Instruction:
rural and Urban difference in prevalence is seen in all of the following, EXCEPT -
A. Lung cancer
B. Tuberculosis
C. Mental illness
D. Chronic bronchitis

Response:
TB in India (National TB survey, I MR 1955-58). Rural population suffered as equally as urban population. Elderly suffered more than young ones Mental illness in India Prevelence rates are significantly higher in urban areas (Except for epilepsy and hysteria) Bronchitis and Lung cancer in India : Is more common in Urban areas Ref: Textbook of community medicine by Sunder Lal 2nd edition Pgno : 419,591,612

So the answer to this question is B


Instruction:
Onodi cells are seen in?
A. Sphenoid sinus
B. Maxillary sinus
C. Anterior ethmoidal sinus
D. Posterior ethmoidal sinus

Response:
Ethmoidal sinuses are divided into two groups :A) Anterior groupi) Anterior ethmoidal air cellsAnterior ethmoidal air cells drain into- either the ethmoidal infundibulum or the frontonasal duct. Some air cells may invade the orbital floor. These are known as the Haller' cells.ii) Middle ethmoidal air cellsAlso known as bullar sinuses. The middle ethmoidal air cells drain- into the middle meatus by one or more orifices on or above the ethmoidal bulla.B) Posterior groupPosterior ethmoidal air cells usually drain- into the superior meatus. The posterior group lies very close to the optic canal and optic nerve. The Onodi cell is usually regarded as the most posterior ethmoid cell that pneumatizes lateral and superior to the sphenoid sinus and is intimately associated with the optic nerve.

So the answer to this question is D


Instruction:
A17-year-old boy presented with TLC of 138x109/ L with 80% blasts on the peripheral smear. Chest X-ray demonsnstrated a large mediastinal mass. Immunophenotyping of this patent's blasts would most likely demonstrate:
A. No surface antigens (null phenotype)
B. An immature T cell phenotype (Tdt/CD34/CD7 positive)
C. Myeloid markers, such as CD13,CD33 and Cd15
D. B cell markers, such as CD19,CD20 and CD22

Response:
Answer is B (An immature T cell phenotype-Tdt/CD34/CD7 positive) The presence of a mediastinal mass in a young adolescent male suggests the diagnosis of precursor T cell ALL. Precursor T cell ALL is phenotypically characterized by an immature T cell phenotype and is positive for TDT and CD7 and may he positive for CD34. The patient in question has a Tcell ALL (Precursor T cell ALL) Patient is presenting with characteristic clinical features of T cell ALL Occurance in an adolescent age group (17 year old) Occurance in a male (predilection for males) Presence of a mediastinal mass High WBC count > 100,000/mm3 Presursor T cell ALL will show an immature T cell Phenotype and will be positive for CD7 and Td t Immunophenotypic classification for ALL FAB classification Immunologic classification Phenotype Incidence (% cases) Cytogenetic Abnormalities Pre-B Cell Early Pre-B CD19, CD20-/+, CD10, CD34, TdT 55 75 t(9;22), t(4, 11), t(1; 19) Pre-B CD19, CD20+/-, CD10, CD34-, clgM, Tdt+/- 20 B cell B cell CD19, CD20, CD22, CD10+/-, CD34-, Tdt-, slg 5 14q 11 or 7q34 T cell T cell CD1, CD2, CD3, CD5, CD7, CD10+/-, CD34-/+, Tdt, dual CD4/CD8 20 t(8; 14), t(8; 22), t(2;8)

So the answer to this question is B


Instruction:
A 16 year old boy complains of pain in the right eye. After refractometry,he was prescribed a +3.5 D sphere lens. The cover test is normal. There is no heterophoria. The diagnosis is :
A. Organic amblyopia
B. Anisometric amblyopia
C. Emmetropic amblyopia
D. Toxic amblyopia

Response:
B i.e. Anisometric amblyopia

So the answer to this question is B


Instruction:
Example of neurohormone: September 2012
A. ACTH
B. Coisol
C. Oxytocin
D. Somatostatin

Response:
Ans. C i.e. OxytocinNeurohormoneIt is any hormone produced and released by neuroendocrine cells (also called neurosecretory cells) into the blood.By definition of being hormones, they are secreted into the circulation for systemic effect, but they can also have a role of neurotransmitter or other roles as autocrine (self) or paracrine (local) messenger.The hypothalamus produces the hypophysiotropic and neurohypophysial hormones in specialized hypothalamic neurons which extend to the median eminence and posterior pituitary.The adrenal medulla produces adrenomedullary hormones in chromaffin cells, cells which are very similar in structure to post-synaptic sympathetic neurons, even though they are not neurons they are derivatives of the neural crest.Enterochromaffin and enterochromaffin-like cells, both being enteroendocrine cells, are also considered neuroendocrine cells due to their structural and functional similarity to chromaffin cells, although they are not derivatives of the neural crest.

So the answer to this question is C


Instruction:
A 58-year-old woman had a mitral valve replacement, and was placed on anticoagulants and prophylactic antibiotics following her surgery. Five days after her surgery, she developed a sharply demarcated, erythematous rash on her left thigh. Two days after the rash appeared, large hemorrhagic bullae began to form in the area of the rash. Which of the following medications most likely caused the patient's rash?
A. Aspirin
B. Cefazolin
C. Heparin
D. Warfarin

Response:
Warfarin is a coumarin anticoagulant used for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation, as well as the prophylaxis and treatment of venous thrombosis and pulmonary embolism. Warfarin may cause necrosis of the skin (typically on the breasts, thighs, and buttocks) generally between the third and tenth days of therapy. The lesions are initially sharply demarcated, erythematous, and purpuric. They may resolve or progress to large, irregular, hemorrhagic bullae that can eventually lead to necrosis. The mechanism for this reaction is related to warfarin's ability to deplete protein C, which can lead to a state of hypercoagulability and thrombosis in the cutaneous microvasculature. Aspirin is commonly used for its antiplatelet effect; however, it would not be indicated for anticoagulation of a patient with a recent cardiac valve replacement. Fuhermore, aspirin is not associated with the development of this type of skin necrosis. Cefazolin is a first-generation cephalosporin antibiotic commonly used as a perioperative prophylactic agent. If the patient was allergic to this antibiotic, an erythematous rash might have appeared. However, the rash would not lead to the appearance of large, hemorrhagic bullae. Heparin is an intravenous anticoagulant indicated for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation. It is also indicated for the prophylaxis and treatment of venous thrombosis, pulmonary embolism, and for treatment of some coagulopathies. Although heparin is associated with the development of thrombocytopenia, it is not associated with skin necrosis.

So the answer to this question is D


Instruction:
Parathormone increases calcium absorption by acting at -
A. PCT
B. DCT
C. Loopofhenle
D. Collecting duct

Response:
Ans. is 'b' i.e., DCT [Ref: Ganong 24th/ep. 382,Paratharmoneo Paratharmone is 84 aminoacid polypeptide hormone secreted from parathyroid glands,o Its secretion is regulated by plasma Ca++ concentration -- fall in Ca++ concentration increases the secretion of paratharmone.o ActionsPTH increases resorption of calcium from bone - most prominent action.PTH increases calcium reabsorption from distal tubules of kidney.PTH decreases phophate reabsorption from proximal tubules of kidney.PTH has no direct effect on calcium absorption from intestine but increases it indirectly by enhancing the formation of calcitriol by activating la-hydroxylose.PTH decreases calcium level in milk, saliva, and ocular lens -- may be responsible for development of cataract in hypothyroidism.

So the answer to this question is B


Instruction:
Conditions associated with incoagulable state are
A. Abruption placentae
B. Acute promyelocytic leukaemia
C. Severe falciparum malaria
D. Heparin overdose

Response:
All the above four options is answer Ref Robbins 7/e p657; 9/e p664-665 severe falciparum malaria: The incidence and progression of coagulation abnormalities were studied in 52 patients with acute falciparum malaria. The patients were prospectively divided into 3 groups; severe (parasitaemia greater than or equal to 5% or vital organ dysfunction), 12 patients; moderate (parasitaemia 1%- less than 5% without complications), 16 patients; and mild (parasitaemia less than 1%), 24 patients. No case died or developed clinical evidence of disseminated intravascular coagulation. Conventional indices of coagulation (prothrombin time, paial thromboplastin time, fibrinogen, fibrin degradation products) were usually within the normal range but reduced plasma concentrations of antithrombin III (AT-III) levels were noted in all groups, and the incidence was significantly higher in patients with severe and moderate malaria (83% and 81%) compared with the mild group (37%; P less than 0.005). Depletion of AT-III was associated with thrombocytopenia, acute promyelocytic leukemia: Acute promyelocytic leukemia (APL) is a is a unique subtype of acute leukemiacharacterized by abnormal proliferation of promyelocytes, life-threatening coagulopathy, and the chromosome translocation t(15;17)(q22;q11-12). heparin overdose: Heparin is an anticoagulant, meaning it inhibits the formation of blood clots in the body. In heparin overdose, the body is unable to deploy its natural defenses against hemorrhage (excessive bleeding), and life-threatening blood loss can occur quickly. Excessive bleeding from an open wound is unlikely to go unnoticed, but internal bleeding can be sneakier. All patients receiving heparin should be monitored closely for the signs and symptoms of internal bleeding due to delayed clotting action abruption placentae: Placental abruption can cause life-threatening problems for both mother and baby. For the mother, placental abruption can lead to: Shock due to blood loss Blood clotting problems (disseminated intravascular coagulation)

So the answer to this question is A


Instruction:
2 months old child having bih weight 2kg, with poor feeding, very sleepy and wheezing. The diagnosis is?
A. No pneumonia
B. Severe pneumonia
C. Very severe disease
D. None

Response:
Ans. is 'c' i.e., Very severe disease

So the answer to this question is C


Instruction:
By using Ultrasonogram the smallest size of gallstone which can be confidently diagnosed is of size:
A. 1.5 mm
B. 3 mm
C. 5mm
D. 10 mm

Response:
Ultrasonography of the gallbladder is very accurate in the identification of cholelithiasis. Stones as small as 1.5 mm in diameter may be confidently identified provided that firm criteria are used. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2619

So the answer to this question is A


Instruction:
Which of the following medical conditions can present with Depression?
A. Hypothyroidism
B. Cushing syndrome
C. Addison's disease
D. All of the above

Response:
Impoant medical conditions causing depression are: Cushing syndrome Addison disease Parkinson's disease Stroke Epilepsy Coronary aery disease Hypothyroidism

So the answer to this question is D


Instruction:
Fowl smelling ear discharge with presence of pale granulation tissue in ear in an adolescent boy is suggestive of ?
A. Cholesteatoma
B. Exostosis
C. Otomycosis
D. Malignant otitis externa

Response:
Ans. is 'a' i.e., Cholesteatoma Fowl smelling ear discharge with presence of granulation tissue in earin adolescent boy is suggestive chronic suppurativeotits media of the unsafe type (atticoantral disease). Such patients have underlying cholesteatomaalongwith evidence of bone destruction. Clinical features of cholesteatoma/atticoantral CSOM Otorrhoea :- Scanty, foul smelling discharge due to bone destruction. Hearing loss :- Initially conductive due to destruction of ossicles. Later sensorineural element may be added, which results in mixed hearing loss. Bleeding :- May occur from granulation or the polyp when cleaning the ear. Tympanic membrane show posterior marginal or attic perforation. Also granulation tissue and polyps may be present in ear.

So the answer to this question is A


Instruction:
Renshaw cells are inhibitory interneurons found in?
A. Gray matter of brain
B. White matter of brain
C. Gray matter of the spinal cord
D. White matter of spinal cord

Response:
ANSWER: (C) Gray matter of the spinal cordREF: Neurobiology: molecules, cells, and systems By Gary G. Matthew, Page 176-177 "Renshaw cells of grey matter of spinal cord produces self-inhibition of motor neurons.The axons of motor neurons send branches that make excitatory synaptic connection onto Renshaw cells. The Renshaw cells in turn make inhibitory synaptic connections back onto the same motor neuron"

So the answer to this question is C


Instruction:
Which of the following muscle is supplied by superficial branch of ulnar nerve
A. Palmaris longus
B. Palmaris brevis
C. Abductor digiti minimi
D. Adductor pollicis

Response:
Palmaris longus is supplied by the median nerve. Abductor digiti minimi and adductor pollicis is supplied by the deep branch of ulnar nerve. Palmaris Brevis is supplied by the superficial branch of ulnar nerve along with digital branches. B D Chaurasia 7th edition Page no: 124,123

So the answer to this question is B


Instruction:
Moraxella catarrhalis is resistant to which antibiotic?
A. Amoxicillin
B. Clarithromycin
C. Azithromycin
D. Amoxicillin and clavulanic acid combination

Response:
Ans. is 'a' i.e., Amoxicillin Treatment of M. caterrahlis infection: M. catarrhalisrapidly acquired -lactamases during the 1970s and 1980s; antimicrobial susceptibility patterns have remained relatively stable since that time, with >90% of strains now producing -lactamase and thus resistant to amoxicillin. Most strains of M. catarrhalisare susceptible to amoxicillin and clavulanic acid combination, extended-spectrum cephalosporins, newer macrolides (azithromycin, clarithromycin), trimethoprim- sulfamethoxazole, and fluoroquinolones.

So the answer to this question is A


Instruction:
Trendelenburg's sign is negative in an Inter-Trochanteric fracture because of:
A. Gluteus medius
B. Gluteus maximus
C. Gluteus minimus
D. Tensor fascia lata

Response:
(d) Tensor fascia lata- In cases of fracture intertrochanteric femur both gluteus muscles become ineffective as these are inserted in greater trochanter. Tensor fascia lata (TFL) which is inserted through the iliotibial tract on to the lateral condyle of tibia will still be in a position to affect some abduction thereby causing a negative trendelenburg test.

So the answer to this question is D


Instruction:
Transport of molecules in simple diffusion is not determined by:
A. ATP usage
B. Size of molecule
C. Lipid solubility
D. Number of channels

Response:
Ref: Pal GK. Transport across Cel! membrane. In: Textbook of medical physiology. 2""' ed. Abuja publishing house. 2011: 4: 32,33.Explanation:Permeability of substances across the membrane is decided by1. Lipid - solubility2. Molecular size3. Charge of the molecule4. Temperature5. Distribution of channels in the membrane6. Pressure gradientSimple and passive diffusion are passive transport and energy is not do not require utilization of metabolic energy (ATP)

So the answer to this question is A


Instruction:
Physiological effect that is not produced by stimulation of Kappa opioid receptor is:
A. Sedation
B. Diuresis
C. Miosis
D. Constipation

Response:
Ans. D. ConstipationBecause of the stimulation of u receptor constipation will occur. They can be found in the intestinal tract.This will be the cause of constipation i.e. a major side effect of u agonists, due to inhibition of peristaltic action.a. Sedationb. Analgesiac. Miosisd. Dysphoriae. DiuresisAmong the five related receptors the k-opioid receptor will bind opium-like compounds in the brain which are responsible for mediating the effects of these compounds.It effects includes altering the: -a. Moodb. Perception of painc. Consciousnessd. Motor control

So the answer to this question is D


Instruction:
Hyponatremia has no effect on the RMP (resting membrane potential) because
A. The cell membrane is impermeable to Na+
B. ECF Na+ concentration is high
C. Intracellular K+ concentration is high
D. Equilibrium potential for Na+ is +60 mV

Response:
Resting membrane potential depends on the concentration of potassium ion and not on sodium ion. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, 23)

So the answer to this question is D


Instruction:
The length of the small bowel in a full term newborn is:
A. 250 cm
B. 500 cm
C. 750 cm
D. 100 cm

Response:
Length of small bowel in newborn : 250 cm.Length of small bowel in adults : 600 - 800 cm.

So the answer to this question is A


Instruction:
Fluid administration in an infant of 10 kg is
A. 1 ml/kg/hr
B. 2 ml/kg/hr
C. 3 ml/kg/hr
D. 4 ml/kg/hr

Response:
For infants 3.5 to 10 kg the daily fluid requirement is 100 mL/kg. For children 11-20 kg the daily fluid requirement is 1000 mL + 50 mL/kg for every kg over 10. A guide for maintenance fluid therapy for children is as follows: 0-10 kg - 100 mL/kg/day (4 mL/kg/hr) 10-20 kg - 1000 mL/day + 50 mL/kg/day (40 mL/hr + 2 mL/kg/hr) >20 kg - 1500 mL/day + 25 mL/kg/day (60 mL/hr + 1 mL/kg/hr) Reference: GHAI Essential pediatrics, 8th edition

So the answer to this question is D


Instruction:
The following tetracycline has the potential to cause vestibular toxicity :
A. Minocycline
B. Demeclocycline
C. Doxycycline
D. Tetracycline

Response:
None

So the answer to this question is A


Instruction:
Murine Typhus is caused by
A. Rickettsia prowazekii
B. Rickettsia Conori
C. Rickettsia Typhi
D. Coxiella Burnetii

Response:
Murine Typhus / Endemic typhus caused by R-typhi.

So the answer to this question is C


Instruction:
A radiographic film becomes too dark and fogged, due to:
A. Inappropriate processing
B. Concentrated developer
C. Poor film storage
D. Longer exposure duration

Response:
FILM FOG

Improper safelighting (improper filter; excessive bulb wattage; inadequate distance between safelight and work surface; prolonged exposure to safelight)
Light leaks (cracked safelight filter; light from doors, vents, or other sources)
Overdevelopment
Contaminated solutions
Deteriorated film (stored at high temperature; stored at high humidity; exposed to radiation; outdated)

White and Pharoah's Oral  Radiology Principles and Interpretation 8th edition

So the answer to this question is C


Instruction:
N K cell shows presence of -
A. CD 44
B. CD 16
C. CD 54
D. CD 32

Response:
Ans. is 'b' i.e., CD 16 o NK cells have CD-56 and CD-16 on their surface.

So the answer to this question is B


Instruction:
Which of the following is likely to be found in a patient with lesion in shaded area?
A. Fluent speech output
B. Normal repetition
C. Acalculia
D. Dysarthric speech pattern

Response:
Wernicke's aphasia is caused by a lesion in the posterior superior temporal gyrus of the dominant hemisphere. It is characterized by impaired language comprehension, inability to repeat, and fluent speech output with paraphasic errors. The only associated neurologic sign may be a right superior quadrantanopia second~ to the proximity of the inferior optic radiation to Wernicke's area in the left temporal lobe.

So the answer to this question is A


Instruction:
Which is not true about the thoracic outlet syndrome
A. Resection of first rib solves symptoms
B. Neurological features are most common
C. Positive adson's test
D. Radial nerve is commonly affected

Response:
Not the Radial nerve, but Ulnar nerve is most commonly affected in thoracic outlet syndrome. Thoracic Outlet Syndrome is the collective name which includes - Cervical rib syndrome Scalenus anterior syndrome Costoclavicular syndrome Hyperabduction syndrome Pectoralis minor syndrome First thoracic rib syndrome The syndrome is caused by compression of the brachial plexus or subclan vessels in the region of thoracic inlet. The symptoms may arise from neural, vascular or combined compression. Neurological symptoms (are more common) Compression of the brachial plexus usually affects its lower trunk (C8 & T1). Symptoms are - Pain, paraesthesia and numbness usually in the finger and hands in the ulnar nerve distribution. Symptoms of Aerial Compression are seen less frequently in about 1/4 of the cases. Symptoms are - Pain, numbness, paresthesia, coldness and weakness of the arm or hand. Raynauds phenomenon may also occur. Venous symptoms are less common and include edema, venous distention, pain and cyanosis. Diagnostic tests or manoeuvres : Adsons test Costoclavicular compressive test Hyperabduction test. Ref : S. Das text book of Surgery 3/e p170

So the answer to this question is D


Instruction:
Not true about right kidney is
A. Right kidney is preferred over the left for transplantation
B. Rt. is lower than the left kidney
C. Right renal vein is shoer than the left
D. Right kidney is related to the duodenum

Response:
Renal Transplantation Before the donation it is essential to perform imaging (usually MR angiography or CT angiography) to delineate the anatomy of the aerial supply to the kidneysQ. If the left kidney has a single renal aery (10% of kidneys have two or more aeries) it is usually chosen for transplantation because it has a longer renal vein, which simplifies the transplant operationQ. The presence of multiple aeries does not necessarily preclude donation although implantation of living donor kidneys with multiple aeries may increases the chances of vascular complications developing after implantationQ.

So the answer to this question is A


Instruction:
The maximum amount of mercury vapour allowed in the work place:
A. 0.005 mg/m3
B. 0.5 mg/m3
C. 0.05 mg/m3
D. 0.025 mg/m3

Response:
None

So the answer to this question is C


Instruction:
The technique of laproscopic cholecystectomy was first described by?
A. Erich Muhe
B. Phillip Mouret
C. Kurt Semm
D. Eddie Reddick

Response:
Ans. a. Erich Muhe The technique of laproscopic cholecystectomy was first described by Erich Mu he."Eric Muhe performed the first laparoscopic cholecystectomy in 1982. He used a modified operating laparoscope placed at the umbilicus after establishing pneumoperitoneum. - Bhangar t 5/e p5l2History of laparoscopic Cholecystectomy* Dr. Kurt Semm, the father of "pelviscopy," performed the first laparoscopic appendectomy in 1980y.* Eric Muhey performed the first laparoscopic cholecystectomy in 1982. He used a modified operating laparoscope placed at the umbilicus after establishing pneumoperitoneum.* In 1987, Phillipe Mouret performed the first video laparoscopic cholecystectomy by using a camera attached to the laparoscope.

So the answer to this question is A


Instruction:
The action of intramedullary 'K' nail is -
A. Two-point fixation
B. Three-point fixation
C. Compression
D. Weight concentration

Response:
K-nail is used for transverse or short oblique fracture of the femur, especially in the ischemic area.
K-nail (Kuntscher cloverleaf intramedullary nail) provides three points fixation due to elastic deformation.
These three points of fixation are both ends of bone (2 points) and isthmus (3rd point).

So the answer to this question is B


Instruction:
'Intermediate form' of Non hodgkin's lymphoma is :
A. Small non cleaved cell
B. Diffuse, small cleaved cell
C. Lymphoblastic
D. Large cell immunoblastic

Response:
Answer is B (Diffuse, small cleaved cell): Working formulation of NHL for clinical usage is as follows: Low grade Small lymphocytic Q Follicular, predominantly small cleaved cell Q Follicular, mixed, small cleaved and large cell. Q Intermediate grade Follicular predominantly large cell Q Diffuse small cleaved cell Diffuse mixed small and large cell. Diffuse large cell. High grade Large cell immunoblastic Q Lymphoblastic Q Small non cleaved cell. Note that all varieties of diffuse fall in the intermediate grade category only.

So the answer to this question is B


Instruction:
Whole thickenss of bowel is involved with skin lesions in ?
A. Crohn' disease
B. Ulcerative colitis
C. Irritable bowel disease
D. Both Crohn's and ulcerative colitis

Response:
Davidson&;s principles and practice of medicine 22nd edition. *In crohn&;s disease there the entire wall of bowel is oedematous and thickened involving terminal ileum ,right side colon,jejunum.

So the answer to this question is A


Instruction:
All of the following statements about cadherins are true, EXCEPT:
A. Adhesion is Ca++-dependent and homophilic
B. When mixed together, cells expressing different cadherins so out into homotypic cell aggregates
C. Cadherins associate with the actin cytoskeleton
D. Cadherins interact with components of the basement membrane

Response:
This is an incorrect statement and hence the correct answer for this EXCEPT question. Cadherins are involved in cell-cell adhesive interactions and not cell-ECM interactions. Binding of epithelial cells to basement membrane components, such as occurs with hemidesmosomes, involves integrins.

So the answer to this question is D


Instruction:
Day light factor in living room should he?
A. 8%
B. 6%
C. 10%
D. 15%

Response:
Ans. is 'a' i.e., 8%

So the answer to this question is A


Instruction:
Thymidylated RNA present in:
A. mRNA
B. rRNA
C. tRNA
D. 16-s-RNA

Response:
C i.e. t RNAThe TN/ C arm of tRNA has sequence of thymidineQ, Pseudouridine, and cytosine.The Tyr C arm of tRNA is involved in binding of amino acyl - tRNA to the ribosomal surface at the site of protein synthesis.hn RNA is heterogenous nuclear RNA, they are processed to generate the mRNA, which then enter the cytoplasm to serve as template for protein synthesis.

So the answer to this question is C


Instruction:
Crown completion of deciduous mandibular 1st molar occur:
A. At birth
B. 1 ½ months after birth
C. 9 months after birth
D. 5 ½ months after birth

Response:
None

So the answer to this question is D


Instruction:
A 2-year-old intellectutually disabled child is having blue eyes, blonde hair and fair skin. He also have a peculiar body odour. What is the diagnosis?
A. MSUD
B. Isovaleric aciduria
C. Phenyl ketonuria
D. Canavan's disease

Response:
Ans. C. Phenyl ketonuriaIdentifying features:* Blue eyes, blonde hair and fair skin is a classical description of a case of PKU. The child is intellectually disabled and they have mousy body odour.

So the answer to this question is C


Instruction:
Non -proliferative Glomerulonephritis include all of the following, Except:
A. Focal Segmental Glomerulonephritis (FSGS)
B. Mesangiocapillary Glomerulonephritis
C. Membranous Glomerulonephritis
D. Amyloidosis

Response:
Answer is B (Mesangiocapillary Glomerulonephritis) Mesangiocapillary Glomerulonephritis is the other name for Membranoproliferative glomerulonephritis. It is a type of proliferative Glomerulonephritis. Proliferative changes in Glomerulonephritis Glomerulus contains Endothelial cells, Epethelial cells, and Mesangial cells. Any of the three cell types may undergo proliferation in different types of Proliferativ Glomerulonephritis. Proliferative changes are not limited to Membranoproliferative and Mesangioproliferative Glomerulonephritis, hut may be seen in several other. forms of Glomerulonephritis

So the answer to this question is B


Instruction:
Iceberg phenomenon & disease is not shown by all except
A. Rabies
B. Diabetes mellitus
C. Tetanus
D. Meascles

Response:
None

So the answer to this question is A


Instruction:
True about adductor hiatus is
A. Opening in aponeurosis of adductor magnus
B. Lies close to adductor tubercle
C. Imporatnt vessels pass through it
D. All of the above

Response:
The adductor hiatus is a hiatus (gap) between the adductor magnus muscle and the femur that allows the passage of the femoral vessels from the anterior thigh to the posterior thigh and then the popliteal fossa .It is the termination of the adductor canal and lies about 8-13.5 cm. superior to the adductor tubercle .Only two structures enter and then leave through the hiatus; namely the femoral aery and femoral vein . Ref - pubmed.com

So the answer to this question is D


Instruction:
Mediastinal surface of the left lung is related to all except
A. Left ventricle
B. Ascending aoa
C. SVC
D. Arch of aoa

Response:
Structures related to the mediastinal surfaces of the right and left lungsRight sideLeft sideRight atrium and Left ventricle, leftauricleLeft ventricle, leftauricle, infundibulumand adjoining pa ofthe right ventricleA small pa of the right ventriclePulmonary trunkSuperior vena cavaArch of aoaThe lower pa of the rightbrachiocephalic veinDescending thoracic aoaAzygos veinLeft subclan aeryOesophagusThoracic ductInferior vena cavaOesophagusTracheaLeft brachiocephalic veinRight vagus nerveLeft vagus nerveRight Phrenic nerveLeft recurrent laryngeal nerveRef: BD Chaurasia; Volume 1; 6th edition

So the answer to this question is C


Instruction:
Average daily intake of fluoride from all sources combined for adults and children is:
A. 2.0 to 2.2mg & 1.2mg
B. 1.2 to 2.0mg & 1.2mg
C. 2.2 to 2.4mg & 1.5mg
D. 2.6 to 2.8mg & 1.4mg

Response:
None

So the answer to this question is A


Instruction:
Which anaesthetic agent does not affect blood flow to liver?
A. Halothane
B. Isoflurane
C. Enflurane
D. Sevoflurane

Response:
- Total hepatic blood flow = hepatic aery blood flow + poal blood flow- Liver maintains total hepatic blood flow by autoregulation- All inhalational anesthetic agents disrupt dual blood supply of liver - Halothane completely disrupts dual blood supply- Halothane - acyl halide (metabolite) - Auto immune hepatitis - Enflurane also affects liver blood flow- Isoflurane, sevoflurane & desflurane - maintain hepatic blood flow - Desflurane - Best in maintaining liver blood flow - Not metabolized by liver and kidney - Sevoflurane - Higher MAC- Decreases little amount of hepatic blood flow

So the answer to this question is B


Instruction:
Haldane effect is defined as: September 2010
A. Impoant mechanism meant for oxygen transpo in the body
B. Binding of oxygen to hemoglobin increases capacity for carbon dioxide
C. Deoxygenation of blood increases capacity for carbon dioxide
D. All of the above

Response:
Ans. C: Deoxygenation of blood increases capacity for carbon dioxide The Haldane effect is a propey of hemoglobin first described by the Scottish physician John Scott Haldane. Deoxygenation of the blood increases its ability to carry carbon dioxide; this propey is the Haldane effect. Conversely, oxygenated blood has a reduced capacity for carbon dioxide.

So the answer to this question is C


Instruction:
Autoimmunity can be caused due to all of the all following except -
A. The pressure of forbidden clones
B. Expression of cryptic antigens
C. Negative selection of T-cells in the thymus
D. Inappropriate expression of the MHC proteins

Response:
Altered T or B cell function also contribute to autoimmunity. Enhanced helper T cell and decreased suppressor T cell functions have been suggested as cause of immunity. - defect in the tymus, in stem cell development and macrophage function have also been postulated as causes. Reference: Anathanarayan & paniker's 9th edition, pg no: 179 <\p>

So the answer to this question is C


Instruction:
Preisz Nocard bacilli is other name of
A. C. diphtheriae
B. C. minutissimum
C. C. pseudotuberculosis
D. C. parvum

Response:
C. pseudotuberculosis also called preisz Nocard bacilli affect sheep and horse.

So the answer to this question is C


Instruction:
Aetiology of the hernia includes all EXCEPT:
A. Obesity
B. Whooping cough
C. Peritoneal dialysis
D. Chronic prostitis

Response:
(Chronic prostatitis): Ref: 1272 - LB, 1200 - 1202-SB (968-B & L 25th)Causes of hernia:1. Whooping cough2. Straining on micturition or defecation3. Obesity, Pregnancy4. Intraabdominal malignancy5. Smokers, result of an acquired collagen deficiency6. Peritoneal dialysis - from a previously occult weakness or enlargement of a patent processus vaginalis* Indirect inguinal hernia is the most common hernia, regardless of gender* Inguinal hernias remains the most common hernia in women* Both indirect inguinal and femoral hernias occur more commonly on the right side.* Strangulation, the most common serious complication of a hernia, Most strangulated hernias are indirect inguinal hernias, however, femoral hernias have the highest rate of strangulation (15 to 20%) of all hernias, and for this reason it is recommended that all femoral hernia be repaired at the time of discovery. (1200 - 1- SB)

So the answer to this question is D


Instruction:
All of the following are functions of CD4 helper cells, except -
A. Immunogenic memory
B. Produce immunoglobulins
C. Activate macrophages
D. Activate cytotoxic cells

Response:
Based on the secretion of different cytokines CD4 Helper T cells are divided into TH1 and TH2.
Based on function CD4 helper T cells are divided into-

1) Effector CD4 helper T-cells
- These cells secrete cytokines and other products that perform all major functions.
- These include TH1 and TH2 helper cells.
- Functions are-
A) By TH1 cells

Activate macrophages
Delayed hypersensitivity
Cell-mediated immunity
The killing of intracellular microbes. e.g. tuberculosis and leprosy
Destruction of target cells by-

Activate CD8 T cells to become cytotoxic cells.
Activate NK cells

B) By TH2 cells
i)    Activate B cells to develop into antibody-producing plasma cells → facilitate the synthesis of antibodies.
2) Memory CD4 helper T cells

Retain the antigenic affinity of the originally activated T cells and are used to act as later effector cells during a second immune response.

So the answer to this question is B


Instruction:
Community water fluoridation is important because
A. All groups of socio economic status have accessibility to it
B. Does not pose a health hazard
C. Leads to decrease in the dental caries incidence
D. All of the above

Response:
None

So the answer to this question is D


Instruction:
A patient was on DVT prophylaxis. All of the following has perforators which connect superficial veins to the deep veins, except?
A. Ankle
B. Below the inguinal ligament
C. Mid calf
D. Lower thigh

Response:
Below inguinal ligament.Blood flows from the superficial to the deep veins through perforating (communicating veins)Perforators are located- below the medial malleolus (inframalleolar perforator)- in the medial calf (Cockett perforators)- just above (Dodd perforator) & below the knee (Boyd perforator)- at the level of the adductor canal (Hunterian perforator)

So the answer to this question is B


Instruction:
Additional energy requirement during Pregnancy (Kcalories/day)
A. +300 kcal
B. +600 kcal
C. +350 kcal
D. +520 kcal

Response:
Energy requirement MAN WOMAN Sedentary 2300 1900 (kcal/day) Moderate 2700 2200 (kcal/day) Heavy 3500 2900 (kcal/day) Additional energy requirements 2/3rd trimester - + 350 1st trimester- 150 2/3rd trimester - 350 Lactation 0-6 month = +600 6-12 month = +520

So the answer to this question is C


Instruction:
1 primary oocyte forms how many number of ova:
A. 1
B. 2
C. 3
D. 4

Response:
Primary oocyte formed after meiotic division forms 1 ovum. Ref : Datta textbook of Obstetrics 9 e pg16.

So the answer to this question is A


Instruction:
Characteristic feature of diabetic retinopathy: September 2005, 2010 March 2007
A. Hard exudate
B. Soft exudate
C. Ambylopia
D. Microaneurysm

Response:
Ans. D: Microaneurysm Diabetic retinopathy is an ocular manifestation of systemic disease which affects up to 80% of all patients who have had diabetes for 10 years or more. Diabetic retinopathy often has no early warning signs. As new blood vessels form at the back of the eye as a pa of proliferative diabetic retinopathy, they can bleed (hemorrhage) and blur vision. On fundoscopic exam, one can see cotton-wool spots, flame hemorrhages, and dot-blot hemorrhages. Diabetic retinopathy is the result of microvascular retinal changes. Hyperglycemia-induced pericyte death and thickening of the basement membrane lead to incompetence of the vascular walls. The initial loss of pericytes leads to the formation of the dilatations of the vessels seen as microaneurysms and breakdown of the blood-retinal barrier making the retinal blood vessels more permeable. Small blood vessels in the eye are especially vulnerable to poor blood sugar control. An over accumulation of glucose and/or fructose damages the tiny blood vessels in the retina. During the initial stage, called nonproliferative diabetic retinopathy (NPDR), most people do not notice any change in their vision. Some people develop macular edema. It occurs when the damaged blood vessels leak fluid and lipids onto the macula, the pa of the retina that lets us see detail. The fluid makes the macula swell, which blurs vision. As the disease progresses, severe nonproliferative diabetic retinopathy enters an advanced, or proliferative, stage. The lack of oxygen in the retina causes fragile, new, blood vessels to grow along the retina and in the clear, gel-like vitreous humour that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina. Fibrovascular proliferation can also cause tractional retinal detachment. The new blood vessels can also grow into the angle of the anterior chamber of the eye and cause neovascular glaucoma. Nonproliferative diabetic retinopathy shows up as cotton wool spots, or microvascular abnormalities or as superficial retinal hemorrhages. Diabetic retinopathy is detected during an eye examination that includes: Visual acuity test: Ophthalmoscopy: Note that hand-held ophthalmoscopy is insufficient to rule out significant and treatable diabetic retinopathy. Ocular Coherence Tomography or OCT: This is a scan similar to an ultrasound which is used to measure the thickness of the retina. Digital Retinal Screening Programs: This involves digital image capture and transmission of the images to a digital reading center for evaluation and treatment referral. Slit Lamp Biomicroscopy Retinal Screening Programs: Systematic programs for the early detection of diabetic retinopathy using slit-lamp biomicroscopy. Early signs of the disease (over retina): Leaking blood vessels, Retinal swelling, such as macular edema, Pale, fatty deposits on the retina (exudates) - signs of leaking blood vessels, Damaged nerve tissue (neuropathy), and Any changes in the blood vessels. Panretinal photocoagulation, or PRP (also called scatter laser treatment), is used to treat proliferative diabetic retinopathy (PDR).Rather than focus the light on a single spot, hundreds of small laser burns are made away from the center of the retina, a procedure called scatter laser treatment or panretinal photocoagulation. The treatment shrinks the abnormal blood vessels.

So the answer to this question is D


Instruction:
In hyperkalamia-
A. Serum level >5.5 meq/L
B. Serum level > 6.5 meql
C. T. wave inversion
D. Peaking of p wave

Response:
Hyperkalemia is defined as a plasma potassium level of 5.5 mM, Early ECG changes of hyperkalemia, typically seen at a serum potassium level of 5.5-6.5 mEq/L, include the following: Tall, peaked T waves with a narrow base, best seen in precordial leads Shoened QT interval ST-segment depression At a serum potassium level of 6.5-8.0 mEq/L, the ECG typically shows the following: Peaked T waves Prolonged PR interval Decreased or disappearing P wave Widening of the QRS Amplified R wave At a serum potassium level higher than 8.0 mEq/L, the ECG shows the following: (reference : harrisons principles of internal medicine,19E, page 308,310) Absence of P wave Progressive QRS widening Intraventricular/fascicular/bundle branch blocks Ref Davidson 23rd edition pg 364

So the answer to this question is A


Instruction:
A patient has just been admitted to hospital for observation. Based on patient's laboratory results. What is the patient's primary problem?Hematocrit 45%Hemoglobin 16g/dlPlatelets 50×109/L
A. Hemochromatosis
B. Deep vein thrombosis
C. Hepatic vein thrombosis
D. Recurrent nose bleeds

Response:
Due to low platelet count of 50×109/L. There is recurrent nose bleeds
	Normal platelet count = 1,50,000 - 4,00,000/ L

So the answer to this question is D


Instruction:
Treatment of choice of cystic hygroma
A. Percutaneous aspiration
B. Intralesional sclerosant injection
C. En Block resection
D. Surgical excision

Response:
Surgical excision is most definitive treatment of cystic hygroma. Other treatments include Sclerotherapy and cautery etc.

So the answer to this question is D


Instruction:
30 years old male patient came to chest OPD with pain in right side of chest and cough for past 3 weeks. On examination, decreased breath sounds were heard in basal segment of right lung. Chest x-ray revealed obscuration of bilateral CP angle. Subsequently CECT chest was done . Most probable diagnosis is?
A. Empyema
B. Loculated pleural effusion
C. Pulmonary abscess
D. Mesothelioma

Response:
The split pleura sign is seen with pleural empyemas and is considered the most reliable CT sign helping to distinguish empyemas from noninfectious pleural effusions. The sign results from fibrin coating of both the parietal and visceral surface of the pleura with resulting in growth of blood vessels. Following IV contrast injection CT shows a loculated fluid collection and thickened pleural layers with accompanying enhancement. Both layers of the pleura can then be visualized as linear regions of enhancement that divide around a less dense empyema or in other words come together at the margins of the collection.

So the answer to this question is A


Instruction:
Crown completion of Mandibular 2nd premolar occur
A. At birth
B. 1 ½ year
C. 2 ½ to 3 year
D. 6-7 years

Response:
None

So the answer to this question is D


Instruction:
Which among the following is an impoant fatty acid present in breast milk essential for growth?
A. Docosahexaenoic acid
B. Palmitic acid
C. Linoleic acid
D. Linolenic acid

Response:
Docosahexaenoic acid and eicosapentaenoic acid are omega 3 fatty acids which are impoant constituents of the communication membranes of the brain, and they are necessary for normal brain development. They are also active in the retina of the eye. Docosahexaenoic acid is formed from linolenic acid. Linolenic acid is an essential fatty acid present in the breast milk. It is the staing material for the synthesis of eicosapentaenoic acid and Docosahexaenoic acid. Biochemically impoant omega 3 and 6 fatty acids: Omega 3 acid Omega 6 acid Linolenic acid Linoleic acid Eicosapentaenoic acid Arachidonic acid Docosahexaenoic acid Ref: Organic and Biological Chemistry By H. Stephen Stoker page 301

So the answer to this question is A


Instruction:
Enterovirus species that causes conjunctivitis:
A. Enterovirus 68
B. Enterovirus 69
C. Enterovirus 70
D. Enterovirus 71

Response:
Ref. Textbook of Microbiology and Immunology BY Parija. Page. 780
Acute haemorrhagic conjunctivitis is caused by Enterovirus 70 and Coxsackie A-24.

So the answer to this question is C


Instruction:
Zidovudine toxicity is increased by all except -
A. Azithromycin
B. Probenecid
C. Cisplatin
D. Paracetamol

Response:
Paracetamol increases zidovudine toxicity ,probably by competing for glucuronidation. Azole antifungals also inhibit AZT metabolism. Other nephrotoxic & myelosuppressive drugs & probenecid enhance toxicity . Reference :Tripathi textbook of pharmacology 7th edition pg no 807.

So the answer to this question is A


Instruction:
Most common side effect of inhalational beclomethasone is :
A. Adrenal suppression
B. Oropharyngeal candidiasis
C. Bronchoconstriction
D. Hepatitis

Response:
None

So the answer to this question is B


Instruction:
Lumpy feeling in throat relieved on taking food is attributed to ?
A. Globus pharyngeus
B. Pharyngeal pouch
C. Diveicular disease
D. Esophageal atresia

Response:
Ans. is 'a' i.e., Globus Pharyngeus Globus Pharyngeus Symptom where in a patient describes something stuck in throat or a sensation of lump or tightness in throat which is relieved by taking food or talking.

So the answer to this question is A


Instruction:
Most common cause of empyema is -
A. Bronchopleural fistula
B. Tubercular pneumonia
C. Bacterial pneumonia
D. Pleurisy

Response:
None

So the answer to this question is C


Instruction:
Riboflavin is an important group of water soluble vitamin. Cereals and pulses are relatively good sources of Riboflavin. Most common lesion associated with Riboflavin deficiency, which can also be used as an index of state of nutrition of group of children is
A. Cheilosis
B. Angular stomatitis
C. Glossitis
D. Nosolabial dyssberia

Response:
None

So the answer to this question is B


Instruction:
Which of the following is not pa of epithalamus?
A. Trigonum Habenulae
B. Geniculate bodies
C. Pineal body
D. Posterior commissure

Response:
EPITHALAMUS:It occupies the caudal pa of the roof of the diencephalon and consists of 1.The right and left habenular nuclei,each situated beneath the floor of the corresponding habenular trigone. 2.The pineal body or epiphysis cerebri 3.The habenular commissure 4.The posterior commissure REF.B D Chaurasia's human anatomy,Vol.3,Fifth edition

So the answer to this question is B


Instruction:
Commonest complication of Colles' fracture is:
A. Nonunion
B. Malunion
C. Vascular injury
D. Sudeck's osteodystrophy

Response:
B i.e. Malunion

So the answer to this question is B


Instruction:
The commonest type of Porphyria is
A. Variegate porphyria
B. Porphyria cutanea tarda
C. Congenital erythropoietic porphyria
D. Acute intermittent porphyria

Response:
None

So the answer to this question is B


Instruction:
Dense middle cerebral aery (MCA) Sign in brain is seen in
A. Acute infarct
B. Subacute infarct
C. Subacute haemorrhage
D. Chronic infarct

Response:
The hyperdense MCA sign refers to the focally increased density of the middle cerebral aery on CT and is a direct visualization of thromboembolic material within the lumen. It is thus the earliest visible sign of MCA infarction as it is seen within 90 minutes after the event - acute infarct. It is the longitudinal equivalent of the MCA dot sign and hyperdense basilar tip sign.

So the answer to this question is A


Instruction:
Which of the following statements is true regarding thyroglobulin?
A. It is a specific marker for anaplastic carcinoma
B. Elevation after complete therapy suggests recurrence in well-differentiated thyroid malignancies
C. Preoperative elevation always suggests thyroidal disease
D. Intra op estimation from thyroid veins is very useful for prognosis

Response:
None

So the answer to this question is B


Instruction:
A 4-year-old child with blue sclera and a history of multiple fractures with minimal trauma. For the mention disorder, select the serum concentration of calcium (Ca2+) and phosphate (PO4) with which it is most likely to be associated.
A. Low PO4, normal Ca
B. Low PO4, high Ca
C. Normal PO4, low Ca
D. Normal PO4, normal Ca

Response:
Osteogenesis imperfecta (blue sclera, easily broken bones with minimal trauma) is transmitted as an autosomal recessive (severe form) or, more commonly, autosomal dominant (milder form) disorder. The basic defect is an abnormality in the production and composition of the matrix of bone. Serum calcium and phosphate concentrations are normal.

So the answer to this question is D


Instruction:
Meralgia paresthesia is an entrapment neuropathy of the
A. Ilioinguinal nerve
B. Lateral popliteal nerve
C. Musculocutaneous nerve
D. Lateral cutaneous nerve of thigh

Response:
(D) Lateral cutaneous nerve of thigh NERVE PALSIESNerve palsiesNerves involved* Bell's palsyLower motor neurone paralysis of facial nerve* Saturday nightRadial nerve palsy* Wrist dropRadial nerve* Foot dropDeep peroneal nerve* Erb's palsyLesion of upper trunk policeman's tip of brachial plexus hand deformity (C5, C6)* Klumpke'sLesion of lower trunk paralysis of brachial plexus (c8,t1)* ClawUlnar nerve deformity* Ape thumbMedian nerve deformity* Carpal tunnelMedian nerve at syndrome wrist* Tarsal tunnelPosterior tibial nerve syndrome at ankle* EpicondylarUlnar nerve at elbow tunnel syndrome* Meralgia parastheticaLateral cutaneous nerve of thigh* Horner's syndromeCervical sympathetic

So the answer to this question is D


Instruction:
What is the percentage of fibre in animal foods?
A. 0%
B. 1%
C. 2%
D. 5%

Response:
Animal foods do not contain any fibre. A daily intake of about 40 grams of dietary fibre per 2000 Kcal is desirable. Ref: Park 21st edition, page 567.

So the answer to this question is A


Instruction:
Gastric lavage turns black in presence of Silver nitrate, most probable poisoning was -
A. Celphos
B. Malathion
C. Organophosphorus
D. Parathion

Response:
Gastric lavage fluid gives black colour in presence of silver nitrate because of reaction of posphine with silver nitrate.

So the answer to this question is A


Instruction:
Life cycle of filaria is?
A. Cyclodevelopmental
B. Cyclopropagative
C. Propagative
D. Transovarian

Response:
None

So the answer to this question is A


Instruction:
Cryoprecipitate contains all except -
A. Factor VIII
B. Factor IX
C. Fibrinogen
D. VWF

Response:
None

So the answer to this question is B


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

Response:
Derivatives of neural crest in eye: Corneal stroma, keratocytes and endothelium Sclera Trabecular meshwork endothelium Iris stroma Ciliary muscles Choroidal stroma Pa of the vitreous Uveal and conjunctival melanocytes Meningeal sheaths of the optic nerve Ciliary ganglion Orbital bones Orbital connective tissue Connective tissue sheath and muscular layer of the ocular and orbital vessels Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon, 21st edition, Page 5.

So the answer to this question is A


Instruction:
All of the following muscles form the Rotator cuff EXCEPT
A. Teres minor
B. Subscapularis
C. Deltoid
D. Supraspinatus

Response:
(C) Deltoid # Rotator cuff:> This is a fibrous sheath formed by the four flattened tendons which blend with the capsule of the shoulder joint and strengthen it.> The muscles which form the cuff arise from the scapula and are inserted into the lesser and greater tubercles of the humerus.> They are 1. Subscapularis 2. Supraspinatus, 3. Infraspinatus and 4. Teres minor.# Musculotendinous cuff of shoulder (or) Rotator cuff:> It is a fibrous sheath formed by four flattened tendons which blend with shoulder joint capsule and strengthen it.> Muscles are: Subscapularis Supra and infraspinatus Teres minor The cuff gives strength to the capsule of the shoulder joint except interiorly. This is why humerus dislocation most commonly occur in downward direction.

So the answer to this question is C


Instruction:
Lesions of lateral cerebellar coex causes all except
A. Incoordination
B. Intentional tremors
C. Akinesia
D. Ataxia

Response:
Akinesia is a feature of Parkinson's disease Ref: Ganong 25th ed/page 251

So the answer to this question is C


Instruction:
Indications of steroids in SLE are all except:
A. Myocarditis
B. Endocarditis
C. Thrombocytopenia
D. Neuropsychiatric symptoms

Response:
Answer is B (Endocarditis) :

So the answer to this question is B


Instruction:
Which of the following is not a feature of torus mandibular's?
A. Common in Mongoloids
B. Present on the Lingual surface of mandible below the nnylohyoicl Line
C. Usually Bilateral.
D. May or may not associated with torus palatinus

Response:
None

So the answer to this question is B


Instruction:
Which of the following is selective myosin activator?
A. Istaroxime
B. Omecamtiv & Mecarbil
C. Tolvaptan
D. Levosimendan

Response:
Ans. B. Omecamtiv & MecarbilThese are selective Myosin activator. They prolong the ejection period and increases fractional shortening.

So the answer to this question is B


Instruction:
Site of maximum bicarbonate absorption-
A. Proximal convoluted tubule
B. Distal convoluted tubule
C. Cortical collecting duct
D. Medullary collecting duct

Response:
Ans. is 'a' i.e., Proximal convoluted tubule o About 80-90 of filtered HCO3- is absorbed in PCT.o Absorption of HCO3- is indirect, which is due to secretion H+, i.e., secretion of H+ is coupled with absorption of HCO3o Filtered HCO3- reacts with H+ to form H2CO3 which then is dissociated into H2O and CO2.o CO2 diffuses into epithelial cell and generate HCO3- which is then reabsorbed.

So the answer to this question is A


Instruction:
Tension pneumothorax due to fracture rib is treated by:
A. Strapping
B. Tube drainage
C. IPPV
D. Internal fixation with open reduction

Response:
Tension pneumothorax due to fracture rib is treated by tube drainage.

So the answer to this question is B


Instruction:
All are true about polio, except -
A. 99% non paralytic
B. Flaccid paralysis
C. Exaggerated tendon reflexes
D. Aseptic meningitis

Response:
90-95% of susceptible individuals develop only inapparent infections. In those preceding to paralytic poliomyelitis, flaccid paralysis may develop. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO: 486, 487

So the answer to this question is C


Instruction:
Intermittent dysphagia is caused by
A. Stricture
B. Achalasia cardia
C. Pharyngeal diveiculum
D. All

Response:
Answer is C (Pharyngeal diveiculum) Progressive Achalasia Progressive systemic sclerosis Peptic stricture Carcinoma Intermittent Lower esophageal ring/Spatzki ring Diffuse esophageal spasm Zenker's diveiculum

So the answer to this question is C


Instruction:
Extreme hunger in starvation lasts upto -
A. 6 - 12 hours
B. 12 - 24 hours
C. 24 - 36 hours
D. 36 - 48 hours

Response:
Ans. is 'd' i.e., 36 - 48 hours Starvation is the result of actual deprivation of food or administration of unsuitable food. Starvation may be :? Acute (complete) : Sudden and complete stopage of food. Chronic (paial) : Gradual deficient supply of food. An acute starvation, the reserve carbohydrates, then fat and last the proteins are used up. Feeling of hunger with hunger pain lasts for 30-48 hours. After 4-5 days, there is emaciation, absorption fat and loss of weight (7-8 kg in 10 days).

So the answer to this question is D


Instruction:
Basal bone is
A. That part of the bone embracing apices of root of teeth
B. Lower border of the mandible
C. Ramus of the mandible
D. That part of the bone containing teeth

Response:
None

So the answer to this question is A


Instruction:
Anemia of chronic disorder is characterized by -
A. ↑Sideroblast
B. ↑TIBC
C. ↑Bone marrow iron
D. ↑Protoporphyrin

Response:
None

So the answer to this question is C


Instruction:
High risk pregnancy includes all except :
A. Twins
B. 25 years old primi
C. Hydramnios
D. Previous LSCS

Response:
GROUP A GROUP B GROUP C GROUP D UNIVERSAL REPRODUCTIVE HISTORY PRESENT OBSTETRIC HISTORY INTRAPAUM FACTORS Maternal age >35 or<17 primiparity grand multiparity height <140cm low socioeconomy long period of infeility recurrent miscarriage previous IUD,Stillbih previous preterm instrumental delivery previous CS Third stage complications bih weight less than 2.5kg Rh or ABO isoimmunisation unbooked patient medical disorders hypeensive ectopic or hydatidiform mole IUGR Rh isoimmunisation APH Multiple pregnancy hydramnios malpresentations prolonged pregnancy obesity PROM Cord complications fetal distress prolonged labour PPH retained placenta unskilled attendant TEXTBOOK OF GYNECOLOGY,SHEILA BALAKRISHNAN,Pg no:586,2nd edition

So the answer to this question is B


Instruction:
A patient of scleroderma who has hypeension is at significant risk of developing
A. MI
B. Sudden renal failure
C. Thrombotic stroke
D. Pulmonary hypeension

Response:
.

So the answer to this question is B


Instruction:
Diameter of varicose veins is
A. ≥ 1mm
B. ≥ 2mm
C. ≥ 4mm
D. ≥ 3mm

Response:
Varicose veins are dilated tortuous subcutaneous veins ≥ 3mm in diameter.

So the answer to this question is D


Instruction:
All of the following are indicative of effective leprosy control programme, EXCEPT:
A. High new case detection rate
B. Increasing number of children affected
C. Decreased type 2 disability
D. None of the above

Response:
Operational indicators of effective leprosy control programme: Relapse rate Case detection ratio (that is the number of cases registered to estimated number of cases) Propoion of children (0-14 years) among newly detected cases Propoion of multibacillary cases on regular treatment during the year Propoion of female cases among newly detected cases Treatment condition or cure rate Propoion of new cases presenting with grade 2 disability/impairment at the time of diagnosis Propoion of treatment defaulters Propoion of patients who develop new/additional disability during MDT Ref: Park's Textbook of Social and Preventive Medicine, 19th edition, Page 277.

So the answer to this question is B


Instruction:
Single dose aminoglycoside administration is more preferable than 8 hourly dose because of :
A. MIC
B. Increase perfusion of renal cortex
C. Post antibiotic effect
D. None

Response:
None

So the answer to this question is C


Instruction:
A 45-year-old man is worried about a dark pigmented skin lesion on his arm. The "mole" is 3 mm wide, symmetric with a regular border and even pigmentation. He reports no change in size or other symptoms. Which of the following is the most appropriate next step in management?
A. observation only
B. excisional biopsy
C. punch biopsy
D. chemotherapy, then surgical excision

Response:
(a) Source: (Kasper, pp. 500-502) Observation alone is adequate for this lesion. The "ABCD" rules are helpful in distinguishing benign skin lesions from malignant melanoma. (A) asymmetry, benign lesions are symmetric; (B) border irregular, most nevi have clear-cut borders; (C) color variation, benign lesions have uniform color; (D) diameter, >6 mm is more likely to be malignant. In addition, recent rapid change in size is also helpful in distinguish benign from malignant lesions. Thickness of the tumor is the most important prognostic factor in the majority of cases, and ulceration indicates a more aggressive cancer with a poorer prognosis. Although cumulative sun exposure is a major factor in melanoma (e.g., more frequent near the equator), it cannot explain such things as the more common occurrence of some types in relatively young people. It is possible that brief, intense exposure to sunlight may contribute to, or initiate, carcinogenic events.

So the answer to this question is A


Instruction:
The transition from G2 to M phase of the cell cycle is controlled by :
A. Retinoblastoma gene product
B. p53 protein
C. Cyclin E
D. Cyclin B

Response:
Ans. is' D i.e. Cyclin BRef Robbins Illustrated 6th/e 284Cyclins control the passage of cells through specific phases of the cell cycleThe entry and progression of cells through the cell cycle are controlled by changes in levels and activities of cyclinsSo the levels of several of the cyclins peak during specific phases of the cell cycle, they are rapidly degraded as the cell enters the next phase of the cell cycleCyclins perform their function by forming a complex with a group of constitute expressed proteins called cyclin-dependent kinases (CDKs).Different combination of cyclins and CDKs are associated with each of the important transitions in the cell cycle.As the cell moves into any phase the cyclin specific for that phase is synthesized and then it binds to its constitutive CDK, creating the cyclin/CDK complex, whose activity is necessary for cells to enter the next phase.This complex when activated participates in the reactions and after the reactions are over these cyclins are degraded.Examples of cyclin/CDK complexes controlling the cell cycle cyclins B/CDK1Regulates the transition from G2 to M phaseCyclin D/CDK4 Cyclin D/CDK6 Cyclin E/CDK2regulates the transition from G1-SCyclin A/CDK2 and cyclin B/CDK1Active in S phase

So the answer to this question is D


Instruction:
Antiphospholipid antibody detection is indicated in all of the following conditions except:
A. Three or more consecutive first trimester pregnancy losses
B. Unexplained cerebrovascular accidents
C. Early onset severe pre-eclampsia
D. Gestational Diabetes

Response:
Indications for antiphospholipid antibody testing during pregnancy includes, adverse pregnancy outcome, recurrent first trimester aboion (>=3), unexplained death of morphologically normal fetus after 10wks of gestation, severe early pre-eclampsia, venous thromboembolism, aerial thromboembolism, lividorericularis, transverse myelitis, skin necrosis and chorea. Ref: Clinical Manifestations of Antiphospholipid Antibodies (APS) By Davidson, 21st Edition, Page 1050 ; Neurohospitalist Medicine By S. Andrew Josephson, W. David Freeman, David J. Likosky, Page 146 ; Current Medical Diagnosis and Treatment, 2012, Chapter 20.

So the answer to this question is D


Instruction:
All are seen in fetal alcohol syndrome except
A. Microcephaly
B. Poor coordination
C. Overgrowth of body
D. Flat face

Response:
Poor growth. Newborns may have low bih weights and microcephaly. They may not grow or gain weight as well as other children and may be sho as adults. Developing babies may have bone, and kidney problems. Vision problems and hearing loss are common.epilepsy and other neurologic problems, such as poor balance and coordination. Delayed development. Kids may not reach milestones at the expected time. Behavioral problems. Babies may be fussy or jittery, and have trouble sleeping. Older children and teens may have: * a lack of coordination and poor fine motor skills * poor social skills (difficulty getting along with friends and relating to others, etc.) * learning difficulties, including poor memory, difficulty in school (especially math), and poor problem-solving skills * behavioral problems such as hyperactivity, poor attention and concentration, stubbornness, impulsiveness, and anxiety Reference: GHAI Essential pediatrics, 8th edition

So the answer to this question is C


Instruction:
Ameboid ulcer is a feature of -
A. Parasitic corneal ulcer
B. Mycotic corneal ulcer
C. Herpetic corneal ulcer
D. Bacterial corneal ulcer

Response:
It is seen primary ocular herpes.Sometimes the margins of the dendritic ulcer enlarge and coalesce to form a large epithelial ulcer with a 'geographical' or 'ameboid' configuration</p. Reference:Comprehensive ophthalmology,AK Khurana,6th edition,page no.108

So the answer to this question is C


Instruction:
MAC is not affected by all of the following except?
A. Species
B. Sex
C. Duration of anaesthesia
D. Age

Response:
MAC decreases with age. Excluding patients < 1 year of age every decade there is 6% decrease in value of MAC. Endocrine disorders, duration of anaesthesia, species ,sex does not affect MAC

So the answer to this question is D


Instruction:
All of the following organisms can be detected by BANA analysis EXCEPT
A. Tannerella forythia
B. Porphyromonas gingivalis
C. Capnocytophaga
D. A. actinomycetemcomitans

Response:
None

So the answer to this question is D


Instruction:
All of the following muscles are attached to oblique line of thyroid cartilage except
A. Superior constrictor
B. Inferior constrictor
C. Thyrohyoid
D. Sternothyroid

Response:
None

So the answer to this question is A


Instruction:
Herpes zoster most commonly involves:
A. Facial nerve
B. Ophthalmic division of Trigeminal
C. Mandibular division of Trigeminal
D. Maxillary ivision of Trigeminal nerve

Response:
Ref: Harrison's l8th editionExplanation:The clinical syndrome caused by the reactivation of VZV from sensory ganglia is herpes zoster.The commonly involved dermatomes are:The thoracic dermatomes, especially T4 to T12. are involved in about 50% of casesThe lumbosacral dermatomes in about 16%The cranial nerves in 14 to 20% ot patientso Opthalmic division of trigeminal in 10 to 15 percent ando Other cranial nerves causing 4 to 5 percentThere are two rather characteristic cranial herpetic syndromes are ophthalmic herpes and geniculate herpes.In ophthalmic herpes, which accounts for 10 to 15 percent of all cases of zoster, the pain and rash are in the distribution of the first division of the trigeminal nerve, and the pathologic changes are centered in the gasserian ganglion. The main hazard in this form of the disease is herpetic involvement of the cornea and conjunctiva, resulting in corneal anesthesia and residual scarring. Palsies of extraocular muscles, ptosis, and mydriasis are frequently associated, indicating that the third, fourth, and sixth crania] nerves are affected in addition to the gasserian ganglion.The less common but also characteristic cranial nerve syndrome called Ramsay Hunt syndrome - consists of a facial palsy in combination with a herpetic eruption of the external auditory meatus, sometimes with tinnitus, vertigo, and deafness. This is due to the reactivation of herpes from the geniculate ganglion.

So the answer to this question is B


Instruction:
CO affinity to Hb_____ compared to O2 is
A. 50 times
B. 100 times
C. 150 times
D. >200 times

Response:
(D) >200 times# CARBON MONOXIDE is a common cause of accidental and suicidal poisoning. Its affinity for hemoglobin is 250 times greaterthan that of 02- It therefore binds to hemoglobin and reduces the 02-carrying capacity of blood.> The symptoms of poisoning are due to tissue hypoxia; they progress from headache and fatigue to confusion, syncope, tachycardia, coma, convulsions, shock, respiratory depression, and cardiovascular collapse.> Carboxyhemoglobin levels below 15% rarely produce symptoms; above 40%, symptoms become severe. Treatment includes establishment of an airway, supportive therapy, and administration of 100% O2.> Sulfur dioxide, ozone, and nitrogen dioxide are mucous membrane and respiratory irritants. Methane is a simple asphyxiant.> PATHOPHYSIOLOGYFig: Carbon monoxide shifts the oxygen-haemoglobin saturation curve to the left and changes it to a more hyperbolic shape. Less oxygen is available for the tissues. Shown is the oxygen diffusion gradient difference at 50% saturation> Carbon monoxide has 210 times greater affinity for haemoglobin than oxygen. A small environmental concentration will thus cause toxic levels of carboxyhaemoglobin.> After the carbon monoxide has selectively bound to haemoglobin the oxygen-haemoglobin dissociation curve of the remaining oxyhaemoglobin shifts to the left, reducing oxygen release.> The affinity of carbon monoxide for myoglobin is even greater than for haemoglobin. Bindin g to cardiac myoglobin causes myocardial depression, hypotension and arrhythmias.> Cardiac decompensation results in further tissue hypoxia and is ultimately the cause of death.> Carbon monoxide has a predilection for 'watershed' areas of the brain where there is a meagre blood supply.> Basal ganglia, with their high oxygen consumption, are most often affected. Other commonly affected areas are the cerebral white matter, hippocampus and cerebellum.

So the answer to this question is D


Instruction:
Nasal mucosa is supplied by
A. Only external carotid aery
B. Only internal carotid aery
C. Mainly internal carotid aery
D. Mainly external carotid aery

Response:
Branch of external carotid aery supplying nasal mucosa are Sphenopalatine aery, Greater palatine aery, Superior labial aery (Branch of facial aery), while, the only branch of Branch of internal Carotid aery supplying nose is Anterior ethmoidal aery.

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.
Oroantral communication is predominantly seen during extraction of
A. Maxillary premolars
B. Maxillary first molars
C. Maxillary second molar
D. Maxillary paramolar

Response:
None

So the answer to this question is B


Instruction:
Lesion of globus pallidus causes
A. Chorea
B. Athetosis
C. Hemibalismus
D. Flexion dystonia

Response:
. *Athetosis results due to lesions in neostriatum and globus pallidus , breaking neuronal circuit involving basal nuclei and cerebral coex. Athetosis is a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongueLesions to the brain are most often the direct cause of the symptoms, paicularly to the corpus striatum. Ref Harrison20th edition pg 2456

So the answer to this question is B


Instruction:
Senile caries refers to:
A. Residual caries.
B. Root caries.
C. Pit and fissure caries
D. Recurrent caries.

Response:
Root caries or senile caries occur on the tooth that has been exposed to the oral environment.

So the answer to this question is B


Instruction:
Antiboiotic Prophylaxis for infective endocarditis is indicated in:
A. Isolated secundum ASD
B. Mitral valve prolapse without regurgitation
C. Prior coronary aery bypass graft
D. Coarctation of aoa

Response:
Answer is D (Coarctation of Aoa) Coarctation of Aoa is a high risk cardiac lesion fior the development of infective endocarditis and an indication fir antibiotic prophyloxis.

So the answer to this question is D


Instruction:
A traveling nerve impulse does not depolarize the area immediately behind it, because:
A. It is hyperpolarised
B. It is refractory
C. It is not self-propagating
D. The conduction is always ohodromic

Response:
When an AP is initiated at a point, the point goes into refractoriness when the Na+ entered through that point has excited the adjacent (2nd) point. so it will travel in single direction Hyperpolarization event is after the refractory period.

So the answer to this question is B


Instruction:
Weil-Felix reaction with OXK antigen indicates infection with
A. R. tsustsugamushi
B. R. mooseri
C. R. quintana
D. R. akari

Response:
Weil-Felix reaction:
Serological diagnosis of Rickessial infection. Weil-Felix reaction is a Heterophile agglutination test. Antigens used are Nonmotile strains of Proteus vulgaris (OX 19, OX 2), Proteus mirabilis (OX K).
Mechanism: Proteus and Rickessiae will share alkali stable carbohydrate antigen will be basis of the Weil-Felix reaction. Weil-Felix is a tube agglutination test. It is a simple and useful test for the diagnosis. The Antibody rises in 2nd week of illness and reaches the peak and get decline rapidly during the course of convalescence.

So the answer to this question is A


Instruction:
Chromosomal translocation wen in CMS?
A. 2:08
B. 8:14
C. 9:22
D. 15:17

Response:
A translocation is a type of abnormal change in the structure of a chromosomethat occurs when a pa of one chromosomebreaks off and sticks to anotherchromosome. These "mutations" are an impoant cause of many types of lymphomas and leukemias

So the answer to this question is C


Instruction:
Which of the following is true about female health
A. Acts at PHC level
B. Covers a population of 5000 population
C. Chlorinates well at regular intervals
D. Makes at least 3 post natal visits for each delivery

Response:
Female and male health workers work at subcentre level, i.e. cover 5000 population in general or 3000 population inhilly, tribal & backward area.

So the answer to this question is B


Instruction:
Which of the following investigations is most confirmatory for diagnosis of pelvic inflammatory disease?
A. Gram stain and culture
B. USG.
C. Laparoscopy.
D. Culdocentesis.

Response:
Laparoscopy in PID Considered the most confirmatory Most reliable aid to suppo the clinical diagnosis but it may not be feasible to do in all cases. Reserved only in those cases in which differential diagnosis includes salpingitis, appendicitis or ectopic pregnancy.

So the answer to this question is C


Instruction:
ECG of a patient showed tall T waves with normal rhythm. Laboratory examination showed serum potassium levels to be 7.5 mEq/L. Which of the following therapies will lead to fastest reduction in the serum potassium levels?
A. Insulin glucose IV
B. Calcium gluconate
C. Cation exchange resin
D. NaHCO3

Response:
Regulation of insulin secretion: The beta cells have a glucose sensing mechanism dependent on entry of glucose into Beta cells (through the aegis of a glucose transpoer GLUT2) and its phosphorylation by glucokinase. Glucose entry and activation of the glucoceptor indirectly inhibits the ATP-sensitive K+ channel resulting in paial depolarization of the beta cells This increases intracellular Ca2+ availability (due to increased influx, decreased efflux and release from intracellular stores) beta exocytotic release of insulin storing granules. Other nutrients that can evoke insulin release are--amino acids, fatty acids, and ketone bodies, but glucose is the principal regulator and it stimulates the synthesis of insulin as well. Glucose induces a brief pulse of insulin output within 2 min (first phase) followed by a delayed but more sustained second phase of insulin release. Glucose and other nutrients are more effective in invoking insulin release when given orally than i.v. They generate chemical signals 'incretins ' from the gut which act on cells in the pancreas to cause the anticipatory release of insulin. Glucagon and some of the peptides enhance insulin release by increasing cAMP formation in the beta cells. ESSENTIALS of MEDICAL PHARMACOLOGY SEVENTH EDITION:K.D TRIPATHI Page:259,260

So the answer to this question is A


Instruction:
At physiological pH DNA is ?
A. Acidic
B. Negatively charged
C. Amphipathic
D. All of the above

Response:
Ans. is 'd' i.e., All of the above DNA is amphipathic Amphipathic molecule is one which contains both polar (hydrophilic) and nonpolar (hydrophobic) regions in its structure, i.e. the pa of molecule is water soluble and pa is water insoluble. In DNA helix Hydrophilic (polar) deoxyribose-phosphate of each chain is on outside of molecule. Hydrophobic (nonpolar) bases are stacked in. Thus DNA is regarded as amphipathic in nature. DNA is negatively charged and acidic Phosphate group lies on outside of molecule of DNA. Each phosphate group has a negative charge at physiological pH, making DNA a negatively charge (anion) at physilogical pH. "Histones are strongly cationic and can bind non-specifically to strongly aniomic DNA" Harper "At physiological pH DNA is negatively charged, and is associated with positively charged (basic) histones" Ronald Hofmann. o Anionic molecules are acidic in nature.

So the answer to this question is D


Instruction:
All are included in Biophysical profile and Manning's score EXCEPT:
A. Respiratory movement
B. Fetal movement
C. Non-stress test
D. Vibroacoustic stimulation reflex

Response:
Ans. d (Vibroacoustic stimulation reflex). (Ref. Dutta, Obstetrics, 6th ed., p 109, 464)BIOPHYSICAL PROFILE (MANNING SCORE)# The BPP measures fetal heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around fetus.# A BPP is commonly done in the last trimester of pregnancy.# If patient has a high-risk pregnancy, a BPP may be done by 32 to 34 weeks or earlier.# Its 5 components are:0- Non-stress test (NST)- Fetal breathing movements (at least 1 episode within 30 min lasting for > 30 seconds).- Fetal tone (> 1 episode of limb extension with return to flexion within 30 seconds.)- Gross fetal movements (at least 3 discrete GFM with in 30 minutes).- Amniotic fluid volume (> 1 large pocket more than 1 cm vertical diameter).# Score - In absence of oligohydramnios:- Normal score = 8-10,- Equivocal = 6 and- Abnormal = < 4.Fetal heart rate in "sinusoidal pattern" is seen inFetal heart rate in "saltatory pattern" is seen ina) Rh isoimmunizationb) Normal fetusc) Drugs-alphaprodine.a) Acid-base imbalanceb) Labourc) Acute brief hypoxia in fetusd) Depressed fetus with low AP6AR.

So the answer to this question is D


Instruction:
Magaldrate is converted by gastric acid to -
A. Magnesium hydroxide
B. Magnesium hydroxide and calcium carbonate
C. Magnesium hydroxide and Aluminium hydroxide
D. Calcium carbonate and aluminium hydroxide

Response:
Ans. is 'c' i.e., Magnesium hydroxide and Aluminium hydroxide Magaldrate:o Magaldrateis a common antaciddrug that is used for the treatment of duodenal and gastric ulcers, esophagitis from gastroesophageal reflux.o Magaldrate is a hydroxymagnesium aluminate complex that is converted rapidly in gastric acid to Mg(OH)2 and Al(OH)3, wrhich are absorbed poorly and thus provide a sustained antacid effect.

So the answer to this question is C


Instruction:
Critical Limb ischemia results from
A. Mild Arterial Occlusive Disease
B. Moderate Arterial Occlusive disease
C. Severe Arterial occlusive disease
D. All of the above

Response:
None

So the answer to this question is C


Instruction:
Cadaveric spasm occurs:
A. Immediately after death
B. Within 2 hours
C. Within 6 hours
D. Within 12 hours

Response:
Ans: a (Immediately after death)Ref: Reddy 29th ed. R146 Also refer Q 112 Kerala 2007, Q 151 Kerala 2008Cadaveric spasm is found in muscles contracted at the time of death which becomes stiff immediately without passing into the stage of primary relaxation.Cadaveric spasmSynonyms include instantaneous rigor, cataleptic rigidity, and instantaneous rigidityCadaveric spasm may affect all muscles in the body, but typically only groups, such as the forearms, or hands. Cadaveric spasm often crystallizes the last activity one did prior to death and is therefore significant in forensic investigations, e.g. holding onto a knife tightly.Rigor mortis - Starts within 1 hr. Fully develops by 6 hrs. Remains for 6-8 hrs. Starts disappearing after 18hrs. Completely disappears by 24 - 36 hrs.Rigor mortis starts first in the heart (1 hr). It then appears in the eyelid within 2 hrs. Rigor mortis is due to decreased ATRPutrefaction - Starts by 12 - 24 hrs but in summer it may start as early as 6 hrs.1. External sign of putrefaction - greenish discolouration of skin over the region of caecum. Internally putrefaction is seen on the undersurface of liver.Marbling - 24 - 36 hrs -Maggots appear after 48 hrs -Liquefaction - after 5 -12 hrs -Bone destruction -Uncoffined: 1 yrCoffined: 3 - 10 yrsCompleted by: 25 yrs

So the answer to this question is A


Instruction:
Major criteria for jones classification is
A. Fever
B. Arthralgia
C. Chorea
D. TPR Interval

Response:
i.e. (Chorea): (380 - Ghai 7th)JONES CRITERIA FOR RHEUMATIC FEVERMajor Criteria Minor Criteria* Carditis* Arthritis* Subcutaneous nodule* Chorea* Erythema marginatumA. Clinicali. Feverii. Arthralgiaiii. Previous rheumatic fever rheumatic heart diseaseB. Laboratoryi. Acute phase reactants leukocytosis, elevated ESR and CRPii. Prolonged PR interval on ECGEssential criteriaEvidence for recent streptococcal infection as evidenced bya. Increased antistreptolycin 'O' titerb. Positive throat culturec. Recent scarlet feverTwo major qr one major and two minor criteria are required in the presence of essential criteria to diagnose acute rheumatic feverAssessment for Presence of Heart DiseaseNadas' CriteriaMajor Minor* Systolic murmur* Systolic murmur less than grade III* Grade III or more* Abnormal second sound* Diastolic murmur* Abnormal ECG* Cyanosis* Abnormal X-ray* CHF* Abnormal blood pressurePresence of one major or two minor criteria indicate heart disease (399- Ghai 7th)

So the answer to this question is C


Instruction:
Teduglutide is used in small bowel syndrome because its action is similar to:
A. Pancreatic lipase
B. Biliary lipase
C. Glucagon like peptide 2
D. Somatostatin

Response:
Drug ending with GLUTIDES act as glucagon like peptide 2 (GLP 2) agonist Liraglutide: GLP 1 agonist Teduglutide: GLP 2 Agonist GLP agonist: -| Insulin, | Gastric Emptying Somatotropin is a large polypeptide that is released by the anterior pituitary in response to growth hormone (GH)-releasing hormone produced by the hypothalamus. Secretion of GH is inhibited by another hypothalamic hormone, somatostatin. GH is released in a pulsatile manner, with the highest levels occurring during sleep.

So the answer to this question is C


Instruction:
Which of the following antipsychotic drugs is available as a depot injection ?
A. Fluphenazine
B. Ziprasidone
C. Trifluoperazine
D. Aripiprazole

Response:
None

So the answer to this question is A


Instruction:
Adverse effect of tocolytic agonist in pregnancy:
A. Pulmonary edema
B. Arrythmia
C. 1K+
D. All

Response:
Ans is a, b and c i.e.

So the answer to this question is D


Instruction:
Drug of choice for cheese reaction
A. Amitryptaline
B. Dantrolene sodium
C. Phentolamine
D. Yohimbine

Response:
Cheese reaction occurs when cheese,red wine or beer is consumed along with MAO - A inhibitors as they inhibits metabolism of tyramine present in these items.
Increase tyramine levels can rlevate blood pressure of cause hypertensive crisis which is treated by Phentolamine that blocks alpha1 and alpha2 receptors.

So the answer to this question is C


Instruction:
Below X-ray is seen in:
A. Ulcerative colitis
B. Carcinoma colon
C. Crohn's disease
D. Whipple's disease

Response:
Pipestem colon is seen in ulcerative colitis
String sign of Kantor is seen in Crohn 's disease.

So the answer to this question is A


Instruction:
School Health was first recommended by
A. Bhore committee
B. Chadah committee
C. Jungalwallah committee
D. Srivastava committee

Response:
School Health was first recommended by Bhore committee Bhore committee (1946) : 'Health survey and Development committee' Sho term measure : 1 PHC per 40,000 population, 30 beds, 3 subcenters and 2 medical officers Long term measures (3 million) : Primary health units with 75- bedded hospitals per 10,000- 20,000 population, secondary health units with 650- bedded hospitals , Regional health units with 2,500 beds Prepare 'Social Physicians' ( 3 month training in preventive and social medicine in medical education School Health Comprehensive health care concept : 1. Promotive - primordial level 2. Preventive - Primary level 3. Curative - Secondary level

So the answer to this question is A


Instruction:
Proportional mortality rate is -
A. Number of death due to particular a specific cause
B. Number of death during that year
C. Number of death in one month
D. None

Response:
Ans. is 'a' i.e., Number of death due to particular a cause Proportional mortality rate o Proportional mortality rate measures the proportion of total death due to specific cause or proportion of deaths in a particular age group. o It is defined as "number of deaths due to a particular cause (or in a specific age group) per 100 total deaths o It is the 6simplest measure of estimating the burden of disease' in the community o It is a useful 'health Status indicator indicates the magnitude of preventable mortality o It is used when population data is not available. o It does not indicate the risk of members of population contracting or dying from the disease. Proportional mortality from TB = No. of deaths due to TB in a year ---------------------------- Total no. of deaths in that year x 100 Under-5 proportional mortality rate = No. of deaths under 5 years of age -------------------------------- Total no of death during same period x 100

So the answer to this question is A


Instruction:
The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of:
A. Intracapsular fracture of the femoral neck
B. Extra capsular fracture of the femoral neck
C. Posterior dislocation of hip
D. Anterior dislocation of hip

Response:
C i.e. Posterior dislocation

So the answer to this question is C


Instruction:
Lateral ventricle is connected to third ventricle by
A. Foramen of Monro
B. Foramen of luschka
C. Foramen of magendie
D. Median foramen

Response:
The lateral ventricle communicates with the third ventricle through interventricular foramen MonroThe foramen of luschka is an apeure through which the lateral recess opens into the subarachnoid space of cerebellopontine angleForamen of magendie is an opening in the roof of 4th ventricle through which its cavity communicates with the subarachnoid space of cerebellomedullary cistern.( Reference: Vishram Singh textbook of clinical neuroanatomy 2nd edition pg -137,121)

So the answer to this question is A


Instruction:
The most common type of ovarian tumour is :
A. Dermoid
B. Cystadenoma
C. Fibroma
D. Cystadenocarcinoma

Response:
Cystadenoma

So the answer to this question is B


Instruction:
Most common supratentorial tumour in children is -
A. Craniopharyngioma
B. Astrocytoma
C. Glioma
D. Meningioma

Response:
Ans. is 'a' i.e., Craniopharyngioma Most common supratentorial tumours in children is - Craniopharyngioma.

So the answer to this question is A


Instruction:
IMNCI differs from IMCI in all of the following, Except -
A. Malaria and anemia are included
B. 0-7 days neonates are included
C. Emphasis on management of sick neonates over sick older children
D. Treatment is aimed at one disease at a time

Response:
<p> Sick neonates are preferred over sick older children . Reference:Park&;s textbook of preventive and social medicine,K.Park,21st edition ,of no:414,23rd edition,page no:459. <\p>

So the answer to this question is C


Instruction:
Initial drug of choice in a child with status epilepticus -
A. Lorazepam
B. Phenobarbitone
C. Valproate
D. Phenytoin

Response:
Ans. is 'a' i.e., Lorazepam o Drug used are Lorazepam, Clonazepam, Diazepam, Phenytoin, Phenobarbitone, Thiopentol, Propofol, Midazolam. 0 Lorazepam i.v. is now the preferred initial choice.

So the answer to this question is A


Instruction:
Which vitamin required for hydroxylation of proline?
A. A
B. D
C. C
D. K

Response:
Vitamin-c is required for hydroxylation of proline and lysine They form cross links and maintain stability of collagen Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:229

So the answer to this question is C


Instruction:
Type I hypersensitivity is mediated by which of the following immunoglobulins ?
A. Ig A
B. Ig G
C. Ig M
D. Ig E

Response:
Harshmohan textbook of pathology 7th edition. *type 1 or anaphylactic or atopic reaction mediated by humoral antibodies of IgE type or reagin antibodies in response to antigen.

So the answer to this question is D


Instruction:
The internal pudendal artery supplies which of the following
A. Proximal vagina
B. Distal vaginal walls
C. Posterior vaginal wall
D. Bladder trigone

Response:
Proximal vagina →

Cervical branch of uterine artery
Vaginal artery

Posterior vaginal wall → Middle rectal artery
Distal vaginal wall → Internal pudendal artery.

So the answer to this question is B


Instruction:
A woman complains of right-sided lower abdominal pain and mild bleeding per vagina for one day after a period of amenorrhoea of 6 weeks. Her general condition is satisfactory. There is tenderness in the right iliac fossa. The urine hCG test is positive. Transvaginal ultrasound scan does not reveal an adnexal mass or an intrauterine pregnancy.What is the next step in the management?
A. Commence treatment with methotrexate
B. Perform a laparoscopic examination
C. Perform two serum beta hCG tests 48 hours apart
D. Repeat the ultrasound scan after 7 days

Response:
Ans. is c, i.e. Perform two serum bhCG tests 48 hours apartNow in this question:Patient has Rt sided abdominal pain + tenderness + Amenorrhea of 6 weeks + Bleeding + UPT is positive + TVS is unconfirmatorySo most probably diagnosis is ectopic but D/D can be:(i) Abortion(ii) Early intrauterine pregnancy.

So the answer to this question is C


Instruction:
Atrial myxoma is associated with the following except -
A. Fever
B. Weight loss
C. Systolic murmur at apex
D. Subungual splinter haemorrhage

Response:
None

So the answer to this question is C


Instruction:
Hedstroem file is an instrument used for
A. Canal enlargement
B. Length determination
C. Obturating with gutta percha in McSpadden technique
D. Endodontic implants

Response:
None

So the answer to this question is A


Instruction:
Prophylaxis for anthrax
A. Erythromycin
B. Doxycycline
C. Penicillin
D. Vancomycin

Response:
None

So the answer to this question is B


Instruction:
Which of the following is the commonest organism responsible for angular conjunctivitis?
A. Moraxella lacunata
B. Staphylococcus pyogenes
C. Herpes simplex
D. Haemophilus influenzae

Response:
Angular conjunctivitis is characterised by a mild inflammation confined to the conjunctiva and lid margins near the angle. The commonest causative organism is Moraxella lacunata. Ref: A K Khurana, 2nd Edition, Page 88.

So the answer to this question is A


Instruction:
Cock's peculiar tumour is: September 2007
A. Infected sebaceous cyst
B. Osteomyelitis of skull
C. Cyst in the skull
D. Tumour of the skull

Response:
Ans. A: Infected sebaceous cyst Cock's peculiar tumour is a sebaceous cyst linked growth. One form of sebaceous cyst is the trichilemmal cyst; these are thought to arise from the hair follicle epithelium and are most commonly found on the scalp. Usually they are multiple but occasionally there can be a proliferating trichilemmal cyst which grows to a large size and ulcerates. These can resemble a squamous cell carcinoma (both clinically and histologically) and these ulcerating solitary cysts are called Cock's peculiar tumour.

So the answer to this question is A


Instruction:
HCG is secreted by:
A. Cytotrophoblasts
B. Syncytiotrophoblasts
C. Both
D. Habfaur cells

Response:
Ans. b (Syncytiotrophoblasts). (Ref. Ganong Physiology 21st ed. -453)HUMAN CHORIONIC GONADOTROPIN (hCG)# It is a glycoprotein (molecular wt 36,000 to 40,000 d) with highest carbohydrate (30%) content of any human hormone. It is structurally related to three other glycoprotein hormones--LH, FSH, and TSH.# The 36-hour plasma half-life of intact hCG is much longer than the 2 hours for LH.# Biosynthesis:- Source: Syncytiotrophoblasts of placenta- A single gene located on chromosome 6 encodes the -subunit of all four glycoprotein hormones--hCG, LH, FSH, and TSH.- The secretion of b-hCG roughly corresponds to placental mass, whereas the rate of secretion of the complete hCG molecule is maximal at 8 to 10 weeks' gestation. Plasma cone of beta-hCG, although a minor portion of intact hCG at 10 weeks, can represent 30 to 50 percent during the last trimester.# Concentrations of hCG in Serum and Urine:- The intact hCG molecule is detectable in plasma of pregnant women about 7 to 9 days after the midcycle surge of LH that precedes ovulation. Thus, it is likely that hCG enters maternal blood at the time of blastocyst implantation. Blood levels increase rapidly, doubling every 2 days, with maximal levels being attained at about 8 to 10 weeks' gestation.- Because hCG circulates as multiple highly related isoforms with variable cross-reactivity between commercial assays, there is considerable variation in calculated serum hCG levels among the more than 100 assays. Peak levels reach about 100,000 mlU/mL between the 60th and 80th days after the last menses. Beginning at about 10 to 12 weeks' gestation, maternal plasma levels of hCG begin to decline, and a nadir is reached by about 20 weeks. Plasma levels are maintained at this lower level for the remainder of pregnancy.- The pattern of appearance of hCG in fetal blood is similar to that in the mother, however, fetal plasma levels are only about 3 percent of those in maternal plasma.# Elevated or Depressed hCG Levels in Maternal Plasma or Urine:- Significantly higher plasma levels of hCG are sometimes found in:- Women pregnant with multiple fetuses or with a single erythroblastotic fetus resulting from maternal D-antigen isoimmunization.- Hydatidiform mole or choriocarcinoma.- Women carrying a fetus with Down's syndrome, and this finding can be used in biochemical screening tests# Relatively lower levels of hCG in plasma are found with:- Ectopic pregnancies and impending spontaneous abortion.# Biological Functions of hCG- The best-known biological function of hCG is the so-called rescue and maintenance of function of the corpus luteum--that is, continued progesterone production.- Used to detect pregnancy because it appears in the urine 8 days after successful fertilization (blood and urine tests available).- Elevated hCG in women with hydatidiform moles or choriocarcinoma.- It stimulates fetal testicular testosterone secretion that is maximum at approximately the same time that maximal levels of hCG are attained. hCG enters fetal plasma from the syncytiotrophoblast, acts as an LH surrogate, and stimulates replication of testicular Leydig cells and testosterone synthesis to promote male sexual differentiation.- There is hCG stimulation of the maternal thyroid gland.- Other functions include:* Promotion of relaxin secretion by the corpus luteum.* LH-hCG receptors are found in myometrium and in uterine vascular tissue, and it has been hypothesized that hCG may act to promote uterine vascular vasodilatation and myometrial smooth muscle relaxation.Note: Peak levels reached on 72nd day or 12th week of pregnancy.

So the answer to this question is B


Instruction:
True about National population policy (2000)-
A. Reduce IMR< 20
B. Reduce MMR < 50
C. 100% immunization
D. 100% institutional deliveries

Response:
Ans. is 'c' i.e., 100% immunization National population policy (2000)o Objectives of National Population Policy 2000# Immediate objectives: To meet unmet need of contraception; to strengthen health infrastructure; to strengthen health personnel and to promote integrated service delivery for basic RCH care# Mid term objective: 'To bring the total fertility rate (TFR) to Replacement Level; Le, TFR to 2.1'.# Long term objective: To stabilize population by 2045o National Socio-demographic Goals of NPP 2000 (achieve by 2010)# Address the unmet needs for basic reproductive and child health services, supplies and infrastructure# Make school education up to age 14 free and compulsory, and reduce drop outs at primary and secondary school levels to below 20 percent for both boys and girls# Reduce infant mortality rate to below 30 per 1000 live births'# Reduce maternal mortality ratio to below 100 per 100,000 live births# Achieve universal (100%) immunization of children against all vaccine preventable diseases# Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age# Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons# Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices.# Achieve 100 per cent registration of births, deaths, marriage and pregnancy# Contain the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater integration between the management of reproductive tract infections (RTI) and sexually transmitted infections (STI) and the National AIDS Control Organisation# Prevent and control communicable diseases# Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households# Promote vigorously the small family norm to achieve replacement levels of TFR# Bring about convergence in implementation of related social sector programs so that family welfare becomes a people centred programme

So the answer to this question is C


Instruction:
Scopolamine is used mostly in:
A. Hyperemesis gravidarum
B. Vomiting
C. Constipation
D. Motion sickness

Response:
(Ref: Katzung's Pharma, 14th ed. pg. 135)* Scopolamine (hyoscine) is a prototypic muscarinic receptor antagonist and is one of the best agents for the prevention of motion sickness.* Scopolamine has many effects in the body including decreasing the secretion of fluids, slowing the stomach and intestines, and dilation of the pupils.* Scopolamine is also used to relieve nausea, vomiting, and dizziness associated with motion sickness and recovery 3 from anesthesia and surgery.

So the answer to this question is D


Instruction:
A patient at 22 weeks gestation is diagnosed as having IUD which occurred at 17 weeks but did not have a miscarriage. This patient is at increased risk for:
A. Septic abortion
B. Recurrent abortion
C. Consumptive coagulopathy with hypofibrinogenemia
D. Future infertility

Response:
Ans. is c, i.e Consumptive coagulopathy with hypofibrinogenemiaRef. Dutta Obs. 9/e, p 304, p 304Dead fetus, if retained for more than 4 to 5 weeks, release thromboplastin which leads to DIC (consumptive coagulopathy).In the question, the fetus has been dead and has been retained for five weeks so there are increased chances of DIC.Obstetrical conditions leading to DICa. Septic abortionb. IUDc. Abruptio placentaed. Amniotic fluid embolisme. Severe preeclampsia, eclampsia. HELLP syndrome.

So the answer to this question is C


Instruction:
70 year old male presented with 3-months history of generalised weakness. On examination, bilateral axillary lymphadenopathy was noted. Histopathological examination of enlarged lymph node showed effacement of lymph node architecture by diffuse proliferation of small-sized, mature-appearing lymphoid cells. Peripheral blood showed lymphocytosis with presence of CD5-positive and CD23-positive B-cells. Which of the following is the most likely diagnosis of this patient?
A. Burkitt leukemia
B. Hodgkin lymphoma
C. Chronic lymphocytic leukemia (CLL)
D. Diffuse large B-cell lymphoma (DLBCL)

Response:
Chronic lymphocytic leukemia (CLL) CLL is the most common leukemia of adults in the Western world. Median age at diagnosis is 60 years. In CLL, absolute lymphocyte count is more than 5000/cumm. Lymph nodes are diffusely effaced by predominantly small lymphocytes. When present, proliferation centers are pathognomonic for CLL/SLL. The tumor cells express the pan B-cell markers CD19 and CD20, as well as CD23 and CD5. Burkitt lymphoma/leukemia - Adolescents or young adults with extranodal masses; uncommonly presents as "leukemia"; aggressive DLBCL - relatively large cell size (usually four to five times the diameter of a small lymphocyte) and a diffuse pattern of growth. CD5 and CD23 negative. Hodgkin lymphoma - arises in a single node or chain of nodes and spreads first to anatomically contiguous lymphoid tissues. Morphologically, the distinctive feature of Hodgkin lymphoma is the presence of neoplastic giant cells called Reed-Sternberg cells.

So the answer to this question is C


Instruction:
Mallory Hyaline is characteristically seen with -
A. Yellow fever
B. Hepatitis B infection
C. Alcoholic hepatitis
D. Primary sclerosing cholangitis

Response:
None

So the answer to this question is C