AIIMS MAY 2007 Recall questions : post all questions here

Discussion in 'AIIMS Nov 2013' started by Sagarikag, May 8, 2007.

  1. Sagarikag

    Sagarikag Guest

    I have recollected this paper with help of my friends, Please help with solutions and corrections of errors in this paper....

    1- whats the root value of pudendal nerve supplying ext urethral sphint-
    A- l3l4
    B-l 4l5
    C- l5s1
    D- s1s2

    2 - perioperative monitoring of which nerve is done commonly-

    3 l-j charting is done for
    4 specificity

    Lj charting is for search

    What is a levey-jennings chart?

    The levey-jennings chart usually has the days of the month plotted on the x-axis and the control observations plotted on the y-axis.
    At the left is the gaussian or "bell-shaped" curve turned on its side to show the correlation of the curve to the chart (i.e. Fewer data points should appear on the upper and lower extremities of the chart, since the "bell" is thinner farther from the mean).

    By observing the data plotted in the l-j chart, we can determine if test results are in control and accurate, or if test results are not in control and consequently unacceptable.

    Use of the westgard, cumulative summation rules and the youden plots will help establish an effective error-detecting scheme.

    4- cause of "nail & half nail" syndrome in uremia-
    C-dialatation of capillaries of nail-bed

    5- spongy-mass with sun-burst calcification on ct-
    A-serous cystadenoma pancreas
    B-mucious cystadenoma pancreas
    D-adeno ca of pancreas

    6 ) which anti-ht drug most likely to cause impotence-?
    A-beta blokers
    B-calcium channel blocker
    C-angiotensin receptor blocker.

    7) -myopathy is not a feature of
    Cushings syndrome
    Oncogenic osteomalacia
    Nutritional osteomalacia
    X linked hypophosphatemic rickets

    8 plasmal exchange is useful in

    9) comprehensive emergency obstetric care doesnot include
    Blood transfusion
    Caesarian section
    Manual removal of placenta

    10) bilateral germ cell tumour is
    Embryonal carcinoma
    Immature teratoma

    11) for diagmnosis of x y genotype quickest method is
    Usual karyotyping

    12 a neonate at 14 days has unconjugated bilrubin of 14 so whats not the diagnosis
    Breast milk jaundice

    13 ast/alt>1 is seen in
    Wilsons disease
    Alcholic hepatitis
    All of the above

    14 hypothalamic pitutary damage first causes decrease in which hormone

    15 common carotid bifurcation occours at
    Thyroid cartilage
    Sterncoclavicular joint

    16 which is not a b cell lineage marker
    Cd 15

    17 muscle relaxant to be used in renal and liver failure is
    Ropa curium

    18 most common site of hetrotropic pancreatic tissue is
    Hilum of spleen

    19 hcc tumour marker not useful is
    Alfa 2 macroglobulin
    Alfa fetoprotein

    20 what is a an atkin diet

    Diet deficient in carbohydrates ,protiens,fats,essential vitamins.

    21 gene related to pulmonary hypertension is
    Bone morphogenic protien

    22 a pregnant women in the 9 th month had jaundice and delivered a healthy baby in post partum her alt level was 1100 and bilirubin was 5.her urine out put was decreased and she had pedal; edema,the aschtic fluid had lymphocytes 10 in number per ml
    Whatz the diagnosis

    Buddchuiari syndrome
    Fatty liver of pregnanacy
    Acute liver failure
    Hellp syndrome

    23 which drug is used in the pregnancy
    Sodium nitroprusside

    24 vit a causes injury to
    Endoplasmic reticullum

    25 endothelin receptor doesnot cause

    1 bronchodilation
    Inotropic action

    26 which doesnot act thru no


    27 interstial; nephritis is not caused by

    28 maximum amount of vitamin d is found in

    29 mechanism of action of imatinyb mesylate is
    .bcl bcr fusion inhibitor

    20 fk 505 class is
    Macrolide antibiotic

    31 mc site of osteosarcoma is

    Lower end of femur
    Lower end of tibia

    32 during isometric exercise testing whats not present
    Increased systemic resistance

    33 not a feature of malignant hyperthermia

    34 which of this is not a cause of hypertension

    35 which of these is not a cause of reticulocytosis.
    Acute hemorage
    Congenital eruthroid congenita

    36 which of these is not a endogenous amine

    37 one patient comes wid anaemia and jaundice and diarrhea which investigation will u suggest
    Anti smooth muscle antibody
    Anti endomysial antibody

    38 which of these is not a antioxidant in the cataract
    Vit a
    Vit c
    Vit e

    39 copper excretion in urine is increased in all of the following exceot
    Primary biliary cirrhosis

    40 sternal angle is between

    11 th rib and sacrospinous
    12 th rib and sacrospinous
    11 th rib and quadratus lumborum
    12 th rib and quadratus lumborum

    41 y chr is acrocentric

    Q on asha

    42 wht happens if confidenc levels inc .... Non sig bcms significnt nephrocalcinosis isnt a featur of dta, mck ds, sarcoidosis

    43 krebs cycl begins wid pyruvic acid
    44 which 1 isnt an essential amino acid
    45 advantage of nasotracheal intubn <infxn <blding > endotrach displ , better oral hygiene

    46 histiocytosis x most commonly affect

    47 acute gvhd rejection... Affect

    48 5 yr old with pain abd 2 weeks present with generalized petechiae overnight and mild hepatosplenomegaly
    Ac leukemia
    Ac viral illness
    Aplastic anemis

    49 a women comes with thyrotoxic feature and 2 by 2 nodule palbabe..tsh is not raised but t 4 is raised next step of investigation will be
    Thyroid scan
    Radio immuno assay

    50 raised ict monitor

    51 in haematochromais the first phenotypic manifestation is

    Slate gray pigmentation

    52 in pheochromocytoma not to be done is

    53 not a componenet of men 2 is
    Meddulary ca of thyroid
    Pancreatic islet tumour
    Parathyroid adenoma

    54 colonic diverticula best inv
    Ba enema

    Raised postprandial iron
    Raised ferritin
    Raised transferrin saturation

    55 malaria h/p
    Inc kupfer cell

    56 hemochromatosis
    Raised postprandial iron
    Raised ferritin
    Raised transferrin saturation

    57 c difficile true
    By toxin a
    Toxin b

    58 in addisons disease what is not true
    1.cardiac atrophy
    2.reduced diastolic pressure
    3.serum cortisol>8 units
    4.diastolic pressure is reduced

    59 one option in the addisons question was some thing of serum renin is decreased or increased....

    1.a women has recurrent abortion and isolated increase in aptt whatz the coz
    1.hemophilia a
    2.vonwillibrands disease
    3.isolated factor 8 deficiency

    60 m/c cause of common nosocomial in fection in neonates in indian hospitals
    E coli
    Done remember other options

    61 pseudomonal endocarditis is caused specially in
    Drug abusers using pentazocin
    Splenectomised patients

    62 which of theses is not a coz of hemolytic uremic syndrome
    Campylobacter jejuni

    63 the mother is not given naltrexone
    If she has history of intake of follwing drug during pregnancy


    64 which one is tuberculid?
    Lupus vulgaris
    Lupus scrofulorum

    65 2 yr child with echymosis. H/o delayed bleeding stump cause?
    Factor ix
    Factor xiii

    66 cause of bacteremia in iv catheterized individuals
    Cuagulase +ve staph
    Cuagulase negative staph

    67 child with iq of 50
    Copy circle
    Identify colors
    Ride bicycle

    68 q:bnp is degraded by?
    Ans: option b i.e. Neutral endopeptidase
    Source : read mudit khanna 2005, q no. 103.

    69 q:muscle not to be cut to expose subclavian artery.

    70 q:complication not seen following right sided thoracic inlet injury

    L-j chart is used for:

    71 which of the following is not worth for a good screening test?
    1.low cost
    4.high safety margin

    72 what is the most common cause of post menopausal bleeding in india? endometrium cervix
    This is a real threat question cause many books have different openions...we dont know what to consider? Aa says that post menopausal bleeding m.c. Cause is ca endometrium and post coital bleeding m.c. Cause is ca cx but speed solutions as well as some other solutions

    Q vk 506 is

    73 bifurcation of common carotid artery occurs at- the level of thyroid cartilage the level of hyoid cartilage

    74 drug of choice for prophyllaxis of rheum fever in a pt with penicillin allergy
    A. Erythromycin
    B. Clindamycin
    C. Vancomycin
    D. Cefaclor

    75 highest mortality rate in cases of heart disease in pregnancy
    A. Ms
    B. As
    C. Eisenmenger's complex
    D. Vsd

    76 17 year old female, presents with primary amenorrhea. Has well developed sec sexual characteristics, b/l inguinal hernia and absent pubic hair.
    Usg shows absent uterus and ovaries. Diagnosis?
    A. Turner's
    B. Mullerian agenesis
    C. Androgen insensitivity synd
    D. Star syndrome

    77 mc myopathy asso with osteoarthritis involves
    A. Quadriceps only
    B. Hamstrings only
    C. Both quadriceps and hamstrings
    D. Gastrocnemius

    78 commonest hormone deficiency after cranial irradiation
    A. Gh
    B. Acth
    C. Gonadotropins
    D. Prolactin

    79 q. Cea is not a marker in
    A)breast ca
    B)osteogenic sarcoma
    C)hepatocellular ca

    80 . Not a marker in hepatocellular ca
    B)alpha feto protein
    D)pcysa like option?

    81 glue ear treatment is
    1.myringotomy with laser
    2.myringotomy with cold knife
    3.myringotomy with ventilation tube

    82 bodies assosciated with endodermal sinus tumour is bodies
    2.hd bodies answer is hd bodies

    83 mutation in which gene in steroid resistant nephrotic syndrome 1.hoxa

    84 organism on iv catheters
    1.coagulase negative staph.
    2.coagulase positive staph ans is cns

    85 bodies assosciated with endodermal sinus tumour is bodies
    2.hd bodies

    Answer is hd bodies - schiller duval bodies

    86 mutation in which gene in steroid resistant nephrotic syndrome 1.hoxa

    87 standard mean error\underroot n
    (rootsquare mean)

    88 least common compliction of measles

    89 comprehensive obstetric care includes all except.
    A.manual removal of placenta
    C.blood transfusion
    D.caesarian section

    90 which tumour is not radiosensitive
    4.wilms tumour

    91 q. S.calcium-9.5, phosphate-3.6, alp-210 units,cotton wool spots in skull ,ivory line.
    1.pagets disease
    2.fibrous dysplasia
    3.osteogenesis imperfecta

    92 ercp commonest complication is

    1.duodenal perforation
    2.acute pancreatitis
    4.acute cholecystitis
    (trick question - i am sure new research is the answer - acute pancreatitis)

    93 pt giving h/o melaena and haematemesis .upper gi endoscopy was he had rebleed in hospital management would be-
    1.repeat upper gi endoscopy.

    94 oxygen availability to tissue depends on a\e
    1.type of fluid adminstered
    2.saturation of hb

    95 most com. B/l germ cell tumor
    2.end. Sinus tumor
    3imm. Teratoma
    4embyr. Cell ca

    96 nulliparous cervical canal - transverse (repeat)
    97 bohlers ang - frac. Calcaneum (repeat)
    98 case history for testing gp. A strepto - bacitracin sensitivity (repeat)
    99 pyelonepritis best inv. Of choice - gram stain (repeat)
    100 mrsa not used - cefaclor
    101 aryl gp not present in - malathion (both repeats)
    102 disability limitation - keep leg in neutral position. (repeat)
    103 antimetabolite - methotrexate (repeat in past exams)
    104 all antiemetics except ;
    - ondansetron -domperidome -phenazocine - cyclizine.(new)

    105 pt had asingle bloodtransfusion till now .hb=5gm%age=21 years old.what cud be it
    1.thalassemia major Minor Intermedia immune haemolytic anaemia

    106 inv for syncope are all except
    1.carotid sinus massage
    2.carotid duplex
    3.tilt table

    107 vitamin a causes injury to 1.mitochondria

    108 social health activist does all except
    1.volunteer health worker
    2.skilled birth attendant
    3.mobilizes people
    My answer - 2 - dai is skilled birth attendent

    109 all are markers of b-cell lineage
    1 cd19
    2 cd25
    3 cd23
    4 cd15

    Ans 4 cd 15

    110 comprehensive obstetric care includes all except.
    A.manual removal of placenta
    C.blood transfusion
    D.caesarian section

    111 all cause interstitial nephritis except
    3.beta lactamase inhibitors

    112.which of the following is not an essential amino acid?
    A. Alanine
    B. Lysine
    C. Leucine
    D. Methionine

    Ans. Alanine

    113.water hammer pulse is found in:
    A. Ms
    B. Mr
    C. As
    D. Ar

    Ans. Ar

    114 .bile acids are synthesized from
    A. Amino acids
    B. Cholesterol

    Answer cholesterol

    115 apoptosis is characactised by all except
    A. Inflammatory process
    B. Nuclear condensation
    C. Chromation cleavage
    D. Cell shrinkage

    Ans. Inflammatory process

    116 most common electrolyte ab. In cong. Hypertrophic pyloric stenosis
    A. Hyperkalemic met. Acidosis
    B. Hypernatremic met. Acidosis
    C. Hypokalemic met. Alkalosis

    Answer hypokalemic met. Alkalosis

    117 plasma exchange is useful in:
    Ans. Mostly aiha..not sure though

    118 the best investigation for colonic diverticula is:
    Ans. Ba-enema?

    119 michaelis-gutmann bodies are found in:
    B.fabry’s disease
    C.nail-patella syndrome
    Ans a - repeat

    120 charcoal hemoperfusion is done in:
    A.barbiturate poisoning
    B.salicylate poisoning
    C.digitalis toxicity
    I have marked this as barbiturate poisoning..

    121 a woman with h/o recurrent abortions presents with isolated increase in ptt.most likely cause is:
    A.lupus anticoagulant
    B.factor vii deficiency
    C.vonwillebrand’s disease
    D.hemophilia a

    Ans. Lupus anticoagulant

    122.most common cause of neonatal sepsis in india is:

    Ans. E.coli

    123.hus is caused by a/e:
    A.campylobacter jejuni

    Ans. V.cholera

    124.traveller’s diarrhoea is caused by:
    A.enterotoxigenic e.coli
    B.enteroinvasive e.coli
    C.enteropathogenic e.coli
    D.enterohemorrhagic e.coli

    Ans. Etec

    125.naltrexone is c/i in a pregnant lady,if she has a h/o intake of which of the following drugs:

    Ans. Methadone

    126 most common finding in children with renal artery stenosis is:
    A.fibrointimal hyperplasia
    B.fibromedial hyperplasia
    C.takayasu’s disease
    D.polyarteritis nodosa

    127.liver secretes all of the following except:
    C.complement c3
    Ans immunoglobulin

    128 all of the following are causes of clubbing except:
    A.fungal infective endocardititis
    B.pulmonary arteriovenous fistula
    C.aortic dissection
    D.tricuspid atresia

    Ans. Aortic dissection

    129 life threatening complications of diabetes mellitus are all except:
    A.malignany otitis externa
    B.emphysematous appendicitis
    C.emphysematous diverticulitis

    Ans i think malignant otitis externa

    130 arsenic is used to treat:
    A.acute lymphocytic leukaemia
    B.acute promyelocytic leukaemia
    C.myelodysplastic syndrome
    D.transient myelofibroproliferative disorders

    Ans is acute promyelocytic leukaemia

    131..which of the following is antimetabolite-methotrexate

    132..hyaluronic acid found in high conc in-vitreous humour

    133..carbimazole therapy in mother causes all exept
    2scalp defect
    3.choanal atresia

    134 not seen in hemolysis is:
    A.decreased haptoglobin levels
    C.burr and tear drop cells

    Ans is c.

    135 raised jugular venous pulse with shock is seen in a/e:
    A.heart failure
    B.cardiac tamponade
    C.right ventricular infarction
    D.second degree av block

    Ans. Is d.

    137 .water hammer pulse seen in
    Ans aortic regrgitation

    128 .hb electrophoresis separates on the basis of
    .mol wt etc

    Ans is charge(isoelectric focussing)

    139 most easily cultivable virus in vitro
    Hep a
    Hep b
    Hep c
    Hep e

    140 .all except the following cause myopathy with osteomalacia
    1. Nutritional rickets
    2.oncogenic osteomalacia
    3.x linked hypophosphatemic rickets

    141 renin is secreted by-juxtaglomerular apparatus

    142 which cells in villi do not reach the apex of villi
    2.goblet cells
    3 endocrine cells
    4peyers patches

    143 no mediated mechanism in all except

    Ans hydrallazine

    144 protective against coronary disease
    N3 omega fa

    145 isometric exercise increases all expt
    1.cardiac outpt
    2mean arterial presure
    3peripheral resitance
    4heart rate

    Ans peripheral resistance??/(not sure)

    146 what will not constitute rct
    ...distributng groups on even/odd basis

    147 most common site for osteosarcoma
    Lower end of femur

    148 post operative regime in female with axilarry ln status positive undergone mrm is
    1.adraimycin based chemotherapy
    2.doxorubicin based chemotherapy
    3 no need for ct

    149 dic seen in
    Promylocytic leukemia

    150 mercury affects-pct

    151 screening is imp in -colonic carcinoma

    152 one question on solitary rectal ulcer---???

    153 all r endogenous catecholamines except-

    A adrenaline
    B noradrenaline
    C dopamine
    D dobutamine

    154 most appropriate management following ami
    1.w3 pufa
    2.k+ supplements
    3.high fibre diet
    4. Esters

    155 the end-product of purine catabolism in nonprimate mammals is:
    1. Inosine
    2. Uric acid
    3. Xanthine
    4. Allantoin

    Ans is allantoin. (ref: vasudevan)

    156 vision 2020: what isn't included:
    -chronic conjunctivitis

    157 q on autosomal dominant retinal disease

    158 2 yr old child completed 8 days of 10-day course of cefaclor then developed low grade fever, lymphadenopathy, rash... Diagnosis?
    -post-viral syndrome
    -type 3 hypersens

    159 5 yr old child after completing a course of antibiotics for urti suddenly developed bronchoconstriction, ... , cxr revealed hypeluscency... Diag?
    -bronchiolitis obliterans

    160 all r comp.of o2 therapy except,
    A.absorbtive atelectasis.
    B.increase lung compican. Vital capacity.
    D.endothelial damage

    161 cx vertebra d/d from thoracic vertebra

    Ans.foramen transvarsorium

    162 baby born premature with ?? Lesions what test to do:
    I marked VDRL
  2. Guest

    Guest Guest

    newborn of 14 days, with unconjugated hyperbilirubinemia of 18mg/dl, it can be all the following except:
    1) breast milk jaundice
    2) G6PD deficiency
    3) neonatal cholangiopathy
    4) hypothyroidism
  3. Guest

    Guest Guest

    vision 2020: what isn't included:
    -Epidemic conjunctivitis
  4. Guest

    Guest Guest

    no mediated mechanism in all except

    Ans:- fenoldopam.(Hydralazine does act by releasing NO)
  5. Guest

    Guest Guest

    carbimazole therapy in mother causes all exept
    2scalp defect
    3.choanal atresia
    4.fetal goitre

    Ans:- ?cleft lip/ palate ( i have referred in several websites and they
    have mentioned scalp defect, choanal atresia
    and fetal goitre, aplasia cutis)
  6. Guest

    Guest Guest

    129 life threatening complications of diabetes mellitus are all except:
    A.malignany otitis externa
    B.emphysematous appendicitis
    C.emphysematous pyelitis
    D.rhinocerebral mucormycosis

    Ans:- emphysematous appendicitis( malignant otitis externa is definitely associated with diabetes) (just referred dhingra)
  7. Guest

    Guest Guest

    139 most easily cultivable virus in vitro
    Hep a
    Hep b
    Hep c
    Hep e

    Ans:- only cultivable hepatitis virus is hep. A virus (ananthnarayan)
  8. Guest

    Guest Guest

    105 pt had asingle bloodtransfusion till now .hb=5gm%age=21 years old.on physical exam he has hepatospleenomegaly. what cud be it
    1.thalassemia major Minor Intermedia immune haemolytic anaemia
  9. Monika

    Monika Guest

    most common deficiency after cranial irradation is GH deficiency.
    check harrison.
  10. Monika

    Monika Guest

    A thoroughly unpredictable many repeats , some new Qs were easy but some I felt were too twisted and indirect...... the typical subtle tricks which the examiners are masters at playing....

    what made me upset was....... too few Qs on scoring subjects like FSM, Dermatology , PSYCHI......... some of the PSM Qs I found quite unkmown............ the most surprising part was NO Q PRACTICALLY ON ONCOLOGY...........SOMETHING WHICH ALL OF US READ SO PAINSTAKINGLY............... VERY UNCHARACTERISITIC OF A PG ENTRANCE EXAM..........................!!

    God knows......... I'm not really expecting anything for myself..... I'll check out answers later.............. relaxing now
  11. Anjali.

    Anjali. Guest

    what is the most common cause of post menopausal bleeding in india? endometrium cervix
    this is a real threat question cause many books have different openions...we dont know what to consider? aa says that post menopausal bleeding m.c. cause is ca endometrium and post coital bleeding m.c. cause is ca cx but speed solutions as well as some other solutions also say that its ca endometrium??guys plz help me out to solve this question with solid refferences....i also dont know what difference india makes in this question?

    bifurcation of common carotid artery occurs at- the level of thyroid cartilage the level of hyoid cartilage
  12. drnilay

    drnilay Guest

    ans for nail and halfnail syndrome

    ans is melanin deposition
  13. varun.dasari

    varun.dasari Guest

    FK 506 is: (i dont think its fk 505)

    and fk 506 is nothing but Tacrolimus and immunomodulator is given among the options. So, i think the answer is immunomodulator (option d in the exam)
  14. Guest

    Guest Guest

    commonest complication of ERCP

    Commonest complication of ERCP now a days is pancreatitis

    Rate of complications according to last study by Rabenstein et al 1998

    Pancreatitis 4.7 % (n = 778)

    Perforation 0.1 %

    Sepsis (choleangitis + acute cholesystits) 1.4 %

    The other important aspect to note here is Bleeding which was supposed to be the most common complication in 1991 - 1997 has now decreased to 2.1 % where as pancreatitis has increased from 1.9 to 4.7 % :: if we compare 3 different studies.

    Cotton et al 1991
    Freeman et al 1996
    Rabenstein et al 1998

    Hope that helps
  15. Sagarikag

    Sagarikag Guest

  16. Monika

    Monika Guest

    lithotripsy is not effective in which stones?
    1. ca oxalate
    2.triple phosphate
    4.cysteine stones ans.

    Mitchell Guttman bodies are seen in... malakoplakia (ans)...

    cerebral lood flow dont depends on
    cerebral metabolic rate
    ans ? k+?
  17. Monika

    Monika Guest

    Q-which of the following is most likely to cause impotence ?
    c-angiotensin receptor blocker

    answer- A-beta blocker

    which muscle is not cut while exposing left subclavian artery?
    c-scalenus anticus
    d-scalenus medius

    d- sca. medius

    check out following link,,petty nicely illustrated surgery steps..
  18. skh

    skh Guest


    1.which of the following doesnt act through activation of NO?
    ANS. fenoldopam

    2.merit of endotracheal intubation is
    [a]less infection
    oral hygeine
    anyone who can complete the question nd give references

    3.which is the most common nerve tested for perioperative evaluation?
    [a]facial nerve
    ulnar nerve
    ans.ulnar nerve - reference;ajay yadav

    4.which musle is looked for testing facial nerve
    [a]orbicularis oculi
    ans.orbicularis -reference ajay yadav

    5.drug of choice for prophylaxis of infective endocarditis in penicillin allergic patients?
    ans.cmdt says for git surgeries[except esophagus] and genitourinary surgeries vancomycin is given and for dental and esophagus surgeries clindamycin is given.
    does anyone remember that whether there was a mention of type of surgery in the question?

    6.most common cause of neonatal sepsis in hospitals in india?
    [a]staph aureus
    any references?
  19. nil

    nil Guest

    comprehensive emergency obs care includes iv/im antibiotics
    iv/im oxytoxics
    iv/im anticonvulsants
    manual removal of
    assisted vaginal delivery
    removal of retained
    ceasarean section
    blood trasfusion
    so answer is hystrectomy which not in comp obs care
  20. nil

    nil Guest

    Mutations in the BMPR2 gene cause pulmonary arterial hypertension.
    check robbins
  21. nil

    nil Guest

    18 most common site of hetrotropic pancreatic tissue is
    Hilum of spleen

    ans is stomach check robbins
  22. ddeepak

    ddeepak Guest

    answer to most common virus that can be isolated id hav

    answer for most common substance abuse being tobacco
  23. Anamika.

    Anamika. Guest

    .juxtaglomerular cells (JG cells)
    are present in
    b.aseding distal tubules
    c.decending dital tubule

    answer d glomerulus
    guyton 11th editon

    Renin is synthesized and stored in an inactive form
    called prorenin in the juxtaglomerular cells (JG cells)
    of the kidneys. The JG cells are modified smooth
    muscle cells located in the walls of the afferent arterioles immediately proximal to the glomeruli.

    now glomerular is tuft of capillary into bowman capsule of nephron that we all know and jg cell are laocated in the wall affernt arterioles.

    so best answer is glomerulus.
  24. Anamika.

    Anamika. Guest

    34. In hereditary hemochromatosis the earliest phenotypic manifestation is:
    a. Elevated post prandial iron levels
    b. Elevated serum ferritin levels
    c. Slate grey pigmentation of the skin
    d. Elevated percent serum transferin saturation

    answer d.

    harrison 2299,2301

    now every other book like willimas hematology wintrobe hematology except harrison mention answer d as the first manifestation.

    harrsion mentiones increased iron level and percent transferin saturation are early effect.

    no mention about which of them is which answer to choose but still answer is d.

    because read again question it ask first phenotypic change in heriditory hemochromatosis.

    now harrison page 2299 says that in heriditray hemochromatosis mutation of hfe gene occur as a result mutant hfe gene trapped intracelluarly reducing transferrin mediated iron uptake by intestinal crypt cell(of course due to transferin satruration so that new iron can not be take up)

    now what is phenotype observed effect dur to genes so here phenotype of hfe mutation is increased transferrin saturation ans so is the answer.phenotype is effect due to gene.for xample xy is genotype and being male is phenotype.right.

    in this question mutation in hfe is genotype and this mutation causes increased transferin saturation so that is phenotype.
  25. Izac

    Izac Guest

    36.arsenic is used to treat
    a.acute lymphocytic leukemia
    b.acute promyelocytic leukemia
    c.myelodysplastic syndrome
    d.transient myeloproliferative disorders
    answer b acute promyelocytic leukemia

    refrence william's hematology chapter 16

    Arsenic had been used in the treatment of chronic myelogenous leukemia and other malignancies in the 1930s with little effect. It has reappeared as an effective therapy for promyelocytic leukemia when used in the form of arsenic trioxide (As2O3), which induces differentiation and apoptosis in APL cells131 and produces remissions in most patients refractory to tRA and conventional chemotherapy. Remissions appeared in 2 to 3 months after beginning doses of 0.15 mg/kg/day for 25 days every 3 to 6 weeks, with evidence of leukemic cell differentiation and a progressive peripheral blood leukocytosis after 2 weeks of therapy.132,133 No consistent side effects have been observed, although occasional patients complain of fatigue, dysesthesias, and lightheadedness. A maximum plasma concentration of 5.5 to 7.3 µM was achieved in the initial studies from China, and small amounts of drug are eliminated in the urine, the rest residing in tissues.133

    ...please go through the THERAPY topic in this states arsenic is used in MDS.....
    Friends, please give your valuable opinion.
  26. aysa

    aysa Guest

    para from wintrobe's hematology 2003 edition chapter 83 myelodysplastic syndrome

    Arsenic trioxide (ATO) (Trisenox, Cell Therapeutics Incorporated, Seattle, WA), recently received orphan drug designation from the Food and Drug Administration for
    the treatment of MDS. Arsenicals have a long history of application in human leukemia but only recently gained renewed recognition by virtue of activity in acute
    promyelocytic leukemia. ATO has multiple biologic effects that include apoptosis induction via disruption of survival signals, suppression of angiogenesis, and
    promotion of cellular differentiation ( 409 ). Phase II multicenter trials are ongoing in the United States and Europe to delineate its potential in advanced MDS.
    Preliminary results of the U.S. trial indicate that approximately one-third of patients treated with ATO may benefit by multilineage hematopoietic improvement or
    reduction in BM blast percentage, or both ( 410 ).

    and this book also mentions arsenic in the therapy of acute promyelocytic leukemia.just like both answers are right you decide ar god only knows what is there in AIIMS answer keys
  27. Guest

    Guest Guest

    guys found the catch point refrence wintrobe's hematology chapter 82 acure promyelocytic leukemia

    Abandoned 30 years ago as an anticancer medicine, arsenic has recently attracted renewed attention as a treatment for relapsed APL.

    so it is for relapsed acute promyelocytic leukemia not for acute promyelocytic leukemia

    so for me better answer may be myelodysplastic syndrome but still i am not sure .i have given you all the facts.i think we should just remember that
  28. Anamika.

    Anamika. Guest

    Q. Endothelin does not cause a. Vasoconstriction b. Bronchodilation c. Decrease gfr d. Positive ionotropic effect Ans. B bronchodilation (ref. Page 577 ganong 20th ed) Q. Liver secretes a/e a. Immunoglobin b. Haptoglobin c. Fibrinogen d. Complement C3 ?? Ans. A immunoglobulin ( ref. 522-23t ganong 20th ed) Q. Bile acid synthesized from a. Aminoacid b. Cholesterol c. Billirubin d. Glucose Ans. B cholesterol ( ref. Page 485 ganong 20th ed)
  29. Anamika.

    Anamika. Guest

    33.A woman comes with features of thyrotoxicosis. with thyroid nodule.t4 is high tsh is low.Next step in the investigation would be:
    a. Thyroid scan
    b. Radioactive iodine uptake
    c. USG
    d. CT scan

    answer a.thyroid scan page 2126-2127

    if tsh is low than thyroid scan is carred out.
  30. Anamika.

    Anamika. Guest

    29myopathy is not a feature of
    a.cushing's syndrome
    b.oncogenic osteomalacia
    c.nutritional osteomalcia
    d. x linked hypophosphetemic rickets

    answer d.hypophosphatemic rickets.

    nelson 17th edition page 2345

    in x linked hpophosphatemic rickets profound myopathy ,rachitic rosary and Harrison groove charecterstic of calcium dependent rickets are not evident.
  31. Anamika.

    Anamika. Guest

    29myopathy is not a feature of
    a.cushing's syndrome
    b.oncogenic osteomalacia
    c.nutritional osteomalcia
    d. x linked hypophosphetemic rickets

    answer d.hypophosphatemic rickets.

    nelson 17th edition page 2345

    in x linked hpophosphatemic rickets profound myopathy ,rachitic rosary and Harrison groove charecterstic of calcium dependent rickets are not evident.
  32. Dr.Dhaka.

    Dr.Dhaka. Guest

    . wat is not included in Comprehensive Emergency Obstetric care?
    a. Cesarean Section
    b. Hysterectomy
    c. Blood transfusion
    d. Manual removal of placenta

    Any clue?
  33. Dr.Dhaka.

    Dr.Dhaka. Guest

    30.bilateral germ cell tumor is
    b.immature teratoma
    c.embyonal cell carcinoma
    d.endodermal sinus tumor

    refrence novak gynacology chapter 35 ovarian malignancy

    answer a dysgerminioma

    About 85% to 90% of stage I tumors are confined to one ovary; 10% to 15% are bilateral. In fact, dysgerminoma is the only germ cell malignancy that has this significant rate of bilaterality. Other germ cell tumors are rarely bilateral
  34. aayush.

    aayush. Guest

    31. not a cause of reticulocytosis
    a.acute haemorrhage
    c.nutrional anemia
    d.duserthropoitic anesmia

    answer c
    refrence williams hematology 6th edition

    for pnh it writes

    A mild to moderate reticulocytosis is usually present

    further it writes in hemolytic anemia section

    Furthermore, reticulocytosis is usually marked in hemolytic disorders but minimal or absent in iron deficiency anemia
  35. aayush.

    aayush. Guest

    32.acute graft verses host disease affects all expect

    answer b lung

    refence robins pathological basis of disease 7th edition page 222

    Acute gh disease occurs within days to weeks after allogenic bone marrow transplantation.Although any organ may be affected, the majot clinical manifestation result from invovement of the immune system and epithelia of the skin,liver and intestine.
  36. aayush.

    aayush. Guest

    53. A 5 year old child presents with multiple petechiae all over the body overnight.he had h/o abdominal pain 2 weeks back.presently he has mild hepatosplenomegaly.most likely diagnosis is:
    a. Acute viral illness
    b. ITP
    c. Aplstic anaemia
    d. Acute leukaemia

    Answer b.Itp

    nelson 17th edition page 1670

    classic presentation of itp is that of a previousslu healthy child who has sudden episode of generalised petechia and purpura.The parents often state that the child was fine yesterday and now is coverd with bruised and purple dots.often there is bleeding from the gums and mucous membrane.particularly with profound thrombocytopenia.There is history of a preceding viral infection 1 to 4 week before onser of throbocytopenia.The physical examination is nomal other than finding of petechiea and pupura.spleenomegaly is rare.the presence of abnormal finding such has hepatospeenomegaly or remarkable lyphadenopathy suggest other diagnoses.
  37. Dr.Dhaka.

    Dr.Dhaka. Guest

    28.A pateint comes with hematemesis and malena since 2 days>An endoscopy revelaed no abnormal finding.He again has one episode of bleeding.Next step would be.

    b.repeat endoscopy at the time of rebleed

    Answer : c enteroscopy

    refrence harrison 16th edition page 238


    Obscure GIB is defined as recurrent acute or chronic bleeding for which no source has been identified by routine endoscopic and contrast x ray studeis.Push enteroscopy with a specially designed enterscope or a pediatric colonoscope to inspect entire duodenum an part of jejunum is generally the next step.
  38. Dr.Dhaka.

    Dr.Dhaka. Guest

    26.drugs causing interstitial nephritis are all except


    refrence: oxford text book of nephrology chapter 10.6.2

    Answer c

    Numerous drugs may cause acute interstitial nephritis ). Those most commonly now implicated are the b-lactam antibiotics and the non-steroidal anti-inflammatory drugs. Sulphonamides, rifampicin, phenindione, thiazide diuretics, triamterene, cimetidine, and allopurinol have all been held responsible for some cases of acute interstitial nephritis

    The reaction develops in a small number of patients, several days or weeks after taking the drug, and is not dose-dependent except in some cases after penicillin G and allopurinol

    harrison 15th edition table 71-2(drug adverse reaction table which is deleted in 16th eidtion.)

    page 435

    gives list of drugs causing intersitial nephritis

  39. aayush.

    aayush. Guest

    27.cause of "half-and-half nail" syndrome in uremia is

    a.melanin (or melatonin i do not remembr exact option)
    c.dilation of the capillary bed

    answer c.capillary bed

    refrence:eek:xford text book of clinical nephrology second edition chapter 11.3.11

    The so-called ‘half-and-half nail’ is typical of uraemia. The distal portion of each nail bed is red, pink, or brown, occupies 20 to 60 per cent of the total nail length, and always sharply demarcated; the proximal portion has a dull whitish ground-glass appearance (Lindsay 1967). When pressure is applied, the discoloration does not fade completely. This change can affect single nails, or all the nails of the hands or feet or both (Fig. 5). Half-and-half nail often begins before dialysis. It occurs in 15 to 50 per cent of patients on regular dialysis (Kint et al. 1974; Lubach et al. 1982). The histology of the nail plate itself shows no change and it contains no melanin. The number of capillaries under the nail plate is increased, with remarkable thickening of the capillary walls. The increase in capillary density of the nail bed might account for the band of discoloration. The disorder is probably partially reversible. In some patients a lightening of the colour and a decrease in the width of the brown nail arc have been seen after months of observation

    so it celarly says that it contains no melanin and histology of nail does not change.

    and subsequent role of capillary caus is not melanin but increase in capillary bed.

    Ansewer is c
  40. aayush.

    aayush. Guest

    29.Final product of purine metabolism in non primate mammals is
    c.Uric acid

    Answer d.allantoin

    refrence harper's biochemisty 27th edition

    Humans convert adenosine and guanosine to uric acid (Figure 33–8). Adenosine is first converted to inosine by adenosine deaminase. In mammals other than higher primates, uricase converts uric acid to the water-soluble product allantoin. However, since humans lack uricase, the end product of purine catabolism in humans is uric acid.
  41. aayush.

    aayush. Guest

    Mechanism of action of Imatinib mesylate is:
    a. Blocks the action of the chimeric fusion protein of bcr-abl
    b. Increase the metabolism of P glycoprotein
    c. Blocking the action of P glycoprotein
    d. Competitive inhibition of ATP binding site

    answer a.bcr-abl


    Chemistry. Imatinib mesylate (STI 571, GLEEVEC, GLIVEC) was identified through the combined use of high throughput screening and medicinal chemistry and is 4-[(4-methyl-1-piperazinyl)methyl]-N-[4-methyl-3-[[4-(3-pyridinyl)-2-pyrimidinyl] amino]-phenyl]benzamidemethanesulfonate. The lead compound of this series, a 2-phenylaminopyrimidine, had low potency and poor specificity, inhibiting both serine/threonine and tyrosine kinases (Buchdunger et al., 2001). The addition of a 3¢-pyridyl group at the 3¢-position of the pyrimidine enhanced the cellular activity of the derivatives. A number of chemical modifications resulted in improved activity against the platelet-derived growth factor receptor (PDGFR) tyrosine kinase and loss of serine/threonine kinase inhibition. These compounds also were found to possess inhibitory activity toward the cytoplasmic ABL tyrosine kinase and receptor tyrosine kinase, KIT. Introduction of N-methylpiperazine as a polar side chain greatly improved water solubility and oral bioavailability, yielding imatinib, whose chemical structure is:

    Mechanism of Action. Imatinib has inhibitory activity against ABL and its activated derivatives v-ABL, BCR-ABL, and EVT6-ABL (Buchdunger et al., 1996; Druker et al., 1996). IC50 values are in the range of 0.025 uM using in vitro kinase assays with immunoprecipitated or purified proteins. Activity against the PDGFR and KIT are in a similar range. In contrast, the IC50 values for a large number of other tyrosine and serine/threonine kinases generally are at least 100 times higher, demonstrating that imatinib exhibits a high level of selectivity (Buchdunger et al., 2001).

    Cellular studies showed that imatinib specifically inhibited the proliferation of myeloid cell lines that express the BCR-ABL fusion protein associated with CML (Druker et al., 1996). The IC50 for BCR-ABL phosphorylation in intact cells is between 0.25 and 0.5 uM (Buchdunger et al., 2001). Complete inhibition of proliferation with cell death through apoptotic mechanisms occurs between 0.5- and 1-uM concentrations of imatinib. Similar concentrations of imatinib inhibit the proliferation of cells dependent on KIT or PDGFR for proliferation. This includes cells expressing mutant KIT isoforms associated with gastrointestinal stromal tumors (GISTs) (Heinrich et al., 2000), the ETV6-PDGFR fusion associated with a subset of chronic myelomonocytic leukemia (CMML) (Carroll et al., 1997), and the FIP1L1-PDGFRA fusion associated with hypereosinophilic syndrome (HES) (Cools et al., 2003).
    Mechanisms of Resistance. Resistance to imatinib can be primary, that is, failure to achieve a specific desired response, or secondary (acquired), that is, loss of a desired response. The acquired resistance predominantly results from mutations in the kinase domain (Shah et al., 2002), although some patients have amplification of BCR-ABL (Hochhaus et al., 2002). Interestingly, in CML patients in whom the malignancy is driven by the BCR-ABL tyrosine kinase, mutations have only been observed in the ABL kinase, whereas in GIST and HES, only KIT and PDGFR mutations have been observed, respectively (Cools et al., 2003; Wakai et al., 2004). These data demonstrate the critical tumor dependence on the specific mutated kinase. ABL mutations are scattered throughout the kinase domain and variably render the kinase less sensitive to imatinib (Corbin et al., 2003). Mutations affect sites that are direct contact points between the kinase and imatinib or affect residues that are required for the kinase to adopt a conformation to which imatinib can bind (Deininger and Druker, 2004; Shah et al., 2002). Alternate kinase inhibitors that can inhibit the imatinib-resistant mutations are currently in clinical development (Deininger and Druker, 2004).

    In contrast to acquired resistance, the mechanisms mediating primary resistance are unknown. Hypotheses include alternate pathways that allow tumors to escape the antiapoptotic effects of an agent targeting a single pathway, quiescence of a population of cells in the tumors that are not susceptible to the antiproliferative effects of this class of agents, or inadequate drug levels due to poor tumor penetration of the drug, drug efflux, protein binding, or unappreciated mutations that affect drug sensitivity.

    Pharmacokinetics. Imatinib is well absorbed after oral administration with maximum plasma concentrations (Cmax) achieved within 2 to 4 hours (Peng et al., 2004). Mean absolute bioavailability for the capsule formulation is [snip]%. Following oral administration in healthy volunteers, the elimination half-lives of imatinib and its major active metabolite, the N-desmethyl derivative, are approximately 18 and 40 hours, respectively. Mean imatinib AUC increases proportionally with increasing dose in the range 25 to 1000 mg (Peng et al., 2004). There is no significant change in the pharmacokinetics of imatinib on repeated dosing or with administration of food. Doses >300 mg per day achieve trough levels of 1 uM, which corresponds to in vitro levels required to kill BCR-ABL-expressing cells. Pharmacodynamic inhibition of the BCR-ABL tyrosine kinase can be demonstrated in white blood cells from patients with CML with a plateau in inhibition between doses of 250 and 750 mg (Druker et al., 2001). Nonrandomized studies suggest that improved responses may be observed with doses of 600 or 800 mg per day as opposed to 400 mg per day (Kantarjian et al., 2004; Talpaz et al., 2002), consistent with dose-dependent inhibition of the kinase.

    CYP3A4 is the major enzyme responsible for metabolism of imatinib. Other cytochrome P450 enzymes, such as CYP1A2, CYP2D6, CYP2C9, and CYP2C19, play a minor role in its metabolism. Plasma levels of drugs that are substrates for these cytochromes may increase if coadministered with imatinib due to competition for biotransformation pathways, and those that are enzyme inhibitors or inducers may increase or decrease the plasma levels of imatinib, respectively. A single dose of ketoconazole increases mean Cmax and AUC of imatinib by 26% and 40%, respectively, confirming that imatinib is a CYP3A4 substrate (Dutreix et al., 2004). Imatinib increased the Cmax and AUC of simvastatin by 2 and 3.5 times, respectively, indicating inhibition of CYP3A4 (O'Brien et al., 2003). Coadministration with rifampin, an inducer of CYP3A4, reduces plasma imatinib AUC by approximately 70% (Bolton et al., 2004). Elimination of imatinib occurs predominantly in the feces, mostly as metabolites.

    Therapeutic Uses. Imatinib has efficacy in diseases in which the ABL, KIT, or PDGFR have dominant roles in driving the proliferation of the tumor. This dominant role is defined by the presence of a mutation that results in constitutive activation of the kinase, either by fusion with another protein or point mutations. Thus, imatinib shows remarkable therapeutic benefits in patients with CML (BCR-ABL), GIST (KIT mutation positive), CMML (EVT6-PDGFR), HES (FIP1L1-PDGFR), and dermatofibrosarcoma protuberans (constitutive production of the ligand for PDGFR) (Druker, 2004). The situation in GIST is particularly instructive, as patients with an exon 11 mutation of KIT have a significantly higher partial response rate (72%) than those with no detectable KIT mutations (9%) (Heinrich et al., 2003). Thus, KIT mutational status predicts response. The currently recommended dose of imatinib is 400 to 600 mg per day.

    Clinical Toxicity. The most frequently reported drug-related adverse events are nausea, vomiting, edema, and muscle cramps (Deininger et al., 2003). Most events are of mild-to-moderate grade, and only 2% to 5% of patients permanently discontinue therapy, most commonly because of skin rashes and elevations of transaminases (each in <1% of patients). Edema can manifest at any site, most commonly in the ankles and periorbital tissues. Severe fluid retention (pleural effusion, pericardial effusion, pulmonary edema, and ascites) is reported in 1% to 2% of patients taking imatinib. The probability of edema increases with higher imatinib doses and in persons >65 years old. Neutropenia and thrombocytopenia are consistent findings in all studies in leukemia patients, with a higher frequency at doses ³750 mg. The occurrence of cytopenias also is dependent on the stage of CML, with a frequency of grade 3 or 4 neutropenia and thrombocytopenia between two- and threefold higher in blast crisis and accelerated phase compared to chronic phase. In solid tumor patients, grade 4 neutropenia has been reported in <5% of patients. Thrombocytopenia is much less common.
  42. nikhil.

    nikhil. Guest

    24.Spongy-mass with central ‘sunburst’ calcification on CT is seen in:
    a. Serous cystadenoma of the pancreas
    b. Mucinous cystadenoma of the pancreas
    c. Somatostatinoma
    d. Adeno Ca of the pancreas

    answer a.serous cysadenoma of the pancrease

    refrnce:advanced imaging of abdomen jovitas skukas page 546

    reagrding serous custadenoma imaging:Imaging
    A majority of microcystic (serous) neoplasms
    contain many small cysts, a minority consist of
    larger cysts (macrolacunar) and a minority are
    mixed; imaging can suggest the diagnosis in a
    majority of the small and mixed cystic variety,
    but the larger cystic tumors are indistinguishableindistinguishable
    from other pancreatic cysts by either CT
    (Fig. 9.21) or MR (Fig. 9.22).
    Some of these tumors containing small cysts
    have a “honeycomb” appearance on imaging.At
    times the cysts are sufficiently small to suggest
    a solid tumor (Fig. 9.23). A central scar with
    radiating septa is evident in some, and occasionally
    sunburst-like calcifications are detected
    in the central scar.
    In some, thin septations
    enhance on immediate postcontrast images.
    Any solid component also enhances.
    Even when large, these benign tumors tend
    not to obstruct the pancreatic duct. Also, only
    a small minority of serous cystadenomas communicate
    with the pancreatic duct. An occasional
    microcystic adenoma is sufficiently large
    to compress and occlude the splenic vein, resulting
    in hepatopetal collaterals via gastric fundal
  43. ronypack32

    ronypack32 Guest

    atkins diet is

    a.protein restricted
    b.fat restricted
    c.vitamin restricted
    d.carbohydrate restricted

    Answer d.carbohydrate restricted

    harrison 16th edition page 428
    recent data suggest that very low carbohydrate "atkins" stayle diets are more effective for short tem weight loss when compared to standard caloric restriction.
  44. ronypack32

    ronypack32 Guest

    46.hypervitaminosis a causes injury to
    d.endoplamic reticulum

    answer c lysosomes
    refrence o.p.ghai 5th edition page 79

    excess of vitamin a can lead to rupture of lysosomal membranes.
  45. ronypack32

    ronypack32 Guest

    47.increased urinary copper excretion is seen in all except

    a.primary billiary cirrhosis
    b.hepatic tumors
    c.scerosing cholangitis
    d.fuminant hepatic failure

    Answer : b.hepatic tumours

    refrence schiff's diseases of the liver 10th edition

    i am quoting the lines from various part of schiff

    PBC, like other cholestatic syndromes, is
    associated with copper retention, resulting in raised urinary copper and serum
    ceruloplasmin levels (28).

    hepatic copper concentrations may also be elevated in other liver diseases,
    particularly chronic cholestatic diseases such as primary biliary cirrhosis and
    primary sclerosing cholangitis.

    increases in urinary copper level may be seen in in fulminant liver failure.

    Increase urinary copper level is seen in chronic chloestatic disorders

    we all know when hepatic copper concntration increase in wilson disease urinary copper also increase so we can take that in pbc and psc also same can occur.

    so the answer is hepatic tumours
  46. aayush.

    aayush. Guest

    q on pseudocolitis ws::which is true n i think its toxin b,becoz it is 1000 times more potent than toxin a n respsble 4major clinical features.
  47. aayush.

    aayush. Guest

    41.common carotid artery bifurcation occurs at:

    a.cricoid cartilage
    b.thyroid cartilage
    c.sternoclavicular joint
    d.angel of mandible

    Answer b.thyroid cartilage

    snell Anatomy 7th edition page 736

    The common carotid artery runs upwards through the nexk ,from the sternoclavicular joijnt to the upper border of the thyroid cartilage,where it devides into external and internal carotid arteries.
  48. aayush.

    aayush. Guest

    33.A woman comes with features of thyrotoxicosis. with thyroid nodule.t4 is high tsh is low.Next step in the investigation would be:
    a. Thyroid scan
    b. Radioactive iodine uptake
    c. USG
    d. CT scan

    answer a.thyroid scan page 2126-2127

    figure 320-13

    if tsh is low than thyroid scan is carred out.
  49. aayush.

    aayush. Guest

    42.pcr utilises all of the follwoing except??

    b.taq polymerase
    c.radiolabelled probe

    Anser c radiolabbeld probe

    d ntp= de oxy nucelotide trei phosphate

    refrence lippincott Biochemistry 3rd edition

    A. Steps of a PCR
    PCR uses DNA polymerase to repetitively amplify targeted portions
    of DNA. Each cycle of amplification doubles the amount of DNA in
    the sample, leading to an exponential increase in DNA with
    repeated cycles of amplification. The amplified DNA sequence can
    then be analyzed by gel electrophoresis, Southern hybridization, or
    direct sequence determination.

    Primer construction: It is not necessary to know the nucleotide
    sequence of the target DNA in the PCR method. However, it is
    necessary to know the nucleotide sequence of short segments on
    each side of the target DNA. These stretches, called flanking
    sequences, bracket the DNA sequence of interest. The nucleotide
    sequences of the flanking regions are used to construct two, sin-
    gle-stranded oligonucleotides, usually 20 to 35 nucleotides long,
    which are complementary to the respective flanking sequences.
    The 3'-hydroxyl end of each primer points toward the target
    sequence (see Figure 32.19). These synthetic oligonucleotides
    function as primers in PCR reactions.

    2. Denature the DNA: The DNA to be amplified is heated to separate
    the double-stranded target DNA into single strands.

    Annealing of primers to single-stranded DNA: The separated
    strands are cooled and allowed to anneal to the two primers (one
    for each strand).

    Chain extension: DNA polymerase and deoxyribonucleoside
    triphosphates (in excess) are added to the mixture to initiate the
    synthesis of two new chains complementary to the original DNA
    chains. DNA polymerase adds nucleotides to the 3'-hydroxyl end
    of the primer, and strand growth extends across the target DNA,
    making complementary copies of the target. [Note: PCR products
    can be several thousand base pairs Iong.] At the completion of one
    cycle of replication, the reaction mixture is heated again to dena-
    ture the DNA strands (of which there are now four). Each DNA
    strand binds a complementary primer, and the cycle of chain
    extension is repeated. By using a heat-stable DNA polymerase (for
    example, Taq polymerase) from a bacterium that normally lives at
    high temperatures (a thermophilic bacterium), the polymerase is
    not denatured and, therefore, does not have to be added at each
    successive cycle. Typically twenty to thirty cycles are run during
    this process, amplifying the DNA by a million-fold to a billion-fold.
    [Note: Each extension product of the primer includes a sequence
    complementary to the primer at the 5' end of the target sequence
    (see Figure 32.19). Thus, each newly synthesized polynucleotide
    can act as a template for the successive cycles (see Figure 32.20).
    This leads to an exponential increase in the amount of target DNA
  50. aayush.

    aayush. Guest

    43.In pheochromocytoma test not be done is??
    c.mibg scan

    Answer d FNac

    refrence harrion 16th edition page 2151

    ct,meri and mibg has been mentioned as preoperative localisation of tumour regarding fnac it says

    Percutaneus fine needle aspiration of chromaffin tumours is contraindicated

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