← Combined Technical (NG)
Past Questions
Which government initiative focuses on water conservation in India?
A)
Swachh Bharat Abhiyan
B)
Jal Shakti Abhiyan
C)
Make in India
D)
Digital India
The correct option is 'Jal Shakti Abhiyan' because it is a campaign launched by the Government of India specifically for water conservation and water security, focusing on rainwater harvesting, recharge of aquifers, and renovation of traditional water bodies.
Other options are incorrect because:
- Swachh Bharat Abhiyan (a) focuses on sanitation and cleanliness (Open Defecation Free India).
- Digital India (d) focuses on transforming India into a digitally empowered society and knowledge economy.
- Make in India (c) is an initiative to encourage companies to manufacture their products in India to boost the economy and employment.
Which of the following is NOT a typical finding in Chronic Kidney Disease?
A)
Broad casts in urinary sediment
B)
Kidneys reduced in size bilaterally
C)
Persistent increase in serum sodium levels
D)
Persistent rise in serum creatinine levels
The correct option is (c) because Chronic Kidney Disease (CKD) typically leads to a deficit in the kidney's ability to excrete water and sodium, often resulting in hyponatremia (low serum sodium) due to water retention or dilution, rather than a persistent increase in serum sodium levels.
Other options are typical findings in CKD:
- (a) Broad casts: These are formed in dilated tubules of damaged kidneys and are a hallmark of end-stage renal disease.
- (b) Kidneys reduced in size: Chronic inflammation and fibrosis lead to atrophy and shrinkage of the kidneys (except in specific cases like diabetic nephropathy or polycystic kidney disease).
- (d) Persistent rise in serum creatinine: As the Glomerular Filtration Rate (GFR) declines permanently, creatinine clearance decreases, leading to a steady rise in serum creatinine levels.
Dialysis disequilibrium syndrome is primarily due to:
A)
Rapid removal of sodium
B)
Rapid potassium removal
C)
Rapid urea removal causing cerebral edema
D)
Inadequate removal of urea
Dialysis Disequilibrium Syndrome (DDS) occurs when urea is removed from the blood more rapidly than it can diffuse out of the brain cells. This creates an osmotic gradient where the blood becomes hypotonic relative to the brain tissue, drawing water into the brain cells and resulting in cerebral edema. This typically occurs during the first few sessions of dialysis in patients with very high blood urea nitrogen (BUN) levels.
Incorrect options:
- Option (a) and (b): While sodium and potassium levels are managed during dialysis, their rapid removal does not cause the specific osmotic shift in the brain associated with DDS.
- Option (d): Inadequate removal of urea would maintain the osmotic balance; it is the *rapid* removal (the steep drop in serum urea) that triggers the syndrome.
A protein deficient diet can cause:
A)
Kwashiorkor
B)
Diabetes
C)
Hypertension
D)
Hyperthyroidism
1. Correct Option: Kwashiorkor is a severe form of malnutrition caused specifically by a deficiency of protein in the diet, even if caloric intake is sufficient. It is characterized by edema (swelling), particularly in the abdomen, and stunted growth.
2. Incorrect Options:
- Diabetes: A metabolic disorder characterized by high blood glucose levels due to insulin deficiency or resistance, not protein deficiency.
- Hypertension: High blood pressure, typically caused by genetics, high salt intake, obesity, or kidney issues.
- Hyperthyroidism: An overactive thyroid gland producing excessive thyroid hormone, which is an endocrine disorder rather than a nutritional deficiency.
The richest dietary source of carbohydrate is:
A)
Meat
B)
Cereals
C)
Eggs
D)
Fish
Cereals (such as rice, wheat, maize, and oats) are primarily composed of starch, which is a complex carbohydrate, making them the richest source among the given options. In contrast, meat, eggs, and fish are animal-based proteins; they are rich in proteins and fats but contain negligible to no carbohydrates.
Food pattern refers to:
A)
Type of food eaten
B)
Eating behaviour, types, frequency and quantity of food
C)
Meal timings
D)
Cultural eating habits
Food pattern is a comprehensive term in nutrition and dietetics that describes the overall characteristics of food consumption. Option (b) is correct because it encompasses all critical dimensions: the 'types' of food (what is eaten), 'frequency' (how often), 'quantity' (how much), and 'eating behaviour' (how it is consumed). Options (a), (c), and (d) are incorrect because they are too narrow; 'type of food' (a), 'meal timings' (c), and 'cultural habits' (d) are individual components or drivers of a food pattern, but none of them alone define the entire pattern.
The recommended daily allowance for protein is:
A)
0.8g/kg body weight
B)
2g/kg body weight
C)
4g/kg body weight
D)
5g/kg body weight
The Recommended Dietary Allowance (RDA) for a healthy adult is generally set at 0.8 grams of protein per kilogram of body weight per day. This amount is considered sufficient to meet the protein needs of most healthy individuals to maintain nitrogen balance and prevent muscle wasting. Options b, c, and d (2g, 4g, and 5g/kg) are significantly higher than the standard RDA; while athletes or individuals with specific medical conditions (like severe burns or kidney failure in certain stages) may require higher protein intake, these values are not the general recommended daily allowance for the average population.
For massive transfusion, the ratio recommended is:
A)
3:1 (PRBC:FFP)
B)
1:1:1 (PRBC:FFP:Platelets)
C)
4:1 (FFP:PRBC)
D)
2:2:1 (PRBC:Platelets:FFP)
The current gold standard for Massive Transfusion Protocols (MTP) is a balanced ratio of 1:1:1 (Packed Red Blood Cells [PRBC] : Fresh Frozen Plasma [FFP] : Platelets). This ratio is designed to mimic the composition of whole blood, aiming to prevent the 'lethal triad' of trauma (acidosis, hypothermia, and coagulopathy) by replacing clotting factors and platelets simultaneously with red cells, rather than waiting for laboratory results.
- Option (a) 3:1 (PRBC:FFP) was an older practice but is now considered insufficient as it often leads to dilutional coagulopathy.
- Option (c) 4:1 (FFP:PRBC) is not a standard protocol for massive transfusion.
- Option (d) 2:2:1 is not the standard recommended ratio for initial massive transfusion resuscitation.
All of the following antibiotics are nephrotoxic, EXCEPT:
A)
Gentamicin
B)
Linezolid
C)
Amikacin
D)
Vancomycin
Linezolid is an oxazolidinone antibiotic that is primarily metabolized by the liver and excreted; it is not associated with nephrotoxicity. In contrast, the other options are well-known for their potential to cause kidney damage: Gentamicin and Amikacin are Aminoglycosides, which are classic causes of acute tubular necrosis (ATN), and Vancomycin is a glycopeptide that can cause nephrotoxicity, especially when used in high doses or combined with other nephrotoxic agents.
Which of the following is a characteristic of unsaturated fats:
A)
They are solid at room temperature
B)
They can help reduce bad cholesterol levels
C)
They are found only in animal products
D)
They cause an increase in LDL cholesterol
Unsaturated fats (found in olive oil, nuts, and fish) are considered 'healthy fats' because they can improve blood cholesterol levels by increasing HDL (good) cholesterol and reducing LDL (bad) cholesterol, thereby lowering the risk of heart disease.
Incorrect Options:
- Option (a): Unsaturated fats are typically liquid at room temperature; saturated fats are solid.
- Option (c): Unsaturated fats are primarily found in plant oils and fish, not exclusively or primarily in animal products.
- Option (d): Saturated and trans fats increase LDL cholesterol; unsaturated fats generally help decrease it.
Which of the following is a good source of dietary fiber?
A)
Chicken
B)
Cheese
C)
Apple
D)
Fish
Dietary fiber is a type of carbohydrate found exclusively in plant-based foods. Apples are fruits and contain significant amounts of pectin and cellulose, making them a good source of fiber. In contrast, chicken (a), cheese (b), and fish (d) are animal-based products; animal tissues do not contain fiber, as they primarily provide proteins and fats.
FIFO in food storage means:
A)
First in first out
B)
Food in food out
C)
Fast in fast out
D)
Fresh inside fresh outside
FIFO stands for 'First In, First Out'. It is a stock rotation system used in food storage to ensure that the oldest stock (the items that arrived first) is used before the newer stock. This prevents food spoilage and reduces waste by ensuring products are consumed before their expiration dates. Options b, c, and d are incorrect as they are fabricated phrases that do not represent standard industry terminology for inventory management or food safety.
Normal Body Mass Index (BMI) range for adult is:
A)
18.5 to 24.9
B)
30.0 to 39.9
C)
25.0 to 29.9
D)
16.0 to 18.5
The Body Mass Index (BMI) is a standard tool used to categorize weight status in adults. According to the World Health Organization (WHO) and CDC guidelines:
1. Option (a) 18.5 to 24.9 is the correct range for a 'Normal' or 'Healthy' weight.
2. Option (b) 30.0 to 39.9 falls under the 'Obese' category (specifically Class I and II obesity).
3. Option (c) 25.0 to 29.9 is categorized as 'Overweight'.
4. Option (d) 16.0 to 18.5 falls under the 'Underweight' category (specifically severe thinness to mild thinness).
Recommended daily salt intake for chronic kidney disease (CKD) patient is:
A)
< 2g/day
B)
<5g/day
C)
<4g/day
D)
<3g/day
The recommended daily salt (sodium chloride) intake for patients with Chronic Kidney Disease (CKD) is generally <5g/day. This is based on global health guidelines (such as WHO and KDIGO) to manage hypertension, reduce edema, and slow the progression of kidney failure. Note: 5g of salt is approximately equivalent to 2g of sodium.
- Option (b) is correct as <5g/day is the standard clinical recommendation for salt intake in CKD patients to control fluid balance and blood pressure.
- Options (a), (c), and (d) are incorrect because while further restriction (e.g., <3g or <2g) may be prescribed in severe cases of heart failure or refractory edema, they are not the general standard recommendation for all CKD patients and can lead to malnutrition or hyponatremia if applied too broadly.
Which drug class slows CKD progression in proteinuric patients:
A)
Loop diuretics
B)
Beta blockers
C)
Calcium channel blockers
D)
ACE inhibitors
ACE inhibitors (and ARBs) are the gold standard for slowing the progression of Chronic Kidney Disease (CKD) in proteinuric patients. They work by dilating the efferent arteriole of the glomerulus, which reduces intraglomerular pressure and decreases the amount of protein leaking into the urine (proteinuria), thereby protecting the nephrons from further damage.
Other options are incorrect because:
- Loop diuretics (a) are used to manage fluid overload and edema but do not have a disease-modifying effect on CKD progression.
- Beta blockers (b) are used for cardiovascular conditions (like hypertension or heart failure) but do not specifically target proteinuric kidney disease.
- Calcium channel blockers (c) can treat hypertension, but unlike ACE inhibitors, they do not consistently reduce proteinuria or slow the decline of GFR in the same targeted manner.
Recommended daily energy intake for stable hemodialysis is:
A)
25-35
B)
40-45
C)
45-50
D)
50-55
The recommended daily energy intake for adults on stable hemodialysis is generally 30-35 kcal/kg/day, though some guidelines suggest a range of 25-35 kcal/kg/day depending on the patient's age, activity level, and nutritional status. Option (a) aligns with these clinical standards (KDOQI guidelines). Options (b), (c), and (d) provide energy values (40-55 kcal/kg) that are excessively high and would likely lead to obesity and metabolic complications in a stable hemodialysis patient.
Magnesium deficiency can cause:
A)
Muscle cramps
B)
Tooth decay
C)
Weight gain
D)
Skin rashes
Magnesium is a critical mineral for neuromuscular function; it acts as a natural calcium blocker to help muscles relax after contraction. A deficiency (hypomagnesemia) leads to increased neuromuscular excitability, which manifests as muscle cramps, spasms, and tremors.
Other options are incorrect because:
- Tooth decay (b) is primarily caused by fluoride deficiency and poor oral hygiene.
- Skin rashes (d) are typically associated with allergies, autoimmune issues, or deficiencies in vitamins like Zinc or B-complex.
- Weight gain (c) is generally a result of caloric surplus or metabolic disorders (like hypothyroidism) rather than a specific magnesium deficiency.
Bananas are a well-known source of:
A)
Calcium
B)
Potassium
C)
Iron
D)
Zinc
Bananas are widely recognized as an excellent dietary source of Potassium, an essential mineral and electrolyte that helps maintain fluid balance, nerve transmission, and muscle function.
Other options are incorrect because:
- Calcium (a) is primarily found in dairy products and leafy greens.
- Iron (c) is most abundant in red meats, legumes, and spinach.
- Zinc (d) is primarily sourced from oysters, red meat, and seeds.
Which of the following vitamin helps in the absorption of calcium?
A)
Vitamin A
B)
Vitamin D
C)
Vitamin E
D)
Vitamin B12
Vitamin D is the correct answer because it acts as a hormone that facilitates the absorption of calcium and phosphorus from the intestinal tract into the bloodstream, which is essential for maintaining bone density and strength.
Other options are incorrect because:
- Vitamin A (a) is primarily involved in vision, immune function, and skin health.
- Vitamin E (c) acts as an antioxidant protecting cell membranes from oxidative damage.
- Vitamin B12 (d) is crucial for red blood cell formation, neurological function, and DNA synthesis.
Heparin induced thrombocytopenia (HIT) is due to:
A)
Increased fibrin degradation products
B)
Calcium loss
C)
Complement activation
D)
Autoantibodies to PF4
Heparin-Induced Thrombocytopenia (HIT) is a prothrombotic immune-mediated reaction. It occurs when heparin binds to Platelet Factor 4 (PF4), forming a complex. The body then develops IgG autoantibodies against this PF4-heparin complex. These antibodies bind to the complex on the surface of platelets, activating the FcγIIa receptors, which leads to massive platelet activation, consumption (thrombocytopenia), and the release of procoagulant microparticles, increasing the risk of thrombosis.
Incorrect options:
- Option a: Increased fibrin degradation products are markers of fibrinolysis (e.g., in DIC), not the primary cause of HIT.
- Option b: Calcium loss is not associated with the pathogenesis of HIT.
- Option c: While the complement system can be involved in some immune reactions, HIT is specifically driven by the antibody-mediated activation of platelets via the Fc receptor, not primary complement activation.
A closed bed is also known as:
A)
Occupied bed
B)
Empty bed
C)
Admission bed
D)
Recovery bed
A closed bed is referred to as an empty bed because it is made and prepared for a new patient but is not currently occupied. The top covers are pulled up to the head of the bed to keep the linens clean and protect the mattress until a patient is admitted.
Incorrect options:
- Occupied bed (a): A bed that is made while the patient remains in it.
- Admission bed (c): Also known as an open bed; it is prepared for a patient arriving soon, with the top covers folded back (fan-folded) for easy access.
- Recovery bed (d): A bed specifically prepared for a patient returning from surgery, often involving extra warming devices or specific positioning.
Proteins are made up of which basic units?
A)
Fatty acids
B)
Amino acids
C)
Monosaccharides
D)
Nucleotides
Proteins are polymers composed of long chains of monomers called amino acids, which are linked together by peptide bonds.
Incorrect options:
- Fatty acids (a) are the building blocks of lipids (fats).
- Monosaccharides (c) are the basic units of carbohydrates (sugars).
- Nucleotides (d) are the basic units of nucleic acids (DNA and RNA).
Which of the following is NOT a macro mineral?
A)
Calcium
B)
Sodium
C)
Potassium
D)
Selenium
Minerals are categorized into macro minerals and trace minerals based on the amount required by the body daily.
1. Why Option 'd' is correct: Selenium is a trace mineral (micro mineral). Trace minerals are required in very small quantities (typically less than 100 mg per day). Other trace minerals include iron, zinc, copper, and iodine.
2. Why other options are incorrect: Calcium (a), Potassium (c), and Sodium (b) are all macro minerals. Macro minerals are required by the body in larger amounts (typically 100 mg or more per day) to maintain osmotic balance, bone structure, and nerve transmission.
Recommened daily protein intake for stable hemodialysis patient is:
A)
2.2-3.2 g/kg/day
B)
2.2-2.5 g/kg/day
C)
1-1.2 g/kg/day
D)
1.5-1.8 g/kg/day
1. Patients on stable hemodialysis (HD) require a high protein intake to compensate for the loss of amino acids and peptides during the dialysis process, as well as to combat the catabolic state associated with uremia and chronic inflammation.
2. According to KDOQI (Kidney Disease Outcomes Quality Initiative) guidelines, the recommended protein intake for adults on maintenance hemodialysis is 1.2 g/kg/day. However, in many clinical and exam contexts, the range is extended to 1.5-1.8 g/kg/day to ensure the prevention of protein-energy wasting (PEW).
3. Option (c) 1-1.2 g/kg/day is typically the minimum threshold or recommended for peritoneal dialysis (which has different loss profiles), but for HD, the higher end of the spectrum is preferred to maintain lean body mass.
4. Options (a) and (b) are excessively high and would place an unnecessary solute load on the patient, potentially increasing uremic toxins between dialysis sessions.
Absorption of medication is fastest in:
A)
Subcutaneous tissue
B)
Intradermal route
C)
Intramuscular route
D)
Oral route
The rate of medication absorption depends primarily on the vascularity (blood flow) of the administration site.
1. **Intramuscular (IM) route (Correct):** Muscle tissue is highly vascularized, meaning it has a rich supply of blood vessels. This allows the medication to be absorbed into the bloodstream much more rapidly than in tissues with lower blood flow.
2. **Subcutaneous tissue (Incorrect):** This layer has fewer blood vessels than muscle tissue, leading to a slower, more sustained absorption rate.
3. **Intradermal route (Incorrect):** The dermis is the least vascularized of the injection sites listed; it is designed for very slow absorption (e.g., TB tests or allergy tests).
4. **Oral route (Incorrect):** This is the slowest method among the options because the drug must pass through the gastrointestinal tract, undergo digestion, and survive 'first-pass metabolism' in the liver before reaching systemic circulation.