Internal Medicine
1 questionsSausage finger appearance is associated with which of the following conditions?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1301: Sausage finger appearance is associated with which of the following conditions?
- A. Rickets
- B. Hyperthyroidism
- C. Addison's disease
- D. Psoriatic arthritis (Correct Answer)
Explanation: ***Psoriatic arthritis*** - **Dactylitis**, or "sausage finger," is a characteristic inflammatory finding in psoriatic arthritis, resulting from inflammation of the **entire digit** [1]. - This condition involves inflammation of tendons, joints, and soft tissues which leads to diffuse swelling of fingers or toes [1]. *Rickets* - Rickets is a bone-softening disease in children caused by **vitamin D deficiency**, leading to bone deformities like bowed legs or widened wrists. - It does not present with inflammatory dactylitis or "sausage digits." *Hyperthyroidism* - Hyperthyroidism is a condition of excessive thyroid hormone production, which can cause symptoms like **tremors**, **tachycardia**, and **weight loss** [2]. - It is not associated with dactylitis or changes in finger morphology. *Addison's disease* - Addison's disease results from **adrenal insufficiency**, leading to symptoms like **fatigue**, **skin hyperpigmentation**, and hypotension. - There is no clinical association between Addison's disease and "sausage finger" appearance.
Pharmacology
1 questionsWhich of the following is the only clinically available depolarizing muscle relaxant?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1301: Which of the following is the only clinically available depolarizing muscle relaxant?
- A. Decamethonium
- B. Suxamethonium (Correct Answer)
- C. Mivacurium
- D. None of the options
Explanation: ***Suxamethonium*** - **Suxamethonium** (also known as succinylcholine) is currently the **only depolarizing neuromuscular blocker** available for clinical use. - It works by mimicking acetylcholine, binding to and activating nicotinic acetylcholine receptors at the **neuromuscular junction**, causing initial muscle fasciculations followed by relaxation. *Decamethonium* - **Decamethonium** is a depolarizing neuromuscular blocker but is **no longer clinically available** due to its prolonged action and side effects. - It also acts by opening nicotinic acetylcholine receptor channels, leading to depolarization and muscle paralysis. *Mivacurium* - **Mivacurium** is a **nondepolarizing neuromuscular blocker**, meaning it acts as a competitive antagonist at the acetylcholine receptor. - It is known for its **short duration of action** due to rapid hydrolysis by plasma cholinesterases but is not depolarizing. *None of the options* - This option is incorrect because suxamethonium is indeed a clinically available depolarizing muscle relaxant. - The question specifically asks for the *only* clinically available one, which suxamethonium fulfills.
Psychiatry
3 questionsWhat is a common medical treatment for sexual paraphilias?
What is an illusion?
The site of lesion in Korsakoff's psychosis is
NEET-PG 2015 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1301: What is a common medical treatment for sexual paraphilias?
- A. Benzodiazepines
- B. Anti-androgens (Correct Answer)
- C. SSRIs
- D. Opioids
Explanation: ***Anti-androgens*** - **Anti-androgens are the established first-line pharmacological treatment** for paraphilias when medication is indicated. - Medications like **medroxyprogesterone acetate (MPA)** and **cyproterone acetate (CPA)** reduce testosterone levels, thereby reducing sexual drive and paraphilic urges. - They are particularly effective in **reducing the frequency and intensity of deviant sexual fantasies and behaviors**. - Used in combination with psychotherapy for comprehensive management of paraphilic disorders. *SSRIs* - May have a role as **adjunctive therapy** for compulsive sexual behaviors or when comorbid OCD, depression, or anxiety is present. - They can help reduce obsessive thoughts but are **not considered the primary treatment** for paraphilias themselves. - More useful for comorbid mood and anxiety symptoms than for core paraphilic symptoms. *Benzodiazepines* - Primarily used for **anxiety and insomnia** due to their sedative effects. - They do not address sexual urges or paraphilic behaviors and have no role in paraphilia treatment. *Opioids* - Prescribed for **pain management** and associated with risk of dependence. - They have **no established role** in the treatment of sexual paraphilias.
Question 1302: What is an illusion?
- A. Perception without stimuli
- B. Abnormal perception by a sensory misinterpretation of actual stimulus (Correct Answer)
- C. Fear of closed spaces
- D. A false unshaken belief not keeping one's sociocultural background
Explanation: ***Abnormal perception by a sensory misinterpretation of actual stimulus*** - An **illusion** involves the misinterpretation of an **actual external stimulus**, where the perception of that stimulus is distorted. - This means an object or event is present, but it is perceived incorrectly, for example, mistaking a shadow for an animal. *Perception without stimuli* - This describes a **hallucination**, which is a perception in the absence of an external stimulus, such as hearing voices when no one is speaking. - Hallucinations are fundamentally different from illusions because they do not rely on an existing sensory input to be misperceived. *Fear of closed spaces* - This refers to **claustrophobia**, which is a specific phobia characterized by an intense and irrational fear of confined spaces. - Claustrophobia is an anxiety disorder, not a type of perceptual disturbance. *A false unshaken belief not keeping one's sociocultural background* - This defines a **delusion**, which is a fixed, false belief that is not amenable to change in light of conflicting evidence and is not in line with an individual's cultural or religious background. - Delusions are disorders of thought content, whereas illusions are disorders of perception.
Question 1303: The site of lesion in Korsakoff's psychosis is
- A. Frontal lobe
- B. Mammillary body (Correct Answer)
- C. Cingulate gyrus
- D. Corpus striatum
Explanation: ***Mammillary body*** - **Korsakoff's psychosis** is a neurocognitive disorder characterized by severe **memory impairment**, confabulation, and apathy, primarily due to **thiamine deficiency**. - The disease involves damage to several brain areas, most notably the **mammillary bodies** and the dorsal medial nucleus of the thalamus, which are critical for memory formation. *Frontal lobe* - While frontal lobe dysfunction can lead to cognitive deficits, the **primary lesion** in Korsakoff's psychosis is not typically located here. - Damage to the frontal lobe is more commonly associated with executive dysfunction, personality changes, and disinhibition, rather than the profound amnesia seen in Korsakoff's. *Cingulate gyrus* - The cingulate gyrus plays a role in emotion, learning, and memory, but it is **not considered the primary site of lesion** in Korsakoff's psychosis. - Although it can be affected, lesions in the mammillary bodies are more directly linked to the characteristic memory deficits. *Corpus striatum* - The corpus striatum is involved in motor control and habit formation, and its damage is associated with movement disorders like **Parkinson's or Huntington's disease**. - This area is **not the primary site of pathology** in Korsakoff's psychosis, which is fundamentally a memory disorder.
Radiology
5 questionsWhich of the following is NOT a typical ultrasonographic finding in autosomal recessive polycystic kidney disease (ARPKD)?
Cobra head appearance on excretory urography is suggestive of?
Investigation of choice to evaluate intracranial hemorrhage of less than 48 hours is -
Investigation of choice for acute intracerebral hemorrhage is -
Epidural hematoma on CT scan shows which of the following?
NEET-PG 2015 - Radiology NEET-PG Practice Questions and MCQs
Question 1301: Which of the following is NOT a typical ultrasonographic finding in autosomal recessive polycystic kidney disease (ARPKD)?
- A. Increased echogenicity
- B. Cysts larger than 2 cm (Correct Answer)
- C. Enlarged kidneys
- D. Corticomedullary differentiation is lost
Explanation: **Cysts larger than 2 cm** - **ARPKD** is characterized by numerous tiny cysts (typically 1-2 mm, rarely up to 1 cm) that are microscopically dilated collecting ducts, leading to diffuse renal enlargement. - Cysts larger than 2 cm are much more typical of **autosomal dominant polycystic kidney disease (ADPKD)**, which involves macroscopic cysts of various sizes. *Enlarged kidneys* - The proliferation of dilated collecting ducts and associated interstitial fibrosis in **ARPKD** leads to significantly enlarged kidneys, which is a hallmark ultrasound finding. - This enlargement is often bilateral and can be detected prenatally or in neonates. *Increased echogenicity* - The presence of numerous tiny cysts and dense fibrous tissue throughout the renal parenchyma in **ARPKD** causes increased diffuse echogenicity on ultrasound. - This is a common and important diagnostic feature, often described as "bright" or "hyperechoic" kidneys. *Corticomedullary differentiation is lost* - In **ARPKD**, the normal distinct differentiation between the renal cortex and medulla is obliterated due to the widespread involvement of the collecting ducts and the diffuse nature of the disease. - This loss of corticomedullary differentiation is a typical finding on ultrasound for severe renal parenchymal disease, including ARPKD.
Question 1302: Cobra head appearance on excretory urography is suggestive of?
- A. Horseshoe kidney
- B. Duplication of renal pelvis
- C. Simple cyst of kidney
- D. Ureterocele (Correct Answer)
Explanation: ***Ureterocele*** - A **cobra head appearance** on excretory urography is a classic sign of a **ureterocele**, which is a cystic dilation of the distal ureter that protrudes into the bladder. - This appearance is due to the dilated ureter appearing like an oval or round filling defect within the bladder lumen, surrounded by a thin radiolucent halo created by the ureteral wall and urine. *Horseshoe kidney* - A horseshoe kidney is characterized by the fusion of the lower poles of the kidneys, causing a **"U" shape** across the midline, often identified by the isthmus. - It does not present with a cobra head appearance but rather a typical anatomical variation of renal position and fusion. *Duplication of renal pelvis* - Duplication of the renal pelvis involves two separate collecting systems draining one kidney, which can be seen as two distinct pelvicalyceal systems. - This condition does not create a cobra head appearance; instead, it shows an abnormal number of collecting systems within a single kidney. *Simple cyst of kidney* - A simple renal cyst typically appears as a **well-defined, anechoic (on ultrasound) or hypodense (on CT) mass** within the kidney parenchyma. - It does not involve the ureter or bladder and thus does not produce a cobra head appearance on urograms.
Question 1303: Investigation of choice to evaluate intracranial hemorrhage of less than 48 hours is -
- A. CT scan (Correct Answer)
- B. MRI
- C. PET
- D. SPECT
Explanation: ***CT scan*** - **Non-contrast CT** is the most sensitive and rapid imaging modality for detecting acute intracranial hemorrhage, appearing as a **hyperdense** (bright) area within the brain parenchyma or subarachnoid space. - It is readily available in emergency settings and is crucial for immediate diagnosis to guide management, especially within the first **48 hours**. *MRI* - While MRI can detect hemorrhage, its sensitivity for **acute hemorrhage** (especially within the first few hours) is less than CT, and it is more time-consuming. - MRI is superior for detecting older hemorrhage or subtle lesions, but it is not the **first-line investigation** for acute bleeding. *PET* - **Positron Emission Tomography** (PET) scans are primarily used to assess metabolic activity and blood flow in the brain, often for conditions like cancer, epilepsy, or dementia. - It does not directly visualize fresh blood and therefore is not used for the diagnosis of **acute intracranial hemorrhage**. *SPECT* - **Single-Photon Emission Computed Tomography** (SPECT) is used to evaluate cerebral blood flow and neuronal activity, similar to PET but with different tracers and resolution. - It is not indicated for the rapid assessment of **acute intracranial hemorrhage** as it does not directly image blood.
Question 1304: Investigation of choice for acute intracerebral hemorrhage is -
- A. NCCT (Correct Answer)
- B. MRI
- C. PET scan
- D. None of the options
Explanation: ***NCCT*** - **Non-contrast Computed Tomography (NCCT)** is the investigation of choice for acute intracerebral hemorrhage because it can **rapidly and reliably detect acute blood** within the brain parenchyma. - Acute hemorrhage appears as a **hyperdense (bright) lesion** on NCCT, allowing for quick diagnosis and management vital in emergency settings. *MRI* - While MRI can detect hemorrhage, its sensitivity for **acute hemorrhage** can be variable, and it is **less readily available** and takes longer to perform than NCCT. - MRI is generally preferred for subacute or chronic hemorrhage, or to investigate the **underlying cause** of the bleed (e.g., tumor, vascular malformation). *PET scan* - **Positron Emission Tomography (PET) scan** primarily measures **metabolic activity** and blood flow within the brain. - It is **not suitable for detecting acute bleeding** and is typically used for diagnosing conditions like tumors, epilepsy, or neurodegenerative diseases. *None of the options* - This option is incorrect because **NCCT** is indeed the gold standard for diagnosing acute intracerebral hemorrhage.
Question 1305: Epidural hematoma on CT scan shows which of the following?
- A. Biconvex hyperdense lesion (Correct Answer)
- B. Crescent-shaped hyperdense lesion
- C. Biconcave hypodense lesion
- D. Ring-enhancing hypodense lesion
Explanation: ***Biconvex hyperdense lesion*** - An epidural hematoma is characterized by a **biconvex** (lens-shaped) collection of blood between the dura mater and the skull. - Since it is an acute hemorrhage, the blood appears **hyperdense** (bright white) on a CT scan. *Crescent-shaped hyperdense lesion* - A **crescent shape** is characteristic of an **acute subdural hematoma**, not an epidural hematoma. - While acute subdural hematomas are also hyperdense, their crescent shape (following the contour of the brain) distinguishes them from the biconvex epidural hematomas. - Epidural hematomas are limited by suture lines and appear lens-shaped, while subdural hematomas can cross suture lines. *Biconcave hypodense lesion* - A **biconcave** shape is not a standard description in neuroradiology and does not represent epidural hematoma. - **Hypodense** would indicate an older lesion or other pathology, not acute hemorrhage. *Ring-enhancing hypodense lesion* - **Ring-enhancing lesions** are typically associated with abscesses, glioblastoma, or metastatic tumors, not an acute hematoma. - A **hypodense** (darker) center with enhancement would indicate an abscess or necrotic tumor, not a fresh extravasation of blood.