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arunarali144
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Repeat compilaton of AIIMS
May08 Qs. Also refer Kavish's pos
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05.31.08 (4 months ago)
#1
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Please post relevant links and references rather than long explanations. that helps in browsing.
Take care.
ARUN
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arunarali144
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05.31.08 (4 months ago)
#2
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1. Tumor suppressor genes are all except RAS.
2. Folate transporter gene is on chromosome 21. Folate-preventable neural tube defects are caused by the well-known trisomies and the only one mentioned among the options was 21.
3. TAR syndrome ( actually the phenotype of the child was described rather than mentioning the diagnosis directly in the question ) (Is the diagnosis TAR syndrome or something else?).
All are useful in the diagnostic work-up except Karyotyping. It is due to a yet unknown mutation ( it is supposedly due to a micro-deletion involving chromosome 1) and hence karyotyping which is useful in detecting chromosomal anomalies has no role in the diagnostic work-up.
4. Most common inherited tumor is Retinoblastoma.
5. Loss of heterozygosity is a feature of – seems Retinoblastoma. Dragon has explained it on page 78 of Kavish's thread.
6. GSD seen only in females is - seems like one of those questions one should leave unattempted. usually there are a few questions like this in every exam intended to invite negatives. or must have been a printing mistake.
7. Adult cells don’t divide like fetal and embryonic cells because CDK inhibitors prevent the cell form progressing from Go to S phase.
8. Macrocephaly with Leukodystrophy is a feature of Canavan’s disease. relevant link
more are definitely available. please GOOGLE.
9. True about Androgen insensitivity syndrome is phenotype can be entirely female.
10. Primary amenorrhea with inadequate secondary sexual characters in a young female with normal height is - relevant link is
Relevant part from the page is below -
Dysgenetic gonads (histologically disordered gonads) are noted primarily in mixed gonadal dysgenesis, pure gonadal dysgenesis, and gonadal dysgenesis (Turner Syndrome). Mixed gonadal dysgenesis is the second most common intersex disorder. Karyotype is usually a mosaic 45XO/46XY. A testis is usually found intraabdominally opposite a streak gonad (resembling ovarian stroma histologically). A unicornuate (only one side of the uterus is present) uterus, fallopian tubes and vagina are present. The genitalia are ambiguous with severe hypospadias, a urogenital sinus, and labioscrotal fusion, with an undescended testicle. One third exhibit Turner stigmata (short stature, shield like chest, webbed neck, multiple pigmented nevi, and cubitus valgus) as well as cardiovascular and renal anomalies (5,6).
The incidence of gonadal tumors is 25 percent in patients with mixed gonadal dysgenesis and may arise in the streak gonad or the undescended testes. A gonadal tumor has not been described in a scrotal testes (8). Early bilateral gonadectomy with female rearing is appropriate in phenotypic females. In phenotypic males with a scrotal testes, male rearing is appropriate, but the streak gonads must be removed.
Pure gonadal dysgenesis is an abnormal differentiation of the gonads without a chromosomal abnormality. A 46XX female has normal immature female external genitalia, intact Mullerian duct structures and bilateral streak gonads. They have no stigmata of Turner syndrome. They usually present as adolescent females who fail to mature and reach menarche (5).
Patients with 46XY "pure gonadal dysgenesis" also have bilateral streak gonads, intact Mullerian structures, a female phenotype, and the absence of Turner stigmata. Some may present in the newborn period with clitoromegaly. These patients with the Y chromosome are at high risk for the development of gonadal tumors, so prophylactic gonadectomy is indicated (6,8).
Gonadal Dysgenesis (Turner Syndrome) is due to the loss of the second X chromosome (45XO), with resultant bilateral streak gonads, normal Mullerian duct development, and phenotypically female external genitalia. Mosaicism (45XO/46XX) lessens the severity of the gonadal abnormality. As neonates do not have ambiguous genitalia, the syndrome is usually diagnosed from investigations for other neonatal anomalies, which include: intrauterine growth retardation, head and facial anomalies, lymphatic anomalies, cardiovascular or urinary tract malformations or skeletal anomalies) (8). All should be raised as females, with gonadectomy indicated only in those with virilization or with clear evidence of a Y cell-line (6,8).
11. Multiple congenital defects with anencephaly is - ?Trisomy13. what were the other options?
12. Equal and opposite innervation of extraocular muscles is according to - ?Sherrington’s rule. ?Hering’s rule. Refer Dragon's comments in Kavish's thread.
13. Well-circumscribed orbital cone mass in an adult male that does not expand with Valsalva maneuver is - ?Cavernoma.
They are the most common orbital cone mass in adults.
14. Iris-corneal endothelial syndrome is characterized by diffuse iris atrophy.
15. Left head-tilt, diplopia worse on left gaze and a right hypertropia are all indicative of a right superior oblique muscle weakness.
The steps mentioned in the test are those of Beilschowsky’s modification of Marshall- Park's three part test specifically designed for detecting obliques’ and vertical recti palsy.
16. Choroidal neovascularisation is seen in all except - pptions were trauma, myopia, hypermetropia and angioid streaks.
17. All have been given importance in Vision 2020 except Epidemic keratoconjunctivitis.
18. Retinitis pigmentosa is a feature of all except Marfan syndrome.
19. Painful ophthalmoplegia without fever and with an enlarged cavernous sinus on MRI in a middle-aged female is diagnostic of Tolosa-Hunt syndrome. The msot relevant and informative link is
20. Nerve most commonly involved in compression by a Posterior communicating artery aneurysm is Oculomotor nerve. Same is the case even with an Anterior communicating artery aneurysm.
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arunarali144
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05.31.08 (4 months ago)
#3
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21. Telecanthus is wide intercanthal distance with normal interpupillary distance. relevant link is
this is also an useful link. basically an online TB of Pathology
. refer this for some useful info in the future too.
22. Pathogenesis of diabetic macular edema involves all except - ? breach in retinal pigment epithelium. other three options were increased PKC and VEGFR expression and oxidative stress.
23. Blue-White selection during Polymerase chain reaction - Kavish's thread has the best possible explanations for this.
Blue-white selection is used to identify colonies which have insert-containing plasmids eliminates those that have plasmids with no DNA insert
Use a pUC cloning vectors and host cells which produce an incomplete (inactive) b-galactosidase protein
MCS in pUC vector is in the is in the middle of the LacZ gene
The blue-white selection involves addition of ITPG and X-gal to the medium
ITPG induces the LacZ operon
24. True about Alpha fetoprotein is – I think the options were
A- yolk sac is the major source during the fetal period
B- afp has a half-life of 5-7 days
C- maximum levels are reached by 20 weeks of pregnancy
D- levels are always elevated in Wilm's tumor.
probably the best answer is option B.
25. A pH of 3.5 has the following effect on lysophospholipid in biological membranes – seems the answer is ‘ there is no effect’.
here is an useful link
27. True about GPCRs is – the G protein binds the transmitter at the cell surface. unable to recollect the other options correctly.
28. Marker of bone turnover is - options were pyrridinoline cross links, Osteocalcin, alkaline pphosphatase, TRAP.
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arunarali144
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05.31.08 (4 months ago)
#4
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29. Amino acid infusions to critically ill patients helps by decreasing protein breakdown.
Here are some useful links
30. Causes of high anion gap metabolic acidosis are all except glue sniffing.. the other options were DKA, starvation and ethylene glycol poisoning.
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arunarali144
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05.31.08 (4 months ago)
#5
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29. Amino acid infusions to critically ill patients helps by decreasing protein breakdown.
Here are some useful links
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arunarali144
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06.01.08 (4 months ago)
#6
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Rasmussen in Kavish's thread has come up with a very interesting and meaningful explanation for Q.3.
3. TAR syndrome ( actually the phenotype of the child was described rather than mentioning the diagnosis directly in the question ) (Is the diagnosis TAR syndrome or something else?).
All are useful in the diagnostic work-up except ?Karyotyping. It is due to a yet unknown mutation ( it is supposedly due to a micro-deletion involving chromosome 1) and hence karyotyping which is useful in detecting chromosomal anomalies has no role in the diagnostic work-up.
Rasmussen has convincing evidence. Seems the answer is bone marrow biopsy and it's a more sensible diagnosis of 'Radial thumb hypoplasia'.
Good work Rasmussen. I appreciate it sincerely.
Wishing you the best.
ARUN
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arunarali144
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06.01.08 (4 months ago)
#7
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30. Causes of high anion gap metabolic acidosis are all except - ?glue sniffing. the answer comes from a table in CMDT on causes of metabolic acidosis. very beautifully classified and a good table to read and ?memorise.
I recommend to all readers and aspirants that all must and should have a CMDT08 with them and the chapter on metabolic disturbances is a must read. he gives all info well classified in little comprehensive tables and flow-charts. very useful.
31. Glutathione is required for all except - conversion of oxyhemoglobin to methemoglobin.
other options were
A- as a scavenger for free radicals
B- as a cofactor for some enzymes
C- ------------------.
32. True about Vitamin d are all except – Williams’ syndrome is characterized by obesity, mental retardation and hypogonadism. Only mental retardation and dysmorphic facial features with cardiac anomalies are a feature of Williams’ syndrome. It is also characterized by precocious puberty and not hypogonadism.
Other options were
A- 1-hydroxylation occurs in the liver
B- 25-hydroxylation occurs in the kidney
C- --------------------.
33. Translation product of PolyA tail of mRNA will yield polyLysine.
34. Steroid receptors are comprised of all except transcriptional repressors. Transcriptional repressors or activators are bound by SREBs (steroid receptor response element binding proteins) and are not standard components of the steroid receptor complex. Harper's Biochemistry
explains this well.
This is a comprehensive link.
35. The structure of Prion proteins and certain membrane proteins is - options were
A- extended
B- alpha helix
C- beta sheet
D- linear (was it something else?)
The answer seems to be alpha-helix.
here are some useful links.
36. Anti-oxidants in lens of the eye are all except - ?vitamin A. other options were vitamins C & E and catalase.
some useful links for this.
google keywords 'ANTIOXIDANTS LENS MADHAVI' for a book search on Food antioxidants. Has some useful info.
37. Thiamine supplementation to patients in intensive care units is because it is a co-factor for PDH and a-KGDH enzymes. It reduces intracellular acidosis by not allowing pyruvate to accumulate and it also decreases systemic metabolic acidosis by activating PDH which generates acetyl coA an inhibitor of lipolysis and hence prevents from ketoacidosis developing.
38. Biochemical mechanisms of insulin-induced lipogenesis are all except inhibition of PDH. Other options were
A- activation of acetyl coA carboxylase
B- enhanced glucose entry into cells
C- decreasing cAMP levels
Harper's is useful in this regard.
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arunarali144
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06.01.08 (4 months ago)
#8
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39. Diarrhea due to a villous adenoma is characterized by - chloride-responsive metabolic acidosis ( NAGMA).
acid loss causes alkalosis and alkali loss causes acidosis.
any severe fluid loss with hypovolemia will be complicated by metabolic acidosis due to systemic hypoperfusion.
isotonic losses from the small intestine as occurs in cholera will lead to hypernatremia and not hyponatremia due to avid renal Na retention.
Anion gap as measured is the difference between the Na content and the sum of Cl and HCO3 content of serum. Na - (Cl + HCO3). Electroneutrality is maintained by other anions like proteins, phosphates, sulfates and cations like K+, Mg2+ etc.
Metabolic acidosis is characterised by a reduction in the levels of HCO3. If there is no other anion being added to the serum Cl level increases to maintain electroneutrality and hence the anion gap remains normal. If there is addition of an anion like lactate or or a ketone body, then the chloride level does not rise because electroneutrality has been maintained by the added anion and hence the anion gap is increased.
Conditions like hypoproteinemias etc lead to a NAGMA even in the presence of a HAGMA or a LAGMA when there is actually a NAGMA because chloride levels are elevated to maintain electroneutrality.
Please refer CMDT (any year) for a better account and understanding of Acid-Base disturbances.
Arun
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dragonlives4ever
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06.01.08 (4 months ago)
#9
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hich is an example of disability limitation?
a)resting limb in neutral posn
b)arranging for schooling of child suffering from PPRP
c)reducing occurence of polio immunisation
d)providing calipers for walking
and-a
ref speed sOln p176 of AIIMS
MAY 2007
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arunarali144
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06.01.08 (4 months ago)
#10
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40. Protein denaturation leads to all effects except - retention of function.
41. Acid base abnormality in CHPS is hypokalemic hypochloremic metabolic alkalosis.
Something that I would like to add here.
Why should you not give anti-emetics to a child with severe diarrhea who develops vomiting later on in the course of the disease?
It is because the best treatment for the vomiting then is correction of hypovolemia. anti-emetics will worsen the child's clinical condition because hypovolemia due to severe diarrhea has resulted in a metabolic acidosis and the body is trying to correct the acid-base disturbance by putting out acid form the body and what better way than vomiting out gastric secretions!
42. Keratin +ve epithelial mediastinal tumor with lymphocytic infiltration is probably a Thymoma. Carcinoid is difficult to rule out though. The other options in the question were hematologic malignancies. They are sarcomas and are not likely to be keratin-positive.
43. Microcytosis (MCV 55fL) with moderate anemia (Hb 9g/dL) in a 23 yr old with no history of transfusions in the past is indicative of iron-deficiency anemia though Thalassemia minor is extremely difficult to rule out with the info given. Microcytic hypochromic anemia in an Indian female; can we think of anything other than IDA? the degree of anemia and microcytosis are complementary. only hypochromia was not mentioned in the question. whatever it is, I find it difficult to rule out Thalassemia minor.
Please suggest.
44. Gingival hyperplasia and other infiltrative features in an adult male with a hematologic malignancy is likely to be due to AML-M4.
45. Clue cells are seen in Bacterial vaginosis.
46. Call-Exner bodies are found in Granulosa cell tumor.
47. Histopathology of chalazion reveals non-specific chronic inflammation. another option was lipogranuloma.
48. Histological activity in Ulcerative colitis is characterized by cryptitis. other options were crypt abscess, crypt loss and thick muscularis propria.
49. All are visualized by bronchoscopy except sub-carinal lymphnodes. other options were vocal cords, epiglottis and 1st subsegmental bronchi.
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