NEET-PG 2024 Practice Questions

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

Epiphyseal plate. ***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.

Q: 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?

Lachman. ***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.

Q: Identify the condition shown in the given X-ray:

Osgood-Schlatter disease. ***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.

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

Primary healing. **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.

Q: Identify the condition shown in the image:

Spondylolysis. ***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.

Q: 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?

Cubitus varus deformity. ***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.

Q: After ovulation, the oocyte is:

Secondary oocyte arrested in metaphase II. ***Secondary oocyte arrested in metaphase II*** - After ovulation, the **oocyte** has completed **meiosis I** and extruded the **first polar body**, becoming a secondary oocyte. - It then arrests in **metaphase II** and will only complete meiosis II upon fertilization by a sperm. *Primary oocyte arrested in prophase II* - A **primary oocyte** is the stage before meiosis I is completed, and it is arrested in **prophase I** at birth, not prophase II. - Oocytes do not arrest in **prophase II** during normal meiotic development. *Secondary oocyte arrested in prophase II* - While it is a **secondary oocyte** that is ovulated, it is arrested in **metaphase II**, not prophase II. - **Prophase II** is a transient stage that occurs just before metaphase II, and arrest at this stage is not typical for the ovulated oocyte. *Primary oocyte arrested in prophase I* - This describes the state of the oocyte from **fetal development** until just before ovulation. - A **primary oocyte** completes meiosis I only in response to the **LH surge** before ovulation.

Q: Which of the following prevents polyspermy?

Cortical reaction. ***Cortical reaction*** - The **cortical reaction** is the primary mechanism that prevents **polyspermy** following sperm-oocyte fusion. - Upon fusion, **cortical granules** in the oocyte cytoplasm release their contents (including proteases and peroxidases) into the **perivitelline space**. - These enzymes modify the **zona pellucida** proteins, making it impermeable to additional sperm - this modification is called the **zona reaction**. - The cortical reaction represents both the **fast block** (depolarization of oocyte membrane) and **slow block** (zona pellucida hardening) to polyspermy. *Zona reaction* - The **zona reaction** is the biochemical and structural change that occurs in the zona pellucida as a **result** of the cortical reaction. - It involves hardening and altered permeability of the zona pellucida, making it resistant to sperm penetration. - While this is the ultimate barrier to polyspermy, it is a **consequence** rather than the active mechanism - the cortical reaction is the causative event. *Acrosome reaction* - The **acrosome reaction** is essential for fertilization, allowing sperm to penetrate the zona pellucida by releasing hydrolytic enzymes. - It **facilitates** sperm entry rather than preventing additional sperm from binding. - This reaction must occur for the first sperm to fertilize the egg but plays no role in preventing polyspermy. *Capacitation* - **Capacitation** is the physiological maturation of sperm in the female reproductive tract. - It enables sperm to undergo the acrosome reaction and achieve fertilization competence. - It is a preparatory process and has no role in preventing polyspermy.

Q: 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?

Spinous process fracture. ***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 1

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

Accepted Answer

Epiphyseal plate

Answer

Epiphysis

Answer

Diaphysis

Answer

Metaphysis

Answer

Periosteum

Question 2

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

Accepted Answer

Flexor pollicis longus

Answer

Opponens pollicis

Answer

Flexor pollicis brevis

Answer

Abductor pollicis brevis

Answer

Flexor digitorum profundus (index finger)

Question 3

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?

Accepted Answer

Lachman

Answer

Posterior drawer for PCL

Answer

McMurray

Answer

Anterior drawer for ACL

Question 4

Identify the condition shown in the given X-ray:

Accepted Answer

Osgood-Schlatter disease

Answer

Tibial tuberosity fracture

Answer

Gerdy's tubercle fracture

Answer

Lateral epicondyle of femur

Question 5

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

Accepted Answer

Primary healing

Answer

Secondary healing

Answer

Tertiary healing

Answer

Distraction histiogenesis

Question 6

Identify the condition shown in the image:

Accepted Answer

Spondylolysis

Answer

Renal osteodystrophy

Answer

Spondylolisthesis

Answer

Tuberculosis (TB)

Question 7

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?

Accepted Answer

Cubitus varus deformity

Answer

Madelung deformity

Answer

Nursemaid's elbow

Answer

Klippel-Feil syndrome

Question 8

After ovulation, the oocyte is:

Accepted Answer

Secondary oocyte arrested in metaphase II

Answer

Primary oocyte arrested in prophase II

Answer

Secondary oocyte arrested in prophase II

Answer

Primary oocyte arrested in prophase I

Question 9

Which of the following prevents polyspermy?

Accepted Answer

Cortical reaction

Answer

Acrosome reaction

Answer

Zona reaction

Answer

Capacitation

Question 10

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?

Accepted Answer

Spinous process fracture

Answer

Chance fracture

Answer

Compression fracture

Answer

Fracture of base of vertebrae

NEET-PG 2024

Anatomy

Orthopaedics

Physiology

Radiology