NEET-PG 2013 Practice Questions

Q: What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?

200mg. ***200mg*** - The standard dose of **mifepristone** for medical termination of pregnancy (MTP) is **200mg orally**. - This dose is typically followed 24-48 hours later by a **prostaglandin analog** (e.g., misoprostol) to complete the termination process. *10mg* - This dose is significantly lower than the recommended therapeutic dose for medical abortion. - Such a low dose would likely be **ineffective** in achieving termination. *20 mg* - This dose is also much lower than the standard therapeutic recommendation. - It would not adequately block progesterone receptors to initiate the termination process effectively. *100mg* - While closer to the standard dose, 100mg is still considered **sub-therapeutic** for many individuals undergoing medical abortion. - A lower efficacy rate would be expected compared to the 200mg dose.

Q: At which gestational week does the maximum volume of amniotic fluid occur?

36 weeks. ***36 weeks*** - The volume of **amniotic fluid** gradually increases during pregnancy, reaching its **peak** around **36 weeks** of gestation. - After 36 weeks, the volume of amniotic fluid typically begins to **decrease** as the pregnancy approaches term. *32 weeks* - At 32 weeks, the amniotic fluid volume is still **increasing** and has not yet reached its maximum level. - The fetus is actively growing and contributing to fluid production, but the peak is still several weeks away. *34 weeks* - Although significant, the amniotic fluid volume at 34 weeks has not yet reached its **maximum**. - The volume will continue to rise for another two weeks before plateauing and then declining. *40 weeks* - By 40 weeks, a normal-term pregnancy, the volume of amniotic fluid has typically **decreased** from its peak at 36 weeks. - A declining amniotic fluid volume (oligohydramnios) can be a concern at term if it's too low.

Q: Thurston Holland sign is seen in ?

Type II. ***Type II*** - The **Thurston Holland sign** is characteristic of a **Salter-Harris Type II fracture**, often described as a metaphyseal fragment (the "Thurston Holland fragment") remaining attached to the epiphyseal plate. - This fragment typically occurs at the corner of the **metaphysis**, making the fracture line extend obliquely through the physis and then along the metaphysis. *Type I* - A **Salter-Harris Type I fracture** involves a clean horizontal separation through the **growth plate (physis)** without involving the metaphysis or epiphysis. - No metaphyseal fragment is seen in Type I fractures, distinguishing it from the Thurston Holland sign. *Type III* - **Salter-Harris Type III fractures** extend from the **physis into the epiphysis**, creating an intra-articular fracture involving the joint surface. - These fractures do not involve a metaphyseal fragment, as they solely affect the physis and epiphysis. *Type IV* - **Salter-Harris Type IV fractures** involve a fracture line extending through the **epiphysis, physis, and metaphysis**, effectively dividing the bone into three parts. - While complex, Type IV injuries do not specifically describe the characteristic metaphyseal fragment that defines the Thurston Holland sign.

Q: Which of the following is NOT a common fracture in children?

Fracture of hand. ***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.

Q: What is the most common structural deformity associated with transient synovitis of the hip?

None of the options. ***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.

Q: What splint is used in CTEV after correction?

Dennis Brown splint. ***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.

Q: Von-Rosen's sign is positive in which of the following conditions?

Developmental Dysplasia of the Hip (DDH). ***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.

Q: All are features of Paget's disease except which of the following?

Affects only axial skeleton. ***Affects only axial skeleton*** - This statement is **FALSE** and therefore the correct answer to this "EXCEPT" question. - Paget's disease **can affect any bone in the body**, including both axial skeleton (spine, skull, pelvis) and appendicular skeleton (femur, tibia, humerus) [1]. - Common sites include: **pelvis (70%), spine, skull, femur, and tibia** [1]. - While it frequently affects axial bones, it is **not exclusive** to them. *Defect in osteoclasts* - This is a TRUE feature of Paget's disease. - The disease is characterized by **abnormal, hyperactive osteoclasts** with increased number of nuclei (up to 100 vs normal 3-5). - These osteoclasts show **excessive bone resorption activity** followed by disorganized bone formation [1]. - The primary defect involves **increased osteoclast activity and sensitivity to RANKL**. *Can lead to hearing loss* - This is a TRUE feature of Paget's disease. - Skull involvement can lead to **compression of cranial nerve VIII** (vestibulocochlear nerve) [1]. - Enlargement and disorganization of temporal bone can cause **conductive or sensorineural hearing loss**. - Occurs in approximately 30-50% of patients with skull involvement. *Can lead to bone cancer* - This is a TRUE feature of Paget's disease. - **Osteosarcoma** develops in approximately **1%** of Paget's disease patients. - Risk is higher in patients with **polyostotic disease** and long-standing involvement. - This is a rare but serious complication with poor prognosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, pp. 1192-1194.

Q: Depot preparations are administered by ?

Both subcutaneous and intramuscular route. ***Both subcutaneous and intramuscular route*** - **Depot preparations** are designed for **sustained release** of medication over an extended period - This is achieved by forming a 'depot' in the tissue, often facilitated by a viscous vehicle or sparingly soluble form of the drug - Both **subcutaneous** and **intramuscular** tissues can sustain depot formulations effectively - **SC depot examples:** Insulin glargine, contraceptive implants (Nexplanon), leuprolide acetate - **IM depot examples:** Haloperidol decanoate, medroxyprogesterone acetate (Depo-Provera), paliperidone palmitate, long-acting risperidone *Subcutaneous route* - While some **depot preparations** are administered **subcutaneously**, it is not the *only* route for all depot formulations - The **subcutaneous tissue** offers relatively low blood flow, suitable for slow absorption - Alone, this option is incomplete as many depot preparations require IM administration *Intramuscular route* - Many **depot preparations** are given **intramuscularly** due to the muscle tissue's vascularity and tissue volume - The **muscle tissue** provides an excellent site for drug reservoir formation - Alone, this option is incomplete as some depot preparations are given subcutaneously *Intravenous route* - **Intravenous administration** is used for immediate and rapid drug delivery directly into the bloodstream - This route is **unsuitable for depot preparations** which require sustained release over time - No 'depot' can be formed with IV route as the drug is immediately diluted and distributed throughout the body

Q: In which condition is the 'Picture frame vertebra' seen?

Paget disease. ***Paget disease*** - The "picture frame vertebra" sign is a classic radiographic finding in **Paget disease**, characterized by **cortical thickening** and sclerosis around the vertebral body circumference, resembling a picture frame. - This appearance is due to the disordered bone remodeling processes (increased osteoclastic bone resorption followed by disorganized osteoblastic new bone formation) characteristic of Paget disease. *Osteopetrosis (marble bone disease)* - Osteopetrosis is characterized by **increased bone density** due to defective osteoclast function, leading to bones that are dense but brittle. - It does not typically present with the specific "picture frame" appearance of individual vertebrae, but rather with diffuse sclerosis of bones. *Ankylosing spondylitis (AS)* - Ankylosing spondylitis primarily affects the **axial skeleton**, causing inflammation and eventual fusion of the vertebrae (leading to a "bamboo spine" appearance). - While it involves the spine, it does not produce the "picture frame" vertebral sign seen in Paget disease. *Osteoporosis* - Osteoporosis is characterized by **reduced bone mass** and microstructural deterioration of bone tissue, leading to increased bone fragility and fracture risk. - Radiographically, it shows **decreased bone density** and possible vertebral compression fractures, which is the opposite of the increased bone density and cortical thickening seen in the "picture frame" sign.

Question 1

What is the standard dose of mifepristone in medical termination of pregnancy (MTP)?

Accepted Answer

200mg

Answer

10mg

Answer

20mg

Answer

100mg

Question 2

At which gestational week does the maximum volume of amniotic fluid occur?

Accepted Answer

36 weeks

Answer

32 weeks

Answer

34 weeks

Answer

40 weeks

Question 3

Thurston Holland sign is seen in ?

Accepted Answer

Type II

Answer

Type I

Answer

Type III

Answer

Type IV

Question 4

Which of the following is NOT a common fracture in children?

Accepted Answer

Fracture of hand

Answer

Supracondylar humerus

Answer

Radius-ulna fracture

Answer

Lateral condyle humerus

Question 5

What is the most common structural deformity associated with transient synovitis of the hip?

Accepted Answer

None of the options

Answer

Abduction

Answer

Flexion

Answer

External rotation

Question 6

What splint is used in CTEV after correction?

Accepted Answer

Dennis Brown splint

Answer

Bohler-Brown splint

Answer

Thomas splint

Answer

None of the options

Question 7

Von-Rosen's sign is positive in which of the following conditions?

Accepted Answer

Developmental Dysplasia of the Hip (DDH)

Answer

Perthe's disease

Answer

SCFE

Answer

CTEV

Question 8

All are features of Paget's disease except which of the following?

Accepted Answer

Affects only axial skeleton

Answer

Defect in osteoclasts

Answer

Can lead to hearing loss

Answer

Can lead to bone cancer

Question 9

Depot preparations are administered by ?

Accepted Answer

Both subcutaneous and intramuscular route

Answer

Subcutaneous route

Answer

Intravenous route

Answer

Intramuscular route

Question 10

In which condition is the 'Picture frame vertebra' seen?

Accepted Answer

Paget disease

Answer

Osteopetrosis (marble bone disease)

Answer

Ankylosing spondylitis (AS)

Answer

Osteoporosis

NEET-PG 2013

Obstetrics and Gynecology

Orthopaedics

Pathology

Pharmacology

Radiology