Internal Medicine
1 questionsIn an EMG/NCV study, which radiculopathy is most closely associated with the H. reflex?
NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1111: In an EMG/NCV study, which radiculopathy is most closely associated with the H. reflex?
- A. S1 radiculopathy (Correct Answer)
- B. L3 radiculopathy
- C. L4 radiculopathy
- D. L5 radiculopathy
Explanation: ***S1 radiculopathy*** - The **H-reflex (Hoffmann reflex)** primarily assesses the integrity of the **S1 nerve root** and the **tibial nerve** pathway. - A diminished or absent H-reflex is a sensitive indicator of **S1 radiculopathy**, often correlating with **Achilles reflex loss** [1]. *L3 radiculopathy* - **L3 radiculopathy** typically affects the **quadriceps muscle** and the **patellar reflex** [1]. - The H-reflex is not a primary diagnostic tool for isolated L3 nerve root involvement. *L4 radiculopathy* - **L4 radiculopathy** usually presents with weakness in **tibialis anterior** and altered sensation over the medial leg/foot [1]. - While it can sometimes impact the patellar reflex, the H-reflex is not the most direct or specific measure for L4 involvement. *L5 radiculopathy* - **L5 radiculopathy** often leads to weakness in **foot dorsiflexion** and **toe extension**, with sensory loss over the dorsum of the foot [1]. - It does not directly involve the reflex arc assessed by the H-reflex.
Orthopaedics
5 questionsWhich of the following statements is true regarding supracondylar fractures of the humerus?
Which of the following describes grade 2 fracture neck femur?
Anterolateral decompression is primarily indicated for
Which of the following bone tumors characteristically presents with nocturnal pain relieved by NSAIDs and shows a radiolucent nidus surrounded by sclerotic bone?
What type of cast is primarily associated with the development of Cast syndrome?
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1111: Which of the following statements is true regarding supracondylar fractures of the humerus?
- A. Extension type most common (Correct Answer)
- B. Flexion type is less common than extension type
- C. Both types are equally common
- D. More common in adults
Explanation: **Extension type most common** - **Extension-type supracondylar fractures** account for the vast majority (about 95%) of all supracondylar humerus fractures. - This type typically results from a fall on an **outstretched hand** with the elbow in extension, forcing the distal fragment posteriorly. *More common in adults* - **Supracondylar fractures of the humerus** are predominantly observed in children, especially between 5 and 10 years of age. - They are the **most common elbow fracture in children**, making this statement incorrect. *Flexion type is less common than extension type* - While flexion-type fractures do occur, they are significantly less common, representing only about 5% of all supracondylar fractures. - This type typically results from a direct blow to the posterior aspect of the elbow, with the distal fragment displaced anteriorly. *Both types are equally common* - As established, extension-type fractures are far more prevalent than flexion-type fractures, making them not equally common. - The significant disparity in incidence confirms that this statement is incorrect.
Question 1112: Which of the following describes grade 2 fracture neck femur?
- A. Incomplete fracture, medial trabeculae intact
- B. Complete fracture with undisplaced neck (Correct Answer)
- C. Complete fracture with ischemic head
- D. Moderate displacement of neck, vascularity damaged
Explanation: ***Complete fracture with undisplaced neck*** - A **Garden Type II fracture** of the femoral neck is characterized by a **complete fracture line** through the femoral neck. - Despite the complete fracture, the **femoral head remains undisplaced** and in its anatomical position, indicating an intact or minimally disrupted posteromedial soft-tissue hinge. *Incomplete fracture, medial trabeculae intact* - This description corresponds to a **Garden Type I fracture**, which is an **incomplete fracture** of the femoral neck, usually impacted in valgus. - In such cases, the medial trabeculae are often intact, or show buckling on the lateral side, indicating a stable fracture. *Complete fracture with ischemic head* - The presence of an **ischemic head** is a complication that can occur with any displaced femoral neck fracture (Garden Type III or IV), but it's not a primary defining characteristic of a specific Garden grade. - **Avascular necrosis (AVN)** of the femoral head is a risk, especially with displacement, due to disruption of the blood supply. *Moderate displacement of neck, vascularity damaged* - This description is more consistent with a **Garden Type III fracture**, where there is a **complete fracture with moderate displacement** of the femoral head, usually with some varus angulation. - Such displacement significantly increases the risk of **vascular injury** to the femoral head, predisposing to avascular necrosis.
Question 1113: Anterolateral decompression is primarily indicated for
- A. Spinal tuberculosis (Pott's disease) (Correct Answer)
- B. Lumbar disc herniation
- C. Ankylosing spondylitis
- D. Spinal metastasis
Explanation: ***Spinal tuberculosis (Pott's disease)*** - **Anterolateral decompression** is crucial for **Pott's disease** to remove infected bone and pus, relieve pressure on the spinal cord, and facilitate fusion. - This approach allows direct access to the anterior spinal column, which is commonly affected by the destructive process of **tuberculosis**. *Spinal metastasis* - While spinal metastasis can cause compression, **anterolateral decompression** is less common as a primary approach; often, surgical treatment involves posterior decompression, stabilization, and adjuvant therapies like radiation. - The goal is often **pain management** and neurological preservation in the context of advanced disease. *Lumbar disc herniation* - **Lumbar disc herniation** is typically addressed by posterior approaches like **microdiscectomy** or laminectomy, which directly access the posterior aspect of the disc. - **Anterolateral decompression** is generally not indicated as the primary treatment for standard disc herniations. *Ankylosing spondylitis* - Surgical intervention in **ankylosing spondylitis** is usually reserved for severe kyphosis or spinal fractures, employing osteotomies and stabilization techniques, often through posterior approaches. - **Anterolateral decompression** is not a standard procedure for the typical manifestations or complications of **ankylosing spondylitis**.
Question 1114: Which of the following bone tumors characteristically presents with nocturnal pain relieved by NSAIDs and shows a radiolucent nidus surrounded by sclerotic bone?
- A. Osteoid osteoma (Correct Answer)
- B. Chondrosarcoma
- C. Enchondroma
- D. None of the options
Explanation: ***Osteoid osteoma*** - This benign bone tumor is characterized by **nocturnal pain** that is typically **relieved by NSAIDs**, a highly distinctive clinical feature due to prostaglandin production within the nidus. - Radiographically, it presents as a small **radiolucent nidus** (less than 1.5 cm) surrounded by a significant margin of **sclerotic bone**. *Chondrosarcoma* - This is a **malignant cartilage-forming tumor** that usually presents with a dull, aching pain that is often **not relieved by NSAIDs** and may worsen over time. - Radiographically, it appears as a **large, destructive lesion with calcifications**, not a small nidus with surrounding sclerosis. *Enchondroma* - An enchondroma is a **benign cartilaginous tumor** that is typically found in the medullary cavity of long bones, often in the small bones of the hands and feet. - It is usually **asymptomatic** and discovered incidentally, and on imaging, it appears as a **well-circumscribed lytic lesion** without the prominent sclerotic rim or specific nocturnal pain pattern seen in osteoid osteoma. *None of the options* - This option is incorrect because **osteoid osteoma** perfectly matches the clinical and radiographic description provided in the question.
Question 1115: What type of cast is primarily associated with the development of Cast syndrome?
- A. Full arm cast
- B. Short arm cast
- C. Hip spica cast (Correct Answer)
- D. Above knee cast
Explanation: ***Hip spica cast*** - A **hip spica cast** encases the trunk and one or both legs, increasing intra-abdominal pressure due to its extensive coverage. - This pressure can compress the **superior mesenteric artery** against the **duodenum**, leading to Cast syndrome (also known as superior mesenteric artery syndrome). *Full arm cast* - A full arm cast does not cover the abdomen and therefore does not exert pressure on the **superior mesenteric artery** or duodenum. - It is associated with complications like compartment syndrome or nerve impingement in the upper extremity, but not Cast syndrome. *Short arm cast* - Similar to a full arm cast, a short arm cast is limited to the forearm and hand and poses no risk for **abdominal compression**. - Complications are localized to the distal upper limb, such as carpal tunnel syndrome or skin breakdown. *Above knee cast* - An above knee cast covers the lower leg and thigh but does not extend to the abdomen. - It does not contribute to the increased intra-abdominal pressure necessary for the development of **superior mesenteric artery syndrome**.
Physiology
1 questionsNarcolepsy is due to abnormality in ?
NEET-PG 2012 - Physiology NEET-PG Practice Questions and MCQs
Question 1111: Narcolepsy is due to abnormality in ?
- A. Hypothalamus (Correct Answer)
- B. Neocortex
- C. Cerebellum
- D. Medulla oblongata
Explanation: **Hypothalamus** - Narcolepsy is primarily caused by the loss of **orexin (hypocretin)** producing neurons in the **hypothalamus**, which are crucial for maintaining wakefulness. - This deficiency leads to dysregulation of **sleep-wake cycles**, causing excessive daytime sleepiness and other narcolepsy symptoms. *Neocortex* - The neocortex is involved in higher-level cognitive functions, sensory perception, and voluntary movement, but it is not the primary site of pathology in narcolepsy. - While sleep stages involve cortical activity, the core deficit in narcolepsy does not originate here. *Cerebellum* - The cerebellum is mainly responsible for motor control, coordination, and balance. - Its dysfunction is associated with ataxic gait and coordination problems, not the sleep disturbances characteristic of narcolepsy. *Medulla oblongata* - The medulla oblongata controls vital autonomic functions like breathing, heart rate, and blood pressure. - While involved in sleep regulation pathways, it is not the primary anatomical location affected in narcolepsy.
Psychiatry
2 questionsWhich of the following factors is most commonly associated with suicidal tendencies?
Which of the following is not a characteristic of schizoid personality disorder?
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1111: Which of the following factors is most commonly associated with suicidal tendencies?
- A. Female gender
- B. Severe depression (Correct Answer)
- C. Chronic illness
- D. Younger age group
Explanation: ***Severe depression*** - **Major depressive disorder** is the strongest and most common risk factor for suicidal ideation and attempts, significantly increasing suicidal tendencies [1]. - The profound **hopelessness**, **worthlessness**, and altered cognitive processing associated with severe depression contribute largely to suicidal thoughts [2]. - Depression is present in approximately **90%** of individuals who die by suicide. *Female gender* - While **females** have higher rates of **suicide attempts** and self-harm, **males** have a higher rate of completed suicides using more lethal methods. - Female gender alone is not the most common risk factor for suicidal tendencies compared to the profound impact of severe mental illness like depression [1]. *Chronic illness* - **Chronic medical conditions** can increase the risk of depression and subsequent suicidal ideation due to pain, functional limitations, and loss of independence [3]. - However, chronic illness is generally considered an **indirect risk factor**, often mediating its effect through the development of mental health disorders like depression [3]. *Younger age group* - Suicide is a leading cause of death in **adolescents and young adults**, highlighting significant concern in this demographic [1]. - While younger age is a risk factor, especially with concurrent mental health issues or stressors, it is not as universally predictive of suicidal tendencies as severe depression across all age groups [1].
Question 1112: Which of the following is not a characteristic of schizoid personality disorder?
- A. Prone to fantasy
- B. Introspective
- C. Aloof & detached
- D. Suspicious (Correct Answer)
Explanation: ***Suspicious*** - **Suspiciousness** and mistrust of others are core features of **paranoid personality disorder**, not schizoid personality disorder. - Individuals with schizoid personality disorder are typically apathetic towards others rather than actively distrustful. *Aloof & detached* - Individuals with schizoid personality disorder are characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression. - They often appear emotionally cold and indifferent to praise or criticism, indicating their aloof nature. *Prone to fantasy* - People with schizoid personality disorder frequently engage in **excessive daydreaming** and imaginative fantasy as an escape from reality. - This tendency is a coping mechanism for their limited social interaction and emotional expression. *Introspective* - Schizoid individuals tend to be **preoccupied with their inner world** and thoughts, often to the exclusion of external social interactions. - Their introspective nature contributes to their social withdrawal and isolation.
Surgery
1 questionsHirschsprung disease is confirmed by ?
NEET-PG 2012 - Surgery NEET-PG Practice Questions and MCQs
Question 1111: Hirschsprung disease is confirmed by ?
- A. Rectal biopsy (Correct Answer)
- B. Per/Rectal examination
- C. Rectal manometry
- D. X-ray abdomen
Explanation: ***Rectal biopsy*** - A **rectal biopsy** is the most definitive diagnostic test for Hirschsprung disease, revealing the absence of **ganglion cells** in the submucosal and myenteric plexuses. - This procedure involves taking a small tissue sample from the rectum, which is then examined under a microscope for characteristic histological changes. *Per/Rectal examination* - A **per/rectal examination** may reveal an empty rectum followed by a gush of stool and gas upon withdrawal of the finger, which is suggestive but not diagnostic. - It is a **clinical finding** that prompts further investigation but does not provide histological confirmation of aganglionosis. *Rectal manometry* - **Rectal manometry** measures pressures within the rectum and can detect the absence of the **rectoanal inhibitory reflex** (RAIR), a hallmark of Hirschsprung disease. - While highly sensitive, it is a **physiological test** indicating functional abnormalities, but it does not provide the definitive histological diagnosis of aganglionosis. *X-ray abdomen* - An **X-ray of the abdomen** may show dilated loops of bowel proximal to a narrowed, aganglionic segment, indicating intestinal obstruction. - This imaging study is useful for **initial assessment** and identifying signs of obstruction, but it is not specific for Hirschsprung disease and cannot confirm the absence of ganglion cells.