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AIIMS PAPER MAY 2005 SOLVED QUESTIONS AND ANSWERS

ANATOMY
Q 1. The gastroduodenal artery is derived from: A. Celiac artery B. Hepatic artery C. Splenic artery D. Cystic artery B Meckels diverticulum is a remnant of: A. Stensons duct B. Wolffian duct C. Mullerian duct D. Vitellointestinal duct D Sensory fibers from the taste buds in the hard and soft palate travel along: A. Trigeminal nerve B. Facial nerve C. Glossopharyngeal nerve D. Vagus nerve B The ducts of all the following glands consist of stratified cuboidal epithelium except: A. Sweat glands B. Sebaceous glands C. Salivary glands D. Pancreas B Neuro-epithelium type of sensory receptors are present in the following system except: A. Visual B. Auditory C. Gustatory D. Olfactory D The neck of pancreas is related on its posterior surface to: A. Gastroduodenal artery B. Superior mesenteric vein C. Inferior vena cava D. Bile duct B

Ans. Q 2.

Ans. Q 3.

Ans. Q 4.

Ans. Q 5.

Ans. Q 6.

Ans.

The palatine tonsil receives its arterial supply from all of the following except: A. Facial B. Ascending palatine C. Sphenopalatine D. Dorsal lingual Ans. C Q 8. Compression of a nerve within the carpal tunnel produces inability to: A. Abduct the thumb B. Adduct the thumb C. Flex the distal phalanx of the thumb D. Oppose the thumb Ans. A Q 9. Deep inguinal ring is a deficiency in the: A. Internal oblique muscle B. Transversus abdominis muscle C. Internal spermatic fascia D. Transversalis fascia Ans. D Q 10. Ceruminous glands present in the ear are: A. Modified eccrine glands B. Modified apocrine glands C. Mucous gland D. Modified holocrine glands Ans. B

Q 7.

PHYSIOLOGY
Q 11. In a foetus the insulin secretion begins by: A. 3rd month B. 5th month C. 7th month D. 9th month Ans. A Q 12. Which of the following hormones is an example of a peptide hormone? A. Parathormone B. Adrenaline C. Cortisol D. Thyroxine Ans. A

Q 13. The intrapleural pressure is negative both during inspiration and expiration because: A. Intrapulmonary pressure is always negative B. Thoracic cage and lungs are elastic structures C. Transpulmonary pressure determines the negativity D. Surfacant prevents the lungs to collapse Ans. B Q 14. Synaptic potentials can be recorded by: A. Patch clamp technique B. Voltage clamp technique C. Microelectrode D. EEG Ans. C Q 15. The ECG of a 40-year-old male was recorded using standard bipolar limb leads. The sum of voltages of the three standard leads was found to be 5 millivolts. This indicates: A. A normal heart B. Right ventricular hypertrophy C. Left ventricular hypertrophy D. Increased cardiac muscle mass Ans. A Q 16. The velocity of blood is maximum in the: A. Large veins B. Small veins C. Venules D. Capillaries Ans. A Q 17. Which of the following methods is not used for measurement of body fluid volumes? A. Antipyrine for total body water B. Inulin for extracellular fluid C. Evens blue for plasma volume D. 125I-albumin for blood volume Ans. D Q 18. Group A nerve fibers are most susceptible to: A. Pressure B. Hypoxia C. Local anaesthetics D. Temperature Ans. A

Q 19. Phantom limb sensations are best described by: A. Weber Fechner law B. Power law C. Bell-Magendie law D. Law of projection Ans. D Q 20. The following statements are true regarding the SA node except: A. Is located at the right border of the ascending aorta B. It contains specialized nodal cardiac muscle C. It is supplied by the atrial branches of the right coronary artery D. It initiates cardiac conduction Ans. A

BIOCHEMISTRY
Q 21. The molecule, which is the initiator of cataract formation in the eye lens and whose 1-phosphate derivative is responsible for liver failure, is: A. Sorbitol B. Mannitol C. Inositol D. Galactitol Ans. D Q 22. Membrane fluidity is increased by: A. Stearic acid B. Palmitic acid C. Cholesterol D. Linoleic acid Ans. C Q 23. Which one of the following is not a transport or binding protein? A. Erythropoietin B. Ceruloplasmin C. Lactoferrin D. Transferrin Ans. A Q 24. All of the following enzymes are active within a cell except: A. Trypsin B. Fumerase C. Hexokinase D. Alcohol dehydrogenase Ans. A

Q 25. Which of the following conditions leads to tissue hypoxia without alteration of oxygen content of blood? A. CO poisoning B. Met Hb C. Cyanide poisoning D. Respiratory acidosis Ans. C

MICROBIOLOGY
Q 26. Autoimmunity can be caused due to all of the following except: A. The presence of forbidden clones B. Expression of cryptic antigens C. Negative selection of T-cells in the thymus D. Inappropriate expression of the MHC proteins Ans. C Q 27. In reference of mycoplasmas, the following are true except: A. They are inhibited by penicillins B. They can reproduce in cell free media C. They have an affinity for mammalian cell membranes D. They can pass through filters of 450 nm pore size Ans. A Q 28. A 30-year-old patient presented with features of acute meningoencephalitis in the casualty. His CSF on wet mount microscopy reveald motile unicellular micro-organisms. The most likely organism is: A. Naegleria fowleri B. Acanthamoeba castellani C. Entamoeba histolytica D. Trypanosoma cruzi Ans. A Q 29. The following methods of diagnosis utilize labelled antibodies except: A. ELISA (Enzyme linked immunosorbent assay) B. Haemagglutination inhibition test C. Radio immunoassay D. Immunofluorescence Ans. B Q 30. A 3-week-old child presented to the pediatrician with meningitis. A presumptive diagnosis of late onset of a perinatal infection was made. The CSF culture was positive for gram positive bacilli. Which of the following characteristic of this bacteria would be helpful in differentiating it from other bacteria agents: A. Ability to grow on blood agar B. Ability to produce catalase 6

C. Fermentative attack on sugars D. Motility at 25C Ans. D Q 31. Reduvid bug is a vector for the transmission of: A. Relapsing fever B. Lymes disease C. Scrub typhus D. Chagas disease Ans. D Q 32. All of the following are a part of the innate immunity except: A. Complement B. NK cells C. Macrophages D. T cells Ans. D Q 33. The following statements are true regarding Chlamydia except: A. Erythromycin is effective for therapy of Chlamydial infections B. Their cell wall lacks a peptidoglycan layer C. They can grow in cell free culture media D. They are obligate intracellular bacteria Ans. C Q 34. The following is the etiological agent of Rocky mountain spotted fever: A. Rickettsia rickettsii B. Rochalimaea quintana C. Rickettsia tsutsugamushi D. Coxiella burnetii Ans. A Q 35. Intraspecies competition is the competition among: A. Species B. Individuals of a population C. Individuals of a community D. Populations and their regulatory factors Ans. B Q 36. Recurrent facial/oropharyngeal/laryngeal edema in a patient has low C4, normal C3 and normal factor B. The pathogenesis is most likely due to: A. Immune complex disease B. C1 esterase inhibitors deficiency C. Hereditary deficiency of C2 D. Classical pathway activation by IgM Ans. B

Q 37. The hypersensitivity reaction involved in the hyper acute rejection of renal transplant is: A. Type I B. Type II C. Type III D. Type IV Ans. C Q 38. Cell type which lacks HLA antigen is: A. Monocyte B. Thrombocytes C. Neutrophil D. Red blood cell Ans. D

PATHOLOGY
Q 39. All of the following arteries are common sites of occlusion by a thrombus except: A. Anterior interventricular B. Posterior interventricular C. Circumflex D. Marginal Ans. D Q 40. The tissue of origin of the Kaposis sarcoma is: A. Lymphoid B. Vascular C. Neural D. Muscular Ans. B Q 41. All of the following are mediators of inflammation except: A. Tumor necrosis factor- (TNF- ) B. Interleukin-1 C. Myeloperoxidase D. Prostaglandins Ans. C Q 42. For which one of the following tumors gastrin is a biochemical marker: A. Medullary carcinoma of thyroid B. Pancreatic neuroendocrine tumor C. Pheochromocytoma D. Gastrointestinal stromal tumor Ans. B

Q 43. Which of the following is known as the guardian of the genome? A. p53 B. Mdm2 C. p14 D. ATM Ans. A Q 44. Chemotherapeutic drugs can cause: A. Only necrosis B. Only apoptosis C. Both necrosis and apoptosis D. Anoikis Ans. C

PHARMACOLOGY
Q 45. Which one of the following statement is not true about NSAIDs? A. Acetyl salicylic acid is an irreversible inhibitor of COX enzyme B. Salicylic acid reduces in vivo syntehsis of prostaglandins C. Duration of action of aspirin is primarily related to the pharmacokinetic clearance of the drug from the body D. Antiplatelet effect of low-dose aspirin is related to presystemic COX inhibition Ans. C Q 46. Resistance to zidovudine develops due to: A. Mutations at reverse transcriptase B. Increased efflux of the drug from inside the cell C. Increased metabolism of the drug D. Decreased zidovudine 5 triphosphate formation Ans. A Q 47. Which one of the following is not an alpha-adrenoceptor agonist? A. Clonidine B. Methyldopa C. Guanabenz D. Guanfacine Ans. B Q 48. All of the following are the indications for use of ACE inhibitors, except: A. Hypertension B. Myocardial infarction C. Left ventricular dysfunction D. Pheochromocytoma Ans. D

FORENSIC MEDICINE
Q 49. The ideal place to record temperature in dead body is from: A. Axilla B. Groin C. Rectum D. Mouth Ans. C Q 50. Diffusion of oxygen at the tissue level is affected in all the following poisonings except: A. Carbon monoxide B. Curare C. Phosgene D. Cyanides Ans. B Q 51. Postmortem caloricity may be seen in all the following causes of death except: A. Septicemia B. Barbiturate poisoning C. Strychnine poisoning D. Tetanus Ans. B Q 52. When a group of muscles of a dead body were in state of strong contraction immediately prior to death and remain so even after death, the condition is termed as: A. Gas stiffening B. Rigor mortis C. Cadaveric spasm D. Cold stiffening Ans. C Q 53. Patterned abrasion is variety of: A. Linear abrasion B. Pressure abrasion C. Sliding abrasion D. Superficial bruise Ans. B

PREVENTIVE AND SOCIAL MEDICINE


Q 54. The most common cancer, affecting both males and females of the world, is: A. Cancer of the pancreas B. Buccal mucosa cancer C. Lung cancer 10

D. Colo-rectal cencer Ans. C Q 55. Which one of the following statements regarding pre- post clinical trial is most appropriate? A. They cannot be randomized B. They are useful studies involving mortality C. They use the patient as his or her own control D. They are usually easier to interpret than the comparable parallel clinical trial Ans. C Q 56. Mean and standard deviation can be worked out only if data is on: A. Interval/Ratio scale B. Dichotomous scale C. Nominal scale D. Ordinal scale Ans. A Q 57. For a negatively skewed data mean will be: A. Less than median B. More than median C. Equal to median D. One Ans. A Q 58. Which of the following is the national level system that provides annual national as well as state level reliable estimates of fertility and mortality? A. Civil registration system B. Census C. Adhoc survey D. Sample registration system Ans. D Q 59. National Family Health Survey has successfully completed: A. One round B. Two round C. Three round D. Four round Ans. B Q 60. The following is true about prevalence and incidence: A. Both are rates B. Prevalence is a rate but incidence is not C. Incidence is a rate but prevalence is not D. Both are not rates Ans. C

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Q 61. The age and sex structure of a population may be described by a: A. Life table B. Correlation coefficient C. Population pyramid D. Bar chart Ans. C Q 62. The rate adjusted to allow for age distribution of the population is: A. Perinatal mortality rate B. Crude mortality rate C. Fertility rate D. Age-standardized mortality rate Ans. D Q 63. A one day census of in patients in a mental hospital could: A. Give good information about the patients in that hospital at that time B. Give reliable estimates of seasonal factors in admissions C. Enable us to draw conclusions about the mental hospitals of India D. Enable us to estimate the distribution of different diagnosis in mental illness in the local area Ans. A Q 64. If the prevalence is very low as compared to the incidence for a disease, it implies: A. Disease is very fatal and/or easily curable B. Disease is non-fatal C. Calculation of prevalence and incidence is wrong D. Nothing can be said, as they are independent Ans. A Q 65. After applying a statistical test, an investigator gets the p value as 0.01. It means that: A. The probability of finding a significant difference is 1% B. The probability of declaring a significant difference, when there is truly no difference, is 1% C. The difference is not significant 1% times and significant 99% times D. The power of the test used is 99% Ans. B Q 66. A bacterium can divide every 20 minutes. Beginning with a single individual, how many bacteria will be there in the population if there is exponential growth for 3 hours? A. 18 B. 440 C. 512 D. 1024

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Ans. C Q 67. The carrying capacity of any given population is determined by its: A. Population growth rate B. Birth rate C. Death rate D. Limiting resource Ans. D Q 68. Which of the following is characteristic of a single exposure common vehicle outbreak? A. Frequent secondary cases B. Severity increases with increasing age C. Explosive D. Cases occur continuously beyond the longest incubation period Ans. C Q 69. Which of the following is the drug of choice for chemoprophylaxis of cholera? A. Tetracycline B. Doxyclycline C. Furazolidone D. Co-trimoxazole Ans. A Q 70. Which of the following statements is true about BCG vaccination: A. Distilled water is used as diluent for BCG vaccine B. The site for injection should be cleaned thoroughly with spirit C. Mantoux test becomes positive after 48 hours of vaccination D. WHO recommends Danish 1331 strain for vaccine production Ans. D Q 71. The most common cause of maternal mortality in India is: A. Toxaemias B. Puerperal sepsis C. Hemorrhage D. Abortion Ans. C Q 72. Which one of the following pulses has the highest content of iron? A. Bengal gram B. Black gram C. Red gram D. Soya bean Ans. D Q 73. Human development index is measured by all except: A. Under five mortality 13

B. Life expectancy at birth C. Literacy D. Per capita income Ans. A

MEDICINE
Q 74. Which of the following is the drug of choice for syndrome of inappropriate secretion of antidiuretic hormone (SIADH)? A. Demeclocycline B. Vasopressin C. Thiazide diuretic D. Chlorpropamide Ans. A Q 75. The most common side-effect of chemotherapy administration is: A. Nausea B. Alopecia C. Myelosuppression D. Renal distinction Ans. A Q 76. Which of the following has a normal level of alpha fetoprotein value is serum? A. Ovarian dysgerminoma B. Hepatoblastoma C. Embryonal carcinoma D. Yolk sac tumors Ans. A Q 77. Chronic adrenal insufficiency is characterized by all of the following except: A. Excess pigmentation B. Asthenia C. Weight gain D. Hypoglycemic episodes Ans. C Q 78. All of the following conditions are observed in gout, except: A. Uric acid nephrolithiasis B. Deficiency of enzyme xanthine oxidase C. Increase in serum urate concentration D. Renal disease involving interstitial tissues Ans. B Q 79. The most common site of intestinal obstruction in gallstone ileus is: A. Duodenum B. Jejunum

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C. Ileum D. Sigmoid colon Ans. C Q 80. Carcinoid syndrome produces valvular disease primarily involving: A. Pulmonary valves B. Tricuspid valves C. Mitral valve D. Aortic valve Ans. B Q 81. Nelsons syndrome is most likely seen after: A. Hypophysectomy B. Adrenalectomy C. Thyroidectomy D. Orchidectomy Ans. B Q 82. Which one of the following is the earliest manifestation of Cushings syndrome? A. Loss of diurnal variation B. Increased ACTH C. Increased plasma cortisol D. Increased urinary metabolites of cortisol Ans. A Q 83. Multiple submucosal neuromas is most likely associated with: A. Medullary carcinoma of the thyroid B. Ovarian carcinoma C. Testicular teratoma D. Pancreatic beta cell carcinoma Ans. A Q 84. Which of the following does not occur in a patient with gastrinoma? A. Epigastric pain B. Diarrhoea C. Basal acid output (BAO) less than 15 mEq/litre D. Serum gastrin levels > 200 pg/ml Ans. C Q 85. The most appropriate drug for the treatment of bulimia nervosa is: A. Amitriptyline B. Lithium C. Fluoxetine D. Sertraline Ans. C

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Q 86. D-dimer is the most sensitive diagnostic test for: A. Pulmonary embolism B. Acute pulmonary oedema C. Cardiac tamponade D. Acute myocardial infarction Ans. A Q 87. Which of the following drugs can be safely prescribed in pregnancy? A. Warfarin B. ACE inhibitors C. Heparin D. Beta-blockers Ans. C Q 88. The best possible intervention for acute myocardial infarction is: A. Streptokinase B. Streptokinase and aspirin C. Early primary coronary intervention D. Streptokinase and heparin Ans. C Q 89. Which of the following lymphomas is associated with HTLV-I virus infection? A. Burkitts lymphoma B. B-cell lymphoma C. Adult T-cell leukemia and lymphoma D. Hodgkins disease Ans. C Q 90. Which one of the following is not a feature of multiple myeloma? A. Hypercalcemia B. Anemia C. Hyperviscosity D. Elevated alkaline phosphatase Ans. D Q 91. Which of the following antiretroviral drugs is a non-nucleoside reverse transcriptase inhibitor? A. Zidovudine B. Efavirenz C. Saquinavir D. Stavudine Ans. B Q 92. Which one of the following diseases is an autosomal dominant disorder? A. Hemochromatosis B. Phenylketonuria 16

C. Maturity onset diabetes of the young D. Glucose-6-phosphate dehydrogenase deficiency Ans. C Q 93. All of the following are causes of microvesicular fatty liver except: A. Reyes syndrome B. Obesity C. Acute fatty liver of pregnancy D. Valprpoc acid Ans. B Q 94. Which of the following is not a precipitating factor for hepatic encephalopahy in patirnts with chronic liver disease? A. Hypokalemia B. Hyponatremia C. Hypoxia D. Metabolic acidosis Ans. D Q 95. Alpha-fetoprotein in maternal serum and/or amniotic fluid is increased in all except: A. Fetal neural tube defects B. Downs syndrome C. Anencephaly D. Encephalocele Ans. B Q 96. A 10-year-old school girl has recurrent episodes of boils on the scalp. The boils subside with antibiotic therapy but recur after some time. The most likely cause of the recurrences is: A. Primary immunodeficiency syndrome B. Juvenile diabetes mellitus C. Pediculosis capitis D. HIV infection Ans. C Q 97. A 25-year-old male had pigmented macules over the palm, sole and oral mucosa. He also had anemia and pain in abdomen. The most probable diagnosis is: A. Albrights syndrome B. Cushings syndrome C. Peutz-Jeghers syndrome D. Incontinentia pigmenti Ans. C Q 98. Which one of the following is the treatment of choice for Kawasakis diseases? A. Cyclosporine 17

B. Dapsone C. Intravenous immunoglobulin D. Methotrexate Ans. C Q 99. Migratory necrolytic erythemia is seen in: A. Glucaganoma syndrome B. Peutz-Jeghers syndrome C. Sarcoidosis D. Amyloidosis Ans. A Q 100. Which one of the following is the treatment of choice for dermatitis herpetiformis? A. Corticosteroids B. Dapsone C. Methotrexate D. Retinoids Ans. B Q 101. All of the following are features of absence seizures except: A. Usually seen in childhood B. 3-Hz spike wave in EEG C. Postictal confusion D. Precipitation by hyperventilation Ans. C Q 102. A continous murmur is heard in all of the following conditions except: A. Ventricular septal defect with aortic regurgitation B. Patent ductus arteriosus C. Coronary arteriovenous fistula D. Venous hum Ans. A Q 103. Infliximab is directed against: A. Tumor necrosis factor- (TNF- ) B. Interleukin-1 (IL-1) C. Interleukin-12 (IL-12) D. Intercellular adhesion molecule (ICAM) Ans. A Q 104. All of the following statements about HRT (hormone replacement therapy) are true except: A. It increases the risk of coronary artery disease B. It increases bone mineral density C. It increases the risk of breast cancer D. It increases the risk of endometrial cancer 18

Ans. A Q 105. In which of the following arthritis erosions are not seen: A. Rheumatoid arthritis B. Systemic lupus erythematosus (SLE) C. Psoriasis D. Gout Ans. B Q 106. Flapping tremors are seen in the following conditions except: A. Uremic encephalopathy B. Parkinsonism C. Hepatic encephalopathy D. Carbon dioxide narcosis Ans. B Q 107. Which one of the following is not feature of irritable bowel syndrome? A. Abdominal pain B. Constipation C. Rectal bleeding D. Bloating Ans. C Q 108. In which of the following conditions of malabsorption, an intestinal biopsy is diagnostic? A. Celiac disease B. Tropical sprue C. Whipples disease D. Lactose intolerance Ans. C Q 109. At what value of one hour glucose challenge test will you recommend a standard glucose tolerance test? A. 120 mg/dl B. 140 mg/dl C. 150 mg/dl D. 160 mg/dl Ans. B Q 110. All of the following are calcium channelopathies, except: A. Episodic ataxia-1 B. Spinocerebellar ataxia-6 C. Familial hemiplegic migraine D. Hypokalemic periodic paralysis Ans. A Q 111. All of the following herediatry conditions predispose to CNS tumors, except: A. Neurofibromatosis 1 & 2 19

B. Tuberous sclerosis C. Von-Hippel-Lindau syndrome D. Xeroderma pigmentosum Ans. D Q 112. Which one of the following is not a non-metastatic complication of malignancies? A. Cushings syndrome B. Cerebral cortical degeneration C. Cerebellar degeneration D. Polymyositis Ans. B Q 113. Complications of lobar pneumonia do not include: A. Lung abscess B. Amyloidosis C. Suppurative arthritis D. Infective endocarditis Ans. B Q 114. Hemolytic anemia may be characterized by all of the following except: A. Hyperbilirubinemia B. Reticulocytosis C. Hemoglobinuria D. Increased plasma haptoglobin level Ans. D Q 115. Which of the following is the most common type of pituitary adenoma? A. Thyrotropinoma B. Gonadotropinoma C. Prolactinoma D. Corticotropinoma Ans. C Q 116. Lung to lung metastasis is seen in: A. Adenocarcinoma of lung B. Squamous cell carcinoma of lung C. Small cell carcinoma D. Neuroendocrine tumor of lung Ans. A Q 117. Which is the most common site of metastatic disease? A. Lung B. Bone C. Liver D. Brain Ans. A 20

Q 118. WHO ladder is for the rational titration of: A. Oral analgesia B. Chemotherapy C. Radiotherapy D. Antidepressants Ans. A

PEDIATRICS
Q 119. The following cardiac defects are characterized by ductus dependent blood flow except: A. Transposition of great arteries with intact septum B. Interrupted aortic arch C. Truncus arteriosus D. Hypoplastic left heart syndrome Ans. C Q 120. Which of the following syndromes is best associated with congenital heart disease? A. Lesch-Nyhan syndrome B. Rasmussen syndrome C. Holt-Oram syndrome D. LEOPARD syndrome Ans. C Q 121. Which of the following would be the plasma osmolality of a child with plasma Na+ 125 mEq/l, glucose of 108 mg/dl, and blood urea nitrogen (BUN) of 140 mg/dl? A. 300 mOsm/kg B. 306 mOsm/kg C. 312 mOsm/kg D. 318 mOsm/kg Ans. B Q 122. Epiglottitis in a 2-year-old child occurs most commonly due to infection with: A. Influenza virus B. Staphylococcus aureus C. Hemophilus influenzae D. Respiratory syncytial virus Ans. B Q 123. Which one of the following is the leading cause of mortality in under five children in developing countries? A. Malaria B. Acute lower respiratory tract infections C. Hepatitis 21

D. Prematurity Ans. B Q 124. Dengue shock syndrome is characterized by the following except: A. Hepatomegaly B. Pleural effusion C. Thrombocytopenia D. Decreased hemoglobin Ans. D Q 125. Characteristic radiological feature of transient tachypnoea of newborn is: A. Reticulogranular apearance B. Low volume lungs C. Prominent horizontal fissure D. Air bronchogram Ans. C Q 126. Which mechanism in phototherapy is chiefly responsible for reduction in serum biliruibin? A. Photo-oxidation B. Photo-isomerization C. Structural isomerization D. Conjugation Ans. C Q 127. Which of the following is the most common inherited malignancy? A. Infant leukemia B. Retinoblastoma C. Wilms tumor D. Neuroblastoma Ans. B Q 128. Which of the following is true of mumps? A. Salivary gland involvement is limited to the parotids B. The patient is not infectious prior to clinical parotid enlargement C. Meningoencephalitis can precede parotitis D. Mumps orchitis frequently leads to infertility Ans. C Q 129. All of the following are true regarding tetralogy of Fallot except: A. Ejection systolic murmur in second intercostal space B. Single second heart sound C. Predominantly left to right shunt D. Normal jugular venous pressure Ans. C

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Q 130. Deficiency of enzyme -keto acid decarboxylase leading to a block in the metabolism of branch chain amino acids is observed in: A. Maple syrup urine disease B. Hartnup disease C. Alkaptonuria D. Phenylketonuria Ans. A Q 131. When does switch-over from fetal to adult hemoglobin synthesis begin? A. 14 weeks gestation B. 30 weeks gestation C. 36 weeks gestation D. 7-10 days postnatal Ans. A Q 132. All of the following conditions are oberved in marasmus, except: A. Hepatomegaly B. Muscle wasting C. Low insulin levels D. Extreme weakness Ans. A

DERMATOLOGY
Q 133. A 6-month-old infant presented with multiple papules and exudative lesions on the face, scalp, trunk and few vesicles on the palms and soles for 2 weeks. His mother had history of itchy lesions. The most likely diagnosis is: A. Scabies B. Infantile eczema C. Infantile seborrhoeic dermatitis D. Impetigo contagiosa Ans. A Q 134. A 27-year-old male had burning micturition and urethral discharge. After 4 weeks he developed joint pains involving both the knees and ankles, redness of the eye and skin lesion. The most probable clinical diagnosis is: A. Psoriasis vulgaris B. Reiters syndrome C. Behcets syndrome D. Sarcoidosis Ans. B Q 135. Pinch purpura is diagnostic of: A. Primary systemic amyloidosis B. Secondary systemic amyloidosis C. Idiopathic thrombocytopenic purpura

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D. Drug induced purpura Ans. A

PSYCHIATRY
Q 136. Exercise is also prescribed as an adjuvant treatment for depression. Most probably it acts by: A. Increasing pulse pressure B. Improving hemodynamics C. Raising endorphin levels D. Inducing good sleep Ans. C Q 137. A 16-years-old male is found to have a mental age of 9 years on IQ testing. He has: A. Mild mental retardation B. Moderate mental retardation C. Severe mental retardation D. Profound mental retardation Ans. A Q 138. A 50-year-old male present with a 3-year history of irritability, low mood, lack of interest in surroundings and general dissatisfaction with everything. There is no significant disruption in his sleep or appetite. He is likely to be suffering from: A. Major depression B. Non psychiatric disorder C. Dysthymia D. Chronic fatigue syndrome Ans. C Q 139. A 25-year-old woman complains of intense depressed mood for 6 months with inability to enjoy previously pleasurable activities. This symptom is known as: A. Anhedonia B. Avolition C. Apathy D. Amotivation Ans. A Q 140. Which of the following is an alternative to methadone for maintenance treatment of opiate dependence? A. Diazepam B. Chlordiazepoxide C. Buprenorphine D. Dextropropoxyphene Ans. C 24

Q 141. All are adulterants of heroin, except: A. Chalk powder B. Quinine C. Charcoal D. Fructose Ans. C Q 142. Which of the following is not an opioid peptide? A. -Endorphin B. Epinephrine C. Leu5-enkephalins D. Met5-enkephalin Ans. B

SURGERY
Q 143. A Warthins tumour is: A. An adenolymphoma of parotid gland B. A pleomorphic adenoma of the parotid C. A carcinoma of the parotid D. A carcinoma of submandibular salivary gland Ans. A Q 144. Which of the following statements best represents Ludwigs angina? A. A type of coronary artery spasm B. An infection of the cellular tissues around submandibular salivary gland C. Oesophageal spasm D. Retropharyngeal infection Ans. B Q 145. Which of the following best represents ranula? A. A type of epulis B. A thyroglossal cyst C. Cystic swelling in the floor of mouth D. Forked uvula Ans. C Q 146. Complications of total thyroidectomy include all except: A. Hoarseness B. Airway obstruction C. Hemorrhage D. Hypercalcemia Ans. D Q 147. Treatment of choice for medullary carcinoma of thyroid is: A. Total thyroidectomy B. Partial thyroidectomy 25

C. I131 ablation D. Hemithyroidectomy Ans. A Q 148. Thoracic extension of cervical goiter is usually approached through: A. Neck B. Chest C. Combined cervico-thoracic route D. Thoracoscopic Ans. A Q 149. Which of the following is not an indication for cholecystectomy? A. 70-year-old male with symptomatic gallstones B. 20-year-old male with sickle cell anemia and symptomatic gallstones C. 65-year-old female with a large gallbladder polyp D. 55-year-old with an asymptomatic gallstone Ans. D Q 150. The initial investigation of choice for a post cholecystectomy biliary stricture is: A. Ultrasound scan of the abdomen B. Endoscopic cholangiography C. Computed tomography D. Magnetic resonance cholangiography Ans. D Q 151. The treatment of choice for an 8 mm retained common bile duct (CBD) stone is: A. Laparoscopic CBD exploration B. Percutaneous stone extraction C. Endoscopic stone extraction D. Extracorporeal shock wave lithotripsy Ans. C Q 152. The most common cause of morbidity and mortality in patients undergoing major vascular surgery is: A. Renal complications B. Thromboembolic phenomenon C. Coagulopathies D. Cardiac complications Ans. D Q 153. All of the following clinicopathologic features are seen more often in seminomas as compared to non-seminomatous germ cell tumors of the testis except: A. Tumors remain localized to testis for a long time B. They are radiosensitive

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C. They metastasize predominantly by lymphatics D. They are often associated with raised levels of serum AFP and HCG Ans. D Q 154. The direction of flow of venous blood in conditions of valve incompetence affecting perforating veins of lower limb is: A. Along gravity B. Superficial to deep C. Along osmotic gradient D. Deep to superficial Ans. D

ORTHOPAEDICS
Q 155. De Quervains disease classically affects the: A. Flexor pollicis longus and brevis B. Extensor carpi radialis and extensor pollicis longus C. Abductor pollicis longus and brevis D. Extensor pollicis brevis and abductor pollicis longus Ans. D Q 156. In trigger finger the level of tendon sheath constriction is found at the level of: A. Middle phalanx B. Proximal interphalangeal joint C. Proximal phalanx D. Metacarpo-phalangeal joint Ans. D Q 157. What is pathognomonic feature of rheumatoid arthritis? A. Rheumatoid factor B. Rheumatoid nodule C. Morning stiffness D. Ulnar drift of fingers Ans. B Q 158. Which one of the following bone tumors typically affects the epiphysis of a long bone? A. Osteosarcoma B. Ewings sarcoma C. Chodroblastoma D. Chondromyxoid fibroma Ans. C

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ANAESTHESIA
Q 159. What is the most acute effect of smoking cessation? A. Shift of oxyhemoglobin curve to the right B. Increased ciliary function C. Decreased mucous production D. Decreased incidence of post operative pneumonia Ans. A Q 160. There is mutation of gene coding for the ryanodine receptors in malignant hyperthermia. Which of the following statements best explains the increased heat production in malignant hyperthemia? A. Increased muscle metabolism by excess of calcium ions B. Thermic effect of food C. Increased sympathetic discharge D. Mitochondrial thermogenesis Ans. A Q 161. A patient was administered epidural anaesthesia with 15 ml of 1.5% lignocaine with adrenaline for hernia surgery. He developed hypotension and respiratory depression within 3 minutes after administration of block. The most common cause would be: A. Allergy to drug administered B. Systemic toxicity to drug administered C. Patient got vasovagal shock D. Drug has entered the subarachnoid space Ans. D Q 162. The drug which is not suitable for patients with acute porphyria for intravenous induction is: A. Thiopentone sodium B. Propofol C. Midazolam D. Etomidate Ans. A Q 163. Which one of the following device provides fixed performance oxygen therapy: A. Nasal cannula B. Ventimask C. O2 by T-piece D. Edinburgh mask Ans. B Q 164. All of the following drugs are recommended for treatment of beta blocker induced excessive bradycardia and/or decrease in cardiac output, except: A. Dopamine

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B. Doubtamine C. Glucagon D. Calcium chloride Ans. B Q 165. The physiologic dead space is decreased by: A. Upright position B. Positive pressure ventilation C. Neck flexion D. Emphysema Ans. C Q 166. Which one of the following local anaesthetics is highly cardio-toxic: A. Lignocaine B. Procaine C. Mepivacaine D. Bupivacaine Ans. D Q 167. Sodium nitroprusside infusion may result in: A. Hypertension B. Pulmonary oedema C. Cyanide toxicity D. Heart block Ans. C Q 168. The most common rhythm disturbance during early postoperative period is: A. Bradycardia B. Ventricular fibrillation C. Tachycardia D. Complete heart block Ans. C

OBSTETRICS AND GYNAECOLOGY


Q 169. The following are indications for post operative radiotherapy in a case of carcinoma endometrium except: A. Myometrial invasion of more than half thickness B. Positive lymph nodes C. Endocervical involvement D. Tumor positive for estrogen receptors Ans. D Q 170. Which of the following drug is containdicated to treat hypertension with pregnancy? A. Enalapril B. Methyldopa

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C. Nifedipine D. Labetolol Ans. A Q 171. All the following can cause DIC during pregnancy except: A. Diabetes mellitus B. Amniotic fluid embolism C. Intrauterine death D. Abruptio placentae Ans. A Q 172. Use of oral contraceptives decreases the incidence of all the following except: A. Ectopic pregnancy B. Epithelial ovarian malignancy C. Hepatic adenoma D. Pelvic inflammatory disease Ans. C Q 173. The best time to do chorionic villous sampling is: A. Between 6-8 weeks B. Between 7-9 weeks C. Between 9-11 weeks D. Between 11-13 weeks Ans. D Q 174. In a young female of reproductive age an absolute containdication for prescribing oral contraceptive pills is: A. Diabetes B. Hypertension C. Obesity D. Impaired liver function Ans. D Q 175. All of the following are biochemical markers included for triple test except: A. Alfa fetoprotein (AFP) B. Human chorionic gonadotropin (HCG) C. Human placental lactogen (HPL) D. Unconjugated oestriol Ans. C Q 176. In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is the first polar body extruded? A. 24 hours prior to ovulation B. Accompanied by ovulation C. 48 hours after the ovulation D. At the time of fertilization

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Ans. B Q 177. Which of the following is the most common pure malignant germ cell tumor of the ovary? A. Choricarcinoma B. Gonadoblastoma C. Dysgerminoma D. Malignant teratoma Ans. C Q 178. During laparoscopy the preferred site for obtaining cultures in a patient wtih acute pelvic inflammatory disease is: A. Endocervix B. Pouch of Douglas C. Endometrium D. Fallopian tubes Ans. D Q 179. The risk of complex hyperplasia of endometrium with atypia progressing to malignancy in a postmenopausal woman is about: A. 3% B. 8% C. 15% D. 28% Ans. D Q 180. At 28 weeks gestation, amniocentesis reveals a OD 450 of 0.20 which is at the top of third zone of the Liley curve. The most appropriate management of such a case is: A. Immediate delivery B. Intrauterine transfusion C. Repeat Aminocentesis after 1 week D. Plasmaphresis Ans. B Q 181. In the perspective of the busy life schedule in the modern society, the accepted minimum period of sexual cohabitation resulting in no offpsring for a couple to be declared infertile is: A. One year B. One and a half-year C. Two years D. Three years Ans. A Q 182. Characteristics of an ideal candidate for copper-T insertion include all of the following except: A. Has borne at least one child B. Is willing to check IUD tail 31

C. Has a history of ectopic pregnancy D. Has normal menstrual periods Ans. C

ENT
Q 183. Otoacoustic emissions arise from: A. Inner hair cells B. Outer hair cells C. Both inner and outer hair cells D. Organ of Corti Ans. B Q 184. A laryngocele arises from the: A. True vocal cord B. Subglottis C. Saccule of the ventricle D. Anterior commissure Ans. C Q 185. Which focal length in the objective piece of microscope is commonly used for ear surgery? A. 100 mm B. 250 mm C. 450 mm D. 950 mm Ans. B Q 186. Which one of the following statements truly represents Bells paralysis? A. Hemiparesis and contralateral facial nerve paralysis B. Combined paralysis of the facial, trigeminal and abducens nerves C. Idiopathic ipsilateral paralysis of the facial nerve D. Facial paralysis with a dry eye Ans. C

OPHTHALMOLOGY
Q 187. Painless sudden visual loss is seen in all except: A. CRAO B. Retinal detachment C. Vitreous hemorrhage D. Angle closure glaucoma Ans. D Q 188. In which of the following conditions Berlins edema is seen? A. Open angle glaucoma B. After cataract surgery

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C. After concussional trauma D. Diabetic retinopathy Ans. C Q 189. Magnification obtained with direct ophthalmoscope for an emmetropic patient is: A. 5 times B. 10 times C. 15 times D. 20 times Ans. C Q 190. Which laser is used in the management of after cataracts? A. Argon B. Krypton C. Nd-YAG D. Excimer Ans. C Q 191. In human corneal transplantation, the donor tissue is: A. Synthetic polymer B. Donated human cadaver eyes C. Donated eyes from live human beings D. Monkey eyes Ans. B Q 192. The conversion of CO2 and H2O into carbonic acid during the formation of aqueous humour is catalysed by which one of the following enzymes? A. Carboxylase B. Carbamylase C. Carbonic anhydrase D. Carbonic deoxygenase Ans. C Q 193. Which of the following best defines the saccade? A. Voluntary slow eye movements B. Involuntary slow eye movements C. Abrupt, involuntary slow eye movements D. Abrupt, involuntary rapid eye movements Ans. D

RADIOLOGY
Q 194. Heberdens nodes are found in: A. PIP joints in osteoarthritis B. DIP joints in osteoarthritis C. PIP joint in rheumatoid arthritis

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D. DIP joints in osteoarthritis Ans. B Q 195. Investigation of choice for detection and characterization of interstitial lung disease is: A. MRI B. Chest X-ray C. High resolution CT scan D. Ventilation perfusion scan Ans. C Q 196. A 40-year-old female patient on long term steroid therapy presents with recent onset of severe pain in the right hip. Imaging modality of choice for this problem is: A. CT scan B. Bone scan C. MRI D. Plain X-ray Ans. C Q 197. Which of the following techniques is the bset for differentiating recurrence of brain tumour from radiation therapy induced necrosis? A. MRI B. Contrast enhanced MRI C. PET scan D. CT scan Ans. C Q 198. Which of the following is the most common cause of a mixed cystic and solid suprasellar mass seen on cranial MR scan a 10-year-old child? A. Pituitary adenoma B. Craniopharyngioma C. Optic chiasmal glioma D. Germinoma Ans. B Q 199. Which of the following is the most common cause of sclerotic skeletal metastasis in a female patient? A. Carcinoma breast B. Carcinoma ovary C. Endometrial carcinoma D. Melanoma Ans. A Q 200. Which of the following is the most radiosensitive tumour? A. Ewings tumour B. Hodgkins disease

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C. Carcinoma cervix D. Malignant fibrous histocytoma Ans. A

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