information for both diagnosis and surgical planning. *Hysterosalpingography (HSG)* - HSG can delineate the **uterine cavity morphology** and patency of fallopian tubes. - However, it is an **X-ray based test** and does not provide information about the external contour of the uterus, which is crucial for differentiating anomalies like a bicornuate from a septate uterus. *Transvaginal Sonography (TVS)* - While TVS is an excellent initial screening tool and can suggest a uterine anomaly, it often **lacks the definitive resolution** to precisely classify the anomaly, especially differentiating between septate and bicornuate uteri. - Its accuracy can be **operator-dependent** and limited in visualizing the external uterine contour. *Laparoscopy* - Laparoscopy alone provides an excellent view of the **external uterine contour** and pelvic organs. - However, it **does not visualize the internal uterine cavity**, which is essential for identifying and classifying anomalies such as a uterine septum.

Q: The image shows a wrist deformity and an X-ray of a bone lesion near the distal radius. Based on the clinical and radiological features, what is the most likely diagnosis?

Giant Cell Tumor (GCT). ***Giant Cell Tumor (GCT)*** * The image shows a **lytic (lucid) lesion** located in the **epiphysis/metaphysis of the distal radius**, which is a classic presentation site for GCT. * GCTs are typically seen in individuals aged 20-40, often present with **pain, swelling, and reduced range of motion**, and can show a **soap bubble appearance** on X-ray even with cortical erosion as seen in the image. *Ewing's Sarcoma* * Ewing's Sarcoma commonly affects the **diaphysis of long bones** and may present with an **onion skin periosteal reaction**, none of which are clearly depicted. * It primarily affects children and young adults (5-20 years old), which does not align with the assumed adult presentation given the fused epiphysis. *Osteochondroma* * Osteochondromas are **bony prominences covered by cartilage** and grow **outward from the bone surface**, often away from the joint, unlike the intraosseous lytic lesion seen. * They typically appear as **pedunculated or sessile exostoses** and are benign growth plate abnormalities, not lytic lesions of the marrow cavity. *Osteoid Osteoma* * Osteoid osteomas are characterized by a **small lucent nidus** (usually <1.5 cm) surrounded by a significant margin of **sclerotic bone**, which is not seen here. * They classically cause **nocturnal pain** relieved by NSAIDs and are typically smaller than the lesion depicted, which appears expansile.

Q: A baby was playing unattended and suddenly developed respiratory distress. Based on the X-ray provided, where is the foreign object most likely located?

Esophagus. ***Esophagus*** - The frontal X-ray shows a **coin-shaped foreign body** that is oriented in the **coronal plane** (flat face visible), which is characteristic of an object lodged in the esophagus. - The foreign body is located in the **upper mediastinum**, directly in the known anatomical path of the esophagus, causing respiratory distress due to **extrinsic compression** of the trachea or aspiration. *Trachea* - Foreign bodies in the trachea, especially flat objects like coins, typically orient themselves in the **sagittal plane** (on edge) due to the C-shaped cartilaginous rings. - While tracheal foreign bodies can cause respiratory distress, the orientation on the image is inconsistent with a tracheal location. *Right main bronchus* - The **right main bronchus** is the most common site for aspirated foreign bodies in children due to its wider diameter and more vertical orientation. - However, foreign bodies in the bronchus would typically show air trapping or atelectasis on chest X-ray, and the location and orientation of this object in the upper mediastinum are not consistent with bronchial placement. *Gastrointestinal tract* - The foreign body is located in the **chest cavity**, well above the stomach and intestines. - If a foreign body reaches the gastrointestinal tract, it would typically be beyond the esophagus and would not usually cause acute respiratory distress. *Below diaphragm* - The diaphragm separates the chest cavity from the abdominal cavity. The foreign body is clearly visible within the **chest cavity**, high up in the mediastinum. - A foreign body below the diaphragm in the gastrointestinal tract would not result in the appearance or the acute respiratory distress described without other symptoms.

Q: A patient presents with ear discharge. The CT image is shown below. Based on the clinical presentation and imaging, what is the most likely diagnosis?

Temporal lobe abscess. ***Temporal lobe abscess*** - The CT scan shows a **ring-enhancing lesion** in the **temporal lobe**, which is characteristic of a brain abscess. - **Ear discharge** (otorrhea), particularly from otitis media, is a common predisposing factor for temporal lobe abscesses due to the proximity of the middle ear and mastoid to the temporal lobe. - Otogenic brain abscesses account for a significant proportion of intracranial complications from ear infections, with the temporal lobe being the most common location. *Extradural abscess* - An **extradural abscess** would typically be located between the dura mater and the skull, often presenting as a **lenticular or biconvex collection** displacing the dura and brain, not within the brain parenchyma as seen here. - While ear infections can lead to extradural abscesses, the imaging clearly shows an intraparenchymal lesion. *Cerebellar abscess* - A **cerebellar abscess** would be located in the cerebellum (posterior fossa), which is a different anatomical location from the lesion seen in the image (which is in the supratentorial compartment, consistent with the temporal lobe). - Although ear infections can also lead to cerebellar abscesses, the lesion's position on the CT scan does not correspond to the cerebellum. *Meningitis* - **Meningitis** is an inflammation of the meninges and typically manifests on CT as **leptomeningeal enhancement**, particularly in the sulci and basal cisterns, rather than a discrete, encapsulated mass lesion like an abscess. - While ear discharge can be associated with meningitis, the imaging findings strongly point to an abscess, not diffuse meningeal inflammation.

Question 1

A 50-year-old male presents with backache, morning stiffness, red eye, and ankle swelling. Based on the X-ray provided, what is the most likely diagnosis?

Accepted Answer

Ankylosing Spondylitis

Answer

Paget's Disease

Answer

Healed TB spine

Answer

Osteopetrosis

Question 2

A mother brings her daughter with short stature, webbed neck, and other physical features. What is the most likely finding on ultrasound?

Accepted Answer

Streak ovaries with small uterus

Answer

Hepatomegaly with altered echotexture

Answer

Echo showing tricuspid stenosis

Answer

Single kidney

Question 3

A patient with infertility has an ultrasound (USG) suggestive of a uterine anomaly. Which of the following is the best method to confirm the diagnosis?

Accepted Answer

Hysteroscopy + Laparoscopy

Answer

Hysterosalpingography (HSG)

Answer

Transvaginal Sonography (TVS)

Answer

Laparoscopy

Question 4

The image shows a wrist deformity and an X-ray of a bone lesion near the distal radius. Based on the clinical and radiological features, what is the most likely diagnosis?

Accepted Answer

Giant Cell Tumor (GCT)

Answer

Ewings Sarcoma

Answer

Osteochondroma

Answer

Osteoid Osteoma

Question 5

A baby was playing unattended and suddenly developed respiratory distress. Based on the X-ray provided, where is the foreign object most likely located?

Accepted Answer

Esophagus

Answer

Trachea

Answer

Gastrointestinal tract

Answer

Below diaphragm

Answer

Right main bronchus

Question 6

A patient presents with ear discharge. The CT image is shown below. Based on the clinical presentation and imaging, what is the most likely diagnosis?

Accepted Answer

Temporal lobe abscess

Answer

Extradural abscess

Answer

Cerebellar abscess

Answer

Meningitis

NEET-PG 2021

Internal Medicine

OB/GYN

Obstetrics and Gynecology

Orthopaedics

Pediatrics

Radiology