Internal Medicine
1 questionsWhich condition is associated with calcification of the intervertebral disc?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1121: Which condition is associated with calcification of the intervertebral disc?
- A. Gout
- B. Rheumatoid
- C. Alkaptonuria (Correct Answer)
- D. Psoriasis
Explanation: ***Alkaptonuria*** - **Alkaptonuria** is a rare autosomal recessive disorder characterized by a deficiency of the enzyme **homogentisate 1,2-dioxygenase**, leading to the accumulation of **homogentisic acid**. - This accumulation results in the deposition of a **dark pigment (ochre pigment)** in connective tissues, including the intervertebral discs, causing **calcification (ochronosis)** and early degenerative arthritis. *Gout* - **Gout** is caused by the deposition of **monosodium urate crystals** in joints and soft tissues, leading to inflammation and pain [1]. - While it can affect various joints, it does not typically cause **calcification of intervertebral discs**; rather, it can form tophi in periarticular soft tissues [1]. *Rheumatoid* - **Rheumatoid arthritis** is a chronic autoimmune inflammatory disease primarily affecting the **synovial lining of joints**, leading to joint destruction and deformity. - It does not involve the **calcification of intervertebral discs**; spinal involvement is usually restricted to the cervical spine, particularly the atlantoaxial joint. *Psoriasis* - **Psoriasis** is a chronic inflammatory skin condition, which in some cases can be associated with **psoriatic arthritis**, an inflammatory arthritis. - Psoriatic arthritis primarily affects peripheral joints, the sacroiliac joints, and the spine, but it does not cause **calcification of the intervertebral discs** as seen in alkaptonuria.
Psychiatry
3 questionsDerealization and depersonalization are symptoms of which type of disorder?
Which of the following is a recognized type of anxiety disorder?
What does the term 'etheromania' refer to?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1121: Derealization and depersonalization are symptoms of which type of disorder?
- A. Dissociative disorder (Correct Answer)
- B. Personality disorders
- C. Mania
- D. Anxiety disorders
Explanation: ***Dissociative disorder*** - **Derealization** involves experiencing the outside world as unreal or dreamlike - **Depersonalization** is the experience of feeling detached from one's own body or mental processes - These are hallmark symptoms of **dissociative disorders**, specifically depersonalization-derealization disorder in DSM-5 *Personality disorders* - Characterized by enduring, maladaptive patterns of inner experience and behavior - While some personality disorders (e.g., **borderline personality disorder**) may display transient dissociative symptoms under stress, derealization and depersonalization are not core diagnostic features *Mania* - A state of abnormally elevated mood and energy, involving **racing thoughts**, **decreased need for sleep**, and **impulsive behavior** - Does not typically involve consistent derealization or depersonalization as core features *Anxiety disorders* - Depersonalization can occur transiently during **panic attacks** or severe anxiety - However, when derealization and depersonalization are the primary, persistent symptoms, they indicate a **dissociative disorder** rather than an anxiety disorder
Question 1122: Which of the following is a recognized type of anxiety disorder?
- A. Bipolar Disorder
- B. Major Depressive Disorder
- C. Schizophrenia
- D. Panic Disorder (Correct Answer)
Explanation: ***Panic Disorder*** - **Panic disorder** is a recognized **anxiety disorder** characterized by recurrent unexpected **panic attacks** - sudden episodes of intense fear accompanied by physical symptoms like heart palpitations, shortness of breath, chest pain, dizziness, and trembling. - It involves persistent worry about having more attacks (anticipatory anxiety) and maladaptive behavioral changes to avoid situations where attacks might occur. - Classified under **Anxiety Disorders** in DSM-5 and ICD-11. *Major Depressive Disorder* - **Major Depressive Disorder (MDD)** is a **mood disorder**, not an anxiety disorder. - Characterized by persistent depressed mood, loss of interest or pleasure (anhedonia), changes in appetite/sleep, fatigue, feelings of worthlessness, and potential suicidal ideation. - Classified under **Depressive Disorders** in DSM-5, distinct from anxiety disorders, though anxiety symptoms may co-occur. *Bipolar Disorder* - **Bipolar disorder** is a **mood disorder**, not an anxiety disorder. - Characterized by significant mood swings including episodes of mania/hypomania (elevated, expansive, or irritable mood with increased energy) and depression. - Classified under **Bipolar and Related Disorders** in DSM-5, distinct from anxiety disorders. *Schizophrenia* - **Schizophrenia** is a **psychotic disorder**, not an anxiety disorder. - Characterized by disturbances in thought, perception, emotions, and behavior, including hallucinations, delusions, disorganized thinking, and negative symptoms. - Classified under **Schizophrenia Spectrum and Other Psychotic Disorders** in DSM-5, distinct from anxiety disorders.
Question 1123: What does the term 'etheromania' refer to?
- A. Ether addiction (Correct Answer)
- B. Acute psychosis following ether anesthesia
- C. Excessive use of ether as an anesthetic
- D. Delirium tremens from ether withdrawal
Explanation: ***Ether addiction*** - **Etheromania** specifically refers to the compulsive use and dependence on **ether** for its psychoactive effects. - This term was historically used to describe individuals who developed a significant **addiction** to ether. - The suffix "-mania" in psychiatric terminology often denotes an obsessive or compulsive behavior pattern related to a specific substance. *Acute psychosis following ether anesthesia* - While ether anesthesia can sometimes lead to transient psychomotor agitation or emergence delirium, **acute psychosis** is not the primary definition of etheromania. - Etheromania describes a long-term pattern of **addictive behavior**, not an acute post-anesthesia complication. *Excessive use of ether as an anesthetic* - This describes a medical application of ether, albeit potentially misused, but does not primarily denote the **addictive state** of the person using it. - **Etheromania** focuses on the individual's psychological and physiological dependence, not merely the quantity used for medical purposes. *Delirium tremens from ether withdrawal* - Delirium tremens is specifically associated with **alcohol withdrawal**, not ether withdrawal. - While ether withdrawal can cause symptoms, the term **etheromania** refers to the addiction itself, not withdrawal complications.
Radiology
6 questionsInvestigation of choice for studying Renal Cortical mass
Which of the following features is used to identify the colon on an X-ray?
Which of the following appears the same on both T1 and T2 weighted MRI sequences?
HU is a measure of
Investigation of choice for screening of proximal internal carotid artery stenosis is :
Rat tail appearance in contrast radiography is seen in?
NEET-PG 2012 - Radiology NEET-PG Practice Questions and MCQs
Question 1121: Investigation of choice for studying Renal Cortical mass
- A. 99mTc DTPA
- B. 53Cr Study
- C. 99mTc DMSA (Correct Answer)
- D. 99mTc Pyrophosphate
Explanation: ***99mTc DMSA*** - **99mTc DMSA** (Technetium-99m dimercaptosuccinic acid) is the radiopharmaceutical of choice for imaging the **renal cortex** and assessing **renal cortical mass** and scarring. - It binds preferentially to the cells of the **renal tubules**, allowing for excellent visualization of cortical tissue. *99mTc DTPA* - **99mTc DTPA** (Technetium-99m Diethylenetriaminepentaacetic acid) is primarily used to assess **glomerular filtration rate (GFR)** and renal blood flow. - It is filtered by the **glomeruli** but not reabsorbed or secreted by the tubules, making it suitable for functional studies rather than morphological assessment of cortical mass. *53Cr Study* - **53Cr** (Chromium-51) is used in studies to measure **red blood cell mass**, survival, or gastrointestinal protein loss. - It has no role in the direct assessment of **renal cortical mass** or function. *99mTc Pyrophosphate* - **99mTc Pyrophosphate** is primarily used to evaluate **myocardial infarction** (hot spots) or detect bone lesions. - It is not indicated for, nor does it provide useful information about, **renal cortical mass**.
Question 1122: Which of the following features is used to identify the colon on an X-ray?
- A. Haustra (Correct Answer)
- B. Valvulae conniventes
- C. String of beads sign
- D. More number of loops
Explanation: ***Haustra (Correct Answer)*** - **Haustra** are sacculations or pouches of the colon created by the uneven contraction of the **taeniae coli** - They are THE characteristic feature that helps distinguish the large bowel from the small bowel on an X-ray - These indentations typically do **not cross the entire width** of the bowel lumen, unlike the valvulae conniventes of the small intestine - Haustra appear as incomplete septations on plain radiographs *Valvulae conniventes (Incorrect)* - **Valvulae conniventes** (also known as plicae circulares) are large, circular folds of the **small intestine** mucosa that project into the lumen - They extend **completely across the lumen** of the small bowel, making them easily distinguishable from haustra which only partially traverse the colon - This is a feature of small bowel, not colon *String of beads sign (Incorrect)* - The "**string of beads sign**" is a **pathological radiographic finding** associated with small bowel obstruction - It refers to multiple small, gas-filled loops of small bowel stacked on top of each other, often with small pockets of fluid or air trapped between the folds, resembling beads on a string - This is not a normal anatomical feature used to identify the colon *More number of loops (Incorrect)* - The number of loops is **not a primary distinguishing feature** between the large and small bowel on an X-ray - While the small intestine generally has more convolutions or loops than the colon, this is a **less reliable and specific sign** compared to the presence of haustra - Haustra remain the gold standard feature for colon identification
Question 1123: Which of the following appears the same on both T1 and T2 weighted MRI sequences?
- A. Gall bladder
- B. Fat (Correct Answer)
- C. Kidney
- D. CSF
Explanation: ***Fat*** - On both T1 and T2 weighted MRI sequences, fat appears **bright** (high signal intensity). - This consistent bright signal makes fat a useful internal reference point for signal interpretation. *Gall bladder* - The gall bladder is filled with **bile**, which appears bright on T2-weighted images due to its high water content, but can be variable on T1. - Bile does not maintain consistently the **same signal intensity** as fat on both sequences. *Kidney* - The renal parenchyma typically has **intermediate signal intensity** on both T1 and T2, but its signal characteristics are different from the consistently bright signal of fat. - The signal can vary depending on the specific sequence parameters and hydration status, unlike fat. *CSF* - **Cerebrospinal fluid (CSF)** appears dark (low signal) on T1-weighted images and bright (high signal) on T2-weighted images due to its high water content. - This distinct signal intensity difference between T1 and T2 is contrary to the shared bright appearance of fat on both sequences.
Question 1124: HU is a measure of
- A. CT (Correct Answer)
- B. MRI
- C. PET
- D. USG
Explanation: ***Correct Answer: CT*** - HU stands for **Hounsfield Units**, a standardized quantitative scale used exclusively in **computed tomography (CT)** to describe the **radiodensity** of tissues based on **X-ray attenuation**. - On this scale, **water is assigned 0 HU**, air is -1000 HU, and dense bone can be +1000 HU or more. - This allows objective measurement and comparison of tissue densities across different CT scanners and examinations. *Incorrect: MRI* - **Magnetic Resonance Imaging (MRI)** does not use Hounsfield Units. - MRI signal intensity is based on the **magnetic properties of tissues** and local hydrogen proton density, not X-ray attenuation. *Incorrect: PET* - **Positron Emission Tomography (PET)** measures the metabolic activity of cells using **radioactive tracers**. - Its output is typically quantified in **Standardized Uptake Value (SUV)**, not Hounsfield Units. *Incorrect: USG* - **Ultrasound (USG)** imaging uses sound waves to create images of internal body structures. - It measures the **acoustic impedance** of tissues and displays findings in terms of echogenicity, not Hounsfield Units.
Question 1125: Investigation of choice for screening of proximal internal carotid artery stenosis is :
- A. Doppler ultrasound (USG) (Correct Answer)
- B. CT angiography
- C. Magnetic resonance imaging (MRI)
- D. Digital subtraction angiography (DSA)
Explanation: ***Doppler ultrasound (USG)*** - **Doppler ultrasound** is the investigation of choice for screening carotid artery stenosis due to its **non-invasive nature**, widespread availability, and cost-effectiveness. It provides excellent anatomical information and hemodynamics, including **blood flow velocity** and presence of **plaque**. - It can effectively estimate the degree of **stenosis** based on flow characteristics and is safe for serial monitoring. *CT angiography* - **CT angiography** provides detailed anatomical imaging of the carotid arteries but involves **ionizing radiation** and **iodinated contrast agents**, making it less suitable for routine screening, especially in patients with renal impairment or contrast allergies. - While it offers higher resolution for certain plaque characteristics, it’s typically reserved for cases where ultrasound findings are inconclusive or for surgical planning. *Magnetic resonance imaging (MRI)* - **MRI** and **MR angiography (MRA)** can visualize carotid stenosis without ionizing radiation but are more expensive and time-consuming than ultrasound, and can be limited by artifacts from patient movement. - Patients with **claustrophobia** or **metallic implants** may not be suitable for MRI, making it less ideal for general screening. *Digital subtraction angiography (DSA)* - **Digital subtraction angiography (DSA)** is the **gold standard** for diagnosing carotid stenosis as it provides the most detailed and accurate images of the arterial lumen. However, it is an **invasive procedure** associated with risks such as stroke, arterial dissection, contrast nephropathy, and radiation exposure. - Due to its invasiveness and potential complications, DSA is typically reserved for cases with **discordant non-invasive findings** or prior to intervention rather than as a primary screening tool.
Question 1126: Rat tail appearance in contrast radiography is seen in?
- A. Carcinoma esophagus
- B. Plummer-Vinson syndrome
- C. Diffuse esophageal spasms
- D. Achalasia cardia (Correct Answer)
Explanation: ***Correct: Achalasia cardia*** - The **"rat tail" or "bird's beak" sign** is the classic radiological appearance of **achalasia cardia** on barium swallow study - Shows **smooth, symmetrical, tapered narrowing** of the distal esophagus with proximal esophageal dilatation - Due to **failure of the lower esophageal sphincter (LES) to relax**, causing functional obstruction - The smooth tapering distinguishes it from irregular narrowing seen in malignancy *Incorrect: Carcinoma esophagus* - Esophageal carcinoma shows **"shouldered lesion"** or **"apple core" appearance** - Characterized by **irregular, shelf-like margins** with abrupt transition - Narrowing is **asymmetric and irregular**, not the smooth tapering of rat tail sign - May show mucosal destruction and filling defects *Incorrect: Plummer-Vinson syndrome* - Shows **postcricoid web** in the upper esophagus on barium swallow - Associated with iron deficiency anemia, glossitis, and increased risk of esophageal cancer - Presents as a thin, web-like membrane rather than distal narrowing *Incorrect: Diffuse esophageal spasms* - Shows **"corkscrew esophagus"** or **"rosary bead" appearance** on barium swallow - Multiple, **simultaneous, non-peristaltic contractions** create segmented appearance - Dynamic finding with normal segments between contractions - Represents uncoordinated muscular activity, not fixed narrowing