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AIIMS November 2004 Question Paper

Author: RxPG Team, Posted on Monday, November 08 @ 17:26:24 IST by RxPG  

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AIIMS

1. Which one of the following is correct regarding Eaton-Lambert syndrome?
a. It commonly affects the ocular muscels.
b. Neostigmine is the drug of choice for this syndrome.
c. Repeated electrical stimulation enhances muscle power in it.
d. It is commonly associated with adenocarcinoma of lung.

2. Which of the following statements is correct regarding chronic granulomatous disease?
a. It is an autosomal dominant disease.
b. It is characterized by abnormal bacterial phagocytosis.
c. Recurrent streptococcal infections are usual in this disease.
d. Nitroblue tetrazolium test is useful for screening.

3. All of the following are true about therapy for tuberculosis except:
a. “Flu like syndrome” is usually seen in people taking rifampicin on daily basis,
b. Ethambutol accumulates in renal failure.
c. Hyperuricemia is a recognized side effect of pyrazinamide.
d. Red-green color impairment is an early sign of ethambutol induced optic neuritis.

4. A 60 years old man with rheumatic mitral stenosis with atrial fibrillation is on therapy for a fast ventricular rate. While on treatment, he developed a regular pulse of 64 beats per min. the most likely drug being administered was:
a. Verapamil.
b. Digoxin.
c. Carvedilol.
d. Propranolol.

5. In a patient with Listeria meningitis who is allergic to penicillin, the antimicrobial of choice is:
a. Vancomycin
b. Gentamicin
c. Trimethoprim-sulphamethoxazole.
d. Ceftriaxone.

6. Ropinirole is the most useful for the treatment of:
a. Parkinson’s disease
b. Wilson’s disease
c. Hoffman’s syndrome
d. Carpal tunnel syndrome.

7. All of the following can cuase of megakaryocytic thrombocytopenia except;
a. Idiopathic thrombocytopenic purpura.
b. Systemic lupus erythematosus.
c. Aplastic anemia
d. Disseminated intravascular coagulation. (DIC)

8. The following test may be abnormal in disseminated intravascular coagulation except:
a. Prothrombin time.
b. Activated partial thromboplastin time.
c. D-dimer levels.
d. Clot solubility.

9. Which one of the following gram positive organisms is the most cause of urinary tract infection (UTI) among sexually active women?
a. Staphylococcus epidermidis
b. Staphylococcus aureus
c. Staphylococcus saprophyticus.
d. Enterococcus.

10. Laboratory evaluation for the differential diagnosis of chronic myeloproliferative disorders includes all of the following except:
a. Chromosomal evaluation
b. Bone marrow aspiration
c. Flow cytometric analysis
d. Determination of red blood cell mass.

11. When a person has suspended himself by applying ligature around neck so that the point of suspension (Knot) is situated in the region of the occiput. Such a hanging is called as:
a. Typical
b. Atypical
c. Partial
d. Incomplete

12. Which of the following statements about blood grouping is not correct?
a. It can be used to resolve confusion of identity in alleged exchange of babies in maternity unit.
b. It is the method to conclusively fix the paternity.
c. It can assist in matching fragmented human remains in mass disaster.
d. It can help to show whether blood stain on the weapon belongs to the suspect or victim.

13. The dead body of a murdered person is brought for preservation in mortuary. Which of the following statements is not correct?
a. The body should be stored averagely at 4C .
b. The body can be stored before postmortem.
c. The body should be never undressed before the forensic doctor has seen it.
d. The body can be stored at 20 C to preserve it for long duration.

14. An eleven year old rape victim rape victim is brought to casualty for medical examination. The medical officer is required to do the following things. Except:
a. The consent is to be taken from the patient.
b. The patient should be examined in presence of a female attendant.
c. The patient should be given necessary emergency treatment.
d. All the necessary forensic samples should be collected.

15. A body is brought for autopsy with history of poisoning. On postmortem examination, there is dark brown postmortem staining and garlic odour in stomach. In this case the poisoning is most likely due to:
a. Hydrocyanic acid
b. Carbon dioxide.
c. Aniline dye.
d. Phosphorus.

16. A 13-year-old boy has bilateral gynecomastia. His height is 148 cm, weight 58 kg: the sexual maturity rating is stage 2. The gynecomastia is most likely due to:
a. Prolactinoma
b. Testicular tumor
c. Pubertal gynecomastia
d. Chronic liver disease.

17. A 9-year-old boy present with growth retardation and propensity to hypoglycemia. Physical examination reveals short stature, micropenis, increased fat and high-pitched voice. The skeletal survey reveals bone age of 5 years. Which of the following is most appropriate diagnosis?
a. Malabsorption.
b. Growth hormone deficiency
c. Adrenal tumor
d. Thyroxin deficiency

18. A 50 year old male with type 2 diabetes mellitus is found to have 24-hours urinary albumium of 250 mg. which of the following drugs may be used to retard progression of renal disease.
a. Hydrochlorthiazide
b. Enalapril
c. Amiloride
d. Aspirin.

19. Which of the following is the most common extrarenal involvement in autosomal dominant polycystic kidney disease?
a. Mitral valve prolapse.
b. Hepatic cysts
c. Splenic cysts
d. Colonic diverticulosis.

20. All of the following can cause hypercalcemia, except:
a. Prolonged immobilization.
b. Tumor lysis syndrome.
c. Sarcoidosis
d. Multiple myeloma.

21. A patient of acute leukemia is admitted with febrile neutropenia. On day four of being treated with broad-spectrum antibiotics, his fever increases. X-ray chest shows bilateral fluffy infiltrates. Which of the following should be the most appropriate next step in the management.
a. Add antiviral therapy
b. Add antifungal therapy
c. Add contrimoxazole
d. Continue chemotherapy.

22. A patient is admitted with 3rd episode of deep venous thrombosis. There is no history of any associated medical illness. All of the following investigations are required for establishing the diagnosis, except:
a. Protein C deficiency
b. Antithrombin III deficiency
c. Antibodies to factor VIII
d. Antibodies to cardiolipin.

23. Humoral immunodeficiency is suspected in a patient and he is under investigation. Which of the following infections would not be consistent with the diagnosis?
a. Giardiasis
b. Pneumocystis carinii pneumonia
c. Recurrent sinusitis.
d. Recurrent subcutaneous abscesses.

24. A patient presents with melaena, normal renal function, hypertension and mononeuritis multipex. The most probable diagnosis is:
a. Classical polyarteritis nodosa
b. Microscopic polyangitis.
c. Henoch-Schonlein purpura.
d. Buerger’s disease.

25. A 27-year-old man is noted to have blood pressure of 170/100 mmHg. He has prominent aortic ejection click and murmurs heard over the ribs on both sides anteriorly and over the back posteriorly. In addition, the pulses in the lower extremities are feeble and he complains of mild claudication with exeration. The most likely diagnosis is:
a. Atrial septal defect.
b. Aortic stenosis
c. Coarctation of the aorta
d. Cardiomyopathy.

26. All of the following statements are true regarding Staphylococci except:
a. A majority of infections caused by coagulase-negative Staphylococci are due to Staphylococcus epidermidis.
b. -lactamase production in Staphylococci is under plasmid control.
c. Expression of methicillin resistance in Staphylococcus aureus increases when it is incubated at 37C on blood agar.
d. Methicillin resistance in Staphylococcus aureus is independent of -lactamase production.

27. All of the following are correct regarding Legionellae except:
a. Legionellae can be grown on complex media.
b. Legionella pneumophila serogroup 1 is the most common serogroup isolated from humans.
c. Legionellae are communicable from infected patients to others.
d. Legionella pneumophila is not effectively killed by polymorphonuclear leukocytes.

28. Which of the following is the aetiological agent most often associated with Epiglottitis in children?
a. Streptococcus pneumoniae.
b. Haemophilus influenzae type B.
c. Neisseria sp.
d. Moraxella catarrhalis.

29. A 30-year-old male patient presents with urethritis. All of the following can be the causative agent except:
a. Neisseria gonorrhoeae.
b. Chlamydia trachomatis.
c. Trichomonas vaginalis.
d. Haemophilus ducreyi.

30. Which one of the following is detected by the antigen detection test used for the diagnosis of P. falciparum malaria?
a. Circum-sporozoite protein.
b. Merozoite surface antigen.
c. Histidine – Rich – Protein I (HRP-I)
d. Histidine – Rich – Protein II (HRP - II)

31. A 15-year-old girl was admitted to the infectious disease hospital with a provisional diagnosis of rabies. The most suitable clinical sample that can confirm the antemortem diagnosis is:
a. Serum for anti-rabies IgG antibody.
b. Corneal impression smear for immunofluorescence statin.
c. CSF sample for viral culture.
d. Giemsa stain on smear prepared from salivary secretions.

32. In a completely and adequately immunized child against Diphtheria, the throat swab was collected. It showed the presence of Corynaebacterium diphtheriae like organisms on Albert staining. These organisms can have one of the following properties on further laboratory processing:
a. It can grow on Potassium tellurite medium.
b. It would show a positive Elek’s gel precipitation test.
c. It can be pathogenic to experimental guinea pigs.
d. It can produce cytotoxicity in tissue cultures.

33. A 35-year-old patient complains of abdominal cramps along with profuse diarrhea. The treating physician wants to process the stool specimen for isolation of Campylobacter jejuni. Which of the following is the method of choice for the culture of stool?
a. Culture of TCBS medium incubated at 37C under aerobic conditions.
b. Culture on skirrow’s medium incubated at 42C under micro-aerophilic conditions.
c. Culture on Mackconkey’s medium incubated at 42C under anaerobic conditions.
d. Culture on Wilson and Blair’s medium incubated at 37C under microaerophilic conditions.

34. Which of the following organisms, when isolated in the blood, requires the synergistic activity of penicillin plus an aminoglycoside for appropriate therapy?
a. Enterococcus faecalis.
b. Staphylococcus auresus.
c. Streptococcus pneumoniae.
d. Bacteroides fragilis.

35. A fourteen year old boy is admitted with history of fever, icterus, conjunctival suffusion and haematuria for twenty days. Which of the following serological test can be of diagnostic utility?
a. Widal test
b. Microscopic Agglutination Test
c. Paul Bunnel test
d. Weil felix reaction.

36. All of the following are indications for post operative Radiotherapy in a case of Carcinoma Endometrium except:
a. Myometrial invasion > ˝ thickness.
b. Positive lymph nodes.
c. Endocervical involvement.
d. Tumor positive for estrogen receptors.

37. Use of the following drug to treat hypertension with pregnancy is contraindicated:
a. Enalapril
b. Methyldopa
c. Nifedipine
d. Labetolol.

38. All of the following can cause DIC during pregnancy except:
a. Diabetes mellitus.
b. Amniotic fluid embolism
c. Intrauterine fetal death
d. Abruptio Placentae.

39. Use of oral contraceptives decreases the incidence of all of the following except:
a. Ectopic pregnancy.
b. Epithelial ovarian malignancy.
c. Hepatic adenoma.
d. Pelvic inflammatory disease.

40. A 40-year-old patient is suffering from carotid body tumor. Which of the following is the best choice of treatment for him?
a. Excision pregnancy.
b. Radiotherapy
c. Chemotherapy.
d. Carotid artery ligation both proximal and distal to the tumor.

41. In a yound female of reproductive age an absolute contraindication for prescribing oral contraceptive pills is:
a. Diabetes.
b. Hypertension
c. Obesity
d. Impaired liver function.

42. All of the following biochemical markers are included for triple test except:
a. Alfa feto protein (AFB)
b. Human chorionic gonadotropin (HCG)
c. Human Placental Lactogen (HPL)
d. Unconjugated oestriol.

43. 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. At the time of ovulation.
c. 48 hours after the ovulation
d. At the time of fertilization.

44. When does switchover from fetal to adult hemoglobin synthesis begin:
a. 14 weeks gestation
b. 30 weeks gestation
c. 36 weeks gestation
d. 7 – 10 days postnatal.

45. The most common pure malignant germ cell tumor of the ovary is:
a. Choriocarcinoma.
b. Gonadoblastoma.
c. Dysgerminoma.
d. Malignant teratoma.

46. During laparoscopy the preferred site for obtaining cultures in a patient with acute pelvic inflammatory disease is:
a. Endocervix
b. Pouch of Douglas.
c. Endometrium.
d. Fallopian tubes.

47. The risk of complex hyperplasia of endometrium with atypia progressing to malignancy in a postmenopausal woman is:
a. 3%
b. 8%
c. 15%
d. 28%

48. At 28 weeks gestation, amniocentesis reveals a OD 450 nm of 0.20, which is at the top of third zone of the liley curve. Appropriate management of such a case is:
a. Immediate delivery
b. Intrauterine transfusion.
c. Repeat Amniocentesis after 1 week
d. Plasmaphresis.

49. Which of the following is the investigation of choice for assessment of depth of penetration and perirectal nodes in rectal cancer?
a. Trans rectal ultrasound.
b. CT scan pelvis.
c. MRI Scan.
d. Double contrast Barium enema.

50. A primigravida presents to casualty at 32 weeks. Gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by:
a. Immediate caesarean section
b. Immediate induction of labour
c. Tocolytic therapy
d. Magnesium sulphate therapy.

51. A 15-year-old boy presented with painful swelling over the left shoulder. Radiograph of the shoulder showed and osteolytic area with stippled calcification over the proximal hymeral epiphysis. Biopsy of the lesion revealed an immature fibrous matrix with scattered giant cells. Which of the following is the most likely diagnosis?
a. Giant Cell Tumor.
b. Chodroblastoma
c. Osteosarcoma
d. Chondromyxoid fibroma.

52. A 46-year-old, known alcoholic, presented with pain in the dorsal spine. On examination there is tenderness at the dorso-lumbar junction. Radiograph shows destruction of the 12th dorsal vertebra with loss of disc space between D12-L1 vertebrae. The most probable diagnosis is:
a. Metastatic spine disease.
b. Pott’s spine
c. Missed trauma.
d. Multiple myeloma.

53. A 50-year-old man sustained posterior dislocation of left hip in an accident. Dislocation was reduced after 3 days. He started complaining of pain in left hip after 6 months. X-rays of the pelvis were normal. The most relevant investigation at this stage will be:
a. CRP levels in blood.
b. Ultrasonography of hip
c. Arthrography of hip
d. MRI of hip.

54. A one and a half year old child holding her father’s hand slipped and fell but did not let go of her father’s hand. After that, she continued to cry and hold the forearm in pronated position and refused to move the affected extremity. Which of the following management at this stage is most appropriate?
a. Supinate the forarm.
b. Examine the child under GA.
c. Elevate the limb and observe.
d. Investigate for osteomyelitis.

55. A 30-year-old man involved in a fisticuff, injured his middle finger and noticed slight flexion of DIP joint. X-rays were normal. The most appropriate management at this stage is:
a. Ignore
b. Splint the finger in hyperextension
c. Surgical repair of the flexor tendon.
d. Buddy strapping.

56. Ebstein Barr virus is associated with:
a. Carcinoma larynx
b. Carcinoma bladder.
c. Carcinoma nasopharynx.
d. Carcinoma Maxilla.

57. The type of Allergic reaction seen in Allergic fungal sinusitis is:
a. Type 1 and Type 2
b. Type 2 and Type 3
c. Type 1 and Type 3
d. Type 4 and Type 1

58. Calcification of soft tissues without any disturbance of calcium metabolism is called:
a. Ionotrophic calcification.
b. Monotrophic calcification.
c. Dystrophic calcificartion.
d. Calcium induced calcification.

59. All of the following techniques are used to control bleeding from bone during mastoid surgery except:
a. Cutting drill over the bleeding area.
b. Diamond drill over the bleeding area.
c. Bipolar cautery over the bleeding area.
d. Bone wax.

60. To prevent synachiae formation after nasal surgery, which one of the following packings is the most useful:
a. Mitomuycin.
b. Ribbon gauze.
c. Ribbon gauze with liquid paraffin.
d. Ribbon gause steroids.

61. A 2 month old girl has failure to thrive, polyuria and medullary nephrocalcinosis affecting both kidneys. Investigations show blood pH 7.48, bicarbonate 25 mEq/I, potassium 2 mEq/I, sodium 126 mEq/I and chloride 88 Eq/I. The most likely diagnosis is:
a. Distal renal tubular acidosis.
b. Primary hyperaldosteronism
c. Bartter syndrome
d. Pseudohypoaldosteronism.

62. A 3-year-old boy has bilateral renal calculi secondary to idiopathic hypercalciuria. The dietary management includes all of the following except:
a. Increased water intake.
b. Low sodium diet.
c. Reduced calcium intake
d. Avoidance of meat proteins.

63. A 9-year-old boy has steroid dependent nephritic syndrome for the last 5 years. The patient is markedly cushingoid with blood pressure of 120/86 mmHg and small subcapsular cataracts. The most appropriate therapy of choice is:
a. Longterm frusemide with enalapril.
b. Cycolophosphamide.
c. Intravenous immunoglobulin.
d. Intravenous pulse corticosteroids.

64. An 8 day old breast fed baby presents with vomiting, poor feeding and loose stools. On examination the heart rate is 190/ minute, blood pressure 50/30 mm Hg, respiratory rate 72 breaths/minute and capillary refill time of 4 seconds. Investigation show hemoglobin level of 15 mEq/1, urea 30 mg/dL and creatinine 0.6 mg/dL. The most likely diagnosis is:
a. Congenital adrenal hyperplasia.
b. Acute tubular necrosis.
c. Congential hypertrophic pyloric stenosis.
d. Renal tubular acidosis.

65. A 2-year-old child is being evaluated for persistent metabolic acidosis. Blood tests show Na+ 140 mEq/1, Ca2+ 8mg/dL, Mg2+ 2 mg/dL, phosphate 3 mg/dl, pH 7.22, bicarbonate 16 mEq/1 and chloride 112 mEq/I. The plasma anion gap is:
a. 9
b. 15
c. 22
d. 25

66. A child underwent a tonsillectomy at 6 years of age with no complications. He underwent a preoperative screening for bleeding at the age of 12 years before an elective laparotomy, and was found to have a prolonged partial thromboplastin time but normal prothrombin time. There was not family history of bleeding. The patient is likely to have:
a. Acquired vitamin K deficiency.
b. Acquired liver disease.
c. Factor XII deficiency.
d. Mild hemophilia A

67. A child presents with peripheral circulatory failure. The arterial pH is 7.0. pCO2 of 15 mmHg. pO2 76 mm Hg. Which of the following will be the immediate therapy?
a. Sodium bicarbonate infusion
b. Bolus of Ringers lactate.
c. Bolus of hydroxyethyl starch.
d. Dopamine infusion

68. A 5-year-old child is rushed to casualty reportedly electrocuted while playing in a park. The child is apneic and is ventilated with bag and a mask. Which of the following will be the next step in the management
a. Check pulses
b. Start chest compression
c. Intubate
d. Check oxygen saturation

69. A 12-year-old girl has history of recurrent bulky stools and abdominal pain since 3 years of age. She has moderate pallor and her weight and height are below the 3rd percentile. Which of the following is the most appropriate investigation to make a specific diagnosis?
a. Small intestinal biopsy
b. Barium studies
c. 24-hours fecal fat estimation.
d. Urinary d-xylose test.

70. The treatment of choice for primary grade V vesicoureteric reflux involving both kidneys in a 6 months old boy is:
a. Antibiotic prophylaxis
b. Ureteric reimplantation.
c. Cystoscopy followed by subureteric injection of Teflon.
d. Bilateral ureterostomies.

71. The most common causative organism for lobar pneumonia is:
a. Staphylococcus aureus.
b. Streptococcus pyogenes.
c. Streptococcus pneumoniae
d. Haemophilus influenzae

72. 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
c. They metastasize predominantly by lymphatics.
d. They are often associated with raised levels of serum alpha-feto protein and human chorionic gonadotrophin.

73. All of the following statement are true regarding central nervous system infections. Except:
a. Measles virus is the causative agent for subacute sclerosing pan encephalitis (SSPE)
b. Cytomegalo virus causes bilateral temporal lobe hemorrahgeic infarction.
c. Prions infections causes spongiform encephalopathy.
d. JV virus is the causative agent for progressive multifocal leucoencephalopathy.

74. HIV associated nephropathy is a type of:
a. Membranous glomerulonephritis.
b. Immunotactoid glomerulopathy.
c. Collapsing glomerulopathy.
d. Fibrillary glomerulopathy.

75. Ladder pattern of DNA electrophoresis in apoptosis is caused by the action of the following anzyme:
a. Endonuclease .
b. Transglutaminase.
c. DNAse.
d. Caspase.

76. Which one of the following is not a criterion for making a diagnosis of chronic myeloid leukemia in accelerated phase:
a. Blasts 10-19% of WBC’s in peripheral blood.
b. Basophils 10-19% of WBC;s in peripheral blood.
c. Increasing spleen size unresponsive to therapy,
d. Persistent thrombocytosis (>1000 x 109 /L) unresponsive to therapy.

77. CD 19 positive, CD 22 positive, CD 103 positive monoclonal B-cell with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 x 109/L. Which one of the following is the most likely diagnosis?
a. Splenic lymphoma with villous lymphocytes.
b. Mantle cell lymphoma.
c. B-cell prolymphocytic leukemia.
d. hairy cell leukemia.

78. A four year old boy was admitted with a history of abdominal pain and fever for two months, maculopapular rash for ten days, and dry cough, dyspnea and wheezing for three days. On examination, liver and spleen were enlarged 4cm and 3 cm respectively below the costal margins. His hemoglobin was 10.0 g/dl, platelet count 37 x 109/L and total leukocyte count 70 x 109/L, which included 80% eosinophils. Bone marrow examination revealed a cellular marrow comprising 45% blasts and 34% Eosinophils and eosinophilic precursors. The blasts stained negative for myeloperoxidase and non specific esterase and were positive for CD19, CD10, CD22 and CD20.
Which one of the following is the most likely diagnosis?
a. Biphenotypic acute leukemia (lymphoid and eosinophil lineage).
b. Acute eosinophilic leukemia.
c. Acute lymphoblastic leukemia with hypereosinophilic syndrome.
d. Acute myeloid leukemia with eosinophilia.

79. All of the following are examples of tumor markers, except:
a. Alpha – HCG (-HCG).
b. Alpha – Feto Protein.
c. Thyroglobulin.
d. 2 – microglobulin.

80. Which of the following combination of cytogenetic abnormality and associated leukemia / lymphoma is incorrect?
a. t(8:14)Burkitts lymphoma.
b. t(15:17)AML – M3.
c. t(9:22)CML.
d. t(9:20)ALL.

81. Endoscopic biopsy from a case of H. Pylori related duodenal ulcer is most likely to reveal:
a. Antral predominant gastritis.
b. Multifocal atrophic gastritis.
c. Acute erosive gastritis.
d. Gastric atrophy.

82. Early gastric cancer generally indicates:
a. Gastric adenocarcinoma detected early.
b. Gastric adenocarcinoma confined to the mucosa
c. Gastric adenocarcinoma confined to the mucosa and submucosa.
d. Gastric adenocarcinoma less than 1 cm. In size.

83. A neonate is being investigated for jaundice. A liver biopsy shows features of a “Giant Cell/ Neonatal hepatitis”. Which one of the following conditions usually results in this case?
a. Congenital hepatic fibrosis.
b. Hemochromatosis.
c. Alpha-1-antitrypsin deficiency.
d. Glycogen storage disease Type 1

84. A 20-year-old male has presented with repeated episodes of hematemesis. There is no history of jaundice or liver decompensation. On examination the significant findings include splenomegaly (8 cms below costal margin). And presence of esophageal varices. There is no ascites or peptic ulceration. The liver function tests are normal. The most likely diagnosis is:
a. Extahephatic portal venous obstruction
b. Non cirrhotic portal fibrosis.
c. Cirrhosis.
d. Hepatic venous outflow tract obstruction.

85. A male infant presented with distension of abdomen shortly after birth with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show:
a. Fibrosis of submucosa.
b. Lack of ganglion cells
c. Thickened muscularis propria.
d. Hyalinisation of the muscular coat.

86. Women receiving oestrogen therapy have an increased risk of developing all of the following cancers, except;
a. Breast cancer.
b. Endometrial carcinoma
c. Carcinoma of gall bladder
d. Hepatocellualr carcinoma

87. All of the following disease cause massive spleenomegaly except:
a. Malaria
b. Kalrazar
c. Lymphoblstic leukaemia
d. Idiopathic myelofibrosis.

88. A 48-year-old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 237 x 109 / L and total leukocyte count 40 X 109/ L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid cells were positive for CD19,CD5, CD20 and CD23 and were negative for CD79B and FMC -7.
Which one of the following statements in not true about this disesase?
a. Trisomy 12 correlates an aggressive clinical course.
b. Abnormalities of 13q14 are associated with long term survival
c. Cases with 11q22-23 deletions have excessive lymphadenopathy.
d. T(11;14) translocation is present in most of the cases.

89. All of the following statements are incorrect about the treatment of prolonged suzamethonium apnoea due to plasma cholinesterase deficiency (After a single dose of suzamethonium) except:
a. Reversal with increamental doses of neostigmine
b. Continue anaesthesia and mechanical ventilation till recovery.
c. Transfusion of fresh frozen plasma.
d. Plasmapheresis.

90. The operating temperature in an ethylene oxide sterilization during a warm cycle is:
a. 20-35 C.
b. 49-63 C
c. 68-88 C
d. 92-110 C

91. Which of the following does not represent a significant anaesthetic problem in the morbidly obsese patient?
a. Difficulties in endotracheal intubation.
b. Suboptimal arterial oxygen tension.
c. Increased metabolism of volatile agents.
d. Decreased cardiac output relative to total body mass.

92. A 6-month old child with tetralogy of Fallot develops cyanotic spell initiated by crying. Which one of the following drugs you would like to avoid?
a. Sodium bicarbonate.
b. Proproanolol
c. Phenylephrine.
d. Isoprenaline.

93. A 10-days old neonate is posted for pyloric stenosis surgery. The investigation report shows a serum calcium level of 6.0 mg/dl. What information would you like to know before you supplement calcium to this neonate?
a. Blood glucose.
b. Serum protein.
c. Serum bilirubin
d. Oxygen saturation.

94. A 20-year-old female weighing about 55 kg is admitted to an emergency department having consumed 10 g of paracetamol (acetaminophen) together with alcohol, 6 hours earlier. A serum paracetamol level is reported as 400 micrograms/ml. Which one of the following is correct in this case?
a. Gastrisc lavage is mandatory.
b. Administration of activated charcoal.
c. Abnormalies of kidney function are likely to be present.
d. Hepatotoxicity is likely to occur.

95. An unconscious man is brought into hospital suffering from methyl alcohol poisoning. All of the following are correct except:
a. Kussmaul’s breathing could be expected to be a feature of the condition.
b. Papilloedema would be consistent with this form of intoxication.
c. His plasma bicarbonate might be very low
d. Methyl alcohol would be metabolized to acetaldehyde.

96. All of the following for managing status epilepticus except
a. Phenytoin
b. Diazepam
c. Thiopentone sodium
d. Carbamazepine

97. A patient following head injury was admitted in intensive care ward with signs of raised intracranial pressure. He was put on ventilator and started on intravenous fluids and diuretics. Twenty four hours later his urine output was 3.5 liter, serum sodium 156 mEq/l and serum osmolarity of 316 mOsm/kg. The most likely diagnosis based on these parameters is
a. High output due to diuretics
b. Diabetes insipidus
c. Too much infusion of normal saline
d. Cerebral salt retaining syndrome

98. Which one of the following statements regarding desflurane is correct
a. It causes severe myocardial depression
b. It is structural analogue of isoflurane
c. It has vary high blood and tissue – gas partition coefficients
d. It is metabolically unstable

99. A 52-year-old male diagnosed as triple vessel coronary artery disease with poor left ventricular function. Coronary artery bypass grafting surgery maintenance of anaesthesia which one of the following agents should be preferred
a. IV Opioids
b. Isoflurane
c. Halothane
d. Nitrous oxide

100. Trendelenberg position produces decreases in all of the following except
a. Vital capacity
b. Functional residual capacity
c. Compliance
d. Respiratory rate

101. Urgent reversal of Warfarin therapy can be done by administration of
a. Cryoprecipirtates
b. Platelet concentrates
c. Fresh frozen plasma
d. Packed red blood cell

102. All of the following drugs are eliminated by kidney except
a. Pancuronium bromide
b. Atracurium besylate
c. Vecuronium bromide
d. Pipecuronium

103. Which one of the following opioids has maximum plasma protein binding capacity
a. Morphine
b. Sufentanil
c. Fentanyl
d. Pethidine

104. In computed tomography (CT), the attenuation values are measured in Hounsfield units (HU). At attenuation value of ‘O’ (zero) HU corresponds to
a. Water
b. Air
c. Very dense bone structures
d. Fat

105. The EEG cabins should be completely shielded by a continuous sheet of wire mesh of copper to avoid the picking up of noise from external electromagenetic disturbances. Such a shielding is called as
a. Maxwell cage
b. Faraday cage
c. Edison’s cage
d. Ohms cage

106. Which one of the following phenomena is closely associated with slow wave sleep
a. Dreaming
b. Atonia
c. Sleep walking
d. Irregular heart rate

107. If a single spinal nerve is cut, the area of tactile loss is always greater than the area of loss of painful sensations, because
a. Tactile information is carried by myelinated fast conducting fibres
b. Tactile receptors adapt quickly
c. Degree of overlap of fibres carrying tactile sensation is much less
d. In the primary sensory cortex tactile sensation is represented on a larger area

108. Massage and the application of liniments to painful areas in the body relieves pain due to
a. Stimulation of endogenous analgesic system
b. Release of endorphins by the first order neurons in the brain stem
c. Release of glutamate and substance P in the spinal cord
d. Inhibition by large myelinated afferent fibres

109. One of the following statements about hydralazine is not true
a. It causes direct relaxation of blood vessels
b. It causes dilatation of both arteries and veins
c. Postural hypotension is not a common problem
d. In increases plasma rennin activity

110. One of the following diuretics does not require its presence in the tubular lumen for its pharmacological effects
a. Thiazide diuretics
b. Loop diuretics
c. Carbonic anhydrase inhibitors
d. Aldosterone antagonists

111. Many of our bad habits of day to day life can be removed by
a. Positive conditioning
b. Biofeedback
c. Negative conditioning
d. Generalization

112. A 30-year-old unmarried woman of average socio – economic background believes that her boss in secretly love with her. She rings him upto odd hours and writes love letters to him despite his serious warning not to do so. She holds this belief despite contradiction from her family members and his denial. However, she is able to manage her daily activities as before. She is most likely to be suffering from
a. Depression
b. Schizophrenia
c. Delusional disorder
d. No psychiatric ailment

113. A 35-year-old male, with pre – morbid anxious traits and heavy smoker, believes that he has been suffering from ‘lung carcinoma’ for a year. No significant clinical finding is detected on examination and relevant investigations. He continues to stick to his belief despite evidence to the contary. In the process, he has spent a huge amount of money, time and energy in getting himself unduly investigated. He is most likely suffering from
a. Carcinoma lung
b. Delusional disorder
c. Hypochondriacal disorder
d. Malingering

114. A 14-year-old has difficulty in expressing himself in writing, and makes frequent spelling mistakes. He passes his examinations with poor marks. However, his mathematical ability and social adjustment are appropriate for his age. Which of the following is the most likely diagnosis
a. Mental retardation
b. Lack of interest in studies
c. Specific learning disability
d. Examination anxiety

115. A 35-year-old man with an obsessive compulsive personality disorder likely to exhibit of the following features, except
a. Perfectionism interfering with performance
b. Compulsive checking behaviour
c. Preoccupation with rule
d. Indecisiveness

116. Which one of the following organs should always be imaged in a suspected case of bronchogenic carcinoma
a. Adrenals
b. Kidneys
c. Spleen
d. Pancreas

117. A middle aged man presents with progressive atrophy and weakness of hands & forearms. On examination he is found to have slight spasticity of the legs, generalized hyper – reflexia and increased signal in the cortico – spinal tracts on T2 weighted MRI. The most likely diagnosis is
a. Multiple sclerosis
b. Amyotrophic lateral sclerosis
c. Subacute combined degeneration
d. Progressive spinal muscular atrophy

118. A 6-year-old boy has been complaining of headache, ignoring to see the objects on the sides for four months. On examination, he is not mentally retarded, his grades at school are good, and visual acuity is diminished in both the eyes. Visual charting showed significant field defect. CT scan of the head showed suprasellar mass with calcification. Which of the following is the most probable diagnosis
a. Astrocytoma
b. Craniopharyngioma
c. Pituitary adenoma
d. Meningioma

119. Which of the following is the incorrect statement regarding GI Bleeding
a. The sensitivity of angiography for detecting GI bleeding is about 10-20% as compared to Nuclear Imaging
b. Angiography can image bleeding at a rate of 0.05 – 0.1/min or less
c. 99mTc-RBC scan will image bleeding at rates as low as 0.05 – 0.1 ml/min
d. Angiography will detect bleeding only if extravasation is occurring during the injection of contrast

120. Which one of the following hepatic lesions can be diagnosed with high accuracy by using nuclear imaging
a. Hepatocellular Carcinoma
b. Hepatic Adenoma
c. Focal Nodular Hyperplasia
d. Cholangiocarcinoma

121. Which one of the following is the most beneficial technique of using chemotherapy with a course of radiotherapy in head and neck malignancies
a. Neo adjuvant chemotherapy
b. Adjuvant chemotherapy
c. Concurrent chemotherapy
d. Alternating chemotherapy and radiotherapy

122. The treatment of choice in renal cell carcinoma with the tumor of less than 4 cm in size is
a. Partial nephrectomy
b. Radical nephrectomy
c. Radical nephrectomy + post operative radiotherapy
d. Radical nephrectomy + chemotherapy

123. A 7-year-old boy with left renal mass had bone pain was detected to have bone metastatic deposits. The most likely renal tumor is
a. Favorable histology Wilms tumor
b. Renal cell carcinoma
c. Clear cell sarcoma
d. Rhabdoid tumor

124. Which one of the following is the earliest radiographic manifestation of childhood leukemia
a. Radiolucent transverse metaphyseal bands
b. Diffuse demineralization of bones
c. Osteoblastic lesions in skull
d. Parenchyamal pulmonary lesions on chest films

125. Migratory thrombophlebitis is associated with the following malignancies except
a. Lung cancer
b. Prostate cancer
c. Pancreas cancer
d. Gastro – intestinal cancer

126. A 35-year-old insulin dependent diabetes mellitus (IDDM) patient on Insulin for the past 10 years complains of gradually progressive painless loss of vision. Most likely he has
a. Cataract
b. Vitreous haemorrhage
c. Total rhegmatogenous retinal detachment
d. Tractional retinal detachment not involving the macula

127. Which one of the following extraocular muscles is served by a contralateral brain stem subnucleus
a. Superior rectus
b. Medial rectus
c. Inferior oblique
d. Inferior rectus

128. A 20-year-old student has a myopia of -2.0 D and a post traumatic nebular corneal opacity in her right eye. Which of the following is the best refractive surgery option for her
a. Photorefractive keratectomy
b. LASIK
c. Radical keratotomy
d. Epikeratoplasty

129. A 56-year-old man has painful weeping rashes over the upper eyelid and forehead for the last 2 days along with ipsilateral acute punctuate keratopathy. About a year back, he had chemotherapy for Non – Hodgkin’s lymphoma. There is no other abnormality. Which of the following is the most likely diagnosis
a. Impetigo
b. Systemic lupus Erythematosus
c. Herpes Zoster
d. Pyodema gangrenosum

130. An 18-year-old girl who was using spectacles for last 10 years, came with the history of photosia and sudden loss of vision in right eye. Which one of the following clinical examinations should be preformed to clinch the diagnosis
a. Cycloplegic refraction
b. Indirect ophthalmoscopy
c. Schiotz tonometry
d. Gonioscopy

131. A 55-year-old male presents with features of Obstructive Jaundice. He also reports a weight loss of seven kilograms in last two months. On CT scan, the CBD is dilated till the lower end and the main pancreatic duct is also dilated. Pancreas is normal. The most likely diagnosis is
a. Choledocholithiasis
b. Carcinoma Gallbladder
c. Hilar Cholangiocarcinoma
d. Periampullary carcinoma

132. Hypoparathyroidism following thyroid surgery occurs within
a. 24 hours
b. 2 – 5 days
c. 7 – 14 days
d. 2 – 3 weeks

133. Which of the following is generally not seen in idiopathic thrombocytopenic purpura (ITP)
a. More common in females
b. Petechiae, ecchymosis and bleeding
c. Palpable splenomegaly
d. Increased megakaryocytes in bone marrow

134. In which of the following conditions the head pipe appearance of the colon a barium enema is seen
a. Amoebiasis
b. Ulcerative colitis
c. Tuberculosis of the colon
d. Crohn’s involvement of the colon

135. During bilateral adrenalectomy, intraoperative dose of hydrocortisone should be given after
a. Opening the abdomen
b. Ligation of left adrenal vein
c. Ligation of right adrenal vein
d. Excision of both adrenal glands

136. A 20-year-old female patient presented with a thyroid swelling. Most probably, the fine needle aspiration cytology will not diagnose
a. Papillary carcinoma of thyroid
b. Medullary carcinoma of thyroid
c. Non – Hodgkin’s lymphoma of thyroid
d. Follicular carcinoma of thyroid

137. A 40-year-old woman has undergone a cholescytectomy. The histopathology reveals that she has a 3 cm adenocarcinoma in the body of the gallbladder infiltrating upto the serosa. Which of the following further management would you advise her
a. Chemotherapy
b. Radiotherapy
c. Radical Cholcystectomy
d. Follow up with regular ultrasound examinations

138. Which of the following statements is incorrect with regard to hepatorenal syndrome in a patient with cirrhosis
a. The creatinine clearance is <40 ml/min
b. The urinary sodium is less than 10 mmol/L
c. The urine osmolality is lower than the plasma osmolality
d. There is poor response to volume expansion

139. A young patient presenting with massive hematemesis was found to have splenomegaly. In this case the most likely source to bleeding is
a. Duodenal ulcer
b. Esophageal varices
c. Erosive mucosal disease
d. Gastric ulcer

140. Following resuscitation, a patient with bleeding oesophageal varices should be treated initially with
a. Sclerotherpy
b. Sangstaken Blackmore tube
c. Propranolol
d. Surgery

141. A 62-year-old diabetic female patient presented with history of progressive right – sided weakness of one – month duration. The patient was also having speech difficulty. Fundus examination showed papilledema. Two months ago, she also had a fall in her bathroom and struck her head against a wall. The most likely clinical diagnosis is
a. Alzheimer’s disease
b. Left parietal glioma
c. Left MCA territory stroke
d. Left chronic subdural haematoma

142. Ramakali bai, a 35-year-old female presented with one year history of menstrual irregularity and galactorrhea. She also had off – and – on headache. Her examination revealed bitemporal superior quadrantopia. Her fundus examination showed primary optic atrophy. Which of the following is the most likely diagnosis in this case
a. Craniopharyngioma
b. Pituitary macroadenoma
c. Ophthalmic ICA aneurysm
d. Chiasmal glioma

143. A young female patient with long history of sinusitis presented with frequent fever along with personality changes and headache of recent origin. The fundus examination revealed papilledema. The most likely diagnosis is
a. Frontal lobe abscess
b. Meningitis
c. Encephalitis
d. Frontal bone osteomyelitis

144. Which one of the following is the treatment of choice for a 4 cm retroperitoneal lymph node mass in a patient with non seminomatous germ cell tumor of the testis
a. Radical radiotherapy alone
b. High Orchidectomy + RPLND
c. RPLND alone
d. High Orchidectomy alone

145. A 13-year-old boy presents with acute onset right scrotal pain. The pain is not relieved on elevation of the scrotum and he has no fever or dysuria. The testis is enlarged and tender. His routine urinary examination is normal. There is no history of trauma. Which of the following is the most appropriate management
a. Immediate exploration
b. Antibiotics
c. Psychiatric evaluation
d. Antibiotics and scrotal elevation

146. Which of the following produces the least damage to blood elements
a. Disc oxygenator
b. Membrane oxygenator
c. Bubble oxygenator
d. Screen oxygenator

147. A 25-year-old lady presents with spontaneous nipple discharge of 3-months duration. On examination this discharge is blood and from a single duct. The following statements about management of this patient are true except
a. Ultrasound can be useful investigation
b. Radical duct excision is the operation of choice
c. Galactogram, though useful, is not essential
d. Majority of blood – stained nipple discharge are due to Papillomas or other benign condition

148. All of the following statements are correct about renal transplantation except
a. Renal Transplantation is heterotopic
b. Cyclosporine is the mainstay of immunosuppression
c. In India, organ harvesting from Brain Dead patients is not permitted by Law
d. Kidney after removal is flushed with cold perfusion solution

149. All of the following statements are true about repair of groin hernias except
a. Lichtenstein tension free repair has a low recurrence rate
b. TEPP repair is an extraperitoneal approach to laparoscopic repair of groin hernia
c. In Shouldice repair, non – absorbable mesh is used
d. The surgery can be done under local anaesthesia in selected cases

150. A 25-year-old male presents to Emergency with history of road traffic accident two hours ago. The patient is hemodynamically stable. Abdomen is soft. On catheterization of the bladder, hematuria is noticed. The next step in the management should be
a. Immediate laparotomy
b. Retrograde Cystouretherography (RGU)
c. Diagnostic Peritoneal Lavage (DPL)
d. Contrast Enhanced Computed Tomography (CECT) of Abdomen

151. Which of the following is the best – known metabolic function of the lung
a. Inactivation of serotonin
b. Conversion of angiotensin – I to angiotensin II
c. Inactivation of bradykinin
d. Metabolism of basic drugs by cytochrome P – 450 system

152. When the aviator is subjected to negative G
a. The hydrostatic pressure in veins of lower limb increases
b. The cardiac output decreases
c. Black out occurs
d. The cerebral arterial pressure rises

153. The normal value of P50 on the oxyhaemoglobin dissociation curve in an adult is
a. 1.8 kPa
b. 2.7 kPa
c. 3.6 kPa
d. 4.5 kPa

154. Which combination of the following statements is correct with reference to hypoxia
a. When it is severe, causes stimulation of the sympathetic nervous system
b. It leads to the accumulation of hydrogen and lactate ions
c. It causes decreases in cerebral blood flow
d. If it is chronic, causes rightward shift of oxygen Hb curve
1. All of the above statements are correct
2. b & c
3. a, b, & d
4. b, c & d

155. Examine the shape of the flow volume curve carefully

This flow volume loop indicates one of the following
a. Normal
b. Extrathoracici obstruction
c. Intrathoracic obstruction
d. Fixed large airway obstruction

156. A baby girl presents with bilateral inguinal masses, thought to be hernias but are found to be testes in the inguinal canales. Which karyotype would you except to find in the child
a. 46, XX
b. 46, XY
c. 47, XXY
d. 47, XYY

157. All of the following muscles undergo paralysis after injury to C5 and C6 spinal nerves except
a. Biceps
b. Corachobrachialis
c. Brachialis
d. Brachioradialis

158. All of the following are characteristic of a bronchopulmonary segment, except
a. It is surgically respectable
b. It is named according to the segmental bronchus supplying it
c. It is drained by intrasegmental branch of pulmonary vein
d. It is the largest subdivision of a lobe

159. Injury to the common peroneal nerve at the lateral aspect of head of fibula result in all of the following except
a. Weakness of ankle dorsi – flexion
b. Foot drop
c. Loss of ankle reflex
d. Sensory impairment of lateral aspect of leg extending to the dorsum of foot

160. The mesentery of small intestine, along its attachment to the posterior abdominal wall, crosses all of the following structures except
a. Left gonadal vessels
b. Third part of duodenum
c. Aorta
d. Right ureter

161. Venous drainage from neurohypophysis is routed through all of the following except
a. Portal vessels to adenohypophysis
b. Superior hypophyseal veins to ventricular tanycytes
c. Inferior hypophyseal veins to dural venous sinuses
d. Capillaries to median emienence and hypothalamus

162. The efferent fiber bundle of the substance nigra transmits dopamine to one of the following areas
a. Thalamus
b. Corpus straitum
c. Tegmentum of pons
d. Tectum of midbrain

163. A posteriorly perforating ulcer in the pyloric antrum of the stomach is likely to produce initial localized peritonitis or abscess formation in the
a. Greater sac
b. Left subhepatic and hepatorenal spaces (pouch of Morrison)
c. Omental bursa
d. Right subphrenic space

164. Knowledge of the segmental cutaneous innervation of the skin of the lower extremity is important in determining the level of intervertebral disk disease. Thus, S1 nerve root irritation will result in pain located along the
a. Anterior aspect of the thigh
b. Medial aspect of the thigh
c. Anteromedial aspect of the leg
d. Lateral side of the foot

165. A 59-year-old man complains of recurrent attacks of pain in the region of left shoulder radiating to sternum and the pit of stomach. The attacks of pain came at lengthy intervals Until the last two days when it became continuous. The physician diagnosed it as angina pectoris. In this case the pain pathway from the heart is carried by
a. Superior cervical cardiac nerve
b. Middle and inferior cervical cardiac nerve
c. Thoracic splanchnic nerve
d. Vagus

166. Which one of the following amino acids is most likely to be found in the transmembrane region of a protein
a. Lysine
b. Arginine
c. Leucine
d. Aspartate

167. Which one of the following statements about Hemoglobin S (HbS) is not true
a. Hemoglobin HbS differs from hemoglobin HbA by the substitution of Val for Glu in position 6 of the beta chain
b. One altered peptide of Hb S migrates faster towards the cathode (-) than the corresponding peptide of HbA
c. Binding of HbS to the deoxygenated HbA can extend the polymer and cause sicking of the red blood cells
d. Lowering the concentration of deoxygenated Hb S can prevent sickling

168. The following are true about Tumor Suppressor Gene p53 except
a. It regulates certain genes involved in cell cycle regulation
b. Its increased levels can induce apoptosis
c. Its activity in the cells decreases following UV irradiation and stimulates cell cycle
d. Mutations of the p53 gene are the most common genetic alteration seen in human cancer

169. During the dark phase of visual cycle, which form of vitamin A combines with opsin to make Rhodopsin
a. All trans – Retinaldehyde
b. All trans – Retinol
c. 11 – cis – retinaldehyde
d. 11 – cis – Retinol

170. Which one of the following microorganisms uses antigenic variation as a major means of evading host – defences
a. Sterptococcus pneumoniae
b. Borrelia recurrenitis
c. Mycobacterium tuberculosis
d. Listeria monocytogenes

171. Which one of the following is not a prion associated disease
a. Scrapia
b. Kuru
c. Creutzfeldt – Jakob disease
d. Alzheimer’s disease

172. Oral rehydration mixture contains glucose and sodium because both of them
a. Are needed to maintain the plasma osmolality
b. Are prominent energy sources for the body
c. Facilitate the transport of each other from the intestinal mucosa to the blood
d. Are required for the activation of sodium potassium ATPase

173. The following interleukin is characteristically produced a Tul response
a. IL – 2
b. IL – 4
c. IL – 5
d. IL -10

174. Which one of the following acts to increase the release of Ca2+ from endoplasmic reticulum
a. Inositol triphosphate
b. Parathyroid hormone
c. 1, 25 – dihydroxy cholecalciferol
d. Diacyglycerol

175. Increased susceptibility to breast cancer is likely to associated with a mutation in the following gene
a. P53
b. BRCA – 1
c. Retinoblastoma (Rb)
d. H – Ras

176. Which of the following techniques uses piezoelectric crystals
a. Ultrasonography
b. NMR imaging
c. X- ray diffraction
d. Xeroradiography

177. Erythropoiesis is promoted by all of the following except
a. ACTH
b. Thyroxine
c. Oestrogen
d. Prolactin

178. The molecular weight of a protein can be determined by
a. Native Poly Acrylamide Gel Electrophoresis (PAGE)
b. Sodium Dodecyl Sulphate h-PAGE
c. Isoelectric focusing
d. Ion Exchange Chromatography

179. Weight of an Indian reference woman is
a. 45 kg
b. 50 kg
c. 55 kg
d. 60 kg

180. Orthotolidine test is used to determine
a. Nitrates in water
b. Nitrites chlorine in water
c. Free and combined chlorine in water
d. Ammonia content in water

181. The analytical study where population is the
a. Cross sectional
b. Ecological
c. Case – control
d. Cohort

182. An outbreak of streptococcal pharyngitis has occurred in a remote village. In order to carry out the epidemiological investigations of the outbreak it is necessary to perform the culture of the throat swab of the patients suffering from the disease. The transport media of choice would be
a. Cross sectional
b. Ecological
c. Case – control
d. Cohort

183. Which one of the following arbovirus disease has not been reported in India
a. Japanese Encephilitis
b. Yellow fever
c. Chikungunya fever
d. Kyasanur Forest Disease

184. As compared to a routine case control study, nested case control study avoids problems (in study design) related to
a. Temporal association
b. Confounding bias
c. Need for long follow up
d. Randomization

185. To test the association between risk factor and disease, which of the following is the weakest study design
a. Case – control study
b. Ecological study
c. Cohort Study
d. Cross – sectional study

186. All of the following statements regarding Dracunculiasis are true except
a. India has eradicated this disease
b. Niridazole prevents transmission of the disease
c. The disease is limited to tropical and subtropical regions
d. No animal reservoir has been proved

187. In which of the Indian states the maximum number of AIDS cases have been reported till now
a. Delhi
b. Kerala
c. Tamil Nadu
d. Bihar

188. Which one of the following statements is false regarding vincristine
a. It is an alkaloid
b. Its use is associated with neurotoxicity
c. It does not cause alopecia
d. It is useful drug for induction of remission in acute lymphoblastic leukaemia

189. All of the following statements about mosquito are true except
a. It is a definitive host in malaria
b. It is a definitive host in filaria
c. Its life cycle is completed in 3 weeks
d. The female can travel upto 3 kilometers

190. All of the following statements about quarantine are true except
a. It is synonymous with isolation
b. Absolute quarantine is restriction during the incubation period
c. Exclusion of children from schools is an example of modified quarantine
d. Quarantine should not be longer than the longest incubation period

191. A total 5000 patients of glaucoma are identified and surveyed by patient interviews regarding family history of glaucoma. Such a study design is called
a. Case series report
b. Case – control study
c. Clinical trial
d. Cohort study

192. In a 3 X 4 contigency table, the number of degrees of freedom equals to
a. 1
b. 5
c. 6
d. 12

193. The literacy rate of Indian Population as per Census 2001 is
a. 54.5%
b. 65.4%
c. 85.8%
d. 75.5%

194. In assessing the association between maternal nutritional status and the birth weight of the newborns, two investigators A and B studied separately and found significant results with p values 0.02 and 0.04 respectively. From this information, what can you infer about the magnitudes of association found by the two investigators
a. The magnitude of association found by Investigator A is more than that found by B
b. The magnitude of association found by Investigator B is more than that found by A
c. The estimates of association obtained by A and B will be equal, since both are significant
d. Nothing can be concluded as the information given is inadequate

195. A Cardiologist wants to study the effect of an anti – hypertensive drug. He notes down the initial systolic blood pressure (mmHg) of 50 patients and then administers the drug on them. After a week’s treatment, he measures the systolic blood pressure again. Which of the following is the most appropriate statistical test of significance to test the statistical significance of the change in blood pressure
a. Paired t-test
b. Unpaired or independent t – test
c. Analysis of Variance
d. Chi – square test

196. The number of malaria cases reported during the last 10 years in a town are given below; 250,320,190,300,5000,100,260,350,320& 160. The epidemiologist wants to find out the average number of malaria cases reported in that town during the last 10 years. The most appropriate measures of average for this data will be
a. Arithmetic mean
b. Mode
c. Median
d. Geometric mean

197. In a group of patients presenting to a hospital emergency with abdominal pain, 30% of patients have acute appendicitis, 70% of patients with appendicitis have a temperature greater than 37.50C and 40% of patients without appendicitis have a temperature greater than 37.50C. Considering these findings, which of the following statements is correct
a. The sensitivity of temperature greater than 37.50C as a marker for appendicitis is 21/49
b. The specificity of temperature greater than 37.50C as a marker for appendicitis is 42/70
c. The positive predictive value of temperature greater than 37.50C as marker for appendicitis is 21/30
d. The specificity of the test will depend upon the prevalence of appendicitis in the population to which it is applied

198. A patient with leprosy had slightly erythematous, anaesthetic plaques on the trunk and upper limbs. He was treated with paucibacillary multidrug therapy (PB – MDT) for 6 months. At the end of 6 months, he had persistent erythema and induration in the plaque. The next step of action recommended by the World Health Organization (WHO) in such a patient is
a. Stop antileprosy treatment
b. Continue PB – MDT till erythema subsides
c. Biopsy the lesion to document activity
d. Continue dapsone alone for another 6 months

199. A 40-year-old woman presented with a 8 month history of erythema and swelling of the periobital region and papules and plaques on the dorsolateral aspect of forearms and knuckles with ragged cuticles. There was no muscle weakness. The most likely diagnosis is
a. Systemic lupus erythematosus
b. Dermatomyositis
c. Systemic sclerosis
d. Mixed connective tissue disorder

200. A 40-year-old male had multiple blisters over the trunk and extremities. Direct immunoflurescence studies showed linear IgG Which of the following is the most likely diagnosis
a. Pemphigus vulgaris
b. Pemphigus foliaceous
c. Bullous Pemphigoid
d. Dermatitis herpetiformis



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