True about spinal cord | PGI Nov 2017 Preparations MCQ

True about spinal cord: 

A. in adults spinal cord ends at lower border of L1 vertebra 
B. in newborn may extend up to L3 
C. Cauda equina extends from lumbar vertebra to coccyx 
D. In embryonic period cord extends up to coccyx 
E. It has same diameter all throughout the length.

Answer. A. In adult spinal cord ends at lower border of L1; (B) In newborn may extend up to L3; (C) Cauda equina extends from lumbar vertebra to coccyx; (D) In embryonic period cord extends up to coccyx.

• Spinal cord extends from the level of upper border of atlas to the lower border of L1 or upper border of L2 vertebra .it is about 45cm long

• It has 31 pairs of spinal nerves.

• Below the lower end of spinal cord the roots form a bundle known as cauda equina

• The spinal cord first extends throughout the length of vertebral canal. Subsequently, recession of spinal cord occurs so that at full term lower end of spinal cord is at level of L3 vertebra.

Adult lower end of spinal cord is at level of L1 vertebra

III cranial nerve supplies | PGI Nov 2017 Preparations MCQ

III cranial nerve supplies: 

A. Superior oblique 
B. Inferior oblique
C. Medial rectus 
D. Superior rectus 
E. Lateral rectus

Answer. B. Inferior oblique ; (C) Medial rectus ; (D) Superior rectus

• IIIrd cranial nerve supplies:

— Medical rectus

— Inferior rectus

— Inferior oblique

— Superior oblique — 4th Nv

— Lateral rectus      — 6th Nv. 

Functions of basal ganglia | PGI Nov 2017 Preparations MCQ

Functions of basal ganglia include 

A. Planning and voluntary movements 
B. Sensory integration 
C. Short term memory 
D. Coordination of motor functions 
E. Pain perception

Answer. A. Planning and voluntary movements

• Functions of basal Ganglia

— Planning and programming of movements.

— Subconscious execution of learned patterns of movement

— Cognitive control of sequences of motor patterns

• Co-ordination of motor functions — by cerebellum

• Short term memory - hippocampus

• Sensory relay station — thalamus

• Pain perception — free nerve endings.

Blood supply of lungs | PGI Nov 2017 Preparations MCQ

Blood supply of lungs are

A. Pulmonary artery 
B. Pulmonary vein 
C. Bronchial artery 
D. Intercostal artery 
E. Internal thoracic artery

Answer. A. Pulmonary artery ; (B) Pulmonary vein ; (C) Bronchial artery :

• Blood supply of lungs

— Bronchial arteries-they are branches of descending aorta, supplies bronchi and visceral pleura

— Pulmonary arteries

— Pulmonary veins

• The intercostal arteries (large single posterior and two smaller anterior) supplies skin, muscles of chest wall and parietal pleura

• Internal thoracic A is a branch of 1st part of subclavian A supplies anterior wall of the body form the clavicle to umbilicus.

Draining channels of cavernous sinus | PGI Nov 2017 Preparations MCQ

Which of the following are draining channels of cavernous sinus

A. Inferior petrosal sinus 
B. Inferior opthalmic vein 
C. Sphenoparietal sinus 
D. Middle cerebral vein 
E. Superior ophthalmic vein


Answer. A. Inferior petrosal sinus ; (E) Superior ophthalmic vein.

The draining channels (communications) of cavernous sinuses are

(a) Into transverse sinus through the superior petrosal sinus.

(b) Into the internal jugular vein through the inferior petrosal sinus and through a plexus around the internal carotid artery

(c) Into pterygoid plexus of veins through the emissary veins.

(d) Into facial vein through superior ophthalmic vein.

(e) The rt. and lt cavernous sinuses communicate with each other through the ant, and post. inter

cavernous sinuses and through basilar plexus of veins.

THE TRIBUTARIES (Incoming channels)

A. From orbit                                           :Superior opthalmic and central vein of retina

B. From Brain                                         :Superficial middle cerebral V, inferior cerebral V

C. From meninges                  :Sphenoparietal sinus, the frontal trunk of middle meningeal V may drain

into pterygoid plexus or spheno-parietal or cavernous sinus. 

Arterial supply to ACL | PGI Nov 2017 Preparations MCQ

Which of the following arteries gives arterial supply to ACL? 

A. Circumflex fibular artery 
B. Descending genicular artery 
C. Superior genicular artery 
D. Middle genicular artery 
E. None of the above

Answer. D. (Middle genicular artery)

• Middle genicular artery is a branch of popliteal artery and supplies cruciate ligaments and synovial membrane of the knee joint. It reaches the interior of the knee by piercing the oblique popliteal ligament of the knee.

• Cruciate ligaments are supplied by the middle genicular nerves, branches from the tibial nerve.

• Anterior cruciate ligament (ACL) is attached to the anterior aspect of the tibia and runs backwards, upwards and laterally to reach the

lateral femoral condyle, where it gets attached.

• ACL prevents excessive anterior movement of the tibia on the femur. If it is torn (e.g., terrible triad) anterior drawer test becomes positive.

• Descending genicular artery is a branch of femoral artery and contributes to the anastomosis around the knee joint. ment.

• This coronary ligament on the medial side fixes the medial meniscus to the capsule as well as to the tibia.

• The relatively fixity of medial meniscus leads to increased incidence of medial

meniscal injuries, as compared to the lateral.

• The lateral meniscus is protected by popliteus, which pulls it backwards, and avoids its crushing between articular surface.

Ligament of Humphrey (Anterior Menisco-Femoral Ligament) — lies anterior to the PCL and attaches on the anterior aspect of PCL and runs upto the medial femoral condyle.

• Ligament of Wrisberg (Posterior Menisco-Femoral Ligament) — lies posterior to the PCL and attaches on to the posterior aspect of PCL and runs upto the medial femoral condyle

• Fibular head artery is the circumflex fibular branch given by the posterior tibial artery, which also contributes towards the knee anastomosis.

• Superior genicular artery is a branch of popliteal artery which also plays a role in the anastomosis around the knee joint.

Note: Accessory blood supply to the ACL—

• Inferior genicular artery:

— Medial inferior genicular artery

— Lateral inferior genicular artery 

“Face of giant panda” sign on MRI brain | NEET Based MCQ

“Face of giant panda” sign on MRI brain is seen in 

A. Wilson’s disease 
B. Japanese encephalitis 
C. Rasmussen’s encephalitis 
D. Wernicke’s encephalopathy

Ans. A. Wilson’s disease
MR IMAGING SHOWS ABNORMALITIES IS WILSON’S DISEASE
• Basal ganglia lesions are most often bilateral and symmetrical.
• The putamina shows striking increase in T2 signal intensity. This is present to a lesser degree in other deep gray matter structures.
• Thalamic lesions are often present but typically spare the dorsomedial nuclei. White matter tracts including the dentatothalamic, corticospinal, and pontocerebellar tracts are commonly involved. The claustrum may show high T2 signal intensity. The midbrain is bright on T2 weighted images with relative sparing of its deep nuclei giving rise to the so-called Panda sign.

X-ray sign of pneumoperitonium | NEET Based MCQ

X-ray sign of pneumoperitonium? 

A. Steeple sign 
B. Rigler’s sign 
C. Golden ‘S’ sign 
D. ‘Bird of prey’ sign

Ans. B. Rigler’s sign                                                                                                       
• The typical finding in sigmoid volvulus is smooth tapered end of contrast column: hook-like in appearance - ‘bird of prey sign’ (where the tapered blind end is seen as a hook).

• Laryngotracheobronchitis (croup) is characterized by the narrowing of the subglottic airway (Steeple sign)
• Rigler’s sign - bowel wall outlined by intraluminal and free peritoneal gas.
• The focal bulge at the apex of the collapsed right upper lobe corresponds to the centrally located bronchogenic carcinoma causing the lobar collapse. The combined radiologic appearance on frontal radiograph is known as
‘Golden S sign’.

Trapezoid body | PGI Nov 2017 Preparations MCQ

Which of the following is NOT seen in low radial nerve palsy? 

A. Weakness of brachioradialis 
B. Loss of nerve supply to extensor pollicis brevis 
C. Paralysis of extensor carpi radialis brevis 
D. Loss of sensations over first dorsal web space 
E. None of the above

Answer. A. (Weakness of brachioradialis)

• Radial nerve course: It emerges out from the radial groove and enters the anterior compartment of the arm. Here it gives muscular branches to brachioradialis and extensor carpi radialis longus. Then it reaches the anterior aspect of the lateral epicondyle and divides into two terminal branches:

• PIN (posterior interosseous nerve)—supplies extensor carpi radialis brevis (ECRB) as well as all the extensors of the fingers (including thumb).

• Superficial cutaneous branch to the postero-lateral hand.

• Now, in a lesion of radial nerve below radial groove, there should be paralysis of Extensor carpi radialis brevis and finger extensors. There should also be cutaneous loss on dorsum of the hand. Only option that appears to be the answer is weakness of brachioradialis. And this will happen only if the nerve was damaged below the radial groove and above its terminal branches. 

Serratus anterior | PGI Nov 2017 Preparations MCQ

True about serratus anterior 

A. Laterally rotates the scapula. 
B. It is attached in the inner side of the scapula 
C. Retraction of scapula. 
D. Protracts the scapula. 
E. It supports the clavicle.

Answer. A. Laterally rotates the scapula ; (B) It is attached to the inner side of the scapula

(D) Protracts the scapula ;

* Serratus anterior muscle arises from the upper  ribs by eight digitations and inserted into the

costal surface of scapula along the medial border.

* Nerve to serratus anterior (C5, 6,7) supplies the muscle.

* Actions of serratus anterior

- Pull the scapula forwards around the chest wall to protract it as a prime muscle in all reaching

and pushing movements (helped by pectoralis minor)

- Rotates the scapula so that the glenoid cavity is turned upwards. This help in reaching arm

above the head (helped by Trapezius)

- Steadies the scapula during weight carrying.

- Helps in forced expiration. 

Hypernatremia (Serum sodium> 170 mg/dL) | NEET Based MCQ

A breast fed child presents with hypernatremia (Serum sodium> 170 mg/dL). His urine sodium is 70 mg/dL. Most probable cause in this patient is 

A. Diabetes insipidus 
B. Acute necrosis 
C. Severe dehydration 
D. Excessive intake of sodium

Ans. D. (Excessive intake of sodium)
1. Hypernatremia due to excess sodium: (e.g., intake of sodium as oral or IV, Hyperaldosteronism, etc).
• In excess sodium intake there will be hypenatremia with raised urinary sodium. But breast-feeding child can not have hypernatremic unless given improperly mixed formula, excess NaHCO3, ingestion of sea water, etc.
2. Hypernatremia due to water deficit: (child with renal water loss, e.g., Diabetes insipidus) Diabetes insipidus: The diagnosis is suggestive in a male infant with polyuria, hypernatremia, and diluted urine (urine Na <20 mg/dL).
3. Hypernatremia due to combined sodium and water deficits: Analysis of the urine differentiates renal and non-renal etiologies.
• When the losses are extra-renal (e.g., from gut and cutaneous losses), the kidney responds to volume depletion with low urine volume, a concentrated urine, and sodium retention (urinary sodium <20 mg/dL) (Therefore severe dehydration can not be an Answer).

• With renal causes (e.g., Diabetes mellitus, osmotic diuresis, polyuric phase ofATN, etc), the urine volume is not appropriately low, the urine is not maximally concentrated, and the urine sodium may be inappropriately elevated.
• Therefore Answer is excessive intake of sodium.
• Acute tubular necrosis could have been answer but child did not have any problem suggesting ATN.. Remember polyuric phase of ATN can also present as hyponatremia.

Treatment of Kawasaki disease | NEET Based MCQ

Treatment of Kawasaki disease in children is 

A. Oral steroids 
B. IV steroids 
C. IV Ig 
D. Mycophenolate mefentil


Ans. C. (IV Ig)
Treatment involves use of a single dose IV immunoglobulin (2 g/kg) and aspirin in anti-inflammatory dose (75—80 mg/kg) till the child becomes afebrile.
• Low dose aspirin (3—5 mg/kg/day) is then continued for a few weeks for its antiplatelet activity.
• Some patients with severe disease, resistant to IV immunoglobulin, may benefit from pulse steroid therapy.

Alpha-1 antitrypsin deficiency | PGI Nov 2017 Preparations MCQ

True about alpha-1 antitrypsin deficiency, is are: 

A. Autosomal dominant 
B. Pulmonary emphysema 
C. Diastase resistant hepatic cells 
D. Hepatic cells are orcein stain positive 
E. Associated with berry aneurysm

Ans. B. Pulmonary emphysema ; (C) Diastase resistant hepatic cells :
• alpha1-anti-trypsin deficiency, is an autosomal recessive diseasemarked by abnormally low levels of (serum) of this major protease inhibitor (Pi)
• Deficiency of the enzyme leads to pulmonary emphysema.
• It is characterised by
— Presence of round to oval cytoplasmic globular inclusions in hepatocytes which on H and E stains show cidophilic and indistinctly demarcated from surrounding cytoplasm. In most part, only distinctive feature is globules. Infrequently-fatty change, mallory bodies

Most prone to hypoxic injury | PGI Nov 2017 Preparations MCQ

Which of the following is/are true statements?

A. Calcium is reabsorbed in DCT 
B. 90% calcium is excreted by glomerulus 
C. Parathormone (PTH) promotes absorption of Ca from intestine 
D. PTH promotes action of calcitonin

Ans. A. Calcium reabsorbed in DCT ; (C) Parathormone (PTH) promotes absorption of Ca from intestine :
• A large amount of calcium is filtered in the kidneys but 98-99% of filtered calcium is eabsorbed.
• Parathyroid hormone promotes absorption of calcium from intestine.
• Calcitonin is stimulated when there is hypercalcemia. Calcium level parallels the calcitonin level.
• Approximately 60% of calcium in ECF is ultrafiltrable and exists as free in solution ionized calcium or complexed with anions e.g. citrate, phosphate. Remaining 4 bind to albumin Manual of Nephrology).