NEET-PG 2013 Practice Questions

Q: Root value of the thoracodorsal nerve

C6, C7, C8. ***C6, C7, C8*** - The **thoracodorsal nerve**, also known as the middle subscapular nerve, originates from the **posterior cord of the brachial plexus**. - Its specific root values are **C6, C7, and C8**, which supply motor innervation to the **latissimus dorsi muscle** [1]. - This nerve is one of the three subscapular nerves arising from the posterior cord [1]. *C5, C6, C7* - While these roots contribute to the **posterior cord**, the thoracodorsal nerve specifically arises from **C6, C7, C8**. - **C5** primarily contributes to the **upper and middle trunk** and is more associated with nerves like the **suprascapular** and **axillary nerves**. *C6, T1* - These root values contribute to various nerves of the **brachial plexus**, but not specifically the thoracodorsal nerve. - **T1** contributes mainly to the **medial cord** and its branches like the **ulnar nerve**, not the posterior cord from which the thoracodorsal nerve arises. *T1, T2* - These are typical root values for **intercostal nerves** and contribute to the **sympathetic trunk**, not the **brachial plexus** or its branches like the thoracodorsal nerve. - The brachial plexus predominantly arises from **C5 to T1 spinal nerve roots**, and **T2** is not part of the brachial plexus.

Q: What maneuver is used to deliver the head of a baby during a breech delivery?

Prague maneuver. ***Prague maneuver*** - The **Prague maneuver** is used to deliver the aftercoming fetal head in breech delivery when specific traction on the shoulders is needed. - **Prague I (or Prague-Veit)**: Used when the fetal **back is anterior** - the operator's fingers hook over the shoulders while traction is applied. - **Prague II**: Used when the fetal **back is posterior** - less commonly performed. - This maneuver involves supporting the fetal body while applying traction to the shoulders to facilitate head delivery. *Pinard's maneuver* - **Pinard's maneuver** is used to assist with the delivery of the fetal **legs** in a **frank or complete breech** presentation, not the head. - This maneuver involves flexing the hip and knee to bring down a foot, aiding in the delivery of the lower extremities. *Lovset's maneuver* - **Lovset's maneuver** is used during a breech delivery to assist with the delivery of the **shoulders by rotating the fetal trunk**. - It involves rotating the baby's trunk 180 degrees to bring the posterior shoulder anterior under the pubic symphysis, allowing for easier delivery of both arms and shoulders. *Burns-Marshall method* - The **Burns-Marshall method** is another technique used to deliver the aftercoming head in breech delivery. - It involves allowing the fetal body to hang by its own weight until the **nape of the neck and hairline appear** at the vulva, then lifting the body in an arc towards the mother's abdomen to deliver the head by flexion. - While this is also used for head delivery, the **Prague maneuver** involves more direct manual traction and is the answer expected for this examination context.

Q: Bishop scoring is done for ?

Induction of labor assessment. ***Induction of labor assessment*** - The **Bishop score** is a pre-labor scoring system used to assess the ripeness of the cervix. - A higher score indicates a more **favorable cervix** for the successful **induction of labor**. *Exchange transfusion in newborns* - **Exchange transfusion** is primarily indicated for severe hyperbilirubinemia or hemolytic disease in newborns. - Its assessment is based on **bilirubin levels** and other clinical factors, not the Bishop score. *Newborn ventilation assessment* - **Newborn ventilation assessment** involves evaluating respiratory effort, heart rate, and oxygenation status, often using scores like the **Apgar score**. - The Bishop score is unrelated to neonatal respiratory function. *Newborn gestation assessment* - **Newborn gestation assessment** is typically performed using methods like the **New Ballard Score** or by reviewing prenatal ultrasound dating. - The Bishop score is used in *maternal* obstetric management, not directly for neonatal gestational age estimation.

Q: Non-sterile hypopyon is seen in ?

Fungal infection. ***Fungal infection*** - **Fungal keratitis** produces a **non-sterile hypopyon**, meaning the hypopyon contains actual fungal elements and organisms, not just inflammatory cells alone. - This is characteristically seen with **filamentous fungi** (Aspergillus, Fusarium) and yeast (Candida), which can directly invade the anterior chamber. - The hypopyon is typically **indolent, greyish-white, and does not shift with position** unlike bacterial hypopyon, and shows poor response to antibacterial therapy. - **Fungal culture and KOH mount** are diagnostic. *Pneumococcal infection* - **Bacterial keratitis** caused by *Streptococcus pneumoniae* produces a **sterile hypopyon** consisting purely of inflammatory cells (polymorphonuclear leukocytes) without organisms in the anterior chamber. - Presents with **acute onset, severe pain, and rapid progression** with a dense stromal infiltrate. - The hypopyon is **white, mobile, and shifts with head position**. *Pseudomonas aeruginosa infection* - **Pseudomonas keratitis** causes an aggressive infection with a **sterile hypopyon** due to intense inflammatory response. - Characterized by **rapidly progressive stromal necrosis** with a ground-glass appearance and greenish discharge. - Often associated with **contact lens wear** and can lead to corneal perforation within 24-48 hours. *Gonococcal conjunctivitis* - **Neisseria gonorrhoeae conjunctivitis** causes severe **hyperacute purulent conjunctivitis** with copious discharge. - Typically does **not cause hypopyon** unless there is secondary corneal ulceration leading to keratitis or endophthalmitis. - Primary manifestation is conjunctival inflammation, chemosis, and lid edema.

Q: On USG, a mass was found in the abdomen which was displacing the kidney laterally in a 1-year-old child. What is the most likely diagnosis?

Neuroblastoma. ***Neuroblastoma*** - A retroperitoneal mass displacing the kidney laterally in an infant is highly characteristic of **neuroblastoma**, which originates from neural crest cells in the adrenal gland or sympathetic ganglia. - The key finding is **extrarenal origin** - the mass pushes the kidney aside rather than arising from within it. - Most common extrarenal abdominal mass in children under 2 years. *Wilms' tumor* - This is an **intrarenal mass** that originates within the kidney parenchyma. - Wilms' tumor **expands and distorts the kidney** rather than displacing it laterally from outside. - Most common renal tumor in children (peak age 3-4 years), presenting with abdominal mass, hematuria, and hypertension. *Renal cell carcinoma* - Exceedingly **rare in a 1-year-old child** - primarily an adult malignancy (typically >40 years). - Would be an intrarenal mass, not an extrarenal mass displacing the kidney laterally. *All of the options* - Incorrect because the specific imaging finding of **lateral kidney displacement** indicates an extrarenal origin, which is pathognomonic for neuroblastoma, not the intrarenal tumors listed.

Q: Which anaesthetic belongs to the ester group?

Procaine. ***Procaine*** - **Procaine** is a classical **ester-type** local anesthetic, characterized by an ester linkage between the aromatic and amine parts of its chemical structure. - Ester-type local anesthetics are metabolized by **plasma pseudocholinesterase**, leading to a shorter duration of action compared to amides. *Benzocaine* - **Benzocaine** is also an ester local anesthetic, but it is typically used topically due to its poor water solubility and absorption. - While an ester, the question implies a common injectable agent, making procaine a more representative answer for the "ester group" in general anesthetic use. *Lignocaine* - **Lignocaine** (also known as lidocaine) is an **amide-type** local anesthetic, which can be identified by an amide linkage in its chemical structure. - Amide local anesthetics are primarily metabolized in the **liver** and generally have a longer duration of action than esters. *Propofol* - **Propofol** is a **short-acting intravenous general anesthetic** and is not classified as a local anesthetic or belonging to the ester group. - It works by potentiation of **GABA-A receptors** and is used for induction and maintenance of general anesthesia.

Q: In ophthalmology, if a patient is allergic to aminoesters, which local anesthetic can be safely used?

Prilocaine. **Local anesthetics are classified into two chemical groups: esters (aminoesters) and amides. Allergies to esters typically do not cross-react with amides.** ***Prilocaine*** - **Prilocaine** is an **amide-type local anesthetic**, and allergies to **aminoesters** typically do not cross-react with **amides**. - It is a safe alternative in patients with a known allergy to **ester-type local anesthetics**. *Cocaine* - **Cocaine** is an **ester-type local anesthetic**, sharing a similar chemical structure with **aminoesters**. - Patients allergic to **aminoesters** are likely to experience a **cross-reaction** with **cocaine**. *Procaine* - **Procaine** is a classic **ester-type local anesthetic** (an aminoester). - An allergy to aminoesters directly implies an allergy to **procaine** due to its chemical classification. *Tetracaine* - **Tetracaine** is also an **ester-type local anesthetic** (an aminoester). - It is contraindicated in patients with an allergy to **aminoesters** due to the high risk of **allergic reaction**.

Q: Which type of delusion is primarily associated with Cotard's syndrome?

Nihilistic delusions. ***Nihilistic delusions*** - **Cotard's syndrome** is characterized by beliefs of **non-existence**, such as the patient being dead, not existing, or having lost their organs, which are typical of **nihilistic delusions**. - These delusions can also extend to the belief that the world or parts of it no longer exist. *Persecutory delusions* - These involve the belief that one is being **harassed, tricked, spied upon, or conspired against**, which is not the primary feature of Cotard's syndrome. - While they can co-occur with other psychiatric conditions, **persecutory themes** are distinct from the non-existence themes of Cotard's. *Religious delusions* - These delusions focus on **religious or spiritual themes**, such as believing one is a prophet or has a special relationship with a deity. - They are not a core component of Cotard's syndrome, which centers on themes of **death and non-existence**. *Hypochondriacal delusions* - These involve a preoccupation with the belief that one has a **serious, undiagnosed medical condition**, despite medical reassurance. - While Cotard's syndrome can involve bodily concerns, the belief in **non-existence of organs** or death goes beyond typical hypochondriacal fears of illness.

Q: Commonest site of carcinoma tongue -

Lateral borders. ***Lateral borders*** - The **lateral borders** of the tongue are the most common site for squamous cell carcinoma due to chronic irritation from teeth, dental appliances, and exposure to carcinogens. - This area is subjected to considerable mechanical stress and chemical exposure, making it more susceptible to malignant transformation. *Apical* - While the apex (tip) of the tongue can be affected, it is **less common** compared to the lateral borders. - Tumors in this location may present earlier due to their prominent position, but incidence rates are lower. *Dorsum* - The **dorsum** (top surface) of the tongue is covered by papillae which provide some protective barrier, making it a **less frequent site** for carcinoma. - Carcinomas on the dorsum are often associated with other risk factors like syphilis or immunosuppression. *Posterior 1/3* - Carcinomas of the **posterior one-third** (base of the tongue) are often associated with **Human Papillomavirus (HPV)** infection. - These are typically harder to detect early due to their location and may present with different symptoms such as dysphagia or referred otalgia, but they are not the most common overall site.

Question 1

Root value of the thoracodorsal nerve

Accepted Answer

C6, C7, C8

Answer

T1, T2

Answer

C5, C6, C7

Answer

C6, T1

Question 2

Which of the following statements about acute retropharyngeal abscess is true?

Accepted Answer

Acute retropharyngeal abscess is often due to lymphadenitis.

Answer

Treatment often involves incision and drainage.

Answer

Acute retropharyngeal abscess is common in adults.

Answer

Swelling typically occurs unilaterally.

Question 3

What maneuver is used to deliver the head of a baby during a breech delivery?

Accepted Answer

Prague maneuver

Answer

Pinards maneuver

Answer

Lovsets maneuver

Answer

Burn Marshall method

Question 4

Bishop scoring is done for ?

Accepted Answer

Induction of labor assessment

Answer

Exchange transfusion in newborns

Answer

Newborn ventilation assessment

Answer

Newborn gestation assessment

Question 5

Non-sterile hypopyon is seen in ?

Accepted Answer

Fungal infection

Answer

Pneumococcal infection

Answer

Pseudomonas aeruginosa infection

Answer

Gonococcal conjunctivitis

Question 6

On USG, a mass was found in the abdomen which was displacing the kidney laterally in a 1-year-old child. What is the most likely diagnosis?

Accepted Answer

Neuroblastoma

Answer

Wilms' tumor

Answer

Renal cell carcinoma

Answer

All of the options

Question 7

Which anaesthetic belongs to the ester group?

Accepted Answer

Procaine

Answer

Lignocaine

Answer

Propofol

Answer

Benzocaine

Question 8

In ophthalmology, if a patient is allergic to aminoesters, which local anesthetic can be safely used?

Accepted Answer

Prilocaine

Answer

Procaine

Answer

Cocaine

Answer

Tetracaine

Question 9

Which type of delusion is primarily associated with Cotard's syndrome?

Accepted Answer

Nihilistic delusions

Answer

Persecutory delusions

Answer

Religious delusions

Answer

Hypochondriacal delusions

Question 10

Commonest site of carcinoma tongue -

Accepted Answer

Lateral borders

Answer

Apical

Answer

Dorsum

Answer

Posterior 1/3

NEET-PG 2013

Anatomy

ENT

Obstetrics and Gynecology

Ophthalmology

Pediatrics

Pharmacology

Psychiatry

Surgery