Instruction:
Transverse mesocolon contains which artery?
A. Left colic artery
B. Right colic artery
C. Middle colic artery
D. Ileocolic artery

Response:
Transverse mesocolon contains middle colic artery
Transverse Mesocolon
Peritoneal fold suspending transverse colon from posterior abdominal wall
Attachment of root of transverse mesocolon: anterior surface of head & anterior border of body of pancreas
Contents : middle colic vessels, ascending branches of the right and leftcolic vessels; nerves & lymphatic’s of transverse colon

So the answer to this question is C


Instruction:
The most common organism amongst the following that causes acute meningitis in an AIDS patients is a-
A. Streptococcus pneumoniae
B. Streptococcus agalactiae
C. Cryptococcus neoformans
D. Listeria monocytogenes

Response:
C. neoformans infection - most common in patients with advanced HIV infection with CD4 T-cell counts < 200/ml Meningitis in Neonates or infants of 0-2 months: Escherichia coli > Group B streptococcus (S. agalactiae) > Listeria monocytogenes Overall Aseptic meningitis: Cryptococcus neoformans.. Capsular antigen detection from CSF or serum by latex agglutination test is a rapid and sensitive (95%).

So the answer to this question is C


Instruction:
Fetal hemoglobin contains
A. a 2, ss 2
B. a 2, d 2
C. a 2, g 2
D. None

Response:
The blood of the human fetus normally contains fetal hemoglobin (hemoglobin F). Its structure is similar to that of hemoglobin A except that the b chains are replaced by g chains; that is, hemoglobin F is a2g2. The g chains have 37 amino acid residues that differ from those in the b chain. Fetal hemoglobin is normally replaced by adult hemoglobin soon after bihRef: Ganong&;s Review of medical physiology 25th edition. Page: 557

So the answer to this question is C


Instruction:
In G6PD deficiency hemolysis can be caused byall except ?
A. Chloroquine
B. Primaquine
C. Quinine
D. Penicillin

Response:
Ans. is 'd' i.e., Penicillin

So the answer to this question is D


Instruction:
TIPS is a type of
A. Non selective shunt
B. Selective shunt
C. Both selective and non selective shunt
D. Systemic shunt

Response:
TIPS is a non selective shunt, created between poal and hepatic vein TIPS is a poahepatic or intrahepatic shunt Ref: Sabiston 20th edition Pgno : 1439

So the answer to this question is A


Instruction:
Which prostaglandin helps in cervical ripening ?
A. PGI2
B. PGF2
C. PGE2
D. PGD2

Response:
None

So the answer to this question is C


Instruction:
Most common primary leading to secondaries in pancreas;-
A. Lung
B. Breast
C. Colon
D. Stomach

Response:
Metastatic tumors to pancreas MC site of primary: RCC > malignant melanoma On autopsy, MC site of primary: Ca lung

So the answer to this question is A


Instruction:
Mutation in NPHS 1 gene causes which disease?
A. Alport syndrome
B. Congenital Finnish type nephrotic syndrome
C. Focal segmental glomerulonephritis
D. Nail patella syndrome

Response:
Ans. (b) Congenital Finnish type nephrotic syndromeRef: Nelson 18th ed./ Table 527.1* CNF is one of the Finnish heritage diseases and rare form of nephrotic syndrome.* It occurs predominantly in families of Finnish origin and manifests shortly after birth* The condition is caused by a defect in the protein nephrin, which is found in the kidney.* Gene responsible is NPHSL.

So the answer to this question is B


Instruction:
Ocular symptom not seen in Herpes zoster is-
A. Nummular keratitis
B. Glaucoma
C. Uveitis
D. Satellite lesions

Response:
The ocular lesions of herpes zoster ophthalmicus include conjunctivitis,zoster keratitis,episcleritis and scleritis,iridocyclitis,acute retinal necrosis,secondary glaucoma,anterior segment necrosis and phthisis bulbi and associated neurological complications such as motor nerve palsies.Reference:Comprehensive ophthalmology,AK Khurana,6th edition,page no.111

So the answer to this question is D


Instruction:
Causative agent of acute rheumatic fever:
A. Group `A' b-hemolytic streptococcus
B. Group -B b-hemolytic streptococcus
C. Group -C b-hemolytic streptococcus
D. Group -D b-hemolytic streptococcus

Response:
Group `A' b-hemolytic streptococcus

So the answer to this question is A


Instruction:
In korsakoff psychosis all are seen except :
A. Loss of remote memory
B. Loss of intellectual function but preservation of memory
C. Loss of intellectual function but preservation of memory
D. Reversible State

Response:
A. i.e. Loss of remote memory

So the answer to this question is A


Instruction:
Homogenous opacification of right hemithorax with right sided shift of mediastinum may be caused by
A. Collapse of Right lung
B. Consolidation of Right lung
C. Right sided hemothorax
D. Left sided hydrothorax

Response:
Answer is A (Collapse of Right lung): Collapse of Right lung may present with homogeneous opacification of right hemithorax and ipsilateral mediastinal Shift. Condition Findings Consolidation : Ipsilateral Hamogenous opacification & No mediastinal shift Collapse : Ipsilateral Homogenous opacification & Ipsilateral mediastinal shift Hemothorax : Ipsilateral homogenous opacification & Contralateral shift Hydrothorax : Ipsilateral homogenous opacification & Contralateral shift

So the answer to this question is A


Instruction:
About cetirizine all are true except-
A. It is a 2nd generation anti histaminic
B. It is a metabolite of hydroxyzine
C. Good CNS penetration
D. Inhibits release of histamine

Response:
Ans. is 'c' i.e., Good CNS penetration Cetrizine* Cetrizine is a 2nd generation anti histaminic* It is a metabolite of hydroxyzine with marked affinity for the peripheral H1 receptors,* It penetrates CNS poorly and has mild sedating effect.* It inhibits release of histamine from mast cells and therefore has been used for urticarial and atopic dermatitis.* It is non - arrhythmogenic.

So the answer to this question is C


Instruction:
In Burkitts lymphoma , translocation seen is chromosome
A. 12 -14 translocation
B. 8-14 translocation
C. 4-8 translocation
D. 12-18 translocation

Response:
Ans. is 'b' 8-14 translocation Chromosomal translocations Associated Neoplasms8 - 14 -Burkitt's lymphoma*.Acute lymphocytic leukemia (FAB type L3) Immunoblastic B cell lymphoma*15-17 -Promyelocytic leukemia*4-11 -Acute lymphocytic leukemiaH-14 -Chronic lymphocytic leukemia14- 18 -Some B cell lymphomas6 - 14 -Cystadenocarcinoma of ovary3.8 -Renal adenocarcinoma*, mixed parotid tumour.

So the answer to this question is B


Instruction:
The most impoant prognostic factor in breast carcinoma is
A. Histological grade of the tumor
B. Stage of the tumor at the time of diagnosis
C. Status of estrogen and progesterone receptors
D. Over expression of p-53 tumour suppressor gene

Response:
Stage I and II has got better prognosis. Spread to axillary nodes is the most impoant prognostic indicator. Age: Younger the age worser the prognosis. Sex: Carcinoma male breast has got worser prognosis compared to female breast. Because of early spread in carcinoma male breast. Atrophic scirrhous has got best prognosis. Medullary carcinoma has got better prognosis than scirrhous carcinoma because of lymphocytic infi ltration. Invasive carcinoma has got worser prognosis. Inflammatory carcinoma breast has worst prognosis. Ref; (page no;559 ) 5th edition of SRB&;S manual of Surgery

So the answer to this question is B


Instruction:
Wof agents is often combined with local anesthetics to prevent its systemic distribution from the site of injection
A. Acetylcholine
B. Dopamine
C. Epinephrine
D. g-Aminobutyric acid (GABA)

Response:
Addition of a vasoconstrictor, e.g. adrenaline (1:50,000 to 1:200,000): * Prolongs duration of action of LAs by decreasing their rate of removal from the local site into the circulation: contact time of the LA with the nerve fibre is prolonged. * Enhances the intensity of nerve block. * Reduces systemic toxicity of LAs: rate of absorption is reduced and metabolism keeps the plasma concentration lower. * Provides a more bloodless field for surgery. * Increases the chances of subsequent local tissue edema and necrosis as well as delays wound healing by reducing oxygen supply and enhancing oxygen consumption in the affected area. Ref:- kd tripathi; pg num:-363

So the answer to this question is C


Instruction:
Earliest HCG is detected -
A. 8-10 days after ovulation
B. 8-9 days post fertilization
C. 3-4 weeks
D. 10th day of menstruel cycle

Response:
Ans-B

So the answer to this question is B


Instruction:
The following statement about Gomez classification is false:
A. Based on height retardation
B. Based on 50th centile Harvard standards
C. Between 75-89% implies mild malnutrition
D. This classification has prognostic value for hospitalization of children.

Response:
Gomez classification is based on weight for age criteria

So the answer to this question is A


Instruction:
Not a cause of objective tinnitus -
A. Palatal myoclonus
B. Glomus tumor
C. Carotid artery aneurysm
D. Presbyacusis

Response:
Ans. is 'd' i.e., PresbyacusisTinnituso Tinnitus is ringing sound or noise in the ear.o The characteristic feature is that the origin of this sound is within the patient,o Two types of tinnitus have been describeda) SubjectiveI. OtologicII. Non-otologico Impacted waxo Fluid in the middle earo Acute and chronic otitis mediao Abnormally patent eustachian tubeo Meniere's diseaseo Otosclerosiso Presbyacusiso Noise traumao Ototoxic drugso Tumors of VUIth nerveo Disease ofCNSo Anaemiao Arteriosclerosiso Hypertensiono Hypotensiono Hypoglycaemiao Epilepsyo Migraineo Drugsb) Objectiveo Vascular tumours of middle ear (glomus tumour)o Aneurysm of carotid arteryo Palatal myoclonus

So the answer to this question is D


Instruction:
Regarding the hip joint, which of the following statements is true ?
A. Retinaculum attaches femur to hip
B. Inferior gluteal nerve supplies the abductors of the hip
C. Capsule is attached to the intertrochanteric line
D. iliopsoas cuses abduction of hip

Response:
Superior gluteal nerve supplies the abductors of the hip-gluteus medius and gluteus minimus. Iliopsoas causes flexion of hip. Capsule is attached to acetabular labrum on hip bone and intertrochanteric line on femur.

So the answer to this question is C


Instruction:
Specific stain for myeloblasts -
A. Sudan black
B. PAS
C. Myeloperoxidase
D. LAP

Response:
The specific stain for myeloblast is myeloperoxidase And the specific stain for erythroblasts is periodic acid schiff Reference :textbook of Pathology 6th edition Author Harsha Mohan page number 362

So the answer to this question is C


Instruction:
Turn-buckle cast is used for -
A. Fracture shaft humerus
B. Fracture shaft femur
C. Scoliosis
D. Cervical spine injury

Response:
Turn- buckle cast and Risser&;s cast are used in case of SCOLIOSIS. Minerva cast- cervical spine disease. U-slab or hanging cast- fracture of humerus. Hip spica - fracture of femur. REF:Essential ohopaedics- Maheshwari-5 th edn- pg no 17.

So the answer to this question is C


Instruction:
In thyroid gland, iodine is transpoed into the lumen of the follicles by
A. Endocytosis
B. Pendrin protein
C. Antipo
D. Primary active transpo

Response:
Pendrin protein is a chloride-iodide transpoer protein encoded by the gene responsible for Pendred syndrome, impoant in function of thyroid gland, kidney, and inner ear.Endocytosis is defined as the uptake by a cell of material from the environment by invagination of the plasma membrane; it includes both phagocytosis and pinocytosis.Antipo a cell membrane transpo mechanism that transpos two molecules at once through the membrane in opposite directions.Primary active transpo - Active transpo is the movement of all types of molecules across a cell membrane against its concentration gradient (from low to high concentration). In all cells, this is usually concerned with accumulating high concentrations of molecules that the cell needs, such as ions, glucose, and amino acids. If the process uses chemical energy, such as from adenosine triphosphate (ATP), it is termed primary active transpo.Ref: Ganong&;s review of medical physiology; 24th edition; page no-341

So the answer to this question is B


Instruction:
The treatment of early stage of East African sleeping sickness is by
A. Pentamidine
B. Eflornithine
C. Suramin
D. Melarsopol

Response:
Early stage (Normal CSF)Late stage (Abnormal CSF = CNS involvement)W. African (T. brucei gambiense)PentamidineEflornithineE. African (T. brucei rhodesiense)SuraminMelarsoprol

So the answer to this question is C


Instruction:
In adults seeking orthodontic treatment with esthetic appliances, the following may be choices EXCEPT:
A. Lingual orthodontics
B. Ceramic brackets
C. Clear aligner therapy
D. Titanium brackets

Response:
For 15- to 17-year-olds, clear aligners or esthetic brackets with a clear wire are considered most attractive. For this group, clear aligners can make sense because the permanent teeth are fully erupted and rapid growth is completed. Adults prefer lingual appliances, clear aligners, or esthetic brackets, especially when combined with a clear wire. The spectrum changes from unique and colorful for children to esthetic appliances with older adolescents and adults. With this combination of acceptable alternatives, it is possible to meet esthetic demands and accomplish the biomechanics for almost every patient.

So the answer to this question is D


Instruction:
In a removable partial denture, the clasps provide
retention and stability; support is provided by
A. Minor connector
B. Occlusal rests
C. Rigid portion of the class arm
D. Resilient portion of the class arm

Response:
None

So the answer to this question is B


Instruction:
All are true regarding axillary lymph nodes except
A. Posterior group lies along subscapular vessels
B. Lateral group lies along lateral thoracic vessels
C. Apical group lies along axillary vessels
D. Apical group is terminal lymphnodes

Response:
AXILLARY LYMPH NODES: The axillary lymph nodes are scattered in the fibrofatty tissue of the axilla. They are divided into 5 groups. 1)The nodes of the anterior {pectoral} group lie along the lateral thoracic vessels, i.e along the lower border of the pectoralis minor. They receive lymph from the major pa of the breast. 2)The nodes of the posterior {scapular}group lie along the subscapularis vessels, on the posterior fold of the axilla. They receive lymph from the posterior wall of the upper half of the trunk, and from the axillary tail of the breast. 3)The nodes of the lateral group lie along the upper pa of the humerus, medial to the axillary vein. They receive lymph from the upper limb. 4)The nodes of the central group lie in the fat of the upper axilla. They receive lymph from the preceding groups and drain into the apical group. They receive some direct vessels from the floor of the axilla. The intercostobrachial nerve is closely related to them. 5)The nodes of the apical or infraclavicular group lie deep to the clavipectoral fascia, along the axillary vessels. They receive lymph from the central group, from the upper pa of the breast, and from the thumb and its web. The lymphatics from the thumb accompany the cephalic vein. REF: BD Chaurasia 7th edition page no:55

So the answer to this question is B


Instruction:
The beta blocker with alpha blocking action
A. Carvedilol
B. b)Atenolol
C. pindolol
D. Nadolol

Response:
Ans) a (Carvedilol) Ref Goodman&Gilman 11th ed.KDT 7th ed, Katzung 11th edCarvedilol is a third-generation beta receptor antagonist that has a unique pharmacological profile.It blocks beta1, beta2, and alphatreceptors similarly to labetalol, but also has antioxidant and anti- proliferative effects.It has membrane-stabilizing activity but it lacks intrinsic sympathomimetic activity.Carvedilol produces vasodilation.It is thought that the additional properties (e.g., antioxidant and antiproliferative effects) contribute to the beneficial effects seen in treating congestive heart failure.Carvedilol does not increase beta receptor density and is not associated with high levels of inverse agonist activity.BETA BLOCKERSCardioselective (betal) beta blockersMetoprololBetaxololAtenololCeliprololBisoprololNebivolol.Esmolol Non selective beta blockersPropranolol ,Sotalol,Timolol, Pindolol, Labetalol, Carvedilol, Medroxolol, Bucindolol and Levubunonol.- Pindolol has intrinsic sympathomimetic activity.- Butoxamine is a beta 2 selective blocker.- Carvedilol is a non-selective beta blocker showing anti-oxidant property and alpha 1 receptor antagonism.- Labetolol, Medroxalol, and Bucindolol also shows alpha 1 receptor blocking activity.Propranalol has highest degree of membrane stabilizing actionNadolol is longest acting beta blocker (t Vi -14-24 hrs) andEsmolol is the shortest acting.(t Vi -10 minutes)Propranolol has poor oral bioavailability.Pindolol and Penbutolol have approx 100% bioavailabilityPropranolol and Metoprolol are extensively metabolized in the liver, with little unchanged drug appearing in the urine.

So the answer to this question is A


Instruction:
The representational hemisphere (cerebral) is better than the categorical hemisphere at
A. Language functions
B. Recognition of objects by their form
C. Understanding oprinted words
D. Mathematical calculation

Response:
Left hemisphere is specialized for language and analytical ability, and is also called categorical hemisphere. The right hemisphere specialized for visuospatial ability is the representational hemisphere --is true for 97% of all people Ref: guyton and hall textbook of medical physiology 12 edition page number:543,544,545

So the answer to this question is B


Instruction:
Which is not true about Langenbeck Kocher operation?
A. Adequate exposal of posterior segment
B. Anterior segment is not visualized adequately
C. Superior exposure is very well exposed
D. Sciatic nerve injury in 10% in cases

Response:
(c) Superior exposure is very well exposed- Please observe this question is not the same as previous as Kocher-Langenbeck approach is not a good approach for superior segment as its visualization is limited hence D option will be considered acceptable as nerve injuries in earlier studies were more than 6% as compared to now.

So the answer to this question is C


Instruction:
Most Common congenital GI Tract anamoly is
A. Meckels diveiculum
B. Patent rachus
C. Ileal atresia
D. Jejunal aplasia

Response:
Answer- A. Meckels diveiculumMeckel's diveiculum is a true diveiculum as it has all the 3layers of the intestine.It's the most common congenital anomaly of the gastrointestinal tract

So the answer to this question is A


Instruction:
Use of nitrous oxide is contraindicated in all of the following surgeries except ?
A. Cochlear implant
B. Microlaryngeal surgery
C. Vitreoretinal surgery
D. Exentration operation

Response:
Exentration operation One major problem with N20 is that it will exchange with N2 in any air containing cavity in the body. Moreover, because of their differential blood : gas paition coefficients, nitrous oxide will enter the cavity faster than nitrogen escapes, thereby increasing the volume and/or pressure in the cavity. Examples of air collections that can be expanded by nitrous oxide are : - Pneumothorax - Air embolus - Obstructed middle ear - Obstructed loop of bowel - lntracranial air - A pulmonary (bleep) Nitrous oxide should be avoided in these clinical settings: Now lets move on to the options Nitrous oxide in vitreoretinal surgery The use of nitrous oxide anaesthesia in patients with an intraocular gas bubble is potentially sight threatening. Patients who have vitreoretinal surgery often have a gas bubble deliberately left within the eyes as it helps keep the retina attached while adhesions develop. Filtered room air, Sulfur hexqfluoride and perfluoropropane are the most commonly used gases. By varying the concentration volume and type of gas used, bubbles can be produced that will last upto 70 days before being completely absorbed. If nitrous oxide is administered during this time the bubble will rapidly expand with the risk of retinal and optic nerve ischemia. Nitrous oxide and middle ear surgeries Middle ear cavity is connected to eustachian tube. When nitrous oxide is inhaled in large quantities N20 replaces the N2 in the middle air cavity thereby increasing the pressure in the cavity. After discontinuation of N20 the gas is rapidly reabsorbed from the cavity thus creating negative pressure in the cavity this may cause: ? - Serous otitis media - Disaiculation of stapes - Impaired hearing N20 anaesthesia is hazadrous to hearing iu patients who have previously undergone reconstructive middle ear surgery. Microlaryngeal surgery CO2and (Nd : YAG) lasers are frequently used for microsurgery on the upper airway and trachea. Lasers can ignite materials used in anaesthesia. The CO2 laser can penetrate an endotracheal tube and ignite a fire. Nitrous oxide suppos combustion just like 02 and and may ignite fire.

So the answer to this question is D


Instruction:
Which of the following is an arthropod borne disease-
A. Tetanus
B. Q Fever
C. Scrub typhus
D. Rabies

Response:
Ans. is 'c' i.e., Scrub typhus o Vector bone diseases are the diseases in which an arthropod insect acts as a vector for transmission of infectious agent. Therefore, these diseases are also called as 'Arthropod Borne Diseaseso Among the given options only scrub typhus is transmitted to man by arthropod (mite).Note : In Q-fever, no arthropod is involved in transmission to man. But in extrahuman host, tick acts as a vector for transmission.

So the answer to this question is C


Instruction:
Which of the following factors is not an impoant risk factor for tubal ectopic?
A. A history of tubal surgery
B. Intrauterine device (IUD) use
C. In utero diethylstilbestrol (DES) exposure
D. History of pelvic inflammatory disease

Response:
Ectopic pregnancy results from various factors that interrupt the successful migration of the conceptus to the endometrium. The most impoant risk factors for ectopic pregnancy are history of tubal surgery, including tubal ligation, for prior ectopic pregnancy, infeility history of prior ectopic: increases risk 5 folds in utero diethylstilbestrol (DES) exposure: causes congenital fallopian tube anomalies history of pelvic inflammatory disease, sexually transmitted disease peritubal adhesions: secondary to salpingitis, endometriosis, appendicitis SIN: salpingitis isthmica nodosa infeility: use of A: increases risk of atypical/ non tubal ectopic failed contraception: IUCD, sterilisation, progesterone only contraceptives. PLEASE NOTE IT IS FAILURE OF THESE CONTRACEPTIVE PRACTICES, AND NOT THE CONTRACEPTIVE PRACTICE IN ITSELF Intrauterine device (IUD) use are associated with reduce pregnancies and reduced ectopic rates, however, if there is a failure of the IUD and a pregnancy results, ectopic gestation is more likely as compared to normal population conceiving These are not very clear relations. Many other risk factors, including smoking and multiple lifetime sexual paners, are weakly associated with ectopic pregnancy .

So the answer to this question is B


Instruction:
Radiation emits by Ir-192
A. 0.5 Mev
B. 0.6 Mev
C. 0.66 Mev
D. 0.47 Mev

Response:
Irradiation damage in In/sub 0.53/Ga/sub 0.47/As p-i-n photodiodes by 1-MeV fast neutrons is studied as a function of fluence for the first time.
The degradation of the electrical and optical performance of diodes increases with increasing fluence.
The induced lattice defects in the In/sub 0.53/Ga/sub 0.47/As epitaxial layers and the InP substrate are studied by DLTS methods.
In the In/sub 0.53/Ga/sub-0.47/As epitaxial layers, hole and electron capture levels are induced by irradiation.
The influence of radiation source on device degradation is then discussed by comparison to 1-MeV electrons with respect to the numbers of knock-on atoms and the nonionizing energy loss (NIEL). In order to examine the recovery behavior, isochronal thermal annealing is carried out for temperatures ranging from 75 to 300/spl deg/C.
After 300/spl deg/C thermal annealing, the light current only recovers to 20% of pre-irradiation for a fluence of 1/spl times/10/sup 13/ n/cm/sup 2/, while it recovers to 53% for a fluence of 1/spl times/10/sup 15/ e/cm/sup 2/.
The different recovery behavior is thought to be due to a different type of radiation damage.

So the answer to this question is D


Instruction:
First line therapy in smoking dependence:
A. Nicotine replacement gum
B. Rimonabant
C. Naloxone
D. Acute cessation

Response:
(Ref: Katzung, 14th ed. pg. 584)Treatment of smoking dependence:* First line: Nicotine replacement therapy (gum, patch, inhaler).* Bupropion and Varenicicline (Nicotine receptor agonist): Also, first line. Considered more effective.* 2nd line: Clonidine and Nortryptiline* Rimonabant: Cannabinoid receptor inverse agonist. Withdrawn due to increased depression and suicide risk.

So the answer to this question is A


Instruction:
Operation theatre fire is most commonly due to?
A. Argon beam coagulators
B. Laser
C. Fiber optic illumination
D. Electrosurgical equipment

Response:
ANSWER: (D) Electrosurgical equipmentREF: British Journal of Anesthesia Volume 50, Issue 7 p. 659-664, Current Opinion in Anaesthesiology: December 2008 Volume 21 Issue 6 p. 790-795The two most common source of operation theatre fire is electrosurgical unit (ESU) and lasers.Other equipments that can produces fire are, but not limited to, fiber optic light cables, light source box, drills, saws & burrs, handheld cautery, argon beam coagulators and defibrillators.ECRI's analysis of case reports showT that the most common ignition sources are electrosurgical instruments (68%) and lasers (13%); and the most common fire location is the airway (34%), head or face (28%), and elsewhere on or inside the patient (38%), An oxygen-enriched atmosphere wTas a contributing factor in 74% of all cases.

So the answer to this question is D


Instruction:
Caries on the enamel surface leads to accentuation of:
A. Incremental lines of Retzius
B. Mineralization
C. Demineralization
D. None

Response:
A change in early enamel caries is the accentuation of the incremental lines of Retzius. This conspicuous appearance of the calcification lines is an optical phenomenon due to loss of minerals, which causes the organic structures to appear more prominent. There may also be accentuation of perikymata which are the external manifestation of striae of Retzius.
Ref: Shafer's textbook of oral pathology 7th edition page 447

So the answer to this question is A


Instruction:
The main ingredient in dental plaster is:
A. Calcium sulphate hemihydrate
B. Calcium phosphate
C. Calcium anhydrate
D. Calcium sulphate dihydrate

Response:
None

So the answer to this question is A


Instruction:
Which of the following is NOT a complication of bronchiectasis -
A. Lung abscess
B. Lung cancer
C. Amyloidosis
D. Empyema

Response:
None

So the answer to this question is B


Instruction:
Peri-natal transmission of hepatitis B is maximum in:
A. 1st trimester
B. 2nd trimester
C. 3rd trimester
D. During labour and delivery

Response:
Peri-natal transmission of hepatitis B is maximum in 3rd trimester. Maximum chances of perinatal transmission :- Disease Maximum chances Varicella 1 trimester Rubella 1 trimester Syphilis III trimester Toxoplasmosis III trimester Hepatitis B III trimester HIV During delivery

So the answer to this question is C


Instruction:
Giant cell is seen in: (PGI Dec 2006)
A. Osteoclastoma
B. Chondroblastoma
C. Chordoma
D. Osteitis fibrosa cystisca

Response:
Ans: A (Osteoclastoma) (Ref: Maheshwarl 3rd/216]Osteoclastoma (Giant Cell Tumour)Pathology: The cell of origin is uncertain. Undifferentiated spindle-cells, profusely inter- spersed with multinucleate giant cell. The tumour stroma is highly vascular. These giant cells were mistaken as osteoclasts in the past, hence the name osteoclastoma.# The tumour is seen commonly in the age group of 20-40 years.A characteristic 'egg-shelf crackling' is often not elicited. The limb may be deformed if a pathological fracture has occurred.Characteristic radiological feature : Soap-bubble appearance

So the answer to this question is A


Instruction:
Glucose is reabsorbed in
A. PCT
B. DCT
C. Loop of Henle
D. Collecting tubules

Response:
Ans. a (PCT). (Ref. Ganong, Physiology, 21st/pg.713; Table 38-6.)PROXIMAL CONVOLUTED TUBULE (PCT) - "Workhorse of the nephron".# Reabsorbs all of the glucose, inorganic phosphate, Cl, lactate and amino acids and most of the bicarbonate, sodium, and water.# Secretes ammonia, which acts as a buffer for secreted H\Transport Proteins Involved in the Movement of Na+ and Cl Across the Apical Membranes of Renal Tubular Cells.SiteApical TransporterFunctionProximal tubuleNa+/ glucose CTNa+ uptake, glucose uptake Na+/ Pi CTNa+ uptake, Pi uptake Na+ amino acid CTNa+ uptake, amino acid uptake Na+/lactate CTNa+ uptake, lactate uptake Na+/H+ exchangerNa+ uptake, H extrusion Cl-/base exchangerCl- uptakeThick ascending limbNa+-K4-2CINa+ uptake, Cl uptake, K+ uptake Na+/H+ exchangerNa+ uptake, H+ extrusion K+ channelsK+ extrusion (recycling)Distal convoluted tubuleNaCI CTNa+ uptake, Cl uptakeCollecting ductNa+ channel (ENaC)Na+ uptake

So the answer to this question is A


Instruction:
A village with 10000 population 250 suffered from malaria out of which 50 dead, another 100 suffered from dengue out of which 30 died in 2013 case fatality rate of dengue is ?
A. 40
B. 80
C. 30
D. 70

Response:
Ans. is 'c' i.e., 30

So the answer to this question is C


Instruction:
Sadism is?
A. Painful sex
B. Having intercourse with an animal
C. Anal intercourse
D. Sexual intercourse with dead bodies

Response:
Ans is 'a' i.e. Painful sexSadism:o Sexual gratification is obtained or increased from acts ofphysical cruelty or infliction ofpain on one's partner.o It is seen more commonly in men. To obtain sexual gratification, the sadist may bite, beat, whip, produce cuts on the victim, etc.Other options:o Having intercourse with an animal - Bestialityo Anal intercourse - Sodomyo Sexual intercourse with dead bodies - Necrophilia

So the answer to this question is A


Instruction:
An 70 year old lady who had previously had a few attacks of dizziness, fell and broke her hip. She was found to have slow pulse, ECG was performed. Which is the next best step for management of this patient?
A. Temporary pacemaker
B. Permanent pacemaker
C. I.C.D
D. Proceed with hip joint Repair surgery

Response:
Image shows ventricular rate of 30/min with no relation between P waves and qRS complexes. QRS complexes are broad indicating origin from the ventricle and presence of escape rhythm. All these findings indicate presence of complete hea block. She needs a permanent pacemaker. However in the current circumstances she needs ohopaedic surgery --> to reduce moality -> temporary pacemaker should be the next best step.

So the answer to this question is A


Instruction:
The established benefits of estrogen replacement therapy in menopausal woman include a reduction in all of the following EXEPT
A. Osteoporosis
B. Mood depression
C. Atrophic vaginitis
D. Hot flushes

Response:
Estrogen replacement therapy has many advantages, including reduction in symptoms of estrogen deficiency such as hot flushes, sweating, and atrophic vaginitis. Estrogens have a orable effect on lipoprotein profiles, increasing high-density lipoprotein (HDL) cholesterol and slightly decreasing low-density lipoprotein (LDL) cholesterol. The risk of osteoporosis is also reduced when estrogen replacement therapy is used in combination with calcium supplements. Although menopausal women often feel better physically when receiving estrogen replacement therapy, a few may experience mood depression severe enough to necessitate discontinuation of therapy.

So the answer to this question is B


Instruction:
A 78 year old man who lives alone and prepares his own food is found to have ecchymotic patches over posterior aspect of his lower extremities. He has haemorrhagic areas around hair follicles, hair are fragmented and splinter haemorrhages are present in nail beds and several hematomas are present in the muscles of arms and legs. PT and CT are normal. This clinical syndrome is most likely due to :
A. Vitamin K deficiency
B. Vitamin C deficiency
C. Pyridoxine deficiency
D. Vitamin A deficiency

Response:
Ans. is 'b' Vitamin C deficiency Bleeding manifestations with normal prothrombin time and clotting time almost confirms the diagnosis of vitamin C deficiency.Vitamin CVitamin C is required for the synthesis of collagen*It acts as a cofactor in the hydroxylation* of proline* and lysine*Aggregation of polypeptide chain into triple helixSo in Vitamin C deficiency the collagen types with highest hydroxyproline (those in blood vessels) are severely affected. Therefore, the early clinical feature of Vitamin C deficiency is increased tendency to hemorrhage d/t increased fragility of capillaries.Bleeding in Vitamin C is d/t defect in capillary therefore only bleeding time will be increased in Vitamin C deficiency. All other tests such as PT, PTT, Thrombin time, clotting time will remain normalVitamin K deficiencyVitamin K deficient patient can also present with similar bleeding manifestations. In Vitamin K deficiency bleeding occurs d/t lack of coagulation factors (vit K dependent factors which are II, VII, IX, X.)Therefore patients presents with following abnormalitiesClotting time - increasedPTT - increasedPT - increasedThrombin time - increased

So the answer to this question is B


Instruction:
One is not the indication of total parenteral nutrition ?
A. Acute pancreatitis
B. Enterocolic fistula
C. Chronic liver disease
D. Faecal fistula

Response:
Ans is 'c' i.e. Chronic liver disease Parenteral nutrition involves the continuous infusion of a hyperosmolar solution containing carbohydrates, proteins, fat and other necessary nutrients through an indwelling catheter inseed into (usually) the superior vena cava. Indications for Total parenteral Nutrition (Ref: Sabiston 18/e p168, 17/e p162) The principal indications for parenteral nutrition are found in seriously ill patients when use of the gastrointestinal tract for feeding is not possible. In some instances intravenous nutrition may be used to supplement inadequate oral intake. (A)As primary therapy I. Gastrointestinal cutaneous fistula including enteroenteric, enterocolic, enterovesical or enterocutaneous fistula. 2. Renal failure (Acute tubular necrosis) 3. Sho bowel syndrome 4. Severe burns 5. Hepatic failure (acute decompensation superimposed on cirrhosis) 6. Crohn's ds 7. Anorexia nervosa (B) As a suppoive therapy I. Acute radiation enteritis Acute chemotherapy toxicity Prolonged ileus Weight loss preliminary to major surgery (C) Areas under Intensive study Patients with cancer Patients with sepsis About Pancreatitis TPN was once a preferred route of providing nutritional suppo to patients with sever acute pancreatitis, but now jejunal enteral feeding is the preferred method with TPN required for few cases when - there is delay in providing jejuna] enteral nutrition to patient with significant malnutrition for more than 3- 4 days there is persistent ileus there is exacerbation of pancreatitis after enteral nutrition

So the answer to this question is C


Instruction:
Prolonging a person's life through technological means is known as :?
A. Dysthanasia
B. Novus actus interveniens
C. Euthanasia
D. Ohotanasia

Response:
Ans. is 'a' i.e., Dysthanasia In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine: Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life.

So the answer to this question is A


Instruction:
Subepithelial deposits in kidney are seen in-
A. MPGN-1
B. GPS
C. PSGN
D. All

Response:
Glomerular deposits : (i) Subepithelial: o Acute GN (like PSGN) o Membranous GN o Heyman GN o RPGN (ii) Sub endothelial : (iii) Basement membrane : (iv) Mesangium : MPGN (Type- I) SLE o Acute ON (H&; 1583) o MPGN (Type II) o Good pasture syndrome o IgA nephropathy, HSP REF: ROBBINS pathology 10th edition

So the answer to this question is C


Instruction:
Viral enterotoxin is detected as a possible mechanism of pathogenesis in:
A. Adenovirus
B. Rotavirus
C. Calcivirus
D. Astrovirus

Response:
None

So the answer to this question is B


Instruction:
All of the following are features of sarcoidosis except:
A. Right paratracheal lymphadenopathy
B. Cardiomyopathy
C. Hypercalcemia
D. Malabsorption syndrome

Response:
Right paratracheal lymphadenopathy - garland sign in sarcoidosis. Non-caseating granulomas are seen in the hea - most impoant cause of noninfectious dilated cardiomyopathy. Granulomas produce vitamin D3 leading to hypercalcemia.

So the answer to this question is D


Instruction:
A 17-year-old boy comes to the physician because of edema of both legs as well as pen-
orbital edema There is no history of diarrhea and no urinary symptoms suggestive of
infection. He had a throat infection 3 weeks ago. His blood pressure is 110/70 mmHg. He
undergoes a kidney biopsy and light microscopy is normal. The patient is treated and makes
a full recovery.

Which of the following is the most likely diagnosis?
A. Accelerated hypertension
B. ANCA associated vasculitis
C. Minimal change glomerulonephnitis
D. Post-streptococcal glomerulonephritis

Response:
None

So the answer to this question is C


Instruction:
Which muscleft is the chief mover of the mandible towards the left
A. Left medial pterygoid
B. Left lateral pterygoid
C. Right medial pterygoid
D. Right lateral pterygoid

Response:
The formula method states that the right lateral pterygoid moves the mandible left, whereas the left lateral pterygoid moves the mandible right.

So the answer to this question is D


Instruction:
In order to expose the coeliac axis, left renal aery, superior mesenteric aery and abdominal aoa in a case of trauma, which of the following is performed :Left medial visceral rotation
A. Left medial visceral rotation
B. Right medial visceral rotation
C. Cranial visceral rotation
D. Caudal visceral rotation

Response:
Ans. is 'a' i.e. Left medial visceral rotation The major abdominal vessels are retroperitoneal structures that lie posterior to the contents of peritoneal sac & close to the midline. The vessels which are notoriously difficult to expose are : retrohepatic vena cava, suprarenal aoa; the coeliac axis; the proximal superior mesentric aery; the junction of the superior mesentric, splenic and poal veins and the bifurcation of the vena cava. Rapid exposure of these vessels can be accomplished during abdominal trauma by following maneuvers : - The principle behind visceral rotation is to rotate the viscera of one side towards the midline after freeing their lateral peritoneal attachments so as to expose the vessels of that side A left medial visceral rotation (Mattox maneuver) provides excellent exposure of the aoa, coeliac axis, superior mesentric aery, left renal aery and iliac aeries. A right medial visceral rotation (Catell maneuver) readily exposes the vena cava (with a combined Kocher maneuver), right renal vessels and iliac veins. The infrarenal aoa may be approached a transperitoneal incision at the base of the mesocolon. The junction of the superior mesentric, splenic and poal veins can be readily exposed in trauma surgery by dividing the neck of the pancreas. The bifurcation of the vena cava is obscured by the right common iliac aery. This vessel is to be divided to expose extensive vena caval injuries of this area.

So the answer to this question is A


Instruction:
radiation exposure occurs in all except ?
A. ct scan
B. mri
C. fluroscopy
D. plain xray

Response:
fluoroscopy uses sonographic waves which is a sound wave and doesnt have radiation effect. Fluoroscopy is also an imaging tool. Allows physicians to look at various body systems. Shows movement of body pas. Also shows instruments or dye a continuing stream of x-ray images. Approximately 25-30 images per second Used in a variety of procedures Ohopedic Surgery Catheter Inseion Barium X-Rays Blood Flow Studies ref : david sutton 9th ed

So the answer to this question is C


Instruction:
Which one of the following congenital malformation of the fetus can be diagnosed in first trimester by ultrasound ?
A. Anencephaly
B. Inencephaly
C. Microcephaly
D. Holoprosencephaly

Response:
As discussed in chapter on fetal malformation, anencephaly can be diagnosed as early as 8-10 weeks/first trimester in experienced hards.
Microcephaly:
USG in Obs and Gynae Callen 4/e, p 298, 299

It is decreased head size.
In these patients both brain mass and total cell number are reduced.
There is disproportion in size between the skull and face.
It is difficult to recognize this anomaly by ultrasound – A head circumference below 2 SD from the mean is used as a diagnostic criteria in midtrimester scan.

Holoprosencephaly is the presence of a single centrally placed cerebral ventricle and may be associated with midline abnormalities of the face.
With the use of vaginal probe it can be recognised in the beginning of midtrimester.

So the answer to this question is A


Instruction:
Bilateral carcinoma breast is common in which of the following type
A. Inflammatory
B. Lobular
C. Scirrhous
D. Colloid

Response:
<img style="box-sizing: border-box; border: 0px; veical-align: middle; max-width: 100%;" src=" /> Ref - Srb's manual of surgery 5e p529,530

So the answer to this question is B


Instruction:
An elderly female with a history of alcoholic disease develops jaundice and marked anasarca. Which of the following is the most likely pathophysiology of her persistent edema?
A. Lymphatic obstruction
B. Reduced central venous pressure
C. Reduced plasma oncotic pressure
D. Sodium retention

Response:
Hepatic failure occurring in cirrhosis reduces the capacity of the liver to synthesize sufficient quantities of plasma proteins (mostly albumin) necessary to maintain plasma oncotic pressure. Low plasma oncotic pressure allows fluid from the intravascular fluid component to move into the interstitial space, producing plasma volume contraction and edema. Lymphatic obstruction occurs as a result of mechanical blockage of lymphatics by tumor, inflammatory processes, or ceain parasitic infections. Cirrhosis does not lead to lymphatic obstruction. Reduced central venous pressure does not cause edema. Conversely, increased central venous pressure, which may arise with congestive hea failure, thrombosis, or cirrhosis can lead to increased hydrostatic pressure and edema. Sodium retention is an impoant cause of edema in patients with poor renal perfusion. The kidneys respond by retaining sodium and increasing plasma volume in an effo to increase renal blood flow. Sodium retention in cirrhosis is secondary to the decrease in plasma oncotic pressure and consequent decrease in plasma volume. Ref: Geller D.A., Goss J.A., Tsung A. (2010). Chapter 31. Liver. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

So the answer to this question is C


Instruction:
Essential criteria for major depression are all except -
A. Delusion of grandeur
B. Loss of pleasure
C. Insomnia
D. Hypersomnia

Response:
Ans. A. Delusion of grandeurDiagnostic criteria for major depression5 or more of the following symptoms should be present most of the day for at least 2 weeks: -Depressed moodLoss of interest or pleasure in all activities.Decrease/increase appetite or loss/gain of weight.Insomnia or hypersomnia (Increased or decreased sleep).Psychomotor retardation or agitation (decreased or increased psychomotor activity).Fatigue or loss of energy (weakness or lethargy).Feelings of wohlessness or excessive guilt.Diminished concentrationRecurrent thoughts of death or recurrent suicidal ideation or suicidal attempt.

So the answer to this question is A


Instruction:
Cirrhosis can lead to development of?
A. Metabolic alkalosis, Chloride responsive
B. Metabolic alkalosis, Chloride non-responsive
C. Hyperchloremic metabolic acidosis
D. Hypochloremic metabolic acidosis

Response:
None

So the answer to this question is B


Instruction:
Which of the following organs is not involved in Whipple's disease
A. Hea
B. CNS
C. Lungs
D. GI tract

Response:
The organs in which these foamy macrophages can be seen are liver, small intestine, lymph nodes, hea,eyes,CNS,synvoial membrane of joints Refer Robbins 9/e p 792

So the answer to this question is C


Instruction:
Most commonly amyloidoisis is secondary to ?
A. Chronic suppuration
B. Acute inflammation
C. Cellular necrosis
D. Hyaline degeneration

Response:
Ans. is 'a' i.e., Chronic suppurationo Most common cause of secondary amyloidosis is chronic inflammatory condition.

So the answer to this question is A


Instruction:
Vidian nerve is also called ?
A. Superior petrosal nerve
B. Greater petrosal nerve
C. Nerve to pterygoid canal
D. Auricular branch of vagus

Response:
Greater petorsal nerve units with deep petrosal nerve to form nerve to pterygoid canal (also called vidian nerve).It carries secretomotor fibers to nasal gland pterygopalatine ganglion.Also knowAuricular branch of vagus is also called as Arnold's nerve or Alderman's nerve.

So the answer to this question is C


Instruction:
Which of the following is anti-inflammatory?
A. IL-1
B. IL-4
C. IL-6
D. TNF-Alpha

Response:
The following are the anti-inflammatory cytokines: IL-10 TGF-b IL-4 IL-13 Pro-inflammatory cytokines IL-1 IL-6 TNF-Alpha Major anti-inflammatory cytokines include interleukin (IL)-1 receptor antagonist, IL-4, IL-6, IL-10, IL-11, and IL-13. Specific cytokine receptors for IL-1, tumor necrosis factor-alpha, and IL-18 also function as proinflammatory cytokine inhibitors ref basic pathology robbins 9th ed page 48

So the answer to this question is B


Instruction:
A 26-year-old man has had myalgias and a fever for the past week. On physical examination, his temperature is 38.6deg C. He has diffuse muscle tenderness, but no rashes or joint pain on movement. Laboratory studies show elevated serum creatine kinase and peripheral blood eosinophilia. Larvae of Trichinella spiralis are present within the skeletal muscle fibers of a gastrocnemius biopsy specimen. Two years later, a chest radiograph shows only a few small calcifications in the diaphragm. Which of the following immunologic mechanisms most likely contributed to the destruction of the larvae?
A. Abscess formation with neutrophils
B. Antibody-mediated cellular cytotoxicity (ADCC)
C. Complement-mediated cellular lysis
D. Formation of Langhans giant cells

Response:
When antibody is directed at a parasitic infection, there is Fc receptor-mediated inflammation and phagocytosis, characteristic for ADCC. IgG and IgE antibodies bearing Fc receptors coat the parasite. Macrophages, natural killer cells, and neutrophils can then recognize the Fc receptor and destroy the antibody-coated target cells. Acute inflammatory reactions with abscess formation have little effect against tissue parasites. Complement-mediated lysis is most typical of immune destruction of RBCs with hemolysis. Langhans giant cells are seen in granulomatous inflammation, a form of type IV hypersensitivity. Leukotriene C4 is a potent agent that promotes vascular permeability and bronchial smooth muscle contraction in type I hypersensitivity reactions.

So the answer to this question is B


Instruction:
Principles of condensation for direct filling gold include all of the following except:
A. Forces of condensation should be 90◦ to the cavity walls and floors
B. Forces of condensation should be 90◦ to previously condensed gold
C. Condensation is done by a process called ‘stepping’
D. The gold pellet used must be of minimal thickness

Response:
Principles of condensation
The unique thing about direct gold materials and restorations is that certain principles must be strictly followed to arrive at a successful restoration. Any deviation from such principles leads to immediate failure. These essential condensation principles are as follows:

The forces of condensation must be at 45o to cavity walls and floors. In other words, they should bisect line angles and trisect point angles. This leads to the maximum adaptation of gold against walls, floors, line, and point angles, with minimal irritation to the vital pulp-dentin organ.
Forces of condensation must be directed  at 90o to previously condensed gold. This avoids shear components that can displace or loosen the already condensed pieces of gold.
Whenever condensing a piece of direct gold, always start at a point on one side and proceed in a straight line to another point on the opposite side, then back to the original side on a different straight line, also starting at and arriving to a specific point. This ensures that the condenser has covered the entire surface of that  piece of gold. During these disciplined movements, the condenser should overlap at least ¼ of the previously condensed area. This further assures that each portion of the gold increment has been welded and cold worked and cold worked and that there are no voids present. This process, called “stepping” ensures the maximal adaptation of the gold to the cavity walls.
Use the minimal thickness of pellet possible, provided that the condensers will not penetrate it. The thinner that the cross-section of each increment is, the easier will be the fulfillment of the objectives of condensation.
Energy of condensation - Energy used in condensing direct gold restorations should only be dissipated in fulfilling the objectives of condensation.

So the answer to this question is A


Instruction:
Precursor for the synthesis of testosterone is:
A. Aldosterone
B. Cholesterol
C. Pregnenolone
D. Cortisol

Response:
Pregnenolone or Progesterone are the precursors for the synthesis of testosterone, aldosterone, estradiol and cortisol.

So the answer to this question is C


Instruction:
Label for bio-medical waste containers/ bags is in accordance with which schedule of Bio medical waste rules?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV

Response:
Schedule I - categorisation of biomedical waste Schedule II- colour coding and type of container for disposal of bio-medical wastes Schedule III - label for bio-medical waste containers /bags Ref: Park's textbook of Preventive and Social Medicine, 21stedition, page-735.

So the answer to this question is C


Instruction:
A patient with abdominal wall desmoids tumor should be screened for
A. Lung cancer
B. Breast cancer
C. Colonic Polyps
D. Pancreatic cancer

Response:
Desmoid TumourTumour arising in the musculoaponeurotic structures of the abdominal wall, especially below the level of the umbilicus.It is a completely unencapsulated fibroma. Distribution: Extra-abdominal (60%), abdominal wall (25%), intra-abdominal (15%).Some cases recur repeatedly in spite of apparently adequate excision.About 80% of cases occur in women, many of whom have borne childrenOccurs occasionally in scars of old hernial or other abdominal operation woundsSurgical trauma: Impoant etiological factorEstrogens stimulate desmoid growthOccur in cases of FAPPathologyDiagnosisTreatmentTumour is composed of fibrous tissue containing multinucleated plasmodial masses resembling foreign body giant cells.Usually, of very slow growth, it tends to infiltrate muscle in the immediate areaEventually, it undergoes a myxomatous change and it then increases in size more rapidly.Metastasis does not occur, no sarcomatous changeMRI is the investigation of choice for extremity and abdominal wall desmoids.Wide local excision (with 2 cm margin) is the treatment of choice.Surgery + Radiotherapy: For recurrent desmoid tumors.(Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1095)

So the answer to this question is C


Instruction:
Rate of elimination of a new drug is 20 mg/hr at a steady state plasma concentration of 10 mg/L, then its renal clearance will be:
A. 0.5 L/hr
B. 2.0 L/hr
C. 5.0 L/hr
D. 20 L/hr

Response:
None

So the answer to this question is B


Instruction:
Under NPCB, screening of school children is firstdone by
A. School teachers
B. Village health guide
C. Ophthalmologic assistant
D. Medical officer

Response:
School teachers Under the National Programme for Control of Blindness, all children aged 10-14 years will be screened for refractive errors by trained teachers. Children who cannot read the 6/9 line with any eye are then sent to the ophthalmic assistant of the CHC for refraction test. Children needing spectacles are then provided free spectacles by opticians who have been contracted by the NPCB.

So the answer to this question is A


Instruction:
Ba's hydrops fetalis is lethal because:
A. Hb Ba's cannot bind oxygen
B. The excess a-globin form insoluble precipitates
C. Hb Ba's cannot release oxygen to fetal tissues
D. Microcytic red cells become trapped in the placental

Response:
Hb Ba: Most severe form of Alpha thalassemia As Hb Ba's consists of 4-gamma chains - have very high oxygen affinity Thus, it cannot release oxygen to fetal tissues.

So the answer to this question is C


Instruction:
Drug of choice for primary open angle glaucoma:
A. Beta blockers
B. Prostaglandin analogues
C. Alpha agonists
D. Cholinergics

Response:
Prostaglandin analogues are now the drug of choice for open angle glaucoma and normal tension glaucoma.

So the answer to this question is B


Instruction:
LA causing cutaneous vasoconstriction:
A. Lidocaine.
B. Ropivacaine.
C. Mepivacaine.
D. Procaine.

Response:
None

So the answer to this question is B


Instruction:
Enzyme deficiency in Alkaptonuria is
A. Tyrosine hydroxylase
B. Homogentisate acid oxidase
C. Phenyl alanine hydroxylase
D. Cystathione synthase

Response:
B. i.e. (Homogentisate oxidase) (259 - Harper 27th)ALKAPTONURIA = lack of enzyme homogentisate oxidase enzyme most striking clinical manifestation - occurrence of dark urine black on standing in air*** Classical type Galactosemia - Galactose-1 p- uridyl transferase enzyme* Classical phenylketonuria - Phenyl alanine hydroxylase* Type I Tyrosinemia - Fumatyl acetoacetate hydrolase enzyme* Type II Tyrosinemia - Hepatic transaminase enzyme.

So the answer to this question is B


Instruction:
If you calculate the plasma osmolality of a child with plasma Na+ 125 mEq/l, glucose 108 mg/ dl, and BUN (blood urea nitrogen) 140 mg/ dl, the most appropriate answer would be:
A. 300 mOsm/kg
B. 306 mOsm/kg
C. 312 mOsm/kg
D. 318 mOsm/kg

Response:
B i.e. 306 mOsm/kg

So the answer to this question is B


Instruction:
Not a Epiphyseal tumors
A. Chondroblastoma
B. Osteoclastoma
C. Clear cell Chandrosarcoma
D. Simple bone Cyst

Response:
Simple bone cyst (Unicameral bone cyst) is a Metaphyseal tumor.

So the answer to this question is D


Instruction:
Which of the following is the causative agent of Yaws?
A. Treponema peenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum

Response:
Yaws is a contagious disease of tropical regions caused by Treponema pallidum subspecies T peenue. It is characterized by granulomatous lesions of the skin, mucous membrane and bone. It is acquired by direct non sexual contact often during play or group sleeping, and may be enhanced by disruption of the skin by insect bites or abrasions. The first lesion begins as a papule usually on an extremity and then enlarges to become papillomatous or raspberry like. A generalized secondary eruption accompanied by generalized lymphadenopathy, appears either concurrent with or following the primary lesion. Late yaws is manifested by gummas of the skin and long bone, hyperkeratoses of the palms and soles, osteitis and periostitis, and hydrahrosis. Ref: Lukeha S.A. (2012). Chapter 170. Endemic Treponematoses. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds),Harrison's Principles of Internal Medicine, 18e.

So the answer to this question is A


Instruction:
Active principle of oleander plant is: NEET 14; AIIMS 14
A. Cannabinol
B. Atropine
C. Semicarpol
D. Nerin

Response:
Ans. Nerin

So the answer to this question is D


Instruction:
Moures sign is seen in
A. Carcinoma
B. Appendicitis
C. Varicose vein
D. Pancreatitis

Response:
Moure's sign: in normal persons, there is a click felt when the larynx is moved from side to side over the veebral column. This sign is absent in patients with post-cricoid carcinoma (Moure's sig n positive).

So the answer to this question is A


Instruction:
A 53-year-old woman presents with weight loss, increased appetite, sweating, palpitations, and preference for cold weather, hot, moist palms, and tremors. What is the best investigation for the clinical diagnosis of this patient?
A. TSH levels
B. Autoimmune panel
C. Plasma catecholamines
D. Plasma Cortisol

Response:
Ans. A TSH levelsRef: CMDT 2019 page 1139This patient presents with classic signs and symptoms of hyperthyroidism. The increased Basal metabolic rate and calorigenesis explain the symptoms of the patient. These patients have highly suppressed TSH levels. The highlights of hyperthyroidism are:* Sweating, weight loss or gain, anxiety, palpitations, loose stools, heat intolerance, fatigue, menstrual irregularity.* Tachycardia; warm, moist skin; stare; tremor.* Graves disease: Majority have a palpable goiter (sometimes with bruit); ophthalmopathy.* Suppressed TSH in primary hyperthyroidism; usually increased T4 ,FT4 ,T3 ,FT3 .

So the answer to this question is A


Instruction:
Only certificate of vaccination required for international travel is
A. Hepatitis B
B. BCG
C. Tetanus
D. Yellow fever

Response:
None

So the answer to this question is D


Instruction:
Submandibular gland is divided into superficial and deep pas by ?
A. Digastric
B. Geniohyoid
C. Mylohyoid
D. Stylohyoid

Response:
Submandibular gland This walnut sized gland lies below the mandible in the anterior pa of digastric triangle. It is .1-shaped and consists of a large superficial and a small deep pas, separated by mylohyoid muscle and continuous with each other around the posterior border of mylohyoid muscle. Superficial pa It is situated in the anterior pa of digastric triangle. The gland is paially closed in a capsule formed by two layers of deep cervical fascia. It has three surfaces : (i) inferior, (ii) lateral, and (iii) medial. i) Inferior surface is covered by skin, platysma, cervical branch of facial nerve, deep fascia, facial vein and submandibular lymph nodes. ii) Lateral surface is related to submandibular fossa (on mandible), medial pterygoid (inseion) and facial aery. iii) Medial surface is related to mylohyoid, hyoglossus and styloglossus muscles. Deep pa It lies on the hyoglossus muscle deep to mylohoid. It is related above to lingual nerve and submandibular ganglion; and below to hypoglossal nerve.

So the answer to this question is C


Instruction:
Ovarian aery is a branch of :
A. Abdominal aoa
B. Anterior iliac aery
C. Common iliac aery
D. Posterior iliac aery

Response:
A. i.e. Abdominal aoa

So the answer to this question is A


Instruction:
Most common site of histiocytosis is
A. Bone
B. Skin
C. Lung
D. Liver

Response:
Ans. is 'a' i.e. bone Histiocytosis is a disorder of the mononuclear phagocytic system.Mononuclear phagocytic system consists of monoblasts, promonocytes, monocytes and tissue macrophages.Macrophages are transformed monocytes i.e. monocytes present in the tissues. Monocytes emigrate continuously from peripheral blood into the tissuesHistiocyteThe term histiocyte is synonymous with macrophage.In diseases of mononuclear phagocytic system the terms histiocyte and histiocytosis are used.Langerhans cellsLangerhans cell is macrophage and plays important role in immunity.It processes antigen and present it to T cells.Langerhans cells histiocytosis (LCH) is a clonal histiocytosis and the lesions are characterized by the presence of Langerhans cells, eosinophils and Lymphocytes in a variable number.The various features of Langerhans cells are:Presence of Birbeck granules (E/M - HX bodies)Presence of enzymes likea Naphthyl acetate esterasea Naphthyl butyrate esteraseAcid phosphataseMarkers likeS-100 positivityCD-I a positivityHCA-DR expressionEarlier the term histiocytosis X was used which includedLetterer-Siwe diseases (generalised disease)Hand schuller-christian diseaseEosinophilic granuloma (localised lesion)However, now the term Langerhans cell histiocytosis is preferred Langerhans cell histiocytosis includes 3 clinicopathologic entitiesAcute disseminated Langerhans cell histiocytosisMultifocal Langerhans cell histiocytosisUnifocal Langerhans cell histiocytosisAcute disseminated LCH (Letterer siewers disease)* This is the most severe form with systemic lesionsUsually affects children < 2 yearsSeborrheic type of skin rash is present over the front and back of the trunk and scalpHepatosplenomegaly is moderateLymphadenopathy is positivePulmonary lesions are not uncommonLytic lesions in bones are seenFever is of moderate degreeOtitis media andMastoiditis may be present Hematological findings of LCH CytopeniasAnemia, neutropenia and thrombocytopenia. These may occur in isolation or in combination.Cytopenias occur because hematopoietic cells in marrow get replaced by histiocytes.Bone marrowBone marrow shows infiltration by histiocytes which are large cells with abundant cytoplasm having a vesicular, oval or indented nucleus. These cells are loaded with cholesterol.E/M reveals Birbeck granulesS100, CD1a positiveMultifocal LCHMultiple lesions involving many systems.Prognosis is better than in the disseminated LCH.Usually affects children who presents with fever and skin eruptions on the scalp.Some of the patients demonstrate involvement of posterior pituitary stalk of hypothalamus resulting in diabetes insipidus.Some manifests proptosis of eye.There is evidence of osteolytic lesions in some of the bones like skull, orbit, jaw, femur, vertebrae and ribsHistomorphology of the lesion demonstrates histiocytes admixed with eosinophils.Unifocal LCHThis is characterized by a focal lesion amenable to treatment and carry a good prognosis.This focal disease affects the skeletal system.Commonly affected bones are calvaria, ribs and femur.The lesions may be asymptomatic or may cause pain, tenderness and pathological fractures.

So the answer to this question is A


Instruction:
Right Gastric Aery is a branch of :
A. Coelic Trunk
B. Hepatic aery
C. Gastroduodenal aery
D. Splenic aery

Response:
Right gastric aery originates from the hepatic aery just distal to the origin of gastroduodenal aery. It turns to the left and runs upwards along the the lesser curvature of the stomach and ends by anastomosing with the left gastric aery which is a branch of the coeliac trunk. Coeliac trunk: Arises at the level of interveebral disc between T12 and L1 veebrae. It is an unpaired branch of the abdominal aoa that arises from its ventral/anterior aspect (front) just below the aoic opening of diagphragm. Branches: Left Gastric aery (Smallest branch) Common Hepatic aery Splenic Aery (Largest branch of trunk) Ends by anastomosing with right gastric aery (Right Gastric aery is a branch of the hepatic aery) Common hepatic aery is a direct branch of the celiac trunk till the origin of gastroduodenal aery. The pa distal to this origin is termed proper hepatic aery Sho gastric aeries (5-7) Left gastroepiploic aery Numerous pancreatic branches Aeria pancreaticamagna Aeria cauda pancreatic Splenic hila branches Common Hepatic aery gives off a branch called Gastroduodenal aery and continues as the Hepatic aery proper. Right gastric aery originates from the hepatic aery just distal to the origin of gastroduodenal aery. Thus the right gastric aery may be termed as a branch of the hepatic aery proper rather than the common hepatic aery. Hepatic aery Branches: Gastro-duodenal aery Right gastric Aery Hepatic Aery proper Right gastroepiploic aery Superior pancreaticoduodenal aery Right gastric aery (ends by anastomosing with the left gastric aery) Hepatic aery proper ends by dividing into left and right hepatic aeries Right hepatic aery Left hepatic aery (cystic aery) is a branch of the right hepatic aery Ref: Vishram Singh 2nd edition Pgno: 120

So the answer to this question is B


Instruction:
To say twin discordance the differences in the two twins should be:
A. 15% with the larger twin as index
B. 15% with the smaller twin as index
C. 25% with the larger twin as index
D. 25% with the smaller twin as index

Response:
Unequal sizes of twin fetuses with a difference of 25% (larger twin being used as the index), is called as Discordant growth.

It is a sign of pathological growth restriction in the smaller fetus.
As the weight difference within a twin pair increases and the earlier the growth discordance is evident, perinatal mortality increases.
Most common cause of discordance:

In dichorionic twins – unequal placental mass.
In monochorionic twins – Twin-twin transfusion syndrome/genetic syndrome.

Hazards of discordant growth.

The smaller fetus is at increased risk of perinatal mortality due to:

Respiratory distress
Intra ventricular hemorrhage
Seizure
Sepsis
Periventricular leukomalacia
Necrotising enterocolitis.

At a difference of more than 30%—Risk of fetal death increases.
Extra Edge

Besides weight—other ultrasonographic parameters indicating discordance:

Difference in biparietal diameter is 6 mm or more.
Difference in head circumference is 5% or more.
Difference in abdominal circumference is 20 mm or more.
On colour Doppler ultrasound in umbilical arteries systolic to diastolic (S/D) ratio difference is 15% or more.

But amongst all criterias best is fetal weight difference i.e. more than equal to 25%.

Route of delivery: In case of discordant growth vaginal delivery is indicated if:

Cervix is ripe
Presentation is vertex/vertex
Weight of smaller twin is > 1500 gm.

So the answer to this question is C


Instruction:
Glucagon acts on muscle to cause
A. Gluconeogenesis
B. Gycogenolysis
C. Glycolysis
D. Kreb's cycle

Response:
Glucagon - a polypeptide hormone secreted by the alpha cells of the islets of Langerhans in response to hypoglycemia or to stimulation by growth hormone. It increases blood glucose concentration by stimulating glycogenolysis in the liver and can be administered parenterally to relieve severe hypoglycemia from any cause, especially hyperinsulinism.Ref: Ganong&;s review of medical physiology; 24th edition page no: 432

So the answer to this question is A


Instruction:
A patient came to emergency after RTA, He was conscious, could speak in single words, RR=40/minute, BP=90/40 mm Hg. There is absence of Breath Sounds on Right side. What is your next step immediately?
A. Intubate the patient
B. Urgent Fluid infusion
C. Chest X ray
D. Needle Insertion in 2nd ICS

Response:
Ans. (d) Needle insertion in 2nd ICS.Ref. ATLS Guidelines 10th Edition Page 66, Ref Surgery Sixer 2nd Edition Page 95* A hyper resonant note on percussion, deviated trachea, distended neck veins, and absent breath sounds are signs of tension pneumothorax.* But the Question setter has given an incomplete question, nothing mentioned about breath sounds, tracheal deviation.* But let us take into consideration the Tension pneumothorax which fits with above features and let us proceed with Needle Insertion in 5th ICS in MCL.* Newer Guidelines recommend Needle insertion in Adults in 5th ICS in Mid axillary line nowadays, But Bailey speaks the old method and conventional method, 2nd ICS MCL.

So the answer to this question is D


Instruction:
Prevalance is given by which study?
A. Case-control study
B. Cohort study
C. Cross-sectional study
D. Correlation study

Response:
Ans. is 'c' i.e., Cross-sectional study CharacteristicsCohort StudyCase control StudyCross Sectional StudyDesignProspectiveRetrospectiveOne point in timeIncidenceEstimatedNot estimatedNot estimatedPrevalenceNot estimatedNot estimatedEstimatedCalculationso Incidence rateso Relative risko Attributable risko Odds ratio

So the answer to this question is C


Instruction:
In central nervous system, the cell that scavenges the debris created after breakdown of an axon and its myelin:
A. Microglia
B. Macrophages
C. Astrocytes
D. Neutrophils

Response:
Macrophages are responsible for the phagocytosis of various cell debris in the body. Macrophages in various organs are given special names. eg: Kupffer cells - liver Microglia - brain Osteoclasts - bone Dust cells - lungs.

So the answer to this question is A


Instruction:
Following is a bacterial infection
A. Pyoderma gangrenosum
B. Impetigo herpitformis
C. Pitted keratolysis
D. Mycosis fungoides

Response:
Pitted keratolysis shallow pits on palms and soles causative organism: coryneform bacteria most common in: hyperhidrotics, marshy lands, housewives treatment: topical antibacterials pyoderma gangrenous: neutrophilic dermatosis of skin and mucous membranes impetigo herpitiformis: pustular psoriasis of pregnancy mycosis fungicides: cutaneous T cell lymphoma iadvl textbook of dermatology page 237

So the answer to this question is C


Instruction:
Bagassosis is most likely caused due to the inhalation of the dust of –
A. Free silica
B. Coal
C. Sugarcane
D. Cotton fibre

Response:
Anthracosis – Coal dust
Silicosis – Silica
Siderosis – Iron
Byssinosis – Cotton dust
Farmer's lung – Hay or grain dust
Sequousis – Moldy red wood saw dust
Suberosis – Moldy cork dust
Detergent worker's lung – Enzyme additives
Baggassosis – Sugarcane dust

So the answer to this question is C


Instruction:
Intraductal papillary mucin neoplasm is a precursor of-
A. Mucinous cystic neoplasm
B. Mucinous non-cystic neoplasm
C. Ductal adenocarcinoma
D. Solid pseudopapillary neoplasm

Response:
Intraductal papillary mucinous neoplasm (IPMN)

IPMN is a papillary neoplasm that arises within the main pancreatic duct (MPD) or its branches.
IPMN is characterized by

Intraductal, papillomatous growth pattern
Excessive mucin secretion
Excessive mucin secretion results in progressive ductal dilatation and cyst formation

IPMNs are most commonly localized to the head of the pancreas, but they may occur at any site along the pancreatic ductal system.
IPMTs are premalignant and may histologically demonstrate areas ranging from hyperplasia to carcinoma within a single tumor.
IPMTs which is positive for MUG 2 (Intestinal-type secretory mucin) may form an adenocarcinoma (ductal adenocarcinoma).

So the answer to this question is C


Instruction:
The active principle of abrus precatorius is:
A. Abrin and abrine
B. Calotoxin and Calotropin
C. Ricin and Ricinoleic acid
D. Semicarpol and Bhilawanol

Response:
Ans. (A). Abrin and abrineThe seed shown in the picture is abrus precatorius (Rati seeds), a plant irritant.Abrin and abrine - abrus precatoriusCalotoxin and Calotropin - calotropis giganteaRicin and Ricinoleic acid - ricinus communisSemicarpol and Bhilawanol- semicarpus anacardium (marking Nut)

So the answer to this question is A


Instruction:
Corpus delicti means: TN 07; AIIMS 08
A. Proof of occurrence of crime
B. Decomposed body
C. Identification of dead person
D. None

Response:
Ans. Proof of occurrence of crime

So the answer to this question is A


Instruction:
The only Sugar normaly absorbed in the intestine against a concentration gradient is :
A. Xylose
B. Mannose
C. Glucose
D. Ribose

Response:
C i.e. GlucoseFinal products of carbohydrate digestion in intestinal chyme are glucose & fructoseQ.The glucose transpo in intestine is an example of secondary active transpo i.e., the energy of glucose transpo is provided indirectly by active transpo of Na+ out of cell. Because glucose & Na+ share the same cotranspoer (sympo) the sodium dependent glucose transpoer (SGLT, Na+ - glucose cotranspoer, cross cell membrane 12 times), the high concentration of Na+ on mucosal surface of cells facillitate & low concentration inhibit hexose sugar influx into epithelial cells.

So the answer to this question is C


Instruction:
Process cochleariformis attaches to:
A. Tendon of tensor tympani
B. Basal turns of helix
C. Handle of malleus
D. Incus

Response:
Anterior to oval window lies a hook-like projection called the processus cochleariformisQ for tendon of tensor tympani. The cochleariform process marks the level of the Genu of the facial nerve which is an impoant landmark for surgery of the facial nerve

So the answer to this question is A


Instruction:
M-spike in multiple myeloma is due to?
A. IgM
B. IgA
C. IgG
D. IgD

Response:
In Multiple myeloma laboratory analyses reveal increased levels of Igs in the blood and/or light chains (Bence-Jonesproteins) in the urine. The most common monoclonal Ig ("M protein") is IgG (approximately 55% ofpatients), followed by IgA (approximately 25% of cases).

So the answer to this question is C


Instruction:
All the following are contents of suboccipital triangle EXCEPT:
A. Veebral aery
B. Dorsal ramus of C1 nerve
C. Sub occipital plexus of vein
D. Occipital aery

Response:
Contents of suboccipital triangle are : veebral aery (3rd pa), suboccipital nerve (dorsal ramus of C1) and suboccipital venous plexus. Occipital aery lies in occipital (not suboccipital) triangle. Suboccipital triangle is a muscular space situated deep on posterior aspect of the neck, below occipital bone, one on each side of the midline and bounded by four suboccipital muscles.

So the answer to this question is D


Instruction:
Hypocalcemia results in: September 2010
A. Absent tendon reflexes
B. Shoened QT interval in ECG
C. Reduced excitability of nerves and muscle cells
D. Tetany

Response:
Ans. D: TetanyFeatures of hypocalcemia:Petechia which appear as one-off spots, then later become rashes.Perioral tingling and paraesthesia, 'pins and needles' sensation over the extremities of hands and feet. This is the earliest symptom of hypocalcaemia.Tetany, carpopedal spasm are seen.Trousseau sign of latent tetany (eliciting carpal spasm by inflating the blood pressure cuff and maintaining the cuff pressure above systolic)Chvostek's sign (tapping of the inferior poion of the zygoma will produce facial spasms)Tendon reflexes are hyperactiveLife threatening complications- Laryngospasm- Cardiac arrythmiasECG changes include:- Prolonged QT interval- Prolonged ST interval

So the answer to this question is D


Instruction:
Hospital acquired organisms are all except ?
A. Staphylococcus
B. Acinobacter
C. Streptococcus
D. Pseudomonas

Response:
Ans. is 'b i.e., Acinobacter Common hospital acquired infections Bacteria Virus Fungus Protozoa . Staphylococci . HIV . Candida . E. histolytica . Streptococci . HBV . Aspergillus . Plasmodia . E. coli . HCV . Mucor . P. Carinii . Pseudomonas . CMV . Toxoplasma . Proteus . HSV * Klebsiella . Enteroviruses . Enterobacter * Serratia

So the answer to this question is B


Instruction:
A reduction in the total leucocyte count is called:
A. Leucocytosis
B. Leucopenia
C. Leucorrhoea
D. Leukemia

Response:
Leukopenia is a condition where a person has fewer white blood cells in their bloodstream than they should. Leukopenia is diagnosed with a blood test called a complete blood count or CBC.
A healthy white blood cell count is between 3,500 and 11,000 white blood cells per microliter. A person with leukopenia may have fewer than 3,500 white blood cells per microliter.
White blood cells are made in the bone marrow and are critical for the immune system. Having too few of them means the body is less able to fight off infections and diseases.

So the answer to this question is B


Instruction:
Increased airway resistance is/are caused bya)  Forced expirationb) Denser airc)  Low lung volumed) High lung volue
A. ab
B. bc
C. acd
D. abc

Response:
There is dynamic compression of the small airways during forceful expiration, resulting in increased airway resistance. When the air is denser, the airway resistance is more. Less volume of the lung also increases the airway resistance.

So the answer to this question is D


Instruction:
An 80-year-old person has started forgetting the names of familiar persons and places. There has been confabulation. He tends to forget whether he has had his meals. Clinical and neurological examination reveals no abnormality.CT scan of the brain showed symmetrical enlargement of lateral ventricles and wider sulci. The most likely diagnosis is-
A. Confusional state
B. Alzheimer's disease
C. Alcholol dementia
D. Chronic cerebrovascular insufficiency

Response:
None

So the answer to this question is B


Instruction:
All of the following are associated with supracondylar fracture of humerus, except-
A. It is uncommon after 15 yrs of age
B. Extension type fracture is more common than the flexion type
C. Cubitus varus deformity commonly results following malunion
D. Ulnar nerve is most commonly involved

Response:
Median nerve, especially anterior interosseous branch, is injured most commonly.

So the answer to this question is D


Instruction:
Who is the Founder of school of psychoanalysis and Psychotherapy is after the name of?
A. Bleuler
B. Freud
C. Kraeplin
D. Melanie Klien

Response:
Ans. b (Freud). (Ref. Psychiatry by Niraj Ahuja, 5th ed., 55, 210, 219)SIGMUND FREUDo 'Psychotherapy' is after his name.o Invention of 'psychoanalysis',o Described "Oedipus complex"Eugen bieulero Named schizophrenia o First introduced the term autism. o Coined the term ambivalenceKRAEPLINo Coined the term 'dementia precoxa'.ERIKSONo The eight-stage classification of human life.PSYCHOTHERAPHY# Psychotherapy is after the name of Freud.# Psychotherapy can be defined as the treatment by psychological means, of problem of an emotional nature in which a trained person (therapist) deliberately establishes a professional relationship with the patient to:# Remove, modify or retard existing symptoms.# Mediate disturbed patterns of behavior, &/or# Promote positive personality growth & development.# Psychotherapy can be done either by verbal or non-verbal means.Therapy/schoolProponentPsychoanalysisSigmund FreudAnalytical psychologyCarl Gustav JungTransactional analysisEric BerneClient-centered psychotherapyCarl r RogersHypnosisJames BraidGroup therapyJoseph PrattCognitive therapyAaron T BeckClassical conditioningIvan Petrovich PavlovOperant conditioningBurrhus Frederic SkinnerDual sex therapyWilliams mastersVirginia JohnsonPsychodramaJacob L MorenoCharacter analysisWilhelm Reich

So the answer to this question is B


Instruction:
Infant of HIV +ve mother, which should be done –
A. BCG vaccine should not be given
B. AZT therapy
C. Separation from mother
D. Other than BCG, all other vaccines are given

Response:
HIV infected mother can transmit the virus to fetus/infant during pregnancy, during delivery or by breast feeding.
Early diagnosis and antiretroviral therapy to mother and infant significantly decrease the rate of intrapartum and perinatal transmission (Vertical transmission) of HIV infection.
Zidovudine treatment of HIV infected pregnant women from the beginning of the second trimester through delivery and of infant for 6 weeks following birth decreases the rate of transmission from 22.6 % to < 5%
Single dose of nevirapine given to the mother at the onset of labor followed by a single dose to the newborn within 72 hours of birth decreased transmission by 50%. This is the preferred regimen now in developing countries.

So the answer to this question is B


Instruction:
A 34 year old man diagnosed of having H. pylori infection after biopsy. Where can H. pylori be found in the stomach?
A. Epithelial lining
B. Mucous layer
C. Lamina propria
D. Local toxins

Response:
H. pylori is a noninvasive organism that colonizes the mucous layeroverlying gastric epithelium. Factors impoant in the organism's ability to colonize the stomach include its flagellae, which facilitate its locomotion; its ability to adhere to the mucous layer; and its production of urease.

So the answer to this question is B


Instruction:
A lady presented with hematuria was found to have stage II Transitional cell carcinoma of bladder. Which of the following statements about management of her condition is true
A. Cystoscopic falguration is the standard treatment
B. 70% chance of requiring cystectomy in 5 yrs after TURP
C. History of smoking is not a risk factor
D. There is no role of chemotherapy

Response:
.

So the answer to this question is B


Instruction:
Aortic diameter less than--cm at the level of the renal arteries should raise the suspicion of hypovolemic shock
A. 12 mm
B. 15 mm
C. 20 mm
D. 25 mm

Response:
Ans AThe CT criteria for shock bowel are bowel-wall thickening greater than 3 mm and mucosal enhancement greater than the psoas muscle. The finding of a collapsed IVC was defined as an anteroposterior diameter of less than 9 mm on at least three contiguous sections. A collapsed aorta was defined as an anteroposterior diameter less than 1.3 cm at the levels of 2 cm above and 2 cm below the renal arteries. CT findings of shock pancreas were peripancreatic fluid and variable pancreatic enhancement. Hypoenhancement of the spleen and liver was assessed subjectively. Hypotension was defined as a systolic blood pressure less than 90 mm Hg or a diastolic blood pressure less than 60 mm Hg.

So the answer to this question is A


Instruction:
Ferruginous bodies are seen in
A. Silicosis
B. Byssinosis
C. Asbestosis
D. Bagassosis

Response:
Inorganic paicles may become coated with iron protein complexes and ate called Ferruginous bodies A ferruginous body is a histopathologic finding in interstitial lung disease suggestive of significant asbestos exposure (asbestosis). Asbestos exposure is associated with occupations such as shipbuilding, roofing, plumbing, and constructio Refer robbins 9/e

So the answer to this question is C


Instruction:
True about caisson's disease -
A. O2 release from tissues
B. CO2 release from tissues
C. N, release from tissues
D. H, release from tissues

Response:
Ans. is 'c' i.e., N, release from tissues Caisson's diseaseo Caisson's disease, (also called decompression sicknessQ, Bendst Diver's Paralysis, Dysbarism) is a particular form of gas embolism, which occurs when individuals are exposed to sudden lowering of atmospheric pressure like - rapid ascend of scuba and deep sea divers0, individuals in unpressurized aircraft in rapid ascent (e.g., in pilotsQ), underwater construction workers and extra-vehicular activity from spacecraft.o When air is breathed at high pressure (e.g., during a deep sea dive), increased amounts of gas (particularly nitrogen) become dissolved in the blood and tissues. If the diver then ascends (depressurizes) too rapidly, the nitrogen expands in the tissues and bubbles out of solution in the blood to form gas emboli.o Since bubbles can form in or migrate to any part of the body, it can produce many symptoms, and its effects may vary from joint pain, ischemia in tissues to paralysis and death,o The rapid formation of gas bubbles within skeletal muscles and supporting tissues in and about joints is responsible for the painful condition called the bends. In the lungs, edema hemorrhages, and focal atelectasis or emphysema may appear, leading to respiratory distress, the so-called chokes,o Treatment of gas embolism requires placing the individual in a compression chamber where the barometric pressure may be raised, thus forcing the gas bubbles back into solution. Subsequent slow decompression theoretically permits gradual resorption and exhalation of the gases so that obstructive bubbles do not re-form.

So the answer to this question is C


Instruction:
Bronchogenic cysts occurs commonly in-
A. Post mediastinum
B. Sup.mediastinum
C. Carina
D. Periphery of lung

Response:
Ans. is 'c' i.e., Carina Bronchogenic cysts o Bronchogenic cyst is a congenital lung defect, which develops from abnormal lung budding of primitive foregut. o Most of the bronchogenic cyst arise in the mediastinum, where they are usually located in the mid mediastinum near carina. o About 15% of Bronchogenic cyst also occurs in pulmonary parenchyma. o When located in the lung they are more common in right lung and lower lobe. o They are lined by cuboidal or ciliated columnar epithelial cells and are usually filled with mucoid material.

So the answer to this question is C


Instruction:
4 year old child with severe wasting and voracious apetite without pedal edema -
A. Kwashiorkar
B. Marasmus
C. Both
D. None

Response:
Ans. is 'b' i.e,, Marasmus o See explanation of previous question.

So the answer to this question is B


Instruction:
The following features is common to both cytotoxic T cell and NK cell
A. Synthesis antibody
B. Require antibiodies to be present for action
C. Effective against virus infected cells
D. Recognise antigen in association with HLA class2 markers

Response:
Ref Harrison 17/e p2024-2028,9/e p192 Natural killer cells, or NK cells, are a type of cytotoxiclymphocyte critical to the innate immune system. The role NK cells play is analogous to that of cytotoxic T cells in the veebrate adaptive immune response. NK cells provide rapid responses to virus-infected cells, acting at around 3 days after infection, and respond to tumor formation. Typically, immune cells detect the major histocompatibility complex (MHC) presented on infected cell surfaces, triggering cytokine release, causing lysis or apoptosis. NK cells are unique, however, as they have the ability to recognize stressed cells in the absence of antibodiesand MHC, allowing for a much faster immune reaction. They were named "natural killers" because of the initial notion that they do not require activation to kill cells that are missing "self" markers of MHC class 1. This role is especially impoant because harmful cells that are missing MHC I markers cannot be detected and destroyed by other immune cells, such as T lymphocyte cells.

So the answer to this question is C


Instruction:
Statutary rape is considered below the age
A. 16 years
B. 18 years
C. 20 Years
D. 22 years

Response:
None

So the answer to this question is B


Instruction:
True about mycoplasma -
A. Obligate intracellular organism
B. Penicillin is effective treatment
C. Require cholesterol for growth
D. Have thick cell wall

Response:
None

So the answer to this question is C


Instruction:
This manouver helps to
A. Decrease risk of aspiration
B. Improve laryngoscopic view
C. Open the airway
D. Stabilize ET tube position

Response:
This is BURP manouver . here thyroid cartilage is pushed back up with right pressure to improve laryngoscopic view.

So the answer to this question is B


Instruction:
If two buds of pancreas do not fuse, the anomaly is
A. Ectopic pancreas
B. Pancreatic divisum
C. Annular pancreas
D. Accessory pancreas

Response:
Pancreatic divisum is a congenital anomaly in the anatomy of the ducts of the pancreas in which a single pancreatic duct is not formed, but rather remains as two distinct dorsal and ventral ducts. imageref- researchgate.net

So the answer to this question is B


Instruction:
Complications encountered in intrauterine growth retardation (IUGR) babies include:
A. Perinatal asphyxia
B. Hypoglycemia
C. Polycythemia
D. All of the above

Response:
Ans. D. All of the aboveBabies who are IUGR have failed to attain their genetic potential of growth. Overall, perinatal mortality and subsequent morbidity have been found to be 8-10 times higher in IUGR fetuses compared to their age appropriate counterparts.Complications of IUGR infants include: Increased mortality, perinatal asphyxia, hypothermia, hypoglycemia, meconium aspiration syndrome, persistent pulmonary hypertension of newborn, poor maintenance of nutrition and growth, polycythemia, hyperbilirubinemia, infection, necrotizing enterocolitis, pulmonary hemorrhage and congenital malformations.

So the answer to this question is D


Instruction:
What will be the Bmi of a male whose weight is 89 kg and height is 182cm -
A. 26
B. 30
C. 33
D. 36

Response:
Park's textbook of preventive and social medicine 23rd edition. *BMI : wt (kg)/ht (m) square. :89/1.89/1.89 =26.868

So the answer to this question is A


Instruction:
Thoracic duct opens into ?
A. Subclan vein
B. Internal jugular vein
C. Right brachiocephalic vein
D. Left brachiocephalic vein

Response:
Left brachiocephalic vein

So the answer to this question is D


Instruction:
45 years male, blood sample gives purple-brown colour in Ehrich&;s solution, the substance is
A. Urobilinogen
B. Conjugated bilirubin
C. Unconjugated biliburin
D. Haemosedrin

Response:
Bilinogens(UBG and SBG) react with Ehrlich solution to form red/brown color. Ehrlich&;s aldehyde reagent(para dimethylamino benzaldehyde) don&;t react with any other forms of bilirubin or hemosiderinRef: Textbook of biochemistry for medical students, seventh edition, page no: 279

So the answer to this question is A


Instruction:
Causes of hyperkalemia includes all except -
A. Crush syndrome
B. Haemolysis
C. Renal failure
D. Intestinal obstruction

Response:
None

So the answer to this question is D


Instruction:
Millary mottling on X-ray chest is seen in:
A. Histoplasmosis
B. Sarcoidosis
C. Secondaries from Ca. colon
D. All

Response:
A i.e. Histoplasmosis; B i.e. Sarcoidosis; C i.e. Secondaries from CA colon

So the answer to this question is D


Instruction:
Typically bilateral inferior lens subluxations of the lens is seen in:
A. Marfan's syndrome
B. Homocystinuria
C. Hyperinsulinemia
D. Ocular trauma

Response:
B i.e. Homocystinuria Uniocular diplopia together with finding of shining golden crescent on oblique and dark black crescent line on coaxial illuminationQ (both b/o edge of subluxated lens) suggest a diagnosis of subluxated ectopia lentis. Congenital rubella presents with deafness, cardiac malformation and cataract Q. Other defects include glucoma, salt pepper retinopathy, microcephalus, cerebral palsy, intrauterine growth retardation, hepatosplenomegaly, mental & motor retardation. (but not ectopia lentis or lens dislocation.) Q Ectopia lentis (or displacement of lens) may be seen in Marfan's syndrome (bilateral supero-temporal)Q, homocystinuria (bilateral infero-nasal or infero temporal)Q and sulfite oxidase deficiencyQ. Ectopia Lentis (Displaced Lens) - It refers to displacement of lens from its normal position (in patellar fossa. Paial displacement of lens (i.e. still remaining in pupillary area) is called subluxation whereas, completely dislocated lens rendering the pupil aphakia is k/a dislocation (luxated). - It is usually a bilateral conditionQ caused by extensive zonular malformation. The lens is displaced in the opposite direction to the weak zonules (usually superomedially)Q i.e. mostly upwards and bilateral. - Ectopia lentis may be congenital or acquired. The condition is often hereditary (congenital)Q and usually presents in childhood or young adulthood. - The clinical features of subluxated lens include poor vision, uniocular diplopia, glare, myopia, astigmatism, reduced amplitude of accomodation and sudden loss of visionQ. Signs include an obvious lens displacement, however, this may not be visible through an undilated pupil. The lens is small but the edge and zonules are generally invisible until the pupil is dilated. So the pupil should be dilated to assess the extent of displacement and intactness of zonules. Fluctuating anterior chamber depth and vision, iridodinesis/ iridodonesis (i.e. tremulous iris) and phacodinesis/ phacodonesis (i.e. tremulous or a visibly mobile lens) accentuated by eye movements. The lens may displace completely into anterior chamber or vitreous or become cataractous. Vitreous may herniate forward into anterior chamber. Pupillary block glucoma commonly occurs d/t anterior herniated vitreous or subluxated lens. Posterior displacement of lens into vitreous may cause lens induced uveitis. - In Marfan's syndrome because of frequently intact zonules, the accomodation in retained. Whereas, in homocystinuria the zonules containing high levels of cysteine, disintigrate so the accomodation is often lost.

So the answer to this question is B


Instruction:
Vaccine contraindicated in pregnancy is the following:
A. Diphtheria
B. Hepatitis-B
C. MMR
D. Killed polio vaccine

Response:
Killed virus, toxoid, or recombinant vaccines may be given during pregnancy. Diphtheria and tetanus toxoid, hepatitis B vaccine series, and killed polio vaccine may be administered during pregnancy to women at risk. Live attenuated vaccines (varicella, measles, mumps, polio, and rubella) should be given 3 months before pregnancy or postpaum. Live virus vaccines are contraindicated in pregnancy secondary to the potential risk of fetal infection. Secondary prophylaxis with immune globulin is recommended for pregnant women exposed to measles, hepatitis A, hepatitis B, tetanus, chicken pox, or rabies. Ref: Bernstein H.B., VanBuren G. (2013). Chapter 6. Normal Pregnancy and Prenatal Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

So the answer to this question is C


Instruction:
All are risk factors for preterm delivery except :
A. Absence of fetal fibronectin at < 37 weeks
B. Previous history of preterm baby
C. Asymptomatic cervical dilatation
D. Chylamydial infection of genital tract

Response:
Absence of fetal fibronectin at < 37 weeks

So the answer to this question is A


Instruction:
Which of the following vasculitis is ANCA negative
A. Microscopic polyangitis
B. Churg straus syndrome
C. Granulomatosis with polyangitis
D. Polyarteritis nodosa

Response:
ANCAs are not seen in Polyarteritis nodosa.

So the answer to this question is D


Instruction:
Corneal endothelium is embryologically derived from
A. Neural crest
B. Ectoderm
C. Mesoderm
D. Endoderm

Response:
Endothelium, Descemet&;s membrane, stroma and Bowman&;s layer are derived from the fibrous layer of mesenchyme lying anterior to the optic cup . The corneal endothelium is embryologically derived from the neural crest. The corneal endothelium is attached to the rest of the cornea through Descemet&;s membrane, which is an acellular layer composed mostly of collagen IV. Reference : A K KHURANA Comprehensive Ophthalmology edition 4,page-8

So the answer to this question is A


Instruction:
Earliest detected fetal anomaly by USG:
A. Spinal anomaly
B. Craniofacial anomaly
C. Cardiac anomaly
D. Limb anomaly

Response:
Ans b Ref: Sheila Balakrishnan page 5812nd trimester scan done forA, Nuchal translucencyB, Structural anomaliesEarliest anomaly to be picked up is anencephaly at 10 wks.Some skeletal anomalies- limb reduction defects gross abdominal wall defects- encephalocele, cystic hygroma can also be picked up

So the answer to this question is B


Instruction:
Which of the following Conjunctivitis can also involve intact cornea?
A. Acute mucopurulent conjunctivitis
B. Acute membranous conjunctivitis
C. Acute purulent conjunctivitis
D. Angular conjunctivitis

Response:
Acute purulent conjunctivitis caused by Gonococci. Gonococus can penetrate intact cornea.

So the answer to this question is C


Instruction:
Cork-screw appearance of esophagus:
A. Achalasia cardia
B. Cancer esophagus
C. Schatzki ring
D. DES

Response:
Ans. (d) DESRef: Bailey and Love 26th edition, Page 1017 Diffuse Esophageal Spasm:* Hyper Motility disorder characterized by chest pain and dysphagia* Most common finding is cork screw esophagus in lower 2/3rd esophagus commonly.* Medical treatment is primary: Calcium channel blockers, vasodilators, endoscopic dilatation* Long myotomy up to arch of aorta is done in cases with dysphagia only. Chest pain will not improve with surgery

So the answer to this question is D


Instruction:
T3 Stage in oral cancer is -
A. Tumour > 2cm in greatest dimension
B. Tumour > 4cmin greatest dimension
C. Tumour > 6cmin greatest dimension
D. Tumour > 8cmin greatest dimension

Response:
Ans. is 'b' i.e., Tumour > 4cmin greatest dimension Primary tumor staging of oral cavity carcinomaT0No evidence of primary tumorT1Tumor is <2 cm in greatest dimensionT2Tumor is > 2 cm and < 4 cm in greatest dimensionT3Tumor > 4 cm in greatest dimensionT4a (lip)Primary tumor invading cortical bone, inferior alveolar nerve, floor of mouth, or skin of face (e.g., nose or chin)T4a (oral cavity)Tumor invades adjacent structures (e.g., cortical bone, into deep tongue musculature, maxillary sinus) or skin of faceT4b (lip & oral)Tumor invades masticator space, pterygoid plates, or skull base and/or encases the internal carotid artery

So the answer to this question is B


Instruction:
The first step in public health procedure is-
A. Analysis of programme
B. Planning of programme
C. Situation analysis
D. Appraisal of programme

Response:
* The steps in public health procedure are as follows- 1) Survey. 2) Situation analysis. 3) Programme planning. 4) Programme operation. 5) Financing. 6) Programme appraisal.

So the answer to this question is C


Instruction:
Which tumor is not seen in AIDS:
A. Kaposi sarcoma
B. GI adeno carcinoma
C. Non-Hodgkin's lymphoma
D. Astrocytoma

Response:
Ans. is 'D' Astrocytoma Brain tumours associated with AIDS is CNS lymphoma. Astrocytoma has no association with AIDS infection.Cancers associated with HIV infection are:-Kaposi sarcoma* (Most common)Non Hodgkins lymphoma*Hodgkins lymphoma*Multiple myeloma*Leukemia*Melanoma.*Cervical cancer*Brain cancer (CNS lymphoma)*Testicular cancerAnal cancer*Oral cancer*Burkin' s lymphoma*

So the answer to this question is D


Instruction:
Police inquest is A/E
A. Senior head constable can investigate
B. Most common inquest
C. Panchnama has to be signed by IC)
D. 10 may not summon

Response:
D i.e. 10 may not summon

So the answer to this question is D


Instruction:
Primary action of inferior oblique -
A. Abduction
B. Adduction
C. Extorsion
D. Elevation

Response:
Ans. is 'c' i.e., ExtorsionMusclePrimary actionSecondary actionTertiary actionMRLRSRIRSOIOAdductionAbductionElevationDepressionIntensionExtorsion--IntorsionExtorsionDepressionElevation--AdductionAdductionAbductionAbduction

So the answer to this question is C


Instruction:
"Crocodile tears syndrome" (spontaneous lacrimation during eating because of misdirection of regenerating autonomic nerve fibers) occurs after injury to which of the following nerves?,
A. Facial nerve proximal to the geniculate ganglion
B. Auriculotemporal nerve
C. Chorda tympani in the infratemporal fossa
D. Facial nerve at the stylomastoid foramen

Response:
"Crocodile tears syndrome" (lacrimation during eating) is caused by a lesion of the facial nerve proximal to the geniculate ganglion. This happens due to misdirection of regenerating parasympathetic fibers, which formerly innervated the salivary glands, to the lacrimal glands.

So the answer to this question is A


Instruction:
Direct opening in the right atrium with
A. Anterior cardiac vein
B. Oblique vein
C. Middle cardiac vein
D. Great cardiac vein

Response:
All veins of hea except the anterior cardiac veins and the venae cordis minimi drain into the coronary sinus which opens into the right atrium.The anterior cardiac veins and the venae cordis minimi open directly into the right atrium. BD CHAURASIA'S HUMAN ANATOMY .VOLUME 1.FIFTH EDITION.Page no-254

So the answer to this question is A