NEET-PG 2019 Practice Questions

Q: Which nerve supplies the area marked as ‘Area B’ in the image?

Radial nerve. ***Radial nerve*** - Area B represents the sensory distribution of the **radial nerve**, specifically its superficial branch. - The radial nerve provides sensory innervation to the **dorsal (back) aspect of the hand** over the radial (lateral) side, including the thumb, index, middle, and radial half of the ring finger up to the proximal interphalangeal joints. - The superficial branch of the radial nerve also innervates the **anatomical snuffbox** and the radial side of the dorsum of the hand. - **Note:** The radial nerve does NOT supply the palmar surface of the hand; its sensory distribution is limited to the dorsal aspect. *Ulnar nerve* - The ulnar nerve provides sensory innervation to the **medial 1.5 fingers** (little finger and ulnar half of ring finger) on both palmar and dorsal aspects. - It also supplies the **hypothenar eminence** and medial portion of the palm and dorsal hand. - This distribution corresponds to **Area C** in the image, not Area B. *Median nerve* - The median nerve provides sensory innervation to the **lateral 3.5 fingers** (thumb, index, middle, and radial half of ring finger) on the **palmar surface**. - It also supplies the **palmar aspect** of these digits and the **nail beds (dorsal tips)** of the same fingers. - This distribution corresponds to **Area A** in the image, not Area B. *Posterior interosseous nerve* - The **posterior interosseous nerve (PIN)** is a **motor branch** of the radial nerve with no cutaneous sensory distribution. - It supplies the extensor muscles of the posterior forearm compartment. - It does not provide sensory innervation to the skin of the hand.

Q: A child presents with a rash in the neck folds as shown in the image. The area appears erythematous with satellite lesions and maceration. What is the most likely diagnosis?

Intertrigo. ***Intertrigo*** - The image shows a reddened, inflamed rash in skin folds (neck creases), which is characteristic of **intertrigo**. This condition results from skin-on-skin friction, moisture, and warmth. - The rash appears to have satellite lesions and a somewhat macerated appearance, which would be consistent with secondary fungal (e.g., Candida) or bacterial infection, common complications of intertrigo. *Heat rash* - **Heat rash (miliaria)** typically presents as small, itchy red bumps or clear blisters, often found in areas prone to sweating. - While it can occur in skin folds, the diffuse, raw-looking erythema and presence of potential satellite lesions shown in the image are less typical for simple heat rash. *Eczema* - **Eczema (atopic dermatitis)** is characterized by dry, itchy, inflamed skin, often with scaling, crusting, or lichenification during chronic stages. - While eczema can affect skin folds, the appearance in the image (intense redness, maceration, potential satellite lesions) is more suggestive of an irritant or infectious process like intertrigo rather than typical eczema. *Impetigo* - **Impetigo** is a bacterial skin infection characterized by honey-colored crusts, vesicles, or bullae, typically appearing anywhere on the body, especially around the nose and mouth. - The rash in the image lacks the characteristic honey-colored crusts or vesiculobullous lesions associated with impetigo.

Q: A patient presents with painful vesicular eruptions on one side of the body. What is the most likely diagnosis based on the clinical image?

Herpes zoster. ***Herpes zoster*** - The image displays characteristic **vesicular lesions** grouped together on an erythematous base, typically following a **dermatomal distribution**, which is classic for herpes zoster (shingles). - These lesions often cause significant pain and are due to the **reactivation of the varicella-zoster virus**. *Smallpox* - Smallpox lesions are typically **deep-seated, firm, round pustules** that are all in the same stage of development. - While smallpox also features vesicular lesions, their appearance and distribution are distinct from the clustered, dermatomal pattern seen in the image. *Chickenpox* - Chickenpox presents as a generalized rash with lesions at **various stages of development** (macules, papules, vesicles, scabs), often described as a "dewdrop on a rose petal." - Unlike the localized, dermatomal pattern of herpes zoster, chickenpox lesions are typically **widespread** over the body. *Atopic dermatitis* - Atopic dermatitis typically manifests as **erythematous, scaly, intensely itchy patches or plaques**, often in areas like the flexural creases. - It does not present with the characteristic **vesicular, grouped lesions in a dermatomal pattern** seen in the image.

Q: What is the causative organism for the condition depicted in the image?

Staphylococci. ***Staphylococci*** - The image shows **impetigo** with **crusted lesions**, consistent with **_Staphylococcus aureus_** infection. - **Staphylococcus aureus** is a major causative organism of impetigo, particularly **bullous impetigo**, and commonly produces the characteristic **honey-colored crusts** seen in non-bullous forms as well. - This superficial bacterial skin infection is highly contagious and responds well to topical or systemic antibiotics. *Candidal infection* - **Candidal infections** (e.g., candidiasis) typically present as **erythematous patches** with satellite lesions, or white plaques in mucosal areas, which is not consistent with the image. - This fungal infection is often seen in immunocompromised individuals or in warm, moist skin folds, not as crusted superficial lesions. *Streptococcus* - While **_Streptococcus pyogenes_** can also cause impetigo (especially non-bullous impetigo), the clinical presentation in the image is most consistent with **staphylococcal infection**. - Streptococcal infections may present similarly but can also cause other conditions like cellulitis or erysipelas with distinct features. *Actinomycetes* - **Actinomycosis** is a rare, chronic bacterial infection that forms **abscesses and sinus tracts**, often with "sulfur granules," which is distinct from the superficial skin lesions shown. - This infection usually involves deeper tissues and presents as a chronic, indolent infection, unlike the acute superficial presentation of impetigo.

Q: Which of the following treatments is used for vulvar atrophy and itching?

Estrogen ointment. ***Estrogen ointment*** * **Estrogen ointment** is the primary treatment for vulvar atrophy and itching because it directly addresses the underlying cause of these symptoms, which is the decline in estrogen levels after **menopause**. * By restoring estrogen to the vulvar tissues, it helps to **thicken the epithelium**, improve blood flow, and increase lubrication, thereby alleviating dryness, itching, and discomfort. *Antihistamines* * **Antihistamines** are used to treat allergic reactions and reduce itching associated with conditions like hives or insect bites, but they do not address the hormonal deficiency causing vulvar atrophy. * While they might temporarily relieve some itching, they do not treat the underlying **tissue thinning** and dryness characteristic of vulvar atrophy. *Tamoxifen* * **Tamoxifen** is a selective estrogen receptor modulator (SERM) primarily used in the treatment and prevention of breast cancer, as it blocks estrogen's effects in breast tissue. * However, in vulvovaginal tissues, **tamoxifen can actually worsen atrophy and dryness** due to its anti-estrogenic effects, making it an inappropriate treatment for vulvar atrophy. *None of the options* * This option is incorrect because **estrogen ointment** is a well-established and effective treatment specifically designed to address vulvar atrophy and associated itching, by restoring estrogen levels to the affected tissues.

Q: A patient presented with a history of diplopia and restricted eye movements. What is the most likely diagnosis based on the clinical and CT images?

Blowout fracture. ***Blowout fracture*** - The CT image shows a **fracture of the orbital floor**, with associated **herniation of orbital contents** (fat and inferior rectus muscle) into the maxillary sinus. - This type of fracture commonly causes **diplopia** (due to muscle entrapment) and **restricted eye movements**. *Le Fort fracture* - Le Fort fractures involve the **midface and maxilla** as a whole, typically causing widespread facial instability. - They are classified into three types (I, II, III), none of which are exclusively characterized by an isolated orbital floor fracture with muscle entrapment. *Maxillary fracture* - While an orbital floor fracture involves the maxilla, a "maxillary fracture" is a broad term and does not specifically describe the characteristic features of **orbital content prolapse** and their resulting symptoms. - Isolated maxillary fractures might not cause diplopia or restricted eye movements unless they directly involve the orbit. *Zygomatic fracture* - A zygomatic fracture (either isolated or as part of a zygomaticomaxillary complex fracture) primarily affects the **cheekbone**. - While it can involve the orbital rim, it typically presents with **facial asymmetry**, **numbness** in the infraorbital nerve distribution, and sometimes **trismus**, rather than isolated muscle entrapment causing diplopia, as seen in the image.

Q: A baby born at 34 weeks gestation weighs 3kg. Which of the following conditions is this child most likely to develop in the immediate postnatal period?

Anemia. ***Anemia*** - A 3kg baby at 34 weeks is **large for gestational age (LGA)** and often associated with maternal diabetes, leading to initial **polycythemia** due to chronic intrauterine hypoxia and increased erythropoietin production. - After birth, the excess red blood cells undergo rapid **hemolysis**, resulting in **anemia** in the immediate postnatal period as a recognized complication of LGA babies. *APH* - **Antepartum hemorrhage (APH)** is a maternal obstetric complication involving bleeding before delivery, not a condition that develops in the newborn. - This is a **maternal complication** that occurs during pregnancy, not a neonatal condition that the baby would present with after birth. *Diabetes* - While **maternal diabetes** is often the cause of fetal macrosomia, the newborn does not develop diabetes itself in the immediate postnatal period. - These babies are instead at risk for **hypoglycemia**, **respiratory distress**, and **polycythemia** due to fetal hyperinsulinemia, but not diabetes as a presenting condition. *None of the options* - This is incorrect because **anemia** is indeed a valid condition that LGA babies can develop through the **polycythemia-hemolysis cycle**. - While other complications like **hypoglycemia** are more statistically common, anemia remains a recognized sequela among LGA babies in the immediate postnatal period.

Q: Type of sensation lost on same side of Brown Sequard syndrome?

Loss of proprioception. ***Loss of proprioception*** - In **Brown-Séquard syndrome**, the lesion on one side of the spinal cord interrupts the **dorsal columns** on the same side, which carry **proprioception** and vibration sense [1]. - This results in the loss of **fine touch and proprioception** ipsilateral to the lesion [1]. *Loss of pain sensation* - **Pain and temperature sensations** are carried by the **spinothalamic tracts**, which cross in the spinal cord one or two levels above their entry [1]. - Therefore, a lesion in **Brown-Séquard syndrome** typically causes a loss of pain and temperature sensation **contralateral** to the lesion, starting a few segments below the injury [1]. *Loss of touch sensation* - **Crude touch** (non-discriminative touch) is carried by the spinothalamic tract, crossing to the contralateral side. - **Fine touch** (discriminative touch) is carried by the dorsal columns, which ascend ipsilaterally and cross in the medulla, leading to ipsilateral loss of fine touch in Brown-Séquard syndrome [1]. This option is too general, as fine touch is lost but crude touch involves a different pathway. *Loss of temperature sensation* - Similar to pain sensation, **temperature sensation** is carried by the **spinothalamic tracts** and crosses over in the spinal cord [1]. - This leads to a loss of temperature sensation **contralateral** to the lesion below the level of injury in **Brown-Séquard syndrome** [1].

Q: Identify the radiological procedure shown in the image?

Barium meal follow through. ***Barium meal follow through*** - The image shows opacification of the stomach and the entire small bowel loops via oral uptake of a contrast agent, which is characteristic of a **barium meal follow-through**. - This procedure tracks the passage of **barium** from the esophagus, stomach, and duodenum, through the jejunum and ileum, to assess the **small intestine's morphology and function**. *Barium enema* - A **barium enema** involves introducing contrast material rectally to visualize the **colon and rectum**, which is not depicted in this image. - The primary structures opacified in a barium enema are the **large intestine**, not the stomach and small bowel as seen here. *Enteroclysis* - **Enteroclysis** is a specialized study of the small bowel where contrast is directly instilled into the **duodenum** or **proximal jejunum** via a nasoenteric tube. - While it visualizes the small bowel, the image shows oral contrast progression from the stomach, not direct jejunal intubation. *Proctography* - **Proctography**, also known as defecography, is a dynamic study focused specifically on the **rectum and anal canal** during defecation. - This procedure is highly specific to the distal gastrointestinal tract for assessing anorectal function and does not visualize the stomach or extensive small bowel loops.

Q: The most common site of the branchial cyst is:

Anterior border of sternocleidomastoid. ***Anterior border of sternocleidomastoid*** - Branchial cysts most commonly present as a mass along the **anterior border of the sternocleidomastoid muscle**, typically in the upper to middle third of the neck [3]. - This location corresponds to the embryological remnants of the **second branchial cleft**. *Posterior border of sternocleidomastoid* - Cysts or masses in this region are less likely to be branchial cysts and might indicate other conditions like **lymphadenopathy** or a **cystic hygroma** [1]. - The posterior border is not the typical embryological location for branchial cleft remnants to form cysts. *Digastric muscle* - While the digastric muscle is located in the neck, cysts directly associated with this muscle are rare and usually of **different embryological origin** (e.g., salivary gland cysts or submandibular space infections). - Branchial cysts are specifically tied to the branchial apparatus remnants. *Omohyoid muscle* - The omohyoid muscle crosses the lower neck, and masses in its vicinity are typically not branchial cysts but could involve **thyroid pathology**, **lymph nodes**, or **vascular anomalies** [2]. - This location is anatomically distinct from the typical presentation of a branchial cleft cyst.

Question 1

Which nerve supplies the area marked as ‘Area B’ in the image?

Accepted Answer

Radial nerve

Answer

Ulnar nerve

Answer

Median nerve

Answer

Posterior interosseous nerve

Question 2

A child presents with a rash in the neck folds as shown in the image. The area appears erythematous with satellite lesions and maceration. What is the most likely diagnosis?

Accepted Answer

Intertrigo

Answer

Heat rash

Answer

Eczema

Answer

Impetigo

Question 3

A patient presents with painful vesicular eruptions on one side of the body. What is the most likely diagnosis based on the clinical image?

Accepted Answer

Herpes zoster

Answer

Smallpox

Answer

Chickenpox

Answer

Atopic dermatitis

Question 4

What is the causative organism for the condition depicted in the image?

Accepted Answer

Staphylococci

Answer

Candidal infection

Answer

Streptococcus

Answer

Actinomycetes

Question 5

Which of the following treatments is used for vulvar atrophy and itching?

Accepted Answer

Estrogen ointment

Answer

Antihistamines

Answer

Tamoxifen

Answer

None of the options

Question 6

A patient presented with a history of diplopia and restricted eye movements. What is the most likely diagnosis based on the clinical and CT images?

Accepted Answer

Blowout fracture

Answer

Le Fort fracture

Answer

Maxillary fracture

Answer

Zygomatic fracture

Question 7

A baby born at 34 weeks gestation weighs 3kg. Which of the following conditions is this child most likely to develop in the immediate postnatal period?

Accepted Answer

Anemia

Answer

APH

Answer

Diabetes

Answer

None of the options

Question 8

Type of sensation lost on same side of Brown Sequard syndrome?

Accepted Answer

Loss of proprioception

Answer

Loss of pain sensation

Answer

Loss of touch sensation

Answer

Loss of temperature sensation

Question 9

Identify the radiological procedure shown in the image?

Accepted Answer

Barium meal follow through

Answer

Barium enema

Answer

Enteroclysis

Answer

Proctography

Question 10

The most common site of the branchial cyst is:

Accepted Answer

Anterior border of sternocleidomastoid

Answer

Posterior border of sternocleidomastoid

Answer

Digastric muscle

Answer

Omohyoid muscle

NEET-PG 2019

Anatomy

Dermatology

Microbiology

Obstetrics and Gynecology

Ophthalmology

Pediatrics

Physiology

Radiology

Surgery