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AIIMS November 2000

Author: Guest, Posted on Tuesday, January 28 @ 00:00:00 IST by RxPG  

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AIIMS

1. If a missile enters the body just above the pubic ramus through the anterior abdominal wall, it will most likely pierce which of the following structures a.Abdominal aorta b.Left renal vein c.Urinary bladder d.Spinal cord

2. Which of the following is not a boundary of the Koch's triangle a.Tendon of Todaro b.Limbus fossa ovalis c.Coronay sinus d.Tricuspid valve ring

3. Which of the following aminoacids is associated with increased risk of Myocardial infarction a.Methionine b.Homocysteine c.Ornithine d.Valine

4. Kalloo 65 years presents with complaints of abdominal pain. On examination there was distension of abdomen and the stools were maroon colored. He gives a past history of Cerebro vascular accident and Myocardial infarction. What would be the probable diagnosis a.Ulcerative colitis b.Crohn's disease c.Acute mesenteric ischemia

5. Which of the following ECG changes is least likely in a patient with left pneumothorax a.Inversion of Twave b.Left axis deviation c.Small R wave d.Electrical alternans

6. A patient presents 12 hours following a Myocardial infarction. Which of the following enzymes will be elevated at this period a.Lactate dehydrogenase b.Serum Glutamate Oxalo acetate Transferase c.Creatinine Phospho Kinase d.Myoglobin

7. Which of the following features denote a contraindication for surgical resection in a case of carcinoma lung a.Malignant pleural effusion b.involvement of visceral pleura c.Hilar lymphadenopathy d.Consolidation of one lobe

8. Lalloo 50 years, a chronic smoker, presents with history of hemoptysis. He was having trunkal obesity and hypertension. He had an elevated ACTH level which was not suppressible with high dose dexamethasone. What would be the most probable diagnosis a.Bilateral adrenal hyperplasia b.adrenal adenoma c.pituitary tumor d.ectopic ACTH producing lung cancer

9. When the following aminoacids are separated by running them on agarose gel, at pH 7, which one of them will migrate slowest to the anodic end a.Glycine b.Valine c.Aspartic acid d.Lysine

10. While bathing a 6 month old child, his mother noted that there was a swelling in the abdomen towards the left side. On examination there was an abdominal mass, which showed calcification near the left kidney. What is the most probable diagnosis a.Lymphoma b.Leukemia c.Neuroblastoma d.Renal cell carcinoma

11. A G2P1+0+0, Diabetic mother presents at 32 weeks of pregnancy. She gives a history of full term fetal demise during her last pregnancy. Her sugar is now controlled and the child is stable. What is the best plan of action a.Await spontaneous delivery b.Induce at 38 weeks c.Induce at 40 weeks d.Cesarian section at 38 weeks

12. Which of the following is an absolute indication for Cesarian section in pregnancy associated with heart disease a.Pulmonary stenosis b.Coarctation of Aorta c.Eisenmenger syndrome d.Ebstein's anomaly

13. Basanti, 23 year old pregnant women presents with features of dilated cardiomyopathy. Which of the following drugs you will not give to treat her a.Digoxin b.ACE Inhibitors c.Diuretics d.vasodilators

14. The ?9 month old child of a diabetic mother presents with tachypnea and hepatomegaly. Echo cardiography of the heart showed normal cardiac morphology with asymmetric septal hypertrophy. Which of the following you will give to treat this child a.Digoxin b.Frusemide c.Propranolol d.Isoptin

15. Under the National Polio Eradication Program, a case of Acute Flaccid Paralysis is confirmed as Polio, under the following circumstances except a.If a case is lost to follow up b.If a case could not be confirmed because the patient died before that c.If a wild strain of polio virus is isolated from stool d.If a patient develops paralysis 30 days after diagnosis of AFP

16. What is the number of FRU units per district a.01-- 03 b.04 -- 06 c.07 -- 09 d.10 -- 12

17. Child of Vasanthi, was weaned from breast milk on the fifth day and was given sugar cane juice. The child developed hypoglycemia and hepatomegaly. Biochemical examination showed hypophosphatemia and reducing substances in urine. The child is probably suffering from which of the following enzyme deficiencies a.Aldolase B b.Fructokinase c.Glucose 6 Phosphatase d.Beta Galactosidase

18. Sex ratio in India according to the 1991 Census is a.929 b.972 c.934 d.1012

19. Calculate the median from the following values 1.9, 1.9, 1.9, 2.1, 2.4, 2.5, 2.5, 2.5, 2.9 a.1.2 b.1.9 c.2.25 d.2.5

20. Which of the following is not spread by Aedes mosquito a.Dengue fever b.Chickungunya c.Japanese Encephalitis d.Yellow fever

21. Median weight of 100 children was 12kgs. The Standard Deviation was 3. Calculate the percent coefficient of variance a.25% b.35% c.45% d.55%

22. All of the following are random sampling methods except a.Simple random b.Cluster sampling c.Stratified random d.Quota Sampling

23. In a group of persons taking part in a controlled trial of an antihypertensive drug, the Blood Pressures were measured before and after giving the drug. Which of the following tests will you use for comparison a.paired t test b.F test c.t test d.Chi square test

24. Widmark's formula is used for measurement of blood levels of a.Benzodiazepines b.Barbiturates c.Alcohol

25. Cherry red color in post mortem staining is a feature of poisoning with a.Nitrites b.aniline c.Phosphorus d.Carbon Monoxide

26. Elevated levels of cyanide is seen in death due to which of the following a.Cold b.Scald c.Starvation d.Thermal burns

27. Kalloo 45 years old, having a 10 year history of alcoholism, presents with complaints of confusion, ataxia, ophthalmoplegia and peripheral neuropathy. What is the most probable diagnosis a.Wernicke's encephalopathy b.Korsakoff's psychosis c.Delerium tremens d.Alcoholic hallucinations

28. Lalloo, 60 yrs of age, a known case of cirrhosis liver, presents with increased levels of Alpha feto protein , hepatomegaly 3 cm below costal margin. USG showed lesions involving the right lobe of the liver. What is the most probable diagnosis a.Focal nodular hyper plasia b.Hepato cellular carcinoma c.Hepatic adenoma d.metastasis

29. What is the most common mode of inheritance of von Williebrand's disease a.Autosomal dominant b.Autosomal recessive c.X linked recessive d.Co dominant

30. 20 year old boy, presented with severe hematemesis. On examination there was no hepatomegaly, mild splenomegaly present. On endoscopy esophageal varices were seen. What is the most probable diagnosis a.Cirrhosis liver b.Budd Chiari syndrome c.Non cirrhotic portal fibrosis d.Veno occlusive disease

31. What is the most common cause for Budd Chiari syndrome a.Right ventricular failure b.PNH c.valve in hepatic veins d.Nephrotic syndrome

32. Which of the following is not seen in Paroxysmal Nocturnal Hemoglobinuria a.Hypocellular bone marrow b.Hemosiderinuria c.Increased LAP score d.Pancytopenia

33. All of the following are seen in polycythemia rubra vera except a.Increased Vit B12 binding capacity (>900micromols/dL) b.decreased LAP score c.Leucocytosis d.increased platelets

34. What is the size of the microfilter used in blood transfusion sets a.50micro meters b.150 micro meters c.170 micro meters d.250 micro meters

35. All of the following are part of Manning's criteria except a.Fetal respiratory movements b.Non stress test c.Fetal body movements d.Vibroacoustic stimulation

36. A patient with choriocarcinoma, is not responding to the usual doses of methotrexate. She is having jaundice. Which drug will you prefer for further treatment a.Actinomycin D b.Cyclophosphamide c.Cisplatin d.Chlorambucil

37. Which of the following is the most reliable indicator of Ectopic gestation a.No gestational sac in USG b.Arias Stella reaction c.Culdo centesis showing blood in the posterior cul-de-sac d.Absence of the normal doubling of hCG levels

38. A 22 year old lady present with pain in the right iliac fossa. On examination there was tenderness and guarding . Which of the following should not be done in this case a.Put patient Nil orally b.give I.V.glucose c.Inj. Pethidine I.M. d.Plain X ray abdomen

39. A child presents with history of blunt injury abdomen associated with splenic trauma. On examination the child is stable. Which of the following is the treatment of choice a.Splenorrhaphy b.Observation c.Splenectomy d.Arterial embolisation

40. Which of the following is true about carcinoma colon a.Lesion on the left side of the colon presents with features of anemia b.Solitary metastasis is liver is not a contraindication for surgery c.mucinous carcinoma has a good prognosis d.Duke's A stage should receive adjuvant chemotherapy

41. A patient with Hodgkin's lymphoma is having a single cervical lymphnode. Biopsy showed lymphocyte predominant variant. Which of the following is the treatment of choice a.Chemotherapy with Radiotherapy b.Chemotherapy only c.Radiotherapy only d.No treatment needed

42. Lalloo, a 55 year old chronic smoker, presents with complaints of hoarseness of voice. On examination there is a single enlarged painless lymphnode in the left supraclavicular area. What is the next step to be done a.Excision biopsy of the node b.Laryngoscopy and Chest X ray c.CT scan d.Sputum for AFB

43. A girl presents with complaints of melena. On examination there are pigmented lesions involving her mouth and lips. Two of her sisters also had similar complaints. Which of the following is the most probable diagnosis a.Kronchite Canada syndrome b.Puetz Jegher's syndrome c.Gardner's syndrome

44. 30 year old Basanti presents with light brown lesions involving both her cheeks. The lesions had never been erythematous. Which of the following is the most probable diagnosis a.SLE b.Chloasma c.Air borne Contact Dermatitis d.photodermatitis

45. All the following malignancies are associated with HIV except a.Astrocytoma b.Non Hodgkin's lymhoma c.Gastric adenocarcinoma d.Kaposi's sarcoma

46. Babloo, 5 years, presents with small hypopigmented scaly macules on his cheek. Some of his classmates also have similar lesions. Which of the following is the most probable diagnosis a.Pityriasis alba b.Pityriasis rosea c.Pityriasis versicolor d.Indeterminate leprosy

47. A 11 month old child presents with complaints of respiratory distress. On examination there is bilateral crepitations and wheezing . Which of the following is the most likely cause a.pneumonia b.respiratory syncitial virus c.adenovirus d.rhinovirus

48. A patient presents with features suggestive of chronic pancreatitis. ERCP examination showed "chain of Lakes" appearance. Which of the following is the most appropriate management for this patient a.Side to side pancreatico jejunostomy b.Distal pancreatic resection and end to side anastomosis. c.Whipple's resection d.sphincterotomy

49. A patient presents with a pancreatic pseudocyst 5cm in size, 3 weeks duration. What is the best method to manage this case a.External drainage b.USG and follow up c.cystogastrostomy d.Needle aspiration

50. Kalloo, 25yrs, presented with a mass in the right iliac fossa. On laprotomy it was found to be a carcinoid 2.5cms in diameter. What is the next step in management a.Segmental resection b.Right hemicolectomy c.Appendicectomy d.do yearly 5-HIAA

51. A patient presents with head ache, intermittent claudication and dizziness. Which of following may be the underlying cause a.Tetrology of Fallot b.Coarctaion of aorta c.Patent ductus arteriosus d.Atrial septal defect

52. A needle aspiration from the thyroid nodule of a patient with pituitary tumor and pheochromocytoma shows which of the following a.Follicular carcinoma b.Medullary carcinoma c.Anaplastic carcinoma d.Papillary carcinoma

53. Kalloo 45 years presents with a swelling in the thyroid gland and a lymphnode in the neck. Aspiration of the node shows amyloid material. What is the management of choice for this patient a. Hemithyroidectomy with neck dissection b.Total thyroidectomy with neck dissection c.Total thyroidectomy with neck irradiation d.Hemithyroidectomy

54. A patient presents with intermittent head ache. On examination there is hypertension and a thyroid nodule. Which of the following steps is to be taken next a.Urine HIAA levels b.Urine VMA and aspiration of the thyroid nodule

55. Basanti, 40 yrs, underwent subtotal thyroidectomy. In the recovery room she developed stridor. There was some staining of the wound with blood. Which of the following is the least likely cause a.Tracheomalacia b.Bilateral recurrent nerve palsy c.Hematoma formation d.Hypocalcemia

56. After thyroidectomy, a patient developed a wound hematoma in the ward associated with respiratory distress. Which of the following is the next best step to do a.Orotracheal intubation b.immediate opening of the wound c.observation d.Send the patient to the theatre to remove the clots

57. A post thyroidectomy patient presents with tingling and perioral paresthesia. Serum calcium level was 7 mg/dL. Which of the following is the best line of management a.Oral vitamin D3 b.Oral vitamin D3 with calcium c.I.V.calcium gluconate d.Observation

58. Bowel does not get strangulated in which of the following a.Recto uterine pouch b.Omental bursa c. Ileo-colic recess d.Para duodenal and peritoneal recess

59. Vocal cord paralysis is due to involvement of which of the following nerves a.External laryngeal b.Internal laryngeal c.Recurrent laryngeal d.Superior laryngeal

60. Vasanti, 28 year old, presents with complaints of tightness of fingers. There is also history of dysphagia. Which of the following is the probable diagnosis a.Dermatomyositis b.Scleroderma c.Rheumatoid arthritis

61. A lady approaches a physician for contraceptive advice. On examination there were two symmetrical ulcers on vulva, which were well defined with a firm base. Which of the following is the most likely cause a.Syphilis b.Chancre c.Herpes d.Malignancy

62. Carcinoma endometrium with involvement of inguinal nodes belongs to which stage a.StageI b.Stage II c.Stage III d. Stage IV

63. Cone biopsy is indicated in all the following conditions except a.Micro invasive carcinoma b.indefnite diagnosis on colposcopy c.CIN III d.Cervical metaplasia

64. Pap smear from a lady shows CIN grade III. Which of the following is the next step in management a.cone biopsy b.punch biopsy c.large loop excision d.colposcopy directed biopsy

65. A patient is diagnosed to have CIN II. She approaches you for advice. You can definitely tell her the risk of lesion progressing to malignancy as a.5% b.15% c.60% d.30%

66. A child presents with multiple permeating lesions involving all the bones in body. Which of the following is the most probable diagnosis a.Neruoblastoma b.Histiocytosis X c.Metastasis from osteosarcoma d.Metastasis from Wilm's tumor

67. A 70 year old man presents with urinary retention and back pain. Which of the following investigations is needed next a.Serum acid phosphatase b.Serum alkaline phosphatase c.serum electrophoresis d.serum calcium

68. Which of the following is not seen after trans urethral resection of prostate a.Hyponatremia b.Hypernatremia c.Transient blindness d.convulsions

69. A patient is having benign prostatic hyperplasia. He is having a blood pressure of 180/110mmHg and a serum Creatinine of 3.5. Which of the following drugs is not to be used to treat him a.Prazocin b.Enlapril c.Amlodipine d.Metoprolol

70. A patient presents at 32 weeks of pregnancy with suspected antepartum hemorrhage. Her blood pressure is 80/60mmHg. Which of the following is the next step in management a.Immediate cesarian section b.careful observation c.blood transfusion

71. Scanty, foul smelling, painless discharge from the ear is a characteristic feature of which of the following lesions a.Acute otitis media b.otitis externa c.central perforation d.cholesteatoma

72. A 70 year old man presents with complaints of tinnitus. Which of the following is the most probable diagnosis a.labrynthitis b.acoustic trauma c.ASOM d.acoustic neurinoma

73. A 55 year old smoker presents with complaints of hemoptysis. On bronchoscopic examination, there was a lesion in the distal trachea which was growing in to the lumen. Which of the following is the most probable diagnosis a.Squamous cell carcinoma b.adenoid cystic carcinoma c.squamous papilloma d.Muco Epidermoid carcinoma

74. After hyperventilating for some time, holding the breath is dangerous since a.it can lead on to CO2 narcosis b.due to the lack of stimulation by CO2 anoxia can go into dangerous levels c.decreased CO2 shift the ODC to the left d. alkalosis can lead on to tetany

75. Blood gas measurements of a patient shows the following values pH 7.2 p CO2 80mmHg, pO2 46mmHg. Which of the following could be the most probable diagnosis a.acute asthma b.acute exacerbation of COPD c.ARDS d.severe pneumonia

76. Sulfur granules in actinomycosis are composed of a.organisms b.Neutrophils and lymphocytes c.monocytes d.eosinophils

77. In lipoprotein lipase deficiency which of the following is increased a.VLDL b.LDL c. HDL d.Chylomicrons

78. Lipid lowering agents Statins, act in all the following ways except a.decreased hepatic cholesterol synthesis b.decreased LDL receptors c.Inhibiting HMG Co-A reductase d.decreasing VLDL

79. Statin induced myopathy is not exacerbated by which of the following drugs a.Nicotinic acid b.Enlapril c.Erythromycin d.Clofibrate

80. What is the attitude of the lower limb following posterior dislocation of hip a.abduction, flexion and internal rotation b.adduction, flexion and internal rotation c.abduction flexion and external rotation d.adduction flexion and external rotation

81. A child falls from a height and lands on his fully outstretched hands. On examination there is pain and swelling over his right elbow. The probable diagnosis is a.Fracture both bones forearm b.Supra condylar fracture of humerus c.posterior dislocation of elbow. d.Fracture olecranon

82. A man was diagnosed to have myositis ossificans progressiva at the age of 20 years. He died five years later. What is the most probable cause of death a.starvation and chest infection b.myocarditis c.hypercalcemia d.hyperphosphatemia

83. A patient is having a left tibial fracture which is on POP cast for two months. Now he needs mobilization of a single crutch. On which side will you use this crutch a.Any side b.left side c.right side d.both sides

84. A 10 year old child presents with a mass on his thigh which was found to be arising from the diaphysis and involving the soft tissues. The child was having fever also. What is the most probable diagnosis a.Osteosarcoma b.Ewing's sarcoma c.chondrosarcoma d.malignant fibrous histiocytoma

85. Histology of Ewing's sarcoma shows small round cells. These cells are filled with which of the following a.Iron b.Fat c.Mucin d.Glycogen

86. A 50 year old patient presents with a lesion in the midline involving the sacrum which is sclerotic. What is the likely diagnosis a.osteosarcoma b.chordoma c.metastasis

87. A child was taken to the doctor by his mother, complaining that there is decrease in his school performance. His teacher says that he frequently squeezes his eyes and says that there is difficulty in seeing the black board. What is the most probable diagnosis a.Myopia b.Hyperopia c.Presbyopia

88. Basanti, a 20 year old female presents with complaints of difficulty in reading near print. On examination there is ptosis and diplopia in looking in all directions. What is the most probable diagnosis a.Lateral rectus palsy b.Oculomotor palsy c.presbyopia d.Myasthenia gravis

89. 25 year old Kalloo, presents with one day history of pain and redness associated with watering from his left eye. This was associated with intolerance to light. What is the most probable diagnosis a.Acute anterior uveitis b.acute posterior uveitis c.epidemic keratoconjunctivitis

90. Which of the following is the commonest infection which causes blind ness in adult men a.Toxocara b.Toxoplasma gondii c.Tenia solium d.Plasmodium falciparum

91. All the following anatomical changes will predispose to primary angle closure glaucoma except a.small cornea b.flat cornea c.anterior chamber shallow d.short axial length of eye ball

92. In a hypertensive patient with glaucoma which of the following is not used a.Dipivefrine b.Beta blockers c.alpha agonist d.laser trabeculoplasty

93. A patient complains of evening halos and occasional head aches for some months. On examination anterior chamber of both the eyes are shallow and the intra ocular pressure is normal. This condition represents what stage of glaucoma a.constant instability b.prodrome c.absolute d.acute

94. A five year old child presents with mild proptosis and loss of vision of one eye. On examination direct pupillary reflex is absent and consensual reflex is present. What is the most probable diagnosis a.Retinoblastoma b.optic disc angioma c.optic nerve glioma d.optic sheath meningioma

95. A 48year old lady presents with unilateral mild axial proptosis . There is no history of redness or pain. Which of the following is the most appropriate investigation a.CT scan to rule out meningioma b.USG to rule out orbital pseudotumor c.T3 and T4 measurement to rule out thyrotoxicosis d.Thyroid scan

96. Ramesh 60 years, presents with generalized bone pain . On examination there is elevated ESR of 100mm, serum globulin 7, lytic lesions in the skull, serum creatinine of 3.5mg/dL and serum calcium of 11mg/dL. What is the most likely diagnosis a.Waldenstrom'smacroglobulinemia b.Multiple myeloma c.Hyperparathyroidism

97. Blood turbulence is increased in which of the following situations a.Multiple myeloma b.lukemia c.polycythemia d.anemia

98. Serum alkaline phosphatase in increased in which of the following diseases a.osteoporosis b.Paget's disease c.hypoparathyroidism d.Multiple myeloma

99. 76 year old man presents with lytic lesions in the vertebra. X ray skull showed multiple punched out lesions . The most likely diagnosis a.Multiple myeloma b.hyperparathyroidism

100. Basanti, an 8 year old girl, presents with recent onset of genu valgum and difficulty in walking. On X-ray examination there is metaphyseal widening and osteoporosis. Investigations showed a serum calcium of 11mg/dL, serum phosphorus of 2.5 mg/dL and Alkaline Phosphatase of 30KAU.PTH was elevated The possible cause is a.Hypophosphatemic rickets b.nutritional rickets c.primary hyperparathyroidism d.azotemic renal dystrophy

101. Recurrent Giardiasis is associated with a.C1 esterase deficiency b.Common variable immunodeficiency c.Di George syndrome d.C8 deficiency

102. Which of the following best denotes classical complement pathway activation in immuno inflammatory conditions a.C2, C4 and C3 decreased b.C2 and C4 normal C3 is decreased c.C3 normal and C2, C4 decreased

103. Vasanti, a 25 year old girl, presents with complaints of fever and weakness. On examination there is splenomegaly of 3cm below the costal margin. Hb is 8 mg/dL TLC is 3,000/mm3 , platelet count is 80,000/mm3. Which of the following is the least likely diagnosis a.Acute lymphocytic lukemia b.Anemia of chronic disease c.Aplastic anemia d.Megaloblastic anemia

104. A child with Ventricular septal defect developed Eisenmenger syndrome. What is the correct sequence of events which leads to this change a.Left to right shunt, Right ventricular hypertrophy, Pulmonary hypertension, Right to left shunt b.Left to right shunt, Pulmonary hypertension, Right ventricular hypertrophy, Right to left shunt c.Left to right shunt, Right ventricular hypertrophy, Right to left shunt, Pulmonary hypertension d. Pulmonary hypertension, Right to left shunt, Right ventricular hypertrophy, Left to right shunt

105. A child is diagnosed to have acute gastro enteritis. The doctor wants to sent a stool sample to a lab in the periphery which is 16 - 18 hrs away. Which of the following mediums should he use to sent this sample a.Charcol cotton bud b.Carry Blair medium c.sterilized jar d.A medium with high CO2 content

106. Laparotomy of a lady with a suspected ovarian tumor showed bilaterally enlarged ovaries with smooth surfaces. Histology showed mucin secreting cells with a signet ring appearance. What is the likely diagnosis a.primary adenocarcinoma of ovary b.granulosa cell tumor c.Krukenberg tumor d.Dysgerminoma

107. Lalloo 54 years, who is a known diabetic patient develops cirrhosis. There is associated skin hyperpigmentation and restrictive cardiomyopathy. Which of the following is the best initial test to diagnose this case a.Total Iron Binding Capacity b.Serum ferritin c.Serum copper d.Serum ceruloplasmin

108. A child presents with complaints of oliguria, abdominal distension and diarrhea. On examination there is deep jaundice. Hepatomegaly was present measuring 4cm below the costal margin. Conjugated bilirubin in blood was 38mg/dL, and there was urine urobilinogen and bile pigments. Hemoglobin was 4mg/dL and serum creatinine was 3 mg/dL. Which of the following tests is of least importance to diagnose this case a.G-6-PD level in blood b.Serum ceruloplasmin c.reticulocyte count d.leptospiral antibody level

109. A farmer rearing sheep, presented with complaints of fever and weakness for the last one month. There is generalized lymphadenopathy. There was also associated hepatomegaly. Biopsy of liver showed non-caseating granuloma. These are most likely due to infection with a.Brucella melitensis b.Brucella canis c.Francisella tularensis d.Yersinia pestis

110. A child presents with complaints of abdominal colic and hematuria. USG showed a renal stone 2.5cm in diameter in the renal pelvis. The next step in management of this case is a.ESWL b.pyelolithotomy c.nephroureterostomy d.Conservative

111. A hemophiliac patient is going to undergo a tooth extraction under monitored anaesthetic care. Which of the following is not true under this situation a.Factor 8 cryoprecipitate may be needed b.HIV screening should be done for all cases c.Dental extraction should be done only under General anesthesia d.The dose of lignocaine is same as their normal counterparts

112. Which of the following is true regarding Mallet finger a.avulsion of extensor tendon at the base of the distal phalanx b.fracture of the distal phalanx c.fracture of the proximal phalanx d.avulsion of tendon at the base of the middle phalanx

113. The most effective way of preventing tetanus is a.Surgical debridement and toilet b.hyperbaric oxygen c.antibiotics d.Tetanus toxoid

114. Best epidemiological tool for investigation of Hepatitis B is a.Anti HBs Ag b.Anti HBc Ag c.Anti Hbe Ag d.HBc Ag

115. A pregnant lady is diagnosed to be HBs Ag positive . Which of the following is the best way to prevent infection to the child a.Hepatitis B immunization to mother b.Hepatitis B vaccine to the child c.Full course of Hepatitis B vaccine and immunoglobulin to the child d.Hepatitis B immunoglobulin to mother

116. A lady of 24 weeks of gestation presents with complaints of abdominal pain. On examination there is a tender mass in the lower abdomen which is in continuity with the uterus. Which of the following is the most likely diagnosis a.Hyaline change in myoma b.Red degeneration of fibroid c.premature placental separation

117. Fothergill's repair for prolapsed uterus will not lead to a.first trimester abortions b.cervical distocia c.premature labor d.premature rupture of membrane

118. A patient presents with post coital bleeding. On speculum examination there is a friable mass in the cervix. What is the next step in management a.punch biopsy b.coloposcopy directed biopsy c.6 monthly pap smear

119. A five year old child of normal intelligence presents with features of hypotonia. On examination there was tongue fasciculations and he keeps his body in a frog like position. What is the most probable diagnosis a.Down's syndrome b.Guillain Barre syndrome c.Spinal muscular atrophy d.Limb girdle atrophy

120. Babloo, a 4 year old boy, presents with history of seizures. On examination there is hypopigmented patches on his face. There is mental retardation also. What is the most likely diagnosis a.Neurofibromatosis b.Tuberous sclerosis c.Sturge Weber syndrome d.incontinentia pigmenti

121. ANCA is not associated with which of the following diseases a.Wegener's granulamatosis b.Henoch Schonlein purpura c.microscopic PAN d.Churg Strauss syndrome

122. A child presents with a solitary white well defined patch of his right thigh. What is the diagnosis a.Piebaldism b.Nevus achromicus c.acral vitiligo d.albinism

123. What is the best prognostic indicator of multiple myeloma at the time of diagnosis a.number of myeloma cells in the marrow b.beta2 microglobulin c.alkaline phosphatase level d.hyper calcemia

124. What is the line of management of a case of moderate to severe hepatic insufficiency with portal hypertension, according to the modified Pugh's classification a.sclerotherapy b.orthotopic liver transplantation c.shunt surgery d.conservative

125. A five year old male child presents with complaints of fever and abdominal distension. He is having vomiting for the last five days. On examination there are 6 -- 8 pus cells/hpf in urine. WBC count shows 78% neutrophils. What is the best line of management a.send urine for culture and sensitivity and wait for results b.send for urine culture and sensitivity and start i.v.antibiotics immediately c.send urine for culture, do an USG and start choroquine

126. What is the treatment of choice in a pregnant lady having Plasmodium vivax infection a.chloroquine b.chloroquine+primaquine c.quinine d.chloroquine+pyrimethamine

127. Which of the following is not a feature of idiopathic cholestasis associated with pregnancy a.serum bilirubin of 2 mg/dL b.serum alkaline phosphatase of 30 KAU c.SGPT of 200 units d.prolongation of prothrombin time

128. A pregnant lady presents with fulminant hepatitis. Which of the following is the most likely causative agent a.Hepatitis A b. Hepatitis B c.Hepatitis E d. Hepatitis D

129. A lady presents with complaints of hemoptysis. Her chest X ray appears to be normal. What is the next best investigation a.bronchoscopy b.High Resolution CT c.sputum cytology

130. A boy presents with one episode of painless gross hematuria. An excretory urogram showed a filling defect towards the lower renal infundibulum 1.5 cm in size. What is the next investigation to be done a.cystoscopy b.ultrasonography c.retrograde pyelography d.urine cytology

131. All are true regarding treatment with aminophylline except a.it decreases the oxygen tension b.its dose is to be decreased in smokers c.it increases the contractility of the diaphragm d.interaction with erythromycin can increase its toxicity

132. What is the treatment of choice for myoclonic epilepsy in children a.phenytoin b.phenobarbitone c.sodium valproate d.ethosuximide

133. A patient is having normal lung compliance and increased airway resistance. What is the most economical way of breathing for him a.slow and deep b.slow and shallow c.rapid and deep d.rapid and shallow

134. A 45 year old man presents with history frequent falls. He has difficulty in looking down also. What is the most probable diagnosis a.Normal pressure hydrocephalus b.Parkinson's disease c.Alzheimer's disease d.Progressive supraneuclear palsy

135. Impotence is a feature of which of the following a.Multiple sclerosis b.Poliomyelitis c.Amyotropic lateral sclerosis d.Meningitis

136. Non immune hydrops is not a feature of which of the following a.chromosomal abnormalities b.alpha thalassemia c.renal malformations in fetus d.fetal cardiac abnormalities

137. A boy presents two weeks after an injury to his left eye. He complaints of bilateral pain and redness and watering from right eye. What is the probable diagnosis a.endophthalmitis b.optic neuritis c.sympathetic irritation d.sympathetic ophthalmitis

138. A 29 day old child presents with features of congestive cardiac failure and left ventricular hypertrophy. There was an associated short systolic murmur. Which of the following is the most likely cause a.Tetrology of Fallot b.Ventricular septal defect c.Transposition of Great arteries d.Rheumatic fever

139. A five year old child presents with left ventricular hypertrophy and central cyanosis. Which of the following is the underlying cardiac lesion a.Partial anomalous pulmonary venous drainage b.Tricuspid atresia c.Eisenmenger syndrome d.Tetrology of Fallot

140. The murmur of HOCM is decreased in which of the following a.supine position b.standing position c.valsalva maneuver d.amyl nitrate inhalation

141. A young lady presents with hypertension. DTPA scan was normal. USG showed a small kidney on left side. What is the next investigation a.DMSA b.Digital subtraction angiography c.CT scan abdomen d.Retrograde pyelogram

142. A breast fed child presents with hyper natremia (serum sodium >170mEq/L). His urine sodium is 70mEq/L. Which of the following is the most likely cause a.Diabetes insipidus b.acute tubular necrosis c.severe dehydration d.excessive intake of sodium

143. Which of the following values are suggestive of acute tubular necrosis a.urine osmolality >500 b.urine sodium >40 c.Blood urea nitrogen/plasma creatinine >20 d.Urine Creatinine / plasma creatinine >40

144. What is the management of a case of bullet injury to left side of the colon presenting at 12 hrs after the incident a.Primary closure b.proximal colostomy and bringing out the distal part as a mucus fistula c.resection and primary anastomosis d.proximal defunctioning colostomy

145. Endoscopy of a patient having peptic ulcer disease showed features of chronic antral gastritis.Which of the following dyes will you use to stain a specimen taken from the stomach a.PAS b.gram stain c.Warthin starry stain d.Zeihl Nielson stain

146. All are done as part of radical mastoidectomy except a.closure of the Eustachian tube b.removing the cochlea c.removal of the ossicles d.exteriorisation of the mastoid

147. All the following can lead on to trophic ulcers in the fingers except a.cervical disc prolapse b.subacute combined degeneration of spinal cord c.leprosy d.syringomyelia

148. Zileuton is a.5 lipooxygenase inhibitor b.TX A2 inhibitor c.Leukotriene receptor antagonist

149. In calculating crude birth rate which of the following is used as denominator a.women in 15-49 yrs age group b.all persons in 15-49 yrs age group c.mid year population d.all live births

150. The calculate infant mortality rate you take mortality of which of the following age group a.less than 7 days b.less than 28 days c.less than1-4 days d.less than 1 year

151. If the greater tuberosity of the humerus is lost which of the following movements will be affected a.adduction and flexion b.abduction and lateral rotation c.medial rotation and adduction d.flexion and medial rotation

152. The prognosis of soft tissue sarcoma depends on which of the following a.tumor grade b.tumor size c.histological type d.nodal metastasis

153. While calculating the incubation period for measles in a group of 25 children, the standard deviation is 2 and the mean incubation period is 8 days. Calculate the standard error a.0.4 b.1 c.2 d.0.5

154. Chemoprophylaxis is not indicated in which of the following a.measles b.cholera c.meningococcemia d.plague

155. Which of the following is true regarding Nisseria meningitidis infection a.In India the sero type B is the most common cause b.all strains are uniformly sensitive to sulfonamides c.in children less than 2 years the vaccine is not effective d.it is the most common cause of meningitis in children

156. Extrapyramidal symptoms are not seen in a.paralysis agitans b.carbon monoxide poisoning c.cerebro vascular accident d.multiple sclerosis

157. According to the WHO, what is the minimum bacteriological standard for drinking water a.all the samples should not contain coliform organisms b.3 consecutive samples of water should not contain any coliforms c.3 coliforms in a 100ml

158. Starvation and diabetes mellitus can lead on to ketoacidosis. Which of the following features is in favor of ketoacidosis due to diabetes mellitus a.increase in glucagon/insulin ratio, increased cAMP and increased blood glucose b.decreased insulin, increased free fatty acids which is equivalent to blood glucose c.decreased insulin, increased free fatty acids which is not equivalent to blood glucose

159. If correlation between weight and heights are very strong what will be the correlation coefficient a.+1 b.>1 c.0 d.- 1

160. A lady presents with a history of fracture radius, which was put on plaster of paris cast for 4 weeks. After that she developed swelling of hands with shiny skin.What is the most likely diagnosis a.rupture of extensor policis longus tendon b.myositis ossificans c.reflex sympathetic dystrophy d.malunion

161. In hand surgery which area is called "No man's land" a.proximal phalanx b.distal phalanx c.between distal palmar crease and proximal phalanx d.wrist

162. While doing below knee amputation which of the following is the most important technical consideration a.posterior flap should be longer than the anterior flap b.anterior flap should be longer than the posterior flap c.stump should be long d.stump should be short

163. For breast reconstruction which of the following is not used a.Transverse rectus abdominus myocutaneous flap b.Transverse rectus abdominus free flap c.Pectoralis major myocutaneous flap d.Lattismus dorsi myocutaneous flap

164. Kalloo, a 24 year old occasional alcoholic has got a change in his behavior. He has become suspicious that people are trying to conspire against him though his father states that there is no reason for his fears. He is getting hallucinations of voices commenting on his actions. What is the most probable diagnosis a.Delerium tremens b.Alcohol induced psychosis c.Schizophrenia d.Delusional disorder

165. Lalloo 40 years has recently started writing books. But the matter in his book could not be under stood by any body since it contained words which were not there in any dictionary and the theme was very disjoint. Now a days he has becomes very shy and self absorbed. When he addresses people he speaks about metaphilosophical ideas. What is the likely diagnosis a.Mania b.Schizophrenia c.A genius writer d.delusional disorder

166. A patient was on treatment with trifluperazine for some time. He presents with complaints of hyperthermia, lethargy and sweating. What is the next step in management a.do a CT scan brain and a hemogram b.Hemogram, electrolyte levels and creatinine c.ECG, chest X ray and hemogram d.Hemogram, CPK and RFT

167. Vasanti, 45 years , was brought to casualty with abnormal movements which included persistent deviation of neck to right side. One day before she was prescribed Haloperidol 5mg three times daily from the psychiatry OPD. She also had an alternation with her husband recently. Which of the following is the most likely cause for her symptoms a.acute drug dystonia b.conversion reaction c.acute psychosis d.cerebro vascular accident

168. A patient presents with pain in the hip joint and the knee joint. There is defective adduction of his hip joint. Which of the following nerves is most likely involved a.femoral nerve b.obturator nerve c.saphenous nerve d.sciatic nerve

169. A patient was undergoing abdominal surgery under local anesthesia. He suddenly developed sharp severe pain. Which of the following structures will be responsible for his pain a.parietal peritoneum b.liver parenchyma c.colon d.small intestine

170. While doing central venous catheterization of a patient through internal jugular vein, the patient suddenly developed respiratory distress and hypoxemia. What would be the likely cause a.pneumothorax b.tamponade c.hypovolumia d.septiciemia

171. Which of the following is true regarding cortical blindness a.Direct and consensual reflex absent in both the eyes b.Direct and consensual reflexes are present in both the eyes c.Direct reflex present and consensual reflex absent on the affected side d.Direct reflex present and consensual absent on the normal side

172. A low lander goes to the mountains. When he reaches about 50,000 feet high, he develops dyspnea. Which of the following is the correct explanation for his symptom a.Carbon dioxide wash out b.increased blood flow to the pulmonary tissues c.CNS depression

173. All the following are radiological features of mitral stenosis except a.straight left heart border b.oligemia of upper lung fields c.pulmonary hemo siderosis d.lifting of the left bronchus

174. The sodium content of the filtrate in renal medulla is very high because a.at the loop of henle and vasa recta there is a counter current mechanism b.increased blood flow to vasa recta c.increased absorption of sodium from PCT

175. Which of the following is the most common cause of late neurological deterioration in a case of cerebro-vascular accident a.rebleeding b.vasospasm c.embolism d.hydrocephalus

176. Head trauma patient presents four weeks after his injury with features of irritability and altered sensorium. What is the most likely diagnosis a.electrolyte imbalance b.chronic subdural hematoma

177. If a patient on digitalis develops ventricular tachycardia, which of the following drugs you will not use in management a.amiodarone b.quinidine c.phenytoin d.lidocain

178. An 85 year old man under went Trans urethral resection of prostate. A histological examination of his specimen showed foci of adenocarcinoma. What is the next step in management a.endocrine therapy b.no furthur treatment c.radical surgery d.hormone therapy

179. Skin graft survival within 48hrs of transplantation is due to a.new vessels growing from the side b.plasmatic imbibition

180. Which of the following drugs is used to reverse the effect of d-tubocurarin a.atropine b.neostigmine c.physostigmine

181. Which of the following congenital malformations is seen in a child of a mother who is on treatment with oral anticoagulants a.craniofacial malformations b.renal agenesis c.long bone defects

182. Which of the following is least likely to cause interstitial nephritis on chronic use a.methicillin b.cephalothin c.heparin d.ampicillin

183. What is the right time in the menstrual cycle to do endometrial biopsy as a part of investigation for infertility a.3--5 days b.12--14 days c.17--19 days d.22--24 days

184. Which of the following is the best method to assess the adequacy of replacement fluid in a case of shock a.decrease in thirst b.increase in urine out put c.blood pressure d.increased Pa O2

185. Which of the following is not associated with increase in intracranial pressure a.increase in blood pressure b.respiratory depression c.tachycardia d.deterioration of consciousness

186. Which of the following is not a myeloproliferative disease a.polycythemia rubra vera b.acute myeloid lukemia c.chronic myeloid lukemia d.essential thrombocytosis

187. Too much false positives in a test is due to which of the following a.high prevalence b.tests with high specificity c.tests with high sensitivity d.low prevalence

188. According to the Central Birth and Death registration act of 1969, birth is to be reported within a.10 days b.14 days c.7 days d.4 days

189. Which of the following gives the best idea regarding the morbidity in a community a.sentinal surveillance b.active surveillance c.passive surveillance

190. Which of the following studies is best for calculating the incidence of a disease a.case control study b.cohort study c.cross sectional study

191. A patient suffers a decelerating injury in which the pituitary stalk was damaged. Which of the following in least likely to occur a.Diabetes insipidus b.Diabetes mellitus c.thryoid insufficiency d.adreno cortical insufficiency

192. Which of the following is not a feature of Mullerian dysgenesis a.46XX karyotype b.absent vagina b.absent uterus d.ovarian agenesis

193. A patient gets recurrent urticaria while doing exercising and on exposure to sunlight. Which of the following is the most likely cause a.chronic idiopathic urticaria b.universal dermographism c.cholinergic urticaria

194. On complete hydrolysis of DNA we will get all the following except a.Deoxy pentose sugar b.phosphoric acid c.adenosine d.purine bases

195. Which of the following is true about autoclaving a.it kills by denaturation of proteins b.presence of air is good for the killing of organisms c.it is best for oils and jellys d.kills all organisms except HIV

196. Which of the following methods is best for controlling an out break of Methicillin resistant staph aureus infection of wounds in a post operative ward a.using of a face mask by the personnal b.washing the hands thoroughly before and after dressing the wounds c.thorough fumigation of the room d.pre operative vancomycin to every patients

197. Transition temperature of lipid bilayers of cell membranes is increased by a.cholesterol b.saturated fatty acids c.unsaturated fatty acids d.hydrocarbons

198. Regarding the vessels in the umbilical cord which of the following are true a.there are two arteries and two veins b.there are two arteries and the right vein c.there are two arteries and left vein d.there is only one artery and one vein

199. What is the average protein requirement of a reference Indian
man
a.50gms b.60gms c.80gms d.40gms

200. A patient presents with complaints
of sciatica. On radiological
examination, there were sclerotic
lesions involving his pelvis, verte-
brae and ribs. There were also
sclerotic lesions on his skull. Which of the following markers is most likely to be elevated in this patient a.CEA b.Prostate specific antigen



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