Anatomy
1 questionsSertoli cells are derived from -
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 431: Sertoli cells are derived from -
- A. Genital swelling
- B. Coelomic epithelium (Correct Answer)
- C. Primordial germ cells
- D. Germinal epithelium
Explanation: Sertoli cells are derived from the **coelomic epithelium** (surface epithelium) of the urogenital ridge during gonadal development. - The coelomic epithelium proliferates to form the **primitive sex cords** (medullary cords in males), and cells within these cords differentiate into Sertoli cells. - These cells are essential for **spermatogenesis**, providing structural support and nutrition to developing germ cells, and producing **anti-Müllerian hormone (AMH)** which causes regression of Müllerian ducts in male development [1]. *Germinal epithelium* - This is an **outdated term** previously used for the surface epithelium of the gonad, based on the misconception that it gave rise to germ cells. - Modern embryology uses the term **coelomic epithelium** or surface epithelium instead. - While historically used, this terminology is no longer preferred in current medical literature. *Genital swelling* - **Genital swellings** (labioscrotal swellings) are external mesodermal structures that develop into the **scrotum** in males or **labia majora** in females. - These are external genitalia components and are not the source of internal testicular cells like Sertoli cells. *Primordial germ cells* - **Primordial germ cells (PGCs)** originate from the epiblast, migrate via the hindgut to the developing gonads, and differentiate into **spermatogonia** (males) or **oogonia** (females) [1]. - They form the **germ cell lineage** (gametes), not somatic support cells like Sertoli cells, which are of coelomic epithelial origin.
Biochemistry
5 questionsBoiled cabbage or rancid butter smelling urine is seen in
Which amino acid is not involved in transamination?
Which of the following is not a metabolic product of the urea cycle?
Which coenzyme is not required in the formation of glutamate?
In the context of energy metabolism, which coenzyme is niacin a precursor to?
NEET-PG 2015 - Biochemistry NEET-PG Practice Questions and MCQs
Question 431: Boiled cabbage or rancid butter smelling urine is seen in
- A. Tyrosinemia
- B. Phenylketonuria
- C. Isovaleric Acidaemia (Correct Answer)
- D. Multiple carboxylase deficiency
Explanation: ***Isovaleric Acidaemia*** - **Boiled cabbage or rancid butter odor** in urine is a classic feature of isovaleric acidemia, caused by the accumulation of isovaleric acid. - This **inborn error of metabolism** affects **leucine metabolism** due to deficiency of isovaleryl-CoA dehydrogenase. *Tyrosinemia* - Does NOT present with boiled cabbage or rancid butter odor. The characteristic features are **liver dysfunction** and **renal tubular defects**. - Tyrosinemia Type I is caused by deficiency of **fumarylacetoacetate hydrolase**, leading to accumulation of tyrosine metabolites. *Phenylketonuria* - Characterized by a **mousy or musty odor** in urine, resulting from the accumulation of phenylacetic acid. - The defect is in the enzyme **phenylalanine hydroxylase**, not associated with boiled cabbage odor. *Multiple carboxylase deficiency* - Typically presents with a **"cat urine" smell** due to the accumulation of various organic acids. - The deficiency impairs the function of several **biotin-dependent carboxylases**, not specifically linked to the boiled cabbage odor.
Question 432: Which amino acid is not involved in transamination?
- A. Alanine
- B. Aspartate
- C. Lysine (Correct Answer)
- D. Histidine
Explanation: ***Lysine*** - **Lysine** cannot undergo transamination because it lacks the structural requirements for typical transaminase enzymes. - While lysine has both an **α-amino group** and an **ε-amino group**, its metabolic pathway involves **oxidative deamination** rather than transamination. - Along with **threonine**, lysine is one of only two amino acids that do not participate in transamination reactions. *Alanine* - **Alanine** is a major substrate for transamination, readily converting to pyruvate via **alanine transaminase (ALT)**. - This reaction involves the transfer of its **α-amino group** to an α-keto acid, typically α-ketoglutarate, forming glutamate. *Aspartate* - **Aspartate** is actively involved in transamination, converting to oxaloacetate via **aspartate transaminase (AST)**. - Its **α-amino group** is easily transferred to α-ketoglutarate, forming glutamate. *Histidine* - **Histidine** can undergo transamination, though less commonly cited as a primary substrate compared to aspartate and alanine. - It can transfer its **α-amino group** to an α-keto acid, leading to the formation of imidazolepyruvate.
Question 433: Which of the following is not a metabolic product of the urea cycle?
- A. Citrulline
- B. Arginine
- C. Alanine (Correct Answer)
- D. Ornithine
Explanation: ***Alanine*** - **Alanine** is an amino acid primarily involved in the **glucose-alanine cycle** for glucose production and ammonia transport, not as a direct metabolic product within the urea cycle. - While it plays a role in nitrogen metabolism, it is not synthesized or directly consumed as an intermediate in the reactions that convert ammonia to urea. *Citrulline* - **Citrulline** is a key intermediate formed during the second step of the urea cycle when **ornithine carbamoyltransferase** combines carbamoyl phosphate with ornithine. - It is then transported out of the mitochondrion into the cytosol to continue the cycle. *Ornithine* - **Ornithine** is an amino acid that acts as a **catalytic intermediate** in the urea cycle, being regenerated at the end of the cycle to combine with carbamoyl phosphate. - It does not directly contribute a nitrogen atom to urea but is essential for the cycle's continuation. *Arginine* - **Arginine** is an amino acid that is a direct precursor to urea in the penultimate step of the urea cycle, where **arginase** cleaves it into urea and ornithine. - It provides one of the nitrogen atoms and the carbon atom for the formation of urea.
Question 434: Which coenzyme is not required in the formation of glutamate?
- A. None of the above
- B. Pyridoxal phosphate
- C. Thiamine pyrophosphate (Correct Answer)
- D. Niacin
Explanation: ***Thiamine pyrophosphate*** - **Thiamine pyrophosphate (TPP)** is a coenzyme derived from **vitamin B1** that is essential for reactions involving decarboxylation, such as those catalyzed by pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase. - The formation of glutamate primarily involves transamination or reductive amination, which do not require TPP. *Pyridoxal phosphate* - **Pyridoxal phosphate (PLP)**, derived from **vitamin B6**, is a crucial coenzyme for **transamination reactions**, which are a major pathway for glutamate synthesis (e.g., from alpha-ketoglutarate). - It also plays a role in decarboxylation and deamination reactions of amino acids. *Niacin* - **Niacin (vitamin B3)** is a precursor for **NAD+** and **NADP+**, which are essential coenzymes in many metabolic pathways. - **NADPH**, derived from NADP+, is required as a reductant in the **reductive amination** of **alpha-ketoglutarate** to form glutamate, catalyzed by glutamate dehydrogenase. *None of the above* - This option is incorrect because **thiamine pyrophosphate** is indeed not required for the formation of glutamate. - The other two coenzymes, **pyridoxal phosphate** and **niacin (as NAD(P)H)**, are involved in glutamate synthesis.
Question 435: In the context of energy metabolism, which coenzyme is niacin a precursor to?
- A. Thiamine pyrophosphate (TPP)
- B. NADP
- C. NAD (Correct Answer)
- D. Flavin adenine dinucleotide (FAD)
Explanation: ***NAD*** - Niacin (vitamin B3) is a direct precursor to **nicotinamide adenine dinucleotide (NAD/NAD+)**. - NAD is the crucial coenzyme in **energy metabolism**, primarily involved in **catabolic pathways** such as glycolysis, TCA cycle, and electron transport chain. - Functions as an **electron carrier** in redox reactions, accepting electrons during oxidation of fuel molecules. *Thiamine pyrophosphate (TPP)* - **Thiamine (vitamin B1)** is the precursor to TPP, not niacin. - TPP plays a vital role in **carbohydrate metabolism**, particularly in pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase complexes. *NADP* - While niacin is also a precursor to **NADP/NADPH**, this coenzyme is primarily used in **anabolic (biosynthetic) pathways**, not energy metabolism. - NADP functions in reductive biosynthesis (fatty acid synthesis, cholesterol synthesis) and **oxidative stress protection** via the pentose phosphate pathway. - The question specifically asks about **energy metabolism**, making NAD the correct answer as it participates in catabolic, energy-producing reactions. *Flavin adenine dinucleotide (FAD)* - **Riboflavin (vitamin B2)** is the precursor to FAD, not niacin. - FAD is a coenzyme involved in various metabolic reactions, especially in the **TCA cycle** and **electron transport chain**, acting as an electron acceptor.
Obstetrics and Gynecology
1 questionsWhich drug is contraindicated before delivery of the baby (during first and second stages of labor)?
NEET-PG 2015 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 431: Which drug is contraindicated before delivery of the baby (during first and second stages of labor)?
- A. Mifepristone
- B. Oxytocin
- C. Misoprostol
- D. Ergometrine (Correct Answer)
Explanation: ***Ergometrine*** - **Ergometrine** is a potent uterotonic agent that causes **tetanic (sustained) uterine contractions**. - It is **absolutely contraindicated before delivery of the baby** (during first and second stages of labor) because: - Sustained contractions lead to **fetal hypoxia** and **fetal distress** by reducing placental blood flow - Risk of **uterine rupture** due to excessive uterine tone - **Obstructed labor** and **cervical lacerations** from forcing delivery against sustained contraction - Ergometrine is **only used after delivery of the baby** in the third stage for active management and prevention of postpartum hemorrhage. *Mifepristone* - **Mifepristone** is an antiprogesterone used for medical abortion in early pregnancy or cervical ripening before labor induction. - It is not relevant during active labor as it acts by blocking progesterone receptors, not by causing immediate uterine contractions. *Oxytocin* - **Oxytocin** is the drug of choice for induction and augmentation of labor. - It causes **rhythmic, intermittent contractions** that allow for adequate placental perfusion between contractions. - Safe to use during first and second stages when properly monitored. *Misoprostol* - **Misoprostol** is a prostaglandin E1 analog used for cervical ripening and labor induction. - Can be used before and during labor for induction, though requires careful monitoring. - Unlike ergometrine, it does not cause sustained tetanic contractions when used in appropriate doses.
Pharmacology
3 questionsWhich of the following is an aromatase inhibitor?
Which antithyroid drug is preferred during the first trimester of pregnancy due to relatively lower placental transfer?
Which triptan is available in nasal spray form?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 431: Which of the following is an aromatase inhibitor?
- A. Letrozole (Correct Answer)
- B. Tamoxifen
- C. Danazol
- D. Taxane
Explanation: ***Letrozole*** - **Letrozole** is a commonly used **aromatase inhibitor**, which works by blocking the enzyme **aromatase** that converts androgens into estrogens [1]. - This reduction in estrogen levels is crucial in treating **hormone-sensitive breast cancers** [1]. *Tamoxifen* - **Tamoxifen** is a **selective estrogen receptor modulator (SERM)**, not an aromatase inhibitor [2]. - It acts by blocking estrogen receptors in breast tissue while potentially stimulating them in other tissues like bone and uterus [2]. *Danazol* - **Danazol** is a synthetic androgen that suppresses the hypothalamic-pituitary-gonadal axis, leading to **decreased estrogen production**. - It works by inhibiting gonadotropin release and directly inhibiting ovarian steroidogenesis, rather than blocking the aromatase enzyme directly. *Taxane* - **Taxanes** are a class of **chemotherapy drugs** that interfere with cell division by stabilizing microtubules. - They are used to treat various cancers, including breast cancer, but do not act as aromatase inhibitors.
Question 432: Which antithyroid drug is preferred during the first trimester of pregnancy due to relatively lower placental transfer?
- A. Carbimazole
- B. Propylthiouracil (Correct Answer)
- C. Both
- D. None of the options
Explanation: ***Propylthiouracil*** - **Propylthiouracil (PTU)** is the preferred antithyroid drug during the **first trimester** of pregnancy because it crosses the placenta less readily than methimazole/carbimazole. - While it still crosses the placenta, its lower placental transfer and association with fewer fetal anomalies in early pregnancy make it a safer initial choice, especially to minimize the risk of **fetal embryopathy** associated with methimazole. *Carbimazole* - **Carbimazole** (which is metabolized to methimazole) can cross the placenta more easily than PTU and has been associated with **fetal anomalies**, particularly in the first trimester. - Its use is generally avoided during the first trimester due to concerns about congenital malformations such as **aplasia cutis** and **esophageal atresia**. *Both* - While both drugs can cross the placenta to some extent, their safety profiles and recommended use during pregnancy differ significantly. - Carbimazole (methimazole) has a higher risk of teratogenicity in the first trimester compared to PTU. *None of the options* - This option is incorrect because propylthiouracil is indeed known to cross the placenta and is commonly used in pregnancy, especially during the first trimester. - The choice of antithyroid drug is a critical consideration in managing hyperthyroidism in pregnancy.
Question 433: Which triptan is available in nasal spray form?
- A. Sumatriptan (Correct Answer)
- B. Rizatriptan
- C. Naratriptan
- D. Frovatriptan
Explanation: ***Sumatriptan*** - **Sumatriptan** is available in multiple formulations, including **oral, subcutaneous injection, and nasal spray**, making it versatile for migraine treatment [1], [2]. - The nasal spray formulation allows for **faster absorption** and onset of action, which can be beneficial for patients with nausea or vomiting during migraine attacks [1]. *Rizatriptan* - **Rizatriptan** is primarily available in **oral tablet** and **orally disintegrating tablet** (ODT) forms [2]. - It does not have a commonly available nasal spray formulation for migraine treatment [2]. *Naratriptan* - **Naratriptan** is available as an **oral tablet** and is known for its **longer half-life** and generally milder side effect profile compared to sumatriptan [2]. - It is not available in a nasal spray formulation [2]. *Frovatriptan* - **Frovatriptan** is available exclusively as an **oral tablet** and is notable for having the **longest half-life** among triptans, making it useful for preventing recurring migraines [2]. - There is no nasal spray formulation for frovatriptan [2].