Medicine September 2008
1. Carotid sinus massage acts via controlling the heart rate by:
a. Decreasing AV blockage
b. Decreasing SA node discharge
c. Increasing AV blockade
d. Increasing Absolute refractory period of purkinje fibres
2. Carotid sinus massage should be given for duration of? --------To prevent death
a. 10 seconds
b. 15 seconds
c. 30seconds
d. 60seconds
3. Prophylaxis for meninigococcal meningitis is:
a. Tetracycline
b. Rifampicin
c. Sulfadiazine
d. Trimethoprim
4. Shampoo preapartion is all except:
a. Selenium
b. ketoconazole
c. x
d. x
5. Splenomegaly is a feature of
a. Hereditary spherocytosis
b. Sickle cell anemia
c. Rhabdomyosarcoma
d. Paroxysmal nocturnal hemoglobinuria
6. All are used in management of burns except:
a. Eusol
b. Silver sulphadiazine
c. Savlon
d. Betadine
7. More bleeding occurs in scalp because of:
a. Separation of ruptured ends of blood vessels due to separation of galea aponeurotica
b. Relatively More vascular area
c. Sub-periosteal bleeding from emissary veins
d. Tortous course of scalp blood vessels
8. Epleys maneurver is used for management of?
a. Beningn positional paroxysmal vertigo
b. Acoustic neuroma
c. Menerier’s disease
d. otosclerosis
Benign paroxysmal positional vertigo (BPPV) is caused by a rapid change in head movement. The person feels they or their surroundings are moving or rotating. Common causes are head trauma or ear infection. BPPV can be caused by debris in the semicircular canal of the ear that continues to move after the head has stopped moving. This causes a sensation of ongoing movement that conflicts with other sensory information. The review of trials found the Epley manoeuvre (four specific movements of the head and body designed to move the debris out the ear canal) is safe and effective.
http://www.cochrane.org/reviews/en/ab003162.html
9. Tracheostomy three mcq on upper middle and lower Tracheostomy?
a. x
b. x
c. x
d. x
10. Site of appendix incision?
a. Junction middle and outer third of line joining umbilicus with ant sup iliac spine
b. Junction middle and inner third of line joining umbilicus with ant sup iliac spine
c. Junction inner and outer third of line joining umbilicus with ant sup iliac spine
d. Junction inner and outer third of line joining umbilicus with ant sup iliac spine
11. Marcus Gunn pupil seen in?
a. Neurosyphilis
b. Diabetes mellitus
c. Multiple sclerosis
d. Gullian barre syndrome.
Explanation: answer is C
Choice C: MARCUS GUNN pupil is weird pupil, which does not have a direct light reflex but has a consensual light reflex. HOW? Read on …………………………
Light reflex has an afferent pathway of optic and efferent pathway through Occulomotor nerve. The afferent info is sent via the lateral geniculate body to the edinger Westphal nucleus located in the midbrain. The basic point to be understood is that the Edinger westphal nucleus has a bilateral discharge i.e. if you shine a torch in lets say left eye of the patient, the left eye of the patient shows pupillary constriction known as DIRECT LIGHT reflex and the opposite eye also shows papillary constriction known as CONSENSUAL light reflex.
Multiple sclerosis as per English language means gliosis at multiple sites in the brain. These sites of gliosis are known as plaques and can be seen in an MRI. The plaques have a propensity to involve the optic pathway, mainly the optic pathway.
Assuming In case only the left optic nerve is affected the DIRECT light reflex on the left side will be afflicted. So the pupil on left side is not constricting. In these circumstances you shall now swing your torchlight to the right side and voila!!!! You manage to stimulate the edinger westphal nucleus, which has a bilateral discharge. You get a direct light reflex in the right eye and a consensual light reflex in the left eye.
Choice A: neurosyphilis has ARGYL ROBERTSON pupil. [Read it as ARP: ACCOMODATION reflex present, PRA – Pupillary reflex absent.]
Choice B: Diabetes mellitus neuropathy can have 3rd nerve palsy with pupillary sparing as per Harrison so light reflex would be preserved.
Choice D: Gullian Barre syndrome is a de-myelinating disorder of the spinal cord presenting with ASCENDING SYMETRICAL FLACCID paralysis. The cranial nerve involved in GBS is the 7th nerve and therefore can be easily excluded.
12. A pregnant woman on phenytoin presents to your clinic, which shall be the best recommendation for her?
a. Continue phenytoin add folic acid
b. Start phenobarbitone
c. Start phenobarbitone and folic acid
d. Start vigarbatrin and folic acid
EXPLANATION: answer is C
Phenytoin causes folic acid deficiency, which is obviously going to cause a dimorophic anemia in the mother. But at the same time the folic acid deficiency has been categorically linked to neural tube defects NTD, the most common being spina bifida occulta.
Hence it is prudent that phenytoin be withdrawn and cover up with phenobarbitone be recommended but with a COVER Of folic acid 0.4mg once a day.
13. Thyrotoxicosis patient presents with palpitations to the OPD. Best immediate management shall be?
a. Propranolol
b. Start propylthiouracil with propranolol
c. Start levothyroxine
d. Start carbimazole with iodine drops
EXPLANATION: ANSWER IS A
Thyroid hormones have a sympathomimetic effect via beta 1 receptors causing palpitations. At the same time they act via beta 2 receptors to cause tremors. Adding fuel to the fire is increased BMR causing heat intolerance.
Since this query does not talk about atrial fibrillation but simple presentation of the patient to the OPD the best answer shall be non selective beta blocker – propranolol.
Choice B would be prudent in case the question talked about a thyroid storm where propyl-thioracil would also prevent formation of T3 form T4
Choice C is used for hypothyroidism
Choice D is used for preoperative management of toxic nodular goiter to prevent the onset of thyroid storm
THYROTOXICOSIS
Primary
Secondary
Cause
L.A.T.S. long acting thyroid stimulator antibody, which mimics TSH.
Remember its different from T.P.O. thyroid peroxidase antibody which is seen in Hashimoto’s Thyroiditis
Pituitary adenoma
Manifestations
Young patient mainly women
Bilateral PROPTOSIS +
MYXEDEMA+
ACROPACHY+
No gender predilection
PROPTOSIS absent
MYXEDEMA absent
ACROPACHY absent
ATRIAL FIBRILLATION present
14. A patient of Tuberculosis present with malaise, fatigue and hyperpigmentation on flexural creases. On lab investigation sodium is 120meq /dl and potassium is 6.5meq/dl. Most probable diagnosis is
a. Addison disease
b. Conn syndrome
c. Secondary Hyperaldosteronism
d. Simmond syndrome
Explanation: Answer is A
Every time you read in any MCQ sodium and potassium values given together the MCQ is obviously gonna talk about aldosterone. The basic action of aldosterone is sodium and water reabsorbtion through the distal tubule and in return gives away potassium. Potassium is precious so after a while the body gives up losing potassium and in turn loses hydrogen ions.
Normal values
Sodium = 135-145meq/dl
Potassium = 3.5-5.5meq/dl
MCQ data states
Hyponatremia
Hyperkalemia
So obviously this MCQ is about hypo aldosteronism. Moreover the cementing point in its favor is hyper pigmentation due to ACTH increase by feedback mechanism.
Tuberculosis dissemination involves various organs incidence wise: peritoneum, genitourinary, Potts spine and adrenal in that order. So in this case TB has spread to the adrenal gland and damaged it causing Addison disease.
Most common cause of ADDISON disease is autoimmunity globally bout in India is TB
The manifestations are weakness due salt wasting, hyper pigmentation, Hyponatremia, Hyperkalemia and metabolic acidosis.
The IOC is ACTH stimulation test that will fail [miserably ………the gland is damaged.]
Drug support would be salt intake to be increased to 8gms /day with FLUDORCORTSIONE which has a high mineralo-corticoid activity.
15. Zollinger Ellison syndrome the best diagnostic protocol:
a. 24 hr basal acid output and maximal acid output.
b. 24 hr secretin study
c. 24 hr gastrin study
d. Histamine stimulation test
16. Bitemporal hemianopia is seen with
a. Pituitary tumor
b. Empty sella syndrome
c. Optic tract damage
d. Occipital cortex damage
17. Definitive diagnosis of phaeochromocytoma?
a. 24 hr urinary catecholamines
b. MIBG Scan
c. CTU
d. Metapyrone test
18. Vessel rupture in hypertension in all parts of the brain except:
a. Temporal lobe
b. Thalamus
c. Cerebellum
d. Putamen
ICH, bleeding occurs directly into the brain parenchyma. The usual mechanism is thought to be leakage from small intracerebral arteries damaged by chronic hypertension. Other mechanisms include bleeding diatheses, iatrogenic anticoagulation, cerebral amyloidosis, and cocaine abuse. ICH has a predilection for certain sites in the brain, including the thalamus, putamen, cerebellum, and brain stem. In addition to the area of the brain injured by the hemorrhage, the surrounding brain can be damaged by pressure produced by the mass effect of the hematoma. A general increase in intracranial pressure may occur.
http://www.emedicine.com/EMERG/topic557.htm
19. Most common cause of mortality after 70 yrs of age?
a. Cardiovascular mortality
b. Diabetes mellitus and complications
c. Peripheral vascular disease
d. Mesenteric insufficiency
20. Which is a pre-cancerous lesion of esophagus
a. barret esophagus
b. peutz jehgers
c. crohn disease
d. Ulcerative colitis
21. Recurrent episodes of Blood stained sputum can be the presenting symptom of?
a. Bronchial adenoma
b. Cavity
c. Bronchiectasis
d. Tuberculosis
22. Lesion of the caudate lobe of basal ganglia causes
a. Chorea
b. atheotosis
c. hemiballismus
d. Intentional tremors
EXPLANATION: The answer is A
Chorea
Atheotosis
Hemiballismus
Lesion of caudate nucleus
Remember the C word
Lesion of putamen
Lesion of subthalaamic nucleus
Involuntary proximal movements eg shrugging of shoulders
Involuntary distal movements eg snake head like movement of hand
Combo of proximal and distal involuntary movements eg involuntary flinging of the arms
Choice D is intentional tremors, which are seen in patients of cerebellar disease.
23. Deficiency of which vitamin does not cause anemia?
a. Biotin
b. Pyridoxine
c. Folic acid
d. B12
24. Punched out lesion in the skull is seen in:
a. Mutiple myeloma
b. Hyperparathyroidism
c. Pagets disease
d. Osteopetrosis
25. Closed Pneumothorax, the best position of the CXR shall be?
a. Expiration in erect position
b. Lateral decubitus position
c. Inspiration in erect position
d. Inspiration in lateral decubitus position.
26. Wide fixed split S2 is seen in:
a. ASD
b. VSD
c. PDA
d. TOF
27. Thrombocytopenia is diagnosed by
a. Bleeding time
b. Clotting time
c. Prothrombin time
d. Activated partial thromboplastin time
28. Extrinsic pathway is measured by
a. BT
b. CT
c. APTT
d. PT
29. Hemophilia pattern of inheritance is:
a. XLR
b. XLD
c. AR
d. AD
30. Digitalis toxicity is managed by:
a. Potassium
b. digiband
c. amiodarone
d. lignocaine
31. Preserved blood does not contain
a. Citrate
b. Heparin
c. Dextrose
d. Phosphate
32. Tumor marker for pancreatic cancer
a. Ca19.9
b. Ca –125
c. BRCA
d. CEA
33. Lumbar puncture needle doesn’t puncture
a. supraspinatus
b. infraspinatus
c. ligamentum flavum
d. x
34. CSF glucose levels are reduced in all of the following except:
a. Bacterial meningitis
b. Viral meningitis
c. Tubercular meningitis
d. Subdural Empyema
35. Diagnostic procedure for kala azar can be which of the following?
a. Indirect fluoroscent antibody test
b. L.D. bodies in splenic aspirate
c. Aldehyde test
d. ELISA
36. Most dangerous toxin is:
a. botulinism
b. x
c. x
d. x
37. NNN media is used for diagnosis of
a. Brucella
b. Leshmania
c. ankylostoma
d. strongyloides stercoralis
38. Young female with complaints of dysnea on exertion and related symptoms of heart etiology. Best modality for investigation shall be:
a. CXR
b. ECG
c. Echocardiography
d. Angiography
39. The following can cause Hypocalcemia
a. calcitonin
b. Hyperparathyroidism
c. Sarcoidosis
d. Lithium therapy
40. The following vitamin is given with vitamin D for osteoporosis
a. Vitamin A
b. Vitamin E
c. Vitamin K
d. Vitamin E
41. Least common fungal infection in immunocompromised hosts shall be:
a. Malazzia furfur
b. Cryptosporidium
c. Candida
d. Penicillium marafucci
Malassezia furfur a lipophilic yeast causes pityriasis versicolor , follicular titriasis, sebborheic dermatitis .
Penicillium marafucci causes hyalohyphomycosis.
42. All are features of hypothyroidism except
a. pretibial myxedema
b. Puffiness of face
c. Low voltage ECG
d. Alopecia and constipation
43. Type 2 diabetes mellitus is caused by:
a. Deficiency of insulin
b. Excess of insulin
c. Resistance to insulin
d. Defective structure of insulin
44. Most common Valvular lesion after MI is seen in:
a. Mitral regurgitation
b. Mitral stenosis
c. Aortic stenosis
d. Aortic regurgitation
45. Auer rods are seen in:
a. ALL
b. AML
c. CML
d. CLL
46. Falciparum malaria causes all except:
a. blackwater fever
b. Algid malaria
c. Hypoglycemia
d. Alkalosis
47. Splenomegaly is not seen in:
a. Sickle cell anemia
b. Gaucher
c. TORCH
d. Kala Azar
48. Bilaterally shrunken kidneys are seen in:
a. Diabetes mellitus
b. Amyloidosis
c. Hydronephrosis
d. Renal vein thrombosis
49. Daily sodium requirement per day would be?
a. 3-5gm
b. 300mg-500mg
c. 3ug- 5ug
d. 3-5mg
50. FTA –ABS is used for diagnosis of
a. Syphilis
b. Borrelia
c. Brucella
d. Lyme disease
Pathology
51. curcshman spirals are seen in:
a. Bronchial asthma
b. Chronic bronchitis
c. Acute bronchitis
d. Bronchiectasis
Pharmacology
52. Anti-diabetic drug which causes weight loss shall be:
a. metformin
b. phenformin
c. glibenclamide
d. repaglinide
53. Anti- diabetic drug that does not cause hypoglycemia shall be
a. tolbutamide
b. repaglinide
c. chlorpropamide
d. acarbose
54. Regimen for hodgkins lymphoma
a. ABVD
b. MOPP
c. CHOP
d. MECOPP
55. Renal toxicity is highest for:
a. Azathiorpine
b. Cyclophosphamide
c. Vincristine
d. Sirolimus
56. Maintenance therapy for uncomplicated bipolar disorder is
a. Lithium
b. Olenzapine
c. mainserin
d. haloperidol
57. Timolol maleate acts by
a. Increasing trabecular outflow
b. Increasing uveoscleral outflow
c. Decreased production of aqueous humor production.
d. Increased production of aqueous humor production.
58. pilocarpine mechanism of action in glaucoma
59. Mechanism of action of sulfonylaurea:
a. Increase insulin release
b. Decrease of insulin release
c. Increase GLUT 4 receptors
d. Increase sensitivity of insulin receptors
60. Bromocriptine mechanism of action:
61. mifeprisotne is an:
a. abortifacient
b. x
c. x
d. x
62. Drug dependence means
a. x
b. x
c. x
d. x
63. Fluoride toxicity is seen with:
a. methoxyflurane
b.
64. Competitive antagonist is:
a. x
b. x
c. x
d. x
65. Myasthenia gravis is resistant to which drug:
a. depolarisingmuscle relaxant
b. Non depolarizing muscle relaxant
c. Both of above
d. None of above
Ophthalmology
66. Distance direct opthalmoscopy can detect all except:
a. Retinal detachment
b. Macular edema
c. Vitreous hemorrhage
d. x
67. All are false for retinoblastoma except:
a. 60% chances of death
b. Translocation of 11q 14
c. 50% chance of transmission
d. Mean age of diagnosis at 5yrs
http://www.emedicine.com/RADIO/topic604.htm
About 60% of patients have unilateral RB, with a mean age at diagnosis of 24 months, and about 40% have bilateral RB, with a mean age at diagnosis of 15 months. Mutations in the RB gene (chromosomal location 13q14) predispose individuals to the disease
The mortality rate associated with optic nerve invasion up to the lamina cribrosa is 15%; beyond the lamina cribrosa, the rate is 44%; and to the line of resection, the rate is 65%.
Preferred Examination
Detailed ophthalmologic examination includes indirect ophthalmoscopy, examination under anesthesia, visual field charting, and visual acuity testing. Routine systemic evaluations are performed, such as complete blood cell counts, liver function studies, and kidney function studies.
Fine-needle aspiration (FNA) biopsy can be used as a diagnostic modality in select intraocular tumors and similar conditions. In advanced cases, a metastatic workup must be performed, including a bone marrow biopsy, CSF cytologic tests for malignant cells, and bone scanning
Management
External-beam irradiation
External-beam irradiation is not used as often as some other therapies because of long-term radiation complications—the most important of which is the development of radiation-induced tumors—and because of greater success with other modalities (Shields et al, 2004). Patients with RB have a higher-than-normal incidence of secondary tumors, which is further increased by radiation. Radiation also arrests bone growth, resulting in an asymmetrical face. This treatment is, however, useful in patients who have progressive disease despite chemotherapy or who have marked vitreous spread.
Plaque radiation therapy
Plaque radiation therapy delivers radiation in a more localized manner than external-beam radiation, which, theoretically, should minimize development of radiation-induced tumors. Plaque radiation therapy is more effective for larger tumors than cryotherapy and photocoagulation. However, plaque radiotherapy has a higher incidence of localized radiation complications involving the optic nerve and retina. Commonly used plaques are cobalt-60 (60Co) and ruthenium-106 (106Ru).
Cobalt-60 ophthalmic plaques
Cobalt-60 eye plaques were the first type of plaque therapy used for intraocular tumors and act as a high-energy source. 60Co rings are encased in a platinum shell that does not block the radiation; therefore, 60Co eye plaques send out radiation in all directions. On a standard radiograph, a 60Co eye plaque demonstrates a spherical distribution of radiation.
Ruthenium-106 ophthalmic plaques
Ruthenium-106 ophthalmic plaques emit beta particles, which typically travel 4-5 mm into the eye. High-energy bremsstrahlung photons are also emitted, although they are minor components of the radiation dose.
Low-energy plaques
Low-energy plaques have largely replaced 60Co and 106Ru sources for plaque radiation therapy.
Treatment of metastasis
Post enucleation adjuvant therapy is safe and effective in that it significantly reduces the occurrence of metastasis in patients with RB that has high-risk histo-pathologic characteristics.
68. Causes of ectopia lentis are all except:
a. refsum disease
b. ehler danlos
c. aniridia
d. hyperlysinemia
69. Snow flake cataract is seen in:
a. Diabetes mellitus
b. Galactosemia
c. Anderson disease
d. Myotonic Dystrophy
70. Young girl with trauma with a cracker in one eye presents with pain in the other eye after one month. The diagnosis shall be:
a. Sympathetic opthalmitis
b. Anterior iridocyclitis
c. Eale’s disease
d. Vitreous hemorrhage
71. All of the following cause cataract except:
a. Steroids
b. miotics
c. x
d. x
72. rubeosis iridis is seen in:
a. Diabetes mellitus
b. CRVO
c. Eales disease
d. Myotonic dystrphy
73. All of the following cause follicular conjunctivits except:
a. Chylamydia
b. Adenovirus
c. Allergy
d. X
74. Best investigation for best disease is:
a. EOG
b. Direct opthlmoscopy
c. VEP
d. Optokinetic nystagmus
75. In a retina diagram:
a. Detached retina is red
b. Attached retina is blue
c. Detached retina is green
d. Attached retina is green
76. All of the following form the orbit except:
a. Anterior and posterior wall of ethmoid
b. Sphenoid
c. trochlear fossa
d. Frontal process of maxilla
77. S in SAFE strategy for Trachoma is:
a. Surgery
b. Sanitation
c. Sulfonamides
d. All of the above
Radiology
78. Right border of the heart is not formed by:
a. Aortic bulb
b. Right ventricle
c. Right atrium
d. Auricle right
79. Gallium scan are used for all except:
a. Sarcoidosis
b. HL
c. NHL
d. Cardiac output
80. X rays are discovered by:
a. Roentogen
b. Madam curie
c. Piccasso
d. Michalengelo
81. For thyroid scan which of the following are used:
a. I 131
b. I 1123
c. B
d. J
82. Double bubble appearance is seen in:
a. Duodenal atresia
b. ileal atresia
c. Meckel’s dicvericulum
d. gastrochisis
Forensic medicine
83. Vitreous humor is preserved in:
a. Arsenic poison
b. Ethylene glycol
c. dhatura
d. organophosphorus poisoning
84. Beveling of the inner table of the skull is found in:
a. Entry wound
b. Exit wound
c. Stab wound
d. Penetrating injury
Orthopedics
85. TB commonly afflicts which joint?
a. Hip
b. Knee
c. Vertebra
d. Elbow
86. myositis ossificans traumatica is common in:
a. Elbow
b. Hip
c. Shoulder
d. Knee
87. Trendelenburg test is positive due to
a. Weakness of gluteus medius and minimus
b. X
c. X
d. X
88. Most common metastasis to vertebra is:
a. Secondaries
b. X
c. X
d. X
89. Acute osteomyleitis is seen commonly with:
a. staphylocccccus aureus
b. Streptococcus viridans
c. enterococcus
d. Salmonella typhi
90. Complication of fracture of lateral condyle of elbow are all except:
a. Tardy ulnar nerve palsy
b. Non union
c. valgus
d. x
ENT
91. Immediate tracheostomy is not done in:
a. Acute severe asthma
b. Laryngeal carcinoma causing stridor
c. Foreign body
d. X
92. otospongiosis is a common focus in:
a. Anterior
b. Posterior
c. circumventricular
d.
93. Bone which does not take part in formation of nasal septum
a. Lacrimal
b. Frontal
c. Vomer
d. Nasal
94. Acoustic neuroma
a. x
b. x
c. x
d. x
95. Recurrent papilloma in the larynx is best treated by:
a. Cryosurgery
b. radiotheraphy
c. Laser
d. x
96. MC congenital anomaly of larynx is:
a. laryngomalacia
b. x
c. x
d. x
97. Distance beween incisor and cricophyranx:
a. X
b. X
c. C
d. X
Surgery
98. Breast abscess is mainly caused by:
a. Staphy locus aureus
b. Streptococcus
c. X
d. X
99. Intermittent claudication with rest pain is
a. Pain while hanging the leg, walking and persists on elevation of leg
b. Pain only while hanging the leg
c. Pain on hanging the leg and walking
d. Pain only on walking
100. varicocele in left sided testis is caused by:
a. left sided hydronephrosis
b. x
c. x
d. x
101. Treatment of choice for a seminoma stage 1
a. x
b. x
c. x
d. x
102. Urinary incontinence in older patients is due to:
a. a x
b. x
c. x
d. x
103. While catheterization of urethra which part of the urethra is most prone to rupture?
a. a. x
b. x
c. x
d. x
104. Pre-malignant lesion of breast
a. ductal ectasia
b. x
c. x
d. x
105. Congenital hydrocele is best managed by:
a. Aspiration
b. x
c. x
d. x
106. Narrowest part of small intestine is
a. a x
b. x
c. x
d. x
107. Pouch of doughlas is seen between
a. Rectum and vagina
b. x
c. x
d. x
108. sialdolithiasis is seen with:
a. xx
b. x
c. x
d. x
109. Cholesterol stones in gall bladder?
a. x
b. x
c. x
d. x
110. Most common cause of solitary adenoma of thyroid is
a. multinodualr goiter
b. Adenoma
c. Carcinoma
d. Thyroiditis
111. Fournier gangrene afflicts
a. Scrotum
b. Abdominal wall
c. Rectum
d. Anus
112. subcapsular orchidectomy is done for :
a. Cancer prostate
b. Cancer testis
c. Ca penis
d. Cancer bladder
113. Complication of total parenteral nutrition is :
a. Hyperkalemia
b. X
c. X
d. X
OBG and GYNAE
114. 3rd degree perineal tear should be repaired by
a. Within 24 hrs
b. Within 48hrs
c. Within 3 weeks
d. Within 6 weeks
115. Urethral injury in case of obstrucuted labor is best managed by:
a. LSCS
b. Hysterectomy
c. Continous cathreterization for 14 days
d. Conservative
Psychiatry
116. A young woman after stress leaves home and goes to another place and then returns to her house one and a half months later. The most Probable diagnosis shall be:
a. Dissociative fugue
b. Adjustment disorder
c. Schizophrenia
d. Schizophreniform disorder
117. In dementia what is absent:
a. Global intelligence
b. X
c. X
d. X
118. Alcohol withdrawal symptoms:
a. Tremors
b. Palpitations
c. x
d. x
Dermatology
119. Erythroderma is seen in all except:
a. Mycosis fungoides
b. psoriaisis
c. x
d. x
Physiology
120. Immunoglobulin passing through the placenta is:
a. IG A
b. IGG
c. IGE
d. IGD
121. Buffer of interstitial fluid is:
a. H2 PO4
b. X
c. X
d. x
122. Glucose is maximally absorbed in:
a. Proximal convoluted tubule
b. Distal convoluted tubule
c. Collecting duct
d. Xx
123. Inverse stretch reflex is mediated through
a. golgi tendon
b. x
c. x
d. x
124. Extra-cellular fluid has mainly which cation
a. Sodium
b. Potassium
c. Calcium
d. Phosphate
125. Glucose uses which transporter for absorbtion through gut
a. GLUT1
b. GLUT2
c. GLUT3
d. SGLT1
126. Water absorption and urine production is mediated by
a. ADH
b. X
c. X
d. X
Biochemistry
127. Largest store of glycogen is seen in:
a. Liver
b. Muscle
c. x
d. x
128. NADPH has a role mainly in:
a. Energy production
b. X
c. X
d. X
129. Major breakdown product of triglycerides is
a. Fatty acid
b. Xx
c. X
d. X
130. In starvation body mainly uses:
a. ketone bodies
b. x
c. x
d. x
131. RBC enzyme is
a. HMP
b. X
c. X
d. x
132. codon
a. x
b. x
c. x
d. x
133. amphibolic reaction is seen in:
a. x
b. x
c. x
d. x
134. cytochrome oxidase inhibitor is :
a. Cyanide
b. Phosphate
c. Phosgene
d. acarbose
135. DNA contains all except:
a. uracil
b. Adenine
c. Guanine
d. thymine
Anatomy
136. Nerve supply of hypo-thenar muscles is:
a. Ulnar
b. Median
c. x
d. x
137. Length of cartilaginous part of Eustachian tube shall be:
a. 8cm
b. 10cm
c. 15cm
d. 20cm
138. Length of esophagus
a. 25cm
b. 30cm
c. 40cm
d. 45cm
139. Nerve present below 3rd molar tooth is:
a. x
b. x
c. x
d. x
140. Shape of cartilage of trachea is:
a. Horse shoe
b. Circle
c. x
d. x
141. Clavipectoral fascia is pierced by all except:
a. Lateral pectoral nerve
b. Medial pectoral nerve
c. x
d. x
SPM
142. All show herd immunity except:
a. Measles
b. Chickenpox
c. Rabies
d. Mumps
143. Incineration is done for:
a. x
b. x
c. x
d.
144. Extra calories required in a lactating mother
a. 150kcal
b. 300kcal
c. 550kcal
d. 750kcal
145. Total dose of vitamin A in vitamin A prophylaxis pprgramme is:
a. 2 lacs iu
b. 5lacs iu
c. 9lacs iu
d. 15 lacs iu
146. BOAA causes:
a. Endemic ascites
b. lathyrism
c. x
d. x
147. Standard deviation is a measure of:
a. Central tendancy
b. x
c. x
d. x
148. Normal water supply per head in rural india
a. 20litres
b. 40litres
c. 60litres
d. 80 litres
149. All of the following are indicators of obesity except:
a. Pearl index
b. Body mass index
c. Xx
d. Xx
150. HIV prevention encompasses all except:
a. Behavioral communication
b. Provision of condoms
c. Treatment of STD
d. Giving ART
151. BMI is:
a. Weight by height
b. Height by weight
c. Surface area by height
d. Weight by surface area
Microbiology
152. Staphylococcus causes vomiting by which mechanism:
a. x
b. x
c. xx
d. x
153. Cellulitis is commonly caused by:
a. Staphylococcus
b. Streptococcus
c. x
d. x
154. All of the following cause diarrhea except:
a. Rotavirus
b. Norwalk virus
c. Astrovirus
d. All of above
155. negri bodies for ante-mortem diagnosis of rabies are seen in
a. Saliva
b. Eye
c. Brain
d. Heart
156. Malignant pustule is seen in;
a. Anthrax
b. x
c. x
d. x
Pediatrics
157. SSPE is a complication of
a. Measles
b. Mumps
c. Rubella
d. Hepatitis
158. Rickets radiological features are;
a. Widening cupping and splaying of distal end of radius
b. Widening cupping and splaying of distal end of femur
c. White line of calcification
d. Fraying of distal end of ulna
159. Frenkel line and Wimberger sign is seen in:
a. Scurvy
b. Rickets
c. Enhler Danlos
d. Muco-polysaccharidosis
160. koplik spots are seen in :
a. Measles
b. Mumps
c. Rubella
d. Hepatitis D
161. Surfactant is produced by?
a. Type 2 pneumocytes
b. Type 1 pneumocytes
c. Pores of kahn
d. Cuboidal lining of surfactant
162. Normal birth weight of a baby shall be:
a. 2.5kg
b. 2.7kg
c. 2.8kg
d. 3.0kg
163. Physiological jaundice is not seen in which of the following on the first day of life of a baby?
a. Low birth weight baby
b. G 6PD deficiency
c. Term small for date baby
d. Term large for date baby
164. Physiological jaundice is relieved in how many days?
a. 3 days
b. 5 days
c. 7 days
d. 14 days
165. A child can draw a circle by the age of:
a. 2 yrs
b. 3yrs
c. 4yrs
d. 5yrs
166. 6month old baby with an abdominal mass shall be:
a. Neuroblastoma
b. Wilms tumor
c. Rhabdomyosarcoma
d. Cavernous Hemangioma liver
167. Breast milk secretion is mediated by:
a. Prolactin
b. Oxytocin
c. ADH
d. All of above.
168. Commonest leukemia in down syndrome
a. ALL
b. AML
c. CML
d. CLL
169. Zinc deficiency causes
a. acrodermatuitis enterohepatica
b. casal necklace
c. Chronic diarrhea
d. Megalobalstic anemia
170. Dose of folic acid required per day to prevent neural tube defects would be ?
a. 400mcg
b. 400mg
c. 4mg
d. 40mg
171. Urethral anomaly in children is:
a. Stricture
b. x
c. x
d. x
172. Allergic reaction mainly seen with which vaccine
a. BCG
b. DPT
c. Measles
d. OPV
