Instruction:
Hypokalemia is seen with -
A. Frusemide
B. Coisol
C. Metabolic acidosis
D. Amiloride

Response:
Furosemide also can lead to gout caused by hyperuricemia. Hyperglycemia is also a common side effect. The tendency, as for all loop diuretics, to cause low serum potassium concentration (hypokalemia) has given rise to combination products, either with potassium or with the potassium-sparing diuretic amiloride (Co-amilofruse). Other electrolyte abnormalities that can result from furosemide use include hyponatremia, hypochloremia, hypomagnesemia, and hypocalcemia. In the treatment of hea failure, many studies have shown that the long-term use of furosemide can cause varying degrees of thiamine deficiency, so thiamine supplementation is also suggested. Although disputed, it is considered ototoxic: "usually with large intravenous doses and rapid administration and in renal impairment". Other precautions include: nephrotoxicity, sulfonamide (sulfa) allergy, and increases free thyroid hormone effects with large doses Ref Davidson 23rd edition pg 365

So the answer to this question is A


Instruction:
True about EMLA:
A. Can be used for intubation
B. Mixture of local anesthesia
C. Faster acting
D. All

Response:
B i.e. Mixture of local anesthesia - Procaine, Mepivacaine & BupivacaineQ (Provide me BUM) are never used topically. - EMLA is eutectic mixture of local anesthetics (2.5% lidocaine & 2.5% prilocaine)Q commonly used to make venepuncture painless especially in children.

So the answer to this question is B


Instruction:
Which condition is Autosomal dominant
A. Hemophilia A
B. Duchenne muscular dystrophy
C. Wilson's disease
D. Adult polycystic kidney disease

Response:
Adult polycystic kidney disease → Autosomal dominant
Duchenne muscular dystrophy → X linked
Wilson's disease → Autosomal recessive (AR)
Hemophilia A → X-linked

So the answer to this question is D


Instruction:
Two regarding use of Bromocriptine for suppression of lactation includes
A. It can cause deep vein thrombosis
B. It can cause hypotension
C. Metaclopramide potentiates the action of Bromocriptine
D. It is given for 1 week only

Response:
Refer KDT 6/e p236 For suppression of lactation D2 agonists like Bromocriptine can be used In hyoerprolactinemia these are given for long periods Metoclopromide being a D2 antogonist will stop the action of Bromocriptine Adverse effects of Bromocriptine include nausea, vomiting, postural hypotension, digital vasospasm and CNS effects like hallucinations ,psychosis

So the answer to this question is B


Instruction:
All the following are true regarding blood supply to the kidney, except
A. Stellate veins drain superficial zone
B. It is site of poosystemic anastomosis
C. The renal aery divides into five segmental aeries before entering the hilum
D. Its segmental aeries are end-aeries

Response:
.

So the answer to this question is B


Instruction:
Which of the following is the most common site of traumatic CSF Rhinorrhea
A. Ethmoid sinus
B. Frontal sinus
C. Pariental fossa
D. Sphenoid sinus

Response:
CSF from anterior cranial fossa reaches the nose (i) cribriform plate, (ii) roof of ethmoid air cells or (iii) frontal sinus. CSF from middle cranial fossa follows injuries to sphenoid sinus. In fractures of temporal bone, CSF reaches the middle ear and then escapes through the eustachian tube into the nose (CSF otorhinorrhoea)Anterior skull base leaks are more common than middle or posterior leaks, due to the firm adherence of the dura to the anterior basilar skull. The most common sites of CSF rhinorrhea following accidental trauma are the sphenoid sinus (30%), frontal sinus (30%), and ethmoid/cribriform (23%) (*Please note how close the percentages are, so can vary author to author)Dhingra 6e pg: 163

So the answer to this question is D


Instruction:
Which of the following is the hallmark of programmed cell death?
A. Apoptosis
B. Coagulation necrosis
C. Fibrinoid necrosis
D. Liquefaction necrosis

Response:
Apoptosis results from the activation of enzymes called caspases (so named because they are cysteine proteases that cleave proteins after aspaic residues). The activation of caspases depends on a finely tuned balance between production of pro- and anti-apoptotic proteins. Two distinct pathways converge on caspase activation: the mitochondrial pathway and the death receptor pathway.( Robbins Basic Pathology, 9th edition, page 19 )

So the answer to this question is A


Instruction:
What is your diagnosis:
A. Anencephaly
B. Iniencephaly
C. Myelomeningocele
D. Craniorachischisis

Response:
Ans. D. CranioschisisCranioschisis (Greek: "kranion - kranion" skull, and "schisis -skhi/sis;" - split), or dysraphism, is a developmental birth defect involving the skull. In this disease, the cranium fails to close completely (especially at the occipital region). Thus, the brain is exposed to the amnios, and eventually degenerates, causing anencephaly.Craniorachischisis is on the extreme end of the dysraphism spectrum, wherein the entire length of the neural tube fails to close

So the answer to this question is D


Instruction:
37 weeks primi with uterine contraction for 10 hours, cervix is 1 cms dilated and poorly effaced. Management is
A. Cesarean section
B. Amniotomy
C. Oxytocin drip
D. Sedation and wait

Response:
The patient is presenting at 37 weeks with mild labor pains for 10 hours. Cervix is 1 cms dilated and is not effaced. Now this can either be a case of false labor pains or it can be prolonged latent phase of labor.
Lack of progress during the latent phase is defined as lack of change or minimal change in cervical effacement and dilatation during a 2 hour period in a woman having regular uterine contractions.
The patient in the question has been having mild labor pains for 10 hours with no change in cervical dilatation and effacement. But again the question does not specify whether she is having regular uterine contractions or not.

False labor can be differentiated from latent phase of labor by therapetuic rest i.e., patient is sedated with morphine.

So the answer to this question is D


Instruction:
Intercostal vessels and nerve runs in:
A. Upper border of the ribs
B. External intercostal and Internal intercostal muscle
C. Between the external intercostal and innermost internal, inter costal muscle
D. Between the innermost intercostal and internal intercostal muscle

Response:
(Between the innermost intercostal and internal intercostal muscle) (208-BDC-l 4th) (57-Snell 7th)* Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries.* The corresponding posterior intercostal vein drain backward into the azygos or hemiazygos vein and the anterior intercostal vein drain forward into the internal thoracic and musculophrenic veinsIntercostal nerves* The intercostal nerves are the anterior rami of the first 11 thoracic spinal nerves. The anterior ramus of the 12th thoracic nerve lies in the abdomen and runs forward in the abdominal wall as the subcostal nerve* In the costal groove the nerve lies below the posterior intercostal vessels. The relationship of structures in the costal groove from above downwards is vein-artery-nerve (VAN)*** Each intercostal nerve enters an intercostal space between the parietal pleura and the posterior intercostal membrane. It then runs forward inferiorly to the intercostal vessels in the subcostal groove of the corresponding rib, between the innermost intercostal and internal intercostal muscle

So the answer to this question is D


Instruction:
BARS&; system is a method of -
A. System analysis
B. Performance appraisal
C. Network analysis
D. None of the above

Response:
System analysis is essentially finding the cost effectiveness of the available alternatives A network analysis is a graphic plan of all events and activities to be completed inorder to reach an end objective (refer pgno:872 park 23 rd edition)

So the answer to this question is B


Instruction:
Which of the following has the highest protein content per 100 gm ?
A. Egg
B. Groundnut
C. Soyabean
D. Meat

Response:
Ans. is 'c' i.e., Soyabean

So the answer to this question is C


Instruction:
Upper Gastrointestinal Endoscopy (UGIE) is indicated in All exept
A. Septic Shock
B. Atypical chest pain
C. Barrett esophagus
D. Malabsorption syndrome

Response:
(A) Septic Shock# Most common indications for diagnostic EGD include Dyspepsia unresponsive to medical therapy or associated with systemic signs, Dysphagia or odynophagia, Persistent gastroesophageal reflux symptoms, Occult gastrointestinal bleeding, and Surveillance for malignancy.# Indications for UGIE:> Upper Gastrointestinal (GI) disease: Dyspepsia, Dysphagia, Noncardiac chest pain, or Recurrent emesis)> Surveillance for upper GI cancer in high-risk settings: Barrett esophagus or Polyposis syndromes)> Biopsy for known or suggested upper GI disease: Malabsorption syndromes, neoplasms, or infections> Therapeutic intervention: Retrieval of foreign bodies, Control of hemorrhage, Dilatation or stenting of stricture, Ablation of neoplasms, or Gastrostomy placement> Contraindications for UGIE: Possible perforation Medically unstable patients Unwilling patients> Anticoagulation, Pharyngeal diverticulum, or Head and neck surgery (relative contraindications)> Septic Shock is a medically unstable patient, hence UGIE is contraindicated.

So the answer to this question is A


Instruction:
Kallu, a 24-year-old occasional alcoholic had got a change in behaviour. He has become suspicious that people are trying to conspire against him, though his father states that there is no reason for his fears. He is getting hallucinations of voices commenting on his actions. What is the most probable diagnosis:March 2013 (f, g)
A. Delirium tremens
B. Alcohol induced psychosis
C. Schizophrenia
D. Delusional disorder

Response:
Ans. C i.e. Schizophrenia

So the answer to this question is C


Instruction:
In amyotrophic lateral sclerosis true statement is-a) Present with seizuresb) Lesion in ant. horn cellsc) Corticospinal tractd) Hyporeflexia
A. abc
B. bcd
C. ac
D. bd

Response:
None

So the answer to this question is B


Instruction:
A young man is with known heroin addiction is brought in the emergency in unconscious state. On examination, the patient has decreased bowel sounds, depressed respiration and pin point pupil. The treatment of choice for this patient is
A. Oral natrexone
B. IV naloxone
C. Oral diazepam
D. Oral Buprenorphine

Response:
IV Naloxone 0.1-0.4 mg . Dose repeated every 1-2 hour as naloxone is sho acting. As patient is unconscious drug cannot be given orally. Ref: KD Tripathi 8th ed.

So the answer to this question is B


Instruction:
Clue cell is seen in -
A. Bacterial vaginosis
B. Candidial vaginosis
C. Chlamydiasis
D. Trichomonas

Response:
Ans. is 'a'i.e., Bacterial vaginosis Clue cells are seen in bacterial vaginosis - Clue cells are vaginal epithelial cells coated with coccobacillary organisms which have granular appearance and indistinct borders, on a wet mount prepared by mixing vaginal secretions with normal saline in a ratio of -1:1. Amsel criteria for the diagnosis of bacterial vaginosis Includes any three of the following four clinical abnormalitiesObjective signs of increased white homogenous vaginal discharge.Vaginal discharge pH of >4.5Liberation of distinct fishy odour (attributable to volatile amines such as trim ethylamine) immediately after vaginal secretions are mixed with a 10% solution of KOHMicroscopic demonstration of clue cells.

So the answer to this question is A


Instruction:
Tonsil is formed from
A. Ist Pharyngeal pouch
B. IInd Pharyngeal pouch
C. IIIrd Pharyngeal pouch
D. IV Pharyngeal pouch

Response:
Second Pouch(a) The epithelium of the ventral pa of this pouch contributes to the formation of the tonsil.(b) The dorsal pa takes pa in the formation of the tubotympanic recess.Reference: Inderbir Singh Embryology; 10th edition; Page no: 135

So the answer to this question is B


Instruction:
Avascular structure of the eye is -
A. Conjuctiva
B. Ciliary body
C. Cornea
D. Retina

Response:
Ans. is 'c' i.e. Cornea o Lens and cornea are avascular structures of eye, that's why fluorescein angiography can't be used to identify lesions.

So the answer to this question is C


Instruction:
Chemoprophylaxis is not required in
A. Typhoid
B. Meningococcal meningitis
C. Bacterial conjunctivitis
D. Malaria

Response:
Cholera: Tetracycline or furazolidone for household contacts Bacterial conjunctivitis: Erythromycin ophthalmic ointment Diphtheria: Erythromycin Influenza: Oseltamivir Meningitis, meningococcal: Ciprofloxacin, and minocycline Plague: Tetracycline for contacts of pneumonic plague Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 137

So the answer to this question is A


Instruction:
Which of the following gland is known as a master of endocrine gland orchestra:
A. Pituitary gland.
B. Hypothalamus
C. Thyroid gland.
D. Adrenal gland.

Response:
It is so called because, it controls thyroid, mammary glands, adrenal cortex and gonads etc.

So the answer to this question is A


Instruction:
A 10 year old child presents with pallor & history of blood transfusion 2 months back. On investigation, Hb 4.5gm, total count 60000, platelet count- 2 lakhs and CD 10(+) ve, CD 19 (+)ve, CD 117 (+) ve, 1 VEPO (+) ve & CD 33(-)ve. What is the most likely diagnosis?
A. ALL
B. AML
C. Undifferentiated leukemia
D. Mixed phenotypic acute leukemia

Response:
None

So the answer to this question is D


Instruction:
Calcification of all teeth except last molars are completed by:
A. 2 years
B. 4 years
C. 6 years
D. 8 years

Response:
None

So the answer to this question is D


Instruction:
If median nerve is injured at the wrist, then loss of function of all of the following muscles will take place, EXCEPT:
A. Lumbrical muscles to the Index finger
B. Lumbrical muscles to the middle finger
C. Muscles of the thenar eminence
D. Abductor pollicis

Response:
Median nerve (C6-T1):Provides most of the innervation to the anterior forearm, excluding one and one half muscles, the flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus muscle, which are innervated by the ulnar nerve. The median nerve continues into the hand to innervate the thenar eminence and lumbricals 1 and 2. It provides cutaneous innervation to the medial palmar side of the hand and the palmar surface of digits 1 through 3 and half of digit 4. Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 29. Overview of the Upper Limb. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy.

So the answer to this question is D


Instruction:
False statement regarding trigeminal autonomic cephalgia is:
A. Cluster headache is more common in males
B. SUNCT has highest attack frequency rate
C. Lidocaine is effective in SUNCT
D. Cutaneous trigger is seen in cluster headache

Response:
Option D is false as cutaneous trigger is seen in SUNCT and not cluster headache.

So the answer to this question is D


Instruction:
Man is dead end, except
A. Malaria
B. Tetanus
C. Rabies
D. Japanese Enaphalitis

Response:
None

So the answer to this question is A


Instruction:
In retinoscopy for refractive error at 1m, we add 1D ; if done at a distance of 66 cm, the additional factor will be –
A. –2
B. –1.5
C. –0.5
D. –5

Response:
Deduction of 1D for lm and 1.5D when retinoscopy is performed at 2/3rd m (67 cm) distance.

So the answer to this question is B


Instruction:
Which of the following are hardest renal stones
A. Calcium Oxalate
B. Struvite
C. Xanthine
D. Cysteine

Response:
Answer- A. Calcium OxalatePure calcium phosphate stones and calcium monohydrate stones are the densest per volume ofstone.Among the given options calcium oxalate stones are densest (hardest).

So the answer to this question is A


Instruction:
Highest amount of protein is seen in:(1987)
A. Soya beans
B. Ground nut
C. Bengal gram
D. Mysore dhal

Response:
Ans: aRef: Park, 17th ed, p 428, Table (19) & 18th ed, p. 454

So the answer to this question is A


Instruction:
Micro-Wick and Mierocatheter sustained release devices are used in:
A. Drooling of saliva
B. Frey's syndrome
C. Control of epistaxis
D. Delivering drug to the round membrane

Response:
Ans. d. Delivering drug to the round membrane Micro Wick and Micro catheter are methods of delivery of medications directly to the inner ear (AIIMS November 2008 Repeat).Intratympanrc Direct Therapy for Inner Ear DiseaseIntratympanic direct therapy for inner ear disease has several advanges over the conventional systemic and indirect therapy:* Increased therapeutic concentrations in the inner ear* Reduced side-effects* Can be used when systemic therapy is contraindicated* Can be used when systemic therapy fails.In direct therapy to the inner ear, the drug is delivered at the Round window membrane.Round window membrane separates the middle ear from the inner ear. A large range of substances are able to cross the RWM, including antimicrobials, corticosteroids, anesthetics etc.Delivery methodsTypical intratympanic injectionGelfoam methodMechanical sustained release devicesFully implantable micropump system* Drug is administered directly around RWM. using injection after a myringotomy.* Drawbacks: Injected medication my leak down the Eustachian tube, escape out of the external auditory canal, or be sequestered in the middle ear* In order to address these problems, several sustained release vehicles have been developed.* A dry' gelfoam pad can be placed directly in the round window niche.* The medication is directly injected over the gelfoam pad.* The Silverstein micro wick: It is made of polyvinyl acetate. It is wick measuring 1x9 mm small enough to fit through a tympanostomy tube. The wick absorbs medication which can be instilled into the external auditory canal by the patient at home and delivers it to the RWM.* The Intra Ear Microcatehter: Consists of an electronic pump connected to catheter tip that is placed directly on the RWM Implantation of the Microcatheter is more invasive and requires the elevation of tympanomeatal flap.* This device is made from pure titanium, polyethylene, and silicone and is designed for life-long implantation in humans.* To place the device, a cavity is drilled in the mastoid bone to house the pump and the reservoir system.* This device can deliver drugs which require chronic and continuous application.

So the answer to this question is D


Instruction:
All are alkylating agents, except
A. 5-Fluorouracil
B. Melphalan
C. Cyclophosphamide
D. Chlorambucil

Response:
Ans. (A) 5-Fluorouracil(Ref: Katzung 11th/e p945, KDT 8th/e p918-919)5-Fluorouracil is an antimetabolite whereas melphalan, cyclophosphamide and chlorambucil are alkylating agents.

So the answer to this question is A


Instruction:
The test used to diagnose Dubin Johnson syndrome is -
A. Serum transaminases
B. Bromsulphalein test (BSP)
C. Hippurate test
D. Gamma glutamyl transferase level

Response:
None

So the answer to this question is B


Instruction:
All the following signs could result from infection within the right cavernous sinus except-
A. Constricted pupil in response to light
B. Engorgement of the retinal veins upon ophthalmoscopic examination
C. Ptosis of the right eyelid
D. Right ophthalmoplegia

Response:
Cavernous sinus thrombosis

Source → Infection from nose, sinuses, orbits, ear or pharynx
Onset → Abrupt with high fever and chills and with signs of toxemia.
Cranial N involvement → III to VII
Ocular features

Patient develops severe pain in the eye and forehead of the involved side.
Conjunctiva is swollen and congested
Proptosis
Ptosis (due to 3rd N. palsy)
Ophthalmegia (due to palsy of 3rd , 4th and 6th cranial N)
Dilated pupil (due to 3rd N involvement)
Retinal veins shows congestion
Papilloedema
Fundus may be normal

So the answer to this question is A


Instruction:
Insulin stress test assay estimates -
A. Diabetes mellitus
B. Growth hormone
C. Glucagon assay
D. Catecholaines

Response:
An insulin tolerance test (ITT) is a medical diagnostic procedure during which insulin is injected into a patient's vein, after which blood glucose is measured at regular intervals. Normally, both coisol and GH serve as counterregulatory hormones, opposing the action of insulin, i.e. acting against the hypoglycemia . When used to assess insulin sensitivity, a standard dose of insulin is administered, and blood glucose is monitored with frequent sampling; the plasma glucose disappearance rate (KITT) indicates the degree of whole-body insulin sensitivity . Ref - pubmed.com

So the answer to this question is B


Instruction:
Which of the following typical antipsychotic drug is not available in depot form ?
A. Haloperidol
B. Risperidone
C. Olanzapine
D. Chlorpromazine

Response:
Ans. D. ChlorpromazineAntipsychotic drugs with depot preparations are risperidone, poliperidone, halopetidol, fluphenazine, flupenthixol, zuclopenthixol, olannpine, clozapine, imipramine and quetiapine.

So the answer to this question is D


Instruction:
In which of the following condition is spastic ileus seen?
A. Porphyria
B. Retroperitoneal abscess
C. Hypokalemia
D. MI

Response:
Spastic, or dynamic ileus is rare and results from extreme and prolonged contraction of intestine. It is seen in: Heavy metal poisoning Uremia Porphyria Extensive intestinal ulceration Ref: Harrison 17/e, Page 1912.

So the answer to this question is A


Instruction:
Fibrous dysplasia associated with intramuscular myxoma is known as:
A. Maza rahe syndrome.
B. Hans Schuller disease.
C. Marfan Syndrome.
D. Elher danlos syndrome.

Response:
Enamel hypoplasia → Rickets + Hypoparathyroidism
Hans Schuller disease – Advanced pdl disease
Mazabraud syndrome: Fibrous dysplasia associated with intramuscular myxoma

↓
Greater risk of Sarcomatous transformation seen

So the answer to this question is A


Instruction:
Baby 20 year old female complains of sudden onset palpitation and apprehension. She is sweating for last 10 minutes and fears of impending death. Diagnosis is
A. Hysteria
B. Generalized Anxiety Disorder
C. Cystic fibrosis
D. Pannic Attack

Response:
D i.e. Pannic attack

So the answer to this question is D


Instruction:
All of the following hormones have receptors on the cell surface, EXCEPT:
A. Adrenalin
B. Growth Hormone
C. Insulin
D. Thyroxine

Response:
Hormones act on their specific receptors located on or within their target cells. Receptor activation by hormones is translated into response in a variety of ways. Thyroxine hormone has its receptor within the nucleus. This hormone penetrates the nucleus -> combines with its receptor --> alter DNA-RNA mediated protein synthesis. Ref: Essentials of Medical Pharmacology, 5th Edition, Page 214

So the answer to this question is D


Instruction:
All of the following are true statement for Arbovirus EXCEPT: March 2013 (c)
A. Japanese encephalitis is caused by group B Arbovirus (Flavivirus)
B. Chikungunya fever is transmitted by Aedes mosquito
C. Kyasanur Forest Disease is transmitted by mites
D. West nile fever is transmitted by Culex mosquito

Response:
Ans. C i.e. Kyasanur Forest Disease is transmitted by mites There are a variety of animals thought to be reservoir hosts for the Kyasanur Forest disease, including porcupines, rats, squirrels, mice and shrews. The vector for disease transmission is Haemaphysalis spinigera, a forest tick. Humans contract infection from the bite of nymphs of the tick.

So the answer to this question is C


Instruction:
Nerve commonly involved in fracture distal shaft of the humerus
A. Radial nerve
B. Medial
C. Ulnar
D. Circumflex Brachial nerve

Response:
Radial nerve is the most commonly injured nerve in fracture shaft humerus It is paicularly common in oblique fracture at junction of middle and distal third bone

So the answer to this question is A


Instruction:
Most radiosensitive among the following is
A. Nuclear DNA
B. Mitochondrial DNA
C. Satellite DNA
D. Nucleosomal DNA

Response:
(D) Nucleosomal DNA > Among the factors contributing to the distribution of DNA damage within irradiated mammalian cell nuclei are the interactions of DNA with nuclear proteins and the formation of multi-molecular chromatin structures. Studies on the manipulation of chromatin structures of isolated nuclei are summarised.> The majority of chromatin within the nucleus of living cells is tightly compacted into nucleosomal superhelices and other higher order structures which have a limited ability to be damaged by radiation.> The treatment of isolated nuclei with hypotonic buffers causes a decondensation of these structures and markedly sensitises the DNA to radiation, while retaining the majority of the chromosomal proteins

So the answer to this question is D


Instruction:
A 2-year-old child presented with recurrent pain abdomen, failure to thrive and iron deficiency anemia refractory to Iron therapy. His anti TTG anti-body titres were 300 U/L. An upper GI endoscopy was done and duodenal biopsy was taken which showed the following. What is the diagnosis?
A. Crohn disease
B. Hirschsprung disease
C. Celiac disease
D. Congenital lactase deficiency

Response:
Intestinal biopsy showing villous atrophy, crypt hyperplasia, intraepithelial lymphocytic infiltration in the given case scenario, suggest a diagnosis of Celiac disease

So the answer to this question is C


Instruction:
Congenital hydrocephalus treatment -
A. V-P shunt
B. Acetazolamide
C. Glycerine
D. Frusemide

Response:
Ans. is 'a' i.e., V-P shunt Congenital hydrocephaluso Starts in fetal life and may manifest or even develop sub sequentially,o Causes -Intrauterine infections - TORCHIC bleedIVHCongenital malformation -Aqueductal stenosis (MQDandy walker cystArnold chiary malfomationMidline tumorTreatmento Depends upon primary cause, course and severely.o Usually mild, non progessine require medical mx like - acetazolamide and glycerin,o Large, progressive - require surgeryo Sx. include shunt operation (VP shunt, VA shunt),o Endoscopic third ventriculatomy is another option.

So the answer to this question is A


Instruction:
Depression and Protrusion of the mandible:
A. Medial (INTERNAL) pterygoid muscle
B. Lateral (EXTERNAL) pterygoid muscle
C. Masseter muscle
D. Temporalis muscle

Response:
None

So the answer to this question is B


Instruction:
All are seen in acute HIV syndrome Except
A. Pneumonia
B. Lymphadenopathy
C. Myelopathy
D. Encephalitis

Response:
Clinical findings in HIV syndromeGeneralNeurologicDermatologic1. Fever2. Pharyngitis3. Lymphadenopathy4. Headache/Retroorbital pain5. Ahralgias/myalgias6. Lethargy/Malaise7. Anorexia/Weight loss8. Nausea/Vomiting/Diarrhea1. Meningitis2. Encephalitis3. Peripheral neuropathy4. Myelopathy1. Erythematous maculopapular rash2. Mucocutaneous ulcerationReference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 226; Human Immunodeficiency virus disease: AIds and Related Disorders

So the answer to this question is A


Instruction:
Magnetostrictive handpiece
A. Is Ultrasonic instrument
B. Has elliptical motion
C. Heats up more, requires coolant
D. All of the above

Response:
None

So the answer to this question is D


Instruction:
Investigation of choice in a 55 years old post menopausal woman who has presented with postmenopausal bleeding :
A. Pap smear
B. Fractional Curettage
C. Transvaginal ultrasound
D. CA - 125 estimation

Response:
Ans. is b i.e. Fractional curettage In a woman with postomenopausal bleeding chances of Endometrial carcinoma are very high. Therefore such a patient should be evaluated so as to rule out Endometrial carcinoma. Investigations for Endometrial Carcinoma : Endanietrial Aspiratio _illus.:1)T is the accepted first step in evaluating a patient with abnormal uterine bleeding or suspected pa gy. The diagnostic accuracy of an office based endometrial biopsy is 90-98% when compared with subsequent findings at dilatation and curettage (D&C)".... Novak 13/e. p 1350 Endometrial biopsy can be performed in outpatients and has the advantage of being simple, quick. safe, inexpensive, convenient and avoding the need of anaesthesia. Dilatation and Fractional Curettage : It is most definitive procedure for diagnosis of endometrial carcinoma but should be res rued for situations in which Aspiration biopsy cannot be performed like : Cervical Sten is Patient's non mpliance for biopsy Specimen obta ned is inadequate for biopsy If in case bleeding recurs after a negative repo on endometrial aspiration. - Fractional currettage comprises of histological study of endocervical scraping before dilating the cervix followed by cervical dilatation and currettage from the isthimus, body of uterus and fundus separately. 3. Hysteroscopy : It is required for ruling out polyps as cause of bleeding. 4. Transvaginal Ultrasound : May be useful adjunct to Endometrial biopsy for evaluating abnormal uterine bleeding and selecting patients for additional testings. Findings on USG requiring fuher evaluation : Endometrial thickness > 4mmdeg Polypoidal mass. Collection of fluid within the uterus. 5. Pap smear : It is not a reliable test for diagnosis of Endometrial carcinoma. Only 30 - 50% patients with Endometrial carcinoma have positive pap test and they are women with advanced disease. Remember : * First investigations in case of endometrial cancer - Endometrial aspiration biopsy. Best investigation for diagnosing endometrial cancer - Fractional curettage.

So the answer to this question is B


Instruction:
All are features of irritable bowel syndrome except-
A. Vomiting
B. Pain abdomen
C. Diarrhoea
D. Constipation

Response:
Clinical features The most common presentation is that of recurrent abdominal discomfo . This is usually colicky or cramping in nature, felt in the lower abdomen and relieved by defecation. Abdominal bloating worsens throughout the day; the cause is unknown but it is not due to excessive intestinal gas. The bowel habit is variable. Most patients alternate between episodes of diarrhoea and constipation but it is useful to classify them as having predominantly constipation or predominantly diarrhoea. Those with constipation tend to pass infrequent pellety stools, usually in association with abdominal pain or proctalgia. Those with diarrhoea have frequent defecation but produce low-volume stools and rarely have nocturnal symptoms. Passage of mucus is common but rectal bleeding does not occur. Patients do not lose weight and are constitutionally well. Physical examination is generally unremarkable, with the exception of variable tenderness to palpation. Ref Davidson edition23rd pg 825

So the answer to this question is A


Instruction:
The following statements are related to Krukenberg tumour except:
A. It is always secondary
B. The most common primary site is pylorus of the stomach
C. The tumour is bilateral
D. 'Signet ring' looking cells are characteristic

Response:
<p> -Krukenberg tumor is diagnosed only if it conforms to the following pattern ; Almost bilateral Smooth surfaces Freely mobile in pelvis It retains the shape of normal ovary. The tumors are secondary growth in the ovary and most often arise from a primary carcinoma of the stomach(70%). Histologically, the tumor has a cellular or myxomatous stroma amongst which are scattered large signet ring cells. Reference : Shaw&;s textbook of gynaecology, 16th edition, pg no:524 <\p>

So the answer to this question is A


Instruction:
Excessive eating of non-nutritive substances is known as?
A. PICA
B. Anorexia nervosa
C. Bulimia
D. Trichoteliomania

Response:
Ans. a (PICA). (Ref. O.P Ghai, 6th/pg.p 58)PICA# PICA is a disorder involving repeated or chronic ingestion of non-nutritive substances including plaster, charcoal, clay, wood, ashes and earth.# PICA after 2nd year of life needs to be investigated.# MR, lack of parental nurturing, autism, and behavior disorders like Kleine-Terin syndrome, family disorganization, low socioecomy.# Geophagia (earth eating) is seen with pregnancy.# Here patient develops craving for substance such as- Starch (amylophagia),- Ice (pagophagia) &- Clay (geophagia) these symptoms are peculiar i.e. Characteristic of iron deficiency.# Some of these materials such as starch & clay bind iron in the gastrointestinal tract, worsening the deficiency.# The basis of this bizarre behavior is unknown.# A particularly invidious consequence of iron deficiency, is increased by intestinal absorption of lead.# Children from impoverished families who often have both iron deficiency & pica are at greatest risk of developing lead poisoning.# The toxicity of lead is at least in part due to a disruption of hemesynthesis in neural tissue, a process abetted by iron deficiency.# Thus, these children are at increased risk of lead poisoning, iron deficiency anemia and parasitic infection.

So the answer to this question is A


Instruction:
Torsades de pointes causes ?
A. Eide QRS
B. Short QRS
C. Wide QT
D. Short QT

Response:
None

So the answer to this question is C


Instruction:
Cretinism is -
A. Dispropoionate dwarfism
B. Sho stature with long trunk
C. Sho stature with sho trunk
D. Long stature with long trunk

Response:
Ans. is 'a' i.e., Dispropoionate dwarfism Note - Patient has sho stature with sho limbs.

So the answer to this question is A


Instruction:
Which of the following is known to be severely pruritic?
A. Lichen planus
B. Psoriasis
C. Icthyosis
D. Secondary syphilis

Response:
Purple polygonal papules marked by severe pruritus; lacy white markings, especially associated with mucous membrane lesions is feature of lichen planus. Psoriasis is variably pruritic. Icthyosis: characterised by severe dryness, fish like scales. There are 5 P in Lichen Planus:Plain, Purple, Polygonal, Pruritic, Papule/ Plague

So the answer to this question is A


Instruction:
Crescents are characteristic of
A. Membranous nephropathy
B. PSGN
C. MPGN
D. RPGN

Response:
Crescents are histological characteristic of RPGN.

So the answer to this question is D


Instruction:
In PT test, the addition of Ca2+ & tissue thromboplastin activates which pathway?
A. Extrinsic
B. Intrinsic
C. Fibrinolytic
D. Common

Response:
Ans. (a) ExtrinsicTo PT we add of Ca2+ & tissue thromboplastin which activates extrinsic pathway, while to test for aPTT we add kaolin, silica which activates intrinsic pathway.

So the answer to this question is A


Instruction:
Which of the following is not an exception to Meyer Oveon rule
A. Non anaesthetics
B. Non immobilizer
C. cut off effect
D. Hydrophobic site

Response:
Meyer-Oveon correlation of anesthetic potency with solubility in olive oil interpreted by the majority of researchers as an indicator that lipids are likely the anesthetic target. This interpretation focused attention on anesthetic effects on the bulk physical propeies of cell membranes, which were known at that time to consist primarily of lipid molecules. Such nonspecific or "lipoid-based" anesthetic theories dominated the field from the 1960s to the 1980s. Moreover, the simple elegance of the relationship between MAC and lipid solubility graphically illustrated Meyer and Oveon's conclusion that "All chemically indifferent substances that are soluble in fat are anesthetics ... their relative potency as anesthetics will depend on their affinity to fat on the one hand and water on the other hand, that is, on the fat/water paition coefficient. This was interpreted as oring lipids as the primary targets of anesthetics and a single nonspecific theory to explain anesthesia. Objections to the outdated lipid hypotheses: 1. Stereoisomers of an anesthetic drug Stereoisomers that represent mirror images of each other are termed enantiomers or optical isomers (for example, the isomers of R-(+)- and S-(-)-etomidate). Physicochemical effects of enantiomers are always identical in an achiral environment (for example in the lipid bilayer). However, in vivo enantiomers of many general anesthetics (e.g. isoflurane, thiopental, etomidate) can differ greatly in their anesthetic potency despite the similar oil/gas paition coefficients. For example, the R-(+) isomer of etomidate is 10 times more potent anesthetic than its S-(-) isomer 2. Non-immobilizers According to the Meyer-Oveon correlation, the anesthetic potency of the drug is directly propoional to its lipid solubility, however, there are many compounds that do not satisfy this rule. These drugs are strikingly similar to potent general anesthetics and are predicted to be potent anesthetics based on their lipid solubility, but they exe only one constituent of the anesthetic action (amnesia) and do not suppress movement (i.e. do not depress spinal cord functions) as all anesthetics do. These drugs are referred to as non-immobilizers. 3. Temperature increases do not have an anesthetic effect 4. Effect vanishes beyond a ceain chain length According to the Meyer-Oveon correlation, in a homologous series of any general anesthetic (e.g. n-alcohols, or alkanes), increasing the chain length increases the lipid solubility, and thereby should produce a corresponding increase in anesthetic potency. However, beyond a ceain chain length, the anesthetic effect disappears. For the n-alcohols, this cutoff occurs at a carbon chain length of about 13 and for the n-alkanes at a chain length of between 6 and 10, depending on the species. 5. Non-hydrophobic anesthetics. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e

So the answer to this question is D


Instruction:
Selective alpha 2 agonist is
A. Tizanidine
B. Prazosin
C. Adrenaline
D. Propanolol

Response:
Ref: HL Sharma 3rd ed pg no:180 Clonidine, methyldopa, tizanidine, relminidine are central alpha 2 agonists

So the answer to this question is A


Instruction:
Hypospadias in the baby is caused by maternal use of which of the following drug?
A. Diethylstilbestrol
B. Tolbutamide
C. Clomiphene
D. Clobazam

Response:
Clomiphene is antiestrogens. It can cause hypospadias in the baby- in which the opening of the urethra is on the underside of the penis instead of at the tip Clomiphene, a drug used to induce ovulation, is chemically related to diethylstilbestrol (DES). DES is associated with vaginal adenocarcinoma among daughters and with hypospadias among second-generation male offspring. (REF. Essentials of medical pharmacology K D TRIPATHI 6 Edition, Page No 312)

So the answer to this question is C


Instruction:
Antibody mediated enhancement is a feature of
A. Yellow fever
B. Dengue heomorrhagic fever
C. Omsk heomorrhagic fever
D. Japanese encephalitis

Response:
Antibody mediated enhancement is non-neutralizing antibody produced against the first serotype will combine, cover and protect the second serotype from host immune responce.seen in dengue hemorrhagic fever.

So the answer to this question is B


Instruction:
In direct pulp capping cases most important for the formation of dentinal bridges by dentinogenesis is:
A. Calcium hydroxide and pulp interaction.
B. Extracellular Matrix.
C. De occlusion of involved teeth.
D. Lack of pulpal inflammation.

Response:
Though there is no direct reference in book about dentinal bridge formation but bridge formation definitely occurs only after interaction between calcium hydroxide & cells of pulp tissue.

So the answer to this question is A


Instruction:
MC orbital tumor in adult is -
A. Nerve sheath tumor
B. Hemangioma
C. Lymphoma
D. Meningioma

Response:
Ans. is 'b' i.e., Hemangiomao Most common orbital tumor- Cavernous hemangioma.o Most common malignant orbital tumor- Lymphoma.IMPORTANT FACTSo Most common intraocular tumor in adults is metastasis. Metastasis is particularly common from carcinoma of breast and lung.o Most common primary intraocular tumor in adults is uveal melanoma. Most of the uveal malignant melanoma arise in choroid.o Most common primary intraocular tumor is children is retinoblastomao Most common orbital tumors in adults are benign vascular tumors - Cavernous hamangiomao Most common malignant orbital tumor in adult - lymphomao Most common orbital tumors in children are benign tumors - Dermoid cyst > capillary hemangiomao Most common malignant orbital tumor in children - rhabdomyosarcomao Overall most common primary malignant tumor of eye is malignant melanoma followed by retinoblastomao Most common malignant eyelid tumor - Basal cell carcinomao Most common epithelial tumor of lacrimal gland - Pleomorphic adenoma (benign mixed tumor)o Overall most common tumor of lacrimal gland Lymphoid tumour and inflammatory pseudo - tumorso Most common malignant tumor of conjunctiva - Squamous cell carcinomao Most common malignant tumor of cornea - Squamous cell carcinoma

So the answer to this question is B


Instruction:
Chalazion of lid is:
A. Caseous necrosis
B. Chronic nonspecific inflammation
C. Chronic lipogranulomatous inflammation
D. Liposarcoma

Response:
Chronic lipogranulomatous inflammation

So the answer to this question is C


Instruction:
Administrative unit of ICDS project in rural area is
A. PHC
B. Community development block
C. Zilla parishad
D. Gram panchayat

Response:
The administrative unit of an ICDS project is the community development block in rural areas, the tribal development block in tribal areas and a group of slums in urban areas.Park 23e pg: 592

So the answer to this question is B


Instruction:
Claviceps fusiformis is responsible for
A. Neurolatyrism
B. Ergotism
C. Epidemic dropsy
D. Endemic ascites

Response:
Ergot Unlike Aspergillus, ergot is not a storage fungus, but a field fungus. Foodgrains such as bajra, rye, sorghum, and wheat have a tendency to get infested during the flowering stages by the ergot fungus (Claviceps purpurea). Fungus grows as a blackish mass and the seeds become black and irregular and are harvested along with food grains. Consumption of ergot infested grain leads to ergotism. Sporadic outbreaks of ergot poisoning in human population have been repoed from time to time in areas where bajra is consumed as a staple. The symptoms are acute but rarelyfatal and include nausea, repeated vomiting, giddiness and drowsiness extending sometimes for periods upto 24 to 48 hours after the ingestion of ergoty grain. In chronic cases, painful cramps in limbs and peripheral gangrene due to vasoconstriction of capillaries have been repoed. However, the long-term effects of consuming small amounts of the Toxin are not known. A disquieting feature is that the recently introduced high-yielding varieties of bajra are more susceptible to infestation. Ergot-infested grains can be easily removed by floating them in 20 per cent salt water. They can also be removed by hand-picking or air floatation. The upper safe limit for the ergot alkaloids has been estimated to be 0.05 mg per 100 grams of the food material. Ref: Park 25th edition Pgno : 694

So the answer to this question is B


Instruction:
Winging of scapula is seen in paralysis of which muscle-
A. Serratus anterior
B. Supraspinatus
C. Pectoralis major
D. Infraspinatus

Response:
Ans. is 'a' i.e., Serratus anterior Winging of scapulao In this condition the vertebral border of scapula becomes more prominent when patient tries to push against wall.o It occurs in paralysis of the serratus anterior muscle in long thoracic nerve palsy.

So the answer to this question is A


Instruction:
Which of the following is not true, regarding abutment selection for overdenture  fabrication?
A. Abutment should have healthy periodontal tissues
B. If bone loss is present, teeth should not be selected as overdenture abutments
C. A circumferential band of attached gingiva should be present
D. If a tooth has grade III mobility, it should not be selected as overdenture abutment

Response:
If mild to moderate bone loss is present, change in crown:root ratio can make the tooth suitable as an overdenture abutment.

So the answer to this question is B


Instruction:
The most common type of tracheoesophageal fistula is
A. Esophageal atresia with out tracheosophageal fistula
B. Esophageal atresia with proximal tracheosophageal fistula
C. Esophageal atresia with distal tracheoesophageal fistula
D. Esophageal atresia with proximal and distal tracheosophageal fistula

Response:
The most common type of TRACHEO-OESOPHAGEAL FISTULA(TOF) is Atresia with distal TOF constituting 85% of all. It is also known as type C according to Gross classification of TOF. Reference : SRB's Manual of Surgery, 6th Edition, page no = 794.

So the answer to this question is C


Instruction:
Persistent coarse crepitations in the chest are diagnostic of?
A. Pulmonary TB
B. Pulmonary edema
C. Cavity lesion
D. Bronchiectasis

Response:
Fine crackles Coarse crackles Soft, high-pitched and very brief Louder, lower in pitch and last longer Indicates an interstitial process- pulmonary fibrosis or congestive hea failure. Indicates an airway disease- bronchiectasis.

So the answer to this question is D


Instruction:
False about Budd-Chiari syndrome
A. Associated with coagulopathy
B. Cirrhosis may occur
C. Ascites may be present
D. Hepatic aery involved

Response:
Budd-Chiari syndrome in its pure form consists of slowly developing thrombosis of the hepatic veins and the adjacent inferior vena cava . ETIOLOGY.: idiopathic in one third, in the remaining cases various causes associated with increased thrombotic tendencies are attributed to polycythaemia vera, paroxysmal nocturnal haemoglobinuria, oral contraceptives, pregnancy, postpaum state, intra-abdominal cancers (e.g. hepatocellular carcinoma), chemotherapy, radiation and myeloproliferative diseases. Formation of membranous webs, probably congenital or as a consequence of organised thrombosis, in the suprahepatic poion of inferior vena cava is another impoant cause. MORPHOLOGIC FEATURES. Grossly, the liver is enlarged, swollen, red-purple and has a tense capsule. Histologically, the changes in sudden hepatic vein occlusion are those of centrilobular congestion, necrosis and rupture of sinusoids into the space of Disse. In slowly developing thrombosis, the changes are more chronic and include fibrosing reaction in the centrilobular zone that may progress to cardiac cirrhosis. CLINICAL FEATURES : acute form -abdominal pain, vomiting, enlarged liver, ascites and mild icterus. chronic form - the patients present with pain over enlarged tender liver, ascites and other features of poal hypeension. The acute form of illness leads to acute hepatic failure and death, whereas in chronic form the patient may live for months to a few years. TEXT BOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PGNO.603 IMAGE REF:

So the answer to this question is D


Instruction:
Transfer of genetic material by bacteriophage is -
A. Transduction
B. Transformation
C. Transcription
D. Integration

Response:
Ans. is 'a' i.e., Transduction Transduction* The transfer of a portion of DNA from one bacterium to another by a bacteriophage (virus).* Bacteriophages are viruses that parasite bacteria and consist of nucleic acid core and a protein coat.* Transduction may be1. Generalised - When it involves any segment of donor DNA2. Restricted - When a specific bacteriophage transduces only a particular genetic trait eg. prophage lambda in E coli K 12 (Gal +gene - Determines fermentation of galactose)* Transduction is not confined to transfer of chromosomal DNA, episomes and plasmid may also be transduced.* The plasmid determining penicillin resistance in staphylococci are transferred from cell to cell by transduction.* Transduction appears to be the most widespread mechanism of gene transfer among prokaryotes.* Transduction is an excellent tool for the genetic mapping of bacteria.* Transduction has been proposed as a method of genetic engineering in the treatment of some inborn errors of metabolism.Lysogenic conversion* In lysogenic conversion the phage DNA itself is the new genetic element as it becomes integrated with the bacterial host DNA with which it multiplies and is transferred to daughter cells, e.g. diptheriae corynebacterium.T ransformation* This is the transfer of genetic material through the agency of free DNA (May involve taking up of soluble DNA with host DNA and codes new species through the cell wall).* Transformation was the first example of genetic exchange (horizontal gene transfer) in bacteria to have been discovered.* It was demonstrated in Streptococcus pneumoniae by Griffith in 1928.* Other organisms in which transformation has been studied are Bacillus, Haemophilus and BPH.Conjugation* Bacterial conjugation is the transfer of genetic material between bacteria through direct cell to cell contact or through a bridge- like connection between two cells.* Conjugation is process where by a donor (male) bacterium makes physical contact with a recipient (female) bacterium.* Donor status is determined by the presence of plasmid.* This plasmid codes for specialized fimbria (sex pilus) and for self transfer.* Sex pilus (conjugation tube) helps in transfer of genetic material from male bacterium to female bacterium.* The plasmid is known as transfer factor (sex factor or fertility factor).* Plasmid may be Rfactor, which codes for transferable multiple drug resistance.* The DNA of the plasmid replicates during transfer so that each bacterium receives a copy - Recipient becomes donor and the donor retains its donor status.SummaryGene transfer in bacteriaa) Transformation-Transfer of genetic material through the agency of free DNA (may involve taking up soluble DNA fragments across their cell wall from other species).b) Transduction-Transfer of a portion ofDNA by bacteriophage (a virus).c) Conjugation-Transfer of genetic material by physical contact.d) Lysogenic conversion-Incorporation of phage DNA into host DNA.

So the answer to this question is A


Instruction:
All are seen in Gigantism EXCEPT:
A. Mental retardation
B. Visceromegaly
C. Large foot
D. Cardiovascular damage

Response:
ANSWER: (A) Mental retardationREF: Harrisons 17th ed chapter 338In children and adolescents, initiation of GH hypersecretion prior to epiphyseal long bone closure is associated with development of pituitary gigantism,Soft tissue swelling results in increased heel pad thickness, increased shoe or glove size, ring tightening, characteristic coarse facial features, and a large fleshy nose.Other commonly encountered clinical features include hyperhidrosis, deep and hollowsounding voice, oily skin, arthropathy, kyphosis, carpal tunnel syndrome, proximal muscle weakness and fatigue, acanthosis nigricans, and skin tags.Generalized visceromegaly occurs, including cardiomegaly, macroglossia, and thyroid gland enlargement.The most significant clinical impact of GH excess occurs with respect to the cardiovascular system, Coronary heart disease, cardiomyopathy with arrhythmias, left ventricular hypertrophy, decreased diastolic function, and hypertension occur in about 30% of patients.Upper airway obstruction with sleep apnea occurs in more than 60% of patients and is associated with both soft tissue laryngeal airway obstruction and central sleep dysfunction,Diabetes mellitus develops in 25% of patients with acromegaly, and most patients are intolerant of a glucose load (as GH counteracts the action of insulin).Acromegaly is associated with an increased risk of colon polyps and mortality from colonic malignancy; polyps are diagnosed in up to one-third of patients

So the answer to this question is A


Instruction:
Apoprotein for chylomicron remnant:-
A. Apo E
B. Apo C1
C. Apo A2
D. Apo A1

Response:
APOPROTEIN -PROTEIN PRESENT IN LIPOPROTEIN Lipoprotein Protein Chylomicron APO B48 Chylomicron remnant APO B48 + APO E VLDL APO B100 IDL APO B100 + APO E LDL APO B 100 + APO E HDL APO A, C, E

So the answer to this question is A


Instruction:
Placenta previa should be suspected in 3rd trimester in case of
A. Painless vaginal bleeding
B. Unengaged Head
C. Painful uterine bleeding
D. Painful vaginal bleeding

Response:
Ans-A (Painless vaginal bleeding)Ref: William's Obstetrics, 23rd ed. chapter 35Placenta previa is used to describe a placenta that is implanted over or very near the internal cervical os.There are several possibilities: total placenta previa, marginal placenta previa, partial placenta previa.The most characteristic event in placenta previa is painless hemorrhage, which usually does not appear until near the end of the second trimester or after. However, bleeding may begin earlier, and some abortions may result from such an abnormal location of the developing placenta.Digital cervical examination is never permissible unless the woman is in an operating room with all the preparations for immediate cesarean delivery--even the gentlest digital examination can cause torrential haemorrhage.The simplest, safest, and most accurate method of placental localization is provided by transabdominal sonography. Accordingly, the average accuracy is 96 percent, and rates as high as 98 percent have been obtained. False-positive results are often a result of bladder distension. Therefore, scans in apparently positive cases should be repeated after emptying the bladder.Cesarean delivery is necessary in practically all women with placenta previa. Most often, a transverse uterine incision is possible. However, because foetal bleeding may result from a transverse incision into an anterior placenta, a vertical incision is sometimes employed. But, even when the incision extends through the placenta, maternal or fetal outcomes are rarely compromised.

So the answer to this question is A


Instruction:
In Downs syndrome there is?
A. Translocation
B. Mutations
C. Paternal nondisjunction
D. Maternal nondisjunction

Response:
Ans. (d) Maternal nondisjunction(Ref: R 9th/pg 161)Down's syndrome is most commonly caused by Maternal nondisjunction Q > Translocation > Mosaicism

So the answer to this question is D


Instruction:
Massive splenomegaly with pancytopenia -
A. CLL
B. Pure red cell aplasia
C. CML
D. Myelofibrosis

Response:
Ans. is 'd' i.e., Myelofibrosiso Massive splenomegaly is referred to as extension of spleen greater than 8 cm below the left costal margin or weight of spleen more than 1 Kg.o Causes of massive Splenomegaly are - CML Polycythemia vera Autoimmune hemolytic anemia Lymphomas Gaucher's disease Diffuse splenic hemangiomatosis Hairy cell leukemia CLL Myelofibrosis Sarcoidosiso Amongst these conditions pancytopenia is seen in i.e., massive splenomegaly with pancytopenia : - o Hairy cell leukemia Myelofibrosis Gaucher's disease

So the answer to this question is D


Instruction:
Cresentic glomerular deposits are seen in -
A. Wegener's granulomatosis
B. Polyarteritis nodosa
C. Thromboangiitis obliterans
D. All of the above

Response:
None

So the answer to this question is A


Instruction:
A 42-year-old woman presents to the clinic complaining of dry skin, fatigue, and weight gain over the past 3 months. She is not on any medications and there is no significant medical history.On physical examination, her blood pressure is 110/70 mm Hg, pulse 52/min, and heart and lungs are normal. Her skin feels rough and dry, but the rest of the examination is normal. Her biochemistry is normal but the thyroid-stimulating hormone (TSH) level is 39 mU/L (0.5-5 mU/L). Which of the following is the most likely cause for her elevated TSH?
A. trauma
B. radioactive iodine ingestion
C. autoimmune hypothyroidism
D. parathyroid surgery

Response:
Autoimmune hypothyroidism is the most common cause of hypothyroidism in adults. It is several times more common in women than in men and occurs most often between the ages of 40 and 60. Post ablative hypothyroidism (radiation or surgery induced) can also occur if the patient has a history of thyroid surgery or neck radiotherapy. Medications such as amiodarone or lithium can also cause hypothyroidism as a side effect of their use if there is a history of such medication use.

So the answer to this question is C


Instruction:
A patient presents with unconjugated hyperbilinibinemia and presence of urobilinogen in urine. Which amongst the following is the least likely diagnosis-
A. Hemolytic jaundice
B. Crigler Najjar syndrome type 1
C. Gilbe s syndrome
D. crigler najjar syndrome type 2

Response:
Hemolytic jaundice results from excessive RBC destruction.there is increased release of Hb that leads to overproduction of bilirubin. Hyperbilirubinemia develops whn the capacity of liver to conjugate large amt of bilirubin is exceeded. There is also increased urinary excretion of urobilinogen. Ref.Harsh mohan page no.598 6th edition

So the answer to this question is A


Instruction:
Tensile strength of wound after laparoscopic cholecystectomy in a 30 years old woman depends upon:
A. Replacement of type 3 collagen
B. Extensive crosslinking of tropocollagen
C. Macrophage activity/invasion
D. Granulation tissue

Response:
The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.

So the answer to this question is B


Instruction:
The most potent and longest acting anaesthetic agent is :
A. Dibucaine
B. Tetracaine
C. Bupivacaine
D. Lignocaine

Response:
None

So the answer to this question is A


Instruction:
When do progesterone levels rise to their highest point during the female hormonal cycle?
A. Between ovulation and the beginning of menstruation
B. Immediately before ovulation
C. When the blood concentration of LH is at its highest point
D. When 12 primary follicles are developing to the antral Stage

Response:
The corpus luteum is the only source of progesterone production, except for minute quantities secreted from the follicle before ovulation. The corpus luteum is functional between ovulation and the beginning of menstruation, during which time the concentration of LH is suppressed below the level achieved during the preovulatory LH surge

So the answer to this question is A


Instruction:
Unnatural sexual offences is/are - (
A. Sodomy
B. Adultery
C. Rape
D. Incest

Response:
Ref:Textbook of Forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.404 As per sec.377IPC "Whoever voluntarily has carnal intercourse against the order of nature with any man, woman,or animal shall be punished with imprisonment for life, or with imprisonment of either description for a term which may extend to ten years, and shall also be libale to fine."this section covers all offence which have come to be clubbed under the trem"Unatural Sexual offences".examples are sodomy, buccal coitus, bestiality etc.

So the answer to this question is A


Instruction:
Most detrimental methods of brusing causing damage to tooth soft tissues and hard tissues is:
A. Side to side
B. Bass
C. Up and down
D. Roll

Response:
None

So the answer to this question is A


Instruction:
Relaxation volume of lungs is equal to-
A. FRC
B. RV
C. VC
D. TLC

Response:
Ans. is 'a' i.e., FRC Relaxation volume* The relaxation volume is the volume of the relaxed respiratory system, i.e., the volume at which net elastic recoil of he total respiratory system is zero (the elastic recoil of chest wall is equal and opposite to that of lungs). In healthy subjects, this occurs at the end of quiet expiration, i.e., at functional residual capacity. Therefore, in healthy adults at rest FRC is essentially equal to relaxation volume of respiratory system and FRC is usually treated as synonymous with relaxation volume.* However, in real sense FRC and relaxation volume are not synonymous terms and, while the two volumes are some times equal, more often they are not, i.e., active or passive mechanisms often operate to make FRC different from relaxation volume. For example, neonates have a more compliant (less stiff) chest wall. The chest wall thus has less elastic recoil to balance that of lung, thus decreasing the relaxation volume of lung. FRC then is often maintained above relaxation volume by active mechanisms like inspiratory muscle activity and slowing of expiration.

So the answer to this question is A


Instruction:
Saffron coloured meconium is seen in :
A. Post maturity
B. TB
C. Breech
D. Normal in appearance

Response:
Post maturity

So the answer to this question is A


Instruction:
Micro Munro abscess is seen in
A. Dermal tissue
B. Stratum corneum
C. Stratum basale
D. Stratum malphigi

Response:
Munro micro abscesses are seen in psoriasis it is the collection of neutrophils in stratum corneum. IADVLtextbook of dermatology page 1041

So the answer to this question is B


Instruction:
Neuromuscular disorder is related to which type of lung cancer?
A. Adeno carcinoma
B. Squamous cell carcinoma
C. Small cell carcinoma
D. Bronchoavelolar carcinoma

Response:
ANSWER: (C) Small cell carcinomaREF: Harrison 18th ed chapter 89, table 96-1

So the answer to this question is C


Instruction:
Features of SLE include all of the following except:
A. Recurent aboion
B. Sterility
C. Coomb's positive hemolytic anemia
D. Psychosis

Response:
Answer is B (Sterility): Systemic Lupus Erythematosus. Recurrent Aboions in SLE may be seen as a manifestation of Antiphospholipid Antibody syndrome. Small propoion of patients with SLE may have a Coomb's Positive Haemolytic anemia. Psychosis is a known neurological manifestation of SLE.

So the answer to this question is B


Instruction:
A patient has subclinical folate deficiency. All of the following drugs can precipitate megaloblastic anemia in this patient except:
A. Alcohol
B. Phenytoin
C. Chloroquine
D. Sulfasalzine

Response:
Ans. (C) Chloroquine(Ref: Harrison 17/e p649)Megaloblastic anemia can be caused by deficiency of folic acid or vitamin B12 . The drugs that can result in deficiency of folic acid include alcohol, phenytoin and sulfonamides

So the answer to this question is C


Instruction:
The following are used for treatment of postoperative nausea and vomiting following squint surgery in children except:
A. Ketamine
B. Ondansetron
C. Propofol
D. Dexamethasone

Response:
Ketamine is not used for treatment of postoperative nausea and vomiting. In fact ketamine use is itself associated with nausea and vomiting and requires prophylaxis. Ref: Lee's Synopsis of Anaesthesia, 12th Edition, Page 192; Textbook of Anaesthesia By Aitkinhead, 4th Edition, Pages 176, 244-49

So the answer to this question is A


Instruction:
Mechanism of action of oral contraceptive pill can be all except ?
A. Hostile to sperm penetration
B. Anovulatory cycle
C. Failure of blastocyst implantation
D. Blockade of fimbrial ostia

Response:
Ans. is 'd' i.e., Blockade of fimbrial ostia Mechanism of action of OCPs 1nihibition of gonadotropin release from pitutary by reinforcement of normal feedback inhibition - No prevulatory LH surge - No ovulation This is the most impoant mechanism. Thickening of cervical mucus secretion (due to progesterone) - hostile to sperm penetration. Even if ovulation and feilization occur, the blastocyte fails to implant because endometrium is either hyperproliferative or hypersecretory - not suitable for nidation - Impoant in case of postcoital pill. Uterine and tubal contractions may be modified to disour feilization. Postcoital pills may dislodge a just implated blastocyte or may interfere feilization/implantation.

So the answer to this question is D


Instruction:
Least chances of complication like dumping syndrome and diarrhoea are seen in the following condition:
A. Parietal cell vagotomy
B. Truncal vagotomy & Gastrojejunostomy
C. Antrectomy with truncal vagotomy
D. Vagotomy with pyloroplasty

Response:
Vagal denervation of just the parietal cell area of the stomach is called parietal cell vagotomy or proximal gastric vagotomy. The technique spares the nerves of Latarjet but divides all vagal branches that terminate on the proximal two thirds of the stomach. Parietal cell vagotomy appears to have about the same effectiveness as truncal or selective vagotomy for curing the ulcer disease, but dumping and diarrhea are much less frequent. It is probably the procedure of choice for intractable and perforated duodenal ulcers and is relatively less useful for obstructing and bleeding ulcers. The principal disadvantage is recurrent ulceration in about 10% of patients. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.

So the answer to this question is A


Instruction:
Thiamine deficiency may be seen in all of the following except: March 2009
A. Homocystinemia
B. Chronic alcoholism
C. Hea failure patients on diuretics
D. Starvation

Response:
Ans. A: Homocystinemia Causes of thiamine deficiency: Lack of thiamine intake : - Diets consisting mainly of the following: Food containing a high level of thiaminases, including milled rice, raw freshwater fish, raw shellfish, and ferns Food high in anti-thiamine factor, such as tea, coffee, and betel nuts Processed food with a content high in sulfite, which destroys thiamine - Alcoholic state - Starvation state Increased consumption states - Diets high in carbohydrate or saturated fat intake - Pregnancy - Hypehyroidism - Lactation - Fever - severe infection - Increased physical exercise Increased depletion - Diarrhea - Diuretic therapies - Peritoneal dialysis - Hemodialysis - Hyperemesis gravidarum Loss of thiamine through renal excretion can occur with most, if not all, diuretics. It has been seen with the use of such diuretics as mannitol, acetazolamide, chlorothiazide, amiloride, and loop diuretics. Thiamine loss is associated with the increase in urine flow rate, but it is not related to sodium excretion. This suggests that patients with polyuria, even if the condition is unrelated to diuretics, may benefit from thiamine supplementation.

So the answer to this question is A


Instruction:
The following are the risk factors for inguinal hernia:
A. Family history of inguinal hernia
B. Weight lifter
C. COPD
D. All

Response:
Ans. is ' a ' , ' b ' , ' c Family history of inguinal hernia, Weight lifter, COPD 2 factors are responsible for causing any hernia:a. weakness of abdominal muscleb. chronically increased intraabdominal pressureWeakness of abdominal muscles1. Patent processus vaginalis2. Patent canal of Nuck causes indirect inguinal hernia in females3. Connective tissue disorders like Ehlers Danlos syndrome4. Congenital condition like Exstrophy of bladder, Prune belly syndrome5. Advancing age and chronic debilitating diseasesIncreased abdominal pressureMarked obesityAbdominal strain from heavy exercise or liftingChronic cough in bronchitis, tuberculosis etc. (Whoopic cough in children)Chronic constipation with straining at stoolEnlarged prostate with straining at micturitionPregnancyCirrhosis with ascites8.Chronic ambulatory peritoneal dialysis9.Intraabdominal tumors10. Chronically enlarged pelvic organsOther risk factorsFamily history -[Ref: - Indirect inguinals are more common in boysPreterm babiesHistory of hernia - h/o of hernia on one side is risk factor for the other side.

So the answer to this question is D


Instruction:
During the following procedure, optimum interval between uterine incision and delivery should be less than ______ seconds.
A. 30 seconds
B. 45 seconds
C. 60 seconds
D. 90 seconds

Response:
Ans. D 90 secondsRef: Datta, 8th ed. pg. 673The image shows LSCS being performed, with the head being delivered by hooking fingers carefully between the lower uterine flap. The head is delivered by elevation and flexion using the palm as fulcrum and the optimum time between the uterine incision and delivery should be less than 90 seconds.

So the answer to this question is D


Instruction:
Debucain number refers to
A. Ach cholinestrase activity derangement
B. Potency of muscle relaxants
C. Potency of general anaesthetics
D. None

Response:
DIBUCAINE NUMBER * The Dibucaine Number is a measure of the qualitative activity of Pseudo cholinesterase and is the percentage of inhibition of the enzyme by the local anesthetic Dibucaine. * It is used to differentiate individuals who have substitution mutations of the Butryl cholinesterase enzyme

So the answer to this question is A


Instruction:
Swimming pool conjunctivitis is caused by
A. Picorna virus
B. Chlamydia trachomatis
C. Adenovirus type 8
D. Gonococcus

Response:
ADULT INCLUSION CONJUNCTIVITIS Etiology : Inclusion conjunctivitis is caused by serotypes D to K of Chlamydia trachomatis. The primary source of infection is urethritis in males and cervicitis in females. The transmission of infection may occur to eyes either through contaminated fingers or more commonly through contaminated water of swimming pools (hence the name swimming pool conjunctivitis). Reference :- A K KHURANA;6th edition , page:- 68

So the answer to this question is B


Instruction:
A patient was hospitalized after a road accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin, and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhoea and pseudomembranous enterocolitis. Antibiotic associated diarrhoea and the more serious pseudomembranous enterocolitis can be caused by
A. Clostridium sordellii
B. Clostridium perfringens
C. Clostridium difficile
D. S. aureus

Response:
Pseudomembranous enterocolitis and antibiotic-associated diarrhea are caused by an anaerobic Gram-positive rod, Clostridium difficile. Patients treated with antibiotics develop diarrhea that, in most cases, is self-limiting. However, in some instances, paicularly in those patients treated with ampicillin or clindamycin, a severe, life-threatening pseudomembranous enterocolitis develops. This disease has characteristic histopathology, and membranous plaques can be seen in the colon by endoscopy. It has been recently shown that C. difficile produces a protein toxin with a molecular weight of about 250,000. The "toxin" is, in fact, two toxins, toxin A and toxin B. Both toxins are always present in fecal samples, but there is approximately one thousand times more toxin B than toxin A. Toxin A has enterotoxic activity--that is, it elicits a positive fluid response in ligated rabbit ileal loops-- whereas toxin B appears to be primarily a cytotoxin.

So the answer to this question is C


Instruction:
Glomerular filtration rate stas declining at what age?
A. 10-15 years
B. 30-40 years
C. 45-55 years
D. 55-65 years

Response:
Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman&;s capsule per unit time.The normal range of GFR, adjusted for body surface area, is 100-130 ml/min/1.73m2 in men and women. In children, GFRmeasured by inulin clearance is 110 ml/min/1.73m2 until 2 years of age in both sexes, and then it progressively decreases. After age 40, GFR decreases progressively with age, by about 0.4 - 1.2 mL/min per yearRef: Ganong&;s review of medical physiology; 24th edition; page no; 679

So the answer to this question is B


Instruction:
Most common CNS tumor associated with NF-1 is?
A. Optic nerve glioma
B. Meningioma
C. Medulloblastoma
D. Ependymoma

Response:
Ans. is 'a' i.e., Optic nerve glioma * Optic nerve glioma is one of the diagnostic sign of NF-1.

So the answer to this question is A


Instruction:
High FMA angle indicates which of the following?
A. Poor prognosis
B. Good bone growth
C. Class III relation
D. Good prognosis

Response:
High FMA angle indicates that the patient has more vertical growth pattern. This angle is large in case of mandibular retrognathism and less in mandibular prognathism. This angle can be influenced by orthopaedic or orthodontic therapy. If angle is more, then the facial pattern is of vertical type and mandible is placed more posteriorly, so to bring the mandible to normal relationship with maxilla is quite difficult. So, such cases are difficult to treat and pose poor prognosis.
Key Concept:
If angle is more, then the facial pattern is of vertical type and mandible is placed more posteriorly, so to bring the mandible to normal relationship with maxilla is quite difficult. So, such cases are difficult to treat and pose poor prognosis.
Reference: Textbook of orthodontics 2nd ed Gurkeerat Singh page no 502

So the answer to this question is A


Instruction:
Levels of which of the following hormones are increased in post menopausal women:September 2011, March 2013
A. Estrogen
B. FSH
C. Progesterone
D. Coisone

Response:
Ans. B: FSHThe ovarian changes in menopause are not due to lack of anterior pituitary gonadotropins (FSH and LH) which actually increase, as negative effect of estrogen and progesterone is reduced.Ovaries no longer secrete 17-beta-pestradiolMenopauseThe stages of the menopause transition have been classified according to a woman's repoed bleeding pattern, suppoed by changes in the pituitary follicle stimulating hormone/ FSH levels.In younger women, during a normal menstrual cycle the ovaries produce estradiol, testosterone and progesterone in a cyclical pattern under the control of FSH and luteinising hormone (LH) which are both produced by the pituitary gland.Blood estradiol levels remain relatively unchanged, or may increase approaching the menopause, but are usually well preserved until the late perimenopause.This is presumed to be in response to elevated FSH levels.Menopause is based on the natural or surgical cessation of estradiol and progesterone production by the ovaries, which are a pa of the body's endocrine system of hormone production, in this case the hormones which make reproduction possible and influence sexual behavior.After menopause, estrogen continues to be produced in other tissues, notably the ovaries, but also in bone, blood vessels and even in the brain.However the dramatic fall in circulating estradiol levels at menopause impacts many tissues, from brain to skin.In contrast to the sudden fall in estradiol during menopause, the levels of total and free testosterone, as well as dehydroepiandrosterone sulfate (DHEAS) and androstenedione decline more or less steadily with age.

So the answer to this question is B


Instruction:
According to Transplantation of Humans Act, all of the following specialist are authorized for pronouncing brain death except:
A. Neurosurgeon
B. Doctor performing the liver transplant
C. Doctor attending the patient
D. RMP in charge of the hospital

Response:
Ans. (B). Doctor performing the liver transplantAccording to THOA, Brain stem death is certified by a board of medical experts consisting of all of the followingRegistered Medical Practitioner (RMP) in charge of hospital where brain death has occurredQRMP treating the patientQA Neurologist/Neurosurgeon nominated by panelQAn independent RMP - a specialistQAs per latest amendment, if neurologist is not available, any surgeon, physician, anaesthetist or intensivist, nominated by medical in-charge of the hospital may certify brain death.Transplant Surgeon should never be a part of the team.

So the answer to this question is B


Instruction:
A contrast enema is performed on a one-day-old infant presenting with bilious emesis and abdominal distension. Based on the findings, which of the following is the MOST likely diagnosis?
A. Hirschprung Disease
B. Meconium Plug Syndrome
C. Meconium ileus
D. Small Left Colon Syndrome

Response:
The examination shows a microcolon, which is a term applied to an unused colon; this happens in infants with congenital distal bowel obstruction. A. Patients with Hirschsprung disease should demonstrate a zone of transition between normal caliber colon distally, and dilated colon proximally. Such findings are not present in this case. B. Patients with meconium plug syndrome do not have a microcolon. The colon is normal in caliber, and demonstrates a large filling defect representing the meconium plug. C. There is microcolon with dilated proximal small bowel loops. Multiple filling defects are consistent with inspissated meconium. D. In patients with small left colon syndrome, the left colon and often poions of the sigmoid are small, similar to a microcolon; however, unlike the findings in the test case, the remainder of the colon, including the rectum, is normal in caliber. Therefore this answer is not correct.

So the answer to this question is C


Instruction:
International red cross was founded by-
A. Henry dunant
B. Claude bernard
C. samuel hahnemann
D. Gergar mendel

Response:
Ans. is 'a' i.e., Henry dunant* The international committee of the Red Cross (ICRC) is a private humanitarian institution founded in 1863 Geneva, Switzerland, by Henry Dunant and Gustave Moynier. Its 25-member committee has a unique authority under international humanitarian law to protect the life and dignity of the victims of international and internal armed conflicts. The ICRC was awarded the Nobel Peace Prize on three occasions (in 1917, 1944 and 1963)

So the answer to this question is A


Instruction:
In intravenous pyelography, one contracted kidney indicates:
A. Hydronephrosis
B. Polycystic kidney
C. Chronic glomerulonephritis
D. Chronic pyelonephritis

Response:
Ans. Chronic pyelonephritis

So the answer to this question is D


Instruction:
Fine needle aspiration cytology is not able to detect which of the the following
A. Papillary carcinoma
B. Hashimotos thyroiditis
C. Follicular cancer
D. Medullary cancer

Response:
Refer Robbins page no 1094 Because of the beer for evaluating capsular integrity the definitive diagnosis o Adenoma can be made only aferr6 careful histologic examination o Te respected specimen .Suspected Adenoma of thyroid are therefore removed surgically to exclude malignancy

So the answer to this question is C


Instruction:
One of the following is not a malignant feature
A. Aplasia
B. Anaplasia
C. Abnormal mitosis
D. Pleomorphism

Response:
None

So the answer to this question is A


Instruction:
Corduroy appearance on X-ray is seen in?
A. Osteoclastoma
B. Osteosarcoma
C. Hemangioma
D. Ewing's sarcoma

Response:
Corduroy cloth appearance/ jail bar sign (veical striations in veebrae)-Hemangioma Hemangioma result of the replacement of normal cancellous by thickened veical trabeculae surrounded by fat marrow or vascular lacunae in veical intraosseous hemangiomas. It is a benign tumor and consists of vascular channels. It is seen commonly in middle-aged patients The spine is the commonest site Note: Polka Dot sign seen on CT scan

So the answer to this question is C


Instruction:
Which organism causes hemolytic uremic syndrome
A. Neisseria
B. Salmonella
C. Pseudomonas
D. E. Coli

Response:
Hemolytic uremic syndrome (HUS) is a type 3 hypersensitivity reaction associated with small vessel vasculitis.
• Organisms causing HUS is E.Coli (particularly EHEC) and shigella dysenteriae.

So the answer to this question is D


Instruction:
Chocolate Brown postmoem staining is seen in -
A. KCI Poisoning
B. Opium Poisoning
C. H S Poisoning
D. Cyanide poisoning

Response:
In poisoning by nitrites, potassium chlorate, nitrobenzene, potassium bicarbonate and aniline the colour of postmoem hypostasis is chocolate brown due to methhemoglobinemia. Dr.Narayana Reddys Synopsis of Forensic Medicine and Toxicology 27th edition pg. 76.

So the answer to this question is A


Instruction:
Deficiency of which element can lead to the syndrome of growth failure, anemia, and hypogonadism?
A. Calcium
B. Copper
C. Zinc
D. Magesium

Response:
Zinc deficiency is characterized by growth retardation, loss of appetite, and impaired immune function. In more severe cases, zinc deficiency causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, and eye and skin lesions. Reference: GHAI Essential pediatrics, 8th edition

So the answer to this question is C


Instruction:
Which cancauseprofoundhyperlipidemia ?
A. Hyperinsulinemia
B. Hypothyroidism
C. Hyperparathyroidism
D. Hypehyrodism

Response:
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:687-688 CAUSES OF HYPERLIPIDAEMIA The following conditions predispose to the development of these exacerbations: a. Poorly controlled diabetes mellitus b. Alcoholism c. Oestrogen containing contraceptive pills d. Hypothyroidism. There is an increased prevalence of obesity and diabetes in these people.

So the answer to this question is B


Instruction:
Plasma cells are mostly seen in one of the stages of gingivitis
A. Initial lesion
B. Early lesion
C. Established lesion
D. Advanced lesion

Response:
None

So the answer to this question is C


Instruction:
28 year old female presents with irregular slight bleeding after taking combined OCPs 3 months for heavy menstrual bleeding. What is your advice
A. Endometrial sampling to rule out neoplasia.
B. Change over to progestin only preparations.
C. Reassure the patient as it is break through bleeding.
D. Discontinue OCPs.

Response:
With hormone replacement therapy, irregular spotting or bleeding is side effect. There is no need to sample endometrium, as this is seen only in early months of use.

So the answer to this question is C


Instruction:
Percentage of T4 and T3 released from thyroid gland?
A. 50% T4 ; 50% T3
B. 25% T4 ; 75% T3
C. 80% T4 ;20% T3
D. 1000% T4 ;0% T,

Response:
Ans. is 'c' i.e., 80% T4 ;20% T3 ,(Ref: Elsefier's medical laboratory science examination review p.246)Approximately 80% of secreted hormone is T4 & 20% T3 ," .

So the answer to this question is C


Instruction:
When hypothyroidism is caused by pituitary dysfunction (Central hypothyroidism), the following profile is present
A. Goitre present, raised TSH, low T3, T4
B. No goitre, reduced TSH, low T3, T4
C. No goitre, raised TSH, low T3, T4
D. Goitre present, reduced TSH, low T3, T4

Response:
None

So the answer to this question is B


Instruction:
flouroquilones C/I in liver diseases is ?
A. pefloxacin
B. levofloxacin
C. oflaxacin
D. lomefloxacin

Response:
PEFLOXACIN : WELL ABSORBED IN GIT NO EFFECT KIDNEYS C/I IN LIVER FAILURE REF : KD TRIPATHI 8TH ED

So the answer to this question is A


Instruction:
A 71 year old man comes to the emergency depament because of blurry vision and blood tinged urine. He states that he has a long history of hypeension treated with a beta blocker, an ACE inhibitor and a calcium channel blocker. He repos that he has had 3 days of blurry vision and urine that is "cola" colored. The symptoms began when he ran out of his medications 3 days ago and he has "not had the time" to get the prescriptions refilled. His physical examination is remarkable for a blood pressure of 200/110 mmHg in both arms, and funduscopic examination showing flame hemorrhages and papilledema. Urinalysis shows red blood cells and some dysmorphic red blood cell casts. He has an abdominal bruit. Which of the following is the most appropriate next step in management?
A. Order an ECG and observe the patient
B. Order an abdominal CT scan to rule out aoic aneurysm
C. Give the patient his usual daily doses of BP medications and observe him
D. Give the patient intravenous medication to reduce his BP

Response:
This patient has a hypeensive emergency, as evidenced by both the presence of elevated systolic and diastolic blood pressure, as well as evidence of end- organ damage. The blood pressure numbers themselves are a good reason for urgency, but the presence of increased intracranial pressure and renal failure require that this patient be triaged as an emergency. Elevated blood pressure alone, in the absence of symptoms or end organ damage, rarely requires emergency therapy. The therapy for a hypeensive emergency requires IMMEDIATE LOWERING of the blood pressure by approximately 20-30 mm Hg by intravenous administration of medication. The blood pressure should not be reduced to normotensive levels because of the risk of watershed cerebral infarcts with such a dramatic reduction. Ordering an ECG and observing the patient is incorrect. Observation is ceainly warranted, but not without intervention. Giving the patient his usual daily doses of blood pressure medications and observing him would not achieve a rapid enough reduction of the blood pressure, given the presence of end-organ damage on physical examination. Ordering an abdominal CT scan to rule out aoic aneurysm is not an appropriate intervention in the case of an active hypeensive emergency. Ref: Lepe M., Varon J. (2012). Chapter 252. Hypeensive Urgencies. In G.V. Lawry, J. Matloff, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine.

So the answer to this question is D


Instruction:
Predominant constituent of hyaline membrane is
A. A. Albumin
B. B. Anthracotic pigment
C. C. Fibrin rich pigment
D. D. None of the above

Response:
The membranes are largely made up of fibrinogen and fibrin admixed with cell debries derived chiefly from necrotic type -2 pneumocytes There is remarkable paucicity in neutrophilic inflammation reaction associated with necrosis

So the answer to this question is C


Instruction:
Umbilical cord has:
A. 1 vein and 2 aeries
B. 2 vein and 2 aeries
C. 1 vein and 1 aery
D. 2 veins and 1 aery

Response:
CONTENTS OF UMBILICAL CORD: - 2 Umbilical aeries - 1 Umbilical vein - Rudimentary allantois - Remnant of omphalomesenteric / vitellointestinal duct - Whaon's jelly

So the answer to this question is A


Instruction:
Which of the following is the most common cause of meningoencephalitis in children -
A. Mumps
B. Arbovirus
C. HSV
D. Enterovirus

Response:
Ans. is 'd' i.e., Enterovirus "Enteroviruses are the most common cause of meningoencephalitis"

So the answer to this question is D


Instruction:
The dye used for OCG is:
A. lopanoic acid
B. Sodium diatrozite
C. Biligraffin
D. Meglumine iodothalamate

Response:
Ans. lopanoic acid

So the answer to this question is A


Instruction:
Maximum visual impairment occurs in:
A. Leukoma adherens at periphery
B. Centrocaecal leucoma
C. Nebular corneal opacity
D. Med peripheral Leucoma

Response:
Nebular corneal opacity has maximal visual disability. Type of corneal opacities Nebular: Superficial layers involving upto superficiial stroma. It do more disability of vision owing to the irregular astigmatism. Macular: Upto mid stroma is involved as opacity Leucomatous: Full thickness stromal opacity. Adherent leucoma is iris tissue incarcerated in opacity, seen normally after perforation. Peripheral, mid peripheral and centrocaecal leucomas will not affect the visual axis and hence would not produce visual disability. However a central leucoma would not allow light to pass through and hence would cause maximum visual problems.

So the answer to this question is C


Instruction:
Mechanism of action of vincristine in the treatment of all is
A. Inhibition of topoisomerse II to cause breaks in DNA standards
B. Alkylation and cross linking DNA standards
C. Inhibition of DNA mediated RNA synthesis
D. Inhibition of polymerization of tubulin to form microtubes

Response:
Ref-KDT 6/e 824,825 Vincristine is a chemotherapy drug that belongs to a group of drugs called vinca alkaloids. Vincristine works by stopping the cancer cells from separating into 2 new cells. So, it stops the growth of the cancer by polymerization

So the answer to this question is D


Instruction:
Which one of the following postural reflexes/reaction requires intact coex?
A. Tonic neck reflex
B. Neck righting reflex
C. Magnet reaction
D. Optical righting reflex

Response:
Posture is regulated or acquired by reflex redistribution of tone in various muscle groups. Magnet reaction, also known as positive suppoing reaction, is seen in the spinal animal; Centre - Spinal cord Tonic neck reflex is seen in the decerebrate animal;Center - Vestibular nuclei. Neck righting reflex is seen in the midbrain or thalamic animal. Center - Midbrain nuclei/red nucleus. Optical righting reflex ~ When a person is falling, the surrounding objects will be seen tilted; and, from this visual input the upright posture will be retained. Center - Visual coex. Thus, intact coex is required for this reaction. Postural Reflexes and their centres Reflexes Integrated in Stretch reflex Positive suppoing reaction Negative suppoing reaction Spinal cord Tonic labyrinthine and tonic neck reflexes Medulla Righting reflexes (except optical righting reflexes) Labyrinthine righting reflexes Neck righting reflexes Body on head righting reflexes Body on body righting reflexes Midbrain Conditioned reflex Optical righting reflexes Hopping and placing reaction Coex

So the answer to this question is D


Instruction:
All of the following statements about Phenytoin are true, Except:
A. Follows saturation kinetics
B. Is teratogenic
C. Is highly protein bound
D. Stimulates Insulin secretion

Response:
Phenytoin inhibits the release of insulin and cause hyperglycemia. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 372, 373.

So the answer to this question is D


Instruction:
About lidocaine all are true, except
A. Dose need to altered in renal failure
B. Loading dose before infusion
C. It is little effected by heat & pH
D. Prolongs refractory period

Response:
Local anaesthetics are poorly water-soluble and this limits their renal excretion to less than 5%. For treating ventricular arrhythmias initial loading dose is to be followed by infusion. The amides are so stable that they are not effected even by autoclaving. Effective refractory period (of cardiac tissue) is prolonged by local anaesthetics.

So the answer to this question is A


Instruction:
Which aery is responsible for epistaxis after ligation of external carotid aery?
A. Ethmoidal aery
B. Greater palatine aery
C. Ascending pharyngeal aery
D. Superior labial aery

Response:
Ethmoidal aery is a branch of internal carotid aery while rest of the aeries provided in the options are branches of external carotid aeries, thereby after ligation of external carotid aery, ethmoidal aery is the only aery which can cause epistaxis.

So the answer to this question is A


Instruction:
Which of the following is not true about amoebiasis-
A. ALA in 10% cases in tropics
B. Portal system efficient filter
C. Abscess due to suppuration
D. Abscess wall good for culture

Response:
Amoebic liver abscess

Pus in amoebic liver abscess is not due to suppuration but is a mixture of sloughed liver tissue and blood.
It is chocolate brown in colour and thick in consistency (anchovy sauce pus)
In the tropics, 2-10% of the individuals infected with Entamoeba histolytica suffer from hepatic complications. The trophozoites are carried from the large intestine to the liver by the portal vein. In the liver, the capillary system acts as an efficient filter and holds these parasites.
In the case of an amoebic liver abscess, the diagnostic aspiration is done from the abscess wall because the trophozoites are confined to the periphery.

So the answer to this question is C


Instruction:
Reactionary hemorrhage occur within: March 2010
A. 24 hours
B. 1-2 days
C. 2-4 days
D. 4-6 days

Response:
Ans. A: 24 hoursAccording to the "time of appearence" hemorrhage can be classified in to:Primary hemorrhage - Is one which occur at the time of injury or operation.Reactionary hemorrhage - In majority of cases reactionary occur within 4 to 6 hours. Such bleeding may also occur due to:- Restlessness- Coughing- Vomiting with raises the venous pressure.Secondary hemorrhage -This occurs usually after 7 to 14 days of injury or operation. This is usually due to infection and sloughing of a pa of the aerial wall.

So the answer to this question is A


Instruction:
Common symptoms of panic attacks include the all of following except?
A. Fear of dying
B. Fear of losing control
C. Fear of going crazy
D. Suicidal thoughts

Response:
Suicidal thought is not common symptom of panic attack. Patient has a feeling of impeding doom. There is feeling of going crazy , losing control and dying.

So the answer to this question is D


Instruction:
A blood donor is not considered for safe transfusion if he has-
A. Anti HBsAg +ve
B. Anti HBsAg and HBcAg (+)ve
C. HBsAg +ve and IgM anti HBc+ve
D. Anti HBc +ve

Response:
it indicate acute hepatitis.so patirnt cant trandfuse blood REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.546

So the answer to this question is C


Instruction:
A twitch of motor unit is called
A. Myoclonic jerk
B. Tremor
C. Fasciculation
D. Chorea

Response:
Fasciculations are jerky, visible contractions of groups of muscle fibres as a result of pathological discharge of spinal motor neurons. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 50)

So the answer to this question is C


Instruction:
In non zinc containing dental amalgam alloy, the percentage of zinc present is
A. Less than 0.02%
B. Less than 0.1%
C. Less than 0.01%
D. None of the above

Response:
The ANSI/ADA specification also includes a notation about the presence of zinc in amalgam alloys, with more than 0.01% zinc classified as zinc containing and those with less than 0.01% as non-zinc alloys. Zinc has been included in amalgam alloys as an aid in manufacturing; it helps produce clean, sound castings of the ingots used for producing lathe-cut alloys. The presence of contamination within the amalgam must be avoided because it can degrade the integrity of the restoration.

So the answer to this question is C


Instruction:
The commonest cranial nerve palsy in tabes dorasalis is:
A. III nerve
B. IV nerve
C. VI nerve
D. Total ophthalmoplegia

Response:
Ans. III nerve

So the answer to this question is A


Instruction:
QT prolongation is caused by:-
A. Quinidine
B. Omeprazole
C. Lidocaine
D. Penicillin

Response:
Drugs causing QT prolongation are: Cisapride Astemizole Terfanidine Class 1A anti-arrythmic drugs: Quinidine, Procainamide. Class 3 anti-arrythmic drugs: Bretylium, Ibutilide

So the answer to this question is A


Instruction:
Which of the following is not a fundamental aspect of Disaster Management?
A. Disaster response
B. Disaster mitigation
C. Disaster awakening
D. Disaster preparedness

Response:
Ans. C. Disaster awakening. (Ref. Park's Textbook of PSM 22nd/pg. 741)Discussion:A disaster can be defined as "any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area.A "hazard''can be defined as any phenomenon that has the potential to cause disruption or damage to people and their environment.DISASTER MANAGEMENTThere are three fundamental aspects of disaster management: -# Disaster response,# Disaster preparedness,# Disaster mitigation.Response# Response after disaster.# Include rescue, first aid, triage etc.# Note that triage is the only approach that can provide max benefit to the greatest no. of injured in major disaster situations. Red indicates high priority Rx or transfer, yellow signals medium priority, green indicates ambulatory patients and black for dead or moribund patients.Preparedness# Objective to ensure that appropriate systems, procedures and resources are in place to provide prompt effective assistance to disaster victims.Mitigation# Measures to prevent hazards or lessen likely effect of emergencies.

So the answer to this question is C


Instruction:
WRONG about ileum as compared with jejunum is
A. Sho club shaped Villi
B. Long vasa recta
C. More lymphoid nodules
D. More fat in mesentery

Response:
Jejunum has long and sparse vasa recta as compared to ileum. Jejunum are thick walled and peritoneal windows are transparent as compared to ileum. Peyer patches are present in ileum which are absent in jejunum. Jejunum have 1 or 2 rows of aerial arcades whereas ileum have 4 to 5 aerial arcades Ileum have sho club shaped villi. Ileum have more fat in mesentry.

So the answer to this question is B


Instruction:
Preload is determined by -
A. Enddiastolic volume
B. Endsystolic volume
C. Ventricular ejection volume
D. None of the above

Response:
Ans. is 'a' i.e., Enddiastolic volume Factors affecting cardiac outputo Cardiac output is the product of stroke volume and heart rate. Hence any factor which affects either the stroke volume or the heart rate or both affects the cardiac output.A) Factors affecting stroke volume# Stroke volume, which is the amount of blood pumped by the heart during one stroke, depends mainly on three factors : -1) Preload (Degree of ventricular fdling during diastole) : - Cardiac preload is represented by volume of venous blood that distends the ventricle, i.e., venous return determines the preload. An increase in preload, i.e., increase in venous return results in a higher end-diastolic volume (Preload). This results in stretching of myocardial fiber and this increase in length of myofibril increases the strength of cardiac contraction in accordance with the Frank-Star ling law or Starling rs taw of the heart. According to Starling's law, greater the initial length of muscle fiber, greater is the force of contraction. The initial length of muscle fiber (length of fiber at the initiation of contraction/systole) refers to length of the fiber at the end of the diastole, i.e., end-diastolic fiber length. Thus, the factors which improve venous return increase the cardiac output by increasing end-diastolic ventricular volume and length, i.e., preload. Opposite is true for factors which decrease venous return.| Stroke volume| Stroke volumeFactors increasing end-diastolic ventricular muscle fiber length (Factors increasing venous return or preload)#Increased total blood volume#Increased venous tone#Increased pumping action of skeletal muscle#Increased negative intrathoracic pressure (e.g. inspiration)o Lying down from sitting or standing position# Sympathatic discharge causing decrease in venous capacitance by decreasing venous complianceFactors decreasing end-diastolic ventricular muscle fiber length (Factors decreasing venous return or preload)o Decreased total blood volumeo Decreased venous toneo Decreased pumping action of skeletal muscleso Less negative or positive intrathoracic pressure (expiration)o Sitting or standing (venous pooling of blood)Contractility of ventricle : - If the contractile strength of ventricle increases, stroke volume increases. Contractility is increased by increase in sympathetic discharge or circulating catecholamines (epinephrine), for example during exercise.After load (resistance offered to ventricular pumping action): - Left ventricle has to pump out blood against aortic resistance. Increased aortic resistance (e.g., high BP) tends to decrease stroke volume. Decreased peripheral resistance increases cardiac output e.g., in exercise, AVfistula or shunt, severe anemia (due to vasodialtion by anemic hypoxia), thyrotoxicosis (due to vasodilation caused by in- creased O2 consumption), and wet beri-beri.B) Factors affecting heart rate# Heart rate is predominantly under neurohumoral influence. Sympathetic stimulation increases heart rate and therefore cardiac output. Thus, sympathetic stimulation increases cardiac output massively by : (i) Increasing stroke volume by increasing contractility, and (ii) Increasing heart rate; but without increasing the end-diastolic volume.

So the answer to this question is A


Instruction:
Commonest type of Anal canal Ca is -
A. Sq. cell Ca
B. Adeno Ca
C. Adenoacanthoma
D. Papillary type

Response:
Mainly 3 types of malignant neoplasm are seen in anal canal

Squamous cell Ca (MC)
Basal cell Ca (IInd mc)
Melanoma

Remember

MC type of rectal & colon Ca → Adenocarcinoma*.

So the answer to this question is A