INI-CET 2023 Practice Questions

Q: What can cause the absence of fructose in seminal fluid?

Both of the above. ***Both of the above*** - **Fructose** in seminal fluid is primarily produced by the **seminal vesicles**, providing energy for sperm motility. - Therefore, either a **congenital absence of seminal vesicles** or an **ejaculatory duct obstruction** (preventing seminal vesicle secretions from reaching the ejaculate) would lead to the absence of fructose. *Congenital absence of seminal vesicle* - The **seminal vesicles** are the primary source of fructose in seminal fluid. - If a person is born without these glands, **fructose will be absent** from their seminal fluid. *Ejaculatory duct obstruction* - An obstruction in the **ejaculatory ducts** would block the passage of secretions from the **seminal vesicles** and vasoepididymis into the urethra. - This prevents **fructose** (from the seminal vesicles) and sperm (from the testes/epididymis) from being present in the ejaculate. *None of the above* - This option is incorrect because both **congenital absence of seminal vesicles** and **ejaculatory duct obstruction** are valid causes for the absence of fructose in seminal fluid.

Q: DNA sequence is determined by?

Sanger sequencing. ***Correct: Sanger sequencing*** - **Sanger sequencing** (chain-termination method) is the gold standard technique used to determine the exact order of nucleotides within a DNA molecule - It uses dideoxynucleotides (ddNTPs) to terminate DNA strand elongation at specific bases, producing fragments of varying lengths - These fragments are separated by capillary electrophoresis and the sequence is read based on the terminal fluorescent label - Directly determines DNA sequence with high accuracy *Incorrect: PCR* - **Polymerase Chain Reaction (PCR)** amplifies specific DNA segments to create millions of copies - It does NOT determine the sequence itself - it only makes copies of DNA - PCR-amplified DNA can be used as a template for subsequent sequencing, but PCR itself doesn't reveal sequence information *Incorrect: FISH* - **Fluorescence in situ hybridization (FISH)** detects and localizes specific DNA sequences on chromosomes - Used for chromosomal mapping and detecting chromosomal abnormalities - Does not determine the nucleotide sequence *Incorrect: Gel electrophoresis* - Separates DNA fragments based on size and charge - Used to analyze DNA but cannot determine the specific nucleotide sequence - Useful for visualizing DNA after amplification or restriction digestion

Q: Liver produces ketones but cannot use it due to the deficiency of which of the following enzyme?

Thiophorase. ***Thiophorase*** - The liver lacks **thiophorase (succinyl-CoA:3-ketoacid CoA transferase)**, which is crucial for converting **acetoacetate** to **acetoacetyl-CoA**. - This enzyme deficiency prevents the liver from utilizing ketones as an energy source, even though it is a primary site for their production. *Alkaline phosphatase* - **Alkaline phosphatase** is a non-specific enzyme found in various tissues, including bone, liver, and intestine. - Its primary role is to **hydrolyze phosphate esters**, and it is not directly involved in ketone metabolism. *Alanine transaminase* - **Alanine transaminase (ALT)** is a liver enzyme primarily involved in **amino acid metabolism**, specifically in the transfer of an amino group from alanine to α-ketoglutarate. - It plays no direct role in the synthesis or utilization of ketone bodies. *Thiolase* - **Thiolase** is an enzyme involved in both the synthesis and breakdown of ketone bodies. - It converts **two acetyl-CoA molecules into acetoacetyl-CoA** during ketogenesis and also cleaves acetoacetyl-CoA into two acetyl-CoA molecules during ketolysis in extrahepatic tissues.

Q: A urine sample shows a maroon-colored ring at the interface of two layers after adding reagents. Identify the test:

Rothera's test. ***Rothera's test*** - The image displays a **maroon-colored ring** at the interface of two layers, which is a characteristic positive result for Rothera's test. - Rothera's test is used to detect the presence of **ketone bodies**, specifically **acetone and acetoacetate**, in urine. *Benedict's test* - Benedict's test is used to detect **reducing sugars**, such as glucose, in urine. - A positive Benedict's test typically produces a color change from blue to green, yellow, orange, or brick-red precipitate after heating, which is not what is seen here. *Biuret test* - The Biuret test is used to detect **peptide bonds** and thus the presence of **proteins**. - A positive Biuret test results in a **violet or purple color** when proteins are present, which is different from the reaction shown. *Fehling's test* - Fehling's test is another test used to detect the presence of **reducing sugars** in a sample. - A positive result is indicated by the formation of a **brick-red precipitate** of cuprous oxide after heating, which is not consistent with the image.

Q: Match the following: Column A: a. Syphilis b. Chickenpox c. COVID-19 d. Hepatitis A Column B: 1. 6 Days 2. 90 Days 3. 16 Days 4. 28 Days

a-2, b-3, c-1, d-4. ***a-2, b-3, c-1, d-4*** - **Syphilis**: 90 days represents the **maximum incubation period** for *Treponema pallidum* (range 10-90 days, typical 21 days). While not the most common presentation time, it remains medically accurate and is the only viable match among available options. - **Chickenpox**: 16 days falls within the typical incubation period for **varicella-zoster virus** (range 10-21 days, commonly 14-16 days). - **COVID-19**: 6 days is consistent with the **median incubation period** for SARS-CoV-2 (range 2-14 days, mean 5-6 days). - **Hepatitis A**: 28 days represents the **typical incubation period** for HAV (range 15-50 days, average 28-30 days). *a-3, b-4, c-2, d-1* - Incorrectly assigns **Syphilis** 16 days (below the 10-90 day range's typical value), **COVID-19** 90 days (far exceeding the 2-14 day range), and **Hepatitis A** only 6 days (well below the minimum 15-day period). *a-1, b-4, c-2, d-3* - Incorrectly matches **Syphilis** with 6 days (insufficient for *T. pallidum* to produce primary chancre), **Chickenpox** with 28 days (exceeds the typical VZV range), and **Hepatitis A** with 16 days (below typical range). *a-3, b-4, c-1, d-2* - Incorrectly assigns **Syphilis** 16 days, **Chickenpox** 28 days (exceeding typical range), and **Hepatitis A** 90 days (inconsistent with acute HAV infection pattern).

Q: Calculate Anion Gap? Na: 145 K: 4 CI: 90 HCO3 : 15

40. ***40*** - The anion gap is calculated using the formula: **Na - (Cl + HCO3)**. - Plugging in the values: **145 - (90 + 15) = 145 - 105 = 40**. *28* - This value would result if there were a different **bicarbonate** or **chloride** level or a miscalculation. - For example, if the bicarbonate was 30 instead of 15, the calculation would be 145 - (90 + 30) = 145 - 120 = 25, which is closer but still not 28. *35* - This value is obtained if there's an error in summing the **anions** or subtracting from **sodium**. - For instance, if the bicarbonate was incorrectly taken as 20, the calculation would be 145 - (90 + 20) = 145 - 110 = 35. *12* - A value of 12 represents a **normal anion gap**, indicating that the patient in this scenario has a high anion gap [1]. - This result would only occur if the sum of **chloride and bicarbonate** were around 133, which is not the case here.

Q: Least chances of perinatal transmission are seen in?

HSV. ***HSV*** - **Perinatal transmission of HSV** is rare, occurring in approximately 1 in 3,000 to 1 in 20,000 live births, primarily from contact with maternal genital lesions during vaginal delivery. - Transmission rates are lowest when the mother has **recurrent herpes lesions** due to the presence of maternal antibodies offering some fetal protection. *Rubella* - **Congenital rubella syndrome** carries a high risk of transmission (up to 90%) if the mother contracts rubella in the first trimester. - It can lead to severe birth defects such as **heart abnormalities**, **cataracts**, and **deafness**. *Hepatitis B* - The risk of **vertical transmission of Hepatitis B** is significant, especially if the mother is HBeAg-positive (up to 90%). - Without intervention, chronic infection develops in 70-90% of infected infants, often leading to **liver disease** later in life. *CMV* - **Congenital CMV infection** is the most common congenital viral infection, with a transmission rate of 30-40% in primary maternal infection. - It can cause severe neurological deficits, **sensorineural hearing loss**, and **developmental delays** in affected infants.

Q: Which of the following lens is used in direct gonioscopy?

Koeppe. ***Koeppe*** - The **Koeppe lens** is designed for direct gonioscopy, providing a wide-angle view of the **anterior chamber angle**. - It is typically used with the patient in a **supine position** and requires a coupling solution to be placed directly on the cornea. *Goldmann* - The **Goldmann lens** (3-mirror lens) is used for **indirect gonioscopy** and is characterized by mirrors that reflect the image of the angle. - It is used at a **slit lamp** and provides a magnified view as the light is reflected through the mirrors. *Richardson* - The **Richardson-Shaffer lens** is another direct gonioscopy lens, similar to the Koeppe lens. - However, the question asks for "**the**" lens used in direct gonioscopy, and **Koeppe** is the most commonly recognized and frequently used direct gonioscopy lens. - Richardson-Shaffer is less commonly used in modern practice compared to Koeppe. *Zeiss* - The **Zeiss lens** (4-mirror lens) is used for **indirect gonioscopy** and allows a rapid 360-degree view of the angle. - It is commonly used with a **slit lamp** and requires minimal or no coupling fluid due to its small contact surface.

Question 1

What can cause the absence of fructose in seminal fluid?

Accepted Answer

Both of the above

Answer

None of the above

Answer

Congenital absence of seminal vesicle

Answer

Ejaculatory duct obstruction

Question 2

DNA sequence is determined by?

Accepted Answer

Sanger sequencing

Answer

PCR

Answer

FISH

Answer

Gel electrophoresis

Question 3

Liver produces ketones but cannot use it due to the deficiency of which of the following enzyme?

Accepted Answer

Thiophorase

Answer

Alkaline phosphatase

Answer

Alanine transaminase

Answer

Thiolase

Question 4

A urine sample shows a maroon-colored ring at the interface of two layers after adding reagents. Identify the test:

Accepted Answer

Rothera's test

Answer

Benedict's test

Answer

Biuret test

Answer

Fehling's test

Question 5

A person is bitten by a dog. The dog and the person are fully immunized. There is a small abrasion mark on the site of bite. What would you advise to the person?

Accepted Answer

Observation

Answer

Amoxiclav

Answer

Metronidazole

Answer

Ciprofloxacin

Question 6

Match the following:

Column A:
a. Syphilis
b. Chickenpox
c. COVID-19
d. Hepatitis A

Column B:
1. 6 Days
2. 90 Days
3. 16 Days
4. 28 Days

Accepted Answer

a-2, b-3, c-1, d-4

Answer

a-3, b-4, c-2, d-1

Answer

a-1, b-4, c-2, d-3

Answer

a-3, b-4, c-1, d-2

Question 7

Calculate Anion Gap?
Na: 145 K: 4 CI: 90 HCO3 : 15

Accepted Answer

40

Answer

28

Answer

35

Answer

12

Question 8

A 15-year-old girl child with primary amenorrhea has pubic hair, prepubertal breast, blind vagina, clitoromegaly, and normal testosterone. Karyotype given is 46 XY , what is the cause?

Accepted Answer

5-alpha reductase deficiency

Answer

17 hydroxylase deficiency

Answer

Swyer syndrome

Answer

Complete AIS

Question 9

Least chances of perinatal transmission are seen in?

Accepted Answer

HSV

Answer

Rubella

Answer

Hepatitis B

Answer

CMV

Question 10

Which of the following lens is used in direct gonioscopy?

Accepted Answer

Koeppe

Answer

Goldmann

Answer

Richardson

Answer

Zeiss

INI-CET 2023

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Ophthalmology