INI-CET 2019 Previous Year Questions Practice Questions

Q: Lesion of the marked structure affects all EXCEPT

Superior oblique. ***Superior oblique*** - The **superior oblique** muscle is innervated by the **trochlear nerve (CN IV)**. - A lesion affecting the **oculomotor nerve (CN III)**, which usually controls the marked structure, would therefore **not** affect the superior oblique. *Superior rectus* - The **superior rectus** muscle is innervated by the **oculomotor nerve (CN III)**. - A lesion of the oculomotor nerve would impair its function, leading to difficulty in **elevating** and **adducting** the eye. *Inferior oblique* - The **inferior oblique** muscle is innervated by the **oculomotor nerve (CN III)**. - Damage to this nerve would result in compromised function of the inferior oblique, affecting **extorsion** and **elevation** of the eye. *Medial rectus* - The **medial rectus** muscle is innervated by the **oculomotor nerve (CN III)**. - A lesion of the oculomotor nerve would lead to an inability to perform **adduction** (moving the eye inward). [Practice more INI-CET 2019 questions on OnCourse]

Q: In a clinical scenario where a patient presents with flaccid paralysis, which of the following toxins is most likely responsible?

Botulism. ***Correct Option: Botulism*** - **Botulinum toxin** blocks the release of **acetylcholine** at the neuromuscular junction, leading to **flaccid paralysis**. - This paralysis typically progresses symmetrically and can affect ocular, bulbar, and peripheral muscles. *Incorrect Option: Tetanus* - **Tetanus toxin** inhibits the release of **inhibitory neurotransmitters** (**GABA** and **glycine**) in the central nervous system. - This leads to uncontrolled muscle contractions, presenting as **spastic paralysis** and **lockjaw**. *Incorrect Option: Diphtheria* - **Diphtheria toxin** causes local inflammation and can lead to systemic effects, including **myocarditis** and **neuropathy**. - The neuropathy can cause weakness, but it is typically a **delayed polyneuropathy** rather than acute flaccid paralysis. *Incorrect Option: Cholera* - **Cholera toxin** activates adenylyl cyclase in intestinal cells, leading to excessive fluid and electrolyte secretion. - The primary symptom is **severe watery diarrhea** and dehydration, not paralysis. [Practice more INI-CET 2019 questions on OnCourse]

Q: Slow growing alveolar like tumor in liver is caused by:

E. multilocularis. **Correct: E. multilocularis** - *Echinococcus multilocularis* causes **alveolar echinococcosis**, characterized by a slow-growing, infiltrative, and destructive lesion in the liver with a sponge-like, alveolar appearance - This parasite's larval stage forms multiple small cysts that are not encapsulated, leading to a tumor-like mass, often described as having an "alveolar" structure - The growth pattern mimics a malignant tumor, with irregular borders and infiltration into surrounding liver tissue *Incorrect: Amoebic liver abscess* - An amoebic liver abscess is caused by **Entamoeba histolytica** and typically presents as a single or multiple well-defined, encapsulated lesions filled with "anchovy paste-like" pus, which is distinct from an alveolar tumor - These abscesses usually develop relatively quickly (acute to subacute) and are often associated with fever and right upper quadrant pain, unlike the slow, asymptomatic growth of alveolar echinococcosis *Incorrect: E. granulosus* - *Echinococcus granulosus* causes **cystic echinococcosis** (hydatid disease), which typically presents as a single, large, unilocular cyst with a clear, laminated membrane, often surrounded by a fibrous capsule - Unlike *E. multilocularis*, *E. granulosus* cysts tend to be well-defined, spherical, and expansile rather than infiltrative and alveolar - The key distinguishing feature is the **cystic** (unilocular or with daughter cysts) versus **alveolar** (multiple small vesicles) morphology *Incorrect: Cysticercus cellulosae* - *Cysticercus cellulosae* is the larval form of **Taenia solium** and causes cysticercosis, which primarily affects muscles, subcutaneous tissue, brain, and eyes - While it forms cysts, these are typically small, solitary, and calcify in various tissues, not forming a large, infiltrative, alveolar tumor-like mass in the liver - Hepatic cysticercosis is extremely rare [Practice more INI-CET 2019 questions on OnCourse]

Q: The patient who developed a rash on the skin, hypotension, and difficulty in breathing after being given 2 g of ampicillin intravenously should be managed by.

0.5 ml of 1:1000 adrenaline by intramuscular injection. ***0.5 ml of 1:1000 adrenaline by intramuscular injection*** - This presentation describes **anaphylaxis**, characterized by a rapid onset of rash, **hypotension**, and **difficulty breathing** following drug administration. - The immediate and definitive treatment for anaphylaxis is **intramuscular adrenaline (epinephrine)**, typically at a concentration of **1:1000** for rapid absorption and systemic effect. *0.5 ml of 1:1000 adrenaline by intravenous injection* - **Intravenous adrenaline** is generally reserved for patients who are unresponsive to intramuscular administration or are in **cardiac arrest**, as it carries a higher risk of adverse effects like arrhythmias. - The initial, first-line treatment in an evolving anaphylactic reaction should be **intramuscular injection** due to its safer profile and rapid onset of action. *0.5 ml of 1:10000 adrenaline by intramuscular injection* - A concentration of **1:10,000 adrenaline** is typically used for **intravenous administration** during advanced cardiac life support (ACLS) protocols, not for initial intramuscular injection in anaphylaxis. - Administering 1:10,000 adrenaline intramuscularly would provide a **suboptimal dose** for treating severe anaphylaxis effectively. *0.5 ml of 1:10000 adrenaline by intravenous injection* - While intravenous adrenaline uses a **1:10,000 concentration**, it's not the initial route for managing anaphylaxis unless the patient is in **cardiac arrest** or unresponsive to IM adrenaline. - Starting with IV adrenaline carries a higher risk of **cardiac complications** and can be difficult to administer promptly in an emergency outside of a controlled setting. [Practice more INI-CET 2019 questions on OnCourse]

Q: Golgi tendon organ function is?

Detects the muscle tension. ***Detects the muscle tension*** - The **Golgi tendon organ (GTO)** is a proprioceptor located at the musculotendinous junction, specifically designed to monitor and respond to changes in **muscle tension** or force. - When muscle tension increases, such as during a strong contraction, the GTO sends inhibitory signals to the motor neurons of the same muscle, leading to muscle relaxation and preventing injury (autogenic inhibition). *Detects the dynamic change in muscle length* - This function is primarily attributed to **muscle spindles**, which are specialized sensory receptors that detect changes in the **length** and rate of change of length of a muscle. - Muscle spindles are responsible for the **stretch reflex**, initiating a contraction when a muscle is stretched too quickly. *Detects the muscle stretch* - While GTOs are involved in reflex responses that can follow muscle stretch, their primary role is not to detect the stretching itself, but rather the **tension** that results from that stretch. - **Muscle spindles** are the primary mechanoreceptors responsible for detecting the stretch of a muscle. *Detects the muscle strength* - "Muscle strength" is a broader term referring to the force a muscle can exert, which is controlled by a combination of neural input and muscle fiber characteristics. - While GTOs contribute to the overall proprioceptive feedback regulating muscle force, they specifically detect **tension** rather than directly measuring "strength" as a global concept. [Practice more INI-CET 2019 questions on OnCourse]

Question 1

Lesion of the marked structure affects all EXCEPT

Accepted Answer

Superior oblique

Answer

Superior rectus

Answer

Inferior oblique

Answer

Medial rectus

Question 2

In a clinical scenario where a patient presents with flaccid paralysis, which of the following toxins is most likely responsible?

Accepted Answer

Botulism

Answer

Tetanus

Answer

Diphtheria

Answer

Cholera

Question 3

Slow growing alveolar like tumor in liver is caused by:

Accepted Answer

E. multilocularis

Answer

Amoebic liver abscess

Answer

E. granulosus

Answer

Cysticercus cellulosae

Question 4

The patient who developed a rash on the skin, hypotension, and difficulty in breathing after being given 2 g of ampicillin intravenously should be managed by.

Accepted Answer

0.5 ml of 1:1000 adrenaline by intramuscular injection

Answer

0.5 ml of 1:1000 adrenaline by intravenous injection

Answer

0.5 ml of 1:10000 adrenaline by intramuscular injection

Answer

0.5 ml of 1:10000 adrenaline by intravenous injection

Question 5

Golgi tendon organ function is?

Accepted Answer

Detects the muscle tension

Answer

Detects the dynamic change in muscle length

Answer

Detects the muscle stretch

Answer

Detects the muscle strength

Question 6

Arrange the steps of spermatogenesis in the sequence of their formation.

Accepted Answer

Spermatogonium > Spermatocyte > Spermatid > Spermatozoa

Answer

Spermatocyte > Spermatogonium > Spermatid > Spermatozoa

Answer

Spermatogonium > Spermatocyte > Spermatozoa > Spermatid

Answer

Spermatozoa > Spermatogonium > Spermatocyte > Spermatid

INI-CET 2019

Anatomy

Microbiology

Pharmacology

Physiology