Anatomy
5 questionsAzygos vein drains into:
Which of the following is not a branch of the inferior mesenteric artery?
Right ovarian artery is a branch of ?
Ovarian fossa is formed by all except?
Where is the neurovascular plane located in the anterior abdominal wall?
NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs
Question 311: Azygos vein drains into:
- A. Left brachiocephalic vein
- B. Inferior vena cava
- C. Superior vena cava (Correct Answer)
- D. Right brachiocephalic vein
Explanation: Wait, what? Azygos vein drains into: ***Superior vena cava*** - The **azygos vein** ascends along the right side of the vertebral column and typically arches over the root of the right lung before draining into the **superior vena cava (SVC)**. - This anatomical arrangement allows the azygos system to collect venous blood from the posterior thoracic and abdominal walls, as well as the bronchi and esophagus, ultimately returning it to the systemic circulation via the SVC [1]. *Left brachiocephalic vein* - The **left brachiocephalic vein** drains blood from the upper left limb and left side of the head and neck. - It merges with the right brachiocephalic vein to form the SVC; the azygos vein does not directly drain into it. *Inferior vena cava* - The **inferior vena cava (IVC)** collects deoxygenated blood from the lower body. - The azygos system primarily drains structures above the diaphragm, distinct from the IVC's drainage area. *Right brachiocephalic vein* - The **right brachiocephalic vein** drains blood from the upper right limb and right side of the head and neck. - While it contributes to the formation of the SVC, the azygos vein's direct connection is to the SVC itself, not the right brachiocephalic vein.
Question 312: Which of the following is not a branch of the inferior mesenteric artery?
- A. Left colic
- B. Middle rectal (Correct Answer)
- C. Superior rectal
- D. Sigmoidal artery
Explanation: ***Middle rectal artery*** - The **middle rectal artery** [2] is typically a branch of the **internal iliac artery** [2], supplying the middle part of the rectum. - It is not a direct branch of the inferior mesenteric artery. *Left colic artery* - The left colic artery is a direct branch of the **inferior mesenteric artery** [1], supplying the distal transverse colon and descending colon. - It forms an important anastomosis with the middle colic artery [1]. *Superior rectal artery* - The **superior rectal artery** is the terminal branch of the **inferior mesenteric artery**, supplying the upper rectum. - This artery provides the primary arterial supply to the proximal large intestine structures. *Sigmoidal artery* - The **sigmoidal arteries** are typically 2-4 branches arising from the **inferior mesenteric artery**, supplying the sigmoid colon. - These arteries anastomose with branches of the superior rectal and left colic arteries.
Question 313: Right ovarian artery is a branch of ?
- A. Abdominal aorta (Correct Answer)
- B. Right internal iliac
- C. Common iliac
- D. External iliac
Explanation: ***Abdominal aorta*** - The **right ovarian artery** typically originates directly from the **abdominal aorta**, just inferior to the renal arteries [1]. - This is a direct branch, supplying blood to the **right ovary**, **fallopian tube**, and surrounding structures [1]. *Right internal iliac* - The **internal iliac artery** primarily supplies the **pelvic organs**, gluteal region, and medial thigh [1]. - While it has branches to pelvic structures, the ovarian artery does not originate from it. *Common iliac* - The **common iliac artery** bifurcates into the **internal and external iliac arteries** at the level of the sacroiliac joint. - It does not directly give off the ovarian artery. *External iliac* - The **external iliac artery** continues as the **femoral artery** below the inguinal ligament, primarily supplying the lower limb. - It does not give off branches to the ovary.
Question 314: Ovarian fossa is formed by all except?
- A. Internal iliac artery
- B. Ureter
- C. Obliterated umbilical artery
- D. Round ligament of ovary (Correct Answer)
Explanation: ***Round ligament of ovary*** - The **round ligament of ovary** (ovarian ligament) connects the ovary to the lateral wall of the uterus and does NOT form any boundary of the ovarian fossa [1]. - It lies medial to the ovary and is not involved in forming the depression of the ovarian fossa [1]. - This ligament anchors the ovary but is separate from the peritoneal boundaries defining the fossa [1]. *Obliterated umbilical artery* - The **obliterated umbilical artery** (medial umbilical ligament) forms the **anterior boundary** of the ovarian fossa [2]. - This is a key anatomical landmark running along the lateral pelvic wall anterior to the ovary [2]. *Internal iliac artery* - The **internal iliac artery** forms the **posterior boundary** of the ovarian fossa [2]. - It lies on the lateral pelvic wall, deep and posterior to the ovarian fossa [2]. - This is one of the main structures defining the fossa's posterior limit [2]. *Ureter* - The **ureter** runs along the lateral pelvic wall and forms part of the **posterior/floor boundary** of the ovarian fossa [2]. - It passes posteroinferior to the ovary, contributing to the fossa's posterior limits [2].
Question 315: Where is the neurovascular plane located in the anterior abdominal wall?
- A. Between external oblique and internal oblique
- B. Between internal oblique and transversus abdominis (Correct Answer)
- C. Below transversus abdominis
- D. Above external oblique
Explanation: ***Between internal oblique and transversus abdominis*** - This space, often referred to as the **transversus abdominis plane (TAP)**, contains the major neurovascular bundles supplying the anterior abdominal wall [1]. - The nerves here are the lower **thoracic (T7-T11)** and **iliohypogastric/ilioinguinal (L1) nerves**, along with accompanying blood vessels [1]. *Between external oblique and internal oblique* - This fascial plane primarily houses some superficial nerves and vessels but not the main neurovascular supply to the abdominal wall muscles. - The major neurovascular bundles for deeper muscle layers and skin are located deeper to the **internal oblique** [1]. *Below transversus abdominis* - Below the **transversus abdominis** muscle lies the **transversalis fascia**, an extraperitoneal fat layer, and then the **peritoneum**. - This deeper region primarily contains retroperitoneal structures and organs, not the main neurovascular plane for the abdominal wall. *Above external oblique* - The layer above the **external oblique** muscle is primarily subcutaneous tissue and skin. - While superficial nerves and vessels are present here, this is not the main neurovascular plane that supplies the muscles of the anterior abdominal wall.
Biochemistry
1 questionsWhat are isoenzymes?
NEET-PG 2012 - Biochemistry NEET-PG Practice Questions and MCQs
Question 311: What are isoenzymes?
- A. Physically same forms of different enzymes
- B. Forms of same enzyme that catalyze different reactions
- C. Forms of different enzyme that catalyze same reactions
- D. Physically distinct forms of the same enzyme (Correct Answer)
Explanation: ***Physically distinct forms of the same enzyme*** - Isoenzymes are **multiple forms of an enzyme** that catalyze the **same reaction** but differ in their **physical or biochemical properties**, such as electrophoretic mobility, optimal pH, or kinetic parameters. - These differences usually arise from **genetic variations** (different genes encoding isoforms) or **post-translational modifications** (e.g., phosphorylation, glycosylation). *Physically same forms of different enzymes* - This statement is incorrect as isoenzymes are forms of the **same enzyme**, not different enzymes. - While different enzymes can catalyze similar reactions in certain pathways, they are not referred to as isoenzymes if they are structurally identical. *Forms of same enzyme that catalyze different reactions* - This describes enzymes with **broad substrate specificity** or those that act on different substrates but are not necessarily isoenzymes. - Isoenzymes specifically catalyze the **same chemical reaction**, but they may do so with different efficiencies or under different regulatory controls. *Forms of different enzyme that catalyze same reactions* - This describes a scenario where different enzymes might exhibit **catalytic promiscuity** or broad specificity, but not isoenzymes. - Isoenzymes are always derived from the **same parent enzyme** and catalyze the identical reaction.
Obstetrics and Gynecology
1 questionsThe thickness of the endometrium at the time of implantation is:
NEET-PG 2012 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 311: The thickness of the endometrium at the time of implantation is:
- A. 7 - 10 mm (Correct Answer)
- B. 20 - 30 mm
- C. 30 - 40 mm
- D. 3 - 4 mm
Explanation: ***7 - 10 mm*** - At the time of **implantation** (day 6-10 post-fertilization, around day 20-24 of the menstrual cycle), the endometrium is in the **mid-secretory phase** and measures **7-10 mm** in thickness. - This is the **optimal thickness** for successful embryo implantation, characterized by a receptive endometrium with **decidualization**, **spiral artery development**, and **glycogen-rich glandular secretions**. - Endometrial thickness <7 mm is associated with **poor implantation rates** and reduced pregnancy success. *3 - 4 mm* - An endometrial thickness of 3-4 mm is **too thin** for successful implantation. - This thickness is typically seen in the **early proliferative phase** (immediately after menstruation), not during the implantation window. - Thin endometrium (<7 mm) is associated with **poor receptivity** and lower pregnancy rates in both natural conception and assisted reproduction. *20 - 30 mm* - An endometrial thickness of 20-30 mm is **abnormally thick** and not conducive to normal implantation. - Such thickness may indicate **endometrial hyperplasia**, **polyps**, or other pathological conditions requiring investigation. *30 - 40 mm* - An endometrial thickness of 30-40 mm is **severely abnormal** and would likely prevent successful implantation. - This extreme thickness suggests significant pathology such as **endometrial hyperplasia** or **malignancy** and requires urgent evaluation.
Physiology
1 questionsWhat happens to the pressure in the calf compartment during the heel touch phase of walking?
NEET-PG 2012 - Physiology NEET-PG Practice Questions and MCQs
Question 311: What happens to the pressure in the calf compartment during the heel touch phase of walking?
- A. Decreases compared to resting pressure
- B. First increases and then decreases
- C. Remains the same as resting pressure
- D. Increases compared to resting pressure (Correct Answer)
Explanation: ***Increases compared to resting pressure*** - During **heel strike (initial contact)**, the calf muscles (**gastrocnemius and soleus**) contract eccentrically to control ankle dorsiflexion and decelerate the foot - Simultaneous **weight bearing** and **muscle contraction** within the confined fascial compartment lead to increased intramuscular pressure - This is a well-documented phenomenon in gait biomechanics and exercise physiology *Decreases compared to resting pressure* - Incorrect: Muscle activation and weight bearing during initial contact inherently increase compartment pressure - Pressure decrease occurs during swing phase when the limb is unloaded and muscles are relaxed *First increases and then decreases* - While pressure varies throughout the complete gait cycle, the **heel touch phase specifically** is characterized by an initial pressure increase - The brief duration of heel strike does not typically show a biphasic pressure pattern within this single phase *Remains the same as resting pressure* - Incorrect: Active weight bearing and eccentric muscle contraction during heel strike necessarily elevate intramuscular pressure above resting levels - Resting pressure only occurs when the limb is unloaded and muscles are inactive
Surgery
2 questionsIVC filter is used in the following situations except -
What is the appropriate treatment for an incidentally detected appendicular carcinoid tumor measuring 2.5 cm?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 311: IVC filter is used in the following situations except -
- A. To reduce symptoms
- B. As primary treatment for acute DVT (Correct Answer)
- C. Negligible size of emboli
- D. To prevent progress of native blood vessel disease
Explanation: ***As primary treatment for acute DVT*** - The **primary treatment** for **acute deep vein thrombosis (DVT)** is **anticoagulation therapy** (heparin, warfarin, or DOACs) to prevent clot propagation and embolization. - An **IVC filter** is **NOT primary therapy**—it is reserved for specific situations and does not treat the underlying thrombosis. - **Indications for IVC filter include:** - Absolute **contraindication to anticoagulation** (active bleeding, recent hemorrhagic stroke) - **Recurrent PE despite adequate anticoagulation** - Complications from anticoagulation therapy - Therefore, using IVC filter as primary treatment for acute DVT is **incorrect and not indicated**. *Negligible size of emboli* - While IVC filters trap **large emboli**, the concept of "negligible size emboli" is not a standard clinical consideration for filter placement. - IVC filters are indicated based on **risk of PE** and **contraindications to anticoagulation**, not based on emboli size assessment. *To reduce symptoms* - **IVC filters** do not reduce symptoms of DVT such as pain, swelling, or discomfort. - They function as a **mechanical barrier** to prevent emboli from reaching pulmonary circulation. - Symptom management requires anticoagulation, compression therapy, and leg elevation. *To prevent progress of native blood vessel disease* - IVC filters do not influence progression of underlying **vascular disease** such as atherosclerosis or chronic venous insufficiency. - Their sole function is **mechanical prevention of PE**, not disease modification.
Question 312: What is the appropriate treatment for an incidentally detected appendicular carcinoid tumor measuring 2.5 cm?
- A. Right hemicolectomy (Correct Answer)
- B. Limited resection of the right colon
- C. Total colectomy
- D. Appendicectomy
Explanation: ***Right hemicolectomy*** - An appendiceal carcinoid tumor **larger than 2 cm** (or with **mesoappendix invasion, positive margins, or high-grade features**) warrants a right hemicolectomy due to a significantly higher risk of lymph node metastasis (20-30%). - This 2.5 cm tumor clearly exceeds the 2 cm threshold, making right hemicolectomy the standard of care. - This procedure ensures adequate oncological margins and removal of regional lymph nodes, which is crucial for complete treatment. *Limited resection of the right colon* - This option is insufficient for an appendiceal carcinoid of this size, as it may not remove all regional lymph nodes or provide adequate oncological margins. - Limited resection lacks the systematic lymphadenectomy required for tumors exceeding 2 cm. *Total colectomy* - This is an **overly aggressive** and unnecessary procedure for an isolated appendiceal carcinoid tumor, even one of this size. - Total colectomy is typically reserved for diffuse colonic involvement, multifocal tumors, or specific genetic syndromes, which is not indicated here. *Appendicectomy* - An appendicectomy alone is only appropriate for very small appendiceal carcinoid tumors, typically **less than 1 cm** in size, with negative margins and without evidence of mesoappendix invasion or aggressive features. - For a 2.5 cm tumor, the risk of regional lymph node involvement (20-30%) is too high for appendicectomy to be considered adequate oncological treatment.