RxPG AIIMS BOOK may 2002 and nov 2001 papers [ fully
solved, completely referenced, mnemonics and tips]
First five pages for preview
ST segment elevation is seen in all except:
104, ECG Made Easy, 5th edn
1364, HPIM, 14th edn
11,21,62,179,81, Martin Dunitz
Repeat, but with difference choices
of the ST segment is an indication of acute myocardial injury usually due either
to a recent infarction or to pericarditis. The leads in which elevation occurs
indicate the part of the heart that is damaged,
V leads—anterior damage
Ventricular aneurysm is a sequelae of MI. So it may cause ST segment
elevation but not necessarily.
Coronary spasm causes printzmetals (variant) angina. Angina is an
ischaemic disease. Usually ischaemia presents as horizontal depression of the ST
segment associated with upright T wave as opposed to infarction. But
printzmetals is an exception and causes ST elevation.
AMI has been explained above as a cause of ST segment elevation.
Acute pericarditis is characterised by ST elevation (concave upward) in
leads facing the effusion.
Ans: None of the above as all the choices are correct. However
ventricular aneurysm shows incosnsitent association as compared to rest of the
three which have characteristic associations.
Which of the following is not a tributary of cavernous sinus?
Petrosal sinus (superior)
Middle cerebral vein
73, BDC III, 2nd edn
veins connecting to cavernous sinus are of two types, tributaries (incoming
channels) and draining channels (communications).
Sphenoparietal sinus is a
tributary coming from the meninges.
Superior petrosal sinus is a
draining channel and not a tributary. It drains cavernous sinus into transverse
Ophthalmic veins (superior and
inferior) are tributaries coming from orbit.
Middle cerebral vein
(superficial) is a tributary coming from brain.
So folks, you must have never expected a “catch” in
such an innocuous looking question. But in a AIIMS paper, you should be prepared
for everything and never attempt a question only on face value.
Ans: (B) Petrosal
Most common virus infection after 2 months of renal transplantation is:
Ref: 843, HPIM, 14th edn (Table 136-3)
Infection with herpes group
viruses (except CMV) may become evident within 6 months of renal transplantation
or later. VZV may cause fatal disseminated infection in nonimmune kidney
transplant recipients, but in immune patients reactivated zoster usually does
not disseminate outside the dermatome.
Toxoplasmosis is excluded in
the first instance it self as it is not a virus (toxoplasma gondii—protozoan).
Moreover it is not a very much common infection after renal transplant and is
implicated only in some ensuing CNS infections.
HSV can infect post-transplantation though not as frequently. The most
common strain implicated in infection after renal transplant is HSV6.
CMV infection is responsible
for about 50% of all renal transplant recipients presenting with fever 1 to 4
months after transplantation. Thus it is the most common viral infection,
Ans: (D) CMV
4. What is
required to detect infection of fetus in utero in toxoplasmosis?
A. IgG in mother
IgG in fetus
IgM in fetus
IgM in Mother
Ref: 1498, CMDT 2002
IgG specific antibody is
invariably present in mother if she is positive for toxoplasmosis. But that does
not prove infection of fetus.
IgG specific antibody is nearly
always present in the fetus if the mother is positive, but this passively
transferred antibody disappears in 6-12 months and it does not definitely prove
IgM specific antibody in fetus
is detected by cordocentesis and is diagnostic of fetal infection. But a
negative result does not exclude the diagnosis.
Using the same logic as applied in option a, IgM specific antibody in
mother does not prove fetal infection. However, it increases the risk of
infection in fetus.
The most useful tests for confirmation of fetal infection
Aminocentesis for detection of toxoplasma DNA in amniotic fluid.
for detection of IgM specific antibody.
Ans: (C) IgM
5. In an old
patient, the best indicator of probability of developing cardiovascular disease
can be calculated by:
None of the above
Ref: 1255-57, CMDT 2002
Status: New question
measurements for the purpose of screening for cardiovascular disease can be via
various strategies like (1) measuring total cholesterol alone, (2) measuring
total cholesterol and HDL cholesterol, (3) measuring LDL and HDL cholesterol
ratio. Each is acceptable, but treatment decisions are always
based on the LDL and HDL cholesterol levels. But this is for general
population and not specifically for elderly patients.
TG (triglycerides) levels are not an
acceptable criterion of the cardiovascular disease risk screening.
As discussed in option one
total cholesterol can be one of the criteria of cardiovascular disease risk
screening but is not specifically mentioned for elderly population.
This is a bit confusing. In
this question the age of the elderly patient is not provided and CMDT says that
meta-analysis of evidence relating cholesterol to coronary heart disease in the
elderly suggests that cholesterol is not a risk factor for coronary heart
disease for persons over age 75.
So it is a confusing question with two probable options.
Although the question is unclear about the age of the patient, we feel that
option D is the correct answer or you people can find some direct proof from
some where to convince yourself. Anyway check out for errata at http://books.meramamc.com.
Ans: (D) None
of the above