NEET-PG 2013 Practice Questions

Q: Upper two posterior intercostal arteries arise from ?

Superior intercostal artery. ***Superior intercostal artery*** - The **superior intercostal artery** is a branch of the **costocervical trunk**, which itself arises from the subclavian artery. - It supplies the **first two posterior intercostal spaces**, hence the "upper two" mentioned in the question. *Aorta* - The **descending thoracic aorta** directly supplies the posterior intercostal arteries from the **3rd to the 11th intercostal spaces**. - It does not, however, supply the first two posterior intercostal arteries. *Internal mammary artery* - The **internal mammary artery** (also known as the internal thoracic artery) supplies the **anterior intercostal arteries** [1]. - It arises from the **subclavian artery** [1] but is not involved in supplying the posterior intercostal spaces. *Bronchial artery* - **Bronchial arteries** primarily supply the **lungs and bronchi**, providing oxygenated blood to the lung tissue. - They are not the main source of blood supply for the intercostal spaces.

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 approximate ratio of connective tissue to smooth muscle in the cervix?

Approximately 8:1. ***Approximately 8:1*** - The **cervix** is predominantly composed of **fibrous connective tissue**, which provides its structural integrity and rigidity [1]. - This high ratio of **collagenous connective tissue** to smooth muscle is crucial for maintaining pregnancy and undergoing significant remodeling during parturition [1]. - The approximate ratio is **8:1 to 10:1**, with connective tissue forming about 85-90% of cervical tissue [1]. *2:1* - This ratio would imply a significantly higher proportion of **smooth muscle** (33%), making the cervix much more muscular and less fibrous than it actually is. - Such a composition would compromise the cervical function of maintaining a **closed uterine orifice** during pregnancy. *5:1* - While higher than 2:1, this ratio still underestimates the true dominance of **connective tissue** in the cervical structure. - The **cervix's mechanical properties**, including its ability to resist stretching, are primarily due to its abundant collagen content. *15:1* - This ratio overestimates the proportion of connective tissue, suggesting less than 7% smooth muscle. - While the cervix is indeed fibrous, it does contain a modest amount of **smooth muscle** (10-15%) particularly in the internal os region, making this ratio too extreme [1].

Q: Which muscle plays a role in winking?

Orbicularis oculi. ***Orbicularis oculi*** - This muscle is responsible for **closing the eyelid** and is essential for actions like blinking, squinting, and winking. - Its fibers encircle the eye and facilitate the **controlled closure** required for winking. *Levator labii superioris* - This muscle primarily functions to **elevate the upper lip**, playing a role in facial expressions such as sneering or smiling. - It has no direct involvement in the movement of the eyelids or the act of winking. *Corrugator supercilii* - This muscle is located in the eyebrow region and is responsible for **drawing the eyebrows medially and inferiorly**, creating vertical wrinkles between the eyebrows. - It is associated with expressions of frowning or concern, not eyelid closure. *Levator palpebrae* - This muscle is responsible for **opening the upper eyelid**, thus counteracting the action of the orbicularis oculi. - While essential for eye movement, it is not involved in the closing action required for winking.

Q: Which subtype of Acute Myeloid Leukemia (AML) is most commonly associated with gum hypertrophy?

Acute Myeloid Leukemia M4. ***M4*** - **Acute Myeloid Leukemia (AML) M4** is associated with **monocytic differentiation**, leading to gum hypertrophy due to infiltration of the gums by leukemic cells [1]. - Patients may present with **gingival bleeding**, pain, and swelling in addition to other systemic symptoms of leukemia. *M3* - Known as **acute promyelocytic leukemia**, it typically presents with **coagulopathy** and not gum hypertrophy [1]. - Characterized by **promyelocytes** with heavy granulation and the presence of **faggot cells** (auer rods) [1]. *M2* - Represents a **myeloblastic type** of acute leukemia but is less commonly associated with **gingival hyperplasia**. - Associated with **more typical myeloid features** and presents with **anemia** and **thrombocytopenia**. *M1* - This is a **minimally differentiated type** of acute myeloid leukemia with **myeloblasts** and no significant differentiating features like gum hypertrophy. - Often presents with **rapid onset of symptoms** related to bone marrow failure, rather than localized gum issues. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 620-622.

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 of the following statements is true regarding light microscopy findings in minimal change disease?

No significant changes are seen under light microscopy.. ***No change seen*** - In minimal change disease, **light microscopy** typically shows no significant changes, which is a key characteristic of the condition [1]. - The disease primarily affects the **podocytes** leading to **nephrotic syndrome**, while light microscopy does not reveal any abnormalities [1]. *Loss of foot process seen* - Loss of foot processes is actually observed under **electron microscopy**, not light microscopy. - Light microscopy remains normal, differentiating minimal change disease from other glomerular diseases. *IgA deposits seen* - IgA deposits are associated with **IgA nephropathy**, which is a different condition characterized by mesangial deposition. - Minimal change disease does not have **immunofluorescence** findings, and thus shows no such deposits on light microscopy [1]. *Anti GBM Abs seen* - Anti-GBM antibodies are characteristic of **Goodpasture syndrome**, which presents with significant changes in glomerular structure. - In minimal change disease, there are no **anti-GBM antibodies** or major changes visible under light microscopy. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 927-928.

Q: Localized Langerhans cell histiocytosis affecting head and neck is?

Eosinophilic granuloma. ***Eosinophilic granuloma*** - This is a localized form of **Langerhans cell histiocytosis** that typically presents in the head and neck region, often affecting areas like the skull and mandible [1]. - Characterized by **bone lesions** and may present with **pain or swelling** in the affected area, making it a prominent form in children and young adults. *Pulmonary langerhans cell histiocytosis* - Primarily affects the **lungs** and is associated with **cough, dyspnea**, and pulmonary nodules, not the head and neck region. - Occurs predominantly in **smokers** and involves interstitial lung disease patterns on imaging studies. *Hand-schuller-christian disease* - This condition is a systemic form of Langerhans cell histiocytosis that affects multiple systems rather than being localized, commonly presenting with **diabetes insipidus** and bone lesions. - It is often associated with **exophthalmos** and may involve lymphadenopathy, affecting older children and adults, not localized head and neck involvement. *Letterer-siwe disease* - This represents the acute, disseminated form of Langerhans cell histiocytosis, affecting infants, and is marked by systemic symptoms like **fever**, **rash**, and **hepatosplenomegaly** [1]. - Typically presents with serious manifestations and not specifically localized in the **head and neck area** as seen in eosinophilic granuloma. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, p. 630.

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: Which of the following statements about Polycythemia vera is false?

Increased LAP score. ***Decrease LAP score*** - In polycythemia vera, the **LAP (leukocyte alkaline phosphatase) score** is typically increased, indicating more mature leukocytes. - A **decrease in LAP score** is not consistent with the disease, making this statement incorrect. *Increased platelets* - Polycythemia vera often results in **thrombocytosis**, characterized by increased platelet counts [1]. - This is a common feature of the disorder, reflecting overproduction of blood cells in the bone marrow. *Leucocytosis* - Patients with polycythemia vera frequently exhibit **leucocytosis**, or increased white blood cell counts, due to hypercellularity of the bone marrow [1]. - This is an important aspect of the disease, often seen alongside increases in red blood cells and platelets. *Increased vit B12* - An elevation in **vitamin B12** levels can occur in polycythemia vera, often due to increased binding proteins. - This is a well-recognized phenomenon associated with the increased cell turnover in this condition. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 626-627.

Question 1

Upper two posterior intercostal arteries arise from ?

Accepted Answer

Superior intercostal artery

Answer

Internal mammary artery

Answer

Bronchial artery

Answer

Aorta

Question 2

Which organ is primarily supplied by the portal vein?

Accepted Answer

Liver

Answer

Spleen

Answer

Pancreas

Answer

Colon

Question 3

What is the approximate ratio of connective tissue to smooth muscle in the cervix?

Accepted Answer

Approximately 8:1

Answer

2:1

Answer

5:1

Answer

15:1

Question 4

Which muscle plays a role in winking?

Accepted Answer

Orbicularis oculi

Answer

Levator labii superioris

Answer

Levator palpebrae

Answer

Corrugator supercilii

Question 5

Which subtype of Acute Myeloid Leukemia (AML) is most commonly associated with gum hypertrophy?

Accepted Answer

Acute Myeloid Leukemia M4

Answer

Acute Myeloid Leukemia M2

Answer

Acute Myeloid Leukemia M3

Answer

Acute Myeloid Leukemia M1

Question 6

What is a cochleate uterus?

Accepted Answer

Acute anteflexion

Answer

Large uterus

Answer

Acute retroflexion

Answer

Large cervix

Question 7

Which of the following statements is true regarding light microscopy findings in minimal change disease?

Accepted Answer

No significant changes are seen under light microscopy.

Answer

Foot process effacement is observed under electron microscopy, not light microscopy.

Answer

Anti-GBM antibodies are associated with Goodpasture syndrome, not minimal change disease.

Answer

IgA deposits are characteristic of IgA nephropathy, not minimal change disease.

Question 8

Localized Langerhans cell histiocytosis affecting head and neck is?

Accepted Answer

Eosinophilic granuloma

Answer

Letterer-siwe disease

Answer

Pulmonary Langerhans cell histiocytosis

Answer

Hand-Schuller-Christian disease

Question 9

Anemia with reticulocytosis is seen in -

Accepted Answer

Hemolysis

Answer

Iron deficiency anemia

Answer

Vitamin B12 deficiency

Answer

Aplastic anemia

Question 10

Which of the following statements about Polycythemia vera is false?

Accepted Answer

Increased LAP score

Answer

Increased vitamin B12 levels

Answer

Leukocytosis is present

Answer

Increased platelet count

NEET-PG 2013

Anatomy

Dental

Obstetrics and Gynecology

Pathology