TARGET MDS TEST SERIES

AIIMS Paper1

Q1)Most common genital leison in HIV patient is?

a)Chlymadie
b)Herpes
c)syphilis
d)Candida
Ans:b( Herpes)

Herpes virus is the most common opportunistic infection causing genital lesion in HIV
patients.

Q2)Which of following drug is used for narcoanalysis?

a)Atropine
b)Phenobarbitone
c)Scopolamine
d)Pethidine

Ans:C ( SCOPOLAMINE)

Drug used for narcoanalysis(TRUTH SERUM DRUGS)

 SCOPOLAMINE
 SODIUM PENTATHAL
 SODIUM SCEONAL

Q3)Which of following is a marker for langerhans cell histocytosis?

a)CD1a
b)CD10
c)CD30
d)CD56
Ans:a (Cd1a)

Tumour cells in langerhans cell histocytosis expresses HLADR,S100 and cd1a.

Q4)AFP is raised in?

a)teratoma
b)yolk sac tumour
c)Choriocarcinoma
d)Dysgerminoma
Ans:a ( Yolk sac tumour)

Alpha foeto protein level are elevated in non seminomas germ tumours including
embroysal carcinoma, yolk sac tumour and mixed germ cell tumour”

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TARGET MDS TEST SERIES

Q5)In patient with head injury damage in the brain aggrevates by?
a)Hyperglycemia
b)Hypocalcemia
c)hypocapnia
d)Serum osmarility
Ans:a ( HYPERGLYCEMIA)

Q6)Which of following represent site of lesion in motor neuron disease?

a)anterior horn cells
b)Peripheral horn cells
c)spinothalmic tract
d)spinocerebellar tract
Ans: a ( anterior horn cells)

Q7)maxiumum water resorption in gastrointestinal tract is seen in?

a)Stomach
b)Jejunum
c)Illeum
d)colon
Ans:b ( Jejunum)
AIPGMEE Q 18,2010

Q8)Sphinglomyelins dificienecy is seen in?

a)Niemaan pick disease
b)farber disease
c)tay sacch disease
d)krabbe disease
Ans:a ( niemaann pick disease)
AIPGMEE Question 2010-Q29

Q9)Basal metabolic rate depends most closely on?

a)lean body mass
b)body mass index
c)obesity
d)Body surface area
Ans:A ( LEAN BODY MASS)

Q10)Low csf protein may be seen in all of following condition except?

a)recurrent lumbar puncture
b)hypothyroidism
c)pseudotumor cerebri
d)hYPERTHYROIDISM
Ans:B ( Hypothyroidism)
AIPGMEE Q24 2010

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TARGET MDS TEST SERIES

Q11)Leison of lateral cerebellum causes all of following except?

a)Incordination
b)intentional tremor
c)resting tremor
d)ataxia
Ans:C ( Resting tremor)

Q12)Ethosuxamide is drug of choice of?

a)SSRI
b)Tricyclic antidepressant
c)RIMA
d)Atypical antidepressant
Ans:b ( tricyclic antidepressant)

Q13)Narrow theurapeutic index is seen with?

a)despirramine
b)lithium
c)pencillin
d)Diazepam
ANS:B ( Lithium)
Q14)Provision of primary health care was done by?
a)Alma ata decrelation
b)shrinavsatava committee
c)National heath policy
d)Bhore community
Ans:b ( Alma ata decleration)

Q15)Asha is posted at?

a)village level
b)primary health centre
c)community health centre
d)Subcentre
Ans:A ( Village level)

Q16)Mass chemoprophylaxis is endemic area recommended for all of following

except?
a)Yaws
b)Leprosy
c)Trachoma
d)Filiria
Ans:b ( Leprosy)

Q17)A STANDARD Z SCORE IS RELATED TO?

A) binomial distribution
b)normal distribution
c)chi square test

TARGET MDS TEST SERIES

TARGET MDS TEST SERIES

d)t test
Ans:b ( Normal distribution)

Q18)Bences jones protein are derived from?

a)alpha heavy chain disease
b)gamma heavy chain disease
c)mu heavy chain disease
d)epsilon heavy chain disease
Ans:c ( Mu chain heavy disease

Q19)which of following laser is most commonly used in laryngeal surgery?

a)co2 laser
b)nd yag laser
c)argon laser
d)ktp laser
Ans: a (co2 laser)

Q20)which is the most ionizing radiation?

a)alpha
b)beta
c)x rays
d)gamma
Ans:a ( alpha)

Q21)which of following best estimates the amount of radiation delivered to an organ

in raditation filed?
a)absorbed dose
b)equivalent dose
c)effective dose
d)exposure dose
Ans: A ( ABSORBED DOSE)

Q22)Autism disorder is characterstic by all of following except?

a) sual disturbance
b)lack of social interaction
c)delayed development of speech
d)sterogenic movements
Ans:a ( visual disturbances)

Q23)Incidence rate can be calculated by?

a)case control study
b)cohort study
c)cross sectional study
d)cross over study
Ans:b ( Cohort study)

TARGET MDS TEST SERIES

TARGET MDS TEST SERIES

Q24)Gut associated lymphoid tissue is associated with ?

a)Lamina propria
b)submucosa
c)muscularis
d)serosa
Ansa:Lamina propria

Q25)When a person changes position from standing to lying position following

changes are seen?
a)heart rate increases
b)venous return to heart increases immediately
c)cerebral blood flow increases
d)blood flow at apices of the lung decreases
ANS:b(venous return to heart increases immediately)

Q26)Key regulator of sleep are located in?

a)Hypothalamus
b)Thalamus
c)putamen
d)Limbic cortex
ANS:a ( Hypothalamus)

Q27)Which is not a sign of successful stellate ganglion block?

a)Nasal stiffness
b)guttman sign
c)hornor syndrome
d)Bradycardia
Ans:d ( Bradycardia)

Q28)The anesthetic agent injected for paravertebral block is least likely to fiffuse
to?
a)epidural space
b)subarachnoid space
c)intercostal space
d)superior and inferior paravertebral space
Ans:b ( Subarachnoid space)

Q29)Sodium bicarbonate when given with local anesthesia has following effects?
a)increases speed and quality of anesthesia
b)decreases diffusion rate of anesthesia
c)cause rapid elimination of anesthesia
d)decrease speed and quality of anesthesia
Ans:a (increases speed and quality of anesthesia)

Q30)T-10 protocol for treatment of osteosarcoma includes all of following except?

a)High dose methotreaxte

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b)bleomycin,cyclophosphamide, doxorubicin,( BCD)

c)vincristine
d)Etoposide
Ans: d ( etoposide)
Q31)SEPS is a procedure for?
a)veins
b)arteries
c)lymphatics
d)av fistula
Ans:a ( veins)
Q32)Facial colliculus is seen in?
a)midbrain
b)pons
c)medulla
d)interpeduncular fossa
Ans:B ( Pons)
Q33)Which of following regarding secretin is least correct?
a)ncreases bicarbonate rich secretion
b)inhibit gastric acid secretion
c)increases gastric acid secretion
d)causes contraction of pyloric sphincter
Ans:c ( increases gastric acid secretion)
Q34)The site where myosin heads bind to actin in skelton system are covered by?
a)tropomyosin
b)troponin
c)calcium
d)none of the above
Ans:a ( tropomysoin)
Q35)Which of following oncogenes is a growth factor?
a)fos
b)myc
c)jun
d)sis
Ans:d

Q36)which of following is a specific marker for Hodgkin lymphoma?

a)cd 15 and cd 30
b)cd15 and cd45
c)cd30 and cd 68
d)cd15 and cd5
ans:a ( cd15 and cd30)
Q37)Reactive oxygen intermediate are released by?
a)catalase
b)NADPH OXIDASE
C)GLUTHATHIONE PEROXIDASE
D)SUPEROXIDE DISMUTASE
Ans:b ( nadph oxidase)

Q38)High amount of saturated fatty acid are seen in?

a)soyabean oil
b)groundnut oil
c)palm oil
d)sunflower oil
ANS: C ( Palm oil)
Q39)which of following is not a landmark for facial nerve injury during parotid
surgery?
a)digastrics triangle
b) inferior belly of
omohyoid c)tragal pointer
d)retrograde dissection of distal branch
Ans:b

Q40)Abbe estlander flap is used for?

a)lip
b)tongue
c)eyelid
d)ears
Ans:a ( lips)

Q41)Which of following is the most radiosensitive phase of cell cycle?

a)G2M
b)G2
c)s
D)G1
Ans:a ( G2M)
Q42)Train of four is a characterstics feature of?
a)depolarizing agents
b)non depolarizing agents
c)both depolarizing and non depolarizing agents
d)malignant hyperthermia
Ans:b ( Non depolarizing agents)
Q43) Cavernous sinus thrombosis is due to infection of:-
(A). Pterygoid plexus
(B). Submental space
(C). Maxillary sinus
(D). Submandibular space

Ans. (A). Pterygoid plexus

PATHOLOGY
Aseptic thrombosis of the cavernous sinus occurs with trauma, tumor invasion, aneurysmal
expansion, dehydration, emaciation and hypercoagulable states, Septic thrombosis is much more
common and occurs according to Shaw (1952) from the spread of infection through various
routes:
1) From the face via the angular and ophthalmic veins,
2) From the middle ear via the superior petrous sinus,
3) From the teeth, maxillary sinus and cervical vertebrae via the pterygoid plexus which empties
into the inferior ophthalmic vein,
4) From the sphenoid sinus by direct extension or draining emissary veins,
5) By extension from an infected Internal jugular vein, lateral sinus or petrosal sinus, or
6) From the plexus of veins surrounding the internal carotid artery. Often there is a latency of 5-6
days between the initial infection and the subsequent signs of cavernous sinus thrombosis.
The extension of an Infection into the cavernous sinus is explained by several mechanisms:
1) A continuous, infected clot bridges the initial infected site to the cavernous sinus;
2) A septic embolus lodges in the cavernous sinus; or
3) Bacterial toxins induce endothelial changes and thrombosis of the cavernous sinus which
subsequently becomes infected.
Q.1. Q44) Base pairs in human DNA:-
(A). 1.5billion
(B). 46billion
(C). 3.2 billion
(D). 100 billion

Ans. (C). 3.2 billion

The Escherichia coli chromosome, one of the bacterial genomes that have been completely
sequenced, is a circular DNA molecule (in the sense of an endless loop rather than a perfect
circle) with 4,639,675 bp. These base pairs encode about 4,300 genes for proteins and another
157 genes for structural or catalytic RNA molecules. Among eukaryotes, the approximately 3.1
billion base pairs of the human genome include almost 29,000 genes on 24 different
chromosomes.

LEHNINGER PRINCIPLES OF BIOCHEMISTRY 5th edi, pg 948

Q.2. Q45) Suxamethonium is available as clear aqueous colour solution has a shelf life of:-
(A). 6 months
(B). 1 year
(C). 2 year
(D). 3 year

Ans. (C). 2 year

Suxamethonium chloride is a white, crystalline powder. It is odourless, highly soluble in

water, soluble in alcohol, slightly soluble in chloroform , and practically insoluble in ether.
Suxamethonium chloride is packed in double-sealed clear polyethylene bags, which are placed
in fibre drums. It is presented as a clear colourless aqueous solution of pH 3.0–5.0 with a shelf-
life of 2 years, and stored at 4°C.

Lee's Synopsis of Anaesthesia - Page 189

Q46) A pregnant lady uses fluoridated drinking water. All of the following are true
regarding exposure of the fetus to fluoride except:-
(A). Placenta acts as a regulator and reduces the concentration of fluoride reaching the
fetus
 (B). Placenta acts as a regulator and increases the concentration of fluoride reaching the
fetus
(C). Placenta has no role in fluoride regulation to fetus
(D). Placenta acts as a barrier to fluoride ions.

Ans. (B). Placenta acts as a regulator and increases the concentration of fluoride reaching the
fetus

Distribution of fluoride to the foetus

There are different views regarding the passage of fluoride across the placenta. Some authors
have said that placenta acts as a complete barrier to fluoride, others have said that it is only
partial. The fact that primary dentition exhibits less severe degrees of dental fluorosis, than
permanent dentition, indicates the presence of a placental barrier.
Soben Peter 3rd edi, pg 284
Most of the investigators agree that fluoride ingested by pregnant women passes through the
placenta and is incorporated into the developing bones & teeth of fetus. However,
concentration of fluoride that actually reaches the fetus is generally lower than that in
maternal blood.
Nutrition in clinical dentistry 3rd edi, pg181

Q47) Metallic taste after application of stannous fluoride varnish is due to: (A).
Stannous trifluorophosphate
(B). Stannic trifluorophosphate
(C). Calcium trifluorostannate
(D). Tin hydroxyl phosphate

Ans. (D). Tin hydroxyl phosphate

Stannous Fluoride-8 pe rce nt [M u hle r ’s Te c

hniq ue ]
Available in powder form either in bulk containers or pre-weighed capsules. The recommended
and approved concentration is 8 percent
Method of Preparation
The solution has to be freshly prepared as they are not stable. It can be prepared by dissolving
0.8 gm of powder in 10 ml of distilled water. The solution is acidic, with a pH of about 2.4– 2.8.
the left over solution should be discarded after application.
Method of Application
1. Cleaning and polishing of teeth is done.
2. Teeth are isolated with cotton rolls and dried with compressed air.
3. Freshly prepared SnF2 solution is applied using cotton applicator. Care should be taken that
all teeth surfaces are treated.
4. Repeated loading of cotton applicator should be done and swabbing is continuously done so as
to keep tooth surface moist for 4 minutes.
5. Patient is allowed to expectorate after cotton rolls are removed.
Recommended Schedule
A six monthly interval treatment schedule is advised.
Mechanism of Action
Stannous fluoride reacts with hydroxy apatite and in addition to fluoride the Tin of solution also
reacts with enamel and forms Stannous tri-fluorophosphate, which is more resistant to carious
attack. Tin hydroxy phosphate gets dissolved in oral fluids and is responsible for the metallic
taste. Tin trifluorophosphate which is the main end product is responsible for making the
tooth structure more stable and less susceptible to decay. Calcium fluoride [CaF2] so formed
further reacts with hydroxy apatite and some fluorhydroxyapatite also gets formed.
Q48) All of the following assumptions are considered true when doing space analysis for
calculating space discrepancy except:-
(A). All permanent teeth will develop normally
(B). Correlation in size of mandibular incisors and succedaneous teeth
(C). Prediction tables are most valid for all populations
(D). Arch dimension remain stable

Ans. (C). Prediction tables are most valid for all populations

Prediction tables should be valid for the population in question and not for all populations as
different populations have different tooth and jaw sizes and a single table cannot predict
accurately the discrepancy for all populations.
Q49) Gjessing's canine retractor is made up of:- (A).
.016-0.22 stainless steel
(B). .018-.025 stainless steel
(C). .017-.025 TMA
(D). .015-.022 TMA

Ans. (A). .016-0.22 stainless steel

Gjessing spring used for canine retraction with segmental or frictionless mechanics. Gjessing
spring is usually made using 0.16" x 0.22" SS or TMA wire. The predominant active element of
the spring is the ovoid double helix loop extending 10 mm in height apically and has a maximum
width of 5.5 mm. The smaller occlusal loop has a diameter of 2 mm. Canine retraction in to
extraction spaces can be achieved either with segmental mechanisms or a continuous archwire.
High labially placed canines can be gently moved distal and occlusal with light continuous wires
such as 0.014" nickel-titanium wires during the initial stages of leveling. Segmental mechanisms
using retraction loop of Ricketts1 and Gjessing spring work well for bodily retraction of the
canines using favourable moment to force ratio.

Q50)Massetric notch is formed by the action of:-

(A). Buccinator on masseter
(B). Masseter on buccinator
(C). Superior constrictor on buccinator
(D). Buccinator on superior constrictor

Ans. (B).Masseter on buccinator

When the masseter contracts, it pushes inward against the buccinator, producing a bulge into
the mouth. This bulge can be recorded only when the masseter contracts. It is reproduced as a
notch in the denture flange called massetric notch.

Nallaswamy pg56

51. If there is no response to heat and cold testing, the pulp is

a. Non-vital b. Excessive calcification
c. Patient premedication d. All of these
Ans d If there is no response, the pulp is either nonvital or possibly vital but giving a false-
negative response because of excessive calcification, an immature apex, recent trauma, or
patient premedication.
cohen

52. Which of the following statement is incorrect about enamel caries

a. Translucent zone is the first recognizable histological change at the advancing
edge of the lesion
b. Magnesium- and carbonate- rich mineral is preferentially dissolved in translucent
zone.
c. Dark zone is wider in rapidly advancing lesions and narrow in more slowly
advancing lesions
d. Remineralization occurs in the dark zone
Ans: c refer page 24,25:
Translucent zone: This is the first recognizable histological change at the advancing edge
of the lesion. It is more porous than normal enamel and contains 1 per cent by volume of
spaces, the pore volume, compared with the 0.1 per cent pore volume in normal enamel.
The pores are larger than the small pores in normal enamel which approximate to the size
of a water molecule. Chemical analysis shows that there is a fall in magnesium and
carbonate when compared with normal enamel, which suggests that a magnesium- and
carbonate- rich mineral is preferentially dissolved in this zone. Dissolution of mineral
occurs mainly from the junctional areas between the prismatic and interprismatic enamel.
Dark zone This zone contains 2-4 per cent by volume of pores. Some of the pores are
large, but others are smaller than those in the trAnslucent zone, suggesting that some
remineralization has occurred due to reprecipitation of mineral lost from the trAnslucent
zone. It is thought that the dark zone is Narrowinrapidly advancing lesions and wider
inmoreslowly advancing lesions when more remineralization may occur.

53. The zone showing the features enhancement of the striae of Retzius,
interprismatic markings, and cross-striations of the prisms.
a. Translucent zone b. Body of lesion
c. Surface zone d. Dark zone

Ans: b: As the lesion enlarges more mineral is lost and the centre of the dark zone becomes
the body of the lesion. This is relatively trAnslucent compared with sound enamel and
shows enhancement of the striae of Retzius, interprismatic markings, and cross-striations
of the prisms. The lesion is now clinically recognizable as a white spot.

54. Which of the following zone is an area of active remineralization

a. Surface zone b. Body of the lesion
c. Dark zone d. Translucent zone
Ans: a
Enamel caries
· a dynamic physicochemical process involving dissolution and repreciptation of mineral
· caries progression is usually a slow process
· zonation of the early (white spot) lesion reflects different degrees of demineralization
· four zones usually seen: trAnslucent zone (1 per cent loss), dark zone (2-4 per cent
loss), body (5-25 per cent loss), surface zone (intact)
· surface zone is an area of active remineralization
· the morphology of the lesion differs in pits and fissures compared with approximal
surfaces

55. Which of the following statement is incorrect regarding the fissure caries
a. Caries in a fissure does not start at the base, but develops as a ring around the wall
of the fissure
b. A cone shaped lesion is formed
c. The area of dentine ultimately involved is smaller than with smooth surface
lesions.
d. Histological features of the lesion being similar to those seen on smooth surfaces
Ans: c: Caries in a fissure does not start at the base, but develops as a ring around the
wall of the fissure, the histological features of the lesion being similar to those seen on
smooth surfaces. As the caries progresses it spreads outwards into the surrounding
enamel and downwards towards the dentine, and eventually coalesces at the base of the
fissure. This produces a cone-shaped lesion, but the base of the cone is directed towards
the amelodentinal junction and is not on the
enamelsurfaceasinsmoothsurfacecaries.Theareaofdentineultimatelyinvolvedistherefore
larger than with smooth surface lesions.

56. Pathological attrition may result from

a. Excessive intake of acid beverages
b. Faulty tooth brushing
c. Abnormal occlusion
d. Habits of pipe smoking
Ans: c : Pathological attrition may result from:
(1) abnormal occlusion - either developmental or following extractions;
(2)bruxism and habits suchas tobacco andbetelchewing;
(3) abnormal tooth structure, for example amelogenesis imperfecta, dentinogenesis
imperfecta

57. Pathological wearing away of tooth substance by the friction of a foreign

body independent of occlusion. Is termed as
a. Attrition b. Abrasion c. Erosion d. None of these
Ans: b Abrasion This is the pathological wearing away of tooth substance by the friction of
a foreign body independent of occlusion. Different foreign bodies produce different
patterns of abrasion
 58. Drugs most commonly associated as a trigger factor for Erythema multiforme
are all except
a. Nonsteroidal antiinfammatory drug b. Sulphonamides
c. Phenytoin d. Calciuml channel blocker
Ans: d: The drugs most frequentlyassociated with EM reactions are oxycam nonsteroidal
antiinflammatorydrugs (NSAIDs); sulfonamides; anticonvulsants such as carbamazepine,
phenobarbital, and phenytoin; trimethoprim-sulfonamide combinations, allopurinol, and
penicillin
Burket Page 57

59. A knife wound to the neck damages the posterior cord of the brachial plexus.
Which of the following muscles would be most likely be paralyzed?
a. Deltoid b. Flexor carpi ulnaris
c. Flexor digitorum superficialis d. Flexor pollicis brevis
The correct answer is a. The posterior cord supplies the axillary and radial nerves. Of the
muscles listed, only the deltoid is supplied by one of these two nerves, specifically the
axillary nerve. The deltoid originates from the clavicle and scapula. It inserts into the
deltoid tuberosity of the humerus. This muscle is responsible for abduction of the arm.

60. During the process of meiosis, a single homologous chromosome pair fails to
separate during the first meiotic division. This failure would be most likely to
produce which of the following conditions if fertilization occurs and an embryo
later develops?
a. Balanced translocation b. Triploidy
c. Trisomy d. Unbalanced translocation
The correct answer is c. Meiosis is cell division that produces gametes with half of the
normal somatic chromosome complement. The process described is nondisjunction, which
will cause one daughter cell to have 24 chromosomes, while the other will have 22
chromosomes. When a gamete with the normal 23 chromosomes combines at fertilization
with a gamete with 22 or 24 chromosomes, the embryo will have 47 chromosomes (trisomy)
or 45 chromosomes (monosomy). Nondisjunction can occur in either the first or second
meiotic division.

61. The superior ophthalmic vein directly communicates with which of the
following dural venous sinuses?
a. Cavernous sinus b. Occipital sinus
c. Sigmoid sinus d. Superior petrosal sinus
The correct answer is a. The anterior continuation of the cavernous sinus, the superior
ophthalmic vein, passes through the superior orbital fissure to enter the orbit. Veins of the
 face communicate with the superior ophthalmic vein. Because of the absence of valves in
emissary veins, venous flow may occur in either direction. Cutaneous infections may be
carried into the cavernous sinus and result in a cavernous sinus infection, which may lead
to an infected cavernous sinus thrombosis. The cavernous sinus is lateral to the pituitary
gland and contains portions of cranial nerves III, IV, V1, V2, and VI, and the internal
carotid artery.

62. In preparation for a procedure to remove the fingernail on an index finger,

the physician would most likely anesthetize a branch of the
a. Anterior interosseus nerve b. Median nerve
c. Musculocutaneous nerve d. Radial nerve
The correct answer is b. The median nerve supplies the surface of the lateral palm, the
palmar surface of the first three digits, and the distal dorsal surface of the index and
middle fingers (including the nail beds). Therefore, prior to performing surgery in this
area, it is essential to anesthetize a branch of this nerve (possibly a proper digital branch)
to eliminate pain sensation around the nail bed of the index finger. The median nerve of
the branchial plexus distributes to the flexor muscles on the forearm (flexor carpi radialis
and palmaris longus), the pronators (p. quadratus and p. teres), digital flexors, and skin
over the lateral surface of the hand.

63. Which glandular area secretes hormones which are products of tyrosine
metabolism?
a. Alpha cells of pancreas b. Beta cells of pancreas
c. Adrenal cortex d. Adrenal medulla
The correct answer is d. The products of the adrenal medulla are epinephrine
(adrenalin) and norepinephrine (noradrenalin). The pathway of production of these
compounds is a s follows: tyrosine to DOPA to dopamine to norepinephrine to
epinephrine. The hormone secreted by alpha cells of the pancreas is glucagon, while beta
cells secrete insulin. Both are peptide hormones. The adrenal cortex secretes a variety of
hormones including cortisol and aldosterone, both steroid hormones. The testes secrete
testosterone, also a steroid hormone.

64. Which of the following substances is likely to be present in significant

amounts in urine that has a stable, frothy, white foam on top?
a. Bilirubin b. Blood
c. Glucose d. Protein
The correct answer is d. In this case, you need to know that a stable froth on urine is usually
caused by proteinuria (more than several grams per 24 hours).

65. Tissue taken from a fracture site of a patient with end stage renal failure is
noted to have increased osteoclastic activity, with notable tunnel-like dissection
by osteoclasts into the bony trabeculae. Increased levels of which of the following
hormones is most likely to be responsible for this lesion?
a. Calcitonin b. Cortisol
c. Erythropoietin d. Parathyroid hormone
The correct answer is d. The histological picture suggests hyperparathyroidism, a well-
recognized sequela of chronic renal failure. This condition is caused by high levels of
serum phosphate and low serum calcium, which stimulate the release of parathyroid
hormone (PTH) in an effort to normalize the calcium/phosphate ratio. PTH stimulates
osteoblasts to become osteoclasts, which dissolve the bone reservoir of calcium and
release it into the blood. This condition, known as renal osteodystrophy, may lead to
osteomalacia and osteitis fibrosa cystica, which is classically associated with dissecting
osteitis, as described in this question. With respect to parathyroid hormone physiology,
the following apply. The PTH has 5 effects: (1) stimulates osteoclasts; (2) inhibits
osteoblasts; (3) promotes intestinal absorption of calcium and phosphate ions; (4) reduces
urinary excretion of calcium; (5) stimulates formation and secretion of calcitrol at the
kidneys.

66. Nonfunctioning of complement component C36 would be expected to

interfere with which of the following biologic functions?
a. Decreased appetite
b. Fever
c. Increased collagen synthesis by fibroblasts
d. Opsonization to facilitate phagocytosis

The correct answer is d. C 3b acts as an opsonin, together with IgG, to facilitate

phagocytosis. None of the other functions listed in the answer choices is attributable to
C3b. Instead, all of the other answer choices are functions of the cytokines interleukin-1
(IL-1) and tumor necrosis factor (TNF). Tumor necrosis factor is produced by
macrophages and activated T-cells, whereas many different cell types (including
macrophages) produce IL-1.

67. If a creatinine clearance of 100 mL/min changes to 50 mL/min over 1 year,

assuming that there has been no change in diet, which of the following
physiologic changes can be expected?
a. A 2-fold decrease in blood urea nitrogen concentration
b. A 2-fold decrease in creatinine excretion rate
c. A 2-fold increase in creatinine excretion rate
d. A 2-fold increase in plasma creatinine concentration
The correct answer is d. Creatinine clearance is used clinically to estimate glomerular
filtration rate (GFR). The 50% decrease in creatinine clearance in this patient therefore
suggests that GFR has decreased by 50% over the past year. Because creatinine is freely
filtered but not reabsorbed the filtration rate and excretion rate of creatinine are equal
during steady state conditions. When GFR decreases, the rate of creatinine excretion will
also decrease, causing the rate of creatinine excretion to decrease to below the rate of
creatinine production. The result is an increase in plasma creatinine concentration. When
plasma creatinine levels have increased by 2-fold, normal amounts of creatinine can then
again be excreted (compare with choices B and C) because the excretion rate of
creatinine is equal to the product of GFR and plasma creatinine concentration. In
summary, when GFR decreases, the plasma creatinine concentration continues to increase
 until the rate of creatinine filtration (and excretion) becomes equal to the rate of
creatinine production by the body.

68. A cell biologist wants to activate protein kinase C in cultured cells.

Stimulation of which of the following receptor types would most likely produce
the greatest activation?
a. Alpha 1 adrenergic
b. Beta 1 adrenergic
c. Dopamine-2 (D2)
d. Gamma-aminobutyric acid, type A (GABAA)
The correct answer is a. It is a good idea to know the mechanism of action of various
receptors. Alpha-1 adrenergic receptors are coupled to the G protein, Gq. This G protein
causes breakdown of the membrane phospholipid phosphatidylinositol bisphosphate
(PIP2), forming the products diacylglycerol, which stimulates protein kinase C, and
inositol triphosphate (IP3), which releases calcium from the endoplasmic reticulum. It is
important to note that cyclic AMP activates protein kinases by dissociating the complex
of regularity and catalytic subunits, which results in activation of the cellular response.

69. Which of the following enzymes is stimulated by glucagon?

a. Acetyl-CoA carboxylase b. Glycogen phosphorylase
c. Glycogen synthase d. HMG-CoA reductase
The correct answer is b. Before you started analyzing all of the answer choices you should
have reminded yourself that glucagon increases serum glucose. So an enzyme stimulated
by glucagon might be involved in either the breakdown of glycogen to glucose
(glycogenolysis) or in the creation of glucose from noncarbohydrate precursors
(gluconeogenesis). Glycogen phosphorylase catalyzes the first step in glycogenolysis; it
makes sense that it would be stimulated by glucagon. Clinical correlate: patients with
Type I diabetes lose their response to hypoglycemia (but not to amino acids in protein
containing meals) within a year or so after developing diabetes. Type I diabetics rely on
the sympathetic nervous system to counter regulate hypoglycemia.

70. The majority of ATP generated during a 100 meter race is derived from
which of the following?
a. ATP stores b. Creatine phosphate
c. Gluconeogenesis d. Glycolysis
The correct answer is d. The key to this question is understanding how and when the body
utilizes fuel stores. The stores of ATP (choice A) will be used up in less than 1 second
once the race has started. Creatine phosphate (choice B) will be the primary source of
energy for the next 3 or 4 seconds. After the creatine phosphate stores are depleted, the
majority of ATP needed to complete the race will be derived from glycolysis (anaerobic
respiration). If the race were to last for an extended period of time, then the processes of
 gluconeogenesis (choice C) and lipolysis (choice E) might be utilized. Gluconeogenesis
is the process of synthesizing glucose in the liver from non-carbohydrate sources, such as
amino and fatty acids. Lipolysis is the splitting up or decomposition of fat in the body.

71. As cells in the erythrocytic lineage mature and lose their nuclei, mitochondria,
and ribosomes, which of the following pathways can still be used to produce
ATP?
a. Citric acid cycle b. Electron transport chain
c. Glycolysis d. Malate shuttle
The correct answer is c. Circulating erythrocytes have a life span of about 60 days and
are dependent on a functioning Na+/K+ ATPase in the plasma membrane. This pump
provides the electrochemical force across the plasma membrane that helps to maintain the
volume of the red cell at a constant level by regulating salt, and consequently water, flow
into and out of the cell. When the pump stops, the erythrocytes tend to lyse. It is therefore
of extreme importance to the erythrocyte to supply the ATP necessary to keep the pump
running. This is accomplished through the use of glycolysis, which converts glucose to
pyruvate, with a net production of 2 ATP per glucose molecule.

72. Megaloblastic anemia with folate deficiency is linked to an inability to

perform which type of enzymatic process?
a. Acyl transfer b. Carboxylation
c. Decarboxylation d. Methylation

The correct answer is d. Folic acid is a pteridine vitamin that exists as tetrahydrofolate
(TH4) in its most reduced form. TH4 can accept methyl, methylene, or formyl carbons and
transfer them as methyl groups. This function is vital in nucleotide and amino acid synthesis.

73. What seating position is generally considered most successful when trying to
communicate with a patient?
a. Sitting alongside the patient or at a diagonal angle to them.
b. Standing opposite and facing towards the patient
c. Making the patient lie down in left lateral position on the dental chair
d. Making the patient lie down in supine position
Ans. a

74. Which of the following food substances can act as Antioxidants

a. Food substances containing reactive oxygen species
b. Food substances containing free radicals
c. Food substances containing proteins
d. Food substances containing vitamin
Ans. d: Antioxidants counter the effect of reactive oxygen species (free radicals). Free
radicals are produced as part of the body’s natural metabolic processes and can damage
DNA and proteins; these cells may be more prone to developing cancer. Many food
substances such as vitamins have antioxidant properties.
 75. Provision of carotene rich diet in order to prevent xerophthalmia is a measure
under:
a. Health promotion b. Specific protection
c. Early diagnosis and treatment d. Rehabilitation
Ans. b: Specific protection intervention measures are:
a. Immunization. b. Use of
specific nutrients.
c. Chemoprophylaxis. d.
Protection against occupational hazards.
e. Protection against accidents. f.
Protection from carrcinogens.
g. Avoidance of allergens.
h. Control of specific hazards in general environment e.g., air pollution, noise control.
i. Control of consumer product quality and safety of food, drugs cosmetics etc.

76. Pasteurisation of milk is an example of:

a. Precurrent disinfection b. Concurrent disinfection
c. Terminal disinfection d. Absolute disinfection
Ans. a: Disinfection is killing of infectious agents outside the body by direct exposure to
chemical or physical agents.
Types:
1. Concurrent disinfection: It is the application of disinfective measures as soon as
possible after the discharge of infectious material from the body of an infecetd person
or after the soiling of articles with such infectious discharges. It consists of
disinfection of urine, faeces, vomit, contaminated linen, clothes, hands, dressings,
aprons, gloves etc. throughout the course of an illness.
1. Precurrent (Prophylactic) disinfection: Disinfection of water by chlorine,
pasteurization of milk and handwashing.
2. Terminal disinfection: It is application of disinfective measures after the patient has
been removed by death or to a hospital or has ceased to be a source of infection or
after other hospital isolation practices have been discontinued.

77. Dietary fats are often classified as visible and invisible fats. Visible fats are so
classified because:
a. The fats in the diet are visible to the naked eye
b. It is easy to estimate their content in the diet
c. The deficiency manifestations due to these fats are easily visible
d. Of no particular reason other than the need to distinguish between one set of fats
from another

Ans. B: ‘Visible’ fats are those that are separated from their natural source e.g., ghee (butter)
from milk, cooking oil from oil-bearing seeds and nuts. It is easy to estimate their intake
in the daily diet. ‘Invisible’ fats are those which are not visible to the naked eye. They are
present in almost every article of food e.g., cereals, pulses, nuts, milk etc. It is difficult to
estimate their intake. Major contribution to total fat intake is from invisible sources rather
than visible sources.
78. As per nutritional surveys, the diet of an average Indian of lower socio-
economic strata is highly deficient in:
a. Thiamin b. Riboflavinc. c.Nicotinic acid d. Vitamin C
b. Ans. B: Deficiency of riboflavin is widespread in India particularly in
population where rice is the staple. The most common lesion associated with
riboflavin deficiency is angular stomatitis, which occurs frequently in
malnourished children and its prevalence is used as an index of the state of
nutrition of groups of children. Studies conducted at National Institute of
Nutrition in India showed that subclinical riboflavin deficiency (as judged by
erythrocyte glutathione reductase activation test) was present in over 80
percent of low income group children and adults.

79. One of the films in a full mouth series of dental radiographs has crescent-
shaped marks on it. What is the most likely cause of these marks?
a. Overbent films
b. Exposure to secondary radiation
c. Patient had glasses on
d. Cone cutting
Ans. a
• Overbent films (cracked emulsion) Some other common errors made when taking
dental radiographs/cause:
• Light films (underexposed, image NOT dense enough) / Incorrect milliamperage (too
low) or time (too short); incorrect focal film distance; cone too far from patient's face
• Dark films (overexposed, image too dense) / Incorrect milliamperage (too high) or time
(too long)
• Double exposure / film was used twice
• Fogged films / exposed to radiation other than primary beam
• Artifacts / patient didn't remove eyeglasses, earrings, or removable prosthetic
appliances
• Poor contrast / incorrect kVp (too high)
• Blurred image / patient movement or drifting of x-ray arm
• Clear films / were not exposed to radiation

80. Digoxin is NOT indicated in

a. Atrial flutter b. Atrial fibrillation
c. High output failure d. PSVT
Ans. c

81. Beta blocker which has less first pass metabolism and more excretion
through kidney is
a. Propanolol b. Sotalol c. Bisprolol d. Nadolol
Ans. b

82. All of the following anaesthetic agents can be given in children except
a. halothene b. ether
 c. morphine d. none of the above
Ans. c

83. In low doses aspirin acts on

a. cyclo oxygenase b. thromboxane A2
c. PGI 2 d. lipoxygenase
Ans. b

84. Afferent component of corneal reflex is mediated by:

A. Vagus nerve B. Facial nerve
C. Trigeminal nerve D. Glossopharyngeal nerve.
Ans C.

85. Calcitonin is secreted by:

A. Thyroid gland B. Parathyroid gland
C. Adrenal glands D. Ovaries.
Ans A.

86. Which of the following organ is not involved in calcium homeostasis?

A. Kidneys B. Skin C. Intestines D. Lungs

Ans D.
87. Which of the following secretions has a very high pH?
A. Gastric juice B. Pancreatic juice
C. Bile in gall bladder D. Saliva
Ans B.
88. Iron is present in all of the following except:
A. Myoglobin B. Cytochrome C. Catalase D. Pyruvate Kinase
Ans D.
89. Vitamin B12 acts as coenzyme to which one of the following enzymes:
A. Isocitrate dehydrogenase
B. Homocysteine methyl transferase.
C. Glycogen synthase D. G-6 - P dehydrogenase
Ans B
90. The ligand receptor complex dissociates in the endosomes because:
A. Of its large size.
B. The vesicle loses its clathrin coat
C. Of the acidic pH of the vesicle
D. Of the basic pH of the vesicle
Ans C.