Tuesday, September 17, 2013

MCQ IN MEDICAL SCIENCE - 1

Questions of All India PG Entrance Exam 2006

1.    All of the following are features of prematurity  in a neonate, except:


   

    1.    No creases on sole.

    2.    Abundant lanugo.

    3.    Thick ear cartilage.

    4.    Empty scrotum.




2.    A normally developing 10 month old child should be able to do all of the following except :

   

    1.    Stand alone.

    2.    Play peek a boo.

    3.    Pick up a pellet with thumb and index finger.


    4.    Build a tower of 3-4 cubes.



3.    The following are characteristic of autism except :

   

    1.    Onset after 6 years of age.

    2.    Repetitive behaviour.


    3.    Delayed language development.

    4.    Severe deficit in social interaction.



4.    The earliest indicator of response after starting iron in a 6- year-old girl with iron deficiency is:

   

    1.    Increased reticulocyte count.


    2.    Increased hemoglobin.

    3.    Increased ferritin.

    4.    Increased serum iron.



5.    A 1 month old boy is referred for failure to thrive.  On examination, he shows features of congestive failure.  The femoral pulses are feeble as compared to branchial pulses.  The most likely clinical diagnosis is :


   

    1.    Congenital aortic stenosis.

    2.    Coarctation of aorta.

    3.    Patent ductus arteriosus.

    4.    Congenital aortoiliac disease.




6.    All of the following statements regarding subendocardinal infarction are true, except :

   

    1.    These are multifocal in nature.

    2.    These often result from hypotension or shock.

    3.    Epicarditis is not seen.


    4.    These may result in aneurysm.

7.    All of the following are true for mitral valve prolapse, except :

   

    1.    Transmission may be as an Autosomal dominant trait.

    2.    Majority of the case present with features of mitral regurgitation.

    3.    The value leaflets characteristically show myxomatous degeneration.


    4.    The disease is one of the common cardiovascular manifestations of Marfan Syndrome.



8.    The following diseases are associated with Epstein – Barr virus infection, except :

   

    1.    Infectious mononucleosis.

    2.    Epidermodysplasia verruciformis.


    3.    Nasopharyngeal carcinoma.

    4.    Oral Hairy  leukoplakia



9.    Megaloblastic anaemia due to folic acid deficiency is commonly due to :

   

    1.    Inadequate dietary intake.


    2.    Defective intestinal absorption.

    3.    Absence of folic acid binding protein in serum.

    4.    Absence of glutamic acid in the intestine.



10.    The most important prognostic factor in breast carcinoma is :

   


    1.    Histological grade of the tumour.

    2.    Stage of the tumour at the time of diagnosis.

    3.    Status of estrogen and progesterone receptors.

    4.    Over expression of p-53 tumour suppressor gene.




11.    Smoking is generally not associated as a risk factor with :

   

    1.    Small cell carcinoma.

    2.    Respiratory bronchiolitis.

    3.    Emphysema.

    4.    Bronchiolitis obliterans organizing pneumonia.


12.    The tumour, which may occur in the residual breast or overlying skin following wide local excision and radiotherapy for mammary carcinoma, is :

   

    1.    Leiomyosarcoma.

    2.    Squamous cell carcinoma.

    3.    Basal cell carcinoma.

    4.    Angiosarcoma.




13.    The type of mammary ductal carcinoma in situ (DCIS) most likely to result in a palpable abnormality in the breast is :

   

    1.    Apocrine DCIS.

    2.    Neuroendocrine DCIS.

    3.    Well differentiated DCIS.


    4.    Comedo DCIS.



14.    Acinic cell carcinomas of the salivary gland arise most often in the :

   

    1.    Parotid salivary gland.

    2.    Minor salivary glands.


    3.    Submandibular salivary gland.

    4.    Sublingual salivary gland.



15.    All of the following statements regarding primary effusion lymphoma are true except :

   

    1.    It generally presents in elderly patients.


    2.    There is often an association with HHV-8.

    3.    The proliferating cells are NK cells.

    4.    Patients are commonly HIV positive.



16.    Mantle cell lymphomas are positive for all of the following, except :

   


    1.    CD 23.

    2.    CD 20.

    3.    CD 5.

    4.    CD 43.




17.    Fine needle aspiration cytology is not suitable for diagnosing :

   

    1.    Tubercular lymphadenitis.

    2.    Papillary carcinoma thyroid.

    3.    Plasmacytoma.

    4.    Aneurymal bone cyst.




18.    All of the following immunohistochemical markers are positive in the neoplastic cells of granulocytic sarcoma, except :

   

    1.    CD 45 RO.

    2.    CD 43.

    3.    Myeloperoxidase.


    4.    Lysozyme.



19.    B cell prolymphocytic leukemia patients differ from those with B cell chronic lymphocytic leukemia in :

   

    1.    Presenting at a younger age.

    2.    Having a lower total leucocyte count.


    3.    Having prominent lymphadenopathy.

    4.    Having a shorter survival.



20.    Which of the following statements is incorrect about pthisis bulbi?

   

    1.    The intraocular pressure is increased.


    2.    Calcification of the lens is common.

    3.    Sclera is thickened.

    4.    Size of the globe is reduced.



21.    Which one of the following statements is incorrect about Optic glioma?

   


    1.    Has a peak incidence in first decade.

    2.    Arises from oligodendrocytes.

    3.    Causes meningeal hyperplasia.

    4.    Is associated with type I neurofirbromatosis.




22.    Which one of the following stromal dystrophy is a recessive condition ?

   

    1.    Lattice dystrophy.

    2.    Granular dystrophy.

    3.    Macular dystrophy.

    4.    Fleck dystrophy.




23.    In which of the following conditions Parakeratosis most frequently occurs?

   

    1.    Actinic Keratoses.

    2.    Seborrheic keratoses.

    3.    Molluscum contagiosum.


    4.    Basal cell carcinoma.



24.    Which one of the following is the most significant risk factor for development of gastric carcinoma?

   

    1.    Paneth cell metaplasia.

    2.    Pyloric metaplasia.


    3.    Intestinal metaplasia.

    4.    Ciliated metaplasia.



25.    Which of the following is the most common presenting symptom of non-cirrhotic portal hypertension?

   

    1.    Chronic liver failure.


    2.    Ascites.

    3.    Upper gastrointestinal bleeding.

    4.    Encephalopathy.



26.    Ethosuximide is used in the treatment of :

   


    1.    Tonic-clonic seizure.

    2.    Absence seizure.

    3.    Myoclonic seizure.

    4.    Simple partial seizure.




27.    Which of the following statements is not true about etomidate?

   

    1.    It is an intravenous anesthetic.

    2.    It precipitates coronary insufficiency.

    3.    It inhibits cortisol synthesis.

    4.    It causes pain at site of injection.




28.    Which one of the following antibacterials should not be used with d-tubocurarine?

   

    1.    Norfloxacin.

    2.    Streptomycin.

    3.    Doxycycline.


    4.    Cefotaxime.



29.    Which one of the following drugs is an antipseudomonal penicillin?

   

    1.    Cephalexin.

    2.    Cloxacillin.


    3.    Piperacillin.

    4.    Dicloxacillin.



30.    The following statements regarding benzodiazephines are true except:

   

    1.    Binds to both GABAA and GABAB receptors.


    2.    They have active metabolites.

    3.    Decreases nocturnal gastric secretion in human being.

    4.    Extensively metabolized by CYP enzymes.



31.    One of the following statements regarding mycophenolate mofetil is incorrect:

   


    1.    It is a prodrug.

    2.    It is a selective uncompetitive and reversible inhibitor of inosine monophosphate dehydrogenase.

    3.    It also inhibits calcineurin.

    4.    Selectivity inhibits lymphocyte proliferation.




32.    All of the following mechanisms of action of oral contraceptive pill are true, except :

   

    1.    Inhibition of ovulation.

    2.    Prevention of fertilization.

    3.    Interference with implantation of fertilized ovum.

    4.    Interference with placental functioning.




33.    Which one of the following drugs does not interfere with folic acid metabolism?

   

    1.    Phenytoin.

    2.    Gabapentin.

    3.    Phenobarbitone.


    4.    Primidone.



34.    Which one of the following drugs causes constipation?

   

    1.    Propranolol.

    2.    Verapamil.


    3.    Nitroglycerin.

    4.    Captopril.



35.    Which of the following drugs is not used topically for treatment of open angle glaucoma:

   

    1.    Latanoprost.


    2.    Brimonidine.

    3.    Acetazolamide.

    4.    Dorzolamide.



36.    Concomitant administration of clonazepam with which of the following antiepileptic drug can precipitate absence status?

   


    1.    Sodium valproate.

    2.    Phenobarbitone.

    3.    Carbamazepine.

    4.    Phenytoin.




37.    Which one of the following agents has been associated with hemorrhagic stroke?

   

    1.    Phenylpropanolamine.

    2.    Terfenadine.

    3.    Quinidine.

    4.    Fenfluramine.




38.    All of the following are therapeutic uses of Penicillin G, except :

   

    1.    Bacterial meningitis.

    2.    Rickettsial Infection.

    3.    Syphilis.


    4.    Anthrax.



39.    All of the following are major complications of massive transfusion, except:

   

    1.    Hypokalemia.

    2.    Hypothermia.


    3.    Hypomagnesemia.

    4.    Hypocalcemia.



40.    Which one of the following muscle relaxant has the maximum duration of action ?

   

    1.    Atracurium.


    2.    Vecuronium.

    3.    Rocuronium.

    4.    Doxacurium.



41.    Which enzyme is inhibited by Aminophylline?

   


    1.    Monoamine Oxidase.

    2.    Alcohol dehydrogenase.

    3.    Phjosphodiesterase.

    4.    Cytochrome P-450.




42.    Which one of the following local anaesthetics belongs to the ester group?

   

    1.    Procaine.

    2.    Bupivacaine.

    3.    Lignocaine.

    4.    Mepivacaine.




43.    The following are the benozodiazepines of choice in elderly and those with liver disease, except:

   

    1.    Lorazepam.

    2.    Oxazepam,

    3.    Temazepam.


    4.    Diazepam.



44.    Which one of the following agents sensitises the myocardium to catecholamines?

   

    1.    Isoflurane

    2.    Ether.


    3.    Halothane.

    4.    Propofol.



45.    Which of the following is the muscle relaxant of choice in renal failure?

   

    1.    Rapacurium


    2.    Pancuronium

    3.    Atracurium

    4.    Rocuronium



46.    Ovulation is primarily caused by preovulatory surge of :

   


    1.    Estradiol.

    2.    Luteinizing hormone.

    3.    Progesterone.

    4.    Follicle stimulating hormone.




47.    Most afferent fibers from the lateral geniculate nucleus terminate in the primary visual cortex in :

   

    1.    Layer 1.

    2.    Layer 2 & 3.

    3.    Layer 4.


    4.    Layer 5 & 6.



48.    The blobs of the visual cortex are associated with :

   

    1.    Ocular dominance.

    2.    Orientation.


    3.    Color processing.

    4.    Saccadic eye movements.



49.    The parvocellular pathway, from the lateral geniculate nucleus to the visual cortex, carries signals for the detection of :

   

    1.    Movement, depth and flicker.


    2.    Color vision, shape and fine details.

    3.    Temporal frequency.

    4.    Luminance contrast.



50.    A pilot in Sukhoi aircraft is experiencing negative G.  Which of the following physiological events will manifest in such situation?


   

    1.    The hydrostatic pressure in veins of lower limb increases.

    2.    The cardiac output decreases.

    3.    Black out occurs.

    4.    The cerebral arterial pressure rises.




51.    In human being, the least useful physiological response to low environmental temperature is :

   

    1.    Shivering.

    2.    Vasoconstriction.

    3.    Release of thyroxine.


    4.    Piloerection.



52.    The cell bodies of orexinergic neurons are present in:

   

    1.    Locus coeruleus.

    2.    Dorsal raphe.


    3.    Lateral hypothalamic area.

    4.    Hippocampus.



53.    The tubuloglomerular feedback is mediated by:

   

    1.    Sensing of Na+ concentration in the macula densa.


    2.    Sensing of Cl+ concentration in macula densa.

    3.    Sensing NaCl concentration in the macula densa.

    4.    Opening up of voltage gated Na+ channels in afferent arteriole.



54.    The prime driving force for counter current multiplier system is :

   


    1.    Medullary hperosmolarity.

    2.    Reabsorption of Na+ in thick ascending limb.

    3.    Action of ADH via aquaporin channels.

    4.    Urea recycling.




55.    Which of the following organs is not involved in calcium homeostasis?

   

    1.    Kidneys.

    2.    Skin.

    3.    Intestines.

    4.    Lungs.




56.    Testosterone production is mainly contributed by:

   

    1.    Leydig cells.

    2.    Sertolie cells.

    3.    Seminiferous tubules.


    4.    Epididymis.



57.    Which of the following secretions has a very high pH?

   

    1.    Gastric juice.

    2.    Pancreatic juice.


    3.    Bile in gall bladder.

    4.    Saliva.



58.    The maintenance of posture in a normal adult human being depends upon:

   

    1.    Integrity of reflex are.


    2.    Muscle power.

    3.    Type of muscle fibres.

    4.    Joint movements in physiological range.



59.    The first reflex response to appear as spinal shock wears off in humans is :

   


    1.    Tympanic reflex.

    2.    Withdrawal reflex.

    3.    Neck righting reflex.

    4.    Labyrinthine reflex..




60.    The hyperkinetic features of the Huntington’s disease are due to the loss of :

   

    1.    Nigrostriatal dopaminergic system.

    2.    Intrastriatal cholinergic system.

    3.    GABA-ergic and choloinergic system.

    4.    Intrastriatal GABA-ergic and cholinergic system.




61.    All of the following are part of the treatment of Lithium toxicity, except:

   

    1.    Treating dehydration.

    2.    Ingestion of polystyrene sulfonate.

    3.    Hemodialysis.


    4.    Using an antagonist.



62.    All are side effects of Clozapine except:

   

    1.    Granulocytopenia.

    2.    Seizures.


    3.    Sedation.

    4.    Extrapyramidal side effects



63.    Pavlov’s experiment is an example of:

   

    1.    Operant conditioning.


    2.    Classical conditioning.

    3.    Learned helplessness.

    4.    Modelling.



64.    Bright light treatment has been found to be most effective in treatment of :

   


    1.    Anorexia Nervosa.

    2.    Seasonal Affective Disorder.

    3.    Schizophrenia.

    4.    Obsessive Compulsive Disorder.




65.    The most common side effect reported with treatment with haloperidol is :

   

    1.    Hypotension.

    2.    Akathisia.

    3.    Dryness of mouth.

    4.    Tic disorder.




66.    Mutism and akinesis in a person, who appears awake and even alert, is best described as :

   

    1.    Twilight State.

    2.    Oneroid state.

    3.    Stupor.


    4.    Delirium.



67.    Loosening of association is an example of :

   

    1.    Formal thought disorder.

    2.    Schneiderian first rank symptoms.


    3.    Perseveration.

    4.    Concrete thinking.



68.    Intense nihilism, somatization and agitation in old age are the hallmark symptoms of:

   

    1.    Involutional melancholia.


    2.    Aty[pical depression.

    3.    Somatized depression

    4.    Depressive stupor.



69.    Rivastigmine and Donepezil are drugs used predominantly in the management of:

   


    1.    Depression.

    2.    Dissociation.

    3.    Delusions.

    4.    Dementia.




70.    All of the following are associated with better prognosis in schizophrenia, except :

   

    1.    Late onset.

    2.    Married.

    3.    Negative symptoms.

    4.    Acute onset.




71.    The following features are true for Tetralogy of Fallot, except:

   

    1.    Ventricular septal defect.

    2.    Right ventricular hypertrophy.

    3.    Atrial septal defect.


    4.    Pulmonary stenosis.



72.    Which of the following statements is true regarding testicular tumours?

   

    1.    Are embryonal cell carcinomas in 95% of cases.

    2.    Bilateral in upto 10% cases.


    3.    Teratomas are more common than seminomas.

    4.    Usually present after 50 years of age.



73.    The most common retrobulbar orbital mass in adults is:

   

    1.    Neurofibroma.


    2.    Meningioma.

    3.    Cavernous haemangioma.

    4.    Schwannoma.



74.    In which of the following conditions left atrium is not enlarged:

   


    1.    Ventricular septal defect.

    2.    Atrial septal defect.

    3.    Aorto-pulmonary window.

    4.    Patent ductus arteriosus.




75.    Expansile lytic osseous metastases are characteristic of primary malignancy of :

   

    1.    Kidney.

    2.    Bronchus.

    3.    Breast.

    4.    Prostate.




76.    Which is the objective sign of identifying pulmonary plethora in a chest radiograph?

   

    1.    Diameter of the main pulmonary artery > 16mm.

    2.    Diameter of the left pulmonary artery > 16mm.

    3.    Diameter of the descending right pulmonary artery > 16mm.


    4.    Diameter of the descending left pulmonary artery > 16mm.

77.    The most accurate investigation for assessing ventricular function is :

   

    1.    Multislice CT.

    2.    Echocardiography.

    3.    Nuclear scan.


    4.    MRI.



78.    The most important sign of significance of renal artery stenosis on an angiogram is:

   

    1.    A percentage diameter stenosis > 70%.

    2.    Presence of collaterals.


    3.    A systolic pressure gradient > 20mm Hg across the lesion.

    4.    Post stenotic dilatation of the renal artery.



79.    The MR imaging in multiple sclerosis will show lesions in:

   

    1.    White matter.


    2.    Grey matter.

    3.    Thalamus.

    4.    Basal ganglia.



80.    The most common location of hypertensive intracranial haemorrhage is :

   


    1.    Subarachnoid space.

    2.    Basal ganglia.

    3.    Cerebellum.

    4.    Brainstem.




81.    Which of the following causes rib-notching on the chest radiograph?

   

    1.    Bidirectional Glem shunt.

    2.    Modified Blalock-Taussing shunt.

    3.    IVC occusion.

    4.    Coarctation of aorta.




82.    The most sensitive imaging modality to detect early renal tuberculosis is:

   

    1.    Intravenous urography.

    2.    Computed tomography.

    3.    Ultrasound.


    4.    Magnetic Resonance Imaging.



83.    All of them use non-ionizing radiation, except:

   

    1.    Ultrasonography.

    2.    Thermography.


    3.    MRI.

    4.    Radiography.



84.    Mixed tumours of the salivary glands are:

   

    1.    Most common in submandibular gland.


    2.    Usually malignant.

    3.    Most common in parotid gland.

    4.    Associated with calculi.



85.    In which of the following types of breast carcinoma, would you consider biopsy of opposite breast?

   


    1.    Adenocarcinoma-poorly differentiated.

    2.    Medullary carcinoma.

    3.    Lobular carcinoma.

    4.    Comedo carcinoma.




86.    A malignant tumour of childhood, that metastasizes to bones most often, is:

   

    1.    Wilm’s tumour.

    2.    Neuroblastoma.

    3.    Adrenal gland tumours.

    4.    Granulosa cell tumour of ovary.




87.    When carcinoma of stomach develops secondarily to pernicious anemia, it is usually situated in the :

   

    1.    Pre Pyloric region.

    2.    Pylorus.

    3.    Body.


    4.    Fundus.



88.    With regard to the malignant behaviour of leiomysarcoma, the most important criterion is :

   

    1.    Blood vessel penetration by tumour cells.

    2.    Tumour cells in lymphatic channels.


    3.    Lymphocyte infiltration.

    4.    The number of mitoses per high power field.



89.    The most radiosensitive  tumour among the following is:

   

    1.    Bronchogenic carcinoma.


    2.    Carcinoma parotid.

    3.    Dysgerminoma.

    4.    OSteogenic sarcoma.



90.    Ina suspected of ovarian cancer, imaging work-up is required for all of the following information, except:

   


    1.    Detection of adenexal lesion.

    2.    Characterization of the lesion.

    3.    Staging.

    4.    Assess resectability.




91.    In which of the following age group Myelodysplastic Syndromes (MDS) are most common?

   

    1.    2-10.

    2.    15-20.

    3.    25-40.

    4.    >50.




92.    A patient with leukemia on chemotheraphy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leukopenia.  Which of following is the clinical diagnosis?

   

    1.    Appendictis.

    2.    Leukemic colitis.

    3.    Perforation peritonitis.


    4.    Neutropenic colitis.



93.    All of the following modalities can be used for in-situ ablation of liver secondaries, except:

   

    1.    Ultrasonic waves.

    2.    Cryotherapy.


    3.    Alcohol.

    4.    Radiofrequency.



94.    All of the following radioisotopes are used as systemic radionucleide, except:

   

    1.    Phosphorus-32.


    2.    Strontium-89.

    3.    Iridium-192.

    4.    Samarium-153.



95.    Phosphorous-32 emits:

   


    1.    Beta particles.

    2.    Alfa particles.

    3.    Neutrons.

    4.    X-rays.




96.    The ideal timing of radiotherapy for Wilms Tumour after surgery is:

   

    1.    Within 10 days.

    2.    Within 2 weeks.

    3.    Within 3 weeks.

    4.    Any time after surgery.




97.    The percentage of pulmonary emboli, that proceed to infraction, is approximately:

   

    1.    0-5%.

    2.    5-15%.

    3.    20-30%.


    4.    30-40%.



98.    Which of the following is used in the treatment of differentiated thyroid cancer:

   

    1.    131I.

    2.    99mTc.


    3.    32p.

    4.    131I-MIBG.



99.    Which one of the following imaging techniques gives maximum radiation exposure to the patient?

   

    1.    Chest X-ray.


    2.    MRI.

    3.    CT scan.

    4.    Bone scan.



100.    Which one of the following has the maximum ionization potential?

   


    1.    Electron.

    2.    Proton.

    3.    Helim ion.

    4.    Gamma() – Photon.




101.    Which of the following is not a major criteria for dignosis of multiple myeloma?

   

    1.    Lytic bone lesions.

    2.    Plasmacytoma on tissue biopsy.

    3.    Bone marrow plasmacytosis > 30%

    4.    ‘M’Spike > 3g% for 1g G, >2g% for 1g A.




102.    The treatment of choice for squamous cell anal cancer is:

   

    1.    Abdomino perennial resection.

    2.    Laser fulgaration.

    3.    Chemoradiotherapy.


    4.    Platinum based chemotheraphy.



103.    The magnification obtained with a direct ophthalmoscope is:

   

    1.    5 times.

    2.    10 times.


    3.    15 times.

    4.    20 times.



104.    The average distance of the fovea from the temporal margin of the optic disc is:

   

    1.    1 disc diameter.


    2.    2 disc diameter.

    3.    3 disc diameter.

    4.    4 disc diameter.



105.    The most common cause of vitreous haemorrhage in adults is :

   


    1.    Retinal hole.

    2.    Trauma.

    3.    Hypertension.

    4.    Diabetes.




106.    The retina receives its blood supply from all except:

   

    1.    Posterior ciliary artery,

    2.    Central retinal artery.

    3.    Retinal arteries.

    4.    Plexus of zinn & Haller arteries.




107.    Which drug can cause macular toxicity when given intravitreally?

   

    1.    Gentamycin.

    2.    Vancomycin.

    3.    Dexamethasone.


    4.    Ceftazidime.



108.    Typically bilateral inferior lens subluxation of the lens is seen in :

   

    1.    Marfan’s syndrome.

    2.    Homocystinuria.


    3.    Hyperlusinaemia

    4.    Ocular trauma.



109.    Which of the following antiglaucoma medications can cause drowsiness?

   

    1.    Latanoprost.


    2.    Timolol.

    3.    Brimonidine,

    4.    Dorzolamide.



110.    Which of the following is the drug of choice for treatment of corneal ulcers caused by filamentous fungi?

   


    1.    Itraconazole.

    2.    Natamycin.

    3.    Nystatin.

    4.    Fluconazole.




111.    Which of the following medications is contraindicated in patients with allergy to sulphonamides?

   

    1.    Levobunolol.

    2.    Bimatoprost.

    3.    Brinzolamide.

    4.    Brimonidine.




112.    In which of the following uveitic conditions is it contraindicated to put in an intraocular lens after cataract surgery?

   

    1.    Fuch’s heterochromic cyclitis.

    2.    Juvenile rheumatopid arthritis.

    3.    Psoriatic arthritis.


    4.    Reiter’s syndrome.



113.    A case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year should have an ophthalmic examination:

   

    1.    As early as feasible.

    2.    After 5 years.


    3.    After 10 years.

    4.    Only after visual symptoms develop.



114.    SAFE Strategy is recommended for the control of ?

   

    1.    Trachoma.


    2.    Glaucoma.

    3.    Diabetic retinopathy.

    4.    Cataract.



115.    As per the  1986-89 NPCB survey, what was the prevalence of blindness in India (at visual acuity <6/60 in better eye)?


   

    1.    1.38%

    2.    1.49%

    3.    1.72%

    4.    1.8%




116.    Under the National Programme for Control of Blindness, who is supposed to conduct the vision screening of school students?

   

    1.    School teachers.

    2.    Medical officers of health centres.

    3.    Ophthalmologists.


    4.    Health assistants.



117.    According to the World Health Organization, the definition of blindness is:

   

    1.    Visual acuity <6/60 in the better eye with available correction.

    2.    Visual acuity <3/60 in the better eye with available correction.


    3.    Visual acuity <6/60 in the better eye with best correction.

    4.    Visual acuity <3/60 in the better eye with best correction.



118.    The most common cause of ocular morbidity in India is :

   

    1.    Cataract.


    2.    Conjunctivitis.

    3.    Refractive error.

    4.    Trachoma.



119.    A vitreous aspirate from a case of metastatic endophthalmitis on culture yields Gram positive round to oval cells, 12-14 in size.  The aspirate on  Gram staining shows the presence of pseudohyphae.  Which of the following is the most likely aetiological agent?


   

    1.    Aspergillus.

    2.    Rhizopus.

    3.    Candida.

    4.    Fusarium.




120.    The most common malignancy found in Marjolin’s ulcer is:

   

    1.    Basal cell carcinoma.

    2.    Squamous cell carcinoma.

    3.    Malignant fibrous histiocytoma.


    4.    Neurotrophic malignant melanoma.



121.    Mycotic aneurysm is an aneurysm infected because of :

   

    1.    Fungal infection.

    2.    Blood borne infection (intravascular)


    3.    Infection introduced from outside (extravascular)

    4.    Both intravascular & extravascular infection.



122.    The procedure of choice for the evaluation of an aneurysm is :

   

    1.    Ultrasonography.


    2.    Computed tomography.

    3.    Magnetic resonance imaging.

    4.    Arteriography.



123.    The most common cause of acquired arteriovenous fistuala is:

   


    1.    Bacterial infection.

    2.    Fungal infection.

    3.    Blunt trauma.

    4.    Penetrating trauma.




124.    Laryngocele arises as a herniation of laryngeal mucosa through the following membrance:

   

    1.    Thyrochyoid.

    2.    Criciothyroid.

    3.    Crico-tracheal.

    4.    Crisosternal.




125.    Which one of the following statements is incorrect regarding stones in the common bile duct?

   

    1.    Can present with Charcot’s Triad.

    2.    Are suggested by a bile duct diameter >6mm of ultrasound.

    3.    ERCP, sphincterotomy and balloon clearance is now the standard treatment.


    4.    When removed by exploration of the common bile duct the T-tube can be removed after 3 days.



126.    Which of the following colonic polyps is not pre-maligant?

   

    1.    Juvenile polyps.

    2.    Hamartomatous polyps associated with Peutz-Jeghers syndrome.


    3.    Villous adenomas.

    4.    Tubular adenomas.



127.    A patient of post-cholecystectomy biliary stricture has undergone an ERCP three days ago.  Following this she has developed acute cholangitis.  Th most likely organism is:

   


    1.    Escherichia coli.

    2.    Bacillus fragilis.

    3.    Streptococcus viridans.

    4.    Pseudomonas aerogenosa.




128.    Biliary stricture developing after Laparascopic cholecystectomy usually occurs at which part of the common bile duct?

   

    1.    Upper.

    2.    Middle.

    3.    Lower.

    4.    All sites with equal frequency.




129.    Apart from Escherichia Coli, the other most common organism implicated in acute suppurative bacterial peritonitis is:

   

    1.    Bacteroides.

    2.    Klebsiella

    3.    Peptostreptococcus.


    4.    Pseudomonas.



130.    The treatment of choice for the management of carcinoma of the anal canal is :

   

    1.    Abdomino perineal resection.

    2.    Primary radiotherapy.


    3.    Combined radio-and chemotheraphy.

    4.    Neoadjuvant chemotherapy and local excision.



131.    The following statements about thyroglossal cyst are true, except:

   

    1.    Frequent cause of anterior midline neck masses in the first decade of life.


    2.    The cyst is located within 2 cm of the midline.

    3.    Incision and Drainage is the treatment of choice.

    4.    The swelling moves upwards on protrusion of tongue.



132.    Which of the following is not a preferred site for planning vascular access for maintenance haemodialysis ?

   


    1.    Non-dominant extremity.

    2.    Upper limb.

    3.    Radio-cephalic AV fistula.

    4.    Sapheno-femoral fistula.




133.    Which of the following drugs is not a part of the ‘Triple Therapy’ immunosuppression for post renal transplant patients?

   

    1.    Cyclosporine.

    2.    Azathioprine.

    3.    FK 506.

    4.    Prednisolone.




134.    Which of the following is not a component of Glasgow Coma Scale?

   

    1.    Eye opening.

    2.    Motor response.

    3.    Pupil size.


    4.    Verbal response.



135.    Allen’s test is useful in evaluating:

   

    1.    Thoracic outlet compression.

    2.    Presence of cervical rib.


    3.    Integrity of palmar arch.

    4.    Digital blood flow.



136.    Neointimal hyperplasia causes vascular graft failure as a result of hypertrophy of:

   

    1.    Endothelial cells.


    2.    Collagen fibers.

    3.    Smooth muscle cells.

    4.    Elastic fibers.



137.    Dacron vascular graft is :

   


    1.    Nontextile synthetic.

    2.    Textile synthetic

    3.    Nontextile biologic.

    4.    Textile biologic.




138.    Total score in Glasgow Coma Scale of a conscious person is :

   

    1.    8

    2.    3

    3.    15

    4.    10




139.    Mycotic abscesses are due to:

   

    1.    Bacterial infection

    2.    Fungal infection.

    3.    Viral infection.


    4.    Mixed infection.



140.    The most preferred approach for pituitary surgery at the present time is:

   

    1.    Transcranial.

    2.    Tranethmoidal


    3.    Transphenoidal.

    4.    Transcallosal.



141.    The normal range of serum osmolality (in mOsm/L) is:

   

    1.    270 to 285.


    2.    300 to 320.

    3.    350 to 375.

    4.    200 to 250.



142.    Which of the following is the most common type of Glial tumors?

   


    1.    Astrocytomas.

    2.    Medulloblastomas.

    3.    Neurofibromas.

    4.    Ependymomas.




143.    Which of the following tumors is not commonly known to increase in pregnancy?

   

    1.    Glioma.

    2.    Pituitary adenoma.

    3.    Meningioma.

    4.    Neurofibroma




144.    The requirement of potassium in a child is :

   

    1.    1-2 mEq/kg.

    2.    4-7 mEq/kg.

    3.    10-12 mEq/kg.


    4.    13-14 mEq/kg.



145.    The common cause of subarachnoid hemorrhage is :

   

    1.    Arterio-venous malformation.

    2.    Cavernous Angioma.


    3.    Aneurysm.

    4.    Hypertension.

146.    Brain abscess in cyanotic heart disease is commonly located in :

   

    1.    Cerebellar hemisphere

    2.    Thalamus.


    3.    Temporal lobe.

    4.    Parietal lobe.



147.    Afferent component of corneal reflex is mediated by :

   

    1.    Vagus nerve.


    2.    Facial nerve.

    3.    Trigeminal nerve.

    4.    Glossopharyngeal nerve.



148.    In adults, the spinal cord normally ends at:

   


    1.    Lower border of L1.

    2.    Lower border of L3.

    3.    Lower border of S1.

    4.    Lower border of L5.




149.    Middle meningeal artery is direct branch of :

   

    1.    External carotid artery.

    2.    Internal maxillary artery.

    3.    Superficial temporal artery.

    4.    Middle cerebral artery.




150.    Which of the following is not a common feature of Anorexia Nervosa?

   

    1.    Binge eating.

    2.    Amennorhea.

    3.    Self perception of being ‘fat’.


    4.    Under weight.



151.    An affected male infant born to normal parents could be an example of all of the following, except:

   

    1.    An Autosomal dominant disorder.

    2.    An Autosomal recessive disorder.


    3.    A polygenic disorder.

    4.    A vertically transmitted disorder.



152.    The following methods can be used to detect the point mutation in the beta () – globin gene that causes sickle cell anemia, except:

   

    1.    Polymerase chain reaction with allele-specific oligonucleotide hybridization.


    2.    Southem blot analysis.

    3.    DNA sequencing.

    4.    Northern blot analysis.



153.    A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of the following, except:

   


    1.    A chromosomal syndrome.

    2.    A teratogenic syndrome.

    3.    A Mendelian syndrome.

    4.    A polygenic syndrome.




154.    In a family, the father has widely spaced eyes, increased facial hair and deafness.  One of the three children has deafness with similar facial features.  The mother is normal.  Which one of the following is most likely pattern of inheritance in this case ?

   

    1.    Autosomal dominant.

    2.    Autosomal recessive.


    3.    X-linked dominant.

    4.    X-linked recessive.



155.    Mitochondrial DNA is :

   

    1.    Closed circular.


    2.    Nicked circular.

    3.    Linear.

    4.    Open circular.



156.    Polar bodies are formed during :

   


    1.    Spermatogenesis.

    2.    Organogenesis.

    3.    Oogenesis.

    4.    Morphogenesis.




157.    Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the following, except:

   

    1.    Amniotic fluid.

    2.    Maternal blood.

    3.    Chorionic villi.

    4.    Fetal blood.




158.    The long and short arms of chromosomes are designated respectively as :

   

    1.    p and q arms.

    2.    m and q arms.

    3.    q and p arms.


    4.    l and s arms.



159.    Euchromatin is the region of DNA that is relatively:

   

    1.    Uncondensed.

    2.    Condensed.


    3.    Overcondensed.

    4.    Partially condensed.



160.    Microsatellite sequence is:

   

    1.    Small satellite.


    2.    Extra chromosomal DNA.

    3.    Short sequence (2-5) repeat DNA.

    4.    Looped-DNA.



161.    All of the following cell types contain the enzyme telomerase which protects the length of telomeres at the end of chromosomes, except :

   


    1.    Germinal

    2.    Somatic.

    3.    Haemopoetic.

    4.    Tumour.




162.    All of the following are the components of the white pulp of spleen, except :

   

    1.    Periarteriolar lymphoid sheath.

    2.    B cells.

    3.    Antigen presenting cells.

    4.    Vascular sinus.




163.    All of the following development events are dependent on the production of maternal or fetal glucocorticoid, except

   

    1.    Induction of thymic involution

    2.    Production of surfactant by type II alveolar cells

    3.    Functional thyroid


    4.    Functional hypothalamopituitary axis



164.    Referred pain from all of the following conditions may be felt along the inner side of right thigh, except:

   

    1.    Inflamed pelvic appendix

    2.    Inflamed ovaries


    3.    Stone n pelvic Ureter

    4.    Pelvic abscess



165.    A 43 year old woman came with a large abscess in the middle of the right posterior triangle of the neck.  The physician incised and drained the abscess.  Five days later the patient noticed that she could not extend her right hand above her head to brush her hair.  Which of the following are the signs and symptoms of additional harm?


   

    1.    Damage to scalenus medius

    2.    Injury to suprascapular nerve

    3.    Cut to spinal part of accessory nerve

    4.    Spread of infection to shoulder joint




166.    Which of the following inhalational agents is the induction agent of choice in children?

   

    1.    Methyoxyflurae

    2.    Sevoflurane

    3.    Desflurane


    4.    Isoflurane



167.    Which of the following anesthetic agents doesn’t trigger malignant hyperthermia?

   

    1.    Halothane

    2.    Isoflurane


    3.    Suxamethonium

    4.    Thiopentone



168.    Which of the following is not an indication for endotracheal intubation?

   

    1.    Maintenance of a patent airway


    2.    To provide positive pressure ventilation

    3.    Pulmonary toilet

    4.    Pneumothorax



169.    Which of the following agents is not used to provide induced hypotension during surgery?

   


    1.    Sodium nitroprusside

    2.    Hydralazine

    3.    Mephenteramine

    4.    Esmolol




170.    Which of the following agents is used for the treatment of postoperative shivering?

   

    1.    Thiopentone

    2.    Suxamethonium

    3.    Atropine

    4.    Pethidine




171.    Which of the following is not a sign of stellate ganglion block?

   

    1.    Meiosis

    2.    exopthalmus

    3.    Nasal congestion


    4.    Conjuctival redness



172.    Which of the following intravenous induction agents is the most suitable for day care surgery?

   

    1.    Morphine

    2.    Ketamine


    3.    Propofol

    4.    Diazepam



173.    Blalock and Taussig shunt is done between:

   

    1.    Aorta to Pulmonary artery


    2.    Aorta to Pulmonary vein

    3.    Subclavian artery to Pulmonary vein

    4.    Subclavian vein to artery



174.    A two month old infant has undergone a major surgical procedure.  Regarding post operative pain relief which one of the following is recommended:


   

    1.    No medication is needed as infant does not feel pain after surgery due to immaturity of nervous system

    2.    Only paracetamol suppository is adequate

    3.    Spinal narcotics via intrathecal route

    4.    Intravenous narcotic infusion in lower dosage




175.    A 5 year old patient is scheduled for tonsiilectomy.  On the day of surgery he had running nose, temperature 37.5ºC and dry cough.  Which of the following should be the most appropriate decision for surgery?

   

    1.    Surgery should be cancelled.

    2.    Can proceed for surgery if chest is clear and there is no history of asthma


    3.    Should get x-ray chest before proceeding for surgery

    4.    Cancel surgery for 3 week and patient to be on antibiotic



176.    A common feature of all serine proteases is:

   

    1.    Autocatalytic activation of zymogen precursor


    2.    Tight binding of pancreatic trypsin inhibitor

    3.    Cleavage of protein on the carboxyl site of serine residues

    4.    Presence of Ser-His-Asp catalytic triad at the active site



177.    During replication of DNA, which one of the following enzymes polymerizes the Okazaki fragments?

   


    1.    DNA Polymerase I

    2.    DNA Polymerase II

    3.    DNA Polymerase III

    4.    RNA Polymerase I




178.    During phagocytosis, the metabolic process called respiratory burst involves the activation of:

   

    1.    Oxidase

    2.    Hydrolase

    3.    Peroxidase

    4.    Dehydrogenase




179.    Which one of the following is the complementary sequence of 5' TTAAGCTAC 3’?

   

    1.    5’ GTACGCTTAA 3’

    2.    5’ AATTCGCATG 3’

    3.    5’ CATGCGAATT 3’


    4.    5’ TTAAGCGTAC 3’



180.    Base substitution mutatins can have be following molecular consequences except:

   

    1.    Changes one codon for an amino acid into another codon for that same amino acid

    2.    Codon for one amino acid is changed into a codon of another amino acid


    3.    Reading frame changes downstream to the mutant site

    4.    Codon for one amino acid is changed into a translation termination codon



181.    Vitamin B12 acts as coenzyme to which one of the following enzymes?

   

    1.    Isocitrate dehydrogenase


    2.    Homocysteine methyl transferase

    3.    Glycogen synthase

    4.    G-6-P dehydrogenase



182.    The normal cellular counterparts of oncogenes are important for the following functions except:

   


    1.    Promotion of cell cycle progression

    2.    Inhibition of apoptosis

    3.    Promotion of DNA repair

    4.    Promotion of nuclear transcription




183.    The ligand-receptor complex dissociates in the endosome because:

   

    1.    Of its large size

    2.    The vesicle looses its clathrin coat

    3.    Of the acidic pH of the vesicle

    4.    Of the basic pH of the vesicle




184.    The amino acid which serves as a carrier of ammonia from skeletal muscle to liver is:

   

    1.    Alanine

    2.    Methionine

    3.    Arginine


    4.    Glutamine



185.    All of the following amino acids are converted to succinyl – CoA, except:

   

    1.    Methionine

    2.    Isoleucine


    3.    Valine

    4.    Histidine



186.    The specialized mammalian tissue/organ in which fuel oxidation serves not to produce ATP but to generate heat is:

   

    1.    Adrenal gland


    2.    Skeletal muscle

    3.    Brown adipose tissue

    4.    Heart



187.    The human plasma lipoprotein containing the highest percentage of triacylglycerol by weight is:

   


    1.    VLDL

    2.    Chylomicrons

    3.    HDL

    4.    LDL




188.    All of the following enzymes are regulated by calcium or calmodulin, except:

   

    1.    Adenylate cyclase

    2.    Glycogen synthase

    3.    Guanylyl cyclase

    4.    Hexokinase




189.    The sigma () subunit of prokaryotic RNA Polymerase:

   

    1.    Binds the antibiotic Rifampicin

    2.    Is inhibited by -amanitin

    3.    Specifically recognizes the promoter site


    4.    Is part of the core enzyme



190.    Which type of RNA has the highest percentage of modified base:

   

    1.    mRNA

    2.    tRNA


    3.    rRNA

    4.    snRNA



191.    There are more than 300 variants of human hemoglobin gene.  Among these only a few are fatal.  Hence, the most important factor to be conserved in a protein for its function is the:

   


    1.    Amino acid sequence

    2.    Ligand binding residues

    3.    Structure

    4.    Environment




192.    Proteins are linear polymers of amino acids.  They fold into compact structures.  Sometimes, these folded structures associate to form homo – or hetero-dimers. Which one of the following refers to this associated form?

   

    1.    Denatured state

    2.    Molecular aggregation

    3.    Precipitation


    4.    Quaternary structure



193.    Which one of the following can be a homologous substitution for isoleucine in a protein sequence?

   

    1.    Methionine

    2.    Aspartic acid


    3.    Valine

    4.    Arginine



194.    The comparison of the amino acid sequence of Cytochrome C from different species shows many variations.  Most of these variations are found:

   

    1.    Randomly


    2.    Only in helical regions

    3.    Only in strand regions

    4.    Mainly in loop regions



195.    The structural proteins are involved in maintaining the shape of a cell or in the formation of matrices in the body.  The shape of these proteins is:


   

    1.    Globular

    2.    Fibrous

    3.    Stretch of beads

    4.    Planar




196.    The major purpose of randomization in a clinical trails is to:

   

    1.    Facilitate double blinding

    2.    Help ensure the study subjects are representative of general population

    3.    Ensure the groups are comparable on base line characteristics


    4.    Reduce selection bias in allocation to treatment



197.    The purpose of double blinding in clinical trials is to:

   

    1.    Achieve comparability between study and control groups

    2.    Avoid observer bias


    3.    Avoid subject bias

    4.    Avoid observer and subject bias



198.    When a drug is evaluated for its usefulness in controlled conditions, it is termed as a trial signifying:

   

    1.    Efficacy


    2.    Effectiveness

    3.    Efficiency

    4.    Effect modification



199.    Which of the following is most strongly associated with coronary heart disease?

   


    1.    Apolipoproteins

    2.    VLDL

    3.    HDL

    4.    Total liproproteins




200.    The extra energy allowances needed per day during pregnancy is:

   

    1.    150 KCals

    2.    200 KCals

    3.    300 KCals

    4.    550 KCals




201.    In a village having population of 1000, we found patients with certain disease and the results of a new diagnostic test on that disease are given below.

   

        Disease

    Test result    Present    Absent

    +    180    400


        20    400

       

    Which of the following is the positive predictive value of diagnostic test in that population

    1.    45

    2.    31


    3.    95

    4.    50



202.    Physical quality of life index is measured by all except:

   

    1.    Infant mortality


    2.    Life expectancy at age one

    3.    Literacy

    4.    Per capita income



203.    All the statements are true about standardization except:

   


    1.    Standardization allows comparison to be made between two different populations

    2.    The national population is always taken as the standard population

    3.    For Direct Standardization, age specific rates of the study population are applied to that of the standard population

    4.    For Indirect Standardization, age specific rates of the standard population are applied to that of the study population




204.    All the following are true in a randomized control trial (RCT) except:

   

    1.    Baseline characteristics of intervention and control groups should be similar

    2.    Investigator’s bias is minimized by double blinding

    3.    The sample size required depends on the hypothesis

    4.    The drop-outs from the trial should be excluded from he analysis.




205.    Study the following table carefully and answer the following question:

        Disease

    Test result    Present    Absent

    +    40    225


        10    225

       

    What is the sensitivity of diagnostic test?

    1.    45

    2.    20


    3.    80

    4.    50



206.    Pre-treatment evaluation for Lithium therapy should include:

   

    1.    Fasting blood sugar


    2.    Serum creatinine

    3.    Liver function tests

    4.    Platelet count



207.    According to the World Health Report 2000, India’s health expenditure is:

   


    1.    4.8% of G.D.P.

    2.    5.2% of G.D.P.

    3.    6.8% of G.D.P.

    4.    7% of G.D.P.




208.    The premium of the “Community based Universal Health Insurance Scheme” launched during 2003-04 ranges from

   

    1.    Rs.1 per day poor and individual to

Rs.2 per day for a family of seven

    2.    Rs.1 per day poor and individual to

Rs.3 per day for a family of seven

    3.    Rs.2 per day poor and individual to


Rs.2 per day for a family of seven

    4.    Rs.1 per day poor and individual to

Rs.7 per day for a family of seven



209.    In which of the following year the Transplantation of Human Organs Act was passed by Government of India?

   

    1.    1994

    2.    1996


    3.    2000

    4.    2002



210.    Indian (economic) real GDP growth for the year 2003 is:

   

    1.    6.0


    2.    6.5

    3.    7.8

    4.    10.5

   

211.    A 6-month-old infant had itchy erythematous papules and exudative lesions on the scalp, face, groins and axillae for one month.  She also had vesicular lesions on the palms.  The most likely diagnosis is:


   

    1.    Congenital syphilis

    2.    Seborrhoeic dermatitis

    3.    Scabies

    4.    Psoriasis




212.    Pterygium of nail is characteristically seen in:

   

    1.    Lichen planus

    2.    Psoriasis

    3.    Tinea unguium


    4.    Alopecia areata



213.    A patient had seven irregular hyperpigmented macules on the trunk and multiple small hyperpigmented macules in the axillae and groins since early childhood.  There were no other skin lesions.  Which is the most likely investigation to support the diagnosis?

   

    1.    Slit lamp examination of eye


    2.    Measurement of intraocular tension

    3.    Examination of fundus

    4.    Retinal artery angiography



214.    A 24-year-old unmarried woman has multiple nodular, cystic, pustular and comadonic lesions on face, upper back and shoulders for 2 years.  The drug of choice for her treatment would be:


   

    1.    Acitretin

    2.    Isotretinoin

    3.    Doxycycline

    4.    Azithromycin




215.    A 45-year-old farmer has itchy erythematous papular lesions on face, neck, ‘V’ area of chest, dorsum of hands and forearms for 3 years.  The lesions are more severe in summers and improve by 75% in winters.  The most appropriate test to diagnose the condition would be:

   

    1.    Skin biopsy

    2.    Estimation of IgE levels in blood


    3.    Patch test

    4.    Intradermal prick test



216.    Finger Print Bureau was first established in:

   

    1.    England


    2.    China

    3.    India

    4.    Singapore



217.    Spalding’s sign occurs after:

   


    1.    Birth of live foetus

    2.    Death of foetus in uterus

    3.    Rigor mortis of infant

    4.    Cadaveric spasm




218.    Medical qualifications awarded by institutions out side India and recognized by MCI are registered in:

   

    1.    First schedule of Indian Medical Council Act 1956

    2.    Second schedule of Indian Medical Council Act 1956

    3.    Part I of third schedule of Indian Medical Council Act 1956

    4.    Part II of third schedule of Indian Medical Council Act 1956




219.    Scab or Crut of abrasion appears brown:

   

    1.    Between 12-24 hours

    2.    Between 2-3 days

    3.    Between 4-5 days


    4.    Between 5-7 days



220.    Which of following tests is used to detect semen?

   

    1.    Phenolphthalein test

    2.    Reine’s test


    3.    Barberio’s test

    4.    Paraffin test



221.    The presence of anti-Saccharomyces cerevisae antibody is a surrogate marker of one of the following

   

    1.    Coeliac disease


    2.    Crohn’s disease

    3.    Ulcerative colitis

    4.    Tropical sprue



222.    The most common cause of gastric outlet obstruction in India is:

   


    1.    Tuberculosis

    2.    Cancer of stomach

    3.    Duodenal lymphoma

    4.    Peptic ulcer disease




223.    Which of the following parasitic infestation can led to malabsorption syndrome?

   

    1.    Amoebiasis

    2.    Adcariasis

    3.    Hookworm infestation

    4.    Giardiasis




224.    Which of the following is not a feature of hypercalcemia:

   

    1.    Diarrhoea

    2.    Polyuria

    3.    Depression


    4.    Vomiting



225.    Joint erosions are not a feature of:

   

    1.    Rheumatoid arthritis

    2.    Psoriasis


    3.    Multicentric reticulohistiocytosis

    4.    Systemic lpus erythematosus



226.    Nevirapine is a:

   

    1.    Protease inhibitor


    2.    Nucleoside reverse transcriptase inhibitor

    3.    Non-nucleoside reverse transcriptase inhibitor

    4.    Fusion inhibitor



227.    Anticentromere antibodies are most commonly associated with:

   


    1.    Diffuse cutaneous systemic sclerosis

    2.    Mixed connective tissue disease

    3.    CREST syndrome

    4.    Polymyositis




228.    A 58 years old woman, who had backache and recurrent chest infections for 6 months, develops sudden weakness of the legs and urinary retention.  Her investigations show a hemoglobin of 7.3gm/dl, serum calcium 12.6mg/dl, phosphate-2.5mg/dl, alkaline phosphatase-100u/l, serum albumin-3 gm/dl, globulin-7.1gm/dl and urea-178 mg/d.  What is the most likely diagnosis?

   

    1.    Lung cancer

    2.    Disseminated tuberculosis

    3.    Multiple myeloma


    4.    Osteoporosis



229.    All of the following drugs are protease inhibitors except:

   

    1.    Nelfinavir

    2.    Saquinavir


    3.    Abacavir

    4.    Ritonavir



230.    Which one of the following clinical findings excludes the diagnosis of polymyositis?

   

    1.    Neck muscle involvement


    2.    Extraocular muscle involvement

    3.    Dysphagia

    4.    Abdominal muscle involvement



231.    All of the following are the known causes of osteroporosis except:

   


    1.    Flurosis

    2.    Hypogonadism

    3.    Hyperthyroidism

    4.    Hyperparathyroidism




232.    A 28 years old woman having limited cutaneous scleroderma for the last 10 years complains of shortness of breath for last one month.  Her pulmonary function tests (PFT) are as follows:

   

    PFT    Observed    Predicted

    FVC    2.63    2.82


    FEV1    88%    80%

    DLCO    5.26    16.3

           

    What is the most likely diagnosis in this case?


    1.    Interstitial lung disease

    2.    Pulmonary artery hypertension

    3.    Congestive heart failure

    4.    Bronchiectasis




233.    Which of the following is least likely to cause infective endocarditis:

   

    1.    Staphylococcus albust

    2.    Streptococcus faecalis

    3.    Salmonella typhi

    4.    Pseudomonas aeruginosa




234.    All of the following may occur due to hyperkalemia, except:

   

    1.    Prolonged PR interval

    2.    Prolonged QRS interval

    3.    Prolonged QT interval


    4.    Ventricular asystole



235.    Renal artery stenosis may occur in all of the following, except:

   

    1.    Atherosclerosis

    2.    Fibromuscular dysplasia


    3.    Takayasu’s arteritis

    4.    Polyarteritis nodosa



236.    Sudden cardiac death may occur in all of the following, except:

   

    1.    Dilated cardiomyopathy


    2.    Hypertrophic cardiomyopathy

    3.    Eisenmenger’s syndrome

    4.    Ventricular septal defect



237.    All of the following are risk factors for atherosclerosis except:

   


    1.    Increased waist-hip ratio

    2.    Hyperhomocysteinemia

    3.    Decreased fibrinogen levels

    4.    Decreased HDL levels




238.    All of the following may occur in Down’s syndrome except:

   

    1.    Hypothyroidism

    2.    Undescended testis

    3.    Ventricular septal defect

    4.    Brushfield’s spots




239.    All of the following may be seen in patients of cardiac tamponade except:

   

    1.    Kussmaul’s sign

    2.    Pulsus paradoxus

    3.    Electrical alternans


    4.    Right ventricular diastolic collapse on echocardiogram



240.    A 15 year old female presents with primary amenorrhoea. Her breasts are Tanner 4 but she has no axillary or pubic hair.  The most likely diagnosis is:

   

    1.    Turner’s syndrome

    2.    Mullerian agenesis


    3.    Testicular feminization syndrome

    4.    Premature ovarian failure

241    The common side effect with Fluoxetine therapy is:

   

    1.    Seizure

    2.    Anxiety


    3.    Hypotension

    4.    Loose stools



242    A young girl has consumed barium carbonate with suicidal intent.  She complains of generalized muscle weakness.  The most likely electrolyte is:

   


    1.    Hyponatremia

    2.    Hypocalcemia

    3.    Hypokalemia

    4.    Hypomagnesemia




243    All of the following antibacterial agents acts by inhibting cell wall synthesis, except:

   

    1.    Carbapenems.

    2.    Monobactams

    3.    Cephamycins

    4.    Nitrofurantoin




244    A veterinary doctor had pyrexia of unknown origin.  his blood culture in special laboratory media was positive for gram negative short bacilli which was oxidase positive.  Which one of the following is the likely organism grown in culture?

   

    1.    Pasturella spp.

    2.    Francisella spp.


    3.    Bartonella spp.

    4.    Brucella spp.



245    Which one of the following statement is true regarding pathogenicity of Mycobacteria species?

   

    1.    M.tuberculosis is more pathogenic than M.bovis to the humans.


    2.    M. Kansasii can cause a disease indistinguishable from tuberculosis.

    3.    M.africanum infection is acquired from the environmental source.

    4.    M.marinum is responsible for tubercular lymphadenopathy.



246    A young boy had a flea bite while working in a wheat grain godown.  After 5 days he developed fever and had axillary lymphadenopathy.  A smear was sent to the laboratory to perform a specific staining.  Which one of the following staining method would help in the identification of the suspected pathogen:


   

    1.    Albert staining.

    2.    Zeihl – Neelson staining

    3.    Mc Fadyean’s staining

    4.    Wayson staining




247    A 40 years old women presented to the gynecologist with complaints of profuse vaginal discharge.  There was no discharge from the cervical os on the speculum examination.  The diagnosis of bacterial vaginosis was made based upon all of the following findings on microscopy except:

   

    1.    Abundance of gram variable coccobacilli.

    2.    Absence of Lactobacilli.


    3.    Abundance of polymorphs.

    4.    Presence of clue cells.



248    A patient complained of chills and fever following a louse bite 2 weeks before.  He had rashes all over the body and was delirious at the time of presentation to the hospital and subsequently went into coma.  A provisional diagnosis of vasculitis due to Rickettsial infection was made.  Which one of the following can be cansative agent:


   

    1.    Rickettsia typhi.

    2.    Rickettsia rickettsiae

    3.    Rickettsia prowazekii.

    4.    Rickettsia akarai.




249    A diabetic patient developed cellutitis due to Staphylococcus aureus, which was found to be Methicillin resistant on the antibiotic sensitivity testing.  All the following antiboditics will be appropriate except.

   

    1.    Vancomycin

    2.    Imipenem

    3.    Teichoplanin


    4.    Linezoiid





250    A VDRL reactive mother gave birth to an infant.  All of the following would help in determining the risk of transmission to the infant except:

   

    1.    TPHA test on the serum sample of the mother.

    2.    TPHA test on the serum sample of the infant


    3.    VDRL on the paired serum sample of the infant and mother.

    4.    Time interval between the treatment of the mother and her delivery.



251    At what period does tuberculosis flare up most commonly in a pregnant patient?

   

    1.    First trimester


    2.    Second trimester

    3.    Third trimester

    4.    Puerperium.



252    which surgical procedure has the highest incidence of ureteric injury?

   


    1.    Vaginal hysterectomy

    2.    Abdomainal hysterectomy.

    3.    Wertheim’s hysterectomy

    4.    Anterior colporraphy.




253    The following hormone is raised in polycystic ovarian syndrome:

   

    1.    17-OH Progesterone

    2.    Follicular stimulating hormone

    3.    Lutenising hormone

    4.    Thyroid stimulating hormone




254    which vitamin deficient is most commonly seen in a pregnant mother who is on phenytion therepy for Epilesy?

   

    1.    Vitamin B6

    2.    Vitamin B12

    3.    Vitamin A.


    4.    Folic Acid



255    Which of the following ovarian tumour is most prone to undergo torsion during pregnancy?

   

    1.    Serous Cystadenoma

    2.    Mucenous Cystadenoma


    3.    Dermois cyst

    4.    Theca Lutein Cyst



256    Which one ot the following congenital malformation of the fetus can be diagnosed in first trimester by ultrasound?

   

    1.    Anencephaly


    2.    Inencephaly

    3.    Microcephaly

    4.    Holoprosencephaly.



257    The most common cause of tubal block in India is:

   


    1.    Gonorrhoea infection

    2.    Chlamydia infection

    3.    Tuberculosis

    4.    Bacterial Vaginosis




258    The following complications dueing pregnancy increase the risk of Post Partum Haemorrhage (PPH) except:

   

    1.    Hypertension

    2.    Macrosomia

    3.    Twin pregnancy

    4.    Hydramnios.




259    Indicators of impending uterine rupture during labour include all of the following except:

   

    1.    Fetal distress.

    2.    Hematuria

    3.    Fresh bleeding per vaginum


    4.    Passage of meconium



260    which of the following statements is incorrect regarding polycystic ovarian disease?

   

    1.    Elevated LH hormone

    2.    Can cause infertility


    3.    May be associated with abnormal glucose tolerance test.

    4.    Results in postdated pregnancy.



261    Which of the following statements is incorrect regarding levonorgestral releasing intra-uterine system?

   

    1.    There is increased incidence of menorrhagia.


    2.    This system can be used as hormone replacement therapy.

    3.    this method is useful for the treatment of Endometerial hyperplasia

    4.    Irregular uterine bleeding can be problem initially.



262    All of the following mechanisms might account for a reduced risk of upper genital tract infection in users of progestin – releasing IUDs, except:

   


    1.    Reduced retrograde menstruation

    2.    Decreased ovulation

    3.    Thickened cervical mucus

    4.    Decidual changes in the endometrium.




263    Emergency contraception prevents pregnancy by all of the following mechanisms, except.

   

    1.    Delaying / inhibiting ovulation

    2.    Inhibiting fertilization

    3.    Preventing implantation of the fertilized egg.

    4.    Interrupting an early pregnancy.




264    Misoprostol is a:

   

    1.    Prostaglandin E1 analogue

    2.    Prostaglandin E2 analogue

    3.    Prostaglandin antagonist


    4.    Antiprogestin.



265    Lymphatic drainage of the cervix occurs by all of the following lymph nodes, except:

   

    1.    Parameterial lymph nodes.

    2.    Deep inguinal lymph nodes.


    3.    Obtruator lymph nodes

    4.    Ext. iliac lymph nodes.



266.    The treatment for a case of virilising adrenal hyperplasia is:

   

    1.    Estrogens


    2.    Antiandrogens

    3.    ACTH.

    4.    Cortisone.



267    A primigravida presents to casually at 32wks. 


gestation with acute pain abdomen for 2hours, vaginal bleeding and decreased fetal movements, She should be managed by:

   

    1.    Immediate caesarean section

    2.    Immediate induction of labour

    3.    Tocolytic therapy

    4.    Magnesium sulphate therapy




268    The investigation of choice in a 55 year old postmenopausal woman who has presented with postmenopausal bleeding is:

   

    1.    Pap smear

    2.    Fractional curettage

    3.    Transvaginal ultrasound


    4.    CA-125 estimation



269    In which of the following genital tract malignancy, the risk of metastasis to ovary is the least?

   

    1.    Carcinoma cervix

    2.    Carcinoma endometrium


    3.    Carcinoma fallopian tube

    4.    Uterine sarcoma



270    The best way of diagnosing Trisomy-21 during second trimester of pregnancy is:

   

    1.    Triple marker estimation


    2.    Nuchal skin fold thickness measurement

    3.    Chorionic villus sampling

    4.    Amniocentesis



271    Calcitonin is secreted by:

   


    1.    Thyroid gland

    2.    Parathyroid gland

    3.    Adrenal glands

    4.    Ovaries

272    Which of the following is an intraarticular tendon?


   

    1.    Sartorius

    2.    Semitendinosus

    3.    Anconeus

    4.    Popliteus




273    which of the following conditions is least likely to present as an eccentric osteolytic lesion:

   

    1.    Aneurysmal bone cyst.

    2.    Giant cell tumor

    3.    Fibrous cortical defect


    4.    Simple bone cyst



274    Bisphosphonates act by:

   

    1.    Increasing the osteoid formation.

    2.    Increasing the mineralisation of osteoid.


    3.    Decreasing the osteoclast mediated resorption of bone.

    4.    Decreasing the parathyroid hormone secretion.



275    All the statements are true about exotosis, except:

   

    1.    It occurs at the growing end of bone.


    2.    Growth continues after skeletal maturity.

    3.    It is covered by cartilaginous cap.

    4.    Maligant transformation may occur.



276    “Rugger Jersey Spine” is seen in:

   


    1.    Fluorosis

    2.    Achondroplasia

    3.    Renal Osteodystrophy.

    4.    Marfan’s Syndrome.




277    Brown tumours are seen in:

   

    1.    Hyperparathyroidism.

    2.    Pigmented villonodular synovitis

    3.    Osteomalacia

    4.    Neurofibromatosis




278    All of the following statements are true about development dysplasia (DDH) of the hip, except:

   

    1.    It is more common in females.

    2.    Oligohydramnios is associated with a higher risk of DDH.

    3.    The hourglass appearance of the capsule may prevent a successful closed reduction.


    4.    Twin pregnancy is a known risk factor.



279    All are true regarding brachial plexus injury, except:

   

    1.    Preganglinoic lesions have a better prognosis than postganglionic lesions.

    2.    Erb’s palsy causes paralysis of the abductors and external rotators of the shoulder.


    3.    In Klumpke’s palsy, Horner’s syndrome may be present on the ipsilateal side.

    4.    Histamine test is useful to differentiate between the preganglinoic and postganglinoic lesions.



280    The ideal treatment of bilateral idiopathic clubfoot in a newborn is:

   

    1.    Manipulation by mother.


    2.    Manipulation and Dennis Brown splint.

    3.    Manipulation and Casts.

    4.    Surgical release.



281    The postero superior retraction pocket, if allowed to progress, will lead to:

   


    1.    Sensori-neural hearing loss.

    2.    Secondary Cholesteatoma.

    3.    Tympanoscelerosis.

    4.    Tertiary cholesteatoma.




282    A 30 year old male is having Attic cholesteatoma of left ear with lateral sinus thrombophelebitis.  Which of the following will be the operation of choice?

   

    1.    Intact canal wall mastiodectomy.

    2.    Simple mastoidectomy with Tympanoplasty.

    3.    Canal wall down mastoidectomy.


    4.    Mastoidectomy with cavity obliteration.



283    Which of the following conditions causes the maximum hearing loss?

   

    1.    Ossicular disruption with intact  tympanic membrane

    2.    Disruption of malleus and incus as well tympanic membrane.


    3.    Partial fixation of the stapes foorplate.

    4.    Ottitis media with effusion.



284    During inspiration the main current of airflow in a normal nasal cavity is through:

   

    1.    Middle part of the cavity in middle meatus in a parabolic curve.


    2.    Lower part of the cavity in the inferior meatus in a parabolic curve.

    3.    Superior part of the cavity in the superior meatus.

    4.    Through olfactory area.



285    Which is the investigation of choice in assessing hearing loss in neonates ?

   


    1.    Impedance audiometry.

    2.    Brainstem Evoked Response Audiometry (BERA).

    3.    Free field audiometry.

    4.    Behavioral audiometry.




286    The most common etiological agent for acute bronchiolitis  in infancy  is :

   

    1.    Influenza virus.

    2.    Para influenza virus.

    3.    Rhinovirus.


    4.    Respiratory syncytial virus.



287    Which of the following is the principal mode of heat exchange in an infant incubator?

   

    1.    Radiation.

    2.    Evaporation.


    3.    Convection.

    4.    Conduction.



288    Late onset hemorrhagic disease of newborn is characterized by all of the following features except:

   

    1.    Usually occurs in cow-milk fed babies.


    2.    Onset occurs at 4-12wk of age.

    3.    Intracranial hemorrhage can occur.

    4.    Intramuscular vitamin K prophylaxis at birth has a protective role.



289    Which of the following malformation in a newborn is specific for maternal insulin dependent diabetes mellitus?

   


    1.    Transposition of great arteries

    2.    Caudal regression

    3.    Holoprosencephaly.

    4.    Meningmyelocele.




290    the prognosis of rhabdomysarcoma is likely to be poor if the site of the tumour is:

   

    1.    Orbit

    2.    Para testicular

    3.    Extremity

    4.    Urinary bladder.




291    Which of the following malignant tumors is radioresistant?

   

    1.    Ewing’s sarcoma.

    2.    Retinoblastoma.

    3.    Osteosarcoma


    4.    Neuroblastoma.



292    The most common second malignancy in survivors of retinoblastoma is:

   

    1.    Thyroid cancer.

    2.    Nasopharyngeal carcinoma


    3.    Optic glioma.

    4.    Osteosarcoma.



293    The most important determinant of prognosis in Wilms tumor

   

    1.    Stage of disease.


    2.    Loss of heterozygosity of chromosome 1p.

    3.    Histology.

    4.    Age less than one year at presentation.



294    The finnish type of cogential nephrotic syndrome occurs due to gene mutations affecting the following protein.

   


    1.    Podocin

    2.    Alpha-actinin

    3.    Nephrin

    4.    CD2 activated protein.




295    Sensorineural deafness may be feature of all, except:

   

    1.    Nail patella syndrome

    2.    Distal renal tubular acidosis.

    3.    Bartter syndrome.

    4.    Alport syndrome.




296    With reference to mumps which of the following is true?

   

    1.    Meningoencephalitis can precede parotitis.

    2.    Salivary gland involvement is limited to the parotids.

    3.    The patient is not infectious prior to clinical parotid enlargement.


    4.    Mumps orchitis frequently leads to infertility.



297    A child is below the third percentile for height.  His growth velocity is normal, but chronologic age is more than skeletal age. The most likely diagnosis is:

   

    1.    Constitutional delay in growth.

    2.    Genetic short stature.


    3.    Primordial dwarfism.

    4.    Hypopituitarism.



298    Drug induced lupus can be identified by

   

    1.    Anti-histone antibodies.


    2.    Double stranded DNA antibodies.

    3.    Antinuclear antibodies.

    4.    Anti-SM antibodies.



299    The process underlying differences in expression of a gene, according to which parent has transmitted, is called:

   


    1.    Anticipation

    2.    Mosaicism

    3.    Non-penetrance

    4.    Genomic imprinting.




300    the sodium content of ReSoMal (rehydration solution for malnourished children) is:

   

    1.    90mmol/L.

    2.    60mmol/L

    3.    45mmol/L

    4.    30mmol/L

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