INI-CET 2018 Previous Year Questions Practice Questions

Q: Cranial nerve that is involved in olfaction:

Trigeminal. ***Trigeminal*** - The **trigeminal nerve (CN V)** carries sensory information from the face and contributes to olfactory perception through its **ophthalmic (V1) and maxillary (V2) divisions** [1]. - These divisions detect **chemical irritants, pungency, cooling, and warming sensations** in the nasal cavity (chemesthesis), contributing to the overall perception of smells. - Examples include the stinging sensation of **ammonia**, cooling of **menthol**, and burning of **capsaicin** - all part of the smell experience. - This is distinct from true olfaction (CN I) but is an essential component of how we perceive "smell" in daily life. *Hypoglossal* - The **hypoglossal nerve (CN XII)** is purely a **motor nerve** that controls the intrinsic and extrinsic muscles of the **tongue**. - It is essential for **speech, swallowing, and tongue movement** but has **no role in olfaction or smell perception**. *Glossopharyngeal* - The **glossopharyngeal nerve (CN IX)** mediates **taste sensation from the posterior third of the tongue**, swallowing, and salivation. - While important for taste, it has **no role in olfactory pathways or smell detection**. *Vagus* - The **vagus nerve (CN X)** has extensive **parasympathetic functions** and carries taste sensation from the **epiglottis and pharynx**. - It innervates thoracic and abdominal organs but is **not involved in olfactory perception**. [Practice more INI-CET 2018 questions on OnCourse]

Q: Identify the structure marked in the image of cardiac myocyte. (AIIMS Nov 2018)

Lipofuscin granules. ***Lipofuscin granules*** - The image displays electron-dense, irregular structures, characteristic of **lipofuscin granules**, which are wear-and-tear pigments accumulating in aging cardiac myocytes. - They are typically located near the nucleus and appear dark due to their complex lipid-protein composition. *Lysosomes* - Lysosomes are typically smaller, more uniformly shaped, and contain hydrolytic enzymes, which is not clearly depicted. - While involved in cellular waste breakdown, they do not typically accumulate as large, intensely electron-dense, irregular aggregates like those shown. *Phagolysosome* - A phagolysosome forms when a phagosome fuses with a lysosome, containing engulfed material often of foreign or cellular debris origin. - The image does not show evidence of recently engulfed material or the typical morphology of a phagocytic vesicle. *Inflammasome* - An inflammasome is a multi-protein intracellular complex involved in the inflammatory response, not a visibly distinct organelle with this characteristic electron microscopic appearance. - It is a signaling platform, not a storage granule, and would not appear as dense, granular deposits in a routine electron micrograph. [Practice more INI-CET 2018 questions on OnCourse]

Q: Which of the following tubes contain sodium fluoride as an anti-coagulant?

Gray-top tube. ***a. Gray-top tube*** - The **gray-top tube** contains **sodium fluoride** and **potassium oxalate** as anticoagulants. - Sodium fluoride acts as both an **anticoagulant** and an **antiglycolytic agent**, preserving glucose concentration by inhibiting glycolysis. - This tube is the **standard choice for glucose testing** in clinical laboratories. *b. Green-top tube* - The **green-top tubes** contain **heparin** (either sodium, lithium, or ammonium heparin) as an anticoagulant. - These tubes are used for various tests including **plasma chemistry** and some hormone assays, but not for glucose preservation with sodium fluoride. *c. Pink-top tube* - The **pink-top tube** generally contains **EDTA** (ethylenediaminetetraacetic acid) and is specifically designed for **blood bank** tests due to its special labeling and anticoagulant properties for cross-matching. - While it contains an anticoagulant, it is not sodium fluoride and is not used for glucose measurement. *d. Blue-top tube with yellow checkerboard pattern* - While some manufacturers may use different labeling systems, the **standard tube for sodium fluoride** is the gray-top tube, not the blue-top with checkerboard pattern. - Blue-top tubes typically contain **sodium citrate** and are used for coagulation studies (PT, PTT, INR). [Practice more INI-CET 2018 questions on OnCourse]

Q: A patient presents with intermittent fever, no weight loss and enlarged retroperitoneal lymph nodes. Peripheral smear is normal. Gross sample and its histopathology slide is shown below. Comment on the diagnosis.

Castleman disease. ***Castleman disease*** - The image shows **"lollipop lesions"** or **"onion-skinning"** of follicles with **regressed germinal centers** and prominent mantle zones, characteristic of the hyaline-vascular variant of Castleman disease. - Clinical features like **intermittent fever** and **enlarged retroperitoneal lymph nodes** with **no weight loss** can be seen in Castleman disease, particularly the unicentric type. *Non-Hodgkin's lymphoma* - This would typically show effacement of the normal lymph node architecture by a **monotonous proliferation of atypical lymphocytes**. - While it can cause lymphadenopathy and fever, the specific histological features presented do not align with typical non-Hodgkin's lymphoma. *Angiolymphoid hyperplasia* - Characterized by **multiple vascular channels** lined by plump endothelial cells with **lymphoid infiltrates**. - It often presents as subcutaneous nodules, usually in the head and neck region, and lacks the follicular changes seen here. *IgG4 related disease* - Histologically, this disease is characterized by a **dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells**, storiform fibrosis, and obliterative phlebitis. - While it can cause lymph node enlargement, the specific follicular changes in the image are not typical of IgG4-related disease. [Practice more INI-CET 2018 questions on OnCourse]

Q: Immunofluorescence staining pattern from a kidney biopsy from a 35-year-old patient presenting with proteinuria has been shown below. What is the most probable cause? (AIIMS Nov 2018)

Lupus nephritis. ***Lupus nephritis*** - The image likely shows a **"full house" immunofluorescence pattern** (deposits of IgG, IgA, IgM, C3, and C1q), which is characteristic of **lupus nephritis** [1]. - This pattern indicates immune complex deposition in the glomeruli, a hallmark of systemic lupus erythematosus affecting the kidneys [1]. *FSGS* - **Focal segmental glomerulosclerosis (FSGS)** typically shows **negative immunofluorescence** or only non-specific IgM and C3 in sclerotic areas [3,4]. - It does not present with the diffuse, multi-immunoglobulin deposition seen in the characteristic "full house" pattern. *PSGN* - **Post-streptococcal glomerulonephritis (PSGN)** characteristically shows a **"starry sky" or granular pattern** of C3 and IgG deposition, often with a dominant C3 [2]. - It does not typically show the full spectrum of immunoglobulins and complement components seen in lupus nephritis. *Goodpasture syndrome* - **Goodpasture syndrome** is characterized by a **linear deposition of IgG** along the glomerular basement membrane (GBM) on immunofluorescence [2]. - This pattern is distinct from the granular, multi-immunoglobulin deposition seen in immune complex-mediated diseases like lupus nephritis. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 532-533. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, p. 915. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 530-531. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 531-532. [Practice more INI-CET 2018 questions on OnCourse]

Question 1

Cranial nerve that is involved in olfaction:

Accepted Answer

Trigeminal

Answer

Hypoglossal

Answer

Glossopharyngeal

Answer

Vagus

Question 2

Identify the structure marked in the image of cardiac myocyte. (AIIMS Nov 2018)

Accepted Answer

Lipofuscin granules

Answer

Lysosomes

Answer

Phagolysosome

Answer

Inflammasome

Question 3

Which of the following tubes contain sodium fluoride as an anti-coagulant?

Accepted Answer

Gray-top tube

Answer

Green-top tube

Answer

Pink-top tube

Answer

Blue-top tube with yellow checkerboard pattern

Question 4

A patient presents with intermittent fever, no weight loss and enlarged retroperitoneal lymph nodes. Peripheral smear is normal. Gross sample and its histopathology slide is shown below. Comment on the diagnosis.

Accepted Answer

Castleman disease

Answer

Non-Hodgkin's lymphoma

Answer

Angiolymphoid hyperplasia

Answer

IgG4 related disease

Question 5

Immunofluorescence staining pattern from a kidney biopsy from a 35-year-old patient presenting with proteinuria has been shown below. What is the most probable cause? (AIIMS Nov 2018)

Accepted Answer

Lupus nephritis

Answer

FSGS

Answer

PSGN

Answer

Goodpasture syndrome

Answer

IgA nephropathy

Question 6

A macrophage engulfs different cells as shown in the image. This is known as?

Accepted Answer

Emperipolesis

Answer

Phagocytosis

Answer

Killing

Answer

Cytotoxicity

Question 7

Identify the inheritance pattern shown below.

Accepted Answer

X linked recessive

Answer

Y linked recessive

Answer

X linked dominant

Answer

Y linked dominant

Question 8

What does the given chest X-ray show?

Accepted Answer

Pneumoperitoneum

Answer

Emphysema

Answer

Diaphragmatic hernia

Answer

Diaphragmatic eventration

Question 9

Identify the type of investigation shown in the image below.

Accepted Answer

Myelography

Answer

Angiography

Answer

Neurography

Answer

Fluoroscopy

Question 10

A 25-year-old female presents with neck pain and tingling sensation in her left arm. An X-ray of the cervicothoracic region is obtained. What is the radiological finding shown in the image?

Accepted Answer

Cervical rib

Answer

Costochondritis

Answer

Fracture of 2nd rib

Answer

Spondylolisthesis

INI-CET 2018

Anatomy

Pathology

Physiology

Radiology