AIPMEE 2010: Subjectwise Questions with All Options & An ALL INDIA Postgraduate Medical Entrance Examination 2010 Subjectwise Questions with All Options & Answers ANAESTHESIA 1. A patient with bilirubin value of 8 mg/dl and serum creatinine of 1.9 mg/dl is planned for surgery. What is the muscle relaxant of choice in this patient? A. Vecuronium B. Pancuronium C. Atracurium D. Rocuronium Ans: C. 2. A 25 year old overweight female was given fentanyl-pancuronium anesthesia for surgery. After surgery and extubation she was observed to have limited movement of the upper body and chest wall in the recovery room. She was conscious and alert but voluntary respiratory effort was limited. Her blood pressure and heart rate were normal. The likely diagnosis is: A. Incomplete reversal of pancuronium B. Pulmonary embolism C. Fentanyl induced chest wall rigidity D. Respiratory depression Ans A. 3. All of the following statements about neuromuscular blockage produced by succinylcholine are true, except: A. No fade on train of four stimulation B. Fade on tetanic stimulation C. No post tetanic facilitation D. Train of four ratio > 0.4 Ans: B. 4. A 27 year old female was brought to emergency department for acute abdominal pain following which she was shifted to the operation theatre for laparotomy. A speedy intubation was performed but after the intubation, breath sounds were observed to be decreased on the left side and a high end trial CO2 was recorded. The likely diagnosis is: A. Endotracheal tube blockage B. Bronchospasm C. Esophageal intubation D. Endobronchial intubation Ans: D. ANATOMY 5. Hypogastric Sheath is a condensation of A. Scarpaâ€™s fascia B. Colleâ€™s fascia C. Pelvic fascia D. Inferior layer of Urogenital diaphragm Ans: C. Pelvic fascia 6. Which of the positions best describes the location of celiac plexus A. Anterolateral to aorta B. Posterolateral to aorta C. Anterolateral to sympathetic chain D. Anteromedical to sympathetic chain Ans: A. Anterolateral to aorta 7. (a) Gluteus medius is supplied by A. Superior Gluteal Nerve B. Inferior Gluteal Nerve C. Nerve to Obturator Internus D. Nerve to Quadratus Femoris Ans: A. Superior Gluteal Nerve (b) Gluteus medius is supplied by A. Superior Gluted Artery B. Inferior Gluteal Artery C. Obturator Artery D. Ilio-inguinal Artery Ans: A. Superior Gluted Artery 8. (a) Which of the following tendons passes below the sustenticulum tali A. Tibialis Anterior B. Tibilias Posterior C. Flexor Digtorum Longus D. Flexor Hallucis longus Ans: D. Flexor Hallucis longus (b) Which of the following tendons has attachments on sustenticulum Tali A. Tibialis Anterior B. Tibialis Posterior C. Flexor digitorum longus D. Flexor Hallucis longus Ans: B. Tibialis Posterior 9. Which of the following passes through the foramen magnum A. Vertebral artery B. Sympathetic chain C. XIth cranial nerve D. Internal carotid artery Ans: A. Vertebral artery 10. All of the following movements occur abduction of shoulder except A. Elevation of humerus B. Axial rotation of clavicle C. Medial rotation of scapula D. Acromioclavicular joint movement Ans: C. Medial rotation of scapula 11. All of the following are composite muscles, except: A. Flexor carpi ulnaris B. Flexor digitorum profundus C. Pectineus D. Biceps femoris Ans: A. Flexor carpi ulnaris 12. Urogenital Diaphragm is made up of the following, except: A. Deep transverse perineus B. Perinial membrane C. Colleâ€™s fascia D. Sphincter Urethrae Ans: C. Colleâ€™s fascia 13. In post-ductal coarctation of aorta collaterals may be formed by all of the following, except: A. Vertebral artery B. Suprascapular artery C. Subscapular artery D. Posterior intercostals artery Ans: none 14. Left sided superior vena cava drains into: A. Right Atrium B. Left atrium C. Coronary sinus D. Pericardial space Ans: A. Right Atrium PHYSIOLOGY 15. All of the following statements about bronchial circulation are true, except: A. Contribute 2% of systemic circulation B. Contribute to gaseous exchange C. Cause venous admixing of blood D. Provide nutritive function to lung Ans: B. 16. An important non-respiratory function of lungs is: A. Anion balance B. Sodium balance C. Potassium balance D. Calcium balance Ans: B. 17. Maximum water reabsorption in the gastrointestinal tract occurs in: A. Stomach B. Jejunum C. Ileum D. Colon Ans: B. 18. The primary action of Nitric oxide (NO) in the gastrointestinal tract is: A. Vasodilatation B. Vasoconstriction C. Gastrointestinal smooth muscle relaxation D. Gastrointestinal slow smooth muscle contraction Ans: C. 19. Hot water bottle relieves pain of abdominal spasm by: A. Stimulation of adrenergic fibers B. Stimulation of cholinergic fibers C. Inhibition of cold receptors D. Inhibition of heat receptors Ans: A. 20. Vitamin K deficiency coagulation factors include: A. II and III B. IX and X C. III and V D. VIII and XII Ans: B. IX and X 21. During heavy exercise the cardiac output (CO) increase upto five fold while pulmonary arterial pressure rises very little. This physiological ability of the pulmonary circulation is best explained by: A. Increase in the number of open capillaries B. Sympathetically mediated greater distensibility of pulmonary vessels C. Large amount of smooth muscle in pulmonary arteries D. Smaller surface area of pulmonary circulation Ans: A. 22. Venous return to heart during quiet standing is facilitated by all of the following factors, except: A. Calf muscle contraction during standing B. Valves in perforators C. Sleeves of deep fascia D. Gravitational increase in arterial pressure Ans: D. 23. During cardiac imaging the phase of minimum motion of heart is: A. Late systole B. Mid systole C. Late diastole D. Mid diastole Ans: D. 24. Insulin secretion is inhibited by: A. Secretin B. Epinephrine C. Growth hormone D. Gastrin Ans: B. 25. Which of the following is not seen in humans: A. Estrous cycle B. Menstrual cycle C. Endometrial cycle D. Ovarian cycle Ans: A. 26. Lesions of the lateral cerebellum cause all of the following, except: A. Incoordination B. Intention tremor C. Resting tremor D. Ataxia Ans: C. 27. Basal Metabolic Rate depends most closely on: A. Lean body mass B. Body mass index C. Obesity D. Body surface area Ans: A. 28. Decreased Basal Metabolic Rate is seen in: A. Obesity B. Hyperthyroidism C. Feeding D. Exercise Ans: A. 29. Low CSF protein may be seen in all of the following conditions, except: A. Recurrent lumbar puncture B. Hypothyroidism C. Pseudotumor cerebri D. Infants Ans: B. BIOCHEMISTY 30. Sphingomyelinase deficiency is seen in: A. Niemann â€“ pick disease B. Farberâ€™s disease C. Tay Sachâ€™s disease D. Krabbeâ€™s disease Ans: A. 31. Which of the following lipoproteins does not move towards charged end in electrophorsis? A. VLDL B. LDL C. HDL D. Chylomicrons Ans: D. 32. Insulin like fructans are used as prebiotics as they are non digestible. Resistance to digestion in the upper GI tract results from: A. Absence of Digestive enzyme in the upper GIT B. Beta configuration of anomeric C2 C. Low pH of the stomach D. Presence of alpha-osidic linkages Ans: B. 33. Method of chromatography in which molecules that are negatively charged are selectively released from stationary phase into the positively charged molecules in mobile phase is termed. A. Affinity chromatography B. Ion â€“ Exchange chromatography C. Adsorbtion chromatography D. Size â€“ exclusion chromatography Ans: B. 34. Which of the following techniques is used for detection of variation in DNA sequence and Gene expression? A. Northern Blot B. Southern Blot C. Western Blot D. Microarray Ans: D. 35. Which of the following tests is not used for detection of specific aneuploidy? A. FISH B. RT-PCR C. QF-PCR D. Microarray Ans: D. 36. Prenatal Diagnosis of hemophilia is best done by: A. PCR B. Linkage analysis C. Cytometry D. Microarray Ans: A. 37. Rotheraâ€™s test used for detection of A. Proteins B. Glucose C. Fatty Acid D. Ketones Ans: D. 38. Which of the following liver enzymes is predominantly mitochondrial? A. SGOT (AST) B. SGPT (ALT) C. GGT D. 5â€™ Nucleotidase Ans: A. PHARMACOLOGY 39. (a) Mechanism of action of Theophylline in Bronchial Asthma include all of the following except: A. Phosphodiesterase inhibition B. Adenosine receptor antagonism C. Increased Histone deacteylation D. Beta-2 receptor stimulation Ans: D. (b) Mechanism of action of Theophylline in bronchial asthma in: A. Phosphodiesterase Inhibition B. Mast cell stabilization C. Leukotriene Antagonism D. Beta-2 agonist Ans: A. 40. Narrow therapeutic index is seen with: A. Desipamine B. Lithium C. Penicillin D. Diazepam Ans: B. 41. Which of the following is a â€˜Protein pump inhibitorâ€™? A. Ranitidine B. Misoprostol C. Omeprazole D. Laxatidine Ans: C. 42. Methyldopa is primarily used in: A. Parkinsonism B. Pregnancy Induced hypertension C. Hirsuitism D. Refractory hypertension Ans: B. 43. Fetal Hydantoin Syndrome is cause by A. Phenytoin B. Alcohol C. Tetracycline D. Sodium valproate Ans: A. 44. Which of the following drugs should not be used with Rivastigmine in patients with Alzheimerâ€™s except: A. SSRI B. Tricyclic Antidepressant C. RIMA D. Atypical Antipressants Ans: B. 45. Ethosuxamide is the drug of choice for: A. Generalized Tonic clonic seizures B. Complex partial seizures C. Absence seizures D. Myoclonic seizures 46. Which of the following about Opioid receptor antagonists is false? A. Naloxone can be used to for treatment of opioid induced constipation B. Naltrexone may be used for treatment of alcohol dependence C. Nalmefine has a longer half life than Naloxone D. Naloxone is more potent than Naltrexone Ans: D. 47. L-Dopa is combined with Carbidopa in the treatment of parkinsonism to: A. Decrease the efficacy of levodopa B. Inhibit peripheral decarboxylation of levodopa C. Increase the dose of levodopa required D. inhibit conversion of levodopa to dopamine in the CNS Ans: B. 48. All of the following statements about Phenytoin are true, except: A. Follows saturation kinetics B. Is teratogenic C. Is highly protein bound D. Stimulates insulin secretion Ans: D. 49. Which of the following teratogenic effects in incorrectly matched A. Phenytoin â€“ Cleft lip / palate B. Zidovudine â€“ Skull Defects C. Valproate â€“ Neural tube effects D. Warfarin â€“ Nasal bone dysplasia Ans: B. 50. All of the following agents are used for prophylaxis of migraine, except A. Propanalol B. Valproate C. Topiramate D. Ethosuxamide Ans: D. 51. MAO inhibitors should not be used with A. Pethidine B. Pentazocine C. Buprenorphine D. Morphine Ans: A > B. 52. Serotonin syndrome may be precipitated by all of the following medications, except: A. Chlorpromazine B. Pentazocine C. Buspirone D. Meperidine Ans: A. 53. A young male presents with meningococcal meningitis and allergy to penicillin. Which is the most suitable drug: A. Chloramphenicol B. Meropenem C. Ciprofloxacin D. Teicoplanin Ans: A. 54. All of the following drugs may cause Hirsuitism, except A. Danazol B. Phenytoin C. Norethisterone D. Flutamide Ans: D. 55. Most common congenital anomaly associated with lithium A. Cardiac Malformations B. Neural tube defects C. Renal anomaly D. Fetal Hydantoi syndrome Ans: A. 56. Which of the following should be monitored in patient receiving linezolid therapy? A. Renal function B. Liver function C. Auditory function D. Platelet count Ans: D. 57. All of the following statements about thalidomide are true, except: A. It has been re introduced for its activity in ENL. B. Developed as antiemetic in pregnancy but withdrawn because of phacomelia C. Used for new and relapsed cases of multiple myeloma D. Most common side effects are diarrhea and euphoria Ans: D. 58. Pancreatitis occurs with: A. Abacavir B. Zidovudine C. Lamivudine D. Didanosine Ans: D. 59. Which of the following agents is recommended for treatment of Gastrointestinal Stromal Tumors (GIST)? A. Sorafenib B. Imatinib C. Gefitinib D. Erlotinib Ans: B. 60. Amphoterecin B toxicity can be lowered by A. Giving it with Glucose B. Decreasing the dose C. Using Liposomal Delivery systems D. Combining with flucytosine Ans: C > D. 61. Which of the following newer drugs has activity on both HER 1 and HER 2 new Receptors? A. Erlotinib B. Gefitinib C. Canertinib D. Lapatinib Ans: D. 62. Tyrosine kinase inhibitors are used in the treatment of A. Gastrointestinal strimal tumors (GIST) B. Acute myeloid leukemia C. Neurofibromatosis D. Small cell carcinoma lung Ans: A. 63. Which of the following statements about Mycophenolate Mofetil is not true? A. Most common adverse effect is Nephrotoxicity B. Used in Transplant rejection C. It is a prodrug and converted to Mycophenolic acid D. Is not used with Azathioprine Ans: A. 64. Which of the following drugs is recommended for the treatment of Heparin induced thrombocytopenia? A. Abciximab B. Lepirudin C. Warfarin D. Alteplase Ans: B. 65. All of the following statements about Trientine are true, except: A. More potent than penicillamine and orally absorbed B. Alternative to penicillamine in non tolerant C. Not given with iron within two hours of ingestion D. May cause iron deficiency anemia Ans: A. 66. Allopurinol is used in the treatment of A. Osteoarthritis B. Gout C. Rheumatoid Arthritis D. Ankylosing spondylitis Ans: B. 67. In equivalent concentrations, steroids are more potent in which form: A. Gel B. Cream C. Ointment D. Lotion Ans: C. PATHOLOGY 68. Caspases are involved in: A. cell division B. necrosis C. apoptosis D. Inflammation Ans: C. 69. (a) Actions of Bradykinin include all of the following, except: A. Vasodilatation B. Bronchodilatation C. Increased vascular permeability D. Pain Ans: B. (b) What is the most important role of Bradykinin in acute inflammation? A. Increase in vascular permeability B. Vasodilatation C. Mediation of pain D. Bronchoconstriction Ans: A. 70. Heterozygous sickle cell anemia gives protection against: A. G6PD B. Malaria C. Thalassemia D. Dengue fever Ans: B. 71. Burkittâ€™s Lymphoma is associated with: A. t (8:14) B. t (11:14) C. t (15:17) D. t (14:18) Ans: A. 72. Translocation t (2:8)(p12:q24) is associated with: A. Chronic Myeloid leukemia (CML) B. Acute Myeloid Leukemia (LML) C. T cell - ALL D. Burkittâ€™s Lymphoma Ans: D. 73. (a) The characteristic feature of apoptosis on light microscopy is A. cellular swelling B. nuclear compaction C. intact cell membrane D. Cytoplasmic eosinophlia Ans: B. (b) All of the following are features of apoptosis, except A. Cellular swelling B. nuclear compaction C. intact cell membrane D. Cytoplasmic eosinophlia Ans: A. 74. (a) PNH is associated with deficiency of: A. DAF B. MIRL C. GPI Anchored protein D. All of the above Ans: D. (b) PNH is associated with deficiency of: A. DAF (Decay accelerating factor) B. MIRL (Membrane inhibitor of reactive lysis) C. GPI Anchored Protein (Glycosyl phosphatidyl inosital anchored proteins) D. LFA (Lymphocyte function associated antigen) Ans: C. 75. Plasmacytoid lymphomas may be associated with: A. IgG B. IgM C. IgA D. IgE Ans: B. 76. Which of the following have most friable vegetation? A. Infective endocarditis B. Libman Sackâ€™s endocarditis C. Rheumatic heart disease D. SLE Ans: A. 77. Characteristic pathological finding in carcinoid heart disease is: A. Fibrous endocardial thickening of right ventricle, tricuspid valve & pulmonary valve B. Endometrial thickening of tricuspid valve with severe tricuspid stenosis C. Collagen rich, elastic deposits in endocardium of right ventricle and pulmonary valve D. Calcification of tricuspid and pulmonary valve Ans: A. 78. A female presents with history of progressive breathlessness. Histology shows heterogenous patchy fibrosis with several fibroblastic foci. The most likely diagnosis is: A. Cryptogenic organizing pneumonia B. Non specific interstitial pneumonia C. Usual interstitial pneumonia D. Desquamative interstitial pneumonia Ans: C. 79. Chromophobe variant of renal cell carcinoma is associated with A. VHL gene mutations B. Trisomy of 7 and 17 (+7, +17) C. 3 p deletions (3p-) D. Monosomy of 1 and Y (-1, -Y) Ans: D. 80. All of the following condition are associated with granulomatous pathology, except: A. Wegnerâ€™s granulomatosis (WG) B. Takayasu Arteritis (TA) C. Polyarteritis Nodosa (Classic PAN) D. Giant cell arteritis (GCA) Ans: C. 81. Electron microscopy is diagnostic in: A. Goodpastureâ€™s syndrome B. Alportâ€™s syndrome C. Wegenerâ€™s syndrome D. Chung strauss syndrome Ans: B. 82. Which of the following is the most characteristic ultrastructural feature of paraganglioma on electron microscopy? A. Shrunken mitochondria B. Large Golgi apparatus C. Frequent mitoses D. Dense core neuroendocrine granules Ans: D. 83. Which of the following is a marker of langerhans cell histiocytosis? A. CD 1a B. CD 10 C. CD 30 D. CD56 Ans: A. 84. Hypercoagulation in nephritic syndrome is caused by A. Loss of Antithrombin III B. Decreased fibrinogen C. Decreased metabolism of vitamin K D. Increase in protein C Ans: A. 85. Which of the following markers is specific for Gastro intestinal stromal tumors (GIST)? A. CD 117 B. CD 34 C. CD 23 D. S â€“ 1000 Ans: A. 86. Downâ€™s syndrome is most commonly caused by: A. Maternal nondisjunction B. Paternal Nondisjunction C. Translocation D. Mosaicism Ans: A. 87. Cystic fibrosis is inherited as an autosomal recessive condition. A normal couple has one daughter affected with the disease. They are now planning to have another child. What is the cause of her sibling being affected by the disease? A. 0 B. Â½ C. Â¼ D. Â¾ Ans: C. 88. Males are more commonly affected than females in: A. Autosomal Dominant B. Autosomal Recessive C. X-linked dominant D. X-linked recessive Ans: D. MICROBIOLOGY 89. Peptide binding site on class I MHC molecules for presenting processed antigen to CD8 T cells is formed by: A. Proximal domain to alpha subunits B. Distal domain of alpha subunit C. Proximal domains of Alpha and Beta subunit D. Distal domains of alpha and beta subunit Ans: B. 90. All of the following statements about staphylococcus aureus are true, except: A. Most common source of infection is cross infection from infected people B. About 30% of general population is healthy nasal carriers C. Epidermolysin and TSS toxin are superantigens D. Methicillin resistance is chromosomally mediated. Ans: A. 91. A child presents with sepsis. Bacteria isolated showed beta hemolysis on blood agar, resistance to bacitracin, and a positive CAMP test. The most probable organism causing infection is: A. S. pyogenes B. S. agalacitae C. Enterococcus D. S. pneumoniae Ans: B. 92. All of the following statements about EI-Tor Vibrios are true, except: A. Humans are the only reservoir B. Can survive in ice cold water for 2-4 weeks C. Killed boiling for 30 seconds D. Enterotoxin can have direct effects on other tissues besides intestinal epithelial cells. Ans: D. 93. Isolation of Chlamydia from tissue specimen can be done by A. ELISA (Enzyme linked immune assay) B. Yolk sac inoculation C. Direct immunofluorescence antibody test (DFA) D. Polymerase chain reaction (PCR) Ans: B. 94. Varicella Zoster remains latent in: A. Trigeminal ganglion B. T cells C. B cells D. Macrophages Ans: A. 95. Most common genital lesion in HIV patient is: A. Chlamydia B. Herpes C. Syphilis D. Candida Ans: B. 96. A diabetic patient present with bloody nasal discharge, orbital swelling and pain. Culture of periorbital pus showed branching septate hyphae. Which of the following is the most probable organism involved? A. Mucor B. Candida C. Aspergillus D. Rhizopus Ans: C. 97. (a) All of the following statements about Penicillin binding proteins (PBP) are true, except: A. PBPâ€™s are localized on the outer face of cell wall B. PBPâ€™s are essential for cell wall synthesis C. PBPâ€™s act as carboxypeptidases and transpeptidases D. Alteration in PBPâ€™s is the primary bases of resistance in MRSA Ans: A. (b) All of the following statements about Penicillin Resistance are true, except: A. Beta lactamase production is the most common mechanism of resistance B. Alteration in target PBPs is an important resistance mechanism in Gram negative bacteria C. Alteration in permeability / penetration of antibiotic causes resistance only in gram negative bacteria D. Beta lactamase production causes resistance in both gram positive and gram negative bacteria Ans: B. 98. Which of the following may cause biliary obstruction? A. Ancylostoma B. Entrobius C. Strongyloides D. Clonorchis Ans: D. 99. A young woman complains of recurrent rhinitis, nasal discharge and bilateral nasal blockage since one year. She also had history of allergy and asthma. On examination, multiple polyps with mucosal thickening and impacted secretions are seen in nasal cavities. Biopsy was taken and the material on culture showed many hyphae with dichoyomous branching typically at 45 degree. Which of the following is most likely organism responsible? A. Rhizopus B. Aspergilus C. Mucor D. Candida Ans: B. FORENSIC 100. Primary impact injuries are commonly seen on: A. Chest B. Abdomen C. Legs D. Head Ans: C. 101. A woman died within 5 years of marriage under suspicious circumstances. Her parents complained that her in laws used to frequently demand for dowry. Under which of the following sections can a magistrate authorize autopsy of the case: A. Section 174 CrPc B. Section 176 CrPc C. Section 304 IPC D. Section 302 IPC Ans: B. 102. A factory worker presents with excessive salivation, blue lines on gums, tremors, disturbed personality, insomnia and lose of appetite. The most likely poisoning is: A. Mercury B. Lead C. Arsenic D. Phosphorus Ans: A. 103. Which of the following bullets leaves a visible mark, so that a person can see it: A. Tandem bullet B. Tracer bullet C. Dum dum bullet D. Incendiary bullet Ans: B. 104. Lightening flash can cause injury by all of the following, except: A. Direct effect of electric current B. Super Heated air C. Expanded and repelled air D. Compressed air pushed in front of the current Ans: D. 105. Aconite poisoning causes all except: A. Hypersalivation B. Tingling and numbness C. Increased BP D. Chest pain Ans: C. 106. Which of the following drug is used for Narcoanalysis? A. Atropine B. Phenobarbitone C. Scopolamine D. Pethidine Ans: C. SPM 107. Which of the following is associated with emotional valence and is most likely to be influenced by motivation? A. Attitude B. Belief C. Practice D. Knowledge Ans: C. 108. ASHA is posted at: A. Village level B. Primary Health centre C. Community health centre D. Subsentre Ans: A. 109. Movement across socioeconomic levels is termed as: A. Social Equality B. Social upliftment C. Social Mobility D. Social insurance Ans: C. 110. â€œJSYâ€ stands for: A. Janani Surksha yojana B. Jeevan swastha yojana C. Jan sewa yojna D. Jan suraksha yojna Ans: A. 111. Provision of primary Health care was done by: A. Bhore committee B. Alma â€“ Ata declaration C. Shrivastava committee D. National Health policy Ans: B. 112. Which of the following best reflects the highest level of community participation? A. Planning of intervention by community B. Intervention based on assessment of community needs C. Provision of resources by community d. Community supports and cooperates with workers Ans: A. 113. Which of the following regarding maternal mortality rate (MMR) is not true? A. Numerator includes total number of females deaths within 42 days of delivery B. Denominator includes still births and abortions C. it is expressed as a rate and not ratio D. It is expressed per 100 Ans: B. 114. Perinatal mortality rate includes: A. Still borns and death within 7 days of birth B. Neonatal deaths within 30 days of birth C, Abortions and death within 7 days of birth D. Deaths between 7 and 28 days of birth Ans: A. 115. Which of the following is not an essential component of primary health care? A. Provision of essential drugs B. Cost effectiveness C. Immunization against major infectious diseases D. Health education Ans: B. 116. Which of the following is the current trend in health care? A. Qualitative enquiry B. Community Participation C. Equitable distribution D. Primary health care Ans: B. 117. IMNCI differs from IMCI in all of the following, except: A. Malaria and anemia are included B. 0-7 days neonates are included C. Emphasis on management of sick neonates over sick older children D. Treatment is aimed at more than one disease at a time Ans: D. 118. Mass chemoprophylaxis is endemic area is recommended for all of the following, except: A. Yaws B. Leprosy C. Trachoma D. Filaria Ans: B. 119. Rural and urban difference in prevalence is seen in all of the following, except: A. Lung cancer B. Tuberculosis C. Mental illness D. Chronic Bronchitis Ans: B. 120. All of the following factors contribute to Resurgence of malaria, except: A. Drug resistance in host B. drug resistance in parasite C. Drug resistance in vectors D. Antigenic variations in parasite Ans: A. 121. A case of acute flaccid paralysis must be observed for how may days for residual weakness: A. 30 days B. 42 days C. 60 days D. 90 days Ans: C. 122. India aims to eliminate which of the following diseases by 2015: A. Malaria B. Tuberculosis C. Kala Azar D. Filariasis Ans: D. 123. The screening strategy for prevention of blindness from diabetic retinopathy according to the NPCB involves: A. Opportunistic screening B. High risk screening C. Mass screening D. Screening by primary care physician Ans: B. 124. All of the following statements about Tuberculosis annual rate of infection (ARI) are true, except: A. The average estimated ARI for India in 1.7%. B. 1% ARI corresponds 75 new cases of smear positive TB/ 100,00 population C. ARI reflects the current trend and effectiveness of control measures D. ARI represents the percentage new infections Ans: B. 125. All of the following statements about scrub are true, except: A. caused by O. Tsutsugamushi B. Mites as reservoirs C. Transmitted when adult mites feed on hosts D. Tetracycline is the drug of choice Ans: C. 126. Which of the following statements about confidence limits / interval is true: A. Smaller the confidence level lager will be the confidence interval B. Less variable the data, wider will be the confidence interval C. Sample size does not affect the confidence interval D. 95% confidence interval will cover 2 standard errors around the mean Ans: D. 127. A standard â€˜z-scoreâ€™ is related to: A. Binomial distribution B. Normal distribution C. Chi-square test D. t-test Ans: B. 128. A new test for diabetes was carried out of the 80 people who were tested positive, it was found that actually 40 had diabetes and out of 9920 people who were tested negative only 9840 did not have the disease actually. The sensitivity of this new test is: A. 33% B. 50% C. 65% D. 99% Ans: A. 129. Which of the following is not a Synthetic Pyrethyroid Compound? A. DDT B. Permethrin C. Proparthrin D. Cypermethrin Ans: A. 130. The population of a community on the 1st of June was recorded as 1,65,000. Total no. of new cases of Tuberculosis, recorded from 1st January to 31st June were 22. Total registered cases of tuberculosis in the community were recorded as 220. what is the incidence of TB in this community per 10 lakh population? A. 133 B. 220 C. 13.3 D. 22 Ans: A. 131. All of the following about â€˜Red Crossâ€™ emblem are true, except: A. Size of bars in the cross in equal horizontally and vertically B. Can be used by personnel of United Nations Organizations (UNO) C. Misuse of emblem is punishable offence under Indian Law D. Was convened in Geneva Ans: B. MEDICINE 132. A 16 year old young girl present with a history of fatiguability weakness and lethargy. Complete blood picture (CBC) reveals a Heamoglobin of 7.0, MCV of 70, MCH of 20 pg/cell and red cell distribution width (RDW) of 20. The most likely diagnosis is: A. Iron deficiency anemia B. Thalassemia Minor C. Thalassemia Major D. Sickle cell trait Ans: A. 133. Which of the following investigations should be done immediately to best confirm a non matched blood transfusion reaction? A. Indirect Coombâ€™s test B. Direct Coombâ€™s test C. Antibody in patientâ€™s serum D. Antibody in donor serum Ans: B. 134. Bence Jones proteinuria may be seen in: A. Alpha heavy Chain disease B. Gamma heavy chain disease C. â€˜Muâ€™ heavy chain disease D. Epsilon heavy chain disease Ans: C. 135. Bence Jones proteins are derived from: A. Alpha Globulins B. Beta Globulins C. Gamma globulins D. Delta globulins Ans: C. 137. Which of the following is a major criteria for diagnosis of poycythemia vera? A. Presence of JAK-2 mutation B. Low Erythropoetin levels C. High leucocyte alkaline phosphatase (increase LAP score) D. Thrombocytosis Ans: A. 138. All of the following statements about Fanconiâ€™s anemia are true, except: A. Autosomal dominant inheritance B. Hypocellular bone marrow C. Congenital Anomalies D. Usually normocytic / macrocytic cell morphology Ans: A. 139. All of the following statements about third heart sound (S3) are true, except: A. Occurs due to rapid filling of the ventricles during atrial systole B. Seen in in constrictive pericarditis C. Seen in atrial septal defect (ASD) D. Seen in Ventricular septal defect (VSD) Ans: A. 140. A young asymptomatic female is observed to have a Midsystolic Click on routine examination. Valves are likely to show: A. Myxomatous degeneration B. Aschoff bodies C. Calcific degeneration D. Ruptured chordae tendinae Ans: A. 141. Beckâ€™s Triad is seen in: A. Constrictive Pericarditis B. Cardiac tamponade C. Right ventricular Myocardial infarction (RVMI) D. Restrictive cardiomyopathy Ans: B. 142. A patient presents with following parameters pH 7.5, p CO2 30 mmHg, pO2 102 mmhg and HCO3 16 meq/I. Which of the following correctly describes the compensatory mechanisms? A. Respiratory alkalosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Metabolic Acidosis Ans: D. 143. A 29 year old anxious lady presents with a history of progressive breathlessness and exercise intolerance since four months. Her FVC is 90% and FEV 1 / FVC is 86%. Oxygen saturation after exercise was observed to drop from 92% to 86%. What is the likely diagnosis? A. Primary alveolar hypoventilation B. Primary pulmonary hypertension C. Anxiety disorder D. Interstitial lung disease Ans: B. 144. Accelerated Idioventricular Rhythm (AIVR) is the most common arrhythmia associated with: A. Dilated cardiomyopathy B. Myocardial Reperfusion C. Digitalis intoxication D. Myocarditis Ans: B. 145. Streptokinase and urokinase are contraindicated in: A. Intracranial malignancy B. Pulmonary embolism C. A V fistula D. Thrombophlebitis Ans: A. 146. A truck driver presented with history of fever since four weeks, and dry cough. He also gives a history of weight loss of about 10 kg. X-ray shows bilateral reticulonodular infiltrates. The most likely diagnosis is: A. Tuberculosis B. Pneumocystis carinii Pneumonia C. Pneumococcal pneumonia D. Interstitial lung disease Ans: B. 147. Cavitatory lesions in lung are seen in: A. Primary pulmonary tuberculosis B. Staphylococcal pneumonia C. Preumoconiosis D. Interstitial lung disease Ans: B. 148. Pre-renal azotemia is characterized by all of the following except: A. Fractional excretion of Na < 1% B. Urinary osmolality > 500 mosm/kg C. Urinary sodium concentration > 40 meq/l D. Reversible with replacement fluids Ans: C. 149. A patient is found to be positive for HBs Ag on routine laboratory evaluation. Other serological tests for hepatitis are unremarkable. He is clinically asymptomatic and liver enzymes are within the normal range. Which of the following best describes his diagnosis? A. Inactive HBV carrier B. Acute Hepatitis B C. Chronic Hepatitis B D. Active HBV carrier Ans: A. 150. A male patient is observed to be HBs Ag antigen positive HBe Ag antigen negative and anti-HBe antibody positive. HBV DNA copies are observed to be 100,000/ml while SGOT and SGPT are elevated to 6 times the upper limit of normal value. What is the likely diagnosis? A. HBV surface mutant B. HBV precore mutant C. Wild HBs Ag D. Inactive HBV carrier Ans: B. 151. (a) A patient presents with unconjugated hyperbilirubinemia and presence of urobilinogen in urine. Which amongst the following is the least likely diagnosis? A. Hemolytic jaundice B. Crigler Najjar syndrome C. Gilbertâ€™s syndrome D. Dubin Johnson syndrome Ans: D. (b) A patient presents with unconjugated hyperbilirubinemia and elevated urobilinogen levels in urine. The most diagnosis is: A. Hemolytic Jaundice B. Crigler Najjar syndrome C. Gilbertâ€™s Syndrome D. Dubin Johnson Syndrome Ans: A. 152. A lady presented with no progressive dysphagia only for solids. Barium study showed proximal esophageal dilatation with distal constriction. The most likely diagnosis is: A. Peptic Stricture B. Carcinoma esophagus C. Achalasia cardia D. Lower esophageal ring Ans: D. 153. A young girl presents with abdominal pain and a recent change in bowel habit, with passage of mucus in stool. There is no associated blood in stool and symptoms are increased with stress. The most likely diagnosis is: A. Irritable bowel syndrome B. Ulcerative colitis C. Crohnâ€™s disease D. Amebiasis Ans: A. 154. Which of the following statements about lung carcinoma is true: A. Squammous cell variant accounts for 70% of all lung cancers B. Oat cell variant typically present with cavitation C. Oat cell variant is typically associated with hilar adenopathy D. Adenocarcinoma variant is typically central in location Ans: C. 155. Plasma urea / creatinine ratio of 20:1 may be seen in: A. Rhabdomyolysis B. Ureteric calculi C. Pre-renal failure D. Chronic Glomerulonephritis Ans: C. 156. An elderly patient presents with a prolonged history of weakness and lethargy. On examination he is found to be anemic and stool is positive for occult blood. Which of the following is the investigation of choice? A. Colonoscopy B. Barium meal C. Barium enema D. CT abdomen Ans: A. 157. Which of the following statements about Wilsonâ€™s disease is true: A. Low serum ceruloplasmin and low urinary copper B. Low serum ceruloplasmin and high urinary copper C. High serum ceruloplasmin and low urinary copper D. High Serum ceruloplasmin and high urinary copper Ans: B. 158. Gout is a disorder of: A. Purine metabolism B. Pyrimidine metabolism C. Ketone metabolism D. Protein metabolism Ans: A. 159. Which of the following is recommended in a woman with antiphospholipid antibodies and history of prior abortions / still birth? A. Aspirin only B. Aspirin + low molecular weight heparin C. Aspirin + Low molecular weight heparin + prednisolone D. No treatment Ans: B. 160. All of the following may be associated with Thymoma, except: A. SIADH B. Myaesthenia gravis C. Hypogammaglobulinemia D. Cushingâ€™s syndrome Ans: A. 161. Plasmapharesis is used in all of the following except: A. Myaesthenic crisis B. Cholingergic crisis C. Gullian barre syndrome D. Polymyositis Ans: B. 162. All of the following statements about primary Gout Arthritis are true, except: A. 90% of cases are caused by over production of uric acid B. Uric acid levels may be normal at the time of an acute attack C. Men are more commonly affected than women (Male > Females) D. Definitive diagnosis requires aspiration of synovial fluid Ans: A. 163. Antiphospholipid Antibody (APLA) syndrome is associated with all of the following except: A. Bleeding disorders B. Thrombotic disorders C. Coagulation disorders D. Recurrent fetal loss Ans: A. 164. All of the following statements about Antiphospholipid antibody syndrome (APLAb) are true except: A. Single titre anticardiolipin is diagnostic B. Commonly presents with recurrent fetal loss C. May cause pulmonary hypertension D. Warfarin is given as treatment Ans: A. 165. Low calcium and high phosphate is seen in: A. Hyperparathyroidism B. Hypoparathyroidism C. Hyperthyroidism D. Hypothyroidism Ans: A. 166. All of the following statements about Pseudohypoparathyroidism are true, except: A. Decrease serum PTH B. Decrease serum calcium C. Increase serum phosphate D. Albreightâ€™s hereditary osteodystrophy Ans: A. 167. A patient presents with symptoms of Hypoglycemia. Investigations reveal decreased blood glucose and increased insulin levels. C-peptide assay is done which shows normal level of C-peptide. The most likely diagnosis is: A. Insulinoma B. Accidental sulfonylurea ingestion C. Accidental exogenous insulin administration D. Accidental metformin ingestion Ans: C. 168. Which of the following is associated with peripheral artery disease, coronary heart disease and stroke? A. Insulin deficiency B. Hyperstrogenemia C. Hypothyroidism D. Hyperprogesteronemia Ans: A. 169. All of the following statements about hyponatremia are true, except: A. Pseudohyponatremia is associated with low plasma osmolality B. Hyponatremia associated with hyperglycemia has high plasma osmolality C. Hyponatremia associated with SIADH is normovolemic D. NSAIDs incrase the potency of vasopressin Ans: A. 170. A patient presents with ataxia, urinary incontinence and dementia. The likely diagnosis is: A. Alzheimerâ€™s disease B. Parkinsonâ€™s disease C. Steel richardson syndrome D. Normal pressure hydrocephalus Ans: D. 171. A patient known to have mitral stenosis and atrial fibrillation, presents with acute onset of weakness in the left upper limb which recovered completely in two weeks. The most likely diagnosis is: A. Transient ischemic attack B. Ischemic stroke C. Hemorrhagic stroke D. Vasculitis Ans: B. 172. A 25 year old person presents with acute onset of fever and focal seizures. MRI scan shows hyperintensity in the temporal lobe and frontal lobe with enhancement. The most likely diagnosis is: A. Meningococcal meningitis B. Herpes simplex encephalitis C. Japanese encephalitis D.----------- Ans: B. 173. IN a patient with head injury damage in the brain is aggravated by A. Hyperglycemia B. Hypothermia C. Hypocapnia D. Serum osmolality Ans: A > C. 174. (a) All of the following are associated with hypergonadotrophic hypogonadism in males, except: A. Viral orchitis B. Klinefelterâ€™s syndrome C. Kallmanâ€™s syndrome D. Noonan syndrome Ans: C. (b) Which of the following is the most common cause of hypogonadotrophic hypogonadism in males? A. Viral orchitis B. Klinefelterâ€™s syndrome C. Kallmanâ€™s syndrome D. Noonan syndrome Ans: B. 175. Which of the following represents the site of the lesion in Motor Neuron disease? A. Anterior Horn cells B. Peripheral nerve C. Spinothalamic tract D. Spinocerebellar tract Ans: A. 176. All of the following are true about Guillain Barre Syndrome (GBS), except: A. Ascending paralysis B. Flaccid paralysis C. Sensory level D. Albumino-Cytological dissociation Ans: C. 177. Kayer â€“ Fleischer rings (KF rings) are seen in: A. Pterygium B. Hematochromatosis C. Wilsonâ€™s disease D. Menkeâ€™s kinked hair syndrome Ans: C. SURGERY 178. Lordâ€™s placation is done for: A. Inguinal hernia B. Testicular cancer C. Hydrocele D. Testicular varices Ans: C. 179. A 50 year old female is admitted with abdominal pain and anuria. Radiological studies revealed bilateral impacted ureteric stones with hydronephrosis. Urine analysis showed RBCs with pus cells in urine. Serum creatinine level was 16 mg/dl and urea level was 200 mmol/l which of the following should be the immediate treatment? A. Hemodialysis B. â€˜Jâ€™ stent drainage C. Lithotripsy D. Ureteroscopic removal of stones Ans: B. 179. What complication should be one except when PCNL is done through 11th intercostals space? A. Hydrothorax B. Hematuria C. Damage to colon D. Ramnants fragments Ans: A. 180. Which of the following stones is hard to break by ESWL? A. Calcium oxalate monohydrate B. Calcium oxalate dehydrate C. Uric acid D. Struvite Ans: A. 181. Which of the following is the most common renal vascular anomaly? A. Supernumerary renal arteries B. Supernumerary renal veins C. Double renal arteries D. Double renal veins Ans: A. 182. First autologous renal transplantation was done by: A. Hardy B. Kavosis C. Higgins D. Studor Ans: A. 183. Best time for surgery of undescended testis is: A. Just after birth B. 6 months of age C. 12 months of age D. 21 months of age Ans: C. 184. The Grayhack shunt is established between A. Corpora cavernoso and corporo spongiosa B. Corpora cavernosa and saphenous vein C. Corpora cavernosa and dorsal vein D. Corpora cavernosa and glands Ans: B. 185. Most common site of urethral carcinoma in men is: A. Bulbomembranous urethra B. Penile urethra C. Prostatic urethra D. Fossa Navicularis Ans: A. 186. An adult presented with hemetemesis and upper abdominal pain. Endoscopy revealed a growth at the pyloric antrum of the stomach. Ct scan showed growth involving the pyloric antrum without infiltration or invasion into surrounding structures and no evidence of distant metastasis. At laparotomy neoplastic growth was observed to involve the posterior wall of stomach and the pancreas extending 6 cm up to tail of pancreas. What will be the most appropriate surgical management? A. Closure of the abdomen B. Antrectomy and vagotomy C. Partial gastrectomy + distal pancreatectomy D. Partial gastrectomy + distal pancreatectomy + splenectomy Ans: C. 187. All of the following about Gastrointestinal carcinoid tumors are tumors are true, except: A. Small intestine and appendix account for almost 60% of all gastrointestinal carcinoid B. Rectum is pared C. 5 year survival for carcinoid tumors is >60% D. Appendical carcinoids are more common in females than males Ans: B. 188. Treatment of choice for annular pancreas is: A. Division of pancreas B. Duodenoduodenostomy C. Duofenojejunostomy D. Roux-en-Y loop Ans: C. 189. A lady presented with recurrent attacks of giddiness and abdominal pain since three months. Endoscopy was normal. Her fasting blood glucose was 40 mg % and insulin levels were elevated. CT abdomen showed a well defined 8 mm enhancing lesion in the head of pancreas, with no other abnormal findings. What should be the treatment plan for this patient? A. Whippleâ€™s operation B. Enucleation C. Enucleation with radiotherapy D. Administration of streptozotocin Ans: B. 190. A young male patient presents with complete rectal prolapse. The surgery of choice is: A. Abdominal rectopexy B. Deleromeâ€™s procedure C. Anterior resection D. Goodsallâ€™s procedure Ans: A. 191. According to the Bismuth / Strasberg classification â€˜cystic blow outâ€™ is classified is: A. Type A B. Type B C. Type C. D. Type D. Ans: A. 192. In orthotropic liver transplantation, which is the best way to get bile drainage in donor liver? A. Donor bile duct with recipient bile duct or Roux en Y choledochojejunostomy B. Donor bile duct with duodenum of recipient C. Donor bile duct with jejunum of receipt D. External drainage for few days followed by choledochojejunostomy Ans: A. 193. Most common cysts of the spleen are: A. Hydatid Cyst B. Dermatoid cyst C. Pseudocyst D. Lymphangioma Ans: A. 194. All of the following are primary restrictive operations for morbid obesity, except: A. Vertical band gastroplasty B. Switch duodenal operations C. Roux en Y operation D. Laparoscopic adjustable gastric banding Ans: B. 195. Trauma and injury severity score (TRISSI includes A. GCS + BP + RR B. RTS + ISS + Age C. RTS + ISS + GCS D. RTS + GCS + BP Ans: B. 196. (a) A 27 year old patient presented with left sided abdominal pain to the emergency room; 6 hours after an RTA. He was hemodynamically stable and FAST positive. Contrast enhanced CT (CECT) scan showed grade III splenic laceration. What will be the most appropriate treatment? A. Splenectomy B. Splenorrhaphy C. Splenic artery embolization D. Conservative management Ans: D. (b) A 27 year old patient presented with left sided abdominal pain to the emergency room; 6 hours after an RTA. He was hemodynamically stable and FAST positive. A CECT scan shows a contrast blush along with a grade III laceration. What will be the most appropriate management? A. Splenectomy B. Splenorrhaphy C. Splenic artery embolization D. Conservative management Ans: C. 197. A lady presented in the emergency department with a stab injury to the left side of the abdomen. She was hemodynamically stable and a contrast enhanced CT scan revealed a laceration in spleen. Laparoscopy was planned however the patientâ€™s pO2 suddenly dropped as soon as the pneumoperitoneum was created. What is the most likely cause? A. Gaseous embolism through splenic vessels B. Injury to the left lobe to the diaphragm C. Inferior vena cava compression D. Injury to colon Ans: A. 198. A patient presents with fever for 3 weeks. On examination he is observed to have splenomegaly. Ultrasonography reveals a hypoechoic shadow in spleen nar the hilum. Gram negative bacilli aare isolated on blood culture. Which of the following is the most likely causative organism? A. Cytomegalovirus B. Toxoplasmosis C. Salmonella D. Lymphoma virus Ans: C. 199. A patient with ITP has a platelet count of 50,000 and is being planned for splenectomy. What is the best time for platelet infusion in this patient? A. 2 hours before surgery B. At the time of skin incision C. After ligating the splenic artery D. Immediately after removal of spleen Ans: C. 200. Most common cause of abdominal Aortic aneurysm is: A. Atherosclerosis B. Trauma C. Syphilis D. Vasculitis Ans: A. 201. Which of the following grading methods is used to evaluate the prognosis / outcome after subarachnoid hemorrhage? A. Glasgow coma scale B. Hess and hunt scale C. Glasgow â€“ Blatchford bleeding score D. Intracerebral hemorrhage score Ans: B. PEDIATRICS 202. Health status of a child under 5 years of age will be adversely affected by all of the following, except: A. Malnutrition B. Low birth weight C. Maternal Hb of 11 gm% D. Infections Ans: C. 203. A seven year old asymptomatic girl is found to have persistant hypertension. There is no significant history and urine examination is normal. Which of the following is the most likely cause? A. Essential hypertension B. Renal parenchymal disease C. Polycystic kidney disease D. Coarctation of aorta Ans: B. 204. A child presented with intermittent episodes of left sided flank pain. Ultrasonography reveals a large hydronephrosis with dilated renal pelvis and cortical thinning with a normal ureter. Kidney differential function was observed to be 19% which of the following is the bet management: A. Nephrectomy B. Pyeloplasty C. External drainage D. Endopylostomy Ans: B. 205. A neonate presented with fever, lethargy, abdominal distension, vomiting and constipation. Clinically he was diagnosed as volvulus neonatarum with suspected perforation. Best investigation would be: A. Plain X-ray B. Barium enema C. Upper GI endoscopy D. Barium meal follow through Ans: A. 206. A ten year old boy presents to the pediatric emergency unit with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is: A. Takayasu aortoarteritis B. Renal parenchymal disease C. Grandmal seizures D. Coarctation of Aorta Ans: D. 207. A child presents with hepatomegaly and hypoglycemia. There is no improvement in blood sugar even after administration of epinephrine. What is the likely diagnosis? A. Von Girkeâ€™s disease B. Andersonâ€™s disease C. Pompeâ€™s disease D. Mc Ardleâ€™s disease Ans: A. 208. All of the following factors are associated with a substantially greater risk of developing epilepsy after febrile seizures, except: A. Complex febrile seizures B. Early age of onset C. Development abnormalities D. Positive family history of epilepsy Ans: B or None 209. A child presents with short episodes of vacant stare several times a day. The vacant episode begins abruptly and the child remains unresponsive during the episode. There is no associated history of aura or postictal confusion and the child is otherwise normal. The likely diagnosis is: A. Grandmal seizures B. Absence seizures C. Complex partial seizures D. Day dreaming Ans: B. 210. Which of the following is the most common cause of meningoencephalitis in children? A. Mumps B. Arbovirus C. HSV D. Enterovirus Ans: D. 211. Which of the following agents is most commonly associated with recurrent meningitis due to CSF leaks? A. Meningococci B. Pneumococci C. Hemophilus influenza D. E. Coli Ans: B. 212. A two year old child with a long history of purulent nasal discharge & fever now presents with conjunction congestion and edema. His fever is 102 / 103 F and WBC count 12,000. The culture of eye discharge was negative. X-rays show opacification of ethmoid sinus. Which of the following should be next step in evaluating this patient? A. CT scan B. Urine culture C. Blood culture D. Repeat culture of eye discharge Ans: A. 213. A boy presented with weakness in lower limbs, calf hypertrophy, positive Gowerâ€™s sign and an elevated CPK value of 10,000. The most likely diagnosis is: A. Duchenne muscular dystrophy B. Spinal muscular atrophy C. Myotonia congenita D. Myotonic dystrophy Ans: A. 214. Primary metabolic bone disorder in scurvy is: A. Decreased mineralization B. Decreased osteoid matrix formation C. Increased bone resorption D. Decreased bone mass with normal mineralization and osteoid formation Ans: B. 215. Which of the following drugs is not used in Juvenile Myoclonic epilepsy (JME)? A. Topiramate B. Zonisamide C. Carbamezapine D. Valproate Ans: C. 216. A child presents to the clinic with history of seizures and mental retardation. Clinical examination reveals multiple hypopigmentated macules. What is the likely diagnosis? A. Tuberous sclerosis B. Neurofibromatosis C. Sturge weber syndrome D. Linear epidermal nevus syndrome Ans: A. OBSTETRICS & GYNAECOLOGY 217. Which of the following condition present with absence of both Mullerian and Wolffian duct structures? A. Antimullerian hormone deficiency B. Androgen insensitivity syndrome C. FSH receptor defect D. Ovotesticular syndrome Ans: B. 218. A lady presented with secondary amenorrhea 6 months after having an abortion. Her FSH levels were measured as 6 mIU/ml what is the most probable diagnosis: A. Pituitary failure B. Ovarian failure C. Fresh pregnancy D. Uterine synechiae Ans: D. 219. Which of the following methods for assessment of female fertility during a menstrual cycle can best predict the timing of ovulation? A. Basal body temperature (BBT) B. Fern test C. Spinnbarkeit phenomenon D. Hormonal study Ans: D. 220. (a) Primary Amenorrhea with absent uterus, normal breasts and scant pubic hair is seen in: A. Mayer Rokitanski Kuster Hauser syndrome B. Turnerâ€™s syndrome C. Androgen insensitivity syndrome D. Noonan syndrome Ans: C. (b) Primary amenorrhea with normal ovaries normal external genitalia and normal breasts is seen in: A. Mayer Rokitanski Kuster Hauser syndrome B. Turnerâ€™s syndrome C. Androgen insensitivity syndrome D. Noonan syndrome Ans: A. 221. Which of the following agents is most commonly associated with carcinoma cervix? A. HPV 16 B. HPV 18 C. HPV 33 D. HPV 35 Ans: A. 222. (a) A 52 year old lady presents with constant leakage of urine and dysuria two weeks after a complicated total abdominal hysterectomy. A diagnosis of Vesicovaginal fistula is suspected. The most important test for the diagnosis is: A. Triple swab test B. Urine culture C. Cystoscopy D. IVP Ans: A. (b) A 52 year lady with a vesocovaginal fistula after abdominal hysterectomy is not responding to conservative management. Most useful / important next investigation is: A. Triple swab test B. Urine culture C. Cystoscopy D. IVP Ans: C. 223. Which of the following statements about partial mole is false: A. Usually associated with triploidy B. Rarely causes persistant gestational trophoblastic neoplasia C. Usually present as Missed abortions D. Can be reliably diagnosed by USG in early gestation Ans: D. 224. (a) Conversation of a complete hydaliform mole into invasive mole is indicated by all of the following except: A. Plateau HCG B. Enlarged uterine size C. Persistance of Theca-lutein cysts D. Suburtheral nodule Ans: D. (b) Conversation of a complete hydatiform mole into choriocarcinoma is indicated by all, except: A. Plateau HCG B. Enlarged uterine size C. Persistance of Theca-lutein cysts D. Suburtheral nodule Ans: None > D 225. A 40 year old woman presents with abnormal cervical cytology on PAP smear suggestive of CIN III (HSIL). The nest, best step in management is: A. Hysterectomy B. Colposcopy and LEEP C. Coploscopy and Cryotherapy D. Conization Ans: B. 226. Sentinel lymph biopsy is most useful for which of the following gynecological malignancies: A. Carcinoma endometrium B. Carcinoma cervix C. Carcinoma vulva D. Carcinoma vagina Ans: C. 227. All of the following are associated with polycystic ovarian syndrome, except: A. Ovarian carcinoma B. Endometrial carcinoma C. Insulin resistant D. Osteoporosis Ans: D. 228. Which of the following is the most specific marker for neural tube defects? A. Actylcholinesterase B. Pseudocholinesterase C. Alpha feto protein (AFP) D. Human chorionic Gonadotrophin (HCG) Ans: A. 229. AFP is raised in: A. Teratoma B. Yolk sac tumor C. Choriocarcinoma D. Dysgerminoma Ans: B. 230. Weight gain in pregnancy depends on all of the following factors, except: A. Socioeconomic status B. Prepregnancy weight C. Smocking D. Ethinicity Ans: C. 231. Which of the following statements about â€˜multiple pregnanciesâ€™ is true? A. Fetuses of same gender excludes dichorionicity B. Twin peak sign is seen in dichorionicity C. Thick separating membrane is a feature of monochorionic twins D. Chorionicity can be reliably detected only after 16 weeks of gestation Ans: B. 232. Treatment of choice for intrahepatic cholestasis in pregnancy is: A. Cholestyramine B. Ursodiol (Ursodeoxycholic acid) C. Corticosteroids (Dexamethasone) D. Antithistaminics Ans: B. 233. All of the following are cardiac contraindications to pregnancy, except: A. Eisenmengerâ€™s syndrome B. Pulmonary hypertension C. Coarctation of aorta D. WPW syndrome Ans: D. 234. (a) The drug of choice to treat Chlamydia infection in pregnancy is: A. Tetracycline B. Doxycycline C. Erythromycin D. Azithromycin Ans: D. (b) The drug of choice to treat Chlamydia infection in pregnancy is: A. Tetracycline B. Doxycycline C. Erythromycin D. Penicillin Ans: C. 235. Which of the following conditions is associated with polyhydramnios? A. Posterior urethral valves B. Cleft palate C. Congenital Diaphragmatic hernia D. Bladder extrophy Ans: B. 236. Increased nuchal translucency at 14 weeks gestation is seen in: A. Turnerâ€™s syndrome B. Downâ€™s syndrome C. Hydrocephalus D. Skeletal dysplasia Ans: B. 237. Non immune hydrops fetalis is caused by: A. CMV B. Parvovirus C. HSV D. HIV Ans: B. 238. A lady presented with features of threatened abortion at 32 weeks of pregnancy. Which of the following statements with regard to antibiotic usage is not correct? A. Antibiotic prophylaxis even with unruptured membranes B. Metronidazole if asymptomatic but significant bacterial vaginosis C. Antibiotics if asymptomatic but significant bacteremia D. Antibiotics for preterm premature rupture of membranes Ans: A. 239. A woman presents with leakage of fluid per vaginum and meconium stained liquor at 34 weeks of gestation. The most likely organism causing infection would be: A. Listeria monocytogenes B. Toxoplasmosis C. CMV D. Herpes Ans: A. 240. (a) Which of the following interventions is not recommended in active management of third stage of labour? A. Administration of uterotonic within 1 minutes of delivery B. Immediate clamping, cutting and ligation of cord C. Gentle massage of uterus D. Controlled cord traction Ans: B. (b) Active management of third stage of labor includes all of the following except: A. Oxytocin injection B. Ergometrine injection C. Controlled cord traction D. Gentle massage of uterus Ans: None 241. All of the following maneuvers are used in shoulder dystocia, except: A. Woods corkscrew maneuver B. Mc Roberts Maneuver C. Suprapubic pressure D. Mauriceau â€“ Smellie veit maneuver Ans: D. 242. All of the following interventions are recommended t prevent mother to child transmission of HIV, except: A. Avoid ergometrine in third stage of labour B. Highly active antiretroviral therapy (HAART) C. Elective Caesarian section D. Intrapartum Zidovudine Ans: A. OPHTHALMOLOGY 243. A PERSON WITH PROLONGED usage of control lenses presented with irritation of left eye. After examination a diagnosis of keratitis was made and corneal scrapings revealed growth of pseudomonas aeroginosa. The bacteria were observed to be multidrug resistant. Which of the following best explains the mechanism to antimicrobial resistance in these isolated pseudomonas aeroginosa strains? A. Ability to transfer resistance genes from adjacent commensal flora B. Improper contact lens hygiene C. Frequent and injudicious use of topical antibiotics D. Ability to pseudomonas to produce biofilms Ans: D. 244. Endophthalmitis involves inflammation of all of the following, except: A. Sclera B. Uvea C. Retina D. Vitreous Ans: A. 245. Which of the following is the least common corneal dystrophy? A. Macular dystrophy B. Lattice type I C. Lattice III D. Granular corneal dystrophy Ans: A. 246. Cherry red spot is seen in all except A. Niemann pick disease B. GM1 gangliosidosis C. Tay sachâ€™s disease D. Gaucherâ€™s disease Ans: None 247. Relative afferent papillary defect (RAPD) is characteristically seen in damage to: A. Optic nerve B. Optic tract C. Lateral geniculate body D. Occulomotor nerve Ans: A. 248. A patient with ptosis presents with retraction of the ptotic eye lid on chewing. This represents: A. Marcus gum jaw winking syndrome B. Third nerve misdirection syndrome C. Abducent palsy D. Occulomotor palsy Ans: A. 249. Which of the following statements regarding corneal transplantation is true? A. Whole eye needs to be preserved in tissue culture B. Donor not accepted if age > 60 years C. Specular microscopy analysis is used to assess endothelial cell count D. HLA matching is mandatory Ans: C. 250. Arden Index is related to A. ERG (Electroretinogram) B. EOG (Electrooculogram) C. VER (Visual Evoked response) D. Perimetry Ans: B. 251. A patient with known mutation in the â€˜Rb geneâ€™ is â€˜disease freeâ€™ from retinoblastoma. The patient is at highest risk of developing which of the following malignancies: A. Renal cell carcinoma B. Osteosarcoma C. Pinealoblastma D. Chondrosarcoma Ans: B. ENT 252. Vestibular Schwannoma arises most frequently from: A. Superior vestibular nerve B. Inferior vestibular nerve C. Cochlear nerve D. Facial nerve Ans: A > B 253. Otoacoustic emissions arise from: A. inner hair cells B. outer hair cells C. organ of corti D. Both outer & inner hair cells Ans: B. 254. All of the following statements about sodium in otosclerosis are true, except: A. Acts by inhibiting proteolytic enzymes in cochlea B. Acts by inhibiting osteoblastic activity C. In contraindicated in chronic nephritis D. In indicated in patients with a positive schwartze sign Ans: B. 255. All of the following statements about CSF leak are true, except: A. Most common site of CSF leak is fovea ethmoidalis B. Beta is transferring estimation is highly specific for diagnosis of C. Fluorescin Dye can be used intratheclly for diagnosis of site of leak D. MRI (Gladilonium chanced) T1 images are best for diagnosis of site of leak Ans: D. 256. All of the following statements about Nasopharyngeal carcinoma are true, except: A. Bimodal age distribution B. Nasopharyngectomy with radical neck dissection is the treatment of choice C. IgA antibody to EBV is observed D. Squammous cell carcinoma is the most common histological subtype Ans: B. 257. All of the following are extrinsic laryngeal membranes / ligaments, except: A. Hyoepiglottic B. Cricothyroid C. Cricotracheal D. Thyrohyoid Ans: B. 258. Which of the following structure is not seen on bronchoscopy? A. Trachea B. Vocal cords C. Subcarinal lymph nodes D. First segmental division of bronchi Ans: C. 259. A child presents with stridor, barking cough and difficulty in breathing since 2-3 days. He has fever and elevated leukocyte count. All of the following statements about his condition are true, except: A. Subglottis stenosis and hypopharyngeal dilatation may be seen on X-rays B. Boys are more commonly affected than girls C. Symptoms are predominantly caused by involvement of the subglottis D. Antibiotics from the mainstay of treatment Ans: D. 260. Drug of choice in Laryngeal stenosis is: A. Cyclophosphamide B. Doxorubicin C. Adriamycin D. Mitomycin C Ans: D. 261. Which of the following Lasers is most commonly used in Laryngeal surgery? A. CO2 laser B. Nd YAG laser C. Argon laser D. KTP laser Ans: A. ORTHOPEDICS: 262. Which of the following statements about â€˜Menisciâ€™ is not true? A. Medial meniscus is more mobile than lateral B. Lateral meniscus covers more tibial articular surface than lateral C. Medial meniscus is more commonly injured than lateral D. Menisci are predominantly made up of type I collagen Ans: A. 263. Which of the following statements about changes in atricular cartilage with aging is nit true? A. Total proteoglycan content is decreased B. Synthesis of proteogycans is decreased C. Enzymatic degradation of proteoglycans is increased D. Total water content of cartilage is decreased Ans: C. 264. Metal on metal articulation should be avoided in: A. Osteonecrosis B. Young female C. Inflammatory arthritis D. Revision surgery Ans: B. 265. A patient developed breathlessness and chest pain, on second postoperative day after a total hip replacement. Echo-cardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis? A. Acute MI B. Pulmonary embolism C. Hypotensive shock D. Cardiac tamponade Ans: B. 266. The characteristic triad of Klippel â€“ Feil syndrome includes all of the following, except: A. Short neck B. Low hair line C. Limited neck movements D. Elevated scapula Ans: D. 267. Progression of congenital scoliosis is least likely in which of the following vertebra anomalies: A. Fully segmented hemivertebra B. Wedge vertebra C. Block vertebra D. Unilateral unsegmented bar with hemivertebra Ans: C. 268. A patient involved in a road traffic accident presents with quadriparesis, sphincter disturbance, sensory level up to the upper border of sternum and a respiratory rate of 35/minutes. The likely level of lesion is: A. C1-C2 B. C4-C5 C. T1-T2 D. T3-T4 Ans: B. 269. All of the following statements about synovial cell sarcoma, are true, except: A. Originate from synovial lining B. Occur more often at extra articular sites C. Usually seen in patients less than 50 year of age D. Knee and foot are common sites involved Ans: A. 270. Lift off test is done to assess the function of: A. Supraspinatus B. Infraspinatus C. Teres Minor D. Subscapularis Ans: D. 271. Median nerve lesion at the wrist causes all of the following, except: A. Thenar atrophy B. Weakness of adductor pollicis C. Weakness of 1st and 2nd lumbricals D. Weakness of flexor pollicis brevis Ans: B. 272. Hyperglycemia is associated with: A, Multiple myeloma B. Ewingâ€™s sarcoma C. Osteosarcoma D. Chondrosarcoma Ans: None 273. Brown Tumor is seen in: A. Hypothyroidism B. Hyperthyroidism C. Hypoparathyroidism D. Hyperparathyroidism Ans: D.