NEET-PG 2012

1213 Questions — Page 89 of 122

Internal Medicine

2 questions

Q881

In axillary nerve paralysis, which of the following statements is false?

Q882

Tuberculosis of the spine; what is the most common site affected?

NEET-PG 2012 - Internal Medicine NEET-PG Practice Questions and MCQs

Question 881: In axillary nerve paralysis, which of the following statements is false?

A. Extension of shoulder with arm abducted to 90 degrees is impossible (Correct Answer)
B. Deltoid muscle is wasted
C. Small area of numbness is present over the shoulder region
D. Patient cannot initiate abduction

Explanation: Extension of shoulder with arm abducted to 90 degrees is impossible - The **axillary nerve** primarily innervates the **deltoid** and **teres minor muscles**. [2] - While axillary nerve paralysis would affect abduction and external rotation, the ability to *extend* the shoulder from an abducted position is mainly a function of muscles like the **posterior deltoid** (also innervated by axillary nerve to varying degrees) and latissimus dorsi, and its impossibility is not a definitive and exclusive sign of axillary nerve paralysis, as other muscles contribute to extension. *Deltoid muscle is wasted* - The **deltoid muscle** is the principal muscle supplied by the **axillary nerve**. [2] - Paralysis leads to **denervation atrophy**, causing visible wasting and weakness of the deltoid. [1] *Small area of numbness is present over the shoulder region* - The **axillary nerve** gives rise to the **upper lateral cutaneous nerve of the arm**. - Damage to the nerve results in sensory loss in a small, circumscribed area over the **deltoid insertion**. [2] *Patient cannot initiate abduction* - The **deltoid muscle**, innervated by the **axillary nerve**, is the primary abductor of the arm after the initial 0-15 degrees (supraspinatus). [2] - Paralysis of the deltoid significantly impairs or prevents the initiation and execution of **shoulder abduction**.

Question 882: Tuberculosis of the spine; what is the most common site affected?

A. Sacral
B. Dorsolumbar (Correct Answer)
C. Lumbosacral
D. Cervical

Explanation: ***94ed055d-c7da-4d18-a2fd-52720dfe8b6e*** - The **dorsolumbar (thoracolumbar)** region is the most common site of **spinal tuberculosis (Pott's disease)** [1] due to its high vascularity, facilitating hematogenous spread. - **Spinal tuberculosis** typically affects the vertebral bodies, leading to their destruction, kyphosis (angular deformity), and potentially neurological deficits [1]. *aebdfe6c-98dc-4073-892f-bb24d047bab4* - The **sacral** region can be affected by **tuberculosis**, but it is considerably less common than the thoracolumbar region. - Involvement of the sacrum is often associated with **direct extension** from adjacent structures, such as the sacroiliac joint, rather than primary vertebral involvement. *15c1feef-e3ca-496f-a180-127d52b77bfa* - **Cervical spine tuberculosis** is relatively rare, accounting for a small percentage of all spinal tuberculosis cases. - While possible, it presents with specific challenges due to the proximity of vital neurological and vascular structures. *d05d4d13-bb83-4f26-aa2d-c9c0203d299c* - The **lumbosacral region** (L5-S1) can be involved in **tuberculosis**, but it is less frequently affected than the thoracolumbar region. - While the lumbar spine is a common site, the entire lumbosacral region as a single entity is not the most common spot for spinal TB.

Obstetrics and Gynecology

3 questions

Q881

Caput succedaneum indicates that the fetus was alive until which point?

Q882

What is the treatment of choice for Bartholin's cyst?

Q883

Gold standard technique for diagnosis of endometriosis?

NEET-PG 2012 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs

Question 881: Caput succedaneum indicates that the fetus was alive until which point?

A. Immediately after birth (Correct Answer)
B. Till 2-3 days after birth
C. 2-3 weeks after birth
D. 2-3 months after birth

Explanation: ***Immediately after birth*** - **Caput succedaneum** is a benign condition characterized by a **diffuse, edematous swelling** of the fetal scalp, crossing suture lines. - It results from pressure on the fetal head during vertex delivery, causing **extravasation of fluid** into the subcutaneous tissue, indicating the fetus was alive and circulating blood until birth. *Till 2-3 days after birth* - This option is incorrect because **caput succedaneum** is a direct consequence of the **birthing process** itself, forming during labor and delivery. - The presence of this scalp swelling signifies that the baby was alive and experienced the forces of birth, not that it survived for several days afterward. *2-3 weeks after birth* - This option is incorrect as **caput succedaneum** typically resolves within a few days of birth. - Its presence is a temporary finding related to the immediate perinatal period and does not indicate survival for several weeks. *2-3 months after birth* - This option is incorrect because **caput succedaneum** is a transient condition appearing at birth and usually disappearing within a few days. - It has no implication for the baby's survival beyond the immediate postnatal period, let alone for several months.

Question 882: What is the treatment of choice for Bartholin's cyst?

A. Excision
B. Antibiotic therapy
C. Marsupialization (Correct Answer)
D. Cyst drainage

Explanation: ***Marsupialization*** - This procedure involves incising the cyst, draining its contents, and then everting and suturing the edges of the cyst wall to the surrounding skin, creating a permanent-draining pouch. - **Marsupialization** is the treatment of choice because it prevents recurrence by allowing continuous drainage of mucus, unlike simple incision and drainage. *Excision* - Complete surgical excision of the Bartholin's gland or cyst is a more invasive procedure and is typically reserved for cases of **recurrent cysts** after marsupialization or suspected malignancy. - It carries a higher risk of bleeding and infection compared to marsupialization, and can lead to **vaginal dryness** due to loss of glandular secretions. *Antibiotic therapy* - Antibiotics are primarily used if the Bartholin's gland becomes **infected**, leading to an **abscess**, or if there is surrounding cellulitis. - They do not address the underlying blockage of the duct and will not resolve a Bartholin's cyst, which is a collection of mucus due to duct obstruction. *Cyst drainage* - Simple incision and drainage (I&D) provides temporary relief by emptying the cyst contents but has a **high recurrence rate** because the duct often re-occludes. - While it may be used as an initial temporizing measure, it is not the definitive treatment for preventing future episodes of Bartholin's cysts.

Question 883: Gold standard technique for diagnosis of endometriosis?

A. Ca 125 level
B. Ultrasound
C. MRI
D. Laparoscopy (Correct Answer)

Explanation: ***Laparoscopy*** - **Laparoscopy** allows for direct visualization of endometrial implants and enables **biopsy confirmation**, making it the gold standard. - This minimally invasive surgical procedure is crucial for diagnosing, staging, and often treating endometriosis simultaneously. *Ca 125 level* - **CA-125** is a serum marker that can be elevated in endometriosis, but it is **not specific** and can be raised in other conditions like ovarian cancer or physiologic states. - It is primarily used for monitoring treatment response or recurrence, rather than as a primary diagnostic tool. *Ultrasound* - **Transvaginal ultrasound (TVS)** can identify endometriomas (chocolate cysts) and deep infiltrating endometriosis, but it cannot reliably visualize small peritoneal implants. - While it's a good initial imaging modality, its sensitivity for diagnosing all forms of endometriosis is **limited**. *MRI* - **MRI** offers better soft tissue contrast than ultrasound and can identify deep infiltrating endometriosis and some peritoneal implants, especially those involving the bowel or bladder. - However, MRI is **more expensive** and less accessible, and it still cannot definitively rule out all small, superficial endometrial lesions without direct visualization.

Orthopaedics

3 questions

Q881

What is the primary pathology associated with Congenital Dislocation of the Hip (CDH)?

Q882

In neglected cases of CTEV, which joints are fused?

Q883

What is the primary reason for early stabilization of a femur shaft fracture?

NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs

Question 881: What is the primary pathology associated with Congenital Dislocation of the Hip (CDH)?

A. Large head of femur
B. Shallow acetabulum (Correct Answer)
C. Excessive retroversion
D. Coxa vara deformity

Explanation: ***Shallow acetabulum*** - A **shallow or dysplastic acetabulum** is the primary pathological feature in CDH, leading to an unstable or dislocated femoral head. - This anatomical abnormality prevents the femoral head from seating properly, causing **instability** and potential **dislocation**. *Large head of femur* - While femoral head abnormalities can occur, a **disproportionately large femoral head** is not the primary or most common pathological feature causing CDH. - The issue primarily lies with the **acetabular socket** rather than the size of the femoral head itself. *Excessive retroversion* - **Femoral retroversion** (backward twisting of the femoral neck relative to the femoral condyles) can be a contributing factor or an associated finding, but it is not the primary anatomical defect. - The principal pathology is the **inadequate containment** of the femoral head by a poorly formed acetabulum. *Coxa vara deformity* - **Coxa vara** is a deformity where the angle between the head and shaft of the femur is decreased. - While it can be associated with or contribute to hip instability in some conditions, it is not the primary or defining pathological feature of CDH.

Question 882: In neglected cases of CTEV, which joints are fused?

A. Calcaneocuboid, talonavicular, and talocalcaneal joints (Correct Answer)
B. Tibiotalar, calcaneocuboid, and talonavicular joints
C. None of the above joints
D. Ankle joint, calcaneocuboid, and talonavicular joints

Explanation: ***Calcaneocuboid, talonavicular, and talocalcaneal joints*** - In neglected cases of **clubfoot (CTEV)**, a **triple arthrodesis** is performed to correct the deformity. - This procedure involves the fusion of the **subtalar (talocalcaneal)**, **talonavicular**, and **calcaneocuboid joints** to provide a stable, plantigrade foot. *Tibiotalar, calcaneocuboid, and talonavicular joints* - The **tibiotalar joint (ankle joint)** is generally preserved in triple arthrodesis for CTEV to maintain ankle motion. - Fusing the tibiotalar joint would significantly **reduce ankle dorsiflexion and plantarflexion**, leading to a stiff ankle. *None of the above joints* - This option is incorrect because the fusion of specific joints is a recognized surgical treatment for severe, neglected CTEV. - **Triple arthrodesis** is a well-established procedure for correcting rigid foot deformities. *Ankle joint, calcaneocuboid, and talonavicular joints* - As mentioned, fusion of the **ankle joint (tibiotalar joint)** is generally avoided in triple arthrodesis for CTEV to preserve functional ankle motion. - The goal is to stabilize the foot while retaining as much articulation as possible in the ankle itself.

Question 883: What is the primary reason for early stabilization of a femur shaft fracture?

A. To prevent significant blood loss.
B. To reduce pain and discomfort.
C. To facilitate quicker healing.
D. To prevent fat embolism syndrome and systemic complications (Correct Answer)

Explanation: ***To prevent fat embolism syndrome and systemic complications*** - Early stabilization of femur shaft fractures significantly **reduces the incidence of fat embolism syndrome (FES)**. Fat emboli released from the bone marrow can travel to the lungs and brain, causing severe respiratory distress and neurological deficits. - By stabilizing the fracture, the **release of fat globules is minimized**, thereby preventing FES and associated systemic complications such as acute respiratory distress syndrome (ARDS) and adult respiratory distress syndrome (ADRS). *To prevent significant blood loss.* - While femur fractures can cause significant blood loss, the primary reason for early stabilization is not solely to prevent it but to reduce complications. **Blood loss is a direct consequence**, but FES poses a greater immediate threat to life. - Furthermore, **blood loss can often be managed initially by other means**, such as fluid resuscitation and direct pressure, while FES requires prompt reduction of fracture movement. *To reduce pain and discomfort.* - Reducing pain and discomfort is an important benefit of stabilization, but it is **not the primary life-saving reason** for early intervention. Analgesics and proper splinting can also address pain. - The focus on early stabilization goes beyond symptomatic relief to actively prevent **potentially fatal systemic complications**. *To facilitate quicker healing.* - While stability is crucial for proper healing, **early stabilization primarily addresses acute, life-threatening complications** rather than long-term healing rates. Optimal healing depends on many factors, including blood supply and infection control, not solely on initial stabilization. - **Quicker healing is a secondary benefit**; the immediate priority is to prevent acute morbidity and mortality associated with the fracture.

Pathology

1 questions

Q881

In which condition is pannus formation typically observed?

Surgery

1 questions

Q881

Volkmann's contracture: which artery is involved in this condition?