Anatomy
1 questionsWhich of the following structures is present in an XY child but absent in an XX child?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 1221: Which of the following structures is present in an XY child but absent in an XX child?
- A. Urethral glands (Cowper's glands)
- B. Prostate gland (Correct Answer)
- C. Ovaries
- D. Vestibular glands (Bartholin's glands)
Explanation: ***Prostate gland*** - The **prostate gland** is the most characteristic male-specific accessory reproductive organ that is **definitively present in XY and absent in XX individuals**. - It develops from the **urogenital sinus** under the influence of **dihydrotestosterone (DHT)** during embryonic development. - The prostate is a **substantial glandular structure** that surrounds the urethra and produces approximately 30% of seminal fluid. - It has **no homologous structure in females**—there is no female equivalent organ. *Incorrect: Urethral glands (Cowper's glands)* - **Cowper's glands (bulbourethral glands)** are indeed male-specific structures present only in XY individuals. - However, they are **homologous to Bartholin's glands** in females—meaning both develop from similar embryonic tissue (urogenital sinus). - While the question technically could accept this answer, the **prostate gland is the more definitive answer** as it is larger, more clinically significant, and has no female homologue. - Cowper's glands are small pea-sized glands that contribute to pre-ejaculate fluid. *Incorrect: Ovaries* - **Ovaries** are the primary female gonads present in **XX individuals**, not XY individuals [1]. - They produce ova and female sex hormones (estrogen and progesterone) [1]. - In XY individuals, the **testes** develop instead under the influence of the SRY gene. *Incorrect: Vestibular glands (Bartholin's glands)* - **Bartholin's glands** are female-specific structures present in **XX individuals**, not XY individuals. - Located at the posterior vaginal opening, they secrete mucus for vaginal lubrication. - They are homologous to Cowper's glands in males but are distinct structures.
Orthopaedics
5 questionsAeroplane splint is used in ?
The A1 pulley involved in trigger finger is located at the level of which joint?
A child presented to an orthopaedic clinic with a limp. The surgeon suspected him to have a fixed flexion deformity of the hip. Which test should the surgeon perform to confirm his finding?
During performing a total hip replacement, the surgeon found destruction of the articular cartilage and multiple wedge-shaped subchondral depressions. What is this called?
The Salter Harris classification is used for classifying which type of injuries?
NEET-PG 2015 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 1221: Aeroplane splint is used in ?
- A. Brachial plexus injury (Correct Answer)
- B. Ulnar nerve injury
- C. Radial nerve injury
- D. Scoliosis
Explanation: ***Brachial plexus injury*** - The **aeroplane splint** is specifically designed to support the arm in **abduction** and **external rotation** at the shoulder, with the elbow flexed. - This position helps to relieve tension on the injured **brachial plexus** nerves and prevents contractures, particularly after an **upper brachial plexus injury** (e.g., Erb's palsy). *Radial nerve injury* - Radial nerve injuries typically present with **wrist drop** and difficulty with finger extension. - Splints for radial nerve injury, such as a **dynamic wrist extension splint**, focus on supporting wrist and finger extension, not shoulder abduction. *Ulnar nerve injury* - Ulnar nerve injuries lead to a **claw hand deformity** and sensory loss in the pinky and half of the ring finger. - Splints for ulnar nerve injury aim to prevent hyperextension of the metacarpophalangeal joints and support the interphalangeal joints, often involving static or dynamic splints for the hand. *Scoliosis* - Scoliosis is a **lateral curvature of the spine**, usually treated with bracing (e.g., Boston brace or Milwaukee brace) or surgery. - An aeroplane splint has no role in the management or treatment of scoliosis.
Question 1222: The A1 pulley involved in trigger finger is located at the level of which joint?
- A. Proximal Interphalngeal joint
- B. Metacarpophalangeal joint (Correct Answer)
- C. Carpometacarpal joint
- D. Distal Interphalangeal joint
Explanation: ***Metacarpophalangeal joint*** - The **A1 pulley** is located at the base of the finger, overlying the **metacarpophalangeal (MCP) joint**. - Its pathological thickening or narrowing can impede the smooth gliding of **flexor tendons**, causing **trigger finger**. *Proximal Interphalangeal joint* - The **A2** and **A3 pulleys** are located at the level of the **proximal phalanx** and **proximal interphalangeal (PIP) joint**, respectively. - While essential for tendon function, they are not primarily involved in typical **trigger finger**. *Distal Interphalangeal joint* - The **A4** and **A5 pulleys** are located at the level of the **middle phalanx** and **distal interphalangeal (DIP) joint**, respectively. - Pathologies at these pulleys are less common in trigger finger and typically affect the **distal tendon glide**. *Carpometacarpal joint* - The **carpometacarpal (CMC) joints** are located at the base of the hand, between the carpal bones and metacarpals. - There are no A pulleys associated with the CMC joints, and they are not directly involved in the mechanism of **trigger finger**.
Question 1223: A child presented to an orthopaedic clinic with a limp. The surgeon suspected him to have a fixed flexion deformity of the hip. Which test should the surgeon perform to confirm his finding?
- A. Thomas test (Correct Answer)
- B. Trendelenburgs test
- C. Telescoping test
- D. Nelaton's test
Explanation: ***Thomas test*** - The **Thomas test** is specifically designed to detect a **fixed flexion deformity of the hip**, where the hip cannot fully extend. - During the test, the patient's hip is flexed to flatten the lumbar spine, and if the contralateral leg then rises off the table, it indicates a fixed flexion deformity. *Trendelenburg's test* - The **Trendelenburg's test** assesses the strength and function of the **hip abductor muscles**, primarily the gluteus medius. - A positive result indicates weakness of the abductors on the standing leg, causing the pelvis to drop on the unsupported side, which is unrelated to fixed flexion deformity. *Nelaton's test* - **Nelaton's test** is used to determine the relative position of the **greater trochanter** in relation to the **ischial tuberosity** and **anterior superior iliac spine (ASIS)**, primarily in cases of hip dislocation or fracture. - It would not specifically identify a fixed flexion deformity of the hip joint itself. *Telescoping test* - The **telescoping test** is used to evaluate for hip instability, particularly in infants with **developmental dysplasia of the hip (DDH)**. - It involves applying axial pressure to the femur while moving the hip, assessing for abnormal movement of the femoral head within the acetabulum, and does not directly detect fixed flexion deformity.
Question 1224: During performing a total hip replacement, the surgeon found destruction of the articular cartilage and multiple wedge-shaped subchondral depressions. What is this called?
- A. Osteolysis
- B. Osteomyelitis
- C. Osteonecrosis (Correct Answer)
- D. Osteogenesis
Explanation: ***Osteonecrosis*** - **Osteonecrosis**, also known as **avascular necrosis**, is characterized by the death of bone tissue due to a lack of blood supply, which leads to the collapse of the subchondral bone and articular cartilage destruction. - The description of **wedge-shaped subchondral depressions** and **articular cartilage destruction** is highly indicative of osteonecrosis, especially in the context of advanced hip joint pathology requiring total hip replacement. *Osteolysis* - **Osteolysis** refers to the active resorption of bone, often seen around implants in prosthetic joints due to wear particles, leading to bone loss. - While it involves bone destruction, it typically presents as diffuse bone loss rather than specific wedge-shaped subchondral depressions. *Osteomyelitis* - **Osteomyelitis** is an infection of the bone or bone marrow, often leading to bone destruction, but it is primarily characterized by inflammation and pus formation. - The presented scenario does not mention signs of infection (e.g., fever, pus, inflammation) but focuses purely on structural destruction consistent with vascular compromise. *Osteogenesis* - **Osteogenesis** is the process of bone formation or development. - This term describes the creation of bone tissue and is the opposite of bone destruction, making it an incorrect answer for a condition involving cartilage and bone deterioration.
Question 1225: The Salter Harris classification is used for classifying which type of injuries?
- A. Soft tissue injuries in pediatric patients
- B. Long bone fractures without growth plate involvement
- C. Joint dislocations in pediatric orthopedics
- D. Fractures involving the physis in children (Correct Answer)
Explanation: ***Fractures involving the physis in children*** - The **Salter-Harris classification system** is specifically designed for classifying fractures that involve the **growth plate (physis)** in children. - This system helps predict the risk of **growth disturbance** and guides treatment decisions based on the fracture pattern. *Soft tissue injuries in pediatric patients* - The Salter-Harris classification does not apply to **soft tissue injuries** like sprains or strains. - Soft tissue injuries are assessed using different classification systems or descriptive terms. *Long bone fractures without growth plate involvement* - Fractures in children that do not involve the growth plate are classified using descriptive terms, such as **transverse**, **oblique**, or **spiral fractures**, or other systems like the **AO pediatric classification**, not Salter-Harris. - The Salter-Harris system is unique to physis involvement. *Joint dislocations in pediatric orthopedics* - **Joint dislocations** involve the displacement of bones at a joint and are classified by the direction of displacement (e.g., anterior, posterior). - They do not involve a fracture of the growth plate itself, so the Salter-Harris system is not applicable.
Pathology
1 questionsWhich is the most common type of male breast cancer?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 1221: Which is the most common type of male breast cancer?
- A. Inflammatory Breast Cancer
- B. Invasive Ductal Carcinoma (Correct Answer)
- C. Invasive Lobular Carcinoma
- D. Mucinous Carcinoma
Explanation: ***Invasive Ductal Carcinoma*** - This is by far the most common type of breast cancer in men, accounting for approximately **80-90%** of all male breast cancer cases. - It originates in the **milk ducts** and then invades the surrounding breast tissue. *Invasive Lobular Carcinoma* - This type of cancer originates in the **milk-producing glands (lobules)**. - It is **extremely rare** in men due to the underdeveloped and non-functional lobules in the male breast. *Mucinous Carcinoma* - This is a **rare subtype** of invasive ductal carcinoma characterized by cancer cells that produce **mucin**. - It accounts for only a small percentage of male breast cancers, typically **2-3%** of cases. *Inflammatory Breast Cancer* - This is a **rare and aggressive** form of breast cancer characterized by rapid onset of redness, swelling, and warmth in the breast, often mistaken for an infection. - Although it can occur in men, it is not the most common type and represents a very small fraction of male breast cancer diagnoses.
Physiology
1 questionsOsteoclasts have all of the following functions except -
NEET-PG 2015 - Physiology NEET-PG Practice Questions and MCQs
Question 1221: Osteoclasts have all of the following functions except -
- A. Receptor for parathormone (Correct Answer)
- B. Ruffled border
- C. Bone resorption
- D. RANK ligand production
Explanation: ***Receptor for parathormone*** - **Osteoclasts** do not directly have receptors for **parathormone (PTH)**; instead, **osteoblasts** have PTH receptors. - When PTH binds to osteoblasts, they release factors (like **RANKL**) that stimulate osteoclast activity, thus indirectly regulating bone resorption. *Bone resorption* - **Osteoclasts** are specialized cells primarily responsible for **resorbing bone matrix**, a critical process in bone remodeling. - They secrete **acids and enzymes** to break down the mineral and organic components of bone. *Ruffled border* - The **ruffled border** is a characteristic morphological feature of active osteoclasts, representing a highly folded plasma membrane. - This specialized structure increases the surface area for the secretion of **protons and lysosomal enzymes** into the bone-resorbing compartment. *RANK ligand production* - **Osteoclasts** do not produce **RANK ligand (RANKL)**; rather, they have **RANK receptors** that bind to RANKL produced by **osteoblasts and stromal cells**. - The binding of RANKL to RANK is essential for the **differentiation, activation, and survival** of osteoclasts.
Surgery
2 questionsWhich of the following is resected in Whipple's operation, except?
CA Breast may locally spread to all of the following muscles except
NEET-PG 2015 - Surgery NEET-PG Practice Questions and MCQs
Question 1221: Which of the following is resected in Whipple's operation, except?
- A. Duodenum
- B. Head of pancreas
- C. Neck of pancreas (Correct Answer)
- D. Common bile duct
Explanation: ***Neck of pancreas*** - In a **Whipple procedure** (pancreaticoduodenectomy), the **neck of the pancreas** is the site of transection (division), not resection. - The **head of the pancreas** (distal to the neck) is removed, while the **body and tail** (proximal to the neck) are preserved. - The transected surface at the neck is anastomosed to the jejunum to maintain pancreatic drainage. *Duodenum* - The **entire duodenum** is resected during a Whipple operation. - This is necessary because the **head of the pancreas** is intimately involved with the duodenum, sharing blood supply and lymphatic drainage. *Head of pancreas* - The **head of the pancreas** is the primary target for resection in a Whipple procedure. - This is typically performed for **malignancies** (pancreatic or periampullary tumors) or severe inflammatory conditions affecting this region. *Common bile duct* - The **distal common bile duct** is resected as part of the specimen to ensure complete tumor excision with adequate margins. - The remaining **proximal common bile duct** is then anastomosed to the jejunum (hepaticojejunostomy).
Question 1222: CA Breast may locally spread to all of the following muscles except
- A. Latissimus Dorsi (Correct Answer)
- B. Pectoralis Minor
- C. Serratus Anterior
- D. Pectoralis Major
Explanation: ***Latissimus Dorsi*** - The **latissimus dorsi** muscle is located on the posterior aspect of the trunk and arm, significantly deeper and further away from the breast tissue compared to other surrounding muscles. - Direct local invasion of breast cancer to the latissimus dorsi is rare and typically requires extensive tumor growth or metastasis to more distant sites before affecting this muscle. *Pectoralis Minor* - The **pectoralis minor** muscle lies directly beneath the pectoralis major and is in close proximity to the deeper aspects of the breast tissue. - Tumors that invade the **deep fascia** of the breast can directly extend into this muscle. *Serratus Anterior* - The **serratus anterior** muscle is located on the lateral wall of the thorax, forming part of the chest wall beneath the breast. - **Aggressive breast cancers**, particularly those in the outer quadrants, can invade the fascial planes covering this muscle. *Pectoralis Major* - The **pectoralis major** forms the anterior wall of the axilla and lies directly beneath the majority of the breast tissue. - It is one of the most common muscles to be affected by **direct local invasion** from breast cancer due to its anatomical proximity.