Errata All India Mock 2010

Q-13 An alert 6 month old child is brought with vomiting & diarrhea. RR-45/min,HR-180/min, SBP-85 mm of Hg. Extremities are cold & mottled. Capillary refilling time is 4 secs. Diagnosis is

    1. Early compensated hypovolemic shock
    2. Early decompensated hypovolemic shock
    3. Late compensated hypovolemic shock
    4. Late decompensated shock due to SVT

Ans-13: (c) Late compensated hypovolemic shock

· In this patient having SBP=85 which is in the normal range

· Heart rate is 180 so not tachycardic so its late compensated hypovolemic shock

Q-22 The most frequent type of primary brain tumor is

a. Meningioma

b. Glioma

c. Neural sheath tumor

d. Squamous cell carcinoma

Ans-22: (b) Glioma

Ref:Read the text below

Sol:

§ Gliomas are the most frequent type of primary brain tumor and include astrocytomas, ependymomas, oligodendrogliomas, and medulloblastomas.

§ Meningiomas are the next most common type of primary brain tumor. Neural sheath tumors are less common.

Q-32 65 yrs old man with history of back pain since 3 months. ESR is raised. Marked stiffness on examination. Mild restriction of chest movements. On X- ray,syndesmophytes are present. Diagnosis is

a. Ankylosing spondylitis

b. Degenerative osteoarthritis of spine

c. Ankylosing hyperosteosis

d. Lumbar canal stenosis

Ans-32: (c) Ankylosing hyperosteosis

Ref:Read the text below

Sol:

Answer is option (c) Ankylosing hyperosteosis

ERRATA Q-35 Which of the following is a pulsatile tumor?

a. Chondrosarcoma

b. Osteoclastoma

c. Osteosarcoma

d. Ewing’s sarcoma

Ans-35: (B) Osteoclastoma

Q-101 IMNCI defers from IMCI by all except

a. Malaria & anemia are included

b. 0-7 days neonates are included

c. Sick neonates are preferred over sick older child

d. Treatment is aimed at more than 1 disease at a time

Ans-101: (c) Sick neonates are preferred over sick older child

Ref: Park 20e/387

Sol:

· Proportion of training time devoted to sick young infant and sick child is almost equal

Q-133 A 6-year-old boy who received Bactrim for otitis media presents with high fever; target lesions on the palms and soles, trunk, and the extensor surfaces of the extremities; and inflammatory bullae on his mucous membranes. What type of hypersensitivity rash does this child have?

a. Eczema

b. Urticaria

c. Erythema multiforme

d. Stevens-Johnson syndrome

Ans 133: (d) Stevens-Johnson syndrome

Ref– Read the text below

Sol:

· Stevens-Johnson syndrome is the most severe form of erythema mul-tiforme. Stevens- Johnson syndrome is characterized by fever,erythema multiforme rash, and inflammatory bullae of two or more mucous membranes (oral mucosa, lips, bulbar conjunc-tiva, anogenital area).

ERRATA Q-243 A patient brought in unconscious state with external injuries. CT is normal with no midline shift and ventricles are normal. Multiple small hemorhages are seen at the base of the brain. Diagnosis is

a. Subarachnoid hemorrhage

b. Diffuse axonal injuries

c. Concussion

d. Contusion

Ans-243: (b) Diffuse axonal injuries

Ref: Grainger & Allison's Diagnostic Radiology, 5th ed.

Sol:

Q-259 Barrett’s esophagus shoes

  1. Intestinal dysplasia
  2. Intestinal metaplasia
  3. Squamous cell metaplasia
  4. Columnar cell metaplasia

Ans-259: (d) Columnar cell metaplasia

Ref:Read the text below

Sol:

Q-263 CD marker specific for myeloid series

    1. CD34
    2. CD45
    3. CD99
    4. CD117

Ans-263: (d) CD117

Ref:Read the text below

Sol:

ERRATA Q-290 25 yr old male having fever & malaise since 2 weeks, arthritis of ankle joint and erythematous nodules over the shin. Diagnosis is

a. Erythema nodosum

b. Hensen’s disease

c. Weber-Christian disease

d. Urticarial vasculitis

Ans-290: (a) Erythema nodosum

Ref: Fitzpatrick Dermatology Atlas 5th ed

Sol:

Recent Census 2011

Dear friends,

Merry X Mas and a wishing u all a happy New Year…

As the preliminary reports of Cencus is not yet out, I suggest to use the following data which is the recent most data available in Govt records so far….

Though the data is published in Oct 2009 report.

CBR 22.8

CDR 7.4

Natural Increase ( CBR-CDR)=15.4

AGR 1.93

IMR 53

TFR 2.6

TMFR 4.3

MMR 254 ( last updated 2006 )

Literacy rate 54.28

Sex Ratio 933 (Source : Census 2001)

Sex Ratio (0-4)=915 (Source: SRS-Bulletin 2009, Vol 44 No-1, published on Oct 2009)

Mean age marriage (females)=20.6

CPR 46.5

GFR 88

GMFR 121.1

GRR 1.2

Neonatal MR 35

Early NeoMR 27

PMR 35

Still BR 8

U5MR 69

Source: SRS-Bulletin 2009, Vol 44 No-1, published on Oct 2009

Interview with our topper Dr Nikhil nair


Dr Nikhil Nair did his MBBS from MAMC Delhi and joined DAMS TEST SERIES

He secured Rank 22 in PGI -2010

DAMS: Congratulations on securing rank -22 in PGI-2010 What is the secret of your success in this exam?

Dr Nikhil Nair : Consistent hard work, preservation, and an unwavering, focused mind.

DAMS: How did your parents, family and friends contribute to your success?

Dr Nikhil Nair: Family &friends provided me with a comfort zone & shielded me from many extrinsic distractions.

DAMS: Who influenced you to take up Medicine?

Dr Nikhil Nair: My father, Late Mr. A.K Nair

DAMS: We appreciate the fact that preparing for an extremely competitive exam must be really challenging. During your preparation, did you ever doubt your ability to succeed in it?

Dr Nikhil Nair: Everyday !!! I have had nightmares about not being selected in any exam.

DAMS: Which books did you read for the theory part?

Dr Nikhil Nair: For Surgery –Schwartz Surgery, , ENT – Dr. Dhingra ENT, Micro – DR.C.P. Bawega’s Microbiology, Pharma – K.D.T

DAMS: Which books did you read for MCQ revision? Which revision books were the most productive and which were least”

DR Nikhil Nair: I read AA for Medicine& Surgery, Rachna Chaurasia for Micro, Gobind Garg for Pharma, Sakshi Arora for OBG& ENT ACROSS for short subjects.
Most productive- AA, Gobind Garg
Least productive- Across ( as quite a lot of answers were giver wrongly)

DAMS: How important you think was DAMS in your preparation?

DR Nikhil Nair: Grand tests organized by DAMS are undoubtedly the toughest in the business and prepared me for tough, challenging exam:

DAMS : What do you think is the better way of preparation between selective, intensive study and wide, extensive study? What did you choose as your style of studding?
Dr Nikil Nair: I Personally favor wide, extensive study, however selective, intensive study of some topics is necessary for success in PGI

DAMS: Indian PG entrances are highly competitive so to compete them students end up in appearing in multiple PG exams , kindly extend your views on this and also their pros and cons of appearing in multiple PG entrances .

Dr Nikhil Nair: Multiple PG exams give one a Multiple of options to fall back upon& choose from in case one of your exam goes badly. I am all for it!

DAMS: Which subjects did you focus on?

Dr Nikhil Nair: I gave special emphasis to Pharma, Micro , Surgery & most of the short subjects.

DAMS: What was your strategy for the exam day? How many questions did you attempt and why?

DR Nikhil Nair: My strategy in PGI exam was to analyze each option carefully before marking but once I had decided on one, I didn’t hesitate before marking it. I attempted 248/250 as I had decided to give it my best shot.

DAMS: What do you want to specialize in, why and where?

Dr Nikhil Nair: orthopedics/ ophthalmology from PGI as I have always liked these 2 streams from my MBBS days . PGI is undoubtedly one of the most reputed institutions in India for both theses branches

DAMS: Which teacher in DAMS influenced you most and what do you like about DAMS and would recommend to your juniors ?

DR Nikhil Nair: I was highly influenced by Dr Sumer Sethi and I would strongly recommended My juniors to join DAMS.

Interview with out topper Dr Saransh Jain DAMS Student for 2 years

DR Saransh Jain did his MBBS from MAMC Delhi and joined DAMS in his 6th semester in foundation and followed it up with test and discussion course in internship with DAMS Delhi, enrolment number- F-1576/2008& T-0676/2010

He secured RANK 12 in AIIMS NOVEMBER 2010 & rank 33 in PGI- 2010

DAMS: Congratulations on securing a rank in AIIMS 2010. What is the secret of your success in this exam?

DR Saransh Jain: Hard work and self confidence I think any Body can achieve a PGI Seat with. Proper dedication and guidance

DAMS: How did your parents, family and friends contribute to your success?

Dr Saransh Jain: Their contribution cannot be described in words the parents and my sister gave me in my times emotional support was key to my success and my friends. With whom I studied and cribbed about.

DAMS: Who influenced you to take up Medicine?
Dr Saransh jain: My parents both are doctors . my father himself DM Gastro from AIIMS was the iron pillar of support throughout my higher secondary and MBBS also my inspiration

DAMS: We appreciate the fact that preparing for an extremely competitive exam must be really challenging. During your preparation, did you ever doubt your ability to succeed in it?

Dr Saranh Jain: Definitely my 1st day of internship I was very nervous about usually but it but key to success is. hard work .and hard work with right guidance and emotional support helped me to achieve what I did

DAMS: Which books did you read for the theory:

Dr Saransh Jain: I read my DAMS notes and then did retro study from AA & MK

DAMS: Which books did you read MCQ? Which revision books were the most productive and which were least?

Dr Saransh Jain: AA & MK. Anatomy subject will Gobind Garg for Pharma.
DAMS: How important think was DAMS in your preparation?

Dr Saransh Jain : DAMS laid my foundation in 2007 (I joined the foundation course) and kept my revision up to date in 2010 (when I joined Test and discussion).

DAMS: What do you think is the better way of preparation between selective intensive study and wide, extensive study? What did you chose as your style of studying.

Dr Saransh Jain: Selective intensive study

DAMS: Indian PG entrance are highly competitive so to compete them students end up in appearing in multiple PG exams, kindly extend your views on this and also their pros and cons of appearing in the multiple PG entrances.

Dr Saransh Jain: Sitting in multiple exams gives you many demands at same time we should focus on two main exams rest can be done on basis of preparation of these exams

DAMS: Which subjects did you focus on?

Dr Saransh Jain: Pathology/ Pharma/ Physiology, Short subjects

DAMS : What was your strategy for the exam day? How many questions did you attempt and why?

Dr Saransh Jain: (AIIMS) 185 /200 . ( PGI)195/200

DAMS: What do you want to specialize in, why and where?

DR Saransh Jain: Medicine AIIMS

DAMS: Which teachers in DAMS influenced you most and what do you like about DAMS and would recommend to your juniors?

Dr Saransh Jain: Dr Sumer Sethi , Dr Varun gupta, Dr Rajiv tiwari
I especially liked the student friendly atmosphere And would recommend DAMS to my juniors.

Interview with our topper Dr Zohra Ahmed DAMS Student For 2 Years


Dr Zohra Ahmed did her MBBS from Lady Hardinge medical college and joined DAMS in her 6th semester in foundation and followed it up with test and discussion course in internship with DAMS Delhi, enrolment number- F-1593/2008 & T-0698/2010

She secured Rank 1 in AIIMS NOVEMBER 2010.

DAMS: Congratulations on securing a Rank 1 in AIIMS Nov 2010. What is the secret of your success in this exam?

Dr Zohra Ahmed: Starting early (3rd year), focussing on ten years, completion by studying class notes of DAMS

DAMS: How did your parents, family and friends contribute to your success?

Dr Zohra Ahmed: My parents and family have been a pillar of strength throughout understanding the sacrifices I had to make during the preparation period (i.e. not able to give them time etc.) My friends have always encouraged me to excel and nothing would be possible without them

DAMS: Who influenced you to take up Medicine?

Dr Zohra Ahmed: The book “Doctors” by Eric Sehgal

DAMS: We appreciate the fact that preparing for an extremely competitive exam must be really challenging. During your preparation, did you ever doubt your ability to succeed in it?

Dr Zohra Ahmed: The doubt crept creeping in everyday now & then and it was the ranks in DAMS grand tests that keeps up ur morale and tells you where you really stand

DAMS: Which books did you read for the MCQ Revision & theory part ?

Dr Zohra Ahmed: MK/AA( 10 yrs) , Across, Review of Radiology by Dr Sumer Kr Sethi , Gobind Garg(Pharama) Rachna Chaurasia.(micro), review of forensic Sumit Seth ,AA( medicine , surgery)theory part

DAMS : Which books did you read for MCQ revision? Which revision books were the most productive and which were least?

Dr Zohra Ahmed: Most productive 10 yrs MK&AA, Sakshi Arora (Gynaecology), Harrison’s medicine , other regular theory books used in our colleges

DAMS : How important you think was DAMS in your preparation ?

Dr Zohra Ahmed: Couldn’t have done without the classes in 3rd yr in DAMS. They were I think a keystone in my preparation . I covered a good chunk of my course in 3rd yr itself. DAMS foundation course is well planned and covers a whole syllabus well on time.

DAMS: What do you think is the better way of preparation between selective, intensive study and wide, extensive study? What did you choose as your style of studying?

Dr Zohra Ahmed: Selective Intensive Study

DAMS: Indian PG entrances are highly competitive so to compete them students end up in appearing in multiple PG exams , kindly extend your views on this and also their pros and cons of appearing in multiple PG entrances .

Dr Zohra Ahmed: well appearing in different exams gives us a chance of succeeding in our exam if not another. Papers are different from exam to exam and your performance varies too

DAMS: Which subjects did you focus on?

Dr Zohra Ahmed : All subjects are equally important , Short subjects –SARP , Anatomy Medicine .Surgery

DAMS: What was your strategy for the exam day? How many questions did you attempt and why?

Dr Zohra Ahmed: I just thought to myself “m going to attack each and every question “ I attempted 199 questions as I attempt a question I can rule out 1 option

DAMS: What do you want to specialize in, why and where?

Dr Zohra Ahmed : Radio diagnosis AIIMS , most advanced department of RD in India

DAMS: Which teachers in DAMS influenced you most and what do you like about DAMS and would recommend to your juniors?

Dr Zohra Ahmed : 1. Dr Sumer k. Sethi 2. Dr Ruchi Rai 3. Dr Rajiv ( ENT) Dr Rajeev Tewari
DAMS has a pretty intensive programme of study in 3rd year covering a good part of the course of final yr & 3rd year subjects , Their notes are good to revise before PG- entrance exams-concise and high yielding.

ERATTA AIIMS MOCK

ANSWER B,C,D Q-47 All of the following statements concerning mammalian chromosomes are true :
a. DNase I can be used to treat chromosomes to determine inactive regions of DNA
b. Approximately 7% of the sequences contained in the eukaryotic genome are copied into RNA
c. Heterochromatin is a term used for inactive DNA, and euchromatin is a term used for those regions of DNA that are transcriptionally active.
d. In higher eukaryotic genomes, cytosine is methylated at cytosine-guanine (CG) islands in inactive segments of DNA
Ans-47: (a) DNase I can be used to treat chromosomes to determine inactive regions of DNA
Ref:Read the text below
Sol:

Q-49 Which one of the following descriptions is typically associated with a nephrotic syndrome?
a. Red blood cell casts, a low level of proteinuria, and granular casts
b. Heavy proteinuria, oval fat bodies, and fatty casts
c. Hematuria, granular casts, and borad waxy casts
d. A proliferative glomerulonephritis on renal biopsy
Ans-49: (b) Heavy proteinuria, oval fat bodies, and fatty casts
Ref:Read the text below
Sol:

ANSWER ALL Q-95 Digitalis toxicity enhanced by all of the following except:
a. Renal failure
b. Hypokalemia
c. Hypercalcemia
d. Hypomagnesemia



ANSWER A AND B Q-129 Clomiphene citrate – True statement is
a. Enclomiphene is anti-estrogenic
b. Pregnancy rate is 3 times as compared to placebo
c. Incidence of twins is 5-6%
d. It has been shown to increase fertility in oligospermic males



NO CHANGE Q-168 Heat rupture characterised by
a. Irregular margin
b. Clotted blood
c. Regular margin
d. Clotted blood vessels
Ans-168: (a) Irregular margin
Ref: Read the text below
Sol:

NO CHANGE READ EXPLANATION Q-178 A 30-year-old man complains of dizziness, palpitations, derealization, and a sense of detachment that are not associated with any obvious stress. The differential diagnosis includes all of the following conditions except
a. Partial complex seizures
b. Acute stress disorder
c. Panic disorder
d. Hypercalcemia

ANSWER B AND C Q-170 Regarding ultrasound of the gastrointestinal tract:
a. The mucosa of the pylorus appears echopoor.
b. The thickness of the normal pyloric muscle should not exceed 3 mm.
c. The pancreas is more easily visualized in children through the left lobe of the liver.
d. The right lobe of the liver extends anterior to the spleen.
Ans 170: (b) The thickness of the normal pyloric muscle should not exceed 3 mm.
(c) The pancreas is more easily visualized in children through the left lobe of the liver.
Reference: Read the text below
Sol:
•The mucosa of the pylorus is echobright and muscle is echopoor.
•Dimensions of pyloric muscle vary depending on size of the child. However upper limits in the longitudinal section are as follows: 3 mm thickness of pyloric muscle, and 17 mm in length for the pyloric canal. With measurements above these figures pyloric stenosis has to be suspected.
•The pancreas is more easily visualized in children through the left lobe of the liver and provides an acoustic window.
•The left lobe of the liver extends anterior to the spleen,trace of free fluid between the left lobe of liver and spleen may give rise to an erroneus diagnosis of laceration of the spleen.

NO CHANGE READ EXPLANATION Q-186 A 35-year-old man with an obsessive-compulsive personality disorder is likely to exhibit all of the following symptoms except
a. Perfectionism that interferes with performance
b. Compulsive checking behavior
c. Preocupation and concern for rules
d. Indecisiveness
Ans-186: (b) Compulsive checking behavior
Ref: Read the text below
Sol:
It is important to remember that the obsessive-compulsive disorder (i.e., the anxiety disorder) is a different illness form the obsessive-compulsive personality disorder.
Individuals with the obsessive – compulsive personality disorder seen to have perfectionistic and inflexible personalities.
These individuals are often indecisive, stingy with compliments and preoccupied by trivial details, but they do not exhibit symptoms of the anxiety disorder, such as compulsive checking and excessive washing.

Bounce Back 25 Errata

21. ANS..C (AIIMS MAY 2007)

22. ANS..C (AIIMS MAY 2007)
24. ANS...A AIIMS MAY 2008
26. ANS..A (AIIMS MAY 2007)
27. ANS... A AIPG 2009
74. ANS ..B AIIMS NOV 2008(the question given in amit ashish is with EXCEPT in yhat case the answer is C , THE QUESTION WAS TAKEN FROM DAMS BOOK WERE THAT TIME ANS GIVEN WAS B)
80. ANS…B AIPG 2008
90. ANS ..B AIIMS NOV 2008
97. ANS…B AIPG 2008
99. ANS..B (AIIMS NOV 2005)
100. Ans. C

Errata Grand Test 89

Q-55 Concerning CNS involvement in AIDS:
a. Toxoplasma may give rise to a focal lesion with neurological weakness.
b. The HIV virus can be isolated from the brain of an encephalopathic patient.
c. A diagnostic elevation in the CSF IgM occurs in toxoplasmic infection.
d. Occular involvement may cause blindness.
Ans 55: A,B,D
Reference: Read the text below
Sol:
• Cerebral toxoplasmosis presents very variably, from an acute encephalopathy to subtle neurological syndromes. It should be considered in all undiagnosed neurological disease in the under ones, especially if there are retinal lesions.
• Characteristic are hydrocephalus, seizures with focal defects, spinal or bulbar palsies, microcephaly, and decreased IQ. Investigations such as skull x-ray or CT scan show calcification of the periventricular area, tachyzoites in the CSF and positive blood titres.
• Pyrimethamine and Sulphadiazine have a synergistic effect in treating it, and folinic acid may be necessary to prevent seizures.


Q-135 An 8-year-old boy with sickle cell disease presents with left leg pain and a high fever. He has been refusing to walk since yesterday. On physical examination, his temperature is 39.8 C (103.6 F), blood pressure is 122/68 mm Hg, pulse is 102/min, and respirations are 20/min. His left femur is tender to palpation 3 cm above the left knee, and there is marked soft tissue swelling. A plain film of his left leg is normal. A bone scan shows increased uptake around the metaphysis of the left femur. Which of the following is the most likely pathogen?
a. Escherichia coli
b. Haemophilus influenzae
c. Salmonella
d. Staphylococcus aureus
Ans 135: (c) Salmonella
Ref– Read the text below
Sol:
• Osteomyelitis is a pyogenic infection of the bone. The pathogenesis of the disease is similar to septic arthritis, with the origin of infection occurring from hematogenous spread, direct extension of a local infection, or direct inoculation of bone either from trauma (e.g.puncture wound or open fracture) or surgical manipulation. In children, the most frequent presentation is acute hematogenous spread.
• The most common location of osteomyelitis is the metaphysis of the distal femur and proximal tibia.
• The most prevalent pathogens are the same as those seen in septic arthritis. Staphylococcus aureus is the most common pathogen, with group A beta-hemolytic streptococci a distant second.
• Neonates are at risk for group B beta-hemolytic streptococci. Haemophilus influenzae may occur in infants and young children, but it is not seen as frequently as in septic arthritis.
• In addition, children with H. influenzae osteomyelitis usually have fever and concomitant joint infection. Patients with puncture wounds of the foot are susceptible to Pseudomonas aeruginosa osteomyelitis.
• Patients with sickle cell disease are at risk for infection by Salmonella and other gram-negative bacteria, and patients in the 18- to 48-month age range are at increased risk for acute recurrent Salmonella osteomyelitis.
• Salmonella osteomyelitis frequently involves multiple sites and creates punched-out destructive lesions of the metaphysis and diaphysis. However, even in patients with sickle cell disease, Staphylococcus aureus is still the most common pathogen for osteomyelitis.
• Most patients with osteomyelitis will present with a chief complaint of fever and bone pain. The pain is usually severe, constant, and aggravated by motion. The older the child, the more exquisite the point tenderness, because the bone has a thicker metaphyseal cortex with a dense fibrous periosteum. Localized swelling, warmth, and erythema are signs seen late in the infection, as the periosteum becomes more involved.
• Neonates can present with vague symptoms, consisting only of irritability and poor feeding, or can show signs of fulminant sepsis. The peripheral white blood cell count may be normal, or elevated with a left shift. The erythrocyte sedimentation rate (ESR) is usually elevated, and blood cultures are positive in approximately 60% cases.
• Bone cultures taken either surgically or by needle aspiration result in a culture yield of 80%. Plain radiographs may be normal for up to 2 weeks from the onset of illness, and the earliest signs on plain films are soft tissue swelling and displacement of muscle plane.
• Bony changes begin to appear by 7-10 days, starting with a hazy appearance of the metaphysis followed by irregular areas of trabecular necrosis and absorption. Eventually, subperiosteal new bone formation occurs as the infection spreads through the cortex. A bone scan usually diagnoses osteomyelitis as early as 24-48 hours from onset.
• Treatment should begin with empiric parenteral antibiotics. The selection of antibiotic should include coverage of Staphylococcus aureus, as well as other organisms; the agent can probably be based on the patient's age and history of illness. Surgical debridement may be necessary if pus is present on needle aspiration, or if evidence of either joint involvement or abscess is present.

Q-178 A 32-year-old farmer presents to the emergency room 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 178 : (d) Administration of tetanus and diphtheria toxoid
Ref– Read the text below
Sol:

Q-220 Abortion is defined as expulsion of fetus
a. Before Viability
b. Before 28 weeks
c. Any of the above
d. None of the above
Ans 220: (a) Before Viability

• Abortion is the termination of pregnancy before the period of viability which is considered to occur at 28th Week
• However for international acceptance, the limit of viability is brought down to either 20th week or fetus weighing 500 gm.
• If the expelled fetus weighs less than 500 gm, it is called abortus. The term miscarriage, which is mostly used, is synonymous with abortion

Q-226 Which one of the following is a cofactor and not a coenzyme?
a. Biotin
b. Tetrahydrofolic acid
c. Copper
d. Methylcobalamin
Ans 226 : (c) Copper
Ref– Read the text below
Sol:
• Cofactors are distinguished from coenzymes because cofactors do not function in group transfer and do not undergo chemical reactions (other than changes in valence due to oxidation/ reduction).
• Cofactors are usually metallic ions rather than organic molecules. Examples of cofactors include copper in cytochrome oxidase, iron in all the cytochromes, magnesium for all enzymes utilizing ATP, and zinc in lactate dehydrogenase.
• Methylcobalamin, biotin, tetrahydrofolic acid, and pyridoxal phosphates all assist with enzyme catalysis by transfer of groups from or to the primary substrate.

Q-282 Read the statements carefully and find out which is false :
a. No exact criteria exist for defining when acute osteomyelitis becomes chronic.
b. The hallmark of chronic osteomyelitiis is the presence of dead bone (the sequestrum)
c. Involucrum (reactive bony encasement of the sequestrum), local bone loss, persistent drainage, and/or sinus tracts are other common features of actute disease.
d. The patient with chronic osteomyelitis commonly presents with chronic pain and sinus formation with purulent drainage.
Ans 282: (c) Involucrum (reactive bony encasement of the sequestrum), local bone loss, persistent drainage, and/or sinus tracts are other common features of actute disease.
Reference: Read the text below
Sol:
• Involucrum (reactive bony encasement of the sequestrum) local bone loss, persistent drainage, and/or sinus tracts are other common features of chronic disease, prospects of halting the infection are reduced when the integrity of surrounding soft tissue is poor or the bone are unstable due to an infected nounion or an adjacent septic joint.
• Squamous cell carcinoma at the site of tissue draingage and amyloidosis are rare complications of chronic osteomyelities.

Chapter concepts of Health and Disease

New topics in New Edition of park (20th edition)


HUMAN POVERTY INDEX ( HPI) :
• HPI measures: Deprivation in basic dimensions of human development
o HPI is complimentary to Human Development index (HDI)
• Components of Hpi –I ( Used for developing countries )
o Probability at birth of not surviving to age 40
o Adult illiteracy Rate
o Un-weighted average or two indicators:
1) % Population not using an improved water source
2) % Children underweight- for-age

• Components of HPI – II ( Used for developed countries)
o Probability at birth of not surviving to age 60
o % adults (aged 16-65 year ) lacking functional literacy skills
o % People living below poverty line (BPL)
o Rate of ling term employment (12 month or more)

Learn about PG medical entrance with DAMS. Leading Institute for PG medical entrance in India.

Eratta Grand Test-88

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

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

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

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)

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

Dr. Shivya Tucker Interview


Interview with our topper Shivya Tucker

DAMS STUDENT FOR TWO YEARS
Dr Shivya did her MBBS from Lady Hardinge medical college and joined DAMS in her 6th semester in foundation and followed it up with test and discussion course in internship with DAMS Delhi, enrolment number- 0298/09, 1009/06.

She secured Rank 1 in PGI Chandigarh and Rank 24th in AIIMS 2009.

DAMS: Congratulations on securing a top rank in AIPGE 2009. What is the secret of your success in this exam?

Dr Shivya: I think secret to cracking any exam is hard work and perseverance.

DAMS: How did your parents, family and friends contribute to your success?

Dr Shivya: My parents supported me throughout the year. They were always there when I went through my low moods and always encouraged me to do well.

DAMS: Who influenced you to take up Medicine?

Dr Shivya: I have grown up in a family of Doctors.I guess medicine was ingrained in me from the very beginning !!!

DAMS: We appreciate the fact that preparing for an extremely competitive exam must be really challenging. During your preparation, did you ever doubt your ability to succeed in it?


Dr Shivya: Every single time!!! Each and every moment in the last year was spent in doubts. But somewhere knew that my hard work will pay off!!! But I had never assigned, that it would in such a nice way.

DAMS: Which books did you read for the theory part?

Dr Shivya: Robins – Pathology, Maheshwari – Ortho,
B.D.Chaurasia – Anatomy, Ajay Yadav – Anaesthesia, Radio- Sumer Sethi, Ruchi Rai – Opthal, Ganong – Physio, Forensic – Sumit Seth,
Lipincott – Biochem. DAMS books on AIIMS were especially helpful.

DAMS : Which books did you read for MCQ revision? Which revision books were the most productive and which were least?

Dr Shivya: Amit Ashish and Mudit Khanna were helpful, Soumya Sukhla for Radio/Derma/Psychiatry was not as yielding as I thought it would be. Many answers were wrong. Triple A for various subjects (but after reading text).

DAMS : How important you think was DAMS in your preparation ?

Dr Shivya: DAMS was an integral part. It kept me on schedule with the regular tests. New topics discussed in classes were very helpful. Many prospective questions were asked in the exam. The teachers always helped me and answered all my innumerable questions. Probably DAMS is the only institute which has the ability to predict questions.

DAMS: What do you think is the better way of preparation between selective, intensive study and wide, extensive study? What did you choose as your style of studying?

Dr Shivya: My style was always selective intensive study. I revised what I had read rather than read new things every time.

DAMS: Indian PG entrances are highly competitive so to compete them students end up in appearing in multiple PG exams , kindly extend your views on this and also their pros and cons of appearing in multiple PG entrances .
Dr Shivya: Preparing for multiple PG exams is difficult as the pattern of every exam is different. But I think one should give all exams. As questions in every exams are different.

DAMS: Which subjects did you focus on?

Dr Shivya: First year subjects – Anatomy/Physics/B.C along with Pathology, Pharmacology & short subjects.

DAMS: What was your strategy for the exam day? How many questions did you attempt and why?

Dr Shivya: In PGI – I attempted around 245/250 questions.

In AIIMS – 180/200

DAMS: What do you want to specialize in, why and where?

Dr Shivya: Radiology, in PGI Chandiogarh, as PGI is one of the best institutes in India and Radiology is an upcoming and interesting branch.


DAMS: Which teachers in DAMS influenced you most and what do you like about DAMS and would recommend to your juniors?

Dr Shivya : Dr. Sumer Sethi (Radiology) is always a big influence and his style of teaching is too good. Dr Rajiv for ENT was very good. Teachers for medicine was very good. Dr.Ruchi Rai, Dr. Deep were good teachers. In fact, I don’t remember any teacher at DAMS who was not upto the mark. Personal attention is one of the most important thing because of which I would rush for DAMS.

Clean sweep in 2010 by DAMS STUDENTS

PG Medical Entrance exams have seen emergence of DAMS (Delhi Academy of Medical Sciences) as the leader in the MD/MS coaching business.

This year PG medical entrance exams have seen emergence of DAMS (Delhi Academy of Medical Sciences) as the leader in the MD/MS coaching business. Never before has any coaching institute registered such a high percentage of selection. 90% of the students registered with DAMS in 2009 have a rank in PG medical entrance exams.

In some state PG exams like Delhi PG, Rajasthan PG, Maharashtra PG there have been a huge percentage of DAMSONIANS getting through for yet another year.

Delhi Academy of Medical Sciences (DAMS), one of the best PG Medical Entrance Coaching Institute gets Rank 1 in Delhi PG Entrance Examination and Rajasthan PG 2010. Earlier PGI Rank 1 for December 2010, a two year student of DAMS said in an interview given to DAMS personnel that DAMS contributed significantly in her success.

DAMS shares its joy with all the student of DAMS who has done the institution proud by topping this year’s PG Entrance Examination. DAMS are delighted that this years PG Medical Entrance Examination result.

Speaking on this proud moment, Dr. Sumer Sethi, Director, Delhi Academy of Medical Sciences (DAMS), said, “We very cordially congratulate all students for this unprecedented achievement and this will be remembered in the annals of our outstanding record.
Delhi Academy of Medical Sciences (DAMS) a well-established name in the field of PG Medical Entrance Education for over 11 years now. Today under the leadership of Dr Sumer Sethi, Radiologist and pervious topper in AIPG/ AIIMS . DAMS is recognized for its impeccable foresight, enviable expertise and innate acumen.

For more details you can visit DAMS website http://www.damsdelhi.com.

AIIMS NOV 2009 FULLY SOLVED

DAMS (Delhi Academy of Medical Sciences Pvt Ltd) has been an institution of excellence for PG entrance preparation for more than 10 years now. We have produced toppers in exam after exam every year. While our competitors apparently claim to be the best without actually delivering the quality material and faculty required for PG entrance DAMS has silently but steadily emerged the leader in the business. Not only do we provide the study material and classes, our counsellors take special efforts in motivating the students to achieve to their potential’s best. We are the only institute authorized by authorities like leading medical colleges SMS Jaipur and SN Medical college Jodhpur to take classes for their students in their college premises for last 3 years now. Currently we have class room coaching Delhi, Maharashtra (Mumbai, Nagpur, Pune), Gujarat (Ahmedabad & Baroda), MP (Indore & Bhopal), Rajasthan (Jaipur & Jodhpur), Andhra Pradesh (Hyderabad*, New Centre), Punjab (Chandigarh) and UP (Lucknow) and test centres across the country. We run our monthly AIPG pattern test called as All India Grand Test on 3rd Sunday of each month along with our exclusive Bounce Back series which is a rapid revision of the previous years’ questions. We are the only institute which frames new questions for our grand tests and provide references to the answers along with an exclusive point by point explanations. Also we receive all email queries and regarding the grand test questions and produce an errata if necessary in the next GT.

We are originators of the concept of Test and Discussion Series in Delhi and boast of faculty par excellence. Probably we are the only institute which can actually lead an average student to success. We take pride in our percentage results which are the highest in this business, every year 90% of the students enrolled with us get through PG entrance, which is exceptional. DAMSONIANS have been the leaders in medical fraternity always.

We have taken an AIIMS guide every year for last five years now and students look forward to our publications, because they are accurate and fast. This is the usually first book which hits the market and yet the most accurate, in terms of questions and authentic duly referenced and discussed answers. Further we encourage the students to discuss their doubts on this book on our website www.damsdelhi.com , through emails and through Elsevier Exam zone.

Our institute is lead by Dr Sumer Sethi, MD who has been a topper in previous AIIMS, AIPG (AI RANK 4) and PGI entrance exams and was a topper in CBSE PMT before. He is MD Radiology and is author leading book for PG entrance called as Review of Radiology, Peepee Publishers. With his guidance institute provides the student a unique advantage wherein not only is he taught his subjects with DAMS but we provide him with success mantra by people who have done it before. On the contrary most of the other institutes are run by businessmen or people who have never actually gotten through PG entrance and don’t actually understand the way to success.

We have teachers and question writers who are MD or DM or M.Ch in their respective fields, who are leaders in their respective branches, are popular authors of PG entrance books, toppers in previous exams and now have been exclusively teaching with us for years now.

We hope that this book once again proves upto your expectations and helps you to climb the ladder to success.

This book is compilation and effort of all the DAMS faculty without their efforts and inputs this book couldn’t be possible. Our faculty have been widely acknowledged and renowned as the subject wise authorities’ country wise.

Best Regards

Entire DAMS Team &
Sumer Sethi, MD (Radiology)
Director DAMS
Teacher, Author and Motivator

Best Wishes

Hi ,
I wuld like to emphasise on a few points which i learnt from my experience of prepairing for the enterance exams myself and now teaching for the same

- the first and most imp thing to do is to manage your time judiciously ,it is seen that the correct formula for success in pg entrance exam is not how much time n effort you have put into your prep. but where you have decided to concentrate your time n effort

- to optimize the utilisation of your time try to identify high output facts ,tables and diagrams and preferably compile them in the form of notes for quick review n reff.

- allowt specific time to various subjects based on the no. of ques. being asked from that subject eg for ortho one week should be the ideal time to finish the course in the first go, and try to strictly restrict yourself to the time table

-dont waste endless hours searching n discussing about some contradictory or dubious questions more often than not they would not reappear in the next exam n u will save alot of time n effort which you can use more profitably

-restrict yourself to reading only standard text eg in ortho most of the problems can be solved by looking them up in maheshwari n appleys ,no need to refer to higher text which if not read in entirety can be misleading n difficult to decipher

dont blindly follow the guides apply your own mind n believe in yourself n your knwledge many times the author misinterprets what the examiner wants to ask or what the refferal book is trying to say

-and in the end i would like to tell you guys to be positive n confident and be sure of what you want becouse you just might get it !!!!! BEST OF LUCK


BEST WISHES,
Dr Deep Sharma
(Orthopedics)

Errata AIIMS Mock

Ans 26: (d) Typhoid
Ans 55: (a) Chromosome 6
Ans 75: (b) 1 and 2
Ans 107: (a) Pulmonic stenosis, (b) Aortic stenosis
Q-146 A 39-year-old woman has the sudden onset of weakness and “fluttering” in her chest. She is pale; her pulse is 160/min and irregularly irregular; and her blood pressure is 82/64 mm Hg. The ECG shows atrial fibrillation with a rapid ventricular response.Immediate treatment of choice is
a. Verapamil
b. Quinidine
c. Coumarin
d. Cardioversion

Ans 146: (d) Cardioversion

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.