NEET-PG 2015 Practice Questions

Q: Which of the following is not a metabolic product of the urea cycle?

Alanine. ***Alanine*** - **Alanine** is an amino acid primarily involved in the **glucose-alanine cycle** for glucose production and ammonia transport, not as a direct metabolic product within the urea cycle. - While it plays a role in nitrogen metabolism, it is not synthesized or directly consumed as an intermediate in the reactions that convert ammonia to urea. *Citrulline* - **Citrulline** is a key intermediate formed during the second step of the urea cycle when **ornithine carbamoyltransferase** combines carbamoyl phosphate with ornithine. - It is then transported out of the mitochondrion into the cytosol to continue the cycle. *Ornithine* - **Ornithine** is an amino acid that acts as a **catalytic intermediate** in the urea cycle, being regenerated at the end of the cycle to combine with carbamoyl phosphate. - It does not directly contribute a nitrogen atom to urea but is essential for the cycle's continuation. *Arginine* - **Arginine** is an amino acid that is a direct precursor to urea in the penultimate step of the urea cycle, where **arginase** cleaves it into urea and ornithine. - It provides one of the nitrogen atoms and the carbon atom for the formation of urea.

Q: Which of the following statements are true regarding the visual cycle cascade?

All of the options are true. ***All of the statements are true*** The visual cycle cascade involves multiple interconnected events in phototransduction: **Light causes isomerization of 11-cis-retinal to all-trans-retinal** - This is the **primary photochemical event** that initiates vision - Light absorption causes the **cis-trans isomerization** in less than a picosecond - This conformational change is the only light-dependent step in the entire cascade **Retinal is involved in the visual cycle** - **11-cis-retinal** serves as the chromophore bound to opsin forming rhodopsin - After isomerization to **all-trans-retinal**, it must be converted back to 11-cis-retinal - This regeneration occurs through the **retinoid cycle** involving RPE cells **Involves a conformational change in opsin** - The isomerization of retinal triggers **conformational changes in opsin** - This converts rhodopsin to **metarhodopsin II** (the active form) - Activated opsin then activates **transducin** (G-protein), amplifying the signal and leading to hyperpolarization of photoreceptor cells All three statements accurately describe essential components of the visual cycle cascade.

Q: Which of the following statements about NADP is correct?

Involved in HMP shunt. ***Involved in HMP shunt*** - **NADPH**, the reduced form of NADP+, is primarily generated in the **hexose monophosphate shunt (HMP shunt)**, specifically during the oxidative phase. - The NADPH produced in the HMP shunt is crucial for **reductive biosynthesis** reactions and maintaining the **redox balance** of the cell. *Acts as a coenzyme form of Riboflavin* - **NADP is derived from Niacin (Vitamin B3)**, not Riboflavin (Vitamin B2). - **Flavin adenine dinucleotide (FAD)** and **flavin mononucleotide (FMN)** are the coenzyme forms of Riboflavin. *Involved in glycolysis* - **NADP is not directly involved in glycolysis**; instead, **NAD+** is the primary coenzyme that accepts electrons in glycolysis, specifically during the oxidation of glyceraldehyde-3-phosphate. - While some enzymes in glycolysis can interact with NADP+ under specific conditions, its main role is not within the glycolytic pathway. *Involved in fatty acid oxidation* - **Fatty acid oxidation (beta-oxidation)** primarily utilizes **NAD+** and **FAD** as electron acceptors. - **NADP+** is not a direct participant in the electron transport chain during fatty acid breakdown.

Q: Base of sphenoid fuses with occiput at the age of -

20 years. ***20 years*** - The **spheno-occipital synchondrosis** typically fuses by the age of **20 to 25 years**, marking the cessation of growth in the cranial base. - This fusion is an important indicator of skeletal maturity and is often used in **forensic anthropology** for age estimation. *30 years* - Fusion of the **spheno-occipital synchondrosis** beyond the early twenties is considered late and is not the typical age for this event. - By 30 years, most cranial sutures and synchondroses are already fused. *40 years* - At 40 years of age, the **spheno-occipital synchondrosis** would have been completely fused for many years, making this an incorrect age for the fusion process itself. - This age is well past the usual developmental timeframe for cranial base closure. *50 years* - Fusion at 50 years would be an **anomalous finding** as this synchondrosis is known to fuse much earlier in life. - By this age, the skull is fully mature, and fusion events of this nature have long since completed.

Q: What is the drug of choice for drug-induced peptic ulcer?

Proton pump inhibitors. ***Proton pump inhibitors*** - **PPIs** are the most effective agents for treating and preventing **NSAID-induced peptic ulcers** by profoundly suppressing gastric acid secretion. - They provide **rapid symptom relief** and promote ulcer healing by creating an environment conducive to mucosal repair. *Prostaglandin analogues* - **Misoprostol**, a prostaglandin E1 analogue, can prevent NSAID-induced ulcers, but its use is limited by **gastrointestinal side effects** such as diarrhea and abdominal cramping. - While they protect the gastric mucosa, their efficacy in healing established ulcers is generally **inferior to PPIs**. *H2-receptor antagonists* - **H2-blockers** are effective in reducing gastric acid, but they are **less potent** than PPIs and typically do not heal **gastric ulcers** as effectively, especially those induced by NSAIDs. - They are more commonly used for preventing **duodenal ulcers** and managing symptoms of GERD. *Antacids* - Antacids provide **immediate, temporary relief** of ulcer symptoms by neutralizing existing stomach acid. - They do not address the underlying pathology or promote **ulcer healing** and are therefore not considered the drug of choice for treatment.

Q: Which of the following is the most characteristic sexual side effect of SSRIs?

Delayed ejaculation. ***Delayed ejaculation*** - **Delayed ejaculation** is a common and characteristic sexual side effect of SSRIs due to their impact on serotonin pathways involved in sexual response. - This effect can lead to significant distress and non-adherence to treatment, and often requires dose adjustment or switching to an alternative antidepressant. *Erectile dysfunction* - While **erectile dysfunction** can occur with SSRIs, it is a less specific and less consistently reported sexual side effect compared to ejaculatory dysfunction. - Many factors, including underlying mood disorder and comorbidities, can contribute to erectile dysfunction, making it less characteristic of SSRI use alone. *Retrograde ejaculation* - **Retrograde ejaculation** is a condition where semen enters the bladder during orgasm, and while it can be a side effect of some medications (e.g., alpha-blockers), it is not a hallmark sexual side effect of SSRIs. - SSRIs primarily affect the process of emission and expulsion, leading more commonly to delayed or absent ejaculation rather than retrograde flow. *Anxiety* - **Anxiety** is generally a *primary symptom* of the conditions SSRIs are prescribed to treat, such as depression or anxiety disorders, not a sexual side effect of the medication itself. - Although SSRIs can initially cause or worsen anxiety in some patients before therapeutic effects are seen, this is a systemic side effect, not a sexual one.

Q: Which of the following is an action of muscarinic cholinergic receptors?

Decreased heart rate. ***Decreased heart rate*** - Activation of **muscarinic cholinergic receptors (M2 receptors)** in the heart leads to a decrease in heart rate and conduction velocity. - This effect is mediated by the **vagus nerve (parasympathetic nervous system)**, which releases acetylcholine to act on these receptors. - This is the **most characteristic and clinically significant cardiovascular effect** of muscarinic receptor activation, making it the expected answer. *Skeletal muscle contraction* - **Skeletal muscle contraction** is mediated by **nicotinic acetylcholine receptors (nAChRs)** at the **neuromuscular junction**, NOT muscarinic receptors. - Nicotinic receptors are **ligand-gated ion channels** that cause direct depolarization and muscle contraction when activated. - This is the only option that is **NOT a muscarinic receptor action**. *Acid secretion in stomach* - **Gastric acid secretion** IS mediated by **M3 muscarinic receptors** on parietal cells. - Acetylcholine from the vagus nerve directly stimulates parietal cells and also stimulates histamine release from enterochromaffin-like cells. - While this is a valid muscarinic action, in the context of distinguishing muscarinic effects, **cardiac effects** (decreased heart rate) are more emphasized as the classic teaching point. *Salivation and lacrimation* - **Salivation and lacrimation** ARE mediated by **M3 muscarinic receptors** in exocrine glands. - These are classic parasympathetic/muscarinic effects taught in physiology. - However, when distinguishing key muscarinic actions, **M2 receptor-mediated cardiac effects** are typically highlighted as the primary cardiovascular manifestation, while M3 effects on glands are secondary teaching points.

Q: Which of the following is the longest acting carbapenem?

Ertapenem. ***Ertapenem*** - **Ertapenem** has the **longest half-life** among the carbapenems, allowing for once-daily dosing. - Its prolonged action is due to its **chemical structure**, which provides high protein binding and reduced renal clearance compared to other carbapenems. *Imipenem* - **Imipenem** has a **relatively short half-life** and requires co-administration with cilastatin to prevent its renal metabolism by dehydropeptidase-1. - Its short duration of action necessitates **frequent dosing**, typically every 6 to 8 hours. *Meropenem* - **Meropenem** has a **shorter half-life** than ertapenem, generally requiring dosing every 8 hours. - Although it does not require cilastatin, its pharmacokinetic profile is not as extended as ertapenem's. *Doripenem* - **Doripenem** also has a **shorter half-life** than ertapenem, necessitating administration every 8 hours. - Its spectrum of activity is similar to meropenem, but it does not offer the same extended duration of action.

Q: Which part of the sympathetic nervous system is responsible for secreting catecholamines?

Adrenal medulla. ***Adrenal medulla*** - The adrenal medulla acts as a modified **sympathetic ganglion**, directly innervated by **preganglionic sympathetic fibers**. - Upon stimulation, it releases a high concentration of **epinephrine** (adrenaline) and a smaller amount of **norepinephrine** (noradrenaline) into the bloodstream, acting as hormones. *Cardiac ganglion* - **Cardiac ganglia** are parasympathetic ganglia located in the heart, involved in regulating heart rate and contractility via acetylcholine release. - They do not secrete **catecholamines** but rather act as relay stations for parasympathetic innervation. *Cervical sympathetic chain* - The **cervical sympathetic chain** primarily innervates structures in the head, neck, and upper limbs, influencing functions like pupils, salivary glands, and sweat glands. - While it contains sympathetic neurons, its primary role is not the systemic release of **catecholamines** into the bloodstream. *Thoracic sympathetic chain* - The **thoracic sympathetic chain** provides sympathetic innervation to organs in the thoracic and abdominal cavities, influencing heart rate, bronchodilation, and visceral blood flow. - Like other sympathetic ganglia, it releases norepinephrine at target organ synapses, but it does not serve as a major endocrine gland for systemic catecholamine release.

Q: Solution currently used for liver preservation for transplantation is?

University of Wisconsin (UW) solution. ***University of Wisconsin (UW) solution*** - The **University of Wisconsin (UW) solution** is widely considered the gold standard for **organ preservation**, particularly for liver transplantation, due to its superior ability to extend cold ischemia time. - It contains a unique blend of components, including **lactobionate, raffinose, and hydroxyethyl starch**, which help to minimize cellular swelling, prevent free radical injury, and maintain cellular integrity during cold storage. *IGL-1 solution* - **IGL-1** is a more recent preservation solution designed to be used with **machine perfusion** systems. - While showing promise, it is **not yet as universally adopted** as UW solution for static cold storage of livers. *Ross Marshall Citrate solution* - The **Ross Marshall Citrate solution** was an older solution primarily used for **kidney preservation**. - It has been largely **superseded by newer solutions** with improved efficacy for liver and other organ preservation. *Kyoto ET solution* - **Kyoto ET solution** is another preservation solution primarily used in **Japan**, particularly for **kidney and pancreas preservation**. - While effective for those organs, it is **not the most commonly used** or preferred solution for liver preservation globally.

Question 1

Which of the following is not a metabolic product of the urea cycle?

Accepted Answer

Alanine

Answer

Citrulline

Answer

Arginine

Answer

Ornithine

Question 2

Which of the following statements are true regarding the visual cycle cascade?

Accepted Answer

All of the options are true

Answer

Light causes isomerization of 11-cis-retinal to all-trans-retinal

Answer

Retinal is involved in the visual cycle

Answer

Involves a conformational change in opsin

Question 3

Which of the following statements about NADP is correct?

Accepted Answer

Involved in HMP shunt

Answer

Involved in fatty acid oxidation

Answer

Involved in glycolysis

Answer

Acts as a coenzyme form of Riboflavin

Question 4

Base of sphenoid fuses with occiput at the age of -

Accepted Answer

20 years

Answer

30 years

Answer

40 years

Answer

50 years

Question 5

What is the drug of choice for drug-induced peptic ulcer?

Accepted Answer

Proton pump inhibitors

Answer

Prostaglandin analogues

Answer

H2-receptor antagonists

Answer

Antacids

Question 6

Which of the following is the most characteristic sexual side effect of SSRIs?

Accepted Answer

Delayed ejaculation

Answer

Retrograde ejaculation

Answer

Erectile dysfunction

Answer

Anxiety

Question 7

Which of the following is an action of muscarinic cholinergic receptors?

Accepted Answer

Decreased heart rate

Answer

Skeletal muscle contraction

Answer

Acid secretion in stomach

Answer

Salivation and lacrimation

Question 8

Which of the following is the longest acting carbapenem?

Accepted Answer

Ertapenem

Answer

Imipenem

Answer

Meropenem

Answer

Doripenem

Question 9

Which part of the sympathetic nervous system is responsible for secreting catecholamines?

Accepted Answer

Adrenal medulla

Answer

Cardiac ganglion

Answer

Cervical sympathetic chain

Answer

Thoracic sympathetic chain

Question 10

Solution currently used for liver preservation for transplantation is?

Accepted Answer

University of Wisconsin (UW) solution

Answer

IGL-1 solution

Answer

Ross Marshall Citrate solution

Answer

Kyoto ET solution

NEET-PG 2015

Biochemistry

Forensic Medicine

Pharmacology

Physiology

Surgery