ANATOMY
Q 1. Meiosis occurs in human males in:
A. Epididymis
B. Seminiferous tubules
C. Vas deferens
D. Seminal vesicles
Ans. B
Q 2. The right lobe of liver consists of which of the following segments:
A. V, VI, VII and VIII
B. IV, V, VI, VII and VIII
C. I, V, VI,VII and VIII
D. I, IV, V, VI, VII and VIII
Ans. A
Q 3. A young boy who was driving motorcycle at a high speed collided with a tree & was thrown on his right shoulder. Though there was no fracture, his right arm was medially rotated and forearm pronated. The following facts concerning this patient are correct, except:
A. The injury was at Erb’s point
B. A lesion of C5 and C6 was present
C. The median and ulnar nerves were affected
D. Supraspinatus, infraspinatus, subclavius & biceps brachii were paralyzed
Ans. C
Q 4. In a vehicular accident, the musculocutaneous nerve was completely severed, but still the person was able to weakly flex the elbow joint. All of the following muscles are responsible for this flexion, except:
A. Brachioradialis
B. Flexor carpi radialis
C. Ulnar head of pronator teres
D. Flexor carpi ulnaris
Ans. C
Q 5. Which of the following nuclei belongs to the general visceral efferent column:
A. Facial nerve nucleus
B. Trigeminal nerve nucleus
C. Dorsal nucleus of vagus
D. Nucleus ambiguous
Ans. C
Q 6. Dislocation of the vertebra is uncommon in thoracic region because in this region:
A. The articular process are interlocked
B. The vertebral body is long
C. Anterior longitudinal ligament is strong
D. Spinous process is long and pointed
Ans. A
Q 7. Joint between epiphysis and diaphysis of a long bone is a type of:
A. Plane synovial joint
B. Fibrous joint
C. Symphysis
D. Synchondrosis
Ans. D
PHYSIOLOGY
Q 8. Which one of the following clearly states the role of cerebellum in motor performance:
A. Planning and programming of movement
B. Convert abstract thought into voluntary action
C. Initiation of skilled voluntary action
D. Smoothens and coordinates ongoing movements
Ans. D
Q 9. Which of the following phrase adequately describes Pacinian corpuscles:
A. A type of pain receptors
B. Slowly adapting touch receptors
C. Rapidly adapting touch receptors
D. Located in the joints
Ans. C
Q 10. Ovulation is associated with sudden rise in:
A. Prolactin
B. Testosterone
C. LH
D. Oxytocin
Ans. C
Q 11. The normal adult human electroencephalogram (EEG):
A. Will not show high frequency waves during stage 3 sleep
B. Shows alpha rhythm when a person is awake but inattentive
C. Has lower frequency waves during mental activity
D. Is predominated by large amplitude waves during REM sleep
Ans. A
Q 12. The afferent fibers which are most sensitive to local anesthetic belong to group:
A. A
B. B
C. C
D. D
Ans. C
Q 13. Lower esophageal sphincter:
A. Has no tonic activity
B. Has a tone which is provided by the sympathetic system
C. Relaxes on increasing abdominal pressure
D. Relaxes ahead of the peristaltic wave
Ans. D
Q 14. Drinking can be induced by:
A. Electrical stimulation of the posterior hypothalamus
B. Osmotic stimulation of supraoptic nucleus
C. Lesions in the paraventicular nucleus
D. Neuronal lesion of the preoptic nucleus
Ans. B
Q 15. When information memorized afterwards is interfered by the information learnt earlier, it is called:
A. Retroactive inhibition
B. Proactive inhibition
C. Simple inhibition
D. Inhibition
Ans. B
Q 16. Wedged hepatic venous pressure represents pressure in:
A. Main portal vein
B. Main hepatic vein
C. Sinusoids
D. Central vein radicles
Ans. C
Q 17. The pressure-volume curve is shifted to the left in:
A. Mitral regurgitation
B. Aortic regurgitation
C. Mitral stenosis
D. Aortic stenosis
Ans. D
Q 18. The intrafusal fibers of the striated skeletal muscles are innervated by one of the following type of motor neurons. Choose the correct answer:
A. Alpha
B. Beta
C. Gamma
D. Delta
Ans. C
Q 19. The inhibitory neurotransmitter in CNS neurons is:
A. Glutamate
B. Aspartate
C. Gamma-amino butyric acid
D. Taurine
Ans. C
Q 20. The correct sequence of cell cycle is:
A. G0-G1-S-G2-M
B. G0-G1-G2-S-M
C. G0-M-G2-S-G1
D. G0-G1-S-M-G2
Ans. A
BIOCHEMISTRY
Q 21. Misexpression of which of the following homeobox genes alters the position of the forelimbs during development:
A. HOXA7
B. HOXB8
C. HOXC9
D. HOXDI0
Ans. B
Q 22. All of the following statements about LDL are true except:
A. It delivers cholesterol to cells
B. It contains only one apoprotein
C. It is a marker for cardiovascular disease
D. It contains Apo-B4
Ans. D
Q 23. The most important source of reducing equivalents for fatty acid synthesis in the liver is:
A. Glycolysis
B. TCA cycle
C. Uronic acid pathway
D. HMP pathway
Ans. D
Q 24. Insulin increases the activities of all of the following enzymes, except:
A. Glucokinase
B. Pyruvate carboxylase
C. Glycogen synthase
D. Acetyl-CoA carboxylase
Ans. B
Q 25. Which of the following combinations of biologically active molecules does vitamin A consists of:
A. Retinol, retinal and retinoic acid
B. Retinal, retinal and tetrahydrofolate
C. Retinal, conjugase and retinoic acid
D. PABA, retinal and retinaldehyde
Ans. A
Q 26. The primary structure of a protein refers to:
A. Linear structure and order of the amino acids present
B. Regular conformational forms of a protein
C. Complete three-dimensional structure of the polypeptide units of a given protein
D. Subunit structure of the protein
Ans. A
Q 27. Excessive ultraviolet (UV) radiation is harmful to life. The damage caused to the biological systems by ultraviolet radiation I by:
A. Inhibition of DNA synthesis
B. Formation of thymidine dimers
C. Ionization
D. DNA fragmentation
Ans. B
Q 28. Biological role of metallothioneins is to sequester harmful metal ions. These bind:
A. Cd++, Cu++ & Zn++
B. AI+++, Hg++ & NH4+
C. Pt++, As+++ & PO4–
D. Fe+++, Na+ & K+
Ans. A
Q 29. Which one of the following is not true for an -helix:
A. It is one of the most important secondary structure
B. It has a net dipole moment
C. All hydrogen bonds are aligned in the same direction
D. Long stretches of left handed -helices occur in proteins
Ans. D
FORENSIC
Q 30. In each freshwater drowning the death occurs within 4-5 minutes of submersion due to ventricular fibrillation. Which of the following reasons is responsible for this?
A. Total asphyxia is produced due to fresh water
B. Laryngospasm causing vagal inhibition
C. Haemoconcentration of blood caused by the osmotic pressure effect
D. Haemodilution, overloading of heart and haemolysis resulting in release of potassium
Ans. D
Q 31. A 25 years female was found in room with 100% burns on her body. The tongue was protruding out; body was in pugilistic attitude with heat ruptures, peeling of skin, and heat haematoma and heat fractures of skull. Carboxy hemoglobin was 25% and soot particles were present in trachea. Which of the combinations of two findings will establish that the burns were antemortem in nature:
A. Heat haematoma & heat ruptures
B. Heat fracture of skull and peeling of skin
C. Heat haematoma and pugilistic attitude
D. Carboxy hemoglobin (25%) and soot particles in trachea
Ans. D
Q 32. The phenomenon of suspended animation may be seen in:
A. Throttling
B. Drowning
C. Strangulation
D. Brain hemorrhage
Ans. B
Q 33. A lady died due to unnatural death within seven years after her marriage. The inquest in this case will be done by:
A. Forensic medicine expert
B. Deputy superintendent of police
C. Sub-divisional magistrate
D. Coroner
Ans. C
Q 34. Cheiloscopy is the study of prints of:
A. Foot
B. Fingers
C. Palate
D. Lips
Ans. D
PREVENTIVE AND SOCIAL MEDICINE
Q 35. Mean hemoglobin of a sample of 100 pregnant woman was found to be 10 mg% with a standard error of 1.0 mg%. The standard error of the estimate would be:
A. 0.01
B. 0.1
C. 1.0
D. 10.0
Ans. B
Q 36. For every 1,00,000 population, the highest prevalence of blindness in the world is seen in:
A. Sub-Saharan Africa
B. South Asia
C. Eastern Europe
D. Latin America
Ans. A
Q 37. All of the following statements about plague are wrong, except:
A. Domestic rat is the main reservoir
B. Bubonic is the most common variety
C. The causative bacillus can survive up to 10 years in the soil of rodent burrows
D. The incubation period for pneumonic plague is one to two weeks
Ans. B
Q 38. National Health Policy of India-2002 includes all of the following as goals, except:
A. Eradicated polio and yaws by the year 2005
B. Achieve zero level transmission of HIV/AIDS by year 2010
C. Eliminate kala-azar by year 2005
D. Eliminate lymphatic filariasis by year 2015
Ans. C
Q 39. The incubation period of yellow fever is:
A. 3 to 6 days
B. 3-4 weeks
C. 1 to 2 weeks
D. 8-10 weeks
Ans. A
Q 40. Mode of transmission of Q fever is:
A. Bite of infected louse
B. Bite of infected tick
C. Inhalation of aerosol
D. Bite of infected mite
Ans. C
Q 41. The following are characteristic features of staphylococcal food poisoning, except:
A. Optimum temperature for toxin formation is 37°C
B. Intradietetic toxins are responsible for intestinal symptoms
C. Toxins can be destroyed by boiling for 30 minutes
D. Incubation period is 1-6 hours
Ans. C
Q 42. Which of the following is the best indicator of severity of a short duration acute disease:
A. Cause specific death rate
B. 5-year survival
C. Case fatality rate
D. Standardized mortality ratio
Ans. C
Q 43. Which of the following is the most common cause of maternal mortality in India:
A. Hemorrhage
B. Anemia
C. Abortion
D. Sepsis
Ans. A
Q 44. Which of the following is the nodal ministry for Integrated Child Development Services (ICDS) Programme Centre:
A. Ministry for Human Resource Development
B. Ministry for Rural Development
C. Ministry for Health and Family Welfare
D. Ministry for Social Justice
Ans. A
Q 45. The systematic distortion of retrospective studies that can be eliminated by a prospective design is:
A. Confounding
B. Effect modification
C. Recall bias
D. Measurement bias
Ans. C
Q 46. If we reject null hypothesis, when actually it is true, it is known as:
A. Type I error
B. Type II error
C. Power
D. Specificity
Ans. A
Q 47. If a new effective treatment is initiated and all other factors remain the same; which of the following is most likely to happen:
A. Incidence will not change
B. Prevalence will not change
C. Neither incidence nor prevalence will change
D. Incidence and prevalence will change
Ans. A
Q 48. Which one of the following relationships shown between different parameters of a performance of a test, is correct:
A. Sensitivity = 1 – specificity
B. Positive predictive value = 1 – negative predictive value
C. Sensitivity is inversely proportional to specificity
D. Sensitivity = 1 – positive predictive value
Ans. C
Q 49. A 25-year-old female has been diagnosed to be suffering from tuberculosis categorized as category I (sputum +ve relapse). The treatment regimen recommended under DOTS is:
A. 2 (HRZE)3 + 5 (HR)3
B. 2 (HRSZE)3 + (HRZE)3 + 5 (HR)3
C. 3 (HRZE)3 + 2 (HRE)3 + 4 (HR)3
D. 3 (HRSZE)3 + 1 (HRZE)3 + 6 (HRE)3
Ans. B
Q 50. Which sampling method is used in assessing immunization status of children under an immunization programme:
A. Quota sampling
B. Multi stage sampling
C. Stratified random sampling
D. Cluster sampling
Ans. D
Q 51. All of the following are true about break point chlorination, except:
A. Free chlorine is released in water after break point chlorination
B. Chlorine demand is the amount needed to kill bacteria, oxidize organic matter and neutralize ammonia
C. 1 ppm free chlorine should be present in water after break point has reached
D. Contact period of 1 hour is necessary
Ans. C
Q 52. Tablets supplied by Govt. of India contain the following amount of iron and folic acid:
A. 60 mg elemental iron + 500 µg FA
B. 100 mg elemental iron + 500 µg FA
C. 200 mg elemental iron + 1 mg FA
D. 100 mg elemental iron + 5 mg FA
Ans. B
PHARMACOLOGY
Q 53. All of the following drugs are contraindicated in patients with G-6-PD deficiency, except:
A. Cotrimoxazole
B. Furazolidine
C. Nalidixic acid
D. Ceftriaxone
Ans. D
Q 54. Which of the following is not a prodrug:
A. Enalapril
B. Oxcarbazepine
C. Chloral hydrate
D. Diazepam
Ans. D
Q 55. Which of the following antimalarial is a slow acting schizonticide:
A. Artemether
B. Mefloquine
C. Pyrimethamine
D. Quinine
Ans. C
Q 56. Thalidomide can be used in:
A. Myocardial infraction
B. Erythema nodosum leprosum
C. Wernicke’s encephalopathy
D. Epilepsy
Ans. B
Q 57. Aldosterone antagonists are not useful in the treatment of:
A. Hypertension
B. Congestive heart failure
C. Gynaecomastia
D. Hirsutism
Ans. C
Q 58. The following statements are true for therapy with lithium, except:
A. It is used in bipolar disorder
B. Thiazides are useful in treating lithium induced diabetes insipidus
C. Regular measurements of blood concentration of lithium is necessary
D. Na+ is a specific antidote for lithium intoxication.
Ans. D
Q 59. Which of the following is a fourth generation cephalosporin:
A. Ceftriaxone
B. Cefaclor
C. Cefepime
D. Cefuroxime
Ans. C
Q 60. Which of the following drug causes pseudotumour cerebri:
A. Sparfloxacin
B. Tetracycline
C. Gentamicin
D. Clofazimine
Ans. B
Q 61. Which of the following is caused by amphotericin B:
A. Hypokalemia
B. Hyperkalemia
C. Hypermagnesemia
D. Hyponatremia
Ans. A
Q 62. A patient with cancer received extreme degree of radiation toxicity. Further history revealed that the dose adjustment of a particular drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment in that patient during radiotherapy in order to prevent radiation toxicity:
A. Vincristine
B. Dactinomycin
C. Cyclophosphamide
D. 6-Mercaptopurine
Ans. B
Q 63. Following drugs are immunosuppressive drug except:
A. Cyclosporine
B. Cefaclor
C. Azathioprine
D. Steroids
Ans. B
Q 64. All of the following drugs can induce methemoglobinemia, except:
A. Nitroglycerine
B. Procaine
C. Prilocaine
D. Phenytoin
Ans. D
Q 65. Which of the following enzyme is inhibited by aminophylline:
A. Monoamine oxidase
B. Alcohol dehydrogenase
C. Cytochrome P-450
D. Phosphodiesterase
Ans. D
Q 66. Nevirapine is:
A. Protease inhibitor
B. Nucleoside reverse transcriptase inhibitor
C. Non-nucleoside reverse transcriptase inhibitor
D. Fusion inhibitor
Ans. C
Q 67. Which of the following substances is the most potent androgen:
A. Dehydroepiandrostenedione
B. Dihydrotestosterone
C. Androstenedione
D. Testosterone
Ans. B
Q 68. Women receiving tamoxifen should be periodically screened with:
A. Mammography
B. PAP smear
C. CA-125 level
D. Endometrial sampling
Ans. D
MICROBIOLOGY
Q 69. The protection against small pox by previous infection with cowpox represents:
A. Antigenic cross-reactivity
B. Antigenic specificity
C. Passive immunity
D. Innate immunity
Ans. A
Q 70. Which of the following class specific antigenic determinants of an immunoglobulin is associated with?
A. L-chain
B. H-chain
C. J-chain
D. Variable region
Ans. B
Q 71. Which of the following infestations lead to malabsorption:
A. Giardia lamblia
B. Ascaris lumbricoides
C. Necator americana
D. Ancylostoma duodenale
Ans. A
Q 72. Hepatitis C virus is a:
A. Togavirus
B. Flavivirus
C. Filovirus
D. Retrovirus
Ans. B
Q 73. A 23-year old male had unprotected sexual intercourse with a commercial sex worker.Two weeks later, he developed a painless, indurated ulcer on the glans that exuded clear serum on pressure. Inguinal lymph nodes in both groins were enlarged and not tender, The most appropriate diagnostic test is:
A. Gram’s stain of ulcer discharge
B. Dark field microscopy of ulcer discharge
C. Giemsa stain of lymph node aspirate
D. ELISA for HIV infection
Ans. B
Q 74. Which of the following is the most predominant constituent of sulfur granules of actinomycosis:
A. Organisms
B. Neutrophils and monocytes
C. Monocytes and lymphocytes
D. Eosinophils
Ans. A
Q 75. Conjugate vaccines are available for the prevention of invasive disease caused by all of the following bacteria, except:
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Neisseria meningitidis (group C)
D. Neisseria meningitidis (group B)
Ans. D
Q 76. A clinical specimen was obtained from the wound of a patient diagnosed as nocardiosis. For the selective isolation of Nocardia sp., which one of the following would be the best method:
A. Paraffin bait technique
B. Castaneda’s culture method
C. Craige’s tube method
D. Hair bait technique
Ans. A
Q 77. Anti-tubercular drug susceptibility can be done by all of the following methods, except:
A. Resistance ratio method
B. Disc diffusion method
C. Molecular method
D. Radiometric broth method
Ans. B
PATHOLOGY
Q 78. Which of the following is the most likely inheritance pattern in the pedigree given below:
A. Autosomal dominant
B. Mitochondrial
C. Autosomal recessive
D. X-linked dominant
Ans. C
Q 79. If both husband and wife are suffering with achondroplasia, what are their chances of having a normal child:
A. 0%
B. 25%
C. 50%
D. 100%
Ans. B
Q 80. In which of the following conditions, aniridia and hemihypertrophy are most likely present:
A. Neuroblastoma
B. Wilms’ tumour
C. Non-Hodgkin’s lymphoma
D. Germ cell tumour
Ans. B
Q 81. In the mitogen activated protein kinase pathway, the activation of RAS is counteracted by:
A. Protein kinase C
B. GTPase activating protein
C. Phosphatidyl inositol
D. Inositol triphosphate
Ans. B
Q 82. Wire loop lesions are often characteristic for the following class of lupus nephritis:
A. Mesangial proliferative glomerulonephritis(WHO class II)
B. Focal proliferative glomerulonephritis (WHO class III)
C. Diffuse proliferative glomerulonephritis (WHO class IV)
D. Membranous glomerulonephritis (WHO class V)
Ans. C
Q 83. Which of the following would be the best morphological feature to distinguish ulcerative colitis from Crohn’s disease:
A. Diffuse distribution of pseudopolyps
B. Mucosal edema
C. Crypt abscesses
D. Lymphoid aggregates in the mucosa
Ans. A
Q 84. In chronic viral hepatitis:
A. Hepatitis A virus infection is a common cause in children
B. Morphological classification into chronic active hepatitis and chronic persistent hepatitis are important
C. Fatty change is pathognomic of hepatitis C virus infection
D. Grading refers to the extent of necrosis and inflammation
Ans. D
Q 85. Mesangial deposits of monoclonal kappa/lambda light chains is indicative of:
A. Mesangioproliferative glomerulonephritis
B. Focal and segmental glomerulosclerosis
C. Kimmelsteil-Wilson lesions
D. Amyloidosis
Ans. D
Q 86. In a patient with acute leukemia, immunophenotype pattern is CD 19 +ve, CD 10 +ve, CD33 +ve, CD 13 +ve. He may probably have:
A. Biphenotypic leukemia
B. ALL
C. AML-M2
D. AML-M0
Ans. A
Q 87. A patient with cirrhosis of liver has the following coagulation parameters – platelet count 2,00,000, prothrombin time 25s/12s, activated partial thromboplastin time 60s/35s, thrombin time 15s/15s. In this patient:
A. D-dimer will be normal
B. Fibrinogen will be < 100 mg
C. AT III will be high
D. Protein C will be elevated
Ans. A
Q 88. The liver biopsy in acute hepatitis due to hepatitis B virus is likely to show all of the following, except:
A. Ballooning change of hepatocytes
B. Ground glass hepatocytes
C. Focal or spotty necrosis
D. Acidophil bodies
Ans. B
Q 89. In renal disease, albumin is first to appear in urine because:
A. Of its high concentration in plasma
B. Has molecular weight slightly greater than the molecules normally getting filtered
C. High albumin:globulin ratio
D. Tubular epithelial cells are sensitive to albumin
Ans. B
Q 90. Which of the following tumours have an increased elevation of placental alkaline phosphatase in the serum as well as a positive immunohistochemical staining for placental alkaline phosphatase:
A. Seminoma
B. Hepatoblastoma
C. Hepatocellular carcinoma
D. Peripheral neuroectodermal tumour
Ans. A
Q 91. A baby girl with ambiguous genitalia is found to have 21-hydroxylase deficiency of the salt-wasting type. Which of the following karyotypes would you expect to find:
A. 46, XX
B. 46, XY
C. 47, XXY
D. 47, XYY
Ans. A
Q 92. Troponin-T is a marker of:
A. Renal diseases
B. Muscular dystrophy
C. Cirrhosis of liver
D. Myocardial infarction
Ans. D
MEDICINE
Q 93. All of the following conditions are known to cause diabetes insipidus. except:
A. Multiple sclerosis
B. Head injury
C. Histiocytosis
D. Viral encephalitis
Ans. A
Q 94. Raised serum amylase levels are used to diagnose:
A. Autoimmune disease
B. Degenerative diseases
C. Acute cholecystitis
D. Acute pancreatitis
Ans. D
Q 95. Which one of the followin is a cause for “restrictive cardiomyopathy”:
A. Alcohol
B. Hemochromatosis
C. Amyloidosis
D. Sarcoidosis
Ans. C
Q 96. Which of the following lesions is associated with HIV infection:
A. Hairy leukoplakia
B. Erythroplakia
C. Oral lichen planus
D. Bullous pemphigoid
Ans. A
Q 97. A 59-year-old male came with Hb 18.0 gm/dl on three occasions. The resident doctor wants to exclude polycythemia vera. Which of the following is the most relevant investigation:
A. Hematocrit
B. Total leukocyte count
C. Red cell mass
D. Reticulocyte count
Ans. C
Q 98. A 32-year-old female, asymptomatic, not requiring blood transfusion, presents with Hb 13.0 gm/dl. Her HbF levels are 95%, Hb A2 1.5%. Which of the following is the most likely diagnosis:
A. Hereditary persistence of fetal hemoglobin
B. Beta homozygous thalassemia
C. Thalassemia intermedia
D. Beta heterozygous thalassemia
Ans. A
Q 99. Huntington’s disease is due to the loss of:
A. Nigrostriatal dopaminergic neurons
B. Intrastriatal cholinergic neurons
C. Intrastriatal GABAergic neurons
D. Intrastriatal cholinergic and GABAergic neurons
Ans. D
Q 100. Lesion in which of the following structure leads to Kluver-Bucy syndrome:
A. Amygdala
B. Hippocampus
C. Hypothalamus
D. Temporal lobe
Ans. A
Q 101. A 25-year-old man presented with fever and cough for two months. CT chest showed bilateral upper lobe fibrosis and mediastinal enlarged necrotic nodes with peripheral rim enhancement. What is the most likely diagnosis:
A. Sarcoidosis
B. Tuberculosis
C. Lymphoma
D. Silicosis
Ans. B
Q 102. Which one of the following statements is wrong regarding adult polycystic kidney disease:
A. Kidneys are enlarged in size
B. The presentation is unilateral
C. Intracranial aneurysms may be associated
D. Typically manifests in the 3rd decade
Ans. B
Q 103. Angiographically, the typical “beaded” or “pile of plates” appearance involving the internal carotid artery is seen in:
A. Takayasu’s disease
B. Non-specific aorto-arteritis
C. Fibromuscular dysplasia
D. Rendu-Osler-Weber disease
Ans. C
Q 104. Carcinoid syndrome produces valvular disease primarily of the:
A. Venous valves
B. Tricuspid valve
C. Mitral valve
D. Aortic valve
Ans. B
Q 105. Carcinoid tumour is most common in:
A. Esophagus
B. Stomach
C. Jejunum
D. Appendix
Ans. D
Q 106. Most common cause of subarachnoid hemorrhage is:
A. Hypertension
B. Aneurysm
C. Arterio-venous malformation
D. Bleeding disorders
Ans. B
Q 107. Subdural haematoma most commonly results from:
A. Rupture of intracranial aneurysm
B. Rupture of cerebral AV malformation
C. Injury to cortical bridging veins
D. Hemophilia
Ans. C
Q 108. What would be the first line of treatment in a patient who develops ventricular fibrillation after intravenous injection of potassium chloride
A. Cardiac massage
B. IV adrenaline
C. Defibrillation
D. IPPV
Ans. C
Q 109. After contrast media injection in the radiology department, a patient develops severe hypotension, bronchospasm and cyanosis. Which one of the following drugs should be used for treatment:
A. Atropine
B. Aminophylline
C. Dopamine
D. Adrenaline
Ans. D
Q 110. A 30-year-old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side. On examination, BP was 160/140 mmHg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed Hb 12 gm%, TLC 12,000 per cumm, platelets 4,30,000 and ESR 49 mm. Urine examination showed proteinuria and RBC 10-15/hpf with no casts. What is the most likely diagnosis:
A. Polyarteritis nodosa
B. Systemic lupus erythematosus
C. Wegener’s granulomatosis
D. Mixed cryoglobulinemia
Ans. A
Q 111. A 23-year-old college student has asymptomatic and hyperpigmented macules on both palms for three weeks. The most appropriate diagnostic test is:
A. Venereal Diseases Research Laboratory (VDRL) test
B. Skin biopsy
C. Serum cortisol levels
D. Assay for arsenic in hair, skin and nails
Ans. A
Q 112. A 42-year-old engineer developed redness of the glans and radial fissuring of the prepuce 2 weeks ago. A potassium hydroxide preparation of scrapings from the glans showed pseudohyphae and buds. Which one of the following systemic illness should he be screened for:
A. Pulmonary tuberculosis
B. Diabetes mellitus
C. Systemic candidiasis
D. Chronic renal failure
Ans. B
Q 113. All of the following are the electrocardiographic features of hyperkalemia, except:
A. Prolonged PR interval
B. Prolonged QT interval
C. Sine wave patterns
D. Loss of P waves
Ans. B
Q 114. A patient with acute inferior wall myocardial infarction has developed shock. Which of the following is the most likely cause of shock:
A. Cardiac rupture
B. Interventricular septal perforation
C. Papillary muscle rupture
D. Right ventricular infarction
Ans. D
Q 115. Which one of the following cardiac lesions is at highest risk of occurrence of infective endocarditis:
A. Atrial septal defect
B. Mitral valve prolapse without regurgitation
C. Valvular aortic regurgitation
D. Mitral stenosis
Ans. C
Q 116. All of the following drugs are used in the management of acute myocardial infarction, except:
A. Tissue plasminogen activator
B. Intravenous beta blockers
C. Acetylsalicylic acid
D. Calcium channel blockers
Ans. D
Q 117. The most common cause of sporadic viral encephalitis is:
A. Japanese B encephalitis
B. Herpes simplex encephalitis
C. Human immunodeficiency virus encephalitis
D. Rubeola encephalitis
Ans. B
Q 118. The only thrombolytic agent approved for the treatment of acute ischemic stroke is:
A. Tissue plasminogen activator
B. Streptokinase
C. Urokinase
D. Pro-urokinase
Ans. A
Q 119. All of the following are neurologic channelopathies, except:
A. Hypokalemic periodic paralysis
B. Episodic ataxias
C. Familial hemiplegic migraine
D. Huntington’s disease
Ans. D
Q 120. A 35-year-old male patient presented with history of jaundice for 15 days. The onset was preceded by a prodromal illness. His serum tested positive for HBsAg. A clinical diagnosis of acute hepatitis B was made. What should be the next best confirmatory investigation:
A. Anti-HBeAg antibody
B. HBe antigen
C. Anti-HBe IgM antibody
D. HBV DNA by PCR
Ans. D
Q 121. A 20-year-old female presents with history of dyspnoea on exertion. On examination, she has wide, fixed split of S2 with ejection systolic murmur (III/VI) in left second intercostal space. Her EKG shows left axis deviation. The most probable diagnosis is:
A. Total anomalous pulmonary venous connection
B. Tricuspid atresia
C. Ostium primum atrial septal defect
D. Tetralogy of Fallot
Ans. C
Q 122. In a patient with chronic congestive cardiac failure, all of the following drugs prolong survival, except:
A. Metoprolol
B. Carvedilol
C. Enalapril
D. Digoxin
Ans. D
Q 123. All of the following are features of juvenile myoclonic epilepsy, except:
A. Myoclonus on awakening
B. Generalized tonic-clonic seizures
C. Automatism
D. Absence seizures
Ans. C
Q 124. All of the following statements about Creutzfeldt-Jakob disease are true, except:
A. It is a neurodegenerative disease
B. It is caused by infectious proteins
C. Myoclonus is rarely seen
D. Brain biopsy is specific for diagnosis
Ans. C
Q 125. All of the following statements about Wilson’s disease are true, except:
A. It is an autosomal recessive disorder
B. Serum ceruloplasmin level is < 20 mg/dl
C. Urinary copper excretion is < 100 µg/day
D. Zinc acetate is effective as maintenance therapy
Ans. C
PAEDIATRICS
Q 126. A 2-year-old boy has vitamin D resistant rickets. His investigations revealed serum calcium 9 mg/dl, phosphate 2.4 mg/dl, alkaline phosphatase 1041 IU, normal intact parathyroid hormone and bicarbonate 22 mEq/L. Which of the following is the most probable diagnosis?
A. Distal renal tubular acidosis
B. Hypophosphatemic rickets
C. Vitamin D dependent rickets
D. Hypoparathyroidism
Ans. B
Q 127. The renal biopsy of a 6-year-old boy with recurrent gross hematuria shows IgA nephropathy. The urinary protein excretion is 130 mg/day. Which of the following is the most appropriate next step in the management:
A. Administer corticosteroids
B. Give azathioprine
C. Start cyclosporine
D. Urinary bag sample
Ans. A
Q 128. Which of the following is the most appropriate method for obtaining a urine specimen for culture in an 8 month old girl:
A. Suprapubic aspiration
B. Indwelling catheter sample
C. Clean catch void
D. Urinary bag sample
Ans. A
Q 129. An 8 year old boy during a routine check up is found to have E. coli 1,00,000 cc/ml on a urine culture. The urine specimen was obtained by midstream clean-catch void. The child is asymptomatic. Which is the most appropriate next step in the management:
A. Treat as an acute episode of urinary tract infection
B. No therapy
C. Prophylactic antibiotics for 6 months
D. Administer long term urine alkalinizer
Ans. A
Q 130. A 2-year-old child comes with discharge, seborrheic dermatitis, polyuria and hepatosplenomegaly. Which of the following is the most likely diagnosis:
A. Leukemia
B. Lymphoma
C. Langerhan’s cell histiocytosis
D. Germ cell tumour
Ans. C
Q 131. Injection glucagon is effective for management of persistent hypoglycemia in all, except:
A. Large for date baby
B. Galactosemia
C. Infant of diabetic mother
D. Nesidioblastosis
Ans. B
Q 132. The most appropriate management for maintaining patency of ductus arteriosus in a neonate is:
A. Prostaglandin E1
B. Oxygen
C. Nitric oxide
D. Indomethacin
Ans. A
Q 133. Congenital hypertrophic pyloric stenosis usually presents:
A. Within 2 days after birth
B. Around 1 week after birth
C. Around 2 weeks after birth
D. Around 2 months after birth
Ans. C
Q 134. ‘Weak giants’ are produced by:
A. Thyroid adenomas
B. Thyroid carcinomas
C. Parathyroid adenomas
D. Pituitary adenomas
Ans. D
Q 135. Vesicoureteric reflux is more common in:
A. Newborn females
B. Older girls
C. Older boys
D. Only during pregnancy
Ans. A
Q 136. Bag and mask ventilation is contraindicated in:
A. Cleft lip
B. Meconium aspiration
C. Diaphragmatic hernia
D. Multicentric bronchogenic cyst
Ans. C
Q 137. A 3-month-old male infant developed otitis media for which he was given a course of cotrimoxazole. A few days later, he developed extensive peeling of the skin; there were no mucosal lesions and the baby was not toxic. The most likely diagnosis is:
A. Toxic epidermal necrolysis
B. Staphylococcal scalded skin syndrome
C. Stevens Johnson syndrome
D. Infantile pemphigus
Ans. B
Q 138. A neonate develops signs of meningitis at seven days of birth. The presence of which of the following infectious agent in the maternal genital tract can be the causative agent of this disease:
A. Neisseria gonorrhoeae
B. Chlamydia trachomatis
C. Streptococcus agalactiae
D. Haemophilous ducreyi
Ans. C
SURGERY
Q 139. A 65-year-old smoker presents with hoarseness, hemoptysis and a hard painless lump in the left supraclavicular fossa. Which of the following is the most appropriate diagnostic step:
A. Undertake an open biopsy of the neck lump
B. Undertake a radical neck dissection
C. Do fine needle aspiration cytology
D. Give a trial of anti tuberculous therapy
Ans. A
Q 140. During surgery of hernia, the sac of a strangulated inguinal hernia should be opened at the:
A. Neck
B. Body
C. Fundus
D. Deep ring
Ans. C
Q 141. The most common site of a benign (peptic) gastric ulcer is:
A. Upper third of lesser curvature
B. Greater curvature
C. Pyloric antrum
D. Lesser curvature near incisura angularis
Ans. D
Q 142. Which of the following is the most common endocrine tumour of pancreas:
A. Insulinoma
B. Gastrinoma
C. VIPoma
D. Glucagonoma
Ans. A
Q 143. Cock’s peculiar tumour is:
A. An infected sebaceous cyst
B. A malignant tumour of the scalp
C. A metastatic lesion of the scalp
D. An indicator of underlying osteomyelitis
Ans. A
Q 144. A 43-year-old lady presents with a 5 cm lump in right breast with a 3 cm node in the supraclavicular fossa. Which of the following TNM stage she belongs to as per the latest AJCC staging system:
A. T2N0M1
B. T1N0M1
C. T2N3M0
D. T2N2M0
Ans. C
Q 145. Which of the following statements about the Holmium:YAG laser is incorrect:
A. It has a wavelength of 2100 nm
B. Its use for uric acid stones has caused deaths due to generation of cyanide
C. It is effective against the hardest urinary stones
D. It can even cut the wire of stone baskets
Ans. B
Q 146. Which of the following liver tumour has a propensity to invade the portal or hepatic vein:
A. Cavernous hemangioma
B. Hepatocellular carcinoma
C. Focal nodular hyperplasia
D. Hepatic adenoma
Ans. B
Q 147. The treatment of choice for a mucocele of gall bladder is:
A. Aspiration of mucous
B. Cholecystectomy
C. Cholecystostomy
D. Antibiotics and observation
Ans. B
Q 148. Virchow’s triad includes all of the following, except:
A. Venous stasis
B. Injury to veins
C. Blood hypercoagulability
D. Venous thrombosis
Ans. B
Q 149. The most common cause of superficial thrombophlebitis is:
A. Trauma
B. Infection
C. Varicosities
D. Intravenous infusion
Ans. D
Q 150. A man is rushed to casualty, nearly dying after a massive blood loss in an accident. There is not much time to match blood groups, so the physician decides to order for one of the following blood groups. Which one of the following blood groups should the physician decide:
A. O negative
B. O positive
C. AB positive
D. AB negative
Ans. A
Q 151. All of the following are risk factors for carcinoma gal1 bladder, except:
A. Typhoid carriers
B. Adenomatous gall bladder polyps
C. Choledochal cysts
D. Oral contraceptives
Ans. D
ORTHOPAEDICS
Q 152. A 44-year-old man presented with acute onset of low backache radiating to the right lower limb. Examination revealed SLRT < 40° on the right side, weakness of extensor hallucis longus on the right side, sensory loss in the first web space of the right foot and brisk knee jerk. Which of the fol1owing is the most likely diagnosis:
A. Prolapsed intervertebral disc L4-5
B. Spondylolysis L5-S1
C. Lumbar canal stenosis
D. Spondylolisthesis L4-5
Ans. A
Q 153. A woman of 45, a known cause of pemphigus vulgaris on a regular treatment with control1ed primary disease presented with pain in the right hip and knee. Examination revealed no limb length discrepancy but the patient has tenderness in the Scarpa’s triangle and limitation of adduction and internal rotation of the right hip joint as compared to the other side. The most probable diagnosis is:
A. Stress fracture of neck of femur
B. Avascular necrosis of femoral head
C. Perthes’ disease
D. Transient synovitis of hip
Ans. B
Q 154. A 24-year-old male, known epileptic, presented fol1owing a seizure with pain in the right shoulder region. Examination revealed that the right upper limb was adducted and internal1y rotated and the movements could not be performed. Which of the fol1owing is the most likely diagnosis:
A. Posterior dislocation of shoulder
B. Luxatio erecta
C. Intrathoracic dislocation of shoulder
D. Subglenoid dislocation of shoulder
Ans. A
Q 155. A 30-year-old male underwent excision of the right radial head. Fol1owing surgery, the patient developed inability to extend the fingers and thumb of the right hand. He did not have any sensory deficit. Which one of the fol1owing is the most likely cause?
A. Injury to posterior interosseus nerve
B. Iatrogenic injury to common extensor origin
C. Injury to anterior interosseus nerve
D. High radial nerve palsy
Ans. A
Q 156. A 10-year-old boy presenting with a cubitus varus deformity and a history of trauma 3 months back. On clinical examination, has the preserved 3 bony point relationship of the elbow. The most probable diagnosis is:
A. Old unreduced dislocation of elbow
B. Non-union lateral condylar fracture of humerus
C. Malunited intercondylar fracture of humerus
D. Malunited supracondylar fracture of humerus
Ans. D
Q 157. Which of the following usually produces osteoblastic secondaries:
A. Carcinoma lung
B. Carcinoma breast
C. Carcinoma urinary bladder
D. Carcinoma prostate
Ans. D
Q 158. A 33-year-old man presented with a slowly progressive swelling in the middle 1/3rd of his right tibia. X-ray examination revealed multiple sharply demarcated radiolucent lesions separated by areas of dense and sclerotic bone. Microscopic examination of a biopsy specimen revealed island of epithelial cells in a fibrous stroma. Which of the following is the most probable diagnosis?
A. Adamantinoma
B. Osteofibrous dysplasia
C. Osteosarcoma
D. Fibrous cortical defect
Ans. A
OBSTETRICS & GYNAECOLOGY
Q 159. All of the following agents are used for emergency contraception, except:
A. Danazol
B. Levonorgestrel
C. Misoprostol
D. Mifepristone
Ans. C
Q 160. Emergency contraceptives are effective if administered within following period after unprotected intercourse:
A. 24 hours
B. 48 hours
C. 72 hours
D. 120 hours
Ans. C
Q 161. Minimum effective dose of ethinyl estradiol in combination oral pills is:
A. 20 µgm
B. 35 µgm
C. 50 µgm
D. 75 µgm
Ans. A
Q 162. From which of the following layers the regeneration of endometrium take place:
A. Zona basalis
B. Zona pellucidum
C. Zona compacta
D. Zona spongiosa
Ans. A
Q 163. All of the following pelvic structures support the vagina, except:
A. Perineal body
B. Pelvic diaphragm
C. Levator ani muscle
D. Infundibulopelvic ligament
Ans. D
Q 164. A case of gestational trophoblastic neoplasia is detected to have lung metastasis. She should be staged as:
A. Stage-I
B. Stage-II
C. Stage-III
D. Stage-IV
Ans. C
Q 165. All of the following are the indications for myomectomy in a case of fibroid uterus, except:
A. Associated infertility
B. Recurrent pregnancy loss
C. Pressure symptoms
D. Red degeneration
Ans. D
Q 166. All of the following are used for induction of labour, except:
A. PGF2 tablet
B. PGE1 tablet
C. PGE2 gel
D. Misoprostol
Ans. A
Q 167. In which of the following conditions, the medical treatment of ectopic pregnancy is contraindicated:
A. Sac size is 3 cm
B. Blood in pelvis is 70 ml
C. Presence of fetal heart activity
D. Previous ectopic pregnancy
Ans. C
Q 168. Which one of the following is the best drug of choice for treatment of bacterial vaginosis during pregnancy:
A. Clindamycin
B. Metronidazole
C. Erythromycin
D. Rovamycin
Ans. B
Q 169. Conservative management is contraindicated in a case of placenta previa under the following situations, except:
A. Evidence of fetal distress
B. Fetal malformations
C. Mother in a hemodynamically unstable condition
D. Women in labour
Ans. C
OPHTHALMOLOGY
Q 170. Which one of the following is not used in glaucoma:
A. Timolol
B. Physostigmine
C. Donepezil
D. Dipivefrine
Ans. C
Q 171. On performing refraction using a plane mirror on a patient who has a refractive error of –3 D sphere with –2 D cylinder at 90° from a distance of 1 metre under no cycloplegia, the reflex would be seen to move:
A. With the movement in the horizontal axis and against the movement in the vertical axis
B. With the movement in both the axes
C. Against the movement in both the axes
D. With the movement in the vertical axis and against the movement in horizontal axis
Ans. C
Q 172. A 25-year-old male gives a history of redness, pain and mild diminution of vision in one eye for past 3 days. There is also a history of low backache for the past one year. On examination there is circumcorneal congestion, cornea is clear apart from a few fine keratic precipitates on the corneal endothelium, there are 2+ cells in the anterior chamber and the intraocular pressure is within normal limits. The patient is most likely suffering from:
A. Acute attack of angle closure glaucoma
B. HLA B-27 related anterior uveitis
C. JRA associated uveitis
D. Herpetic keratitis
Ans. B
Q 173. A soft contact lens user presents to you with pain, watering, photophobia and a white spot in the centre of the cornea. What will be your initial management?
A. Start frequent antibiotic eye drops after discontinuing the contact lens
B. Pad and bandage the eye for 12 hours
C. Frequent instillation of artificial tears
D. Topical non steroidal anti inflammatory drugs (NSAIDs)
Ans. A
Q 174. A 3-year-old child presents with a right convergent squint of 6 months duration. What is the appropriate management?
A. Immediate surgical correction folIowed by amblyopia therapy
B. Proper refractive correction, amblyopia therapy followed by surgical correction
C. Prescribe spectacles and defer surgery until the child is 5 year old
D. Botulinum toxin injection followed by occlusion therapy
Ans. B
Q 175. A young man aged 30 years, presents with difficulty in vision in the left eye for the last 10 days. He is immunocompetent, a farmer by occupation, comes from a rural community and gives history of trauma to his left eye with vegetative matter 10-15 days back. On examination, there is an ulcerative lesion in the cornea, whose base has raised soft creamy infiltrate. Ulcer margin is feathery and hyphate. There are a few satellite lesions also. The most probable etiological agent is:
A. Acanthamoeba
B. Corynebacterium diphtheriae
C. Fusarium
D. Streptococcus pneumoniae
Ans. C
Q 176. A patient presented with normal eyesight and absence of direct and consensual light reflexes. Which of the following cranial nerves is suspected to be lesioned?
A. Oculomotor
B. Trochlear
C. Optic
D. Abducent
Ans. A
ENT
Q 177. All of the following cause a gray-white membrane on the tonsils, except:
A. Infectious mononucleosis
B. Ludwig’s angina
C. Streptococcal tonsillitis
D. Diphtheria
Ans. B
Q 178. A tracheostomised patient, with Portex tracheostomy tube, in the ward, developed sudden complete blockage of the tube. Which of the following is the best next step in the management:
A. Immediate removal of the tracheostomy tube
B. Suction of tube with sodium bicarbonate
C. Suction of tube with saline
D. Jet ventilation
Ans. A
Q 179. All of the following surgical procedures are used for allergic rhinitis, except:
A. Radiofrequency ablation of the inferior turbinate
B. Laser ablation of the inferior turbinate
C. Submucosal placement of silastic in inferior turbinate
D. Inferior turbinectomy
Ans. C
SKIN
Q 180. A 9-year-old boy has multiple itchy erythematosus wheals all over the body for 2 days. There is no respiratory difficulty. Which is the best treatment?
A. Antihelminthics
B. Systemic corticosteroids
C. Antihistamines
D. Adrenaline
Ans. C
Q 181. A 27-year-old patient was diagnosed to have borderline leprosy and started on multibacillary multi-drug therapy. Six weeks later, he developed pain in the nerves and redness and swelling of the skin lesions. The management of his illness should include all of the following, except:
A. Stop anti-leprosy drugs
B. Systemic corticosteroids
C. Rest to the limbs affected
D. Analgesics
Ans. A
Q 182. Rakesh, a 27-year-old boy had itchy, excoriated papules on the forehead and the exposed parts of the arms and legs for 3 years. The disease was most severe in the rainy season and improved completely in winter. The most likely diagnosis is:
A. Insect bite hypersensitivity
B. Scabies
C. Urticaria
D. Atopic dermatitis
Ans. A
Q 183. A 55-year-old male, with uncontrolled diabetes mellitus and hypertension, developed severe air- borne contact dermatitis. The most appropriate drug for his treatment would be:
A. Systemic corticosteroids
B. Thalidomide
C. Azathioprine
D. Cyclosporine
Ans. C
ANAESTHESIOLOGY
Q 184. The neuromuscular blocking action of curare is brought about by:
A. Blocking acetylcholine synthesis
B. Preventing the release of acetylcholine
C. Causing persistent depolarization
D. Competitive inhibition
Ans. D
Q 185. Which of the following local anesthetic is most likely to produce an allergic reaction:
A. Prilocaine
B. Ropivacaine
C. Etidocaine
D. Benzocaine
Ans. D
Q 186. A 6-year-old child is posted for elective urology surgery under general anesthesia. He refuses to allow the anesthesiologist an IV access. The best inhalational agent of choice for induction of anaesthesia is:
A. Sevoflurane
B. Methoxyflurane
C. Desflurane
D. Isoflurane
Ans. A
Q 187. A 70-year-old male is posted for a surgery, which is likely to last for 4-6 hours. The best inhalational agent of choice for maintenance of anaesthesia in such a case is:
A. Methoxyflurane
B. Ether
C. Trichloroethylene
D. Desflurane
Ans. D
Q 188. A 30-year-old lady is to undergo surgery under intravenous regional anaesthesia for her left ‘trigger finger’. Which of the following should not be used for this patient:
A. Lignocaine
B. Bupivacaine
C. Prilocaine
D. Lignocaine + ketorolac
Ans. B
Q 189. A 21-year-old lady with a history of hypersensitivity to neostigmine is posted for an elective caesarean section under general anesthesia. The best muscle relaxant of choice in this patient should be:
A. Pancuronium
B. Atracurium
C. Rocuronium
D. Vecuronium
Ans. B
RADIOLOGY
Q 190. For the evaluation of blunt abdominal trauma, which of the following imaging modalities is ideal?
A. Ultrasonography
B. Computed tomography
C. Nuclear scintigraphy
D. Magnetic resonance imaging
Ans. B
Q 191. Following are common features of malignant gastric ulcer on barium meal, except:
A. Location on the greater curvature
B. Carman’s meniscus sign
C. Radiating folds which do not reach the edge of the ulcer
D. Lesser curvature ulcer with a nodular rim
Ans. D
Q 192. The investigation of choice for imaging of urinary tract tuberculosis is:
A. Plain X-ray
B. Intravenous urography
C. Ultrasound
D. Computed tomography
Ans. B
Q 193. “Sunray appearance” on X-rays is suggestive of:
A. A chondrosarcoma
B. A metastatic tumour in the bone
C. An osteogenic sarcoma
D. An Ewing’s sarcoma
Ans. C
Q 194. The gold standard for the diagnosis of osteoporosis is:
A. Dual energy X-ray absorptiometry
B. Single energy X-ray absorptiometry
C. Ultrasonography
D. Quantitative computed tomography
Ans. A
Q 195. What dose of radiation therapy is recommended for pain relief in bone metastases:
A. 8 Gy in one fraction
B. 20 Gy in 5 fractions
C. 30 Gy in 10 fractions
D. Above 70 Gy
Ans. C
PSYCHIATRY
Q 196. A 23-year-old engineering student is brought by his family to the hospital with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, violent outbursts, and lack of interest in studies for 8 months. Mental status examination revealed a blunt effect, thought broadcast, a relatively preserved cognition, impaired judgement and insight. He is most likely to be suffering from:
A. Delusional disorder
B. Depression
C. Schizophrenia
D. Anxiety disorder
Ans. C
Q 197. A 34-year-old housewife reports a 3-month history of feeling low, lack of interest in activities, lethargy, multiple bodyaches, ideas of worthlessness, decreased appetite and disturbed sleep with early morning awakening. She is likely to benefit from:
A. Antipsychotics
B. Antidepressants
C. Anxiolytics
D. Hypno-sedatives
Ans. B
Q 198. A 31-year-old male, with mood disorder, on 30 mg of haloperidol and 1000 mg of lithium, is brought to the hospital emergency room with history of acute onset of fever, excessive sweating, confusion, rigidity of limbs and decreased communication for a day. Examination reveals tachycardia and labile blood pressure and investigations reveal increased CPK enzyme levels and leucocytosis. He is likely to have developed:
A. Lithium toxicity
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome
D. Hypertensive encephalopathy
Ans. C
Q 199. A 19-year-old boy suffering from chronic schizophrenia is put on haloperidol in the dose of 20 mg/day. A week after the initiation of medication, the patient shows restlessness, fidgety, irritability and cannot sit at one place. The most appropriate treatment strategy is:
A. Increase in the dose of haloperidol
B. Addition of anticholinergic drug
C. Addition of beta blocker
D. Adding another antipsychotic drug
Ans. C
Q 200. A 42-year-old male with a past history of a manic episode presents with an illness of 1-month duration characterized by depressed mood, anhedonia and profound psychomotor retardation. The most appropriate management strategy is prescribing a combination of:
A. Antipsychotics and antidepressants
B. Antidepressants and mood stabilizers
C. Antipsychotics and mood stabilizers
D. Antidepressants and benzodiazepines
Ans. B
Q 1. Meiosis occurs in human males in:
A. Epididymis
B. Seminiferous tubules
C. Vas deferens
D. Seminal vesicles
Ans. B
Q 2. The right lobe of liver consists of which of the following segments:
A. V, VI, VII and VIII
B. IV, V, VI, VII and VIII
C. I, V, VI,VII and VIII
D. I, IV, V, VI, VII and VIII
Ans. A
Q 3. A young boy who was driving motorcycle at a high speed collided with a tree & was thrown on his right shoulder. Though there was no fracture, his right arm was medially rotated and forearm pronated. The following facts concerning this patient are correct, except:
A. The injury was at Erb’s point
B. A lesion of C5 and C6 was present
C. The median and ulnar nerves were affected
D. Supraspinatus, infraspinatus, subclavius & biceps brachii were paralyzed
Ans. C
Q 4. In a vehicular accident, the musculocutaneous nerve was completely severed, but still the person was able to weakly flex the elbow joint. All of the following muscles are responsible for this flexion, except:
A. Brachioradialis
B. Flexor carpi radialis
C. Ulnar head of pronator teres
D. Flexor carpi ulnaris
Ans. C
Q 5. Which of the following nuclei belongs to the general visceral efferent column:
A. Facial nerve nucleus
B. Trigeminal nerve nucleus
C. Dorsal nucleus of vagus
D. Nucleus ambiguous
Ans. C
Q 6. Dislocation of the vertebra is uncommon in thoracic region because in this region:
A. The articular process are interlocked
B. The vertebral body is long
C. Anterior longitudinal ligament is strong
D. Spinous process is long and pointed
Ans. A
Q 7. Joint between epiphysis and diaphysis of a long bone is a type of:
A. Plane synovial joint
B. Fibrous joint
C. Symphysis
D. Synchondrosis
Ans. D
PHYSIOLOGY
Q 8. Which one of the following clearly states the role of cerebellum in motor performance:
A. Planning and programming of movement
B. Convert abstract thought into voluntary action
C. Initiation of skilled voluntary action
D. Smoothens and coordinates ongoing movements
Ans. D
Q 9. Which of the following phrase adequately describes Pacinian corpuscles:
A. A type of pain receptors
B. Slowly adapting touch receptors
C. Rapidly adapting touch receptors
D. Located in the joints
Ans. C
Q 10. Ovulation is associated with sudden rise in:
A. Prolactin
B. Testosterone
C. LH
D. Oxytocin
Ans. C
Q 11. The normal adult human electroencephalogram (EEG):
A. Will not show high frequency waves during stage 3 sleep
B. Shows alpha rhythm when a person is awake but inattentive
C. Has lower frequency waves during mental activity
D. Is predominated by large amplitude waves during REM sleep
Ans. A
Q 12. The afferent fibers which are most sensitive to local anesthetic belong to group:
A. A
B. B
C. C
D. D
Ans. C
Q 13. Lower esophageal sphincter:
A. Has no tonic activity
B. Has a tone which is provided by the sympathetic system
C. Relaxes on increasing abdominal pressure
D. Relaxes ahead of the peristaltic wave
Ans. D
Q 14. Drinking can be induced by:
A. Electrical stimulation of the posterior hypothalamus
B. Osmotic stimulation of supraoptic nucleus
C. Lesions in the paraventicular nucleus
D. Neuronal lesion of the preoptic nucleus
Ans. B
Q 15. When information memorized afterwards is interfered by the information learnt earlier, it is called:
A. Retroactive inhibition
B. Proactive inhibition
C. Simple inhibition
D. Inhibition
Ans. B
Q 16. Wedged hepatic venous pressure represents pressure in:
A. Main portal vein
B. Main hepatic vein
C. Sinusoids
D. Central vein radicles
Ans. C
Q 17. The pressure-volume curve is shifted to the left in:
A. Mitral regurgitation
B. Aortic regurgitation
C. Mitral stenosis
D. Aortic stenosis
Ans. D
Q 18. The intrafusal fibers of the striated skeletal muscles are innervated by one of the following type of motor neurons. Choose the correct answer:
A. Alpha
B. Beta
C. Gamma
D. Delta
Ans. C
Q 19. The inhibitory neurotransmitter in CNS neurons is:
A. Glutamate
B. Aspartate
C. Gamma-amino butyric acid
D. Taurine
Ans. C
Q 20. The correct sequence of cell cycle is:
A. G0-G1-S-G2-M
B. G0-G1-G2-S-M
C. G0-M-G2-S-G1
D. G0-G1-S-M-G2
Ans. A
BIOCHEMISTRY
Q 21. Misexpression of which of the following homeobox genes alters the position of the forelimbs during development:
A. HOXA7
B. HOXB8
C. HOXC9
D. HOXDI0
Ans. B
Q 22. All of the following statements about LDL are true except:
A. It delivers cholesterol to cells
B. It contains only one apoprotein
C. It is a marker for cardiovascular disease
D. It contains Apo-B4
Ans. D
Q 23. The most important source of reducing equivalents for fatty acid synthesis in the liver is:
A. Glycolysis
B. TCA cycle
C. Uronic acid pathway
D. HMP pathway
Ans. D
Q 24. Insulin increases the activities of all of the following enzymes, except:
A. Glucokinase
B. Pyruvate carboxylase
C. Glycogen synthase
D. Acetyl-CoA carboxylase
Ans. B
Q 25. Which of the following combinations of biologically active molecules does vitamin A consists of:
A. Retinol, retinal and retinoic acid
B. Retinal, retinal and tetrahydrofolate
C. Retinal, conjugase and retinoic acid
D. PABA, retinal and retinaldehyde
Ans. A
Q 26. The primary structure of a protein refers to:
A. Linear structure and order of the amino acids present
B. Regular conformational forms of a protein
C. Complete three-dimensional structure of the polypeptide units of a given protein
D. Subunit structure of the protein
Ans. A
Q 27. Excessive ultraviolet (UV) radiation is harmful to life. The damage caused to the biological systems by ultraviolet radiation I by:
A. Inhibition of DNA synthesis
B. Formation of thymidine dimers
C. Ionization
D. DNA fragmentation
Ans. B
Q 28. Biological role of metallothioneins is to sequester harmful metal ions. These bind:
A. Cd++, Cu++ & Zn++
B. AI+++, Hg++ & NH4+
C. Pt++, As+++ & PO4–
D. Fe+++, Na+ & K+
Ans. A
Q 29. Which one of the following is not true for an -helix:
A. It is one of the most important secondary structure
B. It has a net dipole moment
C. All hydrogen bonds are aligned in the same direction
D. Long stretches of left handed -helices occur in proteins
Ans. D
FORENSIC
Q 30. In each freshwater drowning the death occurs within 4-5 minutes of submersion due to ventricular fibrillation. Which of the following reasons is responsible for this?
A. Total asphyxia is produced due to fresh water
B. Laryngospasm causing vagal inhibition
C. Haemoconcentration of blood caused by the osmotic pressure effect
D. Haemodilution, overloading of heart and haemolysis resulting in release of potassium
Ans. D
Q 31. A 25 years female was found in room with 100% burns on her body. The tongue was protruding out; body was in pugilistic attitude with heat ruptures, peeling of skin, and heat haematoma and heat fractures of skull. Carboxy hemoglobin was 25% and soot particles were present in trachea. Which of the combinations of two findings will establish that the burns were antemortem in nature:
A. Heat haematoma & heat ruptures
B. Heat fracture of skull and peeling of skin
C. Heat haematoma and pugilistic attitude
D. Carboxy hemoglobin (25%) and soot particles in trachea
Ans. D
Q 32. The phenomenon of suspended animation may be seen in:
A. Throttling
B. Drowning
C. Strangulation
D. Brain hemorrhage
Ans. B
Q 33. A lady died due to unnatural death within seven years after her marriage. The inquest in this case will be done by:
A. Forensic medicine expert
B. Deputy superintendent of police
C. Sub-divisional magistrate
D. Coroner
Ans. C
Q 34. Cheiloscopy is the study of prints of:
A. Foot
B. Fingers
C. Palate
D. Lips
Ans. D
PREVENTIVE AND SOCIAL MEDICINE
Q 35. Mean hemoglobin of a sample of 100 pregnant woman was found to be 10 mg% with a standard error of 1.0 mg%. The standard error of the estimate would be:
A. 0.01
B. 0.1
C. 1.0
D. 10.0
Ans. B
Q 36. For every 1,00,000 population, the highest prevalence of blindness in the world is seen in:
A. Sub-Saharan Africa
B. South Asia
C. Eastern Europe
D. Latin America
Ans. A
Q 37. All of the following statements about plague are wrong, except:
A. Domestic rat is the main reservoir
B. Bubonic is the most common variety
C. The causative bacillus can survive up to 10 years in the soil of rodent burrows
D. The incubation period for pneumonic plague is one to two weeks
Ans. B
Q 38. National Health Policy of India-2002 includes all of the following as goals, except:
A. Eradicated polio and yaws by the year 2005
B. Achieve zero level transmission of HIV/AIDS by year 2010
C. Eliminate kala-azar by year 2005
D. Eliminate lymphatic filariasis by year 2015
Ans. C
Q 39. The incubation period of yellow fever is:
A. 3 to 6 days
B. 3-4 weeks
C. 1 to 2 weeks
D. 8-10 weeks
Ans. A
Q 40. Mode of transmission of Q fever is:
A. Bite of infected louse
B. Bite of infected tick
C. Inhalation of aerosol
D. Bite of infected mite
Ans. C
Q 41. The following are characteristic features of staphylococcal food poisoning, except:
A. Optimum temperature for toxin formation is 37°C
B. Intradietetic toxins are responsible for intestinal symptoms
C. Toxins can be destroyed by boiling for 30 minutes
D. Incubation period is 1-6 hours
Ans. C
Q 42. Which of the following is the best indicator of severity of a short duration acute disease:
A. Cause specific death rate
B. 5-year survival
C. Case fatality rate
D. Standardized mortality ratio
Ans. C
Q 43. Which of the following is the most common cause of maternal mortality in India:
A. Hemorrhage
B. Anemia
C. Abortion
D. Sepsis
Ans. A
Q 44. Which of the following is the nodal ministry for Integrated Child Development Services (ICDS) Programme Centre:
A. Ministry for Human Resource Development
B. Ministry for Rural Development
C. Ministry for Health and Family Welfare
D. Ministry for Social Justice
Ans. A
Q 45. The systematic distortion of retrospective studies that can be eliminated by a prospective design is:
A. Confounding
B. Effect modification
C. Recall bias
D. Measurement bias
Ans. C
Q 46. If we reject null hypothesis, when actually it is true, it is known as:
A. Type I error
B. Type II error
C. Power
D. Specificity
Ans. A
Q 47. If a new effective treatment is initiated and all other factors remain the same; which of the following is most likely to happen:
A. Incidence will not change
B. Prevalence will not change
C. Neither incidence nor prevalence will change
D. Incidence and prevalence will change
Ans. A
Q 48. Which one of the following relationships shown between different parameters of a performance of a test, is correct:
A. Sensitivity = 1 – specificity
B. Positive predictive value = 1 – negative predictive value
C. Sensitivity is inversely proportional to specificity
D. Sensitivity = 1 – positive predictive value
Ans. C
Q 49. A 25-year-old female has been diagnosed to be suffering from tuberculosis categorized as category I (sputum +ve relapse). The treatment regimen recommended under DOTS is:
A. 2 (HRZE)3 + 5 (HR)3
B. 2 (HRSZE)3 + (HRZE)3 + 5 (HR)3
C. 3 (HRZE)3 + 2 (HRE)3 + 4 (HR)3
D. 3 (HRSZE)3 + 1 (HRZE)3 + 6 (HRE)3
Ans. B
Q 50. Which sampling method is used in assessing immunization status of children under an immunization programme:
A. Quota sampling
B. Multi stage sampling
C. Stratified random sampling
D. Cluster sampling
Ans. D
Q 51. All of the following are true about break point chlorination, except:
A. Free chlorine is released in water after break point chlorination
B. Chlorine demand is the amount needed to kill bacteria, oxidize organic matter and neutralize ammonia
C. 1 ppm free chlorine should be present in water after break point has reached
D. Contact period of 1 hour is necessary
Ans. C
Q 52. Tablets supplied by Govt. of India contain the following amount of iron and folic acid:
A. 60 mg elemental iron + 500 µg FA
B. 100 mg elemental iron + 500 µg FA
C. 200 mg elemental iron + 1 mg FA
D. 100 mg elemental iron + 5 mg FA
Ans. B
PHARMACOLOGY
Q 53. All of the following drugs are contraindicated in patients with G-6-PD deficiency, except:
A. Cotrimoxazole
B. Furazolidine
C. Nalidixic acid
D. Ceftriaxone
Ans. D
Q 54. Which of the following is not a prodrug:
A. Enalapril
B. Oxcarbazepine
C. Chloral hydrate
D. Diazepam
Ans. D
Q 55. Which of the following antimalarial is a slow acting schizonticide:
A. Artemether
B. Mefloquine
C. Pyrimethamine
D. Quinine
Ans. C
Q 56. Thalidomide can be used in:
A. Myocardial infraction
B. Erythema nodosum leprosum
C. Wernicke’s encephalopathy
D. Epilepsy
Ans. B
Q 57. Aldosterone antagonists are not useful in the treatment of:
A. Hypertension
B. Congestive heart failure
C. Gynaecomastia
D. Hirsutism
Ans. C
Q 58. The following statements are true for therapy with lithium, except:
A. It is used in bipolar disorder
B. Thiazides are useful in treating lithium induced diabetes insipidus
C. Regular measurements of blood concentration of lithium is necessary
D. Na+ is a specific antidote for lithium intoxication.
Ans. D
Q 59. Which of the following is a fourth generation cephalosporin:
A. Ceftriaxone
B. Cefaclor
C. Cefepime
D. Cefuroxime
Ans. C
Q 60. Which of the following drug causes pseudotumour cerebri:
A. Sparfloxacin
B. Tetracycline
C. Gentamicin
D. Clofazimine
Ans. B
Q 61. Which of the following is caused by amphotericin B:
A. Hypokalemia
B. Hyperkalemia
C. Hypermagnesemia
D. Hyponatremia
Ans. A
Q 62. A patient with cancer received extreme degree of radiation toxicity. Further history revealed that the dose adjustment of a particular drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment in that patient during radiotherapy in order to prevent radiation toxicity:
A. Vincristine
B. Dactinomycin
C. Cyclophosphamide
D. 6-Mercaptopurine
Ans. B
Q 63. Following drugs are immunosuppressive drug except:
A. Cyclosporine
B. Cefaclor
C. Azathioprine
D. Steroids
Ans. B
Q 64. All of the following drugs can induce methemoglobinemia, except:
A. Nitroglycerine
B. Procaine
C. Prilocaine
D. Phenytoin
Ans. D
Q 65. Which of the following enzyme is inhibited by aminophylline:
A. Monoamine oxidase
B. Alcohol dehydrogenase
C. Cytochrome P-450
D. Phosphodiesterase
Ans. D
Q 66. Nevirapine is:
A. Protease inhibitor
B. Nucleoside reverse transcriptase inhibitor
C. Non-nucleoside reverse transcriptase inhibitor
D. Fusion inhibitor
Ans. C
Q 67. Which of the following substances is the most potent androgen:
A. Dehydroepiandrostenedione
B. Dihydrotestosterone
C. Androstenedione
D. Testosterone
Ans. B
Q 68. Women receiving tamoxifen should be periodically screened with:
A. Mammography
B. PAP smear
C. CA-125 level
D. Endometrial sampling
Ans. D
MICROBIOLOGY
Q 69. The protection against small pox by previous infection with cowpox represents:
A. Antigenic cross-reactivity
B. Antigenic specificity
C. Passive immunity
D. Innate immunity
Ans. A
Q 70. Which of the following class specific antigenic determinants of an immunoglobulin is associated with?
A. L-chain
B. H-chain
C. J-chain
D. Variable region
Ans. B
Q 71. Which of the following infestations lead to malabsorption:
A. Giardia lamblia
B. Ascaris lumbricoides
C. Necator americana
D. Ancylostoma duodenale
Ans. A
Q 72. Hepatitis C virus is a:
A. Togavirus
B. Flavivirus
C. Filovirus
D. Retrovirus
Ans. B
Q 73. A 23-year old male had unprotected sexual intercourse with a commercial sex worker.Two weeks later, he developed a painless, indurated ulcer on the glans that exuded clear serum on pressure. Inguinal lymph nodes in both groins were enlarged and not tender, The most appropriate diagnostic test is:
A. Gram’s stain of ulcer discharge
B. Dark field microscopy of ulcer discharge
C. Giemsa stain of lymph node aspirate
D. ELISA for HIV infection
Ans. B
Q 74. Which of the following is the most predominant constituent of sulfur granules of actinomycosis:
A. Organisms
B. Neutrophils and monocytes
C. Monocytes and lymphocytes
D. Eosinophils
Ans. A
Q 75. Conjugate vaccines are available for the prevention of invasive disease caused by all of the following bacteria, except:
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Neisseria meningitidis (group C)
D. Neisseria meningitidis (group B)
Ans. D
Q 76. A clinical specimen was obtained from the wound of a patient diagnosed as nocardiosis. For the selective isolation of Nocardia sp., which one of the following would be the best method:
A. Paraffin bait technique
B. Castaneda’s culture method
C. Craige’s tube method
D. Hair bait technique
Ans. A
Q 77. Anti-tubercular drug susceptibility can be done by all of the following methods, except:
A. Resistance ratio method
B. Disc diffusion method
C. Molecular method
D. Radiometric broth method
Ans. B
PATHOLOGY
Q 78. Which of the following is the most likely inheritance pattern in the pedigree given below:
A. Autosomal dominant
B. Mitochondrial
C. Autosomal recessive
D. X-linked dominant
Ans. C
Q 79. If both husband and wife are suffering with achondroplasia, what are their chances of having a normal child:
A. 0%
B. 25%
C. 50%
D. 100%
Ans. B
Q 80. In which of the following conditions, aniridia and hemihypertrophy are most likely present:
A. Neuroblastoma
B. Wilms’ tumour
C. Non-Hodgkin’s lymphoma
D. Germ cell tumour
Ans. B
Q 81. In the mitogen activated protein kinase pathway, the activation of RAS is counteracted by:
A. Protein kinase C
B. GTPase activating protein
C. Phosphatidyl inositol
D. Inositol triphosphate
Ans. B
Q 82. Wire loop lesions are often characteristic for the following class of lupus nephritis:
A. Mesangial proliferative glomerulonephritis(WHO class II)
B. Focal proliferative glomerulonephritis (WHO class III)
C. Diffuse proliferative glomerulonephritis (WHO class IV)
D. Membranous glomerulonephritis (WHO class V)
Ans. C
Q 83. Which of the following would be the best morphological feature to distinguish ulcerative colitis from Crohn’s disease:
A. Diffuse distribution of pseudopolyps
B. Mucosal edema
C. Crypt abscesses
D. Lymphoid aggregates in the mucosa
Ans. A
Q 84. In chronic viral hepatitis:
A. Hepatitis A virus infection is a common cause in children
B. Morphological classification into chronic active hepatitis and chronic persistent hepatitis are important
C. Fatty change is pathognomic of hepatitis C virus infection
D. Grading refers to the extent of necrosis and inflammation
Ans. D
Q 85. Mesangial deposits of monoclonal kappa/lambda light chains is indicative of:
A. Mesangioproliferative glomerulonephritis
B. Focal and segmental glomerulosclerosis
C. Kimmelsteil-Wilson lesions
D. Amyloidosis
Ans. D
Q 86. In a patient with acute leukemia, immunophenotype pattern is CD 19 +ve, CD 10 +ve, CD33 +ve, CD 13 +ve. He may probably have:
A. Biphenotypic leukemia
B. ALL
C. AML-M2
D. AML-M0
Ans. A
Q 87. A patient with cirrhosis of liver has the following coagulation parameters – platelet count 2,00,000, prothrombin time 25s/12s, activated partial thromboplastin time 60s/35s, thrombin time 15s/15s. In this patient:
A. D-dimer will be normal
B. Fibrinogen will be < 100 mg
C. AT III will be high
D. Protein C will be elevated
Ans. A
Q 88. The liver biopsy in acute hepatitis due to hepatitis B virus is likely to show all of the following, except:
A. Ballooning change of hepatocytes
B. Ground glass hepatocytes
C. Focal or spotty necrosis
D. Acidophil bodies
Ans. B
Q 89. In renal disease, albumin is first to appear in urine because:
A. Of its high concentration in plasma
B. Has molecular weight slightly greater than the molecules normally getting filtered
C. High albumin:globulin ratio
D. Tubular epithelial cells are sensitive to albumin
Ans. B
Q 90. Which of the following tumours have an increased elevation of placental alkaline phosphatase in the serum as well as a positive immunohistochemical staining for placental alkaline phosphatase:
A. Seminoma
B. Hepatoblastoma
C. Hepatocellular carcinoma
D. Peripheral neuroectodermal tumour
Ans. A
Q 91. A baby girl with ambiguous genitalia is found to have 21-hydroxylase deficiency of the salt-wasting type. Which of the following karyotypes would you expect to find:
A. 46, XX
B. 46, XY
C. 47, XXY
D. 47, XYY
Ans. A
Q 92. Troponin-T is a marker of:
A. Renal diseases
B. Muscular dystrophy
C. Cirrhosis of liver
D. Myocardial infarction
Ans. D
MEDICINE
Q 93. All of the following conditions are known to cause diabetes insipidus. except:
A. Multiple sclerosis
B. Head injury
C. Histiocytosis
D. Viral encephalitis
Ans. A
Q 94. Raised serum amylase levels are used to diagnose:
A. Autoimmune disease
B. Degenerative diseases
C. Acute cholecystitis
D. Acute pancreatitis
Ans. D
Q 95. Which one of the followin is a cause for “restrictive cardiomyopathy”:
A. Alcohol
B. Hemochromatosis
C. Amyloidosis
D. Sarcoidosis
Ans. C
Q 96. Which of the following lesions is associated with HIV infection:
A. Hairy leukoplakia
B. Erythroplakia
C. Oral lichen planus
D. Bullous pemphigoid
Ans. A
Q 97. A 59-year-old male came with Hb 18.0 gm/dl on three occasions. The resident doctor wants to exclude polycythemia vera. Which of the following is the most relevant investigation:
A. Hematocrit
B. Total leukocyte count
C. Red cell mass
D. Reticulocyte count
Ans. C
Q 98. A 32-year-old female, asymptomatic, not requiring blood transfusion, presents with Hb 13.0 gm/dl. Her HbF levels are 95%, Hb A2 1.5%. Which of the following is the most likely diagnosis:
A. Hereditary persistence of fetal hemoglobin
B. Beta homozygous thalassemia
C. Thalassemia intermedia
D. Beta heterozygous thalassemia
Ans. A
Q 99. Huntington’s disease is due to the loss of:
A. Nigrostriatal dopaminergic neurons
B. Intrastriatal cholinergic neurons
C. Intrastriatal GABAergic neurons
D. Intrastriatal cholinergic and GABAergic neurons
Ans. D
Q 100. Lesion in which of the following structure leads to Kluver-Bucy syndrome:
A. Amygdala
B. Hippocampus
C. Hypothalamus
D. Temporal lobe
Ans. A
Q 101. A 25-year-old man presented with fever and cough for two months. CT chest showed bilateral upper lobe fibrosis and mediastinal enlarged necrotic nodes with peripheral rim enhancement. What is the most likely diagnosis:
A. Sarcoidosis
B. Tuberculosis
C. Lymphoma
D. Silicosis
Ans. B
Q 102. Which one of the following statements is wrong regarding adult polycystic kidney disease:
A. Kidneys are enlarged in size
B. The presentation is unilateral
C. Intracranial aneurysms may be associated
D. Typically manifests in the 3rd decade
Ans. B
Q 103. Angiographically, the typical “beaded” or “pile of plates” appearance involving the internal carotid artery is seen in:
A. Takayasu’s disease
B. Non-specific aorto-arteritis
C. Fibromuscular dysplasia
D. Rendu-Osler-Weber disease
Ans. C
Q 104. Carcinoid syndrome produces valvular disease primarily of the:
A. Venous valves
B. Tricuspid valve
C. Mitral valve
D. Aortic valve
Ans. B
Q 105. Carcinoid tumour is most common in:
A. Esophagus
B. Stomach
C. Jejunum
D. Appendix
Ans. D
Q 106. Most common cause of subarachnoid hemorrhage is:
A. Hypertension
B. Aneurysm
C. Arterio-venous malformation
D. Bleeding disorders
Ans. B
Q 107. Subdural haematoma most commonly results from:
A. Rupture of intracranial aneurysm
B. Rupture of cerebral AV malformation
C. Injury to cortical bridging veins
D. Hemophilia
Ans. C
Q 108. What would be the first line of treatment in a patient who develops ventricular fibrillation after intravenous injection of potassium chloride
A. Cardiac massage
B. IV adrenaline
C. Defibrillation
D. IPPV
Ans. C
Q 109. After contrast media injection in the radiology department, a patient develops severe hypotension, bronchospasm and cyanosis. Which one of the following drugs should be used for treatment:
A. Atropine
B. Aminophylline
C. Dopamine
D. Adrenaline
Ans. D
Q 110. A 30-year-old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side. On examination, BP was 160/140 mmHg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed Hb 12 gm%, TLC 12,000 per cumm, platelets 4,30,000 and ESR 49 mm. Urine examination showed proteinuria and RBC 10-15/hpf with no casts. What is the most likely diagnosis:
A. Polyarteritis nodosa
B. Systemic lupus erythematosus
C. Wegener’s granulomatosis
D. Mixed cryoglobulinemia
Ans. A
Q 111. A 23-year-old college student has asymptomatic and hyperpigmented macules on both palms for three weeks. The most appropriate diagnostic test is:
A. Venereal Diseases Research Laboratory (VDRL) test
B. Skin biopsy
C. Serum cortisol levels
D. Assay for arsenic in hair, skin and nails
Ans. A
Q 112. A 42-year-old engineer developed redness of the glans and radial fissuring of the prepuce 2 weeks ago. A potassium hydroxide preparation of scrapings from the glans showed pseudohyphae and buds. Which one of the following systemic illness should he be screened for:
A. Pulmonary tuberculosis
B. Diabetes mellitus
C. Systemic candidiasis
D. Chronic renal failure
Ans. B
Q 113. All of the following are the electrocardiographic features of hyperkalemia, except:
A. Prolonged PR interval
B. Prolonged QT interval
C. Sine wave patterns
D. Loss of P waves
Ans. B
Q 114. A patient with acute inferior wall myocardial infarction has developed shock. Which of the following is the most likely cause of shock:
A. Cardiac rupture
B. Interventricular septal perforation
C. Papillary muscle rupture
D. Right ventricular infarction
Ans. D
Q 115. Which one of the following cardiac lesions is at highest risk of occurrence of infective endocarditis:
A. Atrial septal defect
B. Mitral valve prolapse without regurgitation
C. Valvular aortic regurgitation
D. Mitral stenosis
Ans. C
Q 116. All of the following drugs are used in the management of acute myocardial infarction, except:
A. Tissue plasminogen activator
B. Intravenous beta blockers
C. Acetylsalicylic acid
D. Calcium channel blockers
Ans. D
Q 117. The most common cause of sporadic viral encephalitis is:
A. Japanese B encephalitis
B. Herpes simplex encephalitis
C. Human immunodeficiency virus encephalitis
D. Rubeola encephalitis
Ans. B
Q 118. The only thrombolytic agent approved for the treatment of acute ischemic stroke is:
A. Tissue plasminogen activator
B. Streptokinase
C. Urokinase
D. Pro-urokinase
Ans. A
Q 119. All of the following are neurologic channelopathies, except:
A. Hypokalemic periodic paralysis
B. Episodic ataxias
C. Familial hemiplegic migraine
D. Huntington’s disease
Ans. D
Q 120. A 35-year-old male patient presented with history of jaundice for 15 days. The onset was preceded by a prodromal illness. His serum tested positive for HBsAg. A clinical diagnosis of acute hepatitis B was made. What should be the next best confirmatory investigation:
A. Anti-HBeAg antibody
B. HBe antigen
C. Anti-HBe IgM antibody
D. HBV DNA by PCR
Ans. D
Q 121. A 20-year-old female presents with history of dyspnoea on exertion. On examination, she has wide, fixed split of S2 with ejection systolic murmur (III/VI) in left second intercostal space. Her EKG shows left axis deviation. The most probable diagnosis is:
A. Total anomalous pulmonary venous connection
B. Tricuspid atresia
C. Ostium primum atrial septal defect
D. Tetralogy of Fallot
Ans. C
Q 122. In a patient with chronic congestive cardiac failure, all of the following drugs prolong survival, except:
A. Metoprolol
B. Carvedilol
C. Enalapril
D. Digoxin
Ans. D
Q 123. All of the following are features of juvenile myoclonic epilepsy, except:
A. Myoclonus on awakening
B. Generalized tonic-clonic seizures
C. Automatism
D. Absence seizures
Ans. C
Q 124. All of the following statements about Creutzfeldt-Jakob disease are true, except:
A. It is a neurodegenerative disease
B. It is caused by infectious proteins
C. Myoclonus is rarely seen
D. Brain biopsy is specific for diagnosis
Ans. C
Q 125. All of the following statements about Wilson’s disease are true, except:
A. It is an autosomal recessive disorder
B. Serum ceruloplasmin level is < 20 mg/dl
C. Urinary copper excretion is < 100 µg/day
D. Zinc acetate is effective as maintenance therapy
Ans. C
PAEDIATRICS
Q 126. A 2-year-old boy has vitamin D resistant rickets. His investigations revealed serum calcium 9 mg/dl, phosphate 2.4 mg/dl, alkaline phosphatase 1041 IU, normal intact parathyroid hormone and bicarbonate 22 mEq/L. Which of the following is the most probable diagnosis?
A. Distal renal tubular acidosis
B. Hypophosphatemic rickets
C. Vitamin D dependent rickets
D. Hypoparathyroidism
Ans. B
Q 127. The renal biopsy of a 6-year-old boy with recurrent gross hematuria shows IgA nephropathy. The urinary protein excretion is 130 mg/day. Which of the following is the most appropriate next step in the management:
A. Administer corticosteroids
B. Give azathioprine
C. Start cyclosporine
D. Urinary bag sample
Ans. A
Q 128. Which of the following is the most appropriate method for obtaining a urine specimen for culture in an 8 month old girl:
A. Suprapubic aspiration
B. Indwelling catheter sample
C. Clean catch void
D. Urinary bag sample
Ans. A
Q 129. An 8 year old boy during a routine check up is found to have E. coli 1,00,000 cc/ml on a urine culture. The urine specimen was obtained by midstream clean-catch void. The child is asymptomatic. Which is the most appropriate next step in the management:
A. Treat as an acute episode of urinary tract infection
B. No therapy
C. Prophylactic antibiotics for 6 months
D. Administer long term urine alkalinizer
Ans. A
Q 130. A 2-year-old child comes with discharge, seborrheic dermatitis, polyuria and hepatosplenomegaly. Which of the following is the most likely diagnosis:
A. Leukemia
B. Lymphoma
C. Langerhan’s cell histiocytosis
D. Germ cell tumour
Ans. C
Q 131. Injection glucagon is effective for management of persistent hypoglycemia in all, except:
A. Large for date baby
B. Galactosemia
C. Infant of diabetic mother
D. Nesidioblastosis
Ans. B
Q 132. The most appropriate management for maintaining patency of ductus arteriosus in a neonate is:
A. Prostaglandin E1
B. Oxygen
C. Nitric oxide
D. Indomethacin
Ans. A
Q 133. Congenital hypertrophic pyloric stenosis usually presents:
A. Within 2 days after birth
B. Around 1 week after birth
C. Around 2 weeks after birth
D. Around 2 months after birth
Ans. C
Q 134. ‘Weak giants’ are produced by:
A. Thyroid adenomas
B. Thyroid carcinomas
C. Parathyroid adenomas
D. Pituitary adenomas
Ans. D
Q 135. Vesicoureteric reflux is more common in:
A. Newborn females
B. Older girls
C. Older boys
D. Only during pregnancy
Ans. A
Q 136. Bag and mask ventilation is contraindicated in:
A. Cleft lip
B. Meconium aspiration
C. Diaphragmatic hernia
D. Multicentric bronchogenic cyst
Ans. C
Q 137. A 3-month-old male infant developed otitis media for which he was given a course of cotrimoxazole. A few days later, he developed extensive peeling of the skin; there were no mucosal lesions and the baby was not toxic. The most likely diagnosis is:
A. Toxic epidermal necrolysis
B. Staphylococcal scalded skin syndrome
C. Stevens Johnson syndrome
D. Infantile pemphigus
Ans. B
Q 138. A neonate develops signs of meningitis at seven days of birth. The presence of which of the following infectious agent in the maternal genital tract can be the causative agent of this disease:
A. Neisseria gonorrhoeae
B. Chlamydia trachomatis
C. Streptococcus agalactiae
D. Haemophilous ducreyi
Ans. C
SURGERY
Q 139. A 65-year-old smoker presents with hoarseness, hemoptysis and a hard painless lump in the left supraclavicular fossa. Which of the following is the most appropriate diagnostic step:
A. Undertake an open biopsy of the neck lump
B. Undertake a radical neck dissection
C. Do fine needle aspiration cytology
D. Give a trial of anti tuberculous therapy
Ans. A
Q 140. During surgery of hernia, the sac of a strangulated inguinal hernia should be opened at the:
A. Neck
B. Body
C. Fundus
D. Deep ring
Ans. C
Q 141. The most common site of a benign (peptic) gastric ulcer is:
A. Upper third of lesser curvature
B. Greater curvature
C. Pyloric antrum
D. Lesser curvature near incisura angularis
Ans. D
Q 142. Which of the following is the most common endocrine tumour of pancreas:
A. Insulinoma
B. Gastrinoma
C. VIPoma
D. Glucagonoma
Ans. A
Q 143. Cock’s peculiar tumour is:
A. An infected sebaceous cyst
B. A malignant tumour of the scalp
C. A metastatic lesion of the scalp
D. An indicator of underlying osteomyelitis
Ans. A
Q 144. A 43-year-old lady presents with a 5 cm lump in right breast with a 3 cm node in the supraclavicular fossa. Which of the following TNM stage she belongs to as per the latest AJCC staging system:
A. T2N0M1
B. T1N0M1
C. T2N3M0
D. T2N2M0
Ans. C
Q 145. Which of the following statements about the Holmium:YAG laser is incorrect:
A. It has a wavelength of 2100 nm
B. Its use for uric acid stones has caused deaths due to generation of cyanide
C. It is effective against the hardest urinary stones
D. It can even cut the wire of stone baskets
Ans. B
Q 146. Which of the following liver tumour has a propensity to invade the portal or hepatic vein:
A. Cavernous hemangioma
B. Hepatocellular carcinoma
C. Focal nodular hyperplasia
D. Hepatic adenoma
Ans. B
Q 147. The treatment of choice for a mucocele of gall bladder is:
A. Aspiration of mucous
B. Cholecystectomy
C. Cholecystostomy
D. Antibiotics and observation
Ans. B
Q 148. Virchow’s triad includes all of the following, except:
A. Venous stasis
B. Injury to veins
C. Blood hypercoagulability
D. Venous thrombosis
Ans. B
Q 149. The most common cause of superficial thrombophlebitis is:
A. Trauma
B. Infection
C. Varicosities
D. Intravenous infusion
Ans. D
Q 150. A man is rushed to casualty, nearly dying after a massive blood loss in an accident. There is not much time to match blood groups, so the physician decides to order for one of the following blood groups. Which one of the following blood groups should the physician decide:
A. O negative
B. O positive
C. AB positive
D. AB negative
Ans. A
Q 151. All of the following are risk factors for carcinoma gal1 bladder, except:
A. Typhoid carriers
B. Adenomatous gall bladder polyps
C. Choledochal cysts
D. Oral contraceptives
Ans. D
ORTHOPAEDICS
Q 152. A 44-year-old man presented with acute onset of low backache radiating to the right lower limb. Examination revealed SLRT < 40° on the right side, weakness of extensor hallucis longus on the right side, sensory loss in the first web space of the right foot and brisk knee jerk. Which of the fol1owing is the most likely diagnosis:
A. Prolapsed intervertebral disc L4-5
B. Spondylolysis L5-S1
C. Lumbar canal stenosis
D. Spondylolisthesis L4-5
Ans. A
Q 153. A woman of 45, a known cause of pemphigus vulgaris on a regular treatment with control1ed primary disease presented with pain in the right hip and knee. Examination revealed no limb length discrepancy but the patient has tenderness in the Scarpa’s triangle and limitation of adduction and internal rotation of the right hip joint as compared to the other side. The most probable diagnosis is:
A. Stress fracture of neck of femur
B. Avascular necrosis of femoral head
C. Perthes’ disease
D. Transient synovitis of hip
Ans. B
Q 154. A 24-year-old male, known epileptic, presented fol1owing a seizure with pain in the right shoulder region. Examination revealed that the right upper limb was adducted and internal1y rotated and the movements could not be performed. Which of the fol1owing is the most likely diagnosis:
A. Posterior dislocation of shoulder
B. Luxatio erecta
C. Intrathoracic dislocation of shoulder
D. Subglenoid dislocation of shoulder
Ans. A
Q 155. A 30-year-old male underwent excision of the right radial head. Fol1owing surgery, the patient developed inability to extend the fingers and thumb of the right hand. He did not have any sensory deficit. Which one of the fol1owing is the most likely cause?
A. Injury to posterior interosseus nerve
B. Iatrogenic injury to common extensor origin
C. Injury to anterior interosseus nerve
D. High radial nerve palsy
Ans. A
Q 156. A 10-year-old boy presenting with a cubitus varus deformity and a history of trauma 3 months back. On clinical examination, has the preserved 3 bony point relationship of the elbow. The most probable diagnosis is:
A. Old unreduced dislocation of elbow
B. Non-union lateral condylar fracture of humerus
C. Malunited intercondylar fracture of humerus
D. Malunited supracondylar fracture of humerus
Ans. D
Q 157. Which of the following usually produces osteoblastic secondaries:
A. Carcinoma lung
B. Carcinoma breast
C. Carcinoma urinary bladder
D. Carcinoma prostate
Ans. D
Q 158. A 33-year-old man presented with a slowly progressive swelling in the middle 1/3rd of his right tibia. X-ray examination revealed multiple sharply demarcated radiolucent lesions separated by areas of dense and sclerotic bone. Microscopic examination of a biopsy specimen revealed island of epithelial cells in a fibrous stroma. Which of the following is the most probable diagnosis?
A. Adamantinoma
B. Osteofibrous dysplasia
C. Osteosarcoma
D. Fibrous cortical defect
Ans. A
OBSTETRICS & GYNAECOLOGY
Q 159. All of the following agents are used for emergency contraception, except:
A. Danazol
B. Levonorgestrel
C. Misoprostol
D. Mifepristone
Ans. C
Q 160. Emergency contraceptives are effective if administered within following period after unprotected intercourse:
A. 24 hours
B. 48 hours
C. 72 hours
D. 120 hours
Ans. C
Q 161. Minimum effective dose of ethinyl estradiol in combination oral pills is:
A. 20 µgm
B. 35 µgm
C. 50 µgm
D. 75 µgm
Ans. A
Q 162. From which of the following layers the regeneration of endometrium take place:
A. Zona basalis
B. Zona pellucidum
C. Zona compacta
D. Zona spongiosa
Ans. A
Q 163. All of the following pelvic structures support the vagina, except:
A. Perineal body
B. Pelvic diaphragm
C. Levator ani muscle
D. Infundibulopelvic ligament
Ans. D
Q 164. A case of gestational trophoblastic neoplasia is detected to have lung metastasis. She should be staged as:
A. Stage-I
B. Stage-II
C. Stage-III
D. Stage-IV
Ans. C
Q 165. All of the following are the indications for myomectomy in a case of fibroid uterus, except:
A. Associated infertility
B. Recurrent pregnancy loss
C. Pressure symptoms
D. Red degeneration
Ans. D
Q 166. All of the following are used for induction of labour, except:
A. PGF2 tablet
B. PGE1 tablet
C. PGE2 gel
D. Misoprostol
Ans. A
Q 167. In which of the following conditions, the medical treatment of ectopic pregnancy is contraindicated:
A. Sac size is 3 cm
B. Blood in pelvis is 70 ml
C. Presence of fetal heart activity
D. Previous ectopic pregnancy
Ans. C
Q 168. Which one of the following is the best drug of choice for treatment of bacterial vaginosis during pregnancy:
A. Clindamycin
B. Metronidazole
C. Erythromycin
D. Rovamycin
Ans. B
Q 169. Conservative management is contraindicated in a case of placenta previa under the following situations, except:
A. Evidence of fetal distress
B. Fetal malformations
C. Mother in a hemodynamically unstable condition
D. Women in labour
Ans. C
OPHTHALMOLOGY
Q 170. Which one of the following is not used in glaucoma:
A. Timolol
B. Physostigmine
C. Donepezil
D. Dipivefrine
Ans. C
Q 171. On performing refraction using a plane mirror on a patient who has a refractive error of –3 D sphere with –2 D cylinder at 90° from a distance of 1 metre under no cycloplegia, the reflex would be seen to move:
A. With the movement in the horizontal axis and against the movement in the vertical axis
B. With the movement in both the axes
C. Against the movement in both the axes
D. With the movement in the vertical axis and against the movement in horizontal axis
Ans. C
Q 172. A 25-year-old male gives a history of redness, pain and mild diminution of vision in one eye for past 3 days. There is also a history of low backache for the past one year. On examination there is circumcorneal congestion, cornea is clear apart from a few fine keratic precipitates on the corneal endothelium, there are 2+ cells in the anterior chamber and the intraocular pressure is within normal limits. The patient is most likely suffering from:
A. Acute attack of angle closure glaucoma
B. HLA B-27 related anterior uveitis
C. JRA associated uveitis
D. Herpetic keratitis
Ans. B
Q 173. A soft contact lens user presents to you with pain, watering, photophobia and a white spot in the centre of the cornea. What will be your initial management?
A. Start frequent antibiotic eye drops after discontinuing the contact lens
B. Pad and bandage the eye for 12 hours
C. Frequent instillation of artificial tears
D. Topical non steroidal anti inflammatory drugs (NSAIDs)
Ans. A
Q 174. A 3-year-old child presents with a right convergent squint of 6 months duration. What is the appropriate management?
A. Immediate surgical correction folIowed by amblyopia therapy
B. Proper refractive correction, amblyopia therapy followed by surgical correction
C. Prescribe spectacles and defer surgery until the child is 5 year old
D. Botulinum toxin injection followed by occlusion therapy
Ans. B
Q 175. A young man aged 30 years, presents with difficulty in vision in the left eye for the last 10 days. He is immunocompetent, a farmer by occupation, comes from a rural community and gives history of trauma to his left eye with vegetative matter 10-15 days back. On examination, there is an ulcerative lesion in the cornea, whose base has raised soft creamy infiltrate. Ulcer margin is feathery and hyphate. There are a few satellite lesions also. The most probable etiological agent is:
A. Acanthamoeba
B. Corynebacterium diphtheriae
C. Fusarium
D. Streptococcus pneumoniae
Ans. C
Q 176. A patient presented with normal eyesight and absence of direct and consensual light reflexes. Which of the following cranial nerves is suspected to be lesioned?
A. Oculomotor
B. Trochlear
C. Optic
D. Abducent
Ans. A
ENT
Q 177. All of the following cause a gray-white membrane on the tonsils, except:
A. Infectious mononucleosis
B. Ludwig’s angina
C. Streptococcal tonsillitis
D. Diphtheria
Ans. B
Q 178. A tracheostomised patient, with Portex tracheostomy tube, in the ward, developed sudden complete blockage of the tube. Which of the following is the best next step in the management:
A. Immediate removal of the tracheostomy tube
B. Suction of tube with sodium bicarbonate
C. Suction of tube with saline
D. Jet ventilation
Ans. A
Q 179. All of the following surgical procedures are used for allergic rhinitis, except:
A. Radiofrequency ablation of the inferior turbinate
B. Laser ablation of the inferior turbinate
C. Submucosal placement of silastic in inferior turbinate
D. Inferior turbinectomy
Ans. C
SKIN
Q 180. A 9-year-old boy has multiple itchy erythematosus wheals all over the body for 2 days. There is no respiratory difficulty. Which is the best treatment?
A. Antihelminthics
B. Systemic corticosteroids
C. Antihistamines
D. Adrenaline
Ans. C
Q 181. A 27-year-old patient was diagnosed to have borderline leprosy and started on multibacillary multi-drug therapy. Six weeks later, he developed pain in the nerves and redness and swelling of the skin lesions. The management of his illness should include all of the following, except:
A. Stop anti-leprosy drugs
B. Systemic corticosteroids
C. Rest to the limbs affected
D. Analgesics
Ans. A
Q 182. Rakesh, a 27-year-old boy had itchy, excoriated papules on the forehead and the exposed parts of the arms and legs for 3 years. The disease was most severe in the rainy season and improved completely in winter. The most likely diagnosis is:
A. Insect bite hypersensitivity
B. Scabies
C. Urticaria
D. Atopic dermatitis
Ans. A
Q 183. A 55-year-old male, with uncontrolled diabetes mellitus and hypertension, developed severe air- borne contact dermatitis. The most appropriate drug for his treatment would be:
A. Systemic corticosteroids
B. Thalidomide
C. Azathioprine
D. Cyclosporine
Ans. C
ANAESTHESIOLOGY
Q 184. The neuromuscular blocking action of curare is brought about by:
A. Blocking acetylcholine synthesis
B. Preventing the release of acetylcholine
C. Causing persistent depolarization
D. Competitive inhibition
Ans. D
Q 185. Which of the following local anesthetic is most likely to produce an allergic reaction:
A. Prilocaine
B. Ropivacaine
C. Etidocaine
D. Benzocaine
Ans. D
Q 186. A 6-year-old child is posted for elective urology surgery under general anesthesia. He refuses to allow the anesthesiologist an IV access. The best inhalational agent of choice for induction of anaesthesia is:
A. Sevoflurane
B. Methoxyflurane
C. Desflurane
D. Isoflurane
Ans. A
Q 187. A 70-year-old male is posted for a surgery, which is likely to last for 4-6 hours. The best inhalational agent of choice for maintenance of anaesthesia in such a case is:
A. Methoxyflurane
B. Ether
C. Trichloroethylene
D. Desflurane
Ans. D
Q 188. A 30-year-old lady is to undergo surgery under intravenous regional anaesthesia for her left ‘trigger finger’. Which of the following should not be used for this patient:
A. Lignocaine
B. Bupivacaine
C. Prilocaine
D. Lignocaine + ketorolac
Ans. B
Q 189. A 21-year-old lady with a history of hypersensitivity to neostigmine is posted for an elective caesarean section under general anesthesia. The best muscle relaxant of choice in this patient should be:
A. Pancuronium
B. Atracurium
C. Rocuronium
D. Vecuronium
Ans. B
RADIOLOGY
Q 190. For the evaluation of blunt abdominal trauma, which of the following imaging modalities is ideal?
A. Ultrasonography
B. Computed tomography
C. Nuclear scintigraphy
D. Magnetic resonance imaging
Ans. B
Q 191. Following are common features of malignant gastric ulcer on barium meal, except:
A. Location on the greater curvature
B. Carman’s meniscus sign
C. Radiating folds which do not reach the edge of the ulcer
D. Lesser curvature ulcer with a nodular rim
Ans. D
Q 192. The investigation of choice for imaging of urinary tract tuberculosis is:
A. Plain X-ray
B. Intravenous urography
C. Ultrasound
D. Computed tomography
Ans. B
Q 193. “Sunray appearance” on X-rays is suggestive of:
A. A chondrosarcoma
B. A metastatic tumour in the bone
C. An osteogenic sarcoma
D. An Ewing’s sarcoma
Ans. C
Q 194. The gold standard for the diagnosis of osteoporosis is:
A. Dual energy X-ray absorptiometry
B. Single energy X-ray absorptiometry
C. Ultrasonography
D. Quantitative computed tomography
Ans. A
Q 195. What dose of radiation therapy is recommended for pain relief in bone metastases:
A. 8 Gy in one fraction
B. 20 Gy in 5 fractions
C. 30 Gy in 10 fractions
D. Above 70 Gy
Ans. C
PSYCHIATRY
Q 196. A 23-year-old engineering student is brought by his family to the hospital with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, violent outbursts, and lack of interest in studies for 8 months. Mental status examination revealed a blunt effect, thought broadcast, a relatively preserved cognition, impaired judgement and insight. He is most likely to be suffering from:
A. Delusional disorder
B. Depression
C. Schizophrenia
D. Anxiety disorder
Ans. C
Q 197. A 34-year-old housewife reports a 3-month history of feeling low, lack of interest in activities, lethargy, multiple bodyaches, ideas of worthlessness, decreased appetite and disturbed sleep with early morning awakening. She is likely to benefit from:
A. Antipsychotics
B. Antidepressants
C. Anxiolytics
D. Hypno-sedatives
Ans. B
Q 198. A 31-year-old male, with mood disorder, on 30 mg of haloperidol and 1000 mg of lithium, is brought to the hospital emergency room with history of acute onset of fever, excessive sweating, confusion, rigidity of limbs and decreased communication for a day. Examination reveals tachycardia and labile blood pressure and investigations reveal increased CPK enzyme levels and leucocytosis. He is likely to have developed:
A. Lithium toxicity
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome
D. Hypertensive encephalopathy
Ans. C
Q 199. A 19-year-old boy suffering from chronic schizophrenia is put on haloperidol in the dose of 20 mg/day. A week after the initiation of medication, the patient shows restlessness, fidgety, irritability and cannot sit at one place. The most appropriate treatment strategy is:
A. Increase in the dose of haloperidol
B. Addition of anticholinergic drug
C. Addition of beta blocker
D. Adding another antipsychotic drug
Ans. C
Q 200. A 42-year-old male with a past history of a manic episode presents with an illness of 1-month duration characterized by depressed mood, anhedonia and profound psychomotor retardation. The most appropriate management strategy is prescribing a combination of:
A. Antipsychotics and antidepressants
B. Antidepressants and mood stabilizers
C. Antipsychotics and mood stabilizers
D. Antidepressants and benzodiazepines
Ans. B
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