Instruction:
Accidendal chocking of respiratory passage by bolus of food -
A. Gaging
B. Overlying
C. Cafe coronary
D. Burking

Response:
Ans. is 'c' i.e., Cafe coronary TermsMeaningAutoerotic hangingVictims usually young males (with masochism or transvestism) enhance sexual pleasure by compressing the blood vessels of neck by any means.LynchingWhen several persons acting jointly and illegally over power an individual and hang him.Mugging (choke-holding)Strangulation of victim's neck against the forearm.GarrottingVictim is attacked from back without warning and strangled by throwing a ligature over the neck and tightening it quickly.Spanish windlassIt is a type of garrottingQ. It used to be the official mode of execution in Spain. In this an iron callar around the neck was tightened by a screw for strangling.BansdolaNeck is compressed between two sticks or hard objects. ThrottlingManual strangulation effected by hand.Burking method of somethering used by Burk and Hare and traumatic asphyxiaBurk used to sit on chest covering with one hand the mouth and nostril and pushing upthe jaw with other hand and Hare used to pull him round the room by feet.SomtheringAsphyxia caused by mechanical occlusion of external are passage.ChockingAsphyxia caused by mechanical occlusion of enternal are passage.GagingChocking by preventing air entry through mouth and nostril by filling cloth etc in mouthCafe coronaryAccidental chocking by bolus of food obstructing larynx.Q Death is mostly due to asphyxia or less commonly due to reflex cardiac arrest caused by stimulation of laryngeal nerve endings.Overlying (compression suffocation)Compression of chest prevents breathing. It occurs when mother shares a bed with infant.

So the answer to this question is C


Instruction:
An example of high level disinfectant is
A. Phenol
B. Glutaraldehyde
C. Alcohol
D. Povidone Iodine

Response:
None

So the answer to this question is B


Instruction:
Which of the following is not a part of lower motor neuron?
A. Anterior nerve root
B. Peripheral ganglia
C. Peripheral nerve
D. Anterior horn cells

Response:
Ans. B Peripheral gangliaRef: Gray's, 41st ed. pg. 231, 303Lower motor neuron (LMN): It consists of-* Anterior horn cells or homologous cells in brainstem* Anterior spinal nerve root* Peripheral nerve

So the answer to this question is B


Instruction:
All extra-ocular muscles are supplied by the oculomotor nerve except
A. Superior rectus
B. Inferior oblique
C. Lateral rectus
D. Medial rectus

Response:
The superior oblique is supplied by the trochlear nerve The lateral rectus is supplied by abducent nerve The superior rectus, inferior rectus, medial rectus and inferior oblique are supplied by occulomotor nerve Ref BDC volume 3,sixth edition pg 208

So the answer to this question is C


Instruction:
Pralidoxime is ineffective in case of which poisoning:
A. Organophosphorous
B. Carbaryl
C. Both of the above
D. None of the above

Response:
Carbaryl

So the answer to this question is B


Instruction:
There is a real relationship between the incidences of fracture of anterior teeth and the
A. caries in those teeth
B. hardness of the enamel
C. hardness of dentin
D. protrusion of those teeth

Response:
None

So the answer to this question is D


Instruction:
Tamoxifen predisposes to :
A. Endometrial cancer
B. Ovarian cancer
C. Cervical cancer
D. Vaginal cancer

Response:
In Breast Cancer although tamoxifen improves the survival period, it causes endometrial hyperplasia and cancer, and requires regular monitoring with ultrasound study of endometrium and endometrial biopsy. Reference: Shaw's Textbook of Gynaecology 16th edition page no 540

So the answer to this question is A


Instruction:
In transitional phase of secretory stage:
A. Ameloblasts undergo apoptosis
B. 25% of cells die during transitional phase
C. Cell volume and organelle decreases
D. All of the above

Response:
Transitional Phase of the Presecretory Stage

Ameloblasts undergo significant morphological changes.
Height of cell reduces.
Cell volume and organelle decreases.
Ameloblasts undergo programmed cell death (Apoptosis)
25 of cells die during during transitional phase.

So the answer to this question is D


Instruction:
In cleft lip surgery rule of 10 says
A. 10 weeks of age, having 10 dL/mg Hb and weight 10 pounds
B. 10 weeks of age, having 10 dL/mg Hb and weight 10 kgs
C. 10 months of age, having 10 dL/mg Hb and weight 10 pounds
D. 10 months of age, having 10 dL/mg Hb and weight 10 kgs

Response:
None

So the answer to this question is A


Instruction:
All of the following drugs are used in treatment of dementia except?
A. Memantine
B. Duloxetine
C. Galantamine
D. Donepezil

Response:
Ans. B. DuloxetineManagement of patient with Dementia:Mini Mental status examination (MMSE)- score of <24 suggestive of dementia* Treat the cause* CHOLINESTERASE INHIBITORS: FDA for treatment of AD cholinesterase inhibitors: Tacrine, donepezil, rivastigmine, and galantamine. Reversible inhibitors of enzyme acetylcholinesterase, which degrades ACh in synaptic cleft, thereby increasing availability of intra synaptic ACh.* MEMANTINE: noncompetitive NMDA receptor antagonist that may modulate excitatory signaling & have neuro- protective actions. FDA approved for use only in moderate to severe AD. Has demonstrated efficacy for both cognitive & functional improvements over placebo.

So the answer to this question is B


Instruction:
Best radiolabelled marker for DNA replication is
A. Ribose
B. Thymidine
C. Phosphate
D. Uracil

Response:
Nucleic acids are readily labeled with tags that facilitate detection or purification. A variety of enzymatic or chemical methods are available to generate nucleic acids labeled with radioactive phosphates, fluorophores, or nucleotides modified with biotin or digoxygenin for example.

So the answer to this question is B


Instruction:
Arlt's line is seen in-
A. Vernal keratoconjunctivitis
B. Pterygium
C. Ocular pemphigoid
D. Trachoma

Response:
Arlt's line is seen in trachoma due to conjuctival scrarring,which may be irregular,star shaped or linear. this linear scar present in the sulcus subtarsalis is called Al's line Ref ; A K KHURANA Comorehensive Ophtalmology edition 4,page-69 ref img

So the answer to this question is D


Instruction:
The Broca's area is situated in the
A. Temporal lobe
B. Posterior part of Inferior frontal gyrus
C. Occipital calcarine fissure
D. Mammillary body region

Response:
(B) Inferior frontal gyrus # BROCA'S AREA is a section of the human brain that is involved in language processing, speech or sign production, and comprehension.> Broca's area is located in the opercular and triangular sections of the inferior frontal gyrus of the frontal lobe of the cortex.> Broca's and Wernicke's areas are found unilaterally in the brain (left hemisphere).> Broca's area comprises Brodmann area 44 and (according to some authorities) Brodmann area 45.> Broca's Area is connected to Wernicke's area by a neural pathway called the arcuate fasciculus.

So the answer to this question is B


Instruction:
Thumb Sign is seen in-
A. Epiglottitis
B. Layngitis
C. CA Larynx
D. Mediastinitis

Response:
Ans. is 'a' i.e., Epiglottitis o Thumb sign (thickening of epiglottis) and vallecula sign are seen in epiglottitis.

So the answer to this question is A


Instruction:
A 28 year old male admitted in the hospital with a history of vague pains. His examination revealed many scars of previous surgeries. He was very curious about knowing his diagnosis and was persistently asking for various diagnostic procedures and biopsy. He gave the past history of gall stone & appendicitis pain diagnosed by previous doctors, but the history regarding this was inappropriate and semed to be manipulative. There were no previous records suggesting this diagnosis. The probable diagnosis is:
A. Hypochondriasis
B. Somatization disorder
C. Conversion disorder
D. Factitious disorder

Response:
D i.e. Factitious disorder

So the answer to this question is D


Instruction:
All are involved in fast axonal transpo, except
A. Kinesin
B. Dynein
C. Lysosomes
D. Neurofilaments

Response:
In axonal transpo, the protein kinesin, with a myosin-like ATPase activity, uses hydrolysis of ATP to move vesicles down the axon toward the positive end of the microtubular formation. Flow of materials in the opposite direction, toward the negative end, is powered by cytosolic dynein, another protein with ATPase activity. Similarly, axonemal dyneins power ciliary and flagellar movement. Another protein, dynamin, uses GTP and is involved in endocytosis. Kinesins, dyneins, dynamin, and myosins are referred to as molecular motorsReference: Harper biochemistry 30th edition page no 665

So the answer to this question is D


Instruction:
Dry mouth during antidepressant therapy is caused by blockade of -
A. Muscarinic acetylcholine receptors
B. Serotonergic receptors
C. Dopaminergic receptors
D. GABA receptors

Response:
Ans. is 'a' i.e., Muscarinic acetylcholine receptors "Blurred vision, dry mouth, urinary hesitancy or retention, and constipation represent the most common antimuscarinic complaints".

So the answer to this question is A


Instruction:
All the following statements are true for influenza viruses except:
A. Helical symmetry
B. Single stranded non segmented RNA
C. Haemagglutinin and neuraminidase spikes present
D. RNA dependent RNA polymerase

Response:
Influenza viruses show following features: 1. Influenza viruses are spherical or filamentous,posses helical symmetry, enveloped paicles 80-120 nm in diameter. 2. Influenza virus is composed of a characteristic segmented single-stranded RNA genome, a nucleocapsid, and an envelope. 3. The viral genome is a single-stranded antisense RNA. The genome consists of an RNA-dependent RNA polymerase, which transcribes the negative-polarity genome into mRNA. 4. The genome consists of eight segments. These segments code for different proteins which are NS1, NS2, NP, M1, M2, M3, HA, and NA. 5. Two types of spikes or peplomers project from the envelope: (a) the triangular hemagglutinin (HA) peplomers and (b) the mushroom-shaped neuraminidase (NA) peplomers.

So the answer to this question is B


Instruction:
Chickengunya fever is transmitted by which mosquito?
A. Anopheles
B. Culex
C. Aedes
D. Any of the above

Response:
Ans. is 'c' i.e., Aedes Mosquito speciesDisease transmittedAnophelesMalaria, filariasis (not in India), arboviruses of febrile and encephalitic diseaseCulexBaneroftian filariasis, Japanese encephalitis, West-Nile fever, St. Louis encephalitis, western equine encephalitisAedesYellow fever (in Africa), Dengue, Dengue haemorrhagic fever, nChickengunya haemorrhagic fever, Rift valley fever, Sindbis, Baneroftian filariasis (not in India)MansoniaBrugian filariasis, Baneroftian filariasis, Chickengunya

So the answer to this question is C


Instruction:
Full blown Immunodeficiency syndrome is ?
A. High viral titres with low CD 4 count
B. Low viral titres with low CD 4 count
C. Low viral titres with high CD 4 count
D. High viral titres with high CD 4 count

Response:
Ans. is 'a' i.e.,viral titres with low CD 4 count

So the answer to this question is A


Instruction:
Most common cause of gallbladder fistula is
A. Liver abscess aspiration
B. Laparoscopic surgery
C. Gallstones
D. Trauma

Response:
Internal fistulas are spontaneous, rare and occur without a significant collection of bile External fistulas are common and are often caused by iatrogenic injury after operation, invasive procedures or trauma involving the biliary tract Etiology External fistula Bile leakage from the cystic duct remnant Central hepatectomy and caudate resection. Difficult cases of open cholecystectomy Hepatic cryotherapy or harmonic scalpel use Internal fistula Calculous biliary tract disease (90%) Duodenal ulcer (6%) Neoplasm, trauma, Parasitic infestation and congenital anomalies Ref: Sabiston 20th edition Pgno :1507

So the answer to this question is C


Instruction:
In submandibular gland excision all of the following nerves may be affected except
A. Lingual nerve
B. Hypoglossal nerve
C. Glossopharyngeal nerve
D. Mandibular division of trigeminal nerve

Response:
Ans. (c) Glossopharyngeal nerveRef: Bailey and Love 27th edition Page 780The following nerves are at risk during Submandibular surgery:2 Superficial nerves:* Marginal Mandibular branch of Facial nerve* Rarely Cervical Branch of Facial nerve* 2 Deep Cranial nerves:* Lingual Nerve* Hypoglossal nerve

So the answer to this question is C


Instruction:
The following structure may be injured during the repair of an inguinal hernia
A. Ilioinguinal nerve
B. Lateral femoral urtaneous nerve
C. Iliohypogastic nerve
D. All of the above

Response:
None

So the answer to this question is D


Instruction:
Impedance denotes -
A. Site of perforation
B. Disease of cochlea
C. Disease of ossicles
D. Higher function disorder

Response:
“Impenance audiometry, measures the resistance of tympanic membrane and middle ear and also compliance of tympanic membrane and ossicular chain to sound pressure transmission. Tympanogram is the graphic representation of compliance and impendance of tympanic osscular system with air pressure changes.”
From above text it is quite obvious impedance is for disease of ossicles.

So the answer to this question is C


Instruction:
Levels of progesterone indicating unble pregnancy and ble intrauterine pregnancy are:
A. 5 ng/ml; 20 ng/ml
B. 10 ng/ml; 20 ng/ml
C. 5 ng/ml; 50 ng/ml
D. 10 ng/ml; 50 ng/ml

Response:
Serum progesterone concentration <5 ng/ml suggest a dying pregnancy Level > or = 20 ng/ml suppo the diagnosis of a healthy pregnancy. Ref: Williams Obs 24e pg 355.

So the answer to this question is A


Instruction:
All are features of neurosis except
A. Symptoms cause subjective distress
B. Contact with reality preserved
C. Personality disturbances
D. Insight is maintained

Response:
DSM-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive-compulsive personality disorder.

So the answer to this question is C


Instruction:
A new test to measure B.P has successive reading of same person as follow: 110/70 mmHg, 128/80 mmHg, 132/70 mmHg, 160/90 mmHg. The given test has, when mean B.P =120/80mmHg.
A. Low validity, Low reliability
B. Low validity, high reliability
C. High validity, low reliability
D. High validity, high reliability

Response:
None

So the answer to this question is A


Instruction:
In-situ DNA nick end labeling can quantitate:
A. Fraction of cells in apoptotic pathways
B. Fraction of cells in S phase
C. p53 gene product
D. bcr/abl gene

Response:
In situ DNA nick end - labeling In-situ method for detecting areas of DNA which are nicked during apoptosis. Terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL) is a method for detecting apoptotic cells that exhibit DNA fragmentation.

So the answer to this question is A


Instruction:
Which one of the following transmitter is not a protein/ glycopeptide/polypeptide?
A. Serotonin
B. Dynorphin
C. Substance-P
D. Met-enkephalin

Response:
(A) Serotonin # Serotonin (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in CNS & enterochromaffin cells in the gastrointestinal tract of animals including humans.> Dynorphin is a class of peptides produced by many different populations of neurons, which has some opiate-like activity.> It is thus classed as an endogenous opioid peptide.> Dynorphin functions primarily as a kappa opioid receptor agonist, meaning that it acts mainly at kappa opioid receptors.> Substance Pis a neuropeptide: a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator. It belongs to the tachykinin neuropeptide family.> Enkephalin is a pentapeptide ending with either leucine ("leu") or methionine ("met"). Both are products of the proenkephalin gene. Met-enkephalin is Tyr-Gly-Gly-Phe-Met. Leu-enkephalin has Tyr-Gly-Gly-Phe-Leu. Enkephalins play many roles in regulating pain.

So the answer to this question is A


Instruction:
Under NRHM, post-natal visits are conducted by ASHA as Home Based Newborn Care. In case of institutional delivery, these visits should be conducted by ASHA on days
A. 3,7,14,21,28,42
B. 1,3,7,14,21,42
C. 3,7,14,28,35,42
D. 3,7,10,14,21,42

Response:
Under NRHM, postnatal visits by ASHA are done k/a HBNC (Home based New-born care) 6-7 visits are done 6 visits in case of institutional delivery on day 3, 7, 14, 21, 28, 42 7 visits in case of home delivery on day 1, 3, 7, 14, 21, 28, 42

So the answer to this question is A


Instruction:
Asbestos used in -
A. Painting
B. Bakery
C. Cement production
D. Cotton industry'

Response:
Ans. is 'c' i.e., Cement production o Asbestos is the commercial name given to certain types of fibrous material.o They are silicates of varying composition; the silica is combined with such bases as magnesium, iron, calcium, sodium and the aluminium.o Asbestos is of two tvpes-serpentine or chrysolite variety and the amphibole type.o Ninety per cent of the world's production of asbestos is of the serpentine variety', which is hydrated magnesium silicate, the amphibole type contains little magnesium.o The amphibole type occurs in different varieties, e.g., crocidolite (blue), amosite (brown), and anthrophyllite (white),o Asbestos fibres are usually from 20 to 500 p in length and 0.5 to 50 p in diameter.o Asbestos is used in the manufacture of asbestos cement, fire-proof textiles, roof tiling, brake lining, gaskets and several other items.o Asbestos is mined in Andhra Pradesh (Cudappah), Bihar, Jharkhand, Karnataka, and Rajasthan - but most of it is imported from USSR, Canada. US and South Africa.

So the answer to this question is C


Instruction:
Differential blockade by central neuraxial blockade is achieved by-
A. Epidural Anaesthesia
B. Spinal Anaesthesia
C. Both
D. None of above

Response:
Spinal anaesthesia is used for Intraoperative anaesthesia only. Epidural used both for Intraoperative anaesthesia and post operative analgesia by decreasing the concentration of local anaesthetics. Depending on the level of anaesthesia required epidural catheter is put. Drug is put according to the required number of segment to be blocked. Differential block is achieved by only epidural . Different concentrations are used for blocking different nerve fibres. A differential block refers to the clinical phenomenon that nerve fibers with different functions have different sensitivities to local anesthetic blockade. This is well proven in both neuraxial and peripheral nerve blocks.

So the answer to this question is A


Instruction:
Commonest complication of chronic gastric ulcer is which of the following?
A. Adenocarcinoma
B. Perforation
C. Lymphoma
D. Haematenesis

Response:
GI bleed is the commonest complication of acute or chronic gastric ulcer. Outlet obstruction is the least commonest complication.

So the answer to this question is D


Instruction:
All of the following antihypeensives decrease plasma renin activity except-
A. Clonidine
B. Methyldopa
C. Atenolol
D. Chlorothiazide

Response:
Ans. is d i.e., Chlorothiazide

So the answer to this question is D


Instruction:
Which ion helps is resting membrane potential in neurons: September 2005, March 2013
A. Potassium
B. Calcium
C. Chloride
D. Sodium

Response:
Ans. A: Potassium In neurons resting membrane potential is about -70 mV, which is close to the equilibrium potential of potassium ions

So the answer to this question is A


Instruction:
A patient is brought with the history of intentionally consuming nail polish remover. Which of the following poisoning can be suspected?
A. Aniline
B. Turpentine
C. Sodium hypochlorite
D. Acetone

Response:
Common household poisons & toxic preparations : Nail polish removers Acetone Suntan lotions Denatured alcohol; methyl salicylate Moth balls Naphthalene Marking ink Aniline Ink remover sodium hypochlorite 0.5 % Fluorescent lamps beryllium Furniture polish Turpentine; petroleum hydrocarbons Paint remover Sodium hydroxide; lead acetate Shoe polish Aniline; nitrobenzene Crayons (wax) Para-nitroaniline.

So the answer to this question is D


Instruction:
Leiden mutation is associated with?
A. Factor IV
B. Factor V
C. Factor VIII
D. Factor IX

Response:
Leiden mutation is associated with factor 5.This is also a autosomal dominant disorder in which mutation lies in the replacement of arginine by glycine at position 506.Most common cause of thrombophilia. Reference :Harsh Mohan textbook of pathology 7th edition.Pg no.102

So the answer to this question is B


Instruction:
Endolymphatic decompression is seen in
A. Tinnitus
B. Acoustic neuroma
C. Meniere disease
D. Endolymphatic fistula

Response:
Surgical management of Meniere&;s disease-Conservative Surgeries-1.Endolymphatic sac decompression2.Cochleostomy3.Sacculotomy4.Cervical sympathectomyDestructive surgeries-1.Vestibular nerve section2.Labyrinthectomy3.Laser destruction of inner earRef: Hazarika; 3rd ed; Pg 196

So the answer to this question is C


Instruction:
When is Oxygen is effective during radiotherapy?
A. Just before staing the therapy
B. During and within microsecond of staing
C. After 5 min
D. After 10 min

Response:
The inhalation of oxygen during radiotherapy may increase the radiation kill effect on the tumor by counteracting areas of hypoxia-based radioresistance, and thus improve overall survival. Breathing normobaric oxygen before and during radiation therapy could increase the effectiveness of conventional radiotherapy for advanced squamous cell carcinomas of the head and neck. Hyperbaric oxygen is a mode of therapy in which the patient breathes pure, 100-percent oxygen at pressures two to three times greater than normal atmospheric pressure. This hyperoxygenation provides immediate suppo to poorly perfused tumor tissue in areas of compromised blood flow. These include radiation-damaged tissue that has lost blood supply and is oxygen deprived due to scarring and narrowing of the blood vessels within the area treated.

So the answer to this question is A


Instruction:
The earliest and most conclusive sign of intrauterine fetal death is / sure sign of IUD is:
A. Spalding sign
B. Intrafetal gas in areas of great vessels and hea
C. Crowding of ribs
D. Hyperflexion of spine

Response:
Intrafetal gas in areas of great vessels and hea

So the answer to this question is B


Instruction:
Nerve to pterygoid canal is formed from
A. Deep petrosal nerve + greater petrosal nerve
B. Facial nerve
C. Lesser superficial petrosal nerve
D. Lesser petrosal nerve

Response:
In the anterior pa of the foramen lacerum, the greater petrosal nerve unites with the deep petrosal nerve to form the nerve of the pterygoid canal which leaves the foramen by entering the pterygoid canal in the anterior wall of the foramen lacerum. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.

So the answer to this question is A


Instruction:
In general systolic BP in young females is less than that in the males of same age due to
A. Dietary habits
B. Oestrogen which prevents atherosclerosis
C. Progesterone effect on blood vessels
D. Low sympathetic activity

Response:
In females before menopause SBP is 4-5 mmhg less than that in the males of same age .After menopause SBP is 4-5 mmhg more than males of same age. This effect may be due to oestrogen which prevents atherosclerosis. Ref: page number 349 Textbook of physiology Volume 1 AK Jain 7th edition

So the answer to this question is B


Instruction:
Gold standard investigation for Gastro-esophageal reflux disease is
A. Lower esophageal pH monitoring
B. Lower esophageal & pharyngeal pH monitoring
C. Endoscopic examination of esophagus
D. X-ray pharynx

Response:
Answer- A. Lower esophageal pH monitoring24 Hour pH monitoring for reflux esophagitis24 hour pH monitoring (pH probe study), is the most sensitive test for diagnosis of gastroesophageal reflux. The test is performed by placing a catheter with a microelectrode that measures pH in the distal esophageal lumen for a duration of 24 hours. An episode of acid reflux usually is defined as an esophageal pH <4, for a duration greater than l5 - 20 seconds.

So the answer to this question is A


Instruction:
A man had infection with Extended spectrum betalactamase (ESBL) Klebsiela pneumonae is staed with cefotaxim plus amikacin therapy. On culture sensitivity after 48 hrs ESBL Klebsiela were found. Which of the following would be the best next course of action?
A. Continue with same antibiotic but in higher dose
B. Change ceftriaxone to ceftazidime
C. Sta imipenem therapy in place of ceftriaxone
D. Change Amikacin to Quinolones

Response:
Ans. is 'c' i.e., Sta imipenem therapy in place of ceftriaxone Carbapenems like imipenem are the only beta lactams reliably efficacious against ESBL producing bacteria. Drugs used for ESBL producing bacteria are: A) beta-lactamase inhibitor combination o Clavulinic acid +Amoxcillin Clavulanic acid + Ticarcillin o Sulbactam + ampicillin o Tazobactam + piperacillin B) Cefamycins Cefoxitin, Cefotetan Carbapenems : Imipenem, meropenem

So the answer to this question is C


Instruction:
Which of the following autosomal dominant disorder is characterized by formation of multiple gastrointestinal polyps along with pigmented lesions around the oral cavity
A. Peutz-Jeghers syndrome
B. Rotor syndrome
C. Gardner syndrome
D. Cowden disease

Response:
The Peutz-Jeghers syndrome is an autosomal dominant disorder that is characterized by the combination of hamaomatous polyps of the small intestine and pigmented lesions around the oral cavity. The most common site for the hamaomatous polyps is the jejunum. This syndrome is associated with a slight increased risk for the development of colon cancer. Ref:- Harsh mohan textbook of Pathology

So the answer to this question is A


Instruction:
Receptor on neural membrane that induces development of Glioma-
A. CD133
B. CD33
C. CD48
D. CD44

Response:
Therefore CD133 is also used as a tumor marker in gliomas.

So the answer to this question is A


Instruction:
HCN causes-
A. Histotoxic anoxia by inhibiting cytochrome oxidase
B. Histotoxic anoxia by inhibiting succinyl oxidase
C. Cytotoxic anoxia by inhibiting cytochrome oxidase
D. Cytotoxic anoxia by inhibiting succinyl oxidase

Response:
Ans. is `a' i.e., Histotoxic anoxia by inhibiting cytochrome oxidase Cyanide inhibits cellular respirationby inhibiting cytochrome oxidase, hence oxygen cannot be utilized by cells. Death is due to histotoxic (cytotoxic) anoxia. HCN is less effective if kept too long or if patient has achlorhydria. Fatal dose of HCN is 50-60 mg (or 300 mg NaCN/KCN). Potassium ferrocyanide is nonpoisonous salt of cyanide.

So the answer to this question is A


Instruction:
Vomiting centre
A. Area postrema
B. Suprachiasmatic
C. Medial nuclei
D. Laternal nuclei

Response:
Vomiting refers to the forceful expulsion of contents from stomach and intestine. Vomiting centre is situated in the reticular formation of medulla oblongata near the vagal nucleus. Vomiting may be initiated by either activation of vomiting centre or by an activation of the chemoreceptor trigger zone. It may be activated directly or through afferents: Direct activation of the vomiting centre Afferent impulses activating vomiting centre. Sequence of mechanical events of vomiting: Pre-ejection phase Retching phase Ejection phase. Ref: guyton and hall textbook of medical physiology 12 edition page number:442,443,444

So the answer to this question is A


Instruction:
Annular herald patch is seen in –
A. Psoriasis
B. P. alba
C. P. rosea
D. Nocardiasis

Response:
Mother patch or Herald patch is characteristic of P. rosea.

So the answer to this question is C


Instruction:
Lineage specific T Cell marker is
A. CD 1
B. CD 19
C. CD 3
D. CD 4

Response:
CD 3 is considered as lineage specific for Tcells.

So the answer to this question is C


Instruction:
Ratio of doors and windows to the floor for a classroom should be at least: September 2009
A. 20%
B. 25%
C. 30%
D. 35%

Response:
Ans. B: 25% Healthful school environment: Location-well connected Site-10 acres for higher elementary schools and 5 acres for primary schools with an additional 1 acre of land per 100 students. Structure-if possible, single storied and exterior wall thickness should be 10 inches Class room-No class room should accommodate more than 40 students. Per capita space for students in a class for students should not be less than 10 sq.ft. Furniture-if possible, single desks and chairs. Doors and windows-Combined door and window area should be at least 25% of the floor space, provision of cross ventilation and ventilators should not be less than 2% of the floor area. Colour-inside colour of the class room should be white Sufficient natural light Water supply Eating facilities Lavatory-1 urinal for 60 students and 1 latrine for 100 students.

So the answer to this question is B


Instruction:
All are the causes of intrauterine growth retardation except :
A. Anemia
B. Pregnancy induced hypeension
C. Maternal hea disease
D. None

Response:
Ans. is None

So the answer to this question is D


Instruction:
A 22 years old man presents with a solitary 2 cm space occupying lesion of mixed echogenecity in the right lobe of the liver on USG. The rest of the liver is normal. Which of the following test should be done next?
A. Ultrasound guided biopsy of the lesion
B. Hepatic scintigraphy
C. Hepatic angiography
D. Contrast enhanced CT scan of the liver

Response:
MRI as the diagnostic test of choice for hepatic hemangioma at most centers. Nuclear medicine studies may be used to confirm the diagnosis when a probable hemangioma is detected on ultra-sonography. Nuclear medicine studies may also help to clarify the nature of a lesion when the diagnosis is equivocal on CT or MRI. Percutaneous biopsy of a hepatic hemangioma carries an increased risk of hemorrhage. Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass. Hepatic angiography: The diagnostic accuracy of noninvasive tests has obted the need for hepatic aeriography in most cases.

So the answer to this question is B


Instruction:
Fatal dose of Pottasium cyanide is:
A. 5 mg
B. 10 mg C
C. 20 mg D.
D. 200 mg

Response:
200 mg

So the answer to this question is D


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

Response:
Antral sign or Holman-Miller sign (anterior bowing of posterior wall of maxillary sinus) on CT scan is pathognomic of JNA.

So the answer to this question is A


Instruction:
Which of the following is the least common cause of ambiguous genitalia in a female child?
A. Fetal placental steroid sulfatase deficiency
B. Fetal placental aromatase deficiency
C. Congenital adrenal hyperplasia
D. WNT-4 gene mutation

Response:
Fetal placental steroid sulfatase deficiency is an X-linked disorder therefore occur only in males. So it's the least common cause of ambiguous genitalia in a female child. Ref: Principles and practice of endocrinology and metabolism, Page 957 By Kenneth L. Becker page1061.

So the answer to this question is A


Instruction:
All are good prognostic factors for neuroblastoma except-
A. Trk-A expression absent
B. Absence of 1ploss
C. Absence of 17 p gain
D. Absence of 11 qloss

Response:
Ans. is 'a' i.e., Trk-A expression absent Prognostic Factors in NeuroblastomasVariableFavorableUnfavorableStage Age HistologyStage 1,2A, 2B,4S < 1 yearStage 3,4> 1 yearEvidence of schwannian stroma and gangliocytic differentiation Mitotic rateMitosis-karhorrhexis index Intratumoral calcification DNA ploidyPresent Low< 200/500 cellsPresentHyperdiploid or near-triploidAbsent High>200/500 cellsAbsentDiploid, near-diploid or near-tetraploid N-mycChromosome I7q GainChromosome Ip LossChromosome 11 q lossTrK-B expressionTrk-A ExpressionTelom erase ExpressionMRP ExpressionCD-44 ExpressionSerum Biochemical MarkersFerritinLactate DehydrogenaseNot amplifiedAbsentAbsentAbsentAbsentPresentLow or absentAbsentPresent Normal< 1500 U/mL.AmplifiedPresentPresentPresentPresentAbsentHighly expressedPresentAbsent Elevated>1500 U/mL.

So the answer to this question is A


Instruction:
The adenocarcinoma of esophagus-develops in ?
A. Barret's esophagus
B. Long standing achalasia
C. Corrosive stricture
D. Alcohol abuse

Response:
Ans. is 'a' i.e., Barrett's Esophagus Adenocarcinoma of esophagus almost always arises in Barrett's esophagus. Other option i.e. long standing achalasia, corrosive stricture and alcohol abuse are risk factors for squamous cell Ca of esophagus

So the answer to this question is A


Instruction:
All are true regarding Early Post-cibal syndrome except:
A. Distension of abdomen
B. Managed conservatively
C. Hypermotility of intestine is common
D. Surgery is usually indicated

Response:
Answer is D (Surgery is usually indicated) There is no role of striven., in management of post cibal syndromes. Both types of postcibal syndrome are treated by dietary measures including: - limitation of sugar containing liquids and solids, - elimination of liquids at meal time, and - eating of frequent small meals. In severe cases, symptoms may improve, with the somatostatin-analogue Octreotide. There is no role of surgery in management of post cibal syndromes.

So the answer to this question is D


Instruction:
Drugs that consistently reduce the potassium repolarising current and thereby prolong the action potential duration include all of the following except:
A. Amiodarone
B. Lignocaine
C. Quinidine
D. Sotalol

Response:
None

So the answer to this question is B


Instruction:
Most common malignant bone tumor-
A. Osteogenic sarcoma
B. Secondaries
C. Osteoma
D. Enchondroma

Response:
Secondaries are most common malignant bone tumor.
Osteogenic sarcoma is the most common primary malignant bone tumor.
Osteoma is most common benign bone tumor.

So the answer to this question is B


Instruction:
Which of the following seen in Psoriasis -
A. Pautrier's micro abscess
B. munro's micro abscess
C. Grenz zone
D. Hyperkeratosis

Response:
PSORIASIS:-
PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. Clinical features:-1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. Histopathology:-1. Hyperkeratosis 2. Parakeratosis- retention of nuclei3. Munro's microabscess in stratum corneum focal collection of neutrophils in stratum corneum4. Spongiform pustules of kogoj- collection of neutrophils in malpighian layer.5. Absence of granular layer.6. Regular elongation of rete ridges with branches and clubbing CAMEL FOOT APPEARENCE7. Thinning of suprapapillary epidermis 8. Elongation of dermal papillae with dilated and touous capillaries . IADVL textbook of dermatology page 1041

So the answer to this question is B


Instruction:
VDRL is an example of -
A. Slide agglutination
B. Tube agglutination
C. Slide flocculation
D. Tube flocculation

Response:
The Veneral Disease Research Laboratory test (VDRL) is a non-specific test for syphilis and it is a slide flocculation (precipitation) test.

So the answer to this question is C


Instruction:
False about osteoarthritis is -
A. Involves synovial joints
B. Progressive softening of the articular cartilage
C. It is an inflammatory arthritis
D. Marginal osteophytes are produced

Response:
Ans. is 'c' i.e., It is an inflammatory arthritis o Osteoarthritis (OA) is a chronic disorder of synovial joints in which there is progressive softening and disintegration of articular cartilage accompanied by new growth of cartilage and bone at the joint margins (osteophytes), cyst formation and sclerosis in the subchondral bone, mild synovitis and capsular fibrosis,o The term osteoarthritis is a misnomer as it is a non-inflammatory condition.o The right term is osteoarthrosis or degenerative joint disorder because it is a degenerative wear - and - tear process occuring in joints.

So the answer to this question is C


Instruction:
Maximum vital capacity decreased in
A. Prone
B. Supine
C. Trendelenberg
D. Left lateral

Response:
C i.e. Trendelenberg Trendelenburg (head down) position causes cephalad shift of abdominal viscera and diaphragm leading to marked decrease in lung capacities (i.e. vital capacity, functional residual capacity, total lung volume, lung compliance) Q Respiratory rate is not affected in any position.Q Physiological effects of patient position Trendelenburg Horizontal Lithotomy Prone Lateral decubitus * Cardiac : Activation of * Cardiac * Cardiac * Cardiac * Cardiac baroreceptors produce - Decreased hea rate - Increase in - Decrease - Cardiac output unchanged decrease in - Decreased peripheral circulating preload, cardiac unless venous return - Cardiac output resistance blood volume output, blood obstructed. - Hea output - Equalization of and preload. pressure due to - Aerial blood pressure - B.P. pressure through out - Effect on peripheral may fall as a result of - Peripheral vascular resistance the aerial system blood pooling of blood. decreased vascular * Respiratory : Cephalad shift of - Increased right sided pressure and * Respiratory resistance. abdominal viscera produces filling & cardiac cardiac - Decreases total * Respiratory - Marked decrease in lung output. output lung compliance - Decreased volume of capacities (VC, FRC, Total * Respiratory depends on and increases dependent lung. lung volume, lung - Diaphragm is volume work of - Increased perfusion of compliance)Q displaced cephalad status. breathing. dependent lung. - Atelactasis by abdominal viscus * Respiratory - Increased ventilation of - Increase ventilation perfusion - Increase perfusion of - Decreased dependent lung in awake mismatch dependent vital capacity. patient (No v/q mismatch) - Increase likelihood of (posterior) segment - Increase - Decreased ventilation of regurgitation - Functional residual likelihood of dependent lung in * Others - Increase intraocular pressure in glaucoma - Increase in intracranial Pressure & decrease in cerebral blood flow. capacity decreases aspiration anaesthetized patient (v/q mismatch) - Fuher decrease in dependent lung ventilation with paralysis and open chest.

So the answer to this question is C


Instruction:
Intercavitatory radiotherapy is treatment modality for
A. Ca Cervix
B. Ca Oesophagus
C. Ca Stomach
D. Renal cell CA

Response:
Intracavitary brachytherapy is used most commonly in patients with cancer cervix after radiation therapy has been completed.

So the answer to this question is A


Instruction:
A patient with CHF with LVEF <40% should be given?
A. ACEI + beta blocker
B. ACEI + furisemide
C. ACEI + CCB
D. ACEI + ARB

Response:
Answer- A. ACEI + beta blockerPatient of hea failure with reduced resection fraction are treated by a combination of drugs.Drug combination- ACE inhibitors + beta blockers

So the answer to this question is A


Instruction:
The best radiographic view for TMJ is
A. Lateral oblique
B. PA view
C. Waters view
D. OPG

Response:
The panoramic image is a useful tool for providing a broad overview of the TMJ and surrounding structures. It serves the purpose of allowing the clinician to rule out gross disease, and for some patients, it is the only imaging required before conservative therapy is initiated. Gross osseous changes in the condyles may be identified, such as asymmetries,  extensive erosions, large osteophytes, tumors, or fractures. The panoramic projection also provides a means of comparing left and right sides of the mandible and can reveal odontogenic diseases and other disorders that may be the source of TMJ symptoms.

So the answer to this question is D


Instruction:
All of the following statement are true about pediatric airway except ________
A. Narrowest part is the glottic region
B. Laryngnx is funnel shaped
C. Epiglottis is long and floppy
D. Large tongue

Response:
In pediatric airway narrowest part is the subglottic region at the level of cricoid cartilage.

So the answer to this question is A


Instruction:
Cognizable offence comes under which section of CrPC: NEET 13
A. 2 (c)
B. 2 (b)
C. 1 (a)
D. 2 (1)

Response:
Ans. 2 (c)

So the answer to this question is A


Instruction:
Chop wound is also known as ?
A. Slash wounds
B. Incised looking lacerated wounds
C. Stab wounds
D. Slit wounds

Response:
Ans. is 'a' i.e. Slash wounds Chop Wounds/ Slash Wounds They are deep gaping wounds caused by a blow with the sharp cutting edge of a fairly heavy weapon like hatchet, axe, sword, road heavy knife, chopper, saber, meat cleaver. Dimetions of the wound correspond to the cross section of the penetrating blade.

So the answer to this question is A


Instruction:
A 29-years-old male taking oral hypoglycemic drug never had ketonuria in his life. His BMI is 20.5. His grandfather had diabetes and his father who is only son of his grandfather did not have the disease. Which type of DM this person will be most likely -
A. pancreatic
B. MODY
C. Type I
D. TypeII

Response:
A number of unusual genetic diseases are associated with diabetes. In rare families, diabetes is caused by single gene defects with autosomal dominant inheritance. These subtypes constitute less than 5% of all cases of diabetes and typically present as 'maturity-onset diabetes of the young' (MODY), i.e. non-insulin-requiring diabetes presenting before the age of 25 years (Box 21.6). Very rarely, diabetes can develop at or soon after bih. This neonatal diabetes is usually genetic in origin, with 50% due to mutations in the KATP channel of the pancreatic b cell causing insulin deficiency and diabetic ketoacidosis. However, sulphonylurea drugs overcome the defect in potassium channel signalling, so that insulin therapy is not necessary in these cases. DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-806,807

So the answer to this question is D


Instruction:
Most common site of brain metastasis is-
A. Cerebrum
B. Cerebellum
C. Medulla oblongata
D. Pons

Response:
(Refer: Nelson’s Textbook of Pediatrics, SAE, 1st edition, pg no. 2460)

MC site of brain metastases (85%) CEREBRUM
2nd MC site of brain metastases- CEREBELLUM
LUNG, BREAST, MELANOMA (SKIN CANCER), COLON AND KIDNEY cancers commonly spread to the brain.

So the answer to this question is A


Instruction:
Which of the following are alkylating agents ? a) Cyclophosphamide b) Ifosfamide c) Paclitaxel d) Methotrexate e) Vincristine
A. ad
B. c
C. ab
D. ac

Response:
None

So the answer to this question is C


Instruction:
Dienes stain is used for?
A. Compylobactor
B. Helicobacter
C. Rickettsiae
D. Mycoplasma

Response:
Ans. is 'd' i.e., Mycoplasma Dienes method (Dienes staining) - For colonies of mycoplasma. Dienes phenomenon - To eletect swarming of proteus.

So the answer to this question is D


Instruction:
Type B adverse drug reaction
A. Augmented effect of the drug
B. Allergic effect of the drug
C. Effect seen on chronic use of drug
D. Delayed effect of the drug

Response:
Adverse drug reactions (ADRs) are increasingly common and are a significant cause of morbidity and moality. ... Type B reactions are idiosyncratic, bizarre or novel responses that cannot be predicted from the known pharmacology of adrug and are associated with low morbidity and high moality. Refer KDT 7/e p83

So the answer to this question is B


Instruction:
Post operative pancreatitis is seen in which type of surgery
A. Billroth type I
B. Splenectomy
C. Nephrectomy
D. Roux-en-Y hepaticojejunostomy

Response:
Iatrogenic pancreatitis Acute pancreatitis can be associated with a number of surgical procedures, most commonly those performed on or close to the pancreas, such as pancreatic biopsy, biliary duct exploration, distal gastrectomy and splenectomy Acute pancreatitis is associated postoperatively with Billroth II gastrectomy and jejunostomy, in which increased intraduodenal pressure can cause backflow of activated enzymes into the pancreas Pancreatitis also can occur in association with surgery that uses low systemic perfusion, such as cardiopulmonary bypass and Cardiac transplantation Ref: schwaz's principle of surgery 10th edition Pgno :1352

So the answer to this question is B


Instruction:
Which movement is not affected in Ls root involvement
A. Knee extension
B. Knee flexion
C. Toe extension
D. Thigh adduction

Response:
D i.e. Thigh adduction - Movements affected by L5 nerve root include great (long) toe extension, (main; ASIA), toe dorsiflexion, foot dorsiflexion & eversion, knee flexion and hip abduction. Although knee extension is main movement of L3 root (a/t ASIA) and assessory movement of L4 root; there is some role of L5 & S1 also because of tensor fascia lataQ (which is supplied by L4L5S1). Whereas, hip adduction is accessory movement of L3 & L4 root.

So the answer to this question is D


Instruction:
Epidemiology of cholera in England was clasified by
A. John Snow
B. Winslow
C. Chadwick
D. Howard huges

Response:
An english epidemiologist John Snow studied the epidemiology of cholera in London from 1848 to 1854. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition

So the answer to this question is A


Instruction:
All are used in treatment of amoebic liver abscess Except
A. Diloxanide furoate
B. Choloquine
C. Metronidazole
D. Emetine

Response:
Drugs for amoebic liver abscess * Tab. Metronidazole 800 mg tid or inj. metronidazole 500 mg IV tid for 10 days. IV or oral antibiotics are essential to control secondary infection (cefotaxime, ciprofloxacin, amoxicillin). (Small abscesses < 3 cm respond to drugs). * Other drugs: 1. Injection dihydroemetine 1.5 mg/kg/day IM for 5 days should be given under cardiac monitoring. 2. Chloroquine 250 mg BD given for 10-14 days. Ref: SRB&;s manual of surgery,3 rd ed, pg no 531

So the answer to this question is A


Instruction:
Caplan Syndrome is Pneumoconiosis with
A. Lymphadenopathy
B. Congestive Cardiac Failure
C. Rheumatoid Ahritis
D. HIV

Response:
Answer is C (Rheumatoid Ahritis): Caplan's syndrome refers to the association of Pneumoconiosis and Rheumatoid Ahritis. Caplan's Syndrome is a rare subset of pulmonary nodulosis characterized by the development of nodules and pneumoconiosis following silica exposure in patients with Rheumatoid Ahritis. Caplan's Syndrome first described in coal miners but subsequently found in patients with silicosis includes seropositive Rheumatoid ahritis with charachteristic pneumoconiotic nodules. Silica has immunoadjuvant propeies and is often present in anthractic coal dust.

So the answer to this question is C


Instruction:
The uronic acid level in urine is elevated in -
A. Tyrosinosis
B. Maple syrup urine disease
C. Nieman picks disease
D. Mucopolysaccharidosis.

Response:
Ans. is 'd' i.e. Mucopolysaccharidoses: Mucopolysaccharidosesare hereditary disorders caused by a deficiency of one of the lysosomal hydrolases involved in degradation of one or more of the glycosaminoglycans (GAGs also called as mucopolysaccharides).This results in the accumulation of GAGs in various trisaccharides).This results in the accumulation of GAGs in various tissues of the body. GAGs, as well as their oligosaccharides, are excreted in urine.GAGs are long, heteropolysaccharide chains generally composed of a repeating disaccharide unit .The amino sugar is either --D - glucosamine orD - galactosamineThe acidic sugar is either --D - glucuronic acid orL - Iduronic acid.There is increased excretion of this D - glucuronic acid or L - iduronic acid in urine in urine in mucopolysaccharidoses.There are many types of mucopolysaccharidoses of which the following are imp.Name - Enzyme defectHurler's syndrome - L- iduronidase*Hunter syndrome - Iduronate sulfatase*Morquio A syndrome - Galactosamine - 6 - sulfatase*Morquio B syndrome - B galactosidase*

So the answer to this question is D


Instruction:
Anterior ethmoidal nerve is a branch of nasociliary nerve. All of the following areas are supplied by anterior ethmoidal nerve, EXCEPT:
A. Maxillary sinus
B. Interior of nasal cavity
C. Dural sheath of anterior cranial fossa
D. Ethmoidal air cells

Response:
The infraorbital nerve (CN V-2) primarily innervates the maxillary sinus.Anterior ethmoidal nerve supplies the ethmoid sinus, nasal cavity, and skin on the tip of the nose. Dura mater of anterior cranial fossa is supplied by anterior and posterior ethmoidal nerves. Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 18. Orbit. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy.

So the answer to this question is A


Instruction:
Stocker's line is seen in
A. Pinguencula
B. Pterygium
C. Congenital Ocular Melanosis
D. Conjunctival epithelial melanosis

Response:
Ans is 'b' i.e. Pterygium Stocker's line is line of iron deposition in the corneal epithelium seen adjacent to the head of the pterygium.Pterygium and Pinguecula are degenerative conditions of the cornea.PingueculaAre areas of bulbar conjunctival thickening, near the limbus in the palpebral fissure area.These are triangular, horizontally oriented with apex away from the cornea.These are white to yellow in color, often having a fatty appearance. (The name pinguecula is derived from fat- pinguis)Usually found in elderly persons, especially those exposed to strong sunlight, dust, wind etc.Usually bilateralUsually nasalEtiology is not well known, however good evidence exists, of an association with increasing age and ultraviolet light exposure.Pinguecula do not cause any symptom, apart from cosmetic defect and sometimes inflammation (pingueculitis). Hence no treatment is required. However rarely, simple excision may be done for cosmetic reasons or for chronic pingueculitis.PterygiumPterygium is a wing shaped fibrovascular growth of the conjunctiva encroaching upon the cornea.It occurs in the palpebral fissure area, usually nasally but may also occur on the temporal side.Elevated whitish opacities ("islets of Vogt") and an iron deposition line ("Stocker") may delineate the head of the Pterygium on the cornea.Like pinguecula, pterygium is associated with ultraviolet light exposure. It occurs at highest prevalence and most severely in tropical areas near the equator and to a lesser and milder degree in cooler climates. The predominantly nasal location is related to reflection of light from the nose onto the nasal conjunctiva.Usually the pterygium is symptomless, so no treatment is required.Indications for surgery are:cosmetic deformityimpaired vision due to encroachment into the pupillary area of the corneasignificant astigmatismrestriction of ocular motilitySimple excision is done.Recurrence of the pterygium after surgical excision is the main problem. Methods to prevent recurrence areconjunctival autografting andmitomycin C application.Is Pinguecula precursor of Pterygium?This is controversial.Parson writes- "A Pterygium frequently follows a Pinguecula"But Yanoff Ophthalmology contradicts this and writes- "Current information, however, suggests that pinguecula does not progress to Pterygium and that the two are distinct disorders."Pterygium and PseudopterygiumPterygium resembles pseudopterygium. Pseudopterygium is conjunctival adhesion to the cornea secondary to previous trauma or inflammation such as peripheral corneal ulceration. A pseudopterygium often has an atypical position and is not adherent at all points, so a probe can be passed beneath it peripherally.

So the answer to this question is B


Instruction:
Clinical features of Uraemia will appear when GFR is < ___ml/min/ 1.73 m2?
A. 15
B. 30
C. 45
D. 60

Response:
Development of: Uraemia <15 ml/min/1.73m2 Acidosis, hyperkalemia 15-29 ml/min/1.73m2 Anemia 30-59 ml/min/1.73m2 Hypeension 60-89 ml/min/1.73m2

So the answer to this question is A


Instruction:
True about nasopharyngeal angiofibroma are all except
A. Commonly seen in girls
B. Hormonal etiology
C. Miller's sign positive
D. Radiotherapy can be given

Response:
NASOPHARYNGEAL FIBROMA (JUVENILE NASOPHARYNGEAL ANGIOFIBROMA) CLINICAL FEATURES :- 1. Age and sex:- Tumour is seen almost exclusively in males in the age group of 10-20 years. Rarely, it may be seen in older people and females. 2. Profuse, recurrent and spontaneous epistaxis. This is the most common presentation. Patient may be markedly anaemic due to repeated blood loss. 3. Progressive nasal obstruction and denasal speech. It is due to mass in the postnasal space. 4. Conductive hearing loss and otitis media with effusion. It occur due to obstruction of eustachian tube. 5. Mass in the nasopharynx. Tumour is sessile, lobulated or smooth and obstructs one or both choanae. It is pink or purplish in colour. Consistency is firm but digital palpation should never be done until at the time of operation. Ref:- Dhingra; pg num:-246

So the answer to this question is A


Instruction:
Proteins which have DNA binding domain in its structure are
A. Zinc finger
B. b - Sheet
C. b - band
D. Beta meander

Response:
The specificity involved in the control of transcription requires that regulatory proteins bind with high affinity and specificity to the correct region of DNA. Three unique motifs--the helix-turn-helix, the zinc finger, and the leucine zipper-- account for many of these specific protein-DNA interactions.Harper 30th edition pg: 444

So the answer to this question is A


Instruction:
MHC CLASS III CODES for all except –
A. complement C3
B. properdin
C. TNF –alpha
D. heat shock proteins.

Response:
None

So the answer to this question is A


Instruction:
Yellowing of the skin occurs in hypothyroidism because of:
A. Increased bilirubin
B. Increased cholesterol
C. Increased carotene
D. Increased

Response:
Answer is C (Increased Carotene): The yellow colour of skin in patients with hypothyroidism results from the accumulation of carotene (carotenoderma) in the top layer of the epidermis (Stratum Corneum). Increased levels of carotene are believed to result from impaired hepatic conversion of beta-carotene to Vitamin A. 7'4 is essential for conversion of carotene to vitamin A. In hypothyroidism, this reaction is very slow and carotene accumulation in the blood and tissue (carotenaemia) gives a yellow colour to the skin (carotenoderma). Carotenaemia can be clinically differentiated from jaundice by the fact that sclera of the eyeballs are not affected Carotenaemia

So the answer to this question is C


Instruction:
Following thoracotomy, in a 20-year-old man a lesion is detected in the right lower lung lobe and is found to be nonfunctioning lung tissue that is served by vessels separate from those of the adjacent lung tissue. What is the most likely diagnosis?
A. Mesothelioma
B. Hiatal hernia
C. Glomus tumor
D. Bronchopulmonary sequestration

Response:
Bronchopulmonary sequestration can be differentiated from a bronchogenic cyst; in that it is composed of nonfunctioning lung tissue that is disconnected from the remaining lung; it has a separate blood supply. Glomus tumors are rare tumors that arise in the middle ear or jugular bulb. Patients complain of tinnitus and hearing loss.

So the answer to this question is D


Instruction:
All of the following statement(s) is/are true except:
A. Denever group F-contain X chromosome
B. Denever group C- contain X chromosome
C. Denever group G- contain acrocentric chromosome
D. Bar body is inactive X chromosome

Response:
Ans: A (Denever...) Denver ClassificationThe classification of human CHROMOSOMES on the basis of size and centromere position; the 23 pairs of chromosomes areclassifted in seven groups (A to G), in order of decreasing length. Used before it was possible to distinguish among thechromosomes of the groupsCHROMOSOME GROUP (Arranged in the following order in karyotype)ChromosomesLocation Of CentromereA1-3MetacentricB4-5SubmetacentricD13-15AcrocentricF19-20MetacentricG21-22, YAcrocentricE16-1816- Metacentric 17,18- SubmetacentricC6-12, XSubmetacentric MetacentricSubmetacentricAcrocentricGroup A. E (16). FGroup B, C, E (17,18)Group D, G " Lyon hypothesis: It states that (1) only one of the X chromosomes is genetically active, (2) the other X of either maternal or paternal origin undergoes heteropyknosis anti is rendered inactive, (3] inactivation of either the maternal or paternal X occurs at random among all the cells of the blastocyst on or about the 16 th day of embryonic life, and (4) inactivation of the same X chromosome persists in all the cells derived from each precursor cell. Thus, the great preponderance of normal females are in reality mosaics and have two populations of cells, one with an inactivated maternal X and the other with an inactivated paternal X. Herein lies the explanation of why females have the same dosage of X-linked active genes as have males. The inactive X can be seen in the interphase nucleus as a darkly staining small mass in contact with the nuclear membrane known as the Barr body, or Ar chromatin"-Robbins 8th/164X-INACTIVATION Harrison 18th/515;17th/411In normal females one of the chromosomes undergoes X inactivationin somatic cells.The inactivation ofthe paternal or maternal X chromosome occurs randomly in each somatic cell and thereby serves as a mechanism of dosage compensation, ensuring that males and females have equal expression of most X-linked genes.Some genes on the X chromosome "escape" the inactivating mechanism and are expressed from both X chromosomes.In disorders such as Klinefelter syndrome, some genes may be expressed from both X chromosomes, resulting in its phenotypic features.

So the answer to this question is A


Instruction:
WHAT IS ATKINS DIET ?
A. LOW CALORIES AND CARBOHYDRATES
B. HIGH CARBS AND LOW CALORIES
C. LOW CARBS AND HIGH CALORIES
D. HIGH CARBS AND HIGH CALORIES

Response:
ATKINS DIET Atkins Diet * The Atkins Diet is a popular low-carbohydrate diet and lifelong eating plan created in 1972 by cardiologist Robe C. Atkins. * The Atkins Diet restricts carbohydrates while emphasizing protein and fats. * The Atkins Diet has several phases for weight loss and maintenance, staing out with a very low carbohydrate eating plan. * The Atkins Diet, formally called the Atkins Nutritional Approach, has been detailed in many books and is credited with launching the low-carb diet trend. REF : VASUDEVAN 8TH ED

So the answer to this question is A


Instruction:
All are true about pentose phosphate pathway, EXCEPT:
A. CO2 is produced
B. Oxidation utilises NADP
C. No ATP is generated
D. None of the above

Response:
Although glucose 6-phosphate is common to both pathways, the pentose phosphate pathway is markedly different from glycolysis. Oxidation utilizes NADP rather than NAD, CO2, which is not produced in glycolysis, is a characteristic product No ATP is generated in the pentose phosphate pathway, whereas it is a major product of glycolysis. Ref: Harper 28th edition, chapter 21.

So the answer to this question is D


Instruction:
Bernad-Soulier syndrome is a defect in platelet
A. Aggregation
B. Adhesion
C. Morphology
D. Release reaction

Response:
Bernad-Soulier syndrome is a defect in platelet adhesion defect with gp Ib / IX defect.

So the answer to this question is B


Instruction:
Wigabatrin' a new antiepileptic agent acts by ?
A. GABA- antagonis
B. GABA - agonism
C. NMDA antagonism
D. Carbonic anhydrase inhibition

Response:
Ans is 'b' i.e., GABA-agonism o Vigabatrin (y-vinyl GABA) is an inhibitor of GABA transaminase, the enzyme which degrades GABA. o Anticonvulsant action is due to increase synaptic GABA concentration.

So the answer to this question is B


Instruction:
Muscle relaxant contraindicated in Renal failure is –
A. Gallamine
B. d-TC
C. Vecuronium
D. Atracurium

Response:
None

So the answer to this question is A


Instruction:
Pepsin is an example for which class of enzymes?
A. Oxido reductase
B. Lyases
C. Hydrolases
D. Ligases

Response:
Pepsin and most of the other digestive enzymes belong to IUBMB Enzyme class IV (Hydrolases)
Refer the byte "IUBMB Classification of Enzymes"

So the answer to this question is C


Instruction:
Not A sexually transmitted disease-
A. Pinta
B. Candidiasis
C. HBV
D. Trichomonisis

Response:
Pints, yaws and endemic syphilis constitute a group of distinct spirochetal infection that are known as the endemic non venereal treponematoses. Transmission occurs from skin to skin contact rather than sexual contact. All the other drugs given can be transmitted sexually. From Fitzpatrick dermatology in general medicine7th edition page no 1977

So the answer to this question is A


Instruction:
Which of the following describes the Westermark sign in Pulmonary Thromboembolism?
A. Peripheral Wedge shaped infarct
B. Pulmonary Oligemia
C. Prominence of Main Pulmonary Aery
D. Prominence of Descending Rt Pulmonary aery

Response:
Sign in Pulmonary Thromboembolism: * Fleischner sign: enlarged pulmonary aery * Hampton hump:peripheral wedge of airspace opacity and implies lung infarction * Westermark sign:regional oligemia and highest positive predictive value. * Palla sign: enlarged right descending pulmonary aery * Chang sign: dilated right descending pulmonary aery with sudden cut-of

So the answer to this question is B


Instruction:
Which of the adult skeletal remains is the best for identification of the sex?
A. Pelvis
B. Skull
C. Long bones
D. Sternum

Response:
Accuracy of sexing adult skeletal remains is as given below: Entire skeleton - 100% Pelvis + skull - 98% Pelvis alone - 95% Skull alone - 90% Long bones alone - 80% Ref: Essentials of Forensic Medicine and Toxicology by Narayan Reddy, 21st Edition, Page 55.

So the answer to this question is A


Instruction:
Millennium Development goals are to be achieved by:March 2012
A. 2005
B. 2010
C. 2015
D. 2020

Response:
Ans: C i.e. 2015Governments have set a date of 2015 by which they would meet the Millennium Development Goals/ MDGs, i.e. eradicate extreme povey and hunger; achieve universal primary education; promote gender equality; improve maternal health; combat HIV/ AIDS, malaria and other communicable diseases; ensure environmental sustainability; and develop a global panership for development.

So the answer to this question is C


Instruction:
Which of the following is the major side effect of rifampicin?
A. Renal failure
B. Hepatotoxicity
C. Bone marrow suppression
D. Blood dyscrasias

Response:
Ans. is 'b' i.e., Hepatotoxicity

So the answer to this question is B


Instruction:
The most common source of pulmonary embolism is:
A. Amniotic fluid embolism
B. Calf vein thrombi
C. Large veins of leg
D. Cardio thoracic surgery

Response:
Answer is C (Large veins of leg): About half the patients with pelvic vein thrombosis or proximal leg deep vein thrombosis have pulmonary thromboembolism. Isolated calf vein thrombosis pose a lower risk of pulmonary embolism- Harrisons

So the answer to this question is C


Instruction:
All the following strains of Salmonella are motile by peritrichous flagella except
A. S. bongor
B. S. Gallinarum pullorum
C. S. choleraesuis
D. Salmonella enterica

Response:
Ceain members of the family Enterobacteriaceae are non-motile-Atypical E.coli, Klebsiella, Shigella, Yersinia pestis, and Salmonella gallinarum-pullorum Ref ganong's review of medical physiology 25e

So the answer to this question is B


Instruction:
The most likely diagnosis in a newborn who had a radiopaque shadow with an air-fluid level in the chest along with hemivertebrae of the 6th thoracic vertebra on plain X-ray is –
A. Congenital diaphragmatic hernia
B. Oesophageal duplication cyst
C. Bronchogenic cyst
D. Staphylococcal pneumonia

Response:
Air-fluid level on the chest in a neonate with hemivertebrae suggests the diagnosis of esophageal duplication cyst.

So the answer to this question is B


Instruction:
Vitamin A intoxication causes injury to
A. Lysosomes
B. Mitochondria
C. Endoplasmic reticulum
D. Microtubules

Response:
Hypervitaminosis A Common in arctic explorers who eat polar bear liver Organelle damaged in hypervitaminosis is Lysosomes Acute toxicity: Pseudotumor cerebri (headache, dizziness, vomiting, stupor, and blurred vision, symptoms that may be confused with a brain tumor) and exfoliative dermatitis. In the liver, hepatomegaly and hyperlipidemia Chronic toxicity: If intake of > 50,000 IU/day for > 3 months Weight loss, anorexia, nausea, vomiting, bony exostosis, bone and joint pain, decreased cognition, hepatomegaly progresses to cirrhosis In pregnancy, retinoids cause teratogenic effects. ref DM Vasudevan 8th ed page 457

So the answer to this question is A


Instruction:
The type of laser used in pulpotomy procedure is
A. Nd :YAG Laser
B. Carbon dioxide laser
C. Argon Laser
D. Er:YAG laser

Response:
None

So the answer to this question is A


Instruction:
The scalpel blade most commonly used for oral surgical procedures is:
A. No: 22
B. No: 12
C. No: 11
D. No: 15

Response:
None

So the answer to this question is D


Instruction:
Which one of the following statement is NOT TRUE for an a-helix structure of a protein?
A. It is one of the most impoant secondary structure
B. It has a net dipole moment
C. All hydrogen bonds are aligned in the same direction
D. Long stretches of left handed a-helices occur in proteins

Response:
The hydrogen bonds in secondary structure of proteins are hydrogen bonds and disulfide bonds. The hydrogen bonds either form alpha helix or beta pleated sheet structure. Alpha helix can be either right handed or left handed. Left handed alpha helix is less stable than right handed alpha helix. Only right handed alpha helix has been found in protein structure. Beta pleated sheet structure is formed when hydrogen bonds are formed between the carbonyl oxygen and amide hydrogen of two or more adjacent extended polypeptide chains. Thus hydrogen bonding in beta pleated sheet structure is interchain. The structure is not absolutely planar due to the angles of bonds. Ref: Textbook of Medical Biochemistry By Chatterjea page 90.

So the answer to this question is D


Instruction:
Design Effect' is associated with which of the following sampling techniques -
A. Stratified sampling
B. Systemic sampling
C. Cluster sampling
D. Simple Random Sampling

Response:
None

So the answer to this question is C


Instruction:
Motorcyclist fracture among the following is -
A. Ring facture
B. Sutural separation
C. Comminuted fracture of vault of skull
D. Fracture base of skull into anterior & posterior halves

Response:
The synopsis of forensic medicine & toxicology ;Dr k.s narayan reddy ; 28th edition ; pg.no. 151 . At autopsy the base of the skull is seen divided into 2 halves each moving independently of each other like a hinge ,it is called motor cyclist's fracture.

So the answer to this question is D


Instruction:
Lisch nodules are seen in: March 2004
A. Albright syndrome
B. Neurofibromatosis
C. Tuberous sclerosis
D. Piebaldism

Response:
Ans. B i.e. Neurofibromatosis Lisch nodule It is a pigmented hamaomatous nodular aggregate of dendritic melanocytes affecting the iris These nodules are found in neurofibromatosis type 1, and are present in greater than 94% of patients over the age of six. They are clear, yellow-brown, oval to round, dome-shaped papules that project from the surface of the iris. These nodules typically do not affect vision, but are very useful in diagnosis. They are detected by slit lamp examination. lmmunohistochemistry stains positive against vimentin and S-100, and points to an ectodermal origin. They are not found in neurofibromatosis type 2.

So the answer to this question is B


Instruction:
Which endocrine disorder is associated with epiphyseal dysgenesis?
A. Hypothyroidism
B. Cushings syndrome
C. Addison's disease
D. Hypoparathyroidism

Response:
Epiphyseal dysgenesis is characteristic of hypothyroidism.

So the answer to this question is A


Instruction:
True about pilocytic astrocytoma all except -
A. Long survival
B. Total surgical resection possible
C. Can involve posterior fossa
D. Median age at presentation is more than 80 years

Response:
Pilocytic astrocytomas are relatively benign tumors, typically affecting children and young adults. Most commonly located in the cerebellum, they also may involve the third ventricle, the optic pathways, spinal cord, and occasionally the cerebral hemispheres. There is often a cyst associated with the tumor, and symptomatic recurrence from incompletely resected lesions is often associated with cyst enlargement, rather than growth of the solid component. Tumors that involve the hypothalamus are especially problematic because they cannot be resected completely. Ref: Robbins Basic Pathology 9th edition pg no 843

So the answer to this question is D


Instruction:
Cherry red colour of blood is seen in poisoning with
A. Nitrate
B. Cyanide
C. Lead
D. Sulphite

Response:
Colour of death by poisoning: Cyanide- bright red Carbon monoxide - cherry red Carbon dioxide- deep blue Phosphorus, copper- dark brown Hydrogen sulphide- bluish green Opiates- black Nitrite, aniline, potassium chlorate, nitrobenzene, potassium bicarbonate- chocolate brown or coffee brown. Ref: FORENSIC MEDICINE AND TOXICOLOGY DR P C IGNATIUS THIRD EDITION PAGE 24

So the answer to this question is B


Instruction:
Decision regarding surgery in a case of hemothorax due to blunt trauma chest should be based on
A. Chest symptoms
B. Hemodynamic status
C. Nature of chest tube output
D. X-ray finding

Response:
Decision regarding surgery for haemothorax due to blunt trauma chest is based on the hemodynamic status of the patient & whether features of shock present or not.Treatment usually consists of ICT placement in the mid -axillary line in the 6th intercoastal space.Thoracotomy is done when ICT shows persistent drainage /hourly collection of 200-300 ml or initial chest tube output of 1500 ml of blood .

So the answer to this question is B


Instruction:
Pentameric antibody with a J chain is?
A. IgA
B. IgG
C. IgM
D. IgE

Response:
ANSWER: (C) IgMREF: Jawetz, Melnick, & Adelberg's Medical Microbiology, 24 11 edition Chapter 44 Chapter 8 See APPENDIX-20 below for "IMMUNOGLOBULINS"Note: Both secretory IgA (dimeric) and IgM (pentameric) have J chainsIgM is the main immunoglobulin produced early in the primary immune response. IgM is present on the surface of virtually all uncommitted B cells. It is composed of five H..L-, units (each similar to one IgG unit) and one molecule of J (joining) chain. APPENDIX - 20Immunoglobulins IgGIgAIgMIgDIgEHeavy chaingaudePercentage75-85 (max)7-155-100.30.019 (min)Carbohydrate %41010.71212serum half-life (days)21 (max)6532 (min)Concentration12 mg/ml2 mg/ml1.2 mg/ml0.03 mg/ml0.00004 mg/mlMolecular formmonomerSerum IgA = monomerPentamerMonomerMonomer Secretory IgA = Dimer Molecular weight150,000(lightest)Serum IgA = 160,000950,000(heaviest)175,000190,000Secretory IgA = 400,000SubclassesIgGl > IgG2 > IgG3 > IgG4IgAl = circulatory, IgA2 = secretoryMl, M2nonenoneComplimentactivationClassical ++ G4 subclass= alternateAlternate (only IgAl fixes complement)Classical +++AlternateAlternate or NoneSedimentationcoefficient7SMonomer = 7S7S7S8SDimer = 15SPlacental crossingYesNoNoNoNoPresence in milkPresentPresentAbsentAbsentAbsentCompartmentEqual in intravascular (45%) and extravascular(55%)compartmentMostly extravascular (Minimum intravascular distribution)mostlyintravascular MostlyextravascularHeat stabilityStableStableStableStableHeat labileAlso know- Producessecondaryresponse - First to appear in fetus (20 wk)- Producesprimaryresponse Homocytotropic

So the answer to this question is C


Instruction:
Agents Recommended for treatment of chronic Hepatitis B include all of the following, Except.
A. Interferon
B. Lamuvudine
C. Adefovir
D. Famcyclovir

Response:
Answer is D (Famcyclovir) Fannyclovir is not an approved drug for treatment of chronic hepatitis B Seven drugs have been approved for treatment of chronic Hepatitis B (Harrisons) Interferon alpha and Pegylated Interferon (PEG) Lamuvudine (oral) Adefovir (oral) Entecavir (oral) Dipivoxil (oral) Telbivudine Tenofovir

So the answer to this question is D


Instruction:
Spongy appearance with sunburst calcification is seen in
A. Pancreatic adenocarcinoma
B. Mucinous cyst adenocarcinoma
C. Somatostatinoma
D. Serous cyst adenoma

Response:
Serous cystadenoma-Serous cystadenomas (microcystic adenomas) are the second most common cystic tumours of the pancreas. The clinical presentation of serous cystadenomas is similar to that of mucinous cystic pancreatic tumours.- An association with VHL disease has been described.-Most patients present with nonspecific symptoms of vague abdominal pain or discomfo, but many have a palpable mass.- These tumours can be large, with a size of 1-25 cm. Because of increasing use of cross-sectional imaging, many of these tumours are detected as an incidental, asymptomatic finding.- On CT scans, sunburst central calcification in a spongy mass is pathognomonic of this tumour, but this finding occurs only in 10% of patients.- Endoscopic Ultrasonography (EUS) allows better resolution of the honeycomb structure than CT. At times, the cysts may be large, a feature that makes it difficult to differentiate these cysts from MCNs.g. Hypervascularity may be demonstrated on angiograms, and some tumours occur with intra-abdominal haemorrhage.-Analysis of the cyst fluid characteristically reveals low viscosity and low levels of CEA, with negative cytologic results for malignant cells, as the vast majority of serous cystadenomas are benign.-Surgical resection is the treatment of choice for symptomatic tumours and tumours that show continuous growth.-Many of these tumours may require a Whipple procedure or distal pancreatectomy, depending on the anatomic location. Distal pancreatectomy may be performed and the spleen can be preserved, given the absence of malignant potential.Mucinous cystic neoplasmsa. Nonenhanced CT scans show a well-defined, unilocular or multilocular, externally smooth, round-to-ovoid mass with fluid attenuation.b. The attenuation values of the multilocular cysts vary according to the degree of haemorrhage or protein in the mucoidc. Visualization of nodular or papillary excrescences with irregular borders of the septae is possible. If present, calcification is curvilinear or punctate and confined to the cyst wall or septa. Contrast-enhancedd. CT scans show enhancement of the cyst wall, internal septations, mural nodules, and other intracavitary projections. CT more clearly demonstrates the enhancement of cystic walls and septa than do other studies.e. Compared with serous cystic tumours, the cysts in MCNs are larger (>20 mm in diameter) and less numerous (usually <6).f. CT guided aspiration of the cyst can provide fuher diagnostic clues and enable their differentiation from other pancreatic cystic masses (eg, pseudocyst, serous cystadenoma, and solid and pseudopapillary neoplasm).g. MCN cyst fluid typically has a high viscosity, low amylase levels, and high CEA and carbohydrate antigen (CA) 72-4 levels, and they may show malignant cytology in patients with mucinous cystadenocarcinomas.h. Periodic acid Schiff (PAS) and May Grunwald/Giemsa (MGG) stains are usually positive for extracellular as well as intracellular mucin.i. Treatment is the same as that of serous cystadenoma.(REF. SCHWAZ SURGERY 8TH EDITION PG 1572; David Sutton; Textbook of radiology and imaging, 7th edition, page no.793 )

So the answer to this question is D


Instruction:
The hea sound associated with the mitral valve is best heard?
A. In the jugular notch
B. In the second left intercostal space
C. In the second right intercostal space
D. In the fifth left intercostal space

Response:
The four valves of the hea can be auscultated at very distinct spaces. The mitral valve can be auscultated in the left 5th intercostal space, slightly below the nipple. The aoic valve can be auscultated in the 2nd right intercostal space, just lateral to sternal angle. The pulmonary valve can be auscultated in the 2nd left intercostal space, just lateral to sternal angle. The tricuspid valve can be auscultated in the 4th left intercostal space, just lateral to sternum. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 30. The Hea as a Pump. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds),Ganong's Review of Medical Physiology, 24e.

So the answer to this question is D


Instruction:
IQ (Intelligence quotient) of a child means?
A. The creative effciency of child
B. The capability of the child to perfrom intellectual tasks in relation to other children of same age
C. The efficiency of memory of child
D. Quantification of the learning ability of child

Response:
Ans. is 'b' i.e., The capability of the child to perfrom intellectual tasks in relation to other children of same age.

So the answer to this question is B


Instruction:
Temporal association of a disease is best established by
A. Case-Control study
B. Cross-section study
C. Coho study
D. Descriptive study

Response:
Temporal relationship: Exposure must precede disease"A well-designed coho study is considered the most reliable means of showing an association between a suspected risk factor and subsequent disease"Park 23e pg:76

So the answer to this question is C


Instruction:
Potassium is maximally absorbed in which pa of nephron?
A. PCT
B. DCT
C. Collecting ducts
D. Loop of Henle

Response:
Much of the filtered K+ is removed from the tubular fluid by active reabsorption in the proximal tubules K+ is then secreted into the fluid by the distal tubular cells. In the absence of complicating factors, the amount secreted is approximately equal to the K+ intake, and K+ balance is maintained. Ref: Ganong 25th ed/page 681

So the answer to this question is A


Instruction:
All are true about primary bacterial peritonitis, EXCEPT:
A. Ascitic fluid PMN count > 250 is diagnostic
B. Microbiology of PBP is distinctive
C. Some patients may be totally asymptomatic
D. Usually does not respond to routine antimicrobial therapy

Response:
PBP is commonly present with fever, but it can present without any symptoms too. Ascitic fluid analysis should be performed in all suspected cases and PMN > 250/l is diagnostic of PBP. Escherichia coli are most commonly encountered as the cause of PBP. In PBP, a single organism is typically isolated. PBP is usually treated with cefotaxime and it responds very well to it. Ref: Harrison, E-18, P-1081.

So the answer to this question is D


Instruction:
The causative organism of late prosthetic valve endocarditis is
A. Streptococcus viridans
B. Proteus mirabilis
C. Beta hemolytic streptococci
D. Staphylococci

Response:
Streptococcus viridans is a group which normally resides in the mouth and upper respiratory tract and is alpha hemolytic. In persons with pre-existing cardiac lesions, they may cause bacterial endocarditis, Streptococcus sanguis being most often responsible. Following the tooth extraction or dental procedures, they cause transient bacteremia and get implanted on damaged or prosthetic valves or in congenitally diseased hea and grow to form vegetation. Streptococcus mutans is also a member of viridans group which causes endocarditis in individuals with risk factors ( dental extraction in people with damaged valves). The bacterium has a polysaccharide coat that allows it to stick to teeth and also to damaged hea valves, it can invade the bloodstream. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 220, 221

So the answer to this question is A


Instruction:
About infective endocarditis (IE), the following is false:
A. Duke’s criteria is used to diagnose IE
B. Libman Sack’s endocarditis is seen in Systemic Lupus Erythematosus
C. Osler’s nodes are seen at the occiput and pressure bearing areas
D. Janeway lesions are present on the skin

Response:
Osler's Nodes are seen in the pulp of fingers.

So the answer to this question is C


Instruction:
Treatment of choice for severe falciparum malaria is?
A. Chloroquine
B. Intravenous aesunate
C. Intravenous quinine
D. Intravenous quinidine

Response:
Intravenous or intramuscular aesunate is the treatment of choice in severe malaria. Quinine can be used when aesunate is not available. Aemether by intramuscular route is acceptable as an alternative in the treatment of severe falciparum malaria during an epidemic. Ref: Harrison's Principles of Internal Medicine, 17th Edition, Pages 1288-9 ; Guidelines for The Treatment of Malaria By World Health Organization, 2nd Edition, Pages 17, 57 ; Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Pages 747-8

So the answer to this question is B


Instruction:
The minimum concentration of reduced hemoglobin required for cyanosis is
A. 1gm/dl.
B. 3 gm/d
C. 7 gm/d
D. 5 gm/d

Response:
Cyanosis refers to a bluish colour of the skin and mucous membranes resulting from an increased quantity of reduced hemoglobin, or of hemoglobin derivatives, in the small blood vessels of those areas. It is usually most marked in the lips, nail beds, ears, and malar eminences.
The degree of cyanosis is modified by the colour of the cutaneous pigment and the thickness of the skin, as well as by the state of the cutaneous capillaries.
In some instances, central cyanosis can be detected reliably when the SaO2 has fallen to 85%; in others, particularly in dark-skinned persons, it may not be detected until it has declined to 75%.
The increase in the quantity of reduced hemoglobin in the mucocutaneous vessels that produces cyanosis may be brought about either by an increase in the quantity of venous blood as a result of dilation of the venules and venous ends of the capillaries or by a reduction in the Sa in the capillary blood. In sulhaemoglobmemia cyanosis occurs when its level exceeds 0.5gm/dl A methemogiobm level of 15% (i.e.,1.5gm/dl) 3 is associated with visible cyanosis-Nelson

So the answer to this question is D


Instruction:
CSF pressure (lumbar) -
A. 70 -180 mm CSF
B. 70 -180 mm CSF
C. > 200 mm CSF
D. 150 - 200 mm CSF100. The most impoant

Response:
A i.e. 70-180 mm CSF

So the answer to this question is A


Instruction:
Contraceptive to be avoided in epilepsy :
A. OCP
B. Condom
C. IUCD
D. Mirena

Response:
Rifampicin, an antibiotic prescribed for a tubercular patient, reduces the absorption of the pill; hence, it is contraindicated in a tubercular patient on rifampicin. Other drugs interfering with OC are tetracycline and anticonvulsants, antifungal, cephalosporin and phenobarb. Ritonavir for HIV also interferes with absorption of OC. SHAW'S TEXTBOOK OF GYNECOLOGY 16th EDITION PAGE NO 367

So the answer to this question is A


Instruction:
Normal PCV value is?
A. 30-35%
B. 40-45%
C. 50-55%
D. 60-65%

Response:
Ans. is 'b' i.e. 40-45% * Normal values are about 45% for men and about 42% for women.Hematocrit or Packed cell volume (PCV)* It is the proportion of blood volume that is occupied by red blood cells.* A decrease in the number or size of red cells also decreases the amount of space they occupy, resulting in lower hematocrit.* Similarly an increase in the number or size of red cells increases hematocrit.* Exceptions are thalassemia which can cause an increased number of red blood cells but a decreased size and hematocrit, and megaloblastic anemia which causes increase in size of red cells with decreased hematocrit

So the answer to this question is B


Instruction:
During a paial hysterectomy leaving the ovaries intact, the surgeon detaches the ovary from the uterus by transecting the ovarian ligament. This ligament developed from which embryonic structure?
A. Mesonephric duct
B. Urogenital folds
C. Gubernaculum
D. Processus vaginalis

Response:
The ovarian ligament and the round ligament of the uterus are formed by the gubernaculum. The mesonephric duct gives rise only to the vestigial epoophoron in the female. The urogenital folds form the labia minora. The processus vaginalis forms no adult female structures, while the paramesonephric ducts form the uterine tubes, uterus, cervix, and upper vagina.

So the answer to this question is C


Instruction:
AH are live vaccines except:
A. BCG
B. Salk vaccine
C. Measles
D. Mumps

Response:
Ref: A nanthanarayan, Paniker CJ. Textbook of microbiology. 8th Edition. London: John Wiley & Sons: 2009. Pg. 88. 451Explanation:Types of vaccines (See the following table)

So the answer to this question is B


Instruction:
The primary mechanism of action of fluoride on topical application is -
A. Conversion of hydroxyapatite to fluoroapatite by replacing the OH- ions
B. Inhibition of plaque bacteria
C. Form a reservoir in saliva
D. Improvement in tooth morphology

Response:
Ans. is 'a' i.e., Conversion of hydroxy-apatite to fluro-apatite by replacing the OH ions When hydroxyapetite is exposed to low fluoride concentrations (about 1 ppm) a layer offluorapetite forms on the hydroxyapetite crystals. The thin layer governs the rate of enamel dissolutin and reduces rate of caries progression. o During caries attack, the enamel is exposed to a pH of about 5.5 or lower, thereby leading to its dissolution. o The presence of fluoride reduces the solubility of enamel by promoting the precipitation of hydroxyapetite and phosphate mineral.

So the answer to this question is A


Instruction:
Agents recommended in treatment  of aortic dissection are all except
A. Beta blockers
B. Labetolol
C. Sodium nitoprusside
D. Diazoxide

Response:
Diazoxide is vasodilator ,which can aggravate dissection, so containdicated in aortic dissection.

So the answer to this question is D


Instruction:
A 25 year old man with a psychotic illness, was treated with haloperido130mg/day. On the third day, he developed pacing, and inability to sit still in one place. The medication likely to be helpful is -
A. Phenytoin
B. Propranolol
C. Methylphenidate
D. Trihexyphenedyl

Response:
Restlessness (inability to sit still) and pacing suggests the diagnosis of Akathesia.
The drug of choice for Akathesia is one of the β-blocker.

So the answer to this question is B


Instruction:
In acute diverticulitis of the colon, the sigmoidoscopic finding is -
A. Mucosa is inflammed
B. Minute diverticuli seen
C. Saw toothed appearance
D. Sigmoidoscope cannot be passed beyond 15 cm

Response:
None

So the answer to this question is A


Instruction:
Which of the following causes retinal pigmentation?
A. Quinine
B. Chloroquine
C. Mefloquine
D. Atovaquone

Response:
Ans. is 'b' i.e., Chloroquine * Chloroquine is a 1st line anti malarial drug, which is an erythrocytic schizonticide.* However, its prolonged use of high doses (as in DLE, rheumatoid arthritis) may cause loss of vision due to retinal damage in the form of retinal pigmentation.* Chloroquine may also cause corneal deposits and affect vision and are reversible on discontinuation.* Loss of hearing, rashes, photoallergy, myopathy, graying of hair may occur.

So the answer to this question is B


Instruction:
In the court of law, the act of witness giving false evidence after taking oath is punishable under
A. 191 IPC
B. 192 IPC
C. 193 IPC
D. 197 IPC

Response:
191 IPCDefinition of perjury192 IPCFabrication of evidence193 IPCPunishment of perjury197 IPCPunishment for issuing false certificates

So the answer to this question is C


Instruction:
Mark the FASLE statement related to tracheostomy
A. Only indication for high tracheostomy is laryngeal carcinoma
B. Pneumothorax is complication of mid and low tracheostomy
C. In Vocal cord palsy and subglottic stenosis mid tracheostomy is planned
D. Most commonly performed tracheostomy is low-tracheostomy

Response:
TYPE SITE INDICATION COMPLICATIONS High tracheostomy Above level of thyroid Isthmus (Between I & II tracheal Ring) Carcinoma larynx Perichondritis of cricoid cailage and subglottic stenosis Mid tracheostomy Through II or III ring, at level of thyroid Isthmus Elective indication Less chance of perichondritis, stenosis & pneumothorax Low tracheostomy Below the level of isthmus (Between III & IV Tracheal Ring) Laryngeal papilloma/ Permanent tracheostoma Pneumothorax Only indication for high tracheostomy is laryngeal carcinoma Vocal cord palsy and subglottic stenosis are planned for mid tracheostomy Most commonly performed tracheostomy is mid-tracheostomy

So the answer to this question is D


Instruction:
A third degree circumferential burn in the arm & forearm region, which of the following is most impoant for monitoring?
A. Blood gases
B. Carboxy-oxygen level
C. Macroglobinuria cryoglobinuria
D. Peripheral pulse and circulation

Response:
When deep second and third degree burn wounds encompass the circumference of an extremity, peripheral circulation to the limb can be compromised. Development of generalized edema beneath a non - yielding eschar impedes venous outflow and affects aerial inflow to the distal beds. This can be recognized by numbness and tingling in the limb and increased pain in digits. Aerial flow can be assessed by determination of Doppler signals in the digital aeries and the palmar and planter arches in affected extremities. Capillary refill can also be assessed.

So the answer to this question is D


Instruction:
In a patient with gall stone disease, laproscopic cholecystectomy was performed & specimen was sent to pathology lab. The biopsied tissue was repoed as adenocarcinoma (Stage 1A ). What will be your treatment approach?
A. Extended cholecystectomy
B. Chemotherapy
C. Observation & follow up
D. Extended cholecystectomy + Extended Right hepatectomy

Response:
Treatment is observation & follow up (as lap cholecystectomy is already performed) Staging & Treatment for CA Gall bladder IA - T1a Laproscopic cholecystectomy IB - T1b IIA - T2a IIB - T2b IIIA - T3 IIIB - T1-3 N1 Extended cholecystectomy IVA - T4 N0-1 Extended cholecystectomy+Extended R hepatectomy IVB - T any N any M2 Palliation(Chemotherapy)

So the answer to this question is C


Instruction:
Paracusis is seen in
A. CSOM
B. Otosclerosis
C. Meniere's disease
D. ASOM

Response:
(Otosclerosis) (87-Dhingra 4th edition) (89- Maqbool 11th)Paracusis- Willisii - An otosclerotic patients hears better in noisy than quite surrounding. This is because a normal person will raise his voice in noisy surroundings, like in public transport, machine shops, engine rooms"Schwartze sign " - tympanic membrane shows flemingo-pink tinge in otosclerosis"Carhart's notch " -This is a pure tone audiometric findings is characteristic of otosclerosis (maximum at 2000 Hz)Clinical symptoms of Otosclerosis* Hearing loss conductive deafness* Paracusis - willisii* Tinnitus - More common in cochlear otosclerosis* Speech- monotonous* Vertigo- is uncommon* Presbycusis - sensorineural hearing loss associated with physiological aging process in the ear

So the answer to this question is B


Instruction:
Physiological umbilical hernia reduces because:-
A. Regression of mesonephric kidney
B. Reduced growth of liver
C. Expansion of abdominal cavity
D. All of above

Response:
During the 6th week, the primary intestinal loop grows rapidly, as a result of rapid growth and expansion of liver, the abdominal cavity temporarily becomes too small to contain the loops of intestine and they enter to the extra embryonic coelom forming the physiological umbilical hernia. During the 10th week of development, the herniated intestinal loops sta to return to abdominal cavity. Although the factors responsible for it are not known, it is thought that regression of mesonephric kidneys, reduced growth of liver and expansion of abdominal cavity play impoant role.

So the answer to this question is D


Instruction:
Osteogenesis imperfect defect in
A. Collagen type I
B. Elastin
C. Collagen type IV
D. basement membrane

Response:
harshmohan textbook of pathology 7th edition. *osteogenesis imperfecta is an autosomal dominant or recessive disorder of synthesizing type1 collagen that constitutes 90 to 95 % bone matrix Osteogenesis Imperfecta Osteogenesis imperfecta (OI), also known as "brittle bone disease," is actually a group of genetic disorders caused by defec- tive synthesis of type I collagen. Because type I collagen is a major component of extracellular matrix in other pas of the body, there are also numerous extraskeletal manifesta- tions (affecting skin, joints, teeth, and eyes, for example). The mutations underlying OI characteristically involve the coding sequences for a1 or a2 chains of type I collagen. Because collagen synthesis and extracellular expo require formation of a complete and intact triple helix, any primary defect in a collagen chain tends to disrupt the entire structure and results in its premature degradation (an example of a dominant negative mutation) (Chapter 6). As a consequence, most defects manifest as autosomal domi- nant disorders and may be associated with severe malformations. There is, however, a broad spectrum of severity, and mutations that result in qualitatively normal collagen but at only reduced levels generally have milder manifestations. The fundamental abnormality in all forms of OI is too little bone, resulting in extreme skeletal fragility. Four major sub- types are recognized. The type II variant is uniformly fatal in utero or immediately postpaum as a consequence of multiple fractures that occur before bih. By contrast, patients with type I OI have a normal lifespan, with only a modestly increased proclivity for fractures during child- hood (decreasing in frequency after pubey). The classic finding of blue sclerae in type I OI is attributable to decreased scleral collagen content; this deficit causes a relative trans- parency that allows the underlying choroid to be seen. Hearing loss can be related to conduction defects in the middle and inner ear bones, and small misshapen teeth are a result of dentin deficiency. Ref Robbins 9/e p767

So the answer to this question is A


Instruction:
A 58-year-old man had chest pain persisting for 4 hours. A radiographic imaging procedure showed an infarction involving a 4-cm area of the posterior left ventricular free wall. Laboratory findings showed serum creatine kinase of 600 U/L. Which of the following pathologic findings would most likely be seen in the left ventricular lesion 1 month later?
A. Chronic inflammation
B. Coagulative necrosis
C. Complete resolution
D. Fibrous scar

Response:
The elevated creatine kinase level indicates that myocardial necrosis has occurred. A fibrous scar gradually replaces the area of myocardial necrosis. Chronic inflammation is typically driven by ongoing stimuli such as persistent infection, autoimmunity, or irritation from endogenous or exogenous chemical agents, and it is not a feature of ischemic myocardial injury. Coagulative necrosis is typical of myocardial infarction, but after 1 month, a scar would be present. The destruction of myocardial fibers precludes complete resolution. Nodular regeneration is typical of hepatocyte injury because hepatocytes are stable cells.

So the answer to this question is D


Instruction:
All of these drugs can be used in the treatment of postmenopausal osteoporosis EXCEPT:
A. Alendronate
B. Teriparatide
C. Calcium
D. Thyroxine

Response:
None

So the answer to this question is D


Instruction:
In an obese patient the most likely respiratory change is
A. FRC is unchanged
B. Alveolar hypo ventilation
C. Residual volume is decreased
D. Normal work of breathing

Response:
Obesity hypoventilation syndrome is characterized by :

Obesity.
Hypoxemia.
Hyper carbia.
Respiratory acidosis.
Pulmonary hypertension.
Right ventricular failure.

So the answer to this question is B


Instruction:
Syneresis seen in a hydrocolloid gel is:
A. Seen as water loss
B. Water absorption
C. Shrinkage
D. Gelation

Response:
Some basic terminologies associated with hydrocolloids. These are as follows:

Sol: Colloidal suspension of very small solid particles in a continuous liquid medium.
Gel: Network of ﬁbrils that form a weak, slightly elastic brush heap structure.
Gelation: Transformation from sol to gel.
Liquefaction temperature: The temperature at which the gel converts to the sol state.
Syneresis: Fluid exuded when gel structures reconﬁgure to achieve equilibrium through stress relaxation.
Imbibition: Absorption of water.
Micelles: The dispersed phase agglomerates to form chains or ﬁbrils in the gel state called micelles.

Reference: Materials Used in Dentistry, S Mahalaxmi first ed page no 430

So the answer to this question is A


Instruction:
Which of the following has the worst prognosis -
A. Rolandic epilepsy
B. Versive epilepsy
C. Absence epilepsy
D. Infantile spasm

Response:
Ans. is 'd' i.e., Infantile spasm Prognosis for normal mental development is poor.

So the answer to this question is D


Instruction:
Wickham's striae are seen in:
A. Lichen nitidus
B. Lichenoid eruption
C. Lichen striatus
D. Lichen planus

Response:
Lichen planus is a self limiting condition in which flat topped violaceous papules are seen on the flexor aspect of the body. Wickham's striae are white streaks seen on the lesions especially when viewed with magnifying lens. Ref: Illustrated Synopsis of Dermatology and STD's By Neena Khanna, Page 55

So the answer to this question is D


Instruction:
HIV virus has a paicularly high affinity for which of the following?
A. CD4 T Lymphocytes and B cells
B. CD4 T Lymphocytes and monocytes
C. CD8 T Lymphocytes and B cells
D. CD8 T Lymphocytes and CD4 T Lymphocytes

Response:
HIV has a paicular tendency to bind to CD4 T lymphocytes (helper T lymphocytes) and monocytes and then become internalized. Most other cells, include CD8 T lymphocytes (suppressor T cells) and B cells, are not paicularly susceptible to the HIV virus. HIV preferentially infects and kills helper (CD4) T lymphocytes, resulting in the loss of cell-mediated immunity and a high probability that the host will develop oppounistic infections. Other cells (e.g., macrophages and monocytes) that have CD4 proteins on their surfaces can be infected also. Also know: The genome of HIV consists of two identical molecules of single-stranded, positive-polarity RNA and is said to be diploid. In addition to the three typical retroviral genes gag, pol, and env, which encode the structural proteins, the genome RNA has six regulatory genes. Two of these regulatory genes, tat and rev, are required for replication, and the other four, nef, vif, vpr, and vpu, are not required for replication and are termed "accessory" genes. Ref: Levinson W. (2012). Chapter 45. Human Immunodeficiency Virus. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

So the answer to this question is B


Instruction:
Fordyce spots are?
A. Ectopic sebaceous glands
B. Ectopic eccrine
C. Ectopic apocrine
D. Ectopic mucosal glands

Response:
Fordyce's spots are ectopic sebaceous glands which appear as whitish-yellow bumps on the edge of your lips (most common) / inside your cheeks/penis/scrotum/labia DD of Koplik's spots (pathognomonic of measles) Miliaria occurs due to obstruction of eccrine sweat glands. Fox Fordyce disease occurs due to obstruction of apocrine glands.

So the answer to this question is A