Instruction:
True statement of Buerger's desease is/are -a) Small and medium sized vessels involvedb) Commonly involves upper limb than lower limbsc) Common in maled) Common in female
A. a
B. bc
C. ac
D. b

Response:
Buerger's ds. may involve both upper or lower extremity. It is more common in lower limbs

So the answer to this question is C


Instruction:
'Physiologic programmed cell death' is termed as
A. Apoptosis
B. Lysis
C. Autolysis
D. Autopsy

Response:
None

So the answer to this question is A


Instruction:
All the following are true about measles vaccine except –
A. Given subcutaneously
B. High efficacy
C. Given below 1 year of age
D. Diluent not required

Response:
None

So the answer to this question is D


Instruction:
Most common symptom of thallium poisoning ?
A. Neuropathy
B. Abdominal pain
C. Headache
D. Visual disturbances

Response:
Ans. is 'B' i.e., Abdominal pain"Most common symptom of acute thallium poisoning is abdominal pain with nausea 6- vomiting and diarrhea or constipation".

So the answer to this question is B


Instruction:
Causes of anterior polar cataract –
A. Diabetes
B. Perforating corneal injury
C. Irradiation
D. Chalcosis

Response:
None

So the answer to this question is B


Instruction:
Occipitofrontal is muscle is present in which layer of scalp:
A. Aponeurotic layer
B. Subaponeurotic layer
C. Dense connective tissue layer
D. Loose connective tissue layer

Response:
Ans. A. Aponeurotic layerThe term scalp is applied to the soft tissues covering the vault of skull. It extends anteriorly up to the eyebrows (superciliary arches), posteriorly up to the superior nuchal lines, and laterally on each side up to superior temporal line. The scalp consists of five layers. From superficial to deep these are as follows:1. Skin. 2. Connective tissue (superficial fascia). 3. Aponeurosis (occipitofrontal is muscle and its aponeurosis). 4. Loose areolar tissue. 5. Pericranium.

So the answer to this question is A


Instruction:
Which of the following conditions needs emergency endotracheal intubation?
A. GCS<7
B. Tension pneumothorax
C. Cardiac tamponade
D. Bleeding gastric ulcer

Response:
Ans. is 'a' i.e., GCS < 7 o See above explanation

So the answer to this question is A


Instruction:
Patient with a history of fall presents weeks later with headache and progressive neurological deterioration. The diagnosis is:-
A. Acute subdural hemorrhage
B. Extradural hemorrhage
C. Chronic subdural hemorrhage
D. Fracture skull

Response:
Chronic Subdural Hematoma Chronic SDH: collection of blood breakdown products that is at least 3 weeks old Chronic SDHs often occur in patients without a clear history of head trauma, as they may arise from minor trauma . A chronic SDH >1 cm or any symptomatic SDH should be surgical drained .

So the answer to this question is C


Instruction:
Which of the following regarding stress ulcers is true?
A. Cimetidine should be used prophylactically in intensive care patients to prevent stress ulcers
B. Stress erosions take days to develop and resolve slowly
C. Surgery is usually the best way to cure stress ulcers
D. Stress ulcers most often involve the body and fundus of the stomach

Response:
Stress ulcersStress ulcers are single or multiple mucosal defects which can become complicated by upper gastrointestinal bleeding during the physiologic stress of serious illnessRisk factors Non-critically ill medical patients with 2 or more of the following: respiratory failure, sepsis, hea failure, hepatic encephalopathy, jaundice, renal failure, stroke, hypeension, previous gastrointestinal disease and treatment with coicosteroids, NSAIDS, heparin, or warfarin. In surgical critically ill patients, only those patients who are on a mechanical ventilator for more than 48 hours and/or those with a coagulopathyPathogenesisSite of ulcerationReduction in mucosal blood flow or a breakdown in other normal mucosal defense mechanisms in conjunction with the injurious effects of acid and pepsin on the gastroduodenal mucosaSuperficial ulcers confined to the mucosa and submucosa of stomach and duodenumDiagnosisUpper GI endoscopy TreatmentProphylaxisTreat the cause Hourly antacid administration to maintain intragastric pH above 4 H2 blockersAntacids, H2-receptor blockers, sucralfate, proton pump inhibitors (PPIs), prostaglandin analogs, and nutritionRefer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2203

So the answer to this question is D


Instruction:
Screening of prostate Ca is done by
A. Transrectal USG
B. Digital rectal exam
C. PSA
D. CT scan

Response:
Screening for malignancy according to America cancer society Recommendations for early detection of cancer in Average - Risk, Asymptomatic individuals Cancer site : Prostate Population : Men aged >= 50 years Test or procedure : Digital rectal examination (DRE) and prostate specific antigen (PSA) test. Frequency : Offer PSA test and DRE annually, staing at age 50,for men who have life expectancy of atleast 10 years Ref: Harrison's 19th edition Pgno : 481

So the answer to this question is B


Instruction:
Antral sign is seen in ?
A. Juvenile angiofibroma
B. CSOM
C. Sinusitis
D. Otoscelrosis

Response:
Investigations of JNA Following investigations are used in JNA :- i) Soft tissue lateral film of nasopharynx :- shows soft tissue mass in the nasopharynx. ii) X-rays paranasal sinus and base of skull :- findings have been explained in previous explanation. iii) CT scan of head with contrast :- is the investigation of choice. It shows the extent of tumour, bony destruction, or displacement. Anterior bowing of the posterior wall of maxillary sinus (antral sign or Hohnan-Miller sign) is pathgnomonic of JNA. iv) MR1 complementory to CT when soft tissue extensions are present intracranially, in infratemporal foss or in orbit. v) Carotid angiography :- shows extension of tumor, its vascularity and feeding vessels. Biopsy should be avoided as it can cause severe bleeding.

So the answer to this question is A


Instruction:
Depressed of skull results from:
A. Heavy object with small striking surface
B. Heavy object with large striking surface
C. Fall over the ground
D. Light object

Response:
A i.e. Heavy object with small striking surface

So the answer to this question is A


Instruction:
Salmonella typhi is the causative agent of typhoid fever. The infective dose of S. typhi is -
A. One bacillus
B. 1 08-1 01deg bacilli
C. 102-105 bacilli
D. 1-10 bacilli

Response:
Typhoid and paratyphoid (enteric) fevers Typhoid and paratyphoid fevers, which are transmitted by the faecal-oral route, are impoant causes of fever in the Indian subcontinent, sub-Saharan Africa and Latin America. Elsewhere, they are relatively rare. Enteric fevers are caused by infection with Salmonella Typhi and Salmonella Paratyphi A and B. After a few days of bacteraemia, the bacilli localise, mainly in the lymphoid tissue of the small intestine, resulting in typical lesions in the Peyer's patches and follicles. These swell at first, then ulcerate and usually heal. After clinical recovery, about 5% of patients become chronic carriers (i.e. continue to excrete the bacteria after 1 year); the bacilli may live in the gallbladder for months or years and pass intermittently in the stool and, less commonly, in the urine. Clinical features Typhoid fever The incubation period is typically about 10-14 days but can be longer, and the onset may be insidious. The temperature rises in a stepladder fashion for 4 or 5 days with malaise, increasing headache, drowsiness and aching in the limbs. Constipation may be caused by swelling of lymphoid tissue around the ileocaecal junction, although in children diarrhoea and vomiting may be prominent early in the illness. The pulse is often slower than would be expected from the height of the temperature, i.e. a relative bradycardia. At the end of the first week, a rash may appear on the upper abdomen and on the back as sparse, slightly raised, rose-red spots, which fade on pressure. It is usually visible only on white skin. Cough and epistaxis occur. Around the 7th-10thday, the spleen becomes palpable. Constipation is followed by diarrhoea and abdominal distension with tenderness. Bronchitis and delirium may develop. If untreated, by the end of the second week the patient may be profoundly ill. Salmonella enterica is a facultative anaerobe and is a gram negative, motile ... For enteric fever, the infectious dose is about 105 bacilli by ingestion Ref Harrison20th edition pg 1079

So the answer to this question is C


Instruction:
A patient of 47 XXY karyotype presents with features of hypogonadism; likely diagnosis is:
A. Turners syndrome
B. Klinefelter syndrome
C. Edwards syndrome
D. Down syndrome

Response:
KLEINELFELTER SYNDROME XXY male (XY male with an extra X chromosome) Enlarged breasts Sparse facial and body hair Small testes Azoospermia primary testicular failure Increase LH and FSH levels Androgen deficiency causes eunuchoid body propoions Absent facial, axillary, pubic, or body hair Gynecomastia Small testes and penis Diminished libido

So the answer to this question is B


Instruction:
A 25-year female presented with mild pallor and moderate hepatosplenomegaly. Her hemoglobin was 92g/L and fetal hemoglobin level was 65%. She has not received any blood transfusion till date. She is most likely to be suffering from:
A. Thalassemia major
B. Thalassemia intermedia.
C. Hereditary persistent fetal hemoglobin, homozygous state.
D. Hemoglobin D, homozygous state.

Response:
Ans. is 'b' Thalassemia intermedia The symptoms and the investigations of the patient point towards the diagnosis of thalassemia intermedia.Thalassemia intermedia (Geno type bdeg/b or b+/b+) :-Clinical FeaturesAnaemia (moderate to severe), seen after 2 years of age. The Hb level is usually (6-10%).Moderate hepatosplenomegaly can be seenAnisocytosis and poikilocytosisThe characteristic feature is that patient can survive without blood transfusions. Due to abnorm al synthesis of adult Hb (HbA), the level of HbA and Hb F is increased.Level of various Hemoglobin in thalassemia intermedia-HbA - reduced (20-40%)HbF - increased (60-80%)HbA2 - increasedSo it is clear that the diagnosis is Thalassemia intermedia.Now let's see the other options.Thalassemia :Thalassemia major can also have the same presentations but 2 important points rule it out.In thalassemia major the patient cannot survive without transfusions. Blood transfusion is a must for the survival of the patientThe fetal Hemoglobin level is greater than 90%.Hereditary persistence of fetal hemoglobin :This condition is characterized by continued synthesis of high level of HbF in adult life.No other abnormalities (ie. anemia or hepatosplenomegaly) are present in the patient even if the total Hb is replaced by Hb FHemoglobin D homozygous stateHemoglobin D is an abnormal hemoglobin and occurs in two forms:Homozygous state andHeterozygous state * Hemoglobin D heterozygous state- no abnormality is seen * Hemoglobin D homozygous state:In this condition 95% of the body's hemoglobin is HbDLevels of HbA2 and HbF remain normalClinically pt. presents with mild splenomegaly and mild anemia.

So the answer to this question is B


Instruction:
A 6 month old baby presents with bilateral cataract. A urine test is requested to suspect:
A. Homocystinuria
B. Galactosemia
C. Hyperlysinemia
D. Sulfite oxidase deficiency

Response:
Ans. (b) GalactosemiaRef: Parson's 22/e, p. 273Laboratory investigations for the diagnosis of bilateral, non- hereditary pediatric cataractBlood testSerum biochemistry for levels of blood glucose, calcium and phosphorusRed blood cell transferase and galactokinase levelsSerology for estimating the tiers of antibody for infections such as toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus (TORCH) and hepatitis B virusUrine testUrine assay for the presence of reducing substances after milk feeding (for galactosaemia)Screening for amino acids in the urine (if Lowe syndrome is suspected)

So the answer to this question is B


Instruction:
Sensory nerve supply to Submandibular gland is by:
A. Lingual nerve.
B. Spinal accessory nerve.
C. Mandibular branch of facial nerve.
D. Hypoglossal nerve.

Response:
None

So the answer to this question is A


Instruction:
True regarding cytoplasmic m RNA?
A. It is chiefly translated from nuclear DNA
B. The sugar is deoxyribose
C. Thymine is present in place of uracil
D. Its MW is greater than heterogenous RNA

Response:
mRNA is chiefly transcribed from nuclear DNA
MW of cytoplasmic mRNA is lesser than the heterogenous RNA .
mRNA contain only uracil not the thymine .
Sugar is ribose moiety, not the deoxyribose moiety . Messenger RNA (mRNA) is a molecule of RNA that encodes a chemical "blueprint" for a protein product. mRNA is transcribed from a DNAtemplate, and carries coding information to the sites of protein synthesis, the ribosomes. In the ribosomes, the mRNA is translated into a polymer of amino acids: a protein. (This process is sometimes referred to as the central dogma of molecular biology.) Heterogeneous nuclear RNA (hnRNA) a diverse group of long primary transcripts formed in the eukaryotic nucleus, many of which will be processed to mRNA molecules by splicing.

So the answer to this question is A


Instruction:
Anatomical dead space is
A. 1/3rd of tidal volume
B. 2/5th of tidal volume
C. 10 ml/kg of body weight
D. 15 ml/kg of body weight

Response:
Dead space is the volume of air that is inhaled that does not take pa in the gas exchange, because it either remains in the conducting airways or reaches alveoli that are not perfused or poorly perfused. In other words, not all the air in each breath is available for the exchange of oxygen and carbon dioxide Ref: guyton and hall textbook of medical physiology 12 edition page number: 324,325,326

So the answer to this question is A


Instruction:
Nitric oxide is derived from which amino acid-
A. Histidine
B. Lysine
C. Methionine
D. Arginine

Response:
Ans. is 'd' i.e., Arginine Nitric oxide (NO)o Nitric oxide, also called endothelium-derived-relaxing factor (EDRF), is formed from amino acid arginine, by the action of the enzyme NO synthase, which is cytosolic.NO synthase Arginine [?][?][?][?][?][?][?][?][?][?][?]- Citrulline + NOo Three isoforms of NO synthase have been identified :- Neuronal NOS (nNOS or A'OS-1); (ii) Macrophage or inducible NOS (iNOS or NOS-2); and (iii) Endothelial NOS (eNOS or NOS-3). NOS-1 and NOS-3 are constitutive enzymes, whereas NOS2 is inducible in inflammatory conditions,o NOS-1 and NOS-3 are activated by Ca+2.o NO synthase is a very complex enzyme, employing five redox cofactors : NADPH. FAD, FMN, heme, and tetrahydrobiopterin.o The most important physiological source of NO is endothelial ceils.o NO has a very short half-life (approximately 3-4 seconds) in tissues because it reacts with oxygen and superoxide. The product of reaction with superoxide is peroxynitirite (ONOO), which decomposes to form the highly reactive OH radical. NO acts through group IIB hormonal mechanisms, i.e., through cGMPas the second messenger.

So the answer to this question is D


Instruction:
Casal's Necklace is seen in deficiency of
A. Vitamin A
B. Vitamin B3
C. Vitamin B6
D. Vitamin D

Response:
Pellagra Pellagra occurs due to Vitamin B3 (Niacin) deficiency Pellagra is characterized by by 4D's : 1.Diarrhoea 2.Dermatitis 3.Dementia 4.Death. Skin rash in Pellagra may appear as pigmented and scaly in areas exposed to sunlight. Especially neck when it is known as 'Casal's Necklace' Ref: Park 25th edition Pgno : 657 Harrison's 15th edition Pgno : 463

So the answer to this question is B


Instruction:
Cataracts and PDA in a newborn suggests in utero infection with which viral family? (NOT RELATED)
A. Adenovirus
B. Paramyxovirus
C. Togavirus
D. Picornavirus

Response:
This is seen in congenital rubella infection. Rubella virus belongs to the togavirus family. The infection is transmitted by the respiratory route. The rash of rubella occurs for only three days. Infected pregnant women can transmit the infection to the fetus.

So the answer to this question is C


Instruction:
which of the following is the course of donovanosis
A. H Ducreyi
B. K granulomatosis
C. Leishmania donovani
D. Treponema Pallidum

Response:
Donovanssis or granuloma inguinale is a STD caused by Klebsiella granulomatis ref : ananthanaryana

So the answer to this question is B


Instruction:
Retention appliance should be
A. Retentive only
B. Passive only
C. Passive + retentive
D. Active + retentive

Response:
None

So the answer to this question is C


Instruction:
Most specific marker for neural tube defects is
A. Alpha-fetoprotein
B. Unconjugated estriol
C. Acetylcholinesterase
D. Pseudocholinesterase

Response:
Both alpha-fetoprotein and acetylcholinesterase in amniotic fluid are markers for neural tube defects. But acetylcholinesterase is the most specific marker. Ref : Dutta book of obstetrics 8th Ed

So the answer to this question is C


Instruction:
who gave the stage of insustry versus inferiority
A. erikson
B. lorenz
C. freud
D. bleuler

Response:
ERIC ERIKSON ERIC ERIKSON gave the psychosocail stages of development There are 8 psychosocial stages A person has to succesfully pass one stage to move to the next stage If he gets arrested in one stage he may develop some disorders Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pf no. 485

So the answer to this question is A


Instruction:
Caisson's disease is caused due to exposure to:
A. Heat
B. Cold
C. Pressure
D. Noise

Response:
Exposure to pressure causes Caisson's disease, air embolism. Ref: Park 21st edition page: 746.

So the answer to this question is C


Instruction:
A 43-year-old male high-level executive presents to his physician due to a persistent dizziness when standing quickly. He also has been exhibiting chronic fatigue, some muscle weakness, and an unusual craving for salty foods. The physician notices that the patient has a constant "bronze tan," and blood obtained during the visit demonstrated not only normal cholesterol levels but also hypoglycemia, hyperkalemia, and hyponatremia. The underlying cause for these problems is which one of the following?
A. Adrenal insufficiency
B. Pituitary insufficiency
C. Lack of insulin
D. Lack of glucagon

Response:
The patient is exhibiting the symptoms of Addison disease, initiated by an adrenal insufficiency. Owing to the problem in the adrenal glands, cortisol and aldosterone cannot be produced and released. The lack of cortisol leads to hypoglycemia and fatigue. The lack of aldosterone leads to the alteration in salt balance in the blood and the craving for salt. The hyperpigmentation occurs because of excessive ACTH production, which gives rise to the MSH. The ACTH levels are high because of reduced repression of ACTH synthesis, which is caused by the lack of cortisol release from the adrenal cortex. A reduction of insulin levels would lead to diabetes, not the constellation of symptoms observed in this patient. A lack of GH (in the adult) would lead to increased body fat, high cholesterol, and reduced bone density. A lack of glucagon would lead to hypoglycemia, but not the other symptoms observed in this patient.

So the answer to this question is A


Instruction:
Which of the following condition is characterized by presence of hyaline deposits in alveolar walls?
A. Interstitial lung disease
B. Asthma
C. Hyaline membrane disease
D. Chronic bronchitis

Response:
Ref: Robbins 9th ed. P 672The immature lungs in hyaline membrane disease show eosinophilic hyaline membranes in alveoli, alveolar ducts and terminal bronchioles.The membranes contain necrotic epithelial cells admixed with extravasated plasma proteins.

So the answer to this question is C


Instruction:
Which of the following non ionizing radiations used in thermography?
A. Visible light
B. Microwaves
C. Infrared
D. Radio waves

Response:
Infrared thermography is the process of using a thermal imager to detect infrared radiation (heat) that is emitted by an object. Thermography detects the radiant heat of the body by using infrared rays. Breast cancers have higher blood flow to the mitotically active tumor cells and hence will have a difference in temperature than surrounding normal breast which can be detected using thermography.

So the answer to this question is C


Instruction:
Otosclerosis mostly affects:
A. Malleus
B. Stapes
C. Incus
D. Tympanic membrane

Response:
Otosclerosis is caused by immobility of the stapes. Its most distinctive feature is conductive hearing loss, but sensorineural hearing loss and veigo are also common; tinnitus is infrequent. Otosclerosis is suggested by a positive family history, a tendency toward onset at an earlier age, the presence of conductive hearing loss, or bilateral symmetric auditory impairment Treatment with a combination of sodium fluoride, calcium gluconate, and vitamin D may be effective. If not, surgical stapedectomy should be considered.

So the answer to this question is B


Instruction:
Glutamine in blood acts as-
A. NH3 transpoer
B. Toxic element
C. Store energy
D. Abnormal metabolite

Response:
Glutamine is the major form of transpo of ammonia

So the answer to this question is A


Instruction:
Lactose content of breast milk per 100 ml is –
A. 3.5 gm
B. 4.5 gm
C. 6 gm
D. 7 gm

Response:
None

So the answer to this question is D


Instruction:
A 58 years old woman, who had backache and recurrent chest infections for 6 months, develops sudden weakness of the legs and urinary retention. His investigations show a hemoglobin of 7.3 gm/dl, serum calcium 12.6 mg/dl, phosphate-2.5 mg/dl, alkaline phosphatase-100 u/1, serum albumin-3 gm/dl, globulin-7.1 gm/dl and urea-178 mg/d. What is the most likely diagnosis?
A. Lung cancer
B. Disseminated tuberculosis
C. Multiple myeloma
D. Osteoporosis

Response:
The above mentioned features are consistent with the diagnosis of mutiple myeloma. So multiple myeloma is the single best answer of choice. Ref: Harrison's Principles of Internal Medicine, 16th Edition Pages 657-60; Ferri's Clinical Advicer, 2009, Page 589.

So the answer to this question is C


Instruction:
A 30 year old male presents with severe pain chest, breathlessness, hypotension and ECG shows ST elevation in V3, V4 V5 and V6 leads. He will be best treated with
A. Streptokinase
B. t-PA
C. Heparin
D. PTCA

Response:
Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.

So the answer to this question is D


Instruction:
An Anganwadi worker is paid a monthly amount of:
A. 1000 rupees
B. 1500 rupees
C. 2000 rupees
D. None of the above

Response:
An Anganwadi worker is selected from the community she is expected to serve. She is a pa time worker and is paid an honorarium of 1500 rupees per month for the services rendered by her. Ref: Park 21st edition page: 839.

So the answer to this question is B


Instruction:
Tinel's test is:
A. Loss of sensation.
B. Loss of 2 point discrimination.
C. Percussion produces tingling sensation.
D. Not associated with carpel tunnel syndrome.

Response:
None

So the answer to this question is C


Instruction:
Quantity of Hb catabolised every day in a normal adult:
A. 8 gm
B. 10 gm
C. 12 gm
D. 13.3 gm

Response:
8 gm

So the answer to this question is A


Instruction:
All can lead to development of ove anemia in patients with long standing compensated hemolytic anemia, EXCEPT:
A. Pregnancy
B. Renal failure
C. Folate deficiency
D. Hypothyroidism

Response:
A patient with a hemolytic condition may present without anemia (Compensated hemolytic anemia) It becomes decompensated in Pregnancy Folate deficiency Renal failure (Interfering with adequate EPO production) Also in Acute infections- which depresses erythropoiesis. The most dramatic example is parvovirus B19 infection, which may lead to aplastic crisis. Ref: Harrison, E-18, P-873.

So the answer to this question is D


Instruction:
Medullary thyroid carcinoma occurs due to the mutation of: (Repeat)
A. RET oncogene
B. P53 gene
C. RAS H-RAS, K-RAS, N-RAS
D. BRCA-I

Response:
Ans: A (RET oncogene) Ref: Robbins Pathologic Basis of Disease, 8th editionExplanation: (See table 10) Table 10 : Selected Oncogenes. Their Mode of Activationand Associated Human TumorsCategoryProto-oncoqeneAssociated Human TumorGROWTH FACTORSPDGF-b chainSIS (official name PBGFB.AstrocytomaOsteosarcomaFibroblast growthHST1Stomach cancerfactorsINT2 (official name FGF3)Bladder cancer Breast cancer MelanomaTGF-aTGFAAstrocytomas Hepatocellular carcinomasHGFHGFThyroid cancerGROWTH FACTOR RECEPTORSEGF-receptor familyERBB1 (EGFR). ERRB2Squamous cell carcinoma of lung, gliomasFMS-like tyrosine kmase 3FLT3Breast and ovarian cancersReceptor for neurotrophic factorsRETLeukemia Multiple endocrine neep asia 2A and B, fam lial medullary' thyroid carcinomasPDGF receptorPDGFRBGliomas. leukemiasReceptor for stem cell (steel) factorKITGastrointestinal stromal tumors, seminomas, leukemiasPROTEINS INVOLVED IN SIGNAL TRANSDUCTIONGTP-bmdsngKRASColon, lung, and pancreatic tumors HRASBladder and kidney tumors NRASMelanomas, hematoloqic malignanciesNonrec eptor tyrosineABLChrome myeloid leukemiakinase Acute lymphoblastic leu Kern iaRAS signal transductionBRAFMelanomasWNT signal transductionb-cateninHepatoblastomas, hepatocellular carcinomaNUCLEAR-REGULATORY PROTEINSTranscriptionalC-MYCBurkitt lymphomaactivatorsN-MYCNeuroblastoma, small-cell carcinoma of lung L-MYCSmall-cell carcinoma of lungCELL CYCLE REGULATORSCyclinsCyclin DMantle cell lymphoma Breast and esophageal cancers Cyclin EBreast cancerCyclin-dependent kinaseCDK4Glioblastoma, melanoma, sarcoma

So the answer to this question is A


Instruction:
Ifa Panchayat is dissolved, elections are to be held within?
A. 1 month
B. 3 months
C. 6 months
D. 1 year

Response:
Ans. is 'c' i.e., 6 months

So the answer to this question is C


Instruction:
A patient with microcytic hypochromic anemia, Hb-9%, serum iron is 20 ?/dl, ferritin level 800 mg/ ml, transferrin percentage saturation is 64. What is possible diagnosis -
A. Atransferrinemia
B. Iron deficiency anemia
C. DMT 1 mutation
D. Hemochromatosis

Response:
None

So the answer to this question is A


Instruction:
Rofecoxib was withdrawn due to:
A. lschemic hea disease
B. Renal complication
C. Liver adenoma
D. Gastric ulcer

Response:
celecoxib,etoricoxib,parecoxib are available in India.Rofecoxib and valdecoxib were withdrawn within a few years of marketing for increasing cardiovascular risk by increasing the levels of TXA2 which increases platelet aggregation ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 205

So the answer to this question is A


Instruction:
Brucellosis can be transmitted by all of the following modes, except -
A. Contact with infected placenta
B. Ingestion of raw vegatable from infected farms
C. Person to person transmission
D. Inhalation of infected dust or aerosol

Response:
<p> Person to person transmission not occur. Mode of transmission of brucellosis are contact infection,food borne infection,air borne infection. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:290-291. <\p>

So the answer to this question is C


Instruction:
Not true regarding Argyll robeson pupil
A. Accomodation reflex present
B. Pupillary reflex present
C. Pupillary reflex absent
D. Seen in Tabes dorsalis

Response:
Pupillary reflex is absent in Argyll robeson pupil Argyll Robeson pupil Accomodation Reflex present Pupillary Reflex absent Seen in Tabes dorsalis, DM

So the answer to this question is B


Instruction:
Diabetic gangrene is due to -
A. Ischemia
B. Increased blood glucose
C. Altered defense by host and neuropathy
D. All of the above

Response:
Ans. is 'd' i.e., All of the above

So the answer to this question is D


Instruction:
CBNAAT stands for
A. Caridge based nucleic acid amplification test
B. Computer based nucleic acid amplification test
C. Chromatograohy based new amino acid test
D. Care based new Amino Acid test

Response:
Caridge-based nucleic acid amplification test (CBNAAT) is a recently introduced polymerase chain reaction (PCR) based method for detection of TB. It also detects rifampicin resistance as it targets the rpoB gene of mycobacteria. CBNAAT is a Mycobacterium tuberculosis-specific automated, caridge-based nucleic acid amplification assay, having fully integrated and automated amplification and detection using real-time PCR, providing results within 100 minutes. It is a highly specific test as it uses 3 specific primers and 5 unique molecular probes to target the rpoB gene of M. tuberculosis, which is the critical gene associated with rifampicin resistance.

So the answer to this question is A


Instruction:
Which one of the following is a cyanotic congenital hea disease ?
A. Patent ductus aeriosus
B. Atrial septal defect
C. Ventricular septal defect
D. Tetralogy of Fallot

Response:
TOF is a cyanotic hea disease. Ref : Ghai essential of pediatrics, eighth edition, p.no:420

So the answer to this question is D


Instruction:
Hypokalemia with hypertension is associated with following except
A. Liddle's syndrome
B. Conn's syndrome
C. Bartter's syndrome
D. Cushing's syndrome

Response:
Ans. c (Bartter's syndrome) (Ref H-18th/ table 284-2; 17th/1801; LB 25th / 811)The combination of hypokalemia and alkalosis in a normotensive, nonedematous patient can be due to Bartter's or Gitelman's syndrome, magnesium deficiency, vomiting, exogenous alkali, or diuretic ingestion. Bartter's syndrome is featured by Salt wasting and hypokalemia; while Gitelman's syndrome is characterized by Salt wasting, hypokalemia and hypomagnesemia.Presence of chronic hypertension and chronic hypokalemia in an alkalotic patient suggests either mineralocorticoid excess or that the hypertensive patient is receiving diuretics. Low plasma renin activity and normal urine and in a patient who is not taking diuretics indicate a primary mineralocorticoid excess syndrome. It should be noted that Bartter's syndrome is associated with normotension unlike other endocrine causes of hypokalemia (which are associated with hypertension): # Conn' syndrome, # Cushing's syndrome and # Liddle's syndrome.

So the answer to this question is C


Instruction:
The Final Evaluation of the root surface smoothness after root planning is done by?
A. Probe
B. Explorer
C. Scaler
D. Curettes

Response:
None

So the answer to this question is B


Instruction:
35 years old man presenting with acute pancreatitis.  Ideal fluid of choice
A. Isotonic crystalloid
B. Hypertonic crystalloids
C. Hypotonic crystalloid
D. Vasopressin

Response:
Ref. API Textbook of Medicine. Pg. 813

Most imp consideration in the management of acute pancreatitis is conservative approach

Fluids >Pain >Nutrition >Inflammation
Ideal fluid of choice is Isotonic crystalloids
1st line management : NPO , IV Fluids ,IV antibiotics, IV anti inflammatory  + Blood investigations (Amylase and lipase)

So the answer to this question is A


Instruction:
Which of following is the most common cause of hypergonadotrophichypogonadism in nuk>>-
A. Viral orchitis
B. Klinefelter's syndrome
C. Kallman's syndrome
D. Noonan syndrome

Response:
Ans is option 2.. Klinefelter&;s syndrome Hypogonadism occurs if the hypothalamic pituitary axis is interrupted at any level. Hypergonadotrophic Hypogonadism occurs due to low testosterone and increased LH and FSH Most common cause of Hypergonadotrophic Hypogonadism in males is Klinefelter&;s syndrome In females turner syndrome Ref Harrison 17 /e p 2316 2317

So the answer to this question is B


Instruction:
Which of the following drug increases the duration of orthodontic treatment?
A. Phenytoin
B. Aspirin
C. Paracetamol
D. Vitamin D

Response:
None

So the answer to this question is B


Instruction:
In a blast injury , which of the following organ is least vulnerable to the blast wave
A. G .I tract
B. Lungs
C. Liver
D. Ear drum

Response:
None

So the answer to this question is C


Instruction:
ECT is contraindicated in
A. Pregnancy
B. Seizure disorder
C. Mania
D. Raised Intracranial pressure

Response:
Raised intracranial pressure is the only absolute contraindication for ECT

So the answer to this question is D


Instruction:
The need for vitamin B12 and folic acid inthe formation of red blood cells is related primarily of their effects on:
A. Synthesis and release of erythropoietin from the kidney
B. Absorption of iron from the gut
C. DNA synthesis in bone marrow
D. Hemoglobin formation in the red blood cell

Response:
Within 6-9 hours of treatment with vitamin B12 formation of nuclear DNA component promotes normoblastic reaction of the bone marrow. Folic acid also promotes the formation of nucleic acids.

So the answer to this question is C


Instruction:
A 60-year-old otherwise healthy woman Presents to her physician with a 3-week history of severe headaches. A contrast CT scan reveals a small, circular, hypodense lesion with ring like contrast enhancement. Which of the following is the most likely diagnosis?
A. High-grade astrocytoma
B. Metastatic lesion
C. Parenchymal Haemorrhage
D. Brain abscess

Response:
Although these CT findings can be consistent with all the options given but in immunocompetent individual there is more incidence of it being a metastatic lesion. M/C cancers to metastasise to brain includes :- Lung CA, Breast CA, Melanomas, RCC, few GI tumours. These lesions become symptomatic due to mass effect from white matter edema. Rx- includes combination of Sx, radios, and whole brain radiation therapy. Immunocompromised patients are at increased risk for toxoplasmosis and central nervous system lymphomas.

So the answer to this question is B


Instruction:
Best gas used for creating pneumoperitonium at laparoscopy is
A. N2
B. O2
C. CO2
D. N2O

Response:
Ans. (c) CO2Ref: Shaws 15th ed. 1492Pnenumoperitoneum in created with CO2 or nitrous oxide. CO2 is preferred because nitrous oxide can cause explosion in the presence of volatile anaesthetic drug.

So the answer to this question is C


Instruction:
Calcification of soft tissue without any distrubances of calcium metabolism is called
A. Inotrophic calcification
B. Monotrophic calcification
C. Dystrophic calcification
D. Calcium induced calcification

Response:
Ref Robbins 9/e p65 Dystrophic Calcification Dystrophic calcification is encountered in areas of necrosis of any type. It is viually inevitable in the atheromas of advanced atherosclerosis, associated with intimal injury in the aoa and large aeries and characterized byaccumulation of lipids (Chapter 9). Although dystrophic calcification may be an incidental finding indicating insig- nificant past cell injury, it may also be a cause of organ dysfunction. For example, calcification can develop in aging or damaged hea valves, resulting in severely com- promised valve motion. Dystrophic calcification of the aoic valves is an impoant cause of aoic stenosis in elderly persons (Fig. 10-17, Chapter 10). The pathogenesis of dystrophic calcification involves initiation (or nucleation) and propagation, both of which may be either intracellular or extracellular; the ultimate end product is the formation of crystalline calcium phos- phate. Initiation in extracellular sites occurs in membrane- bound vesicles about 200 nm in diameter; in normal cailage and bone they are known as matrix vesicles, and in pathologic calcification they derive from degenerating cells. It is thought that calcium is initially concentrated in these vesicles by its affinity for membrane phospholipids, while phosphates accumulate as a result of the action of membrane-bound phosphatases. Initiation of intracellular calcification occurs in the mitochondria of dead or dyingcells that have lost their ability to regulate intracellular calcium. After initiation in either location, propagation of crystal formation occurs. This is dependent on the concen- tration of Ca2+ and PO4 - , the presence of mineral inhibitors, and the degree of collagenization, which enhances the rate of crystal growth.

So the answer to this question is C


Instruction:
Mechanism of action of levosimendon include
A. Na channel opener
B. Potassium channel opener
C. Beta blockers
D. Beta 1 agonist

Response:
Mechanism of action Levosimendan exes its positive inotropic effect by increasing calcium sensitivity of myocytes by binding to cardiac troponin C in a calcium-dependent manner. ... The combined inotropic and vasodilatoryactions result in an increased force of contraction, decreased preload and decreased afterload. Refer katzung 11e p221

So the answer to this question is B


Instruction:
Which of the following is not a sequelae of trachoma?
A. Proptosis
B. Tylosis
C. Pseudocyst
D. Dacrocystitis

Response:
Proptosis REF: Khurana 4th ed p. 66 Sequelae of trachoma: Lids : entropion, tylosis, ptosis, madarosis , ankyloblepharon Conjuctiva: concretions, pseudocyst, xerosis, symblepharon. Cornea: opacity, ectasia, xerosis. Others: Dacrocystitis, chronic dacryoadenitis.

So the answer to this question is A


Instruction:
Not a cause for Mikulicz's syndrome:-
A. Leukemia
B. Lymphosarcoma
C. Sarcoidosis
D. Diphtheria

Response:
Diphtheria is not a recognised cause for Mikulicz's syndrome Mikulicz's syndrome Bilateral symmetrical enlargement of lacrimal and salivary glands Causes Leukemia Lymphosarcoma Benign Lymphoid hyperplasia Hodgkin's disease Sarcoidosis Tuberculosis

So the answer to this question is D


Instruction:
Only pure hinge movements of the mandible occur at:
A. Centric occlusion
B. Centric relation
C. Lateral excursion
D. Terminal Hinge Position

Response:
None

So the answer to this question is D


Instruction:
Regarding transpo of substances through the cell membrane, all are true except
A. Glucose is transpoed Via facilitated diffusion
B. Active transpo is an energy driven proces
C. Facilitated diffusion requires energy
D. Facilitated diffusion requires carrier protein

Response:
Diffusion primarily depends on the concentration of molecules. Passage of ions or molecule from a region of higher concentration to lower concentration without the expenditure of energy is called diffusion. (REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 4)

So the answer to this question is C


Instruction:
Which of the following is not a cause of communicating hydrocephalus?
A. Choroid plexus papilloma
B. Vein of Galen malformation
C. Achondroplasia
D. Meningeal metastasis

Response:
- Vein of Galen causes Obstructive or Non-communicating hydrocephalus. Causes: COMMUNICATING HYDROCEPHALUS NON-COMMUNICATING HYDROCEPHALUS C - Choroid plexus papilloma A - Achondroplasia M - Meningeal malignancy or metastasis P - Post hemorrhagic M - Mass lesion (ICSOL) A - Abscess A - Aqueductal stenosis A - Arnold Chiari malformation D - Dandy walker malformations H - Hematoma I - Infections (Toxoplasma, mumps, Neurocysticercosis) V - Vein of Galen malformations

So the answer to this question is B


Instruction:
Liquefactive action on necrotic tissue results in-
A. Gangrene
B. Embolism
C. Infarct
D. Caseation

Response:
infraction is the process of tissue necrosis usually coagulative type resulting from ischemia. In cerebral infract there is characteristic liquifactive necrosis. * Liquefactive necrosis is seen in focal bacterial or, occasionally, fungal infections, because microbes stimulate the accumulation of inflammatory cells and the enzymes of leukocytes digest ("liquefy") the tissue. For obscure reasons, hypoxic death of cells within the central nervous system often evokes liquefactive necrosis (Fig. 1-10). Whatever the pathogenesis, the dead cells are completely digested, transforming the tissue into a liquid viscous mass. Eventually, the digested tissue is removed by phagocytes. If the process was initiated by acute inflammation, as in a bacterial infection, the material is frequently creamy yellow and is called pus .ref Robbins 9/e p 10

So the answer to this question is C


Instruction:
True regarding Oncogenes are all except ?
A. Derived from protooncogenes
B. Oncogenes code for specific protein
C. Causes in vitro cell variation in animals
D. Multiple growth factors govern the gene

Response:
Protooncogenes o These are physiological regulator of cell proliferation ando They act under proper physiological stimuli.o Without physiological stimuli they will be silent and there will be no replication.Oncogenes When, due to any cause (mutation or overexpression), protooncogenes become autonomous, i.e. they promote cell growth without any physiological stimulus.So, oncogenes is derived from protoncogens.o Infact oncogene and protooncogene is the same, in normal cell it acts as protooncogen while in cancer cell it acts as oncogene.Oncoproteins o Oncogenes encode proteins called Oncoproteins which resemble the normal products of protoncogenes with the exception that ?(a) Oncoproteins are devoid of impoant regulatory elements.(b) Their production in the transformed cells does not depend on growth factors or other external signals.Proto-oncogenes (Normal genes required for cell proliferation and differentiation) Oncogenes (Genes promoting autonomous cell growth in cancer cells) Oncoproteins (Proteins lacking regulatory control and responsible for promoting cell growth)

So the answer to this question is D


Instruction:
To provide anesthesia to a patient in the third stage of labor, an obstetrician palpates the ischial spine transvaginally, then injects a local anesthetic. Injection of anesthetic at this approximate location will most likely block which of the following nerves?
A. Inferior gluteal nerve
B. Lateral femoral cutaneous nerve
C. Obturator nerve
D. Pudendal nerve

Response:
The pudendal nerve is often anesthetized to provide obstetric anesthesia (although epidural blocks are now more commonly used in preparation for delivery). The pudendal nerve arises from sacral segments 2, 3, and 4. It exits the pelvis by way of the greater sciatic foramen and then courses around the ischial spine (and sacrospinous ligament) to pass through the lesser sciatic foramen. It then runs through Alcock's canal to supply the muscles and skin of the perineal area. The inferior gluteal nerve leaves the pelvis by passing through the greater sciatic foramen to supply the gluteus maximus muscle. The lateral femoral cutaneous nerve courses by the anterior superior iliac spine and supplies the anterolateral skin of the thigh. The obturator nerve passes through the obturator foramen to supply muscles and skin in the medial thigh.

So the answer to this question is D


Instruction:
Protapers of same tip diameter are
A. Sx-S1
B. S1-S2
C. S2-F1
D. Sx-S2

Response:
PROTAPER INSTRUMERNTS

A unique feature of Pro Taper instructions is each one has changing percentage tapers over the length of the cutting blades.
Pro taper instruments have convex, triangular cross – sections, a changing helical angle and push over their cutting blades and a non-cutting, modified guiding tip.
The Pro Taper system is comprised of three Shaping and three Finishing instruments.

So the answer to this question is C


Instruction:
Which of the following are the markers of paediatric non accidental injury
A. Abuse in sibling
B. Perineal injury
C. Repeated hospital visits for minor injuries
D. All the above

Response:
Ans. is 'd' i.e., All the above Markers for non-accidental injury* Repeated hospital visits for minor injuries* Late presentations and multiple visits to different hospitals* Vague or inconsistent history from the child's parent or guardian and the child* Withdrawn behaviour of the child with resistance to examination* History of abuse in a sibling* Bite marks, finger marks, belt marks or cigarette burns* Multiple fractures of different ages* Perineal injury* Intracranial haemorrhage without a history of MVA

So the answer to this question is D


Instruction:
Highly aggressive and lethal thyroid cancer:
A. Papillary
B. Follicular
C. Medullary
D. Anaplastic

Response:
Ans. (d) Anaplastic CancerRef: Bailey and Love 27th Edition, Page 820* Lethal almost always in 6 months.* It can arise de novo or dedifferentiation of a papillary or poorly differentiated carcinoma** RT and CT does not increase survival

So the answer to this question is D


Instruction:
The most impoant constituent in soda lime for reabsorption of CO2 in a closed circuit
A. Sodium hydroxide
B. Barium hydroxide
C. Calcium hydroxide
D. Potassium hydroxide

Response:
Sodalime is most common Co2 absorbant . Indicators added to sodalime changes the color of sodalime . It contains 94% Ca(OH)2 , 5%NaOH,1% KOH.

So the answer to this question is C


Instruction:
A thiy-year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/d1 (conjugated 5.0 mg/dl) with SGOT/ SGPT (AST/ALT) of 1230/900 IU/mi. The serological tests showed presence of HBs Ag. IgM anti-HBc and Hbe Ag. The most likely diagnosis is:
A. Chronic hepatitis B infection with high infectivity.
B. Acute hepatitis B infection with high infectivity
C. Chronic hepatitis infection with low infectivity.
D. Acute hepatitis B infection with low infectivity

Response:
Answer is B (Acute hepatitis B infection with high infectivity): Presence of Anti HB IgM and Hbs Ag indicates acute infection. Presence of Hbe Ag indicates high infectivity

So the answer to this question is B


Instruction:
Contrast material used in the diagnosis of esophageal atresia is:
A. Barium swallow
B. Gastrograffin
C. Conray
D. Dianosil

Response:
Ans. Dianosil

So the answer to this question is D


Instruction:
In cholangiography CBD stone appears as ?
A. Meniscus sign
B. Cut off sign
C. Slight flow of dye from the sides of stone
D. Chain of lake appearance.

Response:
Ans is a ie Meniscus sign

So the answer to this question is A


Instruction:
The function of grit chamber in modern sewage plants is
A. Formation of sludge
B. Removal of floating large objects
C. Settlement of heavy objects
D. Formation of Zoogleal layer

Response:
None

So the answer to this question is C


Instruction:
Pseudopolyps are features of -
A. Crohn's disease
B. Ulcerative colitis
C. Celiac sprue
D. Whipple's disease

Response:
Ulcerative colitis

Ulcerative colitis is an inflammatory bowel disease characterized by -

Inflammation involving only the mucosa and submucosa.
Formation of pseudopolyps
Involvement is in a continuous fashion (absent of skip lesions which are characteristic of CD).

Ulcerative colitis involves the rectum and extends proximally in a retrograde fashion to involve the entire colon (pancolitis) in more severe cases.
UC is associated with HLA-DR2, polymorphism in IL-10 gene and an abnormal T-cell response particularly of CD4 T-cells (T H2 cells).

So the answer to this question is B


Instruction:
Pseudohypoparathyroidism is characterized by:
A. Normal serum Ca++ and decreased serum PTH
B. Decreased serum Ca++ and decreased serum PTH
C. Decreased serum Ca++ and Increased serum PTH
D. Normal serum Ca++ and Increased serum PTH

Response:
c. Decreased serum Ca++ and Increased serum PTH(Ref: Nelson's 20/e p 2695-2697, Ghai 8/e p 521-524)Pseudohypoparathyroidism (PHP)Parathyroid glands are normal or hyperplastic and they can synthesize and secrete parathyroid hormone (PTH)Serum levels of immunoreactive PTH are elevated even when the patient is hypocalcemic normocalcemicNeither endogenous nor administered PTH raises the serum levels of calcium or lowers the levels of phosphorus.

So the answer to this question is C


Instruction:
Pyromania refers to an irresistible urge to -
A. Set things on fire
B. Eat out of proportion
C. Sleep for long periods
D. None

Response:
Ans. is 'a' i.e., Set things on fire

So the answer to this question is A


Instruction:
Non-specific esterase is present in -
A. Megakaryocytic leukaemia
B. Lymphocytic leukaemia
C. Erythroleukemia
D. AML

Response:
None

So the answer to this question is D


Instruction:
The best sampling procedure that can be followed is
A. Simple random
B. Stratified random
C. convenient
D. Systematic

Response:
None

So the answer to this question is B


Instruction:
In carcinoma of lower lip secondaries are seen in
A. Upper cervical LN
B. Axillary LN
C. Supraclavicular LN
D. Mediastinal LN

Response:
Carcinoma Lip: Mostly, it is squamous cell carcinoma, often seen in males in the age group of 40-70 years. Lower lip is more often involved. Site of predilection is between the midline and commissure of the lip. Lesion is of exophytic or ulcerative type. Lymph node metastases develop late. Submental and submandibular nodes are the first to be involved; other deep cervical nodes may also get involved later. Treatment: It is surgical excision with adequate safety margin of healthy tissue and plastic repair of the defect. Lymph node metastases require block dissection. Radiotherapy also gives good results in early cases. Ref:- Dhingra; pg num:-226

So the answer to this question is A


Instruction:
Which type of shift in intracranial content is common in children with progressive hydrocephalus-
A. Transforam inal herniation
B. Upward cerebellar herniation
C. Unilateral transtentorial herniation
D. Central transtentorial herniation

Response:
Ans. is 'd' i.e., Central transtentorial herniation o Central transtentorial (uncinate, mesial temporal) herniation occurs when the medial aspect of the temporal lobe is compressed against the free margin of tentorium cerebelli. o It can results in increased ICT and hydrocephalus.

So the answer to this question is D


Instruction:
Hamburger phenomenon deals with the following:
A. Chloride shift
B. Oxygen uptake
C. Cellular ATP levels
D. Plasma potassium level

Response:
Chloride shift (Hamburger phenomenon) the HCO3- diffuses out of the RBCs into the plasma, the inside of the cells become less negatively charged. Because the RBC membrane is relatively impermeable to cation, so in order to neutralize this effect, negatively charged chloride ions diffuse from the plasma into the RBCs to replace the HCO3-. The movement of chloride ions into the RBCs is called chloride shift or Hamburger phenomenon. Ref: Essentials of Medical Physiology By Khurana, 2008, Page 256.

So the answer to this question is A


Instruction:
Coagulation defect associated with increased coagulation are seen in
A. Increased protein C
B. Increased protein S
C. Increased anti thrombin 3
D. Protein C resistance

Response:
Ref Harrison 16/e p1491 ,9/e p123 Protein C and protein S are two vitamin K-dependent proteins that act in a complex to proteolytically inacti- vate cofactors Va and VIIIa. Protein C activation by thrombomodulin was described earlier; protein S is a cofactor for protein C activity Resistance to activated protein C due to the factor V R506Q (Leiden) mutation is the most common clotting abnormality in patients with venous thromboembolism

So the answer to this question is D


Instruction:
Auditory impulse relays to
A. Inferior geniculate ganglion
B. Medial geniculate body
C. Medial lemniscus
D. Superior colliculus

Response:
(B) Medial geniculate body > The afferent fibers in the auditory division of the eighth cranial nerve end in dorsal and ventral cochlear nuclei.> From there, auditory impulses pass by various routes to the inferior colliculi, the centers for auditory reflexes, and via the medial geniculate body in the thalamus to the auditory cortex.> Other impulses enter the reticular formation. Information from both ears converges on each superior olive, and beyond this, nrnst of the neurons respond to inputs from both sides.> The primary auditory cortex is Brodmann's area 41. In humans, low tones are represented anterolaterally and high tones postero-medially in the auditory cortex.

So the answer to this question is B


Instruction:
All of the following type of renal stones are seen in females, EXCEPT:
A. Stones associated with Idiopathic hypercalciuria
B. Renal stones in Distal renal tubular acidosis
C. Renal stones in Primary hyperoxaluria
D. Renal stones in Lesch-Nyhan syndrome

Response:
The HP gene is located on the X chromosome. Affected males are hemizygous for the mutant gene; carrier females are asymptomatic. A complete deficiency of HP, the Lesch-Nyhan syndrome, is characterized by hyperuricemia, self-mutilative behavior, choreoathetosis, spasticity, and mental retardation. A paial deficiency of HP, the Kelley-Seegmiller syndrome, is associated with hyperuricemia but no central nervous system manifestations. In both disorders, the hyperuricemia results from urate overproduction and can cause uric acid crystalluria, nephrolithiasis, obstructive uropathy, and gouty ahritis. Early diagnosis and appropriate therapy with allopurinol is needed. Ref: Harrisons Principles of Medicine, 18th Edition, Page 3185 See the Table 287-1 in 18th edition Harrison, Page 2383

So the answer to this question is D


Instruction:
Which of the following is vitamin B-complex disease
A. Scurvy
B. Pellegra
C. Night blindness
D. Rickets

Response:
(Pellegra): (535 - Harper 29th edition & Tryptophan)* Pellegra - caused by Niacin deficiency* Com is low in both niacin and tryptophan, com based diets can cause pellegra(i) Symptoms 3Ds - dermatitis, diarrhea, dementia(ii) Pellegra is frequently observed in Hartnup's disease(iii) Megadoses of niacin are useful in the treatment of hyperlipidemia* Retinoic acid has a role in the regulation of gene expression and tissue differentiation* Vitamin A deficiency is a major public health problem world wide* Vitamin E is the major lipid soluble antioxidant in cell membranes and plasma lipoproteins* Vitamin K is the coenzyme for carboylation of glutamate in post synthetic modification of calcium-binding proteins* Thiamine nutritional status can be assessed by erythrocyte transketolase activation* *** Viatamin B6 status is assessed by Assaying erythrocyte transaminases* Methyl malonyl CoA mutase, Leucine aminomutase and methionine synthase are three vitamin B12 dependant enzymes* Vitamin B12 deficiency causes functional folate deficiency - the "Folate Trap"* Folic acid supplements reduce the risk of Neural tube defects and hyperhomeocysteinemia & may reduce the incidence of cardiovascular disease & some cancers* Beta carotene, Vitamin E, Ascorbic acid and Lipoic acids serve as antioxidants and reduce the risk of heart attacks and cancers* Vitamin B6 is required for glycogen degradation by glycogen phosphorylase. A deficiency would result in fasting hypoglycemia, Additionally a deficiency of biotin (required by pyruvate carboxylase of gluconeogenesis) would also result in fasting hypoglycemia. (394- Lippincotts 6th)

So the answer to this question is B


Instruction:
All are parts of anterior segment of eye except-
A. Lens
B. Cornea
C. Vitreous
D. None

Response:
Ans. is 'c' i.e., Vitreouso The eyeball is divided into two segments : -Anterior segmentPart of eyeball anterior to posterior border of lens is called anterior segment.It consists of lens, and structures anterior to it, i.e., cornea, iris and two aqueous humor-filled spaces, i.e., anterior and posterior chambers.Anterior chambers : - It is bounded anteriorly by back of cornea and posteriorly by the iris & part of ciliary body. It contains aqueous humor.Posterior chamber: - This triangular chamber is bounded anteriorly by the posterior surface of the iris & ciliary body and posteriorly by the lens and it zonules. It also contains aqueous humor.Thus, both anterior and posterior chambers are part of anterior segment and both contain aqueous humor.Posterior segmentPart of eye ball posterior to lens is called posterior segment.It consists of vitreous humor, retina, choroid and optic disc.

So the answer to this question is C


Instruction:
Professional secrecy is A:
A. Legal responsibility
B. Ethical responsibility
C. Social responsibility
D. Implied term of contract between doctor and patient

Response:
(As per definition, Professional secrecy is an implied term of contract between a doctor and his patient. It is a DUTY of the doctor i.e. the doctor should keep secret whatever he has acquired as part of his professional work from the patient.  If the doctor discloses anything then the patient can sue him for damages/fine in a court of law. The doctor should not disclose anything about the patient without the written consent of the patient; if he is a minor or an insane the parents/guardians should be informed of the patient’s illness. However in case of Notifiable diseases, the public health authorities should be informed about the patient’s illness. Doctor can be charged with Defamation for disclosing secrets of his patients.)

So the answer to this question is D


Instruction:
NOT a content of superior mediastinum
A. Pulmonary trunk
B. Thymus
C. Left superior intercostal aery
D. Arch of aoa

Response:
Mediastinum refers to the space between two lungs in thorax. SUPERIOR MEDIASTINUM Space above 2nd costal cailage CONTENTS: thymus, arch of aoa, superior venacava, pulmonary aeries, esophagus, trachea, T1 - T4 veebra, PICA - 1, 2. INFERIOR MEDIASTINUM Space below superior mediastinum, again divided into anterior, middle and posterior mediastinum. CONTENTS: pulmonary trunk, bronchus, thymus, hea, ascending aoa, PICA 3 - 12 esophagus, descending aoa, T5 - T12 veebra. Angle between manubrium of sternum & body of sternum is called angle of louis, which is 1630.

So the answer to this question is A


Instruction:
MOST common side effect of mycophenolate mophetil is:
A. Marrow suppression
B. Nephrotoxicity
C. Diarrhea
D. Glucose intolerance

Response:
Gastrointestinal side effects (diarrhea/cramps) are common with mycophenolate mophetil. Immunosupressive drugs and their common side effects. Glucocoicoids: Hypeension, glucose intolerance, dyslipidemia, osteoporosis Cyclosporine: Nephrotoxicity, hypeension, dyslipidemia, glucose intolerance, hirsutism/hyperplasia of gums Tacrolimus: Similar to Cyclosporine, but hirsutism/hyperplasia of gums unusual, and diabetes more likely. Azathioprine: Marrow suppression Mycophenolate mofetil (MMF): Diarrhea/cramps; dose-related liver and marrow suppression is uncommon Sirolimus: Hyperlipidemia, thrombocytopenia Ref: Harrisons principles of internal medicine, 18th edition, Page: 1369.

So the answer to this question is C


Instruction:
Gout can be precipitated by -
A. Calcium channel
B. Omeprazole
C. Thiazide diuretics
D. Digitalis

Response:
None

So the answer to this question is C


Instruction:
Impotence may be pleaded as a ground for defense in males in all the following conditions Except
A. Divorce
B. Rape
C. Adultery
D. Unnatural sexual offence

Response:
Impotence is not a ground for defense in a case of Rape. That is to say, that rape can be committed even if a person is impotent. Ref: Krishan Vij textbook of forensic medicine, 5th edition pg : 393

So the answer to this question is B


Instruction:
Dosage of Albendazole given as per National deworming program in <2years old child.
A. 200mg
B. 400mg
C. 500mg
D. 2 tablets of 400 mg

Response:
None

So the answer to this question is A


Instruction:
What percentage of weight loss in infants constitutes severe dehydration?
A. >10% loss of body weight
B. > 6%' loss of body weight
C. 5%' loss of body weight
D. 7% loss of body weight

Response:
Ans: A (> 10% loss of body weight) Ref: Nelson s Textbook of Pediatrics. 19th Edition, Chapter on 'Deficit Therapy'. Page 245Explanation:In an older child with diarrhea, 6% loss of body weight amounts to Severe dehydration whereas 10% loss of body weight is required to cause the same in infants (Ref: Nelson).CLINICAL EVALUATION OF DEHYDRATIONMild dehydration (<5% in an infant: <3% in an older child or adult):Normal or increased pulseDecreased urine outputThirstyNormal physical findingsModerate dehydration (5-10% in an infant: 3- 6% in an older child or adult):TachycardiaLittle or no urine output: Irritable/lethargieSunken eyes and fontanelDecreased tearsDry mucous membranesMild delay in elasticity (skin turgor)Delayed capillary refill (>1.5 sec)Cool and paleSevere dehydration (>10% in an infant; >6% in an older child or adult):Peripheral pulses either rapid and weak or absentDecreased blood pressureNo urine outputVery sunken eyes and fontanelNo tearsParched mucous membranesDelayed elasticity (poor skin turgor)Very delayed capillary refill (>3 see)Cold and mottledLimp, depressed consciousness

So the answer to this question is A


Instruction:
Drug causing maximum peripheral neuropathy is:
A. Zidovudine
B. Lamivudine
C. Stavudine
D. Didanosine

Response:
Stavudine :(d4T) It is a thymidine analogue which acts in the same way as AZT. By utilizing the same thymidine kinase for activation, AZT antagonises the effect of stavudine. Resistance to stavudine develops as for other Nis. It is well absorbed orally and rapidly metabolized(half life 1 .5 hr). The anti-HIV efficacy of stavudme IS comparable to AZT, and it is used in c_ombination regimens. Peripheral neuropathy, lipodystrophy and rarely pancreatitis are the serious toxicies which have restricted its use. zidovudine(AZT): triphosphate selectively inhibits viral reverse transcriptase (RNA-dependent DNA polymerase) in preference to cellular DNA polymerase. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:771,772

So the answer to this question is C


Instruction:
Which among the following is contraindicated in myasthenia patient?
A. Aminoglycosides
B. Sulphonamides
C. Penicillin
D. All

Response:
Ref:KD Tripathi pharmacology 7th edition (page.no: 745) All aminoglycosides reduce ACh release from the motor nerve endings. They interfere with the mobilization of centrally located synaptic vesicles to fuse with the terminal membrane (probably by antagonizing Ca2+) as well as decrease the sensitivity of the muscle endplates to ACh. Myasthenic weakness is accentuated Aminoglycosides. Neuromuscular blockers should be used cautiously in patients receiving aminoglycosides.

So the answer to this question is A


Instruction:
1,25-dihydroxycholecalciferol is secreted by:
A. Adrenal coex
B. Liver
C. Proximal tubules of kidney
D. Collecting ducts of kidney

Response:
It is the most active form of vitamin D(1,25-dihydroxycholecalciferol) / (calcitriol) When UV rays fall on the skin, 7-dehydrocholesterol in the skin is conveed into cholecalciferol. It goes to the liver, a hydroxyl group is attached to it, 25-(OH) cholecalciferol is formed. It then travels to kidneys. In the cells of the PCT, one more hydroxyl group is attached, to form the active metabolite 1,25-dihydroxycholecalciferol. Vit. D is considered a steroid hormone. It acts on the intestines, kidneys, and bone. Its chief function is to increase Ca2+ and PO42- in the ECF.

So the answer to this question is C


Instruction:
Male with erythematous patch over penis after taking an over the counter medicine. Causal drug is:
A. Azithromycin
B. Ofloxacin
C. Doxycycline
D. Aceclofenac

Response:
Ans. D. AceclofenacRef: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7th/ed p498-99Explanation# Findings given in question are suggestive of 'fixed drug eruptions (FDE)'.# Among the given options ofloxacin, doxycycline and azithromycin are prescription only drugs hence most probably the answer is aceclofenac.# If in question 'over the counter' has not been mentioned then the answer will be doxycycline.# A FDE is an adverse cutaneous reaction to an ingested drug, characterized by the formation of a solitary (but at times multiple) erythematous patch or plaque.# If the patient is rechallenged with the offending drug, the FDE occurs repeatedly at the identical skin site (i.e., fixed) within hours of ingestion.# Usually asymptomatic. May be pruritic, painful, or burning.# Time to onset oflesion(s): Occur from 30 min to 8 h after ingestion of drug in previously sensitized individual.# Duration oflesion(s): Lesions persist if drug is continued. Resolve days to few weeks after drug is discontinued.* Tetracyclines (tetracycline, doxycycline, minocycline)* Sulfonamides, other sulfa drugs* Metronidazole, nystatin, salicylates, NSAIDs, phenylbutazone, phenacetin* Barbiturates* Oral contraceptives* Quinine (including quinine in tonic water), quinidine* Phenolphthalein* Food coloring (yellow): in food or medications

So the answer to this question is D


Instruction:
After an endoscopy a technician kept the instrument for sterilization. Which of the following agent is used for sterilization of fibre optic instruments?
A. Glutaraldehyde
B. Chlorine
C. Autoclave
D. Phenol

Response:
Glutaraldehyde, which has two reactive aldehyde groups, is 10 times more effective than formaldehyde and is less toxic. It denatures proteins and nucleic acids. Both proteins and nucleic acids contain essential -NH2 and -OH groups, which are the main sites of alkylation. In hospitals, it is used to sterilize respiratory therapy equipment, endoscopes, and hemodialysis equipment. Ref: Levinson W. (2012). Chapter 13. Sterilization & Disinfection. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

So the answer to this question is A


Instruction:
None Not seen in alpha helix ?
A. Alanine
B. Leucine
C. Proline
D. Isoleucine

Response:
Ans. is 'c' i.e., Proline Proline is never found in a-helix as it has imino group (-NH) not amino (-N112).Thus it cannot provide hydrogen for hydrogen bonding, the major stabilizing force of a-helix.Glycine also tends to disrupt a-helix; because of its high flexibility and small size it often induces bends in a-helix.

So the answer to this question is C


Instruction:
Insecticide of choice to prevent kala-azar-
A. DDT
B. HCH
C. Malathione
D. Paris green

Response:
Ans. is 'a' i.e., DDT * Resistance to DDT has not been demonstrated in sandflies* A single application of DDT or lindane has been found effective in reducing sandflies.* DDT residue may remain effective for a period of 1 to 2 years and lindane only for a period of 3 months.

So the answer to this question is A


Instruction:
All of the following are true about fibrolamellar carcinoma of the liver except :
A. More common in females
B. Better prognosis than HCC
C. AFP levels always greater than 1000
D. Occur in younger individuals

Response:
Answer is C (AFP levels always greater than 1000) : Fibrolamellar variant has no AFP elevation - Chandrasoma Taylor Equal sex incidence - Robbins More common in Jetnales -Chandrasoma Taylor Although Robbins and Chandrasoma Taylor are contradicting each other as far us distribution of the tumor in the two sexes is concerned, elevation of AFP appears ceainly not to be so significant as to rise to levels greater than 1000. The single best answer is undoubtedly option 'C'.

So the answer to this question is A


Instruction:
Under ICDS one Anganwadi is for:
A. 1000
B. 10000
C. 3000
D. 5000

Response:
Ans: a (1000) Ref: Park, 19th ed, p. 473The most important scheme in the field of child welfare is the ICDS scheme. It was initiated by the Govt.of India in The Ministry of Social and Women's Welfare in 1975.At present 5671 ICDS projects are sanctioned. One Anganwadi centre for 1000 persons in rural and urban areas, and one Anganwadi for 700 persons in tribal areas.Services delivered by ICDS are:1. Supplementary nutrition2. Immunization3. Health check up4. Medical referral services5. Nutrition and health education for women6. Non formal education of children up to the age of 6 years, and pregnant and nursing mothers in rural, urban and tribal areas.Services under ICDS are delivered through trained local woman called Anganwadi worker (AWW). Other functionaries are child development project officer (CDPO), who is in charge of 4 supervisors and lOOAWWs.

So the answer to this question is A


Instruction:
In the study of latent finger prints, Poroscopy involves _____ level detail in individualization on ridge formations.
A. First
B. Second
C. Third
D. Fouh

Response:
Poroscopy is arrangement of sweat pores in between the ridges. Fingerprint study is done in different levels. Level I : study of different pattern. i) Loop ii) Whorls iii) Arch iv) Composite Level II : study of ridge islands i) Lates ii) Delta iii) Core Level III : every ridge is examined. i) Ridge bifurcation ii) Union iii) Ending

So the answer to this question is C


Instruction:
Sperm capacitation takes place in -
A. Testes
B. Epididymis
C. Female genital tract
D. All of the above

Response:
Ans. is 'c' i.e., Female genital tract * After the ejaculation the sperm cells go through several essential physiological changes during their time in the female genital tract before they, at the end, are able to penetrate the oocyte membrane.* The first change in this cascade is capacitation. The sperm cells accomplish this during the ascension through the female genital tract (in contact with its secretions). It has to do with a physiological maturation process of the sperm cell membranes, which is seen as the precondition for the next step to follow, namely the acrosome reaction.* Capacitation is a functional maturation of the spermatozoon. The changes take place via the sperm cell membrane in which it may be that receptors are made available through the removal of a glycoprotein layer. The area of the acrosomal cap is also so altered thereby that the acrosome reaction becomes possible.* Through the membrane alterations, the motile properties of the spermatozoon also change. Discharging whipping movements of the tail together with larger sideways swinging movements of the head take place. This type of motility is designated as hyperactivity. One can therefore say that the visible consequences of capacitation consist in hyperactivity of the spermatozoon.

So the answer to this question is C


Instruction:
Treatment of choice for polyuria in lithium induced diabetes insipidus is:
A. Vasopressin
B. Mineralocoicoid antagonist
C. Amiloride
D. Loop diuretic

Response:
Answer is C (Amiloride): Amiloride is currently the treatment of choice for polyuria in lithium induced diabetes insipidus. Amiloride a potassium-sparing diuretic is the drug of choice to treat polyuria and raise maximum urinary osmolality in lithium-treated patients. Amiloride blocks the cellular uptake of lithium ENaC, thus antagonizing the inhibitory effects of Lithium on Vasopressin induced water transpo

So the answer to this question is C


Instruction:
Products of uronic acid pathway in human beings are all EXCEPT:
A. Vitamin C
B. Pentoses
C. NADH
D. Glucuronic acid

Response:
Humans cannot synthesize vitamin C due to deficiency of enzyme, L-Gulonolactone Oxidase Uronic acid pathway in humans

So the answer to this question is A


Instruction:
Which of the following stones is hard to break by ESWL
A. Calcium oxalate monohydrate
B. Calcium oxalate dihydrate
C. Uric acid
D. Struvite

Response:
In general CYTINE , calcium phosphate,specifically Brushite ( Calcium phosphate Hydroxyapatite) and Calcium oxalate monohydrate stones , Matrix stones ( Protien rich stone) are most resistant to ESWL . All these are RADIO OPAQUE. Treatment of choice:- Renoscopic removal. The remainder of common stone type by order of increasing fragility are struvite , calcium oxalate dihydrate and finally uric acid stones.These are RADIO LUCENT ref :- Campbell - Walsh urology 11th edition .chapter 53 , pg no :- 1242 Bailey and Love 27th edition . chapter 76 , pg no 1408.

So the answer to this question is A


Instruction:
Which of the following is used in the treatment of well differentiated thyroid cancer?
A. 32 P
B. 131 I
C. 99mTc
D. 131I-MIBG

Response:
I 131 is used in the treatment of well differentiated thyroid cancer and hypehyroidism. I 131 has a half life of 8 days and emits beta paicles as well as gamma rays. Radiation dose to thyroid is mainly due to the emitted beta paicles (90%) rather than gamma radiation. Ref: Oncology for Health-Care Professionals By V. Pervan, Page 262; Radiation in Medicine: A Need for Regulatory Reform By U.S. Nuclear Regulatory Commission, Page 74

So the answer to this question is B


Instruction:
Corneal deposits are seen in all except –
A. Reis–bucklers corneal dystrophy
B. Endothelial dystrophy of fuchs
C. Hunters disease
D. Hurler's disease

Response:
Endothelial dystrophies cause corneal deposits (not epithelial dystrophies like Reis - Buckler's dystrophy).
Hunter's syndrome and Hurler syndrome are mucopolysaccharidosis:-

"In all the mucopolysacharidosis (except MPS III - Sanfilipoo syndrome), corneal deposition may occur". — Pediatric Ophthalmology

So the answer to this question is A


Instruction:
A 12-year-old girl presents to the emergency department following a skiing crash in which the left side of her mid torso hit a tree. She presents with left side lower chest and upper abdominal pain. She also complains of left shoulder pain. The most likely diagnosis is which of the following?
A. Rib fractures
B. Liver injury
C. Ruptured diaphragm
D. Splenic injury

Response:
The spleen is the most common solid organ injured by blunt trauma. Though gastric rupture could cause the clinical presentation described, it is very rare. Rib fracture in the mid torso alone generally does not cause the referred shoulder pain, because blood does not collect under the left diaphragm, as seen in splenic injuries.

So the answer to this question is D


Instruction:
The most common dental procedure contributing to vertical root fracture is
A. Prosthodontic treatment
B. Endodontic treatment
C. Periodontal treatment
D. Orthodontic treatment

Response:
None

So the answer to this question is B


Instruction:
Richest source of vitamin C ?
A. Guava
B. Lime
C. Orange
D. Tomato

Response:
Ans. is 'a' i.e., Guava The richest source of vitamin C is Indian goosebery (Amla). Impoant sources of vitamin C in decreasing order : - Amla > Guava > Cabbage > Amaranath > Lime > Cauliflower > Orange > Spinach > Tomato > Potato

So the answer to this question is A


Instruction:
The Gold standard investigation for Gastro-Oesophageal reflux disease is:
A. Endoscopy
B. 24 hour esophageal pH recording
C. Oesophageal manometry
D. Measurement of length of lower oesophageal sphincter

Response:
24 hour Esophageal pH recording provides a quantitative & sensitive documentation of acidic reflux episodes.

So the answer to this question is B


Instruction:
Digoxin toxicity is aggravated by?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypocalcemia

Response:
Digoxin toxicity causes hyperkalemia, or high potassium. The sodium/potassium ATPase pump normally causes sodium to leave cells and potassium to enter cells. Blocking this mechanism results in higher serum potassium levels (REF.Essentials of medical pharmacology K D TRIPATHI 8th Edition)

So the answer to this question is B


Instruction:
Carbohydrate requirement in ideal balanced dict?
A. 10-20% of total energy intake
B. 20-30% of total energy intake
C. 40-50% of total energy intake
D. 50-70% of total energy intake

Response:
Ans. is 'd' i.e., 50-70% of total energy intake

So the answer to this question is D


Instruction:
BPF (Brazilian purpuric fever) is caused by:
A. H.influenzae biotype aegyptius
B. V. cholerae
C. Salmonella
D. None of the above

Response:
H. aegyptius:
→ Identical to non-capsulated H.influenza, now named as H.influenza biotype aegyptius.
→ Causes highly contagious form of conjunctivitis (PINK EYE) and Brazilian purpuric fever.
→ BPF (Brazilian purpuric fever): Conjunctivitis proceeding to fulminant septicemia in infants and children with high fatality.

So the answer to this question is A


Instruction:
Stevens-Johnson syndrome is caused by:
A. Herpes simplex
B. CMV
C. Chicken pox
D. Toxoplasma

Response:
Ans: A (Herpes simplex) Reference: Thappa DM, edit to: Essentials in Dermatology, 2nd edn. NewDelhi: Jay peeExplanation: (See the following table)Stevens-Johnson Syndrome (SJS)Drug induced SJSPhenvtoinPhenobarbitoneSulfonamidesPenicillinsNS AIDSViral CausesHerpes simplex virus (Most Common cause)AIDSCoxsackievirusViral infectionsInfluenza HepatitisMumpsBacterial causesGroup A beta-hemolytic streptococciNail AbnormalitiesNail abnormalityDescriptionCausesKoilonychiaReverse curvature in the longtitudinal and transverse axisIron deficiency anemiaMacronychia/McronychiaToo small or large nails--OnycholysisDistal or lateral separation of the nail from nail bedPsoriasis, OnychomycosisPterygiumCentral fibrotic tongue like band from proximal nail fold joins the nail bed dividing the nail proximal!}1 into twoLichen planusSubungual hyperkeratosisExcessive collection of squamous debris under the free edge of nailPsoriasis OnychomycosisOnychogryphosisNail get thickened and grows upwards in a spiral mannerChronic traumaPachynychia congenitaHypertrophy of nails associated with nail bed and hyponychial hyperkeratosis--Beau's linesTransverse grooves on nailsTemporary cessation of nail formationChemotherapyHypocalcemiaNail infectionCoronary occlusionMalnutritionTerry's nailNail N white proximally hut normal distallyCongestive cardiac failureCirrhosisDiabetes mellitusPittingPunctate erosions on nail surfacePsoriasisAlopecia areataRed LunulaeNails show erythema of lunulaPsoriasis (Dotted red lunula) Congestive cardiac failure CirrhosisSLESplinter hemorrhagesLongiitudinal hemorrhages in nail bedPsoriasisDermatitisFungal infectionsInfective endocarditis SLEMycosis fungoidesRheumatoid arthritisMees linesWhitening or discoloration of the nail in bands or "stria" that run parallel the lunula (nail base)CirrhosisChemotherapyHeavy metal poisoning(Arsenic, Thallium)TraumaMuehrcke's nailsWhite lines (leukonychia) that extend all the way across the nail and he parallel to the lunula {half moon)Non-specificAssc with decreased protein synthesisHypoalbuminemiaNephrotic syndromeDiphtheriaBrucellosisLymphogranuloma venereumMycobacteriaMycoplasma pneumoniaeRicketsial infectionsTularemiaIt is common in children and young adultsThe disease is preceded by a nonspecific prodrome with fever, myalgia, rhinitis and coughSkin lesions occur abruptly and are purpuric macules, atypical target lesions and papulesBullous lesions may occur in oral, genital and anal mucosaUlcerative stomatitis with hemorrhagic crusting is the most characteristic featureCorneal erosions may lead to symhlepharan. synechiae and opacitiesConstitutional symptoms may be severe during active stagesThe treatment includes supportive care and steroids.SJS Vs TENSJS - Mucosal erosions and epidermal detachment below 10%Toxic epidermal necrolysis (TEN)- Mucosal erosions and epidermal detachment more than 30%

So the answer to this question is A


Instruction:
Because of circle of least diffusion, the distant vision is comparatively good in:
A. Simple myopic astigmatism
B. Compound myopic astigmatism
C. Mixed astigmatism
D. Compound hypermetropic astigmatism

Response:
Ans. Mixed astigmatism

So the answer to this question is C


Instruction:
Which is involve in processing of post-transcriptional modification of mRNA:
A. Lariats formation
B. Splicing
C. Methylation
D. All of the above

Response:
A i.e. Lariats formation; B i.e. Splicing; E i.e. Methylation

So the answer to this question is D


Instruction:
Cause of "bloody" vomitus in a neonate
A. Meckel's diveiculum
B. Intussusception
C. Malrotation
D. Cholecystitis

Response:
Meckel&;s dieiculum may cause severe hemorrhage due to peptic ulceration. The blood is usually passed per rectum and is maroon in colour. it may cause bloody vomitus. Ref : BAILEY AND LOVE&;S SHO PRACTICE OF SURGERY,24 TH EDITION PG NO:1159

So the answer to this question is A


Instruction:
Crystalline lens of the eye develops from
A. Mesoderm
B. Neural ectoderm
C. Surface ectoderm
D. Endoderm

Response:
Answer: c) Surface ectoderm (PARSON 22nd ED, P-5)NEURAL ECTODERMSURFACE ECTODERMMESODERM# Epithelium of iris# Epithelium of ciliary body# Constrictor and dilator pupillae# Retinal pigment epithelium and its 9 sensory layers# Optic vesicle and cup# Optic nerve fibres# Melanocytes# Secondary vitreous# Epithelium of Conjunctiva# Epithelium of cornea# Lacrimal glands# Tarsal glands# Conjunctival glands# Crystalline Lens# Sclera# Corneal stroma# Descemet's membrane# Corneal endothelium# Iris# Choroid# Ciliary muscle# Sheaths of optic nerve# Blood vessels of the eye# Extraocular muscles# Trabecular meshwork# Primary vitreous

So the answer to this question is C


Instruction:
All are seen in Addison disease Except
A. Hyponatremia
B. Hyperkalemia
C. Hypotension
D. Metabolic alkalosis

Response:
An "adrenal crisis" or "Addisonian crisis" is a constellation of symptoms that indicates severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage), or an intercurrent problem (e.g., infection, trauma) in someone known to have Addison's disease. It is a medical emergency and potentially life-threatening situation requiring immediate emergency treatment. Characteristic symptoms are: Sudden penetrating pain in the legs, lower back, or abdomen Severe vomiting and diarrhea, resulting in dehydration Low blood pressure Syncope (loss of consciousness and ability to stand) Hypoglycemia (reduced level of blood glucose) Confusion, psychosis, slurred speech Severe lethargy Hyponatremia (low sodium level in the blood) Hyperkalemia (elevated potassium level in the blood) Hypercalcemia (elevated calcium level in the blood) Convulsions Fever Ref Harrison20th edition pg 288

So the answer to this question is D


Instruction:
Commonly associated in tetralogy of Fallot is:
A. Aberrant right subclavian artery
B. Right sided aortic arch
C. Aortopulmonary window
D. Coarctation of aorta

Response:
Ans BAssociations of Tetralogy of Fallot (TOF) are:Cardiovascular associations#Right-sided aortic arch: seen in 25% of cases (Most common Q)#Pulmonary hypoplasia with or without atresia.#Atrial septal defect (ASD) or Patent ductus arteriosus (PDA) (termed pentalogy of Fallot)#Coronary artery anomalies.#Persistent left-sided superior vena cava.Extra-cardiovascular associations: in 15% of cases#Congenital lobar emphysema (CLE)#VACTERL association#Tracheo-esophageal fistula#DiGeorge syndrome#Prune belly syndrome#Fetal rubella syndrome

So the answer to this question is B


Instruction:
Blue color of contusion is due to: Gujarat 07
A. Bilirubin
B. Hemosiderin
C. Hematoidin
D. Deoxyhemoglobin

Response:
Ans. Deoxyhemoglobin

So the answer to this question is D


Instruction:
Which of the following drugs can be used for the treatment of chloroquine resistant malaria in children?
A. Chloroquine
B. Doxycycline
C. Tetracycline
D. Clindamycin

Response:
CHLOROQUINE It is a rapidly acting erythrocytic schizontocide against all species of plasmodia; controls most clinical attacks in 1-2 days with disappearance of parasites from peripheral blood in 1-3 days. Therapeutic plasma concentrations are in the range of 15-30 ng/ml. However, it has no effect on pre- and exo-erythrocytic phases of the parasite-does not prevent relapses in vivax and ovale malaria. Resistance in P. falciparum is associated with a decreased ability of the parasite to accumulate chloroquine. Veraparnil, a Ca2+ channel blocker, has been found to restore both the chloroquine concentrating ability as well as sensitivity to this drug. For pediatric patients, the treatment options are the same as for adults except the drug dose is adjusted by patient weight. The pediatric dose should never exceed the recommended adult dose. Pediatric dosing may be difficult due to unavailability of non-capsule forms of quinine. If unable to provide pediatric doses of quinine, consider one of the other three options. If using a quinine-based regimen for children less than eight years old, doxycycline and tetracycline are generally not indicated; therefore, quinine can be given alone for a full 7 days regardless of where the infection was acquired or given in combination with clindamycin as recommended above. In rare instances, doxycycline or tetracycline can be used in combination with quinine in children less than 8 years old if other treatment options are not available or are not tolerated, and the benefit of adding doxycycline or tetracycline is judged to outweigh the risk. If infections initially attributed to "species not identified" are subsequently diagnosed as being due to P. vivax or P. ovale, additional treatment with primaquine should be administered. ESSENTIALS OF MEDICAL PHARMACOLOGY, www.cdc.gov/malaria/diagnosis_treatment K.D.TRIPATHI SIXTH EDITION PAGE NO:785

So the answer to this question is D


Instruction:
Which of the following is not true regarding Gleason grading and scoring?
A. It is used in prostate cancer
B. Prostate specific antigen has score of 3
C. It has score from 2 to 10
D. It is a prognostic scoring system

Response:
It is pathological scoring system based on tumor morphology. Doesn't include PSA values

So the answer to this question is B


Instruction:
Conversion of Fe+2 to F+3 reaction is called
A. Haber weiss reaction
B. Fenton's reaction
C. Ne rns t reaction
D. Donnan reaction

Response:
For Options A & B refer image. Option D :When two solutions containing ions are seperated by a membrane that is permeable to some of the ions and not to others an electrochemical equillibrium is established.

So the answer to this question is B


Instruction:
Investigation of choice to demonstrate vesico ureteral reflux
A. Isotope cystogram
B. Contrast Micturating Cysto Urethrogram
C. IVP
D. Cystoscopy

Response:
B i.e. Contract MCU - Patients with suspected urolithiasis (stone) present with painful hematuria and /or recurrent UTI. Ultrasound and KUB X-ray are the initial screening modalityQ followed by unenhanced (i.e. non contrast) helical or spinal CT (imaging modality of choice) if screening is negative. However, IVU (intravenous urography) or IVP is still the best investigation if CT is not available. The test of choice at most centers for diagnosing an acute stone is a non contrast helical CT ScanQ. Helical CT (Non contrast) has the advantage of detecting uric acid stones in addition to the traditional radioopaques stones, and CT does not expose the patient to the risk of radio contrast agents. - Calcification is best detected by CTscanQ. MRI and PET scan have no role in diagnosing renal stone. Intravenous urography (IVP) is the only method which can detect early renal tuberculosis and papillary necrosis. It is the most sensitive and investigation modality of choice for early renal TB. However in advanced cases it should be integrated with cross sectional CT imagesQ. Micturating/Voiding cystourethrography is the best method to visualize posterior urethra, posterior urethral valve & vesico ureteric refluxQ. In post urethral valve,Voiding Cystourethrogram (VCU) shows dialation of prostatic urethra & filling defect corresponding to the valve. VU Reflux occurs when urinary bladder contracts so contrast studies of urinary bladder done during micturation is best way to see VU Reflux. Radionucleotide cystogram is Inv of 2nd choice. It's advantage is that it avoids the need for bladder catheterization. The disadvantage is its lack of anatomical detail. So it may be useful in follow up (not initial assessment).

So the answer to this question is B


Instruction:
A patient with hereditary fructose intolerance is deficient in which of the following enzymes?
A. Aldolase
B. Fructokinase
C. Triokinase
D. All of above

Response:
None

So the answer to this question is A


Instruction:
Storage form of free energy in the cell is:
A. NADH
B. ATP
C. G-6-Phosphate
D. Creatine phosphate

Response:
ATP is the storage form of free energy in most of the cells of the body. Creatine phosphate or Phospho-creatine is the immediate source of ATP in muscles for first 8-10 seconds. High energy compounds in biological systems are : ATP GTP UTP Creatine Phosphate Phosphoenol Pyruvate Coenzyme A 1,3-bisphospho glycerate Carbamoyl Phosphate

So the answer to this question is B


Instruction:
The antibiotic that inhibits protein synthesis by premature chain termination and which structurally resembles an aminoacyl t-RNA is -
A. Tetracycline
B. Chloramphenicol
C. Puromycin
D. Erythromycin

Response:
Ans. is 'c' i.e., Puromycin o Puromycin is a tRNA analogue which combines with amino acid in place of tRNA and forms a complex with amino acid that prevents addition of fuher amino acids to polypeptide (i.e. causes premature chain termination).

So the answer to this question is C


Instruction:
All are true about Adult laryngeal papilloma except -
A. M>F
B. Do not recur
C. Posterior half of vocal cord
D. Treatment is surgery

Response:
Ans. is 'c' i.e., Posterior half of vocal cordAdult-onset papillomao Single, smaller in size, less aggressive and do not recur after surgery,o Most common age affected is 30-40 years and is more common in males,o It arises from anterior half of vocal cord or anterior commissure.o Surgery is the primary modality' of treatment.o Endoscopic surgical removal is the preferred treatment (CO2 laser is the most commonly used modality).

So the answer to this question is C


Instruction:
Sheela 26-year-old female, currently taking phenytoin for idiopathic grand mal epilepsy, and is consulting you because she wants to avoid pregnancy. She is on oral contraceptive pills (OCPs) for the time being. She has searched the internet and read that phenytoin could decrease the effectiveness of her OCPs. Which one of the followings is a suitable alternative?
A. Carbamazepine.
B. Lamotrigine
C. Topiramate.
D. Phenobarbitone.

Response:
Lamotrigine * Lamotrigine (Lamictal) is an excellent alternative in those who wish to avoid pregnancy while taking OCPs. * Topamirate (Topamax) decreases the effectiveness of OCPs; the rest are enzyme inducers that increase the catabolism of OCPs.

So the answer to this question is B


Instruction:
Burr cell is seen in -
A. Uremia
B. Hepatocellular carcinoma
C. Gastric carcinoma
D. Ovarian carcinoma

Response:
None

So the answer to this question is A


Instruction:
The gene that regulates normal morphogenesis during development is :
A. FMR-1 gene
B. Homeobox gene.
C. P-16
D. FTEN.

Response:
Ans. is 'b' i.e. Homeobox gene Homeobox geneis associated with normal morphogenesis.Their expression results in the production of localized cellular condensation of primitive mesenchyme in the sites of future bones.They play an important role in patterning of limbs, vertebrae and craniofacial structures.Mutations in Homeobox gene produces an extra digit between 3rd and fourth fingers as well as some degree of syndactyly.About other optionsFMR geneIt is familial mental retardation gene mutation in this gene causes Fragile-X- syndromePTENIt is phosphatase and tensin homologue.It is frequently deleted in many human cancers such as Glioblastomas, Prostate cancers, endometrial cancers and Breast cancer.P-16It is a tumour suppressor gene.

So the answer to this question is B


Instruction:
Professional misconduct -
A. Association with non medical persons in medical procedures
B. Dichotomy
C. Issuing false ceificate
D. All of the above

Response:
Professional misconduct is any conduct of the doctor which might reasonably be regarded as disgraceful or dishonorable. Conduct is judged by professional men of good repute and competence. The doctor may get a warning notice and his name can be erased from Medical Register if guilty. These offenses include mnemonic 6 A's 1 D. Adultery, unlawful Aboion, Adveising, Association with unqualified persons in professional matters, Addiction, Alcohol, and Dichotomy or fee splitting. REF: Dr.K.S.Narayana Reddys Synopsis of Forensic Medicine & Toxicology 29th edition Pg.15.

So the answer to this question is D


Instruction:
Which of the following organism is identified by interferon
A. Staphylococcus
B. Leptospira
C. Campylobacter
D. Tuberculosis

Response:
Interferon-gamma release assay: This test uses Mycobacterium tuberculosis antigen CFP10 which reacts with T-lymphocytes of the patient to release gamma interferon. This test is not very specific for pulmonary tuberculosis, hence is not recommended any longer. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 360

So the answer to this question is D


Instruction:
Investigation of choice to differentiate pericardial effusion and dilatation of hea:
A. Echocardiography
B. Angio cardiography
C. MR!
D. CT

Response:
Ans. Echocardiography

So the answer to this question is A


Instruction:
Not seen with controlled ventilation set at:
A. Barotrauma
B. Alkalosis
C. Pulmonary embolism
D. Cardiac Temponade

Response:
D i.e. Cardiac Temponade Prolonged controlled ventilation may cause barotrauma & pulmonary embolismQ. And CO2 wash out causes alkalosisQ in controlled ventilation. Intermittent Positive Pressure Ventilation (IPPV) Pathophysiological change - AlkalosisQ dlt CO2 wash out Reduced cardiac outputQ due to decreased venous return because of elevated intrathoracic pressure Increased physiological dead spaceQ because gas flow is directed to more compliant, non dependent areas while blood flow ours dependent areas Complication BarotraumaQ dlt high peak inflation pressure VolutraumaQ dlt repetitive collapse & expansion of lung - PneumothoraxQ Pulmonary embolismo

So the answer to this question is D


Instruction:
An 11 year old female patient complains that her lips remain open and gums can be seen. Extra-oral examination reveals a short upper lip, whereas the intra-oral examination shows normal inclination of the incisors. Which of the following statements regarding this patient's chief complaint is false?
A. Growth of lips trail behind the growth of jaws
B. The lip separation seen is normal
C. Gingival display will reduce with age
D. The lip separation will increase with age

Response:
Growth of the Lips
The lips trail behind the growth of the jaws prior to adolescence, then undergo a growth spurt to catch up. Because lip height is relatively short during the mixed dentition years, lip separation at rest (often termed lip incompetence) is maximal during childhood and decreases during adolescence. Because the lips move downward relative to the lips and teeth during adolescence (and continue to do so as the face ages), what looks like too much display of gingiva prior to and in adolescence can look perfectly normal in a young adult.
Contemporary orthodontics, William Proffit, 4th edition page 47

So the answer to this question is D


Instruction:
The best treatment of contaminated wound of leg
A. Debridement and antibiotics
B. Hyperbaric oxygen
C. Amputation
D. None

Response:
Ans. (a) Debridement and antibiotics(Ref: Bailey 26th 279)* Treatment of contaminated wound includes antibiotics or even a wound wash out. Dead tissue needs to be excised.

So the answer to this question is A


Instruction:
Which one of the following neurological conditions is not inherited in autosomal dominant pattern
A. Neurofibromatosis
B. Friedreich's ataxia
C. Marfan's syndrome
D. None

Response:
Friedreich ataxia Gene :FXN,locus:9q21.1 ; protein :frataxin; repeat GAA; normal: 7-34 ; Disease :34-80 (pre); >100 (full) Friedreich ataxia is an inherited condition that affects the nervous system and causes movement problems.This condition is caused by mutations in the FXN gene and is inherited in an autosomal recessive pattern Ref Robbins 9/e pg 168

So the answer to this question is B


Instruction:
Which is the safest contraceptive method for a woman with sickle-cell anaemia ?
A. Intrauterine device
B. Low dose progesterone pill
C. Condom or diaphragm
D. Low dose oestrogen-progesterone

Response:
Condom or diaphragm

So the answer to this question is C


Instruction:
Drug contraindicated in G6PD deficiency ?
A. Chloroquine
B. Primaquine
C. Quinine
D. All

Response:
Ans. is `b > c > a' i.e., Primaquine > Quinine > Chloroquine o Among antimalarial drugs, primaquine, quinine and occasionally chloroquine can cause hemolytic anemia in G6PD deficiency. But, primaquine has the highest potential to cause hemolytic anemia in patients with G6PD deficiency and, the patients with G6PD dificiency are highly senstive to primaquine. o The hemolytic potential in G6PD deficiency patients - Primaquine (maximum) > Quinine > Chloroquine (rare).

So the answer to this question is D


Instruction:
Basal layer of cell in stratified squamous epithelium is
A. Squamous
B. Transitional
C. Cuboidal- columnar
D. Pseudostratified

Response:
C i.e. Cuboidal - Columnar

So the answer to this question is C


Instruction:
Goldenhar syndrome is associated with which prominent ocular manifestation:
A. Microcornea
B. Megalocornea
C. Sclerocornea
D. Epibulbar dermoids

Response:
Ans. Epibulbar dermoids

So the answer to this question is D


Instruction:
All are true regarding fetal hydantoin syndrome except :
A. Digital hypoplasia
B. Macrocephaly
C. Microcephaly
D. Cleft lip

Response:
Macrocephaly is not a feature of fetal hydantoin syndrome Fetal hydantoin syndrome Phenytoin is teratogenic Features : Hypoplastic phalanges Cleft palate Harelip Microcephaly Due to arene-oxide metabolite

So the answer to this question is B


Instruction:
Following admission to the emergency department, a 26-year-old woman with severe menorrhagia states that both her father and sister have a bleeding disorder. The hemostatic disorder transmitted by autosomal-dominant mode is which of the following?
A. Factor X deficiency
B. von Willebrand's disease
C. Factor VIII deficiency (true hemophilia)
D. Factor IX deficiency (Christmas disease)

Response:
von Willebrand disease is the most common hemostatic disorder transmitted by autosomal- dominant mode. Other disorders transmitted by this mode are hereditary hemorrhagic telangiectasia and factor XI deficiency. Diseases transmitted by an autosomal-recessive mode are factor X, factor V, factor VII, and factor I deficiencies. Factor VIII (true hemophilia) and factor IX (Christmas disease) deficiencies are sex-liked recessive.

So the answer to this question is B


Instruction:
Chang staging is used for -
A. Retinoblastoma
B. Medulloblastoma
C. Ewing's sarcoma
D. Rhabdomyosarcoma

Response:
None

So the answer to this question is B


Instruction:
Most common site of intra peritoneal abscess is
A. Right superior intra peritoneal space
B. Left superior intra peritoneal space
C. Right inferior intra peritoneal space
D. Left inferior intra peritoneal space

Response:
Most common site of abscess in lying and dependent positive - Right inferior intra peritoneal space.

So the answer to this question is C


Instruction:
The common cause of bilateral internuclear ophthalmoplegia is:
A. Multiple sclerosis
B. Lead toxicity
C. Diphtheria
D. Diabetes mellitus

Response:
Ans. Multiple sclerosis

So the answer to this question is A


Instruction:
If a fibrinolytic drug is used for the treatment of acute myocardial infarction, the adverse effect most likely to occur is :
A. Acute renal failure
B. Development of antiplatelet antibodies
C. Encephalitis secondary to liver dysfunction
D. Hemorrhagic stroke

Response:
None

So the answer to this question is D