NEET-PG 2013 Practice Questions

Q: Which muscle receives a muscular branch from the ulnar nerve?

Both FCU and FDP. ***Both FCU and FDP*** - The **flexor carpi ulnaris (FCU)** is solely innervated by the **ulnar nerve** in the forearm. - The **flexor digitorum profundus (FDP)** has dual innervation: the **ulnar nerve** supplies the medial half (tendons to ring and little fingers), while the anterior interosseous nerve (branch of median nerve) supplies the lateral half (tendons to index and middle fingers). - Both muscles receive muscular branches from the ulnar nerve, making this the most complete and accurate answer. *FCU* - While the FCU does receive innervation from the ulnar nerve (and only the ulnar nerve), this option is incorrect because the FDP also receives branches from the ulnar nerve. - Selecting only FCU ignores the dual innervation of FDP and is therefore an incomplete answer when "Both FCU and FDP" is available. *FDP* - While the medial half of FDP does receive innervation from the ulnar nerve, this option is incorrect because FCU also receives innervation from the ulnar nerve. - Selecting only FDP ignores the complete innervation of FCU and is therefore an incomplete answer when "Both FCU and FDP" is available. *None of the options* - This option is incorrect because both the **flexor carpi ulnaris** and the medial portion of the **flexor digitorum profundus** definitively receive muscular branches from the ulnar nerve. - The ulnar nerve provides motor innervation to these specific forearm muscles before continuing into the hand.

Q: Which muscle is not part of the superficial anterior compartment of the forearm?

Flexor pollicis longus (FPL). **Flexor pollicis longus (FPL)** - The **FPL** is located in the **deep anterior compartment** of the forearm, differentiating it from the superficial muscles [1]. - Its primary function is **flexion of the thumb's interphalangeal joint**, requiring a deeper anatomical position for mechanical advantage [1]. *FDS* - The **Flexor digitorum superficialis (FDS)** is a key muscle of the superficial anterior compartment, visible just beneath the skin and fascia. - It is responsible for **flexing the middle phalanges** of the medial four digits. *FCR* - The **Flexor carpi radialis (FCR)** is situated in the superficial anterior compartment, running obliquely across the forearm. - It functions in **flexion and abduction of the wrist**. *Palmaris longus* - The **Palmaris longus** is a superficial anterior compartment muscle, though it is absent in a significant portion of the population. - When present, its main action is **flexion of the wrist** and tightening of the palmar aponeurosis.

Q: All are infraclavicular branches of brachial plexus except ?

Long thoracic nerve. Long thoracic nerve - The long thoracic nerve originates directly from the roots (C5, C6, C7) of the brachial plexus, making it a supraclavicular branch. - It does not arise from the cords of the brachial plexus, which are located infraclavicularly. Ulnar nerve - The ulnar nerve arises from the medial cord of the brachial plexus, which is an infraclavicular structure. - It supplies many intrinsic hand muscles and the ulnar half of the flexor digitorum profundus. Axillary nerve - The axillary nerve is a branch of the posterior cord of the brachial plexus, classifying it as an infraclavicular branch. - It innervates the deltoid and teres minor muscles. Thoracodorsal nerve - The thoracodorsal nerve also originates from the posterior cord of the brachial plexus, making it an infraclavicular branch [1]. - It provides motor innervation to the latissimus dorsi muscle [1].

Q: Which of the following statements is false regarding hereditary spherocytosis?

Decreased MCHC. ***Decreased MCHC*** - Hereditary spherocytosis typically presents with an **increased MCHC** due to the spherocytes being more concentrated. - MCHC is a measure of the hemoglobin concentration in red blood cells, and in spherocytosis, this value is often elevated rather than decreased. *Defect in ankyrin* - This is a true statement; hereditary spherocytosis is associated with a defect in **ankyrin**, a protein that helps maintain the cell's membrane structure [2]. - Mutations in ankyrin lead to instability of the red blood cell membrane, resulting in spherocyte formation [2]. *Decreased MCV* - In hereditary spherocytosis, MCV is often **normal or slightly increased**, as it reflects the volume of red blood cells, which can be misinterpreted due to the presence of spherocytes. - Spherocytes are smaller cells, which can mistakenly suggest a falsely decreased MCV if not properly interpreted [1]. *Reticulocytosis* - This condition typically presents with **reticulocytosis** as a response to hemolysis, indicating the bone marrow is producing more red blood cells to compensate [1]. - The presence of reticulocytosis is a common finding in hereditary spherocytosis due to increased destruction of spherocytes. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 597-598. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 640-641.

Q: Intracorpuscular hemolytic anemia is seen in ?

Thalassemia. ***Thalassemia*** - Thalassemia is characterized by **intracorpuscular hemolysis** due to defective hemoglobin synthesis, leading to premature destruction of red blood cells [1][2]. - It manifests as **microcytic anemia** with associated **extramedullary erythropoiesis** in severe cases [1]. *Autoimmune hemolytic anemia* - This condition leads to **extravascular hemolysis**, primarily affecting red blood cells in the spleen, not within the plasma [2]. - It is often associated with **positive direct Coombs test**, indicating reactants on the RBC surface. *TIP* - TIP (Thrombotic Microangiopathy) primarily involves **microangiopathic hemolytic anemia** and is not classified as intracorpuscular [2]. - The hemolysis in TIP occurs due to **microthrombi**, causing damage to red blood cells as they pass through narrowed vessels. *Infection* - Infections can lead to **hemolysis**, but this is typically **extravascular** due to splenic clearance or due to other mechanisms like **malaria** [2]. - The hemolytic mechanism is not intracorpuscular, as seen in conditions like thalassemia. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 601-602. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 596-597.

Q: Which of the following statements about sickle cell anemia is false?

Ringed sideroblasts are associated with sickle cell anemia.. ***Ringed sideroblast*** - **Ringed sideroblasts** are not typically associated with sickle cell anemia; they are indicative of disorders like **sideroblastic anemia**. - In sickle cell anemia, the primary findings include **hemolysis** and ineffective erythropoiesis, not ringed sideroblasts [3]. *Howell jolly bodies* - These bodies are remnants of nuclear material and can be found in individuals with **spleen dysfunction**, which can occur in sickle cell anemia [1]. - They are actually a common finding due to **hyposplenism** or **asplenia** in patients with sickle cell disease [2]. *Sickle cells* - The presence of **sickle-shaped red blood cells** is a hallmark of sickle cell anemia, caused by the mutation in the **beta-globin chain** [3]. - These sickle cells are responsible for the characteristic complications of the disease, such as **vaso-occlusive crises** [1][3]. *Target cells* - Target cells, or **codocytes**, are often seen in disorders like **thalassemia** and liver disease, and can also be present in sickle cell anemia. - They are formed due to an increase in the **surface area to volume ratio** of red blood cells, often secondary to **membrane abnormalities** seen in sickle cell changes [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 644-646. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 570-571. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599.

Q: Linitis plastica is a type of ?

Manifestation of gastric cancer. ***Diffuse carcinoma of stomach*** - Linitis plastica is a specific type of **gastric cancer** characterized by **thickening of the stomach wall**, leading to a rigid, non-distensible abdomen [1]. - It often presents with **significant weight loss** and **early satiety**, distinguishing it from other stomach conditions. *Benign ulcer* - Benign ulcers do not cause the **extensive wall thickening** or **desmoplastic response** seen in linitis plastica [1]. - They typically heal with treatment and are associated with typical ulcer symptoms, unlike the progressive nature of linitis plastica. *Plastic like lining of stomach* - While linitis plastica describes a **plastic-like appearance**, it is not classified as a mere lining change but rather a sign of underlying **malignancy** [1]. - This option misrepresents it as a benign condition rather than a serious **stomach adenocarcinoma**. *GIST* - Gastrointestinal stromal tumors (GIST) are **soft tissue tumors** of mesenchymal origin, differing fundamentally from the **invasive** characteristics of linitis plastica [2]. - GISTs typically present with **mass lesions** in the GI tract, not the diffuse rigidity seen in linitis plastica [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 779-780. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 779.

Q: Anemia with reticulocytosis is seen in -

Hemolysis. ***Hemolysis*** - Reticulocytosis indicates a compensatory response to anemia, often occurring in hemolytic processes where the **bone marrow increases red blood cell production** in response to red blood cell destruction. - Conditions like **sickle cell disease** or **autoimmune hemolytic anemia** lead to hemolysis, further confirming increased reticulocyte count. *Iron deficiency anemia* - Typically presents with a **low reticulocyte count** as the bone marrow does not have sufficient iron to produce new red blood cells. - This condition is characterized by **microcytic, hypochromic** red blood cells due to inadequate iron stores. *Vitamin B12 deficiency* - Often results in a **macrocytic anemia** with a variable reticulocyte count; however, reticulocytosis is generally not seen initially. - This deficiency affects DNA synthesis, leading to ineffective erythropoiesis and the presence of **megaloblastic changes**. *Aplastic anemia* - Characterized by a **decrease in all types of blood cells** (pancytopenia) and typically has a **low reticulocyte count** due to bone marrow failure. - There is insufficient production of red blood cells, hence **reticulocytosis is not observed**.

Q: In which condition are Pseudo-Pelger-Huët cells typically seen?

Myelodysplastic syndrome. ***Mylodysplastic syndrome*** - Pseudo-Pelger-Huet cells are characteristic and often observed in myelodysplastic syndromes, indicating an ineffective hematopoiesis [1]. - These cells appear as **hyposegmented neutrophils** and are associated with dysplastic changes in the bone marrow [1]. *Hairy cell leukemia* - Typically presents with **hairy cells** in peripheral blood and often involves splenomegaly; pseudo-Pelger-Huet cells are not usual in this condition. - Associated with **PANCYTOPENIA** and reticulin fibrosis, differing from myelodysplastic syndrome. *Hodgkin's lymphoma* - Characterized by the presence of **Reed-Sternberg cells** and typically involves lymphadenopathy. - Peripheral blood findings generally do not include pseudo-Pelger-Huet cells; the focus is on lymphatic tissue. *Multiple myeloma* - Commonly presents with **plasma cells** and related symptoms like bone pain and renal failure, not associated with pseudo-Pelger-Huet cells. - It primarily causes an increase in monoclonal proteins rather than dysplastic changes seen in myelodysplastic syndrome. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 613-614.

Question 1

Which muscle receives a muscular branch from the ulnar nerve?

Accepted Answer

Both FCU and FDP

Answer

FCU

Answer

None of the options

Answer

FDP

Question 2

Which muscle is not part of the superficial anterior compartment of the forearm?

Accepted Answer

Flexor pollicis longus (FPL)

Answer

FDS

Answer

FCR

Answer

Palmaris longus

Question 3

All are infraclavicular branches of brachial plexus except ?

Accepted Answer

Long thoracic nerve

Answer

Axillary nerve

Answer

Thoracodorsal nerve

Answer

Ulnar nerve

Question 4

Which of the following statements is false regarding hereditary spherocytosis?

Accepted Answer

Decreased MCHC

Answer

Defect in ankyrin

Answer

Reticulocytosis

Answer

Normal to increased MCV

Question 5

Intracorpuscular hemolytic anemia is seen in ?

Accepted Answer

Thalassemia

Answer

Infection

Answer

Thrombotic thrombocytopenic purpura (TTP)

Answer

Autoimmune hemolytic anemia

Question 6

Which of the following statements about sickle cell anemia is false?

Accepted Answer

Ringed sideroblasts are associated with sickle cell anemia.

Answer

Sickle cells are present in sickle cell anemia.

Answer

Target cells are commonly seen in sickle cell anemia.

Answer

Howell Jolly bodies can be found in sickle cell anemia.

Question 7

Linitis plastica is a type of ?

Accepted Answer

Manifestation of gastric cancer

Answer

Benign ulcer

Answer

GIST

Answer

Plastic-like appearance of stomach lining

Question 8

Anemia with reticulocytosis is seen in -

Accepted Answer

Hemolysis

Answer

Iron deficiency anemia

Answer

Vitamin B12 deficiency

Answer

Aplastic anemia

Question 9

In which condition are Pseudo-Pelger-Huët cells typically seen?

Accepted Answer

Myelodysplastic syndrome

Answer

Hairy cell leukemia

Answer

Multiple myeloma

Answer

Hodgkin's lymphoma

Question 10

Persons with heterozygous sickle cell trait are protected from infection by:

Accepted Answer

P. falciparum

Answer

Pneumococcus

Answer

P. vivax

Answer

Salmonella

NEET-PG 2013

Anatomy

Pathology