Anatomy
1 questionsMost common location of ectopic salivary gland is -
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 1051: Most common location of ectopic salivary gland is -
- A. Posterior triangle
- B. Parathyroid gland
- C. Cervical lymph nodes (Correct Answer)
- D. Anterior mediastinum
Explanation: Cervical lymph nodes - **Ectopic salivary gland tissue** is most frequently found within or adjacent to **cervical periparotid lymph nodes**. - This is thought to be due to inclusion of salivary gland anlage within lymph nodes during embryological development. *Anterior mediastinum* - While ectopic tissues can occur in the mediastinum, **salivary gland tissue** is not a common finding there. - The **mediastinum** is more commonly associated with ectopic **thymic** or **thyroid** tissue. *Posterior triangle* - The **posterior triangle of the neck** is a common site for various neck masses , but **ectopic salivary gland tissue** is rare in this location. - Masses here are more typically **lymphadenopathy**, **brachial cleft cysts**, or **fibromas**. *Parathyroid gland* - The **parathyroid glands** are endocrine glands located near or within the thyroid, and are not typically associated with containing **ectopic salivary gland tissue**. - Their embryological development is distinct from that of salivary glands.
Dermatology
1 questionsAll of the following are premalignant conditions except which of the following?
NEET-PG 2015 - Dermatology NEET-PG Practice Questions and MCQs
Question 1051: All of the following are premalignant conditions except which of the following?
- A. Bowen's Disease
- B. Pyoderma Gangrenosum (Correct Answer)
- C. Xeroderma Pigmentosum
- D. Actinic Keratosis
Explanation: ***Pyoderma Gangrenosum*** - This is a **neutrophilic dermatosis** characterized by rapidly enlarging, painful ulcers with undermined, violaceous borders. It is an inflammatory condition, not premalignant. - While often associated with systemic diseases such as **inflammatory bowel disease** or **rheumatoid arthritis**, it does not inherently carry an increased risk of developing into skin cancer. *Bowen's Disease* - This is a form of **squamous cell carcinoma in situ**, meaning the cancerous cells are confined to the epidermis and have not yet invaded the dermis. - It is considered a **premalignant lesion** because it has the potential to progress to invasive squamous cell carcinoma if left untreated. *Actinic Keratosis* - These are **rough, scaly patches** on the skin caused by years of sun exposure, predominantly in fair-skinned individuals. - Actinic keratoses are considered **premalignant lesions** with a risk of transforming into invasive squamous cell carcinoma. *Xeroderma Pigmentosum* - This is a rare, **autosomal recessive genetic disorder** characterized by a defect in DNA repair mechanisms, specifically nucleotide excision repair. - Individuals with xeroderma pigmentosum have an extremely high risk of developing various **skin cancers** (basal cell carcinoma, squamous cell carcinoma, melanoma) at an early age due to their inability to repair UV-induced DNA damage.
Internal Medicine
4 questionsClassic triad in Renal cell carcinoma includes all of the following, Except:
All of the following are paraneoplastic syndromes for renal cell carcinoma except which of the following?
Pseudoclaudication is caused by
CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is being investigated for the treatment of which malignancy?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1051: Classic triad in Renal cell carcinoma includes all of the following, Except:
- A. Hematuria
- B. Hypertension (Correct Answer)
- C. Flank mass
- D. Abdominal Pain
Explanation: ***Hypertension*** - While hypertension can occur in patients with renal cell carcinoma due to **renin secretion** or other mechanisms, it is **not considered one of the classic triad symptoms**. - The classic triad represents symptoms that historically led to diagnosis, though most RCCs are now discovered incidentally. *Hematuria* - **Gross or microscopic hematuria** is a common symptom of renal cell carcinoma [1], resulting from tumor invasion into the collecting system. - It is one of the **three classic symptoms** associated with advanced disease. *Flank mass* - A palpable **flank mass** indicates a sizable tumor infiltrating the renal parenchyma and is a classic sign of renal cell carcinoma [1]. - This symptom is often associated with later-stage disease. *Abdominal Pain* - **Flank pain** or abdominal pain is a frequent symptom of renal cell carcinoma, which may be caused by tumor growth, hemorrhage, or obstruction. - This symptom, along with hematuria and a flank mass, constitutes the **classic diagnostic triad**.
Question 1052: All of the following are paraneoplastic syndromes for renal cell carcinoma except which of the following?
- A. Fever
- B. Amyloidosis
- C. Anaemia
- D. Acanthosis Nigricans (Correct Answer)
Explanation: Acanthosis Nigricans - Acanthosis nigricans is primarily associated with **insulin resistance** and is not a known paraneoplastic syndrome related to renal cell carcinoma. - Paraneoplastic syndromes typically involve **systemic effects** of tumors rather than dermatological manifestations like acanthosis nigricans. *Fever* - Fever can occur as a result of the body's response to tumors, including renal cell carcinoma, and is classified as a **paraneoplastic syndrome**. - It reflects the **systemic inflammatory response** often seen with malignancies. *Anaemia* - Anaemia is a common paraneoplastic syndrome associated with renal cell carcinoma due to the production of **erythropoietin** or as a result of **chronic disease** [1]. - It can lead to **fatigue** and pallor in affected individuals, making it relevant to renal cancers [1]. *Amyloidosis* - Amyloidosis can occur as a paraneoplastic syndrome in various malignancies, including renal cell carcinoma, due to **protein misfolding** states. - It can lead to complications affecting **kidney function** and other organs, aligning it with renal cell carcinoma, though kidney tumors also frequently present with hypercalcemia [1].
Question 1053: Pseudoclaudication is caused by
- A. Femoral Artery stenosis
- B. Popliteal Artery stenosis
- C. Lumbar canal stenosis (Correct Answer)
- D. Radial Artery stenosis
Explanation: ***Lumbar canal stenosis*** - **Pseudoclaudication**, also known as **neurogenic claudication**, is a characteristic symptom of **lumbar canal stenosis**. - It is caused by **compression of spinal nerve roots** in the lumbar spine, leading to pain, numbness, or weakness in the legs, often exacerbated by standing or walking and relieved by sitting or stooping forward [1]. *Femoral Artery stenosis* - **Femoral artery stenosis** causes **vascular claudication**, which is pain in the leg muscles due to insufficient blood flow during exercise [2]. - Unlike pseudoclaudication, vascular claudication is typically relieved by rest and is not influenced by spinal position [2]. *Popliteal Artery stenosis* - **Popliteal artery stenosis** also leads to **vascular claudication**, presenting as calf pain during walking due to reduced blood supply to the distal leg [2]. - This condition is related to **peripheral artery disease**, distinct from neurological compression [2]. *Radial Artery stenosis* - **Radial artery stenosis** typically affects blood flow to the **hand and forearm**, potentially causing symptoms of ischemia in those areas. - It is not associated with leg pain or claudication.
Question 1054: CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is being investigated for the treatment of which malignancy?
- A. Acute Lymphoblastic Leukemia (Correct Answer)
- B. Renal Cell Carcinoma
- C. Pancreatic Cancer
- D. Glioblastoma Multiforme
Explanation: ***Acute Lymphoblastic Leukemia*** - **CAR T-cell therapy** has shown remarkable success, particularly in treating refractory or relapsed **B-cell acute lymphoblastic leukemia (ALL)** in children and young adults. - The therapy targets the **CD19 antigen** found on malignant B-cells, leading to their destruction by engineered T-cells. *Renal Cell Carcinoma* - While immune therapies are used for **renal cell carcinoma (RCC)**, traditional CAR T-cell therapy targeting specific antigens has not yet achieved widespread clinical success for this solid tumor. - RCC often presents with a **heterogeneous antigenic landscape**, making it challenging for single-target CAR T-cells. *Pancreatic Cancer* - **Pancreatic cancer** is a challenging malignancy due to its dense stroma and immunosuppressive microenvironment, which limits T-cell infiltration and efficacy. - CAR T-cell therapy for pancreatic cancer is still largely in **early-stage clinical trials**, facing significant hurdles in solid tumor treatment. *Glioblastoma Multiforme* - **Glioblastoma multiforme (GBM)** is an aggressive brain tumor with unique challenges for CAR T-cell therapy, including the **blood-brain barrier** and tumor heterogeneity. - Research is ongoing to develop CAR T-cells that can effectively target GBM, often using **regional delivery methods** or targeting multiple antigens.
Orthopaedics
1 questionsAdson's test is positive in -
NEET-PG 2015 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1051: Adson's test is positive in -
- A. Cervical rib (Correct Answer)
- B. Cervical spondylosis
- C. Cervical fracture
- D. Cervical dislocation
Explanation: ***Cervical rib*** - **Adson's test** assesses for **thoracic outlet syndrome (TOS)**, which can be caused by a cervical rib compressing the **subclavian artery** or **brachial plexus**. - A positive test occurs when the radial pulse diminishes or disappears upon specific head and arm maneuvers, indicating neurovascular compression. *Cervical spondylosis* - This condition involves **degenerative changes** in the cervical spine, such as bone spurs and disc herniation. - While it can cause neurological symptoms, it typically does not lead to a positive Adson's test, as the compression site is different from that assessed by the test. *Cervical fracture* - A cervical fracture is a **traumatic injury** to the bones of the neck. - Adson's test is not indicated for diagnosing fractures and performing it could exacerbate the injury. *Cervical dislocation* - Cervical dislocation is a severe injury where cervical vertebrae are **displaced from their normal alignment**. - Similar to fractures, Adson's test is not appropriate for diagnosing or evaluating dislocations and carries a risk of further injury.
Pharmacology
1 questionsIntracranial pressure may be increased by all of the following drugs except -
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1051: Intracranial pressure may be increased by all of the following drugs except -
- A. Quinolones
- B. Aminoglycosides (Correct Answer)
- C. Vitamin A
- D. Corticosteroids
Explanation: ***Aminoglycosides*** - **Aminoglycosides** are not typically associated with increasing intracranial pressure. Their primary toxicities include **ototoxicity** and **nephrotoxicity**. - There is no established physiological mechanism by which aminoglycosides directly elevate ICP. *Vitamin A* - **Vitamin A toxicity**, particularly the chronic form of hypervitaminosis A, is a known cause of **idiopathic intracranial hypertension (pseudotumor cerebri)**, which directly increases ICP. - This occurs due to an unknown mechanism that leads to impaired CSF absorption or increased CSF production. *Corticosteroids* - While corticosteroids are often used to reduce cerebral edema and ICP, their **withdrawal**, particularly after prolonged use, can lead to rebound increases in ICP. - In certain susceptible individuals, or with paradoxical reactions, corticosteroids can also induce **pseudotumor cerebri**, leading to elevated ICP. *Quinolones* - **Quinolones** (fluoroquinolones) have been implicated in cases of **drug-induced intracranial hypertension (pseudotumor cerebri)**. - The mechanism is not fully understood but is thought to involve effects on **cerebrospinal fluid dynamics**.
Surgery
2 questionsESWL is contraindicated in which of the following stones -
Surgery for undescended testis is recommended at what age?
NEET-PG 2015 - Surgery NEET-PG Practice Questions and MCQs
Question 1051: ESWL is contraindicated in which of the following stones -
- A. Urate stones
- B. Phosphate stones
- C. Oxalate Stones
- D. Cystine stones (Correct Answer)
Explanation: ***Cysteine stones*** - **Cystine stones** are very dense and hard, making them resistant to fragmentation by the shock waves generated during **Extracorporeal Shock Wave Lithotripsy (ESWL)**. - Due to their resistance to fragmentation, ESWL is generally ineffective for cystine stones, and other treatments like **ureteroscopy** or **percutaneous nephrolithotomy (PCNL)** are often preferred. *Oxalate Stones* - **Calcium oxalate stones** are generally **amenable to ESWL** as they are effectively fragmented by shock waves. - They are the **most common type of kidney stone** and often respond well to lithotripsy. *Urate stones* - **Uric acid stones** are typically **radiolucent** but are often **well-fragmented by ESWL**. - Their non-calcium composition does not hinder the effectiveness of shock waves. *Phosphate stones* - **Struvite (magnesium ammonium phosphate) stones** and **calcium phosphate stones** generally respond well to ESWL. - While sometimes large and branched (**staghorn calculi**), the individual components are susceptible to shock wave fragmentation, though multiple sessions or adjunctive therapies might be needed.
Question 1052: Surgery for undescended testis is recommended at what age?
- A. 36 months
- B. 12 months (Correct Answer)
- C. 24 months
- D. 6 months
Explanation: ***12 months*** - **Orchiopexy** for undescended testes is generally recommended around **12 months of age** to optimize fertility and reduce cancer risk. - This timing is within the ideal surgical window of **6-18 months**, balancing the allowance for potential spontaneous descent (which rarely occurs after 6 months) with minimizing germ cell damage. - Most pediatric surgeons prefer operating around **12 months** as it provides optimal outcomes. *6 months* - While **6 months is within the acceptable surgical window** (6-18 months), most surgeons prefer waiting closer to 12 months. - Operating at 6 months is not incorrect, but waiting a few more months allows for logistical planning and ensures any late spontaneous descent has occurred. - The key is to operate **before 18 months** to preserve fertility potential. *24 months* - Delaying surgery until 24 months (2 years) **exceeds the recommended window** and increases the risk of germ cell damage and potential future infertility. - While still beneficial compared to no surgery, the ideal timing for preserving fertility and minimizing malignancy risk has passed. *36 months* - Surgery at 36 months (3 years) is considered a **significant delay** and carries higher risks for long-term complications, including reduced fertility potential and increased risk of testicular cancer. - The benefits of early intervention are largely diminished by this age, though orchiopexy is still indicated to reduce cancer risk and for cosmetic/psychological reasons.