Anatomy
2 questionsWhich muscle receives a muscular branch from the ulnar nerve?
How many ossification centers develop at the distal end of the humerus?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 81: Which muscle receives a muscular branch from the ulnar nerve?
- A. Both FCU and FDP (Correct Answer)
- B. FCU
- C. None of the options
- D. FDP
Explanation: ***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.
Question 82: How many ossification centers develop at the distal end of the humerus?
- A. 2
- B. 3 (Correct Answer)
- C. 5
- D. 4
Explanation: ***3*** - The distal end of the humerus develops **three primary ossification centers**: the capitellum, trochlea, and medial epicondyle [1]. - These centers appear sequentially and their ossification pattern is important for assessing **skeletal maturity** in children using the CRITOE mnemonic [1]. - The capitellum appears at 1 year, medial epicondyle at 5 years, and trochlea at 9 years. *2* - This number is too low and only accounts for the **capitellum and medial epicondyle**, missing the trochlea. - While these are the first two to appear, there is an additional primary ossification center (trochlea) that develops later. *5* - This number is incorrect; there are only **three primary ossification centers** at the distal humerus, not five. - This may cause confusion with other joints or by counting secondary ossification centers. *4* - This number is incorrect; while the lateral epicondyle does ossify, it is not consistently counted as a **primary ossification center**. - The standard anatomical teaching recognizes **three primary centers**: capitellum, trochlea, and medial epicondyle.
Internal Medicine
2 questionsWhich of the following glands is NOT typically involved in Multiple Endocrine Neoplasia type II A (MEN II A)?
Autoimmune thyroiditis is associated with all except which of the following?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 81: Which of the following glands is NOT typically involved in Multiple Endocrine Neoplasia type II A (MEN II A)?
- A. Pituitary gland (Correct Answer)
- B. Thyroid gland
- C. Parathyroid gland
- D. Adrenal gland
Explanation: ***Pituitary gland*** - The **pituitary gland** is not a characteristic component of **MEN II A**. It is, however, associated with **Multiple Endocrine Neoplasia type I (MEN I)**, which involves the 3 Ps: **pituitary**, **parathyroid**, and **pancreas** [1]. - **MEN IIA** classically involves **medullary thyroid carcinoma**, **pheochromocytoma**, and **parathyroid hyperplasia** [1]. *Thyroid gland* - The **thyroid gland** is centrally involved in MEN IIA, specifically through the development of **medullary thyroid carcinoma (MTC)**, a hallmark feature. - MTC arises from the parafollicular C cells of the thyroid and secretes **calcitonin**. *Parathyroid gland* - The **parathyroid gland** is often involved in MEN IIA, typically presenting as **parathyroid hyperplasia** or adenoma, leading to **primary hyperparathyroidism**. - This typically results in elevated **parathyroid hormone** levels and **hypercalcemia**. *Adrenal gland* - The **adrenal gland** is a key player in MEN IIA due to the occurrence of **pheochromocytoma**, a tumor of the adrenal medulla. - Pheochromocytomas can be bilateral and secrete **catecholamines**, leading to hypertension and other symptoms.
Question 82: Autoimmune thyroiditis is associated with all except which of the following?
- A. DM
- B. Myasthenia gravis
- C. SLE
- D. Psoriasis (Correct Answer)
Explanation: ***Psoriasis*** - Psoriasis is generally not associated with **autoimmune thyroiditis**, which is more commonly linked to other autoimmune disorders [1]. - Autoimmune thyroiditis does not typically result in the **skin changes** seen in psoriasis, distinguishing them clinically. *Sly* - Sly syndrome, while a genetic disorder, is not directly connected to **autoimmune thyroiditis**. - Conditions like Sly syndrome are metabolic and do not involve the autoimmune pathways typically seen in thyroiditis. *Myasthenia gravis* - Myasthenia gravis is an **autoimmune neuromuscular disorder** that can occur concurrently with thyroid diseases, particularly **thyroiditis** [1]. - Both conditions arise from **autoimmune processes**, making their association plausible [1]. *DM* - Diabetes Mellitus (DM), particularly Type 1, is often linked with other autoimmune diseases, including **autoimmune thyroiditis** [2]. - They share a common **autoimmune pathway**, making them more likely to co-occur than psoriasis [2].
Pathology
3 questionsFlexner-Wintersteiner rosette is seen in-
Hurthle cell carcinoma is a variant of which type of carcinoma?
What are Councilman bodies and in which condition are they typically observed?
NEET-PG 2013 - Pathology NEET-PG Practice Questions and MCQs
Question 81: Flexner-Wintersteiner rosette is seen in-
- A. Retinoblastoma (Correct Answer)
- B. Hepatoblastoma
- C. Nephroblastoma
- D. Neuroblastoma
Explanation: ***Retinoblastoma*** - Flexner-Wintersteiner rosettes are **characteristic histological features** seen in retinoblastoma, indicating retinal differentiation [1]. - These rosettes reflect the **presence of photoreceptor-like structures**, which are specific to this type of tumor [1]. *Hepatoblastoma* - Histologically, hepatoblastoma shows **primitive epithelial cells** and **mixed patterns**, not Flexner-Wintersteiner rosettes. - It is primarily associated with **liver** and does not present with retinal differentiation. *Nephroblastoma* - Nephroblastoma, or Wilms tumor, typically exhibits **triphasic histology** (epithelial, stromal, and blastemal components) without rosette formation. - It primarily affects the **kidney** and does not involve the retina. *Neuroblastoma* - Neuroblastoma is characterized by **small round blue cells** and **neuroid differentiation** but lacks Flexner-Wintersteiner rosettes. - This tumor usually arises in the **adrenal glands** or sympathetic nervous system, not in retinal tissue. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Eye, p. 1342.
Question 82: Hurthle cell carcinoma is a variant of which type of carcinoma?
- A. Medullary carcinoma
- B. Papillary carcinoma
- C. Follicular carcinoma (Correct Answer)
- D. Anaplastic carcinoma
Explanation: **Follicular carcinoma** - **Hürthle cell carcinoma**, also known as **oxyphilic follicular carcinoma**, is a specific variant of **follicular carcinoma of the thyroid**. - It is characterized by the presence of large polygonal cells with abundant eosinophilic, granular cytoplasm known as **Hürthle cells** (or oxyphil cells) within the neoplastic growth. *Medullary carcinoma* - **Medullary carcinoma** originates from the **parafollicular C cells** of the thyroid, which produce calcitonin. - It is histologically distinct, featuring nests or cords of cells often associated with **amyloid deposits**, and is not related to Hürthle cell morphology. *Papillary carcinoma* - **Papillary carcinoma** is the most common type of thyroid cancer, characterized by distinctive **nuclear features** such as **Orphan Annie eye nuclei**, nuclear grooves, and intranuclear cytoplasmic inclusions. - Its histological origin and morphological appearance are different from Hürthle cell neoplasms, which are follicular in origin. *Anaplastic carcinoma* - **Anaplastic carcinoma** is a highly aggressive and undifferentiated thyroid malignancy with a very poor prognosis. - It is characterized by pleomorphic, giant, and spindle cells and lacks the specific differentiation seen in follicular or Hürthle cell tumors.
Question 83: What are Councilman bodies and in which condition are they typically observed?
- A. Wilson's disease
- B. Ballooning degeneration of hepatocytes
- C. Acute viral hepatitis (Correct Answer)
- D. Alcoholic liver disease
Explanation: **Option G*****Acute viral hepatitis*** - Councilman bodies are **characteristic histological findings** in acute viral hepatitis, associated with apoptotic hepatocytes [1]. - They represent **necrosis** of liver cells, which is commonly seen during the acute phase of viral infections affecting the liver [1]. *Alcoholic cirrhosis* - While liver damage is present, Councilman bodies are not typical; they are more associated with acute conditions rather than the chronic nature of cirrhosis. - **Fibrosis** and **bridging necrosis** are evident in alcoholic cirrhosis, distinct from the **acute necrotic changes** seen in viral hepatitis. *Ballooning of cells - Damaged cells show diffuse swelling known as ballooning degeneration.* - Ballooning degeneration indicates **cellular swelling**, often noted in conditions like steatosis or alcoholic liver disease, but does not lead to the formation of Councilman bodies. - These changes are different from the **pyknotic or karyolytic changes** associated with Councilman bodies in acute infections. *Hepatic cell necrosis - The necrosis is usually focal or centirzonal.* - This refers to various types of necrosis in the liver but does not specifically indicate the presence of Councilman bodies, which are linked with apoptotic cells. - While necrosis is common in hepatic pathology, Councilman bodies are particularly associated with **viral hepatitis**. *Wilson's disease* - Although it causes liver damage, it typically results in **copper accumulation** and associated features, not specifically Councilman bodies in its pathology. - The findings in Wilson's disease include **hepatocellular degeneration** without the distinct apoptotic features seen in **acute viral hepatitis**. Option F*Autoimmune hepatitis* - This condition may cause liver cell damage and necrosis but does not typically show Councilman bodies in its histological profile. - It primarily shows **interface hepatitis** and **lymphocytic infiltration**, contrasting with the **apoptotic bodies** seen in acute viral scenarios. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 386-387.
Pharmacology
2 questionsWhich of the following factors influences the duration of action of a drug?
Which of the following is not a cardioselective beta blocker?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 81: Which of the following factors influences the duration of action of a drug?
- A. Bioavailability
- B. Clearance
- C. Rate of elimination
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - **Clearance** and **rate of elimination** are the primary determinants of how long a drug stays in the body at therapeutic levels, thus directly influencing its duration of action. - **Bioavailability** affects the intensity and onset but can influence the perceived duration if subtherapeutic concentrations are achieved. - The interplay of these pharmacokinetic parameters ultimately determines the drug's therapeutic window and frequency of dosing. *Clearance* - **Clearance** is the rate at which the active drug is removed from the body, primarily by the kidneys and liver. - A higher clearance generally leads to a shorter elimination half-life and a **shorter duration of action**, as the drug is removed more quickly from the systemic circulation. *Rate of elimination* - The **rate of elimination** directly dictates how quickly the concentration of a drug in the body decreases over time. - A faster elimination rate (shorter half-life) means the drug's effects will wear off sooner, resulting in a **shorter duration of action**. - This is quantified by the elimination rate constant (Kel) and half-life (t½). *Bioavailability* - **Bioavailability** refers to the fraction of an administered dose of unchanged drug that reaches the systemic circulation. - While bioavailability primarily affects the **peak concentration (Cmax)** and **intensity** of drug effect, it can indirectly influence duration. - If bioavailability is very low, therapeutic concentrations may not be sustained long enough, effectively shortening the **clinically relevant duration of action**. - However, two drugs with identical elimination rates but different bioavailabilities will have the same elimination half-life and similar duration at therapeutic doses.
Question 82: Which of the following is not a cardioselective beta blocker?
- A. Nebivolol
- B. Atenolol
- C. Betaxolol
- D. Oxprenolol (Correct Answer)
Explanation: ***Oxprenolol*** - **Oxprenolol** is a non-selective beta-blocker with **intrinsic sympathomimetic activity (ISA)**, meaning it blocks both β1 and β2 receptors and partially stimulates them. - Its non-selective action means it affects both the heart (β1) and other organs like the lungs (β2), making it less suitable for patients with respiratory conditions. *Nebivolol* - **Nebivolol** is a highly cardioselective beta-blocker that primarily blocks **β1 receptors** and also has **vasodilatory properties** due to nitric oxide release. - Its high selectivity translates to fewer β2-mediated side effects, such as bronchoconstriction. *Atenolol* - **Atenolol** is a **cardioselective beta-blocker** that predominantly blocks **β1 receptors** at therapeutic doses. - This selectivity makes it a common choice for cardiovascular conditions, reducing the risk of bronchospasm compared to non-selective agents. *Betaxolol* - **Betaxolol** is a **cardioselective beta-blocker** primarily used for the treatment of hypertension and glaucoma. - It selectively blocks **β1 adrenergic receptors**, minimizing effects on the lungs compared to non-selective beta-blockers.
Surgery
1 questionsWhich condition typically presents with irregular, hard palpable masses in the breast?
NEET-PG 2013 - Surgery NEET-PG Practice Questions and MCQs
Question 81: Which condition typically presents with irregular, hard palpable masses in the breast?
- A. Non comedo DCIS
- B. Fibroadenoma
- C. Invasive ductal carcinoma (Correct Answer)
- D. Comedocarcinoma
Explanation: ***Paget's disease*** - Paget's disease of the breast leads to **palpable abnormalities** such as skin changes and underlying mass formation [1]. - Often presents with **nipple discharge** and alterations in the areola, indicating an underlying malignancy [2]. *Non comedo DCIS* - Non comedo ductal carcinoma in situ (DCIS) typically presents with **microscopic changes** and lacks palpable masses. - Frequently asymptomatic and may not cause any **significant clinical findings** or changes in the breast. *None* - This option suggests the absence of a related condition, which does not address the query about a type of DCIS causing a **palpable abnormality**. - In the context of DCIS, there are sure conditions (like Paget's) that **do cause palpable changes**. *Comedocarcinoma* - This type of DCIS is characterized by **necrosis and calcifications**, rather than a palpable mass. - While potentially aggressive, it usually does not present with noticeable **palpable abnormalities** like Paget's disease. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1061-1062. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 456-457.