Anatomy
1 questionsThe dental numbering system shown below represents: R 8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 (permanent teeth) and R e d c b a | a b c d e (deciduous teeth) for upper and lower quadrants. Which dental numbering system is this?
INI-CET 2025 - Anatomy INI-CET Practice Questions and MCQs
Question 141: The dental numbering system shown below represents: R 8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 (permanent teeth) and R e d c b a | a b c d e (deciduous teeth) for upper and lower quadrants. Which dental numbering system is this?
- A. FDI formula
- B. Universal system
- C. Palmer's notation (Correct Answer)
- D. Haderup system
Explanation: ***Palmer's notation*** - This system, also known as the **Zsigmondy-Palmer notation**, utilizes numerical digits (1-8) for permanent teeth and lower-case letters (a-e) for deciduous teeth within each quadrant. - The defining characteristic shown is the use of a **quadrant symbol (or grid symbols)** to indicate the location relative to the midline and the occlusal plane (e.g., $\text{8}\rfloor$ for upper right third molar). ***Universal system*** - This system uses a continuous sequence of numbers (1-32) for permanent teeth starting from the **Maxillary Right Third Molar (tooth 1)** and proceeding clockwise. - It does not use quadrant diagrams or grid lines; deciduous teeth are designated using capitalized letters A through T. ***FDI formula*** - The FDI system (ISO 3950) is a **two-digit numbering system** where the first digit identifies the quadrant (1-4 for permanent; 5-8 for deciduous) and the second digit identifies the tooth type (1-8). - For example, the upper right central incisor is denoted as **11**, which is different from the single digit representation shown. ***Haderup system*** - This system uses positive (+) or negative (-) signs to indicate the jaw (maxilla/mandible) alongside the tooth number (1-8). - The sign's position relative to the number determines the side of the midline, such as $+1$ indicating the **upper right central incisor**.
Community Medicine
1 questionsOne of the following is not seen in a worker exposed to mercury in a thermometer manufacturing company:
INI-CET 2025 - Community Medicine INI-CET Practice Questions and MCQs
Question 141: One of the following is not seen in a worker exposed to mercury in a thermometer manufacturing company:
- A. Tremors and Mad Hatter's disease
- B. Peripheral neuropathy
- C. Basophilic stippling (Correct Answer)
- D. Mees' lines
Explanation: ***Basophilic stippling*** - **Basophilic stippling** is a characteristic finding in the peripheral blood smear of patients with **lead poisoning**, caused by the inhibition of pyrimidine 5'-nucleotidase, leading to aggregated RNA. - It is **not associated** with chronic mercury exposure, which primarily affects the neurological and renal systems. - This is the correct answer as basophilic stippling is NOT seen in mercury poisoning. *Tremors and Mad Hatter's disease* - **Tremors** (intention tremor) are a classic sign of chronic inhaled elemental mercury exposure, often leading to a condition historically known as **"Mad Hatter's disease"** (erethism). - **Erethism** is a neuropsychiatric syndrome characterized by irritability, shyness, insomnia, emotional lability, and loss of memory, resulting from mercury's neurotoxicity. - This IS seen in mercury-exposed workers. *Mees' lines* - **Mees' lines** (transverse white bands on the fingernails) are classically associated with **arsenic** and **thallium** poisoning, NOT mercury poisoning. - While the original explanation incorrectly linked this to mercury, Mees' lines are not a typical manifestation of mercury toxicity. - Mercury poisoning causes neurological (tremors, erethism) and renal manifestations, not Mees' lines. - This option is somewhat controversial but traditionally NOT considered a classic sign of mercury poisoning. *Peripheral neuropathy* - Exposure to **organic mercury compounds** (like methylmercury) is known to cause severe neurological damage, including **peripheral neuropathy**, visual field constriction, and hearing impairment. - Chronic high-level exposure to elemental mercury vapor can also lead to neuropathic symptoms. - This IS seen in mercury-exposed workers.
Forensic Medicine
4 questionsAs per Bharatiya Nyaya Sanhita (BNS), which of the following is not classified as grievous hurt?
In which of the following poisonings does silver nitrate impregnated filter paper turn black when exposed to gastric lavage contents?
The triad of abrasions, bruises and punctate lacerations are typically seen in:
One of the following statements regarding venom is incorrect:
INI-CET 2025 - Forensic Medicine INI-CET Practice Questions and MCQs
Question 141: As per Bharatiya Nyaya Sanhita (BNS), which of the following is not classified as grievous hurt?
- A. Emasculation
- B. Severe body pain for 5 days (Correct Answer)
- C. Dislocation of elbow
- D. Loss of a member
Explanation: ***Severe body pain for 5 days*** - Grievous hurt requires a specific threshold of duration, which is **severe body pain** or inability to follow ordinary pursuits for a period of **twenty days** or more, as per the definition in the Bharatiya Nyaya Sanhita (BNS) Section 122. Five days of severe pain does not meet this criterion. - This injury would typically be classified as **simple hurt**, which involves pain, disease, or infirmity, but does not meet the specified severity criteria for grievous hurt. *Emasculation* - **Emasculation** (deprivation of the power of procreation) is explicitly listed as the first clause defining **grievous hurt** in BNS Section 122 (formerly IPC Section 320). - Legal definitions of grievous hurt include eight specific types of injuries that are presumed to be severe. *Dislocation of elbow* - **Fracture or dislocation** of a bone or tooth is explicitly defined as an instance of **grievous hurt** under BNS Section 122. - A dislocation of a major joint like the elbow falls under this specified clause of grievous hurt. *Loss of a member* - The **privation of any member or joint** (loss of a limb, eye, ear, etc.) is specifically enumerated as a clause defining **grievous hurt** in BNS Section 122. - This category includes any injury that permanently impairs a significant part of the body's structure or function.
Question 142: In which of the following poisonings does silver nitrate impregnated filter paper turn black when exposed to gastric lavage contents?
- A. Malathion
- B. Opium
- C. Barbiturates
- D. Aluminium phosphide (Correct Answer)
Explanation: ***Aluminium phosphide*** - Aluminium phosphide ($AlP$) reacts vigorously with water or gastric acid to release highly toxic **phosphine gas** ($PH_3$). - Phosphine gas is a strong reducing agent that reacts with **silver nitrate ($AgNO_3$)** impregnated paper, reducing it to black **metallic silver ($Ag$)** and thus turning the paper black, a method known as the field test for Celphos. ***Malathion*** - Malathion is an **organophosphate insecticide**, and its poisoning is diagnosed primarily by clinical features of cholinergic crisis (SLUDGE syndrome) and measuring depressed **serum/RBC cholinesterase levels**. - Organophosphates do not release phosphine gas and therefore do not produce a positive reaction with silver nitrate filter paper. ***Barbiturates*** - Barbiturate poisoning is confirmed using tests like the **Dille-Koppanyi test** (for color change) or advanced **chromatographic methods** on blood or urine samples. - The barbiturate structure does not produce a reducing gas like phosphine upon reaction, so the silver nitrate paper test would remain negative. ***Opium*** - Opium poisoning (due to alkaloids like **morphine**) is confirmed by detecting the drug or its metabolites in urine or blood using **immunoassays** or gas/liquid chromatography. - Opium alkaloids are not detected by this specific qualitative test, as it is designed to detect the highly reducing nature of phosphine gas.
Question 143: The triad of abrasions, bruises and punctate lacerations are typically seen in:
- A. Road traffic accidents (Correct Answer)
- B. Fall from height
- C. Firearm injuries
- D. Bomb blast injuries
Explanation: ***Correct: Road traffic accidents*** - This specific combination of injuries—**abrasions** (due to sliding/friction), **bruises** (due to blunt force), and **punctate lacerations** (often caused by glass, debris, or gravel impacts)—is highly characteristic of **Road Traffic Accidents (RTAs)**. - These injuries reflect the simultaneous interplay of both **blunt impact** and **shearing/grinding forces** sustained as the body strikes the vehicle interior or the external road surface. - The **triad** is a classic forensic finding that distinguishes RTAs from other patterns of traumatic injury. *Incorrect: Fall from height* - Injuries from a fall are typically dominated by **high-energy blunt trauma** resulting in internal organ damage and severe skeletal fractures, such as bilateral calcaneal or vertebral fractures. - While abrasions and bruises are present at points of impact, the organized triad including numerous small, **punctate lacerations** is less distinct than in RTAs. *Incorrect: Bomb blast injuries* - Blast injuries are primarily categorized by specific mechanisms: primary (barotrauma), secondary (penetrating injuries from flying fragments), and tertiary (blunt force from body displacement). - The dominant findings are **severe organ damage** (like blast lung) and penetrating injuries; while trauma occurs, the described superficial triad is not the main characteristic pattern. *Incorrect: Firearm injuries* - Forensic examination of firearm injuries focuses on the **entry and exit wounds**, which are typically perforating or penetrating defects. - Characteristic features include the **abrasion collar**, contusion ring, and presence of GSR residue (soot or tattooing), rather than a diffuse superficial triad across multiple body areas.
Question 144: One of the following statements regarding venom is incorrect:
- A. Viperidae - Hemotoxic
- B. Elapidae - Myotoxic (Correct Answer)
- C. Common krait - Neurotoxic
- D. Common cobra - Neurotoxic
Explanation: ***Elapidae - Myotoxic*** - This statement is **incorrect**. Venom from the **Elapidae** family (e.g., cobras, kraits, mambas) is **predominantly neurotoxic**, affecting the nervous system and causing paralysis. - The primary target of Elapidae venom is the **neuromuscular junction**, leading to respiratory failure, not muscle degeneration (myotoxicity). - While some Elapidae subspecies (certain sea snakes, Australian elapids) may have myotoxic components, the family is **classically characterized as neurotoxic**, especially in the Indian context where cobras and kraits are the main representatives. ***Common cobra - Neurotoxic*** - This statement is **correct**. The venom of the **Common Cobra** (Naja naja), which belongs to the Elapidae family, is highly **neurotoxic**. - It primarily contains long and short-chain neurotoxins that cause rapid, progressive **paralysis** and respiratory failure. ***Common krait - Neurotoxic*** - This statement is **correct**. **Common Krait** (Bungarus caeruleus), also an Elapid, possesses venom that is highly potent and entirely **neurotoxic**. - Krait venom often causes severe, often delayed, **neuromuscular blockade** and paralysis, making it one of the most dangerous snakes in India. ***Viperidae - Hemotoxic*** - This statement is **correct**. Venom from the **Viperidae** family (e.g., Russell's viper, saw-scaled viper) is mainly **hemotoxic** and **cytotoxic**. - It primarily targets the blood and vascular system, causing coagulopathy, massive tissue necrosis, bleeding disorders, and often **disseminated intravascular coagulation (DIC)**.
Pharmacology
2 questionsCarbamazepine and erythromycin were given to a patient, and he presented with ataxia and dizziness. Which of the following is the reason for the symptoms?
Loading dose of an oral drug depends on all of the following except?
INI-CET 2025 - Pharmacology INI-CET Practice Questions and MCQs
Question 141: Carbamazepine and erythromycin were given to a patient, and he presented with ataxia and dizziness. Which of the following is the reason for the symptoms?
- A. Toxicity of carbamazepine (Correct Answer)
- B. Toxicity of erythromycin
- C. Erythromycin speeds up carbamazepine metabolism
- D. Sub-therapeutic carbamazepine levels causing seizures
Explanation: ***Toxicity of carbamazepine*** - Erythromycin is a potent inhibitor of the hepatic **CYP3A4 enzyme**, which is primarily responsible for the metabolism and subsequent clearance of carbamazepine. - Inhibition of carbamazepine metabolism leads to increased plasma concentration, resulting in **CNS side effects** such as **ataxia, dizziness**, nystagmus, and drowsiness. *Toxicity of erythromycin* - Erythromycin toxicity typically presents with **gastrointestinal symptoms** (e.g., nausea, vomiting, diarrhea) or cardiac issues like **QT prolongation**. - The described symptoms, ataxia and dizziness, are classic manifestations of **anticonvulsant toxicity**, not macrolide toxicity. *Erythromycin speeds up carbamazepine metabolism* - This statement is incorrect; erythromycin **inhibits** CYP3A4, thus slowing down carbamazepine metabolism and resulting in drug accumulation. - If metabolism were sped up (i.e., enzyme induction), the patient would likely experience sub-therapeutic carbamazepine levels, increasing the risk of **seizure recurrence**. *Sub-therapeutic carbamazepine levels causing seizures* - Recurrent seizures are caused by **sub-therapeutic levels** of carbamazepine, often due to enzyme induction (e.g., by phenytoin, carbamazepine itself) or non-compliance. - The symptoms of ataxia and dizziness indicate **supratherapeutic levels** (toxicity), which is the opposite of the low levels that cause breakthrough seizures.
Question 142: Loading dose of an oral drug depends on all of the following except?
- A. Volume of distribution
- B. Half-life (Correct Answer)
- C. Plasma concentration
- D. Bioavailability
Explanation: ***Correct Answer: Half-life*** - **Half-life** primarily determines the **maintenance dose** and **dosing interval**, not the loading dose - The **loading dose (LD)** is calculated to rapidly achieve the desired therapeutic **plasma concentration** using the formula: **LD = (Cp × Vd) / F** - Half-life determines how long it takes to reach steady state (4-5 half-lives) and how frequently maintenance doses should be given - The loading dose bypasses the waiting time by immediately achieving therapeutic levels *Incorrect: Volume of distribution* - **Vd** is a mandatory parameter in the calculation of the loading dose formula - It determines how widely the drug distributes in the body relative to the target plasma concentration - A higher **Vd** necessitates a higher loading dose to saturate tissue binding sites and achieve therapeutic plasma levels quickly *Incorrect: Plasma concentration* - The loading dose is specifically calculated to quickly achieve the desired therapeutic **steady-state plasma concentration (Cp)** - The target concentration (Cp) is central to the loading dose calculation and appears in the numerator of the formula - The goal of the loading dose is to bypass the time required to reach this concentration with maintenance doses alone *Incorrect: Bioavailability* - **Bioavailability (F)** represents the fraction of the administered drug that reaches systemic circulation - It is crucial for oral drugs where absorption may be incomplete due to first-pass metabolism or incomplete absorption - The loading dose formula includes **F** in the denominator (LD = (Cp × Vd) / F) to adjust for incomplete absorption
Psychiatry
1 questionsWhich among the following psychoactive substances has antidepressant properties?
INI-CET 2025 - Psychiatry INI-CET Practice Questions and MCQs
Question 141: Which among the following psychoactive substances has antidepressant properties?
- A. Cannabidiol
- B. Mephedrone
- C. Bupropion
- D. Ketamine (Correct Answer)
Explanation: ***Correct: Ketamine*** - Ketamine, traditionally an anesthetic, exhibits rapid and potent **antidepressant properties**, particularly effective in treatment-resistant depression (TRD). - It primarily acts as an **NMDA receptor antagonist**, increasing **glutamate** release, which subsequently causes a surge in neurotrophic factors (like BDNF) crucial for synaptic plasticity. - Esketamine (S-ketamine) nasal spray is FDA-approved for treatment-resistant depression. *Incorrect: Bupropion* - Bupropion is an antidepressant that acts as a **norepinephrine-dopamine reuptake inhibitor (NDRI)**, but it is **not classified as a psychoactive substance of abuse** in the same context as the other options. - It is a prescription medication clinically used for depression and **smoking cessation**, often preferred due to minimal sexual side effects. - While it has antidepressant properties, it is not a "psychoactive substance" in the classical sense used in this question. *Incorrect: Cannabidiol* - Cannabidiol (CBD) is a non-psychoactive component of cannabis used for various conditions, showing promise for **anxiety** and certain seizure disorders (FDA-approved Epidiolex for specific epilepsies). - While some studies hint at potential antidepressant effects, evidence is limited and inconsistent. - It is primarily researched for its anxiolytic and anticonvulsant properties, not as a primary or fast-acting antidepressant like ketamine. *Incorrect: Mephedrone* - Mephedrone is a synthetic substituted cathinone, often illegally used as a recreational drug with potent **stimulant** and **euphoric** effects. - It primarily acts as a **dopamine** and **serotonin** releasing agent, posing high risks of addiction, neurotoxicity, and cardiovascular complications. - It has no recognized clinical antidepressant use and carries significant abuse potential.
Surgery
1 questionsA patient has burns involving the face, both upper limbs and front of the chest. What is the percentage of burns involved?
INI-CET 2025 - Surgery INI-CET Practice Questions and MCQs
Question 141: A patient has burns involving the face, both upper limbs and front of the chest. What is the percentage of burns involved?
- A. 30 to 37 (Correct Answer)
- B. 25 to 48
- C. 27 to 30
- D. 38 to 42
Explanation: ***Correct: 30 to 37*** - This percentage is derived using the **Rule of Nines** for adults: Face (part of Head) = 4.5%, Both Upper Limbs (9% each) = 18%, and Front of Chest (part of Anterior Trunk) = 9%. Total = 4.5 + 18 + 9 = **31.5%**. - The Rule of Nines is a quick method for estimating the total body surface area burned (TBSA) in adults, assigning 9% to major body sections (or multiples thereof). *Incorrect: 27 to 30* - This range is too low; the precise calculation according to the Rule of Nines is **31.5%**, which falls outside and above this range. - This would underestimate the burn area and potentially lead to inadequate fluid resuscitation. *Incorrect: 38 to 42* - This range is too high; it would imply involvement of additional surface area beyond what is described. - 36% would cover the entire head (9%), both upper limbs (18%), and the entire anterior trunk (18%), which is more than just the front of the chest. *Incorrect: 25 to 48* - While the calculated value (31.5%) falls within this excessively wide range, it is an unnecessarily broad estimation and not clinically useful. - The most precise option provided is **30 to 37**, which appropriately contains the calculated value of 31.5%.