All india pre pg 2011 recall-exam on 9.1.11

Discussion in 'NEET 2013 All india Exam' started by Guest, Jan 8, 2011.

  1. Guest

    Guest Guest

    All india pre pg 2011 recall- kindly post here
  2. Guest

    Guest Guest

    rave drug - ectaasy

    Punnet square :shock: - genotype of offspring

    ant division of mandibualr n. supplies A/E- medial pterygoid

    necrotising lymphdenitis- Kikuchi dz
  3. Guest

    Guest Guest

    NARP is a - mitochondrial inheritance

    Denominator of maternal mortality is- Live births
  4. Guest

    Guest Guest

    Q1. Punnet Square?
    a. genotype of offspring
    b. statiscal analysis
    c.
    d.

    The Punnett square is a mathematical tool used by geneticists to show allelic combinations of gametes and to predict offspring ratios.

    For example, what might be the gametes formed by a male fruit fly that is homozygous dominant for gray body color? What might be the gametes formed by a female fruit fly that is homozygous recessive for ebony body color? This will be the parental generation of our cross and the alleles would be: GG for the male and gg for the female.

    When both the alleles of a gene pair are the same, the organism is said to be homozygous for that characteristic. It can be homozygous dominant (GG) or homozygous recessive (gg). When the two alleles in a gene pair are NOT the same, for example, when the genotype is Gg, the organism is heterozygous, or hybrid for that trait. When working with only one trait this condition is called a monohybrid. If we were to work with two traits, we would call the combination a dihybrid and so on. We use the term "genotype" to refer to the allele combinations of an organism.

    Q2. Q.blount's disease is-
    1.genu valgum
    2.genu varum-answr
    3.genu recurvatum
    4.menisceal injury

    Nelson Pediatrics, 18th edition
    Idiopathic tibia vara, or Blount disease, is a growth disorder of the medial aspect of the proximal tibial epiphysis, leading to varus angulation and medial rotation of the tibia. The incidence is greater in female black obese children who have an affected family member, started walking early in life. It has been classified into three types depending on the age at onset: infantile (1–3 yr), juvenile (4–10 yr), and adolescent (11 yr or older). The juvenile and adolescent forms are commonly combined as late-onset tibia vara. Although the exact cause of tibia vara remains unknown, it may be secondary to growth suppression from increased compressive forces across the medial aspect of the knee.

    Q3. A/E are supplied by the anterior division of Mandibular nerve:
    a. lateral pterygoid
    b. medial pterygoid
    c. temporalis
    d. masseter
    A: medial pterygoid

    The n. to med pterygoid is a direct branch of the mandibular trunk.

    Q4. Pain of ethmoidal sinusitis is referred along the course of
    a. nasociliary n.
    b. infratrochlear
    c. frontal n.
    d.

    Q5. which of the following is pneumatic bone except?
    1.frontal
    2.ethmoid
    3.mandible
    4. maxilla

    Q6. parenteral nutrition not concisits of
    fat
    carbohydrate
    fibre
    micronutrient

    Q7. urea cycle occurs in
    liver
    kidney
    colon

    Q8. choice of inotrope drug in right heart failture
    dobutamine
    amrinone
    digoxin
    milrinone

    Q9. contraindicated in hypertensive
    ketamine
    propofol
    etomidate
    diazepam

    Q10. buprenorphine is
    partial agonist of mu receptor
    full agonist at kappa
    antagonist of kappa

    Q11. sparrow marks r seen in??
    1. gunshot injuries
    2. stab injry of face
    3 vitriolage
    4 windshield glass injury

    Q12. necrotizing lymphadenitis is seen in
    a. kimura
    b. kikuch

    Q13. baby born at 33 wks/1.5 kg should be started on
    1. nil oral and iv fluids
    2.oral nasogastric tube / aternate oral rute
    3.iv fluids and oral feeding
    4.TPN

    Q14. Body plethysmography findings when pt breathes aginst closed glottis in lungs n recordings respectively
    decreased
    increased
    lungs increases n recording decreased

    Q15. pt undergoing epidural block,becomes aphonic n loses consciousness when drug is injected
    total spinal block
    anaphylaxis
    vasovagal shock

    Q16. which organ obtained from cadver is not used for transplant??
    1.blood vessel
    2.lung
    3.liver
    4.bladder

    Q17. early sign of magnesium toxicity
    1.depression of deep tendon reflexes
    2.respiratory depression

    Q18. after stab injury of 18 yr male
    immidiatelt shift to ot
    FAST
    under LA wound closure

    Q19. epileptogenic anesthetic
    halothane
    ether
    desflurane

    Q20. contraceptive avoided in epilepsy
    combined ocp
    ucd
    pop
    condom

    Q 21. lithium toxicity increased by
    b blocker
    ccb
    clonidine
    diuretics
  5. Guest

    Guest Guest

    1.cavitation in lung commonly seen in =staphylococcal

    2.not a pneumatic bone= mandile

    3.blount ds= genu varum

    4.bipolar staining = waysons

    5.not in parentral nutrition= fibre

    6.signature fracture= depressed fracture

    7. prophylaxis of migraine a/e= leviricetam

    8.rave drug = ectasy

    9.female with features of hypothyroidism= hashimotos thyroiditis

    10.parentral nutirion a/e= fibre

    11. tyre mark= imprint abrasion

    12. CRP= capsule of pneumococcus

    13. mc death in schizophrenia=??????????homicide/suicide/hospital infection/ drug induced

    14. kid with respiratory sympomts started on antibioctics , improves and then worsens = bronchiolitis obliterans

    15.female with 45 x poorly developed breast, short stature= gonadal dysgenesis
  6. Guest

    Guest Guest

    A bipolar stain is a particular staining pattern that colors only the two opposite poles of the microorganism in question, leaving the rest of the bacterium unstained or of a lighter color. Staining tends to be described in relation to Gram-negative staining, which differentiates between Gram-negative and Gram-positive bacteria and provides important information for diagnosis, culture media selection and initial antimicrobial treatment.


    Commonly Used Stains in Bipolar Staining
    •Wayson refers to a fuchsin-methylene blue stain paired with ethyl alcohol-phenol decolorization. Its original form was a modified methylene-blue stain used in the diagnosis of bubonic plague. Wright combines acid and alkaline dyes (eosin red and methylene blue). It allows the differentiation of blood cells, but also confers bipolar staining on Gram-negative bacteria. Giemsa also combines eosin and methylene blue. This differential stain characterizes how pathogenic bacteria adhere to human cells. It plays a role in the diagnosis of spirochete blood parasites.
  7. Guest

    Guest Guest

    branch of trunk of brachial plexus
    a. superior thoracic nerve
    b. lateral thoracic nerve s

    2. post cerebral artery supplies al except
    1. pons
    2. medulla
    3. thalamus
    4. margin of

    anterior choroidal artery supplies...

    al are related posteriorly to head of pancreas except
    1. bile duct
    2. ivc
    3. 1st part of duodenum
  8. Guest

    Guest Guest

    All the following are pneumatic bone except?
    1.frontal
    2.ethmoid
    3.mandible
    4. maxilla
    ans: mandible


    Q.blount's disease is-
    1.genu valgum
    2.genu varum
    3.genu recurvatum
    4.menisceal injury

    ans: 2

    All are supplied by the anterior division of Mandibular nerve except:
    a. lateral pterygoid
    b. medial pterygoid
    c. temporalis
    d. masseter
    Ans: medial pterygoi

    Q. all of the following decrease bone resorption in osteoporosis except?
    a.Alendronate
    b.Etidronate
    C.Strontium
    d.Teriparatide

    Ans: D. TERIPARATIDE

    2. ONODI CELLS & HALLER CELLS are associated with the following structures respectively?
    a.OPTIC NERVE & ORBITAL FLOOR
    b.OPTIC NERVE & INTERAL CAROTID ARTERY
    c.INTERNAL CAROTID ARTERY& OPTIC NERVE
    d.ORBITAL FLOOR & INTERNAL CAROTID ARTERY

    ans: OPTIC NERVE & ORBITAL FLOOR

    Q. a surgeon resects sectors to lt of lig teres of liver....segment 2 and 3
    meningits... gm positiv bacilli....a. st.pneumonia b. listeria c. h.influenza

    Q. a pt develops pneumonia..grows on sheep agar..which test to diff...
    a. bile solubility b. bacitracin c. coagulase

    Q. partially acid fast..causing meningitis... nocardia..

    Q. most common fungal infection in immuno competant pts,,
    aspergillus candida cryptococcus mucor

    Q. most common cause of cutaneous larva migrans.
    st. stercoralis
    toxocara canis

    Q. preterm baby delivered at 33wks,1500g, baby vitals good
    start iv fluids,nil orally
    orogastric tube feeding(nasogastric tube?)
    start iv fluids + oral feeding
    total parentral nutrition


    Q. 37 wks primi in labour for 10 hrs, cervix not properly effaced
    cs
    amniotomy
    oxytocin infusion

    Q. neurofibroma malignancy ass
    juvenile myelomonocytic
    aml
    all

    Q .mc tumor causing sup venacava syn
    lymphoma
    small cell ca


    Q. poor prognosis in aml
    hyperdiploidy
    9;22
    females

    Q. a 5 year old boy while having dinner suddenly becomes aphonic and is brought to the casulty for the complaint of respiratory difficulty. what should be the next appropriate treatment:-
    1) cricothyroidotomy
    2) emergency tracheostomy
    3) humidified oxygen
    4) Hemlich maneouvre
  9. Guest

    Guest Guest

    The shaded area is
    a] true +ve
    b] true –ve
    c] false +ve
    d] false –ve


    Branch of trunk of brachial plexus
    a] suprascalpur
    b] long thoracic n
    c] ant. Thoracic
    d] nerve to sub clavius.

    Orthotoludine test is for
    a] chlorine
    b] nitrites
    c] nitrates
    d] ammonia

    A/E pneumatic bones
    a] mandible
    b] frontal
    c]

    Q-which is the most common tumour associated with neurofibromatosis in a child

    1) juvenile myelomonocytic leuk.
    2) ac.lymphoblastic leuk
    3)ac.monocytic leukemia
    4) ac.myeloid leuk


    Q-m.c. tumor causing sup venacava syn.
    1) lymphoma
    2) small cell ca
    3) non small cell ca.
    4) ?

    Q. a pt.compalined of rt.ear discharge for a year with c/o of severe pain in ear.
    the discharge was cultured and the org.was found to be gm positive cocci.

    the least likely cause is
    1) psuedomonas
    2) strept.pnuemoniae
    3) staphylococcus
    4) h.influenzae

    Q- pain due to ethmoidal sinusitis is referred via:-

    1) nasocilliary
    2) lacrimal
    3) ant.ethmoidal
    4) frontal

    Q. a pt 24 hrs after perforation presents in shock..
    resuscitated..
    next
    a. emergency laprotomy
    b. correct electrolyte imbalance then take for an open laprotomy

    Q. a child presents wit pain abd only during passing stools,. no other symptoms like vomiting blood in stools..
    a. rectal polyp
    b. intusseception
    c. meckels

    Q. necrotizing lymphadenitis is seen in
    a. kimura
    b. kikuch

    Kikuchi's disease, also called Kikuchi-Fujimoto disease or Kikuchi's histiocytic necrotizing lymphadenitis, was originally described in young women and is a rare, benign condition of unknown cause usually characterized by cervical lymphadenopathy and fever

    Q. most important and potential agent that can be used in bioterrorism-
    1)plague
    2) smalpox
    3) t.b.
    4) ?????

    Q- posterior relations of head of pancreas are all except
    1) cbd
    2) duodenum first part
    3) aorta
    4) IVC


    Q.basal matabolic depends on??
    a.lean body mass
    b.body surface area
    c.body mass index
    d.

    Q.maximal water absorption of water in git?
    a jejunum
  10. Guest

    Guest Guest

    NARP?
    1.lipid storage disorder
    2.lysosomal storage disorder
    3.?
    4?

    Neuropathy, ataxia, and retinitis pigmentosa is a condition related to changes in mitochondrial DNA. Mutations in the MT-ATP6 gene cause neuropathy, ataxia, and retinitis pigmentosa. The MT-ATP6 gene provides instructions for making a protein that is essential for normal mitochondrial function. Through a series of chemical reactions, mitochondria use oxygen and simple sugars to create adenosine triphosphate (ATP), the cell's main energy source. The MT-ATP6 protein forms one part (subunit) of an enzyme called ATP synthase, which is responsible for the last step in ATP production. Mutations in the MT-ATP6 gene alter the structure or function of ATP synthase, reducing the ability of mitochondria to make ATP
  11. Guest

    Guest Guest

    A 62 yrs lady with grade 3 osteoarhritis. of knee joint........whatthe treatment of choice?
    1. conservative
    2. partial knee replacement
    3. total knee replacement

    pantology of fallot :
    a. asd
    b. vsd
    c. rvh
    d. pulmonary stenosis

    pantology of fallot :
    a. asd
    b. vsd
    c. rvh
    d. pulmonary stenosis

    ASD

    q.multiple sebaceous cysts seen in:
    gardners syn
    turcots sin
    Turre Moira synd
    cowden syndrome

    deoxy blood thru a/e:
    umbilical a
    umbilical vein
    pulm a
    right ventricle
    A:umbilical vein

    fire during vocal cord surgery by laser.what is not to be done
    putting sterile water
    removing et tube
    stopping anaesthetic gas n supplying oxygen
  12. Guest

    Guest Guest

    Q. hallmark of acute inflammation
    vasoconstriction
    stasis
    vasodilation and increase in permeability
    leucocytic margination

    ANS vasodilation and increase in permeability

    Q. patient of peritonitis with shock for 24 hrs.what to be done
    shift to OT for laparotomy
    shift to OT for laparoscopy
    insert drainage tube n shift to ot for laparotomy

    Q. fire during vocal cord surgery by laser.what is not to be done
    putting sterile water
    removing et tube
    stopping anaesthetic gas n supplying oxygen
    treatment with steroid & antibiotic

    Q- posterior relations of head of pancreas are all except
    1) cbd
    2) duodenum first part
    3) aorta
    4) IVC
    A:1st part of du??

    Q. Nerve most commonly involved in supracondylar fracture
    Radial nerve
    Median nerve
    Ulnar nerve
    Ant int nerve

    Q. which virus crosses placenta least likely
    rubella
    herpes simplex
    HIV
    HBV

    Q a pt has pain radiating t back..relieved by analgesics and?? by taking food..which of these procedures was he subjected t earlier..
    1.vag tomy wd gj
    2.vag tomy wd anterctomy
    3.whipple
    4.pancreatectomy..

    Q. a lady has epigastric pain etc..her amylase is normal but usg shows swollen pancreas wd bile duct stones..dx?
    1.acut cholecystitis
    2.acute pancreatitis
    3.appendicitis

    Q. hyperpyrexia is caused by
    mao i
    alcohol
    cresol
    amphetamine

    Q. A 38 wk delivered neonate,2.2kg develops intolerance to feeds on 2nd day.physical exmn normal,sepsis screen negative,next step??
    wait n watch
    do a 2nd sepsis screen

    Q. hyperpyrexia is caused by a/e
    cocain
    alcohol
    cresol
    amphetamine

    Q. rise in end tidal co2 during thyroid surgery ,,,all except..
    1.anaphyl
    2.malig hyperthermi
    3.?

    Q. wt gain in pregnancy is related to all except
    ethnicity
    smoking
    socioeconomic status
    pre conceptional wt
  13. Guest

    Guest Guest

    rise in end tidal co2 during thyroid surgery ,,,all except..
    1.anaphyl
    2.malig hyperthermi
    3.thyroid storm
    4.neuroleptic malignant syndrome

    •Alkalinization of urine -isnt it ifosphamide?as it causes haemorrhagic cystitis like cyclophosplamide?

    argyl robetrson pupil.....
    accomodation unaffecte
    directed light affected
    consensual un affected
    good visual acuity






    Q1
    Which of the following is pneumatic bone except?
    1.frontal
    2.ethmoid
    3.mandible
    4. maxilla

    Q2
    Which of the following is contraindicated in hypertensive patient
    1.ketamine
    2.propofol
    3.etomidate
    4.diazepam

    Q3
    Buprenorphine is
    1.partial agonist of mu receptor
    2.full agonist at kappa
    3.antagonist of kappa
    4.partial antagonist at mu receptor

    Q4
    sparrow marks r seen in following condition
    1. gunshot injuries
    2. stab injry of face
    3 vitriolage
    4 windshield glass injury

    Q5
    Baby born at 33 wks/1.5 kg should be started on
    1. nil oral and iv fluids
    2.oral nasogastric tube / aternate oral rute
    3.iv fluids and oral feeding
    4.TPN

    Q6
    Clue cells in
    1.bacterial vaginosis
    2.chlamydial vaginosis
    3.Candidasis
    4.Gonorrhoea

    Q7
    Choice of inotrope drug in right heart failture
    1.dobutamine
    2.amrinone
    3.digoxin
    4.milrinone

    Q8
    Which organ obtained from cadver is not used for transplant??
    1.blood vessel
    2.lung
    3.liver
    4.bladder

    Q9
    Epileptogenic anesthetic
    1.halothane
    2.sevoflurane
    3.desflurane
    4.propofol

    Q10
    Contraceptive avoided in epilepsy
    1.combined ocp
    2.ucd
    3.pop
    4.condom

    Q11
    lithium toxicity increased by
    1.b blocker
    2.ccb
    3.clonidine
    4.diuretics
  14. Guest

    Guest Guest

    3.question about diabetes insipidus,2.injury low radial nerve palsy,4 floor of third ventricle related5.something about chimerism6.serotonin syndrome6,morphine tolerance7.proper airway except8.
  15. nidhi.neww

    nidhi.neww Guest

    aipgee

    8)
    which is d least common s/e of thallidomide
    1.diarrhoea
    2.hypothyroidism
    3.teratogenic


    activation of complementary pathway is by
    1.c1
    2.c2
    3.c3
    4.c4

    execution of appoptosis is by
    1nucleus
    2mitochondria
    3golgi
  16. Guest

    Guest Guest

    Sir, question was Visceral larva migrans ? not cutaneous.
    Q: not cns tumor?
    A: Ependymoma..
  17. Dr Manojvss

    Dr Manojvss Guest

    Drug needing urinary alkalinisation -ans-methotrexate
  18. Guest

    Guest Guest

    Q. About yaws all are true except
    caused by t. pertenue
    transmitted non-venerally
    secendory yaw can involve bones
    last stages invoive heart n nerves ------ans


    Yaws (also frambesia tropica, thymosis, polypapilloma tropicum, pian or parangi, "Bouba," "Frambösie,"[1] and "Pian"[2]) is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pallidum pertenue. Other treponemal diseases are bejel (Treponema pallidum endemicum), pinta (Treponema pallidum carateum), and syphilis (Treponema pallidum pallidum).

    The disease is transmitted by skin-to-skin contact with an infective lesion, the bacterium entering through a pre-existing cut, bite or scratch. Within ninety days (but usually less than a month) of infection a painless but distinctive 'mother yaw' appears, which is a painless nodule which enlarges and becomes warty in appearance. Sometimes nearby 'daughter yaws' also appear simultaneously. This primary stage resolves completely within six months. The secondary stage occurs months to years later, and is characterised by widespread skin lesions of varying appearance, including 'crab yaws' on the palms and soles with desquamation. These secondary lesions frequently ulcerate (and are then highly infectious), but heal after six months or more. About ten percent of people then go on to develop tertiary disease within five to ten years (during which further secondary lesions may come and go), characterised by widespread bone, joint and soft tissue destruction, which may include extensive destruction of the bone and cartilage of the nose (rhinopharyngitis mutilans or 'gangosa').
  19. Guest

    Guest Guest

    All are seen in the 3rd ventricle floor except 1infundibulum 2 3rd nerve3 maxillary body 4


    Sickle cell disease anesthesia not given is 1 ga 2brachial plexus block 3 local arterial injection 4 spinal


    Where LA and vaso constrictor not given ans finger


    Isomorphic phenomenon psoriatic arthritis



    A pt with epigastric tenderness 4days no amylase increase stone in Cbd pancreas hardened diagnosis 1st pancreatitis 2nd peritonitis


    5yr boy pain during dedication no other history diagnosis1 polyps 2 intussusception 3mikels diverticulum



    Intranet op mi best diagnosed by 1 trans eso echo 2 ECG 3 enzyme


    Menstrual cycle all except 1 correlates like Estrus cycle 2 hormonal assay for phases of menses 3 vaginal epitheliosis 4 endometrial bx for phase


    All done in expected management 1 cervical encirclage 2


    Pcod all except 1 high lh/fsh 2 high dheas 3 high prolactin 4


    Sensation from studious sinu carried by 1 nasiciliary 2 frontal 3lacrimal 4 supra teochleR
  20. Guest

    Guest Guest

    1.STRUCTURE PASSING THROUGH FORAMEN MAGNUM ?
    a)Int. Carotid Artery
    b)Hypoglosal Nerve
    c)Symp. chain
    d)Vertebral Artery ====ans

    2."rave Drug" means
    a)methadone
    b)ecstasy==========ans
    c)cannabis
    d)heroin

    3.Nerve involved in supracondylar fracture
    a) Radial nerve
    b) Median nerve======ans
    c) Ulnar nerve
    d) Ant int nerve

    4.Acoustic neuroma involves
    a)Sup Vestibular Division of VIII Cr Nrv
    b)Auditary part of VIII Cr Nrv
    c)VII cr. nerve
    d)Inf Vestibular Division of VIII Cr Nrv =======ans


    5.buprenorphine is
    a) partial agonist of mu receptors======ans
    b) antagonist of mu receptors
    c) agonist of mu receptors
    d) agonist of kappa receptors

    6. ALL R PNEUMATIC BONES EXCEPT
    a) ethmoid
    b) mastoid
    c) mandible=======ans
    d) frontal


    7.Contraceptive to be avoided in epilepsy
    a) post coital pills
    b) condoms
    c) IUD
    d) Oral Contraceptive pills ========ans

    8. "Pantology of fallot" includes :
    a) asd=========ans
    b) vsd
    c) Coarctation of aorta
    d) pulmonary stenosis ??


    9. Parenteral neutrition doesnot include :
    a) Carbohydrates
    b) fats
    c) fibres==========ans
    d) micronutrients


    10. DIABETIS WITH " CUT-OFF " 120 mg/dl with diagram
    a) false negative==========ans
    b) true negative
    c) false positive
    d) true positive


    11. Orgenelle for APOPTOSIS
    a) nucleus
    b) mitocondria=======ans
    c) ER
    d) golgi apparatus


    12. MOST COMMON CAUSE OF DEATH in SCHIZOPRENIC PT
    a)homicide
    b)suicide=========ans
    c)hospital infection
    d)drug induced


    13. Solitary kidney with 4 cm solitary mass,Best step Management
    a) total nephrectomy with immediate hemodialysis
    b) partial nephrectomy=========ans
    c) total nephrectomy + kidney transplant
    d) ??

    14. " SIGNATURE FRACTURE " means
    a) depressed fracture========ANS
    b) fracture at foramen magnum
    c) suture displacement #
    d) ??

    15. DEOXIGENATED BLOOD IS CARRIED BY all except:
    a) pulmonary Art.
    b) Umbilical Vein============ANS
    c) Right ventricle
    d) Umbilical Art.

    16.carrier stage not seen in
    1.typhoid
    2. measles=======ans
    3.??
    4.??
  21. Guest

    Guest Guest

    17. a q about punnet square

    18. epileptogenic contraceptive is
    desflurane
    sevoflurane
    ether
    halothane

    19.lithium toxicity is increased by
    diuretic
    ?
    ?
    ?

    20.not an actn of anti muscarinic
    decrease gastric secretion
    contraction of radial muscles
    ?
    ?

    21.a q about pheochromocytoma a/e
    90% malignant
    most common site abdomen
    ?
    ?

    22.not seen in digoxin toxicity
    biventricular tachycardia
    PAT
    ventricular bigeminy
    regularisn of AF

    23 all are in posterior to head of pancreas except
    bile duct
    inferior vena cava
    1 st part of duodenum
    ?

    24.segment of liver present on left of ligamentum ters hepatis
    2 & 3
    1 and 4a
    1 and 4b
    ?

    25. deoxygenated blood is carried by all/e
    umbilical v
    umbilical a
    pulmonary a
    right ventricle

    26.all are seen in PCOD a/e
    high LH
    high LH/FSH
    increased DHEAS
    persistantly increased prolactin

    27.necrotizing lymphadenitis is seen in
    kimura disease
    kikuchi disease
    hodgkin disease
    castelman disease

    28.NARP syndrome is seen in
    mitochondrial
    glycogen storage
    lysosomal
    lipid storage

    29.Nerve involved in supracondylar fracture
    Radial nerve
    Median nerve
    Ulnar nerve
    Ant int nerve

    30.hallmark of acute inflammation
    vasoconstriction
    stasis
    vasodilation and increase in permeability
    leucocytic margination

    31.cadeveric transplant is done for A/E
    blood vessels
    liver
    lung
    bladder

    32.not a cause of primary amoenorrhoea
    kallman syndrome
    turner syndrome
    sheehan syndrome
    rokitansky syndrome

    33.32 yr male a known hypertensive planned for cholecystectomy . which of following is contraindicated
    propofol
    ketamine
    midazolam
    etomidate

    34.m.c. tumor causing sup venacava syn.
    lymphoma
    small cell ca
    non small cell ca.
    ?

    35.buprenorphine is
    partial agonist at mu receptor
    antagonist at mu receptor
    ?

    36.which virus is least transmitted transplacentally
    rubella
    herpes simplex
    HIV
    HBV

    37.A/E pneumatic bones
    mandible
    frontal
    mastoid
    mastoid

    38.pt with solitary kidney hving 4 cm solitary exophytic mass in lower pole. management
    partial nephrectomy
    radical nephrectmy with dialysis
    radical nephrectomy with immediate renal transplant
    observation

    39.basal matabolic depends on??
    lean body mass
    body surface area
    body mass index
    ?

    40.pantology of fallot includes:
    asd
    vsd
    rvh
    pulmonary stenosis

    41.contraceptive to be avoided in epilepsy
    OCP
    condoms
    IUD

    42.Which of the following is true?

    a. Acetylcholinesterase inhibited by malathion can be reversed with increasing levels of acetylcholinesterase
    b. Sulphonilamide inhibits folate reductase irrevesibly.
    c. flouoroacetate competetively inhibits aconitase
    d. ?

    43.aminoacid transfer is done by
    transaminase
    ?
    ?

    44.free radical is produced by all except
    superoxide dismutase
    glutathione peroxidase
    ?

    45.free radical is produced by
    oxidase

    46.vit k promotes posttransalational modification of which aminoacid residue
    glutamine
    ?

    47.pseudoisomorphic phenomena is seen in
    vitiligo
    psoriasis

    48.wt gain in pregnancy is influenced by

    49.an antigen is injected in to a rabbit the first antibody produced will be
    ig M
    igG
    igA
    ig D

    50..STRUCTURE PASSING THROUGH FORAMEN MAGNUM ?
    a)Int. Carotid Artery
    b)Hypoglosal Nerve
    c)Symp. chain
    d)Vertebral Artery
  22. Guest

    Guest Guest

    51.Acoustic neuroma involves
    a)Sup Vestibular Division of VIII Cr Nrv
    b)Auditary part of VIII Cr Nrv
    c)VII cr. nerve
    d)Inf Vestibular Division of VIII Cr Nrv

    52.DIABETIS WITH " CUT-OFF " 120 mg/dl with diagram
    a) false negative
    b) true negative
    c) false positive
    d) true positive

    53.Orgenelle for APOPTOSIS
    a) nucleus
    b) mitocondria
    c) ??
    d) golgi apparatus

    54.MOST COMMON CAUSE OF DEATH in SCHIZOPRENIC PT
    a)homicide
    b)suicide
    c)hospital infection
    d)drug induced

    55." SIGNATURE FRACTURE " means
    a) depressed fracture
    b) fracture at foramen magnum
    c) suture displacement #
    d) ??

    56.carrier stage not seen in
    1.typhoid
    2. measles
    3.??
    4.??

    57.mAX ABSORPTION OF WATER OCCURES IN
    a) stomach
    b) jejunum
    c) ileum
    d) colon

    58.all can be given in prophylaxis of migraine except
    fluphenazine
    levocitarem
    topiramate
    propranolol

    59.anterior division of mandibular n. supplies all except
    lateral pterygoid
    medial pterygoid
    masseter
    temporalis

    60.all are in relation to 3rd ventricle except
    optic n
    ophthalmic n

    61.a question about pearson classification

    62. a qustion in which given that pt is given primaquin and pt develops hemolysis
    diagnosis is
    G6PD
    G6P

    63. a q about MRSA
    plasmid mediated
    due to mutation in penicillin binding protein
    amoxycillin and clavulinate is given
    ?

    64.otogenic abcess is caused by all except
    pseudomonas
    strepto
    h. inflenza
    staph

    65.alkalinisation of urine is done in
    cisplatin
    ifosphamide
    cytocin arabinocide
    mtx

    66.a question with choices
    low dose levothyroxin started
    levothyroxin giiven

    67.increase TSH with low t4 is found in
    hasimotos thyroiditis
    graves disease

    68.in APLA antibody found is

    69.in insulinoma which test is not done
    72 hr bloood sugar
    d xylose test

    70.erythema nodosum all xcept
    pregnancy
    tb
    sle

    71.progesterone in low dose ocp
    lng
    desogesterol
    norethisterone

    72.drug avoided in heart disese periprtum
    ergometrin

    73.45 yr old dub,8mm endomet
    endo sampling
    hysterectomy

    74 about chlamydia dianosis true is
    culture of endocervical discharge
    pts using ocp are carriers

    75.sampling method apllied when group divided into subgroups, n randomly selected
    cluster
    stratifed
    simple

    76. a question with choice ANOVA
  23. Guest

    Guest Guest

    Q.Antibody production is induced by A/E
    1. Infection with virus
    2.addition of Ethylene glycol
    3. electrocution
    4. dilution of cell mmb

    Methods of producing monoclonal antibodies are all except

    1)attaching inactive viral particle on cell membrane
    2)adding ethylene glycol
    3)applying a small electric current
    4)reducing the viscosity of the membrane
  24. Guest

    Guest Guest

    A 35 year old female has proximal weakness of muscles, repeated ptosis and east fatiguability. The best test to diagnose her condition is:
    1) Muscle biopsy
    2) CPK
    3) Edrophonium test
    4) EMG

    Answer: Edrophonium test.
    Explanation: Muscle biops, EMG and CPK are primarily used for diagnosis of inflammatory myopathies e.g. polymyositis, inclusion body myositis. Here the clinical picture is clearly of MG, which most common presentataion is extraocular muscle palsies. Plus inflammtory myopathies usually spare extraocular muscles. BUT proximal muscle weakness is included in the syndrome of myapthic muscle weakness. Anyways, I think what they wanted is to focus on how to distinguish between MG and inflammatory myopathies using a single test and not a diagnostic test. So the answer is Edrophonium which will help us to clarify it in a split second( figuratively) Edrophonium Positive=MG, negative, test further for myopathies.
  25. Guest

    Guest Guest

    Q-which is the most common tumour associated with neurofibromatosis in a child

    1) juvenile myelomonocytic leuk.
    2) ac.lymphoblastic leuk
    3)ac.monocytic leukemia
    4) ac.myeloid leuk

    ANS juvenile myelomonocytic leuk

    About 80% of JMML patients have some sort of genetic abnormality in their leukemia cells that can be identified with laboratory testing. This includes:
    15-20% of patients with neurofibromatosis 1 (NF1)


    Q. pt with central loss of vision, normal retinogram..
    which condition?
    a) best's disease
    b) stargardt's disease
    c) Retinitis pigmentosa
    d) macualr hole

    also - no family history of similar complaints......

    ans - stargardt's syndrome....ref wiki.
    Those with Stargardt disease are sensitive to glare; overcast days offer some relief. Vision is most noticeably impaired when the macula (center of retina and focus of vision) is damaged, leaving peripheral vision more intact. Symptoms usually appear before age 20. Symptoms include wavy vision, blind spots, blurriness, impaired color vision, and difficulty adapting to dim lighting.
    Stargardt disease, or fundus flavimaculatus, is a inherited juvenile macular degeneration that causes progressive vision loss usually to the point of legal blindness. The progression usually starts between the ages of six and twelve years old and plateaus shortly after rapid reduction in visual acuity.
    It can be associated with several different genes:
    STGD1: The most common form of Stargardt disease is the recessive form caused by mutations in the ABCA4 gene. It can also be associated with CNGB3.
    STGD3: There is also a rare dominant form of Stargardt disease caused by mutations in the ELOVL4 gene.
    STGD4: Associated with PROM1.
  26. Guest

    Guest Guest

    Q. best marker for intrahepatic cholestasis of pregnancy:
    a.bile salts
    b.bile pigments
    c.bilirubin
    d.alk phosphatase

    Ans. a. Bile Salts
    To obtain a diagnosis of ICP, there are two LFT and Serum bile acid test. The [liver function test]]s (LFTs)is a simple blood test, the results of which should be available by the next day. If the ALT level is elevated, this, plus pruritus of palms and soles, should be treated as diagnostic of ICP (however LFT's are not always elevated in ICP patients). The serum bile acid blood test for ICP is a quantitative measurement of bile salts. The results of this test often take longer to return, but the test is more specific for ICP

    Q. mineralocorticoid receptor not present in
    a.liver
    b.colon
    c.hippocampus
    d.kidney

    Ans. a. Liver
    MR is expressed in many tissues, such as the kidney, colon, heart, central nervous system (hippocampus), brown adipose tissue and sweat glands. In epithelial tissues, its activation leads to the expression of proteins regulating ionic and water transports (mainly the epithelial sodium channel or ENaC, Na+/K+ pump, serum and glucocorticoid induced kinase or SGK1) resulting in the reabsoprtion of sodium, and as a consequence an increase in extracellular volume, increase in blood pressure, and an excretion of potassium to maintain a normal salt concentration in the body.
    The receptor is activated by mineralocorticoids such as aldosterone and deoxycorticosterone as well as glucocorticoids, like cortisol.
  27. Guest

    Guest Guest

    Q. Girl 20yr intermittant ptosis, proximal mm weakness...best for diagnosis
    a. cpk
    b. msl biopsy
    c. edrophonium

    Ans. Edrophonium - straight-forward myasthenia....extraocular weakness is often ist sign and commonest complaint....the girl is having intermittant ptosis - which is hallmark of myasthenia gravis.

    Q. Dermal biopsy of a patient reveals FOAMY MACROPHAGES and NEUTROPHILS......Diagnosis is?
    a. Sweet's Syndrome
    b. ENL
    c. ?
    d. ?

    Ans. is b. ENL.....
    in sweet's syndrome, only neutrophils are found....
    in ENL, foamy macrophages (lepra cells) and neutrophils are found.....
  28. Guest

    Guest Guest

    What are Rave Clubs?
    "Raves" are large all-night dance parties, held in unusual settings like warehouses or railroad yards that feature computer-generated, high volume pulsating music, known as "techno" or "house" music. Rave clubs got their start in England in the late 1980's and are known for the music and use of drugs like Ecstasy.

    Rave club goers are known as "Ravers". All "Ravers" do not consume drugs. The club scene seems to be attracting adolescents from age 13 to young adults in their mid-to-late 20's. Party announcements can be found posted on colorful fliers, through word of mouth, even on the Internet. The phenomenon known as the "Rave Movement" has been compared to the "Peace & Love Movement" of the 1960 and 1970's.

    What substances are being used on the Rave dance scene? ("RAVE" DRUGS)
    There are a variety of substances that have been connected with Rave Clubs. This is a brief list of some of the drugs by slang names a
    1. Ecstasy
    2. Ephedrine
    3. Ketamine
    4. GHB
    5. Methcathinone
    6. LSD
    7. Magic Mushrooms
    8. Methamphetamine

    Why the sudden popularity of MDMA/Ecstasy?
    This substance has gained in popularity because is enhances self-awareness and it one of the most popular drugs used in "Raves", large all night parties. In the mid-1980's MDMA/Ecstasy burst onto the street drug scene and in 1999, the surge is back again.

    Ecstasy has fast become the drug of choice for young people around the United States and Tennessee is no exception. It seems to be sweeping the country and is gaining in popularity in rural communities as well as urban areas. Some users have reported a sense of well-being and sensuality, also a heightened sensory perception and insight. It makes people who use it feel a strong sense of empathy and emotional intimacy.

    What are some slang names for MDMA/Ecstasy?
    a) Adam, X-TC, X, X-ing
    b) E, Essence
    c) M&M
    d) Domex, Kleenex
    e) Love drug, Love trip
    f) MDM
    g) Rolling, Running, Shabu
    h) Speed for Lovers
  29. ravedave

    ravedave Guest

    o&g questions.... AIPGE 2011 ;-)

    1. Clue cells seen in
    bacterial vaginosis
    2. Not a cause of primary amenorrhea Sheehan's syndrome
    3. Obstructive azoospermia FSH & LH both normal.
    4. C/I in pregnancy Methotrexate.
    5. drug not a treatment for menorrhagia Ethamsylate.
    6. Next step in management of endometrial thickess > 5 mm Histopathological exam.
    7. Mifepristone MAY BE used for a. Threatened abortion, b. Ectopic pregnancy, c. Hyd. Mole, d. Fibriods
    ;-)
  30. Guest

    Guest Guest

    1Q.blount's disease is-
    1.genu valgum
    2.genu varum-answr
    3.genu recurvatum
    4.menisceal injury

    2 Punnet Square?
    a. genotype of offspring
    b. statiscal analysis
    c.
    d.

    3 q. which of the following is pneumatic bone except?
    1.frontal
    2.ethmoid
    3.mandible
    4. Maxilla

    4 Right isomerism?options
    asplenia
    two spleen
    one spleen
    polysplenia

    5 5 Pain of ethmoidal sinusitis is referred along the course of
    a. nasociliary n.
    b. infratrochlear
    c. frontal n.
    d.lacrimal

    6 Car tyre marks over legs of boy!Imprint abrasion,patternd bruise

    7 signature fractuew

    8 parenteral nutrition not concisits of
    fat
    carbohydrate
    fibre
    micronutrient

    9 urea cycle occurs in
    liver
    kidney
    colon

    10 clinical case...bipolar stained organism
    ans wayson staining

    11 Urethral crest elevation

    12 ,growth plate

    13 , hypogastric 7heath nt formed by,

    14 cause of premature death in schizophrenia

    15 homicide/suicide/hospital infection/ drug induced

    16 cavitation seen in
    mycolplasma pneumonia
    tuberculous pneumonia
    streptococcal pneumonia

    17 rave drug = Ectasy

    18 drug not used for prophylaxis in migraine ?
    a) gabapentin
    b) phenytoin
    C) levtriacetam
    d) flunarizine

    19 female with features of hypothyroidism= hasimotos thyroiditis

    20 choice of inotrope drug in right heart failture nd pul htn
    dobutamine
    isoprenaline
    digoxin
    milrinone

    21 contraindicated in hypertensive
    ketamine
    propofol
    etomidate
    diazepam

    22 xanthogranulomatous pyelonephritis= not a/w t b

    23 tpiple phosphate= proteus

    24 intra operative MI diagnosis

    25 buprenorphine is
    partial agonist of mu receptor
    full agonist at kappa
    antagonist of kappa

    26 sparrow feet marks r seen in??
    1. gunshot injuries
    2. stab injry of face
    3 vitriolage
    4 windshield glass injury

    27 ranula is

    28 necrotizing lymphadenitis is seen in
    a. kimura
    b. Kikuchi c.castleman

    29 baby born at 33 wks/1.5 kg should be started on
    1. nil oral and iv fluids
    2.oral nasogastric tube / aternate oral rute
    3.iv fluids and oral feeding
    4.TPN

    30 clue cells in
    bacterial vaginosis
    chlamydial vaginosis

    31 Body plethysmography findings when pt breathes aginst closed glottis in lungs n recordings respectively
    decreased
    increased
    lungs increases n recording decreased

    32 pt undergoing epidural block,becomes aphonic n loses consciousness when drug is injected
    total spinal block
    anaphylaxis
    vasovagal shock

    33 which organ obtained from cadver is not used for transplant??
    1.blood vessel
    2.lung
    3.liver
    4.bladder

    34 early sign of magnesium toxicity
    1.depression of deep tendon reflexes
    2.respiratory depression

    35 after stab injury of 18 yr male
    immidiatelt shift to ot
    FAST
    under LA wound closure

    36 epileptogenic anesthetic
    halothane
    ether
    desflurane

    37 contraceptive avoided in epilepsy
    combined ocp
    ucd
    pop
    condom

    38 lithium toxicity increased by
    b blocker
    ccb
    clonidine
    diuretics

    39 two plants are grown...one in some pigment containing media..other in luciferase containing media in dark.. which plant will grow
    1. both plants wil grow
    2. both wil not grow
    3. first wil grow
    4. second wil grow

    40 kid with respiratory sympomts started on antibioctics , improves and then worsens = bronchiolitis obliterans

    41 female with 45 x poorly developed breast, short stature= gonadal dysgenesis

    42 pt with solitary kidney hving 4 cm exophytic mass in lower pole.mx
    partil nephrectomy
    rdical nephrctmy with dialysis
    radical witth immediate renal transplant
    observation

    43 not a prion disease
    1.alzeimer
    2.TB
    3.

    44 branch of trunk of brachial plexus
    a. superior thoracic nerve
    b. lateral thoracic nerve s

    45 2. post cerebral artery supplies al except
    1. pons
    2. medulla
    3. thalamus
    4. margin of

    46 ant choroidal artery syndrome - hemipareisis,hemisensory loss,ant limb internal capsule, homonymous hemianopia???
    47 al are related posteriorly to head of pancreas except
    1. bile duct
    2. ivc
    3. 1st part of duodenum 4. aorta

    48 pt comes with history of unresponsive fever n cough. afb negtiv, xray pneumonia, bal gram positiv branchin filaments\
    actinomycosis
    nocardiosis
    aspergillus

    49 prophylaxis of migraine
    topiramate
    ppl
    fluner

    50 hot flushes treatment l except
    tamoxifene
    venlafaxine

    51 all of the following decrease bone resorption in osteoporosis except?
    a.Alendronate
    b.Etidronate
    C.Strontium
    d.Teriparatide

    52 ONODI CELLS & HALLER CELLS are associated with the following structures respectively?
    a.OPTIC NERVE & ORBITAL FLOOR
    b.OPTIC NERVE & INTERAL CAROTID ARTERY
    c.INTERNAL CAROTID ARTERY& OPTIC NERVE
    d.ORBITAL FLOOR & INTERNAL CAROTID ARTERY

    53 amp b causes def of
    na
    ca
    k
    mg

    54 injury to common peronel n all except
    loss of senstion over sole
    foot drop
    injury to neck of fibula
    loss of dorsiflex of toe

    55 a surgeon resects sectors to lt of lig teres of liver....segment 2 and 3

    56 18 yr exfra hepatc portal obstrn or ncpf?

    57 a pt develops pneumonia..grows on sheep agar..which test to diff...
    a. bile solubility b. bacitracin c. Coagulase

    58 q.sebaceous tumors seen in:
    gardners syn
    turcots syn / muir toirre/ cowden

    59 to treat chr alcohol dependance not used is
    1.flumazenil
    2.acamprostate
    3.naltrexone
    4.disulfiram

    60 most common fungal infection in immuno competant pts,,
    aspergillus candida cryptococcus mucor

    61 most common cause of cutaneous larva migrans.
    st. stercoralis
    toxocara canis

    62 pt with prolonged used of decongestants, fever ethmoidal tenderness,optic disc edema
    cavernous sins thr
    orbital cellulitis

    63 definitive airway a/e:
    nasotracheal tube
    orotracheal tube
    lma
    cricothyroidectomy

    64 ph 7.5 pco2 30.po2 102,compensated by
    met acidosis
    met alk

    65
    a. diminished kidney function which is done
    N acetylcysteine
    fenoldopam
    low osmolar contrast
    mannitol
    66 endolymp sac dilation
    menieres

    67 acoustic neuroma
    inferior vest n
    superior vest n

    68 grade 3 osteoarthritis mx
    arthroscopc wash out
    conservativ
    replcement

    69 15 yr gal with pin on climbing stairs n standing after prolongd sitting
    chondromalacia
    patellar??/

    70 apprepitant..nfk1 antagonist..

    71 al are actions of muscarinic antagonist except.
    a. decreses gastric secretion
    b. prolongs a-v conduction
    3. decreses resp secretions

    72 pulmonary toxicity bleomycin

    73 apoptosis micochondria

    74 al are seen in argyl robertson pupil except.
    near reflex normal
    direct reflex absent
    consensual reflex normal
    vision normal

    75 Glasgow comma Scale= E2+M5+V3 so total 10....no doubt in this

    76 orthotoluedene test chloride/ nitrate/ nitrite/ ammoni

    77 if Gs subunit affected..
    a. dec camp
    b. dec ip3

    78 leukocoria in 1 eye, other eye 2 small masses.rx

    a. enuc in rl, radio in lt
    b. enuc in 1 and follow up in other

    79 37 wks primi in labour for 10 hrs, cervix not properly effaced
    cs
    amniotomy
    oxytocin infusion

    80 neurofibroma malignancy ass
    juvenile myelomonocytic
    aml
    all AC MONOCYTIC

    81 mc tumor causing sup venacava syn
    lymphoma
    small cell ca non small mets

    82 poor prognosis in aml
    hyperdiploidy
    9;22
    females

    83 a 5 year old boy while having dinner suddenly becomes aphonic and is brought to the casulty for the complaint of respiratory difficulty. what should be the next appropriate treatment:-
    1) cricothyroidotomy
    2) emergency tracheostomy
    3) humidified oxygen
    4) Hemlich maneouvre

    84 The shaded area is
    a] true +ve
    b] true –ve
    c] false +ve
    d] false –ve

    85 Branch of trunk of brachial plexus
    a] suprascalpur
    b] long thoracic n
    c] ant. Thoracic
    d] nerve to sub clavius.

    86 proteus inf which stone?
    Cystine
    oxalate

    87 tolerance develops to all except
    miosis
    analgesia
    euphoria

    88 thalidomide side effects all ex
    diarrhoea
    teratogenicity

    89 drug used as antidepressant cn be used in nocturnal eneuresis,
    imiprmine

    90 diaphragm develops from a/e:
    septum transversum
    dorsal mesocardium
    pleuroperitoneal membrane
    cervical myotomes

    91 deoxy blood thru a/e:
    umbilical a
    umbilical vein
    pulm a
    right ventricle

    92 best to monitor intraop ischaemia
    ecg
    tee
    spo2

    93 best test for hcg
    radioimmunoassay
    elisa

    94 ecg is poor in detecting ischaemia in areas supplied by
    lad
    lt circumflex
    lca
    rca

    95 aortic shadow on pa x ray..obliterated by..
    upper lingula
    lower lingula
    apex of lower lobe

    96 young male fever 14 day neutrophils
    sweet syndrome

    97 erythema nodosum seen in al except..
    chr pancreatits
    preganancy
    sLE tb

    [snip] ophthalmoplegic migrane?

    99 Tetracycline used in prophylaxis
    cholera
    brucellosis
    leptospirosis

    100 bioterrorism- plague smalpox

    101 which virus crosses placenta least likely-rubella , herpes simplex, hiv, hbv

    102 a pt.compalined of rt.ear discharge for a year with c/o of severe pain in ear. the discharge was cultured and the org.was found to be gm positive cocci. the least likely cause is
    1) psuedomonas
    2) strept.pnuemoniae
    3) staphylococcus
    4) h.influenzae

    103 progesterone in low dose ocp
    lng
    desogesterol
    norethisterone gestodene

    104 expectant mx of placenta previa ae
    cervical stitching

    105 drug avoided in heart disese feriprtum
    ergometrine oxytocin

    106 45 yr old dub,8mm endomet
    endo sampling
    hysterectomy

    107 chlamydia trachomatis
    mostly symptomatic culture of endocervical discharge
    pts using ocp are crriers

    108 sampling method apllied when group divided into subgroups, n randomly selected
    cluster
    stratifed

    109 comprision of multiple factors responsible fr a disease by
    ANOVA
    chi squre

    110 pseudo isomorphism
    psoariasis
    arthropathy warts

    111 during surgery using laser..oropharynx cot fire..which is to be avoided.
    100% oxygen after discontinuing anaest gases
    flushing with strile waterfire
    removing et tube
    stopping anaesthetic gas n supplying oxygen

    112 a pt 24 hrs after perforation presents in shock..
    resuscitated..
    next
    a. emergency laprotomy
    b. correct electrolyte imbalance then take for an open laprotomy

    113 hallmark of acute inflammation
    vasoconstriction
    stasis
    vasodilation and increase in permeability
    leucocytic margination

    114 a child presents wit pain abd only during passing stools,. no other symptoms like vomiting blood in stools..
    a. rectal polyp
    b. intusseception
    c. Meckels

    115 NARP?
    1.lipid storage disorder
    2.lysosomal storage disorder
    3.? mitochondrail
    4?

    116 low radial palsy A/E
    ext pol brev
    ext pol lon
    sensation dorsum hand small ms of hand

    117 Q.basal matabolic depends on??
    a.lean body mass
    b.body surface area
    c.body mass index
    d.

    118 maximal water absorption of water in git?
    a jejunum

    119 f.magnun
    a. vertebral a. 12th cn

    120 resp.compliance pul edema , chr bronchitis

    121 prolonged INH t/t leads to def of:
    a.pyridoxine
    b.thiamine
    c.niacin
    d.pantothenic acid

    122 pantology of fallot :
    a. asd
    b. vsd
    c. rvh
    d. pulmonary stenosis

    123 Operelviken interleukin 11 Increases platelet

    124 3 erlotinib tyrocin kinase inhibitor
    a. Food decreases bioavailability

    125 Waxy translucent illuminant phosphorus

    126 insects resistant to DDT
    musca domesticus
    phebotomus
    culex
    anopheles stephensi

    127 pt has pain radiating t back..relieved by analgesics and?? by taking food..which of these procedures was he subjected t earlier..
    1.vag tomy wd gj
    2.vag tomy wd anterctomy
    3.whipple
    4.pancreatectomy..

    128 Alkalization of urine =methotrexate, cisplatin, ifosfamide

    129 A 1yr old child came with constipation,dry skin,palpable goitre.diagnosis
    dysgenesis
    dyshormonogenesis Receptor mutation

    130 a lady has epigastric pain etc..her amylase is normal but usg shows swollen pancreas wd bile duct stones..dx?
    1.acut cholecystitis
    2.acute pancreatitis
    3.appendicitis

    131 hyperpyrexia is caused by
    mao i
    alcohol
    cresol
    amphetamine

    132 rise in end tidal co2 during thyroid surgery ,,,all except..
    1.anaphyl
    2.malig hyperthermi
    3.? Malig neuroleptic syn 4.thyroid storm

    133 wt gain in pregnancy is related to all except
    ethnicity
    smoking
    socioeconomic status
    pre conceptional wt

    134 most common site of obstruction after trup
    navicullar foss
    bulb
    prostatic membranous urethra
    bladder neck

    135 15 DAYS old baby comes with ca 5 po4 8 pth 30 (n=10) & seizures
    1psuedo hypo para thyroid ans
    Vit d def
    Hyper para t
    HIE

    136 true abt epidural opioids a/e
    a.acts on dorsal horn cell
    b.itching
    c.nausea & vomiting
    d.resp depression

    137 most common cause of meningoencephalitis
    hsv
    enterovirus

    138 Urethral crest is situated in:
    1. Prostetic urethra
    2. Membranous
    3. Penile

    139 sewer worker presents with fever then lab findings of renal fail, most appropriate drug?
    cotrimox,????

    140 female with meningitis signs neck rigidity , csf shows gm +ve bacilli??
    listeria
    h. influenza

    141 hish altitude athlete ,pcv 60????
    polycythemia with dehydration

    142 commpliance dec in??
    copd
    pul edema

    143 tpp- transketolase, alpha kg dhg lactate dhg

    144 in bacterial killing activated is???
    oxidase
    peroxidase
    hydrolase

    145 free radicals produced by a/e
    glut peroxidase
    NO synthase
    superoxide dismutase

    146 transfer of an amino grp from one a.a. to alpha-keto acid by:
    a.transaminases
    b.aminases
    c.transketoses
    d.??

    147 not in national screenin programme
    dm
    caries
    a. br ca
    b. ca cx

    148 tetanus true is a/e
    heat resisit spores
    3 times vaccine to be given for prevention
    a. i.c. period 6-10 days

    149 fixative mc in histopat-
    glutaraldehyde
    alc
    formaldehyde

    150 capsule virulence in a/e -
    nisseria memingitis,
    pneumococcus,
    bordetella pertussis
    a. h.inf

    151 integrase inhibitor approved for HIV is
    a.Raltegravir
    b.Efavirennz
    c.?
    d.?
    answer is a

    152 Cicatrical alopecia with grey pigmentation around the hair follicles.. which of the foll do u expect in the patient a) oral mucosal lesions b) nail pitting c)arthropathy d) ?

    153 supra condylar fracture , nerve injured
    1. ulnar
    2. radial
    3. anterior interroseous
    4. Medial

    154 hypogastric sheath a/e
    1. broad ligament
    2. transverse cervical
    3.

    155 neuronal tumors all except
    1 90% malignant ans
    2 95%. In abdomen
    3 secrete catecholamines
    4 arises from ganglion of sympathetic chain

    156 one on Mc Keown considering which factor important for decrease in disease incidence
    a. McKeon's theory on reduced prevalence of TB:
    a.increased awareness and knowledge
    b.medical advancement
    c.social & env factor
    d.??

    157 DLE?

    158 which of the foll does not cause indoor air pollution
    CO, nitrogen dioxide, radon Murcury vapor

    159 fasting hypoglycemia. not a cause
    a)glucagon excess
    b) glucose 6 phospatase deficiency
    c) glycogen synthase deficiency
    d) ?

    160 SECONDARY HAEMORRHAG
    a. 12hr
    b. 24 hr
    c. 6 days

    161 most imp prognostic factor in Cong Dia Hernia
    pulmonary ht
    a. timing of sx
    b. size

    162 superior oblique palsy-
    a. horizontal and down
    b. horizontal and up
    c. vertical and dwn
    d. vertical and up

    163 There was one question about dental numbering
    a. two digit system

    164 not an actn of anti muscarinic
    contn of radial M of iris

    165 Nesidioblastosis-ans is ------islet hyperplasia arising from ductal epithelium

    166 6 yr child—pain in hip in femoral triangle region , x ray –ve. Next step?
    a. Usg
    b. Mri
    c. Aspiration
    d. Traction

    167 Sterile Pyuria present in...
    a. Tb

    168 parvovirus b19 a/e
    a. <10 % by blood
    b. Resp route
    c. its a dna virus

    169 shoulder dystocia
    a. fundal pressure
    b. suprapubic press
    c. mc roberts
    d. woods

    170 a mother with 33weeks gestation with sle. drugs not to be administered
    1.
    2.
    3.prednisolone
    4.methotrexate

    171 mifepristone
    a. molar
    b. threatened
    c. fibroid

    172 Pcod ...
    a. Prolactin
    b. Lh
    c. Lh:fsh increased

    173 hematuria old man..
    a. urine exam nd microscopy
    174 not neuron tumour
    a. ependymoma
    b. gangliocytoma

    175 not seen in digoxin toxicity???
    biventricular tachycardia
    PAT
    ventricular bigeminy
    regularisn of af
    ans—a

    176 rhf and pul htn.cause of orthopnea
    a. pul veins reservoir function

    177 which is a cardio protective fattyacid
    a. stearic,
    b. palmitic
    c. oleic
    d. w3

    178 in treatment of depression drug depends upon.....
    a. side effect profile of drug

    179 after taking haloparidol neck stiffness...... diagnosis is pt having
    a. DYSTONIA

    180 L5 radiculopathy
    a. Knee ext
    b. Knee flex
    c. Toe dorsiflex
    d. Hip adduction

    181 muscle of dorsal aorta develops frm
    a. paraxial
    b. intermediate
    c. lateral plate

    182 floor of 3rd ventricle
    a. optic chiasma
    b. mammilary body

    183 late onset endopthalmitis
    a. propionibacterium acnes
    b. staph epidermidis
    c. pneumococcus

    184 arthropod diseases not found in india
    1.west nile fever
    2.dengue
    3.yellow fever
    4.

    185 Japanese encephalitis in india
    a. Epidemic is 2-3 cases in a village

    186 medical dissolution of gallstone C/I in
    a) radiolucent stone
    b)radio opaque stone
    c) functioning gall bladder
    d) small stones

    187 xanthogranulomatous pyelonephritis not a feature

    188 a person hit by tennis ball suggesting feature
    a. equatorial edema
    b. vitreous base avulsion

    189 for diabetic retinopathy which is not given
    a. tamoxifen

    190 during TURP surgeon takes care to dissect above verumontenum so as not to injure the--------external urethral sphincter

    191 post turp stricture - mid bulb,sphincter vesicae, prostatic part,navicular

    192 least common cause of ambiguous genitalia in female child---
    a. placental steroid sulfatase(causes Ichthyosis vulgaris)
    b. fetal aromatase
    c. wt4 mutation

    193 the best results by which surgery for vvf

    194 .. kelly's, vaginal taping

    195 serotonin syndrome a/e
    a. idiosyncratic and unpredictable
    b. dantrolene tt

    196 a 50 yr lady referred by orthoped with history of sprained ankle 2 mths back.. f/b recovery.. however she now complains of severe pain in that ankle with inability to flex that foot.. physician notes edema n shiny skin in local examination...prob dx:
    a fibromyalgia
    b chr. regional pain synd1
    c chr. regional pain synd 2
    d peripheral neuropathy

    197 bifurcation of common carotid palpated at ?
    a) upper border of thyroid cartilage
    b) at cricoid cartilage
    c) crico-thyroid membrane
    d) against hyiod bone

    198 psammoma bodies seen in all except
    1.follicular ca thyroin ANS
    2.papillary ca thyroid
    3.cystadenoca
    a. m???

    199 denominator for mternal mortality rate
    live births

    200 pt with abnormal platelet function n bleeding episodes
    thrombocytopenis n prolonged bleeding time
    normal pl n prolonged bt

    201 causes of primary amenorrhoea are all except
    1.rokintasky
    2.kallaman synd
    3.sheehan syndrome ANS
    4

    202 hbH disease

    203 variceal bleed
    a. octreotide

    204 high tsh and low t4 hashimotos
    205 azoospermia with blockade
    a. normal lh fsh

    206 vitamin K and glutamate

    207 the primary action of NO in git
    1.vasodilatation
    2.vasoconstriction
    3.gi smooth muscle relaxation ANS
    4.

    208 systemic larva migrans:
    a. toxocara
    b. strongyloides stercoralis

    209 girl 20yr intermittant ptosis, proximal mm weakness...best for diagnosis
    a. cpk
    b. msl biopsy
    c. edrophonium

    210 girl wid occipital headache assoc wid ataxia vertigo.also in mother
    a. vestibular neuronitis
    b. basillar migraine

    211 awareness in snesthesia - how can it be detected i guess -
    a. pulse oximetry
    b. colour doppler
    c. Bispectral imaging
    d.end tidal co2

    212 spinal anaesthesia level:
    a.L1
    b.L2-L4
    c.Mid thoracic level
    d.?

    213 ques on CJ disease:H/o dementia;eeg changes,myoclonic movements

    214 violent shaking of kid by parents leads to -fracture of bones,orbital plate,subdural hmrg???

    215 ca stomach not seen - achlorhydia n hypochlorhydia
    a. occult bleeding in stool
    b. radiotherapy good

    216 open neural tube defects – acetylcholinesterase

    217 d/o/c for leptospirosis...

    218 sudden flashes ,floaters,and veil?
    a.retinal detachment
    b.vitreous h'age
    c,d?

    219 Diff. b/w Follicular CA & Follicular adenoma
    Ans. Vascular invasion

    220 A teenage girl feel pain at knee on standing after long sitting and walking .....
    a. Chondromalacia patellae

    221 blue gray discoloration in conjunctiva,mucous membrane,and nails:poisonong by?
    a.Cu
    b.Ar
    c.Hg
    d.Pb

    222 A 3.8 kg baby of a diabetic mother developed seizure 16 hr after birth ...
    1.hypoglycemia
    2.hypocalcemia
    3.
    4.

    223 C in CRP?

    224 Aflatoxin?
    a. a.flavus
    b. a.niger

    225 best investigation forbone metastases?
    a.MRI
    b.CT
    c.bone scan
    d.?

    226 best investigation forbone metastases?
    a.MRI
    b.CT
    c.bone scan
    d.?

    227 dose of radiation reqd for haematological syndrome:
    a.2.5-5CGY
    b.10 cgy
    c.100 cgy
    d.200 cgy

    228 HDI A/E?
    a) LIFE EXPECTANCY AT BIRTH
    b) LIFE EXPECTANCY AT 1 YEAR
    c) EDUCATION
    d) GDP

    229 BONE RESORPTION A/E
    a) TERIPARTIDE

    230 NECK OF FEMUR SUPPLY BY ?
    a)MFCA
    b) LFCA
    c) FRMORA PROFUNDA
    d)???? Popliteal A.

    231 Anaesthetic agent with vasoconstrictor c'i in:
    a.finger block
    b.spinal block
    c.epidural block
    d.?

    232 Q18yr male with hemetemesis & melena and splenomegaly ....
    1.NCPF
    2.CIRRHOSIS
    3.MALARIA
    4...

    233 Transport vescicles
    a. Rna edting?

    234 Carbohydrate antigen
    a. Memory

    235 most potent activator of T cells?
    1. B cells
    2.immatre dendritic cells
    3. mature dendritic cells
    4. macrophages

    236 1st time inject with ovalbumin...1st antibody
    a. Igm
    b. Igg
    c. Igd
    d. Ige

    237 Phagocytosis
    a. <0.5 mcm
    b. >0.5 mcm
    c. Phagosome+lysosome=phagolysosome

    238 Gene for expession of protein max production ensured by
    a. Promoter gene
    b. Initiator signal
    c. transln and transcription termination signal

    239 machanism of Resistance in MRSA?
    Alteration in PBP's

    240 Obliterated aortic knuckle in CXR ..iNVOLVED PART OF LUNG...
    a. Superior lingual lobe
    b. Inf lingual
    c. Apical of lower
    d. Post of upper

    241 false about C.diphtheriae:
    a.toxin producn chromosome mediated
    b.org cnfd by toxin production c,d??

    242 Unilateral undescended testis ... ideal age of operation
    a. 6mo
    b. 12mo

    243 APL Ab syndrome which Ab seen?
    a.beta 1 microglobulin

    244 cartilage for growth plate:
    a.fibrous
    b.prim cartilagenous
    c.sec cartilagenous
    d,???

    245 Not a predisposer for atherosclerotic plaque formation?
    a.ApoE
    b.alpha-macroglobulin
    c.oxidised LDL
    d.?

    246 False about HDL?
    a.can oxidise LDL
    b.decreased levels fail to clear LDL
    c.best predictor for CAD?

    247 7 mo child with pneumonia..
    a. Nasophayngeal swab
    b. Cough sputum culture

    248 unComplicated uti a/e
    a. <10^3 e.coli on culture
    b. I pus cell per 7 fields

    249 Methods of producing monoclonal antibodies are all except
    1)attaching inactive viral particle on cell membrane
    2)adding ethylene glycol
    3)applying a small electric current
    4)reducing the viscosity of the membrane

    250 Boop

    251 anaesthesia avoided in sickle cell patient...
    a. iv anaesthesia
    b. regional anaes

    252 Pregnancy induced cholestasis marker... is
    a. Bilirubin
    b. Bile salts
    c. Sgot/sgpt
    d. Alp

    253 pt with b/l central loss of vision, normal retinogram.no systemic features. no history of similar complaints in any family members.
    which condition?
    a) best's disease
    b) stargardt's disease
    c) Retinitis pigmentosa
    d) macualr hole

    254 poor prognostic factor for ALL?
    a.hyperdiploidy
    b.t(9;22).....ans
    c.2-8 yrs
    d.?

    255 commonest cause for b/l proptosis in children?
    a.cavernous haemangioma
    b.rhabdomyosarcoma
    c,d?

    256 most reliable radiological sign of pulmonary hypertension-----
    a. descending branch of right pulmonary artery > 16mm
    b. desc of lt pul a. >16mm
    c. lt. Pul a. >16 mm
    d. pul a. >16mm

    257 primi in labour with uterine contractions since last 10 hrs,cx not effaced?;next step?
    a.sedate n observe
    b.syntocin induction
    c.c.s.
    d.?

    258 earliest to be diagnosed by USG?
    a.anencephaly
    b.prosencephaly
    c.meningocele
    d.

    259 An amoebic liver abscess..5cm-5cm Rx of choice
    a. Mz amd antibiotics is choice
    b. Repeated aspiration and antibio
    c. Surgical drainage
    d. Resection of liver

    260 perpuce adhasion 2yr child.rx
    a. adhesiolysis and dilatation
    b. circumscision
    c. dorsal slit

    261 all true except:
    a.human anatomical waste disposed in yellow bag
    b.red bag contents can be source of contamination
    c.black bag for incineration ash
    d.blue bag contents always disposed in secure landfill

    262 not a c/i for pregnancy - wpw syndrome

    263 no carrier state – measels

    264 man with maculopapular rash with prev h/o painless rash.diagn is:
    a.treponema pallidum
    b.chlamydia
    .C.granulomatis
    d.H.ducreyi

    265 false about strep pneumoniae?
    a.capsule aids in infection
    b.commonest cause of o.media and pneumonia
    c.??

    266 Amputation 1st done is
    a. Bone fixing

    267 mineralocorticoid receptor not present in
    a.liver
    b.colon
    c.hippocampus
    d.kidney

    268 pasteurised milk is tested mostly by:
    a.phosphatase test
    b.coliform test

    269 d/o/c for central Diab insipidus?
    a.vasopressin
    b.leuprolide
    c.thiazide

    270 fallopian tube immotility seen in:
    a.churg strauss syndr
    b.kartaganer;s
    c.?d.?

    271 child got cranial sx done ... pituitary got damaged.. which hormone shld b replaced first-
    hydrocort
    thyroxine
    growth hormone

    272 delirium tremens,not seen:
    a.visual hallucination
    b.unconsciousness
    c.coarse tremors
    a. opthalmoplegia

    273 pnt with low Ca,high phosphorus,raised PTH..inv not to be done:
    a.urine microscopy
    b.PTH levels
    c.vit D levels
    d.??

    274 miglitinides all are true except
    1decreases post parendial hyperglycemia
    2 hypoglycemia less than sulfonylurease
    3 it decreases insulin resistance ans it's (thiazolidinedions acts as insulin sensitizer)
    4 it acts by releasing insulin (yes just like sulfonylurease but less hypoglycemia)

    275 Pearson's skewness coefficients
    a. (Mean-median)/sd
    b. Median-mean/sd
    c. Sd/mean-median
    d. Sd/median-mean
  31. Guest

    Guest Guest

    * Pelvic Fascia ( Plate 364) Occupies space between peritoneum and muscles of the pelvic floor and walls
    * Parietal pelvic fascia lines the internal surface (facing the pelvic cavity) of the muscles of the floor and walls
    * Visceral pelvic fascia invests each of the pelvic organs
    * Visceral and parietal fascia are continuous where organs penetrate pelvic floor
    o Where they are continuous, fascia thickens to form the tendineus arch of pelvic fascia (arcus tendinous fasciae pelvis)
    o Arches are bilateral bands running from pubis to sacrum, adjacent to viscera
    * Puboprostatic ligament
    * Pubovesical ligament
    * Sacrogenital ligaments (Plate 347) (Plate 349)
    * Between parietal and visceral fascia is endopelvic fascia
    o Matrix or filler material
    o In certain areas, condenses and becomes more fibrous to form fascial “ligaments” or septa
    * Major condensation is the hypogastric sheath
    o Runs from lateral pelvic wall to pelvic viscera
    o Separates retropubic space from presacral space
    o Serves as a conduit for vessels and nerves
    * Transverse cervical (cardinal) ligaments are part of hypogastric sheath
    o Runs from lateral wall to the uterine cervix and vagina
    o Uppermost part is beneath broad ligament and transmits the uterine artery
    o Is sufficiently fibrous to provide passive support for the uterus
    * Uterosacral(female) or genitosacral (male) ligaments
    * Septa separate the pelvic organs and include
    o Vesicovaginal septum
    o Rectovesical septum
    o Rectovaginal septum
    * Weakness of the pelvic floor muscles or in the pelvic fascia, which support the pelvic organs can result in prolapse of the pelvic organs, e.g., vaginal or rectal prolapse.

    Milrinone Improves Pulmonary Hemodynamics and Right Ventricular Function in Chronic Pulmonary Hypertension
    Edward P. Chen, MD, Hartmuth B. Bittner, MD, PhD, R. Duane Davis, Jr, MD, Peter Van Trigt, III, MD

    Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina

    Accepted for publication December 9, 1996.

    Background. Right ventricular failure after cardiac transplantation is commonly related to preexisting recipient pulmonary hypertension. This study was designed to investigate the effects of intravenous milrinone on pulmonary hemodynamic indices and right ventricular function in a canine model of monocrotaline pyrrole–induced chronic pulmonary hypertension.

    Methods. Eight mongrel dogs underwent pulmonary artery catheterization to measure right-sided hemodynamic indices before and 6 weeks after a right atrial injection of monocrotaline pyrrole. Six weeks after injection, all hearts were instrumented with a pulmonary artery flow probe, ultrasonic dimension transducers, and micromanometers. Data were collected at baseline and after milrinone infusion.

    Results. Six weeks after monocrotaline pyrrole injection, significant increases in the pulmonary artery pressure and pulmonary vascular resistance were observed. Milrinone led to significant increases in right ventricular function as well as significant improvements in pulmonary vascular resistance, pulmonary blood flow, and left ventricular filling.

    Conclusions. This investigation demonstrates the well-known hemodynamic and inotropic effects of milrinone which, in the setting of monocrotaline pyrrole–induced pulmonary hypertension, were also associated with significant increases in pulmonary blood flow and left ventricular filling.
  32. Guest

    Guest Guest

    Nineteenth Century Population
    Why did mortality decline?

    Professor Thomas Mckeown's Modern Rise of Population was published in 1976, summarizing over two decades of painstaking empirical work, applying the insights of medicine and epidemiology to a historical analysis of Britain's detailed national series of death records. This work revolutionized medical and demographic history, overturning a long-standing view regarding the importance of medical advances in bringing about the decline in mortality which accompanied industrialization in Britain. Mckeown effectively demonstrated that advances in medical science, such as the immuno- and chemotherapies which form the basis of today's clinical and hospital practices, played only a very minor role in the late nineteenth century mortality decline: most of the important diseases involved had already disappeared in England and Wales before the date at which the relevant medical innovations occurred.

    In addition to this negative finding, Mckeown claimed that his analysis of the epidemiological evidence showed that the major influence on the decline in mortality was a steady rise in 'living standards' and the associated rise in average nutritional intake. Mckeown also identified 'municipal sanitation' and 'hygiene improvements' as a positive but very much secondary factor, which only assumed importance during the last third of the nineteenth century. This 'nutritional determinism' ascribed improvements in the health of the nation to rising living standards, with a reduced incidence of respiratory tuberculosis (t.b.) the most important epidemiological feature.

    Mckeown's conclusions have achieved broad general acceptance and the importance of rising living standards is now taken for granted in much research on the mortality decline in Victorian and Edwardian Britain. In this respect Britain is an exceptional case, in that neither medical science nor public health practices are judged to have been as important as they seem to have been in other countries. In Discussion Paper No. 121, Research Fellow Simon Szreter examines Mckeown's arguments, and in particular his assertion that rising living standards and improved nutrition should be regarded as the major cause of falling mortality in Britain during the period 1850-1914.

    Szreter first examines the epidemiological evidence, and in particular the role of t.b.. It is essential, he argues, to recognize the interrelations between different diseases. For example, the presence of t.b. impedes an individual's capacity to resist other diseases, so that the prior decline in t.b. detected by Mckeown would be expected to facilitate the reduced fatal incidence of other diseases. On the other hand, t.b. generally takes a lethal hold when an individual has already been weakened by another disease, so that any decrease in the incidence of other diseases would probably have a secondary effect of reducing the number of t.b. victims. The chronology of the declines in various lethal diseases is therefore a crucial element of any analysis of falling mortality, Szreter argues.
    Using Mckeown's own evidence, Szreter challenges his argument that the reduced incidence of respiratory tuberculosis accounted for nearly half of the decline in mortality rates in this period. The incidence of lethal bronchitis, he observes, rose anomalously by 20%. This appears to contradict Mckeown's view that a general fall in airborne diseases was the principal epidemiological change during the nineteenth century. On the other hand, it is plausible that changes in certification accounted for this rise in reported lethal bronchitis, offsetting the fall in reported t.b. death rates.

    These arguments suggest that it is no longer plausible to argue, as did Mckeown, that a sustained fall in fatalities from the airborne diseases began in the 1840s, predating and making possible the later declines in mortality from the 'sanitation' diseases. Instead, Szreter detects no clear trend towards declining t.b. until the late 1860s, making falling death rates from t.b. no more important a contributor to decreasing mortality overall than the falling rates from water-borne diseases such as typhus and typhoid fever or food-borne diseases such as cholera and diarrhoea.

    Szreter suggests an alternative interpretation based on a wider view of trends in national average life expectancy at birth. Although for nearly a century after the 1730s life expectancy had risen steadily, from under 30 to just over 40 years, it remained stationary through the middle quarters of the 19th century, before rising to 47-8 years by 1900 and just over 60 by 1931. This plateau in life expectancy, which did not emerge in Mckeown's analysis, coincided with the most rapid and intense phase of urbanization. Szreter argues that the unprecedented and unplanned growth of overcrowded cities lacking proper water supply and waste disposal facilities was directly reflected in the increasing incidence of the sanitation diseases in the first two thirds of the nineteenth century. This theory is supported by regional variations in life expectancy. For example, in 1840 average life expectancy at birth was 45 years in rural Surrey, but only 26 years in Liverpool, which had trebled in size in 40 years.

    Yet real wages in urban centres generally rose in this period, undermining the primary role accorded to living standards by Mckeown in determining mortality trends. Moreover, Szreter argues that the return to generally declining mortality in the last third of the nineteenth century reflects the chronology of the most significant improvements in public health and urban sanitation. In the 1870s, the establishment of the Local Government Board and the passing of a series of Public Health Acts introduced a period in which local authorities took on an increasing role in safeguarding public health. The majority of urban authorities took over the function of supplying water. A wide range of preventive measures were implemented throughout the country, governing municipal sanitation, the content of food, and the urban environment, particularly overcrowding. The elimination of typhoid and cholera, Szreter argues, testifies to the effectiveness of large-scale preventive health measures.
    This reinterpretation suggests that mortality decline was the result of human agency, in the form of expanding preventive public health provisions and services, rather than the result of an impersonal invisible hand of rising personal 'living standards'. Yet, Szreter notes, the direct effects of improved public health and municipal sanitation on mortality indices cannot as yet be demonstrated conclusively, and future research could profitably investigate this aspect of the mortality decline.
  33. Guest

    Guest Guest

    Flint: Cummings Otolaryngology: Head & Neck Surgery, 5th ed.

    Case A: Fire in the Airway

    The patient was a 65-year-old woman, who was seen in the operating room for a composite bilateral neck dissection, percutaneous endoscopic gastrostomy (PEG), and tracheotomy. The initial airway management was uneventful with general anesthesia and conventional laryngoscopy. During the creation of the tracheotomy, the plastic surgeon requested that the anesthesiologist lower the inspired oxygen concentration and be prepared to withdraw the ETT in anticipation of entering the trachea. As the anesthesiologist was focusing his attention on these tasks, the surgeon used the electrocautery to enter the trachea. There was an immediate burst of flames. The anesthesiologist immediately removed the ETT tube from the patient's mouth, and the surgeon drenched the surgical site with saline. Once there was no evidence of continued fire, mask ventilation was re-established with 100% O2 and the patient reintubated. The procedure was terminated, and patient was taken, intubated, to the intensive care unit. An otolaryngology consult was requested.

    Discussion
    1. The best treatment for fire in the airway is prevention. For there to be a fire, there must be a source of oxygen and a source of combustion. In this case, both were present. Although many consider the ETT to be the only source of combustion in the airway, crusted secretions in a nonintubated patient can also be a nidus for fire. Although lowering the Fio2 and avoiding N2O may decrease the severity of a fire, it will not prevent one. In addition, the patient might not be able to tolerate the lower Fio2. Therefore, the absolute caveat for the surgeon is to not enter the trachea with the electrocautery. The absolute caveat for the anesthesiologist is to maintain vigilance at the moment of entry into the trachea and maintain communication with the surgeon as to the status of the patient.

    2. In the event of an airway fire, the following steps should be taken:
    • Stop the flow of O2 to the ETT.
    • Remove the ETT tube.
    • Flood the field with fluids, if appropriate.
    • Mask ventilate with 100% O2.
    • Reintubate as soon as possible.
    • Consider positive end-expiratory pressure (PEEP), continued ventilatory support, and high-dose steroids.
    • Call for immediate consultation with an otolaryngologist to evaluate the extent of the airway burn.

    Airway Fire Protocol

    If an airway fire or explosion occurs, the surgeon and the anesthesiologist must act quickly, decisively, and in a coordinated fashion. This may not be easy after an explosion because the event may be so traumatic as to incapacitate the operating room staff temporarily. Clear communication and emergency practice (at least a mental drill of the emergency procedure) are key to managing such a crisis. Schramm and coworkers provided a useful review of the ensuing pathologic features and suggested emergency management.

    A surgeon who detects an endotracheal or other source of airway fire should remove the source as quickly as possible and simultaneously inform the anesthesiologist, who should immediately, despite reflexive training to the contrary, stop ventilation. Temporarily disconnecting the breathing circuit from the anesthesia machine may be useful. These maneuvers remove the flame and the retained heat in the tube and stop the flow of oxygen-enriched gas. The flaming material should be extinguished in a bucket of water, which should always be available during laser surgery. Ventilation with 100% oxygen should be provided by mask, and anesthesia should be continued.

    Direct laryngoscopy and rigid (Venturi-ventilating) bronchoscopy should be performed to survey damage and to remove debris. If the fire was of the “interior blowtorch†type, gentle bronchial lavage may be indicated, followed by fiberoptic assessment of the more distal airways. If any airway damage is apparent, the patient should be reintubated. Small fires involving only the exterior of the tube may not cause appreciable damage. If the damage is severe, a low tracheotomy may be indicated.

    The pattern of damage in interior fires tends to be worst in the upper airway and diminishes as the surgeon approaches and passes the carina. The patient's oropharynx and face should be assessed, and a chest radiograph should be obtained. Pulmonary damage due to heat or smoke inhalation, or both, may necessitate prolonged intubation and mechanical ventilation. A brief course of high-dose steroids may be helpful.
  34. Guest

    Guest Guest

    Q21. Epileptogenic
    1. Desflurane
    2. Sevoflurane
    3. Ether
    4. Halothane
    Answer 2. Sevoflurane
    Ref : A practice of anesthesia for infants and children By Charles J. Coté

    Q23. Not a cause of primary amoenorrhoea
    1. kallman syndrome
    2. turner syndrome
    3. sheehan syndrome
    4. rokitansky syndrome
    Answer 3. sheehan syndrome

    Q24. All are indoor air pollutants except
    1.CO
    2. Chloroflurocarbons
    3. Nitrogen oxide
    4. Mercury
    Answer 3) Nitrogen Oxide

    Q25. Denominator in Maternal Mortality rate
    1. Total Number of Live birth
    2. Total Number of Married Women
    3. Total Number of Birth
    4.
    Answer 1. 1. Total Number of Live birth

    Q26.Contraceptive to be avoided in epilepsy
    1. OCP
    2. Condoms
    3. IUD
    4. Post Coital Pill
    ANSWER 1. OCP
    Confusion Lies Between OCP and POST COITAL PILL .
    But Check this standard reference from
    The morning after pill can be used in women with epilepsy after unprotected sexual intercourse. A higher dose is recommended in patients taking hepatic enzyme inducing drugs
    - 1st dose – Levenorgestrol 1.5mgs (2 tablets)
    - 2nd dose 12 hours later – Levenorgestrol 0.75mgs (1 tablet)

    Q27. People are separated into certain sub groups. People are selected randomly from sub groups. What type of sampling is done?
    1. Random sampling
    2. Stratified Sampling
    3. Quota Sampling
    4.
    Answer 2. Stratified Sampling

    Q28. NARP syndrome is seen in
    1. mitochondrial
    2. glycogen storage
    3. lysosomal
    4. lipid storage
    Answer 1. Mitochondrial Disorder
    Neuropathy, ataxia, and retinitis pigmentosa, is a condition related to changes in mitochondrial DNA.
    Mutations in the MT-ATP6 gene cause neuropathy, ataxia, and retinitis pigmentosa.
    The MT-ATP6 gene is contained in mitochondrial DNA. Mitochondria are structures within cells that convert the energy from food into a form that cells can use. Although most DNA is packaged in chromosomes within the nucleus, mitochondria also have a small amount of their own DNA (known as mitochondrial DNA or mtDNA).

    Q30. Necrotizing lymphadenitis is seen in
    1.Kimura disease
    2. kikuchi disease
    3. hodgkin disease
    4. castelman disease
    Answer 2. Kikuchi Disease
    Kikuchi disease ai also called histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease, is an uncommon, idiopathic, generally self-limited cause of lymphadenitis. The most common clinical manifestation of Kikuchi disease is cervical lymphadenopathy. Several viral candidates have been proposed, including cytomegalovirus, Epstein-Barr virus,16 human herpesvirus, varicella-zoster virus, parainfluenza virus, parvovirus B19, and paramyxovirus.

    Superior vena cava syndrome MOST common cause
    a)metastasis
    b)nonsmall cell lung carcinoma
    c)small cell carcinoma
    ANS-B
    William Hunter first described the syndrome in 1757 in a patient with syphilitic aortic aneurysm. In 1954, Schechter reviewed 274 well-documented cases of superior vena cava syndrome (SVCS) reported in the literature; 40% of them were due to syphilitic aneurysms or tuberculous mediastinitis. In more recent times, these infections have gradually decreased as the primary cause of superior vena cava (SVC) obstruction. Lung cancer, particularly adenocarcinoma, is now the underlying process in approximately 70% of the patients with superior vena cava syndrome (SVCS). However, up to 40% of the causes are due to nonmalignant causes.

    Q. 32. Aprepitant is all except
    1. Agonist at NK1
    2. Crosses Blood Brain Barrier
    3. Ameliorate Nausea Vomiting of chemotherapy
    4. Metabolized by CYP450
    Answer 1. Agonist at NK1
    Aprepitant is an antiemetic chemical compound that belongs to a class of drugs called substance P antagonists (SPA). It mediates its effect by blocking the neurokinin 1 (NK1) receptor.

    Q. 33. Buprenorphine is a
    1. Partial agonist at MU Receptor
    2. Partial agonist at Kappa Receptor
    3. Full Agonist at Mu Receptor
    4. It is antagonist at Kappa receptor
    Answer 1. . Partial agonist at MU Receptor

    Q. 34. Local Anaesthetic agent with vasoconstrictor is not used in
    1. Spinal
    2. Epidural
    3. Digital finger block
    4. Skin Anaesthesia
    Answer 3. Digital Finger Block

    The toxicity of LA is related to the amount and speed of their absorption into the systemic circulation !
    Vasoconstrictor ingredient (e.g., adrenaline, felypressin) is often added to LA with the aim to reduce the absorption of LA into the systemic circulation.
    Effects of vasoconstrictors:
    - increase in the effect of LA (increased concentration)
    - decrease in the toxicity of LA (decreased absorption)
    - increase in the duration of the effect of LA
    Vasoconstrictors must not be used for producing ring-block of an extremity (e.g. finger or toe) because they may cause prolonged ischaemia and gangrene.

    Q. 35. All are true about Erlotinib except
    1. Used in Non Small Cell Carcinoma
    2. It is a small peptide acting as EGRF antagonist
    3. Food decreases absorption
    4. It causes skin rashes
    Answer 3. Food decreases absorption
    Explanation : Food enhances the oral absorption and bioavailability of erlotinib.

    Q36. Specific Compliance of lung is decreased by all except
    1. Chronic Bronchitis
    2. Pulmonary fibrosis
    3. Pulmonary Congestion
    4. Decreased Surfactant
    Answer 1. Chronic Bronchitis
    Emphysema / COPD may be associated with an increase in pulmonary compliance due to the loss of alveolar and elastic tissue.

    Q37. Sparrow marks are seen in following condition
    1. gunshot injuries
    2. stab injry of face
    3 vitriolage
    4 windshield glass injury
    Answer 4 windshield glass injury

    Q. Blount’s disease is a cause of?
    1. Coax vara
    2. Coax magna
    3. Genu valgum
    4. Genu varum
    Ans: 3

    Q. 1. Which is a branch from trunk of brachial plexus ?
    1. SupraScapular Nerve
    2. Long Thoracic Nerve
    3. Axillary Nerve
    4. Nerve to Subclavius Muscle
    Answer 1. SUPRASCAPULAR NERVE or NERVE TO SUBCLAVIUS ????
    The nerve to the Subclavius Muscle
    This nerve is from the anterior aspect of the superior trunk, from C5, with occasional additions from C4 and C6.
    It descends posterior to the clavicle and anterior to the brachial plexus to supply the subclavius muscle.
    The Suprascapular Nerve
    This nerve arises from the posterior aspect of the superior trunk, fibres from the ventral rami of C5 and C6 and often C4 (50% of people).
    It supplies the supraspinatus and infraspinatus muscles and the shoulder joint.
    It passes laterally across the posterior triangle of the neck, superior to the brachial plexus and then through the scapular notch.

    A 5 year old boy while having dinner suddenly becomes aphonic and is brought to the casulty for the complaint of respiratory difficulty. what should be the next appropriate treatment:-
    1) cricothyroidotomy
    2) emergency tracheostomy
    3) humidified oxygen
    4) Hemlich maneouvre
    Ans is Emergency tracheostomy
    heimlich's maneuver is not tried in partial or incomplete obstruction as it can cause complete obstruction.
    Cricothyrotomy is performed as an intervention of choice in complete obstruction and when there are no or minimal surgical instruments available.

    Emergency tracheostomy followed by removal of foriegn body by direct laryngoscopy is the procedure to be followed.

    there is no point of doing tracheostomy if the thing can be managed with lessor invasive procedure

    "Chocking" redirects here. For the mechanical tool, see Wheel chock.
    For the act of compressing someone's neck, see Strangling. For other uses, see Choke.
    Choking
    Classification and external resources
    ICD-10 F41.0, R06.8, T17, W78-W80
    ICD-9 784.9, 933.1
    MeSH D000402

    Choking is the mechanical obstruction of the flow of air from the environment into the lungs. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs. Prolonged or complete choking results in asphyxia which leads to anoxia and is potentially fatal. Oxygen stores in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely.

    Choking can be caused by:

    * Physical obstruction of the airway by a foreign body.
    * Respiratory diseases that involve obstruction of the airway.
    * Compression of the laryngopharynx, larynx or trachea in strangulation.

    Contents

    * 1 Choking in non-humans
    * 2 Foreign objects
    * 3 Symptoms and clinical signs
    * 4 Treatment
    o 4.1 Encouraging the victim to cough
    o 4.2 Back slaps
    o 4.3 Abdominal thrusts
    + 4.3.1 Self treatment with abdominal thrusts
    o 4.4 Modified chest thrusts
    o 4.5 Finger sweeping
    o 4.6 Direct vision removal
    * 5 CPR
    * 6 Notable victims
    * 7 Other uses of abdominal thrusts
    * 8 References
    * 9 External links

    Choking in non-humans
    Wiki letter w.svg This section is empty. You can help by adding to it.
    Foreign objects

    The type of choking most commonly recognised as such by the public is the lodging of foreign objects (also known as foreign bodies, but consisting of any object which comes from outside the body itself, including food, toys or household objects) in the airway.

    This type of choking is often suffered by small children, who are unable to appreciate the hazard inherent in putting small objects in their mouth. In adults, it mostly occurs whilst the patient is eating. In one study, peanuts were the most common obstruction.

    Symptoms and clinical signs

    * The person cannot speak or cry out, or has great difficulty and limited ability to do so.
    * Breathing, if possible, is labored, producing gasping or wheezing.
    * The person has a violent and largely involuntary cough, gurgle, or vomiting noise, though more serious choking victims will have a limited (if any) ability to produce these symptoms since they require at least some air movement.
    * The person desperately clutches his or her throat or mouth, or attempts to induce vomiting by putting their fingers down their throat.
    * If breathing is not restored, the person's face turns blue (cyanosis) from lack of oxygen.
    * The person does any or all of the above, and if breathing is not restored, then becomes unconscious.

    Treatment

    Choking can be treated with a number of different procedures, with both basic techniques available for first aiders and more advanced techniques available for health professionals.

    Many members of the public associate abdominal thrusts, also known as the Heimlich Maneuver with the correct procedure for choking, which is partly due to the widespread use of this technique in movies, which in turn was based on the widespread adoption of this technique in the United States at the time.

    Most modern protocols (including those of the American Heart Association and the American Red Cross, who changed policy in 2006[5] from recommending only abdominal thrusts) involve several stages, designed to apply increasingly more pressure.

    The key stages in most modern protocols include:
    Encouraging the victim to cough

    This stage was introduced in many protocols as it was found that many people were too quick to undertake potentially dangerous interventions, such as abdominal thrusts, for items which could have been dislodged without intervention. Also, if the choking is caused by an irritating substance rather than an obstructing one, and if conscious, the patient should be allowed to drink water on their own to try to clear the throat. Since the airway is already closed, there is very little danger of water entering the lungs. Coughing is normal after most of the irritant has cleared, and at this point the patient will probably refuse any additional water for a short time.
    Back slaps

    The majority of protocols now advocate the use of hard blows with the heel of the hand on the upper back of the victim. The number to be used varies by training organization, but is usually between five and twenty.

    The back slap is designed to use percussion to create pressure behind the blockage, assisting the patient in dislodging the article. In some cases the physical vibration of the action may also be enough to cause movement of the article sufficient to allow clearance of the airway.

    Almost all protocols give back slaps as a technique to be used prior to the consideration of potentially damaging interventions such as abdominal thrusts, but Henry Heimlich, noted for promulgating abdominal thrusts, wrote in a letter to the New York Times that back slaps were proven to cause death by lodging foreign objects in to the windpipe.

    The findings of a 1982 Yale study by Day, DuBois, and Crelin that "persuaded the American Heart Association to stop recommending back blows for dealing with choking...was partially funded by Heimlich's own foundation." According to Roger White MD of the Mayo Clinic and American Heart Association (AHA), "There was never any science here. Heimlich overpowered science all along the way with his slick tactics and intimidation, and everyone, including us at the AHA, caved in."

    Abdominal thrusts
    A demonstration of abdominal thrusts

    Abdominal thrusts, also known as the Heimlich Maneuver (after Henry Heimlich, who first described the procedure in a June 1974 informal article entitled "Pop Goes the Cafe Coronary", published in the journal Emergency Medicine). Edward A. Patrick, MD, PhD, an associate of Heimlich, has claimed to be the uncredited co-developer of the procedure. Heimlich has objected to the name "abdominal thrusts" on the grounds that the vagueness of the term "abdomen" could cause the rescuer to exert force at the wrong site.

    Performing abdominal thrusts involves a rescuer standing behind a patient and using their hands to exert pressure on the bottom of the diaphragm. This compresses the lungs and exerts pressure on any object lodged in the trachea, hopefully expelling it. This amounts to an artificial cough.

    Due to the forceful nature of the procedure, even when done correctly it can injure the person on whom it is performed. Bruising to the abdomen is highly likely and more serious injuries can occur, including fracture of the xiphoid process or ribs.

    In some areas, such as Australia, authorities believe that there is not enough scientific evidence to support the use of Abdominal thrusts and their use is not recommended in first aid.

    Self treatment with abdominal thrusts

    A person may also perform abdominal thrusts on themselves by using a fixed object such as a railing or the back of a chair to apply pressure where a rescuer's hands would normally do so. As with other forms of the procedure, it is possible that internal injuries may result.
    Modified chest thrusts

    A modified version of the technique is sometimes taught for use with pregnant and/or obese patients. The rescuer places their hand in the center of the chest to compress, rather than in the abdomen.

    Finger sweeping

    The American Medical Association advocates sweeping the fingers across the back of the throat to attempt to dislodge airway obstructions, once the choking victim becomes unconscious

    Some protocols advocate the use of the rescuer's finger to 'sweep' foreign objects away once they have reached the mouth.[citation needed] However, many modern protocols recommend against the use of the finger sweep as if the patient is conscious, they will be able to remove the foreign object themselves, or if they are unconscious the rescuer should simply place them in the recovery position (where the object should fall out due to gravity). There is also a risk of causing further damage (for instance inducing vomiting) by using a finger sweep technique.

    Direct vision removal

    The advanced medical procedure to remove such objects is inspection of the airway with a laryngoscope or bronchoscope, and removal of the object under direct vision, followed by CPR if the patient does not start breathing on their own. Severe cases where there is an inability to remove the object may require cricothyrotomy.

    CPR

    In most protocols, once the patient has become unconscious, the emphasis switches to performing CPR, involving both chest compressions and artificial respiration. These actions are often enough to dislodge the item sufficiently for air to pass it, allowing gaseous exchange in the lungs.

    Notable victims

    * United States President George W. Bush survived choking on a pretzel on January 13, 2002, receiving major media coverage.
    * Jimmie Foxx, a famous Major League Baseball player, died by choking on a bone.
    * Tennessee Williams, the playwright, died after choking on a bottle cap.
    * An urban legend states that obese singer Mama Cass choked to death on a ham sandwich. This was borne out of a quickly discarded speculation by the coroner, who noted a partly eaten ham sandwich and figured she may have choked to death. In fact, she died of a heart condition, often wrongly referred to in the media as heart failure but specified on her death certificate as fatty myocardial degeneration.
    * The Queen Mother was admitted to a UK Hospital for an operation in May 1993 after choking on a fish bone.

    Other uses of abdominal thrusts

    Dr. Heimlich also advocates the use of the technique as a treatment for drowning and asthma attacks, but Heimlich's promotion to use the maneuver to treat these conditions resulted in marginal acceptance. Criticism of these uses has been the subject of numerous print and television reports which resulted from an internet and media campaign by his son, Peter M. Heimlich, who alleges that in August 1974 his father published the first of a series of fraudulent case reports in order to promote the use of abdominal thrusts for near-drowning rescue

    A 35 year old female has proximal weakness of muscles, repeated ptosis and east fatiguability. The best test to diagnose her condition is:
    1) Muscle biopsy
    2) CPK
    3) Edrophonium test
    4) EMG
    Answer: Edrophonium test.
    Explanation: Muscle biops, EMG and CPK are primarily used for diagnosis of inflammatory myopathies e.g. polymyositis, inclusion body myositis. Here the clinical picture is clearly of MG, which most common presentataion is extraocular muscle palsies. Plus inflammtory myopathies usually spare extraocular muscles. BUT proximal muscle weakness is included in the syndrome of myapthic muscle weakness. Anyways, I think what they wanted is to focus on how to distinguish between MG and inflammatory myopathies using a single test and not a diagnostic test. So the answer is Edrophonium which will help us to clarify it in a split second( figuratively) Edrophonium Positive=MG, negative, test further for myopathies.


    What are the methods for diagnosing Myasthenia Gravis and how long do they take to perform?

    The initial diagnostic exam for Myasthenia Gravis includes the following:

    * Evaluation begins with examination by a neurologist. 1 hour.
    * " Tensilon test. (A Tensilon test is positive in many patients who have MG, but may actually be negative in 20-30% patients with MG diagnosed by other methods.) 15-30 minutes in the physician's office.
    * Acetylcholine receptor antibodies (a blood test). Acetylcholine receptor antibodies are positive in 90% of patients with general myasthenia. The results usually take a week to return from the laboratory.
    * EMG (electromyogram) is a test to determine the electrical response from the muscle after stimulation of the nerve. 1 hour.

    ans: EMG

    An additional test is:

    * Single-fiber EMG. This test is only performed at specialized centers. The exam itself takes 1-3 hours to perform. A single fiber EMG is considered the best test, being positive in 95-99% of MG patients.

    In rare patients all these tests are normal, but examination by a neurologist suggest Myasthenia Gravis. If the disease is mild or purely ocular (symptoms of the eye muscles), then the tests are more frequently negative then in the case of the generalized disease.

    Q: which is NOT a definite airway
    a. nasotracheal tube
    b. orotracheal tube
    c. LMA......ANS
    d. cricothyroidtomy..

    Ref:
    A definitive airway can be: an endotracheal tube, an nasotracheal tube, or a surgical airway (cricothroidotomy).

    The need for a definitive airway is based upon a number of clinical findings:
    the presence of apnea
    inability to maintain a patent airway by less invasive means
    need to protect the lower airway from aspiration of blood or vomitus
    impending or potential airway compromise (following inhalational injury, facial fractures, retroparygeal hematoma or sustained seizure activity)
    presence of a closed head injury requiring assisted ventilation
    inability to maintain adequate oxygenation by face mask oxygen supplementation
    any patient with a Glasgow coma score of 8 or less

    17. Which is not a neural tumor ?
    1. Ependymoma
    2. Neuroblastoma
    3. Gangliocytoma
    4. Ganglioglioma
    Answer CONTROVERSIAL (cant ans be neuroblastoma,neuroendocrine tumor)

    Neuroblastoma is the most common extracranial solid cancer in childhood and the most common cancer in infancy, with an annual incidence of about 650 new cases per year in the US. Close to 50 percent of neuroblastoma cases occur in children younger than two years old. It is a neuroendocrine tumor, arising from any neural crest element of the sympathetic nervous system or SNS.

    REF Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. pp. 1406.
    Ganglioglioma is a tumour that arises from ganglion cells in the central nervous system.
    The term "gangliocytoma" is sometimes equated with ganglioglioma. However, it is also sometimes equated with ganglioneuroma. The term "gangliocytoma" is sometimes used to imply that the tumor is entirely neuronal.
  35. Guest

    Guest Guest

    1. ASD and VSD can be differentiated by which of the following.
    a. Left atrial hypertrophy
    b. Left ventricular hypertrophy
    c. ?
    d. ?

    2. Punnet Square?
    a. genotype of offspring
    b. statiscal analysis
    c.
    d.

    3. C in CRP stands for
    a. C polysaccharide of pneumococcus
    b. Canavalin
    c. ?
    d. ?

    4. Onodi & Haller cells
    a. optic nerve & orbital floor
    b. optic nerve & interal carotid artery
    c. internal carotid artery& optic nerve
    d. orbital floor & internal carotid artery

    5. blount's disease is
    a. genu valgum
    b. genu varum-answr
    c. genu recurvatum
    d. menisceal injury

    6. A/E are supplied by the anterior division of Mandibular nerve:
    a. lateral pterygoid
    b. medial pterygoid
    c. temporalis
    d. masseter

    7. Pain of ethmoidal sinusitis is referred along the course of
    a. nasociliary n.
    b. infratrochlear
    c. frontal n.
    d. lacrimal

    8. which of the following is pneumatic bone except?
    a. frontal
    b. ethmoid
    c. mandible
    d. maxilla

    9. Right isomerism is seen in
    a. asplenia
    b. two spleen
    c. one spleen
    d. polysplenia

    10. parenteral nutrition not concisits of
    a. fat
    b. carbohydrate
    c. fibre
    d. micronutrient

    11. urea cycle occurs in
    a. liver
    b. kidney
    c. colon
    d. ?

    12. All are used in prophylaxis of migraine except
    a. propanalol
    b. leviteracitam
    c. topiramate
    d. ?

    13. cavitation seen in
    a. mycolplasma pneumonia
    b. tuberculous pneumonia
    c. streptococcal pneumonia
    d. Staphylococcal pneumonia

    14. choice of inotrope drug in right heart failture
    a. dobutamine
    b. amrinone
    c. digoxin
    d. milrinone

    15. contraindicated in hypertensive
    a. ketamine
    b. propofol
    c. etomidate
    d. diazepam

    16. Central diabetes insipidus drug used
    a. diuretics
    b. ?
    c. desmopressin
    d. ?

    17. Proteus infection which stone is formed
    a. cysteine
    b. triple phosphate
    c. oxalate
    d. ?

    18. intra operative diagnosis of MI is best done by
    a. Serial ECG monitoring
    b. transoesophageal echo
    c. spO2
    d. enzyme assay

    19. buprenorphine is
    a. partial agonist of mu receptor
    b. full agonist at kappa
    c. antagonist of kappa
    d. ?

    20. sparrow marks r seen in
    a. gunshot injuries
    b. stab injury of face
    c vitriol age
    d windshield glass injury

    21. Ranula is
    a. cystic swelling in the floor of the mouth
    b. ?
    c. ?
    d. ?

    22. necrotizing lymphadenitis is seen in
    a. kimura disease
    b. kikuchi disease
    c. hodgkin disease
    d. castelman disease

    23. baby born at 33 wks/1.5 kg should be started on
    a. nil oral and iv fluids
    b. oral nasogastric tube or feeding alternate oral route
    c. iv fluids and oral feeding
    d. TPN

    24. clue cells in
    a. bacterial vaginosis
    b. chlamydial vaginosis
    c. trichomonas
    d. ?

    25. Body plethysmography findings when patientt breathes against closed glottis in lungs n recordings respectively
    a. decreased
    b increased
    c. lungs increases, recording decreases
    d. lung decreases, recording increases

    26. pt undergoing epidural block,becomes aphonic n loses consciousness when drug is injected
    a. total spinal block
    b. anaphylaxis
    c. vasovagal shock
    d.

    27. which organ obtained from cadaver is not used for transplant
    a. blood vessel
    b. lung
    c. liver
    d. bladder

    28. contraceptive avoided in epilepsy
    a. combined ocp
    b. iucd
    c. POP
    d. condom

    29. epileptogenic anaesthetic
    a. halothane
    b. ether
    c. desflurane
    d. ?

    30. tyre marks
    a. imprint abrasion
    b. patterned abrasion
    c. ?
    d. ?

    31. A child brought by the police, parents give alleged history of vigorous shaking. Which of the following will be seen
    a. fracture of long bones
    b. subarachnoid hemorrhage
    c. ?
    d. ?

    32. Signature Fracture is
    a. depressed fracture
    b. ?
    c. ?
    d. ?

    33. mc death in schizophrenia
    a. Homicide
    b. Suicide
    c. hospital infection
    d. drug induced

    34. female with 45 x poorly developed breast, short stature
    a. gonadal dysgenesis
    b. ?
    c. ?
    d. ?

    35. NARP syndrome is seen in
    a. mitochondrial
    b. glycogen storage
    c. lysosomal
    d. lipid storage

    36. all are related posteriorly to head of pancreas except
    a. common bile duct
    b . ivc
    c. 1st part of duodenum
    d. right crus of the diaphragm

    37. which is called the rave drug
    a. methadone
    b. ecstasy
    c. heroin
    d. ?

    38. hallmark of acute inflammation
    a. vasoconstriction
    b. stasis
    c. vasodilation and increase in permeability
    d. leucocytic margination

    39. All are used in the treatment of hot flushes except
    a. Tamoxifene
    b. venlafaxine
    c. paroxetine
    d. ?

    40. Integrase inhibitor is
    a. Raltegrase
    b. indinavir
    c. ?
    d. ?

    41. all of the following decrease bone resorption in osteoporosis except
    a. Alendronate
    b. Etidronate
    c .Strontium
    d. Teriparatide

    42. injury to common peroneal nerve all are true except
    a. loss of sensation over sole
    b. foot drop
    c. injury to neck of fibula
    d. loss of dorsiflexion of toe

    43. Nerve involved in supracondylar fracture
    a. Radial nerve
    b. Median nerve
    c. Ulnar nerve
    d. Anterior interroseous nerve

    44. Nerve arising from the trunk of the brachial plexus
    a. suprascapular nerve
    b. long thoracic nerve
    c. nerve to subclavius
    d. ?

    45. A surgeon resects to the left of the ligamentum teres. He will cut
    a. Segment 1 and 4a
    b. segment 2 and 3
    c. Segment 1 and 4b
    d. segment 3

    46. Sebaceous cysts are seen in
    a. Turcots syndrome
    b. Gardener’s syndrome
    c. Touirre Moira syndrome
    d. cowdens syndrome

    47. to treat alcohol dependance not used is
    a. flumazenil
    b. acamprostate
    c. naltrexone
    d. disulfiram

    48. definitive airway a/e:
    a. nasotracheal tube
    b. orotracheal tube
    c. laryngeal mask airway
    d. cricothyroidectomy

    49. patient comes to emergency with dyspnea while eating food. Immediate managememn
    a. Tracheostomy
    b. hemlich manouvre
    c. ?
    d. ?

    50. Patient has ph 7.45, pCO2 45, HCO3 ?. The patient has uncompensated
    a. metabolic alkalosis
    b. metabolic acidosis
    c. respiratory acidosis
    d. respiratory alkalosis

    51. Amphotericin B causes deifiiency of
    a. Mg2=
    b.
    c.
    d.

    52. Not a prions disease
    a. Alzheimer
    b. Tuberculosis
    c. CJD
    d. cystic fibrosis

    53. PCA infarct a/e
    a. thalamus
    b. pons
    c. medulla
    d.

    54. Pulmonary toxicity seen in
    a. amphotericin
    b. bleomycin
    c.
    d.

    55. Argyll Robertson pupil all are true except
    a. light reflex present
    b. consensual reflex ?
    c. good visual acuity
    d. accommodation unaffected

    56. Acoustic neuroma arises from
    a. superior vestibular nerve
    b. inferior vestibular nerve
    c.
    d.

    57. Endolymphatic sac dilatation is seen in
    a. meneirre’s disease
    b.
    c.
    d.

    58. Fungal infection in immuno compromised other than HIV
    a. candida
    b. Cryptococcus
    c.
    d.

    59. Ortho toluidene test is for
    a. chlorination
    b.
    c.
    d.

    60. Organelle of apoptosis is
    a. mitochondria
    b.
    c.
    d.

    61. which is the most common tumour associated with neurofibromatosis in a child

    a. juvenile myelomonocytic leuk.
    b. ac. lymphoblastic leuk
    c. ac. monocytic leukemia
    d. ch. Lymphoid leukemia

    62. MC tumor causing SVC syndrome
    a. non small cell lung ca
    b. small cell lung ca
    c. lymphoma
    d.

    63. Thalidomide adverse effects all except
    a. diarrhea
    b. teratogenecity
    c.
    d.

    64. tolerance develops to all except
    a. miosis
    b. analgesia
    c. euphoria
    d.

    65. Antidepressant also used in nocturnal enuresis
    a. imipramine
    b. duloxetine
    c.
    d.

    66. diaphragm develops from a/e:
    a. septum transversum
    b. dorsal mesocardium
    c. pleuroperitoneal membrane
    d. cervical myotomes

    67. deoxygenated blood is present in a/e:
    a. umbilical artery
    b. umbilical vein
    c. pulmonary artery
    d. right ventricle

    68. ECG is poor in detecting ischemia in areas supplied by
    a. lad
    b. lt circumflex
    c. lca
    d. rca

    69. erythema nodosum seen in all except..
    a. chr pancreatits
    b. pregnancy
    c. SLE
    d. tuberculosis

    70. Most dangerous for bioterrorism is
    a. plague
    b. small pox
    c. ? yellow fever
    d.

    71. least likely to cross placenta is
    a. syphilis
    b. HIV
    c. Herpes
    d.

    72. progesterone in low dose ocp
    a. levonorgestrol
    b. desogesterol
    c. norethisterone
    d.

    73. Management of placenta praevia includes all except
    a. Cervical tightening
    b. caeserian
    c.
    d.

    74. In pt of lithium toxicity which of these is contraindicated
    a. diuretics
    b. beta blocker
    c. ccb
    d. clonidine

    75. Psuedo isomorphism is seen in
    a. psoariasis
    b. lichen planus
    c. vitiligo
    d.

    76. during surgery using laser, oropharynx caught fire. Which is to be avoided?
    a. 100% oxygen after discontinuing anesthetic gases
    b. flushing with sterile water
    c. removing et tube
    d. treatment with steroid & antibiotic

    77. basal metabolic depends on
    a. lean body mass
    b. body surface area
    c. body mass index
    d.

    78. maximal water reabsoprtion occurs in
    a. colon
    b. jejunum
    c.
    d.

    79. In India, under the national programme screening is done for all except
    a. cervical cancer
    b. dental caries
    c. colonic cancer
    d.

    80. Which of the following structure passes through foramen magnum
    a. Int. Carotid Artery
    b. Hypoglosal Nerve
    c. Symp. chain
    d. Vertebral Artery

    81. ??
    a. high altitude pulmonary edema
    b. high altitude berebral edema
    c.
    d.

    82. pentology of fallot
    a. asd
    b. vsd
    c. rvh
    d. pulmonary stenosis

    83. pt with solitary kidney having 4 cm solitary exophytic mass in lower pole. management
    a. partial nephrectomy
    b. radical nephrectmy with dialysis
    c. radical nephrectomy with immediate renal transplant
    d. observation

    84. insects resistant to DDT
    a. musca domesticus
    b. phebotomus
    c. culex
    d. anopheles stephensi

    85. Alkalisation of urine is required in
    a. ifosfamide
    b. methotrexate
    c.
    d.

    86. hyperpyrexia is caused by
    a. mao inhibitors
    b. alcohol
    c. cresol
    d. amphetamine

    87. wt gain in pregnancy is related to all except
    a. ethnicity
    b. smoking
    c. socioeconomic status
    d. pre conceptional wt

    88. During reimplantation, 1st step is
    a. joining the bones
    b. vessels
    c. nerves
    d.

    89. Rise in end tidal co2 during thyroid surgery seen in all except..
    a. anaphylaxis
    b. malignant hyperthermia
    c. thyroid storm
    d. neurolept malignant syndrome

    90. About yaws, all are true except
    a. caused by t. pertenue
    b. transmitted non-venerally
    c. secondary yaw can involve bones
    d. last stages involve heart n nerves

    91. A patient remembered intra operative events. What can be done to prevent this?
    a. Transcranial doppler
    b. Bispectral iondex
    c. ?
    d. ?

    92. INH causes deficiency of
    a. pyridoxine
    b. ascorbic acid
    c.
    d.

    93. All are seen in the 3rd ventricle floor except
    a. infundibulum
    b. 3rd nerve
    c. mamillary body
    d. ?optic stalk

    94. Sickle cell disease anesthesia not given is
    a. general anesthesia
    b. brachial plexus block
    c. intravenous regional anesthesia
    d. spinal

    95. Local anaesthetic agent with vasoconstrictor is not given for
    a. digital block
    b.
    c.
    d.

    96. Pcod all except
    a. high LH/FSH
    b. high dheas
    c. high prolactin
    d. raised LH

    97. Which of the following is true?

    a. Acetylcholinesterase inhibited by malathion can be reversed
    b. Sulphonilamide inhibits folate reductase irreversibly.
    c. flouoroacetate competitively inhibits aconitase
    d. ?

    [snip]. All the following r true about nesidioblastoma except
    a. causes hypoglycemia
    b seen more commonly in adults
    c.
    d.

    99. Following are used in diagnosis of insulinoma except?
    a. fasting hyoglycemia
    b. d xylulose test
    c. c peptide levels
    d.

    100. Antigen injected in a rat/rabbit. What antibody it will produce initially
    a. IgG
    b. IgM
    c. IgE
    d. IgD
  36. Guest

    Guest Guest

    Blood supply to the head and neck of femur
    The profunda femoris artery arising from the femoral artery gives off medical circumflex femoral artery. This gives off the lateral epiphyseal and superior and inferior metaphyseal arteries. The lateral epiphyseal arteries are important and supply the laterial 2/3 of the femoral head. The superior metaphyseal artery supplies the superior aspect of the femoral neck. The inferior metaphyseal artery supplies the inferior part of the neck and the adjacent part of the head derived from the metaphysis.
    The medial epiphyseal artery supplies a circumfoveal sector of the head. It is a continuation of the artery of the ligamentum teres which arises from the acetabular branch of the obturator artery.

    Femoral neck fractures that are intracapsular and may threaten any or all of the three sources of blood to the femoral head:

    the cervical vessels in the retinaculum of the joint capsule - usually damaged if the fracture is displaced
    intramedullary vessels - always torn
    from the ligamentum teres - usually contributes minimally in the elderly and not uncommonly, may be non-existent

    In addition to the damage to the blood supply, the intracapsular nature of the fracture hinders recovery from the injury:

    intra-articular bone has only a thin periosteum and has no contact with soft tissues - the response to injury - callus formation - is weak
    blood remains inside the joint capsule, increasing intracapsular pressure and further damaging the femoral head; synovial fluid hinders clotting


    CURRENT DIAGNOSIS & TREATMENT EMERGENCY MEDICINE

    6th Ed. 2008


    FOREIGN BODY AIRWAY OBSTRUCTION



    While uncommon, FBAO is a preventable cause of death. Identifying a patient with an FBAO may be as simple as recognizing the conscious patient with difficulty breathing, coughing, or the universal "I'm choking" sign, with fingers clutching around the throat, but it can be much more difficult to detect in the unconscious/altered level of consciousness patient. In the conscious patient, ask if he or she is choking. If the patient has a strong cough, is not cyanotic, does not have labored breathing or retractions, and can speak, then a partial obstruction with good air exchange exists. Observe the patient, but do not intervene initially. Allow the patient to attempt to clear the obstruction by himself or herself. If the patient has a weak cough, is cyanotic, has labored breathing, stridor, or has difficulty speaking, then a partial obstruction with poor air exchange exists. Prompt intervention is indicated. If the airway is obstructed completely, the patient is unable to speak or cough and may become cyanotic. Rapid intervention is essential.


    The abdominal thrust (Heimlich maneuver) is used in the conscious choking patient. While standing behind the patient, position the fist with the thumb facing up over the umbilicus. Roll the fist so that the thumb is against the abdominal wall. Grasp the fist with the other hand. Apply sharp upward thrusts until the foreign body is cleared or the patient collapses and becomes unconscious. In the unconscious patient, position him or her on the floor. Perform a tongue-jaw lift by grasping the jaw and tongue with one hand and observe the airway. If a solid obstruction is visually identified, use the other hand to perform a finger sweep. Attempt to ventilate. If the first attempt does not succeed, reposition the airway and attempt to ventilate again. If the second attempt fails, perform the Heimlich maneuver by straddling the patient. Place the heel of one hand in the same location as that used for the standing abdominal thrust. Place the other hand over the top of the first. Provide five sharp upward thrusts. Repeat the sequence until the obstruction is relieved or alternative means of clearing the airway arrive (e.g., Magill forceps, surgical or needle cricothyroidotomy, etc.).
  37. Guest

    Guest Guest

    As for the partial nephrectomy debate, the following study gives a strong proof that it is indeed the procedure of choice in sporadic kidney tumors in patients with solitary kidney

    J Urol. 2006 May;175(5):1630-3; discussion 1633.
    Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases.

    Fergany AF, Saad IR, Woo L, Novick AC.

    Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
    Abstract

    PURPOSE: We present a series of 400 patients with tumor in a solitary kidney who underwent open surgical partial nephrectomy performed by a single surgeon (ACN) with a primary focus on postoperative long-term kidney function.

    MATERIALS AND METHODS: A total of 400 patients with sporadic nonfamilial kidney tumors in a solitary kidney underwent open partial nephrectomy between 1980 and 2002. In 323 patients (81%) the contralateral kidney had been surgically removed, while the remaining 77 (19%) had a congenital solitary kidney. Renal insufficiency was present preoperatively in 184 patients (46%). Adverse risk factors for partial nephrectomy were present in a large percent of patients. Intraoperative and postoperative parameters were evaluated at a mean followup of 44 months.

    RESULTS: In the overall series 5 and 10-year cancer specific survival was 89% and 82%, respectively. Surgical complications occurred in 52 patients (13%), most commonly urinary leakage. Early postoperative renal function was achieved in 398 patients (99.5%). Only 2 patients required permanent dialysis postoperatively. Satisfactory long-term renal function was achieved in 382 patients (95.5%). A total of 18 patients had progressed to renal failure a mean of 3.6 years after surgery. Patient age, the amount of renal parenchyma resected, a congenitally absent or atrophic contralateral kidney and the time of contralateral nephrectomy were noted to be significantly associated with postoperative renal function.

    CONCLUSIONS: Open surgical partial nephrectomy can be safely performed in patients with tumor in a solitary kidney. Long-term cancer-free survival with the preservation of renal function can be reliably expected in most of these cases.
  38. Guest

    Guest Guest

    References and further reading may be available for this article. To view references and further reading you must purchase this article.


    Luis O. Carrerasf1, Ricardo R. Forastiero and Marta E. Martinuzzo

    Department of Haematology, Thrombosis and Haemostasis, Favaloro University, Favaloro Foundation, Buenos Aires, Argentina

    2000, 2000 Available online 26 March 2002.

    Abstract
    The diagnosis of antiphospholipid syndrome (APS) requires the presence of both clinical and biological features. Due to the heterogeneity of anti-phospholipid antibodies (aPL) the laboratory approach for their detection includes clotting-based tests for lupus anticoagulant (LA) as well as solidphase assays for anticardiolipin antibodies (aCL). In addition, as it has been shown that autoimmune aPL recognize epitopes on phospholipid (PL)-binding plasma proteins, assays detecting antibodies to β2-glycoprotein I (β2-GPI) or prothrombin have been developed. The association between venous or arterial thrombosis and recurrent fetal loss with the presence of conventional aPL (LA and/or aCL) has been confirmed by many studies. The LA and IgG aCL at moderate/high titre seem to exhibit the strongest association with clinical manifestations of the APS. Several reports indicate that LA is less sensitive but more specific than aCL for the APS. Assays against PLs other than CL as well as the use of mixtures of PLs have been proposed to improve the detection of APS-related aPL. Concerning antibodies to PL-binding proteins (detected in the absence of PLs), there is evidence that anti-β2-GPI are closely associated with thrombosis and other clinical features of the APS. Moreover, these antibodies may be more specific in the recognition of the APS and in some cases may be present in the absence of aPL detected by standard tests. Many issues are still under debate and are discussed in this review, such as the problems of standardization of anti-β2-GPI assays, detection of the IgA isotype of aCL and anti-β2-GPI, the coagulation profiles of LA in the recognition of the thrombotic risk and the association of particular markers with subsets of patients with APS.

    Author Keywords: anti-β2-glycoprotein I antibodies
  39. Guest

    Guest Guest

    53. True about epidural opioids are all except?
    A. Acts on dorsal horn cell
    B. Itching
    C. Nausea & vomiting answer
    D. Respiratory depression
    answer is .. respiratory depression .. and thats the truth ....

    "Benefits of epidural analgesia after surgery Epidural analgesia has been demonstrated to have several benefits after surgery. These include:
    Effective analgesia without the need for systemic opioids.
    The incidence of postoperative respiratory problems and chest infections is reduced.
    The incidence of postoperative myocardial infarction ("heart attack") is reduced.
    The stress response to surgery is reduced.
    Motility of the intestines is improved by blockade of the sympathetic nervous system.
    Use of epidural analgesia during surgery reduces blood transfusion requirements.
    Despite these benefits, no survival benefit has been proven for high-risk patients.


    Side effects In addition to blocking the nerves which carry pain, local anaesthetic drugs in the epidural space will block other types of nerves as well, in a dose-dependent manner. Depending on the drug and dose used, the effects may last only a few minutes or up to several hours. Epidural typically involves using the opiates fentanyl or sufentanil, with bupivacaine, Fentanyl is a powerful opiate with a potency and side effects 80X that of morphine. Sufentanil is another opiate, 5 to 10Xs more potent than Fentanyl. Bupivacaine is markedly toxic, causing excitation: nervousness, tingling around the mouth, tinnitus, tremor, dizziness, blurred vision, or seizures, followed by depression: drowsiness, loss of consciousness, respiratory depression and apnea. Bupivacaine has caused several deaths by cardiac arrest when epidural anesthetic has been accidentally inserted into vein instead of epidural space in the spine. Epidural correctly administered results in three main effects:
    Loss of other modalities of sensation (including touch, and proprioception)
    Loss of muscle power (hence, a risk of falling)
    Loss of function of the sympathetic nervous system, which controls blood pressure
    Pain nerves are most sensitive to the effects of the epidural. This means that a good epidural can provide analgesia without affecting muscle power or other types of sensation. The larger the dose used, the more likely it is that the side-effects will be problematic.
    For example, a laboring woman may have a continuous epidural during labor that in 85% of cases provides good analgesia without impairing her ability to move around in bed. If she requires a Caesarean section, she is given a larger dose of epidural bupivacaine. After a few minutes, she can no longer move her legs, or feel her abdomen. If her blood pressure drops below 80/50 she is given an intravenous bolus of ephedrine or phenylephrine infusion to compensate. During the operation, she feels no pain.
    Very large doses of epidural anaesthetic can cause paralysis of the intercostal muscles and diaphragm (which are responsible for breathing), and loss of sympathetic function to the heart itself, causing a profound drop in heart rate and blood pressure. This requires emergency treatment, and in severe cases may require airway support. This happens because the epidural is blocking the heart's sympathetic nerves, as well as the phrenic nerves, which supply the diaphragm.
    It is considered safe practice for all patients with epidurals to be confined to bed to prevent the risk of falls.
    The sensation of needing to urinate is diminished, which often requires the placement of a urinary catheter for the duration of the epidural


    Opioid drugs in the epidural space are relatively safe (as well as effective). However, very large doses may cause troublesome itch, and rarely, delayed respiratory depression.
  40. Guest

    Guest Guest

    Which of the following condition presents with multiple sebaceous neoplasm-
    a)gardner
    b)muir torre
    c)cowden
    now if goin specifically for the question muir torre suits it the best explanation below..
    1967, Muir and Torre each reported on patients with multiple cutaneous tumors (including sebaceous neoplasms and other tumors) and visceral malignancies (including gastrointestinal and other sites). Muir-Torre syndrome (MTS) is a syndrome that combines at least one sebaceous neoplasm (sebaceous adenoma, sebaceous epithelioma, or sebaceous carcinoma) and at least one visceral malignancy (usually gastrointestinal or genitourinary carcinomas). MTS has an autosomal dominant pattern of inheritance in 59% of cases and has a high degree of penetrance and variable expression.
    for gardner syndrome-
    Gardner syndrome, also known as familial colorectal polyposis,[1] is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon.[2] The extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas and sebaceous cysts,[3] as well as the occurrence of desmoid tumors in approximately 15% of affected individuals. The countless polyps in the colon predispose to the development of colon cancer; if the colon is not removed, the chance of colon cancer is considered to be very significant. Polyps may also grow in the stomach, duodenum, spleen, kidneys, liver, mesentery and small bowel. In a small number of cases, polyps have also appeared in the cerebellum. Cancers related to GS commonly appear in the thyroid, liver and kidneys.
  41. Guest

    Guest Guest

    Clinical Features

    All of the treponemal infections are chronic and are characterized by defined disease stages, with a localized primary lesion, disseminated secondary lesions, periods of latency, and possible late lesions. Primary and secondary stages are more frequently overlapping in yaws and endemic syphilis, and the late manifestations of pinta are very mild relative to the destructive lesions of the other treponematoses. The current preference is to divide the clinical course of the endemic treponematoses into "early" and "late" stages.

    The major clinical features differing between venereal syphilis and the nonvenereal infections are the apparent lack of congenital transmission and of central nervous system (CNS) involvement in the nonvenereal infections. It is not known whether these distinctions are entirely accurate. Because of the high degree of genetic relatedness among the organisms, there is little biologic reason to think that T. pallidum subspecies endemicum and T. pallidum subspecies pertenue would be unable to cross the blood-brain barrier or to invade the placenta. These organisms are like T. pallidum subspecies pallidum in that they can disseminate from the site of primary infection and can persist for decades. The lack of recognized congenital infection may be due to the fact that childhood infections are in the latent stage (low bacterial load) before girls reach sexual maturity. Neurologic involvement may go unrecognized because of the lack of trained medical personnel in endemic regions, the delay of many years between infection and possible CNS manifestations, or a low rate of symptomatic CNS disease. Some published evidence supports congenital transmission as well as cardiovascular, ophthalmologic, and CNS involvement in yaws. Although the reported studies have been small, have failed to control for other causes of CNS abnormalities, have not included specific treponemal serologic tests, and have not analyzed the response to therapy, it may be erroneous to accept unquestioningly the frequently repeated belief that these organisms fail to cause such manifestations.

    harrison 17 edition.
  42. Guest

    Guest Guest

    HEMORRHAGE INTO ADRENAL GLANDS.

    This may occur in the neonatal period as a consequence of a difficult labor (especially breech presentation), or its etiology may not be apparent. An incidence rate of 3 per 100,000 live births has been suggested. The hemorrhage may be sufficiently extensive to result in death from exsanguination or hypoadrenalism. An abdominal mass, anemia, unexplained jaundice, or scrotal hematoma may be the presenting sign. Often, the hemorrhage is asymptomatic initially and is identified later by calcification of the adrenal gland. Fetal adrenal hemorrhage has also been reported. Postnatally, adrenal hemorrhage most often occurs in patients being treated with anticoagulants. It may also occur as a result of child abuse.

    CLINICAL MANIFESTATIONS.

    Primary adrenal insufficiency leads to cortisol and often aldosterone deficiency. The signs and symptoms of adrenal insufficiency are most easily understood in the context of the normal actions of these hormones, which were discussed in Chapter 575 .

    Hypoglycemia is a prominent feature of adrenal insufficiency. It is often accompanied by ketosis as the body attempts to utilize fatty acids as an alternative energy source. Ketosis is aggravated by anorexia, nausea, and vomiting, all of which occur frequently.

    Cortisol deficiency decreases cardiac output and vascular tone; moreover, catecholamines such as epinephrine have decreased inotropic and pressor effects in the absence of cortisol. These problems are initially manifested as orthostatic hypotension in older children and may progress to frank shock in patients of any age. They are exacerbated by aldosterone deficiency, which results in hypovolemia due to decreased resorption of sodium in the distal nephron.

    Hypotension and decreased cardiac output decrease glomerular filtration and thus decrease the ability of the kidney to excrete free water. Vasopressin (AVP) is secreted by the posterior pituitary in response to hypotension and also as a direct consequence of lack of inhibition by cortisol. These factors decrease plasma osmolality and lead in particular to hyponatremia. Hyponatremia is also caused by aldosterone deficiency and may be much worse when both cortisol and aldosterone are deficient.

    In addition to hypovolemia and hyponatremia, aldosterone deficiency causes hyperkalemia by decreasing potassium excretion in the distal nephron. Cortisol deficiency alone does not cause hyperkalemia.

    Cortisol deficiency decreases negative feedback on the hypothalamus and pituitary, leading to increased secretion of ACTH. Hyperpigmentation is caused by ACTH and other peptide hormones (γ-melanocyte-stimulating hormone) arising from the ACTH precursor pro-opiomelanocortin. In patients with a fair complexion, the skin may have a bronze cast. Pigmentation may be more prominent in skin creases, mucosa, and scars. In dark-skinned patients, it may be most readily appreciated in the gingival and buccal mucosa.

    The clinical presentation of adrenal insufficiency depends on the age of the patient, whether both cortisol and aldosterone secretion are affected, and to some extent on the underlying etiology. The most common causes in early infancy are inborn errors of steroid biosynthesis, sepsis, adrenal hypoplasia congenita, and adrenal hemorrhage. Infants have a relatively greater requirement for aldosterone than do older children, possibly owing to immaturity of the kidney and also to the low sodium content of human breast milk and infant formula. Hyperkalemia, hyponatremia, and hypoglycemia are prominent presenting signs of adrenal insufficiency in infants. Ketosis is not consistently present because infants generate ketones less well than do older children. Hyperpigmentation is not usually seen because this takes weeks or months to develop, and orthostatic hypotension is obviously difficult to demonstrate in infants.

    Infants can become ill very quickly. There may be only a few days of decreased activity, anorexia, and vomiting before critical electrolyte abnormalities develop.

    In older children with Addison disease, the onset is usually more gradual and is characterized by muscle weakness, malaise, anorexia, vomiting, weight loss, and orthostatic hypotension. Hyperpigmentation is often but not necessarily present. Hypoglycemia and ketosis are common, as is hyponatremia. Hyperkalemia tends to occur later in the course of the disease in older children than in infants. Thus, the clinical presentation can be easily confused with gastroenteritis or other acute infections. Chronicity of symptoms may alert the clinician to the possibility of Addison disease, but this diagnosis should be considered in any child with orthostatic hypotension, hyponatremia, hypoglycemia, and ketosis.

    Salt craving is seen in primary adrenal insufficiency with mineralocorticoid deficiency. Fatigue, myalgias, fever, eosinophilia, lymphocytosis, hypercalcemia, and anemia may be noted with glucocorticoid deficiency
  43. Guest

    Guest Guest

    190. A 50 yr lady has history of sprained ankle 2 months back followed by recovery. She now complains of severe pain in that ankle with inability to flex that foot. Physician notes edema and shiny skin in local examination. What is the probable diagnosis:
    A. Fibromyalgia
    B. Complex regional pain syndrome 1
    C. Complex regional pain syndrome 2 answer
    D. Peripheral neuropathy

    the ans for above is CRPS 1(RSD)

    Reflex sympathetic dystrophy is the most widely accepted term for a clinical entity characterized by pain, swelling, stiffness, discoloration, hyperhidrosis, and osteoporosis in an extremity resulting from an abnormal and prolonged response of the sympathetic nervous system.

    More recently, the term complex regional pain syndrome has been used and divided into complex regional pain syndrome type I to replace reflex sympathetic dystrophy and complex regional pain syndrome type II to replace causalgia.

    Canale & Beaty: Campbell's Operative Orthopaedics, 11th ed.
  44. Guest

    Guest Guest

    1. Most common nerve injured in supracondylar fracture humerus?
    a. Median………………answer
    b. Radial
    c. Ulnar
    d. Axilary

    2. Damage to Superior oblique nerve causes diplopia
    a. Horizontal and downward ?????
    b. Vertical and downward ?
    c. Horizontal and upward
    d. Vertical and upward

    3. Which of the following contraception method is contraindicated in women with epilepsy?
    a. Oral Contraceptive pill …………..answer
    b. IUCD
    c. Condom
    d. Mifepristone

    4. Deoxygenated blood is not seen in
    a. Pulmonary artery
    b. Umbilical artery
    c. Umbilical vein………answer
    d. Renal vein

    5. Which of the following is not supplied by the anterior division of mandibular nerve (V3) ?
    A. Temporalis
    B. Medial pterygoid………..answer
    C. Lateral pterygoid
    D. Masseter

    6. All of the following are pneumatic bones except?
    A. Frontal
    B. Ethmoid
    C. Mandible……….answer
    D. Maxilla

    7. Which of the following is not a contraindication for pregnancy?
    A. WPW syndrome………….answer
    B. Pulmonary hypertension
    C. Eisenmenger syndrome
    D. Marfan syndrome with aortic root dilatation

    8. Which of the following is a contraindication for medical treatment in gallstones?
    A. Radio opaque stones……….
    B. Radiolucent stones
    C. Normal functioning gall bladder
    D. Small stones answer…..(may cause obs of cbd)

    9. Low dose oral contraceptive pill contains?
    A. Levonorgestrel…………
    B. Norgestrel
    C. Desogestrel answer (feminon)
    D. Norethihisterone

    10. Which of the following antihypertensive drugs is contraindicated in a patient on Lithium in order to prevent toxicity?
    A. Clonidine
    B. Beta blockers
    C. Calcium channel blockers
    D. Diuretics………….answer

    11. Superior vena caval syndrome is most commonly caused by?
    A. Lymphoma
    B. Small cell lung ca………….answer
    C. Non small cell lung ca
    D. Secondary tumours

    12. Which of the following is not an adverse effect of thalidomide?
    A. Diarrhoea………….answer
    B. Teratogenicity
    C. DVT
    D. Peripheral neuropathy

    13. Blount’s disease is:
    A. Genu valgum
    B. Genu varum………..answer
    C. Genu recurvatum
    D. Menisceal injury

    14. A teenaged girl complains of pain in knee on climbing stairs and on getting up after sitting for a long time. What is the probable diagnosis?
    A. Chondromalacia ??????
    B. Plica syndrome
    C. Bipartite patella
    D. Patello-femoral osteoarthritis

    15. Which of the following is not included in parenteral nutrition?
    A. Fat
    B. Carbohydrate
    C. Fibre……………answer
    D. Micronutrients

    16. Sparrow marks are seen in?
    A. Gunshot injuries
    B. Stab injury of face
    C. Vitriolage
    D. Windshield glass injury…………..answer?

    17. Which organ obtained from a cadaver is not used for transwerplantation?
    A. Blood vessel ?????
    B. Lung
    C. Liver
    D. Bladder

    18. 17-Amphotericin B causes deficiency of?
    A. Na
    B. Ca
    C. K…………..answer
    D. Mg

    19. 18-All are seen in injury to common peroneal nerve except?
    A. Loss of sensation over sole……………….answer
    B. Foot drop
    C. Injury to neck of fibula
    D. Loss of dorsiflexion of toe

    20. 19-Cause of premature death in schizophrenia?
    A. Homicide
    B. Suicide……………answer
    C. Toxicity of antipsychotic drug
    D. Hospital acquired infection

    21. 20-Epileptic potential is present in
    A. Desflurane
    B. Halothane
    C. Sevoflurane…………….answer
    D. Ether

    22. 21-Which among the following is the best inotrope drug for use in right heart failure?
    A. Dobutamine
    B. digoxin
    C. Halothane
    D. Milrinone ?????

    23. 22-Which of the following anesthetic drugs is contraindicated in a patient with hypertension?
    A. Ketamine……………answer
    B. Propofol
    C. Etomidate
    D. Diazepam

    24. 23-Baby born at 33 weeks / 1.5 kg should be started on?
    A. Nil oral and IV fluids
    B. Oral nasogastric tube / alternate oral route………………??????
    C. IV fluids and oral feeding ????
    D. TPN

    25. 24-A patient has a single kidney with an exophytic mass of 4 cm size at it’s lower pole. Which among the following is the best course of action?
    A. Partial nephrectomy…………….answer
    B. Radical nephrectomy with dialysis
    C. Radical nephrectomy with immediate renal transwerplant
    D. Observation

    26. 25-All of the following decrease bone resorption in osteoporosis except?
    A. Alendronate
    B. Etidronate
    C. Strontium
    D. Teriparatide………….answer

    27. 26-Ondoni cells and Haller cells are associated with the following structures respectively?
    A. Optic nerve and Orbital floor answer
    B. Optic nerve and Internal carotid artery
    C. Internal carotid artery and Optic nerve
    D. Orbital floor and Internal carotid artery

    28. 27-Pain sensation from the ethmoid sinus is carried by :
    A. Frontal nerve
    B. Lacrimal nerve
    C. Nasociliary nerve…………..answer
    D. Infraorbital nerve

    29. 28-Which among the following is not used to treat alcohol dependence?
    A. Flumazenil ………………..answer
    B. Acamprosate
    C. Naltrexone
    D. Disulfiram

    30. 29-Which among the following is the most common fungal infection seen in immuno competent patients?
    A. Aspergillus ?????
    B. Candida
    C. Cryptococcus
    D. Mucor

    31. 30-All are seen in Argyl Robertson pupil except?
    A. Near reflex normal
    B. Direct reflex absent
    C. Consensual reflex normal answer
    D. Vision normal

    32. 31-A 5 year old boy while having dinner suddenly becomes aphonic and is brought to the casulty for the complaint of respiratory difficulty. What should be the appropriate management?
    A. Cricothyroidotomy
    B. Emergency tracheostomy
    C. Humidified oxygen ????
    D. Heimlich maneuver……….

    33. 32-Which among the following is a branch from the trunk of brachial plexus?
    A. Suprascapular nerve…………..answer?
    B. Long thoracic nerve
    C. Anterior thoracic nerve
    D. Nerve to subclavius………………..answer?

    34. 33-Orthotolidine test is used for detecting:
    A. Chlorine…………answer
    B. Nitrites
    C. Nitrates
    D. Ammonia

    35. 34-Which among the following is the most common tumour associated with neurofibromatosis in a child?
    A. Juvenile myelomonocytic leukemia………….answer
    a. B. Acute lymphoblastic leukemia
    C. Acute monocytic leukemia
    D. Acute myeloid leukemia

    36. Diaphragm develops from all except:
    A. Septum transwerversum
    B. Dorsal mesocardium
    C. Pleuroperitoneal membrane
    D. Cervical myotomes answer

    37. ECG is poor at detecting ischaemia in areas supplied by?
    A. Left anterior descending
    B. Left circumflex
    C. Left coronary artery
    D. Right coronary artery answer

    38. A patient with history of discharge from right ear for past 1 year presented with severe ear ache. The discharge was cultured and the organism was found to be gram positive cocci. The least likely cause is?
    A. Psuedomonas
    B. Streptococcus pneumoniae
    C. Staphylococcus
    D. Haemophilus influenza?…………

    39. Erythema nodosum is seen in all except:
    A. Pregnancy
    B. Tuberculosis
    C. SLE
    D. Chronic pancreatitis………..answer

    40. Posterior relations of head of pancreas are all except?
    A. Common bile duct
    B. First part of duodenum …………..answer
    C. Aorta
    D. Inferior vena cava

    41. Multiple sebaceous cysts seen in:
    A. Gardner’s syndrome
    B. Turcot syndrome
    C. Torre Maura syndrome………….answer
    D. Cowden syndrome

    42. Which among the following is the hallmark of acute inflammation?
    A. Vasoconstriction
    B. Stasis
    C. Vasodilation and increase in permeability………….answer
    D. Leukocyte margination

    43. A fire breaks out during laser vocal cord surgery. What is not to be done?
    A. Pouring sterile water …answer
    B. Removing endotracheal tube
    C. 100% oxygen after discontinuing anesthetic gases
    D. Treatment with steroid & antibiotic

    44. Which insect among the following is not resistant to DDT?
    A. Musca domestica
    B. Phlebotomus…………..answer
    C. Culex
    D. Anopheles stephensi

    45. Which virus among the following is least likely to cross placenta?
    A. Rubella
    B. Herpes simplex……………………
    C. HIV ……….answer
    D. HBV

    46. Which among the following does not cause hyperpyrexia?
    A. MAOI
    B. Alcohol answer
    C. atropine
    D. Amphetamine

    47. Which is not seen in digoxin toxicity?
    A. Biventricular tachycardia
    B. Proxysmal atrial tachycardia
    C. Ventricular bigeminy
    D. Regularisation of AF ????
    i.
    49. Which of the following does not cause indoor air pollution?
    A. CO
    B. Nitrogen dioxide answer
    C. Radon
    D. Mercury vapor

    51. All are true about neuronal tumors except?
    A. 90% are malignant ……answer
    B. 95% occur in the abdomen
    C. They secrete catecholamines
    D. They arise from sympathetic ganglions

    52. Most important and potential agent that can be used in bioterrorism:
    A. Plague
    B. Small pox ,,,,answer
    C. TB
    D. Clostridium botulinum

    53. True about epidural opioids are all except?
    A. Acts on dorsal horn cell
    B. Itching
    C. Nausea & vomiting answer
    D. Respiratory depression

    54. Most common site of obstruction after TURP?
    A. Navicullar foss
    B. Bulb
    C. Prostatic membranous urethra?????
    D. Bladder neck

    55. Intraoperative myocardial infarction is best diagnosed by:
    A. ECG ??
    B. Invasive arterial pressure ?
    C. Central venous pressure
    D. Transwer esophageal echo

    56. Pseudoisomorphic phenomenon seen in
    A. Psoriasis ………answer
    B. Lichen planus
    C. Vitiligo
    D. Plane warts

    57. Some antigen was injected into a rabbit. What antibody will it produce initially?
    A. IgG
    B. IgM…………….answer
    C. IgE
    D. IgD

    58. Regarding PCOD, all are true except?
    A. High LH/FSH
    B. High DHEAS
    C. Very high prolactin…………………….answer
    D. Raised LH

    59. Which anesthetic modality is to be avoided in sickle cell disease?
    A. General anesthesia
    B. Brachial plexus block
    C. Local arterial injection answer
    D. Spinal

    60. About yaws all are true except:
    A. Caused by Treponema pertenue
    B. Transwermitted non-venerally
    C. Secondary yaws can involve bones
    D. Last stages involve heart and nerves answer

    61. Rise in end tidal CO2 during thyroid surgery can be due to all except:
    A. Anaphylaxis answer
    B. Malignant hyperthermia
    C. Thyroid storm
    D. Neuroleptic malignant syndrome

    62. Weight gain in pregnancy is related to all except?
    A. Ethnicity
    B. Smoking …………………………..answer
    C. Socioeconomic status
    D. Pre conceptional weight

    63. A 3.8 kg baby of a diabetic mother developed seizures 16 hours after birth. Most probable cause is?
    A. Hypoglycemia answer
    B. Hypocalcemia…………………………
    C. Birth asphyxia
    D. Intra ventricular hemorrhage

    64. Best marker for intrahepatic cholestasis of pregnancy is?
    A. Bile salts
    B. Bile acid……………………………..answer
    C. Bilirubin
    D. Alkaline phosphatase

    66. A 6 year old child presents with pain in hip in femoral triangle region. X-ray does not reveal any abnormality. What is the next step?
    A. USG
    B. MRI
    C. Aspiration answer
    D. Traction

    68. All are true except:
    A. Human anatomical waste is disposed in a yellow bag
    B. Red bag contents can be a source of contamination
    C. Black bag is used for incineration ash
    D. Blue bag contents are always disposed in secure landfill answer

    69. A patient presented to the casuality with bluish pigmentation of conjunctiva, mucous membranes, nails and tachycardia after ingestion of a poison. What is the poison:
    A. Mercury
    B. Arsenic answer
    C. Lead
    D. Copper

    70. The distant metastasis of bone can be best detected by:
    A. MRI
    B. Bone scan answer
    C. CT
    D. Intravenous venogram

    71. Which of the following is the most probable diagnosis in a patient with loss of central vision and a normal retinogram?
    A. Best's disease
    B. Stargardt's disease ………… answer
    C. Retinitis pigmentosa
    D. Macular hole

    72. Methods of producing monoclonal antibodies are all except?
    A. Attaching inactive viral particle on cell membrane
    B. Adding ethylene glycol …answer
    C. Applying a small electric current
    D. Reducing the viscosity of the membrane

    73. Dose of radiation required for development of haematological syndrome is?
    A. 2.5-5 Gy
    B. 10 Gy
    C. 100 Gy
    D. 200 cGy …………answer

    74. The primary action of NO in git is?
    A. Vasodilatation
    B. Vasoconstriction
    C. GI smooth muscle relaxation…………………..answer
    D. Secretomotor

    76. Renal calculi associated with proteus infection is:
    A. Uric acid
    B. Triple phosphate…………………answer
    C. Calcium oxlalate
    D. Xanthine

    77. Thiamine deficiency causes decreased energy production because?
    A. It is required for the process of transweramination
    B. It is a co-factor in oxidative reduction
    C. It is a co-enzyme for transwerketolase in pentose phosphate pathway
    D. It is a co-enzyme for pyruvate dehydrogenase & alpha ketoglutarate dehydrogenase……..answer

    78. Regarding anterior choroidal artery syndrome, all are true except?
    A. Hemipareisis
    B. Hemisensory loss,
    C. Involvement of anterior limb of internal capsule…………….answer
    D. Homonymous hemianopia

    79. A 40 year old female underwent surgery. Post operatively she told the anaesthetist that she was aware of per-operative events. Individual intraoperative awareness is evaluated by (to prevent such instances from occurring)?
    A. Pulse oximetry
    B. Colour doppler
    C. Bispectral imaging answer
    D. End tidal CO2

    80. Which of the following helps in generating oxygen burst for killing bacteria within neurophils ?
    A. Superoxide dismutase
    B. Oxidase …………answer
    C. Peroxidase
    D. Glutathione reductase

    81. Most common cause of meningoencephalitis in children?
    A. HSV
    B. Enterovirus ………….answer
    C. Mumps
    D. Listeria

    82. A 15 day old baby came with history of seizures. Blood tests revealed Ca 5mg/dl, PO4 9mg/dl, PTH 30pg/ml (n=10-60). What is the most probable diagnosis?
    A. Pseudohypoparathyroidism ………answer
    B. Vitamin D deficiency
    C. Hyperparathyroidism
    4. HIE

    83. A graph of Normal blood sugar level curve and Diabetic blood sugar level curve was shown. An area was seen overlapping towards the normal gycemic curve. A point at 120 mg/dl was shown too. Question : What does that area represent?
    A. True positive
    B. False positive ………………….answer
    C. True negative
    D. False negative

    84. Which among the following not used in diagnosis of insulinoma?
    A. Fasting glucose test
    B. Xylulose test………………………answer
    3. C peptide levels
    4. Insulin / glucose ratio

    85. All are true about Nesidioblastosis except ?
    A. Hypoglycemic episodes are seen
    B. Occurs in adults more than children ………………answer
    C. Histopathology shows hyperplasia of islet cells
    D. Diazoxide is used for treatment

    86. Which among the following is preferred in a patient with decreased renal functio to avoid contrast nephropathy?
    A. N acetylcysteine
    B. Fenoldopam answer……………
    C. Low osmolar contrast
    D. Mannitol

    87. A young lady presents with fever, dysuria and pain abdomen. Uncomplicated acute cystitis was diagnosed. Which among the following is not true?
    A. Nitrate test positive
    B. E.coli count was < 10^3 ……………answer
    C. 1 pus cell per 7 fields
    D. 1 bacilli per field

    88. A patient presented with an abdominal injury with peritonitis and shock. Airway, breathing and IV fluids for circulation were taken care of. What is the next step of management?
    A. Take the patient for laparotomy under GA answer
    B. Take the patient go for a laparoscopy
    C. Insert an abdominal drain under LA and take up for surge...

    89. Mother to baby transwermission of HIV can be minimised by all except?
    A. Zidovudine
    B. Vitamin A
    C. Vaginal delivery …………..answer
    D. Avoidance of breast feeding

    91. A investigator finds out that 5 independent factors influence the occurrence of a disease. Comprision of multiple factors responsible for a disease can be assessed by?
    A. ANOVA
    B multiple linear regression……..answer?
    C. Chi square
    D. multiple logistic regression

    92. A primigravida at 37 weeks of gestation with loss of engagement. Cervix 1cm dilated. 10 uterine contractions per hour. What is management?
    A. Sedate the patient and wait ……..answer
    B. LSCS
    C. Amniotomy
    D. Induction with membrane rupture

    93. Gold standard test for diagnosis of laryngopharyngeal reflux?
    A. 24 hr double probe pH monitoring ……………….answer
    B. Flexible endoscopy
    C. Barium swallow
    D. Laryngoscopy

    94. Acoustic neuroma involves
    A. Superior vestibular division of 8th cranial nerve………………. answer
    B. Auditory part of 8th cranial nerve
    C. 7th cranial nerve
    d. Inferior vestibular division of 8th cranial nerve…

    95. A patient had running nose and pain over medical aspect of eye. He later developed chemosis,protosis and diplopia on abduction of right eye with congestion of optic disc. What is the probable diagnosis?
    A. Acute ethmoidal sinusitis
    B. Orbital cellulitis
    C. Cavernous sinus thrombosis………….answer
    D. Orbital apex syndrome

    96. An anesthesia resident was giving spinal anaesthesia when the patient had sudden aphonia and loss of consciousness. What could have happened?
    A. Total spinal ………………answer
    B. Partial spinal
    C. Vaso vagal attack
    D. Intra vessel injection

    97. Urea cycle occurs in:
    A. Liver……………..answer
    B. G.I.T.
    C. Spleen
    D. Kidney

    [[snip]]. Main blood supply of neck of femur?
    A. Lateral circumflex femoral
    B. Medial circumflex femoral
    C. Profunda femoris answer??
    D. Popliteal artery

    99. Not a part of national screening program?
    A. Diabetes mellitus…………….
    B. Dental caries ??????
    C. Refractive error...
    D. Carcinoma cervix

    100. Definitive airway is all except?
    A. Nasotracheal tube
    B. Orotracheal tube
    C. LMA …………………….answer
    D. Cricothyroidotomy

    101. Right isomerism is?
    A. Asplenia …………………..answer
    B. Two spleens
    C. One spleen
    D. Polysplenia

    103. Least common cause of ambiguous genitalia in a female child?
    A. Placental steroid sulfatase deficiency …….answer
    B. Fetal aromatase deficiency
    C. WT-4 mutation
    D. CAH

    104. Otogenic abcess is caused by all except?
    A. Pseudomonas
    B. Streptococcus
    C. Hemophilus inflenzae
    D. Staphylococcus

    105. True regarding leptospirosis is?
    A. Rats are the only reservoirs answer
    B. Fluroquinolones are the DOC
    C. Person to person transwermission
    D. Hepatorenal syndrome occurs in 50% cases

    106. Principle orgenelle involved in the execution of apoptosis is?
    A. Nucleus
    B. Lysosome
    C. Mitochondria………………answer
    D. Endoplasmic reticulum

    108. Feature of obstructive azoospermia is?
    A. High FSH, high testosterone
    B. Low FSH, high testosterone
    C. High FSH, low testosterone
    D. Normal FSH, normal testosterone…………….answer

    109. ‎'C' in C reactive protein stands for:
    A. Capsular polysaccharide in pneumococcus…………….answer
    B. Concanavalin-a
    C. Calretinin
    D. Cellular

    111. Buprenorphine is?
    A. Partial agonist at Mu Receptor ………………..answer
    B. Partial agonist at Kappa Receptor
    C. Full Agonist at Mu Receptor
    D. Antagonist at Kappa receptor

    112. All are true about aprepitant except?
    A. Agonist at NK1 answer
    B. Crosses blood brain barrier
    C. Ameliorates nausea and vomiting of chemotherapy
    D. Metabolized by CYP450

    113. Time of occurrence of secondary hemorrhage after tonsillectomy?
    A. 24 hrs
    B. 6 days answer
    C. 12 days
    D. 12 hrs

    114. Which of the following is true?
    A. Acetylcholinesterase inhibition by malathion can be reversed by increasing the level of atropine
    B. Sulphonilamide inhibits folate reductase irrevesibly answer
    C. Flouoroacetate competetively inhibits aconitase
    D. Ethanol inhibits aldehyde dehydrogenase when used in methanol poi...

    115. A patient with head injury on examination revealed eye opening in response to pain, inappropriate words and pain localisation. Calculate GCS?
    a. 10 ………………answer
    b. 8
    c. 12
    d. 14

    116. A primigravida in 1st trimester had sputum positive for acid fast bacillus. What is the preferred treatment?
    A. Treatment deferred till 2nd trimester
    B. Category 1 DOTS…………..answer
    C. Category 2 DOTS
    D. Category 3 DOTS

    117. What will you give to treat hypothyroidism in a patient with ischemic heart disease?
    A. Low dose of levothyroxine
    B. Normal dose of levothyroxine
    C. Do not give levothyroxine
    D. Thyroid extract ???

    118. Carrier state is not important in transwermission of:
    A. Measles…………answer
    B. Typhoid
    C. Polio
    D. Diphtheria

    119. A schizophrenic patient started on haloperidol 2 days back, comes with complaints of torticollis and orofaciolingual movements. What is the diagnosis?
    A. Acute dystonia …….answer
    B. Tardive dyskinesia
    C. Parkinsonism
    D. Akathisia

    120. A 55 year old man presents with history of 5 episodes of hematuria each lasting for about 4-5 days in the past 5 years. What will be the best investigation to arrive at a diagnosis?
    A. Urine examination and microscopy………….
    B. X-ray KUB
    C. Abdominal USG……….
    D. DTPA scan answer

    121. Mifepristone is used in?
    A. Molar pregnancy
    B. Threatened abortion
    C. Fibroid ………….answer??
    D. Ectopic pregnancy…

    122. All are true about parvovirus b19 except?
    A. <10 % spread by transwerplacental route answer
    B. Spread by respiratory route
    C. It is a DNA virus
    D. Affects erythroid progenitor cells

    123. Sterile pyuria is present in?
    A. Renal tuberculosis…………………….answer
    B. Chronic hydronephrosis
    C. Wilm's tumour
    D. Neuroblastoma

    124. A 35 year old female has proximal weakness of muscles, ptosis and easy fatiguability. The best test to diagnose her condition is:
    A. Muscle biopsy
    B. CPK
    C. Edrophonium test ………………answer
    D. EMG

    125. Denominator in Maternal Mortality Rate?
    A. Total number of live births……………answer
    B. Total number of married women
    C. Total number of births
    D. Midyear population

    126. Psammoma bodies are seen in all except?
    A. Follicular carcinoma thyroid……………..answer
    B. Papillary carcinoma thyroid
    C. Cystadenocarcinoma
    D. Meningioma

    127. Visceral larva migranswer is seen in?
    A. Strongyloides
    B. Ancylostoma
    C. Toxocara canis…………….answer
    D. Visceral leishmaniasis

    128. Urethral crest is situated in:
    A. Prostatic urethra …………answer
    B. Membranous urethra
    C. Penile urethra
    D. Bulbar urethra

    129. People were separated into 5 sub groups. People were selected randomly from these sub groups. What type of sampling was done?
    A. Simple random sampling
    B. Stratified Sampling answer
    C. Cluster sampling
    D. Systematic sampling

    130. All of the following are true about erlotinib except?
    A. Tyrosine kinase inhibitor
    B. Food delays its absorption ……………answer
    C. Rashes can occur
    D. Used in non small cell lung cancer when there is no response to other chemotherapeutic agents

    131. Compliance is decreased in all except?
    A. Pulmonary congestion
    B. COPD answer
    C. Decreased surfactant
    D. Pulmonary fibrosis

    132. A 70yr old presents with intemittent jerks of recent origin, EEG showing bilateral periodic spikes. What is the most probable diagnosis?
    A. Hepes simplex encephalitis
    B. Lewy body dementia
    C. Alzheimer's
    D. CJD………………answer

    133. Not a disorder of protein misfolding?
    A. Alzheimer's disease
    B. Tuberculosis…………….answer?
    C. Cystic fibrosis
    D. CJD

    134. Pulmonary toxicity is seen with?
    A. Bleomycin ……………answer
    B. Cisplatin
    C. Methotrexate
    D. Actinomycin D

    135. ‎18 year old male presents with hemetemesis, melena and splenomegaly. What is the most probable diagnosis?
    A. NCPF ………………….answer
    B. Cirrhosis
    C. Malaria with DIC
    D. Extra hepatic portal venous obstruction

    136. Following are true about carbohydrate antigen except?
    A. Memory ………………….answer
    B. Poly clonal response
    C. Poor immunogenicity
    D. T cell independent immunity

    137. Ideal age for surgery in unilateral undescended testis is?
    A. 6 months
    B. 12 months………………..answer
    C. 24 months
    D. 36 months

    138. Not a predisposing factor for atherosclerotic plaque formation?
    A. ApoE
    B. Alpha 2-macroglobulin……………answer
    C. Oxidised LDL
    D. Increased homocystiene

    139. What is the type of joint seen in the growth plate?
    A. Fibrous
    B. Primary cartilagenous …………….answer
    C. Secondary cartilagenous
    D. Plane joint

    140. Which of the following is a vector used to increase the yield of protein produced in recombinant protein synthesis?
    A. Promoter induced
    B. Genes for protease inhibitors
    C. Transwerlation initiation ????
    D. Transwerlation and transwercription termination

    141. A poison which is illuminous, transwerlucent and waxy?
    A. Iodine
    B. Ammonium bromide
    C. Cobra venom
    D. Yellow phosphorous………………answer

    142. A 5 year old child presented with ballooning of perpuce while micturition. Perpuce adhesions were present. What is the best treatment for him?
    A. Adhesiolysis and dilatation
    B. Circumcision ……………answer
    C. Dorsal slit
    D. Conservative





    143. A schizophrenic patient started on haloperidol 2 days back, comes with complaints of torticollis and orofaciolingual movements. What is the diagnosis?
    A. Acute dystonia..........answer
    B. Tardive dyskinesia
    C. Parkinsonism
    D. Akathisia





    144 Earliest to be diagnosed by USG is?
    A. Anencephaly ………………….answer
    B. Prosencephaly
    C. Meningocele
    D. Spina bifida

    145. A 45 year old lady presented with DUB & USG finding of 8mm thick endometrium. What is the next step?
    A. Endometrial histopathology………………….answer
    B. Hysterectomy
    C. OCP
    D. Follow up

    146. Fallopian tube immotility is seen in?
    A. Churg strauss syndrome
    B. Kartagener's syndrome……………………..answer
    C. Noonan syndrome
    D. Turner syndrome

    147. First structure to be fixed after amputation is?
    A. Bone fixing………………….answer
    B. Arterial repair
    C. Venous repair
    D. Nerve repair

    148 Pearson's skewness coefficient is?
    A. (Mean-median)/SD
    B. Median-mean/SD
    C. SD/mean-median
    D. SD/median-mean

    149. Poor prognostic factor for ALL is?
    A. Hyperdiploidy
    B. t(9;22) t(4;11) ……..answer
    C. 2-8 yrs of age
    D. TLC < 50000

    150. Most potent activator of T cells?
    A. B cells
    B. Follicular dendritic cells
    C. Mature dendritic cells …………..answer
    D. Macrophages
    151. During TURP, surgeon takes care to dissect above the verumontenum so as to prevent injury to?
    A. External urethral sphincter
    B. Urethral crest answer
    C. Prostatic utricle
    D. trigone of bladder

    152. A neonate delivered at 38 weeks of gestation, birth weight of 2.2kg develops intolerance to feeds on 2nd day. Physical examination reveals no abnormalities. Sepsis screen in negative. What is the next step in management?
    A. Wait and watch answer
    B. Do a 2nd sepsis screen
    C. give prophylactic antibiotics
    D.

    153. True about platelet function defect?
    A. Normal platelet count with prolonged bleeding time …………answer
    B. Thrombocytosis with prolonged bleeding time
    C.
    D.



    154. The acid base status of a patient is as follows : pH - 7.45, pCO2 - 30 mm of Hg, pO2 - 105 mm of Hg. Patient has partially compensated?
    A. Metabolic acidosis answer
    B. Metabolic alkalosis
    C. Respiratory acidosis
    D. Respiratory alkalosis

    156. A patient presents with signs of pneumonia. The bacterium obtained from sputum grows on sheep agar. What test is used to identify the type of organism?
    A. Bile solubility………………answer
    B. Bacitracin sensitivity
    C. Coagulase test
    D.

    157. A female presents with sings of meningitis. CSF shows gram positive bacilli. It is most probably?
    A. Listeria …………answer
    B. Haemophilus influenzae
    C. Pneumococcus
    D.

    158. All are used in the treatment of hot flushes except?
    A. Tamoxifene ………………..answer
    B. Venlafaxine
    C.
    D.

    159. A patient comes with history of fever and cough unresponsive to antibiotics.It was partially Acid fast. X-ray shows consolidation. Bronchioalveolar lavage shows gram positive branching filaments. What is the diagnosis?
    A. Actinomycosis
    B. Nocardiosis
    C. Aspergillus answer
    D.



    160. About Human Development Index, all are true except?
    A. Life expectancy at birth
    B. Life expectancy at 1 year of age ……answer
    C. Education
    D. GDP

    161. Which among the following is not a component of hypogastric sheath?
    A. Broad ligament …………..answer
    B. Transwerverse cervical ligament
    C. lateral ligament
    D. Ligament of bladder

    162. All are seen in the floor of 3rd ventricle except?
    A. Infundibulum
    B. Oculomotor nerve
    C. Mammillary body
    D. Optic chiasm ?????

    163. Late onset endophthalmitis after lens implantation is caused by?
    A. Staphylococcus epidermidis
    B. Pseudomonas
    C. Streptococcus pyogenes
    D. Propionibacterium acnes

    164. All are true about blood coagulation except?
    A. Factor 10 in a part of both intrinsic and extrinsic pathway ….answer
    B. Extrinsic pathway is activated by contact with plasma and negatively charged proteins
    C. Calcium is very important for coagulation
    D. Intrinsic pathway can be activated in vitro

    165. Best treatment option for genuine stress incontinence?
    A. Burch colposuspension
    B. Kelly’s procedure answer
    C. Sling operation
    D. Tension free vaginal taping

    166. All of the following are done in management of shoulder dystocia except?
    A. Fundal pressure ……………….answer
    B. Suprapubic pressure
    C. McRoberts maneuver
    D. Woods maneuver

    167. Pentalogy of fallot has which one of following extra entities:
    A. ASD …………………..answer
    B. VSD
    C. RVH
    D. Pulmonary stenosis

    168. Aortic knuckle shadow on chest X ray, PA view is obliterated by consolidation of which portion of lung?
    A. Upper lingula
    B. Lower lingula ?????
    C. Apex of lower lobe
    D. Posterior part of upper lobe

    171. Best test for HCG action?
    A. Radioimmunoassay……………….answer
    B. ELISA
    C. Latex test
    D. Bioassay

    172. Lines of blaschko are:
    A. Lymphatics
    B. Blood vessel
    C. Nerves
    D. Lines of development…………….answer

    173. A man connected to a body plethysmograph exhales against a closed glottis. What will be the finding?
    A. The pressure in both the lungs and the box increases
    B. The pressure in both the lungs and the box decreases
    C. The pressure in the lungs decreases, but that in the box increases
    D. The pressure in the lungs increases, but that in the box decrease………………….answer

    174. A patient presents with fever and abdominal pain. Clinical examination reveals hepatomegaly extending 4 finger breadths below the costal margin. USG reveals a 4cm*5cm*4cm hypodense lesion 1cm deep to liver surface. Tests for hydatid disease were -ve. Best course of action is?
    A. Hepatectomy
    B. Multiple aspirations and me.dication answer
    C only medication
    d..

    175. Main site of water absorption is:
    A. Jejunum………………..answer
    B. Colon
    C. Ileum
    D. Stomach

    176. All are true about delirium tremens except?
    A. Visual hallucinations
    B. Coarse tremors
    C. 3 Ocular palsy answer
    D. Unconsciousness

    177. All of the following are neuronal tumours except?
    A. Gangliocytoma
    B. Ganglioglioma
    C. Neuroblastoma
    D. Ependymoma…………..answer??

    178. All are true about meglitinides except?
    A. Decreases post parandial hyperglycemia
    B. Hypoglycemia less common than sulfonylureas
    C. It decreases insulin resistance
    D. It acts by releasing insulin nas

    179. Pasteurised milk is most commonly tested by:
    A. Phosphatase test……………….answer
    B. Coliform test
    C. Catalase test
    D. Oxidase Test

    180. All of the following are affected in low radial nerve palsy except?
    A. Extensor carpi radialis longus answer
    B. Extensor carpi radialis brevis
    C. Finger extensors
    D. Sensation on dorsum of hand

    181. Clue Cells are seen in :
    A. Bacterial vaginosis ……………….answer
    B. Vaginal candidiasis
    C. Chlamydial vaginosis
    D. Trichomoniasis

    182. Which complement component is involved in both classical and alternate pathway?
    A. C1
    B. C2
    C. C3…………………..answer
    D. C4

    183. Which of the following are not associated with menstrual cycle?
    A. Hormonal changes
    B. Vaginal cytology changes
    C. Estrus profile……………….answer
    D. Endometrial changes

    184. HbH is seen in?
    A. Deletion of 3 alpha gene
    B. Deletion of all 4 alpha genes answer
    C. Deletion of 3 beta genes
    D. Deletion of all 4 beta genes

    185. Which among the following is a cardioprotective fatty acid?
    A. Palmitic acid
    B. Stearic acid
    C. Oleic acid
    D. Omega-3 fatty acids………………..answer

    186. All are true about xanthogranulomatous inflammation except?
    A. Presence of foamy macrophages
    B. Presence of tuberculous infection………………..answer
    C. Multinucleated giant cell
    D. Presence of yellow Nodules

    187. Site not affected in posterior cerebral artery infarct is?
    A. Midbrain
    B. Pons…
    C. Thalamus
    D. ant Cortex ????

    188. Pregnant mother at 35 weeks of gestation. What drug can you not give her for treatment of SLE?
    A. Prednisolone
    B. Methotrexate…………………..answer
    C. Sulfsalazine
    D. Hydroxychloroquine

    189. Common carotid artery is palpated at?
    A. Upper border of cricoid cartilage
    B. Upper border of thyroid cartilage……………..answer
    C. Hyoid bone
    D. Cricothyroid membrane

    190. A 50 yr lady has history of sprained ankle 2 months back followed by recovery. She now complains of severe pain in that ankle with inability to flex that foot. Physician notes edema and shiny skin in local examination. What is the probable diagnosis:
    A. Fibromyalgia
    B. Complex regional pain syndrome 1
    C. Complex regional pain syndrome 2 answer
    D. Peripheral neuropathy

    191. Tolerance in opioids develops to all except?
    A. Miosis ……………………..answer
    B. Analgesia
    C. Euphoria
    D. Nausea and vomiting

    192. All are actions of muscarinic antagonist except?
    A. Decreases gastric secretion
    B. Prolongs a-v conduction ?????
    C. Decreases respiratory secretions
    D. Contraction of radial muscles of iris

    193. Which among the following is an early sign of magnesium toxicity?
    A. Depression of deep tendon reflexes answer
    B. Respiratory depression
    C. Cardiac arrest
    D. Decreased urine output

    194. Drugs used in prophylaxis of migraine are all except?
    A. Propranolol
    B. Flunarizine
    C. Topiramate
    D. Levetiracetam………………answer

    195. Auto-Rikshaw ran over a child’s thigh, there is a mark of the tyre tracks, it is an
    A. Contact bruise
    B. Patterned bruise
    C. Imprint abrasion……………….answer
    D. Ectopic bruise

    196. Anaesthetic agent with vasoconstrictor is contraindicated in?
    A. Finger block ……………..answer
    B. Spinal block
    C. Epidural block
    D. Regional anaesthesia

    197. Integrase inhibitor approved for treatment of HIV is?
    A. Raltegrase……………….answer
    B. Indinavir
    C. Lopinavir
    D. Elvitegravir

    198. A 65 yrs old lady presented with a swollen and painful knee. On examination, she was found to have grade III osteoarthritic changes. What is the best course of action?
    A. Conservative management answer
    B. Arthroscopic washing
    C. Partial knee replacement
    D. Total knee replacement

    199. Causes of primary amenorrhoea are all except?
    A. Rokintasky syndrome
    B. Kallaman syndrome
    C. Sheehan syndrome……………answer
    4. Turner syndrome

    200. NARP syndrome is seen in?
    A. Mitochondrial function disorder……………………..answer
    B. Glycogen storage disorder
    C. Lysosomal storage disorder
    D. Lipid storage disorder

    201. Necrotizing lymphadenitis is seen in?
    A. Kimura disease
    B. Kikuchi disease ………………………answer
    C. Hodgkin disease
    D. Castelman disease

    202. Two plants are grown. One in some fluorescent pigment containing media. Other in fire fly luciferase containing media. Which plant will glow in the dark?
    A. Both plants will glow
    B. Neither will glow
    C. First one will glow
    D. Second one will glow…………………..answer

    203. CT scan is least accurate for diagnosis of:
    A. 1 cm size aneurysm in an artery
    B. 1 cm size lymph node in thyroid carcinoma answer
    C. 1 cm size mass in tail of pancreas
    D. 1 cm size gall stone

    204. Which is the most reliable objective sign of identifying pulmonary plethora in chest X-ray?
    A. Diameter of the main pulmonay artery >16mm
    B. Diameter of the lt pulmonay artery >16mm
    C. Diameter of the decending Rt pulmonay artery >16mm…………………answer
    D. Diameter of the decending Lt pulmonay artery >16mm

    205. Prolonged treatment with INH leads to deficiency of?
    A. Pyridoxine …………………….answer
    B. Thiamine
    C. Pantothenic acid
    D. Niacin

    206. Mineralocorticoid receptor is not present in?
    A. Liver…………………….answer
    B. Colon
    C. Hippocampus
    D. Kidney

    207. A man presents with a maculopapular rash. He gives a history of previous painless rash. Infection is due to?
    A. Treponema pallidum …………..answer
    B. Chlamydia
    C. Calymmatobacterium granulomatis
    D. Haemophilus ducreyi

    208. In L5 root involvement, which among the following is not affected?
    A. Thigh adduction answer
    B. Knee flexion
    C. Knee extension
    D. Toe extension

    209. Which among the following is not a cause of fasting hypoglycemia?
    A. Glucagon excess
    B. Glucose 6 phospatase deficiency
    C. Ureamia
    D. Glycogen synthase deficiency answer

    210. McKeon's theory on reduced prevalence of TB?
    A. Increased awareness and knowledge
    B. Medical advancement answer
    C. Behavioural modification
    D. Social and environmental factor

    211. Which of the following passes through foramen magnum?
    A. Internal Carotid Artery
    B. Sympathetic chain
    C. Hypoglossal Nerve
    D. Vertebral Artery……………………answer

    212. A child presents with abdominal pain only during passage of stools. No other symptoms like vomiting or blood in stools. There are no signs of intestinal obstruction. Most probable diagnosis is?
    A. Rectal polyp
    B. Intusseception answer
    C. Meckels diverticulum
    D. NEC

    213. Spinal anaesthesia is given at which level?
    A. L1-2
    B. L2-4 ……………………answer
    C. Midline of thorax
    D. Below L5 (caudal)


    215. a child presented with mild fever little breathlessness..... was treated and she improved over 4 days and later deteriorated again with fever and more breathlessness. x ray showed hyperlucency. diagnosis?
    1.bronchiolitis obliteranswer
    2.alveolar proteinosois
    3.bronchitis

    216. coarctation of aorta mc asso with
    1.bicuspid aoric valve………………answer
    2.pda
    3.
    4.

    217. Vitamin K is involved in the posttranswerlational modification of?
    A. Glutamate…………………….answer
    B. Aspartate
    C.
    D.

    218. Muscular component of dorsal aorta develops from?
    A. Axial mesoderm
    B. Paraxial mesoderm answer
    C. Intermediate mesoderm
    D. Lateral plate mesoderm

    219. Maintenance dose of which of the following drugs is used worldwide for opioid dependence?
    A. Naltrexone
    B. Methadone………………..answer
    C. lmma
    D. Disulfiram

    220. Which is not true regarding diet modification recommended in high cardiovascular risk group?
    A. Cholesterol less then 100 mg/1000kcal/day
    B. Avoid alcohol
    C. Fat intake 10% of total calories ????
    D. Salt limitation to less than 5 gm ????

    221. Regarding an imbecile, all are true except?
    A. IQ is 50-60 ………………………………answer
    B. Intellectual capacity equivalent to a child of 3-7 years of age
    C. Not able to take care of themselves
    D. Condition is congenital or acquired at an early age

    222. All are true about ranalozine except?
    A. Causes hypotension
    B. It is recommended as first line treatment for angina
    C. Improves glycemic control
    D. anti angina answer

    223. How to differentiate ASD from VSD in X-ray?
    A. Enlarged Left atrium……………………..
    B. Normal left atrium…………………….answer
    C. Pulmonary congestion
    D. Aortic shadow

    224. Rave drug is?
    A. Cannabis
    B. Cocaine
    C. Heroin
    D. Ecstasy………………….answer

    225. Mr X is a chronic smoker. His family insists on quitting smoking. He is thinking about quitting, but is reluctant to do so because he is worried that on quitting he will become irritable. This is?
    A. Precontemplation and preparation……………………….answer
    B. Contemplation and extent of sickness susceptability
    C. Contemplation and cost factors
    D. Precontemplation and cost factors

    226. A farmer developed a swelling in the inguinal region which later ulcerated. What stain can be used to detect bipolar stained organisms?
    A. Albert's stain
    B. Waysons stain…………………….answer
    C. Ziehl neelsen stain
    D. Nigrosin stain

    227. An 8 year old boy completed 8 out of 10 day course of cefaclor. Now he developed a generalized erythmatic rash which is mildly pruritic and lymphadenopathy. Diagnosis is?
    A. Kawasaki disease
    B. Type 3 hypersensitivity………………………….answer
    C. Anaphylaxis
    D. Infectious mononucleosis

    228. All are true about world health report 2008 except?
    A. Social reforms
    B. Leadership ????
    C. Polices
    D. Economic reforms

    229. Small air way has laminar flow because?
    A. Reynold number more than 2000
    B. Diameter is very small……………………..answer
    C. Density very high / velocity very high
    D. Total cross sectional area low

    230. Which is not an autoimmune disease?
    A. SLE
    B. Grave's disease
    C. Myasthenia gravis
    D. Sickle cell disease……………………answer

    231. All are true regarding selective estrogen receptor downregulator (SERD), fulvestrant except?
    A. Used for breast cancer
    B. Is a selective oestrogen antagonist
    C. Is slower acting, safer, more effective than SERM
    D. Given as once a month dose

    232. In pseudohyperparathyroidism, true is?
    A. Gain of function mutation
    B. Decreased conversion of GTP to GMP
    C. Decreased inositol tri phosphate production
    D. Decreased response to increase cAMP ???

    233. Vectors don't transwermit infection by?
    A. Ingestion
    B. Regurgitation ?????
    C. Rubbing of feces
    D. Contamination with body fluids

    234. All are factors responsible for resurgence of malaria except?
    A. Drug resistance
    B. Use of bed nets…………………….answer
    C. Vector resistance
    D. Mutation in parasite

    235. Administration of which of the following drug needs alkalization of urine?
    A. Cytosine arabinoside
    B. Methotrexate………………………answer
    C. Cisplatin
    D. Ifosfamide

    236. Which drug is not used to control bleeding during delivery in a woman with heart disease ?
    A. Methylergometrine…………………..answer
    B. Carboprost
    C. Syntocin
    D. Misoprostol

    237. In expectant management of placenta praevia, all are done except?
    A. Cervical encirclage answer
    B. Anti D
    C. Corticosteroids
    D. Blood transwerfusion

    238. A 5 yr old boy presented with leukocoria in right eye ball, while other eye had 2-3 small lesions in the periphery. What will be the ideal management for this patient?
    A. Enucleation of both eyes
    B. Enucleation of right eye & conservative management for the other eye
    C. Enucleation for right eye and radiotherapy for the other eye………………….answer??
    D. 6 cycles of chemotherapy

    239. Chimerism is associated with?
    A. Monochorionic monoamniotic twins
    B. Monochorionic diamniotic twins
    C. Singleton pregnancy
    D. Vanishing twin answer

    240. A tennis player gets hit by a ball in the face following which he has complaints of decreased vision. which of the following tells that injury is due to injury by ball.
    1. Optic neuritis
    B. Pars planitis ?
    C. Vitreous base detachment
    D. Equatorial edema ?

    241. What factor is responsible for deciding whether an antibody will remain membrane bound or get secreted?
    A. RNA splicing
    B. Class switching
    C. Differential RNA regulation……………answer
    D. Allelic exclusion

    242. Signature fracture refers to?
    A. Depressed skull fracture………………..answer
    B. Suture displacement fracture
    C. Contrecoup injury
    D. Fracture at foramen magnum

    243. Which among the following is seen in anti phospholipid antibody syndrome?
    A. Beta 2 microglobulin antibody
    B. Anti nuclear antibody
    C. Anti centromere antibody
    D. Anti glycoprotein antibody…………………….answer

    244. All are true regarding phagocytosis by protozoa except?
    A. Amoeba n other unicellular org make their living out of it
    B. Phagocytose particles of < 5 microns size answer
    C. Phagocytose particles of > 5 microns size
    D. Digestion occurs within phagolysosomes

    245. Child brought to casualty with reports of violent shaking by parents. Most likely injury is?
    A. Long bone fracture answer
    B. Ruptured spleen
    C. Subdural hematoma
    D. Skull bone fracture

    246. Gun powder on clothing can be visualized by?
    A. Magnifying lens
    B. UV rays
    C. Infrared rays
    D. dye answer

    247. Capsular antibody protection is seen in all except?
    A. Neisseria meningitidis
    B. Pneumococcus
    C. Bordetella pertussis answer
    D. Haemophilus influenza

    248. Which of the following is not an evidence based treatment for menorrhagia?
    A. Ethamsylate……………answer
    B.OCP
    C.Tamoxefene
    D.

    249. A lady who presented with hematuria on evaluation was found to have stage 2 transweritional cell carcinoma of bladder. Which of the following is true?
    A. 70% chance of requiring cystectomy in 5 yrs………………….answer
    B. Cystoscopic fulguration will have to be done
    C. A 10 year history of beedi smoking is not a risk factor
    D. There is no chemotherapy available

    250. A sewer worker presented with fever. Lab findings revealed renal failure with increased BUN and serum creatinine. What is the most appropriate drug to give him?
    A. Cotrimoxazole
    B. Erythromycin …answer
    C. Ciprofloxacin
    D.Benzyl penicillin

    251. True regarding chlamydia trachomatis is?
    A. Culture of endocervical discharge is used for isolation of organism
    B. Patient using OCP's are carriers answer
    C.
    D.



    253. A female patient presented with depressed mood, loss of appetite and no interest in surroundings. There is associated insomnia. The onset of depression was preceeded by a history of business loss. What is the line of management?
    A. No treatment is necessary as it is due to business loss
    B. SSRI is the best choice………………answer
    C. Start SSRI treatment based on side effect profile
    D. Combination therapy of 2 anti depressant drugs

    254. Antidepressant drug that can be used in nocturnal eneuresis?
    A. Imipramine…………..answer
    B. Fluoxamine
    C.
    D.

    255. Difference between follicular carcinoma and follicular adenoma is?
    A. Vascular invasion…………..answer
    B.
    C.
    D.

    256. If Gs alfa subunit gain of function mutation, there is?
    A. Decreased cAMP ??
    B. Decreased IP3
    C. Increased gtpas activity ??
    257 Cavitation is seen in?
    A. Mycolplasma pneumonia
    B. Tuberculous pneumonia
    C. Streptococcal pneumonia
    D.Staphylococcus pneumonia…………….answer

    258. Punnet Square is used for?
    A. Genotype of offspring ………………answer?
    B. Satistical analysis
    C.
    D.




    260. All are non deleberate measures for control of mosquito except?
    A. Use of alkaline soap water in factory
    B. Use of larvicidal agents
    C. Community participation
    D. use of bed nets for mosquito

    261. All of the following are true regarding diabetes mellitus except?
    A. Insulin is not used in type 2 diabetes………….answer
    B. Sliding scale regimen is used in hospitals
    C.
    D.

    262. A surgeon removed the part of liver to the left of the falciform ligament. Which segments have been removed?
    A. 1 & 4a
    B. 2 & 3…………….answer
    C. 1 & 4b
    D.

    263. A 6 week old male infant was brought in a state of dehydration and shock. Examination revealed hyper pigmentation over the body with normal external genitalia. Blood tests revealed hypoglycemia, Na - 124 mEq/L and K - 7 mEq/L. What is the probable diagnosis ?
    A. Congenital adrenal hyperplasia answer
    B. Adrenal haemorrhage and shock
    C. Acute gastroenteritis with dehydration
    D.

    264. A child presented with mild fever and breathlessness. He was treated and his condition improved over 4 days. Later his condition deteriorated with increase in fever and breathlessness. X-ray showed hyperlucency. What is the probable diagnosis?
    A. Bronchiolitis obliteranswer………………….answer
    B. Alveolar proteinosis
    C. Bronchitis
    D.

    265. All are true regarding serotonin syndrome except?
    A. It is not idiosyncratic and unpredictable
    B. Dantrolene is used for treatment……………answer
    C.
    D.

    266. False regarding Japanese encephalitis is:
    A. Epidemic is 2-3 cases in a village
    B. Mosquito bite is always associated with disease answer
    C. 70 in infants
    D.

    267. Which of the following is given to treat thrombocytopenia secondary to myelosuppresive therapy?
    A. Filgrastim
    B. Oprelvekin answer
    C. Erythropoietin
    D.

    268. True regarding ranula?
    A. It is also known as epulis
    B. It is a cystic swelling in the floor of mouth……………answer
    C. It is a type of thyroglossal cyst
    D. It is a type of mucus retention cyst

    269. A patient who was given primaquin develops hemolysis. Diagnosis is
    A. Glucose 6 phosphate dehydrogenase deficiency……………..answer
    B. Glucose 6 phosphatase deficiency
    C.
    D.

    270. All are true statements regarding use of sodium fluoride in the treatment of otosclerosis except?
    A. It inhibits osteblastic activity answer
    B. Used in active phase of otosclerosis when schwartz sign positive
    C. Has proteolytic activity(bone enzymes)
    D.

    271. A 5 year old child has burns on the surface of his body corresponding to the size of his palm. The percentage of burns is?
    A. 1% answer
    B. 5%
    C. 10%
    D.

    272. False about pneumococcus is?
    A. Capsule aids in virulence answer
    B. Commonest cause of otitis media and pneumonia
    C.
    D.

    273. Medical treatment for variceal bleed is by?
    A. Octreotide
    B. Pantaprazole
    C. desmopressin???
    D.

    274. Dental numbering is done by all except?
    A. FDI two digit system
    B. Anatomic and diagramatic charting
    C. Palmer notation
    D.

    275. Most important prognostic factor in congenital diaphragmatic hernia?
    A. Pulmonary hypertension……………answer
    B. Timing of surgery
    C. Size of defect
    D.

    276. Aflatoxin is produced by?
    A. Aspergillus flavus ……………..answer
    B. Aspergillus niger
    C. Candida
    D.

    277. A 7 month old child has bouts of cough ending with a whoop. What is the best way to confirm the diagnosis?
    A. Nasophayngeal swab …………………answer??
    B. Cough sputum culture
    C. Tracheal aspirate
    D.



    279. Tetracycline is used in prophylaxis of?
    A. Cholera …………..answer
    B. Brucellosis
    C. Leptospirosis
    D.

    280. Orthopnoea in right heart failure develops due to?
    A. Reservoir function of pulmonary veins answer
    B. Pooling of blood in legs
    C.
    D.

    281. A young male presented with history of fever and a nodule in the leg. Histopathology of the nodule revealed foamy histiocytes and neutrophillic infiltrate in the dermis. Most probable diagnosis is?
    A. Sweet's syndrome…………..answer
    B. Rosai Dorfman disease
    C. Erythema Nodosum Leprosum
    D.

    282. True regarding drug resistance of MRSA?
    A. Penicillinase enzyme production
    B. Due to change in penicillin binding receptors
    C. chrosome mediated answer
    D. Treated with amoxicillin + clavulanic acid

    283. Commonest cause for bilateral proptosis in children?
    A. Cavernous haemangioma
    B. Rhabdomyosarcoma………….answer?
    C. ALL
    D. AML

    284. Blood examination of a patient revealed low calcium, high phosphate and raised PTH. Which of the following investigations need not be done?
    A. Urine microscopy answer
    B. PTH reassessment
    C. Vitamin D levels
    D.

    285. A 32 year old mountaineer has a hematocrit of 70%. What is the possible explanation?
    A. Polycythemia with dehydration…………..answer
    B. High altitude cerebral oedema
    C. High altitude pulmonary oedema
    D. Hemodilution

    286. False about C.diphtheriae is?
    A. Toxin production is chromosome mediated……………answer
    B. org cnfd by toxin production
    C. Toxic to heart and neurons
    D.

    287. True about gastric carcinoma is?
    A. Occult bleeding in stool is not seen
    B. associated with achlorhydria/hypochlorhydria………………….answer
    C. Always squamous cell carcinoma
    D. Radiosensitive

    288. Transwerfer of an amino group from an amino acid to an alpha keto acid is done by?
    A. Transweraminases ………answer
    B. Aminases
    C. Transwerketoses
    D.

    289. A patient presented with sudden onset of floaters and sensation of falling of a curtain in front of the eye. Which one of the following is the appropriate diagnosis?
    A. Retinal detachment answer
    B. Eales disease
    C. Vitreous haemorrhage
    D.

    290. A girl presented with occipital headache associated with ataxia and vertigo. Mother also has similar complaints. Most probable diagnosis is?
    A. Vestibular neuronitis
    B. Basillar migraine …………..answer
    C.
    D.

    291. Basal metabolic rate is closely associated with?
    A. Lean body mass ………….answer
    B. Body surface area
    C. Body mass index
    D.

    292. Arthropod transwermitted disease not found in India?
    A. West nile fever
    B. Dengue
    C. Yellow fever ………..answer
    D.

    293. Earliest symptom of GERD in an infant is?
    A. Respiratory distress answer
    B. Upper GI bleed
    C. regurgitation
    D.obstruction

    294. Cicatrising alopecia with perifollicular greying is most commonly associated with?
    A. Nail dystrophy
    B. Whitish lesion in the buccal mucosa
    C. Arthritis
    D. Discoid Plaques in the face answer

    295. Regarding Clostridium tetani, all are true except?
    A. Spores are resistant to heat answer
    B. 3 doses give immunity in primary immunisation
    C. Incubation period is 6-10 days
    D. Person to person transwermission does not occur

    296. Drug of choice for central diabetes insipidus?
    A. Desmopressin ……………answer
    B. Leuprolide
    C. Thiazide

    297. in 7 yr old following Sx for craniopharyngioma hormone first to b given
    Growth hormone ????
    Steroid
    Prolactin
    ACTH
    298. hypothyroidsum is seen in ...
    Hasimoto thyroidits ????

    299 one on diagnosis of diabetis isipidus all except .i dont remember options

    300. most useful in acute illness
    a.case fatalityrate ans

    301 .one on mri contrast
    a.gadollinium crosses BBB
    b.test dose should be
    c.
    302. campylobacter jejuni a/e
    a.humans r reservoirs ans (repeat)

    303 .all are used in diabetic macular edema except
    a.tamoxifen ans

    304. common cause of bilateral proptposis
    a.chloroma ans???
    there were two questions on b/l proptosis

    305. true about prion
    a.catalyses folding of other proteins ans
    totally there were three questions on prion

    306. free radicals generated by all except
    a.superoxide dismutase ans

    307. best bactericidal system
    a.cation basic protein
    b. oxygen metabolite ans
    there werwe 2 similar question oxidase is ans for the other.
  45. Guest

    Guest Guest

    Reduce indoor air pollution at home ................................................ Indoor air pollution at home can cause a host of health problems. There are many things you can do to improve the quality of the air you breathe.
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    WHAT ARE SOME OF THE SYMPTOMS THAT CAN SIGNIFY THAT MY HOME OR WORKPLACE HAS UNHEALTHY AIR?


    · Coughing
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    · Headache

    · Dizziness

    · Lethargy

    · Rashes

    · Nausea

    · Asthma


    WHAT SUBSTANCES CAUSES THE AIR INSIDE OF MY HOME OR WORKPLACE TO BE UNHEALTHY?


    There are a vast variety of reasons and some are more serious than others. The most common ones are:


    · Tobacco smoke
    · Carbon monoxide from improperly working stoves or heaters

    · Exhaust from a motor vehicle(when a garage is attached to a house)

    · Animal dander

    · Molds

    · Dust

    · Formaldehyde

    · Pesticides

    · Solvents or cleaning products

    · Airborne lead

    · Mercury vapor

    · Radon

    · Asbestos
  46. Guest

    Guest Guest

    GENERIC NAME: MIFEPRISTONE - ORAL (miff-eh-PRIH-stone)
    BRAND NAME(S): MifeprexWarning | Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage

    WARNING: Rarely, serious medical problems can occur when a pregnancy ends (e.g., due to medical abortion with medications including mifepristone, surgical abortion, miscarriage), including sometimes fatal infections and bleeding. Read the Medication Guide, read and sign the Patient Agreement, and consult your doctor if you have any questions.

    Your doctor must give you clear instructions regarding whom to call and what to do in case of an emergency (e.g., severe bleeding, infection). If you go to the emergency room or visit another health care professional, show them the Medication Guide so they know you are having a medical abortion.

    Seek immediate medical attention if you experience symptoms such as severe abdominal pain, fainting, fast heartbeat, fever lasting more than 4 hours. You may have a very serious infection even if you do not have a fever. Therefore, seek immediate medical attention if you have abdominal pain or feel sick (e.g., nausea, vomiting, diarrhea, weakness) more than 24 hours after taking the second drug (misoprostol), even if you do not have a fever. Also seek immediate medical attention if you have continued heavy bleeding, which may be a sign of an incomplete abortion or other serious medical problem. You may need surgery or other medical care. See also Side Effects section.

    USES: Mifepristone (also known as RU 486) is used to cause an abortion during the early part of a pregnancy. It is used up to week 7 of pregnancy (up to 49 days after the first day of your last menstrual period). Mifepristone blocks a natural substance (progesterone) that is needed for your pregnancy to continue. It is usually used together with another medicine called misoprostol.Mifepristone must not be used if you have a rare abnormal pregnancy that is outside the womb (ectopic pregnancy). It will not cause an abortion in this case. It may cause an ectopic pregnancy to rupture, resulting in very serious bleeding..............................so ans is fibroid?
  47. Guest

    Guest Guest

    Management of Retinoblastoma
    The most important objective in the management of a child with retinoblastoma is survival of the patient, and the second most important goal is preservation of the globe. The focus on visual acuity comes later, after safety of the patient and globe is established. Therapy is tailored to each individual case and based on the overall situation, including threat of metastatic disease, risks for second cancers, systemic status, laterality of the disease, size and location of the tumor(s), and estimated visual prognosis. There are several options for treatment of retinoblastoma, and the ocular oncologist should be thoroughly familiar with the indications, technique, and expected results of all treatment methods as well as the expected systemic and visual problems. The currently available treatment methods for retinoblastoma include intravenous chemoreduction (sometimes combined with subconjunctival chemoreduction), thermotherapy, cryotherapy, laser photocoagulation, plaque radiotherapy, external beam radiotherapy, enucleation, orbital exenteration, and systemic chemotherapy for metastatic disease. In recent years, eyes with unilateral retinoblastoma are generally managed with enucleation if the eye is classified as Reese-Ellsworth group V; for those eyes in groups I to IV, chemoreduction or focal measures are used. For bilateral retinoblastoma, chemoreduction is utilized in most cases unless there is extreme asymmetric involvement, with one eye having advanced disease necessitating enucleation while the other eye has minimal disease, treatable with focal methods. Most children with bilateral retinoblastoma are treated with chemoreduction for at least one of their two involved eyes.
    Chemoreduction
    Chemoreduction is a method of reducing tumor volume to allow for therapeutic measures that are more focused and less damaging. It has evolved to be an important measure in the initial management of retinoblas- The chemotherapeutic agents vary depending on the preference of the pediatric oncologist. We presently use carboplatin, etoposide, and vincristine ( Table 3 ). Other oncologists include only one agent (carboplatin) or two agents (vincristine, carboplatin) in their protocol. The chemotherapy regimen is generally given for 6 cycles to allow for adequate tumor reduction. Focal therapy to the individual tumors is delivered at cycle 2 after achieving adequate tumor reduction and sub-retinal fluid resolution. The objective of chemoreduction is to reduce tumor size so that focal treatments can be applied to a smaller tumor volume in order to preserve more vision and possibly avoid enucleation and external beam radiotherapy (Figure 5). We reported that the retinoblastomas decreased a mean of 35% in tumor base and nearly 50% in tumor thickness after 2 cycles of chemoreduction. Subretinal fluid resolved in 76% of cases and both vitreous and subretinal seeds showed regression with the treatment. Thus, it is apparent that retinoblastoma is sensitive to current chemo-reduction regimens.
  48. Guest

    Guest Guest

    1. Most common nerve injured in supracondylar fracture humerus?
    A. Median
    B. Radial
    C. Ulnar
    D. Anterior interosseus nerve
    Ans: D (Anterior interosseus nerve)
    2.Gastric reflux is physiological in infant but when it becomes pathological then presents with
    A. Respiratory distress
    B. Upper GI bleed
    C. Regurgitation
    D. Intestinal obstruction
    Ans: A (Respiratory distress)
    3. Basal metabolic rate is closely associated with?
    A. Lean body mass
    B. Body surface area
    C. Body mass index
    D. Body weight
    Ans: A Lean Body mass (REPEAT)
    4. A girl presented with recurrent occipital headache associated with ataxia and vertigo. There is history of Mother having similar complaints.
    Most probable diagnosis is?
    A. Vestibular neuronitis
    B. Basillar migraine
    C. TIA
    D. ¨C
    Ans: B Basilar migraine (REPEAT)
    5. Drug of choice for central Diabetes Insipidus is?
    A. Desmopressin
    B. Leuperolide
    C. Thiazide diuretics
    D. Lithium
    Ans: A Desmopressin
    6. A 32 year old mountaineer has a hematocrit of 70%. What is the possible explanation?
    A. Polycythemia with relative dehydration
    B. High altitude cerebral oedema
    C. High altitude pulmonary oedema
    D. Hemodilution
    Ans.A Polycythemia and relative dehydration
    7. Tetracycline is used in the prophylaxis of which of the following diseases?
    A. Cholera
    B. Brucellosis
    C. Leptospirosis
    D. Meningitis
    Ans: A Cholera
    8. A 7 month old child presents with complaints of recurrent bouts of cough. What is the best way to confirm the diagnosis?
    A. Nasophayngeal swab
    B. Cough plate culture
    C. Tracheal aspirate
    D. ¨C
    Ans: A Nasopharyngeal swab
    9. Aflatoxin is produced by?
    A. Aspergillus flavus
    B. Aspergillus niger
    C. Candida
    D. ¨C
    Ans: A Aspergillus Flavus
    10. Most important prognostic factor in congenital diaphragmatic hernia?
    A. Pulmonary hypertension
    B. Timing of surgery
    C. Size of defect
    D. Gestational Age
    Ans: A Pulmonary hypertension
    11. A surgeon removed the part of liver to the left of the falciform ligament. Which segments have been removed?
    A. 1 & 4a
    B. 2 & 3
    C. 1 & 4b
    D. 5 & 6
    Ans: B 2 & 3(REPEAT)
    12. Punnett square is used for
    A.Finding genotype of offspring
    B.Statistical analysis
    C¨C
    D¨C
    Ans:A Finding the genotype of the offspring
    13. Cavitation in lungs is seen in?
    A. Mycolplasma pneumonia
    B. Primary Tuberculous
    C. Streptococcal pneumonia
    D.Staphylococcal pneumonia
    Ans: D Staphylococcal Pneumonia (REPEAT)
    14. All are false with respect to PSUDOHYPOPARATHYROIDISM except?
    a. Decreased cAMP response
    b. Decreased IP3 response
    c. Increased GTPase activity
    d.Gain of function mutation of Gs alpha subunit
    Ans:A Decreased cAMP
    15. Difference between follicular carcinoma and follicular adenoma is?
    A. Vascular invasion
    B. Mitosis
    C. Nuclear pleomorphism
    D. Hurthle cells
    Ans: A Vascular invasion (REPEAT)
    16. Antidepressant drug that can be used in nocturnal eneuresis?
    A. Imipramine
    B. Fluoxamine
    C.
    D.
    Ans: A Imipramine
    17. A 40yr old female patient presented with depressed mood, loss of appetite and no interest in surroundings for the past 1yr. There is
    associated insomnia. These symptoms followed soon after a business loss 1yr back.Which of the following statements is true regarding the
    management of this patient?
    A. No treatment is necessary as it is due to business loss
    B. SSRI is the most efficacious of the available drugs
    C. Antidepressant treatment is based on the side effect profile of the drugs
    D. Combination therapy of 2 anti depressant drugs
    Ans:C Treatment is started based on the side effect profile
    18. An Infant is brought to the casualty with reports of violent shaking by parents. Most characteristic injury is?
    A. Long bone fracture
    B. Ruptured spleen
    C. Subdural hematoma
    D. Skull bone fracture
    Ans:C Subdural hematoma
    19. Gun powder on clothing can be visualized by?
    A. Magnifying lens/spray
    B. UV rays
    C. Infrared rays
    D. X Ray
    Ans:?? D X Ray/ C Infrared rays(ORIGINAL OPTIONS STILL UNCLEAR)
    20. All have polysaccharide capsule related antigen antibody response except?
    A. Neisseria meningitidis
    B. Pneumococcus
    C. Bordetella pertussis
    D. Haemophilus influenza
    Ans: C Bordetella pertusis
    21. Signature fracture refers to?
    A. Depressed skull fracture
    B. Suture displacement fracture
    C. Contrecoup injury
    D. Fracture at foramen magnum
    Ans: Depressed fracture (REPEAT)
    22. Which among the following is most frequently seen in anti phospholipid antibody syndrome?(Pls CORRECT Q)
    A. Beta 2 microglobulin antibody
    B. Anti nuclear antibody
    C. Anti centromere antibody
    D. Anti beta 2 glycoprotein antibody
    Ans: D Anti beta 2 GP Ab
    23. What factor is responsible for deciding whether an antibody will remain membrane bound or get secreted?
    A. RNA splicing
    B. Class switching
    C. Differential RNA processing
    D. Allelic exclusion
    Ans: C Differential RNA Processing(REPEAT)
    24. Blood Chimerism is associated with?
    A. Monochorionic dizygotic twins
    B. Dichorionic dizygotic twins
    C. Singleton pregnancy
    D. Vanishing twin
    Ans: A Monochorionic dizygotic twins
    25. In expectant management of placenta praevia, all are done except?
    A. Cervical encirclage
    B. Anti D
    C. Corticosteroids
    D. Blood transfusion
    Ans: A Cervical encirclage
    26. Which drug is not in the conduct of labour in a woman with rheumatic heart disease?
    A. Methylergometrine
    B. Carboprost
    C. Syntocin
    D. Misoprostol
    Ans: A Methylergometrine(REPEAT)
    27. Which is not an autoimmune disease?
    A. SLE
    B. Grave's disease
    C. Myasthenia gravis
    D. Sickle cell disease
    Ans: D Sickle Cell Disease(Sickle cell disease is a hemoglobinopathy and not an autoimmune disease)
    28. All are true regarding selective estrogen receptor downregulator (SERD),fulvestrant except?
    A. Used for breast cancer
    B. Is a selective oestrogen antagonist
    C. Is slower acting, safer, LESS effective than SERM
    D. Given as once a month im dose
    Ans: C It¡¯s slower acting and less efficacious than SERM
    29. A farmer developed swellings in the inguinal region which later ulcerated and associated with constitutional symptoms. What stain can be
    used to detect the bipolar stained organisms?
    A. Albert's stain
    B. Waysons stain
    C. Ziehl neelsen stain
    D. Nigrosin stain
    Ans: B Wayson stain(REPEAT)
    30. An 8 year old boy completed 8 out of 10 day course of cefaclor. Now he developed a generalized erythmatic rash which is mildly pruritic and
    associated lymphadenopathy. Diagnosis is?
    A. Kawasaki disease
    B. Type 3 hypersensitivity
    C. Anaphylaxis
    D. Infectious mononucleosis
    Ans: B Type 3 Hypersensitivity (REPEAT)
    31. Rave drug is?
    A. Cannabis
    B. Cocaine
    C. Heroin
    D. Esctasy
    Ans: D Esctasy
    32. How to differentiate ASD from VSD in X-ray?
    A. Enlarged Left atrium
    B. Normal left atrium
    C. Pulmonary congestion
    D. Aortic shadow
    Ans: B Normal LA size
    33. Regarding an imbecile, all are true except?
    A. IQ is 50-60 B. Intellectual capacity equivalent to a child of 3-7 years of age
    C. Not able to take care of themselves
    D. Condition is congenital or acquired at an early age
    Ans: A IQ is 50-60
    34. Which is not true regarding diet modification recommended in high cardiovascular risk group?
    A. Cholesterol less then 100 mg/1000kcal/day
    B. Avoid alcohol
    C. Saturated Fat intake 10% of total calories
    D. Salt limitation to less than 5 gm
    Ans: B Avoid alcohol(park)
    35. Maintenance dose of which of the following drugs is used worldwide for opioid dependence?
    A. Naltrexone
    B. Methadone
    C. Lmma
    D. Disulfiram
    Ans: B Methadone
    36. Best test/Gold standard test for assessing betaHCG function/action?
    A. Radioimmunoassay
    B. ELISA
    C. Latex test
    D. Bioassay
    Ans:???? A RIA / D Bioassay
    37. Vitamin K is involved in the posttranswerlational modification of?
    A. Glutamate
    B. Aspartate
    C. --
    D. ¨C
    Ans: A Glutamate(REPEAT)
    38. Spinal anaesthesia is given at which level?
    A. L1-2
    B. L3-4
    C. S1
    D. Thoracic segment
    Ans: B L3-4
    39. A child presented with mild fever little breathlessness was treated and she improved over 4 days but later deteriorated again with fever and
    more breathlessness. x ray showed hyperlucency. diagnosis?
    A.bronchiolitis obliterans
    B.alveolar proteinosois
    C.bronchitis D. Asthma
    Ans: A Bronchiolitis obliterans(REPEAT)
    40. Which of the following passes through foramen magnum?
    A. Internal Carotid Artery
    B. Sympathetic chain
    C. Hypoglossal Nerve
    D. Vertebral Artery
    Ans: D Vertebral artery (REPEAT)
    41. McKeon's theory on reduced prevalence of TB?
    A. Increased awareness and knowledge
    B. Medical advancement answer
    C. Behavioural modification
    D. Social and environmental factor
    Ans: D Social and environmental factors
    42. Which among the following is not a cause of fasting hypoglycemia?
    A. Glucagon excess
    B. Glucose 6 phospatase deficiency
    C. Ureamia
    D. Glycogen synthase deficiency
    Ans: A Glucagon excess
    43. Mineralocorticoid receptor is not present in?
    A. Liver
    B. Colon
    C. Hippocampus
    D. Kidney
    Ans:A Liver (REPEAT)
    44. Prolonged treatment with INH leads to deficiency of?
    A. Pyridoxine
    B. Thiamine
    C. Pantothenic acid
    D. Niacin
    Ans: A Pyridoxine
    45. Which is the most reliable objective sign of identifying pulmonary plethora in chest X-ray?
    A. Diameter of the main pulmonay artery >16mm
    B. Diameter of the lt pulmonay artery >16mm
    C. Diameter of the decending Rt pulmonay artery >16mm
    D. Diameter of the decending Lt pulmonay artery >16mm
    Ans: C Diameter of the decending Rt pulmonay artery >16mm (REPEAT)
    46. Necrotizing lymphadenitis is seen in?
    A. Kimura disease
    B. Kikuchi disease
    C. Hodgkin disease
    D. Castelman disease
    Ans: B Kikuchi disease (REPEAT)
    47. NARP syndrome is seen in?
    A. Mitochondrial function disorder
    B. Glycogen storage disorder
    C. Lysosomal storage disorder
    D. Lipid storage disorder
    Ans: A Mitochondrial disorder(REPEAT)
    48. A 65 yrs old lady presented with a swollen and painful knee. On examination, she was found to have grade III osteoarthritic changes. What
    is the ¡°BEST COURSE OF ACTION¡±?
    A. Conservative management
    B. Arthroscopic washing
    C. Partial knee replacement
    D. Total knee replacement
    Ans: D Total knee replacement
    THIS QUESTION IS NOT A REPEAT FROM MAY AIIMS....
    Whatever be the grade they are asking the BEST course of action and it is Total knee replacement.
    49. Causes of primary amenorrhoea are all except?
    A. Rokintasky syndrome
    B. Kallaman syndrome
    C. Sheehan syndrome D.Turner syndrome
    Ans: C Sheehan syndrome (REPEAT)
    50. Integrase inhibitor approved for treatment of HIV is?
    A. Raltegravir
    B. Indinavir
    C. Lopinavir
    D. Elvitegravir
    Ans: A Raltegravir
    51. Deoxygenated blood is not seen in
    a. Pulmonary artery
    b. Umbilical artery
    c. Umbilical vein
    d. Renal vein
    Ans: C Umbilical vein
    52. All of the following are pneumatic bones except?
    A. Frontal
    B. Ethmoid
    C. Mandible
    D. Maxilla
    Ans: C Mandible
    53. Which of the following is not a contraindication for pregnancy?
    A. WPW syndrome
    B. Pulmonary hypertension
    C. Eisenmenger syndrome
    D. Marfan syndrome with aortic root dilatation
    Ans: A WPW syndrome(REPEAT)
    54. Which of the following antihypertensive drugs is contraindicated in a patient on Lithium in order to prevent toxicity?
    A. Clonidine
    B. Beta blockers
    C. Calcium channel blockers
    D. Diuretics
    Ans: D Diuretics
    55. Superior vena caval syndrome is most commonly caused by?
    A. Lymphoma
    B. Small cell lung ca
    C. Non small cell lung ca
    D. Secondary tumours
    Ans: ????B Small cell carcinoma
    Reference: Schwartz surgery and Harrison 17th ed
    56. Which of the following is not an adverse effect of thalidomide?
    A. Diarrhoea
    B. Teratogenicity
    C. DVT
    D. Peripheral neuropathy
    Ans: A Diarrhea
    57. Blount¡¯s disease is:
    A. Genu valgum
    B. Genu varum
    C. Genu recurvatum
    D. Menisceal injury
    Ans: B Genu varum
    58. A teenaged girl complains of pain in knee on climbing stairs and on getting up after sitting for a long time. What is the probable diagnosis?
    A. Chondromalacia patellae
    B. Plica syndrome
    C. Bipartite patella
    D. Patello-femoral osteoarthritis
    Ans: A Chondromalacia patellae
    59. Which of the following is not included in parenteral nutrition?
    A. Fat
    B. Carbohydrate
    C. Fibre
    D. Micronutrients
    Ans: C Fibre
    60. Sparrow marks are seen in?
    A. Gunshot injuries
    B. Stab injury of face
    C. Vitriolage
    D. Windshield glass injury
    Ans: D Winshield glass injury
    61. Amphotericin B causes deficiency of?
    A. Na
    B. Ca
    C. K
    D. Mg
    Ans: C Potassium
    62. All are seen in injury to common peroneal nerve except?
    A. Loss of sensation over sole
    B. Foot drop
    C. Injury to neck of fibula
    D. Loss of dorsiflexion of toe
    Ans: A loss of sensation over the sole
    63. Cause of premature death in schizophrenia?
    A. Homicide
    B. Suicide
    C. Toxicity of antipsychotic drug
    D. Hospital acquired infection
    Ans:B Suicide
    64. Epileptic potential is present in
    A. Desflurane
    B. Halothane
    C. Sevoflurane
    D. Ether
    Ans: C Sevoflurane
    65. Which of the following anesthetic drugs is contraindicated in a patient with hypertension?
    A. Ketamine
    B. Propofol
    C. Etomidate
    D. Diazepam
    Ans:A Ketamine
    66. All of the following decrease bone resorption in osteoporosis except?
    A. Alendronate
    B. Etidronate
    C. Strontium
    D. Teriparatide
    Ans: D Teripartide
    67.Ondoni cells and Haller cells are associated with the following structures respectively?
    A. Optic nerve and Orbital floor answer
    B. Optic nerve and Internal carotid artery
    C. Internal carotid artery and Optic nerve
    D. Orbital floor and Internal carotid artery
    Ans: Optic nerve and Orbital floor(REPEAT)
    68. Pain sensation from the ethmoid sinus is carried by :
    A. Frontal nerve
    B. Lacrimal nerve
    C. Nasociliary nerve
    D. Infraorbital nerve
    Ans: C Nasociliary nerve which divides into the ethmoidal branches to supply the ethmoidal sinus
    69. 28-Which among the following is not used to treat alcohol dependence?
    A. Flumazenil
    B. Acamprosate
    C. Naltrexone
    D. Disulfiram
    Ans: A Flumazenil(a MODIFIED REPEAT)
    70. A 40yr old patient has a single kidney with an exophytic mass of 4 cm size at it¡¯s lower pole. Which among the following is the best course of action?
    A. Partial nephrectomy
    B. Radical nephrectomy with dialysis
    C. Radical nephrectomy with immediate renal transwerplant
    D. Observation
    Ans: A Partial nephrectomy
    71.Which among the following is the most common fungal infection seen in immuno competent patients?
    A. Aspergillus
    B. Candida
    C. Cryptococcus
    D. Mucor
    Ans: ?? B Candida / A Aspergillus 72. All are seen in Argyl Robertson pupil except?
    A. Near reflex normal
    B. Direct reflex absent
    C. Consensual reflex normal
    D. Vision normal
    Ans: C Consensual reflex is normal
    73. A 55 year old man while having dinner suddenly becomes aphonic and is brought to the casulty for the complaint of respiratory distress. What should be
    the appropriate management?
    A. Cricothyroidotomy
    B. Emergency tracheostomy
    C. Humidified oxygen
    D. Heimlich maneuver
    Ans: ????D Heimlich manoeveure
    74.Which among the following is a branch from the trunk of brachial plexus?
    A. Suprascapular nerve
    B. Long thoracic nerve
    C. Anterior thoracic nerve
    D. Nerve to subclavius
    Ans:A. Suprascapular nerve /D Nerve to subclavius.
    75.Orthotolidine test is used for detecting:
    A. Chlorine
    B. Nitrites
    C. Nitrates
    D. Ammonia
    Ans: A Chlorine
    76. Which among the following is the most common tumour associated with neurofibromatosis in a child?
    A. Juvenile myelomonocytic leukemia
    B.Acute lymphoblastic leukemia
    C. Acute monocytic leukemia
    D. Acute myeloid leukemia
    Ans: Juvenile myelomonocytic leukemia
    77. Diaphragm develops from all except:
    A. Septum transwerversum
    B. Dorsal mesocardium
    C. Pleuroperitoneal membrane
    D. Cervical myotomes
    Ans:B. Dorsal mesocardium
    78. Erythema nodosum is seen in all except:
    A. Pregnancy
    B. Tuberculosis
    C. SLE
    D. Chronic pancreatitis
    Ans: D Chronic pancreatitis
    79. Posterior relations of head of pancreas are all except?
    A. Common bile duct
    B. First part of duodenum
    C. Aorta
    D. Inferior vena cava
    Ans: B First part of Duodenum
    80. Multiple sebaceous adenoma seen in:
    A. Gardner¡¯s syndrome
    B. Turcot syndrome
    C. Muir Torre syndrome
    D. Cowden syndrome
    Ans:C Muir torre syndrome
    81. Which among the following is the hallmark of acute inflammation?
    A. Vasoconstriction
    B. Stasis
    C. Vasodilation and increase in permeability
    D. Leukocyte margination
    Ans: C Vasodilatation and increased vascular permeability(REPEAT)
    82. Which among the following does not cause hyperpyrexia?
    A. MAOI
    B. Alcohol
    C. Di nitro cresol
    D. Amphetamine
    Ans: B Alcohol
    83. All are true about pheochromocytoma except?
    A. 90% are malignant
    B. 95% occur in the abdomen
    C. They secrete catecholamines
    D. They arise from sympathetic ganglions
    Ans: A 90% are malignant...as per the rule of 10...only 10% are malignant
    84. Campylobacter jejuni false is:
    a.commonest cause of campylobacteriosis
    b.polutry source of infection
    c.humans are reservoir
    d.associated with GBS
    Answer:C humans are the reservoir(REPEAT)
    85. Which of the following does not cause indoor air pollution?
    A. CO
    B. Nitrogen dioxide
    C. Radon
    D. Mercury vapour
    Ans:D Mercury vapour
    86. Most important and potential agent that can be used in bioterrorism:
    A. Plague
    B. Small pox
    C. TB
    D. Clostridium botulinum
    Ans: PRESUMED ANSWER B(SMALLPOX)/A PLAGUE
    87. Earliest to be diagnosed by antenatal USG is?
    A. Anencephaly
    B. Prosencephaly
    C. Meningocele
    D. Spina bifida
    Ans:A Anencephaly(REPEAT)
    88. 151. Dose of radiation required for development of haematological syndrome is?
    A. 2.5-5 cGy
    B. 10 cGy
    C. 100 cGy
    D. 200 cGy
    Ans:????C 100cGy
    89. Intraoperative myocardial infarction is best diagnosed by:
    A. ECG
    B. Invasive arterial pressure
    C. Central venous pressure
    D. Transwer esophageal echo
    Ans: D TEE(REPEAT)
    90. Pseudoisomorphic phenomenon seen in
    A. Psoriasis
    B. Lichen planus
    C. Vitiligo
    D. Plane warts
    Ans: D Plane warts
    91. A fire breaks out during laser vocal cord surgery. What is not to be done?
    A. Pouring sterile water into the oral cavity
    B. Removing endotracheal tube
    C. 100% oxygen after discontinuing anesthetic gases
    D. Treatment with steroid & antibiotic
    Ans: ???
    92. Ovoalbumin was injected into a rabbit. What antibody will it produce initially?
    A. IgG
    B. IgM
    C. IgE
    D. IgD
    Ans: B IgE
    Reference:Microbiology by Paniker
    93. Which insect among the following is not resistant to DDT?
    A. Musca domestica
    B. Phlebotomus
    C. Culex
    D. Anopheles stephensi
    Ans:B Phlebotomus
    94. Which virus among the following is least likely to cross placenta?
    A. Rubella
    B. Herpes simplex
    C. HIV
    D. HBV
    Ans:???
    95. About yaws all are true except:
    A. Caused by Treponema pertenue
    B. Transwermitted non-venerally
    C. Secondary yaws can involve bones
    D. Last stages involve heart and nerves
    Ans: D Late stages involve heart and nerves
    96. Weight gain in pregnancy is related to all except?
    A. Ethnicity
    B. Smoking
    C. Socioeconomic status
    D. Pre conceptional weight
    Ans: B Smoking (REPEAT)
    97. A 3.8 kg baby of a diabetic mother developed seizures 16 hours after birth. Most probable cause is?
    A. Hypoglycemia
    B. Hypocalcemia
    C. Birth asphyxia
    D. Intra ventricular hemorrhage
    Ans: A Hypoglycemia(REPEAT)
    [snip]. Regarding PCOD, all are true except?
    A. High LH/FSH
    B. High DHEAS
    C. Very high prolactin
    D. Raised LH
    Ans: C Very high prolactin(REPEAT)
    99. Which anesthetic modality is to be avoided in sickle cell disease?
    A. General anesthesia
    B. Brachial plexus block
    C. IV regional anesthesia
    D. Spinal
    Ans: C IV regional anesthesia(REPEAT)
    100. Best marker for intrahepatic cholestasis of pregnancy is?
    A. Liver enzymes
    B. Bile acid
    C. Bilirubin
    D. ALP
    Ans: B Bile acids
    101. Which of the following is the most probable diagnosis in a young patient with loss of central vision and a normal ERG with no family history?
    A. Best's disease
    B. Stargardt's disease
    C. Retinitis pigmentosa
    D. Macular hole
    Ans:B Stargardt disease
    102. Renal calculi associated with proteus infection is:
    A. Uric acid
    B. Triple phosphate
    C. Calcium oxlalate
    D. Xanthine
    Ans:B Triple phosphate(REPEAT)
    103. The primary action of NO in git is?
    A. Vasodilatation
    B. Vasoconstriction
    C. GI smooth muscle inhibition
    D. Secretomotor
    Ans:C GI smooth muscle inhibition(REPEAT)
    104. A 40 year old female underwent surgery. Post operatively she told the anaesthetist that she was aware of per-operative events. Individual intraoperative
    awareness is evaluated by (to prevent such instances from occurring)?
    A. Pulse oximetry
    B. Colour doppler
    C. Bispectral index
    D. End tidal CO2
    Ans:C BSI
    105. All of the following helps in generating oxygen burst for killing bacteria within neurophils except?
    A. Superoxide dismutase
    B. Oxidase
    C. Peroxidase
    D. Glutathione peroxidise
    Ans:D Glutathione peroxidise
    106. Most common cause of meningoencephalitis in children?
    A. HSV
    B. Enterovirus
    C. Mumps
    D. Listeria
    Ans:B Enterovirus(REPEAT)
    107. Principle orgenelle involved in the execution of apoptosis is?
    A. Nucleus
    B. Lysosome
    C. Mitochondria
    D. Endoplasmic reticulum
    Answer:C Mitochondria(REPEAT)
    108. Feature of obstructive azoospermia is?
    A. High FSH, high testosterone
    B. Low FSH, high testosterone
    C. High FSH, low testosterone
    D. Normal FSH, normal testosterone
    Ans:D NORMAL Testosterone and FSH(REPEAT)
    109. 'C' in C reactive protein stands for:
    A. Capsular polysaccharide in pneumococcus
    B. Concanavalin-a
    C. Calretinin
    D. Cellular
    Ans:A Capsular polysaccharide of pneumococcus(REPEAT)
    110. Buprenorphine is?
    A. Partial agonist at Mu Receptor
    B. Partial agonist at Kappa Receptor
    C. Full Agonist at Mu Receptor
    D. Antagonist at Kappa receptor
    Ans:A Partial agonist of mu receptor
    111.All are true about aprepitant except?
    A. Agonist at NK1
    B. Crosses blood brain barrier
    C. Ameliorates nausea and vomiting of chemotherapy
    D. Metabolized by CYP450
    Ans:A Agonist at NK1 Receptor
    112. Time of occurrence of secondary haemorrhage after tonsillectomy?
    A. 24 hrs
    B. 6 days
    C. 12 days
    D. 12 hrs
    Ans: 6 Days
    113. A patient with head injury on examination revealed eye opening in response to pain, inappropriate words and pain localisation. Calculate GCS?
    a. 10
    b. 8
    c. 12
    d. 14
    Ans: A 10
    114. A primigravida in 1st trimester had sputum positive for acid fast bacillus. What is the preferred treatment?
    A. Treatment deferred till 2nd trimester
    B. Category 1 DOTS
    C. Category 2 DOTS
    D. Category 3 DOTS
    Ans:B Category 1 DOTS(REPEAT)
    115. HbH is seen in?
    A. Deletion of 3 alpha gene
    B. Deletion of all 4 alpha genes answer
    C. Deletion of 3 beta genes
    D. Deletion of all 4 beta genes
    Ans:A Deletion of 3 alpha genes
    116. Which among the following is a cardioprotective fatty acid?
    A. Palmitic acid
    B. Stearic acid
    C. Oleic acid
    D. Omega-3 fatty acids
    Ans:D Omega-3 fatty acids(modified repeat)
    117. What will you give to treat hypothyroidism in a patient with ischemic heart disease?
    A. Low dose of levothyroxine
    B. Normal dose of levothyroxine
    C. Do not give levothyroxine
    D. Thyroid extract
    Ans:A Low dose of levothyroxine
    118. Carrier state is not important in transmission of:
    A. Measles
    B. Typhoid
    C. Polio
    D. Diphtheria
    Ans:A Measlers(REPEAT)
    119. A schizophrenic patient started on haloperidol 2 days back, comes with complaints of torticollis and orofaciolingual movements. What is the diagnosis?
    A. Acute dystonia
    B. Tardive dyskinesia
    C. Parkinsonism
    D. Akathisia
    Ans:A Acute Dystonia
    120. All are true about parvovirus b19 except?
    A. <10 % spread by transplacental route
    B. Spread by respiratory route
    C. It is a DNA virus
    D. Affects erythroid progenitor cells
    Ans:A <10% spread by transplacental route(REPEAT)
    121. Sterile pyuria is present in?
    A. Renal tuberculosis
    B. Chronic hydronephrosis
    C. Wilm's tumour
    D. Neuroblastoma
    Ans:A Sterile pyuria(REPEAT)
    122. A 35 year old female has proximal weakness of muscles, ptosis and easy fatiguability. The best test to diagnose her condition is:
    A. Muscle biopsy
    B. CPK
    C. Edrophonium test
    D. EMG
    Ans:C Edrophonium test(REPEAT)
    123. Denominator in Maternal Mortality Rate?
    A. Total number of live births
    B. Total number of married women
    C. Total number of births
    D. Midyear population
    Ans:A Total live births(REPEAT)
    124. Psammoma bodies are seen in all except?
    A. Follicular carcinoma thyroid
    B. Papillary carcinoma thyroid
    C. Cystadenocarcinoma
    D. Meningioma
    Ans:A Follicular carcinoma thyroid(REPEAT)
    125. Visceral larva migranswer is seen in?
    A. Strongyloides
    B. Ancylostoma
    C. Toxocara canis
    D. Visceral leishmaniasis
    Ans:A Toxocara canis
    126. Urethral crest is situated in:
    A. Prostatic urethra
    B. Membranous urethra
    C. Penile urethra
    D. Bulbar urethra
    Ans:A Prostatic urethra
    127. People were separated into relevant 5 sub groups. People were selected randomly from these sub groups. What type of sampling was done?
    A. Simple random sampling
    B. Stratified Sampling
    C. Cluster sampling
    D. Systematic sampling
    Ans:A Stratified sampling
    128. All of the following are true about erlotinib except?
    A. Tyrosine kinase inhibitor
    B. Food decreases its absorption
    C. Rashes can occur
    D. Used in non small cell lung cancer when there is no response to other chemotherapeutic agents
    Ans:B Food decreases its absorption
    129Best marker for open nural tube defect.
    A.Acetylcholinesterase
    B.Pseudocholinesterase
    C.AFP
    D. ¨C
    Ans:A Acetylcholinesterase(REPEAT)
    130. Arthropod transmitted disease not found in India?
    A. West nile fever
    B. Dengue
    C. Yellow fever
    D. ¨C
    Ans:C Yellow fever
    131. A 55 year old man presents with history of 5 episodes of hematuria each lasting for about 4-5 days in the past 5 years. What will be the best investigation
    to arrive at a diagnosis?
    A. Urine examination and microscopy
    B. X-ray KUB
    C. Abdominal USG
    D. DTPA scan
    Ans:???
    132. A graph of Normal blood sugar level curve and Diabetic blood sugar level curve was shown. An area was seen overlapping towards the normal gycemic
    curve. A point at 120 mg/dl was shown too. Question : What does that area represent?
    A. True positive
    B. False positive
    C. True negative
    D. False negative
    Ans:D False negative
    133. Which among the following not used in diagnosis of insulinoma?
    A. Fasting glucose test
    B. Xylulose test
    3. C peptide levels
    4. Insulin / glucose ratio
    Ans:B xylose test
    134. All are true about Nesidioblastosis except ?
    A. Hypoglycemic episodes are seen
    B. Occurs in adults more than children
    C. Histopathology shows hyperplasia of islet cells
    D. Diazoxide is used for treatment
    Ans:B Occurs in adults more than children
    135. Gold standard test for diagnosis of laryngopharyngeal reflux?
    A. 24 hr double probe pH monitoring
    B. Flexible endoscopy
    C. Barium swallow
    D. Laryngoscopy
    Ans: A 24hr double probe pH monitoring
    136. Acoustic neuroma involves
    A. Superior vestibular division of 8th cranial nerve
    B. Auditory part of 8th cranial nerve
    C. 7th cranial nerve
    d. Inferior vestibular division of 8th cranial nerve
    Ans:??? D Inferior vestibular nerve(CONFUSING QUESTION OF THE DECADE¡ªlet us not waste time discussing which is the answer...we shall
    assume we made a mistake in this question no matter what option u have marked!!---AIIMS only knows the answer)
    137. A patient had running nose and pain over medical aspect of eye. He later developed chemosis,protosis and diplopia on abduction of right eye with
    congestion of optic disc. What is the probable diagnosis?
    A. Acute ethmoidal sinusitis
    B. Orbital cellulitis
    C. Cavernous sinus thrombosis
    D. Orbital apex syndrome
    Ans:C Cavernous sinus thrombosis(REPEAT)
    138. An anesthesia resident was giving spinal anaesthesia when the patient had sudden aphonia and loss of consciousness. What could have happened?
    A. Total spinal
    B. Partial spinal
    C. Vaso vagal attack
    D. Intra vessel injection
    Ans:A Total spinal(REPEAT)
    139. Urea cycle occurs in:
    A. Liver
    B. G.I.T.
    C. Spleen
    D. Kidney
    Ans:A Liver
    140. Right isomerism is?
    A. Asplenia
    B. Two spleens
    C. One spleen
    D. Polysplenia
    Ans:A Asplenia
    141. Definitive airway is all except?
    A. Nasotracheal tube
    B. Orotracheal tube
    C. LMA(Laryngeal mask airway)
    D. Cricothyroidectomy
    Ans: c LMA
    142. A primigravida at 37 weeks of gestation with loss of engagement and Cervix 1cm dilated for the past 10hrs. What is management?
    A. Sedate the patient and wait
    B. LSCS
    C. Amniotomy and augmentation with oxytocin
    D. Induction with membrane rupture
    Ans:A Sedate the patient and wait (REPEAT)
    143. Regarding anterior choroidal artery syndrome, all are true except?
    A. Hemipareisis
    B. Hemisensory loss,
    C. Involvement of anterior limb of internal capsule
    D. Homonymous hemianopia
    Ans:C Invovement of anterior limb of internal capsule
    144. A 15 day old baby came with history of seizures. Blood tests revealed Ca 5mg/dl, PO4 9mg/dl, PTH 30pg/ml (n=10-60). What is the most probable
    diagnosis?
    A. Pseudohypoparathyroidism
    B. Vitamin D deficiency
    C. Hyperparathyroidism
    4. HIE
    Ans:A Pseudohypoparathyroidism
    145. Thiamine deficiency causes decreased energy production because?
    A. It is required for the process of transweramination
    B. It is a co-factor in oxidative reduction
    C. It is a co-enzyme for transwerketolase in pentose phosphate pathway
    D. It is a co-enzyme for pyruvate dehydrogenase & alpha ketoglutarate dehydrogenase
    Ans:D It is a co-enzyme for pyruvate dehydrogenase & alpha ketoglutarate dehydrogenase
    146. Mother to baby transmission of HIV can be minimised by all except?
    A. Zidovudine
    B. Vitamin A
    C. Vaginal delivery
    D. Avoidance of breast feeding
    Ans: C Vaginal delivery(REPEAT)
    147. True regarding leptospirosis is?
    A. Rats are the main reservoirs
    B. Fluroquinolones are the DOC
    C. Person to person transrmission
    D. Hepatorenal syndrome occurs in 50% cases
    Ans: A Rats are the main reservoirs
    148. 18 year old male presents with hemetemesis, melena and splenomegaly. What is the probable initial diagnosis?
    A. NCPF
    B. Cirrhosis
    C. Malaria with DIC
    D. Extra hepatic portal venous obstruction
    Ans:A NCPF(REPEAT)
    149. Following are true about carbohydrate antigen except?
    A. Memory
    B. Poly clonal response
    C. Poor immunogenicity
    D. T cell independent immunity
    Ans:A Memory(REPEAT)
    150. Ideal age for surgery in unilateral undescended testis is?
    A. 6 months
    B. 12 months
    C. 24 months
    D. 36 months
    Ans:B 12months OR A 6 months(convincing evidence for both answers exist)
    151. A 45 year old lady presented with DUB & USG finding of 8mm thick endometrium. What is the next step?
    A. Endometrial histopathology
    B. Hysterectomy
    C. OCP
    D. Follow up
    Ans:A Endometrial histopathology(REPEAT)
    152. Fallopian tube immotility is seen in?
    A. Churg strauss syndrome
    B. Kartagener's syndrome
    C. Noonan syndrome
    D. Turner syndrome
    Ans:B Karteagener syndrome(REPEAT)
    153. First structure to be fixed after amputation is?
    A. Bone fixing
    B. Arterial repair
    C. Venous repair
    D. Nerve repair
    Ans:A Bone fixing
    154. Poor prognostic factor for ALL is?
    A. Hyperdiploidy
    B. t(9;22) t(4;11)
    C. 2-8 yrs of age
    D. TLC < 50000
    Ans:B . t(9;22) t(4;11)
    155. Most potent activator of T cells?
    A. B cells
    B. Follicular dendritic cells
    C. Mature dendritic cells
    D. Macrophages
    Ans:C Mature dendritic cells(REPEAT)
    156.Not a disorder of protein misfolding ?
    A. Alzheimer's disease
    B. Tuberculosis
    C. Cystic fibrosis
    D. CJD
    Ans: B TB
    157. Aortic knuckle shadow on PA CXR, obliterated by consolidation of which portion of lung?
    A.upper lingula
    B.lower lingula
    C.apex of lower lobe
    D.posterior part of upper lobe
    Answer-D. Posterior part of upper lobe.
    158. CT least accurate for:
    A. 1 cm of aneurysm in hepatic artery
    B.1 cm of lymph node in para-aortic region
    C.1 cm of pancreas mass in tail
    D. 1cm gall stone
    Ans:????D 1cm gall stones (reference is still inadequate)
    159.Best investigation for bone metastases:
    a.MRI
    b.CT
    c.bone scan
    d. x ray
    Ans:????C Bone scan
    160. Compliance is decreased in all except?
    A. Pulmonary congestion
    B. Emphysema
    C. Decreased surfactant
    D. Chronic bronchitis
    Ans:D Chronic bronchitis
    161. A 70yr old presents with intemittent jerks of recent origin, EEG showing bilateral periodic spikes. What is the most probable diagnosis?
    A. Hepes simplex encephalitis
    B. Lewy body dementia
    C. Alzheimer's
    D. CJD
    Ans:D CJD
    162. Pulmonary toxicity is seen with?
    A. Bleomycin
    B. Cisplatin
    C. Methotrexate
    D. Actinomycin D
    Ans:A Bleomycin
    163. 92 young male presented with history of fever and a nodule in the leg. Histopathology of the nodule revealed foamy histiocytes and neutrophillic infiltrate
    in the dermis. Most probable diagnosis is?
    A. Sweet's syndrom
    B. Rosai Dorfman disease
    C. Erythema Nodosum Leprosum
    D.erythema nodosum
    Ans: A Sweet syndrome(REPEAT)
    164. Medical treatment for variceal bleed is by?
    A. Octreotide
    B. Pantaprazole
    C. Desmopressin
    D.¡ª
    Ans: A Octreotide
    165. All are true statements regarding use of sodium fluoride in the treatment of otosclerosis except?
    A. It inhibits osteblastic activity
    B. Used in active phase of otosclerosis when schwartz
    C.Nephritis is a contraindication D.It decreases the release of osteolytic enzymes
    Ans:A inhibits osteblastic activity(REPEAT)
    166. A patient who was given primaquin develops hemolysis. Diagnosis is
    A. Glucose 6 phosphate dehydrogenase deficiency
    B. Glucose 6 phosphatase deficiency
    C. --
    D. ¨C
    Ans:A G6PD deficiency
    167. 86 true regarding ranula?
    A. It is also known as epulis
    B. It is a cystic swelling in the floor of mouth
    C. It is a type of thyroglossal cyst
    D. It is a type of mucus retention cyst
    Ans:B It is a cystic swelling in the floor of mouth
    168.Which of the following is not an evidence based treatment for menorrhagia?
    A. Ethamsylate
    B.OCP
    C.Tamoxefene
    D. ¨C
    Ans:A Ethamsylate(REPEAT)
    169. A 3.8 kg baby of a diabetic mother developed seizures 16 hours after birth. Most probable cause is?
    A. Hypoglycemia
    B. Hypocalcemia
    C. Birth asphyxia
    D. Intra ventricular hemorrhage
    Ans: A Hypoglycemia(REPEAT)
    170. 74 coarctation of aorta mc asso with
    1.Bicuspid aortic valve
    2.PDA
    3. Aortic stenosis
    4. --
    Ans:A Bicuspid aortic valve(REPEAT)
    171. Anaesthetic agent with vasoconstrictor is contraindicated in?
    A. Finger block
    B. Spinal block
    C. Epidural block
    D. Regional anaesthesia
    Ans:A Finger block(REPEAT)
    172. 63Auto-Rikshaw ran over a child¡¯s thigh, there is a mark of the tyre tracks, it is an
    A. Contact bruise
    B. Patterned bruise
    C. Imprint abrasion
    D. Ectopic bruise
    Ans:C Imprint abrasion(REPEAT)
    173. Tolerance in opioids develops to all except?
    A. Miosis
    B. Analgesia
    C. Euphoria
    D. Nausea and vomiting
    Ans: A Miosis
    174. The bifurcation of Common carotid artery is palpated at?
    A. Upper border of cricoid cartilage
    B. Upper border of thyroid cartilage
    C. Hyoid bone
    D. Cricothyroid membrane
    Ans:????B Upper border of thyroid cartilage
    175. Pregnant mother at 35 weeks of gestation. What drug can you not give her for treatment of SLE?
    A. Prednisolone
    B. Methotrexate
    C. Sulfsalazine
    D. Hydroxychloroquine
    Ans:B Methotrexate(REPEAT)
    176. All are true about xanthogranulomatous inflammation except?
    A. Presence of foamy macrophages
    B. Associated with TB
    C. Multinucleated giant cell
    D. Presence of yellow Nodules
    Ans:B Associated with TB(REPEAT)
    177. Clue Cells are seen in :
    A. Bacterial vaginosis
    B. Vaginal candidiasis
    C. Chlamydial vaginosis
    D. Trichomoniasis
    Ans: A Bacterial Vaginosis (REPEAT)
    178. Which complement component is involved in both classical and alternate pathway?
    A. C1
    B. C2
    C. C3
    D. C4
    Ans:C C3(REPEAT)
    179. Which of the following are not associated with menstrual cycle?
    A. Hormonal changes
    B. Vaginal cytology changes
    C. Estrus profile
    D. Endometrial changes
    Ans:C Estrous Profile (REPEAT)
    180. Alkalanization of Urine is done during administration of which of the following chemotherapeutic drugs?
    A. ara-c
    B. Mtx
    C. cisplatin
    D. Ifosfamide
    Ans:A Methotrexate
    181. The Progesterone in low dose OCP is?
    A.Norethisterone
    B.Levonegestrol
    C.Desgestrol
    D.¡ª
    Ans: C Desogestrel > B Levonorgestrel(unless proved 182. Test of Pasterurized milk is performed by:
    A. Phosphatase test
    B. Coliform test
    C. Catalase test
    D. Methylene blue test
    Ans:A Phosphatase test(REPEAT)
    183. All are true about delirium tremens except?
    A. Visual hallucinations
    B. Coarse tremors
    C. Third Nerve palsy
    D. Altered consciousness
    Ans:C Third Nerve Palsy
    184. Main site of water absorption is:
    A. Jejunum
    B. Colon
    C. Ileum
    D. Stomach
    Ans:A Jejunum (REPEAT)
    185. Pentalogy of fallot has which one of following extra entities:
    A. ASD
    B. VSD
    C. RVH
    D. Pulmonary stenosis
    Ans:A ASD(REPEAT)
    186. All of the following are done in management of shoulder dystocia except?
    A. Fundal pressure
    B. Suprapubic pressure
    C. McRoberts manoeuvre
    D. Woods manoeuvre
    Ans:A Fundal pressure(REPEAT)
    187. About Human Development Index, all are true except?
    A. Life expectancy at birth
    B. Life expectancy at 1 year of age
    C. Education
    D. GDP
    Ans: B. Life expectancy at 1 year of age(REPEAT)
    188.A 50yr old patient presents with 2 yrs h/o recurrent abdominal pain, radiating to back, relived only by parenteral analgesic. USG & CT confirmed the
    diagnosis ,appropriate procedure is?
    A.vagotomy with Gastroduodenostomy
    B.vagotomy with antrectomy
    C.whipple procedure
    D.Longitudinal pancreaticojejunostomy
    Ans:D Longitudinal Pacreaticojejunostomy
    189. A young lady presents with fever , dysuria and pain abdomen . Uncomplicated acute cystitis was diagnosed . Which of these is false ?
    A.Nitrate test positive
    B.e.coli count was < 10 power 3
    C.1 pus cell per 7 field
    D.1 bacilli per field
    Ans: ??? B
    190. In a 5 year old child the burn area corresponding to thesize of palm is equal to
    A. 1% BSA
    B. 5% BSA
    C. 10% BSA
    D.20% BSA
    Ans:A 1%
    191 What is the type of joint seen in the growth plate?
    A. Fibrous
    B. Primary cartilagenous
    C. Secondary cartilagenous
    D. Plane joint
    Ans:B Primary cartilaginous joint(REPEAT)
    192.The acid base status of a patient is as follows : pH - 7.45, pCO2 - 30 mm of Hg, pO2 - 105 mm of Hg. Patient has partially compensated?
    A. Metabolic acidosis
    B. Metabolic alkalosis
    C. Respiratory acidosis
    D. Respiratory alkalosis
    Ans:D Respiratory alkalosis(No explanation needed)
    193 A female presents with sings of meningitis. CSF shows gram positive bacilli. It is most probably?
    A. Listeria
    B. Haemophilus influenzae
    C. Pneumococcus
    D. Staphylococcus
    Ans:A Listeria
    194.A 50 yr lady has history of sprained ankle 2 months back followed by recovery. She now complains of severe pain in that ankle with inability to flex that
    foot. Physician notes edema and shiny skin in local examination. What is the probable diagnosis:
    A. Fibromyalgia
    B. Complex regional pain syndrome 1
    C. Complex regional pain syndrome 2
    D. Peripheral neuropathy
    Ans:B Complex regional pain syndrome 1
    195.Drug given for bone megakaryocyte stimulation in patient of thrombocytopenia..?
    1.filgastrim
    2.oprevelkin
    3.--
    4.¡ª
    Ans: B Oprelvekin
    196. A man presents with maculopapular rash 2weeks after having a painless genital.Causative organism of the condition is:
    A.treponema pallidum
    B.chlamydia
    C.c.granulomatis
    D.H.ducreyi
    Ans:A Treponema pallidum(Its 197. A patient with stab injury presents with with omentum protruding in the umbilical area ,vitals stable.The next step in the management of the patient is:
    A.FAST
    B.LAPAROTOMY
    C.WOUND EXPLORATION
    D.CECT ABDOMEN
    Ans:???C Wound Exploration
    198. Site not affected in posterior cerebral artery infarct is?
    A. Midbrain
    B. Pons
    C. Thalamus
    D. Striate Cortex
    Ans:B Pons
    199. A poison Illuminous, translucent, waxy
    A. Yellow phosphorus
    B. Arsenic
    C. Thalium
    D. ?
    Ans:A Yellow phosphorous
    200 . A pt comes with history of unresponsive fever n cough. xray shows pneumonia,sputum reveals aerobic, gram positive and partially acid fast branching
    filaments.Causative organism is?
    A. Actinomycosis
    B. Nocardiosis
    C. Aspergillus
    D.¡ª
    Ans:B Nocardiosis
    201. Which among the following is the best inotrope drug for use in right heart failure with primary pulmonary hypertension?
    A. Dopamine
    B. digoxin
    C. Isoprenaline
    D. Milrinone
    Ans:D Milrinone
    202. Which of the following helps in generating oxygen burst for killing bacteria within neurophils ?
    A. Superoxide dismutase
    B. Oxidase
    C. Peroxidase
    D. Glutathione reductase
    Ans:B Oxidase(REPEAT)
    203. Main blood supply of neck of femur?
    A. Lateral circumflex femoral
    B. Medial circumflex femoral
    C. Profunda femoris answer
    D. Popliteal artery
    Ans: B Medial circumflex femoral artery
    204. All are actions of muscarinic antagonist except?
    A. Decreases gastric secretion
    B. Prolongs a-v conduction
    C. Decreases respiratory secretions
    D. Contraction of radial muscles of iris
    Ans:D Contraction of radial muscles of Iris
    205. All are used in the treatment of hot flushes except?
    A. Tamoxifene
    B. Venlafaxine
    C.
    D.
    Ans:A Tamoxifen(REPEAT)
    206.Pearson's skewness coefficient is?
    A. (Mean-mode)/SD
    B. Mode-mean/SD
    C. SD/mean-mode
    D. SD/mode-mean
    Ans- mean-mode/SD
    207. Best treatment option for genuine stress incontinence?
    A. Burch colposuspension
    B. Kelly¡¯s procedure
    C. Sling operation
    D. Tension free vaginal taping
    Ans:???A Burch colposuspension
    208. Lines of blaschko are:
    A. Lymphatics
    B. Blood vessel
    C. Nerves
    D. Lines of development
    Ans:D Lines of development
    209. All are true about meglitinides except?
    A. Decreases post parandial hyperglycemia
    B. Hypoglycemia less common than sulfonylureas
    C. It decreases insulin resistance
    D. It acts by releasing insulin .
    Ans:C It decreases Insulin resistance
    210. All are true regarding serotonin syndrome except?
    A. It is not idiosyncratic but predictable
    B. Dantrolene is the drug of choice for the condition
    C. ssri can cause it.
    D. Cause increase in BP and Temperature.
    Ans:B Dantrolene is the drug of choice for the condition(A Query on the exact wordings of the 2nd option exists¡ªharrison does mention
    dandrolene in treatment of serotonin syndrome,but its not the drug of choice)
    211. All of the following are neuronal tumours except?
    A. Gangliocytoma
    B. Ganglioglioma
    C. Neuroblastoma
    D. Ependymoma
    Ans:D Ependymoma
    212. Orthopnoea in right heart failure develops due to?
    A. Reservoir function of pulmonary veins
    B. Reservoir function of leg veins
    C. --
    D. ¨C-
    Ans:B Reservoir function of leg veins
    213. Commonest cause for bilateral proptosis in children?
    A. Cavernous haemangioma
    B. Chloroma
    C. Histiocytoma
    D. ---
    Ans:D Chloroma
    214.Most common malignant cause of proptosis in children?
    A. A. Cavernous haemangioma
    B. Rhabdomyosarcoma
    C. ALL
    D. AML
    Ans:B Rhabdomyosarcoma
    215. Blood examination of a patient revealed Ca 12.5, Po4 4.5 and Alkaline Phosphatase 900IU/L. Which of the following investigations need not be done?
    A. Urine microscopy
    B. PTH reassessment
    C. Vitamin D levels
    D. Bone study.
    Ans:Urine microscopy
    216. Most useful indicator for acute illness
    A.case fatality rate
    B. --
    C. --
    D. ¨C-
    Ans:A Case fatality rate(REPEAT)
    217.Endolymphatic Hydrops is seen in
    A. Meniere¡¯s disease
    B.Otosclerosis
    C.¡ª
    D.¡ª
    Ans:A Meniere¡¯s disease
    218. about contrast radiography true is (HIGHLY UNCLEAR ON OPTIONS)
    a.3 parts of iodine with 2 parts of solvent
    b.injection into artery is associated with 1/3 times more complication than injection into a vein
    c.Test dose should be performed if a contrast reaction is suspected
    d.¡ª
    Ans:C Test dose should be performed if a contrast reaction is suspected(Logical)
    219. A female with XO genotype and Primary amenorrhoea most likely diagnosis is?
    A. Gonadal dysgenesis
    B. Androgen insensitivity syndrome.
    C. MRKH
    D. ¨C
    Ans:A Gonadal dysgenesis
    220. 1.Cicatrising alopecia with perifolicular blue-gray pathches (??) is most commonly associated with
    A. Nail dystrophy
    B. Whitish lesion in the buccal mucosa
    C. Arthritis
    D. Discoid Plaques in the face
    Ans:???B. Whitish lesion in the buccal mucosa
    221.Transfer of an amino group from an amino acid to an alpha keto acid is done by?
    A. Transaminases
    B. Aminases
    C. Transketoses
    D. ¨C
    Ans:A Transaminases
    222. True about gastric carcinoma is?
    A. Occult bleeding in stool is not seen
    B. Often associated with achlorhydria/hypochlorhydria
    C. Always squamous cell carcinoma
    D. Radiosensitive
    Ans:B. Often associated with achlorhydria/hypochlorhydria
    223. A boy gets hit by a tennis ball in the eye following which he has complaints of decreased vision. Which of the following tells that blunt injury is due to the ball.
    1. Optic neuritis
    B. Pars planitis
    C. Vitreous base detachment
    D. Equatorial edema
    Ans: C Vitreous base detachment
    224. False about C.diphtheriae is?
    A. Toxin production is chromosome mediated
    B. org cnfd by toxin production
    C. Toxic to heart and neurons
    D. toxin blocks protein synthesis
    Ans:A Toxin production is chromosome mediated
    225. True regarding drug resistance of MRSA? (was a long stem though)
    A. Penicillinase enzyme production
    B. Due to change in penicillin binding receptors
    C. plasmid mediated
    D. Treated with amoxicillin clavulanic acid
    Ans:B Due to change in penicillin binding receptors
    226. Muscular component of dorsal aorta develops from?
    A. Axial mesoderm
    B. Paraxial mesoderm
    C. Intermediate mesoderm
    D. Lateral plate mesoderm
    Ans: B. Paraxial mesoderm
    227. Dental numbering is done by all except?
    A. FDI two digit system
    B. Anatomic and diagramatic charting
    C. Palmer notation
    D. ¨C
    Ans: ???Cant arrive at a conclusion without the 4th option since all the above are used
    228. False about pneumococcus is?
    A. Capsule aids in virulence
    B. Commonest cause of otitis media and pneumonia
    C. Meningitis caused by it is milder than other
    D. ---
    Ans:C Meningitis caused by it is milder than other organisms
    229. False regarding Japanese encephalitis is:
    A. Epidemic is 2-3 cases in a village
    B. Mosquito bite is always associated with disease
    C. 70 in infants
    D. Apparent and nonapparent ratio 1:100
    Ans:B Mosquito bite is always associated with disease
    230. True in keto acidosis is..
    A. Decreased HCO3
    B. Increased levels of lactate
    C. --
    D. ¨C
    Ans:A Decreased Hco3
    231. A 6 week old male infant was brought in a state of dehydration and shock. Examination revealed hyper pigmentation over the body with normal external
    genitalia. Blood tests revealed hypoglycemia, Na - 124 mEq/L and K - 7 mEq/L. What is the probable diagnosis ?
    A. Congenital adrenal hyperplasia
    B. Adrenal haemorrhage and shock
    C. Acute gastroenteritis with dehydration
    D. ¨C
    Ans:A CAH(modified REPEAT)
    232. All of the following are true regarding diabetes mellitus except?
    A. Insulin is not used in type 2 diabetes
    B. Sliding scale regimen is used in hospitals
    C. --
    D. ¨C
    Ans:A Insulin is not used in type 2 DM
    233. Which among the following is an early sign of magnesium toxicity?
    A. Loss of deep tendon reflexes
    B. Respiratory depression
    C. Cardiac arrest
    D. Decreased urine output
    Ans:A Loss of DTR
    234. All of the following are affected in low radial nerve palsy except?
    A. Extensor carpi radialis longus
    B. Extensor carpi radialis brevis
    C. Finger extensors
    D. Sensation on dorsum of hand
    Ans:A ECRL(REPEAT)
    235. A man connected to a body plethysmograph exhales against a closed glottis. What will be the finding?
    A. The pressure in both the lungs and the box increases
    B. The pressure in both the lungs and the box decreases
    C. The pressure in the lungs decreases, but that in the box increases
    D. The pressure in the lungs increases, but that in the box decrease
    Ans: ???
    236. A patient presents with fever and abdominal pain. Clinical examination reveals hepatomegaly extending 4 finger breadths below the costal margin. USG
    reveals a 5cm*5cm*4cm hypodense lesion 1cm deep to liver surface. Tests for hydatid disease were -ve. Best course of action is?
    A. Multiple aspirations,antiamebics and antibiotics
    B. Catheter drainage with antiamebics and antibiotics
    C .Hepatectomy
    d.. Medical management with antiamebics and antibiotics
    Ans: ??????
    237. All are true about blood coagulation except?
    A. Factor 10 in a part of both intrinsic and extrinsic pathway
    B. Extrinsic pathway is activated by contact with plasma and negatively charged proteins
    C. Calcium is very important for coagulation
    D. Intrinsic pathway can be activated in vitro
    Ans: B. Extrinsic pathway is activated by contact with plasma and negatively charged proteins
    238. Late onset endophthalmitis after lens implantation is caused by?
    A. Staphylococcus epidermidis
    B. Pseudomonas
    C. Streptococcus pyogenes
    D. Propionibacterium acnes
    Ans:????A Staph epidermidis/D Propionibacterium acnes
    239. All are seen in the floor of 3rd ventricle except?
    A. Infundibulum
    B. Oculomotor nerve
    C. Mammillary body
    D. Optic stalk
    Ans:D. Optic stalk
    240. Which among the following is not a component of dhypogastric sheath?
    A. Broad ligament
    B. Uterosacral ligament
    C. lateral ligament
    D. Ligament of bladder
    Ans:A Broad ligamnent of uterus ---a peritoneal reflection
    241. A patient presents with signs of pneumonia. The bacterium obtained from sputum was gram positive cocci which grew on sheep agar. What test is used to
    identify the type of organism?(Question stem incomplete---though it seemed like pneumococcal pneumonia)
    A. Bile solubility
    B. Bacitracin sensitivity
    C. Coagulase test
    D. ¨C
    Ans:A Bile solubility
    242. True about platelet function defect?
    A. Normal platelet count with prolonged bleeding time
    B. Thrombocytosis with prolonged bleeding time
    C. --
    D. --
    Ans: A. Normal platelet count with prolonged bleeding time
    243. After removal of pituitary for craniopharyngioma, first drug given is?
    A.cortisone
    B.GH
    C. --
    D. ¨C
    Ans:A Cortisone
    244. A 5 year old child presented with ballooning of perpuce while micturition. Perpuce adhesions were present. What is the best treatment for him?
    A. Adhesiolysis and dilatation
    B. Circumcision
    C. Dorsal slit
    D. Conservative
    Ans:B Circumscision
    245. Which of the following process in a vector is used to increase the yield of protein produced in recombinant protein synthesis?
    A. Promoter induction
    B. Genes for protease inhibitors
    C. Translation initiation
    D. Translation and transcription termination
    Ans:A Promoter induction(logically from these options---u need to increase transcription and then only translation---mere increase in translation
    will not increase protein output...so induce a promoter get more mrna and then more protein via translation---hypothetical
    explanation----absolutely no references...so subject to change in the light of better evidences)
    246. VERSION 1:
    Which of the following is not associated with atherosclerotic plaque formation?
    A.Plasma ApoE
    B. alpha 2-macroglobulin
    C. Oxidised LDL
    D. Increased homocystiene
    Ans:B alpha 2 macroglobulin
    VERSION 2:
    Increased levels of which of the following is not associated with atherosclerotic plaque formation?
    A.Plasma ApoE
    B. alpha 2-macroglobulin
    C. Oxidised LDL
    D. Increased homocystiene
    Ans:Both A and B
    247. Least common cause of ambiguous genitalia in a female child?
    A. Placental steroid sulfatase deficiency
    B. Fetal aromatase deficiency
    C. WT-4 mutation
    D. CAH
    Ans: A. Placental steroid sulfatase deficiency
    248.A patient presented to the with bluish pigmentation of conjunctiva, mucous membranes, nails. What is the poison:
    A. Mercury
    B. Arsenic
    C. Lead
    D. Silver
    Ans:D Silver
    249. Damage to Superior oblique nerve causes diplopia
    A. Horizontal and downward
    B. Vertical and downward
    C. Horizontal and upward
    D. Vertical and upward
    Ans:B. Vertical and downward
    250. Which of the following contraception method is contraindicated in women with epilepsy?
    A. Oral Contraceptive pill
    B. IUCD
    C. Condom
    D. POP
    Ans:A. Oral Contraceptive pill
    251. Which of the following is not supplied by the anterior division of mandibular nerve (V3) ?
    A. Temporalis
    B. Medial pterygoid
    C. Lateral pterygoid
    D. Masseter
    Ans:B. Medial pterygoid
    252. Which of the following is a contraindication for medical treatment in gallstones?
    A. Radio opaque stones
    B. Radiolucent stones
    C. Normal functioning gall bladder
    D. Small stones
    Ans:A. Radio opaque stones
    253. Which organ obtained from a cadaver is not used for transplantation?
    A. Blood vessel
    B. Lung
    C. Liver
    D. Bladder
    Ans:D. Bladder
    254. Baby born at 33 weeks / 1.5 kg should be started on?
    A. Nil oral and IV fluids
    B. Oral nasogastric tube/alternate oral route
    C. IV fluids and oral feeding
    D. TPN
    Ans:B. Oral nasogastric tube/alternate oral route
    255. ECG is poor at detecting ischaemia in areas supplied by?
    A. Left anterior descending
    B. Left circumflex
    C. Left coronary artery
    D. Right coronary artery
    Ans:B. Left circumflex
    256. Slide fixing in pathology most commonly done by
    A.formaldehyde
    B.alcohol
    C.picric acid
    D.glutraldehyde
    Ans:A.formaldehyde
    257.Standardization done for
    A.Age difference
    B.
    C.
    D.
    Ans:A.Age difference
    258. Most common site of obstruction after TURP?
    A. Navicullar foss
    B. Bulb
    C. Prostatic membranous urethra
    D. Bladder neck
    Ans:D. Bladder neck
    259. Rise in end tidal CO2 during thyroid surgery can be due to all except:
    A. Anaphylaxis
    B. Malignant hyperthermia
    C. Thyroid storm
    D. Neuroleptic malignant syndrome
    Ans:A. Anaphylaxis
    260. A 6 year old child presents with pain and tenderness in hip in femoral triangle region.limitation of movements, X-ray does not reveal any abnormality. What is the next step?
    A. USG
    B. MRI
    C. Aspiration
    D. Wait and watch
    Ans:???
    261. All are true except:
    A. Human anatomical waste is disposed in a yellow bag
    B. Red bag contents can be a source of contamination
    C. Black bag is used for incineration ash
    D. Blue bag contents are always disposed in secure landfill
    Ans:D. Blue bag contents are always disposed in secure landfill
    262. Methods of cell fusion for producing monoclonal antibodies are all except?
    A. Attaching inactive viral particle on cell membrane
    B. Adding ethylene glycol
    C. Applying a small electric current
    D. Reducing the viscosity of the membrane
    Ans:??D. Reducing the viscosity of the membrane
    263. Ophtalmoplegic migrain..
    A.Headache with reversible lose of ophthalmic nerve function
    B.
    C.
    D.
    Ans:A.Headache with reversible lose of ophthalmic nerve function
    264. Which among the following is preferred in a patient with decreased renal functio to avoid contrast nephropathy?
    A. N acetylcysteine
    B. Fenoldopam
    C. Low osmolar contrast
    D. Mannitol
    Ans:??? A/C
    265. A patient presented with an abdominal injury with peritonitis and shock. Airway, breathing and IV fluids for circulation were taken care of. What is the next step of management?
    A. Take the patient for laparotomy under GA
    B. Take the patient go for a laparoscopy
    C. Insert an abdominal drain under LA and take up for surge...
    D.
    Ans:???
    266. A investigator finds out that 5 independent factors influence the occurrence of a disease. Comprision of multiple factors responsible for a disease can be assessed by?
    A. ANOVA
    B multiple linear regression
    C. Krushak vaill test
    D. multiple logistic regression
    Ans:C. Krushak vaill test
    267. Not a part of national screening program?
    A. Diabetes mellitus
    B. Dental caries
    C. Refractive error
    D. Carcinoma cervix
    Ans:???B. Dental caries
    268.About diabetes insipidus all true except
    A.Water deprivation test is diagnostic.
    B.Before doing test first correct hypoaldosteronism.
    C.Hypothyroidism not affect the diagnostic test.
    D.Pre test serum osmolarity 288, before giving vasopressin.
    Ans:???
    269. Which of the following is true?
    A. Acetylcholinesterase inhibition by malathion can be reversed by increasing the level of atropine
    B. Sulphonilamide inhibits folate reductase irrevesibly
    C. Flouoroacetate competetively inhibits aconitase
    D. Ethanol inhibits aldehyde dehydrogenase when used in methanol poi...
    Ans:C. Flouoroacetate competetively inhibits aconitase
    270. During TURP, surgeon takes care to dissect above the verumontenum so as to prevent injury to?
    A. External urethral sphincter
    B. Urethral crest
    C. Prostatic utricle
    D. trigone of bladder
    Ans:A. External urethral sphincter
    271. A neonate delivered at 38 weeks of gestation, birth weight of 2.2kg develops intolerance to feeds on 2nd day. Physical examination reveals no abnormalities. Sepsis screen in negative. And PVC is 70% What is the next step in management?
    A. IV fluid
    B. Presumptive trearment of sepsis
    C.
    D.
    Ans:???
    272.What is false about lipoproteins.
    A.HDL inhibit oxidation of LDL
    B.Oxidize LDL not present in foam cells
    C.
    D.
    Ans:B.Oxidize LDL not present in foam cells
    273. Drugs used in prophylaxis of migraine are all except?
    A. Propranolol
    B. Flunarizine
    C. Topiramate
    D. Levetiracetam
    Ans:D. Levetiracetam
    274. Two plants are grown. One in green fluorescent pigment containing media. Other in fire fly luciferase containing media. Which plant will glow in the dark?
    A. Both plants will glow
    B. Neither will glow
    C. First one will glow
    D. Second one will glow
    Ans:D. Second one will glow
    275. In L5 root involvement, which among the following is not affected?
    A. Thigh adduction
    B. Knee flexion
    C. Knee extension
    D. Toe extension
    Ans:A. Thigh adduction
    276. A child presents with abdominal pain only during passage of stools. No other symptoms like vomiting or blood in stools. There are no signs of intestinal obstruction. Most probable diagnosis is?
    A. Rectal polyp
    B. Intusseception
    C. Meckels diverticulum
    D. NEC
    Ans:???
    277. All are true about ranalozine except?
    A. Causes hypotension
    B. It is recommended as first line treatment for angina
    C. Improves glycemic control
    D. anti anginal
    Ans:???
    278. Mr X is a chronic smoker. His family insists on quitting smoking. He is thinking about quitting, but is reluctant to do so because he is worried that on quitting he will become irritable. This is?
    A. Precontemplation and preparation
    B. Contemplation and extent of sickness susceptability
    C. Contemplation and cost factors D. Precontemplation and cost factors
    Ans:B. Contemplation and extent of sickness susceptability
    279. All are true about world health report 2008 except?
    A. Social reforms
    B. Leadership reforms
    C. Polices reforms
    D. Economic reforms
    Ans:??
    280. Small air way has laminar flow because?
    A. Reynold number more than 2000
    B. Diameter is very small
    C. Density very high / velocity very high
    D. Total cross sectional area low Ans:B. Diameter is very small
    281. Vectors don't transmit infection by?
    A. Ingestion
    B. Regurgitation
    C. Rubbing of feces
    D. Contamination with body fluids
    Ans:A. Ingestion
    282. All are factors responsible for resurgence of malaria except?
    A. Drug resistance
    B. Use of bed nets
    C. Vector resistance
    D. Mutation in parasite
    Ans:B. Use of bed nets
    283. A 5 yr old boy presented with leukocoria in right eye ball, while other eye had 2-3 small lesions in the periphery. What will be the ideal management for this patient?
    A. Enucleation of both eyes
    B. Enucleation of right eye & conservative management for the other eye
    C. Enucleation for right eye and
    radiotherapy for the other eye
    D. 6 cycles of chemotherapy
    Ans:D. 6 cycles of chemotherapy
    284. All are true regarding phagocytosis by protozoa except?
    A. Amoeba n other unicellular org make their living out of it
    B. Phagocytose particles of <0. 5 microns size
    C. Phagocytose particles of > 0.5 microns size
    D. Digestion occurs within phagolysosomes
    Ans:B. Phagocytose particles of <0. 5 microns size
    285. A lady who presented with hematuria on evaluation was found to have stage 2 transweritional cell carcinoma of bladder. Which of the following is true?
    A. 70% chance of requiring cystectomy in 5 yrs
    B. Cystoscopic fulguration will have to be done
    C. A 10 year history of beedi smoking is not a risk factor
    D. There is no chemotherapy available
    Ans:A. 70% chance of requiring cystectomy in 5 yrs
    286. A sewer worker presented with fever. Lab findings revealed renal failure with increased BUN and serum creatinine. What is the most appropriate drug to give him?
    A. Cotrimoxazole
    B. Erythromycin
    C. Ciprofloxacin
    D.Benzyl penicillin
    Ans:D.Benzyl penicillin
    287.True about epidural opioids are all except?
    A. Acts on dorsal horn substantia gelatinosa
    B. Can cause Itching
    C. Function of the intestines are not affected
    D. Can cause respiratory depression
    Ans: C Function of the intestine is not affected (better among the options)
    288. True regarding chlamydia trachomatis is?
    A. Culture of purulent endocervical discharge is used for isolation of organism
    B. Patient using OCP's are carriers
    C.
    D.
    Ans:B. Patient using OCP's are carriers
    289. 8 yr old with sign of meningitis and ear infections with ring enhancement in the fronto temporal lobe all can cause it except
    A.H.infuenzeae(dhingra)
    B.staphylococcus
    C.pneumococcus
    D.pseudomonas
    Ans:A.H.infuenzeae(dhingra)
    290. 1yr old child present with growth failure,dry skin and palpable thyroid, what is cause?
    A.Hormonal dysregulation.
    B.Dysgenesis
    C.
    D.
    Ans:??B.Dysgenesis
    291. All are non deleberate measures for control of mosquito except?
    A. Use of alkaline soap water in factory
    B. Use of larvicidal agents
    C. Community participation
    D. use of bed nets for mosquito
    Ans:A. Use of alkaline soap water in factory
    292. A patient presented with sudden onset of floaters and sensation of falling of a curtain in front of the eye. Which one of the following is the appropriate diagnosis?
    A. Retinal detachment
    B. Eales disease
    C. Vitreous haemorrhage
    D.
    Ans:A. Retinal detachment
    293. Regarding Clostridium tetani, all are true except?
    A. are resistant to heat
    B. 3 doses give immunity in primary immunisation
    C.Incubation period is 6-10 days
    D. Person to person transmission does not occur
    Ans:A. are resistant to heat
    294. Mifepristone is used in?
    A. Molar pregnancy
    B. Threatened abortion
    C. Fibroid
    D. Ectopic pregnancy¡­
    Ans:C Fibroid
    295. Not a disorder of protein misfolding ?
    A. Alzheimer's disease
    B. Tuberculosis
    C. Cystic fibrosis
    D. CJD
    Ans: B TB
    296.Which of the following drug is not used for medical treatment of diabetic retinopathy?
    A.Tamoxifen
    B.
    C.
    D.
    Ans:A.Tamoxifen
    297.Which is not seen in digoxin toxicity?
    A. Biventricular tachycardia
    B. atrial tachycardia with variable AV block
    C. Ventricular bigeminy
    D. Regularisation of AF
    Ans:D. Regularisation of AF
    298.Patient prestent with high TSH, low T4, what is the diagnosis?
    A.Grave's disease
    B.Hashimoto's disease
    C.Pituitary failure
    D.Hypothalamic failure
    Ans:B.Hashimoto's disease
    299.Patient having pain in epigastrium which radiates to back, serum amylase is normal, on x ray gall stone seen and pancrease appeares bulky..
    A.Acute Pancreatitis
    B.Acute cholecyctitis
    C.Duodenal ulcer
    D.
    Ans:A.Acute Pancreatitis
    300.
    A.
    B.
    C.
    D.
    Ans:
  49. Guest

    Guest Guest

    Q-All of the following are neuronal tumours except?
    A. Gangliocytoma
    B. Ganglioglioma
    C. Neuroblastoma
    D. Ependymoma

    Ans-none(if these were the options),all are seen
    Ref-
    The new WHO Classification of Tumors affecting the Central Nervous System
    by Stephen B. Tatter, M.D., Ph.D.
    • Neuroepithelial tumors
    • Non-neuroepithelial tumors
    • Astrocytic lineage tumor grading systems
    • Mutations leading to astrocytic tumors
    • Reference
    • Links to other information on tumors affecting the central nervous system

    In 1993 the WHO ratified a new comprehensive classification of neoplasms affecting the central nervous system. The classification of brain tumors is based on the premise that each type of tumor results from the abnormal growth of a specific cell type. To the extent that the behavior of a tumor correlates with basic cell type, tumor classification dictates the choice of therapy and predicts prognosis. The new WHO system is particularly useful in this regard with only a few notable exceptions (for example all or almost all gemistocytic astrocytomas are actually anaplastic and hence grade III or even IV rather than grade II as designated by the WHO system). The WHO classification also provides a parallel grading system for each type of tumor. In this grading sytem most named tumors are of a single defined grade. The new WHO classification provides the standard for communication between different centers in the United States and around the world. An outline of this classification is provided below.

    Neuroepithelial Tumors of the CNS
    1. Astrocytic tumors [glial tumors--categories I-V, below--may also be subclassified as invasive or non-invasive, although this is not formally part of the WHO system, the non-invasive tumor types are indicated below. Categories in italics are also not recognized by the new WHO classification system, but are in common use.]
    1. Astrocytoma (WHO grade II)
    1. variants: protoplasmic, gemistocytic, fibrillary, mixed
    2. Anaplastic (malignant) astrocytoma (WHO grade III)
    1. hemispheric
    2. diencephalic
    3. optic
    4. brain stem
    5. cerebellar
    3. Glioblastoma multiforme (WHO grade IV)
    1. variants: giant cell glioblastoma, gliosarcoma
    4. Pilocytic astrocytoma [non-invasive, WHO grade I]
    1. hemispheric
    2. diencephalic
    3. optic
    4. brain stem
    5. cerebellar
    5. Subependymal giant cell astrocytoma [non-invasive, WHO grade I]
    6. Pleomorphic xanthoastrocytoma [non-invasive, WHO grade I]
    2. Oligodendroglial tumors
    1. Oligodendroglioma (WHO grade II)
    2. Anaplastic (malignant) oligodendroglioma (WHO grade III)
    3. Ependymal cell tumors
    1. Ependymoma (WHO grade II)
    1. variants: cellular, papillary, epithelial, clear cell, mixed
    2. Anaplastic ependymoma (WHO grade III)
    3. Myxopapillary ependymoma
    4. Subependymoma (WHO grade I)
    4. Mixed gliomas
    1. Mixed oligoastrocytoma (WHO grade II)
    2. Anaplastic (malignant) oligoastrocytoma (WHO grade III)
    3. Others (e.g. ependymo-astrocytomas)
    5. Neuroepithelial tumors of uncertain origin
    1. Polar spongioblastoma (WHO grade IV)
    2. Astroblastoma (WHO grade IV)
    3. Gliomatosis cerebri (WHO grade IV)
    6. Tumors of the choroid plexus
    1. Choroid plexus papilloma
    2. Choroid plexus carcinoma (anaplastic choroid plexus papilloma)
    7. Neuronal and mixed neuronal-glial tumors
    1. Gangliocytoma
    2. Dysplastic gangliocytoma of cerebellum (Lhermitte-Duclos)
    3. Ganglioglioma
    4. Anaplastic (malignant) ganglioglioma
    5. Desmoplastic infantile ganglioglioma
    1. desmoplastic infantile astrocytoma
    6. Central neurocytoma
    7. Dysembryoplastic neuroepithelial tumor
    8. Olfactory neuroblastoma (esthesioneuroblastoma)
    1. variant: olfactory neuroepithelioma
    8. Pineal Parenchyma Tumors
    1. Pineocytoma
    2. Pineoblastoma
    3. Mixed pineocytoma/pineoblastoma
    9. Tumors with neuroblastic or glioblastic elements (embryonal tumors)
    1. Medulloepithelioma
    2. Primitive neuroectodermal tumors with multipotent differentiation
    1. medulloblastoma
    1. variants: medullomyoblastoma, melanocytic medulloblastoma, desmoplastic medulloblastoma
    2. cerebral primitive neuroectodermal tumor
    3. Neuroblastoma
    1. variant: ganglioneuroblastoma
    4. Retinoblastoma
    5. Ependymoblastoma

    Other CNS Neoplasms
    1. Tumors of the Sellar Region
    1. Pituitary adenoma
    2. Pituitary carcinoma
    3. Craniopharyngioma
    2. Hematopoietic tumors
    1. Primary malignant lymphomas
    2. Plasmacytoma
    3. Granulocytic sarcoma
    4. Others
    3. Germ Cell Tumors
    1. Germinoma
    2. Embryonal carcinoma
    3. Yolk sac tumor (endodermal sinus tumor)
    4. Choriocarcinoma
    5. Teratoma
    6. Mixed germ cell tumors
    4. Tumors of the Meninges
    1. Meningioma
    1. variants: meningothelial, fibrous (fibroblastic), transitional (mixed), psammomatous, angiomatous, microcystic, secretory, clear cell, chordoid, lymphoplasmacyte-rich, and metaplastic subtypes
    2. Atypical meningioma
    3. Anaplastic (malignant) meningioma
    5. Non-menigothelial tumors of the meninges
    1. Benign Mesenchymal
    1. osteocartilaginous tumors
    2. lipoma
    3. fibrous histiocytoma
    4. others
    2. Malignant Mesenchymal
    1. chondrosarcoma
    2. hemangiopericytoma
    3. rhabdomyosarcoma
    4. meningeal sarcomatosis
    5. others
    3. Primary Melanocytic Lesions
    1. diffuse melanosis
    2. melanocytoma
    3. maliganant melanoma
    1. variant meningeal melanomatosis
    4. Hemopoietic Neoplasms
    1. malignant lymphoma
    2. plasmactoma
    3. granulocytic sarcoma
    5. Tumors of Uncertain Histogenesis
    1. hemangioblastoma (capillary hemangioblastoma)
    6. Tumors of Cranial and Spinal Nerves
    1. Schwannoma (neurinoma, neurilemoma)
    1. cellular, plexiform, and melanotic subtypes
    2. Neurofibroma
    1. circumscribed (solitary) neurofibroma
    2. plexiform neurofibroma
    3. Malignant peripheral nerve sheath tumor (Malignant schwannoma)
    1. epithelioid
    2. divergent mesenchymal or epithelial differentiation
    3. melanotic
    7. Local Extensions from Regional Tumors
    1. Paraganglioma (chemodectoma)
    2. Chordoma
    3. Chodroma
    4. Chondrosarcoma
    5. Carcinoma
    8. Metastatic tumours
    9. Unclassified Tumors
    10. Cysts and Tumor-like Lesions
    1. Rathke cleft cyst
    2. Epidermoid
    3. Dermoid
    4. Colloid cyst of the third ventricle
    5. Enterogenous cyst
    6. Neuroglial cyst
    7. Granular cell tumor (choristoma, pituicytoma)
    8. hypothalamic neuronal hamartoma
    9. nasal glial herterotopia
    10. plasma cell granuloma
    A number of grading systems are in common use for tumors of astrocytic lineage (i.e. astrocytomas, anaplastic astrocytomas and glioblastomas). Grades are assigned solely based on the microsopic appearance of the tumor. The numerical grade assigned for a given tumor, however, can vary depending on which grading system is used as illustrated by the following table. Thus, it is important to specify the grading system referred to when a grade is specified. The St. Anne/Mayo grade has proven to correlate better with survival than the previously common Kernohan grading system. It can only be applied to invasive tumors of astrocytic lineage; it is otherwise similar to the WHO grading system.

    Grading of astrocytic tumors
    WHO designation WHO grade* Kernohan grade* St. Anne/Mayo grade St. Anne/Mayo criteria
    pilocytic astrocytoma I I excluded -
    astrocytoma II I, II 1 no criteria fulfilled
    2 one criterion: usually
    nuclear atypia
    anaplastic III II, III 3 two criteria: usually
    (malignant)astrocytoma nuclear atypia and mitosis
    glioblastoma IV III, IV 4 three or four criteria:
    usually the and/or necrosis

    *The WHO and Kernohan systems are not criteria based. Thus, a given tumor may not fall under the same designation in all three systems.
  50. Guest

    Guest Guest

    Q-All are seen in injury to common peroneal nerve except?
    A. Loss of sensation over sole
    B. Foot drop
    C. Injury to neck of fibula
    D. Loss of dorsiflexion of toe

    Ans-loss of sensation over sole

    Ref-

    “LESIONS OF THE COMMON FIBULAR NERVE
    • The common fibular nerve is relatively unprotected as it traverses the lateral aspect of the neck of the fibula and is easily compressed at this site, e.g. by plaster casts or ganglia.
    • The nerve may also become entrapped between the attachments of fibularis longus to the head and shaft of the fibula. Traction lesions can accompany dislocations of the lateral compartment of the knee, and are most likely to occur if the distal attachments of biceps and the ligaments that insert into the fibular head are avulsed, possibly with a small part of the fibular head: because the nerve is tethered to the bicipital tendon by dense fascia, it is pulled proximally.
    • Patients with such injury present with a foot drop which is usually painless. Examination reveals weakness of ankle dorsiflexion, extensor hallucis longus and eversion of the foot, but inversion and plantar flexion are normal and the ankle reflex is preserved.
    • SINCE THE COMMON FIBULAR NERVE DIVIDES AT THE FIBULAR NECK into the superficial and deep fibular nerves, injuries to the nerve at this level may damage either the main trunk or its branches.”

    MEDIAL PLANTAR NERVE
    The MEDIAL PLANTAR NERVE IS THE LARGER TERMINAL DIVISION OF THE TIBIAL NERVE, and lies lateral to the medial plantar artery. From its origin under the flexor retinaculum, it passes deep to abductor hallucis, then appears between it and flexor digitorum brevis, gives off a medial proper digital nerve to the hallux, and divides near the metatarsal bases into three common plantar digital nerves.
    Cutaneous branches pierce the plantar aponeurosis between abductor hallucis and flexor digitorum brevis to SUPPLY THE SKIN OF THE SOLE OF THE FOOT
    ----------------------Gray's Anatomy, 40th Edition

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