Primary stimulus for respiratory center is?
A. Increase in PCO2
B. Decrease in PCO2
C. Decrease in PO2
D. Increase in H+
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Which among the following is a tumour marker of GIST?
A. Cd34
B. Cd 117
C. ??
D. ??
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Treatment of medullary carcinoma thyroid is:
A. Surgery only
B. Radioiodine therapy
C. ??
D. ??
Please contribute to the discussion by posti
Side effects of tamoxifen are all except:
A. Thrombosis
B. Endometrial carcinoma
C. Carcinoma in contralateral breast
D. ??
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In a patient who dies 4 days after a myocardial infarction, histopathology will show?
A. Neutrophil infiltration
B. Granulation tissue
C. Granulomatous inflammation
D. Coagulative necrosis
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Non stress test was done in a 36-38 week fetus was non reactive. What is the next step?
A. Do a biophysical profile
B. Repeat NST after an hour
C. Induction of labor
D. Caesarean section
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True statement regarding the vasomotor centre is?
A. Interacts with cardiovagal center
B. Receives input from higher centres
C. Only responds to arterial baroreceptors, not to chemoreceptors
D. Is in resting phase during sleep
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12 yr female with 3+proteinuria, lipiduria and hyaline casts but no hematuria. Which of the following is true?
A. Low c3 levels expected
B. No deposits of IgG and c3
C. Nephritic syndrome
D. IgA nephropathy
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Female child with linear verrucuous plaque and vacuolation of keratinocytes in granulosa and spinosum. What is the diagnosis?
A. Linear darriers
B. Linear verrucuous hyperkeratosis
C. ?? nevus
D. ??
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Drugs not used in pregnancy are all except?
A. Angiotensin converting enzyme inhibitors
B. Angiotensin receptor blockers
C. Aldosterone
D. Propylthiouracil
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What is the mode of treatment for a 2 cm sized papillary carcinoma thyroid in left lobe?
A. Total thyroidectomy + radical LN neck dissection
B. Near total thyroidectomy + radical LN neck dissection
C. Only total thyroidectomy
D. Left hemithyroidectomy
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A patient with clinically significant diabetic macular edema with non progressive diabetic retinopathy was treated with Macular grid photocoagulation. The patient still has vitreo macular traction. What is the preferred treatment?
A. Intravitreal bevacizumab
B. Pars plana vitrectomy
C. Repeat macular grid photocoagulation
D. Augmented macula photocoagulation
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True regarding animals that are chronically exposed to cold?
A. No significant change in sympathetic system
B. Inhibition of increased vagal tone
C. Increased insulin levels in blood
D. ??
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A patient with steroid resistant nephrotic syndrome has been given 3 doses of intravenous methylprednisolone, Serum creatinine – 0.8mg/dl, serum albumin – 2g/dl, cholesterol – 350mg/dl. What is the preferred treatment?
A. Oral cyclophosphamide x 3 months
B. Oral mycophenolate x 6 months
C. Cyclosporine
D. IV cyclophosamide x 6 months
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True about non typhoid salmonella?
A. Invasive in infants
B. Blood culture more sensitive than stool in adults
C. Poultry acts as a source of infection
D. Fluoroquinolone resistance is seen in some clinical reports
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Gall bladder poylps have risk of malignancy if
A. Polyp is associated with gall stones
B. Polyp size > 5 mm
C. ??
D. ??
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All are true regarding carcinoma pancreas except?
A. 75% cases have p53 mutation
B. 5 year survival rate after pancreatico duodenectomy is 10-15%
C. Stage III cancer median survival is 3-6 months
D. ??
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Not seen in Gestational Diabetes?
A. Previous macrosomic baby
B. Congenital malformation
C. Polyhydramnios
D. Obesity
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Lady gets Chicken pox 3 days before delivery of the baby. What is the baby’s prognosis?
a) No risk to mother or child
b) Intrapartum antiviral therapy required
c) Fetopathic effects seen
d) ??
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An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has
quadriparesis with areflexia. Both the pupils are non reactive. The most probable diagnosis is:
a) Poliomyelitis
b) Botulism
c) Diphtheria
d) Porphyria
Correct answer : b) Botulism
The important features of the patient are descending paralysis, blurring of vision and non reactive pupils. Descending paralysis is caused by 3 of the conditions mentioned – polio, botulism, and diphtheria. Diphtheria and botulism can cause ocular symptoms. But only botulism will result in a non reactive pupil. Hence the diagnosis of botulism!
Episodic generalized weakness can occur due to all of the following acute electrolyte disturbances, except:
a) Hypokalemia
b) Hypocalcemia
c) Hyponatremia
Correct answer : b) Hypocalcemia
Electrolyte imbalances which result in Episodic generalized weakness:
Hyperkalemia
Hypokalemia
Hypernatremia
Hyponatremia
Hypercalcemia
Hyperphosphatemia
Hypermagnesemia
Which among the following is not a feature of Horner’s syndrome?
A. Ptosis
B. Miosis
C. Loss of sweating
D. Apparent exophthalmos
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True statement regarding the kidney is?
A. Clearance will be more than GFR if the substance is secreted into the tubule
B. Descending limb is permeable to solutes
C. Fluid coming from the descending limb is hypotonic
D. Clearance of a substance is always more than GFR if there is tubular secretion
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True regarding myocardial O2 demand?
A. Inversely related to heart rate
B. Has constant relation to external cardiac work
C. Correlates with duration of systole
D. Is negligible at rest
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In laryngeal surgery vocal cordectomy and ligamentectomy is which type
A. I
B. II
C. III
D. IV
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All of the following is involved in development of carcinoma colon except?
A. APC
B. Beta catenin
C. K Ras
D. Mismatch repair genes
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Which among the following is false regarding familial adenomatous polyposis?
A. Autosomal recessive inheritance
B. Screening done by sigmoidoscopy
C. Polyps develop in late adulthood
D. Epideral cyst may occur with osteoma
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Best method to teach life skills to a mentally retarded child ?
A. Cognitive behaviour therapy
B. Contingency management
C. Conginitive reconstruction
D. Self instruction
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All are true about diazoxide EXCEPT:
A. Anti-hypertensive
B. Causes severe hypoglycemia
C. Used in treatment of insulinomas
D. Acts by ATP mediated K+ channel opening in beta cell membrane
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Mangled Extremity Severity Score (MESS) includes all of the following except?
A. Shock
B. Ischemia
C. Neurogenic injury
D. Energy of injury
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Vertical crest at the junction of the internal auditary canal?
A. Bill’s bar
B. Ponticulus
C. ??
D. ??
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A patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. The best option of treatment is;
a) Anti thymocyte globulin followed by cyclosporine
b) A conventional bone marrow transplantation from the HLA identical sibling
c) A non-myeloablative bone marrow transplantation from the HLA identical sibling
d) Cyclosporine
Correct answer : a) Anti thymocyte globulin followed by cyclosporine
Treatment of choice in an elderly individual with severe aplastic anemia is immunosuppression – Anti thymocyte globulin followed by cyclosporine. Bone marrow transplantation is tried only in young adults.
A couple has two children affected with tuberous selerosis. On detailed clinical and laboratory evaluation (including molecular studies) both parents are normal. Which one of the following
explains the two affected children in this family?
a) Non penetrance
b) Uniparental disomy
c) Genomic imprinting
d) Germline mosaicism
Correct answer : d) Germline mosaicism
A person can be affected with tuberous sclerosis as a result of inheritance from the parents or as a result of spontaneous mutation. In tuberous sclerosis, the mode of inheritance is autosomal dominant. But in this case the parents is not affected with tuberous sclerosis. Hence autosomal dominant mode of inheritance cannot occur. In case of spontaneous mutation, one of the children of unaffected parents can have the disease. But in this case, 2 children have the disease. The same mutation to occur in both children at the same time is very rare! There is one another method by which a child may acquire the disease – Germline mosaicism in the parents. Mosaicism simply means that some of the cells of a person have a particular genetic mutation and the rest of the cells are normal. If the proportion of such cells is very low, the person will not exhibit the properties of the disease. But if some of his / her germ cells contain the mutated gene, it may get transmitted to the offspring. Thus, germline mosaicism can result in birth of more than one affected child to unaffected parents!
Which among the following has a giant cell variant?
A. Chondroblastoma
B. Osteosarcoma
C. Ossifying fibroma
D. Non ossifying fibroma
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Percutaneous vertebroplasty is not done in?
A. Osteoporosis
B. Tuberculosis
C. Metastasis
D. Hemangioma
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Laudanosine is a metabolite of?
A. Atracurium
B. Cisatracurium
C. ??
D. ??
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True regarding ovulatory phase of menstrual cycle is?
A. FSH increases aromatase activity
B. Peak inhibin activity
C. Increased steroidogenesis
D. Activin level is high
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All are true regarding cystic fibrosis except?
A. It is caused by CFTR gene mutation
B. Calcium channel is involved
C. ??
D. ??
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All are true regarding streptococci except?
A. Group A and C are hemolygic
B. Pyrogenic toxin is plasmid mediated
C. ??
D. ??
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All are true regarding mesothelioma except?
A. Bilaterally symmetrical
B. Associated with asbestos exposure
C. Histopathalogy shows bimodal trend
D. Occurs in late middle age
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Drug which does not precipitate angina?
A. Dipyridamole
B. Sumatriptan
C. Levothyroxine
D. Oxyfedrine
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All are true about mucinous neoplasm of pancreas except?
A. Has coloumnar epithelium
B. Ovarian tissue may be found in it
C. Associated with ascites
D. Is premalignant
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A 15 year old boy presented with one day history of bleeding gums, subcoujunctival bleed and purpuric rash. Investigations revealed the following results. Hb-6.4 gm/dL; TLC-26,500/mm3, Platelet 35,000/mm3; prothrombin time-20 sec with a control of 13 sec; partial thromboplastin time-50sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?
a) Myeloblastic leukemia without maturation
b) Myeloblastic leukemia with maturation
c) Promyelocytic leukemia
d) Myelomonocytic leukemia
Correct answer : c) Promyelocytic leukemia
The boy is in a state of disseminated intravascular coagulation (Thrombocytopenia, increased Prothrombin time, increased Partial thromboplastin time and decreased Fibrinogen levels). Promyelocytic leukemia is the one most commonly associated with DIC.
A 70 year old male has a pathologic fracture of femur. The lesion appears as lytic on X-rays film with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following?
a) Diminished and thinned trabecular bone fragments secondary to osteopenia
b) Sheets of atypical plasma cells
c) Metastatic prostatic adenocarcinoma
d) Malignant cells forming osteoid bone
Correct answer : b) Sheets of atypical plasma cells
An elderly patient presenting with lytic, circumscribed punched out lesions on X-ray suggests diagnosis of multiple myeloma. Gross pathology shows gelatinous soft red tumour masses. Histopathology shows plasma cells which infiltrate the marrow diffusely or form sheet like masses and replace the normal marrow elements.
Revascularisation is most effective in
A. Stunned myocardium
B. Hibernating myocardium
C. Partially ischemic myocardium
D. ??
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Histone acetylation leads to
A. Eucrhomatin
B. Heterocrmatin
C. Replication
D. ??
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Survival in untreated gall bladder carcinoma?
A. 2-4 months
B. 8-10 months
C. 12-24 months
D. ??
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Which of the following doesnt occur in Renal cell carcinoma?
A. Polycythemia
B. Cushing’s
C. Malignant hypertension
D. Amyloidosis
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A person having chest pain and sudden palpitations with heart rate of 150/min and regular rhythm. Diagnosis?
A. Sinus tachycardia
B. Idioventricular rhythm
C. SVT
D. AF with heart block
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All are congenital myopathies except?
A. Central core myopathy
B. Z band myopathy
C. Nemaline myopathy
D. Centronuclear myopathy
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Cotrimoxazole used in all except
A. UTI
B. Chancroid
C. Prostatitis
D. Typhoid
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According to enneking system, not true regarding an active benign lesion is
A. Intracapsular
B. Margin of reactive bone
C. Wide rim of reactive bone
D. Extended curettage is treatment
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Regarding Ifosfamide, all are true except?
A. It is an alkylating agent
B. Metabolised by liver
C. More toxic than cyclophosphamide.
D. ??
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Most common cause of death in a patient with thronbolytic therapy?
A. Myocardial rupture
B. Reperfusion arrhythmia
C. Intracranial haemorrhage
D. ?
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Degrees given by institutions in india and recognised by MCI come under?
A. Schedule I
B. Schedule II
C. Part 1 of scedule III
D. Part 3 of scedule III
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All are true regarding Dent’s disease except?
A. Proteinura
B. Hypercalciuria
C. Father will have the same disease
D. Rickets is present
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Central dot sign seen in
A. Caroli disease
B. Primary sclerosing cholangitis
C. Liver hematoma
D. ??
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Most comon cause of acute mesenteric ischemia is
A. Arterial thrombosis
B. Venous thrombosis
C. Embolism
D. Non occlusive ischemia
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Best test for GERD?
A. Manometry
B. 24 hour ph monitoring
C. Endoscopy
D. Esophagogram
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A term male baby, with birth weight 3.5 kg, developed respiratory distress at birth, not responded to administration of surfactant. Echocardiogram was normal. X ray chest shows ground glass appearance. There is history of death of a female sibling at 1 month of age. What is the diagnosis?
A. TAPVC
B. Meconium aspiration
C. Neonatal alveolar proteinosis
D. ??
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Which of the following is not true about JRA?
A. Fever
B. Uveitis
C. Rheumatoid nodules
D. Raynaud’s phenomenon
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Pulsatile liver & ascites are found in?
A. Tricuspid regurgitation
B. Mitral regurgitation
C. Mitral stenosis
D. Pulmonary hypertension
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False about acrodermatitis enteropathica
A. Triad of diarrrhoea, dementia,and dermatitis
B. Low zinc level
C. Symptoms improve with zinc supplem.
D. Autosomal recessive
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A 14 yr old girl on exposure to cold has pallor of extremities followed by pain and cyanosis. She is prone to develop:
A. SLE
B. Scleroderma
C. Rheumatoid arthritis
D. Histiocytosis
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Histopathological featues of fat necrosis in a new born closely resembles?
A. Steroid induced lipid necorsis
B. Lupoid necrosis
C. Erythema induratum
D. Lipodermatosclerosis
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A 9 yr old girl has difficulty in combing hair and climbing upstairs. Gowers sign is positive. What is the next investigation to be performed?
A. ESR
B. RA factor
C. Creatine kinase
D. EMG
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BRCA1 gene is located on chromosome number?
A. 13
B. 11
C. 17
D. 22
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Which among the following is false?
A. Ileum is non feathery
B. Colon has haustrations
C. Jejunum is feathery
D. Distal part of duodenum has a cap
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About RCT all true except
A. Baseline characters are comparable
B. Bias eliminated by double blinding
C. Sample size depends on type of study
D. Dropouts are excluded
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Not true about breast milk
A. Max output at 12 months
B. Co-efficient of iron absorption is 70%
C. Ca utilization more than cows milk
D. Breast milk protien is reference protein
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True about cluster sampling all except
A. Sample size same as simple random
B. It is two stage sampling
C. Cheaper than other methods
D. It is a method for rapid assessment
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Which is true about BCG?
A. Distilled water is used as diluent
B. Site for injection is cleaned with spirit
C. Mantoux test positive in 6 weeks
D. WHO recommends Danish 1331 for vaccine production
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CAP in Lac operon is an example of:
A. Positive regulator
B. Negative regulator
C. Constitutive expression
D. Attenuation
Correct answer : Positive regulator (Repeat question)
Inceneration not done for
A. Cytotoxic drugs
B. Waste sharps
C. Human anatomical waste
D.Cotton contaminated by blood
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The primary direct stimulus for excitation of central chemoreceptors is ?
A. Increased H+
B. Increased CO2
c. Increased O2
D. Decreased CO2
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Which of the following statements regarding DDT is false?
A. Pyrethrum has synergistic action
B. It is a contact poison
C. Immediately kills the prey
D. Residual effect lasts 18 months
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Following are larval control measures except?
A. DDT
B. Paris green
C. Gambusia
D. Intermittent irrigation
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Goals of national population policy are all except?
A. Decrease IMR to below 30/1000 live births
B. Reduce MMR to below 100/100000 live births
C. Achieve 100% registration of births, deaths, marriage and pregnancy
D. Bring down TFR to replacement levels by 2015
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Maximum postprandial motility is seen in?
A. Ascending colon
B. Transverse colon
C. Descending colon
D. Sigmoid colon
Correct answer : D. Sigmoid colon
CSF pressure is mainly regulated by?
A. Rate of CSF formation
B. Rate of CSF absorption
C. Cerebral blood flow
D. Venous pressure
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Terminal group of lymph node for colon is?
A. Paracolic
B. Epicolic
C. Preaortic
D. Ileocolic
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Spleen projects in the following space
A. Left paracolic gutter
B. Infracolic compartment
C. Left subhepatic space
D. Greater sac
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In subclavian artery block at the outer border of 1st rib, all of the following arteries help in maintaining the circulation except?
A. Subscapular
B. Superior thoracic
C. Thyrocervical trunk
D. Suprascapular
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False about hepatic duct is?
A. Left hepatic duct formed in umblical fissure
B. Caudate lobe drains only left hepatic duct
C. Right hepatic duct formed by 5 and 7 segments
D. Left hepatic duct crosses 4 segment
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A 3 month old male child with normal genitilia presents to the emergency department with severe dehydration, hyperkalemia, and hyponatremia. Measurement of which among the following is most helpful?
A. 17-hydroxy progesterone
B. Renin
C. Cortisol
D. Aldosterone
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Regarding ace inhibitors which of the following is true?
A. Inhibits conversion of angiotensinogen to angiotensin 1
B. t 1/2 of enalapril is more than lisinopril
C. Omission of priorc diuretic dose decreases the risk of postural hypotension
D. It is effective only with LV systolic dysfunction
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Which opoid receptor causes musclular rigidity?
A. μ
B. δ
C. κ
D. σ
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Carpel tunnel syndrome is caused by all except
A. Amylodosis
B. Hypothyroidism
C. Addisson’s disease
D. Diabetes mellitus
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True statement regarding clomiphene citrate is?
A. Enclomiphene is an anti estrogenic
B. Increases pregnancy rate 3 times
C. Incidence of twin pregnancy is 5%
D. Shown to increase fertility in oligospermic males in RCT
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Vaginal delivary can be allowed in all except?
A. Monochorionic monoamniotic
B. Mentoanterior
C.Extended breech
D. Dichorionic twins with first vertex and second breech
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A pregnant lady had no complaints but mild cervical lymphadenopathy in first trimester. She was prescribed spiramycin but was non compliant. Baby was born with hydrocephalus and intracerebral calcification. Likely cause is
A. Toxoplasma gondii
B. CMV
C. Cryptococcus
D. Rubella
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Regarding hashimoto’s thyroiditis, all are true except?
A. Follicular destruction
B. Increse in lymphocytes
C. Oncocytic metaplasia
D. Orphan annie eye nuclei
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A child presents with failure to thrive with frequent vomiting, diarrhoea, hepatic splenomegaly and abdominal distension. CT shows adrenal calcification. Which of the following is the diagnosis?
A. Adrenal haemorrage
B. Wolmans disease
C. Pheochromocytoma
D. Addison’s disease
Correct answer: B. Wolmans disease
A girl presented with hyperkalemia and peaked T waves on ECG. The fastest way of shifting potassium intracellularly is?
A. Calcium gluconate IV
B. Oral resin
C. Insulin+glucose
D. Sodium bicarbonate
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Which of the following about athesclerosis is true?
A. Intake of unsaturated fatty acids associated with decreased risk
B. Thoracic aorta involvement is more severe than abdominal aorta
C. Extent of lesion in veins is same as that in arteries
D. Hypercholesterolemia does not always increase the risk of atherosclerosis per se
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Radiological features of LV failure are all except
A. Kerley b lines
B. Cardiomegaly
C. Oligemic lung fields
D. Increased flow in upper lobe veins
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Berry aneurysm defect lies in:
A. Degeneration of internal elastic lamina
B. Degeneration of media/muscle cell layer
C. Deposition of mucoid material in media
D. Low grade inflammation of vessel wall
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Function of CD4 is all except?
A. antibody production
B. Cytotoxicity of T cells
C. Memory B cells
D. Opsonisation
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All the following statements about purification of water are true except
A. Presence of clostridial spores indicate recent contamination
B. Coliforms must not be detectable in any 100ml sample of drinking water
C. Sodium thiosulphate is used to neutralize chlorine
D. Coliforms may be dtected by multiple tube method and indole production at 44 degrees
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True about sickle cell disease are all except
A. Single nucleotide change results in change of glutamine to valine
B. Sticky patch is generated as a result of replacement of a nonpolar residue with a polar residue
C. HbS confers resistance against malaria in heterozygotes
D. RFLP results from a single base change
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After digestion by restriction endonucleases DNA strands can be joined again by?
A. DNA polymerase
B. DNA ligase
C. DNA topoisomerase
D. DNA gyrase
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The loading dose of Aminophylline is:
a) 50-75 mg/kg
b) 0.5-1.0 mg/ kg
c) 2.0-3.5 mg/kg
d) 5-6 mg/kg
Correct answer : d) 5-6 mg/kg
Aminophylline is theophylline complexed with ethylenediamine to permit IV administration. (Theophylline is insoluble and hence cannot be administered via intravenous route.)
The drug imatinib acts by inhibition of:
a) Tyrosine kinase
b) Glutathione reductase
c) Thymidylate synthase
d) Protein kinase
Correct answer :a) Tyrosine kinase
Imatinib is used for treatment of Chronic myeloid leukemia.
All are true about exenatide except?
A. Glucagon like peptide analogue
B. Used in type 1 diabetes mellitus
C. Administered subcutaneously
D. Decreases glucagon level
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!
Commonest infection in cystic fibroisis?
A. Pseudomonas(non mucoid strains)
B. Burkholderia cepacia
C. ??
D. ??
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Root of mesentery crossed by
A. Horizontal part of duodenum
B. Left gonadal vessels
C. Left Ureter
D. Superior mesentric artery
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Laudosine is a metabolite of ?
A. Atracurium
B. Cis atracurium
C. Galantamine
D. Pancuronium
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Ideal contraceptive for a lactating mother is?
A. OCP
B. Barrier
C. POP
D. Lactational amenorrhea
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Fish is the source of all except?
A. Iron
B. Iodine
C. Vitamin A
D. Phosphorus
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Most probable route for transmission of meningitis from CNS to inner ear?
A. Coclear aqueduct (ans)
B. Vestibular aqueduct
C. Endolymphatic sac
D. ??
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
A worker presented with abdominal pain, a line on the nails and garlic odour. It is probably due to poisoning by?
A. Lead
B. Mercury
C. Arsenic
D. ??
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
All of the following drugs will worsen megaloblastic anemia except?
A. Alcohol
B. Phenytoin
C. Methotrexate
D. Chloroquine
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Acetyl CoA cannot be converted back DIRECTLY to?
A. Glucose
B. Ketone bodies
C. Fatty acids
D. Cholesterol
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Most important prognostc factor for colorectal cancer is?
A. Tumour characteristics
B. Tumor site
C. LN status
D. Vascular invasion
Patency of ductus arteriosus is necessary in all except?
A. Persistent truncus arteriosus
B. Hypoplastic left heart
C. Pulmonary stenosis
D. Transposition of great vessels with intact ventricular septum
Which among the following is not fermented by colonic flora?
A. Pectin
B. Lignin
C. Starch
D. Cellulose
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Limb reduction defects & scarring of skin in a newborn is seen due to?
A. Toxoplasma
B. Rubella
C. Varicella
D. Herpes virus
During arteriography dissection most commonly in?
A. Gastroduodenal artery
B. Coeliac trunk
C. Superior mesenteric artery
D. Inferior mesenteric artery
Axillary sheath is derived from?
A. Pretracheal fascia
B. Prevertebral fascia
C. Clavipectoral fascia
D. ??
A 7 day old baby was brought with respiratory distress and shock. Baby was discharged in a healthy state 2 days back. Diagnosis?
A. Aortopulmonary window
B Hypoplastic LV
C. Large VSD
D. Ebsteins anomaly
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!
Healthy thinking is characterized by all except
A. Continuity
B. Constancy
C. Clarity
D. Organisation
Reflex hallucination is a morbid variety of?
A. Kinesthesia
B. Paraesthesia
C. Hyperaesthesia
D. Synaesthesia
Which is NOT true about angiography?
A. Common femoral artery is routinely catheterised
B. Single wall puncture is indicated in those with normal coagulation profile
C. Femoral artery is catheterised at medial third of femoral head
D. Seldinger technique is used both for femoral artery and vein
Ideal contraception for couple living far away, meeting occasionally?
A. IUCD
B. Barrier
C. OCP
D. DMPA
Ideal contraceptive for newly married couple?
A. OCP
B. IUCD
C. Barrier method
D. ??
All the muscles retract the scapula except
A. Rhomboideus major
B. Rhomboideus minor
C. Trapezius
D. Levator scapulae
Upper limb weight is transmitted to axial skeleton by all except?
A. Coracoacromial ligament
B. Claviculoclavicular [interclavicular] ligament
C. Costoclavicular ligament
D. Acromioclavicular ligament
Correct answer : A. Coracoacromial ligament
Transmission of upper limb weight occurs through 2 joints – acromioclavicular joint (scapula to clavicle) and sternoclavicular joint (clavicle to sternum). Acromioclavicular ligament and coracoclavicular ligament (more important) are the ligaments stabilizing the acromioclavicular joint. Sternoclavicular joint is stabilized by anterior and posterior sternoclavicular ligaments, costoclavicular ligaments on each side and the midline interclavicular ligament.
In case of an obstucted labor with mother dehydrated, febrile, and an IUD fetus in cephalic presntation. What is the management?
A. Craniotomy
B. Decapitation
C. Cesarean section
D. Forceps delivery
In civil negligence,the onus of the proof lies with
A. Patient
B. Doctor
C. Magistrate
D. Police not below the rank of sub inspector
Incidence can be determined by
A. Cross sectional studies
B. Prospective studies
C. Case control studies
D. Retrospective studies
Cis atracurium is preferrable to atracurium because?
A. Rapid onset
B. Short duration of action
C. Less cardiac depression
D. Less histamine release
Movement of protein from nucleus to cytoplasm can be seen by?
A. FISH
B. FRAP
C. Confocal microscopy
D. Electron microscopy
Duplication of gene has contributed to the development of?
A. r RNA
B. mRNA
C. hn RNA
D. t RNA
Which among the following is not a border of the triangle of auscultation?
A. Trapezius
B. Scapula
C. Latissimus dorsi
D. Serratus anterior
A 35 year old woman presents with primary infertility and mass per abdomen. CA 125 level is 90U/ml. Most probable diagnosis is?
A. Ovarian cancer
B. Borderline ovarian tumor
C. Tuberculosis
D. Endometrioma
Best answer : D. Endometrioma
CA 125 can be raised in all of the conditions mentioned above. But it is not of much significance in case of tuberculosis. Mass per abdomen can be seen in all of the above. Infertility is a feature of both endometriosis and tuberculosis. Infertility is also a risk factor for ovarian cancer. Based on the age of the patient, endometrioma is the most probably diagnosis among the options given. Ovarian cancer is seen in elderly age group (56-60 years). Borderline tumours are seen at an average age of 46 years. Tuberculosis is seen in patients in 20-30 years of age.
Ovarian reserve measured by?
A. LH
B. FSH
C. LH/FSH
D. Estrogen
First laparoscopic cholecystectomy done by:
A. Eric Muhe
B. Langhenback
C. ??
D. ??
Thrombosis is seen in all except
A. DIC
B. PNH
C. ITP
D. Heparin induced thrombocytopenia
Octreotide is used for all except
A. Gliomas
B. Insulinomas
C. Glucagonomas
C. Carcinoid
Which is true ?
A. Goitre in 5 percent of population is endemic goitre
B. In thyroid storm, the clinical features are primarily due to increased thyroxine
C. Propylthiouracil is contraindicated in pregnancy
D. ??
A 30yr old lady was diagnosed with sputum smear positive tuberculosis. She has a 3yr old child who is asymptomatic. Which of the following should be used as prophylaxis for the child?
A. INH 3mg/kg for 3mths
B. INH 3mg/kg for 6mths
C. INH 5mg/kg for 3mths
D. INH 5mg/kg for 6mths
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!
Formications and delusions of persecution always occur together in ?
A. Cannabis
B. LSD
C. Heroin
D. Cocaine
Blood supply of sternocleidomastoid muscle is from all except?
A. Post auricular artery
B. Occipital artery
C. Thyrocervical trunk
D. Superior thyroid artery
False regarding pioglitazone is?
A. Agonist of PPAR
B. Metabolised by liver enzyme Cyp3A4
C. ??
D. ??
Which among the following is given in a case of hypoglycemia due to insulin and acarbose to overcome hypoglycemia?
A. Glucose
B. Sucrose
C. Maltose
D. Starch
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!
Dystrophic epidermolysis bullosa is caused by a mutation of?
A. Laminin
B. Collagen VII
C. Laminin 5
D. Fibronectin
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
Most common site of cholangiocarcinoma is?
A. Intrahepatic duct
B. Distal bile duct
C. Hilum
D. Multifocal
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!
Axillary abscess is most safely drained through?
A. Floor of axilla
B. Posterior wall
C. Medial wall
D. Lateral wall
A 5 year old boy with pubic hair, enlarged phallus, with BP= 130/90. Which of the following measurements would be diagnostic ?
A. Aldosterone
B. 11 deoxycortisol
C. Deoxycorticosterone
D. ??
In “bounce off” test of knee joint, end feel is described as all except?
A. Bony
B. Empty
C. Springy
D. Firm
Nitrogen narcosis occurs due to?
A. Effect of nitrogen on neurons
B. ??
C. ??
D. ??
True about prolactinoma in pregnancy all except ?
A. Most common pituitary tumors, hardly cause any effect
B. ??
C. ??
D. ??
In autopsy the spine is opened from which direction?
A. Anteriorly
B. Posteriorly
C. Anterolaterally
D. Laterally
Investigation of choice for recurrent GIST?
A. MRI
B. PET
C. MIBG
D. CECT
Which of the following is not a pure beta ray emitter?
A. Samarium
B. Strontium
C. Yttrium
D. Phosphorous 32
Not a side effect of naloxone?
A. Hypertension
B. Seizures
C. Pulmonary edema
D. ??
Non progressing contraction of esophagus is
A. Primary
B. Secondary
C. Tertiary
D. Quarternary
Which of the following does not simulate a bone tumour?
A. Fibrous dysplasia
B. Hurlers
C. Bone island
D. Bone infarction
Bleomycin causes the following in lungs
A. Destruction of type 1 pneumocytes
B. Destruction of type 2 pneumocytes
C. Both 1 and 2
D. Destruction of endothelial cells
True about shunt vessels:
A. Play a role in thermoregulation
B. Role in nutrition distribution
C. Present in all vital organs
D. No autonomic nervous regulation
Most Common site of dissection following arteriography
A. Coeliac plexus
B. Gastroduodenal artery
C. Superior mesenteric artery
D. Inferior mesenteric artery
About exenatide, all are true except
A. Used in type 1 DM
B. GLP-1 agonist
C. Given subcutaneously
D. Decreases glucagon levels
Sphincter of Oddi consists of
A. 2 sphincters
B. 3 sphincters
C. 4 sphincters
D. 5 sphincters
Fine reticulate pigmentation with palmar pitting is seen in?
A. Cockayne syndrome
B. Blooms syndrome
C. Degos syndrome
D. ??
What is a cardiac polyp?
A. Benign mass
B. Fibrinous clot
C. Aneurysn
D. Infarct
Which of the following statements is true of primary grade IV-V vesicoureteric reflux in young children?
a) Renal scarring usually begins in the midpolar regions
b) Postnatal scarring may occur even in the absence of urinary tract infections
c) Long term outcome is comparable in patients treated with either antibiotic prophylaxis or surgery
d) Oral amoxicillin is the antibiotic of choice for prophylaxis
Correct answer : b) Postnatal scarring may occur even in the absence of urinary tract infections
Renal scarring usually begins in the polar regions
Long term outcome is better with surgery
Co-trimoxazole is the drug of choice for prophylaxis
A 15-year old female presented to the emergency department with history of recurrent epistaxis, hematuria and hematochezia. There was a history of profuse bleeding from the umbilicus stump at birth. Previous investigations revealed normal prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen levels. Her platelet counts as well as platelet function tests were normal but urea clot lysis test was positive. Which one of the following clotting factor is most likely to be deficient?
a) Factor X
b) Factor XI
c) Factor XII
d) Factor XIII
Correct answer : d) Factor XIII
Which one of the following in the characteristic feature of juvenile myoclonic epilepsy?
a) Myoclonic seizures frequently occur in the morning
b) Complete remission is common
c) Response to anticonvulsants is poor
d) Associated absence seizures are present in majority of patients
Correct answer : a) Myoclonic seizures frequently occur in the morning
ln acute pulmonary embolism, the most frequent ECG finding is:
a) S1Q3T3 pattern
b) P. pulmonale
c) Sinus tachycardia
d) Right axis deviation
Correct answer : c) Sinus tachycardia
All of the above features may be seen in acute pulmonary embolism, but sinus tachycardia is seen in all cases.
A hoursewife ingests a rodenticide white powder accidentally. She is brought to hospital where the examination shows generalized, flaccid paralysis and an irregular pulse. ECG shows multiple ventricular ectopics, generalized changes with ST-T. Serum potassium is 2.5 m Eq/L. The most likely ingested poison is:
a) Barium carbonate
b) Super warfarins
c) Zinc phosphide
d) Aluminium phosphide
Correct answer : a) Barium carbonate
The endotoxin of the following gram negative bacteria does not play any part in the pathogenesis of the natural disease:
a) Escherichia coli
b) Klebsiella sp.
c) Vibrio cholerae
d) Pseudomonas aeruginosa
Correct answer : c) Vibrio cholerae
Vibrio cholerae exotoxins are responsible for it’s pathogenicity.
A Physician, after examining a group of patients of a certain disease, classifies the condition of each one as “Normal’, ‘Mild’, Moderate’ or ‘Severe’. Which one of the following is the scale of measurement that is being adopted for classification of the disease condition?
a) Nominal
b) Interval
c) Ratio
d) Ordinal
Correct answer : d) Ordinal
5-HIAA is a metabolite of:
a) Serotonin
b) Dopamine
c) Epinephrine
d) Histamine
Correct answer : a) Serotonin
5-HIAA is a metabolite of Serotonin.
Plethoric lung fields are seen in all of the following conditions, except:
a) Atrial septal defect (ASD)
b) TAPVC (Total Anomalous Pulmonary venous connection)
c) Ebsteins’ anomaly
d) Ventricular septal defect
Correct answer : c) Ebsteins’ anomaly
Plethoric lung fields are seen in conditions which increase pulmonary blood flow. They are:
Left to right shunt – ASD, VSD, PDA, Coronary artery fistula into right heart, Aortopulmonary window
Transposition of great arteries with ASD or VSD
Truncus arteriosus
Total anomalous pulmonary venous connection
Which one of the following is the description used for the term allodynia during pain management?
a) Absence of pain perception
b) Complete lack of pain sensation
c) Unpleasant sensation with or without a stimulus
d) Perception of an ordinarily non noxious sitmulus as severe pain.
Correct answer : d) Perception of an ordinarily non noxious sitmulus as severe pain
Allodynia is the perception of an ordinarily non noxious sitmulus as severe pain
Which side effect is commonly seen with fentanyl?
a.Chest wall rigidity
b.Tachycardia
c.Pain in abdomen
d.Hypertension
Correct answer : a) Chest wall rigidly
Chest wall rigidity is an important side effect of opioids like fentanyl. It may even impair ventilation.
Which of the following drugs is contraindicated in a patient with raised intracranial pressure?
a) Thiopentone
b) Propofol
c) Midazolarn
d) Ketamine
Correct answer : d) Ketamine
Ketamine increases cerebral blood flow and intracranial pressure. Hence it is contraindicated in patients with increased intracranial pressure.
Air borne contact dermatitis can be diagnosed by:
a) Skin biopsy
b) Patch test
c) Prick test
d) Estimation of serum IgE levels
Correct answer : b) Patch test
In patch test, the suspected allergens are applied on the back of the patient under separate patches for 48 hours. The presence of dermatitis is then looked for.
The main cytokine, involved in erythema nodusum leprosum (ENL) reaction is:
a) Interleukin—2
b) Interferon-gamma
c) Tumor necrosis factor—alpha
d) Macrophage colony stimulating factor
Correct answer : c) Tumor necrosis factor—alpha (factual question)
The following drug is not used for the treatment of type II lepra reaction:
a) Chloroquin
b) Thalidomide
c) Cyclosporine
d) Corticosteroids
Correct answer : c) Cyclosporine
Drugs used in treatment of type II lepra reaction are :
NSAID’s
Thalidomide
Chloroquine
Clofazimine
Corticosteroids
Parenteral antimony
Band shaped keratopathy is caused by:
a) Amyloid
b) Calcium
c) Monopolysaccharide
d) Lipid
Correct answer : b) Calcium
Band shaped keratopathy occurs due to the accumulation of calcium salts in a band pattern in the anterior corneal layers.
A recurrent chalazion should be subjected to histopathologic evaluation to exclude the possibility of:
a) Squamous cell carcinoma
b) Sebaceous cell carcinoma
c) Malignant melanoma
d) Basal cell carcinoma
Correct answer : b) Sebaceous cell carcinoma
Sebaceous cell carcinoma is a neoplasm of the eyelid with high malignant potential. It arises from Sebaceous glands of caruncle, meibominan glands and the glands of Zeis.
The crystalline lens derives its nourishment from:
a) Blood vessels
b) Connective tissue
c) Aqueous and vitreous
d) Zonules
Correct answer : c) Aqueous and vitreous
Lens is an avascular structure. Nutrition and oxygen for the lens is derived from the aqueous humor (major part) and vitreous humor.
Which of the following among axillary lymph nodes is a terminal group?
A. Pectoral
B. Central
C. Lateral
D. Apical
Correct answer : D. Apical
It receives lymphatic drainage from all other axillary nodes.
The vertebral artery traverses all of the following except?
A. Foramen magnum
B. Subarachnoid space
C. Intervertebral foramen
D. Foramen transversarium
Correct answer : C. Intervertebral foramen (factual question)
All of the following statements about the splenic artery are true except:
A. Has a tortuous course
B. Is a branch of the coeliac trunk
C. It has branches that anastomose freely within the spleen
D. Supplies the greater curvature of stomach
Correct answer : C. It has branches that anastomose freely within the spleen (factual question)
After how many days of ovulation embryo implantation occurs?
a) 3-5 days
b) 7-9 days
c) 10-12 days
d) 13-15 days
Correct answer : b) 7-9 days (factual question)
The shortest diameter in fetal head is:
a) Biparietal diameter
b) Suboccipito frontal diameter
c) Occipito frontal diamter
d) Bitemporal diameter
Correct answer : a) Bitemporal diameter (factual question)
In which of the following heart diseases maternal mortality is found to be highest?
a) Eisenmenger’s complex
b) Coarctation of aorta
c) Mitral stenosis
d) Aortic stenosis
Correct answer : a) Eisenmenger’s complex
Women with Eisenmenger’s complex have upto 50% mortality during pregnancy. Termination of pregnancy is advised.
The differential diagnosis of lesion, histologically resembling giant cell tumour in the small bones of the hands or feet, includes all of the following except:
a) Aneurysmal bone cyst
b) Fibrosarcoma
c) Osteosarcoma
d) Hyperparathyroidism
Correct answer : b) Fibrosarcoma
The ideal place to record body temperature in a dead body is:
a) Rectum
b) Axilla
c) Mouth
d) Groin
Correct answer : a) Rectum
Rectum is the ideal place to record body temperature except in cases of sodomy. Other suitable sites are external auditory canal, nasal passages or by inserting a thermometer into the peritoneal cavity by a small opening and keeping it in contact with the inferior surface of the liver
A 15 year old boy is injured while playing cricket. X-rays of the leg rule out of a possible fracture. The radiologist reports the boy has an evidence of aggressive bone tumor with both bone destruction and soft tissue mass. The bone biopsy reveals a bone cancer with neural differentiation. Which of the following is the most likely diagnosis?
a) Chondroblastoma
b) Ewing‘s sarcoma
c) Neuroblastoma
d) Osteosarcoma
Correct answer : b) Ewing‘s sarcoma
Ewings sarcoma has a neural differentiation. Neuroblastoma may present with skeletal metastasis, but is seen in children less than 5 years old.
The defective migration of neural crest cells results in;
a) Congenital megacolon
b) Albinism
c) Adrenogenital hypoplasia
d) Dentinogenesis imperfecta
Correct answer : a) Congenital megacolon and b) Albinism
Conditions caused by defective migration of neural crest cells:
Congenital megacolon
Albinism
Neurocristopathies
Melanoma
Oropharyngeal teratoma
A 45-year-old gentleman has undergone truncal vagotomy and pyloroplasty for bleeding duodenal ulcer seven years ago. Now he has intractable recurrent symptoms of peptic ulcer. All of the following suggest the diagnosis of Zollinger Ellison syndrome, except:
a) Basal acid output of 15 meq/hour
b) Serum gastrin value of 500 pg/ml
c) Ulcers in proximal jejunum and lower end of esophagus
d) Serum gastrin value of 200 pg/ml with secretin stimulation
Correct answer : d) Serum gastrin value of 200 pg/ml with secretin stimulation
Diagnosis of ZES requires a rise of 200 pg/ml or more in the serum gastrin level when stimulated with secretin.
Which one of the following statements is incorrect in regard to stones in the gallbladder?
a) Pigment stones are due to increased excretion of conjugated bilirubin
b) Are considered a risk factor for the development of gallbladder carcinoma
c) 10% of gallstones are radio-opaque
d) A mucocele of the gallbladder is caused by a stone impacted in Hartman’s pouch
Correct answer : d) A mucocele of the gallbladder is caused by a stone impacted in Hartman’s pouch
Mucocele of gallbladder is caused by stone impaction in the neck of gall bladder or in the cystic duct.
Which of the following haemoglobin (Hb) estimation will be diagnostically helpful in a case of beta thalassemia trait?
a) HbF
b) HbA1c
c) HbA2
d) HbH
Correct answer : c) HbA2
Normal hemoglobin is composed predominantly of HbA1 – which is composed of 2 alpha chains and 2 beta chains. In beta thalassemia trait, there is decrease in production of beta chains of hemoglobin. But since the defect is minor, they will not have any clinical features and the peripheral smear may be normal. But there will be a compensatory increase in HbA2 which is composed of 2 alpha chains and 2 delta chains. Normally HbA2 constitutes about 1.5 to 3.5% of total hemoglobin. But in beta thalassemia trait, this increases to about 3.6 to 8%.
Which of the following does not establish a diagnosis of congenital CMV infection in a neonate?
a) Urine culture of CMV
b) IgG CMV antibodies in blood
c) lntra nuclear inclusion bodies in hepatocytes
d) CMV viral DNA in blood by polymerase chain reaction
Correct answer : b) IgG CMV antibodies in blood
Maternal IgG antibodies can pass into fetal circulation. Hence it is not possible to establish a diagnosis of congenital CMV infection in a neonate just by demonstrating the presence of IgG antibodies.
All of the following are true of Beta thalassemia major, except:
a) Splenomegaly
b) Target cells on peripheral smear
c) Microcytic hypochromic anemia
d) Increased osmotic fragility
Correct answer : d) Increased osmotic fragility
Osmotic fragility is decreases in Thalassemia. Increased osmotic fragility is seen in hereditary spherocytosis.
Salmonella typhi is the causative agent of typhoid fever. The infective dose of S. typhi is:
a) One bacillus
b) 10(8) – 10(10) bacilli
c) 10(2) – 10(5) bacilli
d) 1-10 bacilli
Correct answer : c) 10(2) – 10(5) bacilli (factual question)
The single most common cause of pyrexia of unknown origin is:
a) Mycobacterium tuberculosis
b) Samonella typhi
c) Brucella sp.
d) Salmonella paratyphi A
Correct answer : a) Mycobacterium tuberculosis (factual question)
“lntestinal angina” is a symptom complex of the following:
a) Postprandial abdominal pain, weight loss, actue mesenteric vessel occlusion
b) Postprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
c) Preprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
d) Preprandial abdominal pain, weight gain, acute mesenteric vessel occlusion
Correct answer : b) Postprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
Intestinal angina is due to chronic mesenteric vein occlusion. It causes abdominal pain, cramping following food intake, weight loss and chronic diarrhoea
Amyloid deposits stain positively with all of the following except:
a) Congo-red
b) Crystal violet
c) Methenamine silver
d) Thioflavin T
Correct answer : c) Methenamine silver (Factual question)
A peripheral smear with increased neutrophils, basophils, eosinophils, and platelets is highly suggestive of:
a) Acute myeloid leukemia
b) Acute lymphoblastic leukemia
c) Chronic myelogenous leukemia
d) Myelodysplastic syndrome
Correct answer : c) Chronic myelogenous leukemia
CML is characterised by increase in neutrophils, basophils, eosinophils, and platelets. None of the other conditions mentioned show increase in basophils and eosinophils.
A 17 year-old boy presented with TLC of 138 x 10 (9) /L with 80% blasts on the peripheral smear. Chest X-ray demonstrated a large mediastinal mass. Immunophenotyping of this patient’s blasts would most likely demonstrate:
a) No surface antigens (null phenotype)
b) An immature T cell phenotype (Tdt/D34/CD7 positive)
c) Myeloid markers, such as CD13, CD33 and CD15
d) B cell markers, such as CD19, CD20 and CD22
Correct answer : b) An immature T cell phenotype (Tdt/D34/CD7 positive)
There is increased lymphocytes with 80% blasts – indicating acute leukemia. Also the age group and the mediastinal mass point out to the possibility of T cell leukemia. (T cell leukemia is usually seen in adolescent boys with thymic involvement). Hence the blasts would demonstrate immature T cell phenotype
While applying chi-square test to a contingency table of 4 rows and 4 columns, the degrees of freedom would be:
a) 1
b) 4
c) 9
d) 8
Correct answer : c) 9
Degree of freedom = (no. of rows – 1) * (no. of columns – 1)
=(4-1) * (4-1)
=3 * 3
=9
A diagnostic test for a particular disease has a sensitivity of 0.90 and a specificity of 0.80. A single test is applied to each subject in the population in which the diseased population is 30%. What is the probability that a person, negative to this test, has no disease?
a) Less than 50%
b) 70%
c) 95%
d) 72%
Correct answer : c) 95%
The probability that a person negative to this test has no disease signifies the Negative predictive value of the test.
The following anaesthetic drug causes pain on intravenous adminstration:
a) Midazolam
b) Propofol
c) Ketamine
d) Thiopentone sodium
Correct answer : b) Propofol
Inadvertent intra arterial injection of thiopentone sodium produces pain, not intravenous injection. Propofol causes pain with intravenous injection.
Which of the following fluorinated anesthetics corrodes metal in vaporizers and breathing systems?
a) Sevoflurane
b) Enflurane
c) lsoflurane
d) Halothane
Correct answer : d) Halothane (Factual question)
Which of the following inhalational agents has the minimum blood gas solubility coefficient?
a) Isoflurane
b) Sevoflurane
c) Desflurane
d) Nitrous oxide
Correct answer : c) Desflurane (factual question)
Ivermectin in indicated in the treatment of
a) Syphilis
b) Scabies
c) Tuberculosis
d) Dermatophytosis
Correct answer : b) Scabies
Ivermectin the only orally effective treatment scabies.
Which of the following is not a typical feature of malignant otitis externa?
a) Caused by Pseudomonas aeruginosa
b) Patients are usually old
c) Mitotic figures are high
d) Patient is immune compromised
Correct answer : c) Mitotic figures are high
Malignant otitis externa is an infection, not a malignancy. Hence no mitotic figures are found.
Which of the following is not a typical feature of Ménière’s disease?
a) Sensorineural deafness
b) Pulsatile tinnitus
c) Vertigo
d) Fluctuating deafness
Correct answer : b) Pulsatile tinnitus
Features of Ménière’s disease are:
Aural fullness
Fluctuating sensorineural deafness
Fluctuating tinnitus
Episodic vertigo
Which of the following is the most important factor in the prevention of the endophthalmitis in cataract surgery?
a) Preoperative prepartion with povidone iodine
b) One week antibiotic therapy prior to sugery
c) Trimming of eyelashes
d) Use of intravitreal antibiotics
Correct answer : a) Preoperative prepartion with povidone iodine
Most important source of infection is the patient’s own lid and conjunctival flora. Topical povidone iodine helps prevent this.
The laser procedure, most often used for treating iris neovascularization, is:
a) Goniophotocoagulation
b) Laser trabeculoplasty
c) Panretinal photocoagulation (PRP)
d) Laser iridoplasty
Correct answer : c) Panretinal photocoagulation (PRP)
Panretinal photocoagulation is the treatment of choice for neovascularization of iris. It stops the angiogenic stimulus from the retina which is responsible for neovascularization.
Mucin layer tear film deficiency occurs in:
a) Keratoconjunctivitis sicca
b) Lacrimal gland removal
c) Canalicular block
d) Herpetic keratitis
Correct answer : a) Keratoconjunctivitis sicca
Mucin synthesising goblet cells are destroyed in Keratoconjunctivitis sicca caused by trachoma and ocular pemphigoid
In the Manning scoring system of biophysical profile for fetal monitoring, which parameter is not included
a) Fetal tone
b) Fetal gross body movements
c) Oxytocin challenge test
d) Non stress test
Correct answer : c) Oxytocin challenge test
Components of Mannings biophysical profile:
Non stress test
Fetal breathing movement
Fetal muscle tone
Fetal gross body movement
Amniotic fluid index
The pseudomyxoma peritonei occurs as a complication of the following ovarian tumor:
a) Serous cystadenoma
b) Mucinous cystadenoma
c) Dysgerminoma
d) Gonadoblastoma
Correct answer : b) Mucinous cystadenoma
Causes of pseudomyxoma peritonei – Mucinous cystadenoma of ovary, mucocele of appendix, carcinoma of large intestine in men
With which of the following types of viral hepatitis infection in pregnancy, the maternal mortality is the highest?
a) Hepatitis A
b) Hepatitis B
c) Hepatitis C
d) Hepatitis E
Correct answer : d) Hepatitis E
Hepatitis E infection in pregnancy results in mortality rates upto 20%.
All of the following are complications of supracondylar fracture of humerus in children, except;
a) Compartment syndrome
b) Myositis ossificans
c) Malunion
d) Non Union
Correct answer : d) Non Union (Supracondylar fracture goes for malunion, not non union)
Complications of supracondylar fracture of humerus
Injury to arteries and nerves
Volkmann’s ischemia
Myositis ossificans
Malunion (results in gun stock deformity)
Volkmann’s ischemic contracture
All of the following are the causes of sudden increase in pain in osteochondroma, except:
a) Sarcomatous change
b) Fracture
c) Bursitis
d) Degenerative changes
Correct answer : d) Degenerative changes
Osteochondroma is usually painless. Sudden onset of pain in osteochondroma can be due to :
Malignant transformation
Bursitis
Fracture
Pressure or traction on neighbouring structures (nerve / tendon / muscle)
The lesions associated with recurrent dislocation of shoulder include all, except:
a) Hill-Sach’s lesion
b) Bankart`s lesion
c) Capsular laxity
d) Supraspinatus tear
Correct answer : d) Supraspinatus tear
Lesions associated with recurrent dislocation of shoulder are :
Hill-Sach’s lesion
Bankart`s lesion
Erosion of anterior rim of glenoid cavity
Capsular laxity
Subcapsularis deficiency
Glenoid fossa deficiency
One of the following is not correct in papillary carcinoma of thyroid:
a) Can be reliably diagnosed using fine needle aspiration cytology
b) Always unifocal
c) Typically spreads to the cervical lymph nodes
d) Requires a a total thyroidectomy for large tumours
Correct answer :
b) Always unifocal
Papillary carcinoma is usually mulitifocal. Lymphatic spread occurs to cervical lymph nodes. (Hematogenous spread occurs in case of follicular carcinoma.)
In which of the following conditions acquired (secondary) megacolon is seen?
a) Fissure in-ano
b) Complete absence of parasympathetic ganglion cells
c) Absence of sympathetic ganglion cells
d) Rectal malignancy
Correct answer :
d) Rectal malignancy
Absence of ganglion cells result in congenital megacolon. Fissure in ano causes anal sphincter spasm, but does not result in megacolon. Rectal malignancies cause luminal obstruction leading to development of megacolon.
RET proto oncogene mutation is a hallmark of which of the following tumors?
a) Medullary carcinoma thyroid
b) Astrocytoma
c) Paraganglionoma
d) Hurthle cell tumor thyroid
Correct answer : a) Medullary carcinoma thyroid
RET associations : MEN 2a, MEN 2b, Familial medullary carcinoma thyroid
A 3-year-old boy presents with fever; dysuria and gross hematuria. Physical examination shows a prominent suprapubic area which is dull on percussion. Urinalysis reveals red blood cells but no proteinuria. Which of the following is the most likely diagnosis?
a) Acute glomerulonephritis
b) Urinary tract infection
c) Posterior urethral valves
d) Teratoma
Correct answer :
c) Posterior urethral valves
Lets analyse the question. There is fever, dysuria and gross hematuria – indicates urinary tract infection. But urinary tract infections are uncommon in boys unless there is some congenital anomaly of the urogenital tract. Physical examination shows a prominent suprapubic area which is dull on percussion – due to enlarged bladder – indicating obstruction below the level of bladder. Posterior urethral valve is the most common cause of obstructive uropathy in a male child.
Enzyme replacement therapy is available for which of the following disorders?
a) Gaucher disease
b) Niemann Pick disease
c) Mucolipidosis
d) Metachromatic leukodystrophy
Correct answer :
a) Gaucher disease
Cerezyme is used for treating Gaucher Disease with Enzyme Replacement Therapy. Cerezyme acts like naturally occurring glucocerebrosidases
A premature infant is born with a patent ductus arteriosus. In closure can be stimulated by administration of:
a) Prostaglandin analogue
b) Estrogen
c) Anti-estrogen compounds
d) Prostaglandin inhibitors
Correct answer : d) Prostaglandin inhibitors
Normally ductus arteriosus closes soon after birth. Vasodilatory effect of prostaglandin is what maintains the patency of ductus arteriosus in intrauterine life. Hence in cases of delayed closure of ductus arteriosus, we can use prostaglandin inhibitors to induce its closure.
A 45-year old woman underwent a modified radical mastectomy 4 years ago. She was treated for multiple bone metastases with cyclophosphamide, doxorubicin, and fluorouracil for 6 months. She is complaining of breathlessness on exercise, swelling of the legs, and swelling around eyes in the morning. On examination, she has bilateral rales in the lungs, S3 gallop present. What is the most likely cause for her cardiac condition?
a) Diastolic heart failure
b) Drug induced cardiac toxicity
c) Metastatic cardiac disease
d) Pneumonia
Correct answer :
b) Drug induced cardiac toxicity
Which of the following statements is correct regarding adrenal histoplasmosis:
a) In active disease, calcification is commonly seen
b) Lymphadenopathy is not seen
c) The adrenal glands are usually symmetrically enlarged
d) Adrenal insufficiency is uncommon
Correct answer : c) The adrenal glands are usually symmetrically enlarged
Which of the following is not a B cell neoplasm?
a) Hairy cell leukemia
b) Angiocentric lymphoma
c) Mantle cell lymphoma
d) Burkitt’s lymphoma
Correct answer : b) Angiocentric lymphoma (All others are B cell neoplasms)
Which of the following is characteristically not associated with the development of interstitial lung disease?
al Organic dusts
b) Inorganic dusts
cl Toxic gaes e.g. chlorine, sulphur dioxide
d) lnhalation of tobacco smoke
Correct answer : d) lnhalation of tobacco smoke
Causes of interstitial lung disease include asbestos, radiation, connective tissue disorders, fumes, aspiration pneumonia and certain genetic conditions. Tobacco smoke is not implicated
With reference to Bacteroides fragilis the following statements are true, except:
a) B. fragilis is the same frequent anaerobe isolated from clinical samples.
b) B. fragilis is not uniformly sensitive to metronidazole
c) The lipopolysaccharide formed by B. fragilis is structurally and functionally different from the conventional endotoxin
d) Shock and disseminated intravascular coagulation are common in Bacreriodes bacteremia
Correct answer : d) Shock and disseminated intravascular coagulation are common in Bacreriodes bacteremia
Bacteroides:
Gram negative anaerobic bacilli
Most common anaerobic pathogen isolated from clinical specimens
Virulence factors include capsular polysaccharides and lipopolysaccharide endotoxin
Lipopolysaccharide endotoxin is much less toxic compared to other gram negative bacteria
Hence infections do not directly produce signs of sepsis, which is common in other gram negative bacteria
Some are resistant to metronidazole
ln the gut, anaerobic bacteria outnumber the aerobes by a ratio of
a) 10:1
b) 100:1
c) 1000:1
d) 10,000:1
Correct answer :
c) 1000:1
A patient of thromobosis of hepatic veins has been receiving coumarin therapy for a duration of three years. Recently. she has developed bleeding tendency. How will you reverse the effect of coumarin?
a) Protamine injection
b) Vit K injection
c) Infusion of fibrinogen
d) Whole blood transfusion
Correct answer :
b) Vit K injection
Prolonged use of one of the following anti convulsants can produce weight loss:
a) Gabapentin
b) Oxcarbazepine
c) Topiramate
d) Valproic acid
Correct answer : c) Topiramate
A randomized trial comparing efficacy of two regimens showed that difference is statistically significant with p< 0.001 but in reality the two drugs do not differ in their efficacy. This is an example of: a) Type-I error (alpha error) b) Type-II error (beta error) c) I alpha d) I betaCorrect answer : a) Type-I error (alpha error)
In all of the following diseases chronic carriers are found except:
a) Measles
b) Typhoid
c) Hepatitis B
d) Gonorrhoea
Correct answer :
a) Measles
All of the following indicators are included in Physical Quality of Life Index (PQLI) except:
a) Infant mortality rate
b) Life expectancy at age one
c) Literacy rate
d) Per capita income
Correct answer : d) Per capita income
A middle aged person reported to Psychiatric OPD with the complaints of the fear of leaving home, fear of travelling alone and fear of being in a crowd. He develops marked anxiety with palpitations and swelling if he is in these situations. He often avoids public transport to go to his place of work. The most likely diagnosis is:
a) Generalised anxiety disorder
b) Schizophrenia
c) Personality disorder
d) Agoraphobia
Correct answer :
d) Agoraphobia
A patient with acute psychosis, who is on haloperidol 20 mg/day for last 2 days, has an episode characterized by tongue protrusion, oculogyric crisis, stiffness and abnormal posture of limbs and trunk without loss of consciousness for last 20 minutes before presenting to casualty. This improved within a few minutes after
administration of diphenhydramine HCl. The most likely diagnosis is:
a) Acute dystonia
b) Akathisia
c) Tardive dyskinesia
d) Neuroleptic malignant syndrome
Correct answer :
a) Acute dystonia
A 30 year old man who was recently started on haloperidol 30 mg/day developed hyperpyrexia, muscle rigidity, akinesia, mutism, sweating, tachycardia and increased blood pressure. The investigations showed increased WBC count, increased creatinine phophokinase. These is no history of any other drug intake or any signs of
infection. The most likely diagnosis is:
a) Drug overdose
b) Neuroleptic malignant syndrome
c) Drug induced Parkinsonism
d) Tardive dyskinesia
Correct answer : b) Neuroleptic malignant syndrome
A 40 years old female patient presented with recurrent headaches. MRI showed an extra-axial, dural based and enhancing lesion. The most likely diagnosis is:
a) Meningioma
b) Glioma
c) Schwannoma
d) Pituitary adenoma
Correct answer :
a) Meningioma
Which of the following features on mammogram would suggest malignancy?
a) Well defined lesion
b) A mass of decreased density
c) Areas of spiculated microcalcifications
d) Smooth borders
Correct answer : c) Areas of spiculated microcalcifications
On MRI the differential diagnosis of spinal cord edema is:
a) Myelodysplasia
b) Myelomalacia
c) Myeloschisis
d) Cord tumors
Correct answer : b) Myelomalacia
Which of the following is the neuromuscular blocking agent with the shortest onset of action?
a) Mivacurium
b) Vecuronium
c) Rapacuronium
d) Succinylcholine
Correct answer : d) Succinylcholine
In general, the last muscle to be rendered akinetic with a retrobulbar anesthetic block is:
a) Superior rectus
b) Superior oblique
c) Inferior oblique
d) Levator palpebral superioris
Correct answer : b) Superior oblique
A 20-year old patient presented with early pregnancy was admitted for Medical Termination of Pregnancy (MTP) in day care facility. What will be the anesthetic induction agent of choice?
a) Thiopentone
b) Ketamine
c) Propofol
d) Diazepam
Correct answer : c) Propofol
Max. Joseph’s space is a histopathological feature of:
a) Psoriasis vulgaris
b) Lichen planus
c) Pityriasis rosea
d) Parapsoriasis
Correct answer : b) Lichen planus
Anagen phase of the hair indicates:
a) The phase of activity and growth
b) The phase of transition
c) The phase of resting
d) The phase of degeneration
Correct answer : a) The phase of activity and growth
‘Chancre redux’ is a clinical feature of:
a) Early relapsing syphlis
b) Late syphilis
c) Chancroid
d) Recurrent herpes simplex infection
Correct answer : a) Early relapsing syphlis
A case of carcinoma larynx with the involvement of anterior commissure and right vocal cord, developed perichondritis of thyroid cartilage. Which of the following statements is true for the managements of this case?
a) He should be given radical radiotherapy as this can cure early tumours
b) He should be treated with combination of chemotherapy and radiotherapy
c) He should first receive radiotherapy and if residual tumour is present then should undergo laryngectomy
d) He should first undergo laryngectomy and then post—operative radiotherapy.
Correct answer : d) He should first undergo laryngectomy and then post—operative radiotherapy.
Hyperacusis in Bell’s palsy is due to the the paralysis of the following muscle:
a) Tensor tympani
b) Levator veli palatini
c) Tensor veli palatini
d) Stapedius
Correct answer : d) Stapedius
Which of the following is the most common etiological agent in paranasal sinus mycoses?
a) Aspergillus spp
b) Histoplasma
c) Conidiobolus coronatus
d) Candida albicans
Correct answer : a) Aspergillus spp
Which one of the following statements, concerning persistent hyperplastic primary vitreous (PHPV) is true?
a) It is generally unilateral
b) Visual prognosis is usually good
c) It may calcify
d) It is most easily differentiated from retinoblastoma by the presence of exophthalmos or cataract.
Correct answer : a) It is generally unilateral
The following ocular structure is not derived from surface ectoderm:
a) Crystalline lens
b) Sclera
c) Corneal epithelium
d) Epithelium of lacrimal glands
Correct answer : b) Sclera
The risk of Asherman syndrome is the highest if Dilatation and Curettage (D & C) is done for the following condition:
a) Medical termination of pregancy
b) Missed abortion
c) Dysfunctional uterine bleeding
d) Post partum haemorrhage
Correct answer : d) Post partum haemorrhage
CA-125 is a marker antigen for the diagnosis of:
a) Colon cancer
b) Breast cancer
c) Brain cancer
d) Ovarian cancer
Correct answer : d) Ovarian cancer
The risk of endometrial carcinoma is the highest with the following histological pattem of endometrial hyperplasia:
a) Simple hyperplasia without atypia
b) Simple hyperplasia with atypia
c) Complex hyperplasia without atypia
d) Complex hyperplasia with atypia
Correct answer : d) Complex hyperplasia with atypia
Cushing’s Triad include all except;
a) Hypertension
b) Bradycardia
c) Hypothermia
d) Irregular respiration
Correct answer : c) Hypothermia
On electromyography, all of the following features suggest denervation, except:
a) Unrgulated firing of individual muscle fibres
b) Small short-duration polyphasic action potentials
c) Presence of positive sharp waves
d) Spontaneous firing of motor units
Correct answer : b) Small short-duration polyphasic action potentials
The main difference between REM sleep and wakefulness is:
a) EEG desynchronization
b) Rapid eye movements
c) Decreased muscle tone
d) Penile erection
Correct answer : c) Decreased muscle tone
All of the following are used for giving skeletal traction, except:
a) Steinmann pin
b) Kirschner wire
c) Bohler stirrup
d) Rush pin
Correct answer : d) Rush pin
The malunion of supracondylar fracture of the humerus most commonly leads to:
a) Flexion deformity
b) Cubitus varus
c) Cubitus valgus
d) Extension deformity
Correct answer : b) Cubitus varus
Malunion of supracondylar fracture of humerus results in cubitus varus deformity (gun stock deformity).
Transient synovitis (toxic synovitis) of the hip is characterized by all of the following, except:
a) May follow upper respiratory infection
b) ESR and white blood cell counts are usually normal
c) Ultrasound of the joint reveals widening of the joint space
d) The hip is typically held in adduction and internal rotation
Correct answer : d) The hip is typically held in adduction and internal rotation
In toxic synovitis, the hip is held in abduction and external rotation.
A 40 year-old female patient presented with dysphagia to both liquids and solids and regurgitation for 3 months. The dysphagia was non-progressive. What is the most likely diagnosis?
a) Caricnoma of the esophagus
b) Lower oesophageal mucosal ring
c) Achalasia cardia
d) Reflux esophagitis with esophageal stricture
Correct answer : c) Achalasia cardia
Which of the following brain tumours is highly vascular in nature?
a) Glioblastoma
b) Meningiomas
c) C P angle epidermoid
d) Pituitary adenomas
Correct answer : a) Glioblastoma
(Meningioma is also highly valscular, but it is said that glioblastoma is so vascular that it may resemble an arteriovenous malformation! )
Barrets esophagus is commonly associated with one of the following:
a) Adenocarcinoma
b) Squamous cell carcinoma
c) Sarcoma
d) Gastrointenstinal stromal tumor
Correct answer : a) Adenocarcinoma