Anesthesiology
2 questionsWhich of the following anesthetic agents is most notable for its analgesic properties?
Intraocular pressure is increased by which anaesthetic?
NEET-PG 2013 - Anesthesiology NEET-PG Practice Questions and MCQs
Question 1211: Which of the following anesthetic agents is most notable for its analgesic properties?
- A. Ketamine (Correct Answer)
- B. Thiopentone
- C. Propofol
- D. None of the options
Explanation: ***Ketamine*** - **Ketamine** is unique among general anesthetics for its significant **analgesic properties**, which stem from its action as an **NMDA receptor antagonist**. - Its ability to provide pain relief makes it useful in scenarios where both **anesthesia** and **analgesia** are desired, such as for painful procedures or in trauma settings. *Propofol* - While **propofol** is a widely used intravenous anesthetic, it lacks intrinsic **analgesic properties**. Its primary effects are **sedation** and **hypnosis**. - Pain during propofol injection is common, and other analgesics are usually co-administered for painful procedures. *Thiopentone* - **Thiopentone** is an ultrashort-acting barbiturate primarily used for **induction of anesthesia** due to its rapid onset and profound hypnotic effects. - It has **no analgesic properties** and can even lower the pain threshold, requiring concurrent administration of analgesics.
Question 1212: Intraocular pressure is increased by which anaesthetic?
- A. Ketamine (Correct Answer)
- B. Nitrous Oxide
- C. Isoflurane
- D. Propofol
Explanation: ***Ketamine*** - **Ketamine** is known to increase **intraocular pressure (IOP)**, making it generally avoided in patients with glaucoma or penetrating eye injuries. - This effect is thought to be due to its dissociative properties, causing **nystagmus**, and stimulating extraocular muscles. *Nitrous Oxide* - **Nitrous oxide** by itself has minimal or no direct effect on **intraocular pressure (IOP)**. - However, in cases of an air-filled globe (e.g., after retinal detachment surgery), it can increase IOP by expanding the gas bubble. *Isoflurane* - **Isoflurane**, like most volatile anesthetics, typically **decreases intraocular pressure (IOP)**. - This reduction is generally due to its effects on reducing aqueous humor production and increasing uveoscleral outflow. *Propofol* - **Propofol** is known for its ability to **decrease intraocular pressure (IOP)**. - This effect is mediated by a reduction in aqueous humor production and an increase in uveoscleral outflow, making it a favorable choice in ophthalmic surgery.
Internal Medicine
1 questionsWireless capsule endoscopy is done to visualize which of the following condition?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1211: Wireless capsule endoscopy is done to visualize which of the following condition?
- A. Esophageal varices
- B. Gastric carcinoma
- C. Crohn's disease (Correct Answer)
- D. Ulcerative colitis
Explanation: ***Crohn's disease*** - Wireless capsule endoscopy is primarily used to visualize the **small bowel**, which is the main site of involvement in Crohn's disease [3]. - It helps detect **mucosal inflammation**, ulcers, and strictures that may not be accessible by conventional endoscopy [1]. *Esophageal varices* - **Esophageal varices** are best visualized and treated with conventional **esophagogastroduodenoscopy (EGD)**, which allows for direct intervention [2]. - Capsule endoscopy is not the preferred method due to its inability to adequately distend the esophagus or perform therapeutic maneuvers [4]. *Gastric carcinoma* - Diagnosing **gastric carcinoma** requires visualization of the stomach lining, typically achieved through **conventional upper endoscopy** with biopsies [2]. - The capsule may pass too quickly through the stomach or miss subtle lesions, and it cannot obtain tissue samples. *Ulcerative colitis* - **Ulcerative colitis** primarily affects the **colon**, which is visualized using a **colonoscopy** [3]. - While capsule endoscopy can visualize the small bowel, it is not effective for examining the colon due to insufficient imaging of the entire large intestine and lack of biopsy capabilities.
Orthopaedics
5 questionsMost common nerve injured in fracture of medial epicondyle of humerus is:
Von-Rosen's sign is positive in which of the following conditions?
What splint is used in CTEV after correction?
What is the most common structural deformity associated with transient synovitis of the hip?
Which of the following is NOT a common fracture in children?
NEET-PG 2013 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1211: Most common nerve injured in fracture of medial epicondyle of humerus is:
- A. Radial nerve
- B. Ulnar nerve (Correct Answer)
- C. Median nerve
- D. Musculocutaneous nerve
Explanation: ***Ulnar nerve*** - The **ulnar nerve** runs directly behind the **medial epicondyle** of the humerus in a groove called the **cubital tunnel**, making it highly vulnerable to injury during fractures of this bony prominence. - Injury to the ulnar nerve at this location can cause symptoms like **numbness and tingling** in the **little finger and half of the ring finger**, **weakness in certain hand muscles**, and eventually a **"claw hand" deformity**. *Radial nerve* - The **radial nerve** courses along the posterior aspect of the humerus in the **spiral groove** and is more commonly injured with **mid-shaft humeral fractures**. - Injury typically results in **wrist drop** and **sensory loss over the dorsum of the hand**. *Median nerve* - The **median nerve** travels more anteriorly in the arm and forearm and is most commonly injured with **supracondylar fractures of the humerus** or **carpal tunnel syndrome** at the wrist. - Damage leads to **ape hand deformity** and sensory deficits over the **thumb, index, middle, and radial half of the ring finger**. *Musculocutaneous nerve* - The **musculocutaneous nerve** innervates the biceps brachii and brachialis muscles and provides sensation to the lateral forearm; it is **less commonly injured in elbow fractures**. - Injury would primarily affect **elbow flexion** and **sensation over the lateral forearm**, which is not the typical presentation for medial epicondyle fractures.
Question 1212: Von-Rosen's sign is positive in which of the following conditions?
- A. Perthe's disease
- B. SCFE
- C. CTEV
- D. Developmental Dysplasia of the Hip (DDH) (Correct Answer)
Explanation: ***Developmental Dysplasia of the Hip (DDH)*** - **Von-Rosen's sign** is a clinical test used to detect **instability or dislocation** of the hip in newborns, a hallmark of DDH. - The test involves placing the infant **supine with hips flexed to 90 degrees**, then **externally rotating and abducting** the hips while applying gentle longitudinal traction; positive if abduction is limited to **less than 60 degrees**. *Perthe's disease* - This condition involves **avascular necrosis of the femoral head** in children, typically presenting with a limp and hip pain, not congenital instability. - Diagnosis is usually made by X-rays showing **sclerosis and fragmentation** of the femoral head, not by Von-Rosen's sign. *SCFE* - **Slipped Capital Femoral Epiphysis (SCFE)** is a condition where the femoral head epiphysis displaces from the femoral neck, common in adolescents. - Patients typically present with **hip or knee pain** and a characteristic external rotation of the affected limb, which is not detected by Von-Rosen's sign. *CTEV* - **Congenital Talipes Equinovarus (CTEV)**, or **clubfoot**, is a deformity of the foot and ankle, involving plantarflexion and inversion. - This condition affects the foot, not the hip, rendering tests for hip instability like Von-Rosen's sign irrelevant.
Question 1213: What splint is used in CTEV after correction?
- A. Bohler-Brown splint
- B. Thomas splint
- C. Dennis Brown splint (Correct Answer)
- D. None of the options
Explanation: ***Dennis Brown splint*** - The **Dennis Brown splint** is specifically designed for maintaining the correction of **clubfoot (CTEV)** in infants to prevent recurrence. - It consists of a bar connecting two shoes that hold the feet in an **external rotation** and **abduction** position. *Bohler-Brown splint* - The **Bohler-Brown splint** is primarily used for the management of **tibial shaft fractures**. - It is a **traction splint** designed to maintain alignment and length of the fractured bone. *Thomas splint* - The **Thomas splint** is typically used for **femoral shaft fractures** to provide traction and reduce muscle spasm. - It is not indicated for the long-term management of clubfoot. *None of the options* - This option is incorrect as the **Dennis Brown splint** is a well-established and a primary splint used for CTEV after correction.
Question 1214: What is the most common structural deformity associated with transient synovitis of the hip?
- A. Abduction
- B. Flexion
- C. External rotation
- D. None of the options (Correct Answer)
Explanation: ***None of the options:*** - Transient synovitis of the hip is an inflammatory condition that does not inherently cause a **structural deformity** of the hip joint. - While it causes pain and limited range of motion, these are functional rather than structural changes, and the hip joint's **anatomical structure remains intact**. *Abduction* - Abduction is a **movement**, not a structural deformity. Although the hip may be held in a position of slight abduction to relieve pain, this is a postural adaptation, not a permanent structural change. - Hip abduction contractures can occur in various conditions (e.g., neuromuscular disorders) but are not characteristic of transient synovitis. *Flexion* - Similar to abduction, flexion is a **movement**, not a structural deformity. Patients with transient synovitis often hold the hip in a flexed position (along with abduction and external rotation) for comfort to minimize pressure within the joint capsule. - A fixed flexion deformity can be seen in other conditions like septic arthritis or Legg-Calvé-Perthes disease, but not typically in transient synovitis. *External rotation* - External rotation is also a **movement**, not a structural deformity. Patients may adopt an externally rotated position of the leg to ease pain and reduce intracapsular pressure. - While certain conditions can cause a fixed external rotation (e.g., slipped capital femoral epiphysis), transient synovitis does not lead to this type of structural change.
Question 1215: Which of the following is NOT a common fracture in children?
- A. Supracondylar humerus
- B. Fracture of hand (Correct Answer)
- C. Radius-ulna fracture
- D. Lateral condyle humerus
Explanation: ***Fracture of hand*** - While hand fractures can occur in children, they are generally **less common** compared to fractures of the long bones, especially those of the **upper extremity**, due to the types of activities and falls children typically experience. - The small bones of the hand are often better protected or less frequently exposed to severe direct trauma in routine childhood activities that lead to fractures elsewhere. *Lateral condyle humerus* - This is a common and often challenging fracture in children, particularly affecting those aged 6-10 years. - It usually results from a fall on an **outstretched hand**, with the elbow in extension. *Supracondylar humerus* - This is one of the **most common elbow fractures** in children and is typically due to a fall on an **outstretched hand** with the elbow extended or hyperextended. - Its significance lies in the potential for neurovascular complications due to its proximity to vital structures. *Radius-ulna fracture* - **Forearm fractures** involving the radius, ulna, or both are extremely common in children, often resulting from falls onto an **outstretched hand**. - The **distal radius** is a particularly frequent site of fracture in this age group.
Radiology
2 questionsRadiological sign in case of Perthes disease?
Investigation with least radiation dose in the diagnosis of Meckel's diverticulum is -
NEET-PG 2013 - Radiology NEET-PG Practice Questions and MCQs
Question 1211: Radiological sign in case of Perthes disease?
- A. Flattening of femoral head (Correct Answer)
- B. Fragmentation of femoral head epiphysis
- C. Lateral femoral head displacement
- D. Limited hip abduction
Explanation: ***Flattening of femoral head*** - **Flattening** and **fragmentation** of the femoral head are characteristic radiological findings in **early-stage** Perthes disease. - This flattening is a direct consequence of the **avascular necrosis** and subsequent **remodeling** of the femoral epiphysis. *Fragmentation of femoral head epiphysis* - While **fragmentation** is a key feature of Perthes disease, it's typically observed **after** the initial flattening and sclerosis in the avascular stage. - It represents the process of **resorption** and **revascularization** as the bone attempts to heal. *Lateral femoral head displacement* - **Lateral displacement** of the femoral head is a more common finding in conditions like **slipped capital femoral epiphysis (SCFE)**, where the epiphysis slips from the metaphysis. - In Perthes disease, the primary issue is the **necrosis and collapse** of the femoral head itself, rather than displacement from the neck. *Limited hip abduction* - **Limited hip abduction** is a clinical sign, not a radiological sign, and it is a common symptom in Perthes disease due to pain, inflammation, and deformity of the femoral head. - Radiological signs are visual abnormalities observed on imaging studies like X-rays.
Question 1212: Investigation with least radiation dose in the diagnosis of Meckel's diverticulum is -
- A. MRI
- B. CT
- C. Contrast radiography
- D. Technetium -99m scanning (Correct Answer)
Explanation: ***Technetium-99m scanning*** - **Technetium-99m pertechnetate scan** (Meckel's scan) is the **gold standard investigation** for diagnosing Meckel's diverticulum with ectopic gastric mucosa - Among the investigations that can actually **diagnose Meckel's diverticulum**, it has the **lowest radiation dose** (approximately 1-2 mSv) - The radioisotope is specifically taken up by ectopic gastric mucosa, providing both diagnostic utility and relatively low radiation exposure - **Sensitivity: 85-95%** for detecting ectopic gastric mucosa in Meckel's diverticulum - The radiation dose is comparable to a few months of natural background radiation and significantly lower than CT or contrast studies *MRI* - While **MRI uses no ionizing radiation**, it is **not a standard or practical investigation** for diagnosing Meckel's diverticulum - MRI cannot identify ectopic gastric mucosa specifically - It is rarely used in clinical practice for this indication - The question asks about investigation "in the diagnosis" of Meckel's diverticulum, implying a test that is actually used diagnostically *CT* - **Computed Tomography (CT)** delivers a **high radiation dose** (typically 5-10 mSv or more) - While it can identify structural abnormalities, it is not specific for Meckel's diverticulum - Not the first-line investigation for this condition *Contrast radiography* - **Contrast studies** (barium studies) use **moderate ionizing radiation** (3-5 mSv) - Limited utility in diagnosing Meckel's diverticulum as it primarily assesses luminal patency - Cannot identify ectopic gastric mucosa - Lower sensitivity compared to Tc-99m scanning