Internal Medicine
1 questionsTinel's sign is seen in which of the following conditions?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 981: Tinel's sign is seen in which of the following conditions?
- A. Carpal tunnel syndrome (Correct Answer)
- B. Avascular necrosis of scaphoid
- C. Kienbock's Disease
- D. 1st carpometacarpal joint arthritis
Explanation: ***Carpal tunnel syndrome*** - **Tinel's sign** is elicited by lightly tapping over the median nerve at the wrist, which in carpal tunnel syndrome, reproduces tingling or pain in the median nerve distribution [1]. - This sign indicates **nerve compression** or irritation at the carpal tunnel, a hallmark of the condition [1]. *Avascular necrosis of scaphoid* - This condition involves **bone death** due to interrupted blood supply, leading to pain and reduced range of motion, but not nerve irritation. - Diagnosis is typically made with **imaging studies** like MRI, not by neurological signs like Tinel's. *Kienbock's Disease* - This is a form of **avascular necrosis of the lunate bone**, causing wrist pain and stiffness. - It does not involve nerve compression and therefore **Tinel's sign** would not be expected. *1st carpometacarpal joint arthritis* - This condition affects the **joint at the base of the thumb**, causing localized pain and stiffness during gripping or pinching. - Symptoms are related to **joint degeneration**, not nerve impingement, so Tinel's sign is not relevant.
Microbiology
1 questionsWhich microorganism is the most common cause of pyogenic osteomyelitis?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 981: Which microorganism is the most common cause of pyogenic osteomyelitis?
- A. S. aureus (Correct Answer)
- B. Streptococcus spp.
- C. Corynebacterium spp.
- D. Neisseria gonorrhoeae (gonococcus)
Explanation: ***Staph aureus*** - **_Staphylococcus aureus_** is the most frequent cause of **pyogenic osteomyelitis** across all age groups and routes of infection. - Its ability to adhere to bone, form biofilms, and produce toxins contributes to its prevalence in bone infections. *Streptococcus spp.* - While various **_Streptococcus_** species can cause infections, they are less common causes of pyogenic osteomyelitis compared to **_Staphylococcus aureus_**. - **Group A _Streptococcus_** can cause severe invasive infections but rarely involves primary bone infection. *Corynebacterium spp.* - **_Corynebacterium_** species, particularly **_Corynebacterium striatum_**, are increasingly recognized as opportunistic pathogens, especially in immunocompromised individuals or those with foreign bodies. - However, they are not the most common cause of osteomyelitis in the general population. *Neisseria gonorrhoeae (gonococcus)* - **_Neisseria gonorrhoeae_** can cause **disseminated gonococcal infection (DGI)**, which may include joint involvement (**septic arthritis**). - While it can lead to bone pain and swelling, it primarily affects joints and is a less common cause of direct **pyogenic osteomyelitis** than **_S. aureus_**.
Obstetrics and Gynecology
2 questionsWhich of the following conditions is most commonly associated with malodorous vaginal discharge?
Which of the following statements is true regarding placental site trophoblastic disease?
NEET-PG 2015 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 981: Which of the following conditions is most commonly associated with malodorous vaginal discharge?
- A. Bacterial vaginosis (Correct Answer)
- B. Chlamydia trachomatis
- C. Trichomonas vaginalis
- D. Neisseria gonorrhoeae
Explanation: ***Bacterial vaginosis*** - This condition is characterized by a "fishy" or **malodorous vaginal discharge**, particularly noticeable after intercourse due to the release of amines. - It results from an imbalance in the vaginal flora, with an overgrowth of anaerobic bacteria and a decrease in protective lactobacilli. *Chlamydia trachomatis* - Often presents with **asymptomatic cervicitis** or mild watery discharge; **malodorous discharge** is not a common or prominent symptom. - While it can cause pelvic pain or dysuria, it's not typically associated with the characteristic smell of bacterial vaginosis. *Trichomonas vaginalis* - Can cause a **frothy, yellow-green discharge** that may be malodorous, but the "fishy" odor is more classically associated with bacterial vaginosis. - Other common symptoms include intense itching, burning, and dyspareunia. *Neisseria gonorrhoeae* - Causes cervicitis, which can lead to a **purulent or mucopurulent vaginal discharge**, but it does not typically produce the distinctive malodor seen in bacterial vaginosis. - Infection can also manifest as dysuria, pelvic pain, or be asymptomatic.
Question 982: Which of the following statements is true regarding placental site trophoblastic disease?
- A. Has a highly malignant potential
- B. It secretes human placental lactogen (Correct Answer)
- C. Mainly contains syncytiotrophoblasts
- D. The treatment of choice is hysterectomy followed by chemotherapy
Explanation: ***It secretes human placental lactogen*** - Placental site trophoblastic tumor (PSTT) characteristically consists of intermediate trophoblasts which secrete **human placental lactogen (hPL)**. - Unlike choriocarcinoma, PSTT secretes relatively low levels of **human chorionic gonadotropin (hCG)**. *Has a highly malignant potential* - PSTT generally has a **good prognosis** if the disease is confined to the uterus, with a survival rate of over 95%. - It has a low metastatic potential compared to choriocarcinoma, with metastases occurring in only about 15% of cases. *Mainly contains syncytiotrophoblasts* - PSTT is composed predominantly of **intermediate trophoblasts** that infiltrate the myometrium, rather than syncytiotrophoblasts or cytotrophoblasts. - The distinctive feature is the proliferation of these intermediate trophoblasts at the implantation site. *The treatment of choice is hysterectomy followed by chemotherapy* - **Hysterectomy** is generally the primary treatment for PSTT confined to the uterus, and it often cures the disease. - **Chemotherapy** is usually reserved for metastatic or recurrent disease, or in cases of extensive local invasion, and is not a routine follow-up after an uncomplicated hysterectomy.
Orthopaedics
6 questionsIn which of the following deformities is the distal interphalangeal joint extended?
4 year old child presented to the clinic with a history of fall on outstretched hand. Radiographs revealed a broken anterior cortex with an intact posterior cortex of the radius with an exaggerated bowing of the radius. The fracture sustained is known as -
Greenstick/ Nightstick fractures are seen in -
What condition is characterized by a waddling gait?
Who devised the correction of CTEV by serial casting?
Which nerve is primarily affected by lunate dislocation in the carpal tunnel?
NEET-PG 2015 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 981: In which of the following deformities is the distal interphalangeal joint extended?
- A. Boutonniere deformity (Correct Answer)
- B. Swan neck deformity
- C. Claw Hand
- D. Z deformity
Explanation: ***Boutonniere deformity*** - This deformity is characterized by **flexion of the proximal interphalangeal (PIP) joint** and **hyperextension of the distal interphalangeal (DIP) joint**. - It often results from injury to the **central slip of the extensor tendon** at the PIP joint. *Swan neck deformity* - This deformity presents with **hyperextension of the PIP joint** and **flexion of the DIP joint**, which is the opposite of the question's premise. - It is commonly associated with underlying conditions like **rheumatoid arthritis** or **lupus**. *Z deformity* - This typically refers to the **thumb in rheumatoid arthritis**, where the carpometacarpal (CMC) joint is flexed, the metacarpophalangeal (MCP) joint is hyperextended, and the interphalangeal (IP) joint is flexed. - It does not primarily describe an extended DIP joint in the context of other fingers. *Claw Hand* - This deformity involves **hyperextension of the MCP joints** and **flexion of the PIP and DIP joints**, particularly of the fourth and fifth fingers. - It is caused by **ulnar nerve palsy**, leading to muscle imbalance.
Question 982: 4 year old child presented to the clinic with a history of fall on outstretched hand. Radiographs revealed a broken anterior cortex with an intact posterior cortex of the radius with an exaggerated bowing of the radius. The fracture sustained is known as -
- A. Torus Fracture
- B. Greenstick fracture (Correct Answer)
- C. Galleazi Fracture
- D. Monteggia Fracture Dislocation
Explanation: ***Greenstick fracture*** - This fracture type involves a **broken anterior cortex** but an **intact posterior cortex**, leading to an exaggerated bowing of the bone, characteristic of a greenstick fracture. - It occurs predominantly in **children** due to their softer, more flexible bones, which tend to bend rather than fully break when subjected to force like a fall on an outstretched hand. *Torus Fracture* - A torus fracture, or **buckle fracture**, involves compression of the bone leading to a bulging or buckling of the cortex, usually on one side, without a complete break in the bone. - While it occurs in children, it presents as a compression injury and not with a broken cortex and intact posterior cortex with bowing. *Galleazi Fracture* - A Galleazi fracture is a fracture of the **distal radius** with **dislocation of the distal radioulnar joint (DRUJ)**. - This fracture pattern involves two bones and two distinct injuries (fracture and dislocation), which is fundamentally different from the described single-bone incomplete fracture. *Monteggia Fracture Dislocation* - A Monteggia fracture involves a fracture of the **proximal ulna** with **dislocation of the radial head** at the elbow. - This injury also involves two bones and two distinct components (fracture and dislocation) and affects a different anatomical location (ulna and elbow) than described.
Question 983: Greenstick/ Nightstick fractures are seen in -
- A. Children (Correct Answer)
- B. Elderly
- C. Common in all age groups
- D. Young adults
Explanation: ***
Question 984: What condition is characterized by a waddling gait?
- A. Bilateral congenital dysplasia of hip (Correct Answer)
- B. Coxa valga
- C. CTEV
- D. Muscular dystrophy
Explanation: ***Bilateral congenital dysplasia of hip*** - A **waddling gait**, also known as a **Trendelenburg gait**, occurs due to weakness of the hip abductor muscles (gluteus medius and minimus) on both sides. - In bilateral congenital dysplasia of the hip, the **femoral heads are poorly seated** or dislocated, leading to ineffective abductor function and the characteristic gait. *Coxa valga* - This condition involves an **increased angle** between the femoral neck and shaft, which can alter biomechanics but does not typically cause a waddling gait in isolation. - While it can be associated with other hip pathologies, **coxa valga itself is not the primary cause** of a waddling gait. *CTEV* - **CTEV (Congenital Talipes Equinovarus)**, or **clubfoot**, is a deformity of the foot and ankle, not the hip. - It affects the patient's ability to walk normally, but results in a different type of gait abnormality, typically involving limping or walking on the outer edge of the foot, **not a waddling gait**. *Muscular dystrophy* - While many forms of muscular dystrophy can lead to a waddling gait due to **proximal muscle weakness**, it is a broad category of genetic disorders. - Without further context or specific type of muscular dystrophy, **bilateral congenital hip dysplasia is a more direct and specific cause** for the symptom described.
Question 985: Who devised the correction of CTEV by serial casting?
- A. Gerhardt Kuntscher
- B. Gavril Ilizarov
- C. Hugh Owen Thomas
- D. Ignacio Ponseti (Correct Answer)
Explanation: ***Ignacio Ponseti*** - Dr. Ignacio Ponseti developed the **Ponseti method**, a non-surgical technique for correcting **congenital talipes equinovarus (CTEV)**, commonly known as clubfoot. - This method involves a series of **gentle manipulations** and **serial casting**, followed by the use of a foot abduction brace. *Gerhardt Kuntscher* - **Gerhardt Kuntscher** was a German surgeon known for developing the **intramedullary nail** for fixing long bone fractures. - His contributions revolutionized the surgical management of fractures, but he did not develop the method for CTEV correction. *Gavril Ilizarov* - **Gavril Ilizarov** was a Soviet orthopedic surgeon famous for inventing the **Ilizarov apparatus**, an external fixator used for limb lengthening and complex fracture treatment. - His work focused on osteogenesis and bone regeneration, not the non-surgical correction of clubfoot. *Hugh Owen Thomas* - **Hugh Owen Thomas** was a Welsh orthopedic surgeon regarded as the "father of British orthopaedic surgery," known for the development of the **Thomas splint**. - His contributions were primarily in managing fractures and tuberculosis of the joints, independent of CTEV correction techniques.
Question 986: Which nerve is primarily affected by lunate dislocation in the carpal tunnel?
- A. Ulnar
- B. Median nerve (Correct Answer)
- C. Radial nerve
- D. Median & ulnar nerve
Explanation: ***Median nerve*** - The **lunate bone** dislocates volarly into the **carpal tunnel**, directly compressing the median nerve which passes through this space. - This compression leads to symptoms typical of **carpal tunnel syndrome**, such as numbness and tingling in the thumb, index, middle, and radial half of the ring finger. *Ulnar* - The **ulnar nerve** passes outside the carpal tunnel, through Guyon's canal, and is therefore not typically affected by injuries within the carpal tunnel itself. - Compression of the ulnar nerve would result in symptoms in the little finger and ulnar half of the ring finger, which are not the primary symptoms associated with lunate dislocation. *Radial nerve* - The **radial nerve** primarily innervates the dorsal aspect of the hand and travels more superficially in the forearm, not through the carpal tunnel. - Injuries to the radial nerve usually result from fractures of the humerus or direct trauma to the forearm, not lunate dislocation. *Median & ulnar nerve* - While both nerves can be affected by severe, generalized trauma to the wrist, a classic lunate dislocation specifically targets the **median nerve** within the carpal tunnel. - Concurrent ulnar nerve involvement is less common and would suggest additional or more extensive injury beyond a simple lunate dislocation affecting the carpal tunnel.