AIIMS NOV 2011
PGDIAMS
1. Which of the following worsens of PGE 1 administration
a. Pulmonary stenosis without VSD
b. Obstructed TAPVC
c. Hypoplastic left heart syndrome
d. Aortic interruption
Ans. (b)
Ref: Nelson 18th edition 1901, 1912, 1924, 1928
2. 7 days old baby with leakin meningo myelocele. First choice of investigation?
a. Wound C/S
b. Blood C/S
c. Rectal swab
d. Urine culture
Ans. (b)
Ref: Nelson 18th edition, page 2447
3. Steroid resistant nephritic syndrome due to?
a. ACE
b. NPHS2
c. LMX 1B
d. Hox 11
Ans. (b)
Ref. Nelson 18th edition, page 2195
4. A 7 year old child with fever, sore throat
MPO +ve
TLC-60,000 CD 33-ve
Plt- 20,000 CD 19+ve
CD 117+ve
CD 10 +ve
a. AML
b. ALL
c. Mixed
d. Biphenotypic
Ans. (d)
Ref: Wikipedia, http://tmc.gov.in/clinicalguidelines/ebm/vol5/pathology_final/cytometry/htm
5. All are true in the following except
a. Metabolic Acidosis is based defect > 12-16 Meq/L
b. Co2 is effectively cleared by placenta
c. Apgar score@ 1 min, indicator for neonatal resuscitation
d. Apgar score @ 7 min good indicator for neonatal death
Ans. (a)
Ref: nelson 18th edition, page 1855
http:/aappolicy.aappubilications.org/cgi/content/full/peadiatrics;117/4/1444
6. A 5 yr old child comes with episodic anaemia and jaundice from birth. All of the below are possible diagnosis except?
a. Sickle cell disease
b. G6 PD deficiency
c. Hereditatery spherocytosis
d. PNH
Ans. (d)
Ref. Nelson 18th edition, page 2021, 2025, 2027
7. Nestroft Test is used to detect?
a. Beta thalessemia
b. Hereditary spherocytosis
c. Autoimmune hemolytic anemia
d. G6PD
Ans.(a)
Ref. Care of Newborn, Meharban singh 7th edition, page 39
8. young short stature girl with TSH increased, T4 decreased - mass in pituitary on MRI. What is the likely diagnosis?
a. Primary hypothyroidism
b. Pitutary tumor
c. Pituitary throtrophic adenoma
d. Resistance to action of Thyroxine
Ans. (a)
Ref. Nelson 18th edition, page 2325
9. Down syndrome is associated with all except
a. Trisomy 21
b. Mosaic 21
c. Robertsonian translocation t(21:13)
d. Deletion 21
Ans. (d)
Ref: Nelson 18th edition, page 507-509
10. A child with recurrent sinusitis with rhinitis, CXR shows dextrocardia, most probable diagnosis is:
a. Kartargener syndrome
b. Cystic Fibrosis
c. Beck with widemann syndrome
d. Brown sequard syndrome
Ans. (a)
Ref. Nelson 18th edition, 1817
11. All of the following about Vit.D metabolism are true except:
a. 25-ahydronylation takes place in liver
b. 1- a hydroxylation takes place in kidney
c. Daily requirement in the absence of'sunlight is 450-600IU/day J
d. Williams syndrome is associated with obesity, mental retardation, precious puberty
Ans. (d)
Ref. Nelson 18th edition
12. A 15 year old girl presents with recurrent pains in the knee with appearance of petechial haemorrhage, diagnosis is:
a. Amegakaryocytic thrombocytopenia
b. Megakaryocytic thrombocytopenia
c. Factor VIM inhibitor
d. Platelet dysfunction
Ans. (b)
Ref: Harrison 18th edition
13. All of the following are mechanisms of thermogenesis in neonates except:
a. Shivering
b. Brown fat
c. Increase in movements of the baby
d. Cutaneous vaso constriction
Ans. (a)
Ref. Nelson 18th edition, page 680
14. Neonate presents with CHF of O/E bulging AF bruit on auscultation. Transfontanellar USG - hyerechoric midline mass with dilated lateral ventricles, diagnosis?
a. Vein of galen malformation
b. Encephalocele
c. Medulloblastoma
d. Arachnoid cyst
Ans. (a)
Ref. Nelson 18th edition,
15. The important fatty acid present in breast milk, which is important for growth is
a. Docosa hexaenoic acid
b. Palmitic acid
c. Linoleicacid
d. Linolenicacid
Ans. (a)
Ref. OP Ghai 6th edition.
MEDICINE
16. All of the following are preleukemic except?
a. Paroxysmal nocturnal haemoglobinuria
b. Paroxysmal cold haemoglobinuria
c. Myelo dysplastic syndrome
d. Aplastic anaemia.
Ans. (b)
KEF: Harrison 17th edition page 669,667,670
17. A female patient presents with history of Hb 6 g/dl. MCV 55, TLC 8000 cells/cum, PC -» 2.5 lakhs. She has no history of
transfusion. What is the diagnosis? ,
a. Anaemia of chronic disease
b. Iron deficiency anaemia
c. Thalassemia major
d. Thalassemia minor
Ans. (b)
Ref: Harrison page 17th edition page 641
18. All of the features are consistent with primary aldosteronism except
a. Diastolic hypertension without edema
b. Metabolic acidosis
c. Renin levels are low
d. High secretion of aldosterone inspite of reduced volume of fluid
Ans. (b)
Ref: Harrison 17th edition page 293
19. All of the following are true regarding SIADH except?
a. Vaptans are newly recomended drugs for treatment,
b. Water loading test is diagnostic
c. Urine Na+ is normal or low
d. Serum Na+ is < 125 m eq/l
Ans. (c)
Ref: Harrison page 2223, 17th
http://www.medscape.com/viewarticle/514125j6
20. Most common cause of Addison's disease in India
a. Idiopathic
b. Adrenal TB
c. HIV
d. Auto immune
Ans. (b)
Ref: NatlMedJ India. 2001Jan-Feb;14(1):23-5. Clinical profile and prognosis of Addison's disease in India. This study was done in SGPGI endocrinology department in INDIA. The conclusion of this study is as follows.
21. Which is the specific for rheumatoid arthritis?
a. IgM against Fc portion
b. IgG against Fc portion
c. IgA against Fc portion
d. AntiCCPAb
Ans. (d)
Ref: Harrison 17th edition page 2088.
22. All are true about brown sequard syndrome except?
a. Ipsilateral plantar extensor
b. Ipsilateral cortico spinal tract involvement.
c. Contralateral Dorsal column involvement.
d. Contralateral Spino Thalamic tract involvement.
Ans. (c)
Ref: Harhson 17th edition page 2589
23. A patient presented with abdominal pain, yellowish discolouration of sclera, clay coloured stools. All of the following are raised except?
a. 5' Nucleotidase
b. Glutamate Dehydrogenase
c. Alkaline Phosphatse
d. Gamma Glutamlyl Transferase.
Ans. (b)
Harrison 17th edition page 1925.
24. All are features of myelopathy except
a. Sensory loss of face
b. Brisk jaw jerk
c. Brisk knee jerk
d. Bladder incontinence urgency.
Ans.(a)
25. A 35 year old man having excessive sleep during work time attributing to disturbed sleep at night. He also has h/o falls in parties with friend's probable other symptoms he is having?
a. Generalised seizures while awake
b. Snoring with sleep apnea
c. Discomfort in legs before going to sleep
d. Hallucinations in sleep wake transition.
Ans. (d)
26. A 62 years old man presenting with focal seizures, renal clearance is good, drug of choice?
a. Valproate
b. Levateracitem
c. Oxcarbamezapine
d. Lamotrigine
Ans. (c)
Ref: Harrison page 2507, 17th edition
27. Hydrolysis by Hams test is positive. Which of the following is defective?
a. GPI Anchored protein
b. Complement deficiency
c. Spectrin binding
d. Mannose binding.
Ans. (a)
Ref: Harrison 17th edition page 661.
28. According to new world standards, false about Ml?
a. Sudden death can be due to Ml
b. 3 fold increase in Trop I following post CABG Ml
c. Recurrent Ml can be diagnosed by rise in troponin.
d. Echo test will show regional wall motion abnormalities.
Ans.(c)
Ref: Braunwald text book of cardiovascular medicine 8th edition 1383, 1208
http://ats.ctsnetjournals.Org/cgi/content/abstract/69/2/43
29. A Lady with no previous history of bleeding diathesis, Bleeding time is 3 minutes, PT 14V131, aPTT 35V251, plaletet count is 2.5 lakh. What is the likely diagnosis?
a. Lupus anticoagulant
b. vWB disease
c. Factor VIII inhibitor
d. Factor IX deficiency
Ans. (a)
Hair/son 17th edition page 1795.
30. D A patient has Hb 9 gram%. No previous history of transfusion MCV 60, RBC 4.5 million. What is the diagnosis?
a. Beta Thallessemia Minor
b. Beta Thallessemia Major
c. Iron deficiency anemia
d. Anemia of chronic disease
Ans. (a)>(c)
Ans. a.Beta Thallessemia Minor > c. Iron deficiency anemia
Ref: Harrison page 17th edition page 641
31. Dialysis related Amyloidosis is due to?
a. Beta2 microglobulin
b. AA
c. ATTR
d. AL
Ans. (a)
Ref: Harrison 17th edition page 2145.
32. In MS drug used to prevent EDSS?
a. IFN-Beta
b. Glatiramer acetate
c. Natalizumab
d. Methotrexate.
Ans. (a)
Ref: Harrison page 2617, 17th edition
33. A child presents with clinical features suggestive of demyelination. The chance of progression to MS is least with which of the following?
a. Absent oligoclonal band
b. Bilateral visual loss
c. Poor recovery
d. Complete cord transaction
Ans. (a)
Harrison's 18th ed. Chapter 380, Topic: Prognosis.
34. In Alzheimer's which of the following is not seen?
a. Aphasia
b. Acalculia
c. Agnosia
d. Apraxia
Ans. None of the above
REF: Hamson's 18th ed. Chapter 371. Topic: Alzheimer's diseaseg * / Clinical Manifestations).
35. A patient with hematuria and hypercalciuria, which is seen in urine analysis?
a. Isomorphic RBCs
b. Eosinophiluria
c. Nephrotic Range proteinuria
d. Dysmorphic RBCs
Ans. (a) Isomorphic RBCs
REF: Harrison's 18th ed. Chapter 44. Topic: Hematuria, Pyuria and) Casts.
36. Which of the following is not associated with systemic osinophilia and renal failure?
a. Drug induced
b. Radio contrast induced
c. Athero embolic induced
d. Polyangitis nodosa
Ans. (b)
Ref: Harrison's 18th ed. Chapter 279. Topic: Acute kidney injury/ Blood laboratory findings).
37. A patient with Bilateral radiologically proved VUR / reflux Nephropathy, with Nephrotic range proteinuria. What is the probable type of GN seen in this patient?
a. FSGS
b. Membranous GN
c. Membranoproliferative GN
d. Nodular sclerosis GN
Ans. (a)
REF: Harrison's 18th ed. Chapter 285. Topic:Vesicoureteral Reflux and Reflux Nephropathy.
38. A patient presents with one month history of fever, headache and 2days history of altered sensorium with CT brain showing basal meningitis. CSF analysis more likely will show?
CSF-protein CSF-Sugar Cytology
a. Increase Decrease Lymphocytosis
b. Increase Normal Lymphocytosis
c. Increase Normal ??
d. Increase Normal Neutrophil
Ans. (a)
Ref. Harrison’s 18th ed. Chapter 165. Topic Tuberculous meningitis and Tuberculoma.
39. In a case of renal papillary necrosis following tests are needed for establishing the diagnosis except?
a. Urine PCR for TB
b. Urine culture r
c. Acidification of urine test
d. Sickling
Ans. (c)
REF: Harrison's 18"ed. Chapter285. Topic: Sickle Cell Nephropath
40. In critically ill patient admitted in ICU, all are adequate measures taken to treat based on clinical trials except?
a. Use of low tidal volume will decrease acute lung injury
b. Aggressive goal directed reperfusion therapy, hourly monitoring of CVP, BP, urine output is adequate
c. Strict monitoring of glucose level in hyperglycemic patients known to improve survival
d. Use of Drotrecogin alpha is restricted for patients with APACHE score II > 25
Ans. (c)>(b)
Ref: Harrison's 18th ed. Chapter 267. Topic: Nutrition and Glyceml Control
41. Transcranial patch for Parkinson's disease?
a. Levodopa
b. Apomorphine
c. Rotigotine
Ans. (c)
Ref: Harrison's 18thed. Chapter372. Topic: Treatment: Parkinson's Disease.
42. A elderly man, known case of AS presents with syncope. He develops fatigue after 11 minutes of exercise while performing TMT as per BRUCE protocol. With ECHO, Systolic pressure gradient is found to be 60 mmHg. What is the most Appropriate management?
a. Coronory angiography
b. Follow up
c. Aortic balloon valvuloplasty
d. Valve replacement
Ans. (d)
Ref: Braunwald's Heart Disease 9th ed. Page:1472.
43. Which of the following is not a limb girdle dystrophy?
a. Spinocerebellar ataxia
b. Supranuclear palsy
c. Corticobasiler degeneration
d. Multiple system atrophy
Ans. (b)
Ref: Harrison 16th Edn., p. 2413-2414
44. Which of the following exclusively involve neurouns
a. Spinocerebeelar ataxia
b. Supranuclear palsy
c. Corticobasilar degeneration
d. Multiple system atrophy
Ans. (a)
Ref. Harrison’s 16th ed. P. 2413-2414
45. Lady 25 yrs-fever 1 month, ataxia, head ache, imaging showing dilated ventricles, meningeal enhancement. Likely CSF finding
a. Lymphocytic pleocytosis, low sugar, high protein
b. Lymphocytic, low sugar, low protein
c. Lymphocytic, high sugar, low protein
d. Neutrophilic, low sugar high protein
Ans. (a)
Ref. Harrison 17th edition, page 1009, 1012, 1018
46. A months pregnant lady a konow case of juvenile myoclonicepilepsy onsoddium valproate, presents to you, what is your advice?
a. Stop valproate & shift to lamotrigine
b. Contine valproate and monitor the serum levels
c. Give valproate & add lamotrigine
d. Change to carbamazepine
Ans. (b)
Ref. Harrison 17th edition, page 2500
47. Diabetes is best diagnosed by
a. FBS 100 and PPBS 140
b. FBS > 125 and PPBS>199
c. HbA1c =5.5%
d. FBS more than 70
Ans. (b)
Ref. Harrison text book of medicine 18th table 344-2
48. A 25 year old lady on treatment for rheumatoid arthritis has the following lab findings.-Haemoglobin -6g, MCF-60fl, RBC=2.5 laksh, Ferritin-200ng/ml. Transferrin-298 mg/dl iron-=30. What is the probable diagnosis?
a. Thalassemia
b. Autoimmune hemolytic anemia
c. Anemia of chronic disease
d. Iron deficiency anemia
Ans. (c)
Ref. Harrison Text Book of Medicine, 18th edition, Table 103-4
PHYSIOLOGY
49. Tidal volume excessive load din prevented by
a. Bronchial stretch receptor
b. J receptor
c. Arterial baroreceptor
d. Thoracic muscle spindle
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.627, 632
50. Anticoagulant of choice for anticoagulant assay
a. 3.2% trisodium citrate
b. Heparin
c. EDTA
d. Sodium Oxalate
Ans. (a)
Ref. Diagnosis of hemophilia and bleeding disorders 2nd edition p.11
51. Not the primary action of GUT flora
a. Mucus Fermentation
b. Vit. K Fomation
c. Control of epithelial proliferation
d. Undigested fat converted to short fatty acids
Ans. (a)
Ref. Ganong’s Review of Medical Physiology 23rd edition p.458
52. True regading Prothromin Times is
a. Collected sample should be refrigerated immediately
b. Platelet rich plasma
c. Run within 2 hours
d. Activated by kaolin
Ans. (c)
Ref. Diagnosis pf Hemophilia and bleeding disorders 2nd edition p.10 to 12, 37, 40
53. About 3rd nerve palsy all are true except?
a. Ptosis
b. Diplopia
c. Outward Deviation of Eye
d. Miosis
Ans. (d)
Ref. Ganong’s review of medical physiology 23rd edition p.263
54. Dilator Pupillae supplied by
a. Postganglionic parasympathetic. Edinger westphal nucleus
b. Postganglionic sympathetic from cervical sympathetic chain
c. 3rd cranial nerve
d. Sympathetic fibres of fronto orbital branch of tringeminal nerve
Ans. (b)
Ref. Ganong’s review of medical physiology 23rd edition p. 261 -265
55. All are correct except
a. Glucose concentration of glomerular filtrate same as plasma
b. Oncotic pressure in efferent arteriole is less than that of afferent arteriole
c. Contriction of afferent arteriole decreases the capillary pressure
d. Hematocrit increased as blood travels through glomerulus
Ans. (b)
Ref. Ganong’s Review as blood travels through glomerulus
56. All occur in hypothermia except?
a. Total peripheral resistance decrease
b. Cardiac arrythmia
c. Renal failure
d. Reversible co-agulopathy
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.286
57. LDL Receptors-True except
a. Exclusively extrahepatic
b. Cell to cell receptor medicated endocytosis
c. Clathrin coated Pits
d. LDL Receptors are down regulated on increase cholesterol in tissues
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.27
58. Mean arterial pressure is calculated as (Repeated AIIMS Nov. 2006)
a. (SBP +2DBP)/3
b. (DBP+2SBP)/3
c. (SBP+3DBP)/2
d. (DBP + 3SBP)/2
Ans. (a)
Ref. Ganong, 22nd Edn., p. 587-588
BIOCHEMISTRY
59. CPT 1 is ihbited by
a. Glucose
b. Acetyl COA
c. Malonyl COA
d. Pyruvate
Ans. (c)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 184-186
60. In well fed state, gluconeogensis in liver is inhibited by
a. Alanine content in liver
b. Protein breakdown in muscle
c. ADP level
d. cGMP
Ans. (c)
Ref. Harper’s Illustrated Biochemistry 28th edition p.137 to 139
61. Insulin amino acid sequence and molecular structure discovered by, and he got noble prize for the same?
a. Sanger
b. Banting and best
c. Edman
d. McLeod
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.24-25
62. For Commercial preparation of insulin, by recombinant technology first step is isolation of
a. DNA from lymphocytes
b. DNA from beta cells
c. mRNA from lymphocytes
d. mRNA from beta cells
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p.388-403
63. Not Needed in PCR
a. Deoxyribonucleotide
b. Dideoxyribonucleotide
c. DNA template
d. Thermostable polymerase
Ans. (b)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 394, 395
64. Subtelomeric rearrangements can be dianosed by except
a. FISH
b. MAPH
c. MALDI
d. CGH
Ans. (c)
Ref. Tietz textbook of clinical chemistry 4th edition p. 1123 to 1131
65. All are true about oxygenase except
a. Incorporation of 1 oxygen ATOM
b. Incorporation of 2 oxygen ATOM
c. Involved in hydroxylation
d. Involved in carboxylation of steroids
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 51-52
66. CAP in LAC operon
a. Positive regulator
b. Negaive regulator
c. Operator
d. Promoter
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.371 to 373
67. Which is not required for translation or protein synthesis in eukaryotes
a. Ribosomes
b. Peptidyl transferase
c. Amino acyl tRNA synthetase
d. RNA polymerase
Ans. (d)
Ref. Herper’s Illustrated Biochemistry 28th edition p. 353
68. A 30 yrs old man with LDL-600 mg/dl and THL -140 mg/dl which of the following is manifestation?
a. Tendon xanthoma
b. Eruptive xanthoma
c. Plantar xanthoma
d. Lipemia retinalis
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 232
69. If 4 nucleotides code for an amino acid, theoretically how many amino acids are possible?
a. Same quaternary structure
b. Same nomenclature & number
c. Same site of action & kinetics
d. Same tissue distribution
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 56
70. Which is true statement of isoenzymes
a. Same quaternary structure
b. Same nomenclature & number
c. Same site of action & kinetics
d. Same tissue distribution
Ans. (b)
Ref. Harper’s Illustrated biochemistry 28th edition p.56
71. Poly (A) tail codes for which amino acid
a. Poly lysine
b. Poly alanine
c. Poly proline
d. Poly glycine
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 354
72. About PTH regulation false is?
a. Un ionized Ca2+directly regulates PTH secretion
b. Magnesium has the miliar actions as that of Ca2+
c. Parathramone related protein is responsible for Hypercalcemia in cancer
d. Ca SR in parathyroid respnnsible for calcium regulation
Ans. (a)
Ref. Ref. Harper’s Illustrated Biochemistry 28th edition p. 439 to 440
73. Chemical barrier which prevents bacterial colonization in all microbial exposed areas?
a. Glycogen
b. Lysozyme
c. Lactose
d. Acidic pH
Ans. (b)
Ref. Herper’s Illusrated Biochemistry 28th edition p.35
74. Alanine is increased in blood, in starvation because
a. Increased muscle breakdown
b. Increased glucogenic fatty acid
c. Increased permeability of capillaries
d. Decreased alanine usage in gluconeogensis in liver
Ans. (a)
Ref. Haper’s Illustrated biochemistry 28th edition p.137 to 140
75. On prolonged starvation, which maintain rate of gluconeogenesis in liver?
a. Alanine pool in liver
b. Fatty acid pool in liver
c. Decreased CAMP
d. ADP in liver
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.137 to 140
76. Chymotripsinogen is a
a. Zymogen
b. Carboxypetidase
c. Transaminase
d. Elastase
Ans. (a)
Ref. Lippincott 3rd edition pg-440, Harper 26th edition, p-477
77. More than one codon coding for single amino acid
a. Degeneracy
b. Frame shift mutation
c. Transcription
d. Mutation
Ans. (a)
Ref. Harper 28th edition
78. A PHC medical officer wants to send blood sample for glucose estimation to a district hospital. What is the preservative that should be used?
a. EDTA
b. Calcium oxalate
c. Potassium oxalate +NaF
d. Potassium oxalate* NaI
Ans. (c)
Ref. Clinical Chemistry by Tietz, p.82
79. Chromosomal mutations can be identified from all except
a. Single stranded conformation polymorphism
b. Dideoxy nucleotide trail sequencing
c. Agarose gel electrophoresis
d. Denaturing Gradient Gel Electrophoresis (DGGE)
Ans. (c)
Ref. Tietz Textbook of clinical chemistry 4th ed. P. 1111 to 1121
SURGERY
80. Motorcyclist, trauma due to fast moving vehicle, taken for emergency laparotomy, on left side normal, on right side non pulsatile, stable haematoma seen in contrast study (IVU) contrast is not taken, all vessels are normal. What is the next step in management?
a. On table cystourethrography
b. Nephrectomy
c. Seperation of Gerota’s fascia and exposure of renal vessels
d. On table renal arteriography
Ans. (c)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1465-66 Table 40.2
81. On USG finding in Congenital Hypertorophic pyloric stenosis what is not seen?
a. >95% cases it is accurate
b. Length of Seg. >16mm
c. Thickness >4mm
d. High gastric residue
Ans. (d)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1425-26
82. Most common site of cholangiocarcinoma is?
a. Perihilar
b. Intrahepatic duct
c. Distal biliary duct
d. Multifocal
Ans. (a)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1162, Fig.32.26
83. Inexperienced surgeon is operating for cholecystectomy accidentally found CBD stone. What is further best management?
a. Laproscopic cholecystectomy with laparascopic stone removal
b. Open cholecystectomy with CBD exploration
c. Conversion to open cholecystectomy with choledhocoduodenostomy
d. Removal of stone through cystic duct
Ans. (B)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1152-53
84. Post surgery Ileus maximum manifestation common by
a. Colon
b. Ileum
c. Stomach
d. Duodenum
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9/ed. P. 992
85. Post operative complication of Iloe anal pouch amastomosis in ulcerative colitis?
a. Small bowel obstruction
b. Pouchitis
c. Perianal complication
d. Pelvic abscess
Ans. (b)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1032
86. Which of the following enzyme is not used for prognosis acute pancreatitis?
a. Serum amylase
b. Serum calcium
c. Serum glucose
d. Serum lipase
Ans. (a)
Ref. Schwart’s Principles of Surgery, 9/ed. P. 1181, 83 & Tables
87. Which fruit juice helps in preventing UTI
a. Grape
b. Raspberry
c. Cranberry
d. Orange
Ans. (c)
Ref. Harrison 17th edition page 2469
88. A person presented with H/O RTA, there was anaesthesia below the level of umbilicus, and bladder and bowel disturbances, tenderness present over D10-D12 Vertebrae pulse steroid therapy to be instituted is
a. 30mg/kg within 2 hours
b. 60 mg/kg within 9 hours
c. 75 mg/kg within 12 hours
d. 45 mg/kg within 6 hours
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9/ed. P 1530
89. Trauma to which of the following artery will produce least damage to the organs?
a. Superior mesenteric artery
b. Inferior mesenteric artery
c. Celiac trunk
d. Renal artery
Ans. (b)
Ref. Schwartz’s principles of surgery, 9/edn.
90. Calcification around Foramen of Monro, with preiventicular infiltrate, raised intracranial tesnsion mass and below 3rd ventricle is seen in?
a. Ependymoma
b. Sub epedydomal-astrocytoma
c. Neuronal-cyst
d. Central neurocytoma
Ans. (b)
Ref. www.icdns.og/forums/index.php?showtopic=23.radiopaedia.org/articles/subependymal-giant-cell-astrocytoma
91. True about peripheral vascular disease in the lower limb are all except
a. Ankle brachial index<0.5 indicate sever ischemia
b. Smoking is more specific for peripheral vascular disease than for cardiovascular disease
c. ABI changes during exercise than at rest
d. L-arginine causes Ednothelial independent Vasodilation
Ans. (d)
Ref. Schwartz’s Principles of Surgery, 9th ed.,p.704
ANATOMY
92. Which of the following is not a part of superficial perineal pouch
a. Posterior scrotal artery
b. Bulbo spongiosis
c. Sphinter urethrae
d. Ducts of bulbourethral glands
Ans. (c)
93. Which of these is lateral to SAC of femoral hernia?
a. Femoral artery
b. Femoral vein
c. Femoral nerve
d. Lateral cutaneous nerve of thigh
Ans. (b)
Ref. Schwartz’s Principles of surgery, 9 ed. P. 1312
94. Investigation of choice for Zenker’s diverticulum
a. Barium Swallow
b. Manometry
c. Ednoscopy
d. Dual CT
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9 ed. P 848
95. The structure not passing through oesophageal hiatus is
a. Right phrenic nerve
b. Left gastric artery
c. Right vagus
d. Left vagus
Ans. (a)
Ref. B.D Chaurasia’s human anatomy, volume –II 4/e p. 310
96. Which does not from liver capsular plate
a. Ductal plate
b. Hilar plate
c. Umbilical plate
d. Cystic plate
Ans. (a)
Ref. J hepatobiliary Pancreat Surg., 200; 7(6) 580-6
97. Which of the following is not associated with a defect in neural migration?
a. Lissencephaly
b. Schizencephaly
c. Polymicrogyria
d. Focal cortical brain maldevelopment
Ans. (d)
Ref. NINDS [National Institute of Neurological Disease & Stroke]/NH.
http://www.ninds.nih.gov/disorders/neuronal_migration/neuronal _migration.htmh
PHARMACOLOGY
98. Dugs not used in Multiple Sclerosis
a. Glatiramer
b. IF β 1a
c. IF β 1b
d. Mycophenolate
Ans. (d)
99. Efavirenz is
a. Reverse transcriptase inhibitor
b. Protease inhibitor
c. Integrase inhibitor
d. Inhibitor entry of HIV into cell
Ans. (a)
100. Brinzolamide is
a. Highly selective competitive antagonist and reversible inhibitor of CA inhibitor
b. Highly selective competitive antagonist and irreversible inhibitor of CA inhibitor
c. Highly selective noncompetitive antagonist and reversible inhibitor of CA inhibitor
d. Highly selective noncompetitive antagonist and irreversible inhibitor of CA inhibitor
Ans. (c)
101. True about Octreotide is
a. Stimulates GI secretion
b. Prevents secretary diarrhea
c. Can be given orally
d. Cannot be used in acromegaly
Ans. (b)
102. Wrongly matched optons, regarding drug metabolism is
a. Calcium channel blocker-CYP344
b. Digoxin-P.Glycoprotein
c. Simvastatin-Glucoronide conjugation
d. Carvedilol-CYP2A6
Ans. (d)
103. Bremelanotide is used in
a. Erective dysfunction
b. Prostate carcinoma
c. LUTS
d. Renal CA
Ans. (a)
104. 1% Pilocarpine instilled to a person with dilated pupil. It does not constrict
a. Diabetic with IIIN palsy
b. Pharmacological blockade
c. Adie tonic pupil
d. Uncal herniation
Ans. (b)
105. After giving Thiazine diuretic for HTN. What is seen in 24 hour urine is
Na+ K+ Ca+
a. ↑ ↑ ↑
b. ↓ ↑ ↑
Or
b. ↓ ↓ ↑
c. ↑ ↓ ↑
d. ↑ ↑ ↓
Ans. (d)
106. Most recent oral direct thrombin inhibitor
a. Dabigartran
b. Danaparoid
c. Ximalagatran
d. Fondaparinux
Ans. (a)
107. Peripheral conversion of T4 to T3 is inhibited by all except
a. Propylthiouracil
b. Propranolol
c. Methimzole
d. Amiodarone
Ans. (c)
108. Lid retraction is caused by
a. Apraclonidine
b. Brimonidine
c. Travoprost
d. Danoprost
Ans. (a)
109. Ozurdex:
a. Dexamethasone 0.7%
b. Hydrocortisone
c. 0.7% Triamcinolone acetonide
d. 0.5% Triamcinolone acetonide
Ans. (a)
110. MRSA resistance the following drug should not to be used is
a. Cefaclor
b. Cotrimoxazole
c. Ciprofloxacin
d. Vancomycin
Ans. (a)
111. Chloroquine toxicity predisposed by all except
a. Total daily dose of > 350 mg
b. Cumulative does of 460 gm
c. Renal failure
d. Given for more than 2 yrs
Ans. (a)
112. Adrenaline, noradrnaline dopamine acts through which receptor
a. Seven pass receptor
b. Four pass receptors
c. Single pass
d. Ligand gated receptor
Ans. (a)
MICROBIOLOGY
113. A 5 year old boy with a pustular lesion in the leg. The isolate shows Gram +Ve cocci colony shows β Hemolysis. Which test helps to identify the organism?
a. Bile solubility
b. Optocain sensitivity
c. Bacitracin sensitivity
d. Novobiocin sensitivity
Ans. (c)
114. Which of the following Regarding bacterial Resistance is not true?
a. Most Bacterial Resistance is due to Production of peinicilin Degrading enzymes
b. Plasmid Mediated Resistance is always transmitted vertically only
c. Most Enterococcal Species produce Resistance by degrading target receptor (PBP)
d. Complete elimination of the target by pneumococcus species
Ans. (b)
Important references:
1) http://jac.oxfordjournals.org/content/56/3/463.ful.pdf
2) http://www.horizonpress.com/cimb/v/v5/10/pdf
3) http://www.ncbi.hlm.nih.gov/pubmed/2187594
4) http://www.medscape.com/viewarticle/494612_2
115. A 22 year male H/o burning micturition and urinalysis showed No organisms but abunadant puss cells. Which of the following is the diagnostic modality?
a. Mc Coy cell culture
b. Thayer martin medium
c. Cooked neat Broth
d. Levinthal medium
Ans. (a)
116. A 70 year old man presented with fever and dry Cough, a gram negative organism shows growth only in charcoal yeast agar the organism is?
a. Legionella
b. Pneumococcus
c. Bartonella
d. H. influenza
Ans. (a)
117. Bacteria coated with complement & Ig, phagocytosis is enhanced by?
a. Receptor mediated Endocytosm
b. Pseudopod formation
c. Myelperoxidase mediated destruction
d. C3b-Fc mediate Destruction
Ans. d>c
118. Which is used as an indicator in autoclave
a. Bacillus subtillus
b. Bacillus stearothermophilus
c. C. perfringens
d. C. tetani
Ans. (b)
Ref. http://ehs.virginia.edu/biosafety/bio.documents/autoclaving_Guidlines.pdf & http://www.ehs.iastate.edu/cms/defaultasp?ID=31&=article (the Virginia state policy and the lowa state university principles)
119. A patient admitted to ICU is on central venous line for last one week. He is on ceftazidine and amikacin. After 7 days of fever he develops a spike of fever. On his blood culture, gram positive cocci in chains are found, while are catalase negative. So he was started on vancomycin, but culture remained positive for same organism even after two weeks of therapy, most likely organism?
a. Staph.aureus
b. Viridian streptococci
c. Enterococcus faecalis
d. Coagulase negative staphylococcus
Ans. (c)
120. False about bacteroides is
a. LPS from bacteroides is structurally and functionally different from conventional endotoxin
b. Most common organism isolated in culture
c. DIC and shock common in septicaemia due to bacteroids
d. Not uniformly sensitive to metronidazole
Ans. (c)
121. Maternal to child transmission of HIV is prevented by?
a. Nevirapine
b. Lamivudine
c. Didanosine
d. Abacavir
Ans. (a)
P.S.M
122. Socialization medicine does not includes?
a. Eliminates competition between the doctor?
b. Free of cost health provisions by state
c. Ensures complete utilization of health services
d. Ensure universal coverage of health services
Ans. (c)
Ref. Par textbook of preventive & social medicine 21st edition p.9
123. Direct standardization is used for comparing mortality rates between two countries. This is doen because of difference in:
a. Age distribution
b. Neumerator
c. Denominator
d. Sex
Ans. (a)
Ref. Park textbook of preventive and social medicine 21st edition page 55)
124. INA study in UK, and association was found between increase in sale of anti arrhythmic drugs and deaths related to asthma over 15 years. This is an example of which study?
a. Case control
b. Cohort
c. Prospective study
d. Ecological study
Ans. (d)
Ref. Modern Epidemiology, 3rd Edition. Rothman, Kenneth J; Greenland, Sander; Lash, Timothy L)
125. For the diagnostic of SLE, 6 tests are employed in dat 4 are positive, 2 are negative. To know the probability of SLE
a. Sensitivity and specificity of each test/prior probability of SLE in that area
b. Incidence of SLE and predictive value of each test
c. Incidence each prevalence of SLE
d. Relative risk of SLE in the patient
Ans. (a)
Ref. Textbook of public health and community medicine WHO-AFMC)
126. Hardy-weinber equilibrium is affected by all except
a. Mutation
b. Migration
c. Small population
d. Random mating
Ans. (d)
Ref. A Dictionary of Epidermiology, Fifth Edition Oxford University press, 2008)
127. Hardy Weinberg law is violated in
a. Non-random mating
b. Mutation
c. Small population
d. Gene flow
Ans. (c)
Ref. Ganong’s Review of Medical physiology 23rd edition
128. Which of the following gives the most accurate result
a. Randomised controled trial with double blinding
b. Cohart Study
c. Cohart sectional study
d. Meta analysis /(systemic review analysis)
Ans. (d)
Ref. Basis & clinical Biostatistics, 4th edition Beth Dawson, Robert G. Trapp & Various sources)
129. For a blood sample, HB values are 9.1, 9.2, 10.2, 10.2, 9.3, 9.6, 9.7, 9.8
For the same sample of blood of calorimetric study the values are 10.1 gm/dl. The test has
a. High validity & high reliability
b. High validity & low reliability
c. Low validity & low reliability
d. Low validity & high reliability
Ans. (c)
Ref. Textbook of Public health and community medicine WHO-AFMC)
130. Syndromic management for genital ulcer disease in India, includes following
a. Chancroid chancre
b. Primary chanere, herpes genitalis
c. Chancroid, Primary chanere, herpes genitalis
d. Chancroid, genitalis only
Ans. (c)
Ref. Textbook of public health and community Medicine WHO-AFMC
131. Best method of compare a new test gold standard test is
a. Regression studies
b. Correlational analysis
c. Bland and altman analysis
d. Kimorogov schir
Ans. (C)
Ref. BJA 2007 & various sources)
ORTHOPEDICS
132. A 50 years old female presented with C/o unable to flex thumb, index finger, middle finger which of the test performed to make diagnosis except
a. Phalen test
b. Finkelstein test
c. Tinel sign
d. Tourniquest test
Ans. (b)
Ref. Campbell orthopaedic surgery; pg-3762
133. A diabetic patient presented with flexion deformity f 15 degrees of right little finger TOC?
a. Subtotal fasciectomy
b. Percutaneous fasciotomy
c. Total fasciectomy
d. Observation
Ans. (d)
Ref. Apleys system of orthopedics, Pg. 423, campbells orthopaedics surgery pg.3753
134. A cricketer got injured while catching the ball, complains of pain at base of thumb, which muscle to be injured
a. Abductor pollicis longus
b. Extensor pollicis brevis
c. Volar plate
d. Ulnar collateral ligament
Ans. (d)
Ref. apleys orthopedics, pg. 795, principals and practice of orthopaedics sports medicine pg.244
135. Gallow’s traction used for
a. # Tibia
b. # Femur
c. # Humerus
d. # Cervical spine
Ans. (b)
Ref. Maheshwari
136. In osteoarthritis which muscle get obviously waster or affected?
a. Only quadriceps
b. Quadriceps and hamstrings
c. Only popilteus
d. Gastroenemius
Ans. (a)
Ref. Apleys system of orthopedics
137. A patient with anterior dislocation of shoulder, what is the possible mechanism involved?
a. Abduction and internal rotation
b. Abduction and internal rotation
c. Abduction and external rotation
d. Abduction and external rotation
Ans. (c)
Ref. Apleys orthopedics
138. Spondylosthisis can be diagnosed by all except
a. CT
b. MRI
c. X ray spine AP view
d. Xray spine lateral view
Ans. (c)
139. Patient with c/o pain in the lower back. On examination unable to extend the grate toe right, but no sensory involvement. Probable disc prolapsed at
a. L3-L4
b. L4-L5
c. L5-S1
d. S1-S2
Ans. (b)
Ref. Campbell orthopaedic surgery pg-1999
140. CV junction malformations caused by all except
a. Rheumatoid arthritis
b. Ankylosing spondylitis
c. Odontoid dysgenesis
d. Basilar invagination
Ans. (b)
141. Which is not an indicator of bone formation
a. Alkaline phosphatase
b. Procollagen residue
c. Osteocalcin
d. Hydroxyproliine
Ans. (d)
Ref. Tureks system of orthopedics,
142. A patient presents with heterotopic ossicfication around the knee joint. The laboratory investigation of choice in him is.
a. Serum calcium
b. Serum alkaline phosphatase
c. Serum phosphorus
d. Serum Acid phosphatase
Ans. (b)
Ref. Wheeless textbook of orthopaedics; Garland D.E.A clinical perspective on common forms of acquired heterotopic ossification CORR No. Feb. 1991; Other Journal articles
RADIO DIAGNOSIS
143. How do you differentiate between epidermoid cyst and arachnoid cyst?
a. Contrast enhanced MRI
b. Smooth margins
c. Decreased flair
Ans. (c)
144. About hibernating myocardium all are true except
a. Low does dobutamine scar
b. After rest thallium scar
c. If akinesia revasculatisation will not help
d. Gadolinium scan is not done
Ans. (c)
Ref. Radiology Review Manual, -by Wolfgang Dahnert 6th edition
145. Charactersitic of cavernous hemangioma
a. Popcorn calcification
b. Well-defined nidus
c. Feeding arteries
d. Phelbectasia
Ans. (a)
Ref. Diagnostic Neuro radiology by Anne. G. Osborn 2nd edition
146. IOC for meningeal carcinomatosis
a. NCCT
b. MRI contrast enhanced
c. PET –CT
d. SPECT
Ans. (b)
Ref. Diagnostic Neuroradiology by Anne. G. Osborne 2nd edition.
147. A young male after 2 months of trauma presents with bilateral proptosis, chemosis, subconjuctival hemorrhage & inability to move eyes (cavernous sinus thrombosis) what is the IOC?
a. Intra arterial digital subtraction angiography
b. MR-angiography
c. MRI
d. CT
Ans. (b)
Ref. Nontraumatic Orbital Conditions: Diagnosis with CT and MR imaging in the Emergent Setting –radiographics
148. All of the following are used in deep wave therapy except
a. Microwave
b. Ultrasonic wave
c. Infrared
d. Heat wave diathermy
Ans. (c)
149. Radioresistant layer in retina
a. Pigment layer
b. Gangion well layer
c. Bipolar cell layer
d. Rods & cones
Ans. (a)
Ref: Strangeways Research Laboratory, Cambridge –International Journal of Radiation Biology
150. 45 year old female complains of progressive weakness and spasticity of the lower limb with difficulty during micturition. CT scan shows an intradural mid dorsal midline enhancing lesion. The diagnosis is?
a. Meningioma
b. Intradural lipoma
c. Neuroepithelial cyst
d. Dermoid cyst
Ans. (a)
Ref. Harrison’s 16th Ed. Pg 2456; Dahnert’s Radiology Review manual 5th Ed. P.299-301
OBS/GYNA
151. All changes are normal during pregnancy except?
a. Increase storke volume
b. Increased cardiac output
c. Increased systemic vascular resistance
d. Increased intravascular volume
Ans. (C)
Ref. Williams 22/ed, pg 133-134
152. Fetal karyotyping can be done by all except
a. Cordocentesis
b. Amniocentesis
c. CVS
d. Feta skin biopsy
Ans. (d)
Ref. Williams 22/ed., pg. 328-331
153. Glucose tolerance test is indicated in all except?
a. Previous congenital anomaly
b. Previous eclampsia
c. Polyhydramnios
d. Previous unexpected fetal death
Ans. (b)
Ref. American Diabetes Association. Standards of medical care in diabetes-2007. Diabetes Care Jan 2007
154. All are inaccurate regarding forceps delivery except?
a. The anteroposterior diameter of head should not be more than 15 degree to the axis
b. Vertex and face presentation in mento anterior
c. The presenting part should be at zero station
d. Caput succedaneum is not a contraindication
Ans. (b)
Ref. Williams 22/ed pg 549
155. 17 years old girl came to OPD with primary amenorrhea and b/l inguinal hernia. Normal secondary sexual characteristics with absence of pubic hair. On USG uterus and ovary absent
a. Androgen insensitivity synd.
b. Turners syndrome
c. Mulerian agenesis
d. STAR syndrome
Ans. (a)
Ref. SPEROFF 7th Ed. Pg.402-406
156. A 16 year old girl with 6x6 cm right ovarian mass with absent AFP, negative CA125 and increased ALP, diagnosis is
a. Dysgeminoma
b. Mucinous cystadeno carcinoma
c. Endodermal sinus tumor
d. Teratoma
Ans. (a)
Ref. Novak’s 14th ed.
157. In postmenopausal women. HRT helps in all except
a. Vaginal dryness
b. Hot flushes
c. Coronary artery disease
d. Osteoporosis
Ans. (d)
Ref. Speroff 7th ed. , pga.663, 700
158. Normal ovarian function is seenin
a. MRKH
b. Ovarian dysgenesis
c. Swyer syndrome
d. Turner’s syndrome
Ans. (a)
Ref. Spheroff 7th., pg. 420-421
159. Gestational hypertension causes all except?
a. HELLP synd.
b. Acute renal failure
c. Fetal macrosomia
d. Eclampsia
Ans. (c)
Ref. WILLIAMS 22nd Ed. Pg.774-780
160. Treatment for prenatal CAH
a. Dexamethasone
b. Beta methasone
c. Prednisone
d. Hydrocortisone
Ans. (a)
Ref. Speroff 7th Ed., pg.330-338
161. An infertile women with B/L tubal block at cornua diagnosed on Hysterosalpingography, next treatment of choice is
a. IVF
b. Laparoscopy & Hysteroscopy
c. Tuboplasty
d. Hydrotubation
Ans. (b)
Ref. Speroff 7th ed., pg. 1013-1037
162. Tumor marker for granulose cell tumor
a. CA 19-9
b. Inhibin
c. CA 125
d. CA 50
Ans. (b)
Ref. Novak’s 14th ed.
163. After coming head in breech presentation difficult labour all except
a. Placenta previa
b. Extension head
c. Hydrocephalus
d. Incomplete dilatation of cervix
Ans. (a)
Ref. Williams 22nd ed., pg. 566-570
PSYCHIATRY
164. Type D personality are at risk of developing
a. Coronary artery disease
b. Depression
c. Schizophrenia
d. Personality disorder
Ans. (a)
Ref. No direct reference could be got from standard textbooks
165. Somatic passivity is a feature of
a. Depressive illness
b. Paranoid schizophrenia
c. Hypochondriasis
d. Panic disorder
Ans. (b)
Re. New oxford textbook of psychiatry 4.7.3 Descriptive clinical features of schizophrenia
166. Bipolar type II, is characterized by
a. Hypomania and depression
b. Hypomania and subsyndromal depression
c. Mania and subsyndromal depression
d. Hypomania and Dysthymia
Ans. (a)
Ref. New oxford textbook of psychiatry 4.5.3 Diagnosis, classification and differential diagnosis of mood disorders
167. Which of the following is not a specific somatoform disorder?
a. Somatisation disorder
b. Chronic fatigue syndrome
c. Irritable bowel syndrome
d. Fibromyalgia
Ans. (b)
Ref. ICD-10 and DSM –IV criteria
168. Counter transference is
a. Patient’s feelings towards therapist
b. Doctors feeling towards the patient
c. Psychic connection between patient and disease
d. Type of Defence mechanism
Ans. (b)
Ref. New oxford textbook of psychiatry 6.3.5 Psychoanalysis, and other long-term psychodynamic psychotherapies
169. Associated with panic disorder are all except
a. Seratonin
b. GABA
c. Dopamine
d. Glutamate
Ans. (d)
Ref. Next oxford textbook of psychiatry 4.7.3 panic disorder and agoraphobia
DERMATOLOGY
170. Intra epidermal intercellular IgG deposition is seen in?
a. Epidermolysis bullosa acquistica
b. Dermatitis herpetiformis
c. Bullous pemphgoid
d. Pemphigus vulgaris
Ans. (d)
Ref.
(1) Fizpatrick et al-profile of immune flouroscent studies in pemphgus-Arch of Dermatology, 2006, p. 116, 285-290
(2) Meurer et al-oral pemphigus vulgaris-A report 15 cases-Arch of Dermatology-1987, p.113, 1520-1524
(3) Kolulu et al, Human auto-antibodies against desmosocal core protein in pemphigus, Jr. of Exp. Medicine 2002, p. 1509-1518
171. Which of the following shows deposition of IgA in dermal papilla?
a. Dermatitis herpetiformis
b. Bullous impetigo/bullous Pemphigoid
c. IgG dermatosis of childhood /igA papillomatosis of childhood
d. Gestational herpes
Ans. (a)
Ref.
(1) Collin P et al., Recogniton of cutaneous and immunofluorescent manifestation of D.H-Am J clin Dermatol, 207 p.4 :13
(2) Reunalatl et al., Dermatitis Herpetiformis-Clin Dermatol, 2001 p.19:728
172. Only indication of systemic steroids in which types of Psoriais?
a. Pustular Psoriasis
b. Erythroderma
c. Psoriatic arthropathy
d. Impetigo herpetiformis
Ans. (d)
Ref.
(1) Cather JP, 2006 Combining traditional agents and biologics for the treatment of Psoriasis-Arch of Dermatol, p.24-37.
(2) Goffe B, et al., 2004 Dermatoses of Pregnancy, Am.J. Obstet Gynecol, p.188: 863
173. A boy with multiple bullous lesions over trunk and radiological examination shoed periostitis. What is the next investigation of choice?
a. VDRL for mother and child
b. PCR of maternal TB
c. HBs Ag screening
d. ELISA for mother and baby
Ans. (a)
Ref.
(1) Wender GD at al: Treatment of Syphilis in pregnancy and prevention of Congenital Syphilis, Clin. Infect. DIs., 207, p 35-64
(2) Vrui M, et al., Bone involvement in Congenital syphilis-An overview Clinical and Radiological, 2003, EUr J. Paediatr, p.162-184
174. A 5 years old boy presented in the casualty with multiple petechial hemorrhages. Lab investigation showed IgA deposits. Along the blood vessels the most likely diagnosis
a. Wegener’s granulomatosis
b. Henoch schonlein purpura
c. Kawasaki disease
d. PAN
Ans. (b)
Ref.
(1) Paller et al. lung lesions –Pulmonary hemorrhage-Complication of HSP, pediatr. Dermatol, 2002, p.14-299
(2) HSP An Overview –Clinical and Histological -Tancreede et al., Arch. Dermatol, 2005, P. 133-438
175. Treatment of choice for Kawasaki disease is?
a. Steroids
b. IV immunoglobulin
c. IV antibiotics
d. Methotrexate
Ans. (b)
Ref.
(1) Burns Jc, Glode MP: Kawasaki syndrome Lencet, 2007, p.364- 533
(2) Esper F et al: Association between a novel human corona virus and Kawasaki disease J inject. Dis 2005, p.191: 499
(3) Muta H, et al: Early intravenous gamaglobulin treatment for Kawasaki disease, Arch Dis child, 2004, p.89: 779
(4) Yamanchi H et al: optimal time of surgical treatment for Kawasaki Coronary artery disease J. Nippon med Sch 2004 p. 71: 279
176. A 20 year old man presented with recurrent oral ulcer with yellow base, erythematous hallow and nodules on skin probable diagnosis?
a. Drug eruption
b. Pemphigus vulgaris
c. Behcet’s syndrome
d. Herpes labialis
Ans. (c)
Ref.
(1) Arayssi et al: New insights into Pathogenesis and therapy of Behcets disease- Curr. Opin. Pharmacol, 2004, p.4: 183
(2) Bang D: clinical Spectrum of Behcets, J.Dermatol, 2007, p.28: 610
(3) Ghaten et al: Behcets and complex Aphthosis J.Am Acad. Dermatol, 2005 p.40:1
177. A 3 year old child has inthiotic lesion over scalp, face and extensor extremities. Mother gives H/O bronchial asthma. Diagnosis?
a. Atopic dermatitis
b. Seborrhoeic dermatitis
c. Contact dermatitis
d. Infantile eczematons dermatitis
Ans. (a)
Ref.
(1) Breuer at al: Safety and efficacy of Topical Tacrolimus in Childhood Atopic Dermatitis, 206, Am J. clim Dermatol, p.6: 65
(2) Stone KD: Atopic Diseases of Childhood, Curr. Opin. Paediatric.,2008, p. 15:495
(3) Wadonda N et al: A perspective Study of Atopic Dermatitis in Children, BR. J. Dermatol. 2005, p. 149: 1023
F.S.M
178. Patient diagnosed with delirium tremens assaulted his neighbor, after 4 days of abstinence from alcohol, this offence is
a. Punishable-criminal offence
b. Not punishable under section IPC 84
c. Partially responsible for his act
d. He is not responsible for his act
Ans. (b & d)
Ref. the essentials of Forensic Medicine and Toxicology by Dr. K.S Narayana Reddy, 28/e; (Chapter 21-Forensic Psychiatry & Chapter 3-CNS depressants) p.411 & p. 510-511, pg. 423, chapter 21, Forensic Psychiatry
179. What is the punishment for medical negliance?
a. 2-5 years
b. 5 years
c. 10 years
d. Upto 2 years
Ans. (d)
Ref. The essentials of Forensic Medicine and toxicology, by Dr. K S Naryana Reddy , 28/e;(Chapter 3-medical Low and Ethics) p.34
180. IPC for hostile witness?
a. 151
b. 191
c. 141
d. 171
Ans. (b)
Ref. The Essentials of Forensic and Toxicology, by Dr. K.S Naryana Reddy, 28/e: (chapter 2 –legal procedure) p.11
181. According to human organ transplantation act (1994), the erring doctor can be punished upto?
a. Less than 1 yr
b. Less than 2 yrs
c. >5 yrs
d. 2-5 yrs
Ans. (d)
Ref. the essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e: (Chapter 3-Medical Lw and Ethics) p.51
182. Issue of false medical certificate, is punishable under IPC?
a. 147
b. 157
c. 197
d. 137
Ans. (c)
Ref. The Essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e; (Chapter 2-legal procedure) p.8
183. Stackes formula of teech is used for age group?
a. Infants
b. Old age
c. 25-50 years
d. Above 50
Ans. (a)
Ref. the Essentials of forensic Medicine and toxicology by Dr. K.S Narayana Reddy, 28/e ; (Chapter 4-identification) p.64
184. Flaying is a feature of which laceration
a. Tear
b. Streatch
c. Avulsion
d. Split
Ans. (c)
Ref. The Essentials of Forensic Medicine and toxicology,by Dr. K.S Narayana Reddy, 28/e; (Chapter 8-mechanical injuries) p.167
185. First ossification centre formation in intra uterine life
a. End of 2nd month
b. 3 month beginning
c. End of 3rd month
d. End of 4th month
Ans. (a)
Ref. The essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e; (Chapter 4-idntification) p-74
186. Which is an incorrect match?
a. Murder-300
b. Culpable homicide not amounting to murder-304
c. Attempted suicide-306
d. Attempt murder-307
Ans. (c)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; Chapter 10-Medico-legal Aspects of Wounds) p. 255-265
187. Best specimen for DNA testing in autopsy is
a. Liver
b. Brain
c. Kidney
d. Spleen
Ans. (d)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; (Chapter 20-Blood stains) p.408
188. In palate printing most common site for taking prints
a. Posterior part of palate
b. Anterior part of palate
c. Lateral part of palate
d. Middle part palate
Ans. (b)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; (Chapter 4- identification) p.78
OPHTHALMOLOGY
189. MIZOU phenomenon seen in
a. Oguchi’s disease
b. Choroidermia
c. Flavus albipunctatus
d. Flavus
Ans. (a)
Ref. kansky 6/e p. 683, 692
190. Drug used in LUMINATE programme for non infections uveitis is
a. Cyclosporine
b. Voclosporine
c. Methotrexane
d. Infliximab
Ans. (b)
Ref. www.luxbio.com
191. Azithromycin given for mass propylaxis, if prevalence of trachoma in children of 1-9 years is more than?
a. 10%
b. 6%
c. 8%
d. 4%
Ans. (a)
Ref. Parsons and internet –wikipedia
192. A young man following RTA presented with proptosis and pain in right eye after four days. o/E bruise on forehead and Rt eye what is the cause?
a. Cavernous sinus thrombosis
b. Internal carotid A.Aneurysm
c. Carotico cavernous fistula
d. Fracture of sphenoid
Ans. (c)
Ref. Parson’s 20/e
193. A young female presented with severe sudden bilateral visual loss more on right side with no perception of light. o/E fundus, Pupillary response, optokinetic nystagmus is normal, what is the cause?
a. Functional visual loss
b. Optic neuritis
c. Anterior ischaemic optic neuropathy
d. CMV retinitis
Ans. (a)
Ref. Kanski 6/e
194. Endothelial cells lost in descemet membrane striping in ________keratoplasty?
a. 0.5%
b. 10-20%
c. 30-40%
d. 50-605
Ans. (C)
Ref. Corneal surgery Frederick S.Bright –Bill 4/e p. 66-67
195. In herpes zoster ophthalmicus all are present except
a. Pseudodendritic keratitis
b. Ant stromal keratitis
c. Sclerokeratitis
d. Endothetitis
Ans. (c)
196. Founders of vision 2020 are all except
a. WHO
b. UNICEF
c. ORBIS international
d. Agency for control of blindness
Ans. (b)
Ref. Vision 2020 CME series
ANAESTHESIA
197. Which of the following in anesthesia will produce decreased EEG activities
a. Hypothermia
b. Early Hypoxia
c. Ketamine
d. N20
Ans. (a)
Ref. Textbook of Anesthesia, Aitkenhead 2nd edition, p.187
198. Which of the following is not true about xenon anesthesia
a. Non explosive
b. Minimal cardiovascular side effects
c. Slow induction and slow recovery
d. Low blood gas solubility
Ans. (c)
Ref. www.expresshealthcaremgmt.com/20050515/criticare10.shtml A to Z text of Anaesthesia
PATHOLOGY
199. Endothelial retraction due to cytoskeletal rearrangement in acute inflammation is?
a. Immediate & Transient increased permeability
b. Immediate & prolonged permeability
c. Late & transient permeability
d. Late & prolonged permeability
Ans. (a)
Ref. Robbins and Cotrn pathologic Basis of Disease, 8/E
200. The 40 nm gap in between the tropocollagen molecule in collagen which server as the site of bone formation is occupied by which of the following
a. Calcium
b. Iron
c. Carbohydrate
d. Ligandmoiety
Ans. (a)
Ref. Robbins and cotran pathologic Basis of Disease, 8/E.h
201. Alzheimer’s disease, false?
a. Number of Neural plaques increase with age
b. Neural tangles and severity are directly proportional
c. Extracellular lesions occurs without intracellular lesions
d. Pressure of tau proteins
Ans. (c)
PGDIAMS
1. Which of the following worsens of PGE 1 administration
a. Pulmonary stenosis without VSD
b. Obstructed TAPVC
c. Hypoplastic left heart syndrome
d. Aortic interruption
Ans. (b)
Ref: Nelson 18th edition 1901, 1912, 1924, 1928
2. 7 days old baby with leakin meningo myelocele. First choice of investigation?
a. Wound C/S
b. Blood C/S
c. Rectal swab
d. Urine culture
Ans. (b)
Ref: Nelson 18th edition, page 2447
3. Steroid resistant nephritic syndrome due to?
a. ACE
b. NPHS2
c. LMX 1B
d. Hox 11
Ans. (b)
Ref. Nelson 18th edition, page 2195
4. A 7 year old child with fever, sore throat
MPO +ve
TLC-60,000 CD 33-ve
Plt- 20,000 CD 19+ve
CD 117+ve
CD 10 +ve
a. AML
b. ALL
c. Mixed
d. Biphenotypic
Ans. (d)
Ref: Wikipedia, http://tmc.gov.in/clinicalguidelines/ebm/vol5/pathology_final/cytometry/htm
5. All are true in the following except
a. Metabolic Acidosis is based defect > 12-16 Meq/L
b. Co2 is effectively cleared by placenta
c. Apgar score@ 1 min, indicator for neonatal resuscitation
d. Apgar score @ 7 min good indicator for neonatal death
Ans. (a)
Ref: nelson 18th edition, page 1855
http:/aappolicy.aappubilications.org/cgi/content/full/peadiatrics;117/4/1444
6. A 5 yr old child comes with episodic anaemia and jaundice from birth. All of the below are possible diagnosis except?
a. Sickle cell disease
b. G6 PD deficiency
c. Hereditatery spherocytosis
d. PNH
Ans. (d)
Ref. Nelson 18th edition, page 2021, 2025, 2027
7. Nestroft Test is used to detect?
a. Beta thalessemia
b. Hereditary spherocytosis
c. Autoimmune hemolytic anemia
d. G6PD
Ans.(a)
Ref. Care of Newborn, Meharban singh 7th edition, page 39
8. young short stature girl with TSH increased, T4 decreased - mass in pituitary on MRI. What is the likely diagnosis?
a. Primary hypothyroidism
b. Pitutary tumor
c. Pituitary throtrophic adenoma
d. Resistance to action of Thyroxine
Ans. (a)
Ref. Nelson 18th edition, page 2325
9. Down syndrome is associated with all except
a. Trisomy 21
b. Mosaic 21
c. Robertsonian translocation t(21:13)
d. Deletion 21
Ans. (d)
Ref: Nelson 18th edition, page 507-509
10. A child with recurrent sinusitis with rhinitis, CXR shows dextrocardia, most probable diagnosis is:
a. Kartargener syndrome
b. Cystic Fibrosis
c. Beck with widemann syndrome
d. Brown sequard syndrome
Ans. (a)
Ref. Nelson 18th edition, 1817
11. All of the following about Vit.D metabolism are true except:
a. 25-ahydronylation takes place in liver
b. 1- a hydroxylation takes place in kidney
c. Daily requirement in the absence of'sunlight is 450-600IU/day J
d. Williams syndrome is associated with obesity, mental retardation, precious puberty
Ans. (d)
Ref. Nelson 18th edition
12. A 15 year old girl presents with recurrent pains in the knee with appearance of petechial haemorrhage, diagnosis is:
a. Amegakaryocytic thrombocytopenia
b. Megakaryocytic thrombocytopenia
c. Factor VIM inhibitor
d. Platelet dysfunction
Ans. (b)
Ref: Harrison 18th edition
13. All of the following are mechanisms of thermogenesis in neonates except:
a. Shivering
b. Brown fat
c. Increase in movements of the baby
d. Cutaneous vaso constriction
Ans. (a)
Ref. Nelson 18th edition, page 680
14. Neonate presents with CHF of O/E bulging AF bruit on auscultation. Transfontanellar USG - hyerechoric midline mass with dilated lateral ventricles, diagnosis?
a. Vein of galen malformation
b. Encephalocele
c. Medulloblastoma
d. Arachnoid cyst
Ans. (a)
Ref. Nelson 18th edition,
15. The important fatty acid present in breast milk, which is important for growth is
a. Docosa hexaenoic acid
b. Palmitic acid
c. Linoleicacid
d. Linolenicacid
Ans. (a)
Ref. OP Ghai 6th edition.
MEDICINE
16. All of the following are preleukemic except?
a. Paroxysmal nocturnal haemoglobinuria
b. Paroxysmal cold haemoglobinuria
c. Myelo dysplastic syndrome
d. Aplastic anaemia.
Ans. (b)
KEF: Harrison 17th edition page 669,667,670
17. A female patient presents with history of Hb 6 g/dl. MCV 55, TLC 8000 cells/cum, PC -» 2.5 lakhs. She has no history of
transfusion. What is the diagnosis? ,
a. Anaemia of chronic disease
b. Iron deficiency anaemia
c. Thalassemia major
d. Thalassemia minor
Ans. (b)
Ref: Harrison page 17th edition page 641
18. All of the features are consistent with primary aldosteronism except
a. Diastolic hypertension without edema
b. Metabolic acidosis
c. Renin levels are low
d. High secretion of aldosterone inspite of reduced volume of fluid
Ans. (b)
Ref: Harrison 17th edition page 293
19. All of the following are true regarding SIADH except?
a. Vaptans are newly recomended drugs for treatment,
b. Water loading test is diagnostic
c. Urine Na+ is normal or low
d. Serum Na+ is < 125 m eq/l
Ans. (c)
Ref: Harrison page 2223, 17th
http://www.medscape.com/viewarticle/514125j6
20. Most common cause of Addison's disease in India
a. Idiopathic
b. Adrenal TB
c. HIV
d. Auto immune
Ans. (b)
Ref: NatlMedJ India. 2001Jan-Feb;14(1):23-5. Clinical profile and prognosis of Addison's disease in India. This study was done in SGPGI endocrinology department in INDIA. The conclusion of this study is as follows.
21. Which is the specific for rheumatoid arthritis?
a. IgM against Fc portion
b. IgG against Fc portion
c. IgA against Fc portion
d. AntiCCPAb
Ans. (d)
Ref: Harrison 17th edition page 2088.
22. All are true about brown sequard syndrome except?
a. Ipsilateral plantar extensor
b. Ipsilateral cortico spinal tract involvement.
c. Contralateral Dorsal column involvement.
d. Contralateral Spino Thalamic tract involvement.
Ans. (c)
Ref: Harhson 17th edition page 2589
23. A patient presented with abdominal pain, yellowish discolouration of sclera, clay coloured stools. All of the following are raised except?
a. 5' Nucleotidase
b. Glutamate Dehydrogenase
c. Alkaline Phosphatse
d. Gamma Glutamlyl Transferase.
Ans. (b)
Harrison 17th edition page 1925.
24. All are features of myelopathy except
a. Sensory loss of face
b. Brisk jaw jerk
c. Brisk knee jerk
d. Bladder incontinence urgency.
Ans.(a)
25. A 35 year old man having excessive sleep during work time attributing to disturbed sleep at night. He also has h/o falls in parties with friend's probable other symptoms he is having?
a. Generalised seizures while awake
b. Snoring with sleep apnea
c. Discomfort in legs before going to sleep
d. Hallucinations in sleep wake transition.
Ans. (d)
26. A 62 years old man presenting with focal seizures, renal clearance is good, drug of choice?
a. Valproate
b. Levateracitem
c. Oxcarbamezapine
d. Lamotrigine
Ans. (c)
Ref: Harrison page 2507, 17th edition
27. Hydrolysis by Hams test is positive. Which of the following is defective?
a. GPI Anchored protein
b. Complement deficiency
c. Spectrin binding
d. Mannose binding.
Ans. (a)
Ref: Harrison 17th edition page 661.
28. According to new world standards, false about Ml?
a. Sudden death can be due to Ml
b. 3 fold increase in Trop I following post CABG Ml
c. Recurrent Ml can be diagnosed by rise in troponin.
d. Echo test will show regional wall motion abnormalities.
Ans.(c)
Ref: Braunwald text book of cardiovascular medicine 8th edition 1383, 1208
http://ats.ctsnetjournals.Org/cgi/content/abstract/69/2/43
29. A Lady with no previous history of bleeding diathesis, Bleeding time is 3 minutes, PT 14V131, aPTT 35V251, plaletet count is 2.5 lakh. What is the likely diagnosis?
a. Lupus anticoagulant
b. vWB disease
c. Factor VIII inhibitor
d. Factor IX deficiency
Ans. (a)
Hair/son 17th edition page 1795.
30. D A patient has Hb 9 gram%. No previous history of transfusion MCV 60, RBC 4.5 million. What is the diagnosis?
a. Beta Thallessemia Minor
b. Beta Thallessemia Major
c. Iron deficiency anemia
d. Anemia of chronic disease
Ans. (a)>(c)
Ans. a.Beta Thallessemia Minor > c. Iron deficiency anemia
Ref: Harrison page 17th edition page 641
31. Dialysis related Amyloidosis is due to?
a. Beta2 microglobulin
b. AA
c. ATTR
d. AL
Ans. (a)
Ref: Harrison 17th edition page 2145.
32. In MS drug used to prevent EDSS?
a. IFN-Beta
b. Glatiramer acetate
c. Natalizumab
d. Methotrexate.
Ans. (a)
Ref: Harrison page 2617, 17th edition
33. A child presents with clinical features suggestive of demyelination. The chance of progression to MS is least with which of the following?
a. Absent oligoclonal band
b. Bilateral visual loss
c. Poor recovery
d. Complete cord transaction
Ans. (a)
Harrison's 18th ed. Chapter 380, Topic: Prognosis.
34. In Alzheimer's which of the following is not seen?
a. Aphasia
b. Acalculia
c. Agnosia
d. Apraxia
Ans. None of the above
REF: Hamson's 18th ed. Chapter 371. Topic: Alzheimer's diseaseg * / Clinical Manifestations).
35. A patient with hematuria and hypercalciuria, which is seen in urine analysis?
a. Isomorphic RBCs
b. Eosinophiluria
c. Nephrotic Range proteinuria
d. Dysmorphic RBCs
Ans. (a) Isomorphic RBCs
REF: Harrison's 18th ed. Chapter 44. Topic: Hematuria, Pyuria and) Casts.
36. Which of the following is not associated with systemic osinophilia and renal failure?
a. Drug induced
b. Radio contrast induced
c. Athero embolic induced
d. Polyangitis nodosa
Ans. (b)
Ref: Harrison's 18th ed. Chapter 279. Topic: Acute kidney injury/ Blood laboratory findings).
37. A patient with Bilateral radiologically proved VUR / reflux Nephropathy, with Nephrotic range proteinuria. What is the probable type of GN seen in this patient?
a. FSGS
b. Membranous GN
c. Membranoproliferative GN
d. Nodular sclerosis GN
Ans. (a)
REF: Harrison's 18th ed. Chapter 285. Topic:Vesicoureteral Reflux and Reflux Nephropathy.
38. A patient presents with one month history of fever, headache and 2days history of altered sensorium with CT brain showing basal meningitis. CSF analysis more likely will show?
CSF-protein CSF-Sugar Cytology
a. Increase Decrease Lymphocytosis
b. Increase Normal Lymphocytosis
c. Increase Normal ??
d. Increase Normal Neutrophil
Ans. (a)
Ref. Harrison’s 18th ed. Chapter 165. Topic Tuberculous meningitis and Tuberculoma.
39. In a case of renal papillary necrosis following tests are needed for establishing the diagnosis except?
a. Urine PCR for TB
b. Urine culture r
c. Acidification of urine test
d. Sickling
Ans. (c)
REF: Harrison's 18"ed. Chapter285. Topic: Sickle Cell Nephropath
40. In critically ill patient admitted in ICU, all are adequate measures taken to treat based on clinical trials except?
a. Use of low tidal volume will decrease acute lung injury
b. Aggressive goal directed reperfusion therapy, hourly monitoring of CVP, BP, urine output is adequate
c. Strict monitoring of glucose level in hyperglycemic patients known to improve survival
d. Use of Drotrecogin alpha is restricted for patients with APACHE score II > 25
Ans. (c)>(b)
Ref: Harrison's 18th ed. Chapter 267. Topic: Nutrition and Glyceml Control
41. Transcranial patch for Parkinson's disease?
a. Levodopa
b. Apomorphine
c. Rotigotine
Ans. (c)
Ref: Harrison's 18thed. Chapter372. Topic: Treatment: Parkinson's Disease.
42. A elderly man, known case of AS presents with syncope. He develops fatigue after 11 minutes of exercise while performing TMT as per BRUCE protocol. With ECHO, Systolic pressure gradient is found to be 60 mmHg. What is the most Appropriate management?
a. Coronory angiography
b. Follow up
c. Aortic balloon valvuloplasty
d. Valve replacement
Ans. (d)
Ref: Braunwald's Heart Disease 9th ed. Page:1472.
43. Which of the following is not a limb girdle dystrophy?
a. Spinocerebellar ataxia
b. Supranuclear palsy
c. Corticobasiler degeneration
d. Multiple system atrophy
Ans. (b)
Ref: Harrison 16th Edn., p. 2413-2414
44. Which of the following exclusively involve neurouns
a. Spinocerebeelar ataxia
b. Supranuclear palsy
c. Corticobasilar degeneration
d. Multiple system atrophy
Ans. (a)
Ref. Harrison’s 16th ed. P. 2413-2414
45. Lady 25 yrs-fever 1 month, ataxia, head ache, imaging showing dilated ventricles, meningeal enhancement. Likely CSF finding
a. Lymphocytic pleocytosis, low sugar, high protein
b. Lymphocytic, low sugar, low protein
c. Lymphocytic, high sugar, low protein
d. Neutrophilic, low sugar high protein
Ans. (a)
Ref. Harrison 17th edition, page 1009, 1012, 1018
46. A months pregnant lady a konow case of juvenile myoclonicepilepsy onsoddium valproate, presents to you, what is your advice?
a. Stop valproate & shift to lamotrigine
b. Contine valproate and monitor the serum levels
c. Give valproate & add lamotrigine
d. Change to carbamazepine
Ans. (b)
Ref. Harrison 17th edition, page 2500
47. Diabetes is best diagnosed by
a. FBS 100 and PPBS 140
b. FBS > 125 and PPBS>199
c. HbA1c =5.5%
d. FBS more than 70
Ans. (b)
Ref. Harrison text book of medicine 18th table 344-2
48. A 25 year old lady on treatment for rheumatoid arthritis has the following lab findings.-Haemoglobin -6g, MCF-60fl, RBC=2.5 laksh, Ferritin-200ng/ml. Transferrin-298 mg/dl iron-=30. What is the probable diagnosis?
a. Thalassemia
b. Autoimmune hemolytic anemia
c. Anemia of chronic disease
d. Iron deficiency anemia
Ans. (c)
Ref. Harrison Text Book of Medicine, 18th edition, Table 103-4
PHYSIOLOGY
49. Tidal volume excessive load din prevented by
a. Bronchial stretch receptor
b. J receptor
c. Arterial baroreceptor
d. Thoracic muscle spindle
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.627, 632
50. Anticoagulant of choice for anticoagulant assay
a. 3.2% trisodium citrate
b. Heparin
c. EDTA
d. Sodium Oxalate
Ans. (a)
Ref. Diagnosis of hemophilia and bleeding disorders 2nd edition p.11
51. Not the primary action of GUT flora
a. Mucus Fermentation
b. Vit. K Fomation
c. Control of epithelial proliferation
d. Undigested fat converted to short fatty acids
Ans. (a)
Ref. Ganong’s Review of Medical Physiology 23rd edition p.458
52. True regading Prothromin Times is
a. Collected sample should be refrigerated immediately
b. Platelet rich plasma
c. Run within 2 hours
d. Activated by kaolin
Ans. (c)
Ref. Diagnosis pf Hemophilia and bleeding disorders 2nd edition p.10 to 12, 37, 40
53. About 3rd nerve palsy all are true except?
a. Ptosis
b. Diplopia
c. Outward Deviation of Eye
d. Miosis
Ans. (d)
Ref. Ganong’s review of medical physiology 23rd edition p.263
54. Dilator Pupillae supplied by
a. Postganglionic parasympathetic. Edinger westphal nucleus
b. Postganglionic sympathetic from cervical sympathetic chain
c. 3rd cranial nerve
d. Sympathetic fibres of fronto orbital branch of tringeminal nerve
Ans. (b)
Ref. Ganong’s review of medical physiology 23rd edition p. 261 -265
55. All are correct except
a. Glucose concentration of glomerular filtrate same as plasma
b. Oncotic pressure in efferent arteriole is less than that of afferent arteriole
c. Contriction of afferent arteriole decreases the capillary pressure
d. Hematocrit increased as blood travels through glomerulus
Ans. (b)
Ref. Ganong’s Review as blood travels through glomerulus
56. All occur in hypothermia except?
a. Total peripheral resistance decrease
b. Cardiac arrythmia
c. Renal failure
d. Reversible co-agulopathy
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.286
57. LDL Receptors-True except
a. Exclusively extrahepatic
b. Cell to cell receptor medicated endocytosis
c. Clathrin coated Pits
d. LDL Receptors are down regulated on increase cholesterol in tissues
Ans. (a)
Ref. Ganong’s review of medical physiology 23rd edition p.27
58. Mean arterial pressure is calculated as (Repeated AIIMS Nov. 2006)
a. (SBP +2DBP)/3
b. (DBP+2SBP)/3
c. (SBP+3DBP)/2
d. (DBP + 3SBP)/2
Ans. (a)
Ref. Ganong, 22nd Edn., p. 587-588
BIOCHEMISTRY
59. CPT 1 is ihbited by
a. Glucose
b. Acetyl COA
c. Malonyl COA
d. Pyruvate
Ans. (c)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 184-186
60. In well fed state, gluconeogensis in liver is inhibited by
a. Alanine content in liver
b. Protein breakdown in muscle
c. ADP level
d. cGMP
Ans. (c)
Ref. Harper’s Illustrated Biochemistry 28th edition p.137 to 139
61. Insulin amino acid sequence and molecular structure discovered by, and he got noble prize for the same?
a. Sanger
b. Banting and best
c. Edman
d. McLeod
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.24-25
62. For Commercial preparation of insulin, by recombinant technology first step is isolation of
a. DNA from lymphocytes
b. DNA from beta cells
c. mRNA from lymphocytes
d. mRNA from beta cells
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p.388-403
63. Not Needed in PCR
a. Deoxyribonucleotide
b. Dideoxyribonucleotide
c. DNA template
d. Thermostable polymerase
Ans. (b)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 394, 395
64. Subtelomeric rearrangements can be dianosed by except
a. FISH
b. MAPH
c. MALDI
d. CGH
Ans. (c)
Ref. Tietz textbook of clinical chemistry 4th edition p. 1123 to 1131
65. All are true about oxygenase except
a. Incorporation of 1 oxygen ATOM
b. Incorporation of 2 oxygen ATOM
c. Involved in hydroxylation
d. Involved in carboxylation of steroids
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 51-52
66. CAP in LAC operon
a. Positive regulator
b. Negaive regulator
c. Operator
d. Promoter
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.371 to 373
67. Which is not required for translation or protein synthesis in eukaryotes
a. Ribosomes
b. Peptidyl transferase
c. Amino acyl tRNA synthetase
d. RNA polymerase
Ans. (d)
Ref. Herper’s Illustrated Biochemistry 28th edition p. 353
68. A 30 yrs old man with LDL-600 mg/dl and THL -140 mg/dl which of the following is manifestation?
a. Tendon xanthoma
b. Eruptive xanthoma
c. Plantar xanthoma
d. Lipemia retinalis
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 232
69. If 4 nucleotides code for an amino acid, theoretically how many amino acids are possible?
a. Same quaternary structure
b. Same nomenclature & number
c. Same site of action & kinetics
d. Same tissue distribution
Ans. (d)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 56
70. Which is true statement of isoenzymes
a. Same quaternary structure
b. Same nomenclature & number
c. Same site of action & kinetics
d. Same tissue distribution
Ans. (b)
Ref. Harper’s Illustrated biochemistry 28th edition p.56
71. Poly (A) tail codes for which amino acid
a. Poly lysine
b. Poly alanine
c. Poly proline
d. Poly glycine
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p. 354
72. About PTH regulation false is?
a. Un ionized Ca2+directly regulates PTH secretion
b. Magnesium has the miliar actions as that of Ca2+
c. Parathramone related protein is responsible for Hypercalcemia in cancer
d. Ca SR in parathyroid respnnsible for calcium regulation
Ans. (a)
Ref. Ref. Harper’s Illustrated Biochemistry 28th edition p. 439 to 440
73. Chemical barrier which prevents bacterial colonization in all microbial exposed areas?
a. Glycogen
b. Lysozyme
c. Lactose
d. Acidic pH
Ans. (b)
Ref. Herper’s Illusrated Biochemistry 28th edition p.35
74. Alanine is increased in blood, in starvation because
a. Increased muscle breakdown
b. Increased glucogenic fatty acid
c. Increased permeability of capillaries
d. Decreased alanine usage in gluconeogensis in liver
Ans. (a)
Ref. Haper’s Illustrated biochemistry 28th edition p.137 to 140
75. On prolonged starvation, which maintain rate of gluconeogenesis in liver?
a. Alanine pool in liver
b. Fatty acid pool in liver
c. Decreased CAMP
d. ADP in liver
Ans. (a)
Ref. Harper’s Illustrated Biochemistry 28th edition p.137 to 140
76. Chymotripsinogen is a
a. Zymogen
b. Carboxypetidase
c. Transaminase
d. Elastase
Ans. (a)
Ref. Lippincott 3rd edition pg-440, Harper 26th edition, p-477
77. More than one codon coding for single amino acid
a. Degeneracy
b. Frame shift mutation
c. Transcription
d. Mutation
Ans. (a)
Ref. Harper 28th edition
78. A PHC medical officer wants to send blood sample for glucose estimation to a district hospital. What is the preservative that should be used?
a. EDTA
b. Calcium oxalate
c. Potassium oxalate +NaF
d. Potassium oxalate* NaI
Ans. (c)
Ref. Clinical Chemistry by Tietz, p.82
79. Chromosomal mutations can be identified from all except
a. Single stranded conformation polymorphism
b. Dideoxy nucleotide trail sequencing
c. Agarose gel electrophoresis
d. Denaturing Gradient Gel Electrophoresis (DGGE)
Ans. (c)
Ref. Tietz Textbook of clinical chemistry 4th ed. P. 1111 to 1121
SURGERY
80. Motorcyclist, trauma due to fast moving vehicle, taken for emergency laparotomy, on left side normal, on right side non pulsatile, stable haematoma seen in contrast study (IVU) contrast is not taken, all vessels are normal. What is the next step in management?
a. On table cystourethrography
b. Nephrectomy
c. Seperation of Gerota’s fascia and exposure of renal vessels
d. On table renal arteriography
Ans. (c)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1465-66 Table 40.2
81. On USG finding in Congenital Hypertorophic pyloric stenosis what is not seen?
a. >95% cases it is accurate
b. Length of Seg. >16mm
c. Thickness >4mm
d. High gastric residue
Ans. (d)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1425-26
82. Most common site of cholangiocarcinoma is?
a. Perihilar
b. Intrahepatic duct
c. Distal biliary duct
d. Multifocal
Ans. (a)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1162, Fig.32.26
83. Inexperienced surgeon is operating for cholecystectomy accidentally found CBD stone. What is further best management?
a. Laproscopic cholecystectomy with laparascopic stone removal
b. Open cholecystectomy with CBD exploration
c. Conversion to open cholecystectomy with choledhocoduodenostomy
d. Removal of stone through cystic duct
Ans. (B)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1152-53
84. Post surgery Ileus maximum manifestation common by
a. Colon
b. Ileum
c. Stomach
d. Duodenum
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9/ed. P. 992
85. Post operative complication of Iloe anal pouch amastomosis in ulcerative colitis?
a. Small bowel obstruction
b. Pouchitis
c. Perianal complication
d. Pelvic abscess
Ans. (b)
Ref. Schwartz’s principles of Surgery, 9/edn. P.1032
86. Which of the following enzyme is not used for prognosis acute pancreatitis?
a. Serum amylase
b. Serum calcium
c. Serum glucose
d. Serum lipase
Ans. (a)
Ref. Schwart’s Principles of Surgery, 9/ed. P. 1181, 83 & Tables
87. Which fruit juice helps in preventing UTI
a. Grape
b. Raspberry
c. Cranberry
d. Orange
Ans. (c)
Ref. Harrison 17th edition page 2469
88. A person presented with H/O RTA, there was anaesthesia below the level of umbilicus, and bladder and bowel disturbances, tenderness present over D10-D12 Vertebrae pulse steroid therapy to be instituted is
a. 30mg/kg within 2 hours
b. 60 mg/kg within 9 hours
c. 75 mg/kg within 12 hours
d. 45 mg/kg within 6 hours
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9/ed. P 1530
89. Trauma to which of the following artery will produce least damage to the organs?
a. Superior mesenteric artery
b. Inferior mesenteric artery
c. Celiac trunk
d. Renal artery
Ans. (b)
Ref. Schwartz’s principles of surgery, 9/edn.
90. Calcification around Foramen of Monro, with preiventicular infiltrate, raised intracranial tesnsion mass and below 3rd ventricle is seen in?
a. Ependymoma
b. Sub epedydomal-astrocytoma
c. Neuronal-cyst
d. Central neurocytoma
Ans. (b)
Ref. www.icdns.og/forums/index.php?showtopic=23.radiopaedia.org/articles/subependymal-giant-cell-astrocytoma
91. True about peripheral vascular disease in the lower limb are all except
a. Ankle brachial index<0.5 indicate sever ischemia
b. Smoking is more specific for peripheral vascular disease than for cardiovascular disease
c. ABI changes during exercise than at rest
d. L-arginine causes Ednothelial independent Vasodilation
Ans. (d)
Ref. Schwartz’s Principles of Surgery, 9th ed.,p.704
ANATOMY
92. Which of the following is not a part of superficial perineal pouch
a. Posterior scrotal artery
b. Bulbo spongiosis
c. Sphinter urethrae
d. Ducts of bulbourethral glands
Ans. (c)
93. Which of these is lateral to SAC of femoral hernia?
a. Femoral artery
b. Femoral vein
c. Femoral nerve
d. Lateral cutaneous nerve of thigh
Ans. (b)
Ref. Schwartz’s Principles of surgery, 9 ed. P. 1312
94. Investigation of choice for Zenker’s diverticulum
a. Barium Swallow
b. Manometry
c. Ednoscopy
d. Dual CT
Ans. (a)
Ref. Schwartz’s Principles of surgery, 9 ed. P 848
95. The structure not passing through oesophageal hiatus is
a. Right phrenic nerve
b. Left gastric artery
c. Right vagus
d. Left vagus
Ans. (a)
Ref. B.D Chaurasia’s human anatomy, volume –II 4/e p. 310
96. Which does not from liver capsular plate
a. Ductal plate
b. Hilar plate
c. Umbilical plate
d. Cystic plate
Ans. (a)
Ref. J hepatobiliary Pancreat Surg., 200; 7(6) 580-6
97. Which of the following is not associated with a defect in neural migration?
a. Lissencephaly
b. Schizencephaly
c. Polymicrogyria
d. Focal cortical brain maldevelopment
Ans. (d)
Ref. NINDS [National Institute of Neurological Disease & Stroke]/NH.
http://www.ninds.nih.gov/disorders/neuronal_migration/neuronal _migration.htmh
PHARMACOLOGY
98. Dugs not used in Multiple Sclerosis
a. Glatiramer
b. IF β 1a
c. IF β 1b
d. Mycophenolate
Ans. (d)
99. Efavirenz is
a. Reverse transcriptase inhibitor
b. Protease inhibitor
c. Integrase inhibitor
d. Inhibitor entry of HIV into cell
Ans. (a)
100. Brinzolamide is
a. Highly selective competitive antagonist and reversible inhibitor of CA inhibitor
b. Highly selective competitive antagonist and irreversible inhibitor of CA inhibitor
c. Highly selective noncompetitive antagonist and reversible inhibitor of CA inhibitor
d. Highly selective noncompetitive antagonist and irreversible inhibitor of CA inhibitor
Ans. (c)
101. True about Octreotide is
a. Stimulates GI secretion
b. Prevents secretary diarrhea
c. Can be given orally
d. Cannot be used in acromegaly
Ans. (b)
102. Wrongly matched optons, regarding drug metabolism is
a. Calcium channel blocker-CYP344
b. Digoxin-P.Glycoprotein
c. Simvastatin-Glucoronide conjugation
d. Carvedilol-CYP2A6
Ans. (d)
103. Bremelanotide is used in
a. Erective dysfunction
b. Prostate carcinoma
c. LUTS
d. Renal CA
Ans. (a)
104. 1% Pilocarpine instilled to a person with dilated pupil. It does not constrict
a. Diabetic with IIIN palsy
b. Pharmacological blockade
c. Adie tonic pupil
d. Uncal herniation
Ans. (b)
105. After giving Thiazine diuretic for HTN. What is seen in 24 hour urine is
Na+ K+ Ca+
a. ↑ ↑ ↑
b. ↓ ↑ ↑
Or
b. ↓ ↓ ↑
c. ↑ ↓ ↑
d. ↑ ↑ ↓
Ans. (d)
106. Most recent oral direct thrombin inhibitor
a. Dabigartran
b. Danaparoid
c. Ximalagatran
d. Fondaparinux
Ans. (a)
107. Peripheral conversion of T4 to T3 is inhibited by all except
a. Propylthiouracil
b. Propranolol
c. Methimzole
d. Amiodarone
Ans. (c)
108. Lid retraction is caused by
a. Apraclonidine
b. Brimonidine
c. Travoprost
d. Danoprost
Ans. (a)
109. Ozurdex:
a. Dexamethasone 0.7%
b. Hydrocortisone
c. 0.7% Triamcinolone acetonide
d. 0.5% Triamcinolone acetonide
Ans. (a)
110. MRSA resistance the following drug should not to be used is
a. Cefaclor
b. Cotrimoxazole
c. Ciprofloxacin
d. Vancomycin
Ans. (a)
111. Chloroquine toxicity predisposed by all except
a. Total daily dose of > 350 mg
b. Cumulative does of 460 gm
c. Renal failure
d. Given for more than 2 yrs
Ans. (a)
112. Adrenaline, noradrnaline dopamine acts through which receptor
a. Seven pass receptor
b. Four pass receptors
c. Single pass
d. Ligand gated receptor
Ans. (a)
MICROBIOLOGY
113. A 5 year old boy with a pustular lesion in the leg. The isolate shows Gram +Ve cocci colony shows β Hemolysis. Which test helps to identify the organism?
a. Bile solubility
b. Optocain sensitivity
c. Bacitracin sensitivity
d. Novobiocin sensitivity
Ans. (c)
114. Which of the following Regarding bacterial Resistance is not true?
a. Most Bacterial Resistance is due to Production of peinicilin Degrading enzymes
b. Plasmid Mediated Resistance is always transmitted vertically only
c. Most Enterococcal Species produce Resistance by degrading target receptor (PBP)
d. Complete elimination of the target by pneumococcus species
Ans. (b)
Important references:
1) http://jac.oxfordjournals.org/content/56/3/463.ful.pdf
2) http://www.horizonpress.com/cimb/v/v5/10/pdf
3) http://www.ncbi.hlm.nih.gov/pubmed/2187594
4) http://www.medscape.com/viewarticle/494612_2
115. A 22 year male H/o burning micturition and urinalysis showed No organisms but abunadant puss cells. Which of the following is the diagnostic modality?
a. Mc Coy cell culture
b. Thayer martin medium
c. Cooked neat Broth
d. Levinthal medium
Ans. (a)
116. A 70 year old man presented with fever and dry Cough, a gram negative organism shows growth only in charcoal yeast agar the organism is?
a. Legionella
b. Pneumococcus
c. Bartonella
d. H. influenza
Ans. (a)
117. Bacteria coated with complement & Ig, phagocytosis is enhanced by?
a. Receptor mediated Endocytosm
b. Pseudopod formation
c. Myelperoxidase mediated destruction
d. C3b-Fc mediate Destruction
Ans. d>c
118. Which is used as an indicator in autoclave
a. Bacillus subtillus
b. Bacillus stearothermophilus
c. C. perfringens
d. C. tetani
Ans. (b)
Ref. http://ehs.virginia.edu/biosafety/bio.documents/autoclaving_Guidlines.pdf & http://www.ehs.iastate.edu/cms/defaultasp?ID=31&=article (the Virginia state policy and the lowa state university principles)
119. A patient admitted to ICU is on central venous line for last one week. He is on ceftazidine and amikacin. After 7 days of fever he develops a spike of fever. On his blood culture, gram positive cocci in chains are found, while are catalase negative. So he was started on vancomycin, but culture remained positive for same organism even after two weeks of therapy, most likely organism?
a. Staph.aureus
b. Viridian streptococci
c. Enterococcus faecalis
d. Coagulase negative staphylococcus
Ans. (c)
120. False about bacteroides is
a. LPS from bacteroides is structurally and functionally different from conventional endotoxin
b. Most common organism isolated in culture
c. DIC and shock common in septicaemia due to bacteroids
d. Not uniformly sensitive to metronidazole
Ans. (c)
121. Maternal to child transmission of HIV is prevented by?
a. Nevirapine
b. Lamivudine
c. Didanosine
d. Abacavir
Ans. (a)
P.S.M
122. Socialization medicine does not includes?
a. Eliminates competition between the doctor?
b. Free of cost health provisions by state
c. Ensures complete utilization of health services
d. Ensure universal coverage of health services
Ans. (c)
Ref. Par textbook of preventive & social medicine 21st edition p.9
123. Direct standardization is used for comparing mortality rates between two countries. This is doen because of difference in:
a. Age distribution
b. Neumerator
c. Denominator
d. Sex
Ans. (a)
Ref. Park textbook of preventive and social medicine 21st edition page 55)
124. INA study in UK, and association was found between increase in sale of anti arrhythmic drugs and deaths related to asthma over 15 years. This is an example of which study?
a. Case control
b. Cohort
c. Prospective study
d. Ecological study
Ans. (d)
Ref. Modern Epidemiology, 3rd Edition. Rothman, Kenneth J; Greenland, Sander; Lash, Timothy L)
125. For the diagnostic of SLE, 6 tests are employed in dat 4 are positive, 2 are negative. To know the probability of SLE
a. Sensitivity and specificity of each test/prior probability of SLE in that area
b. Incidence of SLE and predictive value of each test
c. Incidence each prevalence of SLE
d. Relative risk of SLE in the patient
Ans. (a)
Ref. Textbook of public health and community medicine WHO-AFMC)
126. Hardy-weinber equilibrium is affected by all except
a. Mutation
b. Migration
c. Small population
d. Random mating
Ans. (d)
Ref. A Dictionary of Epidermiology, Fifth Edition Oxford University press, 2008)
127. Hardy Weinberg law is violated in
a. Non-random mating
b. Mutation
c. Small population
d. Gene flow
Ans. (c)
Ref. Ganong’s Review of Medical physiology 23rd edition
128. Which of the following gives the most accurate result
a. Randomised controled trial with double blinding
b. Cohart Study
c. Cohart sectional study
d. Meta analysis /(systemic review analysis)
Ans. (d)
Ref. Basis & clinical Biostatistics, 4th edition Beth Dawson, Robert G. Trapp & Various sources)
129. For a blood sample, HB values are 9.1, 9.2, 10.2, 10.2, 9.3, 9.6, 9.7, 9.8
For the same sample of blood of calorimetric study the values are 10.1 gm/dl. The test has
a. High validity & high reliability
b. High validity & low reliability
c. Low validity & low reliability
d. Low validity & high reliability
Ans. (c)
Ref. Textbook of Public health and community medicine WHO-AFMC)
130. Syndromic management for genital ulcer disease in India, includes following
a. Chancroid chancre
b. Primary chanere, herpes genitalis
c. Chancroid, Primary chanere, herpes genitalis
d. Chancroid, genitalis only
Ans. (c)
Ref. Textbook of public health and community Medicine WHO-AFMC
131. Best method of compare a new test gold standard test is
a. Regression studies
b. Correlational analysis
c. Bland and altman analysis
d. Kimorogov schir
Ans. (C)
Ref. BJA 2007 & various sources)
ORTHOPEDICS
132. A 50 years old female presented with C/o unable to flex thumb, index finger, middle finger which of the test performed to make diagnosis except
a. Phalen test
b. Finkelstein test
c. Tinel sign
d. Tourniquest test
Ans. (b)
Ref. Campbell orthopaedic surgery; pg-3762
133. A diabetic patient presented with flexion deformity f 15 degrees of right little finger TOC?
a. Subtotal fasciectomy
b. Percutaneous fasciotomy
c. Total fasciectomy
d. Observation
Ans. (d)
Ref. Apleys system of orthopedics, Pg. 423, campbells orthopaedics surgery pg.3753
134. A cricketer got injured while catching the ball, complains of pain at base of thumb, which muscle to be injured
a. Abductor pollicis longus
b. Extensor pollicis brevis
c. Volar plate
d. Ulnar collateral ligament
Ans. (d)
Ref. apleys orthopedics, pg. 795, principals and practice of orthopaedics sports medicine pg.244
135. Gallow’s traction used for
a. # Tibia
b. # Femur
c. # Humerus
d. # Cervical spine
Ans. (b)
Ref. Maheshwari
136. In osteoarthritis which muscle get obviously waster or affected?
a. Only quadriceps
b. Quadriceps and hamstrings
c. Only popilteus
d. Gastroenemius
Ans. (a)
Ref. Apleys system of orthopedics
137. A patient with anterior dislocation of shoulder, what is the possible mechanism involved?
a. Abduction and internal rotation
b. Abduction and internal rotation
c. Abduction and external rotation
d. Abduction and external rotation
Ans. (c)
Ref. Apleys orthopedics
138. Spondylosthisis can be diagnosed by all except
a. CT
b. MRI
c. X ray spine AP view
d. Xray spine lateral view
Ans. (c)
139. Patient with c/o pain in the lower back. On examination unable to extend the grate toe right, but no sensory involvement. Probable disc prolapsed at
a. L3-L4
b. L4-L5
c. L5-S1
d. S1-S2
Ans. (b)
Ref. Campbell orthopaedic surgery pg-1999
140. CV junction malformations caused by all except
a. Rheumatoid arthritis
b. Ankylosing spondylitis
c. Odontoid dysgenesis
d. Basilar invagination
Ans. (b)
141. Which is not an indicator of bone formation
a. Alkaline phosphatase
b. Procollagen residue
c. Osteocalcin
d. Hydroxyproliine
Ans. (d)
Ref. Tureks system of orthopedics,
142. A patient presents with heterotopic ossicfication around the knee joint. The laboratory investigation of choice in him is.
a. Serum calcium
b. Serum alkaline phosphatase
c. Serum phosphorus
d. Serum Acid phosphatase
Ans. (b)
Ref. Wheeless textbook of orthopaedics; Garland D.E.A clinical perspective on common forms of acquired heterotopic ossification CORR No. Feb. 1991; Other Journal articles
RADIO DIAGNOSIS
143. How do you differentiate between epidermoid cyst and arachnoid cyst?
a. Contrast enhanced MRI
b. Smooth margins
c. Decreased flair
Ans. (c)
144. About hibernating myocardium all are true except
a. Low does dobutamine scar
b. After rest thallium scar
c. If akinesia revasculatisation will not help
d. Gadolinium scan is not done
Ans. (c)
Ref. Radiology Review Manual, -by Wolfgang Dahnert 6th edition
145. Charactersitic of cavernous hemangioma
a. Popcorn calcification
b. Well-defined nidus
c. Feeding arteries
d. Phelbectasia
Ans. (a)
Ref. Diagnostic Neuro radiology by Anne. G. Osborn 2nd edition
146. IOC for meningeal carcinomatosis
a. NCCT
b. MRI contrast enhanced
c. PET –CT
d. SPECT
Ans. (b)
Ref. Diagnostic Neuroradiology by Anne. G. Osborne 2nd edition.
147. A young male after 2 months of trauma presents with bilateral proptosis, chemosis, subconjuctival hemorrhage & inability to move eyes (cavernous sinus thrombosis) what is the IOC?
a. Intra arterial digital subtraction angiography
b. MR-angiography
c. MRI
d. CT
Ans. (b)
Ref. Nontraumatic Orbital Conditions: Diagnosis with CT and MR imaging in the Emergent Setting –radiographics
148. All of the following are used in deep wave therapy except
a. Microwave
b. Ultrasonic wave
c. Infrared
d. Heat wave diathermy
Ans. (c)
149. Radioresistant layer in retina
a. Pigment layer
b. Gangion well layer
c. Bipolar cell layer
d. Rods & cones
Ans. (a)
Ref: Strangeways Research Laboratory, Cambridge –International Journal of Radiation Biology
150. 45 year old female complains of progressive weakness and spasticity of the lower limb with difficulty during micturition. CT scan shows an intradural mid dorsal midline enhancing lesion. The diagnosis is?
a. Meningioma
b. Intradural lipoma
c. Neuroepithelial cyst
d. Dermoid cyst
Ans. (a)
Ref. Harrison’s 16th Ed. Pg 2456; Dahnert’s Radiology Review manual 5th Ed. P.299-301
OBS/GYNA
151. All changes are normal during pregnancy except?
a. Increase storke volume
b. Increased cardiac output
c. Increased systemic vascular resistance
d. Increased intravascular volume
Ans. (C)
Ref. Williams 22/ed, pg 133-134
152. Fetal karyotyping can be done by all except
a. Cordocentesis
b. Amniocentesis
c. CVS
d. Feta skin biopsy
Ans. (d)
Ref. Williams 22/ed., pg. 328-331
153. Glucose tolerance test is indicated in all except?
a. Previous congenital anomaly
b. Previous eclampsia
c. Polyhydramnios
d. Previous unexpected fetal death
Ans. (b)
Ref. American Diabetes Association. Standards of medical care in diabetes-2007. Diabetes Care Jan 2007
154. All are inaccurate regarding forceps delivery except?
a. The anteroposterior diameter of head should not be more than 15 degree to the axis
b. Vertex and face presentation in mento anterior
c. The presenting part should be at zero station
d. Caput succedaneum is not a contraindication
Ans. (b)
Ref. Williams 22/ed pg 549
155. 17 years old girl came to OPD with primary amenorrhea and b/l inguinal hernia. Normal secondary sexual characteristics with absence of pubic hair. On USG uterus and ovary absent
a. Androgen insensitivity synd.
b. Turners syndrome
c. Mulerian agenesis
d. STAR syndrome
Ans. (a)
Ref. SPEROFF 7th Ed. Pg.402-406
156. A 16 year old girl with 6x6 cm right ovarian mass with absent AFP, negative CA125 and increased ALP, diagnosis is
a. Dysgeminoma
b. Mucinous cystadeno carcinoma
c. Endodermal sinus tumor
d. Teratoma
Ans. (a)
Ref. Novak’s 14th ed.
157. In postmenopausal women. HRT helps in all except
a. Vaginal dryness
b. Hot flushes
c. Coronary artery disease
d. Osteoporosis
Ans. (d)
Ref. Speroff 7th ed. , pga.663, 700
158. Normal ovarian function is seenin
a. MRKH
b. Ovarian dysgenesis
c. Swyer syndrome
d. Turner’s syndrome
Ans. (a)
Ref. Spheroff 7th., pg. 420-421
159. Gestational hypertension causes all except?
a. HELLP synd.
b. Acute renal failure
c. Fetal macrosomia
d. Eclampsia
Ans. (c)
Ref. WILLIAMS 22nd Ed. Pg.774-780
160. Treatment for prenatal CAH
a. Dexamethasone
b. Beta methasone
c. Prednisone
d. Hydrocortisone
Ans. (a)
Ref. Speroff 7th Ed., pg.330-338
161. An infertile women with B/L tubal block at cornua diagnosed on Hysterosalpingography, next treatment of choice is
a. IVF
b. Laparoscopy & Hysteroscopy
c. Tuboplasty
d. Hydrotubation
Ans. (b)
Ref. Speroff 7th ed., pg. 1013-1037
162. Tumor marker for granulose cell tumor
a. CA 19-9
b. Inhibin
c. CA 125
d. CA 50
Ans. (b)
Ref. Novak’s 14th ed.
163. After coming head in breech presentation difficult labour all except
a. Placenta previa
b. Extension head
c. Hydrocephalus
d. Incomplete dilatation of cervix
Ans. (a)
Ref. Williams 22nd ed., pg. 566-570
PSYCHIATRY
164. Type D personality are at risk of developing
a. Coronary artery disease
b. Depression
c. Schizophrenia
d. Personality disorder
Ans. (a)
Ref. No direct reference could be got from standard textbooks
165. Somatic passivity is a feature of
a. Depressive illness
b. Paranoid schizophrenia
c. Hypochondriasis
d. Panic disorder
Ans. (b)
Re. New oxford textbook of psychiatry 4.7.3 Descriptive clinical features of schizophrenia
166. Bipolar type II, is characterized by
a. Hypomania and depression
b. Hypomania and subsyndromal depression
c. Mania and subsyndromal depression
d. Hypomania and Dysthymia
Ans. (a)
Ref. New oxford textbook of psychiatry 4.5.3 Diagnosis, classification and differential diagnosis of mood disorders
167. Which of the following is not a specific somatoform disorder?
a. Somatisation disorder
b. Chronic fatigue syndrome
c. Irritable bowel syndrome
d. Fibromyalgia
Ans. (b)
Ref. ICD-10 and DSM –IV criteria
168. Counter transference is
a. Patient’s feelings towards therapist
b. Doctors feeling towards the patient
c. Psychic connection between patient and disease
d. Type of Defence mechanism
Ans. (b)
Ref. New oxford textbook of psychiatry 6.3.5 Psychoanalysis, and other long-term psychodynamic psychotherapies
169. Associated with panic disorder are all except
a. Seratonin
b. GABA
c. Dopamine
d. Glutamate
Ans. (d)
Ref. Next oxford textbook of psychiatry 4.7.3 panic disorder and agoraphobia
DERMATOLOGY
170. Intra epidermal intercellular IgG deposition is seen in?
a. Epidermolysis bullosa acquistica
b. Dermatitis herpetiformis
c. Bullous pemphgoid
d. Pemphigus vulgaris
Ans. (d)
Ref.
(1) Fizpatrick et al-profile of immune flouroscent studies in pemphgus-Arch of Dermatology, 2006, p. 116, 285-290
(2) Meurer et al-oral pemphigus vulgaris-A report 15 cases-Arch of Dermatology-1987, p.113, 1520-1524
(3) Kolulu et al, Human auto-antibodies against desmosocal core protein in pemphigus, Jr. of Exp. Medicine 2002, p. 1509-1518
171. Which of the following shows deposition of IgA in dermal papilla?
a. Dermatitis herpetiformis
b. Bullous impetigo/bullous Pemphigoid
c. IgG dermatosis of childhood /igA papillomatosis of childhood
d. Gestational herpes
Ans. (a)
Ref.
(1) Collin P et al., Recogniton of cutaneous and immunofluorescent manifestation of D.H-Am J clin Dermatol, 207 p.4 :13
(2) Reunalatl et al., Dermatitis Herpetiformis-Clin Dermatol, 2001 p.19:728
172. Only indication of systemic steroids in which types of Psoriais?
a. Pustular Psoriasis
b. Erythroderma
c. Psoriatic arthropathy
d. Impetigo herpetiformis
Ans. (d)
Ref.
(1) Cather JP, 2006 Combining traditional agents and biologics for the treatment of Psoriasis-Arch of Dermatol, p.24-37.
(2) Goffe B, et al., 2004 Dermatoses of Pregnancy, Am.J. Obstet Gynecol, p.188: 863
173. A boy with multiple bullous lesions over trunk and radiological examination shoed periostitis. What is the next investigation of choice?
a. VDRL for mother and child
b. PCR of maternal TB
c. HBs Ag screening
d. ELISA for mother and baby
Ans. (a)
Ref.
(1) Wender GD at al: Treatment of Syphilis in pregnancy and prevention of Congenital Syphilis, Clin. Infect. DIs., 207, p 35-64
(2) Vrui M, et al., Bone involvement in Congenital syphilis-An overview Clinical and Radiological, 2003, EUr J. Paediatr, p.162-184
174. A 5 years old boy presented in the casualty with multiple petechial hemorrhages. Lab investigation showed IgA deposits. Along the blood vessels the most likely diagnosis
a. Wegener’s granulomatosis
b. Henoch schonlein purpura
c. Kawasaki disease
d. PAN
Ans. (b)
Ref.
(1) Paller et al. lung lesions –Pulmonary hemorrhage-Complication of HSP, pediatr. Dermatol, 2002, p.14-299
(2) HSP An Overview –Clinical and Histological -Tancreede et al., Arch. Dermatol, 2005, P. 133-438
175. Treatment of choice for Kawasaki disease is?
a. Steroids
b. IV immunoglobulin
c. IV antibiotics
d. Methotrexate
Ans. (b)
Ref.
(1) Burns Jc, Glode MP: Kawasaki syndrome Lencet, 2007, p.364- 533
(2) Esper F et al: Association between a novel human corona virus and Kawasaki disease J inject. Dis 2005, p.191: 499
(3) Muta H, et al: Early intravenous gamaglobulin treatment for Kawasaki disease, Arch Dis child, 2004, p.89: 779
(4) Yamanchi H et al: optimal time of surgical treatment for Kawasaki Coronary artery disease J. Nippon med Sch 2004 p. 71: 279
176. A 20 year old man presented with recurrent oral ulcer with yellow base, erythematous hallow and nodules on skin probable diagnosis?
a. Drug eruption
b. Pemphigus vulgaris
c. Behcet’s syndrome
d. Herpes labialis
Ans. (c)
Ref.
(1) Arayssi et al: New insights into Pathogenesis and therapy of Behcets disease- Curr. Opin. Pharmacol, 2004, p.4: 183
(2) Bang D: clinical Spectrum of Behcets, J.Dermatol, 2007, p.28: 610
(3) Ghaten et al: Behcets and complex Aphthosis J.Am Acad. Dermatol, 2005 p.40:1
177. A 3 year old child has inthiotic lesion over scalp, face and extensor extremities. Mother gives H/O bronchial asthma. Diagnosis?
a. Atopic dermatitis
b. Seborrhoeic dermatitis
c. Contact dermatitis
d. Infantile eczematons dermatitis
Ans. (a)
Ref.
(1) Breuer at al: Safety and efficacy of Topical Tacrolimus in Childhood Atopic Dermatitis, 206, Am J. clim Dermatol, p.6: 65
(2) Stone KD: Atopic Diseases of Childhood, Curr. Opin. Paediatric.,2008, p. 15:495
(3) Wadonda N et al: A perspective Study of Atopic Dermatitis in Children, BR. J. Dermatol. 2005, p. 149: 1023
F.S.M
178. Patient diagnosed with delirium tremens assaulted his neighbor, after 4 days of abstinence from alcohol, this offence is
a. Punishable-criminal offence
b. Not punishable under section IPC 84
c. Partially responsible for his act
d. He is not responsible for his act
Ans. (b & d)
Ref. the essentials of Forensic Medicine and Toxicology by Dr. K.S Narayana Reddy, 28/e; (Chapter 21-Forensic Psychiatry & Chapter 3-CNS depressants) p.411 & p. 510-511, pg. 423, chapter 21, Forensic Psychiatry
179. What is the punishment for medical negliance?
a. 2-5 years
b. 5 years
c. 10 years
d. Upto 2 years
Ans. (d)
Ref. The essentials of Forensic Medicine and toxicology, by Dr. K S Naryana Reddy , 28/e;(Chapter 3-medical Low and Ethics) p.34
180. IPC for hostile witness?
a. 151
b. 191
c. 141
d. 171
Ans. (b)
Ref. The Essentials of Forensic and Toxicology, by Dr. K.S Naryana Reddy, 28/e: (chapter 2 –legal procedure) p.11
181. According to human organ transplantation act (1994), the erring doctor can be punished upto?
a. Less than 1 yr
b. Less than 2 yrs
c. >5 yrs
d. 2-5 yrs
Ans. (d)
Ref. the essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e: (Chapter 3-Medical Lw and Ethics) p.51
182. Issue of false medical certificate, is punishable under IPC?
a. 147
b. 157
c. 197
d. 137
Ans. (c)
Ref. The Essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e; (Chapter 2-legal procedure) p.8
183. Stackes formula of teech is used for age group?
a. Infants
b. Old age
c. 25-50 years
d. Above 50
Ans. (a)
Ref. the Essentials of forensic Medicine and toxicology by Dr. K.S Narayana Reddy, 28/e ; (Chapter 4-identification) p.64
184. Flaying is a feature of which laceration
a. Tear
b. Streatch
c. Avulsion
d. Split
Ans. (c)
Ref. The Essentials of Forensic Medicine and toxicology,by Dr. K.S Narayana Reddy, 28/e; (Chapter 8-mechanical injuries) p.167
185. First ossification centre formation in intra uterine life
a. End of 2nd month
b. 3 month beginning
c. End of 3rd month
d. End of 4th month
Ans. (a)
Ref. The essentials of Forensic Medicine and Toxicology, by Dr. K.S Narayana Reddy, 28/e; (Chapter 4-idntification) p-74
186. Which is an incorrect match?
a. Murder-300
b. Culpable homicide not amounting to murder-304
c. Attempted suicide-306
d. Attempt murder-307
Ans. (c)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; Chapter 10-Medico-legal Aspects of Wounds) p. 255-265
187. Best specimen for DNA testing in autopsy is
a. Liver
b. Brain
c. Kidney
d. Spleen
Ans. (d)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; (Chapter 20-Blood stains) p.408
188. In palate printing most common site for taking prints
a. Posterior part of palate
b. Anterior part of palate
c. Lateral part of palate
d. Middle part palate
Ans. (b)
Ref. The Essentials of Foresic Medicine and Toxicolgy by Dr. K. S Narayana Reddy, 28/e; (Chapter 4- identification) p.78
OPHTHALMOLOGY
189. MIZOU phenomenon seen in
a. Oguchi’s disease
b. Choroidermia
c. Flavus albipunctatus
d. Flavus
Ans. (a)
Ref. kansky 6/e p. 683, 692
190. Drug used in LUMINATE programme for non infections uveitis is
a. Cyclosporine
b. Voclosporine
c. Methotrexane
d. Infliximab
Ans. (b)
Ref. www.luxbio.com
191. Azithromycin given for mass propylaxis, if prevalence of trachoma in children of 1-9 years is more than?
a. 10%
b. 6%
c. 8%
d. 4%
Ans. (a)
Ref. Parsons and internet –wikipedia
192. A young man following RTA presented with proptosis and pain in right eye after four days. o/E bruise on forehead and Rt eye what is the cause?
a. Cavernous sinus thrombosis
b. Internal carotid A.Aneurysm
c. Carotico cavernous fistula
d. Fracture of sphenoid
Ans. (c)
Ref. Parson’s 20/e
193. A young female presented with severe sudden bilateral visual loss more on right side with no perception of light. o/E fundus, Pupillary response, optokinetic nystagmus is normal, what is the cause?
a. Functional visual loss
b. Optic neuritis
c. Anterior ischaemic optic neuropathy
d. CMV retinitis
Ans. (a)
Ref. Kanski 6/e
194. Endothelial cells lost in descemet membrane striping in ________keratoplasty?
a. 0.5%
b. 10-20%
c. 30-40%
d. 50-605
Ans. (C)
Ref. Corneal surgery Frederick S.Bright –Bill 4/e p. 66-67
195. In herpes zoster ophthalmicus all are present except
a. Pseudodendritic keratitis
b. Ant stromal keratitis
c. Sclerokeratitis
d. Endothetitis
Ans. (c)
196. Founders of vision 2020 are all except
a. WHO
b. UNICEF
c. ORBIS international
d. Agency for control of blindness
Ans. (b)
Ref. Vision 2020 CME series
ANAESTHESIA
197. Which of the following in anesthesia will produce decreased EEG activities
a. Hypothermia
b. Early Hypoxia
c. Ketamine
d. N20
Ans. (a)
Ref. Textbook of Anesthesia, Aitkenhead 2nd edition, p.187
198. Which of the following is not true about xenon anesthesia
a. Non explosive
b. Minimal cardiovascular side effects
c. Slow induction and slow recovery
d. Low blood gas solubility
Ans. (c)
Ref. www.expresshealthcaremgmt.com/20050515/criticare10.shtml A to Z text of Anaesthesia
PATHOLOGY
199. Endothelial retraction due to cytoskeletal rearrangement in acute inflammation is?
a. Immediate & Transient increased permeability
b. Immediate & prolonged permeability
c. Late & transient permeability
d. Late & prolonged permeability
Ans. (a)
Ref. Robbins and Cotrn pathologic Basis of Disease, 8/E
200. The 40 nm gap in between the tropocollagen molecule in collagen which server as the site of bone formation is occupied by which of the following
a. Calcium
b. Iron
c. Carbohydrate
d. Ligandmoiety
Ans. (a)
Ref. Robbins and cotran pathologic Basis of Disease, 8/E.h
201. Alzheimer’s disease, false?
a. Number of Neural plaques increase with age
b. Neural tangles and severity are directly proportional
c. Extracellular lesions occurs without intracellular lesions
d. Pressure of tau proteins
Ans. (c)
