NEET-PG 2013 Practice Questions

Q: Lesion of the marked structure affects all EXCEPT

Superior oblique. ***Superior oblique*** - The **superior oblique** muscle is innervated by the **trochlear nerve (CN IV)**. - A lesion affecting the **oculomotor nerve (CN III)**, which usually controls the marked structure, would therefore **not** affect the superior oblique. *Superior rectus* - The **superior rectus** muscle is innervated by the **oculomotor nerve (CN III)**. - A lesion of the oculomotor nerve would impair its function, leading to difficulty in **elevating** and **adducting** the eye. *Inferior oblique* - The **inferior oblique** muscle is innervated by the **oculomotor nerve (CN III)**. - Damage to this nerve would result in compromised function of the inferior oblique, affecting **extorsion** and **elevation** of the eye. *Medial rectus* - The **medial rectus** muscle is innervated by the **oculomotor nerve (CN III)**. - A lesion of the oculomotor nerve would lead to an inability to perform **adduction** (moving the eye inward).

Q: Which of the following is caused by congenital 17 hydroxylase deficiency:

Hypertension. ***Hypertension*** - **Congenital 17-hydroxylase deficiency** leads to impaired synthesis of **cortisol** and **sex steroids**, resulting in an accumulation of **mineralocorticoid precursors (corticosterone and deoxycorticosterone)** [1]. - Increased levels of these mineralocorticoids cause **sodium and water retention**, leading to **hypertension** and **hypokalemia**. *Virilism* - **17-hydroxylase deficiency** impairs **androgen synthesis**, preventing the development of male secondary sexual characteristics [2]. - Individuals with this deficiency often present with **female external genitalia** regardless of their genetic sex, or **under-virilization** in genetic males, not virilism [2]. *Hyperkalemia* - The excess mineralocorticoids (deoxycorticosterone) in **17-hydroxylase deficiency** promote **sodium reabsorption** and **potassium excretion** in the kidneys [1]. - This leads to **hypokalemia**, which is the opposite of hyperkalemia. *Hermaphroditism* - **17-hydroxylase deficiency** affects the development of gonads and internal reproductive organs depending on genetic sex. - Genetic males (**XY**) with this deficiency typically develop **female external genitalia** (pseudohermaphroditism or 46, XY DSD), while genetic females (**XX**) typically present as normal females but with **primary amenorrhea** [2]. This genetic condition does not result in true hermaphroditism (presence of both ovarian and testicular tissue) [2].

Q: NVBDCP includes all except ?

Yellow fever. ***Yellow fever*** - Yellow fever is a **viral hemorrhagic fever** transmitted by infected mosquitoes, primarily **Aedes aegypti**. - While a significant public health concern, it is **not included in India's National Vector-Borne Disease Control Programme (NVBDCP)**, as it is not endemic to India. *Filariasis* - **Lymphatic filariasis** (elephantiasis) is a major vector-borne disease in India, caused by parasitic worms transmitted by mosquitoes. - It is a key component of the NVBDCP, which focuses on its elimination through **mass drug administration** and vector control. *Malaria* - **Malaria**, caused by Plasmodium parasites transmitted by Anopheles mosquitoes, is a cornerstone of the NVBDCP. - The program actively implements strategies for **case detection, treatment, vector control**, and preventing outbreaks. *Kala-azar* - **Kala-azar** (visceral leishmaniasis) is a severe parasitic disease transmitted by **sandflies**, making it a vector-borne disease. - It is one of the six diseases targeted by the NVBDCP for elimination, particularly in endemic regions of India.

Q: A patient sustained an injury to the right leg in a road traffic accident and his leg was amputated. This is?

Impairment. ***Impairment*** - An **impairment** refers to a problem in body function or structure, such as the loss of a limb or organ. - The amputation of the leg is a direct loss of a **body part**, fitting the definition of an impairment. *Handicap* - A **handicap** refers to a disadvantage for an individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual. - It describes the **social consequences** of the impairment, not the physical loss itself. *Disease* - A **disease** is a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury. - While the accident caused the injury, the loss of the leg is a direct physical result, not an **ongoing pathological process** like a disease. *Disability* - A **disability** is a restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being, as a result of an impairment. - It describes the **functional limitation** that arises from the impairment, such as difficulty walking, rather than the physical loss itself.

Q: Muller's manoeuvre is used to

To find degree of obstruction in sleep disordered breathing. ***To find degree of obstruction in sleep disordered breathing*** - **Muller's manoeuvre** is a diagnostic technique where the patient attempts to inspire forcefully against a **closed mouth and nostrils** while an endoscope observes the upper airway. - This maneuver helps to simulate the negative intraluminal pressure that occurs during sleep, making it useful in identifying the **site and severity of airway obstruction** in patients with sleep-disordered breathing. *To remove foreign body from ear* - Removing foreign bodies from the ear typically involves **irrigation**, specialized instruments (e.g., alligator forceps), or suction, not a breathing maneuver. - This option is unrelated to the physiological assessment of airway obstruction. *To remove laryngeal foreign body* - The primary methods for removing laryngeal foreign bodies are the **Heimlich maneuver** (abdominal thrusts) or direct laryngoscopy and removal. - Muller's manoeuvre is a diagnostic procedure, not a therapeutic one for foreign body extraction. *To find out opening of mouth* - Measuring the **opening of the mouth** is typically done with a ruler or specific instruments to assess jaw mobility (e.g., for temporomandibular joint disorders or trismus). - This is a simple measurement and does not involve the complex physiological assessment of the upper airway that Muller's manoeuvre provides.

Q: Dermatophytes affect -

Keratin. ***Keratin*** - **Dermatophytes** are a group of fungi that have a unique ability to digest **keratin**, a protein found in **skin, hair, and nails**. - This characteristic allows them to colonize and thrive in these superficial tissues, causing infections like **tinea corporis** (ringworm) or **tinea pedis** (athlete's foot). *Dermis of skin* - The **dermis** is the layer of skin beneath the epidermis, rich in **collagen, elastin, blood vessels, and nerves**. - Dermatophytes do not typically invade the dermis; their infections are generally limited to the **stratum corneum** and other keratinized structures. *Stratum spongiosum* - **Stratum spongiosum** is a term sometimes used to describe an edematous (swollen) epidermis, often seen in **eczema** and **dermatitis**. - Dermatophytes do not target this specific architectural change in the epidermis but rather feed on the keratin present in the more superficial layers. *Stratum basal* - The **stratum basale** (also called stratum germinativum) is the deepest layer of the **epidermis**, responsible for cell division and producing new skin cells. - Dermatophytes primarily infect the **dead keratinized cells** of the stratum corneum rather than the metabolically active cells of the stratum basale.

Q: Which nerve block is given in forceps delivery?

Pudendal. ***Pudendal*** - A **pudendal block** anesthetizes the **perineum, vulva, and lower vagina**, providing pain relief for instrumental deliveries like **forceps delivery** and for episiotomy. - It involves injecting a local anesthetic near the **pudendal nerve** as it passes posterior to the **ischial spine**. *Posterior femoral* - The **posterior femoral cutaneous nerve** primarily innervates the skin of the posterior thigh and part of the perineum but does not provide sufficient deep analgesia for a forceps delivery. - Blocking this nerve alone would not adequately cover the extensive area affected during instrumental delivery. *Genitofemoral* - The **genitofemoral nerve** primarily innervates the skin of the upper medial thigh and parts of the genitalia but is not the primary nerve for pain relief during vaginal delivery procedures. - Its blockade would not provide the comprehensive analgesia needed for a forceps delivery. *Ilio inguinal* - The **ilioinguinal nerve** innervates the skin of the groin, mons pubis, and labia majora but does not provide sufficient anesthesia for the deeper structures involved in a forceps delivery. - An ilioinguinal nerve block is more commonly used for pain control in procedures involving the groin or hernia repair, not for instrumental vaginal delivery.

Q: Haarscheiben Cells in epidermis are responsible for

Touch. ***Touch*** - **Haarscheiben cells**, also known as **Merkel cells**, are specialized epidermal cells associated with nerve endings. - They are primarily responsible for sensing **light touch** and **discriminative touch**, playing a crucial role in tactile sensation. *Pressure* - While Merkel cells contribute to touch sensation, the primary receptors for **deep pressure** and vibration are **Pacinian corpuscles**, located deeper in the dermis and hypodermis. - Light pressure can be detected by other mechanoreceptors such as **Meissner's corpuscles**. *Proprioception* - **Proprioception** refers to the sense of body position and movement. - Receptors for proprioception are mainly located in **muscles, tendons, and joints** (e.g., muscle spindles, Golgi tendon organs), not primarily in the epidermis. *Temperature* - **Temperature sensation** is mediated by **thermoreceptors**, which are free nerve endings in the skin. - These receptors (e.g., Krause end bulbs for cold, Ruffini endings for warmth) are distinct from Haarscheiben/Merkel cells.

Q: In which therapeutic approach do both the patient and psychotherapist actively participate?

Psychodynamic psychotherapy. ***Psychodynamic psychotherapy*** - This approach involves **active, collaborative participation** from both the patient and the therapist in exploring emotional conflicts and interpersonal patterns. - The therapy is conducted **face-to-face** with bidirectional dialogue, where both parties actively engage in the therapeutic process. - The therapist takes an **active role** in questioning, clarifying, and interpreting, while the patient actively participates in discussions about their experiences. *Psychoanalytic psychotherapy* - This is also an **interactive approach** where both patient and therapist actively participate, distinguishing it from classical psychoanalysis. - It involves **face-to-face sessions** with active dialogue and collaboration between patient and therapist. - **Note:** In modern practice, the distinction between psychodynamic and psychoanalytic psychotherapy has become blurred, and both involve active participation. *Psychoanalysis* - This is the **classical Freudian approach** where the patient lies on a couch and free associates, with the analyst maintaining a position of **neutrality and anonymity**. - The analyst offers **infrequent interpretations** and maintains minimal interaction, making it less actively collaborative compared to psychodynamic/psychoanalytic psychotherapy. - This represents the **least interactive** of the psychoanalytically-oriented therapies. *All of the options* - While psychodynamic and psychoanalytic psychotherapy both involve active participation, **classical psychoanalysis** does not emphasize active bidirectional collaboration in the same way. - The key distinction is that psychoanalysis maintains therapist neutrality with minimal active engagement, whereas psychodynamic psychotherapy specifically emphasizes **mutual, active participation** in the therapeutic process.

Q: Flask shaped heart is seen in –

Pericardial effusion. ***Pericardial effusion*** - A **"flask-shaped"** or **"water bottle-shaped" heart** on chest X-ray is a classic finding in significant pericardial effusion. - This appearance results from the accumulation of a large amount of fluid in the **pericardial sac**, which causes the cardiac silhouette to enlarge symmetrically and assume a globular shape. *TOF (Tetralogy of Fallot)* - TOF typically presents with a **"boot-shaped" heart** (coeur en sabot) on chest X-ray due to right ventricular hypertrophy and a concave pulmonary artery segment. - This morphology is distinctly different from the flask-shaped appearance of pericardial effusion. *Ebstein anomaly* - Ebstein anomaly is characterized by apical displacement of the tricuspid valve, leading to **massive right atrial enlargement**. - On chest X-ray, this often results in a **markedly enlarged oval-shaped heart**, which can be quite massive but does not typically have the distinct flask/water bottle shape. *TAPVC (Total Anomalous Pulmonary Venous Connection)* - TAPVC can present with different X-ray findings depending on the type, but a classic finding for the supracardiac type is a **"snowman" or "figure-of-8" heart** in children. - This appearance is due to the dilated superior vena cava and anomalous veins draining to it, not a flask shape.

Question 1

Lesion of the marked structure affects all EXCEPT

Accepted Answer

Superior oblique

Answer

Superior rectus

Answer

Inferior oblique

Answer

Medial rectus

Question 2

Which of the following is caused by congenital 17 hydroxylase deficiency:

Accepted Answer

Hypertension

Answer

Virilism

Answer

Hyperkalemia

Answer

Hermaphroditism

Question 3

NVBDCP includes all except ?

Accepted Answer

Yellow fever

Answer

Filariasis

Answer

Malaria

Answer

Kala-azar

Question 4

A patient sustained an injury to the right leg in a road traffic accident and his leg was amputated. This is?

Accepted Answer

Impairment

Answer

Handicap

Answer

Disease

Answer

Disability

Question 5

Muller's manoeuvre is used to

Accepted Answer

To find degree of obstruction in sleep disordered breathing

Answer

To remove foreign body from ear

Answer

To remove laryngeal foreign body

Answer

To find out opening of mouth

Question 6

Dermatophytes affect -

Accepted Answer

Keratin

Answer

Dermis of skin

Answer

Stratum spongiosum

Answer

Stratum basale

Question 7

Which nerve block is given in forceps delivery?

Accepted Answer

Pudendal

Answer

Posterior femoral

Answer

Genitofemoral

Answer

Ilioinguinal

Question 8

Haarscheiben Cells in epidermis are responsible for

Accepted Answer

Touch

Answer

Pressure

Answer

Proprioception

Answer

Temperature

Question 9

In which therapeutic approach do both the patient and psychotherapist actively participate?

Accepted Answer

Psychodynamic psychotherapy

Answer

Psychoanalytic psychotherapy

Answer

Psychoanalysis

Answer

All of the options

Question 10

Flask shaped heart is seen in –

Accepted Answer

Pericardial effusion

Answer

TOF

Answer

Ebstein anomaly

Answer

TAPVC

NEET-PG 2013

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Microbiology

Obstetrics and Gynecology

Physiology

Psychiatry

Radiology