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AIIMS PAPER NOVEMBER 2003 SOLVED QUESTIONS AND ANSWERS

ANATOMY
Q 1. The pronator quadratus has the same innervation as of the following muscle:
A. Flexor digitorum superficialis
B. Palmaris longus
C. Flexor pollicis longus
D. Flexor digitorum profundus of middle finger
Ans. C
Q 2. All of the following are pneumatic bones except:
A. Maxilla
B. Parietal
C. Ethmoid
D. Mastoid
Ans. B
Q 3. The kinetic energy of the body is least in one of the following phases of walking cycle:
A. Heel strike
B. Mid-stance
C. Double support
D. Toe-off
Ans. B
Q 4. When a heavy object in hand is lowered, the extension at the elbow is brought about by:
A. Active shortening of the extensors
B. Passive shortening of the extensors
C. Active lengthening of the flexors
D. Active shortening of the flexors
Ans. C
Q 5. A 40 year old tailor complains of pain, numbness and weakness of the right hand for the last three months. On examination, there is hypoaesthesia and atrophy of thenar eminence. Which one of the following nerves is likely to be involved?
A. Ulnar
B. Radial
C. Axillary
D. Median
Ans. D
Q 6. Which of the following thalamic nuclei does not project to neocortex:
A. Intralaminar nuclei
B. Reticular nuclei
C. Pulvinar nuclei
D. Anterior thalamic nuclei
Ans. B
Q 7. Unequal division of the conus cordis resulting from anterior displacement of the conotruncal septum gives rise to:
A. Persistant truncus arteriosus
B. Coarctation of aorta
C. Tetralogy of Fallot
D. Transposition of great vessels
Ans. C
PHYSIOLOGY
Q 8. Several hormones regulate the tubular reabsorption of water and electrolytes at different sites in the nephron. Which of the following combination is correct?
A. Angiotensin in distal tubule
B. Aldosterone in collecting ducts
C. ADH in proximal tubule
D. ANP in loop of Henle
Ans. B
Q 9. “Inflation of lungs induces further inflation” is explained by:
A. Hering-Breuer inflation reflex
B. Hering-Breuer deflation reflex
C. Head’s paradoxical reflex
D. J-reflex
Ans. C
Q 10. If you calculate the plasma osmolality of a child with plasma Na+ 125 mEq/l, glucose 108 mg/dl, and BUN (blood urea nitrogen) 140 mg/dl, the most appropriate answer would be:
A. 300 mOsrn/kg
B. 306 mOsrn/kg
C. 312 mOsm/kg
D. 318 mOsrn/kg
Ans. B
Q 11. Relative colour and luminosity of photoreceptive input under changing light conditions are regulated and maintained by
A. Muller cells
B. Amacrine cells
C. Ganglion cells
D. Retinal astrocytes
Ans. C




Q 12. Exposure to darkness leads to increased melatonin secretion. It is brought about by:
A. Decreasing the activity of suprachiasmatic nuclei
B. Increasing the serotonin N-acetyl transferase
C. Decreasing the hydroxy-indole-o-methyl transferase activity
D. Blocking the release of norepinephrine from sympathetic nerve terminals
Ans. B
BIOCHEMISTRY
Q 13. A buffer that is most effective at a pH of about 4.5 is:
A. Acetate buffer.
B. Bicarbonate buffer
C. Phosphate buffer
D. Tris buffer
Ans. A
Q 14. NADPH is produced by:
A. Glycolysis
B. Citric acid cycle
C. Hexose monophosphate shunt
D. Glycogenesis
Ans. C
Q 15. Mitochondria is involved in all of the following, except:
A. ATP production
B. Apoptosis
C. Tricarboxylic acid cycle
D. Fatty acid biosynthesis
Ans. D
Q 16. The conjugation of bilirubin to glucuronic acid in the liver:
A. Converts a hydrophilic compound to a hydrophobic one
B. Converts a hydrophobic compound to a hydrophilic one
C. Enables the bilirubin molecule to cross the cell membrane
D. Is increased during neonatal jaundice
Ans. B
Q 17. The 3 dimensional shape of a protein is maintained mainly by:
A. Strong covalent interactions
B. Interactions with other proteins
C. Multiple weak interactions
D. Interactions with prosthetic groups
Ans. C
Q 18. In the following food items, which one has the highest ‘glycemic index’?
A. Corn-flakes
B. Brown rice
C. Ice-cream
D. Whole wheat bread
Ans. A
FORENSIC MEDICINE
Q 19. Which one of the tissues putrefies late:
A. Brain
B. Prostate
C. Liver
D. Stomach
Ans. B
Q 20. Rule of Hasse is used to determine:
A. The age of fetus
B. Height of an adult
C. Race of a person
D. Identification
Ans. A
Q 21. In which of the following weapons empty cartridge case is ejected after firing:
A. Shot gun
B. Revolver
C. Pistol
D. Rifle
Ans. C
PREVENTIVE AND SOCIAL MEDICINE
Q 22. An investigator wants to study the association between maternal intake of iron supplements (yes or no) and incidence of low birth weight (< 2500 or  2500 gms). He collects relevant data from 100 pregnant women as to the status of usage of iron supplements and the status of low birth weight in their newborns. The appropriate statistical test of hypothesis advised in this situation is: A. Paired t-test B. Unpaired or independent t-test C. Analysis of variance D. Chi square test Ans. D Q 23. Under the National Programme for Control of Blindness in India, medical colleges are classified as eye care centers of: A. Primary level B. Secondary level C. Tertiary level D. Intermediate level Ans. C Q 24. Taking the definition of blindness as visual acuity less than 3/60 in the better eye, the number of blind persons per 100,000 population in India is estimated to be: A. 500 B. 700 C. 1000 D. 1500 Ans. B Q 25. If the prevalence is very low as compared to the incidence for a disease, it implies: A. Disease is very fatal and/or easily curable B. Disease is non fatal C. Calculation of prevalence and incidence is wrong D. Nothing can be said, as they are independent. Ans. A Q 26. The following is true about prevalence and incidence: A. Both are rates B. Prevalence is a rate but incidence is not C. Incidence is a rate but prevalence is not D. Both are not rates Ans. C Q 27. The rate adjusted to allow for the age distribution of the population is: A. Perinatal mortality rate B. Crude mortality rate C. Fertility rate D. Age-standardized mortality rate Ans. D Q 28. The fasting blood levels of glucose for a group of diabetics is found to be normally distributed with a mean of 105 mg per 100 ml of blood and a standard deviation of 10 mg per 100 ml of blood. From this data is can be inferred that approximately 95% of diabetics will have their fasting blood glucose levels within the limits of: A. 75 and 135 mgs B. 85 and 125 mgs C. 95 and 115 mgs D. 65 and 145 mgs Ans. B Q 29. The age and sex structure of a population may be best described by a: A. Life table B. Correlation coefficient C. Population pyramid D. Bar chart Ans. C Q 30. In a double blind clinical drug trial: A. Each patient receives a placebo B. Each patient receives both (double) treatment C. The patients do not know which treatment they are receiving D. The patients do not know that they are in a drug trial Ans. C Q 31. The most sensitive index of recent transmission of malaria in a community is: A. Spleen rate B. Infant parasite rate C. Annual parasite incidence D. Slide positivity rate Ans. B Q 32. Additional daily energy requirement during the first six months for a lactating woman is: A. 350 K calories B. 450 K calories C. 550 Kcalories D. 650 K calories Ans. C Q 33. Bagassosis is most likely caused due to the inhalation of the dust of: A. Free silica B. Coal C. Sugar cane D. Cotton fibre Ans. C Q 34. In defining ‘general fertility rate’, the denominator is: A. Population between 15 and 49 years of age B. Women between 15 and 49 years of age C. Mid year population D. Live births Ans. B Q 35. Mites are the vectors of the following diseases except: A. Scabies B. Scrub typhus C. Rickettsial pox D. Kyasanur forest disease Ans. D Q 36. Mean and standard deviation can be worked out only if data is on: A. Interval/ratio scale B. Dichotomous scale C. Nominal scale D. Ordinal scale Ans. A Q 37. The national level system that provides annual national as well as state level reliable estimates of fertility and mortality is called: A. Civil registration system B. Census C. Adhoc survey D. Sample registration system Ans. D Q 38. After applying a statistical test, an investigator gets the ‘p value’ as 0.01, it means that: A. The probability of finding a significant difference is 1% B. The probability of declaring a significant difference when there is truly no difference is 1% C. The difference is not significant 1% times and significant 99% times D. The power of the test used is 99% Ans. B PHARMACOLOGY Q 39. A 50 year old male suffering from renal failure, underwent kidney transplant. He was prescribed a nucleotide derivative following the organ transplant. The nucleotide derivative of therapeutic importance in this organ transplant is: A. Azathioprine B. 5-Fluorouracil C. Cytarabine D. Allopurinol Ans. A Q 40. The H-3 receptor agonist causes: A. Inhibition of H-l receptor induced wakefulness B. Increase in H-l mediated gastrin secretion C. Inhibition of H-l mediated bronchoconstriction D. Negative chronotropic effect on atria Ans. A, C, D Q 41. Sparfloxacin and terfenadine can cause: A. Ventricular arrhythmia B. Myopathy C. Electrolyte imbalance D. Nephropathy Ans. A Q 42. Prolactin secretion is inhibited by: A. Dopamine antagonist B. GABA C. Neurophysin D. Bromocripitine Ans. D Q 43. Which one of the following is not an adverse effect of salbutamol: A. Tachycardia B. Tolerance C. Hypokalemia D. Hypoglycemia Ans. D Q 44. Which one of the following is not an adverse effect of ACE inhibitors: A. Cough B. Hypokalemia C. Angioneurotic edema D. Skin rash Ans. B Q 45. A 30 year old female epileptic on phenytoin, developed weakness and fatigue. Blood examination revealed Hb = 4.6 gm, MCV = 102 fl and MCH = 40 pg/dl. What is the most probable diagnosis: A. Heart failure B. Iron deficiency anaemia C. Phenytoin induced agranulocytosis D. Megalobalstic anaemia Ans. D Q 46. If a diabetic patient being treated with an oral hypoglycemic agent, develops dilutional hyponatremia, which one of the following could be responsible for this effect: A. Chlorpropamide B. Tolazamide C. Glyburide D. Glimepiride Ans. A Q 47. Therapeutic uses of prostaglandin E1 include all of the following except: A. Medical termination of pregnancy B. Impotence C. Primary pulmonary hypertension D. Maintenance of patent ductus arteriosus (PDA) Ans. C Q 48. The drug of choice for the treatment of thyrotoxicosis during pregnancy is: A. Carbimazole B. Iodine therapy C. Propylthiouracil D. Metimazole Ans. C Q 49. Sterile haemorrhagic cystitis is caused by: A. Busulfan B. Ketoprofen C. Methicillin D. Cyclophosphamide Ans. D Q 50. A 58 year old woman has been diagnosed with locally advanced breast cancer and has been recommended for chemotherapy. She has five years history of myocardial infarction and congestive heart failure. Which antinoeplastic drug should be best avoided: A. Anthracycline B. Alkylating agent C. Platinum compound D. Bisphosphonates Ans. A Q 51. Excessive intake (hypervitaminosis) of which of the following vitamin is associated with increased risk of congenital malformations: A. Vitamin A B. Biotin C. Folic acid D. Vitamin K Ans. A Q 52. Peripheral neuropathy may occur with the use of all the following except: A. Vincristine B. Cisplatin C. L-Asparaginase D. Procarbazine Ans. C Q 53. A 30 year old manic patient was prescribed haloperidol one week back. For last two days he has become restless and kept pacing in the room for a day. On examination he was found to have tremors of hand, he is most likely suffering from: A. Anhedonia B. Dystonia C. Restless leg syndrome D. Akathisia Ans. D Q 54. The antimicrobial agent which inhibits the ergosterol biosynthesis is: A. Ciprofloxacin B. Amphotericin B C. 5-Fluorocytosine D. Griseofulvin Ans. B Q 55. Which one of the following substances is the most potent androgen? A. Dihydroepiandrostenedione B. Dihydrotestosterone C. Androstendione D. Testosterone Ans. B Q 56. Pyronaridine is: A. Antimalarial B. Anti-HIV C. Antifungal D. Antibacterial Ans. A MICROBIOLOGY Q 57. All of the following are true regarding Haemophilus influenzae except: A. It can be a part of the normal flora in some persons B. The serotyping is based on the bacterial outer membrane proteins C. It requires haemin and NAD for growth in culture medium D. Type b is responsible for invasive disease Ans. B Q 58. A patient made a self-diagnosis of athlete’s foot (tinea pedis) and began using a product advertised on television. The condition improved but did not clear and then the patient showed himself to a dermatologist. A skin scraping was sent to the laboratory for culture, including culture for fungi. The fungal culture yielded a slow growing colony, which produced a few small microconidia. This is consistent with isolation of a dermatophyte of the genera: A. Trichophyton B. Microsporum C. Epidermophyton D. Trichosporon Ans. A Q 59. All of the following are the most common nosocomial infections, except: A. Staph. aureus B. P. aeruginosa C. Enterobacteriaceae D. Mycobacterium Ans. D Q 60. A 40 year old man underwent kidney transplantation for end stage renal disease. Two months after transplantation, he developed fever and features suggestive of bilateral diffuse interstitial pneumonia. Which one of the following is the most likely etiological agent? A. Herpes simplex virus B. Cytomegalovirus C. Epstein-Barr virus D. Varicella-zoster virus Ans. B Q 61. An elderly diabetic has left sided orbital cellulites. CT scan of paranasal sinuses shows evidence of left maxillay sinusitis. Gram stained smear of the orbital exudates shows irregularly branching septate hyphae. The following is the most likely aetiological agent: A. Aspergillus B. Rhizopus C. Mucor D. Candida Ans. A Q 62. A patient, resident of Himachal Pradesh presented with a series of ulcers in a row, on his right leg. The biopsy from the affected area was taken and cultured on Sabauraud’s dextrose agar. What would be the most likely causative organism? A. Sporothrix schenckii B. Cladosporium spp. C. Pseudoallescheria boydii D. Nocardia brasielensis Ans. A Q 63. A 50 year old chronic alcoholic male agricultural worker presented with high grade fever of one week duration with spells of chills and rigor. Examination of the respiratory system revealed bilateral crepitations with scattered rhonchi. Multiple subcutaneous nodules were found on the extensor surface of the left forearm, arm and left leg. Direct microscopy of the pus aspirated from the skin nodule revealed plenty of Gram negative bacilli with bipolar staining. Culture revealed distinct rough corrugated grey-white colonies on blood agar. The organisms were motile and oxidase positive. The most likely diagnosis is: A. Plague B. Melioidosis C. Bartonellosis D. Actinomycosis Ans. B Q 64. Which one of the following statements is false: A. The presence of ingested erythrocytes is seen only in Entamoeba histolytica B. Young adult male of low socioeconomic status are most commonly affected by invasive amoebiasis C. A low iron content in the diet predisposes to invasive amoebiasis D. The pathogenic and non-pathogenic strains of E. histolytica can be differentiated by the electrophoretic study of zymodemes Ans. C Q 65. The following phenomenon is responsible for antibiotic resistance in bacteria due to slime production: A. Coaggregation B. Biofilm formation C. Mutation evolving an altered target site for antibiotics D. Mutation evolving a target bypass mechanism Ans. B Q 66. The following fungi are thermally dimorphic except: A. Sporothrix schenkii B. Cryptococcus neoformans C. Blastomyces dermatitidis D. Histoplasma capsulatum Ans. B PATHOLOGY Q 67. Transition from G2 to M phase of the cell cycle is controlled by: A. Retinoblastoma gene product B. p53 protein C. Cyclin E D. Cyclin B Ans. D Q 68. Which of he following is not a cyclin dependent kinase (CDK) inhibitor? A. p21 B. p27 C. p53 D. p57 Ans. C Q 69. Hypercoagulability due to defective factor V gene is called: A. Lisbon mutation B. Leiden mutation C. Antiphospholipid syndrome D. Inducible thrombocytopenia syndrome Ans. B Q 70. The presence of small sized platelets on the peripheral smear is characteristic of: A. Idiopathic thrombocytopenic purpura B. Bernard Soulier syndrome C. Disseminated intravascular coagulation D. Wiskott Aldrich syndrome Ans. D Q 71. In malignant hyperthermia the increased heat production is due to: A. Increased muscle metabolism by excess of calcium ions B. Thermic effect of food C. Increased sympathetic discharge D. Mitochondrial thermogenesis Ans. A Q 72. A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examination showed hypoalbuminaemia with hyperlipidaemia. Kidney biopsy was undertaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal: A. Fusion of foot processes of the glomerular epithelial cells B. Rarefaction of glomerular basement membrane C. Deposition of electron dense material in the basement membrane D. Thin basement membrane Ans. A Q 73. The following cereals should be avoided in patients with celiac disease, except: A. Wheat B. Barely C. Maize D. Rye Ans. C Q 74. Obstruction to the flow of CSF at the aqueduct of Sylvius will most likely lead to enlargement of: A. All of the ventricles B. Only lateral ventricle C. Only fourth ventricle D. Both lateral and third ventricles Ans. D Q 75. CD-95 has a major role in: A. Apoptosis B. Cell necrosis C. Interferon activation D. Proteolysis Ans. A Q 76. Which of the following chemical mediators of inflammation is an example of a C-X-C or alpha chemokine? A. Lipoxin LXA-4 B. Interleukin IL-8 C. Interleukin IL-6 D. Monocyte chemoattractant protein MCP-1 Ans. B Q 77. Tectal breaking is seen in: A. Dandy-Walker malformation B. Arnold-Chiari malformation C. Aqueductal stenosis D. Third ventricular tumor Ans. B Q 78. Which of the following is not compatible with a diagnosis of chronic myelomonocytic leukemia? A. Peripheral blood monocytosis more than 1 × 109/L. B. Absence of Philadelphia chromosome C. More than 20% blasts in blood or bone marrow D. Absent or minimal dysplasia in myeloid lineages Ans. C Q 79. Which of the following is not a complication of infective endocarditis: A. Myocardial ring abscess B. Suppurative pericarditis C. Myocardial infarction D. Focal and diffuse glomerulonephritis Ans. B Q 80. A one year old boy presented with hepatosplenomegaly and delayed milestones. The liver biopsy and bone marrow biopsy revealed presence of histiocytes with PAS-positive diastase-resistant material in the cytoplasm. Electron-microscopic examination of these histiocytes is most likely to reveal the presence of: A. Birbeck granules in the cytoplasm B. Myelin figures in the cytoplasm C. Parallel rays of tubular structures in lysosomes D. Electron dense deposit in the mitochondria Ans. C Q 81. The most likely inheritance pattern depicted in the following pedigree is: A. Autosomal dominant B. X-linked recessive C. X-linked dominant D. Autosomal recessive Ans. C Q 82. All of the following are the classical presentation of craniovertrebral junction anomalies except: A. Pyramidal signs B. Low hairline C. Short neck D. Pupillary asymmetry Ans. D Q 83. An Rh –ve woman became pregnant with Rh +ve fetus. Within few days after birth, the infant developed jaundice, ascites, hepatomegaly and edema. The likely substance(s) deposited in skin and sclera in jaundice is/are gi ven below. Which is the best possible answer: A. Biliverdin B. Conjugated and unconjugated bilirubin C. Unconjugated bilirubin D. Conjugated bilirubin Ans. B MEDICINE Q 84. The drug of choice in patients with Wolff-Parkinson-White syndrome with atrial fibrillation is: A. Digitalis B. Procainamide C. Verapamil D. Adenosine Ans. B Q 85. A hypertensive individual had a sudden headache and became unconscious within a few minutes. On regaining consciousness, there was complete flaccid hemiplegia with no involvement of upper face, absence of tendon reflexes and a positive Babinski sign. Which one of the following arteries could have ruptured: A. Lateral striate branch of middle cerebral B. Medial striate branch of anterior cerebral C. Posterolateral branch of posterior cerebral D. Posterior choroidal branch of posterior cerebral Ans. A Q 86. A 55 year old male patient was diagnosed to have chronic hepatitis C. He responded to treatment with interferon. However, after one year of follow up he showed a relapse of disease. Which of the following would be the next most appropriate choice? A. Ribavarin and interferon B. Lamivudine and interferon C. Nevirapine and lamivudine D. lndinavir and ribavarin Ans. A Q 87. History of dislike for sweet food items is typically present in: A. Diabetes mellitus B. Glycogen storage disease C. Hereditary fructose intolerance D. Galactosemia Ans. C Q 88. All of the following drugs are useful in the treatment of a patient with acute bronchial asthma except: A. Ipratropium B. Salbutamol C. Montelukast D. Hydrocortisone Ans. C Q 89. Acute intravascular hemolysis can be caused by infection due to all of the following organisms except: A. Clostridium tetani B. Bartonella bacilliformis C. Plasmodium falciparum D. Babesia microti Ans. A Q 90. Tumor lysis syndrome is associated with all of the following laboratory feature except: A. Hyperkalemia B. Hypercalcemia C. Hyperuricemia D. Hyperphosphatemia Ans. B Q 91. A normal-anion-gap metabolic acidosis occurs in patients with: A. Diarrhoea B. Diabetic ketoacidosis C. Methyl alcohol poisoning D. Acute renal failure Ans. A Q 92. A 45 year old coalmine worker presents with cutaneous nodules, joint pain and occasional cough with dyspnoea. His chest radiograph shows multiple small (1-4 cm) nodules in bilateral lung fields. Some of the nodules show cavitation and specks of calcification. Most likely these features are diagnostic of: A. Sjogren’s syndrome B. Caplan’s syndrome C. Silicosis D. Wegener’s granulomatosis Ans. B Q 93. A 40 year old male patient is suffering from type II diabetes mellitus and hypertension. Which of the following antihypertensive drugs should not be used in such patients: A. Lisinopril B. Hydrochlorthiazide C. Losartan D. Trandolopril Ans. B Q 94. A 41 year old male patient presented with recurrent episodes of bloody diarrhea for 5 years. Despite regular treatment with adequate doses of sulfasalazine, he has had several exacerbations of his disease and required several weeks of steroids for the control for flares. What should be the next line of treatment for him? A. Methotrexate B. Azathioprine C. Cyclosporine D. Cyclophosphamide Ans. B Q 95. Helicobacter pylori is not associated with: A. Gastrointestinal lymphoma B. Gastric cancer C. Gastric leiomyoma D. Peptic ulcer Ans. C Q 96. Enzyme replacement therapy is available for the treatment of the following disorder: A. Gaucher’ disease B. Niemann-Pick disease C. Hunter syndrome D. Phenylketonuria Ans. A Q 97. A 35 year old non-smoker presents with 2 episodes of mild hemoptysis. There is no history of fever or any constitutional symptoms. A plain x-ray of chest is found to be normal. Which one of the following should be the next step in the diagnostic evaluation of this patient: A. Bronchography B. High-resolution computed tomography C. Contrast-enhanced computed tomography D. Fibreoptic bronchoscopy Ans. D Q 98. A 55 year old man, a chronic smoker is brought to emergency with history of polyuria, polydipsia, nausea and altered sensorium for last two days. He had been diagnosed as having squamous cell carcinoma of lung two months prior to this. On examination, he was lethargic and confused. An ECG was normal except for a narrowed QT interval. Which one of the following is the most likely metabolic abnormality? A. Hypernatremia B. Hypercalcemia C. Hypokalemia D. Hyponatremia Ans. B Q 99. In stable angina: A. CK-MB is elevated B. Troponin I is elevated C. Myoglobin is elevated D. The levels of cardiac markers remain unchanged Ans. D Q 100. ln a patient with wide-complex tachycardia, the presence of all of the following in the ECG indicates ventricular tachycardia except: A. Atrioventricular dissociation B. Fusion beats C. Typical right bundle branch block D. Capture beats Ans. C Q 101. A 15 year old boy presents to you with history of fever, altered sensorium and purpuric rash for two days. On examination, the patient is found stuporous. He has a BP of 90/60 mmHg and extensive palpable purpura over the legs. Which of the following would be the most appropriate initial choice of antibiotic: A. Vancomycin B. Pencillin G C. Ciprofloxacin D. Gentamicin Ans. B Q 102. A 45 year old hypertensive male patient presented in the casualty with two hours history of sudden onset of severe headache associated with nausea and vomiting. On clinical examination the patient had necks stiffness and right sided ptosis. Rest of the neurological examination was normal. What is the clinical diagnosis: A. Hypertensive brain haemorrhage B. Migraine C. Aneurysmal subarachnoid haemorrhage D. Arteriovenous malformation haemorrhage Ans. C Q 103. An AIDS patient with a T lymphocyte counts < 200/mm3 presented with complaints of headache, nausea, dizziness and irritability. As a part of the diagnostic tests, spinal fluid was submitted to the laboratory with a request to examine the specimen directly in India ink to enhance visualization of encapsulated organisms. This request was made on the suspicion of a diagnosis of: A. Histoplasmosis B. Candidiasis C. Nocardiosis D. Cryptococcosis Ans. D Q 104. Early diagnosis of acute hepatitis-B infection is made by: A. Presence of HbeAg in serum B. Presence of IgM anti-HBc in serum C. Presence of HbsAg in serum D. Presence of IgG anti-HBc in serum Ans. C Q 105. A patient with salicylic acid poisoning has the following arterial blood gas analysis report: pH = 7.12; PCO2 = 18 mmHg; HCO3 = 12 mmol/L. The resulting acid-base abnormality can be best labeled as: A. Metabolic acidosis with respiratory alkalosis B. Metabolic acidosis with respiratory acidosis C. Respiratory acidosis with metabolic alkalosis D. Metabolic acidosis Ans. A Q 106. A 45 year old female patient presents with symptoms of easy bruisability and frequent headaches. Physical examination show a moderate splenomegaly. Blood counts shows a normal leucocyte count and a platelet count of 1000  103/cumm. The leucocyte alkaline phosphatase score is normal. Which one of the following is the drug of choice for the treatment of this patient? A. Hydroxyurea B. Radioactive phosphorus C. Anagrelide D. Interferon alpha Ans. A Q 107. For the management of intraoperative myocardial ischaemia, all of the following are advised except: A. Heparin B. Intravenous nitroglycerine C. Calcium channel blocker D. Atropine Ans. A Q 108. A 50 year old man presented with orbital mass. Systemic examination revealed anaemia and investigations revealed hypergammaglobulinemia. The patient should be investigated to rule out: A. Squamous cell carcinoma B. Optic nerve glioma C. Multiple myeloma D. Malignant melanoma Ans. C Q 109. A resident doctor sustained a needlestick injury while sampling blood of a patient who is HIV positive. A decision is taken to offer him post- exposure prophylaxis. Which one of the following would be the best recommendation? A. Zidovudine + lamivudine for 4 weeks B. Zidovudine + lamivudine + nevirapine for 4 weeks C. Zidovudine + lamivudine + indinavir for 4 weeks D. Zidovudine + stavudine + nevirapine for 4 weeks Ans. C PAEDIATRICS Q 110. An 8-day old breastfed baby presents with vomiting, poor feeding and loose stools. On examination the heart rate is 190/minute, blood pressure 50/30 mmHg, respiratory rate 72 breaths/minute and capillary refill time of 4 seconds. Investigations show hemoglobin level of 15 g/dl, Na 120 mEq/l, K 6.8 mEq/l, Cl 81 mEq/l, bicarbonate 15 mEq/l, urea 30 mg/dl and creatinine 0.6 mg/dl. The most likely diagnosis is: A. Congenital adrenal hyperplasia B. Acute tubular necrosis C. Congenital hypertrophic pyloric stenosis D. Galactosemia Ans. A Q 111. A 10-month-old boy, weighing 3 kg has polyuria, polydipsia and delayed motor milestones. Investigations show blood levels of creatinine 0.5 mg/ dl, potassium 3 mEq/L, sodium 125 mEq/L, chloride 88 mEq/L, calcium 8.8 mg/dl, pH 7.46 and bicarbonate 26 mEq/L. Ultrasonography shows medullary nephrocalcinosis. The most likely diagnosis is: A. Renal tubular acidosis B. Diabetes insipidus C. Bartter syndrome D. Pseudohypoaldosteronism Ans. C Q 112. A 12-year-old boy is referred for evaluation of nocturnal enuresis and short stature. The blood pressure is normal. The blood urea is 112 mg/dl, S. creatinine 6 mg/dl, sodium 119 mEq/l, potassium 4 mEq/l, calcium 7 mg/dl, phosphate 6 mg/dl and alkaline phosphatase 400 U/l. Urinalysis shows trace proteinuria with hyaline casts; no red and white cells are seen. Ultrasound shows bilateral small kidneys and the micturating cystourethrogram is normal. The most likely diagnosis is: A. Alport’s syndrome B. Medullary sponge kidney C. Chronic glomerulonephritis D. Nephronophthisis Ans. D Q 113. Portal hypertension in children in India is commonly due to: A. Indian childhood cirrhosis B. Extrahepatic portal venous obstruction C. Idiopathic portal hypertension D. Hepatic outflow tract obstruction Ans. B Q 114. Asphyxial injury in a term baby is characterized by all except: A. Seizures B. Differential hypotonia (lower limbs > upper limbs)
C. Altered sensorium
D. Difficulty in clearing oral secretions.
Ans. B
Q 115. All of the following strategies are effective in preventing mother to child transmission of HIV except:
A. Zidovudine to mother & baby
B. Vaginal cleansing before delivery
C. Stopping breast feeding
D. Elective caesarean section
Ans. B
Q 116. A 6-month-old infant presents to the ‘diarrhoea clinic’ unit with some dehydration. The most likely organism causing diarrhea is:
A. Entamoeba histolytica
B. Rotavirus
C. Giardia lamblia
D. Shigella
Ans. B
Q 117. A child with pyoderma becomes toxic and presents with respiratory distress. His chest radiograph shows patchy areas of consolidation and multiple bilateral thin walled air containing cysts. The most likely etiological agent in this case is
A. Mycobacterium tuberculosis
B. Staphylococcus aureus
C. Mycobacterium avium intracellulare
D. Pneumocystis carinii
Ans. B
Q 118. The most common underlying anomaly in a child with recurrent urinary tract infections is:
A. Posterior urethral valves
B. Vesicoureteric reflux
C. Neurogenic bladder
D. Renal calculi
Ans. B
Q 119. A two-year old girl child is brought to the out patient with features of hand wringing stereotype movements, impaired language and communication development, breath-holding spells, poor social skills and deceleration of head growth after 6 months of age. The most likely diagnosis is:
A. Asperger’s syndrome
B. Rett’s syndrome
C. Fragile X syndrome
D. Colard syndrome
Ans. B




SURGERY
Q 120. The intra-abdominal pressure during laparascopy should be set between:
A. 5-8 mm of Hg
B. 10-15 mm of Hg
C. 20-25 mm of Hg
D. 30-35 mm of Hg
Ans. B
Q 121. A young man weighing 65 kg was admitted to the hospital with severe burns in a severe catabolic state. An individual in this state requires 40 kcal per kg body weight per day and 2 gms of protein/kg body weight/day. This young man was given a solution containing 20% glucose and 4.25% protein. If 3000 ml of solution is infused per day:
A. The patient would not be getting sufficient protein
B. The calories supplied would be inadequate
C. Both protein and calories would be adequate
D. Too much protein is being infused.
Ans. C
Q 122. On mammogram all of the following are the features of a malignant tumor except:
A. Spiculation
B. Microcalcification
C. Macrocalcification
D. Irregular mass
Ans. C
Q 123. A 55 year old post menopausal woman, on hormone replacement therapy (HRT), presents with heaviness in both breasts. A screening mammogram reveals a high density speculated mass with cluster of pleomorphic microcalcification and ipsilateral large axillary lymph nodes. The mass described here most likely represents:
A. Cystosarcoma phylloides
B. Lymphoma
C. Fibroadenoma
D. Carcinoma
Ans. D
Q 124. During repair of indirect inguinal hernia, while releasing the constriction at the deep inguinal ring, the surgeon takes care not to damage one of the following structures:
A. Falx inguinalis (conjoint tendon)
B. Interfoveolar ligament
C. Inferior epigastric artery
D. Spermatic cord
Ans. C
Q 125. During bilateral adrenalectomy for Cushing’s disease, intraoperative dose of hydrocortisone should be given after:
A. On opening the abdomen
B. Ligation of left adrenal vein
C. Ligation of right adrenal vein
D. Excision of both adrenal glands
Ans. D
Q 126. Recurrent laryngeal nerve is in close association with:
A. Superior thyroid artery
B. Inferior thyroid artery
C. Middle thyroid vein
D. Superior thyroid vein
Ans. B
Q 127. The treatment of choice for symptomatic, retained common bile duct stones, is:
A. Immediate surgery
B. Conservative treatment with antibiotics
C. Endoscopic sphincterotomy
D. Medical dissolution of the stones
Ans. C
Q 128. A 50 year old smoker male presents with pain along the left arm and ptosis. His chest radiograph shows a soft tissue opacity at the left lung apex with destruction of adjacent ribs. The picture is suggestive of:
A. Adenocarcinoma lung
B. Bronchial carcinoid
C. Pancoast tumour
D. Bronchoalveolar carcinoma
Ans. C
Q 129. A 50 year old male patient, an alcoholic and smoker presents with a 3 hour history of severe retrosternal chest pain and increasing shortness of breath. He started having this pain while eating, which was constant and radiated to the back and interscapular region. He was a known hypertensive. On examination, he was cold and clammy with a heart rate of 130/min, and a BP of 80/40 mmHg. JVP was normal. All peripheral pulses were present and equal. Breath sounds were decreased at the left lung base and chest x-ray showed left pleural effusion. What is the most likely diagnosis?
A. Acute aortic dissection
B. Acute myocardial infarction
C. Rupture of the esophagus
D. Acute pulmonary embolism
Ans. A
Q 130. Breast conservation surgery for breast cancer is indicated in one of the following conditions:
A. T1 breast tumor
B. Multicentric tumor
C. Extensive in situ cancer
D. T4b breast tumor
Ans. A
Q 131. A 65 year old male was diagnosed with prostate cancer three years back and was treated by surgery and hormone therapy. Presently he has developed urinary symptoms and progressive backache. What is the tumor marker, which can be indicative of disease relapse?
A. CA 125
B. Beta-HCG
C. Carcinoembryonic antigen (CEA)
D. PSA
Ans. D
Q 132. Which of the following malignant disease of children has the best prognosis?
A. Wilm’s tumor
B. Neuroblastoma
C. Rhabdomyosarcoma
D. Primitive neuroectodermal tumor
Ans. A
Q 133. A three year old male child presents with history of constipation and abdominal distension for the last two years. The plain radiograph of abdomen reveals fecal matter containing distended bowel loops. A barium enema study done subsequently shows a transition zone at the recto-sigmoid junction with reversal of recto-sigmoid ratio. The most probable diagnosis is:
A. Anal atresia
B. Malrotation of the gut
C. Hirschsprung’s disease
D. Congenital megacolon
Ans. C
Q 134. Investigation of choice to diagnose Hirschsprung’s disease is:
A. Rectal manometry
B. Barium enema
C. Rectal biopsy
D. Laparotomy
Ans. C
Q 135. The tendency of colonic carcinoma to metastasize is best assessed by:
A. Size of tumor
B. Carcinoembryonic antigen (CEA) levels
C. Depth of penetration of bowel wall
D. Proportion of bowel circumference involved
Ans. B
Q 136. A 40 year old patient has undergone an open chlecystectomy. The procedure was reported as uneventful by the operating surgeon. She has 100 ml of bile output from the drain kept in the gallbladder bed on the first post operative day. On examination she is afebrile and anicteric. The abdomen is soft and bowel sounds are normally heard. As an attending physician,what should be your best possible advice?
A. Order an urgent endoscopic retrograde cholangiography and biliary stenting
B. Urgent laparotomy
C. Order an urgent hepatic iminodiacetic acid scintigraphy (HIDA)
D. Clinical observation
Ans. D
Q 137. The following are true about hepatocellular carcinoma except:
A. It has a high incidence in East Africa and South-east Asia
B. Its worldwide incidence parallels the prevalence of hepatitis B
C. Over 80% of tumours are surgically resectable
D. Liver transplantation offers the only chance of cure in those with irresectable disease
Ans. C
Q 138. A 50 year old woman presented with history of recurrent episodes of right upper abdominal pain for the last one year. She presented to casualty with history of jaundice and fever for 4 days. On examination, the patient appeared toxic and had a blood pressure of 90/60 mmHg, she was started on intravenous antibiotics. Ultrasound of the abdomen showed presence of stones in the common bile duct. What would be the best treatment option for her?
A. ERCP and bile duct stone extraction
B. Laparoscopic cholecystectomy
C. Open surgery and bile duct stone extraction
D. Lithotripsy
Ans. A
Q 139. Hypoparathyroidism following thyroid surgery commonly occurs within:
A. 24 hours
B. 2-5 days
C. 7-10 days
D. 2-3 weeks
Ans. B
Q 140. A 69 year old male patient having coronary artery disease was found to have gall bladder stones while undergoing a routine ultrasound of the abdomen. There was no history of biliary colic or jaundice at any time. What is the best treatment advice for such a patient for his gallbladder stones?
A. Open cholecystectomy
B. Laparoscopic cholecystectomy
C. No surgery for gallbladder stones
D. ERCP and removal of gallbladder stones
Ans. C
Q 141. A 14 year old healthy girl of normal height and weight for age, complains that her right breast has developed twice the size of her left breast since the onset of puberty at the age of 12. Both breasts have a similar consistency on palpation with normal nipples areolae. The most likely cause for these findings is:
A. Cystosarcoma phylloides
B. Virginal hypertrophy
C. Fibrocystic disease
D. Early state of carcinoma
Ans. B
Q 142. Which of the following management procedures of acute upper gastrointestinal bleed should possibly be avoided:
A. Intravenous vasopressin
B. Intravenous -blockers
C. Endoscopic sclerotherapy
D. Balloon tamponade
Ans. B
Q 143. Regarding varicose veins, which one of the following statements is true:
A. Over 20% are recurrent varicosities
B. The sural nerve is in danger during stripping of the long saphenous vein
C. The saphenous nerve is closely associated with the short saphenous vein
D. 5% oily phenol is an appropriate sclerosant for venous sclerotherapy
Ans. D
Q 144. Dysphagia lusoria is due to:
A. Oesophageal diverticulum
B. Aneurysm of aorta
C. Oesophageal web
D. Compression by aberrant blood vessel
Ans. D
Q 145. Least malignant thyroid cancer is:
A. Papillary carcinoma
B. Follicular carcinoma
C. Medullary carcinoma
D. Anaplastic carcinoma
Ans. A
Q 146. A blood stained discharge from the nipple indicates:
A. Breast abscess
B. Fibroadenoma
C. Duct papilloma
D. Fat necrosis of breast
Ans. C
Q 147. The commonest site of carcinoma esophagus in India is:
A. Upper 1/3rd
B. Middle 1/3rd
C. Lower 1/3rd
D. GE junction
Ans. B
Q 148. Which of the following substances is not used as an irrigant during transurethral resection of the prostate?
A. Normal saline
B. 1.5% glycine
C. 5% dextrose
D. Distilled water
Ans. A
ORTHOPAEDICS
Q 149. The operative procedure known as “micro fracture” is done for the:
A. Delayed union of femur
B. Non union of tibia
C. Loose bodies of ankle joint
D. Osteochondral defect of femur
Ans. D
Q 150. A thirty one year old male with nephrotic syndrome complains of pain in right hip joint of 2 months duration. The movements at the hip are free but painful terminally. The most likely diagnosis is:
A. Tuberculosis of hip
B. Avascular necrosis of femoral head
C. Chondrolysis of hip
D. Pathological fracture of femoral neck
Ans. B
Q 151. The most commonly affected component of the lateral collateral ligament complex in an “ankle sprain” is the:
A. Middle component
B. Anterior component
C. Posterior component
D. Deeper component
Ans. B
Q 152. The stability of the ankle joint is maintained by all of the following, except:
A. Plantar calcaneonavicular (spring) ligament
B. Deltoid ligament
C. Lateral ligament
D. Shape of the superior talar articular surface
Ans. A
Q 153. You have treated the simple and undisplaced fracture of shaft of right tibia in a nine year girl with above knee plaster cast. Parents want to know the prognosis of union of the fractured limb which was affected by poliomyelitis four years ago. What is the best possible advice will you offer to the parents?
A. Fracture will unite slowly
B. Fracture will not unite
C. Fracture will unite normally
D. Fracture will unite on attaining puberty
Ans. C
Q 154. A pole vaulter had a fall during pole vaulting and had paralysis of the arm. Which of the following investigations gives the best recovery prognosis:
A. Electromyography
B. Muscle biopsy
C. Strength duration curve
D. Creatine phosphokinase levels
Ans. A
Q 155. In a patient with a history of burning pain localized to the plantar aspect of the foot, the differential diagnosis must include:
A. Peripheral vascular disease
B. Tarsal coalition
C. Tarsal tunnel syndrome
D. Planter fibromatosis
Ans. C
Q 156. An elderly woman was admitted with a fracture of the neck of right femur which failed to unite. On examination an avascular necrosis of the head of femur was noted. The condition would have resulted most probably from the damage to:
A. Superior gluteal artery
B. Inferior gluteal artery
C. Acetabular branch of obturator
D. Retinacular branches of circumflex femoral arteries
Ans. D


GYNAECOLOGY & OBSTETRICS
Q 157. With reference to fetal heart rate, a non stress test is considered reactive when:
A. Two fetal heart rate accelerations are noted in 20 minutes
B. One fetal heart rate acceleration is noted in 20 minutes
C. Two fetal heart rate accelerations are noted in 10 minutes
D. Three fetal heart rate accelerations are noted in 30 minutes
Ans. A
Q 158. The commonest cause of primary amenorrhoea is:
A. Genital tuberculosis
B. Ovarian dysgenesis
C. Mullerian duct anomalies
D. Hypothyroidism
Ans. B
Q 159. Which of the following drug is not used for medical management of ectopic pregnancy:
A. Potassium chloride
B. Methotrexate
C. Actinomycin D
D. Misoprostol
Ans. D
Q 160. All of the following are known risk factors for the development of ovarian carcinoma except:
A. Family history of ovarian carcinoma
B. Use of oral pills
C. Use of clomiphene
D. BRCA-1 positive individual
Ans. B
Q 161. A pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks. The most likely diagnosis is:
A. Preterm labour
B. Torsion of fibroid
C. Red degeneration of fibroid
D. Infection in fibroid
Ans. C
Q 162. Which of the following is correct for the calculation of Pearl index:


A.




B.




C.




D.


Ans. A
Q 163. A pregnant woman is found to have excessive accumulation of amniotic fluid. Such polyhdramnios is likely to be associated with all of the following conditions, except:
A. Twinning
B. Microanencephaly
C. Oesophageal atresia
D. Bilateral renal agenesis
Ans. D
Q 164. Use of folic acid to prevent congenital malformation should be best initiated:
A. During 1st trimester of pregnancy
B. During 2nd trimester of pregnancy
C. During 3rd trimester of pregnancy
D. Before conception
Ans. D
Q 165. Which of the following feature on second trimester ultrasound is not a marker of Down’s syndrome:
A. Single umbilical artery
B. Choroid plexus cyst
C. Diaphragmatic hernia
D. Duodenal atresia
Ans. B
Q 166. Which of the following is not associated with chorioamnionitis?
A. Preterm labour
B. Endometritis
C. Abruptio placentae
D. Placenta accreta
Ans. D




Q 167. Apoptosis can occur by change in hormone levels in the ovarian cycle. When there is no fertilization of the ovum, the endometrial cells die because:
A. The involution of corpus luteum causes estradiol and progesterone levels to fall dramatically
B. LH levels rise after ovulation
C. Estradiol levels are not involved in the LH surge phenomenon
D. Estradiol inhibits the induction of the progesterone receptor in the endometrium
Ans. A
Q 168. The use of combined oral contraceptive pill is associated with an increased incidence of:
A. Bacterial vaginosis
B. Chlamydial endocervicitis
C. Vaginal warts
D. Genital herpes
Ans. B
Q 169. In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is first polar body extruded:
A. 24 hours prior to ovulation
B. Accompanied by ovulation
C. 48 hours after the ovulation
D. At the time of fertilization
Ans. B
OPHTHALMOLOGY
Q 170. A 56 year old patient presents after 3 days of cataract surgery with a history of increasing pain and diminution of vision after an initial improvement. The most likely cause would be:
A. Endophthalmitis
B. After cataract
C. Central retinal vein occlusion
D. Retinal detachment
Ans. A
Q 171. All the following signs could result from infection within the right cavernous sinus, except:
A. Loss of pupillary light reflex
B. Loss of corneal blink reflex
C. Ptosis
D. Right ophthalmoplegia
Ans. B
Q 172. All of the following conditions are contraindicated or likely to worsen in a case of primary open angle glaucoma, when treated with timolol maleate 0.5% eye drops, except:
A. Hypertension
B. Hypercholesterolemia
C. Depression
D. Bronchial asthma
Ans. A
Q 173. A 25 year old executive presents with metamorphopsia in his right eye. On examination the fundus shows a shallow detachment at the macula. The fluorescein angiography shows a “smoke stack” sign. Which of the following management should be given?
A. Topical antibiotic-corticosteroid combination
B. Systemic corticosteroid for two weeks and then taper
C. Pulse methylprednisolone for three days and then taper
D. Just wait and watch for spontaneous recovery
Ans. D
Q 174. A case of injury to right brow due to a fall from scooter presents with sudden loss of vision in the right eye. The pupil shows absent direct reflex but a normal consensual pupillary reflex is present. The fundus is normal. The treatment of choice is:
A. Intensive intravenous corticosteroids as prescribed for spinal injuries to be instituted within six hours
B. Pulse methylprednisolone 250 mg four times daily for three days
C. Oral prednisolone 1.5 mg/kg body weight
D. Emergency optic canal decompression
Ans. A
ENT
Q 175. Which of the follwing would be the most appropriate treatment for rehabilitation of a patient, who has bilateral profound deafness following surgery for bilateral acoustic schwannoma:
A. Bilateral high powered digital hearing aid
B. Bilateral cochlear implants
C. Unilateral cochlear implant
D Brain stem implant
Ans. D
Q 176. Iatrogenic traumatic facial nerve palsy is most commonly caused during:
A. Myringoplasty
B. Stapedectomy
C. Mastoidectomy
D. Ossiculoplasty
Ans. C
Q 177. Which of the following is not the site for paraganglioma:
A. Carotid bifurcation
B. Jugular foramen
C. Promontary in middle ear
D. Geniculate ganglion
Ans. D
Q 178. In complete bilateral palsy of recurrent laryngeal nerves, there is:
A. Complete loss of speech with stridor and dyspnea
B. Complete loss of speech but no difficulty in breathing
C. Preservation of speech with severe stridor and dyspnea
D. Preservation of speech and no difficulty in breathing
Ans. D
Q 179. “Gold standard” surgical procedure for prevention of aspiration is:
A. Thyroplasty
B. Tracheostomy
C. Tracheal division and permanent tracheostome
D. Feeding gasgtrostomy/jejunostomy
Ans. B
Q 180. Which of the following statements is not true for contact ulcer?
A. The commonest site is the junction of anterior 1/3rd and middle 1/3rd of vocal cord and gastroesophageal reflux is the causative factor
B. Can be caused by intubation injury
C. The vocal process is the site and is caused/aggravated by acid reflux
D. Can be caused by adductor dysphonia
Ans. A
SKIN
Q 181. A 30 year old male patient has a large, spreading and exuberant ulcer with bright red granulation tissue over the glans penis. There was no lymphadenopathy. The most likely causative organism is:
A. Treponema pallidum
B. Herpes simplex virus type 1
C. Herpes simplex virus type 2
D. Calymmatobacterium granulomatis
Ans. D
Q 182. A 22 years old male patient presents with a complaints of severe itching and white scaly lesions in the groin for past month. Which of the following is most likely to be the causative agent:
A. Trichophyton rubrum
B. Candida albicans
C. Candida glabrata
D. Malassezia furfur
Ans. A
Q 183. A 16 year old student reported for the evaluation of multiple hypopigmented macules on the trunk and limbs. All of the following tests are useful in making a diagnosis of leprosy, except:
A. Sensation testing
B. Lepromin test
C. Slit smears
D. Skin biopsy
Ans. B
Q 184. A 12 year old boy had a gradually progressive plaque on a buttock for the last 3 years. The plaque was 15 cm in diameter, annular in shape, with crusting and induration at the periphery and scarring at the center. The most likely diagnosis is:
A. Tinea corporis
B. Granuloma annulare
C. Lupus vulgaris
D. Borderline leprosy
Ans. C
Q 185. A 24 year old man had multiple, small hypopigmented macules on the upper chest and back for the last three months. The macules were circular, arranged around follicles and many had coalesced to form large sheets. The surface of the macules showed fine scaling. He had similar lesions one year ago which subsided with treatment. The most appropriate investigation to confirm the diagnosis is:
A. Potassium hydroxide preparation of scales
B. Slit skin smear from discrete macules
C. Tzanck test
D. Skin biopsy of coalesced macules
Ans. A
Q 186. A 22 year old woman developed small itchy wheals after physical exertion, walking in the sun, eating hot spicy food and when she was angry. The most likely diagnosis is:
A. Chronic idiopathic utricaria
B. Heat urticaria
C. Solar urticaria
D. Cholinergic urticaria
Ans. D
Q 187. A 45 year old male had multiple hypoaesthetic mildly erythematous large plaques with elevated margins on trunk and extremities. His ulnar and lateral popliteal nerves on both sides were enlarged. The most probable diagnosis is:
A. Lepromatous leprosy
B. Borderline leprosy
C. Borderline tuberculoid leprosy
D. Borderline lepromatous leprosy
Ans. D
ANAESTHESIA
Q 188. Which of the following is not an amide:
A. Lidocaine
B. Procaine
C. Prilocaine
D. Etidocaine
Ans. B
Q 189. Which of the following inhalational agent is contraindicated in a patient with history of epilepsy:
A. Isoflurance
B. Enflurane
C. Halothane
D. Sevoflurane
Ans. B
Q 190. Laryngeal mask airway (LMA) is used for:
A. Maintenance of the airway
B. Facilitating laryngeal surgery
C. Prevention of aspiration
D. Removing oral secretions
Ans. A
Q 191. All of the following are suitable anaesthetic circuits for both controlled and assisted ventilation except:
A. Mapleson A
B. Mapleson B & C
C. Mapleson D
D. Mapleson E
Ans. A
Q 192. At the end of anaesthesia after discontinuation of nitrous oxide and removal of endotracheal tube, 100% oxygen is administered to the patient to prevent:
A. Diffusion hypoxia
B. Second gas effect
C. Hyperoxia
D. Bronchospasm
Ans. A


RADIOLOGY
Q 193. Maximum permissible radiation dose in pregnancy is:
A. 0.5 rad
B. 1.0 rad
C. 1.5 rad
D. 3.0 rad
Ans. A
Q 194. Which one of the following therapeutic mode is commonly employed in intra-operative radiotherapy?
A. Electron
B. Photon
C. X-ray
D. Gamma rays
Ans. A
Q 195. Radiation therapy to hypoxic tissues may be potentiated by the treatment with:
A. Mycostatin
B. Metronidazole
C. Methotrexate
D. Melphalan
Ans. B
Q 196. MRI rooms are shielded completely by a continuous sheet or wire mesh of copper or aluminum to shield the imager from external electromagnetic radiations, etc. It is called:
A. Maxwell cage
B. Faraday cage
C. Edison’s cage
D. Ohm’s cage
Ans. B
PSYCHIATRY
Q 197. An elderly woman suffering from schizophrenia is on antipsychotic medication. She developed purposeless involuntary facial and limb movements, constant chewing and puffing of cheeks. Which of the following drugs is least likely to be involved in this side effect:
A. Halperidol
B. Clozapine
C. Fluphenazine
D. Loxapine
Ans. B
Q 198. A 30-year old male with history of alcohol abuse for 15 years is brought to the hospital emergency with complaints of fearfulness, mis-recognition, talking to self, aggressive behavior, tremulousness and seeing snakes and reptiles that are not visible to others around him. There is history of drinking alcohol two days prior to the onset of the present complaints. He is most likely suffering from:
A. Delirium tremens
B. Alcoholic hallucinosis
C. Schizophrenia
D. Seizure disorder
Ans. A
Q 199. A 25 year old university student had a fight with the neighboring boy. On the next day while out, he started feeling that two men in police uniform were observing his movements. When he reached home in the evening he was frightened. He expressed that police was after him and would arrest him. His symptoms represent:
A. Delusion of persecution
B. Ideas of reference
C. Passivity
D. Thought insertion
Ans. A
Q 200. A 40-year old male is admitted with complaints of abdominal pain and headache. General physical examination revealed six scars on the abdomen from previous surgeries. He seems to maintain a sick role and seeks attention from the nurses. He demands multiple diagnostic tests including a liver biopsy. The treating team failed to diagnose any major physical illness in the patient. His mental status examination did not reveal any major psychopathology. One of the treating staff recognized him to have appeared in several other hospital with abdominal pain and some other vague complaints. He is most likely suffering from:
A. Schizophrenia
B. Malingering
C. Somatisation disorder
D. Factitious disorder
Ans. D

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