NEET-PG 2012 Practice Questions

Q: What is the definitive treatment for preeclampsia?

Delivery of the baby. ***Delivery of the baby*** - **Preeclampsia** is a multisystem disorder of pregnancy; its pathogenesis is directly linked to the **placenta**. - **Removal of the placenta** through delivery is the only definitive cure for preeclampsia, leading to the resolution of symptoms. *Use of antihypertensive medications* - Antihypertensive medications are used to **manage blood pressure** in preeclampsia, preventing complications like stroke. - They **do not address the underlying cause** of the disease and are not a curative treatment. *Dietary modifications* - While a healthy diet is important during pregnancy, **dietary modifications** alone cannot resolve the pathological processes of preeclampsia. - There is **no specific diet** proven to cure or prevent preeclampsia. *Increased rest and monitoring* - **Increased rest and close monitoring** are supportive measures that can help manage symptoms and detect complications. - These interventions **do not reverse the disease process** and are not a definitive treatment.

Q: Which structure is least likely to be injured during common gynecological procedures?

Renal pelvis. ***Renal pelvis*** - The **renal pelvis** is anatomically distant from the surgical fields of most common gynecological procedures, making injury unlikely. - Its protected position deep within the abdominal cavity, surrounded by fat and muscle, generally shields it from inadvertent trauma during pelvic surgery. *Ureter at pelvic brim* - The **ureter** crosses the **pelvic brim**, an area often involved in gynecological dissections, especially during procedures like **pelvic lymphadenectomy** or management of large masses. - It is susceptible to injury during instrumentation or clamping in this region due to its close proximity to pelvic vessels. *Urinary bladder* - The **urinary bladder** is frequently in the surgical field during gynecological procedures, particularly those involving the anterior vaginal wall, cervix, or uterus (e.g., **hysterectomy**, **cystocele repair**). - Its thin wall and close proximity make it vulnerable to perforation, laceration, or thermal injury. *Ureter at infundibulopelvic ligament* - The **ureter** passes perilously close to the **infundibulopelvic ligament** (suspensory ligament of the ovary) as it enters the pelvis. - This area is frequently ligated or clamped during **oophorectomy** or adnexal mass removal, placing the ureter at high risk of kinking, ligation, or transection.

Q: In which scenario is the I-pill (emergency contraceptive) most appropriately used?

In case of contraceptive failure or unprotected sex. ***In case of contraceptive failure or unprotected sex*** - This is the **most comprehensive and appropriate answer** as it covers **both major indications** for emergency contraception. - The **I-pill (levonorgestrel)** is indicated when there has been unprotected intercourse OR when a contraceptive method has failed (e.g., condom breakage, missed pills, dislodged IUD). - It should be taken as soon as possible, ideally within **72 hours** of the event, though it can be used up to 120 hours with reduced efficacy. - This option correctly encompasses the full scope of emergency contraception use. *After unprotected sexual intercourse* - While this is a **valid indication**, it only covers one scenario and is not as comprehensive as the correct answer. - This option misses situations of contraceptive failure where intercourse was technically "protected" but the method failed. *When a contraceptive method fails* - This is also a **valid indication** but only covers contraceptive accidents (condom breakage, missed pills). - It excludes situations where no contraceptive was used at all. - Like the previous option, it is incomplete compared to the correct answer. *As a regular contraceptive method* - The I-pill is **not intended for routine contraception** due to higher hormone doses and lower efficacy compared to regular methods. - It has a higher side effect profile with frequent use and does not protect against sexually transmitted infections. - Emergency contraception should only be used occasionally in emergency situations.

Q: Which of the following statements about cholestasis of pregnancy is false?

Most common cause of jaundice in pregnancy. ***Most common cause of jaundice in pregnancy*** - This statement is **FALSE** - while **intrahepatic cholestasis of pregnancy (ICP)** is the most common **pregnancy-specific** cause of jaundice, it is NOT the most common cause of jaundice overall in pregnancy. - **Viral hepatitis** (especially hepatitis A, B, and E) remains the **most common cause of jaundice in pregnancy** worldwide, accounting for approximately 40-50% of cases. - ICP accounts for about 20-25% of jaundice cases in pregnancy, making it the leading obstetric-specific cause but not the overall leading cause. *Bilirubin level >2mg%* - In ICP, **bilirubin levels** are typically **normal or only mildly elevated** (usually 10 μmol/L), not bilirubin. *Oestrogen is involved* - **TRUE** - Elevated **estrogen and progesterone levels** during pregnancy play a key role in ICP pathophysiology. - These hormones affect **hepatic bile salt transporters** (particularly BSEP and MDR3), leading to impaired bile secretion in genetically susceptible individuals. *Manifestations usually appear in last trimester* - **TRUE** - ICP typically presents in the **third trimester** (usually after 28 weeks), with **pruritus** as the predominant symptom. - Symptoms resolve within days to weeks after delivery, correlating with declining hormone levels.

Q: Apparent lengthening is seen in which stage of TB Hip

Stage III. ***Stage III*** - In **Stage III (destructive stage)** of TB Hip, significant destruction of the femoral head and acetabulum can lead to superior migration of the greater trochanter. - This superior migration results in **apparent lengthening** of the limb due to the loss of bone structure and joint space. *Stage I* - **Stage I (synovitic stage)** involves inflammation of the synovium with effusion, but no significant bone destruction or joint changes that would cause lengthening. - At this stage, the joint space is usually preserved, and **no appreciable limb length discrepancy** is observed. *Stage II* - **Stage II (cartilage and early bone destruction)** begins to show destruction of articular cartilage and subchondral bone. - While there is some destruction, it is generally not extensive enough to cause the characteristic **apparent lengthening** seen in later stages. *None of the options* - This option is incorrect because **apparent lengthening** is a well-recognized feature during the advanced destructive phase (Stage III) of TB Hip. - The progressive nature of the disease directly contributes to specific radiographic and clinical findings like **unstable hip** and subsequent lengthening or shortening.

Q: Heterotopic ossification is primarily associated with which of the following?

Soft tissues. ***Soft tissues*** - **Heterotopic ossification** is the pathological formation of mature, lamellar bone in **non-osseous (soft tissues)** where bone does not normally exist. - This process often occurs in muscles, tendons, ligaments, or fascia, particularly after trauma or neurological injury. *Bone* - Heterotopic ossification is the formation of bone *outside* of normal skeletal structures, not within existing bone. - While it involves bone formation, its defining characteristic is its location in **extraskeletal sites**, not within the bone itself. *Joint* - Although heterotopic ossification can occur around joints, leading to **joint stiffness** and limited range of motion, it is the formation of bone within the **soft tissues surrounding the joint**, not within the joint capsule or articular cartilage itself. - The primary location is the adjacent soft tissue, which then secondarily impacts joint mobility. *None of the options* - This option is incorrect because "Soft tissues" accurately describes the primary location where heterotopic ossification occurs. - The condition is specifically defined by bone formation in these non-skeletal sites.

Q: Most common bone for which nailing is done

Tibia. ***Tibia*** - The **tibia** is the most common long bone for which **intramedullary nailing** (IM nailing) is performed, particularly for fractures of the **tibial shaft**. - Its subcutaneous location and strong cortical bone make it amenable to this type of internal fixation, promoting stability and healing. *Radius* - Fractures of the **radius**, especially distal radial fractures, are more commonly treated with **plate and screw fixation** or external fixation, rather than intramedullary nailing. - While IM nailing can be used for some radial shaft fractures, it is not the most common bone for this procedure. *Ulna* - Like the radius, the **ulna** is less frequently fixed with intramedullary nails; **plate and screw fixation** is generally preferred for ulnar shaft fractures. - Its triangular cross-section and the presence of the interosseous membrane complicate IM nailing in some cases. *Humerus* - While **humeral shaft fractures** can be treated with intramedullary nailing, especially in comminuted or pathological fractures, it is overall less common than tibial nailing. - The risk of shoulder and elbow stiffness, as well as radial nerve injury, are considerations with humeral nailing.

Q: Which of the following is not a definite use for Prostaglandin E2 (PGE2)?

Keeps patency of PDA. ***Keeps patency of PDA*** - **Prostaglandin E1 (PGE1)**, not PGE2, is used to maintain the patency of the **ductus arteriosus** in neonates with certain congenital heart defects. - PGE1 causes **vascular smooth muscle relaxation**, preventing closure of the ductus arteriosus. *Contraception* - **PGE2 analogs** are used in various forms of contraception, including emergency contraception and for cervical ripening before elective abortion. - They act by inducing **uterine contractions** and can interfere with implantation or facilitate expulsion of a fertilized egg. *Induces labour* - **PGE2 (dinoprostone)** is commonly used clinically to induce labor by promoting **cervical ripening** and stimulating **uterine contractions**. - It is administered as a vaginal gel or insert to prepare the cervix for delivery. *Therapeutic abortion* - **PGE2 analogs** are used to induce therapeutic abortion, particularly in the second trimester, by causing powerful **uterine contractions** that lead to the expulsion of the fetus. - They are often used in combination with other agents to enhance their efficacy.

Q: What is the most effective imaging method for the diagnosis of adenomyosis?

MRI. ***MRI*** - **MRI** offers superior soft tissue contrast, allowing for detailed visualization of the **junctional zone** and **myometrial thickening** characteristic of adenomyosis. - It can effectively differentiate adenomyosis from other uterine pathologies like **leiomyomas**, due to its ability to detect **heterogeneous myometrial signal** and small myometrial cysts. *CT scan* - **CT scans** have limited utility in diagnosing adenomyosis due to their **poor soft tissue contrast** in evaluating diffuse uterine conditions. - They expose the patient to **ionizing radiation** and are generally reserved for detecting calcifications or larger structural abnormalities in the pelvis. *Ultrasound* - **Transvaginal ultrasound** is often the first-line imaging modality due to its accessibility and non-invasiveness, but its diagnostic accuracy for adenomyosis is **operator-dependent** and can be limited in subtle cases. - While it can suggest adenomyosis through findings like **globular uterus** or **heterogeneous myometrium**, it often lacks the resolution to definitively characterize the extent and nature of the lesion compared to MRI. *Hysterosalpingography* - **Hysterosalpingography** is primarily used to evaluate the patency of the **fallopian tubes** and the contour of the uterine cavity, making it unsuitable for direct visualization of myometrial pathology. - While it might show an **irregular uterine cavity** if adenomyosis is severe and extends to the endometrium, it cannot definitively diagnose or characterize the condition within the myometrium.

Q: What is a felon or whitlow?

Terminal pulp space infection. ***Terminal pulp space infection*** - A **felon**, also known as a **whitlow**, is a **closed-space infection** of the **digital pulp** of the fingertip, distal to the distal interphalangeal joint. - This area contains numerous fibrous septa that create multiple small compartments, which, when infected, can lead to increased pressure, severe pain, and potential **ischemic necrosis** of the bone. *Infection of the ulnar bursa* - An infection of the **ulnar bursa** involves the synovial sheath surrounding the flexor tendons of the medial three and a half digits, extending into the palm. - This condition is often referred to as **ulnar bursitis** or **tenosynovitis** and presents with distinct clinical signs, such as swelling in the palm and along the little finger, known as Kanavel's signs. *Infection of the radial bursa* - An infection of the **radial bursa** affects the synovial sheath around the flexor pollicis longus tendon of the thumb. - This condition is known as **radial bursitis** or **thenar space infection** and typically presents with swelling and tenderness confined to the thumb and thenar eminence. *Midpalmar space infection* - A **midpalmar space infection** occurs in the deep fascial space of the palm, located between the flexor tendons and the interosseous muscles. - This infection presents as diffuse swelling and tenderness in the central palm, often with pain on passive extension of the fingers, but does not involve the fingertip pulp directly.

Question 1

What is the definitive treatment for preeclampsia?

Accepted Answer

Delivery of the baby

Answer

Use of antihypertensive medications

Answer

Dietary modifications

Answer

Increased rest and monitoring

Question 2

Which structure is least likely to be injured during common gynecological procedures?

Accepted Answer

Renal pelvis

Answer

Ureter at pelvic brim

Answer

Urinary bladder

Answer

Ureter at infundibulopelvic ligament

Question 3

In which scenario is the I-pill (emergency contraceptive) most appropriately used?

Accepted Answer

In case of contraceptive failure or unprotected sex

Answer

When a contraceptive method fails

Answer

After unprotected sexual intercourse

Answer

As a regular contraceptive method

Question 4

Which of the following statements about cholestasis of pregnancy is false?

Accepted Answer

Most common cause of jaundice in pregnancy

Answer

Bilirubin level >2mg%

Answer

Oestrogen is involved

Answer

Manifestations usually appear in last trimester

Question 5

Apparent lengthening is seen in which stage of TB Hip

Accepted Answer

Stage III

Answer

Stage II

Answer

Stage I

Answer

None of the options

Question 6

Heterotopic ossification is primarily associated with which of the following?

Accepted Answer

Soft tissues

Answer

Bone

Answer

Joint

Answer

None of the options

Question 7

Most common bone for which nailing is done

Accepted Answer

Tibia

Answer

Radius

Answer

Ulna

Answer

Humerus

Question 8

Which of the following is not a definite use for Prostaglandin E2 (PGE2)?

Accepted Answer

Keeps patency of PDA

Answer

Induces labour

Answer

Contraception

Answer

Therapeutic abortion

Question 9

What is the most effective imaging method for the diagnosis of adenomyosis?

Accepted Answer

MRI

Answer

CT scan

Answer

Hysterosalpingography

Answer

Ultrasound

Question 10

What is a felon or whitlow?

Accepted Answer

Terminal pulp space infection

Answer

Infection of the ulnar bursa

Answer

Infection of the radial bursa

Answer

Midpalmar space infection

NEET-PG 2012

Obstetrics and Gynecology

Orthopaedics

Pharmacology

Radiology

Surgery