NEET-PG 2019 Practice Questions

Q: Joint involved in movement of head from left to right.

Atlanto axial. ***Atlanto axial*** - The **atlantoaxial joint** is responsible for the **rotation of the head**, allowing for movements such as shaking the head "no." - This joint is a **pivot joint** formed between the atlas (C1 vertebra) and the axis (C2 vertebra), specifically the **dens** of the axis articulating with the anterior arch of the atlas. *Atlanto occipital* - The **atlanto-occipital joint** primarily facilitates **flexion and extension of the head** (nodding "yes" movement). - This joint connects the **atlas (C1)** to the **occipital bone** of the skull. *C2- C3 Joint* - The **C2-C3 joint** is a typical **intervertebral joint** in the cervical spine. - While it contributes to overall cervical spine mobility, it does not primarily mediate the **rotational movement** of the head. *C3- C4 Joint* - The **C3-C4 joint** is another **intervertebral joint** in the cervical spine. - Its main roles include some degree of **flexion, extension, and lateral bending**, but it is not the primary joint for head rotation.

Q: What is the nerve supply of Submandibular gland:

Lingual nerve. ***Lingual nerve*** - The **lingual nerve** carries **parasympathetic fibers** that originate from the **chorda tympani** (a branch of the facial nerve) to the submandibular ganglion. - After synapsing in the submandibular ganglion, **postganglionic parasympathetic fibers** from the lingual nerve innervate the submandibular gland, stimulating saliva production. *Auriculotemporal nerve* - The **auriculotemporal nerve** contains postganglionic parasympathetic fibers from the **otic ganglion**, which primarily innervates the **parotid gland**. - It also provides sensory innervation to the temporomandibular joint, auricle, and temporal region. *Glossopharyngeal nerve* - The **glossopharyngeal nerve (CN IX)** supplies parasympathetic innervation to the **parotid gland** via the otic ganglion. - It does not directly innervate the submandibular gland. *Inferior alveolar nerve* - The **inferior alveolar nerve** is a branch of the mandibular nerve (V3) and provides **sensory innervation** to the lower teeth and gingiva. - It also gives off the mylohyoid nerve, which supplies motor innervation to the mylohyoid and anterior belly of the digastric, but it does not innervate the submandibular gland.

Q: What does a decreased FEV1/FVC ratio typically indicate in pulmonary function tests?

Obstructive lung disease. ***Obstructive lung disease*** - A decreased **FEV1/FVC ratio** indicates that the amount of air forcefully exhaled in one second (FEV1) is disproportionately low compared to the total forced vital capacity (FVC) [1]. This is a hallmark of **airflow limitation**, distinguishing obstructive lung diseases. - This pattern suggests a problem with **airway narrowing** or obstruction, making it difficult to exhale air quickly, which is characteristic of conditions like **COPD** (emphysema, chronic bronchitis) or **asthma** [1]. *Normal pulmonary function* - In normal pulmonary function, the **FEV1/FVC ratio** would be within the expected reference range, typically **above 70%** (or 0.7) for adults [1]. - A low ratio explicitly indicates a deviation from normal airflow dynamics, not a state of healthy lung function. *Restrictive lung disease* - **Restrictive lung diseases** are characterized by a **reduced total lung volume** (decreased FVC), but the FEV1/FVC ratio is typically **normal or even increased**. - This is because the airways are generally not obstructed; instead, the problem lies with the lungs' inability to expand fully, leading to a proportional reduction in FEV1 and FVC. *Both obstructive and restrictive lung disease* - While it is possible to have both conditions, a **decreased FEV1/FVC ratio** primarily points to an **obstructive pattern**. - A definitive diagnosis of both would require further interpretation of other PFT parameters such as **total lung capacity (TLC)**, which would be normal or increased in obstruction and reduced in restriction.

Q: A female patient of 26 years, presents with oral ulcers, photosensitivity and skin malar rash in face sparing the nasolabial folds of both side.

SLE. ***SLE*** - The combination of **oral ulcers**, **photosensitivity**, and a **malar rash** that spares the nasolabial folds is highly characteristic of **Systemic Lupus Erythematosus (SLE)** [1]. - SLE is an autoimmune disease with diverse clinical manifestations involving multiple organ systems. *Sturge weber syndrome* - This is a neurocutaneous disorder characterized by a **port-wine stain** (nevus flammeus) typically on the face, neurological abnormalities like seizures, and ocular involvement. - It does not present with oral ulcers or photosensitivity as primary features. *Dermatitis* - **Dermatitis** is a general term for skin inflammation, often presenting with redness, itching, and sometimes blisters. - It does not typically involve the specific constellation of oral ulcers, photosensitivity, and a malar rash that spares nasolabial folds. *Psoriasis* - **Psoriasis** is a chronic autoimmune disease primarily affecting the skin, characterized by red, scaly patches (plaques) [2]. - While it can cause nail changes and sometimes joint pain, it does not present with photosensitivity, oral ulcers, or the characteristic malar rash described.

Q: Which type of cardiomyopathy is associated with alcohol abuse?

Dilated cardiomyopathy. ### Dilated cardiomyopathy - Chronic **alcohol abuse** is a well-established cause of **dilated cardiomyopathy**, leading to weakening and enlargement of the ventricles [1]. - This condition results in impaired systolic function and can cause **heart failure** [1]. *Hypertrophic cardiomyopathy* - This condition is primarily characterized by **pathological thickening of the heart muscle**, often genetic, and is not directly caused by alcohol abuse. - It leads to issues with relaxation and filling of the heart, rather than dilation and weakness. *Pericarditis* - **Pericarditis** is the inflammation of the sac surrounding the heart (pericardium), most commonly caused by viral infections, autoimmune diseases, or injury. - It is not directly linked to alcohol abuse as a primary cause. *Myocarditis* - **Myocarditis** is the inflammation of the heart muscle, often triggered by viral infections, autoimmune reactions, or certain medications. - While heavy alcohol use can weaken the heart, myocarditis is primarily an inflammatory process not directly caused by alcohol.

Q: Which viral infection is known to cause a condition resembling erythroblastosis?

Parvovirus B19. ***Parvovirus B19*** - **Parvovirus B19** has a specific tropism for **erythroid progenitor cells** in the bone marrow. - In the fetus, congenital infection causes **severe anemia** due to destruction of red blood cell precursors, leading to **hydrops fetalis** with massive compensatory erythropoiesis. - This results in circulating **nucleated red blood cells (erythroblasts)**, hepatosplenomegaly from extramedullary hematopoiesis, and severe anemia - a picture closely **resembling erythroblastosis fetalis**. - Unlike the immune-mediated hemolysis in Rh isoimmunization, parvovirus causes direct viral destruction of erythroid precursors with similar clinical manifestations. *CMV* - **Cytomegalovirus (CMV)** is the most common congenital infection and can cause hepatosplenomegaly, jaundice, and thrombocytopenia. - However, CMV typically causes **direct hyperbilirubinemia** from hepatocellular damage rather than the hemolytic anemia pattern seen in erythroblastosis. - While CMV can affect hematopoiesis, it does not characteristically produce the massive erythroblast response and hydrops pattern typical of erythroblastosis fetalis. *EBV* - **Epstein-Barr virus (EBV)** primarily causes **infectious mononucleosis** in older children and adults, with atypical lymphocytosis. - EBV is rare in neonates and does not cause fetal hydrops or an erythroblastosis-like syndrome. - Associated with lymphoproliferative disorders and post-transplant complications rather than fetal anemia. *HSV* - **Herpes simplex virus (HSV)** causes disseminated neonatal infection with encephalitis, hepatitis, and mucocutaneous lesions. - HSV does not have tropism for erythroid precursors and does not cause the anemia, hydrops, or erythroblastosis-like picture. - Typically acquired perinatally rather than causing congenital infection with hematologic manifestations.

Q: Which culture media is specifically used for the growth of Legionella?

Buffered Charcoal Yeast Extract (BCYE) agar. ***(BCYE) agar media*** - **Buffered charcoal yeast extract (BCYE) agar** is the specific and most widely used culture medium for the isolation and growth of *Legionella* species. - It contains **L-cysteine** and **iron salts**, which are essential growth factors for *Legionella*, along with activated charcoal to neutralize toxic metabolites. *MacConkey agar* - **MacConkey agar** is a selective and differential medium primarily used for the isolation of **Gram-negative enteric bacilli**. - It inhibits the growth of Gram-positive bacteria and differentiates lactose fermenters from non-fermenters. *Baird–Parker agar* - **Baird–Parker agar** is a selective medium specifically designed for the isolation and enumeration of **coagulase-positive staphylococci**, particularly *Staphylococcus aureus*, from food and clinical samples. - It contains tellurite, which is reduced by staphylococci to form black colonies. *Sabouraud’s agar* - **Sabouraud's dextrose agar (SDA)** is a selective medium primarily used for the cultivation of **fungi** (yeasts and molds). - Its low pH and high dextrose concentration inhibit the growth of most bacteria.

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: What is the presenting diameter of a fully flexed head?

Suboccipito-bregmatic diameter. ***Suboccipito-bregmatic diameter*** - This diameter measures from the **nape of the neck** (**suboccipital region**) to the **anterior fontanelle** (**bregma**), which is the smallest presenting diameter of the fetal head when it is in **full flexion**. - A fully flexed head presents the smallest and most favorable diameter for vaginal birth, allowing for optimal passage through the birth canal. *Suboccipito-frontal diameter* - This diameter is measured from the **nape of the neck to the center of the forehead**, indicating a less flexed head than the suboccipito-bregmatic diameter. - While it represents some flexion, it is not the ideal presenting diameter for a fully flexed head and is larger than the suboccipito-bregmatic diameter. *Occipito-frontal diameter* - This diameter is measured from the **occipital protuberance to the forehead**, representing a **deflexed** or **partially flexed** head. - This presentation is less favorable for vaginal delivery as it is a larger diameter than either the suboccipito-bregmatic or suboccipito-frontal diameters. *Biparietal diameter* - This diameter measures the **widest transverse diameter of the fetal head**, between the two parietal eminences. - While clinically important for assessing head size and growth, it is **not a presenting longitudinal diameter** that describes the leading part of the fetal head during engagement and descent.

Q: Which of the following is water soluble contrast?

Iodine. ***Iodine*** - **Iodinated contrast media** (containing iodine atoms) are the most commonly used **water-soluble contrast agents** in medical imaging. - Examples include **non-ionic iodinated compounds** (iohexol, iopamidol, iopromide) and **ionic compounds** (diatrizoate, iothalamate). - The **iodine atoms** provide radiodensity (X-ray attenuation), while the organic molecular structure ensures **water solubility**. - These agents are safely excreted by the kidneys and are used intravenously for CT angiography, intravenous urography, and contrast-enhanced CT scans. *Barium* - **Barium sulfate** is a **water-insoluble** compound used as an oral or rectal contrast agent for imaging the gastrointestinal tract. - It remains in the GI lumen and is not absorbed; if extravasated into soft tissues, it can cause significant inflammatory reactions. - Used for barium swallow, barium meal, barium follow-through, and barium enema studies. *Bromine* - **Bromine** is not used as a contrast agent in medical imaging due to its high toxicity and unsuitability for diagnostic purposes. - It does not form stable, non-toxic water-soluble compounds appropriate for clinical imaging. *Calcium* - **Calcium** is a natural component of bone and provides intrinsic radiodensity on plain X-rays. - It is not administered as an exogenous contrast agent for diagnostic imaging purposes.

Question 1

Joint involved in movement of head from left to right.

Accepted Answer

Atlanto axial

Answer

Atlanto occipital

Answer

C2- C3 Joint

Answer

C3- C4 Joint

Question 2

What is the nerve supply of Submandibular gland:

Accepted Answer

Lingual nerve

Answer

Auriculotemporal nerve

Answer

Glossopharyngeal nerve

Answer

Inferior alveolar nerve

Question 3

What does a decreased FEV1/FVC ratio typically indicate in pulmonary function tests?

Accepted Answer

Obstructive lung disease

Answer

Normal pulmonary function

Answer

Restrictive lung disease

Answer

Both obstructive and restrictive lung disease

Question 4

A female patient of 26 years, presents with oral ulcers, photosensitivity and skin malar rash in face sparing the nasolabial folds of both side.

Accepted Answer

SLE

Answer

Sturge weber syndrome

Answer

Dermatitis

Answer

Psoriasis

Question 5

Which type of cardiomyopathy is associated with alcohol abuse?

Accepted Answer

Dilated cardiomyopathy

Answer

Hypertrophic cardiomyopathy

Answer

Pericarditis

Answer

Myocarditis

Question 6

Which viral infection is known to cause a condition resembling erythroblastosis?

Accepted Answer

Parvovirus B19

Answer

EBV

Answer

CMV

Answer

HSV

Question 7

Which culture media is specifically used for the growth of Legionella?

Accepted Answer

Buffered Charcoal Yeast Extract (BCYE) agar

Answer

MacConkey agar

Answer

Baird–Parker agar

Answer

Sabouraud’s agar

Question 8

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 9

What is the presenting diameter of a fully flexed head?

Accepted Answer

Suboccipito-bregmatic diameter

Answer

Suboccipito-frontal diameter

Answer

Occipito-frontal diameter

Answer

Biparietal diameter

Question 10

Which of the following is water soluble contrast?

Accepted Answer

Iodine

Answer

Barium

Answer

Bromine

Answer

Calcium

NEET-PG 2019

Anatomy

Internal Medicine

Microbiology

Obstetrics and Gynecology

Radiology