INI-CET 2017 Previous Year Questions Practice Questions

Q: Which of the following marked arrows represents the lateral semicircular canal during a cortical mastoidectomy?

C. **Correct Answer: C** - The **lateral semicircular canal** is typically identified by its superior and lateral position to the **facial nerve** and its prominence in the mastoid air cell system. - During a **cortical mastoidectomy**, it serves as a crucial anatomical landmark, especially when approaching the **aditus ad antrum** and planning for otologic surgery. *Incorrect Option A* - This arrow likely indicates the **tegmen tympani** (roof of the tympanic cavity), which is the superior boundary of the mastoid and middle ear, not a semicircular canal. - Damage to this area can lead to a **CSF leak** or **meningitis**. *Incorrect Option B* - This arrow points to the **facial nerve**, which runs inferior and medial to the lateral semicircular canal within the mastoid. - The facial nerve is extremely vulnerable during mastoidectomy and its identification is critical to prevent **facial paralysis**. *Incorrect Option D* - This arrow represents the **posterior semicircular canal**, which lies inferior and posterior to the lateral semicircular canal. - It is typically identified deeper within the mastoid and oriented more vertically compared to the lateral canal. [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]

Q: A patient presents with unilateral painless proptosis. Biopsy shows which of the following?

Schwannoma. ***Schwannoma*** - **Schwannomas** are common causes of **unilateral painless proptosis** when they arise from nerves within the orbit [2]. - Biopsy typically shows **Antoni A** and **Antoni B areas**, with Verocay bodies [1]. *Neurofibroma* - While neurofibromas can occur in the orbit, they are more commonly associated with **Neurofibromatosis type 1** and often present as diffuse plexiform lesions [2]. - Histologically, they are characterized by a mix of **Schwann cells**, fibroblasts, and perineurial-like cells in a myxoid matrix, lacking the distinct Antoni A/B patterns. *Rhabdomyoma* - **Rhabdomyomas** are benign tumors of **striated muscle** and are rare in the orbit. - They are more commonly found in the **heart** (associated with tuberous sclerosis) or head and neck region. *Leiomyoma* - **Leiomyomas** are benign tumors of **smooth muscle** and are extremely rare in the orbit, as the orbit contains very little smooth muscle. - They are more commonly found in the **uterus** (fibroids) or gastrointestinal tract. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, p. 1250. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1248-1249. [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

Which of the following marked arrows represents the lateral semicircular canal during a cortical mastoidectomy?

Accepted Answer

C

Answer

A

Answer

B

Answer

D

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 presents with unilateral painless proptosis. Biopsy shows which of the following?

Accepted Answer

Schwannoma

Answer

Neurofibroma

Answer

Rhabdomyoma

Answer

Leiomyoma

Answer

Meningioma

Question 6

Hemoglobin electrophoresis in a 5-year-old anemic patient shows HbF=90 % and HbA2=3 %. Select the correct combination of findings of peripheral smear from the ones shown below.

Accepted Answer

A, C

Answer

A

Answer

B, C

Answer

A, B

Answer

A, B and C

Question 7

Endoscopic and Barium swallow findings of a patient are shown below. Select the correct histopathological slide of the patient.

Accepted Answer

Image A

Answer

Image B

Answer

Image C

Answer

Image D

Question 8

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 9

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 10

A 50-year-old male presented with blurring of vision. Urine examination shows proteinuria. Fundus shows dot and hemorrhage with microaneurysm. Kidney biopsy picture given below shows:

Accepted Answer

Kimmelstiel Wilson nodules

Answer

Crescents

Answer

Amyloid deposition

Answer

Focal segmental sclerosis

Answer

Diffuse glomerulosclerosis

INI-CET 2017

Dermatology

ENT

Forensic Medicine

Internal Medicine

Pathology