INI-CET 2017 Previous Year Questions Practice Questions

Q: What is the diagnosis based on the image shown below?

Mycosis fungoides. ***Mycosis fungoides*** - The image exhibits **Pautrier microabscesses**, which are collections of atypical lymphocytes within the epidermis, a hallmark of mycosis fungoides. - There is also a **band-like infiltrate of atypical lymphocytes** in the upper dermis, characteristic of this cutaneous T-cell lymphoma. *Pemphigus* - Pemphigus is characterized by **intraepidermal blistering due to acantholysis** (loss of cohesion between keratinocytes), which is not seen in this image. - Histology would show separated keratinocytes, often with a "tombstone" appearance of basal cells, and **no Pautrier microabscesses**. *Dermal leishmaniasis* - Dermal leishmaniasis is caused by _Leishmania_ parasites and typically presents with a **dermal infiltrate rich in macrophages** containing intracellular amastigotes. - The image does not show these features; instead, it shows an atypical lymphoid infiltrate. *Psoriasis* - Psoriasis typically shows **acanthosis (epidermal hyperplasia)** with elongation of rete ridges, **parakeratosis**, and **Munro microabscesses** (neutrophilic collections in the stratum corneum). - While there is some epidermal thickening, the distinct Pautrier microabscesses and atypical lymphoid infiltrate are not features of psoriasis. [Practice more INI-CET 2017 questions on OnCourse]

Q: A person is not criminally responsible for their actions if, at the time of committing the act, they are unable to know the nature of the act or understand that it is either wrong or contrary to the law due to unsoundness of mind.

McNaughten rule. ***McNaughten rule*** - This rule states that a person is not criminally responsible if, at the time of committing the act, they were suffering from a **disease of the mind** that rendered them unable to know the **nature and quality of the act** or that it was wrong. - It focuses on the defendant's **cognitive capacity** to understand their actions and their moral or legal implications. *Durham's rule* - This rule, from the 1954 case *Durham v. United States*, states that an accused is not criminally responsible if their unlawful act was the **product of mental disease or defect**. - It is broader than McNaughten, focusing on the causal link between mental illness and the crime, but was criticized for its vagueness and has been largely replaced. *Currens rule* - From the 1961 case *United States v. Currens*, this test states that a defendant is not criminally responsible if they lacked **substantial capacity** to conform their conduct to the requirements of law due to mental disease or defect. - It is similar to the ALI (American Law Institute) test and focuses on both cognitive and volitional impairment, but is not widely used in Indian forensic practice. *Irresistible impulse test* - This test is a supplement to the McNaughten rule, asserting that a defendant is not criminally responsible if a mental disease prevented them from resisting an impulse to commit the crime, even if they knew the act was wrong. - It focuses on the defendant's **volitional capacity** – their ability to control their conduct. [Practice more INI-CET 2017 questions on OnCourse]

Q: A middle-aged woman with a history of backache who underwent a Schober test and tested positive, and who also has hyperpigmented nose and ears, is most likely diagnosed with:

Ochronosis. ***Ochronosis*** - **Hyperpigmentation of the nose and ears** (due to homogentisic acid accumulation) along with **backache** and a positive **Schober test** (indicating spinal inflexibility from ochronotic arthropathy) are classic features of ochronosis. - This inherited disorder results from a deficiency of **homogentisic acid oxidase**, leading to the accumulation of homogentisic acid. *Ankylosing spondylitis* - While **backache** and a positive **Schober test** (indicating axial skeleton involvement) are characteristic of ankylosing spondylitis, it does not typically present with **hyperpigmented nose and ears**. - **HLA-B27 positivity** and inflammatory back pain improving with activity are key differentiating features not mentioned. *Degenerative disc disease* - This condition is characterized by **chronic backache** due to age-related changes in the intervertebral discs but does not cause **hyperpigmentation of the nose and ears**. - A **positive Schober test** is less specific for degenerative disc disease and is more indicative of widespread spinal stiffness. *Fluorosis* - While severe fluorosis can lead to **skeletal changes** and pain mimicking arthritis, it is primarily associated with **dental mottling** and does not cause characteristic hyperpigmentation of the nose and ears. - มัน usually results from excessive fluoride intake, often from contaminated drinking water. [Practice more INI-CET 2017 questions on OnCourse]

Question 1

A 25-year-old lady presents with painful blisters in oral mucosa and skin. Direct immune-fluorescence picture is given below. Which of the following is incorrect about the condition shown?

Accepted Answer

Basement membrane deposition of IgG is the most common DIF picture in bullous lesions

Answer

Antibodies against hemidesmosomes

Answer

Antibodies against desmoglein 1

Answer

Antibodies against desmoglein-3

Question 2

What is the diagnosis based on the image shown below?

Accepted Answer

Mycosis fungoides

Answer

Pemphigus

Answer

Dermal leishmaniasis

Answer

Psoriasis

Question 3

A person is not criminally responsible for their actions if, at the time of committing the act, they are unable to know the nature of the act or understand that it is either wrong or contrary to the law due to unsoundness of mind.

Accepted Answer

McNaughten rule

Answer

Irresistible impulse test

Answer

Currens rule

Answer

Durham's rule

Question 4

A middle-aged woman with a history of backache who underwent a Schober test and tested positive, and who also has hyperpigmented nose and ears, is most likely diagnosed with:

Accepted Answer

Ochronosis

Answer

Ankylosing spondylitis

Answer

Degenerative disc disease

Answer

Fluorosis

Question 5

A patient with a depressive illness is brought to casualty with acute breathlessness. X-ray shows diffuse infiltrates in right middle lobe and right lower lobe. The patient expired. The lung specimen on biopsy shows:

Accepted Answer

Aspiration pneumonitis

Answer

Pulmonary alveolar proteinosis

Answer

Tuberculosis

Answer

Fat embolism syndrome

Question 6

An 18-year-old male with severe effort intolerance and dyspnea is found to have left atrial enlargement on Chest X-ray. Histopathological examination shows:

Accepted Answer

Aschoff nodules

Answer

Sarcoidosis

Answer

TB

Answer

Fungal granuloma

Question 7

The following brain biopsy of patient who presented with marked psychomotor agitation is diagnostic of?

Accepted Answer

Rabies encephalitis

Answer

Herpes simplex encephalitis

Answer

Creutzfeldt-Jakob disease

Answer

Japanese encephalitis

Answer

Acute disseminated encephalomyelitis

Question 8

A 70-year-old man presents with history of intractable diarrhea. His bone marrow and kidney biopsy are shown below. Which of the following is the most appropriate diagnosis?

Accepted Answer

Multiple myeloma

Answer

Leishmaniasis

Answer

Lymphoma

Answer

Urate nephropathy

Answer

Amyloidosis

Question 9

Identify the stain shown in the liver section.

Accepted Answer

Gordon and Sweet's reticulin stain

Answer

Warthin starry

Answer

Steiner silver stain

Answer

Grimelius silver stain

Question 10

A 50-year-old male presents with colicky abdominal pain and recurrent bloody diarrhea. Colonoscopy shows geographical ulcers. Histopathology is shown below. Diagnosis is:

Accepted Answer

Inflammatory bowel disease

Answer

Pseudomembranous colitis

Answer

NHL

Answer

Adenocarcinoma colon

INI-CET 2017

Dermatology

Forensic Medicine

Internal Medicine

Pathology