← Combined Technical (NG)
Past Questions
Creatinine is an end-product of what metabolism:
A)
Muscle
B)
Amino acid
C)
Nucleic acid
D)
Protein
Creatinine is formed from creatine/phosphocreatine in muscle and is a normal end-product of muscle metabolism. It is produced at a relatively constant rate and excreted in urine. Amino acid and protein metabolism produce mainly urea, while nucleic acid metabolism produces uric acid, not creatinine.
The bond that links amino acids together in a protein is the:
A)
Glycosidic bond
B)
Peptide bond
C)
Phosphodiester bond
D)
Hydrogen bond
Amino acids in proteins are joined by peptide bonds, which form between the carboxyl group of one amino acid and the amino group of the next. Glycosidic bonds link sugars, phosphodiester bonds link nucleotides in nucleic acids, and hydrogen bonds are weak interactions that help stabilize structures but do not link amino acids in the protein backbone.
Vitamin A is important for:
A)
Blood clotting
B)
Vision and epithelial health
C)
Bone mineralization only
D)
Collagen synthesis
Vitamin A is essential for normal vision, especially in low light, because it forms rhodopsin in the retina. It also maintains healthy epithelial tissues such as skin and mucous membranes. Blood clotting is mainly related to vitamin K, bone mineralization is chiefly associated with vitamin D, and collagen synthesis depends largely on vitamin C.
What is the term for the ability of a microorganism to cause disease?
A)
Virulence
B)
Pathogenicity
C)
Infectivity
D)
Colonization
Pathogenicity is the ability of a microorganism to cause disease. Virulence refers to the degree or severity of pathogenicity. Infectivity is the ability to enter, survive, and multiply in a host, while colonization means establishing presence on a host surface without necessarily causing disease.
Which RNA specifies the sequence of amino acids in the protein synthesis?
A)
tRNA
B)
mRNA
C)
rRNA
D)
All of the above
mRNA (messenger RNA) carries the genetic code from DNA to the ribosome in the form of codons, and these codons specify the sequence of amino acids during protein synthesis. tRNA brings amino acids to the ribosome, and rRNA forms the structural and catalytic part of the ribosome. Therefore, the RNA that specifies the amino acid sequence is mRNA.
Light microscopy in minimal change disease typically shows:
A)
Mesangial proliferation
B)
Thickened GBM
C)
Normal glomeruli
D)
Crescent formation
Minimal change disease is named so because on light microscopy the glomeruli usually appear normal. The diagnosis is typically confirmed by electron microscopy, which shows podocyte foot process effacement. Mesangial proliferation is seen in mesangial proliferative diseases, thickened GBM is typical of membranous nephropathy or diabetic nephropathy, and crescent formation is seen in rapidly progressive glomerulonephritis.
GFR calculation formula used in adult includes all except: -
A)
CKD-EPI Equation
B)
MDRD Study Equation
C)
Cockcroft-Gault formula
D)
Revised Bedside Schwartz Formula
Adult GFR estimation commonly uses CKD-EPI, MDRD, and Cockcroft-Gault equations. The Revised Bedside Schwartz formula is primarily used in children and adolescents, not adults. Therefore, it is the exception.
The major energy source for the brain under normal physiological conditions is:
A)
Fatty acids
B)
Ketone bodies
C)
Glucose
D)
Amino acids
Under normal physiological conditions, the brain relies primarily on glucose as its major energy source. Fatty acids are not significantly used by the brain because they do not readily cross the blood-brain barrier. Ketone bodies can become an important fuel during prolonged fasting or starvation, but not under normal conditions. Amino acids are not the main energy source for the brain.
Fever in hemodialysis patient with a catheter and no local signs should raise suspicion of:
A)
UTI
B)
Pneumonia
C)
Catheter-related bloodstream infection
D)
Viral fever
In a hemodialysis patient who has a catheter, fever without local signs of infection strongly suggests catheter-related bloodstream infection (CRBSI). Catheters are a common source of bloodstream infection in dialysis patients. UTI and pneumonia usually have additional localizing features, and viral fever is less likely in this specific clinical context.
The earliest pathological change in diabetic nephropathy is:
A)
Kimmelstiel-Wilson nodules
B)
Glomerular basement membrane thickening
C)
Interstitial fibrosis
D)
Arteriolar hyalinosis
The earliest structural change in diabetic nephropathy is thickening of the glomerular basement membrane. This occurs before the classic nodular glomerulosclerosis (Kimmelstiel-Wilson nodules) appears. Interstitial fibrosis and arteriolar hyalinosis are also later/chronic changes. Therefore, option (b) is correct.
The number one cause of kidney failure is:
A)
Hypertension
B)
Trauma
C)
Diabetes Mellitus
D)
Alcohol
Diabetes mellitus is the leading cause of chronic kidney disease and kidney failure worldwide. Persistent high blood sugar damages the glomeruli and blood vessels in the kidneys over time, eventually causing renal failure. Hypertension is also a major cause, but it is generally second to diabetes. Trauma and alcohol are not the number one causes of kidney failure.
What is known as good cholesterol?
A)
LDL
B)
HDL
C)
VLDL
D)
Chylomicrons
HDL (high-density lipoprotein) is known as the 'good cholesterol' because it helps transport excess cholesterol from the blood and tissues back to the liver for removal or reuse. LDL is called 'bad cholesterol' because it tends to deposit cholesterol in arteries. VLDL mainly carries triglycerides, and chylomicrons transport dietary fats from the intestine.
Simplest group of carbohydrates are:
A)
Monosaccharides
B)
Disaccharides
C)
Oligosaccharides
D)
Polysaccharides
Carbohydrates are classified by the number of sugar units they contain. Monosaccharides are the simplest carbohydrates because they consist of only one sugar unit and cannot be hydrolyzed into smaller carbohydrates. Disaccharides contain two monosaccharide units, oligosaccharides contain a few units, and polysaccharides contain many units.
IgA nephropathy is characterized by deposition of IgA mainly in the:
A)
Subepithelial space
B)
Subendothelial space
C)
Mesangium
D)
Glomerular basement membrane
IgA nephropathy (Berger disease) is defined by predominant deposition of IgA in the mesangium of the glomerulus. This mesangial immune-complex deposition causes mesangial proliferation and hematuria. The other options are incorrect because subepithelial and subendothelial deposits are more typical of other glomerulonephritides, and the glomerular basement membrane is not the main site of IgA deposition in this disease.
The most severe form of lupus nephritis is:
A)
Class II (mesangial)
B)
Class III (focal)
C)
Class IV (diffuse proliferative)
D)
Class V (membranous)
In the ISN/RPS classification of lupus nephritis, Class IV diffuse proliferative nephritis is the most severe and most common serious form. It involves extensive glomerular involvement and is strongly associated with active inflammation, hematuria, proteinuria, hypertension, and risk of renal failure. Class II is usually mild mesangial disease, Class III is focal and less extensive than Class IV, and Class V is membranous nephritis, which is typically severe in terms of proteinuria but not the most aggressive proliferative form.
The dialysis access with the lowest infection risk is:
A)
AV graft
B)
Tunneled catheter
C)
Native AV fistula
D)
Temporary catheter
A native arteriovenous (AV) fistula has the lowest infection risk among dialysis access types because it uses the patient’s own blood vessels and has no foreign material or external catheter. AV grafts have higher infection risk than native fistulas because they contain synthetic material. Tunneled catheters and temporary catheters have the highest infection risk due to direct skin entry and prolonged external access.
Endogenous filtration marker includes all except: :
A)
Urea
B)
Cystatin
C)
C-peptide
D)
Creatinine
Endogenous filtration markers are substances produced within the body and used to assess glomerular filtration. Common examples include creatinine, cystatin C, and C-peptide. Urea is not considered a reliable endogenous filtration marker because its level is significantly affected by factors such as protein intake, liver function, hydration status, and tubular reabsorption. Therefore, the exception is Urea.
How many bones are present in the human body?
A)
204
B)
205
C)
206
D)
207
An adult human body normally has 206 bones. This is the standard anatomical count after some bones fuse during growth. Therefore, option (c) is correct. Options (a), (b), and (d) do not match the accepted adult human skeleton count.
Which enzyme marker is most specific for liver damage?
A)
CK
B)
ALP
C)
ALT
D)
Amylase
ALT (alanine aminotransferase) is the most specific enzyme marker for liver cell damage because it is found mainly in hepatocytes. When liver cells are injured, ALT rises in the blood. CK is a muscle/heart marker, ALP is less specific and also rises in bone and bile duct disorders, and amylase is mainly a pancreatic marker.
HbA1c reflects the patient’s average blood glucose over approximately:
A)
1–2 weeks
B)
2–4 weeks
C)
6–8 weeks
D)
2–3 months
HbA1c (glycated hemoglobin) reflects the average blood glucose level over the lifespan of red blood cells, which is about 120 days. Since HbA1c is weighted more toward recent weeks but still represents long-term control, it is commonly used as an indicator of average glucose over approximately 2–3 months. The other options are too short for HbA1c.
Nephrogenesis completes at what gestational age?
A)
30 weeks
B)
20 weeks
C)
36 weeks
D)
38 weeks
Nephrogenesis, the formation of nephrons in the fetal kidney, is generally completed near term, around 36–38 weeks of gestation. Among the given options, 38 weeks is the best answer. 20 weeks and 30 weeks are too early, and 36 weeks is close but the standard exam answer is usually completion by term, i.e., 38 weeks.
The recommended hepatitis B vaccination schedule in CKD/dialysis patients is:
A)
0, 1, 6 months (standard dose)
B)
0, 1, 2, 6 months (double dose)
C)
Single high dose
D)
Annual booster only
Patients with chronic kidney disease (CKD), especially those on dialysis, have a poorer immune response to hepatitis B vaccine, so an enhanced schedule is recommended. The usual recommendation is a double-dose regimen at 0, 1, 2, and 6 months. Option (a) is the standard adult schedule for immunocompetent persons, while (c) and (d) are incomplete and not the recommended primary vaccination schedule for CKD/dialysis patients.
Which pneumococcal vaccination strategy is recommended in CKD?
A)
PPSV23 only
B)
PCV13 only
C)
PCV13 followed by PPSV23
D)
Annual pneumococcal vaccine
In chronic kidney disease (CKD), patients are at increased risk of invasive pneumococcal disease, so pneumococcal vaccination is recommended. The usual strategy is to give a conjugate vaccine first (PCV13) to build a strong immune response, followed by the polysaccharide vaccine (PPSV23) to broaden serotype coverage. PPSV23 only is less immunogenic, PCV13 only does not provide as broad coverage, and there is no annual pneumococcal vaccine schedule.
Uric acid is the end product of what metabolism?
A)
Purine
B)
Pyramidine
C)
Muscle
D)
Amino acid
Uric acid is the final end product of purine metabolism in humans. Purines such as adenine and guanine are broken down into uric acid. Pyrimidines do not produce uric acid as their end product, and muscle or amino acid metabolism are not the main source of uric acid.
The gold standard for diagnosis of UTI is:
A)
Urine routine microscopy
B)
Urine dipstick test
C)
Urine culture
D)
Blood urine
Urine culture is the gold standard for diagnosing urinary tract infection (UTI) because it can identify the causative organism and determine the bacterial count, helping confirm true infection. Urine routine microscopy can suggest infection by showing pus cells or bacteria, and dipstick tests may screen for nitrites/leukocyte esterase, but neither is as definitive as culture. Blood urine is not a diagnostic test for UTI.