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Thread: AIIMS MAY '09 [Subjectwise Q/A with reference]

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    Post AIIMS MAY '09 [Subjectwise Q/A with reference]

    Anatomy :

    1. Right gastro epiploic artery is a branch of ?
    Ans: Gastroduodenal
    2. Capacitation of sperm takes place in ?
    Ans: Uterus.
    3. Structure not fully developed at birth?
    Ans: Mastoid antrum.
    4. Structure not lined by urothelium?
    Ans: Membranous urethra.
    5. Structure passing through aortic aperature with aorta?
    Ans: Thorasic duct, Azygus vein.
    6. Corneal endothelium is derived from ?
    Ans: Mesoderm.
    7. Pelvic Splanchnic nerve does not supply?
    Ans: Appendix.
    8. Structure does not pass deep to posterior belly of diagastric?
    Ans: Retromandibular vein.
    9. Deltoid ligament is not attached to?
    Ans: Medial cuneiform.
    10. Sphincter of Odii consists of?
    Ans: 3/4 sphincters????


    Physiology :

    11. In fetal hemoglobin oxygen has high affinity due to ?
    Ans: Decrease binding of 2,3 BPG
    12. Not an action of insulin?
    Ans: Ketogenesis.
    13. Muscles spindle detects?
    Ans: length.
    14. Nobel prize 2007 for Physiology ?
    Ans: Stem cell research on mice ...
    15. Central Processing of auditory tract ?
    Ans: Frequency
    16. Romberg sign?
    Ans: Proprioception
    17. False about rods and cones except?
    Ans: Transduction.
    18. Potassium secretion highest in ?
    Ans: Saliva
    19. Spino cerebellar tract ?
    Ans: Coordination of movement.
    20. False about chronic smoking Physiology ?
    Ans: Decrease carboxy haemoglobin and...
    21. Representation in cerebral cortex?
    Ans: ???? Vertical/ horizontal/ tangential/tandem
    22. Somatomedin receptor?
    Ans: ???? Increase glucose uptake/ chondroitin sulfate.
    23. True about color vision?
    Ans: Depends upon discrimination power.



    Biochemistry :

    24. NO synthesis takes place from?
    Ans: L- Arginine.
    25. Thiamine is associated with metabolism of ?
    Ans: Carbohydrate.
    26. Fastest mobility in paper electrophoresis?
    Ans: Aspartic acid.
    27. False about eukaryotic translation?
    Ans: N-formyl methionine is the initial...
    28. Not present in eukaryotic cell membrane?
    Ans: Triglyceride.
    29. LDL uptake in liver depends on?
    Ans: Apo E and Apo B-100.
    30. Patient with isolated increase in LDL and positive family history ?
    Ans: Defect in LDL receptor.
    31. Ammonium chloride bound to protein is separated by ?
    Ans: ???? Ion exchange
    32. Test used to detect single base pair mutation using oligomer as primer?
    Ans: ?? HPLC



    Pathology :
    33. Annexin V is associated with ?
    Ans: apoptosis.
    34. Not a major criteria in jones criteria?
    Ans: Increased ESR
    35. Hypersensitive vasculitis most commonly affects?
    Ans: Post capilary venule.
    36. Pauciimmune glomerulo nephritis seen in ?
    Ans: Microscopic polyangitis.
    37. Gene therapy most successful in ?
    Ans: SCID
    38. Finnish type of Nephrotic syndrome is due to mutation of?
    Ans: Nephrin
    39. True about metastatic calcification?
    Ans: Begins in mitochondria.
    40. In AD biopsy from brain shows?
    Ans: A beta amyloid
    41. Most common cause of oesophagitis?
    Ans: Reflux oesophagitis.
    42. Not associated with oesophageal carcinoma?
    Ans: HPV
    43. Wrong about bacterial killing?
    Ans: Brutton's X linked hypogammaglobulinemia...
    44. Not an heriditary cause of thrombosis?
    Ans: Anti phospholipid antibody syndrome.
    45. Not true about anti-phospholipid antibody syndrome?
    Ans: life threatening bleeding.
    46. Both hyperplasia and hypertrophy is seen in ?
    Ans: Uterus.
    47. Regenerative nodule in liver is most commonly seen in ?
    Ans:??? Autoimmune hepatitis.
    48. Carcinogenesis due to aging?
    Ans: Reactivation of telomerase.
    49. False about aneuploidy?
    Ans: ???


    Microbiology :

    50. Pt. with lip swelling, oedema of face, aggravated by stress?
    Ans: C1 esterase deficiency.
    51. Isolation of T. pallidum from CSF?
    Ans: Secondary syphilis.
    52. NOt a diamorphic fungi?
    Ans: Pylophora verucosa.
    53. Following is microaerophillic?
    Ans: C. jejuni.
    54. Gas gangrene is not caused by?
    Ans: C. sporogenese.
    55. Autoinfection is caused by?
    Ans: ??? Xanthostoma
    56. Does not cause malabsorption?
    Ans: ??? Strongyloides
    57. Culture medium for Leptospirosis?
    Ans: Korthoff medium
    58. MHC restriction is not seen in ?
    Ans: Autoimmune disease.
    59. Pt. with history of 6 months diarrhoea, stool microscopy revealing AFB
    positive and 10 micro meter organism ?
    Ans: Cyclospora
    60. Intermediate host of hydatid disease?
    Ans: Human.
    61. A man returning from a foreign country developed pain abdomen, jaundice,
    presence egg in bile duct?
    Ans: Chlonerchis sinensis.
    62. Not true about diagnosis of Toxoplasmosis?
    Ans: Detection of IgG antibody in newborn serum


    Pharmacology :
    63. Not an alkylating agent?
    Ans: 5-FU
    64. Maximum emetogenic ?
    Ans: Cisplatin.
    65. Do not aggravate myasthenia gravis?
    Ans: Azathioprine.
    66. Digoxin toxicity is not aggravated by ?
    Ans: Hyperkalemia
    67. False about cephalosporin?
    Ans: Cefoxitin is not active against anaerobes.
    68. Not true about amiodarone toxicity?
    Ans: Productive cough.
    69. TOLAZOLINE is ?
    Ans: Vasodialator...
    70. Cetuximab?
    Ans: Head and neck cancer.
    71. Thalidomide is not used in
    Ans: HIV neuropathy.
    72. False about Warfarin?
    Ans: Dose to be increased in liver disease.
    73. Pharmacovigilance?
    Ans: Dealing with adverse effect and safety of drug.
    74. Heparin toxicity counteracted by ?
    Ans: Protamine sulfate.
    75. Can be given orally?
    Ans: Mesna.
    76. Heroine dependance used?
    Ans: Disulfiram.
    77. Not used for anticraving of alcohol withdrawal?
    Ans: Topiramate.
    78. Cerebellar toxicity is seen in ?
    Ans: Cytarabine
    79. False about ACE inhibitor?
    Ans: Diuretics can cause first dose hypotension...
    80. True about MDR?
    Ans: Efflux of drugs out of cell.


    Forensic MEDICINE:

    81. Incised wound found in genitalia?
    Ans: Homicidal.
    82. Injury done by a [bleep] proportional to?
    Ans: Velocity.
    83. Patient with heavy metal poisoning, abdominal pain, garlic odour,
    white line on nail?
    Ans: Arsenic.
    84. Less force cause more damage in ?
    Ans: Face.
    85. Formication and delusion of persecution seen in?
    Ans: Cocaine.
    86. False about antemortem contuison?
    Ans: Sharp margin.
    87. Allopurinol is used ?
    Ans: As preservative.


    SPM :

    88. Prevalence of a disease at a perticular time?
    Ans: Cross-sectional study.
    89. Nested control study?
    Ans: Retrospective study.
    90. After tetanus toxoid vaccination atrophy of shoulder muscle weakness ?
    Ans: Brachial neuritis.
    91. STEPS ?
    Ans: Non communicable disease.
    92. HIV screening not done in?
    Ans: Street children.
    93. NPCB 10th five year plan not true?
    Ans: Vitamin A should be given to all children below 1 year...
    94. Approaval of lisence of blood bank?
    Ans: Central Drug controller.
    95. Profit ahead of health ?
    Ans: ????
    96. Stable behaviour liable to change ?
    Ans: ??? Attitude.
    97. Person realises the effect on him...
    Ans: ??? Belief
    98 . Not true about confounding ?
    Ans: Selecting a small group for eliminating confounding.
    99. Mercury is best disposed by?
    Ans: ??? Deep burial/ safe collection and reuse.
    100. 20 year h/o smoking, relative warn about complication, himself belive it may cause relapse?
    Ans: ?? Precontemplation and preparation.
    101. Not a method of health education?
    Ans: ???
    102. Not denotes association of disease?
    Ans: P Value/ Coefficient of association/ Odd's ratio/ ANSWER
    103. Basic reproductive rate ?
    Ans: ???


    OPTHALMOLOGY :

    104. Refractive index is highest ?
    Ans: Centroid of lens.
    105. Sclera is thinnest at?
    Ans: Just behind the insertion of extra-occular muscles.
    106. Fracture roof of orbit?
    Ans: Blow on frontal bone.
    107. Which does not maintain anterior posterior stability of eye ball?
    Ans: ???
    108. Enophthalmos is caused by?
    Ans: ???
    109. Pt. complaining of right eye blurring, after 3 month left eye, perpheral
    scotoma,macular edema, telengiectasia, pupillary reflex present?
    Ans: Leber's hereditary optic neuropathy.
    110. Bell's palsy treatment?
    Ans: Steroid + acyclovir
    111. One eye abduction defect, other eye adduction defect, normal convergence?
    Ans: ???? INO



    ENT:

    112. Endolymph is secreted from?
    Ans: Stria vascularis
    113. Cranial nerve VIII carries sensation of ?
    Ans: Balance
    114. About spasmodic dysphonia?
    Ans:???
    115. High frequency audiometry?
    Ans: Ototoxicity.


    MEDICINE:

    116. Skip lesions seen in ?
    Ans: Crohn's disease
    117. Most common cause of death in Crohn's disease?
    Ans: Malignancy
    118. Not true about primary sjogren syndrome?
    Ans: Connective tissue disorder.
    119. False about tumorlysis syndrome?
    Ans: Hypercalcemia.
    120 False about neurofibromatosis?
    Ans: Autosomal recessive.
    121. Not a cause of left ventricular hypertrophy?
    Ans: MS
    122. MC cause of acute right ventricular failure?
    Ans: Acute pulmonary embolism.
    123. Not a cause of subcortical dementia?
    Ans: AD
    124. Not used in acute hyperkalemia?
    Ans: Sodium bicarbonate.
    125. Not a blood born disease?
    Ans: EBV
    126. Not a complication of blood transfusion?
    Ans:???? Metabolic acidosis/ Leukocytosis
    127. False about wilson's disease?
    Ans: Urinary excretion of copper less than 200 ...
    128. A lady with sudden onset of headache, neck stiffness...
    Ans: Sub arachnoid haemorrhage.
    129. Not correct about CNS Pathology in HIV?
    Ans: Inclusion body.
    130. Not true about Prion disease?
    Ans: 10 % cases show myoclonus.
    131. Fructosamine measurement useful in?
    Ans: ???
    132. Teratogenicity of DM ?
    Ans: ???
    133. Right sided brain lesion not a feature ?
    Ans: ??



    SURGERY:

    134. Sister Mary Joseph nodule ?
    Ans: Gastric Ca
    135. Penile angiography is not done in?
    Ans: Peronie's disease.
    136. Beevor's sign ?
    Ans: Weakness in abdominal muscle.
    137. Penetrating neck injury ?
    Ans: Breach in platysma.
    138. Highest chance of nosocomial infection?
    Ans: Endoscopic procedure.
    139. Not true about choledocal cyst?
    Ans: Type 2 is most common.
    140. NOt true about hepatic duct?
    Ans: Caudate lobe ...
    141. CDC criteria for stage 4 AIDS all except?
    Ans: Oral candidiasis.
    142. RCC prognosis depends on?
    Ans: ??? Staging/ Histology.
    143. Right hepatic duct drains from all except?
    Ans: Lobe III
    144. Not true about seminoma?
    Ans: Seminoma is more aggressive than non-seminoma.


    PAEDITRICS:

    145. Teatment of choice in Kawasaki disease?
    Ans: IV Ig
    146. Child with rash, palpable purpura, abdominal pain?
    Ans: HSP
    147. False about CPAP?
    Ans: ??? Phophylactically given to all children below 1 kg weight and...
    148. B/l nephrocalcinosis is seen in a/e?
    Ans: ARPKD
    149. A girl with body pigmentation, without hypertension, normal external genitalia?
    Ans: Congenital glucocorticoid deficiency.
    150. Swelling in hip, flexed abducted mgt?
    Ans:?? Send home and follow up
    151. Which is false?
    Ans: Vitamin D deficiency causes keratomalacia.
    152. Wrong about scurvy?
    Ans: Bowing of leg is characteristic
    153. Child with hepatosplenomegaly, adrenal calcification, nausea, vomiting?
    Ans: Wolman syndrome.
    154. False about Langerhans histiocytosis?
    Ans: ??? Gonads are invariably involved / Highly sensitive to radiotherapy.
    155. True about pilocytic astrocytoma a/e?
    Ans: Median age of presentation is 80 years.
    156. Child with Hypotension and hyperkalemia first investigation to be done?
    Ans:??? Aldosterone


    ORTHOPAEDICS:

    157. Osteomyelitis takes place in ?
    Ans: Metaphysis.
    158. Crescentic fracture ?
    Ans: Fracture involving sacroiliac joint and illiac crest.
    159. Most common cause tarsal tunnel syndrome?
    Ans: Rheumatoid arthritis.
    160. Emergency fixation of acetabular fracture is required in a/e?
    Ans: ???
    161. Kocher's Langebach procedure false is?
    Ans: ???
    162. Posterior glenohumeral joint instability is tested by?
    Ans: ??? Sulcus test/ crank test.


    Obs AND GYN:
    163. Most suitable time for trans abdominal CVS ?
    Ans: 11- 13 wks
    164. Pt with creamy discharge and fishy odor t/t?
    Ans: Metronidazole.
    165. MRKH syndrome?
    Ans: ??? None.
    166. Absolute contraindication for pregnancy?
    Ans: Eisermenger syndrome.
    167. WHO guidelines for HIV screening in pregnancy?
    Ans: Opt in.
    168. Ideal contraceptive in early married couple?
    Ans:?? barrier/ OCP
    169. Not an indication of elective caesarian section?
    Ans: WPW syndrome.
    170. Role of Estorgen in DM ?
    Ans: ???
    171. Pregnant lady with sputum AFB positive?
    Ans: Treat as category I
    172. True about Vasa previa?
    Ans: ???
    173. True about Clomefene citrate?
    Ans:???
    174. True about event at the time of Ovulation?
    Ans: ???
    175. Which is not a sphincter of vagina?
    Ans: Internal urethral meatus.


    SKIN :

    176. Patch test ?
    Ans: Type IV hypersensitivity reaction
    177. Deposition of IgG in intercellular region of epidermis?
    Ans: Pemphigus vulgaris.
    178. Subepidermal deposition of IgA ?
    Ans:??? Dermatitis Herpetiformis.


    Psychiatry :

    179. Binge eating with self induced vomiting ?
    Ans: Bulimia nervosa.
    180. Reflex hallucination is a morbid condition of ?
    Ans:Synaesthesia.
    181. Hallucination?
    Ans: ???
    182. Mentally retarded children t/t?
    Ans:???


    Anaesthesia :

    183. Flat capnography is seen in all except?
    Ans: Failing mechanical ventilation.
    184. Decrease in dead space?
    Ans: Artificial ventilation.
    !85. Coeliac plexus block complication ?
    Ans: Hypotension.
    186. Methaemoglobinaemia is caused by?
    Ans: Prilocaine.
    187. Cardiostable drug?
    Ans: Etomidate.
    188. All causes increase in dead space except?
    Ans: Tracheostomy.


    RADIODIAGNOSIS:

    189. Osteosclerotic lesion in bone ?
    Ans: Cancer Prostate.
    190. Double bubble sign?
    Ans: Duodenal atresia.
    191. Best view for c1 C2 vertebra?
    Ans: Odontoid view.
    192. Housfield unit?
    Ans:??? Linear attenuation coefficient.
    193. Not a feature of left heart failure in X ray?
    Ans: Oligemic lung field.
    194. Reversible myocardial ischaemia?
    Ans: Thallium scan.
    195. Stereotactic surgery all are used except?
    Ans: Electron.
    196. Dye used for endoscopic procedure to detect malignancy?
    Ans: ??? Methylene blue/ Toluidine blue.
    197. Cerebral blood flow measured by?
    Ans: MRI perfusion.
    198. Not seen in papilary necrosis?
    Ans: ??? Increased concentration of nephrogram.
    199. MC organ damage occur?
    Ans: ???
    200. ???
    Ans: ???

  2. #2
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    1.Digitalis Toxicity seen in a/e:-
    a) Hyperkalemia
    b)Hypomagnesemia
    c)Hypercalcemia
    d) Renal Failure

    2.Neurofibromatosis all are true except
    a) Autosomal Recessive
    b)Scoliosis
    c)Neurofibroma
    d)Pheochromocytomas association

    3.Enophthalmos is caused by :-
    a) Superior levator palpebriosis paralysis
    b)Tenons capsule instablility
    c)Orbiculis oculi paralysis
    d)

    4.Which is given orally
    a) Mesna
    b)Cytosine
    c)Actinomycin D
    d)Doxorubicin

    5. Sister joseph mary nodule in which ca
    a )gastric
    b) pancreatic
    c) Colon
    d) Ovarian

    6. sphincter of oddi has how many sphincters
    2
    3
    5
    7
    7. Which migrates fastest on paper chromatography (i think it was with solvents like methanol,chloroform)
    A) aspartic acid
    B) glycine
    C) leucine
    D)valine

    8. Methaemoglobinemia is caused by which Local Anaesthetic
    A) prilocaine
    B) procaine
    C)
    D)
    9. NO formed in body by
    A) Arginine
    B)
    c)
    D)

    10. Which s not true about primary sjogrens Syndrome
    a) xerostomia
    b) xeropthalmia
    c) lymphoma
    d) Connective tissue disorder

    11. Left heart failure finding all are true except :-
    a) Oligemic lung fields
    b)Kerley B lines
    c) Redistribution to apex
    d)Cardiomegaly

    12. Contraindications for cesarean section in pregnancy
    a) Eisenmenger synd
    b) AS
    c) Cardiomyopathy
    d) Aortic regurgitation

    13. Stability of post gleno humeral jt tested by :
    a) Jerk's test
    b) falcrum test
    c) Crank test
    d) Sulcus test

    14Cetuximab used in
    a) Palliative rx in head neck ca
    b) anal canal ca
    c) small cell ca lung
    d) gastric cancer

    15. which is not supplied by pelvic splanchnic nerves?
    a).appendix
    b)uterus
    c)rectum
    d)urinary bladder

    16. All are of adult size at birth except
    1. mastoid antrum
    2.ossicles
    3.orbital cavity
    4.Tympanic cavity

    17. Drugs not used for t/t acute hyperkalemia
    A) insulin + glucose
    B) k+ exchange resins
    C)calcium carbonate
    D) sodium bicarbonate

    18.Treatment of TB in pregnancy :-
    a) Category 1 treatment in 1st trimester
    b)Delayed till second trimester
    C)Category 2 treatment in 1st trimester
    D) Cat 3 treatment in 1st trimester

    19) Blood banks get permission to operate from
    A) naco
    B)nabl
    C)state health ministry/ ministry of health
    D)drug CONTROLLER GENERAL OF INDIA

    20)True about Metastatic calcification :-
    a) Starts in mitochondria
    b)Occurs in damaged cardiac valves
    c)Occurs in dead tissues
    d)Calcium levels are normal

    21) Stereotactic surgery includes all except
    a)liner accelerator
    b)proton
    c)electron
    d)Gamma knife

    22) Pharmacovigilance
    A)Check costs
    b)Check drug safety
    c) Check unethical trade practices by pharma companies
    d)Monitoring of students

    23) Most common cause of acute right heart failure
    A) Massive Pulmonary embolism
    B) Tricuspid Stenosis
    c) Pulmonary Stenosis
    d) Tricuspid regurgitation

    24) Hyperplasia and Hypertrophy both are seen in
    A) Breast enlargement during lactation
    B) Uterus during pregnancy
    C) Skeletal muscle enlargement during exercise
    D) Left Vent Hypertrophy during heart failure

    25) Nobel prize 2007 for medicine was given for :-
    a) Detection of chemical /growth factors for for preventing growth of tumors
    b) Principles for introducing specific gene modifications in mice by the use of embryonic stem cells
    c)non genetic method method treating muscular dystrophies
    d)

    26) Site of where osteomyelitis starts establishing
    A)epiphysis
    B)Metaphysis
    C)Diaphysis
    D) Site where nutrient artery enters bone

    27) Tarsal Tunnel syndrome is seen with which arthritis :-
    a)RA
    B) Psoriatic arthritis
    C) Ankylosing Spondylitis
    d) Osteoarthritis

    2Cool Scurvy all are characteristic except
    A) Bowing of legs
    B) Widening of epiphysis
    C) in adults skeletal features are found clinically
    D)

    29) Following are true about Wilson`s disease except
    a) ceruloplasmin <20
    b) cu excretion<100ug
    c) autosomal recessive
    d)

    30) Kocher Langenback procedure done in emergency treatment of acetabular # all except
    a) recurrent dislocations despite treatment
    b) open acetabular fracture
    c) sciatic nerve entrapment
    d)

    31) Alcohol anti craving agents all are used except
    a) Lorazepam
    b) Clonidine
    c) Acamprostat
    d) Naltrexone

    32) Reversible ischemia of the heart is detected by
    a) Angiography
    b) Thallium
    c) MUGA
    D) Resting Echocardiography

    33) Mayer Rokintansky kuster hauser :-(exact options none seem completely true)
    a) ovary uterus tubes absent
    b) uterus absent, tubes and ovary present
    c) uterus present , tubes and ovary absent
    d) Uterus ,tubes and ovary present

    34) Double bubble sign is seen in
    a) Duodenal atresia
    b) Pyloric stenosis
    c) oesophageal atresia
    d) Jejunal atresia

    35) Max potassium ions secretions of :
    a) Colon
    b) salivary glands
    c) Stomach
    d) Duodenum

    35) Most common cause of cancer with ageing :-
    a) telomerase inhibition
    b) telomerase activation
    c) supression of proto oncogenes
    d) increased signals for apoptosis

    36) Death in Crohns of small intestine most commonly due to
    a) Thromboembolism
    b) Sepsis
    c) Malignancy
    d) electrolyte imbalance

    37) VIII nerve receives afferents of
    a) Taste
    b) Balance
    c) Hearing
    d) Equilibrium

    3Cool Rt Gastroepiploic artery is a branch of
    a) Splenic
    b) Gastroduodenal A
    c) Superior Mesenterc
    d) Celiac

    39) Structures deep to the posterior belly of digastric
    a) Hypoglossus
    b) Hypoglossal N
    c) Retromandibular V
    d) Occipital Artery

    40) Treponema pallidum isolated from csf in
    a) primary syphilis
    b) secondary syphilis
    c) tertiary syphilis
    D) tabes dorsalis

    41) Structure passing along with aorta in aortic hiatus:-
    a) thoracic duct and azygous vein
    b) thoracic duct and hemiazygous vein
    c) Lt Vagus nerve and azygous vein
    d) Hemiazygous vein and vagus nerve

    42) In prions disease all are true except:-
    a) They are caused by infectious proteins
    b) Biopsy of brain diagnostic
    c) Neurodegenrative all
    d)

    43) Tolazoline is used in:-
    a) vasoconstrictor used in rx of gastrooesophageal varices
    b) Vasodilator used during Coronary catheterization
    c) newer antispasmodic during billary spasm
    d)

    44) Allopurinol used in organ preservation as:
    a)antioxident
    a) Free radical destruction
    b) Preservative
    c) Antioxidant
    d) None of above

    45) Most important prognostic factor of renal cancer based on
    a) Size of tumour
    b) Pathological grading
    c) Nuclear Grading
    d) Histologic type

    46) Microaerophillic bacteria:-
    A) Campylobacter
    b) Vibrio Cholera
    c)
    d)

    47) Pain in arm after tetanus vaccine 5 days after vaccination due to
    a). Brachial neuritis
    b). Radial n. entrapment
    c) Thoracic outlet syndrome
    d)

    4Cool Which species of Clostridum does not cause gas gangrene?
    a) Cl. perfringes
    b) Cl. Histolyticum
    c) C . Novyii
    d) C. Sporogenes

    49) Sometomedin in physiological conc causes:-
    a) Increase lipolysis
    b) Gluconeogenesis
    c) glucose intake in cells
    d)

    50)Estrogen action on carbohydrate metabolism
    a) Worsening of niddm
    B) Increase uptake of glucose through increase in insulin sensitivity
    c) Glycolysis increase
    d) Increasing central adipose deposition

    51) Cpap all are true except
    a) Given prophylactically in preterm with Resp distress
    b) started with fio2 50-60%
    c) Given in infants less than 28 weeks and less than 1 kg weight
    d) Improves oxygenation and improves lung compliance

    52) All are true except :-
    a) Chediak highashi syndrome due to defective phagolysosome formation
    b) in brutons agammaglobulinemia opsonisation is not affected
    c) myeloperoxidase action mainly due 2 ocl-
    d) nadph oxidase acts via superoxide ions?

    53) Deltoid ligament is not attached to
    1. medial cuneiform
    2. medial malleolus
    3. sustetntaculum tali
    4. spring ligament

    54) Skip Lesions seen in
    a) Crohns Disease
    b) Ulcerative Colitis
    c) Typhoid
    d)

    55) segment of liver which drains into left hepatic duct
    a) 1
    b) 3
    c) 5
    d) 8

    56) Pauci immune glomereulonephritis
    a) After transplant in alports
    b) microscopic polyangitis
    c) Henoch Sconlein nephritis
    d)

    57) Hounsefield Units depends on
    a) Electron density
    b) Mass density
    c) effective atomic no.
    d)attenuation effect

    5Cool Most common cause of esophagitis
    A) Smoking
    B) Alcohol
    c) Reflux Disease
    d) Increased intake of Spices

    59) Most common cause for nosocomial infection
    a) Admission for elective surgery
    b) admission for Cesarean section
    c) Know neoplasm patient in OPD for followup
    d) Endoscopic evaluation

    60) stain used 2 find carcinoma while doin endoscopy
    a) toluidine blue
    b) gentian violet
    c) hematoxylin 2 eosin
    d) Methylene Blue

    61) Cuts on genitalia?
    a) Homicidal
    b) Suicidal
    c) Accidental
    d) Self Inflicted

    62) LV Hypertrophy doesnot occur in
    a) MS
    b) AR
    c) AS
    d) MR

    63) Bruise are easily formed in :-
    a) Scalp
    b) Soles
    c) Palm
    d) Face

    64) Blood bourne infections all/Except
    a) Hep G
    b) EBV
    c) CMV
    d) Parvoviris B19

    65) Not a premalignant lesion of esophagus
    A) medistinal fibrosis
    B) caustic burn
    C) human papilloma virus
    D) diverticula

    66) Most important in CHD:-
    A) LDL
    B) HDL
    C) Triglycerides
    D) VLDL

    67) A 10 month old baby previously normal sudddenly become dead in his cirb. in intensive care unit. external app and genitalia were normal. blood glucose 30 mg%.hyperpigmentation present. Diagnosis :-
    a) 21 hydroxylase deficiency
    b) Hyperinsulinemia
    c) Familial glucocorticoid deficiency
    d) Cushings syndrome

    6Cool Higher freuency audiometry used in :-
    a) Minieres disease
    b)Otosclerosis
    c)Ototoxicity
    d) Non Organic deafness

    69) Hyponatremia and Hyperkalemia in a child. Which hormone is to be evaluated first
    a) Aldosterone
    b) Renin levels
    c) testoseone
    d) Cortisol

    70) Penetrating neck trauma :-
    a) Violating the platysma layer of the neck
    b) 2 cm depth invasion
    c) Any trauma damaging Vital structure in neck
    d)

    71) During Ovulation phase :-
    a) Increase in inhibin A level
    b) Fsh induce steroidogenesis in granulosa cells
    c) activin increase
    D)

    72) medullary Nephrocalcinosis not seen wiith
    A) Hyperoxaluria
    B) Bartter's
    C) Prolonged use of Furosemide
    D) ARPKD

    73) physiological dead space is increased by all except
    A). artificial airway
    B) . neck extension
    C). upright position
    D) anticholineesterases

    74) Highest emetic potential is by
    A) cisplatin
    B) high dose methotrexate
    C) high dose Cyclophosphamide
    D)

    75) All are dimorphic except
    1.Blastomyces
    2. Histoplasma
    3. Pencillium marfucci
    4. Phialopora

    76) which s safe in myasthenia gravis
    A) aminoglycosides
    B) azathioprine
    C) tetracycline
    D) phenytoin

    77) All cause Malabsorption syndromes except
    A) Giardiasis
    B) Ascaris
    C) Strongyloides
    D) Capillaria phillipinesis

    7Cool A 7 year old boy with abrupt onset of pain in hp with hip abducted investigations normal except for a high value of ESR. wats your next line of management?
    A) Observe
    b) intravenous antibiotics
    c) USG guided aspiration of hip
    d)

    79) Thiamine requirement by body depends on consumption of
    A) Carbohydrates
    B) fats
    C) Amino acids
    d)

    80) Hypersensitivity mcly vasculitis involves
    A) arterioles
    B) post capillary venules
    C) capillaries
    D) medium sized arteries

    81) cerebellar ataxia is caused by
    A) cytosine arabinoside
    B) bleomycin
    C)cisplatin
    D) Busulfan

    82) Most cardio stable
    a) Ketamine
    b) propofol
    c) etomidate
    d)

    83) Subcortical dementia occurs in all except
    A) alzheimers
    B) supra nuclear palsy
    C) parkinson's
    D) HIV Ass dementia

    84) C1 C2 best seen in
    a) Lat view
    b) Oblique view
    c) AP view
    d) Odontoid view

    85) Maximum refractive index is for
    a) cornea
    b) anterior part of lens
    c) centroid of lens
    d) posterior part of lens

    86) Thinnest pat of sclera
    a) Equator
    b) Limbus
    c) In front of rectus
    d) cm behind origin of rectus

    87. crescent # pelvis true is
    a) seperation of pubis with ramus #
    b) sacroilliac #
    c) acetabulular --

    88.listeria culture media
    a) baker
    b) kortoff
    c)

    89. which LA causes metHBnemia?
    a. procaine
    b. Prilocaine
    c. cocaine

    90. macronodular regenerative changes most commonly occurs in?
    a. cirrhosis
    b. alcohol
    c. hepatitis b
    d.

    91. intermediate host of e. granulosa is ?
    a. sheep
    b. man
    c. dog
    d. cat

    92.drug of choice in bacterial vaginosis?
    a. metronidazole
    b. doxycycline

    93. a farm worker presented with abdominal pain with garlic odour and linear line in nails?
    a. lead poisoning
    b. arsenic

    94. reflex hallucination is a type of?
    a. kineathesia
    b. parathesia

    95. nested case control study is a?
    a. prospective study
    b. retrospective study

    96. all is true about halucination except?
    a. it occurs in inner subjective
    b it is as vivid as real sensation
    c. it occurs in absence of a stimuli
    d. It occurs without will of subject

    97 .endolymph is secreted by?
    a. striae vascularis
    b.

    [snip].Blood Transfusion complications are all except?
    a. hyperkalemia
    b. citrate toxicity
    c. metabolic acidosis
    d. leukocutosis

    99. amiodarone side effects a/e
    a.hepatic cirrhosis,
    b.corneal microdeposits
    c.productive cough
    d. pulmonary fibrosis

    100 .right eye adducted,near accomodation normal with saccades.
    a.duane's retraction syndrome
    b.partial third nerve palsy
    c.abducent palsy
    d.

    101.Stability of eye ball all responsile except
    a. Superior oblique
    b. Superior rectus
    c. orbital fat
    d.

    102.muscle spindle functions
    a.maintain muscle length.
    b.muscle tension
    c.

    103. Beevor's sign is used for
    a. test rectus abdominis strength.
    b.

    104. CDC screening for HIV screening in pregnancy
    a.opt out testing
    b. opt in testing
    c.universal testing
    d. symptomtic

    105.which one is most common organism causing malabsorption in HIv and is acid fast
    a.Cryptosporidium
    b.Microspora
    c.Isospora
    d.

    106.Diff b/w antemortem and pm bruise
    1) sharp edge
    2) coag in bld vsls
    3) raised
    4)

    107 .capacitance of sperms takes place in
    a.epididymis
    b.seminiferous tubules
    c.uterus
    d.vas deference

    108. Safe disposal of Mercury?
    a. Bury under earth
    b. Collect carefully and reuse
    c. combustion...?
    d. ?

    109.A man taking 20 cigaretts per day coughing,family suggest quitting cigaretts but ready to quit but thinks that quitting will make him irritable
    the best health planning model followed
    a. cost and survival
    b. persuation
    c.
    d.

    110.Gene therapy used in?
    a. Cystic fibrosis
    b. Sickle
    c. Thallasemia
    d. Severe Combined Immunodeficiency

    111.reatment of Kawasaki's?
    a. IVIg
    b. Steroids
    c. Thalidomide

    112.mhc restriction to antigen presentation is not done for
    a. killing of viruses by cytotoxic cells
    b. opsonization bacteria by helper cells
    c.. autoimmune diseases
    d.hypersenstivity


    113.false about cephalosporins
    a.cetazidime s 3rd gen
    b.cefoxitin is not anti anaerobic
    c.cefoperazone s anti pseudomonal


    114.roof of orbit is is blown in due to?
    1.blow on forehead
    2. blow on lower jaw
    3. fall on back
    4. blow in parietal region

    115.subcortical dementia occurs in all except
    1. alzheimers
    2. supra nuclear palsy
    3. parkinson's
    4.supra tentorial tumours


    116.tumour lysis synd all occurs except?
    a. hyperkalemia
    b. hypercalcemia
    c.hyperuricemia
    d.hyperphosphatimia



    117.70.a man on return from a country with pain abdomen, jaudice. usg showin a worm in the common bile duct. wat culd b the organism
    1.fasciola buski
    2, clonarchis sinensis
    3.strogyliods
    4. acylostoma

    118.clomiphene citrate true statement
    a.twin pregnancy in 5-6% of pregnancies
    b.3 fold increase in pregnancy compare 2 placebo
    c.emclomiphene acts an antiestrogen

    119. Formication and delusion of persecution occurs in
    1.Cocaine
    2.Amphetamine
    3.Cannabis
    4.Morphine

    120. Which of the following is NOT a cause of congenital hypercoagulability?
    a) Protein C deficiency
    b) Protein S deficiency
    c) Antiphospholipid antibody syndrome
    d) MLCTR gene mutations

    121. Which doesnt measure association??
    a) p value
    b) Odds ratio
    c) Relative risk
    d) Alpha traditional levels

    122)intercellular deposits of IgG in epithelium
    a.pemphigus
    b.
    c.
    d.
    123)IgA deposits in dermis
    a.dermatitis herpetiformis
    b.
    c.
    d.
    124)repeat question about ace inhibitors
    a.first dose hypotension can be prevented if diuretics are omitted
    b.
    c.
    d.
    125)rods and cones are different from each other in all ways except
    a.signal conduction???????
    b.
    c.
    d.
    126)repeat q about STEPS

    127)thalidomide used in all except
    a.hiv asso neuropathy
    b.hiv asso oral ulcers
    c.enl
    d.

    128)hypersensitivity vasculitis affects
    a.post capillary venules
    b.arteries
    b.veins
    d.
    129)osteosclerotic lesions seen in
    a.prostate ca
    b.kidney ca
    c.
    d.
    130)fructosamine levels used for
    a.short term sugar control
    b.
    c.
    d.
    131)medium for leptospira

    132)structures passing through aortic opening in diaphragm

    133) all are about choledochal cyst except
    a.type 2 is most common
    b.danger of rupture and causing biliary peritonitis
    c.asso with pancreatic duct anomalies?????
    d.

    134)penile angiography indications are a/e
    a.ischemic erectile dysfunctiuon
    b.peyronis disease
    c.
    d.

    135)double sign seen in
    a.duodenal atresia
    b.
    c.
    d.

    136)treatment of cracky spasmodic voice in a child/person???
    a.type 4 thyroplasty
    b.adductor
    c.abductor
    d.

    137)treatment of pregnant lady with primary pulm tb newly diagnoced
    a.immediately start cat 1 treatment
    b.delay cat 1 treatment till second trimester
    c.start cat2
    d.start cat 3

    138)urothelium present in a/e
    bladder
    membranous urethra
    ureter
    calyces

    139)granulomatous pyelonephritis all are true except

    140) best contraception for young married couple

    141)not a part of hiv stage 4 accd to CDC
    a.oral candidiasis
    b.pcp
    c.
    d.toxo???

    142)basic reproduction rate

    143)treponema detected in csf.diagnosis is
    a.primary syphilis
    b.secondary syphilis
    c.tertiaty syphilis
    d.tabes dorsalis

    144) pilocytic astrocytoma.all true except
    a.seen in eldery above 89yr
    b.
    c.
    d.

    145)annexin V

    146)timing of chorionic villous biopsy

    147)heaRT disease asso with which cholesterol
    a.ldl
    b.chylomicrons
    c.
    d.

    148)endothelium of cornea derived from

    149) pelvic splanchnic nerves supply a/e
    a.appendix
    b.rectum
    c.uterus
    d.

    150)patch test based on

    151) intermediate host in hydatid disease

    152)binge eating followed by forceful vomiting

    153)high affinity of hbF with O2 due to

    154)absent in eukaryote cell wall
    a.carbohydrate
    b.lecithin
    c.cholesterol
    d.

    155)mental retardation child.therapy in such case
    a.CBT
    b.cognitive something
    c.self trainig
    d.

    156) extent of [bleep] injury depends on
    a. mass
    b. velocity
    c.shape\
    d.

    157)features of hiv in brain/cns.

    158) MDR defn.

    159)rombergs sign positive on eyes closed.diagnosis

    160)function of spinocerebellar tract

    161) all are true about LCH except

    162)auditory pathway in brain for
    a.speech recognition
    b.direction of sound
    c.
    d.

    163)lebers optic neuropathy

    164)autoinfection seen with

    165)stereotactic surgery done by a/e
    a.gamma
    b.electron
    c.proton
    d.

    166) putting profit before health

    167) A 10 month old baby previously normal sudddenly become dead in his cirb. in intensive care unit. external app and genitalia were normal. blood glucose 30 mg%.hyperpigmentation present. Diagnosis :-
    a) 21 hydroxylase deficiency
    b) Hyperinsulinemia
    c) Familial glucocorticoid deficiency
    d) Cushings syndrome

    168) Higher freuency audiometry used in :-
    a) Minieres disease
    b) Otosclerosis
    c) Ototoxicity
    d) Non Organic deafness

    169) Hyponatremia and Hyperkalemia in a child. Which hormone is to be evaluated first
    a) Aldosterone
    b) Renin levels
    c) testoseone
    d) Cortisol

    170) Penetrating neck trauma :-
    a) Violating the platysma layer of the neck
    b) 2 cm depth invasion
    c) Any trauma damaging Vital structure in neck
    d)

    171) During Ovulation phase :-
    a) Increase in inhibin A level
    b) Fsh induce steroidogenesis in granulosa cells
    c) activin increase
    D)

    172) medullary Nephrocalcinosis not seen wiith
    A) Hyperoxaluria
    B) Bartter's
    C) Prolonged use of Furosemide
    D) ARPKD

    173) physiological dead space is increased by all except
    A). artificial airway
    B) . neck extension
    C). upright position
    D) anticholineesterases

    174) Highest emetic potential is by
    A) cisplatin
    B) high dose methotrexate
    C) high dose Cyclophosphamide
    D)

    175) All are dimorphic except
    1.Blastomyces
    2. Histoplasma
    3. Pencillium marfucci
    4. Phialopora

    176) which is safe in myasthenia gravis
    A) aminoglycosides
    B) azathioprine
    C) tetracycline
    D) phenytoin

    177) All cause Malabsorption syndromes except
    A) Giardiasis
    B) Ascaris
    C) Strongyloides
    D) Capillaria phillipinesis

    178) A 7 year old boy with abrupt onset of pain in hip with hip abducted. investigations normal except for a high value of ESR. What is next line of management?
    A) hospitalize and Observe
    b) intravenous antibiotics
    c) USG guided aspiration of hip
    d)

    179) Thiamine requirement by body depends on consumption of
    A) Carbohydrates
    B) fats
    C) Amino acids
    d)

    180) Hypersensitivity mcly vasculitis involves
    A) arterioles
    B) post capillary venules
    C) capillaries
    D) medium sized arteries

    181) cerebellar ataxia is caused by
    A) cytosine arabinoside
    B) bleomycin
    C) cisplatin
    D) Busulfan

    182) Most cardio stable
    a) Ketamine
    b) propofol
    c) etomidate
    d)

    183) Subcortical dementia occurs in all except
    A) alzheimers
    B) supra nuclear palsy
    C) parkinson's
    D) HIV Ass dementia

    184) C1-C2 # is best seen in
    a) Lat view
    b) Oblique view
    c) AP view
    d) Odontoid view

    185) Maximum refractive index is for
    a) cornea
    b) anterior part of lens
    c) centroid of lens
    d) posterior part of lens

    186) Thinnest pat of sclera
    a) Equator
    b) Limbus
    c) In front of rectus
    d) cm behind origin of rectus

    187. crescent # pelvis true is
    a) seperation of pubis with ramus #
    b) sacroilliac #
    c) acetabulular –
    d)

    188.listeria culture media
    a) baker
    b) kortoff
    c)

    189.Formication and delusion of persecution occurs in
    1)Cocaine
    2.Amphetamine
    3)Cannabis
    4)Morphine

    190. macronodular regenerative changes most commonly occurs in?
    a) cirrhosis
    b) alcohol
    c) hepatitis b
    d)

    191). intermediate host of e. granulosa is ?
    a) sheep
    b) man
    c) dog
    d) cat

    192.drug of choice in bacterial vaginosis?
    a) metronidazole
    b) doxycycline
    c) ofloxacin

    193. a farm worker presented with abdominal pain with garlic odour and linear line in nails?
    a. lead poisoning
    b. arsenic

    194. reflex hallucination is a type of?
    a. kineathesia
    b. parathesia
    c) hyperesthesia

    195. nested case control study is a?
    a. prospective study
    b. retrospective study

    196. all is true about halucination except?
    a. it occurs in inner subjective
    b it is as vivid as real sensation
    c. it occurs in absence of a stimuli
    d. It occurs without will of subject

    197 .endolymph is secreted by?
    a. striae vascularis
    b.

    198.Blood Transfusion complications are all except?
    a. hyperkalemia
    b. citrate toxicity
    c. metabolic acidosis
    d. leukocutosis

    199. amiodarone side effects a/e
    a.hepatic cirrhosis,
    b.corneal microdeposits
    c.productive cough
    d. pulmonary fibrosis

    200 .right eye adducted,near accomodation normal with saccades.
    a. duane's retraction syndrome
    b. partial third nerve palsy
    c. abducent palsy
    d.

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    Q. A young woman has arepititive history of eating followed by purging by laxative. This is suggestive of
    a. Anorexia nervosa
    b. Binge eating disorder
    c. Bulemia nervosa

    ANS-C

    Q. Not a complication of blood tranfusion
    a. Acidosis
    b. Citrate toxicity
    c. Leukocytosis
    d. Hyperkalemia
    ANS-A
    Massive transfusion complications
    Massive transfusion is defined as the replacement of more than one-half of the blood volume within a 24-hour period or the replacement of 10 units of blood over the course of a few hours. Complications of massive transfusion include the following:
    • Coagulopathy is caused by a dilutional effect on the host's clotting factors and platelets, as well as the lack of platelets and clotting factors in packed red blood cells.
    • Volume overload
    • Hypothermia
    • Hyperkalemia may be caused by lysis of stored red cells and is increased in irradiated red blood cells.
    • Metabolic alkalosis and hypokalemia may be caused by the transfusion of a large amount of citrated cells.
    • Hypocalcemia due to citrate toxicity may occur in those with hepatic failure, congestive heart failure (CHF), or other low-output states. It is increasingly uncommon with the use of component therapy.

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    168) Arteriograpghy is NOT needed in
    a)peyronies ds
    b)vascular malformation
    c)erectile dysfunction

    ANS-A?

    In case of peyronies ds -Selective arteriography is recommended only for men who are candidates for arterial revascularization.these are usually young ,healthy men who have suffered trauma to penis or to area of scotrum known as perineum.

    REF
    The Impotence Sourcebook
    By Christopher P. Steidle, John


    148)Capacitance of sperm takes place in
    a)uterus
    b)epididymis
    c)seminal vesicle

    ans-A

    146) Not part of Tenth five year plan.
    a. Cataract operations 450/lakh
    b. Introcular lenses in cataract operations to 89%
    c. Setting up 50 paediatric ophthalm units
    ANS-B
    Explanation:
    Park 19 th edition p362
    Target of 10th ,5yr plan
    Intraocular lens implantation in more than 80% cataract surgery by 2007

    140.Q. a young infant ......... weeks presents wd hepatosplenomegaly and adrenal calcification..................................... ...........................................

    a. wolman disease
    b.adrenal haemmorrhage
    c.
    d.

    ans.a.wolman disease ref. H17E

    table 355-1
    Disorders of Neutral Lipids
    Wolman disease (142)
    enzyme deficiency--Acid lysosomal lipase (BMT)
    stred material--Cholesterol esters, triglycerides
    Infantile
    AR
    Mild mental retardation
    hepatosplenomegaly+++
    skeltal dysplasia-None
    ophthalmologic-None
    haemat--None
    Adrenal calcification

    139.Q. a young male presents wd blurred/diminished vision in rt eye followed by left eye aftr 3months.
    on examination he has parafoveal/juxta foveal telengiectasia ....disc hyperaemia

    he is a case of
    a. leber hereditary optic neuropathy
    b.
    c.
    d.

    ans.a Leber's Hereditary Optic Neuropathy
    ref. H 17E

    This disease usually affects young men, causing gradual, painless, severe, central visual loss in one eye, followed weeks or months later by the same process in the other eye. Acutely, the optic disc appears mildly plethoric with surface capillary telangiectases, but no vascular leakage on fluorescein angiography. Eventually optic atrophy ensues. Leber's optic neuropathy is caused by a point mutation at codon 11778 in the mitochondrial gene encoding nicotinamide adenine dinucleotide dehydrogenase (NADH) subunit 4. Additional mutations responsible for the disease have been identified, most in mitochondrial genes encoding proteins involved in electron transport. Mitochondrial mutations causing Leber's neuropathy are inherited from the mother by all her children, but usually only sons develop symptoms. There is no treatment

    117.Q.young female pateint has absent adduction in rt eye. abduction saccades in left eye
    and normal converge.... ....................she has
    a. duanes retraction
    b.INO
    c.absent medial rectus
    d.partial 3rd nerve palsy
    ANS-INO

    66.Annexin V

    Necrosis
    Apoptosis
    ??
    ??
    ANS-B
    Annexin V, belonging to a recently discovered family of proteins, the annexins, with anticoagulant properties has proven to be a useful tool in detecting apoptotic cells since it preferentially binds to negatively charged

    61.stain used 2 find carcinoma while doin endoscopy
    toluidine blue
    gentian violet
    hematoxylin 2 eosin
    methylene blue

    ANS-D
    Chromoendoscopy is useful technique for detection of dysplasia or intestinal metaplasia.congo red stains acid-containing cells and thus will not stain gastric cancer.both congo red and methylene blue may be used simultaneously
    Ref: Gastrointestinal disease
    By Anthony J. DiMarino, Stanley B.

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    59.not a premalignant lesion of esophagus
    medistinal fibrosis
    caustic burn
    human papilloma virus
    ??????
    ANS-A
    The authors report 4 patients, without a history of tobacco or alcohol abuse, who developed squamous cell carcinoma of the esophagus secondary to mediastinal irradiation. Carcinoma of the esophagus developed in 3 women 8-11 years after mediastinal radiotherapy for breast cancer and in a man 9 years after mediastinal radiotherapy for Hodgkin's disease. Three patients underwent resection, with intrathoracic anastomosis in 2 and cervical in 1. No fistulae were observed despite the presence of esophageal fibrosis. No mediastinal lymph node was metastatic. Patients survived 7, 16, and 26 months, respectively, after resection. This study confirms the concept of radiation-induced carcinogenesis. We conclude that patients with dysphagia and a history of previous mediastinal radiotherapy should undergo repeated endoscopy for biopsy.

    The high frequency of occurrence of HPV in oesophageal tumours (23 of 50 patients; 46%) implicates HPV as one of the possible aetiological factors in this disease. The finding that the low risk HPV subtypes predominate indicates that transformation may be effected via the E6 and E7 proteins.

    Idiopathic mediastinal fibrosis is an occasionally observed disease of mostly unknown etiology characterised by slowly progressive fibrosis and exuberant collagen formation within the mediastinum. This can result in clinical syndromes causing extension to and compression of the mediastinal structures.(IT HAS NOTHING TO DO WITH OESOPHAGEAL CANCER)
    In Europe, this disease is exceptionally rare. More cases are seen in USA where the disease may often be associated with fungal infections that can be rarely identified.
    We present a young male patient who was at first thought to have pulmonary malignancy but later shown to have idiopathic mediastinal fibrosis after a five-year follow-up.
    ==============
    29.subcortical dementia occurs in all except
    1. alzheimers
    2. supra nuclear palsy
    3. parkinson's
    4.?????

    ANS-2?
    Motor syndromes associated with FrontoTemporal Dementia include progressive supranuclear palsy, corticobasal degeneration, and FTD with motor neuron disease

    ======================
    Not a complication of blood tranfusion
    a. Acidosis
    b. Citrate toxicity
    c. Leukocytosis
    d. Hyperkalemia

    ANS-A
    Massive transfusion complications
    Massive transfusion is defined as the replacement of more than one-half of the blood volume within a 24-hour period or the replacement of 10 units of blood over the course of a few hours. Complications of massive transfusion include the following:
    • Coagulopathy is caused by a dilutional effect on the host's clotting factors and platelets, as well as the lack of platelets and clotting factors in packed red blood cells.
    • Volume overload
    • Hypothermia
    • Hyperkalemia may be caused by lysis of stored red cells and is increased in irradiated red blood cells.
    • Metabolic alkalosis and hypokalemia may be caused by the transfusion of a large amount of citrated cells.
    • Hypocalcemia due to citrate toxicity may occur in those with hepatic failure, congestive heart failure (CHF), or other low-output states. It is increasingly uncommon with the use of component therapy.
    ===================
    Q. a young infant ......... weeks presents wd hepatosplenomegaly and adrenal calcification..................................... ...........................................

    a. wolman disease
    b.adrenal haemmorrhage
    c.
    d.

    ans.a.wolman disease ref. H17E

    table 355-1
    Disorders of Neutral Lipids
    Wolman disease (142)
    enzyme deficiency--Acid lysosomal lipase (BMT)
    stred material--Cholesterol esters, triglycerides
    Infantile
    AR
    Mild mental retardation
    hepatosplenomegaly+++
    skeltal dysplasia-None
    ophthalmologic-None
    haemat--None
    Adrenal calcification

    ======================

    Q. a young male presents wd blurred/diminished vision in rt eye followed by left eye aftr 3months.
    on examination he has parafoveal/juxta foveal telengiectasia ....disc hyperaemia

    he is a case of
    a. leber hereditary optic neuropathy
    b.
    c.
    d.

    ans.a Leber's Hereditary Optic Neuropathy
    ref. H 17E

    This disease usually affects young men, causing gradual, painless, severe, central visual loss in one eye, followed weeks or months later by the same process in the other eye. Acutely, the optic disc appears mildly plethoric with surface capillary telangiectases, but no vascular leakage on fluorescein angiography. Eventually optic atrophy ensues. Leber's optic neuropathy is caused by a point mutation at codon 11778 in the mitochondrial gene encoding nicotinamide adenine dinucleotide dehydrogenase (NADH) subunit 4. Additional mutations responsible for the disease have been identified, most in mitochondrial genes encoding proteins involved in electron transport. Mitochondrial mutations causing Leber's neuropathy are inherited from the mother by all her children, but usually only sons develop symptoms. There is no treatment

    ================================
    stain used 2 find carcinoma while doin endoscopy
    toluidine blue
    gentian violet
    hematoxylin 2 eosin
    methylene blue

    ANS-D
    Chromoendoscopy is useful technique for detection of dysplasia or intestinal metaplasia.congo red stains acid-containing cells and thus will not stain gastric cancer.both congo red and methylene blue may be used simultaneously
    Ref: Gastrointestinal disease
    By Anthony J. DiMarino, Stanley B.

    pregnancy and primary pulm TB

    ans is---- start cat 1 treatment immediately
    confirmed from API recommendations in internet.

    all the drugs of cat 1 can be given in pregnancy.
    problem with strepto,ethionamide

    ===========================
    14 Cetuximab used in
    a) Palliative rx in head neck ca
    b) anal canal ca
    c) small cell ca lung
    d) gastric cancer

    ANS-C

    cetuximab drug information
    Head and neck cancer: I.V.:
    Initial loading dose: 400 mg/m2 infused over 120 minutes
    Maintenance dose: 250 mg/m2 infused over 60 minutes weekly
    Note: If given in combination with radiation therapy, administer loading dose 1 week prior to initiation of radiation course. Weekly maintenance dose should be completed 1 hour prior to radiation for the duration of radiation therapy (6-7 weeks).


    Some studies are looking at the use of newer targeted therapies to treat anal cancer. For example, doctors are trying to add the monoclonal antibody cetuximab (Erbitux), which is used in colorectal cancer, to see if it can help make chemotherapy work better.
    ============================
    99. amiodarone side effects a/e
    a.hepatic cirrhosis,
    b.corneal microdeposits
    c.productive cough
    d. pulmonary fibrosis

    ANS-C
    Hepatic: Hepatitis and cirrhosis (<3%)

    Ocular: Corneal microdeposits (>90%; causes visual disturbance in <10%)

    Resspiratory: Pulmonary toxicity has been estimated to occur at a frequency between 2% and 7% of patients (some reports indicate a frequency as high as 17%). Toxicity may present as hypersensitivity pneumonitis; pulmonary fibrosis (cough, fever, malaise); pulmonary inflammation; interstitial pneumonitis; or alveolar pneumonitis. ARDS has been reported in up to 2% of patients receiving amiodarone, and postoperatively in patients receiving oral amiodarone.

    =========================
    104. CDC screening for HIV screening in pregnancy
    a.opt out testing
    b. opt in testing
    c.universal testing
    d. symptomtic

    ANS-A
    Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings

    For pregnant women
    • HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
    • HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
    • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
    • Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.

    ========================
    13. Stability of post gleno humeral jt tested by :
    a) Jerk's test
    b) falcrum test
    c) Crank test
    d) Sulcus test

    ANS-A

    anterior instability tests (fulcrum test)

    posterior instability test (jerk test)

    impingement sign (Neer and Hawkins signs)

    ==========================
    fructosamine levels used for all EXCEPT
    a.short term sugar control
    b. diagnosis of diabetes in pregnancy
    c.
    d.
    ANS-B

    Fructosamine — Many proteins other than hemoglobin also undergo nonenzymatic glycation , leading to the formation of advanced glycosylation end products which may play a direct role in the development of diabetic microvascular complications. The serum concentration of some of these proteins can also be used to estimate glycemic control. The term fructosamine has been applied to the ketoamines formed in this process.

    Several methods are available for measuring serum fructosamine . Some of the assays are cheaper and easier to perform than the A1C assay. There is generally a good correlation between serum fructosamine and A1C values. There are, however, several potential problems with the use of serum fructosamine measurements: The within-subject variation for serum fructosamine is higher than that for A1C; as a result, serum fructosamine concentrations must change more before a significant change can be said to have occurred. The turnover of serum albumin is more rapid than that of hemoglobin days versus 120 days). Thus, serum fructosamine values reflect mean blood glucose values over a much shorter period of time (one to two weeks). Serum fructosamine values must be adjusted if the serum albumin concentration is abnormal. Furthermore, falsely low values in relation to mean blood glucose values will occur with rapid albumin turnover as occurs in patients with protein-losing enteropathy or the nephrotic syndrome.

    These limitations plus the lack of necessity of following changes in mean blood glucose concentrations every one to two weeks means that A1C is usually preferable for estimating mean blood glucose concentrations
    ========================

    Q.nested case control study is type of
    a.case control study
    b.prospective study
    c.retrospective study
    d.rct

    ANS-A?

    The nested case-control study design (or the case-control in a cohort study)

    A nested case-control study may be prospective, identifying cases as they occur, or retrospective, identifying cases that have already occurred

    ref:The nested case-control study in cardiology
    American Heart Journal, Volume 146, Issue 4, Pages 581-590

    thus in the above q we will have two answers retrospective as well as prospective
    =====================
    189) Tarsal Tunnel syndrome is seen with which arthritis :-
    a)RA
    B) Psoriatic arthritis
    C) Ankylosing Spondylitis
    d) Osteoarthritis

    ANS-A

    CLINICAL FEATURE OF RA
    Heel pain may be associated with retrocalcaneal bursitis tarsal tunnel syndrome, caused by impingement of the posterior tibial nerve. Tarsal tunnel syndrome is also associated with parasthesiae of the toes and is important because it is readily diagnosed by ultrasound and treated by local injection or surgical release. Two rare but easily missed causes of heel pain are Achilles tendon rupture or calcaneal stress fracture

    ===============
    181) A 10 month old baby previously normal sudddenly become dead in his cirb. in intensive care unit. external app and genitalia were normal. blood glucose 30 mg%.hyperpigmentation present. Diagnosis :-
    a) 21 hydroxylase deficiency
    b) Hyperinsulinemia
    c) Familial glucocorticoid deficiency
    d) Cushings syndrome

    ANS-C

    Familial glucocorticoid deficiency — Genetic mutations of the ACTH receptor (also known as familial glucocorticoid deficiency) result in unresponsiveness to ACTH stimulation. The lack of ACTH stimulation to cells in the zona fasciculata and reticularis leads to decrease or no production of cortisol. In contrast, the zona glomerulosa is unaffected and continues to normally secrete aldosterone. There appear to be two modes of inheritance of this rare disorder: X-linked and autosomal recessive. A further discussion on ACTH receptor gene mutations is found elsewhere in the program.

    Patients present early in childhood with feeding difficulties (eg, vomiting), failure to thrive, muscle weakness, hyperpigmentation, and hypoglycemia (which may result in seizures). Laboratory evaluation reveals low fasting serum glucose, normal electrolytes, and low (but not absent) cortisol secretion causing subnormal but not undetectable plasma cortisol concentrations. Plasma ACTH levels are elevated. Aldosterone secretion is normal and also increases appropriately with sodium depletion.

    =====================

    63.Blood bourne infections all/Except

    Hep G
    EBV
    CMV
    Parvovirus b19

    ANS-A???????????

    Blood Born Disease
    Is there a risk of blood born disease in blood transfusions? The question should not be if, rather how many blood born diseases?
    Transfusion of blood and blood disease will always be connected to each other. The inherent blood related disease risks are many. What if there were an option to avoid blood transfusions all together?
    What if there were hospitals and health care teams that did surgeries as serious as liver transplants, which could take as much as 50 units of blood, only with out one drop of transfused blood.
    Well, there are. There are doctors, nurses, health care teams that will do just that. Shorter hospital stays. Decreased risk of disease. Decreased risk of death.
    Glutathione plays a part. First, become an educated consumer. Here are the transfusion related blood born diseases you could possibly be exposed to, or not, if you opt for bloodless medicine and surgery.

    Cytomegalovirus
    Cytomegalovirus (CMV) infection lasts for a lifetime. The CMV antibodies prevalence increases with age. It is estimated that approximately 50% to 80% of the adult population are infected with the virus.
    In otherwise healthy people, it does not pose a risk. However, in people with compromised immune systems are at severe risk. Those with bone marrow transplants, solid organ transplant, HIV, cancer, premature infants and pregnant women are at greatest risk.
    CMV is transmitted through blood transfusion, organ and bone marrow transplantation.
    Blood donors have been found to have the antibodies in ranges between 35% and 50% in this blood born disease.
    Since every unit of blood exposes the recipient to lifetime immunomodulation, every additional unit of blood received in a life time increases the risk of CMV negative outcomes.

    Epstein-Barr Virus
    Epstein-Barr (EBV) infection (infectious mononucleosisis) common with an estimated half of all five year olds in the US having been infected.
    In the general population it is usually experienced with out symptoms in children. In adults the infection can display symptoms such as fever and sore throat. EBV increases the risk of developing Burkitt's lymphoma, nasopharyngeal carcinoma, and B-cell lymphoma in those who are immunosuppressed.
    EBV is transmitted by person-to-person contact via saliva and can be transmitted by airborne transmission. EBV can be transmitted via blood transfusion.

    Human Parvovirus B19
    Human parvovirus B19 (HPV-B19) is the causative agent for fifth disease. HPV-B19 infection is common, especially in children. Symptoms are mild, usually a fever, sometimes a round rash appears on the cheek the size of an old fashioned silver dollar.
    Exposure in high risk groups can result in serious complications. Pregnancy exposure can result in fetal anemia and/or fetal death. The infection may cause transient aplastic crisis (TAC) in immunocompromised patients with hemolytic anemia and chronic bone marrow failure.
    HPV-B19 has been transmitted to hemophilia patients via infusion of clotting factors (factor VIII and factor IX).
    Blood is not routinely screened for HPV-B19 infection and the viral inactivation methods are ineffective against the virus.

    Human Herpesvirus 6
    Human herpesvirus 6 (HHV-6), the cause of sixth disease or Roseola (roseola infantum) is a mild illness resulting form this blood born disease. It will typically resolve in 3-5 days with out medication.
    The most notable feature is a sudden rash appearing all over the body once the fever breaks.
    Those with compromised immune systems such as HIV infected patients and transplant recipients may experience severe outcomes. Transmission happens via person-to-person contact with body fluids of infected individuals.

    HHV-6 is considered a potential threat to transfusion safety because due to risks of persistent infection and the high presence of antibodies to HHV-6 among blood donors. There is little evidence based research about its clinical significance in blood recipients. Currently, blood is not routinely screened for HHV-6.

    Human Herpesvirus 8
    Human herpesvirus 8 (HHV-Cool, a more recently discovered virus, is associated with Kaposi's sarcoma. The virus has been transmitted through organ/bone marrow transplantation but it is not known if it can be transmitted through blood transfusion.
    It is not screened due to limited prevalence in donors.

    CJD and vCJD
    Creutzfeldt-Jakob Disease (CJD), the human form of transmissible spongiform encephalopathie (TSE) is characterized by mental deterioration and disfunction, involuntary movements. CJD is rare, only occurring in approximately 1 per million population annually.
    The blood born risk of CJD through blood transfusion has not been established.
    Variant Creutzfeldt-Jakob Disease (vCJD) is the human form of bovine spongiform encephalopathy (BSE). Unlike CJD, vCJD usually affects people under the age of 50. It is most likely transmitted by eating contaminated meats from BSE-infected cattle. It has been speculated that the transmissibility of vCJD through blood may be greater than that of classic CJD.
    Side BarOne day in the mid to late 90’s, a patient in the hospital where I worked seemed despondent. On asking why, he showed me a letter. It was from the CDC. He was informed that a transfusion he received came from a woman who had died and during her autopsy was found to have one of the TSE’s.
    This is not the current procedure for handling such an incident but illustrates what in one form or another will happen should you be exposed to a blood born disease. The number of those affected is clinically insignificant, unless your the one. More importantly, there are hospitals and health care teams that can treat and preform surgeries with out blood transfusions, eliminating these risks.


    In conclusion, transmission of HGV through blood transfusion can occur but may not need to be screened for in blood donors for the following reasons: 1) most infections occur as co-infection with other hepatitis viruses, such as HBV and HCV, 2) most of patients who are infected with HBV alone have little or no clinical disease, 3) the infection rarely causes postransfusion hepatitis, 4) the infection rarely induces chronic hepatitis, and 5) the HGV coinfection does not change the clinical course of other hepatitis viruse
    ===========
    200 .right eye adducted,near accomodation normal with saccades.
    a. duane's retraction syndrome
    b. partial third nerve palsy
    c. abducent palsy
    d.

    ans is A

    What is Duane syndrome?

    Duane syndrome (DS) is a rare, congenital disorder of eye movement. In most patients, DS is diagnosed by the age of 10 years.

    DS is a miswiring of the eye muscles that causes some eye muscles to contract when they should not and other eye muscles not to contract when they should. People with DS have a limited and sometimes absent ability to move their eye outward toward the ear (ie, abduction), and in most cases, they have a limited ability to move the eye inward toward the nose (ie, adduction).

    This probably occurs around the sixth week of pregnancy and is due to poor development of tiny parts of the brainstem that control the eye muscles. In DS, the sixth cranial nerve that controls the lateral rectus muscle (the muscle that rotates the eye out toward the ear) does not develop properly. Why the nerve does not develop is not yet understood. Thus, the problem is not primarily with the eye muscle itself but with the nerve that transmits the electrical impulses to the muscle. There is also irregular innervation of a branch from the third cranial nerve, which controls the medial rectus muscle (the muscle that rotates the eye toward the nose). This is why abnormalities may be found in both left gaze and right gaze.

    Often, when the eye moves toward the nose, the eyeball also pulls into the socket (ie, retraction), and the eye opening narrows. In some cases, the eye moves upward or downward. Many patients with DS develop a habit of turning their face to maintain binocular vision and thus compensate for improper turning of the eyes. In about 80% of all cases of DS, only 1 eye is affected, most often the left eye. However, in some cases, both eyes are affected; usually, 1 eye is affected more than the other.

    In 70% of patients, DS is the only disorder the individual has. However, other conditions and syndromes have been associated with DS. These include malformation of the skeleton, ears, eyes, kidneys, and nervous system, as well as the following: Okihiro syndrome (an association of DS with forearm malformation and hearing loss), Wildervanck syndrome (fusion of neck vertebrae and hearing loss), Holt-Oram syndrome (abnormalities of the upper limbs and heart), morning-glory syndrome (abnormalities of the optic disc or blind spot), and Goldenhar syndrome (malformation of the jaw, cheek, and ear, usually on 1 side of the face).

    What is Duane retraction syndrome?

    Sinclair (in 1895), Bahr (in 1896), Stilling (in 1887), Turk (in 1899), and Wolff (in 1900) first described Duane retraction syndrome (DRS).1,2,3,4,5 In 1905, Duane reported 54 cases, summarizing all the clinical findings, reviewing previous work, and offering theories on the pathogenesis and treatment of the disease.6

    Brown classified the condition into 3 subtypes, based upon clinical observations.7 Type A corresponded to limited abduction and less limited adduction (as described originally by Duane). Type B corresponded to limited abduction but normal adduction. Type C corresponded to limitation of adduction that is greater than limitation of abduction, giving rise to a divergent deviation and a head posture in which the face is turned away from the side of the affected eye.

    In 1974, with the support of electromyography (EMG) and following the suggestions of Lyle and Malbran, Huber classified DRS into the 3 types: Duane 1, Duane 2, and Duane 3.8,9,10 Type 1 is marked limitation of abduction (corresponds to Type B in Brown's classification) explicable by maximum innervation reaching the lateral rectus muscle only when the affected eye is adducted. Type 2 is limitation of adduction (corresponds to Type C in Brown’s classification), which Huber explains as being caused by co-innervation of both medial and lateral rectus muscles on attempted adduction. Type 3 is limitation of both adduction and abduction (corresponds to Type A in Brown’s classification), which Huber explains as being due to co-contraction, accompanied by a loss of innervation to the lateral rectus muscle on attempted abduction.

    DS is a congenital ocular motility disorder characterized by limited abduction and/or limited adduction. The palpebral fissure narrows (ie, the globe retracts) on attempted adduction. Upward or downward deviation may occur with attempted adduction because of a leash effect. Often associated with this condition is a tether phenomenon consisting of overelevation, overdepression, or both during adduction as the retracted globe escapes from its horizontal rectus restrictions. It is a condition of aberrant innervation that results in co-contraction of the medial and lateral recti in the affected eye. Therefore, DS can be considered to be congenital miswiring of the medial and the lateral rectus muscles such that globe retraction occurs on adduction.
    ==========================

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    Internal urethral sphincter is not a vaginal sphincter muscles [ bulbocavernosus, pubovaginalis/rectalis, external urethral sphincter ?? ]–AIIMS may’09

    The urethral sphincter is a collective name for the muscles used to control the flow of urine (micturition) from the urinary bladder. These muscles envelop the urethra, so that when they contract, the urethra is sealed shut. The muscles originate at the pubic ramus with the insertion point at the median raphe. The function of the sphincter urethrae (external sphincter) is controlled by the pudendal nerve and acts to constrict the urethra. There are actually two urethral sphincters in the human body:
    • The internal sphincter muscle of urethra: located at the bladder's inferior end and the urethra's proximal end at the junction of the urethra with the urinary bladder. The internal sphincter is a continuation of the detrusor muscle and is made of smooth muscle, therefore it is under involuntary or autonomic control. This is the primary muscle for prohibiting the release of urine.
    • The external sphincter muscle of urethra (sphincter urethrae): located at the bladder's distal inferior end in females and inferior to the prostate (at the level of the membranous urethra)in males is a secondary sphincter to control the flow of urine through the urethra. Unlike the internal sphincter muscle, the external sphincter is made of skeletal muscle, therefore it is under voluntary control of the somatic nervous system.
    [edit] Gender differences
    Despite common misconceptions, human males do not have stronger urethral sphincter muscles than females, nor are there any noticeable capacity differences in the bladders. Anatomically, females have to urinate more frequently because their bladders share space with the uterus and vagina in the anterior wall. In actuality, females do not have an internal urethral sphincter muscle. This muscle's function is to prevent reflux of seminal fluids into the male bladder during ejaculation. In males the bladder does not share space with any reproductive organs. Females do have a more elaborate external sphincter muscle than men as it is made up of three parts, the sphincter urethrae, urethrovaginal muscle, and the compressor urethrae. The urethrovaginal muscle fibers wrap around the vagina and urethra and contraction leads to constriction of both the vagina and the urethra. The origin of the compressor urethrae muscle is the right and left inferior pubic ramus and it wraps anteriorly around the urethra so when it contracts it squeezes the urethra against the vagina. The external urethrae, like in males, wraps solely around the urethra.

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