Download PGI PG PGI 2015 November Solved Question Paper

Download PGIMER (Post Graduate Institute of Medical Education & Research, Chandigarh) PGI 2015 November Solved Question Paper

1.Truestatementaboutdevelopment
ofpancreas:
a)Uncinateprocessfromventralbud
b)Lowerpartofheadfromdorsalbud
c)DuctofWirsungdevelopsfromdorsalbudonly
d)Pancreaticdivisumisduetoabnormaldevelopmentofducts
ofpancreas
e)Bodyisformedfromdorsalbud
CorrectAnswer-A:D:E
Ans.a.Uncinateprocessfromventralbud;d.Pancreatic
divisumisduetoabnormaldevelopmentofductsofpancreas;
e.Bodyisformedfromdorsalbud
Thepancreasdevelopsfromtwoendodermalbuds,dorsal&ventral,
whicharisefromthepartofthegutthatlaterformsthesecondpart
oftheduodenum
Theventralbudformsthelowerpartofthehead&theuncinate
Processofthepancreas,whiletheupperpartofhead,thebody&
thetailareformedfromthedorsalbud.
Themainpancreaticduct(ductofWirsung)isformed,initsdistal
partbytheductofthedorsalbudandinifsproximalpart,bytheduct
oftheventralbud

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2.Whichofthefollowingcombinationis/are
trueregardingepithelialliningofurinary
system:
a)Urinarybladder-transitionalepithelium
b)Pre-prostaticurethra-stratifiedcolumnar
c)Membranousurethra-transitionalepithelium
d)Distalpartofpenileurethra-non-keratinisingstratified
squamousepithelium
e)Urethralmeatus-keratinisingstratifiedsquamousepithelium
CorrectAnswer-A:D:E
Ans.a.Urinarybladder-transitionalepithelium;d.Distalpartof
penileurethra-non-keratinisingstratifiedsquamousepithelium
e.Urethralmeatus-keratinisingstratifiedsquamousepithelium
Urinarybladderislinedbyuroepithelium(transitionalepithelium)
Theliningofurethravariesfromurotheliumofthebladderto
keratinizedstratifiedsquamousepitheliumoftheglans.
Pre-prostaticurethra:Transitionalepithelium
Prostaticurethra:Transitionalepithelium
Membranousurethra:Pseudostratifiedcolumnarepithelium
Spongyurethra(orpenileurethra):Pseudostratifiedcolumnar-
proximally,Stratifiedsquamous-distally

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3.Whichofthefollowingstatementis/aretrue
regardinglesionofIXCN:
a)Gagreflex-absent
b)Deviationoftonguetooneside
c)Lossoftastesensationintheposteriorl/3ofthetongue
d)Lossoftastesensationintheanterior2/3ofthetongue
e)Maycausebulbarpalsy
CorrectAnswer-A:C:E
Ans.a.Gagreflex-absent;c.Lossoftastesensationinthe
posteriorl/3ofthetongue;e.Maycausebulbarpalsy
GlossopharyngealNervePalsy:
Lossofsensationoverthemucousmembraneofpharynx.
Lossoftastesensationintheposteriorl/3ofthetongue
Gagreflex-LostinlesionofIX&XCN

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4.Feature(s)ofoculomotornervepalsy
is/are:
a)Ptosis
b)Miosis
c)Mydriasis
d)Diplopia
e)Lossofaccommodation
CorrectAnswer-A:B:D:E
Ans.a.Ptosis;b.Miosis;d.Diplopia;e.Lossof
accommodation
OculomotorNervePalsy:
Complete&totalparalysis-ptosis,lateralsquint,dilationofpupil,
lossofaccommodation,slightproptosis&diplopia.
Pupillarylightreflexinaffectedeyeisabsent.
Pupildilates&becomesfixedtolight.
Webersyndrome:amidbrainlesioncausingcontralateralhemiplegia
&ipsilateralparalysisofthethirdnerve

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5.Cervixis/aredrainedby:
a)Externaliliaclymphnode
b)Internaliliaclymphnode
c)Aorticlymphnode
d)Inguinallymphnode
e)Sacrallymphnode
CorrectAnswer-A:B:E
Ans.a.Externaliliaclymphnode;b.Internaliliaclymphnode;
e.Sacrallymphnode
Cervix:Oneachside,thelymphaticsdraininto
Externaliliac,obturatorlymphnodeseitherdirectlyorthrough
paracervicallymphnodes,
Internaliliacgroups
Sacralgroup

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6.Whichofthefollowingmayoccurin
commonperonealnerveinjury:
a)Dorsiflexionnotpossible
b)Footdrop
c)Highsteppinggait
d)Lossofinversionoffoot
e)Eversionoffootaffected
CorrectAnswer-A:B:C:E
Ans.a.Dorsiflexionnotpossibleb.Footdropc.Highstepping
gaite.Eversionoffootaffected
Commonperonealnerveinjury(usuallyd/tfractureof
head/neckfibula)resultsin:
Foot&toedrop
Lossofdorsiflexionofankle
Extensionoffinger
Eversionoffoot
Lossofsensationin1stwebspace,anterolaterallowerleg&dorsum
offootandtoes.
Incommonperonealnerveinjurysensationofsole,lateralborder&
medialborder&inversion&plantarflexionremainnormal.

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7.O'Donoghue'striadcomprisesof:
a)Anteriorcruciateligamenttear
b)Posteriorcruciateligamenttear
c)Medialmeniscus
d)Lateralmeniscus
e)Medialcollateralligament
CorrectAnswer-A:C:E
Ans.a.Anteriorcruciateligamenttear;c.Medialmeniscus;e.
Medialcollateralligament
Anunhappytriad(orterribletriad,"horribletriangleO'Donoghue's
triadora"blownknee-')isaninjurytotheanteriorcruciateligament,
medialcollateralligament,andthemedialmeniscus

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8.

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Whichofthefollowingvein(s)is/arepartof
portalcirculation:
a)Splenicvein
b)Paraumbilicalvein
c)Superiorrectalvein
d)Leftgastricvein
e)Inferiorrectalvein
CorrectAnswer-A:B:C:D
Ans.a.Splenicveinb.Paraumbilicalveinc.Superiorrectalvein
d.Leftgastricvein
Portalveincollectsbloodfromtheforegut,midgut,andhindgut.
Theportalveinislocateddeeptothehepaticarteryandcysticduct
andisformedbytheunionofthesuperiormesentericveinand
splenicvein,deeptotheneckofthepancreas.
Bloodfromportalveintransportedtothehepaticsinusoidsofthe
liverforfiltrationanddetoxification.
Thehepaticsinusoidsemptyintothecommoncentralvein,which
emptiesintothehepaticveinsandultimatelydrainsintotheinferior
venacava.

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9.Thrombosisofanteriorcerebralartery
cause:
a)Leftfootparalysisinrightanteriorcerebralarterythrombosis
b)Urinaryincontinence
c)Paralysisofthecontralateralface,arm,andleg
d)Homonymoushemianopia
e)Gegenhaltenrigidity
CorrectAnswer-A:B:E
Ans.a.Leftfootparalysisinrightanteriorcerebralartery
thrombosis;b.Urinaryincontinence;e.Gegenhaltenrigidity
Signsandsymptomsofanteriorcerebralarterythrombosis:
Paralysisofoppositefootandleg:Motorlegarea
Alesserdegreeofparesisofoppositearmareaofcortexorfibers
descendingtocoronaradiate
Corticalsensorylossovertoes,footandleg:Sensoryareaforfoot
andleg
Urinaryincontinence:SensorimotorareainParacentrallobule
Contralateralgraspreflex,suckingreflexgegenhalten(paratonic
rigidity)
Abulia(akineticmutism),slowness,delayintermittentinterruption,
lackofspontaneity,whisperingreflexdistractiontosightsand
sounds
Impairmentofgaitandstance(gaitapraxia)
Dyspraxiaofleftlimbs,tactileaphasiainleftlimbs

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10.Fibrocartilageis/arefoundin:
a)Temporomandibularjoint
b)Sternoclavicularjoint
c)Hipjoint
d)Vertebraldisc
e)Inferiorradioulnarjoint
CorrectAnswer-A:B:D:E
Ans.a.Temporomandibularjoint;b.Sternoclavicularjoint;d.
Vertebraldisc;e.Inferiorradioulnarjoint
Fibrocartilageisawhiteopaquestructureduetodensecollage
fibres(typeIandII).
Whenafibroustissueissubjectedtopressureitisreplacedby
fibrocartilage.
Itisseeninjoints,symphysis,intervertebraldiscs,menisciandlabra
(shoulderjointandhipjoint).
Pinnaisatypeofelasticcartilage.
Elasticcartilagesareseenatsitesconcernedwithproductionor
receptionofsoundse.g.externalacousticmeatus(lateralpart),
auditorytubeandepiglottis.

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11.Parasympatheticnervestimulationresults
in:
a)Sphincterclosureofgallbladder
b)Increasedperistalsis
c)DecreasedGITmotility
d)Detrusormusclerelaxation
e)Gallbladdermusculaturecontraction
CorrectAnswer-B:E
Ans.(B)Increasedperistalsis(E)Gallbladdermusculature
contraction
[RefGanong25th/257-60,24th/265;Katzung13th110-111]
Parasympatheticnervesaremotortomusculatureofthegallbladder
&bileduct,butinhibitorytothesphincter.
SympatheticnervesfromT7-9arevasomotor&motortosphincters.
Thecranialoutflowoftheparasympatheticdivisionsuppliesthe
visceralstructuresintheheadviaoculomotor,facial,and
glossopharyngealnerves,andthoseinthethoraxandupper
abdomenviathevagusnerves.
Pupil-Constricted(Miosis)
Ciliarymuscle-Constricted(nearvision)
Glands(Nasal,Lacrimal,Parotid,SubmandibulalGastricPancreatic)
-Stimulationofcopioussecretion(containingmanyenzymesfor
enzyme-secretingglands)
Sweatglands-Sweatingonpalmsofhands
Bronchialmuscle-Contraction
Gallbladderandbileducts-Contracted

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LUmen-Increasedperistalsisandtone
Detrusor-Contracted
Trigone-Relaxed

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12.Trueaboutmusclespindle:
a)GroupIafibercontainsensoryafferent
b)Nuclearbag&nuclearchainfiberspresentinintrafusalmuscle
fiber
c)MotorsupplybyAafiber
d)Motorsupplybyyfiber
e)Secondaryendingisstimulatedbynuclearbagfiber
CorrectAnswer-A:B:D
Ans.(A)GroupIafibercontainsensoryafferent(B)Nuclear
bag&nuclearchainfiberspresentinintrafusalmusclefiber
(D)Motorsupplybyyfiber
[Ref.A.K.Jain6th/873-76;Guyton12th/770-73]
MUSCLESPINDLES
Are"Stretchreceptor"locatedwithinamuscle.
Yetfound,interminglingwithmusclefibers.
'Intrafusalfibers'-Specializedmusclefibersseenwithin
spindle
(Note:-Fususreferstospindle).
Nuclearbagfibers:
Usually,2perspindle.
Nuclearbagfiber1-
WithlowlevelofmyosinATPaseactivity.
Nuclearbagfiber2-
WithhighlevelofmyosinATPaseactivity.
Nuclearchainfibers
Arethinner&shorter.
Fourormorefibersperspindle(morethannuclearbagfibers)

---

Sensory/afferentinnervation:
Twoafferentfibertypesoriginateintrafusally,
Annulospiral/primaryendings:
Foundwoundaroundcentralregionofbothnuclearbag&nuclear
chainfiber.
Are"A"/"Ia"fibers.
Flower-spray/secondaryendings:
Innervateperipheralparts/endsofnuclearchainfiber.
Are"A"/"II"fibers.
2.Motor/efferentinnervation:
Innervatesperipheralpartsofbothnuclearbag&nuclearchain
fibers.
Mainlyby"A"type/"-motorneurons"/"Fusimotorneuron"/"Small
motornervesystemofLeksellefferents".
Becauseoftheircharacteristicsmallersize.

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13.Hyperbaricoxygentherapyis/areusedin:
a)Radiationinducedproctitis
b)Tensionpneumothorax
c)Bleomycininducedlungdamage
d)Gasaangrene
e)Carbonmono-oxidepoisoning
CorrectAnswer-A:D:E
Ans.(A)Radiationinducedproctitis(D)Gasaangrene
(E)Carbonmono-oxidepoisoning
[RefManipalsurgeryp.176;A.K.Jainp.461]
HyperbaricOxygenTherapy-Indication:
Anaemichypoxiaespeciallyduetocarbonmono-oxidepoisoningor
severebloodloss)
Stagnanthypoxia
Histotoxichypoxia(Radiationinducedtissueinjury&gasgangrene)
COpoisoning.
Infection(gasgangrene).
Cancertherapytopotentiatercdiathcrapy
Arterialinsufficiency
Decompressionsickness&airembolism
Contraindication-
Untreatedpneumothorax
Duringtreatmentwithdrugslike-Bleomycin(bleomycin-induced
lung
injury),Doxorubicin(Adriamycin),cisplatin,Disulfiram.

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14.Peripheralcyanosisis/areassociated
with:
a)SLE
b)TAPVC
c)Atrialseptaldefect
d)Methemoglobinemia
e)Cardiogenicshock
CorrectAnswer-E
Ans.E.Cardiogenicshock
[Ref:PJM20th/16-19;Ganong25th/642.]
Peripheralcyanosis:
Causedbyslowingofbloodflowandincreasedextractionofoxygen
fromnormallysaturatedblood.
Resultsfromvasoconstrictionordecreasedperipheralbloodflow,
reducedcardiacoutputorvascularocclusion.
Characterizedbycyanosisofskinaloneandsparingofmucous
membranes
Causes:
Vasculorocclusion
Arterialobstruction
Venousobstruction
Reducedcardiacoutput
Coldexposure
Redistributionofbloodflowfromtheextremities

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15.Bloodinfoetusis/areformedby:
a)Liver
b)Lymphnodes
c)Spleen
d)Bonemarrow
e)Yolksac
CorrectAnswer-A:B:C:D:E
Ans.(A)Liver(B)Lymphnodes(C)Spleen(D)Bonemarrow
(E)Yolksac
Bloodformationoccurlater(5wk)throughoutembryonic
mesenchyme,thenliver,spleen/thymus,bonemarrowlymphnode
(ref:embryoIogy.mrd.unsw.au).
FormationofbloodincludeformationofRBC,WBC&platelet.
Bloodproductionstartsfrom3rdweekofintrauterinelife.
3rdweekto3rdmonth(intravascularphase)-Erythropoiesisoccurs
inthemesodermofyolksac
B/w3rdto5thmonthofintrauterinelife,erythropoiesisoccur
principallyintheliver(tosomeextentinthespleen).
5thmonthonwards(myeloidphase)=Erythropoiesisoccursinred
bonemarrow(allmarrowisredbonemarrowatthisstage)

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16.Importantbuffersystemoperatingin
blood:
a)Proteinsystembuffer
b)Phosphatebuffer
c)Carbonicacid-Bicarbonatesystembuffer
d)Hemoglobinsystembuffer
e)None
CorrectAnswer-A:C:D
Ans.(A)Proteinsystembuffer(C)Carbonicacid-Bicarbonate
systembuffer(D)Hemoglobinsystembuffer
[RefA.K.Jain6th/559-60,55;Ganong25th/643-44]
Acidandbaseshiftsinthebloodarelargelycontrolledbythreemain
buffersinblood:(1)proteins,(2)hemoglobin(3)thecarbonicacid-
bicarbonatesystem
Morethan90%ofblood'scapacitytobuffercarbonicacidis
attributedtothehaemoglobinbuffersystem.
Carbonicacid-bicarbonatesystemisoneofthemosteffectivebuffer
systemsinthebody.
Inplasma,phosphateconcentrationistoolowforthissystemtobea
quantitativelyimportantbuffetbutitisimportantintracellularly.

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17.Trueaboutcollagen:
a)Doublehelixstructure
b)Singlehelixstructure
c)Triplehelixstructure
d)-pleatedstructure
e)Componentofconnectivetissueofbody
CorrectAnswer-C:E
Ans:c.Triplehelix...,e.Component....[RefHarper30th/46-
47,627-32;Lippincott6th/43-48;Vasudevan5th/254-55]
Incollagen,thecollagenhelix,ortype-2helix,isamajorshapein
secondarystructure
Allcollagenhaveatriplehelicalstructure.
Astrikingcharacteristicofcollagenisoccurrenceofglycineresidue
ateverythirdpositionoftriplehelicalportionofachain.
Thisrepeatingstructure,representedas(Gly-x-y)n,isanabsolute
requirementfortheformationofthetriplehelix.
300nmlongand1.5nmindiameter,itismadeupofthree
polypeptidestrands(calledalphachains),eachpossessingthe
conformationofaleft-handedhelix(itsnameisnottobeconfused
withthecommonlyoccurringalphahelix,aright-handedstructure).
Thesethreeleft-handedhelicesaretwistedtogetherintoaright-
handedcoiledcoil,atriplehelixor"superhelix"
Collagen,themajorcomponentofmostconnectivetissues,
constitutesapproximately25%oftheproteinofmammals.
Itprovidesanextracellularframeworkforallmetazoananimalsand
existsinvirtuallyeveryanimaltissue.Atleast28distincttypesof

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collagenmadeupofover30distinctpolypeptidechains(each
encodedbyaseparategene)havebeenidentifiedinhumantissues.

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18.Atisoelectricpoint(p1)netchargeof
aminoacisis:
a)-1
b)+1
c)-2
d)+1
e)0
CorrectAnswer-E
Ans:e.0...[RefHarper30th/201]
Isoelectricpoint(pI)isapHinwhichnetchargeofaminoacidis
zero"(Harper30th/20)
"Isoelectricpoint(pI)isapHinwhichnetchargeofaminoacidis
zero.Incaseofproteinsisoelectricpointmostlydependsonseven
chargedaminoacids:glutamate(6-carboxylgroup),aspartate(13-
carboxylgroup),cysteine(thiolgroup),tyrosine(phenolgroup),
histidine(imidazolesidechains),lysine(c-ammoniumgroup)and
arginine(guanidiniumgroup).

---

19.HexosaminidaseAdeficiencycauses:
a)Niemann-pick
b)Tay-Sachsdisease
c)Hurlersyndrome
d)Gaucher'sdisease
e)Krabbe'sdisease
CorrectAnswer-B
Ans:b.Tay-Sachsdisease[RefsHarper30th/251;Lippincott
6th/212;Harrison19th/432e,433e
HexosaminidaseAdeficiencyisanenzymedeficiencythatcauses
brainandothernervecellstodie,whichcanleadtosevere
neurologicalandmentalproblems.
HexosaminidaseA(HEXA)deficiencyiscausedbyadeficiencyin
anenzymecalledbeta-hexosaminidaseA.Thisenzymehelpsbreak
downaparticularfattyacidcalledGM2ganglioside.
Withoutadequateamountsoffunctionalenzymes,GM2ganglioside
willbuildupinnervecellsandcausethemtodie.
ThereareseveralformsofHEXAdeficiency,includingacute
infantile(Tay-Sachsdisease),juvenile,chronic,oradult-onsetforms.

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20.Mitchondrialmatrixcontainsenzymesof:
a)Pyruvatedehydrogenase
b)TCAcycleenzyme
c)AcylCoAsynthetase
d)ATPsynthase
e)-oxidationenzymes
CorrectAnswer-A:B:D
Ans:a.Pyruvatedehydrogenase,b.TCAcycleenzyme,d.ATP
synthase
MatrixoftheMitochondrionisgel-likesolutionintheinteriorof
mitochondriais50%protein.Thesemoleculesincludetheenzymes
responsiblefortheoxidationofpyruvate,aminoacids,fattyacids(by
n-oxidation),andthoseofthetricarboxylicacid(TCA)cycle.
Thesynthesisofglucose,urea,andhemeoccurpartiallyinthe
matrixofmitochondria.Inaddition,thematrixcontainsNAD+and
FAD(theoxidizedformsofthetwocoenzymesthatarerequiredas
hydrogenacceptors)andADPandPi,whichareusedtoproduce
ATP.

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21.Whichofthefollowinggroup(s)are
presentinnaturalaminoacids:
a)Imidazolegroup
b)Tetrapyrrolegroup
c)Indolegroup
d)Guanidiniumgroup
e)Ketogroup
CorrectAnswer-A:B:C:D
Ans:a.Imidazole...,b.Tetrapyrrole...,c.Indole...,d.
Guanidinium(RefHarper30th/20-23;Lippincott6th/I-11;
Vasudevan5th/19]
Imidazolegroup:Histidine,Betacarboxylgroup:Asparticacid
(Vasudevan5th/19)Gammacarboxylgroup:Glutamicacid
(Vasudevan5th/19)?-aminogroup:Lysine(Vasudevan5th/19).
SpecialgroupsinAminoacidsVasudevan5th/17:Benzenegroup-
PhenylalanineIndolegroupin-TryptophanPyrrolidinegroup-
ProlineGuanidiniumgroup-ArgininePhenolgroup-Tyrosine

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22.Whichofthefollowingvitamindeficiency
causetriadofmentalconfusion,
ophthalmoplegia&ataxia:
a)VitB2
b)VitB1
c)VitB6
d)VitC
e)Vit.B12
CorrectAnswer-B
Ans:b.VitBl[RefLippincott6th/378-79;Harrison19th/96e,
18th/594-96;Harper30th/555-56,28th/468]
Classically,Wernicke'sencephalopathyischaracterizedbythetriad
ofophthalmoplegia,ataxia,andmentalconfusion,butconfusion&a
staggeringgaitareperhapsmostcommon"-SynopsisofPsychaitry
by(Kaplan11th/796-799)
Thiaminedeficiencyinitsearlystageinducesanorexiaand
nonspecificsymptoms(e.g.,irritability,decreaseinshort-term
memory).
Alcoholicpatientswithchronicthiaminedeficiencyalsomayhave
centralnervoussystem(CNS)manifestationsknownasWernicke's
encephalopathy,whichconsistsofhorizontalnystagmus,
ophthalmoplegia(duetoweaknessofoneormoreextraocular
muscles),cerebellarataxia,andmentalimpairment

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23.Whichofthefollowingenzyme(s)is/are
involvedingluconeogenesis:
a)Pyruvatecarboxylase
b)Phosphoenolpyruvatecarboxykinase
c)Phosphofructokinase-1
d)Glucose6-phosphatase
e)Pyruvatedehydrogenase
CorrectAnswer-A:B:D
Ans:a.Pyruvatecarboxylase,b.Phosphoenolpyruvate
carboxykinase,d.Glucose6-phosphatase,[RefHarper
30th/188;Lippincott6th/117-122;Harper28th/165-68;
Lippincott4th/329J]
glucose-6-phosphatase,fructose-1,6-bisphosphatase,andPEP
carboxykinase/pyruvatecarboxylase.

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24.Gelusedinelectrophoresisis/are:
a)Agarosegel
b)Polyacrylamideplaingel
c)PolyacrylamideSDS(Sodiumdodecylsulphate)impregnated
Polyacrylamidegel
d)alloftheabove
e)None
CorrectAnswer-D
Ans.d-alloftheabove[www.lonza.com/go/literature/2043;
Shinde7th/7741]
SeparationofRNAinagarosegelsisusedforanumberofdifferent
purposes,includingNorthernblotstomonitorRNAexpression
levels,checkingRNAintegrityandsizeselectionofRNAforcloning
experiments.SeparationofRNAbasedonfragmentlengthrequires
conditionsthataredifferentfromDNAanalysis.
Theseincludesamplepreparation,theuseofsampleandgel
denaturants,electrophoresisbuffers,andvisualization.Thepurpose
oftheexperimentandthesizeoftheRNAbeingseparatedarethe
primarydriversindeterminingwhichdenaturingsystemtouse.
ThemostfrequentlyuseddenaturantsforRNAagarosegel
electrophoresisareformaldehyde,formaldehyde/formamide,and
glyoxalplusDMSO.

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25.Whichofthefollowingmethod(s)is/are
usedfordetectionofnucleicacid:
a)Northernblotting
b)Southernblotting
c)Westernblotting
d)Microarray
e)ELISA
CorrectAnswer-A:B:D
Ans:a.Northern...,b.Southern"',d'Microarray'
Sample
Technique
GelUsed Purpose
Analysed
Southern
DNA?
Yes
DetectDNAchanges
blot
Northern
RNA?
Yes
MeasuresmRNAamounts&size
blot
Western
Protein?
Yes
Measuresproteinamount
blot
ASO
DNA?
No
DetectsDNAmutations?
RNAor
MeasuresmanymRNAlevelsat
Microarray
No
cDNA
onetime
Proteins?
Detectsproteins(antigens)or
ELISA
or
No
antibodies?
antibodies
Measuresabundance,distribution,
posttranslai.iurimodifications,
Proteomics Proteins?
Yes
functions&
interactionsofcellularproteins

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interactionsofcellularproteins

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26.Functionofreversetranscriptase:
a)RNAdependentDNAsynthesis
b)DNAdependentRNAsynthesis
c)DNAdependentDNAsynthesis
d)RNAdependentRNAsynthesis
e)Involvedinproteinsynthesis
CorrectAnswer-A
Ans.a.RNAdependentDNAsynthesis

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27.Whichofthefollowingisnotapyrimidine
base?
a)Cytosine
b)Uracil
c)Guanine
d)Thymine
e)Adenine
CorrectAnswer-C
Ans.is'c'i.e.,Guanine
PurinesPyrimidines
AdenineCytosine
GuanineUraciI
Thymine
Bothpurines(adenineandguanine)arefoundbothinDNA&RNA.
Amongpyrimidines-
LiCytosineanduracilarefoundinRNA(thymineisnotfoundin
RNA).
CytosineandthyminearefoundinDNA(uracilisnotfoundinDNA).
InDNA,adenineisalwayspairedwiththyminebytwohydrogen
bonds;andguaninealwayspairedwithcytosinebythreehydrogen
bonds.

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28.Restrictionendonucleasecleaves:
a)dsDNA
b)RNA
c)Histone
d)Protein
e)ssDNA
CorrectAnswer-A
Ans:a.dsDNA
Restrictionendonucleases(restrictionenzymes),which
cleavedouble-stranded(ds)DNAintosmaller,moremanageable
fragments,hasopenedthewayforDNAanalysis"
Restrictionenzyme(REorRestrictionEndonuclease)isanenzyme
thatcleavedouble-strandedDNAQatspecificrecognitionnucleotide
knownasrestrictionsitesQ
ThecutDNAfragmentsbyREmayhavestickyends(cohesive
ends)?orbluntsends?dependingonthemechanismusedby
enzyme
DNAfragmentswithstickyendsareparticularlyusefulfor
recombinantDNAexperiments(hybridorchimericDNAmolecules)
Restrictionenzymeisnamedaccordingtotheorganismfromwhich
itwasisolated

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29.Trueaboutmiliarytuberculosis:
a)Occurprimarilyduetohematogenousspread
b)Miliarylesionisgenerallyofsize1-2mm
c)Diffusebilateralcrepitationisalwayspresent
d)Onsetisgenerallyacute
e)Sputumsmearmicroscopyisnegativein80%ofcases
CorrectAnswer-A:B:E
Answer-(A)Occurprimarilyduetohematogenousspread
(B)Miliarylesionisgenerallyofsize1-2mm(E)Sputumsmear
microscopyisnegativein80%ofcases
MiliaryTBisduetohematogenousspreadoftuberclebacilli.
Blood-bornedisseminationgivesrisetomiliaryTB.
Thelesionsareusuallyyellowishgranulomasl-2mmindiameter
thatresemblemilletseeds(microscopicorsmall,visible).
Clinicalfeatures-
Fever,nightsweats,anorexio,weaknas,andweightlossare
presentingsymptomsinthemajorityofcases.
Patientshaveacoughandotherrespiratorysymptoms.
Hepatomegaly,splenomegaly,andlymphadenopathy.
Eyeexamination-choroidaltubercles,whicharepathognomonicof
miliaryTB
Investigations-
Chestradiographyrevealsamiliaryreticulonodularpattern.
Sputumsmearmicroscopyisnegativein80%ofcases.
TST(Tuberculinskintest)maybenegative.
Bronchoalveolarlavageandtransbronchialbiopsyaremorelikelyto
providebacteriologicconfirmation.

---

Ausculutionisfrequentlynormalbutinmoreadvanceddisease,
widespreadcracklesareevident
Treatment-
RegimensthatareeffectivefortreatingpulmonaryTBarealso
effectivefortreatingextrapulmonarydisease.

---

30.Whichofthefollowingcancerspread
primarilybyhematogenousroute:
a)Papillarycarcinomathyroid
b)Renalcellcarcinoma
c)Pheochromocytoma
d)Glioblastomamultiforme
e)Follicularcarcinomaofthyroid
CorrectAnswer-B:C:E
Answer-(B)Renalcellcarcinoma(C)Pheochromocytoma
(E)Follicularcarcinomaofthyroid
Themostcommonlocationsofmetastasisarethelungsandbones.
Renalcellcarcinoma:Tumourcelllinethebloodvesselwhichare
responsibleforearlybloodspreadfromRCC
Papillarycarcinomathyroid:Focioflymphaticinvasionbytumorare
oftenPresent,butnobloodvesselinvolvement
Pheochromocytomasisthepresenceofmetastases.
Follicularcarcinomaofthyroid:Bloodbornemetastasesaremore
common.

---

31.PresentationofPierre-Robinsyndrome
includes:
a)Retrognathia
b)Lowsetear
c)Prominentforehead
d)Isolatedcleftpalate
e)Glossoptosis
CorrectAnswer-A:D:E
Answer-(A)Retrognathia(D)Isolatedcleftpalate
(E)Glossoptosis
Triadofmicrognathia,glossoptosis&cleftpalate
Cleftsoftpalate
High-archedpalate
Jawthatisverysmallwithsmall(receding)chin
Jawthatisfarbackinthethroat

---

32.Trueaboutmammalianmitochondrial
DNA:
a)Containsaround16500nucleotidesequence
b)Makesuparound3%totalcellularDNA
c)Makesuparound10%totalcellularDNA
d)Makesuparound0.3%totalcellularDNA
e)Makesuparound1%totalcellularDNA
CorrectAnswer-A:E
Answer-(A)Containsaround16500nucleotidesequence
(E)Makesuparound1%totalcellularDNA
Inmammaliancells,mitochondrialDNAmakesuplessthan1%of
thetotalcellularDNA.
AuniquefeatureofmitochondrialDNAismaternalinheritence.
mitochondriahavethereowngenomesconsistingofdouble-strand
mitochondrialDNA(mtDNA)moleculeconsistingofa16,569
nucleotidesequence.
mtDNAsequencecontainsatotalof37genesencoding13ETC.

---

33.HighlevelofhCGis/areseeninallexcept
:
a)Downsyndrome
b)Neuraltubedefect
c)Germcelltumor
d)Gestationaltrophoblasticdisease
e)Multiplepregnancy
CorrectAnswer-B
Answer-B.Neuraltubedefect
'HighlevelofhCGauldbedetectedin-multiplepregnancy,
hydatiformmole,choriocarcinoma,Downsyndrome,
Plasmalowerlevelsarefoundinectopicpregnancies&in
spontaneousabortion.
hCGisproducedbythesyncytiotrophoblastoftheplacenta.

---

34.Humanpapillomavirusis/areassociated
withallexcept:
a)Oropharyngealtumors
b)Carcinomanasophraynx
c)Carcinomaanalcanal
d)Carcinomapancreas
e)Carcinomacervix
CorrectAnswer-B:D
Answer-(B)Carcinomanasophraynx(D)Carcinomapancreas
Skinwarts(Plantarwart,commonwart,flatwart&
Epidermodysplasiaverruciformis)
Papilloma(Laryngeal,Oral)
Condylomaacuminatum(genitalwart)
Oralsquamouscellcarcinoma
Cervicalintraepithelialneoplasia(CIN)
Carcinomacervix

---

35.TrueaboutHodgkin'slymphoma:
a)Oftenlocalizedtosingleaxialgroupoflymphnode
b)Hepatomegalyisalwayspresent
c)Contiguousspreadoflymphnode
d)Canbecuredbychemotherapy&radiotherapy
e)Commonlyresentswithpainlesslymphadenopathy
CorrectAnswer-A:C:D:E
Answer-(A)Oftenlocalizedtosingleaxialgroupoflymphnode
(C)Contiguousspreadoflymphnode(D)Canbecuredby
chemotherapy&radiotherapy(E)Commonlyresentswith
painlesslymphadenopathy
Hodgkin'slymphomaisamalignantneoplasmoflymphoreticular
system.
Itcaninvolvelymphnodes,spleenandliver.
Commoninmales.
ClassicdiagnosticfeatureisthepresenceofReed-Sternberg(RS)
cellsorDorothy-ReedSternbergcells.
ClassicmarkersforHodgkin'sdiseaseisCD15&CD30.
AxiallymphaticsystemisalmostalwaysaffectedinHodgkin's
disease.
Cervical&mediastinallymphnodesareinvolvedmostfrequently.
Mostcommonlyinpatientspresentaspainless,movableandfirm
lymphadenopathy.
Treatment-
StageI/IIclassicalHodgkin'sdisease-
Chemotherapy+fieldradiotherapy

---

36.CD30is/aremarkerfor:
a)Anaplasticlargecelllymphoma
b)Embryonalcellcarcinoma
c)SquamousCellCarcinoma
d)Seminoma
e)Hodgkin'slymphoma
CorrectAnswer-A:B:E
Answer-(A)Anaplasticlargecelllymphoma(B)Embryonalcell
carcinoma(E)Hodgkin'slymphoma
CD30ispositiveinanaplasticlargecelllymphoma&Hodgkin's
lymphoma.
ActivatedBcells,Tcells,andmonocytes;alsoexpressedbyReed-
SternbergcellsandvariantsinclassicalHodgkinlymphoma.

---

37.Allaretrueaboutintestinalpolyp
syndromeexcept:
a)Cowdendisease-Hamartomatouspolyps
b)Hereditarynonpolyposiscolorectalcarcinoma(HNPCC)-
Multipleadenomatouspolyps
c)Peutz-Jegherssyndrome-associatedwithcoloniccarcinoma
d)Colonichyperplasticpolyphasmalignantpotential
e)Cronkhite-Canadasyndrome-mayhaveassociatedbreast
tumour
CorrectAnswer-D
Answer-D.Colonichyperplasticpolyphasmalignantpotential
Colonichyperplasticpolypsarebeningepithelialproliferation.

---

38.Increasethicknessofgastricmucosalfold
isseenin:
a)Menetrier'sdisease
b)Gastritiscystica
c)Boerhaavesyndrome
d)Zollinger-Ellisonsyndrome
e)All
CorrectAnswer-A:B:D
Answer-(A)Menetrier'sdisease(B)Gastritiscystica
(D)Zollinger-Ellisonsyndrome
TwowelldefinedexamplesareMenetrier'sdisease&Zollinger-
Ellisonsyndrome
Gastricglandhyperplasiasecondarytoexcessivegastrinsecretion,
inthesettingofagastrinoma.

---

39.Bloodtransfusionreactioncanleadsto:
a)Acuteglomerulonephritis
b)Myoglobinuria
c)Hemoglobinuria
d)Transfusion-relatedacutelunginjury
e)Acuterenaltubularnecrosis
CorrectAnswer-C:D:E
Answer-(C)Hemoglobinuria(D)Transfusion-relatedacutelung
injury(E)Acuterenaltubularnecrosis
Hemolytictransfusionreaction
Intravascularhemolysis
Transfusion-relatedacutelunginjury(TRALI)
Renalfailure

---

40.Notseeninpoststreptococcal
glomerulonephritis(PSGN):
a)Nephroticrangeproteinuria
b)Neutrophilicinfiltrationoftubules
c)Subepithelialdeposits
d)Lineardepositsalongglomerularbasementmembrane
e)None
CorrectAnswer-A:B:D
Answer-(A)Nephroticrangeproteinuria(B)Neutrophilic
infiltrationoftubules(D)Lineardepositsalongglomerular
basementmembrane
Ittypicallyaffectschildrenbetweentheagesof2and14years.
Itismorecommoninmales.
Poststreptococcalglomerulonephritisduetoimpetigodevelops2-6
weeksafterskininfectionandl-3weeksafterstreptococcal
pharyngitis.
ThereisgranularsubendothelialimmunedepositsofIgG,IgM,C3,
C4andC5-9,andsubepithelialdeposits.
Clinicalfeatures-
Acutenephritiswithhematuria,pyuriaredbloodcellcasts,edema,
hypetension,andoliguricrenalfailure.
20%ofadultshaveproteinuriainthenephroticrange.
Antibodiesinstreptococcalinfection:ASOAnti-DNAaseB,Anti-
Streptokinase,anti-Nicotinyladeninedinucleotidase&
Anti-Hyaluronidase.

---

41.Trueaboutfibrolamellarcarcinomaof
liver:
a)Betterprognosisthantypicalhepatocellularcarcinoma
b)Associatedwithcirrhosis
c)AFP-positive
d)Occurinyoungeradults
e)Morecommoninfemales
CorrectAnswer-A:D:E
Answer-(A)Betterprognosisthantypicalhepatocellular
carcinoma(D)Occurinyoungeradults(E)orecommonin
females
Itisadistinctivevariantofhepatocellularcarcinoma
Itisseeninyoungadults(20-40yrsofage)
Ithasequalsexincidence
Ithasbetterprognosis
IthasnoassociationwithHBVorcirrhosis
Itisgrosslyencapsulatedmass.
AFPelevationisnotseeninFibrolamellarCa

---

42.ChromosomalabnormalitiesinDown
syndromeis/aredueto:
a)Nondisjunctionalofmaternalchromosome
b)Nondisjunctionalofpaternalchromosome
c)Translocationsbetweenchromosome21&14
d)Disjunctionofpaternalchromosome
e)Disjuctionofmaternalchromosome
CorrectAnswer-A:B:C
Answer-(A)Nondisjunctionalofmaternalchromosome(B)
Nondisjunctionalofpaternalchromosome(C)Translocations
betweenchromosome21&14
Trisomy21(47,XX+21)isthemostcommon(95%)chromosomal
abnormalityinDownsyndrome.
InDownsyndromelargefragmentof14or15or22chromosome
fuseswithlargefragmentofchromosome21Extramaterialcomes
on21anditactslikethird21stchromosomeTrisomy21.
Extrachromosomeisofmaternalinorigin.
I%havemosaicwithsomeallhave46chromosome.
4%haverobertsoniantranslocation.
1. t(13:21)
2. t(14:21)
3. t(15:21)
Veryrarelylongarmofchromosome21istriplicate(Partialtrisomy).

---

43.Schaumannbodiesarenotseenin:
a)Sarcoidosis
b)Histoplasmosis
c)Cryptococcosis
d)Hypersensitivitypneumonitis
e)Tuberculosis
CorrectAnswer-B:C
Answer-B,HistoplasmosisC,Cryptococcosis
Sarcoidosis,
Hypersensitivitypneumonitis,
Berylliosis
Crohn'sdisease&tuberculosis

---

44.Neuroendocrinecelltumourmarkersare:
a)ChromograninA
b)CD56
c)Neuron-specificenolase
d)Synaptophysin
e)Cytokeratin7
CorrectAnswer-A:B:C:D
Answer-A,ChromograninAB,CD56C,Neuron-specific
enolaseD,Synaptophysin
ChromograninAisthemostwidelyused
Neuron-specificenolase(NSE)isacytosolicmarkerof
neuroendocrinedifferentiation.
Synaptophysinfoundinsmallvesiclesofneuronsand
neuroendocrinetumors.
CD56aremarkers.

---

45.Allaretrueaboutfocalnodular
hyperplasiaexcept:
a)Multiplenodulemaypresent
b)Morecommoninmale
c)Maybeassociatedwithcontraceptivepillsuse
d)Hypovascularonthearterial-phaseandhypervascularonthe
delayed-phaseCTimages
e)CTislesssensitivethanMRIindepictingthecharacteristic
centralscar
CorrectAnswer-B
Answer-B.Morecommoninmale
FNHistypicallybenign
"FNHismostfrequentlyfoundinyoungtomiddle-agedadults,witha
strongfemalepredilection.
thelesionismultinodular
Bileductulesareusuallyfoundattheinterfacebetweenhepatocytes
andfibrousregions.
Kupffercellsarepresent

---

46.Allaretrueabouttamoxifenexcept:
a)Usedasadjuvanttherapyinestrogenreceptorpositivebreast
cancer
b)Noeffectonuterus
c)Pro-estrogeneffectonbone
d)Reduceschanceofosteoporosis
e)Reducescoronaryarterydiseases
CorrectAnswer-B:E
Ans.(B)Noeffectonuterus(E)Reducescoronaryartery
diseases
[Ref:KDT7th/312-15;Katzung13th/713;Harrison19th/2498]
Tamoxifen:
Approvalfortheprimaryprophylaxisofbreastcancerinhighrisk
women.
Reducestherecurrencerateofbreastcancerinipsilateralaswellas
contralateralbreast.
Associatedwithreducedriskofcancerinthecontralateralbreast.
Improvesthebonemassduetoantiresorptiveeffect.
Increasestheriskofthromboembolicevents.
Hypertglyceridaemia,deepveinthrombosis,ischemicheartdisease,
retinopathy&othercomplicationstobeobservedduringtamoxifen
therapy.

---

47.TrueaboutHyoscine:
a)Causemydriasis
b)Causemiosis
c)Usedformotionsickness
d)BetterBBBpenetrationthanatropine
e)Centralnervoussystemdepressant
CorrectAnswer-A:C:D:E
Ans.(A)Causemydriasis(C)Usedformotionsickness
(D)BetterBBBpenetrationthanatropine(E)Centralnervous
systemdepressant
Hyoscine(scopolamine):
Appliedtoeyestheyfreelypenetratecornea
HasbetterBBBpenetration
Shorterdurationofactionthanatropine.
Mosteffectivedrugformotionsickness
CNSdepressant.
Producesedationandamnesiaduringlabour(twilightsleep)
Causedefinitemydriasis&lossofaccommodation"
LiedetectorduringworldwarII

---

48.Truestatement(s)aboutRutin:
a)Hasanti-fibrinolyticaction
b)Hasanti-plateletaction
c)Antioxidantproperty
d)Acitrusflavonoidglycosidefoundinmanyplantsincluding
buckwheat
e)None
CorrectAnswer-B:C:D
Ans.(B)Hasanti-plateletaction(C)Antioxidantproperty(D)A
citrusflavonoidglycosidefoundinmanyplantsincluding
buckwheat
Rutin(Bioflavonoids):
Richestsourceisbuckwheat.
Plantglycosideclaimedtoreducecapillarybleeding.
Usedinadoseof60mgoralBD-TDSalongwithVit.Cwhichis
believedtofacilitateitsaction(supportbloodcirculation,asan
antioxidant,afldtotreatallergies,yiruses,orarthritisandother
inflammatoryconditions).
Strengthenstheliningofthebloodvesselsthroughoutthebody.
Helpstreathemorrhoids,internalbleeding.
Helpspreventhemorrhagicstrokes.
Stoptheformationofabloodclot(thrombosis).
Veryeffectivewithbloodclotsbecauseittreatsandpreventclotsin
botharteriesandveins
Mostpotentlyanti-thrombotic.
Anantioxidant.

---

49.Side-effect(s)ofZoledronicacidis/areall
except:
a)Flu-likesymptoms
b)Osteonecrosisofthejaw
c)Dizziness
d)Constipation
e)Renaltoxicity
CorrectAnswer-D
Ans.D.Constipation
Zoledronate:
Flu-likesymptomsduetocytokinereleaseattendthei.vinfusion
Nausea,vomiting,bodyache,dizzinessarecommon
Renaltoxicityhasbeenencountered
OsteonecrosisofJawisararecomplicationofi.vhighdose

---

50.Anti-microbialagentsactingonnucleic
acidareallexcept:
a)Acyclovir
b)Linezolid
c)Fluroquinolones
d)Streptomycin
e)Rifampin
CorrectAnswer-B:D
Ans.(B)Linezolid(D)Streptomycin
[Ref:KDT7th/689-90]
1. Inhibitcellwallsynthesis:Penicillins,Cephalosporins,Cycloserine,
Vancomycin,Bacitracin.
2. Causeleakagefromcellmembranes:Polypeptides-Polymyxins,
Colistin,Bacitracin.Polyenes-AmphotericinB,Nystatin,Hamycin
3. Inhibitproteinsynthesis:Tetracyclines,Chloramphenicol,
Erythromycin,Clindamycin,linemlid,
4. Causemisreadingofm-kNAcodeandaffectpermeability:
Aminoglycosides-Streptomycin,Gentamicin,etc.
5. InhibitDNAgyrase:Fluoroquinolones-Ciprofloxacinandothers
6. InterferewithDNAfunction:Rifampin
7. InterferewithDNAsynthesis:Acyclovir,Zidovudine
8. Interferewithintermediarymetabolism;Sulfonamides,Sulfones,
PAS,Trimethoprim,Pyrimethamine,Metronidazole

---

51.CNSstimulantsare:
a)Cocaine
b)Amphetamine
c)Cannabis
d)Dexamphetamine
e)MDMA(ecstasy)
CorrectAnswer-A:B:D:E
Ans.(A)Cocaine(B)Amphetamine(D)Dexamphetamine
(E)MDMA(ecstasy)
[Ref,KDT7th/486,452.]
Psychotogenic(Hallucinogens)drugsareCannabis,LSD,
mescaline,endocannabinoid.
CNSStimulant:
1. Convulsants:Strychnine,picrotoxin,bicuculline,pentyIenetetrazol
2. Analeptics:Doxapram
3. Psychostimulants:Amphetamine,Methylphenidate,atomoxetine,
modafinil,armodafinil,pemoline,cocaine&caffeine.

---

52.Drugcontraindicatedinpregnancy:
a)Sulfonamide
b)ACEinhibitors
c)Phenytoin
d)Ciprofloxacin
e)Furosemide
CorrectAnswer-B:C
Ans.(B)ACEinhibitors(C)Phenytoin
[Katzung10th/975]
ACEinhibitors-InAlltrimester,especiallysecondandthird-Renal
damage.
Phenytoin-InAlltrimester-FetaIhYdantoinsYndrome
Thalidomide-Firsttrimester=Phocomelia(shortenedorabsent
longbonesofthelimbs)andmanyInternalmalformations

---

53.Inwhichofthefollowingliverflukes,
triclabendazoleis/areused:
a)Clonorchissinensis
b)Opisthorchisviverrini
c)Fasciolahepatica
d)Fasciolagigantica
e)Opisthorchisfelineus
CorrectAnswer-C:D
Ans.(C)Fasciolahepatica(D)Fasciolagigantica
[Ref:Harriison19th/1428;I(DT7th/851]
Triclabendazoleishighlyeffectiveagainstadultsofthecommonliver
fluke(Fasciolahepatica)aswellasallimmaturestages.
AlsoeffectiveagainstFasciolagiganticaandFascioloidesmagna.
Noefficacyagainstroundwormsortapeworms.

---

54.Truestatement(s)regardingthepowerof
chiefjudicialmagistrate:
a)Cangiveimprisonmentof<3yearonly
b)Cangiveimprisonmentofanyduration
c)Cangiveimprisonmentupto5year
d)Cangiveimprisonmentupto7year
e)Canimposeunlimitedfine
CorrectAnswer-D:E
Ans:d.Cangiveimprisonmentupto7yeare.Canimpose
unlimitedfine[RefReddy32nd/6;Reddy27th/6
indiankanoon.orgl
TheCourtofaChiefJudicialMagistratemaypassanysentence
authorisedbylawexceptasentenceofdeathorofimprisonmentfor
lifeorofimprisonmentforatermexceedingsevenyears.
TheCourtofaMagistrateofthefirstclassmaypassasentenceof
imprisonmentforatermnotexceedingthreeyears,oroffinenot
exceedingfivethousandrupees,orofboth.
TheCourtofaMagistrateofthesecondclassmaypassasentence
ofimprisonmentforatermnotexceedingoneyear,oroffinenot
exceedingonethousandrupees,orofboth.
TheCourtofaChiefMetropolitanMagistrateshallhavethepowers
oftheCourtofaChiefJudicialMagistrateandthatofaMetropolitan
Magistrate,thepowersoftheCourtofaMagistrateofthefirstclass.

---

55.Whichofthefollowingfeatureis/are
relatedtomandibleofmaleincomparison
tofemale:
a)Ascendingramus-smallerbreadth
b)Angleoframus-Moreobtuse
c)Largercondyle
d)Mentaltubercles-larger&prominent
e)Symphysealheightmore
CorrectAnswer-C:D:E
Ans:c.Largercondyled.Mentaltubercles-larger&
prominente.Symphysealheightmore[Ref.Reddy32nd/60;
Parikh7th/79]
Symphysealheightismoreinmales(Parikh7th/79)
FemaleSmaller
TraitGeneralsize MaleLarger&thicker
&thinner
Chin
Square(U-shaped)
Rounded
Atsymphysis
Bodyheight
Atsymphysisgreater
smaller
Ascendingramus
Greaterbreadth
Smallerbreadth
Angleofbody
Lessobtuse(under1250);
Moreobtuse&
&,amus(Gonion)
Prominent&Everted
notprominent
Condyles
Larger
Smaller
Mentaltubercles
Large&prominent
Insignificant

---

56.Whichofthefollowingstatementis/are
trueaboutcarbamatepoisoning:
a)Causepinpointpupil
b)Atropineisantidote
c)Adrenergicaction
d)Spontaneouslyhydrolysesfromthecholinesteraseenzymatic
site
e)CNStoxicityismoreascomparedtoorganophosphorus
CorrectAnswer-B:D
Ans:b.Atropineisantidoted.Spontaneouslyhydrolysesfrom
thecholinesteraseenzymaticsite[RefReddy32nd/495-98;
Parikh7th/625-28;GerGIIth/210;KDT7th/111;Katzung
13th/979-80;PharmacologybySatoskar24th/297
Itdifferstoxicologicallyfromorganophosphate:Theywill
spontaneouslyhydrolysefromthecholinesteraseenzymaticsite
within24to48hours,whereasorganophosphateswillnot.
TheydonoteffectivelypenetrateintotheCNS,&assuchCNS
toxicityislimited.
Treatment:Atropineisthespecificantidote.Pralidoximemay
diminishtheseverityofsymptoms&helppreventsomemorbidity.

---

57.WhichofthefollowingisNOTrape:
a)Sexualintercoursewithwife,ofagebelow15year,with
consent
b)Sexualintercoursewithwife,ofage16year,withconsent
c)Sexualintercoursewithagirlbelow18yearsofage,with
consent
d)Sexualintercoursewithagirlof18yearwithconsent
e)Sexualintercoursewithwifewhoislivingseparatelyfrom
himunderadecreeofseparation,oranycustomorusage
withherconsent
CorrectAnswer-B:D:E
Ans:b.Sexualintercoursewith...,d.Sexualintercoursewitha
girl...,e.Sexualintercoursewithwifewhoisliving......[Ref
Reddy32nd/392-95;Parikh7th/389-911
Rape:TheCriminalLaw(Amendment)Bill,2013(5.375,I.P.C)
AcctoGazetteNotificationofGOIregardingCriminalLaw
(amendendment)Act,2013releasedon2april,2013,1tisage15
year.
ExceptiontoS.375,I.P.C:Sexualintercourseorsexualactsby
amanwithhisownwife,thewifenotbeingunder15years.
Thereiscontroversialreferenceregardingageofwife,either16or
15yearinReddy(old&newed.)&Parikh.
Withherconsent,whenthemanknowsthatheisnotherhusband
andthatherconsentisgivenbecauseshebelievesthatheis
anothermantowhomsheisorbelievesherselftobelawfully
married.
Withherconsentwhen,atthetimeofgivingsuchconsent,by

---

reasonofunsoundnessofmindorintoxicationortheadministration
byhimpersonallyorthroughanotherofanystupefyingor
unwholesomeSubstance,sheisunabletounderstandthenature
andconsequencesofthattowhichshegivesconsent.
Withorwithoutherconsent,whensheisundereighteenyearsof
age.
Whensheisunabletocommunicateconsent

---

58.Trueaboutrigormortisareall,
except:
FMGE08
a)Seenimmediatelyafterdeath
b)Itlast18-36hinsummer
c)Itdisappearsinthesequenceasitappears
d)Itlast24-48hinwinter
e)None
CorrectAnswer-A
Ans.Seenimmediatelyafterdeath

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59.Post-mortemcaloricityis/areseeninall
except:
a)Strychninepoisoning
b)Septicaemiccondition
c)Cholera
d)Barbituratepoisoning
e)Tetanus
CorrectAnswer-D
Ans:d.Barbituratepoisoning[RefReddy33rd/155,32rd/149;
Parikh7th/143,6th/3.8-3.9]
Post-MortemCaloricity1.Reddy33rd/155-Inthiscondition,the
temperatureofthebodyremainsraisedforthefirsttwohoursorso
afterdeath.
Whentheregulationofheatproductionhasbeenseverelydisturbed
beforedeath,asinsunstroke&insomenervousdisorder
Whentherehasbeenagreatincreaseinheatproductioninthe
muscleduetoconvulsions,asintetanus&strychninepoisoningetc
Post-MortemCaloricity:SeenIParikhth/3.8-3.9,Pontine
haemorrhage&sunstroke,Tetanus&strychninepoisoning.,acute
viralorviralinfectionssuchaslobarpneumonia,typhoidfever,
encephalitis&encephalomyelitis

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60.Treatmentofcarbolicacidpoisoning
includes:
a)Repeatedlavageshouldbedone
b)Intubationmayberequiredincaseofrespiratorycompromise
c)Emeticsisverybeneficial
d)Salinecontainingsodiumcarbonateisgiven
e)None
CorrectAnswer-A:B:D
Ans:a.Repeatedlavageshouldbedoneb.Intubationmaybe
requiredincaseofrespiratorycompromised.Salinecontaining
sodiumcarbonateisgiven[RefReddy32nd/507;Parikh
7th/535-37]
Anemeticoftenfailsduetotheanaestheticeffect
Lavage:Thestomachshouldbewashedrepeatedly,carefullywith
plentyoflukewarmwatercontainingactivatedcharcoal,oliveoil,
casteroiletc.Washingcontinueduntilthewashingsareclear&
odourless
Whenlavageiscompleted,309ramofmagnesiumsulphateora
quantityofmedicinalliquidparaffinshouldleftinthestomach
Salinecontainingsodiumcarbonateisgiveni.vtocombatcirculatory
depression,todilutecarboilicacidcontentofblood&toencourage
excretionbyproducingdiuresis,Haemodialysis,ifthereisrenal
failure
Carbolicacidmanagement:Evaluateandsupportairway,breathing,
andcirculation.Childrenmaybemorevulnerabletocorrosive
agentsthanadultsbecauseoftherelativelysmallerdiameteroftheir

---

airways.
Incasesofrespiratorycompromisesecureairwayandrespiration
viaendotrachealintubation.Ifnotpossible,surgicallycreatean
airway.

---

61.Griffithexperimentwasdoneon?
a)Salmonella
b)Streptococcuspneumoniae
c)Enterococcus
d)Staphylococcus
e)None
CorrectAnswer-B
Ans.is'b'i.e.,Streptococcuspneumoniae[RefAdvanced
biologyp.396]
In1928,FrederickGriffith'sexperimentfirstdemonstrated
transformationinstreptococcuspneumoniae.
FrederickGriffith'sexperimentonpneumococcus(streptococcus
pneumoniae)provedthatgeneticcharactersaretransmittedfrom
onegenerationtotheotherthroughtransformation.
ItistransferofgeneticinformationthroughtheagencyoffreeDNA.
Itwasthefirstexampleofgeneticexchangeinbacteriatobebeen
discoveredGriffithin1928foundthatmicediedwheninjectedwitha
mixtureoflivenon-capsulated(R)Streptococcuspneumoniae
&heatkilledcapsulated(S)S.pneumoniae,neitherofwhich
separatelyprovedfatal

---

62.AllaretrueaboutEbolavirusinfection
except?
a)Airdroplerismostcommonmodeoftransmission
b)Haemorrhagicmanifestationmayoccur
c)Thaiforesttype-mostcommonspeciesinepidemics
d)presentsassuddenonsetoffeverandsorethroat
e)Casefatalityratemaybehighas70%
CorrectAnswer-A:C
Ans.is'a'i.e.,Airdroplerismostcommonmodeof
transmission&'c'i.e.,Thaiforesttype-mostcommonspecies
inepidemics]RefPark24m/ep.374]
Thevirusistransmittedthroughdirectcontactwithblood,organs,
bodysecretionsorotherbodyfluidsofinfectedanimalslike
chimpanzees,gorillas,monkeys,fruitbatsetc.
Humantohumantransmissionisthroughbloodorbodyfluidsofan
infectedsymptomaticpersonorthroughexposuretoobjects(sucha
needle)thathavebeencontaminatedwithinfectedsecretions.
Itisnottransmittedthroughair,water,orfood.
Thevirusistransmittedthroughdirectcontactwithblood,organs,
bodysecretionsorotherbodyfluidsofinfectedanimalslike
chimpanzees,gorillas,monkeys,fruitbatsetc.
Humantohumantransmissionisthroughbloodorbodyfluidsofan
infectedsymptomaticpersonorthroughexposuretoobjects(such
asneedle)thathavebeencontaminatedwithinfectedsecretions
Itisnottransmittedthroughair,water,orfood
Theillnessischaracterizedbysuddenonsetoffever,intense

---

weakness,musclepain,headache,sorethroat,vomiting,diarrhea,
rash,impairedkidneyandliverfunctionandinsomebothinternal
andexternalbleeding.
ThevirusfamilyFiloviridaeincludesthreegenera:Cuevavirus,
Marburgvirus,andEbolavirus.
WithinthegenusEbolavirus,fivespecieshavebeenidentified:
Zaire,Bundibugyo,Sudan,RestonandTalForest.
Thefirstthree,Bundibugyoebolavirus,Zaireebolavirus,and
Sudanebolavirushavebeenassociatedwithlargeoutbreaksin
Africa.

---

63.Trueaboutchancroid:
a)BacillicausingthediseaseshowsSchooloffishappearance
b)Painfululcer
c)Incubationperiodis10-90day
d)Presentsaspainlesslymphadenopathy
e)Sharplydemarcated&elevatededge
CorrectAnswer-A:B:D
Ans:a.Bacillicausing...,b.Painful...,d.Presents.[Ref
Ananthanarayan9th/331;Harrison19th/880,1012-13]
Chancroidorsoftsoreisavenerealdiseasecharacterizedby
tendernon-induratedirregularulcersonthegenitalia
Thebacillimaybearrangedinsmallgroupsorwhorlsorinparallel
chains,givinga'schooloffish'or'railroadtrack'appearance
Theinfectionremainslocalized,spreadingonlytotheregionallymph
nodeswhichareenlarged&painful
Infectionisacquiredastheresultofabreakintheepitheliumduring
sexualcontactwithaninfectedindividual.
Approximatelyhalfofpatientsdevelopenlarged,tenderinguinal
lymphnodes,whichfrequentlybecomefluctuantandspontaneously
rupture.

---

64.Whichofthefollowingspreadby
ingestionofeggs:
a)Strongyloides
b)Trichinella
c)Trichuris
d)Ascaris
e)Ancylostomaduodenale
CorrectAnswer-C:D
Ans:c.Trichurisd.Ascaris
Strongyloides:Infectiveformisfilariformlarva(Panikar7th/178)
"Trichinella:Infectiveformisencystedlarvafoundinmusclesofpigs
&otheranimals"(Panikar7th/168)
"Ancylostomaduodenale-Infectiveformisthirdstagefilariform
larva"(Panikar7th/168)
ModeofInfectionPanikarParasitology7th/162
1. Byingestion
2. Eggs:Ascaris,enterobius,Trichuris
3. Larvawithinintermediatehost:Dracunculus
4. Encystedlarvaeinmuscle:Trichinella
5. Bypenetrationofskin:Ancylostoma,Necator,Strongyloides
6. Bybloodsuckinginsects:Filariae
7. Byinhalationofdustcontainingeggs:Ascaris,enterobius

---

65.Tochecktheefficiencyoftheheat
sterilization,whichofthefollowing
microbeis/areused:
a)Geobacillusstearothermophilus
b)Bacillussubtilis
c)Salmonella
d)Pneumococcus
e)Bacillusstearothermophilus
CorrectAnswer-A:B:E
Ans:a.Geobacillusstearothermophilusb.Bacillus
subtilise.Bacillusstearothermophilus[RefAnanthanarayan
9th/30,32;Greenwood16th/771
SterilisationControl(DryHeat)
Thesporesofanon-toxigenicstrainofclostridiumtetaniorBacillus
subtilissubspeciesnigerareusedasamicrobialtestofdryheat
efficiency.
Fordeterminingtheefficacyofmoistheatsterilization,sporesof
Bacillusstearothermophilusareusedasthetestorganism
"Geobacillusstearothermophilus(orBacillusstearothermophilus)is
constantlyusedinthebiotechindustrytotestthesuccessof
sterilizationcyclesofequipment.
Duetothebacteria'shighresistancetoheat,itisasuitable
biologicalIndicatorofmicrobelifeafterasterilizationcycle.

---

66.Dimorphicfungiis/are?
a)Histoplasmacapsulatum
b)Sporothrixschenckii
c)Malasseziafurfur
d)Cryptococcusneoformans
e)Aspergillus
CorrectAnswer-A:B
Ans.is'a'i.e.,Histoplasmacapsulatum;&'b'i.e.,Sporothrix
schenckii[RefAnanthanarayanelep.601,609;Jawetz23'/ep.
6451.
Fungithathavetwogrowthforms,suchasmold(filaments)anda
yeast,whichdevelopunderdifferentgrowthconditions.
Inhosttissuesorculturesat37?Ctheyoccurasyeasts,whileinthe
soilandinculturesat22?Ctheyappearasmoulds.
Yeastsareseenasroundedsinglecellsorasbudding
organisms.CandidaandCryptococcusaretraditionallyclassifiedas
yeasts.
Mostfungicausingsystemicinfectionsaredimorphicfungi
DimorphicFungiareJawetz27th/853
Blastomycosisdermatitidis
Paracoccidioidesbrasiliensis
Coccidioidesposadasii&Coccidioidesimmitis
Histoplasmacapsulatum
Sporotrixschenckii
Penicilliummarneffe

---

67.Trueaboutenteroviruses:
a)In1999,wildpoliovirus2waseradicatedfromworld
b)Vaccineassociatedparalyticpoliomyelitis(VAPP)most
frequentlycausedbyserotype1vaccine
c)BivalentOPVcontainstype1&type3strain
d)PrimarycourseofOPVconsistsofonly1dose
e)CoxasackieA7&enterovirustype71causesasepticmeningitis
CorrectAnswer-A:C:D:E
Ans:(A)In1999,wildpoliovirus2waseradicatedfromworld
(C)BivalentOPVcontainstype1&type3strain(D)Primary
courseofOPVconsistsofonly1dose(E)CoxasackieA7&
enterovirustype71causesasepticmeningitis
[RefPark23rd/202-09;Harrison19th/1289-91;Ananthanarayan
9th/485]
Ofthe3strainsofwildpoliovirus,wildpoliovirustype2was
eradicatedin1999&casenumbersoftype3aredowntothe
lowest-everlevelswiththelastcasereportedinNov2012from
Nigeria.
TheWHOprogrammeonimmunization(EPI)&thenational
immunizationprogrammeinIndiarecommendedaprimarycourseof
3dosesofOPVatone-monthintervals,commencingthefirstdose
wheninfantis6weeksold.
Poliovirustype1isresponsibleformostepidemicsofparalytic
poliomyelitis.Type3alsocausesepidemicstoalesserextent..
Type2usuallycausesinapparentinfectionsinwesterncountriesbut
inIndiaparalysisduetotype2isquitecommon"

---

GROUP
SEROTYPE
Poliovirus
1-3
CoxsackievirusA 1-22AND24
CoxsackievirusB
1-6
s
Echovirus
1-9,11-27,
29-34
Numbered
(EV)68-78
echovirus

---

68.Allaretrueaboutcytomegalovirusexcept:
a)Maybetransmittedfrompregnantmothertofoetus
b)Type5Humanherpesvirus
c)Lymphocyteenlargement
d)Causecongenitaldiseases
e)Mayleadtofetaldeath
CorrectAnswer-C
Ans:c.Lymphocyteenlargement[RefHarrison19th/1190-91;
Ananthanarayan9th/473-74;Jawetz27th/470-74]
Cytomegalovirus(HumanHerpesVirusType5)
Itiscytomegalic(notlymphoproliferative,whichoccurinHHV4,6&
7)
Characterizedbyenlargementofinfectedcells
Congenitalinfection-Intrauterineinfectionleadstofetaldeathor
cytomegalicinclusiondiseaseofnewbornwhichisoftenfatal
Thehallmarkofsuchinfectionistheappearanceofatypical
lymphocytesintheperipheralblood;thesecellsarepredominantly
activatedCD8+Tlymphocytes.

---

69.Trueaboutbacteriorhodopsin:
a)Presentinthecellmembrane
b)Itactsasprotonpump
c)GenerateATP
d)Uselightenergy
e)Sameasrhodopsinfoundinhuman
CorrectAnswer-A:B:C:E
Ans:a.Presentinthecellmembraneb.Itactsasproton
pumpc.GenerateATPd.Sameasrhodopsinfoundinhuman
BacteriorhodopsinisaproteinusedbyArchaea,mostnotablyby
Halobacteria,aclassoftheEuryarchaeota.
Itactsasaprotonpump;thatis,itcaptureslightenergyandusesit
tomoveprotonsacrossthemembraneoutofthecell.Theresulting
protongradientissubsequentlyconvertedintochemicalenergy.
Bacteriorhodopsinisatrans-membraneproteinfoundinthecellular
membraneofHalobacteriumsalinarium,whichfunctionsasalight-
drivenprotonpump.
BacteriorhodopsinisaprotonpumpfoundinArchaea,ittakeslight
energyandcovertsitintochemicalenergyi.e.ATP,thatcanbe
usedbythecellforcellularfunctions.

---

70.Allofthefollowingaretrueaboutvasectomy,EXCEPT:
a)Takeabout3monthsbeforethespermstoresareusedup
b)Spermgranulomasarelesscommonifelectrocauteryisused
c)Reversalismostsuccessfulwithin10yearsofinitialsurgery
d)Thereisariskofchronictesticularpain
e)None
CorrectAnswer-B
Ans.(B)Spermgranulomasarelesscommonifelectrocautery
isused
Spermgranulomasarelesscommonifthermalcauteryisused
ratherthanelectrocautery.
Somecomplicationsofvasectomy:
1. Hematomaandinfection
2. SpermGranulomas
3. Chronictesticularpain
4. Spontaneousrecanalisation
5. Antispermantibodyformation
Ref:OxfordHandbookofClinicalSpecialities,8thEdition,Page305;
Shaw'sTextbookofGynaecology,12thEdition,Page182

---

71.Allareelementsofprimaryhealthcare
except:
a)Adequatesupplyofsafewater
b)Provisionoffreeessentialdrugsonlytopoor
c)Promotionoffoodsupply&propernutrition
d)Prevention&controloflocallyendemicdisease
e)Educationconcerninghealthproblems
CorrectAnswer-B
Ans:b.Provisionoffree....
Elementsofprimaryhealthcare:8Essentialcomponent:
1. Educationconcerningprevailinghealthproblems&themethodsof
preventing&controllingthem
2. Promotionoffoodsupply&propernutrition,
3. Anadequatesupplyofsafewater&basicsanitation.
4. Maternal&childhealthcareincludingfamilyplanning
5. Immunizationagainstmajorinfectiousdiseases
6. Prevention&controloflocallyendemicdisease
7. Appropriatetreatmentofcommondiseases&injuries
8. Provisionofessentialdrug

---

72.MMR(Measles,mumps,rubella)vaccineis
anexampleof:
a)Liveattenuatedvaccine
b)Conjugatedvaccine
c)Polysaccharidevaccine
d)Killedvaccine
e)Toxiod
CorrectAnswer-A
Ans:a.Liveattenuated..[RefPark23rd/103;0.P.Ghai8th/195-
96;CommunityMedicinewithrecentAdvancesbySuryakantha
3rd/320]
KILLED
LIVE
TOXOID
WHOLE
POLYSACCHARIDE GLYCOCONJUGATE
ATTENUATED
PROTEINS
ORGANISM
BCG,Yellow
fever,OPV,
Typhoid,
Measles,
Cholera,
Mumps,
Plague,
Diphtheria,
Rubella,
Pertussis,
Tetanus,
Typhoid,
Influenza,
Acellular
Pneumococcus,
Hib,Pneumococ-
Varicella,
Typhus,
pertussis, Meningococcus,
cus,MenACWY
Rotavirus,
lPV,
Anthrax,
Hib,Typhoid(Vi)
(Meningococcus)
Cholera,
Rabies,
Influenza
Cold-adapted JE,Tick
subunit
influenza,
borne
Rotavirus
encephalitis,
reassortants.

---

reassortants.
HAV
Zost

---

73.Allarestepsofinvestigationofan
epidemicexcept:
a)Verifythediagnosis
b)Beforestartinginvestigation,informthemedia
c)Formulationofhypotheses
d)Confirmationoftheexistenceofanepidemic
e)Plan&implementcontrolmeasures
CorrectAnswer-B
Ans:b.Beforestarting....[RefPark23rd/131-33;Community
MedicinebyPiyushGupta1st/598603]
InvestigationofanEpidemicalnStepsPark23rd/131-33
Verificationofdiagnosis
Confirmationofexistenceofanepidemic
Definingthepopulationat-risk
Rapidsearchforallcases&theircharacteristic
Dataanalysis
Formulationofhypotheses
Testingofhypotheses
Evaluationofecologicalfactors
Furtherinvestigationofpopulationatrisk
Writingthereport

---

74.Whichofthefollowingis/aremethodof
healthcommunication:
a)Lecture
b)Imitation
c)Groupdiscussion
d)Paneldiscussion
e)Roleplay
CorrectAnswer-A:C:D:E
Ans:a.Lectu...c.Group...,d.Panel...,e.Roleplay[RefPark
23rd/863-65;CummunityMedicinewithrecentAdvancesby
Suryakantha4th/763;CommunityMedicinebyPiyushGupta
1st/75665]
GROUPdISCCUSION-1.Lectures,2.Demonstration,3.
Discussionmethods,4-Groupdiscussion,5-Paneldiscussion,6--
Symposium-Workshop,7--Conferences,8--Seminars-Roleplay
MASSAPPROACH-1.Television,2.Radio,3.Newspaper,4.
Printedmaterial,5.Directmailing,6.Posters,7.Healthmuseums
andexhibitions,8.Folkmethods,9-Internet.
Individualapproach,1.Personalcontact,2.Homevisits,3-
Personalletter

---

75.Allaretrueaboutlepromatousleprosy(LL)
except:
a)Multibacillary(MB)-Multidrugtherapy(MDT)isgivenfor
treatment
b)Onsplitstain-multiplebacilli
c)Sensationpresentinlesions
d)Multiplesymmetricalskinlesionpresent
e)Lepromintestpositive
CorrectAnswer-E
Ans:e.Lepromintest....[RefNeenaKhanna5th/272-83;
Roxburg17th/;Park23rd/314-29]
Slitsmear:AllpatientswhoareAFBpositiveshouldbegiven
multibacillarytreatment,irrespectiveoftheclinicalpresentation-
NeenaKhanna5th/281,283
SkinlesioninLepromatousleprosy(LL):NormalAesthetic/minimally
hyperaesthetic"-NeenaKhanna5th/276.
MultiDrugTherapy(MDT)BlisterPacksareAvailablein4
ColoursNeenaKhanna5th/284
1. Adultmultibacillary(MB)pack:Pink-redcolour
2. Childmultibacillary(MB)pack:Yellowcolour
3. Adultpaucibacillary(PB)pack:Greencolour
4. Childpaucibacillary(PB)pack:Bluecolour

---

76.

---

Whichofthefollowingispartofnational
healthpolicy2015draftexcept:
a)IncreaseGDPsharetohealthto5%
b)Assureuniversalavailabilityoffree,comprehensiveprimary
healthcareservices,asanentitlement,forallaspectsof
reproductive,maternal,childandadolescenthealth
c)Provisionofrighttohealth
d)Engageprivatedoctors
e)Enableuniversalaccesstofreeessentialdrugs&diagnosticsin
publichealthfacilities
CorrectAnswer-A
Ans:a.IncreaseGDPsharetohealthto5%[Ref
http://www.mohfw.nic.in/showfile.php?lid=3014;www.mohfw.
nic.in/showfile.php?lid=30141]
TheNationalHealthPolicyacceptsandendorsestheunderstanding
thatafullachievementofthegoalsandprinciplesasdefinedwould
requireanincreasedpublichealthexpenditureto4to5%ofthe
GDP
However,giventhattheNHP,2002targetof2%wasnotmet,and
takingintoaccountthefinancialcapacityofthecountrytoprovide
thisamountandtheinstitutionalcapacitytoutilizetheincreased
fundinginaneffectivemanner,thispolicyproposesapotentially
achievabletargetofraisingpublichealthexpenditureto2.5%ofthe
GDP.

---

77.WhichistrueaboutTuningforktestin
hearingloss:
a)Rinnetestisnegativeinconductivedeafness
b)Webertest-lateralizedtotheworstearinsensorineural
deafness
c)LateralizationofsoundinWebertestwithatunningforkof512
Hzimpliesaconductivelossof15-20dBinipsilateralear
d)NegativeRinnetestindicatesaminimumair-bonegapof15-20
dB
e)ARinnenegativeforallthethreetunningforksof256,512&
1024Hzindicatesair-bonegapof30-45
CorrectAnswer-A:C:D
Answer-(A)Rinnetestisnegativeinconductive
deafness(C)LateralizationofsoundinWebertestwitha
tunningforkof512Hzimpliesaconductivelossof15-20dBin
ipsilateralear(D)NegativeRinnetestindicatesaminimumair-
bonegapof15-20dB
RinneTest
Anegativetest(BC>AC)isseeninconductivedeafness.
NegativeRinneindicatesaminimumair-bonegapof15-20dB.
Apredictionofair-bonegapcanbemadeiftuningforksof256,512
&1024Hzareused
ARinnenegativeforallthethreetunningforksof256,512&1024
Hzindicatesair-bonegapof45-60dB
WeberTest-
Itislateralizedtotheworstearinconductivedeafness&tothe

---

betterearinsensorineuraldeafness.

---

78.Whichofthefollowingcauseslower
motorneuron(LMN)typeoffacialnerve
paralysis:
a)Bellpalsy
b)Parotidtumor
c)Guillain-Barresyndrome
d)Middlecerebralarteryinfarct
e)Multiplesclerosis
CorrectAnswer-A:B:C
Answer-(A)Bellpalsy(B)Parotidtumor(C)Guillain-Barre
syndrome
1.Idiopathic(Bell'spalsy)
Pregnancy-3xmorecommon.
Diabetesmellitus
2.lnfective
Herpesvirus
Herpeszoster(RamsayHuntsyndrome)
Epstein-Barrvirus
3.Neurological
Guillain-Barresyndrome.
Mononeuropathy-e.g.duetodiabetesmellitus,sarcoidosisor
amyloidosis
4.Parotidglandtumours.

---

79.Trueabouttympanometry:
a)Flatinossicculardiscontinuity
b)Astypeinotosclerosis
c)Domeshapedindicatesfluidinmiddleear
d)Adtypeinossicculardiscontinuity
e)Ctypeineustachiantubeobstruction
CorrectAnswer-B:C:D:E
Answer-(B)Astypeinotosclerosis(C)Domeshapedindicates
fluidinmiddleear(D)Adtypeinossicculardiscontinuity(E)C
typeineustachiantubeobstruction
A-Normal
As-Reducedcomplianceatambientpressure(otosclerosis).
's'standsforshallowtympanogrambutrememberforstiffness
AD-Increasedcomplianceatambientpressure(ossicular
discontinuity).'d'standsfordeepqrmpanogram.
B-Flatordome-shaped(fluidinmiddleear).
C-Maximumcomplianceatpressuresmorethan-200mmH2O

---

---

80.Trueaboutbilateralabductorparalysis:
a)Voiceisgood
b)Stridorispresent
c)Cordslieinabductedposition
d)Urgenttracheostomyisneeded
e)None
CorrectAnswer-A:B:D
Answer-A,VoiceisgoodB,StridorispresentD,Urgent
tracheostomyisneeded
Trecheostomy
Transyersecordotomy
Partialarytenoidectomy
Reinnervationprocedures
ThyroplastyII
Woodman'soperation(Externalarytenoidectomy)isdoneinb/l
abductorparalysis.
Endoscopiclaserarytenoidectomy&IsshikitypeIIthyroplastyis
doneforlateralizationofcoril(inbilateralabductorparalysis).

---

81.Allaretrueaboutmandiblefracture
except:
a)Condylarneckismostcommonsite
b)Malocclusionofteethmayoccur
c)Anteriorsuperioralveolarnerveismostcommonlyinjured
d)Panorexradiographsareusefulfordiagnosis
e)Malunion&non-unionarecomplications
CorrectAnswer-C
Answer-C.Anteriorsuperioralveolarnerveismostcommonly
injured
Thecondylarneckistheweakestpartofthemandibleand,isthe
mostfrequentsiteoffracture.
Traumatotheinferioralveolarnerveleadstopermanentnumbness
ofthelowerlipandteethontheaffectedside.
Fracturesofthecoronoidprocessofthemandiblecanresultin
trismus
Infractureofcondyle,displacedfragmentsleadstomalocclusionof
teeth&deviationofjawtotheoppositesideonopeningthemouth.
X-raysusefulinmandibularfracturesarePAviewoftheskull(for
condyle),right&leftobliqueviewofmandible&panorexview.
Condylarandsubcondylarmandiblefracturesaremostoftentreated
byIMFalone.
Delayedunionandnonunionoccurinapproximately3%offractures.

---

82.Trueaboutchronicsuppurativeotitis
media(CSOM):
a)Foulsmellingdischargeinatticoantralvariety
b)Facialnerveinvolvementintubotympanicvariety
c)Atticoantralvarietyisassociatewithcholestetoma
d)Maycausehearingloss
e)All
CorrectAnswer-A:C:D
Answer-(A)Foulsmellingdischargeinatticoantralvariety
(C)Atticoantralvarietyisassociatewithcholestetoma(D)May
causehearingloss
Types
Differencesbetweenatticoantralandtubotympanictypeof
CSOM

Tubotympanic(safe)
atticoantral(unsafe)
scantypurulentfoul
Discharge
profusemucoid
smell
Perforation
central
Marginal
Granulation
uncommon
Common
Polyp
Pale
Red,fleshy
Cholesteatoma Absent
Present
Complications Rare
Common
Mildtomoderateconductive Conductiveormixed
Audiogram
deafness
deafness

---

83.Trueaboutranula:
a)Mucousretentioncyst
b)Seeninfloorofmouth
c)Marsupializationforlargecyst
d)Parotidismostcommonsiteoforigin
e)Arisesfromsublingualsalivarygland
CorrectAnswer-A:B:C:E
Answer-(A)Mucousretentioncyst(B)Seeninfloorof
mouth(C)Marsupializationforlargecyst(E)Arisesfrom
sublingualsalivarygland
Itisathinwalledbluishretentioncyst.
Seeninthefloorofmouthononesideofthefrenulum.
Itarisesduetoobstructionofductofsublingualsalivarygland.
Itisalmostalwaysunilateral.
ClinicalFeatures
Seenmostlyinchildrenandyoungadults.
Onlycomplain--swellinginthefloorofmouth
Cystmayrupturespontaneouslybutrecurrenceiscommon
Treatmentiscompletesurgicalexcisionifsmallormarsupialization,
iflarge

---

84.Premalignantlesionoforalcavity
includes
a)Lichenplanus
b)Erythroplakia
c)Bowendisease
d)Behchetdisease
e)None
CorrectAnswer-B
Answer-B.Erythroplakia
Premalignantcondition:-Leukoplakia,Erythroplakia,Speckled
erythroplakia,chronichyperplasticcandidiasis.

---

85.Whichofthefollowingvitamindeficiency
cancausecentrocecalscotoma:
a)VitA
b)VitE
c)B6
d)B2
e)B12
CorrectAnswer-E
Answer-E.B12
Fielddefectinvolvingboththemaculaandtheblindspot.
Seeninopticnervedisease.
TypicalofvitaminB12deficiencyopticneuropathy.
Damagetopapillomacularfiberscausesacecocentralscotomamay
developinopticneuritis,nutritionalopticneuropathy,
toxicopticneuropathy,Leber'shereditaryopticneuropathy,and
compressiveopticneuropathy.

---

86.Trueaboutelectroretinogram:
a)awave-arisesfromrodsandcones
b)bwave-d/tactivityofbipolarcells
c)b-waveresponseissubnormalinearlycasesofretinitis
pigmentosa
d)cwave-representingmetabolicactivityofpigmentepithe-lium
e)BestdiseaseshowsabnormalERG
CorrectAnswer-A:B:C:D
Answer-(A)awave-arisesfromrodsandcones(B)bwave-d/t
activityofbipolarcells(C)b-waveresponseissubnormalin
earlycasesofretinitispigmentosa(D)cwave-representing
metabolicactivityofpigmentepithe-lium
Thechangesinducedbythestimulationoflightintheresting
potentialoftheeyearemeasuredbyelectroretinography.Itis
extinguishedorabsentincompletefailureoffunctionofrodsand
cones,e.g.pigmentaryretinaldystrophy,completeocclutionof
retinalartery,completeretinaldetachment,advancedsiderosisetc.
1. Negative'a'waverepresenttheactivityinrodsandcones.
2. Positive'b'wavearisesininnerretinallayers.
3. Positive'c'waveisassociatedwiththepigmentaryepithelium

---

87.TrueaboutCiliarybody:
a)Itformsaqueoushumour
b)Anteriorsmoothpartiscalledparsplana
c)Ciliaryprocessesarefinger-likeprojectionsfromthepars
plicatapart
d)Ciliarymuscleshelpinaccommodation
e)All
CorrectAnswer-A:C:D
Answer-(A)Itformsaqueoushumour(C)Ciliaryprocessesare
finger-likeprojectionsfromtheparsplicatapart(D)Ciliary
muscleshelpinaccommodation
Ciliarybodyisforwardcontinuationofthechoroidatoraserrata.
Itistriangularinshape
TheinnersideofthetriangleisdividedintotwoParts:
1. anteriorpart-palsPlicata(finger-likeciliaryprocesses)
2. posteriorpart-parsplana(smoothpart)
Microscopicstructure-fivelayers
Supraciliarylamina
Stromaoftheciliarybody
Layerofpigmentedepithelium
Layerofnon-pigmentedepithelium
Internallimitingmembrane
Functionsofciliarybody.
1. Formationofaqueoushumour.
2. Ciliarymuscleshelpinaccommodation

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88.Whichofthefollowingstatement(s)is/are
trueaboutJonesdyetest:
a)Doneforassessmentofepiphora
b)Positivetest-1:primaryhypersecretion
c)Negativetest-1:partialobstructionorfailureoflacrimalpump
mechanism
d)Positivetest-2:failureoflacrimalpumpmechanism
e)Negativetest-2:partialobstruction
CorrectAnswer-A:B:C
Answer-(A)Doneforassessmentofepiphora(B)Positivetest-
1:primaryhypersecretion(C)Negativetest-1:partial
obstructionorfailureoflacrimalpumpmechanism
Jonesdyetestsareofnovalueinthepresenceoftotalobstruction.
Dye-stainedcottonbudindicatesadequatedrainage&primary
hypersecretion
Unstainedcottonbudindicateseitherapartialobstructionorfailure
oflacrimalpumpmechanlsm
Primarytestisnegativeinferiormeatusandlacrimalsyringingis
performed
Negativetestpartialobstruction
Negativetestindicatespresenceoflacrimalpumpfailure.

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89.TrueaboutKayser-Fleischerring-
a)Depositionofcopper
b)Depositionofiron
c)FoundinWilsondisease
d)DepositionunderDescemet'smembraneofthecornea
e)None
CorrectAnswer-A:C:D
Answer-(A)Depositionofcopper(C)FoundinWilsondisease
(D)DepositionunderDescemet'smembraneofthecornea
Kayser-Fleischerringstaketheformofacrescenticrusty-brown
discolorationofthedeepestlayerofthecornea(Descemet
membrane)
Kayser-FleischerringsareasignofWilson'sdisease,whichinvolves
abnormalcopperhandlingbytheliverresultingincopper
accumulationinthebody.
Characterisedbyabnormalitiesofthebasalgangliaofthebrain,liver
cirrhosis,splenomegaly,involuntarymovements,musclerigidity,
psychiatricdisturbances,dystoniaanddysphagia.

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90.Ectopialentisis/areassociatedwith:
a)Homocystinuria
b)Alportsyndrome
c)Lowesyndrome
d)Marfansyndrome
e)Sulphiteoxidasedeficiency
CorrectAnswer-A:D:E
Answer-(A)Homocystinuria(D)Marfansyndrome(E)Sulphite
oxidasedeficiency
Marfansyndrome
Homocystinuria
Weil-Marchesanisyndrome
Sulfiteoxidasedeficiency
Hyperlysinemia

---

91.Trueaboutcongenitalesotropia:
a)Amblyopiamaydevelops
b)Angleofdeviationisusuallyfixed&large
c)Surgeryshouldbedoneafter2year
d)Onsetonlyafter1yearofage
e)Maybeassociatedwithinferiorobliqueoveraction
CorrectAnswer-A:B:E
Answer-(A)Amblyopiamaydevelops(B)Angleofdeviationis
usuallyfixed&large(E)Maybeassociatedwithinferioroblique
overaction
Ageofonset,isusually1-2monthsofage,butoccuranytimein
first6monthsoflife.
Angleofdeviationisusuallyconstant&fairlylarge.
Amblyopiadevelopsin25-40%ofcases
Associationsincludeinferiorobliqueoveractiondissociatedvertical
deviation(DVD).
Treatment-
Timeofsurgery:Surgeryshouldbedoneb/w6monthsto2years
(preferablybefore1yrofage)

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92.Haintestis/areusedfor:
a)DetectionofINHresistanceonly
b)Detectionofrifampicinresistanceonly
c)Detectionofbothrifampicin&INHresistance
d)DetectionofresistanceofalldrugsoffirstlineATT
e)All
CorrectAnswer-C
Answer-C.Detectionofbothrifampicin&INHresistance
"GenotypeMTBDRplus("HAINtest")qNAAandhybridization-based
testuseimmobilizedDNAprobesonnitrocellulosemembranes(line
probeassayLPA)&Colorimetricchangeindicateshybridization.
ldentifiesM.tuberculosisanddetectsRif&INHresistanceinaday.

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93.TrueaboutPulmonaryartery
catheterization(Swan-Ganzcatheter
placement):
a)Measuresrightatrialpressure
b)Measuresleftventricularfillingpressure
c)MeasurePCWP
d)Insertedthroughleftsubclavianvein
e)Measurescentralvenouspressure
CorrectAnswer-A:B:C:D
Answer-(A)Measuresrightatrialpressure(B)Measuresleft
ventricularfillingpressure(C)MeasurePCWP(D)Inserted
throughleftsubclavianvein
Continuouscardiacoutputmonitoring
Centraltemperaturemonitoring
Measurementofpulmonaryarterypressure(canalsomeasureRA
andRVpressuresduringinsertion)
Measurementofmixedvenoussaturations.
Estimationofdiastolicfillingofleftheart
Itmeasuresthepressureatthreedifferentplaces:rightatrium,
pulmonaryarteryandpulmonarycapillaries.

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94.Presentationoftabesdorsalisincludes:
a)Lancinatingpaininleg
b)Lossofproprioception
c)Sensorydefect
d)Noinvolvementofbladder&bowel
e)Sensoryataxia
CorrectAnswer-A:B:C:E
Answer-(A)Lancinatingpaininleg(B)Lossofproprioception
(C)Sensorydefect(E)Sensoryataxia
Symptomsare
Ataxicwide-basedgait
Footdrop
Paresthesia;
Bladderdisturbances;
Impotence;
Areflexia;and
Lossofpositional,Deep-pain,andTemperaturesensations.
Trophicjointdegeneration(Charcot'sjoints)canresultfromlossof
painsensation.
Opticatrophyoccursintabes.

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95.TrueaboutPrinzmetal'sangina:
a)Maypresentatrest
b)Occursdueatheroscleroticobstructionofcoronaryarteries
c)Smokingisariskfactor
d)Nitratesareusedfortreatment
e)CCBsareusedfortreatment
CorrectAnswer-A:C:D:E
Answer-(A)Maypresentatrest(C)Smokingisariskfactor
(D)Nitratesareusedfortreatment(E)CCBsareusedfor
treatment
ThissyndromeisduetofocalspasmofanepicardialcoronAry
artery,leadingtoseveremyocardialischemialeadingtosevere
myocardialischemia.
Therightcoronaryarteryisthemostfrequentsite,followedbythe
leftanteriordescendingcoronaryartery.
Acetylcholinereleasedbytheparasympatheticsystematrestwill
simplycausecontractionofthevascularsmoothmuscle.
ItusuallyoccursatrestandisassociatedwithtransientST-segment
elevation.
Etiology
cigarettesmokers
Treatment-
Nitratesandcalciumchannelblockersarethemaintreatmentsfor
patientswithvariantangina.

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96.Whichofthefollowingis/aretrueabout
RevisedJonesCriteria2015ofAHAfor
diagnosisofacuterheumaticfever-
a)Polyarthritisinlow-riskpopulationsisamajorcriteria
b)Polyarthralgiainmoderate-andhigh-riskpopulationsisaminor
criteria
c)Monoarthritisinmoderate-andhigh-riskpopulationsisamajor
criteria
d)EchocardiographywithDopplerstudyshouldbeperformedin
allcasesofconfirmedandsuspectedARF
e)Echocardiography/Dopplerstudyshouldbeperformedto
assesswhethercarditisispresentintheabsenceof
auscultatoryfindings
CorrectAnswer-A:C:D:E
Answer-(A)Polyarthritisinlow-riskpopulationsisamajor
criteria(C)Monoarthritisinmoderate-andhigh-risk
populationsisamajorcriteria(D)Echocardiographywith
Dopplerstudyshouldbeperformedinallcasesofconfirmed
andsuspectedARF(E)Echocardiography/Dopplerstudy
shouldbeperformedtoassesswhethercarditisispresentin
theabsenceofauscultatoryfindings
Clinicalmanifestationsanddiagnosis
2015RevisedJonesCriteriafordiagnosisofRheumaticFever
B.MajorCriteria
Moderate-andhigh-
Low-riskpopulations
riskpopulation

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Carditis
Carditis
Clinicaland/orsubclinical
Clinicaland/orsubclinicalcarditis
carditis
Arthritis
Arthritis
Monoarthritisor
Polyarthritis
polyarthritis
Polyarthralgia
Chorea
Chorea
Erythemamarginatum
Erythemamarginatum
Subcutaneousnodules
Subcutaneousnodules
C.Minorcriteria
Moderate-andhigh-risk
Low-riskpopulations
populations
Polyarthralgia
Monoarthralgia
Fever(>38.5?)
Fever(>38?C)
ESR.60mmin1'thour
ESR30mm/hand/orCRP>3.0
and/CRP>3.0mg/dl
ormg/dL
4.ProlongedPRinterval,afteraccountingforagevariability
(unlesscarditisisamajorcriterion)inallpopulation.

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97.Feature(s)ofincreasedICPis/are:
a)Hypotension
b)DecreaseHR
c)IncreaseHR
d)Hypertension
e)Decreasedlevelofconsciousness
CorrectAnswer-B:D:E
Answer-(B)DecreaseHR(D)Hypertension(E)Decreasedlevel
ofconsciousness
Cushing'striadisthetriadofwideningpulsepressure(rising
systolic,decliningdiastolic),changeinrespiratory
Pattern(irregularrespirations),andbradycardia.Itissignof
increasedintracranialpressure,and,itoccursasaresultofthe
Cushingreflex.

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98.AllaretrueaboutHepatitisEexcept:
a)Maybefatalinpregnantwomen
b)Causedbynon-enveloped,positive-sense,singlestranded
RNAgenomic,HAVlikevirus
c)Carrierstateiscommon
d)Majorityprogresstochronicity
e)Feco-oraltransmission
CorrectAnswer-C:D
Answer-(C)Carrierstateiscommon(D)Majorityprogressto
chronicity
HEVistransmittedviathefaecal-oralroute.
Itiscausedbynon-enveloped,positive-sense,single-strandedRNA
genomic,HAVlikevirus.
HepatitisEisawaterbornedisease,andcontaminatedwaterorfood
supplieshavebeenimplicatedinmajoroutbreaks.Ingeneral,
hepatitisEisaself-limitingviralinfectionfollowedbyrecovery.
Prolongedviraemiaorfaecalsheddingareunusualandchronic
infectiondoesnotoccur.
Occasionally,afulminantformofhepatitisdevelops,withoverall
patientpopulationmortalityratesrangingbetween0.5-4.0%.
Fulminanthepatitisoccursmorefrequentlyinpregnancyand
regularlyinducesamortalityrateof20%amongpregnantwomenin
the3rdtrimester.
SincecasesofhepatitisEarenotclinicallydistinguishablefrom
othertypesofacuteviralhepatitis,diagnosisismadebybloodtests
whichdetectelevatedantibodylevelsofspecificantibodiesto
hepatitisEinthebodyorbyreversetranscriptasepolymerasechain

---

reaction(RT-PCR).Unfortunately,suchtestsarenotwidely
available.

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99.Whichofthefollowingfavoursdiagnosis
ofchronicrenalfailureratherthanacute
renalfailure-
a)Anemia
b)Peripheralneuropathy
c)Smallkidney
d)Renalosteodystrophy
e)Dailyincreaseincreatinine
CorrectAnswer-A:B:C:D
Answer-A,B,C,D,Anemia,Peripheralneuropathy,Small
kidney,Renalosteodystrophy
Renalsonogramshowingsmallkidneys-UsuallyCKD
Oliguria,dailyincreasesinserumcreatinineandBUN-Probably
ARForARFsuperimposedonCKD
Severeaneminarenalosteotdystrophy(hyperphosphatemia,
hypocalcemia)-PossiblyCKDbutmaybeARFPeripheral
neuropathy

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100.Allarefeature(s)ofsarcoidosisexcept:
a)HighCD4:CD8ratio
b)Hypercalciuriaandhypercalcimiamaybepresent
c)fSerumlevelsofangiotensin-convertingenzyme(ACE)
d)Schaumanandasteroidbodiesarepathognomic
e)None
CorrectAnswer-D
Answer-D.Schaumanandasteroidbodiesarepathognomic
Hypercalcemiaand/orHypercalciuriaoccursinabout10%of
sarcoidosispatients.
Bronchoalveolarlavagefluidlnsarcoidosisisusuallycharacterized
byanincreaseinlymphocyteandahighCD4/CD8ratio.
"Schaumanandasteroidbodies-althoughcharacteristic,thesecells
arenotpathognomicofsarcoidosisbecausetheymaybe
encounteredinothergranulomatousdiseases.
Thegranulomaisthepathologichallmarkofsarcoidosis.
"Serumlevelsofanglotensin-convertingenzyme(ACE)canbe
helpfulinthediagnoslsofsarcoidosis.

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101.Whichofthefollowingcranialnerve
is/areinvolvedinGagreflex:
a)9
b)10
c)11
d)12
e)7
CorrectAnswer-A:B
Answer-(A)9(B)10
Gagreflex
Afferent
Glossopharyngealnerve
Efferent
Vagusnerve

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102.Whichofthefollowingis/aretrueabout
Duchenemusculardystrophy:
a)Mentalimpairmentmaypresent
b)TSerumCKlevels
c)Cardiomyopathymaybepresent
d)Autosomalrecessivedisorder
e)Onsetduringpuberty
CorrectAnswer-A:B:C
Answer-(A)Mentalimpairmentmaypresent(B)TSerumCK
levels(C)Cardiomyopathymaybepresent
DuchenneMuscularDystrophy:ThisX-linkedrecessivedisorder
sometimesalsocalledpseudohypertrophicmusculardystrophy.
Age-Before5years
C/F
Progressiveweaknessofgirdlemuscles
Unabletowalkafterage12
Progressivekyphoscoliosis
Respiratoryfailurein2dor3ddecade
Cardiomyopathy
Mentalimpairment

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103.Trueaboutacuteintermittentporphyria:
a)OccurduetodeficiencyofenzymeHMB-synthase
b)Uroporphyrinispresentinurine
c)Abdominalpainiscommonsymptom
d)TPorphobilinogenintheurine
e)Leukocytosisisoftenpresent
CorrectAnswer-A:B:C:D
Answer-(A)OccurduetodeficiencyofenzymeHMB-synthase
(B)Uroporphyrinispresentinurine(C)Abdominalpainis
commonsymptom(D)TPorphobilinogenintheurine
Deficientenzyme-HMB-synthase
Inheritance-Autosomaldominant
Abdominalpain,themostcommonsymptom.
Cramping,lleus,abdominaldistention,anddecreasedbowelsound.
Peripheralneuropathy
Abdominaltenderness,fever,andleukocytosisareusuallyabsentor
mild
Nausea,vomiting,constipation,tachycardia,hypertension,mental
symptoms,paininthelimbs,head,neck,orchest;
Muscleweakness,sensoryloss,dysuria,andurinaryretentionare
characteris
Tachycardia,hypertension,restlessness,tremors,andexcess
sweatingareduetosympatheticoveractivity.
Investigation-
Thediagnosiscanbeconfirmedbydemonstratinganincreased
amountofporphobilinogenintheurine,ALA,Uroporphyrin.

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104.ChildPughAcriteriaforclinicalseverity
ofcirrhosisincludes:
a)Bilirubin<2.0mg/dL
b)Prothrombintime>70(%ofcontrol)
c)Serumalbumin2.0-3.0g/dl
d)Presenceofencephalopathy
e)Absenceofascites
CorrectAnswer-A:B:E
Answer-(A)Bilirubin<2.0mg/dL(B)Prothrombintime>70(%
ofcontrol)(E)Absenceofascites
Assign Assign
Assign
Parameter
1point 2points
3points
Ascitis
Absent Slight
Mpderate
Bilirubin(mg/dL)
<2
2-3
>3
Albumin(g/dL)
>3.5
2.8-3.5
<2.8
Prothrombintime
<4
4-6
>6
(secondovercontrol) <1.7
1.7-2.3
>2.3
orINR
Grade1-2(Mildto
Grade3-4
Encephalopathy
None
moderate
(Severe)

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105.AllaretrueaboutAbdominalaneurysm
except:
a)Atherosclerosisisthecommonestcause
b)Mostcommonlyarisesfromabovethelevelofrenalartery
c)Forasymptomaticaneurysms,repairisindicatedifthediameter
is>5.5cm
d)Endovascularplacementofanaorticstentisuseforrepair
e)Mostlyasymptomatic
CorrectAnswer-B
Answer-B.Mostcommonlyarisesfromabovethelevelofrenal
artery
90%ofabdominalaorticaneurysm(AAA)ofsize>4cmindiameter
isduetoatherosclerosis.
Malearemorefrequentlyaffectedthanfemale.
Theaneurysmmostcommonlyarisesbelowthelevelofrenalartery.

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106.Apatientdiagnosedwithcushing's
syndrome.Dexamatha?sone
suppressiontestshoweddecreasein
cortisollevelsandcorticotrophin-
releasinghormone(CRH)administration
causesincreasedcortisol
levels.Treatmentoption(s)forthispatient
is/are:
a)Adrenalectomy
b)Pituitaryirradiation
c)Adrenalglandremoval
d)Stereotacticpituitaryradiosurgery
e)SurgicalremovalofectopictissueproducingACTHindifferent
organs
CorrectAnswer-A:B:C:D
Answer-(A)Adrenalectomy(B)Pituitaryirradiation(C)Adrenal
glandremoval(D)Stereotacticpituitaryradiosurgery
Treatmentofchoice-removalofpituritarycorticotropetumour
(transphenoidalapproach)
Pituitaryirradiation
Metyraponeandketoconazole
Adrenocorticalcarcinoma-mitotane

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107.Inwhichofthefollowingvasculitislung
involvementdoesnotoccur:
a)Eosoniphilicgranulomatosiswithvasculitis
b)Polyarteritisnodosa(PAN)
c)Microscopicpolyangitis
d)Granulomatosiswithpolyangitis
e)Bechetsyndrome
CorrectAnswer-B
Answer-B.Polyarteritisnodosa(PAN)
Microscopicpolyangiitis(microscopicpolyarteritis,hypersensitivity,
orleukocytoclasticvasculitis):Thistypeofnecrotizingvasculitis
generallyaffectsarterioles,capillaries,andvenule.
Wegenergranulomatosis(Granulomatosiswithpolyangitis)-isa
necrotizingvasculitischaracterizedbythetriadof
1. acutenecrotizinggranulomas
2. necrotizingorgranulomatousvasculitis
3. renaldiseaseintheformoffocalnecrotizingoftencrescentic,
glomerulitis
"Churg-Strausssyndrome(allergicgranulumatosisandangiitis)isa
multisystemdiseaseswithcutaneousinvolvementgastrointestinal
tractbleeding,andrenaldisease.

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108.Drugcausingsclerodermais/are:
a)Bleomycin
b)Pentazocin
c)Polyinylchloride
d)Steroid
e)Tetracycline
CorrectAnswer-A:B:C
Answer-(A)Bleomycin(B)Pentazocin(C)Polyinylchloride
Vinylchloride,bleomycin,pentazocin,organicsolvents,carbidopa,
tryptophan,rapeseedoil.

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109.Whichofthefollowingstatement(s)
is/areregardingAmericanHeart
Association(AHA)Guideline-2015for
cardiopulmonaryresuscitation(CPR)&
Emergencycardiovascularcare(ECC):
a)Chestcompression:ventilationCompressionventilationratio
withoutadvancedairway?rate30:2irrespectiveofrescuer&
ageofpatient
b)Compressionrate-atleast100/min
c)FailuretoachieveanETCO2of10mmHgbywaveform
capnographyafter20minutesofresuscitationhasbeen
associatedwithanextremelypoorchanceofreturnof
spontaneouscirculation(ROSC)
d)Limitinterruptionsinchestcompressionstolessthan10
seconds
e)None
CorrectAnswer-C:D
Answer-C,FailuretoachieveanETCO2of10mmHgby
waveformcapnographyafter20minutesofresuscitationhas
beenassociatedwithanextremelypoorchanceofreturnof
spontaneouscirculation(ROSC)D,Limitinterruptionsinchest
compressionstolessthan10seconds
Compressionrateismodifiedtoarangeofl00to120/min.
Compressionventilationratiowithoutadvancedairway-1or2
rescuers30:2

---

FailuretoachieveanETCO2ofI0mmHgbywaveform
capnographyafter20minutesofresuscitationhasbeenassociated
withanextremelypoorchanceofROSCandsurvival.
Theclarifiedrecommendatio-nforcfrestcompressiondepthfor
adultsisatleast2inches(Scm)butnotgreaterthan2.4inches(6
cm).

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110.Apatientofasthmawasoninhaledshort
acting13-agonist.Buttherewasno
significantrelief.Afterthatheaddedlow
doseofinhaledsteroidfromlast5day
byMDI,butstillnotresponding.What
youwilladvisehimfornextlineof
treatment:
a)ContinueinhaledshortactingP-agonist
b)Addinhaledlongacting13-agonist
c)Increasedoseofinhaledcorticosteroid
d)Startoralcorticosteroid
e)Startparenteralcorticosteroid
CorrectAnswer-A:B:C
Answer-(A)ContinueinhaledshortactingP-agonist(B)Add
inhaledlongacting13-agonist(C)Increasedoseofinhaled
corticosteroid

---

---

111.Whichofthefollowingclinicalcriteria
belongstoHIVstageI:
a)Asymptomaticpatient
b)Persistentgeneralisedlymphadenopathy
c)Unexplainedchronicdiarrhoeafor>1mth
d)Unexplainedpersistentfever(>37.5?Cfor>1mth)
e)Neutropenia
CorrectAnswer-A:B
Answer-(A)Asymptomaticpatient(B)Persistentgeneralised
lymphadenopathy
WorldHealthOrganization(WHO)clinicalstage-
Asymptomatic
Persistentgeneralisedlymphadenopathy

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112.FullformofSCIWORAis:
a)Spinalcordinjurywithradiographicabnormality
b)Spinalcordinjurywithradiographicaberration
c)Spinalcordinjurywithoutradiographicaberration
d)Spinalcordinjurywithoutradiographicabnormality
e)Spinalcordinjurywithvertebralfracturewithradiographic
abnormality
CorrectAnswer-D
Answer-D.Spinalcordinjurywithoutradiographicabnormality
SCIWORA(SpinalCordInjuryWithoutRadiographicAbnormality)
wasfirstdevelopedand,introducedbyPangandWilbergerwho
usedittodefine'clinicalsmyptomsoftraumaticmyelopathywithno
radiographicorcomputedtomographicfeatutesofspinalfractureor
instability.

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113.Whichofthefollowingis/aretrueabout
breastcarcinomainmaleexcept:
a)Oftenpresentedatadvancedstageatthetimeofdiagnosis
b)Associatedwithgynaecomastia
c)Stagingisdifferentthanfemale
d)Tamoxifeneisusedintreatment
e)Associatedwithexcessendogenousorexogenousoestrogen
CorrectAnswer-C
Answer-C.Stagingisdifferentthanfemale
Thefollowingconditionshavebeenreportedtobeassociatedwith
anincreasedriskofbreastcancerinmen:chronicliverdisorders,
suchascirrhosis,chronicalcoholism,schistosomiasis;ahistoryof
mumpsorchitis,undescendedtestes,ortesticularinjury;and
feminization,geneticallyorbyenvironmentalexposure.Incontrast,
gynecomastiaalonedoesnotappeartobeariskfactor

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114.Allaretrueaboutmedullarythyroid
carcinomaexcept:
a)Involvestheparafollicularcell
b)Radiosensitive
c)Amyloidstromaispresent
d)Elevatedlevelofcalcitonin
e)Highlevelofcarcinoembryonicantigen
CorrectAnswer-B
Answer-B.Radiosensitive
Thesearetumoursoftheparafollicular(Ccells)derivedfromthe
neuralcrest.
Thereisacharacteristicamyloidstroma.
Highlevelsofserumcalcitoninandcarcinoembryonicantigenare
producedmedullarytumours.
Calcitoninlevelsfallefterresectionandriseagainwithrecurrence
makingitavaluabletumourmarkerinthefollowupofpatientswith
thisdisease.
Diarrhoeadueto5-hydroxytrptamineorprostaglandins.
TumoursarenotTSHdependentanddonottakeupradioactive
iodine.

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115.TrueaboutCaroli'sdisease:
a)Intrahepaticbileductdilation
b)Jaundicemaybeseen
c)1stSerumalkalinephosphatase
d)Notassociatedwithportalhypertension
e)Surgeryistreatmentofchoicelocalizedhepaticinvolvement
CorrectAnswer-A:B:C:E
Answer-A,IntrahepaticbileductdilationB,Jaundicemaybe
seenC,1stSerumalkalinephosphataseE,Surgeryistreatment
ofchoicelocalizedhepaticinvolvement
Congenital,multiple,irregulardilatationsofintrahepaticductswith
stenoticsegmentsinbetween
Complications:intrahepaticstoneformation,bililarysepsis
Associatedwithcongenitalhepaticfibrosisandmedullarysponge
kidney
Premalignant
Treatment:
Firstlinetherapy:biliarydrainagewithERCPandPTC
Diffuse:Livertransplantation
Localized:Segmentalresection

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116.Trueaboutesophagealvarices:
a)Leftgastricveinisportalvesselinvolved
b)Occuratmidesophaguslevel
c)Occuratpharyngeallevel
d)Epigastricveinissystemicveininvolved
e)Occuratlowerendofesophagus
CorrectAnswer-A:E
Answer-A,LeftgastricveinisportalvesselinvolvedE,Occurat
lowerendofesophagus
Thepharynxextendsfromthebaseoftheskulldowntotheinferior
borderofthecricoidcartilage(aroundtheC6vertebrallevel),where
itbecomescontinuouswiththeesophagus.

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117.Whichofthefollowingis/arefeatureof
highlyselectivevagotomyincomparison
totruncalvagotomywithdrainage:
a)Bettertolerated
b)Dumpingismorecommon
c)Diarrheaisless
d)Highrecurrencerate
e)Operativemortalityrateveryless
CorrectAnswer-A:C:D:E
Answer-A,BettertoleratedC,DiarrheaislessD,Highrecurrence
rateE,Operativemortalityrateveryless
Highlyselectivevagotomy(HSV),alsocalledparietalcellvagotomy
orproximalgastricvagotomy.
Itpreservesthevagalinnervationtotheantrumandpylorus.
Gastricemptyingofsolidsistypicallynormalinpatientsafterparietal
cellvagotomy.
TherecurrencerateishigherwithHSVthanwithvagotomyand
antrectomy.
ThemostpopulardrainageprocedureistheHeineke-Mikulicz
pyloroplasty.

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118.Whichofthefollowingis/aretrue
regardingparathyroidglandsurgeryin
parathyroidadenoma/hyperplasia:
a)SuperiorparathyroidglandliesposteriortoRLN
b)Glandcanbedifferentiatedfromsurroundingtissueduetoits
colour
c)Thepresenceofanormalparathyroidglandatoperation
indicatesthatthetumorremovedisanadenomaratherthan
parathyroidhyperplasia
d)IntraoperativePTHestimationisdonetocheckstatusofgland
removal
e)6%personhave5parathyroidgland
CorrectAnswer-A:B:C:D
Answer-A,Superiorparathyroidglandliesposteriorto
RLNB,Glandcanbedifferentiatedfromsurroundingtissuedue
toitscolourC,Thepresenceofanormalparathyroidglandat
operationindicatesthatthetumorremovedisanadenoma
ratherthanparathyroidhyperplasiaD,IntraoperativePTH
estimationisdonetocheckstatusofglandremoval
Thereareusuallyfourparathyroidglands,whichlieontheposterior
surfaceofthethyroid.
Commonsitesforectopicparathyroidsarethethyrothymicligament,
superiorthyroidpoles,tracheoesophagealgroove,retroesophageal
space,andcarotidsheath.

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119.Videoassistedthoracotomyis/are
commonlyusedfor:
a)Pneumonectomy
b)Lungbiopsy
c)Hemothoraxwithactivebleeding
d)Repairoflargevesseltearinthorax
e)Diagnosisandstagingofthoracicmalignancies
CorrectAnswer-A:B:C:E
Answer-A,PneumonectomyB,LungbiopsyC,Hemothoraxwith
activebleedingE,Diagnosisandstagingofthoracic
malignancies
Thoracoscopyorvideo-assistedthoracoscopicsurgery:
Pneumonectomy,lobectomyandempyemadrainageareall
possible.
Lungbiopsyandthetreatmentof-recurentpneumothoraxarethe,
mostfrequentindications.
Thotacotomyisrequiredformanagementofinjuriestothelungs,
heart,pericardium,andgreatvessel.

---

120.Whichofthefollowingisincludedin
managementoftraumaticbraininjury:
a)Mannitolinfusion
b)Decompressivecraniectomy
c)CTscan
d)Pneumococcalvaccination
e)Antiepileptics
CorrectAnswer-A:B:C:D:E
Answer-A,MannitolinfusionB,Decompressive
craniectomyC,CTscanD,Pneumococcal
vaccinationE,Antiepileptics
Initial-
Headup
Loosencollar
Optimiseventilation
Optimiseelectrolytebalance(hypertonicfluidsifnecessory),treat
hyperglycemia
Sedation
Seizurecontrol
Intermediate
(Mannito/furosemide/hyperventilationstemporisingmeasures)
Heavysedation
Paralysis
CSFdrainagebyinsertionofEVD
Cooling
Final

---

Inductionofthiopentonecoma
Decompressivecraniectoy

---

121.Trueregardingurethralinjury:
a)Straddleinjuriesareoftenassociatedwithposteriorure?thral
injuries
b)Pelvicinjuriesisfrequentlyassociatedwithanteriorure?thral
injuries
c)Probleminvoiding
d)Initialmanagementisinsertionofasuprapubiccatheter
e)Suspectifthereisbloodattheurethralmeatusincaseofpelvic
fracture
CorrectAnswer-A:D:E
Answer-(A)Straddleinjuriesareoftenassociatedwithposterior
ure?thralinjuries(D)Initialmanagementisinsertionofa
suprapubiccatheter(E)Suspectifthereisbloodattheurethral
meatusincaseofpelvicfracture
Urethralinjuriesaremorecommonincasesofbilateralpelvic
injuries.
Diagnosisofurethralinjuryismadebyahighindexofsuspicionin
thepresenceofbloodattheurethralmeatus,inabilitytourinate.
Whenbloodlspresentatthemeatus,retrogradeurethrographyaids
inthediagnosisofurethralinjury.
Urethralinjuriesare-
1.posteriorurethra(abovetheurogenitaldiaphragm)
2.anteriorurethra(belowtheurogenitaldiaphragm)
StentedFoleycatheter-healingoftheurethralinjury.
anteriorurethrainjuriesareassociatedwithstraddleinjuries.

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122.Statementtrueaboutcrushinjury&
syndrome:
a)Oftenseenduringearthquake
b)Myoglobinuriaoccurs
c)Presentsasglomerulonephritis
d)Maycausecompartmentsyndrome
e)Maybeassociatedwithrhabdomyolysis
CorrectAnswer-A:B:D:E
Answer-(A)Oftenseenduringearthquake(B)Myoglobinuria
occurs(D)Maycausecompartmentsyndrome(E)Maybe
associatedwithrhabdomyolysis
Acrushinjuryoccurswhenabodypartissubjectedtoahighdegree
offorceorpressure,usuallyafterbeingsqueezedbetweentwo
heavyorimmobileobjects.
Crushinjuryincludeslacerations,fractures,bleedingbruising
compartmentsyndromeandcrushsyrdrome
Associationbetweencrushinjuryrhabdomyolysisandacuterenal
failureseeninearthquake
Themyoglobinurialeadstorenalfailutefromtubularobstruction.

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123.Onlysimplecholecystectomyis
adequateinwhichstageofgallbladder
cancer
a)StageIA
b)StageIB
c)StageIII
d)StageIV
e)None
CorrectAnswer-A
Answer-A.StageIA
AccordingtoTNMstaging,SimplecholecystectomyisdoneforT1a
whichisincludedinstage-I.
T1a-simplecholecystectomy
T1b,II&III-Extendedcholecystectomy
IV-Palliativetreatment

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124.Highimperforateanusis/areassociated
with:
a)Underdevelopedpelvic&glutealmusculature
b)Associatedwithmaldevelopedurinarysystem
c)AssociatedwithVACTERLsyndrome
d)Fistulaformationwithbladder
e)Normalanalsphintermechanism
CorrectAnswer-A:B:C:D
Answer-(A)Underdevelopedpelvic&gluteal
musculature(B)Associatedwithmaldevelopedurinary
system(C)AssociatedwithVACTERLsyndrome(D)Fistula
formationwithbladder
Morecommonlythereisfistulatotheurethraorbladderinthemale
ortheuppervaginainthefemale.
Patientswithhighimperforateanusoftenhavedeficientpelvicand
glutealinnervationandmusculature,ahighincidenceofsacral
anomalies.
Anomaliesofthevertebraeandtheurinarytractoccurintwo-thirdof
allpatientswithhighanomalies.
ImperforateanusisassociatedwiththeVACTERLsyndrome.

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125.TrueaboutMallory-Weisstear:
a)Alcoholismisapredisposingfactor
b)Tearinvolvesuptomuscularismucosa
c)Tearinvolvesgastricmucosaneargastro-esophagealjunc-tion
d)Associatedwithhiatushernia
e)ImportantcauseofupperGIbleeding
CorrectAnswer-A:C:D:E
Answer-(A)Alcoholismisapredisposingfactor(C)Tear
involvesgastricmucosaneargastro-esophagealjunc-
tion(D)Associatedwithhiatushernia(E)Importantcauseof
upperGIbleeding
AMallory-Weisstear(MWT)isforcefulorretchingvomitingmay
producealongitudinalmucosaltearimmediatelybelowsquamo
columnarjunctionatthecardiaorgastroesophagealjunctionmainly
andalsoinoesophagus.
ETIOLOGY:
Alcoholism
Hiatushernia
NSAIDabuse
Thetearinvolvesthemucosaandsubmucosabutnotthemuscular
layer

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126.Whichofthefollowingis/aretrueabout
breastselfexamination:
a)Performedindifferentpositionslikestanding,sitting,supineetc
b)Tsurvivalrate
c)Doneabout2-3daybeforemenstrualcycleinpremeno-pausal
women
d)Itshouldbestartonlyafter35year
e)Monthlybreastself-examination(BSE)isrecommended
CorrectAnswer-A
Answer-A.Performedindifferentpositionslikestanding,
sitting,supineetc
Breastself-examination(BSE)hasnotbeenshowntoimprove
survival
TheAmericanCancerSocietynolongerracommendsmonthlyBSE
beginningatage20years.
Premenopausalwomenshouldperformtheexamination7-8days
afterthemenstrualperiod.
Thebreastsshouldbeinspectedinitiallywhilestandingbeforea
mirrorwiththehandsatthesides,overhead,andpressedfirmlyon
thehipstocontractthepectoralismuscles.

---

127.VitaminKdependentcoagulation
factor(s)inchildrenis/are:
a)Factor2
b)Factor7
c)Factor8
d)Factor9
e)Factorl0
CorrectAnswer-A:D:E
Ans.a.Factor2;b.Factor7;d.Factor9;e.Factorl0
Vit.Kcarboxylatesglutamicacidsoftranslationproductsofvitamin
K-dependentproteins,toproduce?-carboxyglutamate
FactorII,VII,IX&XareprocoagulantProenzymeswhereasproteins
C&Sareanticoagulantproenzymes

---

128.ChildcanSwapsobjectfromonehandto
otherin:
a)2-3month
b)5-6month
c)6-12Months
d)12-18Months
e)20-24Months
CorrectAnswer-B
Ans.b.5-6month
Childcantransferobjectsfromonehandtootherby6-7month
Transferobjectshaniltohanilin5'5months

---

129.Congenitalhyperbilirubinemiais/are
seenin:
a)Prematurity
b)Hypoalbuminaemicstate
c)Hepatitis
d)Sepsis
e)Polycythemia
CorrectAnswer-A:C:D:E
Ans.a.Prematurity;c.Hepatitis;d.Sepsis;e.Polycythemia
Albuminlessthan3.0mg/dlisriskforhyperbilirubinemia
neurotoxicity
Twoothergroupsofdisordersareassociatedwith
hyperbilirubinemia:
(1)Unconjugatedhyperbilirubinemiaseenin,
Breastmilkjaundice
Bloodgroupincompatibility
Lucey-Driscollsyndrome
Congenitalhypothyroidism
Upperintestinalobstruction
Gilbertdisease
Crigler-Najjarsyndrome
Hereditaryspherocytosis
Non-spherocytichemolyticanemia
Drug-inducedhyperbilirubinemia
(2)Conjugatedhyperbilirubinemiapresentin,
Dubin-Johnsonsyndrome

---

Rotorsyndrome
Biliaryatresia
Neonatalhepatitis

---

130.Commoncauseofdistalsmallintestinal
obstructionininfants/child:
a)Meconiumileus
b)Jejunalatresia
c)Ilealatresia
d)Meckel'sdiverticulum
e)Duodenalatresia
CorrectAnswer-A:B:C:D
Ans.a.Meconiumileu;sb.Jejunalatresia;c.Ilealatresia;d.
Meckel'sdiverticulum
Theprimaryetiologiesofcongenitalsmallbowelobstruction
involves:
Abnormalitiesinanatomicdevelopment(jejunoilealstenosis&
atresia)
Mucussecretion(meconiumileus)
Bowelwallinnervation(long-segmentHirschsprungdisease)
MeckeldiverticulumisthemostcommoncongenitalanomalyofGI
tract

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131.NotanIntra-articularfracture:
a)Rolandofracture
b)Marchfracture
c)Bennett'sfracture
d)Barton'sfracture
e)Hoffafracture
CorrectAnswer-B
Ans.b.Marchfracture
Marchfracture:Fatiguefractureofshaftofsecondorthird
metatarsal
Rolandofractureisathreepartorcomminutedintraarticular
fracture-dislocationofthebaseofthumb.
Pilonfracture:Itisacommunicatedintra-articularfractureofthe
distalendofthetibia
Bennett'sfracture:Ifisanobliqueintra-articularfractureofthebase
ofthefirstmetacarpalwithsubluxationofthetrapezoid'metacarpal
joint"
Barton'sfracture(Marginalfracture):Intra-articularfracturesthrough
thedistalarticularsurfaceoftheradius,takingamargin,anterioror
posterior,ofthedistalradiuswiththecarpals,displacedanteriorlyor
posteriorly
Hoffafracturesareintra-articularandarecharacterisedbyafracture
inthecoronalplane

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132.Allaretrueaboutsupracondylarfracture
ofhumerusexcept:
a)Posteriorshiftofdistalfragment
b)Mediannerveismostcommonnervedamaged
c)Injuryofbrachialarterymayoccur
d)Commoninelderly
e)Volkmann'sischemiccontracturemayoccur
CorrectAnswer-D
Ans.d.Commoninelderly
SupracondylarFractureoftheHumerus:
Complications:
Immediate-injurytobrachialartery&injurytonerve(mediannerve-
mostcommon,radialnerve-sometimeaffected)
Early-Volkmann'sischemia
Latecomplication-Malunion(cubitusvarusdeformity),myositis
ossificans&Volkmann\ischemiccontracture.
Displacement:Thedistalfragmentmaybedisplacedinthefollowing
direction
Posteriororbackwardshift
Posteriororbackwardtilt
Proximalshift
Medialorlateralshift
Medialtilt
Internalrotation

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133.AllaretrueVolkmannischemic
contractureexcept
a)Ischemicmuscleisreplacedbyfibrous
b)Ulnarnervepalsymaybepresent
c)Extensiondeformityofthewrist&fingers
d)Flexionatthemetacarpophalangeal
e)Tendontransferhelpsinrestoringmovements
CorrectAnswer-C
Ans.c.Extensiondeformityofthewrist&fingers
VOLKMANN'SISCHEMIA
Earlycomplicationofsupracondylarfracture.
Ischemicinjurytothemusclesandnervesoftheflexor
compartmentoftheforearm.
D/tocclusionofbrachialartery.
Tissuepressurereadingswithin30mmHgofthepatient's
diastolicbloodpressure(perfusionpressure
Musclessuppliedbyanteriorinterosseusarteryaremost
susceptible,asitisanendartery.
Mostcommonlyaffectedmuscle:flexorpollicislongus&medial
halfofflexordigitorumprofundus.
Mediannerveismostcommonlyinvolved.
Treatment:fasciotomy

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134.TrueaboutDupuytren'scontracture;
a)Commonlyaffectring&smallfinger
b)Mayinvolvepenis
c)Involvesmetacarpo-phalangealjoint
d)Kneereflexdiminished
e)Involvesneckflexors
CorrectAnswer-A:B:C
Ans.a.Commonlyaffectring&smallfinger;b.Mayinvolve
penis;c.Involvesmetacarpo-phalangealjoint
ClinicalFeaturesofDupuytren'scontracture:
Thickenedfibrousbandsfeltovertheulnarsideofthepalm.
Thickeningofplantarfasciaorthatofthepenilefascia(Peyronie's
disease).
Tendernessovertheinvolvedareaatthebaseofthedigits.
FlexiondeformityattheMCPandPIPjointsofinvolvedfingers

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135.Trueaboutcomplexregionalpain
syndrome:
a)Sudeck'satrophyisanexample
b)Painisoutofproportiontoprecipitatingcause
c)Hyperaesthesiaofskinmaybepresent
d)Adultsareusualsufferer
e)Parasympatheticmediatedenhancementofpain
CorrectAnswer-A:B:C:D
Ans.a.Sudeck'satrophyisanexample;b.Painisoutof
proportiontoprecipitatingcause;c.Hyperaesthesiaofskin
maybepresent;d.Adultsareusualsufferer
ComplexRegionalPainSyndrome
Anumberofclinicalsyndromesappearunderthisheading,including
Sudeck'satrophy,reflexsympatheticdystrophy,algodystrophy,
shoulder-handsyndrome&particularlyafteranerveinjury-
causalgia.
Precipitatingcausesaretrauma(oftentrivial),operationor
arthroscopy,aperipheralnervelesion,myocardialinfarction,stroke
&hemiplegia
Adultsaretheusualsufferersbuttheconditionoccasionallyoccurin
children

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136.Failurerateof<2/100womenyearsis/
areseen:
a)Malecondom
b)Implanon
c)COC
d)Vaginaldiaphragm
e)IUCD
CorrectAnswer-B:C:E
Ans.b.Implanon;c.COC;e.IUCD
Failurerate2/100womenyearsisseenin:
Lactationalamenorrhoea<2
CUT380A<0.8
LNG20(IUCD)<0.1
Combinedoralpills<0.1
Progestinonlypills1
DMPA&NETinjectables<0.3
Norplant<0.05
Implanon<0.01
Vasectomy<0.15
Tubectomy<0.15

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137.Trueaboutbreechpresentation:
a)Morecommoninprimi
b)Incidenceisabout7%attermpregnancy
c)Morecommoninpostdatedpregnancy
d)Moreinpelvicanomaly
e)Externalcephalicversiondecreasesincidenceofbreech
Presentation
CorrectAnswer-D:E
Ans.d.Moreinpelvicanomaly;e.Externalcephalicversion
decreasesincidenceofbreechPresentation
Percentageofbreechattermis3%
ETIOLOGY:
Prematurity
Factorspreventingspontaneousversion:
Breechwithextendedlegs
Twins
Oligohydramnios
Septateorbicornuateuterus
Shortcord,relativeorabsolute
IUDoffetus.
Favourableadaptation:
Hydrocephalus
Placentaprevia
Contractedpelvis
Cornu-fundalattachmentoftheplacenta
Unduemobilityofthefetus
Hydramnios,

---

Multiparaewithlaxabdominalwall.
Fetalabnormality:Trisomies13,18,21,anencephalyandmyotonic
dystrophy

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138.Trueabouttreatmentofbacterial
vaginosis:
a)Metronidazoleisthedrugofchoice
b)Metronidazoleshouldtakeindoseof500mg,orallytwice
adayfor7day
c)Intravaginalclindamycinisused
d)Malepartnerisalsotreatedinallcases
e)Clotrimazole2%creamisusedintravaginally
CorrectAnswer-B:C
Ans.a.Metronidazoleisthedrugofchoice;b.Metronidazole
shouldtakeindoseof500mg,orallytwiceadayfor7day;c.
Intravaginalclindamycinisused
Medication--Treatmentshouldincludebothpartners.
OralMetronidazole--500mgorallytwicedailyaftermealsfor7
days.Or2gstat.
Advisabletodefertreatmentduringfirsttrimesterofpregnancy.
Intravaginalclindamycinisused

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139.Trueaboutgestationalhypertension:
a)ReturntonormalBPwithin12weekofpostpartum
b)BP>140/90mmHg
c)Developbeyondthe20thweekofpregnancy
d)Maycontinueevenafterl2weekofdelivery
e)Finaldiagnosismadeonlyinpostpartum
CorrectAnswer-A:B:C:E
Ans.a.ReturntonormalBPwithin12weekofpostpartum;b.
BP>140/90mmHg;c.Developbeyondthe20thweekof
pregnancy;e.Finaldiagnosismadeonlyinpostpartum
Gestationalhypertension
Asustainedriseofbloodpressureto140/90mmHgormoreon
atleast2occasions4ormorehoursapartbeyondthe20thweeksof
pregnancyorduringthefirst24hoursafterdeliveryinapreviously
normotensivewomaniscalledgestationalhypertension.
Itisassociatedmuchhigherincidenceofessentialhypertensionin
laterlifethanpreeclampsia.
Thehypertensiveeffectisactuallyastressresponse.
Perinatalmortalityremainsunaffectedinacaseofgestational
hypertension.
Thepatientswithgestationalhypertensionaremorelikelytodevelop
hypertensionwiththeuseoforalcontraceptivesorinsubsequent
pregnancies.
B.P.returnstonormalwithin6weeksofdelivery

---

140.TrueaboutstageIbcervixcarcinoma
management:
a)Radiotherapyalone
b)Simplehysterectomyalone
c)Primarychemoradiation
d)Wertheimhysterectomy+pelviclymphadenectomy
e)Simplehysterectomy+adjuvantchemotherapy
CorrectAnswer-C:D
Ans.c.Primarychemoradiation;d.Wertheimhysterectomy+
pelviclymphadenectomy
StagesIBandIIACervicalCancer
Radiationtherapywithchemotherapygivenatthesametime.
Radicalhysterectomyandremovalofpelviclymphnodeswithor
withoutradiationtherapytothepelvis,pluschemotherapy.
Radicaltrachelectomy.
Chemotherapyfollowedbysurgery.
Radiationtherapyalone.

---

141.TrueaboutMirena:
a)Effectivelifeis5-10yr
b)GivesprotectionagainstHMSTD
c)Contraindicatedinsuspectedpregnancy
d)Contraindicatedinbreastcarcinoma
e)Usefulincontrollingmenorrhagiainfibroid
CorrectAnswer-A:C:D:E
Ans.a.Effectivelifeis5-10yr;c.Contraindicatedinsuspected
pregnancy;d.Contraindicatedinbreastcarcinoma;e.Usefulin
controllingmenorrhagiainfibroid
Thelevonorgestrel-releasingIUS,Mirena,releases20mcgof
levonorgestrelperdayandisapprovedforcontraceptionforup
to5years.Itachieveslocalprogestinconcentrationsthatare
~1000-foldhigherthansystemiclevels.
ContraindicationsspecifictotheuseofMirenaare:
Acuteliverdiseaseortumor
Knownorsuspectedcarcinomaofthebreast
Hypersensitivitytoanycomponentofthisproduct
ContraindicationstoUseofanIntrauterineDevice:
Pregnancyorsuspicionofpregnancy
Genitalactinomycosis
Acutepelvicinflammatorydisease
Genitalbleedingofunknownetiology
Womanorherpartnerhavingmultiplesexualpartners
ApreviouslyinsertedIUDthathasnotbeenremoved
Abnormalitiesoftheuterusresultingindistortionoftheuterinecavity
Postpartumendometritisorinfectedabortioninthepast3months

---

Knownorsuspecteduterineorcervicalneoplasia,orunresolved
abnormalcytologicalsmear
Untreatedacutecervicitisorvaginitis,includingbacterialvaginosis,
untilinfectioniscontrolled
Historyofectopicpregnancyorconditionthatwouldpredisposeto
ectopicpregnancy

---

142.Intracytoplasmicsperminjection(ICSI)
is/areusefulinconditionof-
a)Mullerianagenesis
b)Unexplainedinfertility
c)Hostilecervicalmucus
d)Oligospermia
e)Presenceofspermantibodies
CorrectAnswer-B:D:E
Ans.b.Unexplainedinfertility;d.Oligospermia;e.Presence
ofspermantibodies
IndicationsofICSIinmaleinfertilitycomprise:
Spermcountlessthan5million/mL.
Decreasedorabsentmotilityofsperms.
Manyabnormalsperms.
PreviousfailedIVF.
Unexplainedinfertility.
Asthenopermia,teratospermia
Presenceofspermantibodies
Obstructionofefferentductsystem(male)
Congenitalabsenceofvas(bilateral)
Fertilisationofcryopreservedoocytes

---

143.Indicationofartificialinsemination
is/are:
a)Malefactorinfertility
b)Unexplainedinfertility
c)PCOD
d)Tubalfactorinfertility
e)Hostilecervicalmucus
CorrectAnswer-A:B:E
Ans.a.Malefactorinfertility;b.Unexplainedinfertility;e.
Hostilecervicalmucus
Indicationofartificialinsemination:
Hostilecervicalmucus
Cervicalstenosis
Oligospermiaorasthenospermia
Immunefactor(maleandfemale)
Malefactor-impotencyoranatomicaldefect(hypospadias)but
normalejaculatecabbeobtained
Unexplainedinfertility
Chronicmedicaldisorder
HlV-positivemaleorfemale

---

144.TrueaboutEctopicPregnancy:
a)OCPuseincreaserisk
b)IUCDfailureincreasechanceofectopicpregnancy
c)?hCGriseisnotparalleltonormalpregnancy
d)TransvaginalUSGis100%diagnostic
e)MorecommoninPrimi
CorrectAnswer-B:C
Ans.b.IUCDfailureincreasechanceofectopicpregnancy;c.
?hCGriseisnotparalleltonormalpregnancy
RISKFACTORS:
HistoryofPID
Historyoftuballigation
Contraceptionfailure
Previousectopicpregnancy
Tubalreconstructivesurgery
Historyofinfertility
Calendarmethod
ARTparticularlyifthetubesarepatentbutdamaged
IUD(Progestasert)use
Previousinducedabortion
Tubalendometriosis
DIAGNOSIS:
Bloodexamination:
Hemoglobin
ABOandRhgrouping
TLC&DLC
ESR

---

Culdocentesis
Estimationof-hCG
Sonography:
TransvaginalUSG(Mostsensitive)
Absenceofintrauterinepregnancywithapositivepregnancytest.
Fluid(echogenic)inpouchofDouglas
Adnexalmass
Rarelycardiacmotion
ColorDopplerSonography:
Ring-of-firepattern
Enhancedbloodflowpattern
Laparoscopy
D&C
Serumprogesterone
Laparotomy

---

145.Medicaltreatmentofmyomaincludes:
a)Tamoxifen
b)Mifepristone
c)LNG-IUD
d)GnRHagonist
e)GnRHantagonist
CorrectAnswer-B:C:D:E
Ans.b.Mifepristone;c.LNG-IUD;d.GnRHagonist;e.GnRH
antagonist
MedicaltreatmentofMyoma:
Mifepristone(RU-486)10-25mgdailyfor3monthcauses
amenorrhoea&shrinkageofthetumorby50%
Antiprogesterones(Mifepristone)
Danazol
GnRHanologs-Agonists(e,ggoserelin,luporelin)&antagonists(e.g
ganirelix&cetrorelix)
LNG-IUS
Progesteronesynthetaseinhbitors

---

146.TrueaboutMedicalTerminationof
PregnancyinIndia:
a)Canbedoneinanyhospitalbyatrainedobstetrician
b)Onlywomenconsentisneeded,husbandconsentnot
mandatory
c)Opinionoftwodoctorsareneededifcarriedafter20weeks
d)Opinionofonedoctorsisneededifcarriedbefore20weeks
e)Bothsurgical&medicalmethodforterminationareavailable
CorrectAnswer-B:E
Ans.b.Onlywomenconsentisneeded,husbandconsentnot
mandatory;e.Bothsurgical&medicalmethodfortermination
areavailable
MedicalTerminationofPregnancy:
TheIndianactpermitsthewilfulterminationofpregnancybeforethe
ageoffetalviability(20weeksgestation)forwell-definedindication
Tobeperformedbyrecognizedmedicalpractitionersinrecognized
placeapprovedbycompetentauthorityunderact.
TheidentityofpersonktreatedasastatutoryPersonalmatter
Documenttobemaintained:FormI,FormII&admissionregister
Writtenconsentofwomanisneeded.
Husbandconsentisnotrequired.
Incaseofminorgirlorlunaticormentallyretardedwoman,written
consentofherparentsorlegalguardianItobetaken
Bothmedical&surgicalmethodsareused.
Surgicalmethodsinclude-manualvaccumaspiration,suction
evacuation,dilation&evacuation&dilation&curettage.

---

Medicalmethodincludes-Mifepristonealone,Mifepristone&
misoprostolmethotrexate&misoprostol,Tamoxifen&misoprostol,
misoprostolaloneetc.

---

147.Trueaboutemergencycontraceptive:
a)Availableasoverthecounter(OTC)
b)LNGalone,0.75initiallyfollowedbyanother0.75mg12hours
apartisemergencycontraceptivemethodofchoice
c)Ethinylestradiol(EE)shouldbetakenwithin72hours
d)CopperIUDisusedwithin5daysofunprotectedsex
e)LNG-IUSisoneofbestmethod
CorrectAnswer-A:B:C:D
Ans.a.Availableasoverthecounter(OTC);b.LNGalone,0.75
initiallyfollowedbyanother0.75mg12hoursapartis
emergencycontraceptivemethodofchoice;c.Ethinylestradiol
(EE)shouldbetakenwithin72hours;d.CopperIUDisused
within5daysofunprotectedsex
Postcoital(emergency)pills:
Levonorgestrel0.5mg+ethinylestradiol0.1mg-->within72hours
ofunprotectedintercourseandrepeatedafter12hours-Yuzpe
method.
Levonorgestrelalone0.75mgtakentwicewith12hourgapwithin72
hoursofunprotectedintercourse-->methodofchoicefor
emergencycontraception.
Mifepristone600mgsingledosewithin72hoursofunprotected
intercourse.
Othermethods:-progesteroneonlypill(minipills),IUDinsertion,
Highdoseestrogens.

---

148.Whichofthefollowingistrueabout
changesduringPregnancy:
a)Minuteventilation
b)Tidalvolume
c)Minimumalveolarconcentration(MAC)ofanaestheticgases
d)Bloodvolume&RBCvolume
e)Respiratoryrate
CorrectAnswer-A:B:D
Ans.a.Minuteventilation;b.Tidalvolume;d.Blood
volume&RBCvolume
RESPIRATORYCHANGES:
PARAMETERS
CHANGES
Respirationrate/min
Unaffected
Vitalcapacity(mL)
Unaltered
Tidalvolume(ml)
by40%
Residualvolume(mL)
by20%
Inspiratorycapacity(IC) by10%
Minuteventilation
by40%
Totallungcapacity(mL) by5%

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149.Contraindicationofcombinedoral
contraceptive(COC)include(s)-
a)Severehypertension
b)Ischemicheartdisease
c)Pre-menstrualtension
d)Activeliverdisease
e)All
CorrectAnswer-A:B:C:D
Aps.is'a'i.e.,Severehypertensiorr;'b'i.e.,Ischemicheart
disease;&'d'i.c',Activeliverdisease
ContraindicationsofOCPs(WHOguidelines)
Absolute:
Thromboembolismevent,cerebrovascularaccident,coronaryartery
disease,
Breastcancer,
DM(>20yearsduration)
Impendingmajorsurgery
Hyperlipidaemia
Pregnancy
Lactation(<6weekspostpartum)
Activeliverdisease,hepatoma
Uncontrolledhypertensionorwithvasculardiseases
>35yearsoldandheavysmoker(>20cigarettes/day)
Migrainewithaura
Diabeticnephropathy/neuropathy/retinopathy
Structuralheartdiseasewithpulmonaryhypertension,AForSABE.

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Relative:
Lactation(6weeks-6months)
Controlledhypertension
Undiagnosedvaginalbleeding
Migrainewithoutaura
Gallbladderdisease
Age>35yearsandlightsmoker(<20cigarettes/day)
DMwithvascularcomplications.

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150.Mostcommoncauseofprimarypost-
partumhemorrhageis:
a)Uterineatony
b)Uterineinertia
c)Uterineinversion
d)Retainedplacenta
e)Traumatic
CorrectAnswer-A
Ans.a.Uterineatony
PrimaryPostpartumHemorrhage:
Atonicuterus:Uterineatonyismostcommon(80%cases)
Grandmultipara
Overdistensionoftheuterusasinmultiplepregnancy,hydramnios
&bigbaby
Uterinefibroid
Placenta:Morbidlyadherentplacenta(accrete,perceta)
Antepartumhaemorrhage(bothplacentapraevia&abruption)
Prolonglabour,Mismanaged3rdstagelabour

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151.Screeningtestsforcervicalcancer
includes
a)HPVserology
b)Cervicalbiopsy
c)Colposcopy
d)Cytology
e)Conisation
CorrectAnswer-A:D
Ans.a.HPVserology;d.Cytology
CervicalCancerScreening:
Papsmear
colposcopytoexaminethecervixandsurroundingstructures
Abiopsymaybeperformedtoremovetissuesamplesfor
examinationinalaboratory.
ADNAtestmaybeorderedtoseewhetherahigh-riskformofHPV
ispresent.
Cytoplasmicvacuolizationandnuclearenlargementofcellsisseen
ashistologicfeaturesinHPV-relatedcervicalintraepithelial
neoplasia

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152.Trueaboutendometriosis:
a)Laparoscopyisgoldstandardfordiagnosis
b)COCisusedtorelievemildPain
c)GnRHantagonistisusedtorelieveseverepain
d)Canbemanagedexpectantlyinasymptomaticcases
e)Noneoftheabove
CorrectAnswer-A:B:D
Ans.(A)Laparoscopyisgoldstandardfordiagnosis;(B).COCis
usedtorelievemildPain;(D)Canbemanagedexpectantlyin
asymptomaticcases
Friendsthisisthemostoftenaskedquestiononendometriosis.Itis
worthwhiletoknowafewdetailsonthistopic.
Empiricaltreatment:isforpainpresumedtobedueto
endometriosis.(inabsenceofdefinitivediagnosis)andincludes:--
Counselling
1. Analgesia
2. Nutritionaltherapy
3. ProgestinorOCP's
Analgesia:StudieshaveshownNSAID'sexceptniflumicacidare
moreeffectiveinchronicpainreliefduetoendometriosisor
dysmenorrheasuspectedtobeduetoendometriosis.
Hormonalmedicaltreatment:
Basisofmanagement:Sinceestrogenisknowntostimulatethe
growthofendometriosis,hormonaltherapyhasbeendesignedto
suppressestrogensynthesis,therebyinducingatrophyofectopic
endometrialimplantsorinterruptingthecycleofstimulationand
bleeding.

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Indication:--Mildpelvicendometriosisinyoungwomen.?
Treatmentofresidualandrecurrentdiseasefollowingconservative
surgery.

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153.Kobner'sphenomenoncanoccurin:
a)Lichenplanus
b)Vitiligo
c)Psoriasis
d)Bullouspemphigoid
e)Dicoidlupuserythematosus
CorrectAnswer-A:B:C:E
Ans.(A)Lichenplanus(B)Vitiligo(C)Psoriasis(E)Dicoidlupus
erythematosus
[Ref:NeenaKhanna5th/45;Harrison19th/i47,1269;Roxbutg17th/
130]
Kobne/sphenomenonischaracteristicofpsoriasisbutitisalsoseen
inlichenplanus&discoidlupuserythematosus.
Newlesionoforiginaldiseasedevelopsatsitesoftrauma(scratches,
surgicalincisions6injury)
Thisphenomenonisseeninpsoriasis,lichenplanus&vitiligo
Inactivatesactivedisease

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154.Allaretrueaboutpompholyxexcept:
a)Itisaformofhand/footeczema
b)Alsocalledasdyshidroticeczema
c)Vesicle&blistersarepresent
d)Secondarybacterialinfectionarecommon
e)Steroidsshouldnotbeusedasitcanexacerbatethecondition
CorrectAnswer-E
Ans.E.Steroidsshouldnotbeusedasitcanexacerbatethe
condition
[RefNeenaKhanna5th/115-116;www.dermnetnz.org]
Pompholyx:
Aetiology
Unknown.
SomepatientswithpompholyxdevelopaVesicularpalmoplantar
eruptiononingestionofminuteamountofnickel
ClinicalFeatures
Summeraggravation
Recurrentepisodesofdeepseated,bland(withoutinflammation)
vesicles(sometimesblister).Eachepisodeself-limitingbutfresh
cropsofvesiclesDevelopsuccessively,leavingpatientsymptomatic
forlongperiods
Lesionsoccasionallygetsecondarilyinfected.
Fingers&palms&sometimessola
Pointfordiagnosis:Basedon
Recurrentepisode
Presenceoflandvesicles
Presenceonfingers,palms&soles

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Treatment
Salinesoakedfollowedbytopicalsteroids
Appropriateantibiotics,ifbacterialinfectionpresent

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155.Whichofthefollowingstatement(s)
is/arecorrectregardingmanagementof
malignanthyperthermiaexcept:
a)Discontinueallanaestheticsimmediately
b)DantroleneismainstayoftherapyforMH
c)Hyperventilationwith100%oxygenishelpful
d)Sodiumbicarbonateisgiventocorrectalkalosis
e)Correcthyperkalemiabygivingdextrose&insulin
CorrectAnswer-D
Ans.D.Sodiumbicarbonateisgiventocorrectalkalosis
MalignantHyperthermia:
DuetoabnormalityoftypeIRyanodinereceptorwhichiscalcium
releasechannelofsarcoplasmicreticulum.
Geneticdiseaseusuallyautosomaldominantbutcanberecessive
also.
PatientwithnormalCKlevelsshouldundergomusclebiopsystudies
(wheremuscleissubjectedtotriggeringfactors(likehalothane&
suxamethonium).
TreatmentofMH:
Dantrolene-
MainstayoftherapyofMH.
DirectlybindstoRyanodinereceptorinhibitingcalciumrelease

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156.Whichofthefollowingis/aretrueabout
pre-anaestheticcheckup(PAC):
a)Notnecessaryinchildren
b)Usedtoassesspatientconditiontotolerateanaesthesia&
surgery
c)Canbeperformedbysurgicalfaculty
d)Relievesanxietyofpatient
e)Helpinplanninganaesthesiatechnique
CorrectAnswer-B:D:E
Ans.(B)Usedtoassesspatientconditiontotolerate
anaesthesia&surgery(D)Relievesanxietyofpatient(E)Helpin
planninganaesthesiatechnique
PACisequallynecessaryininfant&children(infact,evenmore
thanadults).
Infantsareatamuchgreaterriskofanestheticmorbidity&mortality
thanolderchildren;riskisgenerallyinverselyproportionaltoage.
Pre-anaestheticCheckup(PAC):Goals:
Toreduceanxiety&educatethepatientaboutanaesthesia
Toobtaininformationaboutpatient\medicalhistory
ToPerformPhysicalexamination
Todeterminewhichtestsarerequired
Toplonanaesthetictechnique.
Toobtaininformedconsent
Togiveanypreoperativeinstructions

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157.Whichofthefollowingstatementis/are
trueregardingintravenousfluid:
a)Ringerlactateiscrystalloidofchoiceforbloodlossreplacement
b)Colloidisfluidofchoiceinsevereshock
c)5%Dextroseshouldbeavoidedinheadinjury
d)0.45%salinecontains154mEq/LNa+&154mEq/LCi?
e)Dextrosenormalsaline(DNS)ishypotonic
CorrectAnswer-A:B:C
Ans.(A)Ringerlactateiscrystalloidofchoiceforbloodloss
replacement(B)Colloidisfluidofchoiceinsevereshock
(C)5%Dextroseshouldbeavoidedinheadinjury
[Ref:MorganAnaesthesiaSth/1163-66;Ajayyadav5th/12-15;Lee
Anaesthesia13th/232-33;Miller7th/2799]
Colloidsareonlyreservedforsevereshock.
Bloodglucosecontrol:
Hyperglycaemiaisknowntoexacerbatecerebrallacticacidosisand
consequentlyaggravatescerebralischaemiainheadinjury.
Thereforeglucosesolutionsshouldbeavoided.
Dextrose:
Aggregateischemicneurologicinjury
Hyperglycemiamayalsoconstituteahormonallymediatedresponse
tomoresevereinjury.
Ringerlactate:
Crystalloidofchoiceforbloodlossreplacement.
NormalSaline:
0.9%NaClisotonicsolution

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DextroseNormalSaline:
Hypertonic

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158.Whichofthefollowingis/areusedin
neuroendocrinetumorevaluation:
a)68Ga-DOTA-TOC
b)MIBG
c)68Ga-DOTA-NOC
d)F-18Fluorodopa
e)68Ga-DOTA-TATE
CorrectAnswer-A:B:C:D:E
Ans.(A)68Ga-DOTA-TOC(B)MIBG(C)68Ga-DOTA-NOC(D)F-
18Fluorodopa(E)68Ga-DOTA-TATE
Gallium68DOTATOC/DOTANOC:
Forimagingofneuroendocrinetumors.
HighersensitivityforGIneuroendocrinetumors
F-18Fluorodopa:Dopamineanalogue:
Themostspecific&sensitiveagentforimagingofneuroendocrine
tumorsespeciallypheochromocytoma(adrenal&extra-adrenal)&
neuroblastoma
ScintigraphyofneuroendocrineTumors:
I-131Metaiodobenzylguanidine(MlBG)Sensitivity-77-100%.
I-123Metaiodobenzylguanidine(MIBG).
GlucoseAnalogs2-(fluorine-r8)fluoro-2-deoxy-D-glucose
(FDG)Uptake

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159.USGis/arebasedon:
a)Piezoelectriceffect
b)Diamagneticeffect
c)Paramagneticeffect
d)Ferromagneticeffect
e)Electromagneticeffect
CorrectAnswer-A
Ans.A.Piezoelectriceffect
[Ref:ReviewRadiologybySumerSethi6th/9-11]
Ultrasonography:
Ultrasonicimage(sonographic/echographic)isbasedonmechanical
oscillationsofthecrystalexcitedbyelectricalpulses(Piezoelectric
effect).

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160.X-rayfeature(s)ofLeftAtrial
Hypertrophy:
a)Bootshapedheart
b)Widenedcarina
c)Straightenedleftborder
d)Doubleatrialshadow
e)Moneybagappearance
CorrectAnswer-B:C:D
Ans.(B)Widenedcarina(C)Straightenedleftborder(D)Double
atrialshadow
[Ref:PJM20th/228;DahnertRadiologymanual5th/575,636-
637;ReviewradiologybySumerSethi6th/76-77,80]
X-rayfeatureofleftAtrialHypertrophy:
Doubleatrialshadow(Doubledensityseenthroughrightupper
border)
Straightenedleftborder
Leftbronchusliftedupwithwidenedcarina
EsophaguscurvingaroundthedilatedLeftatrium.
Splayingofmainstembronchi(i.e.Increasedcarinalangle)
Smallaorta(duetoincreaseoffuruardcardiacoutput)
Normal/UndersizedLV

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161.Whichofthefollowingis/arecommon
radiationinducedcancers:
a)Breastcancer
b)Gonadalcancer
c)Leukaemia
d)Renalcellcarcinoma
e)Prostatecancer
CorrectAnswer-A:B:C
Ans.(A)Breastcancer(B)Gonadalcancer(C)Leukaemia
[Ref:DahnertRadiologymanual7th/574,154,408,313.]
Mostcommonlyoccuringradiation-inducedcancerisLeukemia.
Cancerinductionisthelargestriskofradiationexposure
encounteredinradiology.
Bonemarrow,gastrointestinaltract&mucosa,breasttissue,gonads
&lymphatictissuearemostsusceptibletoradiationinduced
malignancy.
Cancerriskishigherforchildrenthanforadults

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162.Neologismischaracteristicof:
a)OCD
b)Mania
c)Bipolardisorder
d)Schizophrenia
e)Autism
CorrectAnswer-D
Ans.D.Schizophrenia
Neologisms:
Referstoanewwordorcondensedcombinationofseveralwords
thatisnotatrueword&isnotreadilyunderstandable,although
sometimestheintendedmeaningorpartialmeaningmaybe
apparent.
Featureofschizophrenia(thought&speechdisorder)

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163.Goodprognosisinschizophreniais/are
seenin:
a)Negativesymptoms
b)Earlyonset
c)Acuteonset
d)Familyhistoryofschizophrenia
e)Insidiousonset
CorrectAnswer-C
Ans.C.Acuteonset
[RefNeerajAhuja7th/62;Kaplan&SadockSynopsisofpsychiatry
1|th/318]
GoodPrognosisinSchizophrenia:
Lateonset(Onset>35yr)
Shortduration(<6months)
Obviousprecipitatingfactors
Acuteonset/Abruptonset
Goodpremorbidsocial,sexuaIandworkhistories
Mooddisordersymptoms
(especiallydepressivedisorders)
Married
Familyhistoryofmooddisorders
Goodsocialsupportsystems
Positivesymptoms:
Presenceofprecipitatingstressor
Catatonicsubtype(paranoid-intermediateprognosis)
Firstepisode

---

Pyknic(fat)body
Femalesex
Presenceofconfusion,perplexityordisorientationintheacute
phase
NormalcranialCT
Outpatienttreatment-Propertreatment&goodresponseto
treatment

---

164.TrueaboutAlprazolam:
a)Antidepressant
b)Antipsychotic
c)Anti-anxiety
d)Hypnotic
e)Benzodiazepine
CorrectAnswer-C:D:E
Ans.(C)Anti-anxiety(D)Hypnotic(E)Benzodiazepine
[RefNeerajAhuja7th/ljL;KDT7th/465;Kaplan&Sailock\Synopsis
ofPsychiatryI1th/949]
Alprazolam:
AntianxietyDrug
Hypnotic
Anticonvulsant

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165.Feature(s)ofDelusion:
a)Shakeable
b)Truebelief
c)Falsebelief
d)Bizarre
e)Non-bizarre
CorrectAnswer-C:D:E
Ans.(C)Falsebelief(D)Bizarre(E)Non-bizarre
[Ref'NeerajAhuja7th/83-84;Kaplan&Sadock\Synopsisof
Psychiatry1lth/202,330-351]
Delusion:
Falseunbelievablebeliefs(falsefixedbeliefsnotinkeepingwiththe
culture).
DiagnosisofdelusionaldisorderismadewhenapersonexhibitNon
Bizarredelusionsofatleast1monthdurationthatcannotbe
attributedtootherpsychiatricdisorders.
invalidquestionid

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