Download NEET PG 2012 Question Paper with Answers

Download NEET PG (The National Eligibility cum Entrance Test Postgraduate) 2012 Question Paper with Answers

This post was last modified on 30 July 2021

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1.Whichmuscleisinsertedintothefloorof
theintertubercularsulcusofthehumerus?
a)Latissimusdorsi
b)Teresmajor
c)Pectoralismajor

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d)Deltoid
CorrectAnswer-A
Ans.is'a'i.e.,Latissimusdorsi
Theshaftofhumerusiscylindricalintheupperhalfandtriangularon
cross-sectioninthelowerhalf.Theupperparthasintertubercular

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sulcus(bicipitalgroove)anteriorly.Bicipitalgroovecontainslong
headofbicepswithitssynovialsheathandanascendingbranchof
anteriorcircumflexhumeralartery.Middlethirdofposteriorsurface
ofshaftofthehumerushasaspiralgroove(radialgroove)which
containsradialnerveandprofundabrachivessels.
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Attachmenttoshaftsare?
*Insertionsofpectoralismajor(onlaterallipofbicipitalgroove),
latissimusdorsi(onfloorofbicipitalgroove),teresmajor(ondeltoid
tuberosity)andcoracobrachialis(mediallyonmidshaft).
*Originofbrachialis(anteriorsurface);Lateralandmedialheadof

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triceps(posteriorsurface);pronaterteres(frommedial
supracondylarridge);brachioradialis(fromlateralsupracondylar
ridge)andECRL(fromlateralsupracondylarridge).

2.Atwhatleveldoesthetracheabifurcates
?

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a)UpperborderofT4
b)LowerborderofT4
c)27.5cmfromtheincisors
d)LowerborderofT5
CorrectAnswer-B

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Ans.is'b'i.e.,LowerborderofT4[RefBDCSth/eVolume1p.
267]
Tracheabifurcatesatcarina,attheleveloflowerborderofT,orT4-
T5discspace.

3.Cricoidcartilageliesatwhichvertebral

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level?
a)C3
b)C6
c)T1
d)T4

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CorrectAnswer-B
Ans.is'b'i.e.,C6[RefBDC5I'VeVol.III,p.237]

4.Whichofthefollowingistrueabout
vertebraldevelopment-
a)Thenotochordformstheannulusfibrosus

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b)Thesclerotomeformsthenucleuspulposus
c)Thesclerotomesurroundsthenotochordonly
d)Thesclerotomesurroundsthenotochordandtheneuraltube
CorrectAnswer-D
Ans.is'd'i.e.,Thesclerotomesurroundsthenotochordandthe
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neuraltube[RefLangman'sembryology10th/ep.140]
Developmentofvertebralcolumn
Thehumannervoussystemdevelopsfromneuroectoderm.
Duringdevelopment,behindtheneuroectodermliesthemesoderm
(paraxialmesoderm)thatenclosesthenotochord(aderivativeof

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endoderm).
Thisparaxialmesodermgiverisetosomites.
Somitesfurtherdifferentratedinto:
Dermatomyotome:-Giverisetoskeletalmusclesanddermis.
Sclerotomes:-Giverisetovertebralcolumn.

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Sclerotorneswhichsurroundnotochordstartsprojectingposteriorly
(dorsally)tosurroundneuraltubeandforms.
Ventralsclerotomes:-Giverisetovertebralbodyandannulus
fibrosus,Lateralsclerotomes:-Giverisetovertebralarch(pedicle
andlamina).

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Dorsalsclerotomes:-Giverisetospinousprocess.Thenotochord
formsthenucleuspulposus.

5.Whichofthefollowingisnotacongenital
anomaly?
a)Amastia

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b)Polymastia
c)Polythelia
d)Mastitis
CorrectAnswer-D
Ans.is'd'i.e.,Mastitis[RefHumanembryologybyInderbir
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Singh8th/ep.103]
Developmentalanomaliesofthemammaryglands:
1. Amastia:Theglandmaybeabsentononeorbothsides.
2. Athelia:Absenceofnipple
3. Polytheliaandpolymastia:Supernumerarybreastsandnipples

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alongthemilkline.
4. Invertedorcraternipple
5. Microormacromastia

6.Rectumdevelopsfrom
a)Cloaca

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b)Hindgut
c)Allantoicremnants
d)Urogeitalsinus
CorrectAnswer-A:B
Ans.is`b>a'i.e.,Hindgut>Cloaca[Ref:InderbirSinghhuman

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embryologySth/ep.149]
Postallantoicpartofhindgutisthedilatedendodermalcloaca,which
isseparatedfromthesurfacebycloacalmembrane.
Urorectalseptumdividesendodermalcloacaeinto
Anteriorpart,knownasprimitiveurogenitalsinus,whichdevelops

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intourinarybladderandurethra.
Posteriorpart,knownasprimitiverectum,whichgivesrisetolower
partofrectumandupperpartofanalcanal.

7.Skeletalderivativeof2?'pharyngealarch-
a)Malleus

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b)Incus
c)Stapes
d)Maxilla
CorrectAnswer-C
Ans.is`c'i.e.,Stapes

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8.Allarederivedfromectodermexcept-
a)Hypophysis
b)Retina
c)Spinalcord
d)Adrenalcortex

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CorrectAnswer-D
Ans.is'd'i.e.,Adrenalcortex[RefInderbirSinghHuman
EmbryologySth/ep.300]
Thecellsoftheadrenalcortexarisefromthecoelomicepithelium
(mesoderm).

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Thecellsofthemedullaarederivedfromtheneuralcrestcells
(ectoderm).
Theanteriorpituitaryisderivedfromthesurfaceectodermliningthe
oralcavityasitisanoutgrowthfromtheRathke'spouch.
Theposteriorpituitaryisactuallyacontinuationofthehypothalamus

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andsoitisderivedfromtheneuralectoderm.?
Thespinalcordandbrainarederivedfromtheneuralectoderm.
Theretinaisalsoderivedfromtheneuralectoderm.

9.Developmentoflabiamajoraisfrom-
a)Urogenitalsinus

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b)Mullerianduct
c)Genitalridge
d)Genitalswelling
CorrectAnswer-D
Ans.is'd'i.e.,Genitalswelling[Ref:InderbirSinghHuman

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EmbryologySth/ep.256]
Embryogical
Fatein
Fateinmale
structure

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female
Genitalswelling Labiamajora
Scrotum
Genitalfold
Labiaminora Ventralaspectof

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penis,penile
urethra
Genitaltubercle Clitoris
Glanspenis

10.Blastocystmakescontactwith

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endometriumon?
a)<3days
b)5-7days
c)8-11days
d)15-16days

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CorrectAnswer-B
Ans.is'b'i.e.,5-7days[Ref:TextbookofHumanembryology-
286]
Contactofblastocystwithendometriumoccursatthetimeof
implantation.

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Implantationoccursataround6-7days.

11.Haploidnumberofchromosomesisseen
in?
a)Spermatogonia
b)Primaryspermatocytes

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c)Secondaryspermatocyte
d)None
CorrectAnswer-C
Ans.is'c'i.e.,Secondaryspermatocyte[RefGanong23'd%p.
403,404]

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Diploidmeansthatcellcontains46chromosomes(diploidof23)and
haploidmeansthatcellcontains23chromosomes.
Developmentofspermisasfollows:-
Spermatogonia(Diploid-46)Primaryspermatocyte(Diploid-46)
Primaryspermatocyte(Diploid-46)isof2types-

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1. SecondaryspermatocyteSpermatid(Haploid-23)
2. Secondaryspermatocyte(Haploid-23)Spermatid(Haploid-23)
Similarlyinoogenesis,haploidnumberisseeninsecondaryoocyts.

12.Spermchromosomefasteris-
a)Xchromosome

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b)Ychromosome
c)Bothsame
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Ychromosome[RefPricipleofmedicalphysiology-

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51]
ThehumanYchromosomeissmallerthanXchromosome.
Hence,thespermscontainingYchromosomesarelighterandswim
fasterupthefemalegenitaltract,reachingtheovumearlierthanthe
Ybearingsperms.

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Thisprobablycontributestothefactthattheglobalmalebirthrateis
slightlyhigherthenthefemalebirthrate.

13.Allarederivedfromectodermexcept?
a)Lens
b)Eustachiantube

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c)Brain
d)Retina
CorrectAnswer-B
Ans.is'b'i.e.,Eustachiantube[RefHUMANEMBRYOLOGY
editedbyKrishnaGarg,2"dlep.56,133]

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Eustachiantubeoriginatesfromthefirstpharyngealpouchi.e.
Endoderm.
Endoderm
Ectoderm
Mesoderm

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Epitheliumof
Brain
LN&Spleen
wholeg.i.t.
NeuralCrest

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Mesenchyme
Resp.tract
AdrenalMedulla
Mesothelium
(Eustachian

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Pharyngealclefts
Pharyngealaches
tube)
Oligodendrocytes
CVS,blood,

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Pharyngeal
Lens(fromsurfaceE-)
BMDuramater
pouches
Irismuscles(Sphincter& TrigoneofUB

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Liver&GB
dilatorpupillae)
Monocytedery(Ex-
Urethra
Epitheliumofcornea,

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Microglia)
UB
conjunctivaouter
Cillarybody&iris
Lowerpartof

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Lids
stroma(except
vagins
Renalpigmentepithelium epithelium)
Ducts&acimiof Sensoryretina

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Sclera,choroid,
pancreas
MembranousLabyrinth
vitreous
Mostendocrinal

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Stromaofcornea
glands(except
Lids(Muscles)Adrenal
adr.medulla&
CortexBonyorbit

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pituitarywhich

CortexBonyorbit
pituitarywhich
areectoderm)

14.Whichofthefollowingisderivedfrom

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endoderm?
a)Gallbladder
b)Lens
c)Spleen
d)Lymphnodes

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CorrectAnswer-A
Ans.is'a'i.e.,Gallbladder[RefEmbryologyGarg2"/evarious
pages]

15.Developmentofperitonealcavityisfrom?
a)Mesenchyme

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b)Intraembryoniccoelom
c)Ectoderm
d)Endoderm
CorrectAnswer-B
Ans.is'b'i.e.,Intraembyoniccoelom[RefEmbryologybyIndu

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Khuran2"dlep.96]
Allbodycavitiesdevelopfromintraembryoniccoelum.These
cavitiesareperitonealcavity,pleuralcavityandpericardialcavity.
Theperitoneumdevelopsultimatelyfromthemesodermofthe
trilaminarembryo.

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Lateralplatemesodermsplitstoformtwolayersseparatedbyan
intraembryoniccoelom.
Thesetwolayersdeveloplaterintothevisceralandparietallayers
foundinallserouscavitiesincludingperitoneum.Andthepotential
spaceofintraembryoniccoelombetweenthesetwolayersbecome

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thebodycavitieslikeperitonealcavity,pleuralcavityandpericardial
cavity.
Asembryodevelops,thevariousabdominalorgansgrowintothe
abdominalcavityfromstructuresintheabdominalwall.Inthis
processtheybecomeenvelopedinalayerofperitoneum,i.e.

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viscerallayer.
Peritonealfoldsdevelopfromtheventralanddorsalmesenteryof
theembryo.
Peritoneum,pericardiumandpleuradevelopfrom-,Mesoderm
(lateralplatemesoderm)

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Peritonealcavity,pericardialcavityandpleuralcavitydevelopfrom

Intraembryoniccoelom.

16.Cytotrophoblastsinvades?
a)Dparietalis
b)Dbasalis

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c)Dcapularis
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Dbasalis[RefHumanEmbryologybyRaniKumarp.
37]

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Afterembeddingofblastocytintheendometrialstroma,the
trophoblastdifferentiatesinto-
Cytotrophoblast
Syncytiotrophoblast
Syncytiotrophoblastinvadesuterineepithelialcells.

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CytotrophoblastinvadesDeciduabasalis(Dbasalis)afterpassing
throughoverlyingsyncytotrophoblast.

17.Coronarysinusdevelopsfrom?
a)Truncusarteriosus

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b)Conus
c)Sinusvenosus
d)AVcanal
CorrectAnswer-C
Ans.is'c'i.e.,Sinusvenosus[RefEssentialsofhuman

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embryologyp.873]
TheCoronarysinusdevelopsfromtheSinusvenosussegmentof
embryonicheart.Lefthornofsinusvenosusretrogressestoform
partofcoronarysinus

18.Whichisderivedfromwolfianduct?

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a)Appendixoftestis
b)Uterus
c)Appendixofepididymis
d)Hydatidofmargagni
CorrectAnswer-C

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Ans.is'c'i.e.,Appendixofepididymis[RefIBsingh8r"/e-260]
Appendixofepididymisdevelopsfrommesonephric(wolffian)duct.
Appendixoftestis(alsocalledhydatidofmargagni)anduterus
developfromparamesonephricduct.

19.Arteryof2ndpharyngealarchis?

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a)Maxillaryartery
b)Stapedialartery
c)Subclavianartery
d)Commoncarotidartery
CorrectAnswer-B

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Ans.is'b'i.e.,Stapedialartery[RefGarg2"/e-223;Langman's-
185]
2nd(hyoid
Stapedialartery
arch):

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3rd:-
Commoncarotid/internalcarotid
4th:-:
Right4thaorticarch,subclavianartery,Left4thaortic
arch:aorticarch

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6th:-
Rightaorticarch:pulmonaryartery,Left6thaortic
arch:Pulmonaryartstxandductusarteriosus

20.Fossaovalisisaremnantof?
a)Septumprimum

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b)Septumsecundum
c)Ductusarteriosus
d)Ductusvenosus
CorrectAnswer-A
Ans.is'a'i.e.,Septumprimum[RefBDC5th/eVolume1p.247;

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IBS7"Vep.265;Garg2"/ep.215]
Fossaovalisisaremnantofforamenovale.Flooroffossaovalisis
remnantofseptumprimum.

21.Ychromosomeis?
a)Metacentric

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b)Submetacentric
c)Acrocentric
d)None
CorrectAnswer-C
Ans.is'c'i.e.,Acrocentric
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Eachchromosomehastwoarms:-
1. parm(theshorteroftwo)
2. qarm(longerone
Dependingonthepositionoftherejunction(centromere)they
canbeclassifiedinto:
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1.Metacentric
Thecentromereisinthemiddlesothatthetwoarmsof
chromosomesarealmostequal.
Thesechromosomesare:chromosomes1,2,3andX-
chromosome.

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2.Submetacentric
parmisshortandqarmislong.Thesechromosomesare:4,5,6,
7,8and9
3.Acrocentricp
(short)armissoshortthatitishardtoobserve,butstillpresent.

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Therearesixacrocentricchromosomes:13,14,15,21,22andY
chromosomes

22.Theouterlayeroftheblastocystforms?
a)Primitivestreak
b)Yolksac

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c)Embryoproper
d)Trophoblast
CorrectAnswer-D
Ans.is'd'i.e.,Trophoblast[RefSinghIB,HumanembryologyStilep.
38]

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Blastocystpossessesaninnercellmasscalledembryoblastwhich
subsequentlyformstheembryoproper,andanouterlayerofcells,
ortrophoblast,whichhelpstoprovidenutritiontotheembryo.

23.Inferiorparathyroiddevelopsfromwhich
arch?

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a)1st
b)2nd
c)3rd
d)4th
CorrectAnswer-C

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Ans.is'c'i.e.,3rd[RefLangman's11th/ep.269]

24.Mesodermalinorigin?
a)Astrocytes
b)Oligodendrocytes
c)Ependymalcells

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d)Microglialcells
CorrectAnswer-D
Ans.is'd'i.e.,Microglialcells[RefI.B.singhp.319-321]
Microglialcellsarethenervoussystemcounterpartofthemonocyte
macrophagesystem.

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Theuniquefeatureaboutmicrogliaisthatunlikeotherneuroglial
cellsitisnotdevelopedfromneuroectoderm.
Thesecellsaremesodermalinorigin.

25.Fossaovalisclosesbecauseoffusionof
?

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a)Septumprimum+Endocardialcushion
b)Septumsecundum+Endocardialcushion
c)Septumprimum+Septumsecundum
d)None
CorrectAnswer-C

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Ans.is'c'i.e.,Septumprimum+Septumsecundum[Ref
Essentialsofhumanembryology--213-215]
Afterbirth,theforamenovaleclosesbyfusionofseptumprimum
withseptumsecundum.

26.Whichofthefollowingisatraction

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epiphysis?
a)Tibialcondyles
b)Trochanteroffemur
c)Coracoidprocessofscapula
d)Headoffemur

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CorrectAnswer-B
Ans.is'b'i.e.,Trochanteroffemur[RefBDChandbookofgeneral
anatomy3r4/ep.34]

27.Glandsareclassifieddependingupontheirmodeofsecretion.Sebaceous
glandisanexampleofwhichofthefollowingtypeofgland?

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a)Eccrine
b)Apocrine
c)Holocrine
d)Paracrine
CorrectAnswer-C

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Sebaceousglandsareholocrineglands.Holocrineglandsarethoseinwhichthecellafter
fillingwithsecretoryproductdiesandisexpelledalongwithitscontent.
Eccrineglandsarethoseinwhichsecretoryproductisexpelledbyexocytosis.Egsweat
glandsinvolvedinthermoregulationandreceivingcholinergicsympatheticinnervation.
Apocrineglandsarethoseinwhichthesecretoryproductaccumulatesintheapical

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cytoplasmandisexpelledoutbypinchingoftheapicalplasmamembrane.Egmammary
glandandapocrinetypeofsweatglandsthatareactiveafterpubertyandarefoundinthe
skinofaxillaandaroundgenitalorgans.
Ref:ClinicalAnatomy:(aProblemSolvingApproach)ByKulkarnipage9

28.Corporaamylaciaeisseenin-

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a)Thymus
b)Lymphnode
c)Spleen
d)Prostate
CorrectAnswer-D

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Ans.is'd'i.e.,Prostate

29.Corporaarenaceaisseenin?
a)Prostrate
b)Pineal
c)Seminalvesicle

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d)Breast
CorrectAnswer-B
Ans.is'b'i.e.,Pineal[RefTextbookofhumanhistology-323]
Corporaarenacea(orbrainsand)arecalcifiedstructuresinPineal
glandandotherareasofbrainsuchaschoroidplexus.

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30.Nutrientarteryruns?
a)Towardsmetaphysis
b)Awayfrommetaphysis
c)Awayfromepiphysis
d)None

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CorrectAnswer-A
Ans.is'a'i.e.,Towardsmetaphysis[RefTextbookofgeneral
anatomyp.80]
Nutrientartery
Itentersthemiddleoftheshaftthroughanutrientforamen,runs

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obliquelythroughthecortex,andthendividesintoascendingand
desendingbranchesthatruntowardsmetaphysis.
Eachbranchsubdividesintoanumberofsmallerparallelvessels
whichenterthemetaphysisandformhair-pinloops.
Theloopsanostomosewithepiphyseal,metaphysealandperiosteal

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arteries.
Therefore,metaphysisisthemostvascularzoneofthelongbone.
Thenutrientarterysuppliesthemedullarycavityandinner-twothird
ofcorticalboneofdiaphysisandmetaphysis

31.Multi-unitsmoothmusclepresentatall

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except?
a)Bloodvessels
b)Iris
c)Gut
d)Ductusdeferens

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CorrectAnswer-C
Ans.is'c'i.e.,Gut[RefBDCgenralanatomy4"/ep.96;
Fundamentalofhumenanatomyp.6]

32.VasaVasorumofascendingaortaarises
from?

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a)Leftcoronaryartery
b)Anteriorinterventricularartery
c)Posteriorinterventricularartery
d)Leftatrium
CorrectAnswer-A

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Clinicalanatomy
"Bothcoronaryarteriessupplyvasavasorumofascendingaorta"
"Coronaryarteriesarevasavasorumofascendingaorta"
Vasavasorumofascendingaortaandarchofaortaarisefrom:
Coronaryarteries(attheirostia).

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Brachiocephalictrunk.
Bronchialartery.
Vasavasorumofdescendingaortaarisefrom':
Intercostalarteries(thoracicpart).
Lumbarandmesentericarteries(abdominalpart).

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33.Renalpapillaopensinto-
a)Cortex
b)Pyramid
c)Minorcalyx
d)Majorcalyx

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CorrectAnswer-C
Ans.is'c'i.e.,Minorcalyx
Eachkidneyhastwodistinctzones:
1. Theoutercortex
2. Theinnermedulla

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-Themedullacomprisesabout10renalpyramids.Theirapicesform
renalpapillaewhichindenttheminorcalyces.
-Thecortexisdividedintotwoparts
Corticalarchesorcorticallobules,whichformcapsoverthebases
ofthepyramids.

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Renalcolumns,whichdipinbetweenthepyramid.
Eachpyramidalongwithoverlyingcorticalarchformsalobeofthe
kidney.
Therenalsinusisaspacethatextendsintothekidneyfromthe
hilus.

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Itcontains:
Branchesoftherenalartery.
Tributariesoftherenalvein.
Renalpelvis:Pelvisdividesinto2to3majorcalyces,andthese,in
turn,divideinto7-13minorcalyces.Eachminorcalyxendsinan

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expansionwhichisindentedbyonetothreerenalpapillae

34.1stcarpometacarpaljointis?
a)Pivot
b)Hinge
c)BallandSocket

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d)Saddle
CorrectAnswer-D
Saddle

35.Structurepassesthroughuppertriangular
space:

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a)Profundabrachii
b)Anteriorcircumflexhumeralartery
c)Posteriorcircumflexhumeralartery
d)Circumflexscapularartery
CorrectAnswer-D

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UpperQuadrangularspace
Ithasthefollowingboundaries:
?theteresmajorinferiorly
?thelongheadofthetricepslaterally
Forthesuperiorborder,somesourceslisttheteresminor,while

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otherslistthesubscapularis.
Itcontainsthescapularcircumflexvessels.

36.Followingadeepcutoverlyingthe
hypothenareminence,itisobservedthat
thepatientcannotholdasheetofpaper
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betweenthe2ndand3rddigits.Whichof
thefollowingnervesismostlikely
damaged?
a)Deepbranchofulnarnerve
b)Deepbranchoftheradialnerve

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c)Superficialbranchofulnarnerve
d)Mediannerve
CorrectAnswer-A
Ans.is'a'i.e.,Deepbranchofulnarnerve[RefBDC5thle
VolumeIp.110-111]

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Inabilitytoholdpapersheetsignifiesinabilitytoadductthefingers.It
isnothingelsebutcardtest.
Deepbranchofulnarnervesuppliesthepalmarinterosseiwhich
controltheadductionbetweenfingers.

37.Whichistrueaboutsynovialjoint?

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a)Stabilityisinverselyproportionaltomobility
b)Hyalinecartilagecoversarticularsurfaceofallsynovialjoints.
c)Metacarpo-phalangealjointisahingejoint
d)"Cartilageusuallydividesthejointintotwocavities".
CorrectAnswer-A

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Ai.e.Stabilityisinverselyproportionaltomobility

38.Apatientisfoundtohaveamelanomaoriginatingintheskinoftheleft
forearm.Afterremovalofthetumorfromtheforearm,allaxillarylymphnodes
lateraltothemedialedgeofthepectoralisminormuscleareremoved.Which
axillarynodeswouldnotberemoved?

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a)Apicallymphnodes
b)Centrallymphnodes
c)Laterallymphnodes
d)Pectorallymphnodes
CorrectAnswer-A

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ThelymphnodeslateraltotheLATERALedgeofthepectoralis
minorarethelateralaxillarynodes.Pectoraloranterioraxillary
nodesaredeeptothelateraledgeofthepectoralismajormuscle.
Centralaxillarynodesarefounddirectlyunderpectoralisminor,
whilesubscapularorposterioraxillarynodesareadjacenttothe

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subscapularismuscle.Theapicalaxillarynodesaremedialtothe
medialedgeofpectoralisminorandsoitwon'tberemoved.
level
Partofaxilla
Lymphnodes

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I
Lowaxilla
Lymphnodeslateraltothe
lateralborderofpectoralis
minor(centralgroup,

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lateralgroup,anterior
group,posteriorgroup)
II
Midaxilla
Lymphnodesbetweenthe

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lateralandmedialborders
ofpectoralisminor.plus
interpectorallymphnodes
III
Apicalaxilla

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Lymphnodesmedialto
medialmarginofpectoralis
minor(including

subclavicular,
infraclavicularorapical).

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39.Whichmusclesteadiestheclavicleduring
movementofshoulder?
a)Pectoralismajor
b)Latissimusdorsi
c)Subclavius

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d)Serratusanterior
CorrectAnswer-C
Ans.is'c'i.e.,Subclavius
(Ref:Clinicalanatomyj'd/ep.1367)
Subclaviussteadiestheclavicleduringmovementsofshoulder.

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40.Duringheeltouchphaseofwalking
pressureincalfcompartmentis?
a)Morethanrestingpressure
b)Lessthanrestingpressure
c)Nochangeinpressure

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d)Firstrisesandthenfalls
CorrectAnswer-C
Ans.is'c'i.e.,Nochangeinpressure
Inheelstrike,theankleisdorsiflexedandthemainmuscleactingon
ankleistibialisanterior.

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Musclesofposteriorcompartmentofleg(Gastrocnemius-soleus)are
attheirnormallength.So,thepressureinposteriorcompartment
doesnotchange.
Ontheotherhand,InpushoffphaseGastrocnemius-soleusare
contractedwhichresultsinincreasedpressureofposterior

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compartment(wheneverthereiscontractionofmusclesofa
compartment,pressureofthatcompartmentisincreased).

41.Thenutrientarterytothefemuris?
a)Profundafemorisartery
b)Femoralartery

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c)Poplitealartery
d)Middlecircumflexfemoralartery
CorrectAnswer-A
Ans.is'a'i.e.,Profundafemorisartery
NutrientArteries
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Thefemurissuppliedby2ndperforatingbranchofprofundafemoris
artery.
Tibiaissuppliedbyabranchofposteriortibial
Thefibulaissuppliedbytheperonealarterywhichisabranchof
posteriortibialartery.

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Thehumerusissuppliedbyabranchofprofundabrachiiartery
Radius/ulnaaresuppliedbytheanteriorinterosseousarterywhichis
abranchoftheulnarartery.

42.Inwalking,gravitytendstotiltpelvisandtrunktotheunsupportedside,major
factorinpreventingthisunwantedmovementis?

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a)Adductormuscles
b)Quadriceps
c)Gluteusmaximus
d)Gluteusmediusandminimus
CorrectAnswer-D

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Thegluteusmediusmuscleabductsandmediallyrotatesthefemur
atthehipjoint.Inaddition,thegluteusmediusholdsthepelvis
secureoverthestanceleg,preventingpelvicdropontheopposite
swingsideduringgait.Thesuperiorglutealnerve(L4,L5,S1)
innervatesthismuscle.

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Theactionofthegluteusminimusmuscleisthesameasthatofthe
gluteusmedius--itabductsthefemuratthehipjoint,holdingthe
pelvissecureoverthestancelegandpreventingpelvicdroponthe
oppositeswingsideduringgaitandhipmedialrotation.Theinferior
glutealnerve(L5,S1,S2)innervatesthismuscle.

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43.Siteofinjectioningluteus?
a)Inferomedial
b)Superomedial
c)Superolateral
d)Superomedial

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CorrectAnswer-C
Ans.is'c'i.e.,Superolateral
level Partofaxilla
Lymphnodes
I

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Upperarm(Deltoid)
5cmdistaltotheacromionor
4cmproximaltotheinsertionof
deltoid.
Thisistopreventinjurytocircumflex

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humeralnerve.
II
Glutealregion
Upperouter(superolateral)quadrant.
Thisistoavoiddamagetosuperior

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andinferiorglutealvesselsand
sciaticnerve.
III
Thigh(lateralaspect) Infant:-Upperlateralquadrantof
(vastuslateralis)

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thighbelowGT
Adult:-Middlethirdoflateralaspect.

44.Lockingofkneejointcanbecausedby:
a)OsgoodSchlatter
b)Loosebodyinkneejoint

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c)Tuberculosisofknee
d)aandbboth
CorrectAnswer-D
Ans.is.d.aandbboth
Lockingofkneejoint(i.e.jointheldinflexion)isseeninmeniscus

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tear,loosebody(d/tosteochondralfracture)andfracturesoftibial
spine
MechanismofLocking
Normallythemedialmeniscusoratleastitsanteriormovableportion
glidesslightlybackwardstowardstheinteriorofjointasthekneeis

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flexed.
Ifthetibiaisatthesametimeabducted(valgus)andthemedial
compartmentofthekneethusopenedup,themobilityofthe
meniscusisstillfurtherincreased.
Suddenmedialrotationoffemuronthefixedtibiaforcesthemedial

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meniscustowardsbackofjointandcausesmedialligamentto
becometautanditmayundergovarietyoftransverseoroblique
tear.
Theinnerfragmentslipsintotheinteriorofthejointandwhen,
extensionisattemptedandthekneebeginstoscrewhome'the

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fragmentisnippedbetweenthecondylesandthejointis'locked'i.e.
heldinflexion.

45.Whichstructure(s)passesbehindthe
inguinalligament:
a)Femoralbranchofgenitofemoralnerve

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b)Femoralvein
c)Psoasmajor
d)All
CorrectAnswer-D
Ai.e.Femoralbranchofgenitofemoralnerve;Bi.e.Femoralvein;C

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i.e.Psoasmajor

46.Deltoidligamentisattachedtoallexcept:
a)Medialmalleolus
b)Medialcuneiform
c)springligament

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d)sustentaculumtali
CorrectAnswer-B
Ans.Bi.e.Medialcuneiform
Medialcollateralligament(deltoidligament)attachestothemedial
malleolusofthetibiaandthenavicular,talus,andcalcaneusbones.

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Thisligamentpreventsmedialdistraction(eversion)andexcessive
rangeofmotion.Itissubdividedintofourparts:
Tibionavicularpartattachesthemarginoftheplantar
calcaneonavicularligament(springligament).
Tibiocalcanealpartattachestothesustentaculumtaliofthe

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calcaneusbone.
Posteriortibiotalarpartattachestothemedialsideandmedial
tubercleofthetalus.
Anteriortibiotalarpartattachestothemedialsurfaceofthetalus.

47.Trueaboutpopliteusareallexcept?

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a)Flexorofknee
b)Intracapsularorigin
c)Suppliedbytibialnerve
d)Causeslockingofknee
CorrectAnswer-D

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Popliteus
Popliteusisadeepmuscleofposteriorcompartmentofleg.
Featuresofpopletiusare-
Origin
Lateralsurfaceoflateralcondyleoffemur,originisintracapsular.

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Outermarginoflateralmeniscusofknee.
Insertion
Posteriorsurfaceofshaftoftibiaabovesolealline.
Nervesupply
Tibialnerve

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Action
Ulockskneejointbylateralrotationoffemurontibiapriorflexion.
Accessoryflexorofknee.

48.Tibialnerveinjury/palsycauses:
a)Dorsiflexionoffootatanklejoint

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b)Planterflexionofthefootatanklejoint
c)Lossofsensationofdorsumoffoot
d)Paralysisofmusclesofanteriorcompartmentofleg
CorrectAnswer-A
Ai.e.Dorsiflexionoffootatanklejoint

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*Tibialnerve(thelargercomponentofsciaticnerve)suppliesall
musclesofposteriorcompartmentofleg(gastrocnemius,soleus,
plantaris,popliteus,tibialisposterior,FHL&FDL)plantiflexingthe
ankle&foot.Therefore,tibialnerveinjuryresultsinlossofplanter
flexionalongwithcalcaneo-valgusattitudeoffoot(iedorsiflexion&

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eversiond/tunopposedanteriorcompartmentmuscles).
-Deepperoneal(fibular)nervesuppliesallanteriorleg
compartmentmuscles(tibialisanterior,EHL,EDL,EDB,PT)
dorsiflexingtheankle&foot.
-Soleissuppliedbymedial&lateralplantarandsuralbranchesof

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tibialnerveQanteriorly(frommedialtolateral)andcalcaneal
branchesoftibialnerve0posteriorly(i.e.overheel).
-ItthenpassesalonglateralsideoffootandlittletoeQsupplying
theoverlyingskin.
-Anterolateralaspectofleg,anddorsumoffootincluding2"-

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4thzvebspacesQaresuppliedbysuperficialperonealnerve.
-Whereasdeepperoneal(fibular)nervesupplies1stwebspace(i.e.
adjacentsidesofgreatandsecondtoes)Q

49.Nervesupplyofcervicalesophagus?
a)Vagus

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b)Leftrecurrentlarynagealnerve
c)Rightrecurrentlarynagealnerve
d)Alloftheabove
CorrectAnswer-D
Ans.isd'.,Alloftheabove
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[RefClinicalanatomy3'd/ep.2891
Nervesupplyofesophagus:
Esophagusissuppliedbybothparasympatheticandsympathetic
fibers.
A)Parasympatheticsupply
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Itprovidessensory,motorandsecretomotorsupplytoesophagus.
Completeparasympatheticinnervationisprovidedbyvagus
nerve:-
1. Cervicalesophagus:Throughboth(right&left)recurrentlaryngeal
nerve.

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2. Upperthoracicesophagus:Throughleftrecurrentlaryngealnerve
andbydirectbranchesfromvagusnerve.
3. Lowerthoracicesophagus:Throughesophagealplexus.
B)Sympatheticsupply
Itprovidessensoryandvasomotorsupply.

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ItisprovidedbyTstoTcspinalsegments.

50.Apatientwithnativeaorticvalvedisease
camewithrighthemiparesis.Whatwill
youdotopreventfurtherstroke?
a)Antiplateletonly

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b)Anticoagulantonly
c)Bothantiplateletandanticoagulant
d)Onedoseoflowmolecularweightheparinsub-cutaneously
followedbydualantiplatelettherapy
CorrectAnswer-A

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Answer-A.Antiplateletonly
*Aspirinistheonlyantiplateletagentthathasbeenproven
elfectivefortheacutetreatmentofischemicstroke;useofaspirin
within48hoarsofstrokeonsetreducedbothstrokerecurrencerisk
andmortalityminimally.

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*Asprinistheonlyantiplateletagentthathasbeenproveneffecfive
fortheacutetreatmentofischemicstroke;thereareseveral
antiplateletagentsprovenforthesecondarypreventionofstroke.
*Twolayertrials,theInternationalStrokeTrial(IST)andthe
ChineseAcuteStrokeTrial(CAST),foundthattheuseofaspirin

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within48hoursofstrokeonsetreducedbothstrokerecurrencerisk
andmortalityminimally.

51.Allformboundariesoftriangleof
auscultationexcept
a)Trapezius

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b)Latissmusdorsi
c)Scapula
d)Rhomboidmajor
CorrectAnswer-D
Ans.is'd'i.e.,Rhomboidmajor

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Triangleofauscultationhasthefollowingboundaries
Superiorlyandmedially,bytheinferiorportionoftheTrapezius.
Inferiorly,bytheLatissimusDorsi.
Laterally,bythemedialborderofthescapula.
ThesuperficialfloorofthetriangleisformedbytheSerratusanterior

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andthelateralportionoftheerectorspinaemuscles.
Deeptothesemusclesaretheosseousportionsofthe6"and7th
ribsandtheinternalandexternalintercostalmuscles.
Typically,theTriangleofAuscultationiscoveredbytheScapula.
Tobetterexposethetriangleandlistentorespiratorysoundswitha

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stethoscope,patientsareaskedtofoldtheirarmsacrosstheirchest,
mediallyrotatingthescapulae,whilebendingforwardatthetrunk,
somewhatresemblingafetalposition.

52.Whichofthefollowingcomplicationsis
notseeninmitralvalveprolapse?

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a)Stroke
b)Infectiveendocarditis
c)Mitralstenosis
d)Ventriculararrhythmia
CorrectAnswer-C

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Answer-C.Mitralstenosis
SurfacemarkingofthemitralvalveisBehindsternalendofleft
4thcostalcartilage.
Infectiveendocarditis
Mitralinsuficiency(mitralregurgitation)

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Strokeorothersystemicinfarctresultingfromembolismofleaflet
thrombi
Arrhythmias

53.IVCfilterisusedinfollowingexcept-
a)Toreducessymptoms

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b)Negligiblesizeofemboli
c)Toprolonglife
d)Topreventprogressofnativebloodvesseldisease
CorrectAnswer-B
Answeris'b'i.e.Negligiblesizeofemboli

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54.Waldeyer'sfascialies?
a)Infrontofthebladder
b)Behindtherectum
c)Betweenbladderanduterus
d)Betweenuterusandrectum

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CorrectAnswer-B
Ans.is'B'i.e.,Behindtherectum
*ThecaveofRetziusisafat-filledretropubicspacethatallowsfor
theaccommodationofadistendedbladder.
*TheWaldeyer'sfascia,alsoknownasthepresacralfascia,

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accommodatesthedistendedrectum.
*ThepouchofDouglasisafoldofperitoneumbetweentheuterus
andtherectum.
*ThepouchofDunnisafoldofperitoneumbetweenthebladder
andtheuterus.

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*ThefasciaofDenonvillierliesbetweenthebladderinfrontand
rectumbehind.

55.Rightcoronaryarterysuppliesall,except?
a)Anterior2/3ofventricularseptum
b)SAnode

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c)AVnode
d)LBB
CorrectAnswer-A
Rightcoronaryarterysupplies
*SAnode(in65%),

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*wholeconductingsystem(AVbundle,bundleofhis,partofleft
bundlebranch)exceptRBBandpartofleftbranchofAVbundle,
*posteriorpartofventricularseptum,
*mostofrightventricleexceptsmallpartadjoininganterior
interventriculargrooveandsmallpartofleftventricleadjoining

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posteriorinterventriculargroove.
Leftcoronaryarterysupplies
*mostoftheleftatrium,
*mostoftheleftventricleincludingapex,
*smallpartofrightventricleodjoininganteriorinterventricular

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septum,
*anterior2/3ofventricularseptum,
*RBB,LBB
*SAnodein35%ofcases.

56.Thethoracicductcrossesfromtheright

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totheleftatthelevelof
a)T12vertebra
b)T6vertebra
c)T5vertebra
d)T2vertebra

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CorrectAnswer-C
Ci.e.T5vertebrae
Thoracicductbeginsascontinuationoftheupperendofthe
cisternachylinearthelowerborderofT12vertebraandentersthe
thoraxthroughtheaorticopeningofdiaphragm(atT12).

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ItthenascendsthroughtheposteriormediastinumandatT5level
crossesfromrightsidetotheleftsideandascendsalongleftmargin
ofoesophagustoentertheneck

57.Whichofthefollowingstatementregardingloweresophagealsphincteris
TRUE?

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a)Ithasnotonicactivity
b)Ithasatonewhichisprovidedbythesympatheticsystem
c)Relaxesonincreasingabdominalpressure
d)Relaxesaheadoftheperistalticwave
CorrectAnswer-D

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Duringswallowingwhentheperistalticwavesweepdownthe
esophagusthegastroesophagealsphincterrelaxessothatthebolus
offoodcanpassintothestomach.
DistanceoftheLowerEsophagealSphincterfromtheupper
incisorsis37.5cm
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theloweresophagealsphincteristonicallyactivebutrelaxeson
swallowing.ThistonicactivityoftheLESbetweenmealsprevents
refluxofgastriccontentsintotheesophagus.itstoneisunderneural
controlbytheparasympatheticnervoussystem.ContractionofLES
iscausedbythereleaseofacetylcholinefromthevagusand

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releaseofNOandVIPfrominterneuronsinnervatedbyothervagal
fiberscausesittorelax.
Ref:FundamentalsofHumanPhysiologyByLauraleeSherwood
page447.Ganong'sReviewofMedicalPhysiology,24eCHAPTER
27.

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58.Thetransversesinusispresentposterior
towhichstructures?
a)Rightatrium
b)Leftatrium
c)Upperpulmonaryartery

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d)Aorta
CorrectAnswer-D
Ans.'D'i.e.,Aorta
Pericardialsinuses
*Ontheposteriorsurfaceoftheheart,thereflectionoftheserous

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pericardium(epicardium)aroundlargeveinsformsarecesscalled
theobliquesinus.
*Obliquesinusisboundedanteriorlybytheleftatrium,and
posteriorlybytheparietalpericardiumandesophagus.
*Thetransversesinusisashortpassagethatliesbetweenthe

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reflectionoftheserouspericardium(epicardium)aroundarterial
(aortaandpulmonarytrunk)andvenousendsofthehearttube.
*Thetransversesinusisboundedanteriorlybyascendingaortaand
pulmonarytrunk,posteriorlybySVC,andinferiorlybytheleftatrium

59.Sympatheticsupplytotheheartarisesfromwhichofthefollowingspinal

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segments?
a)T1toT5
b)T2toT6
c)T3toT7
d)T4toT8

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CorrectAnswer-A
Sympatheticnervecellssupplyingtheheartarelocatedinthe
intermediolateralhornofspinalsegmentsT1toT5.
Sympatheticsupplyiscardio-acceleratory,andonstimulation,they
increasetheheartrate,andalsodilatecoronaryarteries.

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Bothparasympatheticandsympatheticnervesformthesuperficial
anddeepcardiacplexuses,thebranchesofwhichrunalongthe
coronaryarteriestoreachthemyocardium.

60.Surfacemarkingoftheobliquefissureof
thelungincludeallexcept

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a)T3
b)5thrib
c)7thrib
d)6thcostalcartilage
CorrectAnswer-C

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Ans.is'c'i.e.,7thrib
Surfacemarkingoffissures
Theobliquefissurecanbedrawnbyjoining:
Apoint8cmlateralto3rdthoracicvertebrae.
Anotherpointonthe5thribinthemidaxillaryline.

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Athirdpointonthe6thcostalcartilage7.5cmfromthemedian
plane.

61.Leveloflowerborderoflungatmid
axillarylineis
a)6thrib

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b)8thrib
c)10thrib
d)12thrib
CorrectAnswer-B
Bi.e.8thrib

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62.Tributaryofcoronarysinus?
a)Anteriorcardiacvein
b)Thebesionvein
c)Smallestcardiacvein
d)Greatcardiacvein

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CorrectAnswer-D
Ans.(D)Greatcardiacvein
Coronarysinus
Itopensintheposteriorwallofrightatrium,intheposteriorpartof
coronarysulcus.
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ItopensintherightatriumbetweenIVCandtricuspidorifices.
CoronarysinusisguardedbyThebesianvalve(Thebesianvalve
(incompletesemilunarvalve)guardstheorificeofcoronarysinus.)
Tributariesofcoronarysinusare:
Greatcardiacvein:-Liesintheanteriorinterventriculargroove.Left
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marginalveindrainsintoit.
Middlecardiacvein:-Liesintheposteriorinterventriculargroove.
Posteriorveinofleftventricle.
Smallcardiacvein:-Itliesintheposteriorpartofcoronarysulcus
withRCA.Rightmarginnalveinmaysometimesopenintosmall
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cardiacvein,moreoften,however,rightmarginalveinopens
directlyintorightatrium.
Obliqueveinofleftatrium(veinofmarshall):-Itiscontinuousabove
withligamentofIVC.Thesetwostructuresareembryological
remnantsofleftcommoncardinalvein(ductofcuvier).

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63.BoundaryoftheKoch'striangleisnotformedby?
a)Tricuspidvalvering
b)Coronarysinus
c)Tendonoftodaro
d)Limbusfossaovalis

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CorrectAnswer-D
Koch'sTriangleisatriangleenclosedbytheseptalleafletofthe
tricuspidvalve,thecoronarysinus,andthemembranouspartofthe
interatrialseptum.
Koch'striangle:WalterKarlKoch(1880?1962)wasadistinguished

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Germansurgeonwhodiscoveredatriangular-shapedareainthe
rightatriumoftheheartthatmarkstheatrioventricularnode(known
asKoch'striangle).
Thethreesidesofthetrianglearedefinedbythefollowingstructures
withintherightatrium:Theostiumofthecoronarysinus,posteriorly;

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Theanteriorportionofthetricuspidvalveannulus;and
ThetendonofTodaro(atendinousstructureconnectingthevalveof
theinferiorvenacavaostiumtothecentralfibrousbody),posteriorly.
Importance:
Usedasananatomicallandmarkforlocationoftheatrioventricular

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nodeduringelectrophysiologyproceduressuchaspacingor
ablation.

64.Azygosveindrainsinto:
a)Leftbrachiocephalicvein
b)Inferiorvenacava

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c)Superiorvenacava
d)Rightbrachiocephalicvein
CorrectAnswer-C
Theazygosveinendsbyjoiningtheposterioraspectofthesuperior
venacava

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TheAzygosVein
Theazygosveinconnectsthesuperiorandinferiorvenaecavae,
eitherdirectlybyjoiningtheIVCorindirectlybythehemiazygosand
accessoryhemiazygosveins.
Theazygosveindrainsbloodfromtheposteriorwallsofthethorax

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andabdomen.
Itascendsintheposteriormediastinum
Itiscoveredanteriorlybytheoesophagusasitpassesposteriorto
therootoftherightlung.
ItthenarchesoverthesuperioraspectofthisroottojointheSVC.

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Inadditiontotheposteriorintercostalveins,theazygosvein
communicateswiththevertebralvenousplexuses.
Thisveinalsoreceivesthemediastinal,oesophageal,andbronchial
veins.

65.

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Analvalveisfoundinwhichpartofanal
canal?
a)Upper
b)Middle
c)Lower

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d)Atanus
CorrectAnswer-A
Ans.is'a'i.e.,Upper

66.Mainsupportofuterusisfrom-ligament:
a)Cardinal

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b)Broad
c)Round
d)Pubocervical
CorrectAnswer-A
Cardinal

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67.Allofthefollowingarteriesarethebranchesofcoeliactrunk,EXCEPT?
a)Leftgastricartery
b)Rightgastricartery
c)Splenicartery
d)Hepaticartery

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CorrectAnswer-B
Branchesofthecoeliactrunkareleftgastricartery,splenicartery,
andcommonhepaticartery.Thecoeliactrunkarisesfromthe
abdominalaorta,immediatelybelowtheaortichiatusofthe
diaphragmattheT12vertebrallevel.Rightgastricarteryisabranch

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ofcommonhepaticartery.
Branchesofcommonhepaticarteryare:
Properhepaticartery
Rightgastricartery
Gastroduodenalartery:rightgastroomentalartery,superior

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pancreaticoduodenalarteryarebranchesofgastroduodenalartery.
Cysticartery
Branchesofsplenicartery:
Leftgastroepiploicartery
Shortgastricbranches

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Pancreaticbranches

68.Whichofthefollowingstructuresseenin
thecavernoussinus?
a)MaxillarydivisionofVnerve
b)MandibulardivisionofVnerve

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c)Internalcarotidartery
d)Facialnerve
CorrectAnswer-C
Ans.c.Internalcarotidartery
Contentsofthecavernoussinus

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Structuresinthelateralwallofthesinus
Oculomotor(lll)nerve
Trochlear(lV)nerve
Ophthalmic(1stdivisionofV)nerve
Trigeminalganglion

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Internalcarotidartery
Abducent(Vl)nerve

69.Anteriorrelationsoftherightkidneyare
allexcept?
a)Liver

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b)4thpartofduodenum
c)Hepaticflexure
d)Adrenalgland
CorrectAnswer-B
Ans.is'b'i.e.,4thpartoftheduodenum

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Theposteriorsurfaceofbothkidneysisrelatedtothediaphragm,
medialandlateralarcuateligament,psoasmajor,quadratus
lumborum,transversusabdominis,subcostalvessels,subcostal
nerve,iliohypogastricnerve,andilioinguinalnerve.
Inaddition,therightkidneyisrelatedtothe12thribandtheleft

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kidneyisrelatedto11thand12thribs.
Themedialborderofeachkidneyisrelatedtothesuprarenalgland
abovethehilusandureterbelowthehilus.
Thelateralborderoftherightkidneyisrelatedtotherightlobeofthe
liverandhepaticflexureofthecolon.Ontheleftside,itisrelatedto

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spleenanddescendingcolon.

70.Pancreasdivisumindicateswhichofthe
following?
a)Duplicationofthepancreas
b)Failureoffusionofdorsal&ventralpancreaticbuds

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c)Formationofmorethantwopancreaticbuds
d)Formationofonlyonepancreaticbud
CorrectAnswer-B
Answer-.is'b'i.e.,Failureoffusionofdorsal&ventral
pancreaticbuds[RefInderbirSinghHumanEmbryology8thlep.

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168]
Anomaliesofpancreaticdevelopmentmaybe:
1.Annularpancreas:-Twocomponentsoftheventralbudfailto
fuseandgrowinoppositedirectionaroundtheduodenumandmeet
thedorsalpancreaticduct.

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2.Pancreaticdivisum(dividedpancreas):-Ventralanddorsalbuds
failtofusewitheachother.
3.Inversionofpancreaticduct:-Themainpancreaticductis
formedbytheductofdorsalbud,i.e.accessoryductislargerthan
themainductandthemaindrainageofpancreasisthroughthe

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minorduodenalpapilla.
4.Accessorypancreatictissue:-Maybefoundas
*Wallofstomach,duodenum,jejunumorileum.
*Meckel'sdiverticulum

71.'ObstructionofInferiorvenacava'

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presents:
a)Paraumblicaldilatation
b)Thoraco-epigastricdilatation
c)Oesophagusvaries
d)Haemorrhoides

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CorrectAnswer-A:B
A.ParaumbilicusveindilationandBi.e.Thoraco-epigastricdilation
Thethoracoepigastricveinisuniqueinthatitdrainstoboth
theSuperiorVenaCava(SVC)andtotheInferiorVenaCava(IVC).
Hence,itservesasananastomoticcaval-cavallinkbetweenthe

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two.Furthermore,thethoracoepigastricveinisconnectedto
theportalveinviatheparaumbilicalveinandtherebyservesasa
portocavalanastomosisaswell.
Whenapatientexperiencesportalhypertension,therecanbe
congestion(backup)ofbloodthatentersintothecavalsystemvia

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thethoracoepigastricvein.Whenthisoccurs,therecanbean
externallyvisibledilationoftheparaumbilical(andperhapseventhe
thoracoepigastricveins)whichleadstotheappearanceof"Caput
Medusae"

72.Rightovarianarteryisabranchof?

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a)Abdominalaorta
b)Rightinternaliliac
c)Commoniliac
d)Externaliliac
CorrectAnswer-A

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Ans.'a'i.e.,Abdominalaorta[RefBDC5th/eVolume.3p.343]
Lateralbranches:
*Inferiorphrenicartery
*Middlesuprarenalartery
*Renalartery

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*Testicular/ovarianartery

73.Structureimmediatelyposteriorto
pancreatichead?
a)Rightrenalvein
b)Splenicartery

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c)Inferiormesentericvein
d)Coeliactrunk
CorrectAnswer-A
Ans.is'a'i.e.,Rightrenalvein[RefBDC5`Vevolume2p.306]
Terminalpartofrightrenalveinisposteriortoheadofpancreatic

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74.Whichofthesebestdescribestherenal
angle?
a)Theanglebetweenthelattissimusdorsiandthe12thrib
b)Theanglebetweentheerectorspinaeandtheiliaccrest
c)Theanglebetweenthe12thribandtheerectorspinae

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d)Theanglebetweenthe12thribandtherectusabdominis
CorrectAnswer-C
Answer-.is'C'i.e.,Theanglebetweenthe12thribandthe
erectorspinae
Theanglebetweenthelowerborderofthe12thribandtheouter

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borderoftheerectorspinaeisknownastherenalangle.
Overliesthelowerpartofthekidney.
Tendernessinthekidneyiselicitedbyapplyingpressureoverthis
area.

75.Renalveinthrombosisisassociatedwith

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allofthefollowingexcept:
September2011
a)Trauma
b)Sicklecellanemia
c)Nephroticsyndrome

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d)Dehydration
CorrectAnswer-B
Ans.B:Sicklecellanemia
ConditionsassociatedwithRVTare:Trauma,extrinsiccompression
(lymohnodes,aneurysm),invasionbyrenalcellcarcinoma,

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dehydration(infants),nephriticsyndromeandPregnancy/oral
contraceptives
RVT:
Acutecasesoccursinchildrenandpresentswithsuddenlossof
renalfunction

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Gradualthrombosisoccursinelderlyandonlymanifestationmaybe
recurrentpulmonaryemboliordevelopmentofhypertension
Definitivediagnosiscanbedonethroughselectiverenalvenography
withvisualizationoftheoccludingthrombus
Treatmentoptionsconsistsofanticoagulationandthrombectomy

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76.Inpatientswithpenileinjury,Colle's
fasciapreventsextravasationofurinein?
a)Ischiorectalfossa
b)Perineum
c)Abdomen

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Ischiorectalfossa[RefBDC5th/eVolumeHp.211]

77. Duringincision&drainageofischiorectal
abscess,whichnerveis/are

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affected/injured:
a)Superiorrectalnerve
b)Inferiorrectalnerve
c)Superiorglutealnerve
d)Inferiorglutealnerve

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CorrectAnswer-B
Bi.e.Inferiorrectalnerve
Throughaposteriorhorseshoeshapedrecessbothischiorectal
fossaeareconnectedbehindtheanalcanal;soaunilateralabscess
maybecomebilateral.

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Duringdissectionofischiorectalfossa,inferiorrectal,pudendal,
posteriorscrotalorlabialnerve&vesselsalongwithperforating
branchesofS2-S3andperinealbranchesofS4nervemayget
damaged.

78.Righthepaticveindrainswhichsegment

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oftheliver?
a)I
b)II
c)IV
d)VII

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CorrectAnswer-D
Ans.is'd'i.e.,VII
[RelGray's4fh/ep.1163-1167;Sabaton18h/ep.15841
Segmentalanatomyoftheliver:
Basedonthedistributionofportalveinandhepaticvein,Couinaud

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dividedeachphysiological(functional)lobeofliverinto
4segmentseachandhenceliverisdividedinto8segments.
Thephysiologicalleftlobeiscomposedof4segmentsdesignatedI
toIVandissuppliedbyleftbranchofhepaticartery,Ieftbranchof
portalveinanddrainedbylefthepaticductandlefthepaticvein.

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ThephysiologicalrightlobeconsistsofsegmentV,VI,VIIandVIII
andissuppliedbyrighthepaticartery,rightbranchofportalveinand
drainedbyrighthepaticductandrighthepaticvein.

79.Allofthefollowingarestructures
associatedwithpterygopalatinefossa,
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EXCEPT:
a)Pterygopalatineganglion
b)Midthirdofmaxillaryartery
c)Maxillarynerve
d)Greaterpetrosalnerve

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CorrectAnswer-B
Thepterygopalatinefossaistheregionbetweenthe
pterygomaxillaryfissureandthenasalcavity.
*Thefossaaccommodatesbranchesofthemaxillarynerve[cranial
nerve(CN)V-2],thepterygopalatineganglion,theterminal
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branchesofthemaxillaryartery,andgreatersuperficialpetrosal
nerve.

80.Portalveinisformedbyunionofwhichofthefollowingveins?
a)Superiormesentericvein&Splenicvein
b)Superiormesentericvein&inferiormesentericvein

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c)Inferiormesentericvein&Splenicvein
d)inferiormesentericvein&Hepaticvein
CorrectAnswer-A
PortalveinisformedbytheunionofSuperiormesentericvein(SMV)
andsplenicveinposteriortotheneckofpancreas.Theinferior

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mesentericveindrainsintothesplenicvein.
*Thehepaticportalveinpassposteriortothefirstpartofduodenum,
inthefreeedgeoflesseromentum.
*Attheportahepatis,itdividesintorightandleftbranches
supplyingtherightandleftlobesoftheliver.

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*Withinthesinusoidsoftheliver,hepaticportalbloodand
oxygenatedbloodfromthehepaticarterymixtogetherandcome
intocontactwiththehepatocytes,wheremetabolitessuchas
productsofdigestionareexchanged.
*Bloodfromthesinusoidsemptiesintohepaticveinsdrainingthe

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liverandinturndrainintoIVC,andbloodisreturnedtoheart.

81.Treatmentofanincidentallydetected
Appendicularcarcinoidmeasuring2.5cm
is:
September2002

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a)Righthemicolectomy
b)Limitedresectionoftherightcolon
c)Totalcolectomy
d)Appendicectomy
CorrectAnswer-A

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Ans.Ai.e.Righthemicolectomy

82.Neurovascularplaneinanterior
abdominalwall-
a)Betweenextobliqueandinternaloblique
b)Betweenint.obliqueandtransversusabdominis

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c)Belowtransversusabdominis
d)Aboveext.oblique
CorrectAnswer-B
Ans.is'b'i.e.,Betweenint.obliqueandtransverses
abdominis[Ref:Humananatomy5th/p.73]

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Themusclesoftheanteriorabdominalwallconsistofthreebroad
thinsheetsthatareaponeuroticinfront,fromexteriortointeriorthey
areexternaloblique,internalobliqueandtransversus.
Thenerveandaccompanyingintercostalvesselsliebetweenthe
internalobliqueandtrannsverseabdominis.i.e.neurovascular

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plane.

83.Celiacplexusblockallthefollowingis
trueexcept?
a)Relievedpainfromgastricmalignancy
b)Causehypotention

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c)Canbeusedtoprovideanesthesiaforintraabdominalsurgery
d)Canbegivenonlybyretrocrural(classic)approach
CorrectAnswer-D
Ans.is'd'i.e.,Canbegivenonlybyretrocrural(classic)approach
Celiacplexusblockcanbedonebyfollowingthreeapproaches
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:
Retrocrural(classic)approach,anterocruralapproachand
splanchnicnerveblock.
Seeexplanation-4ofsession-8ofAnaesthesiaofAllIndia2014-15
patternofthisbook.

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84.Structurecrossingdorsalsurfaceof
ischialspineareA/E:
a)Internalpudendalvessel
b)Pudendalnerve
c)Obturatornerve

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d)Nervetoobturatorinternus
CorrectAnswer-C
C.i.e.Obturatornerve
Psoasmajor,iliacus&pectineusmuscles,femoralvesselsand
nerve,femoralbranchofgenitofemoralnerve,lateralcutaneous
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nerveofthighandlymphaticspassbelowinguinalligament.
'PIN'structuresi.e.Pudendalnerve,InternalPudendalvessels,
Nervetoobturatorinternuscomeoutofgreatersciaticforamen,
crossthedorsalsurfaceofischialspine&enterintolessersciatic
foramen.

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85.Inbladderinjury,painisreferredtoall
except?
a)Upperpartofthigh
b)Lowerabdominalwall
c)Flank

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d)Penis
CorrectAnswer-C
Ans.is'c'i.e.,Flank[RefB.D.C.VolII6th/ep.375;Clinical
Anatomy-912]
Painfibersfrombladderpassthroughbothparasympatheticand

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sympatheticpathwayandenterT11-L2andS2-S4cordsegments.
Hencereferredpainisfeltinthelowerpartofanteriorabdominal
wall(hypogastrium),upperpartoffrontofthighs,scrotumorlabium
majus,penisorclitoris,andperineum.

86.StructurenotseenatL3level?

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a)Iliacvessels
b)Aorta
c)Coeliactrunk
d)IVC
CorrectAnswer-C

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Ans.is'C'i.e.,Coeliactrunk
CoeliactrunkisatT12-L1level.
ThetransversesectionatthelevelofL3showslowerabdominal
organs.

87.Spleenextendsfrom?

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a)5thto9thrib
b)9thto11thrib
c)2ndto5thrib
d)11thto12thrib
CorrectAnswer-B

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Ans.is'b'i.e.,9thto11thrib[RefBDCVol.IISthIep.431]
Surfacemarkingofspleen
1. Itismarkedontheleftsideoftheback,withitslongaxis
correspondingwiththatofthe10shrib.
2. Theupperbordercorrespondstoupperborderofrib,andthelower

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bordertothelowerborderofthe11"'rib.
3. Medialendlies4-5cmfromthemidline,andthelateralendonthe
midaxillaryline.

88.Whichofthefollowingistrueabout
coeliacplexusblock?

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a)LocatedretroperitoneallyatthelevelofL3
b)Usuallydoneunilaterally
c)Usefulforthepainfulconditionsoflowerabdomen
d)Mostcommonsideeffectisdiarrheaandhypotension
CorrectAnswer-D

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Answer-D(Mostcommonsideeffectisdiarrheaandhypotension)
CeliacPlexusBlock:
LocatedretroperitoneallyatthelevelofLl
Usuallydonebilaterallv
Usefulforthepainfulconditionsofupperabdomen

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Mostcommonsideeffectisdiarrheaandhvpotension

89.Ovarianfossaisformedbyallexcept?
a)Obliteratedumbilicalartery
b)Internaliliacartery
c)Ureter

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d)Roundligamentofovary
CorrectAnswer-D
Eachovaryliesinovarianfossaonlateralpelvicwallwhichis
bounded:?
1. Anteriorly:Obliteratedumbilicalartery

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2. Posteriorly:Ureterandinternaliliacartery

90.Allarebranchesoftheinferiormesenteric
arteryexcept?
a)Leftcolic
b)Sigmoidalartery

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c)Middlerectal
d)Superiorrectal
CorrectAnswer-C
Ans.'C'i.e.,Middlerectal
Inferiormesentericarterybranches:

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1. Leftcolicartery:Itdividesintodescendingandascendingbranches.
2. Sigmoidalarteries:Theseare2or3innumberandsupply
descendingandsigmoidcolon.
3. Superiorrectalartery:Itisacontinuationofinferiormesenteric
arteryinthelesserpelvisandanastomoseswithbranchesofthe

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middleandinferiorrectalarteries.

91.Lymphaticdrainageoflateralwallof
nose
a)Submandibularnodes
b)Retropharyngealnodes

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c)Deepcervicalnodes
d)Alloftheabove
CorrectAnswer-D
Ans.is'd'i.e.,Alloftheabove
LymphaticdrainageofnoseisBYAnteriorhalfofnasalcavity(Both

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septumandlateralwall)-sSubmandibularnodes
Posteriorhalfofnasalcavity(Bothseptumandlateral
wall)Retropharyngealnodesandupperdeepcervicalnodes.

92.Bartholinglandsituatedin?
a)Superficialperinealpouch

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b)Deepperinealpouch
c)Inguinalcanal
d)Ischiorecalfossa
CorrectAnswer-A
Superficialperinealpouch

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93.Lymphaticdrainageofcervixisto
a)Iliaclymphnodes
b)Paraaorticlymphnodes
c)Superficialinguinallymphnodes
d)Deepinguinallymphnodes

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CorrectAnswer-A
A.i.e.Iliaclymphnodes

94.Maximumcontributiontotheflooroforbit
isby:
a)Maxillary

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b)Zygomatic
c)Sphenoid
d)Palatine
CorrectAnswer-A
Ans.A.Maxillary
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Themaxillaearethelargestofthefacialbones,otherthanthe
mandible,andjointlyformthewholeoftheupperjaw.Eachbone
formsthegreaterpartofthefloorandlateralwallofthenasalcavity,
andoftheflooroftheorbit
"Orbitalsurfaceofmaxillaissmoothandtriangular,andforms
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mostoftheflooroftheorbit"
Alsoknow:
Maxillaisalsothemostcommonlyfracturedboneoforbitalfloor.
Thefloor(inferiorwall)isformedbytheorbitalsurfaceofmaxilla,the
orbitalsurfaceofZygomaticboneandtheorbitalprocessofpalatine

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bone
Thesevenbonesthatarticulatetotheorbitare
1. Frontalbone
2. Lacrimalbone
3. Ethmoidbone

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4. Zygomaticbone
5. Maxillarybone
6. Palatinebone
7. Sphenoidbone

95.Posteriorcommunicatingarteryabranch

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of
a)Internalcarotid
b)Externalcarotid
c)Middlecerebral
d)Posteriorsuperiorcerebellar

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CorrectAnswer-A
Ai.e.Internalcarotid

96.Numberofvertebraeisusuallyconstantin
a)Cervical
b)Thoracic

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c)Lumbar
d)Sacral
CorrectAnswer-A
Ans.a.CervicalAuthorpleaseprovide
*IllustratedEncyclopediaofHumanAnatomicVariation:OpusV:

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SkeletalSystems:Vertebralcolumn;NumericalVariationin
VertebralColumnbyRonaldA.Bergman,PhD;AdelK.Afifi,MD,
MS;RyosukeMiyauchi,MD.
*Theusualgroupingformulaof7cervical,12thoracic,5lumbar,5
sacral,and4coccygealvertebraeisfoundinonlyabout

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*ThecervicalregionisreportedtobethemostconstantQ,the
coccygealthemostvariable20%ofindividualsstudied.
*Thenumberofelementsofthevertebralcolumnhasbeenreported
tovarybetween32and35.Additiontoagroupisfrequentlyseen,
whichoccursthroughthereductioninnumberofvertebraeofan

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adjacentgroup,thetotalnumberbeing
*Thelocationofsuchavertebraispredominatelyattheendsofthe
columnandatthelevelsoftransitionbetweenitsregions.Thus,
sacralizationofthefifthlumbar,lumbar-likearticularprocessesinthe
elevenththoracic,andthoraciccostalfacetsontheseventhcervical

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areobserved.
*unchanged.Inthisvariation,thevertebraaddedisusually
intermediateinformbetweentheadjacentgroups.
*Thelevelsoftransitionmaybeshiftedcephalad,resultingin23
mobilevertebrae,orshiftedcaudad,resultingin25presacral

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vertebrae.Suchvariationsmayoccurin2-11%ofthepopulation
*Thenumberofvertebraecomprisingthesacrummaybeincreased
tosix,resultingfromthefusionofthefirstcoccygeal(50%inwhites,
30%inNegroes)or,lessoften,ofthelastlumbar(sacralization)(8%
inwhites,11%inNegroes);oritmaybeincreasedtoseven,resulting

--- Content provided by FirstRanker.com ---

fromthefusionofthefirstcoccygealandthelastlumbar(4%in
whites,1.5%inNegroes).Thenumbermaybereducedtofour,
apparentlybythelumbarizationofthefirstsacral(0.4%inwhites,
1.5%inNegroes).
Numberofvertebrae
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*Mostconstant:Cervicalregion?
*Mostvariable:coccygealregion?

97.Ophthalmicarteryisabranchof?
a)CavernouspartofICA
b)CerebralpartofICA

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c)MCA
d)Facialartery
CorrectAnswer-B
Thecommoncarotidarteriesbifurcateatthelevelofthethyroid
cartilageintotheexternalandinternalcarotidarteries.Theexternal

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carotidarterysendsbranchestotheneckandface,whereasthe
internalcarotidarteryascendstothebaseoftheskull,enteringthe
carotidcanal.Uponexitingthecarotidcanal,theinternalcarotid
arterycourseshorizontallyovertheforamenlacerumandentersthe
cavernoussinusand,afterturningsuperiorly,dividesintoitsterminal

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branches.
Internalcarotidartery
Itisthemainarterysupplyingstructuresinsidethecranialcavityand
orbit.Itisdividedinto4parts:?
*Cervicalpart:-Itextendsfromupperborderofthyroidcartilageto

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thebaseofskull.Thispartgivesnobranch.
*Petrouspart:-Itliesinbonycarotidcanalinthepetroustemporal
bone.Itgivestwobranches(i)Caroticotympanic,and(ii)pterygoid.
*Cavernouspart:-Itrunsthroughthemedialwallofcavernous
sinus.Itgivesthreebranches:(i)Meningealbranch,(ii)

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hypophysealbranchand(iii)cavernousbranch.
*Cerebralpart:-Itisrelatedtoinferiorsurfaceofcerebrum.Itgives
followingbranches:(i)Ophthalmicartery,(ii)posterior
communicatingartery,(iii)anteriorchoroidalartery,(iv)anterior
cerebralarteryand(v)middlecerebralartery.

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98.Whatistrueaboutchordatympani?
a)Postganglionicsympathetic
b)Preganglionicsympathetic
c)Preganglionicparasympathetic
d)Postgalglionicparasympathetic

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CorrectAnswer-C
Chordatympaniarisesfromintratemporalpart(infallopioncanal)of
facialnerve.
*Itcarriespreganglionicsecretomotorfibers(notpostganglionic)to
submandibularandsublingualglands.

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*Itjoinslingualnerveininfratemporalfossa.
*Itcarriestastesensationsfromanterior2/3oftongue.

99.Eustachiantubeopensinmiddleearin?
a)Floor
b)Anteriorwall

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c)Superiorwall
d)Posteriorwall
CorrectAnswer-B
Ans.is'b'i.e.,Anteriorwall
Themiddleearisshapedlikeacube.

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Whenseeninthecoronalsection,thecavityofthemiddleearis
biconcave.
Theboundariesofthemiddleearareasfollows:
1.Roofortegmentalwall
Separatesthemiddleearfromthemiddlecranialcavity.

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Itisformedbyathinplateofbonecalledtegmentympani.
2.Floororjugularwall
Formedbyathinplateofbonewhichseparatesthemiddleearfrom
thesuperiorbulboftheinternaljugularvein.
Theflooralsopresentsthetympaniccanaliculuswhichtransmitsthe

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tympanicbranchoftheglossopharyngealnerve.
3.Anteriororcarotidwall
Theuppermostpartbearstheopeningofthecanalofthetensor
tympani.
Themiddleparthastheopeningoftheauditorytube.

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Theinferiorpartofthewallisformedbyathinplateofbonewhich
formstheposteriorwallofthecarotidcanal.Thisplateseparatesthe
middleearfromtheinternalcarotidartery.
4.Posteriorormastoidwall
Superiorly,istheaditusthroughwhichtheepitympanicrecess

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communicateswiththemastoidantrum.
Belowitisthefossaincudiswhichlodgestheshortprocessofthe
incus.
Belowitisthepyramidgivingattachmenttothetendonofstapedius.
Verticalpartofthefacialcanalforfacialnerve

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5.Lateralormembranouswall
Tympanicmembranealongwiththetympanicringandsulcus.
6.Medialorlabrynthinewall
Promontory-roundedbulgeproducedbythefirstturnofthe
cochlea.

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Ovalwindow-itisposterosuperiortothepromontory.Itisclosedby
thefootplateofthestapes.
Horizontalpartofthefacialcanal-runsjustabovetheovalwindow.
Roundwindow-posteroinferiortothepromontory.Itisclosedbythe
secondarytympanicmembrane.

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Processuscochleariformis-formsapulleyforthetendonofthe
tensortympani.
Prominenceofthelateralsemicircularcanal-abovethefacialcanal.

100.Rouvierenodesaresituatedin?
a)Nasopharynx

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b)Oralcavity
c)Retropharynx
d)Clavicularnodes
CorrectAnswer-C
Ans.is'c'i.e.,Retropharynx

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TheRouviere'snodeisthemostsuperiorofthelateralgroupofthe
retropharyngeallymphnodes,andisfoundatthebaseoftheskull.
Thekrewse'snodesarelymphnodessituatedinthejugular
foramen.Enlargementofthesenodescompressoncranialnerves
IX,XandXI,causingjugularforamensyndrome.

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101.Passavantsridgeisformedby?
a)Palatoglossus
b)Superiorconstrictor
c)Salpingopharyngeus
d)Palatopharyngeus

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CorrectAnswer-D
Ans.is'd'i.e.,Palatopharyngeus
Pharynxhastwogroupofmuscles:?
*Intrinsicmuscles:-Stylopharyngeous,salpingopharyngeous,
palatopharyngeous.

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*Extrinsicmuscles:-Superiorconstrictor,middleconstrictor,inferior
constrictor.
-Allmusclesofpharynxaresuppliedbycranialaccessorythrough
branchesofvagusviapharyngealplexusexceptstylopharyngeus
whichissuppliedbyglossopharyngeal.

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-Inferiorconstrictormusclehastwoparts:-(i)Thyropharyngeous
withobliquefibres,and(ii)Cricophatyngeouswithtransversefibres.
-Betweenthesetwopartsofinferiorconstrictorexistsapotential
gapcalledKillan'sdehiscence.Itisalsocalledthegatewaytotear
asperforationcanoccuratthissiteduringesophagoscopy.Itisalso

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thesiteforherniationofpharyngealmucosaincaseofpharyngeal
pouch.
-UpperfibersofpalatopharyngeusconstitutethePassavant's
musclewhichoncontractionraisesaridgecalledPassavant'sridge
onposteriorwallofnasopharynx.

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102.Lowerlimitofretropharyngealspaceis
at?
a)C7
b)Bifurcationoftrachea
c)4thesophagealconstriction

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d)None
CorrectAnswer-B
Ans.is'b'i.e.,Bifurcationoftrachea
Retropharyngealspaceisdividedintotwolateralspaces(spaceof
gillette)byafibrousband.

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Retropharyngealspaceislimitedabovebythebaseofskulland
belowwherethealarfasciafuseswithbuccopharyngealfasciaatthe
levelofT4andcarina(bifurcationoftrachea).

103.Killiandehiscenceisin?
a)Superiorconstrictor

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b)Inferiorconstrictor
c)Middleconstrictor
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Inferiorconstrictor

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Inferiorconstrictormusclehastwoparts:-(i)Thyropharyngeouswith
obliquefibres,and(ii)Cricopharyngeouswithtransversefibres.
Betweenthesetwopartsofinferiorconstrictorexistsapotentialgap
calledKillan'sdehiscence.Itisalsocalledthegatewaytotearas
perforationcanoccuratthissiteduringesophagoscopy.Itisalsothe

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siteforherniationofpharyngealmucosaincaseofpharyngeal
pouch.

104.Sensorysupplyofthepalmisfrom
whichnerves-
a)MediannerveandRadialnerve

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b)Radialnerveandulnarnerve
c)UlnarnerveandMediannerve
d)MusculocutaneousnerveandRadialnerve
CorrectAnswer-C
Ans.is'c'i.e.,UlnarnerveandMediannerve
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(RelBDC5'h/eVoLIp.108-111)
OnPalmside:
Lateral2/3ofthepalmandlateralthreeandhalffibersMedian
nerve.
Medial1/3ofthepalmandmedialoneandhalffingersUlnar

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nerve.

105.

Whichofthefollowingisnotthepartof
ethmoidbone?
a)Aggernasi

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b)Cristagalli
c)Uncinateprocess
d)Inferiorturbinate
CorrectAnswer-D
Ans.d.Inferiorturbinate
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Inferiorturbinateisnotthepartofethmoidbone.
`Lateralnasalwallhas3bonyprojectionscalledasturbinatesor
conchae.Frombelowupwards,theyareinferior,middleand
superiorturbinates.Theinferiorturbinateisaseparatebone,while
restoftheturbinatesarepartofethmoidallabyrinths.'

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Theaggernasiaircells,arethemostanteriorethmoidalaircells,
lyinganterolateralandinferiortothefrontoethmoidalrecessand
anteriorandabovetheattachmentofthemiddleturbinate.Theyare
locatedwithinthelacrimalboneandthereforehaveaslateral
relationstheorbit,thelacrimalsacandthenasolacrimalduct.'

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Thecristagalliisamedianridgeofbonethatprojectsfromthe
cribriformplateoftheethmoidbone.Itiswherethefalxcerebri
attachesanteriorlytotheskull.Theolfactorybulbslieoneitherside
ofthecristagalliontopofthecribriformplate.'
Intheethmoidbone,acurvedlamina,theuncinateprocess,projects

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downwardandbackwardfromthispartofthelabyrinth;itformsa
smallpartofthemedialwallofthemaxillarysinus,andarticulates
withtheethmoidalprocessoftheinferiornasalconcha.'

106.Whichofthefollowingisnotsuppliedby
theanteriordivisionofmandibularnerve
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(V3)?
a)Temporalis
b)Medialpterygoid
c)Lateralpterygoid
d)Masseter

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CorrectAnswer-B
Bi.e.Medialpterygoid
Temporalis,messeterandlateralpterygoidmusclesQaresupplied
byanteriordivisionofmandibularnervewhereasmedialpterygoid
muscleQissuppliedbythemaintrunkofmandibularnerve.

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107.Nucleusambiguusisnotassociatedwith
whichcranialnerve:
a)X
b)XI
c)IX

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d)XII
CorrectAnswer-D
Ans.D:XII
NucleusAmbiguus
Function:
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*Motorinnervationofipsilateralmusclesofthesoftpalate,pharynx,
larynxandupperesophagus.
Pathway:
*Axonsofmotorneuronsinthenucleusambiguuscoursewiththree
cranialnerves:C.N.IX(glossopharyngeal),C.N.X(vagus),C.N.XI

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(therostralorcranialportionofspinalaccessory)toinnervate
striatedmusclesofthesoftpalate,pharynx,larynxandupper
esophagus.
Deficits:
*Lesionofnucleusambiguusresultsinatrophy(lowermotor

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neuron)andparalysisofinnervatedmuscles,producingnasal
speech,dysphagia,dysphonia,anddeviationoftheuvulatowardthe
oppositeside(strongside).
*NoaffectionoftheSternocleidomastoidorTrapezius.These
musclesareinnervatedbycellsintherostralspinalcord(caudal

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portionC.N.XI).

108.

WhichofthefollowingisNOTabranchof1stpartofmaxillaryartery?
a)Middlemeningealartery
b)Accessorymeningealartery

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c)Inferioralveolarartery
d)Greaterpalatineartery
CorrectAnswer-D
Branchesofmaxillaryartery:

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Themaxillaryarteryconsistsofthreeparts;mandibularpart,
pterygoidpart,pterygopalatinepart.
Branchesofmandibularpart:
Inferioralveolarartery
Middlemeningealartery

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Deepauricularartery
Anteriortympanicartery
Occasionallyanaccessorymeningealbranch.
Branchesofpterygoidpart:
Massetericartery

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Deeptemporalbranches
Pterygoidbranches
Buccalartery
Branchesofpterygopalatinepart:
Posteriorsuperioralveolarartery

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Infraorbitalartery
Descendingpalatineartery
Greaterpalatineartery
Lesserpalatineartery
Sphenopalatineartery

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Lateralposteriornasalarteries
Posteriorseptalbranches

109.Allofthefollowingaretrueabout
locationofoticgangliaexcept:
a)Inferiortoforamenovale

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b)Lateraltotensorvelipalatini
c)Lateraltomandibularnerve
d)Anteriortomiddlemeningealartery
CorrectAnswer-C
Ans:C.Lateraltomandibularnerve
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(RefGray41/ep552.40/ep543)
Mandibularnervelieslateraltooticganglion.
Ie.,Ganglionliesmedialtomandibularnerve.
Oticganglion:
Small,oval,flatreddish-greyganglion.

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Situatedjustbelowforamenovate.
Peripheralparasympatheticganglionlocatedintheinfratemporal
fosse.
Functionallyassociatedwithglossopharyngealnerve&innervates
parotidglandforsalivation.

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Connectedtochordatympaninerve&tonerveofpterygoidcanal.
Pathwaysprovideanalternatepathwayoftastefromanteriortwo-
thirdsoftongue.

110.

Cranialpartofaccessorynervesuppliesallpalatalmuscles,EXCEPT?

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a)Palatoglossus
b)Palatopharyngeus
c)Tensorvelipalatini
d)Tensorvelitympani
CorrectAnswer-C

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Thecranialrootoftheaccessorynerveissmallerthanthespinal
root.Itexitstheskullthroughthejugularforamenandunitesfora
shortdistancewiththespinalroot.Itsfibersinnervatethe
pharyngealandpalatalmuscles,excepttensorvelipalatini.
Becausethecranialpartofaccessorynerve(CNXI)leavesthe

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jugularforamenasjoiningtheCNX,itissometimesconsideredpart
oftheplexusaswell
Thetensorvelipalatiniissuppliedbythemedialpterygoidnerve,a
branchofmandibularnerve,thethirdbranchofthetrigeminalnerve
-theonlymuscleofthepalatenotinnervatedbythepharyngeal

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plexus

111.Passavantridge?
a)Superiorconstrictorandpalatopharyngeus
b)Inferiorconstrictorandpalatopharyngeus
c)Superiorconstrictorandpalatoglossus

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d)Inferiorconstrictorandpalatoglossus
CorrectAnswer-A
Passavantridge
Nearthesuperiormarginofpharynx,afewfibresofsuperior
constrictorblendwithabandofmusclefibresbelongingtothe

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palatopharyngeusmuscle.
Thesefusedfibresformabandorringaroundtheposteriorwalland
sidewallsofthenasopharyngealisthumus.
Whenthesoftpalateiselevatedthismusclebandappearsasa
ridgeisknownaspassavant'sridge.

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112.Whichofthefollowinglaryngeal
cartilageishyaline?
a)Epiglottis
b)Comiculate
c)Cricoid

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d)Cuneiform
CorrectAnswer-C
Ans.is'c'i.e.,Cricoid
Hyalinecartilages
Elasticcartilages(donotossify)

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Thyroidcartilage
Epioglottis
Cricoidcartilage
Corniculate
Basalpartofarytenoidcartilage Cuneiform

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Processesofarytenoid

113.Little'sareais?
a)Anteroinferiorlateralwall
b)Anteroinferiornasalseptum
c)Posteroinferiorlateralwall

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d)Posteroinferiornasalseptum.
CorrectAnswer-B
Ans.is'b'i.e.,Anteroinferiornasalseptum
Little'sareaissituatedintheanteriorinferiorpartofnasalseptum,
justabovethevestibule.

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Woodruff'splexusissituatedintheposteriorinferiorpartoflateral
wall

114.Maxillarybonedoesnotarticulatewith:
a)Ethmoid
b)Sphenoid

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c)Frontal
d)Lacrimal
CorrectAnswer-B
Ans:B.Sphenoid
(RefGray's41/ep484,40/ep473-476)

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Maxillarybonedoesnotarticulatewithsphenoid.
Articulationofmaxilla:
Eachmaxillaarticulateswithninebones:
Twoofcranium:Frontal&ethmoid.
Sevenoftheface:Nasal,zygomatic,lacrimal,inferiornasal
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concha,palatine,vomer&adjacentfusedmaxilla.
Sometimesarticulateswithorbitalsurface&withlateralpterygoid
plateofsphenoid.

115.Primaryandsecondarypalatesare
dividedby

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a)Greaterpalatineforamen
b)Canineteeth
c)Alveolararch
d)Incisiveforamen
CorrectAnswer-D

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D.i.e.Incisiveforamen
Theincisiveforamenisdividinglandmarkbetweentheprimary&
secondarypalateQ;andanterior&posteriorcleftdeformities

116.Parotidductopensoppositeto:
a)Upper1stmolar

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b)Upper2ndmolar
c)Upper2ndpremolar
d)Upper1stpremolar
CorrectAnswer-B
Ans.B:Upper2ndmolar

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117.Multiplesinusesfrominfectionofgreat
toeismainlycausedby:
September2007
a)Tuberculosis
b)Actinomycetes

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c)Trichosporum
d)Histoplasmosis
CorrectAnswer-B
Ans.B:Actinomycetes
Mycetomaisachroniclocalizedgranulomatousinflammatorylesion

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commoninthetropicsandsub-tropics.
MultiplesiAuses,softtissueswellinganddischargeofcoloured
granulescharacterizeamycetomafoot.Chronicsinusesdischarging
granulesarecausedby(1)Eumycetes(truefungi),(2)
Schizomycetes,whichincludes

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Actinomycosis(aerobichigherfilamentousbacteria)and
Botryomycosis(bacterialinfection).
-ActinomycosisisoftencausedbyActinomaduraorNocardia
specieswhereinitgainsentryafterpenetratingtrauma(splinter,
gravelorthornprick).

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Youngmalesarecommonlyaffectedand75%ofthelesionsoccurin
thelowerlimbs.
Thediseaseslowlyprogressesfromanoduletomultiplesinuses
dischargingcolouredgranules.Involvementofboneislatefollowing
dermalandsofttissuespread.

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-Botryomycosis(amisnomer),achronicsuppurativeinfectionis
causedbybacteriainvolvingskinorviscera.Thisrarecondition
mimicsadeepmycoticinfectionandisoftencausedby

mimicsadeepmycoticinfectionandisoftencausedby
StaphylococcusorPseudomonasspeciesofbacteria.Thefeetand

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handsarecommonlyaffectedandpenetratingtraumamaybea
predisposingfactor.Itusuallypresentsasanodule,sinusorulcer,
whichisinitiallylocalized.
Thediagnosisofactinomycosisisbasedonclinicalfindings,
demonstrationofcharacteristicgranulesandcultureoftheorganism

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fromadeeptissuebiopsy.
Immunologicalstudies(counterimmunoelectrophoresisandELISA)
arealsoused.Botryomycosisisdiagnosedbasedonapositive
gram'sstainandculture;negativefungalculturesanddemonstration
ofthecharacteristicbotryomycoticgranulesathistopathologyfroma

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deepbiopsy.
Inendemicareas,subcutaneousswellingwithsinusesshouldbe
consideredasmycetomaunlessprovedotherwise.Thedifferential
diagnosisincludeschronicosteomyelitis,tuberculosisandchronic
abscesses.

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118.Risoriusisamuscleof?
a)Mastication
b)Deglutition
c)Facialexpression
d)Eyemovement

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CorrectAnswer-C
Ans.is'c'i.e.,Facialexpression[RefBDCVol.III,5th/ep.57]
Therisorius(alsorisoriusmuscle,latin:musculusrisorius)isa
muscleoffacialexpressionlocatedlaterallytothemouthopening,
whichpullstheangleofthemouthlaterally.

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*Origin
-Therisoriusoriginatesfromthemassetericfascia.
*Insertion
-Therisoriusinsertsintotheskinoftheangleofthemouth.
*Action

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-Uponactivationtherisoriuspullstheangleofthemouthlaterally.
-Contractionsoftherisoriusmuscleproducefacialexpressionof
pleasureandlaughter.
*Innervation
-Therisoriusisinnervatedbythebuccalbranchofthefacialnerve

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(CNVII).
*Bloodsupply
-Therisoriusismainlysuppliedbythesuperiorlabialbranchofthe
facialartery.

119.Musclecausingflexionofhip?

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a)Bicepsfemoris
b)Psoasmajor
c)Gluteusmaximus
d)TFL
CorrectAnswer-B

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Ans.is'b'i.e.,Psoasmajor

120.

Thethyrocervicaltrunkisabranchofwhich
partofsubclavianartery?
a)1st

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b)2nd
c)3rd
d)None
CorrectAnswer-A
Ans.'a'i.e.,1st

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Branchesofthesubclavianartery:?
1. 1stPartVertebralartery,internalthoracicartery,thyrocervical
trunk,andonleftsidecostocervicaltrunk.
2. 2ndPartOnrightsidecostocervicaltrunk.
3. 3rdPartDorsalscapularartery.

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121.Biphasicactionpotentialofmixednerve
except?
a)Allornonephenomenon
b)Twoormorepositivepeaks
c)Refractoryperiod

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d)Recordedonsurface
CorrectAnswer-B
Ans.is'b'i.e.,Twoormorepositivepeaks
Actionpotentialwhenrecordedbyputtingtwoelectrodesonthe
surfaceofaneuron(insteadofputtingonsurfaceandone

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intracellularly),showsabiphasicresponse,i.e.Biphasicaction
potential.
Asthewaveofdepolarizationreachedthefirstelectrode,this
electrodebecomesnegativeandanupwarddeflection(Peak)is
recorded.

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Vagus,Glossopharyngeal,Facialaremixednerve.

122.Nucleusfasciculatusisseenin?
a)Frontallobe
b)Medulla
c)Temporallobe

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d)Midbrain
CorrectAnswer-B
Ans.is'b'i.e.,Medulla[RefQuantitativeHumanphysiology:An
introductionp.327]
Ithasnotbeenmentionedinanytextbook.

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Butaccordingtotheabovementionedreferencenucleus
fasciculatusistheothernameofnucleuscuneatus.
"Thesensoryfibersofdorsalcolumntravelintracts,fasciculus
gracilisandfasciculusCuneatusintheCordandthesefibersmake
synapseswithsecondorderneuronsinthenucleusgracilisandthe

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nucleusfasciculatus".--QuantitativeHumanphysiology.
Nucleusgracilisandnucleusfasciculusarefoundinthemedulla.

123.Whichofthefollowingisanoperculated
sulcus?
a)Calcarine

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b)Collateral
c)Lunate
d)Central
CorrectAnswer-C
Ans.is'c'i.e.,Lunate

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Operculatedsulcusseparatesbyitslipsintotwoareasand
containsathirdareainthewallsofthesulcuse.g.lunatesulcusis
anoperculatedsulcus,separatingthestriateandparastriateareas.
AxialPosteriorpartofcalcarinesulcus
LimitingCentralsulcusAnteriorpartofcalcarinesulcus

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OperculatedLunatesulcus
CompleteCollateralsulcus,Anteriorpartofcalcarinesulcus

124.Allthefollowingarecharacteristicsof
oculomotornerveexcept:
a)Carriesparasympatheticnervefibres

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b)Suppliesinferiorobliquemuscle
c)Entersorbitthroughtheinferiororbitalfissure
d)Causesconstrictionofpupil
CorrectAnswer-C
Ci.e.Entersorbitthroughtheinferiororbitalfissure

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Oculomotornerveentersorbitthroughthesuperiororbitalfissure.
Thevisceralmotorcomponentcontrolsparasympatheticinnervation
(nervesrelatedtoinvoluntaryactions)oftheciliarymusclesand
constrictorpapillae,aidinginaccommodationandpupillarylight
reflexes.

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TheIIIcranialnervesuppliesallextraocularmusclesexceptLateral
rectusandsuperiorobliquemuscle.

125.TrueaboutCorpuscallosum:
a)Unitefarareaoftwosidesofbrain
b)Connecttwofrontallobe

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c)Unitetwohemisphere
d)All
CorrectAnswer-D
Ai.e.Unitefarareaoftwosidesofbrain;Bi.e.Connecttwofrontal
lobe;Ci.e.Unitetwohemisphere

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126.Whatarethecellularcontentsofcerebellarcortex?
a)Corticalcells
b)Glomuscells
c)Principlecells
d)Intercalatedcells

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CorrectAnswer-A
Ans.ACorticalcells.
CELLSINCEREBRALCORTEX:
Corticalcells:
Majorityarepyramidalcells

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Pyramidalcells-"Sinequanon"forcerebralcortex
Axonsofpyramidalcellsleavethecortex
Formsdescendingtract(e.g.Corticospinal,Corticobulbaretc).

127.Allarelateralbranchesofabdominal
aorta,EXCEPT

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a)Righttesticularartery
b)Leftrenalartery
c)Inferiormesentericartery
d)Middlesuprarenalartery
CorrectAnswer-C

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C.i.e.Inferiormesentericartery
OvarianorTesticulararteryislateralbranchofabdominalaortaand
uterinearteryisabranchofinternaliliacartery(anteriordivision).
Lateralbranchesofabdominalaortaare-Inferiorphrenic,Middle
Suprarenal,Renal&Gonadal(testicularorovarian)arteries.

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Mnemonic-"InferiorMSRuinGonads"

128.Chamberlainslineis?
a)Palatetoocciput
b)Palatetotemporal
c)Palatetoforamenmagnum

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d)Palatetoparietal
CorrectAnswer-C
Ans.is'c'i.e.,Palatetoforamenmagnum[Ref:Atlasof
radiographicmeasurement]
TheChamberlainlineisdrawnfromtheposteriorsurfaceofthehard

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palatetothetipoftheopisthion(posterioraspectoftheforamen
magnum).
Itisusedtomeasurethedistanceofhowmuchtheodontoidtip
extendsabovethisline.Ifthetipofthedensextends>3mmabove
thislinethenithelpstorecognizethepresenceofbasilar

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invagination(acraniocervicaljunctionabnormalitywherethetipof
thedensprojectupintotheforamenmagnum)

129.Osseocartilagenousjunctionispresent
at?
a)Nasion

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b)Rhinion
c)Radix
d)Columella
CorrectAnswer-B
Ans.is'b'i.e.,Rhinion[RefTextbookofgeneralanatomyp.10]

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NasionThedepressionatthejunctionofnosewithforehead.
RhinionThepointlocatedattheosseocartilagenousjunction
overthedorsumofthenose.
RadixJunctionbetweenthefrontalboneandnasalbone.
ColumellaColumnbetweenthenostrilsatthebaseofthenose..

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130.Primordialgermcellsarederivedfrom:
a)Neuralcrest
b)Genitalridge
c)Somatopleuriticmesoderm
d)Yolksac

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CorrectAnswer-D
Formationofprimordialgermcells
Structuresderivedfromneuralcrestareneuronsofspinalposterior
(dorsal)nerverootganglia,neuronsofsensorygangliaofthe5to
10thcranialnerves,neuronsandsatellitecellsofsympathetic

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gangliaetc.
Intheregionwheretestesistodevelop,thegerminalepithelium
getsthickenedandisknownasgenitalridge.
Thecellsofgerminalepitheliumproliferateandformssexcords
whichgetsconvertedintomedullarycordsandfinallygetscanalized

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toformseminiferoustubules
Chorionisformedbytheparital/somatopleuricextraembryonic
mesoderm(ontheinside)andtheoverlyingTrophoblast
Thecellsoftheovariesandthetestes,fromwhichgermcellsare
formed,arebelievedtobesegregatedearlyinthelifeoftheembryo.

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131.WhichofthefollowingdoesNOT
stimulateperipheralchemoreceptors:
a)Hypoxia
b)Hypocapnia
c)Acidosis

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d)Lowperfusionpressure
CorrectAnswer-B
Bi.e.Hypocapnia

132.Peripheralandcentralchemoreceptors
maybothcontributetotheincreased
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ventilationthatoccursasaresultof
whichofthefollowing?
a)Adecreaseinarterialoxygencontent
b)Adecreaseinarterialbloodpressure
c)Anincreaseinarterialcarbondioxidetension

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d)Adecreaseinarterialoxygentension
CorrectAnswer-C
Thecentralchemoreceptorslocatedonorneartheventralsurfaceof
themedullacauseanincreaseinventilationinresponsetoan
increaseinPacO2andtoalesserextenttoadecreaseinarterialpH

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becausethebloodbrainbarrierisrelativelyimpermeableto
hydrogenions.
Theperipheralchemoreceptorsinthecarotidbodiescausean
increaseinventilationinresponsetoanincreaseinPacO2a
decreaseinarterialpH,andadecreaseinPaO2.Neitherthecentral

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chemoreceptorsnorthecarotidbodiesarestimulatedbyadecrease
inarterialbloodpressureorO2content.

133.Transpulmonarypressureisthedifferencebetween:
a)Thebronchusandatmosphericpressure
b)Pressureinalveoliandintrapleuralpressure

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c)Atmosphereandintrapleuralpressure
d)Atmosphereandintraalveolarpressure
CorrectAnswer-B
Transpulmonarypressureisthepressuredifferencebetween
alveolarpressureandintrapleuralpressure.Beforethestartof

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inspirationorattheendofexpirationitisabout+5cmH2O.Positive
transpulmonarypressurekeepsthealveoliopen.
Intrapleuralpressureisthepressurebetweentwolayersofpleura.
Itisabout-5cmH2Obeforethestartofinspirationorattheendof
expiration.

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Alveolarpressureisthepressurewithintheterminalairspaces.It
isthesumofpleuralpressureandelasticrecoilpressureofthelung.
Itisatmosphericbeforethestartofinspirationorattheendof
expiration.
Transthoracicpressureisthepressuredifferencebetween

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alveolarpressureandpressureatthebodysurface.
Ref:FundamentalsofRespiratoryPhysiologyByASChakrabarty,
Page32

134.Differenceintheamountof02inspired
andCO2expired?

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a)20ml/min
b)50ml/min
c)75ml/min
d)100ml/min
CorrectAnswer-B

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Ans.B.50ml/min
250mlofO2entersthebodyperminuteand200mlofCO2is
excreted.

135.Bohreffectisdescribedas:
September2009

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a)DecreaseinCO2affinityofhemoglobinwhenthepHofblood
rises
b)DecreaseinCO2affinityofhemoglobinwhenthepHofblood
falls
c)DecreaseinO2affinityofhemoglobinwhenthepHofblood

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rises
d)DecreaseinO2affinityofhemoglobinwhenthepHofblood
falls
CorrectAnswer-D
Ans.D:DecreaseinO2affinityofhemoglobinwhenthepHofblood

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falls
ThedecreaseinO2affinityofhemoglobinwhenthepHofbloodfalls
iscalledtheBohreffectandiscloselyrelatedtothefactthat
deoxygenatedhemoglobin(deoxyhemoglobin)bindsH+more
activelythandoesoxyhemoglobin.ThepHofbloodfallsasitsCO,

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contentincreases,sothatwhenthePCO2rises,thecurveshiftsto
therightandtheP5,,rises.

136.Truestatementrelatingtocomplianceof
lung:
a)Increasedbysurfactant

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b)Decreasedinemphysema
c)Atheightofinspirationcomplianceisless
d)Itcanbemeasuredbymeasuringintrapleuralpressureat
differentlungvolume
e)None

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CorrectAnswer-A:C:D
Ans.(A)Increasedbysurfactant(C)Atheightofinspiration
complianceisless(D)Itcanbemeasuredbymeasuring
intrapleuralpressureatdifferentlungvolume
[Ref:Ganong25th/629-32,24th/629-33;Guytonllth/473-75;A.K.

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Jain5th/437]
Lungcompliance:
Measuredbymeasuringintrapleuralpressureatdifferentlung
volume.
Animportantfactoraffectingthecomplianceofthelungsisthe

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surfacetensionofthefilmoffluidthatlinesthealveoli.
Deficiencyofsurfactant-lesscompliance;moresurfactant-more
compliance.
Compliancedecreaseswiththeinflationofthelungsasmore
pressureisrequiredtodistendthealreadydistendedlung.

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Thecurveisshifteddownwardandtotheright(complianceis
decreased)bypulmonarycongestionandinterstitialpulmonary
fibrosis;pulmonaryfibrosisisaprogressivediseaseofunknown

causeinwhichthereisstiffeningandscarringofthelung.
Thecurveisshiftedupwardandtotheleft(complianceisincreased)

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inemphysema.

137.Venousbloodwithhighhematocritis
seenin?
a)RBChighchloride
b)PlasmahighNa

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c)PlasmahighHCO3
d)RBChighK
CorrectAnswer-A
Ans.A.RBChighchloride
Hematocritofvenousbloodisnormally3%greaterthanthatof

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arterialblood.

138.
Whichofthefollowingis/areeffectof
increased2,3-DPGonoxygen-
hemoglobindissociationcurve?

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a)edaffinityofheamoglobintooxygen
b)edaffinityofhaemoglobintooxygen
c)Leftshiftofoxygen-hemoglobindissociationcurve
d)Rightshiftofoxygen-hemoglobindissociationcurve
e)Nochangeinoxygen-hemoglobindissociationcurve

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CorrectAnswer-B:D
Ans.(B)edaffinityofhaemoglobintooxygen(D)Rightshift
ofoxygen-hemoglobindissociationcurve
[Ref:Ganong25th/ep.610-41;Guyton's12'h/ep.j56-57;AKlain
6'h/ep.430]

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*Oxygen-hemoglobindissociationcurveis2,3DPGinRBC.
*DPGisanoptionalby-productoftheglycolyticpathway.
*DPGbindswithdeoxygenatedhemoglobinbutnotwithoxygenated
hemoglobin.
*RaisedDPGconcentrationreleasesoxygenfromoxyhemoglobin

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byshiftingthefollowingreversiblereactiontotheright.
Mechanism:
*OnemoleculeofDPGbindswithonemoleofdeoxyhemoglobin.
*HenceanincreaseinDPGconcentrationshiftstheoxygen-
hemoglobindissociationcurvetotheright.

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*Thus2,3DPGcausesdelivery(unloading)ofO,tothetissues.
*Fetalhemoglobinhasconsiderablylessaffinityfor2,3-DPGthan
doesadulthemoglobinthereforefetalhemoglobinhasagreater

affinityforoxygenthanadulthemoglobin.
Inhumanblood,theaffinityoffetalhemoglobinfor2,3-DPGisonly

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about4O%thatofadulthemoglobin.
Thismakesfetalhemoglobinbehaveasif2,3-DPGlevelsarelow.

139.Stabilityofalveoliismaintainedby?
a)Lungcompliance
b)Negativeintrapleuralpressure

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c)Increaseinalveolarsurfaceareabythesurfactant
d)Residualairinalveoli
CorrectAnswer-C
Ci.e.Increaseinalveolarsurfaceareabythesurfactant

140.Whichofthefollowingdefinesvital

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capacity?
a)Airinlungafternormalexpiration
b)Maximumairthatcanbeexpiratedafternormalinspiration
c)Maximumairthatcanbeexpiratedaftermaximuminspiration
d)Maximumairinlungafterendofmaximalinspiration

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CorrectAnswer-C
Ans.C.Maximumairthatcanbeexpiratedaftermaximum
inspiration
Vitalcapacity(VC):
4700ml.

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Amountofairthatcanbeexhaledwithmaximumeffortafter
maximuminspiration(ERV+TV+IRV).
Usedtoassessstrengthofthoracicmusclesaswellaspulmonary
function.

141.HerringBreuerreflexisanincreasein?

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a)Durationofinspiration
b)Durationofexpiration
c)Depthofinspiration
d)Depthofexpiration
CorrectAnswer-B

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Ans.is'b'i.e.,Durationofexpiration
TheHering-Breuerinflationreflexisanincreaseinthedurationof
expirationproducedbysteadylunginflation,andtheHering-Breuer
deflationreflexisadecreaseinthedurationofexpirationproduced
bymarkeddeflationofthelung.

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142.Dailypancreaticsecretion?
a)1.5L
b)2.5L
c)5.0L
d)10L

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CorrectAnswer-A
Ans.A.1.5L

143.Microcirculationconsistsof?
a)Capillaries
b)Capillariesvenulesandarterioles

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c)Aorta
d)Arteriesandveins
CorrectAnswer-B
Ans.,B.Capillariesvenulesandarterioles
Themicrocirculationconsistsofarteriolestovenules,i.e.arterioles,

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capillariesandvenules.

144.Gasexchangeintissuestakesplaceat?
a)Artery
b)Capillary
c)Vein

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d)Venules
CorrectAnswer-B
Ans.B.Capillary
Siteofgasexchange=Capillaries

145.Allofthefollowingstatementsabout

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thirdHeartsound(S3)aretrue,except:
a)Occursduetorapidfillingoftheventriclesduringatrialsystole
b)SeenininConstrictivePericarditis
c)SeeninAtrialSeptalDefect(ASD)
d)SeeninVentricularSeptalDefect(VSD)

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CorrectAnswer-A
AnswerisA(Occursduetorapidfillingoftheventriclesduring
atrialsystole)
Thirdheartsoundoccursattheendofearlyrapidfillingphaseofthe
ventriclebutnotatthetimeofatrialsystole.Theheartsound
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associatedwithventricularfillingduringatrialsystoleisthefourth
heartsound(S4)
FourthHeartsoundoccursinassociationwithaneffectiveatrial
contraction()(Itispresumablycausedbyin-rushofbloodintothe
ventricleswhentheatriacontractsandhenceitisalsocalledthe
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'AtrialHeartSound)
PathologicalThirdHeartSound(S3)maybeassociatedwith
ASDandVSD
`ApathologicalS3isoftenpresentinlargelefttorightshuntsdueto
highflowacrossthemitralvalvewithVSDorpatentductus
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arteriosusandwithhighflowacrossthetricuspidvalvewithASD.
Thepresenceofthissoundintheseconditionsdoesnotimply
congestiveheartfailure,andsuchpatientsmaymaintainnormal
myocardialcontractilityforyearsaftertheS3isdetected'-'Hurst:
TheHeart'11th/271
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CongenitalHeartDiseasesassociatedwithLoudS3
VentricularseptalDefect(VSD)()

PatentDuctusArteriosus(PDA)Q
AtrialSeptalDefect(ASD)Q
PathologicalThirdHeartSound(S3)maybeassociatedwith
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ConstrictivePericarditis
Constrictivepericarditisischaracterixsticallyassociatedwith
pericardialknockwhichisadistinctformofthirdheartsound(S3)
`PericardialknockisS3thatoccursearlier(0.1to0.12afterA2)
andishigherpitchedthannormal.Itspresencedependsupon
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therestrictiveeffectsoftheadherentpericardiumwhichhalts
diastolicfillingabruptly'

146.Durationof2"heartsoundis?
a)0.15sec
b)0.12sec

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c)0.08sec
d)0.1sec
CorrectAnswer-B
Ans.B.0.12sec

147.Trueaboutvolumereceptorsareall,EXCEPT:

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a)Theyarelowpressurereceptors
b)Theyprovideafferentsforthirstcontrol
c)Theyarelocatedincarotidsinus
d)Theymediatevasopressinrelease
CorrectAnswer-C

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Thelow-pressurebaroreceptorsarelocatedinthevenaecavaeand
thepulmonaryveins,andintheatria.Theyarealsocalledvolume
receptors.Thesereceptorsrespondtochangesinthewalltension,
whichisproportionaltothefillingstateofthelowpressuresideof
circulation(below60mmHg).Theirimpulsesregulatethesecretion

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ofantidiuretichormone(ADH/Vasopressin),reninandaldosterone.
Thelow-pressurebaroreceptorshavebothcirculatoryandrenal
effects;theyproducechangesinhormonesecretion,resultingin
profoundeffectsontheretentionofsaltandwater;theyalso
influenceintakeofsaltandwater.

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148.WhichoneofthefollowingistheCORRECTstatementregardingcoronary
bloodflow?
a)Coronarybloodflowisdirectlyrelatedtoperfusionpressureand
inverselyrelatedtoresistance
b)Coronarybloodflowisinverselyrelatedtoperfusionpressure

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anddirectlyrelatedtoresistance
c)Coronarybloodflowisdirectlyrelatedtoperfusionpressureand
alsotoresistance
d)Coronarybloodflowisinverselyrelatedtobothpressureand
resistance

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CorrectAnswer-A
Coronarybloodflowisdirectlyrelatedtotheperfusion
pressure(aorticdiastolicpressure)andthedurationof
diastole.Becausecoronaryflowdropstonegligiblevaluesduring
systole,thedurationofdiastolebecomesalimitingfactorfor

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myocardialperfusionduringtachycardia.
Coronarybloodflowisinverselyproportionaltocoronary
vascularresistance.Resistanceisdeterminedmainlybyintrinsic
factors--includingmetabolicproductsandautonomicactivity--and
byvariouspharmacologicagents.Damagetotheendotheliumof

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coronaryvesselshasbeenshowntoaltertheirabilitytodilateandto
increasecoronaryvascularresistance.
Ref:KatzungB.G.(2012).Chapter12.Vasodilators&theTreatment
ofAnginaPectoris.InB.G.Katzung,S.B.Masters,A.J.Trevor(Eds),
Basic&ClinicalPharmacology,12e.

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149.Einthovenslaw-
a)I+III=II
b)I-III=II
c)I+II+III=0
d)I+III=avL

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CorrectAnswer-A
Ans.A.I+III=II
Einthoven'sLawstatesthatiftheelectricalpotentialsofanytwoof
thethreebipolarlimbelectrocardiographicleadsareknownatany
giveninstant,thethirdonecanbedeterminedmathematicallyby

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simplysummingthefirsttwo(butnotethatthepositiveandnegative
signsofthedifferentleadsmustbeobservedwhenmakingthis
summation).
ThusthesumofthevoltagesinleadsIandIIIequalsthevoltagein
leadII.

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150.MechanismbywhichAchdecreases
heartrateisby:
a)Delayeddiastolicdepolarization
b)Increaseinplateau
c)Decreasepreload

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d)Increaseafterload
CorrectAnswer-A
Ans:A.Delayeddiastolicdepolarization
Acetylcholinedecreasesheartrateprimarilybyinhibitingthe
spontaneousdepolarizationofcellsinSAnode;alsoknownas

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diastolicdepolarization.Thisisachievedbyinhibitionofthefunny
currentintheSAnode.
Effectofacetylcholineoncardiovascularsystem
Heartrate
Achinhibitsfunnycurrentgenerationinthe

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decreases
pacemakercellsofSAnode
AVconduction
AchblocksLtypecalciumchannelsintheAV
decreases

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node
Atrialcontraction Atriumissuppliedbycholinergicfibersmorethan
decreases>
theventricles.Achopenspotassiumchannels
ventricular

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anddecreasescyclicAMPinthemyocardialcells.
contraction
Achincreasescalciuminendothelialcells,which
Vasodilation
stimulatescalciumdependentENOSand

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releasesNOwhichcausesvasodilation.

151.Meanarterialpressureiscalculatedas:
a)(SBP+2DBP)/3
b)(DBP+2SBP)/3
c)(SBP+3DBP)/2

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d)(DBP+3SBP)/2
CorrectAnswer-A
Ai.e.(SBP+2DBP)/3

152.Calculatetheejectionfractionfromthe

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givenvolumepressurecurve:
a)40%
b)50%
c)55%
d)60%

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CorrectAnswer-D
Ans:D.60%
(RefGunong25/ep54024/ep542)
Ejectionfractioncalculatedfromthegivenvolumepressurecurveis
60%.

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PressureVolumeLoop:
ab:isovolumetriccontraction
bc:Ventricularcontractionduringsystole
cd:Isovolumetricrelaxation.
Calculation:
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End-DiastolicVolume(EDV)(Pointa)=130mL

EndSystolicVolume(ESV)(Pointd)=50mL
StrokeVolume(SV)=EDV?ESV=80mL
EjectionFraction=SV/EDV=80/130=0.6i.e.%EF=60%.

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153.Preloadmeasures?
a)Endsystolicvolume
b)Enddiastolicvolume
c)Peripheralresistance
d)Strokevolume

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CorrectAnswer-B
EnddiastolicvolumeREF:Guyton'sphysiology22ndeditionpage
111,http://en.wikipedia.org/wiki/Preload_%28cardiology%29
"Forcardiaccontraction,thepreloadisusuallyconsideredtobethe
end-diastolicpressurewhentheventriclehasbecomefilled"

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Quantitatively,preloadcanbecalculatedas
WhereLVEDP=Leftventricularenddiastolicpressure,LVEDR=
Leftventricularenddiastolicradius(attheventricle'smidpoint),and
h=thicknessoftheventricle.ThiscalculationisbasedontheLawof
Laplace.

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154.Strokevolumeisincreasedby?
a)Increasedend-diastolicandend-systolicvolumes
b)Decreasedend-diastolicandend-systolicvolumes
c)Increasedend-diastolicvolumeanddecreasedend-systolic
volume

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d)Decrasedend-diastolicvolumeandincreasedend-systolic
volume
CorrectAnswer-C
Ans.is'c'i.e.,Increasedend-diastolicvolumeanddecreasedend-
systolicvolume

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Thestrokevolumeistheamountofbloodpumpedoutbyleft
ventricleineachstroke.
Strokevolumeisgivenbythedifferencebetweenend-diastolic
ventricularvolume(thevolumeofbloodintheleftventricleatthe
endofdiastole;normal120inl)andend-systolicventricularvolume

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(thevolumeofbloodattheendofsystole;normal50ml).
Strokevolume(70ml)=End-diastolicventricularvolume(120ml)-
End-systolicventricularvolume(50ml)

155.Theplateauphaseofthisgraphisdue

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to:
a)Themovementoffewersodiumionsacrossthecellmembrane
b)Thecalciumchannelsremainingopenlongerthanthesodium
channels
c)Theincreasedmembranepermeabilitytopotassiumion

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d)Adecreaseintheamountofcalciumdiffusingacrossthe
membrane
CorrectAnswer-B
Ans:B.)Thecalciumchannelsremainingopenlongerthanthe
sodiumchannels.

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Actionpotentialofcardiacmuscles:

Phase2/"Plateauphase":
*Calciumchannelsopenandfastpotassiumchannelsclose.
*Abriefinitialrepolarizationoccurs.

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Whyplateau-shaped?
*Actionpotentialthenplateausasaresultof,
-Increasedcalciumionpermeability
-Decreasedpotassiumionpermeability.
Eventsduringphase2:
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*Thevoltage-gatedcalciumionchannelsopenslowlyduringphases
1and0,andcalciumentersthecell.Potassiumchannelsthenclose,
andthecombinationofdecreasedpotassiumioneffluxand
increasedcalciumioninfluxcausestheactionpotentialto
plateau
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Noteonotherphases:
1.Phase0/Depolarization:
*Fastsodiumchannelsopen.
*Whenthecardiaccellisstimulatedanddepolarizes,themembrane
potentialbecomesmorepositive.

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*Voltage-gatedsodiumchannels(fastsodiumchannels)open
andpermitsodiumtorapidlyflowintothecellanddepolarizeit.

*Themembranepotentialreachesabout+20millivoltsbeforethe
sodiumchannelsclose.
2.Phase1/"InitialRepolarization":
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*Fastsodiumchannelsclose.
*Cellularrepolarizationstarts,andpotassiumionsleavethecell
throughopenpotassiumchannels.
3.Phase3/"RapidRepolarization":
*Calciumchannelscloseandslowpotassiumchannelsopen.

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*Theclosureofcalciumionchannelsandincreasedpotassiumion
permeability.
*Thispermitspotassiumionstorapidlyexitthecell,ends
theplateauandreturnsthecellmembranepotentialtoitsresting
level.

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4.Phase4/"Restingmembranepotential":
*Averagesabout"-90millivolts"

156.Vasoconstrictioninskin?
a)Sympathetic
b)Parasympathetic

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c)Whealandflare
d)Warmclimate
CorrectAnswer-A
Ans.A.Sympathetic
Sympatheticstimulationactingviaalpha1and2arevasoconstrictor

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totheskinarterioles.

157.Normalinterstitialpressureis?
a)10to15mmHg
b)-5to0mmHg
c)20to30mmHg

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d)-10to-20mmHg
CorrectAnswer-B
Ans.B.-5to0mmHg
Normalinterstitialfluidhydrostaticpressure(orsimplyinterstitial
pressure)isusually-1mHg.

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Howeveritvariesaccordingtotissuesandrangesfrom-5mmHgto
-1mmHg.
Itisslightlysubatmosphericinmostofthetissues.

158.Striatumdamageaffectsprimarily?
a)Proceduralmemory

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b)Shorttermmemory
c)Longtermmemory
d)Explicitmemory
CorrectAnswer-A
Ans.A.Proceduralmemory
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Proceduralmemoryisatypeofimplicitmemorythatenablesusto
carryoutcommonlyleanedtaskswithoutconsciouslythinkingabout
them,e.g.,ridingabike,tyingashoeorwashingdishes.
Proceduralmemorylikelyusesadifferentpartofbrainthanepisodic
memory-withbraininjuryyoucanloseone'sabilitywithoutlosing

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other.
That'swhyapersonwhohasexperiencedamnesiaandforgetmuch
abouthisorherpersonallifeoftenretainsproceduralmemoryi.e.,
howtodriveacaroruseaforketc.
Striatum(apartofbasalganglia)isresponsibleforprocedure

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memory.

159.Somatosensorycortexlesionwillcause
?
a)Pain
b)Temperature

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c)Localization
d)Vibration
CorrectAnswer-C
Ans,C,Localization
Corticallesionsdonotabolishallthesomaticsensations.Cortical

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anesthesiamainlyinvolvelossofproprioceptionandtactile
sensations(finetouch,twopointdiscrimination,astereognosisor
stereoanesthesia.
Painandtemperatureareleastaffected,buttheyarepoorly
localization.

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160.Settingposturebeforeplanned
movement?
a)Premotorcortex
b)Motorcortex
c)Frontal

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d)Supplementarymotorcortex
CorrectAnswer-A
Ans.A.Premotorcortex
Thepremotorcortexfunctionisstillincompletelyunderstood,butit
maybeconcernedwithsettingpostureatthestartofaplanned

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movementandwithgettingthelndividualpreparedtomove.
Itismostinvolvedincontrolofproximallimbmusclesneededto
orientthebodyformovement.

161.Allthefollowingfeaturesareseeninneuronsfromdorsalrootganglia,
EXCEPT:

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a)Theyaremultipolar
b)Theycontainlipofuscingranules
c)Theyhavecentrallylocatednuclei
d)Theyarederivedfromneuralcrestcells
CorrectAnswer-A

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Dorsalrootganglionconsistofsensoryneuronswhichare
pseudounipolarandhavenosynapticconnectionsintheganglion.
Theyareclassifiedaspseudounipolarbecauseitlacksdendrites
andhasasingleaxonthatbifurcateintoacentrallyefferentbranch
thatfunctionsasadendritetocarryafferentsensorysignals.

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162.Neuronsinsympatheticgangliaare?
a)Unipolar
b)Bipolar
c)Pseudounipolar
d)Multipolar

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CorrectAnswer-D
Ans,d.Multipolar
Ventral,lateralanddorsalhornsofspinalcordandsympathetic
chaingangliacontunmultigolarneuron,whereasdorsalrootganglia
containspseudounipolarneurons.

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163.Pt.isabletorecognisepersonbyname
butnotbyface.Lesionisin?
a)Postparietalregion
b)Occipital
c)Frontallobe

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d)Temporallobe
CorrectAnswer-D
Ans.D.Temporallobe
Animportantpartofthevisualinputgoestotheinferiortemporal
lobe,whererepresentationsofobjects,particularlyfacesarestored.

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Inhumans,storageandrecognitionoffacesismorestrongly
representedintherightinferiortemporallobeinright-handed
individuals.

164.CSF/plasmaglucoseratiois?
a)0.2-0.4

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b)0.6-0.8
c)1.2-1.6
d)1.6-2.2
CorrectAnswer-D
Ans.D.1.6-2.2

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165.Burningpainiscarriedbywhichtypeof
fibres?
a)Aalpha
b)Adelta
c)Abeta

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d)C
CorrectAnswer-D
Ans.D.C
Painistransmittedviatwofibertypes:
*ThinlymyelinatedAdeltafibers(2-5mindiameter)whichconduct

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atratesof12-30m/s.
*UnmyelinatedCfibers(0.4-1.2mindiameter)whichconductatlow
ratesof0.5-2m/s.
-Thermoreceptorsalsospanthesetwoflbertypes.
-ColdreceptorsareondendriticendingsofAdeltafibersandC

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fibers,whereaswarmth(heat)receptorslueonCfibers.

166.Amansleptwithheadoverforearm,next
morninghecomplainsoftingling,
numbnessoverforearm.Itiscausedby
?

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a)SensitivitytohypoxiaisA>B>C
b)SensitivitytopressureisA>B>C
c)SensitivitytohypoxiaisC>B>A
d)SensitivitytopressureisB>A>C
CorrectAnswer-C

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Ans.C.SensitivitytohypoxiaisC>B>A
TypeCfibers(TypeIVLloyd&Hunt)areleastsusceptibleto
hypoxia'

167.Transducinisaproteinfoundin:
a)Glomerulus

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b)Retina
c)Skeletalmuscle
d)Adrenalmedulla
CorrectAnswer-B
RetinaREF:Ganong22ndedition,chapter8,

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http://en.wikipedia.org/wiki/Transducin
Transducin(alsocalledGt)isaheterotrimericGproteinthatis
naturallyexpressedinvertebrateretinarodsandcones.
Mechanismofaction:HeterotrimericTransducin(alpha-beta-gamma
subunits)isactivatedbyaconformationalchangeinrhodopsindue

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totheabsorptionofaphotonbyrhodopsin'sactivegroupretinal.
ActivationcausestheGDPboundtothealphasubunittobe
exchangedwithGTPfromsolutionandresultsinactivatedalpha
dissociatingfrombeta-gamma.
ActiveTransducin-alphathencausescyclicGMP

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Phosphodiesterasetoincreaseitsactivity,therebyloweringthe
concentrationofcGMP,anintracellularsecond-messenger
molecule.DecreaseincGMPconcentrationleadstotheclosureof
cGMP-regulatedNa+andCa2+ionchannelsandahyperpolarized
membranepotential.Thischainofsignalingeventsisalsocalled

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"thevertebratephototransductioncascade"

168.Lesionofpreopticnucleusof
hypothalamuscauses?
a)Hyperphagia
b)Hyperdypsia

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c)Hyperthermia
d)Hyperglycemia
CorrectAnswer-C
Ans.C.Hyperthermia
Preopticnucleusisconcernedwithregulationofbodytemperature.

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Therefore,itslesionwillresultindefectivetemperature

169.Shiveringiscontrolledby:
September2012,March2013
a)Dorsomedialnucleus
b)Posteriorhypothalamus

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c)Perifornicalnucleus
d)Lateralhypothalamicarea
CorrectAnswer-B
Ans.Bi.e.Posteriorhypothalamus
Shivering/Shuddering
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Itisabodilyfunctioninresponsetoearlyhypothermiainwarm-
bloodedanimals.
Whenthecorebodytemperaturedrops,theshiveringreflexis
triggeredtomaintainhomeostasis.
Musclegroupsaroundthevitalorgansbegintoshakeinsmall

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movementsinanattempttocreatewarmthbyexpendingenergy.
Shiveringcanalsobearesponsetoafever,asapersonmayfeel
cold,thoughtheircoretemperatureisalreadyelevated.
Locatedintheposteriorhypothalamusnearthewallofthethird
ventricleisanareacalledtheprimarymotorcenterforshivering.

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Thisareaisnormallyinhibitedbysignalsfromtheheatcenterinthe
anteriorhypothalamic-preopticareabutisexcitedbycoldsignals
fromtheskinandspinalcord.

170.

Sodiumchannelsaremaximuminwhichpart
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ofneuron?
a)Soma
b)Axonhillock
c)Dendrites
d)Axon

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CorrectAnswer-B
Ans.is'b'i.e.,Axonhillock
Inamotorneuron,theaxonhillockandtheinitialsegmentofaxon
havethelowestthresholdforexcitation.
Thisisbecausetheyhaveamuchhigherintensityofvoltagegated

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sodiumchannel.

171.Thedistancebywhichtwotouchstimuli
mustbeseparatedtobeperceivedas
twoseparatestimuliisgreatestat?
a)Thelips

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b)Thepalmofthehand
c)Thebackofscapula
d)Thedorsumofthehand
CorrectAnswer-C
Ans.C.Thebackofscapula
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Themagnitudeoftwopointdiscriminationthresholdsvariesfrom
placeofplaceonthebodyissmallestwheretouchreceptorsare
mostabundant.
stimulationpointsonthebackmustbeseparatedbyatleast65mm
beforetheycanbedistinguishedasseparate,whereasonthe

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fingertipstwostimuliassrecognizediftheyareseparatedbyaslittle
as2mm.

172.Purkinjefibresareinhibitoryfor?
a)Deepcerebellarnuclei
b)Climbingfibre

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c)Basketcells
d)Spinocerebellartracts
CorrectAnswer-A
Ans.A.Deepcerebellarnuclei
Aftercomplexinhibitingandexcitatoryinteractionsofvariousfibers

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andcellsinthecortex,theoutputofcerebellarcortex,isprojectedto
deepcerebellarnucleibyaxonsofpyramidalcells(onlyoutputcells
ofcerebellarcortex).
TheoutputofthePurkinjecellsisinhibitoryinthedeepcerebellar
nuclei.

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However,theoutputofdeepcerebellarnucleitothebrainstemand
thalamusisalwaysexcitatorybecause,besideinhibitoryinputsof
purkinjecells,deepcerebellarnucleialsoreceiveexcitatoryinputs
fromafferentmossyandclimbingfiberswhichusuallyaremore
prominent.

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173.Neurotransmitterinvolvedin
nigrostriatialpathwayis?
a)Serotonin
b)Dopamine
c)Cholinergic

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d)Adrenergic
CorrectAnswer-B
Ans.B.Dopamine
Dopaminergicnigrostriatalprojectionfromthesubstantianigrapars
compacta(sNpc)tothestriatumCaudatenucleusandputrrnen)and

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correspondingGABAergicproiectionfromstriatumtosubstantia
nigraparsreticulate(SNPR).
Dopamineisthemajorneurotransmitterinsubstantianigra.

174.Lossofproprioception&finetouch?
a)Anteriorspinothalamictract

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b)Lateralspinothalamictract
c)Dorsalcolumn
d)Corticospinaltract
CorrectAnswer-C
Ans.C.Dorsalcolumn

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175.Trueaboutspinocerebellartractis?
a)Equilibrium
b)Smoothensandcoordinatesmovement
c)Learninginducedbychangeinvestibuloocularreflex
d)Planningandprogramming

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CorrectAnswer-B
Ans.B.Smoothensandcoordinatesmovement
Spinocerebellumisconcernedwithsmootheningandcoordinationof
movements.
Itachievesthisbygettingamomenttomomentreportby

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spinocerebellartract.

176.Vomitingcentreissituatedinthe:
September2008
a)Hypothalamus
b)Midbarin

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c)Pons
d)Medulla
CorrectAnswer-D
Ans.D:Medulla
Vomitingisbelievedtobecontrolledbytwodistinctbraincentres--

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thevomitingcentreandthechemoreceptortriggerzone--both
locatedinthemedullaoblongata.
Thevomitingcentreinitiatesandcontrolstheactofemesis,which
involvesaseriesofcontractionsofthesmoothmusclesliningthe
digestivetract

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177.Chemoreceptorsarelocatedinwhich
area?
a)Medulla
b)Archofaorta
c)Bifurcationofcarotidartery

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d)Alloftheabove
CorrectAnswer-D
Ans.is'd'i.e.,AIIoftheabove
Centralchemoreceptors-VentralSurfaceOfMedulla.
Peripheralchemoreceptors-Atbifurcationofcommoncarotidartery

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(carotidbody)andarchofaorta(aorticbodies)

178.Saltytaseisdueto?
a)Ca+2channels
b)Na+channels
c)G-protein

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d)H+channels
CorrectAnswer-B
Ans,B.Na+channels
Salty-tastingsubstancesdepolarizetastecellsbyactivating
amiloride-sensitiveNa+channels.

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179.Restingmembranepotentialinnerve
fibre
a)Isequaltothepotentialofventricularmusclefibre
b)Canbemeasuredbysurfaceelectrodes
c)IncreasesasextracellularK+increases

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d)DependsuponK+equilibrium
CorrectAnswer-D
Di.e.Dependsonpotassiumionequilibrium

180.Epinephrinereducesinsulinby?
a)Alphaactionpredominantly

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b)Betaactionpredominantly
c)Alphaandbeta
d)Muscarinicreceptors
CorrectAnswer-A
Ans.A.Alphaactionpredominantly
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Epinephrinedecreasesinsulinreleaseviaalpha-2actionas
pancreaticbeta-cellshasalpha-2receptors.

181.Adrenalineeffectsinsulinby?
a)Stimulationofalphacells
b)Stimulationofbetacells

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c)Stimulationofdeltacells
d)Stimulationofgcells
CorrectAnswer-B
Ans.B.Stimulationofbetacells
Adrenalinedecreasesinsulinsecretionbyactingonalpha-2

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receptorsonbeta-cellsofpancreas.

182.Smoothmusclephysiologydifferent
fromskeletalmuscle
a)K+requiresforcontraction
b)Ca2+requiredforcontraction

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c)Troponinisabsent
d)Myosinisrequiredforcontraction
CorrectAnswer-C
Ans.is'c'i.e.,Troponinisabsent
*Troponinisabsentinsmoothmusclebutrequiredinskeletal

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musclesforcontraction.
*Ca+andMyosinarerequiredbybothsmoothmusclesandskeletal
muscles.
*K+hasnodirectroleinthecontractionofsmoothmuscleand
skeletalmuscle.

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Smoothmusclecontraction
*Insmoothmuscle,thereisnotroponin.Thereforecalciuminitiates
contractionthroughamechanismdifferentfromthatemployedby
skeletalmuscle.Smoothmusclecontainsacalcium-bindingprotein
calledcalmodulin.Anincreaseincytoplasmic(sarcoplasmic)

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calciumleadstoitsbindingtocalmodulin.Thecalcium-calmodulin
complexactivatesmyosinkinase,alsocalledmyosinlightchain
kinase(MLCK).MLCKisaphosphorylasewhichphosphorylatesa
lightchainbelongingtomyosinchain,oftencalledcross-bridge
phosphorylation.Thephosphorylatedmyosinheadinteractswith

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actin,i.e.,cross-bridgingofmyosinwithactin.Thecross-bridging
leadstocontraction.
*Thereversalofcontractileresponsedependsonareductionin

sarcoplasmiccalciumbycalciumpumpsinthesarcoplasmic
reticulummembraneandsarcolemmawhichpumpcalciumintothe

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sarcoplasmicreticulumandextracellularfluidrespectively.
Reductionincytoplasmic(sarcoplasmic)calciumlevelactivatesan
enzymemyosinphosphatase.Myosinphosphatase
dephosphorylatesthemyosinhead,therebyterminatingtheactin-
myosininteractionandproducesrelaxation.

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So,calciuminfluxhastwofunctionsinsmoothmuscles:-
*Generationofactionpotential
*Essentialforcontractioninitiation(Excitationcontractioncoupling)
-Itisinterestingtoknowthatalthoughdephosphorylationofmyosin
headisnecessaryforrelaxation,thedephosphorylationofmyosin

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doesnotnecessarilyleadtotherelaxationofthesmoothmuscle.
Thisisduetothelatchingeffect,i.e.,myosinbridgesholdontothe
actinfilamentlikealatch.Duetothissmoothmusclecontracts,and
itcanmaintainitscontractionforaprolongedperiod(sustained
contraction)foralongperiodwithminimalexpenditureofenergy

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Characteristicfeatureofsmoothmuscle.
-Aswithskeletal,muscleATPisrequiredwhichishydrolyzedby
myosinheadwhichhasATPaseactivity(Inasimilarwayasin
skeletalmuscle).

183.Motormarchisseenin?

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a)Axontemesis
b)Neurotemesis
c)Neuropraxia
d)Nerveregeneration
CorrectAnswer-A

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Ans.A.Axontemesis
Motormarch(sequentialreinervationofmusclesfromproximalto
distal)isseeninaxontemesis.
InneuroPraxiathereisnoanatomicdisruption,somotormarchisnot
seen.

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Inneurotemesisthereisnorecovery,thusnomotormarch'

184.Whenthetensioninamusclefibreis
maximum,itslengthiscalledas?
a)Equilibriumlength
b)Optimumlength

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c)Initiallength
d)None
CorrectAnswer-B
Ans.B.Optimumlength
Uptoalimitgreatertheinitiallength(i.e.,lengthatrelaxed-state)

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greateristheforceofcontraction.
I.e.,thereisanoptimallength,atwhichtheforcegeneratedbya
muscleismaximal'

185.Tetaniccontractionisdueto
accumulationof?

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a)Na+
b)Ca+
c)K+
d)Cl?
CorrectAnswer-B

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Ans.B.Ca+
Tetaniccontractionisaboutfourtimesthetwitchtension,
Followingtheoryhasbeenputforwardforthishighertension
generatedduringmuscletetanus:-
Duringasingletwitch,theamountofCa+2isreleasedinto

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sarcoplasmisnotenoughtoproducetetanictension.
Whenthemuscleisstimulatedinrapidsuccession,Ca+2comesout
intothesarcoplasmwitheachstimulusandthereisaprogressive
accumulationofCa+2,inthesarcoplasm.
TetanictensionisreachedwhensarcoplasmicCa+2levelsreach

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theirmaximum.

186.WhichofthefollowingisNOTTRUEaboutCSF?
a)RemovalofCSFduringduraltapcausesintenseintracranial
headache
b)Normallycontainnoneutrophils

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c)Formedbyarachnoidvilliwithintheventricles
d)pHislessthanthatofplasma
CorrectAnswer-C
TheCSFisformedinthechoroidplexusesandtheremainderisformedaround
bloodvesselsandalongventricularwalls.CSFfillstheventriclesandsubarachnoid

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space.Inhumans,thevolumeofCSFisabout150mLandtherateofCSFproductionis
about550mL/d.ThustheCSFturnsoverabout3.7timesaday.ThecompositionofCSFis
essentiallythesameasthatofbrainextracellularfluid(ECF),whichinlivinghumansmakes
up15%ofthebrainvolume.pH(7.31-7.34)slightlylessthanplasma(7.35-7.45).CSF
containnoneutrophils.Itsdifferentialcountis:Lymphocyte-60-70%,Monocytes-30-50%,

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Neutrophils-None.
Ref:BarrettK.E.,BarmanS.M.,BoitanoS.,BrooksH.L.(2012).Chapter33.Circulation
throughSpecialRegions.InK.E.Barrett,S.M.Barman,S.Boitano,H.L.Brooks(Eds),
Ganong'sReviewofMedicalPhysiology,24e.

187.Duringacclimitisation,decreased

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sweatingisduetodownregulationof?
a)Epinephrinereceptors
b)Norepinephrinereceptors
c)Acetylcholinereceptors
d)Dopaminereceptors

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CorrectAnswer-C
Ans.C.Acetylcholinereceptors
Examinerjustwantstoknowthereceptorswhicharepresentin
sweatgland.
Sweatingisunderthecontrolofsympatheticsystem.Butthe

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neurotransmitterisacetylcholinewhichactsoncholinergic
sympatheticreceptors.

188.Substancethatiscompletelyreabsorbed
fromthekidney?
a)Na+

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b)K+
c)Urea
d)Glucose
CorrectAnswer-D
Ans.D.Glucose
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Onanormaldietmaximumsolutesarereabsorbedalmost
completely:-Glucose,Aminoacids&HCO3-:100%

189.Substratewhichisbothsecreted&
filtered?
a)UricAcid

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b)Glucose
c)Urea
d)Na+
CorrectAnswer-A
Ans,A.UricAcid
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SubstanceswhicharebothsecretedandfilteredareK+,uricacid
andcreatinine.

190.ANPactsatwhichsite?
a)Glomerulus
b)LoopofHenle

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c)PCT
d)Collectingduct
CorrectAnswer-D
Ans.D.Collectingduct
Theatrialnatriureticpeptides(ANPs)arepresentasgranulesinthe

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atrialmusclecells.
ANPisreleasedinresponsetoincreasedplasma
Na+concentration.
Ingeneral,theeffectsofANParephysiologicallyantagonisticto
thoseofangiotensinII.

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ANPcausesnatriuresisduetoincreasedGFRbyrelaxingmesangial
cellsofglomerulus.
ANPdecreasestheNa+reabsorptionfromthedistaltubuleand
collectingduct.
ANPdecreasesthesecretionofrenin,aldosterone,andADH.

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Inaddition,NPalsorelaxesthevascularsmoothmuscleinarterioles
andvenulesandthereforelowersBP.

191.AsfluidcomesdownthePCT,whatis
true?
a)Concentrationofureafalls

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b)ConcentrationofHCO3-falls
c)ConcentrationofNa'increases
d)Concentrationofinulindecreases
CorrectAnswer-D
Ans.D.Concentrationofinulindecreases

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192.Whichofthefollowingismostimportant
insodiumandwaterretention?
a)Renninangiotensinsystem
b)ANP
c)BNP

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d)Vasopressin
CorrectAnswer-D
Ans.D.Vasopressin
DespiteitseffectonNa+andwaterreabsorption,aldosteroneisa
weakregulatorofbodyNa,andwaterbalance,themajorregulator

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beingthe'thirst-ADH'mechanism.
Aldosteroneisthesoleregulatorofexternalpotossiumbalance".

193.Cephalicphaseofgastricsecretion?
a)20%
b)70%

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c)10%
d)100%
CorrectAnswer-A
Ans.A.20%
Cephalicphaseaccountsfor20%ofgastricacidsecretionand

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gastricphaseaccounts70-80%ofgastricacidsecretion.

194.Cephalicphaseofgastricsecretion?
a)Onfoodenteringstomach
b)Onfoodenteringintestine
c)Onseeingfood

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d)Onstress
CorrectAnswer-C
Ans.C.Onseeingfood
Thecephalicphaseofgastricsecretionoccursevenbeforefood
entersthestomach,especiallywhileitisbeingeaten.

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Itresultsfromthesight,smell,thought,ortasteoffood,andthe
greatertheappetite,themoreintenseisthestimulation.

195.Gastricsecretionis:
a)Inhibitedbycurare
b)Stimulatedbynoradrenaline

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c)Increasedbystomachdistention
d)Stimulatedbyanincreaseintonicactivity
CorrectAnswer-C
Ci.e.Increasedbystomachdistension

196.Whichinhibitsgastricsecretion?

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a)Secretin
b)Insulin
c)HighgastricpH
d)Calcium
CorrectAnswer-A

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Ai.e.Secretin
GastrinisahormonewhichisproducedbyG-cellsinthelateralwall
ofglandsintheantralportionofgastricmucose.Itisalsofoundin
pancreaticisletsinfetallife,gastrinomasofpancreas,andpituitary
glandQ,hypothalamus,medullaoblongataandinvagus&sciatic

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nerves.

197.Motilinsecretiondecreasedin?
a)Thirsty
b)Starving
c)Ingestedmeal

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d)Interdigestivestate
CorrectAnswer-C
Ans.C.Ingestedmeal
Whenamealisingested,secretionofmotilinissuppresseduntil
digestionandabsorptionarecomplete.

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198.WhichismaximallyabsorbedfromGIT?
a)Pentose
b)Hexose
c)Diasaccharide
d)Polysaccharide

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CorrectAnswer-B
Ans.B.Hexose
Hexosesarerapidlyabsorbedacrossthewallofthesmallintestine.

199.Pancreaticlipasehydrolysesester
linkageoftriacidglyceridesatposition?

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a)1&2
b)1&3
c)2&3
d)Only3
CorrectAnswer-B

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Ans.B.1&3
Mostfatdigestionthereforebeginsintheduodenum,pancreatic
lipasebeingoneofthemostimportantenzymesinvolved.
Thisenzymehydrolyzesthe1-and3-bondsofthetriglycerides
(triacylglycerols)withrelativeeasebutactsonthe2-bondsatavery

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lowrate,sotheprincipalproductsofitsactionarefreefattyacids
and2-monoglycerides(2-monoacylglycerols).
Itactsonfatsthathavebeenemulsified.

200.Gastricsecretionsareessentialfor
absorptionof-

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a)Cobalmin
b)Fat
c)Thiamine
d)Folicacid
CorrectAnswer-A

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Ans.A.Cobalmin
VitaminB12isabsorbedintheileum.
Thisvitaminbindstointrinsicfactor,aproteinsecretedbythe
stomach,andthecomplexisabsorbedacrosstheilealmucosa.

201.EffectofaceytylcholineonLES?

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a)Contraction
b)Relaxation
c)Noeffect
d)Contractionfollowedbyrelaxation
CorrectAnswer-A

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Ans.A.Contraction
Thisbarrieragainstrefluxoftheharmfulgastricjuice(pepsinand
HCDisstrengthenedwhenthesplincterpressureisraisedby-
1. Acetylcholine
2. Adrenergicagonists

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3. Gastrin
4. Motilin
5. Somatostatin
6. SubstanceP
7. Histamine

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8. PGF2-alpha.
9. Proteinrichfood
10. Highintraabdominalpressure.

202.Ptylinissecretedby?
a)Gastricgland

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b)Salivarygland
c)Duodenalgland
d)Pancreaticgland
CorrectAnswer-B
Ans.B.Salivarygland
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Salivaryamylaseisalsocalledptylinwhichissecretedinsalivaby
salivarygland.

203.PGsinsemenaresecretedby?
a)Prostate
b)Seminalvesicle

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c)Sperms
d)Testes
CorrectAnswer-B
Ans.B.Seminalvesicle

204.17OHsteroid?

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a)Androgen
b)Progesterone
c)Estrogen
d)None
CorrectAnswer-B

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Ans.B.Progesterone

205.GLUT2ispresentmainlyin?
a)Betacellsofpancreas
b)Placenta
c)Skeletalmuscle

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d)Cardiacmuscle
CorrectAnswer-A
Ans.A.Betacellsofpancreas

206.Glucosetransporterinvolvedininsulin
stimulatedglucosetransportisGLUT?

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a)1
b)2
c)3
d)4
CorrectAnswer-D

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Ans,D.4

207.Insulinisessentialforglucoseentryin?
a)Muscle
b)Corticalneurons
c)Renaltubularcells

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d)Betacellsofpancreas
CorrectAnswer-A
Ans.A.Muscle
Glucoseenterscellsbyfacilitateddiffusionor,intheintestineand
kidneys,bysecondaryactivetransportwithNa+.

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Inmuscle,adipose,andsomeothertissues,insulinstimulates
glucoseentryintocellsbyincreasingthenumberofglucose
transporterslnthecellmembranes.

208.Wolff?Chaikoffeffectisdueto?
a)SuppressionofTSHsecretion

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b)DecreasediodinationofMIT
c)DecreasedT3toT4conversion
d)Iodineintake
CorrectAnswer-D
Ans.D.Iodineintake
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Iodineisthefastestactingthyroidinhibitor.
Themostimportantactionisinhibitionofhormonerelease(thyroid
constipation),butallfacetsofthyroidsynthesismaybeaffected.
Excessiodideinhibitsitsowntransportinthyroidcellsandmayalter
theredoxpotentialofcells,thusinterferingiodinationreducedT3/T4

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synthesis(Wolff?Chaikoffeffect).

209.Majoradrenalandrogenis?
a)Testosterone
b)11-hydroxyderivativeofandrostenedione
c)17-ketosteroiddehydroepiandrosterone

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d)Cortisol
CorrectAnswer-C
Ans.C.17-ketosteroiddehydroepiandrosterone
Themajoradrenalandrogenisthel7-ketosteroid
dehydroepiandrosterone,althoughandrostenedioneisalso

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secreted.
Themajorandrogenoftestisistestosterone.

210.DiurnalvariationofACTHdependson?
a)Suprachiasmaticnucleus
b)Supraopticnucleus

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c)Ventrolateralnucleus
d)Thalamus
CorrectAnswer-A
Ans.A.Suprachiasmaticnucleus
ThebiologicclockresponsibleforthediurnalACTHrhythmis

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locatedinthesuprachiasmaticnucleiofthehypothalamus.

211.Hypothalamusincreasesreleaseofall
hormonesfromthepituitaryexcept?
a)TSH
b)FSH

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c)CRH
d)Prolactin
CorrectAnswer-D
Ans,D.Prolactin
Formostoftheanteriorpituitaryhormones.

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ltisthereleasinghormonethatareimportantbutprolactinismainly
undertheinhibitorycontrol.

212.1stresponsetohypoglycemia?
a)Decreasedinsulin
b)Increasedglucagon

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c)Increasedcortisol
d)Increasednorepinephrine
CorrectAnswer-A
Ans.A.Decreasedinsulin
Decreasedinsulinisthefirstresponsefollowedsuccessivelyby

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increaseinglucagon,epinephrine,cortisolandGH.

213.Velocityofhumansperm-
a)1-3mm/min
b)4-6mm/min
c)6-9mm/min

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d)10-13mm/min
CorrectAnswer-A
Ans.A.1-3mm/min
Humanspermmoveataspeedof-3mm/minthroughthefemale
genitaltract.

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Spermsreachuterinetubes30-60minutesaftercopulation.

214.Acidophilssecrete
a)GH
b)TSH
c)ACTH

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d)FSH
CorrectAnswer-A
Ans.A.GH
Acidophilsoftheanteriorpituitarysecretesgrowthhormone
andprolactin.

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215.Vasopressinissecretedby
a)Supraoptic
b)Preoptic
c)Paraventricular
d)Posteriornucleus

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CorrectAnswer-A
Ans.A.Supraoptic
ADHisformedprimarilyinthesupraopticnuclei,whereasoxytocinis
formedprimarilyintheparaventricularnuclei".

216.Growthhormoneleveldecreasedin

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a)Hypoglycemia
b)Fasting
c)Sleep
d)Exercise
CorrectAnswer-C

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Ans.C.Sleep
REMsleepdecreasesGHsecretionwhereasSlow-wavesleep(N3
ofNREM)causesanincreaseinGHsecretion.

217.Pituicytesareseenin?
a)Anteriorlobe

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b)Posteriorlobe
c)Intermediatelobe
d)All
CorrectAnswer-B
Ans.B.Posteriorlobe
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Pituicytesareglialcellsofposteriorpituitary.

218.Sizeofsperm?
a)100microns
b)65nm
c)100nm

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d)65microns
CorrectAnswer-D
Ans.D.65microns

219.cAMPactionmediatesallexcept?
a)Glucagon

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b)Folliclestimulatinghormone
c)Leutinizinghormone
d)Estrogen
CorrectAnswer-D
Ans.D.Estrogen

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220.InThyroidfollicleforhowlongThyroxine
isstored?
a)2-3weeks
b)2-3days
c)2-3months

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d)2-3years
CorrectAnswer-C
Ans.C.2-3months
Thyroidhormonesarestoredinthefolliclesinanamountsufficient
tosupplythebodywithitsnormalrequirementsofthyroidhormones

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for2to3months.

221.Ghrelinfalseis?
a)Producedbystomachcells
b)Increasedappetite
c)Isrelatedtoregulationofthyroidhormone

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d)Stimulatesgrowth
CorrectAnswer-C
Ans.C.Isrelatedtoregulationofthyroidhormone
Ghrelinissecretedprimarilybythestomachandappearstoplayan
importantroleinthecentralcontroloffoodintake.

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Italsostimulatesgrowthhormonesecretionbyactingdirectlyon
recePtorsinthepituitary.
Itisalsoproducedinthehypothalamusandhasmarkedgrowth
hormone-stimulatingactivity.

222.IsotopeusedtomeasureRBCvolumeis

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?
a)Cr51
b)H3
c)D20
d)I135

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CorrectAnswer-A
Ans.A.Cr51
BloodcellvolumeismeasuredbyCr51labeledRBC.

223.Glucoseistransportedinrenaltubular
cellsby

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a)Ksymport
b)Kantiport
c)Naantiport
d)Nacotransport
CorrectAnswer-D

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Ans.D.Nacotransport
Sodium-dependentglucosetransporters,SGLTIandSGLT2,are
responsibleforthesecondaryactivetransportofglucoseinthe
intestineandrenaltubules.
GlucoseandNa+bindtothesodium-dependentglucosetransPorter

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(SGLT)2intheapicalmembrane,andglucoseiscarriedintothecell
asNa+movesdownitselectricalandchemicalgradient.

224.Watertravellingfromextracellularto
intracellularisby?
a)Co-transport

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b)Diffusion
c)Filtration
d)Activetransport
CorrectAnswer-B
Ans.B.Diffusion
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Bestanswerofthisquestionisnonebecausetransportofwater
(solvent)acrossthecellmembraneiscausedbyosmosis.
Allthegivenoptionsarethetransportprocessesofsoluteacrossthe
cellmembrane(notforsolvent).
Howeveramongthegivenoptions,diffusionistheclosestone:

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"Diffusionofsolventtowardsanareawherethereishigher
concentrationofsoluteiscalledosmosis".

225.Osmolarityisdefinedas?
a)Numberofosmoleperlitre
b)Numberofosmoleperkg

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c)Weightofsoluteperlitre
d)Weightofsolventperlitre
CorrectAnswer-A
Ans.A.Numberofosmoleperlitre
Osmolarity>Numberofosmoleperlitre.

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Osmolality>Numberofosmoleperkg.

226.Insensiblewaterlossperdayis?
a)100ml
b)300ml
c)700ml

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d)1000ml
CorrectAnswer-C
Ans.C.700ml
Insensiblewaterloss-Thereiscontinuouslossofwaterby
evaporationfromrespiratorytractanddiffusionthroughtheskin,

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whichtogetheraccounts700ml/dayofwaterlossundernormal
conditions.
Theinsensiblewaterlossfromskin(diffusionthroughskin)occurs
independentlyofsweatingandaccounts350mlofwaterlossper
day.

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So,intheabsenceofsweating,waterlossfromtheskinis350
ml/day

227.Whichofthefollowingincreasesparticle
diffusionacrossthecellmembrane?
a)Increasingsizeofparticle

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b)Decreasinglipidsolubilityofsubstance
c)Increasinglipidsolubilityofsubstance
d)Decreasingsizeofopeningincellmembrane
CorrectAnswer-C
Ans.C.Increasinglipidsolubilityofsubstance
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Simplediffusionisfavoredbysmallsize,lipidsolubilityandabsence
ofpolarity(non-polarsubstance)andcharge(neutralmolecule)
throughathin,largemembranewheretheconcentrationgradientis
more.

228.MechanismofheatlossinmodernX-ray

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tubeis
a)Radiation
b)Evaporation
c)Conduction
d)Convection

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CorrectAnswer-A
Ans.A.Radiation
ThemechanismofheatlossinthemodernX-raytubeisradiation.
ClassicalX-raytube:
Theoutertubeismadeupofglass.
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Cathode-tungstenfilament.
Ananodeisthetargetandismadeoftungsten.
Themechanismofheatlossisconduction.
Theatomicnumberoftungstenis74.
ModernX-raytube:

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Theoutertubeismadeupofstainlesssteel
Cathode-tungsten+thorium
Anode-tungsten+10%rhenium.Ananodeisrotatingandthe
mechanismofheatlossisradiation.

229.Mostpotentantioxidant?

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a)VitA
b)VitK
c)VitE
d)VitC
CorrectAnswer-C

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Ans.C.VitE
VitaminE(tocopherol)isthemostinpotentantioxidantinthebody,
actinginthelipidphaseofmembranesprotectingagainsttheeffects
offreeradicals.

230.Inmoderateexcercisetherespiratory

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rateisincreasedduetoresponseof?
a)Propioceptionreceptorinthejoints
b)PCO2inarterialblood
c)PO2inarterialblood
d)J-receptorstimulation

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CorrectAnswer-A
Ans.A.Propioceptionreceptorinthejoints
Inmoderateexercisetheabruptincreaseinventilationatthestartof
exerciseisduetopsychicstimuliandafferentimpulsesfrom
proprioceptorsinmuscles,tendonsandjoints.

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231.Myosinfilamenthasafixedlengthof
a)0.16nm
b)1.6micrometers
c)16nm
d)l.6mm

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CorrectAnswer-B
Ans.B.1.6micrometers
Thetotallengthofeachmyosinfilamentisuniform,almostexactly
1.6micrometers.

232.Plasmamembraneismainlycomposed

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of?
a)Cholesterol
b)Carbohydrate
c)Phospholipid
d)Protein

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CorrectAnswer-D
Ans.D.Protein

233.Onweightbasis,themembranecontains
proteinandlipidintheratioof?
a)1:2

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b)1:1
c)2:1
d)4:1
CorrectAnswer-B
Ans.B.1:1
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Thecellmembranecontainsproteinsandlipidsina50:50ratio.This
referstotheratiooftheirmassesandnotnumbers".
Itisworthnotingherethatabovedescribedpercentageisintermsof
areaoccupied.However,intermsofmasses,thecellmembrane
containsproteinsandlipidsina50:50ratio.

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234.Whichofthefollowingisthecauseofnonshiveringthermogenesisin
adults?
a)Noradrenaline
b)Thyroidhormone
c)Musclemetabolism

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d)Brownfatbetweentheshoulders
CorrectAnswer-A
Nonshiveringthermogenesisreferstoincreaseinmetabolicratethatisnotaresultof
muscleactivity.Itappearstobeelicitedthroughsympatheticstimulationandcirculating
catecholamines.Epinephrineandnorepinephrinewhicharereleasedincreasesmetabolic

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activityandheatgeneration.
Ref:GuytonandHall-TextbookofMedicalPhysiology,10thEdition,Pages821,828-829;
MedicalPhysiology:PrinciplesforClinicalMedicineByRodneyA.Rhoades,4thEdition,
Page568;FundamentalsofHumanPhysiologyByLauraleeSherwood,Page489

235.Thethicknessofendometriumatthe

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timeofimplantationis:
a)3?4mm
b)20?30mm
c)15?20mm
d)30?40mm

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CorrectAnswer-A
Ans.isNone/ai.e.3-4mm
"7heEndometriumisinthesecretoryphasecorrespondingto20-
21daysofcycle"atthetimeofimplantation.
"Afterovulation,theendometriumnowdemonstratesacombined

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reactiontoestrogenandprogesteroneactivity.Mostimpressiveis
thattotalendometrialheightisfixedatroughlyitspreovulatory
extent(5-6mm)despitecontinuedavailabilityofestrogen."
Readingtheabovetextitisclearthatendometriumis-5-6mm
thickatthetimeofimplantation,whichisnotgivenintheoption.Still

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ifyouhavetomarkoneansweroption'a'i.e.3-4mmbeingclosest
couldberight.
ExtraEdge
Implantationoccurs7-9daysafterovulation?.
Inhuman,theblastocystburrowsintheuterinecavitytillwholeofit

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lieswithinthethicknessofendometrium.Thisiscalledasinterstitial
implantation.
Afterimplantationoftheembryotheuterineendometriumiscalled
thedecidua".
Deciduabasalis-Thepartofdeciduawheretheplacentaistobe

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formed.
DeciduaCapsularis-Thepartofthedeciduathatseparatesthe
embryofromtheuterinelumen.DeciduaParietalis-Thepartofthe

embryofromtheuterinelumen.DeciduaParietalis-Thepartofthe
decidualiningrestoftheuterinecavity.

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Attheendofpregnancy,thedeciduaisshedoffalongwithplacenta
andmembranes.

236.Digestiveenzymesare
a)Hydrolases
b)Oxidoreductases

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c)Dehydrogenases
d)Ligases
CorrectAnswer-A
Ans.is'a'i.e.,Hydrolases[RefHarper's29thlep.518-19]
Alldigestiveenzymesarehydrolases.

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237.Enzymesthatmoveamoleculargroup
fromonemoleculetoanotherareknown
as-
a)Ligases
b)Oxido-reductases

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c)Transferases
d)Dipeptidases
CorrectAnswer-C
Ans.isC.i.e.,Transferase[RefChatterjea8th/ep.123;Harper
28th/ep.52]

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TransferasesCatalyzetransferofC-N-,orP-containinggroupfrom
onesubstratetoanother,

238.Glucose-6-phosphatedehydrogenase
need-
a)NAD

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b)NADP
c)FAD
d)FMN
CorrectAnswer-B
Ans.is'b'i.e.,NADP[Ref:Harper29th/ep.197]
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NAD*-linkeddehydrogenasesPyruvatedehydrogenase,isocitrate
dehydrogenase,malatedehydrogenase,a-ketoglutarate
dehydrogenase,glutamatedehydrogenase,glyceraldehyde-3-P
dehydrogenase,lactatedehydrogenase,p-hydroxyacylCoA
dehydrogenase,glycerol3-Pdehydrogenase(cytoplasmic).

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NADP'-linkeddehydrogenasesGlucose-6-Pdehydrogenase,6-
Phosphogluconatedehydrogenase,3-ketoacylreductase,Enoyl
reductase,gulonatedehydrogenase.
FAD-linkeddehydrogenasesSuccinatedehydrogenase,fattyacyl
CoAdehydrogenase,glycerol-3Pet*hydrogenase(mitochondrial).

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239.WhichofthefollowingisNADPlinked
a)G6PD
b)APDH
c)a-ketoglutaratedehydrogenaes
d)None

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CorrectAnswer-A
Ans.is'a'i.e.,G6PD[RefHarper28"lep.175]
Amongstthegivenoptions,onlyG6-PD(glucose-6-phosphate
dehydrogenase)isNADPlinkedenzyme.

240.AldehydedehydrogenaserequiresNAD

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as?
a)Cofactor
b)Apoenzyme
c)Coenzyme
d)None

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CorrectAnswer-C
Ans.isC.i.e.,Coenzyme[RefReadbelow]
Thecompleteenzyme,i.e.proteinpart(apoenzyme)withitsnon-
proteinpartiscalledHoloenzyme.
Alcoholdehydrogenaseistheenzyme(protein)partofcomplete

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enzyme(Holoenzyme).Thus,alcoholdedydrogenaseitselfis
apoenzyme.
Itrequiresnon-proteinpartNAD,whichisanorganiccomponent.
So,NADactsascoenzymeforalcoholdehydrogenase.

241.Apoenzymeis?

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a)Cofactor
b)Coenzyme
c)Proteinmoiety
d)None
CorrectAnswer-C

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Ans.is'c'i.e.,Proteinmoiety[RefHarper2815/ep.52]
Thecompleteenzyme(Holoenzyme)ismadeofproteinportion
(apoenzyme)andcofactor/coenzyme.

242.Inxanthineoxidasecofactoris?
a)Selenium

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b)Zn
c)Molybdenum
d)Mg
CorrectAnswer-C
Ans.is'c'i.e.,Molybdenum[Ref:Essentialbiochemistryp.786]
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Twoimportantenzymesusingmolybdenumarexanthineoxidase
andsulfiteoxidase.

243.Whatareisoenzyme-
a)Physicallysameformsofdifferentenzymes
b)Physicallydisinctformsofsameenzyme

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c)Formsofsameenzymethatcatalyzedifferentreactions
d)Formsofdifferentenzymethatcatalyzesamereactions
CorrectAnswer-B
Ans.is'b'i.e.,Physicallydisinctformsofsameenzyme
Isoenzymesarethephysicallydistinceformsofthesameenzyme.

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Theycatalyzethesamechemicalreactionorreactionsbutdiffer
fromeachotherstructurally?,electrophoretically?and
immunologically.
Isoenzymespossessquaternarystructure,andaremadeupoftwo
orthreedifferentsubunit?(multimericQ).

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Thesubunitshaveslightlydifferentprimarystructures.Isoenzymes
catalyzethesamereactionandactonsamesubstrate?,butwith
differentKm?andVmaxvalues,i.e.,isozymeshavedifferent
kinetics?.
Theisoenzymescanbeseparatedfromeachotherby

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electrophoretic,chromatographicorimmunochemicaltechniques.
Separationandquantitationofisoenzymescangiveinformationof
greatdiagnosticimportanceasthetissuedistributionofisoenzymes
isquitespecific

244.Enzymecausingcovalentbondcleavage

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withouthydrolysis?
a)Lyase
b)Ligase
c)Hydrolase
d)Transferase

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CorrectAnswer-A
Ans.is'a'i.e.,Lyase[RefClassificationofenzymesfromyour
notes]
Cleavagebyhydrolysis(additionofwater)Hydrolases
Cleavagewithouthydrolysis(withoutadditionofwater)Lyases

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245.Enzymesactby?
a)Increaseinactivationenergy
b)Decreaseinactivationenergy
c)Shiftequilbriumconstant
d)None

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CorrectAnswer-B
Ans.is'b'i.e.,Decreaseinactivationenergy
Inachemicalreaction,thesubstratehastobeconvertedtoahigher
energyform(calledtransitionform)beforeitcanformthereaction
products.

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Thetransitionstateisstructurallyanintermediatebetweenthe
substrateandtheproduct,andrepresentsthehighestenergy
arrangementofatoms.
Therefore,itisunstable;onceformed,itdecomposesalmost
immediatelytoformthereactionproduct.

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So,thishighenergyintermediateactsasenergybarrier,separating
thesubstratesandtheproducts.
Thisbarrier,calledthefreeenergyofaction,istheenergydifference
betweentheenergyofthesubstratesandhighenergy
intermediates.

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Inotherwords,initiallysomeenergymustbeputintothesubstrate
forconversionintotransitionstate(high-energyintermediate);thisis
thefreeenergyofactivation.
Theenzymesspeedupthechemicalreactionbyloweringthe
magnitudeoftheactivationenergybarrier,i.e.,freeenergyof

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activation.

246.Kmvalueisdefinedas:
a)SubstrateconcentrationatVmax/2
b)SubstrateconcentrationoftwiceVmax
c)SubstrateconcentrationofthriceVmax

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d)SubstrateconcentrationofonethirdVmax
CorrectAnswer-A
Ans.A.SubstrateconcentrationatVmax/2

247.ThepredominantisoenzymeofLDH
occuringinliverinjuryis?

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a)LDH-1
b)LDH-2
c)LDH-4
d)LDH-5
CorrectAnswer-D

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Ans.is'd'i.e.,LDH-5[Ref:Essentialsofbiochemistryp.756]
PredominantforminliverisLDH5.

248.Specificactivityofenzymeis?
a)limo'ofenzymepergramofsubstrate
b)Enzymeunitspermgofprotein

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c)Conc.ofsubstratetransformedperminute
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Enzymeunitspermgofprotein[RefLippincott's
3"1/ep.

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249.Typeofinhibitionofaconitaseby
Transaconitateis?
a)Non-competitive
b)Competitive
c)Allosteric

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d)None
CorrectAnswer-B
Ans.is'b'i.e.,Competitive[RefEssentialsofBiochemistryp.
685]

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enzymes
competitiveinhibitors
1
Lactatedehydrogenase
Oxamate

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2
Aconitase
Transaconitate
3
Succinate

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MalanateQ
dehydrogenase
4
HMG-CoAreductase
HMG,Lovastatin

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5
Dihydrofolatereductase
Amethopterin,Methotrexate
6
Xanthineoxidase

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Allopurinol
7
Alcoholdehydrogenase
Ethanol
8

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Carbonicanhydrase
Acetazolamide
9
Digoxin
Na-KATPase

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10
5-Fluorouracil
Thymidylatesynthase

250.Functionalplasmaenzymeis?
a)Fibrinogen

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b)LDH
c)SGOT
d)SGPT
CorrectAnswer-A
Ans.is'a'i.e.,Fibrinogen[Refharper's28th/ep.59]
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Clotingfactors(includingfibrinogen)arefunctionalplasmaenzymes.

251.Substratelevelphosphorylationisby
a)Pyruvatekinase
b)Phosphofructokinase
c)Hexokinase

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d)ATPsynthase
CorrectAnswer-A
Ans.'A'Pyruvatekinase
SubstrateLevelPhosphorylation-
InGlycolysis-

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Phosphoglyceratekinase
Pyruvatekinase
InCitricAcidCycle-
Succinatethiokinase

252.Substratelevelphosphorylationoccurinstepcatalysedbywhichofthe

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followingenzymeinTCAcycle?
a)Isocitratedehydrogenase
b)Malatedehydrogenase
c)Aconitase
d)Succinatethiokinase

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CorrectAnswer-D
SuccinatethiokinaseistheenzymethatgeneratesATPdirectlyby
substrate-levelphosphorylation.InKrebscyclesuccinatethiokinase
catalyzetheconversionofSuccinylCoAintosuccinate.Inthisstep
GDPisphosphorylatedtoGTP.GTPcanthenbeconvertedtoATP

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byreactingwithanADPmolecule.
Substrate-levelphosphorylationisatypeofmetabolismthatresults
intheformationandcreationofadenosinetriphosphate(ATP)or
guanosinetriphosphate(GTP)bythedirecttransferanddonationof
aphosphoryl(P03)grouptoadenosinediphosphate(ADP)or

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guanosinediphosphate(GDP)fromaphosphorylatedreactive
intermediate.
Inglycolysissubstratelevelphosphorylationoccurintwosteps:
Conversionof1,3BPGto3Phosphoglyceratecatalyzedby
Phosphoglyceratekinase

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ConversionofPhosphoenolpyruvatetopyruvatecatalyzedby
Pyruvatekinase
Ref:TextbookofBiochemistryByDMVasudevan,3rdEdition,
Page195

253.InETC,cyanideinhibits?

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a)ComplexI
b)CytochromeCoxidase
c)ComplexIV
d)ComplexIII
CorrectAnswer-B:C

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Ans.is'b'i.e.,CytochromeCoxidase&'c'i.e.,ComplexIV
[RefHarper29th/ep.127,28th/ep.108,109;Vasudevan6thlep.
234]
*ComplexI:-Barbiturates(amobarbital),piercidinA,rotenone,
chlorpromazine,guanithidine.

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*ComplexII:-Carboxin,TTFA,malonate.
*ComplexIII:-Dimercaprol,BAL,actinomycinA,Naphthyloquinone.
*ComplexIV(cytochromecoxidase):-Carbonmonoxide(CO),
cyanide(CN-),H2S,azide(N')

254.NADPHviaglycerophosphateshunt

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makeshowmanyATP?
a)1
b)2
c)3
d)4

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CorrectAnswer-B
Ans.is>b'i.e.,2[Ref:Harper29"/ep.129-130]
Inglycerophosphateshuttle,themitochondrialenzymeislinkedto
respiratorychain(ETC)viaaflavoprotein,Soonly1.5molofATP
areproduced(Accordingtooldercalculations,2ATPmolofATPare

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produced).
Inmalateshuttle,themitochondrialenzymeislinkedtoETCvia
NAD,so2.5molofATPareproduced(accordingtoolder
calculations3molofATPareproduced).

255.Enzymeinvolvedinoxidative

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phosphorylation?
a)Pyruvatekinase
b)SuccinylCoAthiokinase
c)NADHdehydrogenase
d)None

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CorrectAnswer-C
Ans.is'c'i.e.,NADHdehydrogenase[RefHarper29'/ep.126-
128,Vasudevan6thlep.234]
Oxidativephosphorylationtakesphasealongtheelectrontransport
chain(respiratorychain),wheretheATPissynthesizedindirectly

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fromcreationofaproteingradientandmovementofprotiensacross
innermitochondrialmembranehelpsinformationofATP.
Theproteingradientiscreatedbylargechangeinfreeenergydueto
transportofelectroninETC.ElectronsentertheETCviaNAD'or
FAD.

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ComplexI(NADH-CoQreductase)catalyzesthetransferof
electronfromNADHtocoenzymeQ(CoQ).{NADH-CoQreductase
isalsocalledNADHdehydrogenase.}.

256.Amongthefollowing,themaximum
redoxpotentialisfor:

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a)NADH/NAD
b)Succinate/Fumarate
c)Ubiquinone
d)Fe+3/Fe+2
CorrectAnswer-D

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Ans.Di.e.Fe+3/Fe+2
Becauseelectronstendtoflowspontaneouslyfromcarriesoflower
redoxpotential(E?)tocarriesofhigherredoxpotential.Theorder
(sequence)ofelectroncarriersinETCofmitochondria(andsothe
increasingorderofredoxpotential)is

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Substrate-->NADP+/NADPH-->NADVNADH-->NADH
dehydrogenase(FMN)/NADHdehydrogenase(FMNH2)-->
FAD/FADH2-->UbiquinoneorCoenzymeQ-->Fe3+/Fee*in
cytochromesb-->C-->a-+a3-->02

257.InETCNADHgenerates-

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a)1ATPs
b)2ATPs
c)3ATPs
d)4ATPs
CorrectAnswer-C

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Ans.is'>c'i.e.,3ATPs[Ref:Harper28'"/ep.106,Vasudevan
5thiep.231]
TheenergyliberatedofsiteI(complexI)isusedtosynthesize1
ATPmolecule,atsiteII(complexIII)isusedtosynthesize1ATP
moleculeandatsiteIII(ComplexIV)isusedtosynthesize1/2ATP

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molecule.
Thus,when1NADHmoleculeenterstherespiratorychain,it
produce2.5moleculesofATP?.WhenImoleculeofFADH2
enterstherespiratorychainonly1.5moleculesofATPare
produced?assiteIofenergyliberationisbypassed.

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Note:PreviouslyitwasassumedtheNADHproduces3ATPsand
FADgenerates2ATPs.Recentexperimentsshow-thattheseold
valuesareoverestimatesandNADHproduces2.5ATPs?and
FADH2produces1.5ATPs?.

258.Inglycolysis,inorganicphosphateis

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usedreaction,catalyzedby?
a)Enolase
b)Pyruvatekinase
c)Glyceraldehyde-3-pdehydrogenase
d)Aldolase

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CorrectAnswer-C
Ans.is'c'i.e.,Glyceraldehyde-3-pdehydrogenase[RefHarper's
250/ep.171]

259.Trueaboutglycolysis?
a)HexokinaseproduceATP

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b)1cycleproduces2ATP
c)Itproducesdirectly2moleculesoflactate
d)Aldolaseproducesirreversiblepolymerization
CorrectAnswer-C
Ans.is'c'i.e.,Itproducesdirectly2moleculesoflactate[Ref
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Harper29th/ep.170-177]
Eachcycleofanaerobicglycolysisproduces2moleculesoflactate
(lacticacid)whereasinaerobicconditionitproduces2moleculesof
pyruvate.
Optionbistrickyone.Eachglycolyticcycleproduces4ATPs(not

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2ATPs).Butoutofthese4ATPs,2areusedinthecycleitself.
Therefore,thereisnetgainof2ATPs.So,:-
1. Eachcycleofglycolysisproduces-4ATPs.
2. Eachcycleutilizes2ATPs
3. Netgainineachcycle-2ATPs

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260.Enzymesofglycolysisarefoundin:
a)Cytosol
b)Cellmembrane
c)Mitochondria
d)Ribososmes

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CorrectAnswer-A
Alloftheenzymesofglycolysisarefoundinthecytosol.
Ref:Harper28thedition,chapter18.

261.Theratelimitingstepinglycolysisis
catalyzedby?

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a)Pyruvatekinase
b)Enolase
c)Glucokinase
d)Phosphofructokinase
CorrectAnswer-A:C:D

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Ans.is'd>a&c'i.e.,Phosphofructokinase>Pyruvatekinase&
Glucokinase[RefLippincott's5thlep.99]
Phosphofructokinase,glucokinaseandpyruvatekinasearerate
limitingenzymesofglycolysis.However,phosphofructokinaseis
themostimportantone.

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262.NumberofATPmoleculesandNADH
formedineachcycleofglycolysis?
a)4ATP,2NADH
b)2ATP,2NADH
c)4ATP,4NADH

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d)2ATP,4NADH
CorrectAnswer-A
Ans.is'a'i.e.,4ATP,2NADH
Enegeticsofglvcolysis
Duringglycolysis2ATPareutilizedand4ATPareproducedat

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substratelevel.2reducingequalentsNADH'areproducedand
reoxidizedbyelectrontransportchain,togenerata5ATPmolecules
(2.5ATPperNADH'molecule).Thustotal9ATPmoleculesare
producedand2areutilized,i.e.,Thereisnetgainof7ATP
moleculesinaerobicglycolysis.

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Inanaerobicconditions,thereoxidationofNADHbyelectron
transportchainispreventedandNADHgetsreoxidizedby
conversionofpyruvatetolactatebylactatedehydrogenase.Thus,in
anaerobicglycolysisonly4ATPareproducedatsubstratelevel.
Therefore,thereisnetgainof2ATPmoleculesinanaerobic

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glycolysis.
Note:-PreviouscalculationsweremadeassumingthatNADH
produces3ATPsandFADH2generates2ATPs.Thiswillamountto
anetgenerationof8ATPsperglucosemoleculeduringglycolysis.
Recentexperimentsshowthattheseoldvaluesareoverestimates

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andNADHproduces2.5ATPsandFADH2produces1.5ATPs.
Thus,netgenerationisonly7ATPsduringglycolysis.

263.Allareactivatedbyinsulinexcept?
a)Lipoproteinlipase
b)Pyruvatekinase

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c)Hormonesensitivelipase
d)Acetyl-CoAcarboxylase
CorrectAnswer-C
Ans.isC.i.e.,Hormonesensitivelipase
Enzymes/Pathwaysactivatedbyinsulin

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Glycolysis:PFK-1,Pyruvatekinase,glucokinase,PDH.
Glycogenesis:Glycogensynthase.
Lipogenesis:Acetyl-Co-carboxylase,Fattyacidsynthase.
Cholesterolsynthesis:HMG-CoAreductase.
Triglyceridesynthesis:Acyl-CoAglycerol-3-Ptransferase,glycerol

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kinase.
Lipoproteindegradation:Lipoproteinlipase

264.Nonsensecodonsbringabout?
a)Elongationofpolypeptidechain
b)Pre-translationalmodificastionofprotein

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c)Initiationofproteinsynthesis
d)Terminationofproteinsynthesis
CorrectAnswer-D
Ans.isD.i.e.,Terminationofproteinsynthesis[RefHarper
28"lep.353,354]
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Stoporterminationornonsensecodons:-Threeofthe64possible
nucleotidetripletsUAAQ(amber0),UAGQ(Ochre)andUGAQ(opal)
donotcodeforanyaminoacid.Theyarecallednonsensecodons
thatnormallysignalterminationofpolypeptidechains0.Thus,though
thereare64possibletripletcodons,only61codesfor20amino

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acids(asremainingthreearenon-sensecodons).

265.ATPisconsumedatwhichstepof
glycolysis
a)Enolase
b)Hexokinase

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c)Pyruvatekinase
d)Isomerase
CorrectAnswer-B
Ans.is'b'i.e.,Hexokinase
ATPisconsumedatreactionscatalysedby-hexokinase,

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phosphofructokinaseI.
ATPisproducedatreactionscatalyzedby->phosphoglycerate
kinase,pyruvatekinase.

266.MethioninecanentretheTCAcycleat
whichlevel?

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a)Fumarate
b)Oxabacetate
c)Succinyl-CoA
d)Citrate
CorrectAnswer-C

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Ans.is'c'i.e.,Succinyl-CoA

267.RatelimitingstepsinTCAcycle?
a)a?KetoglutarateSuccinylCoA
b)Citrate-Isocitrate
c)SuccinylCoA4Succinate

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d)Succinate-Fumarate
CorrectAnswer-A
Ans.is'a'i.e.,alpha-Ketoglutarade-SuccinylCoA[RefHarper's
28th/ep.147,154]
RegulatingstepsinTCACyclearecatalyzedby:a)Citrate

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Synthase:CatalyzescondensationofacetylCoA&oxaloacetateto
fromcitrate.
Isocitratedehydrogenase:Catalyzestheconversionofisocitrateto
a-ketoglutaratebydecarboxylation.
a-ketoglutaratedehydrogenase:Catalyzestheconversionofa-

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ketoglutaratetosuccinylCoA

268.RatelimitingstepinTCAcycleis
catalyzedby-
a)a-ketoglotaratesynthase
b)Fumarase

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c)Aconitase
d)Thiokinase
CorrectAnswer-A
Ans.is'a'i.e.,a-ketoglotaratesynthase[RefHarper28th/ep.
147,154]

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269.Fluroacetateinhibits?
a)Citratesynthetase
b)Aconitase
c)Succinatedehydrogenase
d)Alphaketoglutaratedehydrogenase

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CorrectAnswer-B
Ans.is'b'i.e.,Aconitase[RefHarper28thIep.145]

270.Inhibitorsofglycolysisareallexcept?
a)Fluoride
b)Fluoroacetate

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c)Arsenite
d)Iodoacetate
CorrectAnswer-B
Ans.is'b'i.e.,Fluoroacetate[RefHarper's28`"/ep151]
FluoroacetateisaninhibitorofTCAcycle.

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271.Thebiosynthesisoftheenzymepyruvate
carboxylaseisrepressedby?
a)Insulin
b)Glucagon
c)Cortisol

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d)Epinephrine
CorrectAnswer-A
Ans.is'a'i.e.,Insulin[Ref:Harper28th/ep.168]
Gluconeogenesisisregulatedbyfourkeyenzymes:(i)Pyruvate
carboxylase;(ii)Phosphoenolpyruvatecarboxykinase;(iii)Fructose-

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1,6-bisphosphatase;and(iv)Glucose-6-phosphatase.
Thehormoneglucagon,epinephrineandglucocorticoidsstimulate
gluconeogenesis,byinducingtheseenzymes.Conversely,insulin
inhibitsgluconeogenesisbyrepressingtheirsynthesis.

272.Wherecanglucose6phosphatenotbe

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convertedtoglucose?
a)Muscle
b)Liver
c)Adiposetissue
d)Kidney

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CorrectAnswer-A
Ans.is'a'i.e.,Muscle[Ref:Harper250lep.178-179]
Glucose-6-phosphataseisabsentinmusclestherefore,glucose-6-
phosphatecannotbedegradedtofreeglucoseinmuscles.
Moreover,glucose-6-phosphatecannotdiffuseoutofthemuscles.

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Therefore,musclecannotprovideglucosetomaintainbloodglucose
level.Rather,muscleglycogenactsasasourceofenergy;the
glucose-6-phosphateenterstheglycolysistoproduceenergy.

273.Commonintermediatebetween
gluconeogenesisandfattyacid
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synthesis?
a)Glucose-6-phosphate
b)Acetyl-CoA
c)Citrate
d)Succinyl-CoA

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CorrectAnswer-C
Ans.is'c'i.e.,Citrate[RefHarper29thlep.188]
CitrateinGluconeogenesis
Gluconeogenesisinvolvesglycolysis,thecitricacidcycleandsome
specialreactions.

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Citrateisanintermediarymetabolismofgluconeogenesis(through
TCAcycle).

274.Glycogensynthaseisactivatedby?
a)Insulin
b)Glucagon

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c)Epinophrine
d)AMP
CorrectAnswer-A
Ans.is'a'i.e.,Insulin[RefHarper28th/ep.159-161,Lehinger
5th/ep.603,604]

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275.Glycogenstoragediseasewhich
presentsaslysosomalstoragedisease?
a)Vongierke'sdisease
b)Pompesdisease
c)Mcardle'sdisease

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d)Andersen'sdisease
CorrectAnswer-B
Ans.is'b'i.e.,Pompesdisease[RefLippincott's4th/ep.129-
131]
TypeIIglycogenstoragedisease(Pompesdisease)istheonly

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glycogenstoragediseasethatisalysosomalstoragedisease

276.Aldolase-Bisinvolvedinmetabolismof
?
a)Galactose
b)Fructose

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c)Sucrose
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Fructose[RefHarper's28th/ep.179)

277.Inhumans,ascorbicacidcannotbe

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synthesizedbecauseof?
a)DeficiencyofG6PD
b)Deficiencyofxylulosekinase
c)DeficiencyofL-gulonolactoneoxidase
d)Deficiencyofphosphoglucomutase

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CorrectAnswer-C
Ans.is'c'i.e.,DeficiencyofL-gulonolactoneoxidase
Inman,otherprimatesandguineapigs,ascorbicacidcanbe
synthesizedduetoabsenceofL-glucanolactoneoxidase,an
enzymeusedinloweranimalstosynthesiseascorbicacidasa

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byproductofuronicacidpathway(glucuronicacidcycle).

278.Glucoseoxidaseconvertsglucoseto?
a)Gluconicacid
b)Glucuronicacid
c)Iduronicacid

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d)Galacticacid
CorrectAnswer-A
Ans.is'a'i.e.,Gluconicacid[Ref:Internet]
Oxidase-peroxidaseenzymesystemisusedtodetermineglucosein
urine&blood.

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Glucoseoxidaseenzymeproduceshydrogenperoxide&gluconic
acidfromglucose.PeroxidasecatalysesthereactionofH202with
colourlesspotassiumiodidetobrowniodide.Thisproducesacolour
change,theintensityofwhichmayindicateglucoseconcentrationin
sometests(suchasBoehringer,Diastix).

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279.Glucoseisconvertedtoglucuronateby?
a)Oxidationofaldehydegroup
b)Oxidationofterminalalcohol
c)Oxidationofboth
d)None

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CorrectAnswer-B
Ans.is'b'i.e.,Oxidationofterminalalcohol[RefChatterjee8th/e
p.29]
Whenaldosesugarsareoxidizedtheymayformthreedifferent
sugaracid,dependinguponoxidationofaldehydegroup(atC-1)or

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terminalalcoholgroup(atC-6).
1. Aldonicacid:-Oxidationofanaldosewithhypobromousacid
(HOBr)oxidisesonlyaldehydegroupandconvertittocarboxyl
grouptoformaldonicacid.Forexample,glucoseisoxidizedto
gluconicacid.

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2. Saccharicacid:-Oxidationofaldoseswithnitricacidconvertboth
aldehydeandterminalprimaryalcoholgroupstocarboxylgroup,
formicsaccharicacid.Forexample,glucoseisoxidizeto
glucosaccharicacid.
3. Uronicacid:-Whenanaldoseisoxidizedinsuchawaythatthe

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terminalprimaryalcoholisconvertedistocarboxylwithoutoxidation
ofaldehydegroup,auronicacidisproduce.Forexample,glucoseis
oxidizedtoglucuronicacid.

280.Increaseduricacidlevelsareseenin
whichglycogenstoragedisease?

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a)TypeI
b)TypeII
c)TypeIII
d)TypeIV
CorrectAnswer-A

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Ans.is'a'i.e.,TypeI[RefHarper29m/ep.339]
PurineoverproductionandhyperuricemiainvonGierkedisease
(glucose-6-phosphatasedeficiency)occurssecondarytoenhanced
generationofPRPPprecursor,i.e.ribose-5-phosphate(apentose).
Inglucose-6-phosphatasedeficiency,glucose-6-phosphatecannot

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beconvertedtoglucose.Accumulatedglucose-6-phosphateisthen
metabolizedviaHMPshunt,whichinturngenerateslargeamounts
ofribose-5-phosphate,aprecursorofPRPP.Theincreased
synthesisofPRPPthenenhancesdenovosynthesisofpurine
nucleotides

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281.Gulonatedehydrogenaserequires?
a)NADP
b)NAD
c)FAD
d)FMN

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CorrectAnswer-A
Ans.is'a'i.e.,NADP[RepHarper29t5/ep.201-204]
Gulonatedehydrogenaseisanenzymeinglucuronicacidpathway
(uronicacidpathway)thatrequiresNADP'.

282.Allarereducingsugarsexcept-

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a)Sucrose
b)Lactose
c)Glucose
d)Fructose
CorrectAnswer-A

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Ans.A.Sucrose
Disaccharides
SugarUnits
Linkage
Trehalose(Sugarof

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DGlucose+
1-------1linkage
insecthemolymph, DGlucose
yeastandfungi)
Sucrose(CaneSugar) DGlucose

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1-------2
+DFructose
linkage

283.MutationinGLUT-2causes?
a)Dandywalkersyndrome

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b)Fanconibeckersyndrome
c)Beckwithsyndrome
d)Menke'sdisease
CorrectAnswer-B
Ans.is'b'i.e.,Fanconibeckersyndrome[RefDiagnosticof
--- Content provided by‍ FirstRanker.com ---
Endocrinefunctionischildrenandadolescentsp.271]
GLUT2isexpressedinpancreatic13-cells,hepatocytesandin
epithelialcellsofkidneyandintestine.
Fanconi-BickelsyndromeiscausedbyGLUT2mutation,adisease
characterizedbyproximalrenaltubulopathy,impairedglucose

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homeostasisandhepatomegaly.

284.Aminosugarareformedforms?
a)Glucose-1-phosphate
b)Glucose-6-phosphate
c)Fructose-1-phosphate

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d)Fructose-6-phosphate
CorrectAnswer-D
Ans.is'd'i.e.,Fructose-6-phosphate[RefDineshpuri3rdlep.
170]
Aminosugarsaredervativesofmonosaccharidesinwhichanamino

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groupreplacesthe-OHresidueoncarbon-2ofhexose,suchas
glucose,galactoseandmannose,Thecorrespondingcompounds
areglucosamine,galactosamineandmannosamine,respectively.
Theaminoacidgroupisusuallyacetylated,e.g.N-
acetylglucosamineorN-actylgalactosamine.

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Theaminosugarsarerequiredforthesynthesisofglycolipids,
glycoproteinsandproteoglycans.
Theyaresynthesizedfromfructose-6-phosphate

285.Differencebetweenganglioside&
cerebroside,allexcept?

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a)Charge
b)PresenceofNANA
c)Presenceofcarbohydrate
d)Nativetissue
CorrectAnswer-C

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Ans.is'c'i.e.,Presenceofcarbohydrate[RefLippincott's4th/e
p.208-210]
Bothgangliosideandcerebrosidecontaincarbohydrateasbothare
glycolipids.
NANAispresentinganglioside(notincerebroside).

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286.1"acetylgroupdonorinfattyacid
synthesisis?
a)MalonylCoA
b)Palmitate
c)AcetylCoA

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d)Citrate
CorrectAnswer-C
Ans.is'c'i.e.,AcetylCoA[Ref:Harper29"lep.216-217]
Acetyl-CoAactsasaprimertodonate1st2carbonatoms(C-15and
C-16)ofpalmitate.TheadditionofallthesubsequentC2unitsisvia

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malonyl-CoA.
Propionyl-CoAactsasprimer(fordonatingfirst3carbonatoms)in
thesynthesisofodd-carbonnumberfattyacids.

287.Onlyvitaminthathelpincarbonfixation
?

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a)Folicacid
b)Pantothenicacid
c)Niacin
d)Thiamine
CorrectAnswer-A

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Ans.is'a'i.e.,Folicacid

288.Ratecontrollingenzymeoffattyacid
synthesis-
a)Thioesterase
b)Transacetylase

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c)Acetyl-CoAcarboxylase
d)Ketacylsynthase
CorrectAnswer-C
Ans.is'c'i.e.,Acetyl-CoAcarboxylase[RefHarper29th/ep.217,
220]
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Productionofmalonyl-CoAistheinitial?andratelimitingstepinfatty
acidsynthesis.
Acetyl-CoAneedstobeconvertedtoactivatedform,whichwillserve
asthedonorofcarbonunitstogrowingfattyacidchain.
Malonyl-CoA?)a3-carboncompoundissuchactivatedform.

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Itisproducedbycarboxylationofacetyl-CoA,areactioncatalyzed
byacetyl-CoAcaroxylase?.Acetyl-CoAcarboxylaserequiresbiotin
asacofactor?.

289.Whichofthefollowingisrequiredfor
fattyacidsynthesis?

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a)NADPH
b)NADH
c)FADH
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,NADPH[RefHarper29th/ep.216-217]
FattyacidsynthesistakesplaceincytosolQ.
Acetyl-CoAistheimmediatesubstrateforlipogenesisandsynthesis
alwaysendsinformationofplamiticacie.
Inhumans;liverandlactatingmammaryglandsarethemainorgans

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forlipogenesisQ.
Althoughkidney,brain,lungsandadiposetissuearealsoinvolved,
toalesserextent.
CofactorrequirementsforfattyacidsynthesisareNADPH,ATP,
Mr1.2,biotinandHCO3-(asasourceofCO2).

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Becausemostfattyacidshavemultiplesoftwocarbons,theyare
synthesizedfromsuccessiveadditionoftwocarbonunits,thedonor
ofwhichisacetyl-CoA.
So,thebasicbuildingblockisacetyl-CoA?whichisthesourceofall
thecarbonatomsofthefattyacidbeingsynthesized.

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290.Citrateusedinfattyacidsynthesisuses
whichenzyme?
a)CitrateSynthase
b)ATPcitratelyase
c)Aconitase

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d)Malicenzyme
CorrectAnswer-B
Ans.is'b'i.e.,ATPcitratelyase[RefHarper's28th/ep.193,196]
Glucoseistheprimarysubstrateforlipogenesisandacetyl-CoA
(immediatesubstrateforfattyacidsynthesis)isformedfromglucose

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viaoxidationofpyruvatewithinthemitochondria.
However,acetyl-CoAcannotpenetrateinnermitochondrial
membrane.
Thereforeitistransferredintheformofcitrate.
Citrateisformedinthemitochondrialmatrixbythecondensationof

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acetyl-CoAwithoxaloacetate(firstreactionincitricacidcycle).
Thencitrateistransportedintocytosolviathetricorboxylate
transporterinexchangewithmalate.
Incytosol,citrateiscleavedbyATP-citratelyasetooxaloacetate
andacetyl-CoA.

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291.Whichofthefollowingisw-6fattyacid-
a)Cervonicacid
b)Linoleicacid
c)Alphalinolenicacid
d)Elaidicacid

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CorrectAnswer-B
Ans.is'b'i.e.,Linoleicacid[RefHarper28th/ep.123]
AlphalinolenicacidLinoleicacidOleicacid
ClupandonicacidGamalinolenicacidNervonicacid
CervonicacidArachidonicacidElaidicacid

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292.Linoleicacidis-
a)w-3fattyacid
b)w-6fattyacid
c)w-9fattyacid
d)Saturatedfattyacid

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CorrectAnswer-B
Ans.isb'i.e.,w-6fattyacid[RefHarper28thlep.123]

293.Lipogenesisoccursin?
a)Liver
b)Skeletalmuscles

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c)Myocardium
d)Lungs
CorrectAnswer-A:D
Ans.is'a>d'i.e.,Liver>Lungs
Fattyacidsynthesistakesplaceincytosol?.

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Acetyl-CoAistheimmediatesubstrateforlipogenesisandsynthesis
alwaysendsinformationofpalmiticacid.

294.Whichofthefollowingismonoenoicacid
?
a)Arachidonicacid

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b)Linoleicacid
c)Oleicacid
d)Linolenicacid
CorrectAnswer-C
Ans.C.Oleicacid
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Inhumans;liverandlactatingmammaryglandsarethemainorgans
forlipogenesisQ.
Althoughkidney,brain,lungsandadiposetissuearealsoinvolved,
toalesserextent.
CofactorrequirementsforfattyacidsynthesisareNADPH,ATP,

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Mn.2,biotinandHCO3-(asasourceofCO).
Becausemostfattyacidshavemultiplesoftwocarbons,theyare
synthesizedfromsuccessive

295.Whichofthefollowingfattyacidhas
maximumnumberofcarbonatoms?

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a)Oleicacid
b)Linolenicacid
c)Arachidonicacid
d)Cervonicacid
CorrectAnswer-D

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Ans.is'd'i.e.,Cervonicacid
Cervonicacidhas22carbonatoms,morethanoleicacid(18C),
linolenicacid(18C)andarachidonicacid(20C).
So,thebasicbuildingblockisacetyl-CoAQwhichisthesourceofall
thecarbonatomsofthefattyacidbeingsynthesized.

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296.Chylomicronremnantsareassociated
with?
a)Apo-A
b)Apo-B100
c)Apo-E

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d)Apo-C
CorrectAnswer-C
Ans.is'c'i.e.,Apo-E

297.Apoprotein-C?
a)Activateslipoproteinlipase

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b)Inactivateslipoproteinlipase
c)Facilitatestriglyceridetransport
d)Alloftheabove
CorrectAnswer-D
Ans.is'd'i.e.,Alloftheabove[RefHarper28th/ep.213]
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ApoC-IIisanactivatorofLPL,wherasapoA-IIandapoC-IIIactas
inhibitorsofLPL.
Asapo-CisacomponentofchylomicronsandVLDL,itfacilitates
transportofTGs.

298.Whichisnottrueofchylomicrons?

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a)Lowestdesnsity
b)Max.contentisTGs
c)Max.contentischolesterol
d)Largestsize
CorrectAnswer-C

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Ans.is'c'i.e.,Max.contentischolesterol[Ref:Harper29th/ep.
238,Chatterjea8thlep.445,446]

299.OxidisedLDLismoreathreogenic
because?
a)BindstoApoE

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b)BindstoscavengerR
c)BindstoATPbinding
d)Accumulatesinmacrophages
CorrectAnswer-D
Ans.is'd'i.e.,Accumulatesinmacrophages[RefRobbin's8thle
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p.837]
MacrophagesengulfLDLcholesterolandformfoamcellsformation
ofearliestlesion,i.e.fattystreak.
Macrophagesalsoformoxygenfreeradicalsthatcauseoxidationof
LDLtoyieldoxidizedLDL(modifiedLDL).

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300.LCATdeficiencyincreasesthefollowing
a)HDL
b)LDL
c)VLDL
d)Chylomicron

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CorrectAnswer-A
Answer:A.HDL
Lecithincholesterolacyltransferasedeficiency(LCATdeficiency)isa
disorderoflipoproteinmetabolism.
AdeficiencyofLCATcausesaccumulationofunesterified

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cholesterolincertainbodytissues.Cholesteroleffluxesfromcellsas
freecholesterolandistransportedinHDLasesterifiedcholesterol.
LCATistheenzymethatesterifiesthefreecholesterolonHDLto
cholesterolesterandallowsthematurationofHDL.
LCATistheenzymethatesterifiesthefreecholesterolonHDLto

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cholesterolesterandallowsthematurationofHDL.LCATdeficiency
doesnotallowforHDLmaturationresultinginitsrapidcatabolismof
circulatingapoA-1andapoA-2.TheremainingformofHDL
resemblesnascentHDL.

301.Hormonesensitivelipaseisinhibitedby?

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a)Thyroidhomone
b)Insulin
c)GH
d)ACTH
CorrectAnswer-B

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Ans.is`b'i.e.,Insulin[RefHarper29"Vep.246,247]

302.Lecithinehydrolysisyeilds?
a)Choline
b)Pyruvate
c)Glycine

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Choline[RefHarper29th/ep.233]

303.Omegaoxidationoffathyacidsoccur?
a)ER

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b)Mitochondria
c)Cytosol
d)None
CorrectAnswer-A
Ans.is'a'i.e.,ER[RefHarper's28th/ep.185,195]

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Beta(a)Mitochondria
Alpha(a)Endoplasmicreticulum,Mitochandria
Omega(w)Microsomalsystem(smoothER)
a-oxidationofverylongchainFAPeroxisomes

304.Whatistrueregardingmediumchain

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fattyacids?
a)Don'trequirepancreaticlipase
b)Notdepositedinadiposetissue
c)Diffusedirectlyintoportalcirculation
d)Alloftheabove

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CorrectAnswer-D
Ans.is'd'i.e.,Alloftheabove[RefVasudevan6"p.160]
Metabolismofshortchainfattyacids(SCFAs)andmediumchain
fattyacids(MCFAs)isdrasticallydifferentfromlongchainfattyacids
(LCFAs).

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SCFAsandMCFAsdonotrequirepancreaticlipaseandbilesalts
fordigestion,butrequiredforLCFAsdigestion.
SCFAsandMCFAsaredirectlyabsorbedfromintestineintoportal
circulation,whereasLCFAsaretakenbylymphatics,after
incorporationintochylomicrons.

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SCFAsandMCFAsareoxidizedbyperipheralcellsandarenot
usedforstorage.LCFAsareesterifiedwithglyceroltoform
triacylglycerol,storageformoflipid

305.Whatwillyougivetostopchyluriain
diet?

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a)SmallchainFA
b)MediumchainFA
c)LongchainFA
d)Omega3unsaturatedFA
CorrectAnswer-B

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Ans.is'b'i.e.,MediumChainFA[RefHarrison's18thiep.294]
Mediumchainfattyacidsdirectlyentertheportalveinon
absorption,bypassingthelymphatics.Hence,theyareusedinchyluria

306.Inapersonfastingovernightwith
carnitinedeficiency,followingchemicals
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increaseinquantityinblood?
a)Glucose
b)Fattyacids
c)Aminoacids
d)Ketonebodies

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CorrectAnswer-B
Ans.is'b'i.e.,Fattyacids[Ref:Harper29th/ep.208-209,214]
Instarvation,thereisincreasedhydrolysisofTGs(ofadipose
tissues)intoglycerolandfattyacids.Fattyacidsarefurtheroxidized
by[3-oxidationinthemitochondria.

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Carnitineisrequiredfortransportedofactivatedfattyacidinto
mitochondriafor3-oxidation.
Ifcarnitineisdeficient,fattyacidscannotbetransferredintothe
mitochondria,buttheyarecontinuouslyproducedduetohydrolysis
ofTGs(instarvationthereisdecreasedinsulintoglucagonratio,

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whichstimulateshydrolysisofTGs).
Thusfreefattyacidlevelisincreasedasthereisincreased
productionbutnoutilization(p-oxidation).

307.Serumappearymilkywhitein?
a)IncreasedLDL

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b)IncreasedHDL
c)IncreasedVLDL
d)IncreasedChylomicrons
CorrectAnswer-D
Ans.is'd'i.e.,IncreasedChylomicrons[RefHarrison18thlep.

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3151]
"Thefastingplasmaisturbid,andifleftat4?C(39.2?F)forafew
hours,thechylomicronsfloattothetopandformacreamy
supernatant".
Chylomicronsarethelargestlipoproteinmoleculewithmaximum

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lipidcontents.Therefore,theyhaveleastdensityandfloatonthetop
givingacreamy(milky)supernatant.

308.Adiposetissuefatmetabolismisdoneby
?
a)Lipoproteinlipase

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b)Hormonesensitivelipase
c)Acidlipase
d)Acidmaltase
CorrectAnswer-B
Ans.is'bi.e.,Hormonesensitivelipase[Ref:Harper29th/echap.

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16]
Adiposetissuefat(TGs)metabolismHormonesensitivelipase
Lipoproteins(VLDL&chylomicrons)TGsmetabolism-Lipoprotein
lipase

309.EnzymedeficientinTypeI

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Hyperlipidemiais?
a)HMGCoAreductase
b)Lipoproteinlipase
c)Cholesterolacyltransferase
d)Peroxidase

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CorrectAnswer-B
Ans.is'b'i.e.,Lipoproteinlipase[Ref:Harper2e/ep.232table
(26.1)]

310.Apo-Edificiencyisseenin
a)TpyeIhypolipoproteinemia

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b)TpyeIIhypolipoproteinemia
c)TpyeIIIhypolipoproteinemia
d)TpyeIVhypolipoproteinemia
CorrectAnswer-C
Ans.is'c'i.e.,TpyeIIIhypolipoproteinemis[RefHarisonp.3149,

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3150,Chatterjea8th/ep.45]

311.Whichofthefollowingisnotaffectedin
Abetalipoproteinemia?
a)LDL
b)VLDL

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c)HDL
d)IDL
CorrectAnswer-C
Ans.is'c'i.e.,HDL[RefChatterjea8thlep.462,463&DineshPuri
3rdlep.248]

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Hypolipoproteinemia
Inthisgroupofdisordersconcentrationofoneormorelipoproteins
inplasmaisdecreased.Thecommonestofthesedisorders
areabetalipoproteinemia,
hypobetalipoproteinemiaandhypoalphalipoproteinemia.
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Abetalipoproteinemia:-Thereisdefectivesynthesisorsecretionof
apoprotein-B(apo-B)inintestineandliver.So,thereisdeficiencyof
apo-Bcontaininglipoproteinsi.e.chylomicrons?,VLDL?,IDL?
andLDL?.Asaresultextremelylowplasmalevelsofcholesterol
andtriacylglycerols?occurs.HDLlevelsarenormal?asHDLdoes

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notcontainapo-B.
Hypobetalipoproteinemia:-Thereisdecreasedsynthesisofapo-B
duetoapo-Bgenemutations.So,apo-Bcontaininglipoproteinsare
synthesizedatlowerrate.ThereisslightdecreaseinVLDL,IDLand
LDLlevels.HDLisnormal.Plasmacholesterolandtriglyceridesare

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decreased.
Hypoalphalipoproteinemia(Tangierdisease):-Thereismarked
deficiencyofmajorlipoproteinHDL(apo-A-Iandapo-A-II),

probablybecauseofacceleratedcatabolism.

312.InZellwegersyndrome,thereis?

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a)Accumulationoflongfattyacids
b)Accumulationofshortchainfattyacids
c)Accumulationofverylongchainfattyacids
d)Accumulationofmediumchainfattyacids
CorrectAnswer-C

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Ans.is'c'i.e.,Accumulationofverylongchainfattyacids[Ref
Harper29m/ep.554;Chatterjea6thlep.412]
ZellwegerSyndromeisarareinbornerrorofperoxisomalfatty
acidoxidation?duetoabsenceoffunctionalperoxisomesinall
tissues.

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Asaresult,thelongchainfattyacidsarenotoxidizedin
peroxisomesandaccumulateintissuesparticularlyinbrain,liver,
kidneyandmuscleandusuallyresultindeathbyagesix.

313.Autooxidationisseenin?
a)Cholesterol

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b)Arachidonicacid
c)Stearicacid
d)Palmiticacid
CorrectAnswer-B
Ans.is'b'i.e.,Arachidonicacid[RefEssentialofbiochemistryp.

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736]
Polyunsaturatedfattyacids(PUFAs)undergoperoxidation(auto-
oxidation).
Amongstthegivenoptions,onlyarachidonicacidisPUFA.

314.Whichofthefollowingisalipotropic

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factor:?
a)Sphingomyelin
b)Histidine
c)Methionine
d)Bilirubin

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CorrectAnswer-C
Ans.is'c'i.e.,Methionine[RefEssentialsofbiochemistry/p.761]
Lipotropicfactorsaresubstanceswhichpreventaccumulationof
fat(TGs)inliver.
Primarylipotropicfactorscholine,betaine,methionine,lecithine,

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inositol.
Otherfactorswithsomelipotropicaction:-Vitamin-13,2,folic
acid,casein,glycine,essentialfattyacids,selenium,vitaminEand
serine.

315.Huntersyndromeisduetodeficiencyof

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a)Betagalactosidase
b)Sphingomyelinase
c)IduronateSulfatase
d)Hyaluronidase
CorrectAnswer-C

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Ans.is'c'i.e.,IduronateSulfatase

316.Non-Essentialaminoacidis-
a)Tyrosine
b)Phenylalanine
c)Lysine

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d)Threonine
CorrectAnswer-A
Ans.A.Tyrosine

317.Indoleringispresentin?
a)Tryptophan

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b)Tyrosine
c)Phenylalanine
d)Threonine
CorrectAnswer-A
Ans.is'a'i.e.,Tryptophan[Ref:Lehninger4thIep.80]
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Someaminoacidscontainaspecialfunctionalgroupintheir
sidechainwhichprovidesomespecificfunctionstothatamino
acids.Theseare:-
Hydroxylgroupinserineand Guanidiniumin
Imidazolein

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threonine
arginineQ
histidine
Amidegroupinaspargineand Benzenein
Phenolin

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glutamine
phenylalanine
tyrosine
Indoleringin
Pyrrolidinein

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Thioetherinmethionine
tryptophanQ
proline
13-Carboxylin
E-aminoin

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Sulphydrylincysteine
glutamicacid
lysine
y-carboxylinglutamicacid

318.Xanthoproteicreactioninvolves-

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a)Carbolicacid
b)H2SO4
c)HCL
d)Nitricacid
CorrectAnswer-D

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Ans.'D'Nitricacid
Xanthoproteictest:Theringsystemsinphenylalanine,tyrosineand
tryptophanundergonitrationontreatmentwithconcentratednitric
acidwhenheated.Theendproductisyellowincolorwhich
isintensifiedinstrongalkalinemedium.Thisreactioncausesthe

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yellowstainintheskinbynitricacid.

319.Taurineisbiosynthesizedby?
a)Arginine
b)Leucine
c)Valine

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d)Cysteine
CorrectAnswer-D
Ans.is'd'i.e.,Cysteine[RefHarper250/ep.298-99]
Taurineissynthesizedfromcysteineby3enzyme-catalyzed
reactions:

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1. Cysteineisoxidizedtocysteinesulfinate.
2. Cysteinesulfinateisdecarboxylatedtoformhypotaurine.
3. Hypotaurineisoxidizedtoformtaurine

320.Selenocysteineisassociatedwith?
a)Carbonicanhydrase

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b)Catalase
c)Deiodinase
d)Transferase
CorrectAnswer-C
Ans.C.Deiodinase
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Selenocysteineisconsideredas21standardaminoacid.
Itispresentattheactivesiteofsomeenzymesthatcatalyzeredox
reactions,e.g.thioredoxinreductase,glutathioneperoxidase,and
thedeiodinase(convertsthyroxintotriiodothyronine).
Biosynthesisofselenocysteinerequirescysteine,serine,ATPanda

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specifict-RNA.
Serineprovidesthecarbonskeletonofselenocysteine.
Selenocysteinehasastructuresimilartocysteine,butcontainingthe
traceelementseleniuminplaceofsulfuratomofcysteine.

321.Methylmalonylaciduriaisseenin

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deficiencyof?
a)VitB12
b)VitB6
c)VitC
d)Folicacid

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CorrectAnswer-A
Ans.is'a'i.e.,VitB12[RefHarper29"Vep.537]
IsomerizationofmethylmalonylCoAtosuccinylCoA:
Inthisreaction,activeformofvitaminBI2isdeoxyadenosyl
cobalamine.

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Propionyl-CoAisproducedascatabolicendproductofsome
alipathicaminoacidsandn-oxidationofoddchainfattyacids.
PropionylCoAisthenconvertedtosuccinylCoAthrough
methylmalonyl-CoA.
Thusmethylmalonyl-CoAisaccumulatedandexcretedinurineas

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methylmalonicacid(methylmalonate)invitaminB12deficiency0,i.e.
methylmalonicacidurie

322.Carnitineissynthesisedfrom-
a)Lysine
b)Agrinine

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c)Histidine
d)Choline
CorrectAnswer-A
Trimethyllysineand-butyrobetainehydroxylasesarerequiredfor
thesynthesisofcarnitine

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323.Tyrsoineistheprecursorofallexcept?
a)Thyroxine
b)Melanin
c)Dopmine
d)Nicotinicacid

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CorrectAnswer-D
Ans.is'd'i.e.,Nicotinicacid[Ref:Harper's28th/ep.266,268,
254]
Tyrosineisaprecursorofmanyimportantcompoundssuchas
catecholamines(epinephrineQ,norepinephrineQ),dopamine),
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thyroxineQ,triiodothryonine,melanin0.

324.Whichofthefollowingenzymeisnot
usedbyliverinureacycle?
a)CPS-I
b)CPS-II

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c)Arginase
d)Arginosuccinate
CorrectAnswer-B
Ans.is'b'i.e.,CPS-II[RefHarper29th/ep.277-278]
CarbmoylphosphatesynthaseII(CPSII)isinvolvedinpyrimidine

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synthesis(notinureacycle).

325.Aminoacidusedbyliverinureacycle?
a)Glutamine
b)Glutamate
c)Aspartate

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d)Fumarate
CorrectAnswer-C
Ans.is'c'i.e.,Aspartate[RefHarper29`"/ep.276-278]
Thesourceoftwonitrogenatomsofurea->onefromammonia?and
onefromaminogroupofaspartate?.SourceofcarbonisCO,Q.

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Thusoutofallaminoacidsinvolvedinureacycleaspartateis
consumed,whilethereisnonetlossorgainofornithine,citrulline,
arginosuccinateorarginine.Thereisproductionoffumarateasby
product?.
3moleculesofATPareconsumed(2infirstreactionand1inthird

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reaction).However,4highenergyphosphatebondsareutilizedas
3rdATPisconvertedtoAMP+PPi.

326.Hydrolysisoccursatwhichstepofurea
cycle?
a)Cleavageofarginine

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b)FormationofArginosuccinate
c)Formationofcitrulline
d)Formationofornithine
CorrectAnswer-A
Ans.'A',Cleavageofarginine

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Ureasynthesisisa5stepcyclicprocess,with5distinct
enzymes.Thefirst2enzymesarepresentinmitochondriawhilethe
restarelocalizedinthecytosol
Step1.FormationofCarbamoylPhosphate-Onemoleculeof
ammoniacondenseswithCO2inthepresenceoftwomoleculesof

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ATPtoformcarbamoylphosphate.Itiscatalyzedbycarbamoyl
phosphatesynthetase-I(CPS-I).
Step2.FormationofCitrulline-Thecarbamoylgroupistransferred
totheNH2groupofornithinebyornithinetranscarbamoylase.
Step3.FormationofArgininosuccinate-Onemoleculeofaspartic

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acidaddstocitrullineformingacarbontonitrogenbondwhich
providesthe2ndnitrogenatomofurea.Argininosuccinate
synthetasecatalyzesthereaction.
Step4.FormationofArginine-Argininosuccinateiscleavedby
argininosuccinatelyase(argininosuccinase)toarginineand

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fumarate.Theenzymeisinhibitedbyfumarate.Thefumarate
formedmaybefunneledintotheTCAcycletobeconvertedto
malateandthentooxaloacetatetobetransaminatedtoaspartate.
ThustheureacycleislinkedtotheTCAcyclethroughfumarate.

Step5.FormationofUrea-Thefinalreactionofthecycleisthe

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hydrolysisofargininetoureaandornithinebyarginase.

327.Urea&Kreb'scyclearelinkedat?
a)Arginine
b)Ornithine
c)Oxaloacetate

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d)Fumarate
CorrectAnswer-D
Ans.is'd'i.e.,Fumarate[RefHarper250/ep.276-277]
Fumarateisreleasedduringureacycle,whichisanintermediateof
Kreb'scycle,thuslinkingthetwo.

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328.Whichwillactivatecarbomoylphosphate
synthaseI?
a)Alanine
b)N-acetylglutamate
c)Ornithine

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d)None
CorrectAnswer-B
Ans.is'b'i.e.,N-acetylglutamate
Carbamoylphosphatesynthase-I(CPS-I),amitochondrialenzyme,
catalyzestheformationofcarbamoylphosphate?bycondensationof

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CO2andammonia.TwomoleculesofATParerequiredforthe
reaction.CPS-IistheratelimitingenzymeofureacycleQ.Itisan
allostericenzymeandallostericallyactivatedbyN-acetylglutamate

329.TransaminationofAlanineresultsin
formationof?

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a)Oxaloacetate
b)Pyruvate
c)Aspartate
d)Arginine
CorrectAnswer-B

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Ans.is'b'i.e.,Pyruvate

330.Cofactorsforglutamatedehydrogenase?
a)NAD+
b)FAD
c)FMN

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d)FADH2
CorrectAnswer-A
Ans.'A'NAD+
AnaerobicDehydrogenasesaretheenzymesthatcatalyzethe
removalofhydrogenfromasubstratebutoxygencannotactasthe

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hydrogenacceptor.They,therefore,requirecoenzymesas
acceptorsofthehydrogenatoms.
Whenthesubstrateisoxidized,thecoenzymeisreduced.
NAD+isderivedfromnicotinicacid,amemberofthevitaminB
complex.TheNAD+linkeddehydrogenasesare-

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Glyceraldehyde-3-phosphatedehydrogenase
Isocitratedehydrogenase
Malatedehydrogenase
Glutamatedehydrogenase
BetahydroxyacylCoAdehydrogenase

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Pyruvatedehydrogenase
Alpha-ketoglutaratedehydrogenase

331.Hyperammonemiatype-1isdueto
deficiencyof
a)Arginase

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b)Arginosuccinatelyase
c)Arginosuccinatesynthase
d)CPS-1
CorrectAnswer-D
Ans.is'd'i.e.,CPS-1[RefDineshPuri3'/ep.275]
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Disorderscausedbygeneticdefectsofureacycleenzymes
Hyperammonemiatype-IHyperammonemiatype-IICitrullinemia
ArgininosuccinicaciduriaArgininemia
Defectiveenzyme
Carbamoylphosphatesynthase-IOrnithinetranscarbamoylase

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ArgininosuccinatesynthaseArgininosuccinatelyaseArginase
Productsaccumulated
AmmoniaAmmoniaCitrullineArgininosuccinateArginine.

332.Neonataltyrosenemiaisdueto
deficiencyof?

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a)Tyrosinase
b)Fumarylacetoacetatehyroxyase
c)Hydroxyphenylpyruvatehydroxylase
d)Tyrosinetransminase
CorrectAnswer-C

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Ans.is'c'i.e.,Hydroxyphenylpyruvate
hydroxylase[RefHarper's28th/ep.266,268]
Tyrosinemia
Itisadefectinmetabolismoftyrosine.Itmaybeoffollowing
types.

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1. Tyrosinemiatype-I(tyrosinosis/hepatorenalsyndrome):-Itisdueto
defectinfumarylacetoacetatehydroxylasedeficiency.Patientswith
chronictyrosinosisarepronetodevelopcirrhosisandhepatic
carcinoma?.Thereiscabbagelikeodorinacutetyrosinosis.
2. Tyrosinemiatype-II(Richer-Hanhartsyndrome):-Itisdueto

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deficiencyoftyrosinetransaminaseQ(tyrosineaminotransferase).
3. Neonataltyrosinemia:-Itisduetodeficiencyof
hydroxyphenylpyruvatehydroxylase.

333.Separationofproteinsbytheirmass?
a)Electrophoresis

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b)Saltingout
c)SDS-PAGE
d)Ionexchangechromatography
CorrectAnswer-C
Ans.is'c'i.e.,SDS-PAGE[RefVasudevan6"diep.600]

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334.Twosamechargedproteinscanbe
separatedbyallexcept-
a)Agarose
b)DEAECellulose
c)Sephadex

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d)Noneofthese
CorrectAnswer-B
Ans.is'b'i.e.,DEAECellulose[RefEssentialsofBiochemistryp.
670,795]
DEAEcellulosechromatography(anionexchange)separates

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moleculesbasedonmolecularcharge.Therefore,itcannotseparate
twoproteinswithsamecharge.
Agarose(sepharose)anddextran(sephadex)areusedingel
filtrationchromatography,whichisbasedonmolecularsize.Thus,
theycanseparateproteinsofsamecharge.

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335.250nmlightisabsorbedby?
a)Arginine
b)Alanine
c)Tyrosine
d)Histidine

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CorrectAnswer-C
Ans.is'c'i.e.,Tyrosine
Aminoacidsdonotabsorbvisiblelightandthusarecolourless.
However,aromaticaminoacidsQ(tryptophan,tyrosine,
phenylalanine)absorbhigh-wavelength(250-290nm)UVlight.

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Trypytophanhasthegreatestabsorptionmaximainthisregion
thanothertwoaromaticaminoacids.
Thus,aromaticaminoacidsareresponsibleforUVabsorption
ofmostproteins0,maximumabsorptionbeingat280rim.

336.Inglycolysis,inorganicphosphateis

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usedreaction,catalyzedby?
a)Enolase
b)Pyruvatekinase
c)Glyceraldehyde-3-pdehydrogenase
d)Aldolase

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CorrectAnswer-C
Ans.is'c'i.e.,Glyceraldehyde-3-pdehydrogenase

337.AboutDenaturationofprotein,whichis
true?
a)Biologicalpropertypersists

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b)Primarystructurelost
c)Alwaysirreversible
d)Mostlyrendersproteininsoluble
CorrectAnswer-D
Ans.is'd'i.e.,Mostlyrendersproteininsoluble[RefLippincott's
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4thIep.57]
Thetermdenaturationreferstodisruptionofhigherorder
(secondary,tertiaryandquaternary)structureofprotein.
Allnon-covalentbondsthatmaintainhigherorderstructureare
disrupted,butpeptidebond(covalentbond)remainsintact.
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Thus,theprimarystructureisnotalteredduringdenaturation,
i.e.,aminoacidsequenceisnotaltered,butdenaturationmay
completelydisruptsecondary,tertiaryandquaternary
structure,e.g.,denaturatedoligomericproteinsdissociatedinto
subunits,eachwitharandamcoilformation.
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Denaturationisalwaysaccompaniedbyalossofbiological
function,e.g.,enzymesareinactivatedandantibodiesfailtoact
withantigens.
Denaturationisgenerallyirreversible,e.g.,boiledeggdoesnot
regainitsoriginalformwhenkeptincold.

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Denaturedproteinsarelesssolubleandinmanycases
theyprecipitate.

338.Ochronosisisduetoaccumulationof?
a)Homogentisicacid
b)Phenylpyruvate

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c)Xanthurenate
d)Glyoxylate
CorrectAnswer-A
Ans.is'a'i.e.,Homogentisicacid[Ref:Harper29th/ep.287-289]
Alkaptonuria
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Itisduetodeficiencyofhomogentisateoxidase.Asa
resulthomogentisicacid(homogentisate)isexcreted
execessivelyinurine.Therearethreeimportantcharacteristic
featuresinalkaptonuria?
1. UrinebecomesdarkafterbeingexposedtoairQ.Itisdue

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spontaneousoxidationofhomogentisateintobenzoquinone
acetate,whichpolymersetoformblack-brownpigment
alkaptonwhichimpartsacharacteristicblack-browncolourto
urine.
2. Alkaptondepositionoccursinsclera,ear,nose,cheeksand

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intervertebraldiscspace.Aconditioncalledochronosis.There
maybecalcificationofintervertebraldiscsQ.
3. Onchronosisarthritisaffectingshoulder,hips,knee.
4. Benedict'stestisstronglypositiveinurineandsoistheferric
chloride(Pea)testQ.Benedict'sreagentgivesagreenishbrown

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precipitatewithbrownishblacksupernatent.Fehling'sreagent
(FeC13)givesbluegreencolour.

339.Trueaboutalkaptonuria?
a)DeficiencyofTyrosinase
b)Urineisblack

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c)Banedicttestisnotuseful
d)Fecl,testgivesredcolour
CorrectAnswer-B
Ans.is'b'i.e.,Urineisblack[RefNelson18thiep.1812]

340.EnzymedeficientinIsovalericacidemia

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a)IsovalerylCoAdehydrogenase
b)Phenylalaninehydroxylase
c)Arginase
d)None
CorrectAnswer-A

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Ans.is'a'i.e.IsolvalerylCoAdehydrogenase
-Isovalericacidemiaisduetothedefectinthemetabolismof
leucine.
-TheenzymedefectiveisisovalerylCo-Adehydrogenase.
-Acharacteristicodorofsweatyfeetispresent.

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-Vomiting,acidosis,andcomafollowtheingestionofexcessprotein.
Accumulatedisovaleryl-CoAishydrolyzedtoisovalerateand
excreted.

341.Whichofthefollowingmetabolitesis
involvedinglycogenolysis,glycolysis
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andgluconeogenesis?
a)Galactose-l-phosphate
b)Glucose-6-phosphate
c)Uridinediphosphoglucose
d)Fructose-6-phosphate

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CorrectAnswer-B
Ans.is'b'i.e.,Glucose-6-phosphate[RefHarper28thlep.166,
158]
Glucose-6-phosphateisthemetabolitewhich:?
1. Joinsglycolysiswithglycogenesisandglycogenolysis

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2. Joinsglycogenolysistopentosephosphatepathway(PPP)
3. Isinvolvedinglycolysis,glycogenesisandgluconeogenesis,
glycogenolysis,gluconeogenesis,PPP

342.Whycitricacidcyclecalledamphibolic
pathway?

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a)Bothexergonicandendergonicreactionstakesplace
b)Metabolitesareutilizedinotherpathways
c)Itcanproceedbothinforwardandbackwarddirection
d)Sameenzymescanbeusedinreversedirections
CorrectAnswer-A

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Ans.is'a'i.e.,Bothexergonicandendergonicreactionstakes
place[Ref:Harper29th/ep.151,166]
Citricacidcycleiscalledamphibolicpathwaybecauseitactsasa
linkbetweenanabolic(endothermic)andcatabolic(exothermic)
pathways.

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343.Instarvation,nitrogeniscarriedfrom
muscletoliverandkidneyby:
a)Alanine
b)AsparticacidandSerine
c)Glycine

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d)Asparagines
CorrectAnswer-A
Ai.e.Alanine
Instarvation,alanineandglutaminearequantitativelythemost
importantgluconeogenicaminoacidsQ.Soalaninecarriesnitrogen

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frommuscletoliver&kidneyforfurthermetabolism&energy
productionduringstarvation.

344.Allofthefollowingoccurin
mitochondriaexcept
a)Citricacidcycle(Kreb'scycle)

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b)Glycogenolysis
c)Fattyacidoxidation
d)Electrontransportchain
CorrectAnswer-B
Bi.e.Glycogenolysis

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345.HMG-CoAinlivermitochondriais
inhibitedby?
a)Insulin
b)Glucagon
c)Glucocorticoid

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d)Epinephrine
CorrectAnswer-A
Ans.is'a'i.e.,Insulin
Thisquestionisalittletricky.
Effectofinsulinonketogenesis
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Ketogenesisisusuallyassociatedwithexcessivefattyacidoxidation
(lipolysis)whichprovidesthesubstrate(acetyl-CoA)forketogenesis.
Thus,factorswhichinhibitlipolysiswillinhibitketogenesis(andalso
productionofHMG-CoA).
Insulinisanantilipolytichormone.Itinhibitslypolysisandtherefore

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ketogenesis.ThusitdecreasesthesynthesisofHMGCoAin
ketogenesis.
So,insulininhibitsaswellasstimulatesproductionofHMG-CoA.
Thenwhyisinsulintheanswerofthisquestion?
Herecomesthetrickypartofthisquestion.Readthequestion

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carefullyexaminerhasaskedaboutHMG-CoAproductioninliver
mitochondria.
Ketogenesisoccursinmitochondria.
CholesterolsynthesisoccursincytosolandsmoothER.
ThusinsulininhibitsHMG-CoAproductioninmitochondriabut

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stimulatesitincytosol.

346.Organwhichcanutilizeglucose,FAand
ketonebodiesis-
a)Liver
b)Brain

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c)Skeletalmuscle
d)RBC
CorrectAnswer-C
Ans.is'c'i.e.,Skeletalmuscle[RefHarper28th/ep.141]
Skeletalmusclescanutilizeglucose,glycogen,fattyacidsand

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ketonebodies.
Livercannotutilizeketonebodies.
Brainanderythrocytesareexclusivelydependentonglucoseexcept
inprolongedstarvationwherebrainutilizesketonebodies
predominantly

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347.Majorsourceofenergyforbrainin
fasting/starvation?
a)Glucose
b)Glycogen
c)Fattyacids

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d)Ketonebodies
CorrectAnswer-D
Thereisnostoredfuelinthebrain,butitutilized60%oftotalenergy
underrestingconditions.
Glucoseisvirtuallythesolefuelforthebrain,exceptinprolonged

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starvingwhenketonebodiesarethemajorsource.
Fattyacidsdonotserveasfuelforthebrain,becausetheyare
boundtoalbumininplasma;hencecannotcrosstheblood-brain
barrier.

348.Fattyacidmetabolismgives?

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a)AcetylCoA
b)MalonylCoA
c)Ketonebodies
d)Cholesterol
CorrectAnswer-A

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Ans.is'a'i.e.,AcetylCoA[RefHarper250/ep.208-210]
Acetyl-CoAhasaspecialcentralrole.Acetyl-CoAisthecommon
degradationproductofglucose(byglycolysisQandPDHcomplex),
fattyacidsandketogenicaminoacids.
Itsacetylgroupcanbeutilizedinsynthesisoffatty
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acidsQ,cholesterolQandothersteroidsQ,ketonebodiesQ;orcanbe
oxidizedviaTCA(citricacidcycle).
Infedstateacetyl-CoAisoxidisedviaTCAcycleandusedfor
synthesisoffattyacidsandcholesterolQ,whereasinstarvationitis
usedtosynthesizeketonebodiesQ

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349.Whichoneofthefollowingstatements
concerninggluconeogenesisiscorrect?
a)Itoccursinmuscle
b)Itisstimulatedbyfructose2,6-bisphosphate
c)ItisinhibitedbyelevatedlevelsofacetylCoA

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d)Itisimportantinmaintainingbloodglucoseduringthenormal
overnightfast.
CorrectAnswer-D
Ans.is'd'i.e.,Itisimportantinmaintainingbloodglucose
duringthenormalovernightfast[RefMark'sBasicmedical
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biochemistryp.566]
Duringfasting,manyofthereactionsofglycolysisarereversedas
theliverproducesglucosetomaintainbloodglucoselevels.This
processofglucoseproductioniscalledgluconeogenesis.
Duringovernightfast,bloodglucoselevelsaremaintainedbyboth

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gluconeogenesisandglycogenolysis.However,afterapproximately
30hoursoffasting,liverglycogenstoresaremostlydepleted.
Subsequently,gluconeogenesisistheonlysourceofbloodglucose.

350.Chemiosmoticcouplingofoxidation
phosphorylationisrelatedto?

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a)FormationofATPatsubstratelevel
b)ATPgenerationofpumpingofproton
c)ATPgenerationofpumpingofneutron
d)ATPformationbytransportof0,
CorrectAnswer-B

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Ans.is'b'i.e.,ATPgenerationofpumpingofproton[RefHarper
29'diep.125-127]
Chemoiosmotictheory
Itstatesthat"freeenergyofelectrontransport"isconservedby
pumpingprotonsfrommitochondrialmatrixtotheintermembrane

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space,soastocreateanelectrochemicalprotongradientacrossthe
innermitochondrialmembrane,withoutersideofmembraneis
positivelychargedascomparedtoinside.Electrochemicalpotential
ofthisgradientisusedtosynthesizeATPbyATPsynthase

351.Whichofthefollowingistrue?

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a)Glucokinasehashighaffinityforglucose
b)Hexokinasehaslowaffinityforglucose
c)Glucokinasehaslowaffinityforglucose
d)Hexokinaseisinducedbyinsulin
CorrectAnswer-C

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Ans.is'c'i.e.,Glucokinasehasloweffinityforglucose[Ref
Harper28`"/ep.151-152]
Glucokinase,isspecificforglucose.IthashighKinQ(i.e.,lowaffinity
forglucose),highVmaxandunlikehexokinase,itisnotinhibitedby
glucose-6-phosphateQ.Asithaslowaffinityforglucose(highkm),it

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comesintoplayonlywhenintracellularglucoseconcentrationis
high.Itisinducedbyfeedingandinsulin.Glucagoninhibits
glucokinase.
Functionofhexokinaseistoprovideglucose-6-phosphateata
constantrate,accordingtheneedsofcells,i.e.,functionof

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hexokinaseistoprovideconstantglucoseutilizationbyalltissuesof
bodyevenwhenbloodsugarislow.Functionofglucokinaseinthe
liveristoremoveglucosefrombloodafterameal,providing
glucose-6-phosphateinexcessofrequirementforglycolysissothat
itcanbeusedforglycogensynthesisandlipogenesis.

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352.Lipogenesisisstimulatedby?
a)Insulin
b)Glucagon
c)Epinephrine
d)Corticosteroids

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CorrectAnswer-A
Ans.is'a'i.e.,Insulin[RefDineshPuri3rdiep.318]

353.Anapleroticreactioniscatalyzedby?
a)Pyruvatecarboxylse
b)Enolase

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c)Pyruvatekinase
d)G6PD
CorrectAnswer-A
Ans.is'a'i.e.,Pyruvatecarboxylse[RefDineshPuri3`diep.177]
Conversionofpyruvatetomalatebythecytoplasmicmalic-enzyme.

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MalatecanthenenterthemitochondrionasasubstratefortheTCA
cycle.
Pyruvatemayreactwithaspartateorglutamateintransaminase
reactions,producingtheTCAcycleintermediatesoxalocetateanda-
ketogluarate,respectively.

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SeveralglycogenicaminoacidsmayserveassourceofTCA
intermediates

354.Substancewithhighestthermogenic
effect?
a)Fat

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b)Proteins
c)Carbohydrate
d)Allarethesame
CorrectAnswer-B
Ans.is`b'i.e.,Proteins[RefProgressinobesityresearch-397]
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Thermogeniceffect(thermiceffect)offoodreferstotheincreasein
metabolicratethatoccursafteringestionofparticularfood.
Thisresultsinanincreaseintheamountofheatgeneratedbythe
body.
Proteinisatthetopofthehierarelyofmacronutrients,asforasthe

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thermogeniceffectinconcerned.About25-30%ofenergyis
consumedtodigesttheprotein.
Carbohydratescomeinthemiddleandlipids(fats)areinthirdplace.

355.Whichofthefollowingisnotthesource
ofcytosolicNADPH?

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a)Isocitratedehydrogenase
b)ATPcitratelyase
c)Malicenzyme
d)G6PD
CorrectAnswer-B

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Answer.B.ATPcitratelyase
NADPHisacofactorusedinanabolicreactions,suchaslipidand
nucleicacidsynthesis,whichrequireNADPHasareducingagent.
ThemajorsourceofNADPHinanimalsandothernon-
photosyntheticorganismsisthepentosephosphatepathway.

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Thekeyenzymesintheseprocessesare:NADP-linkedmalic
enzyme,NADP-linkedisocitratedehydrogenase,NADP-linked
glutamatedehydrogenaseandnicotinamidenucleotide
transhydrogenase.

356.RQisleastin?

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a)Brain
b)RBC
c)Adipose
d)Heart
CorrectAnswer-D

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Ans.is'd'i.e.,Heart[RefReadbelow]
Respiratoryqnotient(RQ)of:
1. Carbohydrateis1
2. Fatis0.70
3. Proteinis0.82

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Undernormalconditionthemajorfuelofheartisfattyacids,while
otherthreeorgans(giveninoptions)utilizeglucose.
ThusRQvalueisminimumforheart.

357.Overnightfastingwhatoccurs?
a)Glucosedecreases

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b)FFAincreases
c)Increasedgluconeogenesis
d)Increasedbeta-hydroxybutyrate
CorrectAnswer-C
Ans.is'c'i.e.,Increasedgluconeogenesis[RefVasudevan&hie
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p.85,86,Harper28th/ep.240,241]
Inovernightfastingglucoselevelismaintaineddueto
glycogenolysisandgluconeogenesis.
FFAandketonebodies(p-hydroxybutyrate)startsrisingafter2-3
days,i.e.inlaterpartofinitialstageofprolongedstarving

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358.WhichofthefollowingisaFatSoluble
vitamin?
a)Thiamine
b)Niacine
c)VitaminA

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d)Ribaflavin
CorrectAnswer-C
Ans.is'c'i.e.,VitaminA[RefHarper's296/ep.335]

359.Ascorbicacidisrequiredforsynthesisof
?

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a)Phenylserine
b)Homoserine
c)Hydroxylysine
d)Selenocysteine
CorrectAnswer-C

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Ans.is'c'i.e.,Hydroxylysine[RefHarper's29th/ep.540]
Hydroxylationofprolineandlysineresiduetakesplaceduringpost-
translationalmodificationinroughER.
Theenzymecatalyzingthereactionsareprolylhydroxylase(for
proline)andlysylhydroxylase(forlysine).

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Boththeseenzymesaredioxygenases?usingmolecularoxygen(02)
andcofactorforboththeseenzymesisvitaminC(ascorbicacid)?.a-
Ketoglutatrateisacoreductant,whichisoxidizedtosuccinate.

360.Whichofthefollowingvitaminsdoesnot
participateinoxidativedecarboxylation
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ofpyruvatetoacetylCoA?
a)Thiamine
b)Niacine
c)Riboflavin
d)Biotin

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CorrectAnswer-D
Ans.is`d'i.e.,Biotin

361.VitaminKisrequiredfor:
March2005
a)Chelation

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b)Transamination
c)Carboxylation
d)Noneoftheabove
CorrectAnswer-C
Ans.C:Carboxylation

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ThefunctionofvitaminKinthecellistoconvertglutamatein
proteinstogamma-carboxyglutamate(gla).Withinthecell,vitaminK
undergoeselectronreductiontoareducedformofvitaminK(called
vitaminKhydroquinone)bytheenzymevitaminKepoxidereductase
(orVKOR).

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AnotherenzymethenoxidizesvitaminKhydroquinonetoallow
carboxylationofGlutamatetogammacarboxyglutamate;this
enzymeiscalledthegamma-glutamylcarboxylaseorthevitaminK-
dependentcarboxylase.
Thecarboxylationreactionwillonlyproceedifthecarboxylase

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enzymeisabletooxidizevitaminKhydroquinonetovitaminK
epoxideatthesametime;thecarboxylationandepoxidation
reactionsaresaidtobecoupledreactions.

362.Pantothenicacidisneededfordonating
thefollowingmoiety?

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a)Acetyl(oracyl)CoA
b)Carboxyl
c)Hydroxyl
d)Amino
CorrectAnswer-A

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Ans.is'a'i.e.,Acetyl(oracyl)CoA[RefHarper29th/ep.540]
Pantothenicacidfunctionsascoenzymebyprovidingbuildingblock
ofcoenzymeAandACP
1. Coenzyme-Aparticipatesinreactionsofcitricacidcycle,fattyacid
oxidation,acetylation,andcholesterolsynthesis.

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2. ACPtakespartinfattyacidsynthesis

363.Mostpotentantioxidant?
a)VitA
b)VitK
c)VitE

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d)VitC
CorrectAnswer-C
Ans.is'c'i.e.,VitE[Ref:Harper29thiep.532,541,543]
Amongstgivenoptions,vitaminA,EandCareanti-oxidants.
However,VitaminE(tocopherol)isthemostimportantantioxidantin

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thebody,actinginthelipidphaseofmembranesprotectingagainst
theeffectsoffreeradicals.

364.Coenzymeformofpyridoxineis?
a)ADP
b)NAD

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c)PLP
d)FAD
CorrectAnswer-C
Ans.is'c'i.e.,PLP[RefGuyton12thiep.854]

365.ThecofactorvitaminB12isrequiredfor

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thefollowingconversion:
a)DopaminetoNorepinephrine
b)PropionylCoAtomethylmalonylCoA
c)MethylmalonylCoAtosuccinylCoA
d)Cysteinetohomocysteine

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CorrectAnswer-C
Ans:C.MethylmalonylCoAtosuccinylCoA
(Ref:Harper30/ep550,558,28iep346)
VitaminB12asCofactorfor:
MethylmalonylCoAmutase-Isomerizationofmethylmalonylco-Ato

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succinylco-A.
Methioninesynthase-Methylationofpyrimidineringtoform
thymine.
Homocysteinemethyltransferase-Methylationofhomocysteineto
methionine

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Metabolismofdiol.
Inbacteriaforinterconversionofglutamate&beta-methylaspartate?

366.VitaminB1isrequiredforwhichreaction
a)Transamination
b)Oxidativedecarboxylation

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c)Carboxylation
d)Alloftheabove
CorrectAnswer-B
Ans.is'b'i.e.,Oxidativedecarboxylation[RefHarper29th/ep.
534]
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*Activeform(coenzymeform)ofthiamineisthiamine
pyrophosphate(TPP),alsocalledthiaminediphosphate(TDP).
*TPPactsascoenzymefor
-Oxidativedecarboxylation:-Pyruvatedehydrogenase,a-
ketoglutaratedehydrogenase,brached-chainketoacid

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dehydrogenase.
-TransketolaseinPPP.

367.Pyridoxinedeficiencyleadstoaltered
metabolismof?
a)Phenylalanine

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b)Tryptophan
c)Methionine
d)Tyrosine
CorrectAnswer-B
Ans.is'b'i.e.,Tryptophan[RefDineshpuri3rdlep.378]
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Tryptophanloadtestisusedforpyridoxin.
Inpyridoxin(vitaminB6)deficiency,xanturenicacidexcretionis
increasedaftergivingtryptophanloaddose.

368.Thepyruvateutilizationintissuesis
decreasedin?

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a)Perniciousanemia
b)Scurvy
c)Beriberi
d)Pellagra
CorrectAnswer-C

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Ans.is'c'i.e.,Beriberi[RefHarper29th/ep.534]
Pyruvateutilizationisdecreasedinthiaminedeficiency.Beriberiis
duetothiaminedeficiency.
Inthiaminedeficiency,pyruvatecannotbeconvertedtoacetyl-CoA
asthiaminepyrophosphateisacoenzymeforpyruvate

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dehydrogenasewhichcatalyzestheconversionofpyruvateto
acetyl-CoA.Hence,excessofpyruvateismetabolizedtolactateby
lactatedehydrogenase

369.Whichofthefollowingrequiresvitamin
BIZ?

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a)Serinetolysine
b)Homocysteinetomethionine
c)Serinetoglycine
d)Glutaminetoglutamate
CorrectAnswer-B

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Ans.is'b'i.e.,Homocysteinetomethionine[Ref:Harper2967ep.
537-539]
ConversionofhomocysteintomethionineInthisreaction,active
formismethylcobalamine.Thisistheonlyreactionwhichrequires
bothvitaminB,2(asmethylcobalamine)andfolicacid(asN5-methyl-

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Hdolate).Thereactioniscatalyzedbytheenzymecobalamin-
dependentmethioninesynthasealsocalled5-
methyltetrahydrofolate-homocysteinemethyltransferase

370.Whichmicronutrientdeficiencycauses
anemia?

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a)Copper
b)Molybdenum
c)Selenium
d)Flurine
CorrectAnswer-A

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Ans.is'a'i.e.,Copper
Coppercontainingproteinceruloplasminisnecessaryfortransport
ofironintheFerricformacrossmembranes
CopperisanintegralcomponentofALAsynthase,whichis
necessaryforhemesynthesis

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Copperhelpsintheuptakeofironacrossnormoblasts

371.Adeninephosphoribosyltransferaseis
involved?
a)Denovopurinesynthesis
b)Purinedegradation

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c)Salvagesynthesisofpurinenucleotides
d)None
CorrectAnswer-C
Ans.is'c'i.e.,Salvagesynthesisofpurinenucleotides[Ref
Harper29thiep.334-335]
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Salvagepathwayofpurinenucleotidesynthesis
Freepurinebases(adenine,guanineandhypoxanthine)andpurine
nucleosidesareformedincellsduringthemetabolicdegradationof
nucleicacidsandnucleotides.Thesefreepurinebasesandpurine
nucleosidesarereusedintheformationofpurinenucleotides.This

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iscalledsalvagepathway(salvagemeanspropertysavedfrom
loss).Salvagesynthesisrequiresfarlessenergythandenovo
synthesis.

372.Uricacidisformedby?
a)Catabolismofproteins

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b)Catabolismofketones
c)Catabolismofpurines
d)Catabolismfopyrimidines
CorrectAnswer-C
Ans.is'c'i.e.,Catabolismofpurines

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373.Beta-alanineisderivedfrom?
a)Adenosine
b)Guanosine
c)Thymine
d)Uracil

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CorrectAnswer-D
Ans.is'd'i.e.,Uracil[Ref:Harper29illep.339,340]

374.Purineareformedby?
a)Asparticacid,glycine,uricacid
b)Aspartate,glycine,

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c)Aspartate,glutamate
d)Aspartate,glycine,glutamine
CorrectAnswer-D
Ans.is'd'i.e.,Aspartate,Glycine,Glutamine[RefHarper29thie
p.332]
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AminoacidsinvolvedinpurinesynthesisGlycine,aspartate,
glutamine.
AminoacidsinvolvedinpyrimidinesynthesisGlutamine,aspartic
acid(aspartate).

375.Whichofthefollowingisnotinvolvedin

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synthesisofpyrimidines?
a)Glutamine
b)CO
c)Asparticacid
d)Glycine

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CorrectAnswer-D
Ans.is'd'i.e.,Glycine[RefHarper29th/ep.336-337]
AminoacidsinvolvedinpurinesynthesisGlycine,aspartate,
glutamine.
AminoacidsinvolvedinpyrimidinesynthesisGlutamine,aspartic

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acid(aspartate)

376.WatsoncrickmodelisforwhichDNA?
a)BDNA
b)ADNA
c)CDNA

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d)ZDNA
CorrectAnswer-A
Ans.is'a'i.e.,BDNA[Ref:Harper250/ep.344]
DNAistherepositoryofgeneticinformation.DNAislocatedin
nucleus.DNAisalsopresentinmitochondria

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377.

Theanticodonregionisanimportantpartof
the
a)r-RNA
b)m-RNa

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c)t-RNa
d)hn-RNa
CorrectAnswer-C
Ci.e.t-RNA

378.Shinedalgarnosequenceisrelatedto?

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a)Transcription
b)Translation
c)DNAreplication
d)None
CorrectAnswer-B

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Ans.is'b'i.e.,Translation
ShinedalgarnosequenceinprokaryotesandKozakconsensus
sequencesineukaryoteshelpsininitiationofproteinsynthesis
(Translation)
Inprokaryotes,asequenceofnucleotidebasesonmRNAknown

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asShine-Dalgarnosequence(SDsequence)facilitatesthe
bindingofmRNAtothepreinitiationcomplex.SDsequenceisa
purine-richsequenceofnucleotidebases,whichislocated-6to-10
bpfromAUGcodon?.
InEukaryotes,'Kozakconsensus'sequencesurroundsAUG

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(initiationcodon)anddeterminestheinitiatingcodonofmRNA.

379.Nucleotideconsistsofallexcept?
a)Sugar
b)Phosphate
c)Fattyacid

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d)Base
CorrectAnswer-C
Ans.is'c'i.e.,Fattyacid[RefHarper's28"/ep.286]
Nucleotidesaremonomericunitsofnucleicacids.Theyarerequired
forsynthesisofnucleicacid.

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Eachnucleotideismadeupof:(i)Anitrogenousbase,(ii)A
sugar(pentosesugar)and(iii)Aphosphategroup(phosphoric
acid).Nitrogenousbasecombineswithasugarto
formnucleosides.Thenucleosidecombineswithphosphoricacidto
formanucleotide.

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380.CentralDogmaofmolecularbiology
indudesallexcept?
a)Transcription
b)Translation
c)RNAreplication

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d)DNAreplication
CorrectAnswer-C
Ans.is'c'i.e.,RNAreplication
DNAstoresgeneticinformation:-Informationaboutaminoacid
sequenceofalltheproteinsispresentintheformofgenesinDNA.

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TheentiregeneticmaterialpresentintheDNAofanorganismis
knownasgenome.TheimportantroleofDNAintransferof
informationinlivingcellsiscalledcentraldogmaofmolecular
biology.Accordingtothecentraldogma,informationflowsfrom
DNAtoRNAtoprotein.

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381.WhatisthefunctionofDNAligase?
a)Unwinding(denaturation)ofdsDNAtoprovideanssDNA
template
b)Sealsthesinglestrandnickbetweenthenascentchainand
Okazakifragmentsonlaggingstrand

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c)InitiationofDNAsynthesisandelongation
d)InitiatessynthesisofRNAprimers
CorrectAnswer-B
Ans.is'b'i.e.,Sealsthesinglestrandnickbetweenthenascent
chainandOkazakifragmentsonlaggingstrand[RefHarper
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2501ep.367]

382.Primasefunctionsas?
a)JoiningDNAfragments
b)SynthesiningsmallRNAfragmentsduringDNAsynthesis
c)SynthesisingsmallRNAfragmentsduringtranslation

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d)UnwindingofDNA
CorrectAnswer-B
Ans.is'b'i.e.,SynthesiningsmallRNAfragmentsduringDNA
synthesis[RefHarper's29th/ep.366,367]

383.Whatisattatchedto3'endofmRNAafter

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transcription?
a)PolyAtail
b)CCA
c)Intron
d)7-methylguanosine

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CorrectAnswer-A
Ans.is'a'i.e.,PolyAtail[Ref:Harper's29`h/ep.392]
MammalianmRNAmoleculescontaina7-methylguanosinecap
structureattheir5'terminal,andmosthaveapoly(A)tailatthe3'
terminal.

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ProkaryoticmRNAisfunctionalimmediatelyuponsynthesis,i.e.
prokaryoticprimarytranscriptofmRNAisfunctional.
Thusitdoesnotrequirepost-transcriptionalmodification.
InEukaryotestheprimarytranscriptofmRNAisthehnRNA
(hetrogeneousnuclearRNA).

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AftertranscriptionhnRNAisextensivelymodifiedtoformfunctional
mRNA.

384.WhichRNAisusedinRNAsplicing?
a)mRNA
b)SmallnuclearRNA

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c)SmallcytosolicRNA
d)tRNA
CorrectAnswer-B
Ans.is'B'i.e.,SmallnuclearRNA[RefHarper29th/ep.378,390]
SplicesomeSplicesomeisanassemblymadeupofsmallnuclear

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RNA(snRNA),someproteinsandhnRNA.snRNAcombineswith
proteinstoformsmallnuclearribnonucleoproteinparticles(snRNPs
orsnurps)thatmediatesplicing.ItissnRNAcomponentofsnurps
thatcatalyzessplicing?.SnurpsareU,,U,,U3,U4,U5andU6

385.Whichofthefollowingisaribozyme?

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a)Peptidyltransferase
b)Elongationfactor2
c)Primase
d)RNApolymerase
CorrectAnswer-A

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Ans.is'a'i.e.,Peptidyltransferase[RefHarper29thIep.405]
SomeRNAmoleculeshaveintrinsiccatalyticactivity.
Theactivityoftheseribozymesofteninvolvesthecleavageof
nucleicacid.
TwoimportantRNAenzymesorribozymesare:?
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Thepeptidyltransferasethatcatalyzespeptidebondformationon
theribosomeandRibozymesinvolvedintheRNAsplicing.

386.Primerfunctionisin?
a)Transcription
b)Translation

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c)InitiationofDNAreplication
d)TerminationofDNAreplication
CorrectAnswer-C
Ans.is'c'i.e.,InitiationofDNAreplication[RefHarper's29thlep.
366,367]
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DNAsynthesiscannotcommencewithdeoxyribonucleotides
becauseDNApolymerasecannotaddamononucleotidetoanother
mononucleotide.
Thus,DNApolymerasecannotinitiatesynthesisofcomplementary
DNAsynthesisstrandofDNAonatotallysinglestrandedtemplate.

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Forthis,theyrequireRNAprimer,whichisashortpieceofRNA
formedbyenzymeprimase?(RNApolymerase?)usingDNAasa
template.
RNAprimeristhenextendedbyadditionofdeoxyribonucleotides.
Lateron,theribonucleotidesoftheprimerarereplacedbydeoxyribo

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nucleotides.

387.Chargaff'srulestatesthat?
a)A=T,G=C
b)A=G,T=C
c)A=C,G=T

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d)Anycombinationpossible
CorrectAnswer-A
Ans.is'a'i.e.,A=T,G=C[Ref:Harper29th/ep.344&28thlep.302;
Essentialsofbiochemistryp.915]
ChargaffsrulestatesthatinDNAofallspeciesquantitiesofpurines

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isthesameasthatofpyrimidines,i.e.A+G=T+C

388.Inglycolysis,NADHisproducedat?
a)Pyruvatekinase
b)Enolase
c)Glyceraledehyde-3-P-dehydrogenase

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d)PFK-1
CorrectAnswer-C
Ans.is'c'i.e.,Glyceraledehyde-3-P-dehydrogenase[RefHarper
28th/ep.151-152]
Reducingequivalent(NADH)productioniscatalyzedby:

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Glyceraldehyde3-phosphatedehydrogenase

389.Reversetranscriptioninvolves?
a)RNAdependentDNAsynthesis
b)DNAdependentRNAsynthesis
c)DNAdependentDNAsynthesis

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d)RNAdependentRNAsynthesis
CorrectAnswer-A
Ans.is'a'i.e.,RNAdependentDNAsynthesis[RefHarper29thle
p.348]
SynthesisofRNAfromDNAiscalledtranscription.

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Intranscription,RNAissynthesizedbyRNApolymerase.RNA
polymeraseisalsocalledDNAdependentRNApolymerase
becauseitisdependentonDNA(non-codingstrand)forRNA
synthesis.
Reversetranscription,asthenamesuggests,isthereverseof

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transcriptioni.e.synthesisofDNAformRNA.
InreversetranscriptionDNAissynthesizedbyreversetranscriptase.
ReversetranscriptaseisalsocalledRNAdependentDNA
polymerasebecauseitisdependentonRNAforDNAsynthesis.

390.Enzymerequireforcuttingthestrand

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DNAsynthesis?
a)DNApolymerase
b)DNAligase
c)Topoisomerase
d)Helicase

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CorrectAnswer-C
Ans.is'c'i.e.,Topoisomerase[RefLippincott's5thiep.400,401]
AsthetwostrandsofDNAareseparatedaproblemisencountered,
i.e.appearanceofpositivesupercoils(supertwists)intheregionof
DNAaheudofreplicationform.

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Theaccumulationofpositivesupercoilinginterfereswithfurther
unwindingofthedoublehelix.
Tosolvethisproblem,thereisagroupofenzymescalledDNA
topoisomeraseswhichareresonsibleforremovingsupercoilsinthe
helix.

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DNAtopoisomerasesarenickandsealenzymes,i.e.theyhaveboth
nuclease(strand-cutting)andligase(strand-resealing)activities.

391.Whichdoesnotplayaroleinprotein
synthesis?
a)Exon

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b)Intron
c)m-RNA
d)ATP
CorrectAnswer-B
Ans.is'b'i.e.,Intron[RefLippincott's5tvep.426]
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Primarytranscriptcontainsintrons&exons.Splicingremoves
introns(segmentofgenethatisnotrepresentedinmaturem-RNA)
fromprimarytranscript.
SynthesisofproteinfrommRNAiscalled
translation.Translationistheprocessbywhichribosomesconvert

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theinformation(geneticcode)carriedbymRNAtothesynthesisof
newprotein.
Translationoccursinribosomes.Basicrequirementsfor
translationincludemRNA,tRNAs,ribosomes,energy(ATPand
GTP),enzymes,andspecificproteinfactorslikeinitiationfactors,

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elongationfactorsetc.

392.Functionofexonuclease-
a)Polymerization
b)Proofreading
c)Chainelongation

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d)Termination
CorrectAnswer-B
Ans.is'b'i.e.,Proofreading[RefDineshpuri3rd/ep.455,456]
Nucleasesreferstoanenzymethatcatalyzeshydrolysisof
phosphodiesterbondinanucleicacid.

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Thenuclesesareoftwotypes:
*Endonucleases:Cleavetheinternalphosphodiesterbonds.
*Exonucleases:Cleavebondsatends.Someexonucleasescleave
onlyatthe3'end(the3'-exonucleaseactivity)whileothercleaveat
the5'end(the5'-exonucleaseactivity).

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-31-exonucleaseactivityisresponsibleforproofreading.3'-
exonucleaseactivityispresentinDNApolymeraseI,IIandIII.
-51-exonucleaseactivityisresponsibleforerrorcorrectionin
damagedDNA.

393.Insicklecellanemia,translocationon

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codon6isduetosubstitutionof?
a)Valineforglutamate
b)Glutamateforvaline
c)Isoleucineforvaline
d)Valineforisoleucine

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CorrectAnswer-A
Ans.is'a'i.e.,Valineforglutamate[RefHarper's29th/ep.444]
Sicklecelldisease,iscausedbymutationofasinglebaseoutofthe
3x109inthegenome,aT-to-ADNAsubstitution,whichinturn
resultsinanA-to-UchangeinthemRNAcorrespondingtothesixth

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codonofthe13-globingene.Thealteredcodonspecifiesadifferent
aminoacid(valineratherthanglutamicacid),andthiscausesa
structuralabnormalityofthep-globinmolecule.

394.Whichofthefollowingusuallyrequirea
RNAintermediatefor
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cloning/replication?
a)Transposons
b)Plasmids
c)Phages
d)Cosmids

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CorrectAnswer-A
Ans.is'a'i.e.,Transposons[Ref:Lippincot4th/ep.461&Harper
29tVep.436,437]
Transposons(Tn)aremobilesegmentsofDNAthatmoveinan
essentiallyrandommannerfromonesitetoanotheronthesameor

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adifferentchromosome.
Movementismediatedbytransposase,anenzymeencodedbyTn
itself.Movementcanbe:-(i)direct,inwhichtransposasecutsout
andtheninsertsTnatanewsite,or(ii)replicative,inwhichtheTnis
copiedandthecopyinsertedelsewherewhiletheoriginremainsin

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place.
Ineukaryotes,includinghumans,replicativetranspositionfrequently
involvesaRNAintermediate,inwhichcasethetransposoniscalled
aretrotransposoni.e.tronsposonsthatinvolveaRNAintermediate
arecalledretrotransposons

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395.Chromosomalstudyisbestcarriedout
in?
a)Prophase
b)Metaphase
c)Telophase

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d)Anaphase
CorrectAnswer-B
Ans.is`b'i.e.,Metaphase[Ref:Anderson10thlep.225,226,
Robbins8thiep.158]
Methodofkaryotyping
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Karyotypingisthestudyofcoromosone.
Dividingcellsarearrestedinmetaphasebyadditionofcolchicineor
colcemid(deacetylmethylcolchicine).
Subsequently,cellsareexposedtoahypotonicsolutiontoinduce
swellingofthecellforenhancingspreadingofthechromosomes.

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Themetaphasecellsarethenfixedwithmethanol/glacialaceticacid
mixtureandstainedbyoneoftheseveralbandingtechniques.
Afterstainingchromosomesareanalysedunderamicroscopeand
photographed.
Finally,akaryotypeisconstructedbymanualorautomatedpattern.

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Chromosomesarearrangedinpairsanddecreasingorderoflength

396.Terminationcodonis?
a)AUG
b)UAA
c)AUA

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d)AGG
CorrectAnswer-B
Ans.is'b'i.e.,UAA
Initiationcodon.4AUG
Stopcodons(terminationcodonsornonsensecodons)UAA,

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UGA,UAG

397.DNAmicroarraysallowdetectionofGene
mutationsusing?
a)PolymerasechainReaction
b)Cloning

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c)SouthernBlotting
d)Hybridization
CorrectAnswer-D
Ans.is'd'i.e.,Hybridization[RefBiologybyRavenTatap.331]
DNAMicroarray(DNA-Chips)
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DNAmicroarrayscontainthusands(500-5000)ofimmobilizedDNA
probes/sequences(fewdozentohundredsofnucleotidelong)from
knowngenesorganizedinanareanolongerthanamicroscope
slide.DNAsegments(fromDNAlibraries)areamplifiedbyPCRand
placedonsmallwellsinasolidpolystyreneplates,usingrobotic

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devices.Uptomillionsuchspotsaredepositedinapredesigned
arrayonasurfaceareaofjustfewcm'.Analternatewayisto
synthesizeDNAdirectlyonthesolidsurfaceusingphotolithography.
C-DNA(obtaineddirectlyorfrommRNAofpatientsparticularcell
typeorstage)isaddedtoeachwell,hybridizeandfluorescenceis

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assessedtoassessgenesbeingexpressedinthosecells/stage.
Thisisbasedonprinciplesofnucleicacidhybridizationlikesouthern
ornorthernblottestsbutallowssimultaneousstudyofmultiple
genesorentiregenomeratherthansingle.
Hybridizationmeansbindingofcomplementarystrandsofnucleic

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acidaccordingtoWatson-Crickrules(i.e.A=TandG=Cbinding).
SouthernblotforDNAandNorthernblotforRNAallowsthe
study/detectionofsinglegenewhereasmicroarraytechnique(for
DNA&RNA)allowsdetectionofmultiplegenesorentiregenome.

SoitcanbeconsideredasmultipleSouthernorNorthernblot

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analysisrunninginparallel.

398.Whichoffollowingisananalouge
guanosine?
a)Abacavir
b)Allopurinol

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c)Bromodeoxyuridine
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Abacavir[RefEssentialsofbiochemistryp.888]

399.IdentificationofindividedbytheirDNA

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wasinventedby?
a)Shapiro
b)Lewis
c)Jeffreys
d)Pasture

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CorrectAnswer-C
Ans.is'c'i.e.,Jeffreys[RefLippicott'sSthiep.83,474,Lehniger
5thiep.319-21]
TheDNAfingerprintingwasfirstreportedin1984bySirAlec
Jeffreys?attheuniversityofleicesterinEngland.

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400.Whichofthefollowingstatements
regardingmaturecytoplasmic
messengerRNAistrue?
a)TranscribedfromNuclearDNA
b)HasThiamineinplaceofUracil

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c)SugarisDeoxyRibose
d)Itsmolecularweightismorethanhn-RNA
CorrectAnswer-A
Ans.is'a'i.e.,TranscribedfromNuclearDNA[Ref:Lippincott's
Biochemistry5thp.428;FundamentalsofCytogenetics&Genetics
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(2010)p.444]
MesengerRNA(mRNA)isformedbytheprocessof'transcription'
fromoneofthestrandsofdoublestrandednuclearDNA
andcarriesgeneticinformationfromthenuclearDNAtothecytosol
whereitisusedasatemplateforproteinsynthesis.

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mRNAcomprisesonly5-10%oftotalcellularRNA.Itcarriesthe
information(massage)fromthenucleustotheribosome.mRNAis
synthesizedinthenucleusaslieterogenousRNA(hnRNA)',which
isprocessedintofunctionalmRNA.

401.Thefoldsincollagenisdueto?

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a)Glycine
b)Alanine
c)Arginine
d)Histidine
CorrectAnswer-A

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Ans.is'a'i.e.,Glycine[RefEssentialsofbiochemistyp.868]
Inordertoformatriple-helixapolypeptidechain(a-chain)must
containglycineaseverythirdresidueinthesequence.
Thisisbecauseonlytheglycineissmallenoughtobe
accommodatedinthelimitedspaceavailabledownthecentralcore

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ofthetriplehelix.
Eachturnofpolypeptidechain(a-chain)containsthreeaminoacid
residues,andglycine(Gly)ispresentateverythirdpositions.
Thusglycineconstitutes33%ofthetotalaminoacidresidues.
Therepeatingaminoacidresidues,representedas(Gly-X-Y)n,isan

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absoluterequirementforformationoftriplehelix.
XandYcanbeanyaminoacids,butmostofthetimeXisproline
(10%ofthetotalaminoacidresidues)andmostofthetimeYis
hydroxyproline.

402.WhichofthefollowingGAGisnot

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sulphated?
a)Chondroitin
b)Dermatan
c)Keratan
d)Hyaluronicacid

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CorrectAnswer-D
Ans.is'd'i.e.,Hyaluronicacid[Ref:Harper's29thlep.596]
AGlycosaminoglycan(GAG)isanunbranchedpolysaccharidemade
upofrepeatingdisaccharides,onecomponentofwhichisalwaysan
aminosugar(hencethenameGAG),eitherD-glucosamineorD-

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galactosamine.
Theothercomponentoftherepeatingdisaccharide(exceptinthe
caseofkeratansulfate)isauronicacid,eitherL-glucuronicacid
(GlcUA)orits5'-epimer,L-iduronicacid(IdUA).
Proteoglycansareproteinsthatcontaincovalentlylinked

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glycosaminoglycans.
Theproteinsboundcovalentlytoglycosaminoglycansarecalled
"coreproteins".
Withtheexceptionofhyaluronicacid,alltheGAGscontainsulfate
groups,eitheras0-estersorasN-sulfate(inheparinandheparan

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sulfate).
Hyaluronicacidaffordsanotherexceptionbecausethereisnoclear
evidencethatitisattachedcovalentlytoprotein,asthedefinitionof
aproteoglycangivenabovespecifies.

403.Repeatitivechainsofglucosaminewith

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uronicacidareseenin?
a)NANA
b)Heparansulphate
c)Keratansulphate
d)Noneofthese

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CorrectAnswer-B
Ans.is`b'i.e.,Heparansulphate[RefDineshpuriYalep.31,32]
Proteoglycansaremadeupofcoreprotein,coretrisaccharideand
glycosaminoglycans.
Proteoglycans=Glycosaminoglycans+Coretrisaccharide+Core

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protein.
Glycosaminoglycans(mucopolysaccharides)aremadeupof
repeatingdiasaccharideunits.Eachdiasaccharideunitcontains?

404.Acuteintermittentporphyriaisdueto
deficiencyof?

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a)UroporphyrinogenIsynthase
b)UroporphyrinogenIIIsynthase
c)Ferrochelatase
d)ALAsynthase
CorrectAnswer-A

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Ans.is'a'i.e.,UroporphyrinogenIsynthase[RefHarper29tVep.
313]

405.Myoglobincontains?
a)Iron
b)Copper

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c)Zink
d)Selenium
CorrectAnswer-A
Ans.is'a'i.e.,Iron[RefHarper29th/ep.308,Vasudevan6th/ep.
242]
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Hemoproteinsareproteinswhichhavehemeasprostheticgroup.
Importanthemoproteinsarehemoglobie,myoglobinQ,
cytochromesQ(cytochromeCQ,cytochromeP450Q),catalaseQ,
peroxidase,tryptophanpyrrolaseandnitricoxidesynthase.
Allhemoproteinscontainironasironisthecentralcomponentof

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heme

406.Reversefoldingofproteinsiscarriedout
by?
a)Valine
b)Threonine

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c)Chaperone
d)Aspartate
CorrectAnswer-C
Ans.is'c'i.e.,Chaperone[RefHarper's29th/ep.558,559]
Certainproteinsplayaroleintheassemblyorproperfoldingofother

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proteinswithoutthemselvesbeingcomponentsofthelatter.
Suchproteinsarecalledmolecularchaperones.
MostchaperonesexhibitATPaseactivityandbindADPandATP.
Thisactivityisimportantfortheireffectonfolding

407.Ratelimitingenzymeinhemesynthesis

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?
a)ALAsynthase
b)Hmgcoareductase
c)ALAdehydratase
d)Uroporphyrinogen1synthase

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CorrectAnswer-A
Ans.is'a'i.e.,ALAsynthase[RefHarper's29'lep.309]
Hemesynthesistakesplaceinallcells,butoccurstogreatestextent
inbonemarrowandliver.Thefirststepinthesynthesisofhemeis
thecondensationofglycineandsuccinylCo-Atoform6-

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aminolevulinicacid(6-ALA),whichoccursinmitochondria.This
reactioniscatalyzedby6-ALAsynthasewhichrequirespyridoxal
phosphate(PLP)ascofactor.Thisistheratelimitingstepinheme
synthesis.

408.Proteinglycosylationoccursin?

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a)ER
b)Golgibodies
c)Mitochondria
d)Peroxisomes
CorrectAnswer-A:B

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Ans.is'b>a'i.e.,Golgibodies>ER[RefHarper's29th/ep.549,
572]
TheendoplasmicreticulumandtheGolgiapparatusarethemajor
sitesinvolvedinglycosylationprocesses.
However,0-glycosylationoccursonlyintheGolgiapparatusandso

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itistheorganellewherealltypesofglycosylationreactionscantake
place

409.Thisattachestoproteinbefore
destruction?
a)Ubiquitin

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b)RNAseF
c)Zymase
d)Chaperone
CorrectAnswer-A
Ans.is'a'i.e.,Ubiquitin[RefHarper291Vep.560-561]
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UbiquitinIsaKeyMoleculeinProteinDegradation
Therearetwomajorpathwaysofproteindegradationineukaryotes.
OneinvolveslysosomalproteasesanddoesnotrequireATP.The
otherpathwayinvolvesubiquitinandisATP-dependent.
Itplaysthemajorroleinthedegradationofproteins,andis

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particularlyassociatedwithdisposalofmisfoldedproteinsand
regulatoryenzymesthathaveshorthalf-lives.

410.Weakestbondis?
a)Covalent
b)Hydrogen

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c)Electrostatic
d)Vanderwall
CorrectAnswer-D
Ans.is'd'i.e.,Vanderwall[Ref:Harper28thlep.9;Basicsof
molecularbiologyp.786]
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StrongestbondCovalent
Weakestbond-4Vanderwallsforces
Covalent(strongest)?>Electrostatic0(ionicorsaltlinkage)>
hydrogen>hydrophobic>Vanderwaal's(weakest)?

411.Proteinsegregationoccursin?

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a)Golgiappparatus
b)Peroxisomes
c)ER
d)Mitochondria
CorrectAnswer-A

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Ans.is'a'i.e.,Golgiappparatus[RefHarper29th/ep.549]
Golgiapparatusplaysamajorroleinsortingofproteins.

412.Whichofthefollowingtripeptide?
a)Glutathione
b)Angiotensin

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c)Glucagon
d)Oxytocin
CorrectAnswer-A
Ans.is'a'i.e.,Glutathione[RefHarper28thlep.679-680]
AngiotensinIII Heptapeptide(6aminoacids)

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AngiotensinII Octapeptide(8aminoacids)
Oxytocin
Nonapeptide(9aminoacids)
Bradykinin
Nonapeptide(9aminoacids)

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Vasopressin Nonapeptide(9aminoacids)
Glucagon
Decapeptide(10aminoacids)
AngiotensinI Decapeptide(10aminoacids)

413.Shortestpeptide?

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a)AngiotensinII
b)AngiotensinIII
c)Oxytocin
d)Vasopressin
CorrectAnswer-B

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Ans.is'b'i.e.,AngiotensinIII[RefEssentialsof
biochemistryp.627]

414.InFITCthecoloremittedafterbluelight
absorption?\
a)Yellowgreen

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b)Orangered
c)Applegreen
d)Goldenbrown
CorrectAnswer-A
Ans.is'a'i.e.,Yellowgreen
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Fluoresceinisothiocyanate(FITC)isaderivativeoffluoresceinused
inwide-rangingapplicationsincludingflowcytometry.FITCisthe
originalfluoresceinmoleculefunctionalizedwithanisothiocyanate
reactivegroup(-N=C=S),replacingahydrogenatomonthebottom
ringofthestructure.Thisderivativeisreactivetowardsnucleophiles

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includingamineandsulfhydrylgroupsonproteins.
FITC(fluoresceinisothiocyanate)isafluorochromedyethatabsorbs
ultravioletorbluelightcausingmoleculestobecomeexcitedand
emitavisibleyellowgreenlight.Thisemissionceasesuponremoval
ofthelightcausingtheexcitation.

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415.Oxidativedeaminationoccursin?
a)Cytoplasmofallcells
b)Mitochondriaofallcells
c)Cytoplasmofhepatocytes
d)Mitochondriaofhepatocytes

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CorrectAnswer-D
Ans.is'd'i.e.,MitochondriaofHepatocytes[Ref:Harper29'/ep.
274]
Deaminationmeansremovalofaminogroupofaminoacidinthe
formofammonia.Thus,anaminoacidisconvertedtoaketoacid.

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Deaminationcoupledwithoxidationiscalledoxidative
deamination.Itoccursinthemitochondria.
Oxidativedeaminationoccursprimarilyintheliver(majororgan)and
kidney.

416.WhichisoformofLDHisraisedin

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Anemia?
a)LDH5
b)LDH4
c)LDH3
d)LDH2

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CorrectAnswer-D
Ans.is'd'i.e.,LDH2[RefChatterjea7th/ep.600-605,Harper
28th/ep.59]
LDH-2isfoundinRBCsandisincreasedinmegaloblasticanemia.

417.Inapoptosis,cytochromeCactsthrough

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-
a)Apaf1
b)Bcl-2
c)FADD
d)TNF

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CorrectAnswer-A
Ans.is'a'i.e.,Apaf1
Oneoftheseproteinsiscytochromec,wellknownforitsrolein
mitochondrialrespiration.Inthecytosol,cytochromeCbindstoa
proteincalledApaf-1(apoptosisactivatingfactor-1),andthe

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complexactivatescaspase-9.(Bc1-2andBcl-xmayalsodirectly
inhibitApaf-1activation,andtheirlossfromcellsmaypermit
activationofApaf-1).

418.Whenstemcellstransformstoformcells
characteristicofothertissues,the
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processiscalledas-
a)De-differentiation
b)Re-differentiation
c)Trans-differentiation
d)Sub-differentiation

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CorrectAnswer-C
Ans.is'c'i.e.,Trans-differentiation
Transdifferentiation
*Transdifferentiationtakesplacewhenanon-stemcelltransform
intoadifferenttypeofcell,orwhenanalreadydifferentiatedstem

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cellcreatescellsoutsideitsalreadyestabilisheddifferentiation.
*Rememberveryimportantfactthatitisthenon-stemcellor
alreadydifferentiatedstemcell(i.e.maturecell)thatistransformed
intoothertypeofcell.Itisnotstemcellthatistransforming.
*Transdifferentiationisatypeofmetaplasia.

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*Then,whatisthedifferencebetweentransdifferentiationand
metaplasia.
*InTransdifferentiationonlydifferentiatedstemcellistransformed
intoothercelltype,whileinmetaplasiaanyofthetwo,eitherstem
cellordifferentiatedcellcantransformintoothercelltype.

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*So,alltransdifferentiationprocessesaremetaplasia,butnotall
metaplasiaaretransdifferentiation.oMostlikelyquestionhasbeen
wronglyframedhere,thereshouldbenon-stemcellinsteadofstem
cellinthequestion.Anywaysanswerremainsthesame,asnoother
optionisrelatedtothistypeoftransformation.

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419.Cellsmostsensitivetohypoxiaare?
a)Myocardialcells
b)Neurons
c)Hepatocytes
d)Renaltubularepithelialcells

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CorrectAnswer-B
Ans.is'b'i.e.,Neurons
Thesusceptibilityofatissuetohypoxiainfluencesthelikelihoodof
infarction.
Neuronsaremostsensitivetohypoxia(irreversiblechangesdevelop

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in3-4minutes)followedbymyocardialcells(irrversiblechanges
developin20-40minutes).
Fibroblastsareamongstthemostresistentcellstohypoxia.

420.LinesofZahnoccurin-
a)Postmortemclot

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b)Infarct
c)Embolus
d)Corallinethrombus
CorrectAnswer-D
Ans.is'd'i.e.,Corallinethrombus

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ItisseeninPrimaryplateletthrombi.

421.Dohlebodies-
a)DilatedEndoplasmicReticuluminNeutrophils
b)Mitochondria
c)Golgiapparatus

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d)Lysosomes
CorrectAnswer-A
Ans.is'a'i.e.,Dilatedendoplasmicreticuluminneutrophils
Dohlebodiesarelightbluegray,bosophilicinclusionsinthe
peripheralcytoplasmofneutrophils.oTheyarethoughttobe

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remnantsoftheroughendoplasmicreticulumcontainingRNA.

422.whichofthefollowingdoesnotbelongto
thefamilyofselectin?
a)Pselectin
b)Lselectin

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c)Aselectin
d)Eselectin
CorrectAnswer-C
Ans.is'c'i.e.,Aselectin
Leukocyteandendothelialadhesionmolecules

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Leukocyteadhesionandtransmigrationareregulatedlargelyby
bindingofcomplementaryadhesionmoleculesontheleukocyte&
endothelialsurface,andbychemicalmediators.
Cytokinesaffecttheseprocessesbymodulatingtheexpressionof
adhesionmoleculessothatleukocytescanfirmlyadhereto

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endothelium.
Therearefourmolecularfamiliesofadhesionreceptors.
1.Selectin
Selectinsfunctioninthecelltocellinteractioni.e.,adhesionof
leukocytestotheendothelium.

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E-selectin(CD-62E)ispresentonendothelialcellsanditbindsto
sialyl-lewis.(asialylatedformofoligosaccharideonleukocytes).
EndothelialcellexpressionofE-selectionisahallmarkofacute
cytokine-mediatedinflammation.
P-selectin(CD-62P)ispresentonendotheliumandplateletsandit

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bindstosialyl-Lewisonleukocytes.
L-selectin(CD-62L)ispresentonleukocytesanditbindstomucin-
likeglycoproteinG1yCAM-Iontheendothelium.
2.Immunoglobulinfamily

Presentonendothelium

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ICAM-1(intracellularadhesionmolecule-1)bindsto132-integrins
(VLA-4)ofleukocytes.
Plateletendothelialcelladhesionmolecule(PECAMorCD-31)is
presentonbothendotheliumandleukocytes.Itisthemajor
adhesivemoleculefordiapedesis.

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3.Integrins
Integrinspromotecell-cellorcell-matrixinteraction(incontrastto
selectinsthatpromoteonlycell-cellinteraction)i.e.,integrinshelpin
adhesionofleukocytestoendotheliumandadhesionofleukocytes
toanextracellularmatrixsuchasfibronectin,vitronectin,activated

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compliment.
Presentonleukocytes
integrins(VLA-4)bindtoVCAM-1oftheendothelium.
P2-integrins(LFA-1andMAC-1)bindtoICAM-1ofthe
endothelium.

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4.Mucinlikeglycoprotein
Theseglycoproteinsarepresentintheextracellularmatrixandon
thecellsurface.
AnexampleisHeparansulfate,thatservesasaligandforthe
leukocyteadhesionmoleculeCD-44.

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423.Cell-matrixadhesionsaremediatedby?
a)Cadherins
b)Integrins
c)Selectins
d)Calmodulin

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CorrectAnswer-B
Ans.is'b'i.e.,Integrins
Cell-matrixadhesions,areusuallymediatedbyintergrins
Cell-celladhesionsinAnchoringjunctionsaremediatedby
cadherins.

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424.Followinginjurytoabloodvessel,
immediatehaemostasisisachievedby-
a)Fibrindeposition
b)Vasoconstriction
c)Plateletadhesion

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d)Thrombosis
CorrectAnswer-B
Ans.is'b'i.e.,Vasoconstriction
Hemostasis
*Hemostasisisaphysiologicalprocesswherebybleedingishalted,

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thusprotectingtheintegrityofthevascularsystemaftertissueinjury.
*Itisresponsibleforminimizingbloodloss.
*Itiscommonlyreferredtoasstoppageofbleeding.
Thehemostaticmechanismshaveseveralfunctions:?
*l.Maintainbloodinfluidstatewhilecirculatingwithinthevascular

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system.
*Arrestbleedingatthesiteofinjurybyformationofhemostaticplug.
*Ensuretheremovalofhemostaticplugwhenhealingiscomplete.
Thecomponentsofnormalhemostasisinclude:?
-Bloodvessels(endothelium)

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-Platelets
-Plasmacoagulationfactorsandtheirinhibitors.
-Fibrinolyticsystem.
Whenabloodvesselisinjured,severalstepsoccurinhemostasisat
thesiteofinjury:?

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Vasoconstriction
*Afterinitialinjury,thereisabriefperiodarteriolarvasoconstriction,
minimizingvesseldiameterandslowingbleeding.

*Thisisduetoreflexneurogenicmechanismandaugmentedbya
potentendotheliumderivedvasoconstrictorendothelin.

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*Howeverthiseffectistransient,bleedingwouldresumeiftherewill
noactivationofplateletandcoagulationsystem.
Primaryhemostasis
*Endothelialinjuryexposeshighlythrombogenicsubendothelial
extracellularmatrixtobind(adhere)withcollegenofECM.

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*Bindingofplateletsactivatesthesecellsandplateletsrelease
secretorygranules.
*Thesesecretoryproducts(fromsecretorygranules)recruite
additionalplateletsto(plateletplug).
C.Secondaryhemostasis
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*Coagulationsystemisactivatedandthrombinisgenerated.
*Thrombinconvertsfibrinogentofibrin.
*Ultimatelytheseeventsformsanireversiblyfusedmassof
platelets,thrombinRBCsandfibrinogen-->Definitivesecondary
hemostaticplug.

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D.Repairofvesselsanddissolutionofclot
*Theclotattractsandstimulatesthegrowthoffibroblastandsmooth
musclecellswithinthevesselwall,andbeginsrepairprocess.
*Atthisstagefibrinolyticsystemisalsoactivated,resultingin
dissolutionoftheclot.

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425.Maximumcollageninwoundhealingis
seenat-
a)Endoffirstweek
b)Endofsecondweek
c)Endofthirdweek

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d)Endof2months
CorrectAnswer-B
Ans.is'b'i.e.,Endofsecondweek
Duringsecondweekthereiscontinuedaccumulationofcollagen
andproliferationoffibroblast.Maximumcollagenisseeninsecond

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week.

426.MostpotentstimulatorofNaiveT-cells-
a)Maturedentriticcells
b)Folliculardentriticcells
c)Macrophages

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d)B-cell
CorrectAnswer-A
MatureDendriticcells
MatureB-cellsandT-cellsbeforeantigenicexposurearecalled
naive-BandTcellsrespectively.Sequenceofeventsinactivationof

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naiveTcells.
Immaturedendriticcellsintheepidermisarecalledlangerhanscell.
Theseimmaturedendriticcells(langerhanscells)capturethe
antigenintheepidermis.
Aftercapturingtheantigenthesecellssecretecytokines.

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Thesecytokinescauselossofadhesivenessoflangerhanscells.
Langerhanscellsseparatefromeachotherandmigrateinto
lymphaticvessels.
Inlymphaticvessel,maturationoflangerhanscellstakesplace.
ThenthesematurelangerhansdendriticcellsreachtonaiveTcells

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inthelymphnodesandpresentantigentothesecellsandactivate
them.

427.Commonvariable
hypogammaglobulinemiashows?
a)DecreasedBcellcount

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b)IncreasedBcellcount
c)Complimentopsinization
d)Neutropenia
CorrectAnswer-C
Ans.is'c'i.e.,NormalBcells

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Mostpatientswithcommonvariableimmunodeficiencyhavenormal
ornear-normalnumbersofBcellsinthebloodandlymphoidtissues.
TheseBcells,however,arenotabletodifferentiateintoplasma
cells.
Theclinicalmanifestationsarecausedbyantibodydeficiency.

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Thefeaturecommontoallpatientsishypogammaglobulinemia,
generallyaffectingalltheantibodyclassesbutsometimesonlyIgG.

428.Amyloidosisismostcommonlyseenin?
a)MaturityonsetDM
b)TypeIDM

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c)TypeIIDM
d)HTN
CorrectAnswer-C
Ans.is'c'i.e.,TypeIIDM
ThetwobestexamplesoflocalizedamyloidosisareAlzheimer's

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diseaseandtype2diabetesmellitus.
Localizedamyloiddepositionresultsfromtheproductionofaunique
polypeptide,whichcontainsanamyloidogenicsequenceandis
capableofformingabeta-pleatedsheetstructurenecessaryfor
thesedepositstoaggregate.

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Intype2diabetesitistheisletamyloidpolypeptide(IAPP)also
knownasamylin.
InAlzheimer'stheuniquepeptideisthebeta-amyloidprotein(A
beta).

429.WhichtypeofAmyloidosisiscausedby

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mutationofthetransthyretinprotein?
a)FamilialMediterraneanfever
b)Familialamyloidoticpolyneuropathy
c)Dialysisassociatedamyloidosis
d)Prionproteinassociatedamyloidosis

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CorrectAnswer-B
Ans.is'b'i.e.,Familialamyloidoticpolyneuropathy
Transthyretin(TTR)isnormalserumproteinthatbindsandtransport
thyroxineandretinol.
TTRcancausefollowingtypesofamyloidosis:?
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MutantTTR:-MutationinTTRcancausesyndrome
offamilialamyloidoticpolyneuropathyorfamilial
amylodoticcardiomyopathy.
Wild(non-mutant)TTR:-ThereisnomutationofTTRandwildtype
TTRformsfibrilswhichresultsinsenilesystemicamyloidosis(senile
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cardiacamyloidosis).

430.TruestatementaboutinheritenceofanX
linkedrecessivetraitis-
a)50%ofboysofcarriermotherareaffected
b)50%ofgirlsofdiseasedfatherarecarrier

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c)Fathertransmitsdiseasetotheson
d)Mothertransmitsthediseasetothedaughter
CorrectAnswer-A
Ans.is'a'i.e.,50%ofboysofcarriermotherareaffected
allX-linkeddisordersareX-linkedrecessive.
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AsmalehasonlyoneX-chromosome,themalewithaffectedgene
onX-chromosomewillalwaysmanifestthedisease.
Ontheotherhand,femalehas2X-chromosomes,heterozyogous
femalewillbecarrierbecauseofexpressionofnormalallelonthe
otherX-chromosome.

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50%boysofthecarriermotherwillbeaffected.
FatherwillnottransmittthediseasetosonasboysdonotinheritX-
chromosomefromfather.

431.Neurofibromatosistrueall,except-
a)Autosomalrecessive

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b)Associatedwithcataract
c)Scoliosis
d)Multiplefibroma
CorrectAnswer-A
Ans.is'a'i.e.,Autosomalrecessive

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Neurofibromatosiscomprisesoftwodistinctdisorders-
*NeurofibromatosisI
*NeurofibromatosisII
*Thegenesforthesearelocatedondifferentchromosomes.
*Bothareinheritedinanautosomaldominantpattern.

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*Theclassicalformofthediseasewithmultipleneuromasiscalled
NeurofibromatosisIandiscausedbyamutationofthegene
neurofibrominonchromosome17

432.ThetumorsuppressorgeneP53induces
cellarrestat-

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a)Mphase
b)S-G2phase
c)G1-Sphase
d)Go-phase
CorrectAnswer-C

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Ans.is'c'i.e.,G1-Sphase
FactorsactingatG,Spointare:?
Stimulatorofcycle:CyclinD-CDK4(phosphorylateRB
gene);cyclinE-CDK-2.
Inhibitorsofcycle:TheCip/kipfamily(p21,p27,p57);INK4a/ARF

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family(p16INK4a,p14ARF,p16,p17,p18,p19

433.Maletomaletransmissionisseenin-
a)Autosomaldominantdiseases
b)Autosomalrecessive
c)X-linkeddominant

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d)Mitochondrialdisease
CorrectAnswer-A
Ans.is'a'i.e.,Autosomaldominantdisease
Xchromosomeisnottransmittedfromfathertoson(optioncis
excluded)andmitochondrialdisordersarealwaysmaternally

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inherited(optiondisexcluded).
Autosomalrecessivedisordercanbetransmittedfromfathertoson,
butonlyifthemotherisalsoaffectedoratleastsheiscarrier.Ifonly
maleisaffected,autosomalrecessivedisordercannotbe
transmittedtoson.

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Autosomaldominantdisordercanbetransmittedinanydirection:-
Fromfathertosonordaughter.
Frommothertosonordaughter.

434.Femaleisaffected,maleisnot.Disease
isautosomaldominant,whatisthe
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chanceinchildren?
a)50%affected
b)25%affected
c)75%affected
d)Allaffected

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CorrectAnswer-A
Ans.is'a'i.e.,50%Affected
Ifoneoftheparent(motherorfather)isaffectedinautosomal
dominantdisorder,everychildhas50%ofchanceofhavingthe
diseaseand50%ofchancenothavingthedisease.

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435.Overgrowthofaskinstructureata
localisedregion-
a)Hamartoma
b)Malignanttumor
c)Choriostoma

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d)All
CorrectAnswer-A
Ans.is'a'i.e.,Hamartoma
Aberrantdifferentiationmayproduceamassofdisorganizedbut
maturespecializedcellsortissueindigenoustotheparticularsite,

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referredtoasahamartoma.
Anectopicrestofnormaltissueiscalledachoristoma.egarestof
adrenalcellsunderthekidneycapsule.
Whenaneoplasm,benignormalignant,producesamacroscopically
visibleprojectionaboveamucosalsurfaceandprojects,itistermed

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apolyp.

436.Radiationexposureduringinfancyhas
beenlinkedtowhichoneofthefollowing
carcinoma-
a)Breast

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b)Melanoma
c)Thyroid
d)Lung
CorrectAnswer-C
Ans.is'c'i.e.,Thyroid

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"Differentiatedthyroidcarcinomaparticularlypapillaryvariety
frequentlyfollowsaccidentalirradiationofthyroidininfancyand
childhood"-Bailey
Radiationinducedcancers
Radiationmayinducesomenon-lethalchangesinDNAsequences

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whichmaycausemalignanttransformation

437.Li?Fraumenisyndromeisdueto
mutationofwhichgene-
a)P21
b)P53

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c)P41
d)P43
CorrectAnswer-B
CancerarisesthroughaseriesofsomaticalterationsinDNAthat
resultinuncontrolledcelldivision.

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Humancancershavefollowingimportantetiologicalfactors?
Geneticpredispositiontocancer
Non-hereditarypredisposingconditions
Geographicandenvironmentalfactors
Genetic(Hereditaryorinherited)predispositiontocancer

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Alargenumberofcancershavehereditarypredispositions.
Geneticpredispositionmaybeofthreetypes.
AutosomaldominantInheritedcancersyndromes
Thisisthemostcommontypeofgeneticpredisposition.
Themechanisminvolvesuncontrolledcelldivisionduetogermline

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mutationofcancersuppressorgene.
Gene
Inheritedpredisposition
RB
Retinoblastoma

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p53
Li-fraumenisyndrome
pl6INK4A
Melanoma
Familialadenomatouspolyposis/colon

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APC
cancer
NF-1,NF-2
Neurofibromatosis1and2
BRAC-1,BRAC-2

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Neurofibromatosis1and2

BRAC-1,BRAC-2
Neurofibromatosis1and2
MEN1,RET
Multipleendocrineneoplasia

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MSN2,MLH1,MSH
Heriditarynonpolyposiscoloncancer
6
PATCH
Nevoidbasalcellcarcinomasyndrome

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2.DefectiveDNArepairsyndrome
Besidethedominantlyinheritedprecancerousconditions,agroupof
cancerpredisposingconditionsiscollectivelycharacterizedby
defectsinDNArepair.
Normally,iftheDNAdamageispresentitisrepairedatcell-cycle

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checkpoints.
IfDNArepairmechanismisdefective,cellsreplicatewithdefective
DNAandmutationsorchromosomalbreaksaretransferedinthe
progenyofcellsthatcanleadtouncontrolledreplication.
Mostoftheseconditionsareinheritedasautosomalrecessive,e.g?

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1. Xerodermapigmentosa
2. Fanconisyndrome
3. Bloomsyndrome
4. Ataxiatelangectasia
Oneconditioninthisgroupi

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sautosomaldominantheriditorynonpolypidcoloncancer(HNPCC).
3.Familialcancers
Besidestheinheritedsyndromesofcancersusceptibility,some
cancersoccurathigherfrequencyincertainfamilieswithouta
clearlydefinedpatternoftransmission.

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Thatmeans,thereisfamilialclusteringofcases,butroleofinherited
predispositionisnotclearforeachindividual.
Example-Breast,ovarian,andpancreaticcancers.

438.Regardingdesmoidtumourwhichisnot
correct?

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a)Oftenseenbelowtheumbilicus
b)Unencapsulated
c)Morecommoninwomen
d)Highlyradiosensitive
CorrectAnswer-D

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Ans.is`d'i.e.,Highlyradiosensitive
Desmoidtumourisanaggressivefibromatosisor
musculoaponeuroticfibromatosisisamonoclonalfibroblastic
proliferationarisinginmusculoaponeuroticstructures.
Histologicallythesetumoursareconsistofspindleshapedcellsin

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collagenousmatrixandlackthepleomorphic,atypicalor
hyperchromaticnucleiofmalignancy.
AminorityofdesmoidtumoursareassociatedwithGardener
syndromeandmutationsoffamilialadenomatouspolyposis(FAP)
gene.

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Mostspontaneousdesmoidtumoursareassociatedwithmutations
ofbeta-cateningene.

439.Carcinomaoflung,breastmarkeris-
a)CEA
b)AFP

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c)11CG
d)CA-15-3
CorrectAnswer-A
Ans.is'a'i.e.,CEA
Carcinoembryonicantigenisamarkerincancerofcolon,pancreas,

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lung,breast,andovary.

440.Telomerase-
a)RNApolymerase
b)Causescarcinogenesis
c)Presentinsomaticcells

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d)Absentingermcells
CorrectAnswer-B
TelomeraseisaDNApolymerase(RNAdependentDNA
polymerase)whichispresentingermcellsandisabsentfrommost
somaticcells.

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Thustelomeraseactivityandmaintenanceoftelomerelengthare
essentialforthereplicativepotentialincancercells.

441.7dayoldMIthemostsensitive
biochemicalmarker
a)TroponinIT

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b)CPKMB
c)LDH
d)Myoglobin
CorrectAnswer-A
Ans.is'a'i.e.,TroponinIT

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TroponinTorIisasensitivememberandreturntonormalafter7-10
days(seepreviousexplanations).

442.Vegetationsinlibmansacendocarditis
are?
a)Largeandfragile

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b)Smallwartyalongthelineofclosureofvalve
c)Smallormediumsizedoneitherorbothsidesofvalve
d)Smallblandvegetations
CorrectAnswer-C
Ans.is'c'i.e.,Smallormediumsizedoneitherorbothsidesofvalve

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SLE,mitralandtricuspidvalvulitiswithsmall,sterilevegetations,
calledLibman-Sacksendocarditisisoccasionallyencountered.
Thelesionsaresmallsingleormultiple,sterile,granularpink
vegetationsrangingfrom1to4mmindiameter.Thelesionsmaybe
locatedontheundersurfacesoftheatrioventricularvalves,onthe

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valvularendocardium,onthecords,oronthemuralendocardiumof
atriaorventricles.
Anintensevalvulitismaybepresent,characterizedbyfibrinoid
necrosisofthevalvesubstancethatisoftencontiguouswiththe
vegetation.

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Subsequentfibrosisandseriousdeformitycanresultthatresemble
chronicRHDandrequiresurgery.

443.Atheromatouschangesofbloodvessels
affectsearlyin-
a)Kidney

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b)Heart
c)Liver
d)Spleen
CorrectAnswer-B
Ans.is'b'i.e.,Heart

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SitesofAtherosclerosis
Atheroscleroticplaquesdevelopprimarilyinelasticarteries(e.g.,
aorta,carotidandiliacarteries),andlarge&mediumsizedmuscular
arteries(e.g.,coronaryarteryandpoplitialarteries).
Indescendingorder,thevesselsmostcommonlyinvolvedare-

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Abdominalaorta(mostcommon)Causinganeurysm
Coronaryarteries(heart)CausingMI
PoplitealarteriesCausingischemicgangreneoflowerlimbs.
InternalcarotidarteriesCausingstrokeaCircleofwillis
Vesselsusuallysparedare

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Vesselsofupperextremities
Mesentricandrenalvessels,exceptattheirostia.

444.Whichoneofthefollowingsetsof
componentsofcigarettesmokeisa
causalagentofcoronaryarterydisease-

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a)Tarandnicotine
b)Nicotineandcarbonmonoxideandtar
c)CarbonmonoxideandTar
d)Carbondioxide
CorrectAnswer-B

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Ans.is`b'i.e.,Nicotineandcarbonmonoxideandtar
Mechanismsforsmoking-inducedCoronaryheartdisease
Carbonmonoxideinducesatherogenesis.
NicotinestimulationofadrenergicdriveraisingbothBPand
myocardialoxygendemand.

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Lipidmetabolismwithfallinprotectivehigh-densitylipoproteins.
Note:
Tarisassociatedwithcarcinogenesis(notatherosclerosis).But
amongstthegivenoptionsoptionbisthebestanswerasitconsists
ofbothnicotineandCO.

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445.AllistrueaboutGiantcellarteritis
except?
a)Involveslargetosmallsizedareteries
b)Granulomatousinflammation
c)Mostcommonlyinvolvedarteryisabdominalaorta

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d)Segmentalnatureoftheinvolvement
CorrectAnswer-C
Ans.is'c'i.e.,Mostcommonlyinvolvedarteryisabdominalaorta
Itisthemostcommonformofsystemicvasculitisinadults,isan
acuteandchronic,oftengranulomatous,inflammationofarteriesof

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largetosmallsize.
Itaffectsprincipallythearteriesinthehead-especiallythetemporal
arteries--butalsothevertebralandophthalmicarteriesandthe
aorta,whereitmaycausethoracicaorticaneurysm

446.Mostcommoncauseofdissecting

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hematomaisbecauseof-
a)Hypertension
b)Marfan's
c)Iatrogenic
d)Kawasaki

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CorrectAnswer-A
Ans.is'a'i.e.,Hyertension
Morethan90%ofdissectionsoccurinmenbetweentheagesof40
and60withantecedenthypertension.

447.PyogenicgranulomtrueA/E

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a)Bacterialinfection
b)Bleeding
c)Benigntumour
d)Capillaryhemangioma
CorrectAnswer-A

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Answer-A.Bacterialinfection
Pyogenicgranuloma(PG)orlabularcapillaryhemangiomaisa
benignvasculartumouroftheskinormucousmembrane
characterizedbyrapidgrowthandfriablesurface.
Angiogenicgrowthfactorssuchasvascularendothelialgrowth

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factors(VEGE)anddecorin,transcriptionfactors,andsignal
transductionpathways(MAPK)areoverexpressedinpyogenic
granulomas

448.Cysticmedialnecrosisisseenin-
a)Marfanssyndrome

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b)FriedrichsataxiaPattern
c)Downssyndrome
d)Kawasakidisease
CorrectAnswer-A
Ans.is'a'i.e.,Marfan'ssyndrome

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Cysticmedialnecrosis(CMN)isadisorderoflargearteries,
characterizedbyanaccumulationofabasophilicgroundsubstance
inthemediawithcyst-likelesions.
Itisknowntooccurincertainconnectivetissuediseasessuchas
Marfansyndrome,Ehlers-Danlossyndrome,andannuloaortic

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ectasia,whichusuallyresultfromdegenerativechangesintheaortic
wall.
TherelationshipsbetweenCMNandcongenitalheartdefectsaswell
asotherdisordershavebeenevidenced.Themechanismsarestill
controversial,eventhoughmanymolecularstudieshavebeen

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conducted
itischaracterizedbyelastictissuefragmentationandseparationof
theelasticandfibromuscularelementsofthetunicamediabysmall
cleftlikespaceswherethenormalelastictissueislost;theseareas
arefilledwiththeamorphousextracellularmatrixofconnective

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tissueandresemblebutarenottrulycysts.

449.Medialcalcificationisseenin-
a)Atherosclerosis
b)Arteriolosclerosis
c)Monckebergssclerosis

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d)Dissectinganeurysm
CorrectAnswer-C
Ans.is'c'i.e.,Monckebergssclerosis
Firstseetypesofarteries
Basedontheirsizeandstructuralfeatures,arteriesaredividedinto

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threetypes.
LargeorElasticarteries
Aorta
Itslargebranches,eg.-Innominate,Subclavian,commoncarotid,
iliac.

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Pulmonaryarteries.
Mediumsizedormusculararteries
SmallbranchesofaortaCoronary,Renal
Smallarteriesandarterioles
Withinsubstanceofthetissue

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Nowseetheiraffection?
Arteriosclerosis
Dontgetconfusewithatherosclerosis.
Arteriosclerosismeanshardeningofarteriesbythickeningandloss
ofelasticityofarterialwall.oTherearethreepatternsof

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arteriosclerosis.
Atherosclerosis
Characterizedbyintimallesions,i.e.atheromas,whichprojectinto
vascularlumenandmayobstructit.oThisisthemostcommon

patternofarteriosclerosis.

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Itinvolveselasticarteries,andlarge&mediumsizemuscular
arteries.
Arteriolosclerosis
Seeninarteriolesofpatienswithhypertensionanddiabetes.
Twoanatomicvariantsarecommon-->hyalineandhyperplastic

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arteriolosclerosis.
Monkebergmedialcalcificsclerosis
Itisseeninsmallandmediumsizedmusculararteries.
Itisadegenerativeandapparentlynon-inflammatorydisease.
Mediaofthesearteriesbecomescalcified.

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Itoccursinpatientsolderthan50years.

450.Visceralaneurysmismostcommonly
seenin
a)Splenic
b)Renal

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c)Hepatic
d)Coronary
CorrectAnswer-A
Answer-A.Splenic
Mostcommonvisceralarteryaneurysmissplenicarteryaneurysm.

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2ndmostcommonvisceralarteryaneurysmishepaticartery
aneurysm.

451.Raynaud'sphenomenonwhatchangeis
seeninvesselsinitialstage-
a)Nochange(Fibrinoid,Thrombosis)

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b)Thrombosis
c)Fibrinoidnecrosis
d)Hyalinesclerosis
CorrectAnswer-A
Ans.is'a'i.e.,Nochange

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Structuralchangesinthearterialwallsareabsentexceptlateinthe
course,whenintimalthickeningcanappear.

452.Pulmonaryinfarctionoccurswithall
except-
a)Saddleembolusatbifurcation

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b)Blockageof2ndand3rdgenendarteries
c)Arteriolesareblocked
d)None
CorrectAnswer-D
Ans.is'd'i.e.,None

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Themorphologicconsequencesofembolicocclusionofthe
pulmonaryarteriesdependonthesizeoftheembolicmassandthe
generalstateofthecirculation.
Largeembolimayimpactinthemainpulmonaryarteryoritsmajor
branchesorlodgeatthebifurcationasasaddleembolus.Sudden

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deathoftenensues,owinglargelytotheblockageofbloodflow
throughthelungs.Deathmayalsobecausedbyacutefailureofthe
rightsideoftheheart(acutecorpulmonale).
Smallerembolicantraveloutintothemoreperipheralvessels,
wheretheymaycauseinfarction.Inpatientswithadequate

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cardiovascularfunction,thebronchialarterialsupplycanoften
sustainthelungparenchymadespiteobstructiontothepulmonary
arterialsystem.Underthesecircumstances,hemorrhagesmay
occur,butthereisnoinfarctionoftheunderlyinglungparenchyma.
Onlyabout10%ofemboliactuallycauseinfarction.Althoughthe

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underlyingpulmonaryarchitecturemaybeobscuredbythesuffusion
ofblood,hemorrhagesaredistinguishedbythepreservationofthe
pulmonaryalveolararchitecture;insuchcases,resorptionofthe
bloodpermitsreconstitutionofthepreexistingarchitecture.

453.Creolabodiesareseenin-

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a)Bronchialasthma
b)Chronicbronchitis
c)Emphysema
d)Bronchiectatsis
CorrectAnswer-A

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Ans.is'a'i.e.,Bronchialasthma
Creolabodiesareahistopathologicfindingindicativeofbronchial
asthma.
Foundinapatient'ssputum,theyareciliatedcolumnarcells
sloughedfromthebronchialmucosaofapatientwithasthma.

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Othercommonfindingsinthesputumofasthmapatients
includeCharcot-Leydencrystals,Curschntann'sSpirals,and
eosinophils.

454.Bronchogenicsequestrationisseenin
whichlobe-

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a)Leftlowerlobe
b)Rightupperlobe
c)Leftmiddlelobe
d)Leftupperlobe
CorrectAnswer-A

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Ans.is'a'i.e.,Leftlowerlobe
Bronchogenicsequestrationreferstothepresenceofadiscrete
massoflungtissuewithoutanynormalconnectiontotheairway
system.
Intralobarsequestrationsarefoundmostfrequentlyintheposterior
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basalsegmentoftheleftlowerlobe.
Bloodsupplytothesequesteredareaarisesnotfromthepulmonary
arteriesbutfromtheaortaoritsbranches.
Extralobarsequestrationsareexternaltothelung.Foundmost
commonlyininfantsasabnormalmasslesions,theymaybe

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associatedwithothercongenitalanomalies.
Intralobarsequestrationsarefoundwithinthelungsubstanceand
areusuallyassociatedwithrecurrentlocalizedinfectionor
bronchiectasis.

455.Cysticfibrosisisassociatedwithall

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except?
a)Infertility
b)Azoospermia
c)Nasalpolyps
d)Renalfailure

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CorrectAnswer-D
Ans.isdi.e.,Renalfailure
Thickviscidplugsofmucusmayalsobefoundinthesmallintestine
ofinfants.Sometimesthesecausesmall-bowelobstruction,known
asmeconiumileus.
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Chronicsinopulmonarydiseasemanifestedby:Persistent
colonization/infectionwithtypicalcysticfibrosis
pathogens,includingStaphylococcusaureus,nontypeable
Hemophilusinfluenzae,mucoidandnonmucoidPseudomonas
aeruginosa,Burkholderiacepacia;Chroniccoughandsputum

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production,nasalpolyps.
Azoospermiaandinfertilityarefoundin95%ofthemaleswho
survivetoadulthood;congenitalbilateralabsenceofthevas
deferensisafrequentfindinginthesepatients.

456.InthestageofGreyhepatization-

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a)WBC'sfillthealveoli
b)RBC'sfillthealveoli
c)Organismsfillthealveoli
d)Accumulationoffibrin
CorrectAnswer-D

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Ans.is'd'i.e.,Accumulationoffibrin
Pathologicalchangesofbacterialpneumonia
A.Lobarpneumonia
Largeconfluentareaofthelungorentirelobesareconsolidated.
Thelowerlobesareaffectedmostcommonly.

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Therearefourstagesoftheinflammatoryresponse(Laennec's
stages)?
Stageofcongestion(initialphase)
Theaffectedlobeisenlarged,heavy,darkredandcongested.
Cutsurfaceexudesblood-stainedfrothyfluid.

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Thereisdilatationandcongestionofalveolarcapillaries.
Therearefewneutrophilsandnumerousbacteriainthealveolar
fluid.
Stageofredhepatization(earlyconsolidation)
Thetermhepatizationreferstoliver-likeconsistencyoftheaffected

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lobeoncutsection.oTheaffectedlobeisredandfirm.
Theedemafluidofprecedingstageisreplacedbystrandsoffibrin.
Thereismarkedcellularexudateofneutrophilswithextravasationof
redcells.
Stageofgrayhepatization(lateconsolidation)

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Theaffectedlobeisgrayishbrown,firmanddry.
Thefibrinstrandaredenseandmorenumerous.

Thereisprogressivedisintigrationofredcellsandneutrophils.
Themacrophagesbegintoappearintheexudate.
Theorganismsarelessnumerousandappearasdegenerated

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forms.
Resolution
Thepreviouslysolidandfibrinousconstituentisliquefiedby
enzymaticaction.
Granularandfragmentedstrandsoffibrininthealveolarspacesare

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seenduetoprogressiveenzymaticdigestion.
Thereisprogressiveremovaloffluidcontentaswellascellular
exudatefromtheairspaces,resultinginrestorationofnormallung
parenchymawithareation.
B.Bronchopneumonia
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Patchyareasofredorgreyconsolidation,moreoftenmultilobarand
frequentlybilateralandbasal(lowerzones)becauseoftendencyof
secretionstogravitateintolowerlobes.
Thereissuppurativeexudate,consistingchieflyneutrophils,filling
bronchi,bronchiolesandadjacentalveolarspaces.

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Alveolarseptathickenduetocongestedcapillariesandleucocytic
infiltration.

457.Markerofsmallcellcanceroflungis-
a)Chromogranin
b)Cytokeratin

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c)Desmin
d)Vimentin
CorrectAnswer-A
Ans.is'a'i.e.,Chromogranin
Smallcellcarcinomacontains.

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Polypeptidehormoree.g.PTHlikepeptide.
Neuroendocrinemarkers-4chromogranin,Synaptophysin,Leu7

458.Collapseoflungiscalled-
a)Emphysema
b)Bronchiactasis

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c)Atelectasis
d)Bronchitis
CorrectAnswer-C
Ans.is'c'i.e.,Atelectasis
Atelectasis(collapse)
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Atelectasisrefersto:-
1. IncompleteexpansionoflungsNeonatalatelectasis.or
2. CollapseofpreviouslyinflatedlungAcquiredatelectasis.
Thisresultsinareasofrelativelyairlesspulmonaryparenchyma.
Acquiredatelectasismaybedividedinto

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Resorption(obstruction)atelectasis
Itisconsequenceofcompleteobstructionofanairway.
Withtimetrappedoxygenintheaffectedalveoliisresorbedand
collapseoccurs.
Resorptionatelectasisiscausedprincipallybyobstructiondueto

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excessivesecretions(mucusplug)orexudateswithinsmall
bronchiolesasseeninBronchialasthma,chronicbronchitis,
Bronchiactasisandforeignbodyaspiration.
Compressionatelectasis
Collapseoflungoccursduetoexternalperssureonlung.

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Itisseenmostcommonlyinpatientswithcardiacfailurewho
developpleuraleffusionandinpatientswithneoplasticpleural
effusion.
Contractionatelectasis
Thecollapseisduetocontractureinthelungbecauseoffibroctic

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changes.
Exceptforcontractionatelectasis,atelectasisisareversible
disorder,i.e.collapsedlungparenchymacanbere-expanded.

459.FrequencyofrenalinvolvementinHSP?
a)20-40%

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b)>80%
c)40-60%
d)10%
CorrectAnswer-C
Ans.is'c'i.e.,40-60%
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ThereportedincidenceofrenalinvolvementinHSPvaries
considerablybetweendifferentstudies.
Thismaybebecauseofthedifferentcriteriausedtodescribethe
involvement&thevariabilityofthelengthusedtofollowup.
IndifferentstudiesincidenceofpediatricrenalinvolvementinHSP

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wasbetween20-56%andinadults50-78%

460.Mostimportantprognosticfactorof
wilmstumour-
a)Histopathology
b)Ploidyofcells

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c)Age<1yr
d)Mutation,ofclpgene
CorrectAnswer-A
Ans.is'a'i.e.,Histopathology
Anaplasticnuclearchangeistheonlycriterionof"unfavourable"

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histologyinWilm'stumorandallWilm'stumorlackingthisfeature
aredesignatedashaving"favourablehistology".
Anaplasticnuclearchangereflectsextremepolypoidy&isusually
apparentunderlowmagnification.
"Anaplastichistologyremainsacriticaldeterminantofadverse

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prognosis.Evenanaplasiarestrictedtokidney
confersanincreasedriskofrecurrence&death,underscoringthe
needforcorrectlyidentifyingthishistologicfeatures."

461.Renalpapillarynecrosisisalmostalways
associatedwithoneofthefollowing
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conditions:
March2004
a)Diabetesmellitus
b)Analgesicnephropathy
c)Chronicpyelonephritis

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d)Poststreptococcalglomerulonephritis
CorrectAnswer-A
Ans.Ai.e.Diabetesmellitus
`Renalpapillarynecrosis,anaccompanimentofacutepyelonephritis
ismostoftenseenindiabeticsandischaracterisedbynecrosisof
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renalpapillaeofoneorbothkidneyswithsharpeddemarcation
betweennecroticandlivingtissue'--Dorlands
Thuswhilepapillarynecrosisisafeatureofmorethanone
conditionsmentionedinthequestion,itismostcommonlyseenwith
diabetesmellitus.

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462.Oncocyticcarcinomaarisesfrom-
a)Perivascular
b)Glomerulus
c)Loopofhenle
d)Collectingduct

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CorrectAnswer-D
Ans.is'd'i.e.,Collectingducts
OncocyticorChromophoberenalcarcinomarepresents5%ofrenal
cellcancers.
Itiscomposedofcellswithprominentcellmembranesandpale

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eosinophiliccytoplasm,usuallywithahaloaroundthenucleus.
Theyare,likethebenignoncocytoma,thoughttogrowfrom
intercalatedcellsofcollectingducts.oTheyhaveanexcellent
prognosiscomparedwiththatoftheclearcellandpapillarycancers.

463.

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Mostcommoncauseofnephrotic
syndromeinadults?
a)Membranousglomerulonephritis
b)Minimalchangedisease
c)AcuteGN

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d)FocalGN
CorrectAnswer-A
Ans.is'a'i.e.,Membranousglomerulonephritis
MostcommoncauseofNephroticsyndrome
Inadultsmembranousglomerulonephritis

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Inchildrenminimalchangedisease(lipoidnephrosis)Causesof
Nephroticsyndrome
I. PrimaryGlomerulonephritis
V
Malignancy

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Minimalchangedisease(mostcommonin
1.
1. Carcinomas
children)
2. MembranousGN(mostcommoninadults) 2. Myeloma

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Hodgkin's
3. MembranoproliferativeGN
3. disease
4. Focalsegmentalglomerulosclerosis
VI Pregnancy

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Toxaemiaof
5. FocalGN
pregnancy
VIICirculatory
6. IgAnephropathy

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Disturbances
1.Renalvein
II Systemicdiseases
thrombosis
Constrictive

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1. Diabetesmellitus
2. pericarditis

2. Amyloidosis
VIII.Hereditary
diseases

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1.Alport's
3. SLE
disease
M. SystemicInfections
2. Fabry'sdisease

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Nail-patella
1. Viralinfections(HBV,HCV,HIV)
3. syndrome
Bacterialinfections(bacterialendocarditis,
2.

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syphilis,leprosy)
Protozoaandparasites(P.falciparum
3.
malaria,filariasis)
IV. HypersensitivityReactions

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1. Drugs(heavymetalcompoundslikegold
andmercury,otherdrugs
likepenicillamine,trimethadioneand
tolbutamide,heroinaddiction)
2. Beestings,snakebite,poisonivy

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464.Mostcommoncauseofnephritic
syndromeinadults?
a)Membranoproliferativeglomerulonephritis
b)FSGN
c)Membranousglomerulonephritis

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d)None
CorrectAnswer-D
Ans.isNone
MostcommoncauseofNephriticsyndromeisrapidlyprogressive
glomerulonephritis(Poststreptococcalandnonstreptococcal

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glomerulonephritis).
Membranousglomeruulonephritisisthemostcommoncauseof
nephroticsyndrome(notnephriticsyndrome)inadults.
Minimalchangediseaseisthemostcommoncauseofnephrotic
syndromeinchildren.

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CausesofAcuteNephriticSyndrome
Primary
SystemicDisease
Glomerulonephritis
1.

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AcuteGN
1.
SLE
Post-streptococcal
2.

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Polyarteritisnodosa
Wegener's
Non-streptococcal
3.
granulomatosis

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Henoch-Schonlein
2.
RapidlyprogressiveGN 4.
purpura
Membranoproliferative

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3.
5 Cryoglobulinaemia
GN
4.
FocalGN

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5.
IgAnephropathy

465.Podocytesareseenin-

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a)Bowman'scapsule
b)Proximalconvolutedtubule
c)Distalconvolutedtubule
d)Collectingtubuleofthekidney
CorrectAnswer-A

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Ans.is'a'i.e.,Bowman'scapsule
TheBowman'scapsule(capsulaglomeruli/glomerularcapsule)isa
cup-likesacatthebeginningoftubularcomponentofanephron.
Aglomerulusisenclosedinthesac(Bowman'scapsule).
FluidsfrombloodintheglomerulusarecollectedinBowman's

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capsule(i.e.glomerularfiltrate)andfurtherprocessedalongthe
nephrontoformurine.
OutsidetheBowman'scapsuletherearetwopoles.
VascularpoleThesidewithafferentandefferentarterioles.
UrinarypoleThesidewithproximalconvulutedtubule.

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InsidetheBowman'scapsule,thelayersareasfollows,frominside
tooutside?
Thinlayeroffenestratedendothelium
Glomerularbasementmembrane
Partoftheglomerulus

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Visceralepithelium(Podocytes)
Parietalepithelium

466.Crescentsarederivedfrom-
a)Epithelialcells+fibrin+macrophage
b)Mesangium+fibrin+macrophage

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c)Tubule+mesangiaum+fibrin
d)Mesangiaum+fibrin
CorrectAnswer-A
Ans.is'a'i.e.,Epithelialcells+fibrin+macrophage
RenalfeaturesinRPGN
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Crescentformation-crescentsareformsby?
*CellsParietalepithelialcells+WBCs(monocytesand
macrophages)
*Fibrinstrandsareprominentbetweenthecellularlayersinthe
crescents.

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-RuptureofGBM
-SubepithelialdepositsintypeIIRPGN
-LineardepositsintheGBMintypeIRPGN.

467.Transitionalcellcarcinomabladder
causedby-

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a)Schistosomiasis
b)Ascariasis
c)Malaria
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Schistosomiasis
Transitionalcellcarcinoma(TCC).Thisisthecommonestcancerof
thebladder.
Morethan90%ofbladdertumorsarisefromtransitionalepithelial
(urothelium)liningofthebladderincontinuitywiththeepithelial

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liningoftherenalpelvis,ureters,andthemajorpartoftheurethra.
etiology:
Industrialoccupations:Workersinindustriesthatproduceaniline
dyes,rubber,plastic,textiles,andcablehaveahighincidenceof
bladdercancer.

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Schistosomiasis:Thereisanincreasedriskofbladdercancer,
particularlysquamouscellcarcinoma,inpatientshavingbilharzial
infestation(Schistosomahaematobium)ofthebladder.
Dietaryfactors:Certaincarcinogenicmetabolitesoftryptophanare
excretedintheurineofpatientswithbladdercancer.

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Locallesions:Severallocallesionsinthebladderpredisposetothe
developmentofbladdercancer.Theseincludeectopiavesicae
(atrophiedbladder),vesicaldiverticulum,leukoplakiaofthebladder
mucosaandurinarydiversioninthedefunctionalizedbladder.
Smoking:Tobaccosmokingisassociatedwitha2to3fold

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increasedriskofdevelopingbladdercancer,probablydueto

increasedurinaryexcretionofcarcinogenicsubstances.
Drugs:Immunosuppressivetherapywithcyclophosphamideand
patientshavinganalgesic-abuse(phenacetin-)nephropathyhavea
highriskofdevelopingbladdercancer.

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468.Starryskyappearanceisseenin-
a)Burkittslymphoma
b)CIL
c)DiffuselargeBcelllymphoma
d)ALCL

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CorrectAnswer-A
Ans.is'a'i.e.,Burkittslymphoma
Burkittslymphoma
Itincludes(1)African(endemic)Burkittlymphoma,(2)sporadic
(nonendemic)Burkittlymphoma,and(3)asubsetofaggressive

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lymphomasoccurringinindividualsinfectedwithHIV.
Theinvolvedtissuesareeffacedbyadiffuseinfiltrateof
intermediate-sizedlymphoidcellscontainingroundorovalnuclei
withcoarsechromatin,severalnucleoli,andamoderateamountof
faintlybasophilicoramphophiliccytoplasm.

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Thenuclearsizeapproximatesthatofbenignmacrophageswithin
thetumor.
Ahighmitoticindexistypical,asisapoptotictumorcelldeath,
accountingforthepresenceofnumeroustissuemacrophageswith
ingestednucleardebris.

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Thesebenignmacrophagesarediffuselydistributedamongthe
tumorcellsandhaveabundantclearcytoplasm,creatinga
characteristic"starrysky"pattern.
AllformsofBurkittlymphomaareassociatedwithtranslocationsof
thec-MYCgeneonchromosome8.Thepartnerinthetranslocation

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isusuallytheIgHlocus(t(8;14))butmayalsobetheic(t(2;8))ory
(t(8;22))lightchainlocus.
EssentiallyallendemictumorsarelatentlyinfectedwithEBV.

469.BALLiSdueto-
a)Tcells

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b)ImmatureBcells
c)ImmatureTcells
d)BothT&Bcells
CorrectAnswer-B
Ans.is'b'i.e.,ImmatureBcells

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InBALL,precursorcellsarearrestedatstagesprecedingsurface
expressionoflg.Theleukemicblastsalmostalwaysexpressthepan
B-cellmoleculesCD19andCD10.
Inveryearlypre-BcellALL;CD19istheonlyBcell-specificmarker
present.

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Earlypre-BALLisdistinguishedfromlatepre-BALLbytheabsence
ofcytoplasmicIgMheavychainintheformer.

470.Whatisthechromosomaltranslocation
inAMLM3-
a)T(18,21)

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b)T(15,17)
c)T(8,21)
d)T(9,11)
CorrectAnswer-B
Ans.is'b'i.e.,T(15,17)

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Class Chromosomalabnormalities
Mz
t(8:21)
M3
t(15:17)

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M4
inv(16)

471.D.I.C.isseenin:
a)>Acutepromyelocyticleukemia
b)>Acutemyelomonocyticleukemia

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c)>CMC
d)>Autoimmunehemolyticanemia
CorrectAnswer-A
Acutepromyelocyticleukemia[Ref.Harrison16'11/ep636]
Disseminatedintravascularcoagulationisassociatedwith
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promyelocyticleukemia
Acutepromyelocyticleukemia(AML-M3)constitutes5-10%ofall
casesofAML
Theleukemiccellsofthesetypeofanemiaarehypergranular.
Granulesoftheseleukemiccells(promyelocytes)contain

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thromboplastinlikematerialresultinginwidespreaddisseminated
intravascularcoagulation.
Alsoknow
MajorityofM3casesdemonstrateareciprocaltranslocation
involvingchromosome15and17,t(15;17)

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472.Helmetcellsarecharacteristicofanemia
of?
a)Hemolyticuremicsyndrome
b)Polysplenia
c)Spherocytosis

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d)Acanthocytosis
CorrectAnswer-A
Ans.is'a'i.e.,Hemolyticuremicsyndrome
Schistocytes,helmentcells,trianglecells,burrcellsareseenin
microangiopathichemolyticanemia(MAHA).Changesinerythrocyte

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morphology

473.Schistocyteis/arefoundin-
a)TTP
b)DIC
c)Severeirondeficiency

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d)All
CorrectAnswer-D
Ans.isall
Schistocytes
Aschistocyteisdefinedasanirregularlyshapederythrocyte

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fragmentcausedbymechanicaltraumaoranintrinsicabnormalityof
erythrocytes.
Schistocytes:MechanismsandDiseases
Shearingbyfibrinstrands:
Microangiopathichemolyticanemia

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Disseminatedintravascularcoagulation
HemangiosarcomaoGlomerulonephritisoMyelofibrosis
Hemolyticuremicsyndrome
HyperspleenismTurbulentbloodflow
CongestiveheartfailureoValvularstenosis

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Cavalsyndromeinheartwormdisease
HemangiosarcomaIntrinsicabnormalities
Chronicdoxorubicintoxicosis
evereirondeficiencyanemia
Pyruvatekinasedeficiency

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Congenitalandacquireddyserythropoiesis
Microangiopathichemolyticanemiacanoccurin:-oExternalimpact
:Marchhemoglobinuria
Cardiachemolysis:Prostheticcardiacvalves

Fibrindepositinmicrovasculature:TTP,DIC,HUS

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474.Lacunarcellsisseeninwhichtypeof
HodgkinsLymphoma:
September2010
a)Mixedcellularitytype
b)Lymphocytepredominant

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c)NodularSclerosisType
d)Alloftheabove
CorrectAnswer-C
Ans.C:NodularSclerosisType
Reed-Sternbergcells(alsoknownaslacunarhistiocytesforcertain

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types)aredifferentgiantcellsfoundonlightmicroscopyinbiopsies
fromindividualswithHodgkin'slymphoma(akaHodgkin'sdisease;a
typeoflymphoma),andcertainotherdisorders.Theyareusually
derivedfromBlymphocytes.

475.Russellbodiesarefoundin-

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a)MultipleMyeloma
b)Gonadaltumor
c)Parkinsonism
d)Intracranialneoplasms
CorrectAnswer-A

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Ans.is'a'i.e.,MultipleMyeloma
Plasmacelltumoursarecharacterizedbydysregulatedsynthesis
andsecretionofimmunoglobulin.
Thissometimesleadstointracellularaccumulationofintactor
partiallydegradedimmunoglobulins.Thisproducescertainvariants

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ofplasmacellswhichare:
FlamecellsCharacterizedbypresenceoffieryredcytoplasm.
MOTTcellsCharacterizedbypresenceofmultiplebluegrapelike
cytoplasmicdroplets.
Besidesthesetherearecellscontainingvarietyofotherinclusions

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including.
Fibrils
Russelbodies(cytoplasmic)
Crystallinerods.
Dutcherbodies(nuclear)

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476.CDmarkerofhistiocytosisis-
a)CD1A
b)CD1B
c)CDIC
d)CD1D

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CorrectAnswer-A
Ans.is'a'i.e.,CD1A
oCHIAisaTcellsurfaceantigenimportantindendriticcell
presentationofglycolipidsandlipopeptideantigens.oItisusedto
diagnoseLangerhanscellhistiocytosis.

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477.Shapeofbirbeckgranulesis?
a)Tennisracket
b)Hockeystick
c)Bat
d)Ball

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CorrectAnswer-A
Ans.is'a'i.e.,Tennisracket
Undertheelectronmicroscope,Birbeckgranuleshavea
pentalaminar,rodlike,tubularappearanceandsometimesadilated
terminalendresemblingtennis-racketappearance.

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478.Theprimarydefectwhichleadstosickle
cellanemiais-
a)Anabnormalityinporphyrinpartofhemoglobin
b)Replacementofglutamatebyvalineinn-chainofHbA
c)AnonsencemutationintheI3-chainofHbA

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d)Substitutionofvalinebyglutamateinthea-chainofHbA
CorrectAnswer-B
Ans.is'b'i.e.,Replacementofglutamatebyvalinein13chainof
HBA
Sicklecellanemia

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Sicklecellanemiaisahereditaryhemoglobinopathy,i.e.,thetypeof
diseasecharacterizedbyproductionofdefectivehemoglobin.
Sicklecellanemiaresultsfrommutationin13-globingene.
Itiscausedbyapointmutationatthesixthpositionofthef3-globin
chainleadingtosubsitutionofavalineresidueforaglutamicacid

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residueresultinginsicklehemoglobin(HbS).
Sicklecellanemiaisanautosomalrecessivedisorder.
oIfanindividualishomozygousforthesicklecellmutation,almost
allthehemoglobinintheredcellisHbS.oInheterozyogotes,only
about40%ofthehemoglobinisHbS,theremainderbeingnormal

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hemoglobins.

479.Intravascularhemolysisoccursin-
a)Hereditaryspherocytosis
b)AcuteG6PD
c)Sicklecellds

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d)bandc
CorrectAnswer-D
Ans.is'b'i.e.,AcuteG6PD;'c'i.e.,Sicklecelldis
Extravascularhemolysis
Hereditaryspherocytosis

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Thalassemia
Sicklecellanemia
Autoimmunehemolyticanemia3Druginducedimmunehemolytic
anemia
G-6-PDdeficiency

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Intravascularhemolysis
ParoxysmalnocturnalhemoglobinuriaoG-6-PDdeficiency
Clostridialtoxin
Falciparummalaria
Mechanicalinjurytoredcells

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Defectivecardiacvalves
Thrombininmicrocirculation
Sicklecellanemia(minor)
Note:-InG-6-PDdeficiencybothextravascularandintravascular
hemolysisoccur.

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InSicklecellanemia,usuallythereisextravascularhemolysisbut
intravascularhemolysiscanalsooccur.

480.Allofthefollowingprovideprotection
againstmalariaexcept-
a)Duffybloodgroup

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b)Sicklecellanemia
c)Hereditaryspherocytosis
d)PNH
CorrectAnswer-D
Answer-D.PNH
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PNHisahemolyticanemiacausedbyanacquiredintrinsicdefectin
thecellmembrane.
PNHresultsfromacquiredmutationthatinhibitsthesynthesisof
Glycosylphospatidylinositol(GPI).

481.PNHpatientswillbehavingdeficientsurfaceproteinsthatnormallyprotect

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theredcellsfromactivatedcompliments.Whatarethetwodeficientsurface
proteins?
a)CD45andCD59
b)CD51andCD59
c)CD55andCD59

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d)CD58andCD59
CorrectAnswer-C
ThedefinitivediagnosisofPNHisbasedonthedemonstrationthata
substantialproportionofthepatient'sredcellshaveanincreased
susceptibilitytocomplement(C),duetothedeficiencyontheir

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surfaceofproteins(particularlyCD59andCD55).
Reference:HarrisonsPrinciplesofInternalMedicine,18thEdition,
Page884

482.Coldagglutininis-
a)IgG

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b)IgM
c)IgA
d)IgD
CorrectAnswer-B
Ans.is'b'i.e.,IgM

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Coldagglutininhemolyticanemia
ThisformofhemolyticanemiaiscausedbycoldagglutininIgM
antibodies.
AntibodiesreactwithRBCat0?to4?C.
Bothintravascularandextravascularhemolysismayoccur.

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IgMantibodybindtoRBCandfixcomplementonRBCbefore
complementmediatedhemolysisoccur.Thistransientreactionwith
IgMdepositC3bonRBC.C3bactsasanopsoninisthatenhances
thephagocytosisofRBCsinmononuclearphagocyticsystemofliver
andspleenextravascularhemolysis.

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HoweverifIgMremainsattachedtoRBC,sustainedactivationof
complementresultsinformationoflargeamountofmembrane-
attackcomplexthatdestroysRBCdirectly-->Intravascular
hemolysis.
Causesofcoldagglutininimmunohemolyticanemia:-Mycoplasma

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infection,IMN,CMV,Influenza,HIV,Malignantlymphoma

483.Theanaemiaassociatedwithleukaemia
is?
a)Irondeficiency
b)Megaloblastictype

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c)Myelophthisictype
d)Allofabove
CorrectAnswer-C
Ans.is'c'i.e.,Myelophthisistype
Myelophthisicanemia
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Space-occupyinglesionsthatdestroysignificantamountofbone
marrowordisturbthemarrowarchitecture,depressitsproductive
capacity.Thisformofanemiaisreferredtoasmyelophthisic
anemia.
Characteristically,immatureerythroidandmyeloidprogenitors

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appearsintheperipheralblood-->Leukoerythroblastosis.
Causesare
Metastaticcancer(M.C.cause)
Granulomatousdiseaseinfiltratingbonemarrow.
Myeloproliferativedisorders(suchasmyeloidleukemia)

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Myelofibrosis

484.Maximumspherocytesisseenin-
a)Autoimmunehaemolyticanemia
b)VitB12deficiency
c)Aplasticanemia

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Autoimmunehemolyticanemia
Mostcommoncauseofspherocytesisimmunehemolyticanemia.

485.InDIC,followingareseenexcept-

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a)Fibrinogendecreased
b)Thrombocytopenia
c)NormalAPTT
d)PTelevation
CorrectAnswer-C

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Ans.is'c'i.e.,NormalAPTT

486.Nottrueregardingfreshfrozenplasma?
a)Suppliesmajorcoagulationfactors
b)ABOmatchnotrequired
c)ShouldbeusedinreplacementoffactorsinDIC/trauma

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d)Tobeusedwithin30minutesofhavingtrauma
CorrectAnswer-D
Ans.is'd'i.e.,Tobeusedwithin30minutesofhavingtrauma
Freshfrozenplasmacontainscomponentsofthecoagulation,
fibrinolyticandcomplementsystemsandotherproteins.
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FFPcanbegivenwithoutbloodtype-matchedalthoughagglutination
reactionsarepossible,thoughveryrare.oThereisnomentionof
timeperiodwithinwhichFFPshouldbegivenaftertrauma.
TherisksofFFPincludediseasetransmission,anaphylactoid
reactions,alloimmunization,andexcessiveintravascularvolume,as

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wellastransfusionrelatedacutelunginjuryandanincreasein
infections

487.Whatisthevenoushematocritlevelat
whichyouwilldiagnosepolycythemiain
anewborn?

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a)55%
b)60%
c)65%
d)70%
CorrectAnswer-C

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Definitionofpolycythemia:
a.Venoushaematocritofover65%.
b.Venoushaematocritofover64%at2hoursage.
c.Anumbilicalvenousorarterialhaematocritover63%ormore.
Themeanvenoushaematocritofterminfantsis53incordblood,60

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at2hoursofage,57at6hoursofageand52at12-18hoursofage.
Asthehaematocritincreases,thereisincreasedviscosityand
decreasedbloodflow.Whenhaematocritincreasestomorethan
60%thereisafallinO2transport.
Definitionofhyperviscosity:Viscositygreaterthan14.6centiposeat

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ashearrateof11.55asmeasuredbyaviscometer.(normalis1.4-
1.8centipoise).

488.Ecadheringenedeficiencyisseenin-
a)Gastricca
b)Intestinalca

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c)Thyroidca
d)Pancreaticca
CorrectAnswer-A
Themajorityofgastriccancersarenothereditary,themutations
identifiedinfamilialgastriccancerhaveprovidedimportantinsights

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intomechanismofcarcinogenesisinsporadiccancers.
GermlinemutationsinCDHI,whichencodesEcadherin,aprotein
thatcontributestoepithelialintercellularadhesionareassociated
withfamilialgastriccancers,whichareusuallyofdiffusetype.
MutationsinCDH1arepresentinabout50%ofsporadiccasesof

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diffusegastriccancers,whileEcadherinexpressionisdrastically
decreasedintherest,oftenbymethylationoftheCDHIpromotor.
Lobularcarcinomaofbreastwhichalsotendstoinfilterateassingle
cells,&individualswithBRCA2mutationsareatincreasedriskof
developingdiffusegastriccancers.

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489.MostcommonsiteofGISTis-
a)Ileum
b)Esophagus
c)Colon
d)Stomach

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CorrectAnswer-D
Ans.is'd'i.e.,Stomach
?
50-
Stomach

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--> 70%
?Small
20-
intestine
--> 30%

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Colon&
5-
rectum
-3 15%
Esophagus ---> <5%

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490.Pathologicalmanifestationofchronic
alcoholismincludeallofthefollowing
except-
a)Piecemealnecrosis
b)Balloningdegeneration

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c)Microvesicularfattychanges
d)Centralhyalinesclerosis
CorrectAnswer-A
Ans.is'a'i.e.,Piecemealnecrosis
Steatosis(fattyliver)

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?Microvesicularfattychange
?Laterchangestomacrovesicularfattychange
Alcoholichepatitis
?Hepatocellularnecrosis
?Ballooningdegeneration

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?Mallorybodies
?Neutrophilicinfiltration
?Perivenularandperisinusoidolfibrosis-->centralhyaline
Alcoholiccirrhosis
?Nodularity

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?Fibrosis

491.Thoriuminducedtumor
a)Angiosarcomaofliver
b)Renalcellcarcinoma
c)Lymphoma

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d)Astrocytoma
CorrectAnswer-A
Answer-A.Angiosarcomaofliver
Thorotrost(thoriumdioxide)iscommonlyassociatedwithliver
neoplasm.

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Themostcommonliverneoplasmassociatedwiththoriumexposure
Angiosarcomaoftheliver
Cholangiocarcinoma
Hepatocellularcarcinoma

492.Klatskintumoris-

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a)Nodulartypeofcholangiocarcinoma
b)Fibrolamellarhepatocellularcarcinoma
c)Gallbladdercarcinoma
d)Hepatocellularcarcinoma
CorrectAnswer-A

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Ans.is'a'i.e.,Nodulartypeofcholangiocarcinoma
oAccordingtotheirlocalization,cholongiocarcinomasareclassified
into
1.Intrahepatic(10-20%)
2.Extrahepatic(80-90%)
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oTheextrahepaticformsincludeperihilartumorsknownasKlastkin
tumors,whicharelocatedatthejunctionoftherightandlefthepatic
ductsformingthecommonhepaticduct,anddistalducttumors.
oAsubgroupofdistaltumorsariseintheimmediatevicinityof
ampullaofvater.Tumoroftheseregionalsoinclude

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adenocarcinomaofduodenalmucosaandpancreaticcarcinomaand
arecollectivelyreferredtoasperiampullarycarcinomas.

493.Allofthefollowingareriskfactorsfor
carcinomagallbladder,EXCEPT-
a)Typhoidcarriers

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b)Adenomatousgallbladderpolyps
c)Choledochalcysts
d)Oralcontraceptives
CorrectAnswer-D
Ans.isdi.e.,OralContraceptives

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RiskfactorsforCaGallbladderare:
i)Gallstones
ii)Adenomatousgallbladderpolyps(particularlypolypslarger
than10mm)
iii)Calcified(porcelain)gallbladder

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iv)Choleduochalcyst
v)Estrogens
vi)Anomalouspancreaticobiliaryductjunction
vii)Exposuretocarcinogens(azotoulene,nitrosamine)
viii)Typhoidcarriers

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ix)Sclerosingcholangitis

494.Nutmegliverisseenin-
a)Rightsidedheartfailure
b)Leftsidedheart,failure
c)Increasedpulmonarypressure

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d)Decreasedpulmonarypressure
CorrectAnswer-A
Ans.is'a'i.e.,Rightsidedheartfailure
oThecombinationofhypoperfusionandretrogradecongestion
(Chronicpassivecongestion)actssynergisticallytogenerate

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centrilobularhemorrhagicnecrosis.Thelivertakesonavariegated
mottledappearancereflectinghemorrhageandnecrosisinthe
centrilobularregions,knowasnutmegliver.
oChronicpassivecongestionisseeninRHF.

495.Centralstellatescarisseenin

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a)Focalnodularhyperplasia
b)Chronicregenerativehyperplasia
c)Hepatoblastoma
d)None
CorrectAnswer-A

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Answer-A.Focalnodularhyperplasia
Focalnodularhyperplasiaisararetumor-likecondition
predominantlyfoundinwomenduringtothirdtothefifthdecadeof
life.
Mostcommonlyitisincidentallydiscoveredasasymptomaticmass.

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Thepathognomonicmicroscopicfeature.
Acentralstellatescarseeninliverimagingstudiesisahighly
characteristicfeatureoffocalnodularhyperplasia.
ItisalsoseeninRenalcellcarcinoma(RCC).

496.Histopathologyofchronichepatitis-

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a)Balloning
b)Councilmanbodies
c)Bridgingnecrosis
d)All
CorrectAnswer-C

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Ans.is'c'i.e.,Bridgingnecrosis
.Portaltractsshowseverechronicinflammationwith
inflammatorycellsextendingintotheliverlobulesdisrupting
thelimitingplateofhepatocytes.
-Piecemealnecrosis-Portalfibrosis
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.Bridgingnecrosis-Interfacehepatitis

497.Spongiformdegenerationofcerebral
cortexoccursin-
a)Creutzfeldt-Jakobdisease
b)Subacutesclerosingpanencephalitis

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c)Fatalfamilialinsomnia
d)Cerebraltoxoplasmosis
CorrectAnswer-A
Ans.is'a'i.e.,Creutzfeldt-Jakobdisease
oOnmicroscopicexamination,inCreutzfeldt-Jakobdiseasethe

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pathognomonicfindingisaspongiformtransformationofthe
cerebralcortexand,often,deepgraymatterstructures(caudate,
putamen);thisconsistsofamultifocalprocessthatresultsinthe
unevenformationofsmall,apparentlyempty,microscopicvacuoles
ofvaryingsizeswithintheneuropilandsometimesintheperikaryon

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ofneurons.Inadvancedcases,thereissevereneuronalloss,
reactivegliosis,andsometimesexpansionofthevacuolatedareas
intocystlikespaces("statusspongiosus").
oKuruplaquesareextracellulardepositsofaggregatedabnormal
protein;theyareCongored-positiveaswellasPAS-positiveand

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occurinthecerebellumincasesofGerstmann-Striiussler-Scheinker
syndrome;theyarepresentinabundanceinthecerebralcortexin
casesofvariantCJD.
oInallformsofpriondisease,immunohistochemicalstaining
demonstratesthepresenceofproteinase-K-resistantPrPscin

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tissue.
oFatalfamilialinsomniadoesnotshowspongiformpathology.
Instead,themoststrikingalterationisneuronallossandreactive
gliosisintheanteriorventralanddorsomedialnucleiofthethalamus;

neuronallossisalsoprominentintheinferiorolivarynuclei.

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498.Whatisthehistologicalappearanceof
braininCreutzfeldt-Jakobdisease-
a)Neuronophagia
b)Spongiformchangeinbrain
c)Microabscesses

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d)Demyelination
CorrectAnswer-B
Ans.is'b'i.e.,Spongiformchangeinbrain
oTheclassichistologicappearanceinCreutzfeldt-Jakobdiseaseis
spongiformchangeinthegraymatter:inallsixcorticallayersinthe

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cerebralcortexorwithdiffuseinvolvementofthecerebellar
molecularlayer.Thesevacuolesappearglassyoreosinophilicand
maycoalesce.Neuronallossandgliosisarealsoseen.

499.Whichofthefollowingtumorsisnot
derivedfrommeninges-

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a)Hemangioblastoma
b)Meningioma
c)Fibroustumor
d)Hemangiopericytoma
CorrectAnswer-A

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Ans.is'a'i.e.,Haemangioblastoma
Meningealtumors
oMeningothelialtumor:Meningioma(mostcommonmeningeal
tumor).
oMesenchymalnon-meningothelialtumors:Meningealsolitary
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fibroustumor,hemangiopericytoma,meningealsarcoma,fibrous
histiocytoma,meningealmelanocytoma,(melanocytictumor).

500.Whichofthefollowingismostreliable
featureofmalignanttransformationof
pheochromocytoma?

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a)Presenceofmitoticfigures
b)Capsularinvasion
c)Vascularinvasion
d)None
CorrectAnswer-D

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Ans.isNone
"Becausebenignandmalignantpheochromocytomasmayhavean
identicalhistologicalappearance,theonlyabsolutecriterionof
malignancyismetastasis."
"Thediagnosisofmalignantpheochromocytomaismadeonlywhen
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metastasisisdemonstrated."

501.Tumorthatfollowsruleof10is-
a)Pheochromocytoma
b)Oncocytoma
c)Lymphoma

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d)Renalcellcarcinoma
CorrectAnswer-A
Ans.is'a'i.e.,Pheochromocytoma
oPheochromocytomasusuallysubscribetoaconvenient"ruleof
10s":-
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10%ofpheochromocytomasariseinassociationwithoneof
severalfamilialsyndromes.TheseincludetheMEN-2A&MEN-2B
syndromes,typeIneurofibromatosis,vonHippel-Lindausyndrome&
Sturge-Webersyndrome.
10%ofpheochromocytomasareextra-adrenal,occurringin

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sitessuchasorganofZuckerkandl&carotidbody,wherethese
chromaffin-negativetumorsareusuallycalledparagangliomasto
distinguishthemfrompheochromocytomas.
10%ofnonfamilialadrenalpheochromocytomasarebilateral;
thisfiguremayriseto70%incasesthatareassociatedwithfamilial

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syndromes.
10%ofadrenalpheochromocytomasarebiologicallymalignant,
althoughtheassociatedhypertensionrepresentsaserious&
potentiallylethalcomplicationofeven"benign"tumors.
10%ofadrenalpheochromocytomasariseinchildhood,usuallythe

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familialsubtypes,andwithastrongmalepreponderance.The
nonfamilialpheochromocytomasmostoftenoccurinadultsbetween
40&60yearsofage,withaslightfemalepreponderance.

502.TrueaboutPsammomabodiesareall
except?

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a)Seeninmeningioma
b)Concentricwhorledappearance
c)ContainsCalciumdeposits
d)Seeninteratoma
CorrectAnswer-D

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Ans.is'd'i.e.,Seeninteratoma
oPsammomabodiesrepresentaprocessofdystrophiccalcification.
oSinglenecroticcellsmayconstituteseedcrystalsthatbecome
encrustedbythemineraldeposits.Theprogressiveacquisitionof
outerlayersmaycreatelamellatedconfigurations,called

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psammomabodiesbecauseoftheirresemblancetograinsofsand.
oPsammomabodiesareseenin:papillarycancerofthyroid,
meningioma,papillaryserouscystadenocarcinomaofovary.

503.Inthymoma,allareseenexcept-
a)Hypogammaglobulinemia

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b)Hyperalbuminemia
c)Redcellaplasia
d)MyaestheniaGravis
CorrectAnswer-B
Ansis(b)i.e.hyperalbuminemia

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ThymomaisthemostcommonAnteriormediastinalmass.
Thymomasareseentobeassociatedwith
Myastheniagravis
Acquiredhypogammaglobulinemia
PureredcellaplasiaGrave'sds
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-Perniciousanemia
-Dermatomyositis-polymyositis
-Cushingsyndrome

504.Orphanannieeyenucleiappearanceis
characteristicof-

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a)Papillarycarcinomathyroid
b)Carcinomapituitary
c)Paraganglioma
d)Meningioma
CorrectAnswer-A

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Ans.is'a'i.e.,Papillarycarcinomathyroid
oThenucleiofpapillarycarcinomacellscontainfinelydispersed
chromatin,whichimpartsanopticallyclearoremptyappearance,
givingrisetothedesignationgroundglassorOrphanAnnieeye
nuclei.

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505.Mostcommonmalignancyoffallopian
tube
a)SCC
b)SerousCA
c)Teratoma

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d)Chorioca
CorrectAnswer-B
Answer-B.SerousCA
Serous-49.5%-83.3%

506.Rokitanskiprotruberencesareseenin-

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a)Mucinouscarcinoma
b)Teratoma
c)Epidermalcystoidsadenoma
d)Papillarycarcinoma
CorrectAnswer-B

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Ans.is'b'i.e.,Teratoma
Teratoma
oTeratomasaredividedintothreecategories:
(1)Mature(benign):
Mostbenignteratomasarecysticandareknownasdermoid

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cysts.
Theseneoplasmsarepresumablyderivedfromthe
ectodermaldifferentiationoftotipotentialcells.
Theyarebilateralin10%to15%ofcases.
Characteristically,theyareunilocularcystscontaininghair

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andcheesysebaceousmaterial.Onsection,theyrevealathinwall
linedbyanopaque,gray-white,wrinkled,apparentepidermis.
Generally,inoneareaofthecystwall,asolidprominenceis
seenknownasRokitansky'sprotuberancewheretissueelements
suchastooth,bone,cartilage&variousotheroddtissuesare

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present.
Onhistologicexamination,thecystwalliscomposedofstratified
squamousepitheliumwithunderlying
sebaceousglands,hairshafts,andotherskinadnexalstructures.In
mostcases,structuresfromothergermlayerscanbeidentified,
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suchascartilage,bone,thyroidtissue,andotherorganoid
formations.

Dermoidcystsaresometimesincorporatedwithinthewallof
amucinouscystadenoma.
About1%ofthedermoidsundergomalignanttransformation

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ofanyoneofthecomponentelements(butmostcommonly,
squamouscellcarcinoma).
(2)MonodermalorSpecializedTeratomas
Theraregroupoftumors,themostcommonofwhichare
strumaovariiandcarcinoid.
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Theyarealwaysunilateral,althoughacontralateralteratoma
maybepresent.
Strumaovariiiscomposedentirelyofmaturethyroidtissue.
Interestingly,thesethyroidalneoplasmsmayhyperfunction,causing
hyperthyroidism.

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Theovariancarcinoid,whichpresumablyarisesfrom
intestinalepitheliuminateratoma,mightinfactbefunctioning,
particularlyinlargetumors,producing5-hydroxytryptamineandthe
carcinoidsyndrome.
(3)ImmatureMalignantTeratomas

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Theseareraretumorsthatdifferfrombenignteratomasin
thatthecomponenttissueresemblesthatobservedinthefetusor
embryoratherthanintheadult.
Thetumorisfoundchieflyinprepubertaladolescentsand
youngwomen.

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Thesegrowrapidlyandfrequentlypenetratethecapsulewith
localspreadormetastases.
Onmicroscopy,therearevaryingamountsofimmaturetissue
differentiatingtowardcartilage,glands,bone,muscle,nerve,and
others.

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Animportantriskforsubsequentextraovarianspreadisthe
histologicgradeoftumor,whichisbasedontheproportionoftissue
containingimmatureneuroepithelium.

507.Whichisnotariskfactorofendometrial
carcinoma-

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a)Obesity
b)Smoking
c)Infertility
d)Tamoxifen
CorrectAnswer-B

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Ans.is'b'i.e.,Smoking
Endometrialcarcinoma
Endometrialcarcinomaisthemostcommoninvasivecancerofthe
femalegenitaltractandaccountsfor7%ofallinvasivecancerin
women.

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Thepeakincidenceisinthe55-to65-year-oldwoman.
Clinicopathologicalstudies&molecularanalysissupportits
classificationintotwomajorbroadcategories.
Type-ICarcinoma
Mostcommontype.

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Majorityarewelldifferentiated&mimicproliferativeendometetrial
glands.
Theyareassociatedwith-obesity,diabetes,hypertension,infertility
andunopposedestrogenstimulation.Tamoxifenalsoincreasesthe
riskofendometrialcancer.

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Endometrialhyperplasiaisaprecursortoendometroidcarcinoma.
MutationinPTENtumorsuppressorgenehavebeenseenin30-
80%ofendometeriodcarcinoma&20%patientswithendometrial
hyperplasia.
Additionalmolecularchangesthatarecommonaremicrosatellite

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instability&mutationsinKRAS&betacateninoncogenes.

Type-HCarcinoma
TheseoccurinwomenadecadelaterthantypeIcarcinoma.
Theseusuallyariseinsettingofendometrialatropy.
Theyarepoorlydifferentiated.Themostcommonsubtypeisserous

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carcinoma,clearcelltype&malignantmixedmulleriantumor.
Themostfrequentalterationdescribedismutationinp53tumor
suppressorgene.

508.Whichofthefollowinggermcelltumoris
malignant?

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a)Leydigcelltumor
b)Sertolicelltumor
c)Seminoma
d)Dermoidcyst
CorrectAnswer-C

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Ans.is'c'i.e.,Seminoma
oAmongthegivenoptionsonlyoptionsc&daregermcelltumors.
Seminomaismalignantwhiledermoidcystisbenign.
Germcelltumors
oMalignant-Germinoma(seminoma,dysgerminoma),embryonal

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carcinoma,endodermalsinustumor(yolksactumor),
choriocarcinoma,immatureteratoma.
Benign-Matureteratoma,dermoidcyst.

509.ERpositivestatusinCaBreastindicates
-

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a)Prognosis
b)Etiology
c)Site
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Prognosis
oEstrogenreceptor(ER)positivebreastcarcinomasaregenerally
slowgrowingandrespondwelltohormonaltreatment.
oGeneexpressionprolifing,whichcanmeasuretherelative
quantitiesofmRNAforessentiallyeverygene,hasidentifiedfive

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majorpatternsofgeneexpressionininvasiveductalcarcinoma.
LuminalA
oThisisthelargestgroup(40-55%)whichhascharacteristicsof
normalluminalcells.
oThistypeisERpositiveandHER2/neunegative.
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oThesecancersaregenerallyslowgrowingandrespondto
hormonaltreatment.Converselyonlyasmallnumberwillrespondto
standardchemotherapy
LuminalB
oThesetumorsareERpositive,hasahigherproliferativerateand
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overexpressesHER2/neu--->Triple-positivecancer.
oTheycomposeamajorgroupofER-positivecancersthataremore
likelytohavelymphnodemetastasesandmayrespondtostandard
chemotherapy.
Normalbreastline

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oTheseareERpositive,HER2/neunegativeandcharacterizedby

thesimilarityoftheirgeneexpressionpatterntonormaltissue.
Basalline
oTheseareERnegative,PRnegative,HER2/neunegativeTriple
negative.
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oThesearecharacterizedbyexpressionofmarkerstypicalof
myoepithelialcells(e.g.,basalkeratins,Pcodherins,p63,orlaminin),
progenitorcells,orputativestemcells(e.g.cytokeratins5and6).o
ManycarcinomaarisinginwomenwithBRACImutationsareofthis
type.
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oTheseareaggressivetumors,frequentmetastasistovisceraand
braincanbeseen--->havepoorprognosis.
HER2positive
oTheseareERnegativeandoverexpressHER2/neuprotein.

510.Proliferatingbreastmassis-

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a)Ductectasia
b)Fibroadenoma
c)Adenosis
d)Papilloma
CorrectAnswer-D

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Ans.is'd'i.e.,Papilloma
Examplesincludeatypicalductalhyperplasia,atypicallobular
hyperplasia,andintraductalpapillomas.

511.Tadpolecellscommashapedcellson
histopathologyareseenin-

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a)Trichoepithelioma
b)Spideroma
c)Rhabdomyosarcoma
d)Histiocytoma
CorrectAnswer-C

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Ans.is'c'i.e.,Rhabdomyosarcoma
Histologyofrhabdomvosarcoma
Thediagnosticcellofrhabdomyosarcomaisrhabdomyoblast.
Rhabdomyoblastcontainseccentriceosinophilicgranularcytoplasm
richinthickandthinfilaments.oTherhabdomyoblastsmaybe?

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i)Round
ElongatedTadpoleorStrapcells.
Ithasthreevariants
ii)Embryonal
Alveolar

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iii)Pleomorphic
Rhabdomyoblastsarepositivefordesmin,MYOD1andMyogenin.

512.Glomustumorisseenin-
a)Retroperitoneum
b)Softtissue

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c)Distalportionofdigits
d)Proximalportionofdigits
CorrectAnswer-C
Ans.is'c'i.e.,Distalportionofdigits
oItisabenignbutpainfultumorthatarisesfromthemodified

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smoothmusclecellsoftheglomusbody,aspecializedarteriovenous
anastomosisthatisinvolvedinthermoregulation.
oTheyaremostcommonlyfoundinthedistalportionofthedigits,
especiallyunderthefingernails.

513.Ewingssarcomaarisesfrom-

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a)Gcells
b)Totipotentcells
c)Neuroectodermalcells
d)Neurons
CorrectAnswer-C

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Ans.isci.e.,Neuroectodermalcells
oHistologically,Ewing'ssarcomahasacertainresemblanceto
primitiveneuroectodermalcells,andthetumorarisesfromsuch
cells.
oItisararemalignancyprimarilyaffectingchildrenandadolescents.

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Itarisesmainlyinboneandlesscommonlyinsofttissues.
oInthese,thereisacharacteristicreciprocalchromosomal
translocation,whichleadstoanin-framefusionbetweentheEWS
geneandoneoftheETSfamilygenemembers.

514.Medulloblastomamostcommon

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metastasisisto?
a)Lung
b)CNS
c)Liver
d)Spleen

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CorrectAnswer-B
Ans.is'b'i.e.,CNS
oMedullablastomaspreadthroughCSFandfrequentlymetastasizes
todifferentlocationsinthebrainandspine.
oExtraneuralmetastasistotherestofthebodyisrare.

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515.Mutationinmalignantmelanoma-
a)N-myc
b)CDK2A
c)RET
d)None

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CorrectAnswer-B
Ans.is'b'i.e.,CDK2A
"Inmelanomacells,numbersofmutationsand/ordysregulated
expressionofB-RofN-Ras,CDK2A,MDM2,PTEN,p53havebeen
recognized".

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516.Perivascularlymphocytes&microglial
nodulesareseenin-
a)Multiplesclerosis
b)HIVencephalitis
c)CMVmeningitis

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d)Bacterialmeningitis
CorrectAnswer-B
Ans.is'b'i.e.,HIVencephalitis
oPerivascularinfiltrateoflymphocytes(andmacrophages)with
microglialnodulesisseeninHIVencephalitis.

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oPerivascularinfiltrateoflymphocytes(andmonocytes)isalsoseen
inmultiplesclerosis.But,microglialnodules
arecharacteristicofHIVencephalitis.

517.Glomuscellsarefoundin-
a)Bladder

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b)Brain
c)Chemoreceptors
d)Kidney
CorrectAnswer-C
Ans.is'c'i.e.,Chemoreceptors

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Arterialchemoreceptorsconsistofglobularaggregationsof
chemoreceptivecells(glomuscells),andsupportivecells,separated
fromoneanotherbyfibroustissuesepta.
Inthesesetpaandbetweenglomuscells,numerouscapillariesand
nervefibersareseen.

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Theglomuscellshavethestructureofendocrineaminehormone
secretingcells.

518.Commonesttumoroffaceinchidrenis-
a)Rhabdomyosarcoma
b)Sq.cellcarcinoma

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c)Basalcellcarcinoma
d)Mixedparotidtumor
CorrectAnswer-A
Ans.is'a'i.e.,Rhabdomyosarcoma
Rhabdomyosarcoma
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oThemostcommonsofttissuesarcomainchildrenis
rhabdomyosarcoma.
oThecommonsiteofinvolvementare:-
oHead&Neck(25%)2"dmostcommonExtremities
Genitourinary(22%)-->2ndmostcommon

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Retroperitoneum

519.Mostcommonsiteformedulloblastoma
is-
a)Cerebellum
b)Pituitary

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c)Cerebrum
d)Pinealgland
CorrectAnswer-A
Ans.is'a'i.e.,Cerebellum
oMedulloblastomaisaninfratentorialtumorandoccursexclusively

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incerebellum.

520.TypeBadversedrugreaction-
a)Augmentedeffectofdrug
b)UnpredictableBizzarereaction
c)Effectseenonchronicuseofdrug

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d)Delayedeffectofdrug
CorrectAnswer-B
Ans.is'b'i.e.,UnpredictableBizzarereaction
Typesofadversedrugreaction
1. TypesA(Augmented)reaction.

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2. TypesB(Bizzare)reaction
3. TypesC(Chronic)reaction
4. TypesD(Delayed)effects
5. TypesE(Endingofuse)reaction

521.Dopamineallofthefollowingistrue

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Except?
a)CausesincreaseinGIIsehemia
b)Positiveionotropic
c)Improvesrenalperfusion
d)CausesVasoconstriction

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A
Ans.is'a'i.e.,CausesincreaseinGIIschemia
oDopamineactsondopamine(Di&D2)andadrenergic(a1+a2+
[31)receptors,withnoactiononp,receptors.
oAtlowesteffectivedoseitstimulatesD1receptorsinrenal&

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mesentricbloodvessels-->improvesrenalandmesentric
perfusion.
oAtmoderatelyhighdosesitactsas13,agonist-->positive
ionotropic.
oAthighdosesitactivatesa-adrenoreceptors-->vasoconstriction.

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522.Allarealpha-blockerexcept?
a)Atenolol
b)Prazosin
c)Indoramine
d)Idazoxan

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CorrectAnswer-A
Ans.is'a'i.e.,Atenolol

523.Whichofthefollowingpotassium
sparingdiureticalterscardiacmortality-
a)Spironolactone

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b)Amiloride
c)Triamterene
d)Epleronone
CorrectAnswer-A
Ans.is'a'i.e.,Spironolactone

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oAmongpotassiumsparingdiuretics,aldosteroneantagonists
(Spironolactone,eplerenone)reducemortalityinCHF.

524.Antiandrogenusedinheartfailure?
a)Carvedilol
b)Sampatrilat

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c)Spironolactone
d)Abiraterone
CorrectAnswer-C
Ans.is'c'i.e.,Spironolactone
oSpironolactoneandeplerenonearethealdosteroneantagonists.

--- Content provided by⁠ FirstRanker.com ---

Theyareusedaspotassiumsparingdiuretics.Theirdiurecticeffect
isquitefeeble,butinCHFthesedrugsreducethemortality(at
doseslowerthandiureticdoses)byantagonizingtheeffectof
aldosterone(reversalofremodelling).Spironolactonealso
possessesanti-androgeniceffects.

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525.Fosphenytoindifferentfromphenytoinin
whichofthefollowing-
a)Canbeusedinabsenceseizures
b)Canbemixedwithsaline
c)Canbegivenorally

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d)Itisthedrugofchoiceformyoclonicseizures
CorrectAnswer-B
Ans.'b'i.e.,Canbemixedwithsaline
Whilephenytoincannotbeinjectedinadripofglucosesolution,
fosphenytoincanbeinjectedwithsalineandglucose.

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526.Iodinecontentinamiodarone-
a)10-20%
b)20-40%
c)40-60%
d)60-80%

--- Content provided by FirstRanker.com ---

CorrectAnswer-B
Ans.is'b'i.e.,20-40%

527.Whichofthefollowingcausesincreased
renninonprolongeduse?
a)Clonidine

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b)Enalapril
c)Methyldopa
d)Blocker
CorrectAnswer-B
Ans.is'bi.e.,Enalapril

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528.Centrallyactingantihypertensivedrugis
?
a)Phenoxybenzamine
b)Methyldopa
c)Propanolol

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d)Prazosin
CorrectAnswer-B
Ans.is'b'i.e.,Methyldopa
oCentrallyactingsympatholyticantihypertensivesareclonidine,
methyldopa,guanabenz,guanfacine,moxonidineandrilmenidine.

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529.TrueregardingConivaptanis-
a)VasopressinAntagonist
b)V2selectiveaction
c)Givenorally
d)All

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CorrectAnswer-A
Ans.is'a'i.e.,VasopressinAntagonist

530.Guanethidineisusedinthetreatmentofwhichofthefollowingcondition?
a)Thyrotoxicophthalmopathy
b)Ptosis

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c)Bell'spalsy
d)Horner'ssyndrome
CorrectAnswer-A
Guanethidine(10%)eyedropsisusefulindecreasinglidretractioninThyrotoxicophthalmopathy.
Itisanadrenergicneuronblockerwhichactsbyinhibitingthereleaseofnoradrenalineinresponseto

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nervestimulation.

531.5HT1agonistsusedas?(
a)Antianxietydrugs
b)Antipsychoticdrugs
c)GERD

--- Content provided by‌ FirstRanker.com ---

d)Chemotherapyinducedvomiting
CorrectAnswer-A
Ans.is'a'i.e.,Antianxietydrugs
5-HTIAagonists(Buspiron,ipsapirone)actasantianxietydrugs.

532.Mechanismofactionoftheophyllinein

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Bronchialasthmaincludeallofthe
followingExcept?
a)Phosphodiesteraseinhibition
b)Adenosinereceptorantagonism
c)Increasedhistonedeacetylation

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d)Beta-2receptorstimulation
CorrectAnswer-D
Ans.is'd'i.e.,Beta-2receptorstimulation
Proposedmechanismsofactionoftheophylline
Phosphodiesteraseinhibition(Nonselective)
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Adenosinereceptorantagonism(A1,A2)
IncreasedhistoneDeacetylaseactivity(redefficacyof
corticosteroids)
Inhibitionofintracellularcalciumrelease
Stimulationofcatecholaminerelease
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InhibitionofNF-alphaBetatranslocationintothenucleus(nuclear
translocation)
Mediatorinhibition(Prostaglandins,TNFalpha)

533.Omalizumabisusedintreatmentof:
a)Breastcarcinoma

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b)Asthma
c)Rheumatoidarthritis
d)Noneoftheabove
CorrectAnswer-B
OmalizumabisablockingantibodythatneutralizescirculatingIgEwithoutbindingtocell-

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boundIgE;itthusinhibitsIgE-mediatedreactions.
Thistreatmenthasbeenshowntoreducethenumberofexacerbationsinpatientswith
severeasthmaandmayimproveasthmacontrol.However,thetreatmentisvery
expensiveandonlysuitableforhighlyselectedpatientswhoarenotcontrolledonmaximal
dosesofinhalertherapyandhaveacirculatingIgEwithinaspecifiedrange.

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Ref:Harrison'sprincipleofinternalmedicine17thedition,chapter248.

534.Efficacyofsalmeterolisincreasedifitis
givenalongwith-
a)Theophylline
b)Corticosteroid

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c)Ipratropium
d)Sodiumcromoglycate
CorrectAnswer-B
Ans.is'b'i.e.,Corticosteroid
oConcurrentuseofinhaledsalmeterolwithinhaledglucocorticoid

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produceseffectsequivalenttodoubledoseofthecorticoidalone.

535.Whichdrugdoesn'tincludeDMARD:
a)Chloroquine
b)Vincristine
c)Azathioprine

--- Content provided by‌ FirstRanker.com ---

d)Leflunomide
CorrectAnswer-B
Ans.is'b'i.e.,Vincristine
oDiseasemodifyingantirheumaticdrugs(DMARDs):?
1. ImmunosuppresantsMethotrexate,azathioprine,cyclosporine

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2. Sulfasalazine
3. Choloroquineorhydroxychloroquine
4. Leflunomide
5. Goldsod.thiomalate,Auranofin
6. d-Penicillamine

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536.Whichofthefollowingdrugsactdirectly
withoutsexualstimulation?
a)Sildenafil
b)Tadalafil
c)Alprostadil

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d)Testosterone
CorrectAnswer-C
Ans.C.Alprostadil
Alprastadil(pGEl)isdirectlyinjectedintocorporacavernusafor
erectiledysfunction'

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Itactsbyincreasingarterialinflow"byvasodilationandreducing
outflowbycontractingthecarporalsmoothmusclethatoccludes
drainingvenules.

537.PGE2causeallexcept-
a)Waterretention

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b)Uterinecontraction
c)Flushing
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Waterretention

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oPGE2causesincreaseinwaterexcretionbyinhibitingADHaction.

538.Dinoprostis-
a)PGEl
b)PGE2
c)PGF2alpha

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d)PGI2
CorrectAnswer-C
Ans.is'c'i.e.,PGF2alpha
oDinoprost-PGF2alpha,intraamnioticallyformidtermabortion.
oDinoprostone-PGE2,intravaginallyformidtermabortion.

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539.Whichenzymeisirreversiblyinhibitedby
aspirin?
a)Lipooxygenase
b)Cyclooxygenase
c)Thromboxanesynthase

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d)Phospholipase
CorrectAnswer-B
Ans.is'b'i.e.,Cyclooxygenase

540.Indiabetesinsipidus,diureticshowing
paradoxicalantidureticactivity-

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a)Thiazide
b)Triamterene
c)Spironolactone
d)Furosemide
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Ans.is'a'i.e.,Thiazide
ThiazidediureticsparadoxicallydecreaseurineoutputinDIdueto
formationofcAMPindistaltubuleseffectiveinbothcentraland
nephrogenicDI.

541.Sideeffectofthiazidediureticsareall

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except?
a)Hyponatremia
b)Hypokalemia
c)Erectiledysfunction
d)Hypocalcemia

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CorrectAnswer-A
Ans.is'A'i.e.,Hypocalcemia
Thiazidescausehypercalcemia(seeaboveexplanation).

542.Desmopressinispreferredover
vasopressinbecausedesmopressin-

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a)Morepotent
b)MoreselectiveforVireceptor
c)Haslittlevasconstrictoractivity
d)aandc
CorrectAnswer-D

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Ans.is'a'i.e.,Morepotent;'c'i.e.,Haslittlevasconstrictoractivity
oDesmopressinislongeracting
oDesmopressinisV2selective--)NoV,mediated
vasoconstriction.
oDesmopressinis12timesmorepotentthanvasopressin.

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543.Whichofthefollowingisaselective
serotonin&norepinephrinereuptake
inhibitor?
a)Fluoxetine
b)Venlafaxine

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c)Sertaline
d)Arnoxipine
CorrectAnswer-B
Ans.is'b'i.e.,Venlafaxine
oImportantSNRIsare:-Venalafaxine,Milnacipram,

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desvenalafaxine,Duloxetine.

544.Allareneuralplateinducersexcept
a)Notochordappearance
b)HighBMP
c)FGFupregulation

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d)Prechordalmesoderm
CorrectAnswer-B
Bi.e.HighBMP

545.Toxicdoseoflithium-
a)0.6

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b)12
c)2.6
d)<0.6
CorrectAnswer-C
Ans.is'c'i.e.,2.6

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546.Extrapyramidalsyndromelikeside
effectsareseenin-
a)Haloperidol
b)Clozapine
c)Tetracycline

--- Content provided by FirstRanker.com ---

d)Ketoconazole
CorrectAnswer-A
Ans.is'a'i.e.,Haloperidol
Drugscausingextrapvramidaleffects
oButyrophenones(Haloperidol)oMethyldopao

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OCP'SoReserpine
oLevodopaoMetoclopromideo
PhenothiazinesoTricyclicAntidepressants

547.TrilenewhenusedwithSodalimecauses
?

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a)Renaldamage
b)ARDS
c)Myocardialdepression
d)Hepatitis
CorrectAnswer-B

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Ans.is'b'i.e.,ARDS
oFollowingagentsreactwithsodalime:
SevofluraneisdegradedbycontactwithCO2absorbant(sodalime)
inanaesthesiamachine,yieldingavinylethercalledCompoundA
whichcancauserenaldamage.

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Trileneproducesphosgene(causingARDS)anddicholoroacetylene
(causesneurotoxicity)whenusedwithsodalime.

548.Cardiotoxicityofbupivacaine-
a)Depressedpacemakeractivity
b)Toxiccompounddamagingmyocardialcells

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c)Depressedneuralcontrolonheart
d)VascularthrombosisandMyocardialischemia
CorrectAnswer-A
Ans.is'a'i.e.,Depressedpacemakeractivity
oLocalanaestheticsblockcardiacsodiumchannelsandthus

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depressabnormalcardiacpacemakeractivity,excitability,and
conduction.Atextremelyhighconcentrations,localanaestheticscan
alsoblockcalciumchannels.

549.Shortactingnondelpolarizingblocker?
a)Rocurorium

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b)Suxamethonium
c)Mivacurium
d)Pancuronium
CorrectAnswer-C
Ans.is'c'i.e.,Mivacurium

--- Content provided by‌ FirstRanker.com ---

550.Whichisanintermediateactinginsulin?
a)Insulinlispro
b)Regularinsuin
c)NPHinsulin
d)Insulinglargine

--- Content provided by‍ FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,NPHinsulin

551.Steroidingestedforlongtimeleadstoall
ofthefollowingexcept-
a)Avascularnecrosisofheadoffemur

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b)Cataract
c)Glaucoma
d)Growthretardation
CorrectAnswer-C
Ans.is'c'i.e.,Glaucoma

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Glaucomaoccursaftertopicaltherapy(notsystemic)

552.Leastglucocorticoidactionisseenwith
?
a)Fludrocortisone
b)Cortisone

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c)Dexamethasone
d)Betamethasone
CorrectAnswer-B
Ans.is'b'i.e.,Cortisone
Leastpotentglucocorticoid-->Cortisone

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553.Steroidwithmaxmineralocorticoid
activity?
a)Fludrocortisone
b)DOCA
c)Prednisolone

--- Content provided by FirstRanker.com ---

d)Triamsinolone
CorrectAnswer-A
Ans.is'a'i.e,Fludrocortisone

554.Intakeofexogenoussteroidcauses:
a)Addison'sdisease

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b)Cushing'ssyndrome
c)Pheochromocytoma
d)Conn'ssyndrome
CorrectAnswer-B
AnswerisB(Cushing'ssyndrome):

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ThemostcommoncauseofCushing'ssyndromeisiatragenic
administrationofsteroidsforavarietyofreasons.-Harrison

555.Whichofthefollowingisaselective
progesteronereceptormodulator-
a)Onapristone

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b)Ulipristal
c)Nomegestrol
d)Toremifene
CorrectAnswer-B
Ans.is'b'i.e.,Ulipristal

--- Content provided by FirstRanker.com ---

oUlipristalisaSPRMapprovedforuseasanEmergency
Contraceptive.
oSPRM(selectiveprogesteronereceptormodulators):Asoprisnil,ul
ipristal,onapristone,mifepristone.

556.Tiboloneisa?

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a)Naturalsteroidalestrogen
b)Naturalnon-steroidalestrogen
c)Syntheticsteroidalestrogen
d)Syntheticnon-steroidalestrogen
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Ans.C.Syntheticsteroidalestrogen
[RefKDT7Vep.306,311]
Syntheticestrogens
SteroidalEthinylestradiol,mestranol,tibolone.
NonsteroidalDiethylstilbestrol,hexestrol,dienestrol.

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557.Finasterideisa:
a)5alphareductaseinhibitor
b)PDEinhibitor
c)Alphalablocker
d)Androgenreceptorblocker

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CorrectAnswer-A
Finasterideisacompetitiveinhibitoroftheenzyme5-alphareductasewhichisresponsible
fortheconversionoftestosteroneintoamoreactivedihydrotestosteroneresponsibleforthe
androgenaction.
Whenusedinbenignprostatichypertrophy,itreducestheprostatesizeandincreasedpeak

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urinaryflowrate.
Itisalsousedinmalepatternbaldnessandasapalliativetreatmentinprostaticcarcinoma.
Ref:KDTripathiTextbookofPharmacology,5thEdition,Page272

558.Whichofthefollowingisasynthetic
estrogen?

--- Content provided by FirstRanker.com ---

a)Estrone
b)Estriol
c)Estradiol
d)Diethylstibestrol
CorrectAnswer-D

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Ans.is'd'i.e.,Diethylstibestrol
Syntheticprogesterones
1.Progesteronederivatives-->Medroxyprogesterone,Megestrol,
Dydrogesterone,Hydroxyprogesterone,Nomegestrol.
2.19-Nortestosteronederivatives-->Norethindrone,Lynesternol,

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Allylesterone,Levonorgestrel,Desogestrel,Norgestimate,
Gestodene.
Syntheticestrogens
1. Steroidal---->Ethinylestradiol,mestranol,tibolone.
2. Nonsteroidal---->Diethylstilbestrol,hexestrol,dienestrol

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559.Sideeffectofoxytocinisallexcept?
a)Placentalabruption
b)Fetaldistress
c)Peripheralvasculardisease
d)Waterintoxication

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,Peripheralvasculardisease
oSideeffectsofOxytocinaredueto:
i)ADHlikeaction-Waterintoxication
ii)Excessiveuterinecontractions,priortolabour-Fetaldistress,

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Placentalabruption,Uterinerupture.

560.WhichisnotaS/EofCimetidine?
a)Impotence
b)Gynaecomastia
c)Atrophicgastritis

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d)Galactorrhea
CorrectAnswer-C
Ans.is'c'i.e.,Atrophicgastritis

561.Antilipidemicdrugsthatprevent
hypercholesterolemiabyinhibiting
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absorption-
a)Ezetimibe
b)Orlistat
c)Cholestyramine
d)Statins

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CorrectAnswer-A
Ans.is'a'i.e.,Ezetimibe
Ezetimibeinhibitstheabsorptionofcholesterolbybidningto
transporter[NPC-1L1(NiemannPickCl,likel)SRBl,145KDa]
locatedinintestinalbrushborder.

--- Content provided by FirstRanker.com ---

Note:
Orlistatalsoreducescholesterolabsorption,butitisananti-obesity
drug(notanantilipidemicdrug).

562.Antifungalwhichcanbeusedorallybut
notivis?

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a)Voriconazole
b)AmphoterecinB
c)Terbinafine
d)Noneoftheabove
CorrectAnswer-C

--- Content provided by‌ FirstRanker.com ---

Ans.is'c'i.e.,Terbinafine

563.Mostpotentstatin-
a)Simvastatin
b)Pravastatin
c)Rosuvastatin

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d)Simvastatin
CorrectAnswer-C
Ans.is'c'i.e.,Rosuvastatin
oTwomostpotentstatinsare
Pitavastatin(mostpotent)androsuvastatinmostpotent).

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564.An86yearsoldladypresentedwith
severeconstipation.Shewasaknown
hypertensiveonmedicationsfor10
years.Inclinic,herBPwas157/98mm
Hgwithaheartrateof58/min.Ontaking
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hereBPinthesupinepositionitwas
foundtobe90/60mmHg.Shehadthe
recenthistoryofdepression.Sheis
takingatenolol,thiazide,imipramine,
haloperidolanddocusate.Whatwillbe
--- Content provided by‌ FirstRanker.com ---
thenextbeststepinthemanagement?
a)Changeatenololandthiazidetocalciumchannelblockerand
ACEinhibitorandaddbisacodylforconstipation
b)Changeimipramineandhaloperidoltofluoxetineand
risperidoneandaddbisacodylforconstipation

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c)Onlyaddbisacodylforconstipationandcontinuerestofthe
medications
d)Discontinueallhermedicationsandstartheronsteroids
CorrectAnswer-B
Ans:B.Changeimipramineandhaloperidoltofluoxetineand
--- Content provided by FirstRanker.com ---
risperidoneandaddbisacodylforconstipation
(RefHarrison19/ep1623-1624,18/ep3531:GoodmanGilman12/e
p410.1333)
EffectsofImipramine:

Posturalhypotension-DuetoalphablockadebyImipramine&

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thiazidesinteraction.
Anti-cholinergicside-effect.
Hence,Imipramine(TCA)mustbediscontinued.
ShouldbestartedonSSRI,fluoxetin&laxative(existing
constipation).

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Effectofhaloperidol:
Anti-cholinergicsideeffects.
ShouldstartonatypicalantipsychoticRisperidone.

565.ProphylacticdoseofvitaminKgivento
newborninfantsatdeliveryis?

--- Content provided by FirstRanker.com ---

a)1mg
b)5mg
c)10mg
d)15mg
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Ans.is'a'i.e.,1mg
VitaminKDeficiencyinNewborns
ThesymptomsofvitaminKdeficiencyareduetohemorrhage
NewbornsareparticularlysusceptibletovitaminKdeficiency
becauseoflowfatstores,lowbreastmilklevelsofvitaminK,sterility

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oftheinfantileintestinaltract,liverimmaturity,andpoorplacental
transport.
Intracranialbleeding,aswellasgastrointestinalandskinbleeding,
canoccurinvitaminK-deficientinfants17daysafterbirth.
Thus,vitaminK(1mgIM)isgivenprophylacticallyatthetimeof

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delivery.

566.Lowmolecularweightheparinmainly
inhibitswhichfactor:
September2009
a)FactorIlia

--- Content provided by FirstRanker.com ---

b)FactorVIIIa
c)FactorXa
d)FactorXIIa
CorrectAnswer-C
Ans.C:FactorXa

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567.Allofthefollowinghaveinteractionwith
warfarinexcept-
a)Barbiturate
b)Oralcontraceptive
c)Cephalosporins

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d)Benzodiazepens
CorrectAnswer-D
Ans.is'd'i.e.,Benzodiazepenes

568.Clopidogrelmechanismofaction-
a)ThromboxaneA2inhibition

--- Content provided by⁠ FirstRanker.com ---

b)InhibitADPmediatedcAMPactivation
c)GPIIb/Inainhibitors
d)None
CorrectAnswer-B
Ans.is'b'i.e.,InhibitADPmediatedcAMPactivation

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569.Romiplostimactsonwhichofthefollowingreceptors:
a)Thrombopoeitin
b)IL6
c)IL8
d)PGE1

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A
Romiplostim:GeneticallyengineeredproteininwhichtheFccomponentofahuman
antibodyisfusedtotwocopiesofapeptidethatstimulatesthethrombopoietinreceptors;
approvedfortreatmentofidiopathicthrombocytopenicpurpura
Ref:Katzung11theditionChapter33.

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570.Mechanismofactionofquinolonesis?
a)DNAgyraseinhibitors
b)Bindto30sunit
c)Bindtobacterialcellmembrane
d)Bindtotetrahydofolatereductase

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CorrectAnswer-D
DNAgyraseinhibitorsREF:GoodmanGillman's11thedp.722
ThequinoloneantibioticstargetbacterialDNAgyraseand
topoisomeraseIV.Formanygrampositivebacteria,topoisomerase
IVistheprimarytarget.Formanygram-negativebacteria,DNA

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gyraseistheprimaryquinolonetarget.

571.Druginhibitingbacterialprotein
synthesisareallexcept-
a)Aminoglycosides
b)Chloramphenicol

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c)Clindamycin
d)Sulfonamides
CorrectAnswer-D
Ans.is`d'i.e.,Sulfonamides
oSulfonamidesaffectintermediarymetabolismbyinhibitingfolate

--- Content provided by FirstRanker.com ---

synthase.

572.Longestactingsulphonamideis-
a)Sulfadiazine
b)Sulphadoxine
c)Sulfamethoxazole

--- Content provided by‌ FirstRanker.com ---

d)Sulfamethiazole
CorrectAnswer-B
Ans.is'b'i.e.,Sulfadoxine
Sulfadoxineandsulfamethopyrazinearelongactingsulfonamides.

573.Widestspectrumaminoglycosideis-

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a)Streptomycin
b)Amikacin
c)Framycetin
d)Netilmicin
CorrectAnswer-B

--- Content provided by‍ FirstRanker.com ---

Ans.is'b'i.e.,Amikacin

574.Doseofoseltamivirinachildaged9monthsis:
a)2mg/kgtwicedailyfor5days
b)2.5mg/kgtwicedailyfor5days
c)3mg/kgtwicedailyfor5days

--- Content provided by‌ FirstRanker.com ---

d)3.5mg/kgtwicedailyfor5days
CorrectAnswer-C
Agegroups
Recommendeddoseofoseltamivir
0to1month

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2mg/kgtwicedailyfor5days
>1monthto3months
2.5mg/kgtwicedailyfor5days
>3monthsto12months
3mg/kgtwicedailyfor5days

--- Content provided by‍ FirstRanker.com ---

Ref:Park21stedition,page148
Chapter:Epidemiologyincommunicablediseases.

575.IndicationofAcyclovirinpregnancy:
a)Disseminatedherpes
b)Chicken-poxinfirsttrimester

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c)Prophylaxisinrecurrentherpes
d)Alloftheabove
CorrectAnswer-D
Alloftheabove

576.Whichofthefollowingantimalarialisa

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slowactingschizonticide-
a)Artemether
b)Mefloquine
c)Pyrimethamine
d)Quinine

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CorrectAnswer-C
Ans.is'c'i.e.,Pyrimethamine
oAntimalarialsthatactonerythrocyticphaseofschizogonyare
callederythrocyticschizontocides.Theavailabledrugscanbe
dividedinto?

--- Content provided by‍ FirstRanker.com ---

1.Fastacting-Chloroquine,amodiaquine,quinine,mefloquine,
halofantrine,lumefantrine,atovaquone,artemisinin.
2.Slowacting-Pyrimethamine,Proguanil,sulfonamides,
tetracyclines.

577.Redmansyndromeisdueto-

--- Content provided by‍ FirstRanker.com ---

a)Vancomycin
b)Polymyxin
c)Rifampicin
d)Teicoplanin
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Ans.is'a'i.e.,Vancomycin
Vancomycincancauseredmensyndrome.

578.Bleedingisseenwiththeuseof-
a)Cefaloridine
b)Cefazolin

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c)Moxalactum
d)Ceftazidime
CorrectAnswer-C
Ans.is'c'i.e.,Moxalactam
oCeftriaxone,cefoperazone,moxalactam&cefamandolecancause

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hypoprothrmbinemiaandbleeding.

579.Sulphonamideinjectioncausesdecrease
infolicacidby?
a)Competitiveinhibition
b)Noncompetitiveinhibition

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c)Uncompetitiveinhibition
d)Allostericinhibition
CorrectAnswer-A
Ans.is'a'i.e.,Competitiveinhibition
Bacteriasynthesizetheirownfolicacidofwhichparaaminobenzoic

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acid(PABA)isaconstituent-Sulfonamides,beingstructural
analoguesofPABA,inhibitbacterialfolatesynthasecompetitively.

580.Allaretrueaboutciprofloxacinexcept?
a)C/Iinpregnancy
b)DNAinhibition

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c)Mostpotent1stgenerationfluoroquinolone
d)MoreactiveatacidicpH
CorrectAnswer-D
Ans.is'd'i.e.,MoreactiveatacidicpH
CiprofloxacinisthemostpotentfirstgenerationFQ.

--- Content provided by‌ FirstRanker.com ---

oCiprofloxacininhibitDNAgyraseandiscontraindicatedin
pregnancy.
ItislessactiveatacidicpH.

581.Whichofthefollowingisnotusedas
treatmentforlymphaticfilariasis-

--- Content provided by FirstRanker.com ---

a)Ivermectin
b)DEC
c)Praziquantel
d)Albendazole
CorrectAnswer-C

--- Content provided by⁠ FirstRanker.com ---

Ans.is'c'i.e.,Praziquantel
oDrugsusedinlymphaticfiliriasisareDEC,ivermectin,albendazale
anddoxycycline.

582.Aboutvincaalkaloidstrueis?
a)Inhibitsmitoticspindle

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b)Enhancespolymerizationoftubulin
c)InhibitstopoisomeraseI
d)InhibitstopoisomeraseII
CorrectAnswer-A
Ans.is'a'i.e.,Inhibitsmitoticspindle

--- Content provided by FirstRanker.com ---

Vincaalkaloids(vincristine)inhibitmitoticspindlesbypreventing
polymerizationoftubulin

583.WhichofthefollowingAntineoplastic
drugsSHOULDNOTbegivenbyrapidIV
infusion?

--- Content provided by⁠ FirstRanker.com ---

a)Cyclophosphamide
b)Cisplatin
c)Bleomycin
d)Cytosinearabinoside
CorrectAnswer-B

--- Content provided by FirstRanker.com ---

Ans.is`b'i.e.,Cisplatin
oCisplatinisthemostcommonculpritcausingchemotherapy
inducednauseaandvomiting,thereforecisplatinisgivenasslowi.v.
infusion(neverbolus)topreventvomiting.

584.Modeofactionofazathioprine?

--- Content provided by‌ FirstRanker.com ---

a)IL-2
b)T-cellblockade
c)Decreasedlymphophagocyticactivity
d)Wide-spreadantitumoractivity
CorrectAnswer-B

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Ans.is'b'i.e.,T-cellblockade

585.ResistancetoMethotrexatedevelopsdue
to?
a)RapidCancercellmultiplication
b)Deficiencyofthymidylatekinase

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c)Deficiencyofthymidylatesynthetase
d)Increasedproductionofdihydrofolatereductase
CorrectAnswer-D
Ans.is'd'i.e.,Increasedproductionofdihydrofolatereductase
Methotrexateresistance

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oMethotrexateresistancemaybeduetoanyofthefollowing
mechanism:?
i)Defectivetransportintocells
ii)ProductionofalteredformofDHFRthathavedecreased
affinityformethotrexate
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iii)IncreasedconcentrationsofintracellularDHFRthroughgene
amplificationoralteredgeneregulation
iv)Decreasedabilitytosynthesizemethotrexatepolyglutamates
v)Increasedexpressionofadrugeffluxtransporter,oftheMRP
(multidrugresistanceprotein)class

--- Content provided by FirstRanker.com ---

586.Whichofthefollowingpoisoning
presentswithabdominalpain,diarrhea,
Meeslineonnailsand
myelosuppression:
September2011

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a)Lead
b)Arsenic
c)Alcohol
d)Mercury
CorrectAnswer-B

--- Content provided by‍ FirstRanker.com ---

Ans.B:Arsenic
Inchronicarsenicpoisoning,aclassicalstateofillhealthresultsare
representedby4stages.Firststageofnutritionaland
gastrointestinaldisturbances(diarrhoeaiscommon)
Thirdstage(ofskinrashes)showswhitebandsknownasMeesline

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crossingthenailoffingersandtoes
Inadditiontothis,theremaybeevidenceofliverdamage,kidney
damageandbonemarrowdepressionatsomestageArsenic
poisoning
Increasedlevelsoftheelementarsenicinthebody.

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Arsenicinterfereswithcellularlongevitybyallostericinhibitionofan
essentialmetabolicenzyme.
Symptomsofarsenicpoisoningincludeheadache,confusion,
convulsion,diarrhea,vomiting,andinseverecasecomaanddeath
Routesofexposureincludecontaminatedwater,air,andfood.

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Occupationalexposuretoarsenicmayoccurwithcopperorlead

smeltingandwoodtreatmentandamongworkersinvolvedinthe
productionorapplicationofpesticides
Symptomsofarsenicpoisoningbeginwithheadaches,confusion,
severediarrhea,anddrowsiness.

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Asthepoisoningdevelops,convulsionsandchangesinfingernail
pigmentationcalledleukonychiamayoccur.
Whenthepoisoningbecomesacute,symptomsmayinclude
diarrhea,vomiting,bloodintheurine,crampingmuscles,hairloss,
stomachpain,andmoreconvulsions.

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Theorgansofthebodythatareusuallyaffectedbyarsenic
poisoningarethelungs,skin,kidneys,andliver.
Chronicarsenicexposurecanremaininthebodysystemsfora
longerperiodoftimethanashortertermormoreisolatedexposure
andcanbedetectedinalongertimeframeaftertheintroductionof

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thearsenic,importantintryingtodeterminethesourceofthe
exposure.
Hairisapotentialbioindicatorforarsenicexposureduetoitsability
tostoretraceelementsfromblood.
Incorporatedelementsmaintaintheirpositionduringgrowthofhair.

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Thusforatemporalestimationofexposure,anassayofhair
compositionneedstobecarriedoutwithasinglehair
whichisnotpossiblewitholdertechniquesrequiringhomogenization
anddissolutionofseveralstrandsofhair.
Thistypeofbiomonitoringhasbeenachievedwithnewer

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microanalyticaltechniqueslikeSynchrotonradiationbasedXray
fluorescence(SXRF)spectroscopyandMicroparticleinducedXray
emission(PIXE).
Dimercaprolanddimercaptosuccinicacidarechelatingagentswhich
sequesterthearsenicawayfrombloodproteinsandareusedin

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treatingacutearsenicpoisoning.
Themostimportantsideeffectishypertension.
Dimercaprolisconsiderablymoretoxicthansuccimer

587.AllaretrueregardingSunitinibexcept-
a)Itinhibitstyrosinekinasereceptors

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b)Itisusedforrenalcellcarcinoma
c)ItisusedforthetreatmentofGIST
d)Itisexcretedprimarilyinurine
CorrectAnswer-D
Ans.is'd'i.e.,Itisexcretedprimarilyinurine

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SunitinibinhibitsmultipleTyrosinekinasereceptors.Itinhibits
PDGF,VEGFandc-kit.
oSunitinibandsorafinibareusedinrenalcellcarcinoma(inRCC
thereisoverexpressionofVEGF)andGIST(inGISTthereisover
expressionofC-Kit&PDGF).

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oItiseliminatedprimarilybyhepaticroutewithexcretioninfaeces.

588.Whichofthefollowingdrugcauses
hirsutism?
a)Phenytoin
b)Valproate

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c)Carbamazepine
d)Phenobarbitone
CorrectAnswer-A
Ans.is'a'i.e.,Phenytoin

589.Notaselectiveserotoninreuptakeinhibi-

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tor
a)Fluoxitine
b)Fluoxamine
c)Buspirone
d)Citaloforamin

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CorrectAnswer-C
Buspirone

590.Whichofthefollowingdrugcrosses
BBB?
a)Glycopyrrolate

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b)Neostigmine
c)Physostigmine
d)Alloftheabove
CorrectAnswer-C
Ans.C.Physostigmine
--- Content provided by FirstRanker.com ---
[RefKDTp.07,117]
Physostigmine-RapidlyabsorbedfromGITandparenteralsites,
penetratescorneafreelyandcrossesBBB(bloodbrainbarrier).
Neostigmine-Itisaquarternaryammoniumcompoundwhichis
poorlyabsorbedorallywithpoorcornealpenetrationanddoesn't

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crossBBB.
Glycopyrrolate-Itisapotentandrapidlyactinganti-muscarinic
lackingcentraleffectsandisusedasapre-anaestheticmedication.

591.Juvenilejusticeactdefinesajuvenile
whichis

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a)Malebelow16years
b)Femalebelow16years
c)Malebelow18years
d)Noneoftheabove
CorrectAnswer-C

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Ans.is'c'i.e.,Malebelow18years

592.CrPC26?
a)Divisionofoffence
b)Divisionofnegligence
c)Divisionofmalpractice

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Divisionofoffence
AccordingtoSec26ofCrPC,1973,OffencesundertheCriminal
ProcedureCode(hereinafterthe"CrPC")aredividedinto:

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1. OffencesunderIndianPenalCode(IPC)(triablebyHC,Sessions
Courtandothercourtshowninthe1stScheduletotheCrPC)
2. Offencesunderanyotherlaw(empowersHC,whennocourtis
mentionedforanyoffenceunderanylawotherthanIPC,totrysuch
offences)

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593.

Whichsectionbelongstomaritalrape?
a)375A
b)376A
c)376B

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d)375B
CorrectAnswer-B
Ans.is'b'i.e.,376A[RefReddy30"Vep.377]Maritalrape
Itisforcefulsexualintercoursewithwifewhoislivingseparately
fromhimunderadecreeofseparation,oranycustomorusage

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withoutherconsent.
Itispunishablewithimprisonmentupto2yearsprovidedtheageof
wifeisnotbelow12years-Section376A,I.P.C.

594.Policeinquestisrequiredinallexcept:
b)Accidentaldeath

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c)Dowrydeath
d)Murder
CorrectAnswer-C
Ans.C:Dowrydeath
Inpoliceinquest,sub-inspectororofficerinchargeofthepolice

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stationconductstheinquestinsuicide,murder,accidentaldeathsor
deathundersuspiciouscircumstances.
Magistrateinquestisdonein:
Custodialdeath
Deathduetopolicefiring

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Deathinprison
Deathinapsychiatrichospital
Dowrydeaths
Exhumation
Indowrydeaths,inquestshouldbecarriedoutbyamagistrateor

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policeofficer,notbelowtherankofdeputysuperintendentofpolice.

595.Plantiffisapersonwho?
a)Filescaseincivilcourt
b)Actsasdefender
c)Givesjudgement

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Filescaseincivilcourt[RefInternet]
Plaintiffisapersonwhofilesacaseincivilcourt.?

596.Incriminalcases,conductmoneyispaid

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by:
NEET13
a)Court
b)Oppositeparty
c)Judge

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d)Noconductmoneyisgiven
CorrectAnswer-D
Ans.Noconductmoneyisgiven

597.Oralevidenceismoreimportantthan
writtentestimonyas:
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NEET13
a)Oralevidencecannotbecross-examined
b)Oralevidencecanbecross-examined
c)Documentaryevidencerequiresnoproof
d)None

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CorrectAnswer-B
Ans.Oralevidencecanbecross-examined

598.Contributorynegligenceisnegligence
dueto:
NEET13

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a)Doctoronly
b)Patientonly
c)Bothdoctorandpatient
d)Hospitaladministratoranddoctor
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Ans.Bothdoctorandpatient

599.Ina3monthfetus,characteristicfeature
seenis:
NEET13
a)Nailsarevisible

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b)Limbswellformed
c)Anusisseenasdarkspot
d)Meconiumisfoundinduodenum
CorrectAnswer-A
Ans.Nailsarevisible

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600.RuleofHasseisusedtodetermine:
a)Theageoffetus
b)Heightofanadult
c)Raceofaperson
d)Identification

--- Content provided by FirstRanker.com ---

CorrectAnswer-A
Ans.isai.e.Theageoffetus
Hasse'sruleisemployedincalculatingtheageoffetusbyits
length
Duringthefirstfivemonthsofpregnancy,thelengthincmsissquare

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oftheageinmonthsi.e.Lengthincms=(Ageinmonths)?
Ageinmonths=Qlengthincms
Duringsecondfivemonthsofpregnancy,lengthincmsdividedby5
istheageinmonths.Lengthinems
Ageinmonths5

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601.Cruralindexis:
a)Lengthoftibia/femurx100
b)Lengthofradius/humerusx100
c)Lengthoffibula/tibiax100
d)Lengthofradius/ulnax100

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CorrectAnswer-A
Ans.Lengthoftibia/femurx100

602.Whichofthefollowingisnotseenin
fingerprints?
a)Loop

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b)Circles
c)Whorl
d)Arch
CorrectAnswer-B
Ans.is'b'i.e.,Circles[RefReddy30`h/ep.75-76]
--- Content provided by FirstRanker.com ---
Classificationoffingerprints:
Loops(60-70%)-radial,ulnar
Whorls(25-35%)-concentric,spiral,doublespiral,almondshaped
Arches(6-7%)-plain,tented,exceptional
Composite(1-2%)-centralpocketloops,lateralpocketloops,

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twinnedloops,accidentals
Mostcommontype-Loops.
Leastcommontype->Composite.

603.Methodofidentificationusinglips:
a)Dactylography

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b)Poroscopy
c)Cheiloscopy
d)Tricology
CorrectAnswer-C
Ans.Cheiloscopy

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604.Whatisfirstexternalsignof
decompositionofdeadbody-
a)Decompositionofliverandintestine
b)Greenishdiscolourationoverrightiliacfossa
c)Greenishdiscolourationoverdependentparts

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d)Bloodstainedfrothfrommouth
CorrectAnswer-B
Ans.is'b'i.e.,Greenishdiscolourationoverrightiliacfossa
[RefReddy30th/ep.150-152]
Firstexternalsignofputrefaction-Greendiscolorationinrightiliac

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fossa.
FirstinternalsignofputrefactionGreendiscolorationunderliver.
Theseareduetoinvolvementofcaecumwhichcontainsmoregas
andisfullofbacteria.

605.Invitrouswhatismeasuredfortime

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sincedeath-
a)Sodium
b)Potassium
c)Proteins
d)Chloride

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CorrectAnswer-B
Ans.is'b'i.e.,Potassium[Ref:Reddy30th/ep.139]
Postmortemchangesineyeare:
Lossofcornealreflex
Opacityofcornea-corneabecomesopaquein2to4hours.

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Flaccidityofeyeball-withinminutesafterdeathduetodecreased
intraoculartension.
Pupilsaredilatedwithinoneminuteofdeath,pupilsreacttoatropine
foraboutonehour.
Retina-fragmentationofbloodcolumninretinalvesselsoccurwithin

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minutestoonehour.
Chemicalchange-asteadyriseinthepotassiumvaluesoccurinthe
virtoushumorafterdeathupto100times.

606.Postmortemcaloricityisseeninall,
except:
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AP06;Bihar12;BHU12
a)Burns
b)Sunstroke
c)Tetanus
d)Septicemia

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CorrectAnswer-A
Ans.Burns

607.Colorofpostmortemlividityin
hypothermicdeaths:
NEET13

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a)Purple
b)Deepred
c)Cherryred
d)Brightpink
CorrectAnswer-D

--- Content provided by‍ FirstRanker.com ---

Ans.Brightpink

608.Inhowmanyhoursdoesadeadbody
floatinIndiainsummer?
a)6hours
b)12hours

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c)24hours
d)48hours
CorrectAnswer-C
Ans.is'c'i.e.,24hours
Timeoffloatationofdeadbodyindrowiningisordinarily24
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hoursafterdeathinsummerand2to3daysincoldseason.
1. Thebodyfloatsquickerinsummerduetoearlyputrefaction)
2. Itfloatsupsoonerinshalloworsalinewaterbecauseofitshigher
specificgravity)
3. Floatationisquickerinpollutedwaterduetoquickerdecomposition)

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4. Bodiesofwomenandfattypersonsfloatearlierastheyarehighter.
Bodiesofthechildrenfloatupearlierasbonesarelighter.

609.Foamyliverisseenin:
TN08;UP08;NIMS11;NEET13
a)Arsenicpoisoning

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b)Electrocution
c)Hanging
d)Putrefaction
CorrectAnswer-D
Ans.Putrefaction

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610.Inmedicolegalautopsy,cavitytobe
openedfirstis?
a)Thoracic
b)Abdomen
c)Cervical

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d)Anyoftheabove
CorrectAnswer-D
Ans.is'd'i.e.,Anyoftheabove[RefReddy30thlep.97]
Dependingontypeofcase,anyofthebodycavitycanbeopened
first.Spinalcordisroutinelynotopened.

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Itisconvenienttostarttheexaminationwiththecavitychiefly
affected

611.Incisedlookinglacerationisseenat?
a)Forehead
b)Hand

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c)Thorax
d)Abdomen
CorrectAnswer-A
Ans.is'a'i.e.,Forehead
LACERATIONS(TearorRupture)
--- Content provided by FirstRanker.com ---
Lacerationsaretearsorsplitsofskin,mucousmembraneand
underlyingtissue(e.g.,muscleorinternalorgans).Lacerationsare
producedbyapplicationofbluntforcetobroadareaofthebody,
whichcrushorstretchtissuesbeyondthelimitsoftheirelasticity.
Localizedportionsoftissuearedisplacedbytheimpactoftheblunt

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force,whichsetsuptractionforcesandcausestearingoftissues.
Featuresoflacerationsare:?
i)Hairandhairbulb,nervesandbloodvesselsarecrushedThere
maybeparalysis(nervecrushed)andhemorrhageisnot
pronounced(bloodvesselscrushed).
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ii)Siteofinjuryisthesiteofimpact.
iii)Shapeofinjuryisirregular,marginsareirregularand
contused/abradedandshowtagsoftissue.
iv)Sizeofinjurydoesnotcorrespondstoimpactingsurface.
Therearefollowingtypesoflaceration:?
--- Content provided by⁠ FirstRanker.com ---
1)Splitlaceration:Splittingoccursbycrushingofskinbetween
twohardobjects.Bluntforceonareaswheretheskinisclosetorigid
structureslikebonewithscantysubcutaneoustissue,mayproduce
awoundthatbylinearsplittingoftissuemaylooklikeincisedwound,
i.e.,incisedlikeorincisedlookingwound.Examplesofsucharea

--- Content provided by‌ FirstRanker.com ---

arescalp,eyebrows,cheekbones(zygomatic),lowerjaw,iliac
crest,perineumandskin.Awoundproducedbyafallonkneeor
elbowwithlimbflexedandbyasharpstonealsosimulatesincised
wound.
2)Strechlacerations:Overstretchingoftheskin,ifitisfixed,will

--- Content provided by⁠ FirstRanker.com ---

causelaceration,forexample,bykicking,suddendeformityofbone
occursafterfracture,makingitcompound.
3)Avulsion(shearinglaceration):Anavulsionisalaceration
producedbysufficientforce(shearingforce)deliveredatanacute
angletodetach(tearoff)aportionofatraumatizedsurfaceorviscus

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fromitsattachment,theshearingandgrindingforcebyaweight.
Flayingistypeofavulsioninwhichshearingandgrindingforceby
weight(suchasoflorrywheelpassingoveralimb)mayproduce
avulsion(separationofskinfromunderlyingtissue/deglovingofa
largearea).

--- Content provided by⁠ FirstRanker.com ---

4)ears:Tearsoftheskinandtissuescanoccurfromimactbya
againstirregularorsemi-sharpobjects,suchasdoorhandleofa
car.Thisisanotherformofoverstretching.
5)Cutlaceration:Cutlacerationsmaybeproducedbyaheavy
sharpedgedinstrument.

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612.Incisedlookinglacerationisseeninall,
except
AFMC11;NEET13
a)Iliaccrest
b)Zygomaticbone

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c)Shin
d)Chest
CorrectAnswer-D
Ans.Chest

613.Blackeningofeyemostcommon

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becauseof:
NEET13
a)Frictionabrasion
b)Patternedabrasion
c)Imprintabrasion

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d)Contusion
CorrectAnswer-D
Ans.Contusion

614.Ectopicbruiseismostcommonlyseen
in:
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NEET13
a)Leg
b)Eye
c)Pinna
d)Scalp

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CorrectAnswer-B
Ans.Eye

615.Inacaseofhangingneckligaturemarks
areexampleof
a)Contussion

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b)Printedabrasion
c)Laceration
d)Bruise
CorrectAnswer-B
Bi.e.Printedabrasion

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616.TrueaboutStabWounds?
a)DepthisgreaterthanBreadth
b)Breadthisgreaterthandepth
c)Lengthisgreaterthanbreadth
d)Ithaswoundofentryandexit

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CorrectAnswer-A
Ans.is'a'i.e.,Depthisgreaterthanbreadth[RefReddy30thle
p.179]
Stab/puncturewoundisaninjurycausedbypointedweaponssuch
asdagger,knife,needle,arrow,scissoranditsdepthisthegreatest

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dimension.

617.Marshallstriadisseenin?
a)Explosiveinjury
b)Gunshotinjury
c)Drowninginjury

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Explosiveinjury[Ref
epository.up.ac.za/bitstream/handle/2263/19400/Blumenthal_Does(2012).pdj]
Marshall'striadincludespunctate-bruises,abrasionsandsmall

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punctatelacerationsallofwhicharetypicallyfoundinanexplosive
bombblast.

618.Kennedyphenomenonisseenin:
NEET13
a)Roadtrafficaccident

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b)Gunshotinjury
c)Burns
d)Contusion
CorrectAnswer-B
Ans.Gunshotinjury

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619.Gunshotresidueonhandscanbe
detectedby:
DNB10;NEET13
a)Phenolphthaleintest
b)Dermalnitratetest

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c)Benzidinetest
d)H2activationtest
CorrectAnswer-B
Ans.Dermalnitratetest

620.Shotgundoesnotcontainuse:

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NEET13
a)Barrel
b)Chokebore
c)Bullets
d)Muzzle

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CorrectAnswer-C
Ans.Bullets

621.Dirtcollarorgreasecollarisseen
in:
NEET13

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a)Puncturedwoundbysharpweapon
b)Laceratedwound
c)Firearmentrywound
d)Stabwound
e)None

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CorrectAnswer-C
Ans.Firearmentrywound
Smudgering/Leadring/Greasecollar/Dirtcollar
Thisisduetothewipeofthesoftmetalofthebullet,ordirtpresent
onit,orgreasecarriedfromthebarrel&isdepositedroundthe

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entrancewoundinternaltotheabradedcollar
Thesmudgeringmaythereforebeabsentwhenthejacketedbullet
haspassedthroughclothing
Thesmudgingincaseofleadshotorunjacketedbulletscan
bedetectedmicrochemicallyonthetarget(skin/cloth)

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Theforensicvalueofbulletwipeistoestablishaholeasabullet
hole,todeterminetheentrysite,&onoccasionthesequenceof
shotsorbullet'spassagethroughmultipleobjects.

622.Lafaciessymapthiqueisseenin?
a)Hanging

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b)Strangulation
c)Myocardialinsufficiency
d)Railwayaccident
CorrectAnswer-A
Ans.is'a'i.e.,Hanging[RefReddy30th/ep.526]
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Lafaciessymapthique:eyeonthesideoftheknotinhanging
remainsopen,duetooverstretchingofcervicalsympatheticchainof
theneckonthisside.
Itoccursinhangingduetopressureofligatureknotonthecervical
sympatheticchain.

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623.Burkingincludes:
NEET13
a)Choking
b)Ligature
c)Overlaying

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d)Traumaticasphyxia
CorrectAnswer-D
Ans.Traumaticasphyxia

624.Hyoidbonefracturemostcommon
occursin?

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a)Manualstrangulation
b)Hanging
c)Smothering
d)Traumaticasphyxia
CorrectAnswer-A

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Ans.is'a'i.e.,Manualstrangulation
Asmanualstrangulation(throttling)isamongthemostviolentform
ofasphyxia,hyoidfractureandotherinjurytoneckstructuresis
morecommon.

625.Victimwaschokedwithmouth&nose

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coveredwithelbowaroundneck.Itis
calledas?
a)Mugging
b)Garrotting
c)Bansadola

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d)Noneoftheabove
CorrectAnswer-A
Ans.is'a'i.e.,Mugging[RefReddy30th/ep.321]
Mugging:Strangulationiscausedbyholdingtheneckofthevictimin
thebendoftheelbow.

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Garrotting:Thevictimisattackedfrombehind.Thethroatmaybe
graspedoraligatureisthrownovertheneck&quicklytightened,by
twistingitwithalever,whichresultsinsuddenlossinconsciousness
andcollapse.
Bansdola:onestrongbambooorstickisplacedacrossthebackof

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theneck&anotheracrossthefront.Boththeendsaretiedwitha
ropeduetowhichthevictimissqueezedtodeath

626.Causeofdeathfordrowningincold
water:
NEET13

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a)Vagalinhibition
b)Asphyxia
c)Lossofconsciousness
d)Ventricularfibrillation
CorrectAnswer-A

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Ans.Vagalinhibition

627.Insexualassaultofachild,thehymenis
usuallynotruptureddueto:
NEET13
a)Deepseated

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b)Underdeveloped
c)Tootoughtorupture
d)Distensible
CorrectAnswer-A
Ans.Deepseated

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628.Mostcommonhymenruptureinavirgin
is?
a)Anterior
b)Anterolateral
c)Posterolateral

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d)Posterior
CorrectAnswer-C
Ans.is'c'i.e.,Posterolateral
Hymenrupture:
Congenital:anterior

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Duetointercourseorforeignbody:posterolateral(4/8or5/70'
clock)>posterior(60'clock).
Invirginrupture(tears)ofhymenduetosuddentretchingoccursin
posteriorhalfofmembraneusuallyatthesides(i.e.posterolaterally)
in4or8'Oclockor5or7'Oclockposition,orinthemidlineofhymen

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(6'Oclockposition).
Withfirstintercoursetearsusuallyoccurinposteriormidline
becausethehymenliessuspendedacrossapotentialspacehere,
whereasanteriorlyperiurethraltissuesbuttressthehymen.
Morethan2tearsareunusual,Semilunarhymenoftenruptureson

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bothsides.Annularhymenwhichnearlyclosesupthevaginalorifice
maysufferseveralhymenallacerationsindicatefirstsexual
intercourse.
Onedeep'Vshapedcleft/tearat6'0clockoranumberofclefts
usuallyinposteriorhafthymenmembraneindicatepassageofany

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objectthroughhymeorificewhichislargeritsoriginalopening.'
Inprepubertalchildrenposteriortearmayinvolvefourchette
producingadeepUshapeddefect.Fourchetteistorn,fossa

navicularisdisappearandposteriorcommissuremayberuptured.
Thelatterinjuryusuallydoesnotoccurinconsentingsexual

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intercourseunlessthereismuchdisproportionbetweenthemale
andfemaleparts.

629.Frotteruismis?
a)Sexualpleasureisobtainedbywitnessingtheactofurination
b)Sexualgratificationbyrubbingprivateparts

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c)Sexualpractiseinvolvingthreepeople
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Sexualgratificationbyrubbingprivateparts[Ref
Reddy30thiep.395]
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Frotteurism:iscontactwithanotherpersoninordertoobtainsexual
gratification.Sexualgratificationbyrubbingprivatepartsagainsta
femalebodyincrowd.ItispunishableunderSection290I.P.C.,
withfineuptoRs200.

630.Disputedmaternitycanbesolvedby

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usingthefollowingtests,EXCEPT:
a)Bloodgrouping
b)HLAtyping
c)Preciptintest
d)DNAfingerprinting

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CorrectAnswer-C
Precipitintestisanantigen-antibodyreactiontest,usedto
distinguishbetweenspecies.
Itusesspeciesspecificantiserum.
Itwillnotbeusedfordisputedmaternity.

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Ref:TextbookofMedicalJurisprudence,ForensicMedicineand
ToxicologyByParikh,6thEdition,Pages7-21;TheEssentialsof
ForensicMedicineandToxicologyByKSNarayanReddy,27th
Edition,Pages402

631.Gastriclavageiscontraindicatedin

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whichofthefollowing:
September2010
a)Arsenicpoisoning
b)Kerosenepoisoning
c)OrganophosphorusPoisoning

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d)Dhaturapoisoning
CorrectAnswer-B
Ans.B:KerosenePoisoning
Lavageiscontraindicatedwhenpatientshaveacompromised,
unprotectedairwayandinpatientsatriskofgastrointestinal

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hemorrhageorperforation.
Relativecontraindicationsincludewhenthepoisoningisduetoa
corrosivesubstance,hydrocarbons,orforpoisonsthathavean
effectiveantidote.

632.Whatactsasbothpoison&antidote?

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a)CuSO4
b)HgC12
c)Ar203
d)Thalliumarsenate
CorrectAnswer-A

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Ans.is'a'i.e.,CuSO4[Ref:Reddy30th/ep.500,503]
Coppersulphateactsasapoison&anantidoteforphosphorus
poisoning.
Coppersulphatewheningestedcausesburningpaininstomach
withcolickyabdominalpain,vomiting.Inseverecases,hemolysis,

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hemoglobinuria,methemoglobinemia,jaundice,pancreatitis&
cramps&convulsions.Deathcanoccurduetohepatic&renal
failure.
Itisgiveningastriclavageforphosphorouspoisoningasitcoatsthe
particlesofphosphorouswithafilmofcoppersulphidewhichis

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harmless.

633.Firstaidshouldbegiveninacidcontact
?
a)Washwithnormalwatersoap
b)Washwithmildalkaliagent

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c)Washwithstrongalkali
d)Refertohighercentre
CorrectAnswer-B
Ans.is'b'i.e.,Washwithmildalkaliagent[RefReddy30Thlep.
485]
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Themostcriticalaspectofacidburncareistheconstantand
prolongedwashingoftheareawithwaterataroomtemperatureto
gettheacidoutimmediately.
Totryandminimizethedamage,theeffectsofacidshouldbe
neutralizedbyapplyingamildalkalisolutiontotheaffectedarea

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(solutionofsodiumbicarbonateandwater.

634.Amotivationalsyndromeisseenwith:
Maharashtra10;NEET13
a)Heroin
b)Cannabis

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c)Cocaine
d)Clonidine
CorrectAnswer-B
Ans.Cannabis

635.Cyanideodourisof?

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a)Rottenegg
b)Fish
c)Fruity
d)Bitteralmond
CorrectAnswer-D

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Ans.is'd'i.e.,Bitteralmond[RefReddy30th/ep.578]
Odorsassociatedwithpoisoning
Garliklike:Phosphorus,arsenic,zincphosphide,aluminium
phosphide(celphos),arsinegas,tellurium,parathion,malathion,
arsenic.

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Rotteneggs:Hydrogensulphide,mercaptans,disulphiram.
Fishyormusty:Zincphosphide.
Bitteralmonds:Cyanide,HCN.
Acrid:Paraldehyde,chloralhydrate.
Burntrope:Cannabis.

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Kerosenelike:Keroseneandorganophosphates.
Phenolicsmell:Carbolicacid.

636.Instrychnosnuxvomicapoisoning,
patient:
NEET13

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a)Becomesunconsciousimmediately
b)Becomesunconsciousin1horso
c)Becomesunconsciousatendstage
d)Remainsconsciousthroughout
CorrectAnswer-D

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Ans.Remainsconsciousthroughout

637.Innuxvomicapoisoning,posture
commonlyassumedbythespineis:
NEET13
a)Opisthotonus

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b)Emprosthotonus
c)Pleurosthotonus
d)BandC
CorrectAnswer-A
Ans.Opisthotonus

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638.Phossyjawiscausedby?
a)Whitephosphorus
b)RedPhosphorus
c)Arsenic
d)Antimony

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CorrectAnswer-A
Ans.is'a'i.e.,WhitePhosphorus
Phossyjawiscausedbyphosphoruspoisoning.Allphosphorus
poisoningarecausedbywhite(yellow)phosphorus(Red
phosphorusisnontoxic).

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Phosphoruspoisoning
Phosphorusisaprotoplasmicpoisonaffectingcellularoxidationand
causinganoxicnecorbiosis,classicallyaffectingliver.Itincreasesfat
depositionandinhibitsglycogendepositioninliver.Itisusedinfire
works(Diwalipoisoning)andasratpoison.Lethaldoseis60-120

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mg.
Phosphorusoccursintwoforms:?
1)White/yellowphosphorus:Itiswhite,andbecomesyellowon
exposuretoair.Itistranslucent,waxy,luminousandcrystalline
cylinders.Ithasgarliclikeodor.Itisinsolubleinwaterandluminous

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indark.Itsfumesshowphosphorescence.
2)Redphosphorus:Itisreddishbrown,inert,odourlessand
tasteless.Itisnontoxic(thuspoisoningoccursonlyduetowhite
phosphorus).Itisputonthesides(strikingsurface)ofmatchbox
(alongwithpowderedgalss).

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Acutepoisoning
Ithasfollowingstages:
i)1stStage(GIirritation):Thereisnausea,vomiting,diarrheaand
garlicodor.Thisstagelastsfor8hoursto3days.

garlicodor.Thisstagelastsfor8hoursto3days.

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ii)2ndStage(Asymptomatic):Thisstagelastsfor3days.
iii)3rdStage:Thereisliverandkidneydamageduetoabsorbed
phosphorus.Initiallyliverisenlargedduetoacutefattyinfiltration.
Laterlivershruksduetonecrosis,i.e.acuteyellowatrophy.
Chronicpoisoning
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Toothacheisthefirstsymptomwhichisassociatedwithlooseningof
teeth,necrosisofgumsandosteomyelitisofjaw.Thereforechronic
phosphoruspoisoningisalsoknowasphossyjaw(orglassjaw).
Postmortemappearance
Thereisgarlicodor.Visceraandstoolglowindark(dueto

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luminosity).
Topreserveluminosity,visceraarepreservedinsaturatedsaline
solution.Rectifiedspiritisnotusedasitcauseslossofluminosity.

639.Mutteringdeliriumisseenwith:
NEET13

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a)Ricinus
b)Dhatura
c)Cocaine
d)Aconite
CorrectAnswer-B

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Ans.Dhatura

640.Ethyleneglycolwheningestedaffects
kidneybyforming:
NEET13
a)Formaldehyde

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b)Oxalates
c)Phytates
d)Phosphates
CorrectAnswer-B
Ans.Oxalates

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641.Chronicarsenicpoisoningdoesnot
cause:
NEET13,15
a)Mixedsensoryandmotorneuropathy
b)Mesothelioma

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c)Hyperkeratosisofskin
d)Anemia
CorrectAnswer-B
Ans.Mesothelioma

642.Raindroppigmentationiscausedby?

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a)Clofazimine
b)Dapsone
c)Minocycline
d)Arsenic
CorrectAnswer-D

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Ans.is'd'i.e.,Arsenic

643.Brutonianlinesongumsisseenin
poisoningwith?
a)Lead
b)Mercury

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c)Mercury
d)Zinc
CorrectAnswer-A:B
Ans.is'a>b'i.e.,Lead>Mercury[RefReddy306/ep.497-498]
Burtonianlineisblueline,whichisseenonuppergumsinlead

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poisoning.
Similarblueline(butnotcalledburtonianlineinthesecases)isalso
seeninpoisoningwithMercury(Hg),Copper(Cu),Silver(Ag),
bismuth(Bi),andIron(Fe).

644.Oochronosisisseeninwhichpoisoning

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?
a)Hydrochloricacid
b)Carbolicacid
c)Oxalicacid
d)Formicacid

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CorrectAnswer-B
Ans.is'b'i.e.,Carbolicacid[RefReddy30th/ep.489]
Chroniccarbolicacidpoisoning/phenolmarasmus
Thepoisoningischaracterisedbyanorexia,weightloss,headache,
vertigo,darkurineandpigmentationofskin&sclera.

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Carbolicacid/Phenolisconvertedintohydroquinone&pyrocatechol
inthebodybeforebeingexcretedintheurine.
Hydroquinoneerpyrocatecholmaycausepigmentationinthe
corneaandvariouscartilages-Oochronosis.
Oochronosisiscommonlyassociatedwithalkaptonuria,inwhich

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homegentisicacidgetsdepositedincartilages,ligaments&fibrous
tissues.

645.Opiumisderivedfrom:
NEET13
a)Leaf

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b)Root
c)Poppyseed
d)Unripecapsule
CorrectAnswer-D
Ans.Unripecapsule

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646.Mechanismofcyanidepoisoningisby
inhibiting:
NEET13
a)DNAsynthesis
b)Cytochromeoxidase

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c)Proteinbreakdown
d)Proteinsynthesis
CorrectAnswer-B
Ans.Cytochromeoxidase

647.Meaningoftermvitriolageis:

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a)Usingvitriolforsuicide
b)Usingvitriolformurder
c)Vitriolthrowing
d)PerforationofstomachcausedbyH2SO4
CorrectAnswer-C

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Ci.e.Vitriolthrowing
Vitriolage(Vitriolthrowing)isthrowingofanycorrosive,not
necessarilysulphuricacid(H2SO4)onanotherpersonQ.Eyesare
themostaffectedorgans.

648.Antidoteforstrychninepoisoning

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is:
NEET13
a)Fomepizole
b)Physotigmine
c)Barbiturates

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d)Naloxone
CorrectAnswer-C
Ans.Barbiturates

649.Bariumcarbonatepoisoning
causes:
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NEET13
a)Respiratorydistress
b)Gastrointestinalirritation
c)Muscularweakness
d)Cyanosis

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CorrectAnswer-C
Ans.Muscularweakness

650.Oximesarecontraindicatedinwhich
poisoning:
NEET13

--- Content provided by‌ FirstRanker.com ---

a)Malathion
b)Diazinon
c)Phorate
d)Carbamate
CorrectAnswer-D

--- Content provided by⁠ FirstRanker.com ---

Ans.Carbamate

651.EthyleneGlycolantidoteis?
a)Barbiturates
b)Acetycysteine
c)Ferricchloride

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d)Fomipizole
CorrectAnswer-D
Ans.is'd'i.e.,Fomipizole[RefReddy30th/ep.533]
Antidoteforethyleneglycolpoisoningisfomipizole.

652.Tetanyiscausedbypoisoningwith:

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NEET13
a)Oxalicacid
b)Carbolicacid
c)Sulphuricacid
d)Nitricacid

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CorrectAnswer-A
Ans.Oxalicacid

653.Widmark'sformulahelpsinthe
measurementsofbloodlevelof:
a)Barbiturates

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b)Cocaine
c)Alcohol
d)Benzodiazepines
CorrectAnswer-C
Ci.e.Alcohol

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654.Fatheroftoxicology
is:
NEET13
a)Paracelsus
b)Galen

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c)Galton
d)Orfila
CorrectAnswer-A
Paracelsusiscalledfatheroftoxicology.Mathieuorfilais
thoughtofasfatherofmoderntoxicology

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655.MostcommondrugabuseinIndia?
a)Cannabis
b)Amphetamine
c)Cocaine
d)Heroine

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CorrectAnswer-D
Ans.is'd'i.e.,Heroin
Amongstthegivenoptions,heroinisthemostcommonly
abusedsubstance:
Alcohol43.9%

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Opioids(includingheroin)26%
Cannabis11.6%

656.Blackpapperadultrantis?
a)Khesaridal
b)Driedpapayaseed

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c)Finesand
d)None
CorrectAnswer-B
Ans.is`b'i.e.,Driedpapayaseed

657.Hydrogenperoxideisusedinallofthe

--- Content provided by‍ FirstRanker.com ---

followingchemicaltestsforblood
except:
NEET13
a)Benzidinetest
b)KastleMayertest

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c)Orthotoludinetest
d)Teichmanntest
CorrectAnswer-D
Ans.Teichmanntest

658.Whichsnakebitecauseshematologic

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abnormalities?
a)Cobra
b)Crait
c)Viper
d)Seasnake

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CorrectAnswer-C
Ans.is'c'i.e.,Viper[RefParikh&Yep.9.44]
Hematotoxic Vipers
Myotoxic
Seasnakes

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Neurotoxic
Elapids-cobra,Krait,coral

659.Whichofthefollowingshouldnotbe
donewhiledealingwithapatientof
snakebite?

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a)Tightbandapplied
b)Reassuarance
c)Localincision
d)Cleanwithsoapandwater
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Ans.is'c'i.e.,Localincision
Treatmentofsnakebite
Reassuranceshouldbegiventopatient.
Applicationofpressureoverbittenareawhichdelaysabsorptionof
venom.

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Tieabroadfirmbandage(tourniquet)proximaltothebittenareaand
aroundthelimbwhichwouldoccludevenousandlymphatic
drainagebutnotarterialordeepvenousflow.
Limbimmobilization.
Localincisionandsuctionshouldnotbedoneasitcancauselocal

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injuryandnervedamage.
Cleanthewoundwithsoapandwateroriodineandcoverwith
steriledressing.
Polyvalentsnakeantivenomisgiven.Howeveritisgivenonlyin
followingsituations:

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i. Rapidlyprogressiveandseverelocalfindings.
ii. Therearemanifestationsofsystemictoxicity.

660.DNAfingerprintingcannotbetakenfrom
?
a)Saliva

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b)Tooth
c)Buccalmucosa
d)Blood
CorrectAnswer-B
Ans.is'b'i.e.,Tooth[RefParikh6thlep.7.2-7.15]
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DNAfinger-printing/DNAprofiling
Isatechniqueemployedbyforensicscientiststoassistinthe
identificationofindividualsbytheirrespectiveDNAprofile
itisafoolproofmethodtoconclusivelyfixthepaternity/maternity.
Themostdesirablemethodofcollectingareferencesampleisthe

--- Content provided by FirstRanker.com ---

useofabuccalswab.Whenthisisnotavailable(e.g.
becauseacourtordermaybeneededandnotobtainable)other
methodsmayneedtobeusedtocollectasampleofblood,
saliva,semen,orotherappropriatefluidortissuefrompersonal
items(e.g.toothbrush,razor,etc.)orfromstored

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samples(e.g.bankedspermorbiopsytissue)

661.Notagrievousinjury:
September2005
a)Multiplescarsofface
b)Fractureoffemur

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c)Emasculation
d)Contusionofbreast
CorrectAnswer-D
Ans.D:Contusionofbreast
Sec320IPC:anyofthefollowinginjuresaregrievous?
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Emasculation
Permanentprivationofsightoreithereye
PermanentprivationofHearingoreitherear
Permanentprivationofanymemberorjoint
Permanentdisfigurationoftheheadorface

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Destructionorpermanentimpairingofthepowerofanymemberor
joint
Fractureordislocationofaboneortooth
Anyhurtswhichendangerslife,orwhichcausesthevictimtobein
severebodilypainorunabletofollowhisordinarypursuitsfora

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periodoftwentydays

662.Lendrumstainisdonefor?
a)Airembolism
b)Fatembolism
c)Amnioticfluidembolism

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d)None
CorrectAnswer-C
Ans.is'c'i.e.,Amnioticfluidembolism[RefHandbookof
autopsypractise3rdlep.283]
Amnioticfluidembolismdiagnosis
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SectionsoflungsandotherorgansarestainedusingPhloxine-
Tartrazine(Lendrumstaining)todetectsquames,
AlcianBluetodetectmucin.
SudanBlackorOilRedtodetectvernixcaseosa.

663.Malarialparasitewasdiscoveredby-

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a)Ronaldross
b)Paulmuller
c)Laveran
d)Pampania
CorrectAnswer-C

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Ans.is'c'i.e.,Laveran
.Thespecificcausativeagentofmalariawasdiscoveredinthered
bloodcellsofapatientin1880byAlophonseLaveran,aFrench
armysurgeoninAlgeria.
Remember

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.Romanowskydevelopedamethodofstainingmalaria
parasitesinbloodfilms.

664.Whichofthefollowingisaprotista-
a)Algae
b)Fungi

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c)Protozoa
d)Bacteria
CorrectAnswer-C
Ans.is'c'i.e.,Protozoa

665.Katayamafeveriscausedby-

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a)F.hepatica
b)C.sinensis
c)S.haematobium
d)A.lumbricoides
CorrectAnswer-C

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Ans.is'c'i.e.,S.haematobium
Katayamafever(AcuteSchistosomiasis)occursinaboutamonth
afterinfecionwithS.japonicumandS.mansoniandrarelywithS.
haematobium.

666.

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Whichpartofbacteriaismostantigenic?
a)Proteincoat
b)Lipopolysaccharide
c)Nucleicacid
d)Lipids

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CorrectAnswer-A
Ans.isdi.e.,Lipids
Proteinsaremostimmunogenic,whilelipids&nucleicacidsare
leastimmunogenic.
Polysaccharides(carbohydrates)arelessimmunogenicthanprotein

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antigens,butaremoreantigenicthanlipids&nucleicacids.

667.Thecorrectorderofgramstainingis
a)GentianvioletIodineCarbolfuchsin
b)IodineGentianvioletCarbolfuchsin
c)CarbolfuchsinIodineGentianviolet

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d)CarbolfuchsinGentianvioletIodine
CorrectAnswer-A
Answer-A-GentianvioletIodineCarbolfuchsin
1. Applicationoftheprimarystain(crystalviolet).Gentianvioletalso
knownascrystalvioletstainsallcellsblue/purple

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2. Applicationofmordant:Theiodinesolution(mordant)isaddedto
formacrystalviolet-iodine(CV-I)complex;allcellscontinueto
appearblue.
3. Decolourizationstep:Thedecolourizationstepdistinguishesgram-
positivefromgram-negativecells.Theorganicsolventsuchas

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acetoneorethanolextractsthebluedyecomplexfromthelipid-rich,
thin-walledgram-negativebacteriatoagreaterdegreethanfromthe
lipid-poor,thick-walled,gram-positivebacteria.Thegram-negative
bacteriaappearcolourlessandgram-positivebacteriaremainblue.
4. Applicationofcounterstain(safranin):Thereddyesafraninstains

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thedecolourizedgram-negativecellsred/pink;thegram-positive
bacteriaremainblue.
NOTEIfyouarestrugglingtorememberthestainingreagents
usedinthisprocedureandtheirorderyoucanrememberthis
sentence"ComeInAndStain"i.e.theorderisCrystalviolet,Iodine,

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Alcohol/AcetoneandthefinaloneisSafranin.

668.Flagellanottrue-
a)Locomotion
b)Attachment
c)Proteininnature

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d)Antigenic
CorrectAnswer-B
Ans.is'b'i.e.,Attachment

669.Innutrientagarconcentrationofagaris-
a)1%

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b)1.5%
c)3%
d)4%
CorrectAnswer-B
Ans.is'b'i.e.,1.5%

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NutrientAgarisageneral-purpose,nutrientmediumusedforthe
cultivationofmicrobessupportingthegrowthofawiderangeofnon-
fastidiousorganisms.Nutrientagarispopularbecauseitcangrowa
varietyoftypesofbacteriaandfungi,andcontainsmanynutrients
neededforthebacterialgrowth.

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Nutrientagarismadebyadding1.5%agartothenutrientbroth.
0.5%Peptone
0.3%beefextract/yeastextract.
0.5%NaCl
Distilledwater

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pHisadjustedtoneutral(7.4)at25?C.

670.Enrichmentmediaforcholera?
a)VRmedium
b)TCBSmedium
c)Cary-Blairmedium

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d)Alkalinepeptonewater
CorrectAnswer-D
Ans.is'd'i.e.,Alkalinepeptonewater

671.Bloodagarisanexampleof?
a)Enrichedmedia

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b)Indicatormedia
c)Enrichmentmedia
d)Selectivemedia
CorrectAnswer-A
Ans.is'a'i.e.,Enrichedmedia

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672.Indonovanosis-
a)Pseudolymphadenopathy
b)Penicillinisusedfortreatment
c)Painfululcer
d)Suppurativelymphadenopathy

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CorrectAnswer-A
Ans.is`a'i.e.,Pseudolymphadenopathy
Donovanosis
CausedbyCalymmatobacteriumgranulomatis.
C.granulomatisis?
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Gramnegative
Encapsulated
Nonmotile
Intracellular
Itsharesmanymorphologicandserologiccharacteristic(antigenic)

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and>99%homologyatthenucleotidelevelwithKlebsiella.
Clinicalmanifestations
IP1-4weeks
Beginsasoneormoresubcutaneousnodulesthaterodethrough
skintoproduceclean,granulomatous,sharplydefined,usually

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painlesslesions.
Thegenitaliaareinvolvedin90%ofcases.
Genitalswelling,particularlyoflabia,iscommon.
Indonovanosis,heaped-upgranulomatoustissuemayfollowandvia
subcutaneousextensiontoinguinalareamayform"pseudo-

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buboes";however,theabsenceoftruelymphadenopathyisthe
hallmarkofthisinfection.
ComplicationsPseudoelephantiasis,phimosisandparaphimosis.

Diagnosis:
Thepreferreddiagnosticmethodinvolvesdemonstrationoftypical

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intracellularDonovanbodieswithinlargemononuclearcells
visualizedinsmearspreparedfromlesionsorbiopsyspecimens.
Stainusediswright-Giemsa
Treatment:
Azithromycin(DOC)

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Doxycycline(2'dchoice)
Chloramphenicol

673.Necrotizingfascitisiscausedby-
a)Staphylococcusaureus
b)Betahemolyticstreptococci

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c)Clostridiumperfringens
d)Pneumococcus
CorrectAnswer-B
Ans.is'b'i.e.,Betahemolyticstreptococci
Thespectrumofinfectionsofthedeepsofttissuesrangesfrom

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localizedbacterial,viralandparasiticlesionstorapidlyspreading,
tissuedestructiveinfectionssuchasnecrotizingfascitisand
myonecrosis.
A)Pyomyositis:-Itiscommonintropics,thereforealsocalled
tropicalpyomyositis.Itisalocalizedinfectionofskeletalmuscles.It

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iscausedmostcommonlybystaphylococcusaureus.
B)NecrotizingfascitisNecrotizingfascitisisaninfectionofthe
deeperlayersofskinandsubcutaneoustissues,easilyspreading
acrossthefascialplanewithinthesubcutaneoustissues.Thereare
twotypesofnecrotizingfascitis:?
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i)Type1:-Itisapolymicrobialinfection,i.e.mixedaerobicand
anaerobicinfection.Itoccursmostcommonlyaftersurgical
proceduresindiabeticpatientsorinthosewhohaveperipheral
vasculardisease.
ii)Type2:-Itiscausedmostcommonlybystreptococcus
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pyogenes(GroupAbetahemolyticstreptococci).
C)Clostridialmyonecrosis(Gasgangrene):-Itischaracterizedby
rapidandextensivenecrosisofmuscleaccompaniedbygas
formationandsystemictoxicity.ItiscausedbyC.perfringens(most
common),C.novyi,C.septicumandC.histolyticum.Itisalsocalled

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typeIIInecrotizingfascitis.

674.Staphaureuscauses-
a)Erythrasma
b)Chancroid
c)Acnevulgaris

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d)Bullousimpetigo
CorrectAnswer-D
Ans.is'd'i.e.,Bullousimpetigo
Impetigoisdividedintotwotypes:?
i)Non-bullousimpetigo(Impetigocontagiosum):-Causedby

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staphylococcusaureusandstreptococcuspyogenes.
ii)Bullousimpetigo:-Causedbystaphylococcusaureus.

675.TRUEaboutmycoplasmais-
a)Causeslunginfection
b)Penicillinisdrugofchoice

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c)Thickcellwall
d)Thalliumacetateinhibitsthegrowth
CorrectAnswer-A
Ans.is'a'i.e.,Causeslunginfection
Mycoplasmainfections

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.Mycoplasmapneumoniaecausesinfectionofupperandlower
respiratorytract.
.Highestattackratesin5-20yearsold.
.Children<5yrsUpperrespiratorysymptoms
.Children>5yrs--0.Bronchitisandpneumonia

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.disease.Aboutotheroptions
.Penicillinisnotactiveagainstmycoplasmas.
.Mycoplasmaslackcellwall.
Mycoplasmasareresistanttothalliumacetateinaconcentrationof
1:10000

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676.Achildcomewithfever,cold,cough,
membraneovertonsils;nasalswabis
taken,cultureshouldbedoneonwhich
mediumforearliestdiagnosis?
a)Loffelersserumslop

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b)L.J.media
c)MCConkey'sAgar
d)Citratemedia
CorrectAnswer-A
Ans.is'a'i.e.,Loffelersserumslop[Ref:Ananthanarayanelep.
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233]
Fever,cold,coughwithmembraneontonsilssuggestthediagnosis
ofdiphthesia.
ForrapidgrowththespecimenisinoculatedonLoeffer'sserumslop.
DiphtheriabacilligrowonLoeffler'sserumslopeveryrapidlyand

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coloniescanbeseenin6-8hours,longbeforeotherbacteriagrow

677.Botulismismostcommonlydueto-
a)Egg
b)Milk
c)Meat

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d)Pulses
CorrectAnswer-C
Ans.is'c'i.e.,Meat
Followingnewtypesofbotulismhavebeenaddedin18th/eof
Harrison

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.Adultintestinaltoxemiabotulism:-resultsfromabsorptionof
toxinproducedinsituafterrarelyoccuringintestinalcolonizationwith
toxigenicclostridia.
.Iatrogenicbotulism:-resultsfrominjectionofbotulismtoxin.

678.Trueaboutchlamydiaareallexcept:

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a)Obligateintracellularorganism
b)Grampositive
c)Reticulatebodyismetabolicallyactive
d)Replicatebybinaryfission
CorrectAnswer-B

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Ans.is.'b'i.e.,Grampositive

679.Whichgroupofstreptococcusgrowat>
60?C
a)A
b)B

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c)C
d)D
CorrectAnswer-D
Ans.is'd'i.e.,D
Amongstreptococci,enterococcus(groupDstreptococcus)isheat

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resistant.

680.Pigmentproducingatypical
mycobacteria?
a)M.fortutionandM.chelonae
b)M.xenopiandMAC

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c)M.gordonaeandM.szulgai
d)M.ulcerans
CorrectAnswer-C
Ans.is'c'i.e.,M.gordonaeandM.szulgai
Non-tubercularmycobacteria(alsocalledatypicalmycobacteria)

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havebeenclassifiedintofourgroupsbyRunyonbasedonpigment
productionandrateofgrowth.
1)GroupI(photochromogens):-Theseproducepigmented
colonies(yellow-orange)onlywhenexposedtolight,butnotindark.
ExamplesofphotochromogensareM.asiaticum,M.kansasii,M.
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marinum,andM.simiae.
2)GroupII(scotochromogens):-Thesealwaysproduce
pigmentedcolonies(yellow-orange-red),i.e.indarkaswellasin
light.ScotochromogensareM.flovescens,M.gordonae,M.
scrofulaceumandM.szulgi.
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3)GroupHI(Nonchromogens):-Thesedonotproducepigment.
NonchromogensareM.aviumcomplex(MAC),M.haemophilum,M.
gastri,M.ulcerans,M.xenopiandM.nonchromogenicum.
4)GroupIV(rapidgrowers):-Thisisheterogeneousgroupof
mycobacteriacapableofrapidgrowth,coloniesappearingwithin7

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daysofincubation.Withinthegroup,photochromogenic,
scotochromogenicandnonchromogenicspeciesoccur.
Chromogenic(pigmentproducing)rapidgrowersaremostly
saprophytic,e.g.M.phleiandM.smegmetis.M.fortuitumandM.

cheloneidonotproduceanypigment.OtherrapidgrowersareM.
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abscessus,M.vaccae,M.genevense,M.confluentis,andM.
intermedium.

681.Sevensheathedflagellaisseenin-
a)Vcholera
b)Hpylori

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c)Psaeroginosa
d)Spirochetes
CorrectAnswer-B
Ans.is'b'i.e.,H.pyroli
H.pylorihasfivetosevensheathedpolarflagella.

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VibriocholeraeandPseudomonasaeruginosahavesinglepolar
flagellum.Occasionalstrainsofpseudomonasmaycontain2or3
flagella.
Spirochetes(Treponema)ismotilebyendoflagella.

682.TrueaboutHinfluenza-

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a)Grownonsheepbloodagar&CO2
b)itisnotcapsulated
c)Invasivestrainismostcommon
d)Grampositive
CorrectAnswer-C

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Ans.is'c'i.e.,Invasivestrainismostcommon
Invasivediseaseismorecommonthannon-invasivedisease.
H.influenzaedoesnotgrowonbloodagar.
Itisgramnegativeandcapsulated.

683.Meningococcidifferfromgonococciin

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thatthey?
a)Areintra-cellular
b)Possessacapsule
c)Causefermentationofglucose
d)Areoxidasepositive

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CorrectAnswer-B
Ans.is'b'i.e.,Possessacapsule

684.Choleratoxinisdueto-
a)Chromosome
b)Plasmid

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c)Phage
d)Transposons
CorrectAnswer-C
Ans.is'c'i.e.,Phage
.Choleratoxinproductionisdeterminedbyafilamentousphage
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integratedwithbacterialchromosome.

685.Whichofthefollowingisthemechanism
ofactionoftetanospasmin?
a)InhibitionofreleaseofGABAandglycine
b)InhibitionofAchreleasefromsynapse

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c)Inhibitionofproteinsynthesis
d)Activationofadenylylcyclase
CorrectAnswer-A
Ans.is'a'i.e.,InhibitionofreleaseofGABAandglycine
Pathogenicity
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CLtetanihaslittleinvasivepropertyandisconfinedtotheprimary
siteoflodgment.Tetanusresultsfromtheactionofthepotent
exotoxinitproduces.

686.Virulenceofgonococciisdueto-
a)Pili

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b)Endotoxin
c)Exotoxin
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Pili

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.Majorvirulencefactorforgonococciispill
(fimbriae).

687.Tabesdorsalisisseenin-
a)Primarysyphilis
b)Secondarysyphilis

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c)Tertiarysyphilis
d)Latentsyphilis
CorrectAnswer-C
Ans.is'c'i.e.,Tertiarysyphilis

688.Meningitiswithrashisseenin-

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a)Neisseriameningitidis
b)H.influenzae
c)Strepto.agalactae
d)Pneumococcus
CorrectAnswer-A

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Ans.is'a'i.e.,Neisseriameningitidis

689.Ehrlichiachaffeensisiscausativeagents
of
a)HME
b)HGE

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c)Glandularfever
d)None
CorrectAnswer-A
Ans.a.HME

690.Invasiveinfectionscausedbyallexcept

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?
a)Shigella
b)Salmonella
c)V.cholerae
d)Yersinia

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CorrectAnswer-C
Ans.is'c'i.e.,V.cholerae[RefHarrisontelep.1084]

691.AchildwithfeverwithABCs&pusin
stools,causativeorganismis?
a)ETEC

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b)EHEC
c)EPEC
d)EAEC
CorrectAnswer-B
Ans.is'b'i.e.,EHEC[RefHarrison18thlep.1084]
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FeverwithRBCandpusinstoolssuggestinflammatorydiarrhea.
AmongstthegivenoptionsEHECcausesinvasion.

692.WhatisNOTtrueaboutyersiniosis-
a)Gram-negativebacillus
b)CausedbyYpestis

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c)Byyersiniaenterocolitica
d)Byyersiniapseudotuberculosis
CorrectAnswer-B
Ans.is'b'i.e.,Causedbyyersiniapestis
Yersiniosisisaninfectiousdiseasecausedbyabacteriumofthe

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genusYersinia.
YersiniaenterocoliticaisaGram-negativebacillus-
shapedbacterium,belongingtothefamilyYersiniaceae.It
ismotileattemperaturesof22?29?C(72-84?F),butbecomes
nonmotileatnormalhumanbodytemperature.[1][2]Y.
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enterocoliticainfectioncausesthediseaseyersiniosis,whichis
ananimal-bornediseaseoccurringinhumans,aswellasinawide
arrayofanimalssuchascattle,deer,pigs,andbirds.
Infectioncausedbyyersiniagenusaredividedinto:-
i)Plague:-Itisadeadlyinfectiousdiseasecausedbyyersinia
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pestis.
ii)Yersinosis:-Itischaracterizedbyinfectiousdiarrhea,
enteritis,ileitisandoccasionallysepticemia.Itiscausedbyyersinia
enterocolitica(mostcommon)andyersiniapseudotuberculosis.

693.AllaretrueaboutB.Quintanaexcept-

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a)Causestrenchfever
b)Notdetectedbyweilfelixreaction
c)Recurrenceiscommon
d)Tickisthevector
CorrectAnswer-D

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Ans.is'd'i.e.,Tickisthevector
Trenchfever
Trenchfever,alsocalled5-dayfeverorquintanfever,iscausedby
Bartonellaquintana(Rochalimaeaquintana).
Thehumanbodylouce(Pediculushumanscorporis)isthevector
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andhumansistheonlyknownreservoir.Clinicalmanifestations
Theincubationperiodis15-25days(range,3-38days).
'Classical'trenchfeverpresentsasfebrileillness.Feveris
exceedinglyvariable,butcommonlylastsforabout5days.Thefever
isfollowedbyaremissionandarecurrenceafter5days.These
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recurrencesmaybesingleormultipleandupto12recurrences
every5-6daysarenotuncommon.
Othersymptomsandsignsincludeheadache,backandlimbpain,
profusesweating,shivering,myalgia,arthralgia,splenomegaly,a
maculopapularrashinoccasionalcases,andnuchalrigidityinsome

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cases.
Diagnosis
DefinitivediagnosisrequiresisolationofB.quintanabyblood
culture.
Weil-Felixtestusedfordiagnosisofricketssialinfectionisnegative
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intrenchfever.
Treatment

Itistreatedwithgentamycinalongwithdoxycycline.

694.Painlessgenitalulcerinmalewith
evertedmarginisseenin?

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a)Syphilis
b)Chancroid
c)Herpes
d)LGV
CorrectAnswer-A

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Ans.is'a'i.e.,Syphilis[RefHarrison18th/ep.1382,Jawetz
22"/ep.642]
Painlessinduratedulcerwithevertedmargins,h/oofsexual
exposureandlackofsystemicsymptomsfavoursthediagnosisof
syphilis.

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695.Leptospirosisistransmittedby:
a)Rat
b)Cat
c)Dog
d)Fish

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CorrectAnswer-A
Ans.is.'a'i.e.,Rat

696.Fishtankgranulomaisseenin-
a)Mfortuitum
b)Mkansasi

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c)Mmarinum
d)Mleprosy
CorrectAnswer-C
Ans.is'c'i.e.,M.Marinum
'Fishtankgranuloma',alsocalledswimmingpoolgranuloma',is

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causedbyM.marinum.

697.Actinomycosisissensitiveto?
a)Streptomycin
b)Nystatin
c)PenciIlin

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d)Iodox-uridine
CorrectAnswer-C
Ans.is'c'i.e.,Pencillin

698.Allcausefourniergangreneexcept-
a)Staphylococcus

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b)Streptococcus
c)Clostridium
d)Bacteroides
CorrectAnswer-C
Ans.is'c'i.e.,Clostridium

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Fournier'sgangreneisanecrotisingfascitisofgenitalia,usually
affectingthescrotumandpenis.
Therehavebeenmanytypesofbacteriologicalcultureencountered
inFournier'sgangrene,bothsinglestrainandpolymicrobialculture.
Majorityofcasesareduetomixedinfectioncausedbybothaerobic

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andanaerobicbacteria.
Followingarecommoncausativeorganisms:Staphylococcus
aureus,streptococcuspyogenes((3-hemolyticstreptococci),
enterobacteriaceae(E.coli,klebsiella,proteus),enterococci,
pseudomonas,andanaerobeslikebacteroidesand

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peptostreptococcus.

699.Reactivetuberculararthritis:
a)Spinaventusa
b)Pott'sdisease
c)Poncet'sdisease

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d)None
CorrectAnswer-C
Ans.is.'c'i.e.Poncet'sdisease

700.Schistosomiasisistransmittedby?
a)Cyclops

--- Content provided by FirstRanker.com ---

b)Fish
c)Snaile
d)Cattle
CorrectAnswer-C
Ans.is'c'i.e.,Snails

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Intermediatehostforschistosomasp.issnail.

701.Trueabouttrematodes
a)Twohostrequired
b)Segmented
c)Anuspresent

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d)Bodycavitypresent
CorrectAnswer-A
Ans.is'a'i.e.,Twohostrequired
Medicallyimportantmemberoftheclasstrematodabelongto
subclassDigenea,astheyaredigenetic,i.e.requiretwohosts.The

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definitivehostinwhichtheypassthesexualoradultstageare
mammals,humansoranimals,andtheintermediatehostsinwhich
theypasstheirasexualorlarvalstagesarefreshwatermolluscsor
snails.
Trematodesareunsegmented,andhavenoanusandbodycavity.

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702.
Whichorganismcanbeisolatedfrom
stool&sputum-
a)Paragnomus
b)Fasciola

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c)Chlornchis
d)P.carini
CorrectAnswer-A
Ans.is'a'i.e.,Paragnomus[RefRajeshkaryakartep.212]
Twoorganismcanbeisolatedfrombothsputumandstool:-

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1. TrophozoiteofE.histolytica
2. EggsofParagonimus

703.Trueaboutdiphyllobothrium:
a)Manissinglehost
b)Irondeficiencyanemiaisseen

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c)Operculatedeggisdiagnostic
d)Fishisthedefinitivehost
CorrectAnswer-C
Ans.c.Operculatedeggisdiagnostic

704.Cercariaeareinfectiveformof-

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a)S.hematobium
b)P.westermanii
c)F.hepatica
d)T.solium
CorrectAnswer-A

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Ans.is'a'i.e.,S.hematobium
CercariaofSchistosomahematobiumistheinfectiveform.

705.Unsegmentedeggsareinwhich
parasite?
a)Trichuristrichura

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b)Ancylostoma
c)Necatoramericanus
d)Dracunculus
CorrectAnswer-A
Ans.a.Trichuristrichura

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706.Inmalaria,sexualcycleis-
a)Sporozoitetogametocytes
b)GametocytestoSporozoite
c)Occursinhuman
d)Responsibleforrelapse

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CorrectAnswer-B
Ans.is'b'i.e.,Gametocytestosporozoite
LIFECYCLEOFPLASMODIUM
Plasmodiumpassesitslifecycleintwodifferenthosts?
1. Human(intermediatehost)

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2. Femaleanaphelinemosquito(Definitivehost)
Humancycle
.Humancyclestartswiththeintroductionofsporozoitesbythe
biteofaninfectedanaphelinemosquito.
.Itcomprisesthefollowingstages.

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1)Pre-erythrocyticschizogony
-Occursinsidetheparenchymacellsoftheliver.
-Duringthisphasetheparasitesarenotfoundinthe
peripheralblood(bloodissterile).
-Thelibratedmerozoitesarecalledcryptozoites.
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-MicromerozoitesenterthecirculationandstartErythrocytic
schizogony,whilemacromerozoitesre-enterthelivercellsandstart
exoerythrocyticycle(exoerythrocyticcycledoesnotoccurinP
falciparum).
-Durationofpre-erythrocyticschizogony

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P.vivax-->8daysP.malariae--f
15days
P.falciparum-->6daysP.ovale--

>9days
2)Erythrocyticschizogony

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-ParasiteresidesinsidetheRBCs.
-Passesthroughthestagesoftrophozoite,Schizontandmerozoite.
-Theparasiticmultiplicationduringtheerythrocyticphaseis
responsibleforbringingonaclinicalattackofmalaria.
-Duration

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P.vivax,P.ovale,P.falciparum-->48hrs
P.malariae-->72hours
3)Gametogony
Aftererythrocyticschizogony,someofthemerozoitesdevelopinto
gametocytes.

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Theindividualwhoharboursthegametocytesisknownasacarrier.
4)Exoerythrocyticschizogony
Someofmerozoites,afterpre-erythrocyticschizogony,reinfectliver
parenchymacellstostartexoerythrocyticschizogony.
Merozoitesliberatedfromexo-erythrocyticschizogonyarecalled

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phanerozoites.
ItisabsentinP.falciparum.
Itisresponsiblefortherelapse.
Mosquitocycle
SexualcycleoccursinfemaleAnopheles.

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Gametocytesaretransferredtotheinsect.
Gametocytesdevelopintosporozoitesaftercompletesexualcycle.
Sporozoitesareinfectivetoman.

707.Whichtypeofmalariaisassociatedwith
renalfailure-

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a)Falciparum
b)Vivax
c)Malariae
d)Ovale
CorrectAnswer-A

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Ans.is'a'i.e.,Falciparum
Nephroticsyndrome-->quartamalaria(P.malariae)
Acutetubularnecrosis(renalfailure)malignanttertianmalariaor
perniciousmalaria(causedbyPfalciparum).

708.Malariacausingnephroticsyndrome-

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a)P.vivax
b)P.falciparum
c)P.malariae
d)P.ovale
CorrectAnswer-C

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Ans.is'c'i.e.,P-malariae
NephroticsyndromeisseeninQuartanmalarialnephropathy,
causedbyrepeatedorchronicinfectionwithP.malariae.

709.Hangingdropmethodisusedfor-
a)T.trichomonas

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b)Plasmodium
c)Toxoplasma
d)Cryptosporidium
CorrectAnswer-A
Ans.is'a'i.e.,T.trichomonas

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Hangingdropmethodisusedforexaminingmotilityofmicro-
organisms.
Motilityoftrichomonasvaginalismayalsobeobservedbythis
method.

710.Rhaditiformlarvaeisseenin?

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a)Teniasolium
b)Strongyloides
c)D.latum
d)Trichenella
CorrectAnswer-B

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Ans.is`b'i.e.,Strongyloides[RefPanikar6th/ep.171]
Rhabditiformlarvaisthefirststagefeedinglarvafoundinsome
nematodes.Itisnon-infective.
Filiformlarvaisthenonfeedinginfectivelarvainsomenematodes.
Rhabditiformlarvaandfiliformlarvaarefoundinfollowingimportant

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nematodes

711.Wucheriabancrofti,trueis-
a)Unsheathed
b)Tailtipfreefromnuclei
c)Non-periodic

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d)All
CorrectAnswer-B
Ans.is'b'i.e.,Tailtipfreefromnuclei
W.bancroftiissheathedandperiodicwithtailtipfreefromnuclei.

712.Flamecellsareseenin:

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a)Protozoa
b)Cestode
c)Nematodes
d)None
CorrectAnswer-B

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Ans.b.Cestode
Flamecell(alsocalledsolenocyte)istheexcretorycellin
cestodesandtrematodes,thenumberandarrangementofwhichis
usedasabasisforidentification.
Thecellhasatuftofcilia,whosebeatingresemblestheflickeringof

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aflame.
Theflamecellsopenintoacollectingtubule.

713.Whichofthefollowingistoxicto
parasite-
a)Peroxidase

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b)Interferon
c)IL-2
d)IL-6
CorrectAnswer-A
Ans.is'a'i.e.,Peroxidase

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Neutrophilsandmonocytescontainaperoxidase(myeloperoxidase),
thathasbeenimplicatedinantiparasiticactivity.However,
monocyteslosethisenzymewhentheymatureintomacrophages.
Eosinophilsalsocontainperoxidasethatdiffersfrom
myeloperoxidaseofneutrophils.However,likemyeloperoxidase,

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eosinophilperoxidasecombineswithH20,andahalidetoforman
antiparasitesystem.
ParasiteEggsize
1)Fasciolagigantica190X100m
2)Echinostomailiocanum100X70m

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3)Gastrodiscoideshominis150X70-100m
4)Opisthorcisviverni<30X15m

714.Toxoplasmainchildrencauses:
a)Chorioretinitis
b)Conjunctivities

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c)Keratitis
d)Papillitis
CorrectAnswer-A
Ans.a.Chorioretinitis

715.Whichofthefollowingisonlyyeast?

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a)Candida
b)Mucor
c)Rhizopus
d)Cryptococcus
CorrectAnswer-D

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Ans.isdi.e.,Cryptococcus

716.Regardingfungalcellwallallaretrue
except:
a)Containschitin
b)Preventosmoticdamage

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c)Azolesactonthem
d)Doesnotcontainpeptidoglycan
CorrectAnswer-C
Ans.c.Azolesactonthem

717.RenauldBraudphenomenonisseenis:

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a)Candidaalbicans
b)Candidapscitasi
c)Histoplasma
d)Cryptococcus
CorrectAnswer-A

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Ans.a.Candidaalbicans

718.Largestintestinalprotozoais?
a)E.coli
b)Balantidiumcoli
c)Giardia

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d)T.gondii
CorrectAnswer-B
Ans.is'b'i.e.,Balantidiumcoli[RefPanikerp.111]
Largestprotozoa
Balantidumcoli

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Smallestintestinalamoeba Dientamoebafragilis
Smallesttapewormfoundin
H.nana
humanintestine
Largesthelminth(largest

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T.saginata(beeftapeworm)
worm)
Largestliverfluke F.hepatica
Largesttrematodeinfectingman Fasciolopsisbuski
LargestNematode

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Ascaris
SmallestNematode-
Trichinella
Onlyprotozoanparasitefoundin
Giardialamblia

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smallintestineofman
Onlyciliateprotozoanparasiteof
Balantidumcoli
man-
Parthenogenicworm(femaleis

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Strongyloidesstercoralis.
abletoproducefertile
eggsorlarvaewithoutfertilization)

719.Trichophytonspecieswhichiszoophilic
?

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a)T.tonsurans
b)T.violaceum
c)T.schoenleinii
d)T.mentagrophytes
CorrectAnswer-D

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Ans.is'd'i.e.T.mentagrophytes
Zoophilicdermatophytesarethespecieswhichprimarilyinfect
animalsandoccasionallytransmittedtohumans.
ZoophilicspeciesoftrichophytonareT.montegrophytesandT
verrucosum.
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OtherzoophilicspeciesofdermatophytesisM.canis.

720.Aseptatehyphaeisnotseenin-
a)Rhizopus
b)Mucor
c)Aspergillus

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d)None
CorrectAnswer-C
Ans.is'c'i.e.,Aspergillus
Non-septate(aseptate)hyphae-->Rhizopus,mucor.
Septatehyphae-->Aspergillus.

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721.Whichofthefollowingisprimarycellline
?
a)Chickembryofibroblast
b)Helacells
c)Verocells

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d)WI-38
CorrectAnswer-A
Ans.is'a'i.e.,Chickembryofibroblast
Chickembryofibroblastisprimarycellculture.

722.Virusquantificationisdoneby-

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a)Egginoculation
b)Hemadsorption
c)Plaqueassay
d)Electronmicroscopy
CorrectAnswer-C

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Ans.is'c'i.e.,Plaqueassay
PlaqueassayandPockassayarequantitativeinfectiveassays.

723.Whichisenvelopedvirus-
a)Denguevirus
b)Norwalkvirus

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c)HepAvirus
d)Adenovirus
CorrectAnswer-A
Ans.is'a'i.e.,Denguevirus
Denguevirus(amemberofflavivirodae)isanenvelopedvirus.

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Adenovirus,norwalkvirus(calciviridae)andhepatitisAvirus
(Picornaviridae)arenon-envelopedviruses.

724.Coxsackievirusis-
a)Harpesvirus
b)Poxvirus

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c)Enterovirus
d)Myxovirus
CorrectAnswer-C
Ans.is'c'i.e.,Enterovirus

725.Serologicaltestingofpatientshows

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HBsAg,IgManti-HBcandHBeAg
postive.Thepatienthase-
a)ChronichepatitisBwithlowinfectivity
b)AcutehepatitisBwithhighinfectivity
c)Chronichepatitiswithhighinfectivity

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d)Acuteonchronichepatitis
CorrectAnswer-B
Ans.is`b'i.e.,AcutehepatitisBwithhighinfectivity

726.Congenitalvaricellainfectioncausesall
except:

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a)Macrocephaly
b)Limbhypoplasia
c)Corticalatrophy
d)Cicatrix
CorrectAnswer-A

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Ans.a.Macrocephaly

727.Diagnosisofrotavirusisby:
a)Stoolantigen
b)Stoolantibody
c)Stoolculture

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d)Bloodantibody
CorrectAnswer-A
Ans.is'a'i.e.,Stoolantigen[Ref:Hanison18n/ep.1591,
1592;Greenwood1&/ep.5251
InRotavirusdiarrhoea,largeno.ofvirusesareshedinfaeces(atthe

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peakofthedisease,asmanyasl0rrvirusparticlescanbedetected
permloffeces).Thesevirusescanbeeasilydetectedby
thefollowingmethods:
i)Enzymeimmunoassay(ELISA)
Itoffersapproximately90%specificity&sensitivityfordetection

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ofvirusinstools.
ii)Latexagglutination
iii)Immuneelectronmicroscopy
-->Viralsheddingdetectablebythesemethodsusually
subsideswithinaweek

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-->Virusinstoolscanbedetectedforlongerperiodsbyusing
techniquesfordetectingviralRNAs,suchasPCR,Gel
electrophoresis,
probehybridization.

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728.Bollingerbodiesareseenin?
a)Chickenpox
b)Cowpox
c)Fowlpox
d)Smallpox

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CorrectAnswer-C
Ans.is'c'i.e.,Fowlpox

729.Followingvirusisofpoxvirus-
a)Variola
b)Coxsachie

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c)ECHO
d)HSV
CorrectAnswer-A
Ans.is'a'i.e.,Variola

730.Amplifierhostis-

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a)PiginJE
b)Doginrabies
c)ManinJE
d)CattleinJE
CorrectAnswer-A

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Ans.is'a'i.e.,PigJE

731.Falseaboutp24is
a)Seenafter3weeksofinfection
b)Cantbeseeninfirstweek
c)Cantbedetectedafterseroconversion

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d)aandc
CorrectAnswer-D
Ans.is'a>c'i.e.,Seenafter3weeksofinfection>Cantbe
detectedafterseroconversion
AntigendetectioninHIV

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Followingasinglemassiveinfection,asbybloodtransfusion,the
virusantigensmaybedetectableinbloodafterabouttwoweeks.
Themajorcoreantigen,p24istheearliestvirusmarkertoappearin
thebloodandistheonetestedfor.IgMantibodiesappearinabout
4-6weeks,tobefollowingbyIgGantibodies.

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Iftheinfectingdoseissmall,asfollowinganeedle-stickinjury,the
processmaybeconsiderablydelayed.
Theappearanceofp24antigenemiaandviremia,followedbyIgM
antibodyresponse,coincideswithacuteorseroconversionillness.
Afterwards,freep24antigendisappearsfromcirculationand
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remainsabsentduringthelongasymptomaticphase,toreappear
onlywhensevereclinicaldiseasesetsin.
Howeverantibody-boundp24antigencontinuestobedemonstrable,
afterdissociation.Thep24antigencaptureassay(ELISA)which
usesanti-p24antibodyasthesolidphasecanbeusedforthis.The

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testispositiveinabout30%ofHIVinfectedpersons.Withprior
dissociationofantigen-antibodycomplex,thepositivityrate
increasestoabout50%.
Thetestismostusefulinpersonsrecentlyexposedtoriskof

infection,inwhomtheantibodytestisnegative.

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Nowcomingtothequestion
Optionb&darestraight-forward.p24antigenisdetectedbyELISA
(enzymeimmuno-assayorenzymelinkedimmuno-assay)andisnot
detectableinfirstweekaftertheinfection.
Option'a'incorrectbecausethoughthep24antigencanbedetected

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after2weeksofinfection:"Thep24antigentestcandetectthep24
antigenonaverage10-14daysafterinfectionwithHIV".
"Followingasinglemassiveinfection,thevirusantigensmaybe
detectableinbloodafterabouttwoweeks".
Option'c'ispartlycorrectandpartlyincorrectbecause:-

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i)Freep24antigenisnotdetectableafterseroconversion.
However,in30-50%ofinfectedpersons,antibody-boundp24
antigencanbedetectedafteritsdissociationfromantibody.

732.Whichpoxwontgrowinegg,animal
cells:

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a)Cowpox
b)Vaccinia
c)Variola
d)Molluscum
CorrectAnswer-D

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Ans.d.Molluscum

733.AppearanceofcowdrytypeAinclusion
bodies?
a)Granular
b)Circumscribed

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c)Inpolio
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Granular
Intranuclearinclusionbodieswereclassifiedintotwotypesby

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cowdry:
a)CowdrytypeA:-Theseareofvariablesizeandgranularin
appearance,e.g.inherpesvirusandyellowfevervirus.
b)CowdrytypeB:-Thesearemorecircumscribedandoften
multiple,aswithadenovirusandpoliovirus.

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734.Smallpoxbelongstowhichclassof
poxviruses?
a)Parapoxvirus
b)Capripoxvirus
c)Leporipoxvirus

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d)Orthopoxvirus
CorrectAnswer-D
Ans.is'd'i.e.,Orthopoxvirus
i)Entomopoxvirinae:Poxvirusesofinsectswhichdonotinfect
vertebrates.

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Chordopoxvirinaeareclassifiedintosixgeneraorsubgroups-
i)Orthopoxvirus:Thesearemammalianpoxvirusesthattendto
causegeneralizedinfectionwithrash.Exmplesarevariola(smallpox
virus),vaccinia,cowpox,monnkeypox,rabbitpox,buffalopox,
camelpox,mousepox.

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ii)Parapoxvirus:Virusesofungulatesthatmayoccasionally
infacthuman,eg.Orf(contagiouspustulardermatitis)and
paravaccinia(milker'snode,bovinepupularstomatitis).
iii)Copripoxvirus:Virusesofgoatandsheeps,eg.sheep-pox,
goatpox,lumpyskindisease.

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iv)Leporipoxvirus:Virusesofofleporids(rabbits,hares,
squirrels),e.g.myxomaandfibromas.
v)Avipoxvirus:Virusofbirds,eg.fowlpox,turkeypox,
pigeonpox,canarypox.
vi)Suipoxvirus:Virusofswine,eg.swinepox.

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735.Brick-shapedvirus-
a)Chickenpox
b)Smallpox
c)CMV
d)EBV

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CorrectAnswer-B
Ans.is'b'i.e.,Smallpox
Variolavirus
BelongstoPoxvirusesenvelopedDNA(dsDNA)virus.
Brickshaped
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Instainedpreparationelementarybodiesareseen--)Paschen
bodies.
Thevariolavirusisthecausativeagentofsmallpox.
On8thmay1980whoanouncedglobaleradicationofsmallpox.
Vacciniavirus

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Itissimilartovariolavirusinproperties.
Itisanartificialvirusanddoesnotoccurinnatureassuch.
Vacciniavirusisbeingemployedasavectorforthedevelopmentof
recombinantvaccines.
Vacciniagenomecanaccomodateabout25000foreignbasepairs,

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sufficientforintroducingseveralgenes.
Manygeneshavebeeninsertedeg-HBV,HIV,rabiesandfor
pharmacologicallyimportantproductssuchasneuropeptides.
Howeveritisnotsuitableasavectorforhumanuseduetoits
pathogeniceffects.

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736.Bindingofgp120causes:
a)Infectionoftargetcell
b)Facilitationofco-receptor
c)Fusingofvirusandtargetcell
d)None

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CorrectAnswer-B
Ans.b.Facilitationofco-receptor

737.NefgeneinHIVisforuse-
a)Enhancingtheexpressionofgenes
b)Enhancingviralreplication

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c)Decreasingviralreplication
d)Maturation
CorrectAnswer-C
Ans.is'c'i.e.,Decreasingviralreplication
NonstructuralHIVgenes
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oTheseare?
1)Tat(Trans-activatinggene):Enhancingtheexpressionofall
viralgenes.
2)Nef(Negativefactorgene):Down-regulatingviralreplication.
3)Rev(Regulatorofviralgene):Enhancingexpressionof

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structuralproteins.
4)Vif(Viralinfectivityfactorgene):Influencinginfectivityofviral
particles.
5)Vpu(InHIV-1)andvpx(InHIV-2):Enhancematurationand
releaseofprogenyofvirusfromcells.

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6)Vpr:Stimulatespromotorregion.
7)LTR(Longterminalrepeat)sequence:Contains
sequenceswhichgivepromotor,enhancerandintegrationsignals.

738.Whatisp24?
a)EnvelopantigeninHIV

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b)CoreantigeninHIV
c)GenomeofHIV
d)Shellantigen
CorrectAnswer-B
Ans.is'b'i.e.,CoreantigeninHIV[RefAnanthanarayan
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8thiep.571]
A.Envelopantigens
Spikeantigen-gp120(Principalenvelopeantigen)
Transmembranepedicleprotein-gp41
B.Shellantigen

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Nucleocapsidprotein-p18
C.Coreantigens
Principalcoreantigen-p24
Othercoreantigens-p15,p55
Polymeraseantigens-p31,p51,p66

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739.Hemorrhagicfeveriscausedby-
a)West-Milefever
b)Sandflyfever
c)Ebolavirus
d)Alloftheabove

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CorrectAnswer-C
Ans.is'c'i.e.,Ebolavirus
Ebolavirusbelongstohemorrhagicfever(seeaboveexplanation).

740.Influenzaviruscultureisdoneon?
a)Chorioallantoicmembrane

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b)Allantoiccavity
c)Yolksac
d)All
CorrectAnswer-B
Ans.isbi.e.,Allantoiccavity

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Inembryonatedeggcultivationforinfluenzavirussiteofinoculation
are:-Allontoiccavityoramnioticcavity
Inoculationsitesinembryonatedeggs
Chorioallantoicmembrane-4HSV,Poxvirus,Rous-sarcoma
virus

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Amnioticcavity-4Influenzavirus,mumpsvirus
Allantoiccavity-Influenzavirus,mumpsvirus,
avianadenovirus,newcastlediseasevirus
Yolksac-->HSV,chlamydia,rickettisia

741.ColoradoTicfeveriscausedby:

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a)Filoviridae
b)Reoviridae
c)Coronaviridae
d)Calciviridae
CorrectAnswer-B

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Ans.b.Reoviridae

742.Idiotypicclassofantibodyisdetermined
by-
a)Fcregion
b)Hingeregion

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c)Carboxyend
d)Aminoend
CorrectAnswer-D
Ans.is'd'i.e.,Aminoend
TheidiotypeisdefinedasthespecificregionoftheFabportionof

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theIgmoleculetowhichantigenbinds.
Itisonaminoterminalwhereantigenbindingsiteispresent.

743.Prozonephenomenonisseenwith?
a)Sameconcentrationofantibodyandantigen
b)Inantigenexcesstoantibody

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c)Antibodyexcesstoantigen
d)Hyperimmunereaction
CorrectAnswer-C
.Ans.is'c'i.e.,Antibodyexcesstoantigen

744.Apatientwithsorethroathasapositive

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PaulBunnelltest.Thecausative
organismis-
a)EBV
b)Adenovirus
c)CMV

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d)Herpesvirus
CorrectAnswer-A
Ans.is'a'i.e.,EBV
.EBVassociatedmalignancies
-Burkitt'slymphoma0

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-Nasopharynagealcarcinoma
-Hodgkin'sdisease(mixedcellularity
type)-TonsillarCarcinoma
-TCell
lymphoma-

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Thymoma
-Gastriccarcinoma
-CNSlymphomainAIDSand
-AngiocentricnasalNK/Tcellimmunoproliferativelesions
transplantrecipient

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-Angioimmuno-blasticlymphadenopathy
-LeiomyosarcomaOtherassociatednonmalignantconditions
-OralhairyleukoplakiainAIDSpatients
-Chronicfatiguesyndrome
-X-linkedlymphoproliferativesyndrome(Duncan'sdisease)

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Laboratorydiagnosis

1.Heterophileantibodiestest
.Thestandarddiagnosticprocedureinchildrenandyoung
adultsisheterophileantibodiestest-Paul-BunnellTest
.Atitreof40foldorgreaterisdiagnosticofacuteEBVinfection

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inapatientwhohassymptomscompatiblewithinfectious
mononucleosis.
Testusuallyremainspositivefor3months.
Testisusuallynegativeinchildren<5years,inelderlyorinpatients
withsymptomsnottypicalofinfectiousmononucleosis.

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.Monospottestforheterophileantibodiesismoresensitivethan
theclassicalheterphiletest.
2.EBVspecificantibodytest
.Usedinpatientswholackheterophileantibodies(children
anti-viralcapsidantigen(anti-VCA)-->mostcommon

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anti-EBVnuclearantigen(anti-EBNA)
anti-earlyantigen(anti-EA)

745.Paulbunnelreactionisatypeof
a)Agglutination
b)CF

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c)Precipitation
d)Flocculationtest
CorrectAnswer-A
Ans.is'a'i.e.,Agglutinationtest
PaulBunnelltestistubeagglutinationtest.

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746.Whichcellscauserosetteformationwith
sheepRBCs-
a)Tcells
b)NKcells
c)Monocytes

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d)All
CorrectAnswer-A
Ans.is'a.Tcells

747.Allaretureaboutinnateimmunityexcept
?

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a)Non-specific
b)Firstlineofdefence
c)Notaffectedbygeneticaffected
d)Includescomplement
CorrectAnswer-C

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Ans.is'c'i.e.,Notaffectedbygeneticaffected

748.Pentavalentimmunoglobinis
a)IgA
b)IgG
c)IgM

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d)IgE
CorrectAnswer-C
Ans.is'c'i.e.,IgM

749.Centerofcomplementpathway-
a)C3

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b)CI
c)C5
d)C2
CorrectAnswer-A
Ans.is'a'i.e.,C3

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750.Acontinuousquantitativedatacanbe
depictedwiththehelpof:
September2009
a)Bardiagram
b)Piechart

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c)Histogram
d)Pictogram
CorrectAnswer-C
Ans.C:Histogram
Numericaldata/quantitativedataisdatameasuredoridentifiedona

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numericalscale.
Numericaldatacanbeanalyzedusingstatisticalmethods,and
resultscanbedisplayedusingtables,charts,histogramsand
graphs.
Forexample,aresearcherwillaskaquestionstoaparticipantthat

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includewordshowoften,howmanyorpercentage.Theanswers
fromthequestionswillbenumerical.
Examplesofquantitativedatawouldbe:'thereare643dotsonthe
ceiling'or'thereare735piecesofbubblegum'.or'thereare8
planetsinthesolarsystem'

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751.WhichofthefollowingTcell
independentAntigenactsthrough-
a)T-cell
b)B-cell
c)Macrophages

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d)CD8+Tcells
CorrectAnswer-B
Ans.is'b'i.e.,B-cells
T-cellindependentantigensdirectlystimulatesB-cellswithout
processingbyantigenpresentingcells.

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752.Maximumhalflife-
a)IgG
b)IgA
c)IgM
d)IgE

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CorrectAnswer-A
Ans.is'a'i.e.,IgG

753.Whichofthefollowingimmunoglobulin
isresponsibleforopsonisation-
a)IgA

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b)IgG
c)IgM
d)none
CorrectAnswer-C
Ans.is'c'i.e.,IgM>'b'i.e.,IgG

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754.Opsonizationtakesplacethrough-
a)C3a
b)C3b
c)C5a
d)C5b

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CorrectAnswer-B
Ans.is'b'i.e.,C3b

755.Antigenidiotypeisrelatedto-
a)Fcfragment
b)Hingeregion

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c)C-terminal
d)N-terminal
CorrectAnswer-D
Ans.is'd'i.e.,N-terminal
Theidiotypeisthespecificregionofthe

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fabportion(notFcfragment)ofIgmoleculetowhichantigenbinds.
Idiotype(antigenbindingsite)isonvariableregion,whichisat
aminoterminal(N-terminal).
Theaminoacidsequencesofthevariable
regionsarenotuniformlyvariablealongtheirlength,butconsistof

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relativelyinvariable
andsomehighlyvariablezones.
ThehigltlyvariableZonesareinvolvedwlththeformationofantigen
bindingsites.
Thesitesonthehyervariableregionsthatmakeactual

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contactwiththeepitopesarecalled"complementaritydetermining
Regions.

756.Activationofclassicalcomplement
pathway?
a)IgA

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b)IgG
c)IgM
d)IgD
CorrectAnswer-C
Ans.is'c'i.e.,IgM

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757.Superantigencauses-
a)PolyclonalactivationofT-cells
b)StimulationofBcells
c)Enhancementofphagocytosis
d)Activationofcomplement

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CorrectAnswer-A
Ans.is'a'i.e.,PolyclonalactivationofT-cells
Superantigensarecapableofactivatingupto20%oftheperipheral
T-cellpool,whereasconventionalantigensactivate<1in10,000.

758.Complementformedinliver-

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a)C2,C4
b)C3,C6,C9
c)C5,C8
d)C1
CorrectAnswer-B

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Ans.isb'i.e.,C3,C6,C9
Biosynthesisofcomplementcomponents
.Complementcomponentsaresynthesizedinvarioussitesof
body:-
i)Intestine-->Cl

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ii)Macrophages-->C2,C4
iii)Spleen-->C5,C8
iv)Liver-->C3,C6,C9

759.GenecomponentsofHLAclassI
includes-

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a)A,B,C
b)DR
c)DQ
d)DP
CorrectAnswer-A

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Ans.is'a'i.e.,A,B,C
.ClassIHLAcomprisesA,BandCloci.

760.Antibodyelevatedinparasiticinfection?
a)IgA
b)IgE

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c)IgG
d)IgM
CorrectAnswer-B
Ans.is'b'i.e.,IgE

761.Testforcoliformcount?

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a)Eijkmantest
b)Casoni'stest
c)Nitratetest
d)Ureasetest
CorrectAnswer-A

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Ans.is'a'i.e.,Eijkmantest
Adleranalysingpresumptivecoliformcount,Ecolicountiscofirmed
byothertestslikeEijkmanttestandindoleproduction.

762.Trueaboutinterferonis:
a)Itisasyntheticantiviralagent

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b)Inhibitsviralreplicationincells
c)Isspecificforparticularvirus
d)None
CorrectAnswer-B
Ans.(b)InhibitsviralreplicationincellsRt,11itlii
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ilallarayl111CO,ppIiiiitC,i:;r,p
Interferon(hostcodedprotein)hasnodirectactiononvirusesbut
inhibitviralreplicationbyselectivelyinhibitingtranslationofviralm-
RNAwithoutaffectingcellularm-RNA.
IFNarenotvirusspecificbutspeciesspecific.

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Itisof3types:
TypeCellsource.Cell
targetBiologicalctivity
IFNa(protein)orleukocyte
Antiviralactivity;stimulates

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Allcells
IFNAllcells
TL.ell,macrophagesand
NKcellactivity
IFN13(glycoprotein) Allcells AllcellsDirectantitumoreffects

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orFibroblastIFN
UpregulatesMHCclassI
antigenexpression.Used
therepeuticallyinviraland
autoimmunedisease

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?IFNy
Regulatesmacrophage
(glycoprotein)or Tcells
Allcells andNKcellsactivation
immuneIFN

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NK
StimulatesIgsecretionbyB

NK
StimulatesIgsecretionbyB
cells

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cellsInductionofclassII
histocompatibilityantigens
TH1Tcelldifferentiation

763.Schistosomiasisisanexmpleof:
a)Meta-zoonoses

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b)Cyclo-zoonoses
c)Direct-zoonoses
d)Sporo-zoonoses
CorrectAnswer-A
Ans.a.Meta-zoonoses

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764.Whichofthefollowingorganismsdoes
notentersthroughabrasionsintheskin
-
a)Erhusiopathiae
b)Ecorrodens

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c)Chominis
d)Cviolaceum
CorrectAnswer-C
Ans.is'c'i.e.,C.hominis
Bacteriacirculateandmultiplyinblood--->Septicemia

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.Bacteriacirculateinblood-->Bacteremia
.Toxinscirculateinblood-->Toxemia
.Pusinblood-->Pyemia
Eikenellacorrodens(E.corrodens),chromobacteriumviolaceum(C.
violaceum)andEikenellacorrodens(E.corrodens)entersthebody

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throughskinabrasions.
Awidevarietyofmicroorganismsthatresideontheskinand
mucousmembranesofthebody,aswellasthosefoundinthe
environment,cancauseskinandsofttissueinfections.
Theseorganismsenterthebodythroughbreaksintheskinor

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mucousmembranes,throughwoundsmadebytraumaorbitesoras
acomplicationofsurgeryorforeign-bodyimplantation.
Theseorganismshavebeenmentionedinfollowingtable:
Aerobicand
Anaerobicbacteria Aerobic

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Yeast
facultative
microorganismsfrom
microorganisms
unusual,Vspecialized

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andzoonoticinfections

?Coagulase
?
Actinobacillus
?Candida

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negative
Peptostreptococcus ?
albicans
?Candida
staphylococci spp.

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actinomycetemcomitans krusei
?
?Candida
Staphylococcus ?Clostridiumspp. ? Aeromonasspp.
parapsilosis

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aureus
?Enterococcus ?Eubacterium
? Bacillusanthracis
spp.
limosum

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?
?Bacteroides
Streptococcus
Bergeyellazoohelcum
fragilis

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viridans
?
?
Chromobacterium
Corynebacterium ?Prevotellaspp.

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violaceum
spp.
?
?Bacillus
?Porphyromonas ? Eikenellacorrodens

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cereus
?E.coli
?Fusobacterium
? Erysipalothrix
?Serratia

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?Veillonellaspp.
rhusiopathiae
?Enterobactor
? Francisellatularensis
?Proteus

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? Haemophillusspp.
?Morganella
? Kingellakingae
?
? Pasteurellamultocida

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Pseudomonas
Streptobacillus
?Acinetobactor
?
moniliformis

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? Vibriovulnificus

765.18yearsoldgirlpresentswithwatery
diarrhea.Mostlikelycausativeagent-
a)Rotavirus
b)V.cholerae

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c)Salmonella
d)Shigella
CorrectAnswer-B
Ans.is'b'i.e.,V.cholerae
AmongstthegivenoptionsRotavirusandV.choleraecausewatery

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diarrhea.
Acutewaterydiarrhainchildrenisusuallybacterialinorigin,most
commonlyduetoenterotoxigenicE.coli(ETEC).Vcholeraeisalso
acommoncause.
Rotavirusisthemostcommoncauseofdiarrheaininfantand

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children(thepatientinquestionisadult).

766.'Secreteofnationalhealthliesinthe
homesofpeople'statementby?
a)IndiraGandhi
b)Abhrahamlincon

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c)Bhore
d)FlorenceNightingale
CorrectAnswer-D
Ans.is'd'i.e.,FlorenceNightingale[RefHousingandplanning
reviewp.35]
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FlorenceNighingalepointedoutnearlyahundradeyearsago,"the
secretofnationalhealthliesinthehomesofpeople".

767.Fatherofpublichealth-
a)Cholera
b)Plague

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c)Leptospirosis
d)Anthrox
CorrectAnswer-A
Ans.is'a'i.e.,Cholera
Historyofcholera
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oFatherofpublichealthisadisease,notaperson.
oFatherofpublichealthischolera.
oJohnSnow(1813-1858)foundthelinkbetweencholeraand
contaminateddrinkingwaterin1854,usingspotmap.
oRobertKochindifiedV.cholerae(1885).

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Choleramorbus-Usedin19th&early20thcenturiesforbothnon-
epidemiccholeraandothergastrointestinaldiseasesthatresembled
cholera.

768.Whichagencymonitorsairqualityin
India?

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a)Centralpollutioncontrolboard
b)Centralairqualityboard
c)Centralpublicworksdept
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Centralpollutioncontrolboard
TheNationalAirQualityMonitoringProgramme,sponsoredbythe
CentralPollutionControlBoard(CPCB)since1990,hasgenerated
databaseoverlast14yearsin10majorIndiancities.

769.Worksampling?

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a)Samplingdoneforindividualwork
b)Assessmentoftimespentbyworkersinwork
c)Doneinveryshortperiod
d)None
CorrectAnswer-B

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Ans.is'b'i.e.,Assessmentoftimespentbyworkersinwork
Worksamplingisatechniqueusedtoinvestigatetheproportionof
totaltimedevotedtothevariousactivitiesthatconstituteajobor
worksituation.

770.Childprotectionschemeisunderwhich

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ministry-
a)Ministryofhealthandfamilywelfare
b)MinistryofSocialwelfare
c)Ministryofwomenandchilddevelopment
d)Ministryofeducation

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CorrectAnswer-C
Ans.is'c'i.e.,Ministryofwomenandchilddevelopment
oIn2006theMinistryofWomenandChildDevelopment(MWCD)
proposedadoptionofIntegratedChildProtectionScheme(ICPS).
oIn2009thecentralgovernmenttaketheschemeitsapprovaland

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hasbeguntheextensivetaskofprovidingchildrenwithaprotective
andsafeenvironmenttodevelopandflorish.
oThepurposeoftheschemeistoprovideforchildrenindifficult
circumstances,aswellastoreducetherisksandvulnerabilities
childrenhaveinvarioussituationsandactionsthatleadtoabuse,

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neglect,exploitation,abondonmentandseparationofchildren.

771.Schoolhealthcheckupcomesunder-
a)Disricthospital
b)PHC
c)CHC

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d)Schoolhealthcommittee
CorrectAnswer-D
Ans.is'd'i.e.,Schoolhealthcommittee[RefPark22"d/ep.534,
535]
Theschoolhealthcommittee(1961)inIndiarecommendedmedical

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examinationofchildrenatthetimeofentryandthereafterevery4
years.

772.
WebCausationofdiseaseismost
appropriate?

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a)Mostlyapplicableforcommondisease
b)Betterforalltherelatedfactorsassociatedwithcausationof
disease
c)Epidemiologicalratio
d)Helpstointerrupttheriskoftransmission

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CorrectAnswer-B
Ans.is'b'i.e.,Betterforalltherelatedfactorsassociatedwith
causationofdisease
Webofcausation
oThismodelisideallysuitedinthestudyofchronicdisease,where

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thediseaseagentisoftennotknownbutistheoutcomeof
interactionofmultiplefactors.
oThe"webofcausation"considersallthepredisposingfactorsof
anytypeandtheircomplexrelationshipwitheachother.
oThecausalwebprovidesamodelwhichshowsavarietyof

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possibleinterventionsthatcouldbetakenwhichmightreducethe
occurrenceofdisease(e.g.MI)
oThewebofcausationdoesnotimplythatthediseasecannotbe
controlledunlessallthemultiplecausesorchainsofcausationorat
leastanumberofthemareappropriatelycontrolled.Thisisnotthe

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case.Sometimesremovaloreliminationofjustonlyonelinkorchain
maybesufficienttocontroldisease,providedthatlinkissufficiently
importantinthepathogenicprocess.
oTherefore,inamultifactorialevent,individualfactorsarebyno
meansalloftheequalweight.

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773.Iodizedsaltiniodinedeficiencycontrol
programmeis?
a)Primaryprevention
b)Secondaryprevention
c)Teriaryprevention

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Primaryprevention
Fortificationoffoode.g.iodizedsaltisprimaryprevention.
Primarypreventionhastwomaincomponents:-

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i)Healthpromotion
ii)Specificprotection
ModeoftheinterventionofPrimarypreventionHealthpromotion
Specificprotection
1. Healtheducation1.Immunization
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2. Environmentalmodifications2.Useofspecificnutrientsiron
andfolicacidtablet
3. Nutritionalintervention3.Chemoprophylaxis
4. Lifestyleandbehavioralchanges4.Protectionagainst
occupationalHazards

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5. Protectionagainstaccident
6. Protectionfromcarcinogens
7. Avoidanceofallergens
8. ControlofspecificHazardsingeneralenvironmente.g.airpollution,
noisecontrol

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9. Controlofconsumerproductqualityandsafetyoffoodanddrug
10. Usingamosquitonet
11. Contraception

774.Secondarypreventionisapplicableto
a)Causalfactors

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b)Earlystageofdisease
c)Latestageofdisease
d)Noneoftheabove
CorrectAnswer-B
Ans.is'b'i.e.,Earlystageofdisease
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PrimordialpreventionBeforeriskfactorpresent.
PrimarypreventionBeforeonsetofdisease(riskfactorpresent).
SecondarypreventionInearlystageofdisease.
TertiarypreventionLatestageofdisease.

775.DALEisreplacedby?

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a)DALY
b)HALE
c)OALY
d)None
CorrectAnswer-B

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Ans.is'b'i.e.,HALE[RefPark20th/ep.24]
HALE(Health-Adjustedlifeexpectancy):-Thenameofthe
indicatorusedtomeasurehealthylifeexpectancyhasbeenchanged
fromdisabilityadjustedlifeexpectancy(DALE)tohealthadjustedlife
expectancy(HALE).

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HALEisbasedonthelifeexpectancyatbirthbutincludesand
adjustmentfortimespentinpoorhealth.Itismosteasilyunderstood
astheequivalentnumberofyearsinfullhealththatanewborncan
expecttolivebasedoncurrentratesofillhealthandmortality.

776.Naturalhistoryofdiseaseisstudiedwith

--- Content provided by FirstRanker.com ---

?
a)Longitudinalstudies
b)Cross-sectionalstudies
c)Both
d)None

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CorrectAnswer-A
Ans.is'a'i.e.,Longitudinalstudies
Longitudinalstudies
Inthistypeofstudy,observationsarerepeatedinthesame
populationoveraprolongedperiodusingfollowupexaminations.
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Theyareusefulto
1. Studythenaturalhistoryofthedisease
2. Foridentifyingriskfactorsofdisease
3. Forfindingouttheincidencerateorrateofrecurrenceofnewcases
ofthedisease.
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Note:Longitudinalstudiesaredifficulttoorganizeandmoretime
consumingthancross-sectionalstudies.

777.Problemofbiasismaximumwith-
a)Cohortstudy
b)Casestudy

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c)Casecontrolstudy
d)Experimentalstudy
CorrectAnswer-C
Ans.is'c'i.e.,Casecontrolstudy

778.Berkesonianbiasisatypeof?

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a)Selectionbias
b)Intervieverbias
c)Informationbias
d)Recellbias
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Ans.is'a'i.e.,Selectionbias
Berksonianbiasisatypeofselectionbias.
Bias
oItisanysystemicerrorintheanalysisofstudythatresultsina
mistakenestimateofanexposure'seffectontheriskofdisease.

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oMainlybiasesareoffollowingtypes.
1.Selectionbias
Surveillance/detectionbiasReferrelbiasor
volunteerbiasBerksonianbias
NeymansurvivalbiasResponsebias

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2.Information(Misclassification)bias
ReportingbiasInterviewerbias
RecallbiasHawthornebias(attentionbias)
3.Confoundingbias
Confoundingissometimesisreferredtoasathirdmajorclassof

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bias.

779.Allofthefollowingarecharacteristicsof
casecontrolstudyexcept-
a)Quickresultsareobtained
b)Measuresincidencerate

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c)Proceedsfromeffecttocause
d)Inexpensivestudy
CorrectAnswer-B
Ans.is'b'i.e.,Measuresincidencerate
oIncidenceratecannotbemeasuredbycase-controlstudyas

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denominator(populationatriskisnotavailable).

780.Beststudyfordefinitivecauseofdisease
?
a)Case-control
b)Cohort

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c)Ecological
d)Cross-sectional
CorrectAnswer-B
Ans.is'b'i.e.,Cohort
AmongstthegivenoptionsCohortstudyisbesttotestthe

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associationbetweenriskfactoranddisease.
Herearethedifferentepidemiologicalstudieswithdecreasing
orderofaccuracytotesttheassociationbetweenriskfactor
anddisease:-
Systematicreviewandmeta-analysis-->Overallmostreliable

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Randomizedcontrolledtrials(controlledclinicaltrails)-->Most
reliableindividualstudy.
Retrospective(Non-concurrent/historic)Cohortstudy.
Prospective(concurrent)Cohortstudy.
Casecontrolstudy

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Cross-sectionalstudy
Ecologicalstudy

781.Suspectedcauseprecedingthe
observedeffectisanexamplefor-
a)Temporalassociation

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b)Consistencyofassociation
c)Strengthofassociation
d)Coherenceofassociation
CorrectAnswer-A
Ans.is'a'i.e.,Temporalassociation

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Temporalassociation
oItimpliescauseprecedseffectoreffectfollowscause,i.e.,
suspectedcauseprecedingtheobservedeffect.
oItisthemostimportantcriteriaforcausalassociation
oItisbestestablishedbyconcurrentcohortstudy.

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Strengthofassociation
oItimplieshowstronglyexposureisassociatedwithdisease.
oItisdeterminedby
i)Relativerisk(InCohortstudy)IHavebeenexplained
ii)Oddsratio(Incase-controlstudy)
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iii)Dose-responserelationshipWithincreasinglevelofexposureto
theriskfactor,onincreasingrisinincidenceisfound.
iv)Cessationofexposure(Reversibility)-->Removalofpossible
causereducesriskofdisease.
Consistencyofassociation
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oTheassociationisconsistentiftheresultsarereplicatedwhen
studiesindifferentsettingsandbydifferentmethods.
oForexample,differentstudiesindifferentsettingshaveproved
smokingasoneofthecauseforlungcancer-->Smokinghas
consistentassociationwithlungcancer.

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Coherenceofassociation
oThecausalassociationmustbecoherent(supportedby)with
relevantfacts.
oForexample:-
Thedeathratesduetolungcancerincreasingmorerapidlyin

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femalescomparisontomales.
Therelevantfact--->Thisincreasingrateisduetomorerecent
adoptionofcigarretesmokingbywomen.

782.Resultsofanystudyarebetterdefinedin
?

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a)Costeffectiveness
b)Costbenefit
c)Botharesame
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Costeffectiveness[Ref.Park22"dlep.814]
Thestudyresultscanbeevaluatedbycost-benefitanalysisand
cost-effectivenessanalysis.
Incost-benefitanalysisallcostsandbenefitsareevaluatedinterms
ofmoney,i.e.economicbenefitsoftheprogramme/studyare

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comparedwiththecostofprogramme.Themaindrawbackwiththis
techniqueisthatthebenefitsinthehealthfieldcanotalwaysbe
expressedinmonetaryterm.Forexamplebirthordeathprevented,
orillnessavoidedetc.Hencethescopeofapplyingthismethodis
rathervague.

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Cost-effectiveanalysisismorepromisingtoolforapplicationinthe
healthfield.Itevaluateshowbesttospendagivenamountofmoney
toachievespecificgoals,i.e.benefitsareexpressedintermsof
resultsachieved,e.g.numberoflivessaved,orthenumberofdays
freefromdisease.

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783.Forcalculationofincidencedenominator
istakenas?
a)Midyearpopulation
b)Populationatrisk
c)Totalnumberofcases

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d)Totalnumberofdeaths
CorrectAnswer-B
Ans.is'b'i.e.,Populationatrisk
Denominatorforcalculatingincidenceispopulationatrisk

784.Whichoneofthefollowingisnota

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specialincidencerate-
a)Attackrate
b)Secondaryattackrate
c)Hospitaladmissionrate
d)Standardizedmortalityrate

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CorrectAnswer-D
Ans.is'd'i.e.,Standardizedmortalityrate
Specialincidencerates
i)Attackrate(caserate)
ii)Secondaryattackrate
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iii)Hospitaladmissionrate

785.Attributableriskmeans
a)Fatalityofadisease
b)Diseaseriskratiobetweenexposedandnon-exposed
c)Riskdifferencebetweenexposedandnon-exposed

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d)Communicabilityofadisease
CorrectAnswer-C
Ans.is'c'i.e.,Riskdifferencebetweenexposedandnon-exposed
-Attributablerisk(AR)isthedifferenceinincidenceratesofdisease
ordeathbetweenanexposedandnon-exposedgroup.

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-Itisexpressedinpercentageandgivestheextenttowhichthe
diseasecanbeattributedtotheexposureinacohortstudy.

786.Proportionalmortalityrateis?
a)Numberofdeathduetoaparticularcause
b)Numberofdeathduringthatyear

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c)Numberofdeathinonemonth
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Numberofdeathduetoaparticularcause
Proportionalmortalityrate(ratio)
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Proportionalmortalityratemeasurestheproportionoftotaldeath
duetospecificcauseorproportionofdeathsinaparticularage
group.
Itisdefinedas"numberofdeathsduetoaparticularcause(orin
specificagegroup)per100totaldeaths".
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Itisthe'simplestmeasureofestimatingtheburdenofdisears'inthe
community.
Itisauseful'healthStatusindicator';indicatesmagnitudeof
preventablemortality.
Itisusedwhenpopulationdataisnotavailable.

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Itdoesnotindicatetheriskofmembersofpopulationcontractingor
dyingfromthedisease.

787.Nameofmumpsvaccineis-
a)JerylLynn
b)Edmonshonzagreb

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c)Schwatz
d)Moraten
CorrectAnswer-A
Ans.is'a'i.e.,Jeryllynn
oMumpsvaccinestrainisJeryllLynnstrain.

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oOtherthreestrainsareofmeaslesvaccine.

788.Timebetweeninfectionandmaximum
infectivityisknownas?
a)Incubationperiod
b)Serialinterval

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c)Generationtime
d)Communicableperiod
CorrectAnswer-C
Ans.is'c'i.e.,Generationtime
Generationtime
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oIntervalbetweenreceiptofinfectionbyhostandmaximalinfectivity
ofthehost.
oGenerationtimeisroughlyequaltotheincubationperiod.
Ref:PARK22ndeditionpg96

789.

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TransovariantransmissionIsseenin
whichinfection-
a)Plague
b)Guinea
c)Yellowfever

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d)All
CorrectAnswer-C
Ans.is'c'i.e..Yellowfever

790.Transovariantransmissionofinfection
occursin-

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a)Fleas
b)Ticks
c)Mosquitoes
d)bandc
CorrectAnswer-D

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Ans.is'b'i.e.,Ticks;'c'i.e.,Mosquitoes

791.Chroniccarrierstateisnotseeninall
except?
a)Poliomyelitis
b)Measles

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c)Malaria
d)Tetanus
CorrectAnswer-C
Ans.is'c'i.e.,Malaria

792.Followingareexamplesofhuman"dead

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end"diseaseexcept-
a)Bubonicplague
b)Japaniesecephalitis
c)Hydatiddisease
d)Leishmaniasis

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CorrectAnswer-D
Ans.is'd'i.e.,Leishmaniasis
Deadandhost
oAdeadendhostisaninfectedpersonfromwhichinfectious
agentsarenottransmittedtoothersusceptiblehostorfromwhicha

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parasitecannotescapetocontinueitslifecycle.
oThediseasesinwhichhumanactsasdeadendhost,i.e.,dead
anddisease:?
1. Japaniesencephalitis3.
Trichinosis5.Bubonicplaque

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2. Echynococcosis(hydatiddisease)4.Tetanus

793.Propagativecycleisseenin?
a)Plague
b)Filaria
c)Malaria

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d)All
CorrectAnswer-A
Ans.is'a'i.e.,Plague[RefPark22"/ep.94]
PropagativePlaguebacilliinratfleas
Cyclo-developmentalMicorfilariainmosquito.

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Cyclo-propagativeMalarialparasiteinmosquito.

794.Internationaldiseasesurveillanceisfor?
a)Hepatitis
b)Polio
c)TB

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d)Leprosy
CorrectAnswer-B
Ans.is'b'i.e.,Polio

795.Massvaccinationisineffectivein-
a)Measles

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b)Polio
c)Tetanus
d)None
CorrectAnswer-D
Ans.is'None'

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oMassvaccinationisusedinallthethreegivenoptions.

796.Ifprevalenceofadiseaseincreases,
whatistrue?
a)PPVincreases
b)PPVdecreases

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c)NoeffectonPPV
d)PPVmayincreaseordecrease
CorrectAnswer-A
Ans.is'a'i.e.,PPVincrease

797.ScreeningprocedureisbestforCaof-

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a)Prostate
b)Colon
c)Gastric
d)None
CorrectAnswer-B

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Ans.is'b'i.e.,Colon
oTwomostimportantcancers,whichcanbepreventedby
screeningarecarcinomaofcolonandcervix.

798.Highsensitive-
a)Lowfalsepositive

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b)Lowfalsenegative
c)Lowtruenegative
d)Lowtruepositive
CorrectAnswer-B
Ans.is'b'i.e.,LowFalsenegative

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TruepositiveisdirectlyrelatedtosensitivityoFalsenegativeis
inverselyrelatedtosensitivity
TruenegativeisdirectlyrelatedtospecificityoFalsepositiveis
inverselyrelatedtospecificity
oIfatesthashighsensitivity-->moretruepositive,lessfalse

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negative,andalsomorefalsepositive.oIfatesthashighspecificity
-->moretruenegative,lessfalsepositiveandalsomorefalse
negative.

799.Mostreliabletestforscreeningof
diabetesmellitus?

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a)Randomsugar
b)Fastingsugar
c)Glucosetolerancetest
d)Urinesugar
CorrectAnswer-B

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Ans.is'b'i.e.,Fastingsugar
"Thebestscreeningtestfordiabetes,thefastingplasmaglucose
(FPG),isalsoacomponentofgnostictesting"diabetesjournals.org
oThefastingplasmaglucosetestandthe75goralglucose
tolerancetest(GTT)arebothsuitabletestsforscreeningof

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diabetes.
oHowever,theFPGtestispreferredinclinicalsettingsbecauseitis
easierandfastertoperform,moreconvenientandacceptableto
patients,andlessexpensive.
"Fastingplasmaglucoselevelisthemostreliableandconvenient
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test"Problemorientedpatientmanagement

800.Bloodscreeningisnotdonefor?
a)HIV
b)HBV
c)EBV

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d)HCV
CorrectAnswer-C
Ans.is'c'i.e.,EBV
Screeningrecommendedinall
Selectivescreeninginsome

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countries
countries
HIV
Malaria
HBV

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HTLV
HCV
CMV
Syphilis
Chagasdisease

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801.Toeradicatemeaslesthepercentageof
populationtobevaccinatedisat
least............%
a)70
b)80

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c)85
d)95
CorrectAnswer-D
95

802.Inmeaselesvaccinecanbegiven

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within-
a)3months
b)5months
c)7months
d)6months

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CorrectAnswer-D
Ans.is'd'i.e.,6thmonths
oThebestageformeaslesvaccinationis9months.
oTheagecanbeloweredto6monthsifthereismeaslesoutbreak
inthecommunity.Forinfantsimmunizedbetween6monthsand9

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monthsofage,aseconddoseshouldbeadministeredassoonas
possibleafterthechildreachestheageof9monthsprovidedthatat
least4weekshaveelapsedsincethelastdose.

803.Measlesvaccinationisgivenat-
a)9months

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b)Atbirth
c)4weeks
d)8weeks
CorrectAnswer-A
Ans.is'a'i.e.,9months

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oTheWHOexpandedprogrammeonimmunizationrecommends
immunizationat9monthsofage.
oNow,seconddoseofmeaslesisalsogivenat16-24monthsin
NationalImmunizationSchedule.

804.Incubationperiodofswineflu-

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a)1-3days
b)2-3weeks
c)10-15days
d)5weeks
CorrectAnswer-A

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Ans.is'a'i.e.,1-3days
Swineflu
oSwineflu,alsocalledswineinfluenza,orpiginfluenza,iscaused
byinfluenzavirus.
oItismainlyoccursinswines(pigs)andoccasionallytransmittedto

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human.
oItisusuallycausedbyinfluenzavirustypeA(H1-N1).
oIncubationperiodisabout1-3daysandthesymptomsofswineflu
inhumansaresimilartomostinfluenzainfections,e.g.fever,cough,
rhinorrhea,fatigueandheadache.

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805.AsperRNTCPguidelines,Multidrugresistance(MDR)TBisdefinedas
resistanceto:
a)Rifampicin
b)Rifampicinandisoniazide
c)Rifampicin,isoniazideandethambutol

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d)Noneoftheabove
CorrectAnswer-B
ConfirmedMDR-TBcase:MDR-TBsuspectisonewhoissputum
culturepositiveandwhoseTBisduetoMycobacteriumtuberculosis
thatareresistantin-vitrotoatleastisoniazidandrifampicin(the

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cultureandDSTresultbeingfromanRNTCPaccreditedlaboratory).
Ref:Park21stedition,page178.
http://health.bih.nic.in/Docs/Guidelines-DOTS-Plus.pdf.

806.WhyaTBpatientisrecommenda
regimenof4drugson1stvisit-

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a)Toavoidemergenceofpersistors
b)Toavoidsideeffects
c)Tocureearly
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Toavoidemergenceofpersistors
Twophasechemotheraphv
oTherearetwophaseoftreatmentoftuberculosis
i)Intensivephase
Thisisshortphaseintheearlycourseoftreatmentandlastsfor1-

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3months.
Threeormoredrugsaregiventokillasmanybacilliaspossible,
whichpreventsemergenceofpersisters.
Theriskofrelapseisalsolessened.Continuationphase
Itisaimedatsterilizingthesmallernumberofdormantorpersisting

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bacilli.

807.TBmultidrugregimenisgivento-
a)Preventresistance
b)Broadspectrum
c)Preventsideeffects

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Preventresistance
oMultidrugtreatmentinTBisgivento?
i)Preventemergenceofpersisters

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ii)Preventrelapse
iii)Preventemergenceofresistance
iv)shortenthedurationoftreatment

808.4drugsinAKTusedbecause-
a)Decreaseinresistancebymutation

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b)Decreaseinresistancebyconjugation
c)Tocurediseaseearly
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Decreaseinresistancebymutation

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oMostcommonmethodforproductionofresistanceagainstATTis
mutation.
oMultidrugtreatmentpreventsemergenceofresistance.Thus,
multidrugtreatmentpreventemergenceofresistancedueto
mutation.

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809.Chickenpoxvaccineis-
a)Livevaccine
b)Killedvaccine
c)Conjugatedvaccine
d)None

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CorrectAnswer-A
Ans.is'a'i.e.,Livevaccine
Preventionofchickenpox
oForpreventionofchickenpoxfollowingareused?
i)Varicellazosterimmunoglobulin(VZIG)
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VZIGisgivenwithin72hoursofexposureinexposed
susceptibleindividuals.
Itisgivenintramuscularwitharepeatdosein3weeks.
BecauseVZIGbindtovaricellavaccine,thetwoshouldnot
begivenconcomitantly.

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ii)Vaccine
Varicellavaccineisliveattenuatedvaccineandis
recommendedforchildrenbetween12-18monthsofage.
Efficacyofvaccineis90-95%anddurationofimmunityis
probably10years.

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Twodosesarerecommendedinpersonolderthan12yearsofage.

810.AmountofdiphtheriatoxoidinDTis?
a)5Lf
b)10Lf
c)15Lf

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d)25Lf
CorrectAnswer-D
Ans.is'd'i.e.,25Lf[Ref.Park22"dlep.153]
Oridinary(Pediatric)DPT/DTvaccinescontain25Lfofdiphtheria
toxin.

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Forimmunizingadultsandolderchildren(>12years),dTisused
whichcontains2Lfofdiphtheriatoxin.
DPTvaccine
Itcontainscomponentsforimmunizationagainstthreediseases,i.e.,
toxoidofdiphtheriaandtetanus,andkilledB.pertussis.Pertussis

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componentenhancesthepotencyofdiphtheriatoxoid.
Aluminiumsalts(hydroxideorphosphate)areusedasadjuvantto
increaseimmunogenicity.Thiomersalisusedaspreservative.
UsualstoragetemperatureforDPTvaccineincoldchainis+2to
+8?C,storedinrefrigerator.Itshouldneverbestoredindeepfreezer

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(shouldnotbefrozen)andifitgetsfrozenaccidently,vaccineshould
bediscarded.
Exposuretosunlightshouldbeavoided.Openvialswhichhavenot
beenfullyusedshouldbediscardedattheendofsession.
Vaccineisgivenbyintramuscularrouteinthemiddlethirdof

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anterolateralaspectofthigh.
OptimumagetostartDPTvaccinationis6weeksafterbirth.
Totalthreedosesaregiveninprimarlyimmunizationwithaninterval
of4weeksbetweenthreedoses.Firstboosterisgivenat16-24

monthswithsecondboosterat5-6years.

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811.Bivalentmeningococcalvaccineis?
a)AY
b)AC
c)Cy
d)AW-I35

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CorrectAnswer-B
Ans.is'b'i.e.,AC
Twotypeofmeningococcalvaccinedevelop
Unconjugatedpolysaccharidevaccine.
ConjugatedgroupCvaccine.

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Polysaccharidevaccines
Internationallymarketedmeningococcalpolysaccharidevaccines
areoBivalent(AandC),
Trivalent(A,CandW-135)
Tetravalent(A,C,YandW-135).

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Thevaccinesarepurified,heat-stable,lyophilizedcapsular
polysaccharidesfrommeningococcioftherespectiveserogroups.
Aprotectiveantibodyresponseoccurswithin10daysofvaccination.
Inschoolchildrenandadults,onedoseofthesepolysaccharide
vaccinesappearstoprovideprotectionforatleast3years,butin

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childrenunder4yearsofagethelevelsofspecificantibodies
declinerapidlyafter2-3years.

812.AccordingtoEVINCEfastbreathingin5
mthchildisdefinedas-
a)>30/min

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b)40
c)50
d)60
CorrectAnswer-C
Ans.is'c'i.e.,50

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813.1955HepatitisoutbreakinDelhi?
a)A
b)B
c)C
d)E

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CorrectAnswer-D
Ans.is'd'i.e.,E[RefInternet]
HepatitisEwasfirstdocumentedinNewDelhiin1955when29000
casesoficterichepatitisoccured.

814.Whichischoleravaccine-

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a)Ty21A
b)HGD-103
c)WC-rBS
d)None
CorrectAnswer-C

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Ans.is'c'i.e.,WC-rBS
CholeraVaccine
Killedvaccines
Dukoral(WC-rBS)
SancholandmORCVAX

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815.Trivalentoralpoliovaccinecontains,
type3virus-
a)100,000TCID50
b)200,000TCID50
c)300,000TCID50

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d)400,000TCID50
CorrectAnswer-C
Ans.is'c'i.e.,300,000TCID50
Oral(sabin)poliovaccine
Itcontainsliveattenuatedviruss(type1,2and3)growninprimary

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monkeykidneyorhumandiploidcellculture.
oThevaccinecontains:-
i)Over300,000TCID50oftype1poliovirus
ii)Over100,000TCID50oftype2poliovirus
iii)Over300,000TCID50oftype3poliovirusoDose2drop(0.1

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ml)
ScheduleinNationalImmunizationProgrammeofIndia.
DoseAge
OPV-0(Zerodose)Atbirth
OPV-16weeks

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OPV-210weeks
OPV-314weeks
OPV-B(Boosterdose)16-24months
oDevelopmentofimmunity-->OPVinduceslocalintestinal
immunitybyproductionofsecretoryIgAaswellashumoralimmunity

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byinducingproductionofserumantibodies(IgG).So,itgives
protectionfromparalysisandalsopreventsinfectionofthegutby
wildviruses.

816.ORScontains75mEq/l-
a)Sodium

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b)Potassium
c)Glucose
d)Chloride
CorrectAnswer-A
Ans.is'a'i.e.,Sodium

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Glucose
shouldatleastequalthatofsodiumbutshouldnotexceed111mmol/l
Sodium
shouldbewithintherangeof60-90mEq/l
Potassium shouldbewithintherangeof15-25mEq/l
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Citrate
shouldbewithintherangeof8-12mmol/l
Chloride
shouldbewithintherangeof50-80mEq/l

817.ORSnewosmolarityis-

--- Content provided by‍ FirstRanker.com ---

a)270
b)245
c)290
d)310
CorrectAnswer-B

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Ans.is'b'i.e.,245
oOsmolarityofnewORS(reducedosmolarityORS)is245
mmol/litre.

818.Prophaylaxisformalarianotused-
a)Doxycycline

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b)Artesunate
c)Chloroquine
d)Mefloquine
CorrectAnswer-B
Ans.is'b'i.e.,Artesunate

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oDrugsusedforprophylaxisofmalariaarechloroquine,proguanil,
doxycycline,mefloquineandhydroxychloroquine.

819.Yellowfeveraedesagyptiindexshould
be?
a)<1%

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b)<5%
c)<10%
d)<20%
CorrectAnswer-A
Ans.is'a'i.e.,<1%

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820.WhichisthemainvectorofDengue?
a)A.aegypti
b)Aschleri
c)Culex
d)Anopheles

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CorrectAnswer-A
Ans.is'a'i.e.,A.aegypti[RefPark22"/ep.225]
Denguefeveriscausedbyarboviruses(atleast4serotypeshave
beenrecognized)
ItistransmittedbyAedes(Aedesaegyptiisthemainvector).

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Thereservoirofinfectionisbothmanandmosquito.
ThetransmissioncycleisMan-mosquito-man
Denguefeveroccursbothepidemicallyandendemically.Epidemics
startsinrainyseasonandareusuallyexplosive.
Aedesmosquitobecomesinfectivebyfeedingonapatientfromthe

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daybeforeonsettothe5thdayofillness

821.Chemoprohylaxisofchloroquine
includes-
a)300mgBD/week
b)600mgOD/week

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c)600mg/week
d)300mgOD/week
CorrectAnswer-D
Ans.is`d'i.e.,300mgOD/week
DrugDoseforchemoprophylaxis

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Chloroquine300mg(3tabletsof100mgor2tabletsof
150mg)onceaweekor100mg/dayfor6dayeveryweek
Proguanil400mgperday(2tabletsof200mg)
Mefloquine250mgonceaweek
Doxycycline100mgperday.

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822.Epidemictyphuscause&vector-
a)Rickettessiaeprowazki&Louse
b)R.typhi&mite
c)R.conorii&tick
d)R.akari&mite

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CorrectAnswer-A
Ans.is'a'i.e.,Rickettessiaeprowazki&Louse

823.Vectorofscrubtyphusinman?
a)O.tsutsugamushi
b)Leptotrombidiumdeliense

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c)Lice
d)Pediculoushumanus
CorrectAnswer-B
Ans.is'b'i.e.,Leptotrombidiumdeliense
oForscrubtyphus:-

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CausativeagentR.tsutsugamushi
Vectortrombiculidmite(LeptotrombidiumdelineseandL.akamushi)

824."Multibacillary"isaspectrumofdisease,
seenin-
a)Leprosy

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b)TB
c)Tetanus
d)Trachoma
CorrectAnswer-A
Ans.is'a'i.e.,Leprosy

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825. 2yrsdurationintermsofleprosyiswith
regardto-
a)Rxofpaucibacillaryleprosy
b)Rxofmultibacillaryleprosy
c)PostRxsurveillanceofpaucibacillaryleprosy

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d)PostRxsurveillanceofmultibacillaryleprosy
CorrectAnswer-C
Ans.is'c'i.e.,PostRxsurveillanceofpaucibacillaryleprosy

826.Whichvirusisusedtoproducerabies
vaccine?

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a)Wild
b)Street
c)Fixed
d)LiveAttenuated
CorrectAnswer-C

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Ans.is'c'i.e.,Fixed
oTherearetwostrainsofrabiesvirus:?
i)Streetvirus-Thisthevirus,responsiblefornaturalrabiesand
isisolatedfromnaturalhumanoranimalinfection.
ii)Fixedvirus-Itisisolatedafterseveralserialintracerebral

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passageinrabbit.Itisusedtopreparerabiesvaccine.

827.SecondmostcommonSTDafter
gonococcus?
a)Chylamydia
b)HSV

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c)HIV
d)Syphilis
CorrectAnswer-A
Ans.is'a'i.e.,Chlamydia[RefPark2151/ep.304]
FiveclassicalSTDsaresyphilis(T.pallidum),gonorrhoea(N.

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gonorrhoeae),chanchroid(H.ducreyi),lymphogranulomavenerum
(chlamydiatrachomatis),anddonovanosis(calymmatobacterium
granulomatosis).
MostcommonSTDinIndiaisherpesgenitalis(20%)followedby
chancroid(11%),viralwarts/HPV(11%),syphilis(11%)and

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gonorrhoea(9%).
Overall(inworld)mostcommonSTDischlamydiafollowedby
gonorrhoea.

828.ChandlersindexforHookworm,whenit
ishealthproblem?

--- Content provided by FirstRanker.com ---

a)>300
b)>200
c)>100
d)>50
CorrectAnswer-A

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Ans.is'a'i.e.,>300[RefPark21"/ep.221]
Below200Hookworminfectionisnotmuchofsignificance
200-250Potentialdanger
250-300--Minorpublichealthproblem
Above300Importantpublichealthproblem

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829.Whichofthefollowingisazoonotic
disease?
a)Hydatidcyst
b)Malaria
c)Filariasis

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d)denguefever
CorrectAnswer-A
Ans.is'a'i.e.,Hydatidcyst
Importantzoonoses
I.Bacterial?4Anthrax,Brucellosis,Ornithoses,Q-fever,

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Leptospirosis,TB,Plague,Tularemia,Salmonellosis.
2.Viral-->Cowpox,Monkeypox,Easternequine,encephalitis,
Rossriverfever,Yellowfever,Japaneseencephalitis,Lassafever,
Rabies.
3.Protozoal--->Leishmaniasis,Toxoplasmosis,Trypanosomiasis,

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Babesiosis.
4.Helminthic---->Clonorchiasis,Fasciolopsis,Schistosomiasis,
Echinococus(hydatiddisease),Taeniasis,Trichinellosis.

830.HIVpostexposureprophylaxisshouldbe
startedwithin?

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a)1-2hrs
b)14hrs
c)18hrs
d)72hrs
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Ans.is'a'i.e.,1-2hrs
Anti-retroviraldrugforpost-exposureprophylaxisshouldbeinitiated
assoonaspossibleaftertheexposurewithinthefirstfewhoursand
nolaterthan72hours.
So,thebestanswerhereis1-2hours(firstfewhours).

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831.HIVprevalencecanbeassessedby-
a)Sentinelsurveillance
b)Active
c)Passive
d)Register

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CorrectAnswer-A
Ans.is'a'i.e.,Sentinelsurveillance
oSentinelsurveillanceinIndiaisdoneinnationalAIDScontrol
programme.

832.Mostcommoncancerinmenis

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a)Bladdercancer
b)Colorectalcancer
c)Prostatecancer
d)Oralcancer
CorrectAnswer-C

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Answer-C.Prostatecancer
CancersinmalesinIndia:Lip/oralcavity>Prostate>Colorectum>
Pharynx(otherthannssopharynx)>Larynx
Lungcancerwasthemostcommoncancerinmenworldwide,
contributing15.5%ofthetotalnumberofnewcasesdiagnosedin

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2018.
Thetopthree?lung,prostateandcolorectalcancers?contributed
44.4%ofallcancers(excludingnon-melanomaskincancer).

833.Whichindexofobesitydoesnotinclude
height?

--- Content provided by FirstRanker.com ---

a)BMI
b)Ponderal'sindex
c)Broca'sindex
d)Corpulenceindex
CorrectAnswer-D

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Ans.isi.e.,D.Corpulenceindex[RefPark22ndlep.369,370]
Differentindicesusetodetermineobesityare
i)Bodymassindex(Qetelet'sindex)
Itisusedinternationallyasreferencestandardforassessingthe
prevalenceofobesity.

--- Content provided by FirstRanker.com ---

Itisdependentbothonheightandweight(hasbeenexplained
earlier).
ii)Ponderalindex
Itisdependentbothonheightandweight.
Itisdefinedasheight(cm)dividedbycuberootofweight(kg).

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iii)Brocaindex?dealweight=Height(cms)-100
iv)Corpulenceindex?Itisdependentonlyonweight(height
independent.Itshouldbe1.2.

834.Whichofthefollowingstudieshave
givencoronaryriskfactor?

--- Content provided by FirstRanker.com ---

a)Framingham
b)Stanfordstudy
c)NorthKerala
d)MONICA
CorrectAnswer-A

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Ans.is'a'i.e.,Framingham[RefPark22"diep.342]
Optiona,b&callthreeareriskfactorinterventiontrials.
However,optionaisthebestanswer:?
"Since1951,oneofthebestknownlargeprospectivestudies,the
Framinghamstudy,hasplayedamajorroleinestablishingthe

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natureofCHDriskfactorsandtheirrelativeimportance.
Standford-threecommunitystudy.Todeterminewhether
communityhealtheducationcanreducetheriskofcardiovascular
disease,thisstudywasundertakenin1972.
TheNorthKereliaProject:Thisisamultipleriskfactor
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interventiontrialestablishthenatureofCHDriskfactorsandtheir
relativeimportance.Largestprospectivestudywhichstartedsince
1951.

835.Nicotineresponsiblefororalcanceris?
a)10%

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b)40%
c)90%
d)60%
CorrectAnswer-C
Ans.is'c'i.e.,90%[RefPark22"/ep.358]
--- Content provided by FirstRanker.com ---
Approximately90%oforalcancersinSouthEastAsiaarelinkedto
tobaccochewingandtobaccosmoking"--Park

836.Allofthefollowingaregivenglobal
prominenceintheVISION2020goal,
expect:

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a)Refractiveerrors
b)Cataract
c)Trachoma
d)Glaucoma
CorrectAnswer-D

--- Content provided by FirstRanker.com ---

Ans.Glaucoma

837.ForAsianpopulationB.M.I.trueis?
a)Differentfrominternationalvaluestodefineobesity
b)Increasedmorbidityatlowervalues
c)Increasedmorbidityathighervalues

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d)Obesityis>25kg/m2
CorrectAnswer-B
Ans.is'b'i.e.,Increasedmorbidityatlower
values[RefWHOexpertconsultation]
AWHOexpertconsulationaddressedthedebateabout

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interpretationofrecommendedbody-massindex(BMI)cut-offpoints
fordeterminingoverweightandobesityinAsianpopulations,and
consideredwhetherpopulationspecificcut-offpointsforBMIare
necessary.
TheyreviewedscientificevidencethatsuggeststhatAsian

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populationshavedifferentassociationsbetweenBMI,percentageof
bodyfatandhealthrisksthandoEuropeanpopulation.
TheconsultationconcludedthattheproportionofAsianpopulation
withahighriskoftype2diabetesandcardiovasculardiseaseis
substantialatBMI,lowerthanexistingWHOcut-offpointsfor

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overweight(25mg/kg2).AndAsiansgenerallyhaveahigher
percentageofbodyfatincomparisontowhitepeopleofthatsame
age,sexandBMI.
However,availabledatadonotnecessarilyindicateaclearBMIcut-
offpartforallAsiansforoverweightorobesity.

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Thecut-offpointforobservedriskvariesfrom22kg/m2to25
kg/m2indifferentAsianpopulation,forhighriskitvariesfrom26
kg/m2to31kg/m2.
FormanyAsianpopulations,additiondtriggerpointsforpublic

healthactionwereidentifiedas-

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1. 18.5kg/m24Underweight
2. 18.5-23kg/m2Increasedbutacceptablerisk
3. 23-27.5kg/m2Increasedrisk
4. 27.5kg/m2Higherhighrisk

838.Whichofthefollowingstatementsabout

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'LateExpandingPhaseofDemographic
Cycle'isTRUE?
a)BirthRateislowerthanDeathRate
b)HighDeathRateandHighBirthRate
c)DeathRatedeclinesmorethanBirthRate

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d)DeathRatebeginstodeclinewhileBirthRateremains
unchanged
CorrectAnswer-C
Inlateexpandingphaseofdemographiccycledeathratesdeclines
fasterthanthebirthrateandthereisasteadydecreaseinthe

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demographicgap.
Inthisstatepopulationgrowatasteadilydecreasingrate.
Mostofthedevelopingcountriesarenowatearlyexpandingand
lateexpandingstagesofdemographiccycle.
Ref:Park'sTextbookofPreventiveandSocialMedicineByK.Park,

--- Content provided by FirstRanker.com ---

19thEdition,Page379;FoundationsofCommunityMedicineBy
Dhaar,2ndEdition,Page667

839.Nottrueaboutpopulationpyramid?
a)Indiahasbroadbase
b)Indiahasnarrowbase

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c)Indiahasnarrowapex
d)Developingcountrieshavebulgeinthecenter
CorrectAnswer-B
Ans.is'b'i.e.,Indiahasnarrowbase
Incountrieswithhighbirthratesasours,populationpyramidis

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broadbasedconical(narrowapex)becauseofhighbirthrateand
taperingofpopulationwithincreaseinage.
Thepyramidofdevelopingcountry(e.g.India)hasabroadbaseand
ataperingtop.
Indevelopedcountries,thepyramidgenerallyshowsabulgeinthe

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middleandhasanarrowerbase(asinfiguregiveninthequestion).

840.Netreproductionrateis?
a)Numberoflivebirthsper1000mid-yearpopulation
b)Numberoflivebirthper1000womenofchildbearingage
c)Numberofdaughtersanewborngirlwillhaveduringlifetime

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d)Noneoftheabove
CorrectAnswer-C
Ans.is'c'i.e.,Numberofdaughtersanewborngirlwillhave
duringlifetime
Netreproductionrate
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Netreproductiverateisdefinedas
"Theno.ofdaughtersanewborngirlwillbearduringherlifetime
assumingfixedagespecificfertilityandmortalityrates"
Itistheonlyfertilityrelatedstatisticswhichalsotakesmortalityrates
intoconsideration.

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NRRofoneisequivalenttoattainingapproximatelythetwochild
norms.
GoalofNRR=1canbeachievedonlyifatleast60%*oftheeligible
couplesareeffectivelypracticingfamilyplanning.

841.Homeswherechildrenareplacedunder

--- Content provided by FirstRanker.com ---

thecareofdoctorsandpsychiatristsare
called-
a)Fosterhomes
b)Borstals
c)Remandhomes

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d)Childguidanceclinics
CorrectAnswer-C
Ans.is'c'i.e.,Remandhomes
Childplacement:
oOrphanages:Forchildrenwhohavenohomeorcannotbetaken

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careofbytheirparents.
oFosterHomes:Severaltypesoffacilitiesforrearingchildrenother
thaninnaturalfamilies.
oAdoption:Legaladoptionconfersuponchildandtheadoptive
parents,rightsandresponsibilitiessimilartothatofnaturalparents.

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oRemandHomes:Childisplacedunderthecareofdoctors,
psychiatristsandothertrainedpersonneltoimprovethementaland
physicalwellbeingofthechild.

842.MeanbirthweightinIndia-
a)2.0-2.4kg

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b)2.4-2.5kg
c)2.5-2.9kg
d)>3.0kg
CorrectAnswer-C
Ans.is'c'i.e.,2.5-2.9kg
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MeanbirthweightinDifferentpartsoftheworldRegion
Meanbirthweight
NorthAmerica,WesternEurope,Australia
3.5-3.6kg
EasternEurope3.1-

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3.3kg
AfricaandEastAsia2.9-
3.1kg
SouthAsiancountries2.7kg
oInIndia,meanbirthweightrangesfrom24.9

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kgto28.8kg.

843.Highestfundingforreproductivehealth
isby-
a)UNFPA
b)UNICEF

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c)ILO
d)None
CorrectAnswer-A
Ans.is'a'i.e.,UNFPA[RefMaternalhealthfifthreportsession
2007-2008]
--- Content provided by FirstRanker.com ---
UNFPAworkswitharangeofpartnerstopromotereproductive
healthinIndia.
Itpoolsasignificantproportionofitscountryprogrammeresources
inthereproductiveandchildhealthII(RCHII)programme,aimedat
reducingmaternalmortalityandchildmortality,aswellasprovision

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ofrangeofcontraceptiveservices.
UNFPAalsodeliverstechnicalassistanceforeffective
implementationofRCH-IIprogrammeatthenationalaswellasstate
levelparticularlyinthestateofRajasthan,M.P.Maharashtra,Orrisa
andBihar.

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844.Mostcommonmethodofsterilisation
practisedinIndia?
a)Femalesterilization
b)Malesterilization
c)Both

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Femalesterilization[RefPark22"/ep.454]
During2010-2011
Totalsterilization-5.0million

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Femalesterilization(tubectomy)4.78million
Malesterilization(vasectomy)0.219million

845.Lifespanofcut380a-
a)10yrs
b)20yrs

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c)1yrs
d)None
CorrectAnswer-A
Ans.is'a'i.e.,10years

846.WhichofthefollowinghasLEAST

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pregnancyfailurerate:
a)OCP
b)IUCD
c)Diaphragm
d)Condom

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CorrectAnswer-A
OCP

847.Whichistheleastcommoncauseamong
theseofinfantmortalityinIndia-
a)Infections

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b)Prematurity
c)Birthinjuries
d)Congenitalmalformations
CorrectAnswer-C
Ans.is'c'i.e.,Birthinjuries

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848.MCHcareisassessedby-
a)Deathrate
b)Birthrate
c)Maternalmortalityrate
d)Anemiainmother

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CorrectAnswer-C
Ans.is'c'i.e.,Maternalmortalityrate
ImportantMCHindicators
1. Maternalmortalityrate
2. Mortalityininfancyandchildhood

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a)Perinatalmortalityrate
b)Neonatalmortalityrate
c)Post-neonatalmortalityrate
d)Infantmortalityrate
e)1-4yearmortilityrate

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f)Under5mortalityrate
g)Childsurvivalrate

849.Innormaldelivery,breastfeedingshould
bestarted?
a)6hourafterdelivary

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b)2hourafterdelivary
c)4hourafterdelivary
d)None
CorrectAnswer-D
AnsisdNone

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oBreastfeedingshouldbeinitiatedwithin30min.ofanormal
vaginaldelivery.
oBreastfeedingshouldbeinitiatedwithin4hrsofdeliveryby
caesariansection.

850.Bestindicatorofavailability,utilisation&

--- Content provided by FirstRanker.com ---

effectivenessofhealthservices-
a)IMR
b)MMR
c)HospitalbedOCR
d)DALY

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CorrectAnswer-A
Ans.is'a'i.e.,IMR

851.Perinatalmortalityincludesdeaths-
a)After28weeksofgestation
b)First7daysafterbirth

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c)Both
d)Fromperiodofviability
CorrectAnswer-C
Ans.is'c'i.e.,Both

852.Colostrumshasincomparedtonormal

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milk?
a)DecreasedK
b)DecreasedNa
c)Increasedproteins
d)Increasedcalories

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,Increasedproteins

853.Maternalmortalityismaximuminwhich
period
a)Antepartum

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b)Peripartum
c)Postpartum
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Peripartum

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oMaternaldeathmostlyoccurfromthethirdtrimestertothefirst
weekafterbirth.Studiesshowthatmortalityrisksformothersare
particularlyelevatedinthefirsttwodaysafterbirth.

854.Energyrequirementinlatepregnancy-
a)2500cal

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b)1400cal
c)1000cal
d)1000cal
CorrectAnswer-A
Ans.is'a'i.e.,2500Cal

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855.'VitaminArequirementininfantis-
a)350g
b)600g
c)800g
d)1000g

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CorrectAnswer-A
Ans.is'a'i.e.,350g

856.Adultnon-pregnantfemalerequires,
Calciumperday-
a)400mg

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b)600mg
c)800mg
d)1000mg
CorrectAnswer-B
Ans.is'b'i.e.,600mg

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oAdultnon-pregnantfemalerequires600mgcalciumperday.

857.Calciumrequirementabovethenormal
duringthefirstsixmonthoflactationis-
a)400Mgiday
b)550mg/day

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c)600mg/day
d)750mg/day
CorrectAnswer-C
Ans.is'c'i.e.,600mg

858.IodineRDAis-

--- Content provided by FirstRanker.com ---

a)300microgram
b)500microgram
c)150microgram
d)50microgram
CorrectAnswer-C

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Ans.is`c"i.e.,150microgratn
oTheRDAofiodineforadultsis150microgram.

859.Iodinecomesiniodinesalt.Requirmen
tatproductionandconsumerlevel
respectively-

--- Content provided by‍ FirstRanker.com ---

a)20&10PPNI
b)30&10PPM
c)30&15PPM
d)30&20PPM
CorrectAnswer-C

--- Content provided by‌ FirstRanker.com ---

Ans.is"c'i.e.,30&15PPM

860.Bitot'sspotprevalenceaspublichealth
problem-
a)>1%
b)>2%

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c)>0.5%
d)None
CorrectAnswer-C
Ans.isi.e.,c.>0.5%[RefPark22"d/ep.571]
Nightblindness

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Bitot'sspots
>0.5%
Cornealxerosis/cornealulceration/keratomalacia >0.01%
Cornealulcer
>0.05%

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Serumretinol(lessthan10mcg/dl)
>5%

861.JowarisPellogerogenicduetoexcess
of-
a)Leucine

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b)Lysine
c)Tryptophan
d)Methioninc
CorrectAnswer-A
Ans.is'a'i.e.,Leucine

--- Content provided by‌ FirstRanker.com ---

oSimilartomaize,JowaralsoContainsexcessofleucine.
oLeucineinterfereswithconversionoftryptophantoniacin.
oPellagrahasbeenreportedinIndiainTelanganaareaofAndhra
PradeshbecauseofSower(Sorghumvulgare)consumption.

862.Toxinresponsibleforepidemicdropsy:

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AIIMS07;UP09;PGI11
a)BOAA
b)Aflatoxin
c)Sanguinarine
d)Pyrrozolidine

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.Sanguinarine

863.Maximumlinolenicacidispresentin?
a)Coconutoil
b)Soyabeanoil

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c)Groundnutoil
d)Saffloweroil
CorrectAnswer-D
Ans.is'd'i.e.,Saffloweroil[RefPark22"d/ep.566]
Therichestsourceoflinoleicacidissaffloweroil.Sourcesoflinoleic

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acidindecreasingorderaresaffloweroil>cornoil>Sunfloweroil>
Soyabeanoil>Sesameoil>groundnutoil.

864.Thehearttotheactivatedsludge
processis?
a)Primarysedimentationtank

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b)Sludgedigester
c)Aerationtank
d)Finalsettlingtank
CorrectAnswer-C
Ans.is'c'i.e.,Aerationtank
--- Content provided by FirstRanker.com ---
oTheheartoftheactivatedsludgeprocessisaerationtank.

865.Thicknessofleadaprontoprevent
radiation:
a)1mm
b)3mm

--- Content provided by FirstRanker.com ---

c)0.5mm
d)7mm
CorrectAnswer-C
Ans.C.0.5mm
"Itisrecommendedthatforgeneralpurposeradiographytheminimal

--- Content provided by FirstRanker.com ---

thicknessofleadequivalentintheprotectiveapparelshouldbe
0.5mm."
-TextbookofRadiologyPhysicsp.39
Leadapronof0.5mmthicknessreduceintensityofscatteredX-rays
byover90%.

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866.DalyrequirmentofvitaminK?
a)3mg/kg
b)0.3mg/kg
c)0.03mg/kg
d)1mg/kg

--- Content provided by‍ FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,0.03mg/kg[Ref.Park22"d/ep.572]
VitaminA600mcgretinol
VitaminB7(Thiamine)-->0.5mgper1000Kcalofenergyintake
VitaminB,(Riboflavin)0.6mgper1000Kcalofenergyintake

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VitaminB,(Niacin)6.0mgper1000Kcalofenergyintake
Vitamin135(PantothenicAcid)10mg
VitaminB6(Pyridoxine)2mg
VitaminB,(FolicAcid)200mcg
VitaminB12(Cobalamin)1mcg

--- Content provided by FirstRanker.com ---

VitaminD100IU(2.5mcgcalciferol)
VitaminE(Tocopherol)0.8mgpergmofessentialfattyacids
VitaminK0.03mgperkg

867.Avidinhasaffinityfor?
a)Folicacid

--- Content provided by FirstRanker.com ---

b)Thiamine
c)Biotin
d)Riboflavin
CorrectAnswer-C
Ans.is'c'i.e.,Biotin[Ref.Harper29iVep.539]

--- Content provided by FirstRanker.com ---

Peoplewhoeatabnormallylargeamountofuncookedeggwhite
mayhavebiotindeficiencybecauseitcontainsavidin,aproteinthat
bindsbiotinandpreventsitsabsorption

868.Argemainoilcontaminationofmustard
oilcanbedetectedby?

--- Content provided by FirstRanker.com ---

a)Phosphatasetest
b)Nitricacidtest
c)Coliformcunel
d)Methylenebluetest
CorrectAnswer-B

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Ans.is'b'i.e.,Nitricacidtest[Ref.Park22"d/ep.610]
DetectionofArgemoneoil:
1. Nitricacidtest:brownorangeredcolour/ringshowsitispresent
minimumconcentrationofArgemoneoilrequiredisabout0.2%.
2. Paperchromatographytest-Themostsensitivetest

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869.Iodinedeficiencycontrolprogramme?
a)Healtheducation
b)Watertesting
c)Fortificationofsalt
d)None

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,Fortificationofsalt
Iodizedsalt(saltfortifiedwithiodine)ismosteconomical,
convenientandeffectivemeansofmassprophylaxisin
endemicarea.

--- Content provided by FirstRanker.com ---

870.Amountofproteinsinhumanmilk(in
gms):
September2007
a)1.1
b)2.2

--- Content provided by‌ FirstRanker.com ---

c)3.3
d)4.4
CorrectAnswer-A
Ans.A:1.1
Each100gramsofbreastmilkyieldsapproximately:
--- Content provided by FirstRanker.com ---
65Kilocalories
88gwater
7.4gcarbohydrates(primarilylactose)
3.4gfat
1.1gprotein

--- Content provided by FirstRanker.com ---

871.Itwastecontaintoxicsubstances,
organicloadismeasuredby?
a)Biologicaloxygendemand
b)Chemicaloxygendemand
c)Suspendedsolid

--- Content provided by‌ FirstRanker.com ---

d)None
CorrectAnswer-B
Ans.is'b'i.e.,Chemicaloxygendemand[RefPark22"d/ep.708]
"Thestrengthofsewageisexpressedintermsof:
1. Biochemicaloxygendemand

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2. Chemicaloxygendemands
3. Suspendedsolidsdemand
BiochemicalOxygendemand
Itisthemostimportanttestdoneonsewage.Itisdefinedasthe
amountofoxygenabsorbedbyasampleofsewageduringa

--- Content provided by‍ FirstRanker.com ---

specifiedperiod,generally5days,ataspecifiedtemperature,
generally20deg.C,fortheaerobicdestructionoruseoforganic
matterbylivingorganisms.BODvaluerangesfromaboutImgper
litrefornaturalwaterstoabout300mgperlitreforuntreated
domesticsewage.IftheBODis300mg/1andabove,sewageis

--- Content provided by‌ FirstRanker.com ---

saidtobestrong;ifitis100mg/I,itissaidtobeweak."
Chemicaloxygendemand(COD)
TheCODmeasurestheoxygenequivalentofthatportionofthe
organicmatterinasamplewhichissusceptibletooxidationbya
strongchemicaloxidiser.Ifwastescontaintoxicsubsances,COD

--- Content provided by FirstRanker.com ---

maybetheonlymethodfordeterminingtheorganicload.
Suspendedsolids
Iftheamountofsuspendedsolidsis100mg/1,thesewageissaidto

beweak,iftheamountis500mg/dlthesewageissaidtobestrong

872.Fenthionis?

--- Content provided by FirstRanker.com ---

a)Spacespray
b)Residualspray
c)Stomachpoison
d)Fumgant
CorrectAnswer-A

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Ans.is'a'i.e.,Spacespray[RefPark22"dlep.727]
Residualsprapy
Inresidualspray,sprayingofhouseswithresidualinsectisidesis
done.
Residualinsectisidesremainsactiveoverextendedperiodsi.e.,they

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haveresidualactionevenafterthetimeofspray.
CommonlyusedresidualinsectisidesareMalathion,DDT,
Lindane,propoxure(OMS-33)
Spacespray
Spacespraysarethosewheretheinsecticidalformationissprayed

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intotheatmosphereintheformofamistorfogtokillinsect.
Actionisshortlivedandtemporarysincethereisno.residualaction.
ThemostcommonlyusedspacesprayinsecticideisPyrethrum.
Nowresidualinsectisidesarealsobeingusedasresidualsprayby
newequipmentforultra-lowvolume(ULV)spacespraying.

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Melathionandfenthionareusedforthispurpose.

873.Notsafedisposalbutgelidforsoil
building-
a)Incineration
b)Controlledtipping

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c)Composting
d)None
CorrectAnswer-C
Ans.is'c'i.e.,Composting
Composting

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C'ompostigisamethodofcombineddisposalofrefuseandnightsoil
orsluge.
oItisprocessofnaturewherebyorgaicmatterbreaksdownunder
bacterialactionresultingintheformationof
relativelystablehumus-likematerial,calledthecompostwhichhas

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considerablemanurialvalueforthesoil.
oCompostcontainsnoorfewdiseaseproducingorganismsandisa
goodsoilbuildercontainingsmallamountsof
themajorplantnutrientssuchasnitratesandphosphates.
oTherearefollowingtwomethodsofcomposting.

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i)Bangaloremethod(Anaerobicmethod)
ii)Mechanicalcomposting(Aaerobicmethod).

874.Inwinter,watervapoursandpollutants
comestolieinthelowermostlayerof
atmosphereby-

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a)Acidrain
b)Greenhouseeffect
c)Temperatureinversion
d)None
CorrectAnswer-C

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Ans.is`c'i.e.,Temperatureinversion
Atemperatureinversionisathinlayeroftheatmospherewherethe
normaldecreaseintemperaturewithheightswitheestothe
temperatureincreasingwithheight.
Aninversioncanleadtopollutionsuchassmogbeingtrappedclose
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tothegrand(lowerlayersofatmosphere).
Temperatureinversionmayoccurduringthepassageofacoldfront
orresultfromtheinvasionofseaairbyacooleronshorebreeze.
oOvernightradiativecoolingofsurfaceairoftenresultsina
nocturnaltemperatureinversionthatisdissipatedaftersunriseby

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thewarmingofairneartheground.

875.Vagabonddiseaseistransmittedby?
a)Louse
b)Mite
c)Tick

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d)BlackFly
CorrectAnswer-A
Ans.is'a'i.e.,Louse
Vagabond'sdiseaseispediculosiscorporis,causedbybodylouse.

876.Sourceofenvironmentalradiationareall

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except?
a)CO
b)Radium
c)Uranium
d)Radon

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CorrectAnswer-A
Ans.is'a'i.e.,CO[RefPark22'/ep.690]
Environmentalratiationareoftwotypes?
1. Terrestrial
2. Atmospheric

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Terrestrialradiation
Radioactiveelementssuchasthorium,Uranium,radiumandan
isotopofpotassium(K40)arepresentinman'sinvironment,e.g.,
soil,rocks,boiling.
Itisestimatedthatmanderivesabout50mradperyearfrom

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terrestrialradiation.
Areaexists(KeralainIndia)wheretherockformationcontaining
uranium,itcanbeashighas2000,mradayear.
Atmosphericradiation
Theseareradioactivegasesradonandthoron

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877.Theamountofbleachingpowder
necessarytodisinfectcholericstools,is
-
a)50gm/lit
b)75gm/lit

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c)90gm/lit
d)100gm/lit
CorrectAnswer-A
Ans.is'a'i.e.,50gm/lit

878.Socialpsychologyis?

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a)Humanrelationships&behaviour
b)Psychologyofindividualsinsociety
c)Culturalhistoryofman
d)None
CorrectAnswer-B

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Ans.is'b'i.e.,Psychologyofindividualsinsociety[Ref:Park
22"/ep.622]
StudyofhumanrelationshipsandhumanbehaviourSociology
PsychologyofindividualslivinginhumansocietySocial
psychology

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Studyofphysical,socialandculturalhistoryofmanAnthropology

879.Sociology-
a)Studyofhumanrelationship
b)Studyofbehavior
c)Both

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d)None
CorrectAnswer-C
Ans.is'c'i.e.,Both
oSociologydealswiththestudyofhumanrelationshipsandof
humanbehaviour.

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880.Studyofphysical,socialandcultural
historyofmanisknownas?
a)Socialscience
b)Anthropology
c)Acculturation

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d)Sociology
CorrectAnswer-B
Ans.is'bi.e.Anthropology
oAnthropologyisstudyofphysical,socialandculturalhistoryof
man.

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oAnthropologymaybe:
(i)Physicalanthropology:Studyofhumanevolution,racial
differences,inheritanceofbodilytraits,growthanddecayofhuman
organisms
(ii)Socialanthropology:Studyofthedevelopmentandvarious

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typesofsociallife.
(iii)Culturalanthropology:Studyoftotalwayoflifeofcontemporary
primitiveman.hiswayofthinking,feelingandaction.
(iv)Medicalanthropology:Dealswiththeculturalcomponentinthe
ecologyofhealthanddisease.

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881.Organizedgroupofpeoplewithsocial
relationship?
a)Community
b)Association
c)Society

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d)None
CorrectAnswer-C
Ans.is'c'i.e.Society[RefPark22'/ep.622]
Asocietyisabodyofindividualsofspecies,generallyseenasa
communityorgroup,thatisoutlinedbytheboundsoffunctional

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interdependence,comprisingalsopossiblecharactersorconditions
suchasculturalidentity,socialsolidarityoreusociality.
Humansocietiesarecharacterizedbypatternsofrelationships
betweenindividualsthatshareadistinctivecultureorinstitution.
Theimportanceofsocietyliesinthefactthatitcontrolsand

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regulatesthebehaviouroftheindividualbothbylawandcustoms.

882.Acculturationis?
a)Traige
b)Culturalchangesduetosocialisation
c)Attitude

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d)Belief
CorrectAnswer-B
Ans.is'b'i.e.,Culturalchangesduetosocialisation
Acculturationisaprocessofsocial,psychological,andcultural
changethatstemsfromthebalancingoftwocultureswhile
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adaptingtotheprevailingcultureofthesociety.Acculturation
isaprocessinwhichanindividualadopts,acquiresand
adjuststoanewculturalenvironment.

883.Chronologicalage10yrs,mentalage
4yrs.Whatthatpersoncalledas?

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a)Idiot
b)Imbecile
c)Normal
d)Genius
CorrectAnswer-B

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Ans.is'b'i.e.,Imbecile

884.M/CHeavyMetalpoisoninginThe
World?
a)Lead
b)Arsenic

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c)Mercury
d)Cadmium
CorrectAnswer-A
Ans.is'a'i.e.,Lead[RefPark22"'Ilep.752]
Moreindustrialworkersareexposedtoleadthananyothertoxic

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metal.

885.Allareoccupationalcancersexcept?
a)Lung
b)Bladder
c)Breast

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d)Liver
CorrectAnswer-C
Ans.is'c'i.e.,Breast
AsbestosMesothelioma
ArsenicSkin,Lung,Liver

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BenzeneLeukemia
BenzidineUrinarybladder
BeryliumLung
CadmiumLung
ChromiumNasalSinus,Lung

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886.Whichoccupationalexposuremaycause
sterilityinfemales?
a)Lead
b)Carbonmonoxide
c)Mercury

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d)Agriculturalinsecticides
CorrectAnswer-D
Ans.is'd'i.e.,Agriculturalinsecticides[RefHandbookofpesticide
toxicologyp.787
Pesticidesexposurecancause-

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1. Cancers:-Inmultipleorgansystems
2. Endocrineabnormalities
3. Infertilityandsterility
4. Braindamage
5. Birthdefects:-Oralclefts,neuraltubedefects,heartdefects,limb

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defects
6. Respiratorydisorders:-Wheezing,bronchitis,asthma
7. Organfailure:-Chronickidneydiseaseorinterstitialnephritis
8. Skinirritation

887.Effectofenvironmentongenesis

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called?
a)PositiveEugenics
b)NegativeEugenics
c)Euthenics
d)Enthenics

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CorrectAnswer-C
Ans.is'c'i.e.,Euthenics
Eugenics
Sciencewhichaimstoimprovethegeneticendomentofhuman
population.

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oThatisimprovingthequalityofthehumanspeciesorahuman
populationbygeneticmanipulation.
oEugenismaybe:
1.NegativeDiscouragingreproductionbypersonshaving
geneticdefectorpresumedtohaveinheritableundesirabletraitsthis

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includesabortions,sterilization&othermethodsfamilyplaning.
2.PostiveEugenics->Encouragingreproductionpresumedto
haveinheritabledesirabletrait.Forexample,invitro-fertilization,
cloning,eggtransplantationetc.
Euthenick
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Euthenicsdealwithhumanimprovementthroughalteringthe
externalenvironment(environmentalmanipulation).
Itincludeseducation,preventionandremovalofcontagiousdisease
andparasites,educationregardinghomeeconomics,sanitationand
housing.

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888.Hardly-weinberglawisrelatedto-
a)Populationgenetics
b)Healtheconomics
c)Socialmedicine
d)Noneoftheabove

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CorrectAnswer-A
Ans.is'a'i.e.,Populationgenetics
Hardly-Weinberglaw
Thehardly-weinherglawstatesthat"Therelativefrequencies
ofeachgenealleletendstoremainconstantfromgenerationto
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generation".
oThus,thestudyofgenefrequencies,andtheinfluences
whichoperatetoalterthe"genepool"andtheirlongterm
consequencesisthecentralthemeinpopulationgenetics.

889.Blackcolorintriage-

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a)Death
b)Transfer
c)Highpriority
d)Lowpriority
CorrectAnswer-A

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Ans.is'a'i.e.,Death

890.Trueabouttriage-
a)Yellow-leastpriority
b)Red-morbidity
c)Green-ambulatory

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d)Blue-ambulatory
CorrectAnswer-C
Ans.is'c'i.e.,Greenambulatory

891.Amountofwasteinfectiousproducedin
hospitals?

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a)45%
b)65%
c)80%
d)100%
CorrectAnswer-A

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Ans.is'a'i.e.,45%

892.BestforIncinerationofinfectiouswaste?
a)Double-chamber
b)Single-chamber
c)Triple-chamber

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Double-chamber
oThreebasickindsofincinerationtechnologyareofinterestfor
treatmentofhealhcarewastes:

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i)Double-chamberpyrolyticincineratorswhichmaybeespecially
designedtoburninfectioushealthcarewaste.
ii)Single-chamberfurnaceswithstaticgrate,whichshouldbe
usedonlyifpyrolyticincineratorsarenotaffordable.
iii)Rotarykilnsoperatingathightemperatures,capableofcausing

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decompositionofgenotoxicsubstancesandheat-resistant
chemicals.

893.Allaretrueaboutpaneldiscussion
except?
a)Twowaydiscussion

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b)6to20membersparticipates
c)Chiefmembersinitiates
d)Eachonepreparesthetopicofdiscussion
CorrectAnswer-B
Ans.is'b'i.e.,6-20membersparticipates
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Paneldiscussion
oItisatwowaycommunication.
4-8personswhoarequalifiedtotalkaboutatopicanddiscussa
givenprobleminfrontofalargegrouporaudience.
oThepanelcomprisesachairman.
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oThechairmanopensthemeeting,welcomesthegroupand
introducesthepanelspeakers.
oHeindroducestopicbrieflyandinvitethepanelspeakersto
presenttheirpointofview.
oAfterthemainaspectsofsubjectareexploredbypanelspeakers,

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theaudienceisinvitedtotakepart.
oIfmembersofthepanelareunacquaintedwiththismethod,they
mayhaveapreliminarymeeting,preparethematerialonthesubject
anddecideuponthemethodandplanofpresentation.

894.ICDSwaslaunchedat-

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a)Communitydevelopmentblock
b)Townlevel
c)Citylevel
d)Districtlevel
CorrectAnswer-A

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Ans.is'a'i.e.,Communitydevelopmentblock
oICDSwaslaunchedon2"dOctober1975in33Community
developmentblock.
oICDSprogrammeisagloballyrecognizedcommunitybasedearly
childcareprogramme,whichaddressesthebasicinterrelatedneeds

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ofyoundchildren,expectantandnursingmothersandadolescent
girlsacrossthelifecycle,inaholisticmanner.

895.KitBisgivenat-
a)PHC
b)Subccnter

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c)CHC
d)FRUlevel
CorrectAnswer-B
Ans.is'b'i.e.,Subcenter

896.Atraineddalcatersforapopulationof-

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a)1000
b)2000
c)3000
d)4000
CorrectAnswer-A

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Ans.is'a'i.e.,1000
Localdais(Traditionalbirthattendants)
UnderRuralHealthScheme,allcategoriesoflocaldiesaretrained
toimprovetheirknowledgeintheelementryconceptsof:-
i)MCH
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ii)Sterilization(Smallfamilynorm)
Training
Trainingisfor30workingdays.
oTheyarepaidastipendo/Rs.300duringtrainingperiod.
oTrainingisgivenfor2daysinaweekatPHC,subcentreorMHC

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centre.
oOntheremainingfourdaysoftheweektheyaccompanythe
healthworkerfemale.
oDuringhertrainingperiodeachdaiisrequiredtoconductatleast2
deliveriesunderthesupervisionofhealthworker.

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Thenationaltargetistotrainonelocaldaiineachvillage.
Note:Onevillageisequivalentto1000ruralpopulation.

897.Heighttoweightisa/an-
a)Association
b)Correlation

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c)Proportion
d)Index
CorrectAnswer-A
Ans.is'a'i.e.,Association
Firstreadaboutthesetworelatedterms:?
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oAssociation--->Associationmaybedefinedastheconcurrenceof
twovariablesmoreoftenthanwouldbeexpectedbychance.That
mean2variablesexistsimultaneously.
oCorrelation-->Correlationindicatesthedegree(strength)of
associationbetweentwovariables,i.e.relationshipbetweentwo

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quantitativevariables.
oHeighttoweightisanassociationandthestrengthofthis
associationisindicatedbycorrelation.

898.Correlationinheight&weightare
measuredby?

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a)Coefficientofvariation
b)Rangeofvariation
c)Correlationcoefficient
d)None
CorrectAnswer-C

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Ans.is'c'i.e.,CorrelationCoefficient

899.InaLeftskewedcurve,truestatement
is?
a)Mean=Median
b)Mean<Mode

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c)Mean>Mode
d)Mean=Mode
CorrectAnswer-B
Ans.is'b'i.e.,Mean<Mode

900.Trendscanberepresentedby-

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a)Linediagram
b)Bardiagram
c)Scatterdiagram
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Linediagram
Linediagram(Linechart/Linegraph)
oItisusedtoshowthetrendofeventswithpassageoftimeand
showshowthefrequencyofaparticulareventorvariablevaryover
time.

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901. Mostcommondeviationusedinsocial
medicineis-
a)Mean
b)Range
c)Variance

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d)Standarddeviation
CorrectAnswer-D
Ans.is'd'i.e.,Standarddeviation
"Standarddeviationismostcommonandgenerallymostappropriate
measureofdispersion(variation)".

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902. Thefrequentlyoccurringvalueinadata
is-
a)Median
b)Mode
c)Standarddeviation

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d)Mean
CorrectAnswer-B
Ans.is'b'i.e.,Mode

903.Analysisdoneforexpenditureoflarge
proportionforsmallnumberandvice
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versa?
a)ABCanalysis
b)SUSanalysis
c)HMLanalysis
d)VEDanalysis

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CorrectAnswer-A
Ans.is'a'i.e.,ABCanalysis

904.Bajajcommitteein1986proposed?
a)Multipurposehealthworker
b)Manpowerandplanning

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c)RuralHealthService
d)Integratedhealthservices
CorrectAnswer-B
Ans.is'b'i.e.,Manpowerandplanning

905.UnderRCHprogramme,intervention

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doneinselecteddistricts-
a)Immunization
b)TreatmentofSTD
c)ORStherapy
d)VitaminAsupplementation

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CorrectAnswer-B
Ans.is'b'i.e..TreatmentofSTD
oInterventionsinallDistricts
oChildsurvivalinterventionsi.e.,immunization,vitaminA(to
preventblindness),oralrehydrationtherapyandpreventionof

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deathsduetopneumonia.
Safemotherhoodinterventionse.g.,antenatalcheckup,
immunizationfortetanus,safedelivery,anaemiacontrolprogramme.
ImplementationofTargetFreeApproach
Highqualitytrainingatalllevels

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IECactivities.
SpeciallydesignedRCHpackageforurbanslumsandtribal
areas.
Districtsub-projectsunderlocalcapacityenhancement.
RTI/STDclinicsatDistrictHospitals(wherenotavailable).

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FacilityforsafeabortionsatPHCsbyprovidingequipment,
contractualdoctorsetc.
EnhancedcommunityparticipationthroughPanchayats,Women's
GroupsandNGOs.
Adolescenthealthandreproductivehygiene.

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ojnten.entionsinselectedStates/Distts.
aScreeningandtreatmentofRTI/STDatsub-divisionallevel.

EmergencyobstetriccareatselectedFRUsbyprovidingdrugs.
EssentialobstetriccarebyprovidingdrugsandPHN/StaffNurseat
PHCs.

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AdditionalANMatsub-centresintheweakdistrictsforensuring
MCHcare.
Improveddeliveryservicesandemergencycarebyproviding
equipmentkits.IUDinsertionsandANMkitsatsub-centres.
Facilityofreferraltransportforpregnantwomenduringemergency

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tothenearestreferralcentrethroughPanchayatinweakdistricts.
aEnhancedcommunityparticipationthroughPanchayats,Women's
GroupsandNGOs.
uAdolescenthealthandreproductivehygiene.
oInterventionsinselectedStates/Distts.

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ScreeningandtreatmentofRTI/STDatsub-divisionallevel.
EmergencyobstetriccareatselectedFRUsbyprovidingdrugs.
EssentialobstetriccarebyprovidingdrugsandPHN/Staff
NurseatPHCs.
AdditionalANMatsub-centresintheweakdistrictsforensuring

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MCHcare.
Improveddeliveryservicesandemergencycarebyproviding
equipmentkits,IUDinsertionsandANMkitsatsub-centres.
Facilityofreferraltransportforpregnantwomenduringemergency
tothenearestreferralcentrethroughPanchayatinweakdistricts.

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EnhancedcommunityparticipationthroughPanchayats,Women's
GroupsandNGOs.
Adolescenthealthandreproductivehygiene.
oInterventionsinselectedStates/Distts.
ScreeningandtreatmentofRTI/STDatsub-divisionallevel.

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EmergencyobstetriccareatselectedFRUsbyprovidingdrugs.
EssentialobstetriccarebyprovidingdrugsandPHN/StaffNurseat
PHCs.
AdditionalANMatsub-centresintheweakdistrictsforensuring
MCHcare.

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Improveddeliveryservicesandemergencycarebyproviding
equipmentkits,IUDinsertionsandANMkitsatsub-centres.
Facilityofreferraltransportforpregnantwomenduring
emergencytothenearestreferralcentrethroughPanchayatin

weakdistricts.

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906.Ujjwalaisfor-
a)Childabuse
b)Childtrafficking
c)Childlabour
d)None

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CorrectAnswer-B
Ans.is'b'i.e.,Childtrafficking
oThe'Ministryofwomen&childDevelopment'hasformulateda
newcomprehensiveschemeforpreventionoftraffickingandrescue,
rehabilitationandreintegrationofvictimsoftraffickingand

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commercialsexualexploitation.
oThenewschemehasbeenconceivedprimarilyforthepurpose
preventingtraffickingontheonehandandrescueandrehabilitation
ofvictimsontheother.
oTargetgroupincludes-

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i)Women&childrenwhoarevulnerabletotraffickingfor
commercialsexualexploitation.
ii)Women&childrenwhoarevictimsoftraffickingfor
commercialsexualexploitation.

907.NationalLeprosyEradicationProgramme

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wasstartedin-
a)1949
b)1955
c)1973
d)1983

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CorrectAnswer-D
Ans.is'd'i.e.,1983

908.Directcashtransferschemeto
adolescentgirlsiscoveredunder-
a)IndiraGandhischeme

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b)RajivGandhischeme
c)CSSM
d)RCH
CorrectAnswer-B
Ans.is'b'i.e.,RajivGandhiScheme

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oDirectcashtransferschemetoadolescentgirlscomesunder
"RajivGandhiSchemeforEmpowermentofAdolescentGirls"

909.Multi-purposeworkerschemeinIndia
wasintroducedfollowingthe
recommendationof?

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a)SrivastavaCommittee
b)BhoreCommittee
c)KartarSinghCommittee
d)fsludaliarCommittee
CorrectAnswer-C

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Ans.is'c'i.e.,KartarSinghcommittee
HealthPlanninginIndia
Theguidelinesfornationalhealthplanningwereprovidedbya
numberofcommittees.
oThesecommitteeswereappointedbytheGovernmentofIndia

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fromtimetotimetoreviewtheexistinghealthsituationand
recommendmeasuresforfurtheraction.

910.Middaymealprogrammecomesunder?
a)MinistryofSocialWelfare
b)Ministryofeducation

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c)MinistryofHumanResourcesDevelopments
d)None
CorrectAnswer-B
Ans.is'b'i.e.,Ministryofeducation
ItisalsocalledasNationalProgrammeofNutritionalSupportto

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PrimaryEducation.Itwaslaunchedin1995.Mid-daymealshould
provide1/3oftotalenergyand1/2oftotalproteinrequirements.

911.Simplestmeasureofmortality?
a)Crudedeathrate
b)Casefatalityrate

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c)Proportionalmortalityrate
d)Specificdeathrate
CorrectAnswer-A
Ans.is'a'i.e.,Crudedeathrate
oThesimplestmeasureofmortalityisthecrudedeathrate.

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912.Whatisabsentinbreastmilk?
a)VitK
b)VitC
c)Lactose
d)VitA

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CorrectAnswer-A
Ans.is'a'i.e.,VitaminK
oMilksfromthemotherwhosedietissufficientandproperly
balancedwillsupplyallthenecessarynutrientsexceptfluorideand
VitaminD.

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oTheironcontentofhumanmilkislow,butmostnormalterm
infantshavesufficientironstoresforthefirst4-6months.Human
milkironiswellabsorbed.Nonetheless,by6monthsthebreast-fed
infant'sdietshouldbesupplementedwithironfortified
complementaryfoods.

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oTheVitaminKcontentofhumanmilkislowandmaycause
hemorrhagicdiseaseofnewborn.

913.IMNCItargetgroup-
a)Upto5yrs
b)Upto10yrs

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c)Upto15yrs
d)Upto20yrs
CorrectAnswer-A
Ans.is'a'i.e.,Upto5years

914.Abovewhichlevelofheatstressindexit

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isnotpossibletoworkcomfortably-
a)20-40
b)40-60
c)60-80
d)80-100

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CorrectAnswer-B
Ans.isb'.,40-60
oHSI40-60causessevereheatstrainanditisnotpossibletowork
comfortably.

915.

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Studentsreceivehowmuchcereal/day
inmiddaymealprog-

a)50gm
b)100gm

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c)150gm
d)75gm
CorrectAnswer-D
Ans.is'd'i.e.,75gm

916.Lowglycemicindexisclassifiedasvaluelessthan:

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a)25
b)45
c)55
d)65
CorrectAnswer-C

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Conceptofglycemicindexhasutilityinmanagementofdiabetesandobesity.
GIrange
Classification
Example

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Mostfruitsandvegetablesexceptpotatoesandwatermelon,
LowGI
55orless pastabeans,lentils
MediumGI
56-69

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Sucrose,brownrice,basmatirice
70or
HighGI
Cornflakes,whitebread,candybar
more

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Ref:Park22ndedition,page568

917.Nutritionalsupplementfortwoyearold
childunderICDSschemeis-
a)200Calorie
b)300Calorie

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c)400Calorie
d)500Calorie
CorrectAnswer-D
Ans.is'd'i.e.,500calories
oUnderICDSSchemesupplementarynutritionisgivento:

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Childrenbelow6yrs
Nursingmothers
Expectantmothers
oTheaimistosupplementnutritionalintakefor
1)Eachchild6-72monthsofage--)500caloriesand12-15grams

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ofprotein(financialnormofRs6.00perchildperday).
2)Severelymalnourishedchild6-72monthsofage-->800calories
and20-25gramsprotein(financialnormofRs6.00perchildper
day).
3)Eachpregnantandnursingwoman600caloriesand18-20

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gramsofprotein(financialnormofRs5.00perbeneficiaryperday).
Undertherevisednutritionalandfeedingnormsforsupplementary
nutrition,Stategovernments/UTshavebeenmandatedtoprovide
morethanonemealtothechildrenwhocometoAWCs,which
includeprovidingamorningsnackintheformof

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milk/banana/egg/seasonalfruit/micronutrientfortifiedfoodfollowed
byahotcookedmeal.Forchildrenbelow3yearsofageand
pregnant&lactatingmothers,"takehomeration"istobeprovided.o
Supplementarynutritionisgivenfor300daysayear.

918.Blackdeath

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a)Plague
b)Dengue
c)TB
d)Cholera
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Answer-A.Plague
WhitediseaseAIDS
PovertydiseaseCholera
Hundreddaycough:Pertussis(Whoopingcough)
5dayfever:Trenchfever

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8"daydisease:Tetanus
Blacksickness:Kalaazar
Blackdeath:Plague

919.Irregularpupilisseenin?
a)Glaucoma

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b)Trauma
c)Occulomotorpulsy
d)Retinaldetachment
CorrectAnswer-B
Ans,B.Trauma
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Irregular:-Itisjaggedlookingandoccursmostoftenafterorbital
trauma.

920.Dioptericpowerisrelated-
a)Directlytosquareoffocallength
b)Inverselytofocallength

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c)Directlytofocallength
d)Inverselytosquareoffocallength
CorrectAnswer-B
Answer-B.Inverselytofocallength
Opticalpower(alsoreferredtoasdioptricpower,refractivepower,

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focusingPower,orconvergencePower)isthedegreetomirror,or
otheropticalsystemconvergesordivergeslight.

921.Visualaxisis
a)Centerofcorneatoretina
b)Objecttofovea

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c)Centeroflenstocornea
d)None
CorrectAnswer-B
Ans.Objecttofovea

922.Eyestructurewithmaximumrefractive

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power:
March2007
a)Anteriorsurfaceoflens
b)Posteriorsurfaceoflens
c)Anteriorsurfaceofcornea

--- Content provided by FirstRanker.com ---

d)Posteriorsurfaceofcornea
CorrectAnswer-C
Ans.C:Anteriorsurfaceofcornea
Togetherwiththelens,thecornearefractslight,accountingfor
approximatelytwo-thirdsoftheeye'stotalopticalpower.Inhumans,

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therefractivepowerofthecorneaisapproximately43dioptres.
Whilethecorneacontributesmostoftheeye'sfocusingpower,its
focusisfixed.
Thecurvatureofthelens,ontheotherhand,canbeadjustedto
"tune"thefocusdependingupontheobject'sdistance.

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923.Foster'sfusch'sspotsareseenin
a)Hypermetropiea
b)Myopia
c)Astigmatism
d)None

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CorrectAnswer-B
Ans.Myopia

924.Astigmatismisconsideredtobe:
a)Sphericalabberation
b)Curvaturalametropia

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c)Axialametropia
d)Indexametropia
CorrectAnswer-A
Ans.Sphericalabberation

925.Lowastigmatismindimlightisdue?

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a)Pupilconstriction
b)Pupildilatation
c)Increasedcurvatureoflens
d)Decreasedcurvatureoflens
CorrectAnswer-B

--- Content provided by⁠ FirstRanker.com ---

Ans.B.Pupildilatation

926.AwaveinERGisduetoactivityof:
a)Pigmentedepithelium
b)Rodsandcones
c)Ganglioncell

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d)Bipolarcell
CorrectAnswer-B
Ans.Rodsandcones

927.2ndPurkinjeimageis?
a)Erectandmovesinsamedirection

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b)Invertedandmovesinsamedirection
c)Erectandmovesinoppositedirection
d)Invertedandmovesinoppositedirection
CorrectAnswer-A
Ans.is'a'i.e.,Erectandmovesinsamedirection

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1stfromanteriorsurfac:ofcornea-->Erettanilmovesinsame
direction.
2ndfromposteriorsurfaceofcornea-->Erectandmovesinsame
direction.
3rdfromanteriorsurfaceoflens-->Erectandmoveinsame

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direction.
4thfromposteriorsurfaceoflens-->Invertedandmovesinopposite
direction

928.Cornealendothelialcellcountis
measuredby?

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a)Specularmicroscope
b)Ophthalmoscope
c)Synoptophore
d)Amsler'sgrid
CorrectAnswer-A

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Ans.is'a'i.e.,Specularmicroscope
Cornealendotheliumisexaminedwithspecularmicroscope,which
allowsaclearmorphologicalstudyofendothelialcellsincluding
photographicdocumentation.
Thecelldensityofendotheliumisaround3000cells/mm2inyoung

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adults,whichdecreaseswithadvancingage.

929.Featuresofvernalconjunctivitisare:
a)Shieldulcer
b)Horner-Tranta'sspots
c)Papillaryhypertrophy

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d)All
CorrectAnswer-D
Ans.A,BandC

930.Complicationofvernalkerato
conjunctivitis:

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a)Cataract
b)Keratoconus
c)Retinaldetachment
d)Vitreoushemorrhage
CorrectAnswer-B

--- Content provided by FirstRanker.com ---

Ans.Keratoconus

931.Treatmentofvernalkeratoconjunctivitis
includesallexcept:
a)Steroids
b)Chromoglycate

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c)Olopatadine
d)Antibiotics
CorrectAnswer-D
Ans.Antibiotics

932.Neonatalconjunctivitisiscausedbyall

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except:
a)Gonococcus
b)Chlamydia
c)Aspergillus
d)Pseudomonas

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CorrectAnswer-C
Ans.Aspergillus

933.Subconjunctivalcystisseenin?
a)Toxoplasmosis
b)Cysticercosis

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c)Leishmaniasis
d)Chaga'sdisease
CorrectAnswer-B
Ans.isbi.e.,Cysticercosis
Parasiticcystsoccursinsubconjunctivalcysticercus,hydatidcyst

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andfilarialcyst.

934.Whichbacteriapenetratesintactcornea
?
a)Corynebacterium
b)Pneumococcus

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c)Morexella
d)E.coli
CorrectAnswer-A
Ans.is'a'i.e.,Corynebacterium
Bacterialcornealulcer
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Bacterialcornealulcer,alsocalledsuppurativekeratitis,isdueto
organismsthatproducetoxinwhichcausetissuenecrosisandpus
formationinthecornealtissue.Purulentkeratitisisnearlyalways
exogenous,duetopyogenicorganism.Aslongasthecorneais
healthy,themajorityofbacteriaareunabletocrossoradheretothe

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cornealepithelium.Thereforethetwomainpredisposingfactorsfor
bacterialcornealulcerare:-
1. Damagetocornealepithelium
2. Infectionoftheerodedarea
However,thereareafewspeciesthatarecapableofpenetratingan
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intactepithelium:-
1. Neisseriagonorrhoea
2. Neisseriameningitidis
3. Corynebacteriumdiphtheriae
4. Listeriaspecies
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5. Haemophilusagyptus
Bacteriawhichcausecornealulcer(Purulentkeratitis)afterepithelial
injuriesare:-
1. Pseudomonas

2. Pneumococcus
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3. Streptococcusepidermidis
4. Staphylococcusaureus
5. Morexella
6. Enterobacterias
7. Proteus,Klebsiella)

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Althoughtherearespecificpresentationsdependingonthebacteria
involved,thereexistsaseriesofsymptomsandsignscommontoall
thatallowforarapiddiagnosis,andthereforeearlytreatmentof
cornealulcers.Themostimportantsymptomsarepain,lacrimation,
foreignbodysensation,conjunctivalinjection(redeye),photophobia
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andblurredvision.Thereislidswelling,blepharospasmandyellow
whiteareasofulcerwithswollenandoverhangingmarinmaybe
seen.

935.Herpetickeratitisistreatedby
a)Analgesics

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b)Atropine
c)Steroids
d)Idoxuridine
CorrectAnswer-D
Ans:Di.e.Idoxuridine
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DrugofchoiceforherpetickeratitisisAcyclovirQ(topical)
Otherantiviraldrugsusedare
Idoxuridine
Trifluorothyrnidine
Vidarabine

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936.Disciformkeratitisisseen?
a)HSV
b)HIV
c)HBV
d)Rubella

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CorrectAnswer-A
Ans.A.HSV

937.Satellitenodulesareseenin
a)Fungalcornealulcer
b)Tuberculosis

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c)Sarcoidosis
d)Viralulcer
CorrectAnswer-A
Ai.e.Fungalcornealulcer

938.Mostcommonprotozoancausing

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keratitisis
a)Plasmodium
b)Acanthamoeba
c)Toxoplasma
d)W.bancrofti

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CorrectAnswer-B
Ans.is`b'i.e.,Acanthamoeba[RefKanski8th/ep.197]
"Acanthamoebakeratitisisthemostcommonkeratitiscausedbya
protozoanespeciallyincontactlensusers".

939.Cornealdystrophy,trueis-

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a)Inflammatory
b)Neovascularization
c)Bilateral
d)All
CorrectAnswer-C

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Ans.C.Bilateral
CornealdystroPhyisagroupofdisorders,characterizedbyanon-
inflammatory,inherited,bilateralopacityofthecornea.
Thereisnovascularizationofcornea.
Dystrophiesareclassifiedaccordingtotheanatomicalinvolvement.

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940.Followingcornealtransplantation,most
commoninfectionoccur?
a)Staphepidermidis
b)Streptococcus
c)Klebsiella

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d)Pseudomonas
CorrectAnswer-A
Ans.A.Staphepidermidis
Pneumococcusandstaphylococcusaureushavebeenfoundtobe
thecommonestmicroorganismsinthedevelopedworld,whereas

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staphepidermidisisthecommonestindevelopingcountries,for
causinginfectiouskeratitisaftercornealtransplantations.

941.1stsignofanterioruveitis?
a)Keraticprecipitate
b)Aqueousflare

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c)Hypopyon
d)Miosis
CorrectAnswer-B
Ans.B.Aqueousflare

942.1stsignofiridocyclitis?

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a)Retrolentalflare
b)KP
c)Congestion
d)Trichiasis
CorrectAnswer-A

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Ans.A.Retrolentalflare

943.Mostcommoncauseofanterioruveitis?
a)CMV
b)Ankylosingspondylitis
c)Toxoplasma

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d)None
CorrectAnswer-A
Ans,A.CMV

944.Iritisinyoungpatientwithjointpain-
a)Gout

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b)RA
c)AS
d)Toxoplasma
CorrectAnswer-C
Ans,C.AS

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945.Commonestcomplicationofparsplanitis
?
a)Glaucoma
b)Cataract
c)Retinaldetachment

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d)Vitreoushemorrhage
CorrectAnswer-B
Ans.B.Cataract
Themostcommoncomplicationofintermediateuveitis(pers
ptanitis)iscystoidmacularedema,whichmaydecreasethevisual

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acuity.
2ndmostcommoncomplicationiscomplicatedcataract'
Othercomplicationincludesretinaldetachment.

946.Metamorphopsiaisseenin?
a)Anterioruveitis

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b)Posterioruveitis
c)Cataract
d)Glaucoma
CorrectAnswer-B
Ans.B.Posterioruveitis
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Matamorphopsiaisaconditioninwhichpatientsperceivedistorted
imagesoftheobject.
ItoccursinPosterioruveitisduetoalterationinretinalcontour'

947.Recurrentanterioruveitiswithincreased
intraoculartensionisseenin?

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a)Posnerschlossmansyndrome
b)Fosterkennedysyndrome
c)Vogt-koyanagi-haradasyndrome
d)None
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Ans.A.Posnerschlossmansyndrome
Glamatocycliticcrisis(posner-Schlossmansyndrome)isa
unilateralrecurrentnon-granulomatousiritisthatisassociatedwith
anelevatedocularpressureduringtheattacks'

948.

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Congenitalcataractcommonly
associatedwithvisualdefect?
a)PunctateCataract
b)Bluedotcataract
c)Zonularcataract

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d)Fusiformcataract
CorrectAnswer-C
Ans.C.Zonularcataract
Lamellar(Zonular)cataractisthemostcommontypeofcongenital
cataractpresentingwithvisualimpairment.

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Itisusuallybilateralandfrequentlycausesserverevisualdefects'

949.Decreasedreadingabilityisseenin?
a)Fusiformcataract
b)Zonularcataract
c)Bluedotcataract

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d)Punctatecataract
CorrectAnswer-B
Ans,B.Zonularcataract

950.Lenssubluxatesinhomocystinuria?
a)Inferotemporal

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b)Inferonasal
c)Superonasal
d)Superotemporal
CorrectAnswer-B
Ans.B.Inferonasal

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951.Secondsightisseenin?
a)Nuclearcataract
b)Corticalcataract
c)Zonularcataract
d)Punctatecataract

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CorrectAnswer-A
Ans.A.Nuclearcataract
Whenanuclearcataractdevelops,itcanbringaboutatemporary
improvementinnearvision,called'secondsight'.

952.Congenitalcataractwithvisual

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disturbancessurgeryshouldbedone?
a)Immediately
b)After2months
c)After4months
d)After1year

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CorrectAnswer-A
Ans.A.Immediately

953.Mostcommontypeofcongenital
cataractis?
a)Capsular

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b)Zonular
c)Coralliform
d)Bluedot
CorrectAnswer-D
AnsD.Bluedot
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Mostcommontypeofcongenitalcataract=punctate(bluedot)
cataract.
Mostcommontypeofcataractwhichisclinically(visually)significant
+zonularorlamellarcataract.

954.

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Treatmentoftraumaticcataractin
children?
a)ECCE+IOL
b)Lensectomy
c)Contactlens

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d)Glasses
CorrectAnswer-A
Ans.A.ECCE+IOL
Traumaticcataractinchildrenisacommoncauseofunilateralloss
ofvision.

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Penetratinginjuriesareusuallymorecommonthanbluntinjuries.
Atthetimeofpresentationaftertraumatoeye,primaryrepairofthe
cornealorscleralwoundisusuallypreferred,
CataractsurgeryGCCE)withIOLimplantationsisperformedlater
followingcompleteevaluationofdamagetotheintraocular

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structuresbyancillarymethodssuchasB-scanultrasonography.

955.Jackinboxscotomaisseenafter
correctionofAphakiaby?
a)IOL
b)Spectacles

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c)Contactlens
d)None
CorrectAnswer-B
Jack-in-the-boxphenomenonisseeninthecorrectionofaphakiaby
spectaclesduetotheprismaticeffectsattheedgeofthelens.

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Otherdifficultiesinthecorrectionofaphakiabyspectaclesinclude
thefollowing:
Imagemagnificationby25?30%.
PinCushiondistortion-asphericalaberrationduetothick
spectacles.

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RestrictedfieldwithJackintheBoxphenomenona/RovingRing
scotoma-aprismaticaberration.
Cosmetically,theeyeslookenlarged(Frogeyes)behindthethick
spectacles.
Physicalinconvenience.

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Treatmentofchoice:
correctionisobtainedbyintraocularlens(IOL).

956.Falseaboutphacolyticglaucoma?
a)Duetocontactofiristolens
b)Openangleglaucoma

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c)Seeninhypermaturestageofcataract
d)Lensinducedglaucoma
CorrectAnswer-A
Ans.A.Duetocontactofiristolens
Phacolyticglaucomaisanopenangleglaucomainhypermature

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stageofcataractduetoblockageoftrabecularmeshworkbyswollen
macrophages.
Glaucomaduetocontactofiristolens(pupillaryblockglaucoma)is
seeninphacomorphicglaucoma.

957.Neovascularglaucomaisseeninall

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except?
a)Diabetes
b)CRVO
c)Eale'sdisease
d)Openangleglaucoma

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CorrectAnswer-D
Ans.D.Openangleglaucoma
Itisasecondaryangleclosureglaucomawhichresultsdueto
formationofneovascularmembraneovertheirisi.e.,
neovascularizationofiris(rubeosisiridis).

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958.Laseriridotomyisdonein?
a)Angleclosureglaucoma
b)Openangleglaucoma
c)Pigmentoryglaucoma
d)None

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CorrectAnswer-A
Ans.A.Angleclosureglaucoma
TreatmentofchoiceforPACGisperipherallaseriridotomy.

959.Inacuteangleclosureglaucoma,primary
mechanismofpathogenesisis?

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a)Increasedsecretion
b)Increasedabsorptionbutincreasedsecretion
c)Outflowobstruction
d)None
CorrectAnswer-C

--- Content provided by⁠ FirstRanker.com ---

Ans,C.Outflowobstruction
Inacuteangleclosureglaucoma,riseinIOPoccursduetoblockage
ofaqueousoutflowbyclosureofanarrowerangleofanterior
chamber.

960.Notariskfactorforangleclosure

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glaucoma?
a)Smalleye
b)Hypermetropia
c)Smallcornea
d)Smalllens

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CorrectAnswer-D
Ans.D.Smalllens
PredisposingfactorsforPACG:-i)Shallowanteriorchamber,ii)
Shorteye(shortaxiallensth),i1i)Smallercornealdiameter,iv)
Anteriorlocationofiris-lensdiaphragm,v)Hlpermetropiceye,vi)

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Largelens(oldercataractous).

961.Bestdrugforopenangleglaucoma?
a)Latanoprost
b)Pilocarpine
c)Physostigmine

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d)Apraclonidine
CorrectAnswer-A
Ans.A.Latanoprost
Medicaltherapy:-Totalmedicaltherapyisthetreatmentofchoice
forPOAG.Topicalp-blockers(Timolol,Betoxalol,Levobunolol,

--- Content provided by‍ FirstRanker.com ---

carteolol)arethedrugsofchoice.
Topicalprostaglandinanalogues(Iatanoprost,bimatoprost,
travoprost)arethesecondchoicedrugs.

962.Broadestneuroretinalrimisseenin-
a)Suppole

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b)Infpole
c)Nasalpole
d)Temporallobe
CorrectAnswer-B
Ans.,B.Infpole
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Theneurorentinalrimistheareaofopticdiscwhichcontainsneural
elementsandislocatedbetweentheedgeoftheopticdiscandthe
physiologicalcup.
TheneuroretinalrinisbroadestInferiorly,followedbySuperior,
NasalandTemporalregionsindecreasingorderofthickness(the

--- Content provided by⁠ FirstRanker.com ---

ISNT)rule.

963.Retinitispigmentosaisduetodefectin
whichgene-
a)Scotopsin
b)Rhodopsin

--- Content provided by FirstRanker.com ---

c)Pigmentedepithelium
d)None
CorrectAnswer-B
Ans.B.Rhodopsin
Severaldifferentrhodopsingenemutationshavebeenidentifiedin

--- Content provided by FirstRanker.com ---

thepedigreeswithautosomaldominantretinitispigmentosa.

964.Ealesdiseaseis?
a)Recurrentopticneuritis
b)Recurrentpappilloedema
c)Recurrentperiphelbitisretinae

--- Content provided by FirstRanker.com ---

d)None
CorrectAnswer-C
Ans,C.Recurrentperiphelbitisretinae
Eale'sdiseaseisanidiopathicinflammatoryvenousocclusion
(phelbitis)thatprimarilyeffectstheperipheralretinai.e.,periphelbitis

--- Content provided by⁠ FirstRanker.com ---

andischaracterizedbyrecurrentbilateralvitreoushemorrhage.

965.Shaffer'ssignisseenin?
a)Retinitispigmentosa
b)Retinaldetachment
c)CRVO

--- Content provided by‍ FirstRanker.com ---

d)CRAO
CorrectAnswer-B
Ans.B.Retinaldetachment
Vitreousshowpigmentintheanteriorvitreous(tobaccodustingor
shaffersign),withposteriorvitreousdetachement.

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966.Depositinretinalmaculardegeneration?
a)Iron
b)Drusen
c)Lipochrome
d)Hemosiderine

--- Content provided by⁠ FirstRanker.com ---

CorrectAnswer-B
Ans.B.Drusen
DryformofARMDbeginswithcharacteristicyellowdepositsinthe
maculacalleddrusenbetweentheretinalpigmentepitheliumandtie
underlyingchoroid

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967.Vitreoushemorrhageindiabetic
retinopathy?
a)Non-proliferativediabeticretinopathy
b)Proliferativediabeticretinopathy
c)Both

--- Content provided by‍ FirstRanker.com ---

d)None
CorrectAnswer-B
Ans.B.Proliferativediabeticretinopathy

968.Headlightinfogappearanceisseenin?
a)Syphilis

--- Content provided by‌ FirstRanker.com ---

b)Toxoplasmoss
c)Toxocara
d)Herpes
CorrectAnswer-B
Ans.B.Toxoplasmoss
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Onfundoscopicexamination,thereisdiffuse"headtightinthe
fogappearance,incongenitaltoxoplasmosis.
Thisisduetocombinationofactiveretinallesioninthecenterwith
depigmentation(theheadlight)andseverevitreousinflammation
(thefog).

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969.Salt&pepperfundus?
a)Congtoxoplasmosis
b)Conghistoplasmosis
c)Congenitalsyphilis
d)None

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CorrectAnswer-C
Ans.C.Congenitalsyphilis

970.Cattletrackappearence?
a)CRVO
b)CRAO

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c)Diabeticretinopathy
d)Syphiliticretinopathy
CorrectAnswer-B
Ans.B.CRAO

971.Eale'sdiseaseis?

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a)Retinalhemorrhage
b)Vitreoushemorrhage
c)Conjunctivalhemorrhage
d)Choroidalhemorrhage
CorrectAnswer-B

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Ans.B.Vitreoushemorrhage
Eale'sdiseseisanidiopathicinflammatoryvenousocclusionthat
primarilyaffectstheperipheralretinaofyoungadult(20-30yrs)
male.
Itischaracterizedbyrecurrentbilateralvitreoushemorrhage;

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therefore,alsoreferredtoasprimaryvitreoushemorrhage.

972.Extraretinalfibrovascularproliferationat
ridgeis?
a)Normal
b)StageIROM

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c)StageIIROM
d)StageIIIROM
CorrectAnswer-D
Ans.D.StageIIIROM
DiseaseSeverity(Stage)

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PriortothedevelopmentofROPintheprematureinfant,
vascularizationoftheretinaisincompleteor"immature"(Stage0).
Stage1:DemarcationLine:Thislineisthinandflat(intheretina
plane)andseparatestheavascularretinaanteriorlyfromthe
vascularizedretinaposteriorly.

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Stage2:Ridge:Theridgearisesfromthedemarcationlineandhas
heightandwidth,whichextendsabovetheplaneoftheretina.The
ridgemaychangefromwhitetopinkandvesselsmayleavethe
planeoftheretinaposteriortotheridgetoenterit.Smallisolated
tuftsofneovasculartissuelyingonthesurfaceoftheretina,

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commonlycalled"popcorn"maybeseenposteriortothisridge
structureanddonotconstitutethedegreeoffibrovasculargrowth
thatisanecessaryconditionforstage3.
Stage3:ExtraretinalFibrovascularProliferation:Neovascularization
extendsfromtheridgeintothevitreous.Thisextraretinal

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proliferatingtissueiscontinuouswiththeposterioraspectofthe
ridge,causingaraggedappearanceastheproliferationbecomes
moreextensive.
Stage4:PartialRetinalDetachment:Stage4,intheinitial
classificationwasthefinalstageandinitiallyknownasthecicatricial

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classificationwasthefinalstageandinitiallyknownasthecicatricial
phase.Itwaslaterdividedintoextrafoveal(stage4A)andfoveal
(stage4B)partialretinaldetachments.Stage4retinaldetachments
aregenerallyconcaveandmostarecircumferentiallyoriented.
Retinaldetachmentsusuallybeginatthepointoffibrovascular

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attachmenttothevascularizedretinaandtheextentofdetachment
dependsontheamountofneovascularizationpresent.
Stage5:TotalRetinalDetachment:Retinaldetachmentsare
generallytractionalandusuallyfunnelshaped.Theconfigurationof
thefunnelitselfisusedforsubdivisionofthisstagedependingifthe

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anteriorandposteriorportionsareopenornarrowed

973.Allareseenin3'nervepalsy?
a)Mydriasis
b)Lossoflightreflex
c)Lossofabduction

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d)Ptosis
CorrectAnswer-C
Ans.C.Lossofabduction

974.Swinginglighttestispositivein?
a)Conjunctivitis

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b)Glaucoma
c)Retrobulbarneuritis
d)Keratoconus
CorrectAnswer-C
Ans.C.Retrobulbarneuritis
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Swingingflashlightisusedforrelativeefferentpathwaydefect
(RAPD)whichismostcharacteristicofIesionsintheopticnerve.
Thusitispositiveinretrobulbarneuritis.

975.Optictractlesioncauses?
a)Wernicke'shemianopicpupil

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b)Amauraticpupil
c)Amauraticpupil
d)None
CorrectAnswer-A
Ans,A.Wernicke'shemianopicpupil
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Wernicke'shemianopicpupilisseenincompletelesionofoptictract.

976.Amblyopiaiscausedby?
a)Methylalcohol
b)Penicillin
c)Propranolol

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d)None
CorrectAnswer-A
Ans.A.Methylalcohol
Toxicamblyopiaischronicretrobulbarneuritiswhichresultsfromthe
damagetoopticnervebytheexogenouspoisons.

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Thetoxicagentsinvolvemaybe:Tobacco,ethylatcohol,ethylene
glycol,Iead,arsenic,cannabisindica,carbondisulphidevarious
drugs

977.VitaminB12deficiencycauses?
a)Centrocaecalscotoma

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b)Binasalhemianopia
c)Constrictionofperipheralfield
d)Bitemporalhemianopia
CorrectAnswer-A
Ans.,A.Centrocaecalscotoma
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VitaminB12deficiencycausesopticneuritis.
Mostcommonvisualfielddefectinopticneuritisiscentralor
centrocaecalscotoma.

978.Causeofbilateralopticatrophy?
a)Traumatoopticnerve

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b)Intracranialneoplasma
c)CRAO
d)Opticneuritis
CorrectAnswer-B
Ans.B.Intracranialneoplasma

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979.
Earliestmuscletoinvolveinthyroid
ophthalmopathy?
a)MR
b)LR

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c)IR
d)SR
CorrectAnswer-C
Ans.C.IR

980.Whichofthefollowingislongest

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extraocularmuscle?
a)SR
b)MR
c)SO
d)IO

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CorrectAnswer-C
Ans.C.SO
Thesuperiorobliqueisthelongest,thinnestextraocularmuscle.

981.Treatmentofchoiceforamblyopiais?
a)Convergentexercises

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b)Spectacles
c)Surgery
d)Conventionalocclusion
CorrectAnswer-D
Ans.D.Conventionalocclusion
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Thetreatmentofamblyopiashouldbeginasearlyaspossible.
Theamblyopiceyefailstodevelopvisionandvisualimpairment
remainsPermanentunlessitistreatedbeforetheageof7years.
Amblyopictherapyworksbestwhenintitiatedinyoungchildren
under3yearsofage.

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982.Aftertrauma,Apersoncannotmoveeye
outwordbeyondmidpoint.Thenerve
injuredis?
a)2nd
b)3rd

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c)4th
d)6th
CorrectAnswer-D
Ans,D.6th
Alltheextraocularmusclesaresuppliedby3rdcranial(occulomotor)

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nerveexceptforsuperiorobliqueandlateralrectus.superioroblique
muscleissuppliedby4thcranial(trochlear)nerve,andlateralrectus
muscleissuppliedby6thcranial(abducent)nene.Besidethese
extraocularmuscles,occulomotor(3rd)nervealsosupplieslevator
palpebraesuperioris,sphinctorpupillae(causespupillary

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constriction),andciliarymuscle(causesaccommodation).

983.Angleofsquintismeasuredby?
a)Gonioscopy
b)Prism
c)Retinoscopy

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d)Keratometry
CorrectAnswer-B
Ans.B.Prism

984.Mostcommoncauseofophthalmoplegia
?

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a)Aneurysm
b)Infection
c)Mystheniagravis
d)None
CorrectAnswer-A

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Ans.A.Aneurysm
Themostcommonindentifiableetiologiesareischemia,aneurysm,
tumorandttauma;some20%remainunexplained.

985.Ataxia,nystagmusandophthalmoplegia
isseenin-

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a)Mystheniagravis
b)Chronicprogressiveexternalophthalmoplegia
c)3rdnervepalsy
d)None
CorrectAnswer-B

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Ans.B.Chronicprogressiveexternalophthalmoplegia
Themostcommonidentifiableetiologiesareischemia,aneurysm,
tumorandtrauma,some20%remainunexplained.

986.Childwithmildsquint.Intrauterine,birth
history,developmentalhistorytilldateall
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normal.Cornealreflexnormal.Allother
eyeparametersnormalexcept
exaggeratedepicanthalfold.Diagnosis?
a)Pseudostrabismus
b)Accommodativesquint

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c)Exophoria
d)Esophoria
CorrectAnswer-A
Ans,A.Pseudostrabismus
Pseudoesotropia(apparentconvergentsquint-Duetoprominent

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epicanthalfold.
Pseudoexotropia(apparentdivergentsquint-Duetohypertelorism.

987.MCorbitaltumor?
a)Nervesheathtumor
b)Hemangioma

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c)Lymphoma
d)Meningioma
CorrectAnswer-B
Ans.B.Hemangioma
Mostcommonorbitaltumor-Cavernoushemangioma.

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Mostcommonmalignantorbitaltumor?Lymphoma.

988.
Mostcommonorbitaltumorhasits
originfrom?
a)Bloodvessels

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b)Nerves
c)Muscle
d)Lymphnode
CorrectAnswer-A
Ans,A.Bloodvessels
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Mostcommonorbitaltumorsarebenignvasculartumors-
Cavernoushemangioma.

989.Mostcommonmalignanttumourof
eyelidis?
a)Sebaceousglandcarcinoma

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b)Basalcellcarcinoma
c)Squamouscellcarcinoma
d)Malignantmelanoma
CorrectAnswer-B
Ans,b.Basalcellcarcinoma
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Basalcellcarcinomaisthemostcommonmalignanttumourofthe
eyelidsandconstitutes85-90%ofallmalignantepithelialeyelid
tumours.

990.Mostcommoncarcinomaofconjunctiva
?

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a)SquamouscellCa
b)Basalcellca
c)Melanoma
d)Lymphoma
CorrectAnswer-A

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Ans.A.SquamouscellCa
Squamouscellcarcinomaisthemostcommonmalignantlesionof
theconjunctiva"

991.Retinalastrocytomaisseenin?
a)Tuberoussclerosis

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b)Sturgewebersyndrome
c)VonHippel-Lindausyndrome
d)None
CorrectAnswer-A
Ans.A.Tuberoussclerosis

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992.Fusionofpalpebralandbulbar
conjunctivais-
a)Symblepharon
b)Trichiasis
c)Ectropion

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d)Tylosis
CorrectAnswer-A
Ans.A.Symblepharon
Adhesionofthelidstoeyeballiscalledsymblepharon.
Itoccursduetofusionofpalpebralconjunctiva(coveringinner

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surfaceoflid)tobulburconjunctiva(coveringoutersurfaceof
eyeball).

993.Lossofeyelashesis?
a)Tylosis
b)Madarosis

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c)Trichiasis
d)Ectropion
CorrectAnswer-B
Ans.B.Madarosis
Madarosisrefertolossofeyelashesandsometimesalsoeyebrows

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994.Madarosisisseenin?
a)Addison'sdisease
b)Hypothyroidism
c)Acromegaly
d)None

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CorrectAnswer-B
Ans.B.Hypothyroidism
MadarosismaYbeseenin-
Rubella
CongenitalSyphilis

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Congenitalleberamaurosis
MayousBattendisease
Thioridazinetoxicity

995.Abnormallyeccentricplacedpupilis
called?

--- Content provided by FirstRanker.com ---

a)Polycoria
b)Corectopia
c)Corectopia
d)Ectopialentis
CorrectAnswer-B

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Ans.B.Corectopia

996.Massagingofnasolacrimalductisdone
in?
a)Acutedacryocystitis
b)Congenitaldacryocystitis

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c)Conjunctivitis
d)None
CorrectAnswer-B
Ans.B.Congenitaldacryocystitis
Massageoverlacrimalsacisthemainstayoftreatmentincongenital

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dacryocystitis.

997.Mostcommoncauseofintermittent
proptosis?
a)Orbitalvarix
b)Thyroidophthalmopathy

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c)Neuroblastoma
d)Retinoblastoma
CorrectAnswer-A
Ans.A.Orbitalvarix
Intetmittentproptosis:-Proptosisdevelopingintermittentlyand

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rapidlyinoneeyewhenvenousstasisisinducedbyforwardbending
orloweringthehead,turningtheheadforcibly,hyperextensionofthe
neck,coughing,forcedexpirationwithorwithoutcompressionofthe
nostrils,orpressureonjugularveins.Themostimportantcasueis
orbitalvarix(varicocele).

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998.Bilateralptosisisseeninallexcept?
a)Hyperthyroidism
b)Congenital
c)Trauma
d)Myotonicdystrophy

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CorrectAnswer-C
Ans,C.Trauma

999.Unilaterallacrimalglanddestructionmay
becausedby?
a)Inferiororbitalfissurefracture

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b)Fractureofroofoforbit
c)Fractureoflateralwall
d)Fractureofsphenoid
CorrectAnswer-B
Ans.B.Fractureofroofoforbit
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Damagetothesuperiororbitalstructures,infractureofroofoforbit,
cancausediplopia,ptosis,opticneuropathy,ptosis,neuroPathyand
lacrimalglandinjury.

1000.Alkalicauses?
a)Symblepharon

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b)Papilloedema
c)Opticneuritis
d)Retinaldetachment
CorrectAnswer-A
Ans,A.Symblepharon

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1001.Expulsivehemorrhageincataract
surgeryisfrom?
a)Vortexvein
b)Ciliaryartery
c)Choroidalvein

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d)None
CorrectAnswer-B
Ans,B.Ciliaryartery
Expulsivehemorrhageaftercataractextractionorglaucomasurgery
=Ruptureofciliaryartery.

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ExpulsivehemorrhageinRetinal/Vitrousoperation=Directtrauma
tochoroidalorvortexvein.

1002.Coloboma,mostcommonsite?
a)Superotemporal
b)Inferonasal

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c)Inferotemporal
d)Superonasal
CorrectAnswer-B
Ans.B.Inferonasal
Acolobomaisaholeinoneofthestructuresofeye,suchasiris,

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retina,choroidoropticdisc.
Theeyedevelopsintheembryo,fromtheopticcupandoptic
fissure.Theopticfissurefusesat5-7weeksdevelopment.
Failureofthisfusionleadstoagapinoculartissueknowas
coloboma,typicallylocatedintheinferonasalquadrant.

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1003.Irisclobomaismostcommonin?
a)Inferotemporal
b)Soperotemporal
c)Inferonasal
d)Soperonasal

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CorrectAnswer-C
Ans.C.Inferonasal
Allclobomas(includingiris)aremostlyinferonasal.

1004.Enucleationisindicatedin?
a)Acutecongestiveglaucoma

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b)Panophthalmitis
c)Retinoblastoma
d)None
CorrectAnswer-C
Ans,C.Retinoblastoma
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IndicationsofEnucleation
Absolute=Retinoblastoma,malignantmelanoma.
Relative=Painfulblindeye,mutilatingocularinjury,anterior
staphyloma,phthisisDalEi,endophthalmitis,congenital
anophthalmiaorseveremicrophthalmia.

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1005.Cornealtattooingisdoneby?
a)Goldchloride
b)Silverchloride
c)Titaniumchloride
d)Aluminiumchloride

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CorrectAnswer-A
Ans.A.Goldchloride
FortattooingIndianblackinkgoldchlorideorplatinummaybeused.

1006.Staphlyomainvolvement?
a)Iriswithconjunctiva

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b)Conjunctivawithcornea
c)Choroidwithretina
d)Iriswithcornea
CorrectAnswer-D
Ans.D.Iriswithcornea
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Staphylomaisanabnormalprotrusionofuvealtissue(irisorciliary
bodyorchoroid)throughaweekandthinportionofcorneaorsclera.
So,staphylomaislinedinternallybyuvealtissue(irisorciliarybody
orchoroid)andexternallybyweakcorneaorsclera.

1007.65yearoldpersonwithhearingloss

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withnormalspeechdiscriminationis
sufferingfrom?
a)Noiseinducedhearingloss
b)Presbycusis
c)Ototoxicdrug

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d)NOHL
CorrectAnswer-B
Ans.is'B'i.e.,Presbycusis
Informationinthisquestionare:-(i)Oldage(65years),(ii)Hearing
loss,and(iii)Preservedspeechdiscrimnation.

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DiagnosisisPresbycusis.
Presbycusis
Presbycusisreferstosensorineuralhearinglossinelderly
individuals
Characteristically,presbycusisinvolvesbilateralhigh

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frequencyhearinglossassociatedwithdifficultyinspeech
discriminationandcentralauditoryprocessinginformation.
Fourpathologicaltypesofpresbycusishavebeenidentified:-
SensorypresbycusisThereisepithelialatrophywithlossofsensory
haircellsandsupportingcellsintheorganofcorti.This

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processstartsinthebasalturnofcochleaandslowlyprogress
towardstheapex.Higherfrequenciesareaffectedbutspeech
discriminationispreserved.
Neuralpresbycusis:-Thereisatrophyofnervecellsinthecochlea
andcentralneuralpathways.Atrophyoccursthroughoutthe

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cochlea,withthebasilarregiononlyslightlymorepredisposedthan

theremainderofthecochlea.Therefore,noprecipitousdropin
thresholdonaudiometryisobserved.Speechdiscriminationispoor.
Metabolic(strial)presbycusis;;-Thereisatrophyofstriavascularis.
Atrophyresultsinhearinglossrepresentedbyflataudiogram,but

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speechdiscriminationispreserved.
Mechanical(cochlearconductive)presbycusis:-Thereisthickening
andsecondarystiffeningofthebasilarmembraneofthecochlea.
Thethickeningismoresevereinthebasalturnofcochleawherethe
basilarmembraneisnarrow.Thiscorrelateswithagraduallysloping

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highfrequencysensorineuralhearingloss.Speechdiscriminationis
average.

1008.Athleticsyndromeischaracterizedby:
a)IncreasedamplitudeofQRS
b)Tachycardia

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c)DecreasedQTinterval
d)U-waves
CorrectAnswer-A
TheanswerisA(IncreasedamplitudeofQRScomplex):
AthleticHeartSyndrome
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AthleticHeartSyndromeisabenignconditionconsistingof
physiologicadaptationstotheincreasedcardiacworkloadof
exerciseintrainedathletes.
Itrepresentsaconstellationofclinicalfindingsthataretheresultof
normalphysiologicadaptationtostrenuousphysicalactivity.

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Inresponsetotheincreasedphysicaldemand,theleftventricles
dilateandwallthicknessincreases.Themasstovolumeratio,
however,doesnotchange.
Physicalexamination
Decreasedbodyfatandincreasedmusclemass(generallyvery

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physicallyfit)
Pulseslowandoftenirregular(sinusbradycardiaorbradycardiawith
first-andsecond-degreeblocks)
GradeIorIImid-systolicmurmurs(benignfunctionalejection
murmurresolveswithValsalvamaneuver)

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Thirdandfourthheartsoundsverycommon(benignfillingsounds)
Bloodpressuretypicallyremainsnormal
Electrocardiogramrhythm
Rhythm
-Sinusbradycardiaof40to55beats/minwhileatrest

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-Sinuspausesofmorethan2.0secondsduetoincreasedvagal
tone
-Wanderingatrialpacemakerfoundonlyindynamicathletes
-Firstdegreeatrioventricularblockpresentonlyatrest;P-Rinterval
normalizeswithexercise

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-Seconddegreeatrioventricularblockpresentonlyatrest:MobitzI
(wenckebachblock)commoninmarathonrunners;MobitzIIrarein
athlete'sheart.
Voltage:TORSvoltage(Amplitude)
-Leftventricularhypertrophyfoundin85%ofOlympicmarathon

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runners
-Rightventricularhypertrophycommonindynamicathletesbut
rarelyseeninsedentarycontrolsandstaticathletessedentary
controlandstaticathletes
Repolarization

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-S-TsegmentelevationwithpeakedTwavesnormalizeswith
exertion
-S-Tsegmentdepressionmayberarelyfoundinathletes
T-waveinversioninlateralleadsassociatedwithinterventricular
septalhypertrophyinstaticathletes(canbeanormalfindingin

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dynamicathletes)
Chestradiography
-Theheartisglobularinappearance,particularlyinendurance
athletes.
-Cardiomegaly(cardiothoracicratio>0.50)

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1009.TallTwavesonECGareseenin:
a)Hyperkalemia
b)Hypokalemia
c)Hypercalcemia
d)Hypocalcemia

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CorrectAnswer-A
AnswerisA(Hyperkalemia)
HyperkalemiaistypicallyassociatedwithTallpeakednarrowbased
frntedTwave.

1010.-30?to-60?leftaxisdeviationisseen

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in
a)Leftventricularhypertrophy
b)Rightventricularhypertrophy
c)Aorticstenosis
d)Leftatrialenlargement

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CorrectAnswer-A
Answer-A.Leftventricularhypertrophy
Normally,QRSaxisrangesfrom-30?to90?C
Anaxismorenegativethan-30?isreferredtoasleftaxisdeviation
andanaxismorepositivethan+100?iscalledrightaxisdeviation

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Leftaxisdeviation
Axismorenegativethan-30?
Associatedwith
Leftventricularhypertrophy
Leftanteriorfascicularblock

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InferiorM.I.

1011.Kussmaul'ssignisclassically
describedin:
a)RestrictiveCardiomyopathy
b)PericardialTamponade

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c)Constrictivepericarditis
d)RightVentricularInfarct
CorrectAnswer-C
AnswerisC(Constrictivepericarditis)
Kussmaul'ssignisclassicallydescribedinassociationwith
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ConstrictivePericarditis.
Kussmaul'ssignreferstoparadoxicalelevationofJVP/CVPduring
inspiration(Inhealthypersonsvenouspressurefallsduring
inspirationbecausepressuresintherightheartdecreaseas
intrathoracicpressuresfall)TheKussmaul'ssignisclassically
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describedinassociationwithConstrictivepericarditis.Kussmaul's
signishoweveralsoseeninassociationwithRightVentricular
Infarction,RestrictiveCardiomyopathy,PulmonaryEmbolismand
AdvancedSystolicSevereHeartFailure

1012.Jawtightnessistypicallyseenin:

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a)PAN
b)Coarctationofaorta
c)Giantcellarteritis
d)Wegner'sGranulomatosis
CorrectAnswer-C

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AnswerisC(GiantCellArteritis):
JawClaudication(lawTightness)isatypicalmanifestationof
TemporalarteritisorGiantcellarteritis.

1013.The9montholdchildofadiabetic
motherpresentswithtachypneaand
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hepatomegaly.Echocardiographyofthe
heartshowednormalcardiac
morphologywithasymmetricseptal
hypertrophy.Whichofthefollowingyou
willgivetotreatthischild:

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a)Digoxin
b)Frusemide
c)Propranolol
d)Isoptin
CorrectAnswer-C

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AnswerisC(Propranolol)
Thesymptomsofthepatientandechocardiographicfindingof
asymmetricalseptalhypertrophyalmostconfirmsthediagnosisof
Hypertrophiccardiomyopathy.BetaBlockersshouldbetheinitial
drugQinsymptomaticindividuals
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ManagementofHOCM

Avoidanceofstrenuousphysicalactivity
BetaBlockersshouldbetheinitialdrugQinsymptomaticindividuals.
Theyreduce:

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-Heartrate

-Bloodpressure

-Stiffnessofleftventricle

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-Fatalarrythmias
CalciumchannelBlockersQ(verapamilanddiltiazem)arealternative
drugs.
-Theyreduce-stiffnessofventricle
-Elevateddiastolicpressures

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Amiadaronemaybeusedtoreducearrythmias.
Surgicalmyomectomy

1014.Paradoxicalsplittingofsecondheart
soundisseenin?
a)RBBB

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b)ASD
c)LBBB
d)VSD
CorrectAnswer-C
AnswerisC(LBBB)
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LeftBundleBranchBlock(LBBB)istypicallyassociatedwith
ReversedorParadoxicalSplittingofS2
ParadoxicalsplittingofsecondheartsoundiscausedbydelayedA2
orearlyP2.LeftBundleBranchBlock(LBBB)isassociatedwith
delayedAorticclosure(delayedA2)duetodelayedelectrical
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activationoftheleftventricle.
ASDandRBBBareassociatedwithawidephysiological(non-
paradoxical)splitofsecondheartsoundduetodelayedpulmonic
closure(DelayedP2)whileVSDisassociatedwithawide
physiological(non-paradoxical)splitsecondheartsoundfromearly
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aorticclosure(EarlyA2).

1015.Whichisincreasedinplasmaofchronic
heartdiseasepts
a)BNP
b)Endothelin1

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c)Cortisol
d)None
CorrectAnswer-A
Answer-A.BNP
Theplasmaconcentrationsofbothhormonesareincreasedin

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patientswithasymptomaticandsymptomaticleftventricular
dysfunction,permittingtheiruseindiagnosis.
BNPlevelsaresimpleandobjectivemeasuresofcardiacfunction.
Thesemeasurescanbeusedtodiagnooseheartfailureincluding
diastolicfunction.

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1016.Inasthmadiagnosisisby
a)FEVi
b)Measurementoftidalvolume
c)Endexpiratoryflowrate
d)Totallungcapacity

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CorrectAnswer-A
Answer-A.FEVi
Asthmaisclassifiedaccordingtothefrequencyofsymptoms,forced
expiratoryvolumeinonesecond(FEV1),andpeakexpiratoryflow
rate.

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Spirometryisrecommendedtoaidindiagnosisandmanagement.It
isthesinglebesttestforasthma.IftheFEV1measuredbythis
techniqueimprovesmorethan12%andincreasesbyatleast200
millilitersfollowingadministrationofabronchodilatorsuchas
salbutamol,thisissupportiveofthediagnosis.

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1017.Apersonhasasthmaattacksmorethan
onceduringdayandonceduringnight
a)Mildintermittentasthma
b)Mildpersistentasthma
c)Moderateasthma

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d)Severeasthma
CorrectAnswer-D
Answer-D.Severeasthma
Severeasthma
Symptoms-Throughoutday

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Nightawakenings-Daily
Short-actingB2-agonistuseforsymptomcontrol-Severaltimesper
day
Interferencewithnormalactivity-Extremelimitation
FEV1-<60%

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FEV1/FVC=>5%reduced

1018.Antibodyusedinthetreatmentof
BronchialAsthmais:
a)Omalizumab
b)Rituximab

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c)Daclizumab
d)Transtusuzumab
CorrectAnswer-A
AnswerisA(Omalizumab):
OmalizumabisarecombinantIgEAntibodyapprovedforusein
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treatmentofmoderateandseverepersistentasthma
OmalizumabisarecombinantIgEblockingantibodythat
neutralizescirculatingIgE.
ItpreventscirculatingIgEfrombindingtoreceptorsonthesurfaceof
BasophilsandMastcellsandthusinhibitsIgEmediatedreactions.
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Omalizumabisindicatedfortreatmentof'moderatetosevere'
persistentasthmainpatientswhoreacttoperennialallergens
(AllergicAsthma).
TreatmentwithOmalizumabhasshowntoreducethenumberof
exacerbationsinpatientswith
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severeasthmaandmayimproveasthmacontrol.
Howeverthistreatmentisveryexpensiveandisonlysuitablefor
highlyselectedpatientswhoarenotcontrolledonmaximaldosesof
inhalertherapyandhaveahighcirculatingIgE(withinaspecified
range).
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Omalizumabisusuallygivenasasubcutaneousinjectionfor2to4
weeksandmaybeusedinadultsandadolescentsmorethan12
yearsofage.

1019.Achildpresentswithrecurrent
pulmonaryinfectionsforhemoptysis
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duetoassociatedbronchiectasiaand
onimagingcharacterizedbyunilateral
lossoflungvolumewithhyperlucency
onchestradiograph,reductionin
vascularityonCTscanofthechest.The
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abdominalorgansarenormallyplace
(d)mostlilkelycauseis
a)Kartagener'ssyndrome
b)Swyer-James-MacLeodsyndrome
c)Mendelson'ssyndrome

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d)Immotileciliasyndrome
CorrectAnswer-B
Answer-B.Swyer-James-MacLeodsyndrome
Swyer-James-MacLeodsyndromeorunilateralherlucentlun
ndromeisarareentityassociatedwithpostinfectiousbronchiolitis

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obliteransoccurringinchildhood.
Itischaracterizedbyhypoplasiaand/oragenesisofthepulmonary
arteriesresultinginpulmonaryparenchymahypoperfusion,showing
acharacteristicradiologicalpattern,suchastranslucentor
hyperlucentunilaterallung.

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1020.AllareimportantpathogenscausingpneumoniainCOPDpatients,
EXCEPT:
a)Haemophilusinfluenzae
b)Pseudomonasaeruginosa
c)Legionellaspp

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d)Klebsiellapneumoniae
CorrectAnswer-D
AllareimportantpathogenscausingpneumoniainCOPDpatients
Haemophilusinfluenzae
Pseudomonasaeruginosa

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Legionellaspp
S.pneumoniae
Moraxellacatarrhalis
Chlamydiapneumoniae
Klebsiellaisanimportantpathogencausingpneumoniainchronicalcoholism.

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Ref:Harrison,E-18,P-2132

1021.Fibrosisofupperlobeisdueto
a)Pneumonia
b)ABPA
c)BronchiectasisinCOPD

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d)Rheumatoidarthritis
CorrectAnswer-B
Answer-B.ABPA
Silicosis(Progressivemassivefibrosis
Sarcoidosis

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Coalworkerpneumoconiosis
Ankylosingspondylitis
Radiation
Allergicbronchopulmonaryaspergillosis
Tuberculosis

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Extrinsicallergicalveolitis

1022.WhatisnotseeninCRF
a)Hypercalcemia
b)Hyperkalemia
c)Hyperphosphatemia

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d)Hypocalcemia
CorrectAnswer-A
Answer-A.Hypercalcemia
AbnormalitiesseeninCRF
Acidosis

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Hyperkalemia
Anemia
Hypernatremia
Hyperphosphatemia
Hyperlipidemia

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Hyponatremia
Hypocalcemia
Uremia

1023.CRFwithanemiabesttreatment:
a)OralIronTherapy

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b)ErythropoietinStimulatingAgents
c)Bloodtransfusion
d)AndrogenicSteroids
CorrectAnswer-B
AnswerisB(ErythropoietinStimulatingAgents):
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Erythropoiesis-stimulatingagents(ESAs)haveemergedasthe
treatmentofchoiceforanemiainchronicrenaldisease.
Erythropoiesis-stimulatingagents(ESAs)shouldbegiventoall
patientswithchronickidneydisease(CKD)withhaemoglobinlevels
consistentlybelowIIg/dl.
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Thisappliesequallyto:
PatientswithCKD(stages1-5)developinganaemia
PatientswithCKDstage5treatedwithhaemodialysis(HD)or
peritonealdialysis(PD)
Transplantpatientswithchronicrenalinsufficiencyandanaemia.
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StrategiesfortreatmentofAnemiainChronicRenalFailure
Erythropoiesis-stimulatingagents(ESAs)
Erythropoiesis-stimulatingagents(ESAs)haveemergedasthe
treatmentofchoiceforanemiainchronicrenaldisease.
Theyshouldbegiventoallpatientswithchronickidneydisease

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(CKD)withhaemoglobin(Hb)levelsconsistentlybelow11g/dl
[haematocrit(Hct)<33%]
Allchronickidneydisease(CKD)patientswithrenalanaemia
undergoingtreatmentwithanerythropoiesis-stimulatingagent(ESA)
shouldbegivensupplementaryirontomaintainadequatebone

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marrowironstores

Intravenousadministrationistheoptimumrouteforthedeliveryof
irontopatientswithCKD,asoralironispoorlyabsorbedinuremic
individuals.
BloodTransfusion

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Redbloodcelltransfusionsshouldbeavoided,ifatallpossible,in
patientswithchronickidneydisease(CKD),especiallythose
awaitingkidneytransplantation.
Transfusionsshouldnotbegivenunlesspatientshaveoneormore
ofthefollowing:Symptomaticanaemia(fatigue,angina,dyspnoea)

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and/orassociatedriskfactors(diabetes,heartfailure,coronary
arterydisease,arteriopathy)
Acuteworseningofanaemiaduetobloodloss(haemorrhageor
surgery)orhaemolysisSevereresistanceto,orhyporesponsiveness
toESAtherapy,e.g.duetothepresenceofahaematological

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diseaseorsevereinflammatorysystemicdisease.
Androgens
PriortotheintroductionofESAtherapy,androgenswerewidely
usedinthetreatmentofrenalanaemia.
Thereisevidencethatandrogensmaypotentiatetheeffectof

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exogenouserythropoieticproteinandalsostimulateerythropoiesis
byenhancingerythrocytestemcelldifferentiation
Theriskofliverdiseaseandmalignancy,virilisationandhirsutismin
women,priapisminmenanddisfiguringacneinpatientsofboth
sexesmayoutweighthebenefitsofandrogentherapyinmost

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anaemicpatients.
Androgensmaybeaneffectivealternativetherapyincountries
whereESAsarenotavailable

1024.Distalrenaltubularacidosisis
associatedwith:

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a)Oxalatestones
b)Citrate
c)Calciumstones
d)Uricacidstones
CorrectAnswer-C

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AnswerisC(CalciumStones):
DistalRenalTubularAcidosisisassociatedwithincreasedin
cadenceofCalciumPhosphateStonesAlkalineurine,Hypercalciuria
andlowlevelsofurinarycitrateprecipitatecalciumphosphate
stonesinthekidneyinpatientswithDistalRenalTubularAcidosis
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(Typel).
ProximalRenalTubularAcidosis(Type-2)isnotassociatedwith
increasedincidenceofRenalStonesdespiteHypercalciuriabecause
urinarycitratelevelsarenormalorhigh.

1025.ThemostcommonpresentationforIgA

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nephropathyis:
a)Nephriticsyndrome
b)Nephriticsyndrome
c)Microscopichematuria
d)Repeatedgrosshematuria

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CorrectAnswer-D
AnswerisD(RepeatedGrossHematuria):
ThemostcommonpresentationofIgANephropathyiswithrecurrent
episodesofGross(Macroscopic)Hematuriaduringorimmediately
followinganupperrespiratorytractinfection
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'RecurrentattacksofPainlessGrossHematuriarepresentthe
classicclinicalpresentationofIgANephropathy'--Rudolph's
Paediatrics

1026.HIVrenalspecificnephropathyis:
a)FocalSegmentalGlomerulosclerosis

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b)MembranoproliferativeGlomerulonephritis
c)MesangioproliferativeGlomerulonephritis
d)MembranousGlomerulonephritis
CorrectAnswer-A
AnswerisA(FocalSegmentalGlomerulosclerosis):
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ThemostcharacteristicglomerulopathyinHIVisFocalSegmental
Glomerulosclerosis(FSGS)whichtypicallyrevealscollapseofthe
glomerularcapillarytuftcalledcollapsingglomerulopathy.
HIVassociatedNephropathyisasevererapidlyprogressive
collapsingformofFSGS.

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1027.Theinitialtreatmentofchoicefor
secondaryhyperparathyroidisminrenal
osteodystrophyis:
a)Cinacalcet
b)Bisphosphonates

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c)Calciumrestriction
d)Phosphatebinders
CorrectAnswer-D
AnswerisD(PhosphateBinders)
Theinitialtreatmentofsecondaryhyperparathyroidisminrenal
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osteodystrophyismanagementofhighphosphatelevelsbydietary
restrictionandtheuseofPhosphatebinders
Theobjectivesofmanagementaretomaintainbloodlevelsof
calciumandphosphoroustoasclosetonormalaspossible,to
preventortreatestablishedhyperparathyroidismearlyandto
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preventparathyroidhyperplasia.
PhosphateretentionbeginsearlyinthecourseofCKD,perhapsas
earlyasinstage2andparticipatesinthedevelopmentofsecondary
hyperparathyroidism.
Centraltothemanagementofhigh-turnoverbonediseaseis
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controllingtheserumphosphatelevels.
Thismaybeachievedbydietaryphosphaterestrictionorbytheuse
ofphosphatebinders.
Phosphate-bindertherapyisrecommendedwhenserumphosphate
concentrationsareelevateddespitepatientcompliancewithdietary
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phosphaterestriction.
Calcium-basedphosphatebindersareoftenrecommendedasthe

initialbindertherapy.
HighBoneTurnoverDisease
Boneturnover(theformationandremovalofbone)isincreaseddue
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toaprocesscalledsecondaryhyperparathyroidism(SHPT).
Secondaryhyperparathyroidismrepresentsacommondisorderin
patientswithCKD.
Itdevelopsasaresultofhyperphosphatemia,hypocalcemiaand
impairedrenalvitaminDsynthesiswithreductioninserumcalcitriol
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levels

1028.Maximumurinarycatheterinduced
infection
a)E.coli
b)Pseudomonas

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c)Staphylococcusepidermidis
d)Proteus
CorrectAnswer-A
Answer-A.E.coli
Catheterassociatedurinarytractinfectionsrepresentthemost

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commontypeofnosocomialinfection.
Mostcommonorganismcausingcatheterassociatedurinarytract
infectionsareE.coli.

1029.Mostcommonsymptomof
genitourinaryTB

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a)Renalcolic
b)Increasedfrequency
c)Hematuria
d)Painfulmicturition
CorrectAnswer-B

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Answer-B.Increasedfrequency
Theclinicalmanifestationsarevariable.
Theonsetofclinicallyevidentgenitourinarytuberculosisisusually
insidious.
Themostcommonsymptomsare:-

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Dysuria,increasedfrequencyofurinationandgrosshematuria

1030.Whatistheuppermostintercostal
spaceusedforhepaticbiopsy:
a)5th
b)7th

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c)9th
d)11th
CorrectAnswer-B
AnswerisB7th
Therightsurfaceoftheliverisincontactwiththediaphragm
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oppositethe7thto11thribs.
Inneedlebiopsyoftheliverthroughtheintercostalroute,theneedle
maybeinsertedthroughthe6th7th,8th,9thor10thrightintercostal
spaceinthemid-axillaryline.
The8thand9thintercostalspacesaremostcommonlyused.
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Insertioninthe6thor7thintercostalspacemayalsobeusedbutis
associatedwithriskofinjurytotheLung.
Needleistypicallyinsertedattheendofexpiration(Attempted
Apnoea).

1031.ThepreferredtestforconfirmingH.

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pylorieradicationis:
a)Ureasebreathtest
b)Culture
c)Serologicaltest
d)Biopsyureasetest

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CorrectAnswer-A
AnswerisA(UreaseBreathTest)
Thetestofchoicefordocumentingeradicationisureasebreathtest.
AssessmentofsuccessofTreatmentwithEradicationofH.Pylori
shouldbedoneatleast4weeksaftercompletionofantiH.Pylori

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therapy.Non-invasivetestsaretypicallypreferredforassessmentof
Eradication.Thetestofchoicefordocumentingeradicationisurease
breathtest.UreasebreathtestdetectsH.pyloriinfectionby
'bacterialureaseactivity'andremainspositivetillthebacteriahas
notbeeneradicatedwithtreatment.Thusureasebreathtest
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becomesnegativeonlyaftereradicationoforganismfollowing
treatmentandnotwithchronicinfection.

1032.Allofthefollowingareusedfor
treatmentofH.Pylori,except:
a)Gentamycin

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b)Clarithromycin
c)Metronidazole
d)Amoxicillin
CorrectAnswer-A
AnswerisA(Gentamycin):

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Gentamycinisnotusedinanyofthesuccessfulmulti-drugregimens
againstH.PyloriInfection.

1033.Bestprovocativetestfordiagnosisof
Gastrinomais:
a)Ca++infusiontest

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b)Secretininjectiontest
c)ACTHstimulationtest
d)Steroidassay
CorrectAnswer-B
AnswerisB(Secretininjectiontest)

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Gastrinomas(ZollingerEllisonSyndrome)arecharacterizedby
pepticulcerationduetohypersecretionofgastrinbyanon-betacell
tumor.Secretininjectiontestisthemostvaluableprovocativetestin
identifyingpatientswithZES.

1034.Wilson'sdiseaseischaracterizedby-

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a)Increasedserumceruloplasmin
b)Decreasedcopperexcretioninurine
c)Increasedcopperinliver
d)Autosomaldominant
CorrectAnswer-C

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Ans.is'c'i.e.,Increasedcopperinliver
DiagnosisofWilsondisease
Thegoldstandardfordiagnosisisliverbiopsywithquantitative
copperassay-->concentrationofcopperinaliverbiopsysample>
200mg/gdryweight.

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Othertestsare?
Serumceruloplasminlevel-->lowoUrine
copperexcretion-->increased
KFringsoDNA
Haplotypeanalysis.

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1035.Allofthefollowingstatementsabout.
Wilson'sdiseasearetrue,EXCEPT-
a)Itisanautosomalrecessivedisorder
b)Serumceruloplasminlevelis<20mg/dl
c)Urinarycopperexcretionis

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d)Zincacetateiseffectiveasmaintenancetherapy
CorrectAnswer-C
AnswerisC(Urinarycopperexcretionis<100R/day)
Urinecopperisanimportantdiagnostictoo.Symptomaticpatients
invariablyhaveurinecopperlevels>100p(>1.6umol)per24
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hours.
Wilson'sdiseaseisanautosomalrecessivedisorder
ItiscausedbyamutationofageneonchromosomeBQwhich
promotesCuexcretion(ATP7Bgene)
SymptomaticpatientswithWilson'sdiseaseinvariablyhaveurinary

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copperexcretionof>100lig,per24hours(>1.6innol/24hr)
Zincisthetreatmentofchoiceformaintainancetherapyin
Wilson'sdisease
ZincisthetreatmentofchoiceinWilson'sdiseasefor
A.Initialtherapyinpatientswithhepatitiswithoutdecompensation(2
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A.Maintainancetherapy
B.Presymptomaticpatient
C.Pediatricpatients
D.Pregnantpatients

1036.Diagnosisofcarcinoidtumourisdone

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Urinaryestimationof:
a)VMA
b)Metanephrines
c)Catecholamines
d)5HIAA

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CorrectAnswer-D
AnswerisD(5HIAA):
CarcinoidTumors
Carcinoidtumorsareassociatedwithelevatedlevelsofmetabolites
ofTryptophan/serotoninwhichinclude5HIAA,5HTand5HTP.
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Pheochromocytomas
Pheochromocytomasareassociatedwithelevatedlevelsof
catecholaminesandtheirmetaboliteswhichincludeVanillylmandelic
acid(VMA)andmetanephrines
ThediagnosisofTypicalcarcinoidsyndromeissuggestedby
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elevatedlevelsof5HIAAThediagnosisofAtypicalCarcinoid
Syndromeissuggestedbyelevatedlevelsof5HTP.establishedby
elevatedlevelsof5HIAA.

1037.InZollingerEllisonsyndromewhatis
raised?

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a)Insulin
b)VIP
c)Gastrin
d)Glucagon
CorrectAnswer-C

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Ans.is'c'i.e.,Gastrin
ZollingerEllisonsyndrome?
Severepepticulcerdiseasesecondarytogastricacid
hypersecretionduetounregulatedgastrinreleasefromanon13cell
endocrinetumour(gastrinoma),definesthecomponentsofZollinger

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Ellisonsyndrome.
PathophysiologyofZollingerEllisonsyndrome
ThedrivingforceresponsibleforclinicalmanifestationsofZollinger
EllisonsyndromeishypergastrinemiaoriginatingfromGastrinoma
(autonomusneoplasm,non[3cellneoplasm)

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Gastrinoma
Hypergastrinemia
Hyperacidemia
Pepticulcer,erosiveesophagitisanddiarrhoea
OtherimportantcharacteristicofGastrinoma
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oOver80%ofthesetumoursareseeninGastrinomatriangle?
(triangleformedbetweenduodenumandpancreas)mostofthem
areseenintheheadofpancreas.
oAbout2/3'ofthesetumoursaremalignant?.
oAboutonehalfofthesetumoursaremultiple?.

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oAboutonefourthofthepatientshavemultipleendocrineneoplasia
(MENI)syndromewithtumoursofparathyroid,pituitaryand
pancreaticisletsbeingpresent.
Remember:
Mostcommonsiteofgastrinoma'sis

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Duodenum(50-70%),(Pancreas20-40%)
MostcommonhormonetobesecretedACTH
besidesgastrinis
Mostcommonsiteofpepticulcersproducedisls'partof
Duodenum.

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MostvaluableprovocativetestinTheSecretin
injectiontests.identifyingpatientswithZESis
Basalacidoutputisgreaterthan60%ofoutpuBAO>MAO
inducedbymaximalstimulation
Thetermpancreaticendocrinetumourismisnomerbecausethese

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tumourscanoccureitheralmostexclusivelyinthepancreasorat
bothpancreaticandextrapancreaticsites

1038.Allfollowingareat-riskgroupadults
meritingHepatitisBvaccinationinlow
endemicareasexcept:

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a)Patientsonchronichemodialysis
b)Diabeticsoninsulin
c)Medical/nursingpersonnel
d)Patientswithchronicliverdisease
CorrectAnswer-B

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AnswerisB(DiabeticsonInsulin):
Behavioral:Sexuallyactivepersonswhoarenotinalong-term,
mutuallymonogamousrelationship(e.g.,personswithmorethan
onesexpartnerduringtheprevious5months):personsseeking
evaluationortreatmentforasexuallytransmitteddisease(STD):

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currentorrecentinjection-drugusers;andmenwhohavesexwith
men.
Occupational:Healthcarepersonnelandpublic-safetyworkerswho
areexposedtobloodorotherpotentiallyinfectiousbodyfluids.
Medical:Personswithend-stagerenaldisease,includingpatients

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receivinghemodialysis;personwithHIVinfection;andpersonswith
chronicliverdisease.
Other:Householdcontactsandsexpartnersofpersonswithchronic
HBVinfection;clientsandstaffmembersofinstitutionsforpersons
withdevelopmentaldisabilities;andinternationaltravellersto

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countrieswithhighorintermediateprevalenceofchronicHBV
infection.
HepatitisBvaccinationisrecommendedforalladultsinthefollowing
settings:STDtreatmentfacilities;HIVtestingandtreatmentfacilities;

facilitiesprovidingdrug-abusetreatmentandpreventionservices;

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healthcaresettingstargetingservicestoinjection--drugusersor
menwhohavesexwithmen;correctionalfacilities;end-stagerenal
diseaseprogramsandfacilitiesforchronichemodialysispatients;
andinstitutionsandnonresidentialday-carefacilitiesforpersons
withdevelopmentaldisabilities.

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Administermissingdosestocompletea3-doseseriesofhepatitisB
vaccinetothosepersonsnotvaccinatedornotcompletely
vaccinated.Theseseconddoseshouldbeadministered1month
afterthefirstdose;thethirddoseshouldbegivenatleast2months
aftertheseconddose(andatleast4monthsafterthefirstdose).If

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thecombinedhepatitisAandhepatitisBvaccine(Twinrix)isused,
administer3dosesat0,1,and6months;alternatively,a4-dose
Twinrixschedule,administeredondays0,7,and21to30,followed
byaboosterdoseatmonth12maybeused.
Adultpatientsreceivinghemodialysisorwithother

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immunocompromisingconditionsshouldreceive1doseof40pg/mL
(RecombivaxHB)administeredona3-dosescheduleor2dosesof
20Ug/mL(Engerix-B)administeredsimultaneouslyona4-dose
scheduleat0,1,2,and6months.

1039.SchillingtestisAbnormalin:

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a)Intrinsicfactordeficiency
b)Amylasedeficiency
c)Lipasedeficiency
d)Pancreaticendocrineinsufficiency
CorrectAnswer-A

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AnswerisA(Intrinsicfactordeficiency)
Shilling'stestistypicallydonetodeterminethecauseofcobalamine
malabsorption(VitaminB12malabsorption)VitaminB12absorption
(Schilling)testistypicallyusedtodiagnoseconditionsinwhich
intrinsicfactor(IF)maybeabsent,suchasperniciousanemiaor
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gastricatrophy.AdiagnosisofIntrinsicfactordeficiencycanbe
establishedifradiolabelledcobalamine(VitaminB12)appearsin
urineafteradministrationofIntrinsicfactor.
Sincecobalamineabsorptionrequiresmultiplestepsincluding
gastric,pancreaticandilealprocesses,theSchillingtestcanalso

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beusedtoassesstheintegrityoftheseotherorgans.
DietaryvitaminB12isboundinthestomachtoanendogenous
proteincalledRprotein.PancreaticenzymesdegradetheRprotein
intheproximalsmallbowelandloweritsaffinityforvitaminB12
resultingintherapidtransferofB12toIF;TheIF-B12Complex

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continuestotheterminalileum,whereitbindstospecificreceptors
onthesurfaceoftheepithelialcells.
Thuslackofintrinsicfactor,lackofsufficientpancreaticenzymes
(pancreaticexocrinedysfunction)orpresenceofterminalheal
mucosaldiseasemayallresultinabnormalvitaminB12excretion.

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1040.Secretorydiarrheaisnotseenin:
a)Phenolphthalein
b)Celiacdisease
c)Cholera

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d)Addison'sDisease
CorrectAnswer-B
AnswerisB(CeliacDisease)
CeliacDiseaseisassociatedwithSteatorrhealdiarrhoeafrom
mucosa!malabsorption.

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SecretoryDiarrhea
CertainBacterialInfection
VibrioCholera
EnterotoxigenicE.Coli
NonOsmoticStimulantLaxatives

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HormoneProducingEndocrineTumors
Carcinoid,
VlPomas,
Gastrinomas,
MedullaryCarcinomaThyroid(Calcitonin)

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Bileacids(endogenouslaxatives)
Bowelresection/diseaseorfistula
Addison'sDisease
CongenitalElectrolyteAbsorptiondefects
ChronicAlcoholIngestion

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DiabeticDiarrhea

SteatorrhealDiarrhea
Intraluminalmaldigestion
Pancreaticexocrineinsufficiency,
Bacterialovergrowth,

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Bariatricsurgery,
Liverdisease
Mucosalmalabsorption
Celiacsprue,
Whipple'sdisease,

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Infections,
Abetalipoproteinemia,
Ischemia
Postmucosalobstruction
(1?or2?lymphaticobstruction)

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1041.Anominalaphasiaisduetodefectin
a)Leftinferiorfrontal
b)Parietal
c)Temporaloccipital
d)Cerebellum

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CorrectAnswer-C
Answer-C.Temporaloccipital
Anomiacanbegeneticorcausedbydamagetovariouspartsofthe
parietallobeorthetemporallobeofthebrainbyanaccidentor
stroke,orabraintumor.

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1042.Unabletoconsolidatelongterm
memory.Whichlobeofthebrainis
involved
a)Frontal
b)Parietal

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c)Temporal
d)Occipital
CorrectAnswer-C
Answer-C.Parietal
Medialtemporallobeistheareaofbrainresponsiblefor

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consolidation,i.e.processingofshorttermmemoryintolongterm
memory.

1043.Gerstmannssyndromeallexcept
a)Acalculia
b)Agraphia

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c)Aphasia
d)Agnosia
CorrectAnswer-C
Answer-C.Aphasia
Gerstmannsyndromeconsistsof:

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1. Agraphia
2. Acalculia
3. Fingeragnosia
4. Leftrightdisorientation

1044.Lateralmedullarysyndromeiscaused

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bythrombosisof:
a)Anteriorinferiorcerebralartery
b)Posteriorinferiorcerebellarartery
c)Vertebralartery
d)bandc

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CorrectAnswer-D
AnswerisC>B(Vertebralartery>Posteriorinferiorcerebellar
artery):
`Mostcasesresultfromipsilateralvertebralarteryocclusion;inthe
reminderocclusionofposteriorinferiorcerebellararteryis
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responsible'?Harrison
VesselocclusionthatresultinLateralMedullarysyndrome:
-Vertebral(mostcommon)
-Posteriorinferiorcerebellar(2ndmostcommon)
-Superior,middleorInferiorlateralmedullaryarteries

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Vertebralartery
Thevertebralarteryconsistsoffoursegments.Thefourthsegment
coursesupwardtojointtheothervertebralarterytoformthebasilar
artery.
Onlythissegmentgivesrisetobranchesthatsupplythebrainstem

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andcerebellum.
Embolicocclusionorthrombosisofthefourthsegmentis
responsibleforthissyndromeQ
Posteriorinferiorcerebellarartery
Posteriorinferiorcerebellararteryinitsproximalpartsuppliesthe

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lateralmedullaandinitsdistalbranchestheinferiorsurfaceof

cerebellum.

1045.Pontinehemorrhagemostcommon
causeis
a)Hypertension

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b)Diabetes
c)Trauma
d)Aneurysmalrupture
CorrectAnswer-A
Answer-A.Hypertension
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Mostcommoncauseofpontinehemorrhageishypertension.

1046.Anadulthypertensivemalepresented
withsuddenonsetsevereheadache
andvomiting.Onexamination,thereis
markedneckrigidityandnofocal
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neurologicaldeficitwasfound.The
symptomsaremostlikelydueto:
a)Intracerebralparenchymalhemorrhage
b)Ischemicstroke
c)Meningitis

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d)Subarachnoidhemorrhage
CorrectAnswer-D
Ans.d.Subarachnoidhemorrhage
Themostlikelydiagnosishereisasubarachnoidbleed(SAH).
Themostcommoncauseistraumaandismanagedconservatively.

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Thesecondmostcommoncauseisaruptureofaberryaneurysm.
Thetypicalpresentationofasubarachnoidhemorrhageincludesa
`thunderclap'headache.
Meningiticfeaturesofneckstiffnessandphotophobiaoften
developoverhours.

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Computedtomography(CT)istheinvestigationofchoice.
LumbarpunctureshouldbeperformediftheCTscanfailsto
establishthediagnosisofSAH;itshowsaxanthochromicblood
picture.
Delayedischemicneurologicaldeficit(DIND)isattributedto

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vasospasmofthecerebralvasculaturetypicallydeveloping3?10
daysfollowingictus.Itisthemaincauseofapooroutcome.

Endovasculartreatment("coiling")isgenerallypreferredover
craniotomyandclippingforaneurysmsamenabletothisapproach.

1047.Predominantlysensoryneuropathy

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is/arecausedby:
a)Cisplatin
b)Pyridoxineexcess
c)Suramin
d)aandb

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CorrectAnswer-D
AnswerisAandB(CisplatinandPyridoxineexcess):
CisplatinandPyridoxineareassociatedwithpredominantlysensory
neuropathies.

1048.Dailytemperaturevariationin

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remmitentfeveris
a)<0.5C
b)>1?C
c)<1.0C
d)>2C

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CorrectAnswer-B
Answer-B.>1?C
Continuousfever
Temperatureremainsabovenormalthroughoutthedayanddoes
notfluctuatemorethan1?Cin24hours.Intermittentfever

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Thetemperatureelevationispresentonlyforacertainperiod,later
backtonormale.g.malaria,kalaazarsepticaemia.

1049.Hyperthermia
a)Temperature>41.5
b)>40withautonomicdysfunctuion

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c)Nochangeinhypothalamicthermostat
d)Failureofthermoregulation
CorrectAnswer-D
ANswer-D.Failureofthermoregulation
Hyperthermiaisdefinedaselevationofcorebodytemperature

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abovethenormaldiurnalrangeof36to37.5?Cduetofailureof
thermoregulationatthelevelofhypothalamus.
Hyperthermiaisnotsynonymouswiththemorecommonsign
offever,whichisinducedbycytokineactivationduringinflammation,
andregulatedatthelevelofthehypothalamus.

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1050.Myastheniagravisisassociatedwith
a)AntibodiesagainstAchreceptors
b)Decreasedmyosin
c)AbsenttroponinC
d)Increasedmyoneuraljunctiontransmission

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CorrectAnswer-A
Answer-A.AntibodiesagainstAchreceptors
Thecharacteristicpathologicalfeatureofmyastheniagravisis
presenceofantibodiesagainstacetylcholinereceptors.
Theseautoantibodiesagainsttheacetylcholinereceptorsleadto

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lossoffunctionalacetylcholinereceptorsattheneuromuscular
junction.

1051.EatonLambertsyndromeisseenwith-
a)Cabreast
b)Caliver

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c)Calung
d)CNStumors
CorrectAnswer-C
Answer-C.Calung
Paraneoplasticsyndrome

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Associatedwith
Smallcellcarcinomalung
Certainautoimmunediseases

1052.Lesionofglobuspalliduscauses
a)Chorea

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b)Athetosis
c)Hemibalismus
d)Flexiondystonia
CorrectAnswer-B
Answer-B.Athetosis
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Athetosis-Globuspallidus(mainly)andSubthalamicnucleus.
Lesionattheglobuspallidusand
striatumcauseathetosis,whichischaracterizedby
continuous,slowwrithingmovements.
Chorea:rapid,involuntarydancingmovementsMostcommonly,

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thelesionisinthestriatum.
Ballism:involuntaryflailing,intenseandviolentmovements.The
movementsareoflargeamplitudeandpredominantlyinvolves
proximalmuscles.
Thelesioninthesubthalamicnucleus.

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Athetosis:continuous,slowwrithingmovementsLesionatglobus
pallidusandstriatum.

1053.Mostcommontumorassociatedwith
NF1
a)Opticglioma

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b)2ndnerveschwannoma
c)Astrocytoma
d)Bilateralacousticneuroma
CorrectAnswer-A
Answer-A.Opticglioma
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"Opticpathwaygliomas"arethepredominanttypeofneoplasm
associatedwithneurofibromatosistypeIbutothercentralnervous
systemandnonCNStumourscanoccur.

1054.CSFpictureinviralmeningitis
a)Lymphocyticpleocytosis

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b)WBCcount>1500/mL
c)Sugarisreduced
d)Proteinisdecreased
CorrectAnswer-A
Answer-A.Lymphocyticpleocytosis

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Normal Bacterial
Viral
Opening
7-18
>30

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NormalorMildlyIncreased
Pressure
Clear,
Appearance
Turbid

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Clear
Colorless
Protein
23-38
Increased

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NormaltoDecreased
(mg/dl)
2/3rds
Glucose
Serum

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Decreased
Normal
(mmol/L)
Glucose
Positive160-90%of

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GramStain Negative
Negative
Cases)
Glucose
CSF:Serum 0.6

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<0.4
>0.6
Ratio
WhiteCell
cells

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PredominatelyNeutrophils PredominatelyLymphocytes
Count

1055.InherpesencephalitisA/E
a)Focalsymptomscommon
b)Temporallobeinvolved

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c)MRIisdiagnostic
d)EEGnotdiagnostic
CorrectAnswer-D
Answer-D.EEGnotdiagnostic
Diagnosis
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MostsensitiveandspecificinvestigationforHSV-1encephaliticis
MRI
Incontrast,cranialCTscanshaveonly50%sensitivityandthattoo
earlyinthedisease.EEGfindingsinHSV-1encephalitis

1056.Whichofthefollowingisnotseenin

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HereditarySpherocytosis
a)DirectCoomb'sPositive
b)IncreasedOsmoticFragility
c)Splenomegaly
d)Gallstones

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CorrectAnswer-A
Ans.is'a'i.e.,DirectCoomb'spositive
HereditarySpherocytosis
Membranecytoskeletonthatliescloselyopposedtotheinternal
surfaceoftheplasmamembrane,isresponsibleforelasticityand

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maintenanceofRBCshape.
Membraneskeletonconsists:?
SpectrinThechiefproteincomponent
responsibleforbiconcaveshape.
Ankyrinandband4-2Bindsspectrintoband3

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Band3Atransmembraneiontransport
protein.
Band4.1BindsspectrintoglycophorinA,
atransmembraneprotein.
Hereditaryspherocytosisisanautosomaldominantdisorder

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characterizedbyintrinsicdefectsinredcellmembrane.Thisresults
inproductionofredcellsthataresphere(spherocytes)ratherthan
biconcave.
Themutationmostcommonlyinvolvesthegenecodingforankyrin,
followedbyBand-3(anionictransportchannel),spectrin,andBand
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4.2(alsocalledpalladin).

Alsoknow
Mostcommon,defectinhereditaryelliptocytosisisinspectrin
PathogensisofHereditaryspherocytosis
Lossofmembranecytoskeletonproteins(ankyrin,spectrin,Band3,

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4.2)resultsinreducedmembranestability.Reducedmembrane
stabilityleadstospontaneouslossofmembranefragmentsduring
exposuretoshearstressesinthecirculation.Thelossofmembrane
relativetocytoplasmforcesthecellstoassumethesmallest
possiblediameterforagivenvolumecellsbecome

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microspherocytes.
Becauseoftheirspheroidalshapeandreducedmembraneplasticity,
redcellsbecomelessdeformableandaretrappedintospleenas
theyareunabletopassthroughtheinterendothelialfenestrationsof
thevenoussinusoids.Inthesplenicsinusoides,redcellsare

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phagocytosedbyREcellsExtravascularhemolysis.
ClinicalfeaturesofHereditoryspherocytosis
Theclinicalfeaturesarethoseofextravascularhemolysis:
AnemiaMildtomoderate
Jaundice(Mainlyindirectbilirubin)Splenomegaly

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GallstonesElevatedexcretionof
bilirubinpromotesformationofpigmentstone.
LegulcerRareclinical
manifestation.
AplasticcrisisTriggeredbyparvo-

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virusinfection.
Laboratoryfindings
Spherocytosis-->Peripheralsmearshowsmicrospherocyteswhich
aresmallRBCswithoutcentralpallor(Normallycentral1/3palloris
presentinredcells).

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MCV4
MCHCr
Increasedunconjugatebilirubin
Urineurobilinogen1'
Stoolstercobilinogen
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Reticulocytosis-4Asseenwithanytypeofhemolyticanemia.
Hemoglobin1
SerumHeptoglobin-->Nonnaltodecreased.

Increasedosmoticfragilityonpinktest.
Coomb'stestisusedtodistinguishhereditaryspherocytosisfrom

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autoimmunehemolyticanemias.
Autoimmunehemolyticanemiasarecoomb'spositive_whereas
hereditaryspherocytosisiscoomb'snegative.

1057.HaemoglobinFisraisedin:
a)Juvenilechronicmyeloidleukemia

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b)Hereditaryspherocytosis
c)Congenitalredcellaplasia
d)Mysthaniagravis
CorrectAnswer-A
AnswerisA(JuvenileCML)
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FetalHaemoglobinlevels(HbF)areincreasedinmostcasesof
JuvenileCML?
CausesofRaisedHbFlevels(InterpretationofDiagnosticTest
8th/411,412)
Haemoglobinopathies

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-thalassemiamajor
-thalassemiaminor
-Sicklecelldisease
HereditaryPersistanceofHbF
Anemia:

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-NonHereditaryrefractorynormoblasticanemia
-Perniciousanemia
-Aplasticanemia
LeukemiaspeciallyJuvenileMyeloidLeukemia
Multiplemyeloma

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Molarpregnancy
PatientswithTrisomy13orTrisomy21(Down'ssyndrome)
Somechronicviralinfections(egCMV,EBV)

1058.Whichofthefollowingprovide
protectionagainstmalariaallexcept

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a)Duffybloodgroup
b)Sicklecellanemia
c)Thalassemia
d)PNH
CorrectAnswer-D

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Answer-D.PNH
Redcellsurfaceantigenthatofferprotectionagainstmalaria
Duffybloodgroupsystem
ABO(H)bloodgroupsystem
Glycophorins

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Gerbichantigen
ComplementreceptortypeI
Knopsbloodgroup
Abnormalitiesoftheredcellcytoskeletonwhichmayoffer
protectioninclude
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South-eastasiaovalocytosisHereditaryelliptocytosis
HereditaryspherocytosisSicklecellHbA/S

1059.ChemotherapeuticAgentofChoicefor
thetreatmentofCMLis:
a)Imatinib

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b)Vincristine
c)Cyclophosphamide
d)Methotrexate
CorrectAnswer-A
AnswerisA(Imatinib):
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TyrosineKinaseInhibitors(Imatinib)arethechemotherapeutic
agentsforchoiceinthemanagementofCML.TyrosineKinase
inhibitorstargetthe'constitutivelyactivetyrosinekinase'implicated
inthepathogenesisofCML.Althoughtheydonotcurethedisease,
theseagentsareabletoachievelongtermcontrolofCMLinthe
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majorityofpatients.Mostrecenttexts(IncludingHarrisons)
recommendTyrosineKinaseInhibitors(Imatinib)astheinitial
treatmentofchoicefornewlydiagnosedCMLreservingAllogeneic
StemCellTransplantation(SCT)forthosewhodevelopImatinib
Resistance.

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1060.Thromboticthrombocytopenicpurpura
isasyndromecharacterizedby:
a)Thrombocytosis,anemia,neurologicabnormalities,progressive
renalfailureandfever.
b)Thrombocytopenia,anemia,neurologicabnormalities,

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progressivehepaticfailureandfever
c)Thrombocytosis,anemianeurologicabnormalities,progressive
renalfailureandfever
d)Thrombocytopenia,anemia,neurologicalabnormalities,
progressiverenalfailureandfever

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CorrectAnswer-D
AnswerisD(Thrombocytopenia,anemia,neurological
abnormalities,progressiverenalfailureandfever)
ThromboticThrombocytopenicPurpura(TTP)ischaracterized
clinicallybythePentadofMicroangiopathicHemolyticAnemia,
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Thrombocytopenia.DecreasedRenalFunction.Disturbed
NeurologicalfunctionandFever.

1061.Allthefollowingaretrueaboutmultiple
myelomaexcept:
a)Osteolyticbonedisease

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b)t(8-14)translocation
c)Lightchainproliferation
d)Bence-Jonesproteinsinurine
CorrectAnswer-B
AnswerisB(t(8-14)translocation)

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Avarietyofchromosomalalterationshavebeenfoundinpatients
withMultiplemyeloma.Themostcommontranslocationist(11;14)
(q13;q32).13q14deletionsand17p13deletionsand11q
abnormalitiespredominate.Translocation1(8-14)hasnotbeen
mentioned.
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CompleteImmunoglobulinchaincomprisesofbothheavychains
andlightchains.ButinMultiplemyelomathereisexcessproduction
oflightchainseoverheavychains.
TheselightchainsareeliminatedinurineasBenceJonesproteinQ
ProteincastinurinearethusmadeupoflightchainsonlyQ(not

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completeimmunoglobulinchains).
Bonelesionsinmultiplemyelomaarelyticinnatureandarerarely
associatedwithosteoblasticnewboneformation.'-Harrison.
BonelesionsinMMarecausedbytheproliferationoftumorcells
andactivationofosteoclaststhatdestroythebone.'Bonepainisthe
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mostcommonsymptominMMaffecting70%ofpatientsQ'-Harrison

1062.Theimmunoglobulinmostcommonly
involvedinMultipleMyelomais:
a)IgG
b)IgM

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c)IgA
d)IgD
CorrectAnswer-A
AnswerisA(IgG)
TheMcomponentinMultipleMyelomacanbemadeupofthe
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immunoglobulinsIgG,IgM,IgD,IgA,andIgE;lightchainsalone;or
heavychainsalone.IgGMyelomaisthemostcommonformof
MultipleMyelomawhileIgD(2%)andIgE(Rare)aretheleast
common.
Distributionofimmunoglobulintypesinpatientswithmultiple
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myeloma
Typeofprotein
Percentage(%)
IgG
52

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IgA
22
IgM
12
IgD

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2
IgE
Rare

1063.InitialDrugofchoiceforsuspected
caseofacuteadrenalinsufficiencyis:

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a)Norepinephrine
b)Hydrocortisone
c)Dexamethasone
d)Fludrocortisones
CorrectAnswer-C

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AnswerisC(Dexamethasone):
Thetreatmentofchoiceforacuteadrenalinsufficiencyis
GlucocorticoidReplacementTherapy.Incaseswherethediagnosis
ofacuteadrenalinsufficiencyissuspected(notconfirmed)
Dexamethasoneispreferredastheinitialsteroidofchoicebecause
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Dexamethasonedoesnotcompetewiththecortisolassay.
Cosyntropinstimulationtestingmaybeperformedwhilethepatient
isontreatment.

1064.Apregnancywomanisdiagnosedto
sufferingfromGraves'disease.The
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mostappropriatetherapyforherwould
be:
a)Radioiodinetherapy
b)Totalthyroidectomy
c)Carbimazoleparenteral

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d)Propylthiouraciloral
CorrectAnswer-D
AnswerisD(Propylthiouracil):
Propylthiouracil(PTU)isnotassociatedwithanincreasedriskof
congenitalmalformationsandisconsideredthedrugofchoicefor
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treatinghyperthyroidismisPregnancy.
HyperthyroidisminPregnancy
MaternalHyperthyroidisminPregnancyisusuallyduetoGrave's
Disease.TRAbcrossestheplacentaandifmotheristhyrotoxicit
mustbeassumedthatthefoetusissimilarlyaffected

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ThetreatmentofchoiceforthyrotoxicosisinPregnancyistherapy
withsafeAntithyroidDrugs
Thionamides(Carbimazole/Propylthiouracil)areequallyeffectivein
controllingGrave'sHyperthyroidisminPregnancyandare
consideredthedrugsofchoice.

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AmongstCarbimazole(Methimazole)andPropylthiouracil,
Propylthiouracilistypicallythepreferredagent(Traditionaldrugof
choice)
RadioactiveIodineTherapyiscontraindicatedinpregnancyasit
maydestroythefetalthyroidThyroidectomy(Surgery)israrely

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requiredduringPregnancy.Whenindicatedpreoperativetreatment
withantithyroiddrugsandiodineisundertakenandsurgeryis
performedduringthesecondtrimester
Propylthiouracil
EffectiveincontrollingGrave'sHyperthyroidisminPregnancy
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Notassociatedwithincreasedriskofcongenitalmalformation
(AplasiaCutisCongenitahasnotreportedwiththeuseof
Propylthiouracil))
ConsideredthedrugofchoicefortreatmentofHyperthyroidismin
pregnancy
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ConsideredthedrugofchoiceformothersduringBreastfeeding
(TransferredtothemilkonetenthasmuchasCarbimazole)
EffectiveincontrollingGrave'sHyperthyroidisminPregnancy
AplasiaCutisCongenitaisararedisorderreportedinneonatesof
motherswhoreceivedMethimazole(Carbimazole)during
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pregnancy.
(Consensus:Insufficientdatatoestablishadirectcausalrelationship)
ConsideredasaneffectivealternativewherePropylthiouracilisnot
availableorcannotbeusedforanyreason
Maybeusedinmothersduringbreastfeedingatalowdose
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(TransferredtomilkmorethanPropylthiouracilbutusuallydoesnot
adverselyaffecttheinfant'sthyroidfunction)

1065.Richner-Hanhartsyndromeis
a)Autosomaldominant
b)Occularandcutaneousfeatures

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c)Associatedwithabnormalityinlipidmetabolism
d)Normalmentalfunction
CorrectAnswer-B
Answer-B.Occularandcutaneousfeatures
Rareautosomalrecessivedisorderoftyrosinemetabolismdueto

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deficiencyofthecytosolicfractionofhepatictyrosineamino
transferase.
Occursduetodeficiencyof"Tyrosineaminotransferase".
Mentalretardation.
Thepatienthashighurinarytyrosinelevelsalongwithhighplasma

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tyrosinelevels.
Thesepatientsrespondsdramaticallytodietaryrestrictionofthe
aminoacidsphenylalanineandtyrosine

1066.Investigationofchoicein
pheochromocytomais:

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a)CTscan
b)Urinarycatecholamines
c)MIBGscan
d)MRIScan
CorrectAnswer-B

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AnswerisB(UrinaryCatecholamines):
Pheochromocytomassynthesizeandstorecatecholamineswhich
includenorepinephrine,epinephrineanddopamine.The
investigationofchoicefordiagnosisofPheochromocytomasis
determinationofelevatedlevelsofcatecholaminesandtheir
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methylatedmetabolites(metanephrines)intheplasmaandurine.
CTscan,MRIandMBIGScintographyareallusefuldiagnostic
modalitiesforlocalizationofpheochromocytomaoncethediagnosis
isestablished.

1067.Thepredominantsymptom/signof

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pheochromocytomais:
a)Sweating
b)Weightloss
c)Orthostatichypotension
d)Episodichypertension

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CorrectAnswer-D
AnswerisD(EpisodicHypertension):
ThepredominantmanifestationofPheochromocytomais
HypertensionwhichclassicallypresentsasEpisodicHypertension
(SustainedHypertensionandOrthostaticHypotensionmayalsobe

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seen).
'ThedominantsignisHypertension.Classicallypatientshave
episodichypertension,butsustainedhypertensionisalsocommon'-
Harrison

1068.Primaryhyperparathyroidismis

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suggestedbyallofthefollowing,
except:
a)Increasedserumcalcium
b)Lowurinarycalcium
c)IncreasedPTH

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d)IncreasedC-AMP
CorrectAnswer-B
AnswerisB(LowUrinaryCalcium):
PrimaryHyperparathyroidismisassociatedwithnormalorincreased
urinarycalciumlevels.
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IncreasedPTHandIncreasedSerumcalciuminassociationwith
highlevelsofurinarycalciumsuggestadiagnosisofPrimary
Hyperparathyroidism
IncreasedPTHandIncreasedSerumcalciuminassociationwithlow
levelsofurinarycalciumsuggestadiagnosisofFamilial
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HvpocalciuricHvpercalcemia(FHH)
Disorder
S-
S-
PTHrP Urine

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Urinary
Ca2? PHOS
Calcium
Ca2+
Intact

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Creatinine
PTH
Clearance
ratio
PrimaryHPTH 1'

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sl,(or 1'(or ,I,
U-Ca2'>
>0.02
N) N)
100mg/24h

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Familial
l'
.I(or 1'(or ,I,
U-Ca2+
<0.01

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benign
N) N)
<100mg/24h
hypercalcemia
Thisclearanceratioiscalculatedfromsimultaneousfastingserum

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Thisclearanceratioiscalculatedfromsimultaneousfastingserum
andurineCaandcreatininemeasurements.Theurinesamplecan
befromaspotora24hcollection.Theclearanceratioiscalculated
asfollows:
UrineCa(mg/24h)xplasmacreatinine(mg/dl)/plasmaCa(mg/dL)x

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urinecreatinine(mg/24h)

1069.ThemostclassicalsymptomofVIPOMA
is:
a)Gallstones
b)Secretorydiarrhea

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c)Steatorrhea
d)Flushing
CorrectAnswer-B
AnswerisB(SecretoryDiarrhoea)
TheprinciplefeatureofVIPOMAislargevolumesecretory
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Diarrhoea.
Diarrhoeaissecretoryinnature,persistsduringfastingandisalmost
alwaysgreaterthan>ILitreperday(>3Litresperdayin70
percent).Astoolvolumelessthan700mlperdayisproposedto
excludethediagnosis.Mostpatientsdonothaveaccompanying
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Steatorrhea.
VIPOMAS(Verner-MorrisonSyndrome/PancreaticCholera/WDHA
Syndrome)
VIPomasaretumoursthatsecretelargeamountsofVasoactive
IntestinalPeptide(VIP)

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VIPisanimportantneurotransmitterubiquitouslypresentintheCNS
andGIT
ThemostcommonlocationofVlPomasisthePancreas
Mostcommonsitewithinthepancreasisthepancreatictail
UsuallySolitary

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UsuallyMalignant(37-68%havehepaticmetastasisatdiagnosis
VIP
StimulatesSmallIntestinalchloridesecretion
Stimulatessmoothmusclecontractility

Inhibitsacidsecretion
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Hasvasodilatoryeffects
TypicalFeatures
(WDHA)
WateryDiarrhoea(LargeVolumeSecretory
Diarrhoealeadingto

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dehydration)
Hypokalemia(Diarrhoeasevereenoughto
causehypokalemia)
Achlorhydria(Hypochlorhydriafrom
increasedsmallintestinal

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chloridesecretion)
TheprincipleSymptomsarelargevolume
diarrhoea(100%)
severeenoughtocausehypokalemia(80-
100%),dehydration
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(83%),hypochlorhydria(54-76%)and
flushing(20%)
Mostpatientsdonothaveaccompanying
Steatorrhea
OtherFeatures
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IncreasedstoolVolumeduetoincreasedsecretionofsodiumand
potassiumwhichwiththeanionaccountforosmolalityofthestool
Hyperglycemia(25-50%
Hypercalcemia(25-50%)
ThediagnosisrequiresdemonstrationofanelevatedplasmaVIP
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levelandthepresenceoflargevolumesecretorydiarrhea.

1070.Fabry'sdiseaseaffects
a)ER
b)Lysosome
c)Mitochondria

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d)Cellmembrane
CorrectAnswer-B
Answer-B.Lysosome
Fabrydisease,alsocalledAnderson-Fabrydisease,isthesecond
mostprevalentlysosomalstoragedisorderafterGaucherdisease.

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ItisanX-linkedinbornerroroftheglycosphingolipidmetabolic
pathway.Thisresultsinaccumulationofglobotriaosylceramide
(Gb3)withinlysosomesinawidevarietyofcells,therebyleadingto
theproteanmanifestationsofthedisease.

1071.Granulomatousconditioncausing

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hypercalcemiaincludeallofthe
following,except:
a)TB
b)Sarciodosis
c)Berylliosis

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d)SLE
CorrectAnswer-D
AnswerisD(SLE):
SLEisnotclassifiedasagranulomatousdiseaseandisarare
causeofHypercalcemia(DisseminatedSLE).Sarcoidosis,
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Tuberculosis(TB)andBerylliosisaretypicalGranulomatous
disorderscausinghypercalcemia.
GranulomatouscausesofHypercalcemia
InfectiveCauses
Tuberculosis

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Berylliosis
Histoplasmosis
Coccidoimycosis
Pneumocystis
GranulomatousLeprosy

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Cat-ScratchDisease
Non-InfectiveCause
Sarcoidosis(Mostcommon)
Wegner'sGranulomatosis
InflammatoryBowelDisease

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Histiocytosis-X

ForeignbodyGranulomas
AlmosteverysinglediseaseassociatedwithGranulomaformation
hasbeenreportedtocauseHypercalcemia

1072.Hypophosphatemiaisseenin:

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a)Pseudohypoparathyroidism
b)Hyperparathyroidism
c)Hyperthyroidism
d)Hypoparathyroidism
CorrectAnswer-B

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AnswerisB(Hyperparathyroidism):
Hyperparathyroidismistypicallyassociatedwithhypophosphatemia.
PrimaryHyperparathyroidismisassociatedwithHypophosphatemia
andHypercalcemiawhileSecondaryHyperparathyroidismis
associatedwithHypophosphatemiaandHypocalcemia.

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Hyperthyroidismistypicalassociatedwithnormalphosphatelevels
HypoparathyroidismandPseudohypoparathyroidismareassociated
withHyperphosphatemia

1073.Calciumhomeostasisdisturbanceis
seenin

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a)Malignanthyperthermia
b)DMD
c)Tibialmusculardystrophy
d)Limbgirdlemuscledystrophy
CorrectAnswer-A

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Answer-A.Malignanthyperthermia
Malignanthyperthermiaisapharmacogeneticconditioncauseddue
tomutationofthe"Ryanodinereceptorgene".
Ryanodinereceptorgenecontrolsthelevelof"cytosoliccalcium"
andthereforeskeletalmusclecontraction.

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1074.Tetanyisseenin
a)Respiratoryalkalosis
b)Respiratoryacidosis
c)Metabolicacidosis
d)Hyperkalemia

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CorrectAnswer-A
Answer-A.Respiratoryalkalosis
Inalkalosistetanyoccursbecauseofthedecreasedconcentrationof
freeionizedcalcium.
Itisthefreeionizedcalciumthatisphysiologicallymoreimportant.

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[RefHarrison18th/ep.362,360;Guyton10thiep.342]

1075.Hypomagnesemiaisnotseenin
a)Barterssyndrome
b)Diabetesmellitus
c)Diarrhea

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d)Gitelmansyndrome
CorrectAnswer-A
Answer-A.Barterssyndrome
HypomagnesemiamayoccurinBarter'ssyndromebutusuallythe
serummagnesiumlevelisnormalinBarterssyndrome.

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1076.FeaturesofSLEincludeallofthe
followingexcept:
a)Recurentabortion
b)Sterility
c)Coomb'spositivehemolyticanemia

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d)Psychosis
CorrectAnswer-B
AnswerisB(Sterility):
SystemicLupusErythematosus.
RecurrentAbortionsinSLEmaybeseenasamanifestationof

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AntiphospholipidAntibodysyndrome.Smallproportionofpatients
withSLEmayhaveaCoomb'sPositiveHaemolyticanemia.
PsychosisisaknownneurologicalmanifestationofSLE.

1077.Antibodiesmostcommonlyseenin
druginducedlupusare:

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a)AntidsDNAAntibodies
b)AntiSmAntibodies
c)Anti-RoAntibodies
d)AntihistoneAntibodies
CorrectAnswer-D

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AnswerisD(AntihistoneAntibodies):
Themostcommonlyusedmarkerfordruginducedlupusis
AntihistoneAntibodies.
DrugInducedLupusischaracterizedserologicallybythepresence
ofAnti-HistoneAntibodiesandtheabsenceofantibodiesagainst
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doublestrandedDNA(dsDNAAntibodyNegative;Anti-Histone
AntibodyPositive).Anti-dsDNA
SerologyinDrugInducedLupusErythematosus
AlmostallpatientswithDrugInducedLupuswilltestpositivefor
AntinuclearAntibodies(PositiveANATest)

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ThespectrumofAntinuclearantibodiesinDrugInducedLupus
includes
PositiveAntihistoneantibodies(mostcommon;notspecific;also
seeninSLE)
PositiveautoantibodiesagainstsinglestrandedDNA(common;not

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specific;alsoseeninSLE)
Negative(absenceof)autoantibodiesagainstdoublestranded
DNA(dsDNA)
ThepresenceofautoantibodiesagainstdsDNAstronglysuggestsa
diagnosisofSLE

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DrugInducedLupusistypicallyassociatedwithaHomogeneous

ANApatternduetothepresenceofAntihistoneAntibodies
Antibodiesareseeninlessthan5percentofpatientswithDrug
InducedLupus
ThepresenceofAntihistoneantibodiesaloneisnotaspecifictest

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fordiagnosisofDrugInducedLupusasAntibodiestohistonesmay
alsobeseeninupto50to80percentofpatientswithidiopathic
SLE.
Note:HypocomplementemiaisuncommoninDrugInducedLupus
butnotinSLE.

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1078.PrimarySjogrenssyndrometrueis
a)Canbeseeninchildren
b)IncreasedcomplementC4leadstothymoma
c)Associatedwithrheumatoidarthritis
d)Salivaryglandenlargement

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CorrectAnswer-D
Answer-D.Salivaryglandenlargement
Sjogrensyndromeisachronicdiseasecharacterizedbydryeyes
(keratoconjuctivitissicca)anddrymouth(xerostomia)resultingfrom
immunologicalmediateddestructionofthelacrimalandsalivary

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glands.
Itoccursintwoforms
1. Primaryform(SICCASYNDROME)Occursasanisolated
disorder.
2. SecondryformWhenitoccursinassociationwithother

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autoimmunedisorder.Itismorecommon.
Autoimmunediseasesassociatedwithsjogrensyndrome
Symptomsresultfrominflammatorydestructionoftheexocrine
glands.
1. Keratoconjunctivitis

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2. Xerostomia
3. Parotidglandenlargement

1079.ProphylaxisforHIVisoptimally
effectiveifstartedupto.....hrsof
exposure

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a)1
b)2
c)4
d)12
CorrectAnswer-A

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Answer-A.1
goalistostartwithinonetotwohoursorearlierafterexposureoften
usingastarterpackwithappropriatedrugsasimmediatelyavailable.
Themediantimetoinitiationofpostexposureprophylaxisis1.8hrs.
Thecentrefordiseasecontrolandprevention(CDC)

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recommendationsaretoofferprophylaxisupto24-36hrsafter
exposure,forlongertimelapses,therecommendationsistoseek
advicefromanexpert

1080.Oddpair
a)Erythemamarginatum-rheumaticfever

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b)Erythemagyrensripens-malignancy
c)Necroticacralerythema-HCV
d)Erythemachronicummigransmalignancy
CorrectAnswer-D
Answer-D.Erythemachronicummigransmalignancy
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"Erythemagyratumrepens"isarareandcharacteristicrashstrongly
associatedwithmalignancy.
Erythemachromicumnigrans
Ergthemamarginatum
Itisacharacteristiccutaneousmanifestationofrheumaticfever.

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1081.ANCAisNOTassociatedwithwhichof
thefollowingdiseases:
a)Wegener'sgranulomatosis
b)Henochschonleinpurpura
c)MicroscopicPAN

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d)ChurgStrausssyndrome
CorrectAnswer-B
AnswerisB(H.S.Purpura):
H.S.purpuraisnotassociatedwithanyantinuclearcytoplasmic
antibody(ANCA).ItisanexampleofANCAnegativevasculitis.
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ANCA(AntineutrophiliccytoplasmicAntibodies)arcAntibodies
directedagainstcertainproteinsincytoplasmicgranulesof
Neutrophil&monocytes.
ThesearetwomajorcategoriesofANCAbasedondifferenttargets
fortheantibodies.

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ANCA(Antineutrophiccytoplasmicantibodies):
ANCAisof2types
C-ANCA
(Cytoplasmicproteinase3qisthetargetantigen)
WegenersGranulomatosisq(90-95%)

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P-ANCA
(perinuclearmyeloperoxidaseQisthemajortargetantigen)
MicroscopicPAN(microscopicpolyangitis)
Churg-Strausssyndrome
Crescentericglomerulonephritise

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Goodpasteur'ssyndrome

1082.Yellow-nailsyndromeconsistsof
a)Kneejointeffusionandlymphedema,associatedwith
discolorednails
b)Pericardialandlymphedema,associatedwithdiscolorednails

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c)Peritonealeffusionandlymphedema,associatedwith
discolorednails
d)Pleuraleffusionandlymphedema,associatedwithdiscolored
nails
CorrectAnswer-D

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Answer-D.Pleuraleffusionandlymphedema,associatedwith
discolorednails
Yellownailsyndromeisararedisorderofthenail,whichisusually
accompaniedby
Lymphoedema

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Itmayalsobeassociatedwith:
Recurrentpleuraleffusions
Bronchiectasis

1083.Nottobegiveninmalignantmalariais-
a)Quinolone

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b)Quinine
c)Doxycycline
d)Artesunate
CorrectAnswer-A
Answer-A.Quinolone
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Artemisininderivative:Artesunate
QuinineorQuinidine
Plusoneofthefollowing:Doxycycline,Tetracyclineand
Clindamycin

1084.Muir?Torresyndromeshows

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a)Sebaceouskeratomas
b)Lischnodules
c)Intestinalpolyp
d)Hyperelasticjoints
CorrectAnswer-A

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Answer-A.Sebaceouskeratomas
Muir-Torresyndromeisanautosomalskinconditionofgenetic
origincharacterizedbytumorsofthesebaceousglandor
keratoacanthomathatareassociatedwithvisceralmalignant
disease

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Cutaneouscharacteristic
Adenoma
Epithelioma
Carcinoma
Multiplekeratoacanthomas

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1085.DOCforlisteriameningitis-
a)Ampicillin
b)Cefotaxime
c)Cefotriaxone
d)Ciprofloxacin

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CorrectAnswer-A
Answer-A.Ampicillin
Theantibioticofchoiceforlisteriainfectionisampicillinorpenicillin
G.

1086.Kawasakidiseaseisassociatedwithall

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ofthefollowingclinicalfeaturesexcept
a)Truncalrash
b)Posteriorcervicallymphadenopathy
c)Thrombocytopenia
d)Pericarditis

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CorrectAnswer-C
AnswerisC(Thrombocytopenia):
Kawasakidiseaseisassociatedwiththrombocytosisandnot
thrombocytopenia.
CharacteristiclaboratoryfindingsTreatmentof

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ChoicePrognosisinclude
IncreasedESRHighdose
intravenousPrognosisforuneventfulrecoveryis
Thrombocytosiseimmunoglobulinse
excellente

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1087.Firstsymptomofleprosy
a)Decreasedvibration&positionsense
b)Decreasedpain
c)Decreasedtemperature
d)Decreasedlighttouch

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CorrectAnswer-B
Answer-B.Decreasedpain
In90%ofpatientsthefirstsignofthediseaseisafeelingof
numberswhichmaypreceedesskinlesionsbyanumberofyears.
Temperatureisthefirstsensationlostfollowedbylighttourchpain

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andthendeeppressure.
[RefHarrison18thiep.1363-1364]

1088.LupusPernioisseenin:
a)Tuberculosis
b)SLE

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c)PAN
d)Sarcoidosis
CorrectAnswer-D
AnswerisD(Sarcoidosis):
PernioisatypicalcutaneousmanifestationofSarcoidosis.
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LupusPernioisthemosttypicalandeasilyrecognizableskinlesions
ofSarcoidosis.Itischaracterizedbythepresenceofviolaceous,
purpleblueshinyswollenlesionsoverthebridgeofnose,beneath
theeyesandoverthecheeks.Thisspecificcomplexofinvolvement
ofthebridgeofnose,theareabeneaththeeyesandthecheeksis
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considereddiagnosticforachronicformofSarcoidosis.

1089.Migraineisdueto
a)Dilatationofcranialarteries
b)Constrictionofcranialarteries
c)Corticalspreadingdepression

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d)Meningialinflammation
CorrectAnswer-C
Answer-C.Corticalspreadingdepression
Corticalspreadingdepressionisaselfpropagatingwaveofneuronal
andglialdepolarizationthatspreadsacrossthecerebralcortex.

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Theactivationoftrigeminalafferentsbycorticalspreading
depressioninturncausesinflammatorychangesinthepain-
sensitivemeningesthatgeneratetheheadacheofmigrainethrough
centralandperipheralreflexmechanisms.

1090.HowmuchlengthisincreasedinZ

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plastywhenitisdoneat60degrees?
a)25%
b)50%
c)75%
d)100%

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CorrectAnswer-C
Ansis'c'i.e.75%
Z-plastyisaverycommoninterpositionsurgicaltechniqueutilizedinplasticand
reconstructivesurgerytorevisescars.
Ingeneral,thegreatertheangle,thegreaterthegaininwoundlength.

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TissueLengtheningwithZ-Plasty
TypeofZ-Plasty
IncreaseinLengthofCentralLimb
(%)
Simple45-degree

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50
Simple60-degree
75
Simple90-degree
100

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Four-flapwith60-degree
150
angles
Double-opposing
75

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Five-flap
125
Or
Anglescomparedtogaininlengthareasfollows:
30-degreeangleresultsina25%gaininlength

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45-degreeangleresultsina50%gaininlength
60-degreeangleresultsina75%gaininlength
75-degreeangleresultsina100%gaininlength
90-degreeangleresultsina125%gaininlength

1091..Zplastyidealangle

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a)90?
b)45?
c)60?
d)75?
CorrectAnswer-C

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Answer-C.60?
The60degreeZ-plasty(ie,classicZ-plasty)ismostcommonlyused
becauseitprovidestheoptimalbalancebetweenlengtheningand
easeofclosure.

1092.Allofthefollowingareriskfactorsfor

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deepveinthrombosis(DVT)except-
a)Durationofsurgerymorethanthirtyminutes
b)Obesity
c)Agelessthanfortyyears
d)Useoftheoestrogen-progesteronecontraceptivepills

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CorrectAnswer-C
Ans.is'c'i.e.,Agelessthan40years

1093.Lymphedemaprecoxallaretrue
except
a)U/L

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b)Morecommoninmen
c)Affectsthelegs
d)2-35yrsofage
CorrectAnswer-B
Answer-B.Morecommoninmen
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Primarylymphedemawithageofonsetb/wages1yearand35
years.
MCformsofprimarylymphedema.
Female:Male-10:1
Swellinginvolvesfootandcalf.

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Usuallyunilateral

1094.RTAwithmultiplefracturesinitial
treatmentwouldbe-
a)Managementofshock
b)Splintingoflimbs

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c)Airwaymanagement
d)Cervicalspineprotection
CorrectAnswer-C
Answer-C.Airwaymanagement
Managementoftraumabeginswithprimarysurvey.

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TheATLS(AdvancedTraumaLifeSupport)definesprimarysurvey
asassessmentofthe`A,B,C'i.e.,Airwaywithcervicalspine
protection,Breathingandcirculation.

1095.Bestskindisinfectantforcentralline
insertionis:

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a)Povioneiodine
b)Alcohol
c)Cetrimide
d)Chlorhexidine
CorrectAnswer-D

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Ansis'd'i.e.Chlorhexidine
"Chlorhexidineisnowthedisinfectantrecommendedforallcatheter
placementproceduresandforroutinesitecleansingduringdressing
changes."-ComprehensiveHospitalMedicine:AnEvidence-Based
AndSystemsApproachByMarkV.Williams,ScottA.Flanders,

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p320
"Useofantisepticsolutionforskindisinfectionatthecatheter
insertionsitehelpspreventcatheter-relatedinfection.Chlorhexidine-
basedsolutionsappeartobesuperiortobothaqueousandalcohol-
basedpovidone-iodineinreducingtheriskforcathetercolonization

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andcatheter-relatedbloodstreaminfection.Ifthereisa
contraindicationtochlorhexidine,tinctureofiodine,aniodophoror
70percentalcoholcanbeusedasalternatives"-uptodate.com

1096.Withblunttraumaalloverbodythe
amountofN2&nitrogenendproducts
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lost/day
a)35gm
b)45gm
c)55gm
d)65gm

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CorrectAnswer-A
Answer-A.35gm
Afterinjury,theinitialsystemicproteolysis,mediatedprimarilyby
glucocorticoidesincreasesurinarynitrogenexcretiontolevelsin
excessof30gm/day.

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1097.Thefollowingstatementaboutkeloidis
true?
a)Theydonotextendintonormalskin
b)Localrecurrenceiscommonafterexcision
c)Theyoftenundergomalignantchange

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d)Theyaremorecommoninwhitesthaninblacks
CorrectAnswer-B
Ans.is'b'i.e.,Localrecurrenceiscommonafterexcision
Akeloidscarisdefinedasexcessivescartissuethatextends
beyondtheboundariesoftheoriginalincisionorwound.

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Features-
Itcontinuestogetworseevenafter1yearanduptoafewyears.
Severeitchingispresent
Marginistender
Vascular,red,erythematous(immaturebloodvessels)

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Extendstonormaltissues,hasaclaw-likeprocess.Hencethe
name.
Riskfactors-
Blackrace
Tuberculosispatients

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Incisionoverthesternum,earlobe
Equalinbothsexes
Hereditaryandfamilial
Vaccinationsites,injectionsites
Treatment-
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Injectionofsteroidpreparationsuchastriamcinoloneacetate
(Kenacort)hasbeenfoundtobeextremelyuseful.

Itflattensthekeloid.Intrakeloidalexcisionandskingraftingare
tobetriedlast.
Recurrenceiscommon.(Anyformofexcisionhasahighchanceof

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recurrence)
Careshouldbetakennottoextendtheincisionontothenormal
surroundingtissues.
Siliconeapplication
Topicalretinoids

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1098.Indicationsforemergencythoracotomy
areallofthefollowingexcept
a)Majortracheobronchialinjuries
b)Cardiactamponade
c)Penetratinginjuriestoanteriorchest

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d)TensionPneumothorax
CorrectAnswer-D
Answer-D.TensionPneumothorax
Emergencythoracotomyisindicatedafterchesttraumain
followingconditions:
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Cardiacarrest(resuscitativethoractomy)
Massivehemoththorax(>1500mLofbloodthroughthechesttube
acutelyor>200-300ml/hrafterinitialdrainage.
Penetratinginjuriesoftheanterioraspectofthechestwithcardiac
tamponade.

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Largeopenwoundsofthethoraciccage.
Majorthoracicvascularinjuriesinthepresenceofhemodynamic
instability

1099.InvertedChampagnebottleappearance
isseenin

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a)Varicoseveins
b)DVT
c)Lipodermatosclerosis
d)Venousulceration
CorrectAnswer-C

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Answer-C.Lipodermatosclerosis
Themostcommonlyrecognizedformoflipodermatosclerosis(LDS),
chronicLDSpresencewithindurationandhyperpigmentationofthe
skininvolvingtheoneorbothofthelowerlegsinacharacteristic
"invertedchampagnebottle"appearance.

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Associatedwithvenousinsufficiency,LDSismostcommonin
middle-agedwomen.

1100.10cmtumoronanteriorsurfaceof
thigh,whatisdonetoknowto
diagnosis

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a)Incisionbiopsy
b)Excisionbiopsy
c)FNAC
d)USG
CorrectAnswer-A

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Answer-A.Incisionbiopsy
Incisionalbiopsyisindicatedwhentissuesamplesarenotobtained
byFNACorcoreneedlebiopsyasindeeptumorsandforsuperficial
softtissuetumors>3cm.
Excisionalbiopsyisindicatedforeasilyaccesibleextremityor

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truncallesions<3cm.

1101.Bestmethodtotreatalargeport-wine
hemangiomais?
a)Radiotherapy
b)Tatooing

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c)Excisionwithskingrafting
d)PulseddyeLaser
CorrectAnswer-D
PulseddyeLaserREF:Roxburgh'scommonSkinDiseases17th
editionpage194&205,ClinicalDermatologybyJohnHunter,John

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Savin&MarkDahl3'editionpage275
"SelectivePhotothermolysisorPulseddyelaseristhetreatmentof
choiceforPortwinehemangioma"
Port-winestainsarecrimsonblotchesinwhichthereismarked
capillarydilatationcomparedtoacapillaryangioma,whichisared

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noduleorplaquecontainingproliferatingendothelialcells.Thelatter
tendtoflattenanddisappearatpuberty.Largeronesmaycause
problemsfrombleedingand/orerosion.Cavernoushaemangiomata
arelargerandcompressible,containinglargevascularspaces.
Occasionallyaport-winestainofthetrigeminalareaisassociated

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withavascularmalformationoftheleptomeningesonthesameside,
whichmaycauseepilepsyorhemiparesis(theSturgeWeber
syndrome),orwithglaucoma.
Excellentresultshavebeenobtainedwithcarefulandtime-
consumingtreatmentwitha585-nmflashlamp-pumpedpulseddye

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laser.Treatmentsessionscanbegininbabiesandanaesthesiais
notalwaysnecessary.Ifatrialpatchissatisfactory,40-50pulses
canbedeliveredinasessionandtheprocedurecanberepeatedat
3-monthlyintervals.

1102.Flashburn,tender,red&painful,which

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ofthefollowingtypeistheburn-
a)Scaldedburn
b)Firstdegreeburn
c)Seconddegreeburn
d)Fourthdegreeburn

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CorrectAnswer-B
Answer-B.Firstdegreeburn
Firstdegreeburn(alsok/aSuperficialorEpidermalburn)
Theseburnsinvolveonlytheepidermis
Theydonotblister,

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Areerythematousbecauseofdermalvasodilation
Blanchtotouch(i.e.showcapillaryrefilling)
Arequitepainful
Healwithoutscarringin5to10days.
Theyresultinpainandreddeningoftheepidermis(outerlayerof

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theskin).
Theclinicalfearuresareblisteringand/orlossoftheepidermis.The
underlyingdermisispinkandmoist.Thecapillaryreturniscleariy
visiblewhenblanched

1103.VeinusedinbypassSurgery:

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a)Greatsaphenousvein
b)Shortsaphenousvein
c)Femoralvein
d)Brachialvein
CorrectAnswer-A

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Inpatientswithocclusivecoronarydiseasecausedby
atherosclerosis,thediseasedarterialsegmentcanbebypassedby
insertingagraftconsistingofaportionofthegreatsaphenousvein.
Thevenoussegmentisreversedsothatitsvalvesdonotobstruct
thearterialflow.Followingremovalofthegreatsaphenousveinat

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thedonorsite,thesuperficialvenousbloodascendsthelowerlimb
bypassingthroughperforatingveinsandenteringthedeepveins.
Thegreatsaphenousveincanalsobeusedtobypassobstructions
ofthebrachialorfemoralarteries.

1104.Bestgasusedforcreating

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pneumoperitoniumatlaparoscopyis:
a)N2
b)02
c)CO2
d)N20Goniometerisused

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CorrectAnswer-C
CO2
CO,isthegasusedtocreatepneumoperitoneumduring
laparoscopy.
Otheroptionis-N20:Butitisexpensive,lesssolubleinblood
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andsupportscombustion.
Alsoknow:
Instrumentusedforcreatingpneumoperitoneumisveressneedle.
FlowRateofCO,forcreatingpneumoperitoneum200-2000ml/min
&pressurebetween15-25mmofHg.

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1105.Inafemaleabdominalintestinal
perforationoperatedhasserous
dischargeon5thdaywithwoundgap.
Whatisyourdiagnosis
a)Wounddehiscence

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b)Enterocutaneousfistula
c)Scroma
d)Peritonitis
CorrectAnswer-A
Answer-A.Wounddehiscence
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Dehisencemostoftendevelops7to10dayspostoperativelybut
mayoccuranytimeaftersurgery,from1tomorethan20days."-
Sabiston

1106.Peritonitis
a)Neutrophils>250mm3

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b)WBC<100/m1
c)Ascitislactatelevel<25mg/dl
d)AscitisfluidpH>735
CorrectAnswer-A
Answer-A.Neutrophils>250mm3
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Morethan250neutrophills/cummofascitisfluidsuggestanacute
inflammatoryprocess,themostcommonofwhichisspontaneous
bacterialperitonitis.
Anasciteslactatelevelofmorethan25mg/diwasfoundtobe100%
sensitiveandspecificinpredictingactivespontaneousbacterial

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peritonitis.

1107.Ingastrectomyfollowingoccursexcept
-
a)Calciumdeficiency
b)Steatorrhoea

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c)Fe.deficiency
d)Fluidloss
CorrectAnswer-D
Answeris'd'i.e.Fluidloss
Postgastrectomycomplications
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AnemiaasaresultofvitaminB12orironmalabsorptionand
osteoporosis.
Irondeficiencyanemiadevelopsbecauseremovalofthestomach
oftenleadstoamarkeddecreaseintheproductionofgastricacid.
Osteoporosisdevelopsasaresultofpoorcalciumabsorption,

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anotherproblemthatoccursaftergastricsurgery.
Dumpingsyndrome
Diarrhoea-maybeduetodifferentreasons.associatedwith
dumpingsyndromepost-vagotomydiarrhoeaassociatedwithfat
malabsorption.

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Fatmalabsorptionleadingtosteatorrhoeaoccursduetoacid
inactivationofpancreaticenzymesorpoorlycoordinatedmixingof
food&digestivejuices.Fatmalabsorptionleadstomalabsorptionof
fatsolublevitaminsi.e.A,D,E&K.
Pushingfoodfromyourstomachtoyoursmallboweltooquickly

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(dumpingsyndrome)
Acidreflux
Chestinfections,includingbronchitisandpneumonia
Internalbleeding

Nauseaandvomiting

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Stomachacidleakingintoyouresophagus,causingscarringand
narrowing(stricture)
Vitamindeficiencies
Weightloss

1108.Treatmentofchoiceinanorectal

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carcinoma
a)Chemoradiation
b)APRCombinedsurgeryandradiotherapy
c)Chemotherapyalone
d)All

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CorrectAnswer-B
Answer-B
Abdominal-perinealresectionwithcolostomywas
thepreferredsurgicalprocedureformostmajorcancersof
theanalcanal,

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1109.Rectalprolapsesurgeryis
a)Rectalmucosalstapling
b)Mucosalresection
c)Placation/wiring
d)Rectopexy

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CorrectAnswer-D
Answer-D.Rectopexy
Abdominalapproach
1. Reductionofperinealherniaandclosureofced-de-sac
(Moschowitz'soperation)

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2. Fixationofrectumeitherwithaprostheticsling(Ripsteinandwells
rectopexy)orbySutureRectopexy.
3. Resectionofredundantsigmoidcolon?rectalfixation(Resection
rectopexy).

1110.Crohn'sdisease

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a)Continousinvolvement
b)Sinus&fistula
c)Mesentericlymphadenitis
d)Studulcer
CorrectAnswer-B

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Answer-B.Sinus&fistula
Clinicalfeatures-
Intermittentmilddiarrhea,fever,abdominalpain(MC)
Rightlowerquadrantmass,weightloss,anemia
Sometimesmimicsappendicitisorbowelperforation

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Analcomplaints(fissure,fistula,abscess)?frequent
Fat/vitaminmalabsorptionpresent

1111.Stepladderpatternofgasshadowis
seenin
a)Duodenalobstruction

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b)Intestinalobstruction
c)Gastricoutletobstruction
d)Sigmoidvolvulus
CorrectAnswer-B
Answer-B.Intestinalobstruction
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Stepladdersignrepresentstheappearanceofgas-fluiddistended
smallbowelloopsthatappeartobestackedontopofeachother,
typicallyobservedonerectabdominalradiographsinthesetting
ofsmallbowelobstruction.

1112.Whatisnotseeninshortbowel

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syndrome
a)Hypergastrinemia&highgastricsecretionisseen
b)Diarrhea,dehydrationandmalnutrition
c)Hirsutism
d)ChronicTPNdependence

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CorrectAnswer-C
Answer-C.Hirsutism
Resectionofjejunumisbettertoleratedthanresectionofileum,as
thecapacityforbilesaltandvitaminB12absorptionisspecifictothe
ileum

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Malabsorptionaftermassivesmallbowelresectionisexacerbated
byacharacteristichypergastrinemiaassociatedgastricacid
hypersecretionthatpersistsfor1to2yearspostoperatively
Short-bowelsyndromeisadisorderclinicallydefinedby
malabsorption,diarrhea,steatorrhea,fluidandelectrolyte

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disturbances,andmalnutrition.

1113.EsophagealmanometryisusefulallthisconditionsEXCEPT:
a)Achalasia
b)Diffuseesophagealspasm
c)ToassesstheperistalticintegritypriortothesurgeryforGERD

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d)Malignancy
CorrectAnswer-D
Esophagealmanometry,ormotilitytesting,entailspositioningapressuresensingcatheter
withintheesophagus.
Manometryisusedtodiagnose

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1.Motilitydisorders(achalasia,diffuseesophagealspasm)
2.Toassessperistalticintegritypriortothesurgeryforrefluxdisease.
Esophagealmalignancyisnotdiagnosedwithesophagealmanometry.UpperGI
endoscopyistheeffectivemethodformalignancyandbiopsycanbetaken.
Ref:Harrison,Edition-18,Page-2430

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1114.Ogilvie'ssyndromemostcommonly
involves
a)Stomach
b)Colon
c)Gallbladder

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d)Smallintestine
CorrectAnswer-B
Answer-B.Colon
Ogilviesyndrome,oracutecolonicpseudo-obstruction(ACPO),isa
clinicaldisorderwiththesigns,symptoms,andradiographic

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appearanceofacutelargebowelobstructionwithnoevidenceofthe
actualphysicalcauseoftheobstruction.Thecolonmaybecome
massivelydilated;ifnotdecompressed,thepatientrisksperforation,
peritonitis,anddeath.
Pseudo-obstructionmostcommonlyoccursinhospitalizedpatients

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andisassociatedwiththeuseofnarcotics,bedrest,andco-morbid
disease.
Thisconditiondescribesanobstruction,usuallyofthecolon,that
occursintheabsenceofamechanicalcauseoracuteintra-
abdominaldisease.

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Abdominalradiographsshowevidenceofcolonicobstruction,with
markedcecaldistensionbeingacommonfeature.

1115.Spigelianherniais
a)Throughlineaalba
b)Throughlateralborderofrectusabdominis

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c)Throughmedialwallofiinguinalcanal
d)Throughlateralwallofinguinalcanal
CorrectAnswer-B
Answer-B.Throughlateralborderofrectusabdominis
Spigelianherniascanoccuranywherealongthelengthofthe

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spigelianlineorzone--anaponeuroticbandofvariablewidthatthe
lateralborderoftherectusabdominis.Themostfrequentlocationof
theserarehemiasisatorslightlyabovethelevelofthearcuateline.
Spigelianherniaoccursthroughthelinearsemilunariswhich
correspondstothelateralmarginoftherectusabdominis.

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Aspigelianherniaoccursthroughthespigelianfascia,whichis
composedoftheaponeuroticlayerbetweentherectusmuscle
mediallyandthesemilunarlinelaterally.

1116.MostcommontypeofIntussusception
is-

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a)Ileocolic
b)ileoileal
c)Colo-colic
d)Caeco-colic
CorrectAnswer-A

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Ans.is'a'i.e.,Ileocolic
Ileo-ileo-colic(-12)
Ileoileal(-5%)
Colocolic(-2%)
Multiple(1%)

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Retrograde
Themostcommontypeofintussusceptionisileocolic(also
knownasileocecal)(90%).

1117.24dayneonatewithprojectilevomiting
&failuretogainweight.whatisthe
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diagnosis
a)CHPS
b)NEC
c)Duodenalatresia
d)Hirschsprung'sdisease

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CorrectAnswer-A
Answer-A.CHPS
Projectilevomitingin4thweekisquitesuggestiveofCHPS.In
duodenalatresiathevomiting(usuallybilious)isrightfromthe1st
dayoflife.NECandHirschsprung'sdiseasehavedifferentclinical

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presentation.

1118.NottrueaboutBarrett'sesophagus
a)Metaplasiaofcells
b)PredisposestoSCC
c)Precancerouscondition

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d)Intestinaltypeisthemostcommontype
CorrectAnswer-B
Answer-B.PredisposestoSCC
Barrett'sesophagusispremalignantconditionforadenocarcinma
esophagusandnotSCC.

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1119.Gastrotomyis
a)Openthestomachclosedaftertubeinsertion
b)Openingthestomach
c)Resectingtheterminalpartofstomach
d)Resectingtheproximalpartofstomach

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CorrectAnswer-B
Answer-B.Openingthestomach
Gastrostomyreferstoasurgicalopeningintothestomach.;creation
ofanartificialexternalopeningintothestomachfornutritional
supportorgastrointestinalcompression.Typicallythiswouldinclude

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anincisioninthepatient'sepigastriumaspartofaformaloperation.

1120.Parrotbeakappearanceisseenin
a)Volvulus
b)Intussuption
c)Rectalatresia

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d)CAcolon
CorrectAnswer-A
Answer-A.Volvulus
Barium/gastrograffinenema-demonstratesthepointofobstruction,
pathognomonic"Birdbeckdeformity"orparrotbeakdeformity.

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Contrastenemaiscontraindicatedifgangreneissuspected.
"Parrotbeaked"clawingofneilsisalsoseeninchroniccocaine
abuse.

1121.Raspberrytumorisseenin
a)Umbilicalfistula

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b)Meckel'sdiverticulum
c)Umbilicaladenoma
d)Umbilicalgranuloma
CorrectAnswer-C
Answer-C.Umbilicaladenoma
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Anumbilicaladenomaisalsoknownas"Raspberrytumor".
Itisduetoapartiallyunobliteratedvitellointestinalduct.
Itisseenininfants.
Theprolapsingmucosagivestheraspberryappearanceand
bleedsontouch.
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Treatment:
Aligatureistiedarounditsbase,anditfallsoffafterafewdays.
Recurrenceistreatedwithsurgery.

1122.Aftermastectomy,breast
reconstructionisdoneby

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a)Deltopectoral
b)latissimusdorsi
c)Serratusanterior
d)Trapezius
CorrectAnswer-B

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Answer-B.latissimusdorsi
Iftheskinatthemastectomysiteispoor(e.g.following
radiotherapy)orifalargervolumeoftissueisrequired,a
musculocutaneousflapcanbeconstructedeitherfromthe
latissimusdorsimuscle(anLDflap)orusingthe

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transversusabdominismuscle(aTRAMflapas).Thelattergivesan
excellentcosmeticresultinexperiencedhandsbutisalengthy
procedureandrequirescarefulpatientselection.

1123.PeaudeorangeappearanceofCa
breast,whatisthestage

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a)T4b
b)T4a
c)T3a
d)T3b
CorrectAnswer-A

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Answer-A.T4b
StageI:T1N0M0
StageIla:T0N1M0;T1N1M0;T2N0M0.
StageIlb:T2N1M0;T3N0M0
StageIlla:T0N2M0;T1N2M0;T2N2M0;T3N1M0;T3N2M0

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StageIllb:T4N0M0;T4N1M0;T4N2M0
StageIllc:AnyTN3M0
StageIV:AnyT,anyN,M
Earlybreastcancer___StageIand11J1N1,1-2N1;13NOLocally
advancedbreastcancer(LABC)--Stage111AIMetastaticbreast
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cancer--StageIV
Primarytumor(T)
TX-Primarytumorcannotbeassessed
T0-Noevidenceofprimarytumor
Tis-Carcinomainsitu

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Tis(DCIS)-Ductalcarcinomainsitu

Tis(Paget)-PagetdiseaseofthenippleNOTassociatedwith
invasivecarcinomaand/orcarcinomainsitu(DCIS)intheunderlying
breastparenchyma.Carcinomasinthebreastparenchyma
associatedwithPagetdiseasearecategorizedonthebasisofthe

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sizeandcharacteristicsoftheparenchymaldisease,althoughthe
presenceofPagetdiseaseshouldstillbenoted
T1-Tumor20mmingreatestdimension
T1mi-Tumor1mmingreatestdimension
T1a-Tumor>1mmbut5mmingreatestdimension(roundany

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measurement>1.0-1.9mmto2mm)
T1b-Tumor>5mmbut10mmingreatestdimension
T1c-Tumor>10mmbut20mmingreatestdimension
T2-Tumor>20mmbut50mmingreatestdimension
T3-Tumor>50mmingreatestdimension

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T4-Tumorofanysizewithdirectextensiontothechestwalland/or
totheskin(ulcerationorskinnodules),notincludinginvasionof
dermisalone
T4a-Extensiontochestwall,notincludingonlypectoralismuscle
adherence/invasion

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T4b-Ulcerationand/oripsilateralsatellitenodulesand/oredema
(includingpeaud'orange)oftheskin,whichdonotmeetthecriteria
forinflammatorycarcinoma
T4c-BothT4aandT4b
T4d-Inflammatorycarcinoma

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1124.
WhatistrueaboutHER2/neu
overexpressioninCabreast:
a)Goodprognosis
b)Respondswelltotaxanes

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c)Respondswelltomonoclonalantibodies
d)Seenonlyinbreastcancer
CorrectAnswer-C
Ansis'c'i.e.Respondswelltomonoclonalantibodies
TheHER2receptor(previouslycalledHER2/neu,orERBB-2

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receptor)belongstotheepidermalgrowthfactorreceptor(EGFR)
familyofreceptors,whicharecriticalintheactivationofsubcellular
signaltransductionpathwayscontrollingepithelialcellgrowthand
differentiationandpossiblyangiogenesis.
AmplificationofHER2oroverexpressionofitsproteinproductis

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observedin18to20percentofhumanbreastcancers.
HER2overexpressionisalsonotedinothertumorssuchas
esophagogastrictumors,lung,ovary&headandnecksquamous
cellca.(Inallofthesesites,HER2overexpressionhasbeen
identifiedasanegativeprognosticfactor.)

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FollowingpointsaretobenotedaboutHER2overexpressionin
breastCa:
PrognosticvalueofHER2--HER2overexpressionisapoor
prognosticmarker.HER2overexpressionisassociatedwithhigh
ratesofdiseaserecurrenceanddeathintheabsenceofadjuvant

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systemictherapy.
PredictivevalueofHER2--HER2statuspredictsresponseto
specifictherapies:
PatientswithhighlevelsofHER2expressionbenefitfromtreatment

withagentsthattargetHER2,suchastrastuzumab(amonoclonal

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antibody)andlapatinib.
HER2statusappearstopredictresistanceorsensitivitytodifferent
typesofchemotherapeuticagents,includinganthracyclinesand
taxanes.
WomenwhosetumorsoverexpressHER2appeartoderivegreater

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benefitfromanthracycline-basedadjuvanttherapythanfrom
adjuvanttherapythatisalkylatingagent-based,suchasCMF(cycl
ophosphamide,methotrexate,fluorouracil).
RelationshipbetweenHER2overexpressionandtaxanesisstill
understudywithvariousstudiesgivingconflictingreports.

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HER-2positivityisassociatedwithresistancetoendocrine
therapies.
ScoringofHER-2ImmunohistochemistryAssays
Score
HER-2Status

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StainingPattern
0
Nostainingormembranestainingin
Negative
<10%oftumorcells?

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1+
Negative
?Afaintbarelyperceptible
membranestainingisdetectedin
>10%

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oftumorcells.Thecellsareonly
stainedinpartofthemembrane?.
2+
Equivocal
?Weaktomoderatecomplete

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membranestainingisseenin>10%
of
tumorcellsor<30%withstrong
staininga
3+

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Positive
?Strongcompletemembrane
stainingisseenin>30%oftumor
cells?

1125.Notacomponentoftripletestin

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detectionofCabreast-
a)Breastselfexamination
b)USG/mammography
c)FNAC/trucutbiopsy
d)Clinicalexamination

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CorrectAnswer-A
Answer-A.Breastselfexamination
Tripleassessmentincludesexaminationbyaclinician.Self
examinationisnotapartoftripleassessment.
BaileyandLovewrites--"Inanypatientwhopresentswithabreast

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lumporothersymptomssuspiciousofcarcinoma,thediagnosis
shouldbemadebyacombinationofclinicalassessment,
radiologicalimagingandatissuesampletakenforeithercytological
orhistologicalanalysis,thesocalledtripleassessment.Thepositive
predictivevalue(PPV)ofthiscombinationshouldexceed99.9%."

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1126.Treatmentforhydroureter
a)Antibioticprophylaxisalone
b)Immediateureterolithotomy
c)Endoscopicureteralstenting
d)Urinaryalkalization

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CorrectAnswer-C
Answer-C.Endoscopicureteralstenting
Hydroureterismainlycausedbyintrinsicandextrinsicobstructionof
ureter.Causesare-Calculi(ureteric/VVJ)-intrinsicstrictureand
Retroperitonealfibrosis-extrinsic.

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1127.Diversionofurineisbestdoneat
a)Ileum
b)Jejunum
c)Caecum
d)Colon

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CorrectAnswer-A
Answer-A.Ileum
Ilealsegmentisthebestforurinarydiversionaftercystectomy.
Stillbettermethodis"Continentcutaneousdiversion"method.
Butthebestmethodis"Orthotopicneobladders".

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1128.Ureterosigmoistomy
a)Hyperchloremicwithhypokalemicacidosis
b)Hyperkalemia
c)Metabolicalkalosis
d)Hyponatremia

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CorrectAnswer-A
Answer-A.Hyperchloremicwithhypokalemicacidosis
Thereishyperchloremicmetabolicacidosiswithhypokalemia.

1129.Injurytopeniswhichofthefollowing
preventsextravasationofblood?

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a)Bucksfascia
b)Fasciaofcamper
c)Fasciatransversalis
d)None
CorrectAnswer-A

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Answer-A.Bucksfascia
SuperficialtotunicaalbugineathereisBuck'sfacia(deeplayerof
superficialfasciaofpenis),aprolongationofcolle'sfascia
(membranouslayerofsuperficialfasciaofperineum).
IfBuck'sfaciaremainsintact,hematomaisrestrictedtopenileshaft

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onlycausingegg-plantdeformity.
IfBuck'sfasciaisdisrupted,hematomacanextendtoscrotum,
perineumandsuprapubicregions.

1130.Phimosisisassociatedwith
a)Paraphimosis

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b)Meatalstenosis
c)Balanoposthitis
d)Hypospadias
CorrectAnswer-C
Answer-C.Balanoposthitis
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Phismosiscauseddueto
chronicinfection
Congenital
Acquired-trauma,PenisCaandBalanitis
Pathologicalphimosis(asopposedtothenaturalnon-retractabilityof

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theforeskininchildhood)israreandthecausesarevaried.Some
casesmayarisefrombalanitis(inflammationoftheglanspenis).
Phimosismayoccurafterothertypesofchronicinflammation(such
asbalanoposthitis),repeatedcatheterization,orforcibleforeskin
retraction.

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Phimosismayalsoariseinuntreateddiabetics

1131.Circumcisioniscontraindicatedin
a)Balanitis
b)Hypospadias
c)Paraphimosis

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d)Exostrophyofbladder
CorrectAnswer-B
Answer-B.Hypospadias
Circumcisionisnotdoneinpatientswithhypospadiasasthe
prepucecanlaterbeusedinsurgicalrepair.

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Circucisionismostlydoneforculturalreasons.
Themedicalindicationsforcircumcisionare:
Phimosis&Paraphimosis
Recurrentbalanoposthitis(i.e.inflammationoftheforeskin)
Recurrenturinarytractinfection

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1132.Whichisnottrueaboutcancerof
tongue
a)Adenocarcinomamostcommon
b)Lateralsurfaceinvolved
c)Deepcervicallymphnodesnotinvolved

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d)Tobaccoisthecause
CorrectAnswer-A
Answer-A.Adenocarcinomamostcommon
SCCisthemostcommontypeofmalignancy,butleiomyosarcomas
andrhabdomyosarcomasarealsoencountered(rarely).

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Tumorsonthetonguemayoccuronanysurfacebutaremost
commonlyseenonthelateralandventralsurfaces.
Theregionallymphaticsoftheoralcavityaretothesubmandibular
spaceandtheuppercervicallymphnodes.
Riskfactors-tobaccoandalcohol.

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1133.Epulisarisesfrom-
a)Enamel
b)Rootofteeth
c)Gingiva
d)Pulp

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CorrectAnswer-C
Answeris'c'i.e.Gingiva
Epulisliterallymeans'uponthegum'.Thusitisaswellingsituated
onthegum.
Itcanoriginatefromthemucousmembrane,theperiosteumorthe

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bonegivingrisetodifferentvarietiesofEpulis.

1134.Kasaioperation
a)Biliaryatresia
b)Choledochalcyst
c)Hepatocellularcarcinoma

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d)Primarybiliarycirrhosis
CorrectAnswer-A
Answer-A.Biliaryatresia
Kasaioperationisalsoknownashepatoportoenterostomy.
BiliaryatresiaiscurrentlyMCindicationforpediatricliver

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transplantation.

1135.Inapatientofacutecholecystitis,
referredpaintotheshoulderisk/a
a)Murphy'ssign
b)GrayTurnersign

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c)Boa'ssign
d)Cullen'ssign
CorrectAnswer-C
Ansis'c'i.e.Boas'sign
Boas'sign:Incasesofacutecholecystitispainradiatestothetipof
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therightshoulderandanareaofskinbelowthescapulaisfoundto
behypersensitive.Thisisk/aBoas'sign.Sensitivityisquiteless.
AlsoKnow:
Murphy'ssign:Seeninacutecholecystitis.Murphy'ssigniselicited
byaskingthepatienttobreatheoutandthengentlyplacingthehand
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belowthecostalmarginontherightsideatthemid-clavicularline
(theapproximatelocationofthegallbladder).Thepatientisthen
instructedtoinspire(breathein).Normally,duringinspiration,the
abdominalcontentsarepusheddownwardasthediaphragmmoves
down(andlungsexpand).Ifthepatientstopsbreathingin(asthe
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gallbladderistenderand,inmovingdownward,comesincontact
withtheexaminer's.fingers)andwinceswitha'catch'inbreath,the
testisconsideredpositive.Inorderforthetesttobeconsidered
positive,thesamemaneuvermustnotelicitpainwhenperformedon
theleftside.
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GreyTurner&Cullen'ssign:positiveinseverenecrotizing
pancreatitis.GreyTurnerssignisbluishdiscolourationseenatthe
flanks.Bluishdiscolourationaroundtheumbilicusisknownas

Cullen'ssign.

1136.Falseabouthepaticadenoma

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a)Benignlesion
b)OCPuse
c)Olderfemales
d)Coldonisotopescan
CorrectAnswer-C

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Answer-C.Olderfemales
Hepaticadenomasarebenignsolidneoplasmsofliver.
MCseeninyoungerfemales(20-40yearsofage)
Usuallysolitary
Riskfactor-Prior/currentuseofestrogens(OCP)

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1137.Bismuthclassificationinwhichclass,
hepaticductconfluenceisinvolved
a)TypeI
b)TypeII
c)TypeIII

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d)TypeIV
CorrectAnswer-B
Answer-B.TypeII
Bismuth-Corletteclassificationisusedtoclassify
cholangiocarcinoma

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TypeI-Commonhepaticductinvolvement.
TypeII-CHD+bifurcation/confluenceofhepaticducts.TypeIII-a)
Extensiontorightsecondaryintrahepaticduct.b)Extensiontoleft
secondaryintrahepaticduct.
TypeIV-Involvingbothrightandleftsecondaryintrahepaticducts.

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1138.Parathyroidglandsareremovedby
surgery,forrecurrenceinvestigationof
choice
a)Technetiumscan
b)SPECT

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c)MRI
d)Neckultrasound
CorrectAnswer-A
Answer-A.Technetiumscan
Preoperativelocalisationtestsforparathyroidglandsare

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1. Tc99mlabeledsestamibiscan(>80%sensitive)
2. Singlepositronemissioncomputedtomography(SPECT).
3. CTandMRIscan.
4. Neckultrasound.

1139.Whichisnotacontraindicationfor

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pancreaticoduo-denectomy
a)Metastasis
b)Portalveininvolvement
c)StageIIICAheadofpancrease
d)Invasionofsuperiormesentricvein

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CorrectAnswer-B
Answer-B.Portalveininvolvement
Tumor(T)
TX-Primarycan'tbeasscessed.
To-Noevidenceofprimarytumor.

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T1-Cainsitu.
T1-Limitedtopancreasand2cm.
T2-Limitedtopancreasand>2cm.
T3-Extendsbeyondpancreasbutnoinvolvementofceliacaxis
orsuperiormesentricartery.

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T4-InvolvesceliacaxisorSup-mesentericartery(unresectable
primary).
Regionallymphnodes(N)
NX-RegionalLI\l,canotbeassessed.
N1-NoregionalLNmetastasis.

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N2-RegionalLNmetastasis.
Regionallymphnodes(N)
Mx-Distantmetastasiscannotbeassessed.
Mo-Nodistantmetastasis.
M1-Distantmetastasis.

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1140.Mostcommoncauseofchronic
pancreatitis
a)Chronicalcoholism
b)Tropicalpancreatitis
c)Pancreasdivisium

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d)Gallstonedisease
CorrectAnswer-A
Answer-A.Chronicalcoholism
"Worldwide,alcoholconsumptionandabuseisassociatedwith
chronicpancreatitisinupto70%ofcases"

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1141.Mostcommoncauseofacuteparotitis-
a)StaphylococcusAureus
b)StreptococcusPneumonia
c)Klebsiella
d)StreptococcusViridans

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CorrectAnswer-A
Answer-A.StaphylococcusAureus
MCorganismisStaphylococcusAureus>>streptococcusviridans
>>pneumococcus.
Acutebacterialparotitis:ismostoftencausedby

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abacterialinfectionofStaphylococcusaureusbutmay
becausedbyanycommensalbacteria.
UsuallyascendinginfectionStaphylococcusaureus
Ref-ManipalManualofSurgery5thedition

1142.Pre-operativeprophylaxisfor

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pheochromocytoma
a)Alphablockadeafterbetablocker
b)Betablockadeafteralphablocker
c)Alphablocker
d)Betablocker

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CorrectAnswer-B
Answer-B.Betablockadeafteralphablocker
Betablockerssuchaspropanalolatdosesof10to40mgevery6to
8hoursareoftenneededinpatientswhohavepersistant
tachycardiaandarrhythmias.n-blockersshouldonlybeaddedafter

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adequatea-blockadeandrehydration.
a-adrenergicagonistsmaybeneededinimmediatepostoperative
periodtopreventpostoperativehypotensionandcardiovascular
collapse.

1143.VIPomaisassociatedwithwhich

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syndrome:
a)ZollingerEllison
b)VernerMorrison
c)Carcinoidsyndrome
d)Cushing'ssyndrome

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CorrectAnswer-B
Ansis'b'i.e.VernerMorrison
VlPomasareendocrinetumorsthatsecreteexcessiveamountsof
vasoactiveintestinalpeptide(VIP),
ExcessiveVIPcausesadistinctsyndromecharacterizedbylarge-

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volumediarrhea,hypokalemia,anddehydration.Thissyndromealso
iscalledVerner-Morrisonsyndrome,pancreaticcholera,andWDHA
syndromeforwaterydiarrhea,hypokalemia,andachlorhydria.
Theprincipalsymptomsarelarge-volumediarrhea(100%)severe
enoughtocausehypokalemia(80-100%),dehydration(83%),

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hypochlorhydria(54-76%),andflushing(20%).
Inadults80-90%ofVlPomasarepancreaticinlocation,withtherest
duetoVIP-secretingpheochromocytomas,

1144.Childwithpolytraumacametocasualty,
doseofpackedcell

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a)10ml/kg
b)20ml/kg
c)30ml/kg
d)40ml/kg
CorrectAnswer-A

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Answer-A
Usualdosageofpackedredcellsinpediatricpopulationsis10-15
ml/kg,butcanbeincreasedupto20ml/kgincaseswherehigher
increaseinHCtisneeded,asintrauma.
Colloid10ml/kg

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Crystalloid20ml/kg
Requiring>20ml/KgofPRBCsinthe1sthourofresuscitation
PediatricMTGPack(50Kg)
?4UnitsofPRBCs
?2Unitsofthawedplasma

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?1Unitofapheresisplatelets

1145.PolytraumapatientcametoEMS,dose
ofcrystalloidgivenshouldbe
a)500mlRLbolusthenregulatedbyindicators
b)2000mlbolus

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c)1000mlbolusthenregulatedbyclinicalindicators
d)250mlbolus
CorrectAnswer-C
Answer-C.1000mlbolusthenregulatedbyclinicalindicators
Fluidresuscitationbeginswith1000mlbolusofRLforadultand20

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ml/kgforachild.Responsetotherapyismonitoredbyclinical
indicatorsasbloodpressure,skinperfusion,urinaryoutputand
mentalstatus.

1146.Mostcommondiaphragmaticherniais:
a)Bochdalekhernia

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b)Morgagnihernia
c)Paraesophagelhernia
d)Noneoftheabove
CorrectAnswer-A
Diaphragmaticherniasareofvarioustypes.Themostcommonisaposterolateral

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(Bochdalek)hernia,whichoccursasaresultofadefectintheposteriordiaphragminthe
regionofthetenthoreleventhribs.

1147.ApolytraumaCTscan,CTbrainshows
alesionwithconcavemargin
a)EDH

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b)SDH
c)Contusion
d)Diffuseaxonalinjury
CorrectAnswer-B
Answer-B.SDH
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SDH-OnheadCT,theclotisbrightormixeddensity,cresent
shaped(Lunate),mayhavealessdistinctborderanddoesnotcross
midline.
Contusion-ThecontusedareaappearsbrightonCTScan.

1148.Mostcommoncauseofchylothoraxis?

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a)Trauma
b)Lymphoma
c)Left-sidedheartfailure
d)Infections
CorrectAnswer-B

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Answer-B.Lymphoma
Chylothoraxisapleuralcollectionofamilkylymphaticfluid
containingmicroglobulesoflipid.
Itresultsfromlymphformedinthedigestivesystemcalledchyle
accumulatinginthepleuralcavityduetoeitherdisruptionor

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obstructionofthethoracicduct.
Thetotalvolumeoffluidmaynotbelarge,butchylothoraxisalways
significantbecauseitimpliesobstructionofthemajorlymphducts,
usuallybyintrathoraciccancerlikeprimaryorsecondarymediastinal
neoplasm,suchaslymphoma.

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1149.Thecommonestsiteofaspirationofa
foreignbodyinthesupinepositionis
intothe:
a)Rightupperlobeapical
b)Rightlowerlobeapical

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c)Leftbasal
d)Rightmedial
CorrectAnswer-B
Insupinepositionandwiththepatientonbacksuperior
segmentofRLListhemostdependentsegment.

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1150.Apersoninhaledpeanuttwodays
back&nowunabletocoughitout
whereisthepossiblelocation
a)Rightsuperiorlobe
b)Rtmiddlelobe

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c)Rtlowerlobe
d)Ltlowerlobe
CorrectAnswer-C
Answer-C.Rtlowerlobe
Themostcommonanatomiclocationforaforeignbodyistheright

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mainstembronchusortherightlowerlobe.

1151.InMarfan'ssyndrome,Aorticaneurysm
occursmostcommonlyin:
a)Ascendingaorta
b)Descendingaorta

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c)Abdominalaorta
d)Archofaorta
CorrectAnswer-A
TheanswerisA(AscendingAorta)
AorticaneurysmsinMarfan'ssyndromeoccurmostfrequentlyinthe
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ascendingaorta.
CardiovascularlesionsinMarfan'ssyndrome
Cardiovascularlesionsarethemostlife-threateningfeaturesof
Marfan'ssyndrome.
Mitralvalveprolapse(MVP)
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Lossofconnectivetissuesupportinmitralvalvesleafletsmakes
themsoftandblowycreatingtheso-called'floppyvalve'.
Mitralregurgitationfrequentlyresults.
DilatationofAscendingAortae
Themediaundergoescysticnecrosis(cysticmedionecrosis).

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Lossofmedialsupportresultsinprogressivedilatationofaortic
valveringandrootoftheaorta
SevereaorticincompetenceAorticdissections

1152.Herniamostcommonlystrangulatesin
a)Indirect

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b)Direct
c)Spigelian
d)Incisional
CorrectAnswer-A
Answer-A.Indirect
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"Moststrangulatedherniasareindirectinguinalhernias,however,
femoralherniashavethehighestrateofstrangulation(15-20%)ofall
hernias".

1153.AllofthefollowingstatementsregardingSickleCellAnemiaistrue,
EXCEPT:

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a)Patientsrequirefrequentbloodtransfusions
b)Patientsusuallypresentsbeforetheageof6months
c)ThereisapositivecorrelationbetweenHBSandpolymerization
ofHBS
d)Reccurentinfectionsisthemostcommoncauseofdeath

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CorrectAnswer-B
Sicklecellanemiaisanautosomalrecessivedisorder,causedbyanaminoacid
substitutionofvalineforglutamineinthesixthpositiononthebeta-globinchain.Onsetof
thediseasestartsduringthefirstyearoflifeespeciallyafter6monthsofage,when
hemoglobinFlevelsfalls,asasignalissenttoswitchfromproductionofgammaglobinto

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betaglobin.
HemoglobinSisunstableandpolymerizesduringhypoxemiaandacidosis,leadingto
sicklingofredbloodcells.Patientsdevelopsjaundice,pigmentedgallstones,
spleenomegaly,andpoorlyhealingulcersoverthelowertibia.Acutepainfulepisodescan
occurduetoacutevaso-occlusionbyclustersofsickledredcellsduringinfection,

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dehydration,orhypoxia.Commonsitesofacutepainfulepisodesincludethebonesandthe
chest.
Ref:CurrentMedicalDiagnosisandTreatment2012,Chapter13;MedicalAssisting:
AdministrativeandClinicalCompetenciesByLucilleKeir,6thEdition,Page471

1154.Whatstimulatesthegonadsinmaleat8

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weektosecrettestosterone-
a)Inhibinfromcorpusluteum
b)GnRHfromhypothalamusofbaby
c)PlacentalHCG
d)Allofabove

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CorrectAnswer-C
Ans.is'c'i.e.,PlacentalHCG
Duringembryogenesis,Inmaleembryo,at6-7weekofgestatin,
secretionoffirstanti-mullerianhormone(alsok/omullerianinhibiting
substance)causesregressionofmullerianduct.

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Thenat8-12week,underinfluenceofPlacentalHCG,testesstarted
producingtestosterone.

1155.XXbabypresentingwithpenis&
scrotumcause-
a)Highleveloftestosteroneinmaternalblood

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b)Klinfiltersyndrome
c)Turnersyndrome
d)Noneofabove
CorrectAnswer-A
Answer-A.Highleveloftestosteroneinmaternalblood
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Thisisacaseoffemalepseudohermaphroditismi.e.XXkaryotype
withvirilizedexternalgenitalia.
Maternalandrogen(testosterone)isthecauseofthis.
Femalepseudohermaphroditism
GenotypeisXX.Internalgonadisovarybutexternalgenitaliaare

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virilized(maledifferentiation).
Congenitaladrenalhyperplasia(CAH)dueto21-hydroxylase
deficiencyisthecommonestcause.
Othercausesarematernalvirilizingtumor
(arrhenoblastoma),maternalandrogenadministration,CAHdueto

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11-betahydroxylasedeficiency,fetalplacentalaromatase
deficiency,andWNT-4genemutation.

1156.Malepseudohermaphrodismmost
commoncause-
a)Congenitaladrenalhyperplasia

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b)Adrenocorticaltumor
c)Chromosomalabnormalities
d)Cytogeneticabnormalities
CorrectAnswer-D
Answer-D.Cytogeneticabnormalities
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Mostcommoncauseoffemalepseudohermaphroditism-CAHdue
to21hydroxylasedeficiency.
Mostcommoncauseofmalepseudohermaphroditism-Gonadal
dysgenesisanddefectinandrogenaction.

1157.Causesofmentalretardationin

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congenitalhypothyroidismis-
a)Decreasecerebralgrowth
b)DecreasemyelinationofCNSneuron
c)Decreasegrowthhormonebypitutaryglands
d)Decreaeproductionofneurotransmitters

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CorrectAnswer-A
Answer-A.Decreasecerebralgrowth
is'a'i.e.,Decreasecerebralgrowth[Ref:Ghai7h/ep.481;Jornalof
AmericalPhysiologicalReview]
Thyroidhormonehasmajoreffectonbraininutero&neonatal

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period,deficiencycausediminshaxonalgrowth,dendritic
arborisation,delayproliferation&migrationofgranulecellsoit
decreasecerebralgrowth.

1158.Dosageofintravenousfluidfor2month
oldchildindiarrhoeawithsevere
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dehydration-
a)100ml/Kgin6hour
b)50ml/Kgin6hour
c)75ml/Kgin6hour
d)80ml/Kgin6hour

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CorrectAnswer-A
Answer-A.100ml/Kgin6hour
Sototalfluidtobegiven100ml/Kgin6hour.

1159.Rehydrationtherapyina2yearold
severelydehydratedchildis-

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a)30ml/kgin1hour,70mlin5hours
b)30ml/kgin30min,70ml/kgin2'/2hours
c)20ml/kgin30min,80ml/kgin2'/2
d)75ml/kgin4hours
CorrectAnswer-B

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Answer-B.30ml/kgin30min,70ml/kgin2'/2hours
12Month-5year30ml/Kgin30min70ml/Kgin2.30hour

1160.WhichisMCgeneticcauseofmental
retardation-
a)Tuberoussclerosis

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b)Cri-du-chatsyndrome
c)Fragile-x-syndrome
d)Angel'ssyndrome
CorrectAnswer-C
Ans.is'c'i.e.,Fragile-X-syndrome

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oDown'ssyndromeisthemostcommongeneticcauseofmental
retardation,andfragile-XissecondtoDown's.
Alsoknow
oMostcommoninheritedcauseofmentalretardationisfragile-X-
syndrome(becausedown'ssyndromeiscongenitalcausebutnot

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inherited).

1161.Barrbodyisabsentinfemalehaving?
a)46XXgenome
b)45X0genome
c)47XXX

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d)Allofabove
CorrectAnswer-B
Ans.is'b'i.e.,45X0genome
Barrbody(Sex-chromatin)
oItisadenselystaininginactivatedcondensed'X'chromosomethat

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ispresentineachsomaticcellsoffemale.
oItisfoundinthenucleus.
oItisusedasatestofgeneticfemalenessitispossibleto
determinethegeneticsexofanindividualaccordingastowhether
thereisachromatinmasspresentontheinnersurfaceofthe

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nuclearmembraneofcellswithrestingorintermitentnuclei.
Rememberfollowingfactandthequestionwillseemveryeasy.
Chromatidbody(Barrbodyorsexchromatin)isderivedfromoneof
thetwoX-chromosomeswhichbecomesinactivated.
ThenumerofBarrbodiesisthusonelessthanthenumberofX-
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chromosomes.
Note-
oBarrbodyisfoundinfemaleBut-
oKleinefeltersyndromeismalewithBarrbody.
oTurnersyndromeisfemalewithoutBarrbody.

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1162.Downsyndrome-allareseenexcept-
a)t(14;21)
b)t(11:14)
c)Trisomy21
d)t(15:21)

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CorrectAnswer-B
Ans.is'b'i.e.,t(11:14)
In95%ofcasesofDownsyndrome-trisomyof21:-
Extrachromosomeisofmaternalinorigin.
I%havemosaicwithsomeallhave46chromosome.

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4%haverobertsoniantranslocation.
t(13:21)
t(14:21)
t(15:21)
Veryrarelylongarmofchromosome21istriplicate(Partialtrisomy).

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1163.Simiancreaseisnotseenin-
a)Down
b)Trisomy13
c)Atopicdermatitis
d)Noonansyndrome

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Answer-C.Atopicdermatitis
Simiancrease
Singletransversepalmercrease
Resemblesnon-human-simiansoknownassimiancrease.

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Itisseenin:
1. Downsyndrome
2. Fetalalcoholsyndrome
3. Cri-duchatsyndrome(Chr.5)
4. Klinefelter(XXY)

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5. Noonan(Chr.12)
6. Patau(Chr.13)
7. Edward(Chr.18)

1164.Rubellacausesallexcept
a)Microcephaly

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b)VSD
c)Conductiondefect
d)All
CorrectAnswer-B
Ans.is'b'i.e.,VSD

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Organofcorti:Sensorineuralhearingloss(Mostcommonclinical
findingofcongenitalrubella).
Heart:PDA(MostcommonCHDincongenitalrubella),PS,VSD,
ASDTOF,pulmonaryarteryhypoplasia.
Eye:Cataract,retinopathy,microphthalmia,myopia,glaucoma.

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CNS:Mentalretardation,spasticdiplegia,microcephaly,seizures,
behavioraldisorders.
Other:IDDM,thyroiddisorders,inguinalhernia,cryptorchidism,
interstitialpneumonia.

1165.TBinchildren,mostcommonis-

--- Content provided by⁠ FirstRanker.com ---

a)Abscess
b)Consolidation
c)Hilaradenopathy
d)CNStuberculosis
CorrectAnswer-C

--- Content provided by⁠ FirstRanker.com ---

Answer-C.Hilaradenopathy
"MostcommonformofprimaryTBinchildrenispulmonaryTB.This
couldbeintheformofhilarlymphadenopathywithorwithoutlung
parenchymalinvolvement".

1166.LEOPARDsyndromeincludesallexcept

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-
a)Growthretardation
b)ECGchanges
c)Hypertelorism
d)Hypergonadism

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CorrectAnswer-D
Answer-D.Hypergonadism
LEOPARDsyndrome
Lentigines
Electrocardiographicconductionabnormalities

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Ocularhypertelorism
Pulmonarystenosis
Abnormalgenitalia
Retardedgrowth
Deafness

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1167.GBSinachildtreatment-
a)IVIg
b)Ventilation
c)Plasmapharesis
d)Allofabove

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CorrectAnswer-D
Answer-D.Allofabove
TreatmentofGuillain-barresyndrome-
Selflimitedinmajorityofcases.
Intravenousimmunoglobinshowsgoodresponse.

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Plasmapharesis-Removalofautoantibodies.
Assistedventilation-Ifpatienthadrespiratorymuscleparalysis.
Physiotherapy.

1168.Doseofi.v.adrenalineinterminfantis
duringneonatalresuscitation-

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a)0.1-0.3ml/kgin1:1000
b)0.3-0.5ml/kgin1:1000
c)0.1-0.3ml/kgin1:10,000
d)0.3-0.5ml/kgin1:10,000
CorrectAnswer-C

--- Content provided by‍ FirstRanker.com ---

Ans.isci.e.,0.1-0.3mUkgin1:10,000
Doseoradrenlaine?
0.1ml/kgto0.3inlikgdiluted(1:I0,000)
Routs:(1)Intravenous(umbilicalvein)or
(2)Endotracheal

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Indication?
HR<60/minafter30sec.ofpositivepressureventilation&chest
compression

1169.Picarefersto-
a)Icesucking

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b)Thumbsucking
c)Foreignobjectbeingputinthemouth
d)Noneofabove
CorrectAnswer-C
Answer-C.Foreignobjectbeingputinthemouth
--- Content provided by FirstRanker.com ---
Picainvolvesrepeatedorchronicingestionofnon-nutritive
substances,whichincludeplaster,charcoal,clay,wool,ashes,paint
&earth.

1170.Maximumconcentrationofdextrose
thatcanbegiventhroughperipheral
--- Content provided by⁠ FirstRanker.com ---
vascularlineinneonate-
a)5
b)10
c)12.5
d)25

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.is'c'i.e.,12.5
oHypoglycemiainneonatesisbloodsugar<40mg/dl
oCommoninpreteen,IUGR,infantofdiabeticmothers
oTreatedbybreastfeed,formulafeed&I.V.dextrosesolution

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Insymptomatichypoglycemia2ml/g10%DxIVbolusgiventhen
increasedextrosecontentsofintravenousfluid.
Don'tgive>12.5%dextroseinfusionthroughperipheralline
becauseofriskofthrombophlebitis.(Prefercentralline)

1171.CPRwith2candidateisdoneatrateof

--- Content provided by FirstRanker.com ---

(ininfant)-
a)15:2
b)30:2
c)1:3
d)1:5

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CorrectAnswer-A
Answer-A.15:2
Ininfantchildrenwithtworesuscitator=15:2
Inadultwithtworesuscitator-30:2
Insingleresuscitatorchestcompresionventilationratioinallage

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groupi.e.Infant,children&adult=30:

1172.Neonatallupus-
a)Heartblock
b)Thrombocytopenia
c)Cutaneouslesion

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d)Allofabove
CorrectAnswer-D
Answer-D.Allofabove
Neonatallupus
Ageofonsetnewbornto6month

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Skinlesioninclude:
Annularerythematousscalyplaque.
Seenonsunexposed=head,neck
Maybeassociatedwithheartblock/thrombocytopenia
Diagnosedby:
--- Content provided by‌ FirstRanker.com ---
ANA
AntiROantibodies

1173.Mostcommoncerebellartumorin
children?
a)Astrocytoma

--- Content provided by‍ FirstRanker.com ---

b)Medulloblastoma
c)Ependymoma
d)DNET
CorrectAnswer-A
Ans.is'a'i.e.,Astrocytoma

--- Content provided by FirstRanker.com ---

oThemostcommoncerebellartumorinadultsismetastasis,
whereasinchildrenthemostcommontumorisanastrocytoma.

1174.Allofthefollowingarefeaturesof
juvenileCMLexcept-
a)Thrombocytopenia

--- Content provided by FirstRanker.com ---

b)FetalHbisincreased
c)Philadelphiachromosomeispositive
d)Lymphadenopathy
CorrectAnswer-C
Ans.is'c'i.e.,Philadelphiachromosomeispositive

--- Content provided by FirstRanker.com ---

JuvenileCMLismostlyseeninchildrenbelow2yearsofage.
Philadelphiachromosomeisnegativeandleukocytecountisless
than100'000/mm3.
FeaturesAdult
CMLJuvenileCML

--- Content provided by FirstRanker.com ---

Age10-12
years<2years
Bleedingmanifestation
AbsentFrequent
Thrombocytopenia
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UncommonFrequent
Rash
AbsentFrequent
Lymphadenopathy
RareFrequent
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Splenomegaly
MarkedVariable
WBCcountatdiagnosis>
100'000<100'000
WBCtype

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GranulocyteMonocyte
Normoblastic
UnusualCommon
HbF
NormalIncreased
--- Content provided by‍ FirstRanker.com ---
Immunoglobulins
NormalIncreased
Muramidaselevels
NormalIncreased
ResponsetoBusulphan

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GoodPoor
Survival2.5-3
years9months

1175.Mostcommonbenigntumoursduring
infancyis-

--- Content provided by FirstRanker.com ---

a)Lymphangioma
b)Hemangioma
c)Cystichygroma
d)Lipoma
CorrectAnswer-B

--- Content provided by⁠ FirstRanker.com ---

Ans.is'b'i.e.,Hemangioma
oHemangiomas,themostcommonbenigntumorsofinfancy,occur
in10%ofterminfants.

1176.Opsoclonus-Myoclonusisa
phenomenonseenin?

--- Content provided by‌ FirstRanker.com ---

a)Wilmstumor
b)Neuroblastoma
c)Meningioma
d)Corticaltuberculoma
CorrectAnswer-B

--- Content provided by FirstRanker.com ---

Ans.is'b'i.e.,Neuroblastoma
Opsoclonusisadisorderofeyemovementcharacterizedby
involuntary,chaoticsaccadesthatoccurinalldirectionsofgaze.Itis
frequentlyassociatedwithmyoclonusandataxia.
Opsoclonus-myoclonusmaybecancer-relatedoridiopathic.

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Whenthecauseisparaneoplastic,thetumorsinvolvedareusually
cancerofthelungandbreastinadultsandneuroblastomain
children.

1177.Enzymeusedastreatmentforsickle
cellanemia

--- Content provided by FirstRanker.com ---

a)Chymotrypsin
b)Glucose6-phosphatase
c)Trypsin
d)Noneofabove
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Answer-A.Chymotrypsin
ChymotrypsisusedinSicklecelldisease.

1178.Achildisabletobuildblocksof5
Cubesdevelopmentalageis-
a)12months

--- Content provided by FirstRanker.com ---

b)15months
c)18months
d)24months
CorrectAnswer-C
Ans.is'c'i.e.,18month

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Bang2cube-8month
Towerof2cubes-15month
4cubes-18month
6cubes-22month

1179.Achildisabletosayshortsentencesof

--- Content provided by⁠ FirstRanker.com ---

6words-
a)2years
b)3years
c)4years
d)5years

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CorrectAnswer-C
Ans.is'c'i.e.,4years
o2wordsentences=19month
o6wordsentences=48month
o10wordsentences=60month

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1180.Childstartsmonosyllablesspeechin
whichage
a)4months
b)6months
c)8months

--- Content provided by‍ FirstRanker.com ---

d)10months
CorrectAnswer-B
Answer-B.6months
3months-Startscooing
6months-Producesmonosyllablesoundslikeda,ma

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9months-Producesbisyllablesoundlikebaba,mania

1181.Uppersegmenttolowersegmentratio
in3yragechildis-
a)12
b)1.3

--- Content provided by FirstRanker.com ---

c)1.4
d)1.6
CorrectAnswer-B
Ans.is'b'i.e.,1.3
oThelowersegmentextendsfromthesymphysispubistotheheels.

--- Content provided by FirstRanker.com ---

oThelowersegmentgrowsrapidlyafterbirthascomparedtoupper
segmentgivingrisetothegradualreductionintheupper
segment/lowersegmentratiowiththeprogressionofage.
AgeUppersegment:Lowersegmentratio
Atbirth1.7:1.0

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3years1.3-1.0
At7years1.0:1.0
Thereafter1.0:1.1

1182.Firstpermanentteethtoeruptis:
September2008

--- Content provided by FirstRanker.com ---

a)Firstpremolar
b)Secondpremolar
c)Firstmolar
d)Secondmolar
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Ans.C:Firstmolar
Attheageofabout6-7year,firstpermanentmolarteetherupts
behindthesecondtemporarymolar.
Attheageof9,thereare12permanentteeths.Attheageof11,
thereare20permanentteethsAttheageof14,thereare28

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permanentteeths

1183.Delayeddentitionisseeninall/except?
a)Downsyndrome
b)Congenitalhypothyroidism
c)Rickets

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d)Allofabove
CorrectAnswer-D
Ans.is'd'i.e.,Allofabove
Causesofdelayintootheruption:
1)Impactedteeth4)Cong

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hypothyroidsm
2)Downsyndrome5)Gaucher
Cleidocranialdysplasia6)Osteopetrosis

1184.5yearoldchildbedwettingRxof
choice?

--- Content provided by FirstRanker.com ---

a)Notreatment
b)Imipramin
c)Desmopressin
d)Motivationaltherapy
CorrectAnswer-A

--- Content provided by⁠ FirstRanker.com ---

Ans.is'a'i.e.,Notreatment
oNotreatmentisgiventochildrenbelow6yearsofagebecauseof
highspontaneouscurerate.oAfter6yearstreatmentinclude.
t)Behavioraltherapy:Thisisthetreatmentofchoice.
it)Pharmacologicaltreatment:Itisusedwhennon-pharmacological

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(behavioral)therapyfails.Desmopressinisthedrugofchoice.Other
drugsusedareimpramineandoxybutinin.

1185.Nocturnalenuresisbestt/tis
a)Positivereinforcement
b)Punishment

--- Content provided by FirstRanker.com ---

c)Bedalarm
d)Desmopressin
CorrectAnswer-A
Answer-A.Positivereinforcement
Consistentdrybedtrainingwithpositivereinforcementhasa

--- Content provided by‍ FirstRanker.com ---

successrateof85%andbedandpadalarmsystemshavea
successrateofapproximately75%withrelapseratethatarelower
thanthosewithpharmacotherapy.

1186.Whatisthelarche-
a)Pubertalbreastenlargementinboys

--- Content provided by⁠ FirstRanker.com ---

b)Breastenlargementinpregnancy
c)Hormonerelatedbreastenlargementingirls
d)Posthormonaltherapybreastenlargementinpostmenopausal
females
CorrectAnswer-C

--- Content provided by⁠ FirstRanker.com ---

Ans.is'c'i.e.,Hormonerelatedbreastenlargementingirls
Thelarche
oDefinition:-Beginingofsecondary(Postnatal)breast
developmentatonsetofpubertyingirls.
Tannerstage2breastdevelopment

--- Content provided by‌ FirstRanker.com ---

Usuallyafter8yearsofage
Becauseofrisinglevelofestradiol
Breastdevelopmentduringpubertyinmaletermedas
gynaecomastianotthelarche.

1187.InPrecociouspubertyagelimitofgirls

--- Content provided by FirstRanker.com ---

is-
a)8year
b)10year
c)9year
d)11year

--- Content provided by‍ FirstRanker.com ---

CorrectAnswer-A
Answer-A.8year
Precociouspubertyinagirlistheappearanceofanyofthe
secondarysexualcharacteristicsbeforetheageof8yearsorthe
occurrenceofmenarchebeforetheageof10years.

--- Content provided by FirstRanker.com ---

Precociouspubertyinboysistheonsetofsecondarysexual
characteristicsbeforetheageofnineyears.

1188.Diarrhoeainachildof12month,dose
ofZincis?
a)1mg/10-14day

--- Content provided by‍ FirstRanker.com ---

b)10mg/10-14day
c)15mg/10-14day
d)20mg/10-14day
CorrectAnswer-D
Ans.is'd'i.e.,20mg/10-14days

--- Content provided by FirstRanker.com ---

AccordingtoWHOguidlines
DoseofZinc
2month-6month=10mg/dayx14days>6months=20mg/day
x14days

1189.Seleniumdeficiencyisseenin-

--- Content provided by‌ FirstRanker.com ---

a)Keshandisease
b)Wilsondisease
c)Acrodermatitisenteropathica
d)Noneofabove
CorrectAnswer-A

--- Content provided by‌ FirstRanker.com ---

Ans.is'a'i.e.,Keshandisease
oKeshandisease--->DisorderofSe
metabolism
oWilson'sdisease--->DisorderofCu
metabolism

--- Content provided by FirstRanker.com ---

oAcrodermatitisenteropathica-->DisorderofZn
metabolism

1190.Malnourishedchildminimumweight
gain
a)5gm/kg/day

--- Content provided by‍ FirstRanker.com ---

b)10gm/kg/day
c)15gm/kg/day
d)20gm/kg/day
CorrectAnswer-A
Answer-A.5gm/kg/day
--- Content provided by FirstRanker.com ---
Inmalnourishchildifthere
>10gm/kg/day=goodweightgain
5-10gm/kg/day=moderateweightgain
<5gm/kg/day=poorweightgain

1191.Pretermbabyhave

--- Content provided by‍ FirstRanker.com ---

a)Continueextramedullaryhematopoesis
b)Greaterriskofhypothermia
c)Greaterriskofhypoglycemia
d)Allofabove
CorrectAnswer-D

--- Content provided by‍ FirstRanker.com ---

Answer-D.Allofabove
Pretermbaby(<37weekofgestation).Havehighriskfor
RDS(HMD)
Bronchopulmonarydysplasia(BPD)
PDA

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Anemia(early&late)
IVH
Sepsis
NEC
Jaundice

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Hypoglycemia,hypokalemia,hypothermia
IVH
ROP(Retinopathyofprematurity).

1192.Lowglucoselevelinpremature
a)Increasedbraintobodyratio

--- Content provided by‌ FirstRanker.com ---

b)Decreasedglycogenstores
c)Decreasedactionofpyruvatecarboxylase
d)Allofabove
CorrectAnswer-D
Answer-D.Allofabove
--- Content provided by⁠ FirstRanker.com ---
Hypoglycemiaiscommoninpretem&IUGRbabiesb/callthree
reason
1. Increasedbraintobodyratio.
2. Decreaseactionofpyruvatecarboxylase.
3. Decreaseglycogenstore.

--- Content provided by‍ FirstRanker.com ---

1193.TemperatureofNICUis
a)20-22?C
b)22-26?C
c)26-30?C
d)30-35?C

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CorrectAnswer-B
Answer-B.22-26?C
StandardsforNICUthermalinvornment
Specify72-76?F(22-26?C)asacceptablerangeforairtemperature.

1194.Anemiaofprematurity-Trueis

--- Content provided by‍ FirstRanker.com ---

a)Marginalreticulocytosis
b)<10gmcriteria(Hblevel)
c)10ml/kgpackedcell
d)Microcytichypochromictype
CorrectAnswer-B

--- Content provided by‌ FirstRanker.com ---

Answer-B.<10gmcriteria(Hblevel)
Normocytic,normochromic,hyporegenerativeanemiawithEPO
level.
AOPusuallyresolvespontaneouslywithin3-6months.
Aetiology

--- Content provided by FirstRanker.com ---

1. RBCproduction(Reti.count)
2. RBClifespan
3. Bloodloss
Lowhemoglobin(below10gm%)
Reticulocytecountislow.

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Treatment:
Requirebloodtransfusionifneeded.
Observeifneonateisasymptomatic.

1195.Ababyisbornat27weeksofgestation
requiredmechanicalventilationfornext
--- Content provided by‌ FirstRanker.com ---
4weeks&02fornext1week.He
maintainedatroomtemperature
subsequently.Aspernew
Bronchopulmonarydysplasiadefinition,
hehaswhichofthefollowing?

--- Content provided by⁠ FirstRanker.com ---

a)MildBPD
b)ModerateBPD
c)SevereBPD
d)NoBPD
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Mild
SupplementO2(for28days)and
<32weeksGABreathingroomairat36weeksatbirthcorrectedGA
oratdischarge(whichevercomesfirst).
.32weeksGABreathingroomairby56daysatbirthpostnatalage

--- Content provided by FirstRanker.com ---

oratdischarge(whichevercomesfirst).
?Thebabyinquestionfallsincategory<32weeksgestationageat
birth.
?Simplylookingatquestion,answerseemstobeseverBPDas
mechanicalventilation(positivepressureventilation)hasincluded

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onlyindiagnosticcriteriaofseverBPD.
?But,Thisbabywasbornat27weeksofgestationandrequired
mechanicalventilationfor4moreweeks,i.e.upto31weeks
correctedgestationalage.Afterthathemaintainedatroomair.
Thus,at36weekscorrectedgestaionalage,babyisbreathingat

--- Content provided by‍ FirstRanker.com ---

Thus,at36weekscorrectedgestaionalage,babyisbreathingat
roomair-->diagnosticcriteriaofmildBPD.

1196.HyperglycemiainNeonateifblood
sugarisabove?
a)150mg/dl

--- Content provided by FirstRanker.com ---

b)125mg/dl
c)180mg/dl
d)100mg/dl
CorrectAnswer-B
Ans.is'b'i.e.,125mg/dl

--- Content provided by‍ FirstRanker.com ---

oNoestablisheddefinitionofneonatalhyperglycemiaandupper
safelimitofbloodglucosehasbeendetermined
oVariousresearcheshassuggested
Wholebloodglucose>125mg/dl
Plasmaglucose>150mg/dl

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1197.Bloodtransfusiontoneonaterateof
a)1-5ml/min-5ml/min.
b)5-10ml/min
c)10-15ml/min
d)15-20ml/min

--- Content provided by FirstRanker.com ---

CorrectAnswer-B
Answer-B.5-10ml/min
A)Exchangetransfusion
Forterminfant=80-160ml/kg
Forpreterm=100-200ml/kg

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B)Top-uptransfusion
DesiredHb(glds)-actualhbxkgx3(usually10-20ml/kg).
Rateoftransfusion5-10ml/min.

1198.Macrosomiais/areassociatedwith:
a)Gestationaldiabetesmellitus

--- Content provided by FirstRanker.com ---

b)Maternalobesity
c)Hypothyroidism
d)A&B
CorrectAnswer-D
Ans.isaandbi.e.GestationaldiabetesandMaternalobesity
--- Content provided by⁠ FirstRanker.com ---
Macrosomiaisthetermusedtodescribealargefetus.
Therecommendeddefinitionisfetal(neonatal)weightexceeding
twostandarddeviationsorabove90thcentilefortheappropriate
normalpopulation.
AccordingtoACOG:birthweightof>4500gmiscalledas

--- Content provided by FirstRanker.com ---

macrosomia.
InIndiancontextBirthweightof>4000gmiscalledasmacrosomia.

1199.Inchildren,CHF(congestionheart
failure)isdiagnosedby
a)RaisedJVP

--- Content provided by‍ FirstRanker.com ---

b)Pedaledema
c)Tenderhepatomegaly
d)Basalcrepts
CorrectAnswer-C
Answer-C.Tenderhepatomegaly
--- Content provided by⁠ FirstRanker.com ---
Heartfailureininfants&childrenresultssomedegreeof
hepatemegalywhichisusuallytender&sometimessplenomegaly.
Peripheraledemaisagedependent:
Ininfants,edemausuallyeye&overflank.
Olderchildern&adolescentshowsbothperiorbitaledema&pedal

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edemaandoccurslate.

1200.LargePDAleadsto?
a)Endocardialvalvulitis
b)Eisenmengersyndrome
c)CHF

--- Content provided by⁠ FirstRanker.com ---

d)Allofabove
CorrectAnswer-D
Ans.is'd'i.e.,Allofabove
Patentductusarteriosus(PDA)
SmallPDAmaynotcauseanycomplicationbutlargedefectif

--- Content provided by‌ FirstRanker.com ---

untreadmayleadsto:
PulmonaryhypertensionLefttoRightshuntleadstotoomuch
circulationofbloodinlungwhichleadstopulmonaryhypertension.
Eisenmenger'ssyndrome-Largestandingpulmonaryhypertension
leadstopermanentlungdamageandcausesRighttoLeftshunt.

--- Content provided by⁠ FirstRanker.com ---

Endocarditis.
ArrhythmiaEnlargementofheartduetoPDAincreaseriskof
arrhythmias

1201.ASDisassociatedwithallexcept?
a)Infectiveendocarditis

--- Content provided by⁠ FirstRanker.com ---

b)Stroke
c)Arrhythemia
d)Pulmonaryhypertension
CorrectAnswer-A
Ans.is'a'i.e.,Infectiveendocarditis

--- Content provided by⁠ FirstRanker.com ---

oASDisusuallysubtleandnothavingsignificantproblemexcept
mildgrowthdisturbance.
oOstiumsecundunASDisM.C.typeofASD.
oOstiumsecundumASDusuallyassociatedwithmitralvalve
prolopseorstenosis(Lutembacher'sSyndrome).oComplication

--- Content provided by⁠ FirstRanker.com ---

usuallydevelopin4thclecadeandinclude:
I)Pulmonaryhypertension
2)Rt.sidedheartfailure
3)Stroke
4)Eisenmenger'ssyndrome

--- Content provided by‍ FirstRanker.com ---

InfectiveendocarditisisveryrareinASDandnotrequireany
antibioticprophylaxis.

1202.AcuteInfectiveEndocarditiswith
abscessformationismostcommonly
associatedwith

--- Content provided by‌ FirstRanker.com ---

a)Listeria
b)Staphylococcus
c)Streptococcus
d)Enterococcus
CorrectAnswer-B

--- Content provided by⁠ FirstRanker.com ---

AnswerisB(Staphylococcus)
AcuteInfectiveEndocarditiswithabscessformationismost
commonlyassociatedwithstaphylococcus.
`Themostcommonorganismcausingacuteinfectiveendocarditis
overallisstaphylococcusaureus.Staphylococcusaureus
--- Content provided by⁠ FirstRanker.com ---
endocarditisisparticularlyvirulentandassociatedwithannularand
myocardialabscessformationandahighermortality'

1203.Whichofthefollowingstatementsregardingfetalcirculationiscorrect?
a)Theliverandheartofthefetusreceivebloodwithveryhigh
oxygensaturation

--- Content provided by FirstRanker.com ---

b)PO2offetalbloodleavingtheplacentaisslightlygreaterthan
maternalmixedvenousPO2
c)Thepresenceoffetalhemoglobinshiftstheoxyhemoglobin
dissociationtotheright
d)Theforamenovaleclosesduringthethirdtrimesterunlessthe

--- Content provided by FirstRanker.com ---

fetushasanatrialseptaldefect
CorrectAnswer-A
Sincetheliverissuppliedbyumbilicalvenousbloodfromtheplacenta,andtheheart
andheadreceivebloodbeforeithasmixedwithsignificantamountsofdesaturated
blood,theseimportantorgansreceivebloodthatisrelativelyhighinsaturated
--- Content provided by FirstRanker.com ---
oxyhemoglobin.
Thehighrateofbloodflowattheplacentaandthesignificantresistanceoftheplacentato
diffusionofoxygenresultinbloodintheumbilicalveinthathasalowerPO2(30mmHg)
thanthematernalmixedvenousblood.
However,theleftshiftinfetaloxyhemoglobinconcentrationandtheBohreffectbothactto

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increasethetransportofoxygentofetaltissues.
Anumberofsignificantdifferencesincirculatingpatternsarepresentinthefetus.
Theforamenovaleremainsopenuntilafterbirthandasignificantportionofinferior
venacavaflowisshuntedthroughittotheleft.
1/3ofbloodentersdirectlyfromrightatriumtoleftatrium(bypassingrightventricle)through

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foramenoval
Themajorportionofrightventricularoutputisshuntedthroughtheductusarteriosustothe
aorta,notthelungs.
Theneteffectoftheseshuntsinthepresenceofhighfetalpulmonaryvascularresistanceis
verylowfetalpulmonarybloodflow.

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Atbirth,thesepatternsnormallyarequicklychangedtoex-uteropatternswithhigh
pulmonaryperfusion.
Ref:BarrettK.E.,BarmanS.M.,BoitanoS.,BrooksH.L.(2012).Chapter33.Circulation
throughSpecialRegions.InK.E.Barrett,S.M.Barman,S.Boitano,H.L.Brooks(Eds),
Ganong'sReviewofMedicalPhysiology,24e.

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1204.Doublearchaortaisseenin
a)CATCH22
b)Digeorgesyndrome
c)Sphrintzenvelocardiofacialsyndrome
d)Noneofabove

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CorrectAnswer-A
Answer-A.CATCH22
CATCH22standsfor
Cardiacdefect-doublearchaorta.VSD,pulmonaryatresia.
Cleftpalate

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Abnormalfacies
Hypocalcemia
Thymichypoplasia

1205.Decorticatechild-Flasestatementis?
a)AcuteBraininjurys

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b)Susthalamic,CT&frontallobelesion
c)Moredangerousthandecerebratelesion
d)Flexionofarm&extensionoflowerlimb
CorrectAnswer-C
Ans.is'c'i.e.,Moredangerousthandecerebratelesion

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DecorticalPosture
oAlsoknownasflexorposturingorMummybaby
oArmsflexed/bentoverchest,handfisted,legextended&rotated
inward
oDamagetoareaincerebralhemisphere,internalcapsule,

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thalamus&upperpartofbrain.
oDecorticatepostureisominoussignofseverebraindamage.
Decerebrateposture
oAlsoknownasextensorposturing
oExtensionofupperlimb&lowerlimb(ELBOWEXTENDED)

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oIndicatesbrainstemdamage(Belowlevelofrednucleus)
oDecerebratepostureismoreominousthandecorticalposture

1206.Treatmentofsimplefebrileconvulsion
isbasedon
a)Controloffever

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b)Rectaldiazepam
c)CSFfinding
d)Bloodreports
CorrectAnswer-A
Answer-A.Controloffever
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Promptreductionoftemperaturebyhydrotherapy(sponging)and
antipyretics(paracetamole,ibuprofen)isthemostimportant
measure.Ifseizureslastsformorethan5minutes,diazepam(rectal
orIV)istheanticonvulsantofchoice.Phenobarbitoneisan
alternative

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1207.Whatiscorrectaboutfebrileseizures
a)NormalEEG
b)Focaldeficits
c)Repeatedseizure
d)AbnormalEEG

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CorrectAnswer-A
Answer-A.NormalEEG
Spontaneousremmissionoccurswithnopostictalneurological
deficitandEEGchangesfewdaysaftertheseizureisnormal.
Recurrentfebrileseizuresoccurin30-50%ofcases.

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Morethan90%offebrileseizuresaregeneralized.
Acuterespiratoryillnessaremostcommonlyassociatedwithfebrile
seizures.

1208.Chronicconstipationinchildrenisseen
inallA/E?

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a)Hirschspringdisease
b)Jejunalpolyp
c)Hypothyroidism
d)Stricture
CorrectAnswer-B

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Ans.is'b'i.e.,Jejunalpolyp
Organiccausesofconstipationare:
i)Intestinal:Hirschprungdisease,Anal/rectalstenosis,Anal
fissure,anteriorlydisplacedanalopening,strictures.
ii)Drugs:Narcotics,vincristine,Psychotropics.

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iii)Metabolic/endocrine:Cysticfibrosis,hypothyroidism,
Panhypopituitrism
iv)Neuromuscular:Cerebralpalsy,Psychomotorretardation,
spinalcordlesions,Myotonicdystophy,Neuropathyormyopathyof
GIT

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v)Othercauses:Lowfibrediet,Milkproteinallergy.

1209.3monthinfantswithabdominal
palpablemass&nonbiliousvomiting-
a)Hypertrophicbiliarystenosis
b)Hypertrophicpyloricstenosis

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c)Tracheoesophagealfistula
d)Duodenalatresia
CorrectAnswer-B
Ans.is'b'i.e.,Hypertrophicpyloricstenosis
Hypertophicpyloricstenosis
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MostcommoncauseofnonbiliousvomitingisHypertrophicpyloric
stenosis.
Male>female.
Vomitingstartswith3weekofage.
Palpablemassisseeninepigastricregion.

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Visibleperistalsisisseensoonafterfeeding.
ConfirmedbyUSGabdomen.
Contraststudyshows:
.Shouldersign
.Doubletractsign.

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Treatmentsurgery=Ramstedtprocedure.

1210.Causesofconjugated
hyperbilirubinemiais?
a)Rotorsyndrome
b)Breastmilkjaundice

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c)Criglernajjar
d)Gilbertsyndrome
CorrectAnswer-A
Ans.is'a'i.e.,Rotorsyndrome
Conjugatedhyperbilirubinemiaisseenwhen?

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i)Impairedsecretionofconjugatedbilirubinintobile->Dubin
Johnsonsyndrome,Rotorsyndrome.
ii)Impairedbileflow-->Obstructivejaundice,primarybiliary
cirrhosis,Neonatalcholestasis,e.g.Extrahepaticbiliary
atresia/neonateidiopathichepatitis,Choledocalcyst,Sclerosing
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cholangitis,Carolidisease,Metabolic(Tyrosinemia,Wolman
disease,Niemanpickdisease,Galactosemia,Fructosemia).

1211.Causeofneonatalhyperbilirubinemia?
a)Inefficienterythropoiesis
b)RBChemolysis

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c)Immatureliverenzyme
d)Allofabove
CorrectAnswer-D
Answer-D.Allofabove
ImpairedbileflowObstructivejaundice,primarybiliarycirrhosis,

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Neonatalcholestasis,e.g.Extrahepaticbiliaryatresia/neonate
idiopathichepatitis,Choledocalcyst,Sclerosingcholangitis,Caroli
disease,Metabolic(Tyrosinemia,Wolmandisease,Niemanpick
disease,Galactosemia,Fructosemia).

1212.InDiapragmaticHernia.Mostcommon

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anomalyisseenin
a)Cardiovascularanomalies
b)Urinarytract
c)Craniofacialanomaly
d)Skullanomaly

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CorrectAnswer-A
Answer-A.Cardiovascularanomalies
DiaphragmaticHerniaisdefinedasacommunicationbetween
abdominal&thoraciccavitieswithorwithoutabdominalcontentsin
thorax.

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Femalesareaffectedmorethanmales.
Morecommononleftsideandisposterolateral.
Associatedanomaliesmaybeseen30%ofcasesCNSlesions,
esophagealatresia,omphaloceleandCVSlesions.Mostcasesare
sporadic.

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CardiacanomalisisMCanomalis.

1213.Hirschsprungdiseaseisconfirmedby?
a)Rectalbiopsy
b)Per/Rectalexamination
c)Rectalmanometry

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d)X-rayabdomen
CorrectAnswer-A
Ans.is'a'i.e.,Rectalbiopsy
oRectalsuctionbiopsyisprocedureofchoice.

1214.Mostcommonpresentationofwilm's

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tumor?
a)Hematuria
b)Asymptomaticabdominalmass
c)Abdominalpain
d)Headache

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CorrectAnswer-B
Ans.is`b'i.e.,Asymptomaticabdominalmass
Wilm'stumor(Nephroblastoma)
Mostcommonmalignanttumorofkidney.
80%oftumorpresentbelow5yearofage.

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Presention:?
Asymptomaticabdominalmass(M.C.).
Haematuria(10-25%).
Hypertension(25%).
Abdominalpain(30%).

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Fever(20%).

1215.Posteriorurethralvalve-trueA/E?
a)Palpablebladder
b)Hydronephrosis
c)Painfulstressincontinence

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d)RecurrentUTI
CorrectAnswer-C
Ans.is`c'i.e.,Painfulstressincontinence
Posteriorurethralvalve
Mostcommoncauseofsevereobstructiveuropathyinchildren.

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30%ofchildrenexperiencedendstagerenaldisease/CRF
Dilatedprostaticurethra.
Hypertrophyofbladdermuscle
Vesicoureticrefluxseenin50%ofcases.
Backpressurechange:
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Hydronephrosis
Distendedbladder
Thinurinarystream
RecurentUTIbecauseofurinarystasis

1216.Nottrueaboutchronicpyelonephritisin

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children-
a)AssociatedwithUretericreflux
b)AssociatedwithIntrarenalreflux
c)Associatedwithrenalscarring
d)Malesaremoreaffectedthanfemale

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CorrectAnswer-D
Ans.is'd'i.e.,Malesaremoreaffectedthanfemale
o3basicformsofUTI-(1)Pyelonephritis(2)Cystitis(3)
Asymptomaticbacteremia
ChronicPyelonephritis:-

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Characterisedbyrenalinflammation&fibrostsinducedbyrecurrent
orpersistentrenalinfection,vesicouretericrefluxorothercausesof
UTI.
Progressiverenalscarringwhichleadstoendstagerenal
diseaes.

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Inreflexnephropathy,Intrarenalreflexofinfectedurineinduces
renalinjurywhichhealsbyrenalscarring.
Being-straight,short&wideurethra,recurrentUTIismorecommon
infemale,soCPNisalsotwiceascommonisfemalethanmale.

1217.Mousyurineinachildduetodefectin

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phenylalamineto
a)Tyrosine
b)Homogentisicacid
c)Phenylacetate
d)Phenylpyruvate

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CorrectAnswer-A
Answer-A.Tyrosine
Phenylketonuria:
Autosomalrecessive
Deficiencyofphenylalaninehydroxylase.

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Defectinconversionofphenylalaninetotyrosine.
Thisleadstoincreaselevelofphenylalanine.
Thisincreasephenlylalanineconvertedintophenylpyruvateand
phenylacetate.
Thisphenylacetategivesmousyormustyodourinurine/body.

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1218.Highestcurerateisof-
a)Wilm'sTumor
b)Retinoblastoma
c)Rhabdomyosarcoma
d)All

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CorrectAnswer-B
Ans.is'b'i.e.,Retinoblastoma
Tumor
5yearssurvivalrate
Retinoblastoma

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97%
Wilms
tumor
88%
Rhabdomyosarcoma

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61%

1219.Mostcommonsiteofextramedullary
relapseofALLin6yearoldis
a)Testes
b)Liver

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c)Lung
d)None
CorrectAnswer-A
Answer-A.Testes
ThecommonsitesofrelapseofALLaftercompleteremissionare:

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Bonemarrow(mc),CNS(2mc)andtestis.

1220.Proximalhumerusfracturewhichhas
maximumchancesofavascular
necrosis
a)Onepart

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b)Twopart
c)Threepart
d)Fourpart
CorrectAnswer-D
Answer-D.Fourpart
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Neer'sclassifiedproximalhumerusfractureinto4types,based
onthesefoursegments:
1.Onepartfracture:-Fracturewithminimaldisplacement.
2.Twopartfracture:-Onesegmentisdisplacedinrelationtoother.
Importanttwopartfracturesare:

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(i)surgicalneckfracture(mostcommon)(ii)GTfracture,(iii)LT
fracture,(iv)anatomicalneckfracture.
3.Threepartfracture:-Twosegmentsaredisplacedinrelationto
othertwo.
4.Fourpartfracture:-Allfourmajorfragmentsaredisplaced.

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ChancesofAVNofhumeralheadarehigherinfourpartfracture.

1221.Mostcommontypeofshoulder
dislocationis:
March2011
a)Posterior

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b)Anterior
c)Inferior
d)Superior
CorrectAnswer-B
Ans.B:Anterior

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Shoulderjointisthecommonestjointinthebodytodislocate
Anteriorshoulderdislocationismuchmorecommonthanposterior
dislocation
Shoulderdislocation:
MCjointtodislocateinbody:Shoulder

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MCtypeofshoulderdislocation:Subcoracoid/inferior
Raresttypeofshoulderdislocation:Posterior
Posteriortypeofshoulderdislocationisassociatedwith:Epilepticfits
Bankart'slesionisrelatedwithavulsionofglenoidallabrum
HillSach'slesionisfoundonhumeralhead

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Testfordislocationofshoulderjoint:
-Duga'stest,
-Hamiltonrulertest,
-Callawaystest
Kocher'smanouevreisdonetoreduceadislocatedshoulder

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1222.Mostcommonmuscledamagedin
rotatorcuff
a)Supraspinatus
b)Infraspinatus
c)Subscapularis

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d)Teresminor
CorrectAnswer-A
Answer-A.Supraspinatus
Duringinjurytorotatorcuff,tendonsareaffected,notthemuscle.
Supraspinatustendonisaffectedmostfrequently.

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1223.Trueaboutsupracondylarfractureof
humerus
a)Commoninadults
b)Extensiontypemostcommon
c)Flexiontypeismostcommon

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d)None
CorrectAnswer-B
Answer-B.Extensiontypemostcommon
Supracondylarhumeralfracturesarethemostcommonelbow
fracturesinchildren.Mostcommonagegroupaffectedis5-8years.

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Boysareaffectedmorethangirls.Leftsideismorecommonthan
right.
Extensiontypeismostcommon

1224.Themalunionofsupracondylarfracture
ofthehumerusmostcommonlyleads
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to:
a)Flexiondeformity
b)Cubitusvarus
c)Cubitusvalgus
d)Extensiondeformity

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CorrectAnswer-B
Bi.e.CabitusVarus
Malunion:-Itisthecommonestcomplicationofsupracondylar
fractureandresultsincubitusvarus(Gunstockdeformity).Cubitus
valgusisrareandmayoccuroccasionallyinposterolateral

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displacement.

1225.TheMOSTcommontypeofdislocationofelbowjointis:
a)Posterior
b)Posterolateral
c)Posteromedial

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d)Lateral
CorrectAnswer-A
Inadults,theelbowisthesecondmostfrequentlydislocatedmajorjoint,aftertheshoulder.
Itisthemostcommonlydislocatedjointinchildren.Morethan90%ofallelbowdislocations
areposteriordislocations.

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Thisinjuryentailsdisengagementofthecoronoidprocessoftheulnafromthetrochleaof
thehumeruswithmovementposteriorly.
Themechanismofinjuryistypicallyafallontoanoutstretchedhandwiththeelbowin
extensionuponimpact.

1226.Whatisseenonx-raywithposterior

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elbowdislocation
a)Coronoidprocessposteriortohumerus
b)Coronoidprocessanteriortohumerus
c)Coronoidprocessbelowhumerus
d)None

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CorrectAnswer-A
Answer-A.Coronoidprocessposteriortohumerus
APview:Greatersuperimpositionofdistalhumeruswithproximal
ulnaandolecranon(normally,onlyterminalpartofhumerusis
superimposed).

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1227.

Inposteriordislocationofelbow,most
prominentpart
a)Coronoid
b)Radialhead

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c)Olecranon
d)None
CorrectAnswer-C
Answer-C.Olecranon
ThereisexaggratedprominenceoftheOlecranon

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1228.Mostcommoncomplicationoflateral
condylehumerusfracture
a)Malunion
b)Nonunion
c)VIC

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d)Mediannerveinjury
CorrectAnswer-B
Answer-B.Nonunion
Lateralspur(Lateralcondylarspurorlateralcondylarovergrowth)is
oneofthemostcommoncomplication.Delayedunionornon-union

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canoccuriffractureisundetectedorleftuntreated.
Cubitusvalgusisacommoncomplication
Tardyulnarnervepalsyseenafterseveralyears.
Rarelyavascularnecrosisandmyositisossificans.

1229.PulledElbowis:

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a)Disarticulationofelbow
b)Disarticulationofelbow
c)Subluxationofproximalradioulnarjoint
d)Noneoftheabove
CorrectAnswer-C

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Ci.e.subluxationofproximalradioulnarjoint
Ifayoungchildisliftedbythewrist,theheadoftheradiusmaybe
pulledpartlyoutoftheannularligament,i.e.,subluxationofthehead
oftheradius.
Itoccurswhenforearmispronated,elbowisextendedand
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longitudinaltractionisappliedtothehandorwrist,e.g.,lifting,
spinningorswingingachildwithwristorhand.Pulledelbowmost
commonlyoccursbetweentheageof2-5years

1230.Oneofthecommonfracturesthatoccur
duringboxingbyhittingwithaclosed
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fistis?
a)Monteggiafracturedislocation
b)Galeazzifracturedislocation
c)Bennett'sfracturedislocation
d)Smith'sfracture

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CorrectAnswer-C
Ans.is'c'i.e.,Bennett'sfracturedislocation
ThecommonmechanismofinjuryforBenett'sfractureisanaxial
blowdirectedagainstthepartiallyflexedmetacarpal,inmostcases
during'fistfights'.

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Benett'sfracture
Benett'sfractureisanintra-articularfracturedislocationofthe
palmarbaseoffirstmetacarpalboneofthethumbwitheither
subluxationordislocationoffirstcarpometacarpaljoint,i.e.
trapezometacarpaljoint.Thecommonmechanismofinjuryisan

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axialblowdirectedagainstthepartiallyflexedmetacarpal,inmost
casesduring"Fistfights".Patientcomplainsofpain,swellingand
tendernessoverthebaseofthethumb.Movementsofthumbare
restricted.
DisplacingforceinBennett'sfractures

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FollowingarethedeformingforcesinBennett'sfracture:-
i)Atthedistalfragment,itistheadductorpollicis.
ii)Attheproximalfragment,itistheabductorpollicislongus.
Baseofthethumbmetacarpalispulleddorsallyandmediallybythe
abductorpollicislongus,whilethedistalattachmentofadductor

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pollicisfurtherleversthebaseintoabduction.

1231.MostcommoncomplicationofCones
#
a)Malunion
b)Avascularnecrosis

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c)Fingerstiffness
d)RuptureofEPLtendon
CorrectAnswer-C
Answer-C.Fingerstiffness
Thecomplicationrateis55%,withthemostcommoncomplication

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beingsomedegreeofresidualfingerandwriststiffness(39%).
Mostcommoncomplicationofcolle'sfracture-Fingerstiffness

1232.Mostcommoncomplicationoffracture
neckoffemur
a)Malunion

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b)AVN
c)Nonunion
d)Arthritis
CorrectAnswer-B
Answer-B.AVN
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AVNisthemostcommoncomplicationoffemoralneckfracture.
Non-unionisthesecondmostcommoncomplicationoffemoralneck
fracture.

1233.Whichofthefollowingdescribesgrade
2fractureneckfemur?

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a)Incompletefracture,medialtrabeculaeintact
b)Completefracturewithundisplacedneck
c)Completefracturewithischemichead
d)Moderatedisplacementofneck,vascularitydamaged
CorrectAnswer-B

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Answer-B.Completefracturewithundisplacedneck
GardenstageI:undisplacedincomplete,includingvalgusimpacted
fractures
medialgroupoffemoralnecktrabeculaemaydemonstratea
greenstickfracture

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GardenstageII:undisplacedcomplete
nodisturbanceofthemedialtrabeculae

1234.Treatmentofchoiceforfractureneck
femurina40yearsoldfemale
a)Multiplescrewfixation

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b)Bipolarhemiarthroplasty
c)THR
d)None
CorrectAnswer-A
Answer-A.Multiplescrewfixation
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Placementofmultiplescrewsacrossthefracturedfemoralneckis
thetreatmentofchoiceforfemoralneckfractures,andmaybe
performedfollowingeitherclosedoropenreductionusingastandard
lateralapproachoramorelimitedpercutaneoustechnique.

1235.Talusissuppliedby

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a)Anteriortibialartery
b)Posteriortibialartery
c)Dorsalpedisartery
d)All
CorrectAnswer-D

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Answer-D.All
Extraosseousbloodsupply
1. Posteriortibialartery:-Deltoidbranch,arteryofthetarsalcanal.
2. Anteriortibialartery:-SuperiorneckbranchfromDorsalpedisartery,
Arteryoftarsalcanal.

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3. Paronealartery:-Arteryoftarsalsinus.

1236.Commonestligamentinjuredinankle
injury?
a)Anteriortalofibularligament
b)Calcaneofibularligament

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c)Posteriortalofibularligament
d)Springligament
CorrectAnswer-A
Ans.is'a'i.e.,Anteriortalofibularligament
Theankleisoneofthemostcommonsitesforacute

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musculoskeletalinjuries.Sprainsconstitute85%ofallankleinjuries,
and85%ofthoseinvolvealateralinversionmechanism.
InversionSprain-Inversionanklesprainsoccurwhenthefootturns
inorouttoanabnormaldegreerelativetotheankle.Themost
commonmechanismofananklesprainisacombinationof

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plantarflexionandinversionwherethefootispointingdownwardand
inward.
Thelateralligamentsareinvolvedinaninversionanklesprainand
hencemostcommonlydamaged.Theseligamentsareonthe
outsideoftheankle,whichincludestheanteriortalofibular(ATFL),

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calcaneofibular(CFL)andposteriortalofibularligaments(PTFL).
InjurytotheATFListhemostcommon.WhenboththeATFLand
CFLareinjuredtogether,ankleinstabilitywillbemorenoticeable.
ThePTFListhestrongestofthethreeligamentsandisrarelyinjured
inaninversionsprain.

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1237.Posteriorscallopingofvertebraeisnot
seen
a)Neurofibromatosis
b)Astrocytoma
c)Aorticaneurysm

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d)Ependymoma
CorrectAnswer-C
Answer-C.Aorticaneurysm
Posteriorscallopingistheconcavitytotheposterioraspectofthe
vertebralbody.

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AnteriorScallopingistheconcavitytotheanterioraspectofthe
vertebralbody.

1238.Incervicalspineinjury,firsttobedone
a)Trunhead
b)Maintainairway

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c)Immobilizationofspine
d)None
CorrectAnswer-B
Answer-B.Maintainairway
"Initialcareattheaccidentscenemaybecriticaltosurvival.Thefirst

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stepsaretoestablishanairway,maintainoxygenationand
immobilizethecervicalspine".

1239.Inscoliosisdegreeofdeformityis
calculatedby
a)Cobbsmethod

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b)Hamburgermethod
c)Haldanemethod
d)Milwaukeemethod
CorrectAnswer-A
Answer-A.Cobbsmethod
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Cobbangleisameasurementofthedegreeofside-to-sidespinal
curvature,whichisadeformityyoumayknowasscoliosis.

1240.Partialanteriordislocationofone
segmentofthespineoveranotheris
a)Spondylosis

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b)Spondylolisthesis
c)Kyphosis
d)Scoliosis
CorrectAnswer-B
Answer-B.Spondylolisthesis
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Displacement(partial)ofonevertebraeoverotheriscalled
Spondylolisthesis.
Spondylolisthesisisadefectintheparsinterarticularis.

1241.InEMG/NCVstudy,H.reflexcorrelates
with

--- Content provided by FirstRanker.com ---

a)L3radiculopathy
b)L4radiculopathy
c)L5radiculopathy
d)SIradiculopathy
CorrectAnswer-D

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Answer-D.SIradiculopathy
H-ReflexhasitsutilityininvestigatingpatientswithS1radiculopathy.

1242.Inaxillarynerveparalysis,allthe
followingaretrueexcept
a)Deltoidmuscleiswasted

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b)Extensionofshoulderwitharmabductedto90degreesis
impossible
c)Smallareaofnumbnessispresentovertheshoulderregion
d)Patientcannotinitiateabduction
CorrectAnswer-D

--- Content provided by FirstRanker.com ---

Answer-D.Patientcannotinitiateabduction
Initial15?ofabductioniscausedbysupraspinatuswhichissupplied
bysuprascapularnerve(notaxillarynerve).
"Attheinitiationofabductionfromneutralposition,thesupraspinatus
ismoreimportantthandeltoid,whereasdeltoid(middleportion)isof

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greaterimportanceforelevationofarmatthehigherangleof
abduction,suchas60?".

1243.Tardyulnarnervepalsyisseenin
a)Medialcondyle#humerus
b)Lateralcondyle#humerus

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c)Humerusshaftfracture
d)Fractureshaftradius
CorrectAnswer-B
Ans.is'b'i.e.,Lateralcondyle#humerus
Causesoftardyulnarnervepalsyare:-

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1. Malunitedlateralcondylehumerusfracture(cubitusvalgus)
2. Displacedmedialepicondylehumerusfracture
3. Cubitusvarusdeformity(duetosupracondylarfracturehumerus)
4. Elbowdislocation
5. Contusionsofulnarnerve

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6. Shallowulnargroove
7. Hypoplasiaofhumeraltrochlea
8. Jointdeformityafterprolongedarthritisofelbow

1244.Cubitaltunnelsyndromeinvolves:
March2013(c,f)

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a)Radialnerve
b)Ulnarnerve
c)Mediannerve
d)Axillarynerve
CorrectAnswer-B

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Ans.Bi.e.Ulnarnerve
Whentheulnarnervecompressionoccursattheelbow,itiscalled
"cubitaltunnelsyndrome."

1245.Carpaltunnelsyndromeallarepresent
except

--- Content provided by‌ FirstRanker.com ---

a)Ulnarnervedysfunction
b)Tinelsign
c)Phalenssign
d)Pain&paraesthesiaofwrist
CorrectAnswer-A

--- Content provided by⁠ FirstRanker.com ---

Answer-A.Ulnarnervedysfunction
Thesymptomsoftenfirstappearduringnight,sincemanypeople
sleepwithflexedwrists.(Flexiondecreasesthespaceincarpal
tunnelwhichresultsinincreasedpressureovermediannerve).
Sensorysymptomscanoftenbereproducedbypercussingover

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mediannerve(Tina'ssign)orbyholdingthewristfullyflexedfora
minute(Phalen'stest).
Asthediseaseprogresses,clumsinessofhandandimpairmentof
digitalfunctiondevelop.

1246.Fairbanktriangleisseenin

--- Content provided by FirstRanker.com ---

a)CDH
b)Congenitalcoxavara
c)Perthe'sdisease
d)SCFE
CorrectAnswer-B

--- Content provided by FirstRanker.com ---

Answer-B.Congenitalcoxavara
Theepiphysealplatemaybetoovertical.
Theremaybeaseparatetriangleofboneintheinferiorportionof
themetaphysis,calledFairbank'striangle
[RefEbnezar4th/ep.410]

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1247.Dysplastichipinachild,investigation
ofchoice
a)X-ray
b)MRI
c)USG

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d)CTScan
CorrectAnswer-C
Answer-C.USG
UltrasonographyistheinvestigationofchoiceforDDH.
Itvisualizesthecartilageandallowsdynamictestingofthehipjoint.

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1248.PrimarypathologyinCDH
a)Largeheadoffemur
b)Shallowacetabulum
c)Excessiveretroversion
d)Evertedlimbus

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CorrectAnswer-B
Answer-B.Shallowacetabulum
Followingchangesareseenindislocatedhip:
1. Thefemoralheadisdislocatedupwardandlaterally.Itsbony
nucleusappearslateanditsdevelopmentisretarded,therefore

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headissmall.
2. Femoralneckisexcessivelyanterverted.
3. Acetabulumisshallow,withasteepslopingroof(Thisisconsidered
tobetheprimarypathology).

1249.InneglectedcasesofCTEV,jointfused

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are
a)Calcaneocuboid,talonavicularandtalocalcaneal
b)Tibiotalar,calcaneocuboidandtalonavicular
c)Anklejoint,calcaneocuboidandtalonavicular
d)Noneoftheabove

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CorrectAnswer-A
Answer-A.Calcaneocuboid,talonavicularandtalocalcaneal
JointsfusedintriplearthrodesisforCTEVarei)Subtalar
(tolocalcaneal)joint,ii)Calcaneocuboidjoint,iii)Tolonavicularjoint.

1250.Perthe'sdiseaseisOsteochondritisof

--- Content provided by FirstRanker.com ---

theepiphysisofthe:
March2013(g)
a)Capitulum
b)Lunate
c)Femoralhead

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d)Calacanealtuberosity
CorrectAnswer-C
Ans.Ci.e.Femoralhead
Osteochondritis
Perthesdisease:
--- Content provided by FirstRanker.com ---
-Osteochondritisoffemoralhead
-Adductionisunaffected
-IOCforPerthesdisease:MRI
Osteochondritisoflunate:Kienbock'sdisease
Osteochondritisoftibialtubercle:OschGood'sSchlatter'sdisease

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Osteochondritisofcalcaneum:Sever'sdisease

1251.Osteonerosisisseeninallexcept
a)Fractureneckfemur
b)Sicklecellanemia
c)Perthe'sdisease

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d)Paget'sdisease
CorrectAnswer-D
Answer-D.Paget'sdisease
Storagedisorders:-Gaucher'sdisease
Caissondisease:-Dysbaricosteonecrosis

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Hemoglobinopathy&Coagulationdisorder:-Sickelcelldisease,
Familialthrombophilia,Hypofibrinolysis,Hypolipoproteinemia.
Congenitaldisorders:-Perthe'sdisease,Slippedcapitalfemoral
epiphysis.
Hematologicalmalignancies:-Leukemia,lymphoma,Polycythemia.

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Hyperlipedemia:-Nephroticsyndrome

1252.Bestdiagnosticmodalitytodiagnose
avascularnecrosisis:
March2007
a)MRIscan

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b)CTscan
c)X-ray
d)USG
CorrectAnswer-A
Ans.A:MRIScan

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Avascularnecrosis/osteonecrosis/aseptic(bone)necrosis/
ischemicbonenecrosisisadiseaseresultingfromthetemporaryor
permanentlossofthebloodsupplytothebones.Withoutblood,the
bonetissuediesandcausesthebonetocollapse.Therearemany
causesofavascularnecrosissuchas:

--- Content provided by‌ FirstRanker.com ---

Alcoholism
Excessivesteroiduse
Posttrauma
Caissondisease(decompressionsickness)
Vascularcompression

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Vasculitis
Thrombosis
Damagefromradiation
Bisphosphonates(particularlythemandible)
Sicklecellanaemia

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Gaucher'sDisease
Idiopathic(nocauseisfound).
RheumatoidarthritisandlupusarealsocommoncausesofAVN.
Avascularnecrosismostcommonlyaffectstheheadoffemur.Other

Avascularnecrosismostcommonlyaffectstheheadoffemur.Other

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commonsitesincludethetalus,scaphoidandthejaw.Avascular
necrosisusuallyaffectspeoplebetween30and50yearsofage.
Whenitoccursinchildrenatthefemoralhead,itisknownasLegg-
Calve-Perthessyndrome.
Itismostoftenlydiagnoseclinically.

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BecauseearlyX-raysareusuallynormalintheearlystageofthe
disease,bonescintigraphyandMRIarethediagnosticmodalityof
choicesincebothcandetectminimalchangesatearlystagesofthe
disease.
Lateradiographicsignsincludearadiolucencyareafollowingthe

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collapseofsubchondralbone(crescentsign)andringedregionsof
radiodensity

1253.Afterchronicuseofsteroidssevere
paininrighthipwithimmobilityisdue
to

--- Content provided by FirstRanker.com ---

a)Avascularnecrosis
b)Perthesdisease
c)Hipdislocation
d)Osteoarthritis
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

Answer-A.Avascularnecrosis
Paininhipandlimitatationofmovement(immobility)ofterchronic
useofsteroidssuggestthediagnosisofAVNoffemoralhead.

1254.Inelbow,osteochondritisusually
involves

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a)Olecranon
b)Trochlea
c)Radialhead
d)Capitulum
CorrectAnswer-D

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Answer-D.Capitulum
Knee-Lateralsurfaceofthemedialfemoralcondyle
Elbow-Capitulumofhumerus
Hip-Femoralhead
Ankle-Talus

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1255.Mostcommonorganismcausing
infectionafteropenfracture
a)Pseudomonas
b)Staphylococcusaureus
c)Klebsiella

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d)Gonococcus
CorrectAnswer-A
Answer-A.Pseudomonas
staphylococcusaureuswasthemostcommonorganismcausing
infectioninopenfractures.Morerecentstudieshaveshownthat

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gramnegativeorganismssuchaspseudomonasaeruginosaand
E.coliarebecomingmorecommon

1256.Septicarthritisisdiagnosedby
a)X-ray
b)Jointaspiration

--- Content provided by FirstRanker.com ---

c)USG
d)MRI
CorrectAnswer-B
Answer-B.Jointaspiration
Quickestandbestmethodofdiagnosisofsepticarthritisisaspiration

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ofjoint.

1257.Sequestrumisbestdefinedas
a)Apieceofdeadbone
b)Apieceofdeadbonesurroundedbyinfectedtissue
c)Apieceofbonewithpoorvascularity

--- Content provided by FirstRanker.com ---

d)None
CorrectAnswer-B
Answer-B.Apieceofdeadbonesurroundedbyinfectedtissue
Sequestrumisapieceofdeadbone,surroundedbyinfected
granulationtissue.

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1258.Cloacaearepresentin
a)Sequestrum
b)Involucrum
c)Normalbone
d)Myositis

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CorrectAnswer-B
Answer-B.Involucrum
Involucrumisreactivenewboneoverlyingasequestrum.Theremay
besomeholesintheinvolucrumforpustodrainout.Theseholes
arecalledcloaca.

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1259.ComplicationofjointTB
a)Fibrousankylosis
b)Bonyankylosis
c)Normalhealing
d)None

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CorrectAnswer-A
Answer-A.Fibrousankylosis
Theoutcomeoftuberculararthritisisfibrousankylosis,exceptin
spine.Spineistheonlysitewheretuberculosishealswithbony
ankylosis.

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1260.FalseaboutPott'sspine
a)Commonestatdorsolumbarjunction
b)Alwayshealsbychemotherapy
c)Backpainisanearlysymptom
d)Thereisdiscspacenarrowingonx-ray

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CorrectAnswer-B
Answer-B.Alwayshealsbychemotherapy
Chemotherapyisthemainstayoftreatment.Butitisnoteffective
always,surgeryisoftenrequiredinsomecases.
Commonestsiteofpott'sspineisdorsolumbarjunction.

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Backpainistheearliestsymptomandnarrowingofdiscspaceisthe
earliestradiologicalsign.

1261.Apparentlengtheningisseeninwhich
stageofTBHip
a)StageI

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b)StageII
c)StageIII
d)None
CorrectAnswer-A
Answer-A.StageI
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Stageofsynovitis(Stage1):-Threeiseffusioninthehipjointwhich
demandsthehiptobeinapositionofmaximumcapacity.This
positionisacquiredbyflexion,abductionandexternalrotation.
Becauseofabductiondeformity,thereisapparentlengthening.

1262.Tuberculosisspine;mostcommonsite

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is
a)Sacral
b)Cevical
c)Dorsolumbar
d)Lumbosacral

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CorrectAnswer-C
Answer-C.Dorsolumbar
ThemostcommonsiteisDorsolumbarregion.Lowerdorsal
(thoracic)regionisthemostcommonsegmentinvolvedfollowedby
lumbarsegment.Thetuberculosisofspineisalsocalledpott's

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diseaseortubercularspondylytis.

1263.Anterolateraldecompressionisdone
for
a)Spinaltuberculosis
b)ChestTB

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c)HandTB
d)FootTB
CorrectAnswer-A
Answer-A.Spinaltuberculosis
Anteriordecompressioncanbecausedby:-

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1. Anteriorapproach:-Calledanteriordecompression.Itisthemost
preferredprocedure.
2. Anterolateralapproach:-Calledanterolateraldecompression.

1264.Tumorwithmaximumbonematrix
a)Osteoidosteoma

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b)Chondrosarcoma
c)Enchondroma
d)None
CorrectAnswer-A
Answer-A.Osteoidosteoma
--- Content provided by FirstRanker.com ---
Dense,homogenousmineralization(calcification)istypicalof
osteoidmatrix,formedbybenignandmalignantboneforming
lesions.

1265.Whichofthefollowingistrueabout
Giantcelltumor

--- Content provided by FirstRanker.com ---

a)Usuallypresentsasalyticlesionwithscleroticrim
b)Alwaysbeingn
c)Epiphysealorigin
d)Seeninagelessthan15years
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Answer-C.Epiphysealorigin
GCTisanosteolytictumorarisingfromtheepiphysisandis
commonbetweentheageof20-40years.
Thecommonestsitesarelowerendoffemurandupperendoftibia.
Othercommonsitesarelowerendradiusandupperendof

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humerus.Itmayalsooccurinthespineandsacrum.
Theradiologicalfeaturesare:-
1. Asolitarymaybeloculated,lyticlesion.
2. Eccentriclocation,oftensubchondral.
3. Expansionoftheoverlyingcortx(expansilelesion).

--- Content provided by‍ FirstRanker.com ---

4. Soap-bubble'appearance

1266.Striatedvertebraisseenin
a)TBspine
b)Haemangioma
c)Chordoma

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d)Metastasis
CorrectAnswer-B
Answer-B.Haemangioma
Haemangiomaofthevertebrahasatypicalradiographicpicturein
theformoflossofhorizontalstriationsandprominenceofvertebral

--- Content provided by FirstRanker.com ---

striations.ThereisPolkadotappearanceonCT.
Intheskull,hemangiomagenerallyaffectsthecalveriumandisseen
asanexpansilelyticlesionwhichhasasunburstappearancewith
striationradiatingfromthecentre.
Ahemangiomamaybeidentifiedduetoassociatedphlebolithandit

--- Content provided by FirstRanker.com ---

maycauselocalgigantismoftheinvovledarea.

1267.Metastasisnotfoundin
a)Femur
b)Humerus
c)Fibula

--- Content provided by‌ FirstRanker.com ---

d)Spine
CorrectAnswer-C
Answer-C.Fibula
Metastaticbonediseaseisthecommonestmalignancyofbonesand
ismuchmorecommonthanprimarybonetumors.

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Thecommonestsitesforbonemetastasesarevertebrae(most
common),pelvis,theproximalhalfofthefemurandthehumerus.
Extremitiesdistaltoelbowandkneeareleastcommonlyinvolved
sites.
Spreadisusuallyviathebloodstream;occasionally,visceraltumors

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spreaddirectlyintoadjacentbonese.g.,thepelvisandribs.

1268.Periostealreactionsisseenin
a)Osteomyelitis
b)Syphilis
c)Tumor

--- Content provided by FirstRanker.com ---

d)All
CorrectAnswer-D
Answer-D.All
Infection:-Osteomyelitis,Brodie'sabscess,syphilis
Neoplasms

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Benign:Osteoidosteoma
Malignant:Ewing'ssarcoma,osteosarcoma
Eosinophilicgranuloma
Healedstressfracture
Hypertrophicpulmonaryosteoarthropathy

--- Content provided by⁠ FirstRanker.com ---

1269.Volkmannscontracture,whicharteryis
involved
a)Radial
b)Brachial
c)Ulnar

--- Content provided by⁠ FirstRanker.com ---

d)Interosseus
CorrectAnswer-B
Answer-B.Brachial
Injurytobrachialarterymaycausenerveandmuscleischemia
(Volkmann'sischemiaofflexorcompartment)ormayresultin

--- Content provided by FirstRanker.com ---

postischemicswellingduetoedemaorhemorrhage,thereby
causingcompartmentsyndrome,whichcancause,ifnottreated
immediatealy,Volkmann'sischaemiccontracturelateron.

1270.Castsyndromeisdueto
a)Aboveelbowcast

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b)Belowelbowcast
c)HipSpica
d)Abovekneecast
CorrectAnswer-C
Answer-C.HipSpica
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Castsyndrome(Superiormesentricarterysyndrome)isgastric
dilatationwithpartialorcompleteobstructionoftheduodenum.
Itismostfrequentlyseeninorthopaedicspatientswhohavehad
spinalsurgeryorwhoareinhipspicaorbodycasts.

1271.Heterotopicossificationoccursin

--- Content provided by‌ FirstRanker.com ---

a)Bone
b)Joint
c)Softtissue
d)None
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Answer-C.Softtissue
Heterotopicossificationistheprocessbywhichbonetissueis
formedinsofttissueoutsidetheskeleton.

1272.Felonmostcommoncomplication
a)Osteomyelitis

--- Content provided by‌ FirstRanker.com ---

b)Subungualhematoma
c)Infectivearthritis
d)None
CorrectAnswer-A
Answer-A.Osteomyelitis
--- Content provided by‌ FirstRanker.com ---
Felonistheinfectionofdistalpulpspace.Nexttoacuteparanychia,
thisisthemostcommonhandinfection.Itusuallyfollowsapinprick,
withindexfingerandthumbbeingthecommonunfortunatevictim.
Thepatientinitiallycomplainsofdullpainandswelling.
Complicationsareosteomyelitis(mostcommon),skinnecrosis,

--- Content provided by FirstRanker.com ---

osteonecrosisofdigitsandrarelytenosynovitisorinfectivearthritis
ofDIPjoint.

1273.Felon/Whitlowis:
September2012
a)Midpalamrspaceinfection

--- Content provided by⁠ FirstRanker.com ---

b)Terminalpulpspaceinfection
c)Infectionoftheulnarbursa
d)Infectionoftheradialbursa
CorrectAnswer-B
Ans.Bi.e.Terminalpulpspaceinfection

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apainfulabscessofthedeeptissuesofthepalmarsurfaceofthe
fingertipthatistypicallycausedbybacterialinfection(aswitha
staphylococcus)andismarkedbyswellingandpain

1274.Tensionbandwiringisindicatedinfractureofwhichofthefollowing?
a)Fracturehumerus

--- Content provided by‍ FirstRanker.com ---

b)Olecranon
c)Fracturetibia
d)Fracturespine
CorrectAnswer-B
Tensionbandwiringisindicatedinthetreatmentoftwotypesofolecranonfracture.First

--- Content provided by FirstRanker.com ---

typeisacleanbreakwithseparationofthefragments,andsecondtypeiscomminuted
fractureoftheolecranonwithdisplcedfragments.
Acrackintheolecranonwithoutdisplacementistreatedbyimmobilisingtheelbowinan
aboveelbowplasterslabin30degreesofflexion.

1275.Mostcommonboneforwhichnailingis

--- Content provided by⁠ FirstRanker.com ---

done
a)Radius
b)Ulna
c)Tibia
d)Humerus

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CorrectAnswer-C
Answer-C.Tibia
Mostcommonbonesforwhichintramedullarynailingisdoneare
Tibiaandfemur.

1276.Knucklebendersplintisusedfor:

--- Content provided by‌ FirstRanker.com ---

September2009
a)Ulnarnervepalsy
b)Radialnervepalsy
c)Mediannervepalsy
d)Axillarynervepalsy

--- Content provided by⁠ FirstRanker.com ---

CorrectAnswer-A
Ans.A:UlnarNervePalsy
Cock-upsplint?Radialnervepalsy
Knuckle-bendersplint?Ulnarnervepalsy

1277.Whyfractureshaftfemurisearly

--- Content provided by‌ FirstRanker.com ---

stabilised
a)Topreventbloodloss
b)ARDS
c)Nonunion
d)Compartmentsyndrome

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A
Answer-A.Topreventbloodloss
Fractureshaftfemurcancauseupto2Lofbloodlossandsevere
hypotension,ifnotimmoblizedearly.
thefractureshaftfemurshouldbeimmoblizedearly.Thiscanbe

--- Content provided by FirstRanker.com ---

temporaryimmobilizationbyTTsplintfollowedbysurgeryorcanbe
byimmediatesurgery.

1278.Drugusedinosteoarthritis
a)Methotrexate
b)Glucosamine

--- Content provided by FirstRanker.com ---

c)Sulfasalizine
d)All
CorrectAnswer-B
Answer-B.Glucosamine
Chondroitinsufate

--- Content provided by⁠ FirstRanker.com ---

Diseasemodifyinganti-osteoarthritisdrugs(DMAOAD)Diacerin(IL-
1antagonist),Licofelone(combinedCOX-LOXinhibitors)
Steroids(inacuteexacerbations).

1279.Pannusisseenin
a)OA

--- Content provided by FirstRanker.com ---

b)RA
c)Gout
d)None
CorrectAnswer-B
Answer-B.RA
--- Content provided by‌ FirstRanker.com ---
Pannusisseeninrheumatoidarthritis.
Itisneoplasm-likegrowthofinflammedsynovialtissuethatleadsto
destructionofjointstructures.
Thearticularcartilageatpannusinterfaceappeartoundergo
chondrolysis.

--- Content provided by FirstRanker.com ---

Pannusappeartodevelopwithinandaroundthesynovium,
subsequentlycreepingintoandoverthearticularcartilageand
envelopingitandtheunderlyingboneinadeathlikegrasp.

1280.Sausagedigitsisseenin
a)Lymearthritis

--- Content provided by‌ FirstRanker.com ---

b)Osteoarthritis
c)Psoriaticarthritis
d)None
CorrectAnswer-C
Answer-C.Psoriaticarthritis
--- Content provided by FirstRanker.com ---
Sausagedigitreferstodiffusefusiformswellingofthedigitdueto
softtissueinflammationfromunderlyingarthritisordactylitis.
Causesare:-
Psoriaticarthritis
Osteomyelitis

--- Content provided by FirstRanker.com ---

Sicklecellanemia
Sarcoidosis
Tuberculardactylitis(spinaventosa)

1281.Greenstickfractureis
a)Fractureinadults

--- Content provided by FirstRanker.com ---

b)Completefracture
c)Incompletefracture
d)Fracturespine
CorrectAnswer-C
Answer-C.Incompletefracture
--- Content provided by FirstRanker.com ---
Agreenstickfractureisanincompletetransversefracturepattern
seeninchildren.

1282.Resorptionofdistalphalanxisseenin
a)Scleroderma
b)Hyperparathyroidism

--- Content provided by FirstRanker.com ---

c)Reiter'ssyndrome
d)All
CorrectAnswer-D
Answer-D.All
Acro-osteolysisisthetermusedtodescriberesorptionofthe
--- Content provided by FirstRanker.com ---
distalphalangealtufts.Causesare:-
1. Scleroderma
2. Trauma&thermalinjury
3. Hyperparathyroidism
4. Epidermolysisbullosa

--- Content provided by FirstRanker.com ---

5. Arthropathy(RA,Psoriasis)
6. Neuropathy(diabetes,syringomyelia)
7. Raynaud'sdisease
8. Reiter'ssyndrome

1283.Severelyanaemicpregnantpatientin

--- Content provided by‌ FirstRanker.com ---

cardiacfailure.Choiceoftransfusion?
a)Platelets
b)Packedcells
c)Wholeblood
d)Exchangetransfusion

--- Content provided by‍ FirstRanker.com ---

CorrectAnswer-B
Ans.B.Packedcells

1284.Hydropsfetalisisdueto?
a)Rhmismatch
b)Hyperproteinemia

--- Content provided by⁠ FirstRanker.com ---

c)Placentalhypoplasia
d)Alloftheabove
CorrectAnswer-A
Ans.A.Rhmismatch

1285.Caputsuccedaneumindicatesthat

--- Content provided by⁠ FirstRanker.com ---

fetuswasalivetill?
a)Immediatelyafterbirth
b)Till2-3daysafterbirth
c)2-3weeksafterbirth
d)2-3monthsafterbirth

--- Content provided by‌ FirstRanker.com ---

CorrectAnswer-A
Ans.A.Immediatelyafterbirth
CaPutsuccedaneum
Formationofswellingduetostagnationoffluidinthelayersofscalp
beneaththegirdleofcontact.

--- Content provided by‌ FirstRanker.com ---

Boggydiffuseswelling,notlimitedtomidline.
Disappearsspontaneouslywithin24hours.
Usuallyoccursafterruptureofmembranes.

1286.Caputsuccedeumissaidtooccurin
baby?

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a)Within24hrs
b)2-3days
c)2-3weeks
d)2-3months
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Ans.A.Within24hrs

1287.Mostofectopicpregnanciesareat
ampullaas?
a)Itisthenarrowestpart
b)Tubalmovementsareleasthere

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c)Salpingitisproducesleastcryptshere
d)Plicaearemostnumeroushere
CorrectAnswer-D
Ans,D.Plicaearemostnumeroushere

1288.Besttodiagnoseunrupturedectopic

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pregnancy?
a)Scopy
b)UPT
c)USG
d)Culdocentesis

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CorrectAnswer-A
Ans,A.Scopy

1289.Definitivetreatmentforpreeclampsia?
a)Deliveryofbaby
b)Antihypertensivedrugs

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c)Rest
d)Diet
CorrectAnswer-A
Ans,A.Deliveryofbaby

1290.Whichisleastinjuredingynaecological

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procedures?
a)Ureteratpelvicbrim
b)Renalpelvis
c)Urinarybladder
d)Ureteratinfundibulopelvicligament

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CorrectAnswer-B
Ans.B.Renalpelvis
Urinarybladder&pelvicureterarevulnerabletoinjuryduring
gynecologicalsurgery.

1291.Whichofthefollowingcannotbe

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treatedbylaparoscopy-
a)Ectopicpregnancy
b)Sterilization
c)Nondescentofuterus
d)Genitalprolapsed

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CorrectAnswer-C
Ans,C.Nondescentofuterus

1292.Mostcommondegenerationoffibroids
?
a)Calcareous

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b)Hyaline
c)Red
d)Cystic
CorrectAnswer-B
AnsB.Hyaline
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Mostcommondegenerationoverall_hyaline

1293.DefinitivemanagementofAdenomyosis
is?
a)GNRHanalogue
b)Danazole

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c)LH
d)Hysterectomy
CorrectAnswer-D
Ans,D.Hysterectomy
Hysterectomyisthetreatmentofchoice.

--- Content provided by‌ FirstRanker.com ---

Localresectioncanbetriedinyoungerwomeninwhomitis
localized.
MedicaltreatmentoPtionsareNSAIDS&hormonaltherapy,though
notmucheffective
GnRH,danazole,MirenaIUCDformenorrhagea&pain.

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1294.Bartholin'scysttreatmentofchoice-
a)Excision
b)Antibiotics
c)Marsupialisation
d)Drainage

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CorrectAnswer-C
Ans.C.Marsupialisation

1295.Hydronephrosisisseeninwhichstage
ofCacervix?
a)2a

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b)2b
c)3a
d)3b
CorrectAnswer-D
Ans,D.3b

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1296.Endometrialcarcinomainvolving
cervix,stageis?
a)1
b)2
c)3

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d)4
CorrectAnswer-B
Ans,B.2

1297.Diagnosisofadenomyosisismadeby?
a)Histopathology

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b)Ultrasound
c)MRI
d)Laproscopy
CorrectAnswer-D
Ans,D.Laproscopy

--- Content provided by FirstRanker.com ---

1298.Initialdrugforovariancancer?
a)Cisplatin
b)Doxorubicin
c)Ifosfamide
d)Methotrexate

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CorrectAnswer-A
Ans,A,Cisplatin

1299.Fallopiantubetuberculosis?
a)MostcommontypeofgenitalTB
b)Sizeofthetubesisunchanged

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c)Isasymptomatic
d)Primaryfocusofinfectionisalwaysinfallopiantubes
CorrectAnswer-A:C
Ans,A>C.Isasymptomatic>MostcommontypeofgenitalTB
MostcommontypeofgenitalTB>IsasymPtomatic

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1300.TButerusallistrueexcept?
a)Mostlysecondary
b)Increaseincidenceofectopicpregnancy
c)Involvementofendosalpinx
d)Mostcommonisascendinginfection

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CorrectAnswer-D
Ans,D.Mostcommonisascendinginfection

1301.Goldstandarddiagnostictechniquefor
diagnosisofendometriosis?
a)Laproscopy

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b)Ca125level
c)Ultrasound
d)MRI
CorrectAnswer-A
Ans,A.Laproscopy
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Investigationsforendometrioses
Laproscopyisconsideredasgoldstandard.
Usedasbothdiagnosticaswellastherapeutictechnique.
1. CA-f25israised>35u/ml
2. Ultrasound

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3. CT&MRI
4. ColorDoPPler
5. CYstoscoPY

1302.Mostcommonsiteofendometriosis-
a)Ovary

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b)FT
c)Colon
d)LSCSScar
CorrectAnswer-A
Ans,A.Ovary

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1303.Asherman'ssyndromefalseis?
a)Associatedwithmenstrualirregularities
b)Progesteronechallengetestispositive
c)Synechiaeformationinuterus
d)MaybesecondarytoTB

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CorrectAnswer-B
Ans,B.Progesteronechallengetestispositive

1304.
35yearoldwithhistoryofrepeated
D&C.Shenowhassecondary

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amenorrhea.Whatisyourdiagnosis?
a)Hypothyroidism
b)Kallmansyndrome
c)Sheehan'ssyndrome
d)Asherman'ssyndrome

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CorrectAnswer-D
Ans,D.Asherman'ssyndrome

1305.Emergencycontraceptiveshouldmust
bestartedwithinhowmuchtimeafter
unprotectedintercourse?

--- Content provided by‍ FirstRanker.com ---

a)24hrs
b)48hrs
c)72hrs
d)96hrs
CorrectAnswer-C

--- Content provided by‍ FirstRanker.com ---

Ans,C.72hrs
Morningaftnpill:ethinyl-estrediol2.5mg,premarin15mg,thedrug
istakenorallytwicedailyfor5days.
Beginningsoonaftere4tosurebutnotlatcrthan72hrs."

1306.I-pillisusedwhen?

--- Content provided by FirstRanker.com ---

a)Accidentalsexualexposure
b)OCPforgotten
c)Ofchoiceinyoung
d)Alloftheabove
CorrectAnswer-A

--- Content provided by FirstRanker.com ---

Ans.A.Accidentalsexualexposure
I-pill
l-pillisanemergencycontraceptivePillcontaininglevonorgestrel.
AsingledoseofIpillprovidesasafeandeasywaytopreventanunintended
pregnancy,afterunprotectedsexorcontraceptivefailure.

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Itshouldbetakei-pillassoonaspossible,preferablywithin12
hoursandnolaterthan72hoursofunprotectedintercourse.
Singledosetablettobetakenorallyafterameal.

1307.Cholestasisofpregnancyfalseis?
a)Bilirubinlevel>2mg%

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b)Mostcommoncauseofjaundiceinpregnancy
c)Oestrogenisinvolved
d)Manifestationsusuallyappearinlasttrimester
CorrectAnswer-B
Ans.B.Mostcommoncauseofjaundiceinpregnancy

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1308.Leastfailurerateisof?
a)OCpills
b)IUDs
c)Condom
d)DMPA

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CorrectAnswer-A
Ans.A.OCpills
Oralcontraceptivepillshaveleastchancesofpregnancyasthey
haveminimumfailurerate(evaluatedbypearlindex).

1309.FailurerateofPomeroy'smethodof

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tuballigationis?
a)0.2%
b)0.4%
c)0.6%
d)0.8%

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CorrectAnswer-B
Ans,B.0.4%
Thefailurerateis0.4%anditkmainlyduetospontaneous
canalization".

1310.Maximumsuccessafterreversalof

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tuballigation?
a)Cauterization
b)Pomeroy'stechnique
c)Clipmethod
d)Fimbriectomy

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CorrectAnswer-C
Ans,C.Clipmethod
TheFalopesialisticringdestroys2-3cmfallopiantube.TheHulka&
Filshieclipsdestroyasmallersegment(3-4mm)'thuspreservingthe
potentialofsuccessfulreversalofsurgery.Thefailureratevaries

--- Content provided by⁠ FirstRanker.com ---

between.2and15%"

1311.If300microgramantiDisgivento
mother,amountofblooditwill
neutralise?
a)30m1

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b)40m1
c)50m1
d)60m1
CorrectAnswer-A
Ans,A.30m1

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1312.Tdapvaccineisgiveinbetweenwhich
weeksofpregnancy?
a)10-16weeks
b)17-22weeks
c)22-26weeks

--- Content provided by FirstRanker.com ---

d)27-36weeks
CorrectAnswer-D
Ans,D.27-36weeks
Womenshouldgetadulttetanus,diphtheriaandacellularpertussis
vaccine(Tdap)duringeachpregnancy.Ideally,thevaccineshould

--- Content provided by FirstRanker.com ---

begivenbetween27and36weekesofpregnancy".

1313.Leastdiameterofinletofgynecoid
pelvisis?
a)Transverse
b)Oblique

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c)Diagonalconjugate
d)Obstetricconjugate
CorrectAnswer-D
Ans,D.Obstetricconjugate

1314.Whichoffollowingmostcommonly

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clinicallyused?
a)Diagonalconjugate
b)Antpostdiameterofinlet
c)Transversediameterofoutlet
d)Obliquediameterofpelvis

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CorrectAnswer-A
Ans,A.Diagonalconjugate
MostcommonlyusedclinicalconjugateisDiagonalconjugate.

1315.DefiniteuseforPGE2isallexcept?
a)Contraception

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b)Induceslabour
c)Therapeuticabortion
d)KeepspatencyofPDA
CorrectAnswer-A
Ans.A.Contraception

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1316.Allofthefollowingoccursbecauseof
prostaglandinuseexcept?
a)Excesswaterretention
b)Flushes
c)Increasedmotilityofbowel

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d)Nausea
CorrectAnswer-A
Ans,A.Excesswaterretention
Disadvantages&sideeffectsofprostaglandins
1. Cost

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2. Nausea,vomiting,diarrhea,pyrexia,bronchospasm,tachycardia&
chills
3. Cervicallacerations(PGF-2alpha)
4. Tachysystole(hyperstimulation)ofuterus
5. Riskofuterineruptureincaseofuterinescar.

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1317.Metherginisgivenforprophylaxisof?
a)Anaemia
b)Cardiacdisease
c)Renaldisease
d)Lungdisease

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CorrectAnswer-A
Ans,A.Anaemia
Methergin(methyl-ergo-novine)isasemisyntheticergotderivative
derivedfromlysergicacid.
Indications

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1. Prophylactic:Activemanagementof3rdstageoflabourtoprevent
excessbleedingfollowingdelivery(note-bleedingcausesanemia).
2. Therapeutic:Tostopatonicuterinebleeding.

1318.HRTisgivenin?
a)Symptomaticpostmenopausalwomen

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b)Followinghysterectomy
c)Gonadaldysgenesis
d)Alloftheabove
CorrectAnswer-D
Ans,D.Alloftheabove
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IndicationsofHRT
1. Symptomaticwomensufferingfromoestrogendeficiency.
2. Highriskcasesofmenopausalcomplicationssuchascardiovascular
disease,osteoporosis,stroke,Alzheimerdisease&coloniccancer
(prophylactic).

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3. Prematuremenopause,spontaneousorfollowingsurgery
(prophylactic).
4. Gonadaldysgenesisinadolescents.(therapeutic)

1319.Apregnantwomaninfirsttrimesterhas
fourfoldriseinIgGagainst
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toxoplasmosis.itindicates?
a)Protectiveantibodies
b)Acuteinfection
c)Chronicinfection
d)Noneoftheabove

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CorrectAnswer-B
Ans,B.Acuteinfection
AcuteinfectionisdetectedbydetectingIgMspecificantibodyhigh
titreofIgGantibody&detectionofsero-conversionforIgGfrom
negativetopositive

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1320. Drugofchoiceforpneumocystiscarinii
inpregnancy?
a)SMZ/TMP
b)Primaquine
c)Dapsone

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d)Pentamidine
CorrectAnswer-A
Ans,A.SMZ/TMP

1321.Maximumchanceoftransmission
duringdelivery?

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a)HSV
b)CMV
c)VZV
d)Rubella
CorrectAnswer-A

--- Content provided by⁠ FirstRanker.com ---

Ans.A.HSV
"TransplacentalinfectionbyHSVisnotusual.
Thefetusbecomesaffectedbyvirusshedfromthecervixorlower
genitaltractduringvaginaldelivery."

1322.6yearoldsonofpregnantwomenis

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sufferingfromchickenpox.Whichof
thefollowingisgiventopregnant
women?
a)Acyclovir
b)Acyclovir+immunoglobulin

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c)Onlyimmunoglobulin
d)Vaccination
CorrectAnswer-B
Ans.B.Acyclovir+immunoglobulin
Varicelladuringpregnancy
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Theriskofcongenitalmalformationsisnearlyabsentwhenmaternal
infectionoccursafter20weeks.
VariceIavaccineisnotrecommendedinpregnancy.
Varicellazosterimmunoglobulin(VZIG)shouldbegiventoexposed
non-immuneasitreducesthemortality.

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Oralacyclovirissafeinpregnancy&reducesthedurationofillness
whengivenwithin24hrsofrashbutitcannotpreventcongenital
infection.

1323.Prophylacticmethergingivenfor?
a)Inductionoflabour

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b)Inductionofabortion
c)Tostopexcessbleedingfromuterus
d)Alloftheabove
CorrectAnswer-C
Ans,C.Tostopexcessbleedingfromuterus
--- Content provided by FirstRanker.com ---
Methergin(methyl-ergo-novine)isasemisyntheticergotderivative
derivedfromlysergicacid.
Indications
Prophylactic:-Activemanagementof3rdstageoflabourtoprevent
excessbleedingfollowingdelivery.

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Therapeutic:-Tostopatonicuterinebleeding.

1324.DOCformalariainpregnancy?
a)Chloroquin
b)Quinine
c)Primaquin

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d)Artesunate
CorrectAnswer-A
Ans,A.Chloroquin
Drugsfortreatmentofmalariainpregnancy-
Malariacanbelifethreateningduringpregnancy.

--- Content provided by⁠ FirstRanker.com ---

Chloroquinis1stchoiceofdrug.
Ifresistanttochloroquin,quinineshouldbegivenundersupervision.
Primaquin(forradicalcure)shouldbewithhelduntilthepregnancyis
over.
Artesunateisthe1stchoiceincaseofcomplicatedmalaria.

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1325.Foruterineprolapseinpregnancy,Ring
pessarycanbeinsertedupto?
a)12weeks
b)14weeks
c)16weeks

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d)18weeks
CorrectAnswer-D
Ans.D.18weeks
PessarytreatmentforProlaPse
Itdoesnotcuretheprolapse,onlygivessymptomaticreliefby

--- Content provided by FirstRanker.com ---

stretchingthehiatusgenitalis,thuspreventingtheuterine&vaginal
descent.
IndicationsofPessarY
EarlYPregnancy-uPto18weeks
PuerPerium

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Patientsabsolutelyunfitforsurgery
Patientsunwillingforoperation
Whilewaitingforsurgery
Additionalbenefitslikeimprovementofurinarysymptoms

1326.Notamethodfordeliveryofafter-

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comingheadofbreech?
a)Forcepsmethod
b)BurnsandMarshallmethod
c)Malarflexionandshouldertraction
d)Halfhandmethod

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CorrectAnswer-D
Ans.D.Halfhandmethod
Methodsofdeliveryofaftercomingheadare
Burns-Marshallmethod
ForcePsdelivery

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Malarflexionandshouldertraction(modifiedMauriceau-Smellie-Veit
technique)

1327.Investigationofchoiceinpost
menopausalbleeding?
a)PAPsmear

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b)Laproscopy
c)Fractionalcurettage
d)Ultrasound
CorrectAnswer-C
Ans.,C.Fractionalcurettage

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1328.PreferredIUDformenorrhagea?
a)NOVAT
b)CuIUD
c)Mirena
d)Gynefix

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CorrectAnswer-C
Ans.C.Mirena

1329.Preferredtreatmentformenorrhageain
reproductiveagegroup?
a)NOVAT

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b)CuIUD
c)OCPs
d)Hysterectomy
CorrectAnswer-C
Ans.C.OCPs

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1330.Drugnotusedcommonlyfor
menorrhagea?
a)Methergin
b)Clomiphene
c)GnRH

--- Content provided by‌ FirstRanker.com ---

d)NSAIDS
CorrectAnswer-A
Ans.A.Methergin

1331.Drugcausingabruptionplacenta?
a)Methadone

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b)Cocaine
c)Amphetamine
d)Fluoxetine
CorrectAnswer-B
Ans.B.Cocaine

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1332.

ClassicalCsectionindicatedin?
a)CACervix
b)Centralplacentapraevia
c)Failedinduction

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d)Fetaldistress
CorrectAnswer-A
Ans.A.CACervix

1333.DefinitiveindicationofLSCS?
a)Mentoant

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b)Contractedpelvis
c)Occipitoposterior
d)Vertex
CorrectAnswer-B
Ans,B.Contractedpelvis

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1334.Afterdeliveryuptowhichweekis
knownaspuerperium?
a)2weeks
b)4weeks
c)6weeks

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d)8weeks
CorrectAnswer-C
Ans.C.6weeks
Immediatepuerperium:24h
Earlypuerperium:upto1week

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Remotepuerperium:upto6weeks

1335.Vacuumdeliveryproduces?
a)Chingon
b)Cephalhematoma
c)Both

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d)None
CorrectAnswer-C
Ans,C.Both

1336.45yroldfemalepatientunderwent
hysterectomy,on7thpostopday
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complaintsaboutcontinuousdribbling
ofurineandfever.Micturitionwasnot
voluntary,whatdiagnosis?
a)Vesicovaginalfistula
b)Ureterovaginalfistula

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c)Vesicouterinefistula
d)Urethravaginalfistula
CorrectAnswer-C
Ans,C.Vesicouterinefistula
Fetalcomplicationsofvacuumdelivery
--- Content provided by‌ FirstRanker.com ---
SuPerficialscalloPabrasions
Sub-aPoneurotichaemorrhage
Retinalhaemorrhage

1337.Placentaprevia,falseis?
a)MostcommoncauseofAPH

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b)Painfulvaginalbleeding
c)Usgistheinvestigationofchoice
d)Increasedmaternalageisariskfactor
CorrectAnswer-A
Ans.A.MostcommoncauseofAPH

--- Content provided by‍ FirstRanker.com ---

1338.ExclusivelyFetalbloodlossoccursin?
a)Vasaprevia
b)Placentapraevia
c)Polyhydramnios
d)Oligohydramnios

--- Content provided by⁠ FirstRanker.com ---

CorrectAnswer-A
Ans.A.Vasaprevia

1339.
Prolapsedofuterusinnulliparous
women,treatmentis?

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a)Slingusedinvolvingrectussheath
b)Anteriorcolporrhaphy
c)Posteriorcolporrhaphy
d)Manchesteroperation
CorrectAnswer-A

--- Content provided by‌ FirstRanker.com ---

Ans.,A.Slingusedinvolvingrectussheath

1340.Allarecausesofanovulatory
amenorrhoeaexcept?
a)PCOD
b)Hyperprolactemia

--- Content provided by FirstRanker.com ---

c)Gonadaldysgenesis
d)Drugs
CorrectAnswer-C
Ans.C.Gonadaldysgenesis
Causesofanovulatoryamenorrhea
--- Content provided by‌ FirstRanker.com ---
PCOD
Hyperprolactinaemia
Weightloss,stress,exercise
Drugs
Chestwallstimulation

--- Content provided by FirstRanker.com ---

1341. Whatisfalseaboutpostmenopausal
state?
a)LowLH
b)Lowestrogen
c)HighFSH

--- Content provided by FirstRanker.com ---

d)Highandrogen
CorrectAnswer-A
Ans.A.LowLH
Hormonalchangesinpost-menoPausalstate
FSHlevelisincreased

--- Content provided by FirstRanker.com ---

Oestrogenlevelisdecreased&mostofitissynthesisedperipherally
byconversionofandrogentooestrogen
Androgenlevelisslightlyincreased

1342.Inapostmenopausalfemale,which
hormoneincreases?

--- Content provided by FirstRanker.com ---

a)FSH
b)Estrogen
c)GH
d)Noneoftheabove
CorrectAnswer-A

--- Content provided by‌ FirstRanker.com ---

Ans,A.FSH

1343.Roleoflactobacilliinvaginalsecretions
a)TomaintainalkalinepH
b)TomaintainacidicpH
c)Nutrition

--- Content provided by FirstRanker.com ---

d)None
CorrectAnswer-B
Ans.,B.TomaintainacidicpH
TheimportanceofDoderlein'sbacillusisthatitspresenceis
associatedwithproductionoflacticacidcontainedinthevaignaand

--- Content provided by FirstRanker.com ---

thisacidityinhibitsthegrowthofotherorganisms."
Doderlein'sbacillusistheonlyorganismwhichwillgrowatthepHof
4-4.5(normalpHofvagina).

1344.Hegarsignallaretrueexcept?
a)Bimanualpalpationmethod

--- Content provided by FirstRanker.com ---

b)Difficultinobese
c)Canbedoneat14weeks
d)Presentin2/3rdofcases
CorrectAnswer-C
Ans.C.Canbedoneat14weeks
--- Content provided by‍ FirstRanker.com ---
Hegar'ssign:Presentin2/3rdofcases.Demonstratedbetween6-10
weeks,alittleearlierinmultipara.Thissignisbasedonthe2facts
(1)upperpartofthebodyofuterusisenlargedbygrowinguterus
andlowerpartisemptyandsoftandcervixiscomparativelyfilm.
Thereforeonbimannualexamination(2fingersintheanteriorfornix

--- Content provided by⁠ FirstRanker.com ---

andabdominalfingersbehindtheuterus),abdominalandvaginal
fingersseemtoapposebelowthebodyoftheuterus.

1345.Hegarsignisseeninhowmanyweeks
?
a)6-10weeks

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b)10-14weeks
c)14-18weeks
d)18-22weeks
CorrectAnswer-A
Ans.A.6-10weeks

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1346.Palmersignisrelatedto?
a)Contractionofuterus
b)Duskyhueofantvaginalwall
c)Bluishdiscolourationofantvaginalwall
d)Increasedpulsationsfeltthroughlateralfornix

--- Content provided by⁠ FirstRanker.com ---

CorrectAnswer-A
Ans,A,Contractionofuterus
Palmersign:-regularandrhythmiccontractionscanbeelicitedduring
bimanualexaminationasearlyas4-8weeks.

1347.Newborncanbegivenbreastmilkafter

--- Content provided by FirstRanker.com ---

howmuchtimefollowingnormal
delivery?
a)Halfhour
b)1hours
c)2hours

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d)3hours
CorrectAnswer-A
AnsA.Halfhour
Ahealthybabyisputtothebreastimmediatelyoratmost%to1hr
followingnormaldelivery.

--- Content provided by FirstRanker.com ---

Followingcaesareansectionsaperiodof4-6hoursmaybesufficient
forthemothertofeedherbaby.

1348.4monthamenorrhoeawithincreased
FSH,LH&decreasedestrogenina35
yrsold?

--- Content provided by‌ FirstRanker.com ---

a)Prematuremenopause
b)Menopause
c)Latemenopause
d)Perimenopause
CorrectAnswer-A

--- Content provided by⁠ FirstRanker.com ---

Ans,A.Prematuremenopause
Prematuremenopauseisdefinedasovarianfailureoccurring2SD
inyearsbeforethemeanmenopausalageinapopulation.
Itisclinicallydefinedassecondaryamenorrheaforatleast3months
withraisedFSHlevel,raisedFSH:LHratio&lowE2levelina

--- Content provided by FirstRanker.com ---

womenunder40yrsofage."

1349.35yroldwith4monthsamenorrhea
withincreasedFSH,decreased
estrogen.Whatisthediagnosis?
a)Prematureovarianfailure

--- Content provided by‍ FirstRanker.com ---

b)PCOD
c)Pituitaryfailure
d)Hypothalamicfailure
CorrectAnswer-A
Ans.A.Prematureovarianfailure
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ItisacaseofprematuremenoPause(prematureovarianfailure)'

1350.Contractionstresstestfalseis?
a)Oxytocinnotused
b)Invasivemethod
c)Detectsfetalwellbeing

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d)Negativetestisassociatedwithgoodfetaloutcome
CorrectAnswer-A
Ans,A.Oxytocinnotused
Contractionstresstest(CST)(syn:Oxytocinchallengetest):
Itisaninvasivetesttoassesfetalrespiratorywellbeingduring

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pregnancy.
ItdetectsalterationinFHRinresponsetouterinecontraction
inducedbyoxytocinindicatinghypoxia.
Interpretations
Negativetestindicatedgoodoutcome

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1351.NST,whatisseenexcept?
a)Variability
b)Acceleration
c)Timeperiod
d)Oxytocin

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CorrectAnswer-D
Ans,D.Oxytocin
Thenon-stresstest(NST)measuresfetalheartrate,whichis
monitoredwithanexternaltransducerforatleast20minutes.
Duringfetalmovement,tracingisobservedforheartrate

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acceleration.
Testispositiveiftwoormorefetalheartrateaccelerationsoccursin
20minuteperiod.

1352.Menstrualregulationeffectiveupto?
a)14days

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b)21days
c)4weeks
d)6weeks
CorrectAnswer-A
Ans,A.14days
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Menstrualregulation(lnduction/Aspiration)
Aspirationofendometrialcavitywithinl4daysofmissedperiodina
womanwithpreviousnormalcycle.
DoneasanOPDprocedure.
Helpstodetectfailedabortion,molarpregnancyorectopic

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Pregnancy.
Contraindicatedinadvancedpregnancy&inpresenceoflocalpelvic
inflammation.

1353.pHofvaginainpregnantwomanis
usually?

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a)4.0
b)4.5
c)5
d)>5
CorrectAnswer-A

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Ans.A.4.0
Thevaginalacidityisduetolacticacid.
ThenormalpHinthehealthywomenofthechildbearingagegroup
is4.5

1354.VaginalpHbeforepubertyis?

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a)7
b)6
c)4.5
d)5
CorrectAnswer-A

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Ans.A.7

1355.Decidualreactionisduetowhich
hormone?
a)Progesterone
b)Estrogen

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c)LH
d)FSH
CorrectAnswer-A
Ans.A.Progesterone
Increasedstructural&secretoryactivityoftheendometriumthat

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broughtaboutinresponsetoprogesteronefollowingimplantationis
knownasDecidualreaction".

1356.Inhibinlevelsarecheckedonwhichday
ofmenstrualcycle?
a)Day3

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b)Day4
c)Day5
d)Day6
CorrectAnswer-A
Ans.A.Day3
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Ovarianreservetestisdesignedtoassessboththenumberof
immatureeggsintheovariesandtheirquality,whichgivesan
indicationofwoman'spotentialfertility.
Itworksbydetectingthelevelsofthreefemalehormones,
usingabloodsampletakenondaythreeofmenstrualcycle:

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1. Folliclestimulatinghormone(FSH)
2. Anti-mullerianhormone(AMH)
3. Inhibin-B

1357.Besttestforovulation?
a)Serumestrogen

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b)Serumprogesterone
c)Both
d)None
CorrectAnswer-B
Ans.B.Serumprogesterone
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Plasmaconcentrationofprogesteronerisesafterovulation&
reachespeakof15ng/mlatmidlutealphase&thendeclinesasthe
corpusluteumdegenerates".

1358.Cardiacoutputincreasesmaximumat
whichweek?

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a)26-28wks
b)30-32wks
c)32-34wks
d)34-36wks
CorrectAnswer-C

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Ans.C.32-34wks
Cardiacoutput:
Startstoincreasefrom5thweekofpregnancy,reachesitspeak40-
50%atabout30-34weeks.

1359.Inpregnancyplasmavolumeincreased

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maximumatwhatgestationalage?
a)10wks
b)20wks
c)25wks
d)30wks

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CorrectAnswer-D
Ans,D.30wks
Plasmavolumeisincreased.Startingtoincreaseat6weeks&
reachingmaxupto50%at30weeks.Totalplasmavolume
increasestotheextentof1.25litres.

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1360.5monthpregnantfemale,whichofthe
followingistrue?
a)50%havesoftsystolicmurmur
b)Cardiacoutputisreduced
c)Systemicvascularresistanceisincreased

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d)IncreaseinCVP
CorrectAnswer-A
Ans.A.50%havesoftsystolicmurmur
Anatomicalchangesduringpregnancy
Heartispushedupwards&outward.Apexbeatisshiftedin4th

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intercostalsspace.
Asystolicmurmurcanbeheardinapicalorpulmonaryarea.
Mammarymurmurisacontinuoushissingmurmuraudibleover
tricuspidareainleft2nd&3rdiintercostalsspace.
ECGshowsleftaxisdeviation.53andrarely54canbeheard.

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1361.Spinnbarkeitismaximumshownat
whichphase?
a)Menstrualphase
b)Ovulatory
c)Postovulatory

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d)Prefollicular
CorrectAnswer-B
Ans.B.Ovulatory
Spinnbarkeittest(ThreadtestorFerntest)
AsPecimenofcervicalmucuswhenseenunderlowpower

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microscope,showsacharacteristicfernformation.
Donetoseetheestrogenicactivityinovulatoryphaseofmenstrual
cycle.

1362.Rarestpresentationis?
a)Cephalic

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b)Breech
c)Shoulder
d)Vertex
CorrectAnswer-C
Ans.C.Shoulder

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1363.Fertileperiodoffemaleismeasuredby
?
a)LH
b)FSH
c)Estrogen

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d)Oxytocin
CorrectAnswer-A
Ans,A.LH
"LHsurgefromtheanteriorpituitaryglandoccurs24hourspriorto
ovulation.Radioimmunoassaysofthemorningsampleofurine&

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bloodgivesresultsin3hours.NotonlydoestheLHsurgehelpin
predictingovulation,buttheapproximatetimeofovulationcanbe
gauged&coitusaroundthistimecanimprovethechancesof
conception."

1364.Externalversionisdoneafter?

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a)34weeks
b)36weeks
c)38weeks
d)40weeks
CorrectAnswer-B

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Ans.B.36weeks
Themaneuveriscarriedoutafter36weeksinlabour-delivery
complex."

1365.Leastcommonpresentationoftwins?
a)Bothvertex

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b)Bothbreech
c)Bothtransverse
d)Firstvertexand2ndtransverse
CorrectAnswer-C
Ans.C.Bothtransverse
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Lie-Presentationintwinpregnancy:
Themostcommonlieinthefetusesislongitudinal(90%).
Thecombinationofpresentationoffetusesare:
Bothvertex(50%)
Firstbreechsecondvertex(10%)

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Firstvertexandsecondtransverse(rare)
Firstyertexandsecondbreech(30o/o)
Bothbreech(10%)
Bothtransverse(rarest).

1366.

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Presentingpartintransverselie?
a)Shoulder
b)Face
c)Vertex
d)Brow

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CorrectAnswer-A
Ans.A.Shoulder
'Whenthelongaxisofthefetusliesperpendicularothematernal
spineorcentraliseduterineaxis,itiscalledtransverselie.
Butmorecommonly,fetalaxisliesobliquetothematernalspine&is

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thencalledobliquelie.Ineitheroftheconditionsshoulderusually
presentsoverthecervicalopeningduringlabour&bothare
collectivelycalledshoulderpresentations."

1367.Whichofthefollowinglayercontains

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abundantdesmosomes?
a)A
b)B
c)C
d)D

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CorrectAnswer-C
Ans.C.C
Stratumspinosumorpricklecelllayercontainsabundant
desmosomesmarkedwiththelegend'C'intheimage.
Pictureshowslayersofepidermis
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A Stratumcorneum
B Stratumgranulosum
C Stratumspinosum
D Stratumbasale
"Theepidermiscanbedividedintoanumberoflayersfromdeepto

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superficialasfollows:basallayer(stratumbasale),spinousorprickle
celllayer(.stratumspinosum),granularlayer(stratumgranulosum),
clearlayer(stratumlucidum)andcornifiedlayer(stratumcorneum."-
"Thepricklecelllayer(stratumspinosum)consistsofseverallayers
ofcloselypackedkeratinocytesthatinterdigitatewitheachotherby

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meansofnumerouscellsurfaceprojections.Thecellsareanchored
toeachotherbydesmosomesthatprovidetensilestrengthand
cohesiontothelayer.Thesesuprabasalcellsarecommittedto
terminaldifferentiationandgraduallymoveupwardstowardsthe
cornifiedlayerasmorecellsareproducedinthebasallayer.When

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skinisprocessedforroutinelightmicroscopy,thecellstendtoshrink
awayfromeachotherexceptwheretheyarejoinedby
desmosomes,whichgivesthemtheircharacteristicspiny
appearance.Pricklecellcytoplasmcontainsprominentbundlesof
keratinfilaments,(mostlyK1andKIOkeratinproteins)arranged

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concentricallyaroundaeuchromaticnucleus,andattachedtothe
denseplaquesqt.desmosomes.Thecytoplasmalsocontains
melanosomes,eithersinglyoraggregatedwithinmembrane-bound
organelles(compoundmelanosomes).Langerhanscellsandthe
occasionalassociatedlymphocytearetheonlynon-keratinocytes

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presentinthepricklecelllayer."
LayersofEpidermis
Alsoknownasstratumgerminativum?
Itcontainsmitoticallyactivekeratinocytescontaining
Stratum

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housekeepingorganelles?(RER,golgicomplex,
basale
mitochondria,lysosomes,ribosomes)
Giverisetosuperficiallayer?
Spinelikeappearance?ofcellmarginsinhistological

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sections
Stratum
Thesespinesareabundantdesmosomes?,calcium
spinosum
dependentcellsurfacemodificationsthatpromote

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adhesionofepidermalcells&resistancetomechanical
stresses.
Characterizedbybuildupofcomponentsnecessaryfor
theprocessofprogrammedcelldeath&formationof
Stratum

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superficialwaterimpermeablebarrier?.
granulosum Mostapparentstructurewithinthesecellsisbasophilic
containkeratohyalinegranules?
Stratum
Clearlayer,seenonlyinthickskin?

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lucidum
Formedofcornifiedorhornycells(largestcellof
Stratum
corneum

corneum

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epidermis)andhavehighestconcentration

1368.Miliariaarisesfromobstructionof?
a)Eccrinesweatglands
b)Apocrinesweatglands
c)Sebaceousglands

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d)Ectopicsebaceousglands
CorrectAnswer-A
Ans.is'a'i.e.,Eccrinesweatglands
Milliria
Occurasaresultofeitherobliterationordisruptionoftheeccrine

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sweatduct.
Threeforms:-
1. Miliariacrystallina-Clear,thin-walledvesicles,1-2mmindiameter,
withoutaninflammatoryareola,areusuallysymptomlessand
developincrops,mainlyonthetrunk.

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2. Miliariarubra-erythematouspapulesespeciallyinareasoffriction
withclothing,andinflexures,produceintenseprickingsensation.
3. Miliariaprofunda-Thisnearlyalwaysfollowsrepeatedattacksof
miliariarubra,oComplications:-Secondaryinfectionand
disturbanceofheatregulation

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1369.NottrueaboutSkintag?
a)Associatedwithseborrhoeickeratosis
b)Pedunculated
c)Mostcommonsiteisneckandaxilla
d)Premalignant

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CorrectAnswer-D
Ans.D.Premalignant
Skintags(softwarts;achrochordon)
Acommonbenignlesioncomposedofloosefibroustissueand
occurringmainlyontheneckandmajorflexuresasasmallsoft

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PedunculatedProtrusion.
Verycommon,particularlyinwomenatthemenopauseorlater.
Theyarefrequentlyfoundtogetherwithseborrhoeickeratoses.
Treatment:Cauteryandcryotherapy

1370.Spidertelengectaciafalseis?

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a)Morecommoninmales
b)Canbecausedbytrauma
c)Lighttherapyfortreatment
d)Maybeassociatedwithliverdisease
CorrectAnswer-A

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Ans.A.Morecommoninmales
Spidertelangiectasia(arterialspider,spidernevus,nevus
aranus)
Seenin2/3rdofpregnantfemalesandusuallydisappearsafter
delivery.

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Estrogenissaidtobeinvolvedinpathogenesis.
Whenmultiple,liverdiseaseshouldberuledout.
Centralradiatingbodywithradiatingvesselsgivesalookofspider.
Lesionusuallyoverupperhalfofthebody.
Treatmentbydiathermyandexcision.

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1371.Whichofthefollowingisuntrue
regardingpiebaldism?
a)autosomaldominantcondition
b)amelanoticskinassociatedwithawhiteforelock
c)Islandsofnormalorhypermelanoticskin

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d)Usuallyimproveswithage
CorrectAnswer-D
Ans.D.Usuallyimproveswithage
Piebaldism
Piebaldismisarareautosomaldominantconditioncharacterizedby

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stableareasofvitiligo-likeamelanoticskinassociatedwithawhite
forelock.
Presentatbirthandusuallyremainunchangedthroughoutlife.
Mostcommonisafrontalmedianorparamedianpatch,associated
withameshofwhitehair(whiteForelock).

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Often,whitepatchesoccurontheupperchest,abdomenandlimbs,
bilaterallybutnotnecessarilysymmetrically
Thehandsandfeet,aswellastheback,remainnormallypigmented
Islandsofnormalorhypermelanoticskinoccurinthewhiteareas,or
lessoftenonnormalskin.

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1372.Allarefeaturesofatopicdermatitis,except:
a)Dennie-Morganfold
b)Hertoghe'ssign
c)Darier'sSign
d)Hyperlinearityofpalms

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CorrectAnswer-C
Itisseeninurticariapigmentosa.

1373.WhichofthefollowingisnotaNEVUS
ofmelanocyte?
a)Mongolianspot

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b)NevusofIto
c)Nevusofota
d)Beckernevus
CorrectAnswer-D
Ans.D.Beckernevus
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Beckernevusisappendagealneviwhereasotherthreeare
melanocyitcnevi.
Melanocyticneviare:-
Dysplasticnevus
BIuenevus

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Nevusofito&nevusofota
Spitznevus
Giantpigmentednevus
Mongolianspot
Intramucosalneyus

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1374.Koebnerphenomenonseenin?
a)Psoriasis
b)Lichenplanus
c)Warts
d)Alltheabove

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CorrectAnswer-D
Ans.is'd'i.e.,Alltheabove

1375.Ichypurplepapulefollowedby
hayperpigmentationonresolution,is
seenin?

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a)Addison'sdisease
b)DM
c)Hypothyroidism
d)Lichenplanus
CorrectAnswer-D

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Ans.D.Lichenplanus
LPischaracterizedbyshiny,violaceous,flat-toppedpolygonal
papuleswhichretaintheskinlines.
Whitelines,knownasWickham'sstriae,maytraversethesurfaceof
thepapules.

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Linearlesionsoftenappearalongscratchmarksorinscars
(Koebnerphenomenon).
Inmostcases,thepapuleseventuallyflattenaftera6monthsto2
yrs,oftentobereplacedbyanareaofhyperpigmentation.

1376.Pemphigusvulgarisischaracterizedbyall,except:

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a)PositiveNikolsky'ssign
b)Oralerosions
c)Subepidermalbulla
d)Tzancksmearshowingacantholyticcells
CorrectAnswer-C

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Pemphigusvulgarisisanintraepidermalblisteringdisease.

1377.LossofIntercellularcohesionbetween
keratinocytesiscalledas?
a)Acanthosis
b)Acantholysis

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c)Keratinolysis
d)Spongiosis
CorrectAnswer-B
Ans.B.Acantholysis
Separationofepidermalkeratinocytesduetolossofintercellular

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bridgeisreferredtoasacantholysis.
Acantholysisisseenintheepidermis(especiallyinbasallayer).

1378.Tzankcellis?
a)Keratinocyte
b)Fibrobalst

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c)Neutrophil
d)Lymphocyte
CorrectAnswer-A
Ans.A.Keratinocyte
Tzankcellsareacanthoylyticcellsi.e.largeroundedkeratinocytes

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withsrelativelylargenucleuswithcondensedorhazycytoplasm.

1379.Trueaboutlepromatousleprosy?
a)Only3cutaneouslesions
b)Lepromintesthighlypositive
c)Thickenednerveroots

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d)ENLin>50%cases
CorrectAnswer-C
Ans.C.Thickenednerveroots
Nerveinvolvementinlepromatousleprosycausesthickeningof
nerve.

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Lepromintestisnegative.
Therearemorethan10macules/patches/plaques.

1380.Dermatophytosisisnot?
a)Scaly
b)Itchy

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c)Superficial
d)Subdermal
CorrectAnswer-D
Ans.D.Subdermal

1381.Oculoorogenitalulcersareafeatureof

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?
a)Behcetdisease
b)lichenplanus
c)SLE
d)Psoriasis

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CorrectAnswer-A
Ans.A.Behcetdisease
Behcet'sdiseaseisamultisystemdiseasethatisdefinedbythe
presenceoforalaphthosiswithatleasttwoofthefollowing:genital
aphthaesynovitis,posterioruveitis,cutaneouspustularvasculitisor

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meningoencephalitis,intheabsenceofIBDorautoimmune
Diseases.

1382.Allofthefollowingarefeatureof
dermatomyositis,Except:
a)SalmonPatch

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b)Gottron'spatch
c)Mechanicfinger
d)Periungualtelengiectasias
CorrectAnswer-A
AnswerisA(SalmonPatch):

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Salmonpatchisnotafeatureofdermatomyositis.
Cutaneousfeaturesofdermatomvositis
Cutaneous
Description
feature
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Heliotrope
Periocularorfacialerythemaandedemawith
Rash?
pink/purple/blue(heliotrope)hue
(bluepurplediscolorationonupperevelidswith
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edema)
Gottren's
Violaceouspapulesovertheknuckles
PapulesQ
Erythemaoftheknuckleswitharaisedviolaceous

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(Gottren'ssign) scalyeruption
Ervthematousrashoverotherbodysurfacessuch
`V'sign
asanteriorchest(ofteninaVform)
Shawlsign

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Erythematousrashoverotherbodysurfaces
includingtheuppertrunk,neck,back&shoulders
(shawlpattern)
Periungual
Dilatedcapillaryloopsatthebaseoffingernails

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Telengiectasiase
Mechanic's
Irregular,thickened,distortedcuticles,withrough

handsQ
andcrackedareasoverthelateralandpalmar
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areasoffingerswithirregulardirtyhorizontallines
resemblingmechanic'shand.
Calcinosis
Presenceofhardcalciumdepositsintheskin
Cutise

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1383.Hereditaryangioneuroticedemaisdue
to?
a)DeficiencyofC1inhibitor
b)DeficiencyofNADPHoxidase
c)DeficiencyofMPO

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d)Deficiencyofproperdin
CorrectAnswer-A
Ans.is'a'i.e.,DeficiencyofC1inhibitor
HereditaryangioneuroticedemaisduetoC1inhibitor(Ciesterase
inhibitor)deficiency.

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1384.Phrynodermaisdueto...deficiency-
a)VitaminD
b)Niacin
c)VitaminA
d)Essentialfattyacid

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CorrectAnswer-D
Ans.is'd'i.e.,Essentialfattyacid
Invitamin'A'deficiencythereistoadlikeskinalsoknownas
phrynoderma.
oButthisisduetoassociateddeficiencyofessentialfattyacids.

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1385.Maximumcumulativedoseof
isotretinoinshouldn'texceedforacne
treatment?
a)30-60mg/kg
b)60-90mg/kg

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c)90-120mg/kg
d)120-150mg/kg
CorrectAnswer-D
Ans.,D.120-150mg/kg
Isotretinoinisrecommendedforseverenodulocysticacneandalso

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forthepatientswithmilderdiseasewhodon'trespondto
conventionaltreatment.
Treatmentregimensusuallybeginat0.5-1.0mg/kg/dayforthe
durationofbetween16and20weeks.
Cumulativedoseamounttoatotalofatleast12Omg/kg,butthere

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isnoaddedbenefitwhen150mg/kgisexceeded.

1386.Exanthemasubitumiscausedby?
a)HHV
b)HPV
c)HIV

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d)HCV
CorrectAnswer-A
Ans.A.HHV
HHV-6viruscausesroseolainfantum(exanthemsubitum),themost
commonexanthematicfeverinchildrenundertheageof2years,

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withapeakincidencebetween6and9months.

1387.Cocainewasfirstusedaslocal
anaestheticby?
a)Carlkollar
b)Holmerwells

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c)Morton
d)None
CorrectAnswer-A
Ans.A.Carlkollar
CocainewasthefirstlocalanestheticusedbyCarlKoller.Itwas

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usedforanaesthetizingcornea.

1388.Levelsofetheranesthesiawere
demonstratedbywhom?
a)Morton
b)Guedel

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c)Thompson
d)None
CorrectAnswer-B
Ans.B.Guedel
GuedeldescribedfourstagesofetheranesthesiaknownasGuedel

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stages.

1389.Infantcircuitforanaesthesia?
a)Bainscircuit
b)Magillcircuit
c)Ayrestpiece

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d)Water'scircuit
CorrectAnswer-C
Ans.C.Ayrestpiece

1390.Ayre'sT-pieceiswhichtypeofcircuit
a)TypeA

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b)TypeB
c)TypeE
d)TypeD
CorrectAnswer-C
Ans.C.TypeE

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1391.Mostreliableindicatortoprevent
oesophagealintubation?
a)Oxygensaturationonpulseoximeter
b)MeasurementofCO2inexhaledair(Etco2)
c)Directvisualizationofpassingtubebeneathvocalcords

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d)Auscultationoverchest
CorrectAnswer-B
Ans,B.MeasurementofCO2inexhaledair(Etco2)

1392.Allarefeaturesofdifficultairway
except?

--- Content provided by‍ FirstRanker.com ---

a)Miller'ssign
b)Micrognathiawithmacroglossia
c)TMJankylosis
d)Increasedthyromentaldistance
CorrectAnswer-D

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Ans.D.Increasedthyromentaldistance
Decreasedthyromentaldistancepredictsdifficultairway(not
increasedTMdistance).

1393.Ratioof02:N20inEntonoxis?
a)50:50

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b)60:40
c)40:60
d)25:75
CorrectAnswer-A
Ans.A.50:50
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Entonoxcontainequalamount(50/50)ofN2OandO2.

1394.WhichisthecriticaltemperatureofN20
?
a)-118?C
b)-88?C

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c)-26?C
d)-36.5?C
CorrectAnswer-D
Ans.D.-36.5?C
CriticaltemperatureofN2O-36.5

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CriticalpressureofN2O-214.7atm

1395.Whichanaestheticagentisneither
metabolisedbylivernorbykidney?
a)Atracurium
b)Vecuronium

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c)Pancuronium
d)Rocuronium
CorrectAnswer-A
Ans.A.Atracurium

1396.Dibucainnumberrefersto?

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a)Achcholinestraseactivityderangement
b)Potencyofmusclerelaxants
c)Potencyofgeneralanaesthetics
d)None
CorrectAnswer-A

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Ans.is'a'i.e.,Achchlinestraseactivityderangement
Dibucainnumber:Dibucain(alocalanaesthetic)inhibits80%of
normalpseudocholinesteraseand20%ofatypical(non-functional)
pseudocholinesterase.Thereforenormaldibucainnumberis70-
80%.Dibucainnumberisusedtomeasuretheactivityofatypical

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pseudocholinesterase.

1397.Stagesofanesthesiawereestablished
by
a)Ether
b)N20

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c)Halothane
d)Chloroform
CorrectAnswer-A
Ai.e.Ether

1398.Fastinductionandrecoveryisseenin?

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a)Methoxyflurane
b)Ether
c)Halothane
d)N2O
CorrectAnswer-D

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Ans.D.N2O
Speedofonset&recoveryindecreasingorder(Increasingorderof
B:Gpartitioncoefficientandbloodsolubility).

1399.MACofdesfluraneis?
a)1.15

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b)2
c)4
d)6
CorrectAnswer-D
Ans.D.6

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1400.WhichcanreplaceN20as02carrier?
a)Argon
b)Xenon
c)Helium
d)None

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CorrectAnswer-C
Ans.C.Helium
Heliumcanbeusedtoreplacenitrogen,asthecarriergasfor
oxygen(Helium)toreducetheworkofbreathing.

1401.Allofthefollowingarecorrectaboutketamine,EXCEPT:

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a)Itfunctionally"dissociates"thethalamus
b)Itincreasesarterialbloodpressure
c)Itisapotentbronchoconstrictor
d)Itinhibitspolysynapticreflexesinthespinalcord
CorrectAnswer-C

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Ketaminefunctionally"dissociates"thethalamus(whichrelayssensoryimpulsesfromthe
reticularactivatingsystemtothecerebralcortex)fromthelimbiccortex(whichisinvolved
withtheawarenessofsensation).
Ketamineincreasesarterialbloodpressure,heartrate,andcardiacoutput.
Racemicketamineisapotentbronchodilator,makingitagoodinductionagentfor
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asthmaticpatients.

Itinhibitspolysynapticreflexesinthespinalcordaswellasexcitatoryneurotransmitter
effectsinselectedareasofthebrain.
Ref:ButterworthIVJ.F.,ButterworthIVJ.F.,MackeyD.C.,WasnickJ.D.,MackeyD.C.,

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WasnickJ.D.(2013).Chapter9.IntravenousAnesthetics.InJ.F.ButterworthIV,J.F.
ButterworthIV,D.C.Mackey,J.D.Wasnick,D.C.Mackey,J.D.Wasnick(Eds),Morgan&
Mikhail'sClinicalAnesthesiology,5e.

1402.Allaretrueaboutnitrousoxideexcept?
a)Laughinggas

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b)Causesmegaloblasticanemia
c)Causesdiffusionhypoxia
d)Goodmusclerelaxant
CorrectAnswer-D
Ans.is'd'i.e.,Goodmusclerelaxant

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NitrousoxideN,O
Itisalsocalledlaughinggas.
Ithasgoodanalgesicbutpoormusclerelaxantactivity.
SecondgaseffectanddiffusionhypoxiaoccurwithN20only.
N20istheonlyanaestheticreportedtoproducehematologictoxicity

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andneurotoxicitywithlongtermadministration.
BothtoxicitiesaretheresultoftheinteractionofN20withvitB12.

1403.Inducingagentofchoiceinshock?
a)Isoflurane
b)Desflurane

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c)Ketamine
d)Thiopentone
CorrectAnswer-C
Ans.is'c'i.e.,Ketamine
InducingagentofchoiceinAsthma&COPDKetamine.

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InhalationalagentofchoiceinAsthma&COPDHalothane.

1404.Benefitofketamine?
a)CausesdecreaseinBP
b)Goodanalgesicaction
c)DecreaseICT

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d)DecreaseIOT
CorrectAnswer-B
Ans.B.Goodanalgesicaction
Ketamineisdifferentfrommostotheranaestheticinductionagentsin
thatithassignificantanalgesicaction

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1405.Whichofthefollowingisa
sympathomimetic?
a)Propofol
b)Etomidate
c)Ketamine

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d)N2O
CorrectAnswer-C
Ans.C.Ketamine
Ketaminehasanindirectsympathomimeticaction.

1406.Followingistrueabouthalothane

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except?
a)Volatileliquidwithsweetodour
b)Sensitiseshearttoadrenaline
c)Constrictsbronchii
d)Causesmalignanthyperthermia

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CorrectAnswer-C
Ans.is'c'i.e.,Constrictsbronchii
Halothane
Itisavolatileliquidwithsweetodour,nonirritatingand
noninflammable.
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Itisapotentanaestheticwithpooranalgesicandmusclerelaxant
properties.
Halothanecausesdirectdepressionofmyocardialcontractilityby
reducingintracellularCa.
ItcausesfallinBPandCO.

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Heartratedecreasesduetovagalstimulation.
Ittendstosensitizethehearttoarrhythmogenicactionof
adrenalinecontraindicatedinpheochromocytoma.
Itcausesgreaterdepressionofrespirationandventilationperfusion
mismatch.

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Itdilatesthebronchiinhalationagentofchoiceinasthmatics
(intravaneousanaestheticofchoiceinasthmaticsisketamine).
Itisahepatotoxicdrugandcanalsocausemalignanthyperthermia
(Succinylcholineaccentuateit).
Recoveryissmoothandreasonablyquick.

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Itcausespostanaestheticshiveringandchills.
Itinhibitsintestinalanduterinecontractionsagentofchoicefor

assistingexternalorinternalversionduringlatepregnancy.
Becauseitsuterinerelaxantactionitiscontraindicatedduring
labour.

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Itisparticularlysuitableforinductionandmaintenanceinchildren
andasmaintenanceanaestheticinadults.

1407.Allofthefollowingcausemyocardial
depressionexcept:
a)Halothane

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b)Etomidate
c)Thiopentone
d)Ketamine
CorrectAnswer-B
Bi.e.Etomidate

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-Etomidatecausesadreno-corticalsuppressionQbyinhibiting
enzymes11/3hydroxylase(mainly)&17ahydroxylaseinvolvedin
cortisolandaldosterone(mineralocorticoid)productionQ.VitC
supplimentationrestorescortisollevel.
-EtomidateandmidazolamprovidecardiovascularstabilityQ.But

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etomidateismostcardiostableagentQthatcausestheleast
hemodynamicdisturbanceofanyoftheintravenousanesthetic
agents.Soitisintravenousanestheticagentofchoiceforpatients
withcardiacdiseaseandaneurysmsurgeryQ.
-Directmyocardialdepressioniscausedbyhalothane(severe),
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nitrousoxide(moderate),iso/sevo/des-flurane(mild),thiopental
(marked),propofol(dosedependent)andketamineQ(butthisis
maskedbycardiotonicsympatheticstimulatoryaction).Etomidate>
midazolemaremostcardiostableagentsQ.

1408.Midazolamcausesallexcept:

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a)Anterogradeamnesia
b)Retrogradeamnesia
c)Causestachyphylaxisduringhighdoseinfusions
d)Decreasedcardiovasculareffectsascomparedtopropofol
CorrectAnswer-B

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Ans.b.Retrogradeamnesia
Atthetimeofpeakconcentrationinplasma,hypnoticdosesof
benzodiazepines(midazolam)canbeexpectedtocausevarying
degreesoflightheadedness,lassitude,increasedreactiontime,
motorincoordination,impairmentofmentalandmotorfunctions,

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confusion,andanterogradeamnesia."
Midazolam:
ItcausesanterogradeamnesiaQ
Toleranceandtachyphylaxismayoccur,particularlywithlonger-term
infusionsQ(ShaferA.Complicationsofsedationwithmidazolamin

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theintensivecareunitandacomparisonwithothersedative
regimens.CritCareMed.1998;26(5):947-56)
Benzodiazepinewithdrawalsyndromehasalsobeenassociatedwith
highdose/long-termmidazolaminfusionsQ
Comparedwithpropofolinfusions,midazolaminfusionshavebeen

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associatedwithadecreasedoccurrenceofhypotension?butamore
variabletimecourseforrecoveryoffunctionafterthecessationof
theinfusion.

1409.WhichcantbegivenbyEpidural
anaesthesia?

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a)Morphine
b)Remifentanil
c)Alfentanil
d)Fentanyl
CorrectAnswer-B

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Ans.B.Remifentanil
Opioidsusedforepiduralanalgesiaaremorphine,Fentanyl,
Tramadol,Buprenorphine,alfentanil,sulfentanil,pentazocine.
Ramifentanilcontainsglycinewhichcancausemotorweakness--?
hencenotsuitableforepiduralanalgesia.

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1410.ThedrugforOPDanalgesiais-
a)Morphine
b)Pethidine
c)Fentanyl
d)Alfentanil

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CorrectAnswer-D
Ans.is'd'i.e.,Alfentanil
Drugsusefulfordaycaresurgery
oPropofoloSevoflurane,desflurane&isoflurane
oMidazolamoMivacurium

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oAlfantanil

1411.Additionofepinephrinetolignocaine?
a)IncreasesesdistributionofLA
b)DecreasesabsorptionofLA
c)DecreasesdurationofLA

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d)IncreasesmetabolismofLA
CorrectAnswer-B
Ans.B.DecreasesabsorptionofLA
VasoconstrictorsareusedalongwithLAwhichprolongsdurationof
actionasrateofabsorptionisdecreasedduetovasoconstriction.

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Forthesamereason,metabolismofLAisreducedandtoxicityis
decreasedasthereislesserabsorptionofLA,

1412.Maximumconcentrationforepidural
block?
a)Bupivacaine

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b)Lidocaine
c)Ropivacaine
d)Chlorprocaine
CorrectAnswer-D
Ans,D.Chlorprocaine

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1413.VasoconstricatorL.A.is?
a)Cocaine
b)Procaine
c)Lidocaine
d)Chlorprocaine

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CorrectAnswer-A
Ans.A.Cocaine
AllLAsarevasodilatorexceptcocaine.Cocainecauses
vasoconstriction'
"Ropivacaineandbupivacainealsocausevasoconstriction"'

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1414.
Allarecontraindicationsofspinal
anaesthesiaExcept?
a)Bleedingdisorder
b)Raisedintracranialtension

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c)Hypertension
d)Infectionatinjectionsite
CorrectAnswer-C
Ans,C.Hypertension

1415.Forpreventionofheadacheduring

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spinalanaesthesia?
a)Dilutedsolutionoflocalanaestheticshouldbeused
b)Preloadingwithcrystalloids
c)FinerI.P.needleshouldbeused
d)Headendshouldbeelevated

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CorrectAnswer-C
Ans,C.FinerI.P.needleshouldbeused
AssinglemostimPortantpredisposingfactorislargeboreneedle
useoffineneedlepreventsPDPH.

1416.Innewborn,chestcompressionshould

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bestartedifheartrateis?
a)<120/min
b)<100/min
c)<80/min
d)<60/min

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CorrectAnswer-D
Ans,D.<60/min
CompressionfornewbornshouldbestartedifHR<60/min'

1417.Nonionicdyeis
a)Ioxaglate

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b)lohexol
c)Iothalamate
d)None
CorrectAnswer-B
Answer-B.Iohexol
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Iohexolisanonionicmonomercontrastagent.
Thenon-iodineradicalsatpositions1,3and5(includingtheionic
carboxylradical)werereplacedbylongaminohydrocarbonsthat
provideadequatesolubilitywithoutionizing.
Examplesofthistypeofcompoundareiopromide,iohexol,

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iopamidol,ioversol,iopentol,iobitridol,andiomeprol.

1418.HUismeasureof
a)CT
b)MRI
c)PET

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d)USG
CorrectAnswer-A
Answer-A.CT
Hounsfield'scontributionismemorializedintheHounsfieldscale,
whichisusedtomeasurethex-rayattenuationinCTscanning.

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Waterisarbitrarilyassignedavalueof0Hounsfieldunits(HU).
[RefEssentialradiologyp.86]

1419.Whichofthefollowingtechniquesuses
piezoelectriccrystals?
a)Ultrasonography

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b)NMRimaging
c)X-raydiffraction
d)Xeroradiography
CorrectAnswer-A
Ans.Ultrasonography

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Ultrasonographyisbasedonpiezoelectriceffect.
MRIisbasedongyeromagneticpropertyofproton(IP).

1420.WhichlookssameonTi&T2onMRI
a)Gallbladder
b)Fat

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c)Kidney
d)CSF
CorrectAnswer-B
Answer-B.Fat
Fat(adiposetissue)hashighsignalintensityonbothT1&T2

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images.
OtherthreeoptionshavelowsignalintesityonT1andhighsignal
intensityonT2images.

1421.Thescanwithhighestsensitivitytodetectadrenalmetastasisdueto
bronchogeniccarcinomais:

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a)ContrastEnhancedCTabdomenwithAdrenalprotocol
b)PETscan
c)MRIscan
d)Radionuclidescan
CorrectAnswer-B

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Scanstodifferentiateadrenaladenomafromadrenalmetastasisare:
CECT-
ChemicalshiftMRI
FDG-PET
PETscanhasalmost100%sensitivityfordetectingadrenalmetastasis,soanegative

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studyexcludesthepossibilityofadrenalmets.Butadenomascangivefalsepositivetest.
Ref:FundamentalsofDiagnosticRadiology,Edition-4,Page-427.

1422.HypertranslucentchestX-rayisseenin
allexcept
a)Mcleodsyndrome

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b)Emphysema
c)Pneumonectomy
d)Polandsyndrome
CorrectAnswer-C
Answer-C.Pneumonectomy
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Causesofopaquehemithorax
Technical:-Rotation,Scoliosis.
Pleural:-Pleuraleffusion,Pleuralthickening,Mesothelioma.
Surgical:-Pneumonectomy,Thoracoplasty.
Congenital:-Pulmonaryagenesis.

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Mediastinal:-Grosscardiomegaly,tumors.
Pulmonary:-Collapse,Consolidation,fibrosis,Foreignbody.
Diaphragmatichernia

1423.WhatisnotseenonchestX-rayin
pulmonaryarteryhypertension

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a)Enlargementofcentralarteries
b)Peripheralprunning
c)Narrowingofcentralarteries
d)None
CorrectAnswer-C

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Answer-C.Narrowingofcentralarteries
Characteristicradiologicalfeatureofpulmonaryhypertensionis
enlargementofcentralarterieswithperipheralprunning.
Increasedpulmonaryarterypressureandpulmonaryvascular
resistancecharacterizepulmonaryhypertension.PAHisdefinedas

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systolicpressureinthepulmonaryarteryexceeding30mmHg.

1424.Whichchamberenlargementshowsa
doublerightheartborderwithawide
subcarinalangle?
a)Leftatrium

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b)Leftventricle
c)Rightatrium
d)Rightventricle
CorrectAnswer-A
Answer-A-Leftatrium

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Radiologicalsignsofleftatrialenlargement:
A'double'rightheartborder
Elevationoftheleftmainbronchus
Splayingofthecarina
Enlargementoftheleftatrialappendage

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Theprominenceoftheportionoftheleftheartborderatthelevelof
theleftmainbronchus

1425.Corkscrewesophagusisseeninwhich
ofthefollowingconditions?
a)Carcinomaesophagus

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b)Scleroderma
c)Achalasiacardia
d)Diffuseesophagusspasm
CorrectAnswer-D
Ans.isdi.e.,DiffuseEsophagealspasm
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Radiologicalappearancesofdiffuseesophagealspasmhavebeen
describedas:
curlingesophagus
Corkscrewesophagusor
-pseudodiverticulosis
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Diffuseesophagealspasmisamotordisorderofesophagus
characterizedbyrepetitivesimultaneousnon-peristalticcontractions.
Symptomsaresubsternalchestpainand/ordysphagia
Diagnosedbymanometry
Alsoknow
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Nutcrackeresophagus
alsoknownas'supersqueezer'esophagus
-itischaracterizedbyextremelyhigh-amplitudeperistaltic
contraction
-Symptomsarepainanddysphagia
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Diagnosedbymanometrystudywhichshowsperistalticesophageal
contractionswithpeakamplitudesgreaterthantwostandard
deviationsabovethenormalvalues.

1426.Rattailappearanceincontrast
radiographyisseenin?

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a)Achalasiacardia
b)Carcinomaesophagus
c)Corkscrewesophagus
d)Diffuseesophagealspasms
CorrectAnswer-B

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CarcinomaesophagusREF:sabiston's18'editionchapter41See
tableinthepreviousquestion
"Rat-tail"appearanceonbariumstudyisseenincarcinoma
esophagus.

1427.ColonisidentifiedonX-ray

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a)Haustra
b)Valvulaeconniventes
c)Stringofbeadssign
d)Morenumberofloops
CorrectAnswer-A

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Answer-A.Haustra
Haustra(incompletebandacrossthebowelgasshadow)areseenin
colon.

1428.Doubletracksignisseenin
a)Duodenalatresia

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b)CHPS
c)Gastriculcer
d)Achalasia
CorrectAnswer-B
Answer-B.CHPS
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Double/tripletracksignisseenincongenitalhypertrophicpyloric
stenosis.

1429.Investigationofchoiceforstudying
RenalCorticalmass
a)99TcDTPA

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b)53CrStudy
c)99TcDMSA
d)99TcPyrophosphate
CorrectAnswer-C
Ci.e.99-Tc-DMSA

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DTPA(Renogram)
DMSA(IsotopeScanning)
-DTPAisfreelyfilteredat -Tc.99DMSAisusedforrenal
glomeruluswithno morphological
tubularreabsorptionor (anatomic)imagine

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excretion(i.e.GFR=
-Thiscompoundgetsfixedinrenal
Excretoryfunction)
tubules&images
-DTPAisusefulforevaluating maybeobtainedafter1-2hoursof

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perfusionand injection.Lesions
excretoryfunctionofeach
suchastumors&benignlesionsas
kidneyQ
cystsshowfilling

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-Indications: defectQ
1.Measurementofrelative
-Usedtoassesscorticalfunctionof
renal
KidneyQanddetect

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functionQineachkidney. renalscarringQ.
2.UrinarytractobstructionQ
3.Diagnosisof
Renovascularcauseof
hypertensionQ

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4.InvestigationofRenal
transplantQ

1430.RimsigninIVPisseenin
a)PolycysticKidney
b)Hydronephrosis

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c)Chronicpyelonephritis
d)Hypernephroma
CorrectAnswer-B
Bi.e.Hydronephrosis
RimSigninNephrogram-

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1.Severehydronephrosisofthekidneys
2.Acutecompletearterialobstruction

1431.Investigationofchoiceformultiple
sclerosis
a)CT

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b)MRI
c)USG
d)PET
CorrectAnswer-B
Answer-B.MRI
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MRIistheinvestigationofchoicefordemyelinatingdisorder,e.g.
multiplesclerosis.

1432.Investigationofchoicefor
intramedullarySOLis-
a)MRI

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b)USG
c)CT
d)X-ray
CorrectAnswer-A
Answer-A.MRI
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Investigationofchoiceforintramedullaryspaceoccupylesionis
MRI.

1433.Investigationofchoiceforscreeningof
proximalinternalcarotidarterystenosis
is:

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a)DopplerflowUSG
b)CTsubstractionangiography
c)MRI
d)Angiography(DSA)
CorrectAnswer-A

--- Content provided by‍ FirstRanker.com ---

AnswerisA(DopplerflowUSG):
'StenosisattheoriginoftheinternalcarotidArterycanbeidentified
andquantifiedreliablybyultrasonographythatcombinesBmode
ultrasoundimagewithaDopplerultrasoundassessmentofflow
velocity.'

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1434."Sunrayappearance"onX-raysis
suggestiveof:
a)AChondrosarcoma
b)Ametastatictumourinthebone
c)AnOsteogenicsarcoma

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d)AnEwing'ssarcoma
CorrectAnswer-C
Ci.e.OsteogenicSarcoma
Sunrayappearanceisclassicallyseeninosteosarcoma.Itmayalso
occurinmetastases,Ewingssarcoma,Haemangoma,Meningioma

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andtuberculosis.

1435.Bonewithinboneappearanceisseen
in?
a)CML
b)Osteoporosis

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c)Osteopetrosis
d)Boneinfarct
CorrectAnswer-C
Ci.e.Osteopetrosis
Inosteopetrosis,thereisreducedosteoclasticboneresorption

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resultingindiffusesymmetricalskeletonsclerosis.Alsok/amarble
bonediseased/titsstonelikequalityofbones;howeverthebones
areabnormallybrittle&fracturelikeapieceofchalk.Itcanpresent
radiologicallyas?
SclerosisofallbonesmoreprominentatbaseofskullQ.
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Sclerosisofvertebralendplate1/tcharacteristicsandwitchorbroad
stripped(rugbyjerseyspine)QBoneinboneappearanceQd/t
scleroticfociwithinthebone.

1436.WhitelineofFrenkelisseenin:
September2008

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a)Osteoporosis
b)Osteomalacia
c)Scurvy
d)Beri-Beri
CorrectAnswer-C

--- Content provided by FirstRanker.com ---

Ans.C:Scurvy
Clinicalsymptomsandsignsofinfantilescurvy,inorderoffrequency
areirritability,tendernessandweaknessoflowerextremities,a
scorbuticrosaryofthelegs,bleedingofthegums(usuallywhere
teethhaveerupted),andfever.

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Radiographicfindingsofscurvy:
Densemetaphysealline-Thisisduetoanintensificationofthezone
ofpreparatorycalcification,resultingfrommatrixformationfailing,is
hasbeenreferredtoasthewhitelineofFrenkel,butisnon-specific,
asitisalsoseeninhealingrickets,andleadorphosphorus

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poisoning.
Groundglassosteoporosis:Thisappearsattheendoftheshaftwith
blurringordisappearanceoftrabecularmarkings.
Haloossificationcentre:AlsocalledtheWimberger'sring,itisthe
sameeffectthatproducesthewhitelineofFrenkel,affectingthe

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epiphysealossificationcenter.
Cornersign-Seenduetosubepiphysealinfarction,orseparationof
theepiphysisfromthemetaphysis.
Lateralspurs-Thesemetaphysealspursprojectatrightanglestothe
axisoftheshaft,theymaybeseenduetomushroomingofepiphysis

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onthemetaphysis,ormayrepresentearliestcalcificationof

periosteumelevatedbyasubperiostealhemorrhage.
Subperiostealhematomas-Theseoccurattheendoflongbones,
seenafterabout2weeksofonsetofclinicalsymptoms;itisnotthe
periostealhemorrhagethatcalcifies,buttheelevatedperiosteum,

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secondarytoresumptionofboneformation.
Metaphysealfractures-Subperiostealcomminutedfracturesatthe
endoflongbones,extendingonlypartiallythroughthewidthofthe
bone.
Atrophyscurvyline-AradiolucentzoneontheshaftsideofFrenkel's

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whiteline,ithasbeenreferredtoastheTrummerfeldZone.

1437.VonRosen'sviewisfor
a)CDH
b)Perthe'sdisease
c)CTEV

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d)None
CorrectAnswer-A
Answer-A.CDH
InVonRosen'sviewisusedinDDH/CDH.

1438.Popcorncalcificationisseenin:

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a)Pulmonaryhamartoma
b)Fungalinfection
c)Metastasis
d)Tuberculosis
CorrectAnswer-A

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Ans.Pulmonaryhamartoma
Popcorncalcification
oPopcorncalcificationisaclusterofsharplydefined,irregularly
lobulated,calcification,usuallyinapulmonarynodule.
oPopcorncalcificationischaracteristicofhamartomaonchestX-ray
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examination.
oItmayalsobeseeninmediastinallymphnodesofacute
histoplasmosis.
Egg-shellcalcification
oEgg-shellcalcificationmeansperipheralrimcalcificationoflymph

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nodes:
oItisseenin:
NSilicosis(mostcommoncause)
(vi)Histoplasmosis(vii)Tuberculosis
(ii)Coalworker

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pneumoconiosis(v)Sarcoidosis(viii)
Coccidiodomycosis
(iii)Lymphomafollowingradiotherapy(vi)Progressivemassive
fibrosis

1439.Nuchaltranslucencyisusedin

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a)Headscan
b)MRIneck
c)ANCUSG
d)Anthropometry
CorrectAnswer-C

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Answer-C.ANCUSG
Nuchaltranslucencyisusedforscreeningofdownsyndromein
antenatalUSG.

1440.Half-lifeofIodine131is
a)8hours

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b)8days
c)8weeks
d)8months
CorrectAnswer-B
Answer-B.8days
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Iodine-131Halflife8days
Iodine-123-3Halflife13hours
Iodine-132Halflife2.3hours

1441.CalcificationofIntervertebralDiscis
seenin

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a)Gout
b)Rheumatoid
c)Alkaptonuria
d)Psoriasis
CorrectAnswer-C

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Ci.e.Alkaptonuria
Features Disease
FishMouthVertebrae
-SickelCellAnemiaQ
HomocystinuriaQ

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CodFishVertebra
-Osteomalacia,Osteoporosis,
(Biconcavevertebra)
Hyperparathyroid
Ruggerjerseyspine

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-CRFinducedosteomalaciaQ
(sclerosisofupper&
-Osteopterosis(marbelbone
lowerspineborders)
disease)

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Calcificationof
-Alkaptonuria(m.c.)
Intervertebraldisc
PictureFramevertebrae -Paget'sdisease
Vertebraeplana

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-EosinophilicgranulomaQ

1442.ThemaximumDALYlossisforthe
followingdisease-
a)Schizophrenia
b)Unipolardepression

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c)Bipolardepression
d)Mania
CorrectAnswer-B
Ans.B.Unipolardepression
AmongstthepsychiatricdisordersmaximumDALYlossiscausedby

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majordepression.

1443.Etheromaniasreferto?
a)Acutepsychosispostetheranaesthesia
b)Etheraddiction
c)Excessiveetherusedruganaesthesia

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d)None
CorrectAnswer-B
Ans,B.Etheraddiction
Etheraddictionoretheromaniaistheaddictiontoinhalationor
drinkingofdiethylether.

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1444.Theterm"Dementiaprecox"was
coinedby?
a)Freud
b)Bleuler
c)Kraepelin

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d)Schneider
CorrectAnswer-C
Ans.C.Kraepelin

1445.Theterm'id'wascoinedby?
a)Freud

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b)Skinner
c)Wayker
d)Blueler
CorrectAnswer-A
Ans,A.Freud
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Structuraltheoryofmind(theid,egoandsuperego)wasgivenby
sigmundfreud.

1446.
Subcorticaldementiaisseeninall
except?

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a)Parkinsonism
b)Alzheimer'sdisease
c)Wilson'sdisease
d)Huntingtonschorea
CorrectAnswer-B

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Ans.B.Alzheimer'sdisease
Subcorticaldementiaisseeninparkinsonism,Huntington'sdisease,
wilson'sdisease,progressivesupranuclearpalsy,idiopathicbasal
ganglioncalcification(Fahr'sdisease),thalamiclesions,multiple
sclerosis,HIVassociateddementiaandmultisYstematroPhY.

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Alzheimer'sdiseasecausescorticaldementia.

1447.Formicationisseenwith?
a)Acuteamphetamineintoxication
b)Chronicuseofamhetamine
c)Alcoholwithdrawal

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d)Cannabispoisoning
CorrectAnswer-B
Ans.B.Chronicuseofamhetamine
Magnan'ssyndrome(alsocalledformication)isseeninchronic
cocaineandchronicamphetamineabuse.

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1448.Hangoverfollowingalcohol
consumptioncanbetreatedwith?
a)Pyridoxine
b)Thiamine
c)Riboflavin

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d)Niacin
CorrectAnswer-B
ANs.B.Thiamine
Thiaminehelpspreventthebuildupofglutarateinthebrain,which
maybeassociatedwithpartoftheheadacheassociatedwith

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hangover.

1449.Mostcommonlyabusedopioid-
a)Morphine
b)Diacetylmorphine
c)Oxycodine

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d)Bupremorphine
CorrectAnswer-B
Ans,B.Diacetylmorphine
Diacetylmorphine(heroin)isthemostcommonlyabusedopioid.

1450.Hallucinationsareproducedby?

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a)Amphetamine
b)Morphine
c)Paraxetine
d)Chlorpromazine
CorrectAnswer-A

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Ans,A.Amphetamine
Amphetaminepsychosismimicparanoidschizophrenia.Theremay
bedeleusionsandhallucinations.

1451.Anxietyis?
a)Neurosis

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b)Psychosis
c)Personalitydisorder
d)None
CorrectAnswer-A
Ans.,A.Neurosis
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ImportantneuroticdisordersareAnxietydisorders(Panic),Phobia
(Phobicanxietydisorder),obsessivecompulsiveDisorder&
Dissociativeconversiondisorder.

1452.Negativesymptomofschizophrenia?
a)Hallucination

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b)Delusion
c)Ambivalance
d)Motorhyperactivity
CorrectAnswer-C
Ans.is'c'i.e.,Ambivalance

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Symptomsofschizophreniacanbedividedinto:?
1. Positivesymptoms:-Positivesymptomsarepsychoticsymptoms
notseeninnormalindividualsbutare"activelyexpressed"inpatient,
i.e.,hallucinations,delusionsandbizarremotoracts.Positive
symptomsaremorecommoninacuteschizophrenia.Theserespond

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welltotypicalantipsychotics.
2. Negativesymptoms:-Negativesymptomsarenormallyexpected
behaviours,emotions(feeling),thoughtsanddrivesthattheperson
withschizophreniafailtoexhibit,i.e.,deficitstate(diminutionorloss)
ofnormalfunction.Theprominentnegativesymptonsareflattening

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orbluntingofaffect,anhedonia,ambivalence(avolition)asociality
(socialwithdrawal),alogia,apathy,paucityofthoughtandpoverityof
speech.Negativesymptomsaremorecommoninchronic
schizophrenia.Negativesymptomsdonotrespondwelltotypical
antipsychoticsThereforepatientontypicalantipsychoticsmayshow

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improvementofpositivesymptomsandpersistentofnegative
symptoms.
Morerecentlyathirdcategoryhasbeenproposed.
3.Disorganizedsymptoms:-Disorganizedspeech/thinking,and
disorganizedbehavior.

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1453.Typeofschizophreniawithmental
retardation:
NEET13
a)Von-Goghsyndrome
b)Paranoidschizophrenia

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c)Catatonicschizophrenia
d)Pfropfschizophrenia
CorrectAnswer-D
Ans.Pfropfschizophrenia

1454.Erotomaniaisseenin:

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NEET13
a)Bipolarmania
b)Unipolarmania
c)Neurosis
d)Obsessivecompulsivedisorder

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CorrectAnswer-A
Ans.Bipolarmania

1455.Indepressions,thereisdeficiencyof?
a)5-HT
b)Acetylcholine

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c)Dopamine
d)GABA
CorrectAnswer-A
Ans.A.5-HT
Depression=Decreaseinserotoninandnorepinephrine.

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SerotoninisthemostimPortantneurotransmitterindepression.
Mania=Increasedofnorepipherine.

1456.Theaminoacidderivedneurotransmitter
usedfortreatingdepressionis?
a)Serotonine

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b)Histamine
c)acetylcholine
d)none
CorrectAnswer-A
Ans.A.Serotonine
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Thethreemainneurotransmittersinvolvedindepressionare
dopamine,norepinephrineandserotonin(s-HT).
WhenbrainIevelsofoneormoreneurotransmitterarelowor
unbalanced,depressioncanresult.Generally,antidepressantdrugs
workbyincreasingproductionordecreasingthebreakdownofone

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ormoreoftheseneurotransmitters.

1457.Suicidaltendenciesaremostcommonly
seenin:
March2003
a)Female

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b)Youngerage
c)Severedepression
d)Alloftheabove
CorrectAnswer-C
Ans.Ci.e.Severedepression

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1458.Repetitiveirresesistablethoughttodo
something
a)Phobia
b)Obsession
c)Compulsion

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d)Anxiety
CorrectAnswer-B
Ans.is'b'i.e.,Obsession
Obsessivecompulsivedisorder(OCD)
OCDisananxietydisorderwhichischaracterizedbyrecurrent,

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unwantedthoughts(Obsessions)andrepettivebehaviors
(compulsions).
Anobsessionhasfollowingcharacteristic:-
1. Anidea,impulseorimagewhichintrudesintotheconscious
awarenessrepeatedly.

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2. Itisrecognizedasone'sownideas,impulseorimagebutis
perceivedasegoalien(foreigntoone'spersonality).
3. Itisrecognizedasirrationalandabsurd(insightispresent--4
Patientknowsaboutdisorder).
4. Patienttriestoresistagainstitbutisunabletodosowhichleadsto

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markeddistressoranxiety.
Acompulsionhasfollowingcharacteristics:-
1. Itisrepetitive,purposefulformofbehavioriscarriedoutbecauseof
strongfeelingofcompulsiontodoso.
2. Itusuallyfollowsanobsession.

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3. tsgoalistopreventorreducetheanxietyorstresscausedby
obsessionhoweveritdonotalwayssucceedindoingso.
4. Itisirrationalorexcessiveandnotrealistic.

5. Insightispresent.
ApatientwithOCDmayhaveanobsession,acompulsionorboth

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(mostlypatientshaveboth).
ApatientwithOCDrealizestheirrationalityoftheobsessionand
experiencesboththeobsessionandthecompulsionasego-dystonic
(unwantedbehavior).
Thepersonispreoccupiedwithdetailsrules,listorder,organisation

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orschedulestotheextentthatthemajorpointofactivityislost.
Thepersonshowsperfectionismthatinterferswithtaskcompletion
(e.g.,unabletocompleteprojectbecausehisownovertlystrict
standardarenotmet).

1459.Repetitivetimesworkdoingfor

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premonitionof?
a)Obscession
b)Compulsion
c)Anxiety
d)None

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CorrectAnswer-B
Ans.B.Compulsion
Repetitiveirresistablethoughts>Obsession.
Repetitivepurposefulbehavior(workdoing)>compulsion.

1460.Derelation&depersonalisationseenin

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whichtypeofdisorder?
a)Dissociativedisorder
b)Personalitydisorders
c)Mania
d)None

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CorrectAnswer-A
Ans.A.Dissociativedisorder

1461.Phobiais:
a)Psychosis
b)Fearofanimal

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c)Anxiety
d)Neurosis
CorrectAnswer-D
Neurosis

1462.Persistentpreoccupationwithserious

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illnessandnormalbodyfunctionis
called?
a)Obsession
b)Somatization
c)Hypochondriasis

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d)Conversiondisorder
CorrectAnswer-C
Ans.is'c'i.e.,Hypochondriasis
Hvpochondriasis(hypochondriacaldisorder)
Theprimaryfeatureofhypochondriasisispersistentpreoccupation

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withexcessivefearofaserious(e.g.,cancer)orincurable(e.g.,
AIDS)disease,whichisbasedonperson'sowninterpretationof
physicalsymptomsorsensation,i.e.,misinterpretationofphysical
symptomsorsensations,forexampleanoccasionalchangeinheart
ratewillleadapersonwithhypochondriasistofearofheartdisease.

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Therefore,Hypochondriasisisabnormalpreoccupationaboutnormal
bodyfunction,i.e.,bodyfunctioningisnormalbutpatientthinksitas
abnormal.
Thepreoccupationwiththepresenceofafearedillnesspersists
inspiteofnormalmedicalassessmentandinvestigations.Patient

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goesfromonedoctortoanotherforaconsultation.
Peoplewithhypochondriasisareabletoacknowledgethattheir
fearsareunrealistic(insightispresent),butthisintellectual
realizationisnotenoughtoreducetheiranxiety.
Twoimportantfactsdifferentiatehypochondriasisfromsomatization

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disorder:-

1. Patientwithhypochondriasisispreoccupiedwithillness,ontheother
handpatientwithsomatizationdisorderisoccupiedwithsymptoms.
2. Hypochondriasispatientispreoccupiedwithoneillness(usually)
whilepatientwithsomatizationdisorderhasmany(atleast8or

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more)symptoms.

1463.Allaretrueregardingsomatization
dosorderexcept:
a)Maintainsickrole
b)4-Painsymptoms

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c)1-Sexualsymptom
d)1-Pseudoneurologicalsymptom
CorrectAnswer-A
Ai.e.Maintainsickrole

1464.Schizoidpersonalitydisorderallare

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seenexcept?
a)Aloof&detached
b)Pronetofantasy
c)Suspicious
d)Introspective

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CorrectAnswer-C
Ans.C.Suspicious
Suspiciousnessisseeninparanoidpersonalitydisorder.

1465.Narcolepsyisduetoabnormalityin?
a)Hypothalamus

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b)Neocortex
c)Cerebellum
d)Medullaoblongata
CorrectAnswer-A
Ans.A.Hypothalamus
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NarcolepsyisuniqueinthatthosewhosufferfromittyPicalyfall
almostinstantaneouslyintoREMsleep.
Itisthoughtthatnarcolepsyiscausedbyamalfunctioningofthe
hypothalamusinbrain.

1466.MaxdurationoftimespentisinNREM

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stage?
a)I
b)II
c)III
d)IV

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CorrectAnswer-B
Ans.B.II

1467.NREMSleeptrueis?
a)Teethgrinding
b)Narcolepsy

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c)Nightmares
d)Sleepparalysis
CorrectAnswer-A
Ans.A.Teethgrinding
Slowwavesleep(stage3&4ofNREMsleep)disordersrSleep

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walking(somnambulism),nightterror(sleepterroror
pavornocturnus),Nocturnalenuresis,Bruxism(teethgrinning),and
sleeptalking(somniloquy).
REMsleepevents/disorder:-Nightmares,nocturnalpenile
tumescence,Narcolepsy.

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1468.Bruxismis?
a)Walkingduringsleep
b)Nocturnalenuresis
c)Grindingofteethduringsleep
d)Sleepapnoea

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CorrectAnswer-C
Ans.C.Grindingofteethduringsleep

1469.Narcolepsy,nottrue?
a)Cataplexy
b)Sleeparchitecturenormal

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c)Lossofmuscletone
d)Hallucination
CorrectAnswer-B
Ans.B.Sleeparchitecturenormal
ThereisdisturbedREMsleep.

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Cataplexy(suddenlossofmuscletone)isthemostcommon
accessorysymPtom.
Theremaybehallucinations.

1470.Howtodifferentiatebetween
psychologicalandorganicerectile
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dysfunction?
a)Nocturnalpeniletumescence
b)PIPEtherapy
c)Sildenafilinducederection
d)Squeezetechnique

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CorrectAnswer-A
Ans.A.Nocturnalpeniletumescence
Oneoftheimportantmethodtodistinguishpsychogenicimpotence
fromorganicimPotenceisnocturnalpeniletumsescence&early
morningerectionwhicharepreservedinpsychogenicimpotencebut

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notinorganiccauseofimpotence.

1471.Desensitizationisatypeof?
a)Psychotherapy
b)Psychoanalysis
c)Behavioraltherapy

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d)None
CorrectAnswer-C
Ans.C.Behavioraltherapy
Typesofbehavioraltherapyare:-Systemicdesensitization,
therapeuticgradedexPosure,exPosure&responseprevention,

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flooding,aversiontherapy,andoperantconditioning.

1472.Stimulantdrugisgiventochildfor?
a)Conductdisorder
b)Speechdevelopmentaldisorder
c)Pervasivedisorder

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d)ADHD
CorrectAnswer-D
Ans.D.ADHD
Stimulants(likemethylphenidate,dextramphetamine)arethedrugs
ofchoiceforADHD.

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1473.Kleinlevinsyndrome?
a)Insomnia
b)Anxiety
c)Depression
d)Hypersomnia

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CorrectAnswer-D
Ans.D.Hypersomnia
Kleinelevinsyadromeorsleepingbeautysyndromeisaneurological
disorderofrecurringperiodsofexcessiveamountsofsleepingand
eating.

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1474.AccordingtorecentroundsbyDSM
whatcodeisgiventopsychiatric
diseasesinICD10?
a)E
b)F

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c)P
d)G
CorrectAnswer-B
Ans.B.F
ICD-10isWHOclassificationforalldiseasesandhealthproblems

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(andnotonlypsychiatricdisorders).
ICD-10usesalphanumericcodemadeofanalphabet?incontrast
DSM-IVusesnumericalcoding)?'F'isformentaldisorders.
Therearel0maincategoriesdenotedbydigits0to9.

1475.Thecurrentagentofchoicefortreatmentofbipolaraffective(manic-

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depressive)disorderis:
a)Chlorpromazine
b)Haloperidol
c)Diazepam
d)Lithiumcarbonate

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CorrectAnswer-D
Lithiumcarbonateisthecurrentagentofchoice,particularlyduring
themanicphase.Becausetheonsetofactionisslow,concurrent
useofantipsychoticagentssuchaschlorpromazineorhaloperidol
maybenecessarytocontrolmania.

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Concurrentuseoftricyclicantidepressantsmaybenecessaryinthe
depressivephase.
Monitoringoflithiumlevelsisnecessarybecauseoftheserious
natureoftheadverseeffects(neurologic,renal,cardiac).
Ref:RopperA.H.,SamuelsM.A.(2009).Chapter57.Depression

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andBipolarDisease.InA.H.Ropper,M.A.Samuels(Eds),Adams
andVictor'sPrinciplesofNeurology,9e.

1476.DSMIVcriterionfordepressionis?
a)1week
b)2weeks

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c)3weeks
d)4weeks
CorrectAnswer-B
Ans.B.2weeks
Forthediagnosisofminordepression2-4andformajordepression

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>5DSMIVsymptomsarerequiredforatleastforatwoweek
period.

1477.Typeofconnectivetissuepresentinthe
arrowmarkedareais:

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a)Looseandirregular
b)Specialized
c)Denseirregular
d)Denseregular
CorrectAnswer-C

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Ans.C.Denseirregular
Themarkedareaisreticulardermis.
Itiscomposedofdenseirregularcollagenousconnectivetissue
(mostcommonlytypeIcollagen)containingtheusualarrayof
connectivetissueelements,includingcells,bloodandlymphatic

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vessels.
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This post was last modified on 30 July 2021

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