INI-CET 2014 Previous Year Questions Practice Questions

Q: Which of the following induces apoptosis in a cell?

Glucocorticoids. ***Glucocorticoids*** - **Glucocorticoids** are known to induce apoptosis in various cell types, particularly lymphocytes, making them useful in **lymphoid malignancies**. - They activate a complex signaling pathway that leads to the activation of pro-apoptotic proteins and the suppression of anti-apoptotic proteins, ultimately resulting in **programmed cell death**. *Isoprenoids* - **Isoprenoids** are a large class of organic compounds derived from isoprene, involved in various metabolic processes like cholesterol synthesis and protein prenylation, but do not directly induce apoptosis. - While some isoprenoid precursors or inhibitors of isoprenoid synthesis can affect cell proliferation or survival, isoprenoids themselves are not primary apoptosis inducers. *Myristic acid* - **Myristic acid** is a saturated fatty acid primarily involved in protein myristoylation, a post-translational modification essential for various cellular functions. - It is not known to be a direct inducer of apoptosis but can influence signaling pathways that may indirectly impact cell survival or death. *Oleic acid* - **Oleic acid** is a monounsaturated fatty acid that is a major component of cell membranes and is involved in energy storage and signaling. - It is generally considered cytoprotective and can even inhibit apoptosis in some contexts, rather than inducing it. [Practice more INI-CET 2014 questions on OnCourse]

Q: In an act of tribadism, the active partner is known as: (AIIMS 12; COMEDK 14)

Butch. ***Butch*** - While this answer reflects the terminology used in the original examination, it's important to note that **"butch"** is primarily a **sociocultural identity term** describing masculine gender expression in lesbian relationships, rather than standard forensic medicine terminology. - In classical forensic medicine literature, the active partner in tribadism is more accurately termed a **"tribade"** (from Greek "tribein" = to rub). - Tribadism refers to a form of **female same-sex sexual activity** where the active partner achieves sexual gratification by **rubbing or pressing the vulva** against another woman's body, particularly the thigh, pubic region, or vulva. - This question reflects **historical exam terminology** rather than current forensic medicine standards. *Bugger* - This is an archaic/derogatory term historically used for a person who performs **anal intercourse** (buggery/sodomy). - The term is associated with **male same-sex activity** or unnatural sexual offenses under older legal frameworks. - It is **not related to tribadism**, which involves female same-sex activity without penetration. *Femme* - This is a sociocultural term describing the more **feminine-presenting partner** in some lesbian relationships. - It refers to **gender expression/identity**, not a forensic medicine classification of sexual acts. - This is **not standard medicolegal terminology** for describing roles in tribadism. *Catamite* - A catamite refers to a **young boy kept for homosexual purposes**, historically associated with pederasty in ancient civilizations. - This term is related to **male same-sex activity** and is entirely **irrelevant to tribadism**, which is a form of female same-sex sexual activity. - This is an archaic term rarely used in modern forensic medicine. [Practice more INI-CET 2014 questions on OnCourse]

Q: A 65-year-old elderly male has history of sweating and chest pain for last 24 hr with the following ECG. Which of the following is not given in managing the patient?

Thrombolytic therapy. ***Thrombolytic therapy*** - **Thrombolytic therapy** is contraindicated in this patient due to the **24-hour delay** from symptom onset, as fibrinolytic therapy is generally not recommended beyond **12 hours** and absolutely contraindicated after **24 hours**. - The **risk-benefit ratio** becomes unfavorable after this time window, with increased bleeding risk and minimal myocardial salvage potential, making **primary PCI** the preferred reperfusion strategy if available. *Aspirin* - **Aspirin** remains indicated in STEMI regardless of presentation timing as an **antiplatelet agent**. - It provides ongoing **secondary prevention** benefits and helps prevent further thrombotic events even in delayed presentations. *Statin* - **High-dose statin therapy** is recommended immediately in all ACS patients, including those with delayed presentation. - Statins provide **plaque stabilization** and **anti-inflammatory effects** that are beneficial regardless of symptom onset timing. *Morphine* - While **morphine** is generally avoided in STEMI due to potential **delayed absorption** of oral antiplatelet agents and possible increased mortality, it may still be considered for **severe refractory chest pain**. - It can be used cautiously when **nitroglycerin** fails to provide adequate pain relief, especially in delayed presentations where reperfusion options are limited. [Practice more INI-CET 2014 questions on OnCourse]

Q: Commonest cause of thunderclap headache:

Aneursymal SAH. ***Aneursymal SAH*** - An **aneurysmal subarachnoid hemorrhage (SAH)** is the most common and often life-threatening cause of a **thunderclap headache**, characterized by a sudden, severe headache reaching maximum intensity within one minute [1]. - The sudden rupture of a cerebral aneurysm leads to blood spilling into the subarachnoid space, causing a rapid increase in intracranial pressure and meningeal irritation. *Basilar migraine* - While basilar migraine can cause severe headaches, it typically presents with neurological symptoms like **vertigo**, **ataxia**, and **diplopia** preceding the headache phase, and its onset is usually less abrupt than a thunderclap headache. - Basilar migraines usually have a **recurrent pattern** and are associated with a history of similar migraine episodes, unlike the abrupt, singular nature of an SAH-related thunderclap headache. *Extradural hemorrhage* - An **extradural (epidural) hemorrhage** is usually caused by **head trauma** and often presents with a **lucid interval** followed by a progressive neurological decline, rather than an immediate thunderclap headache [2]. - It involves bleeding between the **dura mater** and the skull, which typically develops more slowly than the catastrophic onset of an SAH. *Subdural hemorrhage* - A **subdural hemorrhage** is usually caused by **venous bleeding** and can be acute, subacute, or chronic, often presenting with a gradual onset of symptoms like headache, confusion, and neurological deficits [2]. - While an acute subdural hematoma can be severe, its headache is generally not as instantaneously explosive or universally described as a thunderclap as that seen with SAH. [Practice more INI-CET 2014 questions on OnCourse]

Q: A 65-year-old elderly male with the ECG shown below has a history of sweating and chest pain for the last 24 hrs . Which of the following is not given in managing the patient?

Thrombolytic therapy. ***Thrombolytic therapy*** - The ECG shows significant **Q waves** and **T-wave inversion** in inferolateral leads (II, III, aVF, V5, V6), indicating an **evolving or established myocardial infarction** (MI), not an acute ST-elevation MI (STEMI suitable for immediate thrombolysis). - Given the symptoms began 24 hours ago, the patient is likely outside the optimal window for thrombolytic therapy, which is most effective within **12 hours** of symptom onset for STEMI. After 12-24 hours, the benefits are marginal, and risks of bleeding increase. *Aspirin* - **Aspirin** is an integral part of NSTEMI/STEMI management as an **antiplatelet agent**, given to almost all patients who are not allergic, regardless of time of presentation. - It works by **inhibiting cyclooxygenase** and thereby reducing platelet aggregation, preventing further clot formation. *Statin* - **Statins** are initiated early in MI management, even in the acute phase, for their **pleiotropic effects** beyond lipid-lowering, including **stabilizing plaques** and reducing inflammation. - Long-term statin therapy is crucial for **secondary prevention** in patients with established coronary artery disease. *Morphine* - **Morphine** is often used in the acute management of MI for **pain relief** and can also provide some **venodilation**, reducing preload and myocardial oxygen demand. - While typically used during the active chest pain phase, it remains an option for symptom management if pain persists, even after 24 hours. *Beta-blockers* - **Beta-blockers** are a cornerstone of post-MI management, started within the first 24 hours in hemodynamically stable patients without contraindications. - They reduce **myocardial oxygen demand**, prevent arrhythmias, and improve long-term survival. - Standard therapy even at 24 hours post-MI presentation. [Practice more INI-CET 2014 questions on OnCourse]

Question 1

Which of the following induces apoptosis in a cell?

Accepted Answer

Glucocorticoids

Answer

Isoprenoids

Answer

Myristic acid

Answer

Oleic acid

Question 2

In an act of tribadism, the active partner is known as: (AIIMS 12; COMEDK 14)

Accepted Answer

Butch

Answer

Bugger

Answer

Femme

Answer

Catamite

Question 3

A 65-year-old elderly male has history of sweating and chest pain for last 24 hr with the following ECG. Which of the following is not given in managing the patient?

Accepted Answer

Thrombolytic therapy

Answer

Aspirin

Answer

Statin

Answer

Morphine

Question 4

Commonest cause of thunderclap headache:

Accepted Answer

Aneursymal SAH

Answer

Basilar migraine

Answer

Extradural hemorrhage

Answer

Subdural hemorrhage

Question 5

A 65-year-old elderly male with the ECG shown below has a history of sweating and chest pain for the last 24 hrs . Which of the following is not given in managing the patient?

Accepted Answer

Thrombolytic therapy

Answer

Aspirin

Answer

Statin

Answer

Morphine

Answer

Beta-blockers

Question 6

Which cells are affected in glaucomatous optic neuropathy?

Accepted Answer

Ganglion cells

Answer

Amacrine cells

Answer

Bipolar cells

Answer

Rods and cones

Question 7

A 7-year-old girl is easily distracted in class and exhibits poor scholastic performance. EEG shows? (AIIMS May 2014)

Accepted Answer

Absence seizures

Answer

Myoclonic seizures

Answer

Atonic seizures

Answer

Myoclonia

Question 8

A 6-week-old baby presents with cough and cold for the past 3 days. The respiratory rate is 48/min. On examination, the patient is febrile with wheezing but no chest indrawing. Which of the following statements is not true?

Accepted Answer

The child has pneumonia.

Answer

Antibiotics are not required.

Answer

Wheezing should be treated.

Answer

Fever should be treated.

Question 9

Methacholine acts primarily at which receptor?

Accepted Answer

M3

Answer

M1

Answer

M2

Answer

M4

Question 10

Which of the following conditions is NOT treated with a cholinomimetic agent?

Accepted Answer

Bradycardia

Answer

Glaucoma

Answer

Myasthenia gravis

Answer

Post-surgical atony or ileus

INI-CET 2014

Biochemistry

Forensic Medicine

General Medicine

Internal Medicine

Ophthalmology

Pediatrics

Pharmacology

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