NEET-PG 2012 Practice Questions

Q: What is the anatomical significance of the Rhinion in relation to the osseocartilaginous junction?

Rhinion. ***Correct Answer: Rhinion*** - The **rhinion** is the **most prominent anterior point of the nasal bone**, often palpable as a slight bump or angulation on the dorsum of the nose. - It marks the anatomical location of the **osseocartilaginous junction** of the nasal dorsum, where the bony nasal framework transitions to the cartilaginous framework. - This is the key anatomical landmark that defines the transition from bone to cartilage in the external nose. *Incorrect: Nasion* - The **nasion** is located at the **root of the nose**, specifically at the most anterior and superior point of the nasofrontal suture. - It is a bony landmark and does not directly relate to the osseocartilaginous junction of the nasal dorsum. *Incorrect: Radix* - The **radix** (or nasal root) refers to the **uppermost part of the nose**, corresponding to the nasion. - It defines the point where the nose begins to project from the forehead and is a bony landmark, not directly related to the osseocartilaginous junction. *Incorrect: Columella* - The **columella** is the **fleshy, narrow strip of tissue that separates the nostrils**. - It forms the inferior segment of the nasal septum and is composed of skin, soft tissue, and the medial crura of the alar cartilages, thus having no direct relation to the osseocartilaginous junction of the nasal dorsum.

Q: Which tissue cannot convert glucose 6-phosphate to free glucose due to lack of glucose-6-phosphatase?

Muscle. ***Muscle*** - Muscle tissue lacks the enzyme **glucose-6-phosphatase**, which is essential for hydrolyzing glucose 6-phosphate back to **free glucose**. - Therefore, glucose 6-phosphate in muscle is primarily used for **glycolysis** (energy production) or stored as glycogen for local use. *Liver* - The liver contains **glucose-6-phosphatase**, allowing it to convert **glucose 6-phosphate** to **free glucose**. - This capability is crucial for maintaining **blood glucose homeostasis** and releasing glucose into circulation. *Adipose tissue* - Adipose tissue, like muscle, **lacks glucose-6-phosphatase** and cannot convert glucose 6-phosphate back to free glucose. - Glucose 6-phosphate in adipose tissue is primarily channeled into **fatty acid synthesis** and storage. *Kidney* - The kidney, particularly the renal cortex, possesses **glucose-6-phosphatase** and can convert glucose 6-phosphate to **free glucose**. - This contributes to **gluconeogenesis** and release of glucose into the blood, especially during fasting.

Q: What cofactor is required for the proper functioning of glucose-6-phosphate dehydrogenase?

NADP. ***NADP*** - **NADP+** (nicotinamide adenine dinucleotide phosphate) acts as the **electron acceptor** in the **glucose-6-phosphate dehydrogenase (G6PD)** reaction, becoming **NADPH**. - **NADPH** is crucial for maintaining the **redox balance** in cells, particularly in red blood cells, by reducing **oxidative stress**. *NAD* - **NAD+** (nicotinamide adenine dinucleotide) is a primary cofactor for many **dehydrogenase reactions** in catabolic pathways like **glycolysis** and the **Krebs cycle**. - It primarily functions as an electron acceptor in pathways that generate **ATP**, distinct from the role of **NADPH** in reductive biosynthesis and antioxidant defense. *FAD* - **FAD** (flavin adenine dinucleotide) is a coenzyme derived from **riboflavin (vitamin B2)** that is involved in various redox reactions, often in the form of **flavoproteins**. - Enzymes like **succinate dehydrogenase** in the electron transport chain utilize **FAD** as an electron acceptor, which is not the case for G6PD. *FMN* - **FMN** (flavin mononucleotide) is another coenzyme derived from **riboflavin**, structurally similar to FAD but lacking the additional adenosine monophosphate. - It participates in electron transfer reactions, particularly within **complex I** of the **electron transport chain**, but is not a cofactor for G6PD.

Q: Which enzyme is required for cutting the DNA strand during synthesis?

Topoisomerase. ***Topoisomerase*** - **Topoisomerases** are enzymes essential for DNA replication; they induce temporary **single- or double-strand breaks** in DNA to relieve **supercoiling** ahead of the replication fork. - This cutting and rejoining activity prevents the DNA from becoming excessively tangled and facilitates the unwinding process required for synthesis. *DNA polymerase* - **DNA polymerase** is responsible for **synthesizing new DNA strands** by adding nucleotides, not for cutting the DNA backbone. - It works by moving along the template strand, reading the bases, and then adding complementary nucleotides to the growing DNA strand. *DNA ligase* - **DNA ligase** functions to **join DNA fragments** together by forming phosphodiester bonds, especially in sealing Okazaki fragments during lagging strand synthesis. - Its role is to ligate (join) cut strands, not to initiate cuts in the DNA. *Helicase* - **Helicase** unwinds the DNA double helix into single strands using ATP hydrolysis; it **separates the two strands** but does not cut the phosphodiester backbone. - This enzyme creates the replication fork by disrupting hydrogen bonds between base pairs, making the DNA accessible for replication machinery.

Q: Selenocysteine is associated with ?

Deiodinase. ***Deiodinase*** - Selenocysteine is a critical component of **iodothyronine deiodinases**, a family of enzymes that regulate **thyroid hormone metabolism**. - These enzymes catalyze the removal of iodine from thyroid hormones, converting **thyroxine (T4)** into the more active **triiodothyronine (T3)** or inactive forms. *Carbonic anhydrase* - This enzyme contains **zinc** as its essential metal cofactor and is involved in the interconversion of **carbon dioxide** and **bicarbonate**. - Its primary role is in pH regulation and CO2 transport, without any direct association with selenocysteine. *Catalase* - Catalase is an enzyme primarily found in **peroxisomes** and contains **iron-porphyrin** groups as its prosthetic group. - Its function is to convert **hydrogen peroxide** into water and oxygen, protecting cells from oxidative damage. *Transferase* - Transferases are a broad class of enzymes that catalyze the transfer of **functional groups** (e.g., methyl, glucose) from one molecule to another. - While essential for many metabolic processes, there is no inherent association of the general class of transferases with selenocysteine.

Q: Which of the following is not a component of a nucleotide?

Fatty acid. ***Fatty acid*** - A **fatty acid** is a component of **lipids**, such as triglycerides and phospholipids, which are structurally and functionally distinct from **nucleotides**. - **Nucleotides** are the building blocks of nucleic acids (DNA and RNA), whereas fatty acids are essential for cell membranes and energy storage. *Sugar* - A **pentose sugar** (either **deoxyribose** in DNA or **ribose** in RNA) is a fundamental component of every nucleotide. - This sugar forms the backbone of the nucleic acid strand, covalently linked to the phosphate group and the nitrogenous base. *Phosphate* - A **phosphate group** is a crucial component of a nucleotide, providing the negative charge and forming the phosphodiester bonds that link nucleotides together into a nucleic acid chain. - The number of phosphate groups (mono-, di-, or triphosphate) determines the nucleotide's energy state and function. *Base* - A **nitrogenous base** (adenine, guanine, cytosine, thymine, or uracil) is an essential component of a nucleotide, responsible for genetic information storage and pairing. - This base is attached to the pentose sugar and determines the specific identity of the nucleotide within the DNA or RNA sequence.

Q: All of the following statements about Giant cell arteritis are true except?

Involves large to small sized arteries. ***Involves large to small sized arteries*** - Giant cell arteritis (GCA) predominantly affects **medium to large-sized arteries**, most commonly the branches of the **carotid artery**, such as the temporal arteries [1]. - While it can affect various arteries, it does not typically involve **small-sized arteries**, such as arterioles, directly as a primary site of inflammation. *Granulomatous inflammation* - GCA is characterized histologically by **granulomatous inflammation** within the arterial wall, which includes multinucleated **giant cells** and lymphocytes [2]. - This specific inflammatory pattern is a hallmark feature used in the diagnosis of GCA upon biopsy [2]. *Segmental nature of the involvement* - The arterial inflammation in GCA is often **segmental**, meaning that affected arteries may have inflamed and non-inflamed sections alternating along their length [2]. - This segmental involvement often necessitates **longer biopsies** (e.g., 2-3 cm for temporal artery biopsy) to increase the diagnostic yield. *Can involve the aorta and its major branches* - GCA can indeed affect the **aorta** (aortitis) and its major branches, leading to complications like **aneurysms** or **dissections**. - Involvement of these larger vessels can manifest as symptoms such as **claudication** in the limbs or asymptomatic aneurysms detectable on imaging [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Osteoarticular And Connective Tissue Disease, pp. 688-689. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 516-517.

Q: Which of the following conditions is the classic example of acute intravascular hemolysis triggered by oxidative stress?

Acute G6PD deficiency. ***b and c*** - Intravascular hemolysis is commonly associated with both **Acute G6PD deficiency** and **Hereditary spherocytosis**, leading to destruction of red blood cells in the bloodstream [1]. - These conditions are characterized by **high levels of hemoglobinuria** and **low haptoglobin**, indicative of intravascular hemolysis. *Sickle cell ds* - Sickle cell disease primarily causes **extravascular hemolysis** due to splenic sequestration rather than **intravascular** destruction [3]. - The clinical features include **vaso-occlusive crises** and splenic infarction rather than hemolysis within the blood vessels. *Acute G6PD* - While acute G6PD deficiency can lead to hemolysis, it is typically **triggered by oxidative stress** rather than occurring continuously [2]. - The hemolysis in G6PD deficiency occurs more in an **extravascular** manner unless acute stress occurs, which can result in **acute intravascular hemolysis, marked by anemia, hemoglobinemia, and hemoglobinuria** [4]. *Hereditary spherocytosis* - This condition primarily causes **extravascular hemolysis** through the spleen, where abnormal spherocytes are destroyed [1]. - Although it leads to anemia, the hallmark of hereditary spherocytosis is the **spleen's role** in hemocyte destruction rather than intravascular hemolysis.

Q: Which type of carbohydrate is absorbed most efficiently from the gastrointestinal tract?

Monosaccharides. ***Monosaccharides*** - **Monosaccharides**, like glucose and fructose, are the simplest forms of carbohydrates and do not require further digestion. - They are directly absorbed into the bloodstream from the intestinal lumen via specific **transporters** on the enterocyte membrane. *Disaccharides* - **Disaccharides**, such as sucrose and lactose, must first be broken down into their constituent monosaccharides by **brush border enzymes** (e.g., lactase, sucrase) before absorption can occur. - This additional enzymatic step makes their absorption less efficient than that of monosaccharides. *Polysaccharides* - **Polysaccharides**, including starch and glycogen, are complex carbohydrates requiring extensive digestion by enzymes like **amylase** in the mouth and small intestine. - This multi-step breakdown into monosaccharides is the least efficient process and takes the longest time. *5-carbon sugars* - While 5-carbon sugars (**pentoses**) like ribose and deoxyribose are monosaccharides and can be absorbed, they are not a primary energy source in the diet and are not absorbed as efficiently or in as large quantities as the metabolically more significant 6-carbon monosaccharides (hexoses like glucose). - The question asks which *type* of carbohydrate is most efficiently absorbed, and **monosaccharides** as a general category (including 6-carbon sugars) are the most efficient.

Q: IVC filter is used in the following situations except -

As primary treatment for acute DVT. ***As primary treatment for acute DVT*** - The **primary treatment** for **acute deep vein thrombosis (DVT)** is **anticoagulation therapy** (heparin, warfarin, or DOACs) to prevent clot propagation and embolization. - An **IVC filter** is **NOT primary therapy**—it is reserved for specific situations and does not treat the underlying thrombosis. - **Indications for IVC filter include:** - Absolute **contraindication to anticoagulation** (active bleeding, recent hemorrhagic stroke) - **Recurrent PE despite adequate anticoagulation** - Complications from anticoagulation therapy - Therefore, using IVC filter as primary treatment for acute DVT is **incorrect and not indicated**. *Negligible size of emboli* - While IVC filters trap **large emboli**, the concept of "negligible size emboli" is not a standard clinical consideration for filter placement. - IVC filters are indicated based on **risk of PE** and **contraindications to anticoagulation**, not based on emboli size assessment. *To reduce symptoms* - **IVC filters** do not reduce symptoms of DVT such as pain, swelling, or discomfort. - They function as a **mechanical barrier** to prevent emboli from reaching pulmonary circulation. - Symptom management requires anticoagulation, compression therapy, and leg elevation. *To prevent progress of native blood vessel disease* - IVC filters do not influence progression of underlying **vascular disease** such as atherosclerosis or chronic venous insufficiency. - Their sole function is **mechanical prevention of PE**, not disease modification.

Question 1

What is the anatomical significance of the Rhinion in relation to the osseocartilaginous junction?

Accepted Answer

Rhinion

Answer

Nasion

Answer

Radix

Answer

Columella

Question 2

Which tissue cannot convert glucose 6-phosphate to free glucose due to lack of glucose-6-phosphatase?

Accepted Answer

Muscle

Answer

Liver

Answer

Kidney

Answer

Adipose tissue

Question 3

What cofactor is required for the proper functioning of glucose-6-phosphate dehydrogenase?

Accepted Answer

NADP

Answer

NAD

Answer

FAD

Answer

FMN

Question 4

Which enzyme is required for cutting the DNA strand during synthesis?

Accepted Answer

Topoisomerase

Answer

DNA polymerase

Answer

DNA ligase

Answer

Helicase

Question 5

Selenocysteine is associated with ?

Accepted Answer

Deiodinase

Answer

Carbonic anhydrase

Answer

Catalase

Answer

Transferase

Question 6

Which of the following is not a component of a nucleotide?

Accepted Answer

Fatty acid

Answer

Sugar

Answer

Base

Answer

Phosphate

Question 7

All of the following statements about Giant cell arteritis are true except?

Accepted Answer

Involves large to small sized arteries

Answer

Granulomatous inflammation

Answer

Segmental nature of the involvement

Answer

Can involve the aorta and its major branches

Question 8

Which of the following conditions is the classic example of acute intravascular hemolysis triggered by oxidative stress?

Accepted Answer

Acute G6PD deficiency

Answer

Hereditary spherocytosis

Answer

Sickle cell disease

Answer

None of the options

Question 9

Which type of carbohydrate is absorbed most efficiently from the gastrointestinal tract?

Accepted Answer

Monosaccharides

Answer

Disaccharides

Answer

Polysaccharides

Answer

5-carbon sugars

Question 10

IVC filter is used in the following situations except -

Accepted Answer

As primary treatment for acute DVT

Answer

To reduce symptoms

Answer

Negligible size of emboli

Answer

To prevent progress of native blood vessel disease

NEET-PG 2012

Anatomy

Biochemistry

Pathology

Physiology

Surgery