Tuesday, February 15, 2011

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?


*****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?
c.32 g

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
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
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
D.200Joule Defibrillation

Ans:D.200Joule Defibrillation

58. Filigree burns seen in
B.Electrical burn


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

Ans:B.Infectious mononucleosis..

60. Medial boundary of Inguinal Ring is formed By?
A.Lacunar ligament
B.Pectineal ligament
C.Inguinal Ligamnet
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

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?
C.Bipolar disorder


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
Ans:B.rheumatic fever ---seen in carditis

67. .Juvenile papillomatosis s caused by


68. Biopsy of parotid gland in sjogren's shows


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

Ans:A.Nuchal transluscency

70. Primary sclerosing cholangitis, assoc with
A.Adenoca pancreas
B.adenoca GB

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

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

Ans:A. Aminoglycosides

75. .Extra mammary pagets MC seen in



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


Reference:Ebenezer and Maheshwari Orthopedics

78. .Malignant hyperthermia s common with
A.Local anesthetics
B.Succinyl choline

Ans:B.Succinyl choline

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

Ans:A.Fracture Orbit

80. Urea is formed by the action of the following enzyme?
B.Ornithine transcarbamoylase


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

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?
B.Loss of DTR

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
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?.
C.Submandibular salivary gland


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

Ans:A.Cushing's disease

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

Ans:b. vasomotor center

Reference:See pic below

88. Ability to form a concept and generalise it
A.Concrete thinking
B.Abstract thinking

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

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


92. Metastatic prostate ca,trtmt
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
B. Addisson's disease
C.Insulin Dependent DM

Ans:A Hemochromatosis

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

Ans:A ..Insulinoma

96. which alpha 2 agonist is used to relieve spasticity in amyotrophic lateral sclerosis?


Reference:Katzung Pharmacology


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
C. Muscle atrophy

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
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
C.ureteral obstruction

Ans:C.ureteral obstruction(REPEAT)


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

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.

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