NEET-PG 2020 Practice Questions

Q: The most common site of origin of the diverticulum of the pharynx seen in the barium swallow given below is

Between thyropharyngeus and cricopharyngeus. ***Between thyropharyngeus and cricopharyngeus*** - The diverticulum shown is a **Zenker's diverticulum**, which typically arises in **Killian's triangle** (Killian's dehiscence), a weak spot located between the **thyropharyngeus** and **cricopharyngeus** parts of the inferior pharyngeal constrictor. - This anatomical location represents an area of **muscular dehiscence** where increased intraluminal pressure during swallowing can lead to posterior herniation of the pharyngeal mucosa. - Killian's triangle is the **most common site** for pharyngeal diverticula. *Between stylopharyngeus and palatopharyngeus* - This region is located higher in the pharynx, and a diverticulum here would be extremely rare and not characteristic of a Zenker's diverticulum. - The stylopharyngeus and palatopharyngeus muscles primarily influence **pharyngeal elevation** and **soft palate movement** during swallowing, not the typical site of diverticular formation. *Between middle and inferior constrictor* - This area is located more superiorly in the pharynx and is **not a recognized site** for pharyngeal diverticula. - Diverticula at this level would be extremely rare as there is no significant anatomical weakness or dehiscence comparable to Killian's triangle. - This should not be confused with other posterior pharyngeal weak points like Killian's triangle or the Killian-Jamieson area (which is lateral, not posterior). *Between inferior constrictor and esophagus* - This description is broadly anatomically similar but less precise than specifying the exact muscular components. - While Zenker's diverticulum does occur at the pharyngoesophageal junction, the specific weak point is **Killian's triangle** between the thyropharyngeus and cricopharyngeus muscles within the inferior constrictor complex.

Q: Which absorbs least water?

Cellulose. ***Cellulose*** - **Cellulose** is a **polysaccharide** with strong **intermolecular hydrogen bonding** between its linear chains. - These strong bonds form a highly ordered, crystalline structure that makes it **insoluble in water** and resistant to water absorption. *Mucilage* - **Mucilage** consists of **polysaccharides** that have a high capacity to absorb water, forming a slimy, gelatinous mass. - This property is due to its highly branched structure and abundance of **hydroxyl groups**, which readily form hydrogen bonds with water. *Pectin* - **Pectin** is a complex **polysaccharide** found in plant cell walls, known for its ability to absorb significant amounts of water. - It forms **gels** with water, a property widely utilized in food production. *Gums* - **Gums** are a diverse group of **polysaccharides** that are highly soluble in water and have an excellent capacity for water absorption. - They tend to form **viscous solutions** or gels when mixed with water.

Q: What is the appropriate color for containers used to dispose of chemical liquid biomedical waste?

Yellow container. ***Yellow container*** - **Yellow containers** are specifically designated for disposal of **chemical liquid biomedical waste** as per BMW Management Rules, 2016. - This includes **disinfectants, chemical waste from laboratories, discarded medicines, and cytotoxic drugs**. - Yellow containers are used for Category 10 waste (Chemical Waste) which comprises chemicals used in production of biologicals, chemicals used in disinfection, and chemical liquid waste. - This waste typically requires **incineration or plasma pyrolysis** for safe disposal. *White/Translucent container* - **White or translucent containers** are used for **sharp waste** including needles, syringes with fixed needles, scalpels, blades, and contaminated broken glass. - This is Category 4 waste under BMW Rules and requires autoclaving or dry heat sterilization followed by shredding or mutilation. - These containers are puncture-proof and leak-proof to prevent needle-stick injuries. *Blue container* - **Blue containers** are designated for **glassware and metallic body implants** that can be recycled after proper disinfection. - This includes broken or unbroken glass vials (without chemical contamination), ampoules, and other glass items. - Also used for disposal of metallic implants removed during surgeries. *Red container* - **Red containers** are used for **contaminated recyclable plastic waste** including tubing, bottles, IV sets without needles, catheters, and urine bags. - This is Category 3 waste which requires autoclaving or microwaving followed by shredding before recycling. - Helps in waste segregation for potential recycling of plastic materials.

Q: A body is discovered with burn marks as shown in the image, resembling a 'crocodile skin' pattern. What is the most likely cause?

High voltage electrical burns. ***High voltage electrical burns*** - **High voltage electrical burns** can cause severe damage, including charring and deep tissue necrosis, which can result in a contracted, leathery skin appearance often described as **"crocodile skin"** or **alligator hide**. - The alternating current (AC) associated with high voltage can lead to muscle tetany, causing the victim to clench onto the source, prolonging exposure and increasing the severity of damage and the characteristic burn pattern. *Chemical burns* - Chemical burns result from exposure to corrosive substances and typically manifest as **discoloration**, **blistering**, or **deep tissue damage** depending on the agent and duration of contact. - While severe, chemical burns usually do not produce the specific "crocodile skin" pattern of extensive charring and contraction seen with high voltage electricity. *Scald burns* - Scald burns are caused by hot liquids or steam and commonly result in **blistering**, **redness**, and superficial to partial-thickness skin damage without the deep tissue charring. - The pattern of injury would typically be distinct from the described "crocodile skin," often showing flowing or splash patterns. *Radiation burns* - Radiation burns occur due to exposure to high doses of radiation and can lead to **erythema**, **blistering**, and **skin breakdown** over time. - These burns develop progressively and often have a characteristic delayed presentation and pattern related to the radiation field, not the immediate charring seen with electrical injuries.

Q: In the court of law, the act of a witness giving false evidence after taking an oath is punishable under:

193 IPC. ***193 IPC*** - **Section 193 of the Indian Penal Code (IPC)** specifically deals with the punishment for giving **false evidence** in a judicial proceeding. - This section outlines that any person who intentionally gives false evidence in any stage of a judicial proceeding, or fabricates false evidence for the purpose of being used in any stage of a judicial proceeding, shall be punished. *192 IPC* - **Section 192 IPC** defines what constitutes **"fabricating false evidence."** - While fabricating false evidence is a prerequisite for some offenses related to false evidence, Section 192 itself defines the act, but does not prescribe the punishment for giving false evidence after taking an oath in court. *191 IPC* - **Section 191 IPC** defines what constitutes **"giving false evidence."** - It explains that consciously making a statement which is false, and which a person either knows or believes to be false, or does not believe to be true, while legally bound by oath or by any express provision of law to state the truth, is considered giving false evidence, but does not prescribe the punishment. *197 IPC* - **Section 197 IPC** deals with **issuing or signing a false certificate**, not the act of a witness giving false evidence under oath in court. - This section punishes someone who issues or signs any certificate required by law, knowing or believing it to be false, in any material point.

Q: What is the Child-Pugh class for a patient who has a serum bilirubin of 2.5 mg/dL, serum albumin of 3 g/dL, INR of 2, mild ascites, but no encephalopathy?

Child-Pugh Class B. ***Child-Pugh Class B*** - A serum bilirubin of **2.5 mg/dL** (2 points), serum albumin of **3 g/dL** (2 points), INR of **2** (2 points), and mild ascites (2 points), with no encephalopathy (1 point), sums up to a total of 9 points, which falls into the range for **Child-Pugh Class B** (7-9 points) [1]. - This class indicates **moderate hepatic dysfunction** and is characterized by a higher risk of complications and mortality compared to Class A. *Child-Pugh Class A* - This class is assigned for a total score of **5-6 points**, indicating **well-compensated hepatic disease**. - The patient's total score of 9 points exceeds the threshold for Class A, suggesting more significant liver impairment. *Child-Pugh Class D* - There is no Child-Pugh Class D; the classification system only includes classes A, B, and C. - This option is therefore incorrect based on the established Child-Pugh scoring system. *Child-Pugh Class C* - This class corresponds to a total score of **10-15 points**, indicative of **severe hepatic decompensation**. - The patient's calculated score of 9 points is below the minimum required for Child-Pugh Class C.

Q: All-trans retinoic acid is primarily used in the treatment of which of the following tumors?

PML-RARA. ***PML-RARA*** - **All-trans retinoic acid (ATRA)** is a cornerstone treatment for **acute promyelocytic leukemia (APML)**, which is characterized by the **PML-RARA fusion gene**. - ATRA works by inducing differentiation of leukemic promyelocytes, overcoming the maturation block caused by the **PML-RARA** oncoprotein. *BCR-ABL* - The **BCR-ABL fusion gene** is characteristic of **chronic myeloid leukemia (CML)**, and sometimes in acute lymphoblastic leukemia (ALL). - The primary treatment for **BCR-ABL positive leukemias** involves **tyrosine kinase inhibitors (TKIs)**, such as imatinib, not ATRA. *CMYC* - **CMYC** is an oncogene whose dysregulation is frequently implicated in various cancers, including **Burkitt lymphoma** and some forms of acute myeloid leukemia (AML). - There is no direct therapeutic role for ATRA specifically targeting tumors driven by **CMYC overexpression**. *CEBPA* - **CEBPA** mutations are found in a subset of **acute myeloid leukemia (AML)**, often leading to a favorable prognosis. - While ATRA can be used in some AML subtypes, it is not specifically indicated or primarily effective for AML characterized solely by **CEBPA mutations**; its role is specific to **PML-RARA**.

Q: Identify the sleep stage marked in the EEG during the sleep-wake cycle?

REM sleep. ***REM sleep*** - The marked EEG pattern shows **low-amplitude, mixed-frequency waves** which are characteristic of REM sleep, often resembling an awake state. - This stage is associated with **rapid eye movements**, vivid dreams, and muscle atonias. *Stage 1 sleep* - Characterized by a transition from alpha waves to **theta waves**, which are slightly slower than alpha waves and have a higher amplitude than the waves shown. - This is the **lightest stage of sleep**, with the person easily aroused. *Stage 2 sleep* - Marked by the presence of **sleep spindles** (bursts of high-frequency waves) and **K-complexes** (large, slow waves), which are not visible in the image. - The background activity consists of **theta waves,** which are slower and higher amplitude than the waves present in the image. *Stage 3 sleep* - This is **deep non-REM sleep**, also known as slow-wave sleep, characterized by **delta waves** (high-amplitude, low-frequency waves). - The waves in the image are much faster and lower amplitude than delta waves characteristic of Stage 3 sleep.

Q: On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:

30 days. ***30 days*** - As per the **Mental Healthcare Act, 2017**, under **Section 89 (Independent Admission)**, a person can be admitted independently for a **maximum period of 30 days**. - After 30 days, the person must either be discharged or the admission must be converted to voluntary or involuntary admission with appropriate procedures. - This provision allows for independent treatment-seeking without requiring a caregiver's involvement initially. *48 hours* - **48 hours** is not related to voluntary or independent admission duration. - This timeframe relates to the period within which a voluntary patient must be discharged after they request to leave (unless there are grounds for involuntary admission). *60 days* - **60 days** is not specified in the Mental Healthcare Act, 2017 for any category of admission. - This is neither the duration for voluntary, independent, nor involuntary admission procedures. *90 days* - **90 days** is not the correct maximum period for voluntary or independent admission. - While voluntary admission can continue indefinitely with ongoing consent, **independent admission** specifically has a **30-day limit** as per Section 89 of the Act.

Q: Not a landmark of facial nerve identification in parotid surgery:

Inferior belly of omohyoid. ***Inferior belly of omohyoid*** - The **inferior belly of the omohyoid muscle** is located in the **posterior triangle** of the neck and is not a surgical landmark for the facial nerve during parotidectomy. - Its anatomical position is far removed from the parotid gland and the facial nerve trunk (which exits the stylomastoid foramen and enters the parotid from posteromedially), making it irrelevant as a guide during parotid surgery. *Peripheral branches* - While careful dissection of **peripheral branches** is crucial for preserving facial nerve function, they are typically identified *after* locating the main trunk, not as primary landmarks for initially finding the nerve. - Direct identification of peripheral branches first is challenging and carries a higher risk of injury without prior identification of the main trunk or its primary divisions. *Post belly of digastric* - The **posterior belly of the digastric muscle** serves as a vital deep landmark for locating the facial nerve trunk. - The facial nerve typically passes superior to and deep to the posterior belly of the digastric muscle, providing a reliable point of reference for approaching the nerve. *Tragal pointer* - The **tragal pointer**, referring to the anterior surface of the cartilaginous tragus, is a superficial landmark used to approximate the location of the facial nerve trunk. - The facial nerve's main trunk typically emerges from the stylomastoid foramen, which is positioned approximately 1 cm anterior and inferior to the tragal pointer, making it a useful starting point for surgical dissection.

Question 1

The most common site of origin of the diverticulum of the pharynx seen in the barium swallow given below is

Accepted Answer

Between thyropharyngeus and cricopharyngeus

Answer

Between stylopharyngeus and palatopharyngeus

Answer

Between middle and inferior constrictor

Answer

Between inferior constrictor and esophagus

Question 2

Which absorbs least water?

Accepted Answer

Cellulose

Answer

Mucilage

Answer

Pectin

Answer

Gums

Question 3

What is the appropriate color for containers used to dispose of chemical liquid biomedical waste?

Accepted Answer

Yellow container

Answer

White container

Answer

Blue container

Answer

Red container

Question 4

A body is discovered with burn marks as shown in the image, resembling a 'crocodile skin' pattern. What is the most likely cause?

Accepted Answer

High voltage electrical burns

Answer

Chemical burns

Answer

Scald burns

Answer

Radiation burns

Question 5

In the court of law, the act of a witness giving false evidence after taking an oath is punishable under:

Accepted Answer

193 IPC

Answer

191 IPC

Answer

192 IPC

Answer

197 IPC

Question 6

What is the Child-Pugh class for a patient who has a serum bilirubin of 2.5 mg/dL, serum albumin of 3 g/dL, INR of 2, mild ascites, but no encephalopathy?

Accepted Answer

Child-Pugh Class B

Answer

Child-Pugh Class A

Answer

Child-Pugh Class D

Answer

Child-Pugh Class C

Question 7

All-trans retinoic acid is primarily used in the treatment of which of the following tumors?

Accepted Answer

PML-RARA

Answer

BCR-ABL

Answer

CMYC

Answer

CEBPA

Question 8

Identify the sleep stage marked in the EEG during the sleep-wake cycle?

Accepted Answer

REM sleep

Answer

Stage 1 sleep

Answer

Stage 2 sleep

Answer

Stage 3 sleep

Question 9

On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:

Accepted Answer

30 days

Answer

48 hours

Answer

60 days

Answer

90 days

Question 10

Not a landmark of facial nerve identification in parotid surgery:

Accepted Answer

Inferior belly of omohyoid

Answer

Peripheral branches

Answer

Post belly of digastric

Answer

Tragal pointer

NEET-PG 2020

Anatomy

Biochemistry

Community Medicine

Forensic Medicine

Internal Medicine

Pharmacology

Physiology

Psychiatry

Surgery