NEET-PG 2013 Practice Questions

Q: Which organ is primarily supplied by the portal vein?

Liver. ***Liver*** - The **portal vein** is unique in that it carries **nutrient-rich, deoxygenated blood** from the gastrointestinal tract and spleen directly to the liver [1], [2]. - This specialized circulation allows the liver to **process absorbed nutrients** and detoxify harmful substances before they enter the systemic circulation [1], [3]. *Spleen* - The spleen is supplied by the **splenic artery**, a branch of the **celiac trunk**, which carries oxygenated arterial blood to the organ. - While the splenic vein drains into the portal vein, the portal vein itself does not primarily supply the spleen [2]. *Pancreas* - The pancreas receives its blood supply from branches of the **celiac artery** and the **superior mesenteric artery**, specifically the splenic, gastroduodenal, and superior mesenteric arteries [1]. - While pancreatic veins drain into the portal system, the portal vein is not the primary arterial supply to the pancreas [1]. *Colon* - The colon is supplied by the **superior mesenteric artery** and the **inferior mesenteric artery**, which provide oxygenated arterial blood to different segments of the large intestine. - The venous drainage from the colon primarily collects into the superior and inferior mesenteric veins, which then merge to form part of the portal venous system, but the portal vein does not primarily supply the colon with blood [2].

Q: What is the typical length of the anal canal in adults?

35 - 40 mm. ***35 - 40 mm*** - The **anal canal** in adults typically measures between **3.5 to 4.0 cm** (35 to 40 mm) in length. - This length is measured from the **anorectal ring** to the **anal verge**. *10 - 15 mm* - This length is too short for the **adult anal canal**; it's approximately one-third of the actual length. - Such a short measurement would be anatomically incorrect and clinically significant for various colorectal conditions. *15 - 20 mm* - This measurement is still significantly shorter than the average length of the **adult anal canal**. - A canal this short would likely be pathological or developmental in origin. *25 - 30 mm* - While closer, this range is still generally below the accepted average length of the **adult anal canal**. - Precise anatomical measurements are crucial for diagnostic and surgical procedures in proctology.

Q: Superior wall of middle ear is formed by ?

Tegmen tympani. ***Tegmen tympani*** - The **tegmen tympani** is a thin plate of **petrous temporal bone** that forms the roof or superior wall of the middle ear cavity. - This structure separates the middle ear from the **middle cranial fossa** and its contents, including the **temporal lobe of the brain**. *Jugular bulb* - The **jugular bulb** is the dilated superior portion of the **internal jugular vein** and forms part of the **floor (inferior wall)** of the middle ear cavity, not the superior wall. - Its close proximity to the middle ear makes it vulnerable to injury during otologic surgery. *Tympanic membrane* - The **tympanic membrane** (eardrum) forms the **lateral wall** of the middle ear cavity, separating it from the external auditory canal. - It is crucial for **sound transmission** by vibrating in response to sound waves. *Carotid wall* - The **carotid wall** forms the **anterior wall** of the middle ear cavity and is related to the **internal carotid artery** as it narrows through the carotid canal. - This wall is not the superior boundary of the middle ear.

Q: What is the most dependent part of the peritoneal cavity in a female in the standing position?

Pouch of Douglas. ***Pouch of Douglas*** - The **rectouterine pouch** (Pouch of Douglas) is the most dependent part of the peritoneal cavity in females when standing. - It lies between the **rectum posteriorly** and the **uterus anteriorly**, extending down to the posterior fornix of the vagina [1]. - Due to gravity, any free fluid in the peritoneal cavity (blood, pus, ascitic fluid) collects here in the upright position. - **Clinical significance:** This is why culdocentesis (needle aspiration through the posterior vaginal fornix) can detect intraperitoneal fluid [1]. *Vesicouterine pouch* - Located between the **uterus posteriorly** and the **bladder anteriorly** [1]. - It is **superior** to the Pouch of Douglas and therefore not the most dependent part. - Fluid would collect in the Pouch of Douglas before reaching this pouch in a standing position. *Paracolic gutter* - The **paracolic gutters** are peritoneal recesses lateral to the ascending and descending colon. - While they can collect fluid, they are **not the lowest point** in the peritoneal cavity in an upright position. - The right paracolic gutter can serve as a pathway for fluid to spread between the pelvis and subphrenic spaces. *None of the options* - This is incorrect as the **Pouch of Douglas** is definitively the most dependent part of the peritoneal cavity in females in the standing position. - It is a well-established anatomical fact taught in all standard anatomy textbooks.

Q: All pass through jugular foramen except

Mandibular nerve. ***Mandibular nerve*** - The **mandibular nerve** (CN V3) exits the skull through the **foramen ovale**, not the jugular foramen. - It is a branch of the **trigeminal nerve** and is responsible for motor innervation to muscles of mastication and sensory innervation to the lower face and mouth. *Glossopharyngeal nerve* - The **glossopharyngeal nerve** (CN IX) is one of the three cranial nerves that exit through the **jugular foramen**. - It provides motor, sensory, and parasympathetic innervation including taste from posterior third of tongue and motor to stylopharyngeus muscle. *Vagus nerve* - The **vagus nerve** (CN X) is one of the major cranial nerves that exits the skull through the **jugular foramen**. - It provides extensive motor, sensory, and parasympathetic innervation to the head, neck, thorax, and abdomen. *Internal jugular vein* - The **internal jugular vein** is formed at the jugular foramen by the continuation of the **sigmoid sinus**, and it exits the skull through this foramen. - It is one of the primary venous drainage pathways for the brain.

Q: Which muscle is the deepest in the anterior neck region?

Longus colli. ***Longus colli*** - The **longus colli** muscle is the **deepest muscle** located in the anterior neck region, running along the front of the cervical vertebral column from C1 to T3. - It lies in the **prevertebral layer**, deep to all other anterior neck structures including the carotid sheath, visceral compartment, and superficial muscles. - Its position directly anterior to the vertebral bodies makes it the deepest anterior neck muscle. *Platysma* - The platysma is the **most superficial muscle** of the neck, located just beneath the skin in the superficial fascia. - It is not a deep muscle and lies superficial to all other neck muscles. *Sternocleidomastoid* - The sternocleidomastoid is enclosed within the **investing layer of deep cervical fascia**, making it relatively superficial. - While prominent in the anterior and lateral neck, it is not the deepest anterior neck muscle. *Trapezius* - The trapezius is a large, **superficial muscle of the back and posterior neck**. - It is not located in the anterior neck and is a superficial, not deep, muscle.

Q: What is a cochleate uterus?

Acute anteflexion. ***Acute anteflexion*** - A **cochleate uterus** describes a uterus with an **acute anteflexion**, meaning it is sharply bent forward at the junction of the cervix and the body of the uterus. - This anatomical variation can sometimes be associated with **dysmenorrhea** or difficulty with **intrauterine device (IUD) insertion**. *Large uterus* - A large uterus, also known as **uteromegaly**, is a general descriptive term for an enlarged uterus, which can be due to various causes such as **fibroids** or **adenomyosis**, and is not specific to an acute anteflexion. - It does not directly describe the acute angulation that defines a cochleate uterus. *Acute retroflexion* - **Acute retroflexion** refers to a uterus that is sharply bent backward at the level of the cervix. - This is the opposite of **anteflexion**, which describes a forward bend, and therefore is not a cochleate uterus. *Large cervix* - A **large cervix** describes an enlarged uterine cervix, which is the lower, narrow part of the uterus. - This typically relates to conditions like **cervical hypertrophy** or **nabothian cysts** and is distinct from the overall angulation of the uterine body in relation to the cervix.

Q: Which dopamine receptor is known for its inhibitory action in the central nervous system?

Dopamine Receptor D2. ***Dopamine Receptor D2*** - The **D2 receptor** is a member of the D2-like family (D2, D3, D4), which are **G-protein coupled receptors** that inhibit adenylyl cyclase activity. - Its activation typically leads to a **decrease in neuronal excitability** and neurotransmitter release, providing an inhibitory effect in the CNS. *Dopamine Receptor D5* - The **D5 receptor** belongs to the D1-like family (D1, D5), which are **G-protein coupled receptors** that stimulate adenylyl cyclase activity. - Activation of D5 receptors typically leads to **excitatory effects** rather than inhibitory ones in the CNS. *No inhibitory dopamine receptor present* - This statement is incorrect as specific dopamine receptor subtypes, particularly the **D2-like family**, are well-established to exert inhibitory actions in the CNS. - These inhibitory effects are crucial for various physiological processes, including motor control and reward pathways. *Dopamine Receptor D1* - The **D1 receptor** is part of the D1-like family (D1, D5) and is known for its **excitatory effects** in the CNS. - Activation of D1 receptors leads to an **increase in intracellular cAMP** and generally enhances neuronal activity.

Q: Which of the following statements is true regarding omalizumab?

All of the options. ***All of the options*** is correct because each statement is true: **Anti-IgE** - Omalizumab is a **humanized monoclonal antibody** that specifically targets and binds to **free IgE** in the circulation - By binding free IgE, it prevents IgE from attaching to **high-affinity receptors** on mast cells and basophils - This reduces the allergic cascade and prevents release of inflammatory mediators **Given subcutaneously** - Omalizumab is administered via **subcutaneous injection** only - Dosing is typically every **2 to 4 weeks** based on patient's body weight and baseline IgE levels - Not available in oral or intravenous formulations for asthma treatment **Used as add-on therapy in moderate to severe asthma prophylaxis** - FDA approved as **add-on maintenance treatment** for patients aged ≥6 years with **moderate to severe persistent allergic asthma** - Indicated when asthma is **inadequately controlled** with inhaled corticosteroids - Reduces frequency of asthma exacerbations and improves asthma control - Also approved for chronic spontaneous urticaria All three statements accurately describe omalizumab's mechanism, administration route, and clinical indication, making **"All of the options"** the correct answer.

Q: Which drug has the highest plasma protein binding?

Warfarin. ***Warfarin*** - **Warfarin** exhibits very **high plasma protein binding**, typically greater than 99%, primarily to albumin. - This high binding capacity means that only a small fraction of the drug is free and pharmacologically active. - Due to high protein binding, warfarin is susceptible to drug interactions when displaced from albumin. *Verapamil* - **Verapamil** has a relatively high plasma protein binding, around 90%, but it is not as high as warfarin. - Its binding is predominantly to **albumin** and alpha-1-acid glycoprotein. *Aspirin* - **Aspirin** (acetylsalicylic acid) has moderate plasma protein binding, usually between 50-90%, depending on the dosage. - It binds to **albumin** and can displace other protein-bound drugs. *GTN* - **Glyceryl trinitrate (GTN)** has moderate plasma protein binding, approximately 60%. - Its rapid onset and short duration of action are primarily due to its extensive first-pass metabolism and quick redistribution, rather than protein binding characteristics.

Question 1

Which organ is primarily supplied by the portal vein?

Accepted Answer

Liver

Answer

Spleen

Answer

Pancreas

Answer

Colon

Question 2

What is the typical length of the anal canal in adults?

Accepted Answer

35 - 40 mm

Answer

10 - 15 mm

Answer

15 - 20 mm

Answer

25 - 30 mm

Question 3

Superior wall of middle ear is formed by ?

Accepted Answer

Tegmen tympani

Answer

Jugular bulb

Answer

Tympanic membrane

Answer

Carotid wall

Question 4

What is the most dependent part of the peritoneal cavity in a female in the standing position?

Accepted Answer

Pouch of Douglas

Answer

Vesicouterine pouch

Answer

Paracolic gutter

Answer

None of the options

Question 5

All pass through jugular foramen except

Accepted Answer

Mandibular nerve

Answer

Vagus nerve

Answer

Internal jugular vein

Answer

Glossopharyngeal nerve

Question 6

Which muscle is the deepest in the anterior neck region?

Accepted Answer

Longus colli

Answer

Sternocleidomastoid

Answer

Platysma

Answer

Trapezius

Question 7

What is a cochleate uterus?

Accepted Answer

Acute anteflexion

Answer

Large uterus

Answer

Acute retroflexion

Answer

Large cervix

Question 8

Which dopamine receptor is known for its inhibitory action in the central nervous system?

Accepted Answer

Dopamine Receptor D2

Answer

Dopamine Receptor D5

Answer

No inhibitory dopamine receptor present

Answer

Dopamine Receptor D1

Question 9

Which of the following statements is true regarding omalizumab?

Accepted Answer

All of the options

Answer

Anti-IgE

Answer

Given subcutaneously

Answer

Used as add-on therapy in moderate to severe asthma prophylaxis

Question 10

Which drug has the highest plasma protein binding?

Accepted Answer

Warfarin

Answer

Verapamil

Answer

Aspirin

Answer

GTN

NEET-PG 2013

Anatomy

Obstetrics and Gynecology

Pharmacology