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AIIMS November 2001

Author: Guest, Posted on Friday, February 28 @ 00:00:00 IST by RxPG  

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AIIMS

Physiology

1. On injecting, concentrated NaCl solution into the carotid artery, there was increased production of ADH. The source of it’s secretion in the hypothalamus is in the

a. Paraventricular nucleus

b. Supraoptic nucleus

c. Anterior nucleus

d. Ventromedial nucleus

2. Regarding presynaptic inhibition,which of the following combinations is true

a. Affected by axo-axonic transmission

b. Prolonged by IPSP

c. .

d. Not affected by pharmacologic agents

e. Prolonged by anesthetic agents

f. Prolonged by strychnine

g. Inhibited by picrotoxin

a. a,d and f are true

b. a,e and g are true

c. b, f and d are true

d. a, c and g are true



3. In hyperventilation, muscle spasm occurs because of

a. Increased sympathetic activity

b. Increased parasympathetic activity

c. Decreased Ca++ ions

d. Increased gamma efferent activity



4. In hypercarbia, which of the following is seen

a. Hypertension

b. Bradycardia

c. Cold clammy skin

d. Miosis



5. Which of the following statements is true regarding Clathrin

a. Receptor mediated endocytosis

b. Pinocytosis

c. Exocytosis

d. Calmodulin activation



Anatomy



6. All the following pass behind the ischial spine except

a. Pudendal nerve

b. Internal pudendal vessels

c. Nerve to obturator internus

d. Obturator nerve



7. Which among the following statements is true about the kidney

a. The right kidney is lower than the left kidney

b. The right kidney is preferred for renal transplant

c. The right kidney is related to the duodenum in the anteromedial aspect

d. The right renal vein is longer


Biochemistry



8. Celomic bacteria, on digestion of dietary fiber, would give

a. Free radicals

b. Sucrose

c. Glycerol

d. Butyrate



9. Glucose-6-phosphatase deficiency causes gout by

a. Increased pentose formation

b. Decreased removal of free radicals

c. Decreased availability of glucose to tissues

d. Increased accumulation of sorbitol



10. A 6 month old child with white opacity in the lens and delayed growth could have all the enzyme abnormalities except

a. Galactokinase

b. GPUT (Glucose Phosphate Uridyl Transferase)

c. Lactase

d. Glucose 1 epimerase



11. A boy with delayed growth and mental retardation was found to have a white opacity in the lens. The diagnosis is likely to be

a. Toxoplasmosis

b. Galactosemia

c. Organic acidemia



12. Northern blot test is used for

a. DNA analysis

b. RNA analysis

c. Analysis of proteins

d. Enzyme analysis



13. Enzymes EA, EB are under allosteric control of S2 and P2 respectively. If there is a defect in Ec which of the following will occur

EA + EB - EC

S1 S2 P2 P1

a. Accumulation of S2

b. Increase in S1

c. Decrease in P1

d. Increase in P2


Pharmacology



14. Propanolol is to be avoided in a susceptible population because of one of its side effects. The population is patients having

a. Asthma

b. Cardiac arrhythmias

c. Renal failure

d. Cirrhosis



15. In the curve given the two drugs A and B are given at 500 mg oral dose. The difference in their curves is because of the difference in their



20 B



10 A

Plasma

Conc.



1hr 2hr 3hr 4hr

Time

a. Oral absorption

b. Bioavailability

c. Elimination t

d. Metabolism



16. In the graph given, X-axis represents dose and Y-axis effect. The two drugs X and Y are compared. Which among the following is correct?





Effect



X Y





Dose

a. Y has more maximal response than X

b. Y is more potent than X

c. Both X and Y are pure antagonists

d. Both are agonists and act via similar mechanism



17. A patient taking Theophylline develops chest infection. Which of the following drugs would increase the toxicity of Theophylline

a. Sparfloxacin

b. Erythromycin

c. Cephalexin

d. Amoxicillin



18. A patient on the following drugs takes an alcoholic drink and develops hypotension, headache and flushing. All the drugs might be implicated except

a. Metronidazole

b. Beclamethasone

c. Cefamandole

d. Chlorpropamide

Microbiology



19. Auto infection is seen with

a. Ancylostoma duodenale

b. Enterobius vermicularis

c. Trichinella spiralis

d. Round worm



20. Preformed toxin is found in all the following except

a. Botulinum

b. Bacillus cereus

c. ETEC

d. Staphylococcus aureus



21. A patient developed frontal lobe abscess. The abscess fluid was found to be foul smelling. The organisms released a pigment, which fluoresced to give a red color on ultraviolet light. The organism is

a. Bacteroides

b. Peptostreptococcus

c. Staphylococcus aureus

d. Streptococcus pneumonia



22. CLED media is preferred over MacConkey’s media because

a. It inhibits swarming of proteus

b. It is a selective media

c. Prevents growth of pseudomonal

d. Promotes growth of candida



23. Asim Singh, 30 years, a patient who had laparotomy recently, developed an intraperitoneal abscess post-operatively. Pus culture revealed that the causative organism was gram positive and was resistant to vancomycin. It grew readily on 6.5% NaCl and was bacitracin resistant. The organism is

a. Streptococcus agalactiae

b. Enterococcus fecalis

c. Staphylococcus aureus

d. Peptostreptococcus



24. All of the following are caused by enteroviruses except

a. Pleurodynia

b. Hemorrhagic fever

c. Aseptic meningitis

d. Herpangina



25. In Legionairre’s disease, the culture medium used is

a. Thayer-Martin medium

b. BCYE medium

c. Chocolate agar

d. Bordet and Gengou medium

Pathology



26. All are true about nervous system involvement in HIV except

a. Perivascular giant cell reaction

b. Vacuolar myelopathy involving the posterior columns

c. Microglial nodule can be seen

d. Temporal lobe abscess



27. Cancer cells derive energy via

a. Fatty acid oxidation

b. Glycolysis

c. Oxidative phosphorylation

d. Mitochondria



28. In cell ageing, the changes occurring are

a. Increase in glycolysis

b. Accumulation of lipofuscin

c. Increased DNAase activity

d. Increased oxidative phosphorylation



29. Granuloma is seen in all except

a. Yersinia enterocolitica

b. Mycoplasma pneumonia

c. Tuberculosis

d. Leprosy



30. All are true regarding apoptosis except

a. Chromatin is lysed by endonucleases to form nucleosomes

b. It imitates local inflammatory reactions

c. Macrophages phagocytose remaining apoptotic bodies

d. Caspases are increased and mediate apoptosis



31. Congenital myopathy would include all the following except

a. Nemaline myopathy

b. Central core disease

c. Z band myopathy

d. Centronuclear myopathy



32. Adult polycystic kidney is associated with which of the following

a. Berry aneurysm of the circle of Willis

b. Coarctation of the aorta

c. Renal artery aneurysm

d. Abdominal aorta aneurysm



33. Granuloma is not found in which one of the following arteritis?

a. Microscopic polyangiitis

b. Churg-Strauss syndrome

c. Wegener’s granulomatosis

d. Giant cell arteritis



34. On a biopsy specimen of the stomach, fat laden histiocytes were found. The possible cause could be

a. Signet ring cell carcinoma

b. Past gastrectomy

c. Lymphoma

d. Epithelial hyperplasia



35. Hepatitis B is associated with

a. PAN

b. Wegener’s arteritis

c. Giant cell arteritis

d. Systemic sclerosis



36. In a young boy with weakness and fatigue, CPK was found to be raised. This suggests that the CPK was increased due to

a. Motor neuron disease

b. Demyelination

c. Plasma membrane damage in the muscle

d. Liver cirrhosis



37. The enzyme implicated in immortalizing the cell is

a. DNA polymerase

b. RNA polymerase

c. Telomerase

d. DNA gyrase



38. Reversible changes in the cells with loss of polarity and altered cell size and shape i

a. Metaplasia

b. Hyperplasia

c. Dysplasia

d. Desmoplasia



39. On an autopsy specimen of lung tissue, stratified squamous epithelium was noted in the bronchi. Which among the following would best describe its presence?

a. Metaplasia

b. Hyperplasia

c. Dysplasia

d Hyperplasia



40. Which among the following statements define diapedesis

a. Margination of cells along the endothelium

b. Emigration of cells via the capillary endothelium

c. Migration of leucocytes to areas of inflammation

d. Prior activation of cells before attaching to the endothelium

Medicine



41. A patient presented with a history of incontinence of urine and was found to have a small bladder with calcified lesions in his kidney. The most probable etiology is

a. Schistosomiasis

b. Tuberculosis

c. Amyloidosis

d. Xanthogranulomatous kidney



42. A patient, Hashim Bhai has presented with hematuria, and on urine examination was

found to have dysmorphic RBC casts in his urine. The most probable site of the bleeding is from the

a. Kidney

b. Bladder

c. Ureter

d. Urethra



43. A patient presented with a history of pain in the abdomen, and on USG was found to have an aneurysm. The most probable cause for this is

a. Atherosclerosis

b. Hypertension

c. Infection

d. Trauma



44. A patient was suspected of having a viral esophageal ulcer. The ideal site to take a biopsy is

a. Edge of the ulcer

b. Base of the ulcer

c. Induration of the ulcer

d. From the surrounding mucosa



45. True about prion diseases is all except

a. Prion is an infectious protein

b. Dementia is the presenting feature

c. 10-15% present with myoclonus

d. Brain biopsy is diagnostic



46. All are true regarding a hemophiliac patient undergoing dental extraction except.

a. Cryoprecipitate is required to supplement factor VIII

b. The procedure should be done under monitored anesthesia

c. Increased dose of lignocaine can be given for the procedure

d Screeening for HIV should be done



47. All are causes of seronegative Polyarthritis except

a. Psoriatic arthritis

b. Behcet’s arthritis

c. Rheumatoid arthritis

d. Inflammatory bowel disease associated arthritis



48. In a patient having rheumatic heart disease, dental extraction was done. Subsequently he developed infective endocarditis. The most probable etiology would be

a. Staphylococcus aureus

b. Streptococcus sanguis

c. Streptococcus pneumonia

d. Streptococcus fecalis



49. Regarding multiple myeloma, all the following statements are true except

a. Groups of myeloma cells gives rise to plasmacytoma

b. Renal failure occurs in later stages

c. BJ proteins which are excreted in urine are whole immunoglobulin molecules

d. Presents with back pain



50. A 60-year-old patient, Hashim Bhai, presented with back pain and on examination was found to have tenderness over the L3 vertebra. His blood reports were as follows

Hb : 6.8 mg %

TLC : 6500/ mm3

DLC : P55L40E3M2

ESR : 90 mm/hr

Serum creatinine : 3.6 mg%

Albumin: globulin ratio : 3.9:5.9.

The diagnosis is likely to be

a. Multiple myeloma

b. Waldenstrom’s macroglobulinemia

c. Leukemia

d. Chordoma

51. The best investigation which is sensitive and specific for diagnosing neuroendocrine tumors in the body is

a. Spiral CT scan

b. Endoscopic ultrasound

c. Radiolabelled isotope scan

d. PET scan



52. For a patient with parameningeal rhabdomyosarcoma, the best investigation is

a. CSF cytology

b. CECT

c. MRI

d. SPECT scan



53. The test which is both sensitive and specific for diagnosis of renal artery hypertension is

a. Captopril renogram study

b. Angiography

c. CT

d. MRI



54. A patient presented with hemoptysis and persistent cough. The chest X-ray of the patient was normal. The next best investigation is

a. Helical CT

b. High resolution CT

c. Bronchoscopy

d. Angiography



55. A post-renal transplant patient 1 year after transplant was found to have persistently raised transaminases. The laboratory findings were significant for him being HBeAg positive and IgG antiHBcAg positive. The treatment of choice for the patient would be

a. Lamivudine

b. Lamivudine + interferon

c. Interferon

d. Ribavirin



56. In sickle cell trait, the patient does not manifest the disease because

a. >50% HbS is required to cause significant dysfunction in O2 carriage

b. The amount of HbS chain is not sufficient to form a clump and cause sickling

c. HbA present reacts allosterically with HbS and prevents HbS from being exposed to low O2 states

d. Indadequate HbS to form fibrin polymers



57. A patient has congenital QT prolongation with occasional episodes of Torsades. The treatment of choice would be

a. Metoprolol

b. Magnesium sulfate

c. Pacing

d. Isoprenaline



58. Hashim Bhai, a patient of HIV on the antiretrovirals lamivudine + zidovudine + indinavir develops tuberculosis. Which of the following ATT drugs is to be avoided in this patient?

a. INH

b. Rifampicin

c. Ethambutol

d. Pyrazinamide



59. Naseera Banu, a patient with impaired renal functions (blood urea 136 mg%, creatinine 3.6%) developed pulmonary tuberculosis. The drugs whose dosage has to be reduced are all except

a. INH

b. Rifampicin

c. Ethambutol

d. Pyrazinamide



60. Amphoterecin B would cause all the following side effects except

a. Glomerulonephritis

b. Hypokalemia

c. Azotemia

d. Renal tubular acidosis



61. The following statements are true regarding hemoglobin except

a. HbF is protective for falciparum malaria

b. HbA binds oxygen with higher affinity

c. Hb A2 is the predominant hemoglobin in adults



62. In RPGN, bad prognosis is indicated by

a. Crescent size

b. Number

c. Steroid response

d. Pattern of distribution



63. Which among the following statements is true about toxoplasma

a. In adults it is mostly asymptomatic

b. IgG antibodies in the newborn is confirmatory of diagnosis

c. Toxoplasmic encephalitis can occur in immunocompetent

d. Most infections are anthropozoonotic



64. Aseem Singh, a patient who had upper respiratory tract infection 3 days back, presented with hematuria. The most probable diagnosis is

a. Acute Glomerulonephritis

b. Goodpasture’s syndrome

c. IgA nephropathy

d. Wegener’s granulomatosis



65. Sclerosant agents used for endoscopic sclerotherapy are all except

a. Acetic acid

b. Alcohol

c. Cyanoacrylate

d. Podocyanolate



66. A young child had nephrotic syndrome and was started on steroids. He was responding to steroid therapy. If a biopsy were to be done, what would the light microscopy have shown?

a. Endothelial thickening

b. Split basement membrane

c. Loss of foot processes

d. No abnormality



67. In nephrotic syndrome due to minimal change disease, the pathology is

a. Loss of foot process and loss of poly anion charge both inside and outside

b. Loss of foot processes only

c. Deposition of antigen antibody complex

d. Destruction of glomerulus alone



68. Which among the following is a calicivirus?

a. HAV

b. HBV

c. HCV

d. HEV



69. Rani, a patient with RHD, has presented with fever. On echocardiography, small thrombi were found adherent to the mitral valves. All the following are sites where these might embolise to except

a. Kidney

b. Lung

c. Brain

d. Liver



70. A female patient, Naseera Banu, underwent an illegal abortion and was found to have endocarditic involvement of the tricuspid valve. The most probable site where these embolise to and cause infarction is

a. Brain

b. Lung

c. Spleen

d. Liver



71. A patient with a bee-sting developed itching and subcutaneous edema, which progressed to involve the face. There was laryngeal edema with difficulty in breathing. The immune mechanism implicated in the causation of these manifestations is

a. Immune complexes

b. IgE antibodies

c. IgG antibodies

d Cytotoxic T cells



72. Investigation of choice for invasive amebiasis is

a. Indirect hemagglutination

b. ELISA

c. Counter immune electrophoresis

d. PCR



73. Diagnosis of recent active hepatitis B is by demonstrating

a. IgM antiHBeAg

b. IgG antiHBcAg

c. HBsAg

d. HBeAg



74. The earliest definitive diagnosis of HBV is by demonstrating

a. IgM antiHBcAg

b. IgG antiHBcAg

c. HBsAg

d. HBeAg



75. A 60-year-old patient, Asim Singh, has presented with a history of dizziness and vertigo with Horner’s syndrome of the right side. There is loss of pain and temperature on the contralateral side. The artery involved is most likely to be

a. Anterior inferior cerebellar artery

b. Posterior inferior cerebellar artery

c. Middle cerebral artery

d. Spinal artery



76. Plasmapheresis is indicated for which of the following

a. Wegener’s granulomatosis

b. Henoch-Schonlein purpura

c. Goodpasture’s syndrome

d. Acute transplant rejection



77. In adult polycystic kidney, all the following are true except

a. Cysts are seen in the liver, spleen and pancreas

b. Hematuria occurs

c. Hypertension is rare

d. Autosomal dominant transmission is seen



78. A 30-year-old patient, Hashim Bhai, presenting with jaundice was found to have increased unconjugated bilirubin with normal levels of conjugated bilirubin and alkaline phosphatase. The urine urobilinogen was increased. The diagnosis is most likely to be

a. Obstructive jaundice

b. Cirrhosis

c. Hemolytic jaundice

d. Hepatitis



79. An 18-year-old patient, Ramesh, presented with a history of severe hematemesis. He gave a history of fever previously for which he was on various drugs. There is moderate splenomegaly. There is no other significant past history. The most probable etiology of the bleed is

a. Drug induced gastritis

b. NSAID induced duodenal ulcer

c. Varices

d. Coagulation disorder



80. A patient had a binge drinking of alcohol and subsequently presented with history of palpitations. The most probable cause for this is

a. PSVT

b. Atrial fibrillation

c. Ventricular tachycardia

d. Atrial flutter



81. A patient with pheochromocytoma would secrete which of the following in a higher concentration?

a. Norepinephrine

b. Epinephrine

c. Dopamine

d. VMA



82. A patient had acute pulmonary embolism. Echocardiography showed right ventricular hypokinesia with tricuspid regurgitation. The treatment to be given is

a. LMWH

b. Thrombolytic therapy

c. IVC filters

d. Anticoagulants

83. A patient presented with cough. The mantoux was 19 x 17 mm. Sputum examination was negative for acid-fast bacilli. The diagnosis is most likely to be

a. Pulmonary tuberculosis

b. Pneumococcal pneumonia

c. Mycoplasma pneumonia

d. Viral pneumonia



84. In familial adenomatous polyposis coli, all the following are seen except

a. Abnormal mucin cells

b. Loss of APC gene

c. Decreased expression of c-myc

d. Epithelial hyperplasia



85. A 20-year-old patient presented with severe hematemesis. On examination, there was no hepatomegaly but mild splenomegaly present. On endoscopy, esophageal varices were seen. What is the most probable diagnosis?

a. Cirrhosis of the liver

b. Budd-Chiari syndrome

c. Noncirrhotic portal fibrosis

d. Veno-occlusive disease

OBG

86. A patient has amenorrhea with hypothalamic lesion. The diagnosis is most likely to be

a. Kallman’s syndrome

b. Asherman’s syndrome

c. Stein Leventhal syndrome

d. Sheehan’s syndrome



87. A 32-year-old female patient did not visit the physician for the past 6 years when she had given birth to her last daughter, which was her third child. She has currently come with complaints of vaginal pruritus. She also has history of cold intolerance and repeated skin infections. On examination, the skin is dry and coarse. The pubic and axillary hair is absent. All the following can be given for her treatment except

a. Prednisolone

b. Thyroid hormone

c. Ethinyl estradiol

d. Insulin



88. A patient with carcinoma ovary involving both the ovaries had intact ovarian capsule and ascites with peritoneal washings positive for malignant cells. The stage of the patient is

a. Stage 1

b. Stage 2

c. Stage 3

d. Stage 4



89. A nulliparous female came with a history of pain in the abdomen and 1 month’s history of amenorrhea. On USG, the uterus was empty and there was fluid collection in the pouch of Douglas. The diagnosis is

a. Abortion

b. Ectopic pregnancy

c. Hydatidiform mole

d. Twisted ovarian cyst



90. Which of the following ectopic pregnancies carries on till a later stage?

a. Ampullary

b. Isthmic

c. Cornual

d. Interstitial



91. In a normal pregnancy, due to physiological changes, which among the following can be seen?

a. Apex beat is in the 4th intercostal space

b. Short diastolic murmurs

c. Occasional bouts of atrial fibrillation

d. Cardiomegaly



92. A pregnant lady suffering from diabetes is likely to have which of the following anomalies in the baby?

a. Down syndrome

b. Duodenal atresia

c. Cardiac anomalies

d. Dexamethasone is contraindicated since it causes hyperglycemia



93. In rupture uterus due to lower segment scar dehiscence, all the following findings can aid in the diagnosis except

a. Fetal bradycardia

b. Maternal bradycardia

c. Vaginal bleeding

d. Hematuria



94. The normal amniotic fluid pH is

a. 6.9 – 7.1

b. 7.1-7.4

c. 7.3-7.6

d. 6.0-6.5



95. Phosphatidyl glycerol appears in amniotic fluid at

a. 20 weeks

b. 28 weeks

c. 35 weeks

d. 38 weeks



96. A pregnant lady, Haseen Bibi, is referred from a PHC in Bihar. She is found to be suffering from hepatic encephalopathy. The most probable cause of liver dysfunction is

a. Hepatitis E

b. Acute fatty liver

c. Toxemia of pregnancy

d. Hemolytic anemia



97. Naseema Banu, a 28-year-old female had severe vaginal bleed on the 2nd post partum day. She has no previous history of bleeding disorders. Her APTT is prolonged, but the PT, bleeding time and thrombin time are normal. The factor VIII level in blood was found to be 10% The patient is most probably has

a. DIC

b. Acquired hemophilia

c. Inherited hemophilia

d. Lupus anticoagulant



98. A 12-year-old girl presented with a dysgerminoma cyst in the right ovary with intact capsule. The treatment of choice would be

a. Bilateral oophorectomy

b. Right oophorectomy

c. Right ovarian cystotomy

d. PAN hysterectomy



99. hCG is not a marker for

a. Embryonal carcinoma

b. Endodermal sinus tumor

c. Polyembryoma

d. Dysgerminoma



100. In newer oral contraceptives, the low dose of ethinyl estradiol is

a. 20 micrograms

b. 30 micrograms

c. 25 micrograms

d. 50 micrograms



101. Call-Exner bodies are seen in

a. Dysgerminoma
b. Granulosa cell tumor

c. Arrhenoblastoma

d. Endodermal sinus tumor



102. Regarding semen analysis, all the following are true except

a. Motility of sperm is an important factor

b. A minimum of 6 weeks of abstinence is required for semen analysis

c. The specimen should be collected in the lab

d. Absence of fructose would indicate obstruction of the ejaculatory duct or congenital absence of the vas deferens

Surgery

103. All are true regarding bladder stones except

a. Primary bladder stones are rare in Indian children

b. Small stones can be removed by transurethral endoscopy

c. KUB gives definitive diagnosis

d. >90% are radioopaque



104. Which malignancy would occur in prolonged multinodular goiter?

a. Papillary carcinoma

b. Follicular carcinoma

c. Anaplastic carcinoma

d. Medullary carcinoma



105. Which of the following procedures is associated with least complications like dumping syndrome, post-prandial vomiting and diarrhea?

a. Highly selective vagotomy

b. TV + GJ

c. Antrectomy

d. Truncal vagotomy + pyloroplasty



106. A female patient presents with a hard mobile lump in the breast. Which investigation would best aid you to come to a diagnosis?

a. FNAC

b. Excision biopsy

c. Mammography

d. Needle biopsy



107. An 18-year-old patient, Asim Singh, had pain in his right testis following which a swelling developed. All the following are true except

a. If torsion is present, the other testis also has to be fixed

b. Pyuria favors the diagnosis of torsion testis

c. Decreased uptake in radionuclide scan

d. Scrotal ultrasound is helpful in diagnosis



108. A patient was found to have a hard swelling in his right testis. All are true regarding this condition except

a. Trans-scrotal biopsy is needed

b. Scrotal ultrasound is indicated

c. Inguinal exploration is to be done

d. High inguinal orchidectomy should be done



109. The treatment of choice for Warthin’s adenolymphoma is

a. Total parotidectomy

b. Enucleation

c. Superficial parotidectomy

d. Sclerosant injection



110. The treatment of choice for pleomorphic adenoma is

a. Superficial parotidectomy

b. Total parotidectomy

c. Enucleation

d. Local excision of mass



111. The treatment of choice for solitary nodule of the thyroid is

a. Total thyroidectomy

b. Hemithyroidectomy

c. Lobectomy

d. Subtotal thyroidectomy



112. For a patient presenting with carcinoma penis, all the following are true except

a. Bad hygiene is a causative factor

b. >50% present with associated lymphadenopathy

c. Prepuberty circumcision provides 100% protection

d. Erythroplasia of Queyrat is premalignant



113. In a surgery post-op ward, a patient developed wound infection within 48 hours of his surgery. Subsequently 3 other patients developed similar infections in the ward. The most effective way of preventing these is

a. Fumigation of the ward

b. Wash OT instruments with 1% perchlorate

c. Hand-washing of all staff personnel

d. Prophylactic antibiotics



114. All the following are true regarding fibrolamellar carcinoma of the liver except

a. AFP levels > 1000

b. It occurs in younger individuals

c. More common in females

d. Better prognosis as compared to HCC



115. In an infant with congenital PUJ obstruction, all the following are true except

a. Can be diagnosed antenatally

b. Congenital PUJ obstruction is more commonly due to vascular aberrations than intrinsic cause

c. Diuretic renogram is helpful in diagnosis

d. Retrograde pyloroplasty has to be done to know the type and site of lesion



116. A 36-year-old female came with flank pain and was found to have PUJ obstruction. All the following are true regarding this except

a. Bilateral in 10-15% of the cases

b. Dismembered pyloroplasty is the treatment of choice

c. Endoscopic pyloromyotomy is contra-indicated



117. A patient was found to have renal cell carcinoma of the right kidney with extension into the IVC. All the following are true except

a. Biopsy is not indicated

b. IVC invasion indicates inoperability

c CXR should be done to rule out pulmonary involvement

d. Pre-op radiotherapy is not indicated



118. On performing a hernia operation, a patient develops tingling sensation over the dorsal surface of penis and over the scrotum. The nerve implicated is

a. Genitofemoral nerve

b. Ilioinguinal nerve

c. Hypogastric plexus

d. Pudendal nerve



119. A middle aged female presented with a history of flank pain and fever. On USG, the kidney was an irregular and showed fat density lesion with calculi. The diagnosis is most likely to be

a. Renal abscess

b. Chronic pyelonephritis

c. Xanthogranulomatous kidney

d. TB kidney



120. A patient with carcinoma of the tongue was found to have lymph nodes in the lower neck. The treatment of choice for the lymph nodes is

a. Radical neck dissection

b. Chemotherapy

c. Tele radiotherapy

d. Local excision



121. Thyroidectomy was done for a patient. 2 hours post-op, the patient developed difficulty in breathing and stridor. All the following are possible causes except

a. Tracheomalacia

b. Recurrent laryngeal nerve palsy

c. Hypocalcemia

d. Wound hematoma



122. The most common tumor in the mandible is

a. Osteoblastoma

b. Ameloblastoma

c. Squamous cell carcinoma

d. Lymphoma



123. The most common location of ameloblastoma is near the

a. Alveolar margin in the midline

b. Molar region in the mandible

c. Symphysis menti



124. A patient came with history of dysphagia with recurrent chest infections and was diagnosed to have an esophageal diverticulum at the level of the cricopharyngeus. The treatment of choice is

a. Cricopharyngeal myotomy alone

b. Excision of the sac and myotomy

c. Laser vaporization of the sac

d. Marsupialization of the sac



125. The most common site of lentigo maligna is

a. Face

b. Trunk

c. Palms

d. Soles



126. The most common malignant melanoma is

a. Superficial spreading

b. Lentigo maligna

c. Nodular

d. Acral lentigenous



127. Which among the following is most prone to become malignant

a. Basal nevus

b. Junctional nevus

c. Dermal nevus

d. Epidermal nevus



128. The nevus that would be persistent throughout life is

a. Strawberry angioma

b. Portwine stain

c. Salmon patch

d. Cavernous hemangioma



129. In a patient with varicocele, all the following are true except

a. Varicocele is common in the right side

b. Associated with infertility

c. Bilateral in 10%

d. Association with malignancy described



130. In a patient with triple phosphate stones, all the following are true except

a. Also known as struvite stones

b. Prone to occur because of infection

c. Needs acidic urine to precipitate

d. Forms staghorn calculi



131. A patient presented with pulsatile varicose veins. The cause is most likely to be

a. Right ventricular failure

b. Incompetence of the tricuspid valve

c. DVT

d. Klippel-Trenuayay syndrome



132. In a patient with parathyroid hyperplasia, surgery is planned. The amount of parathyroid to be removed is

a. All four glands

b. Enlarged gland to be removed

c. 3 parathyroids to be removed

d. Radical parathyroidectomy



133. A patient was suspected to have prostatic carcinoma. The best investigation to evaluate him would be

a. TRUS

b. Expressed prostatic secretions

c. CT scan

d. MRI



134. Treatment of choice of stage I seminoma is

a. High inguinal orchidectomy with radiotherapy

b. Intravenous chemotherapy

c. Trans-scrotal orchidectomy

d. High inguinal orchidectomy



135. Conservative management is indicated for ureteric stones when

a. The stones are small (<6 mm)

b. Hydronephrosis and infection is present

c. The stone does not descend for 2 weeks of follow up

d. Anatomic anomalies



136. True regarding urethral injuries are all except

a. Uncommon in females

b. Bladder injury is associated with post urethral injuries

c. Blood at the urethral meatus is indicative of injury

d. Catheterize the patient



137. A patient had increased pulsations of the lower limb veins and local gigantism of the leg. The most probable etiology is

a. Tumor

b. AV fistula

c. Incompetence of the saphenofemoral junction

d. Varicose veins

PSM



138. All are true about case control studies except

a. It is easy to conduct

b. It is cheaper

c. Can measure attributable risk

d. Those with disease are matched with those without



139. The best marker for the health status of a country is

a. Per capita income

b. Infant mortality rate

c. Disease free rate

d. Crude birth rate



140. In a community, the correlation between infant mortality rate and socio-economic status is

a. r = +1 (strong positive correlation)

b. r = -1 (strong negative correlation)

c. r = -0.8 (moderate correlation)

d. r = 2.2 (strong positive correlation)



141. To compare two populations, the best index is a. Standardized death rate

b. Infant mortality rate

c. Crude birth rate

d Couple protection rate



142. In a drug trial, one group showed 40% response and the group with the test drug showed 60% response. The two results can be statistically compared for significance by

a. Chi square test

b. Paired t test

c. t test with different measure

d. Fischer’s test



143. In a correlation test, the association followed the equation a + bx = c. This equation would most likely show a

a. Linear association

b. Sigmoid association

c. Parabolic association

d. No association



144. In a test where cholesterol levels were compared between two groups of obese (n=20) and non-obese (n=15) subjects, the test which can best give the statistical significance of cholesterol association is

a. Chi square test

b. Paired t test

c. t test with different measure

d. Fischer’s test



145. In a population of 100 females in the age group 15-45, the mean systolic BP was found to be 120. In a normal curve distribution, the number of people who would be having a BP above 120 would be

a. 25

b. 50

c. 75

d. 100



146. On a study, it was established that the disease (carcinoma cervix) was 5 times more common in those who had multiple sexual partners than those with single partners. The attributable risk of exposure in the former group is

a. 20%

b. 40%

c. 80%

d. 5%



147. In a population with standard deviation of 1.95, the population covered is

a. 66%

b. 95%

c. 99%

d. 97.5%



148. In a population of 100 females, the mean hemoglobin concentration was 10 and the standard deviation was 1. The standard error is

a. 0.01

b. 0.1

c. 0.001

d. 10



149. In a population, the burden of disease is best represented by

a. Infant mortality rate

b. DALY’s

c. PQLI

d. Life expectancy



150. Human Developmental Index consists of all except

a. Crude birth rate

b. Life expectancy at birth

c. Literacy rate

d. Per capita income



151. Sentinel surveillance is done for all except

a. HIV

b. Diarrhea

c. Acute flaccid paralysis



152. In a study for cholera, the incubation periods obtained were: 2, 5, 8, 10, 25,10 and 30. The median is calculated to be

a. 50

b. 22.5

c. 10

d. 5



153. In a population study for malaria over the past few years, the number of cases reported were: 20, 5000, 100, 80, 60, 70, 40, 60, 80. The average is best represented by

a. Arithmetic mean

b. Median

c. Geometric mean

d. Mode



154. Post exposure prophylaxis is not given for

a. Measles

b. Pertussis

c. Rabies

d. HBV



155. The denominator for calculation of crude birth rate for population is taken as is found on

a. 1st march

b. 1st November

c. 1st July

d. 1st January



156. In an anganwadi, the proteins and calories given to a pregnant lady is

a. 300 Kcal; 12 gms

b. 500 Kcal; 25 gms

c. 500 Kcal; 20 gms

d. 500 Kcal; 15 gms



157. All the following are strategies to prevent a KFD epidemic except

a. Deforestation

b. Vaccination

c. Self protection

d. Preventing roaming of free cattle in the forest

a. Slipped femoral epiphysis

b. Perthe’s disease

c. TB hip

d. Fracture neck of femur

Orthopedics

158. The true statement regarding bone apposition is

a. Osteoblastic activity in enchondral bone

b. Chondroblastic activity in enchondral bone

c. Periosteal changes

d. In cambium bone



159. In a patient with a tight iliotibial band, the test done is

a. Charnley’s test

b. Obson’s test

c. Jones’ test

d. Ober’s test

160. In painful arc syndrome, all the following lesions can be found except

a. Subacromial bursitis

b. Complete tear of supraspinatus

c. Fracture of the greater tubercle

d. Rotator cuff injury



161. An 11-year-old boy weighing 70 kg was found to have pain in the Scarpa’s triangle. There was difficulty in abduction and internal rotation of the lower extremity. The most probable cause would be

a. Slipped femoral epiphysis

b. Perthe’s disease

c. TB hip

d. Fracture neck of femur



162. A boy was treated with steroids for nephrotic syndrome and developed pain in both his hip joints. There was tenderness of hip movements. The diagnosis is most likely to be

a. AVN of head of femur bilaterally

b. Bilateral osteomyelitis of hip joint

c. Septicemia

d. Renal osteodystrophy



163. A 19-year-old patient came with pain in his right femur. The X-ray showed a lytic lesion surrounded by a sclerotic zone in the diaphysis. The diagnosis is most probably

a. Ewing’s sarcoma

b. Osteoid osteoma

c. Osteoclastoma

d. Osteoblastoma

Forensic

164. A person has presented to the casualty after swallowing a poison. On doing lavage and treating the lavage with silver nitrate and on heating, it turned black. The poison is most likely to be

a. Dichlorphos

b. Tic 20

c. Malathion

d. Diazepam



165. A patient was found and brought to the casualty. There was the smell of almond oil in his breath. The substance consumed is most likely to be

a. Hydrocyanic acid

b. Cannabis

c. Morphine

d. Atropine

166. A patient was brought dead to the casualty. On examination, he was found to have fine froth from his mouth and nostrils. He has most likely died due to

a. Hanging

b. Drowning

c. Poison

d. Snake bite



167. Mandatory hemodialysis is done in

a. Organophosphorus poisoning

b. Diazepam overdose

c. Methanol poisoning

168. A patient is brought to the police station for having consumed an illegal drug. On examination, his tongue and oral cavity were jet black in color. The likely drug which was abused is

a. Cannabis

b. Cocaine

c. Heroin

d Charas

ENT



169. A female patient presented with a history of tinnitus, progressive hearing loss and dizziness. All the following could be considered as differential diagnosis except

a. Acoustic neuroma

b. Meningioma of petrous apex

c. Endolymphatic hydrops

d. Histiocytosis X



170. A female patient presented with tinnitus and conductive deafness. On examination of the tympanic membrane, a pulsatile mass was seen. On pneumatic otoscopy, the tympanic membrane appeared to blanch on pressure. All the following can be used as treatment modalities except

a. Surgery

b. Radiotherapy

c. Embolization

d. Interferon



171. A patient was found to have maxillary carcinoma of stage T3 N0 M0. The treatment

of choice would be

a. Maxillectomy with radiotherapy

b. Radiotherapy with chemotherapy

c. Chemotherapy

d. Chemotherapy with radiotherapy

Psychiatry



172. A 70-year-old patient was brought to the hospital with a 1-month history of auditory hallucinations with third person hallucinations. He has no history of similar problems previously. The diagnosis is most likely to be

a. Dementia

b. Schizophrenia

c. Pick’s disease

d. Multiinfarct dementia



173. A 3-year-old boy keeps alone, does not mingle with others and is not attracted to toys. He gets irritable whenever he is slightly disturbed. The diagnosis is

a. Hyperkinetic child

b. Autistic disorder

c. Attention deficit disorder

d. Schizophrenia



174. A patient is brought to the casualty in a state of altered sensorium. He was on lithium treatment for an affective disorder and has suffered through an attack of epileptic fits. On examination, he has tremors, increased DTR’s and incontinence of urine. He has also undergone an episode of severe gastroenteritis 2 days ago. The probable cause for his present state is (Lithium level in serum = 1.95 mEq/L)

a. Lithium toxicity

b. Dehydration

c. Depressive stupor

d. Epilepsy



175. A patient presented to the casualty with a history of sudden palpitations, sensation of impending doom, and constriction in his chest. This lasted for about 10-15 minutes after which he became all right. The diagnosis is likely to be

a. Panic attack

b. Generalized anxiety disorder

c. Phobia

d. Personality disorder



176. A female presenting with a prior history of slashed wrists and attempted suicide now presents with a similar history. The diagnosis is

a. Borderline personality

b. Obsessive compulsive disorder

c. Histrionic personality disorder

d. Depression



177. A patient came with complaints of having a deformed nose and also complained that nobody takes him seriously because of the deformity of his nose. He has visited several cosmetic surgeons, but they have sent him back saying that there is nothingwrong with his nose. He is probably suffering from

a. Delusional disorder

b. Hypochondriasis

c. Obsessive compulsive disorder

d. Somatization

Ophthalmology



178. A patient has history of spontaneous loss of vision, which slowly recovered over a period of 3 months. The possible cause is

a. Macular hole

b. Central serous retinopathy

c. Retinal detachment

d. Melanoma of choroid



179. A patient was examined for refractive error and on Retinoscopy at 1 meter was found to have myopia of –0.5 D. The image would move

a. Against the mirror

b. With the mirror

c. No movement



180. A comatose patient was suspected to have raised intracranial tension. All the following would aid in evaluation to see for papilledema except

a. Blurred margins of disc

b. Abnormal papillary response

c. Cup is filled

d. Disc is pale and hazy



181. ETDRS in ETDRS vision charts stands for

a. Extended treatment for diabetic retinopathy and study

b. Early treatment for diabetic retinopathy and study

c. Eye down movement for research study

d. Elective treatment for diabetic retinopathy scales



182. The most common finding in allergic reaction to TB is

a. Phlyctenular conjunctivitis

b. Koeppe’s nodules

c. Posterior scleritis

d. Optic neuritis



183. All the following are differential diagnoses for leucocoria except

a. Persistent hyperplastic vitreous

b. Congenital glaucoma

c. Fundal endophthalmitis

d. Retinoblastoma

184. A young boy came with a history of redness in the eye with ropy discharge and itching. The diagnosis is

a. Viral conjunctivitis

b. Vernal catarrh

c. Bacterial conjunctivitis

d. Tuberculous scleritis



185. For a patient, refraction has to be done. You want only mydriasis to occur without cycloplegia. The drug to be used is

a. Tropicamide

b. Phenylephrine

c. Atropine

d. Cyclopentolate



186. A fist injury to the eye resulted in a blow out fracture. The region of the orbit most likely to be fractured is

a. Lateral margin

b. Medial side

c. Inferior surface

d. Roof

Dermatology



187. A patient presented with scarring alopecia, thinned nails, hypopigmented macular lesions over the trunk and oral mucosal lesions. The diagnosis is most likely to be

a. Lichen planus

b. Psoriasis

c. Secondary syphilis

d. Scleroderma



188. A young boy presented with a lesion over his right buttock, which had peripheral scaling and central clearing with scarring. The investigation of choice would be

a. Tzanck smear

b. KOH preparation

c. Biopsy

d. Sabouraud’s agar



189. A patient with psoriasis was started on systemic steroids. After stopping treatment, the patient developed generalized pustules all over his body. The cause is most likely to be

a. Drug induced reaction

b. Pustular psoriasis

c. Bacterial infections

d. Septicemia



190. Acne vulgaris is due to involvement of

a. Sebaceous glands

b. Eccrine glands

c. Pilosebaceous glands

d. Apocrine glands


Pediatrics

191. As per the WHO, for children less than 6 months, the Hb cutoff level is

a. 10 g/L

b. 115 g/L

c. 105 g/L

d. 110 g/L



192. In the laboratory, for amplification of a single DNA chain, polymerase chain reaction was allowed to continue for 3 cycles. At the end of this, the number of DNA chains would be

a. 4

b. 8

c. 16

d. 3



193. A blue infant was found to have oligemic lung fields with normal sized heart. The diagnosis is

a. Transposition of great vessels

b. Tricuspid atresia

c. TOF

d. Pulmonary stenosis



194. A young boy had developed congestive failure and was found to have membranous VSD. He spontaneously showed improvement in his condition. This is most likely to be due to

a. Perimembranous closure of VSD

b. Development of AR

c. Pulmonary vascular changes

d. Infective endocarditis



195. A 2-year boy with coarse facial features and hepatosplenomegaly showed tall QRS waves in the ECG. The diagnosis is most likely to be

a. Glycogen storage disease type II

b. Hurler’s disease

c. Hunter’s disease

d. Hemochromatosis



196. A child presented with anemia, which was microcytic hypochromic, and hepatosplenomegaly with target cells. There was a history of similar illness in the family. The best investigation to establish the diagnosis would be

a. G6PD assay

b. Electrophoresis

c. Bone marrow examination

d. Coomb’s test



197. A neonate is presented to the hospital with hepatitis and clay colored stools. Biopsy of the liver shows giant cells. The diagnosis is

a. Neonatal hepatitis with extrabiliary atresia

b. Physiological jaundice

c. Extrabiliary atresia

d. Neonatal hepatitis with physiological jaundice



198. A neonate was born with cleft lip, cleft palate and cardiac anomalies. There is a history of drugs, which the mother was on. The drug most likely to be implicated

a. Isotretinoin

b. Lithium

c. Valproate

d. Phenytoin



199. An 11-year-old child, who is mentally and physically retarded with delayed bone age had wormian calcifications in the epiphyses on X-ray. The probable diagnosis

a. Hypopituitarism

b. Hypothyroidism

c. Malnutrition

d. Hypoadrenalism



200. The fetal anomaly which can be found if a pregnant lady is on Lithium is

a. Renal anomalies

b. Ebstein’s anomaly

c. Tricuspid atresia

d. VSD




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