NEET-PG 2015 Practice Questions

Q: Enzyme deficient in Hers disease -

Liver phosphorylase. ***Liver phosphorylase*** - Hers disease, also known as Glycogen Storage Disease Type VI, is specifically caused by a deficiency of **liver phosphorylase**. - This enzyme is crucial for the breakdown of **glycogen in the liver**, leading to an inability to release glucose into the bloodstream during fasting. *Muscle phosphorylase* - Deficiency of **muscle phosphorylase** (myophosphorylase) causes **McArdle disease** (Glycogen Storage Disease Type V), which primarily affects muscle energy. - Patients typically present with exercise intolerance, muscle pain, and cramps, not the hepatic symptoms seen in Hers disease. *Acid maltase* - Deficiency of **acid maltase** (also known as alpha-glucosidase) is responsible for **Pompe disease** (Glycogen Storage Disease Type II), a lysosomal storage disorder. - This enzyme deficiency leads to glycogen accumulation in lysosomes in various tissues, including muscle, liver, and heart, causing muscle weakness and cardiomyopathy. *Debranching enzyme* - A deficiency in the **debranching enzyme** (amylo-1,6-glucosidase) causes **Cori disease** or **Forbes disease** (Glycogen Storage Disease Type III). - This results in the accumulation of abnormally structured glycogen with short outer branches in the liver, muscle, and heart.

Q: Creatinine is formed from -

Creatine. ***Creatine*** - **Creatinine** is a waste product formed from the non-enzymatic, irreversible degradation of **creatine** and **creatine phosphate**, primarily in muscles. - **Creatine** itself is synthesized endogenously from three amino acids: **glycine, arginine, and methionine** (as S-adenosylmethionine) through a two-step enzymatic process in the kidney and liver. - The amount of creatinine produced daily is relatively constant and directly proportional to an individual's **muscle mass**, making it a useful marker for renal function. *Lysine* - **Lysine** is an **essential amino acid** and a precursor for various compounds like **carnitine** but is not involved in creatinine or creatine formation. - Deficiency can lead to impaired protein synthesis but does not impact creatinine levels. *Leucine* - **Leucine** is another **essential amino acid** and a **branched-chain amino acid (BCAA)** crucial for muscle protein synthesis and repair. - It does not serve as a direct precursor for creatinine or creatine. *Histidine* - **Histidine** is an **essential amino acid** and a precursor for **histamine** and other important compounds, but not creatinine or creatine. - It plays roles in immune response and gastric acid secretion.

Q: What is the most common location for an extra permanent tooth to erupt?

Upper incisor. ***Upper incisor*** - The most common supernumerary tooth is the **mesiodens**, which typically erupts in the **maxillary midline** between the central incisors. - This region is frequently affected by developmental anomalies that lead to the formation of an **extra permanent tooth**. *Canine* - While supernumerary canines can occur, they are **significantly less common** than supernumerary incisors or molars. - Their presence often causes **impaction or displacement** of adjacent permanent teeth. *Molar* - Supernumerary molars, particularly **paramolars** (buccal or lingual to molars) and **distomolars** (distal to third molars), are the second most common type of supernumerary teeth. - However, they are still **less frequent** than mesiodens in the incisor region. *Lower incisor* - Supernumerary lower incisors are **rare** compared to those in the upper arch. - When present, they can cause **crowding or malocclusion** in the mandibular anterior region.

Q: Which type of thyroid cancer is associated with primary hyperparathyroidism and phaeochromocytoma?

Medullary carcinoma of the thyroid. ***Medullary carcinoma of the thyroid*** - Associated with **multiple endocrine neoplasia (MEN) syndrome type 2**, which includes primary hyperparathyroidism and phaeochromocytoma [1]. - Medullary carcinoma arises from **C cells** (parafollicular cells) and is linked with **elevated calcitonin** levels. *Papillary carcinoma of the thyroid* - The most common type of thyroid cancer, but **not associated** with MEN syndromes. - Typically presents as a solitary **nodule** and is linked with **radiation exposure** rather than endocrine syndromes. *Anaplastic carcinoma of the thyroid* - A highly aggressive and undifferentiated form of thyroid cancer, often associated with **poor prognosis**. - Usually arises in older adults and does not have associations with **hyperparathyroidism** or phaeochromocytoma. *Follicular carcinoma of the thyroid* - Characterized by **thyroid follicle formation** and can be associated with **iodine deficiency**, but not with MEN syndromes. - It usually presents as a **solitary thyroid nodule** and lacks connection with **primary hyperparathyroidism**.

Q: What is a distinguishing feature of reticulocytes?

Presence of residual RNA and ribosomes. ***Presence of residual RNA and ribosomes*** - This is the **defining and most distinguishing feature** of reticulocytes that differentiates them from mature red blood cells. - Reticulocytes contain residual **ribosomal RNA** and other organelles that are lost when they mature into erythrocytes. - This residual RNA forms a **reticular (network-like) pattern** when stained with supravital stains like **new methylene blue** or **brilliant cresyl blue**, which is the basis for their name and identification. - The presence of RNA allows for **reticulocyte counting**, an important marker of bone marrow erythropoietic activity. *Slightly larger in size than RBCs* - While reticulocytes may be slightly larger (polychromatophilic appearance), size variation is **not specific** and overlaps significantly with mature RBCs. - Size is not a reliable distinguishing feature and is not used for identification or counting. *Mature in bone marrow* - Reticulocytes are **released from the bone marrow** as immature red cells and complete their maturation in the **peripheral circulation** over 24-48 hours. - They do not fully mature in the bone marrow; their presence in peripheral blood is normal. *Constitute approximately 1% of the red cells* - Normal reticulocyte count is **0.5-2%** (or approximately 1%) of total red blood cells in healthy adults. - This is a **population characteristic** indicating normal erythropoietic activity, not a distinguishing cellular feature.

Q: Quinine primarily acts on which stage of the Plasmodium life cycle?

Erythrocytic. ***Correct: Erythrocytic*** - Quinine primarily acts as a **blood schizonticide**, targeting the asexual erythrocytic stages of the *Plasmodium* parasite. - Its mechanism involves interfering with the parasite's ability to detoxify **heme**, leading to accumulation of toxic byproducts and parasite death within **red blood cells**. - This is why quinine is effective in treating **acute malaria attacks** during the symptomatic phase of the disease. *Incorrect: Exoerythrocytic* - The **exoerythrocytic stage** occurs in the liver, where sporozoites develop into merozoites. - Quinine has **minimal or no activity** against these liver stages, meaning it does not prevent initial infection or relapse from hepatic dormant forms (hypnozoites). - Drugs like **primaquine** target this stage. *Incorrect: Pre-erythrocytic* - The **pre-erythrocytic stage** is another term for the exoerythrocytic or liver stage of the parasite life cycle, occurring before the parasite enters red blood cells. - Medications that target this stage are known as **causal prophylactics**, which quinine is not. - Quinine has **no significant activity** at this stage. *Incorrect: None of the options* - This option is incorrect as quinine specifically targets the **erythrocytic stage**, making that option the correct answer. - Quinine's effectiveness in treating malaria stems from its action during the **symptomatic phase** of the disease, which corresponds to the erythrocytic cycle in red blood cells.

Q: What is the primary process involved in Wallerian degeneration?

Nerve degeneration. ***Nerve degeneration*** - **Wallerian degeneration** specifically refers to the process of **axon degeneration** that occurs distal to the site of injury when a nerve fiber is severed [2]. - This process involves the breakdown of the **axon** and its myelin sheath, leading to loss of function [1]. *Muscle degeneration* - While prolonged nerve degeneration can lead to muscle **atrophy** due to denervation, **muscle degeneration itself** is not the primary process of Wallerian degeneration. - Wallerian degeneration focuses on the **nerve itself**, not the target tissue. *Nerve regeneration* - **Nerve regeneration** is the process where damaged nerves attempt to regrow and re-establish connections [2]. - This is a subsequent, and not always successful, event that can occur *after* Wallerian degeneration has cleared the debris [1]. *Muscle regeneration* - **Muscle regeneration** refers to the repair and regrowth of damaged muscle tissue, typically involving satellite cells. - It is unrelated to Wallerian degeneration, which is a process affecting the **nerve**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 109-110.

Q: EPSP is due to?

Sodium ion influx. ***Sodium ion influx*** - An **Excitatory Postsynaptic Potential (EPSP)** is caused primarily by the binding of an **excitatory neurotransmitter** to its receptor, leading to the opening of **ligand-gated ion channels** permeable to sodium (Na+) ions. - The **influx of positively charged sodium ions** into the postsynaptic neuron causes a **depolarization** of the membrane potential, making it more likely to reach the threshold for an action potential. *Potassium ion influx* - **Potassium (K+) influx** is not the primary mechanism for generating an EPSP; instead, **potassium efflux** (movement out of the cell) is typically involved in **repolarization** after an action potential or in generating **Inhibitory Postsynaptic Potentials (IPSPs)**. - The movement of K+ into the cell would make the membrane potential more negative, leading to **hyperpolarization** or preventing depolarization. *Sodium ion efflux* - **Sodium (Na+) efflux** is mediated by the **Na+/K+ pump** and is crucial for maintaining the resting membrane potential, but it does **not directly cause an EPSP**. - Pumping Na+ out of the cell would **hyperpolarize** the cell or oppose depolarization, making an action potential less likely. *Calcium ion influx* - While **calcium (Ca2+) influx** is vital for many neuronal processes, including **neurotransmitter release** from the presynaptic terminal, it is **not the primary ionic basis** for generating an EPSP in the postsynaptic neuron itself. - Significant Ca2+ influx can occur during an **action potential** or lead to intracellular signaling, but it's not the main depolarizing current responsible for an EPSP.

Q: Which of the following drugs is not used in the treatment of akathisia?

Haloperidol. ***Haloperidol*** - **Haloperidol** is a typical antipsychotic drug known to **cause** or worsen **akathisia**, rather than treat it. - Akathisia is an extrapyramidal symptom, and **first-generation antipsychotics** like haloperidol are frequent culprits due to their strong **D2 receptor blockade**. *Benzodiazepine* - **Benzodiazepines** like lorazepam or clonazepam are often used to treat akathisia due to their **sedative** and **anxiolytic** properties. - They act by enhancing **GABAergic transmission**, which can help calm the motor restlessness associated with akathisia. *Propranolol* - **Propranolol**, a **beta-blocker**, is a first-line treatment for akathisia, particularly effective for its objective motor symptoms. - It works by reducing **adrenergic activity**, which is thought to contribute to the motor restlessness. *Trihexyphenidyl* - **Trihexyphenidyl** is an **anticholinergic** agent primarily used to treat **parkinsonian-like extrapyramidal symptoms** (e.g., dystonia, pseudoparkinsonism). - While sometimes used for generalized EPS, it is **less effective** for the specific motor restlessness of akathisia compared to beta-blockers or benzodiazepines.

Question 1

Enzyme deficient in Hers disease -

Accepted Answer

Liver phosphorylase

Answer

Muscle phosphorylase

Answer

Acid maltase

Answer

Debranching enzyme

Question 2

Creatinine is formed from -

Accepted Answer

Creatine

Answer

Lysine

Answer

Leucine

Answer

Histidine

Question 3

What is the most common location for an extra permanent tooth to erupt?

Accepted Answer

Upper incisor

Answer

Canine

Answer

Molar

Answer

Lower incisor

Question 4

Which type of thyroid cancer is associated with primary hyperparathyroidism and phaeochromocytoma?

Accepted Answer

Medullary carcinoma of the thyroid

Answer

Papillary carcinoma of the thyroid

Answer

Anaplastic carcinoma of the thyroid

Answer

Follicular carcinoma of the thyroid

Question 5

What is a distinguishing feature of reticulocytes?

Accepted Answer

Presence of residual RNA and ribosomes

Answer

Slightly larger in size than RBCs

Answer

Mature in bone marrow

Answer

Constitute approximately 1% of the red cells

Question 6

Which substance plays a significant role in the tumor metastasis cascade?

Accepted Answer

MMP-2 (Matrix Metalloproteinase-2)

Answer

TNF-alpha

Answer

CD99

Answer

NM23

Question 7

Quinine primarily acts on which stage of the Plasmodium life cycle?

Accepted Answer

Erythrocytic

Answer

Exoerythrocytic

Answer

Pre-erythrocytic

Answer

None of the options

Question 8

What is the primary process involved in Wallerian degeneration?

Accepted Answer

Nerve degeneration

Answer

Muscle degeneration

Answer

Nerve regeneration

Answer

Muscle regeneration

Question 9

EPSP is due to?

Accepted Answer

Sodium ion influx

Answer

Potassium ion influx

Answer

Sodium ion efflux

Answer

Calcium ion influx

Question 10

Which of the following drugs is not used in the treatment of akathisia?

Accepted Answer

Haloperidol

Answer

Benzodiazepine

Answer

Propranolol

Answer

Trihexyphenidyl

NEET-PG 2015

Biochemistry

Dental

Internal Medicine

Pathology

Pharmacology

Physiology

Psychiatry