GAMSAT
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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 Nerve’s 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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GAMSAT
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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 © All rights reserved by Prepgenie.com. No parts of this booklet may be produced or utilised in any form without the written permission of Prepgenie.com. [For reporting errors or doubts clearance, mail to
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GAMSAT
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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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GAMSAT 8
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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
9
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 NAG–NAM 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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GAMSAT A C 11.
B D
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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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GAMSAT
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 © All rights reserved by Prepgenie.com. No parts of this booklet may be produced or utilised in any form without the written permission of Prepgenie.com. [For reporting errors or doubts clearance, mail to
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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 JIA’s 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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GAMSAT 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.
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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. © All rights reserved by Prepgenie.com. No parts of this booklet may be produced or utilised in any form without the written permission of Prepgenie.com. [For reporting errors or doubts clearance, mail to
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GAMSAT
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.
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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?
A
B
C
D
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