Instruction:
True statements about asbestosis
A. Causes Lung Ca
B. Pleural mesothelioma
C. Peritoneal mesothelioma
D. All of the above

Response:
Answer is D (All of the above) : Asbestosis may be associated with Bronchogenic carcinoma, Mesotheliomas (pleural and peritoneal) and Pulmonary fibrosis.

So the answer to this question is D


Instruction:
Disulfiram is a type of:-
A. Aversion therapy
B. Anticraving therapy
C. Detoxification
D. Opioid management therapy

Response:
Deterrent agents/Aversive agents Disulfiram (tetraethyl thiuram disulfide) When alcohol is ingested by a person who is on disulfiram, alcohol-derived acetaldehyde cannot be oxidized to acetate and this leads to an accumulation of acetaldehyde in blood. This causes the impoant disulfiram-ethanol reaction (DER) characterized by flushing, tachycardia, hypotension, tachypnoea, palpitations, headache, sweating, nausea, vomiting, giddiness and a sense of impending doom associated with severe anxiety. When we try to decrease the frequency of behavior because it can cause a really bad consequence It will be called as an aversion or Aversive therapy. Anti-craving agents Acamprosate, naltrexone and SSRIs (such as fluoxetine) are among the medications tried as anti-craving agents in alcohol dependence. Detoxification Detoxification is the treatment of alcohol withdrawal symptoms, i.e. symptoms produced by the removal of the 'toxin' (alcohol). The drugs of choice for detoxification are usually benzodiazepines.

So the answer to this question is A


Instruction:
Which is the least malignant pancreatic endocrine tumor ?
A. Zollinger-Ellison syndrome
B. Insulinoma
C. VIPoma
D. Glucagonoma

Response:
Insulinoma patients generally presents with hypoglycemia symptoms. Mainly located in the pancreas, and malignancy is <10%. Reference: Table 350-2, Harrisons Principles of Internal Medicine, 18th Edition, Page 3057

So the answer to this question is B


Instruction:
Which of the following is the selective media for vibrio?
A. TCBS
B. Stua
C. Skirrows
D. MYPA

Response:
Vibrios are curved, Gram-negative rods commonly found in saltwater. Cells may be linked end to end, forming S shapes and spirals. They are highly motile with a single polar flagellum, non-spore-forming, and oxidase-positive, and they can grow under aerobic or anaerobic conditions. The cell envelope structure is similar to that of other Gram-negative bacteria. Vibrio cholerae is the prototype cause of a water-loss diarrhea called cholera. Cholera is limited to O1 and O139 serotypes, Serotype O139 is encapsulated. The organism grows on common clinical laboratory media such as blood agar and MacConkey agar, but its isolation is enhanced by a selective medium (thiosulfate-citrate-bile salt-sucrose agar). TCBS Agar is highly selective for the isolation of V. cholerae and V. parahaemolyticus as well as other vibrios. Also Know: Typical colonial morphology on TCBS agar: V.cholerae -- Large Yellow colonies V.Parahaemolyticus -- Colonies with blue to green centers V.alginolyticus -- Large yellow mucoid colonies Ref: Ray C.G., Ryan K.J. (2010). Chapter 32. Vibrio, Campylobacter, and Helicobacter. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.

So the answer to this question is A


Instruction:
The layer responsible for the strength of an intestinal anastomosis is
A. Mucosa
B. Submucosa
C. Muscularis propria
D. Serosa

Response:
Mechanical propeiesThe mechanical propeies of intact intestine in axial and transversal directions were different. The mechanical strength of the intact intestinal wall was conditioned by the submucosa and muscularis, while the serosa and mucosa showed no significant strength. Comparison of axial specimens&; mechanical propeies of the intact intestinal wall and intestinal wall with all layers sutured through determined that only the submucosa supplies mechanical strength to anastomosis.Other layers contribute no significant force to anastomotic strength. The strength applied to the thread during knot tying does not change the paicipation of the intestinal layers in supplying suture-holding capacity for 8 and 12 mm stitch depth. (Refer:

So the answer to this question is B


Instruction:
Which one of the following biochemical measures would be most likely to be elevated in this patient?
A. Alkaline phosphatase
B. Calcium
C. Ferritin
D. Phosphorus

Response:
Answer A. Alkaline phosphataseThe patient has genu varum and enlarged wrists consistent with nutritional rickets. Alkaline phosphatase usually is increased markedly over the age-specific reference range in rickets. Serum phosphorus and vitamin D concentrations are usually low; serum calcium concentration is decreased only in hypocalcemic rickets. Ferritin is not usually elevated in these patients.

So the answer to this question is A


Instruction:
An alcoholic patient with chronic thiamine deficiency shows CNS manifestations, and also show memory loss and confabulatory psychosis, is suffering from:
A. Wernicke's encephalopathy.
B. Wernicke- korsa koff syndrome.
C. Menke's syndrome.
D. Wilson's disease.

Response:
Alcoholic patients with chronic thiamin deficiency shows CNS manifestations known as Wernicke’s encephalopathy, which consists of horizontal nystgmus, opthalmoplegia, cerebral ataxia and mental impairment.
Along with the above-mentioned symptoms, if there is loss of memory and confabulatory psychosis, it is known as Wernicke-Korsa Koff Syndrome.

So the answer to this question is B


Instruction:
Bacteriophages are -
A. Bacteria that infects virus
B. Virus that infects bacteria
C. Virus that infects protozoa
D. Bacteria that infects protozoa

Response:
Ans. is 'b' i.e., Virus that infects bacteria * Bacteriophages are viruses that infect bacteria.* Phages play an important role in the transmission of genetic information between bacteria by the process of transduction.* The presence of phage genome integrated with bacterial chromosome confer bacteria certain properties by a process known as phage conversion.* Lambda phase is the prototype of bacteriophage.

So the answer to this question is B


Instruction:
New born eye is -
A. Myopic
B. Hypermetropic
C. Presbyopic
D. None of the above

Response:
Ans. is 'b' i.e., Hypermetropic Eve at birtho Anteroposterior diameter of eye ball is about 16.5 mm (70% of adult size). Adult size is attained by 7-8 years,o Corneal diameter is about 10 mm. Adult size (11.7 mm) is attained by 2 years of age.o Anterior chamber is shallow and angle is narrow,o Lens is spherical at birth.o Retina Apart from macular area, the retina is fully differentiated. Macula differentiates 4-6 months after birth.o Myelination of optic nerve fibres has reached the lamina cribrosa.o New born is usually hypermetropic by +2 to +3D.o Orbit is more divergent (50deg) as compared to adult (45deg).o Lacrimal gland is still underdeveloped and tears are not secreted.

So the answer to this question is B


Instruction:
Treatment of choice for endocervical polyp is :
A. Vaginal hysterectomy
B. Conization
C. Polypectomy
D. Radiotherapy

Response:
Ans. is c i.e. Polypectomy Endocervical polyp : These lesions represent overgrowth of benign endocervical stroma covered by epithelium. They appear as single, red, smooth elongated masses extending from the external os. Polyps vary in size and range from several millimetres to 2 or 3cm. These common growths are found more frequently in multiparas and rarely in prepubeal females. Endocervical polyps are typically asymptomatic, but they can cause metrorrhagia, postcoital bleeding and symptomatic vaginal discharge. They are usually identified by visual inspection during pelvic examination. In some instances, Pap smear findings of atypical glandular cells have been associated with endocervical polyps. Although they are typically benign, but malignant transformation may develop in 1 percent. Impoantly, cervical cancer can present as polypoid masses and can mimic these beinign lesions. For this reason removal and histologic evaluation are recommended for an endocervical polyp. Endocervical polyps are removed by grasping the polyp with a ring or polyp forceps. The polyp is twisted repeatedly about the base of its stalk to strangulate its feeding v essels. With repeated twisting the base will avulse. Monsel solution (ferric subsulfate) can be applied with direct pressure to the resulting stalk stub to complete hemostasis.

So the answer to this question is C


Instruction:
Mental health Act was passed in the year: NEET 15
A. 1948
B. 1967
C. 1987
D. 2007

Response:
Ans. 1987

So the answer to this question is C


Instruction:
Coombs test is:
A. Precipitation test
B. Agglutination test
C. CFT
D. Neutralization test

Response:
Ans. is 'b' i.e., Agglutination test(Ref: Ananthanarayan, 9th/e, p. 109 and 8th/e, p. 108)* Coombs test (antiglobulin test or anti - Rh antibody test) is an agglutination test.* The direct Coombs test is used to detect antibodies that are stuck to the surface of red blood cells. Many diseases and drugs can cause this. These antibodies sometimes destroy red blood cells and cause anemia. Your doctor may order this test if you have signs or symptoms of anemia or jaundice.* The indirect Coombs test looks for free-flowing antibodies against certain red blood cells. It is most often done to determine if you may have a reaction to a blood transfusion.

So the answer to this question is B


Instruction:
All of the following agents have polysaccharide capsule related antigen antibody responses except -
A. Pneumococcus
B. Meningococcus
C. Haemophilus influenzae
D. Bordetella pertussis

Response:
None

So the answer to this question is D


Instruction:
The cadaveric position of vocal cords is
A. Midline
B. 1.5mm from midline
C. 3.5mm from midline
D. 7.5mm from midline

Response:
Positions of the vocal cord: 1. Median- cords touching the midline 2. Paramedian-1.5 mm from the midline 3. Intermediate (Cadaveric)- 3.5 mm from the midline 4. Slightly abducted- 7 mm 5. Fully abducted- 9 mm. Ref: Hazarika; 3rd ed; Pg 626

So the answer to this question is C


Instruction:
Systemic features of inflammation (fever & hypotension) are mediated by
A. Lipoxins
B. Cytokines
C. Histamine
D. Leukotriene

Response:
None

So the answer to this question is B


Instruction:
What supplies ammonia to liver ?
A. Arginine
B. Alanine
C. Lactate
D. Pyruvate

Response:
Ans. is 'b' i.e., Alanine Transpo of alanine from muscle to liver (glucose-alanine cycle) has two functions :?Providing substrate for gluconeogenesisTranspo of ammonia (NH4+) to liver for urea synthesis.

So the answer to this question is B


Instruction:
D–tubocurarine acts by –
A. Inhibiting nicotinic receptors at myoneural junction
B. Inhibiting nicotinic receptors at autonomic ganglion
C. Producing depolarizing block
D. By inhibiting reuptake of acetylcholine

Response:
All non-depolarizing blockers (D-tubocurarine) act as competitive antagonist of acetylcholine on nicotinic (Nm) receptors at myoneural junction.

So the answer to this question is A


Instruction:
Extensive abrasions are found on the body of a pedestrian. The cause is: AI 09
A. Primary impact injury
B. Secondary impact injury
C. Secondary injury
D. Postmoem aifact

Response:
Ans. Secondary injury

So the answer to this question is C


Instruction:
Savita is 32 weeks pregnant presents in causality and diagnosed as a case of APH. Vitals are unstable with BP 80/60 which of the following is next step in M/n:
A. Careful observation
B. Blood transfusion
C. Medical induction of labor
D. Immediate cesarean section

Response:
Ans. is b, i.e. Blood transfusionRef. Dutta Obs. 6/e, p 259; Fernando Arias 3/e, p 342, fig. 13.2Unstable vitals (BP =80/60) belong most probably to moderate category bleeding.In Mild cases - Vitals remain stable.Severe cases - Patient is in shock with very low or unrecordable B.P.The gestational age of patient is 32 weeks: As discussed, beyond 36 weeks with moderate bleeding - terminate the pregnancy.Between 32-36 weeks moderate bleeding - Management depends on whether pulmonary maturity is achieved or not.If maturity is not achieved, patient is managed conservatively on:-Close monitoring-Blood transfusions-Betamethasone (to accelerate lung maturity)This is done for 24-48 hours.If patients condition improves: expectant management is continued.If patients condition does not improve: pregnancy is terminated.As the patient in the question is 32 weeks pregnant with moderate bleeding, first we will try to improve the general condition of the patient by giving blood transfusion.

So the answer to this question is B


Instruction:
Which of the following base is usually not present in DNA?
A. Adenine
B. Guanine
C. Cytosine
D. Uracil

Response:
Uracil is not usually present in DNA, instead thymine is present. However in DNA, spontaneous deamination of cytosine can produce uracil. But, this uracil is promptly recognized by Uracil DNA-glycosylase and replaced with cytosine. If uracil were present in DNA, DNA machinery could not differentiate the original uracil and the deaminated cytosine. Thus, presence of thymine/absence of uracil gives stability to DNA. Uracil is present in RNA in place of Thymine in DNA

So the answer to this question is D


Instruction:
Which of the following statement about lepromin test is not true?
A. It is negative in most children in first 6 months of life
B. It is a diagnostic test
C. It is an important aid to classify type of leprosy disease
D. BCG vaccination may convert lepra reaction from negative to positive

Response:
The lepromin test is used to study host immunity to M.leprae.
The test was first described by Mitsuda in 1919. The test is an intradermal skin test performed by using lepromin antigen, which is a suspension of killed M. leprae obtained from infected human or armadillo tissue.
The lepromin test is not used to confirm the diagnosis of leprosy. It is also not useful to indicate prior contact of the person with leprae bacilli. Healthy people residing in areas nonendemic for leprosy with no chance of contact with the bacilli may show a positive lepromin reaction.

Key Points:-
The lepromin test is used mainly to:

Determine the type of leprosy, being positive (suggests resistance to disease) in tuberculoid leprosy and negative (suggests a lack of resistance to the disease) in lepromatous leprosy patients.
Monitor the response of leprosy patients to treatment with chemotherapy. A positive reaction indicates a good prognosis, while a negative test suggests a very bad prognosis.
Evaluate host resistance to leprosy.

Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page: 368

So the answer to this question is B


Instruction:
A patient Geeta began taking alendronate and she was advised to take a large amount of water and remain in the standing position for at least half an hour till she had the first meal of the day. These instructions were given to reduce the risk of:
A. Cholelithiasis
B. Constipation
C. Erosive esophagitis
D. Osteonecrosis

Response:
None

So the answer to this question is C


Instruction:
Subconjunctival hemorrhage occurs in all conditions except -
A. Passive venous congestion
B. Peusis
C. Trauma
D. High intraocular tension

Response:
Subconjunctival haemorrhage may be associated with following conditions:1. Trauma. 2. Inflammations of the conjunctiva 3. Sudden venous congestion of head 4. Spontaneous rupture of fragile capillaries 5. Local vascular anomalies like telengiectasia, varicosities, aneurysm or angiomatous tumour. 6. Blood dyscrasias, Bleeding disorders & Vicarious bleeding associated with menstruation 7. Acute febrile systemic infections ref: A K KHURANA OPHTALMOLOGY,E4, Page-83

So the answer to this question is D


Instruction:
A Pseudo-obstruction of 35-year-old comes to the emergency department with symptoms of pain in abdomen and bilious vomiting but no distension of bowel. Abdominal x-ray showed no air fluid level. Diagnosis is
A. CA rectum
B. Duodenal obstruction
C. Adynamic ileus
D. Pseudoobstruction

Response:
Let's see each option one by one

Adynamic ileus or Paralytic ileus

is seen commonly after abdominal operations, or post inflammatory conditions of abdomen eg Appendicitis, peritonitis, pancreatitis. Metabolic abnormalities are also a cause.
Abdominal distention, usually without the colicky abdominal pain, is the typical & most notable finding.
Vomiting may occur but may also be absent.
Absent or hypoactive bowel sounds.
Multiple air-fluid levels on x-ray.
Points b & e help in ruling out dynamic ileus.

Pseudo-obstruction

This condition describes an obstruction, usually of the colon in the absence of any mechanical cause
This may occur in acute or chronic form (Acute form is k/a Ogilvie syndrome*) Acute form usually involves only the colon.
Vomiting appears late or even absent.
Abd. cramps appear late.
Abd. distention is the chief symptom.
Since it usually involves the colon air-fluid level are not seen if the ileocecal valve is intact.

Points c, d, e help in ruling out Pseudo obstruction in this pt.

Ca Rectum :

Usually ads. of old age
Obstruction is not a common presentation Even if obstruction occurs, it is insidious in onset with pain & vomiting a late feature. There will be abdominal distention.
These point help in ruling Ca Rectum out.

Duodenal obstruction

Features of this pt. match perfectly with duodenal obstruction as
Pain and vomiting are early features.
No distention of the bowel
No air-fluid level. (There is no distention of bowel and no air fluid level as the whole of the intestinal tract distal to the obstruction is patent allowing free passage to gas and the fluids out of the body. Obstruction to duodenum prevent further entry of gas or fluids into the intestines).

So the answer to this question is B


Instruction:
A 52-year-old man presents to the out-patient clinic complaining of episodes of severe unilateral, stabbing facial pain that is intermittent for several hours, and then disappears for several days. The pain is described as "electric shock-like" and only lasts a few seconds. Physical examination of the face and mouth is entirely normal. Which of the following treatments is most effective for this condition?
A. morphine
B. indomethacin
C. cimetidine
D. carbamazepine

Response:
This patient has trigeminal neuralgia. Carbamazepine (an anticonvulsant drug) is given in doses varying from 600 to 1200 mg/day. Phenytoin has also been used. The two drugs can also be used in combination. Operative procedures include alcohol injection of the nerve or ganglion, partial section of the nerve in the middle or posterior fossa, decompression of the root, and medullary tractotomy. Radiofrequency surgery can destroy pain fibers but spare motor fibers. The other treatment options are not considered effective for this condition.

So the answer to this question is D


Instruction:
Horner Tranta's spots are seen in:
A. Vernal conjunctivitis
B. Phylectenular conjunctivitis
C. Angular conjunctivitis
D. Follicular conjunctivitis

Response:
Ans. Vernal conjunctivitis

So the answer to this question is A


Instruction:
In CuT 200, the number denotes: (PGI Dec 2008)
A. Surface Area
B. Weight in microgram
C. Weight in milligram
D. Effective half life in weeks

Response:
Ans: A (Surface Area) [Ref: Park 19th/393-397; Community medicine by Asma Rahim 1st (2008)/361-363} "The number included in the names of the devices refer to the surface area (in sq. mm) of the copper on the device. Nova T & TCu - 380 Ag are distinguished by a silver core over which is wrapped around the copper wire"- Park 19th/394 Intra-Uterine Devices: Classification 1st Generation UJDs (inert or non medicated devices) 2nd Generation HJDs * Earlier devices - Copper 7 - Copper T - 2G0q *Newer devices - Variants of the T device (i) T Cu - 220 CQ (ii) T Cu - 380 A or AgQ - Nova T*3 * Multi-load devices* (i)ML-Cu-250 (ii)ML-Cu-375 3rd Generation IUDs (Hormonal devices) - ProgestasertQ LNG-2o (Mirena) Q IUDs: Review of Facts CuT-200 B being used in India, under the national family welfare programme.Later CuT 3BOA is introduced in the programme. Studies have shown that the effectiveness of the copper device is directly related to the amount of copper surface area (usually this is 200 or 220 mm2J- Park 19th/395 IUD is not a method of first choice for nulliparous women. They have more problems such as expulsion, low abdominal pain & pelvic infection. Cafeteria Approach (community Medicine by Asma Rahim lst/359} Approach directed towards couples in the family planning programme. In this approach a "cafeteria choice" (as in a menu card of a coffee shop), Le. a list of all methods from which an individual couple can choose according to his needs & wishes to promote family planning as a way of life. #Seventy-two condoms/yr needed to protect a couple (community medicine by Asma Rahim lst/360)

So the answer to this question is A


Instruction:
Balancing side contacts in natural teeth
A. Improves muscle balance
B. Provides balanced occlusion
C. Destruct the PDL
D. Direct the forces to the long axis of the tooth

Response:
None

So the answer to this question is C


Instruction:
Damage to RBC resulting in their lysis, increases which isoenzyme in blood?
A. LDH-1
B. LDH-3
C. LDH-4
D. LDH-5

Response:
LDH 1 is pre-dominantly present in RBCs and smooth muscle of heart, thus when RBCs are damaged, LDH1 is raised.

So the answer to this question is A


Instruction:
Sweat glands of palm can be defferentiated from others by the following :
A. Apocrine glands
B. High chloride content
C. Secretion stumulated by emotional stimuli
D. Chemical mediators mediators control control the sectetion.

Response:
C i.e. Secretion stimulated by emotional stimuli

So the answer to this question is C


Instruction:
Huhle cells are seen in
A. Granulomatous thyroid disease
B. Hashimotos thyroiditis
C. Papillary carcinoma of thyroid
D. Thyroglossal duct

Response:
Refer Robbins page no 1087thyroid is often diffusely enlarged, although more localized enlargement may be seen in some cases. The capsule is intact, and the gland is well demarcated from adjacent structures. The cut surface is pale, yellow-tan, firm, and somewhat nodular. There is extensive infiltration of the parenchyma by a mono- nuclear inflammatory infiltrate containing small lympho- cytes, plasma cells, and well-developed germinal centers (Fig. 24-11). The thyroid follicles are atrophic and are lined in many areas by epithelial cells distinguished by the presence of abun- dant eosinophilic, granular cytoplasm, termed Huhle cells. This is a metaplastic response of the normally low cuboidal follicular epithelium to ongoing injury. In fine-needle aspiration biopsy samples, the presence of Huhle cells in conjunction with a heterogeneous population of lymphocytes is character- istic of Hashimoto thyroiditis. In "classic" Hashimoto thyroiditis, interstitial connective tissue is increased and may be abundant. Unlike Reidel thyroiditis (see later), the fibrosis does not extend beyond the capsule of the gland.

So the answer to this question is B


Instruction:
Spermatogenesis occurs at
A. Body temperature
B. Temperature lower than core body temperature
C. Temperature higher than core body temperature
D. Temperature does not play a role

Response:
Spermatogenesis is the process in which spermatozoa are produced from spermatogonial stem cells by way of mitosis and meiosis. The location is specifically impoant as the process of spermatogenesis requires a lower temperature to produce ble sperm, specifically 1deg-8 degC lower than normal body temperature of 37 degC (98.6 degF).Ref: Ganong&;s review of medical physiology; 24th edition; page no:-420

So the answer to this question is B


Instruction:
Which of the following is most likely cause of ARF in patient with renal failure index <1?
A. Acute glomerulonephritis
B. Congestive cardiac failure
C. Bilateral acute pyelonephritis
D. TTP

Response:
Ans. b (Congestive Cardiac Failure) (Ref. Harrison 18th/ p 1649; Table 260-3)CAUSES OFARFA. Diseases that cause renal hypoperfusion without compromising the integrity of renal parenchyma (prerenal ARF, prerenal azotemia) (-55%);B. Diseases that directly involve renal parenchyma (intrinsic renal ARF, renal azotemia) (-40%); andC. Diseases associated with urinary tract obstruction (postrenal ARF, postrenal azotemia) (-5%).CAUSES OFARFPrerenal causes# Volume depletion# Decreased "effective" circulatory volume (e.g., heart failure, liver failure),# Treatment with NSAIDs or ACE inhibitorsIntrinsic renal ARF# Diseases involving large renal vessels- Renal artery thrombosis- Atheroembolism- Renal vein thrombosis# Diseases of small vessels and glomeruli- Glomerulonephritis/ vasculitis- Hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura- Malignant hypertension# ARF mediated by ischemia or toxins (ATN)- Ischemia- Exogenous toxins, e.g., Recent radiocontrast study, nephrotoxic antibiotics or anticancer agents often coexistent with volume depletion, sepsis, or chronic renal insufficiency- Endogenous toxins, e.g., history suggestive of rhabdomyolysis (seizures, coma, ethanol abuse, trauma), History suggestive of hemolysis (blood transfusion)- History suggestive of tumor lysis (recent chemotherapy), myeloma (bone pain), or ethylene glycol ingestion# Acute diseases of the tubulointerstitium- Allergic interstitial nephritis- Acute bilateral pyelonephritis Diagnostic IndexTypical findings in ARF PrerenalIntrinsic RenalFractional excretion of sodium (%) UNa x Pcr-----PNa x Ucrx 100<1>1Urine sodium concentration (mmol/L)<10>20Urine creatinine to plasma creatinine ratio>40<20Urine urea nitrogen to plasma urea nitrogen ratio>8<3Urine specific gravity>1.020-1.010Urine osmolality (mOsm/kg H20)>500-300Plasma BUN/creatinine ratio>20<10-15Renal failure index<1>1UNa---Ucr/Pcr Urinary sedimentHyaline castsMuddy brown granular castsAlso know:More than 70% of kidney function must be lost before features of renal failure become evident

So the answer to this question is B


Instruction:
All of the following statements about Irritable Bowel syndrome are true, except:
A. Associated with anxiety
B. Stress predisposes
C. Constipation
D. Predisposes to malignancy in long term

Response:
Answer is D (Predisposes to malignancy in long term): Irritable Bowel syndrome (IBS) is a benign film:liana,' bowel disorder. IBS does not predispose to malignancy in the long term IBS may be associated with diarrhea or constipation 'The most common pattern in IBS is constipation alternating with diarrhea' - Harrison IBS max be associated with Anxiety and stress Abnormal Psychiatric manifestation are recorded in 80% of IBS patients. Emotional disorder and stress are associated with exacerbation of symptoms in IBS

So the answer to this question is D


Instruction:
A radiolucent root canal suddenly disappears at the mid root portion, the most probable diagnosis is
A. Calcifications within the pulp
B. Bifurcation of the canal
C. Sclerosis of the adjacent bone
D. Ankylosis

Response:
None

So the answer to this question is B


Instruction:
Unsafe eardrum perforation is
A. Central
B. Marginal
C. Paracentral
D. Multiple central

Response:
Ans. b (Marginal) (Ref. Diseases of ENT PL Dhingra 3rd/pg, 91-99).Attic and posterosuperior marginal perforations are seen in dangerous type of CSOM and are often associated with cholesteatoma while central perforation is considered safe, as cholesteatoma is usually not asso with it.OTITIS MEDIA# Tubotympanic disease (central perforation) remains localized to mucosa and that too mostly to anteroinferior part of middle ear cavity.# While atticoantral type or marginal or unsafe otitis media involves posterosuperior part of middle ear cleft (attic, antrum, posterior tympanum and mastoid) and is associated with cholesteatoma, which due to its bone-eroding property causes risk of serious complications and hence called unsafe or dangerous type.Chronic suppurative otitis mediaChronic suppurative otitis media (CSOM) is classified into two types: tubotympanic disease, in which there is a perforation of the pars tensa; and atticoantral disease, in which a retraction pocket develops from the pars flaccida.CSOM of the tubotympanic type. CSOM of the tubotympanic type can result from trauma or infection. When perforated the tympanic membrane usually repairs itself, but occasionally the outer layer of the tympanic membrane fuses with inner mucosa and a chronic perforation results. With this type of disease the patient's main symptoms are of an intermittent or chronic mucoid discharge associated with a mild conductive hearing loss. It is rare for this type of disease to be associated with intracranial complications. A diagnosis is made on otoscopy and the tuning forks usually suggest a conductive hearing impairment. The first-line treatment is topical antibiotic and steroid drops, and on occasion microsuction. If medical treatment fails, the patient may request an operation to graft the tympanic membrane in order to give a dry ear. This operation is termed a myringoplasty (type I tympanoplasty). The edges of the perforation are freshened and a small piece of temporalis fascia is inserted under the tympanic membrane to graft the drum.CSOM of the atticotympanic type. CSOM of the atticoantral type is important because of the complications associated with it. Cholesteatoma is the alternative name and means a cyst or sac of squamous epithelium that is present in the attic part of the middle ear. The exact aetiology of cholesteatoma is not known, although poor eustachian tube function is implicated. A retraction pocket develops in the pars flaccida and, if the squamous epithelium cannot migrate out of this pocket, a cholesteatoma results. The expanding ball of skin causes a low-grade osteomyelitis which results in the release of fatty acids from the bone. This gives the discharge its characteristic faecal smell. Invariably the discharge is accompanied by hearing loss and mild discomfort. The infection spreads to the dura via emissary veins which connect the middle ear mucosa to the dura or by direct extension of the disease through the bone. Meningitis, extradural, subdural or intracerebral abscess, or a combination of these may occur. Diagnosis should be suspected on otoscopy. Pus, crusts, granulations or a whitish debris in the attic are hallmarks of the disease. Examination under the microscope, audiometry and, sometimes, HRCT are indicated. The treatment is surgical and follows the principle of exposing the disease, excising the disease and then exteriorising the affected area. Two commonly applied operations for this disease are an atticotomy and a modified radical mastoidectomy.

So the answer to this question is B


Instruction:
If in a locality API is more than 2, the folloiwng is done-
A. 2 round of DDT per year with active surveillance
B. 2 rounds of DDT per year with active and passive surveillance
C. Only active and passive surveillance
D. 2 rounds of DDT per year only

Response:
Ans. is 'b' i.e., 2 rounds of DDT per year with active and passive surveillance

So the answer to this question is B


Instruction:
Primitive streak develops from:
A. Mesoderm
B. Epiblast
C. Hypoblast
D. Neural plate

Response:
B i.e. EpiblastRef: Essentials of Human Embryology, A.K. Datta, 5th edition, 2005, page 38-42Explanation:Primitive StreakAppears about 15th day of development.Formed by active migration and invagination of p ectodermal cells ( into the space between epiblast and hypoblast.Gastrulation^-Tbe process of invagination of pleuripotent cells in between epiblast and hypoblast.Primitive streak acts as primary organizer- Induces the differentiation of notochord and intraembryonic mesoderm.Primitive streak from its cranial end gives origin to definitive notochord-forerunner in the development of vertebral column.Notochordal cells persist as nucleus pulposus in the center of intervertebral disc.Primitive streak disappears at 26th day of development.If persist gives the development of sacrococcygeal teratoma.

So the answer to this question is B


Instruction:
In thyroid, the bruit is heard in
A. Lower pole
B. Upper pole
C. Medial side
D. Lateral side

Response:
Ans. (b) Upper pole.Ref: Rajamahendran Long Cases In Surgery- Page 32 2nd Edition* Systolic bruit may be heard in superior pole outwards due to increased vascularity.

So the answer to this question is B


Instruction:
All of the following statements regarding adult polycystic kidney disease are TRUE, EXCEPT:
A. Autosomal dominant inheritance
B. Hypeension is rare
C. Can be associated with cysts in liver, lungs and pancreas
D. Pyelonephritis is common

Response:
Hypeension is a common finding associated with ADPKD due to increased activity of the renin-angiotensin system. ADPKD is a systemic disorder resulting from mutation in either the PKD1 or PKD2 gene. IN 90%cases, it is inherited in an autosomal dominant fashion. Phenotypic heterogeneity is a hallmark feature of this condition. Patients presenting signs and symptoms includes abdominal discomfo, hematuria, urinary tract infection, incidental discovery of hypeension, abdominal masses, elevated serum creatinine, and cystic kidneys on imaging studies. Extrarenal manifestations of ADPKD are: Subarachnoid and cerebral hemorrhage from a ruptured intracranial aneurysm Mitral valve prolapse and aoic regurgitation Hepatic cysts Colonic diveicula Abdominal wall and inguinal hernias Ref: Harrison's Principles of Internal Medicine 18e chapter 284.

So the answer to this question is B


Instruction:
The use of broad-spectrum antibiotics can produce a bleeding diathesis characterized by hematomas, hematuria, melena, and bleeding from the gums by decreasing the normal gut flora and inducing a deficiency of:
A. Vitamin A
B. Vitamin B1
C. Vitamin B6
D. Vitamin K

Response:
A deficiency of vitamin K, which can result from fat malabsorption, broad-spectrum antibiotics, or diffuse liver disease, produces a bleeding diathesis characterized by hematomas, ecchymoses, hematuria, melena, and bleeding from the gums. Laboratory tests reveal an increased bleeding with prolonged PT and PTT and normal bleeding time.

So the answer to this question is D


Instruction:
A 28-year-old woman complains of chest pain for 1.5 months. Three months prior to the current visit, she developed cough with expectoration, worse in the early morning. There was no shoness of breath or hemoptysis About 2 months after the onset of the cough, she began to have intermittent pleuritic (worse with coughing or deep breathing) left sided chest pain, increasing fatigue and weight loss of 3kgs but no loss of appetite. On auscultation: fine crackles in the suprascapular areas bilaterally were present(L>>R). The left upper lobe was dull to percussion. All are contents of the classic medium used for the above disease except: -
A. Egg suspension
B. Malachite green
C. Glycerol
D. L-glutamine

Response:
The patient comes with a constellation of weight loss, productive cough, and cavitary pulmonary infiltrates, which is extremely characteristic of TB. The medium being asked is the Lowenstein-Jensen medium, an egg-based solid medium that suppos the growth of Mycobacterium species, including Mycobacterium tuberculosis. CXR shows well defined cavitary lesions in left upper lung zone and right lower lung zone. COMPOSITION OFLJ MEDIUM Ingredients Potato Flour (Potato Starch) L-Asparagine Monopotassium Phosphate Magnesium Citrate Malachite Green Magnesium Sulfate Glycerol Egg suspension Distilled Water

So the answer to this question is D


Instruction:
Darkening of urine on standing is associated with –
A. Alkaptonuria
B. Cystinuria
C. Fabry's disease
D. Tyrosinemia

Response:
Alkaptonuria

It is an autosomal recessive disorder.
It is due to deficiency of enzyme homogentisic oxidase.
A large amount of homogentisic acid is accumulated in the body and excreted in urine.

Clinical manifestations

Clinical features consist of -

Ochronosis → Dark spot on the sclera or ear cartilage.
Arthritis → Spine, hip, knee.

But both these occur in adulthood.
The only sign of disease in children is a blackening of urine on standing. This is caused by oxidation and polymerization of homogentisic acid.
High incidences of heart disease (mitral and aortic valvulitis, calcification of heart valves, MI) have been noted.

So the answer to this question is A


Instruction:
The drug of choice for the treatment of Thyrotoxicosis during pregnancy is:
A. Carbimazole
B. Iodine therapy
C. Propyl thiouracil
D. Metimazole

Response:
Ans. is 'c' i.e. propylthiouracilRef.: K.D. T. 5th/e p 232, 4th/e p 259, 260This question has been repeated several times before, remember these important pointsAll antithyroid drugs can cross placenta so risk of fetal hypothyroidism and goitre is always thereBoth carbimazole and propylthiouracil can be used during pregnancy, but propylthiouracil is the drug of choice because its greater protein binding allows low doses of propylthiouracil to be transferred across the placenta and therefore less chance of hypothyroidism.The lowest effective dose of propyl thiouracil should be given and it is often possible to stop treatment in the last trimester since TSH Receptor antibodies tend to decline in pregnancy.Radioactive iodine is C/I during pregnancyIt can destroy the fetal thyroid tissue resulting in cretinismCarbimazole and methimazole have been associated with rare cases of foetal aplasia cutis.

So the answer to this question is C


Instruction:
Two variables can be plotted together in -
A. Pie cha
B. Histogram
C. Frequency polygon
D. Scatter diagram

Response:
- scatter maps show the relationship between two variables - if dots cluster round a straight line, it shows evidence of relationship of a linear nature. If there is no such cluster, it is probable that there is no relationship between the variables. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:847

So the answer to this question is D


Instruction:
Articular cartilage is made up of -
A. Type I collagen
B. Type II collagen
C. Type III collagen
D. Type IV collagen

Response:
Collagen is the main protein of connective tissue in animals and the most abundant protein in mammals, making up about 25% of the whole-body protein content.
Tough bundles of collagen called collagen fibres are a major component of the extracellular matrix that supports most tissues and gives cells structure from the outside, but collagen is also found inside certain cells. Collagen has the great tensile strength and is the main component of fascia, cartilage, ligaments, tendons, bone and teeth. 28 types of collagens have been found (so far) in humans.
Over 90% of the collagen in the body, however, are of type I, II, III, and IV.

So the answer to this question is B


Instruction:
Term 'schizophrenia' was coined by: TN 06; Ranchi 10; NEET 13
A. Eugene Bleuler
B. Kraepelin
C. Freud
D. Schneider

Response:
Ans. Eugene Bleuler

So the answer to this question is A


Instruction:
Protein requirement of 4 kg new born (daily) ?
A. 3 gm
B. 7 gm
C. 9 gm
D. None

Response:
Ans. is 'None' o Daily protein requirement upto 6 months of age is 1.16 g/kg/day. o 4 kg infant requires 4 x 1.16 =4.64 gm proteins/day.

So the answer to this question is D


Instruction:
A 45 year old female patient presented with features of hypothyroidism. Histopathology is shown below. Based on histological features, what is your diagnosis?
A. Hashimoto thyroiditis
B. Granulomatous thyroiditis
C. Papillary carcinoma of thyroid
D. Reidel's thyroiditis

Response:
Given histopathological slide shows extensive infiltration of thyroid parenchyma by mononuclear inflammatory infiltrate, well-developed germinal centers & Huhle cells. These features along with the history suggests the diagnosis of Hashimoto thyroiditis.

So the answer to this question is A


Instruction:
which of the following is not true regarding tri cyclic antidepressent
A. it is safe in bipolar depression as it does not cause switch to mania
B. it causes sedation
C. it causes weigh tgain
D. it causes giddiness

Response:
TCA * MECHANISM This is an antidepressant with three rings. It acts by blocking the transpoers of neurotransmitters resulting in increased neurotransmitters in synapse DRUGS AMITRYPTILLINE IMIPRAMINE CLOMIPRAMINE DESIPRAMINE NORIPTILLINE DOXEPINE * USE AMITRYPTILLINE========PAIN WITH DEPRESSION IMIPRAMINE==========CHILDHOOD ENEURESIS CLOMIPRAMINE========OCD * SIDE EFFECTS ANTI HISTAMINERGIC==== sedation, weight gain ANTI MUSCURANIC=======dryness of mouth ANTI ADRENERGIC========hypotension, giddiness SWITCH TO MANIA when used in BIPOLAR DEPRESSION Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 955

So the answer to this question is A


Instruction:
Forced dieresis with acidification or alkalinization of urine is a common method for elimination of ceain poisons/ drugs from the body. The elimination of which of the following drugs is commonly enhanced by alkaline dieresis
A. Amphetamines
B. Phenobarbitone
C. Phencyclidine
D. Theophylline

Response:
B i.e. Phenobarbitone - Hemodialysis is not useful in copper sulfate, Kerosine oil, benzodiazepine, gganophosphate and digitalis poisoningQ. Mn "C-Oil BORD" Where hemodialysis is indicated in aspirin (salicylates), barbiturates (phenobarbitone), chloral hydrade, methyl & ethyl alcohol (ie methanol & ethanol), ethylene glycol and theophyllineQ. Charcol hemoperfusion is indicated in barbiturate (phenobarbitone)Q, carbamazepine and theophylline. - Multiple dose of activated charcoal to increase elimination by interrupting entero-enteric and entero-hepatic circulation is indicated in life threatening over dose with barbiturates (phenobarbitone), carbamazapine, theophylline, dapsone and quinineQ. - Forced alkaline dieresis (ie alkalinization of urine) is indicated in phenobarbitone and salicylates (eg aspirin)Q; whereas acid dieresis is indicated in amphetamine, phencyclidine & cocaine overdoseQ and saline diuresis in alcohol. - Most effective & rapid method of reducing plasma K+ level in hyperkalemia is hemodialysisQ (reserved for life threatening hyperkalemia unresponsive to conservative methods, in patients with renal failure). Peritoneal dialysis also works but is only 20% as effective as hemodialysis.

So the answer to this question is B


Instruction:
Average thickness of the periodontal ligament is
A. 0.15 to 0.38 mm
B. 0.05-015 mm
C. 0.38 -0.48 mm
D. 0.26-0.38 mm

Response:
None

So the answer to this question is A


Instruction:
All the following statements about mitral valve prolapse are true except
A. It is more common in females
B. Most patients are symptomatic
C. It has a benign clinical course
D. Transient cerebral ischemic is a know complication

Response:
Ref Harrison 19 th ed pg 1546 Most patients are asymptomatic and remain so for their entire lives. However, in Noh America, MVP is now the most common cause of isolated severe MR requiring surgical treatment.

So the answer to this question is B


Instruction:
TRUE about vitamin K is
A. It is required for synthesis of factor VIII
B. Long term use of antimicrobials can cause deficiency of vitamin K
C. It is a water soluble vitamin
D. DVT is associated with vitamin K deficiency

Response:
(B) Long term use of antimicrobials can cause deficiency of vitamin K[?]VITAMIN K DEFICIENCYoVitamin K is a fat-soluble vitamin that plays an important role in blood clotting-Vitamin K exists in both natural and synthetic forms.oNatural forms of vitamin K include:-Vitamin K1 (Phytonadion) plant & animal sources-Vitamin K2 (Menaquinone) produced by intestinal bacteria-Vitamin K3 (Menndione) syntheticoVitamin K functions:-Activation of clotting factors II, VII, IX, X-Required for gama carboxylation of glutamic acid residues of osteocalcin required for bone development-Activation of anticlotting proteins-Protein C & SoVitamin K deficiency occurs in:-Inadequate absorption (Fat malabsorption syndromes)-Chronic diarrhoea-Use of broad spectrum antibiotics (due to suppression of vitamin K-synthesizing bacterial flora in the gut)-Diffuse liver disease-Coumarin (warfarin) induces deficiencyoDeficiency manifestations:-Bleeding diathesis-Epistaxis, haematuria, GI bleeding, post op bleeding-skinoUses of vitamin k:-Prevention and treatment of bleeding associated with deficiency states-In obstructive jaundice (K1 preferred)-Given routines to all neonates to prevent bleeding as intestinal flora necessary for vitamin k synthesis is not developed-As an antidote to oral anticoagulants toxicity-A/E: Anaphylaxis, flushing, sweating, dyspnoea, cyanosis, cardiovascular collapseVitamin K deficiency*. Source of vitamin KGreen vegetables Synthesized by intestinal flora*. Required for synthesisFactors II, VII, IX, X Protein C and S*. Causes of deficiencyMalnutrition Biliary obstruction Malabsorption Antibiotic therapy*. TreatmentVitamin K Fresh frozen plasmaOther Options[?]It is required for synthesis of factor VIIIoSince a vitamin K dependent protein, protein C, can inactivate factor VIII, a study was undertaken to determine if the level and stability of factor VIII in plasma are influenced by such a protein.[?]It is a water soluble vitaminoVitamin B1 (thiamine), Vitamin B2 (riboflavin), Vitamin B3 (niacin), Vitamin B5 (pantothenic acid), Vitamin B6, Vitamin B7 (biotin), Vitamin B9, Vitamin B12 (cobalamin), Vitamin C[?]Deep vein thrombosis (DVT) low vitamin D levels are associated with idiopathic deep vein thrombosis.oDeep vein thrombosis (DVT) is the formation of a blood clot in one or more deep veins. Idiopathic means that it is a condition that occurs unexpectedly or in which the cause is unknown.oDVT may develop if you are sitting for long periods of time or if you have certain medical conditions that affect your body's ability to form blood clots.

So the answer to this question is B


Instruction:
Nerve suply of cremastric muscle ?
A. Pudendal nerve
B. Femoral branch of genitofemoral
C. Genital branch of genitofemoral nerve
D. Ilioinguinal nerve

Response:
Genital branch of genitofemoral nerveCremastric muscle is a muscle of scrotum. It is supplied by genital branch of genitofemoral nerve.

So the answer to this question is C


Instruction:
All of the following occur in mitochondria except:
A. Citric acid cycle (Krebs's cycle)
B. Glycogenolysis
C. Fatty acid oxidation
D. Electron transport chain

Response:
Ans. B. GlycogenolysisGlycogenolysis occurs in the cytoplasm.Other metabolic reactions in the cytosol - glycolysis, glycogenesis, cholesterol synthesis, HMP shunt, bile acid synthesis

So the answer to this question is B


Instruction:
Lateral orbital wall is formed by
A. Zygomatic bone and greater wing of sphenoid
B. Zygomatic and orbital process of palatine
C. Frontal process of maxilla
D. Frontal bone and lesser wing of sphenoid

Response:
Orbital wall Roof - Frontal - Lesser wing of sphenoid Floor -Zygomatic & orbital process of palatine Medial wall frontal process of maxilla - Lacrimal Bone - Orbital plate of the ethmoid - Body of the sphenoid Lateral wall - Zygomatic - Greater wing of sphenoid

So the answer to this question is A


Instruction:
The hardness of drinking water should be?
A. >3
B. <1
C. 3-Jan
D. >6

Response:
ANSWER: (C) 1-3REF: Park 20th ed p. 636Drinking water should be moderately hard. Softening of drinking water Is recommended when the hardness exceeds 3 mEq/LClassificationLevel of hardness ( mEq/L)Soft water< 1 ( < 50 mg/l)Moderately hard1-3 ( 50-150 mg/l )Hard water3-6 (150-300 mg/l)Very hard water> 6 ( > 300 mg/l)

So the answer to this question is C


Instruction:
Validity of a test is based upon all except -
A. Sensitivity
B. Specificity
C. Precision
D. Accuracy

Response:
→ Precision stands for repeatability (not validity).

So the answer to this question is C


Instruction:
Amount of estrogen in Mala D is:
A. 30 μg
B. 50 μg
C. 10 μg
D. 80µg

Response:
None

So the answer to this question is A


Instruction:
False about Alport syndrome
A. Sensory neural deafness
B. Keratoconus
C. Megalocornea
D. Thrombocytosis

Response:
None

So the answer to this question is D


Instruction:
Substance (s) freely filtered across glomerular capillaries
A. Glucose
B. Albumin
C. Thyroxin
D. Creatinine

Response:
Glomerular filtration the renal process whereby fluid in the blood is filtered across the capillaries of the glomerulus and into the urinary space of Bowman&;s capsule. Glucose is freely filtered across glomerular capillaries.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 678

So the answer to this question is A


Instruction:
A newborn presenting with intestinal obstruction showed on abdominal X-ray, multiple air fluid levels. The diagnosis is not likely to be-
A. Pyloric obstruction
B. Duodenal atresia
C. Illeal atresia
D. Ladd \\ s bands

Response:
A i.e. Pyloric obstruction

So the answer to this question is A


Instruction:
All of the following comes under primary prevention EXCEPT
A. Pap smear
B. Helmets
C. Contraception
D. Vaccines

Response:
Ans. (a) Pap smearRef : K. Park 23rd ed. / 41, 385* PRIMARY PREVENTION is the action taken prior to the onset of disease which removes the possibilities of disease occurrence.* Modes of intervention :# Health promotion# Specific protection* It is applicable for "risk factors are present but disease has not yet taken place"* Pap smear is a screening test, which comes under secondary level of prevention.

So the answer to this question is A


Instruction:
'Doughnut' sign and 'Coiled spring' appearance are seen in
A. Intussusception
B. Meckel's diverticulum
C. Intestinal malrotation
D. Volvulus

Response:
(A) Intusussception # Ultrasound Axial images of intussusception showed a doughnut pattern.> Hypoechoic external ring was formed by the everted returning limb of intussusceptum and, to a lesser degree, by the intussuscipiens.> Doughnut's center varied according to the scan level.> Scans obtained at the middle or at the base of the intussusception showed a characteristic hyperechoic crescent in all cases.> This crescent was formed by the mesentery enclosing the entering limb of the intussusceptum, which the authors have termed the Crescent-in-doughnut sign'.> On scans obtained at the apex of the intussusception, the center was hypoechoic owing to the entering limb of the intussusceptum and the absence of the mesentery.> Crescent-in-doughnut sign appears to be a characteristic feature of intussusception.> Contrast enema remains the gold standard, demonstrating the intussusception as an occluding mass prolapsing into the lurren, giving the "coiled spring" appearance (barium in the lumen of the intussusceptum and in the intraluminal space).> Main contraindication for an enema is a perforation.

So the answer to this question is A


Instruction:
In which of the following patients, thyrotoxicosis should not be suspected
A. Patients with unexplained weight loss
B. Patients with unexplained diarrhoea
C. Patients with distal muscle weakness
D. Patients with paroxysmal atrial tachycardia

Response:
Thyrotoxicosis is a hyper metabolic state caused by elevated levels of free T3 and T4. It leads to increase in metabolic rate and heightened catabolic metabolism resulting in weight loss despite of increased appetite. It also causes cardiac manifestations like paroxysmal atrial tachycardia. Sympathetic hyper stimulation of gut causes hypermotility and diarrhea. Thus in all above cases except weakness of distal muscles one can suspect thyrotoxicosis. (ref:ROBBINS Text book of pathology endocrinology)

So the answer to this question is C


Instruction:
Mental health programme was staed in -
A. 1982
B. 1987
C. 1990
D. 1995

Response:
National mental health programme was launched in 1982 with a view to ensure availability of mental health care services for all , especially the community at risk and underprevileged section of the population ,to encourage application of mental health knowledge in general health care and social devalopment. ref; (page no;473) 23rd edition of PARK&;s textbook of Preventive and Social medicine

So the answer to this question is A


Instruction:
Type of early childhood caries in which labio-lingual extension of caries occurs involving incisors and /or molars is:
A. Type1 ECC
B. Type2 ECC.
C. Type3 ECC.
D. None.

Response:
None

So the answer to this question is B


Instruction:
A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which one of the following digestive enzymes would be affected ?
A. Amylase
B. Pepsin
C. Lactose
D. Trypsin

Response:
Trypsinogen gets activated by enterokinase present in the intestinal microvillus membranes. Once activated trypsin activates other enzyme molecules. Trypsin activated by the removal of hexapeptide from N- terminal end. Trypsin catalyses the hydrolysis of the bonds formed by carboxyl group of Arg and Lys. Ref : TEXTBOOK OF BIOCHEMISTRY, D.M.VASUDEVAN,6TH EDITION PG NO:172

So the answer to this question is D


Instruction:
Spongiform degeneration of cerebral cortex occurs in -
A. Creutzfeldt-Jakob disease
B. Subacute sclerosing panencephalitis
C. Fatal familial insomnia
D. Cerebral toxoplasmosis

Response:
Ans. is 'a' i.e., Creutzfeldt-Jakob disease o On microscopic examination, in Creutzfeldt-Jakob disease the pathognomonic finding is a spongiform transformation of the cerebral cortex and, often, deep gray matter structures (caudate, putamen); this consists of a multifocal process that results in the uneven formation of small, apparently empty, microscopic vacuoles of varying sizes within the neuropil and sometimes in the perikaryon of neurons. In advanced cases, there is severe neuronal loss, reactive gliosis, and sometimes expansion of the vacuolated areas into cystlike spaces ("status spongiosus").o Kuru plaques are extracellular deposits of aggregated abnormal protein; they are Congo red-positive as well as PAS-positive and occur in the cerebellum in cases of Gerstmann-Strdussler-Scheinker syndrome; they are present in abundance in the cerebral cortex in cases of variant CJD.o In all forms of prion disease, immunohistochemical staining demonstrates the presence of proteinase-K-resistant PrPsc in tissue.o Fatal familial insomnia does not show spongiform pathology. Instead, the most striking alteration is neuronal loss and reactive gliosis in the anterior ventral and dorsomedial nuclei of the thalamus; neuronal loss is also prominent in the inferior olivary nuclei.Some important questions on Prions diseaseo Disease confined to nervous system.o Caused by infection proteinaceous particles called prions.o Characterized by neurodegeneration and spongiform changes.o Usually have long incubation period.o Disease is usually chronic progressive disease.o The disease is invariably fatal.o The host shows no inflammatory response and no immune res pons.

So the answer to this question is A


Instruction:
All of the following can be given through endotracheal tube, except
A. Epinephrine
B. Lignocaine
C. Surfactant
D. Calcium

Response:
Lignocaine, epinephrine, atropine and vasopressin can be delivered down a catheter whose tip extends beyond endotracheal tube.

So the answer to this question is D


Instruction:
FNAC needle size
A. 18-22
B. 22-26
C. 27-29
D. 16-18

Response:
Fine needle aspiration cytology (FNAC) is cytological study of tumour cells to find out the disease and also to confirm whether it is malignant or not. It is done using 23 or 24 gauge needle(22-26 G) fixed to specialised syringes which creates negative pressure for aspiration and contents are smeared on the slides. It is done in parotid, thyroid, lymph node, breast and all other surface lesions. Reference : page 278 SRB's manual of surgery 5th edition

So the answer to this question is B


Instruction:
Regarding CEA-false is -
A. Prognostic indicator
B. Glycoprotein
C. Elevated in colorectal carcinoma
D. Elevated only when there is hepatic metastasis

Response:
Ans. is 'd' i.e., Elevated only when there is hepatic metastasis

So the answer to this question is D


Instruction:
Most sensitive imaging for ductal carcinoma insitu breast is
A. Mammography
B. MRI
C. PET
D. USG

Response:
Screening with MRI is superior to mammography in detecting invasive breast cancer in younger women, where the sensitivity of mammography is low due to presence of mammographically dense breast parenchyma. Ref: Grainger 5th edition Pgno: 1190, 1188

So the answer to this question is B


Instruction:
All are true about the round ligament except -
A. Measure 12 cm in length
B. Is homologous to the gubernaculum testis
C. Lies anterior to the obturator aery along its course
D. Contains smooth muscles

Response:
Round ligament They are paired, one on each side, measures about 10-12 cm It is attached to cornu of the uterus below and in front of fallopian tube It courses beneath the anterior leaf of the broad ligament to reach the internal abdominal ring It contains connective tissue During its course, it runs anterior to the obturator aery and lateral to the inferior epigastric aery It corresponds to gubernaculum testis developmentally and is morphologically continuous with the ovarian ligament Ref: D.C. Dutta&;s Textbook of Gynaecology, Pg no: 24, 6th edition

So the answer to this question is D


Instruction:
An 8–month–old female child presented to emergency with a heart rate of 220/minute and features of congestive heart failure. Her heart rate comes down to normal after administering intravenous adenosine. What is the most likely diagnosis ?
A. Atrial fibrillation
B. Atrial flutter
C. Paroxysmal supraventricular tachycardia
D. Ventricular tachycardia

Response:
Adenosine is the DOS for PSVT.

So the answer to this question is C


Instruction:
Most commonly varicose veins are seen with :
A. Long saphenous vein
B. Short saphenous vein
C. Both
D. popliteal and femoral vein

Response:
Ans. is 'a' ie. long saphenous vein (Schwart, 7/e, p 1021) (not mentioned in 8/e)" The usual distribution of veins is below the knee in branches of the greater saphenous system*

So the answer to this question is A


Instruction:
Which investigation is most diagnostic of pulmonary emboli?
A. CTPA
B. V/P scan
C. HRCT
D. D- Dimer Assay

Response:
Computed Tomography Pulmonary Angiography (CTPA) is the initial imaging modality of choice for stable patients with a suspected pulmonary embolism. Pulmonary angiography shows emboli directly but it is an invasive procedure CT is noninvasive, cheaper and widely available. so, it's the most diagnostic investigation of choice. - D-Dimer is the screening investigationin PE pt's

So the answer to this question is A


Instruction:
Which of the following is not conveed into an active metabolite?
A. Lisinopril
B. Fluoxetine
C. Cyclophosphamide
D. Diazepam

Response:
prodrugs are conveed into active metabolites all ACE inhibitors except captopril and lisinopril are prodrugs lisinopril: It is the lysine derivative of enalaprilat: does not require hydrolysis to become an active ACE inhibitor. Fluoxetine has an active demethylated metabolite Diazepam has an active metabolite Desmethyl-diazepam, oxazepam Cyclophosphamide have active metabolite Aldophosphamide, .phosphorarmide mustard, acrolein Ref ;KD Tripathi pharmacology 7th edition (page no; 503,461,22,23)

So the answer to this question is A


Instruction:
Carcinoid of lung (bronchial adenoma) arise from
A. Ciliated cell
B. Kulchitsky cell
C. Type 2 pnemocytes
D. Clara cell

Response:
Ans. (b) Kulchitsky cell(Ref: Robbins 9th/pg 719)Enterochromaffin (EC) cells, or "Kulchitsky cells"; are a type of enteroendocrine and neuroendocrine cell occurring in the epithelia lining the lumen of the digestive tract and the respiratory tract that release serotonin.Tumors from these cells results in carcinoid.

So the answer to this question is B


Instruction:
Moderately increased risk for invasive breast carcinoma is associated with which of the following
A. Sclerosing adenoma
B. Apocrine metaplasia
C. Duct ectasia
D. Atypical ductal hyperplasia

Response:
.

So the answer to this question is D


Instruction:
Which of these statements abut ulcerative colitis (US) and colon carcinoma is FALSE ?(
A. The risk of carcinoma increases with duration of UC
B. Overall risk is less than 5%
C. Cancer of rectum is more common than that of colon
D. Surgery is indicated if biopsy shows severe epithelial dysplasia

Response:
Patients hospitalized for ulcerative colitis (UC) are at high risk for colectomy. The cumulative colectomy risk score ranged from 8%, with significantly higher risk of colectomy in the high-risk stratum (13.7%) compared to the intermediate-risk (4.2%, P < 0.001) and low-risk (1.3%, P < 0.001) strata Ref Davidson edition23rd pg 815

So the answer to this question is B


Instruction:
Physical quality of life index is measured by all, Except
A. Infant moality
B. Life expectancy at age one
C. Literacy
D. Per capita income

Response:
(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no: no: 17, 18)Human Development Index (HDI) Vs Physical Quality of Life Index (PQLI)HDIPQLIComponentsLongevity - Life expectancy at bih (LEdeg/LEdeg)Income (Real GDP per capita in PPP US$)Knowledge (Mean years of schooling - Gross enrolment ratio & Literacy rate)Life expectancy at 1 year age (LE)Infant moality rate (IMR)Literacy rateRange0 to +10 to 100Value of India0.547 (2011)Ranking - 131 in 2017130 as medium development category (2015) among 188 countries65 (old index, now not used)

So the answer to this question is D


Instruction:
Longest acting LA is ?
A. Bupivacaine+ Etidocaine
B. Bupivacaine + lignocaine
C. Procaine + lidocaine
D. Bupivacaine + mepivacaine

Response:
Half life order - Bupivacaine> Etidocaine> Mepivacaine> Lignocaine.
Same will be the order of duration of action.

So the answer to this question is A


Instruction:
Fulminant hepatitis E is seen in?
A. Pregnant women
B. Infants
C. Malnourished males
D. Adolescents

Response:
ANSWER: (A) Pregnant womenREF: Park 18th ed p. 174, Robbins 7th ed 891 table 18-6Important points about hepatitis E:Transmitted by feco-oral routeFulminant hepatitis E seen in pregnant women (20-40%) especially in last trimesterMost common cause opf sporadic cases of hepatitis in adults - Hepatitis EEpidemics are almost exclusively caused by enetrically transmitted Hepatitis E Hepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHepatitis GAgentIcosahedral capsid, ssRNAEevelopeddsDNAEnvelopedssRNAEnvelopedssRNANon enveloped ssRNAssRNATrans-missionFecal oralParenteral, dose contactParenteral, close contactParenteral, close contactWaterborneParenteralIncubationperiod2-6 wks4-26 wks2-26 wks4-7 wks2-8 wksUnknownCarrier stateNone0.1-1% of blood donors in U.S & west0.2-1% of blood donors in U.S & west1-10% in drug addicts & hemophiliacUnknown1-2% of blood donors in U.SChronic hepatitisNone5-10% of acute infections>50%< 5% coinfection, 80% upon super infectionNoneNoneHepato-cellularcarcinomaNoYesYesNo increase above HBVUnknown but unlikelyNone

So the answer to this question is A


Instruction:
Gettler test detects: NEET 14
A. Diatoms in drowning
B. Chloride content of blood in drowning
C. Weight of lungs in drowning
D. Magnesium content of blood in drowning

Response:
Ans. Chloride content of blood in drowning

So the answer to this question is B


Instruction:
Griffith experiment was done on ?
A. Streptococcus
B. Pneumococcus
C. Enterococcus
D. Staphylococcus

Response:
Ans. is 'b' i.e., Pneumococcus In 1928, Frederick Griffith's experiment first demonstrated transformation in streptococcus pneumoniae.Frederick Griffith's experiment on pneumococcus (streptococcus pneumoniae) proved that genetic characters are transmitted from one generation to the other through transformation.

So the answer to this question is B


Instruction:
Most common cause of delayed pubey in males is:
A. Kallman syndrome
B. Klinefelter syndrome
C. Constitutional
D. Prader-willi syndrome

Response:
DELAYED PUBEY: More common in boys Delayed pubey in boys - lack of pubeal changes by 14 yrs of age Most common cause of delayed pubey is constitutional. Constitutional delay in pubey in boys: Have growth retardation & delayed bone age Family history of delayed pubey is present Gonadotropin levels - prepubeal - similar to hypogonadotropic hypogonadism

So the answer to this question is C


Instruction:
A 35 year pregnant woman comes graves disease in first trimester. What is preferred treatment?
A. Drugs alone
B. Surgery followed by drugs
C. Radio- iodine ablation
D. Observation

Response:
PTU is given in pregnant woman. Carbimazole is contraindicated.

So the answer to this question is A


Instruction:
In poal hypeension the sites of poosytemic anastomosis includes all except
A. Lower end of esophagus
B. Around umbilicus
C. Lower third of rectum and anal canal
D. Superior and inferior pancreatic vessels

Response:
A poacaval anastomosis is a specific type of anastomosis that occurs between the veins of poal circulation and those of systemic circulation. The inferior end of the esophagus and the inferior pa of the rectum are some of the most impoant sites of poal systemic anastomosis.In poal hypeension, as in the case of cirrhosis of liver, the anastomoses become congested and form venous dilatations

So the answer to this question is D


Instruction:
A 65-year-old man presents to his GP with vision loss, headaches and cold intolerance. He also mentions he has unintentionally gained 5kg in the last 3 months. On examination, he is found to have a bitemporal hemianopia and a pulse of 50 bpm. A thyroid function test is ordered. Which of the following test results is most likely to belong to this patient?
A. TSH: Low T4: Low T3: Low
B. TSH: high T4: low T3: low
C. TSH: high T4: normal T3: normal
D. TSH: low T4: high T3: high

Response:
Cold intolerance & Weight gain (etiology hypothyoidism) Visual deficit - Bitemporal hemianopnia (pituitary adenoma may be the cause) Secondary (or central) hypothyroidism is caused by disorders of the pituitary gland or hypothalamus. Generally, secondary hypothyroidism is associated with low TSH and low T3 and T4. However, TSH levels may also be normal or even slightly elevated. For this reason, TSH is often an unreliable measure of secondary hypothyroidism and should not be used to assess the adequacy of thyroid replacement in these patients Clinical Diagnosis of 2o Hypothyroidism (pituitary affected) TSH || T4|| T3||

So the answer to this question is A


Instruction:
Apical third root fracture in a vital tooth are related by:
A. Extraction.
B. Relieve from occlusion and observe.
C. RCT.
D. Any of the above.

Response:
None

So the answer to this question is B


Instruction:
The lowest recurrence of peptic ulcer is associated with
A. Gastric resection
B. Vagotomy + drainage
C. Vagotomy + Antrectomy
D. Highly selective vagotomy

Response:
Answer is C (Vagotomy + Antrectomy) Repeat Vagotomy with Antrectomy is associated with lowest recurrence rates.

So the answer to this question is C


Instruction:
In heterochromic cyclitis –
A. 60% of patients develop glaucoma
B. Show a good response when treated with steroids
C. Lens implantation following cataract surgery is contraindicated
D. Hyphaema during cataract surgery is due to iris neovascularization

Response:
Fuch's heterochromic iridocyclitis (Fush's uveitis syndrome)

It is a form of anterior and intermediate uveitis.
The condition is usually unilateral and chronic in nature and is characterized by a chronic non-granulomatous uveitis and eventually results in iris heterochrontia (a change in the colour of iris).

The disease has the following characteristic features :

Heterochrornia of iris.
Diffuse stromal iris atrophy Fine KPs at the back of the cornea.
Faint aqueous flare.
The absence of posterior synechiae.
A fairly common rubeosis iridis, sometimes associated with neovascularisation of the angle of the anterior chamber.
Comparatively early development of complicated cataract and secondary glaucoma (usually open-angle type). Glaucoma has been reported in 10-59% of cases.

Treatment

Fuch's heterchromic uveitis responds variably to steroids and cycloplegics. The complications of long-term use of these drugs may at times outweigh their potential benefits. Therefore, treatment with topical steroids is given to iritis which is sufficiently active to require the treatment, otherwise, the patient is routinely followed without giving any treatment.
Cataract responds well to most forms of intraocular surgeries, including the standard IOL implantation. Hyphentia may occur because of rubeosis iridis (neovascularization of iris).
Glaucoma control may be somewhat more problematic, with surgical options indicated for later forms of the disease.

So the answer to this question is D


Instruction:
Ectopia lentis is seen in all of the following except: March 2007
A. Marfan's syndrome
B. Homocystinuria
C. Weil-Marchesani syndrome
D. Down syndrome

Response:
Ans. D: Down syndrome Ectopia lentis is a displacement or malposition of the eye's crystalline lens from its normal location. More common: Marf an syndrome Homocystinuria Weil-Marchesani syndrome Sulfite oxidase deficiency Hyperlysinemia Less common: Ehlers-Danlos syndrome Crouzon disease Refsum syndrome Sturge-Weber syndrome Pierre Robin syndrome

So the answer to this question is D


Instruction:
Vascular dementia is characterized by
A. Vascular dementia is characterized by
B. Memory deficiet
C. Emotional liability
D. All

Response:
A i.e. Disorientation; B i.e. Memory deficit; C i.e. Emotional lability These all are features of dementia Dementia is characterized by multiple cognitive defects that include impairment in memory, without impairment in consciousnessQ. The cognitive functions that can be affected in dementia include general intelligence, learning & memory, language, problem solving, orientation, perception, attention & concentration, judgement & social abilities (key words : think about a very old man who is unable to learn new things, concentrate, judge & solve problems with poor personal care, general intelligence, social abilities & communication skills.) Vascular dementia characteristically presents with - sudden onset in early age, stepwise & patchy progression with focal neurological signs & symptomsQ & greater preservation of personality.

So the answer to this question is D


Instruction:
A patient with biliary atresia is more prone to the deficiency of:
A. Vit B12
B. Vit K
C. Vit C
D. Niacin

Response:
Biliary atresia leads to malabsorption of fat-soluble vitamins -This is an indirect question. Bile is needed for the digestion of lipids (micelle formation) Absence of bile leads to lipid malabsorption Lipid soluble vitamins are absorbed along with lipids Among the options, Vitamin K is the only fat-soluble vitamin. So, it is the answer. Moreover, Absorption of carotenes and fat-soluble vitamins is impaired on a very low fat diet.

So the answer to this question is B


Instruction:
Increased cardiac oxygen demand is caused by –
A. Ketamine
B. Nitrous oxide
C. Thiopentone
D. Halothane

Response:
None

So the answer to this question is A


Instruction:
Stunning of myocardium without any acute coronary syndrome is:-
A. Subendocardial infarction
B. Restrictive cardiomyopathy
C. Takotsubo cardiomyopathy
D. Transmural infarction

Response:
A/k as broken hea syndrome High degree of emotional stress Increase catecholamines Coronary aery vasospasm | Ischemic dilatedcardiomyopathy M/E: Acute stage a necrosis + contraction band necrosis - Histologically, acute cases may show microscopic areas of necrosis characterized by myocyte hypercontraction (contraction band necrosis); subacute and chronic cases may exhibit microscopic foci of granulation tissue and/or scar. - Elevated levels of catechols also increase hea rate and myocardial contractility, exacerbating ischemia caused by the vasospasm. The outcome of such vasospasm can be sudden cardiac death (usually caused by a fatal arrhythmia) or an ischemic dilated cardiomyopathy, so-called takotsubo

So the answer to this question is C


Instruction:
Which of the following wires is better choice if alignment is needed
A. Nitinol wire
B. TMA wire
C. Elgiloy wire
D. Stainless steel wire

Response:
None

So the answer to this question is A


Instruction:
A 2-year-old child was admitted to the hospital with acute meningitis. The Gram stain revealed Gram-positive short rods, and the mother indicated that the child had received "all" of the meningitis vaccinations. What is the most likely cause of the disease?
A. N. meningitidis, group A
B. N. meningitidis, group C
C. Listeria
D. S. pneumoniae

Response:
Except during a meningococcal epidemic, H. influenzae is the most common cause of bacterial meningitis in children. The organism is occasionally found to be associated with respiratory tract infections or otitis media. H. influenzae, N. meningitidis, S. pneumoniae, and Listeria account for 80 to 90% of all cases of bacterial meningitis. A purified polysaccharide vaccine conjugated to protein for H. influenzae type B is available. A tetravalent vaccine is available for N. meningitidis and a 23-serotype vaccine for S. pneumoniae. No vaccine is available for Listeria.

So the answer to this question is C


Instruction:
Bacterial meningitis in a 2 weeks old neonate is commonly caused by the following organism:
A. Listeria
B. M. tuberculosis
C. S. agalactiae
D. Group B streptococcus

Response:
Listeria monocytogenes is an increasingly impoant cause of meningitis in neonates (60 years, and immunocompromised individuals of all ages. Foodborne human listerial infection has been repoed from contaminated coleslaw, milk, soft cheeses, and several types of "ready-to-eat" foods, including delicatessen meat and uncooked hot dogs. Group B streptococcus, or S. agalactiae, was previously responsible for meningitis predominantly in neonates, but it has been repoed with increasing frequency in individuals >50 years of age, paicularly those with underlying diseases. Ref: Roos K.L., Tyler K.L. (2012). Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.

So the answer to this question is A


Instruction:
Why fetal cells continue to divide but terminally differentiated adult cells do not divide -
A. There are many cyclin inhibitors which prevent cell to enter into S phase in adult
B. Phosphatase absent in fetal cells
C. Proteinase is absent in fetus
D. Absence of CD kinase

Response:
A cyclin-dependent kinase inhibitor protein is a protein which inhibits cyclin-dependent kinase. Several function as tumor suppressor genes. Cell cycle progression is negatively controlled by cyclin-dependent kinases inhibitors (called CDIs, CKIs or CDKIs). CDIs are involved in cell cycle arrest at the G1 phase.

So the answer to this question is A


Instruction:
All are true about femoral triangle, EXCEPT:
A. Lateral margin is formed by saorius
B. Floor is formed by adductor longus
C. Contains the femoral vessels
D. None of the above

Response:
The femoral triangle is a depressed area of the thigh lying distal to the inguinal fold. Its apex is distal, its limits are the medial margin of saorius laterally, the medial margin of adductor longus medially and the inguinal ligament proximally (the base). Its floor is provided laterally by iliacus and psoas major, medially by pectineus and adductor longus. The femoral vessels, passing from midbase to apex, are in the deepest pa of the triangle. Lateral to the aery the femoral nerve divides. The triangle also contains fat and lymph nodes. Ref: Gray's anatomy 40th edition, Chapter 111

So the answer to this question is B


Instruction:
Which of the following variables is measure on ordinal scale -
A. Type of anemia
B. Severity of anemia
C. Hemoglobin
D. Serum ferritin

Response:
Ans. is 'b' i.e., severity of anemia When data is ranked e.g. mild, moderate, severe --) ordinal scale is used. Therefore severity of anemia is measured on ordinal scale. Type of anemia can be divided into qualitative categories (Macrocytic/microcytic, hemolytic/non-hemolytic) --> Nominal scale is used. Serum ferritin and hemoglobin are quantiative variables with a possible absolute zero value Ratio scale is used.

So the answer to this question is B


Instruction:
Who was the first to determine the sequence of a polypeptide?
A. Pehr Edman
B. Frederick Sanger
C. John Kendrew
D. Oakley Fulthrop

Response:
Sanger was the first to determine the sequence of a polypeptide. Mature insulin consists of the 21-residue A chain and the 30-residue B chain linked by disulfide bonds. Frederick Sanger reduced the disulfide bonds, separated the A and B chains, and cleaved each chain into smaller peptides using trypsin, chymotrypsin, and pepsin.
Ref: Harper’s illustrated biochemistry. 30th edition page no: 29

So the answer to this question is B


Instruction:
A 23-year-old male patient presented with a history of back pain, which is more in the morning and relieved by bathing in warm water. What is the likely additional finding present in this patient?
A. Marrow fibrosis
B. Distal phalangeal joint involvement
C. Pleural nodules
D. Decreased chest wall expansion

Response:
Ans. d. Decreased chest wall expansion (Ref: Harrison 19/e p2170, 18/e p2775)History of back pain, which is more in the morning and relieved by bathing in warm water is characteristic of spondylo arthropathy, like ankylosing spondylitis. Ankylosing spondylitis leads to extra-parenchymal restrictive lung disease, associated with decreased chest wall expansion."Ankylosing Spondylitis: The initial symptom is usually dull pain, insidious in onset, felt deep in the lower lumbar or gluteal region, accompanied by low-back morning stiffness of up to a few hours 'duration that improves with activity and returns following inactivity. "- Harrison 19/e p2170"Ankylosing Spondylitis: Initially; physical findings mirror the inflammatory process. The most specific findings involve loss of spinal mobility, with limitation of anterior and lateral flexion and extension of the lumbar spine and of chest expansion. Limitation of motion is usually out of proportion to the degree of bony ankylosis, reflecting muscle spasm secondary to pain and inflammation. Pain in the sacroiliac joints may be elicited either with direct pressure or with stress on the joints. In addition, there is commonly tenderness upon palpation at the sites of symptomatic bony tenderness and paraspinous muscle spasm. ''-- Harrison 19/e p2170A. Obstructive lung diseaseB. Restrictive lung disease* Asthma* Bronchiectasis* Bronchiolitis* Cystic fibrosis* COPD (Chronic bronchitis, Emphysema)Mnemonic- "ABCDE"ParenchymalExtra Parenchymal* Sarcoidosis* Pneumoconiosis* Idiopathic pulmonary fibrosis* Drug/Radiation induced interstitial lung disease* Neuromuscular diseases:- Diaphragmatic palsy- Guillain-Barre syndrome- Muscular dystrophy- Cervical spine injury* Chest wall diseases:- Kyphoscoliosis- Obesity- Ankylosing spondylitisAnkylosing Spondylitis/Marie-Strumpell or Bchtrew's diseaseEtiology & Pathogenesis:More than 90% patients of AS are HLA B27 positiveQ.The enthesis. the site of ligament attachment to bone is primary site of pathology in ASQ.Sacroilitis is the earliest manifestation with features of both enthesitis & synovitisQ.Clinical Presentation:Males are affected more frequently than females.Age of onset is 15-25 years (late adolescence & early adulthood )Q.The initial symptom is usually dull pain, insidious in onset, accompanied by low back morning stiffness of up to few hours duration that improves with activity and returns following period of inactivityQ.Arthritis in hips & shoulders (root joints) occur in 25-35%Q.Peripheral joints (usually shoulder, hips & knees) are involved in one third of patientsQ.Most serious complication of spinal disease is spinal fracture with even minor trauma.MC extra-articular manifestation is acute anterior uveitis (iridocyclitis)Q.Diagnosis:Radiological Examination(The following changes may be seen on an X-ray of the pelvis)* Haziness of sacro-iliac jointsQ* Irregular subchondral erosions in SI jointsQ* Sclerosis of the articulating surfaces of SI jointsQ* Widening of sacro-iliac joint spaceQ* Bony ankylosis of the sacro-iliac jointsQ* Calcification of the sacro-iliac ligaments and sacro- tuberous ligaments* Evidence of enthesopathy: Calcification at the attachment of the muscles, tendons and ligaments, particularly around the pelvis & heelQ.X-ray of Lumbar spine in Ankylosing Spondylitis* Squaring of vertebraQ: The normal anterior concavity of the vertebral body is lost because of calcification of the anterior tongitudinai ligament* Loss of lumbar lordosisQ* Bridging osteophytes (syndesmophytes)Q* Bamboo spine appearanceQ due to syndesmophytes & paravertebral ossificationTreatment:Phenylbutazone is the most effective drugQ (causes aplastic anemia).Indomethacin is most commonly used NSAIDQ.

So the answer to this question is D


Instruction:
A young woman met with an accident and had mild quadriparesis. Her lateral X-ray cervical spine revealed C5-C6 fracture dislocation. Which of the following is the best line of management?
A. Immediate anterior decompression
B. Cervical traction followed by instrument fixation
C. Hard cervical collar and bed rest
D. Cervical laminectomy

Response:
For the cervical spine dislocation management, initially application of cervical traction is impoant followed by instrument fixation. Ref essential ohopaedic maheshwari and mhaskar 9TH ED /e p 267

So the answer to this question is B


Instruction:
Bruxism should be treated by night guard using:
A. Hawley's retainer
B. Occlusal splint
C. Double occlusal splint
D. All of the above

Response:
None

So the answer to this question is B


Instruction:
District population 10 lac, with under-I o are 30%, prevalence of blindness is 0.8/1000 of under-16 population. Calculate the no. of blind under-16
A. 240
B. 2400
C. 24000
D. 240000

Response:
Ans. a. 240 Prevalence = 0.8/1000 District Population = 10 Lakhs Under 16 = 30% of district population Hence, total population of under 16 = 3 Lakhs Hence, No. of blind under 16 = 0.8 x 3,00,000/1,000 = 240

So the answer to this question is A


Instruction:
The theory of impression making that is based on the principle of “occlusal loading during impression making is same as that during function” is
A. Mucostatic technique
B. Mucocompressive technique
C. Selective pressure technique
D. All of the above

Response:
Mucocompressive theory presumes that occlusal loading during impression making is same as during function.

So the answer to this question is B


Instruction:
Survival time of platelet is approximately:
A. 10 hours
B. 10 days
C. 10 weeks
D. 100 days

Response:
None

So the answer to this question is B


Instruction:
A full term baby, exclusively breast fed, at the end of 1 week was passing golden yellow stools and was found to have adequate hydration with normal systemic examination. The weight of the baby was just same as it was at bih. The pediatrician should now advise-
A. Give oral solution with breast feeding
B. Sta tap feeding
C. Investigate for lactic acidosis
D. Reassure the mother that nothing is abnormal

Response:
Ans. is 'd' i.e., Reassure the mother that nothing is abnormal o Loss of weight in the first few days of bih is a normal phenomenon. A new born loses upto 10% of his body weight in the first few days of bih. He regains his bih weight by the age of 10 days. o The golden yellow color of the stool is perfectly normal. " The number colour and consistency ofstools may vary greatly in the same infant and between infants of similar age. The color of the stool has little significance except for the presence of blood or absence of bilirubin products."

So the answer to this question is D


Instruction:
True about Babesiosis -
A. Caused by Babesia microtia
B. Resides in RBC
C. Resides in WBC
D. Chloroquine is the treatment of choice

Response:
human infection is caused by B.micrroti, B.divergens,B. bovis The parasite is present in erythrocytes Resembles ring form of plasmodium falciparum (refer pgno:62 baveja 3 rd edition)

So the answer to this question is A


Instruction:
Fibrin is degraded by -
A. Plasminogen
B. Thromboplastin
C. Plasmin
D. FD

Response:
Clotting also sets into motion a fibrinolytic cascade that moderates the ultimate size of the clot. Fibrinolysis is largely carried out by plasmin, which breaks down fibrin and interferes with its polymerization. The resulting fibrin split products (FSPs or fibrin degradation products) also can act as weak anticoagulants. Elevated levels of FSPs (most notably fibrin-derived D-dimers) can be used for diagnosing abnormal thrombotic states including disseminated intravascular coagulation (DIC), deep venous thrombosis, or pulmonary thromboembolism. Plasmin is generated by proteolysis of plasminogen, an inactive plasma precursor, either by factor XII or by plasminogen activators. The most impoant of the plasminogen activators is tissue-type plasminogen activator (t-PA); t-PA is synthesized principally by endothelial cells and is most active when attached to fibrin. ( Robbins Basic Pathology, 9 th edition, page 85)

So the answer to this question is C


Instruction:
Ritodrine is a:-
A. b 2 agonist
B. b antagonist
C. a agonist
D. a 1 antagonist

Response:
* Selective b2 stimulants : salbutamol, terbutaline, salmeterol, formoterol and ritodrine * b2 agonists can be used for preterm labour as they cause uterine relaxation. * b2 Stimulators Used in preterm labour : RITODRINE ISOXSUPRINE

So the answer to this question is A


Instruction:
Action which halts the progression of a disease in early stage -
A. Primordial prevention
B. Primary prevention
C. Secondary prevention
D. Teiary prevention

Response:
Ans. is 'c' i.e., Secondary prevention Secondary prevention can be defined as "action which halts the progress of a disease at its incipient stage and prevents complications".

So the answer to this question is C


Instruction:
True about anterior intercostal aery
A. Present in 1st to 11th intercostal space
B. Each intercostal space has two anterior intercosta aeries
C. Branch of internal thoracic aery
D. Branch of aoa

Response:
The anterior intercostal branches of internal thoracic aery supply the upper five or six intercostal spaces. BD CHAURASIA&; S HUMAN ANATOMY UPPER LIMB THORAX VOL I SIXTH EDITION PAGE NO223

So the answer to this question is C


Instruction:
"Cork screw appearance" is characteristic of?
A. Carcinoma esophagus
B. Hypertrophic pyloric stenosis
C. Diffuse esophageal spasm
D. Sigmoid volvulous

Response:
ANSWER: (C) Diffuse esophageal spasmREF: Wofganag 5th e p. 846/748SignDiseaseRat tail appearanceCarcinoma esophagusBird beak appearanceAchalasiaBeak sign/ double track/ tram trackHyper trophic pyloric stenosisMedusa head colonies on CTRound wormPincer/daw/coiled spring/target/ meniscus signIntussceptionCoffee bean signSigmoid volvulousLead pipe appearanceUlcerative colitisString of kantor/bulTs eyeChron's diseaseThumb printing signIschemic colitisSaw tooth appeance on barium enemaDiverticulosisApple core signCarcinoma colonCork scretv appearanceDiffuse esophageal spasmString signHypertrophic pyloric stenosis

So the answer to this question is C


Instruction:
Botulism is a disease of: -
A. Neural transmission caused by the toxin of the bacterium Clostridium botulinum
B. Muscular transmission caused by the toxin of the bacterium Clostridium botulinum
C. Neuromuscular transmission caused by the toxin of the bacterium Clostridium botulinum
D. Non neuromuscular transmission caused by the toxin of the bacterium Clostridium botulinum

Response:
Neuromuscular transmission caused by the toxin of the bacterium Clostridium botulinum leads to botulism. C. botulinum produces powerful neurotoxin 'botulinum toxin'(BT). Botulinum toxin is absorbed from the gut, enters the blood circulation, and binds to receptors of presynaptic membranes of motor neurons of PNS and cranial nerves. The toxin does not cross the blood brain barrier or affect the central nervous system. Botulinum toxins act by blocking the release of acetylcholine at synapses and neuromuscular junction- resulting in lack of muscle contraction and flaccid paralysis. C/F - Flaccid ,symmetrical cranial nerve palsy -blurred vision, loss of pupilary reflexes. Symmetrical flaccid descending motor paralysis - Quadriparesis.

So the answer to this question is C


Instruction:
Which of the following intravenous induction agents is the most suitable for day care surgery:
A. Morphine
B. Ketamine
C. Proplofol
D. Diazepam

Response:
None

So the answer to this question is C


Instruction:
Chemotaxis is mediated by-
A. Histamine
B. Leukotriene B4 and C5a
C. Leukotriene C4 and C3a
D. Bradykinin

Response:
Chemotaxis is unidirectional locomotion of leukocytes towards the site of injury, oriented along a chemical gradient. This chemical gradient is created by substances called chemoattractants (chemotactic agents), which may be exogenous (bacterial products) or endogenous (C5a, LTB-4, IL-I, TNF, IL-8). C5a is the most powerful chemo-attractant (chemokine REF: ROBBINS pathology 10th edition

So the answer to this question is B


Instruction:
An infant with history of diarrhoea 5 days back has urea 200 mg% and creatinine 5me/o. The platelet count is 90000. Fragmented RBC s are found in the peripheral smear. The most possible diagnosis ?
A. HUS
B. TTP
C. ITP
D. Hemolytic anemia

Response:
Ans. is 'a' i.e., HUS The clues in this question are ? 1) History of diarrhea 3) Thrombocytopenia 2) Raised BUN and creatinine 4) Fragmented RBCs in peripheral smear All these suggest the diagnosis of HUS.

So the answer to this question is A


Instruction:
All of them use tonsillectomy as important step except
A. Transection of Glossopharyngeal nerve
B. Eagle's syndrom
C. In Treating sleep apnoea
D. Transection of vagus Nerve

Response:
None

So the answer to this question is D


Instruction:
Which statements are true about E. coli chromosomal DNA in relation with eukaryotic chromosomal DNA
A. Circular
B. Negatively supercoiled
C. Nucleoid present
D. All of these

Response:
E.coli (Bacteria) has single, closed, circular, ds DNA which is negatively supercoiled, present in nucleoid. There is no nucleolus in bacteria.

So the answer to this question is D


Instruction:
Acetazolamide is:
A. Competitive and reversible carbonic anhydrase inhibitor
B. Non-competitive and reversible carbonic anhydrase inhibitor
C. Competitive and irreversible carbonic anhydrase inhibitor
D. Non-competitive and irreversible carbonic anhydrase inhibitor

Response:
It is a sulfonamide derivative which noncompetitively but reversibly inhibits carbonic anhydrase in PT cells resulting in slowing of hydration of Carbon dioxide and leads to prompt but mild alkaline diuresis. The extrarenal actions of acetazolamide are: i) Lowering of intraocular tension due to decreased formation of aqueous humor (it is rich in HC03). ii) Decreased gastric HCl and pancreatic NaHC03 secretion: This action requires very high doses-clinically not significant. iii) Raised level of C02 in the brain and lowering of pH - sedation and elevation of seizure threshold. iv) Alteration of C02 transpo in lungs and tissues: these actions are masked by compensatory mechanisms. REF-Essentials of Medical Pharmacology, K.D Tripathi,6 th edition, page 569

So the answer to this question is B


Instruction:
The time interval between reception of infection and maximum infectivity of the host is know as-
A. Generation time
B. Serial interval
C. Latent period
D. Median incubation period

Response:
.generation time is defined as the time interval between the receipt of infection by a host and maximal infectivity of that host.it is roughly equal to incubation period.but not the same.generation time refers to transmission of infection whether clinical or subclinical. ref:park&;s textbook,ed 22,pg no 96

So the answer to this question is A


Instruction:
Not a feature of paradoxical sleep is :
A. Decreased muscle tone
B. Rapid eye movements
C. Brain shows increased metabolism
D. EEG shows decreased activity

Response:
D i.e. EEG shows decreased activity Features NREM REM Other names Synchronised or S-sleep/ Ohodox-Sleep/ Quiet-Sleep Desynchronized D-Sleep, A-wave/ Active-SleepQ, Paradoxical sleepQ EEG - Synchronized - Theta wave' (I) - Sleep spindles & K-ComplexQ (II) - Delta waveQ (III & IV) - Low voltage Fast activity Saw tooth wavesQ - Ponto- geniculo occipita spikes - Reappearance of alpha wavesQ EMG Paial relaxation AtoniaQ of antigravity & intercostal muscles Cerebral metabolism Brain temperature -I, t Q EOG Slow or Quiescent eye movement Rapid eye movementsQ Genital Tumescence Infrequent CommonQ Dreaming Infrequent Frequent Pathology Night terrorQ. Nocturnal eneurasisQ BruxismQ SomnambulismQ Somniloquy Night maresQ NarcolepsyQ

So the answer to this question is D


Instruction:
Twin peak sign seen in
A. Monochorionic Monoamniotic
B. Monochorionic Diamniotic
C. Dichorionic Diamniotic
D. Dichorionic Monoamniotic

Response:
Twin peak or lambda sign it is characterized of dichorionic pregnancies and is due to the chorionic tissue between the two layers of the intewin membrane at the placental origin . twin peak appears as a triangle with base at chorionic surface and apex in intewin membrane.

So the answer to this question is C


Instruction:
A lady presented with secondary amenorrhea 6 months after having an aboion. Her FSH levels were measured as 6 mlU/ml what is the most probable diagnosis:
A. Pituitary failure
B. Ovarian failure
C. Fresh pregnancy
D. Uterine synechiae

Response:
Since the lady in the question is having secondary amenorrhea following an aboion, uterine synechiae is the most likely cause. Low normal FSH level is consistent with uterine abnormality. (Normal serum FSH value in adult is woman is 5-20 mlU). Ref: Novak's, 14th Edition, Chapter 27; Speroff, 7th Edition, Chapter 11; Shaw's, 14th Edition, Pages 263, 264; The Subfeility Handbook : A Clinician's Guide By Gab Kovacs, 2nd Edition, Page 117

So the answer to this question is D


Instruction:
Positive Fouchet's test gives which color?
A. Red
B. Green
C. Violet
D. Yellow

Response:
Fouchet's test : This test is also employed for the detection of bile pigments. Bile pigments are adsorbed on  barium sulfate. Fouchet's reagents (containing ferric chloride in  trichloroacetic acid) oxidizes bilirubin to biliverdin (green) and bilicyanin (blue).
Satyanarayana, Ed 3, Pg No 767

So the answer to this question is B


Instruction:
Pollicization is best described as
A. Amputation of thumb
B. Equalization of fingers
C. Toe to thumb transplantation
D. Reconstruction of thumb

Response:
• Reconstruction of thumb is called pollicization. Typically this Consists of surgically migrating the index finger to
the position of the thumb
• During pollicization the index finger metacarpal bone is cut and the finger is rotated approximately 120—160 degrees and replaced at the base of the hand at the usual position of the thumb
• The arteries and veins are left attached.
Amputated digits should be well washed with saline and wrapped in STERILE GAUZE soaked in STERILE SALINE or RL and put in STERILE plastic bag & put in an CONTAINER with ICE(digits should not be in direct contact with ICE).
TRANSPORT :   room temperature 6 hrs and at 4 deg C for 12 hrs
The vessels SHOULD NOT be clamped but SECURED with pressure DRESSING only.

So the answer to this question is D


Instruction:
Ziemann's dots in RBC are seen in infection with
A. Pl vivax
B. Pl falciparum
C. Pl malaria
D. Pl ovale

Response:
Ziemann dots in RBC-PL Malaria Schaffner dots in RBC- Pl vivax Accola rings-falciparum Ref: D.R. Arora. Medical parasitology 4th ed pg 108

So the answer to this question is C


Instruction:
Dix Hallpike monouvre is used to assess
A. Differentiate peripheral and central lesions of vestibular system
B. Differentiate cochlear and retrocochlear deafness
C. Assess neonatal hearing loss
D. Assess patency of Eustachian tube

Response:
Ans. is 'a' i.e., Differentiate peripheral and central lesions of vestibular system Hallpike test / Positional testo It is a test for assessing vestibular function. It is particularly useful when patients complain of vertigo in certain head positions. It helps to differentiate peripheral and central lesions.Methodo Patient sits on a couch. Examiner holds the patients head, turns it 45deg to the right and then places the patient in supine position so that his head hangs 30deg below the horizontal. Patients eyes are observed for nystagmus. The test is repeated with head turned to left. Four parameters of nystagmus are observed latency, duration, direction, fatigability. Peripheral causes of BPPV can be differentiated from central causes (like tumors of fourth ventricle, cerebellum, temporal lobe, Multiple sclerosis, ICT) by observing the characteristics of nystagmus. PeripheralCentralLATENCY2-20 secondsNo latencyDURATIONLess than 1 minuteMore than 1 minuteDIRECTION OF NYSTAGMUSDirection fixed, towards the undermost earDirection changingFATIGABILITYFatigableNon fatigableACCOMPANYING SYMPTOMSSevere vertigoNone/minimum

So the answer to this question is A