INI CET 2022 Question Paper (Nov) Medicine

INICET
Question
Paper

INI CET 2022 (Nov)
Question Paper
Medicine
(Based on Memory Recall)

Q1. High anion gap is found in

A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Respiratory acidosis

Correct answer : B

Q2. A patient misses everything on the left side, including drawing the petals of a flower
only on the right side, clock numbers on the right side, shaving only the right half of the
face, eating from only the right side. The site of lesion

A) Right posterior parietal cortex
B) Left parietal cortex
C) Right temporal cortex
D) Right frontal cortex

Q3. ECG is given in the figure. The drug not to be used

A) Metoprolol

B) Diltiazem
C) Aminodarone

D) Adenosine

Correct answer : D

Q4. ECG is given the figure, what is the cause?

A) First degree AV block
B) Second degree AV block
C) Third degree AV block
D) Sinus bradycardia

Correct answer : B

Q5. Incorrect statement regarding Hemophilia?

A) X - linked disease
B) Boys mostly affected
C) Causes mucosal bleeding
D) Due to deficiency of factor 8

Correct answer : C

Q6. Correct among following ECG leads?
A. Lead one positive terminal to right arm and negative to left arm
B. Lead two positive terminal to right arm and negative to left leg
C. Lead three positive terminal to left arm and negative to left leg
D. Ground connected to right leg

A) All the above
B) A and B
C) A,B and D
D) Only D

Correct answer : D

Q7. A patient has vomiting and no proper dietary intake for 4 weeks. He was treated

aggressively with IV NS following which the patient developed quadriplegia and became
rigid and mute. Correct statement

A) The effect is due to rapid correction of Na
B) The effect is due to slow correction of Na
C) Both are correct
D) None of the above

Q8. Which of the following differentiate superinfection from coinfection of hepatitis D
with hepatitis B

A) IgM anti Hbc
B) IgM anti HDV
C) High viral load of hepatitis B
D) High viral load of hepatitis D
E) IgG anti HDV
F) IgG anti Hbc

Correct answer : F

Q9. A patient presented with seizures in emergency with elevated liver enzymes, which
drug can be used

A) Midazolam
B) Oxazepam
C) Both are correct
D) None of the above

Correct answer : B

Q10. Scorpion bite with bilateral lower lobe flute accumulation, how will you treat it?

A) Prazosin
B) Furosemide
C) Metoprolol
D) Ivabradine

Q11. A 60 year old man post - MI and type 2 diabetes had lab values as LDL I30, HDL 40
and TG 270 mg/dl. Which of the following must be his treatment plan?

A) Atorvastatin 80 mg
B) Atorvastatin 20 mg

C) Rosuvastation 10 mg
D) Fenofibrate

Q12. Which of the following is a C/I to thermobolysis in Operation present with stroke?

A) Age > 18 yrs
B) Presenting within 3 hours
C) BP > 185/110
D) MCA edema < I/3 of territory

Correct answer : C

Q13. Site of lesion in hemiballismus

A) Subthalamus
B) Globus pallidus
C) Caudate
D) Putamen

Q14. A hypertensive patient with deranged renal function and hyperkalemia on some anti
hypertensive drug, which of the following drug should be stopped

A) Furosemide
B) Amlodipine
C) Losartan
D) Propranolol

Correct answer : C

Q15. Which of the following is most specific antibody for SLE

A) ANA
B) Anti DS DNA
C) Anti smith
D) Anti centromere

Correct answer : C

Q16. Which of the following is not seen in aspergillosis

A) Cavity
B) Pleural effusion
C) Ground glass opacity
D) Wedge shaped consolidation

Correct answer : B

Q17. Diabetic patient with the range kidney function hb Lac around 8.5 refusing insulin
injection, which oral drug can be given

A) Glimepiride
B) Sitagliptin
C) Vildagliptin
D) Linagliptin

Correct answer : D

Q18. And 11 year old boy with intentional tremors and sister having similar complaint
with the image as shown, likely cause

A) Wilson’s disease
B) Huntington’s chorea
C) Hepatitis A
D) Glutaric aciduria

Correct answer : B

Q19. Which is not assign of heart failure

A) Non pulsatile rise in JVP
B) Orthopnea
C) Shortness of breath after 2 - 3 hrs of sleep
D) Right hypochondrial pain

Q20. Cerebral perfusion pressure is

A) MAP - ICP
B) MAP + ICP
C) ICP - MAP
D) None of the above

Q21. Bedridden patient aspirates. Lungs segment involve

A) Right upper lobe apical
B) Right upper lobe posterior
C) Right lower lobe apical
D) Right lower lobe posterior

Correct answer : B

Q22. A patient had this oral examination finding, what is the causes

A) Refsum disease
B) Tangier’s disease
C) Both are correct
D) None of the above

Correct answer : B

Q23. Tetany can be caused by all except

A) Pancreatitis
B) Vit D toxicity
C) Low Mg
D) None of the above

Correct answer : B

Q24. Identify this BM needle

A) Salah
B) Klima
C) Jamshidi
D) None of these

Correct answer : B

Q25. A patient with low Hb, low MCH, low MCV and high ferritin. Diagnosis

A) Iron deficiency anemia
B) Sideroblastic anemia
C) Chronic inflammation
D) Thalassemia

Correct answer : C

Q26. Neurogenic shock results in

A) Hypotension and tachycardia
B) Hypotension and bradycardia
C) Hypertension and tachycardia
D) Hypertension and bradycardia

Correct answer : B

Q27. Patient with proximal muscle weakness facial Rash and knuckle rash in the image,
what is the lesion due to

A) SLE

B) Dermatomyositis
C) Polymyositis
D) None of the above

Correct answer : B

Q28. Resection of which of the following results in macrocytosis

A) Stomach
B) Duodenum
C) Jejunum
D) ILeum
E) All of the following

Correct answer : E

Q29. A patient completed a triple drug Regimen for H pylori. Which investigation will be
best to assess treatment response

A) Biopsy urease test
B) Upper GI endoscopy
C) Breath urea test
D) Serology

Correct answer : C

Q30. What is the corrected reticulocyte count if Hb is 5 and reticulocyte is 9%

A) 3
B) 4
C) 5
D) 6

Q31. A female patient was clinically diagnosed to have Hypothyroidism. Investigations
were sent for Combined protein levels, Total T3, T4, rT3, and Free T3, T4, rT3, and
TSH.Which one of the following options represents her condition.

A) Combined proteins Total T3, T4, rT3. Free T3, T4, rT3. TSH
B) Normal High High Low
C) Normal Low Low High

D) High High Normal Normal
E) Low Low Normal Normal"

F) lodides-wolf chaikoff myxedema coma

Correct answer : F

Q32. A young patient presents to the clinic with erythematous lesions over the
exposed areas of the skin like hands, arms, chest, etc. She also complains of
arthralgia and breathlessness. Which among the following antibodies will be
useful in diagnosing this condition?

A) Anti dsDNA antibodies
B) Antihistone antibodies
C) Anticentromere antibodies
D) Anti-nuclear antibodies

Q33. True about Hereditary spherocytosis ?

A) At least 25 % cases have a family history of HS
B) High MCH is pathognomonic of HS
C) Gallstones develop by 4-5 years of age
D) Splenectomy does not protect against developing gallstones
E) None of the above

Correct answer : E

Q34. WBC count of 4,50000/UL with eosinophilia and basophilia diagnosis?

A) CML
B) CLL
C) AML
D) ALL

Q35. Elderly patient with elevated homocysteine and normal methyl malonyl
acid levels. Identify diagnosis. Megaloblastic anemia present. hb-7??
high MCV- 907? vegetarian 7???

A) Folate deficiency
B) B12 def
C) biotin

D) B27

Q36. EBV interact with B cells via

A) CD20
B) CD21
C) CD19
D) Cd23

Correct answer : B

Q37. The following are parvovirus-related disease-population pairs. Identify
the incorrect pair

A) Pure red cell aplasia - chronic hemolytic anaemia
B) Polymyalgia rheumatica - young women
C) Hydrops fetalis - pregnant women
D) Erythema infectiosum - infants

Correct answer : B

Q39. Hypertensive patient with K+ 6.5 meq/I, Na+ 137 meq/I, Urea 42, Creatinine
3.8 Which of the following drugs should be stopped

A) Furosemide
B) Losartan
C) Metoprolol
D) Amlodipine

Correct answer : B

Q40. Value of oncotic pressure of tissue - oncotic pressure?

A) 12 mm hg
B) 32 mm hg
C) 20 mm hg
D) 54 mm hg

Correct answer : C

Q41. Match the following drugs in column A with their targets:

A) A-2, B-3, C-1, D-4
B) A-4, B-3, C-1, D-2
C) A-3, B-4, C-2, D-1
D) A-4, B-3, C-2, D-1

Correct answer : B

Q42. SARS Covid can be detected by all except:

A) Rapid antigen test to detect spike proteins
B) Real time PCR to detect mRNA
C) Southern blotting
D) ELISA to detect spike protein

Correct answer : C

Q43. What does the zero pressure indicate in the pressure volume curve?

A) Residual volume
B) Functional residual capacity
C) Tidal volume
D) Inspiratory reserve volume

Correct answer : B

Q44. A man presented with fever, night sweat and weight loss for 2 months. On
examination, non tender, rubbery lymph nodes were palpable in the Supraclavicular and

inguinal regions on both sides. Peripheral smear showed the presence of bi - nucleated
cells. Which marker should be seen in this condition?
1. CD15
2. CD30
3. CD19
4. CD38

A) 1,2,4
B) 2,3,4
C) 2 and 3
D) 1 and 2

Correct answer : D

Q45. A 10 year old boy with elevated TL, Hb - 9g/dL, MCV - 60 fl and MCH - 20 pg, ferritin -
185 Microgram/L, elevated lymphocyte and neutrophils, what is the type of anemia?

A) Anemia of chronic disorder
B) Thalassemia
C) Iron deficiency anemia
D) Sickle cell anemia

Q46. 35 year old woman with fatigue. HB- 5 gm %, MCV- 24, Ferritin 10. Diagnosis?
low MCV, leukocytes: 11k, Platelets: Slakhs. What is the diagnosis?

A) Image- microcytic hypochromic
B) (Normal values of MCV and ferritin were given for reference)
C) Iron deficiency anemia
D) Thal. major
E) Megaloblastic anemia
F) Essential thrombocytosis

Correct answer : C

Q47. Hemochromatosis to assess iron overload? Hb - 5g% absolute reticulocyte count -
9%. Calculate corrected reticulocyte count.

A) 5
B) 4
C) 4.5

D) 3

Correct answer : D

Q48. A 65 year old female was admitted to the ICU with ARDS secondary to
urosepsis. She weighs about 60 Kg and was placed on mechanical ventilation.
The tidal volume is 360 ml, f - 30, PEEP - 5cmH20, and Fi02 90%. Arterial
blood gas sampling showed paO2 - 50, paCO2 38, and pH - 7.38. What should
be done for this patient?

A) Increase PEEP
B) Reduce Fi02
C) Increase tidal volume
D) Increase respiratory rate

Q49. Absence of loud S1 in mitral stenosis would indicate all of the following except:

A) Calcified valve
B) Aortic regurgitation
C) Mild mitral stenosis
D) 1st degree heart block

Correct answer : C

Q50. Increased anion gap is seen in

A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis

Q51. An elderly female patient with history of severe vomiting was treated
aggressively for severe dehydration at an outside hospital. One week later, she
became mute, quadriparetic, and rigid. Most likely cause/reason

A) Rapid sodium correction
B) Severe catatonia
C) Malignant hyperthermia
D) Neuroleptic malignant syndrome

Q52. Patient with heart disease has breathlessness on going to the bathroom,
What grade does he belong to?

A) NYHA3
B) NYHA4
C) MMRC 4
D) MMRC

Q53. A patient is having perioral numbness, tingling and tetany. All of the following
conditions can lead to this, except

A) Acute pancreatitis
B) Chronic kidney disease
C) Hypoparathyroidism
D) Vitamin D toxicity
E) 2nd session was on causes for hypercalcemia except

Correct answer : E

Q54. Signs of heart failure:
A. Non pulsatile rise of JVP
B. Orthopnea
C. Dyspnoea after 2 hours of bed rest/ Shortness of breath after 2-3 hours of sleep
D. Right upper quadrant pain/ Right hypochondrial pain

A) A and B
B) A,B,C
C) B,C,D
D) A,C,D

Correct answer : C

Q55. The following clinical examination was performed. What lesion would cause an
exaggerated reflex?

A) UMN
B) LMN
C) Polyneuropathy
D) Radiculopathy

Q56. A patient was brought following an RTA. He was found to have an
incomplete lesion of the spinal cord. What would be seen if the central
part of the cord was involved?
A. LMN lesion of upper limbs and trunk and UMN of lower limbs
B. UMN lesion of upper limbs and trunk and LMN of lower limbs
C. Bladder and bowel involvement
D. Posterior tract involvement.

A) a and d
B) a and c
C) b and c
D) b and d

Correct answer : B

Q57. Patient who is a known case of HIV with CD4 count of 200 came with 5 days
of cough and high grade fever without chills and rigors. No h/o diarrhoea,
vomiting, nuchal rigidity. Chest X ray is normal. What will you do?

A) Amoxicillin-clavulanic acid + Azithromycin
B) Co-trimoxazole + steroids
C) Antitubercular treatment
D) Co-trimoxazole only

Correct answer : B

Q58. Serological finding of a patient with hepatitis is given below. Which of the
the following is most useful in diagnosing HDV co-infection over superinfection?
A. HBsAg positive
B. Anti HbC IgM positive
C. Anti HDV IgM positive C e
D. Titer of HBV DNA- 7.4 X 10 raised to 8
E. Titer of HDV DNA- 4.1 X 10 raised to 4

A) Absence of anti HbC IgG antibodies
B) High HDV viral load
C) High HBV viral load
D) Presence of IgM anti HDV antibodies

Q59. Patient presented with violent, flinging movements. Where is the lesion causing

Hemiballismus seen?

A) Putamen
B) Caudate nucleus
C) Globus pallidus
D) Subthalamic nucleus

Correct answer : D

Q60. Thrombolysis can be considered in all of these conditions except:

A) Blood pressure of more than 180/110
B) MRI showing density in less than 1/3rd of the area supplied by MCA
C) Ischemic stroke within 2 hours
D) Onset of symptoms <4 hours

Q61. A patient is having perioral numbness, tingling and tetany. All of the following
conditions can lead to this, except

A) Acute pancreatitis
B) Chronic kidney disease
C) Hypoparathyroidism
D) Vitamin D toxicity

Correct answer : D

Q62. Pediatric patient with B cell leukemia, poor prognostic factors include all except:

A) Hyperdiploidy
B) Less than one year
C) t(9,22)
D) t(4,11)

Q63. An elderly male patient was brought by his son because he was not using his left
arm for day to day functioning. He has an unkempt appearance on the left side
of his body and has history of bumping into door frames while walking through
them. Evaluation done is shown below. Where does a lesion in the brain cause
this presentation?

A) Right parietotemporal

B) Right Parietal
C) Left parietal

D) Right premotor cortex

Correct answer : B

Q64. Components of MEN2B

A) Medullary carcinoma thyroid
B) Cafe au lait spot
C) Optic nerve glioma?? Ocular hemangioma??
D) Parathyroid adenoma

Q65. Patient has a fever, cough and cold. CXR are given below, what will be the
examination findings in the Infrascapular region?

A) Dull note on percussion
B) Hyperresonance on percussion
C) Fixed…..stridor??
D) Coarse crackles

Q66. Patient presented with |/L horner's syndrome, loss of pain and temperature in face
and in contralateral body, loss of sweating...............0.00000 All these symptoms are
caused due to?
A. Medial medulla
B. Lateral medulla
C. Ventromedial medulla

D. Lateral medulla including nucleus ambiguus, spinothalamic trac

A) A,B
B) A,B,C
C) A,B,C,D
D) B,D

Correct answer : D

Q67. Female presented with loss of pain and temperature but intact touch sensation.
Imaging showed cavitation around the central canal. What is the diagnosis?

A) Syringomyelia
B) Brown Sequard syndrome
C) Tabes dorsalis
D) None of the above

Q68. Match the following:

Correct answer : E

Q69. Electrolyte abnormality in methanol intoxication?

A) Metabolic acidosis with high anion gap
B) Metabolic alkalosis with high anion gap
C) Metabolic alkalosis with normal anion gap
D) Metabolic acidosis with normal anion gap

Q70. Patient with DM+ HTN+ Renal failure (elevated urea and creatinine). Which of
are the following OHAs safe to use?

A) Vildagliptin
B) Linagliptin
C) Glimepriride

D) GLP analogue

Correct answer : B

Q71. Hypertensive patient develops a HBA1c of 8.1. Patient is on losartan. Which of
the following drugs would you replace this drug with?(one of the options was metformin)

A) Amlodipine
B) Olmesartan
C) Telmisartan
D) Metoprolol

Correct answer : C

Q72. The following type of headache required further evolution?
A. Headache for less than 4 hours
B. Worst headache of his life
C. New onset progressive headache
D. Headache with blurring of vision

A) A,B,C,D
B) B,C,D
C) A,B,C
D) A and B

Correct answer : B

Q73. Patient with breathlessness. Has a history of cold intolerance, weight gain and
menorrhagia?

A) Myxedema coma
B) Septic shock
C) Cardiogenic shock
D) Hyperthyroidism

Q74. DM patient with complicated UTI. Hypotensive (shock?) resistant to IVF fluids.
Which antibiotic can be used?

A) Piperacillin - Tazobactam
B) Amoxicillin - clavulanate

C) Ceftriaxone
D) Nitrofurantoin

Q75. Hamman sign seen in

A) Pneumomediastinum
B) Pneumoperitoneum
C) PneumoPericardium
D) Hydropneumothorax

Q76. All of the following Side Effects are more commonly seen with caramazeine than
oxcarbazepine except:

A) Hyponatremia
B) Hypotension
C) Elevated levels of Gamma glutamyl transpeptidases
D) Rash

Q77. Drugs given preoperatively to reduce bleeding intra - op in case of hyperthyroidism
is ?

A) Potassium iodide
B) Propranolol
C) Propylthiouracil
D) Steroids

Q78. 30 year old present with black back pain and pain in leg on walking 100 M because
of which she has to take rest and sit down. She also tell that claudication pain improve
on boxing up Hills at compared to down hills. Diagnosis is?

A) Lumbar canal stenosis
B) TB hip
C) Buerger disease
D) Atherosclerosis

Correct answer : C,D

Q79. Air wave pressure of a patient is being measured. At what capacity in the PV Curve
the pressure recording at mouth will become zero?

A) RV
B) FRC
C) TV
D) TLC

Correct answer : B

Q80. In absence of ADH, the fluid leaving PCT is

A) Hypo - osmolar
B) Hyper - osmolar
C) Iso - osmolar
D) None of the above

Correct answer : C

Q81. Which time is being elicited?

A) Babinski sign
B) Dysdiadochokinesia
C) Astereognosis
D) Wartenberg sign

Q82. Child presented with her severe acute exacerbation of asthma with SPO2 = 80% . In
treatment of the ER patient, what will you do?
1. Order an urgent CXR

2. Nebulization with SABA for 60 min 3 times
3. Oral steroids

High flow O2

A) 1 and 2
B) 1 and 3
C) 2,3,4
D) 1,2,3

Correct answer : C

Q83. 50 years male presented with left sided hemiparesis. Damage to which part of
internal capsule leads to the presentation ?

A) Sub - lentiform
B) Anterior horn
C) Retro lentiform part
D) Posterior limb

Correct answer : D

Q84. 10 year old child presented with hemiballismus with sudden onset wild flailing
movement arms and legs. Which part of the brain is affected ?

A) Substantia Nigra
B) Caudate
C) Subthalamic nucleus
D) Thalamus

Correct answer : C

Q85. A 40 year old man fall from height and presented to ER with traumatic paraplegia.
You find out that the patient has encountered a central cord injury to the spinal cord.
Which of the following is false?

A) UMN lesion of upper limb, LMN lesion of lower limb
B) LMN lesion of upper limb, UMN lesion of lower limb
C) Bladder bowel activity and sensory supply to perianal region can be preserved
D) Dissociated sensory loss

Correct answer : D

Q86. 20 year old boy presented with people for the last 5 days, then he developed
drowsiness and coma. What will be used in Treatment based on P.Smear of the patient ?

A) Chloroquine

B) Artesunate
C) Doxycycline
D) Primaquine

Correct answer : B

Q87. Duration of prophylaxis in a 11 year old child with rheumatic fever without carditis
or valvular lesion?

A) 5 yrs
B) 10 yrs
C) 21 yrs
D) 40 yrs