NEET-PG 2015 Practice Questions

Q: Traumatic optic neuropathy due to closed head trauma commonly affects which part of the optic nerve?

Optic canal. ***Optic canal*** - The **optic nerve** is highly susceptible to injury within the **optic canal** due to its tight anatomical confines and the close proximity of the optic nerve to rigid bone. - Trauma to this region can lead to direct compression, shearing injury, or ischemia from damage to surrounding vasculature, resulting in significant visual impairment. *Intra ocular part* - The intraocular part of the optic nerve, including the **optic disc**, is typically protected by the globe and orbit against blunt trauma. - Direct intraocular trauma, such as a penetrating injury, would be required to significantly affect this segment, which is not usually the cause in closed head trauma. *Intracranial part* - The intracranial part of the optic nerve is relatively mobile within the cerebrospinal fluid and is less prone to direct compression or shearing forces from closed head trauma compared to the optic canal. - While it can be affected by diffuse axonal injury or mass effects within the cranium, it is not the most commonly affected segment for traumatic optic neuropathy in closed head injuries. *Optic tract* - The **optic tract** lies posterior to the optic chiasm and is part of the central nervous system pathways for vision, not the optic nerve itself. - Injuries to the optic tract are more likely to cause homonymous hemianopia rather than the profound unilateral vision loss characteristic of traumatic optic neuropathy, and are generally less vulnerable to direct mechanical trauma from closed head injury.

Q: Which of these is not a part of extracellular matrix:

Integrins. ***Integrins*** - Integrins are **transmembrane receptors** on the cell surface that facilitate cell-extracellular matrix (ECM) adhesion and cell-cell adhesion. - They are part of the cell membrane, **not** an extracellular component. *Laminin* - **Laminin** is a major protein component of the **basal lamina**, a specialized extracellular matrix that underlies epithelial cells. - It plays a crucial role in cell adhesion, differentiation, and migration within the ECM. *Fibronectin* - **Fibronectin** is a large glycoprotein present in the **extracellular matrix** and in soluble form in blood plasma. - It mediates cell adhesion to the ECM by binding to integrins and various ECM components like collagen and proteoglycans. *Collagen* - **Collagen** is the most abundant protein in the human body and a primary structural component of the **extracellular matrix**. - It provides tensile strength and structural integrity to tissues like skin, bone, tendons, and cartilage.

Q: What should be done if 2 OCPs are missed on days 17-18 of the cycle?

Both a and b. ***Both a and b*** - When **two OCPs are missed** on days 17-18 (Week 3) of the cycle, the recommended approach combines two actions to restore contraceptive protection. - The woman should **take two pills on the next two days** to compensate for the missed doses and restore hormonal levels quickly. - Additionally, **backup contraception should be used for at least 7 days** to ensure contraceptive effectiveness, as the missed pills during Week 3 could compromise protection and increase the risk of ovulation. - Both actions together address the hormonal gap and provide adequate contraceptive coverage. *Take 2 pills on the next 2 days* - While this action helps **reestablish hormone levels** after missing two pills, it is **insufficient on its own**. - Without concurrent backup contraception, there remains a risk of **ovulation** and **unintended pregnancy** during the recovery period. - This must be combined with backup contraceptive methods for 7 days. *Use back up contraceptive* - Using **backup contraception** is essential because missing two pills in Week 3 increases the risk of **ovulation**. - However, backup contraception alone without resuming the pill regimen (with catch-up dosing) would not adequately restore the hormonal cycle. - Both resuming pills appropriately and using backup methods are necessary. *Continue taking single pill per day* - Simply continuing with one pill per day without any catch-up dosing would leave a **hormonal gap** from the two missed pills. - This approach does not compensate for the **missed active hormones**, leaving inadequate hormone levels for contraceptive protection. - Without catch-up dosing and backup contraception, the risk of **ovulation** and **pregnancy** remains significantly elevated.

Q: Most common complication of dermoid cyst is -

Torsion. ***Torsion*** - Ovarian dermoid cysts (mature cystic teratomas) are prone to **torsion** due to their common unilateral, round, and easily mobile nature. - Torsion results from the **twisting of the ovarian pedicle**, which can lead to exquisite pain and potential **ischemic necrosis** of the ovary. - **Most common complication** occurring in **15-20% of dermoid cysts**. *Cyst Rupture* - While rupture can occur, it is a **less common complication** than torsion, occurring in **1-4% of cases**. - Rupture can release sebaceous material and hair into the peritoneal cavity, leading to **chemical peritonitis**. *Malignant degeneration* - **Malignant transformation** within a dermoid cyst is rare, occurring in **less than 1-2% of cases**, making it much less common than torsion. - The most common type of malignancy arising from a dermoid cyst is **squamous cell carcinoma**. *Infection* - **Secondary infection** of dermoid cysts is a rare complication. - Much less common than torsion, and typically presents with fever, pain, and signs of inflammation.

Q: What is a common cause of unilateral dysmenorrhea?

One horn of malformed uterus. ***One horn of malformed uterus*** - **Obstructed rudimentary horn** with functional endometrium or **obstructed hemivagina** in uterine anomalies is a **classic cause of unilateral dysmenorrhea**. - The obstruction leads to accumulation of menstrual blood in the non-communicating horn or hemivagina, causing **severe cyclical unilateral pelvic pain** that worsens progressively with each menstrual cycle. - This typically presents in **adolescents or young women** after menarche and is a well-recognized gynecological emergency requiring surgical intervention. - Examples include: **unicornuate uterus with non-communicating rudimentary horn**, **uterus didelphys with obstructed hemivagina** (OHVIRA syndrome). *Endometriosis causing unilateral pain* - While endometriosis causes **dysmenorrhea**, it typically presents with **bilateral pelvic pain** and diffuse tenderness. - Endometriosis pain is usually **generalized** rather than strictly unilateral, though asymmetric involvement can occur. - The pain is associated with **deep dyspareunia**, **dyschezia**, and chronic pelvic pain rather than strictly unilateral cyclical pain. *Small fibroid at the utero tubal junction* - Fibroids (leiomyomas) can cause **dysmenorrhea and menorrhagia**, but unilateral presentation is uncommon. - Cornual fibroids may cause localized pain, but this is not a typical or common presentation of **unilateral dysmenorrhea**. - Pain from fibroids is usually related to **degeneration** or pressure effects rather than cyclical unilateral menstrual pain. *All of the options* - While multiple conditions can cause pelvic pain, **obstructed müllerian anomalies** (one horn of malformed uterus) are the **most classic and important cause** of true unilateral dysmenorrhea. - This is the diagnosis that must be ruled out when a patient presents with unilateral cyclical pelvic pain.

Q: Most common cause of secondary PPH is :

Retained placenta. ***Retained placenta*** - Retained placental tissue prevents the uterus from contracting effectively, leading to continued bleeding after delivery. - While it's a common cause of primary PPH as well, it often presents as a secondary PPH when small fragments remain and later detach or become infected. *Uterine atony* - This is the **most common cause of primary PPH**, occurring within 24 hours of delivery due to the uterus failing to contract. - It is less likely to be the primary cause of secondary PPH unless there's a delayed presentation. *Vaginal laceration* - Lacerations of the vagina usually present as **primary PPH**, with bright red blood despite a well-contracted uterus. - While bleeding can persist, it's not the most common cause of delayed, secondary PPH. *Cervical tear* - Cervical tears also typically cause **primary PPH**, characterized by continuous bleeding immediately after delivery. - Similar to vaginal lacerations, while continuous bleeding can occur, it's not the most common etiology for secondary PPH.

Q: Which of the following neck dissections is considered the most conservative?

Supraomohyoid neck dissection. ***Supraomohyoid neck dissection*** - This dissection is highly **selective**, removing only lymph nodes from **levels I, II, and III**, which are the most superficial and anterior groups in the neck. - It preserves the **internal jugular vein**, spinal accessory nerve, and sternocleidomastoid muscle, minimizing functional and cosmetic morbidity. *Radical neck dissection* - This is the **most extensive** neck dissection, involving the removal of all lymph node levels (I-V), the **internal jugular vein**, the **spinal accessory nerve**, and the **sternocleidomastoid muscle**. - It is reserved for advanced cancers with extensive nodal involvement due to its significant associated morbidity and functional deficits. *Modified radical neck dissection* - This dissection removes lymph nodes in levels I-V but **spares at least one non-lymphatic structure**, such as the spinal accessory nerve, internal jugular vein, or sternocleidomastoid muscle. - While less radical than a full radical neck dissection, it is still more extensive than a supraomohyoid dissection as it targets a broader range of lymph node levels. *All options are conservative.* - This statement is incorrect because **radical neck dissection** is by definition the most extensive and least conservative surgical approach to neck nodal disease. - The different types of neck dissections represent a spectrum of extensiveness, with supraomohyoid being the most selective and conservative.

Q: Supraomohyoid dissection is a type of?

Selective neck dissection. ***Selective neck dissection*** - **Supraomohyoid dissection** specifically refers to a type of selective neck dissection, characterized by the removal of lymph node levels **I, II, and III**. - This procedure is commonly performed for early-stage oral cavity cancers due to their typical lymphatic spread patterns. *Modified radical neck dissection* - This dissection preserves one or more **non-lymphatic structures** (e.g., sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve) that are typically removed in a radical neck dissection. - It involves a broader range of lymph node levels (typically **I-V**) compared to a supraomohyoid dissection. *Radical neck dissection* - This is a more extensive procedure involving the removal of all lymph node groups (levels **I-V**), along with the **sternocleidomastoid muscle**, **internal jugular vein**, and **spinal accessory nerve**. - It is reserved for advanced neck disease due to its significant morbidity. *Posterolateral dissection* - **Posterolateral neck dissection** is a term not commonly used within the standard classification of neck dissections (radical, modified radical, selective). - Lymphatic dissection is typically categorized based on anatomical levels rather than a general directional term like posterolateral.

Question 1

Traumatic optic neuropathy due to closed head trauma commonly affects which part of the optic nerve?

Accepted Answer

Optic canal

Answer

Intraocular part

Answer

Intracranial part

Answer

Optic tract

Question 2

Which of these is not a part of extracellular matrix:

Accepted Answer

Integrins

Answer

Collagen

Answer

Laminin

Answer

Fibronectin

Question 3

What should be done if 2 OCPs are missed on days 17-18 of the cycle?

Accepted Answer

Both a and b

Answer

Take 2 pills on the next 2 days

Answer

Continue taking single pill per day

Answer

Use back up contraceptive

Question 4

Most common complication of dermoid cyst is -

Accepted Answer

Torsion

Answer

Cyst Rupture

Answer

Malignant degeneration

Answer

Infection

Question 5

What is a common cause of unilateral dysmenorrhea?

Accepted Answer

One horn of malformed uterus

Answer

Small fibroid at the utero tubal junction

Answer

Endometriosis causing unilateral pain

Answer

All of the options

Question 6

What is the most appropriate management for a 28-year-old hemodynamically stable patient with mild abdominal pain and an unruptured tubal ectopic pregnancy measuring 2.5 x 3 cm, with β-hCG level of 8500 mIU/mL, visible fetal cardiac activity, and who desires future fertility?

Accepted Answer

Laparoscopic salpingostomy

Answer

Methotrexate therapy

Answer

Laparoscopic salpingectomy

Answer

Expectant management

Question 7

Most common cause of secondary PPH is :

Accepted Answer

Retained placenta

Answer

Cervical tear

Answer

Uterine atony

Answer

Vaginal laceration

Question 8

In which part of the fallopian tube is ectopic pregnancy most likely to survive longer?

Accepted Answer

Interstitial

Answer

Isthmus

Answer

Ampulla

Answer

Cornua

Question 9

Which of the following neck dissections is considered the most conservative?

Accepted Answer

Supraomohyoid neck dissection

Answer

Radical neck dissection

Answer

Modified radical neck dissection

Answer

All options are conservative.

Question 10

Supraomohyoid dissection is a type of?

Accepted Answer

Selective neck dissection

Answer

Modified radical neck dissection

Answer

Radical neck dissection

Answer

Posterolateral dissection

NEET-PG 2015

Anatomy

Biochemistry

Obstetrics and Gynecology

Surgery