Internal Medicine
2 questionsTuberculosis of the spine; what is the most common site affected?
In axillary nerve paralysis, which of the following statements is false?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1071: Tuberculosis of the spine; what is the most common site affected?
- A. Sacral
- B. Dorsolumbar (Correct Answer)
- C. Lumbosacral
- D. Cervical
Explanation: ***94ed055d-c7da-4d18-a2fd-52720dfe8b6e*** - The **dorsolumbar (thoracolumbar)** region is the most common site of **spinal tuberculosis (Pott's disease)** [1] due to its high vascularity, facilitating hematogenous spread. - **Spinal tuberculosis** typically affects the vertebral bodies, leading to their destruction, kyphosis (angular deformity), and potentially neurological deficits [1]. *aebdfe6c-98dc-4073-892f-bb24d047bab4* - The **sacral** region can be affected by **tuberculosis**, but it is considerably less common than the thoracolumbar region. - Involvement of the sacrum is often associated with **direct extension** from adjacent structures, such as the sacroiliac joint, rather than primary vertebral involvement. *15c1feef-e3ca-496f-a180-127d52b77bfa* - **Cervical spine tuberculosis** is relatively rare, accounting for a small percentage of all spinal tuberculosis cases. - While possible, it presents with specific challenges due to the proximity of vital neurological and vascular structures. *d05d4d13-bb83-4f26-aa2d-c9c0203d299c* - The **lumbosacral region** (L5-S1) can be involved in **tuberculosis**, but it is less frequently affected than the thoracolumbar region. - While the lumbar spine is a common site, the entire lumbosacral region as a single entity is not the most common spot for spinal TB.
Question 1072: In axillary nerve paralysis, which of the following statements is false?
- A. Extension of shoulder with arm abducted to 90 degrees is impossible (Correct Answer)
- B. Deltoid muscle is wasted
- C. Small area of numbness is present over the shoulder region
- D. Patient cannot initiate abduction
Explanation: Extension of shoulder with arm abducted to 90 degrees is impossible - The **axillary nerve** primarily innervates the **deltoid** and **teres minor muscles**. [2] - While axillary nerve paralysis would affect abduction and external rotation, the ability to *extend* the shoulder from an abducted position is mainly a function of muscles like the **posterior deltoid** (also innervated by axillary nerve to varying degrees) and latissimus dorsi, and its impossibility is not a definitive and exclusive sign of axillary nerve paralysis, as other muscles contribute to extension. *Deltoid muscle is wasted* - The **deltoid muscle** is the principal muscle supplied by the **axillary nerve**. [2] - Paralysis leads to **denervation atrophy**, causing visible wasting and weakness of the deltoid. [1] *Small area of numbness is present over the shoulder region* - The **axillary nerve** gives rise to the **upper lateral cutaneous nerve of the arm**. - Damage to the nerve results in sensory loss in a small, circumscribed area over the **deltoid insertion**. [2] *Patient cannot initiate abduction* - The **deltoid muscle**, innervated by the **axillary nerve**, is the primary abductor of the arm after the initial 0-15 degrees (supraspinatus). [2] - Paralysis of the deltoid significantly impairs or prevents the initiation and execution of **shoulder abduction**.
Orthopaedics
5 questionsAfter chronic use of steroids severe pain in right hip with immobility is due to
In neglected cases of CTEV, which joints are fused?
What is the primary pathology associated with Congenital Dislocation of the Hip (CDH)?
How is the degree of deformity in scoliosis calculated?
What is a Pulled Elbow?
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1071: After chronic use of steroids severe pain in right hip with immobility is due to
- A. Avascular necrosis (Correct Answer)
- B. Perthes disease
- C. Hip dislocation
- D. Osteoarthritis
Explanation: ***Avascular necrosis*** - Chronic **steroid use** is a major risk factor for avascular necrosis (AVN), particularly affecting the **femoral head** of the hip. - Reduced blood supply leads to bone death, resulting in severe pain and impaired mobility. *Perthes disease* - This is a condition of idiopathic **avascular necrosis of the femoral head** occurring in **children**, primarily between ages 4-10. - It is not associated with steroid use and typically presents in a different age group. *Hip dislocation* - Hip dislocation presents with **acute, severe pain** and an inability to bear weight or move the hip, often due to significant trauma. - While it causes immobility, it is an **acute traumatic event** rather than a chronic consequence of steroid use. *Osteoarthritis* - Osteoarthritis is a degenerative joint disease characterized by **cartilage breakdown** and joint pain that typically **worsens with activity** and improves with rest. - While chronic hip pain can be due to osteoarthritis, its direct link to steroid use for severe pain and immobility as described is less prominent than AVN.
Question 1072: In neglected cases of CTEV, which joints are fused?
- A. Calcaneocuboid, talonavicular, and talocalcaneal joints (Correct Answer)
- B. Tibiotalar, calcaneocuboid, and talonavicular joints
- C. None of the above joints
- D. Ankle joint, calcaneocuboid, and talonavicular joints
Explanation: ***Calcaneocuboid, talonavicular, and talocalcaneal joints*** - In neglected cases of **clubfoot (CTEV)**, a **triple arthrodesis** is performed to correct the deformity. - This procedure involves the fusion of the **subtalar (talocalcaneal)**, **talonavicular**, and **calcaneocuboid joints** to provide a stable, plantigrade foot. *Tibiotalar, calcaneocuboid, and talonavicular joints* - The **tibiotalar joint (ankle joint)** is generally preserved in triple arthrodesis for CTEV to maintain ankle motion. - Fusing the tibiotalar joint would significantly **reduce ankle dorsiflexion and plantarflexion**, leading to a stiff ankle. *None of the above joints* - This option is incorrect because the fusion of specific joints is a recognized surgical treatment for severe, neglected CTEV. - **Triple arthrodesis** is a well-established procedure for correcting rigid foot deformities. *Ankle joint, calcaneocuboid, and talonavicular joints* - As mentioned, fusion of the **ankle joint (tibiotalar joint)** is generally avoided in triple arthrodesis for CTEV to preserve functional ankle motion. - The goal is to stabilize the foot while retaining as much articulation as possible in the ankle itself.
Question 1073: What is the primary pathology associated with Congenital Dislocation of the Hip (CDH)?
- A. Large head of femur
- B. Shallow acetabulum (Correct Answer)
- C. Excessive retroversion
- D. Coxa vara deformity
Explanation: ***Shallow acetabulum*** - A **shallow or dysplastic acetabulum** is the primary pathological feature in CDH, leading to an unstable or dislocated femoral head. - This anatomical abnormality prevents the femoral head from seating properly, causing **instability** and potential **dislocation**. *Large head of femur* - While femoral head abnormalities can occur, a **disproportionately large femoral head** is not the primary or most common pathological feature causing CDH. - The issue primarily lies with the **acetabular socket** rather than the size of the femoral head itself. *Excessive retroversion* - **Femoral retroversion** (backward twisting of the femoral neck relative to the femoral condyles) can be a contributing factor or an associated finding, but it is not the primary anatomical defect. - The principal pathology is the **inadequate containment** of the femoral head by a poorly formed acetabulum. *Coxa vara deformity* - **Coxa vara** is a deformity where the angle between the head and shaft of the femur is decreased. - While it can be associated with or contribute to hip instability in some conditions, it is not the primary or defining pathological feature of CDH.
Question 1074: How is the degree of deformity in scoliosis calculated?
- A. Hamburger method
- B. Haldane method
- C. Milwaukee method
- D. Cobb's method (Correct Answer)
Explanation: ***Cobb's method*** - This is the **standard radiographic measurement** used to assess the severity of spinal curvature in scoliosis. - It involves drawing lines along the **most tilted vertebrae** at the ends of the curve and measuring the angle formed by their intersection. *Hamburger method* - This is not a recognized method for calculating the degree of deformity in scoliosis. - There is **no established medical or orthopedic technique** bearing this name for scoliosis assessment. *Haldane method* - This method is primarily used in **biochemistry** to describe **enzyme kinetics** and is unrelated to scoliosis measurement. - It describes the relationship between reaction rates and reactant concentrations in biological systems. *Milwaukee method* - The **Milwaukee brace** is a historical type of orthotic device used to treat scoliosis, but it is not a method for calculating the degree of deformity. - While it is associated with scoliosis treatment, it does not involve the measurement of the curve itself.
Question 1075: What is a Pulled Elbow?
- A. Subluxation of proximal radio ulnar joint
- B. Complete separation of the elbow joint
- C. No injury present
- D. Partial dislocation of the radial head (Correct Answer)
Explanation: ***Partial dislocation of the radial head*** - A pulled elbow, also known as **nursemaid's elbow**, specifically refers to a **subluxation of the radial head** from the annular ligament. - This injury typically occurs in young children when their arm is suddenly pulled or jerked, causing the **radial head** to slip out of the **annular ligament**. *Complete separation of the elbow joint* - A complete separation of the elbow joint would involve a **full dislocation** of the humeroulnar or humeroradial joints, a much more severe injury than a pulled elbow. - This would present with more significant deformity and instability compared to the subtle presentation of a pulled elbow. *Subluxation of proximal radio ulnar joint* - While the injury involves the radius and ulna, the specific subluxation in a pulled elbow is that of the **radial head** at the **humero-radial joint**, not primarily the proximal radio-ulnar joint itself. - The focus is on the annular ligament's integrity around the radial head, rather than direct forces acting on the proximal radio-ulnar articulation. *No injury present* - A pulled elbow is a recognized and common **pediatric orthopedic injury** requiring intervention to reduce the radial head. - The child will typically present with pain, refusal to use the affected arm, and a characteristic holding posture.
Pharmacology
1 questionsMost commonly abused opioid -
NEET-PG 2012 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1071: Most commonly abused opioid -
- A. Morphine
- B. Diacetylmorphine (Correct Answer)
- C. Oxycodone
- D. Buprenorphine
Explanation: ***Diacetylmorphine*** - **Diacetylmorphine**, commonly known as **heroin**, is synthetically derived from **morphine** but is significantly more potent and lipid-soluble, allowing it to cross the **blood-brain barrier** rapidly [1, 3]. - Its rapid onset of action and intense euphoric effects contribute to its high potential for **abuse** and addiction, making it one of the most commonly abused opioids globally, particularly through intravenous injection [1]. *Morphine* - While **morphine** is a potent opioid and has a high potential for abuse, it is often prescribed in clinical settings for severe pain. - Its slower onset and less intense "rush" compared to **heroin** make it less frequently the **primary opioid of abuse** in illicit street drug markets [1]. *Oxycodone* - **Oxycodone** is a highly abused prescription opioid, especially in the form of controlled-release formulations like **OxyContin**, but its abuse is primarily linked to prescription drug diversion rather than being the most common illicitly manufactured opioid of abuse. - While it contributes significantly to the opioid crisis, **heroin** (diacetylmorphine) remains the most commonly abused opioid in the illicit market due to its widespread availability and potency [1]. *Buprenorphine* - **Buprenorphine** is a **partial opioid agonist** used in the treatment of opioid dependence (opioid replacement therapy) due to its ceiling effect on respiratory depression and ability to block the effects of other opioids. - Although it can be abused, particularly in combination with naloxone (Suboxone) via intravenous injection, its primary role is in **medication-assisted treatment**, making it less commonly abused as a standalone illicit opioid compared to **heroin**.
Psychiatry
1 questionsWhat term describes repetitive, intrusive thoughts that cause significant distress or anxiety?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1071: What term describes repetitive, intrusive thoughts that cause significant distress or anxiety?
- A. Phobia
- B. Obsession (Correct Answer)
- C. Compulsion
- D. Anxiety
Explanation: ***Obsession*** - An **obsession** is defined by the presence of **recurrent and persistent thoughts, urges, or images** that are experienced as intrusive and unwanted, causing significant anxiety or distress. - These thoughts are often recognized as products of one's own mind, and individuals typically attempt to ignore, suppress, or neutralize them. *Phobia* - A **phobia** is an intense, irrational fear of a specific object or situation that poses little or no actual danger. - Unlike obsessions, phobias are typically related to external stimuli and do not primarily involve intrusive thoughts. *Compulsion* - A **compulsion** is a repetitive behavior (e.g., hand washing, checking) or mental act (e.g., praying, counting) that an individual feels driven to perform in response to an obsession. - Compulsions are often aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation. *Anxiety* - **Anxiety** is a general term for a feeling of worry, nervousness, or unease, typically about an event or something with an uncertain outcome. - While obsessions cause anxiety, "anxiety" itself is a broad emotional state, not specifically the intrusive thoughts described.
Surgery
1 questionsVolkmann's contracture: which artery is involved in this condition?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 1071: Volkmann's contracture: which artery is involved in this condition?
- A. Radial
- B. Ulnar
- C. Brachial artery (Correct Answer)
- D. Anterior interosseous artery
Explanation: ***Brachial artery*** - **Volkmann's contracture** is an ischemic contracture of the forearm muscles, classically caused by injury or compression of the **brachial artery** - The most common cause is **supracondylar fracture of the humerus** in children, which can damage or compress the brachial artery - Brachial artery injury → **forearm ischemia** → **compartment syndrome** in the anterior (flexor) compartment → muscle necrosis → **ischemic contracture** - The **brachial artery** is the main arterial supply to the forearm, and its compromise leads to the widespread ischemia necessary for Volkmann's contracture - **Clinical features**: Flexion deformity of the wrist and fingers, claw hand, sensory loss in the distribution of median and ulnar nerves *Anterior interosseous artery* - The **anterior interosseous artery** is a branch of the common interosseous artery (from the ulnar artery) that supplies deep forearm muscles - While it contributes to forearm circulation, **isolated injury** to this smaller branch vessel does not typically cause the extensive ischemia required for Volkmann's contracture - The primary vascular pathology in Volkmann's contracture involves the **main arterial trunk** (brachial artery), not its distal branches *Radial* - The **radial artery** is one of the two terminal branches of the brachial artery in the forearm - It primarily supplies the **lateral compartment** and contributes to hand circulation - Isolated radial artery injury does not cause Volkmann's contracture, as the ulnar artery provides collateral circulation - The pathology requires compromise of the **main arterial supply** proximal to the forearm *Ulnar* - The **ulnar artery** is the other terminal branch of the brachial artery - It supplies the **medial forearm** and hand - Similar to radial artery, isolated ulnar artery injury has collateral compensation from the radial artery - Volkmann's contracture requires **proximal arterial compromise** (brachial artery level) affecting the entire forearm blood supply