NEET-PG 2017 - General Medicine Practice Questions

Q: A head trauma patient is shown below. Diagnosis is?

Decerebrate rigidity. ***Decerebrate rigidity*** - The image shows **extension and internal rotation of the arms** with pronation, and **extension of the legs** with plantar flexion. This posture is characteristic of decerebrate rigidity. - This posturing indicates severe damage to the **brainstem**, specifically below the red nucleus, which is a more ominous sign than decorticate posturing. *Decorticate rigidity* - Decorticate rigidity would present with **flexion of the arms** at the elbows and wrists (to the core), adduction of the shoulders, and extension of the lower limbs. - This posturing is typically due to damage to the **corticospinal tracts above the red nucleus** (e.g., cerebral hemispheres, internal capsule, thalamus). *Acute dystonia* - Acute dystonia involves sustained or repetitive muscle contractions leading to **twisting and repetitive movements** or abnormal fixed postures. - It often affects specific muscle groups, such as the neck (torticollis), eyes (oculogyric crisis), or trunk, and is not typically a generalized rigidity pattern seen in head trauma as extensively as shown. *Catatonia* - Catatonia is a neuropsychiatric syndrome characterized by a variety of motor or behavioral abnormalities, including **immobility, mutism, stupor, waxy flexibility, and negativism**. - While it can involve abnormal posturing, it is a conscious state often associated with psychiatric conditions or general medical conditions, and doesn't manifest as the specific brainstem-related rigidity evident in the image.

Q: The following test is performed for evaluating the integrity of: (Recent NEET Pattern 2016-17)

Cerebellum. ***Cerebellum*** - The image depicts a person performing a **tandem gait** (walking heel-to-toe along a straight line), which is a common test for **cerebellar function**. - The cerebellum is critical for **coordination**, balance, and **fine motor control**, including the ability to maintain a straight path during walking. *Basal ganglia* - The basal ganglia are primarily involved in the **initiation and modulation of movement**, and their dysfunction leads to characteristic movement disorders such as **Parkinsonism (bradykinesia, rigidity, tremor)** or **Huntington's disease (chorea)**. - While gait can be affected in basal ganglia disorders (e.g., shuffling gait in Parkinson's), tandem gait specifically emphasizes balance and coordination more directly attributed to cerebellar function. *Corticospinal pathway* - The **corticospinal pathway** (pyramidal tract) is responsible for **voluntary, skilled movements**, particularly of the distal limbs. - Damage to this pathway typically results in **weakness (paresis)**, spasticity, and hyperreflexia, which would manifest as difficulty with initiating or executing movements rather than purely balance and coordination issues highlighted by tandem gait. *Spinothalamic pathway* - The spinothalamic pathway transmits **pain** and **temperature** sensations from the body to the brain. - Evaluating this pathway involves sensory testing (e.g., pinprick, hot/cold sensation), which is unrelated to the motor task of tandem walking.

Question 1

A head trauma patient is shown below. Diagnosis is?

Accepted Answer

Decerebrate rigidity

Answer

Decorticate rigidity

Answer

Acute dystonia

Answer

Catatonia

Question 2

The following test is performed for evaluating the integrity of: (Recent NEET Pattern 2016-17)

Accepted Answer

Cerebellum

Answer

Basal ganglia

Answer

Corticospinal pathway

Answer

Spinothalamic pathway

NEET-PG 2017 — General Medicine