Anatomy
2 questionsSertoli cells are derived from -
B cells are located in which region of lymph nodes?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 321: Sertoli cells are derived from -
- A. Genital swelling
- B. Coelomic epithelium (Correct Answer)
- C. Primordial germ cells
- D. Germinal epithelium
Explanation: Sertoli cells are derived from the **coelomic epithelium** (surface epithelium) of the urogenital ridge during gonadal development. - The coelomic epithelium proliferates to form the **primitive sex cords** (medullary cords in males), and cells within these cords differentiate into Sertoli cells. - These cells are essential for **spermatogenesis**, providing structural support and nutrition to developing germ cells, and producing **anti-Müllerian hormone (AMH)** which causes regression of Müllerian ducts in male development [1]. *Germinal epithelium* - This is an **outdated term** previously used for the surface epithelium of the gonad, based on the misconception that it gave rise to germ cells. - Modern embryology uses the term **coelomic epithelium** or surface epithelium instead. - While historically used, this terminology is no longer preferred in current medical literature. *Genital swelling* - **Genital swellings** (labioscrotal swellings) are external mesodermal structures that develop into the **scrotum** in males or **labia majora** in females. - These are external genitalia components and are not the source of internal testicular cells like Sertoli cells. *Primordial germ cells* - **Primordial germ cells (PGCs)** originate from the epiblast, migrate via the hindgut to the developing gonads, and differentiate into **spermatogonia** (males) or **oogonia** (females) [1]. - They form the **germ cell lineage** (gametes), not somatic support cells like Sertoli cells, which are of coelomic epithelial origin.
Question 322: B cells are located in which region of lymph nodes?
- A. Paracortical region
- B. Cortical follicles (Correct Answer)
- C. Subcapsular region
- D. Medullary sinuses
Explanation: ***Cortical follicles*** - **B cells** are predominantly found within the **cortical follicles** of lymph nodes, where they mature and become activated upon encountering antigens [2]. - These follicles can be primary (inactive) or secondary (active, containing **germinal centers** for B cell proliferation and differentiation). *Paracortical region* - The **paracortical region** is primarily occupied by **T cells** and is the site where T cells interact with antigen-presenting cells [1]. - While it's adjacent to B cell areas, it's not the primary location for B cells. *Medullary sinuses* - **Medullary sinuses** are channels in the medulla of the lymph node, containing macrophages and plasma cells, which are *differentiated B cells*. - They are not the primary residence for undifferentiated B cells. *Subcapsular region* - **Subcapsular region** is the space immediately beneath the capsule of the lymph node where lymph initially enters. - It contains macrophages and dendritic cells that sample antigens but is not a primary B cell zone.
Biochemistry
2 questionsWhich of the following is not a free radical?
Prolyl hydroxylase requires which cofactor?
NEET-PG 2015 - Biochemistry NEET-PG Practice Questions and MCQs
Question 321: Which of the following is not a free radical?
- A. Superoxide anion
- B. Hydrogen peroxide (H2O2) (Correct Answer)
- C. Nitric oxide (NO·)
- D. Hydroxyl radical (.OH)
Explanation: ***Hydrogen peroxide (H₂O₂)*** - **Hydrogen peroxide** is a **reactive oxygen species (ROS)** but is not a free radical because it has **no unpaired electrons** in its outermost shell. - While it can be converted into the highly reactive hydroxyl radical via the **Fenton reaction**, it is stable enough to be transported across membranes. *Superoxide anion (O₂⁻)* - The **superoxide anion (O₂⁻)** is a free radical because it has an **unpaired electron** in its outer shell. - It is one of the primary **reactive oxygen species** formed during cellular metabolism and can damage cellular components. *Nitric oxide (NO·)* - **Nitric oxide** is an important **free radical** with a single **unpaired electron** in its molecular structure. - It functions as a vital signaling molecule in vascular biology, regulating blood pressure and neurotransmission, despite being a free radical. *Hydroxyl radical (·OH)* - The **hydroxyl radical (·OH)** is one of the most reactive and damaging **free radicals** in biological systems. - It has a single **unpaired electron**, making it highly unstable and able to react indiscriminately with virtually all types of biomolecules.
Question 322: Prolyl hydroxylase requires which cofactor?
- A. Vitamin C (Correct Answer)
- B. Iron (Fe²⁺)
- C. Molybdenum
- D. Vitamin K1
Explanation: ***Vitamin C*** - **Prolyl hydroxylase** is an enzyme critical for the hydroxylation of proline residues during **collagen synthesis**. - **Vitamin C** (ascorbic acid) acts as an essential **cofactor**, reducing the ferric iron of the enzyme back to its ferrous state after each catalytic cycle, enabling continued activity. - The enzyme requires both **iron (Fe²⁺)** as a metal cofactor and **vitamin C** to maintain the iron in its reduced state. *Iron (Fe²⁺)* - While **iron** is indeed required by prolyl hydroxylase as a **metal cofactor**, the question asks for the cofactor, which specifically refers to **vitamin C**. - Iron functions as part of the enzyme's active site, but vitamin C is the reducing agent that keeps iron functional. - Vitamin C deficiency (scurvy) leads to defective collagen synthesis despite adequate iron. *Molybdenum* - **Molybdenum** is a cofactor for several human enzymes, including **xanthine oxidase** and **sulfite oxidase**. - However, it plays no direct role in the activity of prolyl hydroxylase. *Vitamin K1* - **Vitamin K1** is a crucial cofactor for **gamma-glutamyl carboxylase**, an enzyme involved in the carboxylation of glutamic acid residues in clotting factors. - It is not involved in the hydroxylation of proline by prolyl hydroxylase.
Internal Medicine
1 questionsIn which condition is Serum Amyloid Associated (SAA) protein most commonly found?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 321: In which condition is Serum Amyloid Associated (SAA) protein most commonly found?
- A. Alzheimer's disease
- B. Malignant hypertension
- C. Chronic inflammatory states (Correct Answer)
- D. Chronic renal failure
- E. Acute myocardial infarction
Explanation: ***Chronic inflammatory states*** [1][2] - Serum amyloid-associated protein is elevated in response to **chronic inflammation**, such as in rheumatic diseases and infections [1][2]. - It serves as a **biomarker** indicating systemic inflammation and is part of the **acute-phase response** [1]. *Chronic renal failure* - While renal failure can lead to amyloidosis, it is not a direct cause of serum amyloid-associated protein elevation. - **Renal impairment** is more associated with a decrease in clearance rather than production of amyloid proteins. *Alzheimer's disease* - Although amyloid plaques are a hallmark of Alzheimer's, they are related to **A-beta peptide**, not serum amyloid-associated protein. - Alzheimer's pathology primarily involves **neurodegeneration** rather than inflammatory response. *Malignant hypertension* - Malignant hypertension primarily affects the **vascular system** and does not directly involve the production of serum amyloid-associated protein. - It is characterized by end-organ damage, rather than a state of chronic inflammation. *Chronic inflammatory conditions like RA, TB & leprosy, osteomyelitis, ankylosing spondylitis, IBD, bronchiectasis, some tumors* [1][2] - While these conditions can be associated with systemic inflammation, they are too specific and do not comprehensively encompass the broader concept of **chronic inflammatory states**. - This option fails to highlight that serum amyloid-associated protein is a marker for **various chronic inflammatory states** beyond just those listed [1].
Microbiology
2 questionsThe process by which antigen-specific B lymphocytes are selected and activated to proliferate and produce antibodies is called:
In the context of immune response, which of the following cell types does not express MHC class II molecules?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 321: The process by which antigen-specific B lymphocytes are selected and activated to proliferate and produce antibodies is called:
- A. Clonal selection (Correct Answer)
- B. Class switching
- C. Group switching
- D. Hybridisation
Explanation: ***Clonal selection*** - **Clonal selection** is the fundamental process by which an antigen-specific B lymphocyte is **selected** when its B cell receptor (BCR) recognizes and binds to a matching antigen. - This binding triggers the B cell to become **activated**, **proliferate** (undergo clonal expansion), and **differentiate** into plasma cells that produce antibodies specific to that antigen. - This process is the cornerstone of **adaptive immunity**, ensuring that only B cells with receptors matching the encountered antigen are stimulated to respond. *Class switching* - **Class switching** (isotype switching) occurs AFTER clonal selection and activation. - It allows already-activated B cells to change the **antibody class** they produce (from IgM to IgG, IgA, or IgE) while maintaining the **same antigen specificity**. - This process modifies effector functions but does NOT involve the initial selection and activation of antigen-specific B cells. *Group switching* - This is not a recognized term in immunology. - It does not describe any standard process of B cell activation or antibody production. *Hybridisation* - **Hybridization** refers to the formation of double-stranded nucleic acids from complementary strands or the creation of hybrid cells (e.g., hybridomas for monoclonal antibody production). - It is not the physiological process by which B lymphocytes are selected and activated in response to antigen exposure.
Question 322: In the context of immune response, which of the following cell types does not express MHC class II molecules?
- A. Cortical macrophages
- B. Neutrophils
- C. Medullary macrophages
- D. NK cells (Correct Answer)
Explanation: ***NK cells*** - **Natural Killer (NK) cells)** are innate lymphocytes that do **NOT express MHC class II molecules** under any circumstances. - NK cells use alternative recognition mechanisms (KIRs, activating receptors) to detect target cells, primarily recognizing the **absence of MHC class I** or stress-induced ligands. - They function in innate immunity without antigen presentation capability. - **This is the best answer** as NK cells never express MHC class II, making them distinctly different from professional APCs. *Cortical macrophages* - **Cortical macrophages** in lymphoid organs are professional **antigen-presenting cells (APCs)** that constitutively express **MHC class II molecules**. - They present processed antigens to CD4+ T helper cells, playing a crucial role in initiating adaptive immune responses. *Medullary macrophages* - **Medullary macrophages** are also professional APCs that constitutively express **MHC class II molecules**. - They participate in antigen presentation and immune surveillance within the medullary regions of lymphoid tissues. *Neutrophils* - Neutrophils are granulocytes that **typically do not constitutively express MHC class II molecules** in their resting state. - However, under certain inflammatory conditions with prolonged stimulation (IFN-γ, GM-CSF), neutrophils can be induced to express low levels of MHC class II. - While neutrophils generally lack MHC class II, **NK cells are the more definitive answer** as they never express MHC class II under any physiological or pathological conditions.
Pathology
2 questionsPost-streptococcal glomerulonephritis (PSGN) is an example of which type of hypersensitivity?
What is the most common type of graft rejection?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 321: Post-streptococcal glomerulonephritis (PSGN) is an example of which type of hypersensitivity?
- A. Type -1 hypersensitivity
- B. Type -2 hypersensitivity
- C. Type -3 hypersensitivity (Correct Answer)
- D. Type -4 hypersensitivity
Explanation: ***Type -3 hypersensitivity*** - Post-streptococcal glomerulonephritis (PSGN) is caused by **immune complex deposition**, a hallmark of type III hypersensitivity reactions [1][2][3]. - It involves the formation of **antigen-antibody complexes** following a streptococcal infection, leading to inflammation in the kidneys [1][2]. *Type -1 hypersensitivity* - Characterized by **IgE-mediated** reactions, such as allergies and anaphylaxis, which do not apply to PSGN. - It typically involves **mast cells** and histamine release, notably absent in PSGN cases. *Type -4 hypersensitivity* - Involves **T-cell mediated** responses and is related to delayed-type reactions, not applicable to PSGN. - Common examples include **contact dermatitis** and graft-versus-host disease, differing fundamentally from PSGN's mechanism. *Type -2 hypersensitivity* - Characterized by **antibody-mediated cytotoxicity**, such as in hemolytic anemia, unrelated to immune complexes in PSGN. - Typically involves direct damage to cells, contrasting with the immune complex mechanism observed in PSGN [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 214-215. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 910-915. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 215-216.
Question 322: What is the most common type of graft rejection?
- A. Hyperacute
- B. Acute (Correct Answer)
- C. Chronic
- D. Acute on chronic
Explanation: ***Acute*** - **Acute rejection** is the most common type of graft rejection, occurring in **10-40% of transplant recipients**. [1] - It typically occurs **days to weeks to months** after transplantation (most commonly within the first 6 months). [1] - Mediated primarily by **T-lymphocytes** (cellular rejection) or **antibodies** (antibody-mediated rejection) reacting against donor antigens. [1] - Usually **responsive to immunosuppressive therapy** when detected early. *Hyperacute* - **Hyperacute rejection** is rare (occurs in <1% of cases) due to routine **pre-transplant cross-matching**. - Occurs within **minutes to hours** after transplantation due to **pre-existing circulating antibodies** against donor antigens. [1] - Results in immediate thrombosis and graft necrosis, requiring **immediate graft removal**. [1] *Chronic* - **Chronic rejection** (chronic allograft dysfunction) develops **months to years** after transplantation. - It is the **most common cause of late graft failure**, but not the most common type of rejection episode. - Characterized by **gradual, progressive loss of graft function** with vascular and fibrotic changes. - **Largely irreversible** and poorly responsive to treatment. *Acute on chronic* - This is **not a primary category** of graft rejection but represents an **acute rejection episode superimposed** on a graft already undergoing chronic changes. - Reflects exacerbation in a chronically rejecting graft. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 239-242.
Surgery
1 questionsWhich solid organ is considered to have the lowest risk of rejection during transplantation?
NEET-PG 2015 - Surgery NEET-PG Practice Questions and MCQs
Question 321: Which solid organ is considered to have the lowest risk of rejection during transplantation?
- A. Pancreas
- B. Kidney
- C. Heart
- D. Liver (Correct Answer)
Explanation: ***Liver*** - The liver has a unique immunologic environment, often referred to as **immunologic privilege**, which contributes to its lower rates of rejection compared to other transplanted solid organs. - It produces various **immunosuppressive factors** and has a high capacity for regeneration and repair, adapting more readily to the recipient's immune system. - The liver's **dual blood supply** (hepatic artery and portal vein) and tolerogenic properties make it the most immunologically privileged solid organ. *Pancreas* - **Pancreas transplantation** carries a high risk of rejection, with rejection rates significantly higher than liver transplantation. - Pancreatic tissue is highly **immunogenic** due to its endocrine and exocrine functions, requiring aggressive immunosuppression. - Often transplanted with kidney in diabetic patients, and rejection episodes are common. *Kidney* - Kidney transplantation is common, but it carries a significant risk of both **acute and chronic rejection**, requiring lifelong immunosuppression. - The kidney expresses various **MHC antigens** that are readily recognized by the recipient's immune system, making it more immunogenic than the liver. *Heart* - **Heart transplantation** is associated with a high risk of rejection due to the rich vascularity and immunogenicity of cardiac tissue. - It often requires aggressive immunosuppressive regimens to prevent both **acute cellular rejection** and **antibody-mediated rejection**.