ANATOMY
Q 1. All of the following statements about the splenic artery are true except that it:
A. Has a tortuous course
B. Is a branch of the coeliac trunk
C. Has branches that anastomose freely within the spleen
D. Supplies the greater curvature of stomach
Ans. C
Q 2. Which of the following, among axillary lymph nodes, is a terminal group:
A. Pectoral
B. Central
C. Lateral
D. Apical
Ans. D
Q 3. The vertebral artery traverses all of the following except:
A. Foramen magnum
B. Subarachnoid space
C. Intervertebral foramen
D. Foramen transversarium
Ans. C
Q 4. All of the following structures pass through the superior aperture of thorax except:
A. Right recurrent laryngeal nerve
B. Left common carotid artery
C. Left sympathetic trunk
D. Thoracic duct
Ans. A
Q 5. All of the following statements about the vagus nerve are true except that it:
A. Supplies heart & lung
B. Carries postganglionic parasympathetic fibers.
C. Innervates right two third of transverse colon
D. Stimulates peristalsis & relaxes sphincters
Ans. B
Q 6. The narrowest part of the ureter is at the:
A. Uretero-pelvic junction
B. Iliac vessel crossing
C. Pelvic ureter
D. Uretero-vesical junction
Ans. D
PHYSIOLOGY
Q 7. An anterolateral cordotomy relieving pain in right leg is effective because it interrupts the:
A. Left dorsal column
B. Left ventral spinothalamic tract
C. Left lateral spinothalamic tract
D. Right lateral spinothalamic tract
Ans. C
Q 8. Arterial blood gas of a 5 year old child done at sea level gives the following results: pH 7.41, PaO2 100 mmHg, and PaCO2 40 mmHg. The child is being ventilated with 80% oxygen. What is the (A-a) PO2:
A. 570.4 mmHg
B. 520.4 mmHg
C. 470.4 mmHg
D. 420.4 mmHg
Ans. D
Q 9. Pulmonary function abnormalities in interstitial lung diseases include all of the following except:
A. Reduced vital capacity
B. Reduced FEV1/FVC ratio
C. Reduced diffusion capacity
D. Reduced total lung capacity
Ans. B
Q 10. Which of the following situations will lead to increased viscosity of blood:
A. Fasting state
B. Hypoglycemia
C. Multiple myeloma
D. Amyloidogenesis
Ans. C
Q 11. All of the following transport process follow ‘saturation kinetics’ except:
A. Facilitated diffusion
B. Na+-Ca2+ exchanger
C. Simple diffusion
D. Na+ coupled active transport
Ans. C
Q 12. Fetal haemoglobin has all the following characteristic features except:
A. Strong affinity for 2,3-DPG
B. Oxygen dissociation curve is shifted to left
C. At low fetal PO2 gives up more oxygen to tissues than adult haemoglobin
D. Forms 80% of haemoglobin at birth
Ans. A
Q 13. According to myogenic hypothesis of renal autoregulation, the afferent arterioles contract in response to stretch induced by:
A. NO release
B. Noradrenaline release
C. Opening of Ca2+ channels
D. Adenosine release
Ans. C
Q 14. Beta waveforms in electroencephalogram designate which of the following states of the patient:
A. Deep Anaesthesia
B. Surgical Anaesthesia
C. Light Anaesthesia, eyes closed, relaxed
D. Awake/alert state
Ans. D
BIOCHEMISTRY
Q 15. At physiological pH, the carboxy-terminal of a peptide is:
A. Positively charged
B. Negatively charged
C. Neutral
D. Infinitely charged
Ans. B
Q 16. Apart from occurring in nucleic acids, pyrimidines are also found in:
A. Theophylline
B. Theobromine
C. Flavin mononucleotide
D. Thiamine
Ans. D
Q 17. By which of the following anticoagulants used in estimating blood glucose, glycolysis is prevented:
A. EDTA
B. Heparin
C. Sodium fluoride
D. Sodium citrate
Ans. C
Q 18. Which of the following is a component of the visual pigment rhodopsin:
A. -carotene
B. Retinal
C. Retinol
D. Retinoic acid
Ans. B
Q 19. Vitamin A is stored mainly as retinol esters in:
A. Kidney
B. Muscle
C. Liver
D. Retina
Ans. C
Q 20. Xeroderma pigmentosa is caused due to a group of closely related abnormalities in:
A. Mismatch repair
B. Base excision repair
C. Nucleotide excision repair
D. SOS repair
Ans. C
Q 21. Substitution of which one of the following amino acids in place of alanine would increase the absorbance of protein at 280 nm:
A. Leucine
B. Arginine
C. Tryptophan
D. Proline
Ans. C
Q 22. Secretory proteins are synthesized in:
A. Cytoplasm
B. Endoplasmic reticulum
C. First in cytoplasm and then in Endoplasmic Reticulum
D. First in Endoplasmic Reticulum and then in cytoplasm
Ans. B
Q 23. To synthesize insulin on a large scale basis, the most suitable starting material obtained from the beta cells of the pancreas is:
A. Genomic DNA
B. Total cellular RNA
C. cDNA of insulin
D. mRNA of insulin
Ans. D
Q 24. If cellular proteins do not fold into a specific conformation, their function are affected. Certain disorders arise, if specific proteins are misfolded. Which of the following disorders arises due to conformational isomerization:
A. Familial fatal insomnia
B. Hepatitis delta
C. Pernicious anemia
D. Lesch-Nyhan syndrome
Ans. A
FORENSIC MEDICINE
Q 25. ‘La facies sympathique’ is a condition seen in cases of.
A. Hanging
B. Strangulation
C. Myocardial insufficiency
D. Railway accidents
Ans. A
Q 26. ‘Vagitus uterinus’ is:
A. An infection of vagina
B. An infection of uterus
C. A cry of unborn baby from uterus
D. Infection of both vagina and uterus
Ans. C
Q 27. Gunshot residue on hands can be detected by:
A. Phenolphthalein test
B. Dermal nitrate test
C. Benzidine test
D. Hydrogen activation analysis
Ans. B
Q 28. A dead body is found to have marks like branching of a tree on front of chest. The most likely cause of death could be due to:
A. Fire-arm
B. Lightning injury
C. Injuries due to bomb blast
D. Road traffic accident
Ans. B
Q 29. All of the following poison’s are dialyzable except:
A. Ethylene glycol
B. Methanol
C. Barbiturates
D. Copper sulphate
Ans. D
PREVENTIVE AND SOCIAL MEDICINE
Q 30. In an investigation to study the effect of smoking on renal cell cancer, it is observed that 30 of the 50 patients were smokers as compared to 10 out of 50 control subjects. The odds ratio of renal cancer associated with smoking will be:
A. 3.0
B. 0.33
C. 6.0
D. 0.16
Ans. C
Q 31. It is probable that physician have a higher index of suspicion for tuberculosis in children without BCG scar than those with BCG scar. If this is so and an association is found between Tuberculosis and not having BCG scar, the association may be due to:
A. Selection bias
B. Interviewer bias
C. Surveillance bias
D. Non-response bias
Ans. B
Q 32. According to WHO, blindness is defined as a visual acuity of the better eye, less than:
A. 6/60
B. 5/60
C. 4/60
D. 3/60
Ans. D
Q 33. In a study 400 smokers and 600 non-smokers were followed up over a period of 10 years to find out the incidence of hypertension. The following table summarizes the data as the end of the study:
Hypertension
Yes No Total
Smoking Yes 120 280 400
No 30 570 600
Total 150 850 1000
The risk ratio in this study is:
A. 0.06
B. 0.60
C. 6.0
D. 60.0
Ans. C
Q 34. If the objective of the investigator is to assess the incidence of tuberculosis infection in a community, the most appropriate methodology would be to:
A. Identify all individuals with positive tuberculin test
B. Perform sputum examination of chest symptomatics
C. Identify new converts to tuberculin test
D. Screen all under-five children with tuberculin test
Ans. C
Q 35. When an intervention is applied to community to evaluate its usefulness, it is termed as a trial for:
A. Efficacy
B. Effectiveness
C. Efficiency
D. Effect modification
Q 36. The drug of choice for treating cholera in pregnant woman is:
A. Tetracycline
B. Doxycycline
C. Furazolidone
D. Cotrimoxazole
Ans. C
Q 37. The most common cause of blindness in India is:
A. Cataract
B. Trachoma
C. Refractive errors
D. Vitamin A deficiency
Ans. A
Q 38. Under National Programme for Prevention of Nutritional Blindness, a child in the age group of 6-11 months is given a mega dose of vitamin A equal to:
A. 50,000 IU
B. 1 lakh IU
C. 1.5 lakh IU
D. 2 lakh IU
Ans. B
Q 39. Which of the following statements is true about the epidemiological determinants of measles:
A. Measles virus survives outside the human body for 5 days
B. Carriers are important sources of infection
C. Secondary attack rate is less than that of rubella
D. Incidence of measles is more in males than females
Ans. C
Q 40. Study the following table carefully and answer the questions:
Disease
Present Absent
Test result +ve 40 225
–ve 10 225
What is the sensitivity of diagnostic test:
A. 45
B. 20
C. 80
D. 50
Ans. C
Q 41. The usual incubation period for pertussis is:
A. 7-14 days
B. 3-5 days
C. 21-25 days
D. Less then 3 days
Ans. A
Q 42. Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in:
A. 6-12 weeks of pregnancy
B. 20-24 weeks of pregnancy
C. 21-25 weeks of pregnancy
D. 32-36 weeks of pregnancy
Ans. A
Q 43. Deficit in weight for height in a 3 year old child indicates:
A. Acute malnutrition
B. Chronic malnutrition
C. Concomitant acute and chronic
D. Under weight
Ans. A
Q 44. Several studies have shown that 85% of cases of lung cancer are due to cigarette smoking. It is a measure of:
A. Incidence rate
B. Relative risk
C. Attributable risk
D. Absolute risk
Ans. C
Q 45. The distribution of random blood glucose measurements from 50 first year medical students was found to have a mean of 3.0 mmol/litre with a standard deviation of 3.0 mmol/litre. Which of the following is a correct statement about the shape of the distribution of random blood glucose in these first year medical students:
A. Since both mean and standard deviation are equal, it should be a symmetric distribution
B. The distribution is likely to be positively skewed
C. The distribution is likely to be negatively skewed
D. Nothing can be said conclusively
Ans. D
Q 46. In the WHO recommended EPI cluster sampling for assessing primary immunization coverage, the age group of children to be surveyed is:
A. 0-12 months
B. 6-12 months
C. 9-12 months
D. 12-23 months
Ans. D
Q 47. According to a joint study “Health-care in India : The Road Ahead” done by CII and Mekinsky and Company in 2002, India’s executing bed population ratio is:
A. 2:1000
B. 1.5:1000
C. 9:1000
D. 2.5:1000
Ans. B
Q 48. All of the following statements are true about the childhood mortality rates in India except:
A. Almost 3/5th of infant mortality rate (IMR) occurs in neonatal period
B. Almost 3/4th of the under-five mortality occurs in the first five years
C. About one in ten children die before they reach the age of five years
D. Neonatal mortality is higher among female children as compared to males
Ans. D
Q 49. Of the different epidemiological study designs available to test the association between risk factor and disease, the best design is of:
A. Case-control study
B. Ecological study
C. Cohort study
D. Cross-sectional study
Ans. C
Q 50. A 24 years old primigravida wt = 57 kg, Hb 11.0 gm% visits an antenatal clinic during 2nd trimester of pregnancy seeking advice on dietary intake. She should be advised:
A. Additional intake of 300 kcal
B. Additional intake of 500 kcal
C. Additional intake of 650 kcal
D. No extra kcal
Ans. A
Q 51. A known HIV positive patient is admitted in an isolation ward after an abdominal surgery following an accident. The resident doctor who changed his dressing the next day found it to be soaked in blood. Which of the following would be right method of choice of discarding the dressing:
A. Pour 1% hypochlorite on the dressing material and send it for incineration in an appropriate bag
B. Pour 5% hypochlorite on the dressing material and send it for incineration in an appropriate bag
C. Put the dressing material directly in an appropriate bag and send for incineration
D. Pour 2% Lysol on the dressing material and send it for incineration in an appropriate bag
Ans. A
Q 52. A chest physician observed that the distribution of forced expiratory volume (FEV) in 300 smokers had a median value of 2.5 litres with the first and third quartiles being 1.5 and 4.5 litres respectively. Based on this data how many persons in the sample are expected to have a FEV between 1.5 and 4.5 litres:
A. 75
B. 150
C. 225
D. 300
Ans. B
Q 53. If the distribution of intra-ocular pressure (IOP) seen in 100 glaucoma patients has an average 30 mm with a SD of 10, what is the lower limit of the average IOP that can be expected 95% of times:
A. 28
B. 26
C. 32
D. 25
Ans. A
Q 54. A diagnostic test for a particular disease has a sensitivity of 0.90 and a specificity of 0.90. A single test is applied to each subject in the population in which the diseased population is 10%. What is the probability that a person positive to this test, has the disease:
A. 90%
B. 81%
C. 50%
D. 91%
Ans. C
PHARMACOLOGY
Q 55. The blood culture from a patient of febrile neutropenia has grown Pseudomonas aeruginosa, It was found to be a producer of extended spectrum beta lactamase enzyme. The best choice of antimicrobial therapy should be:
A. Ceftazidime + amikacin
B. Aztreonam + Amikacin
C. Cefpirone + Amikacin
D. Imipenem + Amikacin
Ans. D
Q 56. Side effects of a drug arise due to the interactions of the drug to molecules other than the target. These effects of a drug can be minimized by its high:
A. Specificity
B. Affinity
C. Solubility
D. Hydrophobicity
Ans. A
Q 57. Tetracycline inhibits protein synthesis by:
A. Inhibiting initiation and causing misreading of mRNA
B. Binding to 30 S subunit and inhibits binding of aminoacyl tRNA
C. Inhibiting peptidyl transferase activity
D. Inhibiting translocation
Ans. B
Q 58. Which of the following drugs is known to cause granuloma in the liver:
A. Allopurinol
B. Nifedipine
C. Tetracycline
D. Methyl testosterone
Ans. A
Q 59. All the following drugs may cause hyperkalemia except:
A. Cyclosporine
B. Amphotericin
C. Heparin
D. NSAIDs
Ans. B
Q 60. Which of the following is the established biological therapy for Crohn’s disease:
A. Anti TNF -antibody
B. IL-1 antagonist
C. IL-6 antagonist
D. IL-8 antagonist
Ans. A
Q 61. Which one of the following drugs does not produce central anticholinergic syndrome:
A. Atropine sulphate
B. Glycopyrrolate
C. Antihistaminics
D. Tricyclic antidepressants
Ans. B
Q 62. Heparin is the commonly used anticoagulant in cardiac surgery. All of the following are true about heparin except:
A. Weakest acid found in living things
B. Most commercial preparations of heparin now utilize pig intestinal slimes
C. Act via antithrombin activation
D. Produce thrombocytopenia
Ans. A
Q 63. Which of the following antiepileptic agents acts on the GABAergic system to decrease the uptake of GABA into neurons and glial cells:
A. Vigabatrin
B. Progabide
C. Gabapentin
D. Tiagabine
Ans. D
Q 64. The Mu receptor of the opioids is responsible for the following clinical actions except:
A. Analgesia
B. Respiratory depression
C. Sedation
D. Diuresis
Ans. D
Q 65. Which of the following chemotherapeutic drugs has selective action on hypoxic tumor cells:
A. Mitomycin C
B. Cisplatin
C. Doxorubicin
D. 5 Fluorouracil
Ans. A
Q 66. The chemotherapeutic agent, most commonly administered by continuous infusion is:
A. Ara-C
B. 5-FU
C. Cisplatin
D. Etoposide
Ans. C
Q 67. Nephrotoxicity is a side effect of one of the following immuno-suppressives:
A. Sirolimus
B. Tacrolimus
C. Mycophenolate mofetil
D. Azathioprine
Ans. B
Q 68. Which of the following drugs has covalent interaction with its target:
A. Aspirin
B. Penicillin
C. Nitric oxide
D. Bosentan
Ans. A
Q 69. In treatment of papillary carcinoma thyroid, radioiodine destroys the neoplastic cells predominantly by:
A. X rays
B. rays
C. rays
D. particles
Ans. B
Q 70. The new agent pemetrexed, useful in breast cancer, belongs to which of the following category of drugs:
A. Antitumor antibiotic
B. Alkylating agent
C. Hormonal agent
D. Antimetabolite
Ans. D
Q 71. Which of the following property of drug will enable it to be used in low concentrations:
A. High affinity
B. High specificity
C. Low specificity
D. High stability
Ans. D
MICROBIOLOGY
Q 72. A patient of Acute lymphocytic leukemia with fever and neutropenia develops diarrhoea after administration of amoxicillin therapy, which of the following organism is most likely to be causative agent:
A. Salmonella typhi
B. Clostridium difficile
C. Clostridium perfringens
D. Shigella flexneri
Ans. B
Q 73. The following statements are true with reference to Mycoplasma except:
A. They are the smallest prokaryotic organisms that can grow in cell free culture media
B. They are obligate intracellular organisms
C. They lack a cell wall
D. They are resistant to beta-lactam drugs
Ans. B
Q 74. In HIV Infected individual Gram stain of lung aspirate shows yeast like morphology. All of the following are the most likely diagnosis except:
A. Candida tropicalis
B. Cryptococcus neoformans
C. Penicillium marneffi
D. Aspergillus fumigatus
Ans. D
Q 75. A 45 year old female complains of lower abdominal pain and vaginal discharge. On examination there is cervicitis along with a mucopurulent cervical discharge. The best approach to isolate the possible causative agent would be:
A. Culture chocolate agar supplemented with Haemin
B. Culture on McCoy cells
C. Culture on a bilayer human blood agar
D. Culture on vero cell lines
Ans. B
Q 76. A major step in the pathogenesis of listeriosis is:
A. The formation of antigen-antibody complexes with resultant complement activation and tissue damage
B. The release of hyaluronidase by L. monocytogenes, which contributes to its dissemination from local sites
C. The antiphagocytic activity of the L. monocytogenes capsule
D. The survival and multiplication of L. monocytogenes within mononuclear phagocytes and host epithelial cells
Ans. D
Q 77. The following is not a method of isolation of chlamydia from clinical specimens:
A. Yolk sac inoculation
B. Enzyme immunoassay
C. Tissue culture using irradiated McCoy cells
D. Tissue culture using irradiated BHK cells
Ans. B
Q 78. The sputum specimen of a 70 year old male was cultured on a 5% sheep blood agar. The culture showed the presence of -haemolytic colonies next day. The further processing of this organism is most likely to yield.
A. Gram positive cocci in short chains, catalase negative and bile resistant
B. Gram positive cocci in pairs, catalase negative and bile soluble
C. Gram positive cocci in clusters, catalase positive and coagulase positive
D. Gram negative coccobacilli catalase positive and oxidase positive
Ans. B
Q 79. A 25-year old farmer presented with history of high grade fever for 7 days and altered sensorium for 2 days. On examination, He was comatosed and had conjunctival hemorrhage. Urgent investigations showed a hemoglobin of 11 gm/dl, serum bilirubin 8 mg/dl and urea 78 mg/dl. Peripheral blood smear was negative for malarial parasite. What is the most likely diagnosis:
A. Brucellosis
B. Weil’s disease
C. Acute viral hepatitis
D. Q fever
Ans. B
PATHOLOGY
Q 80. The most common histological variant of renal cell carcinoma is:
A. Clear cell type
B. Chromophobe type
C. Papillary type
D. Tubular type
Ans. A
Q 81. The following diseases have defect in DNA repair mechanism except for:
A. Xeroderma pigmentosa
B. Fanconi syndrome
C. Huntington’s disease
D. Hereditary non polyposis colon cancer
Ans. C
Q 82. Which of the following carcinoma most frequently metastasizes to brain:
A. Small cell carcinoma lung
B. Prostate cancer
C. Rectal carcinoma
D. Endometrial cancer
Ans. A
Q 83. A metastatic carcinoma in the brain of an adult, most often comes from a primary in the:
A. Stomach
B. Ovary
C. Oral cavity
D. Lung
Ans. D
Q 84. The expression of the following oncogene is associated with a high incidence of medullary carcinoma of thyroid:
A. P 53
B. Her 2 neu
C. Ret proto oncogene
D. Rb gene
Ans. C
Q 85. The lymphocytic and histiocytic variant of Reed-Sternberg cell is seen in:
A. Follicular center lymphoma
B. Lymphocyte depleted Hodgkin’s disease
C. Nodular sclerosis Hodgkin’s disease
D. Lymphocyte predominant Hodgkin’s disease
Ans. D
Q 86. All of the following are examples of a round cell tumor, except:
A. Neuroblastoma
B. Ewing’s sarcoma
C. Non Hodgkin’s lymphoma
D. Osteosarcoma
Ans. D
Q 87. The inheritance pattern of familial retinoblastomas is:
A. Autosomal recessive
B. Autosomal dominant
C. X-linked dominant
D. X-linked recessive
Ans. B
Q 88. Which of the following is not a common site for metastatic calcification:
A. Gastric mucosa
B. Kidney
C. Parathyroid
D. Lung
Ans. C
Q 89. Internucleosomal cleavage of DNA is characteristic of:
A. Reversible cell injury
B. Irreversible cell injury
C. Necrosis
D. Apoptosis
Ans. D
Q 90. On electron microscopy amyloid characteristically exhibits:
A. -pleated sheet
B. Hyaline globules
C. 7.5-10 nm fibrils
D. 20-25 nm fibrils
Ans. C
Q 91. Acute diffuse proliferative glomerulonephritis will have all of the following features, except:
A. Microscopic haematuria
B. Raised blood urea level
C. Raised serum creatinine level
D. Hypoalbuminaemia
Ans. D
Q 92. All of the following are mediators of acute inflammation except:
A. Angiotensin
B. Prostaglandin E2
C. Kallikrein
D. C 3a
Ans. A
Q 93. Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cell:
A. CD 22
B. CD 40
C. CD 15
D. CD 34
Ans. D
Q 94. During which phase of the cell cycle the cellular content of DNA is doubled:
A. Mitotic phase
B. G1 phase
C. G2 phase
D. S phase
Ans. D
Q 95. The tumor suppressor gene p 53 induces cell cycle arrest at:
A. G2-M phase
B. S-G2 phase
C. G1-S phase
D. G0 phase
Ans. C
Q 96. Which of the following is not compatible with a diagnosis of juvenile myelomonocytic leukemia:
A. Peripheral blood monocytosis, more than 1 × 109/L
B. Increased hemoglobin F levels for age
C. Presence of bcr/abl fusion gene
D. GM-CSF hypersensitivity of myeloid progenitors in vitro
Ans. C
Q 97. Programmed cell death is known as:
A. Cytolysis
B. Apoptosis
C. Necrosis
D. Proptosis
Ans. B
Q 98. The most potent stimulator of naive T cells is:
A. B cell
B. Mature dendritic cells
C. Epithelial cells
D. Macrophages
Ans. B
MEDICINE
Q 99. In the treatment of severe bradycardia, all of the following can be the best modality of treatment except:
A. Atropine
B. Pacing
C. Isoproterenol
D. Diltiazem
Ans. D
Q 100. Henoch-Schonlein purpura is characterized by the deposition of the following immunoglobulin around the vessels:
A. IgM
B. IgG
C. IgA
D. IgE
Ans. C
Q 101. A 45 year old woman, presenting with the history of diplopia and dysphagia worsening as the day progresses, can be diagnosed to have:
A. Thyrotoxicosis
B. Myasthenia gravis
C. Muscular dystrophy
D. Brain tumor
Ans. B
Q 102. A 63 year old man presents with a triad of angina, syncope and congestive heart failure. Which of the following valvular heart lesion can be suspected:
A. Mitral stenosis
B. Tricuspid regurgitation
C. Aortic stenosis
D. Aortic regurgitation
Ans. C
Q 103. A head injured patient, who opens eyes to painful stimulus, is confused and localizes to pain. What is his Glasgow coma score:
A. 7
B. 9
C. 11
D. 13
Ans. C
Q 104. The most definitive method of diagnosing pulmonary embolism is:
A. Pulmonary arteriography
B. Radioisotope perfusion pulmonary scintigraphy
C. EKG
D. Venography
Ans. A
Q 105. Which of the following is the drug of choice for the treatment of inappropriate anti-diuretic hormone secretion:
A. Frusemide
B. Hydrochlorothiazide
C. Spironolactone
D. Demeclocycline
Ans. D
Q 106. A 2 year old boy presents with fever for 3 days which responded to administration of paracetamol. Three days later he developed acute renal failure, marked acidosis and encephalopathy. His urine showed plenty of oxalate crystals. The blood anion gap and osmolal gap were increased. Which of the following is the most likely diagnosis:
A. Paracetamol poisoning
B. Diethyl glycol poisoning
C. Severe malaria
D. Hanta virus infection
Ans. B
Q 107. A young, tall, thin male with arachnodactyly has ectopia lentis in both eyes. The most likely diagnosis is:
A. Marfan’s Syndrome
B. Marchesani’s Syndrome
C. Homocystinuria
D. Ehlers Danlos syndrome
Ans. A
Q 108. A 25 year old woman presents with recurrent abdominal pain and anemia. Peripheral blood smear shows basophilic stippling of the red blood cells. What is the most likely diagnosis:
A. Coeliac disease
B. Hookworm infestation
C. Sickle cell disease
D. Lead poisoning
Ans. D
Q 109. A 30 year old lady presents with features of malabsorption and iron deficiency anaemia. Duodenal biopsy shows complete villous atrophy. Which of the following antibodies is likely to be present:
A. Antiendomysial antibodies
B. Anti-goblet cell antibodies
C. Anti-Saccharomyces cerevisae antibodies
D. Antineutrophil cytoplasmic antibodies
Ans. A
Q 110. Following liver transplantation, recurrence of primary disease in the liver most likely occurs in:
A. Wilson’s disease
B. Autoimmune hepatitis
C. Alpha-1 antitrypsin deficiency
D. Primary biliary cirrhosis
Ans. B
Q 111. A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment:
A. Intravenous ceftriaxone
B. Intravenous metronidazole
C. Intravenous steroids and sulphasalazine
D. Hydrocortisone enemas
Ans. B
Q 112. Minimal change glomerulopathy may be seen in association with all of the following except:
A. Hepatitis B
B. HIV
C. Drug-induced interstitial nephritis
D. Hodgkin’s disease
Ans. A
Q 113. What is the drug of choice to control supraventricular tachycardia:
A. Adenosine
B. Propranolol
C. Verapamil
D. Digoxin
Ans. A
Q 114. Which of the following is the most common location of intracranial neurocysticercosis:
A. Brain parenchyma
B. Subarachnoid space
C. Spinal cord
D. Orbit
Ans. A
Q 115. The paraneoplastic syndrome associated with Hodgkin’s disease is:
A. Nephrotic syndrome
B. Retinopathy
C. Cerebellar degenerative disease
D. Acanthosis nigricans
Ans. C
Q 116. A 25 year old male presented with pigmentation of nose and pinna. After voiding, his urine becomes dark. His spine is most likely to show:
A. Atlantoaxial subluxation
B. Spondyloptosis
C. Basilar invagination
D. Calcification of disc
Ans. D
Q 117. A 50 year old lady presented with history of pain upper abdomen, nausea, and decreased appetite for 5 days. She had undergone cholecystectomy 2 years back. Her bilirubin was 10 mg/dl, SGOT 900 IU/I SGPT 700 IU/I and serum alkaline phosphatase was 280 IU/I. What is the most likely diagnosis:
A. Acute pancreatitis
B. Acute cholangitis
C. Acute viral hepatitis
D. Posterior penetration of peptic ulcer
Ans. C
Q 118. A 70-year old male patient presented to the emergency department with pain in epigastrium and difficulty in breathing for 6 hours. On examination, his heart rate was 56 per minute and the blood pressure was 106/60 mmHg. Chest examination was normal. The patient has been taking omeprazole for gastroesophageal reflux disease for last 6 months. What should be the initial investigation:
A. An ECG
B. An upper GI endoscopy
C. Urgent ultrasound of the abdomen
D. An x-ray chest
Ans. A
Q 119. Which of the following signs is not suggestive of a cervical spinal cord injury:
A. Flaccidity
B. Increased rectal sphincter tone
C. Diaphragmatic breathing
D. Priapism
Ans. B
Q 120. A 48 year old woman was admitted with a history of weakness for two months. On examination cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 237 × 109/L and total leukocyte count 40 × 109/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD 19, CD 5, CD 20 and CD 23 and were negative for CD 79 B and FMC-7.
What is the most likely diagnosis?
A. T-cell rich B-cell lymphoma with leukemic spill over in blood
B. Chronic lymphocytic leukemia
C. Mantle cell lymphoma
D. A definite diagnosis can not be made in this patient without lymph node biopsy
Ans. B
Q 121. The typical movement of mitral valve calcification is:
A. Upwards and downwards
B. Counterclockwise
C. Side to side
D. Circular
Ans. A
PEDIATRICS
Q 122. Recurrent respiratory tract infections may occur in all of the following except:
A. Ventricular septal defect
B. Tetralogy of Fallot
C. Transposition of great arteries
D. Total anomalous venous return
Ans. B
Q 123. A female child has recently learned to eat with spoon without spilling; to dress and undress herself with supervision: and to understand that she is a girl. These skills are first mastered between the ages of:
A. 2 and 3 years
B. 3 and 4 years
C. 4 and 5 years
D. 5 and 6 years
Ans. A
Q 124. A 30-year old lady delivered a healthy baby at 37 week of gestation. She was a known case of chronic hepatitis B infection. She was positive for HBsAg but negative for HBeAg. Which of the following is the most appropriate treatment for the baby:
A. Both active passive immunization soon after birth
B. Passive immunization soon after birth and active immunization at 1 year of age
C. Only passive immunization soon after birth
D. Only active immunization soon after birth
Ans. A
Q 125. At what gestation does the switch over from fetal to adult hemoglobin synthesis begin:
A. 30 weeks
B. 36 weeks
C. 7 days postnatal
D. 3 weeks postnatal
Ans. B
Q 126. A 6-month old boy weighing 3.2 kg presents with recurrent vomiting and polyuria. Investigations show blood area 60 mg/dl creatinine 0.7 mg/dL, calcium 12.8 mg/dL, phosphate 3 mg/dL, pH 7.45, bicarbonate 25 mEq/L and PTH 140 pg ml (normal < 60 pg/ml). Daily urinary calcium excretion is reduced. Ultrasound abdomen show bilateral nephrocalcinosis. The most likely diagnosis is:
A. Bartter syndrome
B. Mutation of the calcium sensing receptor
C. Pseudo-pseudohypoparathyroidism
D. Parathyroid adenoma
Ans. B
Q 127. A child presents with diarrhea and peripheral circulatory failure. The arterial pH is 7.0, PCO2 15 mmHg, and PO2 76 mmHg. What will be the most appropriate therapy:
A. Sodium bicarbonate infusion
B. Bolus of Ringer lactate
C. Bolus of hydroxyethyl starch
D. 5% dextrose infusion
Ans. B
Q 128. A 5 year old child is rushed to casualty reportedly electrocuted while playing in a park. The child is apneic and is ventilated with bag and mask. There are burns on each hand. What will be the next step in the management:
A. Check pulses
B. Start chest compressions
C. Intubate
D. Check oxygen saturation
Ans. A
SURGERY
Q 129. Which of the following statements is true regarding fat embolism:
A. Most patients with major trauma involving long bones have urinary fat globules
B. All patients with urinary fat globules develop fat embolism
C. Peak incidence of respiratory insufficiency for pulmonary fat embolism is around day 7 after injury
D. Heparin as an anticoagulant decreases mortality and morbidity in fat embolism syndrome
Ans. A
Q 130. The diagnosis of congenital megacolon is confirmed by:
A. Clinical features
B. Barium enema
C. Rectal biopsy
D. Recto-sigmoidoscopy
Ans. C
Q 131. The treatment of choice for Anaplastic carcinoma of thyroid infiltrating trachea and sternum will be:
A. Radical excision
B. Chemotherapy
C. Radiotherapy
D. Palliative/Symptomatic treatment
Ans. D
Q 132. Which of the following is the commonest tumour of thyroid:
A. Anaplastic carcinoma
B. Follicular carcinoma
C. Papillary carcinoma
D. Medullary carcinoma
Ans. C
Q 133. A 16-year old boy presents with acute onset pain in the left testis. The following statements about his management are true except:
A. The patient should be prescribed antibiotics and asked to come after a week
B. Colour flow Doppler will be very useful in diagnosis
C. Scrotal exploration should be done without delay if Doppler is not available
D. If left testis is not viable on exploration, patient should undergo left orchidectomy and right orchidopexy
Ans. A
Q 134. All of the following extraintestinal manifestations of ulcerative colitis respond to colectomy except:
A. Primary sclerosing cholangitis
B. Pyoderma gangrenosum
C. Episcleritis
D. Peripheral arthralgia
Ans. A
Q 135. Which of the following is the most effective intravesical therapy for superficial bladder cancer:
A. Mitomycin
B. Adriamycin
C. Thiotepa
D. BCG
Ans. D
Q 136. The most common facial abnormality seen in Gardener’s syndrome is:
A. Ectodermal dysplasia
B. Odontomes
C. Multiple osteomas
D. Dental cysts
Ans. C
Q 137. All of the following soft tissue sarcomas have a propensity for lymphatic spread except:
A. Neurofibrosarcoma
B. Synovial sarcoma
C. Rhabdomyosarcoma
D. Epithelioid sarcoma
Ans. A
Q 138. All of the following are features of Zollinger Ellison syndrome except:
A. Intractable peptic ulcers
B. Severe diarrhoea
C. Beta cell tumours of the pancreas
D. Very high acid output
Ans. C
Q 139. All of the following are modalities of therapy for hepatocellular carcinoma except:
A. Radiofrequency ablation
B. Transarterial catheter embolization
C. Percutaneous acetic acid
D. Nd Yag laser ablation
Ans. D
Q 140. Which of the following statement is true regarding subclavian steal syndrome:
A. Reversal of blood flow in the ipsilateral vertebral artery
B. Reversal of blood flow in the contralateral carotid artery
C. Reversal of blood flow in the contralateral vertebral artery
D. Bilateral reversal of blood flow in the vertebral arteries
Ans. A
Q 141. Features, which are evaluated for histological grading of breast carcinoma, include all of the following except:
A. Tumour necrosis
B. Mitotic count
C. Tubule formation
D. Nuclear pleomorphism
Ans. A
Q 142. All the following can be used to predict severe acute pancreatitis except:
A. Glasgow score 3
B. APACHE II score 9
C. CT severity score 6
D. C-reactive protein < 100
Ans. D
Q 143. A patient presented to emergency ward with massive upper gastrointestinal bleed. On examination, he has mild splenomegaly. In the absence of any other information available, which of the following is the most appropriate therapeutic modality:
A. Intravenous propranolol
B. Intravenous vasopressin
C. Intravenous pantoprazole
D. Intravenous somatostatin
Ans. C
Q 144. Regarding bile duct injuries following cholecystectomy which of the following statement is false:
A. The incidence following open cholecystectomy is in the range of 0.2-0.3%
B. The incidence rate following laparoscopic cholecystectomy is three times higher than the rates following open cholecystectomy
C. Untreated cases may develop secondary biliary cirrhosis
D. Routine use of ‘open’ technique of laparoscopic port insertion has resulted in a decline in the incidence of post-laparoscopic cholecystectomy bile duct injuries
Ans. D
Q 145. Platelets can be stored at:
A. 20-24°C for 5 days
B. 20-24°C for 8 days
C. 4-8°C for 5 days
D. 4-8°C for 8 days
Ans. A
Q 146. The most common cause of peripheral limb ischaemia in India is:
A. Trauma
B. Atherosclerosis
C. Buerger’s disease
D. Takayasu disease
Ans. B
Q 147. A 45 year old male presents with 4 × 4 cm, mobile right solitary thyroid nodule of 5 months duration. The patient is euthyroid. The following statements about his management are true except:
A. Cold nodule on thyroid scan is diagnostic of malignancy
B. FNAC is the investigation of choice
C. The patient should undergo hemithyroidectomy if FNAC report is inconclusive
D. Indirect laryngoscopy should be done in the preoperative period to assess mobility of vocal cords.
Ans. A
Q 148. In patients with breast cancer, chest wall involvement means involvement of any one of the following structures except:
A. Serratus anterior
B. Pectoralis major
C. Intercostal muscles
D. Ribs
Ans. B
Q 149. All of the following are indications for surgery in gastric lymphoma except:
A. Bleeding
B. Perforation
C. Residual disease following chemotherapy
D. Intractable pain
Ans. D
Q 150. A person has been brought in casualty with history of road accident. He had lost consciousness transiently and then gained consciousness but again became unconscious. Most likely, he is having brain hemorrhage of:
A. Intracerebral
B. Subarachnoid
C. Subdural
D. Extradural
Ans. D
Q 151. In which of the following tumors alpha fetoprotein is elevated:
A. Choriocarcinoma
B. Neuroblastoma
C. Hepatocellular carcinoma
D. Seminoma
Ans. C
Q 152. Acalculous cholecystitis can be seen in all the following conditions except:
A. Enteric fever
B. Dengue haemorrhagic fever
C. Leptospirosis
D. Malaria
Ans. D
ORTHOPAEDICS
Q 153. A 50 year old man presented with multiple pathological fractures. His serum calcium was 11.5 mg/dl and phosphate was 2.5 mg/dl. Alkaline phosphatase was 940 IU/dl. The most probable diagnosis is:
A. Osteoporosis
B. Osteomalacia
C. Multiple myeloma
D. Hyperparathyroidism
Ans. D
Q 154. The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of:
A. Intracapsular fracture of the femoral neck
B. Extracapsular fracture of the femoral neck
C. Posterior dislocation of hip
D. Anterior dislocation of hip
Ans. C
Q 155. Pain & tenderness over the lateral condyle of humerus with a painful dorsiflexion of the wrist is indicative of:
A. Golfer’s elbow
B. Tennis elbow
C. Pitcher’s elbow
D. Cricket elbow
Ans. B
Q 156. A one year old child presented with multiple fractures seen in various stages of healing. The most probable diagnosis in this case is:
A. Scurvy
B. Rickets
C. Battered baby syndrome
D. Sickle cell disease
Ans. C
GYNAECOLOGY & OBSTETRICS
Q 157. All of the following are the markers for malignant germ cell tumors of ovary except:
A. CA-125
B. Alpha fetoprotein
C. -HCG
D. LDH
Ans. A
Q 158. In which of the following conditions would maternal serum -fetoprotein values be the highest:
A. Down’s syndrome
B. Omphalocele
C. Gastroschisis
D. Spina bifida occulta
Ans. C
Q 159. Which of the following test is the most sensitive for detection of iron depletion in pregnancy:
A. Serum iron
B. Serum transferrin
C. Serum ferritin
D. Serum erythropoietin
Ans. C
Q 160. The one measurement of fetal maturity that is not affected by a ‘bloody tap’ during amniocentesis is:
A. L/S ratio
B. Phosphatidyl glycerol
C. fetoprotein
D. Bilirubin as measured by OD 450
Ans. B
Q 161. The drug of choice in treatment of typhoid fever in pregnancy is:
A. Ampicillin
B. Chloramphenicol
C. Ciprofloxacin
D. Ceftriaxone
Ans. D
Q 162. The most important indication for surgical repair of a bicornuate uterus is:
A. Infertility
B. Dysmenorrhoea
C. Menorrhagia
D. Habitual abortion
Ans. D
Q 163. Which of the following strategy has been recommended to reduce the hereditary risk for ovarian cancer in woman with BRCA I & BRCA II mutation:
A. Use of oral contraceptive pill
B. Screening with transvaginal ultrasound
C. Screening with CA-125
D. Prophylactic oophorectomy
Ans. D
Q 164. Which of the following antihypertensives is not safe in pregnancy:
A. Clonidine
B. ACE inhibitors
C. -methyldopa
D. Amlodipine
Ans. B
OPHTHALMOLOGY
Q 165. A 55 year old female comes to the eye casualty with history of severe eye pain, redness and diminution of vision. On examination the visual acuity is 6/60, there is circumcorneal congestion, corneal oedema and a shallow anterior chamber, Which of the following is the best drug of choice:
A. Atropine ointment
B. IV mannitol
C. Ciprofloxacin eye drops
D. Betamethasone eye drops
Ans. B
Q 166. A 30 year old patient with history of recurrent headache was sent for fundus evaluation. He was found to be having generalized arterial attenuation with multiple cotton wool spots and flame shaped haemorrhages in both eyes. The most likely cause is:
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Central retinal artery occlusion
D. Temporal arteritis
Ans. B
Q 167. A female presented with loss of vision in both eyes and on examination has normal pupillary responses and normal fundus, Her visually evoked response (VER) examination shows extinguished responses. The most likely diagnosis is:
A. Hysteria
B. Cortical blindness
C. Optic neuritis
D. Retinal detachment
Ans. B
Q 168. The most common retrobulbar orbital mass in adults is:
A. Neurofibroma
B. Meningioma
C. Cavernous haemangioma
D. Schwannoma
Ans. C
Q 169. Which of the following drugs is contraindicated in a patient with history of sulfa allergy presenting with an acute attack of angle closure glaucoma:
A. Glycerol
B. Acetazolamide
C. Mannitol
D. Latanoprost
Ans. B
Q 170. The most common systemic association of scleritis is:
A. Ehlers Danlos syndrome
B. Disseminated systemic sclerosis
C. Rheumatoid arthritis
D. Giant cell arteritis
Ans. C
Q 171. Angioid streaks in the eyes are seen in:
A. Pseudoxanthoma elasticum
B. Tendinous xanthoma
C. Xanthelasma
D. Eruptive xanthoma
Ans. A
Q 172. The corneal transparency is maintained by:
A. Keratocytes
B. Bowman’s membrane
C. Descemet’s membrane
D. Endothelium
Ans. D
Q 173. A 55 year old patient complains of decreased distance vision. However, now he does not require his near glasses for near work. The most likely cause is:
A. Posterior subcapsular cataract
B. Zonular cataract
C. Nuclear sclerosis
D. Anterior subcapsular cataract
Ans. C
Q 174. A patient has a right homonymous hemianopia with saccadic pursuit movements and defective optokinetic nystagmus. The lesion is most likely to be in the:
A. Frontal lobe
B. Occipital lobe
C. Parietal lobe
D. Temporal lobe
Ans. C
Q 175. Idiopathic nyctalopia is due to a hereditary:
A. Absence of rod function
B. Absence of cone function
C. Absence of rod and cone function
D. Decrease of cone function
Ans. A
ENT
Q 176. A 10 year old boy developed hoarseness of voice following and attack of diphtheria. On examination, his right vocal cord was paralysed. The treatment of choice for paralysed vocal cord will be:
A. Gel foam injection of right vocal cord
B. Fat injection of right vocal cord
C. Thyroplasty type-I
D. Wait for spontaneous recovery of vocal cord
Ans. D
Q 177. The current treatment of choice for a large antro-choanal polyp in a 30 year old man is:
A. Intranasal polypectomy
B. Caldwell Luc operation
C. ESS (Endoscopic sinus surgery)
D. Lateral rhinotomy and excision
Ans. C
SKIN
Q 178. ‘Exclamation mark’ hair is a feature of:
A. Telogen effluvium
B. Androgenetic alopecia
C. Alopecia areata
D. Alopecia mucinosa
Ans. C
Q 179. Pautrier’s micro-abscess is a histological feature of:
A. Sarcoidosis
B. Tuberculosis
C. Mycosis fungoides
D. Pityriasis lichenoides chronica
Ans. C
Q 180. ‘Adenoma sebaceum’ is a feature of:
A. Neurofibromatosis
B. Tuberous sclerosis
C. Xanthomatosis
D. Incontinentia pigmenti
Ans. B
ANAESTHESIA
Q 181. Bradycardia is common after injection of:
A. Midazolam
B. Succinyl choline
C. Dopamine
D. Isoprenaline
Ans. B
Q 182. With regard to Ketamine, all of the following are true except:
A. It is a direct myocardial depressant
B. Emergence phenomena are more likely if anticholinergic premedication is used
C. It may induce cardiac dysarrhythmias in patients receiving tricyclic antidepressants
D. Has no effect on intracranial pressure
Ans. D
Q 183. Which of the following is not a cardiovascular monitoring technique:
A. Transesophageal echocardiography
B. Central venous pressure monitoring
C. Pulmonary artery catheterization
D. Capnography
Ans. D
Q 184. Placement of a double lumen tube for lung surgery is best confirmed by:
A. ETCO2
B. Airway pressure measurement
C. Clinically by auscultation
D. Bronchoscopy
Ans. D
Q 185. The most sensitive and practical technique for detection of myocardial ischemia in the periooperative period is:
A. Magnetic Resonance Spectroscopy
B. Radio labeled lactate determination
C. Direct measurement of end diastolic pressure
D. Regional wall motion abnormality detected with the help of 2D transoesophageal echocardiography
Ans. D
Q 186. The most common cause of hypoxia during one lung ventilation is:
A. Malposition of the double lumen tube
B. Increased shunt fraction
C. Collapse of one lung
D. Soiling of lung by secretions
Ans. A
Q 187. A 30 year old woman with coarctation of aorta is admitted to the labour room for elective caesarean section. Which of the following is the anaesthesia technique of choice:
A. Spinal anaesthesia
B. Epidural anaesthesia
C. General anaesthesia
D. Local anaesthesia with nerve blocks
Ans. C
Q 188. A 5 year old child is suffering from cyanotic heart disease. He is planned for corrective surgery. The induction agent of the choice would be:
A. Thiopentone
B. Ketamine
C. Halothane
D. Midazolam
Ans. B
Q 189. While introducing the Swan-Ganz catheter, its placement in the pulmonary artery can be identified by the following pressure tracing:
A. Diastolic pressure is lower in PA than in RV
B. Diastolic pressure is higher in PA than in RV
C. PA pressure tracing has diacrotic notch from closure of pulmonary valve
D. RV pressure tracing for plateau and sharp drop in early diastole.
Ans. C
Q 190. The outcome following resuscitation of a cardiac arrest is worsened if during resuscitation patient is given:
A. Ringer’s lactate
B. Colloids
C. 5% dextrose
D. Whole blood transfusion
Ans. C
Q 191. A 6 month old child is suffering from patent ductus arteriosus (PDA) with congestive cardiac failure. Ligation of ductus arteriosus was decided for surgical management. The most appropriate inhalational anaesthetic agent of choice with minimal haemodynamic alteration from induction of anaesthesia is:
A. Sevoflurane
B. Isoflurane
C. Enflurane
D. Halothane
Ans. A
RADIOLOGY
Q 192. The posterior urethra is best visualized by:
A. Static cystogram
B. Retrograde urethrogram
C. Voiding cystogram
D. CT cystogram
Ans. C
Q 193. For which malignancy, intensity modulated radiotherapy (IMRT) is the most suitable:
A. Lung
B. Prostate
C. Leukemias
D. Stomach
Ans. B
Q 194. Which of the following radioactive isotopes is not used for brachytherapy:
A. Iodine-125
B. Iodine-131
C. Cobalt-60
D. Iridium-192
Ans. B
Q 195. Solitary hypoechoic lesion of the liver without septae or debris is most likely to be:
A. Hydatid cyst
B. Caroli’s disease
C. Liver abscess
D. Simple cyst
Ans. D
PSYCHIATRY
Q 196. A 50 year old male feels uncomfortable in using lift, being in crowded places and travelling. The most appropriate line of treatment is:
A. Counselling
B. Relaxation therapy
C. Exposure
D. Covert sensitization
Ans. C
Q 197. Which of the following statements differentiates the obsessional idea from delusions:
A. The idea is not a conventional belief
B. The idea is held in spite of contrary evidence
C. The idea is regarded as senseless by patient
D. The idea is held on inadequate ground
Ans. C
Q 198. Dementia of Alzheimer’s type is not associated with one of the following:
A. Depressive symptoms
B. Delusions
C. Apraxia and aphasia
D. Cerebral infarcts
Ans. D
Q 199. A person who laughs one minute and cries the next without any clear stimulus is said to have:
A. Incongruent affect
B. Euphoria
C. Labile affect
D. “Split personality”
Ans. C
Q 200. A 9 year old child disturbs other people, is destructive, interferes when two people are talking, does not follow instructions and cannot wait for his turn while playing a game. He is likely to be suffering from:
A. Emotional disorders
B. Behavioural problems
C. No disorder
D. Attention deficit hyperactivity disorder
Ans. D
Q 1. All of the following statements about the splenic artery are true except that it:
A. Has a tortuous course
B. Is a branch of the coeliac trunk
C. Has branches that anastomose freely within the spleen
D. Supplies the greater curvature of stomach
Ans. C
Q 2. Which of the following, among axillary lymph nodes, is a terminal group:
A. Pectoral
B. Central
C. Lateral
D. Apical
Ans. D
Q 3. The vertebral artery traverses all of the following except:
A. Foramen magnum
B. Subarachnoid space
C. Intervertebral foramen
D. Foramen transversarium
Ans. C
Q 4. All of the following structures pass through the superior aperture of thorax except:
A. Right recurrent laryngeal nerve
B. Left common carotid artery
C. Left sympathetic trunk
D. Thoracic duct
Ans. A
Q 5. All of the following statements about the vagus nerve are true except that it:
A. Supplies heart & lung
B. Carries postganglionic parasympathetic fibers.
C. Innervates right two third of transverse colon
D. Stimulates peristalsis & relaxes sphincters
Ans. B
Q 6. The narrowest part of the ureter is at the:
A. Uretero-pelvic junction
B. Iliac vessel crossing
C. Pelvic ureter
D. Uretero-vesical junction
Ans. D
PHYSIOLOGY
Q 7. An anterolateral cordotomy relieving pain in right leg is effective because it interrupts the:
A. Left dorsal column
B. Left ventral spinothalamic tract
C. Left lateral spinothalamic tract
D. Right lateral spinothalamic tract
Ans. C
Q 8. Arterial blood gas of a 5 year old child done at sea level gives the following results: pH 7.41, PaO2 100 mmHg, and PaCO2 40 mmHg. The child is being ventilated with 80% oxygen. What is the (A-a) PO2:
A. 570.4 mmHg
B. 520.4 mmHg
C. 470.4 mmHg
D. 420.4 mmHg
Ans. D
Q 9. Pulmonary function abnormalities in interstitial lung diseases include all of the following except:
A. Reduced vital capacity
B. Reduced FEV1/FVC ratio
C. Reduced diffusion capacity
D. Reduced total lung capacity
Ans. B
Q 10. Which of the following situations will lead to increased viscosity of blood:
A. Fasting state
B. Hypoglycemia
C. Multiple myeloma
D. Amyloidogenesis
Ans. C
Q 11. All of the following transport process follow ‘saturation kinetics’ except:
A. Facilitated diffusion
B. Na+-Ca2+ exchanger
C. Simple diffusion
D. Na+ coupled active transport
Ans. C
Q 12. Fetal haemoglobin has all the following characteristic features except:
A. Strong affinity for 2,3-DPG
B. Oxygen dissociation curve is shifted to left
C. At low fetal PO2 gives up more oxygen to tissues than adult haemoglobin
D. Forms 80% of haemoglobin at birth
Ans. A
Q 13. According to myogenic hypothesis of renal autoregulation, the afferent arterioles contract in response to stretch induced by:
A. NO release
B. Noradrenaline release
C. Opening of Ca2+ channels
D. Adenosine release
Ans. C
Q 14. Beta waveforms in electroencephalogram designate which of the following states of the patient:
A. Deep Anaesthesia
B. Surgical Anaesthesia
C. Light Anaesthesia, eyes closed, relaxed
D. Awake/alert state
Ans. D
BIOCHEMISTRY
Q 15. At physiological pH, the carboxy-terminal of a peptide is:
A. Positively charged
B. Negatively charged
C. Neutral
D. Infinitely charged
Ans. B
Q 16. Apart from occurring in nucleic acids, pyrimidines are also found in:
A. Theophylline
B. Theobromine
C. Flavin mononucleotide
D. Thiamine
Ans. D
Q 17. By which of the following anticoagulants used in estimating blood glucose, glycolysis is prevented:
A. EDTA
B. Heparin
C. Sodium fluoride
D. Sodium citrate
Ans. C
Q 18. Which of the following is a component of the visual pigment rhodopsin:
A. -carotene
B. Retinal
C. Retinol
D. Retinoic acid
Ans. B
Q 19. Vitamin A is stored mainly as retinol esters in:
A. Kidney
B. Muscle
C. Liver
D. Retina
Ans. C
Q 20. Xeroderma pigmentosa is caused due to a group of closely related abnormalities in:
A. Mismatch repair
B. Base excision repair
C. Nucleotide excision repair
D. SOS repair
Ans. C
Q 21. Substitution of which one of the following amino acids in place of alanine would increase the absorbance of protein at 280 nm:
A. Leucine
B. Arginine
C. Tryptophan
D. Proline
Ans. C
Q 22. Secretory proteins are synthesized in:
A. Cytoplasm
B. Endoplasmic reticulum
C. First in cytoplasm and then in Endoplasmic Reticulum
D. First in Endoplasmic Reticulum and then in cytoplasm
Ans. B
Q 23. To synthesize insulin on a large scale basis, the most suitable starting material obtained from the beta cells of the pancreas is:
A. Genomic DNA
B. Total cellular RNA
C. cDNA of insulin
D. mRNA of insulin
Ans. D
Q 24. If cellular proteins do not fold into a specific conformation, their function are affected. Certain disorders arise, if specific proteins are misfolded. Which of the following disorders arises due to conformational isomerization:
A. Familial fatal insomnia
B. Hepatitis delta
C. Pernicious anemia
D. Lesch-Nyhan syndrome
Ans. A
FORENSIC MEDICINE
Q 25. ‘La facies sympathique’ is a condition seen in cases of.
A. Hanging
B. Strangulation
C. Myocardial insufficiency
D. Railway accidents
Ans. A
Q 26. ‘Vagitus uterinus’ is:
A. An infection of vagina
B. An infection of uterus
C. A cry of unborn baby from uterus
D. Infection of both vagina and uterus
Ans. C
Q 27. Gunshot residue on hands can be detected by:
A. Phenolphthalein test
B. Dermal nitrate test
C. Benzidine test
D. Hydrogen activation analysis
Ans. B
Q 28. A dead body is found to have marks like branching of a tree on front of chest. The most likely cause of death could be due to:
A. Fire-arm
B. Lightning injury
C. Injuries due to bomb blast
D. Road traffic accident
Ans. B
Q 29. All of the following poison’s are dialyzable except:
A. Ethylene glycol
B. Methanol
C. Barbiturates
D. Copper sulphate
Ans. D
PREVENTIVE AND SOCIAL MEDICINE
Q 30. In an investigation to study the effect of smoking on renal cell cancer, it is observed that 30 of the 50 patients were smokers as compared to 10 out of 50 control subjects. The odds ratio of renal cancer associated with smoking will be:
A. 3.0
B. 0.33
C. 6.0
D. 0.16
Ans. C
Q 31. It is probable that physician have a higher index of suspicion for tuberculosis in children without BCG scar than those with BCG scar. If this is so and an association is found between Tuberculosis and not having BCG scar, the association may be due to:
A. Selection bias
B. Interviewer bias
C. Surveillance bias
D. Non-response bias
Ans. B
Q 32. According to WHO, blindness is defined as a visual acuity of the better eye, less than:
A. 6/60
B. 5/60
C. 4/60
D. 3/60
Ans. D
Q 33. In a study 400 smokers and 600 non-smokers were followed up over a period of 10 years to find out the incidence of hypertension. The following table summarizes the data as the end of the study:
Hypertension
Yes No Total
Smoking Yes 120 280 400
No 30 570 600
Total 150 850 1000
The risk ratio in this study is:
A. 0.06
B. 0.60
C. 6.0
D. 60.0
Ans. C
Q 34. If the objective of the investigator is to assess the incidence of tuberculosis infection in a community, the most appropriate methodology would be to:
A. Identify all individuals with positive tuberculin test
B. Perform sputum examination of chest symptomatics
C. Identify new converts to tuberculin test
D. Screen all under-five children with tuberculin test
Ans. C
Q 35. When an intervention is applied to community to evaluate its usefulness, it is termed as a trial for:
A. Efficacy
B. Effectiveness
C. Efficiency
D. Effect modification
Q 36. The drug of choice for treating cholera in pregnant woman is:
A. Tetracycline
B. Doxycycline
C. Furazolidone
D. Cotrimoxazole
Ans. C
Q 37. The most common cause of blindness in India is:
A. Cataract
B. Trachoma
C. Refractive errors
D. Vitamin A deficiency
Ans. A
Q 38. Under National Programme for Prevention of Nutritional Blindness, a child in the age group of 6-11 months is given a mega dose of vitamin A equal to:
A. 50,000 IU
B. 1 lakh IU
C. 1.5 lakh IU
D. 2 lakh IU
Ans. B
Q 39. Which of the following statements is true about the epidemiological determinants of measles:
A. Measles virus survives outside the human body for 5 days
B. Carriers are important sources of infection
C. Secondary attack rate is less than that of rubella
D. Incidence of measles is more in males than females
Ans. C
Q 40. Study the following table carefully and answer the questions:
Disease
Present Absent
Test result +ve 40 225
–ve 10 225
What is the sensitivity of diagnostic test:
A. 45
B. 20
C. 80
D. 50
Ans. C
Q 41. The usual incubation period for pertussis is:
A. 7-14 days
B. 3-5 days
C. 21-25 days
D. Less then 3 days
Ans. A
Q 42. Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in:
A. 6-12 weeks of pregnancy
B. 20-24 weeks of pregnancy
C. 21-25 weeks of pregnancy
D. 32-36 weeks of pregnancy
Ans. A
Q 43. Deficit in weight for height in a 3 year old child indicates:
A. Acute malnutrition
B. Chronic malnutrition
C. Concomitant acute and chronic
D. Under weight
Ans. A
Q 44. Several studies have shown that 85% of cases of lung cancer are due to cigarette smoking. It is a measure of:
A. Incidence rate
B. Relative risk
C. Attributable risk
D. Absolute risk
Ans. C
Q 45. The distribution of random blood glucose measurements from 50 first year medical students was found to have a mean of 3.0 mmol/litre with a standard deviation of 3.0 mmol/litre. Which of the following is a correct statement about the shape of the distribution of random blood glucose in these first year medical students:
A. Since both mean and standard deviation are equal, it should be a symmetric distribution
B. The distribution is likely to be positively skewed
C. The distribution is likely to be negatively skewed
D. Nothing can be said conclusively
Ans. D
Q 46. In the WHO recommended EPI cluster sampling for assessing primary immunization coverage, the age group of children to be surveyed is:
A. 0-12 months
B. 6-12 months
C. 9-12 months
D. 12-23 months
Ans. D
Q 47. According to a joint study “Health-care in India : The Road Ahead” done by CII and Mekinsky and Company in 2002, India’s executing bed population ratio is:
A. 2:1000
B. 1.5:1000
C. 9:1000
D. 2.5:1000
Ans. B
Q 48. All of the following statements are true about the childhood mortality rates in India except:
A. Almost 3/5th of infant mortality rate (IMR) occurs in neonatal period
B. Almost 3/4th of the under-five mortality occurs in the first five years
C. About one in ten children die before they reach the age of five years
D. Neonatal mortality is higher among female children as compared to males
Ans. D
Q 49. Of the different epidemiological study designs available to test the association between risk factor and disease, the best design is of:
A. Case-control study
B. Ecological study
C. Cohort study
D. Cross-sectional study
Ans. C
Q 50. A 24 years old primigravida wt = 57 kg, Hb 11.0 gm% visits an antenatal clinic during 2nd trimester of pregnancy seeking advice on dietary intake. She should be advised:
A. Additional intake of 300 kcal
B. Additional intake of 500 kcal
C. Additional intake of 650 kcal
D. No extra kcal
Ans. A
Q 51. A known HIV positive patient is admitted in an isolation ward after an abdominal surgery following an accident. The resident doctor who changed his dressing the next day found it to be soaked in blood. Which of the following would be right method of choice of discarding the dressing:
A. Pour 1% hypochlorite on the dressing material and send it for incineration in an appropriate bag
B. Pour 5% hypochlorite on the dressing material and send it for incineration in an appropriate bag
C. Put the dressing material directly in an appropriate bag and send for incineration
D. Pour 2% Lysol on the dressing material and send it for incineration in an appropriate bag
Ans. A
Q 52. A chest physician observed that the distribution of forced expiratory volume (FEV) in 300 smokers had a median value of 2.5 litres with the first and third quartiles being 1.5 and 4.5 litres respectively. Based on this data how many persons in the sample are expected to have a FEV between 1.5 and 4.5 litres:
A. 75
B. 150
C. 225
D. 300
Ans. B
Q 53. If the distribution of intra-ocular pressure (IOP) seen in 100 glaucoma patients has an average 30 mm with a SD of 10, what is the lower limit of the average IOP that can be expected 95% of times:
A. 28
B. 26
C. 32
D. 25
Ans. A
Q 54. A diagnostic test for a particular disease has a sensitivity of 0.90 and a specificity of 0.90. A single test is applied to each subject in the population in which the diseased population is 10%. What is the probability that a person positive to this test, has the disease:
A. 90%
B. 81%
C. 50%
D. 91%
Ans. C
PHARMACOLOGY
Q 55. The blood culture from a patient of febrile neutropenia has grown Pseudomonas aeruginosa, It was found to be a producer of extended spectrum beta lactamase enzyme. The best choice of antimicrobial therapy should be:
A. Ceftazidime + amikacin
B. Aztreonam + Amikacin
C. Cefpirone + Amikacin
D. Imipenem + Amikacin
Ans. D
Q 56. Side effects of a drug arise due to the interactions of the drug to molecules other than the target. These effects of a drug can be minimized by its high:
A. Specificity
B. Affinity
C. Solubility
D. Hydrophobicity
Ans. A
Q 57. Tetracycline inhibits protein synthesis by:
A. Inhibiting initiation and causing misreading of mRNA
B. Binding to 30 S subunit and inhibits binding of aminoacyl tRNA
C. Inhibiting peptidyl transferase activity
D. Inhibiting translocation
Ans. B
Q 58. Which of the following drugs is known to cause granuloma in the liver:
A. Allopurinol
B. Nifedipine
C. Tetracycline
D. Methyl testosterone
Ans. A
Q 59. All the following drugs may cause hyperkalemia except:
A. Cyclosporine
B. Amphotericin
C. Heparin
D. NSAIDs
Ans. B
Q 60. Which of the following is the established biological therapy for Crohn’s disease:
A. Anti TNF -antibody
B. IL-1 antagonist
C. IL-6 antagonist
D. IL-8 antagonist
Ans. A
Q 61. Which one of the following drugs does not produce central anticholinergic syndrome:
A. Atropine sulphate
B. Glycopyrrolate
C. Antihistaminics
D. Tricyclic antidepressants
Ans. B
Q 62. Heparin is the commonly used anticoagulant in cardiac surgery. All of the following are true about heparin except:
A. Weakest acid found in living things
B. Most commercial preparations of heparin now utilize pig intestinal slimes
C. Act via antithrombin activation
D. Produce thrombocytopenia
Ans. A
Q 63. Which of the following antiepileptic agents acts on the GABAergic system to decrease the uptake of GABA into neurons and glial cells:
A. Vigabatrin
B. Progabide
C. Gabapentin
D. Tiagabine
Ans. D
Q 64. The Mu receptor of the opioids is responsible for the following clinical actions except:
A. Analgesia
B. Respiratory depression
C. Sedation
D. Diuresis
Ans. D
Q 65. Which of the following chemotherapeutic drugs has selective action on hypoxic tumor cells:
A. Mitomycin C
B. Cisplatin
C. Doxorubicin
D. 5 Fluorouracil
Ans. A
Q 66. The chemotherapeutic agent, most commonly administered by continuous infusion is:
A. Ara-C
B. 5-FU
C. Cisplatin
D. Etoposide
Ans. C
Q 67. Nephrotoxicity is a side effect of one of the following immuno-suppressives:
A. Sirolimus
B. Tacrolimus
C. Mycophenolate mofetil
D. Azathioprine
Ans. B
Q 68. Which of the following drugs has covalent interaction with its target:
A. Aspirin
B. Penicillin
C. Nitric oxide
D. Bosentan
Ans. A
Q 69. In treatment of papillary carcinoma thyroid, radioiodine destroys the neoplastic cells predominantly by:
A. X rays
B. rays
C. rays
D. particles
Ans. B
Q 70. The new agent pemetrexed, useful in breast cancer, belongs to which of the following category of drugs:
A. Antitumor antibiotic
B. Alkylating agent
C. Hormonal agent
D. Antimetabolite
Ans. D
Q 71. Which of the following property of drug will enable it to be used in low concentrations:
A. High affinity
B. High specificity
C. Low specificity
D. High stability
Ans. D
MICROBIOLOGY
Q 72. A patient of Acute lymphocytic leukemia with fever and neutropenia develops diarrhoea after administration of amoxicillin therapy, which of the following organism is most likely to be causative agent:
A. Salmonella typhi
B. Clostridium difficile
C. Clostridium perfringens
D. Shigella flexneri
Ans. B
Q 73. The following statements are true with reference to Mycoplasma except:
A. They are the smallest prokaryotic organisms that can grow in cell free culture media
B. They are obligate intracellular organisms
C. They lack a cell wall
D. They are resistant to beta-lactam drugs
Ans. B
Q 74. In HIV Infected individual Gram stain of lung aspirate shows yeast like morphology. All of the following are the most likely diagnosis except:
A. Candida tropicalis
B. Cryptococcus neoformans
C. Penicillium marneffi
D. Aspergillus fumigatus
Ans. D
Q 75. A 45 year old female complains of lower abdominal pain and vaginal discharge. On examination there is cervicitis along with a mucopurulent cervical discharge. The best approach to isolate the possible causative agent would be:
A. Culture chocolate agar supplemented with Haemin
B. Culture on McCoy cells
C. Culture on a bilayer human blood agar
D. Culture on vero cell lines
Ans. B
Q 76. A major step in the pathogenesis of listeriosis is:
A. The formation of antigen-antibody complexes with resultant complement activation and tissue damage
B. The release of hyaluronidase by L. monocytogenes, which contributes to its dissemination from local sites
C. The antiphagocytic activity of the L. monocytogenes capsule
D. The survival and multiplication of L. monocytogenes within mononuclear phagocytes and host epithelial cells
Ans. D
Q 77. The following is not a method of isolation of chlamydia from clinical specimens:
A. Yolk sac inoculation
B. Enzyme immunoassay
C. Tissue culture using irradiated McCoy cells
D. Tissue culture using irradiated BHK cells
Ans. B
Q 78. The sputum specimen of a 70 year old male was cultured on a 5% sheep blood agar. The culture showed the presence of -haemolytic colonies next day. The further processing of this organism is most likely to yield.
A. Gram positive cocci in short chains, catalase negative and bile resistant
B. Gram positive cocci in pairs, catalase negative and bile soluble
C. Gram positive cocci in clusters, catalase positive and coagulase positive
D. Gram negative coccobacilli catalase positive and oxidase positive
Ans. B
Q 79. A 25-year old farmer presented with history of high grade fever for 7 days and altered sensorium for 2 days. On examination, He was comatosed and had conjunctival hemorrhage. Urgent investigations showed a hemoglobin of 11 gm/dl, serum bilirubin 8 mg/dl and urea 78 mg/dl. Peripheral blood smear was negative for malarial parasite. What is the most likely diagnosis:
A. Brucellosis
B. Weil’s disease
C. Acute viral hepatitis
D. Q fever
Ans. B
PATHOLOGY
Q 80. The most common histological variant of renal cell carcinoma is:
A. Clear cell type
B. Chromophobe type
C. Papillary type
D. Tubular type
Ans. A
Q 81. The following diseases have defect in DNA repair mechanism except for:
A. Xeroderma pigmentosa
B. Fanconi syndrome
C. Huntington’s disease
D. Hereditary non polyposis colon cancer
Ans. C
Q 82. Which of the following carcinoma most frequently metastasizes to brain:
A. Small cell carcinoma lung
B. Prostate cancer
C. Rectal carcinoma
D. Endometrial cancer
Ans. A
Q 83. A metastatic carcinoma in the brain of an adult, most often comes from a primary in the:
A. Stomach
B. Ovary
C. Oral cavity
D. Lung
Ans. D
Q 84. The expression of the following oncogene is associated with a high incidence of medullary carcinoma of thyroid:
A. P 53
B. Her 2 neu
C. Ret proto oncogene
D. Rb gene
Ans. C
Q 85. The lymphocytic and histiocytic variant of Reed-Sternberg cell is seen in:
A. Follicular center lymphoma
B. Lymphocyte depleted Hodgkin’s disease
C. Nodular sclerosis Hodgkin’s disease
D. Lymphocyte predominant Hodgkin’s disease
Ans. D
Q 86. All of the following are examples of a round cell tumor, except:
A. Neuroblastoma
B. Ewing’s sarcoma
C. Non Hodgkin’s lymphoma
D. Osteosarcoma
Ans. D
Q 87. The inheritance pattern of familial retinoblastomas is:
A. Autosomal recessive
B. Autosomal dominant
C. X-linked dominant
D. X-linked recessive
Ans. B
Q 88. Which of the following is not a common site for metastatic calcification:
A. Gastric mucosa
B. Kidney
C. Parathyroid
D. Lung
Ans. C
Q 89. Internucleosomal cleavage of DNA is characteristic of:
A. Reversible cell injury
B. Irreversible cell injury
C. Necrosis
D. Apoptosis
Ans. D
Q 90. On electron microscopy amyloid characteristically exhibits:
A. -pleated sheet
B. Hyaline globules
C. 7.5-10 nm fibrils
D. 20-25 nm fibrils
Ans. C
Q 91. Acute diffuse proliferative glomerulonephritis will have all of the following features, except:
A. Microscopic haematuria
B. Raised blood urea level
C. Raised serum creatinine level
D. Hypoalbuminaemia
Ans. D
Q 92. All of the following are mediators of acute inflammation except:
A. Angiotensin
B. Prostaglandin E2
C. Kallikrein
D. C 3a
Ans. A
Q 93. Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cell:
A. CD 22
B. CD 40
C. CD 15
D. CD 34
Ans. D
Q 94. During which phase of the cell cycle the cellular content of DNA is doubled:
A. Mitotic phase
B. G1 phase
C. G2 phase
D. S phase
Ans. D
Q 95. The tumor suppressor gene p 53 induces cell cycle arrest at:
A. G2-M phase
B. S-G2 phase
C. G1-S phase
D. G0 phase
Ans. C
Q 96. Which of the following is not compatible with a diagnosis of juvenile myelomonocytic leukemia:
A. Peripheral blood monocytosis, more than 1 × 109/L
B. Increased hemoglobin F levels for age
C. Presence of bcr/abl fusion gene
D. GM-CSF hypersensitivity of myeloid progenitors in vitro
Ans. C
Q 97. Programmed cell death is known as:
A. Cytolysis
B. Apoptosis
C. Necrosis
D. Proptosis
Ans. B
Q 98. The most potent stimulator of naive T cells is:
A. B cell
B. Mature dendritic cells
C. Epithelial cells
D. Macrophages
Ans. B
MEDICINE
Q 99. In the treatment of severe bradycardia, all of the following can be the best modality of treatment except:
A. Atropine
B. Pacing
C. Isoproterenol
D. Diltiazem
Ans. D
Q 100. Henoch-Schonlein purpura is characterized by the deposition of the following immunoglobulin around the vessels:
A. IgM
B. IgG
C. IgA
D. IgE
Ans. C
Q 101. A 45 year old woman, presenting with the history of diplopia and dysphagia worsening as the day progresses, can be diagnosed to have:
A. Thyrotoxicosis
B. Myasthenia gravis
C. Muscular dystrophy
D. Brain tumor
Ans. B
Q 102. A 63 year old man presents with a triad of angina, syncope and congestive heart failure. Which of the following valvular heart lesion can be suspected:
A. Mitral stenosis
B. Tricuspid regurgitation
C. Aortic stenosis
D. Aortic regurgitation
Ans. C
Q 103. A head injured patient, who opens eyes to painful stimulus, is confused and localizes to pain. What is his Glasgow coma score:
A. 7
B. 9
C. 11
D. 13
Ans. C
Q 104. The most definitive method of diagnosing pulmonary embolism is:
A. Pulmonary arteriography
B. Radioisotope perfusion pulmonary scintigraphy
C. EKG
D. Venography
Ans. A
Q 105. Which of the following is the drug of choice for the treatment of inappropriate anti-diuretic hormone secretion:
A. Frusemide
B. Hydrochlorothiazide
C. Spironolactone
D. Demeclocycline
Ans. D
Q 106. A 2 year old boy presents with fever for 3 days which responded to administration of paracetamol. Three days later he developed acute renal failure, marked acidosis and encephalopathy. His urine showed plenty of oxalate crystals. The blood anion gap and osmolal gap were increased. Which of the following is the most likely diagnosis:
A. Paracetamol poisoning
B. Diethyl glycol poisoning
C. Severe malaria
D. Hanta virus infection
Ans. B
Q 107. A young, tall, thin male with arachnodactyly has ectopia lentis in both eyes. The most likely diagnosis is:
A. Marfan’s Syndrome
B. Marchesani’s Syndrome
C. Homocystinuria
D. Ehlers Danlos syndrome
Ans. A
Q 108. A 25 year old woman presents with recurrent abdominal pain and anemia. Peripheral blood smear shows basophilic stippling of the red blood cells. What is the most likely diagnosis:
A. Coeliac disease
B. Hookworm infestation
C. Sickle cell disease
D. Lead poisoning
Ans. D
Q 109. A 30 year old lady presents with features of malabsorption and iron deficiency anaemia. Duodenal biopsy shows complete villous atrophy. Which of the following antibodies is likely to be present:
A. Antiendomysial antibodies
B. Anti-goblet cell antibodies
C. Anti-Saccharomyces cerevisae antibodies
D. Antineutrophil cytoplasmic antibodies
Ans. A
Q 110. Following liver transplantation, recurrence of primary disease in the liver most likely occurs in:
A. Wilson’s disease
B. Autoimmune hepatitis
C. Alpha-1 antitrypsin deficiency
D. Primary biliary cirrhosis
Ans. B
Q 111. A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment:
A. Intravenous ceftriaxone
B. Intravenous metronidazole
C. Intravenous steroids and sulphasalazine
D. Hydrocortisone enemas
Ans. B
Q 112. Minimal change glomerulopathy may be seen in association with all of the following except:
A. Hepatitis B
B. HIV
C. Drug-induced interstitial nephritis
D. Hodgkin’s disease
Ans. A
Q 113. What is the drug of choice to control supraventricular tachycardia:
A. Adenosine
B. Propranolol
C. Verapamil
D. Digoxin
Ans. A
Q 114. Which of the following is the most common location of intracranial neurocysticercosis:
A. Brain parenchyma
B. Subarachnoid space
C. Spinal cord
D. Orbit
Ans. A
Q 115. The paraneoplastic syndrome associated with Hodgkin’s disease is:
A. Nephrotic syndrome
B. Retinopathy
C. Cerebellar degenerative disease
D. Acanthosis nigricans
Ans. C
Q 116. A 25 year old male presented with pigmentation of nose and pinna. After voiding, his urine becomes dark. His spine is most likely to show:
A. Atlantoaxial subluxation
B. Spondyloptosis
C. Basilar invagination
D. Calcification of disc
Ans. D
Q 117. A 50 year old lady presented with history of pain upper abdomen, nausea, and decreased appetite for 5 days. She had undergone cholecystectomy 2 years back. Her bilirubin was 10 mg/dl, SGOT 900 IU/I SGPT 700 IU/I and serum alkaline phosphatase was 280 IU/I. What is the most likely diagnosis:
A. Acute pancreatitis
B. Acute cholangitis
C. Acute viral hepatitis
D. Posterior penetration of peptic ulcer
Ans. C
Q 118. A 70-year old male patient presented to the emergency department with pain in epigastrium and difficulty in breathing for 6 hours. On examination, his heart rate was 56 per minute and the blood pressure was 106/60 mmHg. Chest examination was normal. The patient has been taking omeprazole for gastroesophageal reflux disease for last 6 months. What should be the initial investigation:
A. An ECG
B. An upper GI endoscopy
C. Urgent ultrasound of the abdomen
D. An x-ray chest
Ans. A
Q 119. Which of the following signs is not suggestive of a cervical spinal cord injury:
A. Flaccidity
B. Increased rectal sphincter tone
C. Diaphragmatic breathing
D. Priapism
Ans. B
Q 120. A 48 year old woman was admitted with a history of weakness for two months. On examination cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 237 × 109/L and total leukocyte count 40 × 109/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD 19, CD 5, CD 20 and CD 23 and were negative for CD 79 B and FMC-7.
What is the most likely diagnosis?
A. T-cell rich B-cell lymphoma with leukemic spill over in blood
B. Chronic lymphocytic leukemia
C. Mantle cell lymphoma
D. A definite diagnosis can not be made in this patient without lymph node biopsy
Ans. B
Q 121. The typical movement of mitral valve calcification is:
A. Upwards and downwards
B. Counterclockwise
C. Side to side
D. Circular
Ans. A
PEDIATRICS
Q 122. Recurrent respiratory tract infections may occur in all of the following except:
A. Ventricular septal defect
B. Tetralogy of Fallot
C. Transposition of great arteries
D. Total anomalous venous return
Ans. B
Q 123. A female child has recently learned to eat with spoon without spilling; to dress and undress herself with supervision: and to understand that she is a girl. These skills are first mastered between the ages of:
A. 2 and 3 years
B. 3 and 4 years
C. 4 and 5 years
D. 5 and 6 years
Ans. A
Q 124. A 30-year old lady delivered a healthy baby at 37 week of gestation. She was a known case of chronic hepatitis B infection. She was positive for HBsAg but negative for HBeAg. Which of the following is the most appropriate treatment for the baby:
A. Both active passive immunization soon after birth
B. Passive immunization soon after birth and active immunization at 1 year of age
C. Only passive immunization soon after birth
D. Only active immunization soon after birth
Ans. A
Q 125. At what gestation does the switch over from fetal to adult hemoglobin synthesis begin:
A. 30 weeks
B. 36 weeks
C. 7 days postnatal
D. 3 weeks postnatal
Ans. B
Q 126. A 6-month old boy weighing 3.2 kg presents with recurrent vomiting and polyuria. Investigations show blood area 60 mg/dl creatinine 0.7 mg/dL, calcium 12.8 mg/dL, phosphate 3 mg/dL, pH 7.45, bicarbonate 25 mEq/L and PTH 140 pg ml (normal < 60 pg/ml). Daily urinary calcium excretion is reduced. Ultrasound abdomen show bilateral nephrocalcinosis. The most likely diagnosis is:
A. Bartter syndrome
B. Mutation of the calcium sensing receptor
C. Pseudo-pseudohypoparathyroidism
D. Parathyroid adenoma
Ans. B
Q 127. A child presents with diarrhea and peripheral circulatory failure. The arterial pH is 7.0, PCO2 15 mmHg, and PO2 76 mmHg. What will be the most appropriate therapy:
A. Sodium bicarbonate infusion
B. Bolus of Ringer lactate
C. Bolus of hydroxyethyl starch
D. 5% dextrose infusion
Ans. B
Q 128. A 5 year old child is rushed to casualty reportedly electrocuted while playing in a park. The child is apneic and is ventilated with bag and mask. There are burns on each hand. What will be the next step in the management:
A. Check pulses
B. Start chest compressions
C. Intubate
D. Check oxygen saturation
Ans. A
SURGERY
Q 129. Which of the following statements is true regarding fat embolism:
A. Most patients with major trauma involving long bones have urinary fat globules
B. All patients with urinary fat globules develop fat embolism
C. Peak incidence of respiratory insufficiency for pulmonary fat embolism is around day 7 after injury
D. Heparin as an anticoagulant decreases mortality and morbidity in fat embolism syndrome
Ans. A
Q 130. The diagnosis of congenital megacolon is confirmed by:
A. Clinical features
B. Barium enema
C. Rectal biopsy
D. Recto-sigmoidoscopy
Ans. C
Q 131. The treatment of choice for Anaplastic carcinoma of thyroid infiltrating trachea and sternum will be:
A. Radical excision
B. Chemotherapy
C. Radiotherapy
D. Palliative/Symptomatic treatment
Ans. D
Q 132. Which of the following is the commonest tumour of thyroid:
A. Anaplastic carcinoma
B. Follicular carcinoma
C. Papillary carcinoma
D. Medullary carcinoma
Ans. C
Q 133. A 16-year old boy presents with acute onset pain in the left testis. The following statements about his management are true except:
A. The patient should be prescribed antibiotics and asked to come after a week
B. Colour flow Doppler will be very useful in diagnosis
C. Scrotal exploration should be done without delay if Doppler is not available
D. If left testis is not viable on exploration, patient should undergo left orchidectomy and right orchidopexy
Ans. A
Q 134. All of the following extraintestinal manifestations of ulcerative colitis respond to colectomy except:
A. Primary sclerosing cholangitis
B. Pyoderma gangrenosum
C. Episcleritis
D. Peripheral arthralgia
Ans. A
Q 135. Which of the following is the most effective intravesical therapy for superficial bladder cancer:
A. Mitomycin
B. Adriamycin
C. Thiotepa
D. BCG
Ans. D
Q 136. The most common facial abnormality seen in Gardener’s syndrome is:
A. Ectodermal dysplasia
B. Odontomes
C. Multiple osteomas
D. Dental cysts
Ans. C
Q 137. All of the following soft tissue sarcomas have a propensity for lymphatic spread except:
A. Neurofibrosarcoma
B. Synovial sarcoma
C. Rhabdomyosarcoma
D. Epithelioid sarcoma
Ans. A
Q 138. All of the following are features of Zollinger Ellison syndrome except:
A. Intractable peptic ulcers
B. Severe diarrhoea
C. Beta cell tumours of the pancreas
D. Very high acid output
Ans. C
Q 139. All of the following are modalities of therapy for hepatocellular carcinoma except:
A. Radiofrequency ablation
B. Transarterial catheter embolization
C. Percutaneous acetic acid
D. Nd Yag laser ablation
Ans. D
Q 140. Which of the following statement is true regarding subclavian steal syndrome:
A. Reversal of blood flow in the ipsilateral vertebral artery
B. Reversal of blood flow in the contralateral carotid artery
C. Reversal of blood flow in the contralateral vertebral artery
D. Bilateral reversal of blood flow in the vertebral arteries
Ans. A
Q 141. Features, which are evaluated for histological grading of breast carcinoma, include all of the following except:
A. Tumour necrosis
B. Mitotic count
C. Tubule formation
D. Nuclear pleomorphism
Ans. A
Q 142. All the following can be used to predict severe acute pancreatitis except:
A. Glasgow score 3
B. APACHE II score 9
C. CT severity score 6
D. C-reactive protein < 100
Ans. D
Q 143. A patient presented to emergency ward with massive upper gastrointestinal bleed. On examination, he has mild splenomegaly. In the absence of any other information available, which of the following is the most appropriate therapeutic modality:
A. Intravenous propranolol
B. Intravenous vasopressin
C. Intravenous pantoprazole
D. Intravenous somatostatin
Ans. C
Q 144. Regarding bile duct injuries following cholecystectomy which of the following statement is false:
A. The incidence following open cholecystectomy is in the range of 0.2-0.3%
B. The incidence rate following laparoscopic cholecystectomy is three times higher than the rates following open cholecystectomy
C. Untreated cases may develop secondary biliary cirrhosis
D. Routine use of ‘open’ technique of laparoscopic port insertion has resulted in a decline in the incidence of post-laparoscopic cholecystectomy bile duct injuries
Ans. D
Q 145. Platelets can be stored at:
A. 20-24°C for 5 days
B. 20-24°C for 8 days
C. 4-8°C for 5 days
D. 4-8°C for 8 days
Ans. A
Q 146. The most common cause of peripheral limb ischaemia in India is:
A. Trauma
B. Atherosclerosis
C. Buerger’s disease
D. Takayasu disease
Ans. B
Q 147. A 45 year old male presents with 4 × 4 cm, mobile right solitary thyroid nodule of 5 months duration. The patient is euthyroid. The following statements about his management are true except:
A. Cold nodule on thyroid scan is diagnostic of malignancy
B. FNAC is the investigation of choice
C. The patient should undergo hemithyroidectomy if FNAC report is inconclusive
D. Indirect laryngoscopy should be done in the preoperative period to assess mobility of vocal cords.
Ans. A
Q 148. In patients with breast cancer, chest wall involvement means involvement of any one of the following structures except:
A. Serratus anterior
B. Pectoralis major
C. Intercostal muscles
D. Ribs
Ans. B
Q 149. All of the following are indications for surgery in gastric lymphoma except:
A. Bleeding
B. Perforation
C. Residual disease following chemotherapy
D. Intractable pain
Ans. D
Q 150. A person has been brought in casualty with history of road accident. He had lost consciousness transiently and then gained consciousness but again became unconscious. Most likely, he is having brain hemorrhage of:
A. Intracerebral
B. Subarachnoid
C. Subdural
D. Extradural
Ans. D
Q 151. In which of the following tumors alpha fetoprotein is elevated:
A. Choriocarcinoma
B. Neuroblastoma
C. Hepatocellular carcinoma
D. Seminoma
Ans. C
Q 152. Acalculous cholecystitis can be seen in all the following conditions except:
A. Enteric fever
B. Dengue haemorrhagic fever
C. Leptospirosis
D. Malaria
Ans. D
ORTHOPAEDICS
Q 153. A 50 year old man presented with multiple pathological fractures. His serum calcium was 11.5 mg/dl and phosphate was 2.5 mg/dl. Alkaline phosphatase was 940 IU/dl. The most probable diagnosis is:
A. Osteoporosis
B. Osteomalacia
C. Multiple myeloma
D. Hyperparathyroidism
Ans. D
Q 154. The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of:
A. Intracapsular fracture of the femoral neck
B. Extracapsular fracture of the femoral neck
C. Posterior dislocation of hip
D. Anterior dislocation of hip
Ans. C
Q 155. Pain & tenderness over the lateral condyle of humerus with a painful dorsiflexion of the wrist is indicative of:
A. Golfer’s elbow
B. Tennis elbow
C. Pitcher’s elbow
D. Cricket elbow
Ans. B
Q 156. A one year old child presented with multiple fractures seen in various stages of healing. The most probable diagnosis in this case is:
A. Scurvy
B. Rickets
C. Battered baby syndrome
D. Sickle cell disease
Ans. C
GYNAECOLOGY & OBSTETRICS
Q 157. All of the following are the markers for malignant germ cell tumors of ovary except:
A. CA-125
B. Alpha fetoprotein
C. -HCG
D. LDH
Ans. A
Q 158. In which of the following conditions would maternal serum -fetoprotein values be the highest:
A. Down’s syndrome
B. Omphalocele
C. Gastroschisis
D. Spina bifida occulta
Ans. C
Q 159. Which of the following test is the most sensitive for detection of iron depletion in pregnancy:
A. Serum iron
B. Serum transferrin
C. Serum ferritin
D. Serum erythropoietin
Ans. C
Q 160. The one measurement of fetal maturity that is not affected by a ‘bloody tap’ during amniocentesis is:
A. L/S ratio
B. Phosphatidyl glycerol
C. fetoprotein
D. Bilirubin as measured by OD 450
Ans. B
Q 161. The drug of choice in treatment of typhoid fever in pregnancy is:
A. Ampicillin
B. Chloramphenicol
C. Ciprofloxacin
D. Ceftriaxone
Ans. D
Q 162. The most important indication for surgical repair of a bicornuate uterus is:
A. Infertility
B. Dysmenorrhoea
C. Menorrhagia
D. Habitual abortion
Ans. D
Q 163. Which of the following strategy has been recommended to reduce the hereditary risk for ovarian cancer in woman with BRCA I & BRCA II mutation:
A. Use of oral contraceptive pill
B. Screening with transvaginal ultrasound
C. Screening with CA-125
D. Prophylactic oophorectomy
Ans. D
Q 164. Which of the following antihypertensives is not safe in pregnancy:
A. Clonidine
B. ACE inhibitors
C. -methyldopa
D. Amlodipine
Ans. B
OPHTHALMOLOGY
Q 165. A 55 year old female comes to the eye casualty with history of severe eye pain, redness and diminution of vision. On examination the visual acuity is 6/60, there is circumcorneal congestion, corneal oedema and a shallow anterior chamber, Which of the following is the best drug of choice:
A. Atropine ointment
B. IV mannitol
C. Ciprofloxacin eye drops
D. Betamethasone eye drops
Ans. B
Q 166. A 30 year old patient with history of recurrent headache was sent for fundus evaluation. He was found to be having generalized arterial attenuation with multiple cotton wool spots and flame shaped haemorrhages in both eyes. The most likely cause is:
A. Diabetic retinopathy
B. Hypertensive retinopathy
C. Central retinal artery occlusion
D. Temporal arteritis
Ans. B
Q 167. A female presented with loss of vision in both eyes and on examination has normal pupillary responses and normal fundus, Her visually evoked response (VER) examination shows extinguished responses. The most likely diagnosis is:
A. Hysteria
B. Cortical blindness
C. Optic neuritis
D. Retinal detachment
Ans. B
Q 168. The most common retrobulbar orbital mass in adults is:
A. Neurofibroma
B. Meningioma
C. Cavernous haemangioma
D. Schwannoma
Ans. C
Q 169. Which of the following drugs is contraindicated in a patient with history of sulfa allergy presenting with an acute attack of angle closure glaucoma:
A. Glycerol
B. Acetazolamide
C. Mannitol
D. Latanoprost
Ans. B
Q 170. The most common systemic association of scleritis is:
A. Ehlers Danlos syndrome
B. Disseminated systemic sclerosis
C. Rheumatoid arthritis
D. Giant cell arteritis
Ans. C
Q 171. Angioid streaks in the eyes are seen in:
A. Pseudoxanthoma elasticum
B. Tendinous xanthoma
C. Xanthelasma
D. Eruptive xanthoma
Ans. A
Q 172. The corneal transparency is maintained by:
A. Keratocytes
B. Bowman’s membrane
C. Descemet’s membrane
D. Endothelium
Ans. D
Q 173. A 55 year old patient complains of decreased distance vision. However, now he does not require his near glasses for near work. The most likely cause is:
A. Posterior subcapsular cataract
B. Zonular cataract
C. Nuclear sclerosis
D. Anterior subcapsular cataract
Ans. C
Q 174. A patient has a right homonymous hemianopia with saccadic pursuit movements and defective optokinetic nystagmus. The lesion is most likely to be in the:
A. Frontal lobe
B. Occipital lobe
C. Parietal lobe
D. Temporal lobe
Ans. C
Q 175. Idiopathic nyctalopia is due to a hereditary:
A. Absence of rod function
B. Absence of cone function
C. Absence of rod and cone function
D. Decrease of cone function
Ans. A
ENT
Q 176. A 10 year old boy developed hoarseness of voice following and attack of diphtheria. On examination, his right vocal cord was paralysed. The treatment of choice for paralysed vocal cord will be:
A. Gel foam injection of right vocal cord
B. Fat injection of right vocal cord
C. Thyroplasty type-I
D. Wait for spontaneous recovery of vocal cord
Ans. D
Q 177. The current treatment of choice for a large antro-choanal polyp in a 30 year old man is:
A. Intranasal polypectomy
B. Caldwell Luc operation
C. ESS (Endoscopic sinus surgery)
D. Lateral rhinotomy and excision
Ans. C
SKIN
Q 178. ‘Exclamation mark’ hair is a feature of:
A. Telogen effluvium
B. Androgenetic alopecia
C. Alopecia areata
D. Alopecia mucinosa
Ans. C
Q 179. Pautrier’s micro-abscess is a histological feature of:
A. Sarcoidosis
B. Tuberculosis
C. Mycosis fungoides
D. Pityriasis lichenoides chronica
Ans. C
Q 180. ‘Adenoma sebaceum’ is a feature of:
A. Neurofibromatosis
B. Tuberous sclerosis
C. Xanthomatosis
D. Incontinentia pigmenti
Ans. B
ANAESTHESIA
Q 181. Bradycardia is common after injection of:
A. Midazolam
B. Succinyl choline
C. Dopamine
D. Isoprenaline
Ans. B
Q 182. With regard to Ketamine, all of the following are true except:
A. It is a direct myocardial depressant
B. Emergence phenomena are more likely if anticholinergic premedication is used
C. It may induce cardiac dysarrhythmias in patients receiving tricyclic antidepressants
D. Has no effect on intracranial pressure
Ans. D
Q 183. Which of the following is not a cardiovascular monitoring technique:
A. Transesophageal echocardiography
B. Central venous pressure monitoring
C. Pulmonary artery catheterization
D. Capnography
Ans. D
Q 184. Placement of a double lumen tube for lung surgery is best confirmed by:
A. ETCO2
B. Airway pressure measurement
C. Clinically by auscultation
D. Bronchoscopy
Ans. D
Q 185. The most sensitive and practical technique for detection of myocardial ischemia in the periooperative period is:
A. Magnetic Resonance Spectroscopy
B. Radio labeled lactate determination
C. Direct measurement of end diastolic pressure
D. Regional wall motion abnormality detected with the help of 2D transoesophageal echocardiography
Ans. D
Q 186. The most common cause of hypoxia during one lung ventilation is:
A. Malposition of the double lumen tube
B. Increased shunt fraction
C. Collapse of one lung
D. Soiling of lung by secretions
Ans. A
Q 187. A 30 year old woman with coarctation of aorta is admitted to the labour room for elective caesarean section. Which of the following is the anaesthesia technique of choice:
A. Spinal anaesthesia
B. Epidural anaesthesia
C. General anaesthesia
D. Local anaesthesia with nerve blocks
Ans. C
Q 188. A 5 year old child is suffering from cyanotic heart disease. He is planned for corrective surgery. The induction agent of the choice would be:
A. Thiopentone
B. Ketamine
C. Halothane
D. Midazolam
Ans. B
Q 189. While introducing the Swan-Ganz catheter, its placement in the pulmonary artery can be identified by the following pressure tracing:
A. Diastolic pressure is lower in PA than in RV
B. Diastolic pressure is higher in PA than in RV
C. PA pressure tracing has diacrotic notch from closure of pulmonary valve
D. RV pressure tracing for plateau and sharp drop in early diastole.
Ans. C
Q 190. The outcome following resuscitation of a cardiac arrest is worsened if during resuscitation patient is given:
A. Ringer’s lactate
B. Colloids
C. 5% dextrose
D. Whole blood transfusion
Ans. C
Q 191. A 6 month old child is suffering from patent ductus arteriosus (PDA) with congestive cardiac failure. Ligation of ductus arteriosus was decided for surgical management. The most appropriate inhalational anaesthetic agent of choice with minimal haemodynamic alteration from induction of anaesthesia is:
A. Sevoflurane
B. Isoflurane
C. Enflurane
D. Halothane
Ans. A
RADIOLOGY
Q 192. The posterior urethra is best visualized by:
A. Static cystogram
B. Retrograde urethrogram
C. Voiding cystogram
D. CT cystogram
Ans. C
Q 193. For which malignancy, intensity modulated radiotherapy (IMRT) is the most suitable:
A. Lung
B. Prostate
C. Leukemias
D. Stomach
Ans. B
Q 194. Which of the following radioactive isotopes is not used for brachytherapy:
A. Iodine-125
B. Iodine-131
C. Cobalt-60
D. Iridium-192
Ans. B
Q 195. Solitary hypoechoic lesion of the liver without septae or debris is most likely to be:
A. Hydatid cyst
B. Caroli’s disease
C. Liver abscess
D. Simple cyst
Ans. D
PSYCHIATRY
Q 196. A 50 year old male feels uncomfortable in using lift, being in crowded places and travelling. The most appropriate line of treatment is:
A. Counselling
B. Relaxation therapy
C. Exposure
D. Covert sensitization
Ans. C
Q 197. Which of the following statements differentiates the obsessional idea from delusions:
A. The idea is not a conventional belief
B. The idea is held in spite of contrary evidence
C. The idea is regarded as senseless by patient
D. The idea is held on inadequate ground
Ans. C
Q 198. Dementia of Alzheimer’s type is not associated with one of the following:
A. Depressive symptoms
B. Delusions
C. Apraxia and aphasia
D. Cerebral infarcts
Ans. D
Q 199. A person who laughs one minute and cries the next without any clear stimulus is said to have:
A. Incongruent affect
B. Euphoria
C. Labile affect
D. “Split personality”
Ans. C
Q 200. A 9 year old child disturbs other people, is destructive, interferes when two people are talking, does not follow instructions and cannot wait for his turn while playing a game. He is likely to be suffering from:
A. Emotional disorders
B. Behavioural problems
C. No disorder
D. Attention deficit hyperactivity disorder
Ans. D
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