Instruction:
Satellite nodule on a corneal ulcer is seen in
A. Fungal infection
B. Bacterial infection
C. Viral infection
D. Mycoplasma infection

Response:
A i.e. Fungal infection Feature Found in Satellite lesion Fungal keratitis (corneal ulcer) C e.g. Aspergillus, Candida Sympathetic opthalmitis Q Dalen fuch's nodule, B/L granulomatous uveitis Dendritic & Geographic ulcer Herpes simplex Q Snow ball opacity in vitreous Pars planitis (intermediate uveitis), sarcoid Q, amyloid, candidiasis, lyme disease Fleischer ring, Munson's sign, Vogt lines, Oil droplet reflex Keratoconus Q Invasion of normal corneal epithelium N. gonorrhoea & Corynebacterium diptheria Q Horner Trantas dots, Cobble stone (pavement stone) papillary hyperophy, no follicles, shield ulcer, Maxwell lyon sign (sting or ropy discharge) Spring catarrh Herbe's pit, Arlt's line, papillary hyperplasia, follicles, pannus, SAFE treatment strategy Trachoma Habb's striae, lens anteroposteriorly flattened & displaced Q Bupthalmos

So the answer to this question is A


Instruction:
The surgical treatment of uterine polyp includes
A. Removal by twisting
B. Removal by morcellation
C. Hysteroscopy
D. All of the above

Response:
Uterine polyps are benign polyps comprising endometrial,fibroid ,adenomyomatous and placental polyps. Cervical polyps are mucous and fibroadenomatous polyp arise from the endocervix. Clinical features Menorrhagia or Metrorrhagia or postmenopausal bleeding If it protudes through the os ,it causes postcoital bleeding. MANAGEMENT D&C can scrape the polyp. Hysteroscopic removal of multiple polyps. REference: Textbook of Shaw, 15th edition, page 351

So the answer to this question is D


Instruction:
Soft tissue curettage is indicated in:
A. Periodontal pockets
B. Edematous gingival pockets
C. Fibrous gingival pockets
D. Supragingival calculus deposits

Response:
None

So the answer to this question is B


Instruction:
Which hormone is converted into active form in liver-
A. Corticosteroid
B. ACTH
C. Thyroid hormone
D. Estradiol

Response:
Ans. is 'c' i.e., Thyroid hormoneo Thyroxine (T4) is converted to T3 (active form) in liver (majority) and kidney

So the answer to this question is C


Instruction:
Which of the following is a poor prognostic factor for childhood ALL.
A. Total Leukocyte count 4000-100,000
B. Age < 2 years
C. Testicular involvement
D. Blasts in peripheral smear

Response:
Answer is C (Testicular involvement) Testicular involvement / enlargement is a typical poor prognostic factor for childhood ALL Age < 2 years versus Testicular Involvement Typically Age < 1 year is considered a poor prognostic factor Although Age < 2 year has been mentioned as a poor prognostic factor in ceain textbooks including Hoffman's Hematology (4th/1158) most textbooks use the criteria of Age < 1 year to define a poor prognostic factor Since testicular involvement provided amongst the option is an established poor prognostic factor, this is selected as the single best answer of choice.

So the answer to this question is C


Instruction:
In WHO 'Road to health card' (growth chart) the upper reference line represents:
A. 80th percentile for boys
B. 50th percentile for girls
C. 80th percentile for girls
D. 50th percentile for boys

Response:
Ans. D. 50th percentile for boys. (Ref. Park's Textbook of PSM 22nd/pg. 506)Discussion:WHO growth chart# WHO growth chart is having 2 reference curves.# The upper reference curve represent the median (50th percentile) for boys and the lower reference curve the 3rd percentile for girls.# The space between the two growth curves is called as road to health. This will include the zone of normality.# The Indian growth chart is having 4 reference curves.# The topmost curve corresponds to 80 % of the median of the WHO reference standard.# The lower lines represent 70 %, 60 %, 50 % of that standard.

So the answer to this question is D


Instruction:
Not seen in children
A. Neuroblastoma
B. Retinoblastoma
C. Hepatoblastoma
D. Seminoma

Response:
Answer- D. SeminomaChildhood malignancies areLeukemia (AML' ALL)Brain tumorsSoft tissue sarcoma - RhabdomyosarcomaLymphomaNeuroblastomaWilm's tumorBone tumorRetinoblastomaHepatoblastoma

So the answer to this question is D


Instruction:
5-FU is the chemotherapeutic agent of choice for all except -
A. Ca Breast
B. Ca Stomach
C. Ca Pancreas
D. Ca Colon

Response:
Ans. is 'c' i.e., Ca pancreas

So the answer to this question is C


Instruction:
The hypersensitivity reaction involved in the hyper acute rejection of renal transplant is -
A. Type I
B. Type II
C. Type III
D. Type IV

Response:
Type II hypersensitivity reaction is initiated by IgG or rarely IgM antibodies that react either with cell surface or tissue antigen. Cell or tissue damage occurs in the presence of complement or mononuclear cells. Hyperacute rejection reaction against an organ transplant is example of type II hypersensitivity reaction in which cytotoxic antibodies are formed against donor antigen. Reference : Harsh mohan text book of pathology, 7th edition, pg no: 60 <\p>

So the answer to this question is B


Instruction:
Anti-inflammatory dose of aspirin ?
A. 500 mg/d
B. 1 - 2 g/d
C. 3 - 6 g/d
D. 6 - 12 g/d

Response:
Ans. is 'c' i.e., 3 - 6 g/d The anti-inflammatory action of aspirin is exeed at high doses of 3 - 6 g/ day or 100 mg/ Kg/ day. The anti-inflammatory action is mainly due to inhibition of COX, causing inhibition of PGs synthesis. In addition to COX inhibition, quenching of free radicals may contribute to its anti-inflammatory action.

So the answer to this question is C


Instruction:
Type of collagen found in basement membrane -
A. I
B. II
C. III
D. IV

Response:
Ans. is 'd' i.e., IV o Type IV collagen with laminin are the major constituent of basement membrane.Type of collagenDistributionType ISkin, tendon, bone, corneaType IIArticular cartilage, intervertebral disc. Vitreous humorType IIIFetal skin, cardiovascular systam, lung, reticular fiberType IVBasement membraneType VPlacenta, skin.

So the answer to this question is D


Instruction:
Factor V mutation is commonly associated with:-
A. Hemahrosis
B. Hematemesis
C. Thrombosis
D. Epistaxis

Response:
Factor V mutation also called as leiden's mutation Leiden's mutation is characterized by substitution of amino acid at the position 506 Arginine at this position is replaced by glutamine Protein C and S inhibit the activity of Factor V and VIII In Factor V mutation, Factor V gets resistant to the action of protein C and S, then Factor V won't get inhibited, which is responsible for causing higher risk of development of thrombosis Inheritable causes of hypercoagulability Factor V mutation (commonest) Mutation in the activity of homocysteine Mutation in the activity of prothrombin gene

So the answer to this question is C


Instruction:
Best method of induction of labour in hydramnios:
A. High rupture of the membranes
B. Low rupture of the membranes
C. Abdominal amniocentesis followed by stabilising oxytocin drip
D. Prostaglandins

Response:
Ans. is c, i.e. Abdominal amniocentesis followed by stabilising oxytocin dripRef Dutta Obs 7/e, p 215Artificial rupture of membranes is C/l in polyhydramnios as it leads to sudden decompression of uterus which can cause abruptio placenta.Method of induction in these patients is:Amniocentesis - drainage of good amount of liquor - to check the favorable lie and presentation of the fetus - a stabilizing oxytocin infusion is started low - rupture of the membranes is done when the lie becomes stable and the presenting part gets fixed to the pelvis. This will minimize sudden decompression with separation of the placenta, change in lie of the fetus and cord prolapse.

So the answer to this question is C


Instruction:
All of the following are true statements with respect to angle closure glaucoma except :
A. Doesn't cause ocular pain at evening-night
B. Vogt's triad is indicative of acute active attack of angle closure glaucoma
C. Bullous keratopathy and shallow anterior chamber may be seen
D. I.v Mannitol is Drug of Choice for angle closure glaucoma

Response:
Vogt's triad is associated with angle closure glaucoma. characterised by : iris atrophy peripheral anterior synechiae glaucomaflecken. Vogt's triad is indicative of past attack. Typically pain due to angle closure is severe and does not allow patient to sleep. Episodes of angle closure glaucoma tend to occur in dim background illumination due to a mid-dilated pupil which increases the chances of an irido-lenticular touch and hence block in circulation of the aqueous from the posterior chamber to the anterior chamber. Shallow Anterior Chamber is the hallmark of Angle Closure Glaucoma Bullous keratopathy occurs in long standing angle closure glaucoma in end stage IV Mannitol is used to reduce the IOP by shrinking volume of vitreous, allowing lens to move backwards and allowing for break in the irido-lenticular contact that precipitates the angle closure attack

So the answer to this question is B


Instruction:
Vertebra plana is seen in – a) Eosinophilic granulomab)  Traumac) Paget's diseased) Malignancy
A. acd
B. abd
C. abc
D. ab

Response:
None

So the answer to this question is B


Instruction:
Status epilepticus is managed best with the use of which of the following drugs?
A. Intravenous diazepam
B. Intravenous phenytoin sodium
C. Intramuscular phenobarbitone
D. Rectal diazepam

Response:
(Ref: KDT 6/e p413) Benzodiazepines like diazepam and lorazepam are fast acting anti-seizure drugs and can be used to abo the seizures in status epilepticus. Lorazepam is the drug of choice for status epilepticus.

So the answer to this question is A


Instruction:
Anti-D prophylaxis should be given in all of the following conditions except:
A. Medical abortion for 63 days pregnancy
B. Amniocentesis at 16 weeks
C. Intrauterine transfusion at 28 weeks
D. Manual removal of Placenta

Response:
Ans. is c, i.e. Intrauterine transfusion at 28 weeksRef. Dutta Obs. 7/e, p 344; Sheila Balakrishnan, p 369Rh anti D immunoglobulin (IgG) is given to unimmunized Rh negative mothers with Rh positive fetus to prevent active immunization and formation of antibodies against fetal RBC's. The Anti D binds to antigen sites on the fetal red cells so that these cells do not mount an immune response, provided the baby is Rh negative and direct coombs test done on baby is negative. If mother's IUT is positive or fetus has positive direct coombs test, it means mother is already immunized. In such cases there is no point in giving anti D.Indications for Anti D immunoprophylaxis:First trimesterLater pregnancyMiscarriageEctopic (medically or surgically managed)Hydatidiform moleThreatened abortionMedical or surgical MTPChorionic villus samplingMiscarriageAmniocentesisFetal blood samplingAntepartum hemorrhageExternal cephalic versionRoutine antepartum prophylaxisDeliveryIntrauterine fetal deathManual removal of placentaNote: As far as intrauterine fetal transfusion is concerned. It is done as a therapy in case Rh isoimmunization has occurred prior to 34 weeks so, administration of anti-D at this stage will not help.Dose:Ideally amount of Anti D should be calculated according to the volume of fetomaternal bleed by doing a Kleihauer test.Generally:-Gestational age <12 weeks - dose is 50 mg-Beyond 12 weeks - dose is 300 mcgAntepartum prophylaxis: At 28 weeks gestation in a Rh negative patient: Indirect coombs test is done and if antibodies are not detected i.e. patient is unimmunised, Anti D 300 mg is given as antepartum prophylaxis.300 mg of Anti D will neutralize about 15 mL of fetal RBC.

So the answer to this question is C


Instruction:
Topical mitomycin C is used to aid the following treatment
A. Endoscopic treatment of angiofibroma
B. Treatment of laryngotracheal stenosis
C. Skull base osteomyelitis
D. Sturge weber syndrome

Response:
Mitomycin-C is an antineoplastic antibiotic that acts as an alkylating agent by inhibiting DNA and protein synthesis. ... Topical application of mitomycin C (0.4 mg/mL) was used as an adjuvant treatment in the endoscopic laser management of laryngeal and tracheal stenosis Ref: Internet sources.

So the answer to this question is B


Instruction:
The optic cup is an evagination of which of the following?
A. Telencephalon
B. Diencephalon
C. Mesencephalon
D. Metencephalon

Response:
The optic cup and its derivatives--the retina and optic nerve--develop from the diencephalon.

So the answer to this question is B


Instruction:
Schamberg's purpura are seen on
A. Face
B. Feet
C. chest
D. Arms

Response:
Schamberg purpura is the result of leakage of blood from small capillaries in the superficial papillary dermis. The resultant purpura is nonblanching but is not palpable. No pronounced damage occurs to the blood vessel walls, differentiating this condition from vasculitis Ref Harrison20th edition pg 1456

So the answer to this question is B


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

Response:
Aminotransferases (transaminases) catalyze the general reaction shown above. The most common compounds involved as a donor/acceptor pairs in transamination reactions are glutamate and 2-oxoglutarate (a-ketoglutarate). Alanine transaminase has an impoant function in the delivery of skeletal muscle carbon and nitrogen (in the form of alanine) to the liver. In skeletal muscle, pyruvate is transaminated to alanine, thus affording an additional route of nitrogen transpo from muscle to liver. In the liver, alanine transaminase transfers the ammonia to 2-oxoglutarate and regenerates pyruvate. The pyruvate can then be diveed into glucon Ref: <a href="

So the answer to this question is B


Instruction:
Occipital myotome gives -
A. Muscle of mastication
B. Tongue muscles
C. Facial muscles
D. Laryngeal muscles

Response:
Ans. is 'b' i.e., Tongue muscles Development of muscels of head regiono Muscles of the head region are derived from following mesodermal masses.Head myotoniesPharyngeal archesHead mvotomeso There are four occipital myotomeso One of these, the first completely disappears and the other three give rise to -1. Tongue muscles arise from hypoaxial division of these three occipital myotomes.2. Extraoculor muscles are thought to be derived from three pairs of anterior (pre-otic) head myotomes .pharyngeal arch muscleso The muscles derived from pharyngeal arch mesoderm are -1. Muscles of mastication2 Muscles of facial expression3. Muscles of pharynx4. Muscles of larynx

So the answer to this question is B


Instruction:
Egg - Shell calcification of lymphnodes is suggestive of
A. Asbestosis
B. Berylliosis
C. Stannosis
D. Coal worker pneumoconiosis

Response:
Silicosis & Coalworker Pneumoconiosis are important cause.

So the answer to this question is D


Instruction:
The given below instrument used in:
A. Cesarean section
B. Vaginal hysterectomy
C. Fothergill surgery
D. Suction evacuation

Response:
Ans. (A) Cesarean section(Ref: DC Dutta's Text book of Obstertics 8th Ed; Page No 751)The given image is Doyen's Retractor.Material: Stainless steelSterilization: AutoclavingUses:#ObstetricCesarean sectionCesarean hysterectomyf Exploratory laparotomy for ruptured tubal ectopic pregnancy#GynecologicAbdominal hysterectomyWertheim's hysterectomyTuboplastySling operationPurandare's cervicopexyExploratory laparotomy for ovarian tumorsMyomectomy

So the answer to this question is A


Instruction:
A person working in hot environment who consumes more water without salt is likely to develop a condition called -
A. Heat stroke
B. Heat exhaustion
C. Heat cramps
D. Heat hyperpyrexia

Response:
Heat cramp occurs in persons who are doing heavy muscular work in high temperature and humidity. The cause of heat cramps is the loss of sodium and chloride in the blood. Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 808

So the answer to this question is C


Instruction:
Titin is absent in
A. Skeletal muscle
B. Smooth muscle
C. Cardiac muscle
D. All

Response:
Titin induces elasticity and is absent in smooth muscle Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:86,87

So the answer to this question is B


Instruction:
NO is secreted by
A. Endothelium
B. Endoderm
C. Ectoderm
D. Bones

Response:
Nitric oxide, known as an endothelium-derived relaxing factor (EDRF), is biosynthesized endogenously from L-arginine, oxygen, and NADPH by various nitric oxide synthase (NOS) enzymes. Reduction of inorganic nitrate may also serve to make nitric oxide. The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, thus resulting in vasodilation and increasing blood flow. Nitric oxide is highly reactive (having a lifetime of a few seconds), yet diffuses freely across membranes. These attributes make nitric oxide ideal for a transient paracrine (between adjacent cells) and autocrine (within a single cell) signaling molecule.(Ref: Ganong&;s review of medical physiology 23rd edition Page no: 405)

So the answer to this question is A


Instruction:
Hypoglycemic unawareness that occurs in diabetic patients when transfered from oral hypoglycemics to insulin, is due to-
A. Autonomic neuropathy
B. Insulin resistance
C. Lipodystrophy
D. Somogi phenomenon

Response:
Hypoglycemia unawareness-- loss of the warning adrenergic and cholinergic symptoms that previously allowed the patient to recognize developing hypoglycemia and therefore to abo the episode by ingesting carbohydrates. Autonomic neuropathy may reduce counter-regulatory hormone release (especially catecholamines), leading to an inability to sense hypoglycemia appropriately (hypoglycemia unawareness, thereby subjecting the patient to the risk of severe hypoglycemia and complicating effos to improve glycemic control. Reference : page 2426 Harrison's Principles of Internal Medicine 19th edition

So the answer to this question is A


Instruction:
The most common cause of cerebrospinal otorrhoea is-
A. Rupture of tympanic membrance
B. Fracture of petrous ridge
C. Fracture of mastoid air cells
D. Fracture of parietal bone

Response:
None

So the answer to this question is B


Instruction:
Air travel in pregnancy is not recommended after What gestational age
A. 12 Weeks
B. 22 Weeks
C. 30 Weeks
D. 36 Weeks

Response:
According to ACOG guidelines, pregnant women can safely fly upto 36 weeks gestation.

So the answer to this question is D


Instruction:
Which terminal plane is favorable for E/E to have class I molar relationship?
A. Flush terminal plane
B. Mesial step
C. Distal step
D. None of the above

Response:
None

So the answer to this question is B


Instruction:
Refractive index of the cornea is
A. 1.37
B. 1.33
C. 1.42
D. 1.45

Response:
The corneal refractive index is 1.376 The index of refraction of the cornea is about 1.376. Rays pass from the cornea into the watery fluid known as the aqueous humor which has an index of refraction of about 1.336, so most of the refraction is at the cornea-air interface. Reference: khurana 6th edition pg 396

So the answer to this question is A


Instruction:
A 30 years old male presented with silvery scales on elbow and knee, that bleed on removal. The probable diagnosis is –
A. Pityriasis
B. Seborrhoeic dermatitis
C. Psoriasis
D. Secondary syphilis

Response:
Morphology of papules/plaques in various papulosquamotas disorders

Psoriasis - Erythematous papules and plaques on extensors (elbow & knee
Lichen planus - Violaceous papules with Wickham's striae an flexural surface
Pityriasis rosea - Annular plaques on Trunk
Seborrheic dermatitis - Yellowish, follicular papules on scalp and face
Pityriasis rubra pilaris - Erythematous follicular papules on Trunk & dorsum of hand
Secondary syphilis - Dusky erythematous papules
Pityriasis lichenoides et varioliformis acuta - Erythematous edematous papules surmounted by vesicles/crust

Coming to question
Clues in this question are :-

Characterstic scales → silver scale
Involvement of elbow & knee
Bleeding on scale removal → Auspitz sign

So the answer to this question is C


Instruction:
A child presented with fever for 2 days, altered sensorium and purpuric rashes. His blood pressure is 90/60 mmHg. Treatment of choice is>
A. IV Quinine
B. IV Artesunate
C. IV Penicillin
D. Chloroquine

Response:
Ans. is 'c' i.e. Penicillin .The clinical presentation of fever, altered sensorium and purpuric rashes, is highly suggestive of meningococcal meningitis.Purpuric rash in quite characteristic of meningococcemia.I. V. Penicillin is the treatment of choice for meningoccal inf. among the given options.The DOC for meningococcal infection is -IIIrd generation cephalosporin e.g. Cefotaxime, Ceftriaxone.Also RememberWaterhouse Friderichsen syndromeSeen in fulminant meningococcemiaadrenal insufficiency occurs* due Haemorrhage and necrosis in the adrenal glandsClinical presentation isprostrationhypotensionshock andUltimately coma and death.

So the answer to this question is C


Instruction:
Amphotericin B causes deficiency of ?
A. Sodium
B. Calcium
C. Potassium
D. Chloride

Response:
None

So the answer to this question is C


Instruction:
In a town with population of 100,000, the number of slides examined is 5000. Out of these, 100 slides were positive for malaria. The API is?
A. 2
B. 5
C. 1
D. 0.5

Response:
ANSWER: (C) 1REF: Park 20th edition page 227API= (confirmed cases/population) x 1000: it is a measure of malaria incidence.= 100/100000 x 1000 = 1ABER= (slides examined/population) x 100: It is a measure of operational efficiency. ABER for this case=5

So the answer to this question is C


Instruction:
Conversion of angiotensin-I to angiotensin-II occurs in ?
A. Kidney
B. Lung
C. Liver
D. RBCs

Response:
Ans. is 'b' i.e., Lung Angiotensinogen (a2 - globulin) is produced in liver and is conveed to angiotensin I (A-I) with the help of renin which is secreted by juxtaglomerular cells of afferent aerioles of kidney and lacis cells (located in the junction between the afferent and efferent aerioles). Angiotensin 1 is conveed to Angiotensin II (A-II) by angiotensin conveing enzyme (ACE). Which is located primarily on the luminal surface of vascular endothelial cells, especially in lungs. Most of actions of this system are due to angiotensin II. Angiotensin II has a very sho tY2 (1 minute), it is degraded into angiotensin-III by aminopeptidase. Angiotensin-III is fuher acted upon by angiotensinases to inactive fragments.

So the answer to this question is B


Instruction:
Irresistible desire to buy something is
A. Mutilomania
B. Dipsomania
C. Oniomania
D. Trichotilomania

Response:
Oniomania Irresistible desire to buy things (shopping addiction) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 360

So the answer to this question is C


Instruction:
Mother of a 10 year old male child is concerned that he appears smaller than other boys of his age. Intraoral examination reveals that the patient is in his mixed dentition stage. Permanent incisors and 1st molars are found to be present. Mandibular permanent canines are erupting and maxillary deciduous molars are present. Physical growth status of a child may vary from the chronologic age in many children, but it correlates well with skeletal age. Which is the best radiographic analysis to ascertain the skeletal age of this patient?
A. Witt’s analysis
B. Demirjian’s system
C. Steiner’s analysis
D. Fishman’s index

Response:
FISH MAN'S SKELETAL MATURITY INDICATORS
Keonord S Fishman proposed a system for evaluation for skeletal maturation in 1982, Fishman made use of four anatomical sites located on the thumb, third finger, fifth finger and radius.
Note:

Witt’s and Steiner’s analysis are cephalometric analysis and not a method to analyze skeletal age.
Demirjian’s system is a method of analysing dental age and not skeletal age.

So the answer to this question is D


Instruction:
Condyloma accuminatum is produced by which type of papillomavirus?
A. KPV6, 16
B. HPV6.11
C. HPV 16, 18
D. HPV11.I8

Response:
Ans: B (HPV 6. 11) Ref: Rook's dermatology, 8th ed Internet sourcesExplanation:HPV associated conditionHPV typesCommon warts2, 7Plantar warts1,2, 4. 63Flat warts3, 10. 8Anogenital warts (Condyloma accuminatum)6, 11,42, 44Anal lesions6, 16. 18, 31, 53, 58Genital cancers16, 18, 31, 45Focal epithelial hyperplasia (oral)13, 32Oral papillomas6. 7, 11, 16, 32Oropharyngeal cancer16Verrucous cyst60Laryngeal papillomatosis6,11

So the answer to this question is B


Instruction:
Treatment of choice for OCD is:
A. Behavior therapy
B. Drug therapy
C. Psychosurgery
D. Combination of behavior and drug therapy

Response:
A combination of pharmacotherapy and psychotherapy has the best evidence in the management of OCD.

So the answer to this question is D


Instruction:
A young male Kallu is brought to the hospital with severe asthma. The pharmacokinetics of theophylline include the following parameters: Vd = 35 L; CL = 48 ml/min; half life is 8 hrs. If an intravenous infusion of theophylline is started at a rate of 0.48 mg/min, how long will it take to reach 93.75% of the final steady state ?
A. Approximately 48 min
B. Approximately 5.8 hrs
C. Approximately 8 hrs
D. Approximately 32 hrs

Response:
None

So the answer to this question is D


Instruction:
Median rhomboid glossitis is seen in?
A. Candidiasis
B. AIDS
C. Chronic kidney disease
D. Mouth breathers

Response:
Median Rhomboid glossitis - - characterised by presence of redness and area of loss of lingual papilla on dorsum of tongue - usually seen among smokers and pt.'s using inhaled steroids - it is characterised by chronic atrophic oral Candidiasis

So the answer to this question is A


Instruction:
A 45-year-old woman undergoes cardiac catheterization through a right femoral approach. Two months later, she complains of right lower extremity swelling and notes the appearance of multiple varicosities. On examination, a bruit is heard over the right groin. What is the most likely diagnosis?
A. Femoral artery thrombosis
B. Superficial venous insufficiency
C. Arteriovenous (AV) fistula
D. Pseudoaneurysm

Response:
A traumatic AV fistula results from a penetrating injury to adjacent artery and vein, permitting blood flow from the injured artery into the vein. The iatrogenic injury in this case occurred during cardiac catheterization. Femoral artery thrombosis results in signs of limb ischemia. A bruit is usually not heard with venous insufficiency. Traumatic pseudoaneurysm presents as an enlarging pulsating mass. Once the diagnosis of AV fistula is made, an angiogram is performed, and surgical repair (division of the fistula and reconstruction of the artery and preferably of the injured vein as well) is carried out.

So the answer to this question is C


Instruction:
Drug of choice in simple paial seizure is -
A. Phenytoin
B. Valproic acid
C. Carbemazepine
D. Phenobarbitone

Response:
Ans. is 'c' i.e., Carbemazepine o DOC for generalized tonic clonic seizure (Grand mal), absence seizure (petit mal), Atonic seizure, myoclonic epilepsy valproate. o DOC for paial seizure carbamazepine / oxcarbazepine o DOC for status epilepticus IV lorazepam o DOC for febrile seizures Rectal Diazepam o DOC for seizure of eclampsia --> Magnesium sulfate. o DOC for infantile spasm Vigabatrin. o DOC .for myoclonic epilepsy Valproic acid.

So the answer to this question is C


Instruction:
1)Paul bunnel tests A.Rickettsial Diseases 2)Weil felix reaction B. Infectious mononucleosis 3)Tzank test C. Herpes virus 4)Sabin Feldman dye D. Toxoplasmosis
A. 1-b,2-a, 3-c, 4-d
B. 1-b, 2-c, 3- d, 4-a
C. 1-c, 2-d, 3-a, 4-b
D. 1-d, 2-A 3- b, 4-a

Response:
1Paul bunnel tests A. Infectious mononucleosis 2)Weil felix reaction B. Rickettsial Diseases 3)Tzank test C. Herpes virus 4)Sabin Feldman dye D. Toxoplasmosis Other test VDRL and RPR: Treponema pallidum Microscopic agglutination test: Leptospirosis Standard agglutination test: Brucella Elk's gel precipitation test: Corneybacterium diphtheria Widal test: typhoid Sabin fieldman dye test: Toxoplasmosis

So the answer to this question is A


Instruction:
Jitteriness can be distinguished from seizures by all of the following except -
A. Senstivity to stimulus
B. Frequency of movement
C. Abnormality of Gaze
D. Autonomic disturbance

Response:
Ans. is 'b' i.e., Frequency of Movement Jitteriness Jitteriness is stimulus sensitive (means, Jitteriness can be initiated by physical stimulation) Jitteriness can be abolished by passive restraint e.g. Flexion of the limb Not associated with autonomic changes or occular phenomena Jitteriness may have same frequency of movements as that of seizures but in jitteriness the rate of movements is identical in either direction Seizure Seizures are rarely stimulus sensitive Can not be abolished by passive restraint Epileptic seizures are often associated with autonomic changes and occular phenomena Clonic fits shows rapid alteration of fast and slow phase of movements

So the answer to this question is B


Instruction:
Thayer-Main medium is used for culture of
A. Mycobacteria
B. Neisseria
C. Moraxella
D. Salmonella

Response:
Blood agar, Chocolate agar, and Mueller-Hinton starch casein hydrolysate agar are the media commonly used for culturing meningococci.Modified Thayer-Main (with vancomycin, Colistin, and Nystatin) is a useful selective medium.Ref: Ananthanarayan; 7th edition; Page no: 223

So the answer to this question is B


Instruction:
Which of the following statements about High-Density Lipoprotein (HDL) is false?
A. HDL increases oxidation of LDL
B. HDL reduces foam cell production by LDL
C. HDL is the best predictor of CAD
D. HDL helps to clear lipids from atheromas

Response:
HIGH-DENSITY LIPOPROTEIN (HDL)High-density lipoproteins transpo cholesterol from peripheral tissues to the liver. The major apoproteins in HDL are Apo-A1, with some Apo-A2, Apo-C and Apo-E. HDL serves as a plasma reservoir of Apo-C and Apo-E which can be transferred to VLDL and chylomicrons and backClinical Significance of HDL The level of HDL in serum is inversely related to the incidence of myocardial infarction. As it is "antiatherogenic" or "protective" in nature, HDL is known as "good cholesterol" in common parlance (Fig. 12.14). It is convenient to remember that "H" in HDL stands for "Healthy". HDL level below 35 mg/dl increases the risk, while level above 60 mg/dl protects the person from coronary aery diseases.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 155-157

So the answer to this question is A


Instruction:
True about Trichobazoers Except
A. It is caused by Trichuris
B. It is a psychlatric manifestation
C. Balls of hairs in the stomach
D. Pulling the hair & sucking of hair is usually seen

Response:
It is a hairball commonly seen in the stomach of females with psychiatric illness who swallow hair regularly. Reference SRB 5th edition page no:840.

So the answer to this question is A


Instruction:
Baroreceptor stimulation produces
A. Decreased hea rate & BP
B. Increased hea rate & BP
C. Increased cardiac contractility
D. Decreased cardiac contractility

Response:
Baroreceptor reflex stimulates the vagus nerves causes release of acetylcholine at the vagal endings in the hea, thus giving a parasympathetic effect.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page:155

So the answer to this question is A


Instruction:
Pulsus bisiferiens is best felt in-
A. Carotid aery
B. Radial aery
C. Brachial aery
D. Femoral

Response:
pulses bisferians is best felt in radial aery and the character is best assesed in carotid aery. Ref Harrison 20th edition pg 1534

So the answer to this question is B


Instruction:
As compared to unfractionated heparin, low molecular weight heparin -
A. Are absorbed more uniformly when given subcutaneously
B. Require more frequent lab monitoring
C. Can be given to patients with heparin induced thrombocytopenia
D. A higher risk of osteopenia

Response:
Ans. is 'a' i.e., Are absorbed more uniformly when given subcutaneously o Unfractionated heparin binds to several plasma proteins, therefore it has less predictable dose-response profile when administered sc or iv. o On the other hand, LMW heparins are less protein bound and have a predictable dose response profile when administered sc or iv. About other options o Since aPTT/clotting time are not prolonged (much) with LMW heparins, laboratory monitoring is not needed. o LMW heparins are unsuitable for HIT as antibody may be cross-reactive. Agent of choice in HIT are direct thrombin inhibitors like hirudin, lepirudin, bivalirudin. o Osteoporosis (osteopenia) occurs as a dose related side effect of unfractionated heparin. The relative risk with LMW heparin is not yet estabilished.

So the answer to this question is A


Instruction:
The following drugs can produce ototoxicity except:
A. Ethacrynic acid
B. Aztreonam
C. Gentamicin
D. Frusemide

Response:
ESSENTIALS of medical PHARMOCOLOGY SEVENTH EDITION K. D TRaiPATHI Page:730 MONOBACTAMS Aztreonam It is a novel b-lactam antibiotic in which the other ring is missing (hence mono- bactam). It inhibits gram-negative enteric bacilli and H. influenzae at very low concentrations and Pseudomonas at moderate concentrations, but does not inhibit gram-positive cocci or faecal anaerobes. Thus, it is a b-lactam antibiotic with a spectrum resembling aminoglycosides. It is resistant to gram-negative b lactamases. The main indications of aztreonam are hospital- acquired infections originating from urinary, biliary, gastrointestinal and female genital tracts. Lack of cross sensitivity with other blactam antibiotics except possibly ceftazidime is the most prominent feature of aztreonam: permiting its use in patients allergic to penicillins or cephalo- sporins. Rashes and rise in serum aminotrans- ferases are the notable adverse effects. It is eliminated in urine with a tlfz of 1.8 hr. Dose: 0.5-2 g i.m. or i.v. 6-12 hourly. AZENAM, TREZAM 0.5, 1 .0, 2.0 g/l inj .

So the answer to this question is B


Instruction:
ALVARADO score 2 defines:
A. Temperature
B. Leukocytosis
C. Tenderness in left iliac fossa
D. Migratory pain

Response:
Leucocytosis has a score of 2 Alvarado Score Aka MANTRELS Score- Used for Appendicitis Manifestation Score Symptoms Migratory RIF pain Anorexia Nausea and vomiting 1 1 1 Signs Tenderness (RIF) Rebound tenderness Elevated temperature 2 1 1 Laboratory Leucocytosis Shift to left 2 1 Total 10 - Score of 9-10 - Ceain diagnosis - Score of 7-8 -High likelihood of diagnosis - Score of 5-6 - Equivocal (most dangerous) - Score of 1-4 - Negative for acute appendicitis - CECT is indicated in cases of Equivocal MANTREL score findings to confirm diagnosis

So the answer to this question is B


Instruction:
Which is not a feature of Gerstmann syndrome?
A. Agraphia
B. Acalculia
C. Chorea
D. Finger agnosia

Response:
Gerstmann Syndrome: lesion of dominant Parital lobe due to occlusion of MCA. Features: 1. Acalculia 2. Agraphia 3. Finger agnosia 4. R and L disorientation

So the answer to this question is C


Instruction:
Virchow’s triad includes all except
A. Injury to vein
B. Venous thrombosis
C. Venous stasis
D. Hypercoagulability of blood

Response:
The factors that predispose to venous thrombosis were initially described by Virchow in 1856 and are known as Virchow’s triad.
These include

Stasis
Vascular damage
Hypercoagulability

So the answer to this question is B


Instruction:
Treatment of choice in Hodgkin's Lymphoma is:
A. CHOP
B. MOPP
C. ABVD
D. MOPP and ABVD hybrid

Response:
Answer is C (ABVD) ABVD is the chemotherapy regimen of choice in Hodgkins lymphoma 'Chemotherapy with ABVD is considered the standard first line treatment for most patients and is superior to MOPP in efficacy and toxicity profile '- Manual of Clinical Oncology 6'"/443 Regimen Agents Comments ABVD Doxorubicin Bleomycin Vinblastine Dacarbazine * First line treatment of choice * Most popular regimen in United States * More effective than MOPP * Lesser incidence of Sterility and secondary malignancies than MOPP * More satisfactory than MOPP and ABVD in alternating cycles or MOPP/ABV Hybrid MOPP Mechlorethamine Vincristine Procarbozine Prednisolone * Less effective and more toxic than ABVD * Higher incidence of sterility and secondary malignancies than ABVD

So the answer to this question is C


Instruction:
The management of eclampsia includes all except:
A. Control of convu1sion
B. Prolongation of pregnancy
C. Control of BP
D. Delivery of fetus

Response:
Ans: B (Prolongation of pregnancy) Ref: DC Dutta's Textbook of Obstetrics, 7th edn, p232Explanation:EclampsiaConvulsions/coma occurring in a women with preeclampsiaAnte partum eclampsia - Most common type of eclampsia (50%)Postpartum eclampsia - occurs within 48 hours after deliveryIntercurrent eclampsia - pregnancy continues beyond 48 hours after recoveryPRINCIPLES OF MANAGEMENT IN ECLAMPSIAMaintain airway, breathing and circulationOxygen administrationPrevention of injuryArrest of convulsionsControl BPDeliver by 6-8 hoursPrevention of complicationsVentilatory support (if required)Postpartum careDrug of ChoiceMagnesium sulphatePritchard regimenLoading dose - 4 gm slow IV (20%) + 10 gm IMMaintenance dose - 5 gm IM q 4 hoursMonitorUrine outputRespiratory rateKnee jerksTherapeutic level of serum MgSO4 - 4-7 meq/L.MgSO4 continued for 24 hours after the last seizure or delivery whichever is later.Status EclamptieusFits occurring in quick successionManagementThiopentone sodiumMuscle relaxation and assisted ventilation

So the answer to this question is B


Instruction:
Most common location of congenital cyst in lung:
A. Right bronchus
B. Left bronchus
C. Pleural surface
D. Perihilar intrapulmonary

Response:
Ans. A. Right bronchus Ref: Nelson Textbook of Pediatrics 20th/ed p2057Explanation# Bronchogenic cysts arise from abnormal budding of the tracheal diverticulum of the foregut before the 16th week of gestation and are originally lined with ciliated epithelium.# They are more commonly found on the right and near a midline structure (trachea, esophagus, carina), but peripheral lower lobe and perihilar intrapulmonary cysts are not infrequent. Cysts are rarely demonstrable at birth.

So the answer to this question is A


Instruction:
A 50-year-old gynecologist complains of dysphagia, regurgitation, and weight loss. She also states that she feels as if food is stuck at the level of the xiphoid. An upright chest x-ray shows a dilated esophagus with an air-fluid level. Which of the following is FALSE?
A. A barium swallow will show a "bird's beak" deformity
B. Manometry will demonstrate that the LES fails to relax during swallowing.
C. Upper endoscopy should be avoided because of the risk of complications.
D. Medical treatment includes nitrates and calcium channel blockers.

Response:
The symptoms and radiologic findings in this patient suggest achalasia. Evaluation includes endoscopy to rule out a stricture or cancer. Barium swallow will show a dilated esophagus, failure of the LES to relax during swallowing, and a lack of peristalsis. Nonoperative management is of limited usefulness but may be considered in high-risk patients who are not candidates for surgery.

So the answer to this question is C


Instruction:
Darwin tubercle is seen in
A. Tragus
B. Helix
C. Antihelix
D. Lobule

Response:
Darwin's tubercle (or auricular tubercle) is a congenital ear condition which often presents as a thickening on the helix at the junction of the upper and middle thirds The features present in approximately 10.4% of the population. This acuminate nodule represents the point of the mammalian ear. Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 3

So the answer to this question is B


Instruction:
Following are tests to confirm blood stains except
A. Phenolphthalein test
B. Takayamma test
C. Florence test
D. Teichmann's test

Response:
To find out whether the stain is blood or Not: 1. Catalytic color test Phenolphthalein test Oho-toluidine test Benzedine test 2. Crystal test Hemin crystal test(Teichmann's test) Hemochromogen crystal test(Takayamma test) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 317

So the answer to this question is C


Instruction:
A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial or ascending branch of the transverse cervical aery?
A. Latissimus dorsi
B. Multifidus
C. Trapezius
D. Rhomboid major

Response:
The trapezius receives blood from the superficial branch of the transverse cervical aery. The latissimus dorsi receives blood from the thoracodorsal aery. The rhomboid major receives blood from the deep or descending branch of the transverse cervical aery. The multifidus and longissimus capitis receive blood from the segmental aeries.

So the answer to this question is C


Instruction:
True about sickle anemia is -
A. Leucopenia
B. Decreased ESR
C. Microcardia
D. Ringed sideroblast

Response:
Answer- B. Decreased ESRInvestigations in sickle cell anemia-Peripheral smear shows sickle cells, target cell and Howell - Jolly bodies.ESR is decreasedPositive sickling testHb electrophoresis shows two bands in heterozygous state/sickle cell trait.Bone changes on X-ray show:-A. Fish mouth veebraeB. Crew hair cut (hair on end) appearance of skull.('Hair on end appearance' is also seen in thalassemia, hereditaty spherocytosis and G6PD deficiency.)Gamma Gandy bodies

So the answer to this question is B


Instruction:
Which of the following is not a cholinergic agent
A. Galantamine
B. Donepezil
C. Tacrine
D. Piracetam

Response:
Ref: HL sharma 3rd ed pg no: 545 Piracetam, aniracetam are nootropic agents(sma drugs) used in Alzheimer's remaining drugs increase cholinergic activity in Alzheimer's

So the answer to this question is D


Instruction:
Following is true about the benefits of hormone replacement therapy except -
A. 40 - 50% improvement in vasomotor symptoms
B. Improvement in urogenital atrophy
C. Increase in bone mineral density (2-5%)
D. Reduction in colorectal cancer (20%)

Response:
Airs. is 'a' i.e., 40 - 50% improvement in vasomotor symptoms Benefits of hormone replacement therapy (HRT)o improvement of vasomotor symptoms (70-80%)o Imporvement urogenital atrophyo increase in bone mineral density (2-5%)o Decreased risk in vertebral and hip fractures (25-50%)o Reduction in colorectal cancer (20%)o Possibly cardioprotection

So the answer to this question is A


Instruction:
A 28 year old woman comes to you with the repo of a USG done at 13 weeks, it shows the child has anencephaly and as a result of which she would like to do an MTP. Which of the following is NOT a preferred method of MTP in this condition?
A. Menstrual regulation
B. Intra amniotic instillation of urea and PGF2 a Extraovular instillation of ethacridine lactate
C. Extraovular instillation of ethacridine lactate
D. Parenteral administration of PGF2 a

Response:
Menstrual regulation is a method of MTP used in the first trimester. It should be done within 42 days of the last menstrual period. The rest of the methods mentioned can be used in the 2nd trimester. Ref: Shaw's textbook of gynaecology,Edition 12, Page - 186.

So the answer to this question is A


Instruction:
Sloglass is used in:
A. Root biomodification
B. Resective osseous surgery
C. Regeneration osseous surgery
D. Mucogingival surgery

Response:
None

So the answer to this question is C


Instruction:
Omenn syndrome is
A. Squamous cell carcinoma
B. Chronic mucocutaneous candidiasis
C. IgA deficiency
D. SCID

Response:
Omenn syndrome is an autosomal recessive form of severe combined immunodeficiency (SCID) characterized by erythroderma (skin redness), desquamation (peeling skin), alopecia (hair loss), chronic diarrhea, failure to thrive, lymphadenopathy (enlarged lymph nodes ), eosinophilia, hepatosplenomegaly , and elevated serum Ref Harrison20th edition pg 1278

So the answer to this question is D


Instruction:
19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze,moderate proptosis & chemosis. On examination optic disc is congested. Most likely diagnosis is
A. Cavernous sinus thrombosis
B. Orbital cellulitis
C. Acute Ethmoidal sinusitis
D. Orbital apex syndrome

Response:
It Stas initially as a unilateral condition which soon becomes bilateral due to intercavernous connection. It should be differentiated from orbital cellulitis and panophthalmitis. Ref: ak khurana 6th edition pg no412

So the answer to this question is A


Instruction:
A bacterium acquires an antibiotic-resistance gene that is carried by a phage vector. The phage vector does not carry randomly chosen poions of bacterial DNA, but instead almost always carries primarily the antibiotic-resistance gene. This is an example of which of the following?
A. Conjugation
B. Generalized transduction
C. Site-specific transduction
D. Transformation

Response:
Transduction is the term used for DNA transfer a bacteriophage vector. Transduction that involves specific genomic information is called site-specific transduction. Conjugation is direct DNA transfer between bacteria sex pili. Generalized transduction is a non selective DNA transfer a bacteriophage vector. Transformation is the uptake of naked DNA from the environment. Ref: Brooks G.F. (2013). Chapter 7. Microbial Genetics. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.

So the answer to this question is C


Instruction:
Persistent diarrhoea in AIDS is caused byA/E ?
A. Microspora
B. Cryptococcus
C. Cryptosporidia
D. Isospora belli

Response:
Ans. is 'b' i.e., Cryptococcus and

So the answer to this question is B


Instruction:
All of the following diseases can be transmitted during the incubation period except
A. Tuberculosis
B. Measles
C. Hepatitis A
D. Pertussis

Response:
• Carrier: An infected person or animal that harbours a specific infectious agent ‘in the absence of discernible clinical disease’ and serves as a potential source of infection to others.
• Incubatory carriers: Shed infectious agent during the incubation period of the disease (esp. during last few days of IP).
For example: Measles, Mumps, Polio, Pertussis, Influenza, Diphtheria, Hepatitis B, HIV.

So the answer to this question is A


Instruction:
A child presents with seborrheic dermatits, lytic skull lesions, ear discharge and hepatospleno- megaly, likely diagnosis -
A. Leukemia
B. Lymphoma
C. Histiocytosis X
D. Multiple myeloma

Response:
None

So the answer to this question is C


Instruction:
Which of the following is not true about PCR -a) Thermostable enzyme is usedb) Annealing is done after DNA denaturationc) Specific primers re-requiredd) Required atleast 1 week time for synthesise) DNA polymerase has to be added on each cycle
A. ab
B. de
C. cd
D. bd

Response:
PCR is a speedy process & does not require 1 week time for synthesis.
DNA polymerase need not be added in each cycle as it is thermostable.

So the answer to this question is B


Instruction:
Which of the following aren't included in the WHO classification of operating dental auxiliaries?
A. Dental hygienist
B. School dental nurses
C. Therapists
D. Denturists

Response:
Non-operating auxiliaries

Dental surgery assistant
Dental secretary/receptionist
Dental laboratory technician
Dental health educator

Operating auxiliaries

School dental nurse
Dental therapist
Dental hygienist
Expanded function dental auxiliaries

Essentials of preventive and community dentistry
Soben Peter
5th edition

So the answer to this question is D


Instruction:
Which of the following forms the tendinous sling in the superficial arch of foot?
A. Peroneus longus and peroneus brevis
B. Peroneus longus and flexor hallucis longus
C. Peroneus longus and tibialis posterior
D. Peronius brevis and tibialis posterior

Response:
Ans. c (Peroneus longus and tibialis posterior) (Ref BDC vol.2/ 4th/ 161; Anat Colour Atlas by IB Singh/p.398)The Peroneus longus and tibialis posterior muscles form the tendinous sling in the superficial arch of footThe foot has three arches. The medial longitudinal arch is the highest and most important of the three arches. It is composed of the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals. The medial longitudinal arch is further supported by the plantar aponeurosis, by the small muscles in the sole of the foot, by the tendons of the Tibialis anterior and posterior and Peroneus longus, and by the ligaments of all the articulations involved. The lateral longitudinal arch is lower and flatter than the medial arch. It is composed of the calcaneus, cuboid, and the fourth and fifth metatarsals. Two strong ligaments, the long plantar and the plantar calcaneocuboid, together with the Extensor tendons and the short muscles of the little toe, preserve its integrity. The transverse arch is composed of the cuneiforms, the cuboid, and the five metatarsal bases. The tendinous slings of muscles also are important parts of the arches. The transverse arches are strengthened by the interosseous, plantar, and dorsal ligaments, by the short muscles of the first and fifth toes (especially the transverse head of the Adductor hallucis), and by the Perones longus, whose tendon stretches across between the piers of the arches.

So the answer to this question is C


Instruction:
Monoclonal Antibody used in Asthma is:
A. Omalizumab
B. Trastuzumab
C. Muromonab
D. Alemtuzumab

Response:
Ans: A (Omalizumab) Ref: Harrison s Principles of Internal Medicine 18th editionExplanation:Omalizumab (Anti-IgE antibody)It is a blocking antibody that neutralizes circulating IgE without binding to cell-bound IgE and. thus, inhibits IgE-mediated reactions.This treatment has been shown to reduce the number of exacerbations in patients with severe asthma and may improve asthma control.However, the treatment is very expensive and is only suitable for highly selected patients who are not controlled on maximal doses of inhaler therapy and have a circulating IgE within a specified range.Omalizumab is usually given as a subcutaneous injection every 2-4 weeks and appears not to have significant side effects, although anaphylaxis is very occasionally seen.

So the answer to this question is A


Instruction:
The Epstein Barr virus is implicated in all of the following conditions, EXCEPT :
A. Nasopharyngeal Ca
B. Burkitt's lymphoma
C. Infectious mononucleosis
D. Leukemia

Response:
EBV is known to cause infectious mononucleosis, lymphoproliferative syndrome(fever, lymphadenopathy and hepatosplenomegaly), burkitt lymphoma, nasopharyngeal carcinoma, and in AIDS patients its known to cause hairy leukoplakia of tongue, interstitial lymphocytic pneumonia and lymphoma. In Sub saharan africa Burkitt lymphoma is the most common malignancy in young children. It is thought to result from an early EBV infection that produces a large pool of infected B lymphocytes. It can be diagnosed by presence of increased IgA antibody levels to both VCA and early EBV antigens. Nasopharyngeal carcinoma is endemic in Southern China, where it is responsible for 25% of moality from cancer. Ref: Ray C.G., Ryan K.J. (2010). Chapter 14. Herpesviruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.

So the answer to this question is D


Instruction:
Children	of	parents	with	which	of	the	following
blood group combinations have the highest risk of
erythroblastosis fetalis:
A. Rh+ father and Rh+ mother
B. Rh+ father and Rh- mother
C. Rh- father and Rh+ mother
D. Rh- father and Rh- mother

Response:
None

So the answer to this question is B


Instruction:
Single-dose mebendazole is effective in treatment of
A. Enterobius vermicularis
B. Ankylostoma duodenale
C. Ascaris lumbricoides
D. All of the above

Response:
Ans. a (Enterobius vermicularis) (Ref. Nelson paediatrics 18th/ p. 1450; KDT Pharmacology 6th/809)Enterobius: 100 mg single dose mebendazole, repeated after 2-3 weeks.Round worm:Hookworm:Mebendazole 100 mg twice a day for 3 consecutive days.Whipworm:NO fasting/purging/other preparation needed.Enterobius vermicularis (pinworm) infection; Drug of choice (adult as well pediatric dosage)# Pyrantel pamoate 11 mg/kg base once (max 1 g); repeat in 2 wk OR# Mebendazole 100 mg once,repeat in 2 wk OR# Albendazole 400 mg once; repeat in 2 wk.Ascariasis (Ascaris lumbricoides. roundworm); Drug of choice# Albendazole 400 mg once OR# Mebendazole 100 mg bid x 3 days or 500 mg once OR# Ivermectin 150-200 microg/kg once

So the answer to this question is A


Instruction:
Unilateral small smooth kidney is seen in ?
A. Reflux nephropathy
B. Lobar infarction
C. Renal aery stenosis
D. Chronic glomerulonephritis

Response:
Ans. is 'c' i.e., Renal aery stenosis

So the answer to this question is C


Instruction:
A 32-year-old man is involved in a vehicular accident and sustains fractures of the right femur and tibia and the left humerus. The fractures are stabilized surgically. He is in stable condition for 2 days, but then suddenly becomes severely dyspneic. Which of the following complications from his injuries is the most likely cause of his sudden respiratory difficulty?
A. Cardiac tamponade
B. Fat embolism
C. Pulmonary edema
D. Pulmonary infarction

Response:
The mechanism for fat embolism is unknown, in particular, why onset of symptoms is delayed 1 to 3 days after the initial injury (or up to 1 week for cerebral symptoms). The cumulative effect of many small fat globules filling peripheral pulmonary arteries is the same as one large pulmonary thromboembolus. Cardiac tamponade and hemothorax would be immediate complications after traumatic injury, not delayed events. Pulmonary edema severe enough to cause dyspnea would be unlikely to occur in hospitalized patients because fluid status is closely monitored. Pulmonary infarction may cause dyspnea, but pulmonary thromboembolus from deep venous thrombosis is typically a complication of a longer hospitalization.

So the answer to this question is B


Instruction:
A person presents with pneumonia. His sputum was sent for culture. The bacterium obtained was gram positive cocci in chains and alpha haemolytic colonies on sheep agar. Which of the following will help in confirming the diagnosis?
A. Novobiocin
B. Optochin
C. Bacitracin
D. Oxacillin

Response:
Ans. b. Optochin (Ref: Ananthanarayan 8/e p205-206)Gram-positive cocci with alpha hemolytic colonies on sheep agar are Streptococcus viridians and Streptococcus pneumoniae. They can be further differentiated on basis of optochin sensitivity, Streptococcus viridians-optochin resistant or Streptococcus pneumonia-optochin sensitive. Streptococci ViridansStreptococcus pneumoniaeBile solubilityInsolubleQSolubleQFermentation of inulinNot a fermenterQFermenter with acid productionQSensitivity to optochinNot sensitiveQSensitiveQPathogenicity to miceNonpathogenicQPathogenicQQuel lung testNegativeQPositiveQ

So the answer to this question is B


Instruction:
All are amino steroid non depolarizing neuromuscular except -
A. Pancuronium
B. Pipecuronium
C. Gantacurium
D. Vacuronium

Response:
Stucture Clinical duration Long acting (>50 min) Intermediate (20-50 min) Sho (15-20 min) Ultra-sho (<10-12 min) Steroidal Pancuronium Pipecuronium Vecuronium Rocuronium Benzyliso- quinolinium d-Tubocurarine Metacurine Doxacurium Atracurium Cis-atracurium Mivacurium Onium chlorofumarate Gantacurium Phenolic ether Gallamine Diallyl derivative of toxiferine Alcuronium

So the answer to this question is C


Instruction:
Eisenmenger syndrome is characterized by all except -
A. Return of left ventricle & right ventricle to normal size
B. Pulmonary veins not distended
C. Pruning of peripheral pulmonary aeries
D. Dilatation of central pulmonary aeries

Response:
Ans. is 'a' i.e., Return of left ventricle and right ventricle to normal size Eisenmenger syndrome is associated with severe pulmonary aerial hypeension and right ventricular hyperophy. The right ventricular size will ceainly not return to normal once eisenminger syndrome develops. Chest X-ray in Eisenmenger syndrome o Dilated and prominent central aeries. o Rapid tapering (pruning) of the peripheral pulmonary vasculature. o The hilar (central) area suggests pulmonary plethora whereas the peripheral lung fields suggest pulmonary oligemia. Clinical manifestations of Eisenmenger syndrome o Symptoms ---> Cyanosis (Differential cynosis in PDA), fatigue, effo intolerance and dyspnea. o Physical examination Cyanosis and clubbing Parasternal impulse (more in ASD) Palpable P2 Wide and fixed splitting of S, in ASD Pulmonary regurgitation murmur. Normal splitting of S2 in PDA Ejection systolic murmur (pulmonic). Single S2 or paradoxical splitting in VSD ECG Right ventricular hyperophy with right axis detion. 'P' pulmonale.

So the answer to this question is A


Instruction:
The following are selective beta blockers except
A. Pindolol
B. Bisoprolol
C. Esmolol
D. Acebutolol

Response:
Pindolol is nonselec ve b-blocker with intrinsic sympathomimetic activity

So the answer to this question is A


Instruction:
The most impoant constituent in soda lime for reabsorption of CO2 in a closed circuit is:
A. Sodium hydroxide
B. Barium hydroxide
C. Calcium hydroxide
D. Potassium hydroxide

Response:
Ans. c. Calcium hydroxide

So the answer to this question is C


Instruction:
All of the following cause Microcytic Hypochromic anemia except:
A. Lead poisoning
B. Thalassemia
C. Iron deficiency anemia
D. Fanconi's anemia

Response:
Answer is D (Fanconi's Anemia) Fanconi's anemia is congenital disorder responsible for a form of aplastic anemia. It does not produce a microcytic hypochromic picture. It causes a normocVtic normochromic anemia. Lead poisoninz Lead causes inhibition of several enzymes involved in haem synthesis including ALA synthetase and leads to sideroblastic anemia with a microcytic hypochronic anemia. The characteristic haematological features of lead poisoning include: Sideroblastic anemia Q Haemolysis Q Punctate basophilia Q

So the answer to this question is D


Instruction:
The function of 8th cranial nerve is related to ?
A. Smell
B. Touch
C. Taste
D. Balance

Response:
Vestibular pathway of vestibulocochlear nerve / 8th cranial nerve - The vestibular receptors are the maculae of the saculae and the utricle (For static balance ) and crista of the ampullaries of semicircular ducts for kinetic balance . Fibres from cristae of anterior and lateral semicircular canals and some fibres from the the two maculae lie in superior vestibular area of internal acoustic meatus. Fibres of cristae of posterior semicircular canal lie in foramen singulare. Most of the fibres from maculae of utricle and saculae lie in inferior vestibular area. Ref : B D Chaurasia 's Human Anatomy, seventh edition , volume 4 , pg. no., 77.

So the answer to this question is D


Instruction:
The most common site of puerperal infection is: March 2013
A. Episiotomy wound
B. Placental site
C. Vaginal laceration
D. Cervical laceration

Response:
Ans. B i.e. Placental site

So the answer to this question is B


Instruction:
"Fleischer ring" is a distinct feature of
A. Keratoconus
B. Pterygium
C. Congenital ocular melanosis
D. Congenital epithelial Melanosis

Response:
A condition in which the clear tissue on the front of the eye (cornea) bulges outward. Visual: astigmatism, blurred vision, distoed vision, double vision, inability to see in dim light, nearsightedness, sensitivity to light, or vision loss Also common: a rim of discolouration around the front of the eye (fleischer ring) Picture show Keratoconus, a non circular, non-centered oval caused by a bulging cornea. Very common in Keratoconus, it is best viewed under cobalt blue light, that's why the sclera looks blue. Reference: Ganong&;s review of medical physiology 25edition page 132

So the answer to this question is B


Instruction:
Okazaki fragments are formed during ?
A. Transcription
B. Translation
C. DNA replication
D. None

Response:
Ans. is 'c' i.e., DNA replication

So the answer to this question is C


Instruction:
Police inquest is done in all, except: NEET 13, 14
A. Suicidal death
B. Homicidal death
C. Dowry death
D. Death by animals

Response:
Ans. Dowry death

So the answer to this question is C


Instruction:
Which of the following is false about mccune Albright syndrome
A. Inherited disorder
B. Bone abnormalities
C. Café au lait spots
D. Precocious puberty

Response:
Mccune-albright syndrome is due to in utero mutation thus it is not an inherited syndrome.

So the answer to this question is A


Instruction:
Anemia with punctuate basophilia is seen in chronic poisoning of: March 2004
A. Lead
B. Arsenic
C. Copper
D. Mercury

Response:
Ans. A i.e. Lead

So the answer to this question is A


Instruction:
The progesterone component of oral contraceptive pills acts by :
A. Preventing ovulation
B. Inhibiting implantation
C. Bringing about alterations in cervical mucus
D. All of the above

Response:
Action of OCPs: 1.The combined oral pill suppresses pituitary hormones,FSH and LH peak and through their suppression prevents ovulation. 2.Progestogen causes atrophic changes in the endometrium and prevents nidation. Progestogen also acts on the cervical mucus making it thick and tenacious and impenetrable by sperms. 3.It also increases the tubal motility, so the feilized egg reaches the uterine cavity before the endometrium is receptive for implantation. Ref: Shaw Gynecology 17 e pg 264.

So the answer to this question is D


Instruction:
Stage II laryngeal carcinoma treated by
A. Radiation
B. Surgery
C. Chemo therapy
D. Neo adjuvant chemotherapy and then surgery

Response:
None

So the answer to this question is A


Instruction:
Wernick's encephalopathy is caused by deficiency of
A. Thiamine
B. Cyanocohalamine
C. Niacin
D. Riboflavin

Response:
None

So the answer to this question is A


Instruction:
Japanese B encephalitis virus is transmitted by-
A. Aedes aegypti
B. Culex fatigans
C. Culex tritaeniorhynchus
D. Hard tick

Response:
None

So the answer to this question is C


Instruction:
Neologism is seen in:
A. Depression
B. Schizophrenia
C. Mania
D. Dysphasia

Response:
Neologisms - creates new own words, seen in Schizophrenia. Neologisms may be new words that are constructed by the patient or ordinary words that are used in a new way. Neologisms may be mannerisms or stereotypies - in patients with catatonia Is a result of formal thought disorder, words are fused together in the same way as concepts are blended with one another.

So the answer to this question is B


Instruction:
Which of the following walls of axilla is formed by shaft of humerus:
A. Anterior
B. Posterior
C. Medial
D. Lateral

Response:
Lateral wall of the axilla is formed by the inteubercular sulcus of humerus Boundaries of Axilla 1. Apex: It is directed upwards and medially towards the root of the neck. It is truncated (not pointed), and corresponds to a triangular interval bounded anteriorly by the clavicle, posteriorly by the superior border of the scapula, and medially by the outer border of the first rib. This passage is called the cervicoaxillary canal. The axillary aery and the brachial plexus enter the axilla through this canal. 2. Base or Floor It is directed downwards, and is formed by skin, superficial and axillary fasciae. 3. Anterior Wall It is formed by the following: The pectoralis major in front. The clavipectoral fascia enclosing the pectoralis minor and the subclavius; all deep to the pectoralis major. 4. Posterior Wall It is formed by the following: Subscapularis above. 5. Medial Wall It is formed by the following: Upper four ribs with their intercostal muscles. Upper pa of the serratus anterior muscle. 6. Lateral Wall It is very narrow because the anterior and posterior walls converge on it. It is formed by the following: Upper pa of the shaft of the humerus in the region of the bicipital groove, and Coracobrachialis and sho head of the biceps brachii. Teres major and latissimus dorsi below Ref: BDC-I, 5th ed., p-52

So the answer to this question is D


Instruction:
What is the recommended period of isolation for a suspected case of diphtheria?
A. 7 days
B. 10 days
C. 12 days
D. 14 days

Response:
All suspected or confirmed cases and carriers of diphtheria should be isolated preferably in a hospital for at least 14 days or until proved free of infection by two consecutive nose and throat swabs taken 24 hours apa. Ref: Park 21st edition, page 150.

So the answer to this question is D


Instruction:
Expectant management of placenta previa includes all except
A. Anti D
B. Cervical encirclage
C. Blood transfusion
D. Steroids

Response:
Macafee and Johnson regime is the name given to the expectant management of placenta previa as it was advocated by McAfee and Johnson
Aim of expectant management in case of placenta previa is to continue pregnancy for fetal maturity without compromising the maternal health.
Prerequisites for expectant management:

Availability of blood for transfusion whenever required
Facilities for caesarean section should be available throughout 24 hours.

Candidates: Suitable for expectant management are:

Mother in god health status- Hemoglobin > 10 gm%
Hematocrit > 30% and she should bev hemodynamically stable.
Duration of pregnancy less than 37 weeks
Active vaginal bleeding is absent
Fetal well being is assured by USG and cardiotocography

The expectant management is carried upto 37 weeks of pregnancy until baby matures.
Expectant management includes (i.e. MacAfee and Johnson regime includes)

Hospitalisation till active bleeding stops and then readmission at 34 weeks
Complete bed rest
Anaemia corrected with blood transfusion (if necessary), but blood should always to be kept ready as placenta previa is a recurrent condition.
Antenatal steroids to promote fetal lung maturity
Anti D if patient is Rh negative
If uterine contractions are present - tocolytics (magnesium sulphate/nifedipine) can be given as it leads to more advanced gestational age at delivery, greater birth weight of fetus, less neonatal complications, and decreased cost of hospitalization. Tocolytics should not be used for more than 48 hours.
Some obstetricians do cervical encirclage in case of placenta previa. The rationale behind the use of cervical cerclage in placenta previa, is that it limits the development of the low uterine segment brought about by advancing gestation and the effect of uterine contraction. But other studies have failed to confirm these findings. Thus, RCOG doesnot recommend the use of cervical cerclage in placenta previa till further data is available

So the answer to this question is B


Instruction:
Nucleus involved in Alzheimer's disease is:
A. Nucleus Basalis of Meyne
B. Superior salivary nucleus
C. Ventromedial nucleus of thalamus
D. All of the above

Response:
The brain of Alzheimer's disease patients shows severe neuronal loss in the nucleus basalis of Meyne. This pa is the major source of cholinergic input to cerebral cortex.

So the answer to this question is A


Instruction:
Secondary oocyte contains -
A. 23, X
B. 46, XY
C. 46, XX
D. 23, Y

Response:
Ans. is 'a'i.e., 23, X o OOGENESIS:

So the answer to this question is A


Instruction:
Pseudoglioma differs from Retinoblastoma in that pseudoglioma is associated with –
A. Decreased intraocular pressure
B. Blurring of vision
C. Enlargement of the optic foramen
D. All of the above

Response:
The intraocular pressure is raised in retinoblastoma while it is reduced in pseudoglioma (conditions simulating retinoblastoma due to leukocoria).

So the answer to this question is A


Instruction:
Test of choice for Reversible Myocardial Ischemia?
A. Thallium scan
B. MUGA scan
C. Resting ECHO
D. Coronary angiography

Response:
A i.e. Thallium Scan

So the answer to this question is A


Instruction:
The term ARCON was coined by
A. Bergstrom
B. Hanau
C. Gillis
D. Fish

Response:
None

So the answer to this question is A


Instruction:
Which of the following opioids cause the least amount of nausea?
A. Fentanyl
B. Sufentanil
C. Alfentanil
D. Remifentanil

Response:
Intraoperative use of opioids is a well-known risk factor for postoperative nausea and vomiting. Opioids stimulate the chemoreceptor trigger zone in the area postrema of the medulla, possibly through d-receptors, and thereby lead to nausea and vomiting. When compared with approximately equipotent doses of fentanyl and sufentanil, alfentanil is associated with a lower incidence of postoperative nausea and vomiting Ref: Miller's anesthesia-7th ed, Chapter 27.

So the answer to this question is C


Instruction:
Which of the following is required in the initial stage of the synthesis of haemoglobin?
A. Glycine
B. Histidine
C. Iron
D. Folic acid

Response:
Heme is synthesized in the mitochondria. Staing substances required in the synthesis of heme are succinyl CoA and glycine. Pyridoxal phosphate is required for activation of glycine. Globin the protein pa of hemoglobin is synthesized in ribosomes.

So the answer to this question is A


Instruction:
Beta HCG is secreted by -
A. Ovary
B. Pituitary
C. Corpus luteum
D. Placenta

Response:
Ans. is 'd' i.e., Placenta [Ref: Ganong 24th/ep. 414 & 23rd/ep. 424Jo b-HCG is secreted by placenta.o This question is a direct repeat from NBE based NEET 2012-13.

So the answer to this question is D


Instruction:
The organism most frequently related to mediastinal fibrosis is -
A. Actinomycosis
B. Histoplasma
C. Hansen's bacillus
D. Staphylococcus

Response:
The organism most frequently related to mediastinal fibrosis is Histoplasma.
• The spectrum of chronic mediastinitis ranges from granulomatous inflammation of the lymph nodes in the mediastinum to fibrosing mediastinitis.
• Most cases are due to TB or histoplasmosis, but sarcoidosis, silicosis, and other fungal diseases are at times causative.
Clinical Features
• Patients are usually asymptomatic.
• Those with fibrosing mediastinitis usually have signs of compression of some mediastinal structure such as the SVC or large airways, phrenic or RLN paralysis, or obstruction of the pulmonary artery or proximal pulmonary veins.
Treatment
• Other than ATT for tuberculous mediastinitis, no medical or surgical therapy has been demonstrated to be effective for mediastinal fibrosis.

So the answer to this question is B


Instruction:
PGE causes worsening in infant with ?
A. PS without VSD
B. Hypoplastic left hea syndrome
C. Pulmonary stenosis
D. TGA with intact ventricular septum

Response:
In patient with Pulmonary stenosis without VSD , PGE cause worsening. Ref : Ghai essential of pediatrics, eighth edition, p.no:433

So the answer to this question is A


Instruction:
Gastric acid secretion is decreased by all except:
A. Somatostatin
B. Histamine
C. Cholecystokinin
D. Prostaglandins

Response:
Enteric hormones that inhibit H+ secretion Hormone Source CCK I cells of duodenum and jejunum and neurons in ileum and colon Secretin S cells in small intestine VIP ENS neurons GIP K cells in duodenum and jejunum Neurotensin Endocrine cells in ileum Peptide YY Endocrine cells in ileum and colon Somatostatin D cells of stomach and duodenum, & cells of pancreatic islets

So the answer to this question is B


Instruction:
Focal segmental glomerulosclerosis is characterized by?
A. IgA +/- IgG
B. IgM and C3
C. Granular IgG and C3
D. Linear IgG and C3

Response:
Focal segmental glomerulosclerosis (FSGS) is characterized by sclerosis of some (but not all) glomeruli that involve only a pa of each affected glomerulus. The affected glomeruli exhibit increased mesangial matrix, obliterated capillary lumina, deposition of hyaline (hyalinosis) and foamy (lipid-laden) macrophages. In affected glomeruli, immunofluorescence microscopy often reveals nonspecific trapping of immunoglobulins, usually IgM, and complement in the areas of hyalinosis. On electron microscopy, the podocytes exhibit effacement of foot processes, as in minimal-change disease. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 556

So the answer to this question is B


Instruction:
Not true about angioneurotic edema?
A. Pitting edema of face, lips and mucous membrane D
B. C1 Esterase inhibitor deficiency can cause it
C. Extreme temperature exposure can provoke it
D. Known with ACE inhibitors.

Response:
A i.e. Pitting edema of face, lips and mucous membrane

So the answer to this question is A


Instruction:
The nerve piercing sphenomandibular ligament is
A. Superior alveolar nerve
B. Inferior alveolar nerve
C. Nerve to mylohyoid
D. Lingual nerve

Response:
Nerve to mylohyoid pierces sphenomandibular ligament.

So the answer to this question is C


Instruction:
Which of the following change occur secondary to hypercarbia?
A. Miosis
B. Cool extremities
C. Bradycardia
D. Hypeension

Response:
Hypercarbia from any cause increase the release of catecholamines and cause hypeension. It cause increase in HR, myocardial contractility, high systolic blood pressure, wide pulse pressure, greater cardiac output and higher pulmonary pressures. Effects of hypercarbia are: Increased respiratory drive Anxiety, restlessness, tachycardia, hypeension and arrhythmias Peripheral vasodilatation Increases in cerebral blood flow and intracranial pressure Decreased level of consciousness and coma Causes of hypercarbia: Most common cause: alveolar hyperventilation. It can be due to airway obstruction, narcotics, CNS disorders, PNS disorders, chest wall disorders. V/Q inequality Increased dead space Ref: Clinical Intensive Care and Acute Medicine By Ken Hillman page 291. Essentials of Anaesthesiology By Arun Kumar Paul page 218

So the answer to this question is D


Instruction:
What is the commonest cause of death in Ca penis?
A. Cerebral metastasis
B. Liver metastasis
C. Uremia
D. Erosion of femoral vessels

Response:
HPV-16 and HPV-18 have been found in one third of men with penile cancer. Risk factors included early and high sexual activity, the lifetime number of sexual paners, the number of sexual paners prior to age 20 years, age at first occurrence of intercourse, penile-oral sex, a history of anogenital was, and never having used condoms. Metastasis to the femoral and inguinal lymph nodes is the earliest path for tumor dissemination. Untreated metastatic enlargement of the regional nodes leads to skin necrosis, chronic infection, and, eventually, death from sepsis or hemorrhage secondary to erosion into the femoral vessels.

So the answer to this question is D


Instruction:
Cause of pulsating proptosis
A. Lymphoma
B. Caroticocavernous fistula
C. Orbital cellulitis
D. Mucocele of paranasal sinuses

Response:
Causes of Pulsatile Proptosis Caroticocavernous fistula Aneurysms of Ophthalmic aery Transmitted cerebral pulsation from deficient orbital roof like congenital meningocele / meningo-encephalocele

So the answer to this question is B


Instruction:
Polio vaccine is which type of prevention:
A. Primary
B. Secondary
C. Tertiary
D. Primordial

Response:
Ans. (a) PrimaryRef.: K. Park 23rd ed. 141, 370-74

So the answer to this question is A


Instruction:
An 18-year-old man who is known to have non-penicillinase producing gonococcal urethritis is given an injection of penicillin and probenecid. What is the mechanism used by probenecid that makes penicillin more efficacious
A. Prolongs the duration of action by affecting the liver metabolism of penicillin
B. Increases the half-life and serum level by decreasing the renal excretion of penicillin
C. Promotes entry of the penicillin into the bacteria
D. Decreases the bacterial resistance by inhibiting penicillinase production

Response:
PENICILLIN-G (BENZYL PENICILLIN) Pharmacokinetics :- Penicillin G is acid labile, therefore destroyed by gastric acid. As such, less than 1/3rd of an oral dose is absorbed in the active form. Absorption of sod. PnG from i.m. site is rapid and complete; peak plasma level is attained in 30 min. It is distributed mainly extracellularly; reaches most body fluids, but penetration in serous cavities and CSF is poor. However, in the presence of inflammation (sinovitis, meningitis, etc.) adequate amounts may reach these sites. About 60% is plasma protein bound. It is little metabolized because of rapid excretion. The pharmacokinetics of PnG is dominated by very rapid renal excretion; about 10% by glomerular filtration and the rest by tubular secretion. The plasma t 1/2 of PnG in healthy adult is 30 min. Neonates have slower tubular secretion-- t 1/2 of PnG is longer; but approaches adult value at 3 months and then is even shoer during childhood. Aged and those with renal failure excrete penicillin slowly. Tubular secretion of PnG can be blocked by probenecid--higher and longer lasting plasma concentrations are achieved. Probenecid also decreases the volume of distribution of penicillins. Ref:- kd tripathi; pg num:-718

So the answer to this question is B


Instruction:
Mechanism involved in the absorption of glucose from small intestine is which of the following:March 2005
A. Active co-transpo with sodium
B. Passive diffusion
C. Facilitated diffusion
D. Active co-transpo with potassium

Response:
Ans. A: Active co-transpo with sodium

So the answer to this question is A


Instruction:
Chemotaxis is the main function of?
A. C5a
B. ICAM1
C. P-selectin
D. IL-5

Response:
Ans. is 'a' i.e., C5a o C5a is the most powerful chemo-attractant (chemokine).Chemotaxiso Chemotaxis is unidirectional locomotion of leukocytes towards the site of injury, oriented along a chemical gradient. This chemical gradient is created by substances called chemoattractants (chemotactic agents), which may be exogenous (bacterial products) or endogenous (C5a, LTB-4, IL-1, TNF, IL-8).

So the answer to this question is A


Instruction:
Following is the marker of HIV infection in blood:
A. Reverse transcriptase
B. DNA polymerase
C. RNA polymerase
D. None

Response:
Ans. is 'a', i.e., Reverse transcriptase(Ref: Harrison, 18th/e, p. 1539, 1540; 19th/e, p. 1219)* Plasma level HIV RNA can be measured by reverse - transcriptase polymerase chain reaction (RT - PCR) or branched DNA assay (b DNA).* Other markers of HIV infection:-p24 antigen.-Double stranded DNA.

So the answer to this question is A


Instruction:
A 46-year-old man sustains a spider bite on his upper eyelid, and an infection develops. The physician is very concerned about spread of the infection to the dural venous sinuses of the brain emissary veins. With which of the following dural venous sinuses does the superior ophthalmic vein directly communicate?
A. Cavernous sinus
B. Occipital sinus
C. Sigmoid sinus
D. Superior petrosal sinus

Response:
The anterior continuation of the cavernous sinus, the superior ophthalmic vein, passes through the superior orbital fissure to enter the orbit. Veins of the face communicate with the superior ophthalmic vein. Because of the absence of valves in emissary veins, venous flow may occur in either direction. Cutaneous infections may be carried into the cavernous sinus and result in a cavernous sinus infection which may lead to an infected cavernous sinus thrombosis. The cavernous sinus is located lateral to the pituitary gland and contains poions of cranial nerves III, IV, V1, V2 and VI, and the internal carotid aery.

So the answer to this question is A


Instruction:
A one day old baby presents with excessive frothing from mouth and baby was cyanosed:
A. Esophageal atresia
B. Diaphragmatic hernia
C. Congenital lung cyst
D. Lung hypoplasia

Response:
a. Esophageal atresia(Ref: Nelson's 20/e p 1783, Ghai 8/e p 176)Congenital diseaseMode of presentationCong diaphragmatic herniaNew born with cyanosis, respiratory distress, shift of mediastinum and scaphoid abdomenBilateral choanal atresiaNew born with feeding difficulty, cyanosis on closing mouth, which disappears on cryingPure esophageal atresiaNeonate with frothing and bubbling at mouth and nose, with coughing, cyanosis and respiratory distress; X-ray shows coiled feeding tube in esophageal pouch and absent gastric air shadow

So the answer to this question is A


Instruction:
False about osteomyelitis in Newborns
A. Common in males
B. Common in post-term babies
C. Poor prognosis
D. Hematogenous spread

Response:
Common in preterm babies.

So the answer to this question is B


Instruction:
Diabetic gangrene is due to:
A. Ischemia
B. Increased blood glucose
C. Altered defense by host and neuropathy
D. All of the above

Response:
Diabetic gangrene is related to: - Trophic changes from peripheral neuropathy - Ischemia as a result of microangiopathy and macroangiopathy (atherosclerosis) - Low resistance to infection because of excess sugar in the tissues

So the answer to this question is D


Instruction:
All of the following conditions are associated with primary amenorrhea except:
A. Testicular feminization syndrome
B. Stein-Leventhal syndrome
C. Turner's syndrome
D. Mayer Rockitansky Kuster Hauser Syndrome

Response:
Ans. is b, i.e. Stein-Leventhal syndromeRef: Shaw 15th/ed, p284-285The Stein-Leventhal Syndrome also known as Polycystic Ovarian Disease (PCOD) is an important cause of Secondary Amenorrhea in young women.Testicular Feminizing syndrome, Turners syndrome and Mayer Rokitansky Kuster Hauser syndrome are causes of Primary amenorrhea.

So the answer to this question is B


Instruction:
30 yr old mom presents with cramping gluteal pain after walking 500Mt which is the vessel involved ?
A. Aerial disease with aoa iliac involvement
B. Varicose vein
C. Aerial disease with femoral aery involvement
D. Femoral venous insufficiency

Response:
Aerial do with aoo iliac involvement, LERCHE&;s SYNDROME patient presents with gluteal claudication and impotence ref : bailey and love 27th ed

So the answer to this question is A


Instruction:
Growth hormone has its effect on growth through?
A. Directly
B. IG1-1
C. Thyroxine
D. Intranuclear receptors

Response:
Ans. is 'b' i.e., IGI-1GH has two major functions :-i) Growth of skeletal system :- The growth is mediated by somatomedins (IGF). Increased deposition of cailage (including chondroitin sulfate) and bone with increased proliferation of chondrocytes and osteocytes.ii) Metabolic effects :- Most of the metabolic effects are due to direct action of GH. These include gluconeogenesis, decreased peripheral utilization of glucose (decreased uptake), lipolysis and anabolic effect on proteins.

So the answer to this question is B


Instruction:
Most commonly used measure of central tendancy is:
A. Mean
B. Median
C. Mode
D. None of the above

Response:
MEAN

Most commonly used in biostatistics.
Most of the value in data spread along the mean.

MEDIAN

BETTER indicator of central tendency
Maximum observation are concentrated around median
If EXTREME VALUEs are recorded, then mean can’t be used. Use median. .

MODE

Rarely used. A series can have – no mode, 1 mode or, multiple mode.

So the answer to this question is A


Instruction:
The length of the eyeball is –
A. 12mm
B. 16 mm
C. 20mm
D. 24 mm

Response:
The length of the eyeball is approximately 24 mm, So the distances from the cornea / crystalline lens to the retina and the focal length of optical rays focused by the cornea/crystalline lens propagating in the vitreous humor and imaging on the retina, are also about 24 mm.

So the answer to this question is D


Instruction:
Antitubercular drug that can cause hyperuricemia is :
A. Rifampicin
B. INH
C. Pyrazinamide
D. Streptomycin

Response:
None

So the answer to this question is C


Instruction:
Carboxypeptidase contains which mineral?
A. Copper
B. Zinc
C. Iron
D. None

Response:
More than 300 enzymes are zinc-dependent. Some impoant ones are carboxypeptidase, carbonic anhydrase, alkaline phosphatase, lactate dehydrogenase, alcohol dehydrogenase and glutamate dehydrogenase. RNA polymerase contains zinc and so it is required for protein biosynthesis. Extracellular superoxide dismutase is zinc-dependent and so, zinc has antioxidant activity.Ref: DM Vasudevan, page no: 429

So the answer to this question is B


Instruction:
Diuretic used in mountain sickness?
A. Hydrochohiazide
B. Furesemide
C. Acetazolamide
D. Spironolactone

Response:
ACTIONS OF ACETAZOLAMIDE: i) Lowering of intraocular tension due to decreased formation of aqueous humor (it is rich in HC03). 2) Raised level of C02 in the brain and lowering of pH - sedation and elevation of seizure threshold. 3) Alteration of C02 transpo in lungs and tissues: - used in high altitude or mountain sickness ( Essentials of Medical Pharmacology, K.D Tripathi,6th edition )

So the answer to this question is C


Instruction:
An old man is diagnosed of having major depressive disorder. His son is telling that he always shows suicidal tendencies. What is the treatment of choice for depression with suicidal tendencies?
A. Clozapine
B. Miazapine
C. ECT
D. Olanzapine

Response:
ECT is the most effective (about 70-85%) treatment of severe depression--paicularly the delusions and agitation commonly seen with depression in the elderly. It is indicated when medical conditions preclude the use of antidepressants, nonresponsiveness to these medications, and extreme suicidality.It is also effective in the manic disorders and psychoses during pregnancy (when medications may be contraindicated). Ref: Eisendrath S.J., Lichtmacher J.E. (2013). Chapter 25. Psychiatric Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.

So the answer to this question is C


Instruction:
All the following factors predispose to Aoic dissection , except
A. Systemic hypeension
B. Takayasu's aeritis
C. 1 at trimester of pregnancy
D. Marfan's syndrome

Response:
Ref Harrison 19 th ed pg 1541 Aoic dissection is the major cause of morbidity and moality in patients with Marfan's syndrome or Loeys- Dietz syndrome, and similarly may affect patients with Ehlers-Danlos syndrome. The incidence also is increased in patients with inflamma- tory aoitis (i.e., Takayasu's aeritis, giant cell aeritis), congenital aoic valve anomalies (e.g., bicuspid valve), coarctation of the aoa, and a history of aoic trauma. In addition, the risk of dissection is increased in otherwise normal women during the third trimester of pregnancy. Aoic dissection also may occur as a consequence of weight lifting, cocaine use, or deceleration injury.

So the answer to this question is C


Instruction:
Pure red cell aplasia is associated with:
A. Thymoma
B. Renal cell carcinoma
C. Hepatocellular carcinoma
D. Prostate carcinoma

Response:
-Pure red cell aplasia is a primary marrow disorder in which only erythroid progenitors are suppressed. -In severe cases, red cell progenitors are completely absent from the marrow. -It may occur in association with neoplasms, paicularly thymoma and large granular lymphocytic leukemia; drug exposures; autoimmune disorders & parvovirus infection.

So the answer to this question is A


Instruction:
Example of peptide chemical transmitter of GIT which is secreted in a paracrine fashion is:
A. Gastrin
B. Secetin
C. Somatostatin
D. Histamine

Response:
Chemical trasmitters of GIT can be classified as: 1. Endocrine 2. Paracrine 3. Neurocrine 4. Autocrine Typical example of a paracrine signaling is seen in somatostatin. Another example is Histamine. Peptide among these two is Somatostatin where as histamine is a non peptide. Ref: Sleisenger and Fordtrans, Edition-9, Page-3.

So the answer to this question is C


Instruction:
Sclerosis of bile duct is seen in -
A. Primary sclerosing cholangitis
B. Obstructive jaundice
C. Bile duct atresia
D. Bile stones

Response:
Ans. is 'a' i.e., Primary sclerosing cholangitis Features of the Bile Duct Disorders Primary Biliary CirrhosisSecondary Biliary CirhossisPrimary Sclerosing CholangitisCausePossibly autoimmuneBiliary atresia, gallstones, stricture, cancer of pancreatic headAutoimmune, usually associated with inflammatory' bowel diseaseSex predilectionFemale to male ; 6:1NoneFemale to male; 1:2Distributionintrahepatic bile duct obstructionExtrahepatic bile duct obstructionExtra + ntra hepatic duct affectedLab, findingsSame as secondary' biliary cirrhosis with elevated serum IgM anlimstoehondrial antibody| conjugated bilirubin, | serum alkaline phosphatase with increased cholesterolSame as secondary' biliary cirrhosis with hypergammaglobulinemia (|IgM), atypical p-ANCA (+)Histological findingsDense lymphocytic infiltrate in porta! tracts with granulomatous destruction of bile ductsBile stasis in bile ducts, bile ductules proliferation with surrounding neutrophils, portal tract edemaPeriductal portal tract fibrosis (onion skin fibrosis), segmental stenosis of extra and intrahepatic bile ductsAn important feature is Atypical p-ANCA (+) is seen with primary1 sclerosing cholangitis but that this antibody is directed against a nuclear envelope protein and not myeloperoxidase seen with typical p-ANCA antibodies.

So the answer to this question is A


Instruction:
After tonsillectomy, secondary hemorrhage occurs-
A. Within 24 hours
B. After 2 weeks
C. 5-10 post operative days
D. After 1 month

Response:
Delayed complications

Secondary hemorrhage : Usually seen between the 5th to 10th postoperative day. It is the result of sepsis and premature separation of the membrane. Usually, it is heralded by bloodstained sputum but may be profuse.
Infection : Infection of tonsillar fossa may lead to parapharyngeal abscess or otitis media.
Lung complications : Aspiration of blood, mucus or tissue fragments may cause atelectasis or lung abscess.
Scarring in soft palate and pillars.
Tonsillar remnants : Tonsil tags or tissue, left due to inadequate surgery, may get repeatedly infected.
Hypertrophy of lingual tonsil : This is a late complication and is compensatory to loss of palatine tonsils.

So the answer to this question is C


Instruction:
Anemia will be more severe in which of the following endocrine condition?
A. Addison's disease
B. Hypothyroidism
C. Castration
D. Hyperparathyroidism

Response:
Anemia will be more severe in Addison's disease. Hyperparathyroidism may lead to mild anemia due to decreased EPO production. Patients who are hypothyroid or have deficits in pituitary hormones also develop mild anemia. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 850

So the answer to this question is A


Instruction:
Numbness of lip seen with no previous dental treatment
A. Meta static carcinoma
B. Central nervous system lesion
C. Osteomyelitis
D. Infection

Response:
None

So the answer to this question is A


Instruction:
Which of the following is true about Pseudocyst of pancreas
A. Usually occurs after 6 weeks of pancreatitis
B. Cysto gastrectomy is surgery of choice
C. Only occurs after acute pancreatitis
D. All of the above

Response:
Pseudocyst of pancreas is complication of pancreatitis.
Cysto - jeyunostomy is surgery of choice.

So the answer to this question is A


Instruction:
McArdle’s disease is caused due to deficiency of
A. Glucose-6-phosphatase
B. Muscle (Myo) Phosphorylase
C. Lysosomal glucosidase
D. Microsomal Pi transporter

Response:
None

So the answer to this question is B


Instruction:
TRAP positivity is seen with:
A. CML
B. Hairy cell leukemia
C. CLL
D. Follicular lymphoma

Response:
B i.e. Hairy cell leukemiaRef: Robbins Pathology, 9th edition, page 603Explanation:Hairy Cell Leukemia:Rare chronic leukemia that commonly presents with massive splenomegaly, with tumor cells containing hair-like projectionsAlso known as leukemic reticuloendotheliosis*.Clinical:Commonly presents with massive splenomegaly with obliteration of white pulp and involvement of red pulp, pancytopenia (50%), marrow fibrosis, monocytopenia, infections in 1/3.Bone marrow aspiration biopsies unsuccessful ("dry tap'') in 30 - 50% due to marrow fibrosis.Peripheral Smear:Tumor cells are larger than small lymphocytes, modest pale blue a granular cytoplasm with circumferential threadlike extensions seen with phase contrast microscope, round or indented/folded (oval) nuclei, no distinct nucleoli.Bone Marrow:Prominent cell borders ("fried egg appearance") with formalin fixation.Stains:TRAP.B cell markers.CD 11c, CD25, CD103.Annexin A1.

So the answer to this question is B


Instruction:
True statement regarding Barrett's esophagus: September 2011
A. Patient present with severe symptoms
B. Normal pH profile
C. Increased risk of squamous cell carcinoma
D. Metaplastic change in the lining mucosa of the esophagus

Response:
Ans. D: Metaplastic change in the lining mucosa of the esophagusBarrett's esophagus is a metaplastic change in the lining mucosa of the esophagus in response to chronic gastro-esophageal refluxEsophageal cancer:Impoant predisposing factors:- Excess alcohol- Smoking- Chronic achalasia- Tylosis- Barrett's esophagus- Plummer Vinson syndromeFeatures:- Progressive dysphagia (MC)- Weight loss- WeaknessEsophagoscopy is diagnosticChemotherapy:- Limited role- Cisplatin- Bleomycin- 5-FluorouracilMC type: Squamous cell CaMC site: Lower endMC site of adenoCa: Lower end.MC site of squamous cell Ca: Middle third

So the answer to this question is D


Instruction:
The newborn has heart rate of 80 bpm and gasping respiration. What is your next step
A. Positive pressure ventilation with room air.
B. Intubate the newborn.
C. Positive pressure ventilation with 50 % oxygen.
D. Continuous positive airway pressure  with 100% oxygen.

Response:
Apnea, gasping respirations or heart rate < 100 bpm beyond 30 seconds after delivery should prompt administration of positive pressure ventilation with room air.

So the answer to this question is A


Instruction:
Early diagnosis of active hepatitis B Infection is done by:
A. IgM HBcAg antibody
B. HBsAg
C. HBcAg
D. IgE HBsAg antibody

Response:
None

So the answer to this question is A


Instruction:
Leprosy do not involve:
A. CNS
B. Testis
C. Skin
D. Cornea

Response:
A i.e. CNS

So the answer to this question is A


Instruction:
Insulin resistance syndrome includes-a) Dyslipidemiab) Hypertensionc) Hyperuricemiad) High HDL
A. ab
B. a
C. ad
D. bc

Response:
None

So the answer to this question is A


Instruction:
A 14 year old male patient with a retrognathic mandible and darkened facial hair over his short upper lip can be categorized into which stage of adolescent growth?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

Response:
None

So the answer to this question is C


Instruction:
Neointimal hyperplasia causes vascular graft failure as a result of hyperophy of:
A. Endothelial cells
B. Collagen fibers
C. Smooth muscle cells
D. Elastic fibers

Response:
The proliferation of smooth muscle cells is a critical event in the neointimal hyperplastic response. Blockade of smooth muscle cell proliferation resulted in preservation of normal vessel phenotype and function, causing the reduction of neointimal hyperplasia and graft failure. Ref: Advances in End-stage Renal Diseases 2005: International Conference on Dialysis By Claudio Ronco, 2005, Page 30 ; Tissue Engineering: From Lab to Clinic By Norbe Pallua, Christoph V. Suscheck, 2011, Page 280

So the answer to this question is C


Instruction:
Gastrojejunostomy is an example of:
A. Clean contaminated wound
B. Clean uncontaminated wound
C. Unclean uncontaminated wound
D. Unclean contaminated wound

Response:
Surgical Wound Classification According to Degree of Contamination Wound Class Definition Clean An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or infected urinary tract is not entered Wounds are closed primarily and, if necessary, drained with closed drainage Surgical wounds after blunt trauma should be included in this category if they meet the criteria Clean-Contaminated An operative wound in which the respiratory, alimentary, genital, or urinary tract is entered under controlled conditions and without unusual contamination Contaminated Open,fresh, accidental wounds In addition, operations with major breaks in sterile technique or gross spillage from the gastrointestinal tract and incisions in which acute, nonpurulent inflammation is encountered are included in this category Diy Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera This definition suggests that the organisms causing postoperative infection were present in the operative field before the operation Ref: Sabiston 20th editionn Pgno: 245

So the answer to this question is A


Instruction:
BETA-blockers are used in all, EXCEPT
A. Hypertension
B. Thyrotoxicosis
C. Variant angina
D. All of the above

Response:
Ans. is 'c' i.e., Variant angina [Ref: K.D.T. 5th/e page 127\We all know that attacks of variant angina occur due to coronary vasospasm.So, the drugs which relieve coronary vasospasms will used in variant angina (C.C.B.'S, Nitrates) b blockers are contraindicated in these patients because b blockers, instead of dilating the coronary arteries constrict the coronary arteries (due to unopposed a mediated constriction).Remember, b blockers are useful in classical angina. (They cause favourable redistribution of blood)Uses of b blocker: -HypertensionCardiac arrhythmiasMyocardial infarctionEssential tremorCHFGlaucomaDissecting aneurysmHOCMPheochromocytomaThyrotoxicosisAngina pectoris (classical)MigraineAnxiety

So the answer to this question is C


Instruction:
Mass in ear on touch bleeding heavily, cause is:
A. Glomus Jugulare
B. Ca mastoid
C. Acoustic neuroma
D. Angiofibroma

Response:
Ans. A Glomus Jugulare The answer to this question is quite obvious as Glomus tumors are highly vascular tumors and bleed on Touch.

So the answer to this question is A


Instruction:
The ideal colloidal solution is:
A. Dextran
B. Plasma
C. Albumin
D. Hydroxyethyl starch

Response:
None

So the answer to this question is C