INI-CET 2021 Practice Questions

Q: Beta hCG is structurally similar to which biochemical moiety?

LH. ***LH*** - **Beta-hCG** and **Luteinizing Hormone (LH)** both belong to the family of glycoprotein hormones and share a common alpha subunit. - Their **beta subunits** are also very similar, with a significant overlap in their amino acid sequences, allowing **hCG** to bind to and activate **LH receptors**. *Oxytocin* - **Oxytocin** is a **peptide hormone** primarily involved in uterine contractions and milk ejection. - It is structurally distinct from **glycoprotein hormones** like **hCG** and lacks the alpha and beta subunit structure. *FSH* - **Follicle-Stimulating Hormone (FSH)** is a glycoprotein hormone that shares the same alpha subunit with hCG, LH, and TSH. - However, its **beta subunit** is distinct from that of **hCG**, which gives it its unique biological specificity. *ACTH* - **Adrenocorticotropic Hormone (ACTH)** is a **peptide hormone** produced by the anterior pituitary gland, regulating adrenal gland function. - It has a completely different structure and function compared to **hCG** and other glycoprotein hormones.

Q: Mobile Medical Units (MMUs) under government health programs can operate through different models. Which of the following statements about MMU operations are correct? 1. MMUs are run by the government 2. MMUs are run by external agencies with medical supplies given by the government 3. MMUs are run by the government and medical supplies are also given by the government 4. MMUs are run by external agencies and medical supplies are also given by the external agency

1, 2, and 3. ***1, 2, and 3*** - This option correctly identifies the flexible operational models of **Mobile Medical Units (MMUs)** under government health programs. - MMUs can be directly managed by the **government**, managed by **external agencies** with government-provided supplies, or managed by the government with **government-provided supplies**. *1, 2, 3, and 4* - This option incorrectly includes the scenario where MMUs are run by **external agencies** and medical supplies are also provided by the **external agency**. - While external agencies can run MMUs, government health programs typically ensure that essential medical supplies are provided or funded by the **government** to maintain standardization and accessibility. *1 and 2* - This option is incomplete as it misses the model where both the MMU operation and medical supplies are provided by the **government** (statement 3). - Government health programs often have fully integrated models, especially in remote areas. *Only 1* - This option is too restrictive, as it only includes the model where MMUs are run by the **government**. - MMUs often involve partnerships with **external agencies** for operational efficiency or specialized services.

Q: You are starting services for hypertension in your PHC. 50 patients who required antihypertensive treatment were transferred from another center. 40 of them were on amlodipine ( 5 mg PO) and 10 were on lisinopril ( 10 mg PO) as they had contraindications to the use of amlodipine. The drugs are supplied at the PHC on a monthly basis and you have to place an order for their medications. What is the number of tablets that you will order and the reorder factor?

1600, rf=2. ***1600, rf=2*** - **Monthly requirement calculation:** 40 patients need amlodipine (40 × 30 = 1,200 tablets/month) and 10 patients need lisinopril (10 × 30 = 300 tablets/month), totaling **1,500 tablets per month**. - With a **reorder factor of 2**, the inventory management principle suggests maintaining stock for potential delays. Using the formula: Order quantity = (Monthly need × Lead time) + Safety stock, this yields approximately **1,600 tablets** accounting for a practical buffer. - This represents a **rational inventory level** balancing supply continuity against storage constraints in a PHC setting. *1000, rf=3* - This quantity (1,000 tablets) is **insufficient** as it doesn't even cover one month's requirement of 1,500 tablets. - A reorder factor of 3 with inadequate base quantity would lead to **stockout** and treatment interruption. *1200, rf=2* - This covers only the **amlodipine requirement** (1,200 tablets) but completely omits the lisinopril requirement (300 tablets). - Would result in **immediate stockout** of lisinopril for 10 patients, compromising patient care. - Does not account for any **safety stock** or lead time buffer. *1400, rf=3* - While closer to the monthly need, **1,400 tablets is still below** the 1,500 required monthly. - A reorder factor of 3 is inconsistent with monthly ordering cycles and would suggest excessive inventory if properly calculated. - Does not follow standard **pharmaceutical inventory management** principles for this scenario.

Q: Compared to a pregnant female, a lactating female would require a higher level of nutrient supplementation for which of the following?

Calcium. ***Calcium*** - **Lactating women** require higher calcium intake compared to pregnant women due to significant calcium transfer into **breast milk** for infant bone development. - This increased demand helps maintain maternal bone density and ensures adequate calcium supply for the baby. *Folic acid* - **Folic acid** is critically important during **pregnancy** to prevent neural tube defects, with supplementation typically decreasing postpartum. - While still necessary, the daily recommended intake for lactating women is generally lower than during pregnancy. *Iron* - **Iron requirements** are highest during **pregnancy** to support increased maternal blood volume and fetal development. - In lactating women, iron needs often decrease postpartum, especially if there was minimal blood loss during delivery and menstruation has not yet resumed. *Vitamin A* - While **Vitamin A** is important for both pregnant and lactating women, the recommended intake for pregnant women tends to be slightly higher, especially for **fetal organ development**. - Excessive vitamin A can be teratogenic during pregnancy, so supplementation needs careful monitoring in both states.

Q: Following a road traffic accident, a patient develops type IIIa compound tibial fracture. Arrange the following external fixators in decreasing order of their stability (highest to lowest) 1. Ilizarov fixator 2. Uniplanar with a single rod 3. Uniplanar with double rod 4. Biplanar frame/Ring with a cylindrical rod

1>4>3>2. ***1>4>3>2*** - **Ilizarov fixator** utilizes multiple wires **under tension** and rings, providing the most **biologically stable** and rigid fixation due to its distributed force across the bone. - **Biplanar frames/Rings with a cylindrical rod** offer high stability by providing pin fixation in **two different planes**, significantly resisting bending and torsional forces. - **Uniplanar with double rod** provides better stability than a single rod by increasing the **moment of inertia** and reducing deflection under axial and bending loads. - **Uniplanar with a single rod** is the least stable due to its limited resistance to **torsional** and **bending forces** as pin placement is restricted to a single plane.

Q: If the outer sheath and nerve fibres are intact and the inner axon is damaged, it is known as

Axonotmesis. ***Axonotmesis*** - This type of nerve injury involves damage to the **axon** itself, while the connective tissue layers (**endoneurium, perineurium, epineurium**) remain intact. - While the axon is disrupted, the preservation of the nerve's outer sheath allows for potential, albeit slow, **regeneration** of the axon. *Axonapraxia* - This term is not a standard classification of nerve injury. The correct term for a transient block in nerve conduction is **neurapraxia**. *Neurotmesis* - **Neurotmesis** is the most severe type of nerve injury, involving complete severance of the **axon** and all supporting **connective tissue sheaths**. - This type of injury requires **surgical repair** for any chance of functional recovery. *Neurapraxia* - **Neurapraxia** is the mildest form of nerve injury, characterized by a temporary **conduction block** without axonal damage. - Recovery is typically complete within days to weeks, as the **myelin sheath** may be temporarily dysfunctional but the axon remains intact.

Q: At what age does a child attain half-height of the adult height?

20 - 24 months. ***20 - 24 months*** - A child typically reaches **half of their adult height at approximately 2 years of age**, which corresponds to 20-24 months. - This is a well-established **pediatric growth milestone** used clinically to assess normal growth patterns. - At 2 years, average height is around **85-87 cm**, which represents approximately 50% of average adult height (170-175 cm). - This milestone applies to both boys and girls, though individual variations occur based on genetics and parental height. *32 - 36 months* - By this age (2.5-3 years), a child has already **exceeded half of their adult height**. - Children at this age are typically around **92-96 cm**, which is more than 50% of eventual adult stature. - This represents continued linear growth beyond the 2-year milestone. *12 - 18 months* - At this age, a child is usually around **74-82 cm** tall. - This period is characterized by rapid infant growth, but height attained is **less than half** of eventual adult height. - Represents approximately 40-45% of adult height. *40 - 48 months* - By this age (3.5-4 years), a child has **significantly exceeded half of their adult height**. - Children at this age are typically around **98-105 cm**, representing approximately 55-60% of adult height. - This marks the slower, steady growth phase of early childhood.

Q: Milk production in pregnancy is inhibited by :

High estrogen. ***High estrogen*** - High levels of **estrogen** and progesterone during pregnancy inhibit milk production by blocking the action of **prolactin** on the mammary glands. - After delivery, the sudden drop in these hormones removes the inhibition, allowing prolactin to stimulate **lactogenesis**. *Low luteinizing hormone* - **Luteinizing hormone (LH)** is primarily involved in ovulation and corpus luteum formation, not directly in the inhibition of milk production. - Low LH levels would impact fertility but not have a direct inhibitory effect on lactation. *Low thyroid-stimulating hormone* - **Thyroid-stimulating hormone (TSH)** regulates thyroid function, which can indirectly affect metabolism and overall well-being. - While **hypothyroidism** can impact milk supply, low TSH itself is not a direct inhibitor of milk production. *Human somatomammotropin* - **Human placental lactogen (HPL)**, also known as human chorion somatomammotropin, is produced by the placenta. - It promotes mammary gland development and has weak lactogenic properties but does not inhibit milk production.

Q: All of the following increases gastric acid secretion except?

Serotonin. ***Serotonin*** - **Serotonin** (5-HT) is primarily known for its roles in gastrointestinal motility and CNS function, but it does not directly stimulate **gastric acid secretion**. - While it can influence gastric function indirectly, it is not a direct secretagogue for **parietal cells**. *Acetylcholine* - **Acetylcholine** (ACh), released from parasympathetic nerve endings, directly stimulates **parietal cells** to secrete hydrochloric acid. - It also enhances the release of **histamine** and **gastrin**, both of which promote acid secretion. *Histamine* - **Histamine**, released from enterochromaffin-like (ECL) cells in the gastric mucosa, is a potent stimulator of **gastric acid secretion**. - It acts on **H2 receptors** on parietal cells, leading to increased acid production. *Gastrin* - **Gastrin**, a hormone produced by G cells in the pyloric antrum, is a powerful stimulator of **gastric acid secretion**. - It acts directly on **parietal cells** and also promotes **histamine release** from ECL cells.

Q: Pacinian corpuscle is stimulated by which of the following?

Pressure. ***Pressure*** - **Pacinian corpuscles** are rapidly adapting mechanoreceptors that detect **deep pressure** and **vibrations**. - Their layered, onion-like structure allows them to be very sensitive to rapid changes in pressure. *Pain* - **Pain** is primarily detected by **nociceptors**, which are free nerve endings, not Pacinian corpuscles. - Nociceptors respond to various noxious stimuli, including mechanical, thermal, and chemical. *Temperature* - **Temperature** changes are detected by **thermoreceptors**, such as Krause end bulbs for cold and Ruffini endings for warmth, not Pacinian corpuscles. - These receptors have specific temperature ranges over which they are active. *Touch* - **Touch** sensation is broadly detected by several mechanoreceptors, including **Meissner's corpuscles** (light touch), **Merkel discs** (sustained touch), and hair follicle receptors. - While Pacinian corpuscles contribute to sensing touch through deep pressure, they are not the primary receptors for general light or sustained touch.

Question 1

Beta hCG is structurally similar to which biochemical moiety?

Accepted Answer

LH

Answer

Oxytocin

Answer

FSH

Answer

ACTH

Question 2

Mobile Medical Units (MMUs) under government health programs can operate through different models. Which of the following statements about MMU operations are correct?

1. MMUs are run by the government
2. MMUs are run by external agencies with medical supplies given by the government
3. MMUs are run by the government and medical supplies are also given by the government
4. MMUs are run by external agencies and medical supplies are also given by the external agency

Accepted Answer

1, 2, and 3

Answer

1, 2, 3, and 4

Answer

1 and 2

Answer

Only 1

Question 3

You are starting services for hypertension in your PHC. 50 patients who required antihypertensive treatment were transferred from another center. 40 of them were on amlodipine ( 5 mg PO) and 10 were on lisinopril ( 10 mg PO) as they had contraindications to the use of amlodipine. The drugs are supplied at the PHC on a monthly basis and you have to place an order for their medications. What is the number of tablets that you will order and the reorder factor?

Accepted Answer

1600, rf=2

Answer

1000, rf=3

Answer

1200, rf=2

Answer

1400, rf=3

Question 4

Compared to a pregnant female, a lactating female would require a higher level of nutrient supplementation for which of the following?

Accepted Answer

Calcium

Answer

Folic acid

Answer

Iron

Answer

Vitamin A

Question 5

Following a road traffic accident, a patient develops type IIIa compound tibial fracture. Arrange the following external fixators in decreasing order of their stability (highest to lowest)

1. Ilizarov fixator
2. Uniplanar with a single rod
3. Uniplanar with double rod
4. Biplanar frame/Ring with a cylindrical rod

Accepted Answer

1>4>3>2

Answer

2>4>3>1

Answer

1>2>3>4

Answer

2>3>1>4

Question 6

If the outer sheath and nerve fibres are intact and the inner axon is damaged, it is known as

Accepted Answer

Axonotmesis

Answer

Axonapraxia

Answer

Neurotmesis

Answer

Neurapraxia

Question 7

At what age does a child attain half-height of the adult height?

Accepted Answer

20 - 24 months

Answer

32 - 36 months

Answer

12 - 18 months

Answer

40 - 48 months

Question 8

Milk production in pregnancy is inhibited by :

Accepted Answer

High estrogen

Answer

Low luteinizing hormone

Answer

Low thyroid-stimulating hormone

Answer

Human somatomammotropin

Question 9

All of the following increases gastric acid secretion except?

Accepted Answer

Serotonin

Answer

Acetylcholine

Answer

Histamine

Answer

Gastrin

Question 10

Pacinian corpuscle is stimulated by which of the following?

Accepted Answer

Pressure

Answer

Pain

Answer

Temperature

Answer

Touch

INI-CET 2021

Biochemistry

Community Medicine

Orthopaedics

Pediatrics

Physiology