NEET-PG 2015 Practice Questions

Q: In the malate shuttle, how many ATPs are produced from one NADH?

2.5 ATP. ***2.5 ATP*** - In the **malate-aspartate shuttle**, mitochondrial **NADH** is regenerated from cytosolic NADH, and then enters the electron transport chain at **Complex I**. - **Complex I** entry means that NADH contributes to the pumping of enough protons to generate approximately **2.5 ATP** through oxidative phosphorylation. *1 ATP* - **1 ATP** is not the direct equivalent produced from the reoxidation of one NADH via the malate shuttle into the electron transport chain. - This value is typically associated with the direct hydrolysis of **ATP** or the energy equivalent of **GTP** produced in the citric acid cycle. *3 ATP* - Historically, **3 ATP** was the accepted stoichiometry for one NADH, but more accurate measurements of proton pumping and ATP synthase activity have revised this. - The value of 3 ATP per NADH does not reflect the most current understanding of mitochondrial bioenergetics. *2 ATP* - **2 ATP** is the approximate yield for **FADH2** entering the electron transport chain at **Complex II**, bypassing Complex I, and thus pumping fewer protons. - This value is not applicable to NADH transferred via the malate-aspartate shuttle, as NADH enters at Complex I.

Q: Chymotrypsinogen is activated into chymotrypsin by:

Trypsin. ***Activation of Chymotrypsinogen by Trypsin*** - **Trypsin** is the primary enzyme responsible for the activation of **chymotrypsinogen** into its active form, **chymotrypsin**, by cleaving a specific peptide bond. - This activation is part of a cascade of proteolytic enzyme activations in the **pancreatic juice**, crucial for protein digestion in the small intestine. *Pepsin* - **Pepsin** is a protease active in the **stomach**, requiring an acidic environment for its activity, and is involved in the initial breakdown of proteins. - It does not play a role in the activation of pancreatic zymogens like chymotrypsinogen; its primary function is protein digestion in the gastric lumen. *Renin* - **Renin** is an enzyme primarily involved in the **renin-angiotensin-aldosterone system** (RAAS), which regulates blood pressure and fluid balance. - Its action involves cleaving **angiotensinogen** to form angiotensin I, and it has no role in the activation of digestive enzymes like chymotrypsinogen. *HCl* - **Hydrochloric acid (HCl)** is produced in the stomach and is essential for providing the acidic environment required for **pepsin's activity** and for denaturing proteins. - While HCl is crucial for digestion, it does not directly activate chymotrypsinogen; this activation is an enzymatic process carried out by another protease.

Q: Location of gene on chromosome is identified by

Genetic mapping. ***Genetic mapping*** - **Genetic mapping** (also called chromosome mapping) uses various techniques to determine the **physical location (locus)** of genes on a chromosome. - Techniques include **linkage analysis**, **FISH (Fluorescence In Situ Hybridization)**, chromosomal banding, and analysis of **inheritance patterns** of traits and genetic markers. - This identifies both the **relative positions** between genes and their **absolute chromosomal addresses**. *Karyotyping* - **Karyotyping** is a technique that visualizes the entire set of chromosomes in an organism. - While it can identify **large chromosomal abnormalities** like aneuploidy or major deletions/insertions, it does not pinpoint the exact location of a specific gene. *Microarray* - **Microarray** technology is used to study the expression levels of thousands of genes simultaneously or to detect specific genetic variations. - It does not directly map the physical location of a gene on a chromosome. *Genomic imprinting* - **Genomic imprinting** is an epigenetic phenomenon where certain genes are expressed in a **parent-of-origin-specific manner**. - It describes a mechanism of gene regulation rather than a method for identifying the location of a gene on a chromosome.

Q: How do thiazides cause hypercalcemia?

Decreased calcium excretion. ***Decreased calcium excretion*** - Thiazides inhibit the **Na-Cl co-transporter** in the **distal convoluted tubule**, leading to increased reabsorption of calcium [1], [2]. - This increased reabsorption of calcium is mediated by a low intracellular sodium concentration, which enhances the activity of the **Na+/Ca2+ exchanger** on the basolateral membrane [1]. *Increased parathyroid hormone secretion* - Thiazides **do not directly stimulate** parathyroid hormone (PTH) secretion; instead, they *decrease* calcium excretion, which would typically *lower* PTH levels through negative feedback. - Elevated PTH would lead to increased bone resorption and kidney calcium reabsorption, but this is not the **primary mechanism** for thiazide-induced hypercalcemia [2]. *Decreased calcitonin secretion* - **Calcitonin** is a hormone that *lowers* blood calcium levels, and its decrease would theoretically contribute to hypercalcemia. - However, thiazides have **no direct effect** on calcitonin secretion, making this an unlikely primary mechanism. *Increased calcium absorption* - While increased calcium absorption from the gut can contribute to hypercalcemia, thiazides do **not directly increase intestinal calcium absorption**. - Their primary action for influencing calcium levels is within the **kidney**, specifically on reabsorption, not absorption from the GI tract [1], [2].

Q: Which of the following drugs is not used for the treatment of H. Pylori?

Domperidone. ***Correct: Domperidone*** - Domperidone is a **prokinetic drug** used to treat nausea, vomiting, and gastric motility disorders, but it has **no direct antibacterial activity** against *H. pylori*. - It works by blocking **dopamine receptors** in the chemoreceptor trigger zone and peripherally. - Therefore, it is **NOT used for *H. pylori* eradication**. *Incorrect: Bismuth* - **Bismuth subsalicylate** is a key component of **quadruple therapy** for *H. pylori* eradication, particularly in cases of antibiotic resistance or treatment failure. - It has **bactericidal effects** against *H. pylori*, disrupts its cell wall, and inhibits its adherence to the gastric mucosa. *Incorrect: Amoxicillin* - **Amoxicillin** is a penicillin-class antibiotic commonly used in various *H. pylori* eradication regimens, including **triple therapy**. - It acts by **inhibiting bacterial cell wall synthesis**, leading to bacterial lysis. *Incorrect: Clarithromycin* - **Clarithromycin** is a macrolide antibiotic frequently included in standard **triple therapy** for *H. pylori* eradication. - It inhibits **bacterial protein synthesis** by binding to the 50S ribosomal subunit.

Q: What effect does morphine have on muscle tone?

Increased muscle tone. ***Increased muscle tone*** - Morphine **increases skeletal muscle tone** and can cause muscle rigidity, particularly with rapid IV administration (truncal rigidity). - It significantly increases **smooth muscle tone** in various organs including the sphincter of Oddi (causing biliary colic), bladder sphincter (causing urinary retention), and GI tract (causing constipation). - This increased tone in sphincters and smooth muscle is a well-documented effect mediated through **opioid receptor activation**. *Bradycardia (not increased heart rate)* - Morphine typically causes **bradycardia** (decreased heart rate) due to vagal stimulation and central effects, not tachycardia. - Increased heart rate would be atypical and not a primary pharmacological effect of morphine. *Miosis (not mydriasis)* - Morphine characteristically causes **miosis** (pinpoint pupils) due to stimulation of the Edinger-Westphal nucleus of the oculomotor nerve. - Mydriasis (dilated pupils) is seen with anticholinergics or sympathomimetics, not opioids. *Respiratory depression (not stimulation)* - Morphine causes **respiratory depression**, not stimulation, by reducing the responsiveness of brainstem respiratory centers to CO2. - This is one of the most dangerous adverse effects and the primary cause of death in opioid overdose.

Q: What is an atypical side effect of montelukast?

Churg-Strauss syndrome. ***Churg-Strauss syndrome*** - The apparent development of **Churg-Strauss syndrome** (eosinophilic granulomatosis with polyangiitis) has been reported in patients treated with montelukast, although it is believed to be related more to the unmasking of the disease rather than a direct drug effect. - This typically occurs when **corticosteroids** are tapered or withdrawn as montelukast takes over, revealing the underlying vasculitis. *Goodpasture syndrome* - **Goodpasture syndrome** is an autoimmune disease causing rapidly progressive glomerulonephritis and pulmonary hemorrhage, characterized by anti-glomerular basement membrane (GBM) antibodies. - There is no established association between montelukast use and the development of Goodpasture syndrome. *Membranous glomerulonephritis* - **Membranous glomerulonephritis** is a common cause of nephrotic syndrome, characterized by immune complex deposition on the glomerular basement membrane. - This condition is not typically linked to the use of montelukast. *Bronchial asthma* - **Bronchial asthma** is the condition montelukast is used to treat, acting as a leukotriene receptor antagonist to reduce inflammation and bronchoconstriction. - It is a primary indication for the drug, not a side effect.

Q: Fastest receptor mediated action is through?

Intrinsic ion channels. ***Intrinsic ion channels*** - Receptors that are also **ion channels** (ligand-gated ion channels) allow direct and rapid ion flow across the membrane upon ligand binding, leading to immediate changes in membrane potential. - This direct mechanism bypasses complex intracellular signaling cascades, resulting in the **fastest cellular response** compared to other receptor types. *Cell surface receptors* - This is a broad category that includes **G protein-coupled receptors** and **receptor tyrosine kinases**, which typically involve more complex and slower signaling pathways. - While located on the cell surface, not all receptors in this category mediate action as quickly as intrinsic ion channels. *Receptor tyrosine kinases* - These receptors initiate signaling by **phosphorylating tyrosine residues** on target proteins, triggering a cascade of intracellular events that take time to manifest. - Their action involves **multiple phosphorylation steps** and protein interactions, making their response slower compared to direct ion channels. *Intracellular receptors* - These receptors, such as **steroid hormone receptors**, are located in the cytoplasm or nucleus and require their ligands to diffuse across the cell membrane. - The activated receptor then typically translocates to the nucleus to regulate gene transcription, a process that is much **slower** due to gene expression and protein synthesis.

Q: What is the classification of Lorcaserin?

Anti-obesity. ***Anti-obesity*** - Lorcaserin is a selective **serotonin 5-HT₂C receptor agonist** that works by promoting satiety and reducing food intake. - It is prescribed as a long-term treatment for **weight management** in adults who are obese or overweight with at least one weight-related comorbidity. *Anti-anxiety* - Anti-anxiety medications, such as **benzodiazepines** or **SSRIs**, primarily target neurotransmitters like GABA or serotonin 5-HT₁A receptors to reduce anxiety symptoms. - Lorcaserin's primary mechanism of action is distinct, focusing on the 5-HT₂C receptor for appetite regulation, not anxiety. *Anti-smoking* - Anti-smoking medications, like **varenicline** or **bupropion**, are designed to reduce nicotine cravings and withdrawal symptoms. - Their mechanisms often involve nicotinic acetylcholine receptors or dopamine and norepinephrine reuptake inhibition, which differs from lorcaserin's action. *Anti-helminthic* - Anti-helminthic drugs are used to treat **parasitic worm infections** by paralyzing or killing the worms. - Common examples include **albendazole** or **mebendazole**, which have no relation to appetite control or obesity treatment.

Q: Lower esophageal sphincter pressure is increased by all of the following substances, EXCEPT:

Secretin. ***Secretin*** - **Secretin** is a gastrointestinal hormone that *decreases* lower esophageal sphincter (LES) pressure - This hormone is released from S cells in the duodenum in response to acidic chyme - Its primary role is to stimulate the pancreas to release **bicarbonate-rich fluid** to neutralize acidic chyme entering the duodenum - By decreasing LES pressure, it facilitates the passage of gastric contents into the duodenum during digestion *Gastrin* - **Gastrin** is a hormone that *increases* lower esophageal sphincter (LES) pressure - This helps prevent gastroesophageal reflux when the stomach is distended - It also stimulates the secretion of **gastric acid** by parietal cells in the stomach - Released from G cells in the gastric antrum in response to protein ingestion *Motilin* - **Motilin** is a peptide hormone that *increases* lower esophageal sphincter (LES) pressure - It initiates the **migrating motor complex (MMC)** during the interdigestive period - Stimulates gastric and intestinal motility - Released from M cells in the duodenum and jejunum *Substance P* - **Substance P** is a neuropeptide that *increases* lower esophageal sphincter (LES) pressure - Functions as both a neurotransmitter and neuromodulator in the enteric nervous system - Plays a role in **smooth muscle contraction** and gastrointestinal motility - Also involved in pain transmission and inflammatory responses

Question 1

In the malate shuttle, how many ATPs are produced from one NADH?

Accepted Answer

2.5 ATP

Answer

1 ATP

Answer

3 ATP

Answer

2 ATP

Question 2

Chymotrypsinogen is activated into chymotrypsin by:

Accepted Answer

Trypsin

Answer

Pepsin

Answer

Renin

Answer

HCl

Question 3

Location of gene on chromosome is identified by

Accepted Answer

Genetic mapping

Answer

Karyotyping

Answer

Microarray

Answer

Genomic imprinting

Question 4

How do thiazides cause hypercalcemia?

Accepted Answer

Decreased calcium excretion

Answer

Increased parathyroid hormone secretion

Answer

Decreased calcitonin secretion

Answer

Increased calcium absorption

Question 5

Which of the following drugs is not used for the treatment of H. Pylori?

Accepted Answer

Domperidone

Answer

Bismuth

Answer

Clarithromycin

Answer

Amoxicillin

Question 6

What effect does morphine have on muscle tone?

Accepted Answer

Increased muscle tone

Answer

Respiratory stimulation

Answer

Decreased muscle tone

Answer

Mydriasis

Question 7

What is an atypical side effect of montelukast?

Accepted Answer

Churg-Strauss syndrome

Answer

Goodpasture syndrome

Answer

Membranous glomerulonephritis

Answer

Bronchial asthma

Question 8

Fastest receptor mediated action is through?

Accepted Answer

Intrinsic ion channels

Answer

Intracellular receptors

Answer

Cell surface receptors

Answer

Receptor tyrosine kinases

Question 9

What is the classification of Lorcaserin?

Accepted Answer

Anti-obesity

Answer

Anti-anxiety

Answer

Anti-smoking

Answer

Anti-helminthic

Question 10

Lower esophageal sphincter pressure is increased by all of the following substances, EXCEPT:

Accepted Answer

Secretin

Answer

Motilin

Answer

Gastrin

Answer

Substance P

NEET-PG 2015

Biochemistry

Pharmacology

Physiology