INI-CET 2021 Practice Questions

Q: Which of the following is not a part of case-control studies?

Follow up. ***Follow up*** - **Follow-up** of participants over time to observe disease incidence or outcomes is a characteristic of **cohort studies**, not case-control studies. - Case-control studies are typically **retrospective**, looking back in time after disease occurrence. *Strength of association* - Measuring the **strength of association** between an exposure and an outcome using metrics like the **odds ratio** is a primary objective of case-control studies. - This helps quantify the increased risk of disease attributable to a particular exposure. *Matching* - **Matching** is a technique frequently used in case-control studies to control for **confounding variables** by selecting controls who are similar to cases in terms of age, gender, or other relevant factors. - This helps ensure that any observed association is truly due to the exposure and not other differences between the groups. *Selection of study subjects* - The **selection of study subjects** is fundamental in case-control studies, involving the identification of individuals with the disease (**cases**) and a comparable group without the disease (**controls**). - Careful selection is crucial to minimize bias and ensure the validity of the study findings.

Q: A new drug has been introduced into the market which was found to decrease mortality but it does not cure the disease. Which of the following is a true statement regarding prevalence and incidence?

Increase in prevalence. ***Increase in prevalence*** - A drug that decreases mortality without curing the disease means people **live longer with the condition**, thus increasing the duration of disease - **Prevalence = Incidence × Duration**: Since duration increases while incidence remains constant, prevalence increases - More existing cases accumulate over time as fewer patients die from the disease *Decrease in incidence* - **Incidence** refers to the rate at which **new cases** develop in a population - This drug affects survival of existing cases, not the development of new cases - Since the drug neither prevents nor promotes new cases, **incidence remains unchanged** (not decreased) *Decrease in prevalence* - Prevalence would decrease if the drug **cured the disease** (removing people from the diseased pool) or if **mortality increased** - The scenario describes the opposite: decreased mortality without cure, which **increases** prevalence *Increase in incidence* - This would mean more new cases are developing over time - The drug affects **survival** of existing cases, not the **rate of new diagnoses** - Incidence remains unchanged, not increased

Q: What is triage for?

To classify the priority of treatment. ***To classify the priority of treatment*** - **Triage** is the process of sorting patients to determine the **priority** of their treatment based on the **severity** of their condition and the likelihood of recovery, especially when resources are limited. - This system ensures that those who need immediate care most urgently receive it first, maximizing the number of lives saved. *To rehabilitate following a disaster* - **Rehabilitation** focuses on restoring health and functional abilities after an injury or illness, which occurs **post-treatment**, not as the initial classification of need. - This phase of care happens *after* triage has been completed and immediate medical needs have been addressed. *To prepare for a disaster* - **Disaster preparedness** involves planning and training *before* a disaster strikes to mitigate its effects and ensure an effective response. - Triage is a **response mechanism** utilized *during* or *immediately after* a disaster, not a preparatory measure. *To assess the impact of a disaster* - **Impact assessment** involves evaluating the damage, casualties, and overall consequences of a disaster. - While disaster impact assessment helps guide overall response, triage is specifically about **individual patient assessment** and prioritization for medical care.

Q: Hepatitis B subunit vaccine contains which of the following antigens?

HbsAg. ***HbsAg*** - The Hepatitis B vaccine is a **subunit vaccine** that contains recombinant **hepatitis B surface antigen (HBsAg)**. - This antigen is highly immunogenic and elicits a protective antibody response (anti-HBs) that neutralizes the virus. *HbeAg* - **HBeAg** indicates active viral replication and high infectivity, but it is not the antigen used in the vaccine. - While important for diagnostic purposes, antibodies to HBeAg (anti-HBe) indicate reduced viral replication. *HbcAg* - **HBcAg (hepatitis B core antigen)** is an internal component of the virion and is not found in the subunit vaccine. - Antibodies to HBcAg (anti-HBc) indicate past or current infection but do not confer protective immunity. *HBV DNA* - **HBV DNA** represents the viral genetic material and is a marker of active viral replication and infectivity. - It is not an antigen and therefore not included in a subunit vaccine designed to induce an immune response to viral proteins.

Q: Which of the following is not classified as OCD as per ICD 11?

PTSD. ***PTSD*** - **Post-traumatic stress disorder (PTSD)** is classified under **disorders specifically associated with stress** in ICD-11, not as an OCD-related disorder. - PTSD involves symptoms like re-experiencing the traumatic event, avoidance, and hyperarousal following exposure to a **traumatic event**. *Hypochondriac disorder* - In ICD-11, **hypochondriac disorder (illness anxiety disorder)** is reclassified under **obsessive-compulsive or related disorders**, focusing on preoccupation with having a serious illness. - This reflects the **compulsive checking** and **obsessive fears** associated with the condition. *Body dysmorphic disorder* - **Body dysmorphic disorder** is classified under **obsessive-compulsive or related disorders** in ICD-11. - It is characterized by **preoccupation with perceived flaws in physical appearance** and repetitive behaviors (e.g., mirror checking) in response to these concerns. *Trichotillomania* - **Trichotillomania (hair-pulling disorder)** is classified as an **obsessive-compulsive or related disorder** in ICD-11. - It involves **recurrent pulling out of one's hair** resulting in hair loss, despite repeated attempts to stop.

Q: Which of the following is a true statement about Korsakoff syndrome?

Anterograde amnesia with loss of recent memory. ***Anterograde amnesia with loss of recent memory*** - **Korsakoff syndrome** is primarily characterized by severe **anterograde amnesia**, making it difficult for patients to form new memories after the onset of the condition. - Patients often present with **significant loss of recent memory**, while older, remote memories may remain relatively preserved. *Loss of implicit memory and immediate recall* - While certain aspects of memory are impaired, immediate recall (e.g., repeating a short list of words immediately after hearing them) is often **relatively spared** in Korsakoff syndrome. - **Implicit memory**, which involves unconscious learning of skills and habits, is also typically **intact**, allowing patients to learn new motor skills despite their declarative memory deficits. *Triad of confusion, ophthalmoplegia, and ataxia* - This triad describes **Wernicke encephalopathy**, which is an acute neurological emergency caused by thiamine deficiency, often preceding Korsakoff syndrome. - Korsakoff syndrome, on the other hand, is a more **chronic neuropsychiatric condition** that often develops in individuals who have recovered from an episode of Wernicke encephalopathy. *Loss of long-term memory but intact personality* - While it primarily impacts the formation of new long-term memories, established **remote long-term memories** from before the illness are often **relatively preserved**. - While personality changes can occur due to the brain damage, the statement "intact personality" is **not a defining hallmark** used to differentiate Korsakoff syndrome from other memory disorders.

Q: During rounds, your senior was discussing the given image. Which of the following investigations does this image represent?

CT scan. ***CT scan*** - The image shows multiple **axial slices** with detailed cross-sectional anatomy of the abdomen, which is characteristic of a **Computed Tomography (CT) scan**. - CT scans provide excellent detail of both **soft tissues** and **bone structures** in cross-sectional format, which is the standard appearance of abdominal CT imaging. *X-ray* - Plain X-rays produce **2D projection images**, not the axial cross-sectional slices seen here. - While CT technology uses X-rays, in medical terminology **"X-ray"** refers to conventional radiographs, not cross-sectional imaging. *Contrast Dye study* - This is **not an imaging modality** but rather an enhancement technique used with various imaging methods. - **Contrast agents** improve visualization but don't define the type of investigation being performed. *Angiography* - Angiography is specifically designed to visualize **blood vessels**, often using contrast injection. - This image shows comprehensive **abdominal anatomy**, not the focused vascular imaging typical of angiographic studies.

Q: A 45-year-old patient presented with vague abdominal pain. On USG, he was found to have a renal cyst of Bosniak class III. CECT was done, as shown below. What imaging modality is shown?

CT scan. ***CT scan*** - The image provided is an **axial view** showing internal organs with different densities, characteristic of a **Computed Tomography (CT) scan**. - A CT scan uses X-rays and computer processing to create detailed cross-sectional images of the body. *Contrast Dye study* - A contrast dye study typically refers to the **administration of a contrast agent** to enhance visibility of structures in imaging, it is not an imaging modality itself but an adjunct. - While a CECT (Contrast-Enhanced CT) was mentioned in the clinical scenario, "Contrast Dye study" alone doesn't describe the image type. *Angiography* - **Angiography** is a specialized imaging technique used to visualize blood vessels, typically involving the injection of contrast media. - The image provided shows **parenchymal structures** like the liver and kidneys, not just blood vessels, making angiography an unlikely description. *X-ray* - A general **X-ray** (radiograph) produces a 2D projection of internal structures and does not provide the detailed cross-sectional view seen in this image. - X-rays are typically less sensitive for soft tissue differentiation compared to a CT scan.

Q: A young child presented with mild intermittent upper abdominal pain. X-ray is given below. What is the diagnosis?

Morgagni hernia. ***Morgagni hernia*** - The X-ray shows a **gas-filled lesion** in the **right cardiophrenic angle**, which is characteristic of a Morgagni hernia, where abdominal contents (often colon or omentum) herniate through the foramen of Morgagni. - The mild intermittent **upper abdominal pain** in a child is consistent with the infrequent or non-specific symptoms these hernias can present, as they are often discovered incidentally. *Bochdalek hernia* - **Bochdalek hernias** typically occur posteriorly and laterally, predominately on the **left side**, and are usually identified in the **neonatal period** with severe respiratory distress. - The radiographic appearance would be of abdominal contents (bowel loops, liver, spleen) largely filling the ipsilateral hemithorax, causing significant mediastinal shift, which is not seen here. *Gastric volvulus* - **Gastric volvulus** involves abnormal rotation of the stomach, often presenting with acute symptoms like **epigastric pain, vomiting, and inability to pass a nasogastric tube (Borchardt's triad)**. - Radiographically, it would show a **distended stomach** with an abnormal position, often high in the chest, but without the distinct localized air-filled mass in the cardiophrenic angle. *Eventration of diaphragm* - **Diaphragmatic eventration** is an abnormal elevation of part or all of an intact hemidiaphragm, usually due to muscular hypoplasia. - The X-ray would show a **uniformly elevated hemidiaphragm** with normal continuity, and there would be no discrete air-filled structures above the diaphragm to suggest herniated bowel.

Question 1

Interpret the following graph.

Accepted Answer

Normal, positively skewed, negatively skewed, normal with outliers

Answer

Normal, negatively skewed, positively skewed, skewed with outliers

Answer

Skewed with outliers, positively skewed, negatively skewed, normal

Answer

Normal, negatively skewed, positively skewed, normal with outliers

Question 2

Which of the following is not a part of case-control studies?

Accepted Answer

Follow up

Answer

Strength of association

Answer

Matching

Answer

Selection of study subjects

Question 3

A new drug has been introduced into the market which was found to decrease mortality but it does not cure the disease. Which of the following is a true statement regarding prevalence and incidence?

Accepted Answer

Increase in prevalence

Answer

Decrease in incidence

Answer

Decrease in prevalence

Answer

Increase in incidence

Question 4

What is triage for?

Accepted Answer

To classify the priority of treatment

Answer

To rehabilitate following a disaster

Answer

To prepare for a disaster

Answer

To assess the impact of a disaster

Question 5

Hepatitis B subunit vaccine contains which of the following antigens?

Accepted Answer

HbsAg

Answer

HbeAg

Answer

HbcAg

Answer

HBV DNA

Question 6

Which of the following is not classified as OCD as per ICD 11?

Accepted Answer

PTSD

Answer

Hypochondriac disorder

Answer

Body dysmorphic disorder

Answer

Trichotillomania

Question 7

Which of the following is a true statement about Korsakoff syndrome?

Accepted Answer

Anterograde amnesia with loss of recent memory

Answer

Loss of implicit memory and immediate recall

Answer

Triad of confusion, ophthalmoplegia, and ataxia

Answer

Loss of long-term memory but intact personality

Question 8

During rounds, your senior was discussing the given image. Which of the following investigations does this image represent?

Accepted Answer

CT scan

Answer

Contrast Dye study

Answer

Angiography

Answer

X-ray

Question 9

A 45-year-old patient presented with vague abdominal pain. On USG, he was found to have a renal cyst of Bosniak class III. CECT was done, as shown below. What imaging modality is shown?

Accepted Answer

CT scan

Answer

Contrast Dye study

Answer

Angiography

Answer

X-ray

Question 10

A young child presented with mild intermittent upper abdominal pain. X-ray is given below. What is the diagnosis?

Accepted Answer

Morgagni hernia

Answer

Bochdalek hernia

Answer

Gastric volvulus

Answer

Eventration of diaphragm

INI-CET 2021

Community Medicine

Pharmacology

Psychiatry

Radiology