Download NEET PG 2012 Question Paper with Answers

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).

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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.

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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]

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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.

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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

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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.

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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.

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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

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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.

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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.

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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.

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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

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CortexBonyorbit
pituitarywhich
areectoderm)

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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]

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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

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Intraembryoniccoelom.

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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.

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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

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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.

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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

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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.

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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

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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.

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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]

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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.

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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.

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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]

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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

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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

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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

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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]

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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

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

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d)Saddle
CorrectAnswer-D
Saddle

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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.

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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.

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37.Whichistrueaboutsynovialjoint?

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

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Ai.e.Stabilityisinverselyproportionaltomobility

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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

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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).

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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.

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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.

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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.

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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

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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.

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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.

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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

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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.

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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.

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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.

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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

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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.

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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.

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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

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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

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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.

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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.

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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.

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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.

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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

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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

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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

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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.

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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

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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"

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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

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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.

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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]

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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.

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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.

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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.

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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.

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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

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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.

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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.

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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.

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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.

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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

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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

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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.

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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.

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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

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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

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95.Posteriorcommunicatingarteryabranch

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

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CorrectAnswer-A
Ai.e.Internalcarotid

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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

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fromthefusionofthefirstcoccygealandthelastlumbar(4%in
whites,1.5%inNegroes).Thenumbermaybereducedtofour,
apparentlybythelumbarizationofthefirstsacral(0.4%inwhites,
1.5%inNegroes).
Numberofvertebrae

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*Mostconstant:Cervicalregion?
*Mostvariable:coccygealregion?

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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.

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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.

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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).

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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.

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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.

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105.

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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.'

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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).

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108.

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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

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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.

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110.

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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

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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

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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

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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.

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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

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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

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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.

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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

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120.

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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.

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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.

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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

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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.

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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).

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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"

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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)

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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

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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.

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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

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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.

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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.

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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

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causeinwhichthereisstiffeningandscarringofthelung.
Thecurveisshiftedupwardandtotheleft(complianceisincreased)

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inemphysema.

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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.

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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

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affinityforoxygenthanadulthemoglobin.
Inhumanblood,theaffinityoffetalhemoglobinfor2,3-DPGisonly

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about4O%thatofadulthemoglobin.
Thismakesfetalhemoglobinbehaveasif2,3-DPGlevelsarelow.

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139.Stabilityofalveoliismaintainedby?
a)Lungcompliance
b)Negativeintrapleuralpressure

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

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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.

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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

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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.

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

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

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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)()

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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'

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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

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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.

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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

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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

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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)

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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:

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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.

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*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"

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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.

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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.

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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.

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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.

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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.

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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.

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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'

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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"

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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

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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.

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170.

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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.

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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.

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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.

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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.

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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)

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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

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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.

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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.

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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

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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).

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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'

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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'

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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.

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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.

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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.

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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%

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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.

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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.

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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".

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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.

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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.

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195.Gastricsecretionis:
a)Inhibitedbycurare
b)Stimulatedbynoradrenaline

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

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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.

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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.

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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.

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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.

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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.

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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.

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203.PGsinsemenaresecretedby?
a)Prostate
b)Seminalvesicle

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

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204.17OHsteroid?

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

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Ans.B.Progesterone

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

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d)Cardiacmuscle
CorrectAnswer-A
Ans.A.Betacellsofpancreas

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206.Glucosetransporterinvolvedininsulin
stimulatedglucosetransportisGLUT?

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

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Ans,D.4

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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.

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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).

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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.

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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.

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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.

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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.

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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.

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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".

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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.

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217.Pituicytesareseenin?
a)Anteriorlobe

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

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Pituicytesareglialcellsofposteriorpituitary.

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

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

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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.

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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.

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222.IsotopeusedtomeasureRBCvolumeis

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

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CorrectAnswer-A
Ans.A.Cr51
BloodcellvolumeismeasuredbyCr51labeledRBC.

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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.

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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".

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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.

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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

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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.

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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.

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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.

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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.

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232.Plasmamembraneismainlycomposed

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

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CorrectAnswer-D
Ans.D.Protein

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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

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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

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embryofromtheuterinelumen.DeciduaParietalis-Thepartofthe
decidualiningrestoftheuterinecavity.

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Attheendofpregnancy,thedeciduaisshedoffalongwithplacenta
andmembranes.

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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,

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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).

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

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.

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240.AldehydedehydrogenaserequiresNAD

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

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

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

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

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241.Apoenzymeis?

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

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

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

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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

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

electrophoretic,chromatographicorimmunochemicaltechniques.
Separationandquantitationofisoenzymescangiveinformationof
greatdiagnosticimportanceasthetissuedistributionofisoenzymes
isquitespecific

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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.

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

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

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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.

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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

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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.

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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

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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).

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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.}.

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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

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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?.

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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]

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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.

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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.

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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

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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).

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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.

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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

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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

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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]

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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.

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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.

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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).

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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

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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)

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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).

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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.

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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'.

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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

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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

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Endocrinefunctionischildrenandadolescentsp.271]
GLUT2isexpressedinpancreatic13-cells,hepatocytesandin
epithelialcellsofkidneyandintestine.
Fanconi-BickelsyndromeiscausedbyGLUT2mutation,adisease
characterizedbyproximalrenaltubulopathy,impairedglucose

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homeostasisandhepatomegaly.

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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

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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.

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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

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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?.

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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]

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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.

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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

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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

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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.

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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]

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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.

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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]

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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]

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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

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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

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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

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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).

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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.

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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

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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)]

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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]

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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),

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probablybecauseofacceleratedcatabolism.

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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.

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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.

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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.

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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

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

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d)Threonine
CorrectAnswer-A
Ans.A.Tyrosine

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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

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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.

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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

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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.

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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

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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.

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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).

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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.

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Step5.FormationofUrea-Thefinalreactionofthecycleisthe

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hydrolysisofargininetoureaandornithinebyarginase.

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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

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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

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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.

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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.

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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.

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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.

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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.

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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]

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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.

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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

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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.

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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.

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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.

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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.

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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

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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]

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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

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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.

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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.

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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]

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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.

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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

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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.

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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

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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.

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364.Coenzymeformofpyridoxineis?
a)ADP
b)NAD

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c)PLP
d)FAD
CorrectAnswer-C
Ans.is'c'i.e.,PLP[RefGuyton12thiep.854]

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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?

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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.

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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.

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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

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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.

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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]

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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).

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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)

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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.

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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.

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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]

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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]

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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.

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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

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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.

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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.

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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

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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

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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.

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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.

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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.

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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.

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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.

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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

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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

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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.

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SoitcanbeconsideredasmultipleSouthernorNorthernblot

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analysisrunninginparallel.

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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]

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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.

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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.

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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.

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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?

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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]

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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

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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

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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.

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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

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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.

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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)?

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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.

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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)

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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]

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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.

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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.

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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).

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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.

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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.

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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.

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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

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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.

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*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.

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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.

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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.

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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).

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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).

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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.

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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

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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

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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.

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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.

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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

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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

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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.

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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.

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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.

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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.

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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).

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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.

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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.

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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

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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.

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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

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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.

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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

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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.

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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.

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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.

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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.

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453.Creolabodiesareseenin-

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

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.

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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.

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455.Cysticfibrosisisassociatedwithall

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

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.

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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.

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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.

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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

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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.

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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%

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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."

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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.

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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

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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

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5.
IgAnephropathy

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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

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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.

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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

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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.

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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.

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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)

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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

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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

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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.

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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.

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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.

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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).

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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

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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

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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

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484.Maximumspherocytesisseenin-
a)Autoimmunehaemolyticanemia
b)VitB12deficiency
c)Aplasticanemia

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d)None
CorrectAnswer-A
Ans.is'a'i.e.,Autoimmunehemolyticanemia
Mostcommoncauseofspherocytesisimmunehemolyticanemia.

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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

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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

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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).

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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

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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

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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.

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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

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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.

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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).

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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

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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;

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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.

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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).

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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."

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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.

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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.

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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

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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%

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506.Rokitanskiprotruberencesareseenin-

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

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.

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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.

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507.Whichisnotariskfactorofendometrial
carcinoma-

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

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.

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Type-HCarcinoma
TheseoccurinwomenadecadelaterthantypeIcarcinoma.
Theseusuallyariseinsettingofendometrialatropy.
Theyarepoorlydifferentiated.Themostcommonsubtypeisserous

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carcinoma,clearcelltype&malignantmixedmulleriantumor.
Themostfrequentalterationdescribedismutationinp53tumor
suppressorgene.

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508.Whichofthefollowinggermcelltumoris
malignant?

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

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.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

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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.

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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

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521.Dopamineallofthefollowingistrue

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Except?
a)CausesincreaseinGIIsehemia
b)Positiveionotropic
c)Improvesrenalperfusion
d)CausesVasoconstriction

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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

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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.

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524.Antiandrogenusedinheartfailure?
a)Carvedilol
b)Sampatrilat

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c)Spironolactone
d)Abiraterone
CorrectAnswer-C
Ans.is'c'i.e.,Spironolactone
oSpironolactoneandeplerenonearethealdosteroneantagonists.

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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%

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CorrectAnswer-B
Ans.is'b'i.e.,20-40%

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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

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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.

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531.5HT1agonistsusedas?(
a)Antianxietydrugs
b)Antipsychoticdrugs
c)GERD

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d)Chemotherapyinducedvomiting
CorrectAnswer-A
Ans.is'a'i.e.,Antianxietydrugs
5-HTIAagonists(Buspiron,ipsapirone)actasantianxietydrugs.

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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)

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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.

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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.

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535.Whichdrugdoesn'tincludeDMARD:
a)Chloroquine
b)Vincristine
c)Azathioprine

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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.

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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.

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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

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540.Indiabetesinsipidus,diureticshowing
paradoxicalantidureticactivity-

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a)Thiazide
b)Triamterene
c)Spironolactone
d)Furosemide
CorrectAnswer-A

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Ans.is'a'i.e.,Thiazide
ThiazidediureticsparadoxicallydecreaseurineoutputinDIdueto
formationofcAMPindistaltubuleseffectiveinbothcentraland
nephrogenicDI.

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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).

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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.

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544.Allareneuralplateinducersexcept
a)Notochordappearance
b)HighBMP
c)FGFupregulation

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d)Prechordalmesoderm
CorrectAnswer-B
Bi.e.HighBMP

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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
?

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

a)Renaldamage
b)ARDS
c)Myocardialdepression
d)Hepatitis
CorrectAnswer-B

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

Ans.is'b'i.e.,ARDS
oFollowingagentsreactwithsodalime:
SevofluraneisdegradedbycontactwithCO2absorbant(sodalime)
inanaesthesiamachine,yieldingavinylethercalledCompoundA
whichcancauserenaldamage.

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Trileneproducesphosgene(causingARDS)anddicholoroacetylene
(causesneurotoxicity)whenusedwithsodalime.

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548.Cardiotoxicityofbupivacaine-
a)Depressedpacemakeractivity
b)Toxiccompounddamagingmyocardialcells

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

c)Depressedneuralcontrolonheart
d)VascularthrombosisandMyocardialischemia
CorrectAnswer-A
Ans.is'a'i.e.,Depressedpacemakeractivity
oLocalanaestheticsblockcardiacsodiumchannelsandthus

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depressabnormalcardiacpacemakeractivity,excitability,and
conduction.Atextremelyhighconcentrations,localanaestheticscan
alsoblockcalciumchannels.

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549.Shortactingnondelpolarizingblocker?
a)Rocurorium

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

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

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551.Steroidingestedforlongtimeleadstoall
ofthefollowingexcept-
a)Avascularnecrosisofheadoffemur

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

b)Cataract
c)Glaucoma
d)Growthretardation
CorrectAnswer-C
Ans.is'c'i.e.,Glaucoma

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Glaucomaoccursaftertopicaltherapy(notsystemic)

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552.Leastglucocorticoidactionisseenwith
?
a)Fludrocortisone
b)Cortisone

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

c)Dexamethasone
d)Betamethasone
CorrectAnswer-B
Ans.is'b'i.e.,Cortisone
Leastpotentglucocorticoid-->Cortisone

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

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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

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554.Intakeofexogenoussteroidcauses:
a)Addison'sdisease

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

b)Cushing'ssyndrome
c)Pheochromocytoma
d)Conn'ssyndrome
CorrectAnswer-B
AnswerisB(Cushing'ssyndrome):

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

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.

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556.Tiboloneisa?

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

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.

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

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557.Finasterideisa:
a)5alphareductaseinhibitor
b)PDEinhibitor
c)Alphalablocker
d)Androgenreceptorblocker

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

CorrectAnswer-A
Finasterideisacompetitiveinhibitoroftheenzyme5-alphareductasewhichisresponsible
fortheconversionoftestosteroneintoamoreactivedihydrotestosteroneresponsibleforthe
androgenaction.
Whenusedinbenignprostatichypertrophy,itreducestheprostatesizeandincreasedpeak

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

urinaryflowrate.
Itisalsousedinmalepatternbaldnessandasapalliativetreatmentinprostaticcarcinoma.
Ref:KDTripathiTextbookofPharmacology,5thEdition,Page272

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558.Whichofthefollowingisasynthetic
estrogen?

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

a)Estrone
b)Estriol
c)Estradiol
d)Diethylstibestrol
CorrectAnswer-D

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

Ans.is'd'i.e.,Diethylstibestrol
Syntheticprogesterones
1.Progesteronederivatives-->Medroxyprogesterone,Megestrol,
Dydrogesterone,Hydroxyprogesterone,Nomegestrol.
2.19-Nortestosteronederivatives-->Norethindrone,Lynesternol,

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

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.

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560.WhichisnotaS/EofCimetidine?
a)Impotence
b)Gynaecomastia
c)Atrophicgastritis

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d)Galactorrhea
CorrectAnswer-C
Ans.is'c'i.e.,Atrophicgastritis

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561.Antilipidemicdrugsthatprevent
hypercholesterolemiabyinhibiting

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absorption-
a)Ezetimibe
b)Orlistat
c)Cholestyramine
d)Statins

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

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).

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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

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563.Mostpotentstatin-
a)Simvastatin
b)Pravastatin
c)Rosuvastatin

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

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

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

hereBPinthesupinepositionitwas
foundtobe90/60mmHg.Shehadthe
recenthistoryofdepression.Sheis
takingatenolol,thiazide,imipramine,
haloperidolanddocusate.Whatwillbe

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

thenextbeststepinthemanagement?
a)Changeatenololandthiazidetocalciumchannelblockerand
ACEinhibitorandaddbisacodylforconstipation
b)Changeimipramineandhaloperidoltofluoxetineand
risperidoneandaddbisacodylforconstipation

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

c)Onlyaddbisacodylforconstipationandcontinuerestofthe
medications
d)Discontinueallhermedicationsandstartheronsteroids
CorrectAnswer-B
Ans:B.Changeimipramineandhaloperidoltofluoxetineand

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risperidoneandaddbisacodylforconstipation
(RefHarrison19/ep1623-1624,18/ep3531:GoodmanGilman12/e
p410.1333)
EffectsofImipramine:

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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

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

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

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

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

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synthase.

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572.Longestactingsulphonamideis-
a)Sulfadiazine
b)Sulphadoxine
c)Sulfamethoxazole

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

d)Sulfamethiazole
CorrectAnswer-B
Ans.is'b'i.e.,Sulfadoxine
Sulfadoxineandsulfamethopyrazinearelongactingsulfonamides.

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573.Widestspectrumaminoglycosideis-

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

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

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

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

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

c)Prophylaxisinrecurrentherpes
d)Alloftheabove
CorrectAnswer-D
Alloftheabove

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576.Whichofthefollowingantimalarialisa

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

slowactingschizonticide-
a)Artemether
b)Mefloquine
c)Pyrimethamine
d)Quinine

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

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.

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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

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

c)Moxalactum
d)Ceftazidime
CorrectAnswer-C
Ans.is'c'i.e.,Moxalactam
oCeftriaxone,cefoperazone,moxalactam&cefamandolecancause

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

hypoprothrmbinemiaandbleeding.

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579.Sulphonamideinjectioncausesdecrease
infolicacidby?
a)Competitiveinhibition
b)Noncompetitiveinhibition

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

c)Uncompetitiveinhibition
d)Allostericinhibition
CorrectAnswer-A
Ans.is'a'i.e.,Competitiveinhibition
Bacteriasynthesizetheirownfolicacidofwhichparaaminobenzoic

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

acid(PABA)isaconstituent-Sulfonamides,beingstructural
analoguesofPABA,inhibitbacterialfolatesynthasecompetitively.

---

580.Allaretrueaboutciprofloxacinexcept?
a)C/Iinpregnancy
b)DNAinhibition

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

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

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

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

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

Ans.is'b'i.e.,T-cellblockade

---

585.ResistancetoMethotrexatedevelopsdue
to?
a)RapidCancercellmultiplication
b)Deficiencyofthymidylatekinase

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

c)Deficiencyofthymidylatesynthetase
d)Increasedproductionofdihydrofolatereductase
CorrectAnswer-D
Ans.is'd'i.e.,Increasedproductionofdihydrofolatereductase
Methotrexateresistance

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

oMethotrexateresistancemaybeduetoanyofthefollowing
mechanism:?
i)Defectivetransportintocells
ii)ProductionofalteredformofDHFRthathavedecreased
affinityformethotrexate

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

iii)IncreasedconcentrationsofintracellularDHFRthroughgene
amplificationoralteredgeneregulation
iv)Decreasedabilitytosynthesizemethotrexatepolyglutamates
v)Increasedexpressionofadrugeffluxtransporter,oftheMRP
(multidrugresistanceprotein)class

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

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586.Whichofthefollowingpoisoning
presentswithabdominalpain,diarrhea,
Meeslineonnailsand
myelosuppression:
September2011

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

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

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

crossingthenailoffingersandtoes
Inadditiontothis,theremaybeevidenceofliverdamage,kidney
damageandbonemarrowdepressionatsomestageArsenic
poisoning
Increasedlevelsoftheelementarsenicinthebody.

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

Arsenicinterfereswithcellularlongevitybyallostericinhibitionofan
essentialmetabolicenzyme.
Symptomsofarsenicpoisoningincludeheadache,confusion,
convulsion,diarrhea,vomiting,andinseverecasecomaanddeath
Routesofexposureincludecontaminatedwater,air,andfood.

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Occupationalexposuretoarsenicmayoccurwithcopperorlead

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smeltingandwoodtreatmentandamongworkersinvolvedinthe
productionorapplicationofpesticides
Symptomsofarsenicpoisoningbeginwithheadaches,confusion,
severediarrhea,anddrowsiness.

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

Asthepoisoningdevelops,convulsionsandchangesinfingernail
pigmentationcalledleukonychiamayoccur.
Whenthepoisoningbecomesacute,symptomsmayinclude
diarrhea,vomiting,bloodintheurine,crampingmuscles,hairloss,
stomachpain,andmoreconvulsions.

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

Theorgansofthebodythatareusuallyaffectedbyarsenic
poisoningarethelungs,skin,kidneys,andliver.
Chronicarsenicexposurecanremaininthebodysystemsfora
longerperiodoftimethanashortertermormoreisolatedexposure
andcanbedetectedinalongertimeframeaftertheintroductionof

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

thearsenic,importantintryingtodeterminethesourceofthe
exposure.
Hairisapotentialbioindicatorforarsenicexposureduetoitsability
tostoretraceelementsfromblood.
Incorporatedelementsmaintaintheirpositionduringgrowthofhair.

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

Thusforatemporalestimationofexposure,anassayofhair
compositionneedstobecarriedoutwithasinglehair
whichisnotpossiblewitholdertechniquesrequiringhomogenization
anddissolutionofseveralstrandsofhair.
Thistypeofbiomonitoringhasbeenachievedwithnewer

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

microanalyticaltechniqueslikeSynchrotonradiationbasedXray
fluorescence(SXRF)spectroscopyandMicroparticleinducedXray
emission(PIXE).
Dimercaprolanddimercaptosuccinicacidarechelatingagentswhich
sequesterthearsenicawayfrombloodproteinsandareusedin

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

treatingacutearsenicpoisoning.
Themostimportantsideeffectishypertension.
Dimercaprolisconsiderablymoretoxicthansuccimer

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587.AllaretrueregardingSunitinibexcept-
a)Itinhibitstyrosinekinasereceptors

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

b)Itisusedforrenalcellcarcinoma
c)ItisusedforthetreatmentofGIST
d)Itisexcretedprimarilyinurine
CorrectAnswer-D
Ans.is'd'i.e.,Itisexcretedprimarilyinurine

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

SunitinibinhibitsmultipleTyrosinekinasereceptors.Itinhibits
PDGF,VEGFandc-kit.
oSunitinibandsorafinibareusedinrenalcellcarcinoma(inRCC
thereisoverexpressionofVEGF)andGIST(inGISTthereisover
expressionofC-Kit&PDGF).

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

oItiseliminatedprimarilybyhepaticroutewithexcretioninfaeces.

---

588.Whichofthefollowingdrugcauses
hirsutism?
a)Phenytoin
b)Valproate

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

c)Carbamazepine
d)Phenobarbitone
CorrectAnswer-A
Ans.is'a'i.e.,Phenytoin

---

589.Notaselectiveserotoninreuptakeinhibi-

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

tor
a)Fluoxitine
b)Fluoxamine
c)Buspirone
d)Citaloforamin

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

CorrectAnswer-C
Buspirone

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590.Whichofthefollowingdrugcrosses
BBB?
a)Glycopyrrolate

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

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

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

crossBBB.
Glycopyrrolate-Itisapotentandrapidlyactinganti-muscarinic
lackingcentraleffectsandisusedasapre-anaestheticmedication.

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591.Juvenilejusticeactdefinesajuvenile
whichis

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

a)Malebelow16years
b)Femalebelow16years
c)Malebelow18years
d)Noneoftheabove
CorrectAnswer-C

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

Ans.is'c'i.e.,Malebelow18years

---

592.CrPC26?
a)Divisionofoffence
b)Divisionofnegligence
c)Divisionofmalpractice

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

d)None
CorrectAnswer-A
Ans.is'a'i.e.,Divisionofoffence
AccordingtoSec26ofCrPC,1973,OffencesundertheCriminal
ProcedureCode(hereinafterthe"CrPC")aredividedinto:

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

1. OffencesunderIndianPenalCode(IPC)(triablebyHC,Sessions
Courtandothercourtshowninthe1stScheduletotheCrPC)
2. Offencesunderanyotherlaw(empowersHC,whennocourtis
mentionedforanyoffenceunderanylawotherthanIPC,totrysuch
offences)

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

---

593.

---

Whichsectionbelongstomaritalrape?
a)375A
b)376A
c)376B

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

d)375B
CorrectAnswer-B
Ans.is'b'i.e.,376A[RefReddy30"Vep.377]Maritalrape
Itisforcefulsexualintercoursewithwifewhoislivingseparately
fromhimunderadecreeofseparation,oranycustomorusage

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

withoutherconsent.
Itispunishablewithimprisonmentupto2yearsprovidedtheageof
wifeisnotbelow12years-Section376A,I.P.C.

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594.Policeinquestisrequiredinallexcept:
b)Accidentaldeath

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

c)Dowrydeath
d)Murder
CorrectAnswer-C
Ans.C:Dowrydeath
Inpoliceinquest,sub-inspectororofficerinchargeofthepolice

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

stationconductstheinquestinsuicide,murder,accidentaldeathsor
deathundersuspiciouscircumstances.
Magistrateinquestisdonein:
Custodialdeath
Deathduetopolicefiring

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

Deathinprison
Deathinapsychiatrichospital
Dowrydeaths
Exhumation
Indowrydeaths,inquestshouldbecarriedoutbyamagistrateor

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

policeofficer,notbelowtherankofdeputysuperintendentofpolice.

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595.Plantiffisapersonwho?
a)Filescaseincivilcourt
b)Actsasdefender
c)Givesjudgement

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

d)None
CorrectAnswer-A
Ans.is'a'i.e.,Filescaseincivilcourt[RefInternet]
Plaintiffisapersonwhofilesacaseincivilcourt.?

---

596.Incriminalcases,conductmoneyispaid

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

by:
NEET13
a)Court
b)Oppositeparty
c)Judge

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

d)Noconductmoneyisgiven
CorrectAnswer-D
Ans.Noconductmoneyisgiven

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597.Oralevidenceismoreimportantthan
writtentestimonyas:

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

NEET13
a)Oralevidencecannotbecross-examined
b)Oralevidencecanbecross-examined
c)Documentaryevidencerequiresnoproof
d)None

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

CorrectAnswer-B
Ans.Oralevidencecanbecross-examined

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598.Contributorynegligenceisnegligence
dueto:
NEET13

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

a)Doctoronly
b)Patientonly
c)Bothdoctorandpatient
d)Hospitaladministratoranddoctor
CorrectAnswer-C

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

Ans.Bothdoctorandpatient

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599.Ina3monthfetus,characteristicfeature
seenis:
NEET13
a)Nailsarevisible

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

b)Limbswellformed
c)Anusisseenasdarkspot
d)Meconiumisfoundinduodenum
CorrectAnswer-A
Ans.Nailsarevisible

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

---

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

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

oftheageinmonthsi.e.Lengthincms=(Ageinmonths)?
Ageinmonths=Qlengthincms
Duringsecondfivemonthsofpregnancy,lengthincmsdividedby5
istheageinmonths.Lengthinems
Ageinmonths5

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

---

601.Cruralindexis:
a)Lengthoftibia/femurx100
b)Lengthofradius/humerusx100
c)Lengthoffibula/tibiax100
d)Lengthofradius/ulnax100

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

CorrectAnswer-A
Ans.Lengthoftibia/femurx100

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602.Whichofthefollowingisnotseenin
fingerprints?
a)Loop

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

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,

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

twinnedloops,accidentals
Mostcommontype-Loops.
Leastcommontype->Composite.

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603.Methodofidentificationusinglips:
a)Dactylography

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

b)Poroscopy
c)Cheiloscopy
d)Tricology
CorrectAnswer-C
Ans.Cheiloscopy

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

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604.Whatisfirstexternalsignof
decompositionofdeadbody-
a)Decompositionofliverandintestine
b)Greenishdiscolourationoverrightiliacfossa
c)Greenishdiscolourationoverdependentparts

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

d)Bloodstainedfrothfrommouth
CorrectAnswer-B
Ans.is'b'i.e.,Greenishdiscolourationoverrightiliacfossa
[RefReddy30th/ep.150-152]
Firstexternalsignofputrefaction-Greendiscolorationinrightiliac

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fossa.
FirstinternalsignofputrefactionGreendiscolorationunderliver.
Theseareduetoinvolvementofcaecumwhichcontainsmoregas
andisfullofbacteria.

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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.

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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

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607.Colorofpostmortemlividityin
hypothermicdeaths:
NEET13

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a)Purple
b)Deepred
c)Cherryred
d)Brightpink
CorrectAnswer-D

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Ans.Brightpink

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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.

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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

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611.Incisedlookinglacerationisseenat?
a)Forehead
b)Hand

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c)Thorax
d)Abdomen
CorrectAnswer-A
Ans.is'a'i.e.,Forehead
LACERATIONS(TearorRupture)

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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:?

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1)Splitlaceration:Splittingoccursbycrushingofskinbetween
twohardobjects.Bluntforceonareaswheretheskinisclosetorigid
structureslikebonewithscantysubcutaneoustissue,mayproduce
awoundthatbylinearsplittingoftissuemaylooklikeincisedwound,
i.e.,incisedlikeorincisedlookingwound.Examplesofsucharea

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---

arescalp,eyebrows,cheekbones(zygomatic),lowerjaw,iliac
crest,perineumandskin.Awoundproducedbyafallonkneeor
elbowwithlimbflexedandbyasharpstonealsosimulatesincised
wound.
2)Strechlacerations:Overstretchingoftheskin,ifitisfixed,will

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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).

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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

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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

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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.

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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.

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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

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620.Shotgundoesnotcontainuse:

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NEET13
a)Barrel
b)Chokebore
c)Bullets
d)Muzzle

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CorrectAnswer-C
Ans.Bullets

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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.

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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.

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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

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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

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navicularisdisappearandposteriorcommissuremayberuptured.
Thelatterinjuryusuallydoesnotoccurinconsentingsexual

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intercourseunlessthereismuchdisproportionbetweenthemale
andfemaleparts.

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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.

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630.Disputedmaternitycanbesolvedby

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

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

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

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.

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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.

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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

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

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.

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636.Instrychnosnuxvomicapoisoning,
patient:
NEET13

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a)Becomesunconsciousimmediately
b)Becomesunconsciousin1horso
c)Becomesunconsciousatendstage
d)Remainsconsciousthroughout
CorrectAnswer-D

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

Ans.Remainsconsciousthroughout

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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

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

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.

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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.

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639.Mutteringdeliriumisseenwith:
NEET13

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

a)Ricinus
b)Dhatura
c)Cocaine
d)Aconite
CorrectAnswer-B

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

Ans.Dhatura

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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

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642.Raindroppigmentationiscausedby?

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

a)Clofazimine
b)Dapsone
c)Minocycline
d)Arsenic
CorrectAnswer-D

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

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

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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).

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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.

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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

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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.

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648.Antidoteforstrychninepoisoning

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is:
NEET13
a)Fomepizole
b)Physotigmine
c)Barbiturates

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d)Naloxone
CorrectAnswer-C
Ans.Barbiturates

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649.Bariumcarbonatepoisoning
causes:

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NEET13
a)Respiratorydistress
b)Gastrointestinalirritation
c)Muscularweakness
d)Cyanosis

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CorrectAnswer-C
Ans.Muscularweakness

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650.Oximesarecontraindicatedinwhich
poisoning:
NEET13

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a)Malathion
b)Diazinon
c)Phorate
d)Carbamate
CorrectAnswer-D

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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%

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656.Blackpapperadultrantis?
a)Khesaridal
b)Driedpapayaseed

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c)Finesand
d)None
CorrectAnswer-B
Ans.is`b'i.e.,Driedpapayaseed

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657.Hydrogenperoxideisusedinallofthe

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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

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659.Whichofthefollowingshouldnotbe
donewhiledealingwithapatientof
snakebite?

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a)Tightbandapplied
b)Reassuarance
c)Localincision
d)Cleanwithsoapandwater
CorrectAnswer-C

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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

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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

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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.

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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.

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664.Whichofthefollowingisaprotista-
a)Algae
b)Fungi

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c)Protozoa
d)Bacteria
CorrectAnswer-C
Ans.is'c'i.e.,Protozoa

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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.

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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.

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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.

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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.

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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.

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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.

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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

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677.Botulismismostcommonlydueto-
a)Egg
b)Milk
c)Meat

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

d)Pulses
CorrectAnswer-C
Ans.is'c'i.e.,Meat
Followingnewtypesofbotulismhavebeenaddedin18th/eof
Harrison

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.Adultintestinaltoxemiabotulism:-resultsfromabsorptionof
toxinproducedinsituafterrarelyoccuringintestinalcolonizationwith
toxigenicclostridia.
.Iatrogenicbotulism:-resultsfrominjectionofbotulismtoxin.

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678.Trueaboutchlamydiaareallexcept:

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

a)Obligateintracellularorganism
b)Grampositive
c)Reticulatebodyismetabolicallyactive
d)Replicatebybinaryfission
CorrectAnswer-B

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

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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.

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680.Pigmentproducingatypical
mycobacteria?
a)M.fortutionandM.chelonae
b)M.xenopiandMAC

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

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.

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cheloneidonotproduceanypigment.OtherrapidgrowersareM.

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

abscessus,M.vaccae,M.genevense,M.confluentis,andM.
intermedium.

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681.Sevensheathedflagellaisseenin-
a)Vcholera
b)Hpylori

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

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.

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682.TrueaboutHinfluenza-

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

a)Grownonsheepbloodagar&CO2
b)itisnotcapsulated
c)Invasivestrainismostcommon
d)Grampositive
CorrectAnswer-C

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

Ans.is'c'i.e.,Invasivestrainismostcommon
Invasivediseaseismorecommonthannon-invasivedisease.
H.influenzaedoesnotgrowonbloodagar.
Itisgramnegativeandcapsulated.

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683.Meningococcidifferfromgonococciin

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

thatthey?
a)Areintra-cellular
b)Possessacapsule
c)Causefermentationofglucose
d)Areoxidasepositive

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

CorrectAnswer-B
Ans.is'b'i.e.,Possessacapsule

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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

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

c)Inhibitionofproteinsynthesis
d)Activationofadenylylcyclase
CorrectAnswer-A
Ans.is'a'i.e.,InhibitionofreleaseofGABAandglycine
Pathogenicity

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CLtetanihaslittleinvasivepropertyandisconfinedtotheprimary
siteoflodgment.Tetanusresultsfromtheactionofthepotent
exotoxinitproduces.

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686.Virulenceofgonococciisdueto-
a)Pili

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

b)Endotoxin
c)Exotoxin
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Pili

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.Majorvirulencefactorforgonococciispill
(fimbriae).

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687.Tabesdorsalisisseenin-
a)Primarysyphilis
b)Secondarysyphilis

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

c)Tertiarysyphilis
d)Latentsyphilis
CorrectAnswer-C
Ans.is'c'i.e.,Tertiarysyphilis

---

688.Meningitiswithrashisseenin-

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

a)Neisseriameningitidis
b)H.influenzae
c)Strepto.agalactae
d)Pneumococcus
CorrectAnswer-A

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

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689.Ehrlichiachaffeensisiscausativeagents
of
a)HME
b)HGE

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c)Glandularfever
d)None
CorrectAnswer-A
Ans.a.HME

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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]

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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.

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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.

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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

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Itistreatedwithgentamycinalongwithdoxycycline.

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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

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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.

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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.

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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

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b)Fish
c)Snaile
d)Cattle
CorrectAnswer-C
Ans.is'c'i.e.,Snails

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Intermediatehostforschistosomasp.issnail.

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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

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703.Trueaboutdiphyllobothrium:
a)Manissinglehost
b)Irondeficiencyanemiaisseen

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c)Operculatedeggisdiagnostic
d)Fishisthedefinitivehost
CorrectAnswer-C
Ans.c.Operculatedeggisdiagnostic

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704.Cercariaeareinfectiveformof-

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

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.

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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--

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>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.

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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).

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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.

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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.

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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

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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.

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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.

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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

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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

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717.RenauldBraudphenomenonisseenis:

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a)Candidaalbicans
b)Candidapscitasi
c)Histoplasma
d)Cryptococcus
CorrectAnswer-A

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

Ans.a.Candidaalbicans

---

718.Largestintestinalprotozoais?
a)E.coli
b)Balantidiumcoli
c)Giardia

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

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
?

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

a)T.tonsurans
b)T.violaceum
c)T.schoenleinii
d)T.mentagrophytes
CorrectAnswer-D

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

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

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

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.

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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.

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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.

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724.Coxsackievirusis-
a)Harpesvirus
b)Poxvirus

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

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

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

d)Acuteonchronichepatitis
CorrectAnswer-B
Ans.is`b'i.e.,AcutehepatitisBwithhighinfectivity

---

726.Congenitalvaricellainfectioncausesall
except:

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

a)Macrocephaly
b)Limbhypoplasia
c)Corticalatrophy
d)Cicatrix
CorrectAnswer-A

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

Ans.a.Macrocephaly

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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

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

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.

---

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

728.Bollingerbodiesareseenin?
a)Chickenpox
b)Cowpox
c)Fowlpox
d)Smallpox

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

CorrectAnswer-C
Ans.is'c'i.e.,Fowlpox

---

729.Followingvirusisofpoxvirus-
a)Variola
b)Coxsachie

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

c)ECHO
d)HSV
CorrectAnswer-A
Ans.is'a'i.e.,Variola

---

730.Amplifierhostis-

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

a)PiginJE
b)Doginrabies
c)ManinJE
d)CattleinJE
CorrectAnswer-A

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

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

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

Followingasinglemassiveinfection,asbybloodtransfusion,the
virusantigensmaybedetectableinbloodafterabouttwoweeks.
Themajorcoreantigen,p24istheearliestvirusmarkertoappearin
thebloodandistheonetestedfor.IgMantibodiesappearinabout
4-6weeks,tobefollowingbyIgGantibodies.

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

Iftheinfectingdoseissmall,asfollowinganeedle-stickinjury,the
processmaybeconsiderablydelayed.
Theappearanceofp24antigenemiaandviremia,followedbyIgM
antibodyresponse,coincideswithacuteorseroconversionillness.
Afterwards,freep24antigendisappearsfromcirculationand

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

remainsabsentduringthelongasymptomaticphase,toreappear
onlywhensevereclinicaldiseasesetsin.
Howeverantibody-boundp24antigencontinuestobedemonstrable,
afterdissociation.Thep24antigencaptureassay(ELISA)which
usesanti-p24antibodyasthesolidphasecanbeusedforthis.The

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

testispositiveinabout30%ofHIVinfectedpersons.Withprior
dissociationofantigen-antibodycomplex,thepositivityrate
increasestoabout50%.
Thetestismostusefulinpersonsrecentlyexposedtoriskof

---

infection,inwhomtheantibodytestisnegative.

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

Nowcomingtothequestion
Optionb&darestraight-forward.p24antigenisdetectedbyELISA
(enzymeimmuno-assayorenzymelinkedimmuno-assay)andisnot
detectableinfirstweekaftertheinfection.
Option'a'incorrectbecausethoughthep24antigencanbedetected

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

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

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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.

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

violaceum
spp.
?
?Bacillus
?Porphyromonas ? Eikenellacorrodens

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

cereus
?E.coli
?Fusobacterium
? Erysipalothrix
?Serratia

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

?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

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

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

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

c)Leptospirosis
d)Anthrox
CorrectAnswer-A
Ans.is'a'i.e.,Cholera
Historyofcholera

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

oFatherofpublichealthisadisease,notaperson.
oFatherofpublichealthischolera.
oJohnSnow(1813-1858)foundthelinkbetweencholeraand
contaminateddrinkingwaterin1854,usingspotmap.
oRobertKochindifiedV.cholerae(1885).

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

Choleramorbus-Usedin19th&early20thcenturiesforbothnon-
epidemiccholeraandothergastrointestinaldiseasesthatresembled
cholera.

---

768.Whichagencymonitorsairqualityin
India?

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

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?

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

a)Samplingdoneforindividualwork
b)Assessmentoftimespentbyworkersinwork
c)Doneinveryshortperiod
d)None
CorrectAnswer-B

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

Ans.is'b'i.e.,Assessmentoftimespentbyworkersinwork
Worksamplingisatechniqueusedtoinvestigatetheproportionof
totaltimedevotedtothevariousactivitiesthatconstituteajobor
worksituation.

---

770.Childprotectionschemeisunderwhich

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

ministry-
a)Ministryofhealthandfamilywelfare
b)MinistryofSocialwelfare
c)Ministryofwomenandchilddevelopment
d)Ministryofeducation

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

CorrectAnswer-C
Ans.is'c'i.e.,Ministryofwomenandchilddevelopment
oIn2006theMinistryofWomenandChildDevelopment(MWCD)
proposedadoptionofIntegratedChildProtectionScheme(ICPS).
oIn2009thecentralgovernmenttaketheschemeitsapprovaland

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

hasbeguntheextensivetaskofprovidingchildrenwithaprotective
andsafeenvironmenttodevelopandflorish.
oThepurposeoftheschemeistoprovideforchildrenindifficult
circumstances,aswellastoreducetherisksandvulnerabilities
childrenhaveinvarioussituationsandactionsthatleadtoabuse,

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neglect,exploitation,abondonmentandseparationofchildren.

---

771.Schoolhealthcheckupcomesunder-
a)Disricthospital
b)PHC
c)CHC

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

d)Schoolhealthcommittee
CorrectAnswer-D
Ans.is'd'i.e.,Schoolhealthcommittee[RefPark22"d/ep.534,
535]
Theschoolhealthcommittee(1961)inIndiarecommendedmedical

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examinationofchildrenatthetimeofentryandthereafterevery4
years.

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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

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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.

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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.

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776.Naturalhistoryofdiseaseisstudiedwith

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?
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.

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777.Problemofbiasismaximumwith-
a)Cohortstudy
b)Casestudy

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c)Casecontrolstudy
d)Experimentalstudy
CorrectAnswer-C
Ans.is'c'i.e.,Casecontrolstudy

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778.Berkesonianbiasisatypeof?

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a)Selectionbias
b)Intervieverbias
c)Informationbias
d)Recellbias
CorrectAnswer-A

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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.

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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.

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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.

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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

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

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-

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

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.

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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

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

---

801.Toeradicatemeaslesthepercentageof
populationtobevaccinatedisat
least............%
a)70
b)80

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c)85
d)95
CorrectAnswer-D
95

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802.Inmeaselesvaccinecanbegiven

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

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.

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804.Incubationperiodofswineflu-

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

a)1-3days
b)2-3weeks
c)10-15days
d)5weeks
CorrectAnswer-A

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

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.

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

---

805.AsperRNTCPguidelines,Multidrugresistance(MDR)TBisdefinedas
resistanceto:
a)Rifampicin
b)Rifampicinandisoniazide
c)Rifampicin,isoniazideandethambutol

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

d)Noneoftheabove
CorrectAnswer-B
ConfirmedMDR-TBcase:MDR-TBsuspectisonewhoissputum
culturepositiveandwhoseTBisduetoMycobacteriumtuberculosis
thatareresistantin-vitrotoatleastisoniazidandrifampicin(the

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

cultureandDSTresultbeingfromanRNTCPaccreditedlaboratory).
Ref:Park21stedition,page178.
http://health.bih.nic.in/Docs/Guidelines-DOTS-Plus.pdf.

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806.WhyaTBpatientisrecommenda
regimenof4drugson1stvisit-

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

a)Toavoidemergenceofpersistors
b)Toavoidsideeffects
c)Tocureearly
d)None
CorrectAnswer-A

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

Ans.is'a'i.e.,Toavoidemergenceofpersistors
Twophasechemotheraphv
oTherearetwophaseoftreatmentoftuberculosis
i)Intensivephase
Thisisshortphaseintheearlycourseoftreatmentandlastsfor1-

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

3months.
Threeormoredrugsaregiventokillasmanybacilliaspossible,
whichpreventsemergenceofpersisters.
Theriskofrelapseisalsolessened.Continuationphase
Itisaimedatsterilizingthesmallernumberofdormantorpersisting

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bacilli.

---

807.TBmultidrugregimenisgivento-
a)Preventresistance
b)Broadspectrum
c)Preventsideeffects

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

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

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

b)Decreaseinresistancebyconjugation
c)Tocurediseaseearly
d)None
CorrectAnswer-A
Ans.is'a'i.e.,Decreaseinresistancebymutation

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

oMostcommonmethodforproductionofresistanceagainstATTis
mutation.
oMultidrugtreatmentpreventsemergenceofresistance.Thus,
multidrugtreatmentpreventemergenceofresistancedueto
mutation.

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

---

809.Chickenpoxvaccineis-
a)Livevaccine
b)Killedvaccine
c)Conjugatedvaccine
d)None

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

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.

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

Twodosesarerecommendedinpersonolderthan12yearsofage.

---

810.AmountofdiphtheriatoxoidinDTis?
a)5Lf
b)10Lf
c)15Lf

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

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

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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.

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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.

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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.

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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

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817.ORSnewosmolarityis-

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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.

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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.

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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

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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

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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)

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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

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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.

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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.

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828.ChandlersindexforHookworm,whenit
ishealthproblem?

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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.

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830.HIVpostexposureprophylaxisshouldbe
startedwithin?

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a)1-2hrs
b)14hrs
c)18hrs
d)72hrs
CorrectAnswer-A

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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.

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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).

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833.Whichindexofobesitydoesnotinclude
height?

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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.

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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.

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834.Whichofthefollowingstudieshave
givencoronaryriskfactor?

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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.

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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]

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Approximately90%oforalcancersinSouthEastAsiaarelinkedto
tobaccochewingandtobaccosmoking"--Park

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836.Allofthefollowingaregivenglobal
prominenceintheVISION2020goal,
expect:

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a)Refractiveerrors
b)Cataract
c)Trachoma
d)Glaucoma
CorrectAnswer-D

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Ans.Glaucoma

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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

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healthactionwereidentifiedas-

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1. 18.5kg/m24Underweight
2. 18.5-23kg/m2Increasedbutacceptablerisk
3. 23-27.5kg/m2Increasedrisk
4. 27.5kg/m2Higherhighrisk

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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

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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).

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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.

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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.

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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.

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843.Highestfundingforreproductivehealth
isby-
a)UNFPA
b)UNICEF

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

c)ILO
d)None
CorrectAnswer-A
Ans.is'a'i.e.,UNFPA[RefMaternalhealthfifthreportsession
2007-2008]

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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

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

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

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845.Lifespanofcut380a-
a)10yrs
b)20yrs

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

c)1yrs
d)None
CorrectAnswer-A
Ans.is'a'i.e.,10years

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846.WhichofthefollowinghasLEAST

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pregnancyfailurerate:
a)OCP
b)IUCD
c)Diaphragm
d)Condom

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

CorrectAnswer-A
OCP

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847.Whichistheleastcommoncauseamong
theseofinfantmortalityinIndia-
a)Infections

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

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

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

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

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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.

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850.Bestindicatorofavailability,utilisation&

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

effectivenessofhealthservices-
a)IMR
b)MMR
c)HospitalbedOCR
d)DALY

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

CorrectAnswer-A
Ans.is'a'i.e.,IMR

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851.Perinatalmortalityincludesdeaths-
a)After28weeksofgestation
b)First7daysafterbirth

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

c)Both
d)Fromperiodofviability
CorrectAnswer-C
Ans.is'c'i.e.,Both

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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

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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.

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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

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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

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858.IodineRDAis-

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a)300microgram
b)500microgram
c)150microgram
d)50microgram
CorrectAnswer-C

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Ans.is`c"i.e.,150microgratn
oTheRDAofiodineforadultsis150microgram.

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859.Iodinecomesiniodinesalt.Requirmen
tatproductionandconsumerlevel
respectively-

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a)20&10PPNI
b)30&10PPM
c)30&15PPM
d)30&20PPM
CorrectAnswer-C

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Ans.is"c'i.e.,30&15PPM

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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%

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861.JowarisPellogerogenicduetoexcess
of-
a)Leucine

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b)Lysine
c)Tryptophan
d)Methioninc
CorrectAnswer-A
Ans.is'a'i.e.,Leucine

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oSimilartomaize,JowaralsoContainsexcessofleucine.
oLeucineinterfereswithconversionoftryptophantoniacin.
oPellagrahasbeenreportedinIndiainTelanganaareaofAndhra
PradeshbecauseofSower(Sorghumvulgare)consumption.

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862.Toxinresponsibleforepidemicdropsy:

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AIIMS07;UP09;PGI11
a)BOAA
b)Aflatoxin
c)Sanguinarine
d)Pyrrozolidine

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CorrectAnswer-C
Ans.Sanguinarine

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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.

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864.Thehearttotheactivatedsludge
processis?
a)Primarysedimentationtank

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b)Sludgedigester
c)Aerationtank
d)Finalsettlingtank
CorrectAnswer-C
Ans.is'c'i.e.,Aerationtank

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oTheheartoftheactivatedsludgeprocessisaerationtank.

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865.Thicknessofleadaprontoprevent
radiation:
a)1mm
b)3mm

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c)0.5mm
d)7mm
CorrectAnswer-C
Ans.C.0.5mm
"Itisrecommendedthatforgeneralpurposeradiographytheminimal

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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

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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

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VitaminD100IU(2.5mcgcalciferol)
VitaminE(Tocopherol)0.8mgpergmofessentialfattyacids
VitaminK0.03mgperkg

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867.Avidinhasaffinityfor?
a)Folicacid

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b)Thiamine
c)Biotin
d)Riboflavin
CorrectAnswer-C
Ans.is'c'i.e.,Biotin[Ref.Harper29iVep.539]

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Peoplewhoeatabnormallylargeamountofuncookedeggwhite
mayhavebiotindeficiencybecauseitcontainsavidin,aproteinthat
bindsbiotinandpreventsitsabsorption

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868.Argemainoilcontaminationofmustard
oilcanbedetectedby?

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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

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CorrectAnswer-C
Ans.is'c'i.e.,Fortificationofsalt
Iodizedsalt(saltfortifiedwithiodine)ismosteconomical,
convenientandeffectivemeansofmassprophylaxisin
endemicarea.

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870.Amountofproteinsinhumanmilk(in
gms):
September2007
a)1.1
b)2.2

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c)3.3
d)4.4
CorrectAnswer-A
Ans.A:1.1
Each100gramsofbreastmilkyieldsapproximately:

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65Kilocalories
88gwater
7.4gcarbohydrates(primarilylactose)
3.4gfat
1.1gprotein

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---

871.Itwastecontaintoxicsubstances,
organicloadismeasuredby?
a)Biologicaloxygendemand
b)Chemicaloxygendemand
c)Suspendedsolid

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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

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specifiedperiod,generally5days,ataspecifiedtemperature,
generally20deg.C,fortheaerobicdestructionoruseoforganic
matterbylivingorganisms.BODvaluerangesfromaboutImgper
litrefornaturalwaterstoabout300mgperlitreforuntreated
domesticsewage.IftheBODis300mg/1andabove,sewageis

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saidtobestrong;ifitis100mg/I,itissaidtobeweak."
Chemicaloxygendemand(COD)
TheCODmeasurestheoxygenequivalentofthatportionofthe
organicmatterinasamplewhichissusceptibletooxidationbya
strongchemicaloxidiser.Ifwastescontaintoxicsubsances,COD

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maybetheonlymethodfordeterminingtheorganicload.
Suspendedsolids
Iftheamountofsuspendedsolidsis100mg/1,thesewageissaidto

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beweak,iftheamountis500mg/dlthesewageissaidtobestrong

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872.Fenthionis?

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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.

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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).

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874.Inwinter,watervapoursandpollutants
comestolieinthelowermostlayerof
atmosphereby-

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a)Acidrain
b)Greenhouseeffect
c)Temperatureinversion
d)None
CorrectAnswer-C

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

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.

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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.

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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

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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

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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.

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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.

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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

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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.

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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

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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.

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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

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890.Trueabouttriage-
a)Yellow-leastpriority
b)Red-morbidity
c)Green-ambulatory

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

d)Blue-ambulatory
CorrectAnswer-C
Ans.is'c'i.e.,Greenambulatory

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891.Amountofwasteinfectiousproducedin
hospitals?

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

a)45%
b)65%
c)80%
d)100%
CorrectAnswer-A

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

Ans.is'a'i.e.,45%

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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.

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893.Allaretrueaboutpaneldiscussion
except?
a)Twowaydiscussion

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b)6to20membersparticipates
c)Chiefmembersinitiates
d)Eachonepreparesthetopicofdiscussion
CorrectAnswer-B
Ans.is'b'i.e.,6-20membersparticipates

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

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.

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894.ICDSwaslaunchedat-

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

a)Communitydevelopmentblock
b)Townlevel
c)Citylevel
d)Districtlevel
CorrectAnswer-A

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

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

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896.Atraineddalcatersforapopulationof-

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

a)1000
b)2000
c)3000
d)4000
CorrectAnswer-A

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

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?

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

a)Coefficientofvariation
b)Rangeofvariation
c)Correlationcoefficient
d)None
CorrectAnswer-C

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

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

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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

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900.Trendscanberepresentedby-

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

a)Linediagram
b)Bardiagram
c)Scatterdiagram
d)None
CorrectAnswer-A

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

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

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

CorrectAnswer-A
Ans.is'a'i.e.,ABCanalysis

---

904.Bajajcommitteein1986proposed?
a)Multipurposehealthworker
b)Manpowerandplanning

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

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

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

CorrectAnswer-B
Ans.is'b'i.e..TreatmentofSTD
oInterventionsinallDistricts
oChildsurvivalinterventionsi.e.,immunization,vitaminA(to
preventblindness),oralrehydrationtherapyandpreventionof

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

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.

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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.

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

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

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weakdistricts.

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---

906.Ujjwalaisfor-
a)Childabuse
b)Childtrafficking
c)Childlabour
d)None

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

CorrectAnswer-B
Ans.is'b'i.e.,Childtrafficking
oThe'Ministryofwomen&childDevelopment'hasformulateda
newcomprehensiveschemeforpreventionoftraffickingandrescue,
rehabilitationandreintegrationofvictimsoftraffickingand

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

commercialsexualexploitation.
oThenewschemehasbeenconceivedprimarilyforthepurpose
preventingtraffickingontheonehandandrescueandrehabilitation
ofvictimsontheother.
oTargetgroupincludes-

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i)Women&childrenwhoarevulnerabletotraffickingfor
commercialsexualexploitation.
ii)Women&childrenwhoarevictimsoftraffickingfor
commercialsexualexploitation.

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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?

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

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.

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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

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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:

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

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

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

milk/banana/egg/seasonalfruit/micronutrientfortifiedfoodfollowed
byahotcookedmeal.Forchildrenbelow3yearsofageand
pregnant&lactatingmothers,"takehomeration"istobeprovided.o
Supplementarynutritionisgivenfor300daysayear.

---

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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,

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

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

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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.

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

---

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

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

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

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926.AwaveinERGisduetoactivityof:
a)Pigmentedepithelium
b)Rodsandcones
c)Ganglioncell

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

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

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

1stfromanteriorsurfac:ofcornea-->Erettanilmovesinsame
direction.
2ndfromposteriorsurfaceofcornea-->Erectandmovesinsame
direction.
3rdfromanteriorsurfaceoflens-->Erectandmoveinsame

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

direction.
4thfromposteriorsurfaceoflens-->Invertedandmovesinopposite
direction

---

928.Cornealendothelialcellcountis
measuredby?

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

a)Specularmicroscope
b)Ophthalmoscope
c)Synoptophore
d)Amsler'sgrid
CorrectAnswer-A

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

Ans.is'a'i.e.,Specularmicroscope
Cornealendotheliumisexaminedwithspecularmicroscope,which
allowsaclearmorphologicalstudyofendothelialcellsincluding
photographicdocumentation.
Thecelldensityofendotheliumisaround3000cells/mm2inyoung

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

adults,whichdecreaseswithadvancingage.

---

929.Featuresofvernalconjunctivitisare:
a)Shieldulcer
b)Horner-Tranta'sspots
c)Papillaryhypertrophy

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

d)All
CorrectAnswer-D
Ans.A,BandC

---

930.Complicationofvernalkerato
conjunctivitis:

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

a)Cataract
b)Keratoconus
c)Retinaldetachment
d)Vitreoushemorrhage
CorrectAnswer-B

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

Ans.Keratoconus

---

931.Treatmentofvernalkeratoconjunctivitis
includesallexcept:
a)Steroids
b)Chromoglycate

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

c)Olopatadine
d)Antibiotics
CorrectAnswer-D
Ans.Antibiotics

---

932.Neonatalconjunctivitisiscausedbyall

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

except:
a)Gonococcus
b)Chlamydia
c)Aspergillus
d)Pseudomonas

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

CorrectAnswer-C
Ans.Aspergillus

---

933.Subconjunctivalcystisseenin?
a)Toxoplasmosis
b)Cysticercosis

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

c)Leishmaniasis
d)Chaga'sdisease
CorrectAnswer-B
Ans.isbi.e.,Cysticercosis
Parasiticcystsoccursinsubconjunctivalcysticercus,hydatidcyst

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

andfilarialcyst.

---

934.Whichbacteriapenetratesintactcornea
?
a)Corynebacterium
b)Pneumococcus

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

c)Morexella
d)E.coli
CorrectAnswer-A
Ans.is'a'i.e.,Corynebacterium
Bacterialcornealulcer

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

Bacterialcornealulcer,alsocalledsuppurativekeratitis,isdueto
organismsthatproducetoxinwhichcausetissuenecrosisandpus
formationinthecornealtissue.Purulentkeratitisisnearlyalways
exogenous,duetopyogenicorganism.Aslongasthecorneais
healthy,themajorityofbacteriaareunabletocrossoradheretothe

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

cornealepithelium.Thereforethetwomainpredisposingfactorsfor
bacterialcornealulcerare:-
1. Damagetocornealepithelium
2. Infectionoftheerodedarea
However,thereareafewspeciesthatarecapableofpenetratingan

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

intactepithelium:-
1. Neisseriagonorrhoea
2. Neisseriameningitidis
3. Corynebacteriumdiphtheriae
4. Listeriaspecies

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

5. Haemophilusagyptus
Bacteriawhichcausecornealulcer(Purulentkeratitis)afterepithelial
injuriesare:-
1. Pseudomonas

---

2. Pneumococcus

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

3. Streptococcusepidermidis
4. Staphylococcusaureus
5. Morexella
6. Enterobacterias
7. Proteus,Klebsiella)

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

Althoughtherearespecificpresentationsdependingonthebacteria
involved,thereexistsaseriesofsymptomsandsignscommontoall
thatallowforarapiddiagnosis,andthereforeearlytreatmentof
cornealulcers.Themostimportantsymptomsarepain,lacrimation,
foreignbodysensation,conjunctivalinjection(redeye),photophobia

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

andblurredvision.Thereislidswelling,blepharospasmandyellow
whiteareasofulcerwithswollenandoverhangingmarinmaybe
seen.

---

935.Herpetickeratitisistreatedby
a)Analgesics

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

b)Atropine
c)Steroids
d)Idoxuridine
CorrectAnswer-D
Ans:Di.e.Idoxuridine

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

DrugofchoiceforherpetickeratitisisAcyclovirQ(topical)
Otherantiviraldrugsusedare
Idoxuridine
Trifluorothyrnidine
Vidarabine

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

---

936.Disciformkeratitisisseen?
a)HSV
b)HIV
c)HBV
d)Rubella

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

CorrectAnswer-A
Ans.A.HSV

---

937.Satellitenodulesareseenin
a)Fungalcornealulcer
b)Tuberculosis

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

c)Sarcoidosis
d)Viralulcer
CorrectAnswer-A
Ai.e.Fungalcornealulcer

---

938.Mostcommonprotozoancausing

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

keratitisis
a)Plasmodium
b)Acanthamoeba
c)Toxoplasma
d)W.bancrofti

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

CorrectAnswer-B
Ans.is`b'i.e.,Acanthamoeba[RefKanski8th/ep.197]
"Acanthamoebakeratitisisthemostcommonkeratitiscausedbya
protozoanespeciallyincontactlensusers".

---

939.Cornealdystrophy,trueis-

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

a)Inflammatory
b)Neovascularization
c)Bilateral
d)All
CorrectAnswer-C

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

Ans.C.Bilateral
CornealdystroPhyisagroupofdisorders,characterizedbyanon-
inflammatory,inherited,bilateralopacityofthecornea.
Thereisnovascularizationofcornea.
Dystrophiesareclassifiedaccordingtotheanatomicalinvolvement.

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

---

940.Followingcornealtransplantation,most
commoninfectionoccur?
a)Staphepidermidis
b)Streptococcus
c)Klebsiella

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

d)Pseudomonas
CorrectAnswer-A
Ans.A.Staphepidermidis
Pneumococcusandstaphylococcusaureushavebeenfoundtobe
thecommonestmicroorganismsinthedevelopedworld,whereas

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

staphepidermidisisthecommonestindevelopingcountries,for
causinginfectiouskeratitisaftercornealtransplantations.

---

941.1stsignofanterioruveitis?
a)Keraticprecipitate
b)Aqueousflare

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

c)Hypopyon
d)Miosis
CorrectAnswer-B
Ans.B.Aqueousflare

---

942.1stsignofiridocyclitis?

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

a)Retrolentalflare
b)KP
c)Congestion
d)Trichiasis
CorrectAnswer-A

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

Ans.A.Retrolentalflare

---

943.Mostcommoncauseofanterioruveitis?
a)CMV
b)Ankylosingspondylitis
c)Toxoplasma

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

d)None
CorrectAnswer-A
Ans,A.CMV

---

944.Iritisinyoungpatientwithjointpain-
a)Gout

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

b)RA
c)AS
d)Toxoplasma
CorrectAnswer-C
Ans,C.AS

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

---

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

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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'

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949.Decreasedreadingabilityisseenin?
a)Fusiformcataract
b)Zonularcataract
c)Bluedotcataract

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d)Punctatecataract
CorrectAnswer-B
Ans,B.Zonularcataract

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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.

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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.

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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).

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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

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

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,

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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

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ISNT)rule.

---

963.Retinitispigmentosaisduetodefectin
whichgene-
a)Scotopsin
b)Rhodopsin

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c)Pigmentedepithelium
d)None
CorrectAnswer-B
Ans.B.Rhodopsin
Severaldifferentrhodopsingenemutationshavebeenidentifiedin

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thepedigreeswithautosomaldominantretinitispigmentosa.

---

964.Ealesdiseaseis?
a)Recurrentopticneuritis
b)Recurrentpappilloedema
c)Recurrentperiphelbitisretinae

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d)None
CorrectAnswer-C
Ans,C.Recurrentperiphelbitisretinae
Eale'sdiseaseisanidiopathicinflammatoryvenousocclusion
(phelbitis)thatprimarilyeffectstheperipheralretinai.e.,periphelbitis

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andischaracterizedbyrecurrentbilateralvitreoushemorrhage.

---

965.Shaffer'ssignisseenin?
a)Retinitispigmentosa
b)Retinaldetachment
c)CRVO

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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

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CorrectAnswer-B
Ans.B.Drusen
DryformofARMDbeginswithcharacteristicyellowdepositsinthe
maculacalleddrusenbetweentheretinalpigmentepitheliumandtie
underlyingchoroid

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---

967.Vitreoushemorrhageindiabetic
retinopathy?
a)Non-proliferativediabeticretinopathy
b)Proliferativediabeticretinopathy
c)Both

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d)None
CorrectAnswer-B
Ans.B.Proliferativediabeticretinopathy

---

968.Headlightinfogappearanceisseenin?
a)Syphilis

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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

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

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)

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

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

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

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

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

Swingingflashlightisusedforrelativeefferentpathwaydefect
(RAPD)whichismostcharacteristicofIesionsintheopticnerve.
Thusitispositiveinretrobulbarneuritis.

---

975.Optictractlesioncauses?
a)Wernicke'shemianopicpupil

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

b)Amauraticpupil
c)Amauraticpupil
d)None
CorrectAnswer-A
Ans,A.Wernicke'shemianopicpupil

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

Wernicke'shemianopicpupilisseenincompletelesionofoptictract.

---

976.Amblyopiaiscausedby?
a)Methylalcohol
b)Penicillin
c)Propranolol

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

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

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

b)Binasalhemianopia
c)Constrictionofperipheralfield
d)Bitemporalhemianopia
CorrectAnswer-A
Ans.,A.Centrocaecalscotoma

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

VitaminB12deficiencycausesopticneuritis.
Mostcommonvisualfielddefectinopticneuritisiscentralor
centrocaecalscotoma.

---

978.Causeofbilateralopticatrophy?
a)Traumatoopticnerve

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

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.

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

---

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

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

constriction),andciliarymuscle(causesaccommodation).

---

983.Angleofsquintismeasuredby?
a)Gonioscopy
b)Prism
c)Retinoscopy

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

d)Keratometry
CorrectAnswer-B
Ans.B.Prism

---

984.Mostcommoncauseofophthalmoplegia
?

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

a)Aneurysm
b)Infection
c)Mystheniagravis
d)None
CorrectAnswer-A

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

Ans.A.Aneurysm
Themostcommonindentifiableetiologiesareischemia,aneurysm,
tumorandttauma;some20%remainunexplained.

---

985.Ataxia,nystagmusandophthalmoplegia
isseenin-

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

a)Mystheniagravis
b)Chronicprogressiveexternalophthalmoplegia
c)3rdnervepalsy
d)None
CorrectAnswer-B

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

Ans.B.Chronicprogressiveexternalophthalmoplegia
Themostcommonidentifiableetiologiesareischemia,aneurysm,
tumorandtrauma,some20%remainunexplained.

---

986.Childwithmildsquint.Intrauterine,birth
history,developmentalhistorytilldateall

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

normal.Cornealreflexnormal.Allother
eyeparametersnormalexcept
exaggeratedepicanthalfold.Diagnosis?
a)Pseudostrabismus
b)Accommodativesquint

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

c)Exophoria
d)Esophoria
CorrectAnswer-A
Ans,A.Pseudostrabismus
Pseudoesotropia(apparentconvergentsquint-Duetoprominent

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

epicanthalfold.
Pseudoexotropia(apparentdivergentsquint-Duetohypertelorism.

---

987.MCorbitaltumor?
a)Nervesheathtumor
b)Hemangioma

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

c)Lymphoma
d)Meningioma
CorrectAnswer-B
Ans.B.Hemangioma
Mostcommonorbitaltumor-Cavernoushemangioma.

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

Mostcommonmalignantorbitaltumor?Lymphoma.

---

988.
Mostcommonorbitaltumorhasits
originfrom?
a)Bloodvessels

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

b)Nerves
c)Muscle
d)Lymphnode
CorrectAnswer-A
Ans,A.Bloodvessels

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

Mostcommonorbitaltumorsarebenignvasculartumors-
Cavernoushemangioma.

---

989.Mostcommonmalignanttumourof
eyelidis?
a)Sebaceousglandcarcinoma

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

b)Basalcellcarcinoma
c)Squamouscellcarcinoma
d)Malignantmelanoma
CorrectAnswer-B
Ans,b.Basalcellcarcinoma

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

Basalcellcarcinomaisthemostcommonmalignanttumourofthe
eyelidsandconstitutes85-90%ofallmalignantepithelialeyelid
tumours.

---

990.Mostcommoncarcinomaofconjunctiva
?

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

a)SquamouscellCa
b)Basalcellca
c)Melanoma
d)Lymphoma
CorrectAnswer-A

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

Ans.A.SquamouscellCa
Squamouscellcarcinomaisthemostcommonmalignantlesionof
theconjunctiva"

---

991.Retinalastrocytomaisseenin?
a)Tuberoussclerosis

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

b)Sturgewebersyndrome
c)VonHippel-Lindausyndrome
d)None
CorrectAnswer-A
Ans.A.Tuberoussclerosis

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

---

992.Fusionofpalpebralandbulbar
conjunctivais-
a)Symblepharon
b)Trichiasis
c)Ectropion

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

d)Tylosis
CorrectAnswer-A
Ans.A.Symblepharon
Adhesionofthelidstoeyeballiscalledsymblepharon.
Itoccursduetofusionofpalpebralconjunctiva(coveringinner

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

surfaceoflid)tobulburconjunctiva(coveringoutersurfaceof
eyeball).

---

993.Lossofeyelashesis?
a)Tylosis
b)Madarosis

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

c)Trichiasis
d)Ectropion
CorrectAnswer-B
Ans.B.Madarosis
Madarosisrefertolossofeyelashesandsometimesalsoeyebrows

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

---

994.Madarosisisseenin?
a)Addison'sdisease
b)Hypothyroidism
c)Acromegaly
d)None

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

CorrectAnswer-B
Ans.B.Hypothyroidism
MadarosismaYbeseenin-
Rubella
CongenitalSyphilis

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

Congenitalleberamaurosis
MayousBattendisease
Thioridazinetoxicity

---

995.Abnormallyeccentricplacedpupilis
called?

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

a)Polycoria
b)Corectopia
c)Corectopia
d)Ectopialentis
CorrectAnswer-B

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

Ans.B.Corectopia

---

996.Massagingofnasolacrimalductisdone
in?
a)Acutedacryocystitis
b)Congenitaldacryocystitis

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

c)Conjunctivitis
d)None
CorrectAnswer-B
Ans.B.Congenitaldacryocystitis
Massageoverlacrimalsacisthemainstayoftreatmentincongenital

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

dacryocystitis.

---

997.Mostcommoncauseofintermittent
proptosis?
a)Orbitalvarix
b)Thyroidophthalmopathy

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

c)Neuroblastoma
d)Retinoblastoma
CorrectAnswer-A
Ans.A.Orbitalvarix
Intetmittentproptosis:-Proptosisdevelopingintermittentlyand

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

rapidlyinoneeyewhenvenousstasisisinducedbyforwardbending
orloweringthehead,turningtheheadforcibly,hyperextensionofthe
neck,coughing,forcedexpirationwithorwithoutcompressionofthe
nostrils,orpressureonjugularveins.Themostimportantcasueis
orbitalvarix(varicocele).

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

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998.Bilateralptosisisseeninallexcept?
a)Hyperthyroidism
b)Congenital
c)Trauma
d)Myotonicdystrophy

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CorrectAnswer-C
Ans,C.Trauma

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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.

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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.

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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.

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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.

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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.

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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

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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.

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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.

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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.

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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

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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.

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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

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-Stiffnessofleftventricle

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-Fatalarrythmias
CalciumchannelBlockersQ(verapamilanddiltiazem)arealternative
drugs.
-Theyreduce-stiffnessofventricle
-Elevateddiastolicpressures

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Amiadaronemaybeusedtoreducearrythmias.
Surgicalmyomectomy

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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).

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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

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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.

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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

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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

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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

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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

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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

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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.

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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

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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

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initialbindertherapy.
HighBoneTurnoverDisease
Boneturnover(theformationandremovalofbone)isincreaseddue

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toaprocesscalledsecondaryhyperparathyroidism(SHPT).
Secondaryhyperparathyroidismrepresentsacommondisorderin
patientswithCKD.
Itdevelopsasaresultofhyperphosphatemia,hypocalcemiaand
impairedrenalvitaminDsynthesiswithreductioninserumcalcitriol

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levels

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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.

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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

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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).

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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.

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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.

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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.

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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

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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.

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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

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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;

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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.

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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

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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.

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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

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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

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cerebellum.

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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.

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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.

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Endovasculartreatment("coiling")isgenerallypreferredover
craniotomyandclippingforaneurysmsamenabletothisapproach.

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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.

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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.

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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.

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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

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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.

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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.

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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

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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

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1056.Whichofthefollowingisnotseenin

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

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).

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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.

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Increasedosmoticfragilityonpinktest.
Coomb'stestisusedtodistinguishhereditaryspherocytosisfrom

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autoimmunehemolyticanemias.
Autoimmunehemolyticanemiasarecoomb'spositive_whereas
hereditaryspherocytosisiscoomb'snegative.

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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)

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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

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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.

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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

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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

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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.

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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)

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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

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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.

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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

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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)

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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

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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.

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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.

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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

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1073.Calciumhomeostasisdisturbanceis
seenin

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

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]

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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

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

AntiphospholipidAntibodysyndrome.Smallproportionofpatients
withSLEmayhaveaCoomb'sPositiveHaemolyticanemia.
PsychosisisaknownneurologicalmanifestationofSLE.

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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

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

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

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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

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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

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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

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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

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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.

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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]

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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.

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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.

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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

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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.

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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

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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

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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.

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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

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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.

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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

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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.

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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.

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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.

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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

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1103.VeinusedinbypassSurgery:

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a)Greatsaphenousvein
b)Shortsaphenousvein
c)Femoralvein
d)Brachialvein
CorrectAnswer-A

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

Inpatientswithocclusivecoronarydiseasecausedby
atherosclerosis,thediseasedarterialsegmentcanbebypassedby
insertingagraftconsistingofaportionofthegreatsaphenousvein.
Thevenoussegmentisreversedsothatitsvalvesdonotobstruct
thearterialflow.Followingremovalofthegreatsaphenousveinat

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thedonorsite,thesuperficialvenousbloodascendsthelowerlimb
bypassingthroughperforatingveinsandenteringthedeepveins.
Thegreatsaphenousveincanalsobeusedtobypassobstructions
ofthebrachialorfemoralarteries.

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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

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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.

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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

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Nauseaandvomiting

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Stomachacidleakingintoyouresophagus,causingscarringand
narrowing(stricture)
Vitamindeficiencies
Weightloss

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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).

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1110.Crohn'sdisease

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

a)Continousinvolvement
b)Sinus&fistula
c)Mesentericlymphadenitis
d)Studulcer
CorrectAnswer-B

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

Answer-B.Sinus&fistula
Clinicalfeatures-
Intermittentmilddiarrhea,fever,abdominalpain(MC)
Rightlowerquadrantmass,weightloss,anemia
Sometimesmimicsappendicitisorbowelperforation

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Analcomplaints(fissure,fistula,abscess)?frequent
Fat/vitaminmalabsorptionpresent

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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.

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1112.Whatisnotseeninshortbowel

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

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.

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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.

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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.

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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%).

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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.

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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.

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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.

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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.

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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.

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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

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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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---

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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

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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?

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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.

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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.

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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

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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.

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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.

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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

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Cullen'ssign.

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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.

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1139.Whichisnotacontraindicationfor

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

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

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1142.Pre-operativeprophylaxisfor

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

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.

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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,

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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

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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.

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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.

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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.

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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).

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

Lossofmedialsupportresultsinprogressivedilatationofaortic
valveringandrootoftheaorta
SevereaorticincompetenceAorticdissections

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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".

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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.

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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

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

11-betahydroxylasedeficiency,fetalplacentalaromatase
deficiency,andWNT-4genemutation.

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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.

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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.

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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).

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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).

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

---

1163.Simiancreaseisnotseenin-
a)Down
b)Trisomy13
c)Atopicdermatitis
d)Noonansyndrome

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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

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

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.

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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

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

Ocularhypertelorism
Pulmonarystenosis
Abnormalgenitalia
Retardedgrowth
Deafness

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

---

1167.GBSinachildtreatment-
a)IVIg
b)Ventilation
c)Plasmapharesis
d)Allofabove

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CorrectAnswer-D
Answer-D.Allofabove
TreatmentofGuillain-barresyndrome-
Selflimitedinmajorityofcases.
Intravenousimmunoglobinshowsgoodresponse.

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

Plasmapharesis-Removalofautoantibodies.
Assistedventilation-Ifpatienthadrespiratorymuscleparalysis.
Physiotherapy.

---

1168.Doseofi.v.adrenalineinterminfantis
duringneonatalresuscitation-

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

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.

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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

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

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:

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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

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

UncommonFrequent
Rash
AbsentFrequent
Lymphadenopathy
RareFrequent

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

Splenomegaly
MarkedVariable
WBCcountatdiagnosis>
100'000<100'000
WBCtype

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

---

GranulocyteMonocyte
Normoblastic
UnusualCommon
HbF
NormalIncreased

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

Immunoglobulins
NormalIncreased
Muramidaselevels
NormalIncreased
ResponsetoBusulphan

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

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.

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

Whenthecauseisparaneoplastic,thetumorsinvolvedareusually
cancerofthelungandbreastinadultsandneuroblastomain
children.

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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

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

Bang2cube-8month
Towerof2cubes-15month
4cubes-18month
6cubes-22month

---

1179.Achildisabletosayshortsentencesof

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

6words-
a)2years
b)3years
c)4years
d)5years

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

CorrectAnswer-C
Ans.is'c'i.e.,4years
o2wordsentences=19month
o6wordsentences=48month
o10wordsentences=60month

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

---

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

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

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

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

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

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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

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1184.5yearoldchildbedwettingRxof
choice?

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a)Notreatment
b)Imipramin
c)Desmopressin
d)Motivationaltherapy
CorrectAnswer-A

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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.

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1185.Nocturnalenuresisbestt/tis
a)Positivereinforcement
b)Punishment

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c)Bedalarm
d)Desmopressin
CorrectAnswer-A
Answer-A.Positivereinforcement
Consistentdrybedtrainingwithpositivereinforcementhasa

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successrateof85%andbedandpadalarmsystemshavea
successrateofapproximately75%withrelapseratethatarelower
thanthosewithpharmacotherapy.

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1186.Whatisthelarche-
a)Pubertalbreastenlargementinboys

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b)Breastenlargementinpregnancy
c)Hormonerelatedbreastenlargementingirls
d)Posthormonaltherapybreastenlargementinpostmenopausal
females
CorrectAnswer-C

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Ans.is'c'i.e.,Hormonerelatedbreastenlargementingirls
Thelarche
oDefinition:-Beginingofsecondary(Postnatal)breast
developmentatonsetofpubertyingirls.
Tannerstage2breastdevelopment

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Usuallyafter8yearsofage
Becauseofrisinglevelofestradiol
Breastdevelopmentduringpubertyinmaletermedas
gynaecomastianotthelarche.

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1187.InPrecociouspubertyagelimitofgirls

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is-
a)8year
b)10year
c)9year
d)11year

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CorrectAnswer-A
Answer-A.8year
Precociouspubertyinagirlistheappearanceofanyofthe
secondarysexualcharacteristicsbeforetheageof8yearsorthe
occurrenceofmenarchebeforetheageof10years.

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Precociouspubertyinboysistheonsetofsecondarysexual
characteristicsbeforetheageofnineyears.

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1188.Diarrhoeainachildof12month,dose
ofZincis?
a)1mg/10-14day

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b)10mg/10-14day
c)15mg/10-14day
d)20mg/10-14day
CorrectAnswer-D
Ans.is'd'i.e.,20mg/10-14days

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AccordingtoWHOguidlines
DoseofZinc
2month-6month=10mg/dayx14days>6months=20mg/day
x14days

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1189.Seleniumdeficiencyisseenin-

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

a)Keshandisease
b)Wilsondisease
c)Acrodermatitisenteropathica
d)Noneofabove
CorrectAnswer-A

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Ans.is'a'i.e.,Keshandisease
oKeshandisease--->DisorderofSe
metabolism
oWilson'sdisease--->DisorderofCu
metabolism

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oAcrodermatitisenteropathica-->DisorderofZn
metabolism

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1190.Malnourishedchildminimumweight
gain
a)5gm/kg/day

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b)10gm/kg/day
c)15gm/kg/day
d)20gm/kg/day
CorrectAnswer-A
Answer-A.5gm/kg/day

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Inmalnourishchildifthere
>10gm/kg/day=goodweightgain
5-10gm/kg/day=moderateweightgain
<5gm/kg/day=poorweightgain

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1191.Pretermbabyhave

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a)Continueextramedullaryhematopoesis
b)Greaterriskofhypothermia
c)Greaterriskofhypoglycemia
d)Allofabove
CorrectAnswer-D

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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).

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1192.Lowglucoselevelinpremature
a)Increasedbraintobodyratio

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b)Decreasedglycogenstores
c)Decreasedactionofpyruvatecarboxylase
d)Allofabove
CorrectAnswer-D
Answer-D.Allofabove

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Hypoglycemiaiscommoninpretem&IUGRbabiesb/callthree
reason
1. Increasedbraintobodyratio.
2. Decreaseactionofpyruvatecarboxylase.
3. Decreaseglycogenstore.

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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.

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1194.Anemiaofprematurity-Trueis

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a)Marginalreticulocytosis
b)<10gmcriteria(Hblevel)
c)10ml/kgpackedcell
d)Microcytichypochromictype
CorrectAnswer-B

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Answer-B.<10gmcriteria(Hblevel)
Normocytic,normochromic,hyporegenerativeanemiawithEPO
level.
AOPusuallyresolvespontaneouslywithin3-6months.
Aetiology

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1. RBCproduction(Reti.count)
2. RBClifespan
3. Bloodloss
Lowhemoglobin(below10gm%)
Reticulocytecountislow.

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Treatment:
Requirebloodtransfusionifneeded.
Observeifneonateisasymptomatic.

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1195.Ababyisbornat27weeksofgestation
requiredmechanicalventilationfornext

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4weeks&02fornext1week.He
maintainedatroomtemperature
subsequently.Aspernew
Bronchopulmonarydysplasiadefinition,
hehaswhichofthefollowing?

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a)MildBPD
b)ModerateBPD
c)SevereBPD
d)NoBPD
CorrectAnswer-A

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Mild
SupplementO2(for28days)and
<32weeksGABreathingroomairat36weeksatbirthcorrectedGA
oratdischarge(whichevercomesfirst).
.32weeksGABreathingroomairby56daysatbirthpostnatalage

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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

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---

Thus,at36weekscorrectedgestaionalage,babyisbreathingat
roomair-->diagnosticcriteriaofmildBPD.

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1196.HyperglycemiainNeonateifblood
sugarisabove?
a)150mg/dl

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b)125mg/dl
c)180mg/dl
d)100mg/dl
CorrectAnswer-B
Ans.is'b'i.e.,125mg/dl

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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

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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.

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1198.Macrosomiais/areassociatedwith:
a)Gestationaldiabetesmellitus

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b)Maternalobesity
c)Hypothyroidism
d)A&B
CorrectAnswer-D
Ans.isaandbi.e.GestationaldiabetesandMaternalobesity

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Macrosomiaisthetermusedtodescribealargefetus.
Therecommendeddefinitionisfetal(neonatal)weightexceeding
twostandarddeviationsorabove90thcentilefortheappropriate
normalpopulation.
AccordingtoACOG:birthweightof>4500gmiscalledas

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macrosomia.
InIndiancontextBirthweightof>4000gmiscalledasmacrosomia.

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1199.Inchildren,CHF(congestionheart
failure)isdiagnosedby
a)RaisedJVP

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b)Pedaledema
c)Tenderhepatomegaly
d)Basalcrepts
CorrectAnswer-C
Answer-C.Tenderhepatomegaly

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Heartfailureininfants&childrenresultssomedegreeof
hepatemegalywhichisusuallytender&sometimessplenomegaly.
Peripheraledemaisagedependent:
Ininfants,edemausuallyeye&overflank.
Olderchildern&adolescentshowsbothperiorbitaledema&pedal

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edemaandoccurslate.

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1200.LargePDAleadsto?
a)Endocardialvalvulitis
b)Eisenmengersyndrome
c)CHF

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d)Allofabove
CorrectAnswer-D
Ans.is'd'i.e.,Allofabove
Patentductusarteriosus(PDA)
SmallPDAmaynotcauseanycomplicationbutlargedefectif

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untreadmayleadsto:
PulmonaryhypertensionLefttoRightshuntleadstotoomuch
circulationofbloodinlungwhichleadstopulmonaryhypertension.
Eisenmenger'ssyndrome-Largestandingpulmonaryhypertension
leadstopermanentlungdamageandcausesRighttoLeftshunt.

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Endocarditis.
ArrhythmiaEnlargementofheartduetoPDAincreaseriskof
arrhythmias

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1201.ASDisassociatedwithallexcept?
a)Infectiveendocarditis

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b)Stroke
c)Arrhythemia
d)Pulmonaryhypertension
CorrectAnswer-A
Ans.is'a'i.e.,Infectiveendocarditis

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oASDisusuallysubtleandnothavingsignificantproblemexcept
mildgrowthdisturbance.
oOstiumsecundunASDisM.C.typeofASD.
oOstiumsecundumASDusuallyassociatedwithmitralvalve
prolopseorstenosis(Lutembacher'sSyndrome).oComplication

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usuallydevelopin4thclecadeandinclude:
I)Pulmonaryhypertension
2)Rt.sidedheartfailure
3)Stroke
4)Eisenmenger'ssyndrome

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InfectiveendocarditisisveryrareinASDandnotrequireany
antibioticprophylaxis.

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1202.AcuteInfectiveEndocarditiswith
abscessformationismostcommonly
associatedwith

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a)Listeria
b)Staphylococcus
c)Streptococcus
d)Enterococcus
CorrectAnswer-B

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AnswerisB(Staphylococcus)
AcuteInfectiveEndocarditiswithabscessformationismost
commonlyassociatedwithstaphylococcus.
`Themostcommonorganismcausingacuteinfectiveendocarditis
overallisstaphylococcusaureus.Staphylococcusaureus

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endocarditisisparticularlyvirulentandassociatedwithannularand
myocardialabscessformationandahighermortality'

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1203.Whichofthefollowingstatementsregardingfetalcirculationiscorrect?
a)Theliverandheartofthefetusreceivebloodwithveryhigh
oxygensaturation

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b)PO2offetalbloodleavingtheplacentaisslightlygreaterthan
maternalmixedvenousPO2
c)Thepresenceoffetalhemoglobinshiftstheoxyhemoglobin
dissociationtotheright
d)Theforamenovaleclosesduringthethirdtrimesterunlessthe

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fetushasanatrialseptaldefect
CorrectAnswer-A
Sincetheliverissuppliedbyumbilicalvenousbloodfromtheplacenta,andtheheart
andheadreceivebloodbeforeithasmixedwithsignificantamountsofdesaturated
blood,theseimportantorgansreceivebloodthatisrelativelyhighinsaturated

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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.

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

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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

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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

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1206.Treatmentofsimplefebrileconvulsion
isbasedon
a)Controloffever

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b)Rectaldiazepam
c)CSFfinding
d)Bloodreports
CorrectAnswer-A
Answer-A.Controloffever

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

Promptreductionoftemperaturebyhydrotherapy(sponging)and
antipyretics(paracetamole,ibuprofen)isthemostimportant
measure.Ifseizureslastsformorethan5minutes,diazepam(rectal
orIV)istheanticonvulsantofchoice.Phenobarbitoneisan
alternative

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

---

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.

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1208.Chronicconstipationinchildrenisseen
inallA/E?

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

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.

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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

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

MostcommoncauseofnonbiliousvomitingisHypertrophicpyloric
stenosis.
Male>female.
Vomitingstartswith3weekofage.
Palpablemassisseeninepigastricregion.

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Visibleperistalsisisseensoonafterfeeding.
ConfirmedbyUSGabdomen.
Contraststudyshows:
.Shouldersign
.Doubletractsign.

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Treatmentsurgery=Ramstedtprocedure.

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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

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

cholangitis,Carolidisease,Metabolic(Tyrosinemia,Wolman
disease,Niemanpickdisease,Galactosemia,Fructosemia).

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1211.Causeofneonatalhyperbilirubinemia?
a)Inefficienterythropoiesis
b)RBChemolysis

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

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).

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1212.InDiapragmaticHernia.Mostcommon

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

anomalyisseenin
a)Cardiovascularanomalies
b)Urinarytract
c)Craniofacialanomaly
d)Skullanomaly

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

CorrectAnswer-A
Answer-A.Cardiovascularanomalies
DiaphragmaticHerniaisdefinedasacommunicationbetween
abdominal&thoraciccavitieswithorwithoutabdominalcontentsin
thorax.

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Femalesareaffectedmorethanmales.
Morecommononleftsideandisposterolateral.
Associatedanomaliesmaybeseen30%ofcasesCNSlesions,
esophagealatresia,omphaloceleandCVSlesions.Mostcasesare
sporadic.

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

CardiacanomalisisMCanomalis.

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1213.Hirschsprungdiseaseisconfirmedby?
a)Rectalbiopsy
b)Per/Rectalexamination
c)Rectalmanometry

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

d)X-rayabdomen
CorrectAnswer-A
Ans.is'a'i.e.,Rectalbiopsy
oRectalsuctionbiopsyisprocedureofchoice.

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1214.Mostcommonpresentationofwilm's

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

tumor?
a)Hematuria
b)Asymptomaticabdominalmass
c)Abdominalpain
d)Headache

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

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%).

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

Fever(20%).

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1215.Posteriorurethralvalve-trueA/E?
a)Palpablebladder
b)Hydronephrosis
c)Painfulstressincontinence

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

d)RecurrentUTI
CorrectAnswer-C
Ans.is`c'i.e.,Painfulstressincontinence
Posteriorurethralvalve
Mostcommoncauseofsevereobstructiveuropathyinchildren.

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

30%ofchildrenexperiencedendstagerenaldisease/CRF
Dilatedprostaticurethra.
Hypertrophyofbladdermuscle
Vesicoureticrefluxseenin50%ofcases.
Backpressurechange:

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

Hydronephrosis
Distendedbladder
Thinurinarystream
RecurentUTIbecauseofurinarystasis

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1216.Nottrueaboutchronicpyelonephritisin

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

children-
a)AssociatedwithUretericreflux
b)AssociatedwithIntrarenalreflux
c)Associatedwithrenalscarring
d)Malesaremoreaffectedthanfemale

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

CorrectAnswer-D
Ans.is'd'i.e.,Malesaremoreaffectedthanfemale
o3basicformsofUTI-(1)Pyelonephritis(2)Cystitis(3)
Asymptomaticbacteremia
ChronicPyelonephritis:-

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

Characterisedbyrenalinflammation&fibrostsinducedbyrecurrent
orpersistentrenalinfection,vesicouretericrefluxorothercausesof
UTI.
Progressiverenalscarringwhichleadstoendstagerenal
diseaes.

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

Inreflexnephropathy,Intrarenalreflexofinfectedurineinduces
renalinjurywhichhealsbyrenalscarring.
Being-straight,short&wideurethra,recurrentUTIismorecommon
infemale,soCPNisalsotwiceascommonisfemalethanmale.

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1217.Mousyurineinachildduetodefectin

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

phenylalamineto
a)Tyrosine
b)Homogentisicacid
c)Phenylacetate
d)Phenylpyruvate

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

CorrectAnswer-A
Answer-A.Tyrosine
Phenylketonuria:
Autosomalrecessive
Deficiencyofphenylalaninehydroxylase.

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

Defectinconversionofphenylalaninetotyrosine.
Thisleadstoincreaselevelofphenylalanine.
Thisincreasephenlylalanineconvertedintophenylpyruvateand
phenylacetate.
Thisphenylacetategivesmousyormustyodourinurine/body.

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

---

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%

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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.

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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.

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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

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

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

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a)L3radiculopathy
b)L4radiculopathy
c)L5radiculopathy
d)SIradiculopathy
CorrectAnswer-D

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

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

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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.

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1246.Fairbanktriangleisseenin

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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

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theepiphysisofthe:
March2013(g)
a)Capitulum
b)Lunate
c)Femoralhead

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d)Calacanealtuberosity
CorrectAnswer-C
Ans.Ci.e.Femoralhead
Osteochondritis
Perthesdisease:

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-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

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

a)Olecranon
b)Trochlea
c)Radialhead
d)Capitulum
CorrectAnswer-D

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

Answer-D.Capitulum
Knee-Lateralsurfaceofthemedialfemoralcondyle
Elbow-Capitulumofhumerus
Hip-Femoralhead
Ankle-Talus

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

---

1255.Mostcommonorganismcausing
infectionafteropenfracture
a)Pseudomonas
b)Staphylococcusaureus
c)Klebsiella

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

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

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

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.

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

---

1260.FalseaboutPott'sspine
a)Commonestatdorsolumbarjunction
b)Alwayshealsbychemotherapy
c)Backpainisanearlysymptom
d)Thereisdiscspacenarrowingonx-ray

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

CorrectAnswer-B
Answer-B.Alwayshealsbychemotherapy
Chemotherapyisthemainstayoftreatment.Butitisnoteffective
always,surgeryisoftenrequiredinsomecases.
Commonestsiteofpott'sspineisdorsolumbarjunction.

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

Backpainistheearliestsymptomandnarrowingofdiscspaceisthe
earliestradiologicalsign.

---

1261.Apparentlengtheningisseeninwhich
stageofTBHip
a)StageI

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b)StageII
c)StageIII
d)None
CorrectAnswer-A
Answer-A.StageI

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

Stageofsynovitis(Stage1):-Threeiseffusioninthehipjointwhich
demandsthehiptobeinapositionofmaximumcapacity.This
positionisacquiredbyflexion,abductionandexternalrotation.
Becauseofabductiondeformity,thereisapparentlengthening.

---

1262.Tuberculosisspine;mostcommonsite

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

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

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

diseaseortubercularspondylytis.

---

1263.Anterolateraldecompressionisdone
for
a)Spinaltuberculosis
b)ChestTB

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

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

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

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

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

humerus.Itmayalsooccurinthespineandsacrum.
Theradiologicalfeaturesare:-
1. Asolitarymaybeloculated,lyticlesion.
2. Eccentriclocation,oftensubchondral.
3. Expansionoftheoverlyingcortx(expansilelesion).

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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.

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

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

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

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

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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

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

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

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b)Subungualhematoma
c)Infectivearthritis
d)None
CorrectAnswer-A
Answer-A.Osteomyelitis

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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

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

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.

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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

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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?

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

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

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

c)Salpingitisproducesleastcryptshere
d)Plicaearemostnumeroushere
CorrectAnswer-D
Ans,D.Plicaearemostnumeroushere

---

1288.Besttodiagnoseunrupturedectopic

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

pregnancy?
a)Scopy
b)UPT
c)USG
d)Culdocentesis

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

CorrectAnswer-A
Ans,A.Scopy

---

1289.Definitivetreatmentforpreeclampsia?
a)Deliveryofbaby
b)Antihypertensivedrugs

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

c)Rest
d)Diet
CorrectAnswer-A
Ans,A.Deliveryofbaby

---

1290.Whichisleastinjuredingynaecological

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

procedures?
a)Ureteratpelvicbrim
b)Renalpelvis
c)Urinarybladder
d)Ureteratinfundibulopelvicligament

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

CorrectAnswer-B
Ans.B.Renalpelvis
Urinarybladder&pelvicureterarevulnerabletoinjuryduring
gynecologicalsurgery.

---

1291.Whichofthefollowingcannotbe

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

treatedbylaparoscopy-
a)Ectopicpregnancy
b)Sterilization
c)Nondescentofuterus
d)Genitalprolapsed

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

CorrectAnswer-C
Ans,C.Nondescentofuterus

---

1292.Mostcommondegenerationoffibroids
?
a)Calcareous

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

b)Hyaline
c)Red
d)Cystic
CorrectAnswer-B
AnsB.Hyaline

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

Mostcommondegenerationoverall_hyaline

---

1293.DefinitivemanagementofAdenomyosis
is?
a)GNRHanalogue
b)Danazole

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

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.

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

---

1294.Bartholin'scysttreatmentofchoice-
a)Excision
b)Antibiotics
c)Marsupialisation
d)Drainage

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

CorrectAnswer-C
Ans.C.Marsupialisation

---

1295.Hydronephrosisisseeninwhichstage
ofCacervix?
a)2a

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

b)2b
c)3a
d)3b
CorrectAnswer-D
Ans,D.3b

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

---

1296.Endometrialcarcinomainvolving
cervix,stageis?
a)1
b)2
c)3

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

d)4
CorrectAnswer-B
Ans,B.2

---

1297.Diagnosisofadenomyosisismadeby?
a)Histopathology

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

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

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

CorrectAnswer-A
Ans,A,Cisplatin

---

1299.Fallopiantubetuberculosis?
a)MostcommontypeofgenitalTB
b)Sizeofthetubesisunchanged

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

c)Isasymptomatic
d)Primaryfocusofinfectionisalwaysinfallopiantubes
CorrectAnswer-A:C
Ans,A>C.Isasymptomatic>MostcommontypeofgenitalTB
MostcommontypeofgenitalTB>IsasymPtomatic

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

---

1300.TButerusallistrueexcept?
a)Mostlysecondary
b)Increaseincidenceofectopicpregnancy
c)Involvementofendosalpinx
d)Mostcommonisascendinginfection

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

CorrectAnswer-D
Ans,D.Mostcommonisascendinginfection

---

1301.Goldstandarddiagnostictechniquefor
diagnosisofendometriosis?
a)Laproscopy

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

b)Ca125level
c)Ultrasound
d)MRI
CorrectAnswer-A
Ans,A.Laproscopy

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

Investigationsforendometrioses
Laproscopyisconsideredasgoldstandard.
Usedasbothdiagnosticaswellastherapeutictechnique.
1. CA-f25israised>35u/ml
2. Ultrasound

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

3. CT&MRI
4. ColorDoPPler
5. CYstoscoPY

---

1302.Mostcommonsiteofendometriosis-
a)Ovary

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

b)FT
c)Colon
d)LSCSScar
CorrectAnswer-A
Ans,A.Ovary

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

---

1303.Asherman'ssyndromefalseis?
a)Associatedwithmenstrualirregularities
b)Progesteronechallengetestispositive
c)Synechiaeformationinuterus
d)MaybesecondarytoTB

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

CorrectAnswer-B
Ans,B.Progesteronechallengetestispositive

---

1304.
35yearoldwithhistoryofrepeated
D&C.Shenowhassecondary

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

amenorrhea.Whatisyourdiagnosis?
a)Hypothyroidism
b)Kallmansyndrome
c)Sheehan'ssyndrome
d)Asherman'ssyndrome

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

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.

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

Itshouldbetakei-pillassoonaspossible,preferablywithin12
hoursandnolaterthan72hoursofunprotectedintercourse.
Singledosetablettobetakenorallyafterameal.

---

1307.Cholestasisofpregnancyfalseis?
a)Bilirubinlevel>2mg%

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

b)Mostcommoncauseofjaundiceinpregnancy
c)Oestrogenisinvolved
d)Manifestationsusuallyappearinlasttrimester
CorrectAnswer-B
Ans.B.Mostcommoncauseofjaundiceinpregnancy

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

---

1308.Leastfailurerateisof?
a)OCpills
b)IUDs
c)Condom
d)DMPA

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

CorrectAnswer-A
Ans.A.OCpills
Oralcontraceptivepillshaveleastchancesofpregnancyasthey
haveminimumfailurerate(evaluatedbypearlindex).

---

1309.FailurerateofPomeroy'smethodof

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

tuballigationis?
a)0.2%
b)0.4%
c)0.6%
d)0.8%

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

CorrectAnswer-B
Ans,B.0.4%
Thefailurerateis0.4%anditkmainlyduetospontaneous
canalization".

---

1310.Maximumsuccessafterreversalof

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

tuballigation?
a)Cauterization
b)Pomeroy'stechnique
c)Clipmethod
d)Fimbriectomy

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

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

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

b)40m1
c)50m1
d)60m1
CorrectAnswer-A
Ans,A.30m1

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

---

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

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

c)Diagonalconjugate
d)Obstetricconjugate
CorrectAnswer-D
Ans,D.Obstetricconjugate

---

1314.Whichoffollowingmostcommonly

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

clinicallyused?
a)Diagonalconjugate
b)Antpostdiameterofinlet
c)Transversediameterofoutlet
d)Obliquediameterofpelvis

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

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

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

---

1316.Allofthefollowingoccursbecauseof
prostaglandinuseexcept?
a)Excesswaterretention
b)Flushes
c)Increasedmotilityofbowel

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

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.

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

---

1317.Metherginisgivenforprophylaxisof?
a)Anaemia
b)Cardiacdisease
c)Renaldisease
d)Lungdisease

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

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

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

b)Followinghysterectomy
c)Gonadaldysgenesis
d)Alloftheabove
CorrectAnswer-D
Ans,D.Alloftheabove

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

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

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

CorrectAnswer-B
Ans,B.Acuteinfection
AcuteinfectionisdetectedbydetectingIgMspecificantibodyhigh
titreofIgGantibody&detectionofsero-conversionforIgGfrom
negativetopositive

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

---

1320. Drugofchoiceforpneumocystiscarinii
inpregnancy?
a)SMZ/TMP
b)Primaquine
c)Dapsone

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

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.

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

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.

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

Therapeutic:-Tostopatonicuterinebleeding.

---

1324.DOCformalariainpregnancy?
a)Chloroquin
b)Quinine
c)Primaquin

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

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

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

CorrectAnswer-D
Ans.D.Halfhandmethod
Methodsofdeliveryofaftercomingheadare
Burns-Marshallmethod
ForcePsdelivery

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

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

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

---

1328.PreferredIUDformenorrhagea?
a)NOVAT
b)CuIUD
c)Mirena
d)Gynefix

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

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

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

---

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

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

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

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

d)None
CorrectAnswer-C
Ans,C.Both

---

1336.45yroldfemalepatientunderwent
hysterectomy,on7thpostopday

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complaintsaboutcontinuousdribbling
ofurineandfever.Micturitionwasnot
voluntary,whatdiagnosis?
a)Vesicovaginalfistula
b)Ureterovaginalfistula

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

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?

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

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

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---

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

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

---

1346.Palmersignisrelatedto?
a)Contractionofuterus
b)Duskyhueofantvaginalwall
c)Bluishdiscolourationofantvaginalwall
d)Increasedpulsationsfeltthroughlateralfornix

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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

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

ItisacaseofprematuremenoPause(prematureovarianfailure)'

---

1350.Contractionstresstestfalseis?
a)Oxytocinnotused
b)Invasivemethod
c)Detectsfetalwellbeing

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

d)Negativetestisassociatedwithgoodfetaloutcome
CorrectAnswer-A
Ans,A.Oxytocinnotused
Contractionstresstest(CST)(syn:Oxytocinchallengetest):
Itisaninvasivetesttoassesfetalrespiratorywellbeingduring

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

pregnancy.
ItdetectsalterationinFHRinresponsetouterinecontraction
inducedbyoxytocinindicatinghypoxia.
Interpretations
Negativetestindicatedgoodoutcome

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

---

1351.NST,whatisseenexcept?
a)Variability
b)Acceleration
c)Timeperiod
d)Oxytocin

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

CorrectAnswer-D
Ans,D.Oxytocin
Thenon-stresstest(NST)measuresfetalheartrate,whichis
monitoredwithanexternaltransducerforatleast20minutes.
Duringfetalmovement,tracingisobservedforheartrate

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

acceleration.
Testispositiveiftwoormorefetalheartrateaccelerationsoccursin
20minuteperiod.

---

1352.Menstrualregulationeffectiveupto?
a)14days

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

b)21days
c)4weeks
d)6weeks
CorrectAnswer-A
Ans,A.14days

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

Menstrualregulation(lnduction/Aspiration)
Aspirationofendometrialcavitywithinl4daysofmissedperiodina
womanwithpreviousnormalcycle.
DoneasanOPDprocedure.
Helpstodetectfailedabortion,molarpregnancyorectopic

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

Pregnancy.
Contraindicatedinadvancedpregnancy&inpresenceoflocalpelvic
inflammation.

---

1353.pHofvaginainpregnantwomanis
usually?

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

a)4.0
b)4.5
c)5
d)>5
CorrectAnswer-A

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

Ans.A.4.0
Thevaginalacidityisduetolacticacid.
ThenormalpHinthehealthywomenofthechildbearingagegroup
is4.5

---

1354.VaginalpHbeforepubertyis?

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

a)7
b)6
c)4.5
d)5
CorrectAnswer-A

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

Ans.A.7

---

1355.Decidualreactionisduetowhich
hormone?
a)Progesterone
b)Estrogen

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

c)LH
d)FSH
CorrectAnswer-A
Ans.A.Progesterone
Increasedstructural&secretoryactivityoftheendometriumthat

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

broughtaboutinresponsetoprogesteronefollowingimplantationis
knownasDecidualreaction".

---

1356.Inhibinlevelsarecheckedonwhichday
ofmenstrualcycle?
a)Day3

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

b)Day4
c)Day5
d)Day6
CorrectAnswer-A
Ans.A.Day3

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

Ovarianreservetestisdesignedtoassessboththenumberof
immatureeggsintheovariesandtheirquality,whichgivesan
indicationofwoman'spotentialfertility.
Itworksbydetectingthelevelsofthreefemalehormones,
usingabloodsampletakenondaythreeofmenstrualcycle:

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

1. Folliclestimulatinghormone(FSH)
2. Anti-mullerianhormone(AMH)
3. Inhibin-B

---

1357.Besttestforovulation?
a)Serumestrogen

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

b)Serumprogesterone
c)Both
d)None
CorrectAnswer-B
Ans.B.Serumprogesterone

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Plasmaconcentrationofprogesteronerisesafterovulation&
reachespeakof15ng/mlatmidlutealphase&thendeclinesasthe
corpusluteumdegenerates".

---

1358.Cardiacoutputincreasesmaximumat
whichweek?

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

a)26-28wks
b)30-32wks
c)32-34wks
d)34-36wks
CorrectAnswer-C

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

Ans.C.32-34wks
Cardiacoutput:
Startstoincreasefrom5thweekofpregnancy,reachesitspeak40-
50%atabout30-34weeks.

---

1359.Inpregnancyplasmavolumeincreased

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

maximumatwhatgestationalage?
a)10wks
b)20wks
c)25wks
d)30wks

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

CorrectAnswer-D
Ans,D.30wks
Plasmavolumeisincreased.Startingtoincreaseat6weeks&
reachingmaxupto50%at30weeks.Totalplasmavolume
increasestotheextentof1.25litres.

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

---

1360.5monthpregnantfemale,whichofthe
followingistrue?
a)50%havesoftsystolicmurmur
b)Cardiacoutputisreduced
c)Systemicvascularresistanceisincreased

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

d)IncreaseinCVP
CorrectAnswer-A
Ans.A.50%havesoftsystolicmurmur
Anatomicalchangesduringpregnancy
Heartispushedupwards&outward.Apexbeatisshiftedin4th

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

intercostalsspace.
Asystolicmurmurcanbeheardinapicalorpulmonaryarea.
Mammarymurmurisacontinuoushissingmurmuraudibleover
tricuspidareainleft2nd&3rdiintercostalsspace.
ECGshowsleftaxisdeviation.53andrarely54canbeheard.

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

---

1361.Spinnbarkeitismaximumshownat
whichphase?
a)Menstrualphase
b)Ovulatory
c)Postovulatory

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

d)Prefollicular
CorrectAnswer-B
Ans.B.Ovulatory
Spinnbarkeittest(ThreadtestorFerntest)
AsPecimenofcervicalmucuswhenseenunderlowpower

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

microscope,showsacharacteristicfernformation.
Donetoseetheestrogenicactivityinovulatoryphaseofmenstrual
cycle.

---

1362.Rarestpresentationis?
a)Cephalic

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

b)Breech
c)Shoulder
d)Vertex
CorrectAnswer-C
Ans.C.Shoulder

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

---

1363.Fertileperiodoffemaleismeasuredby
?
a)LH
b)FSH
c)Estrogen

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

d)Oxytocin
CorrectAnswer-A
Ans,A.LH
"LHsurgefromtheanteriorpituitaryglandoccurs24hourspriorto
ovulation.Radioimmunoassaysofthemorningsampleofurine&

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

bloodgivesresultsin3hours.NotonlydoestheLHsurgehelpin
predictingovulation,buttheapproximatetimeofovulationcanbe
gauged&coitusaroundthistimecanimprovethechancesof
conception."

---

1364.Externalversionisdoneafter?

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

a)34weeks
b)36weeks
c)38weeks
d)40weeks
CorrectAnswer-B

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

Ans.B.36weeks
Themaneuveriscarriedoutafter36weeksinlabour-delivery
complex."

---

1365.Leastcommonpresentationoftwins?
a)Bothvertex

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

b)Bothbreech
c)Bothtransverse
d)Firstvertexand2ndtransverse
CorrectAnswer-C
Ans.C.Bothtransverse

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

Lie-Presentationintwinpregnancy:
Themostcommonlieinthefetusesislongitudinal(90%).
Thecombinationofpresentationoffetusesare:
Bothvertex(50%)
Firstbreechsecondvertex(10%)

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

Firstvertexandsecondtransverse(rare)
Firstyertexandsecondbreech(30o/o)
Bothbreech(10%)
Bothtransverse(rarest).

---

1366.

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---

Presentingpartintransverselie?
a)Shoulder
b)Face
c)Vertex
d)Brow

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

CorrectAnswer-A
Ans.A.Shoulder
'Whenthelongaxisofthefetusliesperpendicularothematernal
spineorcentraliseduterineaxis,itiscalledtransverselie.
Butmorecommonly,fetalaxisliesobliquetothematernalspine&is

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

thencalledobliquelie.Ineitheroftheconditionsshoulderusually
presentsoverthecervicalopeningduringlabour&bothare
collectivelycalledshoulderpresentations."

---

1367.Whichofthefollowinglayercontains

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

abundantdesmosomes?
a)A
b)B
c)C
d)D

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

CorrectAnswer-C
Ans.C.C
Stratumspinosumorpricklecelllayercontainsabundant
desmosomesmarkedwiththelegend'C'intheimage.
Pictureshowslayersofepidermis

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

A Stratumcorneum
B Stratumgranulosum
C Stratumspinosum
D Stratumbasale
"Theepidermiscanbedividedintoanumberoflayersfromdeepto

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

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

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corneum

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epidermis)andhavehighestconcentration

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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

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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.

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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

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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.

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1376.Pemphigusvulgarisischaracterizedbyall,except:

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a)PositiveNikolsky'ssign
b)Oralerosions
c)Subepidermalbulla
d)Tzancksmearshowingacantholyticcells
CorrectAnswer-C

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Pemphigusvulgarisisanintraepidermalblisteringdisease.

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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).

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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.

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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.

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1380.Dermatophytosisisnot?
a)Scaly
b)Itchy

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c)Superficial
d)Subdermal
CorrectAnswer-D
Ans.D.Subdermal

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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.

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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

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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.

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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.

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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.

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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.

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1389.Infantcircuitforanaesthesia?
a)Bainscircuit
b)Magillcircuit
c)Ayrestpiece

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d)Water'scircuit
CorrectAnswer-C
Ans.C.Ayrestpiece

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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)

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1392.Allarefeaturesofdifficultairway
except?

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a)Miller'ssign
b)Micrognathiawithmacroglossia
c)TMJankylosis
d)Increasedthyromentaldistance
CorrectAnswer-D

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Ans.D.Increasedthyromentaldistance
Decreasedthyromentaldistancepredictsdifficultairway(not
increasedTMdistance).

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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.

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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

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1395.Whichanaestheticagentisneither
metabolisedbylivernorbykidney?
a)Atracurium
b)Vecuronium

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c)Pancuronium
d)Rocuronium
CorrectAnswer-A
Ans.A.Atracurium

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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.

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1397.Stagesofanesthesiawereestablished
by
a)Ether
b)N20

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c)Halothane
d)Chloroform
CorrectAnswer-A
Ai.e.Ether

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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).

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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.

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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.

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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.

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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.

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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.

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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

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assistingexternalorinternalversionduringlatepregnancy.
Becauseitsuterinerelaxantactionitiscontraindicatedduring
labour.

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Itisparticularlysuitableforinductionandmaintenanceinchildren
andasmaintenanceanaestheticinadults.

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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.

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1408.Midazolamcausesallexcept:

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

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.

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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

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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,

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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

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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.

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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'

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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.

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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]

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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).

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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.

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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.

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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

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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.

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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

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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.

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1426.Rattailappearanceincontrast
radiographyisseenin?

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

a)Achalasiacardia
b)Carcinomaesophagus
c)Corkscrewesophagus
d)Diffuseesophagealspasms
CorrectAnswer-B

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CarcinomaesophagusREF:sabiston's18'editionchapter41See
tableinthepreviousquestion
"Rat-tail"appearanceonbariumstudyisseenincarcinoma
esophagus.

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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.

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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

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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.

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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:

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

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

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

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.

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1436.WhitelineofFrenkelisseenin:
September2008

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

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.

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

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

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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.

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1437.VonRosen'sviewisfor
a)CDH
b)Perthe'sdisease
c)CTEV

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

d)None
CorrectAnswer-A
Answer-A.CDH
InVonRosen'sviewisusedinDDH/CDH.

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1438.Popcorncalcificationisseenin:

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

a)Pulmonaryhamartoma
b)Fungalinfection
c)Metastasis
d)Tuberculosis
CorrectAnswer-A

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

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

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

a)Headscan
b)MRIneck
c)ANCUSG
d)Anthropometry
CorrectAnswer-C

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

Answer-C.ANCUSG
Nuchaltranslucencyisusedforscreeningofdownsyndromein
antenatalUSG.

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1440.Half-lifeofIodine131is
a)8hours

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

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

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

a)Gout
b)Rheumatoid
c)Alkaptonuria
d)Psoriasis
CorrectAnswer-C

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

Ci.e.Alkaptonuria
Features Disease
FishMouthVertebrae
-SickelCellAnemiaQ
HomocystinuriaQ

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

CodFishVertebra
-Osteomalacia,Osteoporosis,
(Biconcavevertebra)
Hyperparathyroid
Ruggerjerseyspine

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

-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

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

c)Bipolardepression
d)Mania
CorrectAnswer-B
Ans.B.Unipolardepression
AmongstthepsychiatricdisordersmaximumDALYlossiscausedby

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

majordepression.

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1443.Etheromaniasreferto?
a)Acutepsychosispostetheranaesthesia
b)Etheraddiction
c)Excessiveetherusedruganaesthesia

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

d)None
CorrectAnswer-B
Ans,B.Etheraddiction
Etheraddictionoretheromaniaistheaddictiontoinhalationor
drinkingofdiethylether.

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

---

1444.Theterm"Dementiaprecox"was
coinedby?
a)Freud
b)Bleuler
c)Kraepelin

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

d)Schneider
CorrectAnswer-C
Ans.C.Kraepelin

---

1445.Theterm'id'wascoinedby?
a)Freud

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

b)Skinner
c)Wayker
d)Blueler
CorrectAnswer-A
Ans,A.Freud

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

Structuraltheoryofmind(theid,egoandsuperego)wasgivenby
sigmundfreud.

---

1446.
Subcorticaldementiaisseeninall
except?

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

a)Parkinsonism
b)Alzheimer'sdisease
c)Wilson'sdisease
d)Huntingtonschorea
CorrectAnswer-B

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

Ans.B.Alzheimer'sdisease
Subcorticaldementiaisseeninparkinsonism,Huntington'sdisease,
wilson'sdisease,progressivesupranuclearpalsy,idiopathicbasal
ganglioncalcification(Fahr'sdisease),thalamiclesions,multiple
sclerosis,HIVassociateddementiaandmultisYstematroPhY.

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

Alzheimer'sdiseasecausescorticaldementia.

---

1447.Formicationisseenwith?
a)Acuteamphetamineintoxication
b)Chronicuseofamhetamine
c)Alcoholwithdrawal

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

d)Cannabispoisoning
CorrectAnswer-B
Ans.B.Chronicuseofamhetamine
Magnan'ssyndrome(alsocalledformication)isseeninchronic
cocaineandchronicamphetamineabuse.

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

---

1448.Hangoverfollowingalcohol
consumptioncanbetreatedwith?
a)Pyridoxine
b)Thiamine
c)Riboflavin

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

d)Niacin
CorrectAnswer-B
ANs.B.Thiamine
Thiaminehelpspreventthebuildupofglutarateinthebrain,which
maybeassociatedwithpartoftheheadacheassociatedwith

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

hangover.

---

1449.Mostcommonlyabusedopioid-
a)Morphine
b)Diacetylmorphine
c)Oxycodine

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

d)Bupremorphine
CorrectAnswer-B
Ans,B.Diacetylmorphine
Diacetylmorphine(heroin)isthemostcommonlyabusedopioid.

---

1450.Hallucinationsareproducedby?

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

a)Amphetamine
b)Morphine
c)Paraxetine
d)Chlorpromazine
CorrectAnswer-A

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

Ans,A.Amphetamine
Amphetaminepsychosismimicparanoidschizophrenia.Theremay
bedeleusionsandhallucinations.

---

1451.Anxietyis?
a)Neurosis

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

b)Psychosis
c)Personalitydisorder
d)None
CorrectAnswer-A
Ans.,A.Neurosis

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

ImportantneuroticdisordersareAnxietydisorders(Panic),Phobia
(Phobicanxietydisorder),obsessivecompulsiveDisorder&
Dissociativeconversiondisorder.

---

1452.Negativesymptomofschizophrenia?
a)Hallucination

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

b)Delusion
c)Ambivalance
d)Motorhyperactivity
CorrectAnswer-C
Ans.is'c'i.e.,Ambivalance

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

Symptomsofschizophreniacanbedividedinto:?
1. Positivesymptoms:-Positivesymptomsarepsychoticsymptoms
notseeninnormalindividualsbutare"activelyexpressed"inpatient,
i.e.,hallucinations,delusionsandbizarremotoracts.Positive
symptomsaremorecommoninacuteschizophrenia.Theserespond

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

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

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1454.Erotomaniaisseenin:

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NEET13
a)Bipolarmania
b)Unipolarmania
c)Neurosis
d)Obsessivecompulsivedisorder

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CorrectAnswer-A
Ans.Bipolarmania

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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.

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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.

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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.

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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).

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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.

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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

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1461.Phobiais:
a)Psychosis
b)Fearofanimal

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c)Anxiety
d)Neurosis
CorrectAnswer-D
Neurosis

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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:-

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1. Patientwithhypochondriasisispreoccupiedwithillness,ontheother
handpatientwithsomatizationdisorderisoccupiedwithsymptoms.
2. Hypochondriasispatientispreoccupiedwithoneillness(usually)
whilepatientwithsomatizationdisorderhasmany(atleast8or

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more)symptoms.

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1463.Allaretrueregardingsomatization
dosorderexcept:
a)Maintainsickrole
b)4-Painsymptoms

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c)1-Sexualsymptom
d)1-Pseudoneurologicalsymptom
CorrectAnswer-A
Ai.e.Maintainsickrole

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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.

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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.

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1466.MaxdurationoftimespentisinNREM

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stage?
a)I
b)II
c)III
d)IV

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CorrectAnswer-B
Ans.B.II

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.
invalidquestionid

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