INI-CET 2022 Practice Questions

Q: Which of the following statements is true regarding the tape shown in the image?

It is used to assess severe acute malnutrition.. ***It is used to assess severe acute malnutrition.*** - The tape shown is a **Mid-Upper Arm Circumference (MUAC)** tape, which is a simple and effective tool for screening children aged 6-59 months for **severe acute malnutrition (SAM)**. - The color-coded sections (red, yellow, green) on the tape directly indicate nutritional status to facilitate rapid assessment and decision-making for intervention. *Reading of 13.5 to 14.5 cm is considered undernourished.* - A MUAC reading between **11.5 cm and 12.5 cm** often indicates **moderate acute malnutrition (MAM)**, falling in the yellow zone on many MUAC tapes. - A reading of **13.5 to 14.5 cm** would typically fall in the **green zone**, indicating a **healthy nutritional status** for children aged 6-59 months, not undernourished. *It is called Shelter's tape.* - The tape shown is known as a **MUAC tape** (Mid-Upper Arm Circumference tape), not Shelter's tape. - There is no widely recognized medical assessment tool called "Shelter's tape" for nutritional assessment. *It is useful mainly for frontline field workers.* - While it is indeed a valuable tool for **frontline field workers** due to its simplicity and ease of use in community settings, it is also utilized by **healthcare professionals** in clinics and hospitals for rapid screening and assessment of malnutrition. - Its utility extends beyond just field workers, making it an essential tool in various healthcare settings, especially in low-resource environments.

Q: Identify the pattern of abrasion shown in the image below.

Ligature mark. ***Ligature mark*** - The image clearly displays a **linear impression** on the neck, consistent with a **ligature mark**, which is an abrasion caused by a constricting object. - This type of abrasion is often seen in cases of **strangulation or hanging**, where a cord or similar item tightens around the neck. *Pressure abrasion* - Pressure abrasions are typically caused by **blunt forceful contact** with a surface, resulting in a scraped or grazed appearance, which differs from the distinct linear mark shown. - They are usually broad and irregular, not forming a clear, thin line as seen in the image. *Graze abrasion* - Graze abrasions, also known as scrapes, involve the **superficial removal of the epidermis** due to friction against a rough surface. - They tend to be spread out and irregular, lacking the deep, circumscribed linear pattern characteristic of a ligature mark. *Imprint abrasion* - Imprint abrasions reflect the **exact pattern of the impacting object** (e.g., tire track, weapon pattern), which is not evident in the image. - While a ligature itself can leave an imprint, the term "imprint abrasion" is usually reserved for more complex patterns than a simple linear groove.

Q: Hooch tragedy is related to:

Methanol. ***Methanol*** - **Hooch tragedy** refers to incidents of mass poisoning caused by the consumption of adulterated alcoholic beverages, most commonly with **methanol**. - **Methanol poisoning** leads to severe metabolic acidosis, visual disturbances, and organ damage, often resulting in death or permanent disability. *Mercury* - **Mercury poisoning** is typically associated with exposure to elemental mercury, inorganic mercury salts, or organic mercury compounds, leading to neurological and renal symptoms. - It is not directly related to the "hooch tragedy" involving adulterated alcohol. *Ethanol* - **Ethanol** is the type of alcohol consumed in alcoholic beverages and is not typically associated with the "hooch tragedy" unless consumed excessively or in combination with other substances. - While excessive ethanol consumption can lead to **alcohol poisoning**, it does not cause the specific toxic reactions seen in hooch tragedies. *Phosphorus* - **Phosphorus poisoning** can occur from exposure to white phosphorus or ingestion of various phosphorus-containing compounds, affecting multiple organ systems including the liver and cardiovascular system. - It is not a common adulterant in alcoholic beverages and is unrelated to hooch tragedies.

Q: Seminal vesicles and vas deferens would be bilaterally absent congenitally in which of the following conditions?

Cystic fibrosis. ***Cystic fibrosis*** - **Congenital bilateral absence of the vas deferens (CBAVD)** is found in over 95% of males with cystic fibrosis, often leading to infertility. - This condition results from mutations in the **CFTR gene**, which is responsible for chloride transport, causing thick, viscous secretions that block or prevent the development of these structures. *Kartagener syndrome* - This syndrome is a subgroup of **primary ciliary dyskinesia**, characterized by a triad of *situs inversus*, chronic sinusitis, and bronchiectasis. - While it causes **infertility due to immotile sperm**, the male reproductive tract organs like the vas deferens and seminal vesicles are typically present. *Klinefelter syndrome* - Individuals with Klinefelter syndrome have a **47,XXY karyotype** and typically present with small testes, azoospermia, and hypogonadism [1]. - However, the **vas deferens and seminal vesicles are usually present**, though they may be underdeveloped or dysfunctional. *Kallmann syndrome* - This is a form of **hypogonadotropic hypogonadism** associated with anosmia or hyposmia (impaired sense of smell). - It results from a failure of GnRH-producing neurons to migrate to the hypothalamus, affecting hormone production, but the **anatomical structures of the vas deferens and seminal vesicles are usually intact**.

Q: All the following are criteria for SIRS, except

Systolic blood pressure 90/min* - An elevated **heart rate** (tachycardia) is a common physiological response to systemic stress and inflammation. - This criterion fulfills one of the four clinical parameters to diagnose **SIRS**. *Respiratory rate >20 bpm* - An increased **respiratory rate** (tachypnea) reflects the body's attempt to compensate for metabolic acidosis or increased oxygen demand during a systemic inflammatory response. - This criterion is one of the four clinical parameters used to diagnose **SIRS**. *Temperature >38 degree Celsius or 38°C) and **hypothermia** (<36°C) are indicators of a systemic inflammatory response, as the body's thermoregulation is affected [1]. - This criterion is one of the four principal parameters used to diagnose **SIRS** [1].

Q: The following cost-effective investigations are routinely recommended in the screening of antenatal mothers, EXCEPT:

Echocardiography for cardiac disease. ***Echocardiography for cardiac disease*** - **Echocardiography** is not a *routinely recommended* screening investigation for all antenatal mothers due to its cost and the relatively low prevalence of significant congenital heart disease requiring universal screening. - It is typically performed only if there are **specific risk factors** or suspicious findings suggesting cardiac pathology. *Blood sugar levels for GDM* - Screening for **gestational diabetes mellitus (GDM)** with blood sugar levels (e.g., glucose challenge test) is routinely recommended due to the potential maternal and fetal complications if untreated. - GDM is a common condition that can be effectively managed with early diagnosis, making screening a **cost-effective** preventive measure. *VDRL for syphilis* - Screening for **syphilis** using tests like VDRL (Venereal Disease Research Laboratory) is a standard and *routinely recommended* antenatal investigation. - Early detection and treatment of syphilis in pregnant women prevent serious adverse outcomes such as **congenital syphilis**, which can cause severe fetal morbidity and mortality. *Urine analysis for bacteriuria* - **Urine analysis** for **asymptomatic bacteriuria** is routinely recommended during pregnancy because untreated bacteriuria can lead to pyelonephritis, preterm labor, and low birth weight. - It is a simple, **cost-effective** test with significant benefits for maternal and fetal health.

Q: Kassowitz rule is related to:

Congenital syphilis. ***Congenital syphilis*** - The **Kassowitz rule** specifically describes the high rate of perinatal mortality (abortion, stillbirth, or death shortly after birth) in cases of untreated maternal syphilis, especially during early stages of infection. - It highlights that the risk is highest when the mother acquires syphilis shortly before or during pregnancy, leading to severe fetal disease. *Primary syphilis* - This stage is characterized by a **chancre** at the site of infection and is the initial presentation in the infected individual, not directly related to fetal outcomes. - While primary syphilis in the mother can lead to congenital syphilis, the Kassowitz rule itself describes the outcome of congenital infection, not the primary infection in the mother. *Latent syphilis* - **Latent syphilis** refers to a stage where the infection is present but asymptomatic, potentially for years. - While it can be transmitted vertically and lead to congenital syphilis, the Kassowitz rule specifically quantifies the mortality risk of congenital syphilis, not the mother's latent infection itself. *Secondary syphilis* - This stage involves a systemic rash and other widespread symptoms in the infected individual, appearing weeks to months after the chancre. - Though highly infectious and a significant risk for vertical transmission, the rule focuses on the severe consequences *for the fetus* when congenital syphilis occurs, not the symptoms of secondary syphilis in the mother.

Q: Which hormone is secreted by the placenta?

hCG. ***hCG*** - **Human Chorionic Gonadotropin (hCG)** is produced by the **syncytiotrophoblast** of the placenta shortly after implantation. - Its primary role is to maintain the **corpus luteum**, ensuring continued production of **progesterone** to support the pregnancy. *GnRH* - **Gonadotropin-releasing hormone (GnRH)** is secreted by the **hypothalamus** in the brain, not the placenta. - It stimulates the pituitary gland to release FSH and LH. *FSH* - **Follicle-stimulating hormone (FSH)** is produced by the **anterior pituitary gland**. - It plays a crucial role in ovarian follicular development in females and spermatogenesis in males. *LH* - **Luteinizing hormone (LH)** is also secreted by the **anterior pituitary gland**. - Its functions include triggering ovulation in females and stimulating testosterone production in males.

Question 1

Which of the following statements is true regarding the tape shown in the image?

Accepted Answer

It is used to assess severe acute malnutrition.

Answer

Reading of 13.5 to 14.5 cm is considered undernourished.

Answer

It is called Shelter's tape.

Answer

It is useful mainly for frontline field workers.

Question 2

Identify the pattern of abrasion shown in the image below.

Accepted Answer

Ligature mark

Answer

Pressure abrasion

Answer

Graze abrasion

Answer

Imprint abrasion

Question 3

Hooch tragedy is related to:

Accepted Answer

Methanol

Answer

Mercury

Answer

Ethanol

Answer

Phosphorus

Question 4

Seminal vesicles and vas deferens would be bilaterally absent congenitally in which of the following conditions?

Accepted Answer

Cystic fibrosis

Answer

Kartagener syndrome

Answer

Klinefelter syndrome

Answer

Kallmann syndrome

Question 5

All the following are criteria for SIRS, except

Accepted Answer

Systolic blood pressure <90 mmHg

Answer

Heart rate >90/min

Answer

Respiratory rate >20 bpm

Answer

Temperature >38 degree Celsius or <36 degree Celsius

Question 6

Which of the following is false regarding management of diabetes in pregnancy?

Accepted Answer

Elective C-section has no role in reducing incidence of brachial plexus injury

Answer

In active labor, if RBS <70 mg/dL, D5 is started at 100-150 ml/hr till the RBS is >70 mg/dL

Answer

In a patient being planned for induction of labor, night dose of intermediate insulin is given as planned, and the morning dose is withheld

Answer

Capillary blood glucose monitoring levels are kept at fasting- 95 mg/dL; 1 hr postprandial- 140 mg/dL; 2 hrs postprandial- 120 mg/dL

Question 7

The following cost-effective investigations are routinely recommended in the screening of antenatal mothers, EXCEPT:

Accepted Answer

Echocardiography for cardiac disease

Answer

Blood sugar levels for GDM

Answer

VDRL for syphilis

Answer

Urine analysis for bacteriuria

Question 8

Kassowitz rule is related to:

Accepted Answer

Congenital syphilis

Answer

Primary syphilis

Answer

Latent syphilis

Answer

Secondary syphilis

Question 9

Which hormone is secreted by the placenta?

Accepted Answer

hCG

Answer

GnRH

Answer

FSH

Answer

LH

Question 10

An unconscious child is brought to the casualty. What is the correct sequence of the management?

Accepted Answer

Airway, Breathing, Circulation

Answer

Circulation, Airway, Breathing

Answer

Breathing, Circulation, Airway

Answer

Circulation, Breathing, Airway

INI-CET 2022

Community Medicine

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pediatrics