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AIIMS May 2001

Author: Guest, Posted on Friday, June 01 @ 00:00:00 IST by RxPG  

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1) A 65 year old female Kamala gives the history of severe unilateral headache on the right side and complains of blindness since 2 days .On examination there is a thick cord like structure on the lateral side of the head. The ESR is 80 mm/Hr in the first hour. The most likely diagnosis is
a) Temporal arteritis
b) Migraine
c) cluster headache
d) sinusitis

2) A 60 year old man complaining of chest pain since 6 hrs is diagnosed as acute MI . Angiography showed the involvement of anterior descending branch of left coronary artery.
The most probable site of involvement is
a) Anterolateral
b) Posterior
c) Inferior
d) Septal

3) Pulmonary Kerley B lines are seen in all the following except
a) Pulmonary edema
b) Mitral valve disease
c) Interstitial fibrosis
d) Broncho alveolar Ca

4) Infective endocarditis is least likely to occur in
a) ASD
b) Small VSD
c) MVP
d) TOF

5)In a patient with chronic AF with a regular beat of 60/min, the most probable cause is
a) sleep
b) digitalis toxicity
c) Sino nodal block
d) Hypothyroidism

6)An HIV positive female has an indurated ulcer over the tongue. Laboratory findings show growth in cornmeal agar at 20 Degrees, microscopy showing hyphae and growth in human serum at 37 degrees show budding yeasts. The probable cause is
a)Candida albicans
d) Coccidiodomycosis

7) Kallu, a 30 year old man, presented with subcutaneous itchy nodules over the left iliac crest. On examination, they are firm, non tender and mobile .Skin snips contain microfilaria and adult worms of
a) Loa Loa
b) Onchocerca volvulus
c) Brugia malayi
d) Mansonella perstans

8)In an ICU patient on invasive monitoring, all are causes of bacterial sepsis except
a)Orotracheal intubation
b)Intra arterial line
c)Humidified air
d)Central venous catheter

9) In Polycythemia vera, all the following are seen except
a) thrombocytopenia
b) increased GI bleed
c) thrombosis
d) Transient visual loss

10) A stem cell disorder affecting all the 3 cell lines - platelets, RBC's and leucocytes is
a) Hemolytic anemia
b) Paroxysmal cold haemoglobinuria
c) PNH
d) Blackfan Diamond syndrome

11) In beta thalassemia, there is
a) increase in Beta chain , decrease in Alpha chain
b) decrease in Beta chain, increase Alpha chain
c) decrease in Beta chain, decrease Alpha chain
d) Increase in Beta chain, increase Alpha chain

12) Non caseating granulomas are seen in all the following except
a) Tuberculosis
b) Byssinosis
c) Hodgkin's Lymphoma
d) Metastatic carcinoma of lung

13) All are paraneoplastic syndromes except
a) cerebellar degeneration
b) Progressive Multifocal leukoencephalopathy
c) Amyotropic lateral sclerosis
d) Opsoclonus myoclonus

14) In Burkitts lymphoma, translocation seen is
a) 12-14 translocation
b) 8-14 translocation

15) Ingestion of arsenic causes
a) Hepatic Ca
b) Hepatic adenoma
c) Noncirrhotic portal fibrosis
d) Hepatic cirrhosis

16) In malignant hypertension, hyperplastic angiitis is seen in all except
a) Peripancreatic fat
b) Kidney
c) Heart
d) Periadrenal fat

17) In a chronic smoker, a highly malignant, aggressive and metastatic lung carcinoma is
a) Squamous cell Carcinoma
b) Small cell Carcinoma
c) Adenocarcinoma
d) Large cell Carcinoma

18) All are true about Neisseria gonorrhea except
a) Gram positive cocci
b) causes stricture urethra
c) Involves seminal vesicles and spreads to epididymis
d) drug of choice is Ceftriaxone

19) A 30 year old male, Kallu, with a history of sexual exposure comes with a painless indurated ulcer over the penis with everted margins. The diagnosis is
a) Syphilis
b) Chancroid
c) LGV
d) Granuloma inguinale

20) All are features of peripheral neuritis in a patient with Hansens Disease except
a) Predominant sensory involvement
b) Decreased tendon reflexes
c) Mutilations

21) A 32 year old male, Kallu, who recently visited a sea coast presented with an ulcer over the left leg. The probable cause is
a) Pasturella multocida
b) Micrococcus halophilus
c) Vibrio vulnificus

22) An 8 year old boy, Kallu, is brought to the casualty with a history of consuming something while playing outside in a play ground. On examination, there was altered sensorium, hyperpyrexia, dilated pupils. Most probable cause is
a) Dhatura poisoning
b) Organophosphorus poisoning
c) Parthenium poisoning
d) Barbiturate poisoning

23) All the following viruses cause stomach and colon cancer except
a) H pylori
b) EB virus
c) HBV
d) HIV

24) Which of the following is pathognomonic of renal disease
a) Hyaline casts
b) coarse granular casts
c) cystine oxalate crystals
d) epithelial cells

25) Hypoglycemia is seen in
a) Acromegaly
b) Cushings syndrome
c) Hypothyroidism
d) Hypopitutarism

26) A 76 year old male comes with a history of frequent falls and difficulty in looking downwards and laterally. The diagnosis is
a) Alzheimer's disease
b) Supranuclear palsy
c) Amyotropic lateral sclerosis
d) Oculomotor nerve palsy

27) The commonest side effect of cisplatin in a patient using it for esophageal carcinoma is
a) ATN
b) Thrombocytopenia
c) Hepatic failure
d) Cardiomyopathy

28) The most common late CNS complication of HIV is
a) Dementia
b) Ataxia
c) Seizures
d) Delirium

29) In a patient with acute liver failure, the best prognostic indicator is
a) Serum albumin
b) Serum AFP
c) Serum bilirubin
d) Factor V estimation

30) The commonest hepatotropic virus causing increased chronic carrier state is
a) HEV
b) HAV
c) HBV
d) HCV

31) Regarding Addisonian pigmentation, all are true except
a) involves moles and scars
b) involves palmar creases
c) does not involve oral mucosa
d) involves sole pads

32) In an HIV positive patient with tuberculosis, all are true except
a) decreased cavitation
b) increased sputum positivity
c) highly variable tuberculin test
d) decreased fibrosis

33) In essential hypertension, changes seen in the heart are
a) cardiac cell hyperplasia
b) cardiac cell hypertrophy
c) increase in the mitochondrial number

34) In a 32 year old male presenting with the following blood chemistry : Na+ 135, K+ 5.0, HCO3- 14.0, Cl- 116, PO4 5.0, SO4 5.0, Mg 2.0, Ca 8.0, the anion gap is
a) 10
b) 15
c) 13
d) 20

35) Pyramidal tract involvement with absent ankle jerk is seen in
a) Frederick's ataxia
b) Subacute combined degeneration of the spinal cord
c) Lathyrism
d) Tabes dorsalis

36) A patient with BHP underwent TURP and developed altered sensorium. The cause is
a) Hyponatremia
b) Hypernatremia
c) Hypomagnesemia
d) Hypokalemia

37) A patient of BHP underwent TURP under bupivacaine spinal anesthesia. One hour later, he developed nausea, vomiting and altered sensorium. The cause possibly is
a) Hypernatremia
b) Water intoxication
c) Bupivacaine overdose
d) Rupture Bladder

38) Neuroblastoma differs from Wilm's tumor radiologically by all except
a) same location
b) intraspinal extension
c) calcification
d) aorta and IVC are not eroded but pushed aside

39) A 60 year old male, Kallu, on CT scan was found to have a solid tumor involving the inferior vena cava and renal vein. The tumor was within the Gerota's fascia. All the following can be done except
a) chest X-ray to rule out pulmonary metastasis
b) pre-operative radiotherapy is not favorable
c) IVC invasion is inoperable
d) pre-operative biopsy is not indicated

40) A male patient, Kamal, aged 50 years presents with gradually progressive hard scrotal swelling on the right side. All the following can be done except
a) inguinal exploration
b) chest Xray to rule out pulmonary metastasis
c) CT abdomen
d) biopsy through the scrotal skin

41) Orhcidectomy is done in all the following except
a) male breast cancer
b) filarial epididymo-orchitis
c) seminoma testes
d) prostate cancer

42) The treatment of choice in congenital hydrocele is
a) Eversion of the sac
b) Excision of the sac
c) Herniotomy
d) Lord's procedure

43) In a patient with pheochromocytoma, all the following are seen except
a) diarrhea
b) orthostatic hypotension
c) episodic hypertension
d) weight gain

44) Splenectomy is done in all the following except
a) splenic abscess
b) hereditary spherocytosis
c) sickle cell anemia
d) myelofibrosis

45) A patient with recurrent attacks of cholelithiasis had, on ultrasound examination , a dilated CBD of 1 cm. The next best line in management is
b) PTC
c) intravenous cholangiogram
d) cholecystostomy

46) A 40 year old male, Kallu, a chronic alcoholic, diagnosed as cirrhosis presents with a lump in the right lobe of the liver. Serum AFP levels are not elevated. The diagnosis is
a) fibrohyperplasia
b) hepatocellular carcinoma
c) hepatocellular adenoma
d) secondary from carcinoma colon

47) A 60 year old male diagnosed to have carcinoma stomach had, on CT scan of the abdomen, a mass measuring 4x4 cm in the antrum with involvement of celiac nodes and right gastric nodes. The management of choice is
a) palliative
b) subtotal gastrectomy
c) total gastrectomy
d) chemotherapy and radiotherapy

48) A 70 year old male, Kamal, presents with lower GI bleed for the last 6 months. On sigmoidoscopic examination, there is a hard non-obstructing mass of 4 cms about 3 cms above the anal verge. The treatment of choice is
a) anterior resection
b) abdominoperineal resection
c) defunctioning anastomosis
d) colostomy

49) A 14 year old girl, Salu, a regular swimmer presents with sudden onset of pain abdomen, abdominal distension and fever of 390, but without obliteration of the liver dullness. The diagnosis is
a) ruptured typhoid ulcer
b) ruptured ectopic pregnancy
c) primary bacterial peritonitis
d) UTI with PID

50) Left sided pulmonary hypertension is best treated by
a) splenectomy
b) spleno-renal shunt
c) portocaval shunt

51) A 28 year old male, Mallu, a chronic alcoholic, presents with sudden onset of epigastric pain that is radiating to the back. All the following can be seen except
a) hypocalcemia
b) increased serum amylase
c) low serum lipase
d) increased LDH

52) A 28 year old male patient is brought to the casualty with severe hypotension following a car accident. On examination no external bleed or injuries are seen. The cause of hypotension is possibly
a) intrathoracic and abdominal bleed
b) fracture rib
c) intracranial bleed
d) neurogenic shock

53) On prenatal ultrasound examination, the diagnostic feature of congenital diaphragmatic hernia is
a) absence of gas bubble under the diaphragm
b) mediastinal shift with normal heart axis
c) peristalsis in the thoracic cavity
d) a cyst behind the left atrium

54) A 40 year old male, Kallu, a chronic smoker, presents with claudication and a medial leg ulcer. For the past one month, he gives a history of rest pain. All the following can be used to relieve the rest pain except
a) Omentoplexy
b) conservative amputation
c) lumbar sympathectomy
d) femoropopliteal bypass

55) A male patient aged 30 years following a road traffic accident presents with fracture of 4th to 10th ribs and respiratory distress. He is diagnosed to have flail chest and PaO2 is < 60%. The treatment of choice is
a) fixation of ribs
b) strapping of the chest
c) IPPV with oral intubation
d) tracheostomy

56) A post-operative patient presents with duodenal leak and peritonitis with massive contamination. The appropriate management of choice is
a) duodenostomy + feeding jejunostomy + peritoneal lavage
b) total parenteral nutrition
c) duodenojejunostomy
d) four quadrant peritoneal lavage

57) A 52 year old male executive is seen in the casualty with hypotension, vomiting bright red blood at home and in the hospital. There is no previous suggestive history. The estimated blood loss is around 2 liters. The diagnosis is
a) esophageal varices
b) gastritis
c) duodenal ulcer
d) Mallory-Weiss tear

58) All are true about the right kidney except
a) it is related to the duodenum
b) it is lower than the left kidney
c) the right renal vein is shorter than the left
d) right kidney is preferred over the left for transplantation

59) Grade IV esophageal varices, on barium swallow appears as
a) a thick band
b) mucosal folds above the carina
c) mucosal folds below the carina

60) A female patient presents with pigmentation of the lips and oral mucosa and colonic polyps. Her sister also has the same history. The diagnosis is
a) Peutz-Jeghers' syndrome
b) Carcinoid
c) melanoma
d) villous adenoma

61) The commonest site of carcinoma prostate is
a) Transitional zone
b) Central zone
c) Peripheral zone
d) Anterior zone

62) Dissociative sensory loss is seen with
a) Tabes dorsalis
b) Syringomyelia

63) In a patient with raised IgA levels, the commonest finding is
a) proteinuria
b) GI bleed
c) hematuria
d) hypertension

64) In a patient with choledochal cyst, bile diversion into the small intestine is contraindicated because of risk of
a) malignancy
b) recurrent cholangitis
c) pancreatitis
d) increased gall stones

65) Thyrotoxicosis differs from malignant hyperthermia by
a) muscle rigidity
b) CPK
c) hypothermia

66) In a female with sudden onset of severe headache, on CT, a diagnosis of subarachnoid hemorrhage was made. The most common site of subarachnoid hemorrhage is
a) subdural venous sinuses
b) middle meningeal artery
c) Berry aneurysm rupture
d) basilar artery

67) Chamavati, a 30 year old female from rural Assam with a history of chronic tobacco chewing since 15 years of age, presents with difficulty in opening the mouth. On oral examination, no ulcer is seen. The diagnosis is
a) non-ulcerative carcinoma of buccal mucosa
b) submucous oral fibrosis
c) Temporomandibular joint arthritis

68) A 40 year old female patient, Chamavati, presents with a lump that is gradually increasing in the parotid region. On oral examination, the tonsil was pushed medially. On biopsy, pleomorphic adenoma was diagnosed. The appropriate treatment is
a) Superficial parotidectomy
b) Lumpectomy
c) Enucleation
d) Conservative total dissection

69) A female patient, 45 years of age, with a family history of breast carcinoma showed diffuse microcalcification on mammography. On biopsy, intraductal carcinoma in situ was found. The appropriate management is
a) simple mastectomy
b) quadrantectomy
c) radical mastectomy with axillary sampling
d) chemotherapy with CMF regime

70) Tram track appearance on CT scan of the head is seen in
a) Sturge Weber syndrome
b) von Hippel Lindau disease
c) Tuberous sclerosis
d) neurofibroma

71) A patient presents with minimal pleural effusion on the right side. The best method to detect this would be
a) right side chest Xray
b) Left sided chest Xray
c) Left lateral decubitus chest Xray
d) Right lateral decubitus chest Xray

72) A 40 year old farmer with a history of recurrent attacks of porphyria complains of itching when exposed to the sun and maculopapular rash on sun-exposed areas. His symptoms are exaggerated in the summer. The diagnosis is
a) Seborrheic dermatitis
b) Contact dermatitis
c) Psoriasis
d) Porphyria cutanea tarda

73) An 8 year old boy presents with a well defined annular lesion over the buttock with central scarring that is gradually progressing over the last 8 months. The diagnosis is
a) annular psoriasis
b) lupus vulgaris
c) tinea corporis

74) In adult polycystic kidney, all are true except
a) Cysts are seen in the liver, spleen and the pancreas
b) Hematuria occurs
c) Hypertension is rare
d) Autosomal dominant transmission is seen

75) In thymoma, all are seen except
a) red cell aplasia
b) hyperalbuminemia
c) hypogammaglobulinemia
d) myasthenia gravis

76) An adult presents with oval scaly hypopigmented macules over the chest and the back. The diagnosis is
a) Leprosy
b) Lupus vulgaris
c) Pityriasis versicolor
d) Lichen planus

77) The characteristic nail finding in lichen planus is
a) pitting
b) pterygium
c) Beau's lines
d) Hyperpigmentation of the nails

78) In an 8 day old child with no history of consanguinity in the parents, the mother reports blisters and peeling off of the skin at the site of handling and pressure. There was a similar history in the previous child which proved to be fatal. The diagnosis is
a) Bullous pemphigoid
b) Congenital syphilis
c) Congenital epidermolysis bullosa
d) Letterer-Siwe disease

79) The most common complication of hypermature sclerotic cataract is
a) dislocation of the lens
b) phakomorphic glaucoma
c) uveitis

80) A 14 year old boy complains of pain during reading . On examination, his both eyes are normal and vision with non Snellen's reading is 6/5. He still complains of pain on occluding one eye. The diagnosis is
a) myopia
b) pseudomyopia
c) hyperopia
d) emmetropia

81) A 16 year old boy complains of pain in the right eye. After refractometry , he was prescribed a + 3.5 D sphere lens. The cover test is normal. There is no heterophoria. The diagnosis is
a) organic amblyopia
b) anisometric amblyopia
c) emmetropic amblyopia
d) toxic amblyopia

82) A patient complains of pain in both eyes with congestion, blurring of vision, photophobia and mucopurulent discharge since one day. Many cases have been reported from the same community. The causative agent is probably
a) adenovirus
b) enterovirus 70
c) herpes simplex

83) A male patient with a history of hypermature cataract presents with a 2 day history of ciliary congestion, photophobia, blurring of vision and on examination has a deep anterior chamber in the right eye. The left eye is normal. The diagnosis is
a) phakomorphic glaucoma
b) phakolytic glaucoma
c) phakotoxic glaucoma
d) phakoanaphylactic uveitis

84) A 60 year old male patient operated for cataract 6 months back now complains of floaters and sudden loss of vision. The diagnosis is
a) vitreous hemorrhage
b) retinal detachment
c) central retinal artery occlusion
d) cystoid macular edema

85) A 12 year old boy presents with recurrent attacks of conjunctivitis for the last 2 years with intense itching and ropy discharge. The diagnosis is
a) vernal conjunctivitis
b) phlyctenular conjunctivitis
c) trachoma
d) viral conjunctivitis

86) A 25 year old lady presents with severe sudden onset of pain, corneal congestion, photophobia and deep anterior chamber in the right eye. The left eye is normal. Xray pelvis shows sacroiliitis. The diagnosis is
a) anterior uveitis
b) posterior uveitis
c) intermediate uveitis
d) scleritis

87) A 30 day old neonate was presented with a history of photophobia and excessive lacrimation. On examination, both the lacrimal duct systems are normal, but there was a large cornea and corneal haziness. The diagnosis is
a) megalocornea
b) keratoconus
c) congenital glaucoma
d) Hunter's syndrome

88) In high spinal anesthesia, seen are
a) hypotension and bradycardia
b) hypotension and tachycardia
c) hypertension and bradycardia
d) hypertension and tachycardia

89) A patient selected for surgery who was induced with thiopentone i.v through one of the antecubital veins complains of severe pain of the whole hand. The next line of management is
a) give i.v propofol through the same needle
b) give i.v ketamine through the same needle
c) give i.v lignocaine through the same needle
d) leave it alone

90) A patient who was on aspirin for a long period was selected for an elective surgery. What should be done?
a) stop aspirin for 7 days
b) infusion of fresh frozen plasma
c) infusion of platelet concentrate
d) go ahead with the surgery maintaining adequate hemostasis

91) A patient in the ICU was on invasive monitoring with intraarterial cannulation through the right radial artery for the last 3 days. Later, he developed swelling and discoloration of the right hand. The next line of management is
a) stellate ganglion block
b) brachial block
c) radial nerve block on the same side
d) application of lignocaine jelly over the site

92) A 3 year old child with severe sensorineural deafness was prescribed hearing aids, but shows no improvement. The next line of management is
a) cochlear implant
b) fenestration surgery
c) stapes mobilization

93) A 4 year old girl diagnosed as having multiple juvenile papillamotosis of the larynx presents to the casualty with mild respiratory distress. The next line of management is
a) tracheostomy
b) microlaryngoscopy
c) broad spectrum antibiotics
d) systemic steroids

94) A 28 year old female presents to the casualty with gradually increasing respiratory distress since 4 days. She gives history of hospitalization and mechanical ventilation with orotracheal intubation for 2 weeks. Now, she was diagnosed as having severe tracheal stenosis. The next line of management is
a) tracheal resection and end to end anastomosis
b) tracheal dilatation
c) systemic steroids
d) laser excision and stent insertion

95) A 30 year old male, following excision of the 3rd molar for dental caries presents with trismus, fever of 39.50 and swelling pushing the tonsil medially and spreading laterally posterior to the middle sternocleidomastoid. The diagnosis is
a) parapharyngeal abscess
b) retropharyngeal abscess
c) Ludwig's angina
d) submental abscess

96) A 20 year old male, following a road traffic accident was brought to the casualty. His right leg is shortened, internally rotated and adducted. The diagnosis is
a) fracture neck of femur
b) anterior dislocation of the hip
c) posterior dislocation of the hip
d) trochanteric fracture of the femur

97) An 8 year old boy presents with a gradually progressing swelling and pain since 6 months over the upper tibia. On Xray, there is a lytic lesion with sclerotic margins in the upper tibial metaphysis. The diagnosis is
a) Osteogenic sarcoma
b) Osteoclastoma
c) Brodie's abscess
d) Ewing's sarcoma

98) An 8 year old boy with a history of fall from 10 feet height complains of pain in the right ankle. Xrays taken at that time are normal without any fracture line. But after 2 years, he developed a calcaneovalgus deformity. The diagnosis is
a) undiagnosed malunited fracture
b) avascular necrosis talus
c) tibial epiphyseal injury

99) A 6 year old boy has a history of recurrent dislocation of the right shoulder . On examination, the orthopedician puts the patient in the supine position and abducts his arm to 90 degrees with the bed as the fulcrum and then externally rotates it but the boy does not allow the test to be performed. The test done by the orthopedician is
a) apprehension test
b) sulcus test

100) Regarding bone remodelling, all are true except
a) osteoclastic activity at the compression site
b) osteoclastic activity at the tension site
c) osteoclastic activity and osteoblastic activity are both needed for bone remodelling in cortical and cancellous bones
d) osteoblasts transforms into osteocytes

101) A child is spinned around by his father by holding both hands. While doing this the child started crying and does not allow his father to touch his elbow.The diagnosis is
a) pulled elbow
b) radial head dislocation
c) Annular ligament tear
d) Fracture olecranon process

102)The structures piercing the clavipectoral fascia are all except:
a) Cephalic vein
b) Thoraco acromial artery
c) Lateral pectoral nerve
d) Lateral pectoral artery

103) Crossed oculomotor palsy is seen in occlusion of
a) Anterior cerebral artery
b) Middle cerebral artery
c) Posterior cerebral artery
d) Superior cerebral artery

104) Erection of penis is mediated by all the following except
a) Nervi erigentes
b) Pudendal nerve
c) Sacral plexus
d) Hypogastric plexus

105) Active transport of chemicals across the cell membrane is mediated by:
a) Channel protein
b) Carrier protein
c) G protein
d) Na+- K+ ATPase.

106) In a patient with respiratory rate of 14/min, tidal volume of 500 ml with a vital capacity 7000ml, the alveolar ventilation/minute is
a) 2000 ml
b) 4900ml
c) 7000ml
d) 7700ml.

107) During sigmoidoscopy, if the rectum is inflated with gas, increased peristalsis is seen in
a) Whole intestine
b) Distal colon
c) Proximal colon
d) Whole colon

108) In an unacclimatised person suddenly exposed to cold, the physiological effect seen is
a) Hypertension
b) Tachycardia
c) Shift of blood from shell to core
d) Non shivering thermogenesis

109) Spuriously high BP is noted in all the following except
a) Obesity
b) Thick calcified vessels
c) Small cuff
d) Auscultatory gap

110) Cerebellar herniation presents with all the following except
a) Loss of consciousness
b) Autonomic disturbances
c) Neck stiffness
d) Pupil dilatation

111) Positive feedback is seen in all the following except
a) LH Surge
b) Stimulation of the gastric secretion by histamine and gastrin
c) thrombolytic activity in the coagulation cascade
d) Entry of Ca into the sarcoplasmic reticulum

112)Vitamin K is needed for the post translational modification of
a) Carboxylation
b) Methylation
c) Hydroxylation
d) Transketolation

113) Amber codon refers to
a) Initiating codon
b) Mutant codon
c) Stop codon
d) Codon coding for multiple amino acids

114) At physiological pH, the most stable amino acid is
a) Histidine
b) Lysine
c) Arginine
d) Leucine

115) In cystinuria, amino acids excreted are all the following except:
a) Ornithine
b) Arginine
c) Lysine
d) Histidine

116) Dietary triglycerides are transported by
a) Chylomicrons
b) LDL
d) HDL

117) In which of the following reaction, thiamine is not used
a) Alpha ketoglutarate to succinyl CoA
b) Glucose to pentose
c) Oxidative decarboxylation of Alpha keto amino acids
d) Lactate to pyruvate

118) In chromatography, mass movement of the substances is seen in
a) Electrophoresis
b) Diffusion
c) Osmosis
d) Paper chromatography

119) The type of chromatography in which proteins are bound to another substance is
a) Hydrophobic chromatography
b) Absorption ( Affinity ) chromatography

120) The end-product of citric acid cycle used in detoxification of ammonia in brain is
a) Oxaloacetate
b) Alpha keto glutarate
c) Succinate
d) Citrate

121) Right parietal lobe lesions cause all the following except
a) ideomotor apraxia
b) Self neglect

122) Investigation of choice for blood grouping in old blood stain on the cloth is
a) Precipitin test
b) Benzidine test
c) Acid dilution test
d) Hemin crystals

123) Interleukin secreted by the macrophages stimulating lymphocytes is
a) IL 1
b) INF Alpha
c) TNF Alpha
d) IL 6

124) Following injection of lymphokines, the same class of immunoglobulins are produced. This is referred to as
a) Clonal selection
b) Class switching

125) A patient receiving allopurinol requires dose reduction of
a) 6 mercapto purine
b) cyclophosphamide
c) Azathioprine
d) Cimetidine

126) An elderly hypertensive has diabetes mellitus and bilateral renal artery stenosis. The best management is
a) Enalapril
b) Verapamil
c) Beta blockers
d) Thiazides

127) A female suffering from psychosis, taking phenothiazines now complains of sudden onset of high grade fever, muscle rigidity and altered sensorium. The diagnosis is
a) Malignant hyperthermia
b) Neuroleptic malignant syndrome
c) Tardive dyskinesia
d) Akathesia

128) A patient on cisapride for Barrets ulcer suffers from pneumonia. The physician prescribes erythromycin. Which of the following is the correct statement
a) Increase the dose of cisapride needed
b) Increase the dose of erythromycin needed
c) Increased risk of Ventricular arrythmias present
d) Decreased bioavailability of cisapride

129) A 60 year old male comes to the casualty with acute retention of urine since 12 hours. On examination there was distended bladder . His son gives a history of taking some drugs by the patient since 2 days as he is suffering from depression . The most likely drug is
a) Amitryptiline
b) Chlorpromazine
c) Haloperidol

130) Kallu, a 22 year old male suffers from decreased sleep, increased sexual activity , excitement and spending excessive money excessively for the past 8 days. The diagnosis is
a) Acute mania
b) Acute psychosis
c) Schizophrenia
d) Psychosexual disorder

131) Rathi, a 26 year old female diagnosed to be suffering from depression now for the past 2 days had suicidal tendencies, thoughts and ideas. The best treatment is
a) Amitryptiline
b) Selegiline
c) Haloperidol + Chlorpromazine
d) ECT

132) Kallu, a 22 year old single unmarried man is suffering from sudden onset of 3rd person hallucinations for the past 2 weeks. He is suspicious of his family members and had decreased sleep and appetite. The diagnosis is
a) Schizophrenia
b) Acute psychosis
c) Acute mania
d) Delirium

133) A 60 year old male suffering from auditory hallucinations is says that people staying upstairs are talking about him and conspiring against him. He dropped a police complaint against them but the allegations were proved to be wrong. The diagnosis is
a) Schizophrenia
b) Depression
c) Dementia
d) Delusional disorder

134) In India the commonest cause of juvenile onset of DM is
b) Fibrocalcific pancreatopathy
c) Gall stones

135) A neonate has central cyanosis and short systolic murmur on the 2nd day of birth. The diagnosis is
a) TGV
b) TOF
c) VSD
d) ASD

136) An 8 year old female child following URTI developed maculopapular rash on the face spreading onto the trunk which cleared on the 3rd day without desquamation and tender post auricular and suboccipital lymphadenopathy. The diagnosis is
a) Measles
b) Rubella
c) Erythema infectiosum
d) Kawasaki disease(Mucocutaneous LN Syndrome)

137) A 4 month old HIV positive child following URTI ,developed sudden onset of breathlessness. The chest Xray shows hyperinflation. The O2 saturation was greater than 90%. The treatment of choice is
a) Nebulized acyclovir
b) i.v Ganciclovir
c) Ribavirin
d) Cotrimoxazole

138) All of the following are features of systemic juvenile Rheumatoid arthritis except
a) Rash
b) fever
c) Hepato Splenomegaly
d) Uveitis

139)A child climbs with alternate steps , builds a tower of 8-9 cubes , tells "I" but not his name and cannot say his age and sex. The probable age is
a) 24 Months
b) 36 Months
c) 30 Months
d) 48 Months

140) A child suffering from acute diarrhea is brought to the casualty and is diagnosed as having severe dehydration with pH of 7.23 , Serum Na -125 , Serum K- 3 , Hco3 16. The best IV fluid of choice is
a) 3% saline
b) Normal saline
c) N/3 saline + 10 % dextrose
d) N/3 saline + 5% dextrose

141) A child with recent onset of URTI after 2 days presents with acute onset of breathlessness, cough and fever. All of the following can be given except
a) Antibiotics
b) Antipyretics
c) O2 inhalation
d) Morphine

142)A 6 month old child having severe dehydration comes to the casualty with weak pulse and unrecordable BP. Repeated attempts in gaining IV access has failed. The next best step is
a) Venesection
b) Jugular vein catheterisation
c) Intraosseous IV Fluids
d) Try again

143) A 6 year old child with acute onset of fever of 104 F developed febrile seizures and was treated. To avoid future recurrence of seizure attacks what should be given
a) IV diazepam infusion over 12 Hrs
b) Paracetamol 400 mg + Phenobarbitone daily
c) paracetamol 400 mg 6th Hrly
d) Oral diazepam 6th Hrly

144 ) An 8 year old child suffering from recurrent attacks of polyuria since childhood presents to the paediatrics OPD. On examination, the child is short statured, vitals and BP are normal. Serum Cr 6 Mg %, HCO3 16 mEq , Na 134, K 4.2 On USG bilateral small kidneys
The most likely diagnosis is
a) Polycystic Kidney disease
b) Medullary cystic Kidney disease
c) Nephronophthisis
d) Reflux nephropathy

145) A 40 year old male presents with recurrent bouts of vomiting since 9 months because of
pyloric obstruction. The compensatory biochemical change is
a) Respiratory acidosis
b) Respiratory alkalosis
c) Metabolic acidosis
d) Paradoxical aciduria with hypo natremia and hypo chloremia

146)A diabetic female at 40 weeks of pregnancy delivered a baby by elective CS. Soon after birth the baby developed respiratory distress. The diagnosis is
a) Hyaline membrane disease
b) Transient tachypnea of the newborn
c) Congenital diaphragmatic hernia
d) Tracheo esophageal fistula

147)All are prognostic indicators of PIH except
a) Serum Uric acid
b) Low platelets
c) Serum Na
d) Elevated liver enzymes

148) In a woman on subdermal progesterone implant , the menstrual abnormality seen is
a) Amenorrhea
b) Menorrhagia
c) Metrorrhagia
d) Polymenorrhoea

149) Kalavathi ,a 29 year old nulliparous woman complains of severe menorrhagia and lower abdominal pain since 3 months. On examination, there is a 14 weeks size uterus with fundal fibroid . The treatment of choice is
a) Wait and watch
b) Myomectomy
c) GnRH analogues
d) Hysterectomy

150) A pregnant lady in the first trimester presented with random blood glucose of 177 mg /dl
The treatment is
a) Insulin
b) glipizide
c) Phenformin
d) Sulfonylurea

151) In a non-diabetic high risk pregnancy, the ideal time for NST monitoring is
a) 24 Hrs
b) 48 Hrs
c) 72 Hrs
d) 96 Hrs

152) A woman comes with postdated pregnancy at 42 weeks. The initial evaluation should be
a) USG
b) Induction of labor
c) Review previous menstrual history

153) In pregnancy, the most common cause of transient Diabetes Insipidus is
a) Severe pre-eclampsia
b) Multiple pregnancy

154) A 26 year old nulliparous woman is on oral contraceptive pills. She is currently diagnosed as having pulmonary tuberculosis. Which anti-tuberculous drug decreases the effect of OCP's?
a) Rifampicin
b) INH
c) Pyrazinamide
d) Ethambutol

155) The drug that inhibits uterine contractility causing pulmonary edema is
a) Ritodrin
b )Nifedipine
c) indomethacin
d) Atabusin

156) Post-coital test detects all of the following except
a) Sperm count
b) Sperm abnormality
c) Fallopian tube block
d) Cervical factor abnormality

157) A 48 year old female suffering from severe menhorragia (DUB) underwent hysterectomy. She wishes to take hormone replacement therapy. Physical examination and breast are normal, but x ray shows osteoporosis. The treatment of choice is
a) Estrogen
b) Progesterone
c) Estrogen-Progesterone
d) None

158) A pregnant female, 38 years old, had a child with Downs syndrome. How do you assess the risk of Down's syndrome in the present pregnancy?
a) Chorionic villus biopsy
b) Maternal alpha feto protein levels
c) Maternal hCG
d) USG

159) A 28 year old female with a history of 8 weeks amenorrhea complains of vaginal bleeding and lower abdominal pain. On USG examination, there is gestational sac with absent fetal parts. The diagnosis is
a) corpus luteum cyst
b) ectopic pregnancy
c) Incarcerated abortion
d)Threatened abortion

160)Kamla, a 48 year old lady underwent hysterectomy. On the seventh day, she developed fever, burning micturiton and urinary dribbling . She can also pass urine voluntarily. The diagnosis is
a) uretero-vaginal fistula
b) vesico-vaginal fistula
c) Urge incontinence
d) Stress incontinence

161)A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites. The probable cause is
a) Hyperstimulation syndrome
b) Uterine rupture
c) Ectopic pregnancy rupture
d) Multi fetal pregnancy

162) A woman at 8 months of pregnancy complains of abdominal pain and slight vaginal bleed. On examination, the uterine size is above the expected date with absent fetal heart sounds. The diagnosis is
a) Hydramnios
b)Uterine rupture
c) concealed hemorrhage
d) active labor

163) In a woman having a previous history of Caesarian section, all of the following are indications for trial labor except
a) Occipito posterior position
b) fetal distress
c) breech presentation
d) Mid pelvic contraction

164) All are indicators for the assessment of the nutritional program except
a) Weight and height of the preschool child
b) Prevalence of low Birth weight less than 2.5 kg in community
c) Nutritional assessment of the preschool child
d) Prevalence of pregnant mothers having Hb < 11.5 g% in the 3rd trimester

165) A concept directed against prevention of risk factors of CAD is
a) Primordial prevention
b) Secondary prevention
c) Health education
d) Primary prevention

166) In a community, the specificity of ELISA is 99% and sensitivity is 99%. The prevalance of the disease is 5/1000. Then, the positive predictive value of the test is
a) 33%
b) 67%
c) 75%
d) 99%

167) In a village of 1 lakh population, among 20000 exposed to smoking, 200 developed cancer , and among 40000 people unexposed, 40 developed cancer. The relative risk of smoking in the development of cancer is
a) 20
b) 10
c) 5

168) A person wants to visit a malaria endemic area of low level chloroquine resistant falciparum malaria. The best chemoprophylaxis is
a) Chloroquine
b) Proguanil + Chloroquine
c) Sulfadoxine + pyrimethamine
d) Mefloquine

169) A 35 year old male suffering from sudden onset of high grade fever. On malarial slide examination, all stages of the parasite are seen with schizonts of 20 microns size with 14-20 merozoites per cell and yellow brown pigment. The diagnosis is
a) Plasmodium falciparum
b) Plasmodium vivax
c) Plasmodium malariae
d) Plasmodium ovale

170) A child after consuming food in a party complaints of vomiting and diarrhea within 1-5 hours. The diagnosis is
a) Staphylococcus aureus
b) Streptococcus
c) Clostridium Perfringens
d) Clostridium Botulinum

171) Culex tritaenorrhyncus transmits
a) Dengue fever
b) Yellow fever
c) KFD
d) Japanese encephalitis

173) For the disposal of the hospital refuse, the bag made by cadmium is not used because incineration of the bag causes poisonous toxic fumes evolution. The color of the bag is
a) Black
b) Red
c) Blue
d) Yellow

174) Berkesonian bias refers to
a) Different rates of admission to the hospital
b) Interviewers bias

175) A 10 year old boy following a road traffic accident presents to the casualty with contaminated wound over the left leg. He has received his complete primary immunization before preschool age and received a booster of DT at school entry age. All of the following can be done except
a) Injection of TT
b) Injection of human antiserum
c) Broad spectrum antibiotics
d) Wound debridment and cleaning

176) A malarial survey is conducted in 50 villages having a population of one lakh. Out of 20,000 slides examined, 500 turned out to be malaria positive. The annual parasite index is
a) 20%
b) 5/1000 Population
c) 0.5%

178) For a typhoid endemic country like India, the immunization of choice is
a) TAB Vaccine
b) typhoral 21A oral vaccine
c) monovalent vaccine

179) Kallu, a 22 yr old male had an outing with his friends and developed fever of 38.5 degree C, diarrhea and vomiting following eating chicken salad. 24 hours back, two of his friends developed the same symptoms. The diagnosis is
a) Salmonella enteritis poisoning
b) Bacillus cereus
c) Staphylococcus aureus
d) Vibrio cholera

180) Simple randomization is done for
a) Every person has an equal and known chance of selection

181) In a normal distribution curve, the true statement is
a) Mean = SD
b) Median =SD
c) Mean =2 Median
d)Mean = Mode

182)On prescription of oral pills to the user, the health worker will ask about the following except
a) Number of live children
b) calf tenderness
c) Headache
d) Swelling of the feet

183) A patient of paucibacillary tuberculoid leprosy completed 6 months of multidrug therapy. The response to therapy is good, but the lesion has not healed completely. According to the WHO criteria , which of the following should be done?
a) Stop treatment and watch
b) Continue the treatment for 6 more months
c) Continue Dapsone for 2 more months
d) Test for drug resistance

184) General fertility rate is a better measure of fertility than the crude birth rate because
the denominator includes
a) 15-45 years of age female.
b) Midyear population
c) Total woman population
d) Married woman population

185) A patient with sputum positive pulmonary tuberculosis is on ATT for the last 5 months but the patient is still positive for AFB in the sputum. This case refers to
a) New case
b) Failure case
c) Relapse case
d) Drug defaulter

186) Under the baby friendly hospital initiative program, all of the following can be done except
a)Breast feeding started 1-4 hours after birth
b) Mother and the child are kept together for 24 hours of the day
c) Feeding on demand
d) Exclusive breast feeding without any other food is preferred upto 4 months

187) In India. all are direct causes of maternal mortality except
a) Cardiac disease
b) Eclampsia
c) Hemorrhage
d) Abortion

188) In a group of 100 children, the weight of a child is 15 Kg. The standard error is 1.5 Kg.
Which one of the following is true
a) 95% of all children weigh between 12 and 18 Kg
b) 95% of all children weigh between 13.5 and 16.5 Kg
c) 99% of all children weigh between 12 and 18 Kg
d) 99% of all children weigh between 13.5 and 16.5 Kg

189) Malaria incidence in a village in the year 2000 is 430, 500, 410, 160, 270, 210, 300, 350, 4000, 430, 480, 540. Which of the following is the best indicator for assessment of malaria incidence in that village by the epidemiologist?
a) Arithmetic mean
b) Geometric mean
c) Median
d) Mode

190) In which of the following are granulomas not seen
a) Wegeners Granulomatosis
b) Giant cell arteritis
c) Microscopic polyangiiitis
d) Chrug-Strauss vasculitis

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