AIIMS

Fur
NOV 2010 suggessions
SOLUTIONS please mail to
…
By imran.ratnani@
gmail.com
Dr. I. J. Ratnani
Dr. H. Rajyaguru Or
Dr. K. Kikani
https://groups.google.c
om/group/imranratnani?
hl=en

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Repeats 8. A patient presented with thunder clap
1. All are contents of vaginal sphincter except: headache. Followed by unconsciousness with
1) external urethral sphincter progressive 3rd cranial nerve palsy—
2) internal urethral sphincter 1. Extradural Hemorrhage
3) bulbospongiosus 2. Aneurysmal subarachnoid hemorrhage
4) pubovaginalis 3. Basilar Migraine
4. Cluster Headache
2 Pacemaker regulating the rate of respiration
1) Prebotzinger complex 9. A 1.2 Kg child born at 30 weeks thorough
2) Dorsal respiratory nuclei LSCS, presents with moderate respiratory
3) pneumataxic centre difficulty. Which of the following is appropriate
4) Apneustic centre management??
1. Humidified oxygen through hood
3. False about Hemophilus influenzae is- 2. Intubation and Mechanical
1) it needs facor X and V for growth in culture ventilation
media 3. CPAP
2) Capsular polypeptide protein is responsible 4. Surfactant therapy plus
for virulence mechanical ventilation
3) Rarely presents as meningitis in children less
than 2 months of age 10. Clue cells are found in
4) Most common invasive disease is meningitis 1) chlamydia trachomatis
2) trichomonas
3) bacterial vaginosis
4. Which of the following is false?
4) candida
1) food poisoning strains of Cl perfringes
produce heat resistant spores
11. Unilateral disomy of Maternal chromosome
2) it shows positive Naegler's reaction..
15 is associated with
3) most important toxin is hyaluronidase
1. Fragile x syndrome
4) Cl perfringes is the most common cause of
2. Prader villi syndrome
gas gangrene
3. Angelmann syndrome
5. 25 year old laborer 3 year back presented
12. Which is not feature of adrenal adenoma on
with penile ulcer not treated. Later He
CT scan.
presented with neurological symptoms for
1. Low attenuation
which He got treated. Test to monitor response
2. Homogenous density and well defined
in this patient
borders
1. VDRL
3. Enhances rapidly, contrast stay in it relatively
2. Treponema Immobilization test
longer time and wash out later
3. FTA-ABS
4. calcification is rare
4. RPR
13.Most sensitive indicator of DCIS (Ductal
6. Hyperkalemia without ECG changes is
carcinoma in situ)
treated with all except
1. Mammography
1) calcium gluconate
2. Ultrasound
2) resin
3. MRI
3) sodium bicarbonate
4. PET scan
4) insulin with dextrose
14. Which of the following is not major criteria
7. Murmur is accentuated with valsalva
for diagnosis of multiple myeloma.
maneuver in:
1. Lytic bone lesions
1. MS
2. Plasmacytosis greater than 20%
2. AS
3. Plasmacytoma in Biopsy
3. HOCM
4. Monoclonal globulin spike on serum
4. VSD
Melelectrophoresis of > 2.5 Gm/dl for IgG and

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 >1.5 G/dl for IgA 23. Gas used to measure diffusion in lung
a.) CO
15. Which of the following is NOT major Jhon’s b.) NO
criteria for diagnosis of RHD. c.) CO2
1. carditis d.) NO2
2. chorea
3. subcutaneous Nodule 24. wid marks formula
4. High ESR alcohOL.
time since death,
16. In osteomyelitis of long bone,it initially times since injury
involves-
1 -metaphysis 25. 20 year old female with proptosis and 6th
2 -diaphysis nerve palsy. On MRI scan, hyper intense lesion
3 -epiphysis were seen on T2 weighted images which
4 -area supplied by nutrient artery showed intense homogenous contrast
enhancement, most probable diagnosis is.
17. .Pale infarct not seen in? 1. meningioma
a. kidney 2. astrocytoma
b.s pleen 3. Schawanoma
c. heart 4. cavernous hemangioma
d. lung
26. A patient with complaints of
18. Renal stone resistant to ESWL nephrocalcinosis for the past 10 yrs. Which is
1. cystine false about the diet
2. phosphate a.) Protein restriction
3. Ca.Oxalate b.) Calcium restriction
4. Uric acid c.) Sodium restriction
d.) phosphate restriction
19. Which is Vitamin K dependent Clotting
factor? 27 a pt has prosthetic valve and he has
1. Factor VII endocarditis which organism is responsible?
2. Factor I a)s.aureus
3. Factor XI b)s.epedermidis
4. Factor XII c)strep.viridens

20. Rate of newly synthesized osteoid 28. cocks peculiar tumor

mineralizaion can be best estimated by a)basal cell CA
a)tetracyclin labeling b)squamous cell CA
b)alizarin red stain c)sebaceous ulcerated cyst
c)calcein stain
d)von kossa stain 29. Mediators of inflammation are all except
a.) TNF
21. charcots triad ? b.) IFN
A-- pain c.) Prostaglandins
B-- fever d.) myeloperoxidase
C- jaundice
D- palpable gall bladder 30. abnormality to check for if lithium is given to
a pregnant female:
22. Anaesthesia causing adrenal suppression? a.cvs anomaly
etomidate, b.cns anomaly
thiopentone, c.git anomaly
ketamine,
propofol 31. all are supplied by superior gluteal nerve
except

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a:gluteus medius 2. hymenolepsis diminuta
b:gluteus maximus 3. gnathostoma
c:gluteus minimus
d:tensor fascia lata 40. most translucent except
1 -lipoma
32. CORPUS CANCER SYNDROME,all true 2 -meningiocele
except 3 - hydrocele.
1-multiparity 41. Perineural invasions seen in
2-diabetes a.) Adenocarcinoma
3-hypertension b.) Adenoid cystic ca
4-obesity c.) BCC
d.) Sq.CC
33. . malignant pustule....
1. Cutaneous anthrax 42. which of the following is used to treat
ostoporosis in post menopausal women:
34. differentiate maternal & fetal blood cell A. raloxifene
A.KB TEST
b.apt test 43. Hemorrhagic cystitis caused by
A. Cyclophosphamide
35. spores used to test for run of plasma B. MESNA
sterlization:
1. b. subtilis 44. necrotic mass in retroperitonium near left
2. b. stereothermophilus renal hilum
3. b. clostridium tetani a) metastasis from transitional cell epithilium
b) metastasis from liver
36. 25 year old female presents to casuality c) metastasis from grm cell tumour
with chest pain, sweating, restlessness, d) lymphoma
dyspnoea and palpitation. Enzyme analysis
and X-ray are normal. She becomes 45. research on fat levels in a country,data obtd
asymptomatic with supportive treatment. The frm health ministry.type of study is:
probable diagnosis is. a.ecological
1. Angina Pectoris b.cross sectional
2. Panic attack c.psy……?
3. ANS instablility d.case control
4. vaso vagal attack

37. All of the following are true except

A. NADPH oxidase acts via superoxide ions
B. Chediak Higashi syndrome is due to
defective Phagolysosome
C. In brutons agammaglobulinemia
opsonisation is not affected
D. Myeloperoxidase action is mainly due to OCl-
-

38. congenital cause of hypercoagulable states

except
a) protein C deficiency
b) protein S deficiency
c) MTHFR mutation
d) lupus anticoagulant

39. gall bladder

1 chlonorchis

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NEW 8. Frontal Sinus can be best visualised by :
a. Caldwell's view
1. bias can be eliminated by all except- b. Water's view
1. matching c. Towne's view
2. blinding d. Schuller's view
3. randomization
4. multivariate analysis 9. which of the vitamin deficiency lead to lactic
acidosis
2. baciilus cereus piosing true is 1. riboflavin
1. absence of vomiting 2. thiamine
2. absence of diarrhoea 3. niacin
3. Absence of fever 4 panthotheic acid
4. presense of abdominal pain
10. which one of the pair not correct :
3. Hard tick spread all execpt 1. supportive care - acute viral hepatitis B
1 relapsing fever 2. antiviral drugs - chronic viral hepatitis B
2 kfd 3. supportive care - chronic viral hepatitis B
3 turalemia 4. antiviral drugs - acute viral hepatitis B
4 tick paralysi
11. 40 year old man met motor vehicle
4. Intranasal approach for assessing which catastrophe came to hospital in hour an
organ EXCEPT? 1. lacrimal gland hour severe maxillo facial trauma PR 120 /
2. cerebellum min BP - 100 / 70 mm hg spo2 - 80% with
3. pituitary gland oxygen . which was the immediate
4. optic nerve management
1. intravenous acess
5. which develops early --similar to adult type. 2. orotracheal intubation
1 -mastoid 3. naso tracheal intubation
2- ossicles 4. Tracheostomy
3-maxilla
4-parietal bone 12. how much Pottassium is present in the
Ringer Lactate solution?
6 Spanish WINDLASS technique is a form of 1. 1 mEq/L
which type of execution? 2. 4 mEq/L
1. garrotting 3. 2 mEq/L
2. mugging 4. 6 mEq/L
3. bansdola
4. Hanging 13. .Which of the following is not perrmeable
through the Blood Brain Barrier?
7. A woman has consumed several a. Water
tabs of Amitryptiline. All of the following b. Lipophilic drugs
can be used as a part of her c. Gas
management except d. Proteins
a. Sodium bicarbonate to treat acidosis
b. Gastric lavage 14. WHICH IS NON ESSENTIAL
c. Use Atropine as an antidote 1. SODIUM
d. Diazepam for seizure control 2. MANGANESE

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 3. IRON 2. v2-collecting ducts
4. LEAD 3. v3-ant pitutary
15. Which of the following is the least likely 4. v4-cns
cause of Neonatal mortality in India?
a. Prematurity 21. Splenomegaly least with
b. Infection A) cml,
c. Birth Asphyxia B) primary thrombocytosis,
d. Congenital anomalies C) polycythemia ruba vera
D) myelofibrosis
16. In a certain population, there were 4050
births in the last one year. There were 50 22. A patient admitted in the ICU Consuming
still births. 50 infants died within 7 days some poison. He had features of
where another 150 died within 28 days. bronchodilatation, increase in temperature,
What is the Neonatal mortality rate? constipation,tachycardia. The poison
a. 50 consumed is
b. 62.5 a.) mushroom
c. 12.5 b.) atropine
d. 49.4 c.) opc _

17. A 19 year old patient came to the out patient 23. all causeSLE like syndrome except?
department with complaints of Primary 1.inh
Amenorrhea. She had well developed 2.penicillin
breast and pubic hair. However there was 3.hydralazine
abscence of vagina and on USG her uterus 4.sulphonamide
was absent. Likely diagnosis is.
a. XYY 24. A 60 yr old man with c/o progressive
b. Mullerian agenisis dementia for the past 6 months. Suddenly
c. Gonadal dysgenesis he c/o jitteriness of whole body. EEG
d. Kleinfelter's syndrome showed sharp bipolar spikes. Diagnosis is
a.) Alzheimer's
18. Retinitis pigmentosa is a feature of all b.) Creutzfeld Jackob
except . c.) Lewy body dementia
1.NARP d.) progressive multiple encephalopathy
2.abetalipoproteinemia
3.refsum's disease 25. Inclusions in oligodendrogliocytes is a
4. Hallavardian Spatz feature of
a.) Progressive Multifocal Leuco
19. Which of the following is present normally in encephalopathy
the urine of a pregnant women in the third b.) CIDP
trimester? c.) HSV
a. glucose d.) poliomyelitis
b. lactose
c. galactose 26. gallows traction is used in relation to
d. fructose a)shaft femur
b)neck femur
20. which of the pairs is incorrect c)shaft tibia
1. v1-smooth muscles d)tibial tuberosity

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 b.) osteoporosis
27. all can cause candidiasis EXCEPT c.) metastasis
a. DM d) tuberculosis
b. Hypertension
c. Pregnancy 34. tensor tympani is supplied by
d. HIV a)facial
b) glossopharyngeal
28. secondaryhyperparathyroidism ALL c)trigeminal
EXCEPT d)vagus
a) rickets
b) osteomalacia 35. All are true about starting of B-Blocker
c) osteoporosis therapy in a case of heart failure except
d) Renal Failure a. They should be started with optimum
doses
29. Which of the following is associated with b. They should be graually incresed over
poor prognosis in Ewings sarcoma? weeks.
a. B2 microglobulin c. Special precautions should be taken in
b. fever cases of NYHA class III and IV
c. thrombocytosis d. Carvedilol and Metoprolol are the
d. young age preferred drugs.

30. CHILD WITH phocomelia anomaly due to
drug taken by mother....
a) tetracycline
b) thalidomide
31. Cochlear implant which is true
1. Contraindicated in less than 5yrs
2. malformed cochlea is not a
contraindication
3. inserted through oval window
4. indicated in mild to moderate deafness
32. A newborn child presents with inverted foot
and the dorsum of the
foot can not touch the anterior tibia. The
most probable diagnosis
1. Congenital vertical talus
2. Arthrogryposis Multiplex
3. CTEV
4. CEREBRAL PALSY
33. A 35 yr old lady with chronic backache. On
X ray she had a D12 collapse. But
Intervertebral disc space is maintained. All
are possible except
a.) multiple myeloma
36. 20 yr female hirsutism, oligomenorrhea and
normal ovaries on USG- diagnosis
a) idiopathic hirsuitism
b) pcod
c) testestrone secreting tumour
d) adrenal hyperplasia
37. Onion bulb appearence on nerve biopsy
in..?
a.. amyloid neuropathy
b.. diabetic neuropathy..
c.. CIDP
d.. leprosy neutitis
38. placenta previa expectant management
1. page's classification
2. macaffee and Johnson regimen
3. apt
39. grading for abruptio placenta:
1. page's classification
2. macaffee and Johnson regimen
3. Apt
40. not a channelopathy
a) tay sach

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 b) liddle membrane or nonintact skin
c) cystic fibrosis c. semicritical substances. low level
disinfection is enough
41. ) Edema is nephrotic syndrome is due to... d. cardiac catheter is a critical device
a.) Na and water restriction
b.) increased venous pressure 47. A patient met with Road Traffic Accident
c.) hypoalbuminemia and developed knee pain. Dial test was
d. ? positive
1. Medial Collateral Ligament Injury
42. Septum transversum gives rise to all except 2.Medial Meniscal Injury
1. Falciform ligament 3. Lateral Meniscus Tear
2. Ligamentum teres 4. Posterolateral Corner Injury
3. Coronary ligament
4. mesentery/ligament of lesser sac 48. A 9 year old boy with elevated both PT and
ApTT. What is the diagnosis
43. which of the following are true about 1. Defect in extrinsic pathway
Scalaneus anterior muscle: 2. Defect in Intrinsic pathway
a. It is attached to the tubercle of second 3. Platelet function defect
Rib 4. Defect in common pathway
b. It is anterior to the transverse cervical
artery. 49. A G2 female 9 weeks pregnant,had a
c. It is pierced by the Phrenic nerve. previous child with down’s syndrome.she
d. It separates the subclavian vein from the doesn’t want another child with Down’s.you
subclavian artery. will tell her:
a. USG at this stage will confirm presence
44. Respiratory centre depression is caused by or absence
all except b. Chorionic villous biopsy at this stage will
a.) opium confirm presence or absence
b.) strychnine c. triple test /maternal AFP at this stage will
c.) barbiturates confirm presence or absence
d.) gelsemium d. nothing can be done

45. A Bone marrow transplant receipient patient
developed chest infection. ON chest Xray
Tree on Bud appearance . The cause of this
is
a.) kelbsiella
b.) pneumocystis
c.) Tuberculosis
d.) RSV
46. All are true regarding the disinfection
protocol except
a. noncritical devices decontamination is
enuff,
b. semicritical substances are those
which come in contact with the mucous
50. REASSORTMENT PHENOMEN SEEN IN
1. HERPES
2. HEPEDNA
3. ASTRO
4. ROTA
51. pt on ceftriaxone and amikacin,ESBL
klebsiella infection...what will you do next?
1.same antibiotic higher dose
2.change ceftriaxone to ceftazidime
3.start imipenem in place of ceftriaxone
52. All of them develop in the mesentery of
stomach except
a) liver

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 b) spleen 59. Stockers line-
c) kidney A) Pterygium
d) pancreas b) Pinguecula

53. Caisson's disease due to 60. disinfection of sputum is by all execpt

1. Fat embolism 1 autoclaving
2. air embolism 2 boiling
3? 3 cresol
4? 4 cetrimide (or) chlorhexidine

54. Absorbtion of all occur in PCT except:

a. Na
b. Glucose 61. Late onset schizophrenia (except):
c. Hco3- 1. Onset after 45 yrs
d. H+ 2. Onset btwn 25-30 yrs
3. Prognosis is poor
55. Lacrimation decreased in injury to: 4. Olfactory hallucinations are seen
a. greater petrosal nerv e
b. nasociliary nerv.e 62. . Not true about VZ
c. nerve. to stapedius A. Rash on flexor aspect
d. chorda tympani B. Rash of same stage at same time
C. High recurrence 20-30%
56. Not a stimulus for normal respiration? D.
a) stretch
b) J receptor 63. Amoebiasis transmitted by a/e
c) oxygen a. Trans placental transmission
d )pCO2 b. Concrotches
c. Oro rectal route
57. peptide secreted by stomach which controls d. Oro fecal route
d food intake....
1-orexins 64. small pox was eradicated by contributionof
2-cholecystokinin following except
3-insulin like gf 1 a. animal pox cross sensitivity
4-ghrelin b. high efficacy of vaccine
c. subclinical cases are not transmitting the
58. young person with abdominal pain and infections
bilious vomiting repeatedly.The surgeon d. life long immunity
clinches diagnosis on opening the
abdomen.surgical procedure 65. not used in emergency contraceptions ???
followed:Ladd’s band 1. LNG intra uterine system
divided,appendecectomy done.probable 2. oral mifepristone
diagnosis is: 3. oral levonorgesterol
a. repeated caecal volvulus 4. CU T intrauterine device
b. repeated sigmoid volvulus
c. appendicitis 66. All are true about cl.tetani except:
d. malrotation a. soil n intestines of human n animals chief
reservoir
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 b.spread through contaminated wounds
c. more common in winters n dry weather
d. no herd immunity or life long immunity
67. ETEC true is:
a. common cause of diarrhea in children in
developing countries
b. not a cause of traveller’s diarrhea
c. causes invasive disease
d. fomite borne
68. mass chemoprophylaxis not given in:
A. lymphatic filariasis
b. plague
c. scabies
d. vit A administration
69. All are true except
a.) LKM1 - Autoimmune hepatitis
b.) LKM2 - Drug induced
c.) LKM1 - chronic hepatitis B
d.) LKM2 - chronic hepatitis D
70. TURP done if
A. proste volume > gm
b. UTI
C. Hydro uretero nephrosis
71. (A) 70year old having H/O 10yrs difficulty
urinating, poor stream of urine, post voidal
residual vol 400ml, urea 90, creat 3.5, B/L
hydronephrosis, prost enlarged with BPH,
what is your immediate next step?
a) b/l nephrostomy
b) folley catheter
c) search for malignancy
d) TURP
71. (B) ) 70year old having H/O 10yrs difficulty
urinating, poor stream of urine, post voidal
residual vol 400ml, urea 90, creat 3.5, B/L
hydronephrosis, prost enlarged with BPH
most ideal treatment at this time wud be.
a) b/l nephrostomy
b) folley catheter
c) search for malignancy
d) TURP
72. Diabetes diagnosis by a/e
1 FBS
2 RBS
3 D- xylose
4 GTT
73. why is intrapleural pressure negative?
a) alveolar pressure negative
b) surfactant is equally distributed
c) lymphatic drainage
d) ?
74. chemical peeling is done by all except?
1 .trichloroacetic acid
2. phosphoric acid
3. carboxylic acid
4. kojic acid
75. A 35 yr old lady with Normal PT (value ws
given ) and increased aPTT (value nd
reference value ws given), No Bleeding
episode during cholecystectomy. Next
investigation is
a.) Fr.V111 assay
b.) Anti viper venom assay
c.) VWF
d. RISTOCETIN COFACTOR ASSAY
76. Cause of nephrocalcinosis in
granulomatous ds. :-
a) Increased absorption
2) Increased conversion to 1,25 OH
c) dystrophic calcification
d) Mutation in calcium sensing receptor
77. Ramelteon true except:-
a) MT1, MT2 Agonist
b) addiction liability
c) Used for treatment of insomnia
d) Cyp 50 inhibitor
78. Methotrexate resistance occurs by :
a. excess DHFRase
b. deficiency of thymidylate kinase
c. deficiency if thymidylate synthetase
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 d. mutation or amplification of the DHFR
gene 85. Anterograde amnesia cause is ,,,
1 post traumatic
79. all tend to cause hypoxia except? 2 strok
1. Pco2 3 paraplegia
2. Po2 4 spinal trauma
3. altitude
4. hb% 86. Aluminium phosphide poisoning - all true
except
80. what is used in overactive bladder? a. subendocardial infarcts
1. duloxetin b. produces phosphine gas
2. darifinacin c. oesophageal stricture
3. flavoxate d. cyt. A oxidase inhibitor
4. oxybutynin
87. Auto run over a child’s thigh, there is a mark
of the tyre tracks, it is an
81. most dangerous for heart..... A) Contact bruice
1. LDL B) patterned bruise
2. HDL C) Imprint abrasion
3. VLDL
4. CHYLOMICRON 88. Horner syndrome not due to
a) carotid aneurysm
82. what is d appropriate mx for seizures during b) medial medullary syndrome
pregnangy? c) multiple sclerosis
1. mgso4
2. phenytoin 89. Fogarthy catheter is used for
3. diazepam a.) iv parenteral nutrition
4. Lytic cocktail b.) urethral catheter
c.) to empty bladder
83. 8yr old boy wid BP 180/100mmHg, urea 90, d.) to remove blood clots
S.creatinine 5.3, urinalaysis shows 15-20
pus cells, 1-2 RBCs, protein 1+. has no 90. A person is Patient is able to abduct ,
signifiant past history of similar internally rotate and able to take his the
complaints...most likely arm upto the lumbosacral area and the
1. post infective glom nephritis patient is able to put hand on the back but
2.accelertaed hypertension wid acute renal not able to lift off. What is the probable
failure diagnosis ?
3.RPGN 1 long head of biceps tear
4.chr interstitial nephritis wid ...? 2. Tendon of Teres Major tear
obstruction? 3. Tendon of subscapularis tear
4. acromioclavicular junction dislocation
84. True about subendocardial hemorrhage are
all except 91. 20 year old boy had 2 day H/O fever and for
a.) may be seen after head injury those 2 days showing symptoms of talking
b.) involves RV WALL to himself, as observed by the mother
c.) continuous pattern complain of faint hearing of voices,
d.) Flame shaped hemorrhages aggressive behavior, muttering to self, since

11
 2 days and no family H/O any psychiatric 96. Pregnant lady, 37wks, BP- 150/ 100,
illness, what is the diagnosis? albumin++, pelvis adequate, cervix 50%
1. Dementia effaced, station -3, your next step?
2. Acute psychosis a) wait for 10 days
3. Delirium b) induce labour
4. ????? c) Immediate LSCS
d) Antihypertensive regime and Wait for
92. which inhibit oxidative phosphorylation by spontaneous labor
inhibiting transport of ADP inside
mitochondira and ATP out of the 97. A 25 year old male presents with painless
mitochondira? sudden loss of vision, ocular and systemic
a) oligomycin examination is not contributory. What is
b) rotenone probable diagnosis
c) antimycin a 1. Retinal detachment
d) atractyloside 2. Eale’s disease
3. Glaucoma
4. Cataract

93. female present with carcinoma cervix stage 98. young man presenting with
IIIb which of the following would be best lacrimation,diarrhea,sweating,abdominal
management model pain:diagnosis is
A. Werthim’s hysterectomy a. heroin withdrawl
B. Scutula operation b. ocaine withdrawl
C. Chemotherapy c. LSD withdrawl
D. Intracavitatory brachytherapy followed
by teletherapy. 99. Patient on starvation with following values
Na- 140, K-4.7, Cl-112, HCO3-16, pCO232,
94. Which is the SERM? pH-7.34, diagnose?
a) cryptotenone a) Anion gap Met acidosis
b) Raloxifen b) Non Anion gap met acidosis
c)? c) respiratory acidosis
d)? d) metabolic alkalosis

95. A buisness executive who is in the tour

most of the time and take little rest has been
passing fresh blood per rectum for 3-4
ocssions without pain. perabdomen
examinations normal, per rectal examinatins
also normal.........next best investigation
is.......
a) proctoscopy
b) refer to surgeon who can to
sigmoidoscopy
c) barium enema
d) refer to surgeon for colonoscopy

12
 EXPLANATIONS 7. Use Atropine as an antidote
1. randamisation [parikh 6th/P-11.5, Harrison17th/P-289e,
[park 19th/P-68,78] table 35-4]
Randamisaion and sample size donot
minimize biase 8 . Caldwell's view
Matching and blinding reduce biase [PL Dhingara 4th/P-387]

2. presense of abdominal pain 9. Thiamine

[panikar 7th/P-246, 247] [Harper 27th/P-497]
Cooked meat & Veg Cooked and fried
rice from Chinese 10. antiviral drugs - acute viral hepatitis B
restaurant [Harrison17th/P-1946]
Diarrhoea Nausea and Anti viral recommended for
Abdominal pain vomiting
Acute viral Hepatitis C not acute viral
Vomiting rare Diarrohea rare
Special media = MYPA (mannitol egg Hepatitis B
yolk phenol red polymyxin agar)
3. relapsing fever 11. Tracheostomy
[Park 19th/p- ] [Morgan’s anaesthesia4th/ Table 5–7
Q-fever and relapsing fever are spread by mention Mandibular or maxillary
Soft ticks. fracture as Conditions Associated with
Difficult Intubations.
4. cerebellum PL Dhingara4th/ P-291.. mention
[PL Dhingara ENT 4th /P-373] mandibular fracture and maxilla fascial
Advanced Nasal endoscopic technique is injury among indication for tracheotomy
used for
1. Dacryocystorhinostomy 12. 4 mEq/L
2. Pituitary surgery
3. Optic disc decompression 13. Proteins
4. CSF leak repair [Ganong 21st/P-617]
5. Orbital abscess or cellulites Water, O2 and CO2 penetrate BBB easily.
management Lipid soluble steroid hormone also
6. Orbital decompression for grave’s penetrates BBB.
disease Protein and Peptide not penetrate BBB
easily
5. Ossicles Glucose Passive penetration of BBB. Via
[ Amit ashish – may 09/Q10] GluT1 transporter
Tympanic cavity, mastoid antrum,
auditory ossicle and structure of internal 14. LEAD
ear are almost fully developed at birth and
subsequently aftered little. 15. Congenital anomalies
Although mastoid antrum is well [park19th/P-45]
developed at birth, but mastoid air cells Causes of Neonatal motrality in india
are not or minimally developed at birth.  Pre term birth (28%)
 Sever infections (26%)
6. Garroting  Birth Asphyxia (23%)
[parikh 6th/P-3.52]  Congenital malformation (8%)
 Neonatal tetanus (7%)
13
  Diarrhoea (3%) [Harrison17th/P-374/table-60-2]
 Other (7%) Spleenomegaly associated with
 Myelofibrosis
16. 50  Leukemia (AML, ALL, CML, CLL)
 Myelo proliferative disorder
17. Mullerian agenisis (polycythemia vera, essential
thrombocytosis)
18. Hallavardian Spatz [Harrison 17th/P-676]
[IAMS notes and mudit khanna] Essential Thrombocytosis – Phsysical
Causes of Retinitis Pigmentosa examination is generally unremarkable
 Refsum syndrome except occasionally for mild
 Bassen-Karnzweing syndrome spleenomegaly.
(Abetalipoproteinemia)—
autosomal recessive 22. Atropine
 NARP
 Kearns Sayre syndrome 23. Penicillin
 Banadet – Biedl syndrome [Garg 3rd/P-525]
(Laurance moon biedl syndrome) Drug causing SLE like syndrome
 Usher syndrome INH Iodides
Hydralazine Barbiturate
 Freidreich ataxia Sulfonamide Cefalosporine
Phenytoin Methyl dopa
19. Glucose Quinidine Procainamide
[Datta 6th/P-54]
Glycosuria detected in 50% of normal 24. Creutzfeld Jackob
pregnant women. [amit ashish may2009/Q-116]
H/O demensia
20. v4-cns H/O myoclonus in >90% case
[Ganong 21st/P-246,247] EEG- high voltage 1-2Hz sharp wave
Rectptor Site Action complexes, in slow or low voltage
V1A Smooth muscle of Vaso background.
vessel constriction
Brain – area Reduce cardiac
prostama output

Liver Increase 25. Progressive Multifocal Leuco

glycogenesis encephalopathy
V1B = Anterior pituitary Increase ACTH [Harrison17th/P-2635]
V3 Oligodendrocyte have enlarged
V2 Collecting duct Augmented densely staining nuclei that contain viral
Luminal membrane water movement inclusion that formed crystallined array of
of Principal cell by simple JC virus particle
diffusion
thorough water
channel called 26. shaft femur
aquaporine 2
V2 act on aquaporine 2 27. Hypertension
[Panikar 7th/P-616]
21. primary thrombocytosis Candidiasis high risk conditions
 DM
14
  Pregnancy
 Leukemia
 Prolonged immuno suppression
 Immuno deficiency
 Intra cocclear placement of electrode in
28. Osteoporosis
[Harrison17th/P-287/table-47-2]
Causes of Secondary
hyperparathyroidism
 Vitamin D deficiency
 Renal insufficiency
 Drugs (calcium cheater,
Bisphosphonate, Plicamycin,
Phenytoin, Ketoconazole)
 Rhabdoymyolysis
 Acute Pancreatitis
 Osteoblastic metastasis eg Carcinoma
Prostate
29. Fever
[http://www.ncbi.nlm.nih.gov/pubmed/10623
687]
After multivariate analysis, the adverse
independent prognostic factors were male
sex (P <.04), age older than 12 years (P
<.001), fever (P <.0002), anemia (P <.02),
high serum LDH level (P <.0003), axial
location (P <.02), and type of
chemotherapy regimen (P <.0003).
When the multivariate analysis was
restricted to surgically treated patients,
the adverse independent prognostic factors
were poor chemotherapy-induced
necrosis (P <.0001), fever (P <.015),
anemia (P <.02), and high serum LDH
level (P <.025).
CONCLUSION: The prognosis in cases of
nonmetastatic Ewing's sarcoma is
influenced by many different clinical and
hematologic variables, all of which are to be
considered when patients are being
stratified according to the risk of relapse. In
surgically treated patients, the most
important prognostic factor is
chemotherapy-induced necrosis.
30. thalidomide
31. malformed cochlea is not a
contraindication
[PL Dhingara 4th/P-121]
scala tympani is superior to extra cocclear
placement over promontory or round
window.
Indication of Cocclear implant in children
 As early as 12 months
 Bilateral profound hearing loss
 No or minimal benefit from hearing aids
 No medical contra indications
 Willingness and supports of family to
enroll child in post implant training
programme
32. CTEV
[Maheshwary 3rd/P-195]
Normally foot of normal new born child
can be dorsiflexed until dorsum touching
anterior aspect of shin of tibia… good
screening for diagnosis of mild club foot.
33. Tuberculosis
[Maheshwary 3rd/P-175]
Reduced disc space is earliest sign of
TB spine.
34. Trigeminal
[BDC 4th/vol 3/ P-263]
Tensor tympani is supplied by mandibular
branch of trigeminal nerve
Stapedius Is supplied by fascial nerve
35. They should be started with optimum
doses
[Katzung 10th/P-206-207]
 Beta blocker are beneficial if initiated
very cautiously at low dose…………..
even though acute blocking the
supportive effective of catecholamine can
worse the heart failure
 Bisoprolol, carvedilol & Metaprolol
show low mortality in patient with sever
heart failure ---- this effect not seen with
other beta blockers.
15

36. PCOD
[punit bhohani’s smart study O&G/P-243-
244]
Rotterdram 2003 critaria for diagnosis of
PCOS/PCOD- atleast 2 out of 3 should be
present
 Oligo/anouvulation
 Hyperandrogenism- Biochemical
or chemical
 12 or more than 12 follicles 2-9mm
in size present within one or both
ovaries on USG AND OR ovarian
volume > 10ml
 Obesity is not required to make
diagnosis
 FSH/LH = ½ or 1/3 is not essential to
make diagnosis
37. leprosy neutitis
[IAMS NOTES skin/P-15 table]
Borderline leprosy – Onion peel
appearance on nerve biopsy
38. macaffee and Johnson regimen
[punit bhohani’s smart study O&G/P-83]
39. page's classification
[punit bhohani’s smart study O&G/P-80]
40. tay sach
41. hypoalbuminemia
[Harrison 17th/P-234, 233 -table 36-1]
42. Coronary ligament
[Langman’s Medical Embryology P-297-
299]
The lesser omentum and falciform
ligament form from the ventral
mesogastrium,
which itself is derived from mesoderm of the
septum transversum.
When liver cords grow into the septum, it
thins to form (a) the peritoneum of the liver,
(b) the falciform ligament, extending from
the liver to the ventral body wall, and (c) the
lesser omentum, extending from the
stomach and upper duodenum to the liver
(Figs. 13.14 and 13.15). The free margin of
the falciform
ligament contains the umbilical vein (Fig.
13.10A), which is obliterated after birth to
form the round ligament of the liver
(ligamentum teres hepatis). The free
margin of the lesser omentum connecting
the duodenum and liver (hepatoduodenal
ligament) contains the bile duct, portal vein,
and hepatic artery (portal triad). This free
margin also forms the roof of the epiploic
foramen of Winslow, which is the opening
connecting the omental bursa lesser sac)
with the rest of the peritoneal cavity (greater
sac) (Fig. 13.16).
43. It separates the subclavian vein from the
subclavian artery
[Gray student P-921/table 8.15…]
 Insertion of muscle on scalene tubercle on
upper surface of 1st rib.
[BDC/4th/vol 3/ P-198-199]
Anterior Relation Posterior relations
 Phrenic nerve  Subclavian artery
 Subclavian vein  Brachial plexus
 Transverse
cervical artery
 Supra scapular
artery
 Ascending
cervical artery
44. Strychnine
[http://www.health-care-
clinic.org/alternative-
medicines/gelsemium.html]
Toxicology of Gelsemium: All parts of the
plant contain toxic alkaloids that can cause
paralysis and death, and should never be
ingested. Gelsemium alkaloids are highly
toxic. Ingestion of as little as 4 ml of a fluid
extract has been reported to be fatal. Toxic
symptoms include giddiness, weakness,
ptosis, dilated pupils and respiratory
depression. Gelsemicine is more toxic than
gelsemine.
45. Tuberculosis
[http://radiology.rsna.org/content/222/3/771.f
ull]
16
 The tree-in-bud sign has primarily been 48. Defect in common pathway
used as a descriptive term for abnormalities
found on CT scans of the lung in patients 49. Chorionic villous biopsy at this stage will
with endobronchial spread of confirm presence or absence
Mycobacterium tuberculosis
[dahnet radiology] 50. ROTA
TUBERCULOSIS jawetz, microbiology /Table 37–1
"tree-in-bud" appearance = nodular Important Properties of Reoviruses.
opacities along centrilobular artery +  Genetic reassortment occurs readily
bronchiole  Rotaviruses are the major cause of
infantile diarrhea
46. semicritical substances. low level  Reoviruses are good models for molecular
disinfection is enough studies of viral pathogenesis
SPAULDING’S CLASSIFICATION
Classificatio Definition Level of 51. start imipenem in place of ceftriaxone
n processing [Katzung10th/P-739,738]
Critical Equipment/device `Cleaning
Carbapenum (imipanem, meropenem) are
Equipment enter in sterile followed by
/device tissue eg vascular sterilization resistant to beta lactamase but not
system metallo Beta lactamase
Semicritical Equipment/device Cleaning Momobactams (Aztreonam) safe with
Equipment that comes in followed by penicline allergy. And relatively resistant to
/device contact with non High level Beta lactamase
intact skin or disinfection
mucous as minimum
52. kidney
membrane but not sterilization is
penetrate them preferred [Langman’s Medical Embryology P-296]
Non critical Equipment/device Cleaning Figure 13.11 Transverse sections through
Equipment that touches only followed by the region of the stomach, liver, and spleen,
/device intact skin and low level showing formation of the lesser peritoneal
does not mucous disinfections. sac, rotation of the stomach, and position
membrane or In some case of
does not directly cleaning alone the spleen and tail of the pancreas
touch client/ is acceptable between the two leaves of the dorsal
patient/ resident mesogastrium.
With further development, the pancreas
assumes a retroperitoneal position
47. Posterolateral Corner Injury
[http://www.sportsdoc.umn.edu/Clinical_Fol [Langman’s Medical Embryology P- 289]
der/Knee_Folder/Knee_Exam/dialtest%20at Portions of the gut tube and its derivatives
are suspended from the dorsal and
%2090.htm]
ventral body wall by mesenteries, double
After completion of the dial test at 30°, it is layers of peritoneum that enclose
repeated at 90° (if it is found to be positive). an organ and connect it to the body wall.
In an isolated posterolateral knee injury, Such organs are called intraperitoneal,
there sould be a slight decrease in external whereas organs that lie against the
rotation compared to 30°. However if there posterior body wall and are covered
is a concurrent PCL tear, there will be an by peritoneum on their anterior surface only
(e.g., the kidneys) are considered
increase of external rotation at 90°
retroperitoneal
compared to 30°.

17
53. air embolism and upper jejunum are freed of any
[ganong 21st/P-699] bands and remain in the right abdominal
cavity. The colon is freed of adhesions and
54. H+ placed in the right abdomen with the cecum
in the left lower quadrant, usually
55. greater petrosal nerve accompanied by incidental appendectomy.
[BDC 4th/vol3/P-62-63] Extensive intestinal ischemia from
volvulus produces short bowel
56. J receptor syndrome
[Ganong21st/P-686]
J receptor are stimulated by 59. Pterygium
hyperinflation of lung, as well as they
respond intravenous or intra cardiac 60. cetrimide (or) chlorhexidine
administration of chemicals eg capsaicin. [park 19th/P-110]
It produce apnoea followed by rapid Disinfection
breathing, bredycardia and hypotension Sputum Boiling, Autoclave, cresol
(Pumonary Chemoreflex) Feces and Bleaching powder, crude
Physiological role of this reflex is urine phenol, cresol, formalin
uncertain. But probably occur in Cetrimide (cetavlon) and Savlon
pathological state eg Pulmonary (Cetrimide + chlorhexidine)
congestion and embolisation. Active against only gram positive bacteria
not gram negative
57. Ghrelin Savlon for- Plastic appliance eg lippes loop
[Ganong 21st/P-407-408] & clinical thermometer
Main site of Ghrelin synthesis and
secretion is stomach. But it also produced 61. Prognosis is poor
by hypothalamus, and has marked Growth [Niraj Ahuja, short textbook of psychiatry/6th/P-
hormone stimulating property. 64/table-5.6]
In addition it involved in regulation of food Early onset Late onset
intake.  < 20 year age  > 35 year age
 Poor prognosis  Good prognosis
58. Malrotation
62. Rash of same stage at same time
[Kliegman: Nelson Textbook of Pediatrics,
[park19th/P-125/table1]
18th ed………Chapter 327 – Intestinal
Small pox Chicken pox(VZ)
Atresia, Stenosis, and Malrotation]
 Palm and sole  Palm and sole
The majority of patients present in the 1st yr frequently affected rarely affected and
of life with symptoms of acute or chronic and axilla is free axilla frequently
obstruction. Infants often present in the 1st  Extensor aspect  Flexor aspect
wk of life with bilious emesis and acute  One stage of rash  Rash
bowel obstruction. Older infants present at one time pleomorphic-
with episodes of recurrent abdominal pain different stage of
that can mimic colic  No area of rash at given time
inflammation  Area of
Surgical intervention is recommended for
aroung vesicle inflammation
any patient with a significant rotational around vesicle
abnormality, regardless of age. If a volvulus
is present, surgery is done immediately, the 63. Trans placental transmission
volvulus is reduced, and the duodenum [park19th/P-201]
18
 Mode of transmission of amoebiasis
 Faecal-oral route
 Oro –rectal (homosexual)
 Vector eg. Cockroaches & rodent
64. animal pox cross sensitivity
[park 19th/P-123]
Small Pox eradication-basis
 Life long immunity after recovery
 Person with subclinical infection do not
transmit the disease
 Highly effective vaccine
 No known animal reservoir\
 No long term carrier
 International cooperation
 Easy to diagnose case, as occur rash on
visible part of body
65. LNG intra uterine system
[data gynecology/4th/P-452]
Emergency contraception
 Hormone eg. Morning after pill, combined
OC pill, LNG pill,
 IUCD – in 5 days
 Anti progesterone eg Mifepristone –
RU486
66. more common in winters n dry weather
[Park19th/P-261]
 Reservior of infection – soil and intestine
of many animal and man
 Herd immunity is not protective
 Mode of transmission : contaminated
wound
67. common cause of diarrhea in children in
developing countries
[panikar-7th/P-278-279]
ETEC is
 common cause of diarrhea in children in
developing countries
 cause of traveller’s diarrhea
 Do not causes invasive disease
[http://www.drhull.com/EncyMaster/F/fomit
e.html]
A fomite (FOE-mite) is a physical object
that serves to transmit an infectios
agent from person to person. For
example, a comb infested with one or
more head lice would be a fomite.
Likewise, the dust particles containing
infectious cold virus that remain after
droplets of infected saliva are coughed
into the air are fomites.
68. Scabies
69. LKM2 - chronic hepatitis D
[Harrison 17th/P-1968 & 1962]
Anti LKM 1  Auto immune hepatitis
–type 2
 Chronic hepatitis C
Anti LKM 2  Drug induce hepatitis
Anti LKM 3  Hepatitis D
70. .Hydro uretero nephrosis
71. (A) TURP
[Iams Notes/surgery urology/P-2]
Absolute indication for surgery in BPH
 Bladder decompression with outflow
incontinence
 Hydronephrosis
 Azotemia
 Acute retention of urine
 Refractory retention or repeated retention
 Recurrent UTI
 Sever recureent hematuria
“sever symptoms” or “ failure of medical
management by themselves do not
qualify for absolute indications. Similarly
Post voidal residula urine (>40ml is
considered as high PVR) is not absolute
indication.
71. (B) ?? TURP
72. D- xylose
73. Lymphatic drainage
19
 [Guyton 10th/P-450]
Basic cause of negative intrapleural pressure
pressure is pumping of fluid from space by
lymphatics
74. . phosphoric acid
[http://www.medicinenet.com/chemical_peel
/article.htm]
One or more chemical solutions, such as
glycolic acid, trichloroacetic acid,
salicylic acid, lactic acid or carbolic acid
(phenol), are applied to small areas on the
skin. These applications produce a
controlled wound, enabling new,
regenerated skin to appear.
[http://en.wikipedia.org/wiki/Phosphoric_acid
] 78. mutation or amplification of the DHFR
Phosphoric acid may be used as a "rust
converter", by direct application to rusted
iron, steel tools, or surfaces. The
phosphoric acid converts reddish-brown
iron(III) oxide (rust) to black ferric
phosphate, FePO4.
Phosphoric acid is used in dentistry and
orthodontics as an etching solution, to
clean and roughen the surfaces of teeth
where dental appliances or fillings will be
placed
79. Pco2
75. Anti viper venom assay
[Harrison 17th/P-369]
APALA…..Dilute russel viper venum test
and tissue thromboplantine time are
modification of standard test with low
phospholipid reagent…. To increase
sensitivity that interfere with phospholipid
compound
76. Increased conversion to 1,25 OH
[Harrison 17th/P-2387]
Sarcoidosis and other granulomatous
disease. Eg tuberculosis and fungal
infection excess 1,25 (OH)2 D synthesized 80. oxybutynin
in macrophage and other cells in
granuloma.
77. addiction liability
[Katzung 10th/P-350]
 MT1 and MT2 Antagonist (Located around
supra chiasmetic nuclei)
 No effect on GABAargic system
 Use for Insomnia
 No rebound Insomnia/ Withdrawl
symptoms
[http://en.wikipedia.org/wiki/Ramelteon]
Ramelteon is used for insomnia,
particularly delayed sleep onset. Ramelteon
has not been shown to produce
dependence and has shown no potential
for abuse, and the withdrawal and rebound
insomnia that is typical with other GABA
modulators is not present in ramelteon
gene
[Katzung 10th/P-887]
Mechanism of Methotrexate resistance
 Increase drug transport
 Reduced formation of cytotoxic
methotrexate Polyglutamate
 Synthesis of increase level of DHFR
thorough gene amplification
 Altered DHFR with reduced affinity for
methotrexate
[Ganong 21st/687]
Hypoxia – O2 deficiency at tissue level
Hypoxic (Anoxic) Low PO2, Low FiO2 in
arterial blood
Eg High altitude
Anemic Low Hemoblobin, normal
PO2
Stagnant Blood flow impaired, both
(Ischaemic) PO2 and Hb normal
histotoxic Everything normal but
tissue can not utilize
because of toxic agent.
[Bailey and Love/24th/P-1344]
Mainstay of treatment for idiopathic
detrusor overactivity (DO) is
20
 anticholinergic medications eg
Propantheline, Oxybutynin,
tolterodine and amitriptyline
81. LDL
82. mgso4
83. RPGN
[Robbin’s 8th]
In most individuals, chronic
lomerulonephritis develops insidiously and
slowly progresses to renal insufficiency or
death from uremia during a span of years
or possibly decades
Rapidly progressive glomerulonephritis
(RPGN) is a syndrome associated with
severe glomerular injury and does not
denote a specific etiologic form of
glomerulonephritis. It is characterized
clinically by rapid and progressive loss of
renal function associated with severe
oliguria and signs of nephritic syndrome;
if untreated, death from renal failure occurs
within weeks to months
No History of similar complain in past So,
short history with finding of renal failure
favor diagnosis of RPGN.
84. involves RV WALL
[Reddy forensic medicine and
toxicology/24th/P-93]
subendocardial hemorrhage
 seen in the left ventricle
 hemorrhages are flame shaped,
confluent and tend to occur in one
continuous sheath rather than patches
 when bleeding is sever it may give rise to
endocardium into flat blister
They are seen in
 Sudden sever hypotension due to sever
blood loss or shock
 After intracranial damage eg Head injury,
cerebral edema, surgical craniotomy or
tumors
 Death from APH, PPH, ectopic
pregnancy, ruptured uterus
 Various poisoning eg arsenic
85. post traumatic
[http://en.wikipedia.org/wiki/Anterograde_a
mnesia]
This disease is usually acquired in one of
two ways: Either it is drug-induced
(benzodiazepines such as midazolam,
flunitrazepam, temazepam, triazolam, and
nimetazepam are known to have powerful
amnesic effects[1]) or it follows a traumatic
brain injury in which there is usually
damage to the hippocampus or
surrounding cortices. It can also be caused
by shock or an emotional disorder.
86. oesophageal stricture
[Reddy forensic medicine and
toxicology/24th/P445-446]
Aluminium Phosphate
 Each 3 gm of aluminium phosphate
liberate 1 gm of phosphine gas
 Inhibition of cytochrome oxidase
 Can produc shock.. risk factor for sub
endocardical hemorrhage [Reddy
forensic medicine and toxicology/24th/P-
93]
87. Imprint abrasion
[Parikh’s forensic medicine/6th/P-4.3]
Exmaple of Imprint /Pressure/Contact
abrasion
 Tyre mark of Vehicular accident
 Teeth mark biting
 Ligature mark of hanging and
strangulation
 Nail and thumb mark of throttling
88. medial medullary syndrome
[http://en.wikipedia.org/wiki/Horner%27s_syn
drome]
CAUSES OF HORNER’S SYNDROME
 Due to lesion or compression of one
side of the cervical or thoracic
sympathetic chain, which generates
21
 symptoms on the ipsilateral (same side
as lesion) side of the body.
 Lateral medullary syndrome

Cluster headache - combination termed
Horton's headache[
 Trauma - base of neck, usually blunt
trauma, sometimes surgery.
 Middle ear infection
 Tumors - often bronchogenic carcinoma
of the superior fissure (Pancoast tumor)
on apex of lung
 Aortic aneurysm, thoracic
 Neurofibromatosis type 1
 Goitre
 Dissecting aortic aneurysm
 Thyroid carcinoma
 Multiple sclerosis
 Cervical rib traction on stellate ganglion
 Carotid artery dissection
 Klumpke paralysis
 Cavernous sinus thrombosis
 Sympathectomy
 Syringomyelia
 Nerve blocks, such as cervical plexus
block, stellate ganglion or
interscalene block
 As a complication of tube
thoracostomy
89. to remove blood clots
[http://medical-
dictionary.thefreedictionary.com/Fogarty+ca
theter]
Fogarty catheter
A catheter with an inflatable balloon near its
tip; it is used to remove emboli and
thrombi from the cardiovascular system,
and to remove stones from the biliary
ducts.
90. Tendon of subscapularis tear
[http://www.shoulderdoc.co.uk/article.asp?ar
ticle=758]
Lift-Off Test
The lift-off test was originally described
by Gerber and Krushell(199l) and is
sometimes referred to as 'Gerber's
Test'.
Test
The patient is examined in standing and
is asked to place their hand behind Their
back with the dorsum of the hand resting
in the region of the mid- lumbar spine.
The dorsum of the hand is raised off the
back by maintaining or increasing
internal rotation of the humerus and
extension at the shoulder. To perform
this test the patient must have full
passive internal rotation so that it is
physically possible to place the arm in
the desired position and pain cannot be a
limiting factor during the manoeuvre.
Positive
The ability to actively lift the dorsum of
the hand off the back constitutes a
normal lift-off test. Inability to move the
dorsum off the back constitutes an
abnormal lift-off test and indicates
subscapularis rupture or dysfunction.
91. Acute psychosis
[Kaplan & Sadock's Comprehensive
Textbook of Psychiatry, 8th Edition]
DSM-IV-TR Diagnostic Criteria for delirium
Due to a General Medical Condition
A. Disturbance of consciousness (i.e.,
reduced clarity of awareness of the
environment) with reduced ability to focus,
to sustain, or to shift attention.
B. A change in cognition (such as memory
deficit, disorientation, or language
disturbance) or the development of a
perceptual disturbance that is not better
accounted for by a preexisting,
established, or evolving dementia.
C. The disturbance develops over a short
period of time (usually hours to days) and
tends to fluctuate during the course of the
day.
D. There is evidence from the history,
physical examination, or laboratory findings
that the disturbance is caused by the direct
physiological consequences of a general
medical condition.
[Niraj Ahuja/short textbook of
psychiatry/6th/P-91]
22
 Acute and transient Psychotic disorders (GROUP A) wk labour --- NOT
 50% of patient had psychological stressor WISE TO
and 20% of patient had somatic stressor CONTINUE
BEYOND
before onset of illness
EXPECTED
 Onset within 48hour in 50% of case DATE
Partial control Expectant Termination
92. Atractyloside over pre- managemet
[harper 17th/P-107] eclampsic till 34 week
Atractyloside inhibit oxidative feature but
phosphorylation by inhibiting the transport BP Remain
steady high
of ADP into mitochondria and ATP out of
level
mitochondria. (GROUP B)
Persistently Couple counseling and terminate
93. Intracavitatory brachytherapy followed raised BP to the pregnancy ir respective of
by teletherapy.. sever level duration of gestaion
[IAMS/surgery onchology/P-39] despite anti
Management of Ca cervix hypertensive
and/or grave
Stage I and IIa Radical symptoms
Hysterectomy egb
Stage IIb – IVa Chemotherapy + headache,
Radiotherypy oligouria etc
[Datta gynecology/4th/P-327] (GROUP C)
There is as yet, no place of Here the patient fall in group B with > 37
chemotherapy as primary treatment of week gestation… so TERMINATON is
carcinoma cervix. recommended.
As adjuvant it is being used along with
surgery or radiotherapy. 97. Retinal detachment
[khurana ophthalmology/3rd edition/P-252,
94. Raloxifen 265]
[http://emedicine.medscape.com/article/12
95. Proctoscopy 25636-overview]
[Love and bailey/24th/P-1257] Eales disease – bilateral disease
 Internal hmaorroids can not felt by Retinal detachment –age 40-60 year,
digital examinations unless they are but young age is no bar.
thrombosed. Systemic abnormalities have been
 Proctoscopy: - hemorrhoids will buldge reported in association with Eales
into lumen of proctoscope, if present. as disease, mostly neurologic findings.
soon as instrument slowly withdrawned Myelopathy,2,3 ischemic stroke,4
 Sigmoidoscopy: should be performed as hemiplegia,5 and multifocal white matter
precaution in every cse abnormalities have been reported.6,7 A
higher incidence of vestibuloauditory
96. induce labour dysfunction is seen in patients with Eales
[Datta /obs/6th/P-230-231] disease when compared to the general
< 34 wk > 37wk population of the same age. It is
Pre eclampsic Anti Terminate presumed that a similar mechanism of
feature hypertensive pregnancy/ wait vascular occlusion and hypoxia leads to
completely and come for these systemic findings.
subside back after 1 spontaneous
23
 1. her-2 neu assoc with:
98. heroin withdrawl a. predict therapeutic response
b. recurrence
99. Anion gap Met acidosis c .diagnosis
d. screening

predict therapeutic response & recurrence

[http://breastcancer.about.com/od/diagnosis/p
/her2_diagnosis.htm]
HER2 positive breast cancer is diagnosed by
the IHC or FISH test. A result of HER 2
positive is important, as it indicates that the
cancer can be treated with Herceptin, in
combination with other chemotherapy drugs.
If your cancer is diagnosed as HER2 positive,
it is most likely aggressive. Starting
treatment as soon as possible will help
improve your survival, as well as help to
prevent recurrence.

2. imp peripheral blood smear finding of ABO

incompatibility:
a.fragmented RBCs
b. microspherocytes
c. Polychormasia

microspherocytes & Polychormasia

[http://ashimagebank.hematologylibrary.org/cgi
/content/full/2009/0420/9-00040]
Peripheral smear from a newborn with
neonatal alloimmune hemolytic anemia due
to ABO incompatibility is illustrated. Mother
was type O/Rh+, and newborn was type
B/Rh+. The spectrum of RBC abnormalities
in this disorder is shown including numerous
nucleated RBCs (large arrow),
spherocytosis (small arrow), and
polychromtophilic RBCs (double arrow).

3. Baby with nasal flares, grunting but

noretractions. Silverman score will be

24
 Sc Upper Lowe Xipho Nasa Grunt
ore chest r id l
retract chest retrac dilata
ion retrac tion tion
tion
0 synch no no no No
1 Lag Just Just Mini Sthes
on visibl visibl mal cope l
respir e e only
ation
2 See- Mark Mark Mark Naked
saw ed ed ed ear

4. To make a solution of 10% dextrose with

NS sister has to do
a. 20ml 10D with 80ml NS
b. 40 ml 10D with 60ml NS
c. 60 ml 10D in 40ml NS
d. 80 ml 10D in 20ml NS

5. pondreal index of baby of of 2000gm and 50

cm
a)1.6
b)2.2
c)2.6
d)1.0

6. post thoracotomy pain -- best managed by

A-- intercostal cryoanalgesia
B-- oral morphine
C-- brufen
D-- iv fentanyl

25