NEET-PG 2013 Practice Questions

Q: Which muscle will be paralyzed when the radial nerve is injured just below the spiral groove?

Extensor Carpi Radialis Brevis. Extensor Carpi Radialis Brevis - The radial nerve travels in the spiral groove of the humerus and gives off branches in a specific sequence. - Proximal to the spiral groove: Branches to triceps and anconeus - Within/at the spiral groove: Branches to brachioradialis and extensor carpi radialis longus (ECRL) - Just distal to the spiral groove: Branch to extensor carpi radialis brevis (ECRB) [1] - this is the first branch after exiting the spiral groove - More distally: The nerve divides into superficial and deep branches (posterior interosseous nerve) [1] - An injury just below the spiral groove would paralyze ECRB while sparing muscles innervated proximal to or within the groove (triceps, anconeus, brachioradialis, ECRL). Supinator - The supinator is innervated by the deep branch of the radial nerve (posterior interosseous nerve), which branches off more distally in the proximal forearm. - This muscle would only be affected by injuries distal to the bifurcation of the radial nerve into superficial and deep branches, not by an injury just below the spiral groove. Extensor Digitorum - The extensor digitorum is supplied by the posterior interosseous nerve, which is a continuation of the deep branch [1]. - This innervation occurs significantly distal to the spiral groove in the posterior forearm compartment. - It would be affected by posterior interosseous nerve injuries, not by lesions just below the spiral groove. Abductor Pollicis Longus - The abductor pollicis longus is innervated by the posterior interosseous nerve in the distal forearm [1]. - This is the most distal of all the options and would only be affected by posterior interosseous nerve palsy, not by radial nerve injury at the spiral groove level [1].

Q: Which muscles are known as 'Triceps surae'?

Gastro-soleus. ***Gastro-soleus*** - The **Triceps surae** refers to the two heads of the **gastrocnemius muscle** and the **soleus muscle**, which together form the powerful calf muscle. - These three muscles converge to form the **Achilles tendon** (calcaneal tendon) and are prime movers for **plantarflexion** of the ankle. *Popliteus* - The popliteus muscle is located behind the knee joint and acts to **unlock the knee** during flexion. - It does not contribute to the bulk of the calf and is not part of the Triceps surae group. *Extensor hallucis longus* - This muscle is located in the **anterior compartment** of the leg and is responsible for **dorsiflexion** of the ankle and extension of the great toe. - It is an antagonist to the Triceps surae, which primarily performs plantarflexion. *Extensor digitorum longus* - The extensor digitorum longus is also in the **anterior compartment** of the leg, responsible for **dorsiflexion** of the ankle and extension of the lateral four toes. - It is functionally opposite to the actions of the Triceps surae and in a different muscle compartment.

Q: Type of collagen found in space of Disse in liver is -

Collagen III & IV. ***Collagen III & IV*** - The **space of Disse** in the liver contains a delicate extracellular matrix predominantly composed of **collagen type III (reticular fibers)**, which provides structural support, and **collagen type IV**, a major component of basement membranes. - This specific collagen composition is crucial for regulating the exchange of solutes between **sinusoidal blood** and **hepatocytes**, as well as for the functional integrity of the liver [1]. *Collagen I & II* - **Collagen type I** is the most abundant collagen in the human body, found in connective tissues like **bone, skin, tendons, and ligaments**, but is not primary in the space of Disse. - **Collagen type II** is characteristic of **hyaline cartilage** and vitreous humor, and is not a significant component of the liver's extracellular matrix in the space of Disse. *Collagen II* - As mentioned, **collagen type II** is primarily found in **cartilage** and vitreous humor, which are distinct from the architectural requirements of the liver sinusoidal space. - Its presence in the space of Disse would not provide the necessary structural flexibility and support for the metabolic functions of the liver. *Collagen II & V* - While **collagen type V** is a minor fibrillar collagen that associates with collagen type I in many tissues, it is not a primary component of the space of Disse. - **Collagen type II** is, again, largely confined to cartilaginous structures, making this an unlikely combination for the liver microenvironment.

Q: What is the primary enzymatic source of ammonia production in urine?

Glutaminase. ***Glutaminase*** - This enzyme catalyzes the **hydrolysis of glutamine** located predominantly in the cells of the **renal tubules**, producing **ammonia** (NH3) and glutamate. - This process is crucial for **acid-base balance**, as the ammonia can bind with excess hydrogen ions to form ammonium (NH4+), which is then excreted in the urine. *Urease* - This enzyme breaks down **urea into ammonia and carbon dioxide**, primarily produced by **bacteria**, not human renal cells, and contributes to ammonia in urine in cases of **urinary tract infections**. - While it produces ammonia, it is not the primary enzymatic source within the healthy human kidney for **acid-base regulation**. *Glutamate dehydrogenase* - This enzyme converts **glutamate into alpha-ketoglutarate and ammonia**, but its contribution to urinary ammonia production is secondary to glutaminase in the kidney. - Its primary role is in **oxidative deamination** and the interconversion of glutamate and alpha-ketoglutarate, acting in both mitochondrial and cytosolic compartments. *Arginase* - This enzyme is involved in the **urea cycle**, converting **arginine into urea and ornithine** in the liver. - While it is important for the detoxification of ammonia by converting it into urea for excretion, it **does not produce ammonia** in the kidney for urinary excretion.

Q: Catecholamines are synthesized from?

Tyrosine. ***Tyrosine*** - **Tyrosine** is the direct precursor amino acid for the synthesis of all **catecholamines**, including **dopamine**, **norepinephrine**, and **epinephrine**. - The synthesis pathway begins with the conversion of tyrosine to **L-DOPA** by tyrosine hydroxylase, followed by subsequent enzymatic steps. *Methionine* - **Methionine** is an essential amino acid primarily involved in **protein synthesis** and as a precursor for S-adenosylmethionine (SAM), a key methyl donor in various metabolic reactions. - It is not a direct precursor for the synthesis of **catecholamines**. *Histidine* - **Histidine** is the precursor for the synthesis of **histamine**, a neurotransmitter and inflammatory mediator. - It is not involved in the biosynthesis pathway of **catecholamines**. *Tryptophan* - **Tryptophan** is the precursor for the synthesis of **serotonin** and **melatonin**, important neurotransmitters and hormones. - It does not play a role in the synthesis of **catecholamines**.

Q: Reducing equivalents produced in glycolysis are transported from cytosol to mitochondria by ?

Malate-aspartate shuttle. ***Malate shuttle*** - The **malate-aspartate shuttle** is a primary mechanism for transporting **NADH reducing equivalents** from the cytosol to the mitochondrial matrix for **oxidative phosphorylation**. - It involves a series of **enzymes and transporters** that indirectly move electrons from NADH by converting **oxaloacetate to malate** in the cytosol, which then enters the mitochondria. *Carnitine* - **Carnitine** is primarily involved in the transport of **long-chain fatty acids** into the mitochondrial matrix for **beta-oxidation**. - It is not directly involved in the shuttle of NADH reducing equivalents generated during glycolysis. *Creatine* - **Creatine** and its phosphorylated form, **phosphocreatine**, are crucial for **energy buffering and transport** in tissues with high and fluctuating energy demands, like muscle and brain. - The creatine-phosphocreatine shuttle facilitates the rapid regeneration of ATP, but it is not involved in transporting glycolytic reducing equivalents. *Glutamate shuttle* - While glutamate and aspartate are components of the **malate-aspartate shuttle**, there isn't a standalone "glutamate shuttle" for transporting glycolytic reducing equivalents. - The **glutamate-aspartate transaminase** is an enzyme within the malate-aspartate shuttle, converting oxaloacetate to aspartate and alpha-ketoglutarate to glutamate from the matrix to the cytosol.

Q: According to WHO/ISN classification, which class of lupus nephritis shows a membranous pattern in SLE?

Membranous pattern. ***Membranous pattern*** - This corresponds to **Class V lupus nephritis** in the WHO/ISN classification, characterized by widespread immune complex deposition along the **glomerular basement membrane (GBM)**. - The subepithelial immune deposits lead to GBM thickening, creating the characteristic membranous pattern on light microscopy. - This pattern resembles idiopathic membranous nephropathy but occurs in the context of SLE. *Mesangial pattern involvement* - This refers to **Class I (minimal mesangial LN)** or **Class II (mesangial proliferative LN)**, where immune deposits are primarily confined to the mesangium. - There is minimal or no involvement of the glomerular capillary walls, distinguishing it from the membranous pattern. *Diffuse proliferative pattern* - This is **Class IV lupus nephritis**, the most severe form characterized by widespread **endocapillary and/or extracapillary proliferation** involving ≥50% of glomeruli. - The primary feature is cellular proliferation (mesangial, endocapillary, epithelial crescents), not the subepithelial immune deposits typical of membranous pattern. *Focal proliferative pattern* - This corresponds to **Class III lupus nephritis**, involving **endocapillary or extracapillary proliferation** in <50% of glomeruli. - Distinguished by focal (not diffuse) involvement and active proliferation rather than the membranous pattern seen in Class V.

Q: What is the mechanism of metabolism for alcohol, aspirin, and phenytoin at high doses?

Zero order kinetics. ***Zero order kinetics*** - This mechanism occurs when the **metabolic enzymes become saturated at high drug concentrations**, leading to a constant amount (not a constant percentage) of drug being eliminated per unit time. - Alcohol, aspirin, and phenytoin are examples of drugs that exhibit **saturable metabolism**, transitioning from first-order to zero-order kinetics at higher doses. *First pass kinetics* - This describes the **metabolism of a drug by the liver or gut wall enzymes before it reaches systemic circulation** after oral administration. - While relevant to the oral bioavailability of these drugs, it does not describe the specific mechanism of elimination at high doses. *First order kinetics* - In this mechanism, a **constant fraction or percentage of the drug is eliminated per unit of time**, meaning the rate of elimination is directly proportional to the drug concentration. - Most drugs follow first-order kinetics at therapeutic doses because metabolizing enzymes are not saturated. *Second order kinetics* - This is a **less common pharmacokinetic model** where the rate of elimination is proportional to the square of the drug concentration or involves two reactants. - It does not typically describe the common elimination patterns of most drugs, including alcohol, aspirin, and phenytoin.

Q: Which hormone is secreted by the "Delta cells" of the stomach?

Somatostatin. ***Somatostatin*** - **Delta cells (D cells)** in the stomach and pancreas secrete **somatostatin**, a potent inhibitory hormone. - Somatostatin **inhibits the release of gastrin**, histamine, secretin, cholecystokinin, and gastric acid secretion, acting as a "universal off switch." *Cholecystokinin* - **Cholecystokinin (CCK)** is primarily secreted by **I cells** in the duodenum and jejunum. - Its main functions include stimulating gallbladder contraction and pancreatic enzyme secretion. *Gastrin-releasing peptide* - **Gastrin-releasing peptide (GRP)**, also known as **bombesin**, is a neuropeptide released from **enteric neurons**. - It stimulates the release of **gastrin** from G cells. *Secretin* - **Secretin** is secreted by **S cells** in the duodenum in response to acidic chyme entering the small intestine. - Its primary role is to stimulate the pancreas to release **bicarbonate-rich fluid** to neutralize gastric acid.

Q: What physiological mechanism leads to an increase in cardiac output?

Increased myocardial contractility. ***Increased myocardial contractility*** - **Increased myocardial contractility** directly leads to a greater **stroke volume** (the amount of blood pumped with each beat), thus increasing cardiac output (Cardiac Output = Stroke Volume × Heart Rate). - This can be stimulated by factors such as **sympathetic nervous system activation** or positive inotropic agents. *Inhalation* - While inhalation can temporarily affect venous return and intrathoracic pressure, it does not directly or consistently lead to a sustained increase in **cardiac output**. - Its primary effect is on **respiration**, not cardiac performance. *Increased parasympathetic activity* - Increased parasympathetic activity, primarily via the **vagus nerve**, acts to **decrease heart rate** and myocardial contractility. - This effect would typically **reduce cardiac output**, not increase it. *Transitioning from a supine to a standing position* - Transitioning to a standing position usually causes a **temporary decrease in venous return** and a brief drop in cardiac output as blood pools in the lower extremities. - The body then compensates by increasing heart rate and peripheral vascular resistance to maintain blood pressure, but the initial effect on cardiac output is generally a transient decrease.

Question 1

Which muscle will be paralyzed when the radial nerve is injured just below the spiral groove?

Accepted Answer

Extensor Carpi Radialis Brevis

Answer

Extensor Digitorum

Answer

Supinator

Answer

Abductor Pollicis Longus

Question 2

Which muscles are known as 'Triceps surae'?

Accepted Answer

Gastro-soleus

Answer

Popliteus

Answer

Extensor hallucis longus

Answer

Extensor digitorum longus

Question 3

Type of collagen found in space of Disse in liver is -

Accepted Answer

Collagen III & IV

Answer

Collagen I & II

Answer

Collagen II

Answer

Collagen II & V

Question 4

What is the primary enzymatic source of ammonia production in urine?

Accepted Answer

Glutaminase

Answer

Urease

Answer

Glutamate dehydrogenase

Answer

Arginase

Question 5

Catecholamines are synthesized from?

Accepted Answer

Tyrosine

Answer

Histidine

Answer

Methionine

Answer

Tryptophan

Question 6

Reducing equivalents produced in glycolysis are transported from cytosol to mitochondria by ?

Accepted Answer

Malate-aspartate shuttle

Answer

Carnitine

Answer

Creatine

Answer

Glutamate shuttle

Question 7

According to WHO/ISN classification, which class of lupus nephritis shows a membranous pattern in SLE?

Accepted Answer

Membranous pattern

Answer

Diffuse proliferative pattern

Answer

Mesangial pattern involvement

Answer

Focal proliferative pattern

Question 8

What is the mechanism of metabolism for alcohol, aspirin, and phenytoin at high doses?

Accepted Answer

Zero order kinetics

Answer

First pass kinetics

Answer

First order kinetics

Answer

Second order kinetics

Question 9

Which hormone is secreted by the "Delta cells" of the stomach?

Accepted Answer

Somatostatin

Answer

Cholecystokinin

Answer

Gastrin-releasing peptide

Answer

Secretin

Question 10

What physiological mechanism leads to an increase in cardiac output?

Accepted Answer

Increased myocardial contractility

Answer

Inhalation

Answer

Increased parasympathetic activity

Answer

Transitioning from a supine to a standing position

NEET-PG 2013

Anatomy

Biochemistry

Pathology

Pharmacology

Physiology