Which of the following statements is true about hapten?

MedMRI · November 23, 2017, 11:35am

Which of the following statements is true about hapten?
A. It induces brisk immune response
B. It needs carrier to induce immune response
C. It is a T-independent Antigen
D. It has no association with MHC

Correct answer : B. It needs carrier to induce immune response

Hapten is a molecule which can react with antibodies but cannot induce antibody formation. It can induce an immune response after combining with a carrier molecule. Hapten-carrier complexes are T cell dependent antigens, but they require prior processing by macrophages.

A 70 year old male who has been chewing tobacco for the past 50 years presents with a 6 months history of a large, fungating, soft papillary lesion in the oral cavity. The lesion has penetrated into the mandible. Lymph nodes are not palpable. 2 biopsies taken from the lesion proper show benign papillomatosis with hyperkeratosis infiltrating the subjacent tissues. The most likely diagnosis is :
A. Squamous cell papilloma
B. Squamous cell carcinoma
C. Verrucous carcinoma
D. Malignant mixed tumour

Correct answer : C. Verrucous carcinoma

Verrucous carcinoma – also known as giant condyloma acuminatum / Buschke Lowenstein tumour are considered to be an intermediate stage between condyloma acuminatum and squamous cell carcinoma. They tend to be localised. They can be cured by wide excision. They can undergo malignant transformation.

The blood in the vessels normally does not clot because:
A. Vitamin K antagonists are present in plasma
B. Thrombin has a positive feedback on plasminogen
C. Sodium citrate in plasma chelates calcium ions
D. Vascular endothelium is smooth and coated with glycocalyx

Correct answer : D. Vascular endothelium is smooth and coated with glycocalyx

Glycocalyx is a general term referring to extracellular polymeric material (glycoprotein) produced by some bacteria, epithelia and other cells. The highly charged glycocalyx of endothelial cells helps prevent platelet adhesion. It also functions to prevent leukocyte adhesion in normal tissues (prevent unwanted inflammation).

Splenic macrophages in Gaucher’s disease differ from those in ceroid histiocytosis by staining positive for
A. Lipids
B. Phosphlipids
C. Acid fast stain
D. Iron

Answer : ??

Serum C3 is persistently low in the following?
A. Post streptococcal glomerulonephritis
B. Membranoproliferative glomerulonephritis
C. Lupus nephritis
D. Glomerulonephritis related to bacterial endocarditis

Correct answer : A. Post streptococcal glomerulonephritis

C3 is increased in all of the above. But in PSGN, the levels return to normal by 6-8 weeks.

All of the following are associated with low complement levels except:
A. Lupus nephritis
B. Mesangio capillary glomerulonepltritis
C. Diarrhea-associated hemolytic uremic syndrome
D. Post—infections glomerulonephritis

Correct answer : C. Diarrhoea-associated hemolytic uremic syndrome

A 60 year old male presented with acute chest pain of 4 hours duration. Electrocardiographic examination revealed new Q wave with ST segment depression. He succumbed to his illness within 24 hours of admission. The heart revealed presence of a transmural haemorrhagic area over the septum and anterior wall of the left ventricle. Light microscopic examination is most likely to reveal:
A. Edema in between normal myofibres
B. Necrotic myofibres with presence of neutrophils
C. Coagulative necrosis of the myocytes with presence of granulation tissue
D. lnliltration by histiocytes with haemosiderin laden macrophages

Correct answer : B. Necrotic myofibres with presence of neutrophils

After 24 hours of myocardial infarction, there is coagulative necrosis of myofibers with neutrophil infiltration.

All of the following are the good prognostic for Hodgkin’s disease except:
A. Haemoglobin > 10 gm/dl
B. WBC count < 15000/mm3
C. Absolute lymphocyte count < 600/mm3
D. Age < 45 yrs

Correct answer : C. Absolute lymphocyte count < 600/mm3

Adverse prognostic factors for hodgkin’s disease:

Male sex
Age > 45 years
Hemoglobin <10.5 g/dl
Serum albumin < 4g/dl
WBC count > 15000/mm3
Lymphocytopenia (Absolute lymphocyte count < 600/mm3 or lymphocytes < 8% of total WBC’s)
Stage IV disease

All of the following statements about hairy cell leukaemia are true except:
A. Splenomegaly is conspicuous
B. Results from an expansion of neoplastic T lymphocytes
C. Cells are positive for Tartarate Resistant Acid Phosphatase
D. The cells express CD25 consistently

Correct answer : B. Results from an expansion of neoplastic T lymphocytes

Hairy cell leukemia is a chronic B cell leukemia.

Which is the most common cytogenetic abnormality in adult myelodysplastic syndrome (MDS)?
A. Trisomy 8
B. 20q –
C. 5q –
D. Monosomy 7

Correct answer : D. Monosomy 7

Which of the following is an automsomal dominant metabolic disorder?
A. Cystic fibrosis
B. Phenyl ketouuria
C. alpha-1 antitrypsin deficiency
D. Familial hyper cholesterolemia

Correct answer : D. Familial hyper cholesterolemia

The other 3 are autosomal recessive.

Kinky hair disease is a disorder where an affected child has peculiar white stubby hair, does not grow, brain degenration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother’s brother also died of the same condition. Which of the following is the possible mode of inheritence in her family?
A. X-linked recessive
B. X-linked dominant
C. Autosomal recessive
D. Autosomal dominant

Correct answer : A. X-linked recessive

Only males are affected. Females are carriers.

Males who are sexually under developed with rudimentary testes and prostate glands, sparse pubic and facial hair, long arms and legs and large hands & feet are likely to have the chromosome complement of:
A. 45, XYY
B. 46, XY
C. 46, XXY
D. 46, X

Correct answer : C. 46, XXY

The clinical picture is that of Klinefelter syndrome. The correct answer should be 47, XXY. But it is not among the options given. Hence we select 46, XXY as the best option.

Which of the following gene defect is associated with development of medullary carcinoma of thyroid?
A. RET protooncogene
B. FAP gene
C. Rb gene
D. BRCA 1 gene

Correct answer : A. RET protooncogene

Other cancer associated genes:
FAP – Familial adenomatous polyposis
Rb – Retinoblastoma
BRCA 1 – Breast cancer

To which of the following events is ‘good’ outcome in neuroblastoma associated :
A. Diploidy
B. N—myc amplification
C. Chromosome / p depletion
D. Trk A expression

Correct answer : D. Trk A expression

Prognostic factors in neuroblastoma:

Age – Less than 1 year have good prognosis
Stage – I and II have good prognosis
Ploidy – Triploid and hyperploid tumours have good prognosis
Cytogenetics – Chromosome 1 / Chromosome 14 deletions have worse prognosis
n-myc oncogene amplification – associated with bad prognosis
Trk A expression – high levels are associated with favourable outcome

The most abundant glycoprotein present in basement membrane is:
A. Laminin
B. Fibronectin
C. Collagen type 4
D. Heparan sulphate

Correct answer : A. Laminin

Which of the following is an antiapoptotic gene?
A. C-myc
B. P-53
C. bcl-2
D. bax

Correct answer : C. bcl-2

Pro apoptotic genes – bax, bad, bcl-xS
Anti apoptotic genes – bcl-2, bcl-xL

To which of the following family of chemical mediators of inflammation, the Lipoxins belong?
A. Kinin system
B. Cytokines
C. Chemokines
D. Arachidonic acid metabolite

Correct answer : D. Arachidonic acid metabolite

Other arachidonic acid metabolites are leukotrienes and prostaglandins.

Which of the following is a procoagulation protein?
A. Thrombomodulin
B. Protein C
C. Protein S
D. Thrombin

Correct answer : D. Thrombin

Xeroderma pigmentosum is produced as a result of a defect in :
A. DNA polymerase III
B. DNA polymerase I
C. DNA exonuclease
D. DNA ligase

Correct answer : B. DNA polymerase I or D. DNA ligase

Xeroderma pigmentosum is an autosomal recessive disease with defect in DNA repair. It is characterised by extreme sensitivity to sunlight. The enzymes affected in this condition are:

UV specific endonuclease (most common)
DNA polymerase I
DNA ligase

A genetic disorder renders fructose 1,6 — biphosphatase in liver less sensitive to regulation by fructose 2,6 — bi-phosphate. All of the following metabolic changes are observed in this disorder except:
A. Level of fructose 1,6—biphosphate is higher than normal
B. Level of fructose 1,6 — biphosphate is lower than normal
C. Less pyruvate is formed
D. Less ATP is generated

Correct answer : A. Level of fructose 1,6—biphosphate is higher than normal

Fructose 2,6 – biphosphate acts to decrease the activity of fructose 1,6 – biphosphatase. When the enzyme becomes less sensitive to regulation, the inhibitory effect is lost and the enzyme activity increases. The following effects are observed:

Level of fructose 1,6 — biphosphate decreases
Pyruvate is used up for glucose synthesis
ATP is used up for glucose synthesis

Alpha helix and Beta pleated sheet are examples of:
A. Primary structure
B. Secondary structure
C. Tertiary structure
D. Quaternary structure

Correct answer : B. Secondary structure

Cytochrome C of the bacteria has 50% identity of amino acid sequence with that of human. Which of the following is the most conserved parameter in these two proteins?
A. Quarternary structure
B. Tertiary structure
C. Amino acid sequence
D. Loop and turn segments

Correct answer : B. Tertiary structure

A young man finds that every time he eats dairy products he feels very uncomfortable. His stomach becomes distended. He develops gas and diarrhea
frequently. These symptoms do not appears when he eats foods other than dairy products. Which of the following is the most likely enzyme in which this young man is deficient?
A. alpha-amylase
B. B-galactosidase
C. alpha-glucosidase
D. Sucrase

Correct answer : D. Sucrase

The clinical picture is suggestive of lactose intolerance. But lactase is not given in the options. Hence we have to look for an enzyme whose deficiency produces a similar clinical picture. Sucrase-isolamtase deficiency also presents with diarrhoea and bloating (gas) following intake of a diet containing sucrose or glucose polymers.

In which of the following conditions the level of creatinine kinase 1 increases ?
A. Myocardial ischemia
B. Brain Ischemia
C. Kidney damage
D. Electrical cardioversion

Correct answer : B. Brain Ischemia

Localisation of CPK isoenzymes
CPK 1 (CPK BB) – Brain
CPK 2 (CPK MB) – Myocardium
CPK 3 (CPK MM) – Skeletal muscle

Which of the following elements is known to influence the body’s ability to handle oxidative stress ?
A. Calcium
B. Iron
C. Potassium
D. Selenium

Correct answer : D. Selenium

Selenocysteine is a part of the enzyme glutathione peroxidase which has antioxidant action.

A middle aged woman on oral contraceptives for many years, developed neurological symptoms such as depression, irritability, nervousness and mental confusion. Her hemoglobin level was 8g/dl. Biochemical investigations revealed that she was excreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum. All of the above findings are most probably related to vitamin B6 deficiency caused by prolonged oral contraceptive use except :
A. Increased urinary xanthurenic acid excretion
B. Neurological symptoms by decreased synthesis of biogenic amines
C. Decreased hemoglobin level
D. Increased triglyceride and cholesterol level

Correct answer : D. Increased triglyceride and cholesterol level

Increased triglyceride and cholesterol level are due to metabolic effects of OCP’s and are not secondary to vitamin B6 deficiency.

A person on a fat free carbohydrate rich diet continues to grow obese. Which of the following lipoproteins is likely to be elevated in his blood?
A. Chylomicrons
B. VLDL
C. LDL
D. HDL

Correct answer : B. VLDL

High carbohydrate diet increases lipid synthesis. There is increased synthesis of tryglycerides and secretion of VLDL by liver.

A small calcium binding protein that modifies the activity of many enzymes and other proteins in response to changes of Ca2+ concentration, is known as:
A. Cycline
B. Calmodulin
C. Collagen
D. Kinesin

Correct answer : B. Calmodulin

Calmodulin is a calcium dependent regulatory protein which activates enzymes and ion channels.

Which of the following substances acts to increase the release of Ca2+ from endoplasmic reticulum ?
A. Inositol triphosphate
B. Parathyroid hormone
C. 1,25 dihydroxy cholecalciferol
D. Diacylglycerol

Correct answer : A. Inositol triphosphate

Inositol triphosphate (IP3) and diacylglycerol (DAG) are second messengers for G protein coupled receptors. IP3 stimulates release of calcium from endoplasmic reticulum. DAG activates protein kinase C.

Which of the following is a membrane bound enzyme that catalyzes the formation of cyclic AMP from ATP?
A. Tyrosine Kinase
B. Polymerase
C. ATP synthase
D. Adenylate cyclase

Correct answer : D. Adenylate cyclase

Proteins targeted for destruction in eukaryotes are covalently linked to :
A. Clathrin
B. Pepsin
c. Laminin
D. Ubiquitin

Correct answer : D. Ubiquitin

Ubiquitin targets proteins (newly synthesised abnormal proteins and old proteins) for destruction.

Which of the following group of proteins assist in the folding of other proteins?
A. Proteases
B. Proteosomes
C. Templates
D. Chaperones

Correct answer : D. Chaperones

Chaperones help in folding and assembly of other proteins.

Tip : The word ‘chaperone’ refers to an adult who accompanies or supervises young people on social occasions.

The transmembrane region of protein is likely to have
A. A stretch of hydrophilic amino acids
B. A stretch of hydrophobic amino acids
C. A disulphide loop
D. Alternating hydrophilic and hydrophobic amino acids

Correct answer : B. A stretch of hydrophobic amino acids

Cell membrane has a lipid core. Hence the transmembrane region of proteins contain hydrophobic amino acids. The ends of transmembrane proteins contain hydrophilic amino acids.

Which of the following can be a homologous substitution for valine in hemoglobin?
A. Isoleucine
B. Glutamic acid
C. Phenylalanine
D. Lysine

Correct answer : B. Glutamic acid

Valine can be replaced by glutamic acid, aspartic acid or alanine at position 67 of hemoglobin to produce Hb Milwaukee, Hb Bristol and Hb Sydney respectively. All of these are functionally normal hemoglobin types.

An enzyme that makes a double stranded DNA copy from a single stranded RNA template molecule is known as:
A. DNA polymerase
B. RNA polymerase
C. Reverse transcriptase
D. Phosphokinase

Correct answer : C. Reverse transcriptase

Reverse transcriptase is an RNA dependant DNA polymerase. It is seen in retro viruses.

A segment of a eukaryotic gene that is not represented in the mature messenger RNA is known as:
A. Intron
B. Exon
C. Plasmid
D. TATA box

Correct answer : A. Intron

Introns are the intervening sequences, Exons are the expressed sequences.

Tip for easy recollection : ‘Introns are idiots’.

RNA polymerase does not require :
A. Template (ds DNA)
B. Activated precursors (ATP, GTP, UTP, CTP)
C. Divalent metal ions (Mn2+, Mg2+)
D. Primer

Correct answer : D. Primer

DNA polymerase requires a primer.

Shine Dalgarno sequence in bacterial mRNA is near:
A. AUG codon
B. UAA codon
C. UAG codon
D. UGA codon

Correct answer : A. AUG codon

Shine Dalgarno sequence is important in the initiation of translation. It is a sequence of bases (5′-UAGGAGG-3′) which is located 6-10 bases upstream of the AUG codon in mRNA.

A newly posted junior doctor had difficulty in finding out base deficit/excess for blood in a given patient. An experienced senior resident advised a quick method to determine acid base composition of blood based on PCO2. Which of the following is the likely method he suggested to predict acid base composition of blood?
A. Red ford nonuogram
B. DuBio’s normogram
C. Goldman constant Field equation
D. Siggard Andersen normogram

Correct answer : D. Siggard Andersen normogram

Siggard Andersen normogram helps to predict the acid base status of blood. PCO2 is plotted in the Y axis and pH in the X axis.

The force of muscle contraction can be increased by all of the following except :
A. Increasing the frequency of activation of motor units
B. Increasing the number of motor units activated
C. Increasing the amplitude of action potentials in the motor neurons
D. Recruiting larger motor units

Correct answer : C. Increasing the amplitude of action potentials in the motor neurons

Action potential is an ‘all or none’ phenomenon. Increasing the amplitude beyond the threshold level does not influence the outcome.

The main excitatory neurotransmitter in the CNS is:
A. Glycine
B. Acetylcholine
C. Aspartate
D. Glutamate

Correct answer : D. Glutamate

GABA is the main inhibitory neurotransmitter.

Excitatory neurotransmitters – Glutamate, Aspartate
Inhibitory neurotransmitters – Glycine, GABA (Gamma Amino Butyric Acid)

In which of the following form the Anti diuretic hormone (ADH) is circulated in plasma :
A. Bound to neurophysin-I
B. Bound to neurophysin-II
C. Bound to plasma albumin
D. Free form

Correct answer : D. Free form

Before the onset of puberty, the GnRH neurons are under the inhibitory control of :
A. Glycine
B. Glutamate
C. Gamma amino butyric acid (GABA)
D. Beta—endorphin

Correct answer : C. Gamma amino butyric acid (GABA)

The enzyme associated with the conversion of androgen to oestrogen in the growing ovarian follicle is:
A. Desmolase
B. Isomerase
C. Aromatase
D. Hydroxylase

Correct answer : C. Aromatase

Sertoli cells have receptors for:
A. Inhibin
B. Luteinizing hormone
C. Follicle stimulating hormone
D. Melatonin

Correct answer : C. Follicle stimulating hormone

Sertoli cells also have receptors for testosterone.

During the cardiac cycle the opening of the aortic valve takes place at the :
A. Beginning of systole
B. End of isovolumetric contraction
C. End of diastole
D. End of diastasis

Correct answer : B. End of isovolumetric contraction

Valvular events in cardiac cycle:

Atrio-ventricular valves close at the end of diastole
Semilunar valves open at the end of isovolumetric contraction phase
Semilunar valves close at the end of systole
Atrio-ventricular valves open at the end of isovolumetric relaxation phase

Patients having acute cardiac failure do not show pedal oedema, because :
A. The plasma oncotic pressure is high
B. There is renal compensation
C. There is an increase in cardiac output
D. There is a fall in the systemic capillary hydrostatic pressure

Correct answer : D. There is a fall in the systemic capllary hydrostatic pressure

Edema is due to increase in capillary hydrostatic pressure or decrease in plasma oncotic pressure. Acute cardiac failure is usually due to decrease in cardiac output and hypotension. Capillary hydrostatic pressure falls and hence edema is not seen.

One intem calculated the concentration of O2 in blood as 0.0025 ml/ml of blood. Considering atmospheric pressure as 760mmHg, how much approx. O2 tension could have been in the blood ?
A. 40mmHg
B. 60mmHg
C. 80mmHg
D. 100mmHg

Correct answer : C. 80mmHg

(Calculated using a table given in Ganong.)

During acclimatization to high altitude all of the following take place except:
A. Increase in minute ventilation
B. Increase in the sensitivity of central chemoreceptors
C. Increase in the sensitivity of carotid body to hypoxia
D. Shift in the oxygen dissociation curve to the left

Correct answer : D. Shift in the oxygen dissociation curve to the left

During acclimatization, there is shift of oxygen dissociation curve to the right. This improves oxygen release into tissues.

The Couinaud’s segmental nomenclature is based on the position of the :
A. Hepatic veins and portal vein
B. Hepatic veins and biliary ducts
C. Portal vein and biliary ducts
D. Portal vein and hepatic artery

Correct answer : A. Hepatic veins and portal vein

Couinaud’s segmental nomenclature is based on position of hepatic veins and portal vein. It is the French system.

Which of following is the feature of Y chromosome?
A. Acrocentric
B. Telocentric
C. Submetacentric
D. Metacentric

Correct answer : A. Acrocentric

Y chromosome – Acrocentric
X chromosome – Submetacentric

Tip for remembering : Acro- stands for summit, height etc. Men are taller. Hence Y chromosome is acrocentric.

All of the following are catagorised as secondary lymphoid organs except
A. Lymph nodes
B. Spleen
C. Thymus
D. Subepithelial collections of lymphocytes

Correct answer: C. Thymus

Bone marrow and thymus are primary lymphoid organs.

The articular cartilage is characterized by all of the following features except :
A. It is devoid of perichondrium
B. It has a rich nerve supply
C. It is avascular
D. It lacks the capacity to regenerate

Correct answer : B. It has a rich nerve supply

Articular cartilage has no vessels / nerves.

The first costo-chondral joint is a :
A. Fibrous joint
B. Synovial joint
C. Syndesmosis
D. Synchondrosis

Correct answer : D. Synchondrosis

Costochondral joints are primary cartilaginous joints / synchondrosis / hyaline cartilage joint.

The movement at the following joint permits a person to look towards the right or left :
A. Atlanto-occipital joint
B. Atlanto-axial joint
C. C2-C3 joint
D. C3-C4 joint

Correct answer : B. Atlanto-axial joint

Tip : You say ‘yes’ (flexion) with your atlanto occipital joint and you say ‘no’ (rotation) with your atlanto axial joint.

The intricately and prodigiously looped system of veins and arteries that lie on the surface of the epididymis is known as :
A. Choroid plexus
B. Tuberal plexus
C. Pampiniform plexus
D. Pectiniform septum

Correct answer : C. Pampiniform plexus

Infection / inflammation of all of the following causes, enlarged superficial inguinal lymph nodes except :
A. Isthmus of uterine tube
B. Inferior part of anal canal
C. Big toe
D. Penile urethra

Correct answer : D. Penile urethra

Lymphatic drainage of urethra

Penile urethra – deep inguinal lymph nodes
Prostatic urethra and membranous urethra  – Internal iliac nodes
Entire female urethra – Internal iliac nodes

While exposing the kidney from behind, all of the following nerves are liable to injury except:
A. Lateral cutaneous nerve of thigh
B. Ilioinguinal nerve
C. Subcostal nerve
D. Iliohypogastric nerve

Correct answer : A. Lateral cutaneous nerve of thigh

Posterior relations of the kidney:

Diaphragm
Medial and lateral arcuate ligaments
Muscles:
    Psoas major
    Quadratus lumborum
    Transversus abdominis
Subcostal vessels
Nerves:
    Subcostal nerve
    Iliohypogastric nerve
    Ilioinguinal nerve
12th rib (11th rib and 12th ribs in left kidney)

An inhaled foreign body is likely to lodge in the right lung due to all of the following features except:
A. Right lung is shorter and wider than left lung
B. Right principal bronchus is more vertical than the left bronchus
C. Tracheal bifurcation directs the foreign body to the right lung
D. Right inferior lobar bronchus is in continuation with the principal bronchus

Correct answer : A. Right lung is shorter and wider than left lung

An foreign body is more likely to get lodged in the right lung as the right bronchus is wider, shorter and more vertical

After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to :
A. Shrug the shoulders
B. Raise the arm above the head on the affected side
C. Touch the opposite shoulder
D. Lift a heavy object from the ground

Correct answer : B. Raise the arm above the head on the affected side

Long thoracic nerve (Nerve of Bell) supplies the serratus anterior muscle
Serratus anterior rotates the inferior angle of scapula laterally during abduction of the arm above the head – hence it is impaired in injury to long thoracic nerve
Winging of scapula is another classical feature of long thoracic nerve injury

Which of the following passes through foramen magnum?
A. Internal Carotid Artery
B. Sympathetic chain
C. Hypoglossal Nerve
D. Vertebral Artery

Correct answer : D. Vertebral Artery

Structures passing through foramen magnum

Lower part of medulla and meninges
Vertebral artery
Anterior spinal artery
Posterior spinal artery
Spinal root of accessory nerve
Apical ligament
Vertical band of cruciate ligament
Tectorial membrane

Which among the following is a branch from the trunk of brachial plexus?
A. Suprascapular nerve
B. Long thoracic nerve
C. Anterior thoracic nerve
D. Nerve to subclavius

Correct answer : A. Suprascapular nerve

Main blood supply of neck of femur?
A. Lateral circumflex femoral
B. Medial circumflex femoral
C. Profunda femoris
D. Popliteal artery

Correct answer : B. Medial circumflex femoral

All are seen in the floor of 3rd ventricle except?
A. Infundibulum
B. Oculomotor nerve
C. Mammillary body
D. Optic chiasma

Correct answer : B. Oculomotor nerve

Structures in floor of third ventricle

Infundibulum
Mamillary body
Chiasma
Tuber cinerium
Posterior perforated substance
Tegmentum of mid brain

Muscular component of dorsal aorta develops from?
A. Axial mesoderm
B. Paraxial mesoderm
C. Intermediate mesoderm
D. Lateral plate mesoderm

Correct answer : B. Paraxial mesoderm

The most sensitive test for the diagnosis of myasthenia gravis is:
A. Elevated serum ACh-receptor binding antibodies
B. Repetitive nerve stimulation test
C. Positive edrophonium test
D. Measurement of jitter by single fibre electromyography

Correct answer : C. Positive edrophonium test

Edrophonium test has 95% sensitivity for detection of systemic myasthenia gravis and 85% sensitivity for that of ocular variety.

(Note : This is the answer given in Mudit Khanna. But Harrison writes that it is used infrequently to diagnose MG and is limited to situations when other investigations do not yield a conclusive diagnosis. Other sources state single fibre electromyography to be the most sensitive test.)

All of the following are true about manifestations of vitamin E deficiency, except:
A. Hemolytic anemia
B. Posterior column abnormalities
C. Cerebellar ataxia
D. Autonomic dysfunction

Correct answer : D. Autonomic dysfunction

Autonomic dysfunction is not seen with vitamin E deficiency.

Vitamin B12 deficiency can give rise to all of the following, except:
A. Myelopathy
B. Optic atrophy
C. Peripheral neuropathy
D. Myopathy

Correct answer : D. Myopathy

Myopathy is not seen with vitamin B12 deficiency.

All of the following are neurologic channelopathies except:
A. Hypokalemic periodic paralysis
B. Episodic ataxia type 1
C. Familial hemiplegic migraine
D. Spinocerebellar ataxia 1

Correct answer : D. Spinocerebellar ataxia 1

Spinocerebellar ataxia (SCA) type 1 is not a neurological channelopathy. But SCA type 6 is a neurological channelopathy.

EEG is usually abnormal in all of the following, except:
A. Subacute sclerosing panencephalitis
B. Locked — in state
C. Creutzfeldt — Jakob disease
D. Hepatic encephalopathy

Correct answer : B. Locked — in state

In locked in state, normal alpha activity is found in EEG.

Which one of the following is not source of manager’s power:
A. Reward
B. Coercive
C. Legitimate
D. Efferent

Correct answer : D. Efferent

Types of power:

Reward power – Ability to give rewards
Coercive power – Ability to withhold rewards or give punishment
Legitimate power (position power) – Power bestowed upon a person by his / her position in an organisation
Expert power – By virtue of one’s own knowledge
Referent power – By virtue of one’s personality

The information technology has revolutionized the world of medical sciences. In which year the Information Technology Act was passed by the Government of India?
A. 1998
B. 2000
C. 2001
D. 2003

Correct answer : B. 2000

Transplantation of Human Organs Act was passed by Government of India in:
A. 1996
B. 1993
C. 1998
D. 1994

Correct answer : D. 1994

WHO defines adolescent age between:
A. 10-19 years of age
B. 10-14 years of age
C. 10-25 years of age
D. 9-14 years of age

Correct answer : A. 10-19 years of age

Under the WHO ‘Vision 2020‘ programme. the ‘SAFE‘ strategy is adopted for which of the following diseases?
A. Trachoma
B. Glaucoma
C. Diabetic retinopathy
D. Onchocerciasis

Correct answer : A. Trachoma

SAFE strategy was devised by WHO for the treatment of trachoma. SAFE stands for:
S – Surgery (of the lids for trichiasis)
A – Antibiotics
F – Facial cleanliness
E – Environmental change

The membrane protein, clathrin is involved in:
A. Cell motility
B. Receptor-mediated endocytosis
C. Exocytosis
D. Cell shape

Correct answer : B. Receptor-mediated endocytosis

A lattice of clathrin coats the cytosolic pits formed during receptor mediated endocytosis.

Cellular and flagellar movement is carried out by all of the following except:
A. Intermediate filaments
B. Actin
C. Tubulin
D. Myosin

Correct answer : A. Intermediate filaments

Intermediate filaments form a cellular scaffolding that help cells to resist external pressure.

Differential expression of same gene depending on parent of origin is referred to as:
A. Genomic imprinting
B. Mosaicism
C. Anticipation
D. Nonpenetrance

Correct answer : A. Genomic imprinting

Explanation: In genomic imprinting, there is preferential expression of an allele depending on its parental origin.

The chances of having an unaffected baby, when both parents have achondroplasia, are:
A. 0%
B. 25%
C. 50%
D. 100%

Correct answer : B. 25%

Achondroplasia is autosomal dominant.

Which one of the following is not a feature of liver histology in Non cirrhotic portal fibrosis (NCPF)?
A. Fibrosis in and around the portal tracts
B. Thrombosis of the medium and small portal vein branches
C. Non specific inflammatory cell infiltrates in the portal tracts
D. Bridging fibrosis

Correct answer : D. Bridging fibrosis

In NCPF, fibrosis is seen only in portal and periportal region.

Which one of the following diseases characteristically causes fatty change in liver?
A. Hepatitis B virus infection
B. Wilson’s disease
C. Hepatitis C virus infection
D. Chronic alcoholism

Correct answer : D. Chronic alcoholism

A 45 year old male with a history of alcohol dependence presents with confusion, nystagmus and ataxia. Examination reveals 6th cranial nerve weakness. He is most likely to be suffering from:
A. Korsakoff’s psychosis
B. Wernicke encephalopathy
C. De Clerambault syndrome
D. Delirium tremens

Correct answer : B. Wernicke encephalopathy

Wernicke encephalopathy is characterised by a triad of confusion, ophthalmoplegia and ataxia in an alcoholic patient.

A 40 year old male with history of daily alcohol consumption for the last 7 years, is brought to the hospital emergency room with acute onsent of seeing snakes all around him in the room, not recognizing family members, violent behavior and tremulousness for a few hours. There is history of his having missed the alcohol drink for 2 days. Examination reveals increased blood pressure, tremors, increased psychomotor activity, fearful affect, hallucinatory behaviour, disorientation, impaired judgement and insight. He is most likely to be suffering from:
A. Alcoholic hallucinosis
B. Delirium tremens
C. Wernicke encephalopathy
D. Korsakoff’ s psychosis

Correct answer : B. Delirium tremens

The clinical picture is characteristic of Delirium tremens.

Which of the following is a cause of reversible dementia?
A. Subacute combined degeneration
B. Picks disease
C. Creutzfeldt — Jakob disease
D. Alzheimers disease

Correct answer : A. Subacute combined degeneration

Subacute combined degeneration is caused by vitamin B12 deficiency and is potentially reversible.

The best indicator for monitoring the impact of Iodine Deficiency Disorders control programme is:
A. Prevalence of goiter among school children
B. Urinary iodine levels among pregnant women
C. Neonatal Hypothyroidism
D. Idoine level is soil

Correct answer : C. Neonatal Hypothyroidism

Total cholesterol level = a + b (calorie intake) + c (physical activity) + d (body mass index); is an example of:
A. Simple linear regression
B. Simple curvilinear regression
C. Multiple linear regression
D. Multiple logistic regression

Correct answer : C. Multiple linear regression

Here, the total cholesterol level is depicted as depending upon multiple independent factors. The relationship is linear and not logarithmic. Hence it is a multiple linear regression.

The diagnostic power of a test to correctly exclude the disease is reflected by:
A. Sensitivity
B. Specificity
C. Positive predictivity
D. Negative predictivity

Correct answer :D. Negative predictivity

Adenosine deaminase (enzyme) deficiency is associated with:
A. Severe combined immunodeficiency (SCID)
B. X-linked agammaglobulinemia
C. Transient hypogarnmaglobulinemia of infancy
D. Chronic granulomatous disease

Correct answer : A. Severe combined immunodeficiency (SCID)

A woman with infertility receives an ovary transplant from her sister who is an identical Twin. What type of graft it is?
A. Xenograft
B. Autograft
C. Allograft
D. lsograft

Correct answer : D. lsograft

Type l hypersensitivity is mediated by which of the following immunoglobulins?
A. IgA
B. IgG
C. IgM
D. IgE

Correct answer : D. IgE

haracteristic feature in kidney biopsy from a child with hemolytic uremic syndrome is:
A. Thrombotic microangiopathy
B. Proliferative glomerulonephritis
C. Focal segmental glomerulosclerosis
D. Minimal change disease

Correct answer : A. Thrombotic microangiopathy

HUS is classified under thrombotic microangiopathies.

In which of the following conditions bilateral contracted kidneys are characteristically seen?
A. Amyloidosis
B. Diabetes mellitus
C. Rapidly progressive (crescentic) glomerulonephritis
D. Benign nephrosclerosis

Correct answer : D. Benign nephrosclerosis

In benign nephrosclerosis, the kidneys may be reduced in size due to cortical scarring and shrinking.

Atypical pneumonia can be caused by the following microbial agents except?
A. Mycoplasma pneumoniae
B. Legionella pneumophila
C. Human Corona virus
D. Klebsiella pneumoniae

Correct answer : D. Klebsiella pneumoniae

Klebsiella causes ‘typical pneumonia’.

All of the following therapies may be required in a 1 hour old infant with severe birth asphyxia except:
A. Glucose
B. Dexamethasone
C. Calcium gluconate
D. Normal saline

Correct answer : B. Dexamethasone

Steroids should not be used in management of infants with asphyxia.

The karyotype of a patient with Androgen Insensitivity Syndrome is:
A. 46XX
B. 46XY
C. 47XXY
D. 45XO

Correct answer : B. 46XY

Androgen insensitivity is seen in genetic males (XY) who exhibit a female phenotype.

Which one of the following drugs is used for fetal therapy of congenital adrenal hyperplasia?
A. Hydrocortisone
B. Prednisolone
C. Fludrocortisone
D. Dexamethasone

Correct answer : D. Dexamethasone

Dexamethasone acts by suppressing the secretion of steroids by fetal adrenals.

The most common pure germ cell tumor of the ovary is:
A. Choriocarcinoma
B. Dysgerminoma
C. Embryonal cell tumor
D. Malignant Teratoma

Correct answer : B. Dysgerminoma

Patients of Rectovaginal fistula should be initially treated with:
A. Colostomy
B. Primary repair
C. Colporrhaphy
D. Anterior resection

Correct answer : A. Colostomy

The definitive treatment is surgery. But to increase the success rate of surgery, colostomy can be done initially. This decreases inflammation.

All of the following CSF findings are present in tuberculous meningitis, except:
A. Raised protein levels
B. Low chloride levels
C. Cob web formation
D. Raised sugar levels

Correct answer : D. Raised sugar levels

Glucose levels are decreased in tuberculous meningitis.

Normal CSF glucose level in the normoglycemic adult is:
A. 20-40 mg/dl
B. 40-70 mg/dl
C. 70-90 mgdl
D. 90-110 mg/dl

Correct answer : B. 40-70 mg/dl

Which one of the following is the most common location of hypertensive bleed in the brain?
A. Putamen/external capsule
B. Pons
C. Ventricles
D. Lobar white matter

Correct answer : A. Putamen/external capsule

The events A and B are mutually exclusive, so:
A. Prob (A or B) = Prob (A) + Prob (B)
B. Prob (A and B) = Prob (A) * Prob (B)
C. Prob (A) = Prob (B)
D. Prob (A) + Prob (B) = 1

Correct answer : A. Prob (A or B) = Prob (A) + Prob (B)

In mutually exclusive events, the probability of at least one of them occurring will be equal to the sum of their individual probabilities.

The Hb level in healthy women has mean 13.5 g/dl and standard deviation 1.5 g/dl, what is the Z score for a woman with Hb level 15.0 g/dl:
A. 9.0
B. 10.0
C. 2.0
D. 1.0

Correct answer : D. 1.0

The value (15g/dl) lies 1 SD (1.5g/dl) above the mean of 13.5g/dl. Hence the Z score is 1.

At autopsy, the cyanide poisoning case will show the following features, except:
A. Characteristic bitter lemon smell
B. Congested organs
C. The skin may be pinkish or cherry red in colour
D. Erosion and haemorrhages in oesophagus and stomach

Correct answer : A. Characteristic bitter lemon smell

In cyanide poisoning, the characteristic smell is that of bitter almonds.

Etanercept acts by one of the following mechanisms:
A. By blocking tumor necrosis factor
B. By blocking bradykinin synthesis
C. By inhibiting cyclo-oxygenase-2
D. By blocking lipoxygenase

Correct answer : A. By blocking tumor necrosis factor

Nevirapine is a
A. Protease inhibitor
B. Nucleoside reverse transcriptase inhibitor
C. Non-nucleoside reverse transcriptase inhibitor
D. Fusion inhibitor

Correct answer : C. Non-nucleoside reverse transcriptase inhibitor

Which one of the following is used in therapy of Toxoplasmosis?
A. Artensenuate
B. Thiacetazone
C. Ciprofloxacin
D. Pyrimethamine

Correct answer : D. Pyrimethamine

The serum concentration of which of the following human IgG subclass is maximum?
A. lgG1
B. IgG2
C. lgG3
D. lgG4

Correct answer : A. lgG1

IgG1 is most common (65%). IgG4 is least common (4%).

The capsule of Cryptococcus neoformans in a CSF sample is best seen by:
A. Gram stain
B. India ink preparation
C. Giemsa stain
D. Methanamine-Silver stain

Correct answer : B. India ink preparation

With India ink preparation, the capsule can be seen as a clear halo around the cell.

Which of the following infestation leads to malabsorption?
A. Giardia lamblia
B. Ascaris lumbricoides
C. Necator americanus
D. Ancylostama duodenale

Correct answer : A. Giardia lamblia

Giardiasis can cause fulminant diarrhoea and malabsorption. It may even be asymptomatic.

All of the following features are seen in the viral pneumonia except:
A. Presence of interstitial inflammation
B. Predominance of alveolar exudates
C. Bronchiolitis
D. Multinucleate gaint cells in the bronchiolar wall

Correct answer : B. Predominance of alveolar exudates

Viral pneumonia is a type of atypical pneumonia. The inflammation is mostly restricted to the wall of alveoli. Exudates many not be seen inside alveoli.

Aschoff’ s nodules are seen in:
A. Subacute bacterial endocarditis
B. Libman-Sacks endocarditis
C. Rheumatic carditis
D. Non—bacterial Thrombotic endocarditis

Correct answer : C. Rheumatic carditis

Which of the following statement is not true?
A. Patients with lgD myeloma may present with no evident M-spike on serum electrophoresis
B. A diagnosis of plasma cell leukemia can be made if circulating peripheral blood plasmablasts comprise 14% of peripheral blood white cells in a patient with white blood cell count of 1 * 10^9/L and platelet count of 88 * 10^9/L
C. ln smoldering myeloma plasma cells constitute 10-30% of total bone marrow cellularity
D. ln a patient with multiple myeloma, a monoclonal light chain may be detected in both serum and urine

Correct answer : B. A diagnosis of plasma cell leukemia can be made if circulating peripheral blood plasmablasts comprise 14% of peripheral blood white cells in a patient with white blood cell count of 1 * 10^9/L and platelet count of 88 * 10^9/L

To be considered as plasma cell leukemia, plasma cells should constitute more than 20% of peripheral blood WBC’s. (Here it is only 14%)

A 48 year old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 2.7 * 10^9/L and total leukocyte count 40 * 10^9/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD19, CD5, CD20 and CD23 and were negative for CD79B and FMC—7. The histopathological examination of the lymph node in this patient will most likely exhibit effacement of lymph node architecture by:
A. A pseudofollicular pattern with proliferation centers
B. A monomorphic lymphoid proliferation with a nodular pattern
C. A predominantly follicular pattern
D. A diffuse proliferation of medium to large lymphoid cells with high mitotic rate

Correct answer : D. A diffuse proliferation of medium to large lymphoid cells with high mitotic rate

The history, clinical features and immunophenotype is characteristic of chronic lymphoid leukemia.

Neuronal degeneration is seen in all of the following except:
A. Crush nerve injury
B. Fetal development
C. Senescence
D. Neuropraxia

Correct answer : D. Neuropraxia

Neuropraxia is characterized by physiological disruption in conduction.

The first physiological response to high environmental temperature is:
A. Sweating
B. Vasodilatation
C. Decreased heat production
D. Non-shivering thermogenesis

Correct answer : B. Vasodilatation

First response to high environment temperature is cutaneous vasodilatation.

Barr body is found in the following phase of the cell cycle:
A. lnterphase
B. Metaphase
C. G1 phase
D. Telophase

Correct answer : A. lnterphase

An 18 year old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be to:
A. Leave him as normal adolescent problem
B. Rule out depression
C. Rule out migraine
D. Rule out an oppositional defiant disorder

Correct answer : B. Rule out depression

The given features are not something that may be considered as normal adolescent problem. Also the headache described here cannot be classified under migraine. Oppositional defiant disorder often presents at a younger age. Hence it is necessary to rule out depression.

A 25 year old female presents with 2 year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them along with medications. She is most likely to benefit from which of the following therapies?
A. Exposure and response prevention
B. Systematic desensitization
C. Assertiveness training
D. Sensate focusing

Correct answer : A. Exposure and response prevention

The history is suggestive of Obsessive Compulsive Disorder. The first line of treatment is Exposure and response prevention

Which one of the following tumors shows calcification on CT Scan:
A. Ependymoma
B. Meduloblastoma
C. Meningioma
D. CNS lymphoma

Correct answer : C. Meningioma

Both meningioma and ependymoma show calcification. But it is more common in meningioma.

A Lower Segment Caesarean section (LSCS) can be carried out under all the following techniques of anaesthesia except:
A. General anaesthesia
B. Spinal anaesthesia
C. Caudal anaesthesia
D. Combined Spinal Epidural anaesthesia

Correct answer : C. Caudal anaesthesia

Caudal anaesthesia is used only for perineal surgery.

The following modes of ventilation may be used for weaning off patients from mechanical ventilation except:
A. Controlled Mechanical ventilation (CMV)
B. Synchronized intermittent mandatory ventilation (SIMV)
C. Pressure support ventilation (PSV)
D. Assist-control ventilation (ACV)

Correct answer : A. Controlled Mechanical ventilation (CMV)

In CMV, the ventillator delivers the tidal volume. The patient effort is not present. Hence it is not used for weaning off patients from ventillator.

The only definite indication for giving systemic corticosteroids in pustular psoriasis is:
A. Psoriatic enythroderma with pregnancy
B. Psoriasis in a patient with alcoholic cirrhosis
C. Moderate arthritis
D. Extensive lesions

Correct answer : D. Extensive lesions

Systemic corticosteroids are not recommended in treatment of pustular psoriasis. This is because the disease can recur with increased severity once the treatment is stopped. But the best answer is treatment of extensive lesions. Steroids are very useful as a short term life saving measure in severe disease when other drugs have failed.

Androphonia can be corrected by doing:
A. Type l Thyroplasty
B. Type 2 Thyroplasty
C. Type 3 Thyroplasty
D. Type 4 Thyroplasty

Correct answer : D. Type 4 Thyroplasty

Androphonia refers to masculinisation of female voice. This can be treated by type 4 thyroplasty. It increases the length and tension of the cord, thereby increasing the pitch of voice.

In Klippel-Feil syndrome, the patient has all of the following clinical features except:
A. Low hair line
B. Bilateral Neck webbing
C. Bilateral shortness of sterno mastoid muscles
D. Gross limitations of neck movements

Correct answer : C. Bilateral shortness of sterno mastoid muscles

Blood specimen for neonatal thyroid screening is obtained on:
A. Cord blood
B. 24 hours after birth
C. 48 hours after birth
D. 72 hours after birth

Correct answer : A. Cord blood D. 72 hours after birth

Update: The correct answer is 72 hours after birth.
Guidelines for neonatal thyroid screening – American Academy of Pediatrics

When to screen:

Normal hospital delivery at term – Filter paper collection ideally at 2-4 days of age or at time of discharge
NICU / preterm home birth – Within 7 days of birth
Maternal history of thyroid medication / family history of congenital hypothyroidism – cord blood for screening

Cord blood is to be used only if there is family history of hypothyroidism. In normal delivery, blood is taken at 2-4 days of age.

Ref: http://pediatrics.aappublications.org/content/117/6/2290.full.pdf+html

The appropriate approach to a neonate presenting with vaginal bleeding on day 4 or life is:
A. Administration of vitamin K
B. Investigation for bleeding disorder
C. No specific therapy
D. Administration of 10 ml/kg of fresh frozen plasma over 4 hours

Correct answer : C. No specific therapy

Vaginal bleeding can occur in 3rd – 7th day after birth. It occurs due to withdrawal of maternal hormones. It usually subsides in 2-3 days. No specific treatment is required.

In unconjugated hyperbilirubinemia, the risk of kernicterus increases with the use of:
A. Ceftriaxone
B. Phenobarbitone
C. Ampicillin
D. Sulphonamide

Correct answer : D. Sulphonamide

Sulphonamide can displace bilirubin from albumin.

The highest incidence of Gestational Trophoblastic Disease is in:
A. Australia
B. Asia
C. North America
D. Westem Europe

Correct answer : B. Asia

Which one of the following soft tissue sarcomas frequently metastasizes to lymph nodes?
A. Fibrosarcoma
B. Osteosarcoma
C. Embryonal Rhabdomyosarcoma
D. Alveolar soft part sarcoma

Correct answer : C. Embryonal Rhabdomyosarcoma

Rhabdomyosarcoma is a soft tissue sarcoma which frequently metastasizes to lymph nodes.

The earliest manifestation of increased intracranial pressure following head injury is:
A. Ipsilateral pupillary dilatation
B. Contralateral pupillary dilatation
C. Altered mental status
D. Hemiparesis

Correct answer : C. Altered mental status

Which of the following features are seen in lower motor lesions?
A. Flaccid paralysis
B. Hyperactive stretch reflex
C. Spasticity
D. Muscular incordination

Correct answer : A. Flaccid paralysis

Which of the following drugs is useful in prophylaxis of migraine?
A. Propranolol
B. Sumatriptan
C. Domperidone
D. Ergotamine

Correct answer : A. Propranolol

Drugs for prophylaxis of migraine:

Beta antagonists – propranalol, timolol
Anti epileptics – Valproate
Antidepressants – amitryptiline, nortryptiline
MOA inhibitors – phenelzine
Serotonergic agents – methysergide, cyproheptadine
Misc – verapamil

Cluster headache is characterized by all, except:
A. Affects predominantly females
B. Unilateral headache
C. Onset typically in 20-50 years of life
D. Associated with conjunctival congestion

Correct answer : A. Affects predominantly females

Males are predominantly affected by cluster headache.

The PEFR of a group of 11 year old girls follow a normal distribution with mean 300 l/min and standard deviation 20 l/min:
A. About 95% of the girls have PEFR between 260 and 340 l/min
B. The girls have healthy lungs
C. About 5% of girls have PEFR below 260 l/min
D. All the PEFR must be less than 340 l/min

Correct answer : A. About 95% of the girls have PEFR between 260 and 340 l/min

95.4% of values lie within 2 SD (standard deviation) of the mean
Here, SD = 20 l/min
Hence 95.4% of values lie within 300-(2*20) and 300=(2*20)
Which translates into : About 95% of the girls have PEFR between 260 and 340 l/min

The standard normal distribution:
A. Is skewed to the left
B. Has mean = 1.0
C. Has standard deviation = 0.0
D. Has variance = 1.0

Correct answer : D. Has variance = 1.0

A standard normal deviation is not skewed to any side. It is symmetrical
Standard deviation = 1.0
Variance = SD^2 = 1.0

What is the color coding of the bag used in hospitals to dispose off human anatomical wastes such as body parts:
A. Yellow
B. Black
C. Red
D. Blue

Correct answer : A. Yellow

Which one of the following is best associated with Lumefantrine?
A. Antimycobacterial
B. Antifungal
C. Antimalarial
D. Antiamoebic

Correct answer : C. Antimalarial

The group of antibiotics which possess additional anti-inflammatory and immunomodulatory activity is:
A. Tetracyclines
B. Polypeptide antibiotics
C. Fluoroquinolones
D. Macrolides

Correct answer : D. Macrolides

Tacrolimus (which is a macrolide) has anti-inflammatory and immunomodulatory activity.

One of the following is not penicillinase susceptible:
A. Amoxicillin
B. Penicillin G
C. Piperacillin
D. Cloxacillin

Correct answer : D. Cloxacillin

Cloxacillin is a penicillinase resistant penicillin.

Which of the following is not a neuroparasite?
A. Taenia solium
B. Acanthamoeba
C. Naegleria
D. Trichinella spiralis

Correct answer : D. Trichinella spiralis

Trichinella spiralis is seen in striated muscles.

HIV can be detected and confirmed by:
A. Polymerase Chain Reaction (PCR)
B. Reverse Transcriptase PCR
C. Real Time PCR
D. Mimic PCR

Correct answer : B. Reverse Transcriptase PCR

Virus mediated transfer of host DNA from one cell to another is known as:
A. Transduction
B. Transformation
C. Transcription
D. Integration

Correct answer : A. Transduction

Which of the following statements pertaining to leukemia is correct?
A. Blasts of acute myeloid leukemia are typically sudan black negative
B. Blasts of acute lymphoblastic leukemia are typically myloperoxidase positive
C. Low leucocyte alkaline phosphatase score is characteristically seen in blastic phase of chronic myeloid leukemia
D. Tartarate resistant acid phosphatase positivity is typically seen in hairy cell leukemia

Correct answer : D. Tartarate resistant acid phosphatase positivity is typically seen in hairy cell leukemia

The subtype of Hodgkin’s disease, which is histogentically distinct from all the other subtypes. is:
A. Lymphocyte predominant
B. Nodular sclerosis
C. Mixed cellularity
D. Lymphocyte depleted

Correct answer : A. Lymphocyte predominant

The others are part of classical subtype.

The classification proposed by the International Lymphoma Study Group for non Hodgkin‘s lymphoma is known as:
A. Kiel classification
B. REAL classification
C. WHO classification
D. Rappaport classification

Correct answer : B. REAL classification

Which of the following statements can be regarded as primary action of Inhibin?
A. It inhibits secretion of prolactin
B. It stimulates synthesis of estradiol
C. It stimulates secretion of TSH
D. It inhibits secretion of FSH

Correct answer : D. It inhibits secretion of FSH

Hypercalcemia associated with malignancy is most often mediated by:
A. Parathyroid hormone (PTH)
B. Parathyroid hormone related protein (PTHrP)
C. Interleukin – 6 (IL-6)
D. Calcitonin

Correct answer : B. Parathyroid hormone related protein (PTHrP)

Osteoclasts are inhibited by:
A. Parathyroid hormone
B. Calcitonin
C. 1,25-dihydroxycholecalciferol
D. Tumor necrosis factor

Correct answer : B. Calcitonin

The following bacteria are most often associated with acute neonatal meningitis except:
A. Escherichia coli
B. Streptococcus agalactiae
C. Neisseria meningitidis
D. Listeria monocytogenes

Correct answer : C. Neisseria meningitidis

Meningitis by Neisseria meningitidis is seen in 2months-12 years of age.

Which one of the following is the most common cause of congenital hydrocephalus?
A. Craniosynostosis
B. Intra uterine meningitis
C. Aqueductal stenosis
D. Malformations of great vein of Galen

Correct answer : C. Aqueductal stenosis

The most common malignant neoplasm of infancy is:
A. Malignant teratoma
B. Neuroblastoma
C. Wilms’ tumor
D. Hepatoblastoma

Correct answer : B. Neuroblastoma

The following drug is not helpful in the treatment of ectopic pregnancy:
A. Methotrexate
B. Misoprostol
C. Actinomycin-D
D. RU 486

Correct answer : B. Misoprostol

Misoprostol can be used for early abortion. But it is not useful in ectopic pregnancy.

All of the following appear to decrease hot flushes in menopausal women except:
A. Androgens
B. Raloxifene
C. Isoflavones
D. Tibolone

Correct answer : B. Raloxifene

Raloxifene is an orally administered selective estrogen receptor modulator (SERM). It has estrogenic action on bone and anti-estrogenic actions on the uterus and breast. It is used to prevent osteoporosis postmenopausal women. It is also protective against breast and endometrial cancer. It is not useful in treatment of hot flushes.

The following statements regarding finasteride are true except:
A. It is used in the medical treatment of benign Prostatic hypertrophy (BPH)
B. Impotence is well documented after its use
C. It blocks the conversion of dihydrotestosterone to testosterone
D. It is a 5-alpha reductase inhibitor

Correct answer : C. It blocks the conversion of dihydrotestosterone to testosterone

Finasteride blocks the conversion of testosterone to dihydrotestosterone!

According to the Glasgow Coma Scale (GCS), a verbal score of 1 indicates:
A. No response
B. Inappropriate words
C. Incomprehensible sounds
D. Disoriented response

Correct answer : A. No response

GCS verbal score:

No response
Incomprehensible sounds
Inappropriate words
Disorriented and converses
Oriented and converses

Aspermia is the term used to describe:
A. Absence of semen
B. Absence of sperm in ejaculate
C. Absence of sperm motility
D. Occurrence of abnormal sperm

Correct answer : A. Absence of semen

Which of the following is the most troublesome source of bleeding during a radical retropubic prostatectomy?
A. Dorsal venous complex
B. Inferior vesical pedicle
C. Superior vesical pedicle
D. Seminal vesicular artery

Correct answer : A. Dorsal venous complex

Dorsal venous complex passes over the prostate. It is the most troublesome source of bleeding during a prostatectomy.

All of the following conditions are known to cause diabetes insipidus except:
A. Multiple sclerosis
B. Head injury
C. Histiocytosis
D. Viral encephalitis

Correct answer : A. Multiple sclerosis

Pancreatitis, pituitary tumor and phaeochrornocytoma may be associated with:
A. Medullary carinoma of thyroid
B. Papillary carcinoma of thyroid
C. Anaplastic carcinoma of thyroid
D. Follicular carcinoma of thyroid

Correct answer : A. Medullary carinoma of thyroid

Occurs as a part of MEN syndrome.

All of the following can cause osteoporosis, except:
A. Hyperparathyroidism
B. Steroid use
C. Fluorosis
D. Thyrotoxicosis

Correct answer : C. Fluorosis

The recommended daily energy intake for an adult woman with heavy work is:
A. 1800
B. 2100
C. 2300
D. 2900

Correct answer : D. 2900 (2925kcal/day)

The following tests are used to check the efficiency of pasteurization of milk except:
A. Phosphatase test
B. Standard plate count
C. Coliform count
D. Methylene blue reduction test

Correct answer : D. Methylene blue reduction test

Methylene blue reduction test is used to detect the presence of microorganisms in milk. It is done before pasteurization.

All of the following methods are antilarval measures except:
A. Intermittent irrigation
B. Paris green
C. Gambusia affinis
D. Malathion

Correct answer : D. Malathion

Malathion is used to kill adult mosquitoes.

All of the following are topically used sulphonamides except:
A. Sulphacetamide
B. Sulphadiazine
C. Silver sulphadiazine
D. Mafenide

Correct answer : B. Sulphadiazine

Sulphadiazine is given orally.

All of the following are hallucinogens, except:
A. LSD
B. Phencyclidine
C. Mescaline
D. Methylphenidate

Correct answer : D. Methylphenidate

Methylphenidate is a psychostimulant drug used for treatment of attention-deficit hyperactivity disorder.

Inverse agonist of benzodiazepine receptor is:
A. Phenobarbitone
B. Flumazenil
C. Beta-carboline
D. Gabapentin

Correct answer : C. Beta-carboline

An inverse agonist is an agent that binds to the same receptor as an agonist but induces a pharmacological response opposite to that agonist.

Viruses can be isolated from clinical samples by cultivation in the following except:
A. Tissue culture
B. Embryonated eggs
C. Animals
D. Chemically defined media

Correct answer : D. Chemically defined media

Viruses cannot grow in acellular media.

An army jawan posted in a remote forest area had fever and headache. His fever was 104°F and pulse was 70 per min. He had an erythematous lesion of about 1 cm on the leg surrounded by small vesicles, along with generalized lymphadenopathy at the time of presentation to the referral hospital. His blood sample was collected to perform serology for the diagnosis of Rickettsial disease. Which one of the following results in Weil felix reaction will be diagnostic in this clinical setting:
A. High OX-2
B. High OX-19
C. High OX-K
D. High OX-19 and OX-2

Correct answer : C. High OX-K

The history and clinical features described are suggestive of scrub typhus. OX-K is specific for scrub typhus.

Which one of the following statements is true regarding Chlamydia pneumoniae:
A. Fifteen serovars have been identified as human pathogens
B. Mode of transmission is by the airborne bird excreta
C. The Cytoplasmic inclusions present in the sputum specimen are rich in glycogen
D. The group specific antigen is responsible for the production of complement fixing antibodies

Correct answer : D. The group specific antigen is responsible for the production of complement fixing antibodies

Chlamydia trachomatis has atleast 15 identified serotypes. But C. pneumoniae has only one serotype.
Animals have no role in transmission of C. pneumoniae. Transmission is via air borne route
Cytoplasmic inclusions lack glycogen

In familial Mediterranean fever, the gene encoding the following protein undergoes mutation:
A. Pyrin
B. Perforin
C. Atrial natriuretic factor
D. Immunoglobulin light chain

Correct answer : A. Pyrin

Which type of Amyloidosis is caused by mutation of the transthyretin protein?
A. Familial Mediterranean fever
B. Familial amyloidotic polyneuropathy
C. Dialysis associated amyloidosis
D. Prion protein associated amyloidosis

Correct answer : B. Familial amyloidotic polyneuropathy

One of the following stains is specific for Amyloid?
A. Periodic Acid schif (PAS)
B. Alizarin red
C. Congo red
D. Von—Kossa

Correct answer : C. Congo red

Apple green birefringence of amyloid can be observed when stained with congo red and viewed under polarizing microscope.

Heme is converted to bilirubin mainly in:
A. Kidney
B. Liver
C. Spleen
D. Bone marrow

Correct answer : C. Spleen

Heme is converted to bilirubin by the macrophages of reticuloendothelial system. (Mostly spleen, also liver and bone marrow)

The type of hemoglobin that has least affinity for 2,3-Diphosphoglycerate (2,3—DPG) or (2,3-BPG) is:
A. Hb A1
B. Hb F
C. Hb Barts
D. Hg A2

Correct answer : B. Hb F

Foetal hemoglobin does not bind 2,3-DPG.

The parvocellular pathway from lateral geniculate nucleus to visual cortex is most sensitive for the stimulus of:
A. Color contrast
B. Luminance contrast
C. Temporal frequency
D. Saccadic eye movements

Correct answer : A. Color contrast

Parvocellular pathway – Color vision, texture, shape, fine detail
Magnocellular pathway – Detection of movement, depth, flickers

Which one of the following is the most preferred route to perform cerebral angiography?
A. Transfemoral route
B. Transaxillary route
C. Direct carotid puncture
D. Transbrachial route

Correct answer : A. Transfemoral route

Which of the following ultrasound marker is associated with greatest increased risk for Trisomy 21 in fetus:
A. Echogenic foci in heart
B. Hyperechogenic bowel
C. Choroid plexus cysts
D. Nuchal edema

Correct answer : D. Nuchal edema

The most sensitive imaging modality for diagnosis of ureteric stones in a patient with acute colic is:
A. X-ray KUB region
B. Ultrasonogram
C. Non contrast CT scan of the abdomen
D. Contrast enhanced CT scan of the abdomen

Correct answer : C. Non contrast CT scan of the abdomen

An 18 year old boy comes to the eye casuality with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is
A. Iris vessels
B. Circulus iridis major
C. Circulus iridis minor
D. Short posterior ciliary vessels

Correct answer : B. Circulus iridis major

In Von Hippel Lindau Syndrome, the retinal vascular tumours are often associated with intracranial hemangioblastoma. Which one of the following regions is associated with such vascular abnormalities in this syndrome?
A. Optic radiation
B. Optic tract
C. Cerebellum
D. Pulvinar

Correct answer : C. Cerebellum

The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:
A. Congenital cataract
B. Retinoblastoma
C. Endophtalmitis
D. Coats disease

Correct answer : B. Retinoblastoma

1 1/2 year old child with white reflex and calcification in the eye is diagnostic of retinoblastoma.

Heberden’s Arthropathy affects:
A. Lumbar spine
B. Symmetrically large joints
C. Sacroiliac joints
D. Distal interphalangeal joints

Correct answer : D. Distal interphalangeal joints

Heberden’s nodes seen in distal interphalangeal joints is a characteristic feature of idiopathic osteoarthritis.

The most common sequelae of tuberculous spondylitis in an adolescent is:
A. Fibrous Ankylosis
B. Bony Ankylosis
C. Pathological dislocation
D. Chronic osteomyelitis

Correct answer : B. Bony Ankylosis

All tuberculous joints except spine usually heal with fibrous ankylosis. Whereas in the spinal joints, bony ankylosis is seen.

A young woman met with an accident and had mild quadriparesis. Her lateral X-ray cervical spine revealed C5-C6 fracture dislocation. Which of the following is the best line of management?
A. Immediate anterior decompression
B. Cervical traction followed by instrument fixation
C. Hard cervical collar and bed rest
D. Cervical laminectomy

Correct answer : B. Cervical traction followed by instrument fixation

The fracture is an unstable injury because there is dislocation and neurological deficit. The initial management should be closed reduction and traction. Definitive management is instrument fixation after spinal cord edema is decreased.

The most common presentation of a child with Wilms tumor is:
A. An asymptomatic abdominal mass
B. Haematuria
C. Hypertension
D. Hemoptysis due to pulmonary secondary

Correct answer : A. An asymptomatic abdominal mass

ln a child, non functioning kidney is best diagnosed by:
A. Ultrasonography
B. IVU
C. DTPA renogram
D. Creatinine clearance

Correct answer : C. DTPA renogram

Isotope renogram is the best modality for renal function estimation.

The most common cause of renal scarring in a 3 year old child is:
A. Trauma
B. Tuberculosis
C. Vesicoureteral reflux induced pyelonephritis
D. Interstitial nephritis

Correct answer : C. Vesicoureteral reflux induced pyelonephritis

The most common side effect of IUCD insertion is:
A. Bleeding
B. Pain
C. Pelvic infection
D. Ectopic pregnancy

Correct answer : Bleeding

Which one of the following is the ideal contraceptive for a patient with heart disease:
A. IUCD
B. Depo-Provera
C. Diaphragm
D. Oral contraceptive pills

Correct answer : C. Diaphragm

Barrier contraceptives are ideal for those with heart disease. Hormonal contraceptives are best avoided.

Misoprostol has been found to be effective in all of the following except:
A. Missed abortion
B. lnduction of labour
C. Menorrhagia
D. Prevention of post-partum hemorrhage (PPH)

Correct answer : C. Menorrhagia

Menorrhagia is treated with prostaglandin inhibitors. (Misoprostol is a prostaglandin!)

Sclerotherapy is ideal for treatment of
A. External hemorrhoids
B. Internal hemorrhoids
C. Prolapsed hemorrhoids
D. Strangulated hemorrhoids

Correct answer : B. Internal hemorrhoids

Sclerotherapy is ideal for treatment of internal haemorrhoids. (first degree with bleeding and early second degree haemorrhoids)

Which of the following catheter materials is most suited for long-term use?
A. Latex
B. Silicone
C. Rubber
D. Polyurethane

Correct answer : B. Silicone

Silicone catheters can be used for upto 12 weeks.

All of the following are true for patients of ulcerative colitis associated with primary sclerosing cholangitis (PSC), except:
A. They may develop biliary cirrhosis
B. May have raised alkaline phosphatase
C. Increased risk of hilar Cholangiocarcinoma
D. PSC reverts after a total colectomy

Correct answer : D. PSC reverts after a total colectomy

Colectomy does not alter the course of PSC.

A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs of 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 mm Hg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed a Hb 12 gm, TLC — 12000 Cu mm, Platelets 430,000; ESR — 49 mm. Urine examination showed proteinuria and RBC — 10-15/hpf with no casts. Which of the following is the most likely diagnosis?
A. Polyarteritis nodosa
B. Systemic lupus erythematosus
C. Wegener’s granulomatosis
D. Mixed cryoglobulemia

Correct answer : A. Polyarteritis nodosa

In PAN, there is development of digital infarcts even in the presence of good peripheral pulses. Hypertension is due to involvement of renal arteries.

Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease?
A. Amino transaminase
B. Alkaline phosphatase
C. Bilirubin
D. Albumin

Correct answer : D. Albumin

Albumin is significantly decreased in chronic liver diseases.

5’-Nucleotidase activity is increased in:
A. Bone diseases
B. Prostate cancer
C. Chronic renal failure
D. Cholestatic disorders

Correct answer : D. Cholestatic disorders

5′ nucleotidase and Gamma glutamyl transferase are specific for cholestatic disorders.

Which of the following viral infections is transmitted by tick?
A. Japanese encephalitis
B. Dengue fever
C. Kyasanur forest disease (KFD)
D. Yellow fever

Correct answer : C. Kyasanur forest disease (KFD)

KFD is transmitted by bite of hard ticks
Japanese encephalitis – Culex mosquito
Dengue fever – Aedes mosquito
Yellow fever – Aedes mosquito

Which one of the following statements about influence of smoking on risk of coronary heart disease (CHD) is not true?
A. Influence of smoking is independent of other risk factors for CHD
B. Influence of smoking is only additive to other risk factors for CHD
C. Influence of smoking is synergistic to other risk factors for CHD
D. Influence of smoking is directly related to number of cigarettes smoked per day

Correct answer : B. Influence of smoking is only additive to other risk factors for CHD

Smoking is an independent risk factor. It also has a synergistic effect with other risk factors. (More than just additive effect)

What will be the BMI of a male whose weight is 89 kg and height is 172 cm
A. 27
B. 30
C. 33
D. 36

Correct answer : B. 30

BMI = Weight (in kg) / Height (in m) ^2
=89/1.72^2
=30 (approx)

(We know that the square root of 3 is 1.73. So Square of 1.72 will be approximately equal to 3.)

Oculogyric crisis is known to be produced by all of the following drugs except:
A. Trifluoperazine
B. Atropine
C. Prochlorperazine
D. Perphenazine

Correct answer : B. Atropine

Oculogyric crisis is caused by neuroleptic agents.

Antipyschotic drug-induced Parkinsonism is treated by:
A. Anticholinergics
B. Levodopa
C. Selegilin
D. Amantadine

Correct answer : A. Anticholinergics

Central anticholinergics are used to treat drug induced parkinsonism. Other anti parkinsonian drugs are not effective.

The major difference between typical and atypical antipsychotics is that:
A. The latter cause minimal or no increase in prolactin
B. The former cause tardive dyskinesia
C. The former are available as parenteral preparations
D. The latter cause substantial sedation

Correct answer : B. The former cause tardive dyskinesia

Typical antipsychotics cause extrapyramidal side effects like tardive dyskinesia.

Chlamydia trachomatis is associated with the following except:
A. Endemic trachoma
B. Inclusion conjunctivitis
C. Lymphogranuloma venereum
D. Community acquired pneumonia

Correct answer : D. Community acquired pneumonia

Chlamydia pneumoniae causes community acquired pneumonia. (CAP can be caused by many other organisms too.)

It is true regarding the normal microbial flora present on the skin and mucous membranes that:
A. lt cannot be eradicated by antimicrobial agents
B. It is absent in the stomach due to the acidic pH
C. It establishes in the body only after the neonatal period
D. The flora in the small bronchi is similar to that of the Trachea

Correct answer : A. lt cannot be eradicated by antimicrobial agents

Facts regarding normal flora of skin and mucous membranes

They cannot be eradicated by antimicrobial agents. It can only decrease the number of organisms
They are present even in the acidic pH of stomach
They are present even at birth
The flora of the small bronchi are different from those present in the trachea

The most common pathogens responsible for nosocomial pneumonias in the ICU are:
A. Gram positive organisms
B. Gram negative organisms
C. Mycoplasma
D. Virus infections

Correct answer : B. Gram negative organisms

Which one of the following is not used as a tumor marker in testicular tumours?
A. AFP
B. LDH
C. HCG
D. CEA

Correct answer : D. CEA

CEA ( Carcinoembryonic antigen ) is a tumour marker of adenocarcinoma colon, lung, ovary, pancreas and breast.

A simple bacterial test for mutagenic carcinogens is:
A. Ames test
B. Redox test
C. Bacteriophage
D. Gene splicing

Correct answer : A. Ames test

Ames test is used to measure the mutagenic potential of a given chemical. It uses salmonella typhimurium.

The following is not a feature of malignant transformation by cultured cells:
A. Increased cell density
B. Increased requirement for growth factors
C. Alterations of cytoskeletal structures
D. Loss of anchorage

Correct answer : B. Increased requirement for growth factors

In malignant cells, there is decreased requirement for growth factors.

The fibers from the contralateral nasal hemiretina project to the following layers of the lateral geniculate nucleus:
A. Layers 2, 3 & 5
B. Layers 1, 2 & 6
C. Layers 1, 4 & 6
D. Layers 4, 5 & 6

Correct answer : C. Layers 1, 4 & 6

Fibers from contralateral nasal hemiretina project to layers 1, 4 & 6 of the lateral geniculate body.
Fibers from ipsilateral temporal hemiretina project to layers 2, 3 & 5 of the lateral geniculate body.

Which one of the following molecules is used for cell signaling?
A. CO2
B. O2
C. NO
D. N2

Correct answer : C. NO

Nitric oxide plays an important role in cellular signalling. ( as a biological messenger )

Urinary concentrating ability of the kidney is increased by:
A. ECF volume contraction
B. Increase in Renal blood flow
C. Reduction of medullary hyperosmolarity
D. Increase in GFR

Correct answer : A. ECF volume contraction

When there is ECF volume contraction, there is increased release of ADH from posterior pituitary. This stimulates the kidneys to reabsorb more water thereby producing concentrated urine.

All of the following physiological processes occur during the growth at the epiphyseal plate except:
A. Proliferation and hypertrophy
B. Calcification and ossification
C. Vasculogenesis and erosion
D. Replacement of red bone marrow with yellow marrow

Correct answer : D. Replacement of red bone marrow with yellow marrow

The type of joint between the sacrum and the coccyx is a
A. Symphysis
B. Synostosis
C. Synchondrosis
D. Syndesmosis

Correct answer : A. Symphysis

The following statements concerning chorda tympani nerve are true except that it:
A. Carries secretomotor fibers to submandibular gland
B. Joins lingual nerve in infratemporal fossa
C. ls a brach of facial nerve
D. Contains postganglionic parasympathetic fibers

Correct answer : D. Contains postganglionic parasympathetic fibers

Chorda tympani nerve contains preganglionic parasympathetic fibers. It synapses in the submandibular ganglion.

The gold standard for the diagnosis of osteoporosis is:
A. Dual energy X-ray absorptiometry
B. Single energy X-ray absorptiometry
C. Ultrasound
D. Quantitative computed tomography

Correct answer : A. Dual energy X-ray absorptiometry

At t=0 there are 6 x 10^23 radioactive atoms of a substance, which decay with a disintegration constant equal to 0.01/sec. What would be the initial decay rate?
A. 6 X 10^23
a. 6 X 10^22
c. 6 X 10^21
d. 6 X 10^20

Correct answer : c. 6 X 10^21

Rate of decay = Disintegration constant X Number of radioactive atoms
= 0.01 X 6 x 10^23
= 6 X 10^21

The technique employed in radiotherapy to counteract the effect of tumour motion due to breathing is known as
A. Arc technique
B. Modulation
C. Gating
D. Shunting

Correct answer : C. Gating

Respiratory gating is a technique in radiotherapy in which the radiation is applied during that phase of respiratory cycle in which the tumour is in the best range. This is to prevent unnecessary radiation exposure to normal structures.

The most appropriate circuit for ventilating spontaneously breathing infant during anaesthesia
A. Jackson Rees modification of Ayre T piece
B. Mapleson A or MgiIl’s circuit
C. Mapleson C or Waters’ to and fro canister
D. Bains circuit

Correct answer : A. Jackson Rees modification of Ayre T piece

The laryngeal mask airway used for securing the airway of a patient in all of the following conditions except:
A. In a difficult intubation
B. In cardiopulmonary resuscitation
C. In a child undergoing an elective/routine eye surgery
D. ln a patient with a large tumour in the oral cavity

Correct answer : D. ln a patient with a large tumour in the oral cavity

Use of laryngeal mask airway is contraindicated in case of oropharyngeal mass.

The following are used for treatment of postoperative nausea and vomiting following squint surgery in children except:
A. Ketamine
B. Ondansetron
C. Propofol
D. Dexamethasone

Correct answer : A. Ketamine

Ketamine can cause nausea and vomiting following administration.

A 27 year old sexually active male develops a vesiculobullous lesion on the glans soon after taking a paracetamol tablet for fever. The lesion healed with hyperpigmentation. The most likely diagnosis is:
A. Behcet’s syndrome
B. Herpes genitalis
C. Fixed drug eruption
D. Pemphigus vulgaris

Correct answer : C. Fixed drug eruption

History and clinical features are characteristic of fixed drug eruption.

A 40-year old woman presents with a 2 year history of erythematous papulopustular lesions on the convexities of the face. There is a background of erythema and telangiectasia. The most likely diagnosis in the patient is:
A. Acne vulgaris
B. Rosacea
C. Systemic lupus erythematosus
D. Polymorphic light eruption

Correct answer : B. Rosacea

The clinical features are characteristic of rosacea.

A 36 year old factory worker developed itchy, annular scaly plaques in both groins. Application of a corticosteroid ointment led to temporary relief but the plaques continued to extend at the periphery. The most likely diagnosis is:
A. Erythema annulare centrifugum
B. Granuloma annulare
C. Annular lichen planus
D. Tinea cruris

Correct answer : D. Tinea cruris

Tinea cruris is characterised by itchy, annular scaly plaques in both groins. There is central clearing and advancement at the periphery.

Enlarged corneal nerves may be seen in all of the following except:
A. Keratoconus
B. Herpes simplex keratitis
C. Leprosy
D. Neurofibromatosis

Correct answer : B. Herpes simplex keratitis

Contact lens wear is proven to have deleterious effects on the comeal physiology. Which of the following statements is incorrect in connection with contact lens wear?
A. The level of glucose availability in the corneal epithelium is reduced
B. There is a reduction in hemidesmosome density
C. There is increased production of CO2 in the epithelium
D. There is a reduction in glucose utilization by corneal epithelium

Correct answer : A. The level of glucose availability in the corneal epithelium is reduced

Contact lens wear decreases gas exchange across the anterior surface of cornea resulting in hypoxia and hypercapnia. In the hypoxic state there is decrease in glucose utilisation. But there is no decrease in glucose availability as it occurs through the aqueous humour on the posterior surface of cornea. Also, there is decreased epithelial cell adhesion due to decrease in hemidesmosome density.

Which of the following statement is true regarding Acanthamoeba keratitis?
A. For the isolation of the causative agent, corneal scraping should be cultured on a nutrient agar plate
B. The causative agent, Acanthamoeba is a helminth whose normal habitat is soil
C. Keratitis due to Acanthamoeba is not seen in the immunocompromised host
D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

Correct answer : D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

All of the following are true about fracture of the atlas vertebra, except:
A. Jefferson fracture is the most common type
B. Quadriplegia is seen in 80% cases
C. Atlantooccipital fusion may sometimes be needed
D. CT scans should be done for diagnosis

Correct answer : B. Quadriplegia is seen in 80% cases

Usually, there is no neurological damage in atlas fractures.

All of the following areas are commonly involved sites in pelvic fracture except:
A. Pubic rami
B. Alae of ileum
C. Acetabulum
D. Ischial tuberosities

Correct answer : D. Ischial tuberosities

Ischial tuberosity fracture is the rarest among the options given.

Subtrochanteric fractures of femur can be treated by all of the following methods except:
A. Skeletal traction on Thomas splint
B. Smith Patersen Nail
C. Condylar blade plate
D. Ender’s nail

Correct answer : B. Smith Patersen Nail

Smith Patersen Nail was previously used for internal fixation of fracture neck of femur.

A child with recurrent urinary tract infections is most likely to show:
A. Posterior urethral valves
B. Vesicoureteric reflux
C. Neurogenic bladder
D. Renal and ureteric calculi

Correct answer : B. Vesicoureteric reflux

Vesicoureteric reflux is the most common cause of urinary tract infections in childhood. (upto 50%)

Which of the following is the most common renal cystic disease in infants?
A. Polycystic kidney
B. Simple renal cyst
C. Unilateral renal dysplasia
D. Calyceal cyst

Correct answer : C. Unilateral renal dysplasia

One of the intestinal enzymes that is generally deficient in children following an attack of severe infectious enteritis is:
A. Lactase
B. Trypsin
C. Lipase
D. Amylase

Correct answer : A. Lactase

Even in the normal intestine, the lactase activity is limited. Hence it is most prone to become deficient following an attack of infectious enteritis.

Risk of preterm delivery is increased if cervical length is:
A. 2.5 cm
B. 3.0 cm
C. 3.5 cm
D. 4.0 cm

Correct answer : A. 2.5 cm

Cervical length of less than 2.5cm (as per transvaginal USG) is an important predictor of preterm labour.

Use of one of the following vaccination is absolutely contraindicated in pregnancy:
A. Hepatitis B
B. Cholera
C. Rabies
D. Yellow fever

Correct answer : D. Yellow fever (It is a live attenuated vaccine)

Which of the following statements is incorrect in relation to pregnant women with epilepsy?
A. The rate of congenital malformation is increased in the offspring of women with epilepsy
B. Seizure frequency increases in approximately 70% of women
C. Breast feeding is safe with most anticonvulsants
D. Folic acid supplementation may reduce the risk of neural tube defect

Correct answer : B. Seizure frequency increases in approximately 70% of women

Seizure frequency is increased in approximately 30% of women during pregnancy.

In which of the following disease, the overall survival is increased by screening procedure?
A. Prostate cancer
B. Lung cancer
C. Colon cancer
D. Ovarian cancer

Correct answer : C. Colon cancer

Gardner’s syndrome is a rare hereditary disorder involving the colon. It is characterized by:
A. Polyposis colon, cancer thyroid, skin tumours
B. Polyposis in jejunum, pituitary adenoma and skin tumours
C. Polyposis colon, osteomas, epidermal inclusion cysts and fibrous tumours in the skin
D. Polyposis of gastrointestinal tract, Cholangiocarcinoma and skin tumours

Correct answer : C. Polyposis colon, osteomas, epidermal inclusion cysts and fibrous tumours in the skin

A new born presented with bloated abdomen shortly after birth with passing of less meconium. A full thickness biopsy of the rectum was carried out. Which one of the following rectal biopsy findings is most likely to be present?
A. Fibrosis of submucosa
B. Hyalinisation of the muscular coat
C. Thickened Muscularis propria
D. Lack of ganglion cells

Correct answer : D. Lack of ganglion cells

The history is suggestive of congenital aganglionic megacolon (Hirschprung disease). The ganglion cells in the intestinal wall are absent. It occurs due to arrest in migration of neural crest cells.

Which one of the following conditions commonly predisposes to Colonic carcinoma?
A. Ulcerative colitis
B. Crohn’s disease
C. Diverticular disease
D. Ischaemic colitis

Correct answer : A. Ulcerative colitis

Risk of colonic carcinoma is more in Ulcerative colitis compared to Chron’s disease

Serum angiotensin converting enzyme may be raised in all of the following, except:
A. Sarcoidosis
B. Silicosis
C. Berylliosis
D. Bronchogenic carcinoma

Correct answer : D. Bronchogenic carcinoma

Some conditions causing increase in serum angiotensin converting enzyme

Silicosis
Granulomatous hepatitis
Asbestosis
Sarcoidosis
Leprosy
Lymphoma

The abnormal preoperative pulmonary function test in a patient with severe kyphoscoliosis includes:
A. Decreased RV and TLC
B. Reduced FEV1/ FVC ratio
C. Reduced FEF 25-75%
D. Increased FRC

Correct answer : A. Decreased RV and TLC

Kyphoscoliosis is a restrictive lung disease. There is decrease in residual volume and total lung capacity. FEV1 and FVC are proportionately decreased. Hence the ratio of FEV1 to FVC remains normal or is increased. The forced expiratory flow rate (FEF) is normal. Functional residual capacity (FRC) is decreased.

The most common cancer, affecting Indian urban women in Delhi, Mumbai and Chennai, is:
A. Cervical Cancer
B. Ovarian Cancer
C. Breast cancer
D. Uterine Cancer

Correct answer : C. Breast cancer

Most common cancer in Indian urban women

Delhi – Breast cancer
Mumbai – Breast cancer
Chennai – Cancer cervix

All of the following statements are true about Congenital Rubella except:
A. lt is diagnosed when the infant has IgM antibodies at birth
B. It is diagnosed when IgG antibodies persist from more than 6 months
C. Most common congenital defects are deafness, cardiac malformations and cataract
D. Infection after 16 weeks of gestation results in major congenital defects

Correct answer : D. Infection after 16 weeks of gestation results in major congenital defects

Infection in the first trimester has the greatest risk of congenital anomalies. Infection in second trimester can cause deafness. No major congenital defects are seen in infection after 16 weeks of gestation.

Antibiotic treatment of choice for treating cholera in an adult is a single dose of:
A. Tetracycline
B. Cotrimoxazole
C. Doxycycline
D. Furazolidone

Correct answer : C. Doxycycline

Doxycycline is the drug which is effective as a single dose treatment for cholera in adults.

In chronic arsenic poisoning the following samples can be sent for laboratory examination, except:
A. Nail clippings
B. Hair samples
C. Bone biopsy
D. Blood sample

Correct answer : D. Blood sample

Arsenic is rapidly cleared from blood. So a blood sample is useful only in acute poisoning.

In methyl alcohol poisoning there is CNS depression, cardiac depression and optic nerve atrophy. These effects are produced due to:
A. Formaldehyde and formic acid
B. Acetaldehyde
C. Pyridine
D. Acetic acid

Correct answer : A. Formaldehyde and formic acid

Methyl alcohol is converted into formaldehyde by alcohol dehydrogenase. It is in turn converted to formic acid by aldehyde dehydrogenase.

In a firearm injury, there is burning, blackening, tattooing around the wound, along with cherry red colour of the surrounding tissues and is cruciate in shape, the injury is:
A. Close shot entry
B. Close contact exit
C. Contact shot entry
D. Distant shot entry

Correct answer : A. Close shot entry

Dry mouth during antidepressant therapy is caused by blockade of:
A. Muscarinic acetylcholine receptors
B. Serotonergic receptors
C. Dopaminergic receptors
D. GABA receptors

Correct answer : A. Muscarinic acetylcholine receptors

Secretion of saliva is mediated by muscarinic acetylcholine receptors.

One of the following is not true about nesiritide:
A. It is a brain natriuretic peptide analogue
B. It is used in actuely decompensated heart failure
C. It has significant oral absorption
D. lt has a short half life

Correct answer : C. It has significant oral absorption

Nesiritide is a recombinant BNP. It has poor oral absorption.

The following drugs have significant drug interaction with digoxin, except:
A. Cholestyramine
B. Thiazide diuretics
C. Quinidine
D. Amlodipine

Correct answer : D. Amlodipine

Cholestyramine decreases digoxin absorption
Quinidine decreases renal digoxin clearance
Thiazide diuretics promotes inhibition of Na – K ATPase by digoxin

The most common organism amongst the following that causes acute meningitis in an AIDS patients is:
A. Streptococcus pneumoniae
B. Streptococcus agalactiae
C. Cryptococcus neoformans
D. Listeria monocytogenes

Correct answer : C. Cryptococcus neoformans

All of the following organisms are known to survive intracellularly except:
A. Neisseria meningitidis
B. Salmonella typhi
C. Streptococcus pyogenes
D. Legionella pneumophila

Correct answer : C. Streptococcus pyogenes

The following statements are true regarding melioidosis except:
A. It is caused by Burkholderia mallei
B. The agent is a gram negative aerobic bacteria
C. Bipolar staining of the aetiological agent is seen with methylene blue stain
D. The most common form of melioidosis is pulmonary infection

Correct answer : A. It is caused by Burkholderia mallei

Burkholderia mallei causes glanders – a disease of horses, mules and donkeys.
Burkholderia pseudomallei causes melioidosis.

An example of a tumour suppressor gene is:
A. myc
B. fos
C. ras
D. Rb

Correct answer : D. Rb

Both Vitamin K and C are involved in:
A. The synthesis of clotting factors
B. Post translational modifications
C. Antioxidant mechanisms
D. The microsomal hydroxylation reactions

Correct answer : B. Post translational modifications

The predominant isozyme of LDH in cardiac muscle is:
A. LD-1
B. LD-2
C. LD-3
D. LD-5

Correct answer : A. LD-1

Which one of the following statements is true regarding water reabsorption in the tubules?
A. The bulk of water reabsorption occurs secondary to Na reabsorption.
B. Majority of facultative reabsorption occurs in proximal tubule
C. Obligatory reabsorption is ADH dependent
D. 20% of water is always reabsorbed irrespective of water balance

Correct answer : A. The bulk of water reabsorption occurs secondary to Na reabsorption.

The main site of bicarbonate reabsorption is:
A. Proximal convoluted tubule
B. Distal convoluted tubule
C. Cortical collecting duct
D. Medullary collecting duct

Correct answer : A. Proximal convoluted tubule

S.A. node acts as a pacemaker of the heart because of the fact that it:
A. Is capable of generating impulses spontaneously
B. Has rich sympathetic innervations
C. Has poor cholinergic innervations
D. Generates impulses at the highest rate

Correct answer : D. Generates impulses at the highest rate

The superior oblique muscle is supplied by:
A. 3th cranial nerve
B. 4th cranial nerve
C. 5th cranial nerve
D. 6th cranial nerve

Correct answer : B. 4th cranial nerve (Trochlear nerve)

Paralysis of 3rd, 4th and 6th cranial nerves with involvement of ophthalmic division of trigeminal, localizes the lesion to:
A. Cavernous sinus
B. Apex of orbit
C. Brainstem
D. Base of skull

Correct answer : A. Cavernous sinus

3,4,5 cranial nerves pass in relation to the lateral wall of cavernous sinus. 6th cranial nerve passes through the cavernous sinus.

All of the following are branches of the external carotid artery except:
A. Superior thyroid artery
B. Anterior Ethmoidal artery
C. Occipital artery
D. Posterior auricular artery

Correct answer : B. Anterior Ethmoidal artery

Anterior ethmoidal artery arises from ophthalmic branch of internal carotid artery.

An 18 year old boy came to the Psychiatry OPD with a complaint of feeling changed from inside. He described himself as feeling strange as if he is different from his normal self. He was very tense and anxious yet could not point out the precise change in him. This phenomena is best called as:
A. Delusional mood
B. Depersonalization
C. Autochthonous delusion
D. Over valued idea

Correct answer : B. Depersonalization

The given history is the classical description of depersonalization.

One of the following usually differentiates hysterical symptoms from hypochondriacal symptoms:
A. Symptoms do not normally reflect understandable physiological or pathological mechanism
B. Physcial symptoms are prominent which are not explained by organic factors
C. Personality traits are significant
D. Symptoms run a chronic course

Correct answer : A. Symptoms do not normally reflect understandable physiological or pathological mechanism

Hysteria (Conversion disroder) is a condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.

Hypochondria is a belief that physical symptoms are signs of a serious illness, even when there is no medical evidence to support the presence of an illness.

Perseveration is:
A. Persistent and inappropriate repetition of the same thoughts
B. When a patient feels very distressed about it
C. Characteristic of schizophrenia
D. Characteristic of obsessive compulsive disorder (OCD)

Correct answer : A. Persistent and inappropriate repetition of the same thoughts

Perseveration is seen in schizophrenia.

Which one of the following radioisotope is not used as permanent implant:
A. Iodine-125
B. Palladium-103
C. Gold-198
D. Caesium-137

Correct answer : D. Caesium-137

Permanent implants for brachytherapy

Iodine-125
Palladium-103
Gold-198
Caesium-131

In Radionuclide imaging the most useful radio pharamaceutical for skeletal imaging is:
A. Gallium 67
B. Technetium sulphur colloid
C. Technetium-99m
D. Technetium—99m linked to Methylene disphosphonate

Correct answer : D. Technetium—99m linked to Methylene disphosphonate