NEET-PG 2013 Practice Questions

Q: Which muscle originates from tendon of other muscle?

Lumbricals. Lumbricals - The lumbrical muscles are unique in the hand because they originate from the tendons of the flexor digitorum profundus (FDP), not from bone [1]. - This attachment allows them to flex the metacarpophalangeal (MCP) joints while extending the interphalangeal (IP) joints [1]. FCR - The flexor carpi radialis (FCR) muscle originates from the medial epicondyle of the humerus, a bony origin. - Its primary function is flexion and radial deviation of the wrist. Adductor pollicis - The adductor pollicis muscle has two heads, the oblique and transverse heads, both originating from various carpal bones and the third metacarpal. - It plays a crucial role in adducting the thumb. Palmaris longus - The palmaris longus muscle originates from the medial epicondyle of the humerus, similar to the FCR. - It contributes to wrist flexion and is absent in a significant portion of the population.

Q: One PHC covers how much population in hilly area?

20000. ***20000*** - In **hilly, tribal, or difficult areas**, one PHC is generally established for a population of **20,000**. - This lower population coverage is due to challenges in accessibility and the dispersed nature of communities in such regions. - As per **Indian Public Health Standards (IPHS)**, PHCs in difficult terrains serve smaller populations to ensure better healthcare access. *50000* - This figure does not correspond to standard PHC or CHC coverage norms. - A **Community Health Centre (CHC)** typically covers a population of **1,20,000** and serves as a referral unit for four PHCs. - CHCs provide specialist services including surgery, obstetrics & gynecology, pediatrics, and medicine. *10000* - This figure does not match the population coverage of any standard health facility under the Indian health system. - A **Sub-Centre** in hilly/tribal/difficult areas covers approximately **3,000 population**, while in plain areas it covers **5,000 population**. - Sub-Centres are the most peripheral contact point between the primary healthcare system and the community. *30000* - This figure represents the population covered by a Primary Health Centre (PHC) in **plain areas**. - The population coverage is higher in plain areas due to better infrastructure, road connectivity, and accessibility compared to hilly regions. - As per IPHS norms, PHCs in plains serve larger populations than those in difficult terrains.

Q: Professional death in medical profession is -

Removal of name of doctor from panel of RMP. ***Removal of name of doctor from panel of RMP*** - **Professional death** in the medical context refers to the permanent revocation of a doctor's license to practice. - This typically occurs when a physician's name is removed from the **Register of Medical Practitioners (RMP)**, making it illegal for them to practice medicine. *Death sentence ordered by judge* - This is a legal punishment for severe crimes and does not relate to the **professional standing** or *licensure* of a physician. - A death sentence is a judicial outcome for criminal offenses, distinct from *professional misconduct*. *Death during police firing* - This describes a cause of actual physical death and is unrelated to a doctor's **professional status** or ability to practice. - While tragic, it has no bearing on a physician's *professional licensure* or *ethical standing*. *Death of doctor* - This refers to the **biological death** of an individual, which naturally ends their professional career. - However, "professional death" specifically denotes the **loss of professional credentials** while still being alive, due to disciplinary action.

Q: Most common cause of ptosis in adults

Aponeurotic. ***Aponeurotic*** - **Aponeurotic ptosis** is the most common cause of adult-onset ptosis, resulting from a dehiscence, disinsertion, or stretching of the **levator aponeurosis**. - It typically presents as a gradual onset of ptosis and often occurs bilaterally, though one eye may be more affected. *Idiopathic* - While many cases may initially be labeled idiopathic, a specific cause, such as **aponeurotic changes**, is often identified upon closer examination. - This term is a general descriptor and not a specific pathophysiological mechanism. *Myasthenia gravis* - **Myasthenia gravis** can cause fluctuating ptosis that worsens with fatigue, but it is not the most common cause overall. - It is an **autoimmune neuromuscular junction disorder** characterized by weakness in various skeletal muscles. *Paralysis of 3rd nerve* - **Third nerve palsy** causes ptosis along with other signs like an **out-and-down eye deviation** and a **dilated pupil** (if parasympathetic fibers are involved). - While it causes significant ptosis, it is less common than aponeurotic ptosis and presents with a distinct constellation of symptoms.

Q: All are ophthalmological emergencies except -

CRVO. ***CRVO*** - Central Retinal Vein Occlusion (CRVO) is characterized by painless **vision loss** due to retinal hemorrhage and edema, but it is generally *not* considered an immediate, vision-threatening emergency in the same vein as the other options. - While it requires prompt evaluation and management to preserve vision, CRVO allows for a less urgent intervention compared to conditions that can lead to permanent vision loss within hours. *Endophthalmitis* - **Endophthalmitis** is a severe inflammation of the intraocular fluids and tissues, typically caused by infection, and can lead to rapid and irreversible vision loss if not treated urgently. - It presents with pain, redness, reduced vision, and hypopyon (pus in the anterior chamber), necessitating immediate antibiotic treatment and surgical intervention. *Acute congestive glaucoma* - **Acute congestive glaucoma** (acute angle-closure glaucoma) involves a sudden increase in intraocular pressure, causing severe pain, redness, corneal edema, and profound vision loss. - If left untreated, the high pressure can cause irreversible damage to the optic nerve within hours, making it a true ocular emergency. *CRAO* - **Central Retinal Artery Occlusion (CRAO)** is a sudden, painless loss of vision in one eye due to blockage of the central retinal artery, leading to retinal ischemia. - It is an ocular emergency because irreversible retinal damage and vision loss can occur within 90-120 minutes of the occlusion, requiring immediate intervention to restore blood flow.

Q: Surgery of choice in a patient with congenital ptosis with good levator action is:

LPS resection. ***LPS resection*** - **Levator palpebrae superioris (LPS) resection** is the surgery of choice for congenital ptosis with **good levator action** (typically defined as >8-10 mm of levator function). - This procedure directly shortens and strengthens the **levator muscle**, improving eyelid elevation. *Fascia lata sling surgery* - This procedure is indicated for patients with **poor or absent levator function** (typically 10 mm). - It involves resecting a small amount of **Müller's muscle**, **conjunctiva**, and occasionally the **tarsal plate**, but is less effective for moderate-to-severe ptosis. *Müller's resection* - **Müller's muscle resection** is generally reserved for **mild ptosis** (1-2 mm) that responds positively to the **phenylephrine test**. - It primarily addresses ptosis due to sympathetic denervation or mild aponeurotic disinsertion, not significant congenital ptosis with good levator function.

Q: Hormone primarily responsible for blood pressure regulation following acute blood loss is:

ADH. ***ADH*** - **Antidiuretic hormone (ADH)**, also known as **vasopressin**, is released in response to decreased blood volume and pressure detected by **baroreceptors**. - Its primary role is to increase water reabsorption in the **renal collecting ducts** and cause **vasoconstriction**, both of which help restore blood volume and pressure. - This makes ADH the key **hormonal mechanism** for BP regulation following acute blood loss. *Aldosterone* - **Aldosterone** is crucial for long-term **blood pressure regulation** by increasing sodium and water reabsorption in the kidneys. - While important for volume restoration, its effects are **slower** (hours) and more focused on electrolyte balance rather than immediate BP stabilization after acute blood loss. *ANP* - **Atrial natriuretic peptide (ANP)** is released in response to **atrial stretch** due to increased blood volume and acts to lower blood pressure. - It promotes **vasodilation** and **sodium/water excretion**, counteracting the body's efforts to raise blood pressure after blood loss. - ANP levels are **suppressed** during hypovolemia. *Epinephrine* - **Epinephrine** increases heart rate and cardiac contractility, and causes vasoconstriction, providing an immediate increase in blood pressure. - However, it's primarily a **catecholamine** (not a classic hormone) part of the **sympathetic nervous system** response, and while it acts immediately, ADH provides the sustained hormonal BP regulation.

Q: Which of the following actions of GH is mediated by IGF-1?

Antilipolysis. ***Antilipolysis*** * **Insulin-like growth factor 1 (IGF-1)**, stimulated by GH, plays a role in reducing **lipolysis** indirectly. * IGF-1 promotes **anabolic processes** and nutrient storage, which can lead to decreased fat breakdown. *Na+ retention* * **Na+ retention** is more directly influenced by hormones like **aldosterone** and **ADH**, not IGF-1. * While GH can exert some influence on fluid and electrolyte balance, this specific action is not primarily mediated by IGF-1. *decreases insulin* * IGF-1 and GH generally tend to **increase insulin sensitivity** in some tissues or antagonize insulin effects indirectly. * IGF-1's primary metabolic role is not to decrease insulin itself directly. *Lipolysis* * **Growth hormone (GH)** directly promotes **lipolysis**, breaking down fat for energy. * However, the question specifically asks for actions mediated by **IGF-1**, which has an opposite, antilipolytic effect.

Q: Most common type of intellectual disability –

Mild. ***Mild*** - **Mild intellectual disability** is the most prevalent type, accounting for approximately **85%** of all cases. - Individuals with mild intellectual disability can often achieve academic skills up to a **sixth-grade level** and live relatively independently with appropriate support. *Severe* - **Severe intellectual disability** is less common, affecting about **3-4%** of individuals with intellectual disability. - These individuals typically require **daily supervision** and support in structured environments. *Profound* - **Profound intellectual disability** is the least common type, affecting only **1-2%** of individuals with intellectual disability. - Individuals with profound intellectual disability require **intensive support** for all aspects of daily living and often have significant physical impairments. *Moderate* - **Moderate intellectual disability** accounts for about **10%** of all cases. - Individuals with moderate intellectual disability can often develop communication skills and manage basic self-care, but require **ongoing supervision** and support.

Q: Fatal exsanguination occurs most commonly in

Partial transection of an artery. ***Partial transection of an artery*** - A **partially transected artery** is the most dangerous scenario for fatal exsanguination - The vessel walls **cannot retract or undergo effective vasospasm** because they remain tethered - The torn opening remains patent, allowing **continuous and profuse bleeding** - This is a classic surgical principle: **partial arterial injuries bleed more than complete transections** - Without prompt surgical control, this leads to rapid and fatal exsanguination *Complete transection of an artery* - When an artery is completely transected, the vessel ends **retract and go into spasm** - This natural hemostatic mechanism significantly **reduces immediate blood loss** - While still serious and requiring urgent treatment, complete transection is **less likely to cause fatal exsanguination** than partial transection - The retraction and spasm provide temporary hemostasis until definitive repair *Open fracture of the femur and tibia* - Can cause significant bleeding from muscle, soft tissue, and bone - However, the bleeding is typically **not from major arterial injury** unless vessels are directly damaged - Usually controllable with **tourniquets, pressure dressings, and splinting** - Less likely to cause immediate fatal exsanguination compared to major arterial injury *Closed fracture of the femoral shaft* - Can result in substantial internal blood loss (up to **1-1.5 liters** into the thigh compartment) - May cause **hypovolemic shock** requiring transfusion - However, the closed space provides some tamponade effect - Rarely causes immediate **fatal exsanguination** unless associated with other major injuries

Question 1

Which muscle originates from tendon of other muscle?

Accepted Answer

Lumbricals

Answer

FCR

Answer

Adductor pollicis

Answer

Palmaris longus

Question 2

One PHC covers how much population in hilly area?

Accepted Answer

20000

Answer

50000

Answer

10000

Answer

30000

Question 3

Professional death in medical profession is -

Accepted Answer

Removal of name of doctor from panel of RMP

Answer

Death sentence ordered by judge

Answer

Death during police firing

Answer

Death of doctor

Question 4

Most common cause of ptosis in adults

Accepted Answer

Aponeurotic

Answer

Idiopathic

Answer

Myasthenia gravis

Answer

Paralysis of 3rd nerve

Question 5

All are ophthalmological emergencies except -

Accepted Answer

CRVO

Answer

Endophthalmitis

Answer

Acute congestive glaucoma

Answer

CRAO

Question 6

Surgery of choice in a patient with congenital ptosis with good levator action is:

Accepted Answer

LPS resection

Answer

Fascia lata sling surgery

Answer

Fasanella-Servat operation

Answer

Müller's resection

Question 7

Hormone primarily responsible for blood pressure regulation following acute blood loss is:

Accepted Answer

ADH

Answer

Aldosterone

Answer

ANP

Answer

Epinephrine

Question 8

Which of the following actions of GH is mediated by IGF-1?

Accepted Answer

Antilipolysis

Answer

Na+ retention

Answer

decreases insulin

Answer

Lipolysis

Question 9

Most common type of intellectual disability –

Accepted Answer

Mild

Answer

Severe

Answer

Profound

Answer

Moderate

Question 10

Fatal exsanguination occurs most commonly in

Accepted Answer

Partial transection of an artery

Answer

Closed fracture of the femoral shaft

Answer

Complete transection of an artery

Answer

Open fracture of the femur and tibia

NEET-PG 2013

Anatomy

Community Medicine

Forensic Medicine

Ophthalmology

Physiology

Psychiatry

Surgery