NEET-PG 2015 Practice Questions

Q: Intercalated disc is present in:

Cardiac muscle. ***Cardiac muscle*** - **Intercalated discs** are unique structures found only in cardiac muscle, forming specialized cell-cell junctions [1]. - These discs contain **gap junctions** for electrical coupling and **desmosomes** for strong adhesion, allowing the heart muscle to contract in a coordinated fashion. *Smooth muscle* - **Smooth muscle cells** are spindle-shaped and lack striations and organized sarcomeres. - They do not possess intercalated discs; instead, communication and coordination are often mediated by **gap junctions** scattered along the cell membranes [2]. *Skeletal muscle* - **Skeletal muscle cells** are long, multinucleated, and highly organized with prominent striations [3]. - They do not have intercalated discs as individual muscle fibers are innervated separately and generally do not directly communicate via specialized junctions for coordinated contraction. *All of the options* - As **intercalated discs** are characteristic features *only* of **cardiac muscle**, this option is incorrect. - Their presence in all three muscle types would contradict the specific cellular organization of smooth and skeletal muscle.

Q: Which metabolic pathway is least active during 12 days of fasting?

Glycogenolysis. ***Correct: Glycogenolysis*** - **Glycogenolysis**, the breakdown of glycogen stores, is very active during the **initial hours of fasting** (first 24-48 hours) to maintain blood glucose levels. - However, after **12 days of fasting**, liver and muscle **glycogen stores are completely depleted**, making this pathway **essentially inactive** or the least active of all the metabolic pathways. - Once glycogen is exhausted, this pathway cannot contribute further to energy metabolism. *Incorrect: Gluconeogenesis* - This pathway becomes **increasingly active** during prolonged fasting to **synthesize new glucose** from non-carbohydrate precursors (amino acids, lactate, glycerol). - Essential for maintaining blood glucose for **glucose-dependent tissues** like red blood cells and parts of the brain that haven't fully adapted to ketones. - Remains a **crucial and active pathway** throughout prolonged fasting. *Incorrect: Ketogenesis* - **Ketogenesis** is **highly active** during prolonged fasting, producing **ketone bodies** (acetoacetate, β-hydroxybutyrate) from fatty acids in the liver. - Provides the **primary alternative fuel** for the brain (up to 70% of brain energy needs) and other tissues. - This is a **key metabolic adaptation** to preserve protein and glucose during starvation. *Incorrect: Lipolysis* - **Lipolysis** (breakdown of triglycerides into fatty acids and glycerol) is **highly active** during fasting to mobilize stored energy. - Provides **fatty acids** for direct oxidation by most tissues and **glycerol** as a gluconeogenic substrate. - A **fundamental process** for energy supply during nutrient deprivation.

Q: What is the role of colipase in fat digestion?

Assists pancreatic lipase in fat digestion. ***Assists pancreatic lipase in fat digestion*** - Colipase **binds to pancreatic lipase** and the **lipid-water interface** of the fat droplet, providing a conformational change that enables lipase to access and hydrolyze triglycerides. - It also prevents bile salts from inactivating pancreatic lipase, ensuring efficient **fat emulsification and digestion**. *Is secreted in an inactive form* - Colipase is secreted as **procolipase** by the pancreas, which is then activated by **trypsin** in the duodenum. - While correct, this option describes its activation rather than its primary role in fat digestion. *Encoded by the gene CLPS* - The gene **CLPS** indeed encodes for colipase, but this is a genetic detail rather than its functional role in the digestive process. - Knowledge of the encoding gene is not directly relevant to understanding its biochemical function in fat digestion. *Is secreted by pancreatic cells* - Colipase is indeed synthesized and secreted by the **pancreas** into the small intestine. - This statement is true but describes the **origin** of colipase, not its specific functional role in fat digestion.

Q: What is the estimated blood glucose level in mg/dL for a patient with an HbA1c of 8% based on the conversion formula?

200. ***200*** - The estimated average glucose (eAG) can be calculated from HbA1c using the formula: **eAG (mg/dL) = 28.7 × HbA1c (%) – 46.7**. - For an HbA1c of 8%, the calculation is: **28.7 × 8 – 46.7 = 229.6 – 46.7 = 182.9 mg/dL**, which is closest to 200 mg/dL among the given options. *120* - An eAG of 120-125 mg/dL would correspond to an **HbA1c between 5.8% and 6.0%**, which is below the given 8%. - This value typically reflects **well-controlled or pre-diabetic** blood glucose levels. *160* - An eAG of 160 mg/dL would correspond to an **HbA1c of approximately 7.0-7.2%**, which is lower than the given 8%. - This level is often the target for HbA1c in many **diabetic management guidelines**, but not for 8%. *240* - An eAG of 240 mg/dL would correspond to an **HbA1c of approximately 9.9%**, which is significantly higher than the given 8%. - This indicates **poorly controlled diabetes** and a much higher average blood glucose level.

Q: In which condition is Serum Amyloid Associated (SAA) protein most commonly found?

Chronic inflammatory states. ***Chronic inflammatory states*** [1][2] - Serum amyloid-associated protein is elevated in response to **chronic inflammation**, such as in rheumatic diseases and infections [1][2]. - It serves as a **biomarker** indicating systemic inflammation and is part of the **acute-phase response** [1]. *Chronic renal failure* - While renal failure can lead to amyloidosis, it is not a direct cause of serum amyloid-associated protein elevation. - **Renal impairment** is more associated with a decrease in clearance rather than production of amyloid proteins. *Alzheimer's disease* - Although amyloid plaques are a hallmark of Alzheimer's, they are related to **A-beta peptide**, not serum amyloid-associated protein. - Alzheimer's pathology primarily involves **neurodegeneration** rather than inflammatory response. *Malignant hypertension* - Malignant hypertension primarily affects the **vascular system** and does not directly involve the production of serum amyloid-associated protein. - It is characterized by end-organ damage, rather than a state of chronic inflammation. *Chronic inflammatory conditions like RA, TB & leprosy, osteomyelitis, ankylosing spondylitis, IBD, bronchiectasis, some tumors* [1][2] - While these conditions can be associated with systemic inflammation, they are too specific and do not comprehensively encompass the broader concept of **chronic inflammatory states**. - This option fails to highlight that serum amyloid-associated protein is a marker for **various chronic inflammatory states** beyond just those listed [1].

Q: Subepithelial deposits in the kidney are primarily associated with which condition?

Post-Streptococcal Glomerulonephritis (PSGN). ***PSGN*** - Post-streptococcal glomerulonephritis (PSGN) is characterized by **subepithelial immune complex deposits** [1], typically after a streptococcal infection [1]. - It is associated with **hematuria**, **edema**, and elevated **anti-streptolysin O (ASO)** titers. *GPS* - Minimal change disease (often referred to as idiopathic nephrotic syndrome) does not primarily feature **subepithelial deposits** but rather **effacement of podocyte foot processes**. - Clinical presentation includes **nephrotic syndrome** symptoms, not glomerulonephritis like PSGN. *MPGN-1* - Membranoproliferative glomerulonephritis type 1 includes **subendothelial deposits** rather than subepithelial deposits associated with PSGN. - Symptoms often include **nephritic syndrome** and is commonly linked with conditions like **HCV infection**. *All* - While several conditions can show **deposits in kidney**, not all are characterized by **subepithelial deposits**, hence this option is inaccurate. - Each type of glomerular disease has specific types of deposits (immune complex vs. complement) associated with their pathophysiology. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 914-916.

Q: Heart failure cells are seen in -

Pulmonary edema. ***Pulmonary edema*** - Heart failure cells, or **hemosiderin-laden macrophages**, are typically found in the lungs during pulmonary edema due to left-sided heart failure [1]. - This condition leads to **increased pulmonary capillary pressure**, causing leakage of red blood cells into the alveoli, which macrophages then phagocytose [1]. *Pulmonary abscess* - Characterized by a **localized collection of pus** within the lung, typically due to infection, rather than heart failure. - Does not typically involve **hemosiderin-laden macrophages** indicative of chronic pulmonary congestion. *Pulmonary infarction* - Causes **tissue death** due to obstruction of blood flow, leading to necrosis rather than heart failure cells. - Typically presents with **infarcted lung tissue**, showing a different pathological process than seen in heart failure. *PulmonaryTB* - Primarily caused by **Mycobacterium tuberculosis**, leading to cavitary lesions and granulomatous inflammation, not heart failure cells. - The presence of **caseating granulomas** is characterized but does not indicate chronic pulmonary congestion. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 536-538.

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: Which triptan is available in nasal spray form?

Sumatriptan. ***Sumatriptan*** - **Sumatriptan** is available in multiple formulations, including **oral, subcutaneous injection, and nasal spray**, making it versatile for migraine treatment [1], [2]. - The nasal spray formulation allows for **faster absorption** and onset of action, which can be beneficial for patients with nausea or vomiting during migraine attacks [1]. *Rizatriptan* - **Rizatriptan** is primarily available in **oral tablet** and **orally disintegrating tablet** (ODT) forms [2]. - It does not have a commonly available nasal spray formulation for migraine treatment [2]. *Naratriptan* - **Naratriptan** is available as an **oral tablet** and is known for its **longer half-life** and generally milder side effect profile compared to sumatriptan [2]. - It is not available in a nasal spray formulation [2]. *Frovatriptan* - **Frovatriptan** is available exclusively as an **oral tablet** and is notable for having the **longest half-life** among triptans, making it useful for preventing recurring migraines [2]. - There is no nasal spray formulation for frovatriptan [2].

Q: Which of the following statements represents the most clinically significant aspect of drug metabolism?

Most common enzyme involved is CYP 3A4/5. ***Most common enzyme involved is Cyp 3A4/5*** - CYP3A4/5 is the **most abundant and clinically significant** cytochrome P450 enzyme, responsible for metabolizing approximately **50% of all clinically used drugs**. - Its widespread involvement means variations in its activity (due to **genetics, drug interactions, or disease**) have a major impact on drug efficacy and toxicity. *Glucuronidation is a phase II reaction* - While correct that glucuronidation is a **Phase II metabolic reaction**, this statement describes a biochemical classification rather than a clinically significant aspect compared to the involvement of CYP3A4/5. - Phase II reactions generally involve **conjugation** to increase water solubility and facilitate excretion, but they do not collectively account for as many drug interactions as CYP3A4/5 alone. *Reduction is a phase I reaction* - This statement is factually correct as **reduction** is indeed a **Phase I metabolic reaction**. - However, it represents a generic classification of a metabolic pathway and doesn't highlight the specific clinical importance or prevalence of a particular enzyme or reaction in drug metabolism. *Cytochrome P450 is involved in phase I reactions* - This is true; the **cytochrome P450 system** is the primary enzyme system for **Phase I metabolism**, which introduces or exposes polar groups to make drugs more reactive. - While fundamentally important, this statement is too broad; it does not specify the most clinically significant *aspect* or *enzyme* within the P450 system compared to directly identifying CYP3A4/5.

Question 1

Intercalated disc is present in:

Accepted Answer

Cardiac muscle

Answer

Smooth muscle

Answer

Skeletal muscle

Answer

All of the options

Question 2

Which metabolic pathway is least active during 12 days of fasting?

Accepted Answer

Glycogenolysis

Answer

Gluconeogenesis

Answer

Ketogenesis

Answer

Lipolysis

Question 3

What is the role of colipase in fat digestion?

Accepted Answer

Assists pancreatic lipase in fat digestion

Answer

Encoded by the gene CLPS

Answer

Is secreted in an inactive form

Answer

Is secreted by pancreatic cells

Question 4

What is the estimated blood glucose level in mg/dL for a patient with an HbA1c of 8% based on the conversion formula?

Accepted Answer

200

Answer

120

Answer

160

Answer

240

Question 5

In which condition is Serum Amyloid Associated (SAA) protein most commonly found?

Accepted Answer

Chronic inflammatory states

Answer

Alzheimer's disease

Answer

Malignant hypertension

Answer

Chronic renal failure

Answer

Acute myocardial infarction

Question 6

Subepithelial deposits in the kidney are primarily associated with which condition?

Accepted Answer

Post-Streptococcal Glomerulonephritis (PSGN)

Answer

None of these conditions are associated with subepithelial deposits.

Answer

Membranoproliferative Glomerulonephritis (MPGN) Type I

Answer

Goodpasture's Syndrome (GPS)

Question 7

Heart failure cells are seen in -

Accepted Answer

Pulmonary edema

Answer

Pulmonary infarction

Answer

Pulmonary abscess

Answer

Pulmonary tuberculosis

Question 8

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

Accepted Answer

Domperidone

Answer

Bismuth

Answer

Clarithromycin

Answer

Amoxicillin

Question 9

Which triptan is available in nasal spray form?

Accepted Answer

Sumatriptan

Answer

Rizatriptan

Answer

Naratriptan

Answer

Frovatriptan

Question 10

Which of the following statements represents the most clinically significant aspect of drug metabolism?

Accepted Answer

Most common enzyme involved is CYP 3A4/5

Answer

Glucuronidation is a phase II reaction

Answer

Reduction is a phase I reaction

Answer

Cytochrome P450 is involved in phase I reactions

NEET-PG 2015

Anatomy

Biochemistry

Internal Medicine

Pathology

Pharmacology