NEET-PG 2017 Practice Questions

Q: Which of the following is correct about ear speculum insertion?

Pinna : upward, backward and laterally; Tragus: forward. ***Pinna : upward, backward and laterally; Tragus: forward*** - To properly visualize the **tympanic membrane** and ear canal in adults, the **pinna** (auricle) should be gently pulled **upward, backward, and laterally**. This maneuver helps to straighten the **ear canal**. - The **tragus** should be gently pushed **forward** to stabilize the ear and facilitate speculum insertion, minimizing discomfort [1]. *Pinna : downward, backward and laterally; Tragus: forward* - Pulling the **pinna downward** is typically recommended for **children** to straighten their ear canal. - Doing so in adults may not adequately straighten the **ear canal**, hindering visualization. *Pinna : upward, backward and medially; Tragus: forward* - While pulling the pinna **upward and backward** is correct, pulling it **medially** would likely obstruct the view or cause discomfort. - The goal is to open the **ear canal** for better visualization [1]. *Pinna : upward, forward and laterally ; Tragus: forward* - Pulling the pinna **forward** would likely curl the helix and obstruct the **external auditory canal**, making it difficult to insert the speculum. - The correct direction is **backward** to align the cartilaginous and bony parts of the canal [1].

Q: The test shown below is used for the evaluation of

Macular degeneration. ***Macular degeneration*** - The image shown is an **Amsler grid**, a diagnostic tool used to detect **visual disturbances** caused by changes in the retina, especially the macula. - The straight lines appearing wavy or distorted, as seen in the right panel, are characteristic findings in **macular degeneration** or other macular pathologies. - The Amsler grid is the standard screening tool for **age-related macular degeneration (AMD)** and other macular disorders. *Glaucoma* - Glaucoma primarily affects the **optic nerve** and typically causes **peripheral vision loss**, which is not directly assessed by an Amsler grid. - Visual field tests (perimetry) are used for glaucoma diagnosis, not the Amsler grid. *Cataracts* - Cataracts involve **clouding of the lens** of the eye, leading to blurred vision, glare, and difficulty with night vision. - They do not typically cause the **distortion of straight lines** that an Amsler grid helps to detect. *Retinal detachment* - Retinal detachment usually presents with symptoms like flashes of light, **floaters**, or a curtain-like shadow in the vision. - While it can affect vision, the Amsler grid specifically detects **macular distortion**, which is the hallmark of macular pathology rather than peripheral retinal detachment.

Q: A 60-year-old patient during annual check-up had a report of HbA1C of $10 \%$. What does the given fundus examination show?

Proliferative retinopathy. ***Proliferative retinopathy*** - The image shows **neovascularization**, which are new, abnormal blood vessels growing on the surface of the retina or optic disc. This is the hallmark of proliferative retinopathy. - There are also extensive **hard exudates**, retinal hemorrhages, and signs of significant retinal damage consistent with advanced diabetic retinopathy. *Nonproliferative retinopathy* - This stage is characterized by **microaneurysms**, **dot and blot hemorrhages**, hard exudates, and cotton wool spots, but crucially **lacks neovascularization**. - While many features of nonproliferative retinopathy are present (e.g., hemorrhages, exudates), the presence of visible new vessels confirms progression to the proliferative stage. *Neovascularization of the disc* - While **neovascularization of the disc** (NVD) is indeed a feature seen in the image, characterized by the growth of new abnormal vessels on or within one disc diameter of the optic disc, it is a *component* or *sign* of proliferative retinopathy, not the overarching diagnosis. - Proliferative retinopathy encompasses NVD and/or neovascularization elsewhere (NVE), along with other severe changes. *Subhyaloid hemorrhage* - A **subhyaloid hemorrhage** appears as a boat-shaped or D-shaped collection of blood lying beneath the posterior hyaloid face, often obscuring retinal details. - While hemorrhage is present in the image, there is no distinct subhyaloid collection of blood; instead, the picture shows widespread intraretinal and likely preretinal hemorrhages as part of the severe proliferative process.

Q: All are used for the treatment of the condition shown below except:

Canthoplasty. ***Canthoplasty*** - The image depicts **trichiasis**, a condition where eyelashes grow inwards and rub against the cornea. Canthoplasty is a surgical procedure that **modifies the outer or inner canthus of the eye** (the corners) and is not primarily used to address misdirected eyelashes. - Canthoplasty is typically performed for conditions like **ectropion** or **entropion** to correct eyelid position, or for cosmetic purposes, not for direct removal or redirection of individual eyelashes. *Electrolysis* - **Electrolysis** is a common and effective method for treating trichiasis by destroying the hair follicle with an electric current, preventing regrowth. - This procedure targets individual misdirected eyelashes, providing a long-term solution. *Electrodiathermy* - **Electrodiathermy** (also known as diathermy) uses high-frequency electrical currents to generate heat, which can be applied to destroy hair follicles, similar to electrolysis. - It is an effective treatment for permanent removal of eyelashes in cases of trichiasis. *Cryotherapy* - **Cryotherapy** involves freezing the eyelash follicles to destroy them, preventing further abnormal growth. - This technique is another viable option for the permanent removal of eyelashes in trichiasis and can be applied to a group of misdirected lashes.

Q: A 30-year-old woman presents with painful eye swelling. Based on the clinical photograph shown, the most likely diagnosis is:

Acute dacryocystitis. ***Acute dacryocystitis*** - The image shows a **painful, erythematous, and swollen area** at the medial canthus below the **medial palpebral ligament**, characteristic of acute inflammation of the lacrimal sac. - This condition results from **obstruction of the nasolacrimal duct**, leading to bacterial infection and abscess formation in the lacrimal sac. *Lacrimal gland carcinoma* - This condition typically presents as a **slow-growing mass** in the upper outer quadrant of the orbit, often causing **proptosis and displacement** of the globe, rather than acute inflammation at the medial canthus. - While it can be painful, the **acute inflammatory signs** and specific location seen in the image are not typical of lacrimal gland carcinoma. *Orbital cellulitis* - Orbital cellulitis involves inflammation and infection of the **orbital tissues posterior to the orbital septum**, causing generalized swelling of the eyelids, proptosis, pain with eye movements, and potentially vision loss. - The localized swelling near the medial canthus with obvious inflammatory signs is more consistent with a dacryocystitis, whereas orbital cellulitis would involve a broader area of swelling and often more systemic symptoms. *Hordeolum externum* - A hordeolum externum, or stye, is an acute **localized infection of a hair follicle or sebaceous gland** (gland of Zeis or Moll) along the eyelid margin. - The swelling seen in the image is much larger and more medially located, involving the lacrimal sac area, rather than being confined to the eyelid margin.

Q: A patient presents with itching in eyes with redness of eyelids. What is correct about the image shown below? (Recent NEET Pattern 2016-17)

Blepharitis. ***Blepharitis*** - The image shows **redness** and **inflammation of the eyelid margins**, often accompanied by scales or crusts at the base of the eyelashes. This is characteristic of blepharitis. - The history of **itching** and **redness of eyelids** further supports the diagnosis, as these are common symptoms of blepharitis, an immune-mediated inflammation. *Trichiasis* - This condition involves **misdirected eyelashes** that grow inwards and rub against the surface of the eye. - While it can cause irritation, the primary feature in the image is inflammation and crusting of the eyelid margin, not just misdirected lashes. *Blepharospasm* - **Blepharospasm** is an involuntary, repetitive, bilateral twitching or forceful closure of the eyelids. - This is a neurological condition affecting eyelid movement and is not depicted by the visible inflammation in the image. *Distichiasis* - **Distichiasis** is a rare condition where there is an extra row of eyelashes growing from the meibomian gland openings on the eyelid margin. - The image does not show an extra row of lashes; instead, it indicates inflammation and debris along the existing lash line.

Q: What is correct about the composition of fluid in the area marked as $X$ ?

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L. ***Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L*** - The area marked 'X' represents the **scala media** in the cochlear cross-section, which contains **endolymph**. - Endolymph has a unique ionic composition with **high potassium concentration** (150 mEq/L) and **low sodium concentration** (3 mEq/L), similar to intracellular fluid. *Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L* - This composition represents **perilymph**, found in the **scala vestibuli** and **scala tympani**, not in the scala media. - Perilymph has high Na+ and low K+ concentrations, resembling **cerebrospinal fluid** and extracellular fluid. *Na = 150 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The **potassium level of 30 mEq/L** is intermediate and doesn't match any physiological cochlear fluid composition. - This value is too high for perilymph (normally 3 mEq/L) and too low for endolymph (normally 150 mEq/L). *Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The **sodium concentration of 50 mEq/L** is abnormally low for any extracellular fluid compartment. - Neither the Na+ nor K+ values correspond to the known ionic gradients essential for **cochlear hair cell function**.

Q: What is correct about the composition of fluid in the area marked as X?

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L. ***Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L*** - The area marked as X points to the **endolymph** within the scala media of the cochlea, which has a unique high **potassium concentration** (~150 mEq/L) and low **sodium concentration** (~3 mEq/L). - This composition is maintained by the **stria vascularis** and is essential for proper **hair cell function** and hearing transduction. - The high K⁺/low Na⁺ ratio creates the **endocochlear potential** (+80 mV) necessary for cochlear amplification. *Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L* - This represents typical **extracellular fluid** or **perilymph** composition with high sodium and low potassium, which is the opposite of endolymph. - The **perilymph** is found in the scala vestibuli and scala tympani, not in the area marked as X (scala media). *Na = 152 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - The sodium level is too high and potassium too low to represent **endolymph**, which requires an extreme K⁺/Na⁺ gradient for proper cochlear function. - These intermediate values don't match any specific **cochlear fluid compartment** and would not support normal hearing. *Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L* - Both sodium and potassium levels are insufficient to create the **electrochemical gradient** necessary for cochlear hair cell depolarization. - These values don't correspond to either **endolymph** or **perilymph** compositions found in the inner ear.

Q: The image given below shows stapedial reflex. What does ' $X$ ' denote?

Superior olivary complex. ***Superior olivary complex*** - The image depicts the neural pathway for the **stapedial reflex**, where sound input from the cochlea is processed, and the signal travels to the superior olivary complex. - From the superior olivary complex (labeled 'X'), signals project to the **facial nerve nucleus**, which then innervates the **stapedius muscle** to contract and dampen sound. *Medial geniculate body* - The medial geniculate body is part of the **thalamus** and is involved in processing auditory information before it reaches the auditory cortex. - It is a more rostral structure in the auditory pathway and is not directly involved in the brainstem reflex arc of the stapedius reflex at the labeled point 'X'. *Superior colliculus* - The superior colliculus is primarily involved in **visual reflexes** and directing gaze towards salient stimuli. - Although it has some multimodal sensory integration, it is not a key relay in the auditory pathway for the stapedial reflex. *Lateral lemniscus* - The lateral lemniscus is an **ascending auditory pathway** in the brainstem, carrying information from the cochlear nuclei and superior olivary complex to higher centers like the inferior colliculus. - While it carries auditory signals, "X" represents a more specific processing center (superior olivary complex) that integrates bilateral auditory input and projects to motor nuclei for acoustic reflexes.

Question 1

All are correct about the part marked as $X$ and $Y$ except:

Accepted Answer

$X$ is utricle and has anterior upward slope of 30 degrees

Answer

$Y$ is ductus reuniens

Answer

$Y$ connects utricle to cochlear duct

Answer

$X$ is utricle and receives 5 openings of three semicircular canals

Question 2

Which of the following is correct about ear speculum insertion?

Accepted Answer

Pinna : upward, backward and laterally; Tragus: forward

Answer

Pinna : downward, backward and laterally; Tragus: forward

Answer

Pinna : upward, backward and medially; Tragus: forward

Answer

Pinna : upward, forward and laterally ; Tragus: forward

Question 3

The test shown below is used for the evaluation of

Accepted Answer

Macular degeneration

Answer

Glaucoma

Answer

Cataracts

Answer

Retinal detachment

Question 4

A 60-year-old patient during annual check-up had a report of HbA1C of $10 \%$. What does the given fundus examination show?

Accepted Answer

Proliferative retinopathy

Answer

Nonproliferative retinopathy

Answer

Neovascularization of the disc

Answer

Subhyaloid hemorrhage

Question 5

All are used for the treatment of the condition shown below except:

Accepted Answer

Canthoplasty

Answer

Electrolysis

Answer

Electrodiathermy

Answer

Cryotherapy

Question 6

A 30-year-old woman presents with painful eye swelling. Based on the clinical photograph shown, the most likely diagnosis is:

Accepted Answer

Acute dacryocystitis

Answer

Lacrimal gland carcinoma

Answer

Orbital cellulitis

Answer

Hordeolum externum

Question 7

A patient presents with itching in eyes with redness of eyelids. What is correct about the image shown below? (Recent NEET Pattern 2016-17)

Accepted Answer

Blepharitis

Answer

Trichiasis

Answer

Blepharospasm

Answer

Distichiasis

Question 8

What is correct about the composition of fluid in the area marked as $X$ ?

Accepted Answer

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L

Answer

Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Question 9

What is correct about the composition of fluid in the area marked as X?

Accepted Answer

Na = 3 mEq/L, K = 150 mEq/L, Chloride = 125 mEq/L

Answer

Na = 150 mEq/L, K = 3 mEq/L, Chloride = 125 mEq/L

Answer

Na = 152 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Answer

Na = 50 mEq/L, K = 30 mEq/L, Chloride = 125 mEq/L

Question 10

The image given below shows stapedial reflex. What does ' $X$ ' denote?

Accepted Answer

Superior olivary complex

Answer

Medial geniculate body

Answer

Superior colliculus

Answer

Lateral lemniscus

NEET-PG 2017

Anatomy

ENT

Ophthalmology

Physiology