β Combined Technical (NG)
Past Questions β 2026
Which cooking method helps reduce potassium content in vegetables?
A)
Frying
B)
Steaming
C)
Boiling and discarding water
D)
Roasting
Potassium is a water-soluble mineral. When vegetables are boiled, the potassium leaches out of the plant tissues and dissolves into the cooking water. By discarding this water (a process often called 'leaching'), the overall potassium content of the vegetable is significantly reduced. This method is frequently recommended for patients with chronic kidney disease (CKD) to manage potassium intake. In contrast, frying, roasting, and steaming do not involve submerging the food in water that is subsequently discarded; therefore, the potassium remains trapped within the food, keeping the mineral content high.
An important goal of renal diet planning is to:
A)
Increase protein and potassium
B)
Reduce kidney workload and prevent complications
C)
Increase fluid intake
D)
Improve sugar absorption
The primary goal of a renal diet is to manage the buildup of waste products and fluids in the blood when kidneys are impaired. By controlling the intake of protein, sodium, potassium, and phosphorus, the diet reduces the metabolic workload on the kidneys and prevents life-threatening complications such as edema, hyperkalemia, and uremia.
Incorrect options:
- Option (a) is incorrect because protein and potassium are typically restricted in renal diets to prevent the accumulation of nitrogenous waste and dangerous potassium levels.
- Option (c) is incorrect because fluid intake is often restricted in renal patients to prevent fluid overload and hypertension.
- Option (d) is incorrect because improving sugar absorption is a goal related to metabolic or digestive health, not the primary focus of renal diet planning.
Drugs used for delaying CKD progression includes all except:
A)
Sodium bicarbonate tablets
B)
Dapagliflozin
C)
Empagliflozin
D)
Sevelamer
The question asks for the drug that does NOT delay the progression of Chronic Kidney Disease (CKD).
1. **Correct Option (d) Sevelamer**: Sevelamer is a phosphate binder used to treat hyperphosphatemia in patients with CKD. While it manages a complication of kidney failure (mineral and bone disorder), it does not slow down the decline of the glomerular filtration rate (GFR) or delay the progression of the disease itself.
2. **Incorrect Options (a, b, c)**:
- **Sodium bicarbonate (a)**: Used to treat metabolic acidosis in CKD; correcting acidosis has been shown to slow the progression of CKD.
- **Dapagliflozin (b) and Empagliflozin (c)**: These are SGLT2 inhibitors. Large-scale clinical trials (like DAPA-CKD and EMPA-KIDNEY) have proven that SGLT2 inhibitors significantly reduce the risk of kidney failure and slow the progression of CKD, regardless of whether the patient has diabetes.
Which drug can worsen renal function in b/l renal artery stenosis
A)
Calcium channel blockers
B)
ACE inhibitors
C)
Beta- blockers
D)
Diuretics
In bilateral renal artery stenosis (RAS), renal perfusion pressure is significantly reduced. To maintain the Glomerular Filtration Rate (GFR), the body increases Angiotensin II levels, which preferentially constricts the efferent arteriole to maintain glomerular hydrostatic pressure. ACE inhibitors block the production of Angiotensin II, leading to vasodilation of the efferent arteriole. This causes a sharp drop in glomerular filtration pressure, resulting in an acute decline in GFR and worsening renal function.
Other options are incorrect because:
- Calcium channel blockers (a) primarily act on the afferent arteriole and do not typically cause acute renal failure in RAS.
- Beta-blockers (c) do not have a direct mechanism that compromises glomerular filtration pressure in the context of RAS.
- Diuretics (d) may reduce blood volume, but they do not specifically target the efferent arteriolar tone required to maintain GFR in bilateral RAS in the same catastrophic manner as ACE inhibitors.
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.
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.
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.
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).
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.
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 FcΞ³IIa 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.
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.
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.
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.
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 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.
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).
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.
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.
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.
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.
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.
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.
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 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.
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.