NEET-PG 2015 Practice Questions

Q: B cells are located in which region of lymph nodes?

Cortical follicles. ***Cortical follicles*** - **B cells** are predominantly found within the **cortical follicles** of lymph nodes, where they mature and become activated upon encountering antigens [2]. - These follicles can be primary (inactive) or secondary (active, containing **germinal centers** for B cell proliferation and differentiation). *Paracortical region* - The **paracortical region** is primarily occupied by **T cells** and is the site where T cells interact with antigen-presenting cells [1]. - While it's adjacent to B cell areas, it's not the primary location for B cells. *Medullary sinuses* - **Medullary sinuses** are channels in the medulla of the lymph node, containing macrophages and plasma cells, which are *differentiated B cells*. - They are not the primary residence for undifferentiated B cells. *Subcapsular region* - **Subcapsular region** is the space immediately beneath the capsule of the lymph node where lymph initially enters. - It contains macrophages and dendritic cells that sample antigens but is not a primary B cell zone.

Q: Sertoli cells are derived from -

Coelomic epithelium. Sertoli cells are derived from the **coelomic epithelium** (surface epithelium) of the urogenital ridge during gonadal development. - The coelomic epithelium proliferates to form the **primitive sex cords** (medullary cords in males), and cells within these cords differentiate into Sertoli cells. - These cells are essential for **spermatogenesis**, providing structural support and nutrition to developing germ cells, and producing **anti-Müllerian hormone (AMH)** which causes regression of Müllerian ducts in male development [1]. *Germinal epithelium* - This is an **outdated term** previously used for the surface epithelium of the gonad, based on the misconception that it gave rise to germ cells. - Modern embryology uses the term **coelomic epithelium** or surface epithelium instead. - While historically used, this terminology is no longer preferred in current medical literature. *Genital swelling* - **Genital swellings** (labioscrotal swellings) are external mesodermal structures that develop into the **scrotum** in males or **labia majora** in females. - These are external genitalia components and are not the source of internal testicular cells like Sertoli cells. *Primordial germ cells* - **Primordial germ cells (PGCs)** originate from the epiblast, migrate via the hindgut to the developing gonads, and differentiate into **spermatogonia** (males) or **oogonia** (females) [1]. - They form the **germ cell lineage** (gametes), not somatic support cells like Sertoli cells, which are of coelomic epithelial origin.

Q: Shrinking Lung Syndrome is seen in:

SLE. ***SLE*** - **Shrinking lung syndrome (SLS)** is a rare but recognized pulmonary manifestation of **systemic lupus erythematosus (SLE)** [1]. - It is characterized by **dyspnea**, **pleuritic chest pain**, and elevated diaphragms with reduced lung volumes, often without significant interstitial lung disease [1]. *Rheumatoid Arthritis* - While **rheumatoid arthritis** can cause various lung manifestations like **interstitial lung disease (ILD)**, pleural effusions, and rheumatoid nodules, **shrinking lung syndrome** is not typically associated with it [2]. - Lung disease in RA often involves **pulmonary fibrosis** or bronchiolitis, differing from the restrictive physiology of SLS. *Scleroderma* - **Scleroderma (Systemic Sclerosis)** commonly affects the lungs, primarily leading to **interstitial lung disease (ILD)** and **pulmonary hypertension** [1]. - **Shrinking lung syndrome**, with its characteristic restrictive pattern and elevated diaphragms, is not a typical presentation of lung involvement in scleroderma. *Sarcoidosis* - **Sarcoidosis** is characterized by the formation of **non-caseating granulomas**, primarily affecting the lungs and lymph nodes. - Lung involvement in sarcoidosis typically presents as **interstitial lung disease** or nodular infiltrates, not the distinct features of **shrinking lung syndrome** [3].

Q: Which protein is defective in dilated cardiomyopathy?

Dystrophin. ***Dystrophin*** - **Dystrophin** is a crucial protein in the **muscle cell membrane** that anchors the cytoskeleton to the extracellular matrix. - Defects in dystrophin lead to sarcolemmal fragility, causing muscle damage and can result in **dilated cardiomyopathy**, especially in conditions like **Duchenne muscular dystrophy** [1]. *Myosin* - **Myosin** is a fundamental **motor protein** involved in muscle contraction, forming the thick filaments. - While mutations in myosin can cause various cardiac conditions, like hypertrophic cardiomyopathy, direct primary defects in myosin are not typically identified as the cause of dilated cardiomyopathy [2]. *Troponin* - **Troponin** is a protein complex that regulates muscle contraction by controlling the interaction between actin and myosin, particularly in response to calcium. - Although troponins are vital for cardiac function and are released during myocardial injury, their primary defect is not typically implicated in the etiology of dilated cardiomyopathy [2]. *Tropomyosin* - **Tropomyosin** is a protein that winds around actin filaments and, along with troponin, regulates the binding of myosin to actin. - While essential for muscle contraction, direct defects in tropomyosin are not a common genetic cause of dilated cardiomyopathy. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1244-1245. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, p. 574.

Q: Antidepressant drug used in nocturnal enuresis is:

Imipramine. ***Imipramine*** - **Imipramine**, a **tricyclic antidepressant (TCA)**, is frequently used off-label for **nocturnal enuresis** in children [1]. - Its mechanism of action in enuresis is thought to involve a combination of anticholinergic effects (which relax the bladder detrusor muscle) and central nervous system effects (which may increase bladder capacity and arousal from sleep) [1]. *Fluoxetine* - **Fluoxetine** is a **selective serotonin reuptake inhibitor (SSRI)** and is primarily used for depression, anxiety disorders, and OCD [2]. - It is not indicated for the treatment of nocturnal enuresis and does not have the same bladder-relaxing or arousal-modulating properties as imipramine in this context. *Trazodone* - **Trazodone** is a **serotonin antagonist and reuptake inhibitor (SARI)**, commonly prescribed for depression and insomnia due to its prominent sedative effects. - It is not used for nocturnal enuresis and its mechanism of action does not confer benefits for bladder control. *Sertraline* - **Sertraline** is another **selective serotonin reuptake inhibitor (SSRI)** used for a wide range of psychiatric conditions, including depression, anxiety, and panic disorder [2]. - Like fluoxetine, it is not an appropriate treatment for nocturnal enuresis and lacks the specific known effects beneficial for this condition.

Q: Which of the following pairs are considered physiological antagonists in pharmacology?

Histamine and Adrenaline. ***Histamine and Adrenaline*** - **Physiological antagonism** occurs when two drugs produce opposite effects by acting on different receptors or pathways. - **Histamine** causes bronchoconstriction and vasodilation, while **adrenaline** causes bronchodilation and vasoconstriction, counteracting each other's effects through different mechanisms. *Adrenaline and Isoprenaline* - Both **adrenaline** and **isoprenaline** are **adrenergic agonists** that produce similar physiological effects, primarily through beta-adrenergic receptor activation. - They are not physiological antagonists but rather have **synergistic** or similar pharmacological actions. *Isoprenaline and Propranolol* - **Isoprenaline** is a **beta-adrenergic agonist**, while **propranolol** is a **beta-adrenergic antagonist**. - This is an example of **pharmacological antagonism (receptor antagonism)**, where one drug blocks the effect of another at the same receptor site, rather than physiological antagonism.

Q: Which sympathomimetic drug is primarily known to increase heart rate?

Isoprenaline. ***Isoprenaline*** - **Isoprenaline** (isoproterenol) is a non-selective beta-adrenergic agonist, with a strong affinity for **β1 and β2 receptors** [1]. - Its activation of **β1 receptors** in the heart leads to a significant increase in **heart rate (positive chronotropy)** and contractility (positive inotropy) [1]. - It is the **most potent chronotropic agent** among sympathomimetics and is primarily known for increasing heart rate [2]. *Phenylephrine* - **Phenylephrine** is a selective **α1 adrenergic agonist** that causes vasoconstriction [4]. - It increases blood pressure but typically causes **reflex bradycardia** (decreased heart rate) due to baroreceptor activation. - Does NOT directly increase heart rate. *Noradrenaline* - **Noradrenaline** (norepinephrine) primarily acts on **α1 receptors** causing vasoconstriction, and to a lesser extent on **β1 receptors** [3]. - While it can stimulate β1 receptors, its predominant effect is to increase **mean arterial pressure** through vasoconstriction, often causing **reflex bradycardia** [3]. *Adrenaline* - **Adrenaline** (epinephrine) acts on **α1, β1, and β2 receptors** [4]. While it does increase heart rate via **β1 receptor** stimulation, it also causes significant **vasoconstriction** (via α1) and **vasodilation** (via β2). - Its cardiovascular effects are more complex and dose-dependent compared to isoprenaline's specific chronotropic action.

Q: Vibrations are detected by which types of receptors?

Rapidly adapting. ***Rapidly adapting*** - **Rapidly adapting mechanoreceptors**, such as **Pacinian corpuscles** and **Meissner's corpuscles**, are highly sensitive to changes in pressure and movement. - They fire at the **onset and offset of a stimulus**, making them ideal for detecting vibrations, which are rhythmic changes in pressure. *Slowly adapting* - **Slowly adapting mechanoreceptors**, such as **Merkel cells** and **Ruffini endings**, are responsible for sustained pressure and touch. - They continue to fire as long as the stimulus is present, making them less suited for detecting transient vibratory stimuli. *Non-adapting* - The human body does not typically have **truly non-adapting** sensory receptors; most receptors show some form of adaptation to continuous stimuli. - This term is not standard in the classification of mechanoreceptors based on their adaptation rates. *None of the above* - This option is incorrect because rapidly adapting receptors are indeed responsible for detecting vibrations.

Q: Mechanism of secretion of ammonia in distal tubule is?

Passive diffusion. ***Passive diffusion*** - Ammonia (NH3) is a **lipid-soluble molecule** that can readily cross cell membranes, including those of the distal tubule and collecting duct, down its **concentration gradient**. - This process is crucial for regulating **acid-base balance**, as NH3 traps H+ ions to form NH4+, which is then excreted. *Primary active transport* - This mechanism involves the direct use of **ATP hydrolysis** to move ions against their concentration gradient, which is not the primary way ammonia is secreted in the distal tubule. - While NH4+ can be secreted via active transport in some segments (e.g., substituting for K+ on the Na-K-2Cl cotransporter in the thick ascending limb), free ammonia diffusion is distinct. *Symport* - **Symport** involves the co-transport of two or more different molecules or ions in the same direction across a cell membrane, powered by an electrochemical gradient. - This mechanism is not typically involved in the secretion of uncharged, lipid-soluble ammonia. *Antiport* - **Antiport** is a type of coupled transport where two different ions or molecules move in opposite directions across a membrane. - While antiport systems are essential for various renal functions (e.g., Na+/H+ exchanger), they are not the primary mechanism for the secretion of free ammonia in the distal tubule.

Question 1

B cells are located in which region of lymph nodes?

Accepted Answer

Cortical follicles

Answer

Paracortical region

Answer

Subcapsular region

Answer

Medullary sinuses

Question 2

Sertoli cells are derived from -

Accepted Answer

Coelomic epithelium

Answer

Genital swelling

Answer

Primordial germ cells

Answer

Germinal epithelium

Question 3

Shrinking Lung Syndrome is seen in:

Accepted Answer

SLE

Answer

Rheumatoid Arthritis

Answer

Scleroderma

Answer

Sarcoidosis

Question 4

Which protein is defective in dilated cardiomyopathy?

Accepted Answer

Dystrophin

Answer

Tropomyosin

Answer

Myosin

Answer

Troponin

Question 5

Antidepressant drug used in nocturnal enuresis is:

Accepted Answer

Imipramine

Answer

Fluoxetine

Answer

Trazodone

Answer

Sertraline

Question 6

Which of the following pairs are considered physiological antagonists in pharmacology?

Accepted Answer

Histamine and Adrenaline

Answer

Adrenaline and Isoprenaline

Answer

Isoprenaline and Propranolol

Answer

All of the options

Question 7

Which sympathomimetic drug is primarily known to increase heart rate?

Accepted Answer

Isoprenaline

Answer

Phenylephrine

Answer

Noradrenaline

Answer

Adrenaline

Question 8

What is the PRIMARY mechanism by which the Na+-Ca2+ exchanger functions in cardiac muscle cells?

Accepted Answer

Na+-Ca2+ exchanger acts to remove Ca2+ from heart muscle cells

Answer

Na+-Ca2+ exchanger requires ATP directly

Answer

The Na+-Ca2+ exchanger operates in reverse mode during normal cardiac contraction

Answer

The Na+-Ca2+ exchanger primarily moves Ca2+ into cardiac muscle cells during systole

Question 9

Vibrations are detected by which types of receptors?

Accepted Answer

Rapidly adapting

Answer

Slowly adapting

Answer

Non-adapting

Answer

None of the above

Question 10

Mechanism of secretion of ammonia in distal tubule is?

Accepted Answer

Passive diffusion

Answer

Primary active transport

Answer

Symport

Answer

Antiport

NEET-PG 2015

Anatomy

Internal Medicine

Pathology

Pharmacology

Physiology