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Unit 1
Questions 1 3
There is a category of cranial nerve disorders that is considerably different than any of the other diseases that affect
these or other cranial nerves. Trigeminal Neuralgia (the 5th Cranial Nerve), Hemifacial Spasm (the 7th Cranial
Nerve) and Glossopharyngeal Neuralgia (the 9th Cranial Nerve) are specific afflictions that share a common
underlying pathological etiology (cause).
The most common cause is a compression phenomenon exerted on the Cranial Nerve at its junction with the Brain
Stem. This region is inside the skull near its base. The compression actually causes an injury to the normal
insulating material surrounding the nerve, called myelin. This insulating material (which acts like rubber that
insulates electrical wires) is injured in these cranial neuralgias as a result of compression that is exerted on the
cranial nerve (usually by a tortuous artery and/or a vein, which has come to rest upon the nerve) at its junction with
the brain stem. The offending artery gains this peculiar position consequent to Atherosclerosis (hardening of the
arteries). As the atherosclerosis progresses, arteries become slightly elongated and firmer. This lengthening of
the artery results in the artery actually moving to a new position. In these patients, it is their bad luck that the
artery falls into this particular position relative to the Cranial Nerve Root junction with the Brain Stem. Once the
Myelin is injured, any stimulation of the Cranial Nerve can result in a short circuit (and thus the symptoms
specific to the particular Cranial Nerve's function) just as would happen in an electrical wire where its rubber
insulation had been eroded.
The same compression-distortion injury to the Nerve's Myelin has also been seen in patients with Cranial Neuralgias
associated with an Aneurysm (a dilated portion of a blood vessel) or a tumour. While it is acknowledged that
Aneurysms or tumours are very unusual as causes of these Neuralgias, it is imperative to obtain an MRI Scan in any
of these patients early after the diagnosis has been made in order to identify these potentially lethal (Aneurysm or
Tumor) conditions. The majority of these rare tumours are completely Benign Skull Base Tumours.

1.

In a patient with malignant tumour in throat, MRI Scan showed a stiffened, elongated artery in conjunction
with the hypoglossal nerve near the brain stem. This would be a case of:
A
B
C
D

2.

Nerve sheath tumours (NSTs) are rare, although they are relatively common in the head and neck region.
They may grow from any myelinated nerve, but in the skull base region they have an affinity for cranial
nerves. It would be incorrect to say:
A
B
C
D

3.

Cranial neuralgias associated with Aneurysm


Ordinary aneurysm
Cranial neuralgias
Atherosclerosis

All NSTs involve compression-distortion injury to the Nerves myelin.


All NSTs are cranial neuralgias
Not all NSTs involve aneurysm
None of the above

The effect of a herbal drug X on Post-therapeutic neuralgia (PHN) patients is shown in the following graph.

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Drug X should be prescribed for adult human intake starting from the age of:
A
20+
B
30+
C
40+
D
50+

Unit 2
Questions 4 6

Mast cells are pivotal in the allergic response type I or the anaphylactic type - a rapidly progressing chain-reaction
that causes sudden attack of asthma. Mast cells are ubiquitous and are found around blood vessels in the connective
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tissue, in the lining of the gut and importantly in the lining of the upper and lower respiratory tract. The allergen
(antigen) enters into the human body through the respiratory tract, skin and/or Gastro Intestinal Tract (GIT). After
the exposure to antigens, antibodies directed against specific antigens (i.e., IgE) are formed and are fixed to their
respective receptors on the surface of the mast cells. This process is called sensitisation of mast cells. During the
second exposure to antigens, the antigens react with these antibodies at the cell surface. This event leads to a series
of biochemical reactions. These migrate to the periphery in the secretory expulsion of the mast cell granules
containing active substances (vasoactive amines and chemolytic amines) causing asthma attacks. This process is
called mast cell degranulation.
4.

In a patient with acute Bronchial asthma, Biopsy of alveolar lesion shows normal level of IgE. It is safe to
say that the patient is suffering from
A Allergic asthma
B Non-anaphylactic asthma
C Inflammatory-induced asthma
D Difficult to say from this data

5.

Eosinophil content in human body is increased during bronchial muscle contraction. The statement is true
only when:
A
The person is suffering from asthma
B
In synchronous with IgE secretion
C
Mast cell degranulation occurs
D
None of the above

6.

Factors attracting inflammatory cells are released from the mast cell during:
A
Primary exposure to antigen
B
Secondary exposure to antigen
C
Both exposures
D
Sensitisation of mast cells

Unit 3
Questions 7 9
Peptidoglycan, is a vast polymer consisting of interlocking chains of identical peptidoglycan monomers. A
peptidoglycan monomer consists of two joined amino sugars, N-acetylglucosamine (NAG) and N-acetylmuramic
acid (NAM). The polypeptides get denatured on application of heat but shows resistance to alcohol hydrolysis.
Lipopolysaccharide (LPS) is composed of two biosynthetic entities: lipid A - core and the O-polysaccharide. Lipids
contain fatty acids and glycerol which get denatured on application of heat and alcohol. Gram-positive bacteria cell
wall contains nearly 85% peptidoglycan and no lipopolysaccharide layer, but Gram negative cell wall contains about
20% peptidoglycan and has a significant lipopolysaccharide layer above it.
A bacterial smear is subjected to Gram Staining which include applying a primary stain (crystal violet) to a heatfixed smear of a bacterial culture, followed by addition of a trapping agent (Gram's iodine), rapid decolourisation
with alcohol, and counterstaining with safranin or basic fuchsine (pink). But during this procedure, heat fixing of the
bacterial smear was done in excess.
7

If the Bacterium is Gram-positive in nature, what would be the colour of the cells under a light microscope
after gram-staining?
A
C

Purple
Black

B
D

Pink
Colourless

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The biological activity of bacterial endotoxin is associated with many endemic diseases like Shigellosis,
Tuberculosis, etc. Toxicity is associated with the lipid component (Lipid A) found in the causative
bacterium.
Shigella dyssenterae, causative microorganism for Shigellosis, is:
A
C

Gram negative bacteria


Acid fast bacteria

B
D

Gram positive bacteria


Protozoa

The serine unit in the cell wall transmidase enzyme plays an important role in cross linking the peptide tails
of successive NAGNAM units in order to form the bacterial cell wall. A calculation of the total energy of
serine + the peptide tail as a function of their separation yields an estimate of the strength of relevant
interaction. It is found that this interaction is almost equal in strength to the interaction between serine and
a molecule of penicillin. It is inferred that because of this equality the presence of penicillin negatively
affects the formation of cell wall in bacteria.
Cloxacillin, a synthetic derivative of Penicillin, is used against:
A
B
C
D

Campylobacter jejunum (Gram-ve)


Clostridium perfringens (Gram +ve)
Klebsiella spp. (Gram-ve)
Leptospira pomona (Gram-ve)

Unit 4
Questions 10 - 12
Do you ever wonder if your respiratory infection is viral, bacterial, or fungal in origin? Most patients would
probably like an antibiotic but with the rise of resistant bacteria, unwarranted use of antibiotics is not wise.
Wouldn't it be great if a quick test could be done to distinguish among these possibilities? A new sensitive and rapid
method to analyse for specific DNA sequences (which could provide the needed distinction) has been developed by
Saghatelian et. al. They have made an enzyme with a covalently attached single-stranded DNA sequence - an
inhibitor-DNA-enzyme (IDE) complex.

To the other end of the DNA is covalently attached an inhibitor of the enzyme. The inhibitor, tethered to the singlestranded DNA, can bind to and inhibit the enzyme. Now if a complementary strand of DNA (derived from the
bacterial, virus, etc) is added, it can bind to the ssDNA tether through complementary H-bond interactions to form a
double-stranded DNA in which the inhibitor is removed from the active site of the enzyme. The complementary
DNA is, in effect, more accurately a deinhibitor, of the enzyme. If a substrate is now added which can bind to the
enzyme active site and form a fluorescent product, a very sensitive and quick assay is available.
10.

DNA ligase, the enzyme joining two single-stranded DNAs to form a double- strand structure, is inhibited
by the plant extract P4. Therefore in presence of P4, the intensity of the fluorescent product in Saghatelian
method will be:

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A
C
11.

B
D

PAGE | 5

Weak
Normal

The complementary DNA which helps in removing the ssDNA-bound inhibitor from the enzyme, could be
considered as a/an:
A
B
C
D

12.

Strong
Totally absent

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Uncompetitive deinhibitor (removing inhibitor from the enzyme-substrate complex)


Non-competitive deinhibitor (removing inhibitor from an enzyme without affecting the enzymesubstrate complex formation)
Competitive deinhibitor (removing inhibitor directly from the substrate-binding site of the
enzyme)
Allosteric deinhibitor (removing inhibitor from an active site of the enzyme, other than the
substrate-binding site)

Poliovirus contains a single-stranded RNA as its genetic material. cDNA is generally created from mRNA
by the enzyme Reverse transcriptase. Which of following statements is incorrect for Poliovirus?
A
B
C
D

Poliovirus could not be analysed by Saghatelian method.


Poliovirus could be analysed by Saghatelian method
For analysing Poliovirus, the enzyme reverse transcriptase should be included, separately, in the
Saghatelian method
Statement A and B are incorrect.

Unit 5
Questions 13 15
Interfering antibodies can generate different types of disturbances in Immunochemical analysis. The interaction of
interfering antibodies with catching and/ or labelled kit antibody usually leads to a false-negative result. Sometimes,
there is no possibility of the formation of the antibody-antigen-labelled antibody complex (so called sandwich in
the sandwich assay) (Figure A,B,C).In the case of absence or very low concentration of antigen, heterophillic
antibodies present in sample may form a link (bridge) between the catching and the labelled antibody leading to
falsely high values (Figure D). In those immunochemical methods which use an enzyme as label, interfering
antibodies may react with enzyme protein, influencing the course of the reaction catalysed by the enzyme (Figure
E). Whether the substrate decrease or the product formation is measured, the results may be either falsely positive or
falsely negative.

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13.

Interfering antibodies in the blood


No Mycobacterium tuberculosis specific antibody in the blood
Both of the above
None of the above

Suppose in a particular person, the number of interfering antibodies remains constant for a particular
period. In which of the four analytical techniques (A, B, C, and D) the error in result will be maximum?
A
B
C
D

15.

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A patient suffering from fatigue and chronic cough was advised by doctors to undergo a Sandwich-ELISA
test to detect Mycobacterium tuberculosis specific antibody in blood. The test showed negative result. To
confirm it, the patient underwent a direct serum testing for the specific antibody. This time also the result
was negative.
The patient contains:
A
B
C
D

14.

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Figure A
Figure B
Figure C
Figure D

Figure A, B, C, and E are all sandwich-assay for Immunochemical analysis. Which of the alternatives is
incorrect?
A
B
C
D

Figure A shows no antibody-antigen-labelled antibody complex formation.


Figure C shows no antibody-antigen-labelled antibody complex formation.
Figure E shows no antibody-antigen-labelled antibody complex formation.
Both figure A and B shows no antibody-antigen-labelled antibody complex formation.

Unit 6
Question 16
High level of cholesterol happens to be a major facilitator of hypertension. This excess of lipoprotein results in
either narrowing of arteries or plaque formation. Both of these phenomenons perturb normal movement of blood in
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arteries compelling heart to impose a little extra pressure over the outgoing blood. This is the way hypertension
develops among obese and bulky people.
Diabetics could fall prey to hypertension because of one more reason other than high cholesterol. Since diabetics
suffer from high blood sugar level, their blood gets thickened due to excess of sugar molecules in blood. Because of
this thickening, blood can't keep up with normal pace of flow making heart to put extra pressure on blood flow and
the result is occurrence of high blood pressure. Even normal people with extra intake of sugar and rich diet could
suffer from hypertension due to this reason.
16.

A 25 yr old woman, weighing 56 kg, lives on a sugar-rich diet of chocolates, cakes, etc. Another 56 yr old
woman, weighing 75kg, lives on a normal diet. Which of the statements is correct for them?
A
B
C
D

The older woman is more prone to hypertension than the young woman.
The young woman is more prone to hypertension than the older woman.
Both of them are equally prone to hypertension.
None of the above.

Unit 7
Questions 17 21
Juvenile idiopathic arthritis (JIA) is a chronic systemic disease of connective tissue of inflammatory character,
proceeding in different forms, from minor reactions in single joints up to serious generalised forms affecting many
joints and internal organs. The progressing rheumatoid process may lead to deformations and stiffening of many
joints. The disease proceeds with recurring periods of aggravation alternately with periods of remission. Prognosis
of arthritis depends on the seriousness of the process, form of JIA and application of early and appropriate treatment.
The process of adaptation of a child to his own disease depends to a large degree on what his conception of the
disease is, how he understands and assesses it, and also on shaping of the image of a child's disease in the
consciousness of parents.
One of the elements of parents' empowerment in the process of rehabilitation is education conducted by a
therapeutic team. Parents should know the needs, difficulties and limitations resulting from disability of a child as
well as having knowledge about the disease, rules and care and education methods, health recommendations, and of
nursing and improvement methods.
In the first stage of the study, the level of knowledge of parents on etiopathogenesis of miss, symptoms of arthritis
and features characterising a chronic disease were analysed. The result for the causes of JIAs occurrence indicated
by parents is presented in the graph below

17.

From the above passage, which of the following cannot be the cause of JIA?

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A
B
C
D
18.

90
97
100
107

Arthritis is a bone disorder where the bone loses calcium.


Arthritis is a disorder where the fluid is removed.
Arthritis is a muscle disorder.
All of the above are correct

A chronic somatic disease is said to predispose towards occurrence of irregularities in the development and
socio-emotional functioning of children and youth.
Hence, which of the statements is correct with respect to this statement?
A
B
C
D

21.

Genetic disorder
Brain disorder
Immunodeficiency syndrome
Hormonal disorder

Which of the following statements is correct about arthritis?


A
B
C
D

20.

PAGE | 8

What is the total percentage of JIA occurrence as thought by the parents to be due to external factors?
A
B
C
D

19.

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In most cases surprise is the source of negative emotions.


JIA children risk of adaptation difficulties with parents.
JIA children find it difficult to accept themselves the way they are.
There is a huge possibility that they would grow up to be short.

Consider the two statements concerning the JIA affected children


I
Genetic conditionings for JIA can be cured.
II
Parents play a very important role in making their children healthy.
A
B
C
D

Both statements I and II are true and statement II follows statement I.


Both statements I and II are true but statement II does not follow statement I
Statement I is true but statement II is not true.
Statement I is not true but statement II is true.

Unit 8
Question 22
Tonicity is a measure of the osmotic pressure of two solutions separated by a semi-permeable membrane.
22

Of the following, which is true for tonicity?


A
The response of tonicity will be dependent on the cell and its cytoplasm.
B
Tonicity is influenced only by the solvent as it exerts an osmotic pressure.
C
Tonicity depends on the transport of solutes to the other side of the membrane.
D
Tonicity is dependent on the free crossing of solvent molecules across the membrane.

Unit 9
Questions 23 25
The diagram shows the scheme of nitrogen fixation in bacterium Clostridium pasteurianum. Fd. is the short for
Ferredoxin.
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23.

Ferredoxin stimulates nitrogenase to perform enzymatic action to convert nitrogen to ammonia


Ferredoxin facilitates in the oxidation of nitrogen to ammonia
Ferredoxin is the electron carrier
There is no ATP production in this process

In an experiment it was seen that flavodoxin will substitute for ferredoxin in acetyl phosphate formation
from pyruvate and nitrogen fixation by extracts of C. pasteurianum. The compound that can be used to
determine whether flavodoxin can be substituted for ferredoxin is:
A
B
C
D

25.

PAGE | 9

Of the following, the incorrect statement regarding ferredoxin is:


A
B
C
D

24.

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NADP
NADPH2
Ferredoxin
Ammonia

The Fe2S2 ferredoxin from Clostridium pasteurianum (Cp2FeFd) has been recognised as distinct protein
family on the basis of its amino acid sequence, spectroscopic properties of its iron-sulfur cluster and the
unique ligand swapping ability of two cysteine ligands to the [Fe2S2] cluster.
Which one of the following chemical structure is closer to the real Ferredoxin chemical structure?

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