INI-CET 2025

Q: Which of the following is not a boundary of the hepatocystic triangle?

Cystic artery. ***Cystic artery*** - The **cystic artery** is the structure of key surgical importance found *within* the hepatocystic triangle, but it does not form one of its three defining boundaries [1]. - It is crucial for locating and ligating the artery during **cholecystectomy** [2]. *Cystic duct* - The **cystic duct** forms the **lateral boundary** of the hepatocystic triangle (Triangle of Calot) [1]. - This boundary leads directly from the neck of the gallbladder. *Common hepatic duct* - The **common hepatic duct** forms the **medial boundary** of the hepatocystic triangle [2]. - It is formed by the union of the right and left hepatic ducts and is medial to the cystic duct. *Inferior border of liver* - The **inferior border (or visceral surface) of the liver** forms the **superior boundary** of the hepatocystic triangle [2]. - Together with the cystic duct and common hepatic duct, it completes the triangular shape. [Practice more INI-CET 2025 questions on OnCourse]

Q: Observe the provided image showing a muscle indicated by an arrow. What is the primary action of this muscle on the mandible?

Protracts and depresses the mandible. ***Protracts and depresses the mandible*** - The muscle indicated is the **Lateral Pterygoid muscle**, which is unique among the muscles of mastication in being the primary muscle responsible for **mandibular depression** (opening the mouth). - The contraction of the muscle pulls the head of the mandible and the articular disc forward, leading to **protraction** and the initial phase of mouth opening. *Retracts and elevates the mandible* - These actions belong mainly to the **Temporalis muscle**. The anterior and middle fibers elevate and the posterior fibers retract the mandible. - The Lateral Pterygoid muscle is involved in lowering the jaw, which is contrary to elevation. *Elevates and protracts the mandible* - **Elevation** (closing the mouth) is the strongest action and is primarily carried out by the **Masseter**, **Temporalis**, and **Medial Pterygoid** muscles. - While the Lateral Pterygoid facilitates protraction, it is an antagonist to elevation. *Depresses and retracts the mandible* - The **Lateral Pterygoid** is the main muscle for **depression**; however, it causes **protraction** (forward movement) of the mandible, not retraction. - Retraction is primarily achieved by the **posterior fibers of the Temporalis muscle** and assisted by the digastrics muscle. [Practice more INI-CET 2025 questions on OnCourse]

Q: Tight junctions are primarily located at which part of the cell?

Apical. ***Apical*** - **Tight junctions** (Zonula Occludens) are the most **apical** component of the junctional complex in many epithelial cells [1]. - Their primary function is to seal adjacent cells, preventing the passage of molecules between them (paracellular route), thus establishing **epithelial polarity** [1], [2]. *Apicolateral* - This term is less precise; the junctional complex includes the tight junction (**apical**), followed by the adherens junction, and then the desmosome (**lateral**). - The tight junction itself is specifically located at the very **apical** edge, not spanning the entire apicolateral domain [1]. *Basal* - The **basal** part of the cell is where the cell attaches to the **basement membrane** via structures like hemidesmosomes [1]. - Tight junctions are not found here, as they are essential for defining the **apical** vs. basolateral domains. *Basolateral* - The **basolateral** domain comprises the sides and base of the cell, where structures like **desmosomes** (lateral) and hemidesmosomes (basal) are found [1]. - This region is separated from the lumen by the function of the **tight junction** located upstream at the apical pole [2]. [Practice more INI-CET 2025 questions on OnCourse]

Q: A middle-aged lady choked while eating fish and has associated symptoms of coughing, hoarseness of voice, and a foreign body sensation in the throat. On examination, the pyriform fossa is found to be inflamed. Which of the following nerves supplies this region?

Internal Laryngeal Nerve (ILN). ***Internal Laryngeal Nerve (ILN)*** - The **Internal Laryngeal Nerve** (sensory branch of **superior laryngeal nerve**, CN X) provides **sensory innervation to the pyriform fossa** and surrounding hypopharyngeal structures. - Fish bone impaction in the pyriform fossa irritates the **ILN**, causing **cough reflex**, **hoarseness**, and **foreign body sensation** as described in this case. *External Laryngeal Nerve (ELN)* - The **External Laryngeal Nerve** is primarily a **motor nerve** that supplies the **cricothyroid muscle** for vocal cord tensioning. - It provides **minimal sensory contribution** and does not innervate the mucosa of the pyriform fossa. *Glossopharyngeal Nerve* - The **Glossopharyngeal Nerve (CN IX)** provides sensory innervation to the **oropharynx** and **posterior third of tongue**, not the pyriform fossa. - The pyriform fossa is anatomically part of the **hypopharynx (laryngopharynx)**, which is supplied by branches of the **vagus nerve**, not CN IX. *Recurrent Laryngeal Nerve* - The **Recurrent Laryngeal Nerve** primarily provides **motor innervation** to intrinsic laryngeal muscles (except cricothyroid). - Its sensory distribution is limited to the **infraglottic larynx** (below vocal cords), not the pyriform fossa region. [Practice more INI-CET 2025 questions on OnCourse]

Q: A child presents with fatigue and hepatomegaly. Liver enzymes (ALT, AST) are elevated. Ketosis was significant. Liver biopsy shows excess glycogen accumulation. After feeding, blood glucose levels rise, but there is no rise in glucose after overnight fasting. Which of the following enzyme deficiencies is most likely responsible for this presentation?

Glucose-6-phosphatase. ***Glucose-6-phosphatase*** - This deficiency is characteristic of Glycogen Storage Disease type I (**GSD I** or **Von Gierke disease**), which prevents the final step of both glycogenolysis and gluconeogenesis (conversion of **Glucose-6-Phosphate** to free glucose). - The inability to release free glucose from the liver, especially during fasting, causes severe **fasting hypoglycemia**, significant **ketosis**, and massive **hepatomegaly** due to trapped glycogen and fat accumulation. *Liver phosphorylase* - Deficiency in **Liver phosphorylase** (GSD VI or Hers disease) impairs the breakdown of glycogen but does not affect the gluconeogenesis pathway. - While it leads to hepatomegaly and hypoglycemia, the symptoms are generally **milder** than GSD I, and the profound metabolic derangements (severe ketosis, lactic acidosis) seen in this case are typically less pronounced. *Muscle phosphorylase* - This enzyme deficiency, known as **GSD V** or **McArdle disease**, primarily affects the skeletal muscle, leading to muscle pain, cramps, and **exercise intolerance**. - It does not cause hepatomegaly or issues with hepatic glucose release and therefore is an **unlikely** cause of fasting hypoglycemia in a child. *Phosphofructokinase* - Phosphofructokinase (GSD VII or **Tarui disease**) deficiency affects both muscle and erythrocytes, presenting similar to McArdle disease with **exercise intolerance** and often mild hemolysis. - PFK deficiency primarily affects glycolysis and does not directly impair the liver's ability to release glucose via **gluconeogenesis** or the final G6Pase step during fasting. [Practice more INI-CET 2025 questions on OnCourse]

202 Previous Year Questions with Answers & Explanations

202

Questions

Subjects

All (202)Anatomy (16)Anesthesiology (3)Biochemistry (10)Community Medicine (18)Dermatology (5)ENT (5)Forensic Medicine (8)Internal Medicine (31)Microbiology (11)Obstetrics and Gynecology (5)Ophthalmology (10)Orthopaedics (4)Pathology (8)Pediatrics (14)Pharmacology (17)Physiology (11)Psychiatry (5)Radiology (8)Surgery (13)

Anatomy

4 questions

Which of the following is not a boundary of the hepatocystic triangle?

Observe the provided image showing a muscle indicated by an arrow. What is the primary action of this muscle on the mandible?

Tight junctions are primarily located at which part of the cell?

A middle-aged lady choked while eating fish and has associated symptoms of coughing, hoarseness of voice, and a foreign body sensation in the throat. On examination, the pyriform fossa is found to be inflamed. Which of the following nerves supplies this region?

INI-CET 2025 - Anatomy INI-CET Practice Questions and MCQs

Question 1: Which of the following is not a boundary of the hepatocystic triangle?

A. Cystic duct
B. Common hepatic duct
C. Cystic artery (Correct Answer)
D. Inferior border of liver

Explanation: ***Cystic artery*** - The **cystic artery** is the structure of key surgical importance found *within* the hepatocystic triangle, but it does not form one of its three defining boundaries [1]. - It is crucial for locating and ligating the artery during **cholecystectomy** [2]. *Cystic duct* - The **cystic duct** forms the **lateral boundary** of the hepatocystic triangle (Triangle of Calot) [1]. - This boundary leads directly from the neck of the gallbladder. *Common hepatic duct* - The **common hepatic duct** forms the **medial boundary** of the hepatocystic triangle [2]. - It is formed by the union of the right and left hepatic ducts and is medial to the cystic duct. *Inferior border of liver* - The **inferior border (or visceral surface) of the liver** forms the **superior boundary** of the hepatocystic triangle [2]. - Together with the cystic duct and common hepatic duct, it completes the triangular shape.

Question 2: Observe the provided image showing a muscle indicated by an arrow. What is the primary action of this muscle on the mandible?

A. Protracts and depresses the mandible (Correct Answer)
B. Retracts and elevates the mandible
C. Elevates and protracts the mandible
D. Depresses and retracts the mandible

Explanation: ***Protracts and depresses the mandible*** - The muscle indicated is the **Lateral Pterygoid muscle**, which is unique among the muscles of mastication in being the primary muscle responsible for **mandibular depression** (opening the mouth). - The contraction of the muscle pulls the head of the mandible and the articular disc forward, leading to **protraction** and the initial phase of mouth opening. *Retracts and elevates the mandible* - These actions belong mainly to the **Temporalis muscle**. The anterior and middle fibers elevate and the posterior fibers retract the mandible. - The Lateral Pterygoid muscle is involved in lowering the jaw, which is contrary to elevation. *Elevates and protracts the mandible* - **Elevation** (closing the mouth) is the strongest action and is primarily carried out by the **Masseter**, **Temporalis**, and **Medial Pterygoid** muscles. - While the Lateral Pterygoid facilitates protraction, it is an antagonist to elevation. *Depresses and retracts the mandible* - The **Lateral Pterygoid** is the main muscle for **depression**; however, it causes **protraction** (forward movement) of the mandible, not retraction. - Retraction is primarily achieved by the **posterior fibers of the Temporalis muscle** and assisted by the digastrics muscle.

Question 3: Tight junctions are primarily located at which part of the cell?

A. Apical (Correct Answer)
B. Apicolateral
C. Basal
D. Basolateral

Explanation: ***Apical*** - **Tight junctions** (Zonula Occludens) are the most **apical** component of the junctional complex in many epithelial cells [1]. - Their primary function is to seal adjacent cells, preventing the passage of molecules between them (paracellular route), thus establishing **epithelial polarity** [1], [2]. *Apicolateral* - This term is less precise; the junctional complex includes the tight junction (**apical**), followed by the adherens junction, and then the desmosome (**lateral**). - The tight junction itself is specifically located at the very **apical** edge, not spanning the entire apicolateral domain [1]. *Basal* - The **basal** part of the cell is where the cell attaches to the **basement membrane** via structures like hemidesmosomes [1]. - Tight junctions are not found here, as they are essential for defining the **apical** vs. basolateral domains. *Basolateral* - The **basolateral** domain comprises the sides and base of the cell, where structures like **desmosomes** (lateral) and hemidesmosomes (basal) are found [1]. - This region is separated from the lumen by the function of the **tight junction** located upstream at the apical pole [2].

Question 4: A middle-aged lady choked while eating fish and has associated symptoms of coughing, hoarseness of voice, and a foreign body sensation in the throat. On examination, the pyriform fossa is found to be inflamed. Which of the following nerves supplies this region?

A. External Laryngeal Nerve (ELN)
B. Glossopharyngeal Nerve
C. Recurrent Laryngeal Nerve
D. Internal Laryngeal Nerve (ILN) (Correct Answer)

Explanation: ***Internal Laryngeal Nerve (ILN)*** - The **Internal Laryngeal Nerve** (sensory branch of **superior laryngeal nerve**, CN X) provides **sensory innervation to the pyriform fossa** and surrounding hypopharyngeal structures. - Fish bone impaction in the pyriform fossa irritates the **ILN**, causing **cough reflex**, **hoarseness**, and **foreign body sensation** as described in this case. *External Laryngeal Nerve (ELN)* - The **External Laryngeal Nerve** is primarily a **motor nerve** that supplies the **cricothyroid muscle** for vocal cord tensioning. - It provides **minimal sensory contribution** and does not innervate the mucosa of the pyriform fossa. *Glossopharyngeal Nerve* - The **Glossopharyngeal Nerve (CN IX)** provides sensory innervation to the **oropharynx** and **posterior third of tongue**, not the pyriform fossa. - The pyriform fossa is anatomically part of the **hypopharynx (laryngopharynx)**, which is supplied by branches of the **vagus nerve**, not CN IX. *Recurrent Laryngeal Nerve* - The **Recurrent Laryngeal Nerve** primarily provides **motor innervation** to intrinsic laryngeal muscles (except cricothyroid). - Its sensory distribution is limited to the **infraglottic larynx** (below vocal cords), not the pyriform fossa region.

Biochemistry

2 questions

A child presents with fatigue and hepatomegaly. Liver enzymes (ALT, AST) are elevated. Ketosis was significant. Liver biopsy shows excess glycogen accumulation. After feeding, blood glucose levels rise, but there is no rise in glucose after overnight fasting. Which of the following enzyme deficiencies is most likely responsible for this presentation?

Cancer cells take up excess glucose because?

INI-CET 2025 - Biochemistry INI-CET Practice Questions and MCQs

Question 1: A child presents with fatigue and hepatomegaly. Liver enzymes (ALT, AST) are elevated. Ketosis was significant. Liver biopsy shows excess glycogen accumulation. After feeding, blood glucose levels rise, but there is no rise in glucose after overnight fasting. Which of the following enzyme deficiencies is most likely responsible for this presentation?

A. Glucose-6-phosphatase (Correct Answer)
B. Liver phosphorylase
C. Muscle phosphorylase
D. Phosphofructokinase

Explanation: ***Glucose-6-phosphatase*** - This deficiency is characteristic of Glycogen Storage Disease type I (**GSD I** or **Von Gierke disease**), which prevents the final step of both glycogenolysis and gluconeogenesis (conversion of **Glucose-6-Phosphate** to free glucose). - The inability to release free glucose from the liver, especially during fasting, causes severe **fasting hypoglycemia**, significant **ketosis**, and massive **hepatomegaly** due to trapped glycogen and fat accumulation. *Liver phosphorylase* - Deficiency in **Liver phosphorylase** (GSD VI or Hers disease) impairs the breakdown of glycogen but does not affect the gluconeogenesis pathway. - While it leads to hepatomegaly and hypoglycemia, the symptoms are generally **milder** than GSD I, and the profound metabolic derangements (severe ketosis, lactic acidosis) seen in this case are typically less pronounced. *Muscle phosphorylase* - This enzyme deficiency, known as **GSD V** or **McArdle disease**, primarily affects the skeletal muscle, leading to muscle pain, cramps, and **exercise intolerance**. - It does not cause hepatomegaly or issues with hepatic glucose release and therefore is an **unlikely** cause of fasting hypoglycemia in a child. *Phosphofructokinase* - Phosphofructokinase (GSD VII or **Tarui disease**) deficiency affects both muscle and erythrocytes, presenting similar to McArdle disease with **exercise intolerance** and often mild hemolysis. - PFK deficiency primarily affects glycolysis and does not directly impair the liver's ability to release glucose via **gluconeogenesis** or the final G6Pase step during fasting.

Question 2: Cancer cells take up excess glucose because?

A. Lactate is produced even in the presence of Oxygen (Correct Answer)
B. High NADH/NAD ratio
C. High GLUT2
D. Absence of Oxygen

Explanation: ***Lactate is produced even in the presence of Oxygen*** - This phenomenon is known as the **Warburg effect** (or aerobic glycolysis). Cancer cells preferentially ferment glucose to lactate, even when adequate **oxygen** is available, bypassing efficient oxidative phosphorylation. - This inefficient use of glucose allows rapid generation of metabolic intermediates (e.g., carbon backbones) required for the synthesis of **lipids**, proteins, and nucleic acids needed for rapid cell proliferation. *High NADH/NAD ratio* - A **high NADH/NAD+ ratio** signals abundance of reducing equivalents, which would typically inhibit glycolysis and favor oxidative phosphorylation. - Rapid glycolysis, as seen in cancer (Warburg effect), requires the constant regeneration of **NAD+** from NADH via lactate dehydrogenase for the pathway to continue. *High GLUT2* - While cancer cells increase glucose uptake by overexpressing glucose transporters, the typically overexpressed transporter in many solid tumors is **GLUT1**, not GLUT2. - **GLUT2** is primarily found in the liver, kidney, and pancreatic beta cells and is less commonly the primary high-affinity transporter driving the intense uptake seen in malignant cells. *Absence of Oxygen* - The characteristic metabolic change in cancer is that glucose uptake and lactate production occur despite the **presence of oxygen** (aerobic glycolysis). - If oxygen were truly absent (anaerobic conditions), all cell types would produce lactate; hence, the defining feature of cancer is the metabolic shift occurring in an **oxygenated environment**.

Community Medicine

1 questions

What is the minimum age at which a woman can provide valid consent for a Medical Termination of Pregnancy (MTP) in India?

ENT

1 questions

Which of the following statements regarding Juvenile Nasopharyngeal Angiofibroma (JNA) is NOT typically correct or recommended?

INI-CET 2025 - ENT INI-CET Practice Questions and MCQs

Question 1: Which of the following statements regarding Juvenile Nasopharyngeal Angiofibroma (JNA) is NOT typically correct or recommended?

A. Recurrent epistaxis
B. Unilateral nasal obstruction
C. Exclusively to adolescent boys
D. Biopsy under anesthesia to diagnose (Correct Answer)

Explanation: ### **Explanation: Juvenile Nasopharyngeal Angiofibroma (JNA)** **Juvenile Nasopharyngeal Angiofibroma (JNA)** is a benign but locally aggressive, highly vascular tumor. Understanding its management is crucial for NEET-PG/INI-CET. #### **Why "Biopsy" is the Correct Answer (The Incorrect Practice)** * **Contraindication:** A biopsy is **strictly contraindicated** in suspected cases of JNA. Because the tumor is composed of thin-walled blood vessels lacking a muscular coat (*tunica media*), it cannot constrict when injured. * **Risk:** Performing a biopsy can trigger **profuse, life-threatening hemorrhage** that is difficult to control. * **Diagnosis:** Diagnosis is primarily **clinical and radiological**. Contrast-enhanced CT (CECT) or MRI showing the characteristic "Holman-Miller Sign" is sufficient to proceed to surgery without a tissue diagnosis. #### **Analysis of Other Options** * **A & B (Recurrent Epistaxis & Unilateral Nasal Obstruction):** These are the **classic clinical dyad** of JNA. Epistaxis is typically spontaneous, painless, and recurrent. Obstruction is initially unilateral but can become bilateral as the tumor grows. * **C (Exclusively to Adolescent Boys):** JNA is a **testosterone-dependent** tumor. It occurs almost exclusively in males, typically between **10–20 years of age**. If a similar mass is found in a female, a chromosomal analysis or alternative diagnosis should be considered. --- ### **High-Yield Clinical Pearls for INI-CET** * **Origin:** Most commonly arises from the superior border of the **sphenopalatine foramen**. * **Holman-Miller Sign (Antral Sign):** Forward bowing of the posterior wall of the maxillary sinus seen on CT. * **Frog Face Deformity:** Occurs due to the widening of the nasal bridge and proptosis in advanced stages. * **Investigation of Choice:** **CECT** (to assess bone involvement) or **MRI** (to assess intracranial extension). * **Gold Standard Treatment:** Surgical excision (usually via endoscopic or open approaches). **Pre-operative embolization** (24–48 hours prior) is done to reduce intraoperative blood loss. * **Classification:** Fisch or Radkowski classifications are commonly used to stage the tumor.

Forensic Medicine

1 questions

As per the MTP (Amendment) Act, 2021, the opinion of two registered medical practitioners is required for termination of pregnancy at which gestational age?

Physiology

1 questions

A single muscle twitch lasts 40 milliseconds. What is the minimum tetanization frequency required to produce a sustained (fused) contraction in this muscle?