NEET-PG 2015 Practice Questions

Q: Where do primitive red blood cells first originate during early embryonic development?

Yolk sac. ***Yolk sac*** - The **yolk sac** is the primary site of **hematopoiesis** during the first few weeks of embryonic development. - Primitive erythroid cells (red blood cells) originate here to supply the developing embryo with oxygen. *Liver* - The **liver** takes over as the main hematopoietic organ from about the 6th week of gestation, after the yolk sac [1]. - While it produces various blood cells, it is not the *first* site of primitive red blood cell formation. *Bone marrow* - **Bone marrow** becomes the primary site of hematopoiesis during the **fetal period** (around the 20th to 24th week) and continues throughout postnatal life [2]. - It is not involved in the initial production of primitive red blood cell formation in early embryogenesis. *Spleen* - The **spleen** plays a minor role in fetal hematopoiesis, mainly producing lymphoid cells and some myeloid cells, and can take on myeloid functions if the bone marrow is compromised. - It is not the initial site of red blood cell production in the early embryo.

Q: Intercalated disc is present in:

Cardiac muscle. ***Cardiac muscle*** - **Intercalated discs** are unique structures found only in cardiac muscle, forming specialized cell-cell junctions [1]. - These discs contain **gap junctions** for electrical coupling and **desmosomes** for strong adhesion, allowing the heart muscle to contract in a coordinated fashion. *Smooth muscle* - **Smooth muscle cells** are spindle-shaped and lack striations and organized sarcomeres. - They do not possess intercalated discs; instead, communication and coordination are often mediated by **gap junctions** scattered along the cell membranes [2]. *Skeletal muscle* - **Skeletal muscle cells** are long, multinucleated, and highly organized with prominent striations [3]. - They do not have intercalated discs as individual muscle fibers are innervated separately and generally do not directly communicate via specialized junctions for coordinated contraction. *All of the options* - As **intercalated discs** are characteristic features *only* of **cardiac muscle**, this option is incorrect. - Their presence in all three muscle types would contradict the specific cellular organization of smooth and skeletal muscle.

Q: In the malate shuttle, how many ATPs are produced from one NADH?

2.5 ATP. ***2.5 ATP*** - In the **malate-aspartate shuttle**, mitochondrial **NADH** is regenerated from cytosolic NADH, and then enters the electron transport chain at **Complex I**. - **Complex I** entry means that NADH contributes to the pumping of enough protons to generate approximately **2.5 ATP** through oxidative phosphorylation. *1 ATP* - **1 ATP** is not the direct equivalent produced from the reoxidation of one NADH via the malate shuttle into the electron transport chain. - This value is typically associated with the direct hydrolysis of **ATP** or the energy equivalent of **GTP** produced in the citric acid cycle. *3 ATP* - Historically, **3 ATP** was the accepted stoichiometry for one NADH, but more accurate measurements of proton pumping and ATP synthase activity have revised this. - The value of 3 ATP per NADH does not reflect the most current understanding of mitochondrial bioenergetics. *2 ATP* - **2 ATP** is the approximate yield for **FADH2** entering the electron transport chain at **Complex II**, bypassing Complex I, and thus pumping fewer protons. - This value is not applicable to NADH transferred via the malate-aspartate shuttle, as NADH enters at Complex I.

Q: Coenzyme for phenylalanine hydroxylase is?

Tetrahydrobiopterin. ***Tetrahydrobiopterin*** - **Tetrahydrobiopterin (BH4)** is an essential coenzyme for aromatic amino acid hydroxylases, including **phenylalanine hydroxylase (PAH)**. - PAH converts **phenylalanine** to **tyrosine**, and deficiencies in BH4 or PAH itself lead to *phenylketonuria (PKU)*. *Tetrahydrofolate* - **Tetrahydrofolate (THF)** is a coenzyme derived from **folic acid** and is primarily involved in **one-carbon metabolism**, including **purine** and **pyrimidine synthesis**, and various amino acid interconversions. - It does not directly act as a coenzyme for phenylalanine hydroxylase. *Pyridoxal phosphate* - **Pyridoxal phosphate (PLP)**, a derivative of **vitamin B6**, is a crucial coenzyme for many enzymes involved in **amino acid metabolism**, particularly in **transamination**, **decarboxylation**, and side-chain cleavage reactions. - It is not the coenzyme for phenylalanine hydroxylase. *S-adenosyl methionine* - **S-adenosyl methionine (SAM)** is a major **methyl donor** in various biochemical reactions, important for the synthesis of **neurotransmitters**, **hormones**, and **phospholipids**. - While essential for many metabolic pathways, it is not involved as a coenzyme for phenylalanine hydroxylase.

Q: Which coenzyme is not required in the formation of glutamate?

Thiamine pyrophosphate. ***Thiamine pyrophosphate*** - **Thiamine pyrophosphate (TPP)** is a coenzyme derived from **vitamin B1** that is essential for reactions involving decarboxylation, such as those catalyzed by pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase. - The formation of glutamate primarily involves transamination or reductive amination, which do not require TPP. *Pyridoxal phosphate* - **Pyridoxal phosphate (PLP)**, derived from **vitamin B6**, is a crucial coenzyme for **transamination reactions**, which are a major pathway for glutamate synthesis (e.g., from alpha-ketoglutarate). - It also plays a role in decarboxylation and deamination reactions of amino acids. *Niacin* - **Niacin (vitamin B3)** is a precursor for **NAD+** and **NADP+**, which are essential coenzymes in many metabolic pathways. - **NADPH**, derived from NADP+, is required as a reductant in the **reductive amination** of **alpha-ketoglutarate** to form glutamate, catalyzed by glutamate dehydrogenase. *None of the above* - This option is incorrect because **thiamine pyrophosphate** is indeed not required for the formation of glutamate. - The other two coenzymes, **pyridoxal phosphate** and **niacin (as NAD(P)H)**, are involved in glutamate synthesis.

Q: The mechanism of action of uncouplers of oxidative phosphorylation involves:

Disruption of proton gradient across the inner membrane. ***Disruption of proton gradient across the inner membrane*** - Uncouplers such as **2,4-dinitrophenol** increase the permeability of the **inner mitochondrial membrane** to protons. - This dissipates the **proton motive force** that is normally used by ATP synthase to produce ATP, leading to the uncoupling of electron transport from ATP synthesis. *Inhibition of ATP synthase* - Inhibitors of ATP synthase directly block the enzyme's activity, preventing the synthesis of ATP while the **proton gradient** remains intact. - This mechanism is distinct from uncouplers, which allow electron transport to continue while dissipating the proton gradient. *Stimulation of ATP synthase* - Uncouplers do not stimulate ATP synthase; rather, their action prevents ATP synthase from effectively utilizing the **proton gradient** for ATP production. - Stimulation of ATP synthase would lead to increased ATP synthesis, which is contrary to the effect of uncouplers. *Blocking electron transport chain complexes* - Inhibitors of the **electron transport chain** (e.g., cyanide, rotenone) directly prevent the flow of electrons, thereby preventing the pumping of protons and the formation of a **proton gradient**. - Uncouplers, in contrast, allow electron transport to proceed but dissipate the proton gradient after it has been established.

Q: Subepithelial deposits in the kidney are primarily associated with which condition?

Post-Streptococcal Glomerulonephritis (PSGN). ***PSGN*** - Post-streptococcal glomerulonephritis (PSGN) is characterized by **subepithelial immune complex deposits** [1], typically after a streptococcal infection [1]. - It is associated with **hematuria**, **edema**, and elevated **anti-streptolysin O (ASO)** titers. *GPS* - Minimal change disease (often referred to as idiopathic nephrotic syndrome) does not primarily feature **subepithelial deposits** but rather **effacement of podocyte foot processes**. - Clinical presentation includes **nephrotic syndrome** symptoms, not glomerulonephritis like PSGN. *MPGN-1* - Membranoproliferative glomerulonephritis type 1 includes **subendothelial deposits** rather than subepithelial deposits associated with PSGN. - Symptoms often include **nephritic syndrome** and is commonly linked with conditions like **HCV infection**. *All* - While several conditions can show **deposits in kidney**, not all are characterized by **subepithelial deposits**, hence this option is inaccurate. - Each type of glomerular disease has specific types of deposits (immune complex vs. complement) associated with their pathophysiology. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 914-916.

Q: Which of the following drugs is commonly used as a rescue medication for acute asthma attacks?

Salbutamol. ***Salbutamol*** - **Salbutamol** (albuterol) is a **short-acting beta-2 agonist (SABA)** that rapidly relaxes bronchial smooth muscle. - Its quick onset of action makes it ideal for immediate relief of **bronchoconstriction** during an acute asthma attack. - It is the **most commonly used** and **first-line rescue medication** for acute asthma worldwide. *Terbutaline* - **Terbutaline** is also a **short-acting beta-2 agonist (SABA)** similar to salbutamol and can be used as a rescue medication. - While it has comparable bronchodilator effects, **salbutamol is more commonly used** as the preferred rescue inhaler in clinical practice. - Both are SABAs, but salbutamol has become the standard first-choice rescue medication globally. *Theophylline* - **Theophylline** is a **methylxanthine** that acts as a bronchodilator but has a **narrow therapeutic index** and slower onset of action. - It is used as a **maintenance therapy** for chronic asthma and not as a rescue drug for acute exacerbations. *Budesonide* - **Budesonide** is an **inhaled corticosteroid (ICS)** used as a **long-term controller medication** to reduce airway inflammation. - It has a slow onset of action and is *not* effective for immediate relief during an acute asthma attack.

Q: Lower esophageal sphincter pressure is increased by all of the following substances, EXCEPT:

Secretin. ***Secretin*** - **Secretin** is a gastrointestinal hormone that *decreases* lower esophageal sphincter (LES) pressure - This hormone is released from S cells in the duodenum in response to acidic chyme - Its primary role is to stimulate the pancreas to release **bicarbonate-rich fluid** to neutralize acidic chyme entering the duodenum - By decreasing LES pressure, it facilitates the passage of gastric contents into the duodenum during digestion *Gastrin* - **Gastrin** is a hormone that *increases* lower esophageal sphincter (LES) pressure - This helps prevent gastroesophageal reflux when the stomach is distended - It also stimulates the secretion of **gastric acid** by parietal cells in the stomach - Released from G cells in the gastric antrum in response to protein ingestion *Motilin* - **Motilin** is a peptide hormone that *increases* lower esophageal sphincter (LES) pressure - It initiates the **migrating motor complex (MMC)** during the interdigestive period - Stimulates gastric and intestinal motility - Released from M cells in the duodenum and jejunum *Substance P* - **Substance P** is a neuropeptide that *increases* lower esophageal sphincter (LES) pressure - Functions as both a neurotransmitter and neuromodulator in the enteric nervous system - Plays a role in **smooth muscle contraction** and gastrointestinal motility - Also involved in pain transmission and inflammatory responses

Q: In an ECG the cardiac event corresponding to the ST segment is:

Ventricular repolarisation. ***Ventricular repolarisation*** - The **ST segment** represents the **early phase of ventricular repolarization**, corresponding to the **plateau phase (Phase 2)** of the ventricular action potential. - During this phase, the ventricles are completely depolarized and calcium influx balances potassium efflux, creating an isoelectric (flat) segment on the ECG. - The ST segment extends from the **end of the QRS complex (J point)** to the **beginning of the T wave**, after which rapid repolarization occurs. - Together, the **ST segment and T wave** represent the complete process of ventricular repolarization. *Atrial depolarisation* - **Atrial depolarization** is represented by the **P wave** on the ECG, not the ST segment. - This occurs first in the cardiac cycle, triggering atrial contraction and filling of the ventricles. *Ventricular depolarisation* - **Ventricular depolarization** is represented by the **QRS complex**, which immediately **precedes** the ST segment. - This event triggers ventricular contraction (systole) and occurs before the plateau phase. *Atrial repolarisation* - **Atrial repolarization** occurs during the QRS complex and is **obscured** by the much larger electrical signal from ventricular depolarization. - It is not visible as a separate deflection on the standard ECG.

Question 1

Where do primitive red blood cells first originate during early embryonic development?

Accepted Answer

Yolk sac

Answer

Liver

Answer

Bone marrow

Answer

Spleen

Question 2

Intercalated disc is present in:

Accepted Answer

Cardiac muscle

Answer

Smooth muscle

Answer

Skeletal muscle

Answer

All of the options

Question 3

In the malate shuttle, how many ATPs are produced from one NADH?

Accepted Answer

2.5 ATP

Answer

1 ATP

Answer

3 ATP

Answer

2 ATP

Question 4

Coenzyme for phenylalanine hydroxylase is?

Accepted Answer

Tetrahydrobiopterin

Answer

Tetrahydrofolate

Answer

Pyridoxal phosphate

Answer

S-adenosyl methionine

Question 5

Which coenzyme is not required in the formation of glutamate?

Accepted Answer

Thiamine pyrophosphate

Answer

None of the above

Answer

Pyridoxal phosphate

Answer

Niacin

Question 6

The mechanism of action of uncouplers of oxidative phosphorylation involves:

Accepted Answer

Disruption of proton gradient across the inner membrane

Answer

Inhibition of ATP synthase

Answer

Stimulation of ATP synthase

Answer

Blocking electron transport chain complexes

Question 7

Subepithelial deposits in the kidney are primarily associated with which condition?

Accepted Answer

Post-Streptococcal Glomerulonephritis (PSGN)

Answer

None of these conditions are associated with subepithelial deposits.

Answer

Membranoproliferative Glomerulonephritis (MPGN) Type I

Answer

Goodpasture's Syndrome (GPS)

Question 8

Which of the following drugs is commonly used as a rescue medication for acute asthma attacks?

Accepted Answer

Salbutamol

Answer

Theophylline

Answer

Terbutaline

Answer

Budesonide

Question 9

Lower esophageal sphincter pressure is increased by all of the following substances, EXCEPT:

Accepted Answer

Secretin

Answer

Motilin

Answer

Gastrin

Answer

Substance P

Question 10

In an ECG the cardiac event corresponding to the ST segment is:

Accepted Answer

Ventricular repolarisation

Answer

Atrial depolarisation

Answer

Ventricular depolarisation

Answer

Atrial repolarisation

NEET-PG 2015

Anatomy

Biochemistry

Pathology

Pharmacology

Physiology