NEET-PG 2015 Practice Questions

Q: Which of the following statements about the bare area of the liver is false?

It is circular in shape. ***It is circular in shape*** - The bare area of the liver is **triangular** in shape, bordered by the reflections of the **coronary ligaments** and the inferior vena cava. [1] - Its shape is dictated by the anatomical arrangement of these peritoneal folds, making it distinctly non-circular. *Infection can spread from the abdominal to thoracic cavity at this area* - This statement is true because the bare area is the only part of the liver not covered by **peritoneum**, allowing direct contact between the liver and the diaphragm. [1] - This anatomical arrangement facilitates the spread of infections, like **subphrenic abscesses**, from the abdominal cavity to the posterior mediastinum and pleural cavity. [2] *It is not a site of portocaval anastomosis* - This statement is true; there is **no direct portosystemic shunt** at the bare area of the liver that becomes significant in portal hypertension. - While small veins connect the liver capsule to the diaphragm, these do not represent major portocaval anastomoses like those found at the gastroesophageal junction or rectum. *Formed by the reflections of coronary ligaments* - This statement is true; the bare area is specifically demarcated by the points where the **anterior and posterior layers of the coronary ligament** diverge, leaving a triangular region of the liver directly apposed to the diaphragm. [1] - The **coronary ligaments** are reflections of the peritoneum from the diaphragm onto the superior surface of the liver.

Q: Which of the following conditions is ruled out in a twin pregnancy of the same age and sex?

Superfetation. ***Superfetation*** - **Superfetation** refers to the fertilization of an ovum when another pregnancy is already established in the uterus, resulting in two fetuses of **different gestational ages**. - As the question specifies a twin pregnancy of the **same age**, superfetation is ruled out. *Monozygotic twins* - **Monozygotic twins** originate from a single zygote that splits, resulting in genetically identical individuals of the **same sex** and age. - This condition is consistent with the given scenario of same-sex, same-aged twins. *Superfecundation* - **Superfecundation** is the fertilization of two or more ova from the same ovulatory cycle by sperm from **different acts of coitus** (which may involve different partners). - The twins are of the **same gestational age** (same cycle) but are **dizygotic**, and can be either the same sex or different sexes. - This condition is NOT ruled out by the criteria given in the question. *None of the following* - This option is incorrect because **superfetation** is definitively ruled out by the criteria of the question (twins of the same age).

Q: All of the following are paraneoplastic syndromes for renal cell carcinoma except which of the following?

Acanthosis Nigricans. 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].

Q: What condition is diagnosed using the Amsel criteria?

Bacterial vaginosis. ***Bacterial vaginosis*** - The **Amsel criteria** are specifically used for the clinical diagnosis of **bacterial vaginosis (BV)**. - The criteria include the presence of at least three of four findings: **homogeneous discharge**, **vaginal pH >4.5**, **positive whiff test**, and **clue cells** on microscopy. *Antiphospholipid antibody syndrome* - This syndrome is diagnosed based on **clinical criteria** (thrombosis, pregnancy morbidity) and the presence of persistent **antiphospholipid antibodies** (lupus anticoagulant, anti-cardiolipin, anti-β2-glycoprotein I antibodies). - It does not involve the use of the Amsel criteria. *Ovarian ectopic pregnancy* - Diagnosed primarily through **ultrasound imaging** showing a gestational sac or fetal heartbeat within the ovary, often accompanied by clinical symptoms like abdominal pain and vaginal bleeding. - This condition is not related to vaginal infections or the Amsel criteria. *HELLP Syndrome* - **HELLP syndrome** (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe obstetric complication usually occurring in pregnancy, diagnosed by **laboratory findings** of these specific abnormalities. - It is a systemic condition, not a vaginal infection, and does not use the Amsel criteria for diagnosis.

Q: Which of the following statements about MALToma is true?

H. Pylori infection is a known risk factor. ***H. Pylori infection is a risk factor*** - MALToma, or **mucosa-associated lymphoid tissue lymphoma**, is often associated with chronic **H. Pylori infection**, making it a significant risk factor [1]. - **Eradication of H. Pylori** can lead to regression of MALT lymphoma, further supporting the association. *They are a type of T cell lymphoma* - MALToma is classified as a **B-cell lymphoma**, primarily arising from **marginal zone B cells** [1]. - T-cell lymphomas differ significantly in their **pathophysiology** and typical clinical presentations. *They are secondary gastric lymphomas* - MALTomas typically arise **primarily** in the gastric mucosa rather than as secondary lymphomas from another site [1]. - Secondary lymphomas are usually related to more aggressive forms and are often associated with **systemic involvement**. *Commonly seen in gastric cardia* - MALTomas are most frequently found in the **stomach** but are not specifically concentrated in the **gastric cardia** region. - They can also manifest in other areas such as the **antrum**, making this statement misleading. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 356-358.

Q: Substance used for PET scan is

18F-FDG. ***18F-FDG*** - **18F-FDG (Fluorodeoxyglucose)** is a glucose analog labeled with a **positron-emitting radioisotope**, fluorine-18 (18F). - It is the most commonly used radiotracer in PET scans, as it accumulates in cells with high metabolic activity, particularly **cancer cells** and activated brain cells. *Gadolinium* - **Gadolinium** is a paramagnetic contrast agent primarily used in **MRI scans** to enhance the visualization of blood vessels and abnormal tissues. - It does not emit positrons and is therefore not suitable for PET imaging. *Gastrografin* - **Gastrografin** is an oral, water-soluble contrast agent containing **iodine**, typically used in **X-rays** and **CT scans** of the gastrointestinal tract. - It is not a radioactive tracer and has no application in PET imaging. *Iodine* - **Iodine** in various forms can be used as a contrast agent in **X-rays** and **CT scans**, or as a radioactive isotope (e.g., **I-131**) for **thyroid imaging** and treatment. - While some isotopes of iodine are radioactive, they are not typically used for PET imaging, which relies on positron emission.

Q: All of the following may lead to gall bladder carcinoma except which of the following?

Echinococcus Granulosus Infection. ***Echinococcus Granulosus Infection*** - Echinococcus granulosus is primarily associated with **hydatid cyst formation**, not directly linked to gallbladder carcinoma. - This infection typically affects the **liver** rather than inducing malignant transformation in the gallbladder. *Typhoid carriers* - Chronic infection with **Salmonella typhi** in carriers can cause **gallbladder inflammation** and is a risk factor for gallbladder cancer. - Typhoid carriers retain the bacteria in the gallbladder, leading to chronic irritation and potentially malignant changes. *Gall Bladder Polyps* - Certain types of gallbladder polyps, especially those larger than **1 cm**, have a significant risk of undergoing malignant transformation. - They are associated with **chronic inflammation** and may progress to cancer if not monitored. *Exposure to carcinogens like nitrosamine* - Nitrosamines are known **carcinogens** that can induce protein modifications leading to DNA damage, contributing to gallbladder cancer. - Long-term exposure to such chemicals can result in **cellular mutations** in the gallbladder epithelial lining.

Q: Which of the following statements about undescended testis is true?

Increased risk of malignancy. ***Increased risk of malignancy*** - Undescended testis is associated with a **3 to 14 times increased risk** of testicular malignancy, particularly **seminoma**. - The risk remains elevated even after orchiopexy, though the procedure allows for **easier surveillance and examination**. - This is one of the **most important clinical features** of cryptorchidism and a key reason for early surgical correction. - Even a **corrected cryptorchid testis** maintains higher cancer risk compared to normally descended testes. *Secondary sexual characteristics are universally normal* - In **unilateral cryptorchidism** (90% of cases), the normally descended contralateral testis produces **adequate testosterone** for normal secondary sexual development. - However, in **bilateral cryptorchidism** or if the descended testis is functionally impaired, **testosterone deficiency** can occur, leading to delayed or abnormal sexual development. - Therefore, secondary sexual characteristics are **not universally normal** in all cases of undescended testis. *Hormonal therapy is effective* - Hormonal therapy with **hCG (human chorionic gonadotropin)** or **GnRH (gonadotropin-releasing hormone)** has **limited and inconsistent effectiveness**. - Success rates are generally **low** (10-30%), particularly for truly undescended testes (as opposed to retractile testes). - **Orchiopexy** (surgical correction) remains the **definitive treatment**, ideally performed between **6-18 months of age** to optimize fertility potential. *More common on the right side* - Undescended testis is actually **slightly more common on the left side** (~55-60%) than the right (~40-45%). - **Bilateral cryptorchidism** occurs in approximately 10-20% of cases. - There is no significant right-sided predilection.

Question 1

Which of the following statements about the bare area of the liver is false?

Accepted Answer

It is circular in shape

Answer

It is not a site of portocaval anastomosis

Answer

Formed by the reflections of coronary ligaments

Answer

Infection can spread from the abdominal to thoracic cavity at this area

Question 2

Which of the following conditions is ruled out in a twin pregnancy of the same age and sex?

Accepted Answer

Superfetation

Answer

Monozygotic twins

Answer

Superfecundation

Answer

None of the following

Question 3

All of the following are paraneoplastic syndromes for renal cell carcinoma except which of the following?

Accepted Answer

Acanthosis Nigricans

Answer

Fever

Answer

Amyloidosis

Answer

Anaemia

Question 4

What condition is diagnosed using the Amsel criteria?

Accepted Answer

Bacterial vaginosis

Answer

Antiphospholipid antibody syndrome

Answer

Ovarian ectopic pregnancy

Answer

HELLP Syndrome

Question 5

Which of the following statements about MALToma is true?

Accepted Answer

H. Pylori infection is a known risk factor

Answer

They are primary gastric lymphomas

Answer

They are a type of T cell lymphoma

Answer

Exclusively seen in the gastric antrum

Question 6

Substance used for PET scan is

Accepted Answer

18F-FDG

Answer

Gadolinium

Answer

Gastrografin

Answer

Iodine

Question 7

A 55 year old woman presented with history of recurrent episodes of right upper abdominal pain for the last one year. She presented to emergency with history of jaundice and fever for 2 days. On examination, the patient appeared toxic and had a blood pressure of 100/60 mmHg. She was started on intravenous antibiotics. Ultrasound of the abdomen showed presence of stones in the common bile duct. What would be the best treatment option for her -

Accepted Answer

Endoscopic Retrograde Cholangiopancreatography (ERCP) and bile duct stone extraction

Answer

Open bile duct surgery for stone removal

Answer

Lithotripsy for bile duct stones

Answer

Laparoscopic cholecystectomy (gallbladder removal)

Question 8

Which of the following statements about heart transplantation is false?

Accepted Answer

It is only orthotopic and not heterotopic

Answer

High pulmonary arterial resistance is a contraindication

Answer

Immunosuppression is started preoperatively

Answer

A beating heart cadaver/donor is not always needed.

Question 9

All of the following may lead to gall bladder carcinoma except which of the following?

Accepted Answer

Echinococcus Granulosus Infection

Answer

Gall Bladder Polyps

Answer

Typhoid carriers

Answer

Exposure to carcinogens like nitrosamine

Question 10

Which of the following statements about undescended testis is true?

Accepted Answer

Increased risk of malignancy

Answer

Hormonal therapy is effective

Answer

More common on the right side

Answer

Secondary sexual characteristics are universally normal

NEET-PG 2015

Anatomy

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pathology

Radiology

Surgery