Tuesday, February 15, 2011

414 - JIPMER 2011 questions with answers - part 3

101.lobular ca breast histology?
A.Single file pattern
B.Pleomorphic cells in sheets
C.--
D.--

Ans:A.Single file pattern

102.A woman comes to er few hrs back with long bone fracture now complaints of breathlessness ,ther r petechial rashes over chest, auscultation findings r normal , abg p02 50, pc02-20mmhg...., diagnosis?
A. air embolism
B. fat embolism
C. pulmonary embolism
D.--
Ans:B. fat embolism

103.treatment of uveitis consists of:
a.antibiotic and steroid
b.steroid and cyclopegic
c.antibiotic and cyclopegic
d.steroid and mydriatic

Ans:b.steroid and cyclopegic

104.True regarding direct hernia ?
A.mc type in women
B. medial to inferior epigastric a
C. most of the times descends upto the bottom of scrotum
D.we need to open the sac while reducing at surgery

Ans :B. medial to inf epigastric a

105.paranoid schizophrenia is caused by intake of ?
A.Amphetamine
B.Heroin
C.Cannabis
D.
Ans:A.Amphetamine

106.Treatment of Stage A( Superficial and Submucosal )Bladder carcinoma is?
A.Local excision
B.Intravesical Chemotherapy
C.Radiotherapy
D.Chemotherapy

Ans:B>A(QUERY)

107.which is not considered for screening?
A.Disease burden
B.Physician's Knowledge of the the disease
C.Cost of the test
D.Treatment efficacy

Ans:B.Physician's Knowledge of the the disease(BEST ANS--QUERY)

108.pt with rhabdomyolysis with arf what should be done 1st?
A.mannitol
B. alkali diuresis
C.Dopamaine
D.--

Ans:B. alkali diuresis

109.A pt presents with hypotension in confused state & METABOLIC ALKALOSIS which of the following tests will best suggest the diagnosis?
1) urine ph
2) urine Na+
3) urine Cl-
4) urine k+

Ans:QUERY FOR NOW

110.treatment of leukoplakia consist of---
a.topical chemotherapy
b.excision biopsy of ALL lesions
c.ill fitted dencture reposition
d.Local Radiotherapy

Ans:c.ill fitted dencture reposition(OPEN FOR ARGUMENTS)

The treatment of leukoplakia mainly involves ****avoidance of predisposing factors — tobacco cessation, smoking, quitting betel chewing, abstinence from alcohol — and ***avoidance of chronic irritants, e.g., the sharp edges of teeth. A biopsy should be done, and the lesion surgically excised ****if pre-cancerous changes or cancer is detected.

111.Absence of which of foll makes dia of pul. embolism most unlikely:
A.Pleuritic chest pain
B.Hemoptysis
C.Tachypnoea
D.Wheezing

Ans:C.Tachypnoea
Reference:CMDT 2011 LINE TO LINE PICK

Indeed, no single symptom or sign or combination of clinical findings is specific to PE. Some findings are fairly sensitive: ***dyspnea and pain on inspiration occur in ***75–85% and 65–75% of patients, respectively.***** Tachypnea is the only sign reliably found in more than half of patients.

113.RPGN is chaecterised by-------
a.crescent formation
b.splliting of bm
c.neutrophil infiltration of iterstitium
d.---

Ans:a.crescent formation(REPEAT)

114.In which condition is there a pain before the onset of mensturation which relieves after the begining of menses?
A.Spasmodic Dysmenorrhea
B.Congestive Dysmenorrhea
C.Membranous Dysmenorrhea
D.Menorrhagia

Ans:B.Congestive Dysmenorrhea

Reference:Shaw Gynecology Page:265 LINE TO LINE PICK

115.M/C site of ectopic pregncy?
A.ampullary portion of fallopian tube
B.Isthmus
C.Interstitium
D.Abdomen

Ans:A.ampullary portion of fallopian tube(REEAT)

116.hypotension is caused by all except ?
A.Halothane
B.Propofol
C.Ketamine
D.?

Ans: C.Ketamine(REPEAT)

117.Fixed performance device:
A.venturi mask
B.nasal cannula
C.simple mask
D.non rebreathing mask

Ans :A.venturi mask

118.which of the following is not present in dhatura?
A.hyoscine
B.hyocyamine
C.Muscarine
D.stramonium

Ans : C.Muscarine

Reference:Forensic Medicine By Narayan Reddy
Pg:514

The main alkaloids are Atropine,Hyosine and Hyocynamine

Strmonium is the other name of Datura Stramonium

So better answer is Muscarine>Stramonium

119.administration of which of the following can prevent neural defects in newborn?
A.Folic acid
B.vit b 12
C.--
D.--
Ans :A. Folic acid

120.Receptor for vit b 12-IF compelex is located in?
A.ileum
B.colon
C.jejunum
D.Duodenum

Ans:A.ileum

121.Which of the following is best in studying the decline in percentage of alcohol usage in men and women over several years?
A.Pie Chart
B.Histogram
C.Frequency polygon
D.Line diagram

Ans:D.Line diagram(QUERY FOR MORE SOUND REFERENCE)

Reference:Park Page644

Line diagram is used to show the ****trend of events with the ***passage of Time
122.Urinary stone formed in patients with regional bowel enteritis is
A.ca oxalate
B.Urate
C.Phosphate
D.cysteine

Ans:A.ca oxalate

123.Antepartum bleed of fetal origin is?
A.vasa praevia
B.Circumvallate placenta
C.Abruptio placenta
D.Placenta praevia

Ans:A.vasa praevia(REPEAT)

124.All of the following drugs produce active metabolites except ?
A.Propanolol
B.Procainamide
C.Diazepam
D.Fexofenadine

Ans:D.Fexofenadine

125.Prolactin is secreted by
a) chromophobe cells
b) acidophilic cells
c) basophilic cells
d) Chromophill cells

Ans:b) acidophilic cells

126.vasopressin inhibited by ?
a) alcohol
b) carbamazepine
c) clofibrate
d) ?

ans. A(REPEAT)

127.most radio resistant in cell cycle
a) G1
b) early S phase
c) late s phase
d) G2

Ans:c) late s phase

128.Most common cause of End stage renal disease is?
A.DM
B.Hypertension
C.Chronic GN
D.--

Ans:A.DM /C. Chronic GN(WILL DECIDE LATER)

129.Post Kidney transplantation complication caused by CMV is?
1) parotitis
2) cholecystitis
3) pyelonephritis
4) GI Necrosis and stricture

Ans:4) GI Necrosis and stricture

CMV ulcerations occur in both the lower and the upper gastrointestinal tract, and it may be difficult to distinguish diarrhea due to GVHD from that due to CMV infection.

130.Which of the following is least protein bound?
A.Morphine
B.Sufentanyl
C.Meperidine
D.Fentanyl

Ans:A.Morphine

Morphine--30% protein bound

131.Cortex of ovary consist of all the following EXCEPT
a)graffian follicle
b)hilus
c)primordial follicle
d)corpus luteum

Ans:b)hilus(REPEAT)

132.Q: A 25 yr old male complains of paroxysm of unilateral head ache, associated with nasal discharge and tearing of eyes on the side of head ache, precipitated by bouts of alcohol, most likely diagnosis is

A. Cluster head ache
B. Migraine
C. Sinusitis
D. ??

Ans:A. Cluster head ache

133. Which of the following is affected in MEGALOBLASTIC anemia?

A. DNA
B. RNA
C. Globin
D. ??

Ans:A. DNA


134.Best advice to be given to a patient of newly diagnosed type 2 DM

A. Limit intake of carbohydrates
B. Follow consistent calorie diet intake.
C.stop sucrose
D.less than 10% of saturated fat

Ans:A. Limit intake of carbohydrates

Reference:CMDT 2011 and Harrison Medicine


Diet

A well-balanced, nutritious diet remains a fundamental element of therapy. The American Diabetes Association (ADA) recommends about 45–65% of total daily calories in the form of carbohydrates; 25–35% in the form of fat (of which *******< 7% are from saturated fat), and 10–35% in the form of protein. In patients with type 2 diabetes, *******limiting the carbohydrate intake and substituting some of the calories with monounsaturated fats, such as olive oil, rapeseed (canola) oil, or the oils in nuts and avocados, can lower triglycerides and increase HDL cholesterol. Patients with type 1 diabetes or type 2 diabetes who take insulin should be taught "carbohydrate counting," so they can administer their insulin bolus for each meal based on its carbohydrate content. In obese individuals with diabetes, an additional goal is weight reduction by caloric restriction (see Chapter 29: Nutritional Disorders). 135. In a screening test for Ca Breast The sensitivity is 90(ninety)% specificity is [snip](ninety eight)%,what is the chance of a patient with Ca breast to be detected negative in screening conducted in two consecutive years.. A.1/10 B.2/10 C.1/100 D.2/100 Ans: C.1/100 Explanation: Sensitivity=True positivity rate is 90%=0.9 False negative rate=100-sensitivity=10%=0.1 So for 2 yrs of consequitive false negative in a patient with carcinoma breast.we need to apply multiplication rule of probability That is:0.1 X 0.1=1/100 136.Which of the following is false regarding Peritonsilar abcess? A.Usually presents with trismus B.The accumulation of pus is lateral to the superior constrictor muscle C.It does not involve the floor of mouth D.It causes bulge of the uvula/soft palate Ans: C.It does not involve the floor of mouth “”Peritonsillar space is located ***lateral to the superior constrictor muscle”” “””Progressive inflammation and suppuration may extend to directly involve the ****soft palate, the lateral wall of the pharynx, and, occasionally, the base of the tongue.””” “””Many patients present with ipsilateral referred otalgia with swallowing. ****Trismus (ie, a limitation in the ability to open the oral cavity) of varying severity is present in ***all cases, reflecting*** lateral pharyngeal wall and pterygoid musculature inflammation.””” “”As the degree of inflammation and infection proceeds, symptoms include progression in the ****floor of the mouth, the parapharyngeal space, and the prevertebral space.”” 137. Most common serious complication of end colostomy is? A.Parastomal hernia B.prolapse C.obstruction D.bleeding Ans: A.Parastomal hernia Reference:Shwartz surgery and Emergency medicine a comprehensive study guide Most common late complication of End colostomy is Parastomal hernia. More serious complications of end colostomy include necrosis, retraction, stenosis, and parastomal hernias. 138. aromatic enzyme complex is involved in the biosynthesis of A.Cholesterol B.Adrenal hormones C.vitamin D3 D.Estradiol/estrogens Ans: D.Estradiol/estrogens 139. Blunt injury to which region causes max vascular injury a.Inferior dislocation of clavicular region(option unclear) b.Knee dislocation c.Elbow dislocation d.Tibial plateau fracture Ans: b.Knee dislocation (Most probably—shall review more references) High yield Orthopedics A knee dislocation is a difficult injury for the junior surgeon to diagnose. It represents a disabling and limb-threatening injury.Where doubt exists, the patient must be admitted for vascular observation and treatment, in that popliteal artery injury occurs in 35% to 45% of all knee dislocations. 140. which shouldnt be refrigrated before primary innoculation ? a) CSF b) urine c) sputum d) pus Ans: a) CSF(REPEAT) Reference:Anatanarayan csf should not be refrigerated bcoz h.influezae s killed. 141. Most common organ injured in blunt injury ?? a. liver b. spleen c. intestine d. Kidney Ans: b. spleen 142. which of the following occur in ischemic cardiac tissue A.increased ATP B.increased anaerobic glycolysis C.increased PH D.Increased release of Ca Ans: B.increased anaerobic glycolysis 143.Biconcave shape of RBC is useful for all except? A.Helps in passing through capilaries B.Helps in cellular metabolism C.Increased surface area diffusion of gases D.Prevent osmotic lysis Ans: B.Helps in cellular metabolism 144.Regarding appendicitis in CHILDREN, all are true except? A.localised pain is single most imp reliable sign B.vomiting precedes abd pain C.80 % cases perforation occurs in children less than 5 yrs D.60%perf in 48hrs answer: B. 146. Neovascularisation of iris is seen in? A.diabetic maculopathy B.hypertensive retinopathy C.primary open angle glaucoma D.CRVO Ans: D CRVO > A.diabetic maculopathy
147. Modified biophysical profile includes?
A.Fetal tone and breathing
B.Fetal movements and tone
C.NST and AFI
D.—

Ans:C.NST &AMNIOTIC FLUID INDEX
148. all from wolfian duct except

a. eoophoron
b. paraoooporon
c. gartner duct
d . bartholin duct

Ans: d . bartholin duct

149. Antibiotic prophylaxis is indicated in all the following for prevention of endocarditis EXCEPT: (contributed by dragonliver4ever)
a)cardiac catheterisation
b)prostectomt
c)cystescopy
d)Dental procedures

Ans: a)cardiac catheterisation(REPEAT)
150. rubor in inflammation due to
A.Decreased tissue oncotic pressure
B.Decreased oncotic pressure in arterioles
C.Constriction of the capillaries
D.Dilatation of the arterioles

Ans: Dilatation of arterioles.

413 - JIPMER 2011 questions with answers - part 2

51. Which of the following arteries is not involved littles area anastomosis?
A.Anterior ethmoid
B.Sphenopalatine art
C.Greater palatine artery
D.posterior ethmoid artery

Ans:D.posterior ethmoid artery

52. Protein present in brown adipose tissue?
1)thermogenin
2)dinitroprotein
3)--
4)--

Ans:1)thermogenin

Reference:Wikipedia
*****Thermogenin (called uncoupling protein by its discoverers and now known as uncoupling protein 1, or UCP1)[1] is an uncoupling protein found in the mitochondria of brown adipose tissue (BAT)

53. Nitrogen content in 200 gm protein?
A.8g
B.16g
c.32 g
d-64g-

Ans:C 32g

Reference:Biocemistry by satyanarayan

Normal Nitrogen content of protein is 16% that is 16g in 100g of protein....

So for 200g it will be 32g...

54. In which of the following malignancies histological Grade is a good prognositic indicator?
A.Soft tissue sarcoma
B.Renal cell ca
C.?
D.?
Ans:A.Soft tissue sarcoma.. Reference: Sabiston surgery - Sarcoma histiotype is generally important determinants of prognosis and a predictor of distinctive patterns of behavior because none of the existing grading systems is ideal and applicable to all tumor types. Biologic behavior is currently best predicted on the basis of histologic type, histologic grade, tumor size, and depth

55. .A study to evaluate the relationship between smoking and pregnancy was performed with history of smoking exposures taken during PNC visit and the child birthweight after delivery. This type of study is

A. case control
B.prospective cohort
C. Cross sectional
D. clinical trial

Ans:B.prospective cohort

56. Amaurosis fugax caused by lesion/atherosclerosis in ?
A.Internal carotid artery
B. MCA
C.ACA
D.Basilar artery

Ans:A.Internal carotid artery
Reference :Harrison Principles of Medicine

Transient or Sudden Visual Loss

Amaurosis Fugax

This term refers to a transient ischemic attack of the retina (Chap. 364). Because neural tissue has a high rate of metabolism, interruption of blood flow to the retina for more than a few seconds results in transient monocular blindness, a term used interchangeably with amaurosis fugax. Patients describe a rapid fading of vision like a curtain descending, sometimes affecting only a portion of the visual field. Amaurosis fugax usually occurs from an embolus that becomes stuck within a retinal arteriole (Fig. 29-5). If the embolus breaks up or passes, flow is restored and vision returns quickly to normal without permanent damage. With prolonged interruption of blood flow, the inner retina suffers infarction. Ophthalmoscopy reveals zones of whitened, edematous retina following the distribution of branch retinal arterioles. Complete occlusion of the central retinal artery produces arrest of blood flow and a milky retina with a cherry-red fovea (Fig. 29-6). Emboli are composed of either cholesterol (Hollenhorst plaque), calcium, or platelet-fibrin debris. The most common source is an atherosclerotic plaque in the***** carotid artery or aorta, although emboli can also arise from the heart, especially in patients with diseased valves, atrial fibrillation, or wall motion abnormalities.

57. A patient is in ventricular fibrillation with hypotension,unresponsiveness , peripheral pulses are not felt.What would be the initial management of this patient?
A.Lignocaine push
B.Amiodarone push
C.--
D.200Joule Defibrillation

Ans:D.200Joule Defibrillation

58. Filigree burns seen in
A.Radiation
B.Electrical burn
C.Lightening
D.--

Ans:C.Lightening

59. False positive test against treponemal antigen is seen in ?
A.HIV
B.Infectious mononucleosis
C.Lyme's disesase
D.--

Ans:B.Infectious mononucleosis..


60. Medial boundary of Inguinal Ring is formed By?
A.Lacunar ligament
B.Pectineal ligament
C.Inguinal Ligamnet
D.--
Ans:A.Lacunar ligament
Reference:Kieth and Moore Anatomy

The boundaries of the femoral ring are as follows:
laterally, a femoral septum between the femoral canal and the femoral vein; posteriorly, the superior ramus of the pubis covered by the
pectineus and its fascia; ******medially, the lacunar ligament; and anteriorly, the medial part of the inguinal ligament.

61. Toxicity due to ethanol is because of which pathological mechanism?
A.Decreased NADH/NAD+
B.Decreased lactate/pyruvate
C.Inhbition of gluconeogenesis
D.Stimulation of fatty acid oxidation

Ans:C.Inhbition of gluconeogenesis.. Alcohol increases the NADH levels by its converision to aldehyde metabolites....
2.Because of Increased NADH/NAD+ ratio the Kreb's Cycle and Fatty acid Oxidation is halted as these are cycles which provide energy....when energy is already in EXCESS why do we need them.OPTION A and D ruled out
3.Pyruvate is converted to lactate as kreb's inhibited
4.Fatty acid synthesis is started
5. Gluconeogenesis is FAULTILY INHIBITED as the body thinks It has lot of energy ...In actual it does not.....this EXPLAINS HYPOGLYCEMIC episodes in Alcoholics----OPTION C

62. intranasal calcitonin used for?
A.Post menopausal Osteoporosis
B.Paget's Ds
C.--
D.--

Ans:A.Post menopausal Osteoporosis

Reference:Goodman and Gilman

Salmon calcitonin is approved for clinical use. The latter product also is available as a ****nasal spray, introduced for once-daily treatment of ****postmenopausal osteoporosis

63. Which of the following Psychiatric illness is common in a patient with stroke?
A.Schizophrenia
B.Depression
C.Bipolar disorder
D.Psychosis

Ans:B.Depression

Reference:Kaplan and sadock Psychiatry

Mood disorder caused by a general medical condition, with depressive features, appears to affect men and women equally, in contrast to major depressive disorder, which predominates in women. As much as 50 percent of all poststroke patients experience depressive illness

64. volkman's ischemic contracture seen in?
A.supracondylar fracture of humerus
B.Tibial plateau fracture
C. --
D. colles silver fork fracture
Ans:A.supracondylar fracture of humerus

65. Efferent neuron for skeletal muscle
A.Alfa motor neuron
B.Gamma motor neuron
C.Ia fibre
D.Ib fibre

Ans:A.Alfa motor neuron

Alfa motor neurone is the final common efferent for the skeletal muscle.....Gamma motor neurone is for the Muscle spindle

66. "aschoff bodies" are seen in?
A.rheumatoid arthritis
B.rheumatic fever
C.bacterial endocarditis
D.--
Ans:B.rheumatic fever ---seen in carditis

67. .Juvenile papillomatosis s caused by
A.Hpv
B.Ebv
C.cmv
D.--

Ans:A.Hpv

68. Biopsy of parotid gland in sjogren's shows
A.Lymphocytes
B.Neutrophils
C.Eosinophils
D.Basophils

Ans.A.Lymphocytes

Reference:Robbin's Pathology 8th ed

. As mentioned earlier, lacrimal and salivary glands are the major targets of the disease, although other exocrine glands, including those lining the respiratory and gastrointestinal tracts and the vagina, may also be involved. The earliest histologic finding in both the major and the minor salivary glands is periductal and perivascular *****lymphocytic infiltration. Eventually the lymphocytic infiltrate becomes extensive ( Fig. 6-35 ), and in the larger salivary glands lymphoid follicles with germinal centers may be seen.

69. best sonological marker for diagnosis of downs in 1st trimester
A.Nuchal transluscency
B.--
C.--
D.--

Ans:A.Nuchal transluscency

70. Primary sclerosing cholangitis, assoc with
A.Adenoca pancreas
B.adenoca GB
C.cholangioca
D.HCC

Ans:C.cholangioca
Reference:Sabiston surgery

A number of diseases have been linked to cholangiocarcinoma, including ***primary sclerosing cholangitis, choledochal cysts, and hepatolithiasis. Characteristics common to these diseases include bile duct stones, biliary stasis, and infection

71. Stretch reflex is detected by?

A.Muscle spindle
B. golgi tendon organ
C. proprioceptors
D.--

Ans :A.Muscle spindle

72. which of the following is not a objective hearing test?
A.impedance audiometry
B. otoacoustic emmissions
C. Bera
D. Puretone audiometry

Ans:D. Puretone audiometry

Depends on patients response so subjective

73. toxin responsible for staphyloccal toxic shock syndrome?
A. superantigenic toxin
B. alpha hemolysin
C. panton valentine toxin
D. coagulase

Ans:A. superantigenic toxin

74. which group of drugs potentiates the action of Neuromuscular blockers
A. Aminoglycosides
B.--
C.--
D.--

Ans:A. Aminoglycosides

75. .Extra mammary pagets MC seen in
A.Vulva
B.Vagina
C.Penis
D.--

Ans:A.Vulva

EXTRAMAMMARY PAGET DISEASE

This curious and rare lesion of the ****vulva, and sometimes the perianal region, is similar in its manifestations to Paget disease of the breast ( Chapter 23 ). As a vulvar neoplasm, it presents as a pruritic, red, crusted, sharply demarcated, maplike area, occurring usually on the labia majora. It may be accompanied by a palpable submucosal thickening or nodule.

76. Photopsia are present in which of the following?
A.Retinal detachment
B.Open angle glaucoma
C. Uveitis
D. --
Ans: A. Retinal detachment

77. Shoulder dislocation occurs commonly in wch direction
A.Anteriorly
B.Superiorly
C.Postriorly
D.Medially

Ans:A.Anteriorly

Reference:Ebenezer and Maheshwari Orthopedics

78. .Malignant hyperthermia s common with
A.Local anesthetics
B.Succinyl choline
C.Propofol
D.--

Ans:B.Succinyl choline

79. .Blowout injury refers to what?
A.Fracture of orbit
B.Fracture of maxillary antrum
C.--
D--

Ans:A.Fracture Orbit

80. Urea is formed by the action of the following enzyme?
A.Arginase
B.Ornithine transcarbamoylase
C.Aspartate..
D.---

Ans:A.Arginase

81. fetal heart septum is formed at
A.5-8 weeks
B..8-9 wks
C..10-12wks
D.--

Ans:A.5-8 weeks

Reference:Langman Embryology

Formation of the Cardiac Septa
The major septa of the heart are formed between the 27th(4 weeks) and 37th(5 weeks) days of
development, when the embryo grows in length from 5 mm to approximately
16 to 17 mm.

82. Which of the following is an early sign of Hypermagnesemia?
A.Hypotension
B.Loss of DTR
C.--
D.--
Ans:A.Hypotension

Reference:Harrison Medicine

Clinical and Laboratory Findings

The most prominent clinical manifestations of hypermagnesemia are vasodilation and neuromuscular blockade, which may appear at serum magnesium concentrations >2 mmol/L (>4 meq/L; >4.8 mg/dL). ******Hypotension, refractory to vasopressors or volume expansion, may be an ****early sign. Nausea, lethargy, and weakness may progress to respiratory failure, paralysis, and coma, with hypoactive tendon reflexes, at serum magnesium levels >4 mmol/L. Other findings may include gastrointestinal hypomotility or ileus; facial flushing; pupillary dilation; paradoxical bradycardia; prolongation of PR, QRS, and QT intervals; heart block; and, at serum magnesium levels approaching 10 mmol/L, asystole.

83. Progesteron causes stimulation of
A.Myometrial activation
b.Myometrial quessence
c.Increases Oxytocin receptors
d.Causes cervical ripening

Ans:b.Myometrial quessence

Reference:Ganong Physiology

The principal target organs of progesterone are the uterus, the breasts, and the brain. Progesterone is responsible for the progestational changes in the endometrium and the cyclic changes in the cervix and vagina described above. It has an antiestrogenic effect on the myometrial cells, ********decreasing their excitability, their sensitivity to oxytocin, and their spontaneous electrical activity while increasing their membrane potential

84. Endometrial ca wid poor prognosis
A.Adeno grade 2
B.Adenosquamous
C.Adenoacanthoma
D.Clear cell

Ans:D.Clear cell

Reference:Berek and Novak Gynecology

Clear cell carcinoma characteristically occurs in older women and is a *****very aggressive type
of endometrial cancer; the prognosis is similar to or worse than that of papillary serous
carcinoma. Overall survival rates of 33% to 64% have been reported. Myometrial invasion and
LVSI are important prognostic indicators

85. .Duct of Bellini are seen in?.
A.Kidney
B.Lung
C.Submandibular salivary gland
D.---

Ans:A.Kidney

86. A Female patient with hypertension and obese, normal pituitary function. has chronic headache.Most likely diagnosis is?
A.Cushing's disease
B.Empty sella syndrome
C.Prolactinoma
D.--

Ans:A.Cushing's disease

87. Clonidine acts on
a. sym ner v presynaptic end
b. vasomotor center
c. symph ganglion
d.

Ans:b. vasomotor center

Reference:See pic below

88. Ability to form a concept and generalise it
A.Concrete thinking
B.Abstract thinking
C.Intellectualisation
D.--

Ans:B.Abstract thinking

Reference:Kaplan and Sadok Psychiatry

Abstract Thought

Abstract thinking is the ****ability to deal with *****concepts. Patients can have disturbances in the manner in which they ****conceptualize or handle ideas. Can the patient explain similarities, such as those between an apple and a pear or between truth and beauty? Are the meanings of simple proverbs, such as “A rolling stone gathers no moss,” understood? Answers can be concrete (giving specific examples to illustrate the meaning) or overly abstract (giving too generalized an explanation).

89. umblical cord contains ?
A. 1 umblical a, 2 veins
B. 1 veins, 1 a
C. 2 a, 1 vein
D.--

Ans:C. 2 a, 1 vein

90. lower end of spinal cord in adults?
A. lower end of L1
B. lower end of L3
C. lower end of L2
D. upper end of L3

Ans:A. lower end of L1

91. .Multi drug resistance through plasmids is transferred by
A.Transduction
B.Transfection
C.Conjugation
D.Recombination

Ans:C.Conjugation

92. Metastatic prostate ca,trtmt
A.RT
B.estrogen therapy
C.GnRH analogs
D.RT wit chemotherapy

Ans:C.GnRH analogs

Reference:Harrison Medicine

The management of patients with castrate metastatic disease requires first that the castrate status be documented. Patients receiving an antiandrogen alone, whose serum testosterone levels are elevated, should be treated first with a *****GnRH analogue or orchiectomy and observed for response

93. .Poor prognostic factor in a pt with pancreatitis
A.Leucocytosis >20,000
B.Elev serum. amylase
C.Elev serum lipase
D Diastolic BP>90mm Hg

Ans:A.Leucocytosis >20,000---its a RANSON criteria

94. A man presents with weakness , pain in upper abd.,hyperpigmentation, arthritis, hyperglycemia and an enlarged palpable liver.Most probable diagnosis is
A.Haemochromatosis
B. Addisson's disease
C.Insulin Dependent DM
D.--

Ans:A Hemochromatosis

95. A man presents with weakness, tachycardia,sweating, palpitations, giddiness on fasting. Relieved on food..Diagnosis?
A.Insulinoma
B. Pancreatic ca
C. Carcinoid
D.--

Ans:A ..Insulinoma

96. which alpha 2 agonist is used to relieve spasticity in amyotrophic lateral sclerosis?
A.clonidine
B.Brimonidine
C.Apraclonidine
D.Tizanidine

Ans:D.Tizanidine

Reference:Katzung Pharmacology


Tizanidine

As noted in Chapter 11, agonists such as clonidine and other imidazoline compounds have a variety of effects on the central nervous system that are not fully understood. Among these effects is the ability to reduce muscle spasm. Tizanidine is a congener of clonidine that has been studied for its ***spasmolytic actions. ***Tizanidine has *****significant 2-adrenoceptor agonist effects, but it reduces spasticity in experimental models at doses that cause fewer cardiovascular effects than clonidine. Neurophysiologic studies in animals and humans suggest that tizanidine reinforces both presynaptic and postsynaptic inhibition in the cord. It also inhibits nociceptive transmission in the spinal dorsal horn.

97. von gierke"s disease false?
A.Metabolic acidosis
B.Hyperuricemia
C. Muscle atrophy
D.Hypertriglyceridemia


Ans:C. Muscle atrophy

Reference:Harrison Principles Of Medicine


98 . Obstruction at the bifurcation of aorta leads to
A.Claudication of buttocks and thigh
B.Retrograde ejaculation
C.Gangrene
D.Pallor of lower limb

Ans:A.Claudication of buttocks and thigh

Classically, it is described in male patients as a triad of symptoms consisting of:
****claudication of the buttocks and pages
atrophy of the musculature of the legs
impotence (due to paralysis of the L1 nerve)NOT RETROGRADE EJACULATION
Reference:Sabiston surgery

99. retroperitoneal fibrosis MC presents as
A.b/l pedal edema
B.ascites
C.ureteral obstruction
D.--

Ans:C.ureteral obstruction(REPEAT)

Reference:Sabiston

The fibrosis is usually confined to the central and paravertebral spaces between the renal arteries and sacrum and tends to encase the aorta, inferior vena cava, and ureters. The process usually begins at the level of the aortic bifurcation and spreads cephalad. In 15% of instances, the fibrotic process extends outside of the retroperitoneum to also involve the peripancreatic and periduodenal spaces, the pelvis, and the mediastinum.

Patients present with a vague constellation of symptoms, including abdominal or flank pain, weight loss, malaise, and hypertension. Scrotal or leg edema caused by lymphatic obstruction may also be present. Laboratory tests often provide evidence of renal insufficiency and anemia. Other laboratory abnormalities include an elevated erythrocyte sedimentation rate and an elevated C-reactive protein level.

100. Incidence Of H.Pylori in Gastric ulcer is
A.5%
B.20%
C.60%
D.80%

Ans: C.60%

Refernce : Harrison Medicine

H. pylori infection is virtually always associated with a chronic active gastritis, but only 10–15% of infected individuals develop frank peptic ulceration. The basis for this difference is unknown. Initial studies suggested that >90% of all DUs were associated with H. pylori, but H. pylori is present in only *****30–60% of individuals with ****GUs and 50–70% of patients with DUs.

412 - JIPMER 2011 questions with answers - part 1

1. Clue cell is seen in
A.Trichomonas vaginalis
B. Bacterial Vaginosis
C. Candidiasis
D, Herpes

Ans:B. Bacterial Vaginosis(REPEAT)

For repeats we shall not post references

2.Which of the following joint is a syndesmosis?
A.Superior Tibiofibular jt
B.Inferior tibiofibular jt
C.Talocalcaneal
D.Calcaneocuboid

Ans:B.Inferior tibiofibular jt(REPEAT) s type of Fibrous joint

3.Spring Ligament refers to:
A.Plantar Calcaneo-Navicular Ligament
B.Short planatar ligament
C.Long Plantar Ligament
D.--

Ans:A.Plantar Calcaneo-Navicular Ligament

Reference:Kieth and Moore Clinical anatomy

*****Plantar calcaneonavicular (spring) ligament , which extends across and fills a wedge-shaped gap between the sustentaculum
tali and the inferior margin of the posterior articular surface of the navicular. This ligament supports the head of the talus and plays
important roles in the transfer of weight from the talus and in maintaining the longitudinal arch of the foot.

4.Find the mean median and Mode of the following
1,2,2,2,3,4,4,6,7?
Straight answer:
Mean:3.4
Median:3
Mode:2

No reference needed

5.EEG is useful in evaluation of:
A.Intermittent Explosive disorder
B.Panic disorder
C. Anxiety disorder
D.Bipolar Disorder

Ans:A.Intermittent Explosive disorder

Reference : Kaplan and Saddock Psychiatry

Intermittent Explosive Disorder

Intermittent explosive disorder manifests as discrete episodes of losing control of aggressive impulses; these episodes can result in serious assault or the destruction of property. The aggressiveness expressed is grossly out of proportion to any stressors that may have helped elicit the episodes. The symptoms, which patients may describe as spells or attacks, appear within minutes or hours and, regardless of duration, remit spontaneously and quickly. After each episode, patients usually show genuine regret or self-reproach, and signs of generalized impulsivity or aggressiveness are absent between episodes. The diagnosis of intermittent explosive disorder should not be made if the loss of control can be accounted for by schizophrenia, antisocial or borderline personality disorder, ADHD, conduct disorder, or substance intoxication.
******The term epileptoid personality has been used to convey *****the seizure-like quality of the characteristic outbursts, which are not typical of the patient's usual behavior, and to convey the suspicion of an organic disease process, for example, damage to the central nervous system. Several associated features suggest the possibility of an epileptoid state: the presence of auras; postictal-like changes in the sensorium, including partial or spotty amnesia; and hypersensitivity to photic, aural, or auditory stimuli.

6. Sigmud freud'sPrimary Process of thinking is

A.unconcious and primitive aspect
B.absent in dreams
C.Illogical and bizzare
D.Rational

Ans:C.Illogical and bizzare

Reference:Kaplan and Saddok Psychiatry

The mechanisms of condensation, displacement, and symbolic representation are characteristic of a type of thinking that Freud referred to as ****primary process. *****This primitive mode of cognitive activity is characterized by ***illogical, bizarre, and absurd images that seem incoherent.

7.Linezolid belongs to which class of Drugs?
A.Macrolide
B.Aminoglycoside
C.Oxazolidinones
D.Streptogamins

Ans:C.Oxazolidinones

Reference: Katzung Pharmacology
Linezolid is a member of the *****oxazolidinones, a new class of synthetic antimicrobials. It is active against gram-positive organisms including staphylococci, streptococci, enterococci, gram-positive anaerobic cocci, and gram-positive rods such as corynebacteria and Listeria monocytogenes. It is primarily a bacteriostatic agent except for streptococci, for which it is bactericidal. It is active in vitro against Mycobacterium tuberculosis.

8.Which of the following Antibiotics has a NONSPECIFIC MAO INHIBITOR activity?
A.tazobactum
B.ampicillin
C.spectinomycin
D.Linezolid

Ans:D.Linezolid

Reference:Goodman and Gilman Pharmoacology

Linezolid is a weak, ******nonspecific inhibitor of monoamine oxidase. Patients receiving concomitant therapy with an adrenergic or serotonergic agent or consuming more than 100 mg of tyramine a day may experience palpitations, headache, or hypertensive crisis. Peripheral and optic neuropathy, which seem to be reversible upon drug discontinuation, have been reported with prolonged use.

9.Nephrotic syndrome associated with malaria due to infection of
A.P.falciparum
B.P.malariae
C.P.ovale
D.P.vivax

Ans:B.P.malariae

Referece:Harrison Principles Of Internal Medicine

Quartan Malarial Nephropathy

Chronic or repeated infections with ****P. malariae (and possibly with other malarial species) may cause soluble immune-complex injury to the renal glomeruli, resulting in the ****nephrotic syndrome. Other unidentified factors must contribute to this process since only a very small proportion of infected patients develop renal disease.

10. which agent is effective in killing spores?
A.Alcohol
B.Phenol
C.Chlorine
D.Aldehyde

Ans:D.Aldehyde(REPEAT)

11.Colour of urine in phenol poisoning?
A.Red
B.Green
C.Yellow
D.Blue

Ans:B.Green(REPEAT 2010--answer by PG PYREXIA)

12.Hypocalcemia is associated with:
A.Metabolic acidosis
B.QT prlongation
C.--
D.--

Ans:B. QT prolongation(REPEAT)

13.OC pills has been shown to be useful in the prevention of which of the following Malignancies:TRICKY ONE...
A.ca colon
B.ca endometrium
C.ca breast
D.ca Ovary

Ans: D>B

OCP use decreses the risk of Ovarian and Endometrial cancer with more effectiveness for Ca Ovary----""""Open for discussion"""

14. Short head of biceps atttached to :
A.coracoid process
B.supraglenoid tubercle
C.acromion process
D.bicipital groove
Ans:A. coracoid process(REPEAT)

15.vasectomy leads to A/E
A.Scrotal hematoma
B.Infection
C.Decreased libido
D.Anti spermin antibody

Ans: C.decreased libido(REPEAT)

16. Carbon monoxide poisoning is type of
A.Anemic hypoxia
B.Histotoxic hypoxia
C.Hypoxemic hypoxia
D.Stagnant hypoxia

Ans:A.Anemic hypoxia

Reference:Ganong's Physiology

CO is toxic because it reacts with hemoglobin to form carbon monoxyhemoglobin (carboxyhemoglobin, COHb), and COHb cannot take up O2 (Figure 36–15). Carbon monoxide poisoning is often listed as a ****form of** **anemic hypoxia because the amount of hemoglobin that can carry O2 is reduced, but the total hemoglobin content of the blood is unaffected by CO.

17. Posterior gastric artery is a branch of
A. Splenic art
B.Hepatic art
C.Left gastric.
D. Right Gastric artery

Ans.A.Splenic artery


18.VDRL Is most sensitive in the diagnosis of which stage of syphilis?
A.Primary
B.Secondary
C.Tertiary
D.Reactivation

Ans:B.Secondary(REPEAT2009 JIPMER)

19. Carpal tunnel syndrome is due to compression of
A.Median nerve
B.Ant.interosseus ner
C.Radial nerve
D.Ulnar nerve

Ans:A.Median nerve(REPEAT)

20.Which has least hypotensive side effect?
A.Flufenazine
B.Trifluoroperazine
C.Thioridazine
D.Haloperidol.

Ans:C.Thioridazine(REPEAT 2009)

21. Which of the following Nuclei DOES not lie in the floor of 4th ventricle ?

A. Abducens Nerve
B. Facial Nerve
C. Hypoglossal Nerve
D. Vagus Nerve

Ans:B.Facial nerve(REPEAT JIPMER 1992)

22.Mackintosh curved blade laryngoscope is used in ?
A.Indirect laryngoscopy
B.Direct laryngoscopy
C.Video laryngoscopy
D.--

Ans:B.Direct laryngoscopy

23.Grasp reflex deveops at?
A.20 weeks
B.24Weeks
C.28 weeks
D.32 weeks

Ans:C.28 weeks
Reference: Nelson pediatrics

24.killed vaccine ?
A.polio
B.hepatitis b
C.yellow fever
D.Japanese encephalitis

Ans:D.Japanese encephalitis (REPEAT)

25.Which is Eaton agent ?
eaton agent ?
A.Mycoplasma
B.H.influenza
C.Klebsiella
D.--

Ans:A.Mycoplasma

26.Hassal corpuscles are seen in?
A.Thymus
B.Thyroid
C.Parathyroid
D.--
Ans:A.Thymus

27.Cystisarcoma phylloides TOC in a young female?
A.Wide excision with a margin
B.WE and chemo
C.WE and Radio
D.--

Ans:A.Wide excision with a margin

Reference:Sabiston surgery

****Local excision of a benign phyllodes tumor is curative, and clearly benign tumors are treated like a fibroadenoma. There is a group of intermediate tumors, so-called borderline phyllodes tumors, in which it is difficult to assign a benign label. These tumors are treated by excision with margins of at least 1 cm. Affected patients are at some risk for local recurrence, most often within the first 2 years after excision, and close follow-up with examination and imaging allows early detection of recurrence.

28.Pepsin is activated by:
A.HCL
B.Enterokinase
C.--
D.--

Ans:A.Hcl
Refernce:Ganong physiology

The pepsin precursors are called pepsinogens and are activated by ***gastric acid.

29.In post natal period the greatest growth in the CNS is of?
A.Cell body
B.Axon
C.Dendrite
D.Size of perikaryon

Ans:C.Dendrite(REPEAT--KCET 2001)

30.Ongoing hemolysis by whic of the following
A. Target cells
B. Acanthocytes
C. Schistocytes
D. ---
Ans:C Schistocytes

31.All muscles are innervated by oculomotor nerve except

a. superior rectus
b. inferior rectus
c. lateral rectus
d. medial rectus
Ans - c LR

32.Insulin mediated uptake of glucose into muscle is through?
A.GLUT 2
B.GLUT 4
C.--
D.--

Ans:B.GLUT 4
Reference:Lippincott Biochemistry

Membrane effects of insulin: Glucose transport in some tissues, such as skeletal muscle and adipocytes, increases in the presence of insulin (Figure 23.Cool. Insulin promotes the recruitment of insulin-sensitive glucose transporters ***(GLUT-4, see p. 97) from a pool located in intracellular vesicles. [Note: Some tissues have insulin-independent systems for glucose transport

33.Northern Blotting is for:
A.RNA
B.DNA
C.Protein
D.--

Ans:A.RNA

34.Trotters triad includes all except?
A. Diplopia
B. Conductive deafness
C. Ipsilateral temporoparietal neuralgia
D.Palatal paralysis

Ans:A. Diplopia

35.immuno complex reaction
A. Type 1
B. Type 2
C. Type 3
D. Type 4

Ans:C. Type 3(REPEAT)

36.7-Methyl guanosine cap is present in?
A.mRNA
B.tRNA
C.rRNA
D.DNA

Ans:A.mRNA

37.lactating mother best contraceptive is
a. monophasic pill
b. biphasic pill
c. triphasic pill
d. mini pill
Ans: D .minipill(REPEAT)

38.Juene syndrome is
1.AR
2.AD
3.X LINKED DOMINANT
4.X LINKED RECESSIVE
Ans:1.AR
Reference:Emedicine

39.Sample of spinal cord preseved in...
a.oleander poisoning
b.war gases
c.Strychnine poisoning
d.arsenic poisoning

Ans:c.Strychnine poisoning (REPEAT)

40.Candida albicans infection seen in
A. chronic granulomatous disease
B. leukocyte alkaline def
C. myeloperoxidase deficiency
D. chediak - hegasky syndrome

Ans:C. myeloperoxidase deficiency

Reference:Harrison Medicine

Clinically normal except in patients with underlying disease such as diabetes mellitus; then ****candidiasis or other fungal infections

41.Kimmesteil wilson lesion is
A.Hyaline arteriosclerosis
B.Nodular glomerulosclerosis
C.--
D.--

Ans: B.Nodular glomerulosclerosis(REPEAT)

42.Function of ubiquitin in the Cell is?
A.Degradation of intracellular protein
B.Endocytosis
C.?? No mention of apoptosis in the Q
D.Plays an important role in acute inflammation

Ans:A.Degradation of intracellular protein(REPEAT)

43.Sudden onset of Delsuions De Novo in a 35yrs old man with no previous symptom should prompt the physician to think of?

1.substance abuse
2.schizophrenia
3.--
4.--

Ans:1.substance abuse

44.bulls eye retinopathy is seen in toxicity of? A.quinine
B.tobacco
C.ethanol
D.Choroquine

Ans:D.Choroquine(REPEAT)

45.pterygium causes?
A. astigmatism
B.Myopia
C.Hypermetropia
D.--

Ans:A. astigmatism

Reference:Khurana Ophthalmology

Pterygium is an asymptomatic condition in the early stages, except for cosmetic intolerance. Visual disturbances occur when it encroaches the pupillary area or due to corneal ****astigmatism induced due to fibrosis in the regressive stage.

46.Coxsackie A virus causes all except
A. aseptic meningitis
B. herpangina
C. pleurodynia
D. bornholm ds
Ans:D. bornholm ds

Reference:Nelson Pediatrics

Pleurodynia (Bornholm disease) is an epidemic or sporadic illness characterized by paroxysmal thoracic pain, due to myositis involving chest and abdominal wall muscles. Etiologic agents are most frequently coxsackieviruses B3 and B5, as well as coxsackieviruses B1 and B2 and echoviruses 1 and 6.

47.Drug most useful for Bacteriodes fragilis is?
A.cefipime
B.ceftazidime
C.cefoxitin
D.cefotetan

Ans:D.cefotetan

Reference : Goodman and Gilman Pharmacology

Cefotetan is a cephamycin, and like cefoxitin, it has *****good activity against ****B. fragilis. It also is effective against several other species of Bacteroides, and it is slightly more active than cefoxitin against gram-negative aerobes. After an intramuscular dose of 1 g, peak plasma concentrations of cefotetan average 70 g/ml. It has a half-life of 3.3 hours (Phillips et al., 1983; Wexler and Finegold, 1988). Hypoprothrombinemia and inhibition of vitamin K activation with bleeding have occurred in malnourished patients receiving cefotetan owing to the methyl-tetrazole-thiomethyl (MTT) group at position 3; this is preventable if vitamin K is administered as well.

48.Long acting local anaestheic agent
a. procaine
b. lidocaine
c. bupivacaine
d.--
Ans:c. bupivacaine

49.which antiepileptic drug is idicated in pregnancy ?
a. valproic acid
b. carbamazepine
c. trimetazadone
d. dilatin
Ans:B. carbamazepine

50.True about glasgow coma scale ?

a. highest score means bad prognosis
b. It includes measuring pupillary size
c. --
d. it include verbal response

Ans:d. it include verbal response. 

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