Instruction:
A 23-year old patient diagnosed with stage IA malignant ovarian germ cell tumor. Which of the following would be the standard treatment-
A. Unilateral oophorectomy
B. Bilateral oophorectomy and hysterectomy
C. Unilateral oophorectomy followed by chemotherapy
D. Ovarian biopsy followed by chemotherapy

Response:
Approximately 50% to 70% of Germ cell malignancies are stage 1. Since she is a young patient, Feility-sparing surgery ( USO ) is done Almost All germ cell malignancies require Postoperative Chemotherapy.

So the answer to this question is C


Instruction:
Mizou-Nakamura phenomenon in fundus is seen in:
A. Congenital rod absence
B. Congenital stationary night blindness
C. Congential cone defect
D. Best disease

Response:
Congenital stationary night blindness(CSNB) Infantile onset nyctalopia with non progressive retinal dysfunction. Fundus appearance can be normal or abnormal. CSNB with abnormal appearing fundus is known as Oguchi disease. The fundus in oguchi disease is unusual golden yellow in color in light adapted state which becomes normal in color after prolong dark adaptation. This phenomena is known as Mizou-Nakamura phenomena.

So the answer to this question is B


Instruction:
A female presents with persistent painful oral lesions, with acantholytic cells. Most likely diagnosis is –
A. Pemphigus vulgaris
B. Dermatitis herpetiformis
C. Epidermolysis bullosa
D. Bullous pemphigoid

Response:
Painful oral lesion with acantholysis suggests pemphigus vulgaris.

So the answer to this question is A


Instruction:
Drug used to perform stress ECHO –
A. Thallium
B. Dobutamine
C. Adrenaline
D. Adenosine

Response:
Stress echocardiography is done either by Physical stress (Exercise :- treadmill or cycling) or by pharmacological stress (dobutamine).

So the answer to this question is B


Instruction:
Normal weight of term placenta in gms -
A. 300
B. 500
C. 700
D. 1000

Response:
Ans. is 'b' i.e., 500 "The placenta at term is almost circular disk with a diameter ofl5-20cms & thickness of about 3 cms at its centre5. It thins towards the edge. It feels spongy & weighs about 500gmsf the proportion of the weight of the baby being roughly 1:6 at term and occupies the 30% of the uterine wall "

So the answer to this question is B


Instruction:
A feature of Renal vasculitis in children is -
A. IgA raised
B. Antinuclear antibody in serum
C. Low complement level
D. Cytoplasmic antinuclear Ab in serum

Response:
None

So the answer to this question is A


Instruction:
A teenage girl complained about increased growth of facial hair. Her menstrual cycle is regular and she has normal body weight. Following may be used in treatment of hirsutism, EXCEPT:
A. Spironolactone
B. Flutamide
C. Cyproterone
D. Mifepristone

Response:
Mifepristone does not used for hirsutism. Spironolactone is an aldosterone antagonist. It possesses anti androgenic propeies and exes its peripheral antiandrogenic effects in the hair follicle by competing for androgenic receptors and displacing dihydrotestosterone at both nuclear and cytosol receptors. Flutamide is a potent, highly specific, nonsteroidal antiandrogen with no intrinsic hormonal or anti gonadotropic activity. Although the exact mechanism of action is unknown, it competitively inhibits target tissue androgen receptor sites. Cyproterone acetate is the an androgen receptor antagonist. Antiandrogenic effects result from competitive displacement of dihydrotestosterone from its receptor and reduction of 5-reductase activity in the skin. Ref: Guess M.K., Andrew D.E., Gagliardi C.L., Emmi A.M. (2007). Chapter 57. Hirsutism. In A.H. DeCherney, L. Nathan (Eds), CURRENT Diagnosis & Treatment Obstetrics & Gynecology, 10e.

So the answer to this question is D


Instruction:
Cirrhotic ascites has all the features except(NOT RELATED-SURGERY)
A. Straw colour
B. Specific gravity < 1060
C. Leucocyte count < 200/cu mm
D. Serum ascitic albumin gradient <1

Response:
Serum-ascites albumin gradient g/dl > 1.1 in ascitic fluid caused by cirrhosis

So the answer to this question is D


Instruction:
Which of the following weakest phase of the set amalgam:
A. Beta-2
B. Gamma
C. Gamma-1
D. Gamma-2

Response:
None

So the answer to this question is D


Instruction:
Lesion at which pa of visual pathway causes homonymous hemianopia?
A. Optic tract
B. Optic nerve
C. Optic Chiasma
D. Retina

Response:
A left homonymous hemianopsia can be caused by a lesion in the right optic tract or the right side of the brain. With a tract lesion, the pupillary reflex is lost if light is only projected from the blind hemifield; the pupil reacts when the lesion is posterior to the geniculate body in the optic radiations or occipital lobe. Transient homonymous hemianopsia may occur with migraine. Ref: LeBlond R.F., DeGowin R.L., Brown D.D. (2009). Chapter 7. The Head and Neck. In R.F. LeBlond, R.L. DeGowin, D.D. Brown (Eds), DeGowin's Diagnostic Examination, 9e.

So the answer to this question is A


Instruction:
Most common malignant tumour in childhood:
A. Rhabdomyosarcoma
B. Leukaemia
C. Lymphangioma
D. Neuroblastoma

Response:
(Leukemia) (561-G) (580 -Ghai 7th)* Leukemia is most common form of childhood malignancy* Descending order - Leukemia > Brain tumour > Lymphoma > Neuroblastoma > Wilm's tumour > Soft tissue sarcoma.* Most common cancer in children (1686-Nelson 17th)* Lymphohematopoietic (44%) > Nervous system (29%) > Embryoral (12%0 > Connective tissue (10%)

So the answer to this question is B


Instruction:
Which of these does not change or remains same throughout life
A. Salmon patch
B. Strawberry angiomas
C. Portwine stain
D. Capillary hemangiomas

Response:
None

So the answer to this question is C


Instruction:
Torus aoicus is
A. Bulge in the atria
B. Bulge in aoa
C. Aoic wall tear
D. Septal defect

Response:
Torus aoicus is a bulge in the atria . Ref - medscape.com

So the answer to this question is A


Instruction:
Post term baby with tachypnea - commonest cause?
A. Transient tachypnea of newborn
B. Meconium aspiration syndrome
C. Hyaline membrane disease
D. Infection

Response:
Ans. is 'b' i.e., meconium aspiration syndrome Transient Tachypnea of the Newborn Transient tachypnea of the newborn is the most common cause of neonatal respiratory distress, constituting more than 40 percent of cases.1 A benign condition, it occurs when residual pulmonary fluid remains in fetal lung tissue after delivery o Respiratory Distress Syndrome Respiratory distress syndrome of the newborn, also called hyaline membrane disease, is the most common cause of respiratory distress in premature infants Immature type II alveolar cells produce less surfactant, causing an increase in alveolar surface tension and a decrease in compliant Meconium Aspiration Syndrome Meconium-stained amniotic fluid occurs in approximately 15 percent of deliveries, causing meconium aspiration syndrome in the infant in 10 to 15 percent of those cases, typically in term and post-term infants Infection Bacterial infection is another possible cause of neonatal respiratory distress. Common pathogens include group B streptococci (GBS), Staphylococcus aureus, Streptococcus pneumoniae, and gram-negative enteric rods. Pneumonia and sepsis have various manifestations, including the typical signs of distress as well as temperature instability

So the answer to this question is B


Instruction:
Under eradication of congenital rubella syndrome progarmme the first priority group for rubella vaccination is-
A. All non pregnant women of age 15-34
B. All adolescent non pregnant girls 15 to 24 years of age
C. All female children at one year
D. All non pregnant women

Response:
The priorities being first to protect women of child-bearing age (15-34 yrs of age) Then to interrupt transmission of rubella by vaccinating all children currently aged 1-14 yrs And subsequently all children at one year of age. Ref:PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition , Page:151

So the answer to this question is A


Instruction:
The coronary sinus -
A. Lies in anterior part of the coronary sulcus
B. Ends in right atrium
C. Has venae cordis minimae as its tributaries
D. Develops from right anterior cardinal vein

Response:
Development of coronary sinus is from the body and left horn of sinus venosus. It lies in the posterior part of the coronary sulcus and drains into the right atrium. Though the besian veins/ venae cordis minimae drain directly into the right atrium, the the besian valves are guarding the opening of coronary sinus into the right atrium.

So the answer to this question is B


Instruction:
Quetelet&;s index used to assess obesity, is represented as -
A. Weight di vided by Height
B. Height divided by weight
C. Weight divided by square of Height
D. Height divided by square of weight

Response:
Ans, is 'c' i.e., Weight divided by the square of Height Different indices use to determine obesity are : Body mass index, Quetelet's index - FAO/WHO recommends it's use internationally as reference stand-ard for assessing the prevalence of obesity in a community. Wt (kg) BMI = -------------------------- Ht2 (m) Height (cm) Ponderal index = -------------------------------- Cube root of body wt (kg) Broca index = Height (cm) - 100 Simplest index Actual weight Corpulence index = -------------------------- Desirable weight o This should not exceed 1[?]2 Ht (cm) - 150 Lorentz's formula = Ht(cm)-100 ------------------------ 2 (Female) or 4 (Male)

So the answer to this question is C


Instruction:
The following is a pro-apoptic factor
A. Bax
B. Bcl-2
C. Bcl-xL
D. Mci-1

Response:
Ans. (a) Bax (Ref: Robbins 9th/pg 55; 8th/pg 28)Proapoptotic: Apafl, cytochrome c, Bak, Bax, Bim, AIF, P53, Caspases, CD95 (FAS), TNF R1 and Smac/DiabloAntiapoptotic: Bcl2,BclxL ,Bclx ,FLIP,McL-1,IAP

So the answer to this question is A


Instruction:
The function of Phospholamban is
A. Regulates Na+ K+ pump
B. Transports calcium out of the mitrochondria
C. Binds actin with myosin
D. Inhibits Ca++ pump on sarcoplasmic reticulum

Response:
Phospholamban inhibits calcium pump on sarcoplasmic reticulum, thereby preventing uptake of Ca++ from the sarcoplasm.
When it is phosphorylated, the Ca++ channels open up and uptake of Ca++ is increased into the sarcoplasmic reticulum.

So the answer to this question is D


Instruction:
Bannwah's syndrome develops secondary to infection with
A. B. burgdorferi
B. T. pallidum
C. B.cereus
D. afragilis

Response:
Answer- B. T. pallidumIt is also called neuroborrelisosis.It is secondary to infection with B. burgdorferi.Meningeal irritation may develop early in Lyme disease when erphema migrans is present.untreated patients develop frank neurologic abnormalities, including meningitis,subtle encephalitic signs, cranial neuritis (including bilateral facial palsy), motor or sensory radiculoneuropathy, peripheral neuropathy, mononeuritis multiplex, cerebellar ataxia, or myelitis.In Europe and Asia, the first neurologic sign is characteristically radicular pain, which is followed by the development of CSF pleocytosis (called meningopolyneuritis, or Bannwah's syndrome ); meningeal or encephalitic signs are frequently absent.

So the answer to this question is B


Instruction:
Which of the following is a remnant of ductus aeriosus?
A. Ligamentum aeriosum
B. Ligamentum teres
C. Both of the above
D. None of the above

Response:
On the right, when the distal pa of the sixth aoic arch and the fifth aoic arch disappear, the recurrent laryngeal nerve moves up and hooks around the right subclan aery. On the left, the nerve does not move up, since the distal pa of the sixth aoic arch persists as the ductus aeriosus, which later forms the ligamentum aeriosum Ref: Langman's embryology 11th edition Chapter 12.

So the answer to this question is A


Instruction:
Which among the following is not true about Octreotide?
A. Somatostatin analogue
B. Used in secretory diarrhea in AIDS
C. Used in carcinoid
D. An absorbent

Response:
Octreotide is an octapeptide analog of somatostatin (SST) that is effective in inhibiting the severe secretory diarrhea brought about by hormone-secreting tumors of the pancreas and the GI tract. Its mechanism of action appears to involve inhibition of hormone secretion, including 5-HT and various other GI peptides (e.g., gastrin, vasoactive intestinal polypeptide (VIP), insulin, secretin, etc.). Octreotide has been used off label, with varying success, in other forms of secretory diarrhea such as chemotherapy-induced diarrhea, diarrhea associated with human immunodeficiency virus (HIV), and diabetes-associated diarrhea. Its greatest utility, however, may be in the "dumping syndrome" seen in some patients after gastric surgery and pyloroplasty. A long-acting preparation of octreotide acetate enclosed in biodegradable microspheres is available for use in the treatment of diarrheas associated with carcinoid tumors and VIP-secreting tumors, as well as in the treatment of acromegaly. Ref :Sharkey K.A., Wallace J.L. (2011). Chapter 46. Treatment of Disorders of Bowel Motility and Water Flux; Anti-Emetics; Agents Used in Biliary and Pancreatic Disease. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

So the answer to this question is D


Instruction:
In the normal human right eye, the peripheral field of vision is usually least:
A. On the left side (nasally)
B. In the downward direction
C. In the upward direction
D. On the right side (temporally)

Response:
The field of vision is 50 degree superiorly, 60 degree nasally, 70 degree inferiorly and 90 degree temporally. Ref: Textbook of Ophthalmology By Nema, 3rd Edition, Page 73; Comprehensive Ophthalmology By AK Khurana, 2nd Edition, Page 37

So the answer to this question is C


Instruction:
Which type of neurological defect is seen in a fetus of diabetic mother ?
A. Caudal regression
B. Neural tube defect
C. Anencephaly
D. All of the above

Response:
Major bih defects seen in infants of diabetic mothers: CNS & skeletal: Neural tube defects, anencephaly, microcephaly, sacral agenesis Cardiac: VSD, ASD, coarctation of aoa, transposition of great vessels, cardiomegaly Renal: Renal agenesis, hydronephrosis, ureteral duplication Gastrointestinal: Duodenal atresia, anorectal atresia Others: Single umbilical aery

So the answer to this question is D


Instruction:
All of the following cells are present in cerebellum, EXCEPT?
A. Purkinje cells
B. Stellate cells
C. Pyramidal cells
D. Basket cells

Response:
The pyramidal cells are seen in cerebral coex. The coex of the cerebellum consists of only three layers. They are, (1) an outer, molecular layer, (2) a middle, Purkinje layer, and (3) an inner, granular layer. The molecular layer has the least cellular density and consists of two types of neurons, stellate cells and basket cells. The stellate cells have relatively sho dendrites and basket cells have more extensive dendritic processes. Purkinje layer is relatively thin but consists of the densely packed cell bodies of the Purkinje cells. These cell bodies are the largest in the cerebellum and, with their unique dendritic trees, are probably the most distinctive cells in the entire CNS. Granular layer consists of the cell bodies of the very densely packed granular cells and Golgi type II cells.

So the answer to this question is C


Instruction:
False about GG drill is
A. NO. 4 is 1.1 mm in size
B. Operated at 750-1500 rpm
C. Used for coronal flaring of root canal
D. Used for preparing post space

Response:
None

So the answer to this question is D


Instruction:
Drug used in the treatment of Congestive Heart Failure is
A. ACE inhibitor
B. Beta blocker
C. Art blocker
D. All the above

Response:
(D) All the above# First-line therapy for all heart failure patients is angiotensin-converting enzyme (ACE) inhibition. ACE inhibitors (i.e., enalapril, captopril, lisinopril, ramipril) improve survival and quality of life. If the patient is intolerant to ACEI they are replaced by ARB's.> Diuretics have been a mainstay of treatment for treatment of fluid accumulation, and include classes of diuretics such as loop diuretics, thiazide-like diuretic, and potassium-sparing diuretic.> Beta blockers are not given in acute heart failure as it exaggerates heart failure but given in chronic management, bisoprolol, carvedilol, metoprolol are usually used.

So the answer to this question is D


Instruction:
Study of designing equipment and devices that fit the human body, it&;s movements and it&;s cognitive abilities is
A. Economics
B. Ergonomics
C. Bionomics
D. Socionomics

Response:
Study of designing equipment and devices that fit the human body, it&;s movements and its cognitive abilities is ergonomics The object of ergonomics is " to achieve the best mutual adjustment of man and his work, for the improvement of human efficiency and well-being"Park 23e pg: 803

So the answer to this question is B


Instruction:
'Boiled lobster' appearance is seen in poisoning with: DNB 08
A. Carbolic acid
B. Boric acid
C. Oxalic acid
D. H2SO4 poisoning

Response:
Ans. Boric acid

So the answer to this question is B


Instruction:
Bile acid has a detergent action due to
A. Formation of soap
B. Formation of zwitter ion
C. Amphipathic in nature
D. Formation of medium chain triglycerides

Response:
Bile contains bile acids, which are critical for digestion and absorption of fats and fat-soluble vitamins in the small intestine. Many waste products, including bilirubin, are eliminated from the body by secretion into bile and elimination in feces. Ref: guyton and hall textbook of medical physiology 12 edition page number:437,438,439

So the answer to this question is C


Instruction:
Radioprotective drug(s) is/are :
A. Amifostine
B. Cyclophosphamide
C. Methotrexate
D. Paditaxe!

Response:
Ans: A (Amifostine) Radio Protective DrugsAmifostine (VVR 2721} has free SH group which scavenge the free radicals produced due to radio therapy.Free radical scavenger agents such as sulphydryl - containing compounds tend to make cells more resistant. They have also been shown to reduce chromosome abnormalities associated with radiation. This suggests a potential use in reducing treatment induced cancers. The thiol containing drug amifostine (WR 2721) is the best studied drug of this type. Randomized trial has shown that amifostine reduce treatment related toxicities, including radiation induced parotid damage (xerostmia) & dsplatin induced nephrotoxicity' - Devita 7th/ 275Also used for reducing S/E of radiomimeticdrug (dsplatin)Antiradiation agent for astonanats.Radioprotective agents are -* Amifostine (WR 2721)* IL-1* Zinc Oxide* GM-CSF* Pentoxyphyiline* Etramustine* Chlorhexidine* KI* Melatonin* Antioxidant (vit C, E, A)Factors | RadiosensitivityHypoxic environmentSlow or no divisionS-phase of cell cycleRadiation protectors (Amifostine)Chemotherapeutic agents are radiosensitizer not radioprotecter

So the answer to this question is A


Instruction:
Raised AFP is typically seen in -a)  Hepatitisb)  Serninomac)  HCCd)  All of the above
A. a
B. ac
C. ad
D. b

Response:
None

So the answer to this question is B


Instruction:
Premature ovarian insufficiency is defined as hypogonadotropic hypogonadism and amenorrhea arising before the age of
A. 40 years
B. 45 years
C. 50 years
D. 55 years

Response:
Premature ovarian failure (POF), traditionally defined as hypogonadotropic hypogonadism and amenorrhea arising before the age of 40.Reference: Clinical gynecologic endocrinology; 10th edition; Chapter 9; Normal and Abnormal Sexual Development; Page no: 463

So the answer to this question is A


Instruction:
Treatment of acute neuritis in lepra I reaction is all except
A. Dapsone
B. Steroid
C. Thalidomide
D. Incision and drainage

Response:
Thalidomide has no role in Type 1 reaction.
Glucocorticoids are given with antileprotic drugs (Dapson) for neuritis.

If neuritis results in formation of nerve abscess, incision and drainage is the treatment of choice

So the answer to this question is C


Instruction:
Gross feility rate is ?
A. Number of children a women has during reproductive period
B. Number of female children a woman has during reproductive period
C. Number of male children a woman has during reproductive period
D. Total number of live bih per 1000 women 1544 years age

Response:
Ans. is 'b' i.e., Number of female children a woman has during reproductive period Gross reproduction rate (GRR) : Average number of girls that would be born to a married woman if she experiences the current feility pattern throughout her reproductive span (15-44 or 49 year) assuming no moality.

So the answer to this question is B


Instruction:
Oculo-orogenital syndrome is a feature of
A. Behcet's disease
B. Lichen planus
C. SLE
D. Psoriasis

Response:
Ans. a. Behcet's diseaseBehcet's SyndromeClinical features of Behcet's diseaseRecurrence painful aphthous oral ulcersRecurrent painful genital ulcers leading to scarsOcular involvement: Posterior and Anterior uveitis, glaucoma, cataractOther manifestations: Arthritis, thrombophlebitis, Erythema nodosum with renal, cardiac and pulmonary manifestationsTreatmentSymptomatic managementSevere cases-corticosteroids, Dapsone, colchicine, thalidomide

So the answer to this question is A


Instruction:
Stripping naked a female patient for medical examination is punishable under
A. S. 228 A IPC
B. S. 354 IPC
C. S.354 C IPC
D. S.493 IPC

Response:
S. 228 A IPC - PRINTING OR PUBLISHING THE IDENTITY OF SEXUAL ASSAULT VICTIM S. 354 IPC - INDECENT ASSAULT S.354 C IPC - VOYEURISM S.493 IPC - COHABITATION

So the answer to this question is B


Instruction:
Nocturnal pruritis ani is characteristic of
A. Ascaris
B. Trichuris
C. Ancylostoma
D. Enterobius

Response:
Species Disease Form/Transmission Diagnosis Treatment Enterobius vermicularis PinwormLarge intestine,nocturnal perianalitching Eggs/person to personAutoinfection ** Cellophane tape prep of perianal area** Ova have flattened sidewith larvae inside Pyrantel, albendazoleTreat entire family Ref : Paniker's textbook of Medical Parasitology Pgno : 190-194

So the answer to this question is D


Instruction:
High serum uric acid, high serum phosphates and high serum creatinine in a patient will be observed in-
A. Chronic lymphocytic leukemia
B. Obstructive jaundice
C. Status epilepticus
D. Typhoid

Response:
Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed adult leukemia in the USA and Western Europe. Kidney disease can present in patients with CLL as a manifestation of the disease process such as acute kidney injury with infiltration or with a paraneoplastic glomerular disease or as a manifestation of extra renal obstruction and tumor lysis syndrome. In the current era of novel targeted therapies, kidney disease resulting high serum creatinine ,uric acide andphospates can also present as a complication of treatment. Tumor lysis syndrome associated with novel agents such as the B-cell lymphoma 2 inhibitor venetoclax and the monoclonal antibody obinutuzumab are impoant nephrotoxicities associated with these agents. Here we review the various forms of kidney diseases associated with CLL and its therapies. Ref Davidson 23rd edition pg 1313

So the answer to this question is A


Instruction:
Sulcus bleeding index measures:
A. Gingivitis
B. Dental plaque
C. Gingival bleeding
D. Gingival recession

Response:
None

So the answer to this question is C


Instruction:
True about measles
A. Rash appear first on leg
B. Koplik spots are seen in retina
C. Long term complication follows in form of SSPE
D. Caused by DNA virus

Response:
Complications of measles are otitis media ,bacterial bronchopneumonia,respiratory complications like laryngitis, tracheitis ,bronchitis, giant cell pneumonia and bronchiectasis,GI complications like diarrhea ,appendicitis ,hepatitis, ileocolitis,acute encephalitis. Post measles encephalitis may occur after recovery. Fatal subacute sclerosing panecephalitis (SSPE)may occur after several yrs of infection. Koplik spots appear opposite the lower second molar of buccal mucosa on second or third day of illness. Rash appear first behind ear,along hairline and on posterior aspect of cheek. Image : Measles causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet. Reference: Essential pediatrics,op ghai,9 th edition,pg no:209& 210

So the answer to this question is C


Instruction:
New infectious agents are -
A. Nipah virus
B. Pneumocystis jieruveci
C. Corona virus
D. SARS

Response:
A new genus Henipavirus has been recently identified with the Nipah and Henda viruses causing zoonotic outbreaks. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:515

So the answer to this question is A


Instruction:
All of the following are indications for eicosanoids or their inhibitors EXCEPT :
A. Abortion
B. Essential hypertension
C. Patent ductus arteriosus
D. Transposition of the great arteries

Response:
None

So the answer to this question is B


Instruction:
Most common type of shock in surgical practice:-
A. Cardiogenic
B. Hypovolemic
C. Neurogenic
D. Septic shock

Response:
Most common type of shock in surgical practice is hypovolemic shock. HYPOVOLEMIC SHOCK Causes of hypovolemic shock: Blood lossQ(Trauma, bleeding) Loss of plasma due to extravascular fluid sequestration in burnsQ Loss of body sodium & water (diarrhea & vomitingQ)

So the answer to this question is B


Instruction:
Calcification of Posterior Longitudnal Ligament is best diagnosed by
A. X-Ray
B. CT
C. MRI
D. PET

Response:
* Calcifications are best seen on CT Scan images. * Calcification of Posterior Longitudnal Ligament is (OPLL) Ossified Posterior Longitudnal Ligament and was traditionally considered more frequent in Japan and common in cervical spine Figure: Illustration of OPLL Figure: OPLL On plain film Figure: OPLL on sagittal CT scan Calcification of Posterior Longitudnal Ligament is also known as Japan's Disease.

So the answer to this question is B


Instruction:
Irresistible urge to do a thing repeatedly is seen in
A. Obsessive - compulsive disorder
B. Schizophrenia
C. Schizoaffective disorder
D. Depression

Response:
An obsession is defined as an idea, impulse or image which intrudes into the conscious awareness repeatedly, patient tries to resist against it but is unable to . an obsession is usually associated with compulsion and a compulsion is defined as a form of behaviour which usually follows obsessions,the behaviour is not realistic and is either irrational or excessive compulsion may diminish the anxiety associated with obsession (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no 95)

So the answer to this question is A


Instruction:
In run-over accidents the following type of laceration is commonly seen:
A. Split
B. Cut
C. Avulsion
D. Stretch

Response:
In run over accidents, avulsion is seen AVULSION : - It is produced by shearing force delivered at tangential angle to tear off a poion of traumatized skin surface from their attachment. - In run over accidents, avulsion / flaying/ flapping is seen in which flap laid tells us about the direction of force. Split laceration : It occurs due to crushing of the skin in between two hard objects . Stretch laceration : It is due to over stretching of skin. It is seen in case of open fracture. Tear laceration: tearing (of skin or subcutaeus tissue) can occur due to localized impact by some hard and irregular object Cut lacerations: it can occur by a heavy sharp edged weapon which causes a deep and wide cut over the body tissues.

So the answer to this question is C


Instruction:
Which of the following is NOT a pa of hypopharynx
A. Pyriform sinus
B. Post cricoid region
C. Anterior pharyngeal wall
D. Posterior pharyngeal wall

Response:
HYPOPHARYNX or (LARYNGOPHARYNX) Clinically, hypopharynx is subdivided into three regions--the pyriform sinus, postcricoid region and the posterior pharyngeal wall. 1. Pyriform sinus (fossa):- It lies on either side of the larynx and extends from pharyngoepiglottic fold to the upper end of oesophagus. It is bounded laterally by the thyrohyoid membrane and the thyroid cailage and medially by the aryepiglottic fold, posterolateral surfaces of arytenoid and cricoid cailages. It forms the lateral channel for food. Foreign bodies may lodge in the pyriform fossa. Internal laryngeal nerve runs submucosally in the lateral wall of the sinus and thus is easily accessible for local anaesthesia. It is also through this nerve that pain is referred to the ear in carcinoma of the pyriform sinus. 2. Postcricoid region:- It is the pa of the anterior wall of laryngopharynx between the upper and lower borders of cricoid lamina. It is a common site for carcinoma in females suffering from Plummer-Vinson syndrome. 3. Posterior pharyngeal wall:- It extends from the level of hyoid bone to the level of cricoarytenoid joint. Ref:- Dhingra; pg num:-241

So the answer to this question is C


Instruction:
What is the approximate size of miRNA molecules produced by Dicer nuclease?
A. 11 bp
B. 22 bp
C. 56 bp
D. 75 bp

Response:
MicroRNAs : Small (22 nucleotides long) Endogenous, Non-coding RNAs Involved in regulation of gene expression by post-transcriptional gene silencing (PTGS)/RNA interference. Dicer is an endonuclease that trims small double-stranded RNA and generates sho, double stranded (ds) miRNA molecules that can block translation. Dicer cleaves the cytosolic dsRNA encoded by the genome or exogenously supplied into oligonucleotides miRNA or siRNA A single strand (the guide or antisense strand) of the ds miRNA associates with RNA-induced silencing complex, or RISC.

So the answer to this question is B


Instruction:
Angular pregnancy refers to:
A. Ectopic pregnancy of Interstitial pa of FT
B. Intrauterine pregnancy
C. Heterotopic pregnancy
D. Ectopic pregnancy of broad ligament

Response:
Angular pregnancy : It is defined as pregnancy implanted in one of the lateral angles of uterine cavity It may progress to term Ref: Dutta Obs 9e pg 168.

So the answer to this question is B


Instruction:
Permanent retainer is sometimes needed in cases of:
A. Severe malocclusion
B. Anterior cross bite
C. Severe rotations
D. Transposition

Response:
None

So the answer to this question is C


Instruction:
All arc true about Wiskott-Aldrich syndrome exccpt-
A. Bloody diarrhea during infancy
B. Low IgM and elevated IgA and IgE
C. Large size platelets
D. Atopic dermatitis

Response:
Wiskott-Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia). The microthrombocytes seen in WAS patients have only been observed in one other condition, ARPC1B deficiency. In both conditions the defective platelets are thought to be removed from circulation by the spleen and/or liver, leading to low platelet counts. WAS patients have increased susceptibility to infections, paicularly of the ears and sinuses, and this immune deficiency has been linked to decreased antibody production and the inability of immune T cells to effectively combat infection. Genetics WAS is associated with mutations in a gene on the sho arm of the X chromosome (Xp11.23) that was originally termed the Wiskott-Aldrich syndrome protein gene and is officially known as WAS (Gene ID: 7454).X-linked thrombocytopenia is also linked to WAS mutations, although they differ from those that cause full-blown WAS. The rare disorder X-linked neutropenia has also been linked to a specific subset of WAS mutations. The protein product of WAS is known as WASp. It contains 502 amino acids and is mainly expressed in hematopoietic cells (the cells in the bone marrow that develop into blood cells). The main function of WASp is to activate actin polymerization by serving as a nucleation-promoting factor (NPF) for the Arp2/3 complex, which generates branched actin filaments. Several proteins can serve as NPFs, and it has been observed that in WAS platelets the Arp2/3 complex functions normally, indicating that WASp is not required for its activation in platelets. In T-cells, WASp is impoant because it is known to be activated T-cell receptor signaling pathways to induce coical actin cytoskeleton rearrangements that are responsible for forming the immunological synapse. The severity of the symptoms produced by WAS mutations correlate with their effects on WASp. Alleles that produce no or truncated protein have more severe effects than missense mutations. Although autoimmune disease and malignancy may occur with both types of mutations, patients with truncated WASp carry a higher risk. A defect in the CD43 molecule has also been found in WAS patients. Ref Davidson 23rd edition pg 936

So the answer to this question is C


Instruction:
Eisenmenger syndrome-True are All except ?
A. Pulmonary veins are not distended
B. RV & LV walls come back to normal size
C. Dilatation of central pulmonary aery
D. Peripheral pruning of pulmonary aeries

Response:
Eisenmenger syndrome right ventricle has concentric hyperophy. Ref : Ghai essential of pediatrics, eighth edition, p.no:428

So the answer to this question is B


Instruction:
Gamma knife is used in?
A. Radiotherapy
B. Chemotherapy
C. Nuclear medicine
D. Radioisotope scan

Response:
ANSWER: (A) RadiotherapyREF: Practical Radiotherapy physics and equipment Pam Cherry Angela M. Duxbury 2nd Edition page 132, http://en.wikipedia.org/wiki/RadiosurgeryRadiosurgery is a medical procedure that allows non-invasive treatment of benign and malignant tumors. It is also known as stereotactic radiotherapy, (SRT) when used to target lesions in the brain, and stereotactic body radiotherapy (SBRT) when used to target lesions in the body. Inaddition to cancer, it has also been shown to be beneficial for the treatment of some non-cancerous conditions, including functional disorders such as arteriovenous malformations (AVMs) and trigeminal neuralgia.

So the answer to this question is A


Instruction:
Birbeck granules are seen in the cytoplasm of
A. Mast cells
B. Langerhans cells
C. Thrombocytes
D. Myelocytes

Response:
Langerhans cell histiocytosis (LCH)*Langerhans cell is a dendritic cell which is an antigen presenting cell*LCH is a clonal histiocytic disorder*Birbeck granules are present in the cytoplasm of Langerhans cell.Characteristic features of LCHPresence of Birbeck granules - Electron microscopy ( Tennis racquet appearance)Presence of enzymes like 1. a- Naphthyl Acetate Esterase 2. a- Naphthyl Butyrate Esterase 3. Acid phosphatasePresence of markers S-100, CD1a positivity HLA- DR expressionThree clinicopathological entities1.Acute disseminated LCH2.Multifocal LCH3.Unifocal LCH *Earlier Histiocytosis x term was used. This includes-Letterer-Siwe disease (generalized disease)-Hand - Schuller- Christian disease-Eosinophilic granuloma (localized lesion) However now the term LCH is preferred.Acute disseminated LCH ( Letterer- Siwe disease) - Affects children < 2 yrs-Seborrhoeic type of skin rash on front & back of trunk and scalp-Moderate hepatomegaly-Few palpable lymph nodes-Pulmonary lesions- uncommon-Bone- Lytic lesions (> 80%)-Moderate degree fever-Otitis media & mastoiditis may be seen-CNS involvement due to contiguous spread-Hematologic findings: Pancytopenia-Bone marrow: Infiltration by histiocytesMultifocal LCH - Multiple lesion involving multiple systems-Prognosis better than disseminated LCH-Fever & rash-Involvement of posterior pituitary- Diabetes insipidus-Typical Hand- Schuller Christian disease= Triad of exopthalmus+ diabetes insipidus+ calvarial defectUnifocal LCH*Focal lytic lesion in bone*Excellent prognosis(Ref: Robbins 8/e p631, 7/e p701, 702)

So the answer to this question is B


Instruction:
Charcoat triad is seen in: September 2006
A. Acute pancreatitis
B. Acute appendicitis
C. Acute hepatitis
D. Cholangitis

Response:
Ans. D: Cholangitis Cholangitis is due to paial or complete obstruction of the biliary tree with resulting bile stasis and secondary bacterial or microbial infection of the biliary tree Causes ? Common bile duct stones Benign biliary stricture (primary sclerosing cholangitis) Malignancy (head of pancreas adenocarcinoma, ampulla of Vater, bile duct tumors) Chronic pancreatitis Prosthesis or stents in the common bile duct Features: Charcot's triad - right upper quadrant pain, fever, jaundice Reynolds' pentad - right upper quadrant pain, fever, jaundice, hypotension, and mental status changes (delirium, anxiety, and coma) Nausea and/or vomiting Right upper quadrant tenderness (mild to moderate)

So the answer to this question is D


Instruction:
Dupuytren's contracture mvolves-
A. Dorsal fascia
B. Palmar fascia
C. Ulnar bursa
D. Radial bursa

Response:
Ans. is 'b' i.e., Palmar fascia o Dupuytren's contracture is characterized in the established phase by flexion contracture of one or more fingers from thickening and shortening of palmar aponeurosis.o The exact etiology is unknow; However, the condition is more commonly associated with following conditionsi) Epileptics taking phenytoiniv) Alcoholic cirrhosisii) Diabetesv) AIDSiii) Smokingvi) Pulmonary TB o Often both hands are affected (Bilateral disease), one more than the other,o The earliest sign is a small thickened nodule in the mid-palm opposite the base of ring finger,o Gradually this extends distally to involve the ring or little finger.o There is a rare, curious association with fibrosis of the corpus Cavemosum.

So the answer to this question is B


Instruction:
A well-defined focal lesion in the cone of extraocular muscles of the eye with proptosis in a child. The diagnosis will be?
A. Cavernous hemangioma
B. Hemangioendothelioma
C. Capillary angioma
D. Retinoblastoma

Response:
Cavernous haemangioma is the commonest benign orbital tumour among adults. A tumour is usually located in the retrobulbar muscle cone. So, it presents as a slowly progressing unilateral axial proptosis in the second to fouh decade. It may occasionally compress the optic nerve without causing proptosis. Treatment. Surgical excision of a tumour is undeaken lateral orbitotomy approach. Since a tumour is well encapsulated, complete removal is generally possible. REFKhurana 4e pg: 394

So the answer to this question is A


Instruction:
Hydrogen peroxide is used in all of the following chemical tests for blood except:
A. Benzedine test
B. Phenophthalein test
C. Ohotoluidine test
D. Teichmann's test

Response:
D i.e. Teichman's test

So the answer to this question is D


Instruction:
Intestinal anastamosis strength provided by:
A. Mucosa
B. Submucosa
C. Serosa
D. Muscularis mucosa

Response:
Ref: American College of Surgeons text hook of Surgery, 6th edition. Chapter on Intestinal Anastamosis.Explanation:Strongest component of bowel wall is submucosa. due to the presence of collagen.The process of intestinal anastomotic healing mimics that of wound healing elsewhere in the bodyIt can be arbitrarily divided into an- Acute inflammatory (lag) phase- A proliferative phase- A remodeling or maturation phase.The strongest component of the bow el wall, the submucosa, owes most of its strength to the collagenous connective tissue it contains.Collagen is thus the single most important molecule for b. which makes its metabolism of particular interest for understanding anastomotic healing.Principles of Successful Intestinal Anastomosis* Well-nourished patient with no systemic illness* No fecal contamination, either within the gut or in the surrounding peritoneal cavity* Adequate exposure and access* Well - vaseu1arized tissues* Absence of tension at the anastomosis* Meticulous technique

So the answer to this question is B


Instruction:
Pseudotrichiasis is seen in:
A. Entropion
B. Ectropion
C. Distichiasis
D. Healed membranous conjunctivitis

Response:
Ans. Entropion

So the answer to this question is A


Instruction:
Radiological hallmark of primary tuberculosis in childhood is?
A. Ghon's focus
B. Normal chest Xray
C. Lymphadenopathy
D. Pleural effusion

Response:
Ans. is 'c' i.e., Lymphadenopathy Lymphadenopathy with or without parenchymal abnormality is the radiological hallmark of primary tuberculosis in childhood.

So the answer to this question is C


Instruction:
Abdominal pa of esophagus is supplied by:-
A. Pulmonary trunk
B. Bronchial aery and arch of aoa
C. Right gastric aery and inferior phrenic aery
D. Left gastric aery and inferior phrenic aery

Response:
Esophagus is a long tube with approximately 25cm in length, have 3 pas - cervical, thoracic and abdominal pa. PA OF ESOPHAGUS AERY SUPPLY CERVICAL Inferior thyroid aery THORACIC Descending thoracic aoa ABDOMINAL Left gastric and inferior phrenic aery

So the answer to this question is D


Instruction:
Sclerotic bodies 3-15u in size, multiseptate, chestnut brown colour seen in -
A. Rhinosporidiosis
B. Chromoblastomycosis
C. Phaeohyphomycosis
D. Histoplasmosis

Response:
None

So the answer to this question is B


Instruction:
Which of the following statement about Bedaquiline is TRUE:
A. Mycobacterial ATP synthase inhibitor
B. Does not prolongs QT interval
C. It should be given alone
D. It has cross-resistance with rifampicin

Response:
Bedaquiline: - New antitubercular drug for MDR or XDR,- It act by inhibiting ATP synthase in mycobacteria- Food increases the bioavailability - Given along with base line antitubercular drug- Recent studies have shown cross resistance with clofazimine only. It is approved for use for 6 month. Side effect: - Derangement of LFT- Prolongs QT interval Pretomanid in combination withBedaquiline and Linezolid is approved by the FDA for the treatment of extensively drug-resistant, treatment-intolerant or nonresponsive multidrug-resistant pulmonary TB

So the answer to this question is A


Instruction:
Following vaginal delivery, a patient developed profuse bleeding due to uterine atony. The amount of blood loss in postpaum haemorrhage is more than:
A. 200 mL
B. 400 mL
C. 500 mL
D. 700 mL

Response:
Postpaum hemorrhage has been defined as the loss of 500 mL of blood or more after completion of the third stage of labor. Blood loss during the first 24 hours after delivery is early postpaum hemorrhage; blood loss between 24 hours and 6 weeks after delivery is late postpaum hemorrhage. Causes of postpaum hemorrhage include uterine atony, obstetric lacerations, retained placental tissue, and coagulation defects. Ref: Poggi S.B. (2013). Chapter 21. Postpaum Hemorrhage & the Abnormal Puerperium. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

So the answer to this question is C


Instruction:
Community health guide is selected by:
A. Block Development Officer
B. ASHA
C. Zila Parishad
D. Medical officer - in - charge

Response:
Village community is requested to recommended 2-3 persons suitable to be Health guides Final selection is made by Medical offices of PHC jointly selection is made by Medical officers of PHC ficer and field staff of several government organizations.

So the answer to this question is D


Instruction:
In which of the following enzyme deficiencies there is steatorrhea with increased triglycerides?
A. Pancreatic lipase
B. Serum lipase
C. Lipoprotein lipase
D. Acetyl CoA carboxylase

Response:
Hyperiglyceridemia can cause pancreatitis and which will cause steatorrhoea. Lipoprotein lipase deficiency causes the Hyperiglyceridemia and eventually steatorrhoea. Lipoprotein lipase deficiency also causes hyperchylomicronemia Ref: Harrison, 16th Edition, Page 1503

So the answer to this question is C


Instruction:
Most common type of cell death due to sudden occlusion of blood suply-
A. Coagulation necrosis
B. Caseation necrosis
C. Liquefactive necrosis
D. Gangrene

Response:
Ans. is 'a' i.e., Cogulation necrosis

So the answer to this question is A


Instruction:
Stippled Epiphysis is seen in?
A. Congenital Hypothyroidism
B. Juvenile Rheumatoid Ahritis
C. Scurvy
D. Achondroplasis

Response:
Causes for Stippled Epiphysis Congenital hypothyroidism (cretinism) a group of skeletal dysplasias called chondrodysplasia punctate. Alcohol use during pregnancy Warfarin use during pregnancy Vitamin K deficiency

So the answer to this question is A


Instruction:
All muscles of the pharynx are supplied by pharyngeal plexus, EXCEPT:
A. Inferior constrictors
B. Salpingopharyngeus
C. Stylopharyngeus
D. None of the above

Response:
With the exception of stylopharyngeus, which is supplied by the glossopharyngeal nerve, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus.Ref: Gray's anatomy 40th edition, Chapter 35

So the answer to this question is C


Instruction:
Which is the most common primary malignant bone tumor?
A. Osteosarcoma
B. Osteoclastoma
C. Secondaries
D. Multiple myeloma

Response:
Secondaries are the most common malignant bone tumor. But the most common primary malignant bone tumor is Multiple myeloma..

So the answer to this question is D


Instruction:
Enzyme replacement therapy is most commonly used for
A. Gaucher's disease
B. Fabry's disease
C. Niemenn pick's disease
D. Pompe disease

Response:
Gaucher disease is a multisystemuc lipidosis characterized by hematological abnormalities,organomegaly and,skeletal involvement.It has 3 clinical subtypes . It occurs due to the deficient activity of acid beta glucosidase . Thus glucosylceramide accumulate in reticule end I the loam cells. Treatment is mainly enzyme replacement therapy with recombinant acid beta glucosidase.Most extra skeletal symptoms are reversed by 60 IU/kg enzyme iv infusion every other week. Monthly maintenance improves skeletal manifestations. Reference: Nelsons TB of pediatrics 19th edit,pg 487

So the answer to this question is A


Instruction:
Sciatic nerve palsy may occur in the following injury-
A. Posterior dislocation of hip joint
B. Fracture neck of femur
C. Trochanteric fracture
D. Anterior dislocation of hip

Response:
*Injury to sciatic nerve:-The nerve is vulnerable to injury where it lies behind the posterior wall of acetabulum. Ref: Maheshwari 9th/e p.131 &4th/e p.127

So the answer to this question is A


Instruction:
In a 10 year old female patient of Asian ethnicity, which of the following methods would be the best approach to estimate the  size of unerupted permanent teeth?
A. Huckaba’s analysis
B. Tanaka-Johnston analysis
C. Tanaka-Johnston analysis
D. Staley-Kerber method

Response:
The Moyers, Tanaka-Johnston and Staley-Kerber predictions are all based on data from white school children of northern European descent. If the patient fits this population group, the Staley-Kerber method will give the best prediction, followed by the Tanaka-Johnston and Moyers.
On the other hand, if the patient does not fit the population group, as an African or Asian child would not, direct measurement from the radiographs is the best approach.

Huckaba analysis:
The formula recommended by Huckaba was used in all radiographic measurements:
X = (y) (x1)/(y1)
where X is the estimated size of the permanent tooth, x1 is the radiographic size of the permanent teeth, y is the size of the primary mandibular second molar on the cast and y1 is the radiographic size of the primary molar.
Contemporary orthodontics, William Proffit, 4th edition page 198

So the answer to this question is A


Instruction:
Epidemic of polio is due to -
A. Type I virus
B. Type II virus
C. Type III virus
D. Combine type II and III virus

Response:
Poliovirus tyoe 1 is responsible for most epidemics of paralytic poliomyelitis. Type 3 also causes but to a lesser extent. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:490

So the answer to this question is A


Instruction:
Which of the following statements is true about nitrates ?
A. Acts by raising cGMP which causes dephosphorylation of MLCK
B. Metabolized by glutathione reductase
C. Used in achalasia cardia
D. All of the above

Response:
None

So the answer to this question is D


Instruction:
The most definitive method of diagnosing pulmonary embolism is
A. Pulmonary ateriography
B. Radioisotope perfusion pulmonary scintigraphy
C. EKG
D. Venography

Response:
Pulmonary aeriography is the most definitive method of diagnosing pulmonary embolism.Chest CT with contrast has viually replaced invasive pulmonary angiography as a diagnostic test.A definitive diagnosis of PE depends on visualisation of an intraluminal filling defect in more than one projection.Secondary signs of PE include abrupt occlusion("cut-off") of vessels,segmental oligemia or avascularity,a prolonged aerial phase with slow filling,and touous,tapering peripheral vessels. Reference:Harrison's medicine-18th edition,page no:2174.

So the answer to this question is A


Instruction:
Formication and delusion of persecution, both are together seen in:
A. LSD psychosis
B. Amphetamine psychosis
C. Cocaine psychosis
D. Cannabis psychosis

Response:
C. i.e. Cocaine psychosis - Cocaine blocks reuptake of norepinephrine, dopamine & serotonin; impairs nerve conduction (LA action) and Vt hypeensionQ. Cocaine causes no physical dependence but moderate/strong psychological dependence. It is unique in not producing significant toleranceQ. lnfact paranoid psychosis observed with cocaine abuse is produced by sensitization (or reverse tolerance)Q. Cocaine cause tactile hallucinations (Magnan's symptoms or formication or cocaine bugs or feeling of creeping insects) and paranoid psychosis (delusions & hallucinations)Q

So the answer to this question is C


Instruction:
As compared to cow's milk, human milk has a higher content of -
A. Fat
B. Sugar
C. Protein
D. Calcium

Response:
parks textbook of preventive and social medicine 23rd edition * mothers milk is especially rich in fats ,which represents between 35-50percent of total energy value human milk has low in protein content human milk has less in calcuim content than cows milk human milk has more of lactose content than most other milks .

So the answer to this question is A


Instruction:
Spleen originates following space of peritoneal cavity:
A. Dorsal mesentry
B. Ventral mesentry
C. Left subhepatic space
D. Infracolic compament

Response:
Dorsal mesentry

So the answer to this question is A


Instruction:
Ito cells are found in:
A. Brain
B. Kidney
C. Liver
D. Lung

Response:
Hepatic stellate cells are also known as perisinusoidallipocytes or Ito cells and are much less numerous than hepatocytes. They play a major role in pathological processes. In response to liver damage, they become activated and predominantly myofibroblast-like. They are responsible for the replacement of toxically damaged hepatocytes with collagenous scar tissue - hepatic fibrosis, seen initially in zone 3, around central veins. This can progress to cirrhosis, where the parenchymal architecture and pattern of blood flow are destroyed, with major systemic consequences.

So the answer to this question is C


Instruction:
The movement at the following joint permits a person to look towards the right or left :
A. Atlanto-occipital joint
B. Atlanto-axial joint
C. C2-C3 joint
D. C3-C4 joint

Response:
B. i.e. Atlanto - Axial Joint Atlanto - occipital (b/w skull & C1) joint permit nodding of head (as when indicating approval or yes)& Atlantoaxial joint permits the head to be turned from side to side i.e. rotation (as indicating disapproval, the no movement)

So the answer to this question is B


Instruction:
Which of the following conditions can cause bony ankylosis?
A. Rheumatoid ahritis
B. Pyogenic ahritis
C. Osteo ahritis
D. Traumatic ahritis

Response:
Pyogenic ahritis causes bony ankylosis.

So the answer to this question is B


Instruction:
In a child with foreign body in bronchus, next step is:
A. Rigid bronchoscopy
B. Chest X-ray
C. Flexible endoscopy
D. Direct laryngoscopy

Response:
In the question, child has already been diagnosed with bronchial foreign body. Hence next step would be its removal and treatment of choice in a child with foreign body in bronchus is Rigid bronchoscopy.

So the answer to this question is A


Instruction:
Resolution of inflammation caused by -
A. TNF Alfa, IL-1 and CRP
B. TNF beta, IL-6 and CRP
C. TNF Alfa, IL 10 and IL 1 receptor antagonist
D. TNF gamma

Response:
Processes involved in inflammation and its resolution. ILs, interleukins; TNF-a, tumor necrosis factor alpha; TGF-b, transforming growth factor beta; TIMPs, tissue inhibitor of metalloproteinases; MMPs, matrix metalloproteinases; ECM, extracellular matrix; LTs, leukotrienes; PGs, prostaglandins; LXs, lipoxins; RVs, resolvins; Pvs, protectins. Ref Robbins 9/e p40

So the answer to this question is C


Instruction:
Which of the following is an anterior deprogramming device
A. Herbst appliance
B. Hawley's appliance
C. Lucus jig
D. Lucia jig

Response:
None

So the answer to this question is D


Instruction:
In a child with retinoblastoma, which of the following is NOT a common finding in the X-ray: September 2012
A. Intraocular calcification
B. Intracerebral calcification
C. Multiple calcified mass in cranium
D. Widening of optic foramen

Response:
Ans. B i.e. lntracerebral calcification Retinoblastoma May be bilateral in 30-40% cases (paicularly familial ones), Knudsons hypothesis is related to Rb MC manifestation of Rb: Leukocoria/ Amaurotic cat's eye reflex Treatment of diffuse Rb: Enucleation (removal of eyeball with poion of optic nerve from orbit) Treatment of small Rb: Brachytherapy Treatment of bilateral Rb & metastatic disease: Chemotherapy

So the answer to this question is B


Instruction:
Mechanism of action of donepezil is:
A. Centrally acting reversible anticholinesterase
B. Centrally acting irreversible anticholinesterase
C. Irreversible cholinergic action
D. Reversible anticholinesterase

Response:
donepezil is a centrally acting anti cholinesterase which is reversible.other drugs in this category include rivastigmine Ref; KD Tripathi 8th ed.

So the answer to this question is A


Instruction:
The severity of mitral stenosis is assessed by
A. Character of murmur
B. Splitting of S
C. Loudness of S,
D. S2-OS interval

Response:
Mitral stenosis. A normal mitral valve will have an area of >4 cm2, but symptoms are usually only present once the stenosis is moderate-severe. Grading into mild, moderate, or severe disease is based on both the pressure needed to drive blood across the valve (mean pressure gradient) and the valve area. Ref Davidson 23rd edition pg 435

So the answer to this question is D


Instruction:
Cutaneous nerve supply of region marked X
A. Superficial peroneal nerve
B. Deep peroneal nerve
C. Medial plantar nerve
D. Saphenous nerve

Response:
1st web space is supplied by Deep peroneal nerve

So the answer to this question is B


Instruction:
The repolarization phase of an action potential is due to
A. Increasing sodium permability and increasing potassium permeability
B. Increasing sodium permeability and decreasing potassium permeability
C. Decreasing sodium permeability and an immediate increasing potassium permeability
D. Decreasing sodium permeability and a delayed increase potassium permeability

Response:
There is a decrease in sodium permeability (inactivation of the sodium channels) and a delayed increased in potassium permeability during the repolarization phase of the action potential. The pump plays no direct role in the action potential.

So the answer to this question is D


Instruction:
Methicillin-resistant S. aureus (MRSA) was isolated from 7 patients in a 14-bed intensive care unit. All patients were isolated and the unit closed to any more admissions. Which one of the following reasons best explains these rigorous methods to control MRSA?
A. MRSA is inherently more virulent than other staphylococci
B. The alternative for treatment of MRSA is vancomycin, an expensive and potentially toxic antibiotic
C. MRSA causes toxic shock syndrome
D. MRSA spreads more rapidly from patient to patient than antibiotic-susceptible staphylococci do

Response:
Oxacillin- and methicillinresistant S. aureus (MRSA) has been rapidly increasing in incidence. MRSA and methicillin-sensitive S. aureus (MSSA) coexist in heterologous populations. Treatment of a patient harboring this heterologous population may provide a selective environment for the MRSA. Prior to changing therapy, the susceptibility of the isolate should be determined. Vancomycin has often been used effectively for MRSA, but it is expensive and nephrotoxic. There is no evidence that MRSA is any more virulent or invasive than susceptible strains. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition

So the answer to this question is B


Instruction:
Acceptable noise level in hospital wards
A. 20 - 35dB
B. 35 - 40 dB
C. 45-55dB
D. 50-60dB

Response:
Ref:Park's Textbook of Preventive and Social Medicine 25th Ed

So the answer to this question is A


Instruction:
Generally speaking, the distal, burning, painful dysesthesias with reduced pinprick and thermal sensation but with sparing of proprioception and motor functions is seen in -
A. Small fibre neuropathy
B. Large fibre neuropathy
C. Neuromuscular junction disease
D. Anterior horn cell disease

Response:
None

So the answer to this question is A


Instruction:
External acoustic meatus is derived from
A. Dorsal part of the first ectodermal cleft
B. Ventral part of the first ectodermal cleft
C. Dorsal part of the 2nd ectodermal cleft
D. Ventral part of the 2nd ectodermal cleft

Response:
(Dorsal part of the 1st ectodermal cleft) (357-IBS 8th) (317-I.B.Singh 8th)External acoustic meatus is derived from the dorsal part of the first ectodermal cleft. However, its deeper part is formed by proliferation of its lining epithelium.FATE OF ENDODERMAL POUCHESA. First pouch(a) Its ventral part is obliterated by formation of the tongue(b) Its dorsal part receives a contribution from the dorsal part of the second pouch, and these two together form a diverticulum that grows towards the region of the developing ear. This diverticulum that grows towards the region of the developing ear. This diverticulum is called the trubotympanic recess. The proximal part of this recess gives rise to the auditory (pharyngotympanic) tube, and the distal part to the, middle ear cavity including the tympanic antrumB. Second Pouch(a) The epithelial of the ventral part of this pouch contributes to the formation of the tonsil(b) The dorsal part takes part in the formation of the tubotympanic recessC. Third Pouch- give rise to inferior parathyroid gland & ThymusD. Fourth Pouch- gives origin to the superior parathyroid glands and may contribute to the Thyroid glandE. Fifth or Ultimobranchial pouch- give rise to ultimobranchial body (some species) & caudal pharyngeal complex

So the answer to this question is A


Instruction:
Which of the following countries was the first to institute compulsory sickness insurance
A. USA
B. England
C. France
D. Germany

Response:
Germany led by the way to instituting compulsory sickness insurance in 1883. Ref : Park's Textbook of Preventive and Social Medicine; 23rd edition

So the answer to this question is D


Instruction:
Muscle NOT supplied by cranial nerve III:
A. Superior oblique
B. Superior rectus
C. Inferior oblique
D. Medial rectus

Response:
Ans. (a) Superior ObliqueRef.-.BDC 6th ed. Vol-III/360-62* Again remember the mnemonics LR6 S04 and all other by CN III* Superior oblique is supplied by CN IV (trochlear nerve).* Refer to above answer for more detailed explanation.

So the answer to this question is A


Instruction:
To which lymph nodes, the lymph from the umbilicus drain -
A. Axillary and inguinal
B. External and internal iliac
C. Pre-and para-aortic
D. Inter-aortocaval

Response:
The lymph from umbilicus drains into both axillary and inguinal lymph nodes.

So the answer to this question is A


Instruction:
Aery to bleed in duodenal ulcer haemorrhage -
A. Splenic aery
B. Gastroduodenal aery
C. Left gastric aery
D. Sup. mesenteric aery

Response:
Gastro duodenal aery is the most common aery involved in duodenal ulcer hemorrhage. Also, remember A peptic ulcer is the most common cause of massive upper gastrointestinal bleed (Duodenal ulcers > Gastric ulcers) Bleeding ulcers in the duodenum are usually located on the posterior surface of the duodenal bulb. Ref : Bailey & Love 25/e p1045

So the answer to this question is B


Instruction:
Vitamin B12 deficiency is likely to cause:
A. Bitemporal hemianopia
B. Binasal hemianopia
C. Heteronymous hemianopia
D. Centrocecal scotoma

Response:
D i.e. Cetrocecal scotoma Vitamin B12 deficiency is likely to cause optic neuritis; in which most common field defect is central or centro-caecal scotoma Q

So the answer to this question is D


Instruction:
In an epidemic first to be done is-
A. Identity the cases
B. Confirm the diagnosis
C. Identify the prone people
D. Identify the causative factors

Response:
None

So the answer to this question is B


Instruction:
Painful loss of vision is seen in :
A. Senile cataract
B. Primary open angle glaucoma
C. Primary angle closure glaucoma
D. Anterior uveitis

Response:
C i.e Primary angle closure glaucoma

So the answer to this question is C


Instruction:
Hypeonic dysfunctional labour is generally characterised by:
A. Rapid cervical dilatation
B. Less pain In labour
C. Responds ourably to oxytocin stimulation
D. Needs adequate pain relief

Response:
Hypeonic state of uterus or Imcordinate uterine action : Patient is in agony with unbearable pain referred to back Oxytocin cause fetal tachycardia due to fetal stress Inappropriate dilatation of cervix Uterus is tender and gentle manipulation excites hardening of the uterus with pain. Ref: Dutta Obs 9e pg 337.

So the answer to this question is D


Instruction:
If the origin of the masseter muscle is more medial on the zygomatic arch (ramus perpendicular), the space in the distobuccal area is
A. Decreases
B. Remains the same
C. Increases then decreases
D. Increases

Response:
None

So the answer to this question is A


Instruction:
Internal carotid artery crosses -
A. Sigmoid sinus
B. Straight sinus
C. Cavernous sinus
D. Sagittal sinus

Response:
Ans. C. Cavernous sinusThe internal carotid artery arises from the bifurcation of the common carotid artery, ascends in the neck and enters the carotid canal of the temporal bone. Its subsequent course is said to have petrous, cavernous and intracranial parts.Petrous parta. The petrous part of the internal carotid artery ascends in the carotid canal, curves anteromedially and then superomedially above the cartilage that fills the foramen lacerum, and enters the cranial cavity.b. It lies at first anterior to the cochlea and tympanic cavity, and is separated from the latter and the pharyngotympanic tube by a thin, bony lamella that is cribriform in the young and partly absorbed in old age. Further anteriorly, it is separated from the trigeminal ganglion by the thin roof of the carotid canal, although this is often deficient. The artery is surrounded by a venous plexus and by the carotid autonomic plexus, derived from the internal carotid branch of the superior cervical ganglion.c. The petrous part of the artery gives rise to two branches. The caroticotympanic artery is a small, occasionally double, vessel which enters the tympanic cavity by a foramen in the carotid canal and anastomoses with the anterior tympanic branch of the maxillary artery and the stylomastoid artery.d. The pterygoid artery is inconsistent: when present, it enters the pterygoid canal with the nerve of the same name, and anastomoses with a (recurrent) branch of the greater palatine artery.Cavernous parta. The cavernous part of the internal carotid artery ascends to the posterior clinoid process. It turns anteriorly to the side of the sphenoid within the cavernous sinus and then curves up medial to the anterior clinoid process, to emerge through the dural roof of the sinus. The oculomotor, trochlear, ophthalmic and abducens nerves are lateral to it within the cavernous sinus.b. This part of the artery gives off a number of small vessels. Cavernous branches supply the trigeminal ganglion, the walls of the cavernous and inferior petrosal sinuses and the nerves contained therein. A minute meningeal branch passes over the lesser wing of the sphenoid to supply the dura mater and bone in the anterior cranial fossa and also anastomoses with a meningeal branch of the posterior ethmoidal artery. Numerous small hypophysial branches supply the neurohypophysis, and are of particular importance because they form the pituitary portal system.Intracranial parta. After piercing the dura mater, the internal carotid artery turns back below the optic nerve to run between it and the oculomotor nerve. It reaches the anterior perforated substance at the medial end of the lateral fissure and terminates by dividing into the anterior and middle cerebral arteries.b. Several preterminal vessels leave the cerebral portion of the internal carotid. The ophthalmic artery arises from the anterior part of the internal carotid as it leaves the cavernous sinus, often at the point of piercing the dura, and enters the orbit through the optic canal.c. The posterior communicating artery runs back from the internal carotid above the oculomotor nerve, and anastomoses with the posterior cerebral artery (a terminal branch of the basilar artery), thereby contributing to the circulus arteriosus around the interpeduncular fossa.d. The posterior communicating artery is usually very small. However, sometimes it is so large that the posterior cerebral artery is supplied via the posterior communicating artery rather than from the basilar artery ('fetal posterior communicating artery'); it is often larger on one side only. Small branches from its posterior half pierce the posterior perforated substance together with branches from the posterior cerebral artery.e. Collectively they supply the medial thalamic surface and the walls of the third ventricle. The anterior choroidal artery leaves the internal carotid near its posterior communicating branch and passes back above the medial part of the uncus.f. It crosses the optic tract to reach and supply the crus cerebri of the midbrain, then turns laterally, recrosses the optic tract, and gains the lateral side of the lateral geniculate body, which it supplies with several branches. It finally enters the inferior horn of the lateral ventricle via the choroidal fissure and ends in the choroid plexus.g. This small, but important, vessel also contributes to the blood supply of the globus pallidus, caudate nucleus, amygdala, hypothalamus, tuber cinereum, red nucleus, substantia nigra, posterior limb of the internal capsule, optic radiation, optic tract, hippocampus and the fimbria of the fornix.

So the answer to this question is C


Instruction:
After taking some drug for acute attack of migraine, a patient developed nausea and vomiting. He also developed tingling and numbness on the tip of the finger that also turned blue. Which of the following is the most likely drug implicated in causing the above findings?
A. Dihdroergotamine
B. Sumatriptan
C. Aspirin
D. Butorphanol

Response:
This is a classical sign of ergot induced vasoconstriction. Dihydroergotamine can be used for acute attack of migraine and can result in these symptoms. Due to their vasoconstricing potential, ergot alkaloids are contra-indicated in a patient with peripheral vascular disease. These may also lead to development of gangrene. Contraindications for ergotamine : Peripheral vascular disease Coronary aery disease Uncontrolled hypeension Fever and/or sepsis Pregnancy Within 24 hours of using triptans

So the answer to this question is A


Instruction:
Epithelium of ureter develops from?
A. Mesonephros
B. Metanephros
C. Pronephros
D. Paramesonephric duct

Response:
None

So the answer to this question is A


Instruction:
148.Drug of choice for pregnancy-induced hypertension is:(AIIMS November 2015, May 2015)
A. Atenolol
B. Nitroprusside
C. Enalapril
D. Alpha-methyldopa

Response:
Ans. d. Alpha-methyldopa (Ref: Williams Obstetrics 24/e p100; Dutta 7/e p228: Goodman Giffman 12/e p773, 774: Katzung 12/e p176)Drug of choice for hypertension in pregnancy is methyldopa."Methyldopa is a centrally acting antihypertensive agent. It is a prodrug that exerts its antihypertensive action via an active metabolite. Although used frequently as an anti hypertensive agent in the past, methyldopa's significant adverse effects limit its current use largely to treatment of hypertension in pregnancy, where it has a record for safety. "-- Goodman Gillman 12/e p773"Methyldopa is a preferred drug for treatment of hypertension during pregnancy based on its effectiveness and safety for both mother and fetus. The usual initial dose of methyldopa is 250 mg twice daily, and there is tittle additional effect with doses >2 g/day. "-- Goodman Gillman 12/e p774"Methyldopa was widely used in the past but is now used primarily for hypertension during pregnancy. It lowers blood pressure chiefly by reducing peripheral vascular resistance, with a variable reduction in heart rate and cardiac output. Katzung 12/e p176Antihypertensives in PregnancySafeContraindicated* LabetaloQ* Alpha methyldopaQ* Calcium channel blockersQ* Hydralazine* Sodium nitroprusside* ACE inhibitorsQ* Reserpine* Loratidine Drug of Choice in PregnancyConditionDrug of Choice* DOC for malaria in pregnancy* ChioroquineQ* DOC for anticoagulation in pregnancy* HeparinQ* Antihypertensive of choice in pregnancy* Alpha-methyldopaQ* Antihypertensive of choice for hypertensive crisis in pregnancy* LabetalolQ* DOC for nausea in pregnancy* Doxylamine & pyridoxineQ* Analgesic of choice during pregnancy* AcitoaminophenQ* Anti-epileptic of choice during pregnancy* PhenobarbitoneQ

So the answer to this question is D


Instruction:
At the end of the year 1990, the population of primary health centre was 30,000 and there were 120 cases of pulmonary tuberculosis. At the end of the year 1991, the population was 30,600 and 30 new cases were detected and 2 cases had died. Based on this data all of the following rates can be calculated except
A. incidence
B. Prevalence
C. Case fatality
D. Propoional moality

Response:
Ref: Parks 23rd edition pg 58 Propoional moality rate from a specific disease = no. of deaths from the specific disease in a yr / total deaths from all causes in that yr x100. Here the denominator is unavailable. So can&;t be calculated.

So the answer to this question is D


Instruction:
Air pollution may cause -
A. Dermatitis
B. Carcinoma bronchus
C. Bronchiectasis
D. Pneumonia

Response:
Approximately 17% of annual premature lung cancer deaths in adults are attributed to exposure to carcinogens from household air pollution caused by cooking with solid fuels like wood charcoal and coal. Other effects: Respiratory tract infections Bronchial hyperactivity impaired lung defence bronchiolitis obliterans Asthma, COPD impaired neuropsychological development in paediatrics Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 797

So the answer to this question is B


Instruction:
False about the malignant ulcer of stomach is
A. The mucosal folds do not reach the edge of the ulcer
B. Mucosal folds are thickened and fused
C. Ulcer crator is eccentric
D. Margins of the ulcer are overhanging

Response:
widespread thickening of mucosal wall.Ulcers appear firm raised and nodular. margins of ulcers are heaped up beaded irregular ,base is ragged and necrotic. REF :GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PAGE 2ND EDITION NO 386 IMAGE REF: GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK 2ND EDITION TABLE 13.7 PAGE 389

So the answer to this question is D


Instruction:
Which is a better preservative for urine in viscera packing
A. Concentrated Hydrochloric acid
B. Thymol
C. Toluene
D. Sodium fluoride

Response:
- Concentrated Hydrochloric acid, Thymol, Toluene, Sodium fluoride used to preserve urine - Of which, Toluene is better.

So the answer to this question is C


Instruction:
A 13 year old boy present with acute onset right scrotal pain. The pain is not relieved on elevation of the serotum and he has no fever or dysuria. The testis is enlarged and tender. His routine urinary examination is normal. There is no history of trauma. Which of the following is the most appropriate management -
A. Immediate exploration
B. Antibiotics
C. Psychiatric evaluation
D. Antibiotics and scrotal elevation

Response:
Ans. is 'a' i.e., Immediate exploration This is a case of torsion of testis Torsion of testis is a surgical emergency and needs immediate exploration if it cannot be relieved by manipulation.

So the answer to this question is A


Instruction:
False about a firearm Exit wound is
A. Eveed edges
B. Abrasion collar absent
C. Sharply defined outwardly split edges
D. Lead ring may be present

Response:
Grease or di ring may be present inner to or interwoven in the substance of abrasion collar in case of entry wounds , which may be demonstrable on micro-chemical or other tests in the laboratory. Not seen in exit wound Ref : Krishnan vij Textbook of Forensic medicine and Toxicology 5th edtion ; pg no - 249

So the answer to this question is D


Instruction:
Population covered by a community health centre-
A. 5000
B. 30,000
C. 1000
D. 100,000

Response:
As on 31 st march 2014 ,5,363 community health centers were established by upgrading the primary health centers,each community health center covering a population of 80,000 to 1.20 lakh(one in each community development block) with 30 beds and specialists in surgery,medicine,obstetrics and gynecology and paediatrics with x-ray and laboratory facilities (refer pgno:907 park 23 rd edition)

So the answer to this question is D


Instruction:
Which one one of the following acts to increase the release of Ca2+ from endoplasmic reticulum:
A. Inositol triphosphate
B. 4,Parathyroid hormone
C. 1, 25-dihydroxy cholecalciferol
D. Diacyglycerol

Response:
A i.e. Inositol triphosphate Inositol triphosphate diffuses to the endoplasmic reticulum, where it triggers the release of calcium into cytoplasm. Inositol triphosphate and diacylglycerol (DAG) both of which are second messengers, are associated with Gq subset of G protein mediated receptors.

So the answer to this question is A


Instruction:
Which of the following diuretic is used in the given condition?
A. Furosemide
B. Thiazide
C. Acetazolamide
D. Neomycin

Response:
Loop diuretics are 1st choice in hepatic cirrhosis associated edema along with aldosterone antagonist.Ref: Katzung 13thed.Pg 265

So the answer to this question is A


Instruction:
A viral organism was isolated from a painful blister on the lip of a teenage girl. The agent was found to double-stranded, linear DNA and was enveloped. The patient had a similar sore approximately 2 months ago. Which of the following is the most likely causative organism?
A. Adenovirus
B. Coxsackie virus
C. Herpes simplex type 1 virus
D. Herpes zoster virus

Response:
Herpes simplex is an enveloped, linear DNA virus that is a very common infectious agent; most adults will have anti-Herpes simplex antibodies in their serum, although many may not have ever had any clinical signs of disease. The hallmark of this disease is painful skin vesicles often called "cold" sores, or "fever" blisters to denote the precipitating event that preceded the appearance of the lesions. The virus has a propensity to become latent in the host, finding safe refuge in nervous tissue. Activation of the infection occurs following mild trauma (e.g., a visit to the dentist), hormonal changes (e.g., menses), and immunosuppression (e.g., following organ transplantation). Other, more serious, manifestations of disease include encephalitis, pneumonia, and hepatitis; these are paicularly likely to be seen in immunodeficient patients such as those with AIDS. Adenoviruses are naked, linear, double-stranded DNA viruses that cause acute, usually self-limiting, influenza-like illnesses occurring in winter. The symptoms include pharyngitis, fever, cough, and general malaise. Epidemic pharyngoconjunctivitis and pneumonia can occur in closed populations such as military installations. Coxsackie viruses are naked, single-stranded, polycistronic viruses with an RNA genome. They are divided into groups A and B based on their virulence in suckling mice. Coxsackie A group causes generalized myositis and flaccid paralysis, which is rapidly fatal to infant mice, whereas group B produces less severe lesions of the hea, pancreas, and central nervous system. In man, Coxsackie A causes herpangina and hand-foot-and-mouth disease, while Coxsackie B is seen in patients with pleurodynia, myocarditis, and pericarditis. Both groups cause upper respiratory infections, febrile rashes, and meningitis. Herpes zoster, the varicella virus, is an enveloped, double-stranded DNA virus that is a very common infectious agent in children. Chickenpox is a mild, self-limiting illness in children that is evidenced as a fever followed by a macular rash that progresses to papules, then vesicles of the skin and mucous membranes. Shingles is a recurrence of a previously latent varicella infection in which the virus has taken refuge in sensory ganglia of spinal or cranial nerves. Various factors that decrease the immune status of the patient contribute to the exacerbation of the infection. Severe dermatomal pain occurs with a vesicular eruption, fever, and malaise. Ref: Brooks G.F. (2013). Chapter 33. Herpesviruses. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.

So the answer to this question is C


Instruction:
To obtain best long term result, which of the
following procedures for augmentation genioplasty is recommended:
A. On lay bone graft
B. Injection of silastic gel
C. Insertion of silastic rubber implant
D. Pedicled horizontal sliding osteotomy

Response:
None

So the answer to this question is D


Instruction:
Nerve of inguinal canal is
A. Genitofemoral nerve
B. Obturator nerve
C. Iliohypogastric nerve
D. Ilioinguinal nerve

Response:
The inguinal canal is a passage in the anterior abdominal wall that in men conveys the spermatic cord and in women the round ligament of uterus. The inguinal canal is larger and more prominent in men. There is one inguinal canal on each side of the midline. ref -BDC 6e vol2 pg211-216

So the answer to this question is D


Instruction:
True about Post-Streptococcal Glomerulonephritis is:
A. 50% of cases occur after pharyngitis
B. Early treatment of Pharyngitis eliminates the risk of P.S.G.N.
C. Glomerulonephritis, secondary to skin infection, is more common in summer
D. Recurrence is seen

Response:
Answer is C (Glomerulonephritis secondary to skin infection is more common in Summer): 'During cold weather post streptococcal glomerulonephritis commonly follows streptococcal pharyngitis; whereas during warm weather, the G.N. generally follows streptococcal skin infection or pyoderma'. "Early systemicantibiotic therapy of Streptococcal throat and skin infection will NOT eliminate the risk of glomerulonephritis". Nelson 15th / 1488 "Recurrence are extremely rare" Nelson 15th / 1488 ......Immunity to strains causing G.N. is type-specific and long-lasting, and hence repeated infection and nephritis are rare. Post streptococcal glomerulonephritis may follow either pharyngitis or, skin infection (pyoderma) with a nephritogenic strain of group A beta haemolytic streptococci. I could not however, find what percentage of PSGN cases follow pharyngitis and what percentage follow skin infections. . All I could gather was that these incidences are relative, depending upon the climatic conditions of the area concerned such that in the tropics, skin infection is more impoant than pharyngitis as a cause. The epidemic forms, on the other hand, are seen in children of 2-6 years of age, and are secondary to pharyngitis. Thus no exact demarcation in terms of percentages can be made.

So the answer to this question is C


Instruction:
Hydrocution is ?
A. Electric shock in water
B. Cold water submersion
C. Submersion in boiling water
D. None

Response:
Hydrocution : (immersion syndrome ) Type of atypical drowning Mechanism -sudden dyspnoea and vagal inhibition -->hea stops immediately.( ventricular fibrillation has also been repoed.)

So the answer to this question is B


Instruction:
True about measles are all except -
A. Koplik's spots is pathognomonic
B. Source is a case
C. Infectivity is low
D. Affect age group 1 to 3 years

Response:
Ans. is 'c' i.e., Infectivity is low o Measles has high infectivity with secondary attack rate of 80%. o Other options are correct. Measles o Measles is caused by a RNA virus of paramyxovirus family, o Measles in also known as rubeola. o The only source of infection is a case of measles, carriers are not known to occur. o Infective period - 4 days before and 5 days after the appearance of rash. o Infective material - Secretions of nose, throat and respiratory tract o Age group - 6 month to 3 years. o Immunity - One attack of measles generally confer life long immunity'. o Transmission - 1) Droplet infection through respiratory' tract 2) Infection through conjuctiva. o Incubation period - 10 days from exposure to onset of fever. 14 days from exposure to appearance of rash. 7 days for live vaccine of measles. o Clinical manifestations Prodromal stage Begins 10 days after the infection and lasts until day 14. Characterized by fever, coryza with sneezing and nasal discharge, redness of the eyes, lacrimation and photophobia. A day or two before the appearance of rash, Koplik's spots appear on buccal mucosa opposite the 1st and 2nd lower molars. Koplik's spots are pathognomonic of measles. Eruptive phase Maculopapufar rash which begins behind the ear and spread rapidly in a few hour over the face and neck extends down the body. Post measles stage y Weight loss y Growth retardation y Diarrhea y Cancrum oris y Reactivation of pulmonary TB y Candidiasis

So the answer to this question is C


Instruction:
A 30 years old Mrs. X comes to opd with complaints of lethargy, anorexia, weight loss and secondary amenorrhea. She gives a history of postpaum haemorrhage and failed lactation. Which of the following is the most probable diagnosis?
A. Sheehan's syndrome
B. Empty sella syndrome
C. Kallmann syndrome
D. Asherman syndrome

Response:
Sheehan's SyndromeAcute infarction and ischemic necrosis of the pituitary gland resulting from postpaum hemorrhage and hypovolemic hypotension is known as Sheehan's syndrome and is one of the most common causes of hypopituitarism in underdeveloped or developing countries.Failed lactation after delivery is the classical presenting symptom. The rest of the clinical picture varies with the severity of the pituitary insult, ranging from severe hypopituitarism soon after delivery, manifesting as lethargy, anorexia, and weight loss, to secondary amenorrhea, loss of sexual hair, and less severe symptoms of fatigue that emerge weeks and months later.Deficiencies in GH, prolactin, and gonadotropins are most common, although the majority also exhibit ACTH and TSH deficiencies.The evaluation and treatment of Sheehan's syndrome is no different from that for other causes of hypopituitarismReference: Clinical gynecologic endocrinology; 10th edition; Chapter 9; Normal and Abnormal Sexual Development; Page no: 483

So the answer to this question is A


Instruction:
Most common congenital anomaly associated with face presentation is :
A. Anencephaly
B. Hydramnios
C. Microcephaly Hydrocephalus
D. Hydrocephalus

Response:
Anencephaly

So the answer to this question is A


Instruction:
Alfa blocker useful in BPH is?
A. Phentolamine
B. Prazosin
C. Tolazoline
D. Phenoxybenzamine

Response:
ANSWER: (B) PrazosinREF: Goodman and Gillman s 11TH edition page 172, 173, 183a BLOCKERSClassDrugsPharmacologicalActionsApplicationsUntoward EffectsNon selective/ classical a blockersPhenoxvbenzaminePhentolamineTolazolineDecrease in PVR and blood pressure VenodilationTreatment of catecholamine excess (Pheochromocytoma)Postural hypotension Failure of ejaculationSelective cq blockersPrazosinTerazosinDoxazosinTrimazosinAlfuzosinTamsulosinDecrease in PVR and blood pressure Relax smooth muscles in neck of urinary bladder and in prostatePrimary hypertension. Increase urine flow in BPHPostural hypotensionPrazosin, the prototypic quinazoline a blocker, is a potent and selective a receptor antagonist. In treating benign prostatic hyperplasia (BPH), doses from 1 to 5 mg twice daily typically are used. The twice-daily dosing requirement for prazosin is a disadvantage compared with newer a] receptor antagonists.

So the answer to this question is B


Instruction:
1 month old baby has microcephaly, hepatoslenomegaly. His urine stained with Giema shows owl's eye inclusion bodies. What is the diagnosis
A. CMV
B. EBV
C. Herpes simplex
D. Varicella zoster

Response:
OWL'S eye inclusion bodies are seen in CMV virus.

So the answer to this question is A


Instruction:
A death ceificate is given below, main underlying cause of death is :-
A. Pulmonary embolism
B. Secondary carcinoma shaft of femur
C. Fracture of femur
D. Malignant neoplasm of breast

Response:
Death ceificate consists of two pas. Pa I is divided into three sub pas - (a), (b) and (c). These are for disease processes that have led directly to death, (a) is a direct cause of death and is a consequence of (b), which in turn is due to (c). it is the disease in 1(c) or 1(d) that is the most impoant, as it is the primary pathological condition, the sta of the events leading to death. It is this disease that is the underlying cause of death. Pa I (c) and I(d) are the essence of death ceificate and denote the main underlying cause of death

So the answer to this question is D


Instruction:
In Corynebacterium diphtheria
A. Deep invasion is not seen
B. Elek’s test is done for toxigenicity
C. Metachromatic granules are seen
D. Toxigenicity is mediated by chromosomal change

Response:
• Diphtheria acts by its toxin and invasion is not seen.
• Elekc gel precipitation test is done for determination of pathogenicity of diphtheria.
• Metachromatic granules are seen also called as Babes earnest granules. Bacteriophages (extra-chromosomal) are responsible for toxigenicity by phage conversion.

So the answer to this question is D


Instruction:
All are true about Ebner glands, EXCEPT:
A. Is an exocrine gland
B. Situated on the dorsal surface of tongue
C. Secrete an acid labile lipase
D. Their secretion helps in digestion of fat

Response:
Ebner's Gland or Von Ebner Glands are exocrine glands located on the dorsal surface of tongue and are responsible for the secretion of lingual lipase. Lingual lipase is a acid stable lipase. Lingual lipase uses a catalytic triad consisting of Aspaatic Acid, Histidine, and Serine, to initiate the hydrolysis of a triglyceride into a diacyglyceride and a free fatty acid. Ref:Ganong's Review of Medical Physiology, 22nd Edition, Page 473

So the answer to this question is C


Instruction:
In which of the following arthritis erosions are not seen:
A. Rheumatoid arthritis
B. Systemic lupus erthematosus (SLE)
C. Psoriasis
D. Gout

Response:
Ans. is b' i.e., Systemic lupus erythematosus (SLE) About Musculoskeletal manifestation in SLE patients, Harrison writes -"Poly arthralgias and polyarthritis eventually occur in 90% of SLE patients.The arthritis initially involve the small joints in hands, knees and wrists.Joint deformities develop in only 10%.Erosions on joint X-rays are rare, their presence suggest a non lupus inflammatory arthropathy such as rheumatoid arthritis."Joint erosion are well known in all the other three options.

So the answer to this question is B


Instruction:
Complications of elbow dislocation are all EXCEPT: March 2004
A. Vascular injury
B. Median nerve injury
C. Myositis ossificans
D. VIC

Response:
Ans. d i.e. VIC

So the answer to this question is D


Instruction:
Which of the following statements on lymphoma is not True?
A. A single classification system of Hodgkin's disease is almost universally accepted
B. HD tends to remain localized to a single group of lymph nodes and spreads by contiguity
C. Several types of Non-Hodgkin's lymphoma may have a leukemic phase
D. In general follicular NHL has worse prognosis compared to diffuse NHL

Response:
Ans. is 'd' i.e., In general follicular NHL has worse prognosis compared to diffuse NHL o Multiple classification system exist for Non-Hodgkin's lymphoma.o The prognosis of Non-Hodgkins lymphoma varies markedly with various histological types of Non Hodgkin's lymphoma, In general lymphomas with a follicular histological pattern are of lower grade {longer survival than those ofdiffuse pattern).Clinical difference between Hodgkins and Non Hodgkins LymphomaHodgkins lymphomaHon Hodgkins lymphomao More often localized to a single axial group of cervical mediastinal, para-aortic nodes.o Orderly spread by contiguityo More frequent involvement of multiple peripheral nodeso Waldeyer ring and mesenteric nodes commonly involvedo Mesenteric nodes and Waldeyerring rarely involvedo Extra-nodal involvement uncommono Extranodal involvement common

So the answer to this question is D


Instruction:
Adrenocoical suppression causing drugs are all except ?
A. Prednisone
B. Ketoconazole
C. Mitotane
D. Spironolactone

Response:
Ans. is 'd' i.e., Spironolactone Drugs causing adrenocoical suppression are: Steroids (prednisone, hydrocoisone, and dexamethasone) Aminoglutethimide Fludrocoisone Ketoconazole Megestrol Metyrapone Mitotane

So the answer to this question is D


Instruction:
Uremia occurs when total GFR is reduced by-
A. 25%
B. 50%
C. 60%
D. 80%

Response:
There is no specific time for the onset of uremia for people with progressive loss of kidney function. People with kidney function below 50% (i.e. a glomerular filtration rate between 50 and 60 mL) and over 30 years of age may have uremia to a degree. Ref: Wikipedia

So the answer to this question is B


Instruction:
Antigen presenting cells are all of the following EXCEPT:-
A. Astrocytes
B. Endothelial cells
C. Epithelial cells
D. Langerhans cells

Response:
. Astrocytes

So the answer to this question is A


Instruction:
Putrefaction is a :
A. Perimoem sign of death
B. Immediate sign of death
C. Early sign of death
D. Late sign of death

Response:
D i.e. Late sign of death

So the answer to this question is D


Instruction:
The dielectric constant of water  is  ___.
A. 105
B. 78.5
C. 30
D. 60

Response:
Water, a strong dipole, has high dielectric constant.
The dielectric constant for water is 78.5.
It decreases the force of attraction between charged and polar species relative to water free environments with lower dielectric constants.

So the answer to this question is B


Instruction:
Hodgkin's lymphoma caused for by
A. EBV
B. CMV
C. HHV6
D. HHV8

Response:
Ref Robbins 9/e p607 One clue stems from the involvement of EBV. EBV is present in the RS cells in as many as 70% of cases of the mixed-cellularity subtype and a smaller fraction of other "classical" forms of Hodgkin lymphoma. More impoant, the integration of the EBV genome is identi- cal in all RS cells in a given case, indicating that infection precedes (and therefore may be related to) transformation and clonal expansion. Thus, as in Burkitt lymphoma and B cell lymphomas in immunodeficient patients, EBV infection prob- ably is one of several steps contributing to tumor develop- ment, paicularly of the mixed-cellularity subtype. The characteristic non-neoplastic, inflammatory cell infil- trate is generated by a number of cytokines, some secreted by RS cells, including IL-5 (which attracts and activates eosin- ophils), transforming growth factor-b (a fibrogenic factor), and IL-13 (which may stimulate RS cells through an autocrine mechanism). Conversely, the responding inflammatory cells, rather than being innocent bystanders, produce additional factors such as CD30 ligand that aid the growth and survival of RS cells and contribute fuher to the tissue reaction.

So the answer to this question is A


Instruction:
Isoniazide is metabolized by ?
A. Acetylation
B. Oxidation
C. Reduction
D. Hydrolysis

Response:
Ans. is 'a' i.e., Acetylation Isoniazid is extensively metabolized in liver most impoant pathway being N - acetylation by NAT The acetylated metabolite is excreted in urine. Drugs metabolized by acetylation Sulfonamides (including dapson) Procainamide PAS INH Hydralazine

So the answer to this question is A


Instruction:
A 3-year-old child has presented with abdominal lump and aniridia shown below. All genes are responsible for development of this condition except?
A. WT1
B. P53
C. Beta-catenin
D. K-ras

Response:
Ans. (d) K-ras gene.GeneWilms tumor characteristicFrequencyWT1Inselected-20%P-cateninUnselected-15% Tumors with WT1 mutations (-20% of total)-50%p53Anaplastic histology (-5% of total)-80% Image Source:

So the answer to this question is D


Instruction:
Carcinoma of pancreas associated with -
A. Hypoglycemia
B. Syndrome of inappropriate secretion of ADH
C. Erythropoeisis is due to erythropoietin
D. Hypercalcemia

Response:
None

So the answer to this question is B


Instruction:
Population growth is said to be less than adequate requirement when NRR is
A. < 1
B. 1
C. > 1
D. 0

Response:
Net reproductive rate is defined as the number of daughters a newborn girl will bear during her life time assuming fixed age specific feility and moality rates It is a demographic indicator NRR of 1 is equivalent to attaining approximately the 2 child norm If NRR is less than 1, then the reproductive performance of the population is said to below replacement level Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 489

So the answer to this question is A


Instruction:
Which of the following features distinguish Necrotizing Sialometaplasia from squamous Cell carcinoma?
A. Majority of intraoral cases present with ulceration and pain in the later stages
B. Varying degrees of lobar necrosis is seen
C. Squamous metaplasia of excretory ducts and acini are noted
D. Nests of squamous epithelium with several residual ductal lamina within them are noticed

Response:
None

So the answer to this question is D


Instruction:
Currarino triad includes:
A. Pre-sacral meningocele + Sacral defect + Tethered cord
B. Ectopia vesicae + Anorectal malformation + Sacrococcygeal osseous defect
C. Anorectal malformations + Sacrococcygeal osseous defect + Presacral mass
D. Tethered cord + Anorectal malformations + Ectopia vesicae

Response:
Currarino triadorASP triad: - Anorectal malformation or congenital anorectal stenosis - Sacrococcygeal osseous defect (always present) - Classically, hemisacrum with intact first sacral veebra ("sickle-shaped sacrum") - Mild (hypoplasia) to severe (agenesis) of sacrum and coccyx - Presacral mass (various types) - Anterior sacral meningocele - Tumor, e.g. mature teratoma - Dermoid/epidermoid cyst

So the answer to this question is C


Instruction:
Typical silvery scales of psoriasis are absent in –
A. Scalp
B. Kee
C. Groin
D. Elbow

Response:
Scaling is absent or minimal

Flexures (Groins, axillae, infra - mammary folds, vulva, gluteal cleft)
Glans in uncircumcised patients (in circumcised patients scales are present on glans
Guttate psoriasis

So the answer to this question is C


Instruction:
Colour coding of halothane , isoflurane, sevoflurane and desflurane is respectively
A. red, purple, blue , yellow
B. red , purple, yellow , blue
C. red , yellow, purple, blue
D. red, blue , purple, yellow

Response:
None

So the answer to this question is B


Instruction:
Larva found in muscle is -
A. Trichinella spiralis
B. Ancylostoma duodenale
C. Trichuris trichura
D. Enterobius vermicularis

Response:
Larvae of trichinella spiralis becomes encysted in the striated muscle fiber and at the time of encystment measures 1mm in length by 36 micro metre in diameter. Larva in cyst is coiled and hence the name spiralis. Ref : panikers textbook of Medical parasitology 8th edition page 171

So the answer to this question is A


Instruction:
True about esophageal injury:
A. Most common after penetrating injury
B. Can lead to mediastinal collection
C. Barium swallow is diagnostic
D. All

Response:
Ans is All Most injuries to the esophagus are from penetrating trauma. Associated injuries are the rule.Symptoms include odynophagia (pain on swallowing foods or fluids), subcutaneous or mediastinal emphysema, pleural effusion, air in the retro-esophageal space and unexplained fever within 24 hours of injury. Mediastinal and deep cervical emphysema must be seen as evidence of an aerodigestive injury until proven otherwise.If the diagnosis is made early, primary surgical repair is generally possible. If the diagnosis is delayed for more than 24 hours, primary repair may be impractical, with diversion and drainage being the only alternative. The major morbidity and moality associated with esophageal injuries are the result of delay in diagnosis, which underscores the necessity to aggressively exclude esophageal injury during the initial evaluation of a patient with neck injury. "The moality rate rises exponentially if treatment is delayed for more than 12-24 hours."- Bailey and LoveEsophagoscopy can be performed to evaluate the esophagus, but injuries have been missed with this technique alone. Therefore patients at risk should also undergo a soluble contrast esophagram looking for extravasation of contrast. If no extravasation is seen, a barium esophagram should be performed for greater detail. Failure to identify esophageal injuries leads to fulminant mediastinitis that is often fatal.Treatment consists of early debridement, primary repair, and drainage if identified within 24 hours after injury. Injuries diagnosed after 24 hours with mediastinal contamination are treated by cervical esophagostomy and distal feeding access. Esophageal resection is rarely needed but may be indicated in patients with esophageal necrosis or severe mediastinitis.. A drain should be left in place after all esophageal repairs.

So the answer to this question is D


Instruction:
Patient with MCV = 60, b = 5 gm % MCHC = 20 & PCV = 32 %, causes of anemia in him can be-a) Phenytoinb) Blind loop syndc) Hook worm infectiond) CRFe) Renal dialysis
A. cd
B. bc
C. bd
D. ac

Response:
None

So the answer to this question is A


Instruction:
A 15 year old girl with type 1 diabetes is brought to emergency complaining of dizziness. Laboratory findings include severe hyperglycemia, ketoacidosis and blood pH of 7.15. To achieve rapid control of severe ketoacidosis, appropriate drug is:
A. Crystalline zinc insulin
B. NPH insulin
C. Tolbutamide
D. Ultra lente insulin

Response:
Diabetic ketoacidosis must be managed by insulin preparations that can be given by intravenous route. Main insulin given intravenously is Regular insulin . Complication--> Hypoglycemia.

So the answer to this question is A


Instruction:
All of the following symptoms are seen in cystitis Except
A. Fever
B. Hematuria
C. Dysuria
D. Nocturia

Response:
In cystitis there will be increased frequency, pain, haematuria and pyuria. Pyrexia and rigors are not associated with simple UTI but are signs of upper tract infection or septicemia. Reference : Bailey &Love, 27th Edition, page no = 1442.

So the answer to this question is A


Instruction:
Tooth discoloration because of increase amount of bilirubin:
A. Chlorodontia.
B. Acrodontia
C. Trochodontia
D. None of the above

Response:
None

So the answer to this question is A