NEET-PG 2015 Practice Questions

Q: What is the shape of caecum in the newborn?

Conical. ***Conical*** - In newborns, the **caecum** is typically described as having a **conical** shape. - This shape gradually changes as the individual grows and develops. *Ovoid* - The ovoid shape is more characteristic of the adult **caecum**, which tends to be broader and less pointed. - This shape is not typically observed in newborns. *Globular* - A globular shape implies a more rounded and spherical form, which is not accurate for the newborn **caecum**. - This term is sometimes used to describe the general appearance of some organs but not the specific shape of the neonatal caecum. *Trapezoid* - A trapezoid shape is defined by four sides with at least one pair of parallel sides, which does not accurately describe the normal anatomical configuration of the **caecum** at any age. - This shape is completely inconsistent with the morphology of the **caecum**.

Q: In which of the following causes of oral ulcers are auto-antibodies not seen?

Behcet disease. ***Behcet disease*** - Behcet disease is characterized by **recurrent oral and genital ulcers**, along with **eye lesions**, but it does not involve autoantibody formation. - The underlying mechanism is believed to be **immune dysregulation** rather than autoimmunity, making it distinctive. *Celiac disease* - In Celiac disease, **anti-tissue transglutaminase** antibodies are present, which are involved in the body's response to gluten. - Oral ulcers associated with Celiac are often related to nutrient deficiencies, particularly **iron and folate**. *SLE* - Systemic lupus erythematosus (SLE) is marked by various autoantibodies, including **antinuclear antibodies (ANA)** [1]. - Oral ulcers can occur in SLE, and these are a manifestation of its **autoimmune nature** [1]. *Pemphigus* - Pemphigus is characterized by the presence of **autoantibodies** against desmogleins, leading to **blistering** and ulcer formation. - Oral ulcers are common in this condition due to the **disruption of mucosal integrity** caused by the autoimmune response. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, p. 226.

Q: CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is being investigated for the treatment of which malignancy?

Acute Lymphoblastic Leukemia. ***Acute Lymphoblastic Leukemia*** - **CAR T-cell therapy** has shown remarkable success, particularly in treating refractory or relapsed **B-cell acute lymphoblastic leukemia (ALL)** in children and young adults. - The therapy targets the **CD19 antigen** found on malignant B-cells, leading to their destruction by engineered T-cells. *Renal Cell Carcinoma* - While immune therapies are used for **renal cell carcinoma (RCC)**, traditional CAR T-cell therapy targeting specific antigens has not yet achieved widespread clinical success for this solid tumor. - RCC often presents with a **heterogeneous antigenic landscape**, making it challenging for single-target CAR T-cells. *Pancreatic Cancer* - **Pancreatic cancer** is a challenging malignancy due to its dense stroma and immunosuppressive microenvironment, which limits T-cell infiltration and efficacy. - CAR T-cell therapy for pancreatic cancer is still largely in **early-stage clinical trials**, facing significant hurdles in solid tumor treatment. *Glioblastoma Multiforme* - **Glioblastoma multiforme (GBM)** is an aggressive brain tumor with unique challenges for CAR T-cell therapy, including the **blood-brain barrier** and tumor heterogeneity. - Research is ongoing to develop CAR T-cells that can effectively target GBM, often using **regional delivery methods** or targeting multiple antigens.

Q: 4 year old child presented to the clinic with a history of fall on outstretched hand. Radiographs revealed a broken anterior cortex with an intact posterior cortex of the radius with an exaggerated bowing of the radius. The fracture sustained is known as -

Greenstick fracture. ***Greenstick fracture*** - This fracture type involves a **broken anterior cortex** but an **intact posterior cortex**, leading to an exaggerated bowing of the bone, characteristic of a greenstick fracture. - It occurs predominantly in **children** due to their softer, more flexible bones, which tend to bend rather than fully break when subjected to force like a fall on an outstretched hand. *Torus Fracture* - A torus fracture, or **buckle fracture**, involves compression of the bone leading to a bulging or buckling of the cortex, usually on one side, without a complete break in the bone. - While it occurs in children, it presents as a compression injury and not with a broken cortex and intact posterior cortex with bowing. *Galleazi Fracture* - A Galleazi fracture is a fracture of the **distal radius** with **dislocation of the distal radioulnar joint (DRUJ)**. - This fracture pattern involves two bones and two distinct injuries (fracture and dislocation), which is fundamentally different from the described single-bone incomplete fracture. *Monteggia Fracture Dislocation* - A Monteggia fracture involves a fracture of the **proximal ulna** with **dislocation of the radial head** at the elbow. - This injury also involves two bones and two distinct components (fracture and dislocation) and affects a different anatomical location (ulna and elbow) than described.

Q: Which of the following testicular tumours is NOT a germ cell tumour?

Sertoli cell tumour. ***Sertoli cell tumour*** - This is a **sex-cord stromal tumour**, not a germ cell tumour, hence it does not arise from germ cells. - Sertoli cell tumours typically present with abnormal hormone levels, but not the classic germ cell tumour markers. *Choriocarcinoma* - This is a **germ cell tumour** that is aggressive and associated with high levels of **beta-hCG** [1][2]. - It derives from the placental tissue and is characterized by **trophoblastic differentiation** [2]. *Seminoma* - A well-known type of **germ cell tumour**, often presenting as a **homogeneous testicular mass** [1]. - It usually manifests with elevated **LDH** and is associated with a more favorable prognosis compared to non-seminomatous germ cell tumours [1]. *Teratoma* - Teratomas are also classified as **germ cell tumours**, containing differentiated tissues like hair, muscle, and bone [1][2]. - They can be **mature** (benign) or **immature** (malignant), and are typically found in younger patients [2][3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 979-980. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 982-983. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 512-513.

Q: A 45-day-old infant presents with seizures. Examination reveals he is icteric, has bulging fontanelles, and exhibits opisthotonic posture. Which of the following treatments is NOT indicated?

Chlorpromazine. ***Chlorpromazine*** - Chlorpromazine is an **antipsychotic medication** and is **contraindicated** in infants, especially in the presence of seizures and central nervous system (CNS) dysfunction, due to its potential to **lower the seizure threshold** and cause severe extrapyramidal symptoms. - Its mechanism of action via **dopamine receptor blockade** is not relevant for treating bilirubin encephalopathy or its symptoms. *Phototherapy* - Phototherapy is a primary treatment for **neonatal jaundice** to reduce unconjugated bilirubin levels and prevent neurotoxicity. - While the infant's condition suggests severe hyperbilirubinemia with complications, phototherapy would still be indicated as an initial step or adjunct to further interventions, especially if the bilirubin levels are still rising. *Exchange Transfusion* - Exchange transfusion is a **definitive treatment** for severe hyperbilirubinemia, especially when there are signs of **acute bilirubin encephalopathy (kernicterus)**, as suggested by seizures, bulging fontanelles, and opisthotonus. - It rapidly removes bilirubin from the blood and is crucial to prevent further neurological damage in such critical cases. *Phenobarbital* - Phenobarbital is an **anticonvulsant** used to manage seizures, which are a prominent symptom in this infant. - It can also help to **induce hepatic enzymes** involved in bilirubin metabolism, thereby potentially aiding in the reduction of bilirubin levels in cases of severe hyperbilirubinemia, though its primary role here would be seizure control.

Q: The role of human placental lactogen is :

Supports fetal growth and development.. ***Supports fetal growth and development.*** - Human placental lactogen (hPL) acts as a **growth hormone** for the fetus, primarily by altering maternal metabolism to favor fetal nutrient supply. - It increases **maternal insulin resistance**, leading to higher maternal glucose and free fatty acids, which are then shunted to the fetus, supporting its growth and development. *Stimulate milk production* - **Prolactin**, secreted by the anterior pituitary, is the primary hormone responsible for stimulating milk production (lactogenesis). - While hPL has some structural similarity to growth hormone and prolactin, its primary role is not to directly stimulate milk production during pregnancy; rather, it prepares the breasts. *Promotes growth of breast for lactation.* - hPL, along with **estrogen** and **progesterone**, contributes to the **mammary gland development** during pregnancy, preparing the breasts for lactation. - However, its direct role is more about **mammary gland proliferation and differentiation** rather than initiation of milk production. *Provide fetal nutrition by antagonizing the action of insulin in maternal circulation, breakdown of fats and proteins and transport of fatty acids and amino acids from maternal to fetal circulation.* - This is a highly detailed and largely accurate description of *how* hPL supports fetal growth and development, making it a mechanism rather than the primary, concise role. - It describes the metabolic changes induced by hPL, which ultimately lead to the **support of fetal growth and development**.

Q: Which of the following urethral anomalies is the most common?

Hypospadias. ***Hypospadias*** - **Hypospadias** is the most common urethral anomaly, occurring when the **urethral opening** is located on the underside of the penis rather than at the tip. - Its prevalence ranges from approximately **1 in 150 to 1 in 300 live male births**, making it significantly more frequent than other urethral malformations. *Pinhole meatus* - A **pinhole meatus** refers to an abnormally small urethral opening. - While it can be a component or consequence of other anomalies, it is **less common as a standalone finding** compared to hypospadias. *Epispadias* - **Epispadias** is a rare anomaly where the urethra opens on the **dorsal (top) aspect** of the penis. - Its incidence is much lower than hypospadias, estimated at **1 in 100,000 to 1 in 500,000 live births**. *Stricture of the urethra* - A **urethral stricture** is a narrowing of the urethra, often due to **scar tissue** from inflammation, trauma, or infection. - Although it can present at any age, it is more commonly an **acquired condition** rather than a congenital anomaly like hypospadias or epispadias.

Q: Transplanted kidney is relocated to which region in the recipient's body?

Retroperitoneal region. ***Retroperitoneal region*** - The transplanted kidney is typically placed in the **iliac fossa** within the **retroperitoneal space** of the recipient [2]. - This location provides adequate space and a convenient site for connecting the transplant's renal artery and vein to the recipient's **iliac vessels**, and the ureter to the bladder [2]. *Lumbar region* - The native kidneys are located in the lumbar region, but a transplanted kidney is not usually placed there due to the complexity of vascular anastomoses and limited access [1]. - Positioning in the lumbar region would require more extensive surgical dissection and potentially longer vascular connections. *Epigastrium* - The epigastrium is the upper central part of the abdomen, above the navel. - This location is not suitable for kidney transplantation due to anatomical constraints and the lack of readily accessible large blood vessels for connection. *Beside the dysfunctional Kidney* - The dysfunctional native kidneys are usually left in place unless they are causing severe complications like uncontrolled hypertension or infection. - Placing the transplanted kidney directly beside the native dysfunctional kidney is not the standard procedure due to space limitations and to avoid operating near potentially diseased native organs.

Q: Which of the following stoma is formed in Hartmann's procedure?

End Colostomy. ***End Colostomy*** - Hartmann's procedure involves resection of a diseased segment of the **colon**, typically the sigmoid colon, with the creation of a **proximal colostomy** and closure of the distal rectal stump. - The proximal end of the colon is brought out through the abdominal wall to form a **stoma**, which is a type of end colostomy. *End Ileostomy* - An end ileostomy involves bringing the **ileum** (small intestine) to the abdominal wall, which is not part of the standard Hartmann's procedure. - This is typically performed after a **total colectomy** or in cases of severe Crohn's disease affecting the colon. *Loop Ileostomy* - A loop ileostomy involves bringing a **loop of the ileum** to the surface of the abdomen, creating two openings that are then joined together. - This is often a **temporary diversion** and does not involve resection of the colon in the same manner as Hartmann's procedure. *Caecostomy* - A caecostomy is a stoma created from the **cecum**, the beginning of the large intestine. - This is typically performed for various reasons such as **bowel decompression** or management of fecal incontinence, and is not a component of Hartmann's procedure.

Question 1

What is the shape of caecum in the newborn?

Accepted Answer

Conical

Answer

Ovoid

Answer

Trapezoid

Answer

Globular

Question 2

In which of the following causes of oral ulcers are auto-antibodies not seen?

Accepted Answer

Behcet disease

Answer

SLE

Answer

Pemphigus

Answer

Celiac disease

Question 3

CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is being investigated for the treatment of which malignancy?

Accepted Answer

Acute Lymphoblastic Leukemia

Answer

Renal Cell Carcinoma

Answer

Pancreatic Cancer

Answer

Glioblastoma Multiforme

Question 4

4 year old child presented to the clinic with a history of fall on outstretched hand. Radiographs revealed a broken anterior cortex with an intact posterior cortex of the radius with an exaggerated bowing of the radius. The fracture sustained is known as -

Accepted Answer

Greenstick fracture

Answer

Torus Fracture

Answer

Galleazi Fracture

Answer

Monteggia Fracture Dislocation

Question 5

Which of the following testicular tumours is NOT a germ cell tumour?

Accepted Answer

Sertoli cell tumour

Answer

Seminoma

Answer

Teratoma

Answer

Choriocarcinoma

Question 6

A 45-day-old infant presents with seizures. Examination reveals he is icteric, has bulging fontanelles, and exhibits opisthotonic posture. Which of the following treatments is NOT indicated?

Accepted Answer

Chlorpromazine

Answer

Phenobarbital

Answer

Phototherapy

Answer

Exchange Transfusion

Question 7

The role of human placental lactogen is :

Accepted Answer

Supports fetal growth and development.

Answer

Stimulate milk production

Answer

Promotes growth of breast for lactation.

Answer

Provide fetal nutrition by antagonizing the action of insulin in maternal circulation, breakdown of fats and proteins and transport of fatty acids and amino acids from maternal to fetal circulation.

Question 8

Which of the following urethral anomalies is the most common?

Accepted Answer

Hypospadias

Answer

Pinhole meatus

Answer

Epispadias

Answer

Stricture of the urethra

Question 9

Transplanted kidney is relocated to which region in the recipient's body?

Accepted Answer

Retroperitoneal region

Answer

Lumbar region

Answer

Epigastrium

Answer

Beside the dysfunctional kidney

Question 10

Which of the following stoma is formed in Hartmann's procedure?

Accepted Answer

End Colostomy

Answer

End Ileostomy

Answer

Loop Ileostomy

Answer

Caecostomy

NEET-PG 2015

Anatomy

Dental

Internal Medicine

Orthopaedics

Pathology

Pediatrics

Physiology

Surgery