NEET-PG 2012 Practice Questions

Q: Which amino acid-derived neurotransmitter is primarily targeted in the pharmacological treatment of depression?

Serotonin. ***Serotonin*** - **Serotonin** is an amino acid-derived neurotransmitter (from **tryptophan**) known to play a crucial role in mood regulation, sleep, appetite, and other functions, making it a primary target for **antidepressant medications**. - Medications like **Selective Serotonin Reuptake Inhibitors (SSRIs)** increase serotonin levels in the brain to alleviate symptoms of depression. *Histamine* - **Histamine** is an amino acid-derived neurotransmitter (from **histidine**) primarily involved in allergic reactions, inflammation, and regulating wakefulness. - While it has some central nervous system effects, its primary role is not directly in the treatment of **depression**. *Acetylcholine* - **Acetylcholine** is a neurotransmitter involved in muscle contraction, learning, memory, and attention, and is not derived from amino acids; it is synthesized from **choline** and acetyl-CoA. - It is not directly used for treating **depression**, although imbalances can play a role in cognitive aspects of some psychiatric disorders. *None of the options* - This option is incorrect because **Serotonin** is indeed an amino acid-derived neurotransmitter (from tryptophan) targeted for treating **depression**. - Many antidepressant drugs work by modulating **serotonergic pathways**.

Q: Narcolepsy is due to abnormality in ?

Hypothalamus. **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.

Q: Which of the following is not a characteristic of schizoid personality disorder?

Suspicious. ***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.

Q: Which of the following factors is most commonly associated with suicidal tendencies?

Severe depression. ***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].

Q: Popcorn calcification is seen in:

Pulmonary hamartoma. ***Pulmonary hamartoma*** - **Popcorn calcification** is a pathognomonic radiographic finding highly suggestive of **pulmonary hamartoma**, a **benign tumor** composed of cartilage, fat, and connective tissue - This characteristic calcification pattern is due to the presence of **chondroid (cartilaginous) tissue** within the lesion - Appears as coarse, irregular calcifications resembling popcorn on chest X-ray or CT scan *Bronchogenic carcinoma* - Malignant lung lesions typically show **irregular, spiculated, or ill-defined margins** and tend to grow rapidly - While calcification can occur in some lung malignancies, it usually appears as **eccentric, stippled, or amorphous** rather than the distinctive popcorn pattern - Popcorn calcification is not a feature of primary lung cancers *Tuberculosis* - **Granulomatous infections** such as tuberculosis often lead to calcification, but it usually presents as **laminated, clustered, or target-like patterns** in lymph nodes or within granulomas (Ghon lesion, Ranke complex) - **Popcorn calcification** is not a typical feature of active or healed tuberculous lesions *Pulmonary metastases* - **Metastatic lesions** are generally not calcified, although a few primary tumors (e.g., mucinous adenocarcinoma, osteosarcoma, chondrosarcoma) can metastasize as calcified nodules - When calcification is present in metastases, it is rarely in the specific **popcorn pattern** and is usually diffuse, punctate, or amorphous

Q: Investigation of choice for intramedullary SOL is -

MRI. ***MRI*** - **Magnetic Resonance Imaging (MRI)** is the investigation of choice for intramedullary lesions due to its superior **soft tissue contrast** and ability to visualize the **spinal cord** parenchyma. - It provides detailed information on lesion size, location, and internal characteristics, which is crucial for diagnosis and surgical planning. *USG* - **Ultrasound (USG)** has limited utility for intramedullary lesions as a primary diagnostic tool because **bone impedes sound waves**, making it difficult to visualize structures within the spinal canal. - It might be used for neonatal spinal screening or intraoperative guidance, but not for definitive diagnosis of intramedullary lesions in adults. *CT* - **Computed Tomography (CT)** excels at visualizing **bone structures** and calcifications, but it provides less detailed information about soft tissue elements like the spinal cord compared to MRI. - While it can identify bony changes associated with intramedullary lesions, it is not the preferred initial imaging modality for characterizing the lesion itself. *X-ray* - **X-rays** provide basic imaging of bone but offer essentially **no visualization of soft tissues** such as the spinal cord or intramedullary lesions. - They are primarily used to identify gross bony abnormalities like fractures or severe degenerative changes, not for subtle intraspinal pathologies.

Q: Which of the following is not typically seen on a chest X-ray in pulmonary artery hypertension?

Narrowing of central arteries. ***Narrowing of central arteries*** - **Pulmonary artery hypertension** is characterized by the **enlargement of the central pulmonary arteries** due to increased pressure. - **Narrowing of central arteries** would contradict the hemodynamic changes seen in pulmonary hypertension. - This is the finding that is **NOT typically seen**, making this the correct answer. *Enlargement of central arteries* - This is a **hallmark radiographic finding** in pulmonary hypertension, reflecting the **dilatation of the main and proximal pulmonary arteries** due to increased pressure. - The **pulmonary artery segment becomes prominent**, often appearing convex on the left heart border. *Peripheral pruning* - This refers to the **abrupt tapering and loss of peripheral pulmonary vascular markings**, indicating reduced blood flow to the distal lung parenchyma. - It is a **common finding in advanced pulmonary hypertension**, as the distal vessels constrict and become obliterated. *None of the options* - This is incorrect since **narrowing of central arteries** is clearly not a typical finding in pulmonary hypertension.

Q: Which of the following conditions characteristically causes bilateral hypertranslucency of lung fields on chest X-ray?

Emphysema. ***Correct: Emphysema*** - **Emphysema** causes destruction of alveolar walls, leading to enlarged air spaces and **air trapping**, making both lungs appear hypertranslucent on X-ray - This **bilateral hypertranslucency** is due to reduced lung tissue density, decreased vascular markings, and increased air volume - Classic radiographic features include flattened diaphragms, increased retrosternal space, and hyperlucent lung fields *Incorrect: Mcleod syndrome* - Also known as **Swyer–James–MacLeod syndrome**, this condition causes **unilateral** lung or lobe hyperlucency due to post-infectious obliterative bronchiolitis - The key differentiating feature is that it's **unilateral**, whereas the question asks for bilateral hypertranslucency - Affected lung shows air trapping on expiratory films *Incorrect: Pneumothorax* - A **pneumothorax** presents as a **unilateral** or focal hypertranslucent area due to air in the pleural space - Characterized by **absence of lung markings** beyond the visceral pleural line and associated lung collapse - This is a pleural space abnormality, not a bilateral parenchymal lung disease *Incorrect: Poland syndrome* - **Poland syndrome** is a congenital condition with absence or underdevelopment of the pectoralis major muscle - Can lead to **unilateral** apparent hyperlucency on the affected side due to missing chest wall muscle - This is a **chest wall anomaly**, not a parenchymal lung disease causing bilateral hypertranslucency

Q: The most appropriate first-line imaging modality to detect adrenal metastasis due to bronchogenic carcinoma is:

Contrast Enhanced CT abdomen. **Contrast Enhanced CT abdomen** - **Contrast-enhanced CT abdomen** is generally considered the most sensitive and cost-effective imaging modality for detecting **adrenal metastases**. - It allows for detailed visualization of adrenal gland morphology, including size, shape, and enhancement patterns, which can help differentiate benign from malignant lesions. *PET scan* - While **PET (Positron Emission Tomography) scans** are highly sensitive for detecting metabolically active metastatic disease, they are often used as a secondary imaging modality to characterize indeterminate lesions found on CT or MRI. - **PET scans** can have false positives in benign adrenal tumors (e.g., adenomas rich in fat) and are less readily available or higher in cost for initial screening compared to CT. *MRI of the abdomen* - **MRI of the abdomen** can be very useful for further characterization of adrenal masses, especially for distinguishing between lipid-rich adenomas and metastases. - However, for initial detection, especially in the context of screening for distant metastases from bronchogenic carcinoma, **CT is generally preferred due to its wider availability, speed, and lower cost**. *Adrenal radionuclide scan* - **Adrenal radionuclide scans** (e.g., using MIBG or iodocholesterol) are primarily used for functional imaging of adrenal glands, typically to detect specific types of tumors like pheochromocytomas or aldosteronomas. - These scans are **not sensitive for detecting adrenal metastases** from bronchogenic carcinoma, as the metastatic lesions do not typically exhibit the specific uptake patterns targeted by these radiotracers.

Q: Hirschsprung disease is confirmed by ?

Rectal biopsy. ***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.

Question 1

Which amino acid-derived neurotransmitter is primarily targeted in the pharmacological treatment of depression?

Accepted Answer

Serotonin

Answer

Histamine

Answer

None of the options

Answer

Acetylcholine

Question 2

Narcolepsy is due to abnormality in ?

Accepted Answer

Hypothalamus

Answer

Neocortex

Answer

Cerebellum

Answer

Medulla oblongata

Question 3

Which of the following is not a characteristic of schizoid personality disorder?

Accepted Answer

Suspicious

Answer

Prone to fantasy

Answer

Introspective

Answer

Aloof & detached

Question 4

Which of the following factors is most commonly associated with suicidal tendencies?

Accepted Answer

Severe depression

Answer

Female gender

Answer

Chronic illness

Answer

Younger age group

Question 5

Popcorn calcification is seen in:

Accepted Answer

Pulmonary hamartoma

Answer

Bronchogenic carcinoma

Answer

Tuberculosis

Answer

Pulmonary metastases

Question 6

Investigation of choice for intramedullary SOL is -

Accepted Answer

MRI

Answer

USG

Answer

CT

Answer

X-ray

Question 7

Which of the following is not typically seen on a chest X-ray in pulmonary artery hypertension?

Accepted Answer

Narrowing of central arteries

Answer

Enlargement of central arteries

Answer

Peripheral pruning

Answer

None of the options

Question 8

Which of the following conditions characteristically causes bilateral hypertranslucency of lung fields on chest X-ray?

Accepted Answer

Emphysema

Answer

Mcleod syndrome

Answer

Poland syndrome

Answer

Pneumothorax

Question 9

The most appropriate first-line imaging modality to detect adrenal metastasis due to bronchogenic carcinoma is:

Accepted Answer

Contrast Enhanced CT abdomen

Answer

PET scan

Answer

MRI of the abdomen

Answer

Adrenal radionuclide scan

Question 10

Hirschsprung disease is confirmed by ?

Accepted Answer

Rectal biopsy

Answer

Per/Rectal examination

Answer

Rectal manometry

Answer

X-ray abdomen

NEET-PG 2012

Pharmacology

Physiology

Psychiatry

Radiology

Surgery