Q 1. After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to:
A. Shrug the shoulders.
B. Raise the arm above the head on the affected side.
C. Touch the opposite shoulder.
D. Lift a heavy object from the ground.
Q 2. The intricately and prodigiously looped system of veins and arteries that lie on the surface of the epididymis is known as:
A. Choroid plexus.
B. Tuberal plexus.
C. Pampiniform plexus.
D. Pectiniform septum.
Q 3. The movement at the following joint permits a person to look towards the right or left:
A. Atlanto-occipital joint.
B. Atlanto-axial joint.
C. C2-C3 joint.
D. C3-C4 joint.
Q 4. The first costochondral joint is a:
A. Fibrous joint.
B. Synovial joint.
Q 5. The articular cartilage is characterized by all of the following features except:
A. It is devoid of perichondrium.
B. It has a rich nerve supply.
C. It is avascular.
D. It lacks the capacity to regenerate.
Q 6. All of the following are catagorised as secondary lymphoid organs except:
A. Lymph nodes.
D. Subepithelial collections of lymphocytes.
Q 7. While exposing the kidney from behind, all of the following nerves are liable to injury, except:
A. Lateral cutaneus nerve of thigh.
B. Ilioinguinal nerve.
C. Subcostal nerve.
D. Iliohypogastric nerve.
Q 8. Infection/inflammation of all of the following, causes enlarged superficial inguinal lymph nodes except:
A. Isthmus of uterine tube.
B. Inferior port of anal canal.
C. Big toe.
D. Penile urethra.
Q 9. An inhaled foreign body is likely to lodge in the right lung due to all of the following features except:
A. Right lung is shorter and wider than left lung.
B. Right principal bronchus is more vertical than the left bronchus.
C. Tracheal bifurcation directs the foreign body to the right lung.
D. Right inferior lobar bronchus is in continuation with the principal bronchus.
Q 10. One intern calculated the concentration of O2 in blood as 0.0025 ml/ml of blood. Considering atmospheric pressure as 760 mmHg, how much approximately O2 tension could have been in the blood?
A. 40 mmHg.
B. 60 mmHg.
C. 80 mmHg.
D. 100 mmHg.
Q 11. To which of the following family of chemical mediators of inflammation, the Lipoxins belong?
A. Kinin system.
D. Arachidonic acid metabolites.
Q 12. The main excitatory neurotransmitter in the CNS is:
Q 13. During the cardiac cycle the opening of the aortic valve takes place at the:
A. Beginning of systole.
B. End of isovolumetric contraction.
C. End of diastole.
C. End of diastasis.
Q 14. The patients having acute cardiac failure do not show oedema, because:
A. The plasma oncotic pressure is high.
B. There is renal compensation.
C. Increased cardiac output.
D. There is a fall in the systemic capillary hydrostatic pressure.
Q 15. The force of muscle contraction can be increased by all of the following, except:
A. Increasing the frequency of activation of motor units.
B. Increasing the number of motor units activated.
C. Increasing the amplitude of action potentials in the motor neurons.
D. Recruiting larger motor units.
Q 16. During acclimatization to high altitude all of the following take place, except:
A. Increase in minute ventilation.
B. Increase in the sensitivity of central chemoreceptors.
C. Increase in the sensitivity of carotid body to hypoxia.
D. Shift in the oxygen dissociation curve to the left.
Q 17. Duchenne Muscular Dystrophy is a disease of:
A. Neuromusculer junction.
B. Sarcolemmal proteins.
C. Muscle contractile proteins.
D. Disuse atrophy due to muscle weakness.
Q 18. Sertoli cells have receptors for:
B. Luteinising hormone.
C. Follicle stimulating hormone.
Q 19. Before the onset of puberty the GnRH neurons are under the inhibitory control of:
C. Gamma amino butyric acid (GABA).
Q 20. The enzyme associated with the conversion of androgen to oestrogen in the growing ovarian follicle is:
Q 21. Which of the following is a membrane-bound enzyme that catalyzes the formation of cyclic AMP from ATP ?
A. Tyrosine kinase.
C. ATP synthase.
D. Adenlylate cyclase.
Q 22. A small Ca2+ binding protein that modifies the activity of many enzymes and other proteins in response to changes of Ca2+ concentration, is known as:
Q 23. The transmembrane region of a protein is likely to have:
A. A stretch of hydrophilic amino acids.
B. A stretch of hydrophobic amino acids.
C. A disulphide loop.
D. Alternating hydrophilic and hydrophobic amino acids.
Q 24. In which of the following forms the antidiuretic hormone (ADH) is circulated in plasma?
A. Bound to neurophysin-I.
B. Bound to neurophysin-II.
C. Bound to plasma albumin.
D. Free form.
Q 25. A newly posted junior doctor had difficulty in finding out base deficit /access for blood in given patient. An experienced senior resident gave him advise to find out quick method to determine acid-base composition of blood based on PCO2. Which of the following method he suggested to predict acid-base composition of blood?
A. Red ford nomogram.
B. DuBio’s nomogram.
C. Goldman constant field equation.
D. Siggaard-Andersen nomogram.
Q 26. The most abundant glycoprotein present in basement membrane is:
C. Collagen type 4.
D. Heparan sulphate.
Q 27. Shine-Dalgarno sequence in bacterial mRNA is near:
A. AUG codon.
B. UAA codon.
C. UAG codon.
D. UGA codon.
Q 28. An enzyme that makes a double stranded DNA copy from a single stranded RNA template molecule is known as:
A. DNA polymerase.
B. RNA polymerase.
C. Reverse transcriptase.
Q 29. A segment of an eucaryotic gene that is not represented in the mature mRNA, is known as:
D. TATA box.
Q 30. A person on a fat free carbohydrate rich diet continues to grow obese. Which of the following lipoproteins is likely to be elevated in his blood?
Q 31. A genetic disorder renders fructose 1,6- bisphosphatase in liver less sensitive to regulation by fructose 2,6-bisphosphate. All of the following metabolic changes are observed in this disorder, except:
A. Level of fructose 1,6-bisphosphate is higher than normal.
B. Level of fructose 1,6-bisphosphate is lower than normal.
C. Less pyruvate is formed.
D. Less ATP is generated.
Q 32. Xeroderma pigmentosum is produced as a result of a defect in:
A. DNA polymerase II.
B. DNA polymerase I.
C. DNA exonuclease.
D. DNA ligase.
Q 33. RNA polymerase does not require:
A. Template (ds DNA).
B. Activated precursors (ATP, GTP, UTP, CTP).
C. Divalent metal ions (Mn2+, Mg2+).
Q 34. Radio isotopes are used in the following techniques, except:
A. Mass spectroscopy.
D. Sequencing of nucleic acid.
Q 35. Alpha helix and beta pleated sheet are examples of:
A. Primary structure.
B. Secondary structure.
C. Tertiary structure.
D. Quaternary structure.
Q 36. Which of the following substances acts to increase the release of Ca++ from endoplasmic reticulum ?
A. Inositol triphosphate.
B. Parathyroid hormone.
C. 1,25-dihydroxy cholecalciferol.
D. Diacyl glycerol.
Q 37. Which of the following elements is known to influence the body’s ability to handle oxidative stress?
Q 38. In which of the following conditions the level of creatinine kinase-1 increases?
A. Myocardial ischemia.
B. Brain ischemia.
C. Kidney damage.
D. Electrical cardioversion.
Q 39. Proteins targeted for destruction in eukaryotes are covalently linked to:
Q 40. Which of the following can be a homologous substitution for valine in hemoglobin?
B. Glutamic acid.
Q 41. Which of the following groups of proteins assist in the folding of other proteins?
Q 42. Cytochrome C of the bacteria has 50% identity of amino acid sequence with that of human. Which of the following is the most conserved parameter in these two proteins?
A. Quaternary structure.
B. Tertiary structure.
C. Amino acid sequence.
D. Loop and turn segments.
Q 43. Which of the following statements is true about hapten?
A. It induces brisk immune response.
B. It needs carrier to induce immune response.
C. It is a T-independent antigen.
D. It has no association with MHC.
Q 44. Regarding gas gangrene, one of the following is correct:
A. It is due to Clostridium botulinum infection.
B. Clostridial species are gram-negative spore forming anaerobes.
C. The clinical features are due to the release of protein endotoxin.
D. Gas is invariably present in the muscle compartments.
Q 45. The following statements are true about DPT vaccine except:
A. Aluminium salt has an adjuvant effect.
B. Whole killed bacteria of Bordetella pertussis has an adjuvant effect.
C. Presence of acellular pertussis component increases its immunogenicity.
D. Presence of H. influenza type B component increases its immunogenicity.
Q 46. A 20 year-old man presented with hemorrhagic colitis. The stool sample grew Escherichia coli in pure culture. The following serotype of E. coli is likely to be the causative agent:
A. O157 : H7.
B. O159 : H7.
C. O107 : H7.
D. O55 : H7.
Q 47. Haemophilus influenzae has been isolated from the CSF of a two-year old boy suffering from meningitis. The strain is beta-Iactamase producing and resistant to chloramphenicol. The most appropriate antimicrobial choice in such a situation is:
A. Trimethoprim-sulphamethoxazole combination.
C. Third-generation cephalosporin.
Q 48. A 30 year-old woman with a bad obstetric history presents with fever. The blood culture from the patient grows Gram-positive small to medium coccobacilli that are pleomorphic, occurring in short chains. Direct wet mount from the culture shows tumbling motility. The most likely organism is:
A. Listeria monocytogenes.
B. Corynebacterium sp.
C. Enterococcus sp.
D. Erysipelothrix rhusiopathiae.
Q 49. The most common agent associated with neonatal bacterial meningitis is:
A. Haemophilus influenzae type b.
B. Neisseria meningitidis.
C. Streptococcus pneumoniae.
D. Streptococcus agalactiae.
Q 50. In all of the following bacterial diarrhoeas toxins are implicated as a major pathogenetic mechanism, except:
A. Vibrio cholerae.
B. Shigella sp.
C. Vibrio parahaemolyticus.
D. Staphylococcus aureus.
Q 51. A young pregnant woman presents with fulminant hepatic failure. The most likely aetiological agent is:
A. Hepatitis B virus.
B. Hepatitis C virus.
C. Hepatitis E virus.
D. Hepatitis A virus.
Q 52. All of the following clinical features are associated with Enteroviruses, except:
D. Hemorrhagic fever.
Q 53. Which of the following statements is true regarding ARBO viruses?
A. Yellow fever is endemic in India.
B. Dengue virus has only one serotype.
C. Kyasanur Forest disease (KFD) is transmitted by ticks.
D. Mosquito of Culex vishnui-complex is the vector of Dengue fever.
Q 54. Laboratory diagnosis of viral respiratory tract infections can be established by all of the following tests, except:
A. Detection of virus specific IgM antibodies in single serum specimen.
B. Demonstration of viral antigens by indirect immuno-fluorescence assay in nasopharyngeal washings.
C. Isolation of viruses using centrifugation enhanced culture.
D. Detection of viral heamagglutination inhibiting (HAl) antibodies in a single serum specimen.
Q 55. All of the following statements are true regarding poliovirus, except:
A. It is transmitted by feco-oral route.
B. Asymptomatic infections are common in children.
C. There is a single serotype causing infection.
D. Live attenuated vaccine produces herd immunity.
Q 56. A 25 year old woman had premature rupture of membranes and delivered a male child who became lethargic and apneic on the 1st day of birth and went into shock. The mother had a previous history of abortion one year back. On culture, her vaginal swab growth of -haemolytic colonies on blood agar was found. On staining these were found to be gram positive cocci. Which of the following is the most likely etiological agent?
A. Streptococcus pyogenes.
B. Streptococcus agalactiae.
D. Enterococcus faecium.
Q 57. A farmer presenting with fever off-and-on for the past 4 years was diagnosed to be suffering from chronic brucellosis. All of the following serological tests would be helpful in the diagnosis at this stage, except:
A. Standard agglutination test.
B. 2 Mercapto-ethanol test.
C. Complement fixation test.
D. Coombs’ test.
Q 58. A man, after skinning a dead animal, developed a pustule on his hand. A smear prepared from the lesion showed the presence of gram positive bacilli in long chains which were positive for McFadyean’s reaction. The most likely aetiological agent is:
A. Clostridium tetani.
B. Listeria monocytogenes.
C. Bacillus anthracis.
D. Actinomyces sp.
Q 59. Which of the following toxins acts by inhibiting protein synthesis:
A. Cholera toxin.
B. Shiga toxin.
C. Pertussis toxin.
D. LT of enterotoxigenic E.coli.
Q 60. A 20 years old male patient presents to the STD clinic with a genital ulcer. The gram stain of the smear from ulcer shows graim negative coccobacilli. The most appropriate media for culture would be:
A. Thayer-Martin medium.
B. Blood agar with X & V factors.
C. Chocolate agar with isovitale X.
D. Tellurite blood agar.
Q 61. A microbiologist wants to develop a vaccine for prevention of attachment of diarrhoeagenic E. coli to the specific receptors in the gastro-intestinal tract. All of the following fimbrial adhesions would be appropriate vaccine candidates, except:
B. P1- Pili.
D. K 88.
Q 62. Which of the following is a procoagulation protein?
B. Protein C.
C. Protein S.
Q 63. To which of the following events the good outcome in neuroblastoma is associated with:
B. N-myc amplification.
C. Chromosome 1p deletion.
D. Trk A expression.
Q 64. Which of the following is an autosomal dominant metabolic disorder?
A. Cystic fibrosis.
C. -l antitrypsin deficiency.
D. Familial hypercholesterolemia.
Q 65. The following is not a feature of Alzheimer’s disease:
A. Neurofibrillary tangles.
B. Senile (neuritic) plaques.
C. Amyloid angiopathy.
D. Lewy bodies.
Q 66. Which of the following is an antiapoptotic gene?
Q 67. Which is the most common cytogenetic abnormality in adult myelodysplastic syndrome (MDS)?
A. Trisomy 8
Q 68. All of the following are the good prognostic features for Hodgkin’s disease, except:
A. Haemoglobin > 10 g/dl.
B. WBC count < 15,000/mm3.
C. Absolute lymphocyte count < 600/µl.
D. Age < 45 years.
Q 69. A 60 year old male presented with acute chest pain of 4 hours duration. Electrocardiographic examination revealed new Q wave with ST segment depression. He succumbed to his illness within 24 hours of admission. The heart revealed presence of a transmural haemorrhagic area over the septum and anterior wall of the left ventricle. Light microscopic examination is most likely to reveal:
A. Edema in between normal myofibres.
B. Necrotic myofibres with presence of neutrophils.
C. Coagulative necrosis of the myocytes with presence of granulation tissue.
D. Infiltration by histiocytes with haemosiderin laden macrophages.
Q 70. Splenic macrophages in Gaucher’s disease differ from those in ceroid histiocytosis by staining positive for:
C. Acid fast stain.
Q 71. All of the following statements about Hairy cell leukaeumia are true, except:
A. Splenomegaly is conspicuous.
B. Results from an expansion of neoplastic T lymphocytes.
C. Cells are positive for Tartarate Resistant Acid Phosphatase (TRAP).
D. The cells express CD25 consistently.
Q 72. A 12 year old girl with tremors and emotional lability has a golden brown discoloration of Descemet’s membrane. The most likely diagnosis is:
A. Fabry’s disease.
B. Wilson disease.
C. Glycogen storage disease.
D. Acute rheumatic fever.
Q 73. The blood in the vessels normally does not clot because:
A. Vitamin K antagonists are present in plasma.
B. Thrombin has a positive feedback on plasminogen.
C. Sodium citrate in plasma chelates calcium ions.
D. Vascular endothelium is smooth and coated with glycocalyx.
Q 74. A 37 year old multipara construction labourer has a blood picture showing hypochromic anisocytosis. This is most likely indicative of:
A. Iron deficiency.
B. Folic deficiency.
D. Combined iron and folic acid deficiency.
Q 75. Disseminated intravascular coagulation (DIC) differs from thrombotic thrombocytopenic purpura. In this reference the DIC is most likely characterized by:
A. Significant numbers of schistocytes.
B. A brisk reticulocytosis.
C. Decreased coagulation factor levels.
D. Significant thrombocytopenia.
Q 76. All of the following anticancer agents cause bone marrow depression, except:
Q 77. Morphine can be used in all of the following conditions, except:
A. Head injury.
Q 78. Clinically significant drug interaction occurs between pyridoxine and all the following drugs, except:
Q 79. All of the following statements about an alpha- glucosidase inhibitor are true, except:
A. Reduces intestinal absorption of carbohydrates.
B. Effective in both type 1 and 2 diabetes mellitus.
C. Hypoglycemia is a common and serious side effect.
D. Can be used with other oral hypoglycemic agents.
Q 80. Which one of the following statements about biguanides is not true?
A. Do not stimulate insulin release.
B. Decrease hepatic glucose production.
C. Renal dysfunction is not a contraindication for their use.
D. Can be combined with sulfonylureas.
Q 81. Which of the following statements is not true about tacrolimus?
A. It is a macrolide antibiotic.
B. It is indicated for the prophylaxis of organ transplant rejection.
C. Glucose intolerance is a well recognized side effect.
D. It can be safely administered with any nephrotoxic drug.
Q 82. Sympathomimetic drugs are useful in the therapy of all of the following conditions, except:
A. Acute decompensated heart failure.
D. Erectile dysfunction.
Q 83. Which of the following is not an adverse effect of chronic amiodarone therapy:
A. Pulmonary fibrosis.
D. Systemic lupus erythematosus.
Q 84. In which of the following phases of clinical trial of drugs ethical clearance is not required?
A. Phase I.
B. Phase II.
C. Phase III.
D. Phase IV.
Q 85. Which of the following is not a nucleoside reverse transcriptase inhibitor?
Q 86. Which of the following antimicrobials has anti-pseudomonal action:
A. Cefpodoxime proxetil.
Q 87. Which of the following statements is not true regarding sulfonamides:
A. Sulfasalazine is absorbed well from gastrointestinal tract.
B. Crystalluria can occur with sulfonamide administration.
C. Sulfonamide administration to newborn may cause kernicterus.
D. Sulfonamides are of value in treatment of infections due to Nocardia species.
Q 88. Which of the following does not bind to GABA receptor chloride channels?
Q 89. A patient of peptic ulcer was prescribed ranitidine and sucralfate in the morning hours. Why is this combination incorrect:
A. Ranitidine combines with sucralfate and prevents its action.
B. Combination of these two drugs produces serious side effects like agranulocytosis.
C. Ranitidine decreases the gastric pH so sucralfate is not able to act.
D. Sucralfate inhibits absorption of ranitidine.
Q 90. A 30 year old pregnant woman developed tuberculosis. Which of the following antitubercular drugs should not be used:
Q 91. Which of the following fluoroquinolones does not require dose adjustment in a patient with creatinine clearance of < 50 mg/min?
Q 92. Patients suffering from multidrug resistant tuberculosis can be treated with all the following drugs, except:
Q 93. All the following statements regarding interactions of levodopa are correct, except:
A. In parkinsonism, phenothiazines reduce its efficacy.
B. It is a prodrug.
C. Pyridoxine reduces effect of levodopa in parkinsonism.
D. Domperidone blocks levodopa induced emesis and its therapeutic potential.
Q 94. Which of the following actions is ascribed to delta type of opioid receptors?
A. Supraspinal analgesis.
B. Respiratory depression.
D. Reduced intestinal motility.
Q 95. A highly ionized drug:
A. Is excreted mainly by the kidneys
B. Crosses the placental barrier easily.
C. Is well absorbed from the intestine.
D. Is highly protein bound.
Q 96. A post-operative patient developed septicemia and was empirically started on combination chemotherapy by a new resident doctor. However, when the patient did not respond even after 10 days of antibiotics treatment, the review of the charts was done. It was found that the resident doctor had started the combination of antibiotics which was mutually antagonistic in action. Which one of the following is the most likely combination that was given?
A. Vancomycin and Amikacin.
B. Cephelexin and Gentamicin.
C. Ampicillin and Chloramphenicol.
D. Ciprofloxacin and Piperacillin.
Q 97. BAL is useful in treating poisoning due to all, except:
B. Organic mercury.
Q 98. A 39-year-old carpenter has taken two bottles of liquor from the local shop. After about an hour he develops confusion, vomiting and blurring of vision. He has been brought to the emergency out patient. He should be given:
D. Ethyl alcohol.
Q 99. Contre-coup injuries are seen in:
Q 100. Hydrogen peroxide is used in all the following chemical tests for blood, except:
A. Benzedine test.
B. Phenophthalein test.
C. Orthotoluidine test.
D. Teichmann’s test.
Q 101. Disputed maternity can be solved by using the following tests except:
A. Blood grouping.
B. HLA typing.
C. Preciptin test.
D. DNA fingerprinting.
Q 102. In which of the following conditions postmortem caloricity may be seen in death due to:
A. Massive haemorrhage.
B. Cyanide poisoning.
C. Corrosive poisoning.
Q 103. Deep blue colour of hypostasis is seen in death due to poisoning by:
A. Potassium cyanide.
C. Aniline dyes.
D. Carbon monoxide.
Q 104. A 25 year old person sustained injury in right eye. He developed right corneal opacity following the injury. Left eye was already having poor vision. Corneoplasty of right eye was done and vision was restored. Medicolegally such injury is labelled as:
Q 105. A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most possible diagnosis is:
A. Alcohol intoxication.
B. Carbamates poisoning.
C. Organophosphorous poisoning.
D. Datura poisoning.
Q 106. A convict whose family or relations were not known and no biological sample was available with jail authorities, escaped trom the jail. A dead body resembling the convict was found in nearby forest, but due to mutilation of face, identity could not be established. The positive identity that he is the same convict who escaped from jail can be established by:
A. Blood grouping.
B. DNA Profile.
D. HLA typing.
Q 107. The cephalic index of Indian population is between:
PREVENTIVE AND SOCIAL MEDICINE
Q 108. The most common malignant tumor of adult males in india is:
A. Oropharyngeal carcinoma.
B. Gastric carcinoma.
C. Colo-rectal carcinoma.
D. Lung cancer.
Q 109. The National Population Policy of India has set the following goals except:
A. To bring down total fertility rate (TFR) to replacement levels by 2015.
B. To reduce the infant mortality rate to 30 per 1000 live births.
C. To reduce the maternal mortality rate to 100 per 100,000 live births.
D. 100 percent registration of births, deaths, marriages and pregnancies.
Q 110. The following statements are true about intrauterine devices (IUD), except:
A. Multiload Cu-375 is a third generation IUD.
B. The pregnancy rate of Lippes loop and Cu-T 200 are similar.
C. IUD can be used for emergency contraception within 5 days.
D. Levonorgestrel releasing IUD has an effective life of 5 years.
Q 111. All of the following are used as proxy measures for incubation period except:
A. Latent period.
B. Period of communicability.
C. Serial interval.
D. Generation time.
Q 112. “Five clean practices” under strategies for elimination of neonatal tetanus include all except:
A. Clean surface for delivery.
B. Clean hand of the attendant.
C. New blade for cutting the cord.
D. Clean airway.
Q 113. The current recommendation for breast-feeding is that:
A. Exclusive breast-feeding should be continued till 6 months of age followed by supplementation with additional foods.
B. Exclusive breast-feeding should be continued till 4 months of age followed by supplementation with additional foods.
C. Colostrum is the most suitable food for a new born baby but it is best avoided in first 2 days.
D. The baby should be allowed to breast-feed till one year of age.
Q 114. According to International Health Regulations, there is no risk of spread of yellow fever if the Aedes aegypti index remains below:
Q 115. The following statements about breast milk are true except:
A. The maximum milk output is seen at 12 months.
B. The coefficient of uptake of iron in breast milk is 70%.
C. Calcium absorption of human milk is better than that of cow’s milk.
D. It provides about 65 Kcals per 100 ml.
Q 116. All of the following statements about leprosy are true except:
A. MultibacilIary leprosy is diagnosed when there are more than 5 skin patches.
B. New case detection rate is an indicator for incidence of leprosy.
C. A defaulter is defined as a patient who has not taken treatment tor 6 months or more.
D. The target for elimination of leprosy is to reduce the prevalence to less than 1 per 10,000 population.
Q 117. Multipurpose worker scheme in India was introduced following the recommendation of:
A. Srivastava Committee.
B. Bhore Committee.
C. Kartar Singh Committee.
D. Mudaliar Committee.
Q 118. The usefulness of a ‘screening test’ in a community depends on its:
D. Predictive value.
Q 119. If the grading of diabetes is classified as ‘mild’ ‘moderate’ and ‘severe’ the scale of measurement used is:
Q 120. If prevalence of diabetes is 10%, the probability that three people selected at random from the population will have diabetes is:
Q 121. A study began in 1970 with a group of 5000 adults in Delhi who were asked about their alcohol consumption. The occurrence of cancer was studied in this group between 1990-1995. This is an example of:
A. Cross-sectional study.
B. Retrospective cohort study.
C. Concurrent cohort study.
D. Case-control study.
Q 122. The most appropriate test to assess the prevalence of tuberculosis infection in a community is:
A. Mass Miniature Radiography.
B. Sputum examination.
C. Tuberculin test.
D. Clinical examination.
Q 123. A 37 weeks pregnant woman attends an antenatal clinic at a primary health centre . She has not had any antenatal care till now. The best approach regarding tetanus immunization in this case would be to:
A. Give a dose of tetanus toxoid (TT) and explain her that it will not protect the new born and she should take the second dose after four weeks even if she delivers in the meantime.
B. Do not waste the TT vaccine as it would anyhow be of no use in this pregnancy.
C. Given one dose of TT and explain that it will not be useful for this pregnancy.
D. Give her anti-tetanus immunoglobulin along with the TT vaccine.
Q 124. Dietary changes advocated by WHO for prevention of heart diseases include all of the following except:
A. A decrease in complex carbohydrate consumption.
B. Reduction in fat intake to 20 to 30 percent of caloric intake.
C. Consumption of saturated fats be limited to less than 10 percent of total energy intake.
D. Reduction of cholesterol to below 100 mg per 1000 kcal per day.
Q 125. Essential components of RCH Programme in India include all of the following except:
A. Prevention and management of unwanted pregnancies.
B. Maternal care including antenatal, delivery & post-natal services.
C. Reduce the under five mortality to half.
D. Management of reproductive tract infections & sexually transmitted infections.
Q 126. A child aged 4 months was brought to a health worker in the sub center with complaints of cough and fever. On examination, there was chest indrawing and respiratory rate was 45 per minute. Which of the following is best way to manage the child?
A. The child should be classified as a case of pneumonia.
B. Give an antibiotic and advise mother to give home care.
C. Reassess the child within 2 days or earlier if the condition worsens.
D. Refer urgently to hospital after giving the first dose of an antibiotic.
Q 127. A 31/2 year old child has not received primary immunization. Which of the following is the best vaccination advice to such a child?
A. BCG, DPT1, OPV1, and DPT2, OPV2 after 4 weeks.
B. BCG, DT1, OPV1, measles, vitamin A.
C. BCG, DPT1, OPV1, measles, vitamin A.
D. DT1, DT2 and booster after I year.
Q 128. The table below shows the screening test results of disease Z in relation to the true disease status of the population being tested:
Screening Disease Z Total
Test Results Yes No
Positive 400 200 600
Negative 100 600 700
Total 500 800 1300
The specificity of the screening test is:
A. 70%. B. 75%.
C. 79%. D. 86%.
Q 129. If each value of a given group of observations is multiplied by 10, the standard deviation of the resulting observations is:
A. Original standard deviation x 10
B. Original standard deviation/l0.
C. Original standard deviation –10.
D. Original standard deviation itself.
Q 130. If the systolic blood pressure in a population has a mean of 130 mmHg and a median of 140 mm Hg, the distribution is said to be:
B. Positively skewed.
C. Negatively skewed.
D. Either positively or negatively skewed, depending on the standard deviation.
Q 131. All of the following are the mode of transmission of leprosy, except:
A. Breast milk.
B. Insect bite.
C. Transplacental spread.
D. Droplet infection.
Q 132. Which of the fol1owing is the most reliable method of estimating blood alcohol level?
A. Cavett’s test.
B. Breath alcohol analyzer.
C. Gas liquid chromatography.
D. Thin layer chromatography.
Q 133. Fordyce’s (spots) granules in oral cavity arise from:
A. Mucous glands.
B. Sebaceous glands.
C. Taste buds.
D. Minor salivary glands.
Q 134. For which of the following diseases the enzyme replacement therapy is available?
B. Niemann-Pick disease.
C. Metachromatic leukodystrophy.
D. Gaucher disease.
Q 135. Ataxia telangiectasia is characterized by all of the following, except:
A. Chronic sinopulmonary disease.
B. Decreased levels of -fetoprotein.
C. Chromosomal breakage.
D. IgA deficiency.
Q 136. Bone marrow transplantation can be used as a treatment for all, except:
C. Hurler’s syndrome.
Q 137. Epstein Barr (EB) virus has been implicated in the following malignancies, except:
A. Hodgkin’s disease.
B. Non-Hodgkin’s lymphoma.
C. Nasopharyngeal carcinoma.
D. Multiple myeloma.
Q 138. HBA1C level in blood explains:
A. Acute rise of sugar.
B. Long term status of blood sugar.
C. Hepatorenal syndrome.
D. Chronic pancreatitis.
Q 139. Which of the following gene defects is associated with development of medullary carcinoma of thyroid?
A. Ret proto oncogene.
B. FAP gene.
C. Rb gene.
D. BRCA1 gene.
Q 140. The most common histologic type of thyroid cancer is:
A. Medullary type.
B. Follicular type.
C. Papillary type.
D. Anaplastic type.
Q 141. A 40 year old man presented with painless haematuria. Bimnual examination revealed a ballottable mass over the right flank. Subsequently right nephrectomy was done and the mass was seen to be composed of cells with clear cytoplasm. Areas of haemorrhage and necrosis were frequent. Cytogenetic analysis of this mass is likely to reveal the abnormality of:
A. Chromosome 1.
B. Chromosome 3.
C. Chromosome 11.
D. Chromosome 17.
Q 142. Serum C3 is persistently low in the following, except:
A. Post streptococcal glomerulonephritis.
B. Membranoproliferative glomerulonephritis.
C. Lupus nephritis.
D. Glomerulonephritis related to bacterial endocarditis.
Q 143. Persistent vomiting most likely causes:
B. Acidic urine excretion.
Q 144. An 80 year old asymptomatic woman was detected to have a monoclonal spike on serum electrophoresis (lgG levels 1.5 g/dl). Bone marrow revealed plasma cells of 8%. The most likely diagnosis is:
A. Multiple myeloma.
B. Indolent myeloma.
C. Monoclonal gammopathy of unknown significance.
D. Waldenstrom’s macroglobulinemia.
Q 145. A 34-year-old rickshaw puller has been using heroin for the past ten years. One evening his family members found him unconscious. He was brought to the casualty. On examination he had tachycardia, shallow breathing, constricted pupils. His blood pressure was 100/70 mmHg. He had brisk bilateral deep tendon reflexes. The planter reflexes were flexor on both sides. Which of the following is the best treatment for him?
Q 146. A young man with pulmonary tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment, which vascular structure should be evaluated first:
A. Pulmonary artery.
B. Bronchial artery.
C. Pulmonary vein.
D. Superior vena cava.
Q 147. In which of the following a ‘Coeur en Sabot’ shape of the heart is seen:
A. Tricuspid atresia.
B. Ventricular septal defect.
C. Transposition of great arteries.
D. Tetralogy of Fallot.
Q 148. A 55-year old man who has been on bed rest for the past 10 days, complains of breathlessness and chest pain. The chest x-ray is normal. The next step in investigation should be:
A. Lung Ventilation- perfusion scan.
B. Pulmonary arteriography.
C. Pulmonary venous wedge angiography.
Q 149. Which of the following brain tumors does not spread via CSF?
A. Germ cell tumours.
C. CNS Lymphoma.
Q 150. A 20-year-old male presented with chronic constipation, headache and palpitations. On examination he had marfanoid habitus, neuromas of tongue, medullated corneal nerve fibers and a nodule of 2x2 cm size in the left lobe of thyroid gland. This patient is a case of:
A. Sporadic medullary carcinoma of thyroid.
B. Familial medullary carcinoma of thyroid.
C. MEN IIA.
D. MEN IIB.
Q 151. Which of the following is the drug of first choice for Non-Gonococcal Urethritis?
Q 152. In patients with cirrhosis of the liver the site of obstruction in the portal system is in the:
A. Hepatic vein.
B. Post sinusoidal.
C. Extra hepatic portal vein.
Q 153. In Budd Chiari syndrome, the site of venous thrombosis is:
A. Infrahepatic inferior vena cava.
B. Infrarenal inferior vena cava.
C. Hepatic veins.
D. Portal vein.
Q 154. Polycystic disease of the kidney may have cysts in all of the following organs, except:
Q 155. Which of the following is the earliest manifestation of Cushing’s syndrome?
A. Loss of diurnal variation.
B. Increased ACTH.
C. Increased plasma cortisol.
D. Increased urinary metabolites of cortisol.
Q 156. A 30 year old woman presented with secondary amenorrhoea for 3 years along with galactorrhoea. The most likely cause of her symptoms would be:
D. Sub-arachnoid haemorrhage.
Q 157. Webbing of neck, increased carrying angle, low posterior hair line and short fourth metacarpal are characteristics of:
A. Klinefelter syndrome.
B. Turner syndrome.
C. Cri du chat syndrome.
D. Noonan syndrome.
Q 158. Males who are sexually under developed with rudimentary testes and prostate glands, sparse pubic and facial hair, long arms and legs and large hands & feet are likely to have the chromosome complement of:
A. 46, XYY.
B. 46, XY.
C. 46, XXY.
D. 46, X.
Q 159. Kinky-hair disease is a disorder where an affected child has peculiar white stubby hair, does not grow, brain degeneration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother’s brother also died of the same condition. Which of the following is the possible mode of inheritance in her family?
A. X-Iinked recessive.
B. X-Iinked dominant.
C. Autosomal recessive.
D. Autosomal dominant.
Q 160. A young man finds that every time he eats dairy products he feels very uncomfortable. His stomach becomes distended. He develops gas and diarrhea frequently. These symptoms do not appear when he eats foods other than dairy produts. Which of the following is the most likely enzyme in which this young man is deficient?
Q 161. A 45-year old woman visited her physician with complaints of increased appetite and thirst with increased frequency of urination. She also had the symptoms of diminished or impalpable pulses in the feet, besides gangrene of the feet. Her laboratory findings on the oral glucose tolerance test are as follows:
Parameters Fasting 1 hr 2hr
Blood glucose 155 270 205
Urine glucose –ve +++ ++
Ketone bodies –ve –ve –ve
Which of the following statements is not correct for the above mentioned case:
A. She was suffering from insulin dependent diabetes mellitus.
B. She was suffering from non-insulin dependent diabetes mellitus.
C. She was treated with oral hypoglycemic drugs only when diet control and exercise could not control the pathological situation.
D. Knowledge of family history of diabetes mellitus is useful in predicting the nature of the diabetes.
Q 162. A middle aged woman, on oral contraceptives for many years, developed neurological symptoms such as depres-sion. irritability, nervousness and mental confusion. Her hemoglobin level was 8 g/dl. Biochemical investigations revealed that she was excreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum.
All the above findings are most probably related to vitamin B6 deficiency caused by prolonged oral contraceptive use, except:
A. Increased urinary xanthurenic acid excretion.
B. Neurological symptoms by decreased synthesis of biogenic amines.
C. Decreased hemoglobin level.
D. Increased triglyceride and cholesterol level.
Q 163. A 20-year-old woman presents with bilateral conductive deafness, palpable purpura on the legs and hemoptysis. Radiograph of the chest shows a thin-walled cavity in left lower zone. Investigations reveal total leukocyte count I2,000/mm3, red cell casts in the urine and I2,000/mm3, serum creatinine 3 mg/dL. What is the most probable diagnosis?
A. Henoch-Schonlein purpura.
B. Polyarteritis nodosa.
C. Wegener’s granulomatosis.
D. Disseminated tuberculosis.
Q 164. A woman is admitted with complaints of low-grade fever of 6 weeks duration. Chest radiograph reveals bihilar adenopathy with clear lung fields. All of the fol1owing investigations will be useful in differential diagnosis except:
A. CD4/CD8 counts in the blood.
B. Serum ACE levels.
C. CECT of chest.
D. Gallium scan.
Q 165. A 15-year-old boy with epilepsy on treatment with combination of valproate and phenytoin has good control of seizures. Levels of both drugs are in the therapeutic range. All of the following adverse effects can be attributed to valproate except:
A. Weight gain of 5 kg.
B. Serum alanine aminotransaminase 150 IU/L.
C. Rise in serum ammonia level by 20 mg/dL.
Q 166. A known sputum positive pulmonary tuberculosis patient currently on INH, rifampicin, pyrizinamide and ethambutol is found to be HIV positive. His CD4 count was 100/L and viral load was more than 50,000 copies/ml. Which of the following antiretroviral drugs should be avoided:
Q 167. An 18-yr-old boy presents with digital gangrene in third and fourth fingers for last 2 weeks. On examination the blood pressure is 170/110 mm of Hg and all peripheral pulses were palpable. Blood and urine examinations were unremarkable. Antinuclear antibodies, antibody to double stranded DNA and antineutrophil cytoplasmic antibody were negative. The most likely diagnosis is:
A. Wegener’s granulomatosis.
B. Polyarteritis nodosa.
C. Takayasu’s arteritis.
D. Systemic lupus erythematosus (SLE).
Q 168. All of the following are associated with low complement levels except:
A. Lupus nephritis.
B. Mesangio capillary glomerulonephritis.
C. Diarrhea-associated hemolytic uremic syndrome.
D. Post-infections glomerulonephritis.
Q 169. All are true regarding idiopathic edema of women except:
A. It is due to estrogen mediated sodium retention.
B. It is not related to menstrual cycles.
C. There is increased water retention in upright position.
D. ACE inhibitors can be useful in some cases.
Q 170. Estimation of the following hormones is useful while investigating a case of gynaecomastia except:
D. Luteinizing hormone.
Q 171. The occurrence of hyperthyroidism following adminis-tration of supplemental iodine to subjects with endemic iodine deficiency goiter is known as:
A. Jod-Basedow effect.
B. Wolff-Chaikoff effect.
C. Thyrotoxicosis factitia.
D. de Quervain’s thyroiditis.
Q 172. In hematuria of glomerular origin the urine is characterized by the presence of all the Ifollowing except:
A. Red cell casts.
C. Crenated red cells.
D. Dysmorphic red cells.
Q 173. Which one of the following is true regarding HIV infection:
A. Following needle stick injury infectivity is reduced by administration of nucleoside analogues.
B. CD4 counts are the best predictors of disease progression.
C. Infected T cells survive for a month in infected patients.
D. In latent phase HIV is minimal replication.
Q 174. All of the following are true about amiodarone induced thyroid dysfunction except:
A. Hyperthyroidism is common in iodine deficient areas.
B. Hypothyroidism is more common in men.
C. Amiodarone inhibits deiodinase activity.
D. Amiodarone therapy is associated with initial reduction of serum T4 levels.
Q 175. All of the following are seen in cardiac tamponade except:
A. Pulsus paradoxus.
B. Diastolic collapse of right ventricle on echocardiogram.
C. Electrical alternans.
D. Kussmaul’s sign.
Q 176. All of the following may be used in pregnancy associated hypertension except:
Q 177. A 60 year old man with rheumatic mitral stenosis with atrial fibrillation is on therapy for a fast ventricular rate. While on treatment, he developed a regular pulse of 64/min. The most likely drug being administered was:
Q 178. The best marker to diagnose thyroid related disorders is:
Q 179. Elevated serum ferritin, serum iron and percent transferrin saturation are most consistent with the diagnosis of:
A. Iron deficiency anemia.
B. Anemia of chronic disease.
D. Lead poisoning.
Q 180. A young male develops fever, followed by headache, confusional state, focal seizures and a right hemiparesis. The MRI performed shows bilateral frontotemporal hyperintense lesion. The most likely diagnosis is:
A. Acute pyogenic meningitis.
B. Herpes simplex encephalitis.
D. Carcinomatous meningitis.
Q 181. A middle aged man presents with paraesthesia of hands and feet. Examination reveals presence of Mees’ lines in the nails and rain drop pigmentation in the hands. The most likely causative toxin for the above mentioned symptoms is:
Q 182. All of the following can cause neuropathies with predominant motor involvement, except:
A. Acute inflammatory demyelinating polyneuropathy.
B. Acute intermittent porphyria.
C. Lead intoxication.
D. Arsenic intoxication.
Q 183. The first investigation of choice in a patient with suspected subarachnoid haemorrhage should be:
A. Non-contrast computed tomography.
B. CSF examination.
C. Magnetic resonance imaging (MRI).
D. Contrast-enhanced computed tomography.
Q 184. An HIV positive patient complains of visual disturbances. Fundal examination shows bilateral retinal exudates and perivascular heamorrahges. Which of the following viruses are most likely to be responsible for this retinitis:
A. Herpes simplex virus.
B. Human herpes virus 8.
D. Epstein-Barr(EB) virus.
Q 185. Which of the following viruses is not a common cause of viral encephalitis ?
A. Herpes simplex virus type 2.
B. Japanese encephalitis virus.
C. Nipah virus.
Q 186. The most sensitive method for detecting cervical Chlamydia trachomatis infection is:
A. Direct fluorescent antibody test.
B. Enzyme immunoassay.
C. Polymerase chain reaction.
D. Culture on irradiated McConkey cells.
Q 187. Which of the following is not an indication for antiphospholipid antibody testing:
A. Three or more consecutive first trimester pregnancy losses.
B. Unexplained cerebrovascular accidents.
C. Early onset severe pre-eclampsia.
D. Gestational diabetes.
Q 188. Mr. and Mrs. Annadurai have a 2 month old baby suffering with Down syndrome. Karyotype of Mrs. Annadurai shows translocation variety of Down syndrome. Which of the following investigations will you advise to the parents before the next pregnancy?
A. Triple test.
D. -human chorionic gonadotropin (hCG).
Q 189. Bacterial meningitis in children (2 months- 12 years of age) is usually due to the following organisms, except:
A. Streptococcus pneumoniae.
B. Neisseria meningitidis.
C. Hemophilus influenzae type B.
D. Listeria monocytogenes.
Q 190. All of the following are neural tube defects, except:
Q 191. All of the following can cause a white pupillary reflex, except:
C. Retrolental fibroplasia.
Q 192. Retardation of skeletal maturity can be caused by all, except:
A. Chronic renal failure.
C. Protein energy malnutrition (PEM).
D. Congenital adrenal hyperplasia.
Q 193. All of the following are essential features of attention deficit hyperactivity disease (ADHD), except:
A. Lack of concentration.
C. Mental retardation.
Q 194. A two month old child is able to:
A. Show a positive parachute protective reflex.
B. Hold head steady in a seated position.
C. Lift head and chest off a flat surface with extended elbows.
D. Sustain head level with the body when placed in ventral suspension.
Q 195. Drug implicated for prolonging QT interval in a premature baby is:
Q 196. A 10 month old child weighing 8 kg has Bitot spots in both eyes. Which of the following is the most appropriate schedule to prescribe vitamin A to this child?
A. 2 lakh units intramuscular (IM) on day 0, 14.
B. 1 lakh units IM on day 0, 14.
C. 2 lakh units IM on day 0, l and 14.
D. 1 lakh units IM on day 0, 1 and 14.
Q 197. All of the following statements are true about sickle cell disease, except:
A. Patient may require frequent blood transfusions.
B. Acute infection is the most common cause of mortality before 3 years of age.
C. There is positive correlation between concentration HbS and polymerization of HbS.
D. Patient presents early in life before 6 months of age.
Q 198. In neonatal cholestasis, if the serum gamma-glutamyl-transpeptidase (gamma GTP) is more than 600 IU/L the most likely diagnosis is:
A. Neonatal hepatitis.
B. Choledochal cyst.
C. Sclerosing cholangitis.
D. Biliary atresia.
Q 199. The neonatal kidney achieves concentrating ability equivalent to adult’s kidney by:
A. One year of age.
B. Eighteen months of age.
C. Three to six months of age.
D. Just before puberty.
Q 200. A five day old, full term male infant was severely cyanotic at birth. Prostaglandin E was administered initially and later balloon atrial septostomy was done which showed improvement in oxygenation. The most likely diagnosis of this infant is:
A. Tetrology of Fallot.
B. Transposition of great vessels.
C. Truncus arteriosus.
D. Tricuspid atresia.
Q 201. Which of the following is the feature of Y chromosome?
Q 202. A 10 year old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hour, Serum calcium 12.8 mg/dl, serum phosphorus 2.3 mg/dl, alkaline phosphatase 28 KA units and blood urea 32 mg/dl. Which of the following is the most probable diagnosis in his case?
A. Nutritional rickets.
B. Renal rickets.
D. Skeletal dysplasia.
Q 203. A 10 month old child presents with two weeks’ history of fever, vomiting and alteration of sensorium. Cranial CT scan reveals basal exudates and hydrocephalus. The most likely etiological agent is:
A. Mycobacterium tuberculosis.
B. Cryptococcus neoformans.
C. Listeria monocytogenes.
D. Streptococcus pneumoniae.
Q 204. All are the features of absence seizures, except:
A. Usually seen in childhood.
B. 3-Hz spike wave in EEG.
C. Postictal confusion.
D. Precipitation by hyperventilation.
Q 205. A 5 year old girl came with history of progressively increasing pallor since birth and hepatosplenomegaly. Which of the following is the most relevant test for achieving diagnosis:
A. Hb electrophoresis.
B. Peripheral smear examination.
C. Osmotic fragility test.
D. Bone marrow examination.
Q 206. A 5 year old child presents with history of fever off-and-on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 cms below costal margin. The most likely diagnosis is:
A. Acute leukemia.
B. Idiopathic thrombocytopenic purpura.
D. Aplastic anemia.
Q 207. A nine month old boy of Sindhi parents presented to you with complaints of progressive lethargy, irritability & pallor since 6 months of age. Examination revealed severe pallor. Investigations showed Hb - 3.8 gm %; MCV - 58 fl; MCH - 19.4 pg/cell. Blood film shows osmatic fragility is normal (target cells and normoblasts). X-ray skull shows expansion of erythroid marrow. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia.
B. Acute lymphoblastic anemia.
C. Hemoglobin D disease.
D. Hereditary spherocytosis.
Q 208. An infant develops cough and fever. The X- ray examination is suggestive of bronchopneumonia. All of the following viruses can be the causative agent, except:
A. Parainfluenza viruses.
B. Influenza virus A.
C. Respiratory syncytial virus.
D. Mumps virus.
Q 209. Screening by using maternal serum fetoproteins helps to detect all of the following, except:
A. Neural tube defects.
B. Duodenal artesia.
C. Talipes equinovarus.
DERMATOLOGY AND VENEREOLOGY
Q 210. Biopsy from a mole on the foot shows cytologic atypia of melanocytes and diffuse epidermal infiltraton by anaplastic cells, which are also present in the papillary and reticular dermis. The most likely diagnosis is:
A. Melanoma, Clark level IV.
B. Congenital melanocytic nevus.
C. Dysplastic nevus.
D. Melanoma, Clark level III.
Q 211. A 30 year old male had severely itchy papulo-vesicular lesions on extremities, knees, elbows and buttocks for one year. Direct immunofluorescence staining of the lesions showed IgA deposition at dermo-epidermal junction. The most probable diagnosis is:
A. Pemphigus vulgaris.
B. Bullous pemphigoid.
C. Dermatitis herpetiformis.
D. Nummular eczema.
Q 212. A 5 year old male child has multiple hyperpigmented macules over the trunk. On rubbing the lesion with the rounded end of a pen, he developed urticarial wheal, confined to the border of the lesion. The most likely diagnosis is:
A. Fixed drug eruption
B. Lichen planus.
C. Urticaria pigmentosae
D. Urticarial vasculitis
Q 213. A 25-year-old man presents with recurrent episodes of flexural eczema, contact urticaria, recurrent skin infections and severe abdominal cramps and diarrhoea upon taking sea foods. He is suffering from:
A. Seborrheic dermatitis.
B. Atopic dermatitis.
C. Airborne contact dermatitis.
D. Nummular dermatitis.
Q 214. Ms. B, a 27-year-old nurse had extracurricular interest in trecking and painting. She broke up relationship with her boy friend. Two months later she lost interest in her hobbies and was convinced that she would not be able to work again. She thought life was not worth living and has consumed 60 tablets of phenobarbitone to end her life. She is most likely suffering from:
A. Adjustment disorder.
B. Conversion disorder.
C. Depressive disorder.
D. Post-traumatic stress disorder (PTSD).
Q 215. Signs of organic brain damage are evident on:
A. Bender Gestalt test.
B. Rorschach test.
C. Sentence Completion test.
D. Thematic Apperception test.
Q 216. A 25-year old housewife came to the psychiatry out patient department (OPD) complaining that her nose was longer than usual. She felt that her husband did not like her because of the deformity and had developed relationship with the neighboring girl. Further she complained that people made fun of her. It was not possible to convince her that there was no deformity. Her symptoms include:
Q 217. A 40-year old man presents to casualty with history of regular and heavy use of alcohol for ten years and morning drinking for one year. The last alcohol intake was three days back. There is no history of head injury or seizures. On examination, there is no icterus, sign of hepatic encephalopathy or focal neurological sign. The patient had coarse tremors, visual hallucinations and had disorientation to time. Which of the following is the best medicine to be prescribed for such a patient?
Q 218. A 30-year old unmarried woman from a low socio-economic status family believes that a rich boy staying in her neighborhood is in deep love with her. The boy clearly denies his love towards this lady. Still the lady insists that his denial is a secret affirmation of his love towards her. She makes desperate attempts to meet the boy despite resistance from her family. She also develops sadness at times when her effort to meet the boy does not materialize. She is able to maintain her daily routine. She, however, remains preoccupied with the thoughts of this boy. She is likely to be suffering from:
A. Delusional disorder.
Q 219. The non-REM (NREM) sleep is associated with:
A. Frequent dreaming.
B. Frequent penile erections.
C. Increased blood pressure.
D. Night terrors.
Q 220. A 16 year old boy does not attend school because of the fear of being harmed by school mates. He thinks that his classmates laugh at and talk about him. He is even scared of going out to the market. He is most likely suffering from:
A. Anxiety neurosis.
B. Manic Depressive Psychosis.
C. Adjustment reaction.
Q 221. A 41 year old woman working as an Executive Director is convinced that the management has denied her promotion by preparing false reports about her competence and have forged her signatures on sensitive documents so as to convict her. She files a complaint in the police station and requests for security. Despite all this she attends to her work and manages the household. She is suffering from:
A. Paranoid schizophrenia.
B. Late onset psychosis.
C. Persistent delusional disorder.
D. Obsessive Compulsive Disorder.
Q 222. The commonest site of oral cancer among Indian population is:
B. Floor of mouth.
C. Alveobuccal complex.
Q 223. A 70 year old male who has been chewing tobacco for the past 50 years presents with a six months history of a large, fungating, soft papaillary lesions in the oral cavity. The lesion has penetrated into the mandible. Lymph nodes are not palpable. Two biopsies taken from the lesion proper show benign appearing papillomatosis with hyperkeratosis and acanthosis infiltrating the subjacent tissues. The most likely diagnosis is:
A. Squamous cell papilloma.
B. Squamous cell carcinoma.
C. Verrucous carcinoma.
D. Malignant mixed tumour.
Q 224. Which of the following is not an indication of RT in pleomorphic adenoma of parotid:
A. Involvement of deep lobe.
B. 2nd histologically benign recurrence.
C. Microscopically positive margins.
D. Malignant transformation.
Q 225. A 55-year-old male presented with painless terminal hematuria. Cystoscopic examination revealed a solitary papillary tumor. Histopathological examination of completety resected tumor is suggestive of grade III transitional cell carcinoma with no muscle invasion. Further management of this patient is best done by:
A. Just follow up.
B. Intravesical chemotherapy.
C. Intravesical BCG.
Q 226. A 60-year-old male was diagnosed as carcinoma right lung. On CECT chest there was a tumour of 5 × 5 cm in upper lobe and another 2 × 2 cm size tumour nodule in middle lobe. The primary modality of treatment is:
D. Supportive treatment.
Q 227. All of the following are hormonal agents used against breast cancer, except:
Q 228. Unilateral undescended testis is ideally operated around:
A. 2 months of age.
B. 6 months of age.
C. 12 months of age.
D. 24 months of age.
Q 229. The short bowel syndrome is characterized by all of the following, except:
C. Weight loss.
Q 230. All of the following are significant risk factors for colonic carcinoma in an adenomatous polyp, except:
A. Pedunculated polyp.
B. Villous histology.
C. Size >2 cm.
Q 231. Which one of the following preservatives is used while packing catgut suture?
A. Isopropyl alcohol.
B. Colloidal iodine.
D. Hydrogen peroxide.
Q 232. Which of the following is not an important cause of hyponatraemia?
A. Gastric fistula.
B. Excessive vomiting.
C. Excessive sweating.
D. Prolonged Ryle’s tube aspiration.
Q 233. Which of the following types of pancreatitis has the best prognosis?
A. Alcoholic pancreatitis.
B. Gall stone pancreatitis.
C. Postoperative pancreatitis.
D. Idiopathic pancreatitis.
Q 234. Chronically Iymphoedematous limb is predisposed to all of the following, except:
A. Thickening of the skin.
B. Recurrent soft tissue infections.
C. Marjolin’s ulcer.
Q 235. The most common site of intestinal obstruction in gallstone ileus is:
C. Transverse colon.
D. Sigmoid colon.
Q 236. Injection sclerotherapy is ideal for the following:
A. External haemorrhoids.
B. Internal haemorrhoids.
C. Prolapsed haemorrhoids.
D. Strangulated haemorrhoids.
Q 237. For a rectal carcinoma at 5 cm from the anal verge the best acceptable operation is:
A. Anterior resection.
B. Abdomino-perineal resection.
C. Posterior resection.
D. Local resection.
Q 238. Pancreatitis, pituitary tumor and phaeochromocytoma may be associated with:
A. Medullary carcinoma of the thyroid.
B. Papillary carcinoma of the thyroid.
C. Anaplastic carcinoma of the thyroid.
D. Follicular carcinoma of the thyroid.
Q 239. Thoracic extension of cervical goiter is usually approached through:
C. Combined cervico-thoracic route.
Q 240. First treatment of rupture of varicose veins at the ankle should be:
A. Rest in prone position of patient.
B. Application of a tourniquet proximally.
C. Application of a tourniquet distally.
D. Direct pressure and elevation.
Q 241. In some old fractures, cartilaginous tissue forms over the fractured bone ends with a cavity in between containing clear fluid. This condition is called as:
A. Delayed union.
B. Slow union.
C. Non union.
Q 242. All of the following can be the complications of a malunited Colles’ fracture, except:
A. Rupture of flexor pollicis longus tendon.
B. Reflex sympathetic dystrophy (RSD).
C. Carpal tunnel syndrome.
D. Carpal instability.
Q 243. In fracture of the olecranon, excision of the proximal fragment is indicated in all of the following situations, except:
A. Old ununited fractures.
B. Non-articular fracture.
C. Fracture extending to coronoid process.
D. Elderly patient.
Q 244. Aseptic loosening in cemented total hip replacement, occurs as a result of hypersensitivity response to:
A. Titaneum debris.
B. High density polythene debris.
C. N, N- Dimethyltryptamine (DMT).
D. Free radicals.
Q 245. Tuberculosis of the spine commonly affects all of the following parts of the vertebra, except:
C. Spinous process.
Q 246. An army recruit, smoker and 6 months into training started complaining of pain at posterior medial aspect of both legs. There was acute point tenderness and the pain was aggravated on physical activity. The most likely diagnosis is:
A. Burger’s disease.
C. Lumbar canal stenosis.
D. Stress fracture.
Q 247. Management plan for osteogenic sarcoma of the lower end of femur must include:
A. Radiotherapy - amputation - chemotherapy.
B. Surgery alone.
C. Chemotherapy - limb salvage surgery - chemotherapy.
D. Chemotherapy + radiotherapy.
Q 248. The management of fat embolism includes all the following, except:
C. Low Molecular weight dextran.
D. Pulmonary embolectomy.
Q 249. A 25 year old male with roadside accident underwent debridement and reduction of fractured both bones right forearm under axillary block. On the second postoperative day the patient complained of persistent numbness and paresthesia in the right forearm and the hand. The commonest cause of this neurological dysfunction could be all of the following except:
A. Crush injury to the hand and lacerated nerves.
B. A tight cast or dressing.
C. Systemic toxicity of local anaesthetics.
D. Tourniquet pressure.
Q 250. Which of the following is the best indication for propofol as an intravenous induction agent?
B. Day care surgery.
C. Patients with coronary artery disease.
D. In neonates.
Q 251. Which of the following volatile anaesthetic agents should be preferred for induction of anaesthesia in children?
Q 252. When a patient develops supraventricular tachycardia with hypotension under general anaesthesia, all of the following treatments may be instituted except:
A. Carotid sinus massage.
B. Adenosine 3-12 mg IV.
C. Direct current cardioversion.
D. Verapamil 5 mg IV.
Q 253. A patient undergoing caesarean section following prolonged labour under subarachnoid has developed carpopedal spasm. Lignocaine was used as anesthetic agent. The most likely diagnosis
A. Amniotic fluid embolism.
B. Lignocaine toxicity.
GYNAECOLOGY AND OBSTETRICS
Q 254. A pregnant mother at 32 weeks gestation presents in preterm labor. Therapy with antenatal steroids to induce lung maturity in the fetus may be given in all of the following conditions, except:
A. Prolonged rupture of membranes for more than 24 hours.
B. Pregnancy induced hypertension.
C. Diabetes mellitus.
Q 255. The consequences of Rh incompatibility are not serious during first pregnancy because:
A. Antibodies are not able to cross placenta.
B. Antibody titer is very low during primary immune response.
C. IgG generated is ineffective against foetal red cells.
D. Massive hemolysis is compensated by increased erythropoiesis.
Q 256. Choice of adjuvant treatment for endometrial carcinoma stage IA, grade I is:
C. Chemotherapy plus radiotherapy.
D. No treatment.
Q 257. A 21 year old woman presents with complaints of primary amenorrhoea. Her height is 153 cm, weight is 51 kg. She has well developed breasts. She has no pubic or axillary hair and no hirsuitism. Which of the following is the most probable diagnosis?
A. Turner syndrome.
B. Stein-Leventhal syndrome.
C. Premature ovarian failure.
D. Complete androgen insensitivity syndrome.
Q 258. A 28-year old lady has put on weight (10 kg over a period of 3 years), and has oligomenorrhoea followed by amenorrohoea for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following is the most appropriate investigation?
A. Serum electrolytes.
B. Plasma cortisol.
C. Plasma testosterone and ultrasound evaluation of pelvis.
D. T3, T4 and TSH.
Q 259. All of the following conditions are risk factor for urinary tract infections in pregnancy, except:
A. Diabetes mellitus.
C. Sickle cell disease.
D. Vesicoureteral reflux.
Q 260. Which one of the following perinatal infections has the highest risk of fetal infection in the first trimester?
A. Hepatitis B virus.
Q 261. All of the following drugs are effective for cervical ripening during pregnancy, except:
A. Prostaglandin E2.
Q 262. All of the following are ultrasonographic fetal growth parameters, except:
A. Biparietal diameter.
B. Head cirumference.
C. Transcerebellar diameter.
D. Femur length.
Q 263. All of the following are advantages of using Raloxifene over estrogens in post menopausal women, except:
A. Reduces fracture rates.
B. Avoids endometrial hyperplasia.
C. Reduces incidence of venous thrombosis.
D. No increase in incidence of breast carcinoma.
Q 264. Antiprogesterone compound RU-486 is effective for inducing abortion if the duration of pregnancy is:
A. 63 days.
B. 72 days.
C. 88 days.
D. 120 days.
Q 265. Anti-D prophylaxis should be ‘given in all of the following conditions, except:
A. Medical abortion for 63 days pregnancy.
B. Amniocentesis at 16 weeks.
C. Intrauterine transfusion at 28 weeks.
D. Manual removal of placenta.
Q 266. A case of obstructed labour which was delivered by cesarean section complains of cyclical passage of menstrual blood in urine. Which is the most likely site of fistula?
Q 267. Which of the following is the investigation of choice in a pregnant lady at 18 week of pregnancy with past history of delivering a baby with Down’s syndrome?
A. Triple screen test.
C. Chorionic villous biopsy.
Q 268. A case of 35 week pregnancy with hydramnios and marked respiratory distress is best treated by:
A. Intravenous frusemide.
B. Saline infusion.
D. Artificial rupture of membranes.
Q 269. The most appropriate method for collecting urine for culture in case of vesicovaginal fistula is:
A. Suprapubic needle aspiration.
B. Midstream clean catch.
C. Foley’s catheter.
D. Sterile speculum.
Q 270. Which of the following is the most likely diagnosis in a 27 year old obese woman presenting with oligomenorrhoea, infertility and hirsuitism?
A. Polycystic ovaries.
C. Pelvic inflammatory disease.
D. Turner’s syndrome.
Q 271. A fifty year old woman, presenting with bilateral solid ovarian tumors, has ascitis. Upper gastro-intestinal endoscopy reveals a ulcerative growth in pyloric region of stomach. The most likely diagnosis is:
A. Malignant ovarian tumor.
B. Carcinoma in the small intestine.
C. Carcinoma body uterus.
D. Carcinoma stomach with Krukenberg’s tumor.
Q 272. Which of the following tests on maternal serum is most useful in distinguishing between open neural tube defects and ventral wall defects in a fetus?
A. Carcinoembryo antigen.
Q 273. Which of the following tests is most sensitive for the detection of iron depletion in pregnancy?
A. Serum iron.
B. Serum ferritin.
C. Serum transferrin.
D. Serum iron binding capacity.
Q 274. Which of the following conditions is most likely to be associated with a vaginal pH of 4?
A. Atrophic vaginitis.
B. Candidal vaginitis.
B. Trichomonas vaginitis.
D. Gardnerella vaginitis.
Q 275. Which is the most active single chemotherapeutic agent in the treatment of Leiomyosarcoma?
Q 276. Polychromatic luster is seen in:
A. Complicated cataract.
B. Diabetes mellitus.
C. Post radiation cataract.
D. Congenital cataract.
Q 277. In which of the following conditions, severe itching of the eye with ropy discharge in a 10 year old boy with symptoms aggravating in summer season is most likely present?
B. Vernal keratoconjunctivitis.
C. Acute conjunctivitis.
Q 278. Latanoprost used topically in glaucoma primarily acts by:
A. Decreasing aqueous humour formation.
B. Increasing uveoscleral outflow.
C. Releasing pupillary block.
D. Increasing trabecular outflow.
Q 279. Maximum densiy of goblet cells is seen in:
A. Superior conjunctiva.
B. Inferior conjunctiva.
C. Nasal conjunctiva.
D. Temporal conjunctiva.
Q 280. The most common condition of inherited blindness due to mitochondria1 chromosomal anomaly is:
A. Retinopathy of prematurity.
B. Leber’s Hereditary Optic neuropathy.
C. Retinitis pigmentosa.
D. Retinal detachment.
Q 281. A two week old child presents with unilateral cataract. Which of the following statement represents the best management advice:
A. The best age to operate him to get the best visual results is four weeks.
B. The best age to operate him to get the best visual results is four months.
C. The best age to operate him to get the best visual results is four years.
D. The eye is already lost, only cosmetic correction is required.
Q 282. Photodynamic therapy is used in the eye for the following disease:
D. Wet AMD (Age related macular degeneration).
Q 283. All are ocular emergencies, except:
A. Angle closure glaucoma.
B. Central serous retinopathy.
C. Retinal detachment.
D. Central retinal arterial occlusion.
Q 284. A two months old child presents with epiphora and regurgitation. The most probable diagnosis is:
A. Mucopurulent conjunctivitis.
C. Congenital dacryocystitis.
D. Encysted mucocele.
Q 285. Which prominent ocular manifestation is associated with Marfan’s syndrome:
D. Ectopia lentis.
Q 286. Which of the following will be the most important adjuvant therapy in a case of fungal corneal ulcer?
A. Atropine sulphate eye ointment.
B. Dexamethasone eye drops.
C. Pilocarpine eye drops.
D. Lignocaine eye drops.
Q 287. Arlt’s line is seen in:
A. Vernal keratoconjunctivitis.
C. Ocular pemphigoid.
Q 288. In which of the following locations there is collection of pus in the quinsy?
A. Peritonsillar space.
B. Parapharyngeal space.
C. Retropharyngeal space.
D. Within the tonsil.
Q 289. Which of the following statements best represents Bell’s paralysis?
A. Hemiparesis and contralateral facial nerve paralysis.
B. Combined paralysis of the facial, trigeminal and abducens nerves.
C. Idiopathic ipsilateral paralysis of the facial nerve.
D. Facial nerve paralysis with a dry eye.
Q 290. Meniere’s disease is characterized by:
A. Conductive hearing loss and tinnitus.
B. Vertigo, ear discharge, tinnitus and headache.
C. Vertigo, tinnitus, hearing loss and headache.
D. Vertigo, tinnitus and hearing loss.
Q 291. In right middle ear pathology Weber’s test will be:
C. Lateralised to right side.
D. Lateralised to left side.
Q 292. A patient is suspected to have vestibular Schwanomma. The investigation of choice for its diagnosis is:
A. Contrast enhanced CT scan.
B. Gadolinium enhanced MRI.
D. PET scan.
Q 293. In scurvy all the following radiological signs are seen, except:
A. Pelican spur.
B. Soap bubble appearance.
C. Zone of demarcation near epiphysis.
D. Frenkel’s line.
Q 294. On radiography widened duodenal ‘C’ loop with irregular mucosal pattern on upper gastrointestinal barium series is most likely due to:
A. Chronic pancreatitis.
B. Carcinoma head of pancreas.
C. Duodenal ulcer.
D. Duodenal ileus.
Q 295. Which of the following is the most penetration beam?
A. Electron beam. B. 8 MV photons.
C. 18 MV photons. D. Proton beam.
Q 296. The radiation tolerance of whole liver is :
A. 15 Gy. B. 30 Gy.
C. 40 Gy. D. 45 Gy.
Q 297. In which malignancy postoperative radiotherapy is minimally used?
A. Head and neck.
D. Soft tissue sarcomas.
Q 298. The Couinaud’s segmental nomenclature is based on the position of the:
A. Hepatic veins and portal vein
B. Hepatic veins and biliary ducts.
C. Portal vein and biliary ducts.
D. Portal vein and hepatic artery.
Q 299. Which of the following is not a CT scan feature of acute pancreatitis?
A. Ill defined outline of the pancreas.
B. Enlargement of the pancreas.
C. Poor contrast enhancement.
D. Dilated main pancreatic duct.
Q 300. Which of the following is classic CT appearance of an acute subdural hematoma:
A. Lentiform-shaped hyperdense lesion.
B. Crescent-shaped hypodense lesion.
C. Crescent-shaped hyperdense lesion.
D. Lentiform-shaped hypodense lesion.