AIIMS MAY 2007 Recall questions : post all questions here

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

  1. aayush.

    aayush. Guest

    44.which is not a marker of primary hepatic tumour

    a.alpha-2 macroglobulin
    b.fucosulated alfafeto protein
    c.neurotension
    d.pivka
    refrence surgical oncology david n crag

    Alpha-fetoprotein is produced by 40-80% of hepatocellular carcinomas. False
    positive values may be seen in patients with acute or chronic hepatitis, germ cell
    tumors, or normal pregnancy. The other available assay is that for des-y-carboxy
    prothrombin protein induced by a vitamin K abnormality (PIVKA-2), which is
    increased in as many as 91% of patients with hepatoma.1 However, this level may
    also be elevated with chronic active hepatitis or vitamin K deficiency.
  2. aayush.

    aayush. Guest

    44.which is not a marker of primary hepatic tumour

    a.alpha-2 macroglobulin
    b.fucosulated alfafeto protein
    c.neurotension
    d.pivka
    refrence surgical oncology david n crag

    Alpha-fetoprotein is produced by 40-80% of hepatocellular carcinomas. False
    positive values may be seen in patients with acute or chronic hepatitis, germ cell
    tumors, or normal pregnancy. The other available assay is that for des-y-carboxy
    prothrombin protein induced by a vitamin K abnormality (PIVKA-2), which is
    increased in as many as 91% of patients with hepatoma.1 However, this level may
    also be elevated with chronic active hepatitis or vitamin K deficiency.




    refrence shiff liver disease 10th edition


    AFP has very low sensitivity and slight increases may also be observed in patients
    with cirrhosis in the absence of malignancy (34,35). Therefore, it has no clinical
    role in screening and a very reduced role in the diagnosis, this probably being
    limited to patients with very advanced tumor stage in whom no treatment is
    provided. In these terminal patients, no imaging technique is 6ht eidtionneeded after
    ultrasonography to confirm and stage the disease. Other tumor markers such as
    lectin-bound AFP (36), des-γ-carboxyprothrombin (37), or glypican (38) have
    been proposed to surpass the efficacy of AFP, but their clinical efficacy is yet to
    be unequivocally proved. Proteomic techniques may help identify new markers



    now rosenberg's cancer principal and practice of oncology 6th edition


    The most important pathologic issue is the distinct appearance and clinical behavior of the fibrolamellar variant of HCC. The contrast in clinical behavior is summarized in Table 33.5-2. On gross and radiologic inspection, fibrolamellar HCC is generally well demarcated and often encapsulated, with a central fibrotic area. It is a variant that generally occurs in young patients who lack underlying cirrhosis. a-Fetoprotein (AFP), which is commonly elevated in the usual case of HCC, is not elevated in fibrolamellar HCC. Other serum markers that often are elevated in fibrolamellar HCC include neurotensin24 and vitamin B12 binding protein. The fibrolamellar variant of HCC is associated with a prolonged survival as compared with typical HCC, likely owing to the well-demarcated nature of the tumor and the greater range in treatment options for patients without underlying cirrhosis.


    this is maximum i could look for so alfa feto protein and picka are definately marker of hepatocelllaur carcinoma


    neurotensin is a marker of fibrolamellar varient of hepatocellular carcinoma.

    apart from these refrence i have looked in to harrison sabistion, schwartz,oxford textbook of oncology bailey no oone mentions alpha 2 macroglobulin as a marker but still net refrence is full of alpha 2 macroglobulin.

    the other thing is nerutension is a marker of fibrolamellar varient of hepatocellular carcinoma which is not classic hcc but a type of hcc only and ofcourse primary liver tumor .so i could not find answer to this.

    i have given you all the text book refrence if we go by text books answer is definately alpha 2 macro globulin but then you will find so many net refrences mentioning alpha 2 macro glubulin as a marker for hcc.so these was the maximum work i could have done(almost 1.5 hrs) for this question. so just read it.and decide your self.
  3. aayush.

    aayush. Guest

    Mutation of which gene causes primary pulmonary hypertension

    a.bone morphogenic protein receptor -2
    b.endothelin



    Answer a.bone morphogenic protein recptor 2

    refrence current pulmonologic diagnosis and treatment chaptor 18

    Approximately 5–15% of cases of PAH are familial and the gene responsible for familial PAH was recently identified by two separate investigators as the bone morphogenetic receptor protein 2 (BMPR2), a member of the transforming growth factor- (TGF-) superfamily. Abnormalities in this gene have also been found in up to 30% of patients with sporadic PAH. How abnormalities in the BMPR2 gene lead to PAH is not known
  4. aayush.

    aayush. Guest

    pregnant women in the 9 th month had jaundice and delivered a healthy baby.she present with tendor hepatomegaly.In the post partum period her liver function deteriorated further with her ALT levels 1100 and bilirubin 5 mg%.Her urine out put was decreased and she had pedal; edema,the ascitic fluid had lymphocytes 10 in number per ml,ascitic fuild albumin was 3 mg%.The most likely diagnosis is:
    a. Acute fatty liver of pregnancy
    b. HELLP syndrome
    c. Acute liver failure
    d. Acute Budd Chiari syndrome

    answer d.acute budd chairi syndrome

    refrence harrison 1862

    harrison says in thie condition liver is grossly enlarged and tender

    now refrence shiff's disease of liver

    Both pregnancy and oral contraceptive therapy are associated with a
    hypercoagulable state (160). The frequency of hepatic vein thrombosis (Budd-
    Chiari syndrome) is increased in women using oral contraceptives (161). Reports
    from India suggest that it is also more common in pregnant women, usually
    manifesting immediately after delivery (162,163). Several reports have linked
    acute Budd-Chiari syndrome during pregnancy in western women with an
    underlying procoagulant state, such as primary antiphospholipid syndrome (164),
    anticardiolipin antibody (165), factor V Leiden mutation (166,167), or thrombotic
    thrombocytopenic purpura (168). The prognosis for pregnant women with this
    syndrome is ominous, as it is for pregnant women with idiopathic veno-occlusive
    disease. Liver transplantation has been used as a lifesaving measure (166,169),
    but such patients may survive with conservative measures, including delivery and
    anticoagulation. Recurrence has been reported in a patient whose anticoagulants
    were stopped when she became pregnant again (165). Nevertheless, subsequent
    successful, uncomplicated pregnancy has been reported for patients with a
    history of Budd-Chiari syndrome associated with oral contraceptives or an
    underlying myeloproliferative syndrome (170).


    Standard laboratory investigation is rarely helpful in patients with Budd-Chiari
    syndrome. Nonspecific mild transaminase level elevation can be seen in 25% to
    50% of patients but does not aid in establishing the diagnosis (25,37).
    Transaminase values over 1,000 IU/L are possible in acute outflow obstruction or
    hepatic failure, especially if there is accompanying portal vein thrombosis (25).
    Serum bilirubin and alkaline phosphatase levels and prothrombin time are usually
    normal or mildly elevated and are also not specific (25,71,72). Ascitic fluid
    analysis is consistent with portal hypertension.

    Budd-Chiari syndrome) also have a high total ascitic fluid albumin ratio less
    than 1.1. Lactate dehydrogenase and cholesterol concentrations, however, are
    not increased


    patients with chronic Budd-Chiari syndrome, the protein concentration in
    ascitic fluid may be low because of capillarization of the hepatic sinusoids (see
    later) and hepatic stigmata, abnormal liver function test results, splenomegaly,
    and esophageal varices. It is, therefore, essential to seek physical and additional
    diagnostic findings characteristics of these entities.
  5. Dr.Dhaka.

    Dr.Dhaka. Guest

    40.source of ammonia for kidney
    a.glutamine
    b.aspartate
    c.alanine
    d.

    answer a glutamine

    harper 25 the edition chapter 31 catabolism of purine and aminoacid nitrogen.

    page 318

    glutamine also serves as a souce of ammonia for exretion by kidney
  6. saboo

    saboo Guest

    I would like to considerA few questions .i m giving references of 15th edition of harrison plz confirm if any discripancies from latest edition

    55. In 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 serum transferring levels

    page 2259 chapter 345 hemochromatosis, heading diagnosis, 3rd para
    methodsof assesing parenchymal fe status 1 s. fe and saturation transferrin
    2 s feritin
    3 liv biopsy
    4 chelatable fe
    5ct
    6 mri
    the sfe and % saturation transferrin are the earliest changes but are not specific
    s . ferritin is good index of body fe stores increase or decrease
    kindly read pathogenesis and u understand s fe earlier than s % of transferrin
    also see table 345-2 and screening so that u understand the whole funda of diag and screening and application of

    diff indicators used as test in this disease . i cannot type the whole chapter. plz bear with me
    plz see i think the answer will be A.

    24. AST/ALT > 1 is seen in:
    a. NASH
    b. Alcoholic hepatitis
    c. Wilson’s disease
    d. All of the above

    chapter 298 alcohol liver disease sub head lab feature page 1753
    chapter 293 evaluation of liver function ,heading enz
    chap 299 cirhosis and complications headind alc cirhosis , sub head lab finding
    chapter 300 hepatic statosis and nash page 1768 heading diagnosis
    chapter 348 wilson disease p-2275 heading diag
    kindly try to read the above refrences which are hardly more than one para each.... the summary is
    ast / alt increas implies alc disease becoz alcohol is the only cause of fatty liver dis which causes rise in ast and

    almost no rise in alt becoz it decreases pyridoxal po4
    ast/alt > 1 sugest alc liv dis
    ast / alt>2 suggestive of alc c/c liv dis
    ast / alt >3 diagnosticof alc dis
    as/alt diff nash
    both transaminases increase in wilsons.
    so the answer is alc dis

    33. A pregnant women in the 9 th month had jaundice and delivered a healthy baby.In the post partum period her

    liver function deteriorated further with her ALT levels 1100 and bilirubin 5 mg%.Her urine out put was decreased

    and she had pedal; edema,the ascitic fluid had lymphocytes 10 in number per ml,ascitic fuild albumin was 3

    mg%.The most likely diagnosis is:
    a. Acute fatty liver of pregnancy
    b. HELLP syndrome
    c. Acute liver failure
    d. Acute Budd Chiari syndrome

    now the above case is of budd chiari because of following reasons
    in ac fatty liver liver size is reduced harrison p-1768, chapter300 dis of liver heading- microvesicular fatty liver
    also it states that it subsides after delivery and delivery is infact treat ment
    read also budd chiari on chapp 299 page 1759 under cardiac cirhosis heading... u will find all the clasical findings.

    supoting the diagnosis of Budd Chiari syndrome
  7. indp

    indp Guest

    5yr child with pallor, petechiae, no liver & spleen....diagnosis:
    can u explain pallor with ITP. Harrison also says atypical aplastic anemia as DD of ITP, but mark it is atypical( 16th edition page-675). True the age 5 yr goes in favour of ITP but is it hard & fast that no aplastic in 5yr old?
  8. indp

    indp Guest

    IN relation to addison disease false is

    low renin level
    serum cortisol <8mg%
    cardac atrophy
    low diastolic pressure

    refrence william's text book of endocrinogloy



    In primary hypoadrenalism, mineralocorticoid deficiency usually occurs with elevated plasma renin activity


    -- Clinical Features of Primary Adrenal Insufficiency
    Symptom, Sign, or Laboratory Finding Frequency (%)
    Symptom
    Weakness, tiredness, fatigue
    Anorexia
    Gastrointestinal symptoms
    Nausea
    Vomiting
    Constipation
    Abdominal pain
    Diarrhea
    Salt craving
    Postural dizziness
    Muscle or joint pains
    Sign
    Weight loss
    Hyperpigmentation
    Hypotension (<110 mm Hg systolic)
    Vitiligo
    Auricular calcification
    Laboratory Finding
    Electrolyte disturbances
    Hyponatremia
    Hyperkalemia
    Hypercalcemia
    Azotemia
    Anemia


    though there is hypotension important point about blood pressure is

    Salt craving may be a feature, and there may be a low-grade fever. Supine blood pressure is usually normal, but almost invariably there is a fall in blood pressure on standing
  9. dextrap

    dextrap Guest

    For the question on the gene involved in primary pulmonary hypertension......guys who are sceptic about high fi text references and internet sites......it is clearly given in Harrison. Just check out the "genetic considerations" box under the same topic.

    The answer is clearly bone morphogenic protein 2.
  10. dextrap

    dextrap Guest

    160. MC comp of ERCP
    a-acute pancreatitis
    b-acute cholangitis
    c-jejunal perforation
    answer a.acute pancreatitis


    refrence:Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging, 4th Ed
    page 1288
    The most common complication is acute pancreatitis, a complication that is rarely if ever experienced after PTC. Other complications include bleeding and retroperitoneal perforation after endoscopic sphincterotomy and cholangitis following inadequate biliary drainage
  11. dextrap

    dextrap 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
  12. dextrap

    dextrap Guest

    exat sentence from schiff liver disease page 1050

    An elevated TS (≥45%) is recognized as the most common early phenotypic
    marker of HH hh is heridtary hemochromatosis
  13. ruchika

    ruchika Guest

    a patient presents with diarrhea raised liver enzymes anemia what to look for?ans. will be anti endomysial antibodies.the only confusion regarding raised liver enzymes is solved by CMDT 2007.look where celiac disease is given.under the heading laboratory tests last line is.... serum aminotransferases are raised in 40% of the cases.i think its not given in older editions.
  14. aayush

    aayush Guest

    178. A 2 year old child with low grade fever completed with 8 days of 10-day course of cefaclor. His fever was still persistent and he had now developed pruritic rash all over the body with lymphadenopathy.Most likely diagnosis is:
    a. Kawasaki’s disease
    b. Type 3 hypersensitivity reaction
    c. Post viral syndrome
    d. Infectious mononucleosis


    this is the mock test ques:
    5 yr boy presented with fever cough and lap for 6 days . throat has exudative pharyngitis.SPLEEN TIP PALAPABLE.TREATED WITH AMPI ,followed by erythro macular rash.
    1 typhoid
    2scarlet fevr
    3adenoviral
    4i mononucleosis

    now is there not a huge difference between the two presentations.
    spleen tip palapble,presenting lap,ampi tt,

    so whoever says ques same pl rethink.and gaurang ques in mock doesnt mean it will be verbatim repeat.EITHER WE CAN BE HAPPY THINKING WHAT WE MARKED IS CORRECT OR AS AYUSH SAYS LOOK FOR THE RIGHT ANSWER.to decide is upto u now .what do u say shashank?and gaurang?
  15. Dashing

    Dashing Guest

    . Solitary rectal ulcer syndrome show on histology? A.Smooth mus. Proliferation in lamina propria B.Intraepithelial proliferation of lymphocytes C.Dense collagen band in subepithelium D.Distortion of crypt ans.A.Smooth mus. Prol........ Ref.Harshmohan patho4th ed page558. On histology solitary rectal ulcer synd show ulcer,inflam. Of rectal mucosa,lamina propria is occupied with spindile shaped fibroblast &smooth mus cells.Condition is also k/as localised form of colitis cystica profunda.
  16. aayush

    aayush Guest

    which of this is not a cause of hypertension??

    a.erythropoietin
    b.cyclosporin
    c.nsaid
    d.levodopa


    answer d levodopa

    harrison 15th edition page 434
    (adr table)

    drugs causing hypertension
    clonidine withdrawal
    corticotropin
    cyclosporin
    erythropoietin
    glucocorticoids
    monoamine oxidase inhibitors with sympathomimitics
    nsaid(some)
    oral contraceptive
    sympathomimitics
    tca with sympathomimitics


    just to add imp point from goodman-gilman

    levodopa generally cause postural hypotension but when used with moa inhibitor it can cause hypertension
  17. aayush

    aayush Guest

    .To explore subclavian artery which of following muscle isnot divided? 1sternomastoid 2omohyoid 3scalenus anterior 4scalenus medius answer is4scalenus medius ref.Operative surgery by S.das page56 .Also fig.7.3
  18. aayush

    aayush Guest

    michaelis gutmann bodies are found ing

    a.malakoplakia
    fabry's disease
    nail-patella syndrome
    d.metachromatic leucodystrophy

    answer a.melakoplekia

    rerence : Sauer's Manual of Skin Diseases 8th edition

    Malacoplakia. Rare condition of accumulation of phagocytic macrophages usually in immunocompromised patients. Usually involves genitourinary tract but can involve the skin mainly the perineal areas. Michaelis-Gutmann bodies are electron dense intracytoplasmic laminations seen in macrophages.
  19. aayush

    aayush Guest

    The main factors determining cerebral blood flow are:
    1) Cerbral metabolic rate
    2) hypercapnoea
    3) intracranial pressure
    4) hypothermia

    Cerebral blood flow (CBF)
    Cerebral blood flow is normally autoregulated. This maintains a constant blood flow between mean arterial pressures (MAP) of 50–140 mmHg. Outside these limits of autoregulation cerebral blood flow varies passively with perfusion pressure. In patients with chronic hypertension the lower and upper limits of autoregulation are higher than normal so that a blood pressure that may be adequate in a normal patient may lead to cerebral ischaemia in the hypertensive patient. Autoregulation is also impaired or abolished acutely in the presence of a brain tissue acidosis as may occur with hypoxia, hypercarbia, acute intracranial disease, and following head injury.
    Cerebral blood flow varies with:
    Metabolism. CBF is primarily determined by the metabolic demands of the brain. CBF is therefore increased during epileptic seizures and in association with pain and anxiety. Conversely CBF is reduced in coma, hypothermia, and following the administration of anaesthetic agent such as propofol or barbiturates.
    Carbon dioxide tension. Hypocapneoa results in cerebral vasoconstriction and a reduction in CBF. The greatest effect is at normal PaCO2 where a change of 1 kPa results in a 30% change in blood flow. Arterial pressure modifies the response of the cerebral circulation to hyperventilation. High perfusion pressures are associated with an increased responsiveness to hyperventilation, whereas hypotension of 50 mmHg abolishes the effect of increased or decreased PaCO2 on CBF.
    Oxygen tension. PaO2 is not a particularly important determinant of CBF, a value of less than 7 kPa being required before cerebral vasodilatation occurs.
    Temperature. Hypothermia reduces cerebral metabolism thereby reducing CBF. Metabolism falls by approximately 5% for every degree centigrade reduction in body temperature.
    Viscosity. There is no effect on CBF when the haemotocrit is between 30 and 50%. CBF will increase with reduced viscosity outside this range.
    Anaesthetic agents (see p. 402).
  20. aayush

    aayush Guest

    Which of the following is not seen in a pregnant female taking carbimazole?
    a)Choanal atresia
    b)scalp defects
    c)cleft lip/palate
    d)fetal goitre




    Choanal atresia – a recurrent feature of foetal carbimazole syndrome
    Myers, A.K., & Reardon, W.The National Centre for Medical Genetics, Our Ladys Hospital for Sick Children, Crumlin, Dublin, Ireland

    Keypoints

    • Choanal atresia is described as a feature of several congenital anomaly phenotypes.

    • Most cases of choanal atresia arises as an isolated clinical finding.

    • In utero exposure to carbimazole for maternal hyperthyroidism has been reported in five cases of choanal atresia.

    Clinical Otorhinolaryngology ,Volume 30 Issue 4, August 2005
    the site is wwwdotblackwell-synergy.com and just type in a search with the key words choanal atresia and carbimazole

    fetal goitre and scalp defects are seen
    Ref: Katzung 9th edition page 638


    there are have been isolated cases of cleft lip witout palate too and the internet has many references for this but it has been mentioned that choanal atresia has been characteristicaly seen while cleft lip was an isolated incident.

    So i think the answer will be cleft lip/palate
  21. aayush

    aayush Guest

    A survery was done to study the effect of insulin dose and coorsponding hb1Ac levles corrected for age.what would be the best test to study the relation.

    a.Linear regression
    b.logistic regression
    c.pearson corealation
    d.student t test



    Answer a linear regression

    hihg yeild Biostatistics page 50 to 55


    regression:


    If two variable are hihgly corealted,it then becomes possible to predict the value of one of them(the dependent varaible) from value of other(independent variable) by using regrassion techniques.In simple Linear regression the value of one variable is used to predict the value of the other valueby means of simple linear mathemetical function ,the regression equation which quantifies the stratight line relationship between the two variables.This straight line or regression line ,is actually the same 'line of best of fit" to the scattergram as that used in calculating the correlation efficient

    futher it says that to evaluate strenth and association between two variable perason coraelation test is used with the t test to test null hypothesis to test that the relationship doesnot exist in the population.

    two make prediction about the value of one varibale on the bases of other regression techniques are used.


    in these question we are making prediction abhout hba1ac level with the help of other value(insulin dose0

    so i think answer is linear regression.
  22. Dr.Bhaskar

    Dr.Bhaskar Guest

    Ans to Qs22 bilateral germ cell tumor is :
    A .Dysgerminoma
    B.Immature teratoma
    c.Embryonal cell carcinoma
    d.Endodermal sinus tumor.

    Should be (d.)Endodermal sinus tumor

    Ref:current Gynecology and obstetrics 10th edition
    Page :875
    which says

    #Endodermal sinus tumor is bilateral in nearly 100% cases.

    #Dysgerminoma is unilateral in 85-90% cases

    #immature teratoma is bilateral in 5% cases
  23. Dr.Bhaskar

    Dr.Bhaskar Guest

    The common carotid bifurcates at the upper border of the thyroid cartilage.......no doubt

    The commonest site of ectopic pancreas is the stomach mucosa.........


    Both these question have authentic references in multiple standard textbooks which we read....no doubt about that...

    For intracranial pressure measurement intraventricular catheter is the gold standard........

    For the obstetric emergency...............hysterectomy seems to be the answer .
  24. Dr.Bhaskar

    Dr.Bhaskar Guest

    q 13--stedman dictionary
    renal angle 12th rib and erectorspinae(sacrospinalis)

    q21--anybody with reference,i think manual removal as ans

    q26 cca at cricoid

    q-29 splenic hilum

    q-38 a>>>>>d

    q-44 nutritional anemia ref harrison anemia chap

    q-49 ans a is the ans of consensus and also can search on google

    q-88 fibromedial ref robbins
  25. gunjam

    gunjam Guest

    the ans to carbimazole teratogenicity is cleft lip/palate..(refernce; drugs in pregnancy nad lactation by briggs nad freeman.)

    carbimazole causes
    scalp/patchy hair defects
    chaonal atresia
    esophageal atresia
    te fistula
    minor facial anomalies
    hyoplastic pages
    pshychomotor chabnges
    fetal hypothyriodism.
  26. gunjam

    gunjam Guest

    1. L-J (Levey-Jennings) charting is done for:

    a. Accuracy ans
    b. Precision ans
    c. Sensitivity
    d. Specificity

    2. Cause of ‘half-and-half nail’ syndrome in uremia is:
    a. Melatonin
    b. Hypoproteinemia
    c. Dilatation of the capillary nail bed ans
    d. Azotemia

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

    4. Which of the following anti-hypertensive causes impotence:
    a. CCBs ans
    b. Angiotensin receptor blocker
    c. ACE inhibitors
    d. Beta blockers ans

    5. Myopathy is not a feature of:
    a. Cushing’s syndrome
    b. Oncogenic osteomalacia
    c. Nutritional osteomalacia
    d. X-linked hypophosphatemic rickets ans

    6. Plasma exchange is useful in:
    a. HUS
    b. ITP ans
    c. DIC
    d. AIHA

    7. The best investigetion for colonic diverticula is:
    a. CT ans
    b. MRI
    c. Ba-enema
    d. Colonoscopy ans

    8. Michaelis-Gutmann bodies are found in:
    a. Malakoplakia ans
    b. Fabry’s disease
    c. Nail-patella syndrome
    d. Metachromatic leucodystrophy

    9. Charcoal hemoperfusion is done in:
    a. Barbiturate poisoning ans
    b. Salicylate poisoning
    c. Digitalis toxicity
    d. Methyl alcohol poisoning

    10. Liver secretes all of the following except:
    a. Immunoglobulin ans
    b. Hepatoglobin
    c. Complement C3
    d. Fibrinogen
  27. 1234

    1234 Guest

    9month pregnant lady presents wit jaundice abdominal distens

    9month pregnant lady presents wit jaundice abdominal distension pedal edema.though she deliverd a normal baby her clinical condition deteriorated with increasing abdominal distension.her bilirubin is 5d/dl ,sap was 445u/l and elevated liver enzymes,tender hepatomegaly 6cm bcm.her ascetic fluid shows 3g/dl albumin and 10 lymphocytes/ml
    a) Acute liver failure
    b) Acute budd chiari syndrome
    c) Fatty liver of pregnancy
    d) HELLP syndrome
    ANS:b)
  28. 1234

    1234 Guest

    To expose subclavian artery which need not be cut
    a.Sclaneus medius
    b.Sclaneus anticus
    c.Sternocleidomastoid
    d.Omohyoid
    Ans:a
  29. PUDENDAL NERVE

    Root value of pudendal nerve is S2 S3 S4

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