NEET-PG 2019 Practice Questions

Q: Which nerve passes through the marked foramen in the image?

Inferior alveolar nerve. ***Inferior alveolar nerve*** - The image shows the **mandibular foramen**, located on the medial surface of the mandibular ramus, which is the entry point for the **inferior alveolar nerve** into the mandibular canal. - This nerve supplies sensation to the **mandibular teeth** and jaw. *Lingual nerve* - The lingual nerve typically runs anterior and medial to the inferior alveolar nerve, entering the oral cavity, and does not pass through the mandibular foramen. - It provides general sensation and taste to the **anterior two-thirds of the tongue**. *Mandibular nerve* - The mandibular nerve (V3) is a large nerve from which the inferior alveolar nerve branches off before the inferior alveolar nerve enters the mandibular foramen. - The mandibular nerve itself courses through the **foramen ovale** and then divides into several branches, including the inferior alveolar nerve. *Chorda tympani nerve* - The chorda tympani nerve is a branch of the facial nerve that joins the lingual nerve in the infratemporal fossa, but it does not pass through the mandibular foramen. - It carries **taste fibers** for the anterior two-thirds of the tongue and **parasympathetic fibers** to the submandibular and sublingual glands.

Q: In case of LPL deficiency, which of the following will increase after a fat rich diet?

Chylomicron. ***Chylomicron*** - **LPL (lipoprotein lipase)** is crucial for the breakdown of **chylomicrons** and VLDL. A deficiency leads to an accumulation of undigested chylomicrons in the bloodstream after a fat-rich meal. - **Chylomicrons** transport dietary triglycerides from the intestines to tissues. Without LPL, these triglycerides remain packaged in chylomicrons. *LDL* - **LDL (low-density lipoprotein)** levels are not directly increased by a short-term fat-rich diet in the context of LPL deficiency. LDL primarily carries cholesterol and is formed from VLDL remnants, a process that is also impaired by LPL deficiency indirectly. - While chronic LPL deficiency can affect overall lipid metabolism, the immediate post-meal increase is not in LDL but in triglyceride-rich lipoproteins. *HDL* - **HDL (high-density lipoprotein)** is involved in reverse cholesterol transport and is generally not directly increased after a fat-rich diet, especially in LPL deficiency. - In fact, severe hypertriglyceridemia, often seen in LPL deficiency, can sometimes lead to lower HDL levels due to altered lipid exchange. *Lipoprotein (a)* - **Lipoprotein (a)**, or Lp(a), is a genetically determined lipoprotein similar to LDL but with an added apolipoprotein (a) and its levels are not acutely affected by dietary fat intake or LPL deficiency. - Lp(a) levels are determined primarily by genetic factors and do not participate in the post-prandial handling of dietary fats.

Q: Identify the condition in the image

Vitiligo. ***Correct: Vitiligo*** - This image shows **patches of depigmented skin** (white areas) characteristic of vitiligo, often seen in a **segmental or generalized pattern**. - Vitiligo is an **autoimmune condition** where melanocytes are destroyed, leading to loss of skin color. - Patches typically have a **progressive course** and can appear at any age. *Incorrect: Leukoderma* - Leukoderma is a **general term** for any condition causing white patches on the skin due to reduced or lost pigmentation. - While vitiligo is a type of leukoderma, this answer is too broad and not the **most specific diagnosis** for the pattern shown. - In clinical practice, we diagnose the specific type (vitiligo) rather than using the generic term. *Incorrect: Piebaldism* - Piebaldism is a **rare genetic disorder** characterized by a **stable white forelock** (unpigmented hair) and often a congenital white patch on the forehead. - Unlike vitiligo, these patches are usually **present at birth** and do not progress. - The distribution pattern is typically **midline** with characteristic forehead involvement. *Incorrect: DLE* - DLE stands for **Discoid Lupus Erythematosus**, which is a chronic autoimmune condition affecting the skin. - It typically presents as **red, scaly, disk-shaped plaques** that can lead to scarring, atrophy, and permanent hair loss. - Would show **erythema, scaling, and scarring** rather than pure depigmentation as seen here.

Q: Patient presents with pruritus of the interdigital spaces of the left hand as shown in the image. Identify the condition.

Sarcoptes scabiei. ***Sarcoptes scabiei*** - The image shows **papules and excoriations** in the **interdigital spaces**, a classic presentation of **scabies**. Patients typically experience **intense pruritus**, especially at night. - The presence of **burrows**, which are linear or serpiginous tracks, further supports this diagnosis, as these are created by the female mite tunneling into the epidermis. *Dermatitis herpetiformis* - This condition is characterized by **intensely pruritic, symmetrically grouped vesicles and bullae** on extensor surfaces, such as elbows, knees, and buttocks, not primarily interdigital spaces. - It is strongly associated with **celiac disease** and typically responds to a gluten-free diet and dapsone. *Xerotic dermatitis* - **Xerotic dermatitis**, also known as **eczema craquelé** or **winter itch**, is characterized by **dry, fissured skin** that resembles cracked porcelain, often exacerbated by dry weather. - While it causes pruritus, it does not typically present with the papules and burrows seen in scabies, nor is it confined to interdigital spaces in this manner. *Erythema multiforme* - **Erythema multiforme** is an acute, self-limiting inflammatory skin condition characterized by **target lesions** (concentric rings of erythema and edema) and often involves mucous membranes. - It is often triggered by infections (e.g., herpes simplex virus) or drugs and does not primarily present with pruritic papules in interdigital areas.

Q: Which of the following is a risk factor for Alzheimer's disease?

Down’s syndrome. ***Down’s syndrome*** - Individuals with **Down's syndrome** have an extra copy of chromosome 21, which carries the **amyloid precursor protein (APP) gene**. - This **triplication of the APP gene** leads to increased production of **beta-amyloid protein**, a key component of the plaques found in Alzheimer's disease [1]. *Klinefelter syndrome* - **Klinefelter syndrome** is a genetic condition characterized by an extra X chromosome (XXY), primarily affecting males. - While it can be associated with various health issues, it is **not a known risk factor** for Alzheimer's disease. *Low blood pressure* - **Low blood pressure** (hypotension) is generally not considered a direct risk factor for Alzheimer's disease. - In fact, some studies suggest that **midlife hypertension** (high blood pressure) is a risk factor for later cognitive decline and Alzheimer's. *None of the options* - This option is incorrect because **Down's syndrome** is a well-established and significant risk factor for Alzheimer's disease due to the genetic link involving the APP gene.

Q: Female with 41 wk gestation confirmed by radiological investigation, very sure of her LMP, no uterine contractions, no effacement and no dilatation. What should be done to induce labor?

PGE1 tab. ***PGE1 tab*** - **Misoprostol (PGE1)** is an effective agent for **cervical ripening** and labor induction in cases of an unfavorable cervix (no effacement, no dilatation). - It is cost-effective, stable at room temperature, and widely used in resource-limited settings. - Can be administered orally or vaginally with good efficacy for cervical ripening at term. - In this post-term pregnancy with unfavorable cervix, pharmacological ripening is appropriate. *PGE2 gel* - **PGE2 (dinoprostone)** gel or cervical insert is also an effective option for cervical ripening. - Both PGE1 and PGE2 are acceptable first-line agents; the choice may depend on availability, cost, and institutional protocols. - PGE2 formulations are FDA-approved and widely used, though may be more expensive than misoprostol. *PGF2alpha* - **PGF2alpha (carboprost)** is primarily used for the **management of postpartum hemorrhage** due to its potent myometrial contracting effect. - It is **not indicated** for induction of labor at term as its strong uterine contractions can cause excessive uterine stimulation and fetal distress. *Intracervical foley's* - An **intracervical Foley catheter** is a mechanical method that causes cervical ripening through direct pressure and stimulation of local prostaglandin release. - It is an evidence-based alternative with lower risk of uterine hyperstimulation compared to pharmacological methods. - Both mechanical and pharmacological methods are acceptable first-line options for cervical ripening in post-term pregnancy with unfavorable cervix.

Q: The most common cause of proptosis in adults:-

Thyroid eye disease. ***Thyroid eye disease*** - **Thyroid eye disease (TED)**, also known as Graves' ophthalmopathy, is the most common cause of **proptosis** in adults. - It results from an autoimmune process leading to inflammation and expansion of the **extraocular muscles** and orbital fat, which pushes the eyeball forward. *Preseptal cellulitis* - **Preseptal cellulitis** is an infection of the eyelid and periorbital tissue anterior to the orbital septum, typically presenting with **eyelid swelling** and redness. - While it causes periorbital swelling, it generally does not cause true **proptosis**, which is the anterior displacement of the eyeball itself. *Capillary hemangioma* - **Capillary hemangiomas** are benign vascular tumors and are the most common orbital tumor in **infancy and childhood**, not adults. - They typically cause proptosis in young children, often presenting as a **reddish-blue mass** that may increase in size with crying. *Orbital cellulitis* - **Orbital cellulitis** is a serious infection of the tissues within the orbit, posterior to the orbital septum, which can cause **proptosis**, pain, and ophthalmoplegia. - While it is a cause of proptosis, it is an **acute infectious process** and not the most common overall cause of proptosis in the adult population compared to thyroid eye disease.

Q: Fast breathing in a 6-month-old infant is taken as:

>50 breaths/min. ***>50 breaths/min*** - For infants aged 2 to 12 months, a respiratory rate of **greater than 50 breaths per minute** is considered consistent with **tachypnea** or fast breathing. - This is an important indicator of respiratory distress, often used in clinical assessment frameworks like the **Integrated Management of Childhood Illness (IMCI)**. *>30 breaths/min* - A respiratory rate of **>30 breaths/min** would be considered fast breathing for an older child or adult, but it is within the normal range for an infant. - Normal respiratory rates are **higher in infants** and gradually decrease with age. *>60 breaths/min* - While a respiratory rate of **>60 breaths/min** is indeed fast and indicates severe respiratory distress, it is not the initial threshold for defining fast breathing in a 6-month-old infant. - This rate would suggest a more **severe clinical presentation** than simply "fast breathing." *>40 breaths/min* - A respiratory rate **>40 breaths/min** is typically considered fast breathing for children aged 1 to 5 years, but not for infants under 12 months. - For a 6-month-old, this rate is still within the **normal or upper-normal range**, depending on activity and state.

Q: What is the most likely finding in the CT image of the left maxillary sinus in a patient with a history of allergic rhinitis?

Ground-glass opacity. ***Ground-glass opacity*** - This image shows diffuse opacification of the left maxillary sinus with a characteristic **ground-glass appearance**, which is often associated with allergic fungal rhinosinusitis (AFRS), a condition that can complicate allergic rhinitis. - The patient's history of **allergic rhinitis** makes AFRS a strong consideration, and the CT finding of ground-glass opacity within the sinus lumen is a classic imaging feature of this condition, representing fungal elements and mucin. *Honeycomb appearance* - A **honeycomb appearance** on CT is typically seen in the lungs and indicates **pulmonary fibrosis**, characterized by clustered cystic airspaces with thickened walls. - This finding is not associated with paranasal sinus pathology, especially not with allergic rhinitis or its common complications. *Onion peel appearance* - The **onion peel appearance** on imaging refers to periosteal reaction with multiple concentric layers of new bone formation. - This is a hallmark feature of conditions like **Ewing sarcoma** and chronic osteomyelitis, primarily affecting bone, not the soft tissue or mucosal lining of a sinus in the context of allergic rhinitis. *Double density* - **Double density** is a term primarily used in echocardiography to describe specific findings related to left atrial enlargement, or occasionally in chest radiography where it might represent superimposed densities. - This term does not describe a finding relevant to paranasal sinus pathology on CT imaging.

Q: Identify the surgical instrument based on its characteristics: a small, triangular blade used for precise incisions.

Blade no. 11. ***Blade no. 11*** - This blade has a **triangular shape** with a strong, pointed tip, making it ideal for **stab incisions** and precise, short cuts. - Its design allows for sharp, accurate penetration, often used in procedures requiring **minimal tissue disruption**. *Blade no. 15* - This is a small, curved blade, primarily used for **fine, precise cuts** in superficial tissues. - Its small size and rounded belly make it suitable for tasks like excising skin lesions or making incisions in delicate areas, not for triangular stab incisions. *Blade no. 10* - The No. 10 blade has a **large, curved cutting edge** and is generally used for making large incisions in skin and muscle. - It is not designed for precise, triangular stab incisions, but rather for broader, sweeping cuts. *Blade no. 12* - This blade is **sickle-shaped** with the cutting edge on the inside curve, used primarily for mucogingival surgery or removing sutures. - Its unique shape allows it to get into tight spaces and cut from a different angle, but it does not have a triangular tip for precise stab incisions.

Question 1

Which nerve passes through the marked foramen in the image?

Accepted Answer

Inferior alveolar nerve

Answer

Lingual nerve

Answer

Mandibular nerve

Answer

Chorda tympani nerve

Question 2

In case of LPL deficiency, which of the following will increase after a fat rich diet?

Accepted Answer

Chylomicron

Answer

LDL

Answer

HDL

Answer

Lipoprotein (a)

Question 3

Identify the condition in the image

Accepted Answer

Vitiligo

Answer

Leukoderma

Answer

Piebaldism

Answer

DLE

Question 4

Patient presents with pruritus of the interdigital spaces of the left hand as shown in the image. Identify the condition.

Accepted Answer

Sarcoptes scabiei

Answer

Dermatitis herpetiformis

Answer

Xerotic dermatitis

Answer

Erythema multiforme

Question 5

Which of the following is a risk factor for Alzheimer's disease?

Accepted Answer

Down’s syndrome

Answer

Low blood pressure

Answer

Klinefelter syndrome

Answer

None of the options

Question 6

Female with 41 wk gestation confirmed by radiological investigation, very sure of her LMP, no uterine contractions, no effacement and no dilatation. What should be done to induce labor?

Accepted Answer

PGE1 tab

Answer

PGE2 gel

Answer

PGF2alpha

Answer

Intracervical foley’s

Question 7

The most common cause of proptosis in adults:-

Accepted Answer

Thyroid eye disease

Answer

Preseptal cellulitis

Answer

Capillary hemangioma

Answer

Orbital cellulitis

Question 8

Fast breathing in a 6-month-old infant is taken as:

Accepted Answer

>50 breaths/min

Answer

>30 breaths/min

Answer

>60 breaths/min

Answer

>40 breaths/min

Question 9

What is the most likely finding in the CT image of the left maxillary sinus in a patient with a history of allergic rhinitis?

Accepted Answer

Ground-glass opacity

Answer

Honeycomb appearance

Answer

Onion peel appearance

Answer

Double density

Question 10

Identify the surgical instrument based on its characteristics: a small, triangular blade used for precise incisions.

Accepted Answer

Blade no. 11

Answer

Blade no. 15

Answer

Blade no. 10

Answer

Blade no. 12

NEET-PG 2019

Anatomy

Biochemistry

Dermatology

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Pediatrics

Radiology

Surgery