NEET-PG 2015 Practice Questions

Q: APAF-1 is involved in the activation of which of the following caspases?

Caspase 9. ***Caspase 9*** - **APAF-1** (Apoptotic Protease Activating Factor-1) is a key component of the **apoptosome**, which is formed in response to intrinsic apoptotic signals. - The apoptosome recruits and activates **pro-caspase 9**, leading to its proteolytic cleavage and activation into **caspase 9**. *Caspase 8* - **Caspase 8** is primarily involved in the **extrinsic apoptotic pathway**, activated by cell surface death receptors and DISC (Death-Inducing Signaling Complex) formation. - It is not directly activated by APAF-1, which is specific to the intrinsic pathway. *Caspase 10* - **Caspase 10** is also an initiator caspase often associated with the **extrinsic apoptotic pathway**, similar to caspase 8. - Its activation typically occurs within the DISC and not through the apoptosome complex involving APAF-1. *Caspase 3* - **Caspase 3** is an **effector caspase** that is activated by upstream initiator caspases (like caspase 9 or caspase 8) in both intrinsic and extrinsic apoptotic pathways. - While it's a crucial caspase in apoptosis, it is too far downstream and not directly activated by APAF-1; APAF-1 activates caspase 9, which then activates caspase 3.

Q: Which of the following is not a postmortem change:

Atria mortis. ***Atria mortis*** - *Atria mortis* is not a recognized postmortem change; it appears to be a **nonsensical or fabricated term**. - **Postmortem changes** are a well-defined set of physical and chemical alterations that occur in a body after death. *Livor mortis* - This is a postmortem change characterized by the **reddish-purple discoloration** of the skin due to the settling of blood in capillaries under gravity. - It occurs after circulation ceases and typically becomes visible within 30 minutes to 2 hours after death. *Algor mortis* - This refers to the **postmortem cooling of the body** until it reaches ambient temperature. - The rate of cooling is influenced by environmental factors and body size, and it is used to estimate the time of death. *Rigor mortis* - This is the **stiffening of muscles** after death due to the depletion of ATP, preventing the separation of actin and myosin filaments. - It usually begins 2-4 hours after death, reaches maximum stiffness at 8-12 hours, and resolves within 24-36 hours due to muscle decomposition.

Q: A 50-year-old female presents with wrist drop. Which nerve is most likely involved?

Radial Nerve. ***Radial Nerve*** - **Wrist drop** is a classic symptom of **radial nerve** injury, which compromises the innervation of the **extensor muscles** of the wrist and fingers. - The radial nerve supplies motor function to the **triceps brahii**, brachioradialis, supinator, and the wrist and finger extensors. *Ulnar Nerve* - Injury to the ulnar nerve typically causes a **claw hand deformity** due to paralysis of the **interossei** and **lumbricals 3 and 4**, with sparing of the finger extensors. - Patients experience weakness in **finger adduction and abduction**, as well as sensory loss over the medial 1.5 digits and hypothenar eminence. *Median Nerve* - Median nerve injury often results in an **ape hand deformity** or **hand of benediction** (when attempting to make a fist), affecting muscles responsible for **thumb opposition** and **flexion of digits 2 and 3**. - It would not cause wrist drop, as the wrist extensors are innervated by the radial nerve. *Musculocutaneous Nerve* - Injury to the musculocutaneous nerve primarily affects the **biceps brachii** and **brachialis muscles**, leading to weakness in **elbow flexion** and **supination of the forearm**. - It does not innervate any muscles responsible for wrist extension or flexion, therefore it would not cause wrist drop.

Q: Which of the following is not considered an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Uterine malformation. ***Uterine malformation*** - While a uterine malformation can make IUD insertion more difficult or reduce its effectiveness, it is often considered a **relative contraindication**, depending on the specific anomaly and the patient's desire for contraception. - In certain cases, an IUD might still be a viable option, but it requires careful consideration and specialized insertion techniques. *Pregnancy* - The presence of an existing pregnancy is an **absolute contraindication** for IUD insertion, as it can lead to complications such as miscarriage or ectopic pregnancy. - An IUD is a contraceptive device, and inserting it when a woman is already pregnant directly contradicts its purpose and poses significant risks. *Undiagnosed vaginal bleeding* - This is an **absolute contraindication** because it could be a symptom of a serious underlying condition, such as cervical cancer, endometrial cancer, or ectopic pregnancy. - Inserting an IUD before diagnosing the cause of the bleeding could delay treatment of a potentially life-threatening condition and exacerbate the bleeding. *Pelvic inflammatory disease* - Current or recent (within the last 3 months) **pelvic inflammatory disease (PID)** is an **absolute contraindication** due to the increased risk of worsening infection. - IUD insertion can introduce bacteria from the vagina into the uterus, potentially exacerbating an existing infection or causing a new one.

Q: Blebs are associated with which type of cell injury?

Both. ***Correct: Both*** - Blebs (surface membrane protrusions) are associated with **both reversible and irreversible cell injury** - In **reversible injury**: cellular swelling causes cytoskeletal disruption leading to bleb formation; these blebs can resolve if the injurious stimulus is removed - In **irreversible injury**: more extensive and widespread blebbing occurs during apoptosis and necrosis, associated with cell death pathways - The key difference is in the **extent and reversibility**, not the presence or absence of blebs *Incorrect: Reversible* - While blebs do occur in reversible injury, this option is incomplete as it excludes their occurrence in irreversible injury - Blebs are seen in both types of cellular injury, making "reversible" alone an inadequate answer *Incorrect: Irreversible* - While blebs are prominent in irreversible injury (apoptosis and necrosis), they also occur in reversible injury - Standard pathology texts (Robbins) describe bleb formation as a feature of cellular swelling in reversible injury - This option is incomplete as it excludes reversible injury *Incorrect: None of the options* - This is incorrect because blebs are definitively associated with cell injury (both reversible and irreversible types) - Bleb formation is a well-recognized morphological change in cellular pathology

Q: Which type of pain is characterized by unknown etiology?

Idiopathic pain. ***Idiopathic pain*** - This term refers to pain where the **underlying cause** or pathology cannot be identified, despite thorough investigation. - It signifies that the **etiology is unknown**, fitting the description in the question directly. *Nociceptive pain* - This type of pain arises from the activation of **nociceptors** due to actual or threatened tissue damage. - Its etiology is typically clear, involving an injury, inflammation, or mechanical stress. *Neuropathic pain* - This pain results from damage or disease affecting the **somatosensory nervous system**. - The etiology is known to be nerve damage or dysfunction, not an unknown origin. *Inflammatory pain* - This pain is driven by the inflammatory process, involving the release of **pro-inflammatory mediators** at the site of tissue injury or infection. - The cause is directly linked to inflammation, making its etiology known.

Q: A woman firmly and persistently believes that her husband is cheating on her, despite any evidence to the contrary, and she disapproves of accepting any proof given in her husband's support. The other family members do not support her belief. This is an example of-

Delusion. ***Delusion*** - A **delusion** is a **fixed, false belief** that is not amenable to change in light of conflicting evidence. - The woman's persistent belief about her husband's infidelity, despite evidence to the contrary and disagreement from family members, fits the diagnostic criteria for a delusion. - This scenario specifically describes a **jealous delusion (Othello syndrome)**, where a person falsely believes their partner is unfaithful without any reasonable basis. - Key features: **firmly held**, **evidence-resistant**, **not shared by others** (non-bizarre delusion). *Illusion* - An **illusion** is a **misinterpretation of a real external stimulus**. - Example: Seeing a rope in dim light and thinking it's a snake. - In this case, there is no misperception of a real sensory stimulus; rather, it's a false belief held without basis in reality. *Hallucination* - A **hallucination** is a **sensory perception in the absence of an external stimulus**. - Examples include hearing voices when no one is speaking, or seeing objects that aren't present. - The woman is not experiencing false sensory perceptions; she is holding a fixed false belief about her husband's actions. *Perversion* - **Perversion** refers to a **deviation from what is considered normal**, often used in the context of sexual behavior or moral corruption. - This term does not describe a psychotic symptom or cognitive disorder like a delusion. - Not relevant to the clinical presentation of fixed false beliefs in psychiatric disorders.

Q: Sexual asphyxia is seen in cases of:

Masochism. ***Masochism*** - **Sexual asphyxia** (also known as autoerotic asphyxiation or hypoxyphilia) is a dangerous practice where an individual intentionally reduces oxygen supply to the brain during sexual activity to enhance sexual arousal through cerebral hypoxia. - This practice is associated with **sexual masochism disorder**, where sexual gratification is derived from experiencing pain, suffering, or potentially life-threatening situations. - The oxygen deprivation creates a sense of euphoria and heightened arousal, but carries significant risk of accidental death. - This is considered a particularly dangerous form of masochistic sexual behavior. *Sadism* - **Sexual sadism disorder** involves deriving sexual pleasure from inflicting pain, suffering, or humiliation on others. - The focus is on causing distress to another person, whereas sexual asphyxia is typically self-inflicted (autoerotic) or involves the practitioner being the one deprived of oxygen. *Voyeurism* - **Voyeuristic disorder** refers to obtaining sexual pleasure from secretly observing unsuspecting individuals who are naked, disrobing, or engaging in sexual activity. - It does not involve any form of physical risk, asphyxia, or oxygen deprivation. *Fetishism* - **Fetishistic disorder** is a paraphilia where sexual arousal and gratification are primarily associated with inanimate objects (e.g., shoes, underwear) or specific non-genital body parts. - This condition does not involve asphyxiation; the focus is on a particular object or body part as the source of sexual pleasure.

Q: Penile buccal coitus is:

Fellatio. ***Fellatio*** - **Fellatio** specifically refers to oral sex involving stimulation of the penis with the mouth. - The term "buccal coitus" in the context of penile stimulation directly describes the act of fellatio. *Sadism* - **Sadism** is a paraphilia characterized by deriving sexual pleasure from inflicting pain, humiliation, or suffering on others. - It does not describe a specific sexual act involving penile buccal coitus, but rather the motivation behind certain acts. *Fetishism* - **Fetishism** involves sexual attraction to non-genital body parts or inanimate objects. - While oral sex can be a preference, it is not inherently a fetish unless the focus is exclusively or predominantly on the mouth or penis as an isolated object, rather than interpersonal sexual activity. *Cunnilingus* - **Cunnilingus** is a form of oral sex involving stimulation of the vulva or clitoris. - This term describes oral sex directed at female genitalia, not the penis.

Q: In which of the following conditions is Stereotactic Radiosurgery primarily indicated?

Arteriovenous malformation of the brain. ***Arteriovenous malformation of the brain*** - **Stereotactic Radiosurgery (SRS)** is a highly effective treatment for brain AVMs, particularly those that are **small to medium-sized** and located in eloquent brain regions. - SRS delivers a **highly focused dose of radiation** directly to the AVM, causing the abnormal blood vessels to gradually close off over time, reducing the risk of hemorrhage. *Medulloblastoma of the spinal cord* - Medulloblastoma is a **highly aggressive malignant brain tumor** that often metastasizes to the spinal cord via cerebrospinal fluid. - Treatment for spinal medulloblastoma typically involves **cranio-spinal irradiation with chemotherapy**, and SRS is generally not the primary treatment modality for diffuse spinal disease. *Ependymoma* - Ependymomas are tumors arising from the **ependymal cells** lining the ventricles and spinal cord. - While surgery is the primary treatment, radiotherapy, including **conventional fractionated external beam radiation**, is often used as adjuvant therapy, but SRS is less commonly the sole primary indication. *Glioblastoma multiforme* - Glioblastoma multiforme (GBM) is the **most aggressive primary brain tumor** and is typically treated with **maximal surgical resection followed by concurrent chemoradiotherapy**. - While SRS may be used in carefully selected cases for **recurrent GBM** or as a boost in primary treatment, it is not the primary solitary indication for initial management.

Question 1

APAF-1 is involved in the activation of which of the following caspases?

Accepted Answer

Caspase 9

Answer

Caspase 8

Answer

Caspase 10

Answer

Caspase 3

Question 2

Which of the following is not a postmortem change:

Accepted Answer

Atria mortis

Answer

Livor mortis

Answer

Algor mortis

Answer

Rigor mortis

Question 3

A 50-year-old female presents with wrist drop. Which nerve is most likely involved?

Accepted Answer

Radial Nerve

Answer

Ulnar Nerve

Answer

Median Nerve

Answer

Musculocutaneous Nerve

Question 4

Which of the following is not considered an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Accepted Answer

Uterine malformation

Answer

Undiagnosed vaginal bleeding

Answer

Pregnancy

Answer

Pelvic inflammatory disease

Question 5

Blebs are associated with which type of cell injury?

Accepted Answer

Both

Answer

Reversible

Answer

Irreversible

Answer

None of the options

Question 6

Which type of pain is characterized by unknown etiology?

Accepted Answer

Idiopathic pain

Answer

Nociceptive pain

Answer

Neuropathic pain

Answer

Inflammatory pain

Question 7

A woman firmly and persistently believes that her husband is cheating on her, despite any evidence to the contrary, and she disapproves of accepting any proof given in her husband's support. The other family members do not support her belief. This is an example of-

Accepted Answer

Delusion

Answer

Illusion

Answer

Hallucination

Answer

Perversion

Question 8

Sexual asphyxia is seen in cases of:

Accepted Answer

Masochism

Answer

Sadism

Answer

Voyeurism

Answer

Fetishism

Question 9

Penile buccal coitus is:

Accepted Answer

Fellatio

Answer

Sadism

Answer

Fetishism

Answer

Cunnilingus

Question 10

In which of the following conditions is Stereotactic Radiosurgery primarily indicated?

Accepted Answer

Arteriovenous malformation of the brain

Answer

Ependymoma

Answer

Medulloblastoma of the spinal cord

Answer

Glioblastoma multiforme

NEET-PG 2015

Biochemistry

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pathology

Physiology

Psychiatry

Radiology