Anatomy
2 questionsWhich of the following statements regarding axillary lymph nodes is incorrect?
Which of the following statements about the mammary gland is false?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 171: Which of the following statements regarding axillary lymph nodes is incorrect?
- A. Posterior group lies along subscapular vessels
- B. Lateral group lies along lateral thoracic vessels (Correct Answer)
- C. Apical group is terminal lymph nodes
- D. Apical group lies along axillary vessels
Explanation: ***Lateral group lies along lateral thoracic vessels*** - The **lateral group** of axillary lymph nodes is located along the **axillary vein**, receiving lymph primarily from the upper limb [1]. - The **lateral thoracic vessels** are associated with the central and posterior groups of axillary lymph nodes, not the lateral group. *Posterior group lies along subscapular vessels* - The **posterior (subscapular) group** of axillary lymph nodes is indeed located along the **subscapular vessels**. - This group receives lymph from the posterior wall of the trunk and the posterior shoulder region. *Apical group is terminal lymph nodes* - The **apical group** (also known as the subclavian group) is considered the **terminal lymph nodes** of the axilla. - Lymph from all other axillary nodes eventually drains into the apical group before continuing to the supraclavicular nodes and then into the subclavian lymphatic trunk [2]. *Apical group lies along axillary vessels* - The **apical group** of axillary lymph nodes is situated in the apex of the axilla, superior to the pectoralis minor muscle, and lies in close proximity to the **axillary vessels** [1]. - This location allows it to receive lymph from other axillary groups and drain into the supraclavicular lymph nodes.
Question 172: Which of the following statements about the mammary gland is false?
- A. Is a modified sweat gland
- B. Extends from 2nd to 6th rib vertically
- C. Supplied by internal mammary artery
- D. Nipple is supplied by 6th intercostal nerve (Correct Answer)
Explanation: ***Nipple is supplied by 6th intercostal nerve*** - The **nipple and areola** are primarily supplied by branches of the **4th intercostal nerve**. - The 6th intercostal nerve supplies the lower part of the breast and is not the primary innervation for the nipple. *Is a modified sweat gland* - The mammary gland, or breast, is indeed a **modified apocrine sweat gland**. - This embryological origin explains its glandular structure and function of milk production. *Extends from 2nd to 6th rib vertically* - The vertical extent of the mammary gland typically ranges from the **2nd to the 6th rib**. - This anatomical positioning is consistent with its location on the anterior thoracic wall. *Supplied by internal mammary artery* - The **internal mammary artery (internal thoracic artery)** is a major blood supply to the medial aspect of the breast [2]. - Other significant arteries include the lateral thoracic and thoracoacromial arteries for the lateral aspect. The mammary gland is embedded in subcutaneous fat, although fat is absent beneath the nipple and areola [1]. Mature resting breasts lie between the skin and the pectoralis major muscle, supported by Cooper's ligaments [3].
Internal Medicine
1 questionsAnemia with reticulocytosis is seen in -
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 171: Anemia with reticulocytosis is seen in -
- A. Hemolysis (Correct Answer)
- B. Iron deficiency anemia
- C. Vitamin B12 deficiency
- D. Aplastic anemia
Explanation: ***Hemolysis*** - Reticulocytosis indicates a compensatory response to anemia, often occurring in hemolytic processes where the **bone marrow increases red blood cell production** in response to red blood cell destruction. - Conditions like **sickle cell disease** or **autoimmune hemolytic anemia** lead to hemolysis, further confirming increased reticulocyte count. *Iron deficiency anemia* - Typically presents with a **low reticulocyte count** as the bone marrow does not have sufficient iron to produce new red blood cells. - This condition is characterized by **microcytic, hypochromic** red blood cells due to inadequate iron stores. *Vitamin B12 deficiency* - Often results in a **macrocytic anemia** with a variable reticulocyte count; however, reticulocytosis is generally not seen initially. - This deficiency affects DNA synthesis, leading to ineffective erythropoiesis and the presence of **megaloblastic changes**. *Aplastic anemia* - Characterized by a **decrease in all types of blood cells** (pancytopenia) and typically has a **low reticulocyte count** due to bone marrow failure. - There is insufficient production of red blood cells, hence **reticulocytosis is not observed**.
Microbiology
1 questionsPersons with heterozygous sickle cell trait are protected from infection by:
NEET-PG 2013 - Microbiology NEET-PG Practice Questions and MCQs
Question 171: Persons with heterozygous sickle cell trait are protected from infection by:
- A. Pneumococcus
- B. P. falciparum (Correct Answer)
- C. P. vivax
- D. Salmonella
Explanation: ***P. falciparum*** - Individuals with heterozygous sickle cell trait have a **protective effect** against severe malaria caused by *P. falciparum* due to altered red blood cell morphology [1][2]. - The sickle hemoglobin (HbAS) provides a **selective advantage**, reducing the severity of malaria infections and the parasitic load [2][3]. *P. vivax* - Sickle cell trait does not confer significant protection against *P. vivax*, which primarily infects non-sickled red blood cells [2]. - The infection still occurs in individuals with the trait because it specifically affects the reticulocyte count, which is less impacted by sickling. *Salmonella* - While sickle cell disease is linked with increased susceptibility to **Salmonella infections**, the sickle cell trait itself does not provide protection against it [2]. - The trait does not influence immunity or susceptibility to bacterial pathogens like *Salmonella*. *Pneumococcus* - Individuals with sickle cell trait still have a normal risk of **invasive pneumococcal disease**, similar to those without the trait [2]. - Protection against *Pneumococcus* primarily relates to vaccination status and not to hemoglobinopathies. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 398-400. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 50-51.
Pathology
6 questionsIntracorpuscular hemolytic anemia is seen in ?
Which of the following statements is false regarding hereditary spherocytosis?
Linitis plastica is a type of ?
Which of the following statements is true regarding light microscopy findings in minimal change disease?
Donath-Landsteiner antibody is seen in?
Which of the following statements about sickle cell anemia is false?
NEET-PG 2013 - Pathology NEET-PG Practice Questions and MCQs
Question 171: Intracorpuscular hemolytic anemia is seen in ?
- A. Thalassemia (Correct Answer)
- B. Infection
- C. Thrombotic thrombocytopenic purpura (TTP)
- D. Autoimmune hemolytic anemia
Explanation: ***Thalassemia*** - Thalassemia is characterized by **intracorpuscular hemolysis** due to defective hemoglobin synthesis, leading to premature destruction of red blood cells [1][2]. - It manifests as **microcytic anemia** with associated **extramedullary erythropoiesis** in severe cases [1]. *Autoimmune hemolytic anemia* - This condition leads to **extravascular hemolysis**, primarily affecting red blood cells in the spleen, not within the plasma [2]. - It is often associated with **positive direct Coombs test**, indicating reactants on the RBC surface. *TIP* - TIP (Thrombotic Microangiopathy) primarily involves **microangiopathic hemolytic anemia** and is not classified as intracorpuscular [2]. - The hemolysis in TIP occurs due to **microthrombi**, causing damage to red blood cells as they pass through narrowed vessels. *Infection* - Infections can lead to **hemolysis**, but this is typically **extravascular** due to splenic clearance or due to other mechanisms like **malaria** [2]. - The hemolytic mechanism is not intracorpuscular, as seen in conditions like thalassemia. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 601-602. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 596-597.
Question 172: Which of the following statements is false regarding hereditary spherocytosis?
- A. Defect in ankyrin
- B. Reticulocytosis
- C. Decreased MCHC (Correct Answer)
- D. Normal to increased MCV
Explanation: ***Decreased MCHC*** - Hereditary spherocytosis typically presents with an **increased MCHC** due to the spherocytes being more concentrated. - MCHC is a measure of the hemoglobin concentration in red blood cells, and in spherocytosis, this value is often elevated rather than decreased. *Defect in ankyrin* - This is a true statement; hereditary spherocytosis is associated with a defect in **ankyrin**, a protein that helps maintain the cell's membrane structure [2]. - Mutations in ankyrin lead to instability of the red blood cell membrane, resulting in spherocyte formation [2]. *Decreased MCV* - In hereditary spherocytosis, MCV is often **normal or slightly increased**, as it reflects the volume of red blood cells, which can be misinterpreted due to the presence of spherocytes. - Spherocytes are smaller cells, which can mistakenly suggest a falsely decreased MCV if not properly interpreted [1]. *Reticulocytosis* - This condition typically presents with **reticulocytosis** as a response to hemolysis, indicating the bone marrow is producing more red blood cells to compensate [1]. - The presence of reticulocytosis is a common finding in hereditary spherocytosis due to increased destruction of spherocytes. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 597-598. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 640-641.
Question 173: Linitis plastica is a type of ?
- A. Benign ulcer
- B. GIST
- C. Manifestation of gastric cancer (Correct Answer)
- D. Plastic-like appearance of stomach lining
Explanation: ***Diffuse carcinoma of stomach*** - Linitis plastica is a specific type of **gastric cancer** characterized by **thickening of the stomach wall**, leading to a rigid, non-distensible abdomen [1]. - It often presents with **significant weight loss** and **early satiety**, distinguishing it from other stomach conditions. *Benign ulcer* - Benign ulcers do not cause the **extensive wall thickening** or **desmoplastic response** seen in linitis plastica [1]. - They typically heal with treatment and are associated with typical ulcer symptoms, unlike the progressive nature of linitis plastica. *Plastic like lining of stomach* - While linitis plastica describes a **plastic-like appearance**, it is not classified as a mere lining change but rather a sign of underlying **malignancy** [1]. - This option misrepresents it as a benign condition rather than a serious **stomach adenocarcinoma**. *GIST* - Gastrointestinal stromal tumors (GIST) are **soft tissue tumors** of mesenchymal origin, differing fundamentally from the **invasive** characteristics of linitis plastica [2]. - GISTs typically present with **mass lesions** in the GI tract, not the diffuse rigidity seen in linitis plastica [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 779-780. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 779.
Question 174: Which of the following statements is true regarding light microscopy findings in minimal change disease?
- A. Foot process effacement is observed under electron microscopy, not light microscopy.
- B. Anti-GBM antibodies are associated with Goodpasture syndrome, not minimal change disease.
- C. No significant changes are seen under light microscopy. (Correct Answer)
- D. IgA deposits are characteristic of IgA nephropathy, not minimal change disease.
Explanation: ***No change seen*** - In minimal change disease, **light microscopy** typically shows no significant changes, which is a key characteristic of the condition [1]. - The disease primarily affects the **podocytes** leading to **nephrotic syndrome**, while light microscopy does not reveal any abnormalities [1]. *Loss of foot process seen* - Loss of foot processes is actually observed under **electron microscopy**, not light microscopy. - Light microscopy remains normal, differentiating minimal change disease from other glomerular diseases. *IgA deposits seen* - IgA deposits are associated with **IgA nephropathy**, which is a different condition characterized by mesangial deposition. - Minimal change disease does not have **immunofluorescence** findings, and thus shows no such deposits on light microscopy [1]. *Anti GBM Abs seen* - Anti-GBM antibodies are characteristic of **Goodpasture syndrome**, which presents with significant changes in glomerular structure. - In minimal change disease, there are no **anti-GBM antibodies** or major changes visible under light microscopy. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 927-928.
Question 175: Donath-Landsteiner antibody is seen in?
- A. PNH
- B. Waldenstrom's macroglobulinemia
- C. Malaria
- D. Paroxysmal cold hemoglobinuria (Correct Answer)
Explanation: ***Paroxysmal cold hemoglobinuria*** - **Donath-Landsteiner antibody** is a **biphasic IgG autoantibody** that binds to red blood cells in the cold and causes **hemolysis** upon warming, characteristic of paroxysmal cold hemoglobinuria. - This antibody has **anti-P specificity**, meaning it targets the P antigen on red blood cells, leading to complement activation and cell lysis. *PNH* - **Paroxysmal nocturnal hemoglobinuria** (PNH) is characterized by a deficiency in **GPI-anchored proteins** on red blood cells, notably **CD55** and **CD59**, making them susceptible to complement-mediated lysis. - It is not associated with the Donath-Landsteiner antibody; rather, it is identified by **flow cytometry** showing absence of CD55/CD59. *Waldenstrom's macroglobulinemia* - This is a **B-cell lymphoma** characterized by the overproduction of **monoclonal IgM antibodies**, leading to hyperviscosity syndrome and other symptoms. - It does not involve Donath-Landsteiner antibodies or cold-induced hemolysis in the same manner as paroxysmal cold hemoglobinuria. *Malaria* - **Malaria** is caused by **Plasmodium parasites** that infect and destroy red blood cells, leading to hemolytic anemia and fever. - While it causes **hemolysis**, it is not mediated by the Donath-Landsteiner antibody; the destruction is primarily due to parasitic replication and immune responses against infected cells.
Question 176: Which of the following statements about sickle cell anemia is false?
- A. Sickle cells are present in sickle cell anemia.
- B. Target cells are commonly seen in sickle cell anemia.
- C. Ringed sideroblasts are associated with sickle cell anemia. (Correct Answer)
- D. Howell Jolly bodies can be found in sickle cell anemia.
Explanation: ***Ringed sideroblast*** - **Ringed sideroblasts** are not typically associated with sickle cell anemia; they are indicative of disorders like **sideroblastic anemia**. - In sickle cell anemia, the primary findings include **hemolysis** and ineffective erythropoiesis, not ringed sideroblasts [3]. *Howell jolly bodies* - These bodies are remnants of nuclear material and can be found in individuals with **spleen dysfunction**, which can occur in sickle cell anemia [1]. - They are actually a common finding due to **hyposplenism** or **asplenia** in patients with sickle cell disease [2]. *Sickle cells* - The presence of **sickle-shaped red blood cells** is a hallmark of sickle cell anemia, caused by the mutation in the **beta-globin chain** [3]. - These sickle cells are responsible for the characteristic complications of the disease, such as **vaso-occlusive crises** [1][3]. *Target cells* - Target cells, or **codocytes**, are often seen in disorders like **thalassemia** and liver disease, and can also be present in sickle cell anemia. - They are formed due to an increase in the **surface area to volume ratio** of red blood cells, often secondary to **membrane abnormalities** seen in sickle cell changes [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 644-646. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 570-571. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599.