NEET-PG 2024

354 Questions — Page 11 of 36

Anatomy

2 questions

Q101

Linear growth of bone is disturbed when a fracture occurs in which part?

Q102

The "O sign" formed by the thumb and index finger is affected. Which muscle is most likely injured?

NEET-PG 2024 - Anatomy NEET-PG Practice Questions and MCQs

Question 101: Linear growth of bone is disturbed when a fracture occurs in which part?

A. Epiphysis
B. Diaphysis
C. Metaphysis
D. Epiphyseal plate (Correct Answer)
E. Periosteum

Explanation: ***Epiphyseal plate*** - The **epiphyseal plate**, also known as the **growth plate**, is a cartilaginous disc responsible for the **longitudinal growth** of long bones. - A fracture in this region can damage the **chondrocytes** and disrupt the normal process of endochondral ossification, leading to **growth arrest** or limb length discrepancy. *Epiphysis* - The **epiphysis** is the end part of a long bone, often covered by **articular cartilage**, forming a joint. - While an epiphyseal fracture can affect joint function, it typically does not directly disturb the **linear growth** of the bone unless it extends into the growth plate. *Diaphysis* - The **diaphysis** is the main or midsection of a long bone, composed primarily of **compact bone**. - Fractures in the diaphysis generally heal through **callus formation** and remodeling, usually without significantly impacting the overall **linear growth** of the bone. *Metaphysis* - The **metaphysis** is the wider portion of a long bone, adjacent to the growth plate and diaphysis. - Though highly vascular, fractures to the metaphysis usually heal well and do not directly control **linear bone growth** like the epiphyseal plate. *Periosteum* - The **periosteum** is the fibrous membrane covering the outer surface of bones, important for **appositional growth** (bone widening) and fracture healing. - While it contains osteogenic cells that contribute to bone repair and thickness, it does not control **longitudinal bone growth**, which is the function of the epiphyseal plate.

Question 102: The "O sign" formed by the thumb and index finger is affected. Which muscle is most likely injured?

A. Opponens pollicis
B. Flexor pollicis longus (Correct Answer)
C. Flexor pollicis brevis
D. Abductor pollicis brevis
E. Flexor digitorum profundus (index finger)

Explanation: ***Flexor pollicis longus*** - The **"O sign"** (or **"OK sign"**) tests the ability to form a tight **tip-to-tip pinch** between the thumb and index finger, creating a circular "O" shape. - This requires **flexion of the thumb interphalangeal (IP) joint** via the **flexor pollicis longus (FPL)** and **flexion of the index finger distal interphalangeal (DIP) joint** via the **flexor digitorum profundus (FDP)**. - Both FPL and FDP to the index/middle fingers are innervated by the **anterior interosseous nerve (AIN)**, a branch of the median nerve. - **AIN palsy** results in inability to flex the thumb IP and index DIP joints, causing the **"O sign"** to become flattened (pinch sign or **"teardrop sign"**). - Injury to **FPL** specifically impairs thumb IP flexion, directly affecting the ability to form the **"O sign"**. *Flexor digitorum profundus (index finger)* - The **FDP to the index finger** is also innervated by the **AIN** and is essential for flexing the DIP joint of the index finger. - Isolated FDP injury would affect the index finger's contribution to the "O sign" but both FPL and FDP are typically affected together in AIN palsy. - This is a plausible answer, making this a higher-order question testing understanding of the anatomy. *Opponens pollicis* - The **opponens pollicis** enables **opposition** of the thumb, bringing the thumb pad to the finger pads (pad-to-pad pinch). - It is innervated by the **recurrent branch of the median nerve**, not the AIN. - Opposition is different from the **tip-to-tip pinch** required for the "O sign," which requires IP joint flexion, not just opposition at the carpometacarpal joint. *Flexor pollicis brevis* - The **flexor pollicis brevis** flexes the thumb at the **metacarpophalangeal (MCP) joint**, not the IP joint. - The superficial head is innervated by the recurrent branch of the median nerve, while the deep head is innervated by the ulnar nerve. - While it contributes to thumb flexion, it does not flex the thumb IP joint, which is essential for forming the **"O sign"**. *Abductor pollicis brevis* - The **abductor pollicis brevis** abducts the thumb away from the palm in a plane perpendicular to the palm. - It is innervated by the **recurrent branch of the median nerve**. - Abduction is not required for forming the **"O sign"**, which primarily tests flexion at the IP and DIP joints.

Orthopaedics

5 questions

Q101

A patient presents with a 5th metatarsal fracture. How many days would he/she need to wear a cast?

Q102

A football player experienced a twist in the ankle and knee. Clinically, no bone injury was appreciated. The examiner is performing the test shown in the image. Which test is this?

Q103

The X-ray shows plating done for a fracture. How does this fracture heal?

Q104

Identify the condition shown in the image:

Q105

A 10-year-old boy presents with the physical findings shown in the image, characterized by inward angulation of the elbows. What is the most likely diagnosis?

NEET-PG 2024 - Orthopaedics NEET-PG Practice Questions and MCQs

Question 101: A patient presents with a 5th metatarsal fracture. How many days would he/she need to wear a cast?

A. 6-8 weeks (Correct Answer)
B. 2-3 weeks
C. 16-20 weeks
D. 3-5 weeks

Explanation: ***6-8 weeks*** - For most **5th metatarsal fractures**, especially **Jones fractures** or more significant avulsion fractures, **non-weight-bearing** immobilization in a cast, boot, or splint is typically required for **6 to 8 weeks** to allow for proper bone healing. - The **poor vascular supply** to the metaphyseal-diaphyseal junction of the 5th metatarsal (in Jones fractures) often necessitates a longer immobilization period. *2-3 weeks* - This duration is generally too short for the adequate healing of most 5th metatarsal fractures, especially those that are **displaced** or involve the **watershed zone**. - A shorter period might be considered for very minor, stable **avulsion fractures** with minimal pain, but even then, a slightly longer protection might be advised. *16-20 weeks* - This length of time is typically reserved for **severe, complex fractures**, open fractures with complications, or cases requiring **multiple surgical interventions** and prolonged rehabilitation, which is not the standard for an uncomplicated 5th metatarsal fracture. - Such an extended period of immobilization could also lead to **significant muscle atrophy** and joint stiffness. *3-5 weeks* - While sometimes considered for **stable avulsion fractures** of the 5th metatarsal base or mild stress fractures, this period is often insufficient for complete healing of the more common and problematic **Jones fracture**. - Rushing the return to weight-bearing can increase the risk of **non-union** or refracture.

Question 102: A football player experienced a twist in the ankle and knee. Clinically, no bone injury was appreciated. The examiner is performing the test shown in the image. Which test is this?

A. Posterior drawer for PCL
B. McMurray
C. Lachman (Correct Answer)
D. Anterior drawer for ACL

Explanation: ***Lachman*** - The image shows the examiner holding the distal thigh and proximal tibia, with the knee flexed at a **20-30 degree angle**, applying an **anterior translational force** to the tibia. This specific maneuver is characteristic of the Lachman test. - The Lachman test is highly sensitive for detecting **anterior cruciate ligament (ACL) tears**, particularly in acute injuries, due to the reduced hamstring spasm compared to the anterior drawer test. *Posterior drawer for PCL* - The posterior drawer test involves flexing the knee to **90 degrees** and applying a **posterior force** to the tibia to assess the integrity of the **posterior cruciate ligament (PCL)**. - The position of the knee in the image (flexed at a shallower angle) and the direction of the applied force (anteriorly towards the femur) do not match the technique for a posterior drawer test. *McMurray* - The McMurray test is performed to evaluate **meniscal tears** by flexing, extending, and rotating the knee while applying a varus or valgus stress. - The maneuver in the image, involving direct anterior translation of the tibia with the knee in slight flexion, is not consistent with the McMurray test. *Anterior drawer for ACL* - While also testing the **ACL**, the anterior drawer test typically involves flexing the knee to **90 degrees** and sitting on the foot, then pulling the tibia anteriorly. - The knee flexion angle in the image is much shallower than 90 degrees, making it inconsistent with the standard anterior drawer test.

Question 103: The X-ray shows plating done for a fracture. How does this fracture heal?

A. Primary healing (Correct Answer)
B. Secondary healing
C. Tertiary healing
D. Distraction histiogenesis

Explanation: **Primary healing** - **Plating of a fracture** aims to achieve **absolute stability** at the fracture site, which facilitates primary bone healing. - In primary healing, there is **direct bone formation** across the fracture gap without the formation of a significant callus. *Secondary healing* - Secondary healing involves the formation of a **callus** (fibrous tissue, cartilage, and immature bone) to bridge the fracture gap. - This type of healing occurs in situations with **relative stability** and some micromotion at the fracture site, such as with casting or intramedullary nailing. *Tertiary healing* - **Tertiary healing** is not a recognized term in the context of fracture healing. - Bone healing typically involves either primary or secondary mechanisms depending on the stability achieved. *Distraction histiogenesis* - **Distraction histiogenesis** is the process by which new bone is formed between bone surfaces that are gradually pulled apart using an external fixator (**distraction osteogenesis**). - This is used in procedures like **limb lengthening** and is distinct from the direct healing of a fracture fixed with a plate.

Question 104: Identify the condition shown in the image:

A. Renal osteodystrophy
B. Spondylolisthesis
C. Tuberculosis (TB)
D. Spondylolysis (Correct Answer)

Explanation: ***Spondylolysis*** * The image shows a **break in the pars interarticularis** of a vertebra, indicated by the arrow, which is characteristic of spondylolysis. * This condition is a **stress fracture** or defect in the pars interarticularis, a bony segment connecting the superior and inferior articular facets. *Renal osteodystrophy* * Renal osteodystrophy refers to a spectrum of **bone abnormalities** that occur in chronic kidney disease, not a specific vertebral fracture pattern. * It typically involves features such as **osteomalacia**, **osteitis fibrosa cystica**, or **osteoporosis**, which are not directly depicted as a fracture in this image. *Spondylolisthesis* * Spondylolisthesis is the **anterior slippage** of one vertebral body over another, which can be caused by bilateral spondylolysis but is not directly shown as a slip in this specific image. * The image distinctly highlights the **fracture line** itself, rather than the displacement of the vertebral body. *Tuberculosis (TB)* * Spinal tuberculosis (Pott's disease) typically presents with **destruction of vertebral bodies**, disc space narrowing, and often a **paravertebral abscess**. * The image does not show these features; instead, it demonstrates a clear **bony defect** in the pars interarticularis.

Question 105: A 10-year-old boy presents with the physical findings shown in the image, characterized by inward angulation of the elbows. What is the most likely diagnosis?

A. Cubitus varus deformity (Correct Answer)
B. Madelung deformity
C. Nursemaid's elbow
D. Klippel-Feil syndrome

Explanation: ***Cubitus varus deformity*** - The image clearly illustrates an **inward angulation of the elbow** (gunstock deformity), which is characteristic of **cubitus varus**. This often occurs after a supracondylar fracture of the humerus that heals with malunion. - This deformity typically results in a decreased or reversed carrying angle of the elbow. *Madelung deformity* - This is a rare congenital anomaly characterized by **dorsal and radial bowing of the distal radius** and premature fusion of the ulnar physis. - It primarily affects the wrist, leading to a visible prominence of the distal ulna and carpal bone subluxation, which is not depicted in the elbow region in the image. *Nursemaid's elbow* - This is a common injury in young children where the **radial head is subluxated** from the annular ligament, often due to a sudden pull on the forearm. - It presents as acute pain and refusal to use the arm, but does not involve a chronic structural deformity or angulation of the elbow joint as shown in the image. *Klippel-Feil syndrome* - This is a rare congenital disorder characterized by the **fusion of two or more cervical vertebrae**. - Its primary manifestations are a short neck, low posterior hairline, and restricted neck movement, with no direct involvement or deformity of the elbow joint itself.

Physiology

1 questions

Q101

After ovulation, the oocyte is:

Radiology

2 questions

Q101

A man presents with back pain following a road traffic accident (RTA). There is no history of neurological deficit. An X-ray of the spine is done. What is the diagnosis based on the image?

Q102

Identify the condition shown in the given X-ray:

NEET-PG 2024 - Radiology NEET-PG Practice Questions and MCQs

Question 101: A man presents with back pain following a road traffic accident (RTA). There is no history of neurological deficit. An X-ray of the spine is done. What is the diagnosis based on the image?

A. Spinous process fracture (Correct Answer)
B. Chance fracture
C. Compression fracture
D. Fracture of base of vertebrae

Explanation: ***Spinous process fracture*** - The X-ray image reveals a **fracture of the spinous process** of one of the cervical vertebrae, characterized by a visible discontinuity or separation of this posterior bony projection. - This type of fracture, often caused by direct trauma or forceful hyperextension/hyperflexion, typically presents with localized back pain but often **without neurological deficit** as the spinal canal generally remains intact. *Chance fracture* - A **Chance fracture** (or seatbelt fracture) is a horizontal fracture of a vertebral body, usually in the thoracolumbar region, often caused by distractional forces (e.g., flexion over a seatbelt). - It involves all three columns of the spine (anterior, middle, and posterior) and is not seen in the cervical spine X-ray provided. *Compression fracture* - A **compression fracture** is characterized by the collapse of the vertebral body, often resulting in a wedge shape. - This typically appears as reduced height of the anterior vertebral body on an X-ray, which is not the primary finding in the image. *Fracture of base of vertebrae* - A **fracture at the base of the vertebrae** is a non-specific term; specific vertebral fractures are categorized based on the part of the vertebra affected (e.g., vertebral body, pedicle, lamina, spinous process). - The image distinctly shows a fracture in the **spinous process**, not the main body or base of the vertebra.

Question 102: Identify the condition shown in the given X-ray:

A. Tibial tuberosity fracture
B. Osgood-Schlatter disease (Correct Answer)
C. Gerdy's tubercle fracture
D. Lateral epicondyle of femur

Explanation: ***Correct Answer: Osgood-Schlatter disease*** - The X-ray shows characteristic **fragmentation** and **irregularity** of the **tibial tuberosity**, which is pathognomonic for Osgood-Schlatter disease. - This condition commonly affects **adolescents** during periods of rapid growth, causing **anterior knee pain** that worsens with activity. - The radiographic findings demonstrate chronic **traction apophysitis** at the insertion of the **patellar tendon**. *Incorrect: Tibial tuberosity fracture* - An acute tibial tuberosity fracture would show a **distinct fracture line** with possible displacement, rather than the chronic fragmentation pattern seen here. - This type of fracture typically results from **sudden forceful quadriceps contraction** and presents with acute onset of severe pain. *Incorrect: Gerdy's tubercle fracture* - Gerdy's tubercle is located on the **lateral aspect of the proximal tibia**, serving as the insertion point for the **iliotibial band**. - A fracture at this location would not explain the **anterior tibial tuberosity changes** visible in this X-ray image. *Incorrect: Lateral epicondyle of femur* - The lateral epicondyle of the femur is located at the **distal end of the femur**, not at the tibial tuberosity where the radiographic changes are visible. - Pathology at the lateral epicondyle would not cause the **tibial tuberosity fragmentation** seen in this X-ray.