JIPMER Medical PG Entrance November 2014 Question Paper With Answer Key

JIPMER PG Medical Entrance Examination

November-2014

ANATOMY

1. Myelination begins at

(a)   20 weeks

(b)   25 weeks

(c)   30 weeks

(d)   35 weeks

Ans: (a)

2. Pressure on hook of hamate when hand is hyperextended will damage

(a)   Ulnar nerve

(b)   Superficial branch of ulnar nerve

(c)   Median nerve

(d)   Musculoctuaneous nerve

Ans: (a)

3. Wrist is more adducted than to be abducted because

(a)   Ulnar styloind process extends far more distally

(b)   Radial styloid process extends far more distally

(c)   Radial styloid process is bulky and prevents muscle action

(d)   Ulnar styloid process is thin and moves more medially

Ans: (b)

4. Major branches of popliateal artery are

(a)   Genicular, anterior tibial and deep femoral arteries

(b)   Genicular artery only

(c)   Genicular, anterior and posterior tibial artery

(d)   Genicular and circumbflex tibial artery

Ans: (c)

5. Cruciate ligament of knee prevents

(a)   Gliding of femur on tibia during flexion

(b)   Locking of knee

(c)   Extension of knee joint

(d)   Rotational movements of knee joint

Ans: (a)

6. A patient with recurrent chest infections presents to the emergency department. He was ordered for an X ray. The patient says that he has an “azygos lobe” diagnosed few years back. What is the location of azygos lobe?

(a)   Right upper lobe

(b)   Left upper lobe

(c)   Right lower lobe

(d)   Left lower lobe

Ans: (a)

7. A patient present with hematemesis. On oesophago-gastroduodenoscopy, bleeding in lesser curvature was noted. The artery of bleed is

(a)   Right gastric artery

(b)   Left gastro omental artery

(c)   Anterior gastric artery

(d)   Posterior gastric artery

Ans: (a)

8. Not a tributary of portal vein

(a)   Inferior phrenic vein

(b)   Splenic vein

(c)   Cystic vein

(d)   Superior mesenteric vein

Ans: (a)

9. The major support for the liver to be held in position is

(a)   Peritoneal ligaments

(b)   Pressure exerted by the abdominal muscles and their tone

(c)   Attachment of hepatic vein to inferior vena cava

(d)   Suction force given by the diaphragm

Ans: (c > b)

10. True regarding biliary anatomy

(a)   Normal diameter of common bile duct is 10 mm.

(b)   Gall bladder is innervated sympathetic nerve

(c)   1-2 litres of bile is secreted by the liver daily and it is 10 fold concentrated by bladder

(d)   Right and left hepatic ducts join to form common bile duct

Ans: (b)

11. Root of mesentery crosses all except

(a)   Second part of duodenum

(b)   IVC

(c)   Abdominal aorta

(d)   Right ureter

Ans: (a)

12. Pleura that continues into the necks as cervical pleura is

(a)   Costal pleura

(b)   Diaphragmatic pleura

(c)   Visceral pleura

(d)   Mediastinal pleura

Ans: (a)

13. Deep inguinal ring is a defect in

(a)   Fascia transversalis

(b)   Rectus sheath

(c)   External oblique aponeurosis

(d)   Pelvic fascia

Ans: (a)

14. The ligament that maintains the stability of atlanto axial joint is

(a)   Alar ligament

(b)   Apical ligament

(c)   Transverse ligament

(d)   Tectorial ligament

Ans: (c)

15. Gray rami communicans appears gray because

(a)   Post ganglionic sympathetic fibers are nonmyelinated

(b)   Pre gnaglionic sympathetic fibers are nonmyelinated

(c)   Post ganglionic sympathetic fibers are myelinated

(d)   Post ganglionic parasympathetic fibers are nonmyelinated

Ans: (a)

PHYSIOLOGY

16. Action of nor adrenaline in sympathetic nerve endings are terminated by

(a)   Oxidative deamination by monoamine oxidase

(b)   Reuptake by axonal terminals

(c)   Enzymatic inactivation by catecholamine-O Methyl transferase

(d)   Removal by circulation of blood

Ans: (b)

17. Lateral spinothalamic tract of spinal cord

(a)   Transmits contralateral light touch

(b)   Crosses to opposite side in medial lemniscus

(c)   Carries pain sensation from same side

(d)   Crosses from the thalamus to the contralateral  parietal lobe

Ans: (d)

18. Not a component of electrical cardiac conduction pathway

(a)   SA node

(b)   Bundle of His

(c)   Purkinje Fibres

(d)   Sarcomere

Ans: (d)

19. According to Starling’s law of heart, the force of contraction of ventricle is proportional to

(a)   Afterload

(b)   End systolic volume

(c)   End diastolic volume

(d)   Heart rate

Ans: (c)

20. Following is a lecture on cardiovascular physiology, you consultant asks you during a ward rounds to calculate how much blood (in ml) Mr. X’s ventricle ejects every time his heart beats. He gives you the following values; Age of X : 42 years, BP: 136/90 mmHg. Cardiac Output-5L/min, Heart rate- 72 /min, Urine output-5 ml/kg/hr.

(a)   70 ml

(b)   20 ml

(c)   50 ml

(d)   130 ml

Ans: (a)

21. Measurable index of preload and afterload is

(a)   End systolic pressure – volume relation ship

(b)   Ejection fraction

(c)   Stroke volume

(d)   Cardiac output

Ans: (b)

22. A patient met with motor vehicle accident is shifted in an ambulance to the emergency department. Primary survey reveals open fracture of right femur with bleeding profusely in cardiovascular physiological terms, the most likely response to blood loss is

(a)   Stroke volume decreases due to hypovolemia

(b)   Total peripheral resistance increases due to decreased sympathetic output.

(c)   Increased cardiac output due to increased stroke volume and decreased heart rate

(d)   Heart rate increases due to increased vagal stimulation

Ans: (a)

23. Feature seen immediately after lying down

(a)   Increased cerebral blood flow

(b)   Immediate increase in venous return to the heart

(c)   Decrease in blood flow to the lung apex

(d)   No change in heart rate

Ans: (b)

24. Fenestrated capillaries are seen in

(a)   Skeletal muscle

(b)   CNS

(c)   Skin

(d)   Small intestine

Ans: (d)

25. The carbohydrate determining the blood group substance is

(a)   Xylose

(b)   Xylulose

(c)   Fucose

(d)   Arabinose

Ans: (c)

26. Pulmonary vascular system differs from systemic circulation in that the pulmonary system has

(a)   Low pressure, low flow rate

(b)   Low pressure, high flow rate, high compliance vessels

(c)   High pressure, high flow rate, high compliance vessels

(d)   Low pressure, high flow rate, high compliance vessels

Ans: (d)

27. In an acclimatized individuals,

(a)   Periodic breathing occurs

(b)   Increase in mean corpuscular haemoglobin concentration

(c)   Increased airway resistance

(d)   Increased pulmonary artery pressure

Ans: (d)

28. A 30 year old male presents with indigestion for past 4 months. Five years back, he had duodenal ulcer. Fasting gastric values are- 120p mol/L. (NORMAL LEVELS 10-20 pmol/L). True regarding gastrin is

(a)   Produced by parietal cells of stomach

(b)   Produced by alpha cells of pancreas

(c)   Inhibits bicarbonate secretion in a phased manner

(d)   Release is stimulated by presence of gastric  luminal peptides.

Ans: (d)

29. Enterohepatic circulation occurs in

(a)   Rectosigmoid junction

(b)   Terminal ileum

(c)   Jejunum

(d)   Pancreas

Ans: (b)

30. Oxygen requiring metabolic reactions occur in which cells of liver

(a)   Zone-1 cells

(b)   Zone-2 cells

(c)   Zone-3 cells

(d)   Kupffer cells

Ans: (a)

31. True regarding GLP-1

(a)   Acts t the satiety centre

(b)   Inhibits glucose induced insulin secretion

(c)   Secreted by alpha cells of pancreas

(d)   Release is inhibited by the presence of fatty acids

Ans: (a)

32. Insulin independent glucose uptake occurs in

(a)   Liver

(b)   Skeletal muscle

(c)   Heart

(d)   Adipose tissue

Ans: (a)

BIOCHEMISTRY

33. A patient have acquired syndrome associated with defective breakdown and disposal of intracellular fatty acids. Which intra cellular organelle is concerned with this mechanism?

(a)   Mitochondria

(b)   Peroxisomes

(c)   Lysosomes

(d)   Smooth endoplasmic reticulum

Ans: (b)

34. Function of golgi apparatus

(a)   Packs and sorts proteins

(b)   Synthesis of ATPs

(c)   Steroid synthesis

(d)   DNA replication

Ans: (a)

35. Pyridoxine is a co enzyme of

(a)   Carboxylation

(b)   Transamination

(c)   Oxidation

(d)   Reduction

Ans: (b)

36. The vitamin whose RDA is related to protein intake is

(a)   Pantothenate

(b)   Niacin

(c)   Pyriodxine

(d)   Thiamine

Ans: (b)

37. 55 year old presents with bleeding gums. He is an alcoholic, has petechia. The vitamin deficiency associated with this condition is

(a)   Vitamin B1

(b)   Vitamin B 12

(c)   Vitamin C

(d)   Vitamin E

Ans: (c)

38. The common polymorphism in the gene for methylene-tetrahydro folate reductase appears to influence the sensitivity of homocysteine levels to deficiency of

(a)   Vitamin B12

(b)   Folic acid

(c)   Vitamin A & D

(d)   Vitamin B6

Ans: (b)

39. True regarding metabolic acidosis

(a)   Body shunts more glutamine from liver to kidneys

(b)   Less ammonia is excreted in urine

(c)   Urea synthesis is increased

(d)   Liver glutaminase activity increases

Ans: (a)

40. True regarding gamma glutamyl transferase

(a)   Synthesized only in liver.

(b)   Levels are increased in fatty acid

(c)   Better indicator of infectious hepatitis than for cholestasis

(d)   Isolated increase of GGT in patients with prostatic carcinoma indicates hepatic metastasis.

Ans: (b)

41. Impaired glucose tolerance is seen in deficiency of

(a)   Selenium

(b)   Chromium

(c)   Manganese

(d)   Molybdenum

Ans: (b)

42. Divalent zinc ion is essential for

(a)   Catalase

(b)   Pancreatic lipase

(c)   Alkaline phosphatase

(d)   Salivary amylase

Ans: (c)

43. Mucopolysaccharide not containing uronic acid is

(a)   Heparin

(b)   Heparan sulphate

(c)   Keratan sulphate

(d)   Chondroitin sulphate

Ans: (c)

44. Enzyme involved in the synthesis of both cholesterol as well as ketone bodies is

(a)   HMG CoA reductase

(b)   HMG CoA synthase

(c)   HMG CoA lyase

(d)   Acetyl CoA synthetase

Ans: (b)

45. Enzyme action increased in fed state

(a)   Carbomyl phosphate-I transferase

(b)   Pyruvate carboxylase

(c)   HMG coA lyase

(d)   Acetyl COA carboxylase

Ans: (d)

46. Lipoprotein-A is in structural homology to

(a)   Albumin

(b)   Prothrombin

(c)   Collagen

(d)   Plasminogen

Ans: (d)

47. Injections of heparin releases

(a)   Lipoprotein lipase

(b)   Insulin

(c)   Alkaline phosphatase

(d)   Nitric oxide

Ans: (a)

48. The rate limiting enzyme of de novo purine biosynthesis pathway

(a)   Phosphoribosylpyrophosphate synthetase

(b)   Phosphoribosylpyrophosphate amidotransferase

(c)   Adenylosuccinate lyase

(d)   Formyltransferase

Ans: (b)

49. Function of pseudouridine arm of tRNA is

(a)   Terminates translation

(b)   Binding of tRNA to ribosomes

(c)   Recognition of specific tRNA to add with specific amino acid

(d)   Recognition of specific amino acid to be attached to the amino acid arm.

Ans: (b)

50. Polymerase chain reaction is used to amplify a small fragments of DNA for further analysis. To do this, DNA double helix must be split. This is done by

(a)   DNA polymerase

(b)   Centrifuge

(c)   Alkali

(d)   Heating around 100℃

Ans: (d)

51. Northern blot detects

(a)   RNA

(b)   DNA

(c)   Protein

(d)   Antigens

Ans: (a)

PHARMACOLOGY

52. A new drug is being studied to find the most appropriate dose in dose response study. Small does results in linear increase in serum drug concentration. At high doses there is exponential increase in serum levels. This is called as

(a)   Saturations kinetics

(b)   First passes effect

(c)   Zero order kinetics

(d)   First order kinetics

Ans: (d)

53. 72 years old male patient presents with fast atrial fibrillation on treatment with digoxin. Inadequate dosage was suspected. Blood sample was drawn after 6 hours of last dose of digoxin to estimate the plasma concentration of digoxin. Why to wait for 6 hours after the last dose of digoxin?

(a)   Rate of elimination

(b)   Rate of clearance

(c)   Rate of absorption

(d)   Rate of distribution

Ans: (d)

54. Smooth endoplasmic reticulum in liver cell is increased in people using lipid soluble drugs, because

(a)   SER packs drugs away from the cells

(b)   Produces protein against the drug

(c)   Detoxify the drug

(d)   Converts lipid soluble drugs to proteins

Ans: (c)

55. True regarding leukotrienes

(a)   Synthesised from COX pathway

(b)   Increases mucus secretion

(c)   Synthesised by fibroblasts

(d)   LT D4 is Slow Reactive Substance-A which causes bronchial wall smooth muscle relaxation

Ans: (b)

56. Bradycardia is most common in

(a)   Midazolam

(b)   Succinyl choline

(c)   Isoprenaline

(d)   Dopamine

Ans: (b)

57. N-Acetyl Cysteine replenish

(a)   Glutathione

(b)   Cytochrome p450

(c)   Glucuronyl transferase

(d)   Sulfatase

Ans: (a)

58. Am 85 year old female presents with bilateral osteoarthritis. There was no history of any gastro intestinal symptoms. The most appropriate drug that can be recommended is

(a)   Dihydrocodeine

(b)   Celecoxib

(c)   Naproxen

(d)   Paracetamol

Ans: (c)

59. The most potent anti-emetic agent in pre-operative period is

(a)   Ondansetron

(b)   Metochlopramide

(c)   Perchlorperazine

(d)   Chlorpromazine

Ans: (a)

60. A patient was on lithium therapy for bipolar disorder. Initiation of hydrochlorothiazide for hypertension can cause

(a)   Failure of hydrochlorothiazide therapy

(b)   Increased hepatic clearance of lithium

(c)   Increased renal clearance of lithium

(d)   Increase in serum lithium levels

Ans: (d)

61. Drugs decreasing mortality in ischemic heart disease are all except

(a)   Statins

(b)   ACE inhibitors

(c)   Nitrates

(d)   Aspirin

Ans: (c)

62. A 70 years old female presents with H/O pancreatitis, persistent diarrhea and osteoporosis. DVT is present. Drug least effective if given after she takes cholestyramine to relieve the intolerable itching is

(a)   Warfarin

(b)   Thiamine

(c)   Vitamin-D

(d)   Aspirin

Ans: (a)

63. True regarding insulin is

(a)   Interacts with nuclear membrane

(b)   Increases glucose – protein transport in ER

(c)   Has similar mechanism of action of steroid receptors

(d)   Not detected in lymph

Ans: (b)

64. A 35 year old female with 2+ glycosuria with a body mass index of 35, fasting blood sugar-132mgs/dl. The best measure to decrease the insulin resistance is

(a)   Repaglinide therapy

(b)   Insulin therapy

(c)   Metformin therapy

(d)   Weight loss and exercise

Ans: (d)

65. 82 years ld female presents with history of fall on the ground and diagnosed as Colle’s Fracture. She was started with alendronate. The mechanism of action of alendronate in this condition is that it

(a)   Inhibits the osteoblastic activity

(b)   Inhibits the osteoclastic activity

(c)   Increases the osteoblastic activity

(d)   Increased bone turn over

Ans: (b)

66. You are developing a new long acting antagonist for the treatment of SIADH. Where will this drug act?

(a)   Aquaporin-1 channels

(b)   V1 receptors

(c)   Aquaporin-2 channels

(d)   V2 receptors

Ans: (d)

67. The first drug increases the pharmacological action of the second drug, when given concomitantly is

(a)   Erythromycin: theophylline

(b)   Ranitidine: corticosteroids

(c)   Phenytoin: ethinyl estradiol

(d)   Rifampicin: warfarin

Ans: (a)

68. True for poisoning or overdose

(a)   Clomethiazole- causes hypertension and hyperthermia

(b)   Aspirin-causes acidosis due to hypoventilation

(c)   Methanol causes metabolic acidosis with increased anion gap

(d)   Phenobarbitone causes metabolic acidosis.

Ans: (c)

69. Not a cause of drug induced hepatitis

(a)   Isoniazid

(b)   Ethambutol

(c)   Pyrazinamide

(d)   Methyldopa

Ans: (b)

70. Mechanism of action of gentamicin when given synergistically with benzyl penicillin in the treatment of infective endocarditis of streptococcus viridians is

(a)   Interfere with DNA replication

(b)   Inhibit protein synthesis (translocation)

(c)   Inhibit protein synthesis (transcription)

(d)   Cell wall inhibition

Ans: (b)

71. The anti-retroviral drug which acts as a function inhibitor

(a)   Atazanavir

(b)   Emtricitabine

(c)   Enfuvirtide

(d)   Elvitegravir

Ans: (c)

72. A 16 year old male presents with recurrent acne not responding to oral antibiotics. To start with oral isotretinoin, which of the following investigations has to be done before and during the oral administration of isotretinoin?

(a)   Liver function test with fasting lipid profile

(b)   Electrolytes with fasting lipid profile

(c)   Liver function test with Electrolytes

(d)   Liver function test with platelet count

Ans: (a)

73. A 30 years old male is on methotrexate 7.5 mg weekly. His wife is fit and well and is not on any medication except for oral contraceptive pills. They are keen to start family and want to know about continued contraception and whether to stop methotrexate. The appropriate advice is

(a)   Should continue adequate contraception atleast 3 months after stopping methotrexate.

(b)   Should continue adequate contraception atleast for 4 weeks after stopping methotrexate.

(c)   Should continue adequate contraception atleast for 1 year after stopping methotrexate.

(d)   Dispense with contraception now but husband should stop methotrexate.

Ans: (a)

74. Lenalidomide increases the risk of thromboembolic events when combined with

(a)   Barbiturates

(b)   Anti-psychotics

(c)   Alcohol

(d)   Glucocorticoids

Ans: (d)

MICROBIOLOGY

75. Which of the following is not a feature of exotoxin?

(a)   High antigenicity

(b)   Neutralised by antibodies

(c)   Heat stable

(d)   Protein in nature

Ans: (c)

76. Mechanism of development of resistance to penicillin in Streptococcus pneumonia is

(a)   Production of Beta lactamase

(b)   Mutations in the penicillin binding proteins on the bacterial surface

(c)   Changes in the membrane permeability to penicillin

(d)   Production of an alternative penicillin binding protein

Ans: (b)

77. A new agent was developed to increase the recognition of foreign antigens by Antigen presenting cells. True regarding the physiological aspects of APC’s

(a)   Antigen is presented via MCH-I complexes

(b)   APC’s are required before a response to viruses are generated

(c)   Direct antibody stimulation still requires APC’s

(d)   Antigen processed by APC are recognised by CD4+ T cells

Ans: (d)

78. True regarding thymus is

(a)   Mature thymocytes express CD 4 and CD 8

(b)   Thymocytes whose T cell receptor binds with high affinity to self-antigens and MHC complexes are clonally detected

(c)   Mature thymocytes express surface IgM & IgD

(d)   CD 4 & CD 8 double positive cells are eliminated by a process of negative selection

Ans: (d)

79. A 16 years old male patient presents with head ache, fever and neck stiffness for the past 24 h ours. Similar history was present one year back. CSF analysis shows WBC’s-400/ml, with 90% neutrophils. Gram staining shows gram negative diplococcic. The immune system affected in t his condition is

(a)   B lymphocytes

(b)   T lymphocytes

(c)   Immunoglobulins

(d)   Complement system

Ans: (d)

80. All the following are true about Staphylococcus aureus except

(a)   Coagulase positive

(b)   Catalase negative

(c)   DNAse positive

(d)   Indole negative

Ans: (b)

81. There was a sudden outbreak of MRSA infection in generall ward. The best method for reducing the MRSA outbreak in the ward and to reduce the transmission is

(a)   Encourage regular hand wash

(b)   Clean the walls and floors with chlorhexidine

(c)   Screen the ward staff using nasal swabs and exclude those with positive culture for MRSA

(d)   Close the ward for 1 month

Ans: (a)

82. 37 year old person, poorly controlled case to type-1 DM presents with painful, red, swollen middle finger with redness extending to metacarpophalangeal joint. A diagnosis of cellulitis is made and rerated with antibiotics. What is the organism causing this condition?

(a)   Pseudomonas aeruginosa

(b)   Klebsiella penumoniae

(c)   MRSA

(d)   Streptococcus pyogenes

Ans: (d)

83. 19 years old male patient comes to the emergency department with complaints of urthral discharge, 1 week after having unprotected sex. Gram staining reveals numerous neutrophils, some gram negative intracellular diplococcic. He was treated with ceftriaxone 250 mg i.m. 5 days later he returns with the same complaints. What is the diagnosis?

(a)   Chlamydia trachomatis

(b)   Penicillin resistant Neisseria gonorrhoeae

(c)   Reinfection with Neisseria gonorrhoeae

(d)   Ureaplasma urealyticum

Ans: (c)

84. A strain of E.coli isolated from urine is resistant to third generation cephalosporins. The mechanism of development of resistance is

(a)   Extended spectrum β-Lactamases

(b)   Decrased permeability

(c)   Active efflux of β-Lactam agents

(d)   Alteration of PBPs

Ans: (a)

85. Infection that can be acquired in laboratories

(a)   Brucellosis

(b)   Tuberculosis

(c)   Pertusssis

(d)   Melioidosis

Ans: (a)

86. A child presents with tuberculosis. Steroids are not indicated in

(a)   Tuberculoma

(b)   Endobronchial tuberculosis

(c)   Pleural effusion

(d)   Progressive primary pulmonary disease

Ans: (d)

87. Agent used in interferon gamma release assay for diagnosing latent tuberculosis is

(a)   MPT 64

(b)   Mycolic acid

(c)   Lipoarabinomannan

(d)   ESAT-6

Ans: (d)

88. 45 years old female patient presents with duodenal ulcer. The most sensitive test for the detection of H.Pylori is

(a)   Urea breath test

(b)   Serology

(c)   Biopsy & Culture

(d)   Stool antigen test

Ans: (a)

89. Channel activated by cholera toxin

(a)   Adenylate cyclase

(b)   Guanyl cyclase

(c)   ABC transport channel

(d)   Ion transport channel

Ans: (a)

90. A 25 years old male presents with 2 months history of loose stools and weight loss. Laboratory diagnostic tests are positive for HIV. Presence of which of the following disease is most likely in diagnosing HIV/AIDS?

(a)   Lyme disease

(b)   Glandular fever

(c)   Orpharyngeal candidiasis

(d)   Pulmonary TB

Ans: (c)

91. Parotid enlargement in a HIV infected child is characterised in which stage of AIDS according to WHO?

(a)   Stage 1

(b)   Stage 2

(c)   Stage 3

(d)   Stage 4

Ans: (b)

92. Indication for varicella immunoglobulin is

(a)   A pregnant woman non-immune to Varicella Zoster, exposed to a child with chicken pox 12 days ago

(b)   A pregnant woman non-immune to Varicella Zoster, exposed to mother with shingles

(c)   A pregnant woman with no history of chicken pox develops shingles

(d)   A pregnant woman previously treated with varicella immunoglobulin 10 days ago, but re-exposed to a case of chicken pox

Ans: (b)

93. Negri bodies are pathological inclusions seen in some pathological conditions. They are seen in all the following areas except

(a)   Pyramidal neurons of hippocampus

(b)   Subcortical white matter

(c)   Basal ganglia

(d)   Purkinje cells of cerebellum

Ans: (b)

94. Modality not employed in the diagnosis of respiratory viruses in laboratory

(a)   ELISA

(b)   Immunofluorescence

(c)   Single Radial hemolysis (SRH)

(d)   Hemagglutination

Ans: (none)

95. Morphological appearance of Pneumocystis jeroveci infection of lung is best characterized by

(a)   Hemorrhagic and necrotizing pneumonia

(b)   ARDS with wide spread hyaline membrane formation

(c)   Interstitial pneumonitis with foamy intra alveolar exudates

(d)   Broncho pulmonary absecess formation

Ans: (c)

PATHLOGY

96.Apoptosis in initiated by

(a)   Caspases

(b)   DNA

(c)   Antibodies

(d)   MAP kinase

Ans: (a)

97. All the following inflammatory mediators are derived from the cells except

(a)   Kinins

(b)   Cytokines

(c)   Histamine

(d)   Leukotrienes

Ans: (a)

98. 17 years old pregnant woman h as scattered small, raised lesions on trunk and axillary freckles. The mode of inheritance of this condition

(a)   Autosomal dominant

(b)   Autosomal recessive

(c)   X-linked dominant   

(d)   X-linked recessive

Ans: (a)

99. The following condition is not a single gene disorder

(a)   Arrhythmogenic right ventricular cadiomyopathy

(b)   Hypertorphic cardiomyopathy

(c)   Dilated cardiomyopathy

(d)   Mitral valve prolapsed

Ans: (c)

100. A 17 y ear old female with von Willebrand disease presents for dental extraction. She had history of simi9lar dental extraction 2 years back with increased bleeding and two units of plasma was transfused. Now appropriate prior line of management includes

(a)   Cryoprecipitate

(b)   FFP

(c)   Recombinant factor VIII

(d)   Desmopressin (DDAVP)

Ans: (d)

101. Most accurate statement regarding DIC is

(a)   Removal of the underlying cause leads to complete resolution.

(b)   Associated with increased serum fibrinogen levels

(c)   Normal clotting parameters excludes DIC

(d)   DIC is associated with increased levels of D-dimer

Ans: (d)

102. 42 years old female presents with tiredness. There was no H/O smoking, drug abuse or alcohol consumption. Hb 78 g/L, MCV-72 fL, WBC – 7 × 109/μL, platelet count 3, 50, 000/μ Serum ferritin levels – 8 μg/L (15-300 μg/L). She was started on oral iron therapy and her Hb condition during review was 80 g/L. The cause for failure of treatment is

(a)   Acquired sideroblastic anemia

(b)   Inadequate iron dosage

(c)   Poor compliance to oral iron

(d)   Folate deficiency

Ans: (c)

103. True regarding abnormal hemoglobins are

(a)   HbS is caused by single base mutation

(b)   In thalassemia, persistence of HbF indicates bad prognosis

(c)   Alpha thalassemia is due to deficiency of Bea chain production

(d)   Genes for alpha & beta chains are present in the same chromosome

Ans: (a)

104. Severe Hereditary spherocytosis is seen due to the defect of the following protein

(a)   Spectrin

(b)   Ankyrin

(c)   Band 3

(d)   Band 4.2

Ans: (a)

105. Reagent used in A:t test

(a)   Sodium hydroxide

(b)   Sodium chloride

(c)   Sodium acetate

(d)   Sodium bicarbonate

Ans: (a)

106. A 65 years old smoker presents with chronic cough, hemoptysis and loss of weight. X ray chest shows cavitatory lesion. The most appropriate diagnosis is

(a)   Unidifferentiated large cell carcinoma

(b)   Small cell carcinoma

(c)   Adeno carcinoma

(d)   Squamous cell carcinoma

Ans: (d)

107. Carcinoid tumors of lung arises from

(a)   Type-II pneumocytes

(b)   Kulchitsky (K) cells

(c)   Mucus (goblet) cells

(d)   Clara cells

Ans: (b)

108. True in a child with post streptococcal glomerulonephritis is

(a)   Microscopic haematuria decreases within 4 weeks

(b)   Serum triglyceride levels increase

(c)   Severe renal dysfunction is an indication for biopsy

(d)   Serum C3 levels are normal

Ans: (c)

109. A 50 years old male patient develops cardiogenic shock following acute myocardial infarction. The urine output decreases in next few days. Urea levels – 90 mg/dl, creatinine. 4.5 mg/dl. Urine analysis reveals no glycosuria or proteinuria, traces of blood present and numerous hyaline casts is present. Later he develops polyuria and the urea and creatinine levels fall. The pathological finding coinciding with the above situation is

(a)   patchy tubular necrosis

(b)   Glomerular crescents

(c)   Mesangial immune complex deposition

(d)   Hyperlastic arteriosclerosis

Ans: (a)

110. Mutation of STK II/LKB I gene results in

(a)   Peutz Jegher’s syndrome

(b)   Cowden syndrome

(c)   Familial adnomatous polyposis

(d)   Herediatary non-polyposis colorectal cancer

Ans: (a)

FORENSIC MEDICINE

111. First internal sing of putrefaction is seen in

(a)   Under surface of liver

(b)   Under surface of spleen

(c)   Over the region of Caecum

(d)   Over the region of pancreas

Ans: (a)

112. Magistrate inquest in India is conducted for all the following conditions except

(a)   Exhumation

(b)   Custody death

(c)   Homicide

(d)   Dowry death

Ans: (c)

113. Not a characteristic feature of male hip bone

(a)   Preauricular sulcus

(b)   Broad and round pelvic cavity

(c)   Wide and shallow geater sciatic notch

(d)   Everted ischial tuberosity

Ans: (a)

114. A pedestrian was hit by fast moving vehicle on leg and thrown away. He hit the road divider and fell down on the road and sustained head injuries. He was run over by a car moving on the opposite direction. The head injuries sustained by the patient are example of

(a)   Primary impact injuries

(b)   Primary injuries

(c)   Secondary impact injuries

(d)   Secondary injuries

Ans: (d)

115. A child sustained burns in front and back of both thighs and buttocks, face and scalp with singeing of hair. Calculate the percentage of burns

(a)   27

(b)   32

(c)   34

(d)   45

Ans: (b)

116. Dribbling of saliva is common in

(a)   Post-mortem hanging

(b)   Ante mortem hanging

(c)   Homicidal hanging

(d)   Suicidal hanging

Ans: (a)

117. Hanging injuries

(a)   Trachea

(b)   Oesophagus

(c)   Vertebral artery

(d)   Carotid artery

Ans: (d)

118. Identify the true pair in the management of poisoning

(a)   N-acetyl cysteine- Paraquat

(b)   Methylene blue – Cyanide

(c)   Ethanol – Isopropyl alcohol

(d)   Pralidoxime – Sarin (nerve gas)

Ans: (d)

119. A farmer with H/O depression is admitted for treatment with over dosage. He has bradycardia, hypotension, disorientation, hypersalivation and small pupils. The causative substance is

(a)   Organophosphates

(b)   Paracetamol

(c)   Tricyclic anti-depressants

(d)   Cyanide

Ans: (a)

120. According to MTP act, medial termination of pregnancy can be done upto

(a)   28 weeks

(b)   22 weeks

(c)   20 weeks

(d)   Before period of viability

Ans: (c)

ENT

121. A 6 year old boy was referred by his school teacher for a suspected hearing loss. On examination, a middle ear effusion (MEE) was diagnosed. The usual range of hearing loss associated with MEE is

(a)   10-20 dB

(b)   21-30 dB

(c)   31-40 dB

(d)   41-50 dB

Ans: (b)

122. Diplopia on looking to left side in a cased of bilateral CSOM is due to

(a)   Right lateral sinus thrmbophlebitis with cerebellar abscess

(b)   Left lateral sinus thrombophlebitis with cerebellar abscess

(c)   Right petrositis affecting abducent nerve

(d)   Left petrositis affecting abducent nerve

Ans: (d)

123. A child with adenoidal hypertrophy with persistent ET dysfunction can develop into

(a)   Primary acquired cholesteatoma

(b)   Secondary acquired cholesteatoma

(c)   Osteitis and granulation tissue

(d)   Microcholesteatoma

Ans: (a)

124. A case of Meniere’s disease has failed all medical treatment. But still has a serviceable hearing. All can be done except

(a)   Intratympanic gentamicin

(b)   Endolymphatic sac decompression

(c)   Vestibular neurectomy

(d)   Labyrinthectomy

Ans: (d)

125. 8 years old child presents with a preauricular sinus, not associated with any discharge. The sinus opening is visualized clearly. The mother has same H/O preauricular sinus and was operated 30 years b ack. Now, next line of management is

(a)   HRCT of temporal bone

(b)   Sinogram with a radio-opaque dye

(c)   Regular follow up

(d)   MRI to exclude cyst

Ans: (b)

126. A case of Lower motor neuron facial palsy with intact lacrimation on Schirmer’s test and loss of taste sensation in anterior 2/3rd The level of lesion

(a)   At the level of stylomastoid foramen

(b)   At the level of geniculate ganglion

(c)   At the internal acoustic canal

(d)   At the horizontal tympanic canal

Ans: (d)

127. Deep and lower voice in males is due to

(a)   Inferior placement of larynx

(b)   Longer vocal cord

(c)   More vocal vibration due to flaccidity

(d)   Larger arytenoids cartilage

Ans: (b)

128. A school teacher complains of easy fatiguability of voice following upper respiratory tract infection. Indirect laryngoscopy shows key hole appearance of glottis. The next line of management is

(a)   There is weakness of thyroarytenoid and interarytenoid, can  be cured by type-I thyroplasty and arrytenoid adduction

(b)   There is weakness of thyroarytenoid and interarytenoid, can be cured by vocal hygiene and voice rest

(c)   There is weakness of thyroarytenoid and interarytenoid, can be cured by type-I thyroplasty

(d)   Thee is early vocal nodule, can be cured by voice rest and microlaryngeal surgery

Ans: (b)

OPHTHALMOLOGY

129. The ideal rehabi9ilitation for aphakia is

(a)   ACIOL

(b)   PCIOL

(c)   Spectacle

(d)   Contact lens

Ans: (b)

130. Pathognomonic retinal change is seen in

(a)   Wilson disease

(b)   Infective endocarditis

(c)   Polycythemia rubra vera

(d)   Sickle cell anemia

Ans: (d)

131. A 52 year old male on regular diclofenac medication for back pain presents with deteriorating vision. His BP is 142/82 mmGh, PR-72/min, regular respiration. There is bilateral loss of visual acuity and colour vision. There were no other abnormal neurological findings. Diagnosis

(a)   Cataract

(b)   Optic neuritis

(c)   Primary open angle glaucoma

(d)   Primary angle closure glaucoma

Ans: (b)

132. 22 year sold female with one month hisotry of episodic, brief visual loss in the right eye. There was H/O weight gain for last 1 year. Now BMI is 35. Fundus examination shows bilateral optic disc swelling more on right with small retinal Diagnosis

(a)   Optic neuritis

(b)   Craniopharyngioma

(c)   Sagittal sinus thrombosis

(d)   Idiopahtic intracranial hypertension

Ans: (d)

133. 28 years old female presents with complains of her right pupil larger than left after developing Shingles. On examination right pupil is larger than the left, reacts poorly to light, normal near reflex. Diagnosis is

(a)   Third nerve palsy

(b)   Holme-Adie’s pupil

(c)   Argyll Robertson pupil

(d)   Horner syndrome

Ans: (b)

PREVENTIVE & SOCIAL MEDICINE

134. The appropriate level of prevention for preventing childhood obesity

(a)   Primordial prevention

(b)   Primary prevention

(c)   Secondary prevention

(d)   Rehabilitation

Ans: (a)

135. Meta-zoonosis among the following is

(a)   Rabies

(b)   Brucellosis

(c)   Plaque

(d)   Taeniasis

Ans: (c)

136. A new publisher devices a test for tuberculosis. You want to know that proportion of patients with tuberculosis would be confidently identified this test. Which measure will you use?

(a)   Sensitivity

(b)   Specificity

(c)   Negative predictive value

(d)   Positive predictive value

Ans: (a)

137. The fifth millennium development goals for 2015aims at bringing down the MMR by

(a)   0.25

(b)   0.5

(c)   0.75

(d)   1

Ans: (d)

138. The colour code for the bag for collecting waste sharps

(a)   Blue/White

(b)   Black

(c)   Red

(d)   Yellow

Ans: (a)

139. In a study of correlation between serum insulin levels (μU/ml) and waist circumference (cm), 100 patients were recruited. They found that the correlation coefficient was 0.5. The true statement is

(a)   Change in unit of insulin will change the correlation coefficient

(b)   Correlation is weak

(c)   For every cm increase in waist circumference, insulin levels increased by 0.3 μU/mL

(d)   95% confident interval should be considered for correlation coefficient.

Ans: (d)

140. Not a feature of systematic review

(a)   Meta-analysis always performed

(b)   Search for literature is compulsory using explicit search strategy

(c)   Critical appraisal is always criterion based

(d)   Research question is always focused

Ans: (a)

141. True about meta-analysis is all except

(a)   A statistical technique for combining the findings from several independent studies on a specific topic

(b)   Its purpose is not to identify risk factors

(c)   Its purpose is o increase statistical power by increasing the sample size

(d)   The validity does not depend on the quality of thee systematic review

Ans: (d)

MEDICINE

142. Right sided heart sound that decreases in intensity during inspiration is

(a)   Systolic murmur of tricuspid regurgitation

(b)   Systolic murmur of pulmonary stenosis

(c)   Right ventricular S3

(d)   Pulmonary ejection sound

Ans: (d)

143. Treatment of choice in ST segment elevated myocardial ischemia is

(a)   Thrombolysis with streptokinase

(b)   Thrombolysis with alteplase

(c)   Primary percutaneous coronary intervention

(d)   Aspirin with low molecular weight heparin

Ans: (c)

144. Test to detect reversible Myocardial ischemia

(a)   Resting echo

(b)   Multi gated acquisition (MUGA) scan

(c)   Thallium scan

(d)   Cornoary angiogram

Ans: (c)

145. A 41 year old male presents with infective endocarditis. Condition associated with best prognosis is

(a)   Streptococcus viridans

(b)   IV drug abusers

(c)   Prosthetic valve infections

(d)   Staphylococcus aureus infections

Ans: (a)

146. True regarding the diagnosis of infective endocarditis is

(a)   Failure to detect vegetations does not exclude the diagnosis.

(b)   Sensitivity of transthoracic echocardiogram is 95%

(c)   Transthoracic echo is as good as transesophageal echo

(d)   Transthoracic echo can detect vegetations less than 2 mm.

Ans: (a)

147. A staff nurse of cardiology unit measures the blood pressure of a 61 years old male and records as 183/100 on sitting and 190/105 mmHg on standing. The heart rate is 81/min. irregularly irregular. On auscultation, no mumurs but there was bilateral basilar crackles, the most appropriate differential diagnosis is

(a)   Left atrial myxoma

(b)   Mitral regurgitation

(c)   Cor pulmonale

(d)   Left ventricular hypertrophy

Ans: (c)

148. A 24 years old female patient in operation theatre for excision of sebaceous cyst has a pulse rate of 220/min, BP- 70/50 mmHg, Respiratory rate- 32/min. Patient is wake, alert, oriented but feel dizzy. ECG shows a regular rhythm with a QRS width of 0.11 secs. The immediate line of management is

(a)   Adenosine 6mg/6mg/12mg

(b)   Amiodarone 300 mg

(c)   Direct current cardioversion

(d)   Atenolol 50mg

Ans: (a)

149. 18 years old female presents to the emergency department with cyanosis. There are no other notable clinical signs or symptoms. The presence of cyanosis was known to her from her neighbours. The most appropriate cause for her cyanosis would be

(a)   Lead poisoning

(b)   Severe anemia

(c)   Drinking water contaminated with nitrates

(d)   Carbon monoxide poisoning

Ans: (c)

150. Right internal carotid artery stenosis is associated with all except

(a)   Dysphasia

(b)   Drop attacks

(c)   Contralateral hemi sensory loss

(d)   Contralalteral hemiplegia

Ans: (b)

151. 66 years old male presents to the emergency department with ataxia, vomiting, head ache with increasing drowsiness. The most appropriate diagnosis is

(a)   Herpes Simplex Encephalitis

(b)   Acute subdural haemorrhage

(c)   Acute cerebellar haemorrhage

(d)   Transient ischemic attack

Ans: (c)

152. A 73 years old male patient presents with abrupt onset of double vision with left leg weakness, right facial weakness affecting upper and lower parts of face with left hemipareiss. All these clinical features can occur, if the lesion is at the level of

(a)   Left frontal lobe

(b)   Right mid brain

(c)   Left lateral medulla

(d)   Right pons

Ans: (d)

153. An 18 year old male presents with history of head ache for past 6 months in the frontal area, occasionally associated with nausea. He is on paracetamol 3g/day, Aspirin 300 mgtds, Codeine 40 mg tds. It provides only temporary relief. He had a history of depression 2 years back and was on treatment with paroxetine. No abnormalities were detected on clinical examination. The exact diagnosis is

(a)   Medication overuse head ache

(b)   Migraine

(c)   Cluster head ache

(d)   Head ache due to depression

Ans: (a)

154. A 22 years old female presents with distress, shortness of breath with respiratory rate 35/min, pulse rate-120/min, BP- 110/70 mmHg, Oxygen saturation of 90% and peak expiratory flow less than 50%. Salbutamol 5 mg was given twice and face mask O2 was given, the next line of management is

(a)   Prednisolone 40 mg

(b)   Intensive care referral

(c)   Arterial blood gas analysis

(d)   Salbutamol 5 mg + ipratropium bromide 0.5 mg

Ans: (a)

155. 80 years old coal miner who stopped working 16 years back develops dyspnoea. FEV1- 1.4 L(predicted value – 2.5 L), FVC – 2.8L(Predicated value – 3.0 L) Diagnosis

(a)   Silicosis

(b)   Idiopathic pulmonary fibrosis

(c)   COPD

(d)   Hypersensitive pneumonitis.

Ans: (c)

156. A 26 years old patient was brought to the emergency department with severe shortness of breath with BP 80/50 mmHG, tachypnea. On examination he is apyrexial. The oxygen saturation is 74%. ON clinical examination JVP was increased, trachea was shifted to left side. The next step in management include

(a)   Insert a large bore needle in the right side

(b)   Insert a large bore needle in the left side

(c)   Order for an urgent portable Chest X ray and administer high levels of  oxygen

(d)   Aspirate the left side of chest with wide bore cannula

Ans: (a)

157. A patient posted for surgery for squamous cell carcinoma of lung. He suddenly develops. Left hemothroax. The next line of management is

(a)   Tranexamic acid

(b)   Bronchial embolization

(c)   Throacostomy tube

(d)   Radiotherapy

Ans: (c)

158. 18 years old female presents with a red tender lump on shin and arthralgia. Chest X rays shows bilateral hilar lymphadenopathy with clear lung fields. She is diagnosed to be having sarcoidosis. The most appropriate management plan is

(a)   24 hours urinary calcium levels measurement

(b)   Follow up with chest X ray after 3 months

(c)   Mediastinoscopy with lymph node biopsy

(d)   Thoracic CT-scan

Ans: (c)

159. Cavitatory lesion on chest X ray is seen in

(a)   Klebsiella pneumonia

(b)   Pneumococcal pneumonia

(c)   Sarcoidosis

(d)   Leginnaire’s disease

Ans: (a)

160. Conglomerate nodules in chest X ray is seen in

(a)   Silicosis

(b)   Sarcoidosis

(c)   Lobar pneumonia

(d)   Hypersensitive pneumonitis

Ans: (a)

161. Identify the true association

(a)   Broncho pulmonary aspergillosis + wheezing

(b)   Pulmonary embolism + LBBB

(c)   Lung carcinoid + pulmonary embolism

(d)   Pneumoconiosis + clubbing

Ans: (a)

162. 40 years old male patient presents with pulmonary embolism to the emergency department. A ventilation perfusion san is ordered. All the following are true regarding V/P scan except

(a)   Contraindicated in pregnancy

(b)   a normal perfusion scan excludes the diagnosis of clinically significant pulmonary embolism

(c)   An abnormal ventilation with perfusion defects points towards a diagnosis other than pulmonary embolism

(d)   Two or more segmental perfusion defects in the presence of normal ventilation indicates high probability of pulmonary embolism

Ans: (a)

163. A 29 years old female with 30 weeks of pregnancy is receiving subcutaneous low molecular weight heparin for pulmonary embolism. Now she is developing bruises. BP in left lateral position is 125/75 mmHg. Next immediate step is

(a)   Platelet count

(b)   Factor X-a levels

(c)   Aptt

(d)   Serum albumin levels

Ans: (b)

164. 35 years old female with history of 2 previous episodes of DVT now presents with further DVT. Lupus anti-coagulant is positive. The treatment is

(a)   LMW heparin

(b)   Aspirin and warfarin

(c)   Warfarin life long

(d)   Warfarin for 6 months.

Ans: (c)

165. A 30 years primi with no previous significant medical history has a sister suffering from deep vein thrombosis in her second pregnancy. Thrombophilia screening shows she is heterozygous for factor-V (Leiden) The appropriate next line of management is

(a)   Treat her with 75 mg aspirin daily

(b)   Advise her to come for treatment if she develops calf swelling or pain

(c)   Give warfarin

(d)   Start her on prophylactic LMWH

Ans: (d)

166. 30 years old male patient develops heamturia in operation table 15 minutes following blood transfusion. His pulse rate is 120/min, BP- 70/40 mmgHG. Identify the cause

(a)   DIC

(b)   Anaphylaxis to anaesthetic agents

(c)   ABO incompatibility

(d)   Graft versus host disease

Ans: (c)

167. Even after screening of blood before transfusion, post transfusion hepatitis is common because

(a)   Most cases of post transfusion hepatitis are caused by hepatitis C virus

(b)   Most hepatitis B carriers do not have detectable HbS antigen in serum

(c)   Available tests are not sensitive to detect HbS antigen

(d)   Most cases of post transfusion hepatitis are cause by CMV

Ans: (b)

168. Number connection test is done in

(a)   Alzheimer’s disease

(b)   Parkinson’s disease

(c)   Dementia

(d)   Hepatic encephalopathy

Ans: (d)

169. True regarding spontaneous bacterial peritonitis is

(a)   Occurs due to intestinal perforation

(b)   Diagnosed by culture of ascetic fluid

(c)   Treatment of choice is gentamicin

(d)   Usually caused by aerobic bacteria

Ans: (d)

170. A 65 years old female presents with one month history of malaise, weight loss and right sided pain around the eye with head ache. Intermittent diplopia was present. She underwent mastectomy for breast carcinoma five years back. Temperature now is 37.5 C. Tenderness of scalp on right forehead and temple was present. Some minor weakness of abduction of right eye was present, ESR is 55 mm/hr. Diagnosis

(a)   Meningeal metastatic disease

(b)   Giant cell arteritis

(c)   Frontal sinusitis

(d)   Posterior cerebral artery aneurysm

Ans: (b)

171. 53 years old male presents with polyuria, polydipsia and weight loss for 3 months. Presence of one of the following in this patient is diagnostic of Diabetes mellitus

(a)   Urine dipstick test 3+ glucose

(b)   Fasting plasma glucose 135 mgs/dl

(c)   Fasting plasma glucose 117 mgs/dl

(d)   Two-hour plasma glucose 180 mgs during an oral glucose tolerance test

Ans: (b)

172. Feature of hereditary hemorrhagic telangiectasia is

(a)   Cerebral arterio venous malformations

(b)   Responds to oestrogen      

(c)   Telangiectasia of mucus membranes and not skin

(d)   Gastrointestinal haemorrhage is usually starts in the prepubertal age group

Ans: (a)

173. 56 years old male patient in septic shock, fully ventilated is on veno-venous hemofiltration on Noradrenaline, vancomycin and ciprofloxacin, Mean arterial pressure is 60 mmHg, not improving after changing on or adrenaline to adrenaline. No myocardial dysfunction. Next step in the management is

(a)   ACTH stimulation test

(b)   Hydrocortisone

(c)   Activated protein C

(d)   Change of inotropes

Ans: (b)

174. Hallmark of uncompensated shock in a child is imbalance between O2 delivery and O2 consumption. This is manifested by all except

(a)   High anion gap metabolic acidosis

(b)   Increased lactic acid production

(c)   Decreased oxygen extraction in the tissues

(d)   Low mixed venous oxygen saturation

Ans: (a)

175. 42 years old female presents with diazepam and alcohol overdose. Patient is unconscious, temperature 34.5℃, BP 100/80 mmHg, creatinine 242 μmol/L, AST 500 U/L, Gamma glutamyl transferase 35 IU, urine analysis is unremarkable, urine dipstick test shows 3+ blood. USG abdomen was normal. Identify the cause

(a)   Hypothermia

(b)   Dehydration

(c)   Rhabdomyolysis

(d)   Associated paracetamol over dosage

Ans: (c)

176. An 11 year child with failure to thrive, metabolic acidosis with increased anion gap. Not true regarding the differential diagnosis

(a)   Insulin dependent diabetes mellitus

(b)   Chronic renal failure

(c)   Renal tubular acidosis

(d)   Inborn errors of metabolism

Ans: (c)

177. Not an indication to administer anti-snake venom to a child at early morning 4 am is

(a)   Local swelling with fang marks

(b)   Severe abdominal pain without fang marks

(c)   Gum bleeding or prolonged 20 minutes whole blood clotting time (WBCT)

(d)   External ophthalmoplegia with inability to lift the head.

Ans: (a)

178. 45 year old male presents with facial swelling, breathlessness to the emergency department. Urgent chest X-ray shows paral tracheal lymphadenopathy. The most appropriate statement favouring SVC obstruction is

(a)   Most common cause is squamous cell carcinoma of lung

(b)   Associated with hoarseness of voice

(c)   Associated with Kussmaul’s sign

(d)   Commonest symptom is stridor

Ans: (b)

SURGERY

179. Most common organ involved in blunt trauma in children

(a)   Spleen

(b)   Kidney

(c)   Liver

(d)   Small intestine

Ans: (a)

180. IN case of abdominal trauma, if the patient is hemodynamically unstable, investigation of choice is

(a)   Chest X ray erect

(b)   Barium Meal

(c)   FAST (Focussed Abdominal Sonar for Trauma)

(d)   Diagnostic peritoneal lavage

Ans: (c)

181. True regarding reflux of gastric contents into oesophagus

(a)   Neutralised by the bicarbonate secretion by oesophageal mucosa

(b)   Condition can be improved by eradication of H. Pylori

(c)   Diagnosis is excluded by normal appearing oesophagus at endoscopy

(d)   Occurs during transient relaxation of Lower oesophageal sphincter

Ans: (d)

182. 55 years old male presents with dysphagia is diagnosed to be a case of achalasia cardia. Management of choice is

(a)   Nifedipine

(b)   Buscopan

(c)   Omeprazole

(d)   Surgical cardiomyotomy

Ans: (d)

183. A coin is loaded in the oesophagus of an asymptomatic 3 years female child. Treatment is

(a)   Endoscopic removal within 24 hours

(b)   Immediate endoscopic removal

(c)   Wait for 48 hours

(d)   Dislodge the coin to the stomach

Ans: (a)

184. A child with upper gastro intestinal bleed due to varices. Line of management is

(a)   Octreotide is reserved for situations where immediate endoscopy is not available

(b)   Sengstaken Blackmore tube is preferred than pharamcotherapy

(c)   Lavage is given in room temperature

(d)   Target of haemoglobin for blood transfusion is 10g/dl

Ans: (c)

185. 52 years old male presents with heamtemesis and melena. icterus, confusion and flapping tremors. He is a case of chronic liver disease with a pulse rate 110/min and a BP of 100/70 mmHg. Ascites present. Endoscopy reveals small esophageal varcies without evidence of bleeding and an oozing portal hypertensive gastropathy. Treatment is evidence of bleeding an an oozing portal gastropathy. Treatment is

(a)   IV Terlipressin

(b)   Endoscopic injection of ethanolamine

(c)   IV vitamin K

(d)   Endoscopic banding

Ans: (a)

186. Invertogram in a new born with imperforate anus is done

(a)   After 2 hours

(b)   After 4 hours

(c)   After 6 hours

(d)   Immediately

Ans: (c)

187. Intussusception is caused by

(a)   Submucous lipoma

(b)   Subfascial lipoma

(c)   Subserous lipoma

(d)   Intramural lipoma

Ans: (a)

188. A 29 years old male presents with anemia, bleeding, diarrhea, abdominal pain. ON examination, mass is felt in right lower quadrant with skin tags. The most appropriate diagnosis is

(a)   Ulcerative colitis

(b)   Crohn’s disease

(c)   Intestinal lymphoma

(d)   Coeliac disease

Ans: (b)

189. Commonest cause of symptomatic ischemia of gastro intestinal tract

(a)   Superior mesenteric artery thrombosis

(b)   Inferior mesenteric artery thrombosis

(c)   Hepatic artery thrombosis

(d)   Coeliac artery thrombosis

Ans: (a)

190. All the following are features of acute pancreatitis except

(a)   Increased amylase

(b)   Hypocalcemia

(c)   Hypoglycemia

(d)   Leucocytosis

Ans: (c)

191. Nerve affected in sentinel node biopsy in breast cancer

(a)   Intercostobrachial nerve

(b)   Long thoracic nerve

(c)   Nerve to Latissimus dorsi

(d)   Lateral pectroal nerve

Ans: (a)

192. Thyrotoxicosis is characterised by all except

(a)   Palpitation

(b)   Hair loss

(c)   Diarrhea

(d)   Hyper activity

Ans: (c)

193. In an asthma clinic, a 30 years female complains of appearance of a mole. Suspicion for development of malignant melanoma should arise if

(a)   Size of lesion > 6 mm

(b)   Lesion in face

(c)   Lesion with regular outline

(d)   Deeply pigmented lesions

Ans: (a)

PEDIATRICS

194. The normal gain in length in a full term baby, at first 6 months of life is

(a)   6 cm

(b)   9 cm

(c)   15 cm

(d)   24 cm

Ans: (c)

195. Bed wetting is normal upto what age in girls and boys respectively?

(a)   3 years and 4 years

(b)   4 years and 5 years

(c)   5 years and 5 years

(d)   5 years and 6  years

Ans: (c)

196. Molar ratio of Sodium & Glucose in WHO ORS is

(a)   1:1

(b)   1:2

(c)   1:4

(d)   2:1

Ans: (a)

197. According to WHO, severe acute malnutrition in children is defined as

(a)   Weight for height Z score < −3

(b)   Weight for height Z score < −2

(c)   Weight for height Z score < −1

(d)   Weight for height Z score between −2 and −3

Ans: (a)

198. To prevent acute rheumatic fever, acute pharyngitis due to group A streptococci should be treated with antibiotics before

(a)   7 days of illness

(b)   8 days of illness

(c)   9 days of illness

(d)   10 days of illness

Ans: (c)

199. Not a typical localizing sign indicative of involvement of intrathoracic extra pulmonary site in children with respiratory infections

(a)   Stridor

(b)   Wheezing

(c)   Tachypnoea

(d)   Chest retraction

Ans: (b)

200. Neonatal liver failure is uncommonly associated with

(a)   Hereditary fructose intolerance

(b)   Congenital hepatic fibrosis

(c)   Galactosemia

(d)   Hemophagocytic lympho histiocytosis

Ans: (b)

201. Phenylketonuria – true statement

(a)   Urine phenyl alanine metabolites are increased

(b)   Deficiency of tyrosine hydroxylase

(c)   Serum tyrosine levels are decreased

(d)   Mental retardation does not occur if patient is advised to have phenyl alanine free diet

Ans: (d)

202. Component of initial impression in Pediatric Advanced Life Support(PALS)-2010 are all except

(a)   Airway

(b)   Breathing

(c)   Color

(d)   Consciousness

Ans: (a)

OBSTETRICS

203. USG is 18-20 weeks is done to

(a)   Detect maturity

(b)   Detect anomalies

(c)   Detect the sex of the fetus

(d)   Estimate the liquor

Ans: (b)

204. Diabetes mellitus in 32 y ears old female with 16 weeks pregnancy. BMI is 22. On oral glucose tolerance test with 75 mg glucose reveals, 0 hour-108, 2 hours-225 mgs/dl. The next step in the management of this case is

(a)   Repeat Oral glucose tolerance test after 4 weeks

(b)   Low calorie diet with exercise

(c)   Insulin therapy

(d)   Metformin therapy

Ans: (c)

205. Medical termination for a 11 weeks of unwanted pregnancy is done by

(a)   Menstrual regulation

(b)   Manual evacuation

(c)   Misoprostol + Mifepristone

(d)   Dilatation and curettage

Ans: (d)

206. The drug of choice for preventing pre-term labor is

(a)   Ritodrine

(b)   Progesterone

(c)   Nifedipine

(d)   Oestrogen

Ans: (c)

207. Cardiac condition which does not increases the risk during pregnancy

(a)   Pulmonary hypertension

(b)   Cyanotic heart disease

(c)   Ebstein’s anomaly

(d)   Marfan’s syndrome

Ans: (c)

208. A 30 year old female with 12 weeks of pregnancy is diagnosed to be a case of systemic lupus erythematosus. With reference to SLE in pregnancy, true statement is

(a)   Risk of pulmonary embolism is same that of general population

(b)   Stop hydroxychloroquine during breast feeding

(c)   Azathioprine is contraindicated in pregnancy

(d)   In anti-Ro and Anti-la are negative, there is increased risk of congenital heart block.

Ans: (a)

209. Drug of choice for a pregnant woman with Chlamydia trachomatis infection is

(a)   Amoxicillin

(b)   Doxycycline

(c)   Cefazolin

(d)   Azithromycin

Ans: (a)

GYNECOLOGY

210. 17 years old female patient presents with 3 days history of vaginal discharge associated with pruritis. Recently she received treatment for UTI. Identify the causative organism.

(a)   Gradenella vaginalis

(b)   Candida albicans

(c)   Chlamydia trachomatis

(d)   Trichomonas vaginalis.

Ans: (d)

211. An 18 years old female patient with H/o irregular period was diagnosed as polycystic ovaries and started Metformin therapy. The mechanism of action of metoforming in this condition is

(a)   Increases the levels of LH

(b)   Increased peripheral glucose uptake

(c)   Increases estradiol level

(d)   Increases the insulin level.

Ans: (b)

212. A 22-year-old woman consults you for treatment of hirsutism. She is obese and has facial acne and hirsutism on her face and periareolar regions and a male escutcheon. Serum LH level is 35 mIU/mL and FSH is 9 mIU/L. Androstenedione and testosterone levels are mildly elevated, but serum DHEAS is normal .The patient does not wish to conceive at this time. Which of the following single agents is the most appropriate treatment of her condition?

(a)   Oral contraceptives

(b)   Corticosteroids

(c)   GnRH

(d)   Wedge resection

Ans: (a)

213. 23 years old female patient comes to gynaecological OPD with H/O irregular cycles for the past two years and is anxious to conceive. Her BMI is 29. There are features of hirsutism. On USG, her ovarian volumes were high. You have to educate her regarding her life style modification as she is more prone for the risk of developing which of the following carcinoma?

(a)   Cervical Ca

(b)   Endometrial Ca

(c)   Breast Ca

(d)   Ovarian Ca

Ans: (b)

214. 40 years old multiparous woman shows CIN-2 on Pap smear. Next line of management

(a)   Hysterectomy

(b)   Conisation

(c)   Colposcopy

(d)   Cryotherapy

Ans: (c)

ORTHOPEDICS

215. Light bulb sign in anteroposterior view of X ray shoulder is due to

(a)   Fracture humerus with dislocation of glenohumeral joint

(b)   Fracture scapula

(c)   Anterior dislocation of shoulder

(d)   Posterior dislocation of shoulder

Ans: (d)

216. Pointing index in a case of supracondylar fracture humerus in children occurs due to involvement of

(a)   Radial nerve

(b)   Anterior interosseous nerve

(c)   Musculo cutaneous nerve

(d)   Ulnar nerve

Ans: (b)

217. The most appropriate term in bone growth is

(a)   Apposition

(b)   Enlargement

(c)   Hypertrophy

(d)   Hyperplasia

Ans: (a)

218. Features of hemophilic knee joint are all except

(a)   Squaring of patella

(b)   Widening of intercondylar notch

(c)   Sub chondral cyst formation

(d)   Juxta articular osteosclerosis.

Ans: (d)

219. History of twisting strain and locking of knee joint occurs due to

(a)   Tear of Anterior cruciate ligament

(b)   Tear of Medial cruciate ligament

(c)   Meniscal tear

(d)   Patellar fractures

Ans: (c)

220. Conditions requiring open reduction in children is

(a)   Intercondylar fracture femur

(b)   Fracture both bones of forearm

(c)   Lateral condylar fracture of humerus

(d)   Epiphyseal separation of tibia

Ans: (c)

221. Recognizing feature of achondroplasia

(a)   AR inheritance

(b)   Diagnosed radiologically at birth

(c)   Increased liability for fractures

(d)   Short spine

Ans: (d)

222. 58 years old female patient presents with one year history of anterior knee pain on climbing stairs. On examination crepitus was present. There was severe restriction of movements beyond 110 degrees. Examination of hip and back was normal. Diagnosis is

(a)   Osteoarthritis

(b)   Psoriatic arthritis

(c)   Osteonecrosis

(d)   Gout

Ans: (a)

223. Degree of angulation acceptable after reducing tibial fracture is

(a)   5

(b)   10

(c)   15

(d)   20

Ans: (a)

224. Open fracture is best treated by

(a)   Internal fixation

(b)   External fixation

(c)   Debridement

(d)   Tourniquet

Ans: (c)

225. Treatment of club foot in a new born is

(a)   Manipulation and corrective splint

(b)   Corrective splint

(c)   Manipulation alone

(d)   Observe till 6 months of age

Ans: (a)

ANESTHESIA

226. Delivery of high concentration of oxygen (more than 90%) is delivered via

(a)   Partial rebreathing mask

(b)   Nasal cannula with oxygen flow at 5 L/min

(c)   Simple face mask

(d)   Non rebreathing face mask with oxygen reservoir

Ans: (d)

227. A patient on epidural anesthesia with 15 ml of 1.5% lignocaine with adrenaline for hernia surgery develops hypotension and respiratory depression three minutes. Most common cause for this clinical condition is

(a)   Systemic toxicity of anesthetic agents

(b)   Drug allergy

(c)   Vaso vagal shock

(d)   Drug entering into sub archnoid space

Ans: (d)

228. A 20 year old male patient met with motor vehicle accident and sustained head injuries. BP- 90/60 mmHg, Pulse rate – 150/min. All the following anesthetic agents are avoided for induction except

(a)   Thiopentone

(b)   Halothane

(c)   Succinylcholine

(d)   Ketamine

Ans: (a)

229. A child with intestinal obstruction and deranged LFT. Anesthetic agent of choice is

(a)   Halothane

(b)   Enflurane

(c)   Isoflurane

(d)   Sevoflurane

Ans: (d)

230. A 25 years old primi with mitral stenosis and mitral regurgitation wants a normal delivery. The appropriate analgesia is

(a)   Inhalational analgesia

(b)   Spinal anesthesia

(c)   Neuro axial block analgesia

(d)   IV opioids

Ans: (c)

231. True regarding hypothermia during anesthesia

(a)   Body may lose heat by conduction

(b)   Beneficial to patients in some conditions

(c)   Always occur irrespective of the type of anaesthesia

(d)   Prevented by given warm fluids

Ans: (b)

RADIODIAGNOSIS & RADIOTHERAPY

  1. Principle used in radiotherapy

(a)   Double-stranded breaks of nuclear DNA

(b)   Inhibition of protein synthesis

(c)   Inhibition of peroxisomes

(d)   Activation of caspases

Ans: (a)

233. Gamma camera is used in radiotherapy to

(a)   Monitor surface contamination

(b)   Measures radioactivity

(c)   Organ imaging

(d)   Radio immune assay

Ans: (b)

234. A patient presents with a tumor of 4 cms in his left parietal lobe. Patient underwent surgery and radiotherapy. After 2 months, he develops headache and vomiting. The investigation of choice for this condition is

(a)   99m-Tc  hexamethylpropylene amine oxide- SPECT scan

(b)   Digital Subtraction Angiography with dual source CT

(c)   Gadolinium enhanced MRI

(d)   18-FDG PET scan

Ans: (d)

235. A patient with Hodgkin’s disease undergoes mantle field radio therapy. Several months later he complains that on flexion or extension of neck, an electric shock phenomenon is felt down the back and limbs. This is called as

(a)   Uthoff’s sign

(b)   Cervical arthritis

(c)   Malignant spinal cord compression

(d)   Lhermitte’s sign

Ans: (d)

236. Bone scan in multiple myeloma shows

(a)   Cold nodule

(b)   Hot nodule

(c)   Diffusely increased uptake

(d)   Diffusely decreased uptake

Ans: (a)

237. Stereo tactic radio surgery is form of

(a)   Cryotherapy

(b)   Radiotherapy

(c)   Robotic therapy

(d)   Radio iodine Therapy

Ans: (b)

238. 68 years old male patient referred by a general practitioner with detoriated hypertension and renal function. His serum creatanine is 4.5, mild proteinuria +. Renal USG shows left kidney 9 cm and right kidney 7 cm in length (normal length 10 cm). There was no obstruction. Investigation is

(a)   MR angiography

(b)   Isotope renogram

(c)   Intravenous renography

(d)   Retrograde pyelography

Ans: (b)

239. Radiological features indicating increased pulmonary blood flow are all except

(a)   Kerley B lines

(b)   Pulmonary artery diameter more than 6mm

(c)   Diameter of two peripheral arteries greater than accompanying bronchi

(d)   More than 6 blood vessels in outer 1/3rd

Ans: (c)

DERMATOLOGY

240. The peculiar hue of Mongolian spots in new born is due to dermal location of melanin containing melanocytes that are presumably arrested in their migration from neural crest to epidermis. The arrest occurs at the level of

(a)   Neural crest to melanocytosis

(b)   Low dermal melanocytosis

(c)   High dermal melanocytosis

(d)   Mid dermal melanocytosis

Ans: (b)

241. Syndromic management of urethral discharge includes the treatment of

(a)   Syphilis and chancroid

(b)   Neisseria gonorrhea and herpes geniatalis

(c)   Nesseria gonorrhea and chlaymdia trachomatis

(d)   Chlamydia trachomatis and herpes genitalis

Ans: (c)

242. A 16 year old male in dermatology OPD presents with a history of hair loss on scalp. His past medical history includes atopic eczema and he has a number of depigmented areas on the hands. Diagnosis is

(a)   Hypothyrodism

(b)   SLE

(c)   Seborrheic dermatitis

(d)   Alpecia areata

Ans: (d)

PSYCHIATRY

243. Perception in the absence of external stimulus is called as

(a)   Illusion

(b)   Delusion

(c)   Hallucination

(d)   Malingering

Ans: (c)

244. Intentional production of symptoms by a patient for obvious and tangible goals is seen in

(a)   Malingering

(b)   Conversion disorder

(c)   Adjustment disorder

(d)   Factitious disorder

Ans: (a)

245. True regarding pathological grief reaction is

(a)   No psychiatric treatment is required

(b)   Normal response to los of loved ones

(c)   Universal phenomenon

(d)   Lasts more than six months

Ans: (d)

246. True regarding puerperal psychosis

(a)   Begins 2nd week of postpartum

(b)   Recurrence in subsequent pregnancies

(c)   Good prognosis

(d)   Insidious onset

Ans: (b)

247. Strong urge to u se a drug in a person with substance misuse disorder is

(a)   Tolerance

(b)   Salience

(c)   Craving

(d)   Impulse

Ans: (c)

JIPMER Medical PG Entrance January 2014 Question Paper With Answer Key

JIPMER PG Medical Entrance Examination

January-2014

1. The collecting duct of permanent kidneys develop from

(a)   Mesonnephros

(b)   Metanephros

(c)   Pronephros

(d)   Urteric acid

Ans: (d)

2. True regarding epithelial cells

(a)   The lining cells of urinary tract has goblet cells

(b)   Gives rise to sebaceous glands of the scalp

(c)   Lining the respiratory tract are keratinized

(d)   Surrounded by a single layer of membranes

Ans: (d)

3. Actual arterial anastomosis are seen in all except

(a)   Labial branches of facial artery

(b)   Intercostal arteries

(c)   Cortical branches of cerebral arteries

(d)   Uterine and ovarian artery anastomosis

xt=”Show Answer” collapse_text=”Hide Answer” ]

Ans: (c)

4. Cells of Claudius is seen in

(a)   Parenchyma of parathyroid

(b)   Canal of schleiim

(c)   Organ of Corti

(d)   Alveolar duct of lungs

Ans: (c)

5. Part of large intestine with smallest diameter is

(a)   Ascending colon

(b)   Descending colon

(c)   Transverse colon

(d)   Sigmoid colon

Ans: (b)

6. True regarding ligament of Treitz are all except

(a)   Part of dorsal mesogastrium

(b)   Is an important radiological landmark for intestinal malrotation

(c)   Dudenojejunal flexure is suspended here

(d)   Contain suspensory muscle of duodenum

Ans: (a)

7. Mesorectum contains all except

(a)   Branch of inferior mesenteric plexus

(b)   Inferior rectal artery

(c)   Middle rectal vein

(d)   Para rectal lymph nodes

Ans: (b)

8. Fibres traversing through H2 band of Forel

(a)   Ansa lenticularis

(b)   Thalamic fasciculus

(c)   Subthalamic fasciculus

(d)   Fasciculus lenticularis

Ans: (d)

9. 5th cranial nerve-true are all except

(a)   Parasympathetic innervations to salivary glands

(b)   Sensory supply to whole face

(c)   Arises from midbrain

(d)   Innervates the muscles of mastication

Ans: (a)

10. Abductor of vocal cord is

(a)   Posterior cricoarytenoid

(b)   Criconthyroid

(c)   Interarytenoid

(d)   Lateral criarytenoid

Ans: (a)

11. Extraocular muscles supplied by oculomotor nerve are all except

(a)   Inferior oblique

(b)   Inferior rectus

(c)   Superior rectus

(d)   Superior oblique

Ans: (d)

12. Inferior tympani artery is a branch of

(a)   Stylomastoid artery

(b)   Posterior auricular artery

(c)   Ascending pharyngeal artery

(d)   Middle meningeal artery

Ans: (c)

PHYSIOLOGY

13. Normal plasma osmolality in terms of mmHG

(a)   285-295

(b)   310-340

(c)   260-275

(d)   270-285

Ans: (a)

14. Electrical synapse among the following is

(a)   Gap junctions

(b)   Tight junction

(c)   Anchoring junction

(d)   Neuromuscular junction

Ans: (a)

15. Proprioception is carried by

(a)   Aα

(b)   Aβ

(c)   Aγ

(d)   Aδ

Ans: (a)

16. Neuropraxia is defined as

(a)   Physical blockade of conduction

(b)   Complete division of nerve trunk

(c)   Axonal interruption

(d)   Partial division of nerve trunk

Ans: (a)

17. Blood nerve barrier is formed by

(a)   Endoneurium

(b)   Epineurium

(c)   Perineurium

(d)   Cytoplasm of Schwann cells

Ans: (c)

18. Lateral spinothalamic tract of spinal cord

(a)   Transmits contralateral light touch

(b)   Stratifies form fibres of lower spinal region innermost

(c)   Carries pain sensation from same side

(d)   Crosses from the thalamus to the contralateral parietal lobe

Ans: (b)

19. True regarding receptors are all except

(a)   Meissner’s corpuscles are present in hairy skin

(b)   Merkel’s disc is involved in localization of touch

(c)   Hair end organs detect the movement of objects in body surface

(d)   Pacinian corpuscles adapt quickly

Ans: (a)

20. Identify the true statement regarding haemoglobin:

(a)   One molecule of Hb binds with 2 molecules of 2, 3 BPG

(b)   Carboxyhemoglobin shifts the oxygen dissociation curve to the right

(c)   Affinity of oxygen fro haemoglobin decreases as the saturation increases

(d)   Affinity for oxygen remains same if BhA and HbF are sripped of 2, 3BPG

Ans: (d)

21. Partial pressure of carbondioxide in expired air

(a)   32 mmHg

(b)   46 mmHg

(c)   40 mmHg

(d)   50 mmHg

Ans: (a)

22. Partial pressure of carbondioxide is least in

(a)   Capillary blood

(b)   Alveolar air

(c)   Arterial blood

(d)   Expired blood

Ans: (d)

23. Insulin secretion is stimulated by all except

(a)   Amino acids

(b)   Glucagon

(c)   Hypokalemia

(d)   Ketoacids

Ans: (c)

24. Insulin independent glucose uptake occurs in

(a)   Liver

(b)   Skeletal muscle

(c)   Heart

(d)   Adipose tissue

Ans: (a)

25. Basal metabolic rate is increased by all except

(a)   Hypothyroidism

(b)   Cold

(c)   Fever

(d)   Pregnancy

Ans: (a)

26. Most common metabolite of progesterone excreted in urine

(a)   Pregnenolone

(b)   Pregnanediol

(c)   Pregnanetriol

(d)   17 hydroxy pregnenolone

Ans: (b)

27. Feature seen immediately after lying down

(a)   Increased cerebral blood flow

(b)   Immediate increase in venous return to the heart

(c)   Decrease in blood flow to the lung apex

(d)   No change in heart rate

Ans: (b)

BIOCHEMISTRY

28. Correct statement regarding enzyme kinetics

(a)   Non competitive inhibition results in decreased Km

(b)   Non competitive inhibition results in increased Km

(c)   High Km value reflects high substrate affinity

(d)   Low Km value reflects high substrate affinity

Ans: (d)

29. Identify the ligase among the following

(a)   Enolase

(b)   Chymotrypsin

(c)   Fatty acid coA synthase

(d)   Acetyl coA carboxylase

Ans: (d)

30. True regarding mitochondrial oxidative phosphorylation system- are all except

(a)   Oligomycin inhibits the H+ channel

(b)   Aspirin uncouples the oxidation from phosphorylation

(c)   Cyanide inhibits electron flow but not the ATP synthesis

(d)   Atractyloside depletes intramitochondrial ADP pool

Ans: (c)

31. Enzymes involved in substrate level phosphorylation are all except

(a)   Phosphofructokinase

(b)   Pyruvate kinase

(c)   Phosphoglycerate kinase

(d)   Succinate thiokinase

Ans: (a)

32. Enzyme absent in muscles

(a)   Enolase-B

(b)   Thioporase

(c)   Glycogen phosphorylase

(d)   Glucose-6 phosphatase

Ans: (d)

33. Ketone bodies are utilized by all except

(a)   RBCs

(b)   Brain

(c)   Liver

(d)   Heart

Ans: (c)

34. Lipoprotein-A is in structural homology to

(a)   Albumin

(b)   Prothrombin

(c)   Collagen

(d)   Plasminogen

Ans: (d)

35. Injection of heparin releases

(a)   Lipoprotein lipase

(b)   Insulin

(c)   Alkaline phosphatase

(d)   Nitric oxide

Ans: (a)

36. Reverse transcriptase among the following is

(a)   Telomerase

(b)   RNA polymerase-II

(c)   DNA polymerase α

(d)   Topoisomerase

Ans: (a)

37. True regarding telomerase

(a)   Not expressed in stem cells

(b)   Used by DNA templates for nucleotide addition

(c)   Cleaves RNA at 5’ end

(d)   Acts as a reverse transcriptase

Ans: (d)

PHARMACOLOGY

38. Aim of loading dose is to achieve

(a)   Target concentration rapidly

(b)   Attain supramaximal effect

(c)   Maximum receptor stimulation

(d)   Drug delivery at the site of action

Ans: (a)

39. Drug crossing blood brain barrier are all except

(a)   Atropine

(b)   Glycopyrrolate

(c)   Hyoscine butyl bromide

(d)   Hyoscine hydroxyl bromide

Ans: (b)

40. Betablocker with membrane stabilizing activity

(a)   Atenolol

(b)   Metoprolol

(c)   Esmolol

(d)   Sotalol

Ans: (b)

41. Betablocker with additional antioxidant property

(a)   Celiprolol

(b)   Carvedilol

(c)   Bisaprolol

(d)   Betaxolol

Ans: (b)

42. The cornerstone pharmacological therapy in heart failure includes all except

(a)   Antiplatelet agents

(b)   Angiotensin converting enzyme inhibitors

(c)   Diuretics

(d)   Beta blockers

Ans: (a)

43. Anti-arrhythmic agent of choice during resuscitation of a cardiac arrest, ventricular fibrillation and initial unsuccessful defibrillation is

(a)   Amiodarone

(b)   Procainamide

(c)   Lignocaine

(d)   Verpamil

Ans: (a)

44. The pleiotropic effects of stains are all except

(a)   Stability of plaques

(b)   Anti-inflammatory effects

(c)   Improvement in endothelial function

(d)   Decreased LDL levels

Ans: (d)

45. 8 year old child presenting with heterozygous familial cholesterolemia. Drug of choice is

(a)   Simvastatin

(b)   Atorvastatin

(c)   Pravastatin

(d)   Lovastatin

Ans: (c)

46. The antiplatelet drug which is not a prodrug

(a)   Clopidogrel

(b)   Ticlopidine

(c)   Prasugrel

(d)   Ticagrelor

Ans: (d)

47. Capillary leak syndrome occurs as an adverse effect in treatment with

(a)   G-CSF

(b)   GM-CSF

(c)   Filgrastim

(d)   Pegfilgrastim

Ans: (b)

48. Thiazide diuretic ineffective at GFT<30-40 ml/min are all except

(a)   Metolazone

(b)   Bendroflumethiazide

(c)   Chlorthiazide

(d)   Chlrothalidone

Ans: (a)

49. Alkalinsation of urine is the treatment of choice for poisoning with

(a)   Morphine

(b)   Digoxin

(c)   Amphetamines

(d)   Phenobarbitone

Ans: (d)

50. A 70 year old female patient on treatment with alendronate for osteoporosis develops pain in right thigh. Investigation of choice is

(a)   X ray

(b)   DEXA scan

(c)   Serum alkaline phosphatase

(d)   Serum vitamin D levels

Ans: (b)

51. Hypothyroidism is caused by

(a)   Propranalol

(b)   Propafenone

(c)   Amiodarone

(d)   Quinine

Ans: (c)

52. Replacement drug for valproate in juvenile myoclonic epilepsy to be given as monotherapy

(a)   Lacosamide

(b)   Levetiracetam

(c)   Carbmazepine

(d)   Phenytoin

Ans: (b)

53. A patient on disulfiram therapy consumes alcohol. All the features are seen except

(a)   Nausea

(b)   Vomiting

(c)   Flushing

(d)   Hypertension

Ans: (d)

54. Pharmacotherapy decreasing mortality in COPD

(a)   Oxygen

(b)   Beta agonist

(c)   Theophylline

(d)   Oral glucocorticoids

Ans: (a)

55. Drug that has toxic side effect on the retina

(a)   Hydroxychloroquine

(b)   Vigabatrin

(c)   Terbinafine

(d)   Aceclofenac

Ans: (a)

56. The antifungal drug flucanozole acts by inhibiting the

(a)   Mycolic acid

(b)   Peptidoglycan

(c)   Ergosterol

(d)   Microtubules

Ans: (c)

57. The anti retroviral drug which acts as a fusion inhibitor

(a)   Atazanavir

(b)   Emtricitabiine

(c)   Enfuvirtide

(d)   Elvitegravir

Ans: (c)

58. Aseptic meningitis is caused by

(a)   Doxorubicin

(b)   Cisplatin

(c)   Intrathecal dexamethasone

(d)   Intratheacal methotrexate

Ans: (d)

59. Lenalidomide increased the risk of thrombeoembolic events when combined with

(a)   Barbiturates

(b)   Anti psychotics

(c)   Alcohol

(d)   Glucocorticoids

Ans: (d)

60. The chelating agent used in chelating aluminium for hemo dialysis patients

(a)   Succimer

(b)   Desferrioxamine

(c)   Dimercaprol

(d)   Penicillamine

Ans: (b)

61. True regarding iodine therapy are all except

(a)   Contraindicated in hyperthyroidism

(b)   Inhibits thyroxine release

(c)   Can lead to iodism

(d)   Inhibits the synthesis of iodotyrosine ad iodothyronine

Ans: (a)

MICROBIOLOGY

62. All are Koch’s postulates except

(a)   A micro-organism should be constantly associated with the lesion of the disease

(b)   It should be possible to isolate the bacterium in pure culture from the lesions

(c)   Inoculation of such pure culture into laboratory animals should reproduce the lesions

(d)   Administration of broad spectrum antimicrobial agent dependably eradicates the organism and cures the diseases

Ans: (d)

63. All the following are true regarding exotoxin except:

(a)   Highly antigenic

(b)   Heat stable

(c)   Neutralized by antibody

(d)   Active in very minute doses

Ans: (b)

64. Movement of DNA from one bacteria to another through connectin tube or pilus is called

(a)   Transformation

(b)   Transduction

(c)   Conjugation

(d)   Lysogenic conversion

Ans: (c)

65. Endoscopes are sterilized by

(a)   Gluteraldehyde

(b)   Formaldehyde

(c)   Iodine

(d)   Phenol

Ans: (a)

66. Craigie’s tube method is used to differentiate

(a)   Motile and nonmotile strains

(b)   Virulent and avirulent strains

(c)   Capsulated and noncapsulated strains

(d)   Rough and smooth strains

Ans: (a)

67. The Ig which activates alternative complement pathway

(a)   IgG

(b)   IgE

(c)   IgA

(d)   IgM

Ans: (c)

68. The following is not a live vaccine

(a)   Measles

(b)   BCG

(c)   Yellow fever

(d)   Salk’s vaccine

Ans: (d)

69. Null cells that lack characteristics of B or T cells constitute what percentage of peripheral lymphocytes

(a)   0-1

(b)   2-3

(c)   5-10

(d)   15-20

Ans: (c)

70. An adult develops swelling of tongue and neck after ingestion of peanut, Diagnosis

(a)   Angioneurotic edema

(b)   Foreign body larynx

(c)   Parapharyngeal abscess

(d)   Foreign body nose

Ans: (a)

71. Type II lepra reaction is an example hypersensitivity type

(a)   I

(b)   II

(c)   III

(d)   IV

Ans: (c)

72. Allograft rejection is an example of

(a)   GVHD

(b)   Delayed (cell mediated) hypersensitivity

(c)   Immediate hypersensitivity

(d)   Acute rejection

Ans: (b)

73. All the following are true about Staphylococcus aureus except

(a)   Coagulase positive

(b)   Catalase negative

(c)   DNAse positive

(d)   Indole negative

Ans: (b)

74. Infection that can be acquired in laboratories

(a)   Brucellosis

(b)   Tuberculosis

(c)   Pertusssis

(d)   Melioidosis

Ans: (a)

75. All the following bacteria are motile except

(a)   Salmonella

(b)   Klebsiella

(c)   Citrobacter

(d)   Escherichia

Ans: (b)

76. All are true Salmonella typhi except

(a)   Indole negative

(b)   Produce H2S

(c)   Produce acid and gas from glucose

(d)   Citrate positive

Ans: (c)

77. Frie’s test is done for

(a)   LGV

(b)   Donovanosis

(c)   Syphilis

(d)   Herpes simplex

Ans: (a)

78. HIV affects

(a)   B cells

(b)   Helper T cell

(c)   Suppressor T cells

(d)   Cytotoxic T Cells

Ans: (b)

79. Which part of brain is not commonly affected in HIV encephalitis?

(a)   Hippocampus

(b)   Subcortical white matter

(c)   Diencephalon

(d)   Brainstem

Ans: (a)

80. Burkitt lymphoma is caused by

(a)   EBV

(b)   HPV

(c)   CMV

(d)   VZV

Ans: (a)

81. Infectious mononucleosis affects

(a)   T cells

(b)   B cells

(c)   NK cells

(d)   Macrophages

Ans: (b)

82. A 2 year old child presents with maculopapular rash 24 hours after the onset of mild fever. There was prominent Erythema over the cheek. The causative organism also causes

(a)   CML

(b)   ALL

(c)   DIC

(d)   Pure red cell aplasia

Ans: (d)

83. Negri bodies are abundant in the following cells of CNS except

(a)   Subcortical white matter

(b)   Purkinje cells of cerebellum

(c)   Hippocampus

(d)   Basal ganglia

Ans: (a)

84. Mansonoides mosquito is a vector for

(a)   Chikungunya fever

(b)   Dengue fever

(c)   Japanese encephalitis

(d)   Bancroftian filariasis

Ans: (a)

85. The following disease is not caused by fungi

(a)   Kerion

(b)   Favus

(c)   Mycosis fungoides

(d)   Pityrosporum folliclulitis

Ans: (c)

86. Espundia is due to

(a)   Leishmaniasis

(b)   Lymphogranuloma venerum

(c)   Endemic syphilis

(d)   Dnonvanosis

Ans: (a)

PATHOLOGY

87. The following is not an adhesion molecule

(a)   Spectrin

(b)   Integrins

(c)   Selectin

(d)   Cadherin

Ans: (a)

88.The following chemical mediator of inflammation is not cell derived

(a)   Leukotriences

(b)   Kinins

(c)   Cytokines

(d)   Prostaglandins

Ans: (b)

89. Synovial aspiration from a patient with arthritis shows many lymphocytes, plasma cells and few histiocytes. Diagnosis

(a)   Acute inflammation

(b)   Chronic inflammation

(c)   Granulomatous inflammation

(d)   Suppurative inflammation

Ans: (b)

90. A patient with nephritic syndrome presents with ascites and pitting edema of legs. The mechanism by which fluid accumulates in the peritoneum and legs

(a)   Lymphatic obstruction

(b)   Increased hydrostatic pressure

(c)   Increased vascular permeability

(d)   Decreased plasma osmotic pressure

Ans: (d)

91.True statement about Autosomal dominant inheritance

(a)   New mutations seem to occur in the germ cells of relatively older males

(b)   Complete penetrance seen

(c)   Manifestations early in life

(d)   New mutations occur in germ cells rarely

Ans: (a)

92. Globoid cells in the parenchyma around blood vessels is characteristic of

(a)   Krabbe’s

(b)   Canavan disease

(c)   Adrenoleukodystrophy

(d)   Sandhoff’s disease

Ans: (a)

93. In a patient with lead positing, bone marrow contains

(a)   Ringed sideroblasts

(b)   Giant metamyelocytes

(c)   Dwarf megakaryocytes

(d)   Fibrotic changes

Ans: (a)

94. Hemolytic uremic syndrome (HUS) is differentiated from Thrombotic thrombocytopenic purpura (TTP) by

(a)   Presence of Microangiopathic hemolytic anemia

(b)   Presence of renal failure

(c)   Absence of neurologic symptoms

(d)   Absence of fever

Ans: (d)

95. Maternal blood and fetal blood in a sample can be differentiated b y

(a)   Osmotic fragility test

(b)   Kleihauer Betke test

(c)   APT test

(d)   Bubble test

Ans: (c)

96. Reagent used in Apt test

(a)   Sodium hydroxide   

(b)   Sodium chloride

(c)   Sodium acetate

(d)   Sodium bicarbonate

Ans: (a)

97. Severe Hereditary spherocytosis is seen due to the defect of the following protein

(a)   Spectrin

(b)   Ankyrin

(c)   Band 3

(d)   Band 4.2

Ans: (a)

98. A patient presents with bone pain. X ray shows destructive bone lesions. Laboratory examination shows hypercalcemia. Serum electrophoresis shows M spike. 35% cellularity fo marrow is constituted by plasma cells. Diagnosis

(a)   Monoclonal gammopathy of unknown significance

(b)   Smouldering myeloma

(c)   Multiple myeloma

(d)   Plasma cell leukemia

Ans: (c)

99. In bronchial asthma, bronchi and bronchioles are occluded with shed epithelium forming a thick mucus called

(a)   Curschmann spirals

(b)   Council man bodies

(c)   Creola bodies

(d)   Charcot-Leyden crystals

Ans: (a)

100. Which of the following is not a skin manifestation of Sarcoidosis

(a)   Lupus perinio

(b)   Erythema nodosum

(c)   Urticaria pigmentosa

(d)   Keloid formation

Ans: (c)

101. A hyperplastic mass containing Neuroendocrine cells in an area of chronic inflammation and scared tissue of lung

(a)   Carcinoid

(b)   Tumorlet

(c)   Hamartoma

(d)   Teratoma

Ans: (b)

102. Good pasture syndrome, an autoimmune disease, presenting with hemorrhage in lungs and renal disease is due to autoantibodies against

(a)   Collagen type I

(b)   Collagen type II

(c)   Collagen type III

(d)   Collagen type IV

Ans: (d)

103. The following is not a marker of melanoma

(a)   S-100

(b)   MITF

(c)   CK-20

(d)   Vimentin

Ans: (c)

104. Immunohistochemical marker of rhabdomyocsarcoma

(a)   Desmin

(b)   Vimentin

(c)   Cytokeratin

(d)   Neurofilament

Ans: (a)

FORENSIC MEDICINE

105. Magistrate inquest in India is conducted for all the following conditions except

(a)   Exhumation

(b)   Custody death

(c)   Homicide

(d)   Dowry death

Ans: (c)

106. Tattoo mark was described by immediate relatives of a deceased. But it is not found on autopsy. The evidence of the tattoo mark can be obtained from

(a)   Adjacent subcutaneous tissues

(b)   Adjacent fat tissues

(c)   Adjacent lymph nodes

(d)   Underlying muscles

Ans: (c)

107. Which of the following organ decomposes late

(a)   Brain

(b)   Heart

(c)   Prostate

(d)   Liver

Ans: (c)

108. A child sustained burns in front and back of both thighs and buttocks, face and scalp with singeing of hair. Calculate the percentage of burns

(a)   27

(b)   32

(c)   34

(d)   45

Ans: (b)

109. A pedestrian was hit by fast moving vehicle on leg and thrown away. He hit the road divider and fell down on the road and sustained head injuries. He was run over by a car moving on the opposite direction. The head injuries sustained b y the patient are example of

(a)   Primary impact injuries

(b)   Primary injuries

(c)   Secondary impact injuries

(d)   Secondary injuries

Ans: (d)

110. Which bone is involved in Hinge fracture?

(a)   Skull

(b)   Femur

(c)   Vertebrae

(d)   Pelvis

Ans: (a)

111. In India, Medical termination of pregnancy is permitted upto

(a)   20 weeks

(b)   22 weeks

(c)   28 weeks

(d)   Before viability of the fetus

Ans: (a)

112. Bitten fruit from the scene of crime is preserved in

(a)   Saline

(b)   10% Formalin

(c)   Glacial acetic acid

(d)   Metabisulfite solutions

Ans: (d)

113. Red velvety appearance of stomach is seen in the following poisoning

(a)   Arsenic

(b)   Sulphuric acid

(c)   Organophosphate

(d)   Datura fastuosa

Ans: (a)

114. Extract from the following poison resembles viper venom

(a)   Abrus precatorius

(b)   Semecarpus anacardium

(c)   Plumbago rosea

(d)   Croton tiglium

Ans: (a)

115. Not a feature of Wernicke’s encephalopathy

(a)   Tinnitus

(b)   Global confusion

(c)   Ataxia

(d)   Ophthalmoplegia

Ans: (a)

ENT

116. The opening of auditory tube is present in which part of middle ear

(a)   Anterior wall

(b)   Posterior wall

(c)   Medial wall

(d)   Lateral wall

Ans: (a)

117. The threshold for the frequencies 500, 1000 and 2000 in PTA is 45 dB. The degree of hearing loss is

(a)   Mild

(b)   Moderate

(c)   Severe

(d)   No hearing loss

Ans: (b)

118. A Pregnant woman presents with complaints of deafness. What type of curve will be obtained in Impedance audiometry (Tympanometry)?

(a)   Ad

(b)   As

(c)   B

(d)   C

Ans: (b)

119. Minimum gestational period after which the auditory evoke potential is significant

(a)   16

(b)   20

(c)   24

(d)   28

Ans: (d)

120. Sinuses that are present at birth

(a)   Maxillary and Frontal

(b)   Maxillary and Ethmoid

(c)   Maxillary and Sphenoid

(d)   Ethmoid and Sphenoid

Ans: (b)

121. The following structure is not a part of ethmoid bone

(a)   Uncinate process

(b)   Inferior turbinate

(c)   Agar nasi

(d)   Bulla ethmoidalis

Ans: (b)

122. An elderly female presents with nasal block, nasal discharge, diplopia and facial swelling. On examination, there was blackish discharge from the nasal cavity with necrosis of nasal mucosa, palate and fixation of right globe. Laboratory investigations reveal elevated blood sugar levels and urine ketones. Drug of choice

(a)   III generation cephalosporins

(b)   Ketoconazole

(c)   Itraconazole

(d)   Amphotericin-B

Ans: (d)

123. Retropharyngeal space extends from

(a)   Skull base to tracheal bifurcation (T4)

(b)   Skull base to diaphragm

(c)   Skull base to hyoid bone

(d)   Skull base to C6 vertebrae

Ans: (a)

124. Find the false statement about tonsillectomy

(a)   Extracapsular tonsillectomy is done with cold knife

(b)   Enlarged adenoids can be removed along with tonsillectomy

(c)   Grisel syndrome is common

(d)   Enlarged tonsils even without symptoms should be removed because it may occlude airway and cause apnea

Ans: (c, d)

125. Stage of glottis cancer confined to larynx with vocal cord fixation

(a)   T1

(b)   T2

(c)   T3

(d)   T4

Ans: (c)

OPTHALMOLOGY

126. Angle of the anterior chamber is measured by

(a)   Gonioscopy

(b)   Skiascopy

(c)   Tonometry

(d)   Ophthalmoscopy

Ans: (a)

127. Soft contact lens is made of

(a)   Poly-methyl methacrylate

(b)   hydroxyl-ethylmethacrylate

(c)   Methylcellulose

(d)   Silicone

Ans: (b)

128. Vertically oval pupil is seen in

(a)   Uveitis

(b)   Primary open angle glaucoma

(c)   Acute angle closure glaucoma

(d)   Neovascular glaucoma

Ans: (c)

129. Rosette cataract is seen in

(a)   Ocular trauma

(b)   Wilson’s disease

(c)   Diabetes mellitus

(d)   Steroid therapy

Ans: (a)

130. Iridotomy is done using

(a)   CO2 laser

(b)   Argon laser

(c)   Nd: YAG laser

(d)   Excimer laser

Ans: (c)

131. The following is not a feature of vitreous hemorrhage

(a)   Sudden loss of vision

(b)   Floaters

(c)   Metamorphopsia

(d)   Absence of fundal glow

Ans: (d)

132. Retinal tamponade is done by which gas

(a)   Carbon monoxide

(b)   Nitrous oxide

(c)   Ethylene oxide

(d)   Sulfur hexafluoride

Ans: (d)

133. Vision is not affected in

(a)   Berlin’s edema

(b)   Uveitis

(c)   Glaucoma

(d)   Papilledema

Ans: (d)

PREVENTIVE & SOCIAL MEDICINE

134. All are true about point source epidemic except:

(a)   All cases in occur within a single incubation period

(b)   Clustering of cases

(c)   Rapid rise and gradual fall of epidemic curve

(d)   No secondary curves

Ans: (c)

135. Prevention of childhood obesity is an example of

(a)   Primordial prevention

(b)   Primary prevention

(c)   Secondary prevention

(d)   Tertiary prevention

Ans: (a)

136. The following is an example of metazoonoses

(a)   Rabies

(b)   Taeniasis

(c)   Plague

(d)   Brucellosis

Ans: (c)

137. True statement about Case control study

(a)   Proceeds from cause to effect

(b)   To study rare disease

(c)   High cost

(d)   Involves large number of individuals

Ans: (b)

138. Recruitment of ASHA in NRHM is an example of

(a)   Intersectoral coordination

(b)   Community participation

(c)   Appropriate technology

(d)   Equitable distribution

Ans: (b)

139. The best criteria to assess quality of protein

(a)   Biological value

(b)   Net protein utilization

(c)   Digestability co-efficient

(d)   Protein-Energy ratio

Ans: (b)

140. Most abundant element in nature

(a)   Phosphorus

(b)   Calcium

(c)   Iodine

(d)   Fluorine

Ans: (d)

141. RDA of iron during lactation (milligrams/day)

(a)   17

(b)   21

(c)   27

(d)   35

Ans: (b)

142. International food standard are based on

(a)   AGMARK standards

(b)   Codex alimentarius

(c)   Bureau of Indian standards

(d)   PFA standards

Ans: (b)

143. Wastes sharps are disposed in what colour bin

(a)   Red

(b)   Yellow

(c)   Black

(d)   Blue

Ans: (d)

144. All the following are tests of significance except

(a)   Standard error of mean

(b)   Standard error of proportion

(c)   Standard deviation

(d)   Chi square test

Ans: (c)

145. The 5 the Millennium developmental goals (2015) aims to reduce MMR to

(a)   50 per 10000 live births

(b)   80 per 10000 live births

(c)   110per 10000 live births

(d)   125 per 10000 live births

Ans: (c)

MEDICINE

146. Earliest serum biomarker to increase after MI

(a)   Creatine kinase

(b)   Troponin I

(c)   Troponin T

(d)   Myoglobin

Ans: (d)

147. All the following features increase the risk of sudden death in HOCM except

(a)   Left ventricular wall thickness > 30 mm

(b)   History of syncope

(c)   Spontaneous sustained VT

(d)   Triple apical impulse

Ans: (d)

148. The following is not a feature of benign cardiac murmur

(a)   Systolic murmur

(b)   Diastolic murmur

(c)   Soft quality

(d)   Position dependent

Ans: () answer is not found

149. Not an ECG feature in Hyperkalemia

(a)   Widened QRS complex

(b)   Peaked T waves

(c)   Absent P waves

(d)   Prominent U waves

Ans: (d)

150. All the following are ECG features in Ventricular Tachycardia except

(a)   Capture beats

(b)   AV dissociation

(c)   Extreme right axis deviation

(d)   Very broad QRS complex

Ans: (c)

151. Vocal resonance is increased in

(a)   Empymea thoracis

(b)   Fibrosing alveolitis

(c)   Primary tuberculosis

(d)   Bronchogenic carcinoma

Ans: (c)

152. A 55 year old male, a chronic smoker, with obesity and diabetes with BP 180/100 was on smoking cessation. He had more than 5 apnes/hypoapnea in 1 hour. The next appropriate step in the management

(a)   Uvulopalatopharyngeoplasty

(b)   CPAP

(c)   Diet and weight reduction

(d)   Mandibular splint

Ans: (b)

153. Protein accumulated in the brain of Alzheimer’s disease patients

(a)   Tau

(b)   Alph synuclein

(c)   Beta amyloid

(d)   PrPSC

Ans: (a)

154. Expected feature in Horner’s syndrome

(a)   Complete ptosis

(b)   Excessive facial sweating

(c)   Pupillary constriction

(d)   Exophthalmos

Ans: (c)

155. Palpable purpura is seen in all except

(a)   Henoch-Schonlein purpura

(b)   Drug induced vasculitis

(c)   Giant cell arteritis

(d)   Mixed cryoglobulinemia

Ans: (c)

156. Most common artery involved in Takayasu arteritis

(a)   Subclavian

(b)   Carotid

(c)   Renal

(d)   Abdominal aorta

Ans: (a)

157. Hypocalcemia is seen due to all the following conditions except

(a)   Hypoparathyroidism

(b)   Prolonged tourniquet application before drawing blood

(c)   Collection of blood in EDTA vials

(d)   Alkalosis

Ans: (b)

158. All the following cause high anion gap acidosis except

(a)   Diarrhea

(b)   Lactic acidosis

(c)   Salicylate poisoning

(d)   Renal failure

Ans: (a)

159. Even after screening of blood before transfusion, post transfusion hepatitis is common because

(a)   Most cases of post transfusion hepatitis are caused by hepatitis C virus

(b)   Most hepatitis B carriers do not have detectable HbS antigen in serum

(c)   Available tests are not sensitive to detect HbS antigen

(d)   Most cases of post transfusion hepatitis are caused by CMV

Ans: (b)

SURGERY

160. Nerve affected in sentinel node biopsy in breast cancer

(a)   Intercostobrachial nerve

(b)   Long thoracic nerve

(c)   Nerve to Latissimus dorsi

(d)   Lateral pectoral nerve

Ans: (a)

161. All the following are features of thyrotoxicosis except

(a)   Hyperactivity

(b)   Diarrhea

(c)   Hair loss

(d)   Palpitations

Ans: (c)

162. True statement about follicular carcinoma of thyroid

(a)   Hemtaogenous spread

(b)   Multi focal

(c)   Readily diagnosed by FNAC

(d)   Most common tumor of thyroid

Ans: (c)

163. Medullary carcinoma of thyroid

(a)   Most cases are familial

(b)   Arise from C cells

(c)   Secretes high levels of calcitonin

(d)   TSH independent

Ans: (a)

164. Hot spot in Tc99 scan is seen in the parotid tumor

(a)   Adenocarcinoma

(b)   Adenolymphoma

(c)   Adenocystic carcinoma

(d)   Acinar cell carcinoma

Ans: (b)

165. Investigation of choice for H type Tracheo-esophageal fistula

(a)   Tracheobronchoscopy

(b)   Oesophagoscopy

(c)   CT scan

(d)   X-ray

Ans: (d)

166. Most common benign tumor of esophagus

(a)   Squamous papilloma

(b)   Hyperplastic polyp

(c)   Leiomyoma

(d)   Hemangioma

Ans: (c)

167. The neoadjuvant chemotherapeutic agent used in oesophageal cancer

(a)   Mitomycin

(b)   Doxorubicin

(c)   Cisplatin

(d)   5-Flurouracil

Ans: (c)

168. All the following are true regarding H pylori gastritis except

(a)   Intraepithelial neutrophilic infiltration

(b)   Subepithelial plasma cell infiltration

(c)   Intestinal metoplasia

(d)   H.pylori commonly found in the region of gastric intestinal metaplasia

Ans: (d)

169. Intussusception is caused by

(a)   Submucous lipoma

(b)   Subfacial lipoma

(c)   Subserous lipoma

(d)   Any of the above

Ans: (a)

170. True regarding management of Crohn’s disease

(a)   Glucocorticoids should not be given in acute phase

(b)   Antibiotics should be avoided as much as possible

(c)   Sulfasalazine decreases risk of acute intestinal obstruction

(d)   Cholestyramine decreases diarrhea but increases steatorrhea

Ans: (d)

171. Most common immediate complication of ileostomy

(a)   Necrosis

(b)   Diarrhea

(c)   Prolapse

(d)   Obstruction

Ans: (a)

172. All the following are features of acute pancreatitis except

(a)   Increased amylase

(b)   Hypocalcemia

(c)   Hypoglycemia

(d)   Leukocytosis

Ans: (c)

173. A patient presents with desmoids tumor. He should be screened for

(a)   Lung cancer

(b)   Breast cancer

(c)   Pancreatic cancer

(d)   Colonic polyps

Ans: (d)

174. Asymptomatic bacteriuria need not be treated in the following patient

(a)   Patient with urinary catheter

(b)   Patient undergoing urologic surgery

(c)   Pregnant woman

(d)   Renal transplant recipients

Ans: (a)

175. Not an USG feature of acute Pyelonephritis

(a)   Increased vascularity

(b)   Focal area of hypo-echogenicity

(c)   Perinephric collection (pus in perinephric space)

(d)   Enlarged kidney

Ans: (a)

176. An elderly male presents with a solitary lymph node enlargement measuring 4-5 cm on the lateral side of neck. Biopsy reveals a squamous cell carcinoma. Immunohistochemistry cannot reveal the primary tumor suggesting, carcinoma of unknown primary. The staging of this tumor is

(a)   TX N2 M1

(b)   T0 N2 MX

(c)   T0 N2 M1

(d)   T1 N2 MX

Ans: (b)

177. Most common organ involved in blunt trauma in children

(a)   Spleen

(b)   Kidney

(c)   Liver

(d)   Small intestine

Ans: (b)

178. A patient brought with H/O road traffic accident with low PO2m with injury to chest and ribs. Mode USG showed stratosphere sign. Diagnosis

(a)   Pulmonary embolism

(b)   Pneumothorax

(c)   Cardiac tamponade

(d)   Hemothorax

Ans: (b)

179. Damage control surgery is

(a)   Maximum intervention done during the first attempt

(b)   Controlling damage during surgery

(c)   Minimal intervention done first followed by full  procedure after the patient is hemodynamically stable

(d)   Can lead to further injury

Ans: (c)

180. MC type of malignant melanoma

(a)   Superficial spreading melanoma

(b)   Lentigo maligna

(c)   Nodular melanoma

(d)   Acral lentiginous melanoma

Ans: (a)

181. Not a complication of total parenteral nutrition

(a)   Hyperammonemia

(b)   Hyperphosphatemia

(c)   Hypercholesterolemia

(d)   Neutrophil dysfunction

Ans: (d)

PEDIATRICS

182 Percentage of sucrose fro analgesia in newborns

(a)   6

(b)   12

(c)   24

(d)   50

Ans: (c)

183. A child searching for a hidden object persistently (Lack of object permanence) at the age of

(a)   2 months

(b)   5 months

(c)   8 months

(d)   12 months

Ans: (a)

184. The most important finding in a child presenting with respiratory infection

(a)   Grunting

(b)   Tachypnea

(c)   Stridor

(d)   Chest indrawing

Ans: (d)

185. 18 month old child was brought with history of low grade fever and cough for 2 days and noisy breathing since few hours. ON examination, the child was irritable, nontoxic, inspiratory stridor was present. Oxygen saturation 88% Respiratory rate 50/min. Next step in management

(a)   With the child in mothers lap, the most comfortable position, give adrenaline nebulization and O2

(b)   The child is put in the bed and adrenaline nebulization and O2 is given

(c)   Refer the child immediately because it is irritable due to hypoxia

(d)   Observe the child carefully, if any complication arises, then refer

Ans: (a)

186. A child presents with frontal bossing, widened metaphyses, lethargy and bow legs. Diagnosis

(a)   Osteomalacia

(b)   Osteoporosis

(c)   Rickets

(d)   Scurvy

Ans: (c)

187. A 14 year old boy presented with abnormal movements. MRI showing involvement of bilateral stratum, thalamus, pons and centrum semi ovale and asymmetrical diffuse white matter involvement. Diagnosis

(a)   Wilsons disease

(b)   Parkinsonism

(c)   Nigrostriatal degeneration

(d)   Hallervorden-Spatz disease

Ans: (a)

188. A 8 y ears old mentally retarded child presents with left sided flank pain. USG shows hyperechoic lesion in right kidney and multiple lesions in the liver. CT abdomen shows 50-60 HU dense lesion. Diagnosis is

(a)   ADPKD

(b)   Tuberous sclerosis

(c)   VHL disease

(d)   Familial angio-myolipoma syndrome

Ans: (b)

189. Breast feeding is resumed after how many weeks of completion of ATT

(a)   1

(b)   2

(c)   3

(d)   4

Ans: (none)

190. A 3 month old child was bought apneic. RR was irregular (5/min). HR was 54/min. best way to stabilize the child

(a)   Maintain open airway, start BMV, chest compression, give O2, give IV/IO adrenaline

(b)   Insert ETT 3.5 mm, start BMV, chest compression, give adrenaline via ETT

(c)   Insert LMA, start BMV, chest compressions, given adrenaline via LMA

(d)   Chest compressions, Maintain oper airway, start BMV, give O2, give IV/IO adrenaline

Ans: (a)

191. Dose of epinephrine to be administered IV/10 in pediatric cardiac arrest is

(a)   One ampoule

(b)   0.01 mg/kg (0.1 ml/kg of 1 in 10,000 solution)

(c)   0.5 mg/kg (0.5 ml/kg 1 in 10,000 solution)

(d)   0.1 mg/kg (0.1 ml/kg of 1 in 1000 solution)

Ans: (b)

192. A 2 years old unresponsive child brought with history of fall from a height, responsive to verbal stimuli intermittently, breathing rate-30/min, oxygen saturation 94%, heart rate-130/min, peripheral pulses felt,, blood pressure of 104/60 mmHg. Immediate line of management is

(a)   Observe the child carefully and shift if necessary

(b)   Transfer immediately to a tertiary centre for CT brain and further management

(c)   Start oxygen by facemask, immobilise “C” spine and transfer to tertiary care.

(d)   Start oxygen b y facemask, immobilise “C” spine, administer 1 ml/kg of Nacl 3% and transfer to tertiary care accompanied by a doctor

Ans: (d)

193. All are true regarding ischemic stroke in children except

(a)   Arterial dissections are common

(b)   Intracranial aneurysms are common

(c)   VZV infection commonly causes basal ganglia infarcts

(d)   Spontaneous hemorrhages can occur in the parenchyma

Ans: (b)

OBSTETRICS

194. A pregnancy of 6 weeks can be accurately diagnosed by

(a)   Urine HCG

(b)   USG – fetal cardiac activity

(c)   Uterine size

(d)   Doppler scan

Ans: (b)

195. First trimester screening (FTS) for Down’s syndrome involves the measurement of

(a)   Pregnancy associated plasma protein

(b)   Inhibin-A

(c)   Oestradiol

(d)   Acetyl cholinesterase

Ans: (a)

196. Lecithin sphingomyelin ratio is used to assess the maturity of

(a)   Lungs

(b)   Kidneys

(c)   Heart

(d)   Brain

Ans: (a)

197. Medical termination for a 11 weeks of unwanted pregnancy is done by all except

(a)   Menstrual regulation

(b)   Manual evacuation

(c)   Misoprostol + Mifepristone

(d)   Carboprost

Ans: (d)

198. According to WHO recommendations, drug used for active management of third stage labor in a primary health centre is

(a)   Intramuscular oxytocin 10 units

(b)   Intramuscular prostaglandin PGF2α

(c)   Dinoprostone 800 μg tablet rectally

(d)   IV methylergometrine 0.2 mg

Ans: (a)

GYNECOLOGY

199. True regarding anatomy of uterus are all except

(a)   Size of cervix and uterus are same at puberty

(b)   Size of cervix is twice that of uterus in children

(c)   Just lateral to cervix, uterine artery pass below the ureter

(d)   Lymph from fundus drain paraaortic lymph nodes

Ans: (d)

200. Secretory changes in endometrium is produce dby

(a)   Oestrogen

(b)   Progesterone

(c)   Prolactin

(d)   Testosterone

Ans: (b)

201. Whiff test is done to diagnose

(a)   Bacterial vaginosis

(b)   Candidiasis

(c)   Syphilis

(d)   Genital tuberculosis

Ans: (a)

202. 40 years old female presents with dysmenorrheal and menorrhagia. On examination uterus is 14 weeks size and tender, Diagnosis is

(a)   Endometrial hyperplasia

(b)   Adenomyosis

(c)   Intramural fibroids

(d)   Pelvic inflammatory disease

Ans: (b)

203. Hormone replacement therapy is not given for

(a)   Vasomotor symptoms

(b)   Prevention of CAD

(c)   Urogenital atrophy

(d)   Prevention of osteoporosis

Ans: (b)

204. Advantages of laparoscopic sterilization over minilap are all except

(a)   Easily reversible

(b)   Less failure rate

(c)   Less operating time

(d)   Less hospital stay

Ans: (b)

205. 40 years old multiparous woman shows CIN-2 on pap smear. Next line of management

(a)   Hysterectomy

(b)   Conisation

(c)   Colposcopy

(d)   Cryotherapy   

Ans: (c)

206. Maximum radiation dose to be given at Point-A for early and advanced carcinoma cervix is

(a)   70-75 and 75-80gy

(b)   80-85 and 85-90gy

(c)   75-80 and 80-85gy

(d)   85-90 and 90-95gy

Ans: (b)

207. Monteggia fracture dislocation is

(a)   Fracture of atlas

(b)   Fracture of radial styloid

(c)   Fracture of proximal 1/3 of ulna with dislocation of proximal radioulnar joint

(d)   Fracture of distal 1/3 of radius with dislocation of distal radioulnar joint

Ans: (c)

208. Mallet finger is avulsion of

(a)   Stenosing tenosynovitis of flexor tendon

(b)   Stenosing tenosynovitis of extensor tendon

(c)   Avulsion of flexor digitorum tendon at the DIP

(d)   Avulsion of extensor digitorum tendon at the DIP

Ans: (d)

209. A large posterolateral defect in humeral head in recurrent anterior of shoulder is called as

(a)   Bankart’s lesion

(b)   Hill sach’s lesion

(c)   Putti Plat lesion

(d)   SLAP lesion

Ans: (b)

210. Symptomatic spinal injury without radiological evidence is most commonly seen in

(a)   Children

(b)   Teenagers

(c)   Adults

(d)   Elderly

Ans: (a)

211. Light bulb sing in anteroposterior view of X ray shoulder is due to

(a)   Fracture humerus with dislocation of glenohumeral joint

(b)   Fracture scapula

(c)   Anterior dislocation of shoulder

(d)   Posterior dislocation of shoulder

Ans: (d)

212. Most common type of abnormality in a children with lateral epicondyle fracture of humerus

(a)   Cubitus varus

(b)   Cubitus valgus

(c)   Malunion

(d)   Tardy ulnar nerve pasly

Ans: (a)

213. Pointing index in a case of supracondylar fracture humerus occurs due to involvement of

(a)   Radial nerve

(b)   Anterior cutaneous nerve

(c)   Median nerve

(d)   Ulnar nerve

Ans: (c)

214. March fracture is

(a)   Stress fracture of shaft of second or third metatarsal

(b)   Avulsion # of base of fifth metatarsal

(c)   Bimalleolar ankle #

(d)   Complete extra articular # across the base of the first metacarpal

Ans: (a)

215. Wandering acetabulum is seen in

(a)   Ankylosing spoondylitis

(b)   Rheumatoid arthritis

(c)   Tuberculosis

(d)   Gout

Ans: (c)

216. Tom smith’s arthritis is

(a)   Sequelae of tuberculous arthritis of hip in children

(b)   Sequelae of tuberculous arthritis of hip in adults

(c)   Sequelae of acute osteomyelitis of femur in children

(d)   Sequelae of septic arthritis of hip in infants

Ans: (d)

217. Meralgia paraesthetica is sue to the involvement of

(a)   Lateral cutaneous nerve of thigh

(b)   Plantar nerve

(c)   Tibial nerve

(d)   Perneal nerve

Ans: (a)

218. Pathogenesis of osteogenesis imperfect is a defect in

(a)   Calcium deposition and osteoid formation

(b)   Synthesis and deposition of type-I collagen

(c)   Renal absorption of calcium

(d)   Excretion of phosphate in renal tubules.

Ans: (a)

219. A patient presents with L4, L5 disc prolapse with weakness of extensor halluces longus and extensor digitorum longus. The site of compression

(a)   L3

(b)   L4

(c)   L5

(d)   S1

Ans: (c)

220. Maffuci Syndrome is

(a)   Multiple hyperostosis

(b)   Multiple enchondromas

(c)   Multiple bone secondaries

(d)   Multiple osteolytic lesions

Ans: (b)

221. The most characteristic histological feature in osteosarcoma is

(a)   Giant cells in matrix

(b)   Sheets of spindle cells

(c)   Codman’s triangle

(d)   Chicken wire calcification

Ans: (c)

222. Proliferation of malignant cells producing osteoid is characteristic of

(a)   Osteosarcoma

(b)   Osteochondroma

(c)   Osteobalstoma

(d)   Chondroblastoma

Ans: (a)

223. 14 year old obese boy referred from an endocrinologist for painful of hip. The investigation which is least useful in this setting is

(a)   USG

(b)   MRI

(c)   CT

(d)   X ray of both hips

Ans: (a)

ANESTHESIA

224. Delivery of high concentration of oxygen (more than 90%) is delivered via

(a)   Partial rebreathing mask

(b)   Nasal cannula with oxygen flow at 5L/min

(c)   Simple face mask

(d)   Non rebreathing face mask with oxygen reservoir

Ans: (b)

225. A breathing system with maximum efficiency is spontaneous ventilation

(a)   Mapleson A

(b)   Mapleson B

(c)   Mapleson C

(d)   Mapleson D

Ans: (a)

226. The inhalational anaesthetic agent which is maximally metabolized

(a)   Desflurane

(b)   Halothane

(c)   Enflurane

(d)   Isoflurane

Ans: (b)

227. The intravenous anaesthetic agent contraindicated in epilepsy

(a)   Propofol

(b)   Thiopentone

(c)   Ketamine

(d)   Etomidate

Ans: (d)

228. The intravenous anaesthetic agent that increases both the cerebral metabolic rate and cerebral blood flow

(a)   Propofol

(b)   Thiopentone

(c)   Ketamine

(d)   Etomidate

Ans: (c)

229. Muscle relaxant associated with hyperkalemia

(a)   Mivacurium

(b)   Atracurium

(c)   Vecuronium

(d)   Succinyl choline

Ans: (d)

230. Muscle(s) least sensitive to non depolarizing muscle relaxant

(a)   Muscles of arm and legs

(b)   Diaphragm

(c)   Abdominal muscles

(d)   Muscles of face, head and neck

Ans: (b)

231. Most potent local anesthetic agent

(a)   Procaine

(b)   Chlorprocaine

(c)   Bupivacaine

(d)   Dibuciane

Ans: (c)

232. Most anaesthesia (Spinal + epidural) is not contraindicated in

(a)   Clopidogrel

(b)   Platelet less than 50000

(c)   Anti hypertensive therapy

(d)   Local infection

Ans: (c)

233. Lithium should be stopped how many days before anesthesia?

(a)   1 day

(b)   2 days

(c)   3 days

(d)   4 days

Ans: (b)

234. Post lumbar puncture headache can be prevented by

(a)   Supplementation of fluids

(b)   Small diameter of needle

(c)   Keep the style inside and remove the needle

(d)   Atraumatic needle

Ans: (c)

235. True regarding hypothermia during anaesthesia are all except

(a)   Body may lose heat by conduction

(b)   Beneficial to patients in some conditions

(c)   Always occur irrespective of the type of anaesthesia

(d)   Prevented by giving warm fluids

Ans: (c)

236. A patient undergoing laparoscopic cholecystectomy suddenly develops wheezing. Appropriate level of management

(a)   Deepen the general anaesthesia

(b)   IV ketamine

(c)   IV lignocaine

(d)   Beta-2 agonist

Ans: (c)

237. True regarding celiac plexus block

(a)   Most common side effect is diarrhea and hypotension

(b)   Usually in lower abdominal painful conditions

(c)   Usually done unilaterally

(d)   Done retroperitoneally at the level of L3

Ans: (a)

RADIODIAGNOSIS & RADIOTHERAPY

238. Photoelectric effect is

(a)   Interaction between high energy incident photon and inner shell electron

(b)   Interaction between low energy incident photon and outer shell electron

(c)   Interaction between incident photon and inner shell electron

(d)   Interaction between high energy incident photon and nucleus

Ans: (c)

239. Predominant osteoblastic metastasis is seen in

(a)   Renal cell carcinoma

(b)   Breast cancer

(c)   Prostate cancer

(d)   Non small cell cancer of lung

Ans: (c)

240. Radiograph contrast induced nephropathy is best indicated by

(a)   Increased bilirubin

(b)   Decreased bilirubin

(c)   Decreased urine output

(d)   Increased serum creatinine levels

Ans: (d)

241. Radiological features indicating increased pulmonary blood flow ae all except

(a)   Kerley B lines

(b)   Pulmonary artery diameter more than 6 mm  

(c)   Diameter of two peripheral arteries greater than accompanying bronchi

(d)   More than 6 blood vessels in outer 1/3rd

Ans: (c)

242. A 14 year old obese child is referred from an endocrinologist for painful limping of hip. Which of the following investigation is least useful in this clinical setting:

(a)   CT

(b)   USG

(c)   MRI

(d)   X-ray

Ans: (b)

DERMATOLOGY

243. Tinea capitis is mostly caused by

(a)   Trichophyton mentagrophytes

(b)   Trichophyton schoenleinii

(c)   Trichophyton violaceum

(d)   Trichophyton tonsurans

Ans: (d)

244. The best treatment for acute dermatitis

(a)   Ointments

(b)   Pastes

(c)   Creams

(d)   Moist compressions

Ans: (d)

245. 24 years old female presents with a 3 × 4 cm painless ulcer with everted margin in the lateral margin of labia majora. The causative organism is

(a)   Chlamydia

(b)   HPV

(c)   H.ducreyi

(d)   Treponema Pallidum

Ans: (d)

PSYCHIATRY

246. The term psychiatry is coined by

(a)   Jasper

(b)   Esquinol

(c)   Reil

(d)   Pinel

Ans: (c)

247. According to WHO-ICD-10, mental disorders are represented as

(a)   Q

(b)   G

(c)   B

(d)   F

Ans: (d)

248. Mini mental scale examination (MMSE) is done to diagnose

(a)   Dementia

(b)   Obsessive compulsion disorder

(c)   Panic disorder

(d)   Bipolar disorder

Ans: (a)

249. A state in which a person is alert but not able to speak or move is

(a)   Stupor

(b)   Coma

(c)   Delirium

(d)   Hysteria

Ans: (a)

250. A state of low grade, chronic depression lasting for more than 2 years

(a)   Dysthymia

(b)   Cyclothymia

(c)   Minor depression

(d)   Dependant

Ans: (a)

JIPMER Medical PG Entrance 2013 Question Paper With Answer Key

JIPMER PG Medical Entrance Examination-2013

ANATOMY

1. One of the following structure develops from 3rd pharyngeal pouch

(a) Superior parathyroid

(b) Thymus

(c) Parafollicular cells

(d) Thyroid gland

Ans: (b)

2. Vestibule of vagina develops from

(a) Genital ridge

(b) Wolffian duct

(c) Urogenital sinus

(d) Mullerian duct

Ans: (c)

3. Melanocytes are derived from

(a) Ectoderm

(b) Endoderm

(c) Mesoderm

(d) Neural crest

Ans: (d)

4. The ganglion of one of the following cranial nerve is derived from neural crest cell

(a) VI

(b) VII

(c) VIII

(d) X

Ans: (b)

5. Superficial branch of ulnar nerve supplies

(a) Adductor pollicis

(b) Abductor digiti minimi

(c) Opponens digiti minimi

(d) Palmaris brevis

Ans: (d)

6. Root of mesentery crosses all except

(a) Second part to duodenum

(b) Abdominal aorta

(c) Inferior vena cava

(d) Right ureter

Ans: (a)

7. Common bile duct

(a) Lies right to hepatic artery

(b) Lies left of portal vein

(c) Lies posterior to hepatic artery

(d) Lies left to hepatic artery

Ans: (a)

8. Not a perineal muscle

(a) Ischiocavernosus

(b) Puborectalis

(c) Bulbospongiosus

(d) Transverse perineii

Ans: (b)

9. Abductor of vocal cord is

(a) Posterior cricoarytenoid

(b) Cricothyroid

(c) Interarytenoid

(d) Lateral cricoarytenoid

Ans: (a)

10. Abductor of vocal cord is

(a) Posterior cricoarytenoid

(b) Cricothyroid

(c) Interartytenoid

(d) Lateral cricaorytenoid

Ans: (a)

11. All the following muscles are closers of jaw except

(a) Medial pterygoid

(b) Masseter

(c) Temporalis

(d) Mylohyoid

Ans: (d)

12. Left recurrent laryngeal nerve

(a) Curse through the groove between oesophagus and trachea

(b) Pure motor nerve

(c) Arises from vagus as it crosses first part of subclavian artery

(d) Supplied cricothyroid

Ans: (a)

13. True regarding parotid gland

(a) Mucinous gland

(b) Covered by a thick fascia which is derived from deep cervical fascia

(c) Facial nerve exits the gland anteromedially before dividing into 5 branches.

(d) Receives secretomotor fibres from vagus nerve

Ans: (b)

14. False regarding chorda tympani

(a) Contains motor nerves that supplies facial muscles

(b) Contains scretomotor nerves that supplies salivary gland

(c) Contains sensory neurons that supplies anterior 2/3rd of tongue

(d) Passes through the petrotympanic fissure.

Ans: (a)

15. All the following veins drain into internal jugular vein except

(a) Facial vein

(b) Lingual vein

(c) Retromandibular vein

(d) Superior thyroid vein

Ans: (c)

16. 5th cranial nerve-true are all except

(a) Arises from midbrain

(b) Provides sensory innervating to whole face

(c) Innervates muscles of mastication

(d) Supplied parasympathetic fibres to salivary glands

Ans: (d)

17. The hard calcified part of tooth is called as

(a) Dentine

(b) Enamel

(c) Cementum

(d) Neck

Ans: (b)

18. Not a part of medial wall of orbit

(a) Frontal bone

(b) Ethmoid bone

(c) Lesser wing of sphenoid

(d) Tip of maxilla

Ans: (a)

19. The following structure is transmitted via foramen ovale

(a) Greater petrosal nerve

(b) Mandibular nerve

(c) Occulomotor nerve

(d) Sympathetic nerve fibrers

Ans: (b)

20. CSF

(a) Formed mainly in choroid plexus

(b) 10% drain into cerebral lymphatics

(c) Flow from lateral ventricles through aqueduct to third ventricle

(d) Mostly found in skull bones than in spine

Ans: (a)

21. Regarding pituitary- false is

(a) 2cmin diameter

(b) Receives blood supply from circle of Willis

(c) Entirely ectodermal in origin

(d) Connected to thalamus by infundibulum.

Ans: (d)

PHYSIOLOGY

22. The factor that does not affect the diffusion of substance through the cell membrane is

(a) Distribution of channels for the substance in the membrane

(b) Lipid solubility of the membrane

(c) Molecular size of the substance

(d) ATP generating capacity on both sides of membrane

Ans: (d)

23. True for skeletal muscle

(a) Troponin-I tropomyosin complex stimulates muscle contraction.

(b) Myosin-ADP-Pi complex has low affinity for calcium

(c) ATP hydrolysis to ADP + Pi in resting muscle

(d) Myosin detaches from actin when ATP levels decreases.

Ans: (c)

24. Not a RBC membrane protein

(a) Spectrin

(b) Ankyrin

(c) Nebulin

(d) Glycophorin

Ans: (c)

25. Platelet aggregation is promoted b y all except

(a) Thrombospondin

(b) Prostacyclin

(c) Plasmin

(d) Platelet activating factor

Ans: (b)

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26. Bile acids are all except

(a) Lithocholic acid

(b) Taurocholic acid

(c) Deoxy cholic acid

(d) Chenodexycholic acid

Ans: (b)

27. Glomerular filtration rate is decreased by all except

(a) Decrease in capillary hydrostatic pressure

(b) Increased tubular hydrostatic pressure

(c) Decreased effective filtration surface area

(d) decreased plasma protein levels

Ans: (d)

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28. True regarding insulin

(a) Made of 2 chains linked by 3 disulphide bonds

(b) Synthesized by alpha cells of islet fo Langerhans

(c) Elimination half life is 60 mins after subcutaneous injection

(d) Circulated in blood by binding with globulin

Ans: (a)

29. True about potassium- All except

(a) Mostly concentrated inside the cells

(b) Plasma concentration increases at time of metabolic acidosis

(c) Leaves the cell in the presence of insulin

(d) Ingestion of acetazolamide results in potassium loss

Ans: (c)

30. Effects of corticosteroids are all except

(a) Decreases the amount of lymphatic cells in spleen and lymph nodes

(b) Inhibits the peripheral utilization of glucose

(c) Promotes breakdown of proteins

(d) Decreases the catabolism of immunoglobulins

Ans: (d)

31. Androgen not secreted by testis

(a) Dehydroepiandrostenedione

(b) Dihydrotestosterone

(c) Testosterone

(d) Androstenedione

Ans: (b)

32. The cardiovascular parameter which is a best indicator off vagal tone?

(a) Ejection fraction

(b) Stroke volume

(c) Heart rate

(d) Diastolic blood pressure

Ans: (c)

33. False regarding ECG

(a) QRS is due to ventricular repolarization

(b) In normal conditions, QRS is < 0.12 seconds

(c) T wave is due to ventricular repolarization

(d) Prolonged PR interval is seen in second degree heart block

Ans: (a)

34. The shift of the oxygen dissociation curve to the left is facilitated by all except

(a) Decrease in temperature

(b) Decrease in pH

(c) Decrease in 2, 3DPG

(d) Fetal hemoglobin

Ans: (b)

35. The major role of 2, 3 DPG in RBC is

(a) Acid base balance

(b) Reversal of glycolysis

(c) Release of O2

(d) Binding of O2

Ans: (c)

36. Carbondioxide in venous blood

(a) Is carried by hemoglobin

(b) Converted to bicarbonate by carbonic anhydrase in plasma

(c) Transported mainly in the form of bicarbonate

(d) Carbondioxide does not cross the blood brain barrier.

Ans: (c)

37. Myelination has all functions except

(a) Increases speed of conduction

(b) Decreases energy expenditure

(c) Provides protective covering for the axon

(d) Decreases the release of neurotransmitter from the nerve endings

Ans: (d)

38. Cerebellar white matter is well myelinated at

(a) 1 month

(b) 3 months

(c) 6 months

(d) 12 months

Ans: (1)

39. Not true regarding withdrawal (flexion) reflex

(a) Polysynaptic reflex

(b) Has long latency

(c) Afferents are Ia fibers

(d) Response is non linear and usually widespread

Ans: (c)

40. Sympathetic stimulation causes

(a) Pupillary constriction

(b) Bronchial smooth muscle contraction

(c) Vasoconstriction of skin and mucus membranes

(d) Contractions of bladder detrusor

Ans: (c)

41. Increased neutrophil in acute exercise is due to

(a) Increased secretion of colony stimulating factors

(b) Disruption of margination of leucocytes

(c) Hemoconcentration

(d) Hypoxia induced by exercise

Ans: (b)

BIOCHEMISTRY

42. Peptidyl transferase is an example for

(a) Enzyme

(b) Catalyst

(c) Ribozyme

(d) Elongation factor

Ans: (c)

43. Fatty liver in kwashiorkor in children is due to

(a) High fat content in the diet

(b) Lack of substrates fro protein synthesis in liver

(c) Lack of substrates for gluconeogenesis in liver

(d) High carbohydrate content

Ans: (b)

44. The autocatalytic cleavage enzyme among the following is

(a) Proelastase

(b) Procarboxylase

(c) Pepsinogen

(d) Chymotrypsinogen

Ans: (c)

45. False regarding cytochrome p450

(a) Found in bone marrow

(b) Responsible for converting lipophilic molecules to hydrophilic molecules

(c) Involved in first pass metabolism

(d) Essential for analgesic effect of codeine

Ans: (a)

46. Phase-II metabolic reactions are characterized by all except

(a) Involved conjugation reactions

(b) Decreases water solubility

(c) Underdeveloped in neonates

(d) Results in drug excretion by the kidneys or liver

Ans: (b)

47. All are seen after 24 hours of fasting except

(a) Lipolysis

(b) Muscle break down

(c) Hepatic gluconeogenesis

(d) Blood glucose concentration is maintained

Ans: (d)

48. The characteristic feature following acute ingestion of alcohol is

(a) Activation of fatty acid oxidation

(b) Lactic acidosis

(c) Inhibition of ketogenesis

(d) Increase in gluconeogenesis

Ans: (b)

49. Patient with abetalipoproteinemia frequently manifests with delayed blood clotting. This is due to inability to

(a) Produce chylomicrons

(b) Produce VLDL

(c) Synthesize clotting factors

(d) Synthesize fatty acids

Ans: ()

50. Most common inherited defect of urea cycle

(a) Ornithine transcarbomylase

(b) Arginase

(c) Arginosuccinate Lyase

(d) Carbamoyl phosphate synthase

Ans: (a)

51. Northern blotting – true all except

(a) Used to detect DNA molecules

(b) Involves electrophoresis

(c) Requires hybridization probes

(d) Requires restriction endonucleases

Ans: (a)

PHARMACOLOGY

52. True regarding drug metabolism

(a) Lipid soluble beta antagonists cause bad dreams when compared to water soluble beta antagonists.

(b) Drugs with high affinity for plasma proteins have larger volume of distribution

(c) Converts water soluble drugs to lipid soluble drugs

(d) Renal failure significantly increases the plasma protein binding.

Ans: (a)

53. Histamine casues

(a) Bronchodilatation

(b) Increases gastric acid secretion

(c) Vasoconstriction

(d) Negative chronotropic effect

Ans: (b)

54. All are true regarding prostaglandins

(a) Made of 20 carbon unsaturated fatty acids

(b) Thromboxane A2 is involved in vasoconstriction and platelet aggregation

(c) Causes pain when applied directly on nerve endings

(d) Leukotrienes cause vasoconstriction and increases vascular permeability

Ans: (c)

55. Prostaglandin analogue used to treat postpartum hemorrhage that is not responding to conventional methods is

(a) Alprostadil

(b) Carboprost

(c) Isoprost

(d) Lantanoprost

Ans: (b)

56. True regarding β-blockers

(a) Negatively ionotropic and chronotropic

(b) Commonly indicated for postural hypotension

(c) Decreases glucagon secretion

(d) Those with intrinsic sympathomimetic activity are less likely to cause bradycardia.

Ans: (b)

57. The anti cholinergic agent used for overactive bladder treatment which is associated with increased incidence of xerostomia is

(a) Trospium

(b) Tolterodine

(c) Oxybutynin

(d) Solifenacin

Ans: (c)

58. Proton pump inhibitors decreases the antiplatelet action of which of the following anti platelet agents when co administered together?

(a) Aspirin

(b) Ticlopidine

(c) Clopidogrel

(d) Prasugrel

Ans: (c)

59. GI motility is inhibited by all except

(a) Nitroglycerine

(b) Verapamil

(c) Erythromycin

(d) Botulinum toxin

Ans: (c)

60. Glucagon hydrochloride is used as a antidote in the poisoning of

(a) Calcium channel blockers

(b) Sodium channel blockers

(c) Cardiac glycosides

(d) Beta blockers

Ans: (d)

61. Fentanyl at a dose of 50-150mcg/kg causes

(a) Potent cardiac depression

(b) Ciliary body contraction

(c) Causes paralysis of iris dilator muscle

(d) Decreases sweating

Ans: (d)

62. False regarding cocaine

(a) Causes tachycardia and hypertension

(b) Does not cause muscle rigidity

(c) Elimination half life is more than 3 hours

(d) Not enough to relieve stress response to surgery

Ans: (c)

63. Enthanol is used in ethylene glycol poisoning because ethanol is a

(a) Competitive inhibitor of NADPH oxidase

(b) Competitive inhibitor of alcohol dehydrogenase

(c) Competitive inhibitor of aldehyde dehydrogenase

(d) Non competitive inhibitor of aldehyde dehydrogenase

Ans: (b)

64. The drug used in the Rx of both type-I & type-II diabetes mellitus is

(a) Exenatide

(b) Liraglutide

(c) Pioglitazone

(d) Pramlintide

Ans: (d)

65. Action of antibiotics are all except

(a) Sulphonamides interfere with folic acid synthesis

(b) Metronidazole interferes with DNA synthesis

(c) Chloramphenicol inhibits protein synthesis

(d) Tetracyclines inhibit cell wall synthesis

Ans: (d)

66. The antimicrobial agent that potentiates the effect of neuro muscular blocker as like curare is

(a) Erythromycin

(b) Clindamycin

(c) Daptomycin

(d) Vancomycin

Ans: (b)

MICROBIOLOGY

67. In Gram’s staining, all are used except

(a) Congo red

(b) Iodine

(c) Crystal violet

(d) Alcohol

Ans: (a)

68. Wrong statement regarding culture media in microbiology

(a) Blood sugar is best for anaerobic organism

(b) Chocolate agar is best for hemophilic organism

(c) Lowenstein-Jenson media is best for mycobacteria

(d) McConkey agar is best for gram negative enteric pathogens

Ans: (a)

69. All are live vaccines except

(a) Measles vaccine

(b) BCG vaccine

(c) Salk’s vaccine

(d) Yellow fever vaccine

Ans: (c)

70. Macrophages – false statement

(a) Derived from blood monocytes

(b) Can harbor mycobacteria

(c) Involved in type III hypersensitivity reactions

(d) Produce Tumor necrosis factor and interleukins

Ans: (c)

71. Antibody that is produced rapidly and in high amounts during secondary response

(a) IgM

(b) IgG

(c) IgA

(d) IgM and IgG

Ans: (b)

72. Cells that are identified by the presence of immunoglobulins on the surface are

(a) Neutrophils

(b) B cells

(c) Nk cells

(d) Monocytes

Ans: (b)

73. Not true regarding NK cells

(a) Active against malignant cells

(b) Involve MHC antigen for killing microorganisms

(c) First line defence against viral infections

(d) No prior sensitization required

Ans: (b)

74. Class II MHC protein is expressed in all except

(a) Activated T cells

(b) Dendritic cells

(c) Langerhan’s cells

(d) Neutrophils

Ans: (d)

75. Type 2 lepra reaction is an example of

(a) Type I Hypersensitivity

(b) Type II Hypersensitivity

(c) Type III Hypersensitivity

(d) Type IV Hypersensitivity

Ans: (c)

76. Methicillin resistant Staphylococcus aureus

(a) Causes deeper infections more frequently than skin & soft tissue infections

(b) Transmitted via the air-conditioning system

(c) Pulse field gel electrophoresis is useful in the investigation of an outbreak

(d) Resistant to iodine solution

Ans: (c)

77. Non motile bacteria

(a) Salmonella

(b) Klebsiella

(c) Citrobacter

(d) Escherichia

Ans: (b)

78. Aerogenic variants of Shigella are seen in the biotypes of

(a) Shigella dysentriae

(b) Shigell flexneri

(c) Shigella sonnei

(d) Shigella boydii

Ans: (b)

79. In tuberculosis, the cytokine playing major role in the conversion of tissue macrophages into epithelioid cells

(a) Interferon γ

(b) Tumor necrosis factor

(c) Interleukin 12

(d) Macrophage chemoattractant protein

Ans: (a)

80. Exclusive skin pathogen among Mycobacteria

(a) M. xenopi

(b) M. fortuitum

(c) M. szulgai

(d) M. marinum

Ans: (d)

81. Not a feature of Hutchinson’s triad

(a) Interstitial keratitis

(b) Notched incisors

(c) Deafness

(d) Cataract

Ans: (d)

82. All are true regarding CMV except

(a) Double stranded DNA virus

(b) Rarely causes problems inn immunecompetent persons

(c) Foscarnet can eliminate CMV

(d) Retinitis rare when CD4 countd > 200/mm3

Ans: (c)

83. The following viruses are transmitted via blood transfusion except

(a) Parvovirus B-19

(b) Dengue virus

(c) CMV

(d) Hepatitis G virus

Ans: (b)

84. Pathogenic cryptococci differ from non pathogenic strains by all the following criteria except

(a) Produces urease

(b) Grow at 37℃

(c) Pathogenic for mice

(d) Ferment carbohydrates

Ans: (d)

PATHOLOGY

85. Apoptosis- all are true except

(a) Normal physiological process of programmed cell death

(b) Results in products that are removed by phagocytosis

(c) Plasma membrane undergoes zeiosis

(d) Causes inflammation that damage the surrounding cells

Ans: (d)

86. Caspases are involved in

(a) Necrosis

(b) Apoptosis

(c) Cell injury

(d) Phagocytosis

Ans: (b)

87. The following mediators of acute inflammation are derived from cells except

(a) Kinins

(b) Leukotriene

(c) Cytokine

(d) Histamine

Ans: (a)

88. Inheritance of familial hypercholesterolemia is

(a) Autosomal dominant

(b) Autosomal recessive

(c) X-linked dominant

(d) X-linked recessive

Ans: (a)

89. Genetic conditions with increased risk for cancers are all except

(a) Neurofibromatosis 1

(b) Turner syndrome

(c) Down syndrome

(d) Chromosome 13 deletion

Ans: (none)

90. Pathogenetic mechanism of HPV in cervical carcinoma

(a) Downregulation of p16INK4 protein

(b) Degradation of cylcin D1

(c) Genomic instability of E6 an dE7

(d) UP regulation of BCL2

Ans: (c)

91. Paraneoplastic syndrome not associated with any kind of antibody

(a) Limbic encephalopathy

(b) Necrotizing myelopathy

(c) Eaton Lambert syndrome

(d) Stiff Pearson syndrome

Ans: (b)

92. Amyloidosis – false statement

(a) Extracellular eosinophilic hyaline material

(b) Made of calcified proteins

(c) Apple green birefringence in polarized light

(d) Complication of chronic infections

Ans: (b)

93. The following are used in the treatment of Thrombotic thrombocytopenic purpura a/e

(a) Plasmapheresis

(b) Corticosteroids

(c) Immunotherapy

(d) Platelet transfusion

Ans: (d)

94. Lymphoma associated with translocation of c-myc gene on chromosome 8 is

(a) Burkitt lymphoma

(b) Follicular lymphoma

(c) Mantle cell lymphoma

(d) Anaplastic large cell lymphoma

Ans: (a)

95. The following are good prognostic factors for childhood ALL except

(a) Hyperdiploidy

(b) Female sex

(c) Pre B cell ALL

(d) +(12:21) translocation

Ans: (c)

96. Multiple myeloma – all are true except

(a) Proteinuria

(b) Visual disturbances

(c) Bleeding tendency

(d) Dystrophic calcification

Ans: (d)

97. Bence-Jones proteins are derived from

(a) Alpha globulins

(b) Beta globulins

(c) Gamma globulins

(d) Delta Globulins

Ans: (c)

98. Malignancy associated with Waldenstrom macroglobulinemia

(a) Mycosis fungoides

(b) Smouldering myeloma

(c) Primary effusion lymphoma

(d) Lymphoplasmacytic lymphoma

Ans: (d)

99. Mac Callam plaques in rheumatic heart disease are seen in

(a) Right atrium

(b) Right ventricle

(c) Left atrium

(d) Left ventricle

Ans: (c)

100. Typical histological change in benign hypertension

(a) Intimal proliferation and hyalinization of muscular media of medium sized arteries/arterioles

(b) Fibrinoid necrosis of small sized arteries/arterioles

(c) Loss of endothelial cells of arterioles

(d) Formation of new vessels

Ans: (a)

101. Adenocarcinoma is the most common type of lung cancer in females and in nonsmokers. The immunohistochemical marker used for detection adenocarcinoma of lung is

(a) Thyroid transcription factor

(b) Glial fibrillary acidic protein

(c) Progesterone receptor

(d) Alpha fetoprotein

Ans: (a)

102. Paraneoplastic syndromes are most commonly associated with

(a) Bronchial adenocarcinoma

(b) Broncho-alveolar carcinoma

(c) Small cell carcinoma

(d) Bronchial carcinoid

Ans: (c)

103. Glomerulonephritis which is least likely to cause chronic renal failure

(a) Post streptococcal glomerulonephritis

(b) Membranous glomerulonephritis

(c) Membrano proliferative glomerulonephritis

(d) Focal segmental glomerulosclerosis

Ans: (a)

104. Demonstration of the following histological finding in the resected kidney indicate the presence of Wilms tumor in the contralateral kidney

(a) Blastemal component

(b) Nephrogenic rests

(c) Skeletal muscle differentiation

(d) Abnormal mitotic figures

Ans: (b)

FORNESIC MEDICINE

105. As per MCI regulations, a medical practitioner should maintain the records of in patients for a minimum period of

(a) 2 years

(b) 3 years

(c) 4 years

(d) 5 years

Ans: (b)

106. Florence test for seminal stains tests for the presence of

(a) Spermine

(b) Choline

(c) Inositol

(d) Aluminium molybdate

Ans: (b)

107. A factory worker presents with excessive salivation, blue line on gums, tremors, disturbed personality, insomnia and loss of appetite. Diagnosis

(a) Arsenic poisoning

(b) Lead poisoning

(c) Mercury poisoning

(d) Phosphorus poisoning

Ans: (c)

108. Drug used for Narcoanalysis

(a) Atropine

(b) Pethidine

(c) Phenobarbitone

(d) Scopolamine

Ans: (d)

ENT

109. In Tympanometry, tone used is _____ Hz

(a) 220

(b) 320

(c) 120

(d) 256

Ans: (a)

110. The artery which is not a part of Kiesselbach plexus

(a) Superior labial

(b) Anterior ethmoidal

(c) Greater palatine

(d) Infraorbital

Ans: (d)

111. Osteomas are most commonly seen in

(a) Maxillary sinus

(b) Frontal sinus

(c) Sphenoid sinus

(d) Ethmoid sinus

Ans: (b)

112. Extent of retropharyngeal space

(a) Base of skull to diaphragm

(b) Base of skull to thoracic inlet

(c) Base of skull to bifurcation of trachea

(d) Base of skull to post cricoids cartilage

Ans: (c)

113. Mouse nibbled appearance of vocal cords is seen in

(a) Malignancy

(b) Tuberculosis

(c) Syphilis

(d) Rhinoscleroma

Ans: (b)

114. Mid tracheostomy is done through the ______ tracheal rings

(a) 1st and 2nd

(b) 2nd and 3rd

(c) 3rd and 4th

(d) 5th and 6th

Ans: (b)

OPHTHALMOLOGY

115. Laser in situ keratomilieusis (LASIK) uses

(a) Ns-YAG laser

(b) Excimer laser

(c) CO2 laser

(d) Frequency doubled YAG laser

Ans: ()

116. Posterior staphyloma is associated with

(a) Closed angle glaucoma

(b) Uveoscleritis

(c) Pseudocornea

(d) Pathological myopia

Ans: (d)

117. Giant papillary conjunctivitis is usually due to

(a) Rigid gas permeable contact lens

(b) Soft hydrophilic contact lens

(c) Acrylic ball implants

(d) Pegged implants

Ans: (b)

118. Goniotomy is most effective in

(a) Juvenile primary open angle glaucoma

(b) Adult primary open angle glaucoma

(c) Congenital glaucoma

(d) Adult primary closed angle glaucoma

Ans: (c)

119. In diabetic retinopathy

(a) Thinning of capillary basement membrane

(b) Increased number of pericytes

(c) Lipofuscin in retinal pigment epithelium

(d) Macroaneurysm in the areas of ischemia

Ans: (c)

120. Gas used for tamponading retina

(a) Carbon dioxide

(b) Nitrous oxide

(c) Sulfur heaxfluoride

(d) Ethylene oxide

Ans: (c)

121. Harmonious diplopia is a feature of

(a) Exotropia

(b) Hypertropia

(c) Hypotropia

(d) Esotropia

Ans: (d)

122. Dalen Fuch’s nodule is pathognomic of

(a) Tuberculosis

(b) Sarcoidosis

(c) Sympathetic ophthalmitis

(d) Retinitis pigmentosa

Ans: (c)

PREVENTIVE & SOCIAL MEDICINE

123. Human development index includes all except

(a) Adult literacy rate

(b) Life expectancy at birth

(c) Per capita income

(d) Infant mortality rate

Ans: (d)

124. Infectivity of an organism is measured by

(a) Incidence rate

(b) Prevalence rate

(c) Secondary attack rate

(d) Case fatality rate

Ans: (a)

125. In cyclo-propagative transmission, the disease agent undergoes

(a) Only development

(b) Only multiplication

(c) Change in form and numbers

(d) No change

Ans: (c)

126. Measure of risk calculated from case control study is

(a) Odds ratio

(b) Relative risk

(c) Attributable risk

(d) Population attributable risk

Ans: (a)

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127. Positive predictive value of a screening test is measured by

(a) True positive × 100(True positive + False negative)

(b) True negative × 100/(False positive + True negative)

(c) True positive × 100/(True positive + False positive)

(d) True negative × 100/(rue negative + False negative)

Ans: (c)

128. Most cost effective approach for the prevention of non communicable disease

(a) Primary prevention

(b) Secondary prevention

(c) Specific protection

(d) Primordial prevention

Ans: (d)

129. Target for case finding under RNTCP is

(a) 60%

(b) 70%

(c) 85%

(d) 95%

Ans: (b)

130. Low birth weight baby is the one with birth weight less than

(a) 1000 grams

(b) 1500 grams

(c) 2000 grams

(d) 2500 grams

Ans: (d)

131. All are major causes of early neonatal mortality in India except

(a) Prematurity

(b) Asphyxia

(c) Low birth weight

(d) Diarrhea

Ans: (d)

132. Protein content of breast milk

(a) 0.55 gm/100mL

(b) 1.10 gm/100mL

(c) 2.20 gm/100mL

(d) 3.30 gm/100mL

Ans: (b)

133. Recommended content of iodine in salt of consumer level

(a) 25 ppm

(b) 20 ppm

(c) 15 ppm

(d) 10 ppm

Ans: (c)

134. Most extensively used insecticide for ultra low volume (ULV) fogging

(a) DDT

(b) Malathion

(c) Pyrethroids

(d) Abate

Ans: (b)

135. Minimum recommended concentration of free chlorine in drinking water at the end of 1 hour is

(a) 0.1 mg/L

(b) 0.5 mg/L

(c) 1.0 mg/L

(d) 1.5 mg/L

Ans: (b)

136. Wastes that are not to be incinerated

(a) With high heating volume

(b) Content of combustible matter > 60%

(c) Content of non combustible matter < 5%

(d) Moisture content < 30%

Ans: (a)

137. Under ESI, the duration not sickness benefit arising out of confinement is for

(a) 15 days

(b) 30 days

(c) 42 days

(d) 60 days

Ans: (b)

138. Method of sampling when the population is not homogenous

(a) Simple random sampling

(b) Systemic random sampling

(c) Stratified random sampling

(d) Cluster sampling

Ans: (c)

MEDICINE

  1. Giant a wave in JVP is seen in

(a) Junctional rhythm

(b) Pulmonary hypertension

(c) Tricuspid regurgitation

(d) Complete heart block

Ans: (b)

140. Exercise testing is absolutely contraindicated

(a) One week after MI

(b) Unstable angina

(c) Aortic stenosis

(d) Peripheral vascular disease

Ans: (c)

141. Aneurysms- false statement

(a) True aneurysm contains all the 3 layers

(b) Saccular aneurysm involves the entire circumference

(c) In dissecting aneurysms media is defective

(d) Charcot Bouchard aneurysms are seen in brain

Ans: (b)

142. Rasmussen’s aneurysm arises from

(a) Bronchial artery

(b) Pulmonary artery

(c) Vertebral artery

(d) Posterior intercostals artery

Ans: (b)

143. Pulmonary embolism – true statement

(a) Known risk factors include gastric cancer, AIDS

(b) Prompt heparin therapy will dissolve thrombi

(c) Most patients manifest dyspnea, pain, hemoptysis

(d) Free floating ileofemoral thrombi are an indication for a caval filter

Ans: (a)

144. Feature of restrictive lung disease

(a) ↓FEV­1/FVC and ↑ compliance

(b) ↑FEV1/FVC and ↓ compliance

(c) ↓ FEV1/FVC and ↓ compliance

(d) ↑FEV1/FVC and ↑Compliance

Ans: (b)

145. All are seen in ARDS except

(a) Pulmonary edema

(b) Hypercapnea

(c) Hypoxemia

(d) Decreased tidal volume

Ans: (b)

146. The following parameter is consistent with pleural transudate

(a) RBC – 1000/mm3

(b) WB – 1500/ mm3

(c) Specific gravity – 1.120

(d) Protein – 3.5 gram/dl

Ans: (a)

147. In morbidly obese patients obstructive sleep often results in all the following except

(a) Right ventricular failure

(b) Hypoxemia

(c) Hypercapnea

(d) Left ventricular failure

Ans: (none)

148. All the following signs are seen in thalamic hemorrhage except

(a) Hemianopia

(b) Gaze palsy

(c) Miosis

(d) Ocular bobbing

Ans: (d)

149. Xanthochromia of CSF is seen in all except

(a) Traumatic or bloody tap

(b) Hyperbilirubinemia

(c) Carotinemia

(d) Markedly elevated CSF proteins