Ans 9: (c) Elastic fibers
Ans 23: (b) Biparietal diameter
Ans 41: (b) It is independent of height and weight..
Ans 49: (b) 1st July
Ans 121: a,b,c
Ans 203 : (b) Contact shot
Ans 206 : (b) Second schedule of Indian Medical Council Act 1956
Errata PSM
ERRATA
Q-3 : (b) 14 days
Q- 59 : (a) Diphtheria
Q-3 Registration of Birth is mandatory, and is to be done within:
a. 21 days
b. 14 days
c. 7 days
d. 28 days
Ans 3: (b) 14 days
Ref– Read the text below
Sol:
Registration of Birth is mandatory, and is to be done within 14 days, if done after 14 days but within 30 days, it is done with late fee of Rs. 5 and affidavit from concerned officer. After 1 month with late fee of Rs. 10 and an affidavit from first class magistrate.
• For children born abroad, registration can be done without any fee within 60 days of return to India
• Child’s name at the time of registration is not required, but has to be submitted within one year , or with late fee with in 15 years
• Non registration of the birth is punishable under the act.
Q-59 Notifiable diseases under WHO surveillance are all of the following except:
a. Diphtheria
b. Relapsing fever
c. Polio
d. Malaria
Ans 59 : (a) Diphtheria
Ref– Read the text below
Sol:
Notifiable diseases under WHO surveillance:
• Paralytic polio
• Relapsing fever
• Influenza
• Malaria
• Epidemic (louse-borne) typhus
NO CHANGE Q-18 The percentage of persons diagnosed as having a specified disease who die as a result of that illness within a given period is
a. Case-fatality rate
b. fatality percent-age
c. Secondary attack rate
d. Both a and b
Ans 18: (d) Both a and b
READ THE EXPLANATION CAREFULLY OPTION A AND B ARE SYNONYMS
Sol:
• Case-fatality rate—Usually expressed as the percentage of persons diagnosed as having a specified disease who die as a result of that illness within a given period.
• This term is most frequently applied to a specific outbreak of acute disease in which all patients have been followed for an adequate period of time to include all attributable deaths.
• The case-fatality rate must be clearly differentiated from the mortality rate (q.v.). (Synonyms: fatality rate, fatality percent-age, case-fatality ratio)
NO CHANGE Q-38 With reference to meningococcal meningitis, which one of the following statement is not correct.
a. Fatality in untreated cases is 90 percent
b. Disease spreads mainly by droplet infection epidemiological pattern of disease
c. Mass chemoprophylaxis causes immediate drop in the incidence rate of cases.
d. Geographic distribution and epidemic capabilities differ according to the serogroup.
Ans 38: (a) Fatality in untreated cases is 90 percent
Ref– Fatality in untreated cases is 50 percent
Sol:
• Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the meninges that affects the brain membrane. It can cause severe brain damage and is fatal in 50% of cases if untreated.
• Several different bacteria can cause meningitis. Neisseria meningitidis is the one with the potential to cause large epidemics.
• Disease spreads mainly by droplet infection epidemiological pattern of disease
• Twelve serogroups of N. meningitidis have been identified, five of which (A, B, C, W135, and X) can cause epidemics.
• Geographic distribution and epidemic capabilities differ according to the serogroup.
NO CHANGE Q-105 A 32-year-old farmer presents with a crushing injury of the index finger and thumb that occurred while he was working with machinery in his barn. Records show that he received three doses of Td in the past,and that his last dose was given when he was 25 years old. In addition to proper wound cleaning and management, which of the following is the most appropriate prevention intervention?
a. Administration of tetanus toxoid
b. Administration of tetanus immunoglobulin only
c. Administration of tetanus toxoid and immunoglobulin
d. Administration of tetanus and diphtheria toxoid
Ans 105: (d) Administration of tetanus and diphtheria toxoid
Ref– Read the text below
Sol:
• If a person has received three doses or more of the Td, and the last dose was given more than five years before an injury, a tetanus and diphtheria booster should be given if the wound is contaminated, such as the one described.
• It is preferable to administer the combined diphtheria and tetanus booster (Td). You are then also using the opportunity to provide primary prevention for diphtheria.
• If the last dose of Td was given in the preceding five years, then no further action would be necessary. Td and tetanus immunoglobulin (TIG) are recommended for prophylaxis of contaminated wounds when the history of tetanus toxoid is unknown or the person received less than three doses.
• TIG is never recommended as sole prophylaxis as prolonged immunity is desired.
NO CHANGE Q-195 Fish is a poor source of?
a. Fe
b. Iodine
c. Phosphorus
d. Vitamin A
Ans 195 : (c) Phosphorus
Ref– Read the text below
Sol:
• A tricky question. In fact, fish is a rich source of all the above mentioned nutrients. However it is exceptionally good source of Iodine and Vitamin A.
• Of the remaining two choices, Phosphorus seems to be the better answer as it is in same quantities in fish as other meat products.
Fish – Protein rich – (15-25%)
Rich in
• Unsaturated fatty acids
• Vit A – also remember fish oil – richest natural source of Vit A (retinol)
• Vit D
Q-3 : (b) 14 days
Q- 59 : (a) Diphtheria
Q-3 Registration of Birth is mandatory, and is to be done within:
a. 21 days
b. 14 days
c. 7 days
d. 28 days
Ans 3: (b) 14 days
Ref– Read the text below
Sol:
Registration of Birth is mandatory, and is to be done within 14 days, if done after 14 days but within 30 days, it is done with late fee of Rs. 5 and affidavit from concerned officer. After 1 month with late fee of Rs. 10 and an affidavit from first class magistrate.
• For children born abroad, registration can be done without any fee within 60 days of return to India
• Child’s name at the time of registration is not required, but has to be submitted within one year , or with late fee with in 15 years
• Non registration of the birth is punishable under the act.
Q-59 Notifiable diseases under WHO surveillance are all of the following except:
a. Diphtheria
b. Relapsing fever
c. Polio
d. Malaria
Ans 59 : (a) Diphtheria
Ref– Read the text below
Sol:
Notifiable diseases under WHO surveillance:
• Paralytic polio
• Relapsing fever
• Influenza
• Malaria
• Epidemic (louse-borne) typhus
NO CHANGE Q-18 The percentage of persons diagnosed as having a specified disease who die as a result of that illness within a given period is
a. Case-fatality rate
b. fatality percent-age
c. Secondary attack rate
d. Both a and b
Ans 18: (d) Both a and b
READ THE EXPLANATION CAREFULLY OPTION A AND B ARE SYNONYMS
Sol:
• Case-fatality rate—Usually expressed as the percentage of persons diagnosed as having a specified disease who die as a result of that illness within a given period.
• This term is most frequently applied to a specific outbreak of acute disease in which all patients have been followed for an adequate period of time to include all attributable deaths.
• The case-fatality rate must be clearly differentiated from the mortality rate (q.v.). (Synonyms: fatality rate, fatality percent-age, case-fatality ratio)
NO CHANGE Q-38 With reference to meningococcal meningitis, which one of the following statement is not correct.
a. Fatality in untreated cases is 90 percent
b. Disease spreads mainly by droplet infection epidemiological pattern of disease
c. Mass chemoprophylaxis causes immediate drop in the incidence rate of cases.
d. Geographic distribution and epidemic capabilities differ according to the serogroup.
Ans 38: (a) Fatality in untreated cases is 90 percent
Ref– Fatality in untreated cases is 50 percent
Sol:
• Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the meninges that affects the brain membrane. It can cause severe brain damage and is fatal in 50% of cases if untreated.
• Several different bacteria can cause meningitis. Neisseria meningitidis is the one with the potential to cause large epidemics.
• Disease spreads mainly by droplet infection epidemiological pattern of disease
• Twelve serogroups of N. meningitidis have been identified, five of which (A, B, C, W135, and X) can cause epidemics.
• Geographic distribution and epidemic capabilities differ according to the serogroup.
NO CHANGE Q-105 A 32-year-old farmer presents with a crushing injury of the index finger and thumb that occurred while he was working with machinery in his barn. Records show that he received three doses of Td in the past,and that his last dose was given when he was 25 years old. In addition to proper wound cleaning and management, which of the following is the most appropriate prevention intervention?
a. Administration of tetanus toxoid
b. Administration of tetanus immunoglobulin only
c. Administration of tetanus toxoid and immunoglobulin
d. Administration of tetanus and diphtheria toxoid
Ans 105: (d) Administration of tetanus and diphtheria toxoid
Ref– Read the text below
Sol:
• If a person has received three doses or more of the Td, and the last dose was given more than five years before an injury, a tetanus and diphtheria booster should be given if the wound is contaminated, such as the one described.
• It is preferable to administer the combined diphtheria and tetanus booster (Td). You are then also using the opportunity to provide primary prevention for diphtheria.
• If the last dose of Td was given in the preceding five years, then no further action would be necessary. Td and tetanus immunoglobulin (TIG) are recommended for prophylaxis of contaminated wounds when the history of tetanus toxoid is unknown or the person received less than three doses.
• TIG is never recommended as sole prophylaxis as prolonged immunity is desired.
NO CHANGE Q-195 Fish is a poor source of?
a. Fe
b. Iodine
c. Phosphorus
d. Vitamin A
Ans 195 : (c) Phosphorus
Ref– Read the text below
Sol:
• A tricky question. In fact, fish is a rich source of all the above mentioned nutrients. However it is exceptionally good source of Iodine and Vitamin A.
• Of the remaining two choices, Phosphorus seems to be the better answer as it is in same quantities in fish as other meat products.
Fish – Protein rich – (15-25%)
Rich in
• Unsaturated fatty acids
• Vit A – also remember fish oil – richest natural source of Vit A (retinol)
• Vit D
IF YOU ARE A FOREIGN MEDICAL GRADUATE AND LOOKING TO CLEAR MCI SCREENING EXAMINATION IN INDIA,
DAMS are going to start a new Crash Course batch for the MCI Screening. The details of the batch are as follows:-
MCI SCREENING COURSE
MCI Screening test has to be cleared by the Foreign Medical Graduates (FMG) for legal medical practice in India. The MCI screening test is conducted twice every year by national board of examination in March & September. This examination is specially designed by MCI and DNB to evaluate eligibility for FMG for Indian scenario.
DAMS is having presence in national & international level where the classes for the MCI screening is also running even in various universities in China.
COURSE HIGHLIGHTS
Starting 2nd Week of July 2010, Fast track regular -2 months
· Classes can be conducts on 5 days a week are based on advanced audio-visual learning modules.
· Including- Topic Wise Subject Tests & Monthly Mock Tests
· You will be taught by well qualified and experienced teachers.
· We provides detailed and easy to understand notes. Our notes are based on standard text books. You will not need to read standard book
· Limited number of seats for the batch on first come first serve basis.
· Personal attention to each & every students.
· Hostel facilities available
· Guaranteed success
So come and join DAMS to fulfill your dreams by preparing for MCI SCREENING EXAMINATION.
Visit us at- www.damsdelhi.com Contact us at info@damsdelhi.com
DAMS (MCI Screening Division)
Delhi Academy of Medical Sciences (P) Ltd
4B Pusa Road, Third Floor, Near Karol Bagh Metro Station
New Delhi
+91- 9811217431, +91- 9873314110, +911- 42433051. +911-25853434
MCI SCREENING COURSE
MCI Screening test has to be cleared by the Foreign Medical Graduates (FMG) for legal medical practice in India. The MCI screening test is conducted twice every year by national board of examination in March & September. This examination is specially designed by MCI and DNB to evaluate eligibility for FMG for Indian scenario.
DAMS is having presence in national & international level where the classes for the MCI screening is also running even in various universities in China.
COURSE HIGHLIGHTS
Starting 2nd Week of July 2010, Fast track regular -2 months
· Classes can be conducts on 5 days a week are based on advanced audio-visual learning modules.
· Including- Topic Wise Subject Tests & Monthly Mock Tests
· You will be taught by well qualified and experienced teachers.
· We provides detailed and easy to understand notes. Our notes are based on standard text books. You will not need to read standard book
· Limited number of seats for the batch on first come first serve basis.
· Personal attention to each & every students.
· Hostel facilities available
· Guaranteed success
So come and join DAMS to fulfill your dreams by preparing for MCI SCREENING EXAMINATION.
Visit us at- www.damsdelhi.com Contact us at info@damsdelhi.com
DAMS (MCI Screening Division)
Delhi Academy of Medical Sciences (P) Ltd
4B Pusa Road, Third Floor, Near Karol Bagh Metro Station
New Delhi
+91- 9811217431, +91- 9873314110, +911- 42433051. +911-25853434
New All India PG Medical Entrance Examination (AIPGMEE 2010) book launched (10th January 2010)
AIPGMEE 2010 FULLY SOLVED BY DAMS FACULTY NOW AVAILABLE IN ALL BOOK STORES & DAMS CENTRES
Delhi Academy of Medical Sciences (DAMS), one of the leading PG Medical Entrance Coaching Institute in India, in association with Elsevier, a division of Reed Elsevier India Pvt. Ltd. has launched All India PG Medical Entrance Examination (AIPGMEE 2010). This book has been authored by DAMS faculty.
About book
This book gives concise, comprehensive explanatory answer of All India PG Medical Entrance Examination, accurate recall based questions extracted from our student pool.
The purpose of this book is to give right guidance to the students to attempt their previous AIIMS & AIPG entrance examinations’ repeat questions. As you all know the amount of repeat questions asked in various examination & we know that we still do them wrong. The aim of this book is to understand the need of the PG appearing students.
In keeping with the tradition of DAMS in bringing out highly accurate answers and question recall in the past, this book is sure to make a difference in preparation for your AIIMS & AIPG entrance examination.
For ordering the book contact:
Delhi Academy of Medical Sciences,
4B, 3rd Floor, Grovers’ Chamber, Pusa Road,
Near Karol Bagh Metro Station, New Delhi-110 005
Tel : 91-11-42433051,
Fax : 91-11-25853434,
Email: info@damsdelhi.com
Website: www.damsdelhi.com
Delhi Academy of Medical Sciences (DAMS), one of the leading PG Medical Entrance Coaching Institute in India, in association with Elsevier, a division of Reed Elsevier India Pvt. Ltd. has launched All India PG Medical Entrance Examination (AIPGMEE 2010). This book has been authored by DAMS faculty.
About book
This book gives concise, comprehensive explanatory answer of All India PG Medical Entrance Examination, accurate recall based questions extracted from our student pool.
The purpose of this book is to give right guidance to the students to attempt their previous AIIMS & AIPG entrance examinations’ repeat questions. As you all know the amount of repeat questions asked in various examination & we know that we still do them wrong. The aim of this book is to understand the need of the PG appearing students.
In keeping with the tradition of DAMS in bringing out highly accurate answers and question recall in the past, this book is sure to make a difference in preparation for your AIIMS & AIPG entrance examination.
For ordering the book contact:
Delhi Academy of Medical Sciences,
4B, 3rd Floor, Grovers’ Chamber, Pusa Road,
Near Karol Bagh Metro Station, New Delhi-110 005
Tel : 91-11-42433051,
Fax : 91-11-25853434,
Email: info@damsdelhi.com
Website: www.damsdelhi.com
Interview with Dr. Ruchi Rai - Video Version
(Dr. Ruchi Rai, is an apt clinician and a teacher. She has her clinic in Delhi and is associated with various ophthalmology centers in Delhi and Noida. Her passion for academics and teaching made her associate to leading PG entrance centers. She is a faculty in Delhi Academy of Medical Sciences [DAMS] since six years. She travels extensively to take classes for PG entrance exams all over India. This wide and personal interaction with students and her vast experience in teaching were the guiding force to write this book. The author is an active member of All India Ophthalmological Society [AIOS], Delhi Ophthalmological Society [DOS] and Noida Ophthalmological Society [NOS] with published papers in international journals.
Her latest book Review of Ophthalmology, 2nd edition (PeePee Publishers, 2009) won rave reviews in our journal. Naturally we couldn't contain our desire to know more about her. We at the "Anil Aggrawal's Internet Journal of Book Reviews" approached her for an interview and she graciously agreed. The interview was conducted especially for this journal by Anshul Gupta, a graduate student at the Maulana Azad Medical College, New Delhi. The entire interview was recorded on video. Video interview is made available for the first time in this journal on popular demand from several readers. Some excerpts from this interview may be accessed by clicking here)
Her latest book Review of Ophthalmology, 2nd edition (PeePee Publishers, 2009) won rave reviews in our journal. Naturally we couldn't contain our desire to know more about her. We at the "Anil Aggrawal's Internet Journal of Book Reviews" approached her for an interview and she graciously agreed. The interview was conducted especially for this journal by Anshul Gupta, a graduate student at the Maulana Azad Medical College, New Delhi. The entire interview was recorded on video. Video interview is made available for the first time in this journal on popular demand from several readers. Some excerpts from this interview may be accessed by clicking here)
Concept of Grand Test and Bounce Back Series
DAMS conducts its Grand Test and Bounce back series examinations on third Sunday of each month. Grand test is based on All India PG examination with detailed explanation and references (probably the only institute offering references in the country), followed by the famous Bounce Back series based on repeat questions from AIPG and AIIMS, because at DAMS we leave nothing to chance and make you thorough in the repeats. Agreed lots of people people feel the heat in DAMS tests and say why not give some other institutes tests they are much easier, well our principle is better to feel the heat in DAMS than to feel it in your AIPG. DAMSONIANS ROCK!!
Practice questions for PG Medical entrance (MD/MS/MCI Screening)
1. Calcium dipicolinate is found in
a. Aspergillus
b. Bacillus
c. Escherichia
d. Rickettsia
Ans: B Dipicolinic acid is exclusively found in bacterial spores.
2. “Boiled lobster syndrome” is seen in poisoning with:
a. Hydrochloric acid
b. Boric acid
c. Oxalic acid
d. Chromic acid
Ans: B in boric acid poisoning, the major symptom is erythema, desquamation and exfoliation. The skin of the patient looks like a boiled lobster.
3. Ohngern’s classification is used for”
a. Ca maxillary sinus
b. Ca nasopharynx
c. Ca oropharynx
d. Ca tongue
And: A line from medial canthers to angle of mandible divides maxilla, used for staging of Ca maxillary sinus.
4. The antibody seen in miller Fischer syndrome is:
a. Anti GM1
b. Anti GD1a
c. Anti GQ1b
d. Anti GM2
Ans: C the different types of antibodies seen in GBS are
Variant of GBS antibodies
a. AIDP anti GM1
b. AMAN anti GD1a
c. Miller fisher syndrome anti GQ1b
5. Lubiprostone is chloride channel opener used in the management of
a. Diarrhea
b. Idiopathic constipation
c. Glaucoma
d. Urinary retention
e. Ulcerative colitis
Ans: B Lubiprostone is a gut selective chloride channel opener used exclusively in the management of idiopathic constipation.
6. Triple vessel disease refers to A/E:
a. Rt. Coronary artery
b. Circumflex artery
c. Lt. anterior descending artery
d. Post. Inter-ventricular artery
Ans: A Posterior interventicular artery is not included in the group “Triple vessel disease” (lt. ant. Descending artery is also called left anterior inter-ventricular artery or even Widow’s Artery)
7. Hingorani sign is associated with which disease in pregnancy:
a. Overian tumor
b. Fibroid
c. Syphilis
d. Lymphogranuloma venereum
Ans A in a case of ovarian tumor abdominal examaiton reveals the cystic swelling felt separated from gravid uterus. In later month of pregnancy confusion may arise. The pt is examined vaginally in head down trendelenburg position to elicit the groove between the two swelling i.e. gravid uterus and the ovarian tumor (hingorani sign).
8. Blount’s disease is a cause of?
a. Coax vara
b. Coax magna
c. Genu valgum
d. Genu varum
Ans: D it is a typical disorder affecting the postero-medial epiphysis of proximal tibia (due to avascular necrosis) thereby leading to over growth of the lateral epiphysis resulting in agene / tibia vara deformity. It is common in West Indies & Africans.
9. Highest incidence of pneumothorax occurs when branchial plexus is blocked by which route:
a. Interscalene
b. Supraclavicular
c. Infraclavicular
d. Axillary
Ans: B the incidence of pneumothorax may be as high as 1 to 6% when brachial plexus is blocked through supraclavicular route but fortunately most of these pneumothorax resolve by themselves without t/t.
10. Which is true about LAD-2 disease?
a. Defect in beta chain of CD11/CD18 integrin
b. Defect in fucosyl transferase required for synthesis of sialyted oligosaccharide
c. Defect in chemotaxis
d. Defect in adhesion
Ans: B R-62
11. Surgery’s ear is:
a. Osteoma
b. Chondroma
c. Otomycosis
d. SCC
Ans: A due to swollen epiglottis on lateral X ray of neck
12. DVT is more common on the left lower limb as compared to the right lower limb. This finding is easily explained by what is known as:
a. May – Thurner (Cockett) syndrome
b. Kasabach Merritt syndrome
c. Nutcracker syndrome
d. Subclavian steal syndrome
Ans : A May – Thurner syndrome:
The right common iliac vein ascends almost vertically to the inferior vena cava, while the left common iliac vein takes a more transverse course. For this reason, the left common iliac vein may be compressed between the right common iliac artery and lumbosacral spine, a condition known as May-Thurner (Cockett) syndrome resulting in decreased venous return in left leg.
Kasabach Merritt syndrome: Consists of haemangioma or haemangio-endothelioma or angiosarcoma with consumptive thrombocytopaenia with resulting purpura.
Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and aorta. This can lead to renal venous hypertension, resulting in rupture of thin-walled veins into the collecting system.
Subclavian steal syndrome: Subclavian steal syndrome and subclavian steal phenomenon both result from occlusion or severe stenosis the proximal subclavian artery resulting in development of neurologic symptoms (due to cerebral ischemia resulting in syncopal attacks, visual disturbances & decreased blood pressure in affected limb) on exercise of upper limb due to proximal subclavian stenosis or occlusion with reversal of flow thru vertebral artery. Symptoms aggravated by exercise of arm. Javid test: Compression of carotid artery makes ipsilateral pulse feeble
13. The commonest cause of death in flail chest is:
a. Lung Injury
b. Pendulufft
c. Mediastinal flutter
d. Hemopneumothorax
Ans: B Penulufft
All of the above are causes of unmanaged Flail chest but it is pendulufft (movement of air from one lung to another due to paradoxical movement of chest wall resulting in decreased exchange of gases) which results in most deaths in case of flail chest.
14. “Criminal Nerve of Grassi” is a branch of:
a. Hepatic branch of Anterior Vagus
b. Br. Of Anterior nerve of Latarjet
c. Celiac branch of Posterior Vagus
d. Direct branch of Posterior Vagus
Ans : D
Nerve supply:
Left or Anterior Vagus Right or Posterior Vagus
Parasymp = Vagus ® Eso. Hiatus ® Lesser Curvature (90% sensory) / 10% Efferent /
Right or Posterior Vagus = Posterior surface – branch to Gastric Fundus (Criminal nerve of Grassi can result in hyperacidity if left behind since arises before the main trunk) + Posterior nerve of Latarget + Crow’s feet
Left or Anterior Vagus = Anterior surface ® br. to Liver & GB & continue as Anterior Nerve of Latarget which supply acid & pepsin secreting area of stomach & end as ‘Crow’s feet’ to supply pyloric antrum.
Post. Trunk ® Coeliac plexus ® Remnant of G.I. (Posterior trunk of Lt. Vagus) /
* Pregang Fib. of Vag. synapse with Auerbach's Plexus / Postgang Fib. To smooth muscle + mucosa
Sympathetic – via Gr. Splanchnic nerve ® celiac ganglion ® post ganglionic fibers along gastric arteries to stomach (afferent fibers for visceral pain)
Motility: * Pacemaker in Fundal Mus. Near GC - 3 Peristalsis/min
* Vol. of empty gastric lumen = 50cc (cf GB) ® Receptive dilatation = 1000cc
* Gastric emptying = By Vagus / ¯ By Gastrin
15. Osteopenia definition according to WHO is
a. T score < - 2.5
b. T score between - 1 and – 2.5
c. Z score < - 2.5
d. Z score between - 1 and – 2.5
Ans: D
16. Which of the following represents compound myopic astigmatism..?
a. -2D sph
b. -2D sph/-2 D cyl 180°
c. -2D sph/+2 D cyl 180°
d. +1D sph/-2.5D cyl at 90°
Ans: B Both sphere and cylinder are with- ve sign in compound myopic astigmatism.
17. ‘Jack in the Box’ effect of aphakic eye corrected by spectacles is due to
a. Spherical aberration
b. Ring scotoma
c. Astigmatism
d. Inaccurate correction
Ans: A also seen – pin cushion effect, roving ring scotoma.
18. “Starry sky” appearance in immunofluorescence is seen in
a. Post streptococcal glomerulonephritis
b. Goodpasture’s syndrome
c. IgA nephropathy
d. Wegener’s granulomatosis
Ans: A the renal biopsy in poststreptococcal glomerulonephritis demonstrates hypercellularity of mesangial and endothelial cells, glomerular infiltrates of polymorphonuclear leukocytes, granular subendothelial immune deposits of IgG, IgM, C3, C4, and C5-9, and subepithelial deposits (which appear as “humps”). Immunofluorescence staining gives “starry sky” representing deposition of IgG & C3.
19. Features of Hashimoto’s encephalopathy includes all except
a. Myoclonus
b. Slow-wave activity in EEG
c. Associated with TPO antibodies
d. Resistant to steroids
Ans : D Hashimoto’s encephalopathy has been defined as a steroid-responsive syndrome associated with TPO antibodies, myoclonus, and slow-wave activity on electroencephalography, but the relationship with thyroid autoimmunity or hypothyroidism is not established. The hoarse voice and occasionally clumsy speech of hypothyroidism reflect fluid accumulation in the vocal cords and tongue.
20. Vagal nerve stimulation is used in the treatment of which of the following?
a. OCD
b. Schizophrenia
c. Depression
d. Seasonal affective disorder
Ans: C VNS is an emerging method of treatment of depression. It is offered thorugh the cervical portion of the left vagus which is stimulated in a pulsatile manner (like a pace maker). Preliminary studies showing promising results. The VNS received the FDA approval for the treatment of resistant depression since the year 2005, July. Ref: Kaplan, charles B, J Neuropsychopharmacology (2006), 31, 1345-1355.
21. Which of the following is the itegrase inhibitor approved for treatment of HIV
a. Raltigravir
b. Lopinavir
c. Tipranavir
d. Fosamprenavir
Ans: A this is a new drug approved for the treatment of advanced HIV in combination with other anti-HIV durgs
a. Aspergillus
b. Bacillus
c. Escherichia
d. Rickettsia
Ans: B Dipicolinic acid is exclusively found in bacterial spores.
2. “Boiled lobster syndrome” is seen in poisoning with:
a. Hydrochloric acid
b. Boric acid
c. Oxalic acid
d. Chromic acid
Ans: B in boric acid poisoning, the major symptom is erythema, desquamation and exfoliation. The skin of the patient looks like a boiled lobster.
3. Ohngern’s classification is used for”
a. Ca maxillary sinus
b. Ca nasopharynx
c. Ca oropharynx
d. Ca tongue
And: A line from medial canthers to angle of mandible divides maxilla, used for staging of Ca maxillary sinus.
4. The antibody seen in miller Fischer syndrome is:
a. Anti GM1
b. Anti GD1a
c. Anti GQ1b
d. Anti GM2
Ans: C the different types of antibodies seen in GBS are
Variant of GBS antibodies
a. AIDP anti GM1
b. AMAN anti GD1a
c. Miller fisher syndrome anti GQ1b
5. Lubiprostone is chloride channel opener used in the management of
a. Diarrhea
b. Idiopathic constipation
c. Glaucoma
d. Urinary retention
e. Ulcerative colitis
Ans: B Lubiprostone is a gut selective chloride channel opener used exclusively in the management of idiopathic constipation.
6. Triple vessel disease refers to A/E:
a. Rt. Coronary artery
b. Circumflex artery
c. Lt. anterior descending artery
d. Post. Inter-ventricular artery
Ans: A Posterior interventicular artery is not included in the group “Triple vessel disease” (lt. ant. Descending artery is also called left anterior inter-ventricular artery or even Widow’s Artery)
7. Hingorani sign is associated with which disease in pregnancy:
a. Overian tumor
b. Fibroid
c. Syphilis
d. Lymphogranuloma venereum
Ans A in a case of ovarian tumor abdominal examaiton reveals the cystic swelling felt separated from gravid uterus. In later month of pregnancy confusion may arise. The pt is examined vaginally in head down trendelenburg position to elicit the groove between the two swelling i.e. gravid uterus and the ovarian tumor (hingorani sign).
8. Blount’s disease is a cause of?
a. Coax vara
b. Coax magna
c. Genu valgum
d. Genu varum
Ans: D it is a typical disorder affecting the postero-medial epiphysis of proximal tibia (due to avascular necrosis) thereby leading to over growth of the lateral epiphysis resulting in agene / tibia vara deformity. It is common in West Indies & Africans.
9. Highest incidence of pneumothorax occurs when branchial plexus is blocked by which route:
a. Interscalene
b. Supraclavicular
c. Infraclavicular
d. Axillary
Ans: B the incidence of pneumothorax may be as high as 1 to 6% when brachial plexus is blocked through supraclavicular route but fortunately most of these pneumothorax resolve by themselves without t/t.
10. Which is true about LAD-2 disease?
a. Defect in beta chain of CD11/CD18 integrin
b. Defect in fucosyl transferase required for synthesis of sialyted oligosaccharide
c. Defect in chemotaxis
d. Defect in adhesion
Ans: B R-62
11. Surgery’s ear is:
a. Osteoma
b. Chondroma
c. Otomycosis
d. SCC
Ans: A due to swollen epiglottis on lateral X ray of neck
12. DVT is more common on the left lower limb as compared to the right lower limb. This finding is easily explained by what is known as:
a. May – Thurner (Cockett) syndrome
b. Kasabach Merritt syndrome
c. Nutcracker syndrome
d. Subclavian steal syndrome
Ans : A May – Thurner syndrome:
The right common iliac vein ascends almost vertically to the inferior vena cava, while the left common iliac vein takes a more transverse course. For this reason, the left common iliac vein may be compressed between the right common iliac artery and lumbosacral spine, a condition known as May-Thurner (Cockett) syndrome resulting in decreased venous return in left leg.
Kasabach Merritt syndrome: Consists of haemangioma or haemangio-endothelioma or angiosarcoma with consumptive thrombocytopaenia with resulting purpura.
Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and aorta. This can lead to renal venous hypertension, resulting in rupture of thin-walled veins into the collecting system.
Subclavian steal syndrome: Subclavian steal syndrome and subclavian steal phenomenon both result from occlusion or severe stenosis the proximal subclavian artery resulting in development of neurologic symptoms (due to cerebral ischemia resulting in syncopal attacks, visual disturbances & decreased blood pressure in affected limb) on exercise of upper limb due to proximal subclavian stenosis or occlusion with reversal of flow thru vertebral artery. Symptoms aggravated by exercise of arm. Javid test: Compression of carotid artery makes ipsilateral pulse feeble
13. The commonest cause of death in flail chest is:
a. Lung Injury
b. Pendulufft
c. Mediastinal flutter
d. Hemopneumothorax
Ans: B Penulufft
All of the above are causes of unmanaged Flail chest but it is pendulufft (movement of air from one lung to another due to paradoxical movement of chest wall resulting in decreased exchange of gases) which results in most deaths in case of flail chest.
14. “Criminal Nerve of Grassi” is a branch of:
a. Hepatic branch of Anterior Vagus
b. Br. Of Anterior nerve of Latarjet
c. Celiac branch of Posterior Vagus
d. Direct branch of Posterior Vagus
Ans : D
Nerve supply:
Left or Anterior Vagus Right or Posterior Vagus
Parasymp = Vagus ® Eso. Hiatus ® Lesser Curvature (90% sensory) / 10% Efferent /
Right or Posterior Vagus = Posterior surface – branch to Gastric Fundus (Criminal nerve of Grassi can result in hyperacidity if left behind since arises before the main trunk) + Posterior nerve of Latarget + Crow’s feet
Left or Anterior Vagus = Anterior surface ® br. to Liver & GB & continue as Anterior Nerve of Latarget which supply acid & pepsin secreting area of stomach & end as ‘Crow’s feet’ to supply pyloric antrum.
Post. Trunk ® Coeliac plexus ® Remnant of G.I. (Posterior trunk of Lt. Vagus) /
* Pregang Fib. of Vag. synapse with Auerbach's Plexus / Postgang Fib. To smooth muscle + mucosa
Sympathetic – via Gr. Splanchnic nerve ® celiac ganglion ® post ganglionic fibers along gastric arteries to stomach (afferent fibers for visceral pain)
Motility: * Pacemaker in Fundal Mus. Near GC - 3 Peristalsis/min
* Vol. of empty gastric lumen = 50cc (cf GB) ® Receptive dilatation = 1000cc
* Gastric emptying = By Vagus / ¯ By Gastrin
15. Osteopenia definition according to WHO is
a. T score < - 2.5
b. T score between - 1 and – 2.5
c. Z score < - 2.5
d. Z score between - 1 and – 2.5
Ans: D
16. Which of the following represents compound myopic astigmatism..?
a. -2D sph
b. -2D sph/-2 D cyl 180°
c. -2D sph/+2 D cyl 180°
d. +1D sph/-2.5D cyl at 90°
Ans: B Both sphere and cylinder are with- ve sign in compound myopic astigmatism.
17. ‘Jack in the Box’ effect of aphakic eye corrected by spectacles is due to
a. Spherical aberration
b. Ring scotoma
c. Astigmatism
d. Inaccurate correction
Ans: A also seen – pin cushion effect, roving ring scotoma.
18. “Starry sky” appearance in immunofluorescence is seen in
a. Post streptococcal glomerulonephritis
b. Goodpasture’s syndrome
c. IgA nephropathy
d. Wegener’s granulomatosis
Ans: A the renal biopsy in poststreptococcal glomerulonephritis demonstrates hypercellularity of mesangial and endothelial cells, glomerular infiltrates of polymorphonuclear leukocytes, granular subendothelial immune deposits of IgG, IgM, C3, C4, and C5-9, and subepithelial deposits (which appear as “humps”). Immunofluorescence staining gives “starry sky” representing deposition of IgG & C3.
19. Features of Hashimoto’s encephalopathy includes all except
a. Myoclonus
b. Slow-wave activity in EEG
c. Associated with TPO antibodies
d. Resistant to steroids
Ans : D Hashimoto’s encephalopathy has been defined as a steroid-responsive syndrome associated with TPO antibodies, myoclonus, and slow-wave activity on electroencephalography, but the relationship with thyroid autoimmunity or hypothyroidism is not established. The hoarse voice and occasionally clumsy speech of hypothyroidism reflect fluid accumulation in the vocal cords and tongue.
20. Vagal nerve stimulation is used in the treatment of which of the following?
a. OCD
b. Schizophrenia
c. Depression
d. Seasonal affective disorder
Ans: C VNS is an emerging method of treatment of depression. It is offered thorugh the cervical portion of the left vagus which is stimulated in a pulsatile manner (like a pace maker). Preliminary studies showing promising results. The VNS received the FDA approval for the treatment of resistant depression since the year 2005, July. Ref: Kaplan, charles B, J Neuropsychopharmacology (2006), 31, 1345-1355.
21. Which of the following is the itegrase inhibitor approved for treatment of HIV
a. Raltigravir
b. Lopinavir
c. Tipranavir
d. Fosamprenavir
Ans: A this is a new drug approved for the treatment of advanced HIV in combination with other anti-HIV durgs