Instruction:
A 7-year-old female who is somewhat obese is brought to the emergency department because of a soft lump above the buttocks. Upon physical examination you note the lump is located just superior to the iliac crest unilaterally on the left side. The protrusion is deep to the skin and pliable to the touch. Which of the following is the most probable diagnosis?
A. Tumor of the external abdominal oblique muscle
B. Herniation at the lumbar triangle (of Petit)
C. Indirect inguinal hernia
D. Direct inguinal hernia

Response:
The lumbar triangle (of Petit) is bordered medially by the latissimus dorsi, laterally by the external abdominal oblique, and inferiorly by the iliac crest. The floor of Pettit's triangle is formed by the internal abdominal oblique, and this is a possible site of herniation. An indirect inguinal hernia is located in the inguinal canal of the anterior abdominal wall. A direct inguinal hernia is located in the Hesselbach's triangle of the anterior abdominal wall. A femoral hernia occurs below the inguinal ligament. Answer A is not the best answer because this lump is described as soft and pliable, which would not likely indicate a tumor, as tumors tend to be hard masses.

So the answer to this question is B


Instruction:
True statement regarding postmoem hypostasis is/are
A. Also known as rigor mois
B. Stas within 8 hours of death
C. Present all over the body
D. It is present on dependent pa

Response:
D i.e. It is present on dependant pa Post moem lividity does not develop in drowning in running waterQ (due to constantly changing position of body) and areas of contact flatteningQ (due to collapsed capillaries)

So the answer to this question is D


Instruction:
Parenteral Iron therapy is indicated only when:
A. Oral Iron intolerance
B. Pregnancy with Hemoglobin less than 8 g/dL
C. Postpaum period with Anemia
D. Emergency surgery suspected of severe blood loss

Response:
Parenteral Iron Therapy by injection is indicated only when : 1. Oral iron is not tolerated or Non compliance to it. 2. Severe GIT upset , Iron malabsorption (e.g Sprue, Sho-bowel syndrome) 3. In presence of severe deficiency with chronic bleeding. 4. Along with erythropoietin in chronic kidney disease (CKD) patients. 5. Routine supplement to Total Parenteral Nutrition. S/E : Parenteral Iron Therapy should be used only when clearly indicated because acute hypersensitivity, including anaphylactic and anaphylactoid reactions, headache, malaise, fever, generalized lymphadenopathy, ahralgias, uicaria and in some patients with Rheumatoid Ahritis, exacerbation of the disease.

So the answer to this question is A


Instruction:
Health status of a child under 5 years of age will be adversely affected by all of the following except-
A. Malnutrition
B. Low birth weight
C. Maternal Hb of 11 gm%
D. Infections

Response:
Maternal Hemoglobin does not have any direct effect on the health of a child under 5 years of age. A low maternal hemoglobin may indirectly affect 'child health by contributing to IUGR and/or low birth weight. A maternal hemoglobin of 11 is however not significant enough to have any direct or indirect effect on child health as the cut off point for diagnosis of maternal anemia in pregnancy is set at 11gm %.

So the answer to this question is C


Instruction:
Radio-luscent renal stones are composed of -a) Cysteineb) Calcium phosphatec) Uric acidd) Xanthine
A. cd
B. bc
C. bd
D. ac

Response:
None

So the answer to this question is A


Instruction:
Following are true of Widal test except -
A. High titre in first sample is diagnostic
B. 'H' antigen is specific for serotyping
C. Highly +ve H titre not diagnostic
D. Maximum titre in third week

Response:
Ans. is 'a' i.e., High titre in first sample is diagnostic . High titre may be persent due to prior infection or immunization. It is the rising titre in two or more sequential samples which is suggestive of typhoid fever (not high titre in first sample). . The genus salmonella is fuher subdivided into serovars based on the detection of three major antigenic determinants. . Somatic antigen 0 . Surface antigen Vi . Flagellar antigen H . The titre increases steadily, reaching maximum in the 3" or 4'h week.

So the answer to this question is A


Instruction:
The redistribution phenomena is seen in
A. Halothane
B. Ether
C. Thiopentone
D. All

Response:
Ref-KDT 6/e p119 Redistribution which describes the reversible transfer of a drug from one location to another within the body. Once a drug enters into systemic circulation by absorption or direct administration, it must be distributed into interstitial and intracellular fluids .

So the answer to this question is C


Instruction:
In 1990, for the first time, Michaele Blease and W. French Andresco of National Institute of Health, Bethesda, U.S.A. attempted gene therapy on a human patient. Which of the following disease was attempted to be cured?
A. Cystic fibrosis
B. Haemophilia
C. Thalassemia
D. Severe Combined Immunodeficiency Disease

Response:
The first convincing therapeutic effect from gene transfer occurred with : SCID Impoant types of defects in SCID: X-linked Severe Combined Immunodeficiency Disease (SCID): mutations in the gene (IL2RG). IL2RG encodes gc subunit of cytokine receptors. Inheritance pattern: X-Linked. Most common defect in SCID patientsQ. Most common cause of SCID is IL2R defect. Autosomal Recessive SCID: ADA (Adenosine Deaminase enzyme) deficiency. gene therapy is done for ADA deficiency SCID.

So the answer to this question is D


Instruction:
Hemoperfusion with charcoal is useful in poisoning with : -
A. Phenytoin.
B. Methanol
C. Ethylene glycol
D. All of the above

Response:
#NAME?

So the answer to this question is A


Instruction:
Schedule-3 of MCI includes -
A. MBBS degree of indian universities
B. DNB degree
C. Diploma of CPS
D. MBBS degree of foreign universities

Response:
Ans. is 'c' i.e., Diploma of CPS Schedules of MCI Acto MCI was established in 1934 and MCI act was revised in 1956,1964,1993,1999, and 2002. The schedules of MCI includes list of medical degrees recognized by MCI :-Schedule 1Includes list of recognised degrees awarded by Indian universities7^(tm)5 ll) and also DNB awardedby National Board of Examination, New Delhi.Schedule 2 Includes list of recognized medical degrees awarded by foreign universities^7^.Schedule 3 Includes list of medical qualifications awarded by Indian or foreign boards or societies, but are notincluded in schedule 1 or 2. It has two partsPart I: Includes list of recognized degrees other than MBBS awarded by Indian Societies and Boards, e.g LMPand diploma of CPS.Part II: Includes list of recognized degrees other than MBBS awarded by Foreign Societies and Boards.

So the answer to this question is C


Instruction:
A 33-year-old woman is seen for evaluation of infertility. She complains of dyspareunia. On vaginal examination, tender nodularity along the uterosacral ligaments is noted. What is the diagnosis?
A. Adenomyosis
B. Diethylstilbestrol (DES)-related disease
C. Subserosal fibroids
D. Endometriosis

Response:
Tender uterosacral ligament usually are a sign of endometriosis. Although the other conditions listed may be associated with some form of pelvic pain, they do not produce tender uterosacral ligaments.

So the answer to this question is D


Instruction:
In phlebography dye is injected into:
A. Anterior tibial vein
B. Great saphenous vein
C. Dorsal metatarsal vein
D. Sho saphenous vein

Response:
Ans. Dorsal metatarsal vein

So the answer to this question is C


Instruction:
All of the following are ture regarding cephalosporins except -
A. Bactericidal agents
B. Active against only gram negative bacteria
C. IIIrd generation are resistant to beta-lactamases from gram negative bacteria
D. Ceftriaxone is administered parenterally

Response:
Ans. is 'b' i.e., Active against olny gram negative bacteria Cephalosporins are active against gram positive as well as gram negative bacteria, and are bactericidal. o Ceftriaxone is a parentral cephalosporin. o Third generation cephalosporins are highly resistant to beta-lactamases from gram negative bacteria.

So the answer to this question is B


Instruction:
A neonate develops spastic contractions on the second post-partum day Laboratory studies show hypocalcemia. MRI studies demonstrate aplasia of the thymus and parathyroid glands. What is the appropriate diagnosis?
A. Adenosine deaminase deficiency
B. Common variable immunodeficiency
C. DiGeorge syndrome
D. Transient hypogammaglobulinemia of infancy

Response:
DiGeorge syndrome. DiGeorge syndrome is a chromosomal defect that results in developmental anomalies of the branchial (pharyngeal) pouches and organs that develop from these embryonic structures (thymus, parathyroids, and aortic arch). These children present with tetany caused by hypoparathyroidism and deficiency of cellular immunity. They also have characteristic facial features ("angry look"). In the absence of a thymus, T-cell maturation is interrupted at the pre-T stage. DiGeorge syndrome has been corrected by transplanting thymic tissue. None of the other choices are associated with thymic aplasia.Diagnosis: DiGeorge syndrome

So the answer to this question is C


Instruction:
What is the risk of downs syndrome in a 35-year-old pregnant woman?
A. 1 in 75
B. 1 in 100
C. 1 in 250
D. 1 in 1000

Response:
Age of the motherRisk of Down&;s syndrome351 in 250361 in 192371 in 149381 in 115391 in 89401 in 69Reference: William's obstetrics; 25th edition; Chapter 14; Prenatal Diagnosis

So the answer to this question is C


Instruction:
Maximum osmotic gradient is found in
A. Outer medulla
B. Inner medulla
C. Outer coex
D. Inner coex

Response:
In inner medulla osmotic gradient is high as 1200milliosmolarRef: Ganong&;s review of medical physiology; 24th edition; page no: 687

So the answer to this question is B


Instruction:
The following is not a feature of malignant transformation by culturedc
A. Increased cell density
B. Increased requirement for growth factors
C. Alterations of cytoskeleton structure
D. Loss of anchorage

Response:
Ref biology of the cell p357-364 Both normal cells and cancer cells can be cultured in-vitro , however they behave quite differently normal cell: show replicative senescence .is cells pass through limited number of cell division before they decline in vigor and die it may caused by inability to synthesise telomerase

So the answer to this question is B


Instruction:
Earliest sign of papilloedema -
A. Less of pulsation
B. Blurring of disc margin
C. Obliteration of cup
D. Cotton-wool spots

Response:
Early (incipient )papilloedema is characterised by, obscuration of disc margins (nasal margins involved first , then superior , inferior and temporal) blurring of peripapillary nerve fibre layer absence of spontaneous venous pulsations at the disc mild hypaeremia Refer comprehensive ophthalmology (6 th edition )A K Khurana, page no. 324

So the answer to this question is B


Instruction:
The following statement about pilonidal sinus is true:
A. More common in females
B. Mostly congenital
C. Prognosis after surgery is poor
D. Treatment of choice is surgical excision of sinus tract

Response:
Ans. (d) Treatment of choice is surgical excision of sinus tract* MC in males* Acquired due to entry of hair follicles into skin.* Prognosis is good after surgery* Recurrence is common but there are surgeries for recurrent Jeeper's bottom like - Limberg's flap and Bascom technique

So the answer to this question is D


Instruction:
Complication of blood transfusion can be all except -
A. Hyperkalemia
B. Citrate toxicity
C. Metabolic acidosis
D. Hypothermia

Response:
Ans. is 'c' i.e., Metabolic acidosis The question is most probably about complications of massive blood transfusion.Massive Blood Transfusion * Massive blood transfusion is generally defined as transfusion of one to two volumes of patient's own blood volumes (For most adults that is equivalent to 10-20 units.)Complications of Massive Blood TransfusionCoagulopathyThe most common cause of bleeding following massive blood transfusion is dilutional thrombocytopeniaClinically significant dilution of the coagulation factors is unusual in previously normal individuals.Citrate ToxicityCitrate is used as an anticoagulant in the stored blood.Citrate has a property to bind calcium, this calcium binding by the citrate preservative can become significant following transfusion of large volumes of blood or blood products.Hypocalcemia results in some patients after massive transfusion, to prevent this, the transfusion rate should not exceed 1 unit every 5 minutes.Citrate also has an affinity for magnesium ion and the occurrence of hypomagnesemia in the setting of massive transfusion is seen (rarely).HypothermiaBlood is stored at a temperature of 2degC-6degC. So massive blood transfusion can result in hypothermia.Massive blood transfusion is an absolute indication for warming all blood products and intravenous fluids to normal body temperature.Hypothermia due to massive transfusion can result in ventricular arrhythmia.Acid-Base BalanceThe stored blood is acidic for two reasons.Due to the citric acid (the anticoagulants) Due to release of metabolic products by the anaerobic glycolysis of red cells (CO2 and Lactate).Despite the Stored Blood Being Acidic, Significant metabolic acidosis due to transfusion is not common.- Once the resuscitation is complete and normal perfusion is restored, any metabolic acidosis present, typically resolves, and progressive metabolic alkalosis supervenes as citrate and lactate contained in transfusion and resuscitation fluids are converted to bicarbonate by the liver. The most consistent acid base abnormality after massive blood transfusion is postoperative metabolic alkalosis.Serum Potassium ConcentrationThe extracellular concentration of Potassium in stored blood steadily increases with time due to lysis of RBC's.The amount of extracellular potassium transfused with each unit is typically less than 4m Eq per unit. Hyperkalemia can develop regardless of the age of the blood when transfusion rate exceeded 100ml/min.Oxygen Affinity Changes * 2, 3 DPG is greatly reduced in RBC's after about 3 weeks of storage, this increases hemoglobin's affinity for oxygen and adversely affects oxygen delivery to tissues.Acute Respiration? Distress SyndromeCoagulation Factor Depletion

So the answer to this question is C


Instruction:
Frothy discharge with red ulceration in the vagina is seen with infection of :
A. Trichomoniasis
B. Moniliasis
C. Chlamydia
D. Bacterial vaginosis

Response:
Trichomoniasis

So the answer to this question is A


Instruction:
The advantage of bladder drainage over enteric drainage after pancreatic transplantation is better monitoring of:
A. HBA1C levels
B. Amylase levels
C. Glucose levels
D. Electrolyte levels

Response:
Ans. (b) Amylase levelsRef: Sabiston 19th edition, Pages 675-679* Amylase is measured easily in urine in bladder drainage* When urinary amylase decreases it's time to check for graft failure by taking biopsy* Similar amylase testing is difficult in Intestine drainage.

So the answer to this question is B


Instruction:
Decrease in weight for height indicates?
A. Acute malnutrition
B. Chronic malnutrition
C. Both acute and chronic malnutrition
D. Sho stature

Response:
Decrease in weight for height indicates Acute malnutrition Decrease in height for age indicates chronic malnutrition.

So the answer to this question is A


Instruction:
Precocious pubey may be seen in all of the following conditions except :
A. Granulosa-cell tumour
B. Head injury
C. Coicosteroid in take
D. Hypehyroidism

Response:
Causes of precocious pubey GnRH Dependent Constitutional Juvenile primary hypothyroidism Intracranial lesions: trauma, tumour, infection GnRH independent Ovary: Granulosa cell tumor, theca cell tumor, leydig cell tumor, androblastoma Adrenal: hyperplasia,tumor Liver: hepatoblastoma Iatrogenic: Estrogen and androgen intake D.C.DUTTA'S TEXTBOOK OFGYNAECOLOGY, Pg no:51, 6th edition

So the answer to this question is D


Instruction:
Prescription of simple myopic astigmatism:
A. -0.5x180deg
B. +0.5x180deg
C. -3
D. 2

Response:
Ans. a.-0.5x180degSimple myopic astigmatism is one in which one meridian is emmetropic and other meridian is myopic.Hence needs correction only in one meridian with concave (-ve) cylinders. So the answer is -0.5x180deg.ASTIGMATISM TYPES AND CORRECTIONTypes of astigmatismDescriptionOpticsCorrectionSimple myopic astigmatismOne of the foci falls upon the retina while the other falls in front of or behind the retinaConcave cylinder Ex: -0.5x180degConvex cylinder Ex: +0.5x180degSimple hyperopic astigmatismCompound myopic astigmatismNeither of the foci fall upon the retina but both are placed infront of or behind the retinaConcave sphere + Cylinder Ex: -0.5 D sphere, -0.5x180degConvex sphere + Cylinder Ex: +0.5 D sphere, +0.5x180degCompound hyperopic astigmatismMixed astigmatismOne focus is front of the retina while the other is behind so that the refraction is hypermetropic in one direction and myopic in other directionConcave/ConvexSphere+Convex and concavecylinderEx: -1D sphere, +2Dx180deg

So the answer to this question is A


Instruction:
Waxy flexibility is a feature of -
A. Echopraxia
B. Catatonia
C. Stereotype
D. Mannerism

Response:
Ans. is 'b' i.e., Catatonia Disorders of motor activityo Disorder of motor activity may beMannerism Odd, repetitive and goal directed movements, e.g., waving, saluting.Stereotype Odd, repetitive movements which are not goal directed e.g., rocking to and fro. Repetition of speechs (words, phrases) may also occur. Sterotype occur without any stimulus.Perseveration :- There is persistent repetition of movement or speech, beyond fulfilment of purpose. Patient is unable to stop the action or speech beyond fulfilment of purpose. Perseveration is goal directed and requires external stimulus (in contrast to stereotypy).Note : Sterotypy and perseveration may be seen either as speech disturbance or as motor activity disturbance, i.e., repetion of speech or movemnt.Echopraxia Patients senselessly repeat the movement of others around them (associated with echolalia).TIC Sudden, involuntary, rapid, recurrent non-rhythmic motor movements.Catatonia Catatonia is characterized by a marked disturbance of motor behaviour. Most common cause of catatonia is schizophrenia, However it may also occur in depression, Mania, conversion - dissociative disorders, reactive psychosis, hypnosis, anxiety disorders and many medical disorders. Catatonia may be of following typesCatatonic excitmentExcited, uncontrolled motor activity, not influenced by external stimuli.Catatonic posturing :- Voluntary adoption of an unusual or bizarre position that is then maintained for some time.Catatonic rigidity :- Maintaining a fixed position and rigidity resisting all attempts to be moved.Waxy flexibility (flexibilitas cerea or catalepsy) : - Maintaining of particular posture imposed on the patient by examiner, even if the posture is bizzare and uncomfortable, i.e., patient can be moulded like wax into a position that is then maintained.Catatonic stupor :- Patient is mute and immobile (akinetic mutism) but fully conscious.Catatonic negativism :- A seemingly motiveless resistance to all instructions or attempts to be moved.Automatic obedience :- Exactly reverse to negativism, i.e., unhesitating compliance to all instructions without apparent conscious control.

So the answer to this question is B


Instruction:
Major clinical use of nimodipine is in:
A. Raynaud's phenomenon
B. Hypertension
C. Angina
D. Subarachnoid haemorrhage

Response:
Nimodipine:
It is a short-acting DHP which penetrates blood-brain barrier very efficiently due to high lipid solubility and has high affinity for the cerebral blood vessels.
It is believed to selectively relax cerebral vasculature and is approved for prevention and treatment of neurological deficit due to cerebral vasospasm following subarachnoid haemorrhage or ruptured congenital intracranial aneurysms.
Side effects are headache, flushing, dizziness, palpitation and nausea.
Reference: Essentials of Medical Pharmacology Eighth Edition KD  TRIPATHI  page no 596

So the answer to this question is D


Instruction:
Mastoid process antrum begins to develop in the
A. 6th month
B. 9th month
C. 1st year
D. 2nd year

Response:
*MASTOID* *ANTRUM* *DEVELOPEMENT* The antrum, which is the biggest of all mastoid air cells, stas its development between the 22nd and the 24th week of fetal life. It reaches its adult size on the 35th week The antrum develops at the center of the mastoid process on both sides of the petrosquamous fissure. The medial pa of the antrum, the petrous pa, develops from the saccus medius and the lateral pa, the squamous pa, develops from the saccus superior The fusion plane between the petrous pa and the squamous pa gives the petrosquamous fissure. Failure of complete fusion between the two sacci leads to a septation of the mastoid antrum by a bony paition called the Korner's septum Developmental arrest of the vestibule The antrum is well developed at bih and has a mean surface of 1 cm2 The size of the antrum does not change after bih; however, it undergoes medial displacement because of the growth of the mastoid process. The mastoid process continues to grow until pubey and even beyon REF : VISHRAM SINGH EMBRYOLOGY

So the answer to this question is A


Instruction:
All of these are antigen presenting cells (APC's) except-
A. B cells
B. T cells
C. Dendritic cells
D. Langerhans cells

Response:
Antigen-Presenting Cells(APCs): APCs implies to cells that present the antigenic peptide along with MHC class II to TH cells. They may be grouped into: * Professional APCs: e.g. 1.Macrophages, 2.Dendritic cells (Langerhans cells(LC) are members of the dendritic cells family, residing in the basal and suprabasal layers of the epidermis) 3.B-cells * Nonprofessional APCs: e.g. Fibroblasts (skin), Thymic epithelial cells, Pancreatic beta cells, Vascular endothelial cells, Glial cells (brain) and Thyroid epithelial cells.

So the answer to this question is B


Instruction:
The earliest symptom to occur in corneal ulcer is
A. Pain
B. Photophobia
C. Loss of sensation
D. Diminished vision

Response:
Ans. Pain

So the answer to this question is A


Instruction:
The following test is not used for diagnosis of leprosy :
A. Lepromin test
B. Slit skin smear
C. Fine needle aspiration cytology
D. Skin biopsy

Response:
A i.e. Lepromin test

So the answer to this question is A


Instruction:
Risk factors for PPH are all except:
A. Macrosomia
B. Twin pregnancy
C. Nuliparity
D. Previous H/O PPH

Response:
Ans. is c, i.e. NulliparityRef. JB Sharma Obs Pg 335Risk factors for PPHRisk factors for postpartum hemorrhageFactors in historyAntepartum factorsIntrapartum factorsMiscellaneous causes* Advanced maternal age* Overdistended uterus- Multiple pregnancy- Large-sized fetus- Polyhydramnios* Induction of labor* Sepsis* Multiparity, anemia, malnutrition* Antepartum haemorrhage* Prolonged labor * Previous PPH* Chorioamnionitis* Precipitate labor * Previous placenta previa or accrete* Instrumental delivery, operative manipulations* Bleeding and coagulation disorders* Rupture uterus* Fibroid uterus* Genital tract trauma* Non judicious use of oxytocics, sedatives, etc.

So the answer to this question is C


Instruction:
Which is MC genetic cause of mental retardation –
A. Tuberous sclerosis
B. Cri–du–chat syndrome
C. Fragile–x–syndrome
D. Angel's syndrome

Response:
None

So the answer to this question is C


Instruction:
Which vitamin is supplied from only animal source:
A. Vitamin C
B. Vitamin B7
C. Vitamin B12
D. Vitamin D

Response:
Ans. (c) Vitamin B12 Ref: Harrison's 19th ed. P 640* Vitamin B12 (Cobalamin) is synthesized solely by microorganisms.* In humans, the only source for humans is food of animal origin, e.g., meat, fish, and dairy products.* Vegetables, fruits, and other foods of nonanimal origin doesn't contain Vitamin B12 .* Daily requirements of vitamin Bp is about 1-3 pg. Body stores are of the order of 2-3 mg, sufficient for 3-4 years if supplies are completely cut off.

So the answer to this question is C


Instruction:
Which of the following is associated with Renal Papillary Necrosis
A. Alcohol
B. Heroine
C. Morphine
D. Tramadol

Response:
Answer is A (Alcohol) Chronic Alcoholism is an established cause of Renal Papillary Necrosis.

So the answer to this question is A


Instruction:
GABA is produced from:
A. Alanine
B. Glycine
C. Glutamate
D. Glutamine

Response:
Glutamate

So the answer to this question is C


Instruction:
Transport across nucleus is by all except?
A. Caveolins
B. Local signals
C. Importins
D. Rat proteins

Response:
Ans. d. Rat proteinsSource: InternetImportin - Type of karyopherinTransporting protein molecules into nucleus by binding to specific recognition sequences, called nuclear localization sequences (NLS).2 subunits, importin a and importin bCaveolinsFamily of integral membrane proteins that are principal components of caveolae membranes.Involved in receptor-independent endocytosis.Acts as scaffolding proteins within caveolar membranes by compart-mentalizing and concentrating signaling molecules.Rat proteins:Recombinant rat IFN--is a bioactive protein intended for use in cell culture applications.

So the answer to this question is D


Instruction:
Antibody found in patients of myaesthenia gravis is directed against -
A. Acetycholine
B. Acetycholine receptors
C. Acetycholine vesicles in nerve terminal
D. Actin-myosin complex of the muscle

Response:
None

So the answer to this question is B


Instruction:
Most radio dense substance is -
A. Fluid
B. Soft tissue
C. Brain
D. Bone

Response:
Increasing order of radiodensity : AIR FAT WATER BONE METAL

So the answer to this question is D


Instruction:
Drugs used in alcohol dependence to prevent relapse are all except ?
A. Nalmefene
B. Topiramate
C. Ondansetron
D. Fluoxetine

Response:
Ans. is 'd' i.e., Fluoxetine Drugs used for alcohol dependence to prevent relapse are: Naltrexane Acamprosate Ondansetron Nalmefene Disulfiram Topiramate

So the answer to this question is D


Instruction:
A patient aged 50 years presented with a history of jaw expansion and enlargement of maxilla
A. Paget's disease
B. Acromegaly
C. Fibrous dysplasia
D. Hyperparathyroidism

Response:
None

So the answer to this question is A


Instruction:
Role of sodium fluoride as a preservative for blood in viscera packing are all except
A. It prevents glycolysis
B. Acts as anti-coagulant
C. Inhibits bacterial growth
D. Inhibits enolase enzyme

Response:
Potassium oxalate - anti coagulant and 10 mg / ml Sodium or Potassium fluoride are used for blood preservation. Acts as preservative by following mechanism: - Prevents glycolysis - Inhibits bacterial growth - Inhibits enolase enzyme

So the answer to this question is B


Instruction:
Acute flaccid paralysis is reported in a child aged –
A. 0–3 years
B. 0–5 years
C. 0–15 years
D. 0–25 years

Response:
None

So the answer to this question is C


Instruction:
Long term effect of for CNS tumor in children are all except
A. Reduced IQ and learning
B. Endocrine dysfunction
C. Musculoskeletal problems
D. Neuropsychological effects are independent of radiation dose

Response:
D i.e. Neuropsychological effects are independent of radiation dose

So the answer to this question is D


Instruction:
List the odd one out among the following
A. Trisomy 18 (Noonan syndrome)
B. Trisomy 21 (Downs syndrome)
C. Trisomy 18 (Edwards synd.)
D. Trisomy 13 (Patau synd.)

Response:
Trisomy 18 is Edward syndrome & not Noonan syndrome. Noonan syndrome occurs in both males and females with a normal karyotype(46,XX and 46,XY). Refer to the image below.

So the answer to this question is A


Instruction:
If a drug is active against the pre–erythrocytic stage of the malarial parasite it will be useful as a :
A. Suppressive prophylactic
B. Causal prophylactic
C. Clinical curative
D. Radical curative

Response:
None

So the answer to this question is B


Instruction:
Which of the following is a component of deltoid ligament
A. Talofibular ligament
B. Tibiotalar ligament
C. Talonavicular ligament
D. Calcaneo-navicular ligament

Response:
Deltoid ligament has 4 components (all with prefix 'Tibia') : * Anterior tibiotalar ligament * Posterior tibiotalar ligament * Tibio-calcaneal pa* Tibio-navicular ligament - attaching to navicular bone at medial side of the foot. - Spring ligament / calcaneo-navicular ligament which connects navicular bone's plantar surface with sustentaculum of calcaneus is not a component of deltoid ligament fig:-Deltoid ligament of ankle

So the answer to this question is B


Instruction:
World Bank gives loan for -
A. Economic growth
B. Microbiological culture TB control
C. Accident problems
D. All

Response:
The bank gives loan for projects that will lead to economic growth.The projects are usually concerned with electric power, roads,railways,agriculture,water supply,education,family planning etc (refer pgno:923 park 23rd edition)

So the answer to this question is A


Instruction:
The phase of cell cycle, most sensitive to radiation isa) M Phase  b) G2Phase  c) S Phase  d) Early G1 Phase e) G0Phase
A. ac
B. ab
C. de
D. cd

Response:
Cells are most radiosensitive in late G, and early M phase → especially G2M interphase.

So the answer to this question is B


Instruction:
All can be seen as Post-Diarrhoea complications except:
A. HUS
B. Nephritic syndrome
C. Reactive ahritis
D. Guillain Barre syndrome

Response:
Complications of Chronic diarrhea * Lactase deficiency * Small-bowel bacterial overgrowth * Malabsorption syndromes (tropical and celiac sprue) * Initial presentation or exacerbation of inflammatory bowel disease * Irritable bowel syndrome * Reactive ahritis (formerly known as Reiter's syndrome) * Hemolytic-uremic syndrome (hemolytic anemia, thrombocytopenia, and renal failure) * Guillain-Barre syndrome

So the answer to this question is B


Instruction:
What is the definition of society -
A. System of social relationship between individuals
B. Social relationship between families
C. Interaction of individuals and people
D. Relationship of individual family and the country

Response:
- society is an organisation of its member agents where each member has to conform to its norms. - impoant feature is a system of social relationship between its members. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:671 <\p>

So the answer to this question is A


Instruction:
Which one of the following is the contraceptive method of choice for a commercial sex worker :
A. OC pills
B. IUCD
C. Tubectomy
D. Barrier method

Response:
Barrier method

So the answer to this question is D


Instruction:
A patient develops an infection of methicillin-resistant Staphylococcus aureus. Which of the following drug cannot be used to treat the infection:
A. Vancomycin.
B. Cotrimoxazole.
C. Cefaclor.
D. Ciprofloxacin.

Response:
Cefaclor is a second generation cephalosporin and is not active against MRSA.

So the answer to this question is C


Instruction:
Which preparation is used for retention in the incisal area of Class III amalgam?
A. Vertically  oriented  grooves
B. Horizontally oriented grooves
C. Coves
D. Skirts

Response:
Retention Grooves and Coves:
Vertically oriented grooves associated with the facial and lingual aspects of a proximal preparation are used to provide additional retention for the proximal portions of some Class II amalgam restorations. Horizontally oriented retention grooves are prepared in most Class III and V preparations for amalgam and in some root-surface tooth preparations for amalgam and composite resin. Small retentive indendations, referred to as “coves,” are utilized for retention in the incisal areas of Class III amalgams.
Reference: Sturdevant operative dentistry. 7th EDITION, Page No:131

So the answer to this question is C


Instruction:
A two year old child presents with persistent diarrhaea acidic stools and presence of one per cent of reducing substance in the fresh stools. What is the most probable diagnosis ?
A. Cystic fibrosis
B. Lactose intolerance
C. Rotavirus induced diarrhoea
D. Intestinal tuberculosis

Response:
DISACCHARIDASES DEFECIENCY Lactase defeciency diagnosis based on presence of more than .5%of reducing substance in the fresh stools acidic stools abnormal oral sugar tolerance test breath Hydrogen excretion of more than 11ppm following a loading dose of lactose enzyme assay on mucosal biopsies showing low levels of disaccharidases Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:274, 7th edition

So the answer to this question is B


Instruction:
Which of the following antimicrobials should not be given to a chronic asthmatic patient managed on theophylline therapy?
A. Erythromycin
B. Cefotaxime
C. Cotrimoxazole
D. Amoxicillin

Response:
Drugs which inhibit theophylline metabolism and increase its plasma level are -erythromycin, ciprofloxacin, cimetidine, oral contraceptives, allopurinol etc. Enzyme Inducers G - Griseofulvin P - Phenytoin R - Rifampicin S - Smoking Cell - Carbamazepine Phone - Phenobarbitone Enzyme Inhibitors Vit -Valproate K - Ketoconazole Can't -Cimetidine Cause - Ciprofloxacin Enzyme -Erythromycin Inhibition - Isoniazid

So the answer to this question is A


Instruction:
A 50 year old lady with history of jaundice in the past has presented with right upper quadrant abdominal pain. Examination and investigations reveal chronic calculous cholecystitis. The liver functions tests are within normal limits and on ultrasound examination the common bile ducts is not dilated. Which of the following will be the procedure of choice in her-
A. Laparoscopic cholecystectomy
B. Open choledocholithotomy with CBD exploration
C. ERCP ± cholecystectomy followed by laparoscopic cholecystectomy
D. Laparoscopic cholecystectomy followed by ERCP ± choledocholithotomy

Response:
None

So the answer to this question is A


Instruction:
Chronologic hypoplasia occur due to:
A. Exanthematous diseases.
B. Rickets.
C. Hypoparathyroidism.
D. No specific causes.

Response:
None

So the answer to this question is D


Instruction:
The following are the myeloproferative disorders except-
A. Polycythemia vera
B. Essential thrombocytosis
C. Chronic myeloid leukemia
D. Hairy cell leukemia

Response:
Hairy cell leukemia is a B-cell malignancy characteised by the presence of hairy cells in the blood & bone marrow & splenomegaly. Myeloproliferative diseases include chronic myeloid leukaemia ,polycythaemia vera, essential thrombocythaemia,chronic idiopathic myelofibrosis,chronic neutrophilic leukaemia ,chronic eosinophilic leukaemia .Reference :Harsh mohan textbook of pathology 6th edition pg no 357 & 378.

So the answer to this question is D


Instruction:
Breast milk is maximum at –
A. 1–2 months
B. 3–4 months
C. 5–6 months
D. 7–8 months

Response:
Breast milk is maximum at 5-6 months of lactation -9 730 ml/day.
It is minimum at 37-38 months of lactation    --> 345 ml/day.

So the answer to this question is C


Instruction:
Commonest cause of acute otitis media in children is
A. H. inflenzae
B. Strepto-pneumoniae
C. Staph aureus
D. Pseudomonas

Response:
Ans. is 'b' i.e Streptococcus pneumoniae Aetiology of ASOM in children:S. pneumoniae (35%)H. influenzae (25%)M. Catarrhalis (15%)Aetiology in adultsH. influenza (25%)*S. pneumonia (21%)

So the answer to this question is B


Instruction:
What is true about sentinel surveillance ?
A. It monitors health situation in border districts
B. It is an improved method of malaria surveillance
C. It method of supplementing routine surveillance system
D. It is an effective method of surveillance of sanitary condition

Response:
Ans. is 'c' i.e., It method of supplementing routine surveillance system Surveillance Surveillance is defined as "the continous scrutiny of the factors that determine the occurrence and distribution of disease and other conditions of ill health". Surveillance may be of following types :? 1. Passive surveillance Data is repoed itself to health system, e.g. a patient (clinical case) is coming to a doctor. Most of the national health programmes in India rely on passive surveillance for data collection. 2. Active surveillance Data is collected actively by health system, e.g. collection of blood slides every fonight from house to house to control malaria. Active surveillance in India is done in :- National leprosy elimination programme (modified leprosy elimination compaigns). National vector Borne disease control programme (NVBDCP) e.g. malaria. 3. Sentinel surveillance Sentinel surveillance helps in identifying missing cases and supplementing notified cases. Sentinel surveillance in India is done in national AIDS control programme.

So the answer to this question is C


Instruction:
Which cooking oil bast most PUFA?
A. Safflower oil
B. Coconut oil
C. Butter
D. Vanaspati

Response:
Ans. is 'a' i.e., Safflower oil

So the answer to this question is A


Instruction:
All are associated with Wernicke'S encephalopathy except-
A. Cog wheel rigidity
B. Alteration in mental function
C. Vlth nerve palsy
D. Ataxia

Response:
Ans. is 'a' i.e., Cog-wheel rigidity o Wernicke's encephalopathy is characterized by a triad of global confusion (alteration in mental function). Ophthalmoplegia (Bilateral 6th nerve palsy) and ataxia.Wernicke's encephalopathyo It is an acute neurological disorder characterized by a classical triad of ataxia, ophthalmoplegia and confusion. The clinical findings include : -Ocular : - Nystagmus, bilateral lateral rectus palsy, conjugate gaze palsies. The most common ocular abnormality is nystagmus, not complete ophthalmoplegia. Less frequently noted are pupillary abnormalities such as sluggishly reactive pupil, ptosis, scotomas, and anisocoria.CNS (encephalopathy) : - Global confusion, disinterest, inattentiveness or agitation. Rarely stupor and coma may occur.Gait ataxiaPeripheral polyneuropathy : - Weakness, foot drop, decreased proprioception.Other symptoms : - Autonomic dysfunction (tachycardia & postural hypotension). If there is coexisting cardiovascular beriberi; hypothermia; abdominal symptoms (nausea, vomiting, abdominal pain).

So the answer to this question is A


Instruction:
Sodium valproate: Drug of choice for all the following except
A. Absence seizures
B. Myoclonic seizures
C. Atonic seizures
D. Infantile spasms

Response:
DOC for status epilepticus is lorazepam Carbamazepine-DOC for simple and complex paial seizures. Valproate DOC for GTCS,Atonic,myoclonic,absence,LG syndrome,clonic,tonic seizures. Ref: Katzung 12th ed.

So the answer to this question is D


Instruction:
In splenic injury conservative management is done in
A. Hemodynamically unstable
B. Young patients
C. Shattered spleen
D. Extreme pallor and hypotension b

Response:
Most serious complications after splenectomy are OPSI (Oppounistic Post Splenectomy Infections) it is most common in young children and immunocompromised adults. "Therefore it is essential to save the spleen in children." Now spleen salvage methods are the management of choice even in adults. Splenectomy is usually indicated under the following circumstances (Ref: Sabiston 18/e pi639 (17/e} p 1694) 1. the pt. is unstable 2. the spleen is extensively injured with continuous bleeding 3. bleeding is associated with hilar injury 4. other injuries require prompt attention SRB 5th edition page no. 672 & 671

So the answer to this question is B


Instruction:
Which of the following is a cerebro selective calcium channel blocker?
A. Nimodipine
B. Ziconotide
C. Verapamil
D. Diltiazem

Response:
Ans. (a) NimodipineRef KDT 6/e, p 172

So the answer to this question is A


Instruction:
"Paraneoplastic Syndrome" Not seen in RCC is:
A. Acanthosis nigricans
B. Amyloidosis
C. Polycythemia
D. SLE

Response:
SLE

So the answer to this question is D


Instruction:
Which of the following anesthetic is safe in heart failure -
A. Etomidate
B. Propofol
C. Thiopentone
D. Ketamine

Response:
Ans. is 'a' i.e., Etomidate Etomidateo It has a briefer duration of action 4-8 minutes.o It produces little cardiovascular and respiratory depression-->> Agent of choice for cardiovascular surgeries (bypass, aneurysms, valve surgery). Etomidate is most cardiostable inducing agent.o Coronary perfusion pressure is maintained when it is used with fentanyl.o Similar to thiopentone & propofol, etomidate is cerebroprotective - Decreases cerebral blood flow; metabolism, oxygen consumption and ICT.o Etomidate has the highest incidence of nausea and vomiting amongst inducing agents 30%-40%.o It can produce hiccups and myoclonus .o Superficial thrombophlebitis and pain on injection may occur - Pain can be reduced by using larger vein and injecting lidocaine just before etomidate.o Intraarterial injection is not associated with local or vascular complications.o The specific endocrine effects manifested by etomidate are a dose dependent reversible inhibition of enzyme 11-b-hydroxylase, which coverts I I-deoxycortisol to cortisol and a relative minor effect on 17a - hydroxylase,o There is decreased synthesis of adrenal corticoids with increase in precursors 11-deoxycortisol and 17- hydroxyprogesterone.o ACTH secretion increases due to loss of feed back inhibition,o l it 'CT supplementation restores cortisol levels to normal after use of etomidate.

So the answer to this question is A


Instruction:
Atypical (Second generation or newer) antipsychotics are -a) Aripiprazoleb) Risperidonec) Pimozided) Penfluridole) Olanzapine
A. abc
B. abe
C. cde
D. acd

Response:
A typical (second generation) antipsychotics are clozapine, Olanzapine, Risperidone, Questiapine, Aripiprazole, Ziprasidone.

So the answer to this question is B


Instruction:
True statement about fexofenadine is :
A. It undergoes high first pass metabolism in liver
B. Terfenadine is an active metabolite of this drug
C. It does not block cardiac K+ channels
D. It has high affinity for central H1 receptors

Response:
Fexofenadine is an active metabolite of terfenadine. It lacks K+ channel blocking property, therefore is devoid of arrhythmogenic potential. It is available as a separate second-generation H1 blocking agent.

So the answer to this question is C


Instruction:
A 24-year-old man is diagnosed with disseminated histoplasmosis after developing symptoms of fever, lymphadenopathy, hepatosplenomegaly and pancytopenia. Which of the following is the body's major immunologic defense against histoplasmosis?
A. immunoglobulin G (IgG) antibodies
B. mononuclear leukocytes
C. complement
D. immunoglobulin M (IgM) antibody

Response:
The major reaction to fungal infections such as histoplasmosis is delayed-type hypersensitivity. This is a reaction of T cells, which have been stimulated by antigen to react against infectious agents, grafts, and tumors. A classic example is the response to the tuberculin skin test in a person previously exposed to Mycobacterium tuberculosis organisms which occurs between 48 and 72 hours after antigen exposure.

So the answer to this question is B


Instruction:
Elongation arrest occurs due to
A. SRP- R
B. SRP
C. Signal peptide
D. Docking protein

Response:
B i.e. SRP

So the answer to this question is B


Instruction:
Which of the following is true regarding GLUT-5:
A. Present in brain
B. Present in Adipose tissue, skeletal muscle & skin
C. Insulin mediated transpoer
D. Sodium independent transpo

Response:
Ans. (D) Sodium independent transpoGLUT-5 is unusual in that it is the primary transpoer for fructose (instead of glucose) in the small intestine & the testes.Has sodium independent facilitated diffusion mechanism.

So the answer to this question is D


Instruction:
A pateint of Schizophrenia treated for 5 years developed perioral movem-ents. Likely diagnosis is:
A. Tardive dyskinesia
B. Muscular dystonia
C. Akathasia
D. Malignant neurolept syndrome

Response:
A i.e. Tardive dyskinesia

So the answer to this question is A


Instruction:
False regarding gouty arthritis is -
A. Synovial fluid analysis is diagnostic
B. Allopurinol is the treatment of choice in acute gout
C. Arthritis occurs after long attack of hyperuricemia
D. Level of uric acid in blood and severity of gout has good correlation

Response:
None

So the answer to this question is B


Instruction:
Treatment of choice for annular pancrease is
A. Division of pancreas
B. Duodenoduodenostomy
C. Duodenojejunostomy
D. Roux-en-Y loop

Response:
Pancreatic ring surrounds the second or third pa of duodenum. The usual treatment is duodenoduodenostomy. Bailey & Love ,26th,1125

So the answer to this question is B


Instruction:
The triad of hypertension, bradycardia and irregular respiration is seen in:
A. Cushing's reflex
B. Bezold-Zarisch reflex
C. Herring-Bruer reflex
D. Bainbridge's reflex

Response:
Ans. a. Cushing's reflex (Ref: Ganong 24/e p607; Schwartz 9/e p1521; Bailey 25/e p483)The triad of hypertension, bradycardia and irregular respiration is seen in Cushing's reflex.'Elevated intracranial pressure, as caused by space occupying lesion like brain tumor or head trauma with associated intracranial bleeding (e.g. epidural /subdural/cerebral- haemorrhage), results in an increased systemic blood pressure (BP) and bradycardiaQ (rather than tachycardia) and irregular breathing. This response is called Cushing's reflex or phenomenon. 'Cushing's TriadIncrease in systolic blood pressureQ (Widening of pulse pressure)Reduction of the heart rateQ (bradycardia)Irregular respirationQ (caused by impaired brainstem function)Cushing ReflexCushing reflex (also referred to as the vasopressor response), is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing's triad of increased blood pressure, irregular breathing, and a reduction of the heart rateQ.It is usually seen in the terminal stages of acute head injury and may indicate imminent brain herniationQ.These symptoms can be indicative of insufficient blood flow to the brain (ischemia) as well as compression of arteriolesQ.Etiology:It is a special CNS ischemic response that results from increased intracranial tension (or increased CSF pressure around the brain in cranial vault).Causes of increased ICT may be space occupying lesions such as brain tumorQ, cerebral abscess, head traumaQ with associated intra cranial bleeding (epidural/ subdural/ cerebral-haemorrhage)Pathophysiology:When the ICT or CSF pressure rises to equal the arterial pressure, it compresses the whole brain as well as the arteries in the brain and cuts off the blood supply to the brain, thereby activating the CNS ischemic responseCompromised blood supply, local hypoxia and hypercapnia of RVLM (rostral ventrolateral medulla) neurons or vasomotor area increase their discharge and evoke Cushing's reaction raising systemic arterial pressureQ.Cushing ReflexThe resultant rise in systemic arterial pressure (due to ischemic stimulation of vasomotor regions in medulla) tend to restore the blood flow to medulla, thereby protecting the vital centers of brain from loss of nutrition if ICT rises enough to compress cerebral arteries.The rise in BP is proportional to increase in intracranial tension (over a considerable range) and causes a reflex decrease in heart rate via the arterial baroreceptors. This is why bradycardia rather than tachycardia is characteristically seen in patients with increased intra cranial pressureQ.Bezotd-Jarisch reflex* In experimental animals, injections of serotonin, veratridine, capsaicin, phenyldiguanide. and some other drugs into the coronary arteries supplying the left ventricle cause apnea followed by rapid breathing, hypotension, and bradycardia (the coronary chemoreflex or Bezold-Jarisch reflex).* The receptors are probably C fiber endings, and the afferents are vagal.* The response is not produced by injections into the blood supply of the atria or the right ventricle.Hering-Bruer reflex* The Hering-Breuer inflation reflex is an increase in the duration of expiration produced by steady lung inflation, and the Hering-Breuer deflation reflex is a decrease in the duration of expiration produced by marked deflation of the lung.Bainbridge's reflex* Rapid infusion of blood or saline in anesthetized animals sometimes produces a rise in heart rate if the initial heart rate is low. This effect was described by Bainbridge in 1915, and since then it has been known as the Bainbridge reflex.

So the answer to this question is A


Instruction:
Amplifier host in Japanese encephalitis-
A. Horse
B. Pigs
C. Dogs
D. Monkey

Response:
Ans. is 'b' i.e., Pigs Japanese encephalitis* JE is caused by flavivirus, a group B arbovirus. It is a zoonotic disease infecting mainly animals and incidentally man.* In south, epidemics have occured in Karnataka, Andhra pradesh, Tamil-Nadu and Kerala. Now Gorakhpur district of U.P. contributes largest number of cases.* Main vector of JE transmission is culex mosquito (culex tritaeniorhynchus), a zoophilic rural mosquito that breeds in rice paddy fields, shallow ditches and pools. Other important vector species are culex vishnuii and culex gelidus.* Pigs are amplifier host i.e., infected pigs do not manifest overt symptoms but circulate the virus so that mosquito get infected and can transmit virus to man. Horses are the only domestic animals showing symptoms of JE. Man is an 'incidental dead-end host\ there is no man-to-man transmission. 'Cattle and buffaloes' act as mosquito attractants, i.e. infected but are not the natural hosts. Herons (birds) are the reservoir hosts.* There are two natural cycles of JE virus :* i) Pig - mosquito - pig* ii) Ardeid bird - mosquito - Ardeid bird.* Most of the cases are subclinical, ratio of overt disease to inappearent infection varies 1:1000, i.e., cases show tip of iceberg. For clinical cases incubation period is 5-15 days. The disease passes through sequential stages of prodrome, acute encephalitis, and late stage with sequelae. There is no rash at the site of mosquito bite.* Case fatality rate is 20-40%. The endemicity of cases is 1-2 case per village.* The vast majoirty of cases (about 85%) occur among children < 15 years of age. But JE is infrequent in infancy.

So the answer to this question is B


Instruction:
A 55-year-old diabetic woman suddenly develops weakness of the left side of her face as well as of her right arm and leg. She also has diplopia on left lateral gaze. Where is the responsible lesion?
A. Right cerebral hemisphere
B. Left cerebral hemisphere
C. Right side of the brainstem
D. Left side of the brainstem

Response:
This patient has weakness of the left face and the contralateral (right) arm and leg, commonly called a crossed hemiplegia. Such crossed syndromes are characteristic of brainstem lesions. In this case, the lesion is an infarct localized to the left inferior pons caused by occlusion of a branch of the basilar artery. The infarct has damaged the left sixth and seventh cranial nerves or nuclei in the left pons with resultant diplopia on left lateral gaze and left facial weakness. Also damaged is the left descending corticospinal tract, proximal to its decussation in the medulla; this damage causes weakness in the right arm and leg. This classic presentation is called the Millard-Gubler syndrome. Hemispheric lesions cause motor and sensory loss all on the same side (contralateral to the lesion). A lesion in the median longitudinal fasciculus causes third and sixth cranial nerve dysfunction but not motor deficit of the face or body.

So the answer to this question is D


Instruction:
Which of the following parenteral anticoagulants is a dual coagulation factor inhibitor?
A. Clavatadine
B. Tifacogin
C. Tanogitran
D. Flovagatran

Response:
ClavatadineXla inhibitorTifacoginVIIa inhibitorTanogitranDual IIa/Xa inhibitorFlovagatranIIa inhibitor

So the answer to this question is C


Instruction:
Ureteric constriction in the following sites EXCEPT
A. At the pelviureteric junction
B. Crosses the internal iliac artery
C. At bladder wall
D. At mesentery

Response:
(At mesentery) (301 - BDC - 2) (370 - Snell 7th)URETERS - The ureter enters the pelvis by crossing the bifurcation of the common iliac artery in front of the sacroiliac joint. Each ureter then runs down the lateral wall of the pelvis infront of the internal iliac artery to the region of the ischial spine and turns forward to enter the lateral angle of the bladder. Near its termination. It is crossed by the vas deferens. The ureter passes obliquely through the wall of the bladder for about 0.75 in (1.9cm) before opening into the bladder.Three Constrictions (Snell)BDC(i) Where the renal pelvis joins the ureter in the abdomen(ii) Where it is kinked as it crosses the pelvic brim to enter the pelvis(iii) Where it pierces the bladder wall(i) At the pelvi ureteric Junction(ii) At the brim of the lesser pelvis(iii) At its passage through the bladder wall.

So the answer to this question is D


Instruction:
Tangier's disease is characterized by:
A. Low or absence of HDL
B. Low LDL concentration
C. Raised chylomicrons
D. Deficiency of LPL

Response:
Tangier's disease/ Familial alpha-lipoprotein deficiency/Hypo alpha lipoproteinemia. Defect in ABC-A 1 receptors which helps in giving cholesterol from peripheral tissue to HDL. HDL is not properly formed- HDL | Other lipoproteins are normal. | Apo A1. Cholesterol accumulates in reticulo endothelial system C/F : Peripheral neuropathy, Hepatosplenomegaly Large orange/ yellow tonsils.

So the answer to this question is A


Instruction:
A 17-year-old female was admitted to the hospital with a high fever. Following intravenous administration of antibiotics, a routine CT scan revealed a "thoracic outlet" syndrome. Which symptom would most likely result from this syndrome?
A. Problems with respiration because of pressure on the phrenic nerve
B. Reduced blood flow to the thoracic wall
C. Reduced venous return from the head and neck
D. Numbness in the upper limb

Response:
Thoracic outlet syndrome is characterized by the presence of a cervical rib, accessory muscles, or connective tissue bands that constrict the limited dimensions of the thoracic outlet. The cervical rib is usually located on the C7 vertebra and can impinge on the brachial plexus, resulting in loss of some feeling to the upper limb. There would be no impingement on the phrenic nerve because it leaves C3 to C5 directly parallel with the vertebral column. The syndrome does not include reduction of blood flow to the thoracic wall because of extensive anastomoses between the vessels that supply blood to the anterior thoracic wall. Venous return from the head and neck is mainly through the internal jugular vein and would not be affected because of this vein's location near the midline of the body; thus, it would not be occluded or distended.

So the answer to this question is D


Instruction:
Commonest site of Ivory osteoma -
A. Frontal-Ethmodial region
B. Mandible
C. Maxilla
D. Sphenoid

Response:
Ivory osteomas are most commonly seen in frontal sinus followed by ethmoid and maxillary sinus.

So the answer to this question is A


Instruction:
Where is the triglycerides stored in the human body?
A. Nerve cells
B. Adipose tissues
C. Both
D. None

Response:
Triglycerides are stored in adipose tissues.

So the answer to this question is B


Instruction:
Not TRUE statement regarding parotid gland is/are?
A. Deep lobe contains deep lymphatics
B. Divided into superficial and deep lobes by facial nerve
C. Parotid duct opens opposite to the second upper molar
D. Ectodermal in origin

Response:
Ans. is 'a' i.e., Deep lobe contains deep lymphatics Development:Parotid gland is the first salivary gland to appear, in early 6' week.It is ectodermal in origin and develops from the buccal epithelium just lateral to the angle of mouthStructures emerging from parotidThe following structures emerge from the parotid gland:Anterior border:Parotid duct3 Terminal branches of facial nerve:The zygomatic and buccal branches: toward the temporal region, eyelids and cheek, respectively.Mandibular branch : Run along the body of the mandibletowards the mouthApex:5th terminal branch of facial nerve: Cervical branch continues into the neck (to platysma).Anterior & posterior divisions of retromandibular veinPosterior border:Posterior auricular nervePosterior auricular aeryPosterior auricular veinAlong base:superficial temporal aerytemporal branch of facial nerveAuriculotemporal nerveSTRUCTURES WITHIN GLAND:Aeries:External carotid aery enters through posteromedial surfaceMaxillary aerySuperficial temporal vesselPosterior auricular aeryVeins:The retromandibular veins Facial NerveParotid Duct (Stenson's duct)The duct turns opens into the vestibule of the mouth (gingivo- buccal vestibule) opposite the crown of the upper 2nd molar toothNerve supply:PARASYMPATHETIC:auriculo temporal nerveSYMPTHETIC SUPPLY- plexus around the external carotid aery.SENSORY NERVES: auriculotemporal nerve, except for parotid fascia & overlying skin which are innervated by Great auricular nerve (C2, C3).

So the answer to this question is A


Instruction:
All of the following are seen in Homer's syndrome except: September 2005, March 2007
A. Enophthalmos
B. Hyperhydrosis
C. Miosis
D. Ptosis

Response:
Ans. B: Hyperhydrosis Homer's syndrome is characterized by an interruption of the oculosympathetic nerve pathway somewhere between its origin in the hypothalamus and the eye. The classic clinical findings associated with Homer's syndrome are: Ptosis, Pupillary miosis and Facial anhidrosis. Other findings may include apparent enophthalmos, increased amplitude of accommodation, heterochromia of the irides (if it occurs before age two), paradoxical contralateral eyelid retraction, transient decrease in intraocular pressure and changes in tear viscosity. In children Homer's syndrome sometimes leads to a difference in eye color between the two eyes (heterochromia).This happens because a lack of sympathetic stimulation in childhood interferes with melanin pigmentation of the melanocytes in the superficial stroma of the iris.

So the answer to this question is B


Instruction:
Secondary attack rate of chicken pox is
A. 60
B. 50
C. 90
D. 40

Response:
Chicken pox Agent- Human alpha herpes virus 3 Primary infection causes chicken pox Recovery from primary infection is commonly followed by establishment of latent infection in cranial nerves, sensory ganglia, spinal dorsal root ganglia When the cell mediated immunity wanes, the virus may reactivate in 10-30% cases Incubation period -15 days Distribution of rash:- Centripetal; Axilla affected; Rash seen mostly over flexor aspect Characteristics of rash:- Superficial; Unilocular-dew drops like appearance Rash pleomorphic- different stages of rash evident at one time An area of inflammation seen around vesicle Evolution of rash : very rapid Scab begins to form 4-7 days after the rash appears Fever- temperature rises with each fresh crop of rash Secondary attack rate-90% Reference: Park&;s textbook of Preventive and Social medicine, 23rd edition; Page no.144

So the answer to this question is C


Instruction:
Which of the following is a polar amino acid?
A. Tryptophan
B. Serine
C. Valine
D. Tyrosine

Response:
Note: Polar amino acids are hydrophilic and nonpolar amino acids are hydrophobic.

So the answer to this question is B


Instruction:
Which of the following is least commonly associated with renal cell carcinoma?
A. Polycythemia
B. Amyloidosis
C. Cushing's syndrome
D. Hypeension

Response:
Risk factors for Renal Cell Carcinoma : Smoking Hypeension Obesity Occupational exposure to Cadmium Chronic dialysis patient having acquired polycystic disease Patient with polycythemia Amyloidosis Cushing syndrome is the one having the least incidence in renal cell cancer out of the given options.

So the answer to this question is C


Instruction:
Prostacyclin is mainly produced by-
A. Platelet
B. Vascular endothelium
C. Prostate
D. Testis

Response:
Ans. is 'b' i.e., Vascular endotheliumArachidonic acid metabolites During inflammation, various biologically active lipid mediators are derived from membrane phospholipid. o Arachidonic acid is derived from dietry sources or by conversion from the essential fatty acid (linoleic acid).It does not occur free in cell but is normally esterified in membrane phospholipid.When phosphilipase A2 is activated, it releases arachidonic acid from membrane phospholipids.From arachidonic acid, mediators of inflammation are synthesized by two different pathway.

So the answer to this question is B


Instruction:
Middle superior alveolar nerve is a branch of
A. Mandibular division of trigeminal nerve
B. Palatine division of maxillary nerve
C. Anterior nasal division of maxillary nerve
D. Interior alveolar nerve

Response:
C i.e. Anterior nasal division of maxillary nerve

So the answer to this question is C


Instruction:
Positive Trendelenburg sign is seen in: March 2007
A. Superior gluteal nerve palsy
B. Inferior gluteal nerve palsy
C. Obturator nerve palsy
D. Ilihypogastric nerve palsy

Response:
Ans.A: Superior gluteal nerve palsy Trendelenburg's sign is found in people with weak abductor muscles of the hip. The Trendelenburg sign is said to be positive if, when standing on one le.g., the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance le.g., allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, here when the patient lifts the opposing le.g., the shift is not created and the patient cannot maintain balance leading to instability. Trendelenburg sign is caused by paralysis of the gluteus medius and minimus muscles. Para!ysis may arise due to nerve damage, namely, the superior gluteal nerve.

So the answer to this question is A


Instruction:
Infant with carnitine deficiency form hypoglycemia due to what reason?
A. Decreased glycosis
B. Decreased gluconeogenesis
C. Increased utilization of glucose
D. Reduced fatty acid oxidation and ketogenesis

Response:
Carnitine deficiency can occur paicularly in the newborn-- and especially in preterm infants--owing to inadequate biosynthesis or renal leakage. Losses can also occur in hemodialysis.This suggests a vitamin-like dietary requirement for carnitine in some individualsSymptoms of deficiency include hypoglycemia, which is a consequence of impaired fatty acid oxidation and lipid accumulation with muscular weakness.Treatment is by oral supplementation with carnitineReference: Harper biochemistry, 30th edition, page no 231

So the answer to this question is D


Instruction:
Glomerulonephritis in streptococcal infection is diagnosed by -
A. Blood culture
B. Throat culture
C. ASO Titre
D. PCR

Response:
Ans. is 'c' i.e., ASO Titre

So the answer to this question is C


Instruction:
In thymoma , all are seen except
A. Hypogamma globulinemia
B. Hyperalbuminemia
C. Red cell aplasia
D. Myaesthenia gravis

Response:
Thymoma is the most common Anterior mediastinal mass. Thymomas are seen to be associated with Myasthenia gravis Acquired hypogammaglobulinemia Pure red cell aplasia Grave's ds Pernicious anemia Dennatomyositis-polymyositis Cushing syndrome Ref : Robbins (big) 8/e p636

So the answer to this question is B


Instruction:
Most common site of intracranial hemorrhage in hepertensive hemorrhage is :
A. Basal ganglia
B. Brainstem
C. Cerebellum
D. Hippocampus

Response:
Ans. is 'a' i.e. Basal ganglia The most common sites of hypertensive Haemorrhage are:The basal ganglia (putamen, thalamus and adjacent deep white matter)Deep cerebellumPons

So the answer to this question is A


Instruction:
Which of the following is more likely associated with Klebsiella pneumoniae than Escherichia coli?
A. A hospitalized patient who has pneumonia
B. Endotoxic shock
C. Hemolytic uremic syndrome in children
D. An alcoholic who has lobar pneumonia

Response:
Klebsiella pneumoniae is more likely than Escherichia coli to be associated with lobar pneumonia in an alcoholic. K pneumoniae is a fat, nonmotile, gram-negative rod that is surrounded by a capsule that is responsible for its invasiveness. They characteristically produce moist mucoid colonies on culture. K pneumoniae is a weak pathogen and requires a host with weak defenses (e.g., alcoholics, diabetics) to infected tissue. It is more commonly associated with urinary tract infections than with pneumonia. However, it produces a lobar pneumonia, paicularly in alcoholics, diabetics, or those with weakened defenses. The pneumonia are characterized by blood-tinged mucoid sputum, a tendency for lung abscesses, and a moality in 20% of patients. In general, K pneumonia is susceptible to ceftriaxone. Escherichia coli is the most common cause of acute cystitis and pyelonephritis, spontaneous bacterial peritonitis in alcoholics, the enterotoxigenic strain of traveler's diarrhea, hemolytic uremic syndrome in children caused by eating undercooked hamburgers, endotoxic shock, and acute cholecystitis. It is a common pathogen in neonatal meningitis, pneumonia in hospitalized patients caused by colonization of the airways by the organism, enteropathogenic gastroenteritis in infants under 2 years of age, enteroinvasive gastroenteritis with bloody diarrhea, peritonitis, wound infections (paicularly in diabetics), and septicemia. Ref - Harrison's principles of internal medicine 20e pg 1155,1146

So the answer to this question is D


Instruction:
Digitalis has positive Inotropic effect-by the viue of its effect on:
A. Na+K+ ATPase pump
B. Na Glucose channels
C. H+K+ ATPase pump
D. Calcium pump

Response:
Ref:KDT 6/e p496 Digitalis is used clinically because it exes a positive inotropic effect and because it slows transmission in the AV node in patients with supraventricular tachyarrhythmias. The positive inotropic effect is due to inhibition of the sodium/potassium pump at the outer cell membrane.

So the answer to this question is A


Instruction:
Glaucoma is characterised by apoptosis of
A. Bipolar cells
B. Ganglion cells
C. Retinal pigment epithelium
D. Rods and Cones

Response:
Multifactorial optic neuropathy characterised by Retinal Ganglionic cell death by the apoptosis.

So the answer to this question is B


Instruction:
"Spider leg" deformity in excretory urogram occurs in
A. Hydronephrosis
B. Polycystic kidney
C. Uretrocele
D. Renal agenesis

Response:
polycystic kidney, an autosomal dominant disease, common in females; excretory urogram shows 'spider leg' pattern - elongated and compressed renal pelvis with narrowed and stretched calyces over the cysts. ( Reference: emedicine.medscape.com/aicle/983281-workup )

So the answer to this question is B


Instruction:
Whip lash injury occurs in
A. Pedestrian hit from front
B. Pedestrian hit from behind
C. Occupant of a car
D. Any of the above

Response:
Whiplash injury In Road traffic accidents, involving acceleration/ deceleration trauma. commonly sustained by the front seat occupant of a car with no or poorly adjusted head rest Sudden hyperextension & then hyperflexion of neck occurs Resulting in fatal contusion or laceration of spinal cord without fracture of spine.

So the answer to this question is C


Instruction:
If Hemoccult test is negative for screening of colonic cancer, no fuher test is done. If the hemoccult test is positive the individual will have a second stool sample tested with Hemoccult II test. If this second sample is positive for blood, the individual will be referred for more extensive evaluation. The effect of net sensitivity and net specificity of this method of screening is
A. Net sensitivity and net specificity are both increased
B. Net sensitivity is decreased and net specificity is increased
C. Net sensitivity is increased and net specificity is decreased
D. Net sensitivity remains the same and net specificity is increased

Response:
SCREENING TEST USED IN SERIES: A population is subjected to one screening test followed by a second screening test is applied on those individuals only who test positive on th e1st screening test. Combined sensitivity of 2 tests A and B in series: Sensitivity (A) * Sensitivity (B) Combined specificity of 2 tests A and B in series: Specificity (A) + Specificiity (B) - SCREENING TEST USED IN PARALLEL: A population is subjected to two or more screening tests at the both (or all) screening tests. Combined sensitivity of 2 tests A and B in parallel: Sensitivity(A) + Sensitivity (B) - Combines specificity of 2 tests A and B in parallel: Specificity(A)*Specificity(B) Test in series Tests in parallel Combined sensitivity Decreases Increases Combined specificity Increases Decreases Combined PPV Increases Decreases Combined NPV Decreases Increases Ref: Simple Biostatistics by Indrayan and Indrayan 1st edition Pgno: 56

So the answer to this question is B


Instruction:
A pronounced developmental groove is usually present on the mesial marginal ridge of a permanent:
A. Mandibular third molar
B. Mandibular second premolar
C. Maxillary second molar
D. Maxillary first premolar

Response:
None

So the answer to this question is D


Instruction:
In children fracture scaphoid is through rare but usually involves:
A. Waist
B. Proximal pole
C. Neck
D. Distal pole

Response:
D i.e. Distal pole

So the answer to this question is D


Instruction:
The extra - cellular polysaccharide synthesized by cariogenic streptococci in the presence of excess sucrose are best described as
A. Mucopolysaccharide
B. Dextran-like glucan
C. Glycogen-like glucan
D. Amylopectin

Response:
None

So the answer to this question is B


Instruction:
Corpus luteum functions maximally without an implantaton for ...... days :
A. 9
B. 12
C. 6
D. 15

Response:
9 days After ovulation the ruptured graffian follicle develops into corpus luteum. The lile cycle ot corpus luteum has four stages viz : Proliferation Vascularisation Maturation Begression Corpus luteum reaches it maximum maturity by 22nd day of cycle (gze = 2 cms or more). Ovulation occurs on day 14 i.e. 8th days atter ovulation corpus luteum reaches its maximum maturity. Colour of corpus luteum in early stages is greyish yellowdeg due to presence of lipids and later is distinctive yellow due to pigment carotene.deg lf pregnancy does not occur corpus luteum stas degenerating from the eight post ovulatory day and forms coruous albicans. lf pregnancy occurs, HCG similar lo LH stimulates corpus luteum to secrete progesterone. it's groMh roaches a peak at 8th week ol gestation and it remains functionally active till 10-12 weeks of geNation, where by placenta takes over its lunction of producing progesterone. This is followed by degenerative changes in corpus luteum.

So the answer to this question is A


Instruction:
A 30 year old pregnant female was diagnosed with syphilis and 3 doses of injection Benzathine
Pencillin G 2.4 MU was advised. She was found to be allergic to pencillin. What is the next management?
A. Continue the same after reassurance
B. T.Doxycycline 100mg BD for 14 days
C. T.Doxycycline 100mg BD for 21 days
D. Desensitization

Response:
Even though she was allergic to pencillin, Doxycycline was not given as she is pregnant and Doxycycline has teratogenic effects.
Therefore, desensitization should be done by giving repeated small doses of pencillin until the allergic response is subsided. If desensitization is not possible then Erythromycin / Azithromycin / Ceftriaxone is given.

So the answer to this question is D


Instruction:
Ferruginous bodies are commonly seen in:
A. Silicosis
B. Asbestosis
C. Bagassosis
D. Byssinosis

Response:
Inorganic paicles may become coated with iron containing proteinaceous material, these bodies are called ferruginous bodies. They mimic asbestos bodies and can be seen in patient with asbestosis but is not specific hence asbestosis is the best answer. Ferruginous bodies are most commonly seen in Asbestosis. Ref: Robbin's Illustrated Pathology, 7th Edition, Page 736 ; Concise Pathology By Chandrasoma P, Taylor C, 3rd Edition, Page 541

So the answer to this question is B


Instruction:
Intermittent proptosis is seen in?
A. Orbital tumor
B. Orbital cellulitis
C. Orbital varices
D. Cavernous sinus thrombosis

Response:
ANSWER: (C) Orbital varicesREF: Khurana 4th ed p. 381Causes of intermittent proptosis:Orbital varicesPeriodic orbital edemaRecurrent orbital hemmorrhageHighly vascular tumor

So the answer to this question is C


Instruction:
A non diabetic, non hypertensive patient has some extra beats in pulse. Doctor informed that is benign and no intervention required. But patient is worried that it is a serious cardiac disorder and is still going for repeated investigation & going from doctor to doctor. This is a type of:
A. Conversion disorder
B. Hypochondriosis
C. Somatization
D. Depression

Response:
Interpretation of benign symptom (extra beats) as a serious illness (cardiac disorder) is suggestive of Hypochondriosis.

So the answer to this question is B


Instruction:
pH of the whole blood is estimated in
A. Plasma
B. Serum
C. RBC
D. Whole blood

Response:
Ans: a (Plasma) Ref: Vasudevan 4th ed/p. 346.The pH of plasma is 7.4. The pH of plasma is maintained within a narrow range of 7.38 to 7.42

So the answer to this question is A


Instruction:
All are contents of femoral triangle except
A. Femoral aery
B. Femoral vein
C. Superficial inguinal lymph nodes
D. Nerve to pectineus

Response:
FEMORAL TRIANGLE:- Triangular depression on front of the upper one third of the thigh immediately below the inguinal ligament. BOUNDARIES:-1. Laterally: medial border of Saorius.2. Medially: medial border of adductor longus.3. Base: inguinal ligament.4. Apex: directed downwards.formed by the point where the medial and lateral boundaries cross.apex is continuous with the adductor canal.5. Roof: skin,superficial fascia and deep fascia. Superficial fascia contains superficial inguinal lymph nodes,femoral branch of genitofemoral nerve, branches of ilioinguinal nerve, superficial branches of the femoral aery with accompanying veins and the upper pa of the great saphenous vein.6. Floor: medially by adductor longus and pectineus, and laterally by the psoas major and iliacus. CONTENTS:-1. Femoral aery and its branches.- Superficial branches-superficial external pudendalSuperficial epigastric Superficial circumflex iliac Deep branches-profunda femoris, muscular branches and deep external pudendal 2. Femoral vein and its tributaries 3. Femoral sheath 4. Femoral nerve 5. Nerve to pectineus6. Femoral branch of genitofemoral nerve.7. Lateral cutaneous nerve of thigh.8. Deep inguinal lymph nodes. Vein is medial to aery (base)Vein posteromedial to aery (apex) {Reference:BDC 6E pg no. 45}

So the answer to this question is C


Instruction:
Type I Rapidly progressive glomerulonephritis is seen in
A. SLE
B. IgA nephropathy
C. Henoch Schonlein purpura
D. Good pasture syndrome

Response:
Rapidly progressive glomerulonephritis (RPGN) is a syndrome of the kidney that is characterized by a rapid loss of kidney function, (usually a 50% decline in the glomerular filtration rate (GFR) within 3 months) with glomerular crescent formation seen in at least 50% or 75% of glomeruli seen on kidney biopsies. Refer robbins 9/e

So the answer to this question is D


Instruction:
Ototoxicty and nephrotoxicity are the adverse effects of:-
A. Vancomycin
B. Azithromycin
C. Clindamycin
D. Penicillin

Response:
Drugs associated with ototoxicity as well as nephrotoxicity Vancomycin Aminoglycosides Cisplatin

So the answer to this question is A


Instruction:
The professional antigen presenting cells are
A. Endothelial cells
B. Dendritic cells
C. T cells
D. B cells

Response:
Professional APC Express MHC class II molecules Dendritic cells Immature dendritic cells (Langerhans cells) Macrophages B cells Non - professional APC Do not express MHC class II molecules Stimulated by cytokines like IFN Fibroblasts Thymic epithelial cells Thyroid epithelial cells Glial cells Pancreatic beta cells Endothelial cells

So the answer to this question is B


Instruction:
Acidic drugs bind to -
A. Globulin
B. a-1 glycoprotein
C. Albumin
D. None

Response:
Ans. is 'c' i.e., Albumin o Many natural substances circulate around the body partly free in plasma water and partly bound to plasma proteins, e.g. cortisol, thyroxine.o Similarly drugs circulate in protein bound and free states, and the significance is that the free fraction is pharmacologically active whereas the protein bound component is a reservoir of drug that is inactive because of this binding.o Acidic drugs generally bind to plasma albumin.o Basic drugs bind to a{ acid glycoprotein.o Binding to albumin is quantitatively more important.

So the answer to this question is C


Instruction:
what % of testicular carcinoma is associated with crytorchidism?
A. 10%
B. 30%
C. 70%
D. 90%

Response:
Testicular Tumours: Epidemiology and Risk Factors Of all primary testicular tumours, 90-95% are germ cell tumours (seminoma and nonseminoma) More common in whites and individuals of higher socioeconomic class Slightly more common on the right side than on the left, which parallels the increased incidence of cryptorchidism on the right side. Of primary testicular tumours, 1-2% are bilateral, and about 50% of these tumours occur in men with a history of unilateral or bilateral cryptorchidism Seminoma is the most common germ cell tumour in bilateral primary testicular tumours, while malignant lymphoma is the most common bilateral tumour of the testis The strongest association has been with the cryptorchid testis. Approximately 7-10% of testicular tumours develop in patients who have a history of cryptorchidism; seminoma is the most common form of tumor these patients have. However, 5-10% of the testicular tumors occur in the contralateral, normally descended testis. The relative risk of malignancy is highest for the intraabdominal testis (1 in 20) and is significantly lower for the inguinal testis (1 in 80) Orchipexy doesnot alter the malignant potential of the cryptorchid testis; however, it does facilitate examination and tumor detection Ref: Smith 18th edition Pgno: 380

So the answer to this question is A


Instruction:
Incubation period of Influenza is:-
A. 1-3 days
B. 7-10 days
C. 10-14 days
D. 1-6 hours

Response:
Incubation period :- Time interval b/w entry of organism till appearance of first sign / symptom. I.P of influenza is 1-3 days.( 18-72 hours)

So the answer to this question is A


Instruction:
Impoant in Herpes simplex involvement of the eye are all EXCEPT: September 2012
A. Type of lesion
B. Corneal anaesthesia
C. Iridocyclitis
D. Purulent discharge

Response:
Ans. D i.e. Purulent discharge Decreased corneal sensations, dendritic and geographical ulcers are characteristic features of Herpes simplex ocular disease

So the answer to this question is D


Instruction:
Appendix of testes is remnant of ?
A. Mesonephric duct
B. Paramesonephric duct
C. paramesonephric tubule
D. Mesonephric tubule

Response:
Male's derivatives of paramesonephric duct (Mullerian duct) are :-i) Appendix of testis (Hydatid of morgagm).ii) Prostatic utricle.

So the answer to this question is B


Instruction:
How many antenatal visits covering the entire period of pregnancy are minimum required?
A. 3
B. 4
C. 7
D. 13

Response:
Minimum no. of Antenatal visits required in Pregnancy : 4 1st visit - within 12 weeks, preferably as soon as the pregnancy is suspected, for registration of pregnancy and first antenatal check-up. 2nd visit between 14 and 26 weeks POG. 3rd visit - between 28 and 34 weeks POG. 4th visit - between 36 weeks - Delivery Recommended Antenatal visits: 13-14 0-7 months = once a month = 7 visits 8th month = twice a month = 2 visits 9th month onwards = one visit/ week =4-5 visits Post natal visits: 3-4 3 in institutional delivery- Day 3,7,42 4 in home delivery- Day 1,3,7,42

So the answer to this question is B


Instruction:
All of the following statements regarding total anomalous pulmonary connection are true except ?
A. The total pulmonary venous blood reaches the right atrium
B. Always associated with a VSD
C. The oxygen saturation of the blood in the pulmonary aery is higher than that in the aoa
D. Infracardiac type is always obstructive

Response:
Ans. is 'b' i.e., Always associated with VSD Hemodvnamics of TAPVC o TAPVC results in the pulmonary venous blood reaching the right atrium which also receives the systemic venous blood. o This results in volume overload to right atrium Right atrial enlargement. o Larger volume of blood reaches the right ventricle -f Right ventricle enlargement. o The blood flow to the left atrium is through patent foramen ovale or ASD. o Because there is mixing of unoxygenated blood from systemic circulation and oxygenated blood from pulmonary circulation in the right atrium --> The oxygen saturation of blood in pulmonary aery is higher or identical to that in Aoa. o TAPVC can be divided into : - i) TAPVC with pulmonary venous obstruction Pulmonary venous obstruction results in pulmonary aerial hypeension. Pulmonary obstruction T back pressure -4 T Pulmonary capillary pressure T Pulmonary aery pressure Because of pulmonary venous obstruction oxygenated blood cannot reach hea -4 Cyanosis and CHF during first week of life. ii) TAPVC without obstruction (more common) In TAPVC without obstruction, pulmonary blood flow is high. Patients develops CHF at around 6-8 weeks when the fetal pulmonary resistance falls maximally and pulmonary circulation reaches the maximum. o Infracardiac type of TAPVC is always obstructive whereas cardiac and supracardiac type may be obstructive or nonobstructive.

So the answer to this question is B


Instruction:
Apremilast is
A. PDE 3 inhibitor
B. PDE 4 inhibitor
C. PDE 5 inhibitor
D. PDE 6 inhibitor

Response:
Ustekinumab, a monoclonal antibody to the shared IL-23/IL-12p40 subunit, is an efficacious treatment for psoriasis and has shown promise in Psoriatic ahritis in clinical trials. Other newer drugs that have shown efficacy for both psoriasis and PsA include the anti-IL-17 pathway agents, such as secukinumab and brodalumab, and an oral phosphodiesterase-4 inhibitor, apremilast. Data on the oral Jak inhibitor, tofacitinib, has been very limited but promising. Ref: Harrison&;s Principles of Internal Medicine; 20th ed KD TRIPATHI 9th ed

So the answer to this question is B


Instruction:
A-H interval on ECG is for conduction -
A. Through His-Purkinje system
B. From AV node to bundle of His
C. From Purkinje system to ventricular fibres
D. Through ventricular fibers

Response:
Ans. is 'b' i.e., From AV node to bundle of Hiso Certain intervals are measured to provide information regarding AV block.PA interval: It is time taken from onset of P-wave to onset of deflection in atrial catheter. It is an index of intra-atrial conduction. Normal vlaue is less than 55 mS.AH interval : it represents conduction through AV node, i.e., conduction from AV node to bundle of His. Normal vlaue is less than 130 mS.HV interval : It represents conduction through His-Purkinje system, i.e., conduction from His-Purkinje system to ventricular muscle fibers. Normal value is less than 50 mS.

So the answer to this question is B


Instruction:
Barrett's esophagus is diagnosed by-
A. Squamous metaplasia
B. Intestinal metaplasia
C. Squamous dysplasia
D. Intestinal dysplasia

Response:
"The definition of Barrett's esophagus (BE), has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal-type epithelium found in Barrett's mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of Barrett's esophagus is presently made given any length of endoscopically identifiable columnar mucosa that proves on biopsy to show intestinal metaplasia. While long segments of columnar mucosa without metaplasia do occur, they are uncommon and are probably congenital in origin. The hallmark of intestinal metaplasia is the presence of intestinal goblet cells." Ref : Schwaz 9/e p831

So the answer to this question is B


Instruction:
A short stature child's growth variation is normal but bone development is not according to chronological age. What is your diagnosis?
A. Genetic short stature
B. Dwarfism
C. Constitutional delay
D. Growth hormone deficiency

Response:
Ans. C. Constitutional delayShort stature children with normal growth variation include genetic (familial) short stature and constitutional delay. In genetic short stature bone development matches with the chronological age but not in constitutional delay in which bone development lags behind.

So the answer to this question is C


Instruction:
Features of liver damage are all except
A. Decreased factor VII levels
B. Raised prothrombin time
C. Conjugated as well as unconjugated hyperbilirubinemia
D. Decreased erythropoietin production

Response:
Ans. d (Decreased erythropoietin production). (Ref. Harrison's 18,h/Ch. 301., Robbins 6th/846, 1667)SIGNS OF LIVER FAILURE:# Intermediate metabolism of amino acids and carbohydrates# Synthesis and degradation of proteins and glycoproteins# Metabolism and degradation of drugs and hormones# Restriction of lipid and cholesterol metabolism# Coagulation factor# Bile, bile salts and impaired metabolism.

So the answer to this question is D


Instruction:
‘Himalayan P waves’ in ECG is characteristic of:
A. Atrial septal defect
B. Eisenmenger syndrome
C. Tetralogy of Fallot
D. Ebstein’s anomaly

Response:
12 – lead ECG

Rarely normal
Abnormal P waves consistent with right atrial enlargement – ‘Himalaya P waves”.
RBBB in 75-92%
PR prolongation is common due to RA enlargment
Ventricular pre-excitation 10-30%

So the answer to this question is D


Instruction:
Budd Chiari syndrome is: March 2013
A. Poal vein thrombosis
B. Hepatic aery thrombosis
C. Cystic aery thrombosis
D. Hepatic vein thrombosis

Response:
Ans. D i.e. Hepatic vein obstruction

So the answer to this question is D


Instruction:
A 60-year-old woman is having symptoms of muscle weakness and fatigue. On examination, her blood pressure is 110/80 mm Hg, pulse 100/min, JVP 1 cm, heart sounds normal, and lungs clear. Her serum potassium level is 2.5 mEq/L, bicarbonate 15 mEq/L, and anion gap is normal. The urine potassium is 10 mEq/L.For the above patient with hypokalemia, select the most likely diagnosis.
A. lower gastrointestinal (GI) losses
B. prior use of diuretics
C. RTA
D. current use of diuretics

Response:
In lower GI loss (diarrhea), the blood pressure is normal, the urine potassium is low (< 25 mmol/F), and the bicarbonate is either normal or low.

So the answer to this question is A


Instruction:
The following is used for exocytosis
A. Calcium
B. Sodium
C. Potassium
D. All

Response:
Calcium plays an impoant role in exocytosis Exocytosis is an active vesicular transpo system

So the answer to this question is A


Instruction:
Velocity of conduction for A alpha fibers is
A. 70-120 m/s
B. 30-70 m/s
C. 12-30 m/s
D. 0.5-2 m/s

Response:
None

So the answer to this question is A


Instruction:
Acrodermatitis enteropathica is due to deficiency of: March 2012, September 2012
A. Iodine
B. Zinc
C. Copper
D. Iron

Response:
Ans: B i.e. Zinc Acrodermatitis enteropathica is a rare inherited metabolic disease of zinc deficiency caused by a defect in the absorption in the absorption of zinc from the intestine.

So the answer to this question is B


Instruction:
Maximum cholesterol is seen in ?
A. VLDL
B. LDL
C. HDL
D. Chylomicrons

Response:
Ans. is 'b' i.e., LDL Maximum triglyceride content - ChylomicronsMaximum exogenous triglyceride - ChylomicronsMaximum endogenous triglyceride - VLDLMaximum cholesterol content - LDL

So the answer to this question is B


Instruction:
When treated with simple curettage which odontogenic tumour is most likely to recur
A. Complex odontoma
B. Compound odontoma
C. Odontogenic myxoma
D. Ameloblastic fibroma

Response:
None

So the answer to this question is C


Instruction:
Maxillary sinus achieves maximum size at
A. bih
B. Primary dentition
C. At secondary dentition
D. At pubey

Response:
Maxillary sinus is the first sinus to develop at bih. It is completely developed by 9 years of agei.e approximately at secondary dentition Ref Maqbool 11/e,p148.

So the answer to this question is C


Instruction:
Contact lens is best used in:
A. High myopia
B. Irregular astigmatism
C. Aphakia
D. Regular astigmatism

Response:
Ans. Irregular astigmatism

So the answer to this question is B


Instruction:
Bacillary angiomatosis is caused by -
A. B. Quintana
B. B. bacilliformis
C. B. henslae
D. B. elizabethi

Response:
Ans. is 'c' i.e., B. henslae * Bacillary angiomatosis is caused by Bartonella henselae (most commonly) and B. quintana.

So the answer to this question is C


Instruction:
M.C. type of cutaneous T.B. is –
A. Lupus vulgaris
B. Scrofuloderma
C. T.B. verruca cutis
D. Erythema induratum

Response:
Common type of cutaneous tuberculosis

Lupus vulgaris (55%)
 Tuberculids (7%)
Tuberculous gumma (5%)
Scrofulodenna (25%)
TB verrucosa cutis (5%)
Other rare (3%)

So the answer to this question is A


Instruction:
Thyroglossal fistula develops due to -
A. Developmental anomaly
B. Injury
C. Incomplete removal of thyroglossal cyst
D. Inflammatory disorder

Response:
Thyroglossal fistula is never congenital. It follows infection or inadequate removal of a thyroglossal cyst.

So the answer to this question is C


Instruction:
Sorbitol acts in the prevention of dental caries by
A. Microorganisms Lack the enzyme to metabolize sorbitol
B. Lactic acid can not be produced
C. Fermentation of sorbitol does not occur
D. sorbitol is not a carbohydrate

Response:
None

So the answer to this question is A


Instruction:
All of the following are true about  glucose transport in kidney except
A. Sodium Glucose symport is an example of  primary active transport
B. GLUT - 2 receptors are present along basolaterl membrane
C. Defective SGLT - 2 leads to isolated renal glycosuria
D. Transport maximum for glucose is 2 oomg / dL

Response:
Sodium glucose linked transporter is an example of secondary active transport.

So the answer to this question is A


Instruction:
Staple food as maize causes?
A. Xerophthalima
B. Scurvy
C. Beri-beri
D. Pellagra

Response:
ANSWER: (D) PellagraREF: Harper 27th ed chapter 29, Parks 22 ed page 574Also see tryptophan metabolism in Biochemistry 2014 Session 1Maize is deficient is Tryptophan which is required for Niacin biosynthesis. Niacin deficiency causes pellagraFood rich in niacin and/or tryptophan are liver Kidney meat, poultry, fish Legumes and groundnut. Milk is a poor Source of niacin but its proteins are rich in tryptophan which is converted in the body into niacin (about 60 mg of tryptophan is required to result in 1 mg of niacin). In many cereals, especially maize, niacin occurs in "bound" form unavailable to the consumer.While pellagra is historically a disease of the maize eating population it was reported in India in the Telangana area of Andhra Pradesh in some segments of the population eating another cereal that is jowar (Sorghum vulgare).

So the answer to this question is D


Instruction:
Arrhythmias refractory to the treatment of lignocaine can be treated by
A. Sotalol
B. Diltiazem
C. Amiodarone
D. Quinidine

Response:
Katzung 11e p 241. Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of irregular heabeats. This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.

So the answer to this question is C


Instruction:
High calcium intake can lead to
A. Osteoporosis
B. Osteopotrosis
C. Milk alkali syndrome
D. Renal failure

Response:
Refer Robbins page no Milk alkali syndrome is due to excessive ingestion of calcium and absorbabke antacids such as milk or calcium carbonate .This is associated with the development of metastatic Calcification

So the answer to this question is C


Instruction:
Carvallo's sign is seen in
A. Tricuspid stenosis
B. Mitral stenosis
C. Aoic stenosis
D. Aoic regurgitation

Response:
Ref Harrison 19 th ed pg 1548 A prominent RV pulsation along the left parasternal region and a blowing holosystolic murmur along the lower left sternal margin, which may be intensified during inspiration (Carvallo's sign) and reduced during expiration or the strain phase of the Valsalva maneuver, are characteristic findings. The murmur of TR may sometimes be confused with that of MR unless attention is paid to its variation during the respiratory cycle and the extent of RV enlarge- ment is appreciated.

So the answer to this question is A


Instruction:
First manifestation of Alport syndrome is :
A. Microscopic haematuria
B. Proteinuria
C. Oliguria
D. Sensorineural deafness

Response:
Ans. is 'a' Microscopic hematuria (Ref Harrison, 17/e p 2469, 16/e, p 2331 (15/e, p 1595)).The first symptom of Alport's syndrome is not mentioned anywhere.But in Harrison it is written that patients with Alport's syndrome usually presents with microscopic hematuria, proteinuria (nephrotic range in 30%) and progressive renal insufficiency.So the first symptom of Alport's syndrome can be taken as microscopic hematuria.Common extra renal manifestations include:Sensorineural hearing loss* (60%).Bilateral anterior lenticonus SC (15-30%)Recurrent corneal erosions*.

So the answer to this question is A


Instruction:
Pinch purpura around eyelids is one of the most common finding in -
A. Fabry's disease
B. Primary systemic amyloidosis
C. Porphyria cutanea tarda
D. None of the above

Response:
Ans. is 'b' i.e.. Primary systemic amyloidosis o Purpura of the eyelids following pinching (pinch purpura) is a characteristicfeature of primary systemic amyloidosiso Pinch purpura of the eyelids are seen in about 30% of the cases ofprimary systemic amyloidoses.o It occurs due to involvement of cutaneous blood vessels in primary1 systemic amyloidosis.o The most common skin lesions are pete hie or ecchymoses due to amyloid deposition within blood vessel walls with subsequent fragility and dermal hemorrhage.o These are o ften seen at sites predisposed to trauma, such as the hands or intertriginous areas.o Pinching the skin gives charaterstic purpura lesions known as "pinch purpura".o Purpura around the eyes may occur spontaneously but is also seen following proctoscopy or vomiting (postproctoscopic purpura).o Dermatological involvement occur in about 30% - 40% patients with systemic amyloidosis.o Other dermatological manifestations include waxy or translucent papules and lets frequently tense hemorrhagic bullae.o Histopathology of the cutaneous lesions reveal amyloid deposits in the dermis.o Occular findings in primary generalized amyloidosis includes :Purpura of the eyelids.B/l symmetrical small amyloid papules of the skin of the eyelids.PtosisOphthalmalgia or evidence of amyloid neuropathes affective pupillary function or both.Subconjunctival hemorrhages.

So the answer to this question is B


Instruction:
Composition of Nova-T is _______
A. Copper and silver
B. Copper and aluminium
C. Copper only
D. Copper and selenium

Response:
Composition of Nova-T is copper and silver Copper carrying devices: In these, copper wire of surface area 200 to 250mm is wrapped round the veical stem of a polypropylene frame. Among these devices are copper T 200, Copper 7, Multiload copper 250, Cop-per T 380, Copper T 220 and Nova T. They have an effective life of about 3-5 years. It is estimated that about 50 mcg of copper is elute daily in the uterus. Copper T 380, known as Paraguard, has a lifespan of 1 years. Nova-T had silver added to the copper wire, thereby increasing its lifespan to 5 years. IUCDs are a good contraceptive choice for the following groups of women: Low-risk of STD. Multiparous woman Monogamous relationship Desirous of long-term reversible method of contraception, but not yet desirous of permanent sterilization Unhappy or unreliable users of oral contrception or barrier contraception Uses of IUCD: As a contraceptive Postcoital contraception (emergency contraception) Preferably avoid its use in unmarried and nulliparous patients because of the risk of PID and subsequent tubal infeility. Ref: Shaw&;s textbook of Gyaecology 17th edition Pgno: 258

So the answer to this question is A


Instruction:
In normal diurnal variation, intraocular pressure is:
A. Highest on awakening and lowest during evening
B. Lowest during morning and highest during evening
C. Highest in the morning and evening
D. Lowest in the morning and evening

Response:
Ans. Highest on awakening and lowest during evening

So the answer to this question is A


Instruction:
A 25-year-old male patient having seminiferous tubule dysgenesis was diagnosed as a case of Klinefelter&;s syndrome. All of the following are true about Seoli cells except
A. Seoli cells are large, complex glycogen-containing cells stretching from the basal lamina of the tubule to the lumen
B. Tight junctions between adjacent Seoli cells near the basal lamina form a blood-testis barrier
C. The Seoli cells secrete androgen-binding protein (ABP), relaxin, and MIS
D. They can produce estrogens

Response:
"The walls of the seminiferous tubules are lined by primitive germ cells and Seoli cells, large, complex glycogen-containing cells that stretch from the basal lamina of the tubule to the lumen. Germ cells must stay in contact with Seoli cells to survive; this contact is maintained by cytoplasmic bridges. Tight junctions between adjacent Seoli cells near the basal lamina form a blood-testis barrier that prevents many large molecules from passing from the interstitial tissue and the pa of the tubule near the basal lamina. Spermatids mature into spermatozoa in deep folds of the cytoplasm of the Seoli cells. Mature spermatozoa are released from the Seoli cells and become free in the lumens of the tubules. The Seoli cells secrete the androgen-binding protein (ABP), inhibin, and MIS. They do not synthesize androgens, but they contain aromatase (CYP19), the enzyme responsible for the conversion of androgens to estrogens, and they can produce estrogens. ABP probably functions to maintain a high, stable supply of androgen in the tubular fluid. Inhibin inhibits follicle-stimulating hormone (FSH) secretion."

So the answer to this question is C