INI-CET 2021 Previous Year Questions Practice Questions

Q: In conventional oxygen therapy, which device will deliver the highest FiO2?

Non rebreathing mask. **Non rebreathing mask** - This device features a **one-way valve** between the mask and the reservoir bag, preventing exhaled air from mixing with fresh oxygen. This allows for the delivery of the **highest possible FiO2** among conventional oxygen therapy devices, often up to 90-100%. - The **reservoir bag** ensures a continuous supply of high-concentration oxygen during inspiration, maximizing the amount of oxygen inhaled. *Hudson mask* - Also known as a **simple face mask**, it delivers a moderate FiO2 (40-60%) at flow rates of 5-10 L/min. - The open ports on the sides allow for mixing of room air with oxygen, making it less efficient for delivering very high oxygen concentrations. *Venturi mask* - This device uses the Venturi principle to deliver a **precise and consistent FiO2** by entraining room air with oxygen. - While it provides controlled oxygen delivery, its maximum FiO2 typically ranges from 24-60%, which is lower than a non-rebreathing mask. *Nasal cannula* - The nasal cannula delivers a relatively low FiO2 (24-44%) at flow rates of 1-6 L/min. - It is designed for **low-flow oxygen delivery** and is not suitable for patients requiring high concentrations of oxygen. [Practice more INI-CET 2021 questions on OnCourse]

Q: A 60 year old male patient was undergoing laparoscopic cholecystectomy. During the surgery, a sudden drop in EtCO2 to 8 mmHg was noted. His SpO2 became 90%, his blood pressure dropped to 80/50 mmHg, and peak airway pressure was 18 cm of H2O. What is the diagnosis?

Gas embolism. ***Gas embolism*** - A sudden drop in **EtCO2** to 8 mmHg, **hypotension**, and **hypoxemia** during laparoscopic surgery are classic signs of a gas embolism, often from insufflated CO2 entering the bloodstream. - The drop in EtCO2 is due to a sudden decrease in pulmonary blood flow, preventing CO2 from reaching the lungs for exhalation. *Anaphylaxis* - While anaphylaxis can cause hypotension and hypoxemia, it typically presents with **bronchospasm** (increased peak airway pressure), **tachycardia**, and skin manifestations like **urticaria** or angioedema, which are not explicitly mentioned. - Anaphylaxis does not typically cause a drastic, sudden drop in EtCO2 to such low levels as seen with a gas embolism. *Malignant hyperthermia* - This condition is characterized by a rapid and sustained increase in **EtCO2**, **tachycardia**, muscle rigidity, and hyperthermia, which is the opposite of the EtCO2 findings here. - Malignant hyperthermia would lead to a significant elevation in metabolic CO2 production, not a sudden drop in EtCO2. *Pneumothorax* - A pneumothorax would typically present with **increased peak airway pressures**, **hypoxia**, and **hypotension**, but the EtCO2 would likely initially rise or remain stable before dropping due to decreased ventilation, not an acute drop to 8 mmHg. - The primary physiological issue in pneumothorax is lung collapse, leading to ventilation-perfusion mismatch, but not directly causing a sudden near-absence of exhaled CO2 in this manner. [Practice more INI-CET 2021 questions on OnCourse]

Q: Methyl-tetrahydrofolate (5-methyl-THF) gets accumulated in deficiency of which of the following?

Vitamin B12 (Cobalamin). ***Vitamin B12 (Cobalamin)*** - A deficiency in **Vitamin B12** (cobalamin) leads to the accumulation of **5-methyl-tetrahydrofolate (5-methyl-THF)** due to the **"folate trap"** hypothesis. - This occurs because B12 is a cofactor for **methionine synthase**, which converts 5-methyl-THF back to tetrahydrofolate (THF), a necessary step for DNA synthesis and other one-carbon metabolism reactions. - Without B12, folate remains trapped in the methyl form and cannot be utilized for other essential reactions. *Vitamin B2 (Riboflavin)* - **Vitamin B2** (riboflavin) is a precursor for **FAD** and **FMN**, essential coenzymes in various redox reactions in the electron transport chain and other metabolic pathways. - Its deficiency typically presents as **cheilosis**, glossitis, and angular stomatitis, but does not cause methyl-THF accumulation. *Vitamin B1 (Thiamine)* - **Vitamin B1** (thiamine) is a cofactor for enzymes like **pyruvate dehydrogenase** and **alpha-ketoglutarate dehydrogenase** in carbohydrate metabolism. - Its deficiency causes **Beriberi** (wet, dry, or Wernicke-Korsakoff syndrome), affecting the cardiovascular and nervous systems, but does not affect folate metabolism. *Vitamin B6 (Pyridoxine)* - **Vitamin B6** (pyridoxine) is a coenzyme for many metabolic reactions, particularly in amino acid metabolism and neurotransmitter synthesis. - Deficiency can lead to **sideroblastic anemia**, neurological symptoms, and dermatitis, but does not cause methyl-THF accumulation. [Practice more INI-CET 2021 questions on OnCourse]

Q: Which of the following molecular analysis methods is used to detect RNA?

RT-PCR. ***RT-PCR*** - **Reverse transcriptase polymerase chain reaction (RT-PCR)** is a molecular method that first converts **RNA into complementary DNA (cDNA)** using reverse transcriptase before amplification via PCR. - This technique is commonly used to detect and quantify specific **RNA sequences**, such as viral RNA or gene expression levels. *Western blot* - **Western blot** is a laboratory technique used to detect specific **proteins** in a sample. - It involves separating proteins by size using gel electrophoresis, transferring them to a membrane, and then detecting the target protein using specific antibodies. *G banding* - **G banding** is a cytogenetic technique used to produce a visible **karyotype** by staining condensed chromosomes. - This method is primarily used to detect large-scale structural changes in chromosomes, not to detect RNA. *Sanger's method* - **Sanger's method**, also known as **dideoxy sequencing**, is a DNA sequencing technique. - It is used to determine the exact order of **nucleotides within a DNA molecule**, not to detect RNA directly. [Practice more INI-CET 2021 questions on OnCourse]

Q: Glycated hemoglobin (HbA1c) is best measured using?

Ion exchange chromatography. ***Ion exchange chromatography*** - This method separates hemoglobin variants based on their **charge differences** due to the glucose molecule attached to HbA1c. - It is a highly sensitive and specific method for quantifying HbA1c, widely used in clinical laboratories. *Isoelectric focusing* - This technique separates molecules based on their **isoelectric point (pI)**, the pH at which they have no net charge. - While it can differentiate some hemoglobin variants, it is generally **less efficient and more complex** for routine HbA1c measurement compared to ion exchange chromatography. *Affinity chromatography* - This method separates molecules based on their **specific binding affinity** to a ligand immobilized on a stationary phase. - While it has been explored for HbA1c measurement, it is **not the most commonly used** or preferred method due to potential interferences and cost compared to ion exchange chromatography. *Electrophoresis* - This technique separates molecules based on their **charge and size** in an electric field. - While it can separate major hemoglobin variants, it has **lower resolution and accuracy** for routine HbA1c quantification compared to more specialized chromatographic methods, making it less ideal for precise measurement. [Practice more INI-CET 2021 questions on OnCourse]

Question 1

In conventional oxygen therapy, which device will deliver the highest FiO2?

Accepted Answer

Non rebreathing mask

Answer

Hudson mask

Answer

Venturi mask

Answer

Nasal cannula

Question 2

A 60 year old male patient was undergoing laparoscopic cholecystectomy. During the surgery, a sudden drop in EtCO2 to 8 mmHg was noted. His SpO2 became 90%, his blood pressure dropped to 80/50 mmHg, and peak airway pressure was 18 cm of H2O. What is the diagnosis?

Accepted Answer

Gas embolism

Answer

Anaphylaxis

Answer

Malignant hyperthermia

Answer

Pneumothorax

Question 3

Methyl-tetrahydrofolate (5-methyl-THF) gets accumulated in deficiency of which of the following?

Accepted Answer

Vitamin B12 (Cobalamin)

Answer

Vitamin B2 (Riboflavin)

Answer

Vitamin B1 (Thiamine)

Answer

Vitamin B6 (Pyridoxine)

Question 4

Which of the following molecular analysis methods is used to detect RNA?

Accepted Answer

RT-PCR

Answer

Western blot

Answer

G banding

Answer

Sanger's method

Question 5

Glycated hemoglobin (HbA1c) is best measured using?

Accepted Answer

Ion exchange chromatography

Answer

Isoelectric focusing

Answer

Affinity chromatography

Answer

Electrophoresis

Question 6

Which of the following options is false in a patient with advanced liver disease?

Accepted Answer

Increased oxidative decarboxylation of alpha-ketoglutarate

Answer

Decreased ATP synthesis

Answer

Hyperammonemia

Answer

Increased synthesis of glutamine and glutamate from alpha-ketoglutarate

Question 7

Which of the following is not a substrate for glucose formation?

Accepted Answer

Acetyl coenzyme A

Answer

Lactate

Answer

Glycerol

Answer

Alanine

Question 8

What is the repair mechanism associated with CRISPR-cas9?

Accepted Answer

Non-homologous end joining

Answer

Mismatch repair

Answer

Nucleotide excision repair

Answer

Base excision repair

Question 9

Which of the following is not amphipathic?

Accepted Answer

Triglycerides

Answer

Sphingolipids

Answer

Glycolipids

Answer

Phosphoglycerol

Question 10

A forest officer develops the lesion as shown in the image. Which of the following is not a differential to consider?

Accepted Answer

KFD

Answer

Cutaneous anthrax

Answer

Scrub typhus

Answer

Healing brown recluse spider bite

INI-CET 2021

Anesthesiology

Biochemistry

Internal Medicine