Instruction:
How long can blood stored with CPD - A ?
A. 12 days
B. 21 days
C. 28 days
D. 48 days

Response:
Ans. is 'c' i.e., 28 days Blood can stored with CPD -A --> upto 35 days Blood can stored with CPD ---> 21 days

So the answer to this question is C


Instruction:
False about hydatid cyst of liver:
A. Mostly asymptomatic
B. Most commonly located in right lobe of liver
C. Most common causative organism is echinococcus granulosus
D. Hepatic resection is never done

Response:
Ans is 'd' i.e. Hepatic resection is never done Laparoscopic aspiration, unroofing and evacuation of the hepatic hydatid cysts can be done.

So the answer to this question is D


Instruction:
A 30 year old unmarried woman of average socio-economic background believes that her boss is in secretly love with her. She rings him up at odd hours and writes love letter to him despite his serious warning not to do so. She holds this belief despite contradiction from family members & his denial. However she is able to manage her daily activities as before. She is most likely to be suffering from -
A. Depression
B. Shizophrenia
C. Delusional disorder
D. No psychatric ailment

Response:
None

So the answer to this question is C


Instruction:
Which of the following is true regarding IUGR ?
A. Asymmetrical IUGR: is far more common than symmetrical IUGR
B. Ponderal index is normal in symmetrical IUGR
C. Prognosis is better in asymmetrical IUGR than symmetrical IUGR
D. All of the above

Response:
All of the above

So the answer to this question is D


Instruction:
Secondary prevention is applicable to
A. Casual factors
B. Early stage of disease
C. Late stage of disease
D. General population

Response:
Secondary prevention includes early diagnosis and treatment, so it aims at preventing a disease progressing to complications Ref: Park&;s textbook of preventive and social medicine; 23rd edition; Pg no: 42

So the answer to this question is B


Instruction:
Direct uptake of free DNA by bacterial cell is
A. Translation
B. Transcription
C. Transformation
D. Conjugation

Response:
Ans. c (Transformation) (Ref. Anantanarayan, Microbiology, 6th ed., 53; Ref. Q. 101 of MH-2005)Method of transmissionCommentTransformation# A phenomenon in which transfer of genetic information occurs through the agency of free DNA.# Certain cell lines, such as cancer cells, are also able to grow indefinitely in culture by this mechanism.Transduction# Transfer of a portion of DNA from one bacteria to another by bacteriophage.# It is not confined to transfer of chromosomal DNA; it transduces episomes and plasmids also.# Bacteriophages are viruses that parasitise bacteria and consist of nucleic acid core and a protein coat.# It is excellent tool for genetic mapping of bacteria.Lysogenic conversion# Phage DNA becomes integrated with bacterial chromosome as prophage, which multiplies synchronously with host DNA and is transferred to daughter cells; this is lysogeny and bacteria harbouring prophages are lysogenic bacteria.# In transduction, phage acts only as vehicle carrying bacterial genes from one cell to another, but in lysogenic conversion, phage DNA itself is new genetic element.Conjugation# The process whereby 'male' or 'donor' bacteria mates or makes physical contact with female or recipient bacteria and transfers genetic element into it.Sexduction# Process of transfer of host genes through f factor, resembles transductionTransfection# Transfer of a gene into a cell, enabling the transfected cell to form a new gene product.

So the answer to this question is C


Instruction:
Breast milk is deficient in w hich vitamin -
A. Vitamin A
B. Vitamin B1
C. Vitamin K
D. VitaminC

Response:
Ans. is 'c' i.e., Vitamin K o Exclusive breasfed infants may have folfowine deficiencies -i) Vit Bl2 (if mother is strict vegetarian)ii) Vit Diii) Fluorideiv) Vit K"Breastfed infants are protected as the breastmilk contains adequate amounts of vitamin C, except when the mother is deficient in Vitamin C".-- O. P. Ghai 127

So the answer to this question is C


Instruction:
. A village has a total of 100 under-five children. The coverage with measles vaccine in this age group is 60%. Following the occurrence of a measles case in a child after a visit outside, twenty six children developed Of measles is - measles. The secondary attack rate
A. 0.25
B. 0.4
C. 0.5
D. 0.65

Response:
None

So the answer to this question is D


Instruction:
Cherry red spot NOT seen in?
A. Trauma
B. Tay Sachs
C. CRAO
D. CRVO

Response:
Ans. (d) CRVORef: A.K. Khurana 6th ed. 1269, 421Cherry Red Spot of Retina is seen in--*CRAO*Trauma (Blunt trauma, Berlins edema)*Neimann pick disease*Gauchers disease*Tay - Sachs disease*Sand hoff's diseaseMnemonic: Cherry Tree Never Grow Tall in Sand.

So the answer to this question is D


Instruction:
Operation theatres are sterilized by?
A. Carbolic acid spraying
B. Washing with soap and water
C. Formaldehyde
D. ETO gas

Response:
FORMALDEHYDE GAS is used for sterilizing instruments and heat sensitive catheters and for fumigating wards, sick rooms, and laboratories REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:36

So the answer to this question is C


Instruction:
Sorghum contains excess of
A. Lycine
B. Arginine
C. Leucine
D. Histidine

Response:
Ans. is 'c' i.e., Leucine o Jowar (Sorghum) contains excess of leucine which can cause niacine deficiency and pellagra.

So the answer to this question is C


Instruction:
A 5 years old child is having acute liver failure. Which one of the following criterial is not included in the King's college criteria?
A. Age < 11 years
B. INR > 6.5
C. Bilirubin > 300 mmol/L
D. Jaundice < 7 days before development of encephalopathy

Response:
King's College selection criteria for liver transplantation in acute liver failure Acetaminophen/Paracetamol induced pH <7.30 (irrespective of grade of encephalopathy) or INR >6.5+ serum creatinine >300 mmol/L + grade 3 or 4 encephalopathy. Acetaminophen/Non-paracetamol induced(irrespective of encephalopathy) INR >6.5 or any three of the following: Age <11 OR 40 years Drug toxicity,regardless of whether it caused ALF More than 7 days' jaundice before encephalopathy INR >3.5 Bilirubin >300 mmol/L

So the answer to this question is D


Instruction:
I cells of duodenum secrete
A. Secretin
B. Gastrin
C. CCK
D. Motilin

Response:
In addition to its secretion by I cells in the upper intestine, CCK is found in nerves in the distal ileum and colon.
It is also found in neurons in the brain, especially the cerebral cortex, and in nerves in many parts of the body.

So the answer to this question is C


Instruction:
In bacterial meningitis, CSF has
A. High protein
B. High glucose
C. High lymphocytes
D. High leukocytes

Response:
None

So the answer to this question is A


Instruction:
Which of the following is called Dense deposit disease
A. RPGN - I
B. MPGN - II
C. RPGN - II
D. MPGN - I

Response:
It is called Dense deposit disease because of deposition of abnormal, electron dense material within the GBM of kidney and often within Bructis membrance in the eye.

So the answer to this question is B


Instruction:
All tests are used to detect live bih, except: NEET 14
A. Ploucquet's test
B. Fodere's test
C. Gettler's test
D. Raygat's test

Response:
Ans. Gettler's test

So the answer to this question is C


Instruction:
Congenital infection in fetus with minimal teratogenic risk is:
A. HIV
B. Rubella
C. Varicella
D. CMV

Response:
Ans. is a, i.e. HIVRef. Dutta Obs. 7/e, p 300Teratogenic effects have not been documented with HIV infectionRubella, varicella and CMV infections have all been linked to a variety of congenital malformation in the fetusEffects of maternal HIV infection in pregnancyOn motherOn fetusThe course of HIV in mother remains unaltered as a result of pregnancyMaternal mortality or morbidity are not increased by HIVMain problems a/w HIV infection during pregnancy are related to preterm birth and IUGR.No teratogenic effects have been reported. Preterm labor, IUGRNo teratogenic effectsHIVMeaslesInfluenzaMumpsInfections causing congenital malformation (teratogenic effect)RubellaVaricellaToxoplasmosisMumpsCMVParvovirus

So the answer to this question is A


Instruction:
The most common cyst of the oral region is
A. Dentigerous cyst
B. Keratosis cyst
C. Dermoid cyst
D. Periapical cyst

Response:
repeated question.

So the answer to this question is D


Instruction:
CO2 in air is measured by
A. Kieffer test
B. EPKJMAN'S test
C. Silvered thermometer
D. Orthotoludene test

Response:
None

So the answer to this question is A


Instruction:
Treatment of choice for cheese reaction -
A. Prazocin
B. Pentazocin
C. Phentolamine
D. Phenoxybenzamine

Response:
Ans. is 'c' i.e., Phentolamine Cheese reactiono Certain varieties of cheese, beer, wines, picked meat and fish, yeast extract contain large quantities of tyramine, dopa.o in MAO inhibited patients these indirectly acting sympathomimetic amines escape degradation in the intestinal wall and liver - reaching into systemic circulation they displace large amount of NA from adrenergic nerve endings - Hypertensive crisis, cerebrovascular accidents,o This can be treated by Lv. injection of a rapidly acting phentolamine. Prazosin and chlorpromazine are alternative.

So the answer to this question is C


Instruction:
Gonioscope is used for visualization of
A. Anteior chamber angle
B. Posterior chamber angle
C. Anterior surface of lens
D. Posterior chamber

Response:
Gonioscopy: Owing to lack of transparency of corneoscleral junction and total internal reflection of light (emitted from angle structures) at the anterior surface of cornea it is not possible to visualize the angle of anterior chamber directly. Therefore, a device (goniolens) is used to dive the beam of light and this technique of biomicroscopic examination of the angle of the anterior chamber is called gonioscopy. Types of goniolens: (i) Indirect goniolens provides a mirror image of the opposite angle, e.g., Goldmann and the Zeiss goniolens (ii) Direct goniolens provides a direct view of the angle. Koeppe goniolens is the most popular type. The angle structures seen from behind forwards are: 1. The root of the iris 2. The anteromedial surface of the ciliary body (ciliary band), 3. Scleral spur 4. Trabecular meshwork and Schlemm's canal and 5. Schwalbe's line Applications of gonioscopy: 1. Classification of glaucoma into open angle and closed angle based on the configuration of the angle. 2. Localization of foreign bodies, abnormal blood vessels or tumors in the angle. 3. Demonstration of the extent of peripheral anterior synechiae and hence planning of glaucoma surgery. Ref: Khurana comprehensive ophthalmology; 4th edition Pg: 546

So the answer to this question is A


Instruction:
Immunization is
A. Primary Prevention
B. Secondary prevention
C. Teiary Prevention
D. Disability Limitation

Response:
Primary prevention is action taken prior to the onset of disease which removes the possibility that a disease will ever occur.It includes actions taken for the protection of health by personal and community effos, such as enhancing nutritional status, providing immunizations and eliminating environmental risks (sanitation...etc)Park 23epg: 43

So the answer to this question is A


Instruction:
With regards to the anorectal angle, what is true
A. It distributes intraabdominal forces onto the pelvic floor and plays and impoant role in continence mechanism
B. It is due to the pull of the external sphincter
C. It is around 30 degrees at trest
D. The angle increases at the time of defecation

Response:
Answer- A. It distributes intraabdominal forces onto the pelvic floor and plays and impoant role in continence mechanismAt rest the puborectalis muscle creates a 'sling' around the distal rectum, forming a relatively acute angle (Anorectal angle).It is 90 to 100 degrees at rest.Both the internal and external sphincters are innervated by pudendal nerve.

So the answer to this question is A


Instruction:
Secretory sinus in neck, moving upon deglutination:
A. Branchial sinus
B. Pilonidal cyst
C. Thyroglossal fistula
D. Sublingual dermoid cyst

Response:
Ans. (c) Thyroglossal fistulaRef: Dhingra's ENT 5th ed. / 398* Sublingual dermoid cyst present as midline submental swelling. This cyst is not attached to foramen cecum and hence doesn't move upon tongue protrusion or upon deglutition.* The thyroglossal cyst classically moves upwards with swallowing and notably with tongue protrusion, as it is attached to foramen cecum. It merely indicates attachment to the hyoid bone.

So the answer to this question is C


Instruction:
Esthetic restorative materials are
A. Glass ionomer cement
B. composite
C. silicate
D. all of the above

Response:
None

So the answer to this question is D


Instruction:
Peripheral neuropathy in chronic kidney disease starts at :
A. Stage - 1
B. Stage - 2
C. Stage - 3
D. Stage - 4

Response:
Anaemia starts at stage - 3.
P.neuropathy at stage - 4.

So the answer to this question is D


Instruction:
A developer at high temperature will cause
A. Clear white spots on the film
B. Yellow stains
C. Very dark image
D. Very light image

Response:
None

So the answer to this question is C


Instruction:
To which of the following family of chemical mediator of inflammation,the lipoxins belong
A. Kinin system
B. Cytokines
C. Chemokines
D. Arachidonic acid metabolites

Response:
ref Robbins 7/e p69 lipoxins are a recent addition to the family of bioactive products generated from arachidonic acid.they have anti inflammatory activity

So the answer to this question is D


Instruction:
You are called to a maternity ward to see a 23 year-old primi patient who had delivered a 2.7 kg baby boy 2 days back. She had a normal vaginal delivery and placenta delivered spontaneously. Now she complains of bloody vaginal discharge with no other signs. O/E you notice a sweetish odour bloody discharge on the vaginal walls and introitus. Sterile pelvic examination shows a soft nontender uterus. Her P/R-78/min, B/P-110/76 mm of hg, temp-37degC, R/R-16/min. Her WBC count = 10,000 with predominant granulocytes. What is the most appropriate step?
A. Currettage
B. Oral antibiotics
C. Reassurance
D. Order urinalysis

Response:
Ans. is c, i.e. ReassuranceRef. Dutta Obs 7/e, p 146This patient is a puerperal female who is complaining of bloody vaginal discharge with no other significant abnormal signs. On examination there is a sweetish odour bloody discharge on the vaginal walls and introitus. Her vitals are normal suggesting that this cannot be PPH (The most common cause of secondary PPH is retained bits of placenta for which curettage is done, but here it is not required).Slight amount of bloody discharge called as lochia is absolutely normal for the first 15 days after delivery and does not require any treatment, so we will reassure the patient and do nothing.Do not get confused with the finding of WBC count, 10,000 with predominant granulocytes as this is a normal finding in the puerperal period. Note- leucocytes can rise to as high as 25000 during puerperium probably as a response to the stress of labor). Since lochia has no foul smell it means no infection and so no need for culture or antibiotics.

So the answer to this question is C


Instruction:
Cyclophosphamide can cause?
A. Hemorragic cystitis
B. Hand-foot syndrome
C. Radiation Recall
D. Cardiomyopathy

Response:
Ans. is 'a' i.e., Haemorrhagic cystitis "Haemorrhagic cystitis can develop in patients receiving cyclophosphamide or ifbsphamide".

So the answer to this question is A


Instruction:
Magendie foramen or the Median apeure drains CSF from?
A. Lateral ventricle
B. 3rd ventricle
C. 4th ventricle
D. Interpeduncular fossa

Response:
4th ventricleREP: Gray's anatomy 39' edition p. 291The median apeure ("Foramen of Magendie") drains CSF from the fouh ventricle into the cisterna magna.The two lateral apeures (foramina of Luschka), one on the left and one on the right, are the primary routesfor drainage of cerebrospinal fluid from the fouh ventricle into the cerebellopontine angle cistern.The foramen on axial images is posterior to the pons and anterior to the caudal cerebellum.

So the answer to this question is C


Instruction:
Posterior superior iliac spine is at the level of
A. L5
B. S1
C. S2
D. S3

Response:
PSIS line identifies the S2 spinous process most frequently

So the answer to this question is C


Instruction:
During the cardiac cycle the opening of the aortic valve takes place at
A. Beginning of systole
B. End of isovolumetric contraction
C. End of Diastole
D. End of diastasis

Response:
None

So the answer to this question is B


Instruction:
Acceptable noise levels in bed room
A. 40dB
B. 35dB
C. 20dB
D. 25dB

Response:
Acceptable noise levels Expressed in dB (A), sound pressure levels conforming to weighting curve (A) Environment Place Acceptable noise level dB(A) Residential Bed room 25 Living room 40 Commercial Office 35-45 Conference 40-45 Restaurants 40-45 Industrial Work shop 40-60 Laboratory 40-50 Educational Class room 30-40 Library 35-40 Hospitals Wards 20-35 Ref: Park 25th edition Pgno : 779

So the answer to this question is D


Instruction:
Which is the earliest symptom of benign hypertrophy of prostate -
A. Frequency
B. Haematuria
C. Incontinence
D. Strangury

Response:
None

So the answer to this question is A


Instruction:
Which personality disorder can be considered a pa of autistic spectrum disorders?
A. Schizoid
B. Schizotypal
C. Borderline
D. All of the above

Response:
The characteristic feature of autistic spectrum disorder (ASD) is impairment in social interaction and communication. These features are also seen in schizoid personality disorder (Cluster A PD) where pateint prefer solitary activities and is emotionally cold and detached. There can be significant difficulty differentiating between schizoid PD and milder forms of ASD. It must be remembered that patients with ASD have more severe social impairment and also have stereotypical behaviours and interests.

So the answer to this question is A


Instruction:
Radiological appearance of 'thimble' bladder is seen in the following condition:
A. Cystitis cystica
B. Chronic tuberculous cystitis
C. Neurogenic bladder
D. Acute tuberculous cystitis

Response:
Early tuberculosis of the bladder commences around the ureteric orifice or trigone, the earliest evidence being pallor of the mucosa due to submucosal oedema. Subsequently, tubercles may be seen and, in long standing cases, there is marked fibrosis and the capacity of the bladder is greatly reduced giving the radiological appearance of 'thimble bladder'. Ref: Bailey & Love's Sho Practice of Surgery 26E edited by Norman Williams, Christopher Bulstrode, P Ronan O'Connell, 2013, Page 1327-1328

So the answer to this question is B


Instruction:
All are dermatological manifestations of dermatomyositis except -
A. Gottron's patches
B. Mechanic's hands
C. Periungual telangiectasia
D. Salmon Rash

Response:
Cutaneous features of dermatomyositis are heliotrope erythema , gottrons papules, gottrons sign, telangiectasia in nail fold , poikiloderma, mechanics hand , calcinosis cutis, shawl sign, holster sign Salmon rash is seen in adult onset stills disease.

So the answer to this question is D


Instruction:
What is true in case of perforation of pars flaccida?
A. CSOM is a rare cause
B. Associated with cholesteatoma
C. Usually due to trauma
D. All of the above

Response:
Ans. B Associated with cholesteatomaTympanic membrane can be divided in 2 pas:Parstensa : It forms most of the tympanic membrane. Its periphery is thickened to form fibro cailaginous ring called as annulus tympanicus.Pars Falccida : It is situated above the lateral process of malleus between the notch of Rivinus and the anterior and posterior malleolar folD. Perforation in tympanic membrane can be in Central* Occurs in tubotympanic type ofCSOM* Not associated with cholesteatoma* Considered safe Marginal (Perforation destroys even the annulus) theraby reaching sulcus tympanicusMost common is posterio superiormarqinal?- occur in attico antral type of CSOM- associated with cholesteatoma- considered unsafe / dangerous Attic perforation NoteMost common cause of perforation is chronic otitis mediaMnemonicFamousF - Perforation of Pars FlaccidA.A - Seen in Atticoantral/marginal perforationM - Associated with CSOM (of atticoantral type) or acute necrotizing otitis mediao - Associated with CholesteatomaU - Unsafe typeS - Surgery is TOe.

So the answer to this question is B


Instruction:
Risk factors for malignant change in an asymptomatic patient with a gall bladder polyp on ultrasound include all of the following except
A. Age > 60 years
B. Rapid increase in size of polyp
C. Size of polyp > 5 mm
D. Associated Gall stones

Response:
Gall bladder polyp more than 10 mm in size needs surgical intervention as the risk for developing malignancy is greater.Other risk factors include age>60 yrs,association with gallstones,rapid increase in size of polyp,symptomatic,sessile polyp. Reference:SRB's manual of surgery,5th edition,page no:658.

So the answer to this question is C


Instruction:
Renal trauma is best treated by
A. Observation and supportive measures
B. Early drainage of perirenal haematoma
C. Heminephrectomy
D. Nephrostomy

Response:
None

So the answer to this question is A


Instruction:
Which of the following is feminizing ovarian tumours:
A. Granulosa cell tumour
B. Arrhenoblastoma
C. Hilus cell tumour
D. Gynandroblastoma

Response:
(Granulosa cell tumour): Ref: 362-S (339-S14th)TUMOURS ARISING FROM PRIMITIVE MESENCHYME(a) Feminizing: Granulosa cell, Theca cell, Leteoma(b) Neutral: Dyserminoma (Seminoma)(c) Virilising: Arrhenoblastoma, suprarenal cortical tumour, Hilus cell tumours(d) Mixed: Gynandroblastoma

So the answer to this question is A


Instruction:
Warrant cases are punishable with imprisonment: DNB 09
A. More than 1 year
B. More than 2 years
C. Less than 1 year
D. Less than 2 years

Response:
Ans. More than 2 years

So the answer to this question is B


Instruction:
Which of the following is not seen in'Hereditary Spherocytosis:
A. Direct Coomb's Positive
B. Increased Osmotic Fragility
C. Splenomegaly
D. Gall Stones

Response:
Answer is A (Direct Coomb's Positive)Coomb's Negative Haemolytic Anaemia.Coomb's test is impoant to distinguish Hereditary Spherocytosis from Autoimmune haemolysis which is another common cause of Spherocytosis. Hereditary Spherocytosis is a coomb's negative haemolytic anemia (non-immune mediated) characterized clinically by anaemia, jaundice, splenomegaly and pigment gall stones. Typical Laboratory findings include spherocytosis (abundant spherocytes on peripheral smear) and increased osmotic fragility. There is no definitive treatment to correct the primary defect in the membrane cytoskeletal structure. Splenectomy remains the treatment of choice for severe cases of Hereditary Spherocytosis (since Spleen is the primary site of destruction of red blood cells and transit through the splenic circulation makes them more spherocytic thereby accelerating their death.

So the answer to this question is A


Instruction:
While seeing a colour chart a colour blind male has decreased vision for red light colour which appear very light than that of other colours. Which of the following is the likely anomaly in him?
A. Protanomaly
B. Dutanomaly
C. Tritanomaly
D. Butanomaly

Response:
(A) Protanomaly > Prefixes "Prot = red, Deuter = green & Tri = blue refer to defects cone system, respectively Suffixes anomaly = colour weakness; anopia = colour blindness> Individuals with normal colour vision and those with Protanomaly (red colour weakness), deuteranomaly (green colour weakness), and tritanomaly (blue colour weakness) are called Trichomates --i.e. they have all three cones, system but one is weak.> Dichromates: only two cone system present, E.g. Protanopia = red cone absent; Deuteranopia = green cone absent Tritanopia = Blue cone absent.

So the answer to this question is A


Instruction:
Foveola is at what distance from optic disc margin
A. 1 mm
B. 2 mm
C. 3 mm
D. 4 mm

Response:
Distance = 2 disc diopters
     = 2 x 1.5 mm
     = 3 mm

So the answer to this question is C


Instruction:
Not a feature of Venal keratoconjunctivitis is
A. More common in summers
B. Cobble stone appearance
C. Fascicular corneal ulcer
D. Keratoconus

Response:
Fascicular ulcer is seen in Phlyctenular keratoconjunc vi s.

So the answer to this question is C


Instruction:
A 30-year-old patient presented with history of jaundice for 30 days. His liver function tests showed bilirubin of 100mg/dI, SGOT/SGPT-1 100/1450, serum alkaline phosphatase-240 IU. He was positive for Hbs Ag. What should be the confirmatory test to establish Acute hepatitis B infection?
A. IgM Anti-HBc antibody
B. HbeAg
C. HBV DNA by PCR
D. Anti-HBc antibody

Response:
Answer is A (IgM - Anti - HBc antibody) :

So the answer to this question is A


Instruction:
Lymphatic drainage of the stomach include all except-
A. Right gastroepiploic nodes
B. Pyloric nodes
C. Preaortic nodes
D. Coeliac nodes

Response:
Lymphatic drainage of stomach

The stomach can be divided into four lymphatic territories . The drainage of these areas is as follows.
Upper part of left 1/3rd drains into the pancreaticosplenic nodes lying along the splenic artery, i.e. on the back of the stomach. Lymph vessels from these nodes travel along the splenic artery to reach the coeliac nodes.
Right 2/3rd drains into the left gastric nodes lying along the artery of the same name. These nodes also drain the abdominal part of the oesophagus. Lymph from these nodes drains into the coeliac nodes.
Lower part of left 1/3rd drains into the right gastroepiploic nodes that lie along the artery of the same name. Lymph vessels arising in these nodes drain into the first and second parts of the duodenum. From here the lymph is drained further into the hepatic nodes that lie along the hepatic artery; and finally into the coeliac nodes.
Lymph from i.e. pyloric part drains in different directions into the pyloric, hepatic, and left gastric nodes, and passes from all these nodes to the coeliac nodes.
Note that lymph from all areas of the stomach ultimately reaches the coeliac nodes. From here it passes through the intestinal lymph trunk to reach the cisterna chyli.

So the answer to this question is C


Instruction:
A 60-year old female had fallen in the bathroom and she is not able to stand on her feet. On examination, her right leg was in external rotation and was not able to move her leg. There was tenderness in Scarpa's triangle. There is no history of fever. X-ray shows no fracture line. What is the next step of management?
A. MRI
B. Strict bed rest for 10 days and repeat X-ray
C. Joint Aspiration
D. Start proper anlgesia and start mobilization to prevent stiffness

Response:
Ans. a. MRI (Ref: Apley's 11/848, 849)History of fall followed by tenderness in Scarpa's triangle and leg in externally rotated position is suggestive of fracture neck of femur. An impacted, undisplaced fracture is likely to be missed on an X-ray. An MRl or a bone scan would be needed to diagnose the lesion."Impacted fractures may be extremely difficult to discern on plain X-ray. If there is a fracture it will show up on MRI or a bone scan after few days."- Apley 11/848

So the answer to this question is A


Instruction:
Conduct disorder in a child manifests with -a) Disregard for right of othersb) Doesn't care for authorityc) Backward in studiesd) Decreased head circumferencee) Steals things
A. bcde
B. abcd
C. abce
D. abde

Response:
Conduct disorder is characterized by a persistent and significant pattern of conduct in which the basic rights of others are violated or rules of society are not followed (Doesn't care for authority). The characteristic clinical features are frequent lying, stealing or robbery, Physical violence (rape, assault, fire setting, use of weapons, fighting), running away from school (backward in studies), cruelty to animals and people.

So the answer to this question is C


Instruction:
Venous emboli are most often lodged in
A. Intestines
B. Lungs
C. Kidneys
D. Heart

Response:
None

So the answer to this question is B


Instruction:
Fluoride rich materials include:
A. Silicate cement
B. Glass ionomer cement
C. Polycarboxylate cement
D. All of the above

Response:
The anticariogenic potential of silicate cement confirms the ability of F- to inhibit demineralization, leading to the development of several fluoride-containing restorative materials and cements: conventional glass ionomers, resin-modified glass ionomers, polyacid-modified composites (compomers), composites, and even amalgams.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 334

So the answer to this question is D


Instruction:
Best preservative for protozoal cysts is
A. 10 % formalin
B. Isopropyl alchol
C. HCL Solution
D. Naoh solution

Response:
10 % formalin is ALL - purpose fixative used for preservation of morphology of helminth eggs, larvae, protozoan cysts and coccidian.

So the answer to this question is A


Instruction:
Which of the follow ing is gram positive bacillus-
A. Staphylococcus
B. Streptococcus
C. Listeria
D. Meningococci

Response:
Ans. is 'c' i.e., Listeria Gram positive bacteriao There are 6 classic gram positive bacteria that cause human disease,o Of these 2 are cocci1. Staphylococci2 Streptococci (including anaerobic peptostreptococci)o Other 4 are bacilli1. Corynebacterium3. Clostridium2 Bacillus4. Listeria

So the answer to this question is C


Instruction:
Of the light produced by quartz — tungsten -halogen, only a small percentage is suitable for curing composite resin material and most is converted into heat. How much percentage of this light is useful for curing?
A. 0.50%
B. 5%
C. 10%
D. 50%

Response:
None

So the answer to this question is A


Instruction:
Fundal height is more than period of gestation in all except:
A. Hydramnios
B. IUD
C. Twin pregnancy
D. Hydatidiform mole

Response:
Ans. is b, i.e. IUDRef. Dutta Obs. 7/e, p 78Condition where the Height of Uterus is more than the Period of Amenorrhea:Mistaken datesTwinsPolyhydramniosBig babyPelvic tumours - Ovarian/fibroidH moleConcealed accidental hemorrhage.Conditions where the Height of Uterus is less than the Period of Amenorrhea:Mistaken datesScanty liquorFetal growth restrictionIntrauterine fetal death.

So the answer to this question is B


Instruction:
All of the following may lead to pigment gall stones except -
A. Chronic Hemolysis
B. Hepatocellular Carcinoma
C. Alcoholic Cirrhosis
D. Biliary tract infection

Response:
Answer- B. Hepatocellular CarcinomaDemographic/genetic factors: Asia, rural settingChronic hemolysisAlcoholic cirrhosisPernicious anemiaChronic biliary tract infection, parasite infections (Escherichia coli, Ascaris lumbricoides, Clonorchis sinensis)Increasing ageIleal disease, ileal resection orblpassCystic fibrosis

So the answer to this question is B


Instruction:
All of the following are anti-pseudomonal EXCEPT: March 2013
A. Piperacillin
B. Cefoperazone
C. Ceftazidime
D. Cefadroxil

Response:
Ans. D i.e. Cefadroxil Spectrum of Cefadroxil Good gram (+)ve (Streptococcus pyogenes (GAS), Staphylococcus) Gram (-)ve (Proteus, E. coli, Klebsiella)

So the answer to this question is D


Instruction:
This 23-year-old man was involved in a motor vehicle accident. What is the diagnosis?
A. Aortic dissection
B. Cardiac rupture
C. Diaphragmatic rupture
D. Pneumothorax

Response:
Answer D. PneumothoraxThe presence of a deep, lucent, right costophrenic angle on supine chest radiography is an indirect sign of a pneumothorax. In addition, a pneumothorax with associated rib fractures and subcutaneous emphysema is evident in the right chest. The patient's endotracheal tube needs to be withdrawn further into the trachea.

So the answer to this question is D


Instruction:
IVC pierces the diaphgram at what vertebral level-
A. T6
B. T8
C. T10
D. T12

Response:
Ans. is 'b' i.e., T8 OpeningVertebral levelIn which part of diaphragmPassing structureVena CavalT8Central tendon# Inferior vena cava# Right phrenic nerveOseophagealT10Muscular portion derived from right crus# Oesophagus# Oesophageal br. of left gastric artery# Gastric or vagus nerveAorticT12Osseoaponeurotic between right and lateral crus# Aorta# Thoracic duct# Azygous vein

So the answer to this question is B


Instruction:
Which type of Schizophrenia carries the worst prognosis?
A. Catatonic
B. Hebephrenic
C. Paranoid
D. Simple

Response:
Simple Schizophrenia carries the worst prognosis.
It is characterized by presence of only negative symptoms & no positive symptoms. (Presence of negative symptoms always carry bad prognosis)

So the answer to this question is D


Instruction:
Growth hormone secretion is decreased by ?
A. Hypoglycemia
B. Exercise
C. REM sleep
D. Stress

Response:
Ans. is 'c' i.e., REM sleep REM sleep decreases the secretion of GH. Other three stimuli increase GH secretion.

So the answer to this question is C


Instruction:
True about stab wounds:
A. Depth is greater than breadth
B. Breadth is greater than depth
C. Length is greater than breadth
D. It has wound of entry and exit

Response:
Ans. (A). Depth greater than breadthStab injuries are caused by pointed weapons..In stab injury, depth is the maximum dimensionIn incised wound, length is the maximum dimension.Chop injury shows wide gaping.Lacerations shows tissue bridging.

So the answer to this question is A


Instruction:
Epleronone is:
A. Aldosterone antagonist
B. Can cause hyperkalemia in predisposed patients
C. A diuretic
D. All of these

Response:
Epleronone is an aldosterone antagonist (like spironolactone). It is used as potassium sparing diuretic and can cause hyperkalemia in susceptible individuals paicularly in the patients on ACE inhibitors.

So the answer to this question is D


Instruction:
Which of the following cells secrete HCL?
A. Surface Neck Cells
B. Mucous Neck Cells
C. Parietal Cells
D. Chief Cells

Response:
Parietal Cell secretes HCL and intrinsic factor Chief Cells secrete Pepsinogen and Gastric Lipase G cells secrets gastrin NO GOBLET CELLS IN GASTRIC GLANDS

So the answer to this question is C


Instruction:
Endemic ascitis is associated with the following aEUR'
A. Pyrrolizidine
B. Aflatoxin
C. Sanguinarine
D. Beta oxalylamino alanine (BOAA)

Response:
Pyrrolizidine Repeat from Nov 06 Endemic ascites is caused by a hepatotoxin - pyrrolizidine alkaloid found in weed seeds of Crotolaria (Jhunjhunia). These weed seeds of Jhunjhunia contaminate the millet seeds Panicum milare (locally k/a Gondhli) Endemic ascites presented in Sarguja district of Madhya Pradesh during 1973 & 1976 as outbreak of rapidly developing ascites and jaundice with high moality. Preventive measures - educating the people - deweeding of Jhunjhunia plants which grow along with the staple food-millet. - sieving to separate out the Jhunjhunia seeds from millet seeds. Other food toxicant diseases: Neurolathyrism - caused by toxin Beta oxalyl amino alanine (BOAA) found in seeds of pulse Lathyrus sativum (Khersari dal) Epidemic dropsy - caused by toxic alkaloid Sanguinarine found in argemone mexicana seeds. Argemone oil contaminates mustard oil. Aflatoxicosis is due to ingestion of aflatoxins produced by ceain fungi, Aspergillus flavus and A. parasiticus. Aflatoxins are hepatotoxins & also carcinogenic.

So the answer to this question is A


Instruction:
Which of the following drug is a SERM useful for treatment of osteoporosis ?
A. Raloxifene
B. Bisphosphonate
C. Strontium
D. Estradiol

Response:
None

So the answer to this question is A


Instruction:
The performance of a prophylactic salpingo-oophorectomy reduced the risk of BRCA-related gynaecologic cancer by
A. 15%
B. 28%
C. 54%
D. 96%

Response:
The performance of a prophylactic salpingo-oophorectomy reduced the risk of BRCA related gynaecologic cancer by 96%. The risk of developing subsequent breast cancer was reduced by 50% to 80%.

So the answer to this question is D


Instruction:
Which of the following used as a reference for a study through a period of time
A. Base line data
B. Prevalence
C. Incidence
D. Rate

Response:
None

So the answer to this question is B


Instruction:
Most common site of eosinophilic granuloma ?
A. Radius
B. Femur
C. Skull
D. Lumbar veebrae

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

So the answer to this question is C


Instruction:
Most common metabolic disturbance of cirrhosis is
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Response:
Electrolyte abnormalities in Cirrhosis Hyponatremia Hypokalaemia Metabolic alkalosis (precipitate PNH) Ref: Sabiston 20th edition Pgno :565

So the answer to this question is B


Instruction:
Isotope Renogram ?
A. Study of renin mechanism
B. Contrast study of kidneys, ureter and bladder
C. Utilised in mapping the anatomy of kidneys
D. Graphic representation of radioactivity of kidneys

Response:
Ans. is 'd' i.e., Graphic representation of radioactivity of kidneys

So the answer to this question is D


Instruction:
Which of the following present with loss of consciousness:
A. Schizophrenia
B. Dementia
C. Mania
D. Organic brain syndrome

Response:
Ans. (d) Organic brain syndromeORGANIC BRAIN SYNDROME* It is also known as organic brain disease which is decreased mental function due to a medical disease, other than a psychiatric illness.* Cognitive or higher mental functions (i.e. consciousness, orientation & abstract thinking) are impaired in organic brain syndrome.

So the answer to this question is D


Instruction:
Voex vein invasion is commonly seen in -
A. Retinoblastoma
B. Malignant melanoma
C. Optic nerve gliomas
D. Medullo- epitheliomas

Response:
*Voex vein involvement is seen in uveal malignant melanoma. Ref: Ophthalmic pathology : guide for clinicians p.253.

So the answer to this question is B


Instruction:
Major mono-oxygenase in the endoplasmic reticulum is:
A. Cytochrome P450
B. Cytochromes
C. Epoxide reductase
D. Glutathione reductase

Response:
Ans. A. Cytochrome P450Cytochrome P450 is the major monooxygenase present in the endoplasmic reticulum. The usage 450 refers to the absorption peak exhibited by the enzymes when exposed to carbon monoxide.Most of the reactions involve the addition of a hydroxyl group to aliphatic or aromatic compounds.

So the answer to this question is A


Instruction:
Attico antral disease is treated by -
A. Modified radical mastoidectomy
B. Antibiotics
C. Grommet insertion
D. Synringing

Response:
Ans. is 'a' i.e., Modified radical mastoidectomy Treatment of atticoantral diseaseo Since cholesteatoma is going to expand and destroy bone and mucous membrane, it has to be removed. Therefore, surgery is the mainstay of treatment Primary aim is removal of disease by mastoidectomy to make ear safe followed by reconstruction of hearing at a later stage. Modified radical mastoidectomy is the surgery of choice.o Two types of surgical procedures (mastoidectomy) are done to deal with cholesteatoma.Canal wall down proceduresThese leave the mastoid cavity open into the external auditory canal so that the diseased area is fully exteriorized.The commonly used procedures for atticoantral disease are atticotomy, modified radical mastoidectomy and rarely radical mastoidectomy.Modified radical mastoidectomy is the procedure of choice.Canal wall up procedures (cortical mastoidectomy)Here disease is removed by combined approach through the meatus and mastoid but retaining the posterior bony meatus wall, thereby avoiding an open mastoid cavity.o For reconstruction of hearing mechanism myringoplasty or tympanoplasty can be done at the time of primary surgery or as a second stage procedure.

So the answer to this question is A


Instruction:
Cements in dentistry can be used as:
A. Liners
B. Bases
C. RC fillers
D. All of the above

Response:
None

So the answer to this question is D


Instruction:
Pseudo-Pelger-Huet cells or seen in
A. Hairy cell leukemia
B. Multiple myeloma
C. Mylodysplastic syndrome
D. Hodgkin's lymphoma

Response:
Ans. is 'c' i.e., Myelodysplastic syndrome

So the answer to this question is C


Instruction:
Miotics are indicated in the treatment of which type of squint ?
A. Divergent squint
B. Convergent squint
C. Paralytic squint
D. All

Response:
Miotics (ecthiopate 0.125%) can be used for accommodative esotropia (convergent squints). Formation of iris cysts due to echothiopate can be prevented by using phenylephrine 2.5% drops.

So the answer to this question is B


Instruction:
Which of the most common type of fingerprint ?
A. Arch
B. Composite
C. Loops
D. Whorls

Response:
About 60 - 70% people have loop pattern in their fingerprints.
The order of Frequency is

Loops (60 - 70%)
Whorls
Arch
Composite

So the answer to this question is C


Instruction:
A patient presents with jaundice, Physical examination reveals an enlarged nodular liver. CT of the abdomen shows a cirrhotic liver with a large mass. CT guided biopsy of the mass demonstrates a malignant tumor derived from hepatic parenchymal cells. Infection with which of the following viruses would most directly related to the development of this tumor?
A. Epstein-Barr virus
B. Human Herpes virus type A
C. Human T-lymphocyte virus
D. Hepatitis B virus

Response:
None

So the answer to this question is D


Instruction:
Type of sphenoid sinus in the adult population is usually
A. Sellar
B. Post sellar
C. Pre sellar
D. Maximal Pneumatization

Response:
The types of the sphenoid sinus can be classified in three groups in the adult: I. conchal, II. pre sellar, and III sellar types, depending on the extent to which the sphenoid bone is pneumatized.In the conchal type, the area below the sellar is a solid block of bone without an air cavity.In the pre sellar type, the sphenoid sinus has moderate air cavity with no sellar indentation.In the sellar type, which is the most common, the corpus of the sphenoid is well pneumatized with full indentation of the sellar into the sinus and extends posteriorly until the clivusThe conchal type is most common in children and infrequent in the adult (Rhoton).

So the answer to this question is A


Instruction:
Lymphovenous anastomosis is done for -
A. Filarial lymphoedema
B. Lymphoid cyst
C. Cystic hygroma
D. Malignant lymphoedema

Response:
None

So the answer to this question is A


Instruction:
True regarding lateral spinothalamic tract is:
A. Transmits contralateral touch
B. Transmits ipsilateral pain
C. Crosses brain at thalamus
D. Lower most fibres are lateral

Response:
(Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 166-169)

So the answer to this question is D


Instruction:
The most important mechanical property involved when a base metal partial denture clasp is adjusted is:
A. Hardness
B. Elongation
C. Elastic limit
D. Tensile strength

Response:
None

So the answer to this question is B


Instruction:
The processing of short term memory to long term memory is done in
A. Prefrontal cortex
B. Hippocampus
C. Neocortex
D. Amygdala

Response:
(B) Hippocampus # Role of Hippocampus in Memory# HIPPOCAMPUS is currently credited with being the area of the brain in which short term memories are converted into long term memories.> 3 major neuronal pathways have been described in the hippocampus that are responsible for conversion of short term memory into long term memory.> Long term potentiation (LTP) has been used as the cellular model re sponsible for long term memory in the Hippocampus - Journal of Neuroscience> Hippocampus is the site in brain where short term memory are converted into long term memory> Hippocampus is not the site where long term memory is stored.> Memory is a complex function of the brain that uses several storage buffers of differing capacity and duration. It can be divided into three major types: working, episodic, and long-term, or remote, memory.> Memory function includes registration (encoding or acquisition), retention (storage or consolidation), stabilization (consolidation), and retrieval (decoding or recall). Registration and retrieval are conscious processes. The process of encoding is dependent upon the frontal lobes and hippocampal complex, while the process of retrieval requires the frontal lobes.

So the answer to this question is B


Instruction:
Jerne's hypothesis is for
A. Isotypic network
B. Idiotypic network
C. Alotypic network
D. Immune complex

Response:
Ans. b (Idiotypic network) (Ref. Anantanarayan, Microbiology, 6th ed., 91)Sequential anti-idiotypic antibody formation is the basis of Jeme's network hypothesis of immune regulation.IMMUNOGLOBULIN SPECIFICITIES# The immunoglobulin specificity of the greatest biological importances is idiotypic specificity pertaining to the nature of the antigen binding sites (paratopes); the specific antigenic determinants on the paratope are called idiotopes.# The sum total of idiotopes on an Ig molecule constitutes its idiotype.# By immunisation with Fab fragments, anti-idiotypic antibodies can be produced. These resemble the epitopes of the original antigen.# Used as a vaccine, these show protection against the original antigen (pathogen or tumor) in experimental animals.# Sequential anti-idiotypic antibody formation is the basis of Jerne's network hypothesis of immune regulation.# The antigenic specificities which distinguish between the different classes and subclasses of immunoglobulins present in all normal individuals of a given species are termed isotypic Specificities.# Antigenic specificities which distinguish immunoglobulins of the same class, between different groups of individuals in the same species, are called allotypic specificities.# Immunoglobulin allotypes have been studied in detail in the rabit and guinea pig by using type-specific immune sera.# Antiallotype antibodies are also found in sera containing 'rheumatoid arthritis factor'.# Two allotypic systems are known in humans - the Gm system (for gamma marker) and the InV system (abbreviation of patent's name). The Gm is associated with the Fc portion of the IgG heavy chain. More than 25 Gm types have been identified so far the InV system is associated with the Kappa light chain and so has been renamed Km. Three Km allotypes have been identified.# Genetic markers associated with IgA are called 'Am'.# To date, in the human system no allotypic markers have been found for lambda light chains or m, d or e heavy chains.

So the answer to this question is B


Instruction:
The major clinical use of Nimodipine is in
A. Hypeension
B. Angina pectoris
C. Sub arachnoid haemorrhage
D. Raynouds phenomenon

Response:
Refer kDT 6/e p532 subarachnoid hemorrhage USES: Nimodipine is used to decrease problems due to a ceain type of bleeding in the brain (subarachnoid hemorrhage-SAH).Nimodipine is called a calcium channel blocker. The body naturally responds to bleeding by narrowing the blood vessel to slow blood flow.

So the answer to this question is C


Instruction:
All are features of Paget's disease except ?
A. Defect in osteoclasts
B. Common in female
C. Can cause deafness
D. Can cause osteosarcoma

Response:
Ans. is 'b' i.e., Common in female Paget disease Paget's disease is characterized by increased bone turnover and enlargement and thickening of the bone, but the internal architecture is abnormal and the bone is usually brittle. Primary defect is in osteoclasts with increased osteoclastic activity. This results secondarily increase in osteoblastic activity (normal osteoclasts and osteoblasts act in a co-ordinated manner). So, characteristic cellular change is a marked increase in osteoclastic and osteoblastic activity. Bone turnover is acclerated, plasma alkaline phosphatase is raised (a sign of osteoblastic activity) and there is increased excretion of hydroxyproline in urine (due to osteoclastic activity). Clinical features of Paget's disease Paget's disease is slightly more common in males and is seen after 40 years of age. The pelvis and tibia being the commonest sites, and femur, skull, spine (veebrae) and clavicle the next commonest o Most of the patient with Paget's disease are asymptomatic, the disorder being diagnosed when an x-ray is taken for some unrelated condition or after the incidental discovery of raised serum alkaline phosphatase. When patients does present, they present because any of the three : - Pain : - Dull constant ache Deformities : - Bowing of long bones, platybasia. Complications of the disease Complications of Paget's disease Following complications can occur in Paget's disease : - Fracture : Are common in weight bearing bones Cranial nerve compression : - May cause impaired vision, facial palsy, trigeminal neuralgia or deafness. Otosclerosis : - Another cause of deafness in Paget's disease. Spinal canal stenosis and nerve root compression High output cardiac failure Osteoahritis : of Hip and knee Rarely osteosarcoma

So the answer to this question is B


Instruction:
who gave the psychosexual stage of mind
A. freud
B. bleuler
C. lorenz
D. erikson

Response:
CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845

So the answer to this question is A


Instruction:
A 45-year-old lady presents with persistent reflux symptoms. The most accurate investigation in establishing diagnosis before surgical treatment includes
A. Endoscopy
B. An UGI series
C. Esophageal manometry
D. Ambulatory pH monitoring

Response:
investigations for GASTROESOPHAGEAL REFLUX DISEASE, *24 hours oesophageal pH monitoring - the gold standard. PPI should be stopped for 3 weeks prior to pH monitoring. *Barium study in head down position. * Endoscopy to exclude other disease and to assess any mucosal injury - red inflamed mucosa often with ulceration. Sliding hernia can be identified through endoscopy. When patient retches, gastric mucosa will enter the OG junction and ascends upwards to variable distance. Ref: SRB&;s manual of surgery,3 rd ed, pg no 723

So the answer to this question is D


Instruction:
Recommended dose of prednisolone for the treatment of desquamative gingivitis?
A. Daily dose of 40 to 50 mg and maintenance dose of 5 to 10 mg
B. Daily dose of 30 to 40 mg and maintenance dose of 5 to 10 mg
C. Daily dose of 30 to 40 mg and maintenance dose of 10 to 20 mg
D. Daily dose of 40 to 50 mg and maintenance dose of 10 to 20 mg

Response:
The recommended dose of prednisolone in the treatment of desquamative gingivitis is daily dose of 30 - 40mg and gradually reduced to daily maintenance of 5-10mg.

So the answer to this question is B


Instruction:
Suture with least adhesion to tissues and high plasticity is:
A. Nylon
B. Prolene
C. Polyglycolate
D. PDS

Response:
Polypropylene (prolene) is an extremely inert suture with a (low) tissue reactivity and good tensile strength comparable to nylon. It has a very slippery surface with low adherence to tissues. Its extreme smoothness does compromise knot security and extra knots are required to prevent loosening of the suture.

So the answer to this question is B


Instruction:
Nimodipine is used in the management of?
A. Subdural hemorrhage
B. Subarachnoid hemorrhage
C. Extradural hemorrhage
D. Intraventricular hemorrhage

Response:
MEDICAL MANAGEMENT OF SAH MAINTAIN ADEQUATE CEREBRAL PERFUSION PRESSSURE- If the patient is ale, it is reasonable to lower the systolic blood pressure to below 160 mmHg using nicardipine, labetalol, or esmolol. If the patient has a depressed level of consciousness, ICP should be measured and the cerebral perfusion pressure targeted to 60-70 mmHg. If headache or neck pain is severe, mild sedation and analgesia are prescribed. CALCIUM CHANNEL BLOCKER vasospasm remains the leading cause of morbidity and moality following aneurysmal SAH. Treatment with the calcium channel antagonist nimodipine (60 mg PO every 4 h) improves outcome, perhaps by preventing ischemic injury rather than reducing the risk of vasospasm. Nimodipine can cause significanthypotension in some patients, which may worsen cerebral ischemia in patients with vasospasm. TREATMENT OF SYMPTOMATIC CEREBRAL VASOSPASM Symptomatic cerebral vasospams treated by increasing the cerebral perfusion pressure by raising mean aerial pressure through plasma volume expansion and the judicious use of IV vasopressor agents, usually phenylephrine or norepinephrine

So the answer to this question is B


Instruction:
In rape cases, in camera trial is conducted under:-
A. Sec . 164 (A) cr P C
B. 327 crPC
C. Sec 357 (C) Cr PC
D. 54 (A) CrPC

Response:
327 (c) CrPC : Trial of rape case are to be held in-camera by a woman Judge/ Magistrate if available, and allowed the printing or publication of proceedings in rape cases subject to maintaining anonymity of the paies .

So the answer to this question is B


Instruction:
Most common Thyroid CA post radiation exposure
A. Papillary CA
B. Medullary CA
C. Follicular CA
D. None

Response:
Papillary Carcinomas are the most common form of thyroid cancer which can occur at any time of life but more oftenly between the ages of 25 and 50 and they are associated with previous exposure to ionizing radiation. Ref: Robbins and cotrans 9e Pg 1095

So the answer to this question is A


Instruction:
The following regarding colostomy are true except?
A. A colostomy is an aificial opening made in large Bowel to dive the faeces to the exterior
B. Temporary colostomy is established to defunction an anastomosi
C. Permanent colostomy is formed after the resection of Rectum by the abdominoperinea technique
D. Double barreled colostomy is commonly done nowadays

Response:
Ans. is 'd' i.e., Double barreled colostomy is commonly done nowadays

So the answer to this question is D


Instruction:
Volcano ulcers in esophagus are seen in
A. Herpetic esophagitis
B. Candida esophagitis
C. Apthous ulcer in crohn
D. HIV esophagitis

Response:
Answer- A. Herpetic esophagitisThe ulcers of herpes esophagitis can haye a punctate, linear, stellate, or volcano-like appearance, often with a thin halo fo edemaat the margins.The ulcers may be clustered together or widely separated with normal intemening mucosa.

So the answer to this question is A


Instruction:
Mostly death in PEM is due to all except –
A. Hypothermia
B. CCF
C. Worm infestation
D. Electrolyte imbalance

Response:
Hepatomegaly is one of the essential diagnostic feature of kwashiorkor, it does not indicate poor prognosis.
Poor prognostic factors in PEM, which can lead to early death -

Hypothermia
Hypoglycemia
Systemic infections
Diarrhea
Severe anemia
Liver failure
Cardiac failure
Dehydration or over hydration
Fluid & electrolyte imbalance

So the answer to this question is C


Instruction:
In which of the following disorders is administration of barbiturates contraindicated in -
A. Anxiety disorders
B. Acute intermittent porphyria
C. Kern incterus
D. Refractive status epilepticus

Response:
Ans. is 'b' i.e., Acute intermittent porphyria Barbiturates are contraindicated in acute intermittent porphyria.

So the answer to this question is B


Instruction:
Splicing activity is a function of
A. mRNA
B. snRNA
C. rRNA
D. tRNA

Response:
A small nuclear RNA (snRNA) is one of many small RNA species confined to the nucleus; several of the snRNAs are involved in splicing or other RNA processing reactions.Small cytoplasmic RNAs (scRNA) are present in the cytoplasm and (sometimes are also found in the nucleus).snRNPs (snurp) are small nuclear ribonucleoproteins (snRNAs associated with proteins).scRNPs (scyrp) are small cytoplasmic ribonucleoproteins (scRNAs associated with proteins).The spliceosome is a complex formed by the snRNPs that are required for splicing together with additional protein factors.Anti-Sm is an autoimmune antiserum that defines the Sm epitope that is common to a group of proteins found in snRNPs that are involved in RNA splicing. The five snRNPs involved in splicing are U1, U2, U5, U4, and U6.Together with some additional proteins, the snRNPs from the spliceosome.All the snRNPs except U6 contain a conserved sequence that binds the Sm proteins that are recognized by antibodies generated in autoimmune disease.

So the answer to this question is B


Instruction:
Which of the following can occurs in ovary, rectum and appendix -
A. Metastasis
B. Nebothian follicles
C. Para ovarian cyst
D. Endometriosis

Response:
Ans. is 'd' Endometriosis (Ref. Shaws, 13/e, p 439 (12/e, p 370)).Endometriosis is widely dispersed. It occurs anywhere throughout the lower pelvis. The common sites are ovaries*, cul-de-sac including the uterosacral ligaments, peritoneum overlying the bladder, sigmoid colon, back of the uterus, intestinal coils and appendix.It can also be seen in umbilicus following operation* in laparotomy scars, in tubal stumps following sterilization.

So the answer to this question is D


Instruction:
Orally acting direct thrombin inhibitor is?
A. Bivalirudin
B. Ximelgatran
C. Lepirudin
D. Argatroban

Response:
Ximelgatran is an oral direct thrombin inhibitor. All the other given drugs are parenterally acting direct thrombin inhibitor. From medical pharmacology padmaja 4th edition Page no 334

So the answer to this question is B


Instruction:
Bone within bone appearance is seen in -
A. GV1L
B. Osteoporosis
C. Osteopetrosis
D. Bone infarct

Response:
Ans. is 'c' i.e., Osteopetrosis o Bone within a bone appearance may be seen in osteopetrosis.Bone within a Bone appearanceo Bone within a bone appearance is seen in : -# Normal neonate# Prostaglandin El therapy# Growth arrest/recovery lines# Heavy metal (e.g., Lead) poisoning# Bisphosphonate therapy# Hypothyroidism & Hypoparathyroidism# Sickle cell anemia# Hypercalcemia & Hypervitaminosis D# Osteopetrosis# Rickets / Osteomalacia (healed phase)# Acromegaly# Scurvy (healed phase)

So the answer to this question is C


Instruction:
Cardiac muscle contracts due to
A. Extracellular Ca2+
B. Sarcoplasmic Ca2+
C. Extracellular Na+
D. Intracellular Na+

Response:
None

So the answer to this question is A


Instruction:
A 20 years old woman presents with rapid onset hirsutism with a pelvic mass. Which of these is the likely cause?
A. Sex cord stromal tumor of the ovary
B. Polycystic Ovarian Syndrome
C. Congenital Adrenal hyperplasia
D. Large simple ovarian cyst

Response:
sex cord stromal tumours of the ovary are ovarian tumours arising from granulosa, theca, seoli, leydig cells or stromal fibroblasts of the ovary. These may present with abdominal masses and are characterised by the production of sex coicoids (except fibroma) resulting in symptoms of hormonal excess (precocious pubey, virilisation). Hirsuitism may be of rapid onset. polycystic ovaries is the most common cause of hirsutism in young females, however it does not present with a rapid onset. Also PCOD does not present with an abdominal or pelvic mass. congenital adrenal hyperplasia: presents usually at bih with ambigous genitalia, salt wasting , but may also non classically present with adult onset with features of virilisation. However hirsutism is not of rapid onset and does not present with pelvic mass. large simple ovarian cyst: presents with pelvic mass but no features of virilsation as they do not produce androgens

So the answer to this question is A


Instruction:
Mechanism of action of clomiphene citrate is ?
A. Binds to estrogen receptors & causes negative feedback at hypothalamus
B. Binds estrogen receptors & prevents negative feed back at hypothalamus
C. Binds to progesterone receptors
D. Progesterone agonist

Response:
Ans. is 'b' i.e., Binds estrogen receptors & prevents negative feed back at hypothalamus o Induces gonadotropin secretion (LH, FSH) by blocking estrogenic feedback inhibition on hypothalamus.

So the answer to this question is B


Instruction:
In abdominal aoic aneurysm indication of operation is when size of aneurysm is ?
A. >4 cm
B. >5.5 cm
C. >6 cm
D. 6.6 cm

Response:
<p> Abdominal aoic aneurysm: Most commonest type of large vessel aneurysm. 95% have associated atheromatous change. 95% occur below renal aeries. Symptomatic aneurysms may cause minor symptoms such as back and abdominal discomfos, before severe sudden abdominal pain due to rupture develops. Asymptomatic aneurysms are found accidentally on physical examination. Abdominal aoic aneurysms csn rupture into anteriorly into peritoneal cavity (20%) or posterolaterally to retroperitoneal space (80%). Anterior rupture leads to free bleeding into peritoneum whereas posterior rupture leads to retroperitoneal haematoma. The patient remain conscious but in severe pain. If no operation is performed , death is inevitable. Indications for surgery:- 1. Asymptomatic aneurysm more than 5.5 cm 2. Growth rate more than 0.5 cm per year. 3. Painful tender aneurysm 4. Thrombosed aneurysm, aneurysm with distal emboli. {Reference: SRB&;s manual of surgery, 5th edition , page no. 198}

So the answer to this question is B


Instruction:
Following are the causes of painless sudden onset of loss of vision except ?
A. Acute congestive glaucoma
B. Vitreous hemorrhage
C. CRAO
D. Central serous retinopathy

Response:
Ans. is 'a' i.e., Acute congestive glaucoma Acute congestive glaucoma causes sudden painful loss of vision.

So the answer to this question is A


Instruction:
Lord's and Jaboulay's operation is done for:March 2011
A. Rectal prolapse
B. Fistula in Ano
C. Inguinal hernia
D. Hydrocele

Response:
Ans. D: HydroceleProcedures for acquired hydroceles:Lord's operation is suitable when the sac is reasonably thin walledEversion of the sac with placement of the testis in a pouch prepared by dissection in the fascial planes of the scrotum is an alternative (Jaboulay's procedure)

So the answer to this question is D


Instruction:
“Acrodermatitis enteropathica” is seen in a deficiency of
A. Molybdenum
B. Selenium
C. Chromium
D. Zinc

Response:
Essential features of zinc deficiency are:

Distinctive rash, often around the eyes, nose, mouth, anus and distal parts.
Anorexia, often accompanied by diarrhoea
Growth retardation in children
Impaired wound healing
Hypogonadism with I reproductive capacity.
Altered immune function
Impaired night vision related to altered vitamin A metabolism
Depressed mental function
Increased incidence of congenital malformation in infants of Zn-deficient mothers. Micro and macroelements

So the answer to this question is D


Instruction:
Abtacept is used in treatment of which of the following conditions?
A. Rheumatoid ahritis
B. Asthma
C. Paroxysmal nocturnal hemoglobinuria
D. Autoimmune haemolytic anemia

Response:
Abatacept is a recombinant fusion protein composed of the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) fused to human IgG Fc. CTLA-4 is a costimulatory molecule found on T cells that binds to CD80 and CD86 on antigen presenting cells. This fusion protein blocks activation of T cells by binding to CD80 or CD86 so that CD28 on T cells cannot bind and stimulate the T cell and lead to cytokine release. Abatacept is approved for patients with severe rheumatoid ahritis who have failed other disease-modifying antirheumatic drugs Ref: Katzung 11th edition Chapter 61.

So the answer to this question is A


Instruction:
Substance present in both serum and plasma:September 2007
A. Fibrinogen
B. Factor II
C. Factor VII
D. Factor V

Response:
Ans. C: Factor VIISerum has essentially the same composition as that of plasma except that its fibrinogen and clotting factors II,V and VIII has been removed and it has a higher seroton in content.

So the answer to this question is C


Instruction:
Which of the following is not used as vector in genetics?
A. Adeno virus
B. Proteosome
C. Liposome
D. Retrovirus

Response:
VECTORS : The gene is trasferred to acarrier ,known as a vector.Most commonly used vectors are plasmids.Plasmids are circular double -stranded DNA molecuels seen inside bacteria. Different vector systems used for gene delivery are : Retro viruses , Adenoviruses , Adeno associated viralvectors and Herpes simplex virruses.Non -virus systems include Liposomes , Plasmids and physical methods. Proteosomes are protein complexes which degrade unneeded or damaged proteins by proteolysis , a chemical reaction that breaks petide bonds.Enzymes that help such reactions are called proteolysis. REF :DM VASUDEVAN TEXTBOOK ,7th EDITION , Page no :629.

So the answer to this question is B


Instruction:
Normal platelet count is/are seen in: (PGI Nov 2010)
A. D1C
B. Shaken baby syndrome
C. Microangiopathic hemolytic anaemia
D. Splenomegaly

Response:
Ans B "Non-immunological dysfunction casuingThrombocytopenia: Microangiopathic hemolytic anaemia - Robbins 7th/651 (table)"Kasabach-Merritt syndrome (KMS) is defined as profound thrombocytopenia Q related to platelet trapping within a vascular tumor"- Wiliam's Haematology 7th/"Shaken baby syndrome (SBS) is a form of physical child abuse that occurs when an abuser violently shakes an infant or small child,creating a whiplash-type motion that causes acceleration- deceleration injuries. It is common for there to be no external evidence of trauma"-en.wiki_wikipedia.arg_sbsShaken baby syndrome (SBS) is notgiven in list of thrombocytopenia in any' above referencesTable (Wiliam'sHaematology 7th/818)Classification of ThrombocytopeniaPseudo-thrombocytopeniaPlatelet agglutinationPlatelet satellitismAntiphospholipid antibodiesGplla-Illa antagonistsGiant plateletsMiscellaneous associationsimpaired platelet productionCongenita] Sebastian syndrome Epstein syndrome May- Hegglin anomalyM editerranean macrothrombocytopeniaFamilial platelet syndrome with predisposition to acute myelogenous leukemiaThrombocytopenia with linkage to chromosome 10Paris-Trousseau syndromeThrombocytopenia with radial synostosisAutosomal recessiveCongenital amegakaryocytic thrombocytopeniaThrombocytopenia with absent radius (TAR) syndromeBernard-Soufier syndromeGray platelet syndromeX-linked thrombocytopeniasWiskott-Aldrich syndromeX-linked thrombocytopeniaX-linked thrombocytopenia with dyserythrocytosisAcquiredMarrow infiltrationinfectious disease : Cytomegalovirus, HIV& ParvovirusRadiotherapy and chemotherapyFolic acid and vitamin deficiencyParoxysmal nocturnal hemoglobinuriaAcquired aplastic anemiaMyelodysplastic syndromesAcquired pure megakaryocytic thrombocytopeniaAccelerated platelet destructionImmune-mediated thrombocytopeniaAutoimmune thrombocytopenic purpuraIdiopathicSecondary (infections, pregnancy-related, lymphoprolifera- tive disorders, collagen vascular diseases)Alloimmune thrombocytopenia: Neonatal thrombocytopenia Posttransfusion purpuraNon immune thrombocytopeniaThrombotic microangiopathiesThrombotic thrombocytopenic purpura and hemolytic uremic syndromeDisseminated intravascular coagulopathyKasabach-Merritt syndromePlatelet destruction by artificial surfacesHemopbagocytosisAbnormal platelet distribution or poolingSplenomegalyHypersplenismHypothermiaMassive transfusionDrug-induced thrombocytopeniaHeparin-induced thrombocytopenia (HIT)Other drug-induced thrombocytopenias

So the answer to this question is B


Instruction:
Vasponstricator L.A. is
A. Cocaine
B. Procaine
C. Lidocaine
D. Chlorprocain

Response:
All local anaesthetics are vasodilators except cociane which is a vasoconstrictor

So the answer to this question is A


Instruction:
All are seen in the floor of third ventricle except?
A. Mammillary body
B. Oculomotor nerve
C. Optic chiasma
D. Tuber cinereum

Response:
Boundaries of 3rd ventricle: LATERAL WALL - Thalamus, Hypothalamus FLOOR - Mammillary body , tegmentum pa of mid brain , tuber cinereum ,infundibular stalk , optic chiasma. ROOF - Fornix ANTERIOR - lamina terminalis , anterior commissure POSTERIOR - pineal body , posterior commissure Extra edge Septum pellucidum Thin ,triangular,veical double membrane separating the anterior horns of the left and right lateral ventricles of the brain. Extends between corpus callosum and the fornix.

So the answer to this question is B


Instruction:
Koplik spots on the buccal mucosa are seen in relation to which of the following teeth?
A. Incisors and canine
B. Canine and premolar
C. Only premolars
D. Premolar and molars

Response:
Koplik spots: pathognomonic of measles
The Koplik’s spots are white papules resembling table salt like crystals with a red base, which appear usually on the buccal mucosa opposite to first and second molar teeth.
Ref: Shafer's textbook of oral pathology 7th edition page 348

So the answer to this question is D


Instruction:
Source of energy for a running race athlete for the initial 3 minutes of running
A. Free fatty acid
B. Creatine phosphate
C. Muscle glycogen
D. Blood Glucose

Response:
Systems for energy during strenuous exercise or running 1. First System-Phosphagen system (8-10 seconds) - Immediate source of energy for Muscles is Creatine Phosphate. - But this is of limited supply in muscles, so depleted quickly 2. Second system -Anaerobic Glycolysis or Lactate system. (for 1-3 minutes ) - This system derives ATPs using Glucose derived from Muscle Glycogen 3.Third system -Aerobic System (or Mitochondrial Respiration) - can use carbohydrates, Fats, or Proteins to produce energy. - Slowest in providing energy, but more efficient than the other two systems - This system uses mainly TCA & ETC. Reasons for use of Phosphocreatine:- - Does not uses O2 - Does not produce lactate - Quickest source of energy - Most direct form of energy production

So the answer to this question is C


Instruction:
Fecal leucocytes are absent in all of the following, except:
A. Giardiasis
B. Cryptosporidiosis
C. Campylobacter infection
D. Clostridium perfringes infection

Response:
Campylobacter infection

So the answer to this question is C


Instruction:
Which of the following drugs is contraindicated in a patient with raised intracranial pressure?
A. Thiopentone
B. Propofol
C. Midazolam
D. Ketamine

Response:
Cerebral blood flow, metabolism, oxygen consumption and ICT all are increased by ketamine - ketamine is contraindicated in raised ICT.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.186-193)

So the answer to this question is D


Instruction:
Most common cause of acute mesenteric ischemia is:
A. Arterial thrombosis
B. Venous thrombosis
C. Embolism
D. Non occlusive disease

Response:
Acute Mesenteric Ischemia :
• Emboli (50%) :
−− Arrhythmia, Valvular disease, Myocardial infarction
−− Hypokinetic ventricular wall
−− Cardiac aneurysm, Aortic atherosclerotic disease
• Thrombosis (25%) : Atherosclerotic disease
• Nonocclusive (5–15%) :
−− Pancreatitis, Heart failure, Sepsis.
−− Cardiac bypass, Burns, Renal failure.
• Venous occlusion:
−− Hypercoagulable state.
−− Sepsis Compression, Pregnancy, Portal hypertension.

So the answer to this question is C


Instruction:
Glioma of optic nerve is usually -
A. Gemistocytic
B. Pilocytic
C. Fibrillary
D. Lamellar

Response:
Ans. is 'b' i.e., Pilocytic Optic nerve glioma o Optic nerve glioma, also referred to as juvenile pilocytic astrocytoma, is the most frequent tumor of the optic nerve in childhood. o It is a developmental hamaoma. o It is either stationary or only slowly progressive. o Tumor may arise in any poion of nerve --> i) Intraorbital, ii) Intracanalicular iii) Intracranial

So the answer to this question is B


Instruction:
Minimal change glomerulopathy may be seen ' association with all of the following except,
A. Hepatitis B
B. HIV
C. Drug-induced interstitial nephritis
D. Hodgkin's disease

Response:
Secondary MCD wherein the extraglomerular disease process evokes, directly or indirectly, the characteristic changes in permselectivity and morphology. In this circumstance the morphology is similar, if not identical, to primary or 'idiopathic' MCD. Moreover, it is possible, even likely, that similar or identical pathogenetic mechanisms are operative. In this scenario, a distinct etiologic link is presumed to exist between the extraglomerular disease process and the occurrence of MCD. Such a linkage would be strongly suppoed if cure of the extraglomerular disease lead to the eradication of MCD and if recurrence of the extraglomerular disorder was associated with relapse. While an attempt has been made to be comprehensive, it is possible that individual repos describing an association between the specific extra-glomerular disease and MCD may have been overlooked. The majority of the instances in which MCD has been associated with an extraglomerular disease involve neoplastic processes and idiosyncratic, hyper-sensitivity or toxic reactions to drugs. Neoplasia A variety of neoplastic processes have been repoed in association with MCD (Table 2) . In some, the association is rare enough to suspect that chance alone may have been the operational mechanism underlying the association. In others, the association is clearly contemporaneous and likely causal. Among patients with glomerular disease associated with neoplasia, 40% have MCD on renal biopsy. As mentioned previously it is possible that some of the described associations between neoplasia and MCD may be the consequence of treatment of MCD (especially cytotoxic drug therapy) predisposing to the emergence of a malignancy. Hodgkin's disease and non-Hodgkin's lymphoma are among the most frequently repoed neoplastic processes associated with MCD . Interestingly, repos describing the concurrence of MCD and Hodgkin's disease have decreased in recent years, perhaps due to the more effective diagnostic and therapeutic strategies available for this and related diseases. MCD is a rare complication of Hodgkin's ppdisease occurring in from 1:2000 to 1:10 000 cases. MCD has been associated with both limited (Stage 1) and disseminated (Stage 4) forms of Hodgkin's disease.Therapy of Hodgkin's disease, either by local radio- therapy to regional lymph nodes or by systemic chemotherapy, has often resulted in remission of MCD and recurrences of Hodgkin's disease have been associated with recurrence of MCD. These observations strongly imply a causal relationship between the tumour (or a product of the abnormal neoplastic cells) and the pathophysiological abnormalities involved in MCD. Indeed, it is quite possible that the same clone of cells which are involved in the development of Hodgkin's disease are also involved in the pathogenesis of MCD in both the primary and secondary forms. Such an explanation is more difficult to conjecture for the association of MCD with theother tumours listed in Table 2, except for mycosis fungoides, angiofollicular lymph node hyperplasia, non-Hodgkin's lymphoma and chronic lymphatic leukaemia . Perhaps, in these instances, the peurbations for MCD have also triggered the oncogenic potential of cells predisposed to neoplastic transformation (e.g. lack of a wild type tumour suppressor gene). Alternatively, lymphocytes infiltrating neoplastic growths could be induced to elaborate factors responsible for abnormal permeability. Whatever the case may be, it is wohwhile to consider potential underlying neoplasia in patients with MCD when atypical features are present such as weight loss, anorexia, lymphadenopathy, haematuria, fever, pleural effusions or skin lesions. Overall, the occurrence of MCD as a complication of neoplastic disorders is quite uncommon. MCD may precede the diagnosis of neoplasia by months or years or may follow the diagnosis of neoplasia by months or years. Some repos have suggested that NK-cell deficiency is associated with the development of MCD in patients with Hodgkin's disease Ref Harrison20th edition pg 299

So the answer to this question is A


Instruction:
AV node is situated in ?
A. Opening of SVC
B. Interventricular septum
C. Koch's triangle
D. None

Response:
Ans. is 'c' i.e., Koch's triangle AV node is situated in triangular pa (triangle of Koch) in the lower pa of interatrial septum. Triangle of Koch is landmark for AV node with its transition zone. It is bounded by tendon of todaro (superiorly), tricuspid valve septal leaflet (inferiorly) and coronary sinus orifice (basally). Conducting system Location in hea SA node Upper end of crista terminalis, near opening of SVC AV node Triangle of Koch's (near interatrial septum) Bundle of his Membranous pa of interventricular septum RBB Right surface of interventricular septum LBB Left surface of interventricular septum

So the answer to this question is C


Instruction:
Barr body is seen in :
A. Turners syndrome
B. Klinefelters syndromeTesticular feminisation
C. Tesiicular leminisation syndrome
D. 46 XY

Response:
Klinefelters syndrome

So the answer to this question is B


Instruction:
False about sympathetic ophthalmitis
A. Injured eye is called exciting eye
B. Common in children
C. It follows a blunt trauma
D. It is a serious bilateral granulomatous panuveitis

Response:
It follows a penetrating ocular trauma.

So the answer to this question is C


Instruction:
Amoebae not found in human intestine:
A. E. histolytica
B. E. colt
C. E. nana
D. E. gingivalis

Response:
Ans. d. E. gingivalis

So the answer to this question is D


Instruction:
Griseofulvin isnot useful in one of the following:
A. Tinea capitis
B. Tinea cruris
C. Tinea versicolor
D. Tinea pedis

Response:
HETEROCYCLIC BENZOFURAN Griseofulvin It was one of the early antibiotics extracted from Penicillium griseofulvum. However, because of lack of antibacterial activity, little attention was paid to it: clinical utility in dermatophytosis was demonstrated only around 1960. Griseofulvin is active against most dermatophytes, including Epidermophyton, Trichophyton, Microsporum, etc., but not against Candida and other fungi causing deep mycosis. Bacteria are also insensitive. Dermatophytes actively concentrate it: this feature probably accounts for its selective toxicity. Resistance can be induced in vitro and this is associated with loss of concentrating ability. However, emergence of resistance during clinical use is rare. Griseofulvin interferes with mitosis-multinucleated and stunted fungal hyphae result from its action. It also causes abnormal metaphase configurations. However, unlike the typical mitotic inhibitors (colchicine, vinca alkaloids), it does not cause metaphase arrest; rather the daughter nuclei fail to move apa or move only a sho distance. It does not inhibit polymerization of tubulin (microtubular protein which pulls the chromosomes apa), but binds to polymerized microtubules and somehow disorients them. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:760

So the answer to this question is C


Instruction:
Opening of esophagus into diaphragm is at the level of -
A. T6
B. T10
C. T12
D. T8

Response:
Ans. is 'b' i.e., T10 OpeningVertebral levelIn which part of diaphragmPassing structureVena CavaiT8Central tendony Inferior vena cavay Right phrenic nerveOseophageaiT10Muscular portion derived from right crusy Oesophagusy Oesophageal br. of left gastric arteryy Gastric or vagus nerveAorticT12Osseoaponeurotic betweenright and lateral crusy Aortay Thoracic ducty Azygous vein

So the answer to this question is B


Instruction:
Most common cause of Budd Chiari syndrome is:
A. Idiopathic
B. Valves in hepatic veins
C. Hepatocellular carcinoma
D. Thrombosis of hepatic veins

Response:
Answer is D (Thrombosis of hepatic veins) Most common cause of Budd Chiari Syndrome is hepatic vein obstruction Its the common cause of hepatic vein obstruction causing Budd Chiari Syndrome is 'thrombosis of hepatic veins'.

So the answer to this question is D


Instruction:
The narrowest pa of ureter is?
A. At pelvic brim
B. At ischial spine
C. Pelvic ureteric junction
D. At the entry of bladder

Response:
The constrictions of the ureter are three in number as follows : (i) At the junction of pelvis of the ureter with abdominal pa of the ureter. (ii) At the pelvic brim. (iii) Where it pierces the bladder. It is narrowest here. Ureter: The ureter is a retroperitoneal, distensible muscular tube that connects the kidney with the bladder. It runs downward and medialward in front of the Psoas major and, entering the pelvic cavity, finally opens into the fundus of the bladder. The slit like lumen of the ureter has a stellate appearance because its mucosa is folded longitudinally. Aeries and veins: The aeries supplying the ureter are branches from the renal, internal spermatic, hypogastric, and inferior vesical. Nerves: The nerves are derived from the inferior mesenteric, spermatic, and pelvic plexuses. Constrictions - There are three normal anatomical constrictions where a stone from the renal pelvis can become lodged. The sites are; 1) The ureteropelvic junction 2) Site where it crosses the iliac vessels 3) Ureterovesicular junction: Passage of ureter through the bladder wall.

So the answer to this question is D


Instruction:
Best investigation for Bronchiectasis is?
A. Chest X Ray
B. MRI
C. Pulmonary Function Tests
D. HRCT

Response:
ANSWER: (D) HRCTREF: Harrison's Internal Medicine 17th edition chapter 252Though the chest radiograph is important in the evaluation of suspected bronchiectasis, the findings are often nonspecific. CT, especially with high-resolution images 1.0-1.5 mm thick, provides an excellent view of dilated airways. Consequently, it is now the standard technique for detecting or confirming the diagnosis of bronchiectasis.

So the answer to this question is D


Instruction:
A bony hard asymptomatic swelling found on the midline of the hard palate, that appears radiopaque on a radiograph is most likely a -
A. Odontoma
B. Myxoma
C. Bony cyst
D. Torus palatinus

Response:
None

So the answer to this question is D


Instruction:
Ascending aoa Involvement is the commonest site of which aneuryam
A. Syphilitic
B. Atherosclerotic
C. Mycotic
D. None of the above

Response:
Syphilitic aneurysm Teiary sypilis... Trepenomonas has affinity for vaso vasorum of mainly thoracic aoa leads to obliterative endaeritis leads to ischemic damage to the aoic media and aneurysm Ramdas Nayak page no. 379

So the answer to this question is A


Instruction:
How does staphylococcus aureus differ from staphylococcus epidermidis?
A. It is coagulase positive
B. It is a common cause of UTI
C. It forms white colonies on blood agar
D. It causes endocarditis in drug addicts

Response:
Staphylococcus aureus is coagulase positive whereas staphylococcus epidermidis is coagulase negative. Other coagulase negative staphylococci are S haemolyticus, S saccharolyticus, S hominis, S schleiferi, S lugdunensis and S simulans. Test Staphylococcus aureus Staphylococcus epidermidis Coagulase Positive Negative Clumping factor Positive Negative Heat stable nuclease Positive Negative Urease Variable Negative Acid from mannitol Positive Negative Acid from trehalose Positive Negative Ref: Textbook of Microbiology and Immunology By Parija, Pages 188-190

So the answer to this question is A


Instruction:
Which of the following are situated away from the coding region
A. Promoter
B. Enhancer
C. Operator
D. All of these

Response:
Structural genes are present in coding region. Rest all genes, like promoter gene, operator gene, regulatory gene (enhancer/repressor), are present away from coding region.

So the answer to this question is D


Instruction:
Which of the following drugs should not be used in a setting of severe hypeension in elderly on empirical basis
A. Enalapril
B. Amlodipine
C. Chlohiazide
D. Prazosin

Response:
Postsynaptic, selective a-adrenoreceptor antagonists lower blood pressure by decreasing peripheral vascular resistance. They are effective antihypeensive agents used either as monotherapy or in combination with other agents. However, in clinical trials of hypeensive patients, alpha blockade has not been shown to reduce cardiovascular morbidity and moality or to provide as much protection against CHF as other classes of antihypeensive agents. These agents are also effectivein treating lower urinary tract symptoms in men with prostatic hyperophy. Nonselective a-adrenoreceptor antagonists bind to postsynaptic and presynaptic receptors and are used primarily for the management of patients with pheochromocytoma. ref:harrison&;s principles of internal medicine,ed 18,pg no 4279

So the answer to this question is D


Instruction:
Alveolar hypoventilation is observed in:
A. Guillain -Barre syndrome
B. Acute asthma
C. Bronchiectasis
D. CREST syndrome

Response:
Neuromuscular diseases that can cause alveolar hypoventilation include myasthenia gravis, amyotrophic lateral sclerosis, Guillain-Barre syndrome and muscular dystrophy. Patients with neuromuscular disorders have rapid, shallow breathing secondary to severe muscle weakness or abnormal motor neuron function.

So the answer to this question is A


Instruction:
For vascular anastomosis sutures of choice -
A. Polypropylene
B. Chromic catgut
C. Silk
D. Nylon

Response:
Ans. is 'a' i.e., Polypropylene Vascular anastomoses:* Vascular anastomoses require an extremely accurate closure as they must be immediately watertight at the end of the operation when the vascular clamps are removed.* In many cases, some form of prosthetic material or graft may be used which will never be integrated into the body tissues and so the integrity of the suture line needs to be permanent.* For this reason, polypropylene is one of the best sutures as it is not biodegradable. It is used in its monofilament form, mounted on an atraumatic, curved, roundbodied needle.* Knot security is important, and as polypropylene is monofilament and the anastomosis often depends on one final knot, several throws (between six and eight) of a well-laid reef knot are required.* The suture line must be regular and watertight with a smooth intimal surface to minimise the risk of thrombosis and embolus, as well as to avoid any leakage.* Suture size depends on vessel calibre: 2/0 is suitable for the aorta, 4/0 for the femoral artery and 6/0 for the popliteal to distal arteries.* Micro vascular anastomoses are made using a loupe and an interrupted suture down to 10/0 size.

So the answer to this question is A


Instruction:
Splaying and cupping of the'metaphysis is seen in :
A. Rickets
B. Scurvy
C. Paget's disease
D. Lead poisoning

Response:
A i.e. Rickets

So the answer to this question is A


Instruction:
Most common Morphological difference between Ulcerative Colitis and Crohn's disease
A. Mucosal edema
B. Crypt abscess
C. Diffuse polyps
D. Lymphoid aggregates

Response:
Ref:- Bailey and Love 27th Edition; Pg num:- 1268

So the answer to this question is B


Instruction:
Benedict test is for
A. Bile salts in urine
B. Bile pigment in urine
C. Reducing sugar in urine
D. Ketone bodies in urine

Response:
It is commonly employed to detect the presence of glucose in urine. Benedict&;s reagent contains sodium carbonate, copper sulfate, and sodium citrate. In alkalain medium, sugars form enediol, cupric ions are reduced, correspondingly sugar is oxidized. Glucose is a reducing sugar. Any sugar with free aldehyde/keto group will reduce Benedict&;s reagent.Ref: DM Vasudevan, 7th edition, page no: 73

So the answer to this question is C


Instruction:
Structure lying at marker C ?
A. Subclan vein
B. Subclan aery
C. Scalenus anterior
D. Scalenus medius

Response:
Scalenus anterior muscle Attaches to the scalene tubercle on the inner(medial) border of 1st rib. * It's tendon is sandwiched between subclan vein (passing anterior) and subclan aery (passing posterior). Both vessels cross over the superior surface of 1st rib. Key: A - Area for attachment of scalenus medius B - Groove for subclan aeryC - Scalene tubercle (attachment of anterior scalene) D - Groove for subclan vein

So the answer to this question is C


Instruction:
When can one diagnose acute respiratory distress in a newborn?
A. Within 7 days of known clinical insult
B. Respiratory failure not fully explained by cardiac failure or fluid overload
C. Left ventricular dysfunction
D. All of the above

Response:
(D) All of the abovePEDIATRIC CRITICAL CARE MEDICINE -2015 AgeExclude patients with peri-natal related lung diseaseTimingWithin 7 days of known clinical insultOrigin of EdemaRespiratory failure not fully explained by cardiac failure or fluid overloadChest ImagingChest imaging findings of new infiltrate(s) consistent with acute pulmonary parenchymal diseaseOxygenationNon-Invasive mechanical ventilationInvasive mechanical ventilationPARDS (No severity stratification)MildModerateSevereFull face-mask bi-level ventilation or CPAP >=5cmH2 O4<=OI<16OI>=16 PF ratio <3005<=OSI<7.57.5<=OSI<12.3OSI>=12.3Special PopulationsCyanotic Heart DiseaseStandard Criteria above for age, timing, origin of edema & chest imaging with an acute deterioration in oxygenatioin not explained by underlying cardiac disease.Chronic Lung DiseaseStandard Criteria above for age, timing and origin of edema with chest imaging consistent with new infiltrate and acute deterioration in oxygenation from baseline which meet oxygenation criteria above.Left Ventricular DysfunctionStandard Criteria for age, timing and origin of edema with chest imaging changes consistent with new infiltrate and acute deterioration in oxygenation which meet criteria above not explained by left ventricular dysfunction. PATHOPHYSIOLOGIC APPROACH TO CLINICAL CONDITIONS CAUSING RESPIRATORY DI$TRESSEtiologyPathophysiologyClinical conditionsInterference with air flow (entry or exit)*. Upper airway obstruction*. Acute laryngitis, laryngotracheitis, foreign body*. Lower airway obstruction*. Bronchiolitis, asthma*. Mechanical compression*. Large pleural effusion, pneumothorax*. Thoracic wall injuries*. Flail chestInterference with alveolar*. Failure of alveolar ventilation*. Pneumonia, pulmonary edemagas exchange*. Failure of diffusion*. Pneumonia, pulmonary edemaCardiovascular problems*. Mechanical or inadequate function*. Congestive cardiac failure, arrhythmias, myocarditis, pericarditis, Right-to-left shuntsCNS*. Depression of respiratory center*. Raised ICT*. Stimulation of respiratory center*. Acidosis, salicylate intoxication*. Neuromuscular impairment of respiration*. Acute paralytic poliomyelitis, Guillain-Barre Syndrome, organophosphate poisoning, snake bite, diaphragmatic paralysisOther*. Insufficient oxygen supply to tissues and/ or increased oxygen demands*. Sepsis, severe anemia, high altitude, carbon monoxide exposure, smoke inhalation, met-hemoglobinemia*. Compensation for metabolic acidosis*. Diabetic ketoacisosis, acute renal failure

So the answer to this question is D


Instruction:
The ion that contributes maximally to the development of RMP is:
A. Na+
B. K+
C. Cl-
D. Ca++

Response:
A resting cell is much more permeable to K+ as compared to Na+ or other ions. During resting conditions, if all the ions are moving down their concentration gradients to finally reach equilibrium, the movement of K+ will be much greater. Thus, K+ diffusing out, down its concentration gradient will be the greatest contributor to the RMP. As K+ diffuses outward to reach equilibrium, it drags the membrane potential to its own equilibrium potential. (Equilibrium potential for K+ = - 90 mV)

So the answer to this question is B


Instruction:
Adson's test is positive in
A. Cervical rib
B. Cervical fracture
C. Cervical spondylosis
D. Cervical dislocation

Response:
Adson's sign is the loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration . Ref : S. Das surgery 3/e p641

So the answer to this question is A


Instruction:
65 year old patient comes with dysphagia and regurgitation. Barium swallow shows diverticula at lower oesophagus. Which of the following is false about this condition
A. Endoscopy is used to rule out malignancy
B. Chest x ray shows air fluid level in posterior mediastinum
C. It arises from killians triangle
D. Treatment is resection Plus myotomy

Response:
This is the case of epiphanic diverticulum. It is usually seen in lower oesophagus. It is confused with para esophageal hernia.

So the answer to this question is C


Instruction:
'Learned behaviour which is socially acquired' is known as:-
A. Customs
B. Acculturation
C. Standard of living
D. Culture

Response:
Culture : is the learned behavior which is socially acquired. Acculturation : Is 'culture contact' or mixing of two cultures. It can occur through; Trades & commerce Industrialization Propagation of religion Education Conquest Custom : the established pattern of behavior that can be objectively verified within a paicular social setting Folkwares : Right ways doing thing in less vital areas of human conduct. Mores: More stringent customs. Attitude : A relatively enduring organization of beliefs around an object or concept, which predisposes one to respond in a ceain manner Attitude are acquired characteristics which are more or less permanent ways of behaving.

So the answer to this question is D


Instruction:
Superolateral boundary of axillary dissection is
A. Clavipectoral fascia
B. Branchial plexus
C. Axillary aery
D. Axillary vein

Response:
Lateral group of axillary nodes are present along axillary vein. Axillary dissection is the removal of fat, fascia, nodes in the axilla. Usually level 1 and level 2 nodes are removed. Nodes below the axillary vein are usually removed. so the superolateral boundary of axillary dissection is axillary vein. Dissection is done through an individual crease transverse inciaion in the axilla. Reference :SRB's Manual of Surgery, 6th Edition, page no = 543, 529.

So the answer to this question is D


Instruction:
Worm like filling defect is seen In
A. Erosive gastritis
B. Esophageal varices
C. CA esophagus
D. Schatzki's ring

Response:
On USG Thickened sinus, interrupted mucosal folds (earliest sign) Toous radiolucencies of variable size The "worm-eaten" smooth lobulated filling defects Ref: Wolfgang Radiology 2nd edition Pg no : 509

So the answer to this question is B


Instruction:
Calcium does not bind to
A. Tropomyosin
B. Calmodulin
C. Troponin
D. None

Response:
Tropomyosin-A protein that binds to and stabilizes actin filaments in cells. In skeletal and cardiac muscle cells, tropomyosin is released after interacting with troponin and calcium, facilitating the binding of actin to myosin that causes muscle contraction.Calmodulin- a calcium-binding protein present in all nucleated cells, thought to be an essential mediator of most calcium-sensitive cellular processes.Troponin- a complex of muscle proteins which, when combined with Ca++, influence tropomyosin to initiate contraction.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-378

So the answer to this question is A


Instruction:
Procedure to be performed in case of arrest of after coming head due to contracted pelvis in breech:
A. Craniotomy
B. Decapitation
C. Zavanelli maneuver
D. Cleidotomy

Response:
Entrapment of aftercoming head This complication is usually seen with preterm delivery as the incompletely dilated cervix constricts aruond the neck .Duhurssen&;s incisions can be placed over the cervix avoiding the 3 and 9 o&;clock positions .other alternatives are intravenous nitroglycerin for cervical dilatation.General an anaesthesia followed by breech extraction is another option.As a last reso replacement of fetus high into the vagina and uterus followed by Caesarean section can be attended (Zavanelli manoeuvre).Another option with those who have experience of the same is symphysiotomy to widen the anterior pelvis (refer sheila textbook of obstetrics pgno:381 2 nd edition)

So the answer to this question is C


Instruction:
Which of the following local anaesthetic is active topically?
A. Lidocaine and Benzocaine
B. Lidocaine and mepivacaine
C. Mepivacaine and benzocaine
D. Prilocaine and mepivacaine

Response:
None

So the answer to this question is A


Instruction:
Which of the following is given at intervals as a pulsatile therapy?
A. GnRH agonist
B. Insulin
C. FSH
D. Estrogen

Response:
Only pulsatile exposure to GnRH induces FSH/LH secretion while continuous exposure desensatizes pituitary gonadotropes resulting in loss of Gn release GNRH agonists are usually given in pulsatile manner while antagonists are given in continous manner (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 239)

So the answer to this question is A


Instruction:
Percentage of drug existing as enantiomer is:
A. <1%
B. 10%
C. >50%
D. 100%

Response:
Ans: c (>50%) Ref: Katzung, 10 ed, p. 4Due to chirality (stereoisomerism) more than half of all useful drugs exists as enantiomers.Other important properties:One of the enantiomers will be more potent than its mirror image. The potent enantiomer which is active at one type of receptor may not be active at another type.One of the enantiomers will be more susceptible to drug metabolizing enzymes than the other.

So the answer to this question is C