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.

Another Best Seller book by DAMS Faculty

About The Book
1 The book is in form of various chapters arranged topicwise alongwith questions and the key.
2 This is the only book in ophthalmology containing both the notes and the questions specifically aimed for the entrance exams.
3 All the latest questions from the recent examinations have been included in the book.
4. The notes include all the recent advances in ophthalmology.
5. The notes are crisp and concise hence manageable in the short time available to the students.
Some Reviews of the first edition
“The author has put all her clinical knowledge and skill into it which helps you to have a grasp of the whole subject in a very short time which is especially important as there is always shortage of time”.
“The author has put a lot of hard work and it seems that incorporated her vast teaching experience into a perfect blend in form of this book”.
“A Gem of a book- Information provided is definitely a gem of it, and would cater to the needs of every student specially taking care of gaps which are not able to fill while reading from out textbooks”.
About the second edition
The second edition has been reformatted so that it becomes more convenient for the students to prepare the subject chapter wise. All the chapters in the book are now topic wise and at the end of every chapter are the questions asked in various examinations in last 15 years, along with the answers. The explanation is all included and mentioned in the corresponding chapters. This format will help to study more systematically and still in a very concise manner, so that the students can get the grasp of the subject even better in a very short period of time.