Thursday, March 24, 2011

422 - NIMS (Nizam's Institute Hyderabad) 2011 Paper with answers

The key is given below .

Q001 C
Q002 B
Q003 A
Q004 D
Q005 A
Q006 D
Q007 C
Q008 A
Q009 C
Q010 B
Q011 D
Q012 C
Q013 B
Q014 C
Q015 A
Q016 C
Q017 B
Q018 A
Q019 C
Q020 B
Q021 C
Q022 B
Q023 A
Q024 C
Q025 B
Q026 A
Q027 B
Q028 C
Q029 C
Q030 B
Q031 A
Q032 C
Q033 B
Q034 A
Q035 D
Q036 D
Q037 A
Q038 B
Q039 A
Q040 D
Q041 B
Q042 D
Q043 C
Q044 C
Q045 B
Q046 C
Q047 D
Q048 A
Q049 D
Q050 B
Q051 B
Q052 B
Q053 C
Q054 C
Q055 B
Q056 A
Q057 B
Q058 A
Q059 C
Q060 C
Q061 B
Q062 A
Q063 C
Q064 A
Q065 A
Q066 D
Q067 B
Q068 C
Q069 D
Q070 A
Q071 B
Q072 B
Q073 A
Q074 C
Q075 C
Q076 D
Q077 B
Q078 B
Q079 C
Q080 D
Q081 B
Q082 A
Q083 C
Q084 B
Q085 A
Q086 A
Q087 D
Q088 B
Q089 C
Q090 A
Q091 B
Q092 B
Q093 C
Q094 B
Q095 C
Q096 C
Q097 B
Q098 C
Q099 D
Q100 D
Q101 A
Q102 D
Q103 B
Q104 A
Q105 B
Q106 A
Q107 D
Q108 B
Q109 A
Q110 A
Q111 A
Q112 A
Q113 B
Q114 C
Q115 A
Q116 D
Q117 D
Q118 A
Q119 C
Q120 C
Q121 B
Q122 D
Q123 C
Q124 A
Q125 A
Q126 D
Q127 B
Q128 C
Q129 B
Q130 A
Q131 A
Q132 B
Q133 B
Q134 B
Q135 B
Q136 D
Q137 B
Q138 A
Q139 C
Q140 D
Q141 D
Q142 D
Q143 C
Q144 D
Q145 C
Q146 C
Q147 B
Q148 D
Q149 D
Q150 B
Somebody(sony) asked me for explanation to question 44, here it goes :

The question : 35year - female - 8 months of secondary amenorrhea. Last child birth 2 years ago. pregnancy test - negative. thyroid function tests - normal. estrogens decreased. FSH - high. most probable diagnosis ?
a.asherman syndrome
b.polycystic ovarian disease
c.premature ovarian failure
d.sheehan syndrome

explanation : asherman syndrome is a condition where there are uterine synechiae, most commonly secondary to infection, that arrest the menstrual blood from flowing out of the uterus leading to secondary amenorrhea. this condition is not related to the ovaries(estrogen producer) or FSH producer (pituitary)  in anyway and so there is no way that the estrogen and FSH levels will be affected. PCOD is a condition where the ratio of LH/FSH is increased and so naturally the FSH levels will be low rather than high.PCOD is more over a disease of young unmarried girls, where both the androgens and estrogens (all 3 combined) will be increased. postpartum pituitary apoplexy, also called sheehan syndrome affects the pituitary gland, which leads to altered prolactin levels, that are not seen in this case. so the answer is premature ovarian failure. (This is for you SONY, sorry for the delay of 8 months ;-)) 

Wednesday, March 9, 2011

421 - AP PG 2011 (Andhra pradesh) PAEDIATRICS questions with answers

1q: All of the following illnesses are included under IMCI except
a. Diarrhea
b. Respiratory tract infections
c. Malaria
d. Childhood TB

2q: Which of the following are components of FETAL HEMOGLOBIN?
a. alpha2 beta2
b. alpha2 delta2
c. alpha2 gamma2
d. alpha2 zeta2

3q: All of the following are true about rheumatic fever except
a. affects children between 5-15 years
b. arthritis is migratory type
d. arthritis stays for more than 6 months

4q: APT test is used for
a. To detect blood in fetal stool

5q: ASD with left axis deviation is seen in
a. Leutembacher's syndrome
b. Ostium primum
c. Ostium secondum

6q: Miliary TB in a child develops due to
a. Rupture of the cavity
b. Lymphohematogenous dissemination

7q: All of the following are true about Symmetric Tonic Neck Reflex except
c. It is seen only pathologically and in cerebral damage

8q: A baby is affected after 2 weeks of birth .... law relating to congenital syphilis
a. Diday's law
b. Colle's law
c. Kassowitz law
d. Profeta'a law

9q: Leukemias are seen usually associated with which of the following condition
a. Klinefelter's syndrome
b. Down syndrome
c. Turner's syndrome

10q: In a baby it is extremely difficult to pass a nasopharyngeal tube. There is collapse of the superior lobe and there is no gas in the abdomen. What is the probable diagnosis?
a. Proximal atresia with distal tracheoesophageal fistula
b. H shaped fitula

11q: A baby is not taking feeds and on force feeding vomits the milk. He is taking other fluids. What is the next investigation
a. urine galactose

420 - AP PG 2011 (Andhra pradesh) PATHOLOGY questions with answers

1q: Spider cells are seen in
a. Cardiac myxoma
b. Cardiac rhabdomyoma

2q: Crescents are seen in

3q: Dacrocytes are also called as
a. Tear drop cells

4q: Frozen section is done for
a. Fat
b. Amyloid
c. Glycogen

a. acute phase reactant

6q: H.pylori causes cancer by
a. Metaplasia

7q: Metastatic calcification is done by
a. Hyperparathyroidism

Tuesday, March 8, 2011

419 - AP PG 2011 (Andhra pradesh) MEDICINE questions with answers

1q: Which of the following is false about Bacillary angiomatosis?
a. Caused by bartonella
b. Involves liver causing peliosis hepatis
c. Responds to aminoglycosides
d. Involves the CNS

Explanation : Harrison 17th edition mentions erythromycin and doxycycline, but does not mention aminoglycosides. The rest of the statements are definitely true.

2q: Which of the following is false statement regarding Sarcoidosis?
a. Bilateral hilar adenopathy
b. Pleural involvement

3q: Abatacept is used in the treatment of
a. Rheumatoid arthritis
b. SLE

4q: Eculizumab is used in the treatment of
a. PNH
b. Scleroderma

5q: Subungual telangiectasias are pathognomonic of all except
a. SLE
b. DM
c. Mixed connective tissue disorder
d. Scleroderma

418 - AP PG 2011 (Andhra pradesh) OBSTETRICS questions with answers

1q: The rate of production of which of the following hormone is highest during pregnancy?
a. HCG
b. HPL
c. Progesterone
d. Estradiol


There are five genes in the growth hormone–placental lactogen gene cluster that are linked and located on chromosome 17. Two of these genes, hPL2 and hPL3, both encode hPL, and the amount of mRNA in the term placenta is similar for each. In contrast, the prolactin gene is located on chromosome 6 (Owerbach and colleagues, 1980, 1981). The production rate of hPL near term, about 1 g/day, is the greatest, by far, of any known hormone in humans.

2q: Which of the following has the highest carbohydrate content?
a. HCG
b. HPL
c. Human pregnancy specific beta glycoprotein

Read the below lines taken from WILLIAMS OBSTETRICS 22ND EDITION :

Chorionic gonadotropin is a glycoprotein (molecular weight 36,000 to 40,000 d) with the highest carbohydrate (30 percent) content of any human hormone. The carbohydrate component, and especially the terminal sialic acid, protects the molecule from catabolism. The 36-hour plasma half-life of intact hCG is much longer than the 2 hours for LH. The hCG molecule is composed of two dissimilar subunits, designated (92 amino acids) and (145 amino acids), which are noncovalently linked. They are held together by electrostatic and hydrophobic forces that can be separated in vitro. Isolated subunits are unable to bind the LH receptor and thus lack biological activity.

3q: What happens to Central venous pressure during pregnancy?
a. Increases markedly
b. Increases slightly
c. Remains the same
d. Decreases

4q: Which type of placenta is called dangerous placenta
a. Type 2 anterior
b. Type 2 posterior
c. central

5q: The level of which of the following clotting factor is decreased in pregnancy?
a. 7
b. 9
c. 2
d. 11

Monday, March 7, 2011

417 - AP PG 2011 (Andhra pradesh) SURGERY questions with answers

1q: The minimum amount of blood required to cause malena ?
a. 20 ml
b. 40 ml
c. 60 ml
d. 150 ml

2q: What is the most common cause of bleeding per rectum in a 5 year old child ?
a. Anal fistula
b. Meckel's diverticulum
c. Anal fissure
d. Rectal polyp

3q: What is the most common malignancy of liver?
a. Hepatocellular carcinoma
b. Metastasis
c. Angiosarcoma

4q: Which of the following statements is false regarding carcinoid tumors?
a. Involve the mucosa
b. Multicentric
c. Small intestinal carcinoids are of fibrosing variety

5q: What is the most common site of perforation in a peptic ulcer ?
a. Anterior of the first part of duodenum
b. Posterior of the first part of duodenum

6q: Large breast is not a feature of which carcinoma
a. Large fibroadenoma
b. cystosarcoma phylloides
d. Scirrhous carcinoma

7q: What is the treatment of choice for medullary carcinoma of thyroid?
a. Total thyroidectomy
b. Subtotal thyroidectomy
c. hemithyroidectomy
d. Lobectomy

8q: Which of the following is not an absolute contraindication for organ donation?
a. Cardiopulmonary arrest for 15 minutes
b. HIV
c. Malignancy ( except primary brain tumors and low grade skin melanoma )
d. Age of the patient greater than 70

9q: Which of the following is false regarding Hirschsprung's disease?
a. Auerbach's plexus is absent
b. Small intestine is not involved

10q:All of the following are common complications of femoral vein catheterisation except
a. DVT
b. Bleeding
c. Infections

11q: A 2.5 cm stone is found in the renal pelvis of a child. What is the best management?

12q: Most common cause of post renal acute renal failure?
a. Renal stones
b. Retroperitoneal fibrosis
c. Bladder neck obstruction
d. Urethral stenosis

13q: Which of the following is false regarding blunt trauma to the pancreas?
a. Pancreatic necrosis can occur
b. Most commonly presents as an isolated pancreatic injury

14q: Treatment of choice for a 8mm stone in the CBD?
b. endoscopic bile duct exploration

15q: Which of the following is false regarding Oesophageal injury?
a. Penetrating injury is the most common type of injury
b. Barium swallow is used for diagnosis

416 - AP PG 2011 (Andhra Pradesh) ENT questions with answers

1q: Which of the following is not a quadrant of tympanic membrane?
a. Posterosuperior
b. Anteroinferior
c. Posteroinferior
d. Posteroanterior

2q: Crypta magna is seen in
a. Palatine tonsil
b. Nasopharyngeal tonsil
c. Lingual tonsil

3q: Which of the following is true regarding acute epiglottitis?
a. Urgent laryngoscopy is done
b. The mostcommon causative organism is staphylococcus
c. Thumb print sign is seen on lateral x-ray

4q: Epley maneuvre is done for
b. acute labyrinthitis

5q: Which of the following is true regarding cochlear implants?
a. Placed in round window
b. Cochlear malformation is not a contraindication for its placement

6q: What is the wavelength of Co2 laser
a. 1060 nm
b. 10600 nm

7q: Foot plate of stapes (oval window) opens into
a. scala vestibuli
b. scala tympani

8q: Perichondritis of the pinna is caused by
a. streptococcus
b. staphylococcus
c. pseudomonas

9q: Normal conversation in a quiet room is ____ decibels
a. 20-30
b. 30-40
c. 40-50
d. 50-60

*180 decibels, equivalent to a rocket launching pad [hearing loss inevitable].
*140 decibels, equivalent to a gunshot blast, jet plane take-off at close range [approximately 200 feet], air raid siren [any length of exposure time is dangerous and is at the threshold of pain].
*130 decibels, equivalent to sound vibrations felt, as with thunder or near a four-engine jet at thirty meters.
*125 decibels, equivalent to a diesel engine room.
*120 decibels, equivalent to an amplified rock concert in front of speakers, sand-blasting, thunderclap [immediate danger], a nearby airplane engine, some rock or hard-metal cacophony groups, pneumatic hammer at one meter, thunderclap over head [at around 120 dB, the sensation of hearing is replaced by that of pain].
*110 decibels, equivalent to deafening factory noises and some musical boxes turned up too loudly, discotheque, thunder, rock-n-roll band.
*108 decibels, equivalent to the coqui frog croak of Puerto Rico [up to 108 dB].
*105 decibels, In a Malaysian surgical-glove factory, making surgical-latex gloves by dipping porcelain models of the human hand into liquid latex, which when dried, is blown off the hands by air jets. Before modifications to the air jets, the gloves were blown off every 30 seconds at a deafening 125 decibels.
*100 decibels, equivalent to a chain saw, pneumatic drill, printing plant, jackhammer, speeding express train, some car horns at five meters, farm tractor, riveting machine, some noisy subways [about 20 feet].
*90 decibels, equivalent to a police whistle, heavy traffic, truck traffic, noisy home appliances subway-rail train, pneumatic drill [or hammer] at one meter, walk-man ear phone [average volume], rock drill at 100 feet, some motorcycles at 25 feet, shouted conversation.
*80 decibels, equivalent to heavy city traffic [25-50 feet], alarm clock at two feet, factory noise, vacuum cleaner, heavy truck, loud-radio music, garbage disposal.
*70 decibels, equivalent to typewriter, average factory noise, busy traffic [at one meter], office tabulator, noisy restaurant [constant exposure], quiet vacuum cleaner, TV.
*60 decibels, equivalent to an air conditioner at twenty feet, conversation [at one meter], sewing machine, large transformer, ordinary or average street traffic.
*50 decibels, equivalent to quiet radio, average home, light traffic at a distance of 100 feet, refrigerator, gentle breeze, average office, non-electric typewriter, ordinary spoken voice.
*40 decibels, equivalent to quiet office, living room, bedroom away from traffic, residential area [no traffic]; many computer hard drives range an average of 40-50 dB, soft whisper [five feet].
*30 decibels, equivalent to quiet conversation, soft whisper, quiet suburb, speech in a broadcasting studio.
*20 decibels, equivalent to whispering, ticking of a watch [by the ear], rural area [without loud farm machinery or other excessive noises].
*10 decibels, equivalent to the rustling of leaves.
*0-1 decibels, equivalent to the faintest sounds that can be heard, the threshold of audibility.

10q: Anaesthesia used in Dacryocystorhinostomy?
a. Frontal nerve block
b. Nasociliary nerve block
c. Infraorbital nerve block

11q: Which cells of the cochlea generate action potentials
a. Outer hair cells
b. Inner hair cells

415 - AP PG 2011 (Andhra pradesh) ANATOMY questions with answers

1q: All of the following muscles are part of rotator cuff except
a. Deltoid
b. Supraspinatus
c. Infraspinatus
d. Teres minor

2q: All of the following are branches of celiac trunk except
a. Left gastric artery
b. Common hepatic artery
c. Splenic artery
d. Superior mesenteric artery

3q: All of the following are seen in the greater wing of sphenoid except
a. Foramen ovale
b. Foramen spinosum
c. Foramen rotundum
d. Optic canal

The superior or cerebral surface of each greater wing forms part of the middle cranial fossa; it is deeply concave, and presents depressions for the convolutions of the temporal lobe of the brain. It has a number of foramina (holes) in it:
The foramen rotundum is a circular aperture at its anterior and medial part; it transmits the maxillary nerve.
The foramen ovale is behind and lateral to this; it transmits the mandibular nerve, the accessory meningeal artery, and sometimes the lesser petrosal nerve.
The sphenoidal emissary foramen is occasionally present; it is a small aperture medial to the foramen ovale, opposite the root of the pterygoid process; it opens below near the scaphoid fossa, and transmits a small vein from the cavernous sinus.
The foramen spinosum, in the posterior angle near to and in front of the spine; it is a short canal which transmits the middle meningeal vessels and a recurrent branch from the mandibular nerve.

The lateral surface is convex, and divided by a transverse ridge, the infratemporal crest, into two portions.
The superior temporal surface, convex from above downward, concave from before backward, forms a part of the temporal fossa, and gives attachment to the temporalis;
the inferior infratemporal surface, smaller in size and concave, enters into the formation of the infratemporal fossa, and, together with the infratemporal crest, serves as an attachment to the lateral pterygoid muscle.
It is pierced by the foramen ovale and foramen spinosum, and at its posterior part is the sphenoidal spine, which is frequently grooved on its medial surface for the chorda tympani nerve.
To the sphenoidal spine are attached the sphenomandibular ligament and the tensor veli palatini muscle.
Medial to the anterior extremity of the infratemporal crest is a triangular process which serves to increase the attachment of the lateral pterygoid muscle; extending downward and medialward from this process on to the front part of the lateral pterygoid plate is a ridge which forms the anterior limit of the infratemporal surface, and, in the articulated skull, the posterior boundary of the pterygomaxillary fissure.

4q: All of the following are included in basal ganglia except
a. Lenticular nucleus
b. Globus pallidus
c. Thalamus
d. Claustrum

The claustrum, which is suspected to be present in all mammals, is a fairly thin (fraction of 1 mm to multiple mms) vertical curved sheet of subcortical gray matter oriented sagittally between the white matter tracts of the external capsule and extreme capsule. The Claustrum is lateral to the putamen and medial to the insular cortex and is considered by some sources to be part of the basal ganglia. There are lateral and medial tracts connecting to many cortices and perhaps to the hippocampus, the amygdala, and the caudate nucleus (connections with subcortical centers are a matter of debate).

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