PGDIAMS-MD/MS entrance: November 2012

ANATOMY

1. True about testis

a. Ectodermal origin

b. Gubernaculum attached to caudal end

c. Surrounded by peritoneal tunica albuginea

d. 28th weak reach at scrotum

Answer: B (gubernaculum attached to caudal end)

Reference: BDC 4^th vol 2 p 219

2. Which nerve does not supply gluteal region

a. Sciatic nerve

b. Sup gluteal nerve

c. Inf gluteal nerve

d. Nerve to obturator internus

Answer: a (sciatic nerve )

Reference: BDC4th vol 2 p 90

3. Numbness of little and ring finger, atrophy of hypothenar musles nerve dammaged?

a. Palmar cut br of ulnar

b. Deep br of ulnar

c. Ulnar nerve before division into superficial and deep branches

d. Post cord of brachial plexus

Answer: C (ulnar nerve before division into superficial and deep branches.)
Reference: BDC 4^th vol 1 p123

4. "Root value of long thoracic nerve

a. C345

b. C567

c. C78 t1

d. C234

Answer: B (C567)

Refernce: BDC 4^th p53

5. Loss of extension of little ring finger, hypothenar atrophy

a. Post interosseous nerve

b. Radial trunk

c. Ulnar Nerve

d. Median nerve

Answer: (c) ulnar nerve.

Reference: BDC 4^th vol 1 p 117

6. Structures don’t come during surgery for vasectomy

a. Testicular art

b. Ilioinguinal nerve

c. Autonomic nerves

d. Pampiniform plexus

Answer. (b) Ilioinguinal nerve
Reference. BDC 4/e Vol.II-201, 208-II; Snell’s Clinical Anatomy 7/e p.175-177; Gray’s 38/e p-822]

7. Sternocleidomastoid supplied by all except ( AIIMS –Nov 2008)

a. Occipital Artery

b. Sup thyroid Artery

c. Post Auricular Artery

d. Thyrocervical trunk

Answer: c.(posterior auricular artery.)

Reference: AKD 4th EDITION Part2 page 118 , BDC 4^th /e Vol3 P. 73

8. All of the following organs develop in the mesentery of stomach except:

Liver
Spleen
Kidney
Pancreas

Answer.(c)' Kidney
[Reference: I.B. Singh embryology 8/e p166-169, 237; Longman's embryology 11/e p215, 219, 222, 236; Moore's embryology 7/e p 259-266, 288]

9. Abnormal no of vertebra possible with all except

a. Cervical

b. Thoracic

c. Lumbar

d. Sacral

Answer. (b) Thoracic
Reference: Gray’s Anatomy 40^th Edition Page 713, 728

10. Ciliary muscle develops from

a. Surface ectoderm

b. Neural crease mesenchyme

c. Endoderm

d. Neuroectoderm
Answer: (d) Neural crest mesenchyme
Reference: Langman Embryology 11 Edition Pg. 337

11. Epiglottics develop from

a. 1^st pharyngeal arch

b. 2^nd pharyngeal arch

c. 3^rd pharyngeal arch

d. 4^th pharyngeal arch
Answer: (d) pharyngeal arch
Reference: Langman Embryology 11 Edition pg. 277

PHYSIOLOGY

Which is not second messenger?

a. cAMP

b. IP3

c. Guanylyl cyclase

d. Diacylglycerol

Answer. (c) Guanylyl cyclase
Reference : Ganong 22^nd edition, pages 37, 42, 43

Regarding blood supply increase in exercise muscle all except

a. Local metabolite

b. Sympathetic stimulation

c. Cholinergic

d. Inhibition of beta receptor

Answer. (B) sympathetic stimulation
Reference : Ganong 22^nd edition, pages 632, 633, 602

End diastolic volume increases in

a. Decrease in total blood volume

b. Increase in intrapericardial pressure

c. Increase in negative intrathoracic pressure

d. Decrease in ventricular compliance

Answer. (C) increase in negative intrathoracic pressure

Reference : Ganong 22^nd edition, page 573

Right axis deviation seen in

a. Lying down position

b. Thin and tall

c. Obese person

d. Exercise

Answer. (B) thin and tall

Reference : Guyton, 11^th edition, page 138

Internal carotid artery ligation below the carotid sinus

a. Increase in vasomotor centre activity

b. Increase in discharge of carotid sinus afferent nerves

c. Increase in vagal parasympathetic activity

Answer. (A) increase in vasomotor centre activity

Reference : Ganong 22^nd edition, pages 605, 606, 607

17. Self stimulation

a. Medial forebrain bundle

b. Area around aqueduct of sylvius

c. PV region of hypothalamus

d. Radical radiotherapy

Answer. (A) Medical forebrain bundle

Reference: Reference : Ganong 22^nd edition, pages 260

18. Kinemyograhy is used for:

a. Monitoring of neuromuscular function

b. Monitoring of muscle spindle activity

c. Monitoring of Exercize capacity

d. Not Recalled

Answer: A

Reference:http://faculty.washington.edu/ramaiahr/Review%20Articles/Neuromuscular%20Monitoring-Update-1.pdf

19. A politician is shot in the back during a rally at level of T8 vertebral immediately after the shot he losses all the sensation below level of lesion. As the examining doctor you realize there is no chance of improvement in neurological function this can be due to all except

a. Lack of endoneural tubes

b. Lack of growth factors

c. Presence of glial scar

d. Lack of myelin inhibiting substance

Answer. (d) lack of myelin inhibiting substance
Reference: Surgery of the Spinal Cord: Potential for Regeneration and Recovery: Robert N. N. Holtzman, Bennett M. Stein

20. Which is True about dobutamine?

a. Dobutamine decreases peripheral resistance

b. Acts on D1 & D2 receptors

c. Decrease kidney circulation

d. Has no effect on coronary circulation

Answer. (a) Dobutamine decreases peripheral resistance

Reference: Harrison 18th edition/chapter 234/ heart failure and cor-pulmonal

BIOCHEMISTRY

21. Liver enzyme dephosphorylation to phosphorylation true is-

a. Always activates the enzyme

b. Catecholamines stimulate it

c. More commonly seen in fasting state than in fed state

d. Always activated by cAMP dependent Protein kinase

Answer is (d) : Always activated by cAMP dependent Protein kinase.

Reference: vasudevan 6 edi page chap 523

22. Nanotechnology true except

a. Narrow emission spectra

b. Narrow gap between absorbance and re-emission

c. Not recalled

d. Not recalled

For nanotechnology visit our website pgdiams.com

23. No loss of genetic material occurs in

a. Deletion

b. Insertion

c. Substitution

d. Inversion

Answer (d) Inversion

24. Patient present with skin bullae on sun exposure. The defect is of?

a. Thymidine dimmers

b. Trinucleotide repeats

c. Sugar changes

d. DNA methylation

Answer.: (d) DNA methylation or DNA damage can be the answer.

Reference: harpr’s Illustrated biochemistry 27/ep-345 -46

25. True about RIBOZYME

a. Pepitdyl transfuse activity

b. Cut DNA at specific site

c. Portiapate in DNA synthesis

d. GTPase

Answer: A, Pepitdyl transfuse activity

Reference; John Baynes 3/e pg-441; Lippincott 4^th /ed pg-435-39; Harper 28^th /ed pg-363]

26. Test to differentiate in the chromosome of normal & cancer cells

a. PCR

b. Comparative genomic hybridization

c. Western Blotting

d. Southern Blotting

Answer. (B) : Comparative genomic hybridization

Reference: Harrison 18th edition/chapter 62

27. Enzymes fond in CSF

a. GGT+ALP

b. ALP+CK-MB

c. CK+LDH

d. Deaminase and Peroxidase

Answer (c) CK and LDH

(Reference: Cerebrospinal Fluid in Clinical Practice By David N. Irani; Chapter 10.)

28. Which of the following is seen in association with membrane raft

a. Mannose binding protein

b. GTP associated receptor

c. GPI anchored protein

Answer (C) GPI anchored protein

References’

I. Hartlova, A., Cerveny, L., Hubalek, M., Krocova, Z. and Stulik, J. Membrane rafts: a potential gateway for bacterial entry into host cells. Microbiol. Immunol., 54, 237-245 (2010)

II. Merrill, A.H. Sphingolipids. In: Biochemistry of Lipids, Lipoproteins and Membranes (5th Edition). pp. 363-397 (Vance, D.E. and Vance, J. (editors), Elsevier, Amsterdam) (2008).

PATHOLOGY

29. Flow cytometry is done in:

a. Polycythemia

b. Thrombocytosis

c. Neutrophilia

d. Lymphocytosis

Answer: (d) Lymphocytosis

Reference: Robbins 8th ed. Page 603 – 604

30. Which of these does not indicate megaloblastic anemia

a. Increased reticulocyte count

b. Raised Bilirubin

c. Mild splenomegaly

d. Nucleated RBC

Answer:- A. Increased Reticulocyte Count

Reference: Robbins edition 8^th edition, page no 655. / Harrison table 105-1 /18th edition/chapter 105

31. Myelo-fibrosis leading to a dry tap on bone marrow aspiration is seen with which of the following condition

a. Burkitt’s lymphoma

b. Acute erythroblastic leukemia

c. Acute megakaryocytic leukemia

d. Acute undifferentiated leukemia

Answer: (c) Acute megakaryocytic leukemia.

Reference: Robbins Page 6e22

32. Receptor on neuronal membrane that induces development of Glioma

a. CD44

b. CD133

c. CD33

d. CD24

Answer : (b) CD133

Reference: http://cdn.intechopen.com/pdfs/14462/InTech-Glioma_stem_cells_cell_culture_markers_and_targets_for_new_combinationtherapies.pdf

33. CD 95 is a marker of

a. Intrinsic pathway of apoptosis

b. Extrinsic pathway of apoptosis

c. Necrosis of cell

d. Not recalled

Answer. (b) Extrinsic pathway of apoptosis

Reference: Robbins 8^thedpg 29 - 30

34. Marker of myeloid cancers

a. S100

b. HMB45

c. Common leukocyte antigen

d. Cyto-keratin

Answer. (C) Common leukocyte antigen

35. Adult Patient presents with Generalized lymphadenopathy and blood film shows 70% immature looking lymphocytes

a. Genotyping/karyotyping

b. Immunophenotyping

c. Bone marrow

d. Peripheral smear study

Answer. B, Immuno-phenotyping

Reference: Robbins 8^th ed.Page 604

36. Most common fixative used in electron microscopy

a. Glutaraldehyde

b. Formalin

c. Picric acid

d. Absolute Alcohol

Answer. (A) Glutaraldehyde

Reference: Reference: (http://www.abdn.ac.uk/emunit/emunit/fixatives.htm)

37. In a specimen of kidney, fibrinoid necrosis is seen and onion peel appearance is also present. Most probable pathology is

a. Hyaline degeneration

b. Hyperplastic arteriosclerosis

c. Glomerulosclerosis

d. Fibrillary glomerulonephritis

Answer: B, Hyperplastic arteriosclerosis

Reference: Robins Page 950-951

38. Staining done for sebaceous cell carcinoma ?

a. Oil Red O

b. PAS

c. Methamine silver

d. Not Recalled

Answer:(a) , Oil Red O

Reference: Robbins Page 1177

39. Mutation in CoL4A5 chain the diagnosis

a. Alports syndrome

b. Good pasture’s syndrome

c. Thin membrane disease

d. Nodular glomerulosclerosis

Answer: Alport’s syndrome

Reference: Robbins 7^th Edition p 988, 989, /Robbins 8^th Edition p. 931, 932

40. Person having heterozygous sickle cell trait are protected from infection of

a. P. falciparum

b. P. viavax

c. Pneumococcous

d. Solmonella

Answer: (a) P. Falciparum

Ref. Robbin 8^th Edition pg. 645

41. Hyperacute rejection is due to

a. Preformed antibodies

b. Cytotoxic T-lymphocyte medicated injury

c. Circulating macrophage mediated injury

d. Endothelitis caused by donor antibodies

Answer: (a) Preformed antibodies

Reference: Robbins 8^th Edition /Pg. 228

42. True all except

a. Omega-3 fatty acid (abundant in fish oil) decrease LDL

b. Atherosclerosis in less important in age more than 45 years age

c. Cigarette smoking is independent risk factor for M.I

d. Not recalled

Answer: (b) Atherosclerosis in less important in age more than 45 year’s age

Reference: Robbin 8^th Edition pg. 497

PHARMACOLOGY

43. Mechanism of gentamicin toxicity

a. Direct hair cell toxicity

b. Binds to hair cell Na+ K+ ATPAase

c. Non-cummulative toxicity

d. Bind to Ca⁺² channel

Answer (a) Direct hair cell toxicity

(Reference: Dhikav V, Drugs of Choice’ 2013, 5^th Ed, AITBS Publishers, Current Medical Diagnosis & Treatment’ 2012, pp-87-88)

44. -rho kinase inhibitor

a. Fasudil

b. Ranolazine

c. Amiloride

d. Nicorandil

Answer: (a) Fasudil

(Reference: Dhikav V, Drugs of Choice’ 2013, list of new drugs, 5^th Ed, Dhikav V, Newer Drugs’ 2012, 2^nd Ed, Elsevier’s sciences, India, www.wikepedia.com)

45. Best agent for premenstrual syndrome management?

a. Progesterone

b. ANXIOLYTIC

c. SSRI

d. vitamin E

Answer (c) SSRI
Reference: Dikav V, Drugs of Choice, 5^th Ed, 2013, AITBS Publishers, India

46. Which is not a 2nd generation antihistamine?

a. Cetrizine

b. Cyclizine

c. Loratidine

d. Fexofenadine

Answer (b) Cyclizine

(Reference: Dhikav V, Drugs of Choice’ 2013, 5^th Ed, AITBS Publishers, Current Medical Diagnosis & Treatment’ 2012, pp-288-89)

47. Expanded spectrum betalactam resistance drug used

a. Amoxicillin –clavulinic acid

b. Cefepime

c. Piperacillin-Tazobactam

d. Ceftriaxone

Answer (B)Cefepime

(Reference: Dhikav V, Drugs of Choice’ 2013, 5^th Ed, AITBS Publishers, BG Katzung’s Basic & Clinical Pharmacology, 11^th Ed, pp-599)

48. Lidocaine all are true except

a. It acts on sodium channels in both active and inactive state

b. It is most cardiotoxic local anesthetic

c. It is given iv in cardiac arrhythmias

Answer (b)It is most cardiotoxic local anesthetic

(Reference: Dhikav V, Drugs of Choice’ 2013, 5^th Ed, AITBS Publishers, Lee’s Synopsis of anesthesia, pp 59)

49. Unfavourable are all except

a. Omeprazole-reducing acid secretion

b. Methotrexate inhibiting folate

c. Barbiturates-dec B12 absorption

d. Antihistaminic overdose is safe

Answer d: Antihistaminic overdose is save

Reference: (BG Katzung’s Basic & Clinical Pharmacology 6^th Ed 2009, pp-678)

50. Drug not given to glaucoma patient who is on beta blockers

a. Brimonidine

b. Dorzolamide

c. Levobunolol

d. Acetazolamide

Answer (c): Levobunolol
(Reference: Dhikav V, Drugs of Choice’ 2013, 5^th Ed, AITBS Publishers, Lipincott’s Pharmacology, pp-78, BG Katzung’s Basic & Clinical Pharmacology, pp-789)

MICRO

51. Aerosol spread leading to epidemics

a. Legionella

b. Hemophilus

c. Influenza

d. Mycoplasma

Answer. is (c) Influenza.

52. Which of the following features is not shared between ‘T cells’ and B cells’

a. Positive selection during development

b. Class I MHC Expression

c. Antigen Specific Receptors

d. All of the above

Answer is (a) Positive selection during development

Reference: 'Lippincott 'v Immunology' (IllustratedReviews)2007/1 13; The Immune Response: Basic and clinical principles by Sounders (2005)/346; 'Elements of Immunology' by Fahim Halim Khan (Pearson Education)2009/206

53. With reference to Bacteroides fragilis the following statements are true except

a. B. fragilis is the most frequent anaerobe isolated from clinical samples

b. B. fragilis is not uniformly sensitive to Metronidazole

c. The lipoolysaccharide formed by B. fragilis is structurally and functionally different from the conventional Endotoxin

d. Shock and DIC are common in Bacteroides bacteremia

Answer. D Shock and DIC are common in Bacteroides bacteremia

Reference: Jawetz 25/e p 273-278; Harrison 18/e p 1079}

54. A former from the sub-Himalayan region presents with multiple leg ulcers. The most likely causative agent is:

a. Trichophyton Rubrum

b. Cladosporium species

c. Sporothrix Schenkii

d. Aspergillus

Answer (c) (Sporothrix Shenkii): Ananthanarayanan 8^th 609;

Reference: Harrison 's 18^th/1664; Journal of Neglected Tropical Diseases ; vol 6.6; June 2012; 'Sporotrichosis in sub-

Himalayan India (PLOS Negl. Trop Dis. 2012 Junne 6 (6): e 1673

55. Farmer presents with the features of high fever painful inguinal lymphodenopathy, vomiting and diarrhea and hypotension. Which stain will help in the diagnosis

a. Neisser stain

b. Wayson’s stain

c. Alberts stain

d. McFadyean’s stain

Answer.B, Wayson’s stain

Ref. Harrison 17^th /e.p. 983

56. Endotoxin of which gram negative bacteria have no part in pathogensis of disease

a. E. coli

b. Klebsiella

c. Vibrio cholera

d. Pseudomonas

Answer (C) Vibrio cholera-: Ananthnarayanan 8^th /307;

Reference; Lippincort's Microbiology 2^nd/'18; MI MS pathogenesis of Infectious Diseases

57. Which of the following agent is not used in erectile dysfunction

a. PGE2

b. Vardalafil

c. Phenylephrine

d. Alprostadil
Answer: (c)Phenylephrine
Reference: Harrison /17^th Edition Pg.299, KDT/6^th Edition Pg. 295-296

58. True about Penicillin G

a. It can be given orally

b. It is has broad spectrum activity

c. Used for treatment rate bite fever

d. Probenecid given along with PnG decrease its direction of action
Answer: (c) Used for treatment of Rate Bile fever
Reference: Katzung 10^th Edi. Pg. 726-731: KDT 6^th Ed. Pg 694-697

59. Cholinomimetic NOT used for

a. Open angle Glaucoma

b. Bradycardia

c. Cobra bite

d. Myasthenia gravis

Answer: (b) Bradycardia

Reference: Katzung 11 Edition, KDT 6 Edition pg. 104

60. Side effect HAART therapy all are except

a. Steatosis

b. Lipodytrophy

c. Optic neuritis

d. Increased cholesterol

Answer: (c) Optic neuritis
Reference: Gobind Garg Pharmacology 4^th Edition pg. 468

FSM

61. Fracture of teeth and some injury around mouth

a. Simple injury

b. Grievous injury

c. Dangerous injury

d. Assult

Answer (B): Grievous Injury:

Reference: Reddy 29^th Edition Page 261

62. Person had a fight with a neighbor where he assaulted him, he can be booked under ipc

a. IPC 44

b. IPC351

c. IPC319

d. IPC320

Answer. (B)351

Reference: Reddy 29^th Edition Page 351

44 IPC- injury definitions

319- Hurt

320- Grievous Hurt

351- Assault

63. Double base smokeless gun powder contains

a. Nitrocellulose n nitroglycerine

b. Pot nitranate n nitro

c. Pot nitrate n lead

d. Nitro cellulose

Answer (a) nitrocellulose n nitroglycerine

Reference. : forensic reddy 29^th Edition 192 page

64. Blue white colour in UV rays is seen in

a. Semen

b. Blood

c. Pus

d. Leucorrhoea

Answer: (a) Semen

Reference: Forensic Sci. Int. Vol. 51, p.289 (1991)

Reference : Stoilivic, M. “Detection of Semen and Blood Stains Using Polilight as a Light Source”

65. A conceptus material (Fetus) by police has been brought of 2cm length and 10 gm weight. What is the age?

a. 2 weeks

b. 4 weeks

c. 5 weeks

d. 6 weeks

Answer. (d) 6 weeks

Reference: Forensic Reddy Page No: 76

66. Choking is seen in

a. Revolver

b. Pistol

c. Shotgun

d. Rifle

Answer: (c) Shotgun

Reference: Parikh Forensic 6/ep 4.33, Reddy 29/epi 89.

ENT

67. Laser uvulopalatoplasty done for

a. Snoring

b. Pharyngotonsillitis

c. Cleft palate

d. Stammering

Answerwer- A. Snoring

References 1. Elsevier’s ENT SECRETS page no 176 and

68. Cochlear implant is to be done if following is intact?

a. Outer hair cell

b. Inner hair cell

c. Spiral ganglion cell

d. Auditory nerve

Answer- (d). Auditory nerve

References :

Dr Agarwal’s ENT, page no 48 . Quote from the book “for the cochlear implant to function the neural pathway has to be intact”.

69. Third window effect is seen in which of these

a. Perforated tympanum

b. Dehiscent superior semicircular canal

c. Round window

d. Oval window

Answer- (b) Dehiscent superior semicircular canal

Reference 1. Glasscock-Shambaugh surgery of the ear. Page no 62.

70. Pseudosulcus in larynx

a. Vocal abuse

b. Tuberculosis

c. Larangapharangeal reflux

d. Chronic steroid use

Answer-C. laryngopharyngeal reflex.

Reference -1. (Laryngopharyngeal Reflux): Ballenger’s Otorhinolaryngology 17^th / 886, ‘ Head and Neck Surgery Otolaryngology’ by Bailey 4^th / 833, 834.

71. High frequency audiometry used in ?

a. Otosclerosis

b. Ototoxicity

c. Otosclerosis

d. Meniers's disease

Answer: (b) Ototoxicity

Reference: Audiology By Ross J. Roeser, Michael Valente, Holly Hosford-Dunn 2/ep242; Ototoxicity By Peter S. Roland, John A. Rutka p 154]

OPTHA

72. Most common complication after lens extraction in persistent hyperplastic primary vitreous is

a. Orbital cellulite

b. Retinal detachment

c. Vitreous hemorrhage

d. Keratitis

Answer (b) Retinal detachment
Reference: nelson 18th edition/chapter 629

73. In corneal ulcer, what is not to be given

a. Chlorophenicol

b. Methylcellulose

c. Flumetasone

d. Not recalled
Answer: (c) Flumetasone
Reference: Corneal Ulceration and Ulcerative Keratitis in Emergency Medicine Medication/http://emedicine.medscape.com/article/798100-medication

74. Disability certificate for poor vision if 4/60

a. 100

b. 75

c. 40

d. 30

Answer: (b 75
Ref. Guidelines for Assessment of Visual Disability, NIOH, GOI

75. Patient was 20 year old male present with photophobia & Subnormal electrophysiological response?

a. Stargardt disease

b. Batten disease

c. Cone dystrophy

d. Chloroquine toxicity

Answer; (c) Cone dystrophy
Reference: Chapter 620 and 629 /nelson textbook of pediatrics

76. Protozoa can affect eye

a. E. histolytica

b. Toxoplasmosis

c. G. lamblia

d. E. coli

Answer (b) Toxoplasmosis
Reference: Harrison 18th edition/chapter 214

77. Secondary Glaucoma,Iris atrophy, Fixed dilated pupil

a. Benedict syndrome

b. Posner shlosman synd

c. Fuchs Heterochromic Iridocyclitis

d. Uveitic glaucoma

Answer (b) Posner schlossman syndrome
Reference: Posner-Schlossman Syndrome – http//emedicine.medscape.com/article/1205949

78. Tonometer with variation in application surface

a. Mackey Mar tonometer

b. Rebound tonometer

c. Dreger’s tonometer

d. Maklakov tonometer

Answer (d) Maklakov tonometer

Reference: Page no 80 Pearls of Glaucoma Management Edited by JoAnn A. Giaconi, Simon K. Law, Anne L. Coleman, Joseph Caprioli

P.S.M

79. Sampling schools then sections then students

a. Stratified sampling

b. Simple random sampling

c. Cluster sampling

d. Multistage sampling

Answer: (D) Multistage sampling

Reference: The Basics of Social Research by Babbie, 5^th Ed., Pg 234

80. Transition from increased prevalence of infectious pandemic diseases to manmade disease

a. Paradoxic transition

b. Reversal of transition

c. Epidemiological transition

d. Demographic transition

Answer. (C) Epidemiological transition

Reference: Epidemiology for Public Health Practice by Friis & Sellers, 1^st Ed., Pg 58

81. Mass chemoprophylaxis is not given for one of the following

a. Lymphatic filariasis

b. Plague

c. Vit A deficiency

d. Scabies

Answer. (D)Scabies
[Reference: Park 21/e p248, 271, 592, 722 Wikipedia. org, www. wellsphere. com/general-medicine-article/mass-drug-prophylaxis-against-filariasis/877981]

82. District population 10lac,with under-16 are 30%,prevalence of blindness is 0.8/1000 of under-16 population. Calculate no. of blind under-16?

a. 240

b. 2400

c. 24000

d. 240000

Answer. (a) 240

Reference. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 58

83. True regarding tetanus except

a. Tetanus no use if previous unimmunized

b. Herd immunity present

c. Can’t be eradicated

d. Elimination is less than 1 case per 1000 births

Answer. (B) herd immunity present
Reference. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 284-288

84. Current percent of Indian GDP spent on health?

a. 1.2

b. 2

c. 10

d. 15

Answer. (B) 2
Reference. Planning Commission of India, GOI

85. BIRADS

a. Breast Imaging Reporting and Data System

b. Best Imaging Reporting and Data System

c. Brain Imaging Reporting and data system

d. best imaging reporting and data system

Answer. (a) Breast Imaging Reporting and Data System

Reference: Primary Care for Women by Leppert & Piepert, 2^nd Ed., Pg 203

86. Which of the following is the least likely cause of neonatal mortality in India:

a. Prematurity

b. Infection

c. Birth asphyxia

d. Congenital anomalies

Answer. (D) Congenital anomalies
[Reference: Park SPM 21/e p521, 524 (20/e p485, 489)]

{References: http://www.censusindia.gov.inA>ital_statistics/SRS_Bulletins/MMR_release_

070711.pdf http://www. censusindia.gov. in/http://www. who. int/healthinfo/statistics/mortality_neonatal/en/index. html]

87. Population of 5000. 500 are already myopic on January 1, 2011. no. of new myopic cases till December 31,2011 is 90.Calculate incidence

a. 0.018

b. 0.02

c. 0.05

Answer. (B) 0.02
Reference. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 57

88. Current cancer patient in India reported annually

a. 0.5 million

b. 1 million

c. 5 million

d. 10 million

Answer. (B) 1 million
Reference. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 354

89. In a certain population, there were 4050 births in the last one year. There were 50 still births. 50 infants died within 7 days whereas 150 died within the first 28 days. What is the Neontatal mortality rate?

a. 50

b. 62.5

c. 12.5

d. 49.4

Answer: (A) 50
Reference: Park SPM 20/e p486]

90. Which is a MDG

a. Reduce by 2/3rd,the under five mortality by year 1990-2015

b. Half the prevalence of HIV-AIDS by 2015

c. Reduce maternal mortality by 50%

d. Combat PEM & Diarrhoea

Answer: (a) Reduce by 2/3rd,the under five mortality by year 1990-2015

Reference. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 27, 830

91. Trachoma screening age

a. 0- 5 years

b. 5 – 15

c. 5 -10

d. 1 to9 years

Answer. (d) 1 to 9 years
Reference. Trachoma Surveillance Annual Report 2008.

92. NPCDCS

a. Seperate centre for stroke, DM,

b. Implementation in some 5 states over 10 district

c. CHC has facilities for diagnosis and treatment of CVD, Diabetes

Answer. (C) CHC has facilities for diagnosis and treatment of CVD, Diabetes
Reference. NPCDCS Operational Guidelines, DGHS, GOI, Pg 6

93. Rashtriya Suraksa Bima Yojna

a. Applies to BPL only

b. 30000 per family member

c. 75% premium borne by family

d. Implemented all over India

Answer. (A) Applies to BPL only

Reference . RSBY website, GOI

94. HIV sentinel surveillance used to calculate

a. High risk

b. Prevalence

c. Trend finding

d. All of the above

Answer. (d) All of the above
Ref. Textbook of Preventive & Social Medicine by K Park, 21^st Ed., Pg 38, 398

95. Disease with low prevalence, high incidence, true is :

a. Highly curable / fatal

b. Not curable/ not fatal

c. Incidence and prevalence unrelated to each other

d. Calculation of incidence or prevalence is incorrect

Answer. A. highly curable / fatal

[Ref. K Park, 21^st Ed., pg 58]

96. 200 population, (range 70-90) at 1 SD how many people would be included

a. 134

b. 140

c. 150

d. 190

Answer. A. 134

[Reference. K Park, 21^st Ed., pg 788]

97. Roll back malaria all except

a. Insecticide nets

b. Strengthening health system

c. Develop new insecticide

d. Training health workers

Answer. NONE

[Reference. WHO Roll Back Malaria Document]

98. Highest mean lowest mode

a. Positive skewing

b. Negative skewing

c. Normal

d. Symmetrical

Answer. a. positive skewing

[Reference. Statistics: Essentials for Research by Klugh, Pg 36]

99. True about OPV all except

a. We get quick immune response

b. It is a live vaccine

c. It is used in epidemic

d. Maternal antibody interfere with immune response

Answer: (d) Maternal antibody interfere with immune response

Reference: Park 21th Edition Page No. 188

100. If the prevalence is very low as compared to the incidence for a disease. It implies

a. Disease is very fatal and /or easily curable

b. Disease is non fatal

c. Calculation of prevalence and incidence is wrong

d. Nothing can be said as they are independent
Answer: (a) disease in very fatal and /or easily curable
Reference: K Park 21 Edition pg 58

ORTHOPEDIC

101. Forced abduction from the lateral aspect of the knee causes a fracture. The fracture line is passing through the intercondylar eminence. Which of the following structures will most likely be injured?

a. Medial collateral ligament

b. Lateral collateral ligament

c. Anterior cruciate ligament

d. Medial meniscus

Answer – (c) Anterior curciate ligament

Reference: Campbell's Operative Orthopaedics, 11th Edition

102. The ligaments connecting the menisci to the tibia are known as –

a. Coronary

b. Arcuate

c. Transverse

d. Oblique

Answer – (a) Coronary

Reference: Turek's Orthopaedics: Principles And Their Application , 6th edition

103. Ankle sprain due to forced inversion of a plantar flexed foot is due to injury to –

a. Anterior talofibular ligament

b. Posterior talofibular ligament

c. Calcaneofibular ligament

d. Posterior fibres of deltoid

Answer – (a) Anterior talfibular ligament

Reference: www.orthopaedicsplus.in

104. Dennis stability concept is based on which of the following?

a. 2 column

b. 3 column

c. 4 column

d. 5 column

Answer – (b) 3 column

Reference: www.jbjs.org

105. A young male after sudden unconsciousness, on awakening, finds that both of his arms were adducted and internally rotated. The most probable diagnosis is

a. Anterior dislocation

b. Posterior dislocation

c. Greater tuberosity fracture

d. Rotator cuff injury

Answer – (b) Posterior dislocation

Reference: Orthopaedics Clinics of North America

106. After a brawl, a young male presented with inability to extend his distal interphalangeal joint. An X-ray was taken and was shown to be normal. What should be the next step in managing the patient?

a. Splint

b. Surgery

c. Wax bath

d. Ignore

Answer – (a) Splint

Reference: Mallet Finger

107. A 12-year old boy presents with a symmetric, expansile cystic lesion in the proximal humerus. All of the following can be done for his treatment except –

a. Curettage

b. Intralesional steroids

c. Intralesional sclerosing agents

d. Radiotherapy

Answer. : (d) Radiotherapy

SKIN

108. A young man with asymptomatic macules and papule over trunk and reddish patch over palate with a flat, moist lesion on glans penis.patient has generalised lymphadenopathy. What is line of management?

a. Ceftriax

b. Benzathine penicillin

c. Acyclovir

d. Fluconazole

Answer. (b) : Benzathine penicillin
Reference: Harrison 17e P-1038-45; CMDT-2004-1386: Fitzpatrick’s Dermatology in General Medicine 6/e p-2164-2212; Rooks Textbook of Dermatology 7/e p.30.1, 35 25.20-39]

109. 50yr old male present with bulla on body and oral mucosa. Lesion present in

a. Intradermal

b. Suprabasal

c. Epidermal

d. Sub corneal

Answer. (b) Suprabasal
Reference: Harrison’s 17/e p-336; Thomas Habif Clinical Dermatology 4/e p. 549; Fitzpatrick 7/e p. 45-47, 349, 459-84, 1714, 1878, 1892; Rooks textbook of Dermatology 8/e p. 40.3-40.64]

110. Patient with urticaria on sun exposure.

a. Cholinergic urticaria

a. Atopic reaction

b. Photo dermatitis

c. SolarUrticari

Answer. (A) Cholinergic Urticaria
Reference: Roxburgh’s –common Skin disease 17/ep. 71-75; pasricha-Treatment of skin disease 4/e p. 144-150; Harrison 16/e p. 305-306; Fitzpatrick’s Dermatology in General Medicine 6/e p=1181-1203; Rooks Textbook of Dermatology 7/e p. 47.1-47.29]

ANESTHESIA

111. EEG monitoring done in

a. General anesthesia

b. Regional anaesthesia

c. Neuro anesthesia

d. Analgesia

Answer. (c)Neuroanaesthesia

Reference:Clinical Anaesthesiology, Morgan, 4th Ed. , Pg 144-146
Lee's Synopsis of Anaesthesia, 12th Ed. , Pg. 443-447

112. ASA grade in hypertensive pt which is controlled

a. 2

b. 3

c. 4

d. 1

Answer. (a) : 2

Reference: Clinical Anaesthesiology, Morgan, 4th Ed. , Pg 10, table 1-5

Lee' Synopsis. of anaesthesia, 12th. Ed. , Pg 7-8

113. Modified allen test at

a. Wrist

b. Arm

c. Elbow

d. Forearm

Answer. (a). wrist
Reference : Clinical Anaesthesiology, Morgan, 4th Ed. , Pg 123-124

114. MOST POTENT analgesic agent among following

a. Nitrous oxide

b. Nitric oxide

c. Co2

d. Oxygen

Answer. (a) Nitrous oxide

Reference : Clinical anaesthesia , Barash, 5th Ed. , Pg 396-397

115. Dose of which neuromuscular blocking agent in a obese female requires calculation of actual body wt is required instead of average body weight

a. atracuronium

b. vecuronium

c. pancuronium

d. rocurium

Answer: None…… The correct answer should be succinyl choline, the only neuromuscular blocking agent which is dosed by the total body weight rather than the ideal body weight
Reference: Clinical Anaesthesiology, Morgan, 4th Ed. , Pg 814-815

116. A Child is intubated for craniotomy. During surgery after 2 min, bellows of anaesthetic machine collapses. Next step?

a. ventilate manually

b. continue the operation

c. use bigger size tube

d. Increase flow

Answer. (a) Ventilate manually
Reference: Anaesthesia Faculty / Senior Resident Trauma Unit AIIMS

117. A infant present with respiratory distress, was intubated. The fastest and accurate method to confirm intubation

a. Capnography

b. Clinically by auscultation

c. Chest readiography

d. Airway pressure measurement

Answer: Capnography
Reference: Morgan 4^th Edition pg. 590-93

RADIO

118. True about MRCP all are except

a. Entire biliary tree and pancreatic duct are seen in single MRCP

b. T₂ weighted images are used for bile & pancreatic secretions in biliary tree

c. MRCP has less spatial resolution than ERCP

d. Gadolinium based contrast is not used

Answer (a) Entire biliary tree and pancreatic duct are seen in single MRCP

Reference: Cancer Imaging volume 2 by M.A. Hayat

119. Ionizing radiation affects which stage of cell cycle

e. G2 S

f. G1 G2

g. G2 M

h. G0 G1

Answer: C, G2M

Reference: Harrison 17^th Page 516.

PSYCHIATRY

120. 14 year old boy is not able to get good grades on 9th standard exam. But he is very sharp and intelligent. Best test to diagnose his problem?

a. Child behaviour checklist

b. Bhatia's battery

c. Specific learning disability test

d. Child behaviour battery

Answer. (c) Specific learning disability test

Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 3495-3499

121. In insomnia patient sleep most acurately recorded by

a. Barogragph

b. Kymograph

c. Actigraphy

d. Plethysmography

Answer: (C) Actigraphy

Reference: Taber’s Cyclopedic Medical Dictionary 21 Edition page 36

122. Male started alcohol at 20 years, presently taking 3 quarters daily over 30 years, now complains that he gets the kick in 1 quarter, diagnosis

a. Withdrawl

b. Mallenby phenomenon

c. Reverse tolerance

d. Cross tolerance

Answer. (c) reverse tolerance
Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 1271

123. Knowledge of own disease/illness in Mental status examination

a. Insight

b. Orientation

c. Judgement

d. Rapport

Answer. (a) Insight
Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 897

124. Child not eating vegetables. His mother starts giving a chocolate each time he finishes vegetables in the diet. the condition is

a. Operant conditioning

b. Classical conditioning

c. Social training

d. Negative reinforcement

Answer. (a) operant conditioning

Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 2791-92

125. All are true regarding Fronto temporal dementia except

a. Stereotypic movement

b. Loss of insight

c. Less than 65 years

d. Changes in mood

Answer. (a) Stereotypic movement
Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 1194-98

126. Cognitive decline in old age due to

a. Homocysteine

b. Methionine

c. Cysteine

d. Taurine

Answer. (A) Homocysteine
[Reference: Harrison 16/e P. 1430, 1432]

127. A Young man is with known heroin addiction is brought in the emergency in unconscious state. On examination his pupil are pin point. What will be the treatment of choice?

a. Oral natrexone

b. IV naloxone

c. Oral diazepam

d. Oral Buprenorphine

Answer. (b)IV naloxone
Reference: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 09^th Edition page 1375-76 & 1384

OBS/GYNAE

128. Treatment of Ca Cervix IIIB include

a. Wertheims hysterectomy

b. Schuata’s hysterectomy

c. Chemotherapy

d. Concurrent Chemoradiation

Answer. (d) Concurrent Chemoradiation

Reference: William’s Gynae p. 657, 658, 659

129. A female present with 8 week amenorrohea with pain left lower adbomen. On USG thick endometrium with mass in lateral adenexea diagnosis?

a. Ectopic pregnancy

b. T orsion of dermoid cyst

c. Tubo ovarian mass

d. Hydrosalpinx

Answer. (A) ectopic pregnancy

Reference. Shaw 13/e, p 267

130. In a study it is observed that the right ovary ovulates more than the left, all are possible explanation for the cause except

a. Anatomical asymmetry

b. Difference in blood supply to both sides

c. Right handedness is more common in population

d. Some embryological basis

Answer. (C) Right handedness is more common in population

Reference: humrep.oxofordjournal.org/content/12/8/1730.full.pdf]

131. Patient came with vaginal discharge on exam no cervical discharge empirical protocol treament package is

a. Metro + fluconazole

b. Metro+doxycycline

c. Metro + tetracycline

d. Metro+azithromycin

Answer. (a) metro + fluconazole

Reference. Shaw 13/e, p 125,127, 129

132. Leiomyoma of uterus, least likely change to occur

a. Red degeneration

b. Sarcomatous change

c. Fatty generation

d. Hyaline generation

Answer. (B) Sarcomatous change

Reference. Shaw 13/e , p 341

133. Which of the following is seen during heart disease in pregnancy and not during normal pregnancy

a. Pedal edema

b. Engorged neck veins

c. Dyspnea

d. Hypotension

Answer. (b) Engorged neck veins
Reference. Williams Obs. 22/e, p 1019

134. 36 week a female present with amenorhea with blurred vision and headache admission,mx of bp with antihypertensives and delivery at term

a. Admit & give antiHTN ,mgso4 and terminate

b. Admit & give antiHTN ,mgso4 and Observation

c. Only admit & watch pt.

d. Give antihtn and send home

Answer. (A ) Admitt, give MgSO4, antihypertentensive, and terminate the pregnancy

135. Test not useful in case of tubal pregnancy

a. Pelvic examination

b. Usg

c. Hcg levels

d. Hysterosalpingography

Answer. (D) Hysterosalpingography

Reference. Dutta Obs. 6/e, p 186

136. A 19 year old patient came to the out patient department with complaints of Primary Amenorrhea. She had well develope3d breast and pubic hair. However there was abse3nce of vagina and uterus. Likely diagnosis is

a. XYY

b. Mullerian agenesis

c. Gonadal dysgenesis

d. Kleinfelter’s syndrome

Answer. Is ‘b’ i.e., Mullerian agenesis

[Reference; Shaws text book of Gynaecology 14/e p. 252; Novak’s Gynaecology 14/e p. 1004]

137. At 34 weeks multigravida with previous 2 normal delivery now have unstable lie due to

a. Oligohydramnios

b. Placenta previa

c. Pelvic tumor

d. Uterine anomalies

Answer.(b) Placenta previa

Oligohydraminos does’nt present with unstable lie

Reference. Dutta Obs 6/e, p 244

138. Trial of normal labour is contraindicated

a. History of previous classical CS

b. History of previous CS due to CPD

c. No history of prior vaginal delivery

d. History of previous CS due to malpresentation

Answer. (b) History of previous classical caesarean section

Reference. Williams Obs. 21/e, p 542- 543

139. Female with infertility dysparenuia cyclic pain, investigations?

a. TVS

b. Diagnostic laproscopy

c. HSG

d. CT/ MRI

Answer. (b) diagnostic laparoscopy

Reference. Berek and Novak’

140. Beyond which critical value Shock Index [Heart rate/BP] in pregnancy is considered abnormal?

a. 0.9-1.1

b. 0.5 0-.7

c. 0.3-0.5

d. 0.7-0.9

Answer.(A) 0.9-1.1

Reference: http://emedicine.medscape.com/article/168402-differential:

141. All are true except

a. Retinal hemorrhage intra cranial hemorrhage and subgaleal hemorrhage are more common in venthouse delivery than forceps

b. Vaccum needs more skill than forceps delivery

c. Cephal-hematoma is more common with vaccum extraction

d. Less maternal trauma by vaccum as compared with forceps
Answer: (b) Vaccum needs more skill than forceps delivery
Reference: William 22^nd Edition Pg. 549

GENERAL MEDICINE

142. A patient on amphotericin B develops hypokalemia of 2.3meq/l. K+ supplementation requires is?

a. 40meq over 24 hrs

b. 60meq over 24 he's

c. 80 meq over 24 hrs

d. 120-160meq over 24 hrs

Answer (A) 40meq over 24 hrs

Reference: Harrison 18^th edition, chapter 46

143. A patient with 12cm abscess in liver which was drained under sonographic monitoring 3 times and On follow up a residual cavity of 4cm was found to be present .An oral lumicidal drug was given for 14 days. Next plan of action shall be:

a. Stool examination serially

b. USG weekly for 1 month followed by monthly USG till 1 year.

c. USG weekly for 1 month followed by CT scan at 3 months.

d. Monthly CT scan

Answer (b) USG weekly for 1 month followed by monthly USG till 1 year.

Reference: Harrison 18 th edition chapter 202

144. Which of the following is Not true aboutpolymyositis ?

a. Limb girdle weakness

b. Ophthalmoplegia

c. Para-neoplastic syndrome

d. Spontaneous discharge in EMG.

Answer (B) Ophthalmoplegia

Reference: Harrison 18^th chapter 383

145. 35 year old female with recurrent renal stone. not advised is:

a. Increase water

b. Restrict protein

c. Restrict salt

d. Ophthalmoplegia

Answer (D) Ophthalmoplegia

Reference: Harrison 18^th edition/ chapter 281/page 1817/ Reference: www. Uptodate.com/contents/prevention of recurrent calcium stones in adults, Campbell’s urology chapter 43

146. A 28 yr old man has lenticonus and ESRD now. His maternal uncle also died of similar illness. Diagnosis is

a. ARPKD

b. ADPKD

c. Oxalosis

d. Alport's syndrome

Answer: (D) Alport’s syndrome

Reference: Harrison 18^th Chapter 357

147. Pinna calcification Except

a. Gout

b. Onchrnosis

c. Frost bite

d. Addisons disease

Answer (a) Gout
Reference :Chapter 54. Skin Manifestations of Internal Disease, Harrison 18^th (www.nejm.org/doi/full/10.1056/NEJMicm1000193)

148. Which of the following doesnot need treatment?

a. Neuroblastoma

b. Burkitts

c. t cell lymphoblastic leukemia

d. Not Recalled

Answer is A

Reference: Nelson 18^th text book of pediatrics/chapter 498

149. With ageing, a slight decrease in cognitive impairment is seen due to increase in level of

a. Homocysteine

b. Taurine

c. Methionine

d. Cysteine

Answer (a) Homocysteine

Reference: CMDT 2012 / page 1620

150. A Patient presents with pain in Meta-Tarso-Phalangeal jointsM.T.P.andis a known case of Chronic Renal Failure. This is due to accumulation of-

a. Rh factor

b. Uric acid

c. Serum urea

d. HLA B27 typing

Answer (b) Uric Acid

Reference: Harrison 18^th edition/table 280.4/ chapter280 and http://www.ncbi.nlm.nih.gov/pubmed/21321568

151. SARS causative agent

a. Corona-virus

b. Picorna-virus

c. Myxovirus

d. Recalled

Answer: (a) Corona-virus

Reference :Harrison 18^th edition-chapter 179

152. Blink reflex is used for?

a. Mid pontine lesions

b. Neuromuscular transmission

c. Axonal neuropathy

d. Motor neuron disease

Answer (a) Mid pontine lesions
Reference: http://www.ncbi.nlm.nih.gov/pubmed/17727783/ Clinical value of blink reflex

153. Grisel syndrome all are true except:

a. Post-adeniodectomy

b. Conservation treatment

c. Inflammation of cervical spine ligaments

d. No need for neurosurgeon

Answer (d) No need for neurosurgeon

Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639892/

154. Cervical syringomyelia all are seen except

a. Burning sensation in hands

b. Hypertrophy of abductor pollicisbrevis

c. Plantar extensor

d. Absent biceps reflex.

Answer: (b) Hypertrophy of abductor pollicisbrevis
Reference: Harrison textbook of medicine 18 th edition chapter 377/ above figure 377-7http://emedicine.medscape.com/article/1151685-clinical

155. 70year female is on treatment with Alendronate for severe osteoporosis.Now she complains of pain in right thigh. What is the next investigation to be performed?

a. DEXA scan

b. x ray

c. Serum vitamin D levels

d. Serum alkaline phosphate levels

Answer (b) X-ray

Reference: CMDT 2012/page 1118

156. A 70 year old retired Military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish.

a. Chronic tension headache

b. Temporal arteritis

c. Migraine

d. Fibromyalgia

Answer (b) Temporal arteritis

Reference: CMDT 2011 page 819 and http://emedicine.medscape.com/article/809492-clinical#a0216

157. A patient of rheumatoid arthritis develops sudden onset Quadriparesis, , increased muscle tone of limbs with exaggerated tendon jerks and worseningof gait. The investigation to be done:

a. Flexion and extension Cervical area X ray of neck

b. MRI brain

c. EMG and NCV

d. Carotid angiography

Answer( a) Flexion and extension Cervical area X ray of neck

Reference:Harrison chapter 15/18 th edition

158. Patient with ICD collapses, ICD imaging modality

a. Chest x ray

b. MRI

c. CT

d. USG

Answer (a) Chest X ray

Reference: Harrison: 18 th edition/ just above table 233-9/ chapter 233./Emedicine:http://emedicine.medscape.com/article/162245-overview#aw2aab6c12

159. Type 1 renal tubular acidosis all are trueExcept?

a. Renal stones

b. Hypokalemia

c. > 4mg/ day Sodium bicarbonate

d. Urine pH > 5.

Answer (c) > 4mg/ day Sodium bicarbonate

Reference: Harrison 18^th edition 284/ CMDT 2011 page 862

160. A diabetes mellitus patient with fungal infection of sinuses and peri-orbital region with significant visual impairment:

a. Amphotericin B

b. Itraconazole

c. Ketoconazole

d. Broad spectrum antibiotics

Answer: Amphotericin B

Reference: Harrison 18^th Edition/ Chapter 205

161. Gait apraxia?

a. ACA

b. MCA

c. PCA

d. Posterior choroidal artery

Answer: (a) Amphotericin B

Reference: chapter 24 Harrison18th : Gait and balance disorders

162. Prions, which of following is correct

a. Long incubation period

b. Destroyed by autoclaving at 121C

c. Nucleic acid present

d. Immunogenic

Answer (a) Long incubation period

Reference: The following lines are excerpt from Harrison 18^th chapter 383:

163. A patient with Tubercular meningitis was taking ATT regularly. At end of 1 month of regular intake of drugs deterioration in sensorium is noted in condition of the patient. Which of the following investigations is not required on emergency evaluation?

a. MRI

b. NCCT

c. CSF examination

d. Liver function tests

Answer (c) CSF examination

References: included in the text

Therefore the following logical conclusion can be:

ALTERED SENSORIUM due to Hepatic encephalopathy secondary to hepatotoxicity of ATT. Hence LFT should be performed.

ALTEREDED SENSORIUM due to Obstructive hydrocephalus could lead to raised ICT leading to pressure on midbrain and resultant status. Therefore a MRI scan can identify the process and necessitate a neurosurgical consult.

(Page 540 of OP GHAI 7th edition) ALTERED SENSORIUM due to end-arteritis resulting in brain infarction and hypo-dense lesions. Tubercular encephalopathy results in diffuse edema of brain simulating post-infective allergic encephalopathy, Necrotizing or hemorrhagic leuko-encephalopathy may occur in TB meningitis.. In choice NCCT is given and it can identify infarction as well cerebral Edema.

The que3stion mentions altered sensorium in the patient and if we see the table in (Fig 376-1 harry boy 17^th edition Harrison) on altered sensorium, imaging should be performed. Lumbar puncture now can precipitate the ominous herniation of the brain.

164. What is feature of temporal arteritis

a. Giant cell arteritis

b. Granulomatous vasculitis

c. Necrotizing vasculitis

d. Leucocytoclasticvasculitis

Answer (a) Giant cell arteritis
Reference: Harrison: 18^th edition/ chapter 326

165. A patient withHepatits C, exhibits hypo-complimentemia, 2g/day proteinuria andhematuria is present. The most probable diagnosis is: REPEAT

a. M.P.G.N.

b. Cryo-globulinemia

c. Membranous Glomerulopathy

d. Post-infectious Glomerulonephritis

Answer (a) M.P.G.N.

Reference: Chapter 326/ Harrison 18^th edition/http://emedicine.medscape.com/article/329255-clinical/CMDT 2012 pg 899.

166. All are indicated in a patient increased s. cysteine and multiple renal stones except:

a. Cysteamine or

b. Increase fluid intake

c. Alkalinisation of urine

d. Pencillamine

Answer: (a) Cysteamine or

Reference: CMDT 2012/ page 923/chapter 287 harrison 18^th edition

SURGERY

167. Not a Causes of acute anal pain:

a. Thrombosed hemorrhoids

b. Acute anal fissure

c. Fistula in ano

d. Perianal abccess

Answer : (c) Fistula in ano

Reference: Harrison 18^th edition/chapter 297, Bailey and love 26^th edition,page 1263

168. 70 yr old man with prostate cancer was given radiotherapy. The recurrence of the cancer is monitored biochemically by

a. Androgens only

b. Prostate specific antigen and carcino-embryonic antigen

c. Prostate specific antigen only

d. ALP and CEA

Answer: (b) Prostate specific antigen and carcino-embryonic antigen

Reference: NICE clinical guideline 58 – Prostate cancer (http://www.nice.org.uk/nicemedia/pdf/CG58NICEGuideline.pdf) and http://emedicine.medscape.com/article/1967731-treatment#a1156

169. A patient has a surgical cause of obstructive jaundice. USG can tell all of the following except

a. Level of obstruction

b. Peritioneal deposits

c. Gall bladder stones

d. Ascites

ANSWER (b) Peritioneal deposits

Reference:

A. Sutton Textbook of Radiology Volume 1 page 716 & 717

B. Biliary Obstruction Workup Imaging :guidelines/http://emedicine.medscape.com/article/187001-workup#a0720

C. Harrison 18^th edition chapter 311/ table 311.3

Sutton says - In presence of biliary obstruction ultrasound is reported to define level in 95% and cause upto 88% of patients

170. Organism associated with fish consumption and also cause carcinoma gallbladder

a. Clonorchis sinensis

b. Gnathisomia

c. Anglostronglyoidosis cantonensis

d. H. dimunata

Answer. (a) Clonorchis sinensis
[Reference: Harrison 17/e p1330; http//www.ncbi.nlm.nih.gov/pubmed/12483392
http://www.ncbi.nlm.nih.gov/pubmed/3993073]

171. Rupture of urethra above the deep perineal pouch causes urine retention in which region?

a. Medial aspect of thigh

b. Scrotum

c. True pelvis only

d. Anterior abdominal wall

Answer: (c) True pelvis only

Reference: Smith Urology page 910

172. Ileal resection for intusussception in adults would be done in?

a. Carcinoid Tumor

b. Lymphoma

c. Villous adenoma

d. Soft tissue

Answer: C, Villous adenoma

Reference: Chapter 91 Harrison 18^th Edition

Intussusception of the bowel in adults: A review World J Gastroenterol. 2009 January 28; 15(4): 407–411

Pediatric Intussusception Surgery/http://emedicine.medscape.com/article/937730-overview#a0102

173. All are true about intestinal obstruction radio-graphically except

a. On lying supine fluid air gap absence does not signify obstruction

b. Volvulus shows a characteristic appearance on radiograph

c. Small intestine dilation> 3 cm

d. Distal large intestine >9 cm and proximal intestine>3 cm

Answer (d) Distal large intestine >9 cm and proximal intestine>3 cm

Reference: Oxford textbook of surgery Reference: Swartz’s 9e

174. Buerger disease all except are true

a. Ulnar artery and peroneal arteries involved

b. Neural involvement present

c. small acral vessels of limb involved

d. Phlebitis migrans

Answer (c) Small Acral vessels of limb small acral vessels of involvement causes hypohidrosis

Reference: CMDT 2012 page 458

Vascular Disease: Diagnostic and Therapeutic Approaches By Michael R. Jaff

Robbins textbook page 517 8^th Edition

175. Next Investigation to be done for painful breast lump in a lactating woman

a. Mammography

b. USG

c. MRI

d. X

Answer (b) USG

Reference: Breast Ultrasonography/http://emedicine.medscape.com/article/1948269-overview

176. Which of the following is not associated with elevation Right hemi-diaphragam:

a. Amebic abscess

b. Pyogenic abscess

c. Cholecystitis

d. Subdiaphragmatic abscess

Answer. (c) Cholecystis

Reference: Green filed surgery page No: 910& 911

177. Not true of hernia is :

a. Conservative managment

b. In Child hernia treatment with herniotomy

c. Aborshable mesh not used

d. Long standing hernia increases changes of incarceration

Answer: D long standing hernia increases chances of incarceration

Reference: chapter 343 ,Nelson textbook of Pediatrics 18^th edition

178. Stereotactic radiotherapy is used for treatment of ?

a. Brain tumor

b. Lungs carcinoma

c. Cervix cancer

a. Renal carcinoma

Answer. (a>b)
Reference: Neurology tumors of the brain and spine – M.D. Anderson cancer care series Page 136 Radiation Oncology for Tumors of the Central Nervous System

Reference:

http://www.cancerresearchuk.org/cancer-help/type/brain-tumour/treatment/radiotherapy/stereotactic-radiotherapy-for-brain-tumours

Reference:http://www.rtanswers.com/treatmentinformation/treatmenttypes/stereotacticradiation.aspx

Stereotactic Radiation Therapy

Reference:

http://www.radiologyinfo.org/en/info.cfm?pg=stereotactic

179. Patient presents with varicose vein with sapheno-femoral incompetence and normal perforator management :

a. endovascular striping

b. Sclero-theraphy

c. Sapheno-femoral flush ligation

d. saphenofemoral flush ligation with striping

Answer: (d) saphenofemoral flush ligation with striping
Reference: Bailey& Love, Short practice of Surgery, 25^th Edition ,page No: 930,

Sabiston textbook of surgery 18^th Edition Chapter Primary Venus Insufficiency /below figure 68.6

PEDIATRICS

180. A neurosurgeon in parent teacher meeting saw a child with precocious puberty and uncontrollable laughing. He suggested the parent of child to get a MRI done to evaluate for the possibility of

a. Hypothalamic Hamartoma

b. Pineo-germinoma

c. Pituitary adenoa

d. Craniophangioma

Answer: A HYPOTHALAMIC HAMARTOMA

Reference: 563. 2 Precocious Puberty Resulting from Organic Brain Lesions

181. A child presented to the casualty with seizures. On examination an oval hypo-pigmented macules were noted on the trunk, along with sub-normal IQ. Probable diagnosis of the child is:

a. Neurofibromatosis

b. Sturge Weber

c. Tuberous sclerosis

d. IncontinentiaPigmenti

Answer (c) : TUBEROUS SCLEROSIS

PAGE NO. 564 OPG

182. At what age child can eat food without spilling, identify her gender, say her full name, can dress self with supervision

a. 2 yrs

b. 3 yrs

c. 4 yrs

d. 5 yrs

Answer (b) : AGE 3 YEARS

PAGE NO. 31/ OPG 7^th edition

183. A Pre-termer 32 weeks baby after birth had a respiratory rate of 86/min with presence of grunting. On examination there was no nasal flaring, mild chest in-drawing, noxiphisternal recession and abdomen lags behind the chest .Thesilverman scoring for the neonate shall be

a. 3

b. 4

c. 5

d. 6

Answer (b) : 4

Reference: Maternity and Pediatric Nursing By Susan Scott Ricci, Terri Kyle, P. 729-30;Silverman WC, Anderson DH. Controlled clinical trial on effects of water mist on obsrtructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics 1956; 17:1-4; OP Ghai. 7/e, p 143]

184. In a child with rickets with deformity, when should a decision to undertake corrective surgery be undertaken :

a. When vitamin D levels turn to normal

b. When growth plate healing is seen radio-graphically

c. When bone specific alkaline phosphatise is normal

d. When serum calcium becomes normal

Answer (b) When growth plate healing is seen radio-graphically
Reference: Kliegman: Nelson Textbook of PEDIATRICS //Chapter 48 – Rickets and Hypervitaminosis D /Larry A. Greenbaum/ http://emedicine.medscape.com/article/985510-treatment

185. Reversal of shunt not possible in natural history?

a. ASD

b. VSD

c. TOF

d. PDA

Answer( c) TOF

Reference: TOF: PAGE NO 408. OP ghai :

186. A preterm infant with poor respiration at birth starts throwing seizures at 10 hours after birth. Anti- epileptic of choice shall be:

a. Levetiracetam

b. Phenytoin

c. Phenobarbitone

d. Lorazepam

Answer : (c)Phenobarbitone

Reference: PAGE NO. 527. OPG/593.7 NELSON Neonatal seizures

187. Correct about respiratory distress syndrome is:

a. Seen after 6 hours of birth

b. Ante natal steroid

c. Term pregnancy

d. Air bronchograms seen on x-ray chest

Answer (d) Air bronchograms seen on x-ray chest

Reference: PAGE NO. 143/OP GHAI

188. 7 year old girl is easily distracted in class and exhibits poor scholastic performance. Seizures are precipitated by hyperventilation.

a. Myoclonic seizures

b. Absence seizures

c. Atonic seizures

d. Myoclonia

Answer: (b) Absence seizures

Reference: NELSON 593.4

189. Best screening test to evaluate hearing in a neonate

a. Pure Tone Audiometry

b. Stapedial Reflex

c. Oto –acoustic Emissions

d. Brain stem evoked auditory response

Answer: (c) Oto –acoustic Emissions
Reference: Nelson chapter 636 /HEARING SCREENING.

190. One of the parents has a balanced translocation between chromosome 15 and 21. What advice will u provide to the couple to prevent a child being born with Down syndrome?

a. Prenatal diagnosis & advice abortion

b. Artificial insemination with donor's sperm

c. Adoption

d. Does not matter

Answer (c) Adoption

References included in text

· Nelson says - Translocation (21;21) carriers have a 100% recurrence risk for a chromosomally abnormal child.

· Carriers of Robertsonian translocations involving chromosome 21 have a higher chance of having a child with Down syndrome. This is known as a 'translocation Downs'. This is due to a mis-segregation (Non-disjunction) during gametogenesis. The mother has a higher (10%) risk of transmission than the father (1%). Robertsonian translocations involving chromosome 14 also carry a slight risk of uniparental disomy 14 due to trisomy rescue

· If the mother is a 'balanced translocation' carrier to another chromosome (usually 13, 14, 15, 22), then the recurrence risk is about 1 in 8.

191. Trisomy 13 , all of the following are true statement except:

a. Bilateral mircopthalmia

b. Neurofibroma

c. Capillary hemangioma

d. Dermoid cyst

Answer: (a) Bilateral mircopthalmia

Reference:PAGE NO 615 , OP GHAI

192. Which of the following is true for Wilson disease?

a. High ceruloplasmin

b. Low serum and high urinary copper

c. Low serum copper

d. Low urinary copper

Answer is : B>C

Reference: Harrison 18^th edition: chapter 360/OPG PAGE NO. 641 /354.2 Nelson

193. A child with low blood glucose is not able to do glycogenolysis or gluconeogenesis. Which of the following enzyme is missing in the child?

a. Fructokinase

b. Glucokinase

c. Glucose 6 phosphastase

d. Transketolase

Answer (c) Glucose 6 phosphastase

Reference: OP GHAI Page no 636. /7^th edition

194. Which of the following does not require a lumbar puncture in children?

a. ALL

b. HL

c. NHL

d. AML

Answer (b) :Hodgkins lymphoma

Reference : 495.2 NELSON Acute leukemia/496.2 NELSON- NHL

195. Bilateral proptosis is seen in

a. Neurofibromatosis

b. Leukemia

c. Cavernous hemangioma

d. Malignant fibrous Histiocytoma

Answer: (b), Leukemia

Reference:NELSON CHAPTER 632/TUMORS OF THE ORBIT.

196. A child with fever and tibial swelling exhibits on X-ray periosteal reaction and raised ESR .What is the next step in diagnosis of the patient?

a. MRI

b. Pus culture

c. Bone biopsy

d. Blood culture

Answer: (a) MRI

Reference: CMDT 2012 page no 839/nelson chapter 683/Harrison chapter 126

197. A child presents with seborrheic dermatitis, sinusitis and chronically draining ears. On examination child has failure to thrive with hepato-splenomegaly and exophthalmos. Probable diagnosis is

a. Histiocytosis-X

b. Wegenersgranulomatosis

c. x

d. Chediakhigashi syndrome

Answer (a) Histiocytosis-X

Reference: Page no. 595/ OP GHAI

198. Most common cause of sepsis in neonates in developing countries:

a. E.coli

b. Staph. Albus

c. Pseudomonas

d. Group B streptococcus

Answer: (a) E.coli

Reference no1: Report of the National Neonatal Perinatal Database (National Neonatology Forum), 2002-2003

Reference2: journal of clinical neonatology.http://www.jcnonweb.com/article.asp?issn=22494847/yr2012

Reference no 3http://www.ncbi.nlm.nih.gov/pubmed/22455256/2010 Oct-Dec; 22(4):33-6.

199. A preterm baby with Patent ductus arteriosus all are true Except:

a. Narrow pulse pressure

b. Necrotizing enterocolitis

c. Continuous murmur

d. Congestive heart failure

Answer (a) : Narrow pulse pressure

Reference: Nelson textbook of pediaatrics 18^th edition/chapter 426 and 102.2

200. A 6yrs old child belonging to Punjabi family with past history of blood transfusions presented with Hemoglobin – 3.5 g/dl, MCV – 30 fl,MCHC – x (not recalled/controversy)

Peripheral Smear findings of Microcytic Hypochromic anemia with target cell and reduced osmotic fragility. The probable diagnosis of patient:

a. Alpha thalassemia

b. Beta thalassemia

c. Sickle cell anemia

d. G6PD deficiency

Answer. (b) – Beta Thalassemia

Reference: nelson 18^th chapter 462

Reference: Mutational spectrum of thalassemias in India/Inusha Panigrahi, RK Marwaha//Division of Genetics, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

PGDIAMS-MD/MS entrance

Friday 30 November 2012

AIIMS NOV 2012

References’

I. Hartlova, A., Cerveny, L., Hubalek, M., Krocova, Z. and Stulik, J. Membrane rafts: a potential gateway for bacterial entry into host cells. Microbiol. Immunol., 54, 237-245 (2010)

II. Merrill, A.H. Sphingolipids. In: Biochemistry of Lipids, Lipoproteins and Membranes (5th Edition). pp. 363-397 (Vance, D.E. and Vance, J. (editors), Elsevier, Amsterdam) (2008).

Answer (b) : AGE 3 YEARS