@marimphil wrote:
Renal angle is the angle between :
A. 11th rib and Erector Spinae
B. 12th rib and Erector spinae
C. 11th rib and Sacrospinalis
D. 12th rib and Sacrospinalis
ANS-B
Abductor of Vocal Cord is:
A. Cricothyroid
B. Lateral Cricoarytenoid
C. Posterior Cricoarytenoid
D. Thyroarytenoid
ANS-C
BDC/243
IMPT
Only abductor: Post Cricoarytenoid
Only tensor: Cricothyroid
Median Nerve supplies all EXCEPT:
A. Opponens pollicis
B. Adductor pollicis
C. Flexor pollicis brevis
D. Abductor pollicis brevis
ANS-B
Adductor pollicis is supplied by Ulnar Nerve.
FLEXOR POLLICIS BREVIS
It has 2 heads:
Superficial: supplied by Median N
Deep: supplied by Ulnar N.
Median Nerve injury at elbow causes loss of all the following functions EXCEPT:
A. Opposition of thumb.
B. Flexion at 2nd and 3rd MCP joints
C. Flexion at 1st and 2nd PIP jt
D. Flexion at 4th and 5th DIP jts
ANS-D
Opposition of thumb is done by Opponens Pollicis, supplied by Median N.
Flexion at 2nd and 3rd MCP jt is done bt lateral 2 lumbricals, supplied by Median N.
Flexion at 1st and 2nd PIP jt is done by Flexor Digitorum Superficialis, supplied by Median Nerve.
Flexion at 4th and 5th DIP jt is done by medial 2 tendons of Flexor Digitorum Profundus , supplied by ULNAR NERVE.
Lurching Gait is due to paralysis of:
A. Gluteus medius
B. Hamstrings
C. Tensor Fascia Lata
D. Adductor magnus.
ANS- A
Which bone forms floor of the orbit?
A. Maxilla
B. Ethmoid
C. Zygomatic
D. Sphenoid
ANS- A
Fibromuscular stroma is a characterisric feature of:
A. Testis
B. Seminal Vesicles
C. Prostate
D. Epididymis
ANS-C Prostate
During Tonsillitis, pain in the ear is due to involvement of
A. Vagus N
B. Chorda tympani N
C. Glossopharyngeal N
D. Hypoglossal N
Ans- C
BDC VOL 3/219
Tonsillitis/Pharyngitis may cause referred pain in the ear as Glossopharyngeal Nerve is the common sensory supply.
Stem cells are located in which region of hair follicle:
A. Bulb
B. Root
C. Bulge
D. Papilla
ANS-C
GRAY'S ANAT & DAVIDSON:
In hairy skin, stem cells were found to be located in bulge of hair follicle during experimental studies.
In Glabrous skin, stem cells are located in epidermis.
Lymphatics from Cervix drain into:
A. External Iliac Lymph nodes
B. Internal Iliac lymph nodes.
C. Inguinal Lymph nodes.
D. Paraaortic lymph nodes.
ANS- A and B (A>B)
REF
Keith L Moore Anat/5th e /417
"Lymphatics from Cervix pass within the broad ligament to External Iliac Lymph Nodes.
Lymphatics from Cx also pass along uterine vessels within transverse cervical ligaments to Internal Iliac Lymph nodes and along Uterosacral ligaments to Sacral Lymph Nodes."
However EXTERNAL ILIAC NODES seems to be better option of the two :
In all the books (including Dutta Obs) external iliac nodes are mentioned first.
In SHAW'S GYNECOLOGY/Pg19 ONLY EXTERNAL ILIAC NODES have been mentioned.
FURTHER REF FOR THIS Q [LYMPHATIC DRAINAGE OF CERVIX]
THESE LINES ARE FROM GRAY'S ANATOMY
"LYMPHATIC DRAINAGE
page 1334"
Uterine lymphatics exist in the superficial (subperitoneal) and deep parts of the uterine wall.
Collecting vessels from the cervix pass laterally in the parametrium to the external iliac nodes, posterolaterally to the internal iliac nodes, and posteriorly to the rectal and sacral nodes.
Some cervical efferents may reach the obturator or gluteal nodes.
Vessels from the lower part of the uterine body pass mostly to the external iliac nodes, with those from the cervix.
Hematopoiesis in fetus starts first in:
A. Liver
B. Spleen
C. Yolk Sac
D. Bone Marrow
ANS-C
Langman's Embryology 10th ed/78
Yolk sac-19days
Which among the following is NOT a true support of Uterus?
A. Uterosacral ligament
B. Pubocervical ligament
C. Infundibulopelvic ligament
D. Meckenrodt's ligament
ANS- C
BDC VOL2/320
Which among the following is NOT a true support of Uterus?
A. Uterosacral ligament
B. Pubocervical ligament
C. Infundibulopelvic ligament
D. Meckenrodt's ligament
ANS- C
BDC VOL2/320
A sesamoid bone is present in the tendon of :
A. Flexor hallucis longus.
B. Extensor hallucis brevis.
C. Adductor hallucis
D. Flexor hallucis brevis
ANS-D
REF: Keith L Moore
Inferior dislocation of shoulder joint causes damage to:
A. Radial Nerve
B. Median N
C. Axillary N
D. Ulnar N
ANS-C
Portal Vein is formed by union of:
A. Sup Mesentric and Inferior Mesentric Veins
B. Sup Mesentric and Splenic Veins
C. Superior Mesentric And left renal vein
D. Inferior Mesentric and Splenic Vein
ANS-B
Which among the following is NOT a branch of Aorta?
A. Brachiocephalic
B. Right common carotid
C. Left common carotid
D. Left Subclavian
ANS-B
Pseudounipolar neurons are seen in:
A. Dorsal root ganglia
B. Ganglia of Cranial N VIII
C. Mesencephalic Nucleus
D. Motor neurons
ANS-A
BDC/4th ed VOL 3/300
The vessel which can be a source of bleeding in a duodenal ulcer is:
A. Superior Pancreatoduodenal
B. Inferior Pancreaticoduodenal
C. Gastroduodenal
D. Splenic
ANS-C
REF: Keith L Moore/264
Ossification of Ulna is complete by:
A. 9 yrs
B. 11 yrs
C. 13 yrs
D. 15 yrs
ANS-D
BDC/3rd e/Vol 1/20
Ossification of Ulna is complete by 16-18 yrs.
Microscopic examination of articular surface of a synovial joint demonstrates:
A. Hyaline cartilage
B. Adipocytes
C. Endothelial cells
D. Periosteum
ANS-A
Which among the following lies in posterior wall of axilla?
A. Long Thoracic N
B. Intercostobrachial N
C. Subscapular N
D. Thoracodorsal artery
ANS-C
Long thoracic N & Intercostobrachial N lie in the medial wall of the axilla.
Thoracodorsal artery forms anastomosis around scapula. It is a branch of Subscapular artery.
Subscapular N crosses anterior surface of Lattisimus dorsi (which forms post wall of axilla).
BDC/42
FURTHER REF FROM GRAY'S ANATOMY
Subscapular vessels descend on the posterior wall at the lower margin of subscapularis.
The subscapular and thoracodorsal nerves cross the anterior surface of latissimus dorsi at different inclinations.
No large vessel lies on the medial 'wall', which is crossed proximally only by small branches of the superior thoracic artery. The long thoracic nerve descends on serratus anterior and the intercostobrachial nerve perforates the upper anterior part of this wall, crossing the axilla to its lateral 'wall'.
Normal anatomical sites of Uterine constrictions include all the following EXCEPT:
A. Ureteropelvic junction.
B. Brim of Pelvis
C. Crossing of External Iliac Artery
D. Insertion into bladder.
ANS- C
REFERENCES
KEITH L MOORE CLINICAL ANATOMY /5th e/ 394
Ureters are normally relatively constricted at;
(i) Junction of Ureter & renal pelvis.
(ii) during their passage through wall of urinary bladder.
(iii) where they cross EXTERNAL ILIAC ARTERY & PELVIC BRIM.
SNELL'S ANATOMY / 7TH ED/ 370
The Ureter posseses 3 constrictions:
(i) where renal pelvis joins the ureter.
(ii) where it is kinked as it crosses the pelvic brim
(iii) where it pierces bladder wall.
BDC/3rd ed vol 2/261
Ureter is slightly constricted at:
(i) Pelvi-ureteral junction.
(ii) At brim of lesser Pelvis.
(iii) Passage through bladder wall.
Hence, option C is better amongst the four.
Endolymphatic duct opens into:
A. Saccule
B. Subarachnoid space
C. Subdural Space
D. None
ANS-A
REF/Gray's Anatomy
The membranous vestibule, becomes divided into a small ventral saccule and a larger utricle. This is achieved mainly by horizontal infolding that extends from the lateral wall of the vestibule towards the opening of the ductus endolymphaticus until only a narrow utriculosaccular duct remains between saccule and utricle.
The utriculosaccular duct becomes acutely bent on itself: its apex is continuous with the ductus endolymphaticus.
Elastic cartilage is present in:
A. Nasal Septum.
B. Eustachian tube
C. Costal Cartilage
D. Articular cartilage
ANS-B
Normal functions of Peritoneum include all EXCEPT:
A. Fibrinolytic.
B. Lubricates movement of viscera.
C. Provides nourishment to gut.
D. Absorption of fluid & particulates.
ANS-C
CSDT/2010/pg 464
"Peritoneum is a semi-permeable membrane.
Particulate matter, including bacteria upto 20 um in size, are cleared via lymphatics.
It contains plasminogen activator in its cell lining, which is inactivated by injury or infection."
Commonest site of Hypertensive bleed is:
A. Pons
B. Putamen
C. Frontal lobe
D. Thalamus
ANS-B
REF: harrison
Traube's space percussion is done to detect enlargement of:
A. Stomach
B. Liver
C. Spleen
D. Kidney
ANS-C
"Traube's (semilunar) space is a crescent-shaped space, encompassed by the lower edge of the left lung, the anterior border of the spleen, the left costal margin and the inferior margin of the left lobe of the liver.
Beneath Traube's space lies the stomach, which produces a tympanic sound on percussion. Dullness to percussion over Traube's space may indicate splenomegaly."
Level 3 axillary lymph nodes are located:
A. Above & medial to pectoralis minor.
C. below & lateral to pectoralis minor.
C. Posterior to pectoralis minor.
D. Anterior to pectoralis minor.
ANS-A
Surgical classification of Axillary Lymph Nodes:
It is based on the relationship of the lymph nodes to pectoralis minor.
The surgical classification is used in axillary dissection for breast cancer. It is entirely based on the relationship of the lymph nodes to pectoralis minor. The levels usually refer to a dissection, so a 'level 3 dissection' will have removed nodes from levels 1, 2 and 3.
Level 1 nodes
Level 1 includes all those nodes inferior to the inferolateral border of pectoralis minor. It is usually comprised of the lateral, anterior and posterior nodes.
Level 2 nodes
Level 2 consists of those nodes posterior to pectoralis minor. It includes the central nodes and some of the APICAL nodes.
Level 3 nodes
Level 3 consists of those nodes beyond the superior border of pectoralis minor. It includes the REMAINING APICAL nodes and infraclavicular nodes.
Sentinel node
A sentinel node is the first node to drain from a particular area. In breast cancer, it refers to the first node to drain from that portion of the breast. This is usually an anterior node.
30.Ligamentum teres is a remnant of:
A. Left umbilical artery
B. Left unbilical vein
C. Right umbilical artery
D. Right umbilical vein
ANS-B
31.During Hysterectomy, Ureter is liable for injury at :
A. Where it crosses pelvic brim.
B. Where it enters bladder wall.
C. Where it crosses uterine artery.
D. None
ANS-C
Which among the following doesn't have a role in regulating Calcium metabolism?
A. Liver
B. Lungs
C. Kidney
D. Skin
ANS-B
Angiotensin II stimulates thirst by acting on:
A. Subfornicial organ.
B. OVLT
C. Paraventricular nuclei
D. All the above
ANS-A
Ref: Ganong
34.Epiphyseal closure is mediated by:
A. Somatomedin
B. Cortisol
C. Thyroxine
D. Insulin
ANS- C
Ganong/19/312
"Thyroid hormones are essential for skeletal maturation."
"In hypothyroidism, bone growth is slowed & EPIPHYSEAL CLOSURE IS DELAYED."
All the following stimulate Insulin Secretion Except:
A. Glucose
B. Glucagon
C. Sulfonylureas
D. Somatostatin
ANS-D
Ref: Ganong/pg326
Inhibitors of Insulin secretion: Somatostatin, Galanin, Diazoxide, Thiazides, beta blockers, Phenytoin.
36.Normal Left Ventricular Ejection fraction is :
A 55%
B 65%
C 75%
D 80%
ANS- B
Ganong/19/540
End diastolic Ventricular vol : 130 ml
Stroke volume : 70-90 ml (at rest)
End systolic ventricular volume: 50 ml
Ejection fraction= (Stroke volume/End diastolic volume) *100= 65%
37 Androgen binding protein is secreted by:
A. Pituitary
B. Liver
C. Sertoli cells
D. Leydig cells
ANS-C
Ganong/19/407
Sertoli cells secrete:
(i) Androgen binding protein
(ii) Inhibin
(iii) MIS
(iv) Estrogen: they contain 'aromatase' which converts androgens to estrogens.
Impt topic INHIBIN
Action: it inhibits FSH secretion.
Secreted by: Sertolic cell in males & Granulosa cells in females.
Types: Two types Type A and B
Inhibin B is the FSH-regulating inhibin in men.
It is a member of TGFb superfamily of dimeric growth factors.
Most common site of fertilisation is:
A. Cervix
B. Ampulla
C. Fimbriae
D. Uterus
ANS-B
Ganong/428
"Fertilisation usually occurs in midportion of uterine tube."
Neurohypophysis contains which type of cells among the following:
A. Thyrotrophs.
B. Paraventricular.
C. Lactotrophs.
D. Pituicytes
ANS-D
Ganong/379
"In the posterior lobe, there are Pituicytes, stellate cells containing FAT globules, which are believed to be modified ASTROGLIA."
During Ejaculation, Sperms are released from:
A. Rete testis
B. Vas deferens
C. Epididymis
D. Seminal Vesicles
ANS-B
Ganong/409
Emission is a sympathetic reflex, integrated in upper lumbar segments of spinal cord & effected by contraction of smooth muscles of VAS DEFERENS & SEMINAL VESICLES.
Since the q asks specifically regarding 'sperms' which are present in vas deferns & not in secretions from seminal vesicles, ans is VAS DEFERENS.
Which among the following is a feature of denervation of smooth muscle?
A. Atrophy of the muscle.
B. Decrease in no of receptors for neurotransmittors
C. Increased sensitivity to chemical mediators
D. Decreased neurotransmitter release At NMJ.
ANS-C
Ganong/111
"DENERVATION HYPERSENSITIVITY"
When the motor Nerve supply to a smooth muscle is cut :
the muscle does not atrophy (this is in contrast to skeletal muscle which atrophies on denervation.)
It becomes hyperresponsive to the chemical mediators that normally activate it.
42 Which among the following is seen at the time of ovulation?
A. Decreased FSH levels
B. Increased LH levels
C. Increased Progesterone levels.
D. Increased Estrogen levels.
ANS-B
Ganong/419
At the time of ovulation:
LH levels are at peak of the cycle ~50IU/L
FSH levels are also maximum at the time of ovulation : 25 IU/L
Progesterone levels are minimum at the time of ovulation ~0-2 ng/ml, and peak at 21-22nd day ~ 20ng/ml (middle of secretory phase)
Estrogen levels are maximum about 2 days prior to menstuation ~ 250pg/ml, and then decrease to be minimum ~20pg/ml at day 1.
Transducin is a protein found in
A. Glomerulus
B. Retina
C. Skeletal muscle
D. Adrenal medula
ANS-B
Ganong/151
Light alters the configuration of Opsin and Opsin change activates an associated G protein called Transducin.
Protein which mediates relaxation in Skeletal muscle is:
A. Actin
B. Myosin
C. Troponin C
D. Tropomyosin
ANS-D
Ganong/65
"In resting muscle, Troponin I is tightly bound to actin and Tropomyosin to myosin head. Thus TROPONIN-TROPOMYOSIN complex constitutes a RELAXING PROTEIN that inhibits interaction between actin and myosin."
It is clear from this that Troponin I and Tropomyosin constitute muscle relaxing proteins.
Lesion in which part of the Hypothalamus leads to loss of Circadian Rhythm?
A. Suprachiasmatic nuclei
B. Ventromedial Nuclei
C. Lateral areas.
D. Preoptic area
ANS- A
Ganong pg 224-25 , table 14-1
"In humans the mechanisms controlling circadian rhythms are neural and endocrine, and the dominant PACEMAKER is in the SUPRACHIASMATIC NUCLEUS.
The rhythms controlled are:
ACTH Secretion
Melatonin Secretion
Sleep wake cycle
body temperarure cycle
activity patterns."
Ventromedial Nucleus contains'SATIETY CENTRE.'
Lateral areas produce diffuse sympathetic discharge and increased ADRENAL MEDDULARY SECRETION as seen in stress (FLIGHT OR FIGHT RXN).
Preoptic area is concerned with secretion of GnRH.
Lateral Superior Hypothalamus- thirst.
Anterior Ventral Hypothalamus- Sexual behaviour
Anterior Hypothalamus-TEMPERATURE REGULATION
Supraoptic and Paraventricular Nuclei- Vasopressin and Oxytocin.
The major role of 2,3 bisphosphoglycerate in RBCs is:
A. acid-base balance.
B. reversal of glycolysis
C. release of Oxygen
D. binding of oxygen
ANS-C
Ganong/637
2,3 BPG/DPG
PLENTIFUL IN RBCs.
FORMED FROM 3-PHOSPHOGLYCERALDEHYDE, a product of Glycolysis.
Binds to beta chain of deoxy-Hb.
1 mole of 2,3 DPG binds to 1 mole of deoxy-Hb.
Increase in concentration of 2,3 DPG causes more O2 to be liberated from Hb to tissues.
Vit. K dependent clotting factors include all EXCEPT:
A. VII
B. VIII
C. Prothrombin
D. IX
ANS-B
Ganong/19th e/ 520
VIT K DEPENDENT CLOTTING FACTORS ARE:
II/PROTHROMBIN
VII/PROCONVERTIN/STABLE FACTOR
IX/ CHRISTMAS FACTOR/ ANTIHEMOPHILIC FACTOR B
X/ STUART-PROWER FACTOR
PROTEIN C
PROTEIN S
IMPT Q
CLOTTING FACTORS INHIBITED BY ANTITHROMBIN III: IX, X ,XI & XII
In JVP, a wave is due to:
A. atrial filling
B. atrial relaxation
C. atrial contraction.
D. ventricular relaxation.
ANS-C
Vitamin B-12 is absorbed in:
A. Stomach
B. duodenum
C. Jejunum
D. Ileum
ANS- D
Ganong/476
Physiological dead space is:
A. 150 ml
B. 200 ml
C. 250 ml
D. 100 ml
ANS-A
Ganong/627
In CNS, myelin sheath of Neurons is formed by:
A. Astrocytes.
B. Oligodendroglial cells.
C. Schwann cells.
D. All the above.
ANS- B
Ganong/47
" In the central nervous system of mammals, most neurons are myelinated, but the cells that form the myelin are Oligodendrogliocytes rather than Schwann cells."
Unlike the Schwann cell which forms the myelin between 2 nodes of Ranvier on a single neuron, oligodendrogliocytes send off multiple processes that form myelin on many neighbouring axons.
Wolf-Chaikoff effect is seen due to:
A. Inhibition of cAMP response of TSH.
B. Inhibition of proteolysis of Thyroglobulin.
C. Inhibition of organic binding of iodide.
D. Inhibition of iodide trapping mechanism.
ANS-C
Ganong/317
VERY IMPT
There are 3 Mechanisms by which excess IODIDE inhibits thyroid function:
(i) Inhibition of organic binding of iodide: this is referred to as WOLF_CHAIKOFF EFFECT & is the major mechanism.
(ii) Inhibition of cAMP response of TSH.
(iii) Inhibition of proteolysis of Thyroglobulin.
Also "There is no direct effect of increased IODIDE on trapping mechanism but the total iodide uptake is low because of inhibition of organic binding."
Regarding Caisson's disease which statement among the following is CORRECT?
A. Lung damage is caused by air embolism.
B. Pain in the joints is due to nitrogen bubbles.
C. Tremors are seen due to nitrogen narcosis.
D. High pressure Nervous syndrome can be prevented by using mixtures of Oxygen & Helium.
ANS-B
Ganong/662-3
Lung damage is seen due to Oxygen toxicity.
Nitrogen Narcosis can be prevented by using mixtures of Oxygen & Helium.High pressure Nervous syndromeis caused by using mixtures of Oxygen & Helium.
Tremors are seen due to high presurre nervous syndrme.
Nitrogen narcosis causes Euphoria.
Hyperkeratosis is seen in deficiency of:
A. Vit A
B. Vit B
C. Vit C
D. Vit D
ANS-A
Harper/28th e/468 Table 44-1
Absorption of Iron is increased by:
A. Tea
B. Coffee
C. Vitamin C
D. EDTA
ANS-C
Harper/463
Inorganic iron is absorbed in Fe2+ state (reduced state). Hence reducing agents promote absorption of Iron. Most impt among these are:
Vitamin C
Alcohol
Fructose
Absorption of Iron is impaired by Calcium ( in milk & milk products).
Highest velocity of conduction is seen in nerve fibres of type:
A. A alpha
B. A delta
C. B
D. C
ANS-A
Ganong/57
V. IMPT
Nerve fibres with
maxm diameter & highest conduction velocity: A alpha (12-20 um, 70-120 m/s)
minm diameter & lowest conduction velocity: C (0.4-1.2 um, 0.5-2 m/s)
maxm absolute refractory period: C (2ms)
minm absolute refractory period: A alpha (0.4-1 ms)
All the following are consequences of Protein denaturation EXCEPT:
A. Loss of solubility
B. Loss of Function
C. Loss of Primary structure
D. Change in viscosity
ANS-C
Ref: Harper
"Protein denaturation leads to loss of Quaternary, Tertiary & Secondary functions, but the primary function is preserved."
Which among the following is NOT an example of a steroid hormone?
A. Aldosterone
B. Testosterone
C. Thyroxine
D. Cortisol
ANS-C
In Xeroderma Pigmentosum, defect is in the:
A. Methylation
B. Nucleotide Excision Repair
C. DNA replication
D. Protein folding
ANS-B
Which among the following is characterised by DNA repair defect:
A. Incontinentia Pigmenti
B. Bloom Syndrome
C. Aplastic Anemia
D. Tuberous Sclerosis
ANS-B
Ref: Robbins/8th ed/ 275
Inherited Autosomal Recessive conditions of defective DNA Repair:
[i]Xeroderma pigmentosum
[ii] Ataxia Telangiectasia
[iii] Bloom Syndrome
[iv] Fanconi Anemia
Chromosome with centromere near one end are referred to as:
A. Metacentric
B. Telocentric
C. Acrocentric
D. Submetacentric
ANS-C
[i]Metacentric
A chromosome is metacentric if its two arms are roughly equal in length.
[ii]Submetacentric
If arms' lengths are unequal, the chromosome is said to be submetacentric
[iii]Acrocentric
If the p (short) arm is so short that is hard to observe, but still present, then the chromosome is acrocentric .The human genome includes five acrocentric chromosomes: 13, 14, 15, 21 and 22.
[iv]Telocentric
A telocentric chromosome's centromere is located at the terminal end of the chromosome.
Essential amino acids include all EXCEPT:
A. Methionine
B. Tryptophan
C. Leucine
d. Alanine
ANS-D
Ref: Harper/Pg 235
Nutritionally Essential Amino Acids include:
Lysine
Leucine
Isoleucine
Valine
Methionine
Phenylalanine
Histidine
Threnonine
Tryptophan
Arginine(semi-essential)
Peptidyltransferase is an example of:
A. Enzyme
B. Catalyst
C. Elongation Factor
D. Ribozyme
ANS-D
Ref: Harper/pg 363
"Peptidyltransferase is a component of 28S RNA of 60S ribosomal subunit. It is an example of Ribozyme activity."
All the following drugs are given by sublingual route EXCEPT:
A. Isosorbide dinitrate
B. Buprenorphine
C. Glyceryl trinitrare
D. Isosorbide-5-mononitrate
Answer is D
KDT/6th/7, 526
drugs given sublingually are:
GTN
Buprenorphine
desamino-oxytocin
isosorbider dinitrate
Nitrates used orally ( & NOT SUBLINGUALLY)
isosorbide-5- mononitrate
Erythrityl tetranitrate
Pentaerythritol tetranitrate
Related impt topic
GTN should not be administered if
[i]systolic bp < 90 mm Hg.
[ii]Heart rate <50 or >100.
[iii]Right ventricular infarction is suspected.
[iv]Pt. has taken Sildenafil in past 24 hrs.
Regarding Sildenafil, all the following statements are correct EXCEPT:
A. It is a Phosphodiesterase 5 inhibitor.
B .It increases libido & prolongs duration of orgasm.
C. It should not be used by a patient on nitrates.
D. It is metabolised by CYP3A4.
Answer is B.
KDT/6th/ 295-96
"Sildenafil is ineffective in men who have lost libido or when Erectile Dysfunction is due to cord injury or damaged nervi eregantis."
" Sildenafil is erroneously perceived as an aphrodisiac"
impt points:
Sildenafil also inhibits PDE-6 weakly- impairment of colour vision esp. blue-green discrimination.
other PDE-5 inhibitors: Tadalafil, Vardenafil.
PDE-5 inhibitor of choice in Pulmonary Artery Hypertension: Sildenafil.
PDE-3 inhibitors : Amrinone, Milrinone : used in CHF.
Nasal Calcitonin spray is used in treatment of:
A. Paget's disease.
B. Post-menopausal Osteoporosis.
C. Secondary Hyperparathyroidism.
D. Hypercalcemia of malignancy.
Ans is B.
KDT/6th/330
" A nasal spray formulation delivering 200 IU per actuation has become available. one spray daily increases bone mineral density in menopausal women"
" It is less effective than HRT/BPNs"
Uses of Calcitonon:
post menopausal osteoporosis
hyperparathyroidism
hypervitaminosis D
Hypercalcemia of malignancy
Paget's disease
All the following adverse effects can be caused by Loop Diuretics EXCEPT:
A. Hypercalcemia
B. Hyperglycemia.
C. Hypomagnesemia.
D. Hyperuricemia.
Answer is A.
KDT/6th/567
Loop diuretics on chronic use cause Hypocalcemia while thiazides cause Hypercalcemia.
Adverse effect specific to Loop DIuretics:
Hearing loss
Hypocalcemia
excess use causes dehydration & fall in bp.
Adverse effect specific to thiazide Diuretics:
Hypercalcemia.
Adverse effects common to both loop & thiazide diuretics:
Hypokalemia.
Hypomagnesemia.
Hyperglycemia.
Hyperlipidemia.
Hyperuricemia.
CONTRAINDICATION FOR DIURETIC USE:
Edema due to Toxemia of Pregnancy.
Lugol's Iodine contains:
A. 5 % iodine & 10 % KI
B. 10 % iodine & 20 % KI
C. 10 % iodine & 15 % KI
D. 5 % iodine & 15 % KI
ANS - A
KDT/6th/252
All the following statements regarding Adenosine are true EXCEPT:
A. Dipyridamole potentiates its action.
B. Used to produce controlled Hypotension.
C. Administered by slow I.V. injection.
D. Administered by rapid I.V. injection.
ANS- C
KDT/6th/ 518
Adenosine:
Drug of choice for acute Rx of PSVT.
very short t1/2- 10 sec.
administered by rapid iv injection over1-2 sec.
dipyridamole potentiates its action by inhibiting uptake into RBC & endothelial cells where it is degraded to 5-AMP & inosine.
"Adenosine has to be rapidly injected in a large Vein & has brief action."
70.Among the folowing, which one is a long acting Beta agonist?
A. Salbutamol.
B. Propranolol
C. Salmeterol
D. Terbutaline.
ANS_C
KDT/6th/218
71.Which among the following is NOT a beta lactamase resistant Penicillin?
A. Methicillin
B. Carbenicillin
C. Nafcillin.
D. Oxacillin.
ANS- B
KDT/6th/700
Penicillinase resistant Penicillins:
Methicillin
Cloxacillin
Oxacillin
Dicloxacillin
Flucloxacillin (Floxacillin)
Nafcillin
Carbenicillin:
it is an extended spectrum penicillin active against Pseudomonas & Proteus.
"It is neither Penicillinase resistant nor acid resistant."
72.Regarding Phenytoin all the following are correct EXCEPT:
A. It acts on voltage sensitive neuronal Na+ channels.
B. used by slow IV injection in status epilepticus.
C. Kinetics change from 1st order to 0 order over therapeutic range.
D. It inhibits microsomal enzymes.
ANS_D
KDT/6th/404-05
PHENYTOIN induces microsomal enzymes & increases degradation of Steroids, Digitoxin, Doxycycline, etc.
73.Vomiting is mediated by
A. 5 HT1 receptor
B. 5 HT2 receptor
C. 5 HT3 receptor
D. 5 HT4 receptor
ANS-C
All the following drugs act on the microtubular protein Tubulin EXCEPT:
A. Colchicine
B. Vincristin
C. Bleomycin.
D. Paclitaxel.
ANS- C
KDT/6th/824-25-26,206
MECHANISM OF ACTION
Colchicine: cause Metaphase arrest by binding to microtubules of mitotic spindle. By binding to fibrillar protein Tubulin, it inhibits granulocyte migration into the inflamed joint in gout.
Vinca alkaloids: prevent polymerisation of tubulin & cause disruption of mitotic spindle.
Taxanes (Paclitaxel & Docetaxel) : enhances polymerisation of tubulin, stabilise microtubules & prevent their depolymerisation.
IMPT Q : Anti-neoplastic drug with mechanism of action exactly opposite to Vincristine : Paclitaxel/ Docetaxel.
REGARDING BLEOMYCIN:
IT ACTS BY INHIBITING DNA REPAIR.
75.All the following drugs are reversible inhibitors of COX EXCEPT:
A.Diclofenac.
B.Ibuprofen.
C. Aspirin.
D. Indomethacin.
ANS- C
KDT/185
"Aspirin inhibits COX irreversibly , other NSAIDs are competitive & reversible inhibitors of COX."
76.Most effective method of treatment of Digitalis toxicity is:
A. Hemodialysis.
B. Cardioversion.
C. Digoxin Antibody.
D. Atropine.
ANS- C
KATZUNG/9th e/212
"Severe Digitalis intoxication patients are best treated with insertion of a temporary cardiac pacemaker catheter and administration of DIGITALIS ANTIBODIES."
Cardioversion : digitalis induced arrythmias are frequently made worse by cardioversion.
Atropine: indicated only if there is A-V block. (KDT/499)
77.Which antifungal drug is an anti-metabolite?
A. Ketoconazole.
B. Flucytosine.
C. Terbinafine.
D. Griseofulvin.
ANS- B
KDT/761
"Flucytosine (5-FC) is a pyrimidine antimetabolite.
It is taken up by fungal cells & converted into 5- Fluorouracil."
Indications for use of anti-cholinergics include all EXCEPT:
A. Glaucoma
B. Parkinsonism.
C. Refraction testing.
D. Organophosphorus poisoning
ANS- A
KDT/112-113, 144-148
Katzung/992
GLAUCOMA:
In Glaucoma following ANS drugs are used:
(i) topical beta blockers [Timolol (b1+b2 blocker) , Betaxolol (b1 selective)]: preferred drug.
(ii) topical alpha adrenergic agonists : dipivefrine, brimonidine.
(iii) anti-cholinesterases (syn-cholinergics) Miotics: topical Pi;locarpine. NOT PREFERRED due to adverse effects.
NO ROLE OF ANTI-CHOLINERGICS.
PARKINSONISM
Central anti-cholinergics Benzhexol, Procyclidine, Biperiden are used.
IMPT: CENTRAL ANTICHOLINERGICS ARE THE ONLY DRUG EFFECTIVE IN DRUG INDUCED PARKINSONISM. (KDT/421)
REFRACTION TESTING
Anticholinergics cause mydriasis & cycloplegia. Tropicamide having briefer action is preferred over Homatropine. In children- more potent ATROPINE is used.
ORGANOPHOSPHORUS POISONING
Antidotal treatment consists of Atropine & Pralidoxime. Katzung/993
79.Which among the following anti-gout drugs can precipitate an attack of acute arthritis?
A. Colchicine.
B. Probenecid.
C. Allopurinol.
D. Sulfinpyrazone.
ANS- C
Katzung/9th e/599
"Acute attacks of Gouty arthritis occur early in treatment with Allopurinol,
when urate crystals are being withdrawn from the tissues & plasma levels are below normal."
80.Phocomelia is due to-
A. Thalidomide.
B. Warfarin
C. Enalapril
D. Phenytoin
ANS-A
81.Corticosteroid with maximum sodium retaining potential is:
A. Hydrocortisone.
B. Prednisolone.
C. Fludrocortisone.
D. Deoxycorticosterone.
ANS- C
KATZUNG/9th e/647 table 39-1
Relative salt retaining potential is:
Hydrocortisone: 1
Prednisolone: 0.3
Fludrocortisone: 250
Deoxycorticosterone: 20
IMPT: Most potent anti-inflammatory action: Betamethasone (25-40), Dexamethasone (30).
82.Concomitant treatment with which of the following can cause OCP failure?
A. Enalapril.
B. Metformin.
C. Ibuprofen.
D. Rifampicin.
ANS- D
KDT/317
OCP failure can occur with concurrent use of :
Phenytoin.
Phenobarbitone.
Primidone.
Carbamazepine.
Rifampicin.
Tetracyclines, ampicillins & other antibiotics.
83.Corticosteroid of choice in Acute Adrenal Insufficiency is:
A. Fludrocortisone.
B. Hydrocortisone.
C. Dexamethasone.
D. Prednisolone.
ANS- B
KATZUNG/9th e/648
" Acute Adrenal Insufficiency : Hydrocortisone sodium succinate 100 mg IV every 8 hrly is given until the pt. is stable."
KDT/283
In Acute adrenal insufficiency, Hydrocortisone or Dexamethasone are given IV first as bolus & then as infusion.
84.The minimum effective dose of Ethinylestradiol in Oral Contraceptive Pills is:
A. 20 ug
B. 30 ug
C. 40 ug
D. 50 ug
ANS-A
KDT/312
" Ethinylestradiol 30 ug is considered threshold but can be reduced to 20 ug if a progestin with potent anti-ovulatory action is added."
FEMILON pills: Desogestrel 0.15 mg + Ethinylestradiol 20 microgram. (KDT Table 22.1, pg 313)
KATZUNG/674
Loestrin: Ethinyl esrtadiol 0.02 mg + Norethindrone acetate 1 mg
85 .Drug of choice for Epilepsy in a Pregnant lady is:
A. Valproate
B. Phenytoin
C. Ethosuximide
D. Phenobarbital.
E. Carbamazapine.
ANS- E ?
KATZUNG/398
"Phenytoin has been implicated in Fetal Hydantoin Syndrome & a similar syndrome has been attributed to Phenobarbital & to Carbamazepine. Valproate has been implicated in spina bifida."
86.Regarding Neostigmine, all the following are correct EXCEPT:
A. a quarternary ammonium compound.
B. shorter acting than edrophonium.
C. poorly absorbed oraaly.
D. used in myasthenis gravis.
ANS- B
KDT/102-03
Duration of action:
Neostigmine: 3-4 hours.
Edrophonium: 10-30 min.
87.Drug of choice in Pregnant women with Secondary Syphilis :
A. Doxycycline.
B. Benzathine Penicillin.
C. Ceftriaxone.
D. Cotrimoxazole.
ANS- B
KDT/737,909
late Syphilis >1 yr
Benzathine Penicillin 2.4 MU i.m. weekly for 4 weeks is Rx of choice.
Penicillin G is safe in Pregnancy.
Doxycycline is a 2nd line drug & it is CONTRAINDICATED for use in pregnancy.
Ceftriaxone can be used in Pregnant women but it is also a 2nd line drug.
Cotrimoxazole is not effective in Syphilis & also, it is CONTRAINDICATED for use in pregnancy.
88.All of the following act on ion channels EXCEPT:
A. Verapamil
B. Insulin.
C. Gliblenclamide.
D. Diazepam
ANS B
89.Treatment of choice for SIADH is:
A. Lithium carbonate.
B. Demeclocycline.
C. Vasopressin.
D. Hypertonic Saline.
ANS- B
Katzung/ 9th e/253
90.Drug of choice for Neutropenia due to cancer chemotherapy :
A. Vitamin B-12
B. IL 11
C. Filgrastim
D. Erythopoietin
ANS- C
Katzung/ 9th e/ 539-40, 542
"The introduction of G-CSF represented a milestone in treatment of Chemotherapy related Neutropenia. It accelerates the rate of Neutrophil recovery after myelosuppressive chemotherapy. Ability of G-CSF to increase Neutrophil counts after myelosuppressive chemotherapy is nearly universal. "
G-CSF include
(i) Filgrastim
(ii) Sargamostim.
REGARDING INTERLEUKIN 11/ OPRELVEKIN
A megakaryocyte growth factor: Recommended for secondary prevention of Thrombocytopenia in pts receiving cytotoxic chemotherapy for Rx of nonmyeloid cancers.
ERYTHROPOIETIN/Epoietin alpha
For Rx of Anemia in : CRF, aplastic anemia, Myeloproliferative & myelodysplatic disorders, AIDS, malignancies.
Among the following the drug which is contraindicated in HOCM is:
A. Beta blockers
B. Verapamil.
C. Digitalis.
D. Amiodarone
ANS- C
Harrison/17th/1485
Digitalis is contraindicated in HOCM.
Beta blockers :used as initial drug in symptomatic individuals.
Calcium channel blockers are alternative drugs.
Amiodarone may be used to reduce arrythmias.
Other drugs contraindicated in HOCM:
[i]Beta agonists
[ii]Sympathomimetics.
[iii]Nitrates
[iv]Diuretics.
92.Which of the following is NOT a direct acting anti-platelet agent?
A. Aspirin
B. Clopidogrel
C. Atorvastatin
D. Alteplase
ANS- C
93.Drug of choice in acute attack of gout is :
A. NSAIDs
B. Colchicine
C. Allopurinol
D. Steroids
Harrison's Rheumatology/237
ANS-A
NSAIDs are effective in 90% of patients and resolution of symptoms occur in 5-8 days. Most effective drugs are those with a short half life : Indomethacin , Ibuprofen, Diclofenac.
However, it also mentions "In attacks involving one or two joints , intraarticular Glucocorticoid injections may be preferrable & effective."
However the Q doesn't mention "intraarticular" specifically.
94.Efficacy of a drug refers to:
A. Ability of a drug to bind to its receptor.
B. Ability of a drug to activate its receptor.
C. Minimum dose reqd. to produce clinical response.
D. Maximum response that can be elicited by a drug.
ANS-D
REF: KDT/6/54
95.Drug of choice in severe acute Angioedema is:
A. Terfenadine
B. Promethazine.
C. Cimetidine.
D. Hydrocortisone
ANS-D
96.Which ststement among the following is correct regarding Imipenem?
A. It is a narrow spectrum penicillin.
B. It is not resistant to beta lactamases.
C. It is used with Cilastin.
D. it is used with Sulbactum.
KDT/6th/ 708
Imipenem :
extremely potent & broad spectrum penicillin.
resistant to most beta lactamases.'
rapidly hydrolysed by dehydropeptidase-1 located on the brush border of renal tubular cells. Cilastin is a dehydropeptidase 1 inhibitor.
Sulbactum is a beta lactamase inhibitor used parenterally with ampicillin.
Clasvulanic Acid - suicide inhibitor of beta lactamases used with amoxicillin (coamoxiclav)
Tazobactam- used with piperacillin.
97.All the following drugs are teratogenic except:
A. Alcohol
B. Phenytoin
C. Warfarin
D. Chlorpropramide
KDT/6TH/85
Alcohol- foetal alcohol syndrome: IUGR, low IQ, microcephaly, facial & other abnormalities.
Phenytoin- hydantoin syndrome: hypoplastic phalanges, cleft lip/palate, microcephaly
Warfarin- foetal warfarin syndrome: depressed nose, eye & hand defects. anticoagulant of choice during Pregnancy- Heparin.
regarding chlorpropamide KDT/267 mentions "safety of sulfonylureas during pregnancy is not established- change over to insulin" however it is not mentioned in list of teratogenic drugs.
hence best answer is D
Which antineoplastic drug has a very high cardiac toxicity?
A. Bleomycin
B. Actinomycin-D
C. Doxorubicin
D. Mitomycin-C
KDT/6th/ 826
Doxorubicin & Daunorubicin both produce cardiotoxicity - arrythmias, or cardiomyopathy leading to CHF.
bleomycin- pulmonary fibrosis, mucocutaneous toxicity.
Actinomycin D- bone marrow suppression, desquamation of skin. highly efficacious in Wilms' tumour.
Mitomycin C- bone marrow & git toxicity.
Answer- C
Phase IV of Clinical trials collect information specifically about:
A. Drug efficacy
B. Drug potency
C. Drug toxicity
D. Other possible uses of the drug
ANS-C
100.Cephalic index is used for determination of;
A. Sex
B. Race
C. Height
D. Stature
ANS- B
101.Which section of Indian Penal Code describes punishment for Dowry Death?
A. 300
B. 302
C. 304 A
D. 304 B
ANS- D
Sec 300 IPC : defines 'murder'
Sec 302 IPC : describes 'punishment for murder'
Sec 304 A IPC : defines punishment for causing death by 'negligence'
Sec 304 B IPC : defines 'dowry death' as well as describes punishment for the same.
102.Telefono refers to:
A. beating on soles.
B. slaps on either side of head on ears.
C. standing in hot sun.
D. a mode of electrocution.
ANS- B
beating on soles : Falanga/ Bastinado
standing in hot sun on 1 leg: El planton
103.Putrefaction is characteristically delayed in poisoning due to :
A. Lead
B. Arsenic
C. Mercury
D. Copper
ANS_B
CAUSES OF DELAYED PUTREFACTION INCLUDE poisoning due to:
(i) Zinc chloride
(ii) Strychnine
(iii) Heavy Metals , esp. Arsenic.
Since all the options are heavy metals, all may fit in, but in all the referred books, it is specifically mentioned under Arsenic, but not under other heavy metal poisoning.
Hence "Arsenic" is the best amongst the given options.
104.Which among the following is NOT a sexual paraphilia?
A. Transvestism.
B. Fetichism
C. Frotteurism
D. Voyeurism
ANS-None
All the given options are definitely indicated under sexual paraphilias.
105.Bluish discoloration postmortem is indicative of poisoning due to :
A. Nitrobenzene
B. Phosphorus.
C. Hydrocyanic acid
D. Aniline
ANS- D
Colour of PM Hypostasis in various poisonings:
Nitrobenzene- coffee-brown
Phosphorus- dark brown
Hydrocyanic acid/cyanide- bright red
Carbon monoxide- cherry red
Aniline- blue
Hydrogen sulphide- bluish green.
106.Immediate sign of death is :
A. Rise in body temperature.
B. Dilatation of pupil.
C. Changes in Skin.
D. Cessation of respiration & circulation
ANS- D
107.Sweating is absent in:
A. Heat Syncope
B. Heat Exhaustion
C. Heat Stroke
D. Heat cramps
ANS - C
108.Gun powder residues on forearms can be detected by:
A. Benzidine Test
B. Barberio's Test
C. Dermal Nitrate Test
D. Hydrostatic Test
ANS-C
TESTS TO DETECT GUNPOWDER RESIDUES
Paraffin/ Dermal Nitrate test
Neutron Activation Analysis.
Flameless atomic absorption spectrometry.
109.Declaration of Oslo is related to which among the following:
A. Torture
B. Capital Punishment.
C. MTP
D. None of the above
ANS-C
*Declarartion of Tokyo- Torture.
110.Mucocele is commenest in which among the following sinuses?
A. Frontal.
B. Maxillary.
C. Ethmoid.
D. Sphenoid.
ANS- A
Dhingra/3rd e/246
The sinuses commonly affected by mucocele in order of frequency:
Frontal.
Ethmoidal
Maxillary.
Sphenoidal.
111.Causes of Epistaxis include all EXCEPT:
A. Finger Nail Trauma (Nose picking)
B. Foreign body.
C. Allergic Rhinitis.
D. Thrombocytopenia.
ANS-C
Dhingra/216-217
Epistaxis has not been mentioned even as a complication of Allergic Rhinitis.
Epistaxis is characteristically seen in 'CRUST FORMING RHINITIS.' Allergic rhinitis is not crust-forming.
112.Vidian Neurectomy is beneficial in:
A. Atrophic Rhinitis.
B. Vasomotor Rhinitis.
C. Allergic Rhinitis.
D. Non air flow rhinitis
ANS- B
Dhingra/3rs ed/209
"Excessive Rhinorrhea in Vasomotor Rhinitis, not corrected by medical therapy, can be relieved by Vidian Neurectomy."
113.Most common site of CSF Rhinorrhea:
A. Cribriform plate.
B. Temporal bone.
C. Sphenoid sinus.
D. Ethmoid air cells.
ANS-A
Dhingra/202
114.Most common organism causing acute Epiglottitis is:
A. H. influenzae.
B. Parainfluenza virus.
C. Respiratory Synctitial Virus.
D. C. diphtheriae.
ANS-A
Dhingra/3rd e/347
115.Facial paralysis in Zoster ophthalmicus is referred to as:
A. Bell's palsy.
B. Ramsay Hunt Syndrome.
C. Waardenburg's Syndrome
D. van der Hoeve Syndrome
ANS-B
Dhingra/124
116.Investigation of choice for audiometric evaluation of an infant is:
A. Pure Tone Audiometry
B. High frequency Audiometry
C. Tympanometry
D. BERA
ANS-D
117.Salmonella Osteomyelitis is common in:
A. Sickle Cell Anemia.
B. HIV
C. Hereditary Spherocytosis
D. IV drug abusers.
ANS= A
118.Thomas test is used for testing:
A. Flexion of Lumbar Spine.
B. Hip flexion
C. Hip abduction.
D. Knee flexion.
ANS= B
119.Cotton's fracture involves:
A. Ankle
B. Foot
C. Knee
D. Spine
ANS= A
*It is a trimalleolar fracture of the ankle involving both–medial and lateral—malleoli and the posterior articular margin of the distal tibia–referred to as posterior malleolus—with the latter fragment being dislocated posteriorly and/or superiorly.
120.Charlie Chaplin Gait is characteristic of:
A. Coxa vera.
B. Genu valgum.
C. Tibial Torsion.
D. CDH
ANS= C
*Charlie Chaplin gait is seen in bilateral external torsion of tibia, caused by faulty sitting or sleeping, as in prolonged maintenance of ‘spread-eagle’ or frogleg position.
121.Fenesterated Hip Prosthesis is:
A. Austin- Moore
B. Thompson
C. THR
D. All the above
ANS= A
Most common site of TB spine is:
A. Cervical
B Cervical & Thoracic
C. Thoracic & lumbar
D. Sacral
ANS=B
123.Indication for surgical compartment release in compartment Syndrome in any compartment is absolute pressure greater than:
A. 15 mm Hg
B. 20 mm Hg
C. 30 mm Hg
D. Varies from compt to compt.
ANS= C
124.Most common type of Elbow dislocation is:
A. Posterior
B. Posterolateral
C. Posteromedial.
D. Lateral.
ANS= A
125.The bone tumor seen in children with characteristic "onion-peel" periosteal reaction is:
A. Osteosarcoma.
B. Osteoclastoma.
C. Ewing's sarcoma
D. Metastasis from Wilms' tumor.
ANS= C
126.Greyish discoloration of flank seen in Acute Pancreatitis is referred to as:
A. Cullen's Sign
B. Grey Turner Sign
C. Ballance's Sign
D. Alvaradao's Sign
ANS - B
Pain on defecation in a patient having External Haemmorhoids is mediated by:
A. Hypogastric Plexus
B. Pelvic Splanchnic Nerves
C. Pudendal Nerve
D. Perineal Nerve
ANS- C
EXPLANATION:
External haemorrhoids are painful because they occur below the pectinate line and have somatic nerve supply via INFERIOR RECTAL NERVE - a branch of PUDENDAL Nerve.
Internal haemmorhoids are painless because they occur ABOVE the PECTINATE LINE. They are supplied by Sympathetic ( Inferior Hypogastric Nerve) and Parasym (Pelvic Splanchnic Nerves).
128.All the following are used in treatment of ER - ,PR +, Her 2 neu + Ca breast EXCEPT:
A. Tamoxifen
B. Cyclophosphomide
C. Transtuzumab
D. Flutamide
ANS- D
129.Sign of Ischemic limb pain include all EXCEPT:
A. Paresthesia
B. Paralysis
C. Pain
D. Perishing cold
ANS- D
Bailey n Love:
The 5 Ps characteristic of peripheral arterial occlusion are :
Pain
Pallor
Paralysis
Pulselessness
Paraesthesia
Some books add 6th P Poikilothermia/ Perishing Cold , but its nt mentioned in any standard text.
Perishing cold seems to be the best possible answer here.
130.Metabolic abnormalities associated with Congenital Pyloric Stenosis in the early phase include all Except:
A. Hypokalemia
B. Aciduria
C. Hypochloremia
D. None of these
ANS- B
*Paradoxical aciduria is seen only after body stores of Sodium & Potassium get depleted. Initially there is alkaliuria , NOT ACIDURIA
131.Lucid Interval is seen in:
A. Extradural hemorrhage
B. Subdural hemorrhage
C. Subarachnoid hemorrhage
D. All of these
ANS A
Though lucid interval may be seen in both Extradural and Subdural hemorrhage, it is most characteristic of the Extradural Hemorrhage. Also, it is never seen in Subarachnoid Hemorrhage.
Hence best ans is A.
132.Most common malignant tumor of Parotid Gland is :
A. Pleomorphic Adenoma
B. Mucoepidermoid Carcinoma
C. Hemangioma
D. Warthim's tumor
ANS- B
MC BENIGN & OVERALL MC TUMOR OF PAROTID- PLEOMORPHIC ADENOMA
2ND MC TUMOR OF PAROTID- WARTHIN'S TUMOR
MC MALIGNANT TUMOR OF PAROTID-
MUCOEPIDERMOID CA
MC TUMOR OF PAROTID IN CHILDREN: HEMANGIOMA
VERY IMPT Q:
PAROTID TUMOR WHICH SPREADS BY PERINEURAL INVASION: ADENOID CYSTIC CA (2ND MC malignant tumor of Parotid)
133.Which among the following is NOT a feature of Hemobilia?
A. Malena
B. Jaundice
C. Fever
D. Biliary Colic
ANS - C
134.All the following are correct about Paget's Disease of the Breast Except:
A. Associated with underlying invasive Carcinoma in 97% cases.
B. Most carcinoma are present within 2 cm of nipple.
C. 50% are hormone receptor positive.
D. Wedge biopsy of nipple is required for diagnosis.
ANS - ?
135.The triangular interval between the medial border of Scalenus anterior and Longus colli contains all the following structures EXCEPT:
A. Sympathetic trunk
B. Internal Carotid artery
C. Thoracic duct
D. Inferior Cervical Ganglion
ANS- B
This space contains Vertebral Artery and not Internal Carotid Artery.
Tripe assessment of breast includes all the following EXCEPT:
A. MRI
B. Mammography
C. Biopsy
D. Clinical evaluation
ANS- A
137.Maximum risk of invasive breast carcinoma is seen with:
A. Complex Fibroadenoma
B. Sclerosing Adenosis
C. Cysts
D. Atypical ductal hyperlasia
ANS- D
Among the following, the least malignant potential is seen in polyps associated with:
A. Gardner's Syndrome
B. Turcot's Syndrome
C. Peutz Jagher's Syndrome
D. FAP
ANS- C
139.Structure damaged most commonly during Surgery on Ranula is:
A. Lingual Artery
B. Lingual Nerve
C. Submandibular duct
D. Sublingual duct
ANS- C
140.Most common type of Primary Lymphedema is:
A. Congenital Lymphedema
B. Lymphedema precox
C. Lymphedema tarda
D. Milroy's disease
ANS- B
PRIMARY LYMPHEDEMA CLASSIFICATION:
A. Congenital Lymphedema- onset before 1st yr , more likely to be bilalateral
Milroy s disease is familial version of Congenital Lymphedema.
B. Lymphedema precox- MC form (>90%) , onset bw 1 & 35 yrs, more common in f, unilateral
Meige s disease- familial form.
C. Lymphedema tarda- onset after 35 yrs
141.Which among the following correctly describes Prehn's Sign?
A. Elevation of testis increases pain in Epididymorchitis.
B. Elevation of testis increases pain in Torsion.
C. Depression of testis increases pain in Epididymorchitis.
D. Depression of Testis increases pain in Torsion.
ANS- B
142.A patient with blunt abdominal trauma presented to casualty with BP 90/60, pulse rate 124. The investigation of choice in this pt is:
A. CT abdomen
B. MRI abdomen
C. DPL
D. FAST
ANS- D
143.Most common soft tissue tumor of adults is:
A. Embryonal Rhabdomyosarcoma
B. Liposarcoma
C. Synovial Sarcoma
D. Malignant Fibrous Histiocytoma
ANS- D
144.Vertical Banding Gastroplasty is a surgery done for:
A. Gastric Carcinoma
B. Duodenal Ulcer
C. Chronic Pancreatitis.
D. Morbid Obesity.
ANS=D
145.Mercedes Benz sign is seen in:
A. Renal Stones
B. Gall stones
C. Bladder stones
D. Submandibular duct stones.
ANS=B
146.Most common organism causing Cellulitis in Lymphedema is:
A. Peptostreptococcus.
B. Beta hemolytic streptococcus
C. Staphylococcus
D. Pseudomonas
ANS=C
Most common cause of small intestinal obstruction is:
A. Tumors
B. Volvulus
C. Adhesions
D. Intussusception
ANS-C
Omphalocele can be best described as occuring due to:
A. Patent vitellointestinal duct.
B. Herniation through anterior abdominal wall at the site of attachment of Umbilical Cord.
C. Involution of Right Umbilical Vein
D. Failure of migration of intestinal loops back into peritoneal cavity.
ANS- B
149.Extensive Ileal resection can cause all the following EXCEPT:
A. Pancreatic Hypersecretion
B. Ca oxalate calculi
C. Lactic acidosis
D. Macrocytic Anemia
ANS=A
*It can cause Gastric Hypersecretion, not Pancreatic hypersecretion.
Which among the following statements is NOT correct regarding Vesico-Ureteric Reflux:
A. Asymptomatic Reflux do not lead to renal scarring.
B. Investigation of choice is VCUG.
C. It is the most common cause of Pyelonephritis in children.
D. The ideal length:diameter ratio of intravesical ureter should be 5:1.
ANS=A
151."Butcher's Thigh" refers to:
A. Bursa in the femoral triangle.
B. Subcutaneous Lipodermatosclerosis.
C. Vastus Lateralis rupture.
D. Accidental injury to major vessels while the Butcher is cutting with his blade.
ANS= D
152.Best method to treat a large port-wine hemangioma is:
A. Radiotherapy.
B. Tatooing.
C. Excision with skin grafting.
D. Pulsed dye Laser.
ANS-D
Ref: CSDT
"Selective Photothermolysis or Pulsed dye laser is the treatment of choice for Portwine hemangioma."
153.All the following are correct regarding Emphysematous Cholecystitis EXCEPT:
A. It is more common in males.
B. It is more common in diabetics.
C. In many cases, the gall bladder doesnt contain any stones.
D. It is caused most commonly by Pseudomonas.
ANS- D
*Organisms causing Emphysematous Cholecystitis:
(i) Clostridia MOST COMMON
(ii) E coli
(iii) Anaerobic Streptococci
M:F = 3:1
(Ref: CSDT )
154.Drooping Lily sign is seen in :
A. Splenic tumor
B. Liver tumor
C. Mass in Lower pole of Kidney
D. Mass in upper pole of Kidney
ANS= D
*Drooping Lily Sign is seen in :
Obstruction of upper pole of Kidney.
155.Cartwheel appearance is seen in :
A. Hydatid Cyst
B. Hydatidiform Mole
C. Polycystic Ovary
D. All of the above
ANS= A
which among the following is not seen in Chronic Renal Failure?
A. Hyperkalemia.
B. Hyponatremia.
C. Hypercalcemia.
D. Hyperphosphatemia.
ANS-C
Harrison/17th ed/
1.Fluid and electrolyte disturbances;
Volume expansion (I)
Hyponatremia (I)
Hyperkalemia (I)
Hyperphosphatemia (I)
2.Endocrine-metabolic disturbances:
Secondary hyperparathyroidism (I or P)
Adynamic bone (D)
Vitamin D–deficient osteomalacia (I)
Carbohydrate resistance (I)
Hyperuricemia (I or P)
Hypertriglyceridemia (I or P)
Increased Lp(a) level (P)
Decreased high-density lipoprotein level (P)
Protein-energy malnutrition (I or P)
Impaired growth and development (P)
Infertility and sexual dysfunction (P)
Amenorrhea (I/P)
3-Microglobulin associated amyloidosis (P or D)
REASON FOR HYPOCALCEMIA:
decreased levels of ionized calcium, result from diminished calcitriol production by the failing kidney as well as phosphate retention, also stimulate PTH production. Low calcitriol levels contribute to hyperparathyroidism, both by leading to hypocalcemia and also by a direct effect on PTH gene transcription.
157.High Anion Gap Acidosis is seen in all the following EXCEPT:
A. Diabetic Ketoacidosis.
B. Lactic Acidosis.
C. Renal Tubular Acidosis.
D. Methanol Poisoniong
ANS-C
Causes of High-Anion-Gap Metabolic Acidosis
Lactic acidosis
Ketoacidosis
Diabetic
Alcoholic
Starvation
Renal failure (acute and chronic)
TOXINS
Ethylene glycol
Methanol
Salicylates
Propylene glycol
Pyroglutamic acid
158.All the following are signs of Liver Cirrhosis EXCEPT:
A. Spider naevi
B. Palmar Erythema.
C. Testicular Atrophy.
D. Subcutaneous nodules.
ANS-D
159.Which system is primarily affected by TETANUS?
A. Hematological.
B. Nervous
C. Skeletal
D. All
ANS-B
Harrison/17
Tetanus is a neurologic disorder, characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a powerful protein toxin elaborated by Clostridium tetani.
160.Community acquired pneumonia is caused by all EXCEPT:
A. Mycoplasma.
B. Legionella
C. Klebisiella
D. Chlamydiae
ANS-C
H/17
Table 251-2 Microbial Causes of Community-Acquired Pneumonia, by Site of Care
Streptococcus pneumoniae
Mycoplasma pneumoniae
Staphylococcus aureus
Haemophilus influenzae
Chlamydophila pneumoniae
Legionella sp.
Respiratory viruses
161.Triad of Thrombocytopenia, Eczema & recurrent infections is observed in:
A. Wiskott- Aldrich Syndrome.
B. Chediak- Higashi Syndrome
C. Job's Syndrome.
D. Bruton's agammaglobulinemia
ANS-A
*Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia)
162.Procalcitonin is a marker for:
A. Sepsis.
B. Medullary Carcinoma Thyroid.
C. Vit D resistant Rickets.
D. Haemorrhage
ANS-A
Measurement of procalcitonin can be used as a marker of severe sepsis and generally grades well with the degree of sepsis, although levels of procalcitonin in the blood are very low. PCT has the greatest sensitivity (85%) and specificity (91%) for differentiating patients with SIRS from those with sepsis, when compared with IL-2, IL-6, IL-8, CRP and TNF-alpha. Evidence is emerging that procalcitonin levels can reduce unnecessary antibiotic prescribing to people with lower respiratory tract infections.
163.Best Prognosis in Hodgkin's Disease:
A. Lymphocyte depletion.
B. Mixed Cellularity.
C. Nodular Sclerosis.
D. Lymphocyte predominance.
ANS-D
H/17
The treatment of patients with nodular lymphocyte-predominant Hodgkin's disease is controversial. Some clinicians favor no treatment and merely close follow-up. In the United States, most physicians will treat localized disease with radiotherapy and disseminated disease with regimens utilized for patients with classical Hodgkin's disease. Regardless of the therapy utilized, most series report a long-term survival of >80%.
164.Most commonly seen neuropathy in Diabetes is:
A. Mononeuropathy.
B. Distal symmetric sensory polyneuropathy.
C. Polyradiculopathy.
D. Autonomic Neuropathy.
ANS-B
H/16/2165
"Most common form of diabetic neuropathy is DISTAL SYMMETRIC POLYNEUROPATHY. It most frequently presents with distal sensory loss."
165.A middle aged man noticed that he can no longer fit in his shoes and enlarging of jaw and phalanges. These effects are mediated by:
A. ACTH
B. TRH
C. Somatomedin
D. TGF beta
ANS-C
His symptoms are suggestive of Acromegaly {î growth hormone} & GH effects are mediated via Somatomedins.
Principal Somatomedins are IGF-I, IGF-II.
IGF-I is also referred to as Somatomedin C.
Ganong/384
166.An emerging organism responsible for causing Pyelonephritis in Renal Allografts is:
A. Polyoma virus.
B. Herpes virus.
C. Hepatitis B virus.
D. Rota virus.
ANS-A
Robbins/8th ed/939
Most Common organism causing Pyelonephritis: E. Coli.
Other common organisms:
Proteus
Klebsiella
Enterobacter
Streptococcus fecalis
Immunocompromised hosts particularly those with transplanted organs:
Polyoma virus
Cytomegalovirus
Adenovirus
167.Cause of non immune hydrops is:
A. Rh isoimmunisation.
B. Alpha thalassemia major
C. Bilateral renal agenesis
D. Minor blood group incompatibility.
ANS-B
Robins/8/460
168.Recommended dose of Folic acid to be given to women of child bearing age group is:
A. 0.5mg
B. 4 ug
C. 40 ug
D. 400 ug
ANS_D
Katzung/9th ed/536
"Pregnant women have increased requirements for folic acid; at least 400 microgram is recommended."
Best way to dispose e-waste is:
A. Burning
B. Incineration
C. In a landfill
D. Recycling
ANS- D
"Recycling raw materials from end-of-life electronics is the most effective solution to the growing e-waste problem. Most electronic devices contain a variety of materials, including metals that can be recovered for future uses. By dismantling and providing reuse possibilities, intact natural resources are conserved and air and water pollution caused by hazardous disposal is avoided. Additionally, recycling reduces the amount of greenhouse gas emissions caused by the manufacturing of new products. It simply makes good sense and is efficient to recycle and to do our part to keep the environment green.
Discarded cytotoxic medicines should be disposed in:
A. Blue bag
B. Black bag
C. Red bag
D. Yellow bag
ANS-B
Human anatomical waste- Yellow bag
Waste sharps-blue/white bag
Which bag among the following shouldn't be burnt as it contains cadmium?
A. Blue
B. Red
C. Black
D. Yellow
ANS-C
In IMNCI, color coded charts are used to guide treatment. Home advised care is shown in:
A. Red color
B. Green color
C. Pink color
D. Yellow color
ANS-B
Ref: O P Ghai/7thed/pg738
IMNCI charts are 3 color based:
[i]Pink color: Possible serious bacterial infection, Severe Jaundice, Severe Dehydration, Severe persistant diarrheoa, Severe dysentry, not able to feed: REFER URGENTLY
[ii]Yellow: Local bacterial Infection, Jaundice, Low body temperature, Some dehydration, Feeding problem/ low birth wt: Proper Rx & follow up
[iii]Green: No dehydration, No feeding problem: Advise mother about home based care.
173.To prevent Yellow Fever Aedes aegypti index should be less than
A. 0.5 %
B. 1 %
C. 2 %
D 5 %
ANS-B
Also:
Validity of vaccination begins 10 days after the date of vaccination & extends upto 10 yrs.
Period of Quarantine: 6 days from the date of leaving an infected area.
Integrated Surveillance Disease Programme recommends which among the following for non-communicable diseases?
A. Sentinel surveillance.
B. Periodic Surveys.
C. Regular Surveillance.
D. All the above
ANS-C
175.National Family Health Survey is done every:
A. 6 months.
B. 1 yr
C. 5 yrs
D. 10 yrs.
ANS-C
NFHS-1 1992-93
NFHS-2 1998-99
NFHS-3 2005-06
176.MMR: type of vaccine-
A. Live attenuated
B. Killed
C. Toxoid
D. Subunit
ANS-A
As per immunisation schdule, Hepatitis A vaccine is recommended at:
A. 1 yr
B. 2 yrs
C. 5 yrs
D. 10 yrs
ANS- B
Ref: O P Ghai
"In IAP schdule of immunisation, Hepatitis A vaccine is recommended only for children > 18 months of age."
One DALY signifies:
A. 1 yr of disease free life.
B. 1 lost yr of healthy life
C. 1 month of bedridden life
D. None of these.
ANS-B
Tilted desks for IT engineers to prevent neck pain is:
A. Primordial prevention.
B. Secondary prevention.
C. Specific protection.
D. Disability limitation.
ANS- C
Normal range of BMI is:
A. 25- 29.99
B. 18.5-24.99
C. 18.5-29.99
D. 30-34.99
ANS-B
Berkesonian bias is due to:
A. Presence of confounding factors in both cases & controls.
B. Questioning the cases more thoroughly as compared to controls.
C. Different rates of admission to hospital due to different diseases.
D. Better recall by the cases as compared to controls.
ANS- C
A set of statements for monitoring progress towards goal completion is referred to as:
A. Targets
B. Objective
C. Programme
D. Procedure.
ANS-C
Ref: Park
Objective: It is a planned end point of all activities. It is either achieved/not achieved.
Target: It permits concept of degree of achievement, eg, no of blood films collected.
Programme: A sequence of activities designed to implement policies & accomplish objective.
Procedure: A set of rules for carrying out work, which ensures maximum use of resources & effort.
Simple random sampling is ideal for:
A. Vaccinated people.
B. Heterogenous population.
C. Homogenous population.
D. All of the above
ANS-C
For vaccinated children: Cluster sampling
For Heterogenous population: Stratified random sampling
184.Billings method of contraceptio