NEET-PG 2013

1544 Questions — Page 37 of 155

Anatomy

2 questions

Q361

A person had injury to right upper limb, he is not able to extend fingers but able to extend wrist and elbow. Nerve injured is ?

Q362

Which of the following statements regarding axillary lymph nodes is incorrect?

NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs

Question 361: A person had injury to right upper limb, he is not able to extend fingers but able to extend wrist and elbow. Nerve injured is ?

A. Median
B. Ulnar
C. Radial
D. Posterior interosseous (Correct Answer)

Explanation: ***Posterior interosseous*** - This nerve supplies the muscles responsible for **finger extension**, such as the **extensor digitorum**, **extensor indicis**, and **extensor digiti minimi**. - A lesion here would spare wrist and elbow extension because the nerves to the **extensor carpi radialis longus/brevis** and **triceps brachii** branch off the radial nerve proximal to the origin of the posterior interosseous nerve. *Radial* - A more proximal **radial nerve injury** would result in the inability to extend the wrist (leading to **wrist drop**), fingers, and thumb, which is not seen here as wrist extension is preserved. - It also innervates the **triceps brachii**, and a high radial nerve injury would affect elbow extension; this patient can extend their elbow. *Median* - The **median nerve** primarily innervates muscles responsible for **flexion** of the wrist and fingers, as well as **thumb opposition** and **pronation**. - Its injury would not directly lead to an inability to extend the fingers, but rather weakness in flexion and specific thumb movements. *Ulnar* - The **ulnar nerve** innervates most of the **intrinsic hand muscles** and the **flexor carpi ulnaris**, leading to weakness in finger abduction/adduction and flexion of the 4th and 5th digits. - It does not control finger extension, so an injury would not cause this specific deficit.

Question 362: Which of the following statements regarding axillary lymph nodes is incorrect?

A. Posterior group lies along subscapular vessels
B. Lateral group lies along lateral thoracic vessels (Correct Answer)
C. Apical group is terminal lymph nodes
D. Apical group lies along axillary vessels

Explanation: ***Lateral group lies along lateral thoracic vessels*** - The **lateral group** of axillary lymph nodes is located along the **axillary vein**, receiving lymph primarily from the upper limb [1]. - The **lateral thoracic vessels** are associated with the central and posterior groups of axillary lymph nodes, not the lateral group. *Posterior group lies along subscapular vessels* - The **posterior (subscapular) group** of axillary lymph nodes is indeed located along the **subscapular vessels**. - This group receives lymph from the posterior wall of the trunk and the posterior shoulder region. *Apical group is terminal lymph nodes* - The **apical group** (also known as the subclavian group) is considered the **terminal lymph nodes** of the axilla. - Lymph from all other axillary nodes eventually drains into the apical group before continuing to the supraclavicular nodes and then into the subclavian lymphatic trunk [2]. *Apical group lies along axillary vessels* - The **apical group** of axillary lymph nodes is situated in the apex of the axilla, superior to the pectoralis minor muscle, and lies in close proximity to the **axillary vessels** [1]. - This location allows it to receive lymph from other axillary groups and drain into the supraclavicular lymph nodes.

Pharmacology

1 questions

Q361

Microvesicular fatty liver is caused by ?

Physiology

7 questions

Q361

Cushing reflex is associated with all except?

Q362

All should be features of a substance to measure GFR, except?

Q363

What is the normal range of renal blood flow in humans?

Q364

Normal renal threshold for glucose is at plasma glucose level ?

Q365

What is the most important extracellular buffer?

Q366

Which hormone is secreted by the "Delta cells" of the stomach?

Q367

Lowest pH is seen in which of the gastrointestinal secretions?

NEET-PG 2013 - Physiology NEET-PG Practice Questions and MCQs

Question 361: Cushing reflex is associated with all except?

A. Irregular respiration
B. Hypotension (Correct Answer)
C. Increased intracranial pressure
D. Bradycardia

Explanation: ***Hypotension*** - The **Cushing reflex** is a compensatory response to increased intracranial pressure (ICP) aiming to maintain cerebral perfusion, which typically involves **hypertension**, not hypotension. - While prolonged or severe ICP can lead to decompensation and eventual hypotension, it is not a direct component of the reflex itself. *Increased intracranial pressure* - The **Cushing reflex** is triggered by an elevation in **intracranial pressure (ICP)**, as the body attempts to maintain blood flow to the brain. - This increased ICP reduces cerebral perfusion pressure, prompting a systemic response to raise mean arterial pressure. *Bradycardia* - **Bradycardia** is a classic component of the **Cushing reflex**, occurring as a compensatory response to the reflex hypertension. - The increased arterial blood pressure stimulates carotid and aortic baroreceptors, leading to a vagal response that slows the heart rate. *Irregular respiration* - **Irregular respiration** is another key component of the **Cushing reflex**, often manifesting as **Cheyne-Stokes breathing** or **ataxic breathing**. - This respiratory dysregulation is due to direct compression and dysfunction of the brainstem, specifically the medullary respiratory centers, caused by increased ICP.

Question 362: All should be features of a substance to measure GFR, except?

A. Freely reabsorbed (Correct Answer)
B. Not secreted by kidney
C. Freely filtered across the glomerulus membrane
D. None of the options

Explanation: ***Freely reabsorbed*** - A substance used to measure GFR should **not be reabsorbed** by the kidney tubules. If it were reabsorbed, the amount excreted in the urine would be less than the amount filtered, leading to an **underestimation of GFR**. - The ideal GFR marker is **neither reabsorbed nor secreted**, ensuring that its excretion rate directly reflects the filtration rate. *Freely filtered across the glomerulus membrane* - For a substance to accurately measure GFR, it must be **freely filtered** from the blood into the Bowman's capsule, without any restriction due to its size or charge. - This ensures that its concentration in the glomerular filtrate is the same as in the plasma, allowing for a direct calculation of the filtration rate. *Not secreted by kidney* - An ideal GFR marker should **not be secreted** by the renal tubules, as active secretion would add to the amount excreted in the urine, leading to an **overestimation of GFR**. - This property, along with not being reabsorbed, ensures that the amount of the substance appearing in the urine solely reflects the amount filtered. *None of the options* - This option is incorrect because there is a definitive feature listed among the choices that is *not* a characteristic of an ideal GFR marker. The ability to be "freely reabsorbed" is a disqualifying trait.

Question 363: What is the normal range of renal blood flow in humans?

A. 1 to 1.2 L/min (Correct Answer)
B. 1.5 to 2 L/min
C. 2 to 2.5 L/min
D. 2.5 to 3 L/min

Explanation: ***1 to 1.2 L/min*** - The **kidneys** receive a substantial portion of the **cardiac output**, typically around 20-25%, to perform their filtration and regulatory functions. - This translates to an absolute renal blood flow of approximately **1000 to 1200 mL/min**, or **1 to 1.2 liters per minute**. - This represents the normal physiological range for healthy adults at rest. *1.5 to 2 L/min* - This range is **higher than the normal physiological** renal blood flow. - While renal blood flow can be influenced by various factors, sustained flow in this range would typically be considered **above the average baseline** for healthy individuals. *2 to 2.5 L/min* - This range significantly **exceeds the typical** renal blood flow observed in healthy humans. - Such high flow rates would be **unusual** and are not representative of normal renal perfusion. *2.5 to 3 L/min* - This range represents an **extremely high** renal blood flow, far beyond what is considered normal. - Sustained perfusion at this level would be **pathological** or indicative of an experimental setting rather than a physiological state.

Question 364: Normal renal threshold for glucose is at plasma glucose level ?

A. 100 mg/dl
B. 200 mg/dl (Correct Answer)
C. 300 mg/dl
D. 400 mg/dl

Explanation: ** _200 mg/dl_ ** - The **renal threshold for glucose** represents the plasma glucose concentration at which the kidneys begin to excrete glucose into the urine. - This typically occurs when the glucose level exceeds the reabsorptive capacity of the renal tubules, usually around **180-200 mg/dL**. * _100 mg/dl_ * - A plasma glucose level of **100 mg/dL** is within the normal fasting range and well below the renal threshold. - At this level, virtually all filtered glucose is reabsorbed by the renal tubules, and no glucose appears in the urine. * _300 mg/dl_ * - A plasma glucose level of **300 mg/dL** is significantly above the renal threshold for glucose. - At this concentration, the kidney's reabsorptive capacity is overwhelmed, leading to substantial **glucosuria** (glucose in the urine). * _400 mg/dl_ * - A plasma glucose level of **400 mg/dL** is severely elevated and far exceeds the renal threshold. - This level would result in significant glucose excretion in the urine and is indicative of uncontrolled hyperglycemia, as seen in **diabetes mellitus**.

Question 365: What is the most important extracellular buffer?

A. Bicarbonates (Correct Answer)
B. Phosphate buffer
C. Plasma protein buffer
D. Ammonium buffer

Explanation: ***Bicarbonates*** - The **bicarbonate buffer system** is the most important extracellular buffer because its components (carbonic acid and bicarbonate) are present in high concentrations and their levels can be regulated by both the lungs (CO2 excretion) and the kidneys (bicarbonate reabsorption/secretion). - Its pKa (6.1) makes it an effective buffer against metabolically produced acids, which frequently challenge blood pH. *Phosphate buffer* - The **phosphate buffer system** is more important as an intracellular buffer and in renal tubular fluid due to its higher concentration in these compartments. - Its concentration in the extracellular fluid is relatively low compared to bicarbonate, limiting its capacity as the primary extracellular buffer. *Plasma protein buffer* - **Plasma proteins**, particularly albumin, have numerous ionizable groups and contribute to buffering in the extracellular fluid. - However, their overall buffering capacity is less significant than that of the bicarbonate system due to lower concentration compared to bicarbonate and less dynamic regulation. *Ammonium buffer* - The **ammonium buffer system** (ammonia/ammonium) is primarily important for acid-base regulation by the kidneys, where it plays a critical role in excreting excess acid, particularly in chronic acidosis. - It is not a major extracellular fluid buffer in the systemic circulation under normal physiological conditions.

Question 366: Which hormone is secreted by the "Delta cells" of the stomach?

A. Cholecystokinin
B. Gastrin-releasing peptide
C. Somatostatin (Correct Answer)
D. Secretin

Explanation: ***Somatostatin*** - **Delta cells (D cells)** in the stomach and pancreas secrete **somatostatin**, a potent inhibitory hormone. - Somatostatin **inhibits the release of gastrin**, histamine, secretin, cholecystokinin, and gastric acid secretion, acting as a "universal off switch." *Cholecystokinin* - **Cholecystokinin (CCK)** is primarily secreted by **I cells** in the duodenum and jejunum. - Its main functions include stimulating gallbladder contraction and pancreatic enzyme secretion. *Gastrin-releasing peptide* - **Gastrin-releasing peptide (GRP)**, also known as **bombesin**, is a neuropeptide released from **enteric neurons**. - It stimulates the release of **gastrin** from G cells. *Secretin* - **Secretin** is secreted by **S cells** in the duodenum in response to acidic chyme entering the small intestine. - Its primary role is to stimulate the pancreas to release **bicarbonate-rich fluid** to neutralize gastric acid.

Question 367: Lowest pH is seen in which of the gastrointestinal secretions?

A. Gastric juice (Correct Answer)
B. Bile juice
C. Saliva
D. Pancreatic juice

Explanation: ***Gastric juice*** - Gastric juice contains **hydrochloric acid (HCl)**, secreted by parietal cells, which gives it a very **low pH (1.5-3.5)**. - This acidic environment is crucial for protein digestion by **pepsin** and for killing ingested microorganisms. *Bile juice* - Bile juice is typically **alkaline**, with a pH ranging from **7.6 to 8.6**. - Its primary role is to **emulsify fats** in the small intestine, and it does not contain significant acidic components. *Saliva* - Saliva has a relatively neutral pH, typically ranging from **6.2 to 7.6**. - It contains enzymes like **amylase** and **lipase** for initial carbohydrate and lipid digestion, but no strong acids. *Pancreatic juice* - Pancreatic juice is highly **alkaline**, with a pH usually between **8.0 and 8.3**, due to its high concentration of bicarbonate. - This alkalinity neutralizes the acidic chyme entering the duodenum from the stomach, creating an optimal environment for pancreatic enzymes.