Instruction:
Adenomyosis is:
A. Endometriosis interna
B. Endometriosis externa
C. Uterine sarcoma
D. Leiomyoma

Response:
Ans: a (Endometriosis internal) Ref: Shaw, 13th ed, p. 448; Robbins, 7th ed, p. 1083Adenomyosis (uterine endometriosis) is also called endometriosis interna.Commonest symptom of adenomyosis - MenorrhagiaCommonest symptom of endometriosis - DysmenorrhoeaPelvic examinationUterus symmetrically enlarged- SoftSize not more than 14 weeksInvestigation- USGHysteroscopy + curettageTreatment of choiceTotal hysterectomy (No role of hormone therapy)

So the answer to this question is A


Instruction:
A 4 year old female patient complains of decayed teeth. Intra-oral examination reveals occlusal caries with 55. The laser which can be used in this patient?
A. CO2
B. HeNe
C. Excimer
D. Ho:YAG

Response:
Lasers are used primarily for either soft tissue applications or hard tissue surface modification. They generally are not used for tooth preparations because they are inefficient and awkward for removing large amounts of enamel or dentin, and that process with a laser can generate intolerable amounts of heat. Therefore lasers may never replace a high-speed dental handpiece. However, at least one commercial Ho:YAG laser instrument has been approved by the Food and Drug Administration (FDA) for use with hard tissues in primary teeth.
Sturdevant’s Art and Science of Operative Dentistry, Mosby, 4th Edition, Page No: 327

So the answer to this question is D


Instruction:
Which of the following tumors is not commonly known to increase in size during pregnancy ?
A. Glioma
B. Pituitary adenoma
C. Meningioma
D. Neurofibroma

Response:
Answer is option 1 Glioma Tumors which increase in pregnancy are : Meningioma, angioma, neurofibroma,pituitary adenoma (micro and macro) Ref.. Williams Obs 23/e p 1140 for options b and c For option d p1255

So the answer to this question is A


Instruction:
Given below is the histopathology of liver biopsy of hemochromatosis. Which of the following stain is used?
A. Vonkossa
B. Alcianblue
C. Prussian blue
D. Crystal violet

Response:
Ans. (c) Prussian blue(Ref: Complete review of pathology and Hematology 2nd ed; Praveen Kumar, Vandana Puri Annexure 4)This is a straight forward question on the stain used for Iron in tissue (Hemochromatosis) which is Prussian blue stain.

So the answer to this question is C


Instruction:
Kala-azar is transmitted by -
A. Reduvid bug
B. Sandfly
C. Tsetse fly
D. Mosquito

Response:
Ans. is 'b' i.e., Sandfly Arthopods Arthropod borne diseases1) Mosquito :1) AnophelesMalaria2) CulexJapanese encephalitisWest nile feverBancroftian filariasisViral arthritis 3) AedesYellow feverDengueDengue haem. FeverChikangunya feverRift valley fever4) MansonoidesBrugian filariasis2) SandflyKalazarOriental soreOroya feverSandfly fever3) Tse - tse flySleeping sickness4) LouseEpidemic typhus, relapsing fever, trench fever, pediculosis.5) Rat fleaBubonic plague, endemic typhus, chiggerosis, hymenolepis diminua6) Black flyOncocerciasis7) Reduvid bugChaga s disease8) Hard tickTick typhus, viral encephalitis, viral haem. Fever, KFD, Tularemia, tick paralysis, human babesiosis. Contd.9) Soft tickQ fever, relapsing fever, KFD10) Trombiculid miteScrub typhus, Ricketssiai pox11) Itch miteScabies12) CyclopsGuinea worm disease. Fish tape worm ( D. latum )13) CockroachesEnteric pathogens14. HouseflyTyphoid and paratyphoid fever, diarrhoea, dysentery; cholera, gastro-enteritis, amoehiasis, helminthic infestations, poliomyelitis, conjunctivitis, trachoma, anthrax, yaws, etc.Note : KFD is mainly transmitted from Hard tick. But soft tick can also transmit it.

So the answer to this question is B


Instruction:
Minimal dentinal destruction to get evident on the radiograph:
A. 30 microns
B. 40 microns
C. 20 microns
D. 200 microns

Response:
Minimal dentinal destruction of 40 microns is required to be seen on a radiograph.
Lesions confined to the enamel may not be evident until approximately 30% to 40% demineralization has occurred. For this reason, the actual depth of penetration of a carious lesion is often deeper than seen in the image.

Reference: White and Pharoah's Oral Radiology Principles and Interpretation 7th edition page no 288

So the answer to this question is B


Instruction:
Depression is not a side effect of -
A. Propranolol
B. Oral contraceptives
C. L-dopa
D. Flupenthixol

Response:
Drugs causing depression:- Antihypertensives (Reserpine, methyldopa, (-blocker), NSAIDs, calcium channel blockers, anticonvulsants, Bromocriptine, Opioids, Disulfiram, Steroids (corticosteroids, oral contraceptives), Barbiturates, Benzodiazepines (clonazepam), Levodopa, Statins.

So the answer to this question is D


Instruction:
Hypersensitivity vasculitis involves -
A. Capillary
B. Arterioles
C. Postcapillary venules
D. Medium sized arteries

Response:
None

So the answer to this question is C


Instruction:
The axillary sheath is an extension of this fascia around the subclan aery and brachial plexus. Fascia around nerve bundle of brachial plexus is derived from:
A. Preveebral fascia
B. Pretracheal fascia
C. Investing layer
D. Superficial cervical fascia

Response:
The brachial plexus and the subclan aery course between the anterior and middle scalene muscles, and as the nerve plexus and aery emerge from those muscles, they carry an extension of the preveebral fascia along to form the axillary sheath. Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 26. Triangles and Root of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy.

So the answer to this question is A


Instruction:
Sources of the nitrogen in urea cycle are the following:
A. Aspaate and ammonia
B. Glutamate and ammonia
C. Arginine and ammonia
D. Uric acid

Response:
The 2 nitrogen atoms of urea are derived from two sources, one from ammonia and other from alpha amino group of aspaic acid. Ref: Textbook of Biochemistry By DM Vasudevan, 3rd Edition, Pages 163-5

So the answer to this question is A


Instruction:
The investigation of choice in pancreatic trauma is?
A. CECT
B. MRI
C. USG
D. Radionuclide scan

Response:
Ans. A. CECT* CT is the simplest and least invasive diagnostic modality currently available for evaluating suspected pancreatic trauma and its complications, because of the subtlety of the US findings. However, this study is only rarely useful in acute penetrating injury.* Computed tomography is the radiographic examination of choice for hemodynamically stable patients with abdominal trauma as it provides the safest and most comprehensive means of diagnosis of traumatic pancreatic injury.* The pancreas may appear normal in 20%-40% of patients when CT is performed within 12 h after trauma because pancreatic injuries may produce little change in the density which may not be detectable on CT scan.* In addition, there may be minimal separation of lacerated pancreatic fragments. Currently, multidetector-row CT scanners are used for evaluation of abdominal trauma cases as they are faster to scan, which greatly reduces bowel artifacts and resolves many previous technical problems.* Lacerations tend to occur at the junction of the body and tail due to shearing injuries with compression against the spine

So the answer to this question is A


Instruction:
Which off the following is an oncogenic retrovirus?
A. HTLV-1
B. HPV
C. EBV
D. HBV

Response:
Ans: A (HTLV-1) Ref: Jawetz, Mel nick & Adel bergs Textbook of Medical Microbiology, 25th Edition. 2010Explanation:* Viruses which produce tumors in either their natural host or experimental animals or induce malignant transformation in cell cultures are called oncogenic viruses.RNA virusesCANCERHCVHTLV1HIVHepatocellular cancerAdult T cell leukemiaAIDS related malignanciesDNA virusesCANCERHPVGenital tumoursOropharyngeal cancerBurkitt's lymphomaNasopharyngeal carcinomaB cell lymphomaKaposi's sarcomaHepatocellular cancerEBVHHV 8HBV

So the answer to this question is A


Instruction:
"Fothergill's disease" is one of the synonyms of:
A. Sarcoidosis
B. Multiple sclerosis
C. Trigeminal neuralgia
D. Lupus erythematosus

Response:
Trigeminal Neuralgia (Tic Douloureux, Trifacial Neuralgia, Fothergill's Disease)
Trigeminal neuralgia is an archetype of orofacial neuralgias which follows the anatomical distribution of the fifth cranial nerve. It mainly affects the second and third divisions of the trigeminal nerve and almost always exhibits a trigger zone, stimulation of which initiates paroxysm of pain. The pain is often accompanied by a brief facial spasm or tic. Pain distribution is unilateral and lasts for a few seconds to few minutes. Physical examination eliminates alternative diagnoses. Signs of cranial nerve dysfunction or other neurologic abnormality exclude the diagnosis of idiopathic TN and suggest that pain may be secondary to a structural lesion.
Reference: Shafer’s Textbook of ORAL PATHOLOGY Eighth Edition page no 571

So the answer to this question is C


Instruction:
Sclerotic bodies is seen -
A. Sporothrix
B. Blastomycosis
C. Chromoblastomycosis
D. Coccidiodes

Response:
None

So the answer to this question is C


Instruction:
Recent drug for metastatic hormone receptor(+)and HER-2 (-) metastatic breast cancer :
A. Palbociclib
B. Ipataseib
C. Herceptin
D. Buparlisib

Response:
Palbociclib is a recent drug for metastatic hormone receptor(+)and HER-2 (-) breast cancer. It works by inhibiting Cyclin-dependent kinase 4/6. Other examples of this class of drug includes: Ribociclib, Abemaciclib. These drugs are used along with letrozole (aromatase inhibitor) and/or fulvestrant (selective estrogen-receptor downregulator) Herceptin/Trastuzumabis used in Her-2 neu positive breast cancer. Ipataseib is an AKT (Protein kinase B) inhibitor used in metastatic triple-negative breast cancer. Buparlisib is a Phophatidyl-inositol 3 kinase (PI3k) inhibitor which is still in trial stages for treatment of metastatic breast carcinoma

So the answer to this question is A


Instruction:
Modified RND includes which of the following ?
A. I - IV
B. I - VII
C. I - III
D. I - V

Response:
Lymph nodes I - V are removied in MNRD.

So the answer to this question is D


Instruction:
Drug of choice for Herpes simplex Endophthalmitis is –
A. Acyclovir
B. Vidarabine
C. Amantidine
D. Interferon

Response:
Acyclovir is the drug of choice for HSV infection.

So the answer to this question is A


Instruction:
Centrilobular necrosis of liver may be seen with?
A. Phosphorus
B. Arsenic
C. CCI4
D. Ethanol

Response:
Ans. is 'c' i.e., CC14

So the answer to this question is C


Instruction:
Which of the following is not seen in apoptosis?
A. Nuclear fragmentation
B. Cellular shrinkage
C. Inflammation
D. Alteration in cellular membrane structure

Response:
Following changes are seen in apoptosis: Reduced cell size (shrinkage) Nuclear fragmentation into nucleosome-size segments Plasma membrane is intact, however, there is alteration in structure (changes in orientation of lipids) Formation of apoptotic bodies Inflammation is not seen in the vicinity of apoptotic cells

So the answer to this question is C


Instruction:
A patient presents to the emergency complaining of fever, chills, and a painful mass adjacent to his anus. On examination, a tender, fluctuant mass is palpated. Purulent material is noted through the skin and the diagnosis of ischioanal abscess is made. The patient is taken to the operation theatre, and incision and drainage of the abscess is performed. During the procedure, the extent of the lesion is underestimated, and the inferior rectal nerve is damaged. This nerve is a direct branch of which of the following nerves?
A. Inferior gluteal nerve
B. Pelvic splanchnic nerve
C. Pudendal nerve
D. Sciatic nerve

Response:
The pudendal nerve is a branch of the sacral plexus that exits from the greater sciatic foramen, and then enters the lesser sciatic foramen, to lie in the pudendal canal on the lateral wall of the ischioanal fossa. The inferior rectal nerve is a branch of the pudendal nerve, which crosses the ischioanal fossa to reach the anal canal, where it innervates the external anal sphincter and provides sensory innervation to the area. The inferior gluteal nerve, a branch of the sacral plexus, exits through the greater sciatic foramen and innervates the gluteus maximus muscle. The pelvic splanchnic nerves are branches of the second, third, and fouh sacral nerves that carry preganglionic parasympathetic nerves to several pelvic organs. The sciatic nerve is a branch of the lumbosacral plexus that exits through the greater sciatic foramen, then enters the lower limb to innervate muscles of the posterior thigh, the leg, and the foot, and provides sensory innervation to the area as well.

So the answer to this question is C


Instruction:
Which of the following is not used as local injection for of ophthalmic use?
A. Triamcinolone
B. Prednisolone
C. Betamethasone
D. Dexamethasone

Response:
Answer- B. PrednisolonePeriocular steroid injections are:-Subconjunctival injection - Betamethasone or dexamethasoneSubtenon or retrobulbar injection - TriamcinoloneIntraocular steroid injections are :-Injection - intravitreal triamcinoloneSlow-release implants - fluocinolone or dexamethasone

So the answer to this question is B


Instruction:
Pulmonary Plethora is seen in -
A. TOF
B. TAPVC
C. CoA
D. Tricuspid Atresia

Response:
Pulmonary plethora It is a term used to describe the appearances of increased pulmonary perfusion on chest radiographs. It may occur in several situations : Total anomalous pulmonary venous return (TAPVC) Left-to-right cardiac shunts (e.g. ASD, VSD, PDA) Truncus Aeriosus Vein of Galen Malformation Transposition of the Great Aeries It may also been seen in pregnancy due to increased cardiac output.

So the answer to this question is B


Instruction:
HNF- 1b gene defect is seen in?
A. MODY2
B. MODY3
C. MODY4
D. MODY5

Response:
HNF- 1b gene is involved in pathogenesis of MODY5. HNF- 1a gene is involved in pathogenesis of MODY 3. Most common type of MODY is MODY 3.

So the answer to this question is D


Instruction:
Yellowish exudates at multiple sites seen in colonoscopy indicates -
A. Crohn's disease
B. Hirschsprung disease
C. Tuberculosis
D. Lymphoma

Response:
In Crohn's disease focal inflammation and ulceration are frequently seen.
In ulcerative colitis usually hyperemia is seen.

So the answer to this question is A


Instruction:
Wellen's syndrome suggests
A. Stable angina
B. Unstable angina
C. Lugwig's angina
D. Prinzmetal angina

Response:
.

So the answer to this question is B


Instruction:
Shape memory is seen in:
A. Stainless steel wire
B. NITINOL wire
C. TMA wire
D. Aluminium

Response:
None

So the answer to this question is B


Instruction:
All are true regarding symmetric IUGR except
A. Obstretic cause like utero - placental in sufficiency
B. Ponderal index >2
C. Problem occuring in first trimerter
D. Brain growth (head circum ference) spared

Response:
IUGR: Evidence of wasting +

Symmetric IUGR
Asymmetric IUGR

Timing of problem
Problem in first and
			early second trimester
Problem in last second and
			third trimester

Cause
TORCH infection
			Chromosomal anamoly
Maternal problems:
			Maternal hypertension
			Placental insufficiency

Head to foot are
			equally affected
Brain growth (head
			circumference) spared

Ponderal index (PI)
			PI = Weight (gm) X 100
			       Length (cm3)

>2
<2

So the answer to this question is A


Instruction:
Localized myogenic infection is caused by which bacteria?
A. Staphylococcus
B. Clostridium
C. Cornybacterium
D. Streptococcal

Response:
ANSWER: (A) StaphylococcusREF: Harrisons 18th ed chapter 125Important causes of muscle infections:Most common cause of pyomyositis : staphylococcus aureusGas gangrene : CL PerferingensSevere muscle pain : pleurodynia due to coxsackie B, trichinosisRhabdomyolysis : clostridium , streptococcal

So the answer to this question is A


Instruction:
All are USG finding of Autosomal recessive PCKD except?
A. Retain reniform shape (Kidneys)
B. Oligohydramnios
C. Corticomedullary differentiation is lost
D. Cysts are greater than 3 cm in diameter

Response:
Cysts rarely exceed 1 - 2 cm in diameter.

So the answer to this question is D


Instruction:
The following plant poisons do not have specific antidote, except
A. Calotropis
B. Ricinus communis
C. Dathura
D. Croton

Response:
The antidote for Dhatura poisoning is Physostigmine. TREATMENT OF DHATURA : Decontamination Physostigmine - Antidote Suppoive - Anticonvulsants, control body temperature.

So the answer to this question is C


Instruction:
Most common physiological form of DNA
A. A-form
B. B-form
C. Z-form
D. C-form

Response:
DNA can exist in at least six forms, i.e. A, B, C, D, E and Z.The B-form of DNA is the most common form of DNA and is right-handed helix.It is the strandard DNA structure with 10 base pairs per turn.Watson and Crick model describes the B-form of DNA.Other forms of DNA are A-form (contains 11 base pairs per turn and is right handed helix) and Z-form (contains 12 base pairs per turn and is left handed helix).Z-form is ored by alternating G-C sequences in alcohol and high salt solution; and is inhibited by alternating A-T sequnces (Note-B form has minimum base pairs per turn, i.e. 10).

So the answer to this question is B


Instruction:
The following conditions ours mummification
A. Warm & Humid climate
B. Absence of moisture
C. Clostridium perfringes
D. Intrinsic Lipases

Response:
Ideal conditions for mummification: High temperature, dry condition, absence of moisture and free circulation of air. Ideal conditions for Adipocere formation: Warm temperature, moisture, less air, bacteria, and fat splitting enzymes (lipases).

So the answer to this question is B


Instruction:
What is an ideal method to prevent aspiration pneumonia?
A. Cuffed endotracheal tube
B. Inhalational anaesthesia
C. Increased intra abdominal pressure
D. Full stomach

Response:
Ans: A (Cuffed endotracheal tube) Ref: Bailey, 24th ed, p. 46; Ajay Yadav, p. 101A cuffed endotracheal tube is used to:1. Facilitate artificial airway ventilation or surgery around face or airway.2. Protection of lung if there is a risk of pulmonary aspiration.Predisposing factors for aspiration:1. Full stomach-- single, most important factor.2. | Level of consciousness.3. Conditions which reduce the tone of LES:Pregnancy (acid aspiration in late pregnancy- Mendelson syndrome)Abdominal tumorsObesity, hiatus herniaPresence of nasogastric tubeDrugs-Atropine, glycopyrrolate, opioids, thiopentone.4. Conditions delaying gastric emptyingDiabetes, hypothyroidism, pain, anxiety, anticholinergics, opium.Management:Prevention:Management - full stomach patients:1. Empty stomach2. H2blockers- to reduce acid production.3. Metoclopramide4. Neutralisation of gastric contents by antacids1. Regional anesthesia is preferred2. Awake intubation3. Rapid sequence intubation- Sellick maneuver

So the answer to this question is A


Instruction:
Saccharin test is done to assess
A. Ciliary function
B. Blood sugar
C. Bronchial secretion
D. Kidney function

Response:
(A) Ciliary function # SACCHARIN TEST for nasal mucociliary clearance> A simple test of nasal mucociliary clearance is to place a small particle of saccharin approximately 1 cm behind the anterior end of the inferior turbinate.

So the answer to this question is A


Instruction:
Methotrexate resistance occurs by
A. Depletion of folate
B. Overproduction of DHFR
C. Deficiency of thymidylate synthase
D. Deficiency of thiamine kinase

Response:
Overproduction of DHFR Mechanism of action of methotrexate Methotrexate enter the cell by reduced folate carrier Once inside the cell methotrexate is polyglutamylated. The polyglutamylated.forms of methotrexate are potent inhibitors of dihydrofolate reductase The polyglutamased.forms of methotrexate are conveed back to monoglutamate .form in lysosomes by the glytamyl hydrolase and is subsequently effluxed from the cell Methotrexate resistance can occur through any of the following five mechanism Decreased entry into the cell due to impaired transpo Decreased retention as a consequence of lack of pohyglutammate formation An increase in DHFR An altered mutated DHFR that binds less avidly than the normal enzyme to the drug. Increased level of lysosomal enzyme 2 glutamyl hydrolase that hydrolyse methotrexate polyglutamates Decreased transpo A common mechanism of methotrexate resistance is reduced.folale transpo carrier The decreased transpo is common mechanism to methotrexate resistance in relapsed ALL. Impaired Polyglutammation The polyglutammated.forms of methotrexate inhibits dihydrofolate reductase. The intracellular content of polyglutammate derivatives of methotrexate is controlled by a balance between folypolyglutamate synthetase and glutamyl hydrolase activity. Folypolyglutamate synthetase produces polyglutammate while A glutamyl hydrolase conves its bact to monoglutamate form A lower content of methotrexate polyglutamate could he due to decreased synthesis or an increased catabolism of methotrexate polyglutamates by A glutamate hydrolase. Increased DHFR The main mechanism of action of methotrexate is inhibition of the enzyme DHFR. - Methotrexate is a tight binding inhibitor of DHFR and the concentration of methotrexate required to achieve enzyme activity increases in direct propoion to the amount of enzyme in target cells. - If is now well established that an impoant mechanism of resistance of cells to methotrexate is an increase in DHFR production due to amphification of the DHFR gene Mutation in DHFR Mutation is DHFR genes may be responsible .for methotrexate resistance. Mutation in DHFR causes production of altered forms of DHFR that have decreased affinity.for the inhibitor.

So the answer to this question is B


Instruction:
Thanatology is the science that deals with -
A. Death in all its aspects
B. Solving paternity of the child
C. Identification of the living
D. Detection of lie

Response:
Thanatology deals with death in all its aspects. There is a progression from clinical death to brain death, biological death and then cellular death. Brain death follows clinical death which is due to lack of oxygen. First cerebral coex, then cerebellum, and then lower brain centres die. Thereafter the process of cellular death begins. Dr. Narayana Reddys Synopsis of Forensic Medicine & Toxicology 27th edition pg.66

So the answer to this question is A


Instruction:
Chemoreceptor reflex of blood pressure regulation is stimulated by all except
A. Hypoxia
B. Acidosis
C. Decreased BP
D. Hypercapnia

Response:
Stimulus for chemoreceptor reflex ⇒

Hypoxia
Hypercapnia
Acidosis

So the answer to this question is C


Instruction:
Perl's stain is used to demonstrate
A. Melanin
B. Haemosiderin
C. Bilirubin
D. Lipofuscin

Response:
(B) Haemosiderin > Hemosiderosis: With progressive accumulation of hemosiderin, parenchymal cells throughout the body (principally in the liver, pancreas, heart, & endocrine organs) become pigmented, iron can be visualized in tissues by the Prussian blue histochemical reaction, in which colorless potassium ferrocyanide is converted by iron to blue-black ferric ferrocyanide.> Perl's Prussian Blue Stain for Iron-Positive Cells (e.g., activated macrophages) (a.k.a. Perl's acid ferrocyanide reaction)

So the answer to this question is B


Instruction:
What is the time duration for developing a vesicovaginal fistula following an obstructed labour?
A. Within 24 hours
B. WiiW 72 hours
C. Within 1st week
D. After 1st week

Response:
With dystocia, the presenting pa is firmly wedged into the pelvic inlet and does not advance for a considerable time. Tissues of the bih canal lying between the leading pa and the pelvic wall may be subjected to excessive pressure. Because of impaired circulation, necrosis may result and become evident several days after delivery as vesicovaginal, vesicocervical, or rectovaginal fistulas. In vesicovaginal fistula, dribbling of urine occurs after varying interval following delivery (5-7 days). Most often, pressure necrosis follows a very prolonged second stage. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 20. Abnormal Labor. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

So the answer to this question is D


Instruction:
Which of the following do not have ribosomes for protein synthesis
A. Bacteria
B. Viruses
C. Fungi
D. Rickettsia

Response:
Bacteria doesn&;t have complex organelles but ribosomes are present in 30, 50 and 80S. Fungi have all organelle as it is a eukaryotic cell.

So the answer to this question is B


Instruction:
A young lady lost her job, loss of appetite wakes up at 3 am. What's the diagnosis
A. Depression
B. Schizophrenia
C. OCD
D. Mania

Response:
In this question, the details are inadequate, however among the given options the best answer is A, depression

So the answer to this question is A


Instruction:
Milian's ear sign is seen is
A. Cellulitis
B. Erysipelas
C. Lymphangitis
D. Abscess

Response:
Erysipelas being a cutaneous condition can spread to ear lobule = Milian's ear sign.

So the answer to this question is B


Instruction:
Insulin release due to closure of K+ channels is seen with ?
A. Nataglinide
B. Acarbose
C. Exenatide
D. Sitagliptin

Response:
Ans. is 'a' i.e., Nataglinide "Sulfonylureas and Meglititinides (nonsulfonylureas) are the two classes of Insulin secretogogues stimulate insulin secretion by interacting with the ATP-sensitive potassium channel on the beta cell."

So the answer to this question is A


Instruction:
First sign of compament syndrome is ?
A. Pain
B. Tingling
C. Loss of pulse
D. Loss of movement

Response:
Ans. is 'a' i.e., Pain Clinical features of compament syndrome Four signs are reliable in diagnosing a compament syndrome :- Paresthesia or hypesthesia in nerves traversing the compament Pain with passive stretching of the involved muscles (stretch pain) Pain with active flexion of the muscles Tenderness over the compament Amongst these, stretch pain is the earliest sign of impending compament syndrome. The ischemic muscles, when stretched, give rise to pain. Passive extension of fingers (streching the fingers) produce pain in flexor compament of forearm. Other features are Pulselessness, paralysis, Pallor and pain out of propoion to physical findings. Peripheral pulses, are present initially and disappear later. Therefore, pulse is not a reliable indicator for compament syndrome.

So the answer to this question is A


Instruction:
All of the following are used for myoclonic seizures except:
A. Sodium valproate
B. Zonisamide
C. Carbamazepine
D. Topiramate

Response:
*'Carbamazepine and phenytoin can aggravate juvenile myoclonic epilepsy' Drugs useful for myoclonic seizures are: *Valproic acid (Drug of choice) *Benzodiazepines *Zonisamide *Levetiracetam *Topiramate *Lamotrigine REF : KATZUNG 14TH ED.

So the answer to this question is C


Instruction:
Gynaecomastia is seen in:a) Secondary syphilisb)  Lepromatous leprosyc) HIVd) Klinefelter's syndrome
A. bcd
B. acd
C. ac
D. bd

Response:
None

So the answer to this question is A


Instruction:
Phantom limb phenomenon can be described by:
A. Weber Fechner law
B. Power law
C. Bell-Magendie law
D. Law of projection

Response:
Ans. D. Law of projectiona. The Law of Projection: "No matter where a particular sensory pathway is stimulated along its course to the cortex, the conscious sensation produced is referred to the location of the receptor"b. For example, when the cortical receiving area for impulses from the left hand is stimulated, the patient reports sensation in the left hand, not in the head.c. Another dramatic example is seen in amputees. Some of these patients may complain, often bitterly, of pain and proprioceptive sensations in the absent limb (phantom limb).

So the answer to this question is D


Instruction:
Hep-2 cells are the type of
A. Primary cell cultures
B. Diploid cell strain
C. Continuous cell lines
D. Explant culture

Response:
Continuous cell lines - these are cells of a single type usually derived from cancer cells that are capable of continuous serial cultivation indefinitely.
Standard cell lines derived from human cancers such as HeLa, HeP2 and KB cell lines have been used.

So the answer to this question is C


Instruction:
Most common complication of measles in children
A. SSPE
B. Pulmonary Hypertension
C. Otitis media
D. Oophoritis

Response:
None

So the answer to this question is C


Instruction:
Woman of30 years with Raynaud's phenomenon, polyarthritis, dysphagia of 5-years and mild Sclerodactyl, blood showing Anti-centromere antibody positive, the likely cause is -
A. CREST
B. Mixed connective tissue disorder
C. SLE
D. Rheumatoid arthritis

Response:
Ans. is 'a' i.e., CREST Patients scleroderma are typically classified based on the amount and location of skin involvement.SclerodermaDiffuse sclerodermaLimited sclerodermao Widespread skin involvementQo Rapid progression and early- visceral involvementQo Limited skin involvement, confined to fingers, forearms and faceo Slow progression, visceral involvement occurs late, some patients with limited disease also develop CREST syndrome which is a combination of C- Calcinosis distal : subcutaneous calcifications of fingers and along extensor surface of forearm R- Raynaud phenomenon E- Esophageal dysmotility S- Sclerodactyly (skin thickening limited to fingers) T- Telengiectasia (dilated capillaries)Age group in systemic sclerosiso Systemic sclerosis is primarily a disease of womenQ (F/M = 3:1).

So the answer to this question is A


Instruction:
Following blood transfusion, non-cardiogenic pulmonary oedema may sometimes occur because of-
A. RBC incompatibility
B. Antigen-antibody mechanism involving human leucocyte antigen
C. Platelet surface antigen reaction
D. Antibody to IgA in donor plasma

Response:
None

So the answer to this question is B


Instruction:
Inverted papilloma -a) Is common in children b) Arises from lateral wallc) Always benignd) Can be premalignante) Causes obstruction
A. abc
B. ade
C. ace
D. bde

Response:
None

So the answer to this question is D


Instruction:
Mucous membrane of vagina is lined by:
A. Nonkeratinized Stratified Squamous epithelium
B. Keratinized Stratified Squamous epithelium
C. Columnar cells
D. Cuboidal epithelium

Response:
Ans. A: Nonkeratinized Stratified Squamous epithelium

So the answer to this question is A


Instruction:
Intercalated disc is present in
A. Cardiac muscle
B. Smooth muscle
C. Skeletal
D. All

Response:
CARDIAC MUSCLE - With the light microscope the junctions between adjoining cardiac myocytes are seen as dark staining transverse lines running across the muscle fibre. These lines are called intercalated discs. Sometimes these discs do not run straight across the fibres, but are broken into a number of 'steps' . The discs always lie opposite the I bands. Cardiac muscle is involuntary and is innervated by autonomic fibres (in contrast to skeletal muscle that is innervated by cerebrospinal nerves). Nerve endings terminate near the cardiac myocytes, but motor end plates are not seen. REF : Inderbir Singh's Textbook of Human HistologY, seventh edition, pg.no.,122.

So the answer to this question is A


Instruction:
In which of the following condition, flat capnogram is NOT seen?
A. Apnea
B. Complete laryngospasm
C. Foreign body obstructing the upper airway
D. None of the above

Response:
Capnography is a valuable monitor of the pulmonary, cardiovascular, and anesthetic breathing systems. Capnographs in common use rely on the absorption of infrared light by CO2. A value commonly repoed on the capnography device is the end-tidal CO2 (the maximum CO2 concentration at the end of each tidal breath, or ETCO2). A flat-line capnogram can be due to either apnea, upper airway obstruction, or complete laryngospasm. Ref: Miner J.R. (2011). Chapter 41. Procedural Sedation and Analgesia. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.

So the answer to this question is D


Instruction:
Azygos vein drains into:
A. Left brachiocephalic vein
B. Inferior vena cava
C. Superior vena cava
D. Right brachiocephalic vein

Response:
The azygos vein ends by joining the posterior aspect of the superior vena cavaThe Azygos VeinThe azygos vein connects the superior and inferior venae cavae, either directly by joining the IVC or indirectly by the hemiazygos and accessory hemiazygos veins.The azygos vein drains blood from the posterior walls of the thorax and abdomen.It ascends in the posterior mediastinum, passing close to the right QA des of the bodies of the inferior eight thoracic veebrae (T4-T12).It is covered anteriorly by the oesophagus as it passes posterior to the root of the right lung.It then arches over the superior aspect of this root to join the SVC.In addition to the posterior intercostal veins, the azygos vein communicates with the veebral venous plexuses.This vein also receives the mediastinal, oesophageal, and bronchial veins.

So the answer to this question is C


Instruction:
Gold standard test for investigation for chronic Pancreatitis detection of early pathologies and simultaneous treatment possible (e.g., duct dilation, stent inseion) Ductal stones, seen as filling defects "Chain of lakes" or "string of pearls" appearance (characteristic feature) Irregularity, dilation of the main pancreatic duct
A. MRI
B. ERCP
C. Pancreatic function tests
D. Fecal fat estimation

Response:
ERCP - Considered the gold standard for the diagnosis of CP, the advent of secretion MRCP and EUS have significantly decreased its role as a diagnostic test ERCP : detection of early pathologies and simultaneous treatment possible (e.g., duct dilation, stent inseion) Ductal stones, seen as filling defects"Chain of lakes" or "string of pearls" appearance (characteristic feature)Irregularity, dilation of the main pancreatic duct Ref: Sabiston 20th edition Pgno :1535

So the answer to this question is B


Instruction:
Deep inguinal ring is a defect in aponeurosis of:
A. External oblique muscle of abdomen
B. Internal oblique muscle of abdomen
C. Transverse abdominis muscle
D. Transversalis fascia

Response:
Ans. (d) Transversalis fasciaRef: Bailey & Love 26th ed. / 955* Deep inguinal ring is the opening in the transversalis fascia through which the ductus deferens and gonadal vessels (or round ligament in the female) enter the inguinal canal.* Located midway between anterior superior iliac spine and pubic tubercle, it is bounded medially by the lateral umbilical fold (inferior epigastric vessels) and inferiorly by the ilio-pubic tract. Indirect inguinal hernias exit the abdominal cavity through the deep inguinal ring.

So the answer to this question is D


Instruction:
All of the following are sexually transmited, Except-
A. Candida albicans
B. Echinococcus
C. Molluscum contagiosum
D. Group B streptococcus

Response:
None

So the answer to this question is B


Instruction:
The genetic factors that can increase the susceptibility and modify the severity of pancreatic injury in acute pancreatitis are all, except:
A. Cationic trypsinogen mutations
B. Pancreatic secretory trypsin inhibitor
C. CFTR
D. ATP7a gene mutation

Response:
There are some genetic factors that can increase the susceptibility and/or modify the severity of pancreatic injury in acute pancreatitis. They are, (1) Cationic trypsinogen mutations (2) Pancreatic secretory trypsin inhibitor (SPINK1) (3) CFTR, and (4) Monocyte chemotactic protein (MCP-1) Menkes syndrome is caused by mutations in the ATP7A gene. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2636

So the answer to this question is D


Instruction:
Which of the following is the established biological therapy for Crohn's disease?
A. Anti TNF a antibody
B. IL - I antagonist
C. IL - 6 antagonist
D. IL - 8 antagonist

Response:
Tumor Necrosis Factor (TNF) is a key inflammatory cytokine and mediator of intestinal inflammation. The expression of TNF is increased in IBD. Infliximab is a chimeric human monoclonal antibody against TNF that is extremely effective in Crohn's disease. Recently adalimumab has also been approved for treatment of moderate to severe crohn disease. Newer Immunosuppressive Agents for IBD Tacrolimus Mycophenolate mofetil 6-Thioguanine Thalidomide

So the answer to this question is A


Instruction:
Ethosuxamide is the drug of choice for:
A. Generalized Tonic clonic seizures
B. Complex paial seizures
C. Absence seizures
D. Myoclonic seizures

Response:
Answer is C (Absence seizures): Ethosuxamide is primary agent for the treatment of Absence seizures (Petitmal). Ethosuxamide is paicularly effective in the treatment of absence seizures, but it is not useful for generalized tonic clonic seizures or paial seizures' - Harrisons 17th/ 2509 Ethosuxamide is a primary agent for the treatment of Absence seizures' -Goodman & Gillman Selection of Antiepileptic Drugs: Agents Primary Paial' Absence Atypical Generalized Tonic-Clonic Absence, Myoclonic, Atonic Valproic acid Carbamazepine Valproic acid Valproic acid Lamotrigine Phenytoin Ethosuxamide Lamotrigine First-Line Topiramate Lamotrigine Topiramate Oxcarbazepine Valproic acid Levetirucetamb Lamotrigine Clonazepam Phenytoin Topiramate Clonazepam Felbamate Alternatives Carbamazepine Tiagabineb Oxcarbazepine Zonisamideb Phenobarbital Gabapentin Primidone Phenobarbital Felbamate Primidone 'Includes simple paial, complex paial, and secondarily generalized seizures. bAs adjunctive therapy.

So the answer to this question is C


Instruction:
Which of the following is/are true about PCR except:
A. Uses heat labile DNA polymerase
B. Uses heat stable DNA polymerase
C. Is technique for DNA amplification
D. Used to yield multiple copies of DNA

Response:
Ans: A (Uses....) "Reverse transcriptase- PCR is used for qua notification ofRNA Harper 30th/459, Lippincott 6th/ 483Polymerase Chain ReactionPCR provides a sensitive, selective & extremely rapid means of amplifying a desired sequence of DNA. Twenty cycles provide an amplification'* of lO^S 30 cycles of 109 -Harper 27th/410-llSpecificity* is based on the use of two oligonucleotide primers that hybridize to complementary sequence on opposite strands of DNA & flank the target sequenceDouble stranded DNA can be disrupted by beat or high pH, giving rise to single stranded DNA. The single stranded DNAserves as a template for synthesis of a complementary strand by replicating enzymes, DNA polymeraseEarly PCR reaction used an PS coli DNA polymerase that was destroyed by each heat denaturation cycle. Substitution of a heat-stable DNA polymerase (Taq polymerase) 5 from Thermus aquaticus, obviates this problem & has made possible automation of the reaction, since the polymerase reactions can be run at 70,]CPCR is a cyclic process & cycle contains three steps that involves {Chatterjea & Shinde)Denaturation of DNA duplex (94-98degC)Annealing of primers (37-60oC)Extension of the primers with a polymerase in the presence of dNTP (about 72,:C)Use of PCRIn detection of bacterial infections .retroviral infection & latent virusApplication in forensic medicine(r)in prenatal diagnosis - in diagnosis of inherited diseaseIn cancer detectionQIn transplantationTo study evolutionIn sex determination ofembry-osTo determine viral loadIn DNA sequencingFig,; Steps in one cycle of the polymerase chain reaction.

So the answer to this question is A


Instruction:
Shoulder dystocia results in the following except: March 2007
A. Erb's palsy
B. Klumpke's palsy
C. Sternomastoid swelling
D. Anencephaly

Response:
Ans. D: Anencephaly Shoulder dystocia is a specific case of dystocia whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver sholy after the fetal head. In shoulder dystocia, it is the chin that presses against the walls of the perineum Although the definition is imprecise, it occurs in approximately 1% of vaginal bihs. Despite appropriate obstetric management, fetal injury such as brachial plexus injury, fetal asphyxia, fracture humerus, sternomastoid haematoma or even fetal death can be a complication of this obstetric emergency.

So the answer to this question is D


Instruction:
&;Disinfectant&; kills the following -
A. All microorganisms
B. Pathogenic microorganisms
C. Viruses and fungi
D. Non - pathogenic microorganisms

Response:
Disinfection is the destruction or removal of all pathogenic organisms or organisms capable of giving rise to infection Including spores Ref Ananthanarayan & paniker's textbook of Microbiology 9th edition page no 28

So the answer to this question is B


Instruction:
Antimalarial drug safe in pregnancy is: September 2006, March 2007
A. Quinine
B. primaquine
C. Aesunate
D. Chloroquine

Response:
Ans. D: Chloroquine Chloroquine and proguanil are safer antimalarial drugs in pregnancy.

So the answer to this question is D


Instruction:
Commonest sign of aspiration pneumonitis is :
A. Cyanosis
B. Tachypnea
C. Crepitations
D. Rhonchi

Response:
Answer is B (Tachyapnea): Aspiration pneumonitis is characterized by an acute onset of dyspnea, tachypnea, bronchospasm and cyanosis with a chest radiograph often showing diffuse opacities. - Harrisons Dyspnea tachypnea are ceainly the earliest manifestations to appear following aspiration of any material. The commonest and the earliest 'sign' of aspiration pneumonitis thus would be tachypnea.

So the answer to this question is B


Instruction:
Most common cause of pelvic inflammatory disease is -
A. Sexually transmitted disease
B. IUCD
C. Pelvic peritonitis
D. Puerperal sepsis

Response:
Ans. is 'a' i.e., Sexually transmitted disease Etiology of Pelvic Inflammatory Diseaseo Sexually transmitted disease is the most common cause. Gonococcal and chlamydial infections are the most common cause.o Postabortal or puerperal sepsiso IUCDo Tuberculosiso Pelvic peritonitis, due to appendicitis and diverticulitis.

So the answer to this question is A


Instruction:
Amyl nitrate is most commonly administered
A. Intravenously
B. By inhalation
C. Sub lingually
D. Orally

Response:
None

So the answer to this question is B


Instruction:
Perception of objects without external stimulus is called:
A. Hallucination
B. Illusion
C. Delusion
D. Euthymia

Response:
Ans) a (Hallucination) Ref Ahuja 6/E page 59Perception of objects without stimulus is hallucination.Delusion-Are false unshakable beliefs which are not in keeping with the patients sociocultural and educational background and not amenable to reasoningIt is a disorder of thoughtTypes of delusions in the following conditionDepression - nihilistic delusionDelirium - transient delusionSchizophrenia - delusion of persecution/ reference/control/infidelityMania - delusion of grandeurNote:delusions are not seen in compulsive disorder, anxiety and dementiaHallucinationsFalse perception experienced without external stimulus to the sense organsAuditory hallucinations are the commonest in non organic psychiatric disordersVisual hallucinations are commonest in organic psychiatric disordersHallucinations is involuntary, does not depend on will of observerIt occurs in inner subjective spaceIt is vivid sensory perceptionIllusionsIllusions are misconceptions of external stimuli

So the answer to this question is A


Instruction:
1st evidence of calcification of Primary Upper 1st molar is seen in
A. 14 wk IU
B. 16 wk IU
C. 17 wk IU
D. 15 wk IU

Response:
None

So the answer to this question is D


Instruction:
Intermediate metabolite in TCA cycle are A/E
A. Pyruvate
B. Isocitrate
C. Oxaloacetate
D. Malonate

Response:
Pyruvic acid is a key substance in phase-II metabolism. 1. Principally it is formed from oxidation of glucose (glycolysis) by EM Pathway. Conversion of PA to OAA (by CO2-Fixation Reaction) Pyruvic acid can be conveed to oxaloacetate by the enzyme Pyruvate carboxylase. The enzyme requires: * 'Biotin' as a prosthetic group which brings CO2 * ATP and Mg++ * Requires 'acetyl-CoA' Acetyl-CoA does not enter into the reaction but may by combination with the enzyme maintains it in "active" conformation (+ve modifier). The generation of "acetyl-CoA" in metabolic reactions activates the enzyme and promote the formation of oxaloacetic acid (OAA) required for oxidation of acetyl-CoA in the TCA Cycle. Anaplerotic Reactions A sudden influx of Pyruvic acid (PA) or of "acetyl-CoA" to the TCA cycle might seriously deplete the supplies of OAA required for the citrate synthase reaction. Two reactions that are auxiliary to the TCA cycle operate to prevent this situation. These are known as anaplerotic (Filling up) reactions.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th Edition, Page no: 334

So the answer to this question is A


Instruction:
Pit latrine has a depth of ____ feet
A. 4-Feb
B. 6-Apr
C. 10-Jun
D. 12-Oct

Response:
Dug well latrine or pit latrine is an improvement over borehole latrine. A circular pit of 75 cm in diameter and 3-3.5 m (10-12 ft) deep is dug to the ground for the reception of the night soil. The pit may be lined by pottery rings. Merits are: easy to construct, has a longer life than borehole latrine. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 821

So the answer to this question is D


Instruction:
A 32 year old female patient underwent extraction of an upper first molar on right side and 0.3 mm of perforation was created into the sinus wall.
What procedure would you like to carry out?
A. Caldwell luc operation
B. Suture
C. Give an antibiotic dressing and allow for secondary healing
D. No treatment required

Response:
None

So the answer to this question is D


Instruction:
Vibrio parahemolyticus is seen in which of the following if undercooked?
A. Crab
B. v
C. Prawn
D. Fish

Response:
Vibrio parahaemolyticus infections are associated with the consumption of raw shellfish, cross-contaminated food, and the exposure of wounds to seawater containing V. parahaemolyticus. It is the cause of numerous outbreaks of foodborne illness where raw or uncooked seafoods are commonly consumed.

So the answer to this question is B


Instruction:
Daily additional requirement of protein in lactation is-
A. 25 gm
B. 15 gm
C. 35 gm
D. 50 gm

Response:
Ans. is 'a' i.e. 25 gm The additional requirement of protein is : pregnancy -15 gm Lactation - 25 gm

So the answer to this question is A


Instruction:
30-year old Basanti presents with light brown lesions involving both her cheeks. The lesions had never been erythematous. Which of the following is the most probable diagnosis:
A. SLE
B. Chloasma
C. Air borne contact dermatitis
D. Photo sensitive reaction

Response:
Answer is B (Chloasma):

So the answer to this question is B


Instruction:
A 24-year-old man had been treated for gonorrhea 2 months previously. He developed an ulcerative lesion in the glands of the penis that is noted to be condylomata lata. The etiology of condylomata lata is which of the following?
A. Mixture of organisms
B. Hemophilus ducreyi
C. Herpesvirus hominis, type II
D. Treponema pallidum

Response:
Condylomata lata are a manifestation of secondary syphilis. The treatment is intramuscular injection of penicillin. They are distinguished from condylomata acuminata; in that the latter are velvety and filiform in appearance and are result of infection with human papilloma virus (HPV).

So the answer to this question is D


Instruction:
A 38 year old female patient was on Isoniazid therapy for tuberculosis. She developed rashes on the exposed pas of her body. She has disoriented memory. Family members gives history of diarrhea also. What is the diagnosis:
A. Tuberculosis skin lesions
B. Niacin deficiency
C. Isoniazid neuropathy
D. Some other drug has caused this

Response:
Isoniazid inhibits the endogenous synthesis of niacin. So the patient has developed pellagra i.e. dermatitis, dementia and diarrhea. Prolonged treatment with isoniazid leads to pyridoxine deficiency, which is required for endogenous synthesis of niacin.

So the answer to this question is B


Instruction:
Call exner bodies are seen in:
A. Granulosa cell tumor
B. Yolk sac
C. Dysgerminoma
D. Embryonal carcinoma

Response:
Ans: (a) Granulosa cell tumorBerek and Novak's Gynecology, 14th editionWHO classification of ovarian tumoursCommon epithelial tumorsSex cord (gonadal stroma) tumorsGerm cell tumors*. Serous tumors*. Mucinous tumors*. Endometrioid tumors*. Clear cell (mesonephroid tumors)*. Brenner tumors (Transitional cell tumor)*. Mixed epithelial tumors*. Undifferentiated carcinoma*. Unclassified epithelial tumors*. Granulose-stromal cell tumors, theca cell tumors*. Androblastomas: Sertoli-Leydig cell tumors*. Gynandroblastomas*. UnclassifiedGonadoblastoma*. Pure*. Mixed with dysgerminoma or other germ cell tumors.*. Dysgerminoma*. Endodermal sinus tumors (yolk sac tumour)*. Embryonal carcinoma*. Polyembryoma*. Choriocarcinoma*. Teratoma*. Mixed formsLipid (lipoid) cell tumorsSoft tissue tumors not specific to ovaryUnclassified tumorsFamilial ovarian cancers: HNPCC (LYNCH-2), BRCA1 and BRCA2NOTE:Ovarian cancers are the most common cause of death among all gynecological malignancies.Ovarian cyst adeno carcinoma is most common malignant tumor of ovary (33-50% of epithelial cancers)Most common benign tumour of ovary: Dermoid cystMost common benign epithelial tumor: Serous cystadenomaLargest benign ovarian tumor: Mucinous cyst adenomaMost common ovarian tumour in <20 years of age group - germ cell tumourMost common germ cell tumour (GCT): Mature teratomaMost common malignant germ cell tumour (GCT): DysgerminomaOvarian tumor whose incidence is increased during pregnancy: Dermoid cystMost common ovarian tumor to undergo torsion in pregnancy: Dermoid cystMost common ovarian tumour to involve opposite side: Granulosa cell tumourSerous cyst adenoma is overall most common tumour of ovary.Of all the malignant tumors, 90% are epithelial in orgin, 80% are in primary in the ovary and 20% secondary from breasts, gastrointestinal tract and colon.Mucinous cyst becomes malignant in 5% but papillary cystadenoma becomes malignant in 50% if left untreated.Most common ovarian tumor associated with pseudomyxoma peritoni: Mucinous cystadeno Ca.Most common ovarian tumor associated with hyperthyroidism: Germ cell tumour with struma ovarii (struma ovarii is a teratoma with thyroid tissue).Ovarian tumors with calcification:Cystic teratoma / dermoid cyst (bone + teeth)GonadoblastomaFibromaTorsion of ovarian cyst in the most common complication and seen in teratoma/dermoid cyst most commonly.Tumors with lymphocytic infiltration: DysgerminomaOvarian serous tumors, both low- and high-grade, have a propensity to spread to the peritoneal surfaces and omentum and are commonly associated with the presence of ascites.Meig s syndrome: Combination of ovarian Fibroma + Ascites + right sided hemothoraxPseudo Meig's syndrome: Brenner's tumor, Granulosa Cell tumor, ThecomaRisk factorsProtective factors*. Repeated ovulation*. Old age*. Nullipara*. Early menarche, late menopause*. White race*. Late marriage, infertility*. Perineal exposure to talc*. OC pills*. Pregnancy*. Breastfeeding*. Chronic anovulation*. Bilateral salpingo oophorectomy*. Tubal sterilization*. HysterectomyAge Group:Malignant epithelial tumors40-60 yearsBenign cystic teratoma10-20 yearsDysgerminoma<20 yearsEndodermal sinus tumour15-20 yearsGranulose cell tumourPost-menopausalSertoli leydig cell20-30 yearsThecomaPost-menopausalGERM CELL TUMOURSAccount for 15-20% of all ovarian tumors.95% are benign cystic teratoma, also called as dermoids.Below the age of 20 years, 60% of the tumors are of germ cell origin.<10 years: 85% belong to this group and are malignant.Tumour markers of ovarian cancer:CA-125:>35U/ml indicates malignant and residual ovarian tumour. It is also raised in abdominal tuberculosis and endometriosis.CEA: >5 mg/dl seen in Mucinous ovarian tumour.Endodermal sinus tumors produce AFP.a fetoprotein and alpha-1-antitrypsin: Endodermal sinus tumorAFP and HCG: Embryonal carcinomaHCG: ChoriocarcinomaDysgerminomas and other germinomas: No markers, but secrete LDH Krukenberg's TumourPrimary site: Stomach (70%), large intestine (15%) and breast (6%), spread by retrograde lymphatics.Characteristic features: Signet ring cellsInvolvement of ovary by: Retrograde lymphatics.Always bilateral with smooth surface, slightly bossy and freely mobile over the pelvis.Maintains the shape of ovary and has a peculiar solid waxy consistency.No tendency of adhesion and no infiltration of nearby tissues.Ovarian Tumours and Their Specific FeaturesSchiller Duval bodies - Endodermal sinus tumourSignet ring cells - Krukenberg's tumourCoffee bean cells/Call Exner bodies - Granulosa cell tumourSertoli and Leydig cells - ArrhenoblastomaPsammoma bodies - Papillary Serous CystadenomaRokitansky's protuberance - Dermoid cyst (Mature teratoma)Hobnail cells - Clear cell Ca (mesonephroid Ca)Reinke's crystal - Hilus cell tumourWalthard cell nest - Brenner tumour

So the answer to this question is A


Instruction:
Cysticercosis is caused by larva of:
A. Taenia solium
B. T. saginata
C. Echinococcus
D. Ascaris

Response:
Ans. (a) Taenia solium

So the answer to this question is A


Instruction:
Granulomatous uveitis is seen in all of the following except:
A. Uveitis with ankylosing spondylitis
B. Sympathetic ophthalmitis
C. Tubercular uveitis
D. Uveitis in sarcoidosis

Response:
Ans. Uveitis with ankylosing spondylitis

So the answer to this question is A


Instruction:
Thornwaldt's abscess is seen in -
A. Ludwig angina
B. Pharyngeal bursitis
C. Lateral sinus thrombosis
D. Hydrocephalus

Response:
Ans. is 'b' i.e., Pharyngeal bursitis Thornwald's disease (Pharyngeal bursitis)o A thomwaldt cyst is a benign midline nasopharyngeal mucosal cyst.o It is a developmental anomaly which is usually asymptomatic and is found incidentally on imaging of nasopharynxo This is a notochord remnant.o Sometimes cyst may become infected leading to an abscess and can cause halitosis or foul tasting periodic discharge into the mouth.o Asymptomatic lesions require no treatment. If treatment is required then de-roofing the cyst (marsupialization) isusually sufficient, and can be performed via a transpalatal approach,o Antibiotics are given to treat infection

So the answer to this question is B


Instruction:
A 46 year-old man is on a waiting list to secure a renal transplant. The genetic locus of transplant antigens in humans is known as which?
A. Rhesus (Rh)
B. Ig (Immunoglobulin) A and IgM
C. Human leukocyte antigen (HLA)
D. ABO

Response:
HLA was one of the first studied antigens.The transplant antigen is located on the surface. The strongest transplant antigen is known as the major histocampatibility complex (MHC) and is found in humans on chromosome 6. The higher the number of MHC matches, the better chance of survival for the allograft. However, zero MHC-matched grafts have been placed due to overwhelming demands. On the other hand, mismatch in ABO and Rh group results in hyperacute rejection are elevated .

So the answer to this question is C


Instruction:
All are example for randomised control trials except -
A. Natural experiments
B. Clinical trials
C. Risk factor trials
D. Preventive trials

Response:
Ans. is 'a' i.e., Natural experiments Types of randomized controlled trials Clinical trials 3. Risk factor trials 5. Trial of etiological agents Preventive trials 4. Cessation experiment 6. Evaluation of health services Types of nonrandomized trials. Uncontrolled trials Natural experiments Before and after comparison studies

So the answer to this question is A


Instruction:
Dacrocystorhinostomy is contraindicated in all EXCEPT
A. Atrophic-rhinitis
B. DNS
C. Carcinoma lacrimal gland
D. Chronic dacrocystitis

Response:
Ans. d (Chronic dacrocystitis). (Ref. Parson,IWSO1-504; Basak, Ophthomology 2nd /282, 336)Dacrocystorhinostomy (DCR)# It is surgical procedure of choice in chronic dacrocystitis.# A communication is made between lacrimal sac and middle meatus of nose.# Contraindications:# DNS} # Carcinoma of lacrimal gland(Mnemonic = DCR)# Rhinitis (Atrophic)

So the answer to this question is D


Instruction:
According to the transplantation of Human organs act 1994, the provision for the punishment of imprisonment for an erring doctor is:
A. Less than 1 year
B. Less than 2 years
C. 2 to 5 years
D. More than 5 years

Response:
Ans- D Ref- The Transplantation of Human Organs Act, 1994 The Transplantation of Human Organs Act, 1994 was enacted by the Parliament during 1994 and came into force on February 4, 1995 in the States of Goa, Himachal Pradesh and Maharashtra and all the Union Territories. Thereafter it was adopted by all States except the States of Jammu & Kashmir and Andhra Pradesh, which have their own legislations to regulate transplantation of Human Organs. Purpose of the Act The main purpose of the Act is to regulate the removal, storage and transplantation of human organs for therapeutic purposes and to prevent commercial dealings in human organs. The Act contains detailed provisions relating to the authority for removal of human organs, preservation of human organs, regulation of hospitals conducting the removal, storage or transplantation of human organs, functions of appropriate authority, registration of hospitals and punishment/penalties for offences relating to aforesaid matters. For more information, visit THOA Act - 1994 Transplantation of Human Organs (Amendment) Act, 2011 The Government of India enacted the Transplantation of Human Organs (Amendment) Act, 2011 that allows swapping of organs and widens the donor pool by including grandparents and grandchildren in the list. Some of the important amendments under this Act to promote organ donation are as follows. Provision of 'Retrieval Centres' for retrieval of organs from deceased donors and their registration under the amended Act. Definition of near relative expanded to include grandparents and grandchildren. Brain death certification Board has been simplified and more experts have been permitted for this certification. 'Mandatory' inquiry and informing option to donate in case of unfortunate event of brain stem death of ICU patient for the purpose of organ donation. Mandatory 'Transplant Coordinator' for coordinating all matters relating to removal or transplantation of human organs. National Human Organs and Tissues Removal and Storage Network at one or more places and regional network. National Registry of Donors and Recipients. Removal of eye has been permitted by a trained technician to facilitate eye donation. Transplantation of Human Organs and Tissues Rules (THOT), 2014 The Transplantation of Human Organs and Tissues Rules (THOT), 2014 has many provisions to remove the impediments to organ donation while curbing misuse/misinterpretation of the rules. The following are a few The medical practitioner who will be part of the organ transplantation team for carrying out transplantation operation shall not be a member of the Authorisation Committee constituted under the Act. When the proposed donor or recipient or both are not Indian nationals or citizens whether near relatives or otherwise, the Authorisation Committee shall consider all such requests and the transplantation shall not be permitted if the recipient is a foreign national and donor is an Indian national unless they are near relatives. When the proposed donor and the recipient are not near relatives, the Authorisation Committee shall evaluate that there is no commercial transaction between the recipient and the donor and that no payment has been made to the donor or promised to be made to the donor or any other person Cases of swap donation referred to under subsection shall be approved by Authorisation Committee of hospital or district or State in which transplantation is proposed to be done and the donation of organs shall be permissible only from near relatives of the swap recipients. When the recipient is in a critical condition in need of life saving organ transplantation within a week, the donor or recipient may approach hospital in-charge to expedite evaluation by the Authorisation Committee. The quorum of the Authorisation Committee should be minimum four and is not complete without the participation of the Chairman, Secretary (Health) or nominee and Director of Health Services or nominee. Every authorised transplantation centre must have its own website. The Authorisation Committee is required to take final decision within twenty four hours of holding the meeting for grant of permission or rejection for transplant and the decision of the Authorisation Committee should be displayed on the notice board of the hospital and the website within twenty four hours of taking the decision. The website of transplantation centre shall be linked to State/Regional/National Networks through online system for organ procurement, sharing and transplantation. There would be an apex national networking organization at the centre. There would also be regional and State level networking organizations where large of number of transplantation of organ(s) or tissue (s) are performed. The State units would be linked to hospitals, Organ/Tissue matching Labs and Tissue Banks within their area and also to regional and national networking organisations. Such networks shall coordinate procurement, storage, transportation, matching, allocation and transplantation of organs/tissues and shall develop norms and standard operating procedures. A National Registry on Donors and recipients of Human Organ and Tissue accessible on-line through dedicated website having National, Regional and State level specificities will come into force. National/Regional registry shall be compiled based on similar registries at State level. The identity of the people in the database shall not be in public domain.

So the answer to this question is D


Instruction:
A preterm baby was diagnosed having PDA. Which among the following is the LEAST likely finding in this child?
A. CO2 washout
B. Bounding pulses
C. Necrotizing enterocolitis
D. Pulmonary haemorrhages

Response:
In patent ductus aeriosus (PDA), the pulses are bounding, and pulse pressure is widened due to diastolic runoff through the ductus. PDA with left to right shunt is associated with necrotizing enterocolitis (NEC) due to bowel hypoperfusion. It is the most common acquired GI emergency in the newborn and it is most common in preterm infants, with an incidence of 10% in infants less than 1500 g. Pulmonary hemorrhage can occur in PDA from pulmonary over circulation with the pulmonary vascular resistance droping. Ref: Thilo E.H., Rosenberg A.A. (2012). Chapter 2. The Newborn Infant. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds),CURRENT Diagnosis & Treatment: Pediatrics, 21e.

So the answer to this question is A


Instruction:
Young female with 3 days fever presents with headache, BP 90/60 mmHg, Heart rate of 114/min, and pin point spots developed distal to BP cuff. Most likely organism is:
A. Brucella abortus
B. Brucella suis
C. N. meningitidis
D. Staphylococcus aureus

Response:
Ans. is 'c' i.e., N. meningitidis (Ref: Harrison, 19th/e, p. 998)* The patient has low blood pressure, tachycardia (a state of shock) along with meningitis. Meningococcal meningitis is the most common meningitis complicated by shock.* Meningitis is the most common complication of meningococcemia. It usually begins suddenly with an intense headache, vomiting, and stiff neck and progresses to coma within a few hours.* The Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) is probably the best-performing scoring system studied so far and may be clinically useful for severity assessment in meningococcal disease.

So the answer to this question is C


Instruction:
Outlet forceps, means:
A. Head at station "0"
B. Full cervical dilatation
C. Rupture of membrane
D. Rotation > 45

Response:
In modern obstetrics outlet and low forceps are commonly used .Kielland is very rarely used today and only by experienced person s(refer pgno:446 sheila textbook of obstetrics 2 nd edition)

So the answer to this question is B


Instruction:
Shoest skull diameter:
A. Biparietal
B. Mentoveical
C. Bitemporal
D. Bimastoid

Response:
Biparietal diameter - 9.5 cm - between the 2 parietal eminences Bitemporal diameter - 8.5 cm Bimastoid diameter - 7.5 cm - between the 2 mastoid processes

So the answer to this question is D


Instruction:
Urine turns dark on standing in: (Repeat)
A. Alkaptonuria
B. Maple syrup urine disease
C. Phenyl ketonuria
D. Acute intermittent porphyria

Response:
Ans: A (Alkaptonuria) Ref: Harrison's Principles of Internal Medicine 18th edition & Harper's illustrated Biochemistry, 28th edition. Chapter 29, pp 254)Explanation:AlkaptonuriaDue to deficiency in homagentisic acid oxidaseResults in the accumulation of homogentisic acidThe illness has three characteristic symptoms;Homogentisicaciduria (the patient's urine contains elevated levels of homogentisic acid, which is oxidized to a dark pigment on standing,Large joint arthritisBlack ochronotic pigmentation of cartilage and collagenous tissue tOochronsis)Diets low in protein--especially in phenylalanine and tyrosine--help reduce the levels of homogentisic acid, and decrease the amount of pigment deposited in body tissues.Although alkaptonuria is not life-threatening, the associated arthritis may be severely crippling.

So the answer to this question is A


Instruction:
Seabrooks operation is done for
A. Parotid gland
B. Thyroglossal fistula
C. Thyroglossal cyst
D. Branchial fistula

Response:
Parotid Fistula Internal fistula opens inside the mouth and doesn't give rise to symptoms External fistula : Gland fistula or duct fistula Causes Rupture of parotid abscess Inadveent incision during drainage of parotid abscess Penetrating injury After superficial parotidectomy Clinical presentation When the external fistula is connected to the gland, external opening is pinpoint, though discharge is present for several months, usually closes spontaneously When external fistula is connected with major duct, there is outpouring of parotid secretions onto cheek during meals with excoriation of surrounding skin Diagnosis Sialography or sialogram Treatment Newman and Seabrock's operation (in case of fistula connected with main duct, this operation reconstructs the duct) Ref: Bailey and love 27th edition Pgno : 778

So the answer to this question is A


Instruction:
Bronchiolitis abliterans is suggested by all except
A. Hyperlucency on chest X-ray
B. Obstructive curve on pulmonary function test
C. Sequelae of Adenovirus infection
D. Diffuse infiltrates seen on chest X-ray

Response:
There is patchy infiltrates in Bronchiolitis obliterans.

So the answer to this question is D


Instruction:
All the following are criteria for the diagnosis of HELLP syndrome Except
A. Hemolysis
B. Elevated Liver enzymes
C. Low platelet count
D. Pulmonary edema

Response:
Criteria for the Diagnosis of HELLP syndromeHemolysisBurr cells, Schistocytes in the blood smearBilirubin >= 1.2mg/dlAbsent plasma haptoglobinElevated Liver EnzymesAST >= 72 IU/LLDH > 600 IU/LLow platelet countPlatelets < 1,00,000/mm3Reference: Reference: Practical guide to High-risk pregnancy and delivery; Chapter 16; Hypeensive disorders in Pregnancy

So the answer to this question is D


Instruction:
Which of the following debts is least likely to required dosage reaction in Renal dysfunction
A. Amikacin
B. Ciprofloxain
C. Clindamycin
D. Vancomycin

Response:
Ref-KDT 6/e p731,732 Clindamycin is excreted by biliary route and therefore can be used safely in renal dysfunction, Other drugs excreted in bile are: Ampicillin Nafcillin Chloramphenicol Novobiocin Rifampicin Doxycycline

So the answer to this question is C


Instruction:
True about inverted papilloma is -
A. It is also known as Schnedrian papilloma
B. Anatomically It has an inverted appearance
C. It may cause basal cell carcinoma
D. It is commonly seen in young girls

Response:
Ans. is 'a' i.e., It is also known as Schnedrian papilloma "Inverted papilloma of nose" -o It is also called Schneiderian papilloma, squamous papilloma or papillomatosiso It is a polypoid mass occuring on the lateral nasal wall typically in middle aged men.o The name is derived from its histologic appearance of on inverted proliferative growth patterno The significance of this lesion lies in its association with concurrent (8%) and subsequent (4%) invasive squamous cell carcinoma.

So the answer to this question is A


Instruction:
About glycolysis true is:
A. Occurs in mitochondria
B. Complete breakdown of glucose
C. Conversion of glucose to 3C units
D. 3 ATPs are used in anaerobic pathway

Response:
Ans. C. Conversion of Glucose to 3C units(Ref. Harper 3 He page 157)Option a. Glycolysis occur in cytosolOption b. Complete breakdown of Glucose happens when Pyruvate formed by Glycolysis undergo Pyruvate Dehydrogenase reaction, followed by TCA Cycle.Option d. In anaerobic GlycolysisNumber of ATPs produced is 4Number of ATPs used is 2Net ATP yield by anaerobic glycolysis is 2

So the answer to this question is C


Instruction:
All of the following are classified as 'Small fiber' neuropathies except-
A. Vitamin B12 dificiency
B. HIV Induced
C. Hansen's disease
D. Amyloidosis

Response:
*Vitamin B12 neuropathy is large fiber sensory type (dorsal column involvement) There are many possible causes of small fiber neuropathy. The most common causes are diabetes mellitus or impaired glucose intolerance.Other possible causes include hypothyroidism, Sjogren's syndrome, systemic lupus erythematosus, vasculitis, sarcoidosis, Vitamin B12 deficiency, celiac disease, Lyme disease, HIV, Fabry disease, Charcot-Marie-Tooth Disease, amyloidosis, Ehlers-Danlos Syndrome, and alcohol use disorder. A 2008 study repoed that in approximately 40% of patients no cause could be determined after initial evaluation. When no cause can be identified, the neuropathy is called idiopathic. A recent study revealed dysfunction of a paicular sodium channel in a significant poion of the patient population with an idiopathic small fiber neuropathy. Ref Harrison20th edition pg 2789

So the answer to this question is A


Instruction:
A 37 weeks pregnant woman attends an antenatal clinic at a Primary Health Centre. She has not had any antenatal care till now. The best approach regarding tetanus immunization in this case would be to
A. Give a dose of Tetanus Toxoid (TT) and explain to her that it will not protect the new born and she should take the second dose after four weeks even if she delivers in the meantime
B. Do not waste the TT vaccine as it would anyhow be of no use in this pregnancy
C. Given one dose of TT and explain that it will not be useful for this pregnancy
D. Give her anti-Tetanus Immunoglobulin along with the TT vaccine

Response:
None

So the answer to this question is A


Instruction:
According to ADA guidelines, the diagnosis of diabetes is made when the fasting blood glucose is more than -
A. 126 mg/dl
B. 100 mg/dl
C. 140 mg/dl
D. 200mg/dl

Response:
Ans. is 'a' i.e., 126 mg/dl

So the answer to this question is A


Instruction:
Not a complication of orbital cellulitis
A. Exposure keratopathy
B. Optic neuritis
C. Subperiosteal abscess
D. Retinal detachment

Response:
Retinal detachment is not a complication of orbital cellulitis Orbital Cellulitis Inflammation of orbital septum Complications Exposure keratopathy Compression of optic nerve Central retinal aery occlusion Orbital Abscess Intracranial spread of infections Septicemia

So the answer to this question is D


Instruction:
A 40-year-old male complains of hematuria and an aching pain in his flank. Laboratory data show normal BUN, creatinine, and electrolytes. Hemoglobin is elevated at 18 g/dL and serum calcium is 11 mg/dL. A solid renal mass is found by ultrasound. The most likely diagnosis is
A. Polycystic kidney disease
B. Renal carcinoma
C. Adrenal adenoma
D. Urolithiasis

Response:
Renal carcinoma is twice as common in men as women and tends to occur in the 50- to 70-year age group. Many patients present with a hematuria or flank pain, but the classic triad of hematuria, flank pain, and a palpable flank mass occurs in only 10 to 20% of patients. Paraneoplastic syndromes such as erythrocytosis, hypercalcemia, hepatic dysfunction, and fever of unknown origin are common. Surgery is the only potentially curable therapy; the results of treatment with chemotherapy or radiation therapy for nonresectable disease have been disappointing. Interferon a and interleukin 2 produce responses (but no cures) in 10 to 20% of patients. The prognosis for metastatic renal cell carcinoma is dismal.

So the answer to this question is B


Instruction:
Genomic imprinting is seen in-
A. Prader willi syndrome
B. Marfan syndrome
C. EDS
D. Osteogenesis imperfecta

Response:
Ans. is 'a' i.e., Prader willi syndrome

So the answer to this question is A


Instruction:
Skin graft for facial wounds is taken from -
A. Medial aspect of thigh
B. Cubital fossa
C. Groin
D. Post auricular region

Response:
Full thickness skin graft for face is taken from

post-auricular region
supraclavicular region (Ref: Schwartz 7/e, p 2093)

So the answer to this question is D


Instruction:
Laparoscopic cholecystectomy done in a patient with cholelithiasis. Pathology report shows adenocarcinoma with invasion of muscular layer. CT was normal. Further t/t is
A. Wait and regular follow up
B. Wedge hepatic resection with lymph node dissection
C. Excise all port sites
D. Radiotherapy

Response:
HEPATIC RESECTION  (Indications)

Parasitic and non-parasitic cysts.
Benign and primary malignant tumours of the liver.
Secondary tumour that involves by direct extension  like from carcinoma of gallbladder or limited  secondaries from carcinoma colon/carcinoids.
Trauma to liver.Removal of small portion of liver either within the  segment or traversing segments is called as wedge  resection of the liver.

So the answer to this question is B


Instruction:
Which one of the investigation modalities can diagnose gestational diabetes in a primigravida?
A. HbA1C
B. FBS
C. GCT
D. GTT

Response:
The diagnosis of gestational diabetes is based on the result of the glucose tolerance test. If a GCT is +ve a GTT should be done to confirm gestational diabetes. Procedure: Screening with 50g, 1-hr glucose challenge test (GCT) Plasma glucose >140 mg/dL. Diagnosis with 100g, 3-hr glucose tolerance test (GTT) Fasting - 95 mg/dL 1 hr - 180 mg/dL 2 hrs - 155 mg/dL 3 hrs - 140 mg/dL Two abnormal values on GTT confirm gestational diabetes.

So the answer to this question is D


Instruction:
Which of the following represents an orally available fixed Beta-Lactamase Inhibitor and Antibiotic Combination.
A. Ampicillin-Sulbactum
B. Piperacillin-Tazobactum
C. Amoxicillin-Clavulanic acid
D. Ticarcillin-Clavulanic Acid

Response:
Amoxicillin and Clavulanic acid is the only Beta-Lactamase inhibitor + Antibiotic Combinations that is available for oral administration. Amongst the three most commonly available Beta-Lactamase inhibitor (Clavulanic acid, Sulbactum and Tazobactum), only Clavulanic acid is orally absorbed. Amoxicillin and clavulanic acid are well absorbed orally and also can be given parenterally. All other beta lactamase fixed dose combinations with antibiotics are available only for parenterally use. Beta-lactamase Inhibitor + Antibiotic Combinations Beta lactamases are antibiotic-inactivating enzymes produced by resistant bacteria that hydrolytically inactivate the Beta-lactam ring of penicillins, Cephalosporins, and related drugs like Carbapenems. Beta-Lactamase Inhibitor + Antibiotic combinations Penicillin-Beta Lactamase: Amoxicillin-Clavulanate Ticarcillin-Clavulanate Ampicillin-Sulbactum Piperacillin-Tazobactum Cephalosporin-Beta Lactamase Ceftolozane-tazobactum Ceftazidime-avibactum Carbapenem-Beta Lactamase Meropenem-vaborbactum Imipenem-Relebactum Ref: KDT 7th edition Pgno: 723

So the answer to this question is C


Instruction:
Breech presentation is a risk factor for the following condition
A. CTEV
B. SCFE
C. DDH
D. Pehes disease

Response:
Risk factors for DDH/CDH (Remember 4Fs 1HO)FemalesFirstborn childFamilial: DDH is found in families Faulty intrauterine position (Breech presentation)Hormone-induced laxityOligohydramnios(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 347, 363)

So the answer to this question is C


Instruction:
The other name for dengue fever is-
A. Break-bone fever
B. Chikungunya
C. Yellow fever
D. Kyasanurforest fever

Response:
Dengue fever is characteised by fever,backache ,ahralgias ,headache ,generalised pains(break-bone fever) ,pain on eye movement ,nausea,vomiting ,lacrimation,pharyngitis ,prostration,lymphadenopathy. Reference Harrison20th edition pg 987

So the answer to this question is A


Instruction:
Which is the smallest fundamental unit coding for protein synthesis
A. Cistron
B. Operon
C. Replican
D. Anticodon

Response:
Cistron is the smallest unit of genetic expression that codes for one polypeptide chain.

So the answer to this question is A


Instruction:
Anterior division of femoral nerve supplies ?
A. Rectus femoris
B. Saorius
C. Iliacus
D. Pectineus

Response:
Branches of femoral nerve are :? 1) From the main trunk :- Nerve supply to iliacus, nerve supply to pectineus and a few vascular branches. 2) From anterior division :- Intermediate femoral cutaneous nerve (intermediate cutaneous nerve of thigh), medial femoral cutaneous nerve (medial cutaneous nerve of thigh) and muscular branch to saorius. 3) From posteior division :- Saphenous nerve, nerve supply to quadriceps femoris (rectus femoris, vastus medialis, vastus lateralis, vastus intermedius). 4) Aicular supply :- Hip joint is supplied by nerve to rectus femoris; knee joint is supplied by nerve to three vasti.

So the answer to this question is B


Instruction:
The most common cause of bronchiolitis is:
A. Respiratory syncytial virus
B. Adenovirus
C. Herpes virus
D. Influenza virus

Response:
M/C organism causing Bronchiolitis is RSV Other organisms are :- Influenza virus Parainfluenza virus Human metapneumovirus Coronavirus Adenovius Rhinovirus Palivizumab injection is used to prevent serious lung infection in children and babies caused by respiratory syncytial virus (RSV).

So the answer to this question is A


Instruction:
The active principles of Dhatura are all of the following except -
A. Pyricatechol
B. Hyoscyamine
C. Atropine
D. Hyoscine

Response:
Active principles of dhatura are levo-hyoscyamine, hyoscine (scopolamine) and atropine.

So the answer to this question is A


Instruction:
CCEY medium is used for culture of?
A. C jejuni
B. C difficile
C. Yersinia pestis
D. Actinomycosis

Response:
None

So the answer to this question is B


Instruction:
The primary function of surfactant is
A. Prevent overexpansion of alveoli
B. Decrease the surface tension of the fluid lining the alveoli
C. Facilities diffusion of oxygen
D. Prevent airway closure

Response:
Surfactant is a mixture of dipalmitoylphosphatidylcholine, other lipids, and proteins. The phospholipids line up in the alveoli with their hydrophobic fatty acid tails facing the alveolar lumen. Surface tension is inversely propoional to their concentration per unit area. If the surface tension is not kept low when the alveoli become smaller during expiration, they collapse I accordance with Laplace law. Surfactant molecules move apa as alveoli enlarge during inspiration and surface tension increases, whereas it decreases when they move closer together during expiration.Ref: Ganong's Review of Medical Physiology Kim E Barrett, Susan M Barman, Scott Boitano, Heddwen L Brooks 23rd edition, page no -597

So the answer to this question is B


Instruction:
Treatment for Filariasis is,
A. Chloroquin
B. Diethyl Carbamazine
C. Tetracycline
D. Praziquantel

Response:
None

So the answer to this question is B


Instruction:
Approximately how many enamel rods will be present in a maxillary molar?
A. 5 million
B. 7 million
C. 9 million
D. 12 million

Response:
The number of enamel rods ranges from 5 million in Lateral incisor and 12 million in upper 1st molar.

So the answer to this question is D


Instruction:
A patient requires tooth extractions from an area that has been subjected to radiation therapy. Which of the following represents the greatest danger to this patient:
A. Alveolar osteitis
B. Osteoradionecrosis
C. Prolonged healing
D. Fracture of the mandible

Response:
None

So the answer to this question is B


Instruction:
Which of the following antitubercular drugs is contraindicated in pregnancy?
A. Isoniazid
B. Rifampicin
C. Ethambutol
D. Streptomycin

Response:
Streptomycin

So the answer to this question is D


Instruction:
Muscular voice in females is treated by
A. Thyroplasty type 1
B. Thyroplasty type 2
C. Thyroplasty type 3
D. Thyroplasty type 4

Response:
THYROPLASTY Isshiki divided thyroplasty procedures into four categories to produce functional alteration of vocal cords. (a) Type I:- It is medial displacement of vocal cord as is achieved in teflon paste injection. (b) Type II:- It is lateral displacement of vocal cord and is used to improve the airway (c) Type III:- It is used to shoen (relax) the vocal cord. Relaxation of vocal cord lowers the pitch. This procedure is done in mutational falsetto or in those who have undergone gender transformation from female to male. (d) Type IV:- This procedure is used to lengthen (tighten) the vocal cord and elevate the pitch. It conves male character of voice to female and has been used in gender transformation. It is also used when vocal cord is lax and bowing due to aging process or trauma. Ref:- Dhingra; pg num:-301,302

So the answer to this question is D


Instruction:
All are anxiety disorders except ?
A. Phobias
B. OCD
C. Conversion reaction
D. PTSD

Response:
Ans. is 'c' i.e., Conversion reaction Anxiety disorders are :- Panic disorder with or without agoraphobia Agoraphobia with or without panic disorder Specific phobia Social phobia Obsessive - compulsive disorder Post traumatic stress disorder Generalized anxiety disorder

So the answer to this question is C


Instruction:
All of the following are true about glomus-jugulare tumor except:
A. Commonly metastasizes to lymph nodes
B. Pulsatile tinnitus and conductive deafness seen
C. Most commonly affects male
D. Paraganglioma's

Response:
Glomus jugulare tumors are rare, slow-growing, hypervascular tumors that arise within the jugular foramen of the temporal bone. They are included in a group of tumors referred to as paragangliomas, which occur at various sites and include carotid body, glomus vagale, and glomus tympanicum tumors Glomus jugulare tumors occur predominantly in women in the fifth and sixth decades of life. Because of the insidious onset of symptoms, these tumors often go unnoticed, and delay in diagnosis is frequent. The most common symptoms are conductive hearing loss and pulsatile tinnitus. Other aural signs and symptoms are ear fullness, otorrhea, hemorrhage, bruit, and the presence of a middle ear mass. Significant ear pain is uncommon.

So the answer to this question is C


Instruction:
True about Ig gene rearrangement & Ig diversity
A. Somatic mutations theory
B. One loop and two loop joining theory
C. DNA rearrangement
D. Appropriate class switching

Response:
The somatic mutation theory of carcinogenesis has been the dominant force driving cancer research during the 20th century. In brief, it proposes that successive DNA mutations in a single cell cause cancer (monoclonality). This theory places carcinogenesis at the cellular and subcellular hierarchical levels of biological complexity. Its basic premises are that (1) cancer is a defect of the control of cell proliferation and (2) the default state of metazoan cells is quiescence. These two premises have recently been contradicted by evidence. Suppoers of the theory have dealt with these lacks of fit by incorporating ad hoc explanations similar to the use of epicycles in pre-Copernican astronomy. We propose the adoption of an alternative theory, the tissue organization field theory of carcinogenesis and neoplasia. Its basic premises are that (1) proliferation is the default state of all cells and (2) carcinogenesis and neoplasia are defects of tissue architecture. Carcinogens would act initially by disrupting the normal interactions that take place among cells in the parenchyma and stroma of an organ (the equivalent of the "morphogenetic fields" of developing organisms). Stroma appears as the primary target of carcinogens. Carcinogenesis and neoplasia occur entirely through emergent (supracellular) phenomena. Neoplastic cells may be reprogrammed to behave like "normal" cells within normal tissues. We argue that it is necessary to abandon the somatic mutation theory. Researchers will then become free to adopt alternative reliable premises to build a theory that explains carcinogenesis as another outcome, aberrant as it may be, of biological organization.

So the answer to this question is A


Instruction:
WHO formation day is
A. 5-May
B. 7 April
C. 10-Jun
D. 10-Jul

Response:
None

So the answer to this question is B


Instruction:
Language function is preserved in
A. Autism
B. Asperger's syndrome
C. Rett syndrome
D. Tourette syndrome

Response:
(B) Asperger's syndrome # Autism (i.e. marked impairment in reciprocal social and interpersonal interaction):i. Absent social smile,ii. Lack of eye-to-eyecontact,iii. Lack of awareness of others' existence or feelings; treats people as furniture,iv. Lack of attachment to parents and absence of separation anxiety,v. No or abnormal social play; prefers solitary games,vi. Marked impairment in making friends,vii. Lack of imitative behavior, viii. Absence of fear in presence of danger> Asperger syndrome or Asperger's syndrome or Asperger disorder is an autism spectrum disorder that is characterized by significant difficulties in social interaction, along with restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Although not required for diagnosis, physical clumsiness and atypical use of language are frequently reported.> Rett's syndrome is a disorder which is only reported in girls so far. After an apparently normal early development and normal head circumference at birth, there is a deceleration of head growth between the age of 5 months and 30 months. There is also a loss of purposive hand movements and acquired fine motor manipulative skills between the same ages, with the subsequent development of stereotyped movements of hands (e.g. handwringing). Later, other movement disorders also develop and severe mental handicap is invariable> Tourette's disorder is typically characterized by:1. Multiple motor tics.2. Multiple vocal tics.3. Duration of more than 1 year.4. Onset usually before 11 years of age and almost always before 21 years of age.> The disorder is usually more common (about 3 times) in males and has a prevalence rate of about 0.5 per 1000 people.

So the answer to this question is B


Instruction:
Which of the following statments about the biodisposition of penicillins and cephalosporins is NOT accurate?
A. Oral bioavailability is affected by lability to gastric acid
B. Procaine penicillin G is used intramuscular injection
C. Renal tubular reabsorption of beta-lactams is inhibited by probenecid
D. Nafcillin and ceftriaxone are eliminated minly biliary secretion

Response:
(Ref: KDT 6/e p697) Probenecid inhibits renal tubular secretion of penicillins (not reabsorption) Beta lactams eliminated by biliary route are: - Ampicillin - Nafcillin - Ceftriaxone - Cefoperazone Penicillin G has to be given by i.m. route because it is broken down by gastric acid (decreases oral bioavailability).

So the answer to this question is C


Instruction:
IgA nephropathic deposits are senn in-
A. SLE
B. HSP
C. Kawasaki disease
D. Wegner's granulomatosis

Response:
The etiology of IgA nephropathy remains unclear: i) It is idiopathic in most cases. ii) Seen as pa of Henoch-Schonlein purpura. iii) Association with chronic inflammation in various body systems (e.g. chronic liver disease, inflammatory bowel disease, interstitial pneumonitis, leprosy, dermatitis herpetiformis, uveitis, ankylosing spondylitis, Sjogren's syndrome, monoclonal IgA gammopathy IgA nephropathy, characterized by mesangial deposits of IgA-containing immune complexes, is the most common cause of the nephritic syndrome worldwide; it is also a common cause of recurrent hematuria; it commonly affects children and young adults and has a variable course. Henoch-Schonlein purpura is a systemic hypersensitivity disease of unknown cause characterized by a purpuric rash, colicky abdominal pain (presumably due to focal hemorrhages into the gastrointestinal tract), polyahralgia, and acute glomerulonephritis. All these changes result from the deposition of circulating immune complexes within vessels throughout the body and within the glomerular mesangial regions. Ref: Robbins basic book of pathology 9th edition page 531 Ref: Textbook of pathology Harsh Mohan 6th edition page 674

So the answer to this question is B


Instruction:
Hetch Giant cell pneumonia is caused by
A. Mumps virus
B. Rubella
C. Rubeola
D. Varicella

Response:
Hetch Giant cell pneumonia is caused by Rubeola or Measles virus.

So the answer to this question is C


Instruction:
Type III reaction is-
A. Antibody mediated
B. Immune complex mediated
C. Cell mediated
D. None

Response:
Option 2 Type-III hypersensitivity reactions are as a result of excess formation of immune complexes (Ag-Ab complexes) which initiate an inflammatory response through activation of complement system leading to tissue injury: Localized or Ahus reaction Generalized or Systemic type III Reactions, e.g. Serum sickness. Option 1 Type-I: IgE-mediated degranulation of basophils or mast cells. Type-II: IgG Antibodies against cell surface antigen, causing damage by ADCC or complement activation. Option 3 Type-IV hypersensitivity:- It is delayed type (occurs after 48-72 hours of antigen exposure) Cell mediated: Characteristic cells called TDTH cells are the principal mediators

So the answer to this question is B


Instruction:
Cholestasis may lead to the following complications except -
A. Intrauterine fetal death
B. Meconium stained liquor
C. Preterm labour
D. Neonatal jaundice

Response:
Ans-D

So the answer to this question is D


Instruction:
Agent used for eliciting diagnostic differentiation of Myasthenia Gravis from Cholinergic crisis is
A. Neostigmine
B. Ecothiophate
C. Edrophonium
D. Ambenonium

Response:
Edrophonium test * Edrophonium test is used to distinguish between Myasthenic crisis of autoimmune Myasthenia Gravis and Cholinergic crisis. * Edrophonium is a sho acting reversible non-carbamate Acetylcholinesterase inhibitor (indirectly acting cholinomimetic). * It is based on the scientific rationale that muscular weakness of myasthenic crisis (caused by inadequate cholinergic stimulation) dramatically improves on administration of Edrophonium. * In Cholinergic crisis - caused by overeatment with anticholinesterases --> resulting in muscle weakness by induction of persistent depolarization, fuher administration of Edrophonium causes drastic worsening of muscle weakness. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 172

So the answer to this question is C


Instruction:
All are found is Posterior Mediastinum except:
A. Esophagus
B. Azygos vein
C. Thymus
D. Sympathetic Trunk

Response:
Ans. C. ThymusThe part behind the pericardium (enclosing heart) is called posterior mediastinum. Its contents are - Esophagus, thoracic duct, descending aorta, Sympathetic Trunk, Azygos vein, hemiazygos vein, accessory hemiazygos vein, vagus nerve, posterior mediastinal lymph nodes.

So the answer to this question is C


Instruction:
The most probable diagnosis of the lesion depicted in the X-ray below is (GCT)
A. Simple bone cyst
B. Osteoma
C. Ewings tumour
D. Osteoclastoma

Response:
Osteoclastoma 98% cases are benign with potential for metastasis with female predominance Sites - Distal femur/proximal tibia, lower end of radius, proximal humerus Occurrence - 20 - 40 years Arises from epiphysis Egg shell crackling on palpation X ray finding - Soap bubble appearance HPE - mesenchymal stromal cells Treatment Lower end of femur/Upper end of tibia - Excision with turn-o-plasty Veebra - Radiation Ref: Maheshwari 6e pg 237.

So the answer to this question is D


Instruction:
Roseola infantum can be caused by -
A. Herpes virus 6
B. Parvovirus B 19
C. Echovirus 19
D. All of the above

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

So the answer to this question is D


Instruction:
A victim of Tsunami has difficulty in overcoming the experience. She still recollects the happening in dreams and thoughts. The most likely diagnosis is :
A. Post traumatic stress disorder
B. Conversion disorder
C. Panic disorder
D. Phobia

Response:
Recollection of the happening in dreams & thought after a life threatening event suggests the diagnosis of PTSD.

So the answer to this question is A


Instruction:
While performing a vaginal delivery for a nulliparous woman, after successful delivery of the baby and placenta, you observe that a perineal laceration has extended to involve the external anal sphincter. All are true regarding this except?
A. It could have been avoided had you practiced a routine episiotomy
B. Lack of proper perineal support could be the reason
C. Repair is done in the OT under anaesthesia by senior
D. Torn anal sphincter is sutured using end to end anastomosis

Response:
Ans. A. It could have been avoided had you practiced a routine episiotomyPerineal injury during delivery can be prevented by proper perineal support, slow delivery of head in between contractions. Alternatively, if expulsive efforts are inadequate or expeditious delivery is needed, the modified Ritgen maneuver may be employed. With this, gloved fingers beneath a draped towel exert forward pressure on the fetal chin through the perineum just in front of the coccyx. Concurrently, the other hand presses superiorly against the occiput, this allows controlled fetal head delivery. It also favors neck extension so that the head passes through the introitus and over the perineum with its smallest diameters.American College of Obstetricians and Gynecologists has concluded that restricted use of episiotomy is preferred to routine use and episiotomy should be considered for indications such as shoulder dystocia, breech delivery, macrosomic fetuses, operative vaginal deliveries, persistent occiput posterior positions, and other instances in which failure to perform an episiotomy will result in significant perineal rupture.Repair of 3rd and 4th degree perineal tear is performed in OT under proper relaxation and anaesthesia, light and position by a senior obstetrician for best results. Torn anal sphincter is sutured using end to end anastomosis. Overlapping technique is an alternative method. Data based on randomized controlled trials do not support that this method yields superior anatomical or functional results compared with those of the traditional end-to-end method.

So the answer to this question is A


Instruction:
Which of the following is directly involved in sound transduction?
A. Release of neurotransmitter onto the afferent endings of cranial nerve VIII
B. Shearing motion of the basilar membrane against hair cell stereocilia
C. Movement of the tectorial membrane resulting in hair cell depolarization
D. Vibration at the round window via the stapes

Response:
Shearing of the hair cell stereocilia against the tectorial membrane results in depolarization, and the release of neurotransmitter onto afferent endings of the auditory cranial nerve leads to initiation of an action potential.
Sound waves are directed toward the tympanic membrane by the pinna and the external auditory canal of the external ear. The vibration of the tympanic membrane is transmitted to the oval window by way of the ossicles of the middle ear. Induction of waves in the perilymph results in the movement of the basilar and vestibular membranes toward the scala tympani and causes the round window to bulge outward. The movement of the hair cells is facilitated because the tectorial membrane is rigid and the pillar cells form a pivot. The stabilization of the pressure between the middle ear and the nasopharynx is not directly related to the mechanism of sound transmission.

So the answer to this question is A


Instruction:
Age of adolescence:
A. 10-14 years
B. 14-20 years
C. 6-10 years
D. 1-3 years

Response:
Infants (0 to 1 year old)
Toddlers (1 to 3 years old)
Preschoolers (3 to 6 years old)
School-aged children (6 to 12 years old)
Adolescents (12 to 19 years old).

So the answer to this question is B


Instruction:
Which of the following is not a feature of sickle cell disease?
A. Autosplenectomy
B. Heterozygous individuals are at increased risk of Plasmodium falciparum infection
C. Ischemic tissue damage
D. Hydroxyurea is used as a therapeutic agent

Response:
Sickle cell disease Caused by missense mutation in the b-globin gene that leads to the replacement of a charged glutamate residue with a hydrophobic valine residue. Mutation promotes the polymerization of deoxygenated hemoglobin, leading to red cell distoion (sickling), hemolytic anemia, microvascular obstruction, and ischemic tissue damage. Sickle cell trait (heterozygosity) confers protective effect against falciparum malaria. In early childhood, spleen is enlarged. However, as disease progresses, there is chronic erythrostasis leading to splenic infarction, fibrosis, and progressive shrinkage, only a small piece of fibrous splenic tissue is left, a process called autosplenectomy. The mainstay of treatment is an inhibitor of DNA synthesis, hydroxyurea.

So the answer to this question is B


Instruction:
Predictive value of a positive test is defined as-
A. True+ve\/true+ve+false-vex100
B. True + ve\/ true + ve + false + ve x 100
C. False + ve \/ true + ve + false + ve x 100
D. False + ve \/ true + ve + false - ve x 100

Response:
Ref:Parks 23rd edition pg 140 PPV = TP / (TP +FP) * 100 Predictive value reflects the diagnostic power of a test.

So the answer to this question is B


Instruction:
Woodruff's plexus is seen at -
A. Anteroinferior part of superior turbinate
B. Middle turbinate
C. Posterior part of inferior turbinate
D. Anterior part of inferior turbinate

Response:
Ans. is 'c' i.e. Posterior part of inferior turbinate Woodruffs areao It is situated under the posterior end of inferior turbinate.o Sphenopalatine artery anastomoses with posterior pharyngeal artery here,o Posterior epistaxis occurs in this area.

So the answer to this question is C


Instruction:
Cottons fracture is fracture of
A. Foot
B. Knee
C. Ankle
D. Hip

Response:
Ankle

So the answer to this question is C