INI-CET 2021 Practice Questions

Q: You are in the operating room and notice the tracing in yellow colour on this device. What does it indicate?

Capnography. ***Capnography*** - The yellow tracing displays a waveform that is characteristic of a **capnogram**, which measures the concentration of **carbon dioxide (CO2)** in the expired breath over time. - The rectangular shape with a sudden rise, plateau, and rapid fall is typical of the **CO2 waveform** during a respiratory cycle. *O2 pressure in exhaled air* - While oxygen levels can be monitored, the characteristic waveform shown with its distinct plateau phase is specific to **carbon dioxide** measurement. - Oxygen monitoring provides different types of waveforms or numerical values, such as **pulsus oximetry**, which shows oxygen saturation. *O2 pressure in inhaled air* - Monitoring devices typically display **inspired oxygen concentration (FiO2)** as a numerical value rather than a waveform. - The waveform shown is indicative of gas exchange dynamics during **exhalation**, not inhalation. *Airway pressure* - Airway pressure tracings typically show a waveform that correlates with the **inspiratory and expiratory phases** of breathing, indicating the pressure within the airway. - However, the specific shape and plateau of the waveform in yellow are distinct from typical **airway pressure** curves and are characteristic of CO2.

Q: All the following tests are related to pasteurization of milk except

Iodine test. ***Iodine test*** - The **iodine test** is used to detect the presence of **starch**, which is not directly related to the pasteurization process or the quality of milk after pasteurization. - This test is more commonly seen in laboratory settings to detect starch hydrolysis or in food science for specific ingredients, not for routine milk quality assurance post-pasteurization. *Standard plate count* - The **Standard Plate Count (SPC)** measures the number of **viable microorganisms** in a milk sample. - A reduction in SPC after pasteurization indicates the effectiveness of the heat treatment in killing bacteria. *Phosphatase test* - The **phosphatase test** is a crucial indicator for the **adequacy of pasteurization**, as alkaline phosphatase is destroyed at temperatures and times similar to those required to kill common pathogens. - If phosphatase activity is detected after pasteurization, it suggests that the milk was either **insufficiently heated** or has been mixed with raw milk. *Methylene blue reduction test* - The **methylene blue reduction test** (MBRT) assesses the microbial quality of milk by measuring the time it takes for bacteria to **decolorize methylene blue**. - A longer reduction time indicates a **lower bacterial count** and better keeping quality, thus indirectly related to the effectiveness of pasteurization.

Q: Which of the following is the most effective drug in smoking cessation?

Varenicline. ***Varenicline*** - **Varenicline** is a **partial agonist** of the **nicotinic acetylcholine receptor (nAChR)**, reducing cravings and withdrawal symptoms while blocking the pleasurable effects of nicotine. - It has been shown to be more effective than other pharmacological interventions, including bupropion and nicotine replacement therapies, in achieving **long-term abstinence**. *Nicotine gum* - **Nicotine gum** is a form of **Nicotine Replacement Therapy (NRT)** that provides nicotine to reduce withdrawal symptoms. - While effective, NRTs (including gum) are generally less effective than varenicline in achieving sustained smoking cessation. *Buspirone* - **Buspirone** is an anxiolytic drug primarily used to treat generalized anxiety disorder. - It does not have a primary indication or significant evidence of effectiveness for smoking cessation. *Rimonabant* - **Rimonabant** is a **cannabinoid receptor 1 (CB1) antagonist** that was once explored for smoking cessation and weight loss. - It was withdrawn from the market due to significant psychiatric side effects, including depression and suicidal ideation, and is not used for smoking cessation.

Q: Which of the following is a centrally acting non-opioid antitussive?

Dextromethorphan. ***Dextromethorphan*** - **Dextromethorphan** is a **centrally acting non-opioid antitussive** that suppresses the cough reflex by acting on the cough center in the medulla oblongata [1], [2]. - It is an **NMDA receptor antagonist** and a **sigma-1 receptor agonist**, which are the primary mechanisms responsible for its antitussive effects [2]. - Unlike opioid antitussives (codeine, hydrocodone), it does **not bind significantly to opioid receptors** at therapeutic doses and therefore lacks addiction potential, respiratory depression, and other opioid side effects [1], [3]. - It is a synthetic morphine analog (dextro-isomer) but is pharmacologically distinct from opioids [1]. *Ambroxol* - **Ambroxol** is a **mucolytic agent** that helps to thin and clear mucus from the respiratory tract. - It works by stimulating serous gland secretion and breaking down mucopolysaccharide fibers, which is different from suppressing the cough reflex centrally. *Guaifenesin* - **Guaifenesin** is an **expectorant** that increases the volume and reduces the viscosity of respiratory tract secretions. - This action helps to make coughs more productive, rather than directly suppressing the cough reflex. *Diphenhydramine* - **Diphenhydramine** is a first-generation **antihistamine** with significant sedative and anticholinergic properties. - While it has some antitussive effects, these are primarily due to its anticholinergic actions causing drying of respiratory secretions and its sedative properties, rather than direct central action on the cough center.

Question 1

You are in the operating room and notice the tracing in yellow colour on this device. What does it indicate?

Accepted Answer

Capnography

Answer

O2 pressure in exhaled air

Answer

O2 pressure in inhaled air

Answer

Airway pressure

Question 2

All the following tests are related to pasteurization of milk except

Accepted Answer

Iodine test

Answer

Standard plate count

Answer

Phosphatase test

Answer

Methylene blue reduction test

Question 3

A teenage girl presented with irregular cycles and increased facial hair. Her ovaries showed increased volume. Which of the following are used in the first line treatment?

1. Laparoscopic ovarian drilling
2. Anti-androgens
3. Lifestyle modifications
4. Combined oral contraceptive pills

Accepted Answer

2,3,4

Answer

1,2,3

Answer

1,2,4

Answer

1,3,4

Question 4

Which of the following is the most effective drug in smoking cessation?

Accepted Answer

Varenicline

Answer

Nicotine gum

Answer

Buspirone

Answer

Rimonabant

Question 5

Which of the following is a centrally acting non-opioid antitussive?

Accepted Answer

Dextromethorphan

Answer

Ambroxol

Answer

Guaifenesin

Answer

Diphenhydramine

INI-CET 2021

Anesthesiology

Community Medicine

Obstetrics and Gynecology

Pharmacology