INI-CET 2018 Practice Questions

Q: Identify the nerve marked with an arrow in the given section of cranial cavity.

Abducens. ***Abducens*** - The image shows the abducens nerve passing through **Dorello's canal** on its way to the **cavernous sinus**. - Its unique path makes it susceptible to injury in cases of increased intracranial pressure, leading to **lateral rectus palsy**. *Trochlear* - The trochlear nerve is the **smallest cranial nerve** and exits the brainstem dorsally, then wraps around to the ventral side. - It innervates the **superior oblique muscle** of the eye. *Trigeminal* - The trigeminal nerve is a large cranial nerve with **three main divisions** and is responsible for sensations in the face and motor functions like chewing. - It arises more laterally from the pons and is typically seen entering the **Meckel's cave**. *Oculomotor* - The oculomotor nerve emerges from the **midbrain** and controls most of the extrinsic eye muscles and pupillary constriction. - It is usually visible superior to the abducens nerve in the **cavernous sinus**. *Facial* - The facial nerve exits the brainstem at the **cerebellopontine angle** and enters the **internal acoustic meatus** with the vestibulocochlear nerve. - It controls muscles of **facial expression** and carries taste sensation from the anterior two-thirds of the tongue.

Q: The biomedical waste category for the item shown in the image is:

Cytotoxic waste. ***Cytotoxic waste*** - The image displays a **bone marrow needle**, a device used to obtain bone marrow samples, often in the diagnosis and monitoring of cancers. - Materials contaminated with **chemotherapeutic agents** or originating from patients undergoing such treatments are classified as cytotoxic waste due to their genotoxic, carcinogenic, or teratogenic properties. *Biomedical waste* - **Biomedical waste** is a broader category that includes general healthcare waste, but cytotoxic waste requires specific handling due to its hazardous nature. - While a bone marrow needle is a medical device, its association with cancer treatment and potentially cytotoxic substances elevates its classification beyond regular biomedical waste. *Radiation hazard* - **Radiation hazard** waste typically involves materials contaminated with radioactive isotopes, indicated by a trefoil symbol. - The instrument shown is not associated with radioactive materials or procedures involving ionizing radiation. *Bioterrorism* - **Bioterrorism** refers to the intentional release of biological agents to cause illness or death in humans, animals, or plants. - The item pictured is a medical instrument for diagnostic purposes, unrelated to the deliberate use of biological agents for harm.

Q: The following image shows: (AIIMS Nov 2018)

Abrasion. ***Abrasion*** - An **abrasion** is a type of wound caused by the skin rubbing or scraping against a rough surface, resulting in the **removal of the superficial layers of the epidermis**. - The image shows a reddened, raw, and sometimes bleeding area where the top layer of skin has been scraped off, which is characteristic of an abrasion. *Imprint* - An **imprint injury** typically refers to a mark left on the skin by an object that has pressed or struck it, leaving a discernible pattern or shape. - The image does not show a distinct pattern or shape indicative of an object pressing against the skin, but rather a diffuse superficial skin loss. *Laceration* - A **laceration** is a deep cut or tear in the skin or flesh, often with irregular edges, caused by a forceful impact or trauma. - The injury in the image is superficial and does not appear to be a deep cut or tear through the skin layers. *Contusion* - A **contusion**, or bruise, is caused by trauma to blood vessels under the skin, resulting in blood leaking into surrounding tissues. - While there might be some underlying bruising, the primary visible injury is the **surface skin loss and raw appearance**, which is not characteristic of a simple contusion.

Q: The following presentation occurs due to? (AIIMS Nov 2018)

Long term ingestion of arsenic in drinking water. ***Long term ingestion of arsenic in drinking water*** - The image shows **hyperpigmentation and hyperkeratosis** on the palms, often described as "raindrop pigmentation" or diffuse darkening with scattered paler lesions (leukomelanosis). This is a classical dermatological manifestation of **chronic arsenic poisoning**, particularly from contaminated drinking water. - **Arsenicosis** can also cause palmar and plantar keratoses, which can progress to malignant skin lesions over time. *Chronic Copper sulfate poisoning* - Chronic copper poisoning is rare and typically affects the liver, leading to conditions like **cirrhosis** and **hepatitis**, as seen in Wilson's disease. - Skin manifestations from copper poisoning are not typically characterized by the diffuse hyperpigmentation and hyperkeratosis seen in the image. *Application of mercury ointment* - Topical mercury exposure can cause localized skin irritation, dermatitis, or systemic toxicity with features like **acrodynia** (pink disease) in children, characterized by a pink rash, irritability, and hypertension. - It does not typically lead to the described pattern of diffuse hyperpigmentation and hyperkeratosis on the palms. *Application of Calotropis* - **Calotropis** (such as *Calotropis gigantea* or *procera*) is a plant known for its toxic latex, which can cause intense local irritation, vesication, or ulceration upon skin contact. - Its effects are primarily acute irritant or allergic reactions and do not produce the chronic skin changes of hyperpigmentation and hyperkeratosis seen in the image.

Q: Identify the fracture given in the image given below:

Gutter. ***Gutter*** - A **gutter fracture** involves a linear fracture with depression of the adjacent bone fragment, often forming a "gutter" or trough-like deformity, as indicated by the arrow in the image. - This type of fracture is typically caused by a **blunt impact** to the skull that causes focal indentation. *Pond* - A **pond fracture** is a type of depressed skull fracture seen in infants, characterized by a smooth, bowl-like depression without sharp edges or fragmentation, resembling an indentation from a thumb. - It results from **low velocity impact** and the skull's plasticity in infants, which is not what is seen here. *Hinge* - A **hinge fracture** is a type of basilar skull fracture that involves the skull base, often extending bilaterally through structures like the sphenoid bone, creating a "hinge" effect. - This fracture pattern usually results from **severe trauma** and is not depicted in this image, which shows a localized depression. *Comminuted* - A **comminuted fracture** is characterized by the bone breaking into three or more fragments at the site of injury. - While there is bone fragmentation in the image, the primary descriptive feature highlighted by the arrow is the **depressed trough** rather than multiple distinct pieces.

Q: Identify the post mortem lividity of the image: (AIIMS Nov 2018)

Suggillation. ***Suggillation*** - Suggillation refers to the extravasation of blood into the tissues due to crushing pressure or trauma, often seen in cases of severe blunt force injury, leaving **diffuse, purplish discoloration.** - In post-mortem examination, a **suggillation** can be distinguished from common **livor mortis** (lividity) by its darker color and by the fact that it is not blanchable under pressure, indicating **capillary rupture and hemorrhage** rather than just pooling of blood. *Tattooing* - Tattooing involves the insertion of **indelible ink** into the dermis of the skin, creating permanent designs. - Tattoos have distinct, often patterned, appearances and would not resemble the **irregular, deep discoloration** of lividity or hemorrhage. *Putrefaction* - Putrefaction is a later stage of decomposition, characterized by the breakdown of tissues by bacteria, producing **gases, discoloration (greenish-black), and foul odors.** - This process is distinct from the **vascular pooling** or **hemorrhage** that forms suggillation; putrefaction typically starts later (after 24-48 hours) and involves more widespread tissue destruction. *Decomposition* - Decomposition is the broader process of decay of organic matter after death, encompassing various stages like **autolysis, putrefaction, and skeletonization.** - While suggillation occurs post-mortem, it is a specific type of **post-mortem bruising** or lividity, distinct from the generalized tissue breakdown and gaseous changes seen in advanced decomposition.

Q: Identify the flowers shown below:

Aconite. ***Aconite*** - The image displays characteristics consistent with **Aconite** (monkshood) flowers, which are typically **dark purple to blue** and have a distinctive **hooded shape**. - Aconite is known for its **highly toxic** alkaloids, especially **aconitine**, which can cause rapid and severe symptoms upon ingestion or skin contact. *Cerbera Thevetia* - **Cerbera Thevetia** (yellow oleander) flowers are typically **yellow or orange** and are bell-shaped, which differs significantly from the flowers shown. - Poisoning from *Cerbera Thevetia* is primarily due to **cardiac glycosides**, leading to symptoms like bradycardia, nausea, and vomiting. *Datura* - **Datura** flowers are typically **large, trumpet-shaped**, and vary in color from white to purple, but lack the distinctive hooded appearance seen in the image. - *Datura* species contain **tropane alkaloids** (e.g., scopolamine, atropine), which cause anticholinergic effects like mydriasis, delirium, and tachycardia. *Nerium Odorum* - **Nerium Odorum** (pink oleander) flowers are typically **pink, red, or white** and have a pinwheel shape with five petals, which does not match the flowers in the image. - Like *Thevetia*, *Nerium Odorum* is toxic due to **cardiac glycosides**, causing similar cardiovascular and gastrointestinal symptoms.

Q: Identify the correct pair: i. Mummification ii. Adipocere iii. Marbling iv. Livor mortis

i-D, ii-C, iii-B, iv-A. ***i-D, ii-C, iii-B, iv-A*** - Image **D** clearly shows a body exhibiting **mummification**, characterized by a dried, leathery appearance due to dehydration in dry conditions. - Image **C** depicts **adipocere**, where fatty tissues are converted into a grayish-white, greasy, or waxy substance, which can preserve body contours. - Image **B** illustrates **marbling**, which is a pattern of greenish-black discoloration along superficial veins due to the breakdown of blood by putrefactive bacteria. - Image **A** displays **lividity of death (livor mortis)**, characterized by purplish discoloration of the skin in dependent areas due to the gravitational pooling of blood after circulation ceases.

Q: Comment on age of the male patient:

12-14 years. ***12-14 years*** - The radiographs show **open growth plates** (epiphyseal lines) in both the shoulder (A) and elbow (B), indicating the individual is still growing. - The presence of well-developed secondary ossification centers and significant but not fully fused physes is consistent with a male in the **mid-pubertal** range, typically observed between 12-14 years. *5-7 years* - At this age, many **secondary ossification centers** would just be appearing or still quite small, and the growth plates would be much wider and less defined than seen in the images. - The degree of skeletal maturation evident in the shoulder and elbow in the images surpasses that of a 5-7 year old. *17-19 years* - By this age, most **growth plates** in males, especially in key joints like the shoulder and elbow, would be largely **fused** or in the final stages of fusion. - The distinct open physes seen in both images rule out this age range, as significant growth is still occurring. *>25 years* - In an individual over 25 years, **all growth plates** would be completely **fused**, and there would be no visible epiphyseal lines. - The presence of clear, open growth plates in the images definitively excludes an adult age.

Question 1

Identify the nerve marked with an arrow in the given section of cranial cavity.

Accepted Answer

Abducens

Answer

Trochlear

Answer

Trigeminal

Answer

Oculomotor

Answer

Facial

Question 2

The biomedical waste category for the item shown in the image is:

Accepted Answer

Cytotoxic waste

Answer

Biomedical waste

Answer

Radiation hazard

Answer

Chemical waste

Question 3

A female was found dead in her bedroom. The room was not locked from inside. Her blood alcohol value was found to be 350 mg/dL. The picture taken at the post mortem is shown below. The diagnosis is? (AIIMS Nov 2018, AIIMS Nov 2017)

Accepted Answer

Throttling

Answer

Traumatic asphyxia

Answer

Café coronary

Answer

Bansdola

Question 4

The following image shows: (AIIMS Nov 2018)

Accepted Answer

Abrasion

Answer

Imprint

Answer

Laceration

Answer

Contusion

Question 5

The following presentation occurs due to? (AIIMS Nov 2018)

Accepted Answer

Long term ingestion of arsenic in drinking water

Answer

Chronic Copper sulfate poisoning

Answer

Application of mercury ointment

Answer

Application of Calotropis

Question 6

Identify the fracture given in the image given below:

Accepted Answer

Gutter

Answer

Pond

Answer

Hinge

Answer

Comminuted

Question 7

Identify the post mortem lividity of the image: (AIIMS Nov 2018)

Accepted Answer

Suggillation

Answer

Tattooing

Answer

Putrefaction

Answer

Decomposition

Question 8

Identify the flowers shown below:

Accepted Answer

Aconite

Answer

Datura

Answer

Nerium Odorum

Answer

Cerbera Thevetia

Question 9

Identify the correct pair:
i. Mummification
ii. Adipocere
iii. Marbling
iv. Livor mortis

Accepted Answer

i-D, ii-C, iii-B, iv-A

Answer

i-C, ii-D, iii-B, iv-A

Answer

i-C, ii-D, iii-A, iv-B

Answer

i-D, ii-A, iii-C, iv-B

Question 10

Comment on age of the male patient:

Accepted Answer

12-14 years

Answer

5-7 years

Answer

17-19 years

Answer

>25 years

INI-CET 2018

Anatomy

Community Medicine

Forensic Medicine