AIIMS-NOV-2012 TOTAL 200 Q WITH ANS ND EXPL
AIIMS NOV 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 4th 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 4th vol 1 p123
4. "Root value of long thoracic nerve a. C345 b. C567 c. C78 t1 d. C234 Answer: B (C567) Refernce: BDC 4th 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 4th 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 4th /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/ep 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 40th Edition Page 713, 728
10. Ciliary muscle develops from a. Surface ectoderm b. Neural crest mesenchyme c. Endoderm d. Neuroectoderm Answer: (d) Neural crest mesenchyme Reference: Langman Embryology 11 Edition Pg. 337
11. Epiglottis develop from a. 1st pharyngeal arch b. 2nd pharyngeal arch c. 3rd pharyngeal arch d. 4th pharyngeal arch Answer: (d) 4th pharyngeal arch Reference: Langman Embryology 11 Edition pg. 277
PHYSIOLOGY
12.Which is not second messenger? a. cAMP b. IP3 c. Guanylyl cyclase d. Diacylglycerol Answer. (c) Guanylyl cyclase Reference : Ganong 22nd edition, pages 37, 42, 43
13.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 22nd edition, pages 632, 633, 602
14.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 22nd edition, page 573
15.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, 11th edition, page 138
16.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 22nd 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 22nd 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 vertebra.immediately after the shot he loses 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 4th /ed pg-435-39; Harper 28th /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 8th 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 8thedpg 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 8th 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 7th Edition p 988, 989, /Robbins 8th 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 8th 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 8th 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 8th 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, 5th 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, 5th Ed, Dhikav V, Newer Drugs’ 2012, 2nd 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, 5th 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, 5th 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, 5th Ed, AITBS Publishers, BG Katzung’s Basic & Clinical Pharmacology, 11th 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, 5th 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 6th 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, 5th 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 8th 609; Reference: Harrison 's 18th /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 17th /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 8th /307; Reference; Lippincort's Microbiology 2nd/'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 /17th Edition Pg.299, KDT/6th 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 10th Edi. Pg. 726-731: KDT 6th 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 4th 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 29th 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 29th 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 29th 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 17th / 886, ‘ Head and Neck Surgery Otolaryngology’ by Bailey 4th / 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, 5th 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, 1st 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, 21st 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, 21st 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, 2nd 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, 21st 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, 21st 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, 21st 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, 21st 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, 21st 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, 21st 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 4th 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 17th 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 09th 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 09th 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 09th 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 09th 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 09th 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 09th 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 22nd 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 18th 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 18th 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 18th 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 18th 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 18th (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 18th 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 18th 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 18th 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 18th 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 18th 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 18th 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 17th 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: 18th 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 18th 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 18th 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 18th edition/chapter 297, Bailey and love 26th 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 18th 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 18th 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 8th 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 18th 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, 25th Edition ,page No: 930, Sabiston textbook of surgery 18th 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 7th 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 18th 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. /7th 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
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 4th 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 4th vol 1 p123
4. "Root value of long thoracic nerve a. C345 b. C567 c. C78 t1 d. C234 Answer: B (C567) Refernce: BDC 4th 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 4th 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 4th /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/ep 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 40th Edition Page 713, 728
10. Ciliary muscle develops from a. Surface ectoderm b. Neural crest mesenchyme c. Endoderm d. Neuroectoderm Answer: (d) Neural crest mesenchyme Reference: Langman Embryology 11 Edition Pg. 337
11. Epiglottis develop from a. 1st pharyngeal arch b. 2nd pharyngeal arch c. 3rd pharyngeal arch d. 4th pharyngeal arch Answer: (d) 4th pharyngeal arch Reference: Langman Embryology 11 Edition pg. 277
PHYSIOLOGY
12.Which is not second messenger? a. cAMP b. IP3 c. Guanylyl cyclase d. Diacylglycerol Answer. (c) Guanylyl cyclase Reference : Ganong 22nd edition, pages 37, 42, 43
13.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 22nd edition, pages 632, 633, 602
14.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 22nd edition, page 573
15.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, 11th edition, page 138
16.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 22nd 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 22nd 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 vertebra.immediately after the shot he loses 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 4th /ed pg-435-39; Harper 28th /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 8th 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 8thedpg 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 8th 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 7th Edition p 988, 989, /Robbins 8th 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 8th 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 8th 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 8th 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, 5th 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, 5th Ed, Dhikav V, Newer Drugs’ 2012, 2nd 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, 5th 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, 5th 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, 5th Ed, AITBS Publishers, BG Katzung’s Basic & Clinical Pharmacology, 11th 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, 5th 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 6th 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, 5th 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 8th 609; Reference: Harrison 's 18th /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 17th /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 8th /307; Reference; Lippincort's Microbiology 2nd/'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 /17th Edition Pg.299, KDT/6th 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 10th Edi. Pg. 726-731: KDT 6th 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 4th 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 29th 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 29th 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 29th 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 17th / 886, ‘ Head and Neck Surgery Otolaryngology’ by Bailey 4th / 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, 5th 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, 1st 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, 21st 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, 21st 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, 2nd 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, 21st 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, 21st 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, 21st 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, 21st 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, 21st 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, 21st 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 4th 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 17th 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 09th 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 09th 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 09th 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 09th 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 09th 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 09th 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 22nd 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 18th 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 18th 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 18th 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 18th 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 18th (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 18th 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 18th 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 18th 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 18th 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 18th 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 18th 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 17th 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: 18th 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 18th 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 18th 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 18th edition/chapter 297, Bailey and love 26th 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 18th 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 18th 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 8th 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 18th 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, 25th Edition ,page No: 930, Sabiston textbook of surgery 18th 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 7th 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 18th 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. /7th 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
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