INI-CET 2023 Practice Questions

Q: DNA sequence is determined by?

Sanger sequencing. ***Correct: Sanger sequencing*** - **Sanger sequencing** (chain-termination method) is the gold standard technique used to determine the exact order of nucleotides within a DNA molecule - It uses dideoxynucleotides (ddNTPs) to terminate DNA strand elongation at specific bases, producing fragments of varying lengths - These fragments are separated by capillary electrophoresis and the sequence is read based on the terminal fluorescent label - Directly determines DNA sequence with high accuracy *Incorrect: PCR* - **Polymerase Chain Reaction (PCR)** amplifies specific DNA segments to create millions of copies - It does NOT determine the sequence itself - it only makes copies of DNA - PCR-amplified DNA can be used as a template for subsequent sequencing, but PCR itself doesn't reveal sequence information *Incorrect: FISH* - **Fluorescence in situ hybridization (FISH)** detects and localizes specific DNA sequences on chromosomes - Used for chromosomal mapping and detecting chromosomal abnormalities - Does not determine the nucleotide sequence *Incorrect: Gel electrophoresis* - Separates DNA fragments based on size and charge - Used to analyze DNA but cannot determine the specific nucleotide sequence - Useful for visualizing DNA after amplification or restriction digestion

Q: Liver produces ketones but cannot use it due to the deficiency of which of the following enzyme?

Thiophorase. ***Thiophorase*** - The liver lacks **thiophorase (succinyl-CoA:3-ketoacid CoA transferase)**, which is crucial for converting **acetoacetate** to **acetoacetyl-CoA**. - This enzyme deficiency prevents the liver from utilizing ketones as an energy source, even though it is a primary site for their production. *Alkaline phosphatase* - **Alkaline phosphatase** is a non-specific enzyme found in various tissues, including bone, liver, and intestine. - Its primary role is to **hydrolyze phosphate esters**, and it is not directly involved in ketone metabolism. *Alanine transaminase* - **Alanine transaminase (ALT)** is a liver enzyme primarily involved in **amino acid metabolism**, specifically in the transfer of an amino group from alanine to α-ketoglutarate. - It plays no direct role in the synthesis or utilization of ketone bodies. *Thiolase* - **Thiolase** is an enzyme involved in both the synthesis and breakdown of ketone bodies. - It converts **two acetyl-CoA molecules into acetoacetyl-CoA** during ketogenesis and also cleaves acetoacetyl-CoA into two acetyl-CoA molecules during ketolysis in extrahepatic tissues.

Q: A urine sample shows a maroon-colored ring at the interface of two layers after adding reagents. Identify the test:

Rothera's test. ***Rothera's test*** - The image displays a **maroon-colored ring** at the interface of two layers, which is a characteristic positive result for Rothera's test. - Rothera's test is used to detect the presence of **ketone bodies**, specifically **acetone and acetoacetate**, in urine. *Benedict's test* - Benedict's test is used to detect **reducing sugars**, such as glucose, in urine. - A positive Benedict's test typically produces a color change from blue to green, yellow, orange, or brick-red precipitate after heating, which is not what is seen here. *Biuret test* - The Biuret test is used to detect **peptide bonds** and thus the presence of **proteins**. - A positive Biuret test results in a **violet or purple color** when proteins are present, which is different from the reaction shown. *Fehling's test* - Fehling's test is another test used to detect the presence of **reducing sugars** in a sample. - A positive result is indicated by the formation of a **brick-red precipitate** of cuprous oxide after heating, which is not consistent with the image.

Q: Match the following: Column A: a. Syphilis b. Chickenpox c. COVID-19 d. Hepatitis A Column B: 1. 6 Days 2. 90 Days 3. 16 Days 4. 28 Days

a-2, b-3, c-1, d-4. ***a-2, b-3, c-1, d-4*** - **Syphilis**: 90 days represents the **maximum incubation period** for *Treponema pallidum* (range 10-90 days, typical 21 days). While not the most common presentation time, it remains medically accurate and is the only viable match among available options. - **Chickenpox**: 16 days falls within the typical incubation period for **varicella-zoster virus** (range 10-21 days, commonly 14-16 days). - **COVID-19**: 6 days is consistent with the **median incubation period** for SARS-CoV-2 (range 2-14 days, mean 5-6 days). - **Hepatitis A**: 28 days represents the **typical incubation period** for HAV (range 15-50 days, average 28-30 days). *a-3, b-4, c-2, d-1* - Incorrectly assigns **Syphilis** 16 days (below the 10-90 day range's typical value), **COVID-19** 90 days (far exceeding the 2-14 day range), and **Hepatitis A** only 6 days (well below the minimum 15-day period). *a-1, b-4, c-2, d-3* - Incorrectly matches **Syphilis** with 6 days (insufficient for *T. pallidum* to produce primary chancre), **Chickenpox** with 28 days (exceeds the typical VZV range), and **Hepatitis A** with 16 days (below typical range). *a-3, b-4, c-1, d-2* - Incorrectly assigns **Syphilis** 16 days, **Chickenpox** 28 days (exceeding typical range), and **Hepatitis A** 90 days (inconsistent with acute HAV infection pattern).

Q: Calculate Anion Gap? Na: 145 K: 4 CI: 90 HCO3 : 15

40. ***40*** - The anion gap is calculated using the formula: **Na - (Cl + HCO3)**. - Plugging in the values: **145 - (90 + 15) = 145 - 105 = 40**. *28* - This value would result if there were a different **bicarbonate** or **chloride** level or a miscalculation. - For example, if the bicarbonate was 30 instead of 15, the calculation would be 145 - (90 + 30) = 145 - 120 = 25, which is closer but still not 28. *35* - This value is obtained if there's an error in summing the **anions** or subtracting from **sodium**. - For instance, if the bicarbonate was incorrectly taken as 20, the calculation would be 145 - (90 + 20) = 145 - 110 = 35. *12* - A value of 12 represents a **normal anion gap**, indicating that the patient in this scenario has a high anion gap [1]. - This result would only occur if the sum of **chloride and bicarbonate** were around 133, which is not the case here.

Q: Which of the following lens is used in direct gonioscopy?

Koeppe. ***Koeppe*** - The **Koeppe lens** is designed for direct gonioscopy, providing a wide-angle view of the **anterior chamber angle**. - It is typically used with the patient in a **supine position** and requires a coupling solution to be placed directly on the cornea. *Goldmann* - The **Goldmann lens** (3-mirror lens) is used for **indirect gonioscopy** and is characterized by mirrors that reflect the image of the angle. - It is used at a **slit lamp** and provides a magnified view as the light is reflected through the mirrors. *Richardson* - The **Richardson-Shaffer lens** is another direct gonioscopy lens, similar to the Koeppe lens. - However, the question asks for "**the**" lens used in direct gonioscopy, and **Koeppe** is the most commonly recognized and frequently used direct gonioscopy lens. - Richardson-Shaffer is less commonly used in modern practice compared to Koeppe. *Zeiss* - The **Zeiss lens** (4-mirror lens) is used for **indirect gonioscopy** and allows a rapid 360-degree view of the angle. - It is commonly used with a **slit lamp** and requires minimal or no coupling fluid due to its small contact surface.

Q: Least chances of perinatal transmission are seen in?

HSV. ***HSV*** - **Perinatal transmission of HSV** is rare, occurring in approximately 1 in 3,000 to 1 in 20,000 live births, primarily from contact with maternal genital lesions during vaginal delivery. - Transmission rates are lowest when the mother has **recurrent herpes lesions** due to the presence of maternal antibodies offering some fetal protection. *Rubella* - **Congenital rubella syndrome** carries a high risk of transmission (up to 90%) if the mother contracts rubella in the first trimester. - It can lead to severe birth defects such as **heart abnormalities**, **cataracts**, and **deafness**. *Hepatitis B* - The risk of **vertical transmission of Hepatitis B** is significant, especially if the mother is HBeAg-positive (up to 90%). - Without intervention, chronic infection develops in 70-90% of infected infants, often leading to **liver disease** later in life. *CMV* - **Congenital CMV infection** is the most common congenital viral infection, with a transmission rate of 30-40% in primary maternal infection. - It can cause severe neurological deficits, **sensorineural hearing loss**, and **developmental delays** in affected infants.

Q: A patient tells psychiatrist: "My brain is missing. What is the point of me eating anything. I am already dead". The patient has which type of delusion?

Nihilistic delusion. ***Nihilistic delusion*** - The patient's statements ("**My brain is missing**," "**I am already dead**," "What is the point of me eating anything") are characteristic of **nihilistic delusions**, specifically Cotard's syndrome. - This type of delusion involves a belief in the non-existence of oneself, parts of one's body, or the entire world. *Delusion of misidentification* - This involves a belief that familiar people or objects have been replaced by imposters, or that someone is a different person entirely. - The patient's statements do not describe the misidentification of another person or object. *Bizarre Delusion* - While the statements could be considered bizarre, **bizarre delusions** are defined as clearly implausible, not understandable, and not derived from ordinary life experiences (e.g., aliens implanted a chip in my brain). - Nihilistic delusions, especially in the context of Cotard's syndrome, are a specific subtype of delusion that can be bizarre, but "nihilistic delusion" is a more precise characterization here. *Hypochondriacal Delusion* - This involves a false belief of having a severe disease despite medical reassurance. - While there is a physical component to the delusion ("my brain is missing"), the overarching theme of non-existence and being dead goes beyond a simple preoccupation with illness.

Question 1

DNA sequence is determined by?

Accepted Answer

Sanger sequencing

Answer

PCR

Answer

FISH

Answer

Gel electrophoresis

Question 2

Liver produces ketones but cannot use it due to the deficiency of which of the following enzyme?

Accepted Answer

Thiophorase

Answer

Alkaline phosphatase

Answer

Alanine transaminase

Answer

Thiolase

Question 3

A urine sample shows a maroon-colored ring at the interface of two layers after adding reagents. Identify the test:

Accepted Answer

Rothera's test

Answer

Benedict's test

Answer

Biuret test

Answer

Fehling's test

Question 4

A person is bitten by a dog. The dog and the person are fully immunized. There is a small abrasion mark on the site of bite. What would you advise to the person?

Accepted Answer

Observation

Answer

Amoxiclav

Answer

Metronidazole

Answer

Ciprofloxacin

Question 5

Match the following:

Column A:
a. Syphilis
b. Chickenpox
c. COVID-19
d. Hepatitis A

Column B:
1. 6 Days
2. 90 Days
3. 16 Days
4. 28 Days

Accepted Answer

a-2, b-3, c-1, d-4

Answer

a-3, b-4, c-2, d-1

Answer

a-1, b-4, c-2, d-3

Answer

a-3, b-4, c-1, d-2

Question 6

Calculate Anion Gap?
Na: 145 K: 4 CI: 90 HCO3 : 15

Accepted Answer

40

Answer

28

Answer

35

Answer

12

Question 7

A 15-year-old girl child with primary amenorrhea has pubic hair, prepubertal breast, blind vagina, clitoromegaly, and normal testosterone. Karyotype given is 46 XY , what is the cause?

Accepted Answer

5-alpha reductase deficiency

Answer

17 hydroxylase deficiency

Answer

Swyer syndrome

Answer

Complete AIS

Question 8

Which of the following lens is used in direct gonioscopy?

Accepted Answer

Koeppe

Answer

Goldmann

Answer

Richardson

Answer

Zeiss

Question 9

Least chances of perinatal transmission are seen in?

Accepted Answer

HSV

Answer

Rubella

Answer

Hepatitis B

Answer

CMV

Question 10

A patient tells psychiatrist: "My brain is missing. What is the point of me eating anything. I am already dead".
The patient has which type of delusion?

Accepted Answer

Nihilistic delusion

Answer

Delusion of misidentification

Answer

Bizarre Delusion

Answer

Hypochondriacal Delusion

INI-CET 2023

Biochemistry

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Ophthalmology

Pediatrics

Psychiatry