INI-CET 2023 Previous Year Questions Practice Questions

Q: Pompe disease is seen due to deficiency of?

Lysosomal acid alpha glucosidase. ***Lysosomal acid alpha glucosidase*** - **Pompe disease**, also known as **glycogen storage disease type II**, is caused by the deficiency of **acid alpha-glucosidase (GAA)**, a lysosomal enzyme. - This deficiency leads to the accumulation of **glycogen** within lysosomes in various tissues, particularly muscle, liver, and heart, causing muscle weakness and cardiomegaly. *β-galactocerebrosidase* - Deficiency of **β-galactocerebrosidase** is associated with **Krabbe disease** (globoid cell leukodystrophy). - Krabbe disease involves the buildup of **galactocerebroside**, leading to progressive destruction of the myelin sheath in the central and peripheral nervous systems. *β-glucocerebrosidase* - Deficiency in **β-glucocerebrosidase** causes **Gaucher disease**, the most common lysosomal storage disorder. - This results in the accumulation of **glucocerebroside** in macrophages, leading to hepatosplenomegaly, bone pain, and neurologic symptoms in some forms. *β-hexosaminidase-A* - Deficiency of **β-hexosaminidase-A** is the underlying cause of **Tay-Sachs disease**. - Tay-Sachs disease is characterized by the accumulation of **GM2 gangliosides** in neurons, leading to progressive neurodegeneration, developmental delay, and a characteristic cherry-red spot in the retina. [Practice more INI-CET 2023 questions on OnCourse]

Q: Xanthurenic aciduria is seen in which vitamin deficiency?

Vitamin B6. ***Vitamin B6*** - **Xanthurenic aciduria** is a classic sign of **Vitamin B6 (pyridoxine) deficiency** because B6 is a crucial coenzyme for **kynureninase**, an enzyme in the **tryptophan metabolic pathway**. - Without sufficient B6, tryptophan cannot be properly metabolized, leading to the accumulation and excretion of xanthurenic acid. *Vitamin B5* - **Vitamin B5 (pantothenic acid)** is a precursor to **coenzyme A (CoA)**, essential for fatty acid metabolism and the **Krebs cycle**. - Its deficiency is associated with symptoms like paresthesia and fatigue, not xanthurenic aciduria. *Vitamin B12* - **Vitamin B12 (cobalamin)** is critical for DNA synthesis and the formation of **red blood cells**, and its deficiency causes **megaloblastic anemia** and neurological symptoms. - It plays no direct role in the tryptophan-kynurenine pathway, so its deficiency does not lead to xanthurenic aciduria. *Vitamin B7* - **Vitamin B7 (biotin)** acts as a coenzyme in **carboxylase reactions**, involved in fatty acid synthesis, gluconeogenesis, and amino acid metabolism. - Deficiency can cause dermatitis, hair loss, and neurological issues, but it is not linked to xanthurenic acid accumulation. [Practice more INI-CET 2023 questions on OnCourse]

Q: BARTH syndrome is caused by deficiency of?

Cardiolipin. ***Cardiolipin*** - **BARTH syndrome** is a rare, X-linked genetic disorder caused by mutations in the **TAZ gene**, which encodes for the enzyme **tafazzin**. - **Tafazzin** is crucial for the remodeling of **cardiolipin**, a phospholipid essential for mitochondrial membrane integrity and function. Deficiency of properly remodeled (mature) cardiolipin leads to the characteristic cardiomyopathy, skeletal myopathy, neutropenia, and growth delay seen in BARTH syndrome. *Glycolipids* - **Glycolipids** are lipids with a carbohydrate attached, important for cell recognition and signaling. - Their deficiency or abnormal metabolism is associated with conditions like **glycosphingolipidoses** (e.g., Gaucher disease, Fabry disease), not BARTH syndrome. *Sphingomyelin* - **Sphingomyelin** is a type of sphingolipid found in animal cell membranes, particularly in the myelin sheath. - Its deficiency or accumulation is linked to **Niemann-Pick disease**, which presents with hepatosplenomegaly and neurodegeneration, distinct from BARTH syndrome. *Cerebroside* - **Cerebrosides** are a type of glycosphingolipid found in the myelin sheath and nerve cell membranes. - Disorders involving cerebroside metabolism include **Krabbe disease** (globoid cell leukodystrophy) and **Gaucher disease**, which are pathologically distinct from BARTH syndrome. [Practice more INI-CET 2023 questions on OnCourse]

Q: A girl from the village was found dead in the lake and was taken out. It is a case of ante mortem drowning. All are true about this case except?

Washerman hand and finger. ***Washerman hand and finger*** - **Washerman's hand and feet** (cutis anserina) refers to the wrinkled, sodden appearance of skin on the palms and soles due to prolonged immersion in water. - This is a **post-mortem change** that develops after death as a result of water absorption into the skin, typically appearing after **2-3 hours** of immersion. - While it indicates immersion in water, it does **not specifically signify ante-mortem drowning** as it can occur in bodies submerged after death (post-mortem submersion). - This is the **correct answer** to the "except" question as it is not a vital sign of ante-mortem drowning. *Froth on nose and mouth* - **Fine, white, tenacious froth** (mushroom-like foam) at the nose and mouth is a classic sign of **ante-mortem drowning**. - Results from violent mixing of air, mucus, and water in the airways during respiratory efforts while drowning. - This is a **vital sign** indicating the person was alive during submersion. *Cadaveric spasm in hand muscle* - **Cadaveric spasm** (instantaneous rigor mortis) can occur in **ante-mortem drowning** when the victim grasps objects like weeds, mud, or clothes in the final moments before death. - This represents a **vital phenomenon** reflecting a final act of vitality and strongly suggests the person was alive and conscious at the moment of submersion. *Water in the stomach* - Presence of water in the stomach is a common finding in **ante-mortem drowning** as the victim actively swallows water during the struggle and aspiration phase. - Indicates **vital swallowing** during life, supporting the diagnosis of ante-mortem drowning. - Typically, more than **500 mL** of water in stomach suggests ante-mortem drowning. [Practice more INI-CET 2023 questions on OnCourse]

Q: A person handling cat feces is at risk of transmitting an infection. Which of the following is the infective stage of the organism transmitted through cat feces?

Oocyst. ***Oocyst*** - The **oocyst** is the infective stage of *Toxoplasma gondii* that is shed in cat feces. - Cats are the definitive host where sexual reproduction occurs in the intestinal epithelium, producing oocysts. - Humans can become infected by ingesting these **oocysts** directly from contaminated cat litter or soil, or indirectly through contaminated food or water. - Oocysts become infective (sporulated) after 1-5 days in the environment. *Bradyzoite* - **Bradyzoites** are slow-growing forms of *Toxoplasma gondii* found within tissue cysts, particularly in muscle and brain tissue. - While they can be infective if undercooked meat containing cysts is consumed, they are not present in cat feces. - This represents a different route of transmission (foodborne via tissue cysts). *Tachyzoite* - **Tachyzoites** are rapidly multiplying forms of *Toxoplasma gondii* responsible for acute infection and tissue damage. - They are found within host cells during active infection and are not shed in cat feces. - They can cross the placenta causing congenital toxoplasmosis. *Gametocyte* - While **gametocytes** (sexual stages) do develop in the cat's intestinal epithelium during *Toxoplasma gondii* reproduction, they are not the stage shed in feces. - The product of sexual reproduction—the **oocyst**—is what gets excreted and serves as the infective stage. - In contrast, gametocytes of *Plasmodium* species remain in blood and are relevant for malaria transmission. [Practice more INI-CET 2023 questions on OnCourse]

Question 1

Pompe disease is seen due to deficiency of?

Accepted Answer

Lysosomal acid alpha glucosidase

Answer

β-galactocerebrosidase

Answer

β-glucocerebrosidase

Answer

β-hexosaminidase-A

Question 2

Xanthurenic aciduria is seen in which vitamin deficiency?

Accepted Answer

Vitamin B6

Answer

Vitamin B5

Answer

Vitamin B12

Answer

Vitamin B7

Question 3

BARTH syndrome is caused by deficiency of?

Accepted Answer

Cardiolipin

Answer

Glycolipids

Answer

Sphingomyelin

Answer

Cerebroside

Question 4

A girl from the village was found dead in the lake and was taken out. It is a case of ante mortem drowning. All are true about this case except?

Accepted Answer

Washerman hand and finger

Answer

Froth on nose and mouth

Answer

Cadaveric spasm in hand muscle

Answer

Water in the stomach

Answer

Diatoms test positive

Question 5

A person handling cat feces is at risk of transmitting an infection. Which of the following is the infective stage of the organism transmitted through cat feces?

Accepted Answer

Oocyst

Answer

Bradyzoite

Answer

Tachyzoite

Answer

Gametocyte

Question 6

A man has undergone renal transplant and is taking immunosuppressant drug. On biopsy there was presence of budding cells with pseudohyphae. Identify the organism?

Accepted Answer

Invasive candidiasis

Answer

Pneumocystis

Answer

Invasive aspergillosis

Answer

Histoplasmosis

Question 7

An elderly male presented with meningitis. The CSF sample was subjected to Gram staining, and the microscopy image is shown. Which of the following is a characteristic of the likely organism?

Accepted Answer

Motile at 22°C and non-motile at 37°C

Answer

No motility at 22°C and motile at 37°C

Answer

Non motile at both 37°C and 22°C

Answer

Motile at both 37°C and 22°C

Question 8

The given image shows blanching of vascularity after the phenylephrine use. What is the likely diagnosis?

Accepted Answer

Nodular episcleritis

Answer

Nodular scleritis

Answer

Conjunctivitis

Answer

Anterior uveitis

Question 9

Which of the following is true about lithium?

Accepted Answer

It can cause fine postural tremors at therapeutic dosage

Answer

It is also used for treatment of absence seizures

Answer

It is not teratogenic

Answer

It is not absorbed from the gut

Question 10

La belle indifference is seen in?

Accepted Answer

Conversion disorder

Answer

Depression

Answer

Cotard syndrome

Answer

Schizophrenia

INI-CET 2023

Biochemistry

Forensic Medicine

Microbiology

Ophthalmology

Pharmacology

Psychiatry