DNB DEC 2010 QUESTIONS WITH REF. ANSWERS

Discussion in 'Dental PG MDS IQE MFDS ADC Exams' started by Guest, Dec 18, 2010.

  1. Guest

    Guest Guest

    PHARMACOLOGY
    1. All the following drugs are teratogenic except:
    A. Alcohol
    B. Phenytoin
    C. Warfarin
    D. Chlorpropramide

    KDT/6TH/85
    Alcohol- foetal alcohol syndrome: IUGR, low IQ, microcephaly, facial & other abnormalities.
    Phenytoin- hydantoin syndrome: hypoplastic phalanges, cleft lip/palate, microcephaly
    Warfarin- foetal warfarin syndrome: depressed nose, eye & hand defects. anticoagulant of choice during Pregnancy- Heparin.
    regarding chlorpropamide KDT/267 mentions "safety of sulfonylureas during pregnancy is not established- change over to insulin" however it is not mentioned in list of teratogenic drugs.

    hence best answer is D
  2. Guest

    Guest Guest

    2. Which antineoplastic drug has a very high cardiac toxicity?
    A. Bleomycin
    B. Actinomycin-D
    C. Doxorubicin
    D. Mitomycin-C

    KDT/6th/ 826
    Doxorubicin & Daunorubicin both produce cardiotoxicity - arrythmias, or cardiomyopathy leading to CHF.
    bleomycin- pulmonary fibrosis, mucocutaneous toxicity.
    Actinomycin D- bone marrow suppression, desquamation of skin. highly efficacious in Wilms' tumour.
    Mitomycin C- bone marrow & git toxicity.

    Answer- C
  3. Guest

    Guest Guest

    3. Which ststement among the following is correct regarding Imipenem?
    A. It is a narrow spectrum penicillin.
    B. It is not resistant to beta lactamases.
    C. It is used with Cilastin.
    D. it is used with Sulbactum.

    KDT/6th/ 708

    Imipenem :
    extremely potent & broad spectrum penicillin.
    resistant to most beta lactamases.'
    rapidly hydrolysed by dehydropeptidase-1 located on the brush border of renal tubular cells. Cilastin is a dehydropeptidase 1 inhibitor.

    Sulbactum is a beta lactamase inhibitor used parenterally with ampicillin.
    Clasvulanic Acid - suicide inhibitor of beta lactamases used with amoxicillin (coamoxiclav)
    Tazobactam- used with piperacillin.
  4. Guest

    Guest Guest

    4. All the following drugs are given by sublingual route EXCEPT:
    A. Isosorbide dinitrate
    B. Buprenorphine
    C. Glyceryl trinitrare
    D. Isosorbide-5-mononitrate

    answer is D

    KDT/6th/7, 526
    drugs given sublingually are:
    GTN
    Buprenorphine
    desamino-oxytocin
    isosorbider dinitrate

    nitrates used orally ( & NOT SUBLINGUALLY)
    isosorbide-5- mononitrate
    Erythrityl tetranitrate
    Pentaerythritol tetranitrate

    related impt topic
    GTN should not be administered if

    systolic bp < 90 mm Hg.
    Heart rate <50 or >100.
    right ventricular infarction is suspected.
    pt. has taken Sildenafil in past 24 hrs.
  5. Guest

    Guest Guest

    5. Regarding Sildenafil, all the following statements are correct EXCEPT:
    A. It is a Phosphodiesterase 5 inhibitor.
    B .It increases libido & prolongs duration of orgasm.
    C. It should not be used by a patient on nitrates.
    D. Adverse effects are due to inhibition of CYP 3A.

    Answer is B.

    KDT/6th/ 295-96
    "Sildenafil is ineffective in men who have lost libido or when Erectile Dysfunction is due to cord injury or damaged nervi eregantis."

    " Sildenafil is erroneously perceived as an aphrodisiac"

    impt points:
    Sildenafil also inhibits PDE-6 weakly- impairment of colour vision esp. blue-green discrimination.

    other PDE-5 inhibitors: Tadalafil, Vardenafil.

    PDE-5 inhibitor of choice in Pulmonary Artery Hypertension: Sildenafil.

    PDE-3 inhibitors : Amrinone, Milrinone : used in CHF.
  6. Guest

    Guest Guest

    6. Nasal Calcitonin spray is used in treatment of:
    A. Paget's disease.
    B. Post-menopausal Osteoporosis.
    C. Secondary Hyperparathyroidism.
    D. Hypercalcemia of malignancy.

    Ans is B.

    KDT/6th/330

    " A nasal spray formulation delivering 200 IU per actuation has become available. one spray daily increases bone mineral density in menopausal women"

    " It is less effective than HRT/BPNs"

    Uses of Calcitonon:
    post menopausal osteoporosis
    hyperparathyroidism
    hypervitaminosis D
    Hypercalcemia of malignancy
    Paget's disease
  7. Guest

    Guest Guest

    7. All the following adverse effects can be caused by Loop Diuretics EXCEPT:
    A. Hypercalcemia
    B. Hyperglycemia.
    C. Hypomagnesemia.
    D. Hyperuricemia.


    answer is A.

    KDT/6th/567
    Loop diuretics on chronic use cause Hypocalcemia while thiazides cause Hypercalcemia.

    Adverse effect specific to Loop DIuretics:
    Hearing loss
    Hypocalcemia
    excess use causes dehydration & fall in bp.

    Adverse effect specific to thiazide Diuretics:
    Hypercalcemia.

    Adverse effects common to both loop & thiazide diuretics:
    Hypokalemia.
    Hypomagnesemia.
    Hyperglycemia.
    Hyperlipidemia.
    Hyperuricemia.

    CONTRAINDICATION FOR DIURETIC USE:
    Edema due to Toxemia of Pregnancy.
  8. Guest

    Guest Guest

    8. Lugol's Iodine contains:
    A. 5 % iodine & 10 % KI
    B. 10 % iodine & 20 % KI
    C. 10 % iodine & 15 % KI
    D. 5 % iodine & 15 % KI

    ANS - A

    KDT/6th/252
  9. Guest

    Guest Guest

    9. All the following statements regarding Adenosine are true EXCEPT:
    A. Dipyridamole potentiates its action.
    B. Used to produce controlled Hypotension.
    C. Administered by slow I.V. injection.
    D. Administered by rapid I.V. injection.

    ANS- C

    KDT/6th/ 518

    Adenosine:
    Drug of choice for acute Rx of PSVT.
    very short t1/2- 10 sec.
    administered by rapid iv injection over1-2 sec.
    dipyridamole potentiates its action by inhibiting uptake into RBC & endothelial cells where it is degraded to 5-AMP & inosine.

    "Adenosine has to be rapidly injected in a large Vein & has brief action."
  10. Guest

    Guest Guest

    10. Among the folowing, which one is a long acting Beta agonist?
    A. Salbutamol.
    B. Propranolol
    C. Salmeterol
    D. Terbutaline.

    ANS_C

    KDT/6th/218
  11. Guest

    Guest Guest

    11. Which among the following is NOT a beta lactamase resistant Penicillin?
    A. Methicillin
    B. Carbenicillin
    C. Nafcillin.
    D. Oxacillin.

    ANS- B

    KDT/6th/700

    Penicillinase resistant Penicillins:
    Methicillin
    Cloxacillin
    Oxacillin
    Dicloxacillin
    Flucloxacillin (Floxacillin)
    Nafcillin

    Carbenicillin:
    it is an extended spectrum penicillin active against Pseudomonas & Proteus.
    "It is neither Penicillinase resistant nor acid resistant."
  12. Guest

    Guest Guest

    12. Regarding Phenytoin all the following are correct EXCEPT:
    A. It acts on voltage sensitive neuronal Na+ channels.
    B. used by slow IV injection in status epilepticus.
    C. Kinetics change from 1st order to 0 order over therapeutic range.
    D. It inhibits microsomal enzymes.

    ANS_D

    KDT/6th/404-05

    PHENYTOIN induces microsomal enzymes & increases degradation of Steroids, Digitoxin, Doxycycline, etc.
  13. Guest

    Guest Guest

    13.Vomiting is mediated by
    A. 5 HT1 receptor
    B. 5 HT2 receptor
    C. 5 HT3 receptor
    D. 5 HT4 receptor

    ANS-C
  14. Guest

    Guest Guest

    14. All the following drugs act on the microtubular protein Tubulin EXCEPT:
    A. Colchicine
    B. Vincristin
    C. Bleomycin.
    D. Paclitaxel.

    ANS- C

    KDT/6th/824-25-26,206

    MECHANISM OF ACTION
    Colchicine: cause Metaphase arrest by binding to microtubules of mitotic spindle. By binding to fibrillar protein Tubulin, it inhibits granulocyte migration into the inflamed joint in gout.

    Vinca alkaloids: prevent polymerisation of tubulin & cause disruption of mitotic spindle.

    Taxanes (Paclitaxel & Docetaxel) : enhances polymerisation of tubulin, stabilise microtubules & prevent their depolymerisation.

    IMPT Q : Anti-neoplastic drug with mechanism of action exactly opposite to Vincristine : Paclitaxel/ Docetaxel.

    REGARDING BLEOMYCIN:
    IT ACTS BY INHIBITING DNA REPAIR.
  15. Guest

    Guest Guest

    15. All the following drugs are reversible inhibitors of COX EXCEPT:
    A.Diclofenac.
    B.Ibuprofen.
    C. Aspirin.
    D. Indomethacin.

    ANS- C

    KDT/185
    "Aspirin inhibits COX irreversibly , other NSAIDs are competitive & reversible inhibitors of COX."



    16. Most effective method of treatment of Digitalis toxicity is:
    A. Hemodialysis.
    B. Cardioversion.
    C. Digoxin Antibody.
    D. Atropine.


    ANS- C

    KATZUNG/9th e/212

    "Severe Digitalis intoxication patients are best treated with insertion of a temporary cardiac pacemaker catheter and administration of DIGITALIS ANTIBODIES."

    Cardioversion : digitalis induced arrythmias are frequently made worse by cardioversion.

    Atropine: indicated only if there is A-V block. (KDT/499)


    17. Which antifungal drug is an anti-metabolite?
    A. ketoconazole.
    B. Flucytosine.
    C. Terbinafine.
    D. Griseofulvin.

    ANS- B

    KDT/761

    "Flucytosine (5-FC) is a pyrimidine antimetabolite.
    It is taken up by fungal cells & converted into 5- Fluorouracil."




    18. Indications for use of anti-cholinergics include all EXCEPT:
    A. Glaucoma
    B. Parkinsonism.
    C. Refraction testing.
    D. Organophosphorus poisoning

    ANS- A

    KDT/112-113, 144-148
    Katzung/992

    GLAUCOMA:
    In Glaucoma following ANS drugs are used:
    (i) topical beta blockers [Timolol (b1+b2 blocker) , Betaxolol (b1 selective)]: preferred drug.
    (ii) topical alpha adrenergic agonists : dipivefrine, brimonidine.
    (iii) anti-cholinesterases (syn-cholinergics) Miotics: topical Pi;locarpine. NOT PREFERRED due to adverse effects.

    NO ROLE OF ANTI-CHOLINERGICS.


    PARKINSONISM
    Central anti-cholinergics Benzhexol, Procyclidine, Biperiden are used.
    IMPT: CENTRAL CHOLINERGICS ARE THE ONLY DRUG EFFECTIVE IN DRUG INDUCED PARKINSONISM. (KDT/421)


    REFRACTION TESTING
    Anticholinergics cause mydriasis & cycloplegia. Tropicamide having briefer action is preferred over Homatropine. In children- more potent ATROPINE is used.

    ORGANOPHOSPHORUS POISONING
    Antidotal treatment consists of Atropine & Pralidoxime. Katzung/993



    19. Which among the following anti-gout drugs can precipitate an attack of acute arthritis?
    A. Colchicine.
    B. Probenecid.
    C. Allopurinol.
    D. Sulfinpyrazone.

    ANS- C

    Katzung/9th e/599
    "Acute attacks of Gouty arthritis occur early in treatment with Allopurinol,
    when urate crystals are being withdrawn from the tissues & plasma levels are below normal."


    20. Phocomelia is due to-
    A. Thalidomide.

    ANS-A


    21. Corticosteroid with maximum sodium retaining potential is:
    A. Hydrocortisone.
    B. Prednisolone.
    C. Fludrocortisone.
    D. Deoxycorticosterone.

    ANS- C

    KATZUNG/9th e/647 table 39-1

    Relative salt retaining potential is:
    Hydrocortisone: 1
    Prednisolone: 0.3
    Fludrocortisone: 250
    Deoxycorticosterone: 20

    IMPT: Most potent anti-inflammatory action: Betamethasone (25-40), Dexamethasone (30).


    22. Concomitant treatment with which of the following can cause OCP failure?
    A. Enalapril.
    B. Metformin.
    C. Ibuprofen.
    D. Rifampicin.

    ANS- D

    KDT/317

    OCP failure can occur with concurrent use of :
    Phenytoin.
    Phenobarbitone.
    Primidone.
    Carbamazepine.
    Rifampicin.
    Tetracyclines, ampicillins & other antibiotics.

    /
    23. Corticosteroid of choice in Acute Adrenal Insufficiency is:
    A. Fludrocortisone.
    B. Hydrocortisone.
    C. Dexamethasone.
    D. Prednisolone.

    ANS- B

    KATZUNG/9th e/648
    " Acute Adrenal Insufficiency : Hydrocortisone sodium succinate 100 mg IV every 8 hrly is given until the pt. is stable."

    KDT/283
    In Acute adrenal insufficiency, Hydrocortisone or Dexamethasone are given IV first as bolus & then as infusion.



    24. The minimum effective dose of Ethinylestradiol in Oral Contraceptive Pills is:
    A. 20 ug
    B. 30 ug
    C. 40 ug
    D. 50 ug

    ANS-A

    KDT/312

    " Ethinylestradiol 30 ug is considered threshold but can be reduced to 20 ug if a progestin with potent anti-ovulatory action is added."

    FEMILON pills: Desogestrel 0.15 mg + Ethinylestradiol 20 microgram. (KDT Table 22.1, pg 313)

    KATZUNG/674
    Loestrin: Ethinyl esrtadiol 0.02 mg + Norethindrone acetate 1 mg



    25. CONTROVERSIAL QUESTION
    Drug of choice for Epilepsy in a Pregnant lady is:
    A. Valproate
    B. Phenytoin
    C. Ethosuximide
    D. Phenobarbital.
    E. Carbamazapine.


    ANS- ??
    plz contribute.


    KATZUNG/398

    "Phenytoin has been implicated in Fetal Hydantoin Syndrome & a similar syndrome has been attributed to Phenobarbital & to Carbamazepine. Valproate has been implicated in spina bifida."


    26. Regarding Neostigmine, all the following are correct EXCEPT:
    A. a quarternary ammonium compound.
    B. shorter acting than edrophonium.
    C. poorly absorbed oraaly.
    D. used in myasthenis gravis.

    ANS- B

    KDT/102-03

    Duration of action:
    Neostigmine: 3-4 hours.
    Edrophonium: 10-30 min.


    27. Drug of choice in Pregnant women with Secondary Syphilis :
    A. Doxycycline.
    B. Benzathine Penicillin.
    C. Ceftriaxone.
    D. Cotrimoxazole.

    ANS- B

    KDT/737,909
    late Syphilis >1 yr
    Benzathine Penicillin 2.4 MU i.m. weekly for 4 weeks is Rx of choice.
    Penicillin G is safe in Pregnancy.

    Doxycycline is a 2nd line drug & it is CONTRAINDICATED for use in pregnancy.

    Ceftriaxone can be used in Pregnant women but it is also a 2nd line drug.

    Cotrimoxazole is not effective in Syphilis & also, it is CONTRAINDICATED for use in pregnancy.


    28. KINDLY COMMENT ON ANSWER WITH REF
    All of the following act on ion channels EXCEPT:
    A. Verapamil
    B. INsulin.
    C. Chlorpropramide.
    D. Diazepam

    ANS ??


    29. Treatment of choice for SIADH is:
    A. Lithium carbonate.
    B. Demeclocycline.
    C. Vasopressin.
    D. Hypertonic Saline.

    ANS- B

    Katzung/ 9th e/253

    Acute SIADH. Fluid restriction is the treatment of choice in most cases
    Hypertonic saline infusion may be necessary for severe hyponatremia(< 115 mmol/L)


    30. Drug of choice for Neutropenia due to cancer chemotherapy :
    A. Vitamin B-12
    B. IL 11
    C. Filgrastim
    D. Erythopoietin


    ANS- C

    Katzung/ 9th e/ 539-40, 542

    "The introduction of G-CSF represented a milestone in treatment of Chemotherapy related Neutropenia. It accelerates the rate of Neutrophil recovery after myelosuppressive chemotherapy. Ability of G-CSF to increase Neutrophil counts after myelosuppressive chemotherapy is nearly universal. "
    G-CSF include
    (i) Filgrastim
    (ii) Sargamostim.

    REGARDING INTERLEUKIN 11/ OPRELVEKIN
    A megakaryocyte growth factor: Recommended for secondary prevention of Thrombocytopenia in pts receiving cytotoxic chemotherapy for Rx of nonmyeloid cancers.

    ERYTHROPOIETIN/Epoietin alpha
    For Rx of Anemia in : CRF, aplastic anemia, Myeloproliferative & myelodysplatic disorders, AIDS, malignancies.


    31. Among the following the drug which is contraindicated in HOCM is:
    A. Beta blockers
    B. Verapamil.
    C. Digitalis.
    D. Amiodarone

    ANS- C

    Harrison/17th/1485
    Digitalis is contraindicated in HOCM.

    Beta blockers :used as initial drug in symptomatic individuals.
    Calcium channel blockers are alternative drugs.
    Amiodarone may be used to reduce arrythmias.

    other drugs contraindicated in HOCM:
    Beta agonists
    Sympathomimetics.
    Nitrates
    Diuretics.
  16. Guest

    Guest Guest

    33 Drug of choice in acute attack of gout is :
    A. NSAIDs
    B. Colchicine
    C. Allopurinol
    D. Steroids

    Harrison's Rheumatology/237
    ANS-A

    NSAIDs are effective in 90% of patients and resolution of symptoms occur in 5-8 days. Most effective drugs are those with a short half life : Indomethacin , Ibuprofen, Diclofenac.
    However, it also mentions "In attacks involving one or two joints , intraarticular Glucocorticoid injections may be preferrable & effective."
    However the Q doesn't mention "intraarticular" specifically.

    34. Efficacy of a drug refers to:
    A. Ability of a drug to bind to its receptor.
    B. Ability of a drug to activate its receptor.
    C. Minimum dose reqd. to produce clinical response.
    D. Maximum response that can be elicited by a drug.

    ANS-D

    REF: KDT/6/54

    35. Epiphyseal closure is mediated by:
    A. Somatomedin
    B. Cortisol
    C. Thyroxine
    D. Insulin

    ANS- C

    Ganong/19/312
    "Thyroid hormones are essential for skeletal maturation."

    "In hypothyroidism, bone growth is slowed & EPIPHYSEAL CLOSURE IS DELAYED."
  17. Guest

    Guest Guest

    PHYSIOLOGY

    36 Normal Left Ventricular Ejection fraction is :
    A 55%
    B 65%
    C 75%
    D 80%

    ANS- B

    Ganong/19/540
    End diastolic Ventricular vol : 130 ml
    Stroke volume : 70-90 ml (at rest)
    End systolic ventricular volume: 50 ml
    Ejection fraction= (Stroke volume/End diastolic volume) *100= 65%

    37 Androgen binding protein is secreted by:
    A. Pituitary
    B. Liver
    C. Sertoli cells
    D. Leydig cells

    ANS-C
    Ganong/19/407

    Sertoli cells secrete:
    (i) Androgen binding protein
    (ii) Inhibin
    (iii) MIS
    (iv) Estrogen: they contain 'aromatase' which converts androgens to estrogens.

    Impt topic INHIBIN
    Action: it inhibits FSH secretion.
    Secreted by: Sertolic cell in males & Granulosa cells in females.
    Types: Two types Type A and B
    Inhibin B is the FSH-regulating inhibin in men.
    It is a member of TGFb superfamily of dimeric growth factors.

    38. Most common site of fertilisation is:
    A. Cervix
    B. Ampulla
    C. Fimbriae
    D. Uterus

    ANS-B
    Ganong/428
    "Fertilisation usually occurs in midportion of uterine tube."

    39. Neurohypophysis contains which type of cells among the following:
    A. Thyrotrophs.
    B. Paraventricular.
    C. Lactotrophs.
    D. Pituicytes

    ANS-D
    Ganong/379

    "In the posterior lobe, there are Pituicytes, stellate cells containing FAT globules, which are believed to be modified ASTROGLIA."


    40. During Ejaculation, Sperms are released from:
    A. Rete testis
    B. Vas deferens
    C. Epididymis
    D. Seminal Vesicles

    ANS-B
    Ganong/409
    Emission is a sympathetic reflex, integrated in upper lumbar segments of spinal cord & effected by contraction of smooth muscles of VAS DEFERENS & SEMINAL VESICLES.

    Since the q asks specifically regarding 'sperms' which are present in vas deferns & not in secretions from seminal vesicles, ans is VAS DEFERENS.

    41. Which among the following is a feature of denervation of smooth muscle?
    A. Atrophy of the muscle.
    B. Decrease in no of receptors for neurotransmittors
    C. Increased sensitivity to chemical mediators
    D. Decreased neurotransmitter release At NMJ.

    ANS-C
    Ganong/111

    "DENERVATION HYPERSENSITIVITY"
    When the motor Nerve supply to a smooth muscle is cut :
    the muscle does not atrophy (this is in contrast to skeletal muscle which atrophies on denervation.)
    It becomes hyperresponsive to the chemical mediators that normally activate it.

    42 Which among the following is seen at the time of ovulation?
    A. Decreased FSH levels
    B. Increased LH levels
    C. Increased Progesterone levels.
    D. Increased Estrogen levels.

    ANS-B

    Ganong/419
    At the time of ovulation:
    LH levels are at peak of the cycle ~50IU/L
    FSH levels are also maximum at the time of ovulation : 25 IU/L
    Progesterone levels are minimum at the time of ovulation ~0-2 ng/ml, and peak at 21-22nd day ~ 20ng/ml (middle of secretory phase)
    Estrogen levels are maximum about 2 days prior to menstuation ~ 250pg/ml, and then decrease to be minimum ~20pg/ml at day 1.

    43. Transducin is a protein found in
    A. Glomerulus
    B. Retina
    C. Skeletal muscle
    D. Adrenal medula

    ANS-B
    Ganong/151

    Light alters the configuration of Opsin and Opsin change activates an associated G protein called Transducin.

    44. Protein which mediates relaxation in Skeletal muscle is:
    A. Actin
    B. Myosin
    C. Troponin C
    D. Tropomyosin

    ANS-C
    Ganong/65

    "In resting muscle, Troponin I is tightly bound to actin and Tropomyosin to myosin head. Thus TROPONIN-TROPOMYOSIN complex constitutes a RELAXING PROTEIN that inhibits interaction between actin and myosin."

    It is clear from this that Troponin I and Tropomyosin constitute muscle relaxing proteins.

    45. Lesion in which part of the Hypothalamus leads to loss of Circadian Rhythm?
    A. Suprachiasmatic nuclei
    B. Ventromedial Nuclei
    C. Lateral areas.
    D. Preoptic area

    ANS- A
    Ganong pg 224-25 , table 14-1

    "In humans the mechanisms controlling circadian rhythms are neural and endocrine, and the dominant PACEMAKER is in the SUPRACHIASMATIC NUCLEUS.
    The rhythms controlled are:
    ACTH Secretion
    Melatonin Secretion
    Sleep wake cycle
    body temperarure cycle
    activity patterns."

    Ventromedial Nucleus contains'SATIETY CENTRE.'
    Lateral areas produce diffuse sympathetic discharge and increased ADRENAL MEDDULARY SECRETION as seen in stress (FLIGHT OR FIGHT RXN).
    Preoptic area is concerned with secretion of GnRH.
    Lateral Superior Hypothalamus- thirst.
    Anterior Ventral Hypothalamus- Sexual behaviour
    Anterior Hypothalamus-TEMPERATURE REGULATION
    Supraoptic and Paraventricular Nuclei- Vasopressin and Oxytocin.


    46. The major role of 2,3 bisphosphoglycerate in RBCs is:

    A. acid-base balance.
    B. reversal of glycolysis
    C. release of Oxygen
    D. binding of oxygen

    ANS-C

    Ganong/637

    2,3 BPG/DPG
    PLENTIFUL IN RBCs.
    FORMED FROM 3-PHOSPHOGLYCERALDEHYDE, a product of Glycolysis.
    Binds to beta chain of deoxy-Hb.
    1 mole of 2,3 DPG binds to 1 mole of deoxy-Hb.
    Increase in concentration of 2,3 DPG causes more O2 to be liberated from Hb to tissues.


    47. Vit. K dependent clotting factors include all EXCEPT:
    A. VII
    B. VIII
    C. Prothrombin
    D. IX

    ANS-B

    Ganong/19th e/ 520

    VIT K DEPENDENT CLOTTING FACTORS ARE:
    II/PROTHROMBIN
    VII/PROCONVERTIN/STABLE FACTOR
    IX/ CHRISTMAS FACTOR/ ANTIHEMOPHILIC FACTOR B
    X/ STUART-PROWER FACTOR
    PROTEIN C
    PROTEIN S

    IMPT Q
    CLOTTING FACTORS INHIBITED BY ANTITHROMBIN III: IX, X ,XI & XII




    48. In JVP, a wave is due to:
    A. atrial filling
    B. atrial relaxation
    C. atrial contraction.
    D. ventricular relaxation.

    ANS-C

    49. Vitamin B-12 is absorbed in:
    A. Stomach
    B. duodenum
    C. Jejunum
    D. Ileum

    ANS- D
    Ganong/476

    50. Physiological dead space is:
    A. 150 ml
    B. 200 ml
    C. 250 ml
    D. 100 ml

    ANS-A
    Ganong/627


    51. In CNS, myelin sheath of Neurons is formed by:
    A. Astrocytes.
    B. Oligodendroglial cells.
    C. Schwann cells.
    D. All the above.

    ANS- B
    Ganong/47


    " In the central nervous system of mammals, most neurons are myelinated, but the cells that form the myelin are Oligodendrogliocytes rather than Schwann cells."

    Unlike the Schwann cell which forms the myelin between 2 nodes of Ranvier on a single neuron, oligodendrogliocytes send off multiple processes that form myelin on many neighbouring axons.
  18. Guest

    Guest Guest

    52. Wolf-Chaikoff effect is seen due to:
    A. Inhibition of cAMP response of TSH.
    B. Inhibition of proteolysis of Thyroglobulin.
    C. Inhibition of organic binding of iodide.
    D. Inhibition of iodide trapping mechanism.

    ANS-C

    Ganong/317

    VERY IMPT
    There are 3 Mechanisms by which excess IODIDE inhibits thyroid function:
    (i) Inhibition of organic binding of iodide: this is referred to as WOLF_CHAIKOFF EFFECT & is the major mechanism.
    (ii) Inhibition of cAMP response of TSH.
    (iii) Inhibition of proteolysis of Thyroglobulin.

    Also "There is no direct effect of increased IODIDE on trapping mechanism but the total iodide uptake is low because of inhibition of organic binding."

    53. Regarding Caisson's disease which statement among the following is CORRECT?
    A. Lung damage is caused by air embolism.
    B. Pain in the joints is due to nitrogen bubbles.
    C. Tremors are seen due to nitrogen narcosis.
    D. High pressure Nervous syndrome can be prevented by using mixtures of Oxygen & Helium.

    ANS-B

    Ganong/662-3

    Lung damage is seen due to Oxygen toxicity.
    Nitrogen Narcosis can be prevented by using mixtures of Oxygen & Helium.High pressure Nervous syndromeis caused by using mixtures of Oxygen & Helium.
    Tremors are seen due to high presurre nervous syndrme.
    Nitrogen narcosis causes Euphoria.

    54. Hyperkeratosis is seen in deficiency of:
    A. Vit A
    B. Vit B
    C. Vit C
    D. Vit D

    ANS-A

    Harper/28th e/468 Table 44-1

    55. Absorption of Iron is increased by:
    A. Tea
    B. Coffee
    C. Vitamin C
    D. EDTA

    ANS-C

    Harper/463

    Inorganic iron is absorbed in Fe2+ state (reduced state). Hence reducing agents promote absorption of Iron. Most impt among these are:
    Vitamin C
    Alcohol
    Fructose

    Absorption of Iron is impaired by Calcium ( in milk & milk products).

    56. Highest velocity of conduction is seen in nerve fibres of type:
    A. A alpha
    B. A delta
    C. B
    D. C

    ANS-A

    Ganong/57

    V. IMPT
    Nerve fibres with
    maxm diameter & highest conduction velocity: A alpha (12-20 um, 70-120 m/s)
    minm diameter & lowest conduction velocity: C (0.4-1.2 um, 0.5-2 m/s)
    maxm absolute refractory period: C (2ms)
    minm absolute refractory period: A alpha (0.4-1 ms)

    57. Renal angle is the angle between :
    A. 11th rib and Erector Spinae
    B. 12th rib and Erector spinae
    C. 11th rib and Sacrospinalis
    D. 12th rib and Sacrospinalis

    ANS-B

    58. Abductor of Vocal Cord is:
    A. Cricothyroid
    B. Lateral Cricoarytenoid
    C. Posterior Cricoarytenoid
    D. Thyroarytenoid

    ANS-C

    BDC/243

    IMPT
    Only abductor: Post Cricoarytenoid
    Only tensor: Cricothyroid

    59 Median Nerve supplies all EXCEPT:
    A. Opponens pollicis
    B. Adductor pollicis
    C. Flexor pollicis brevis
    D. Abductor pollicis brevis

    ANS-B

    Adductor pollicis is supplied by Ulnar Nerve.

    FLEXOR POLLICIS BREVIS
    It has 2 heads:
    Superficial: supplied by Median N
    Deep: supplied by Ulnar N.

    60 Median Nerve injury at elbow causes loss of all the following functions EXCEPT:
    A. Opposition of thumb.
    B. Flexion at 2nd and 3rd MCP joints
    C. Flexion at 1st and 2nd PIP jt
    D. Flexion at 4th and 5th DIP jts

    ANS-D

    Opposition of thumb is done by Opponens Pollicis, supplied by Median N.
    Flexion at 2nd and 3rd MCP jt is done bt lateral 2 lumbricals, supplied by Median N.
    Flexion at 1st and 2nd PIP jt is done by Flexor Digitorum Superficialis, supplied by Median Nerve.
    Flexion at 4th and 5th DIP jt is done by medial 2 tendons of Flexor Digitorum Profundus , supplied by ULNAR NERVE.
  19. Guest

    Guest Guest

    61. Lurching Gait is due to paralysis of:
    A. Gluteus medius
    B. Hamstrings
    C. Tensor Fascia Lata
    D. Adductor magnus.

    ANS- A

    63 Which bone forms floor of the orbit?
    A. Maxilla
    B. Ethmoid
    C. Zygomatic
    D. Sphenoid

    ANS- A

    63 Fibromuscular stroma is a characterisric feature of:
    A. Testis
    B. Seminal Vesicles
    C. Prostate
    D. Epididymis

    ANS-C

    64 During Tonsillitis, pain in the ear is due to involvement of
    A. Vagus N
    B. Chorda tympani N
    C. Glossopharyngeal N
    D. Hypoglossal N

    Ans- C

    BDC VOL 3/219
    Tonsillitis/Pharyngitis may cause referred pain in the ear as Glossopharyngeal Nerve is the common sensory supply.

    65 Stem cells are located in which region of hair follicle:
    A. Bulb
    B. Root
    C. Bulge
    D. Papilla

    ANS-C

    GRAY'S ANAT & DAVIDSON:
    In hairy skin, stem cells were found to be located in bulge of hair follicle during experimental studies.
    In Glabrous skin, stem cells are located in epidermis.

    66 Lymphatics from Cervix drain into:
    A. External Iliac Lymph nodes
    B. Internal Iliac lymph nodes.
    C. Inguinal Lymph nodes.
    D. Paraaortic lymph nodes.

    ANS- A and B (A>B)

    REF
    Keith L Moore Anat/5th e /417
    "Lymphatics from Cervix pass within the broad ligament to External Iliac Lymph Nodes.
    Lymphatics from Cx also pass along uterine vessels within transverse cervical ligaments to Internal Iliac Lymph nodes and along Uterosacral ligaments to Sacral Lymph Nodes."

    However EXTERNAL ILIAC NODES seems to be better option of the two :
    In all the books (including Dutta Obs) external iliac nodes are mentioned first.
    In SHAW'S GYNECOLOGY/Pg19 ONLY EXTERNAL ILIAC NODES have been mentioned.

    67 Hematopoiesis in fetus starts first in:
    A. Liver
    B. Spleen
    C. Yolk Sac
    D. Bone Marrow

    ANS-C

    Langman's Embryology 10th ed/78
    Yolk sac-19days

    68 Which among the following is NOT a true support of Uterus?
    A. Uterosacral ligament
    B. Pubocervical ligament
    C. Infundibulopelvic ligament
    D. Meckenrodt's ligament

    ANS- C

    BDC VOL2/320

    69 Which among the following do not form posterior wall of Axilla:
    A. Teres major
    C. Subscapularis
    C. Lattisimus dorsi
    D. Supraspinatus

    ANS-D

    70 A sesamoid bone is present in the tendon of :
    A. Flexor hallucis longus.
    B. Extensor hallucis brevis.
    C. Adductor hallucis
    D. Flexor hallucis brevis

    ANS-D

    REF: Keith L Moore

    71 Inferior dislocation of shoulder joint causes damage to:
    A. Radial Nerve
    B. Median N
    C. Axillary N
    D. Ulnar N
    ANS-C

    72 Portal Vein is formed by union of:
    A. Sup Mesentric and Inferior Mesentric Veins
    B. Sup Mesentric and Splenic Veins
    C. Superior Mesentric And left renal vein
    D. Inferior Mesentric and Splenic Vein

    ANS-B

    73 Which among the following is NOT a branch of Aorta?
    A. Brachiocephalic
    B. Right common carotid
    C. Left common carotid
    D. Left Subclavian

    ANS-B

    73 Which among the following is NOT a branch of Aorta?
    A. Brachiocephalic
    B. Right common carotid
    C. Left common carotid
    D. Left Subclavian

    ANS-B

    74 Pseudounipolar neurons are seen in:
    A. Dorsal root ganglia
    B. Ganglia of Cranial N VIII
    C. Mesencephalic Nucleus
    D. Motor neurons

    ANS-A
    BDC/4th ed VOL 3/300

    75 The vessel which can be a source of bleeding in a duodenal ulcer is:
    A. Superior Pancreatoduodenal
    B. Inferior Pancreaticoduodenal
    C. Gastroduodenal
    D. Splenic

    ANS-C
    REF: Keith L Moore/264

    76 Ossification of Ulna is complete by:
    A. 9 yrs
    B. 11 yrs
    C. 13 yrs
    D. 15 yrs

    ANS-D

    BDC/3rd e/Vol 1/20
    Ossification of Ulna is complete by 16-18 yrs.

    77 Microscopic examination of articular surface of a synovial joint demonstrates:
    A. Hyaline cartilage
    B. Adipocytes
    C. Endothelial cells
    D. Periosteum

    ANS-A

    78. Which among the following lies in posterior wall of axilla?
    A. Long Thoracic N
    B. Intercostobrachial N
    C. Subscapular N
    D. Thoracodorsal artery

    ANS-C

    Long thoracic N & Intercostobrachial N lie in the medial wall of the axilla.
    Thoracodorsal artery forms anastomosis around scapula. It is a branch of Subscapular artery.
    Subscapular N crosses anterior surface of Lattisimus dorsi (which forms post wall of axilla).
    BDC/42
  20. Guest

    Guest Guest

    79. Normal anatomical sites of Uterine constrictions include all the following EXCEPT:
    A. Ureteropelvic junction.
    B. Brim of Pelvis
    C. Crossing of External Iliac Artery
    D. Insertion into bladder.

    ANS- C

    REFERENCES

    KEITH L MOORE CLINICAL ANATOMY /5th e/ 394

    Ureters are normally relatively constricted at;
    (i) Junction of Ureter & renal pelvis.
    (ii) during their passage through wall of urinary bladder.
    (iii) where they cross EXTERNAL ILIAC ARTERY & PELVIC BRIM.

    SNELL'S ANATOMY / 7TH ED/ 370

    The Ureter posseses 3 constrictions:
    (i) where renal pelvis joins the ureter.
    (ii) where it is kinked as it crosses the pelvic brim
    (iii) where it pierces bladder wall.

    BDC/3rd ed vol 2/261
    Ureter is slightly constricted at:
    (i) Pelvi-ureteral junction.
    (ii) At brim of lesser Pelvis.
    (iii) Passage through bladder wall.

    Hence, option C is better amongst the four.
  21. Guest

    Guest Guest

    80. Endolymphatic duct opens into:
    A. Saccule
    B. Subarachnoid space
    C. Subdural Space
    D. None

    ANS-A

    REF/Gray's Anatomy
    The membranous vestibule, becomes divided into a small ventral saccule and a larger utricle. This is achieved mainly by horizontal infolding that extends from the lateral wall of the vestibule towards the opening of the ductus endolymphaticus until only a narrow utriculosaccular duct remains between saccule and utricle.
    The utriculosaccular duct becomes acutely bent on itself: its apex is continuous with the ductus endolymphaticus.

    81. Elastic cartilage is present in:
    A. Nasal Septum.
    B. Eustachian tube
    C. Costal Cartilage
    D. Articular cartilage

    ANS-B

    82. Normal functions of Peritoneum include all EXCEPT:
    A. Fibrinolytic.
    B. Lubricates movement of viscera.
    C. Provides nourishment to gut.
    D. Absorption of fluid & particulates.

    ANS-C

    CSDT/2010/pg 464

    "Peritoneum is a semi-permeable membrane.
    Particulate matter, including bacteria upto 20 um in size, are cleared via lymphatics.
    It contains plasminogen activator in its cell lining, which is inactivated by injury or infection."

    83. Commonest site of Hypertensive bleed is:
    A. Pons
    B. Putamen
    C. Frontal lobe
    D. Thalamus

    ANS-B
    REF: harrison

    84. Traube's space percussion is done to detect enlargement of:
    A. Stomach
    B. Liver
    C. Spleen
    D. Kidney

    ANS-C

    "Traube's (semilunar) space is a crescent-shaped space, encompassed by the lower edge of the left lung, the anterior border of the spleen, the left costal margin and the inferior margin of the left lobe of the liver.
    Beneath Traube's space lies the stomach, which produces a tympanic sound on percussion. Dullness to percussion over Traube's space may indicate splenomegaly."

    85. Level 3 axillary lymph nodes are located:
    A. Above & medial to pectoralis minor.
    C. below & lateral to pectoralis minor.
    C. Posterior to pectoralis minor.
    D. Anterior to pectoralis minor.

    ANS-A


    Surgical classification of Axillary Lymph Nodes:

    It is based on the relationship of the lymph nodes to pectoralis minor.

    Level 1 nodes
    Level 1 includes all those nodes inferior to the inferolateral border of pectoralis minor.

    Level 2 nodes
    Level 2 consists of those nodes posterior to pectoralis minor.

    Level 3 nodes
    Level 3 consists of those nodes beyond the superior border of pectoralis minor. It includes infraclavicular nodes.

    86. During Hysterectomy, Ureter is liable for injury at :
    A. Where it crosses pelvic brim.
    B. Where it enters bladder wall.
    C. Where it crosses uterine artery.
    D. None

    ANS-C

    87. Mucocele is commenest in which among the following sinuses?
    A. Frontal.
    B. Maxillary.
    C. Ethmoid.
    D. Sphenoid.

    ANS- A

    Dhingra/3rd e/246
    The sinuses commonly affected by mucocele in order of frequency:
    1. Frontal.
    2. Ethmoidal
    3. Maxillary.
    4. Sphenoidal.

    88. Causes of Epistaxis include all EXCEPT:
    A. Finger Nail Trauma (Nose picking)
    B. Foreign body.
    C. Allergic Rhinitis.
    D. Thrombocytopenia.

    ANS-C

    Dhingra/216-217

    Epistaxis has not been mentioned even as a complication of Allergic Rhinitis.

    Epistaxis is characteristically seen in 'CRUST FORMING RHINITIS.' Allergic rhinitis is not crust-forming.

    89. Vidian Neurectomy is beneficial in:
    A. Atrophic Rhinitis.
    B. Vasomotor Rhinitis.
    C. Allergic Rhinitis.
    D. Non air flow rhinitis

    ANS- B

    Dhingra/3rs ed/209

    "Excessive Rhinorrhea in Vasomotor Rhinitis, not corrected by medical therapy, can be relieved by Vidian Neurectomy."

    90. Most common site of CSF Rhinorrhea:
    A. Cribriform plate.
    B. Temporal bone.
    C. Sphenoid sinus.
    D. Ethmoid air cells.

    ANS-A

    Dhingra/202


    91. Most common organism causing acute Epiglottitis is:
    A. H. influenzae.
    B. Parainfluenza virus.
    C. Respiratory Synctitial Virus.
    D. C. diphtheriae.

    ANS-A

    Dhingra/3rd e/347

    92. Facial paralysis in Zoster ophthalmicus is referred to as:
    A. Bell's palsy.
    B. Ramsay Hunt Syndrome.
    C. Waardenburg's Syndrome
    D. van der Hoeve Syndrome

    ANS-B

    dhingra/124
  22. Guest

    Guest Guest

    very nice ,post more
  23. Guest

    Guest Guest

    Great going . .
  24. Guest

    Guest Guest

    93. which among the following is not seen in Chronic Renal Failure?
    A. Hyperkalemia.
    B. Hyponatremia.
    C. Hypercalcemia.
    D. Hyperphosphatemia.

    ANS-C

    Harrison/17th ed/

    1.Fluid and electrolyte disturbances;

    Volume expansion (I)

    Hyponatremia (I)

    Hyperkalemia (I)

    Hyperphosphatemia (I)

    2.Endocrine-metabolic disturbances:

    Secondary hyperparathyroidism (I or P)

    Adynamic bone (D)

    Vitamin D–deficient osteomalacia (I)

    Carbohydrate resistance (I)

    Hyperuricemia (I or P)

    Hypertriglyceridemia (I or P)

    Increased Lp(a) level (P)

    Decreased high-density lipoprotein level (P)

    Protein-energy malnutrition (I or P)

    Impaired growth and development (P)

    Infertility and sexual dysfunction (P)

    Amenorrhea (I/P)

    2-Microglobulin associated amyloidosis (P or D)


    REASON FOR HYPOCALCEMIA:
    decreased levels of ionized calcium, result from diminished calcitriol production by the failing kidney as well as phosphate retention, also stimulate PTH production. Low calcitriol levels contribute to hyperparathyroidism, both by leading to hypocalcemia and also by a direct effect on PTH gene transcription.


    94. High Anion Gap Acidosis is seen in all the following EXCEPT:
    A. Diabetic Ketoacidosis.
    B. Lactic Acidosis.
    C. Renal Tubular Acidosis.
    D. Methanol Poisoniong

    ANS-C

    Causes of High-Anion-Gap Metabolic Acidosis

    Lactic acidosis
    Ketoacidosis
    Diabetic
    Alcoholic
    Starvation
    Renal failure (acute and chronic)

    TOXINS
    Ethylene glycol
    Methanol
    Salicylates
    Propylene glycol
    Pyroglutamic acid


    95. All the following are signs of Liver Cirrhosis EXCEPT:
    A. Spider naevi
    B. Palmar Erythema.
    C. Testicular Atrophy.
    D. Subcutaneous nodules.

    ANS-D

    Thanks to DR. VALLUVAN for his impt contribution.


    96. Which system is primarily affected by TETANUS?
    A. Hematological.
    B. Nervous
    C. Skeletal
    D. All

    ANS-B

    H/17

    Tetanus is a neurologic disorder, characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a powerful protein toxin elaborated by Clostridium tetani.


    97. Community acquired pneumonia is caused by all EXCEPT:
    A. Mycoplasma.
    B. Legionella
    C. Klebisiella
    D. Chlamydiae

    ANS-C

    H/17

    Table 251-2 Microbial Causes of Community-Acquired Pneumonia, by Site of Care
    Streptococcus pneumoniae
    Mycoplasma pneumoniae
    Staphylococcus aureus
    Haemophilus influenzae
    Chlamydophila pneumoniae
    Legionella sp.
    Respiratory viruses


    98. Triad of Thrombocytopenia, Eczema & recurrent infections is observed in:
    A. Wiskott- Aldrich Syndrome.
    B. Chediak- Higashi Syndrome
    C. Job's Syndrome.
    D. Bruton's agammaglobulinemia

    ANS-A

    Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia)


    99. Procalcitonin is a marker for:
    A. Sepsis.
    B. Medullary Carcinoma Thyroid.
    C. Vit D resistant Rickets.
    D. Haemorrhage

    ANS-A

    Measurement of procalcitonin can be used as a marker of severe sepsis and generally grades well with the degree of sepsis, although levels of procalcitonin in the blood are very low. PCT has the greatest sensitivity (85%) and specificity (91%) for differentiating patients with SIRS from those with sepsis, when compared with IL-2, IL-6, IL-8, CRP and TNF-alpha. Evidence is emerging that procalcitonin levels can reduce unnecessary antibiotic prescribing to people with lower respiratory tract infections


    100. Best Prognosis in Hodgkin's Disease:
    A. Lymphocyte depletion.
    B. Mixed Cellularity.
    C. Nodular Sclerosis.
    D. Lymphocyte predominance.

    ANS-D

    H/17
    The treatment of patients with nodular lymphocyte-predominant Hodgkin's disease is controversial. Some clinicians favor no treatment and merely close follow-up. In the United States, most physicians will treat localized disease with radiotherapy and disseminated disease with regimens utilized for patients with classical Hodgkin's disease. Regardless of the therapy utilized, most series report a long-term survival of >80%.
  25. Guest

    Guest Guest

    101. Most commonly seen neuropathy in Diabetes is:
    A. Mononeuropathy.
    B. Distal symmetric sensory polyneuropathy.
    C. Polyradiculopathy.
    D. Autonomic Neuropathy.

    ANS-B
    H/16/2165

    "Most common form of diabetic neuropathy is DISTAL SYMMETRIC POLYNEUROPATHY. It most frequently presents with distal sensory loss."
  26. Guest

    Guest Guest

    102 A middle aged man noticed that he can no longer fit in his shoes and enlarging of jaw and phalanges. These effects are mediated by:
    A. ACTH
    B. TRH
    C. Somatomedin
    D. TGF beta

    ANS-C

    His symptoms are suggestive of Acromegaly {î growth hormone} & GH effects are mediated via Somatomedins.
    Principal Somatomedins are IGF-I, IGF-II.
    IGF-I is also referred to as Somatomedin C.
    Ganong/384

    103- An emerging organism responsible for causing Pyelonephritis in Renal Allografts is:
    A. Polyoma virus.
    B. Herpes virus.
    C. Hepatitis B virus.
    D. Rota virus.

    ANS-A

    Robbins/8th ed/939

    Most Common organism causing Pyelonephritis: E. Coli.
    Other common organisms:
    Proteus
    Klebsiella
    Enterobacter
    Streptococcus fecalis

    Immunocompromised hosts particularly those with transplanted organs:
    Polyoma virus
    Cytomegalovirus
    Adenovirus

    104- Cause of non immune hydrops is:
    A. Rh isoimmunisation.
    B. Alpha thalassemia major
    C. Bilateral renal agenesis
    D. Minor blood group incompatibility.

    ANS-B

    Robins/8/460

    105- Recommended dose of Folic acid to be given to women of child bearing age group is:
    A. 0.5mg
    B. 4 ug
    C. 40 ug
    D. 400 ug

    ANS_D

    Katzung/9th ed/536

    "Pregnant women have increased requirements for folic acid; at least 400 microgram is recommended."
  27. Guest

    Guest Guest

    105- Recommended dose of Folic acid to be given to women of child bearing age group is:
    A. 0.5mg
    B. 4 ug
    C. 40 ug
    D. 400 ug..

    ANS_D

    Katzung/9th ed/536

    "Pregnant women have increased requirements for folic acid; at least 400 microgram is recommended."

    Finally, recent work in Toronto and Hungary has suggested that women contemplating pregnancy should take a daily multivitamin, as it yields a slight reduction in overall risk of birth defects. So for those without epilepsy or a history of having a baby with spina bifida, taking a multivitamin containing 400 μg folic acid will meet both goals.
  28. rajibsun

    rajibsun Guest

    rest qns....

    its only 105 qns how about rest madam/sir?

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