Dental
1 questionsEpulis arises from -
NEET-PG 2012 - Dental NEET-PG Practice Questions and MCQs
Question 1061: Epulis arises from -
- A. Enamel
- B. Root of teeth
- C. Gingiva (Correct Answer)
- D. Pulp
Explanation: ***Gingiva*** - **Epulis** refers to a localized, tumor-like enlargement of the **gingiva** (gum tissue). - These lesions are typically inflammatory or reactive in nature, arising from the connective tissue of the gum. *Enamel* - **Enamel** is the hard, outermost protective layer of the tooth crown, which is of ectodermal origin. - Lesions originating from enamel itself are rare and typically involve developmental defects or structural damage, not soft tissue growths like epulis. *Root of teeth* - The **root of the teeth** is embedded in the alveolar bone and covered by cementum, with the surrounding structures including the periodontal ligament and alveolar bone. - While infections or cysts can arise from the root, epulis specifically describes a growth of the overlying **gingival tissue**. *Pulp* - The **pulp** is the soft tissue inside the tooth containing nerves, blood vessels, and connective tissue. - Pathologies originating from the pulp are typically infectious (pulpitis), degenerative, or involve growth of odontogenic tissues (e.g., pulp polyps within the tooth chamber), not surface gingival lesions.
Internal Medicine
3 questionsWhat is the best treatment for anemia in patients with Chronic Renal Failure (CRF)?
Which of the following electrolyte imbalances is least likely to be observed in Chronic Renal Failure (CRF)?
In which condition is paradoxical splitting of the second heart sound observed?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1061: What is the best treatment for anemia in patients with Chronic Renal Failure (CRF)?
- A. Oral Iron Therapy
- B. Erythropoietin Stimulating Agents (Correct Answer)
- C. Blood transfusion
- D. Androgenic Steroids
Explanation: ***Erythropoietin Stimulating Agents*** - **Erythropoietin Stimulating Agents (ESAs)** are the cornerstone of anemia treatment in CRF because the primary cause of anemia in these patients is inadequate production of **endogenous erythropoietin** by the damaged kidneys [1]. - ESAs stimulate the bone marrow to produce red blood cells, effectively reversing the anemia and improving symptoms like fatigue and exercise intolerance [1]. *Oral Iron Therapy* - While **iron deficiency** often coexists with **anemia of chronic disease** in CRF patients, oral iron alone is usually insufficient to correct the anemia; it only addresses the iron component. - Many CRF patients have **functional iron deficiency** due to chronic inflammation, which impairs iron utilization, making oral iron less effective even with adequate stores. *Blood transfusion* - **Blood transfusions** provide a rapid increase in hemoglobin but are not the preferred long-term treatment for anemia in CRF due to risks of **iron overload**, **alloreactions**, and potential sensitization, which can complicate future transplantation. - Transfusions are typically reserved for acute, severe anemia or specific circumstances where ESAs are ineffective or contraindicated. *Androgenic Steroids* - **Androgenic steroids** can stimulate erythropoiesis, but their use is limited due to significant side effects such as **hepatotoxicity**, **virilization**, and **cardiac complications**, making them a less favorable option compared to ESAs. - They are considered a secondary or tertiary option, often in patients unresponsive to primary treatments or when other options are exhausted.
Question 1062: Which of the following electrolyte imbalances is least likely to be observed in Chronic Renal Failure (CRF)?
- A. Hyperkalemia
- B. Hyperphosphatemia
- C. Hypercalcemia (Correct Answer)
- D. Hypocalcemia
Explanation: ***Hypercalcemia*** - In **chronic renal failure (CRF)**, the kidneys' inability to activate vitamin D leads to impaired calcium absorption and **hypocalcemia** [1], [2]. - Additionally, the kidneys fail to excrete phosphate, leading to **hyperphosphatemia**, which further exacerbates hypocalcemia by forming calcium-phosphate precipitates [1]. *Hyperkalemia* - **Hyperkalemia** is a common and serious complication of CRF due to the kidneys' impaired ability to excrete **potassium**. - This is exacerbated by conditions like **metabolic acidosis** and certain medications. *Hyperphosphatemia* - In CRF, the kidneys are unable to adequately excrete **phosphate**, leading to an accumulation of **phosphate** in the blood [1]. - This condition directly contributes to **secondary hyperparathyroidism** and bone disease [1], [2]. *Hypocalcemia* - **Hypocalcemia** is very common in CRF, primarily due to decreased production of **calcitriol (active vitamin D)** by the failing kidneys [2]. - Reduced calcitriol leads to lower intestinal **calcium absorption** and impaired bone mineralization [1].
Question 1063: In which condition is paradoxical splitting of the second heart sound observed?
- A. Right Bundle Branch Block (RBBB)
- B. Left Bundle Branch Block (LBBB) (Correct Answer)
- C. Ventricular Septal Defect (VSD)
- D. Atrial Septal Defect (ASD)
Explanation: ***Left Bundle Branch Block (LBBB)*** - In LBBB, the **left ventricle** depolarizes and contracts *after* the right ventricle, causing the **aortic valve (A2)** to close *after* the **pulmonic valve (P2)** [1]. - During inspiration, right ventricular ejection time is prolonged, which further delays P2. However, in LBBB, A2 is already delayed, and the inspiratory delay of P2 can bring P2 closer to A2, or even cause them to merge, making the splitting *less wide* or *disappear* on inspiration, which is paradoxical. *Right Bundle Branch Block (RBBB)* - RBBB causes a **delay in right ventricular depolarization**, leading to a **delayed P2** (pulmonic valve closure). - This typically results in **wide and fixed splitting of S2**, where the splitting persists during expiration and widens further with inspiration, which is not paradoxical. *Ventricular Septal Defect (VSD)* - A VSD can cause a **loud holosystolic murmur** and may lead to increased pulmonary blood flow. - While it can affect the timing of heart sounds, it does not typically cause paradoxical splitting of S2. *Atrial Septal Defect (ASD)* - An ASD causes a **left-to-right shunt**, leading to chronic volume overload of the right ventricle and increased pulmonary blood flow. - This often results in a **widely fixed splitting of S2**, where the split between A2 and P2 is constant regardless of respiration, which is different from paradoxical splitting.
Ophthalmology
1 questionsCorneal tattooing is done by ?
NEET-PG 2012 - Ophthalmology NEET-PG Practice Questions and MCQs
Question 1061: Corneal tattooing is done by ?
- A. Titanium chloride
- B. Aluminium chloride
- C. India ink (Correct Answer)
- D. Gold chloride
Explanation: ***India ink*** - **India ink (carbon black)** is the traditional and most commonly used pigment for corneal tattooing due to its stable black color and inert properties. - It is applied to the **corneal stroma** to mask corneal opacities or for cosmetic purposes in cases of unsightly leucomatous corneal scars. - India ink has been the **gold standard** for corneal tattooing since the 19th century. *Gold chloride* - While **gold preparations** (including platinum-gold) have been used historically for corneal tattooing, they are much less common than India ink. - Gold chloride specifically is not the standard or preferred agent for this procedure. - India ink remains the pigment of choice due to better cosmetic results and established safety profile. *Titanium chloride* - **Titanium chloride** is a corrosive chemical and is not used in corneal tattooing; its application would cause severe damage to the delicate corneal tissue. - It is primarily used in industrial applications and chemical synthesis, not in ophthalmic procedures. *Aluminium chloride* - **Aluminium chloride** is an astringent and antiseptic, often used in dermatological products, but it is not a tattooing pigment for the cornea. - Its chemical properties would be highly irritating to the eye and potentially damaging to corneal cells.
Pediatrics
1 questionsRubella is known to cause all of the following conditions except:
NEET-PG 2012 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1061: Rubella is known to cause all of the following conditions except:
- A. Conduction defects
- B. VSD
- C. Microcephaly
- D. Glaucoma (Correct Answer)
Explanation: ***Glaucoma*** - While rubella can cause **ocular defects** such as **cataracts** and **pigmentary retinopathy**, glaucoma is not a typical congenital manifestation of rubella syndrome. - **Congenital glaucoma** is more commonly associated with other genetic syndromes or developmental anomalies. *Microcephaly* - **Microcephaly** is a recognized neurological complication of congenital rubella syndrome, resulting from impaired brain development due to viral infection. - The rubella virus can interfere with the **proliferation and migration** of neuronal cells during fetal development. *VSD* - **Ventricular septal defect (VSD)** is a common congenital heart defect associated with congenital rubella syndrome. - Other cardiac anomalies seen include **patent ductus arteriosus (PDA)** and **pulmonary artery stenosis**. *Conduction defects* - **Conduction defects** and other **cardiac arrhythmias** can occur in congenital rubella syndrome due to direct viral damage to the developing cardiac conduction system. - This can manifest as **bradyarrhythmias** or various degrees of **heart block**.
Psychiatry
1 questionsWhich of the following is NOT a characteristic of LEOPARD syndrome?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1061: Which of the following is NOT a characteristic of LEOPARD syndrome?
- A. Growth retardation
- B. ECG changes
- C. Hypertelorism
- D. Hypergonadism (Correct Answer)
- E. Lentigines
Explanation: ***Hypergonadism*** - **LEOPARD syndrome** is characterized by **hypogonadism** (underdevelopment or dysfunction of the gonads) and delayed puberty, not hypergonadism. - The acronym LEOPARD stands for multiple clinical features which include **L**entigines, **E**CG conduction abnormalities, **O**cular hypertelorism, **P**ulmonary stenosis, **A**bnormal genitalia, **R**etardation of growth, and **D**eafness. *Growth retardation* - **Retardation of growth** is a defining characteristic of LEOPARD syndrome, often manifesting as short stature. - This is part of the "R" in the LEOPARD acronym, indicating a failure to achieve normal growth milestones. *ECG changes* - **ECG conduction abnormalities** (such as prolonged PR interval, bundle branch block, or Wolff-Parkinson-White syndrome) are primary diagnostic features. - These cardiac issues can be significant and contribute to the morbidity associated with the syndrome. *Hypertelorism* - **Ocular hypertelorism**, meaning widely spaced eyes, is a common facial dysmorphism found in individuals with LEOPARD syndrome. - This feature is represented by the "O" in the LEOPARD acronym, along with other craniofacial anomalies. *Lentigines* - **Lentigines** are multiple pigmented macules (small, flat, darkened spots) that are the hallmark dermatologic feature of LEOPARD syndrome. - These represent the "L" in the LEOPARD acronym and are typically present from early childhood, increasing in number with age.
Radiology
1 questionsA polytrauma patient's CT brain shows a crescent-shaped extra-axial collection with a concave inner margin. What is the most likely diagnosis?
NEET-PG 2012 - Radiology NEET-PG Practice Questions and MCQs
Question 1061: A polytrauma patient's CT brain shows a crescent-shaped extra-axial collection with a concave inner margin. What is the most likely diagnosis?
- A. EDH
- B. SDH (Correct Answer)
- C. Contusion
- D. Diffuse axonal injury
Explanation: ***SDH*** - The image shows a **crescent-shaped collection** of hemorrhage with a concave inner margin, consistent with a **subdural hematoma** (SDH). - SDHs result from the tearing of **bridging veins** and typically conform to the brain's surface, crossing suture lines but not limited by bony sutures. *EDH* - An **epidural hematoma (EDH)** characteristically appears as a **lenticular** or **biconvex** shape on CT, not crescent-shaped. - EDHs are typically caused by arterial bleeding, often from the **middle meningeal artery**, and are limited by cranial sutures. *Contusion* - A **contusion** is brain tissue bruising that appears as **heterogeneous areas** of hemorrhage and edema within the brain parenchyma itself. - It would not manifest as a distinct extra-axial collection with a smooth, concave margin. *Diffuse axonal injury* - **Diffuse axonal injury (DAI)** involves widespread microscopic damage to axons, often at the gray-white matter junction. - It may appear as *punctate hemorrhages* or **small lesions** at these junctions on CT, but often the CT can be normal, and it would not present as a large extra-axial collection.
Surgery
2 questionsWhat is the standard intercostal space used for hepatic biopsy?
Which of the following is not considered a contraindication for pancreaticoduodenectomy?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 1061: What is the standard intercostal space used for hepatic biopsy?
- A. 5th
- B. 9th (Correct Answer)
- C. 7th
- D. 11th
Explanation: ***Correct Option: 9th*** - The **9th intercostal space** in the mid-axillary line is the standard and most commonly used entry point for percutaneous liver biopsy. - This location provides safe access to the **right lobe of the liver** while avoiding injury to the **pleura** and **lungs** superiorly and minimizing risk to the **kidney** and other abdominal organs inferiorly. - At this level, the liver is sufficiently large and the approach avoids the pleural reflection, which typically descends to the 8th-9th intercostal space. - Standard surgical textbooks (Sabiston, Schwartz) recommend the **8th-10th intercostal space**, with the 9th being most frequently used. *Incorrect Option: 5th* - The **5th intercostal space** is far too high for liver biopsy and would result in puncturing the **lung** or **pleura**, causing **pneumothorax** or hemothorax. - This space is well above the liver margin and is not suitable for hepatic access. *Incorrect Option: 7th* - While the **7th intercostal space** may occasionally be mentioned, it is generally considered **too high** for routine percutaneous liver biopsy. - This level carries increased risk of **pleural injury** as the pleural reflection may extend to this level, especially during deep inspiration. - It is not the standard or preferred approach in current surgical practice. *Incorrect Option: 11th* - The **11th intercostal space** is too low and significantly increases the risk of injuring the **right kidney** or entering the peritoneal cavity with potential injury to bowel or other abdominal structures. - This space is below the optimal liver access zone and is not recommended for routine liver biopsy.
Question 1062: Which of the following is not considered a contraindication for pancreaticoduodenectomy?
- A. Metastasis
- B. Portal vein involvement (Correct Answer)
- C. Extensive invasion of superior mesenteric vein
- D. Stage III CA head of pancreas
Explanation: ***Portal vein involvement*** - While extensive portal vein invasion can make the procedure challenging, **segmental portal vein involvement without complete occlusion or direct invasion of the superior mesenteric artery** is often considered resectable with venous reconstruction and is not an absolute contraindication. - Advancements in surgical techniques and patient selection criteria allow for **safe resection and reconstruction of the portal vein** in carefully chosen cases, improving outcomes for patients who would otherwise be deemed inoperable. *Metastasis* - The presence of **distant metastases** (e.g., to the liver, peritoneum, or lungs) unequivocally indicates **Stage IV disease** and is an absolute contraindication to pancreaticoduodenectomy, as the surgery would not offer a curative benefit. - In such cases, systemic chemotherapy or palliative care is the more appropriate treatment approach, as resection would not alter the overall prognosis. *Stage III CA head of pancreas* - **Stage III carcinoma of the head of the pancreas** often implies **locally advanced disease** that involves major peripancreatic vessels, such as the superior mesenteric artery or celiac axis. - This level of extensive vascular involvement typically renders the tumor **unresectable**, making pancreaticoduodenectomy surgically unfeasible and a contraindication. *Extensive invasion of superior mesenteric vein* - **Extensive involvement of the superior mesenteric vein (SMV)**, particularly if it completely occludes the lumen or involves a long segment making reconstruction impossible, is generally considered a contraindication to pancreaticoduodenectomy. - While limited SMV involvement with reconstructive options might be resectable, **extensive, unreconstructable invasion** signifies locally advanced disease beyond surgical cure.