ALL INDIA 2006

1.      Nevirapine is a:

A. Protease inhibitor.

B. Nucleoside reverse transcriptase inhibitor.

C. Non-nucleoside reverse transcriptase inhibitor.

D. Fusion inhibitor.

Ans. C (Katzung 9th ed., p 817)

2.      Anticentromere antibodies commonly associated with:

A. Diffuse cutaneous systemic sclerosis.

B. Mixed connective tissue disease.

C. CREST syndrome.

D. Polymyositis.

Ans. C (Harrison 16th ed., p 317, 1979; Robbins 7th ed., p 229)

3.      A 58 years old woman, who had backache and recurrent chest infections for 6 months, develops sudden weakness of the legs and urinary retention. Her investigations show a hemoglobin of 7.3 gm/dl, serum calcium-12.6 mg/dl, phosphate-2.5 mg/dk, alkaline phosphatase-100 u/k, serum albumin-3 gm/dl, globulin-7.1 gm/dl, and urea-178 mg/dl. What is the most likely diagnosis?

A. Lung cancer.

B. Disseminated tuberculosis.

C. Multiple myeloma.

D. Osteoporosis.

Ans. C (Harrison 16th ed., p 658)

4.      All of the following drugs are protease inhibtors except:

A. Nelfinavir                       B.  Saquinavir

C. Abacavir                         D.  Ritonavir

Ans. C (Katzung 9th ed., p 815)

5.      Which of the following clinical findings excludes the diagnosis of polymyolitis?

A. Neck muscle involvement

B. Extraocular muscle involvement

C. Dysphagia

D. Abdominal muscle involvement

Ans. B (Harrison 16th ed., p 2540)

6.      All of the following are the known causes of osteoporosis except:

A. Fluorosis                         B.  Hypogonadism

C. Hyperthyroidism            D.  Hyperparathyroidism

Ans. A (Harrison 16th ed., p 2271; Apley 8th ed., p 125)

7.      A 28 years old woman having limited cutaneous scleroderma for the last 10 years complains of shortness of breath for last one month. Her pulmonary function tests (PFT) are as follows:

         PFT          Observed          Predicted

         FVC         2.63                   2.82

         FEV1       88% 80%

         DLCO      5.26                   16.3

         What is the most likely diagnosis in this case?

A. UInterstitial long disease.

B. Pulmonary artery hypertension

C. Congestive heart failure.

D. Bronchiectasis

Ans. A (Harrison 16th ed., p 1500, 1556)

8.      Which of the following is least likely to cause infective endocarditis:

A. Staphylococcus albus

B. Streptococcus faecalis

C. Salmonella typhi

D. Pseudomonas aeruginosa

Ans. C (Harrison 16th ed., p 732, 899; Ananthnarayan & Paniker 7th ed., p 192-212)

9.      All of the following may occur due to hyperkalemia, except:

A. Prolonged PR interval

B. Prolonged QRS interval

C. Prolonged QT interval

D. Ventricular asystole

Ans. C (Harrison 16th ed., p 1707, 2007-2009)

10.    Renal artery stenosis may occur in all of the following, except:

A. Atherosclerosis               B.  Fibromuscular dysplasia

C. Takayasu’s arteritis        D.  Polyarteritis nodosa

Ans. D (Harrison 16th ed., p 1707, 2007-2009)

11.    Sudden cardiac death may occur in all the following, except:

A. Dilated cardiomyopathy   B.           Hypertrophic cardiomyopathy

C. Eisenmenger’s syndrome  D.           Ventricular septal defect

Ans. D (Harrison 16th ed., p 13, 85, 1619; Robbins 7th ed., p 586)

12.    All of the following are risk factors for artherosclerosis except:

A. Increased waist-hip ratio.

B. Hyperhomocysteinemia

C. Decreased fibrinogen levels

D. Decreased HDL levels

Ans. C (Harrison 16th ed., p 1427-1430)

13.    All of the following may occur in Down’s syndrome except:

A. Hypothyroidism

B. Undescended testis

C. Ventricular septal defect

D. Brushfield’s spots

Ans. B (OP Ghai 6th ed., p 592)

14.    All of the following may be seen in patients of cardiac temponade except:

A. Kussmaul’s sign

B. Pulsus paradoxus

C. Electrical alternans

D. Right ventricular diastolic collapse on echocardiogram

Ans. A (Harrison 16th ed., p 1416)

15.    A 15 year old female presents with primary amenorrhoea. Her breasts are Tanner 4 but she has no axillary or pubic hair. The most likely diagnosis is:

A. Turner’s syndrome

B. Mullerian agenesis

C. Testicular feminization syndrome

D. Premature ovarian failure

Ans. C (Harrison 16th ed., p 2218; Shaw 13th ed., p 105)

16.    The common side effect with Fluoxetine therapy is:

A. Seizure                           B.  Anxiety

C. Hypotension                   D.  Loose stools

Ans. D (Harrison 16th ed., p 2555; Katzung 9th ed., p 493)

17.    A young girl has consumed barium carbonate with suicidal intent. She complains of generalized muscle weakness. The most likely electrolyte abnormality is:

A. Hyponatremia                B.  Hypocalcemia

C. Hypokalemia                  D.  Hypomagnesemia

Ans. C (Harrison 16th ed., p 259)

18.    All of the following antibacterial agents acts by inhibiting cell wall synthesis, except:

A. Carbapenems                  B.  Monobactams

C. Cephamycins                  D.  Nitrofurantoin

Ans. D (Karzung 9th ed., p 829)

19.    A veterinary doctor had pyrexia of unknown origin. His blood culture in special laboratory media was positive for gram negative short bacilli which was oxidase positive. Which one of the following is the likely organism grown in culture?

A. Pasturella spp.                B.  Fracisella spp.

C. Bartonella spp.               D.  Brucella spp.

Ans. D (Ananthnarayan and Paniker 7th ed., p 331, 345 & 420)

20.    Which one of the following statement is true regarding pathogenicity of Mycobacteria species?

A. M. tuberculosis is more pathogenic than M. bovis to the humans

B. M. kanasii can cause a disease indistinguishable from tuberculosis

C. M. africamum infection is acquired from the environmental source

D. M. marinum is responsible for tubercular lymphadenopathy

Ans. B (Ananthnarayan and Paniker 7th ed., p 368)

21.    A young boy had a flea bite while working in a wheat grain godown. After 5 days he developed fever and had axillary lymphadenopathy. A smear was sent to the laboratory to perform a specific staining. Which one of the following staining method would help in the identification of the suspected pathogen:

A. Albert staining

B. Zeihl-Neelson staining

C. McFadyean’s staining

D. Wayson staining

Ans. D (Harrison 16th ed., p 924)

22.    A 40 years old woman presented to the gynecologist with complaints of profuse vaginal discharge. There was no discharge from the cervical os on the speculum examination. The diagnosis of bacterial vaginosis was made based upon all of the following findings on microscopy except:

A. Abundance of gram variable coccobacilli

B. Absence of Lactobacilli

C. Abundance of polymorphs

D. Presence of clue cells

Ans. C (Shaw’s 13th ed., p 135; Harrison 16th ed., p 767)

23.    A patient complained of chills and fever following a louse bite 2 weeks before. He had rashes all over the body and was delirious at the time of presentation to the hospital and subsequantly went into coma. A provisional diagnosis of vasculitis due to Rickettsial infection was made. Which one of the following can be the causatve agent:

A. Rickettsia typhi              B.  Rickettsia rickettsiae

C. Rickettsia prowazekii     D.  Rickettsia akari

Ans. C (Ananthnarayan and Paniker 7th ed., p 414; Harrison 16th ed., p 1004)

24.    A diabetic patient developed cellutitis due to Staphylococcus aureus, which was found to be Methicillin resistant on the antibiotic sensitivity testing. All the following antibiotics will be appropriate except:

A. Vancomycin                   B.  Imipenem

C. Teichoplanin                   D.  Linezolid

Ans. B (Harrison 16th ed., p 821; Katzung 9th ed., p 748, 750 & 762)

25.    A VDRL reactive mother gave birth to an infant. All of the following would help in determining the risk of transmission to the infant except:

A. TPHA test on the serum sample of the mother

B. TPHA test on the serum sample of the infant

C. VDRL on the paired serum sample of the infant and mother

D. Time interval between the treatment of the mother and her delivery

Ans. B (Ananthnarayan & Paniker 7th ed., p 383; Harrison 16th ed., p 981)

26.    At what period does tuberculosis flare up most commonly in a pregnant patient?

A. First trimester                 B.  Second trimester

C. Third trimester               D.  Puerperium

Ans. D (Tuberculosis SK Sharma p 305)

27.    Which surgical procedure has the highest incidence of ureteric injury?

A. Vaginal hysterectomy

B. Abdominal hysterectomy

C. Wertheim’s hysterectomy

D. Anterior colporraphy

Ans. C (Shaw’s 13th ed., p 181; Current Obstetrics and Gynaecology Diagnosis and Treatment, p 838)

28.    The following hormone is raised in polycystic ovarian syndrome:

A. 17-OH Progesterone      B.  Follicular stimulating hormone

C. Lutenising hormone       D.  Thyroid stimulating hormone

Ans. C (Ashok Kumar Essentials of Gynaecology 1st ed., p )

29.    Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytion therapy for Epilepsy?

A. Vitamin B6                    B.  Vitamin B12

C. Vitamin A                      D.  Folic acid

Ans. D (Katzung 9th ed., p 383)

30.    Which of the following ovarian tumour is most prone to undergo torsion during pregnancy?

A. Serous Cystadenoma

B. Mucenous Cystadenoma

C. Dermoid cyst

D. Theca Lutein cyst

Ans. C (Shaw’s 13th ed., p 467; DC Dutta Textbook of Gynaecology 4th ed., p )

31.    Which one of the following congenital malformation of the fetus can be diagnosed in first trimester by ultrasound?

A. Anencephaly                  B.  Inencephaly

C. Microcephaly                 D.  Holoprosencephaly

Ans. A (DC Dutta Textbook of Obstetrics 5th ed., 439)

32.    The most common cause of tubal block in India is:

A. Gonorrhoea infection

B. Chlamydia infection

C. Tuberculosis

D. Bacterial vaginosis

Ans. A (DC Dutta Textbook of Gynaecology 4th ed., 128)

33.    The following complications during pregnancy increase the risk of Post Partum Haemorrhage (PPH) except:

A. Hypertension                  B.  Macrosomia

C. Twin pregnancy             D.  Hydramnios

Ans. A (DC Dutta Textbook of Obstetrics 5th ed., 441-442)

34.    Indicators of impending uterine rupture during labour include all of the following except:

A. Fetal distress

B. Hematuria

C. Fresh bleeding per vaginum

D. Passage of meconium

Ans. D (DC Dutta Textbook of Obstetrics 5th ed., 464)

35.    Which of the following statements is incorrect regarding polycystic ovarian disease?

A. Elevated LH hormone

B. Can cause infertility

C. May be associated with abnormal glucose tolerance test

D. Results in postdated pregnancy

Ans. D (Ashok Kumar Essentials of Gynaecology 1st ed., 181-184; Harrison 16th ed., p 2163)

36.    Which of the following statements is incorrect regarding levonorgestral releasing intra-uterine system?

A. There is increased incidence of menorrhagia

B. This system can be used as hormone replacement therapy

C. This method is useful for the treatment of Endometrial hyperplasia

D. Irregular uterine bleeding can be a problem initially

Ans. B (Park 18th ed., p 364; Shaw’s 13th ed., 223)

37.    All of the following mechanisms might account for a reduced risk of upper genital tract infection in users of progestin-releasing IUDs, except:

A. Reduced retrograde menstruation

B. Decreased ovulation

C. Thickened cervical mucus

D. Decidual changes in the endometrium

Ans. C (Park 18th ed., p 364; Shaw’s 13th ed., 222-224)

38.    Emergency contraception prevents pregnancy by all of the following mechanisms, except:

A. Delaying/inhibiting ovulation

B. Inhibiting fertilization

C. Preventing implantation of the fertilized egg

D. Interrupting an early pregnancy

Ans. B/D (Ashok Kumar Essentials of Gynaecology 1st ed., 19-21)

39.    Misoprostol is a:

A. Prostaglandin E1 analogue

B. Prostaglandin E2 analogue

C. Prostaglandin antagonist

D. Antiprogestin

Ans. A (Katzung 9th ed., p 299)

40.    Lymphatic drainage of the cervix occurs by all of the following lymph nodes, except:

A. Parametrial lymph nodes

B. Deep inguinal lymph nodes

C. Obtruator lymph nodes

D. Ext. iliac lymph nodes

Ans. B (DC Dutta Textbook of Obstetrics 5th ed., p 7)

41.    The treatment for a case of virilising adrenal hyperplasia is:

A. Estrogens                       B.  Antiandrogens

C. ACTH                            D.  Cortisone

Ans. D (Shaw’s 13th ed., p 102-103)

42.    A primigravida presents to casualty at 32 wks. gestations with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by:

A. Immediate caesarean section

B. Immediate induction of labour

C. Tocolytic therapy

D. Magnesium sulphate therapy

Ans. A (Williams Obstetrics 22nd ed., p 627)

43.    The investigation of choice in a 55 year old postmenopausal woman who has presented with postmenopausal bleeding is:

A. Pap smear

B. Fractional curettage

C. Transvaginal ultrasould

D. CA-125 estimation

Ans. B (Shaw’s 13th ed., p 67)

44.    In which of the following genital tract malignancy, the risk of metastasis of ovary is the least?

A. Carcinoma cervix

B. Carcinoma endometrium

C. Carcinoma fallopian tube

D. Uterine sarcoma

Ans. A (Shaw’s 13th ed., p )

45.    The best way of diagnosing Trisomy-21 during second trimester of pregnancy is:

A. Triple market estimation

B. Nuchal skin fold thickness measurement

C. Chorionic villus sampling

D. Amniocentesis

Ans. D (DC Dutta Textbook of Obstetrics 5th ed., p )

46.    Calcitonin is secreted by:

A. Thyroid gland                B.  Parathyroid gland

C. Adrenal glands               D.  Ovaries

Ans. A (Apley 8th ed., 110)

47.    Which of the following is an intraarticular tendon?

A. Sartorius                         B.  Semitendinosus

C. Anconeus                       D.  Popliteus

Ans. D (Gray 38th ed., 888)

48.    Which of the following conditions is least likely to present as an eccentric osteolytic lesion:

A. Aneurysmal bone cyst

B. Giant cell tumor

C. Fibrous cortical defect

D. Simple bone cyst

Ans. D (Apley 8th ed., 173-180)

49.    Bisphosphonates act by:

A. Increasing the osteoid formation

B. Increasing the mineralisation of osteoid

C. Decreasing the osteoclast mediated resorption of bone

D. Decreasing the parathyroid hormone secretion

Ans. C (Goodman and Gilman 10th ed., 1734)

50.    All the statements are true about exostosis, except:

A. It occurs at the growing end of bone

B. Growth continues after skeletal maturity

C. It is covered by cartilaginous cap

D. Malignant transformation may occur

Ans. B (Apley 8th ed., 178)

51.    “Rugger Jersey Spine” is seen in:

A. Fluorosis

B. Achondroplasia

C. Renal Osteodystrophy

D. Marfan’s Syndrome

Ans. C (Apley 8th ed., 124)

52.    Brown tumours are seen in:

A. Hyperparathyroidism

B. Pigmented villonodular synovitis

C. Osteomalacia

D. Neurofibromatosis

Ans. A (Apley 8th ed., p 122)

53.    All of the following statements are true about development dysplasia (DDH) of the hip, except:

A. It is more common in females

B. Oligohydramnios is associated with a higher risk of DDH

C. The hourglass appearance of the capsule may prevent a successful closed reduction

D. Twin pregnancy is a known risk factor

Ans. D (Apley 8th ed., p 409)

54.    All are true regarding brachial plexus injury, except:

A. Preganglionic lesions have a better prognosis than postganglionic lesions

B. Erb’s palsy causes paralysis of the abductors and external rotators of the shoulder

C. In Klumpke’s palsy, Horner’s syndrome may be present on the ipsilateal side

D. Histamine test is useful to differentiate between the preganglionic and postganglionic lesions.

Ans. A (Apley 8th ed., p 237)

55.    The ideal treatment of bilateral idiopathic clubfoot in a newborn is:

A. Manipulation by mother

B. Manipulation and Dennis Brown splint

C. Manipulation and Casts

D. Surgical release

Ans. A (Apley 8th ed., p 489)

56.    The postero superior retraction pocket, if allowed to progress, will lead to:

A. Sensori-neural hearing loss

B. Secondary Cholesteatoma

C. Tympanoscelerosis

D. Tertiary cholesteatoma

Ans. B (PL Dhingra 3rd ed., p 89)

57.    A 30 year old male is having Attic cholesteatoma of left ear with lateral sinus thrombophebitis. Which of the following will be the operation of choice?

A. Intact canal wall mastoidectomy

B. Simple mastoidectomy with Tympanoplasty

C. Canal wall down mastoidectomy

D. Mastoidectomy with cavity obliteration

Ans. C (PL Dhingra 3rd ed., p 94; Scott & Brown 6th ed., p 3/10/6)

58.    Which of the following conditions causes the maximum hearing loss?

A. Ossicular disruption with intact tympanic membrane

B. Disruption of malleus and incus as well tympanic membrane

C. Partial fixation of the stapes footplate

D. Otitis media with effusion

Ans. A (PL Dhingra 3rd ed., p 38)

59.    During inspiration the main current of airflow in a normal nasal cavity is through:

A. Middle part of the cavity in middle meatus in a parabolic curve

B. Lower part of the cavity in the inferior meatus in a parabolic curve

C. Superior part of the cavity in the superior meatus

D. Through olfactory area

Ans. A (PL Dhingra 3rd ed., p 172)

60.    Which is the investigation of choice in assessing hearing loss in neonates?

A. Impedance audiometry

B. Brainstem Evoked Response Audiometry (BERA)

C. Free field audiometry

D. Behavioral audiometry

Ans. B (Nelson 15th ed., p 2131; PL Dhingra 3rd ed., p 36)

61.    The most common etiological agent for acute bronchiolitis in infancy is:

A. Influenza virus

B. Para influenza virus

C. Rhinovirus

D. Respiratory syncytial virus

Ans. D (OP Ghai 6th ed., p 574-154; Nelson 16th ed., p 1415)

62.    Which of the following is the principal mode of heat exchange in an infant incubator?

A. Radiation                       B.  Evaporation

C. Convection                     D.  Conduction

Ans. C (OP Ghai 6th ed., p 154; Care of the Newborn Meherban Singh p 26)

63.    Late onset hemorrhagic disease of newborn is characterized by all of the following featuers except:

A. Usually occurs in cow-milk fed babies

B. Onset occurs at 4-12 wk of age

C. Intracranial hemorrhage can occur

D. Intramuscular vitamin K prophylaxis at birth has a protective role

Ans. A (Nelson 16th ed., p 600)

64.    Which of the following malformation in a newborn is specific for maternal insulin dependent diabetes mellitus?

A. Transposition of great arteries

B. Caudal regression

C. Holoprosencephaly

D. Meningomyelocele

Ans. B (Dutta Textbook of Obstetric 5th ed., p 303

65.    The prognosis of rhabdomyosarcoma is likely to be poor if the site of the tumor is:

A. Orbit                               B.  Para testicular

C. Extremity                       D.  Urinary bladder

Ans. C/D (OP Ghai 6th ed., p 575) Devita Oncology

66.    Which of the following malignant tumors is radioresistant?

A. Ewing’s sarcoma            B.  Retinoblastoma

C. Osteosarcoma                 D.  Neuroblastoma

Ans. C (OP Ghai 6th ed., p 574-578) Devita’s Oncology

67.    The most common second malignancy in survivors of retinoblastoma is:

A. Thyroid cancer

B. Nasopharyngeal carcinoma

C. Optic glioma

D. Osteosarcoma

Ans. D (Robbins Pathology 7th ed., p 300; OP Ghai 6th ed., p 577)

68.    The most important determinant of prognosis in Wilms tumor is?

A. Stage of disease

B. Loss of heterozygosity of chromosome 1 p.

C. Histology

D. Age less than one year at presentation

Ans. A/C (OP Ghai 6th ed., p 575) Devita

69.    The Finnish type of congenital nephrotic syndrome occurs due to gene mutations affecting the following protein:

A. Prodocin                         B.  Alpha-actinin

C. Nephrin                          D.  CD2 activated protein

Ans. C (Robbins 7th ed., p 981; Nelson 16th ed., p 1757)

70.    Sensorineural deafness may be a feature of all, except:

A. Nail patella syndrome    B.  Distal renal tubular acidosis

C. Bartter syndrome           D.  Alport syndrome

Ans. A (Harrison 16th ed., p 1698-199, 2331; Ganong 22nd ed., p 715)

71.    With reference to mumps which of the following is true?

A. Meningoencaphalitis can precede parotitis

B. Salivary gland involvement is limited to the parotids

C. The patient is not infectious prior to clinical parotid enlagement

D. Mumps orchitis frequently leads to infertility

Ans. A (OP Ghai 6th ed., p 209; Nelson 16th ed., p 1035)

72.    A child is below the third percentile for height. His growth velocity is normal, but chronologic age is more than skeletal age. The most likely diagnosis is:

A. Constitutional delay in growth

B. Genetic short stature

C. Primordial dwarfism

D. Hypopituitarism

Ans. A (OP Ghai 6th ed., p 50)

73.    Drug induced lupus can be identified by:

A. Anti-histone antibodies

B. Double stranded DNA antibodies

C. Antinuclear antibodies

D. Anti-SM antibodies

Ans. A (Robbins 7th ed., p 229)

74.    The process underlying differences in expression of a gene, according to which parent has transmitted, is called:

A. Anticipation                   B.  Mosaicism

C. Non-penetrace                D.  Genomic imprinting

Ans. D (Robbins 7th ed., p 186)

75.    The sodium content of ReSoMal (rehydration solution for malnourished children) is:

A. 90 mmol/L                      B.  60 mmol/L

C. 45 mmol/L                      D.  30 mmol/L

Ans. C (OP Ghai 6th ed., p 109)

76.    All of the following are features of prematurity in a neonate, except:

A. No creases on sole          B.  Abundant lanugo

C. Thick ear cartilage          D.  Empty scrotum

Ans. C (OP Ghai 6th ed., p 155)

77.    A normally developing 10 month old child should be able to do all the following except:

A. Stand alone

B. Play peek a boo

C. Pick up a pellet with thumb and index finger

D. Build a tower of 3-4 cubes

Ans. D (OP Ghai 6th ed., p 46)

78.    The following are characteristic of autism except:

A. Onset after 6 years of age

B. Repetitive behavior

C. Delayed language development

D. Severe deficit in social interaction

Ans. A (OP Ghai 6th ed., p 65)

79.    The earliest indicator of response after starting iron in a 6-year-old girl with iron deficiency is:

A. Increased reticulocyte count

B. Increased hemoglobin

C. Increased ferritin

D. Increased serum iron

Ans. A (OP Ghai 6th ed., p 302; Nelson 16th ed., p 1616)

80.    A 1 month old boy is referred for failure to thrive. On examination, he shows features of congestive failure. The femoral pulses are feeble as compared to branchial pulses. The most likely clinical diagnosis is:

A. Congenital aortic stenosis

B. Coarctation of aorta

C. Patent ductus arteriosus

D. Congenital aortoiliac disease

Ans. B (OP Ghai 6th ed., p 419)

81.    All of the following statements regarding subendocardial infarction are true, except:

A. These are mutifocal in nature

B. These often result from hypotension of shock

C. Epicarditis is not seen

D. These may result in aneurysm

Ans. D (Robbins 7th ed., p 575, 584)

82.    All of the following are true for mitral valve prolapse, except:

A. Transmission may be as an autosomal dominant trait

B. Majority of the cases present with features of mitral regurgitation

C. The valve leaflets characteristically show myxomatous degeneration

D. The disease is one of the common cardiovascular manifestations of Marfan Syndrome

Ans. B (Harrison 16th ed., p 1395, 2330; Robbins 6th ed., p 591-592)

83.    The following diseases are associated with Epstein – Barr virus infection, except:

A. Infectious mononucleosis

B. Epidermodysplasia verruciformis

C. Nasopharyngeal carcinoma

D. Oral Hairy leukoplakia

Ans. B (Robbins 7th ed., p 1046-1047)

84.    Megaloblastic anaemia due to folic acid deficiency is commonly due to:

A. Inadequate dietary intake

B. Defective intestinal absorption

C. Absence of folic acid binding protein in serum

D. Absence of glutamic acid in the intestine

Ans. A (Harrison 16th ed., p 603)

85.    The most important prognostic factor in breast carcinoma is:

A. Histological grade of the tumour

B. Stage of the tumour at the time of diagnosis

C. Status of estrogen and progesterone receptors

D. Over expression of p-53 tumour suppressor gene

Ans. B (Harrison 16th ed., p 519; Bailey and Love 24th ed., p )

86.    Smoking is generally not associated as a risk factor with:

A. Small cell carcinoma

B. Respiratory bronchiolitis

C. Emphysema

D. Bronchiolitis obliterans organizing pneumonia

Ans. D (Robbins 7th ed., p 718, 740 & 759; Harrison 16th ed., p 1495)

87.    The tumour, which may occur in the residual breast or overlying skin following wide local excision and radiotherapy for mammary carcinoma, is:

A. Leiomyosarcoma

B. Squamous cell carcinoma

C. Basal cell carcinoma

D. Angiosarcoma

Ans. D (Robbins 7th ed., p 1151)

88.    The type of mammary ductal carcinoma in situ (DCIS) most likely to result in a palphable abnormality in the breast is:

A. Apocrine DCIS

B. Neuroendocrine DCIS

C. Well differentiated DCIS

D. Comedo DCIS

Ans. D (Robbins 7th ed., p 1139)

89.    Acinic cell carcinomas of the salivary gland arise most often in the:

A. Parotid salivary gland

B. Minor salivary glands

C. Submandibular salivary gland

D. Subliguinal salivary gland

Ans. A (Robbins 7th ed., p 794)

90.    All of the following statements regarding primary effusion lymphoma are true except:

A. It generally presents in elderly patients

B. There is often an association with HHV-8

C. The proliferating cells are NK cells

D. Patients are commonly HIV positive

Ans. C (Harrison 16th ed., p 648-649)

91.    Mantle cell lymphomas are positive for all of the following, except:

A. CD 23                            B.  CD 20

C. CD 5                              D.  CD 43

Ans. A (Robbins 7th ed., p 683)

92.    Fine needle aspiration cytology is not suitable for diagnosing:

A. Tubercular lymphadenitis

B. Papillary carcinoma thyroid

C. Plasmacytoma

D. Aneurymal bone cyst

Ans. D (Apley 8th ed., p ; Robbins 7th ed., p 326)

93.    All of the following immunohistochemical markers are positive in the neoplastic cells of granulocytic sarcoma, except:

A. CD 45 RO                      B.  CD 43

C. Myeloperoxidase            D.  Lysozyme

Ans. A (Harrison 16th ed., p 633; Robbins 7th ed., p 694)

94.    B cell prolymphocytic leukemia patients differ from those with B cell chronic lymphocytic leukemia in:

A. Presenting at a younger age

B. Having a lower total leucocyte count

C. Having prominent lymphadenopathy

D. Having a shorter survival

Ans. D (Harrison 16th ed., p 652; Robbins 7th ed., p 674)

95.    Which of the following statements is incorrect about pthisis bulbi?

A. The intraocular pressure is increased

B. Calcification of the lens in common

C. Sclera is thickened

D. Size of the globe is reduced

Ans. A (Parson 19th ed., p 245)

96.    Which one of the following statements is incorrect about Optic glioma?

A. Has a peak incidence in first decade

B. Arises from oligodendrocytes

C. Causes meningeal hyperplasia

D. Is associated with type I neurofibromastosis

Ans. B (Parson 19th ed., p 515)

97.    Which one of the following stromal dystrophy is a recessive condition?

A. Lattice dystrophy           B.  Granular dystrophy

C. Macular dystorphy         D.  Fleck dystrophy

Ans. C (Parson 19th ed., p 222)

98.    In which of the following conditions Parakeratosis most frequently occurs?

A. Actinic keratoses

B. Seborrheic keratoses

C. Molluscum contagiosum

D. Basal cell carcinoma

Ans. A (Robbins 7th ed., p 1241-1242; Neena Khanna p 277)

99.    Which one of the following is the most significant risk factor for development of gastric carcinoma?

A. Paneth cell metaplasia

B. Pyloric metaplasia

C. Intestinal metaplasia

D. Ciliated metaplasia

Ans. C (Robbins 7th ed., p 823-825; Harrison 16th ed., p 525)

100.  Which of the following is the most common presenting symptom of non-cirrhotic portal hypertension?

A. Chronic liver failure

B. Ascites

C. Upper gastrointestinal bleeding

D. Encephalopathy

Ans. C (Harrison 16th ed., p 1269, 1863)

101.  Ethosuximide is used in the treatment of:

A. Tonic-clonic seizures      B.  Absence seizure

C. Myoclonic seizure          D.  Simple partial seizure

Ans. B (Katzung 9th ed., p 390)

102.  Which of the following statements is not true about etomidate?

A. It is an intravenous anesthetic

B. It precipitates coronary insufficiency

C. It inhibits cortisol synthesis

D. It causes  pain at site of injection

Ans. B (Ajay Yadav 2nd ed., p 74-75; Katzung 9th ed., p 414)

103.  Which one of the following antibacterials should not be used with d-tubocurarine?

A. Norfloxacin                    B.  Streptomycin

C. Doxycycline                   D.  Cefotaxine

Ans. B (Goodman and Gilman 10th ed., p 1230)

104.  Which one of the following drugs is an antipseudomonal penicillin?

A. Cephalexin                     B.  Cloxacillin

C. Piperacillin                     D.  Dicloxacillin

Ans. C (Goodman and Gilman 10th ed., p 1203)

105.  The following statements regarding benzodiazepines are true except:

A. Binds to both GABAA and GABAB receptors.

B. They have active metabolites

C. Decreases nocturnal gastric secretion in human being

D. Extensively metabolized by CYP enzymes

Ans. A (Goodman and Gilman 10th ed., p 403)

106.  One of the following statements regarding mycophenolate mofetil is incorrect:

A. It is a prodrug

B. It is a selective uncompetitive and reversible inhibitor of inosine monophosphate dehydrogenase

C. It also inhibits calcineurin

D. Selectively inhibits lymphocyte proliferation

Ans. C (Goodman and Gilman 10th ed., p 1471)

107.  All of the following mechanisms of action of oral contraceptive pill are true, except:

A. Inhibition of ovulation

B. Prevention of fertilization

C. Interference with implantation of fertilized ovum

D. Interference with placental functioning

Ans. D (Goodman and Gilman 10th ed., p 1625)

108.  Which one of the following drugs does not interfere with folic acid metabolism?

A. Phenytoin                       B.  Gabapentin

C. Phenobarbitone              D.  Primidone

Ans. B (Goodman and Gilman 10th ed., p 530-539)

109.  Which one of the following drugs causes constipation?

A. Propranolol                     B.  Verapamil

C. Nitroglycerin                  D.  Captopril

Ans. B (Goodman and Gilman 10th ed., p 658)

110.  Which of the following drugs is not used topically for treatment of open angle glaucoma:

A. Latanoprost                    B.  Brimonidine

C. Acetazolamide               D.  Dorzolamide

Ans. C (Goodman and Gilman 10th ed., p 1834-1837)

111.  Concomitant administration of clonazepam with which of the following antipileptic drug can precipitate absence status?

A. Sodium valproate           B.  Phenobarbitone

C. Carbamazepine               D.  Phenytoin

Ans. A (Goodman and Gilman 10th ed., p 537)

112.  Which one of the following agents has been associated with hemorrhagic stroke?

A. Phenylpropanolamine

B. Terfenadine

C. Quinidine

D. Fenfluramine

Ans. A (Harrison 16th ed., p 377; Katzung 9th ed., p 134, 1066)

113.  All of the following are therapeutic uses of Penicillin G, except:

A. Bacterial meningitis       B.  Rickettsial Infection

C. Syphilis                          D.  Anthrax

Ans. B (Katzung 9th ed., p 710, 739; Harrison 16th ed., p 708, 1001)

114.  All of the following are major complications of massive transfusion, except:

A. Hypokalemia                  B.  Hypothermia

C. Hypomagnesemia           D.  Hyopcalcemia

Ans. A (Ajay Yadav 2nd ed., p 14; Harrison 16th ed., p 666)

115.  Which one of the following muscle relaxant has the maximum duration of action?

A. Atracurium                     B.  Vecuronium

C. Rocuronium                   D.  Doxacurium

Ans. D (Ajay Yadav 2nd ed., p 91)

116.  Which enzyme is inhibited by Aminophylline?

A. Monoamine Oxidase

B. Alcohol dehydrogenase

C. Phosphodiesterase

D. Cytochrome P-450.

Ans. C (Katzung 9th ed., p 326; Goodman and Gilman 10th ed., p 744)

117.  Which one of the following local anaesthetics belongs to the ester group?

A. Procaine                         B.  Bupivacaine

C. Lignocaine                     D.  Mepivacaine

Ans. A (Ajay Yadav 2nd ed., p 105)

118.  The following are the benzodiazepines of choice in elderly and those with liver disease, except:

A. Lorazepam                     B.  Oxazepam

C. Tempazepam                  D.  Diazepam

Ans. D (Katzung 9th ed., p 364)

119.  Which one of the following agents sensitises the myocardium to catecholamines?

A. Isoflurane                       B.  Ether

C. Halothane                       D.  Propofol

Ans. C (Ajay Yadav 2nd ed., p 61)

120.  Which of the following is the muscle relaxant of choice in renal failure?

A. Rapacurium                    B.  Pancuronium

C. Atracurium                     D.  Rocuronium

Ans. C (Katzung 9th ed., p 432; Ajay Yadav 2nd ed., p 91)

121.  Ovulation is primarily caused by preovulatory surge of:

A. Estradiol

B. Luteinizing hormone

C. Progesterone

D. Follicle stimulating hormone

Ans. B (Ganong 22nd ed., p 438)

122.  Most afferent fibres from the lateral geniculate nucleus terminate in the primary visual cortex in:

A. Layer 1                           B.  Layers 2 & 3

C. Layer 4                           D.  Layers 5 & 6

Ans. C (Ganong 22nd ed., p 161)

123.  The blobs of the visual cortex are associated with:

A. Ocular dominance

B. Orientation

C. Color processing

D. Saccadic eye movements

Ans. C (Ganong 22nd ed., p 161)

124.  The parvocellular pathway, from the lateral geniculate nucleus to the visual cortex, carries signals for the detection of:

A. Movement, depth and flicker

B. Color vision, shape and fine details

C. Temporal frequency

D. Luminance contrast

Ans. B (Ganong 22nd ed., p 161)

125.  A pilot in Sukhoi aircraft is experiencing negative G. Which of the following physiological events will manifest in such situation?

A. The hydrostatic pressure in veins of lower limb increases

B. The cardiac output decreases

C. Black out occurs

D. The cerebral arterial pressure rises

Ans. D (Ganong 22nd ed., p 632)

126.  In human being, the least useful physiological response to low environmental temperature is:

A. Shivering                        B.  Vasoconstriction

C. Release of thyroxine      D.  Piloerection

Ans. D (Guyton 11th ed., p 895)

127.  The cell bodies of orexinergic neurons are present in:

A. Locus coeruleus

B. Dorsal raphe

C. Lateral hypothalamic area

D. Hippocampus

Ans. C (Guyton 11th ed., p 869; Ganong 22nd ed., p 238)

128.  The tubuloglomerular feedback is mediated by:

A. Sensing of Na+ concentration in the macula densa

B. Sensing of Cl– concentration in the macula densa

C. Sensing of NaCl concentration in the macula densa

D. Opening up of voltage gated Na+ channels in afferent arteriole

Ans. C (Guyton 11th ed., p 324; Ganong 22nd ed., p 713)

129.  The prime driving force for counter current multiplier system is:

A. Medullary hyperosmolarity

B. Reabsorption of Na+ in thick ascending limb

C. Action of ADH via aquaporin channels

D. Urea recycling

Ans. B (Guyton 11th ed., p 335; Ganong 22nd ed., p 717)

130.  Which of the following organs is not involved in calcium homeostasis?

A. Kidneys                          B.  Skin

C. Intestines                        D.  Lungs

Ans. D (Ganong 22nd ed., p 391)

131.  Testosterone production is mainly contributed by:

A. Leydig cells                    B.  Sertoli cells

C. Seminiferous tubules      D.  Epididymis

Ans. A (Ganong 22nd ed., p 425)

132.  Which of the following secretions has a very high pH?

A. Gastric juice                   B.  Pancreatic juice

C. Bile in gall bladder         D.  Saliva

Ans. B (Guyton 11th ed., p 794; Ganong 22nd ed., p 488, 491)

133.  The maintenance of posture in a normal adult human being depends upon:

A. Integrity of reflex arc

B. Muscle power

C. Type of muscle fibres

D. Joint movements in physiological range

Ans. A (Ganong 22nd ed., p 207)

134.  The first reflex response to appear as spinal shock wears off in humans is:

A. Tympanic reflex             B.  Withdrawal reflex

C. Neck righting reflex       D.  Labyrinthine reflex

Ans. B (Ganong 22nd ed., p 208)

135.  The hyperkinetic featuers of the Huntington’s disease are due to the loss of:

A. Nigrostriatal dopaminergic system

B. Intrastriatal cholinergic system

C. GABA-ergic and cholinergic system

D. Intrastriatal GABA-ergic and cholinergic system

Ans. D (Ganong 22nd ed., p 215)

136.  All of the following are part of the treatment of Lithium toxicity, except:

A. Treating dehydration

B. Ingestion of polystyrene sulfonate

C. Hemodialysis

D. Using an antagonist

Ans. D (Kaplan 9th ed., p 1071; Harrison 16th ed., p 2611)

137.  All are side effects of Clozapine except:

A. Granulocytopenia

B. Seizures

C. Sedation

D. Extrapyramidal side effects

Ans. D (Katzung 9th ed., p 473; Goodman and Gilman 10th ed., p 488; Kaplan 9th ed., p 1106-1107)

138.  Pavlov’s experiment is an example of:

A. Operant conditioning

B. Classical conditioning

C. Learned helplessness

D. Modelling

Ans. B (Kaplan 9th ed., p 143; Ganong 22nd ed., p 267-268)

139.  Bright light treatment has been found to be most effective in treatment of:

A. Anorexia Nervosa

B. Seasonal Affective Disorder

C. Schizophrenia

D. Obsessive Compulsive Disorder

Ans. B (Kaplan 9th ed., p 1145)

140.  The most common side effect reported with treatment with haloperidol is:

A. Hypotension                   B.  Akathisia

C. Dryness of mouth          D.  Tic disorder

Ans. B (Katzung 9th ed., p 458, 471; Goodman & Gilman 10th ed., p 488; Kaplan 9th ed., p 1055)

141.  Mutism and akinesis in a person, who appears awake and even alert, is best described as:

A. Twillight state                B.  Oneroid state

C. Stupor                            D.  Delirium

Ans. C (Kaplan 9th ed., p 280, 489)

142.  Loosening of associations is an example of:

A. Formal thought disorder

B. Schneiderian first rank symptoms

C. Perservation

D. Concrete thinking

Ans. A (Kaplan 9th ed., p 471, 473)

143.  Intense nihilism, somatization and agitation in old age are the hallmark symptoms of:

A. Involutional melancholia

B. Atypical depression

C. Somatized depression

D. Depressive stupor

Ans. A (Kaplan 9th ed., p 281)

144.  Rivastigmine and Donepezil are drugs used predominantly in the management of:

A. Depression                     B.  Dissociation

C. Delusions                       D.  Dementia

Ans. D (Kaplan 9th ed., p 1043; Harrison 16th ed., p 48)

145.  All of the following are associated with better prognosis in schizophrenia, except:

A. Late onset                      B.  Married

C. Negative symptoms       D.  Acute onset

Ans. C (Kaplan 9th ed., p 474)

146.  The following features are true for Tetralogy of Fallot, except:

A. Ventricle septal defect

B. Right ventricular hypertrophy

C. Atrial septal defect

D. Pulmonary stenosis

Ans. C (Robbins 7th ed., p 568; OP Ghai 6th ed., p 302)

147.  Which of the following statements is true regarding testicular tumours?

A. Are embryonal cell carcinoma in 95% of cases

B. Bilateral in upto 10% cases

C. Teratomas are more common than seminomas

D. Usually present after 50 years of age

Ans. B (Bailey and Love 24th ed., p 1411)

148.  The most common retrobulbar orbital mass in adults is:

A. Neurofibroma

B. Meningioma

C. Cavernous haemangioma

D. Schwannoma

Ans. C (Khurana 3rd ed., p 363)

149.  In which of the following conditions left atrium is not enlarged:

A. Ventricular septal defect

B. Atrial septal defect

C. Aorto-pulmonary window

D. Patent ductus arteriosus

Ans. B (OP Ghai 6th ed., p 400)

150.  Expansile lytic osseous metastases are characteristic of primary malignancy of:

A. Kidney                           B.  Bronchus

C. Breast                             D.  Prostate

Ans. A (Robbins 7th ed., p 1303)

151.  Which is the objective sign of identifying pulmonary plethora in a chest radiograph?

A. Diameter of the main pulmonary artery > 16 mm

B. Diameter of the left pulmonary artery > 16 mm

C. Diameter of the descending right pulmonary artery > 16 mm

D. Diameter of the descending left pulmonary artery > 16 mm

Ans. C (Sutton 7th ed., p 8; Grainger and Allison’s Diagnostic Radiology 4th ed., p 872-876)

152.  The most accurate investigation for assessing ventricular function is:

A. Multislice CT                 B.  Echocardiography

C. Nuclear scan                   D.  MRI

Ans. C/D (Harrison 16th ed., p 1324)

153.  The most important sign of significance of renal artery stenosis on an angiogram is:

A. A percentage diameter stenosis > 70%

B. Presence of collaterals

C. A systolic pressure gradient > 20 mmHg across the lesion

D. Post stenotic dilatation of the renal artery

Ans. C/A (Grainger and Allison’s Diagnostic Radiology 4th ed., p 1525, 1531)

154.  The MR imaging in multiple sclerosis will shown lesions in:

A. White matter                  B.  Grey matter

C. Thalamus                        D.  Basal ganglia

Ans. A (Harrison 16th ed., p 2465)

155.  The most common location of hypertensive intracranial haemorrhage is:

A. Subarachnoid space       B.  Basal ganglia

C. Cerebellum                     D.  Brainstem

Ans. B (Harrison 16th ed., p 2388-2390; Robbins 6th ed., p 1310)

156.  Which of the following causes rib-notching on the chest radiograph?

A. Bidirectional Glem shunt

B. Modified Blalock-Taussing shunt

C. IVC occlusion

D. Coarctation of aorta

Ans. D (Sutton 7th ed., p 48)

157.  The most sensitive imaging modality to detect early renal tuberculosis is:

A. Intravenous urography

B. Computed tomography

C. Ultrasound

D. Magnetic Resonance Imaging

Ans. A (Bailey and Love 24th ed., p 1328)

158.  All of them use non ionizing radiation, except:

A. Ultrasonography            B.  Thermography

C. MRI                               D.  Radiography

Ans. D (Grainger and Allison’s Diagnostic Radiology 4th ed., p 606)

159.  Mixed tumours of the salivary glands are:

A. Most common in submandibular gland

B. Usually malignant

C. Most common in parotid gland

D. Associated with calculi

Ans. C (S Das Concise Textbook of Surgery 3rd ed., p 606; Bailey and Love 24th ed., p  )

160.  In which of the following types of breast carcinoma, would you consider biopsy of opposite breast?

A. Adenocarcinoma – poorly differenciated

B. Medullary carcinoma

C. Lobular carcinoma

D. Comedo carcinoma

Ans. C (S Das Concise Textbook of Surgery 3rd ed., p 714; Bailey and Love 24th ed., p  )

161.  A malignant tumour of childhood, that metastasizes to bones often, is:

A. Wilm’s tumour

B. Neuroblastoma

C. Adrenal gland tumours

D. Granulosa cell tummour of ovary

Ans. B (Bailey and Love 24th ed., p 1425; Apley 8th ed., p 194)

162.  When carcinoma of stomach develops secondarily to pernicious anemia, it is usually situated in the:

A. Pre pyloric region           B.  Pylorus

C. Body                              D.  Fundus

Ans. D (Acta Med Scand 1979; 206 (4): 315-318)

163.  With regard to the malignant behaviour of leiomysarcoma, the most important criterion is:

A. Blood vessel penetration by tumour cells

B. Tumour cells in lymphatic channels

C. Lymphocyte infiltration

D. The number of mitoses per high power field

Ans. D (Robbins 7th ed., p 1090)

164.  The most radiosensitive tumour among the following is:

A. Bronchogenic carcinoma

B. Carcinoma parotid

C. Dysgerminoma

D. Osteogenic sarcoma

Ans. C (Harrison 16th ed., p 556)

165.  In a suspected case of ovarian cancer, imaging work-up is required for all of the following information, except:

A. Detection of adrenal lesion

B. Characterization of the lesion

C. Staging

D. Assess resectability

Ans. C/B (Novak’s Gynaecology 12th ed., p 1169; Shaw’s Gynaecology 13th ed., p 403)

166.  In which of the following age group Myelodysplastic Syndromes (MDS) are most common?

A. 2-10                                B.  15-20

C. 25-40                              D.  > 50

Ans. D (Harrison 16th ed., p 674; Robbins 7th ed., p 695)

167.  A patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leukopenia. Which of following is the clinical diagnosis?

A. Appendicitis

B. Leukemic colitis

C. Perforation peritonitis

D. Neutropenic colitis

Ans. D (Harrison 16th ed., p 492)

168.  All of the following modalities can be used for in-situ ablation of liver secondaries, except:

A. Ultrasonic waves            B.  Cryotherapy

C. Alcohol                          D.  Radiofrequency

Ans. A (Harrison 16th ed., p535; Maingot’s Abdominal Operations, p 1597-1600)

169.  All of the following radioisotopes are used as systemic radionucleide, except:

A. Phosphorus-32               B.  Strontium-89

C. Iridium-192                    D.  Samarium-153

Ans. C (Harrison 16th ed., p 486)

170.  Phosphorous-32 emits:

A. Beta particles                 B.  Alfa particles

C. Neutrons                        D.  X-rays

Ans. A (Walter’s Textbook of Radiotherapy, p 26)

171.  The ideal timing of radiotherapy for Wilms Tumour after surgery is:

A. Within 10 days

B. Within 2 weeks

C. Within 3 weeks

D. Any time after surgery

Ans. C (Forfor and Arneil Paediatrics, p 1130)

172.  The percentage of pulmonary emboli, that proceed to infarction, is approximately:

A. 0.5%                               B.  5-15%

C. 20-30%                           D.  30-40%

Ans. B (Robbins 7th ed., p 742)

173.  Which of the following is used in the treatment of differentiated thyroid cancer:

A. 131I                                B.  99mTc

C. 32P                                 D.  131I-MIBG

Ans. A (Love and Bailey 24th ed., p )

174.  Which one of the following imaging techniques gives maximum radiation exposure to the patient?

A. Chest X-ray                    B.  MRI

C. CT scan                          D.  Bone scan

Ans. C (Grainger and Allison’s Diagnostic Radiology 4th ed., p 238)

175.  Which one of the following has the maximum ionization potential?

A. Electron                          B.  Proton

C. Helium ion                     D.  Gamm (g) - Photon

Ans. C (Harrison 15th ed., p )

176.  Which of the following is not a major criteria for diagnosis of multiple myeloma?

A. Lytic bone lesions

B. Plasmacytoma on tissue biopsy

C. Bone marrow plasmacytosis > 30%

D. ‘M’ spike > 3 g% for Ig G, : 2 g% for Ig A

Ans. A (Wintrobe 10th ed., p 2651)

177.  The treatment of choice for squamous cell anal cancer is:

A. Abdomino perennial reasection

B. Laser fulgaration

C. Chemoradiotherapy

D. Platinum based chemotherapy

Ans. C (Bailey and Love 24th ed., p 1271)

178.  The magnification obtained with a direct ophthalmoscope is:

A. 5 times                            B.  10 times

C. 15 times                          D.  20 times

Ans. C (Basak 3rd ed., p 75)

179.  The average distance of the fovea from the temporal margin of the optic disc is:

A. 1 disc diameter               B.  2 disc diameter

C. 3 disc diameter               D.  4 disc diameter

Ans. B (Basak 3rd ed., p 75; Parson 19th ed., p 17)

180.  The most common cause of vitreous haemorrahge in adults is:

A. Retinal hole                    B.  Trauma

C. Hypertension                  D.  Diabetes

Ans. D (Parson 19th ed., p 360)

181.  The retina receives its blood supply from all except:

A. Posterior ciliary artery

B. Central retinal artery

C. Retinal arteries

D. Plexus of Zinn & Haller arteries

Ans. D/A (Gray’s 38th ed., p 1347)

182.  Which drug can cause macular toxicity when given intravitreally?

A. Gentamycin                    B.  Vancomycin

C. Dexamethasone              D.  Ceftazidime

Ans. A (AK Gupta & V Krishna, Current Topics in Ophthalmology p 50)

183.  Typically bilateral inferior lens subluxation of the lens is seen in:

A. Marfan’s syndrome        B.  Homocystinuria

C. Hyperlysinaemia            D.  Ocular trauma

Ans. B (Parson 19th ed., p 288)

184.  Which of the following antiglaucoma medications can cause drowsiness?

A. Latanoprost                    B.  Timolol

C. Brimonidine                   D.  Dorzolamide

Ans. C (AK Gupta & V Krishna, Current Topics in Ophthalmology p 8)

185.  Which of the following is the drug of choice for treatment of corneal ulcers caused by filamentous fungi?

A. Itraconazole                   B.  Natamycin

C. Nystatin                         D.  Fluconazole

Ans. B (AK Gupta & V Krishna, Current Topics in Ophthalmology p 20)

186.  Which of the following medications is contraindicated in patients with allergy to sulphonamides?

A. Lecobunolol                   B.  Bimatoprost

C. Brinzolamide                  D.  Brinmonidine

Ans. C (KD Tripathi 5th ed., p 88, 533)

187.  In which of the following uveitic conditions is it containdicated to put in an intraocular lens after cataract surgery?

A. Fuch’s heterochromic cyclitis

B. Juvenile rheumatoid arthritis

C. Psoriatic arthritis

D. Reiter’s syndrome

Ans. B (Parson 19th ed., p 262, 280, 310)

188.  A case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year should hae an ophthalmic examination:

A. As early as feasible

B. After 5 years

C. After 10 years

D. Only after visual symptoms develop

Ans. A (Parson 19th ed., p 262, 591)

189.  SAFE Strategy is recommended for the control of?

A. Trachoma                      B.  Glaucoma

C. Diabetic retinopathy      D.  Cataract

Ans. A (Pradeep Sharma p 88-92)

190.  As per the 1986-89 NPCB survey, what was the prevalence of blindness in India (at visual acuity < 6/60 in better eye)?

A. 1.38%                             B.  1.49%

C. 1.72%                             D.  1.8%

Ans. B (Khurana p 425)

191.  Under the National Programme for Control of Blindness, who is supposed to conduct the vision screening of school students?

A. School teachers

B. Medical officers of health centres

C. Ophthalmologists

D. Health assistants

Ans. A (Park 18th ed., p 341)

192.  According to the World Health Organization, the definition of blindness is:

A. Visual acuity < 6/60 in the better eye with available correction

B. Visual acuity < 3/60 in the better eye with available correction

C. Visual acuity < 6/60 in the better eye with best correction

D. Visual acuity < 3/60 in the better eye with best correction

Ans. D (Park 18th ed., p )

193.  The most common cause of ocular morbidity in India is:

A. Cataract                          B.  Conjunctivitis

C. Refractive error              D.  Trachoma

Ans. A/C (Pradeep Sharma p 338-340; Park 18th ed., p 321)

194.  A vitreous aspirate from a case of metastatic endophthalmitis on culture yields Gram positive round to oval cells, 12-14 µ in size. The aspirate on Gram staining shows the presence of pseudohyphae. Which of the following is the most likely aetiological agent?

A. Aspergillus                     B.  Rhizopus

C. Candida                         D.  Fusarium

Ans. C (Ananthnarayan and Paniker 6th ed., p 610, 616)

195.  The most common malignancy found in Marjolin’s ulcer is:

A. Basal cell carcinoma

B. Squamous cell carcinoma

C. Malignant fibrous histiocytoma

D. Neurotrophic malignant melanoma

Ans. B (Bailey and Love 24th ed., p)

196.  Mycotic aneurysm is an aneurysm infected becasue of:

A. Fungal infection

B. Blood borne infection (intravescular)

C. Infection introduced from outside (extravascular).

D. Both intravascular & extravascular infection.

Ans. B/D (Harrison 16th ed., p 1481)

197.  The procedure of choice for the evaluation of an aneurysm is:

A. Ultrasonography

B. Computed tomography

C. Magnetic resonance imaging

D. Arteriography

Ans. D (Harrison 16th ed., p 1482; Bailey and Love 24th ed., p 947)

198.  The most common cause of acquired arteriovenous fistula is:

A. Bacterial infection          B.  Fungal infection

C. Blunt trauma                  D.  Penetrating trauma

Ans. D (Bailey and Love 24th ed., p 950)

199.  Laryngocele arises as a herniation of laryngeal mucosa through the following membrane:

A. Thyrohyoid                    B.  Cricothyroid

C. Crico-tracheal                 D.  Cricosternal

Ans. A (S Das A Concise Textbook of Surgery 3rd ed., p 623; PL Dhingra 3rd ed., p 367)

200.  Which one of the following statements is incorrect regarding stones in the common bile duct?

A. Can present with Charcot’s Traid

B. Are suggested by a bile duct diameter > 6 mm of ultrasound

C. ERCP, sphincterotomy and balloon clearance is now the standard treatment

D. When removed by exploration of the common bile duct the T-tube can be removed after 3 days.

Ans. B/D (Bailey and Love 24th ed., p 1109)

201.  Which of the following colonic polyps is not pre-malignant?

A. Juvenile polyps

B. Hamartomatous polyps associated with Peutz-Jeghers syndrome

C. Villous adenomas

D. Tubular adenomas

Ans. A/B (Bailey and Love 24th ed., p )

202.  A patient of post-cholecystectomy biliary stricture has undergone as ERCP three days ago. Following this she has developed acute cholangitis. The most likely organism is:

A. Escherichia coli

B. Bacillus fragilis

C. Streptococcus viridans

D. Pseudomonas aerogenosa

Ans. A (S Das A Concise Textbook of Surgery 3rd ed., p 908)

203.  Biliary stricture developing after Laparoscopic cholecystectomy usually occurs at which part of the common bile duct?

A. Upper

B. Middle

C. Lower

D. All sites with equal frequency

Ans. A

204.  Apart from Escherichia coli, the other most common organism implicated in acute suppurative bacterial peritonitis is:

A. Bacteroides                    B.  Klebsiella

C. Peptostreptococcus        D.  Pseudomonas

Ans. A/B (S Das A Concise Textbook of Surgery 3rd ed., p 992)

205.  The treatment of choice for the management of carcinoma of the anal canal is:

A. Abdomino perineal resection

B. Primary radiotherapy

C. Combined radio- and chemotherapy

D. Neoadjuvant chemotherapy and local excision

Ans. C (Bailey and Love 24th ed., p 1271)

206.  The following statements about thyroglossal cyst are true, except:

A. Frequent cause of anterior midline neck masses in the first decade of life.

B. The cyst is located within 2 cm of the midline

C. Incision and Drainage is the treatment of choice

D. The swelling moves upwards on protrusion of tongue

Ans. C (Bailey and Love 24th ed., p 771)

207.  Which of the following is not a preferred site for planning vascular access for maintenance haemodialysis?

A. Non-dominant extremity

B. Upper limb

C. Radio-cephalic AV fistula

D. Sapheno-femoral fistula

Ans. D (Harrison 16th ed., p 1665)

208.  Which of the following drugs is not a part of the ‘Triple Therapy’ immunosuppression for post renal transplant patients?

A. Cyclosporine                  B.  Azathioprine

C. FK 506                           D.  Prednisolone

Ans. C (Campbell’s Urology 7th ed., p 364)

209.  Which of the following is not a component of Glasgow Coma Scale?

A. Eye opening                   B.  Motor response

C. Pupil size                        D.  Verbal response

Ans. C (Bailey and Love 24th ed., p 601)

210.  Allen’s test is useful in evaluating:

A. Thoracic outlet compression

B. Presence of cervical rib

C. Integrity of palmar arch

D. Digital blood flow

Ans. C (Bailey and Love 24th ed., p 518, 586)

211.  Neointimal hyperplasia causes vascular graft failure as a result of hypertrophy of:

A. Endothelial cells             B.  Collagen fibers

C. Smooth muscle cells       D.  Elastic fibers

Ans. C (Robbins 7th ed., p 515)

212.  Dacron vascular graft is:

A. Nontextile synthetic       B.  Textile synthetic

C. Nontextile biologic        D.  Textile biologic

Ans. B (Sabiston 15th ed., p )

213.  Total score in Glassgow Coma Scale of a conscious person is:

A. 8                                     B.  3

C. 15                                   D.  10

Ans. C (Bailey and Love 24th ed., p 601)

214.  Mycotic abscesses are due to:

A. Bacterial infection          B.  Fungal infection

C. Viral infection                D.  Mixed infection

Ans. B (Sabiston 15th ed., p )

215.  The most preferred approach for pituitary surgery at the present time is:

A. Transcranial                    B.  Transethmoidal

C. Transphenoidal               D.  Transcallosal

Ans. C (Schwarty 6th ed., p 1615)

216.  The normal range of serum osmolality (in mOsm/L) is:

A. 270 to 285                      B.  300 to 320

C. 350 to 375                      D.  200 to 250

Ans. A (Ganong 22nd ed., p 6)

217.  Which of the following is the most common type of Glial tumors?

A. Astrocytomas                 B.  Medulloblastomas

C. Neurofibromas               D.  Ependymomas

Ans. A (Robbins 7th ed., p 1401; Harrison 16th ed., p 2453)

218.  Which of the following tumors is not commonly known to increase in pregnancy?

A. Glioma                           B.  Pituitary adenoma

C. Meningioma                   D.  Neurofibroma

Ans. A (Williams Obstetrics 21st ed., p 1352, 1436, 1455)

219.  The requirement of potassium in a child is:

A. 1-2 mEq/kg                    B.  4-7 mEq/kg

C. 10-12 mEq/kg                D.  13-14 mEq/kg

Ans. A (Nelson 15th ed., p 203)

220.  The common cause of subarachnoid hemorrhage is:

A. Arterio-venous malformation

B. Cavernous angioma

C. Aneurysm

D. Hypertension

Ans. C (Robbins 7th ed., p 1366; Harrison 16th ed., p 2387)

221.  Brain abscess in cyanotic heart disease is commonly located in:

A. Cerebellar hemisphere

B. Thalamus

C. Temporal lobe

D. Parietal lobe

Ans. D (Harrison 16th ed., p 2485)

222.  Afferent component of corneal reflex is mediated by:

A. Vagus nerve

B. Facial nerve

C. Trigeminal nerve

D. Glossopharyngeal nerve

Ans. C (BD Chawrasia Vol. III, p 43; Ramesh Babu Essential of Clinical Anatomy 1st ed., p 387)

223.  In adults, the spinal cord normally ends at:

A. Lower border of L1

B. Lower border of L3

C. Lower border of S1

D. Lower border of L5

Ans. A (Gray 38th ed., p 975; Ajay Yadav 2nd ed., p 117; Ramesh Babu Essentials of Clinical Anatomy 1st ed., p 416)

224.  Middle meningeal artery is dierct branch of:

A. External carotid artery

B. Internal maxillary artery

C. Superficial temporal artery

D. Middle cerebral artery

Ans. B (Gray 38th ed., p 1519; Ramesh Babu Essentials of Clinical Anatomy 1st ed., p 327)

225.  Which of the following is not a common featuer of Anorexia Nervosa?

A. Binge eating

B. Amennorhea

C. Self perception of being ‘fat’

D. Under weight

Ans. A (Niraj Ahuja 5th ed., p 149)

226.  An affected male infant born to normal paernts could be an example of all of the following, except:

A. An Autosomal dominant disorder

B. An Autosomal recessive disorder

C. A polygenic disorder

D. A vertically transmitted disorder

Ans. A/D (Harrison 16th ed., p 374; Robbins 7th ed., p 150)

227.  The following methods can be used to detect the point mutation in the beta (b)-globin gene that causes sickle cell anemia, except:

A. Polymerase chain reaction with allele-specific oligonucleotide hybridization.

B. Southern blot analysis

C. DNA sequencing

D. Northern blot analysis

Ans. D (Harrison 16th ed., p 378)

228.  A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of the following except:

A. A chromosomal syndrome

B. A teratogenic syndrome

C. A Mendelian syndrome

D. A polygenic syndrome

Ans. D (Nelson 15th ed., )

229.  In a family, the father has widely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is most likely pattern of inheritance in this case?

A. Autosomal dominant     B.  Autosomal recessive

C. X-linked dominant         D.  X-linked recessive

Ans. B (Harrison 16th ed., p 374)

230.  Mitochondrial DNA is:

A. Closed circular               B.  Nicked circular

C. Linear                             D.  Open circular

Ans. A (Ganong 22nd ed., p 10; Harrison 374)

231.  Polar bodies are formed during:

A. Spermatogenesis            B.  Organogenesis

C. Oogenesis                       D.  Morphogenesis

Ans. C (Gray 38th ed., p 123)

232.  Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the following, except:

A. Amniotic fluid               B.  Maternal blood

C. Chorionic villi                D.  Fetal blood

Ans. D (DC Dutta Textbook of Obstetrics 6th ed., p 113)

233.  The long and short arms of chromosomes are designated respectively as:

A. p and q arms                   B.  m and q arms

C. q and p arms                   D.  l and s arms

Ans. C (Robbins 7th ed., p 171)

234.  Euchromatin is the region of DNA that is relatively:

A. Uncondensed                 B.  Condensed

C. Overcondensed              D.  Partially condensed

Ans. A (Lippincott 3rd ed., p 420; Gray 38th ed., p 50; Harper 26th ed., p 316)

235.  Microsatellite sequence is:

A. Small satellite

B. Extra chromosomal DNA

C. Short sequence (2–5) repeat DNA

D. Looped–DNA

Ans. C (Harper 26th ed., p 402; Robbins 7th ed., p 307; Harrison 16th ed., p 449)

236.  All of the following cell types contain the enzyme telomerase which protects the length of telomeres at the end of chromosomes, except:

A. Germinal                        B.  Somatic

C. Haemopoetic                  D.  Tumour

Ans. B (Ganong 22nd ed., p 307; Lippincott 3rd ed., p 405)

237.  All of the following are the components of the white pulp of spleen, except:

A. Periarteriolar lymphoid sheath

B. B cells

C. Antigen presenting cells

D. Vascular sinus

Ans. D (Gray 38th ed., p 1439; Guyton 11th ed., p 434; Robbins 7th ed., p 702)

238.  All of the following developmental events are dependent on the production of maternal or fetal glucocorticoid, except:

A. In duction of thymic involution

B. Production of surfactant by type II alveolar cells

C. Functional thyroid

D. Functional hypothalamopituitary axis

Ans. C (OP Ghai 6th ed., p 482; Guyton 11th ed., p 954; Ganong 22nd ed., p 370)

239.  Referred pain from all of the following conditions may be felt along the inner side of right thigh, except:

A. Inflamed pelvic appendix

B. Inflamed ovaries

C. Stone in pelvic Ureter

D. Pelvic abscess

Ans. D (Campbell’s Urology p 40; Gray 38th ed., p 1307, 1866; Bailey and Love 24th ed., p 1207; S Das A Concise Textbook of Surgery 3rd ed., p 997)

240.  A 43 year old woman came with a large abscess in the middle of the right posterior triangle of the neck. The physician incised and drained the abscess. Five days later the patient noticed that she could not extend her right hand above her head to brush her hair. Which of the following are the signs and symptoms of additional harm?

A. Damage to scalenus medius

B. Injury to suprascapular nerve

C. Cut to spinal part of accessory nerve

D. Spread of infection to shoulder joint

Ans. C (Gray 38th ed., p 823, 1255)

241.  Which of the following inhalational agents is the induction agent of choice in children?

A. Methoxyflurane             B.  Sevoflurane

C. Desflurane                      D.  Isoflurane

Ans. B (Ajay Yadav 2nd ed., p 63)

242.  Which of the following anesthetic agents doesn’t trigger malignant hyperthermia?

A. Halothane                       B.  Isoflurane

C. Suxamethonium             D.  Thiopentone

Ans. D (Ajay Yadav 2nd ed., p 101)

243.  Which of the following is not an indication for endotracheal intubation?

A. Maintenance of a patent airway

B. To provide positive pressure ventilation

C. Pulmonary toilet

D. Pneumothorax

Ans. D (Ajay Yadav 2nd ed., p 99, 184)

244.  Which of the following agents is not used to provide induced hypotension during surgery?

A. Sodium nitroprusside

B. Hydralazine

C. Mephenteramine

D. Esmolol

Ans. C (Ajay Yadav 2nd ed., p 128; Goodman and Gilman 10th ed., p 239)

245.  Which of the following agents is used for the treatment of postoperative shivering?

A. Thiopentone                   B.  Suxamethonium

C. Atropine                         D.  Pethidine

Ans. D (Ajay Yadav 2nd ed., p 101)

246.  Which of the following is not a sign of stellate ganglion block?

A. Meiosis                           B.  Exopthalmus

C. Nasal congestion            D.  Conjunctival redness

Ans. B (Ajay Yadav 2nd ed., p 112; Bailey and Love 24th ed., p 953)

247.  Which of the following intravenous induction agents is the most suitable for day care surgery?

A. Morphine                        B.  Ketamine

C. Propofol                         D.  Diazepam

Ans. C (Ajay Yadav 2nd ed., p 174)

248.  Blalock and Taussig shunt is done between:

A. Aorta to Pulmonary artery

B. Aorta to Pulmonary vein

C. Subclavian artery to Pulmonary vein

D. Subclavian vein to artery

Ans. A (OP Ghai 6th ed., p 304; Nelson 16th ed., p 1527)

249.  A two month old infant has undergone a major surgical procedure. Regarding post operative pain relief which one of the following is recommended:

A. No medication is needed as infant does not feel pain after surgery due to immaturity of nervous system

B. Only paracetamol suppository is adequate

C. Spinal narcotics via intrathecal route

D. Intravenous narcotic infusion in lower dosage

Ans. D (Lee 10th ed., p 497, 519; Updates in Anaesthesia (1997) p 6-7)

250.  A 5 year old patient is scheduled for tonsillectomy. On the day of surgery he had running nose, temperature 37.5°C and dry cough. Which of the following should be the most appropriate decision for surgery?

A. Surgery should be cancelled

B. Can proceed for surgery if chest is clear and there is no history of asthma

C. Should get x-ray chest before proceeding for surgery

D. Cancel surgery for 3 week and patient to be on antibiotic

Ans. D (PL Dhingra 3rd ed., p 490)

251.  A common feature of all serine proteases is:

A. Autocatalytic activation of zymogen precursor

B. Tight binding of pancreatic trypsin inhibitor

C. Cleavage of protein on the carboxyl site of serine residues

D. Presence of Ser-His-Asp catalytic traid at the active site

Ans. D (Harper 26th ed., p 53)

252.  During replication of DNA, which one of the following enzymes polymerizes the Okazaki fragments?

A. DNA polymerase I         B.  DNA polymerase II

C. DNA polymerase III      D.  RNA polymerase I

Ans. C (Harper 26th ed., p 328; Lippincott 3rd ed., p 403)

253.  During phagocytosis, the metabolic process called respiratory burst involves the activation of:

A. Oxidase                          B.  Hydrolase

C. Peroxidase                      D.  Dehydrogenase

Ans. A (Robbins 7th ed., p 60)

254.  Which one of the following is the complementary sequence of 5’TTAAGCGTAC 3’?

A. 5’ GTACGCTTAA 3’

B. 5’ AATTCGCATG 3’

C. 5’ CATGCGAATT 3’

D. 5’ TTAAGCGTAC 3’

Ans. A (Lippincott 3rd ed., p 449; Harper 26th ed., p 330)

255.  Base substitution mutations can have the following molecular consequences except:

A. Changes one codon for an amino acid into another codon for that same amino acid

B. Codon for one amino acid is changed into a codon of another amino acid

C. Reading frame changes downstream to the mutant site

D. Codon for one amino acid is changed into a translation termination codon.

Ans. C (Harper 26th ed., p 361; Lippincott 3rd ed., p 431)

256.  Vitamin B12 acts as coenzyme to which one of the following enzymes?

A. Isocitrate dehydrogenase

B. Homocysteine methyl transferase

C. Glycogen synthase

D. G-6-P dehydrogenase

Ans. B (Lippincott 3rd ed., p 373)

257.  The normal cellular counterparts of oncogenes are important for the following functions except:

A. Promotion of cell cycle progression

B. Inhibition of apoptosis

C. Promotion of DNA repair

D. Promotion of nuclear transcription

Ans. C (Robbins 7th ed., p 293, 295)

258.  The ligand-receptor complex dissociates in the endosome because:

A. Of its large size

B. The vesicle looses its clathrin coat

C. Of the acidic pH of the vesicle

D. Of the basic pH of the vesicle

Ans. C (Lippincott 3rd ed., p 230)

259.  The amino acid which serves as a carrier of ammonia from skeletal muscle to liver is:

A. Alanine                           B.  Methionine

C. Arginine                         D.  Glutamine

Ans. A (Lippincott 3rd ed., p 248)

260.  All of the following amino acids are converted to succinyl-CoA, except:

A. Methionine                     B.  Isoleucine

C. Valine                             D.  Histidine

Ans. D (Lippincott 3rd ed., p 261-263; Harper 26th ed., p 249, 262)

261.  The specialized mammalian tissue/organ in which fuel oxidation serves not to produce ATP but to generate heat is:

A. Adrenal gland                B.  Skeletal muscle

C. Brown adipose tissue     D.  Heart

Ans. C (Harper 26th ed., p 217, 269)

262.  The human plasma lipoprotein containing the highest percentage of triacylglycerol by weight is:

A. VLDL                            B.  Chylomicrons

C. HDL                               D.  LDL

Ans. B (Lippincott 3rd ed., p 227-230; Harper 26th ed., p 206)

263.  All of the following enzymes are regulated by calcium or calmodulin, except:

A. Adenylate cyclase          B.  Glycogen synthase

C. Guanylyl cyclase            D.  Hexokinase

Ans. D (Lippincott 3rd ed., p 130; Harper 26th ed., p 458, 518; Ganong 22nd ed., p 43)

264.  The sigma (d) subunit of prokaryotic RNA Polymerase:

A. Binds the antibiotic Rifampicin

B. Is inhibited by a-amanitin

C. Specifically recognizes the promoter site

D. Is part of the core enzyme

Ans. C (Lippincott 3rd ed., p 415; Harper 26th ed., p 343)

265.  Which type of RNA has the highest percentage of modified base:

A. mRNA                           B.  tRNA

C. rRNA                             D.  snRNA

Ans. B (Harper 26th ed., p 356)

266.  There are more than 300 variants of human hemoglobin gene. Among these only a few are fetal. Hence, the most important factor to be conserved in a protein for its function is the:

A. Amino acid sequence

B. Ligand binding residues

C. Structure

D. Environment

Ans. B (Harper 26th ed., p 46, 48)

267.  Proteins are linear polymers of amino acids. They fold into compact structures. Sometimes, these folded structures associate to form homo- or hetero-dimers. Which one of the following refers to this associated form?

A. Denatured state              B.  Molecular aggregation

C. Precipitation                   D.  Quaternary structure

Ans. D (Lippincott 3rd ed., p 20; Harper 26th ed., p 34)

268.  Which one of the following can be a homologous substitution for isoleucine in a protein sequence?

A. Methionine                     B.  Aspartic acid

C. Valine                             D.  Arginine

Ans. C (Harper 26th ed., p 15)

269.  The comparison of the amino acid sequence of Cytochrome C from different species shows many variations. Most of these variations are found:

A. Randomly

B. Only in helical regions

C. Only in strand regions

D. Mainly in loop regions

Ans. A (Lehninger’s Biochemistry, p 139)

270.  The structural proteins are involved in maintaining the shape of a cell or in the formation of matrices in the body. The shape of these proteins is:

A. Globular                         B.  Fibrous

C. Stretch of beads             D.  Planar

Ans. B (Lippincott 3rd ed., p 43; Harper 26th ed., p 38)

271.  The major purpose of randomization in a clinical trial is to:

A. Facilitate double blinding

B. Help ensure the study subjects are representative of general population

C. Ensure the groups are comparable on base line characteristics

D. Reduce selection bias in allocation to treatment

Ans. C (Park 18th ed., p 76)

272.  The purpose of double blinding in clinical trails is to:

A. Achieve comparability between study and control groups

B. Avoid observer bias

C. Avoid subject bias

D. Avoid observer and subject bias

Ans. D (Park 18th ed., p 77)

273.  When a drug is evaluated for its usefulness in controlled conditions, it is termed as a trial signifying:

A. Efficacy                         B.  Effectiveness

C. Efficiency                      D.  Effect modification

Ans. A (Sabiston 15th ed., p )

274.  Which of the following is most strongly associated with coronary heart disease?

A. Apollipoproteins            B.  VLDL

C. HDL                               D.  Total lipoproteins

Ans. A (Park 18th ed., p 290)

275.  The extra energy allowances needed per day during pregnancy is:

A. 150 KCals                      B.  200 KCals

C. 300 KCals                      D.  550 KCals

Ans. C (Park 18th ed., p 459)

276.  In a village having population of 1000, we found patients with certain disease and the results of a new diagnostic test on that disease are given below.

                                        Disease

         Test result   Present          Absent

         +                   180                 400

         –                   20                   400

         Which of the following is the positive predictive value of diagnostic test in that population?

A. 45                                   B.  31

C. 95                                   D.  50

Ans. B (Park 18th ed., p 117)

277.  Physical quality of life index is measured by all except:

A. Infant mortality

B. Life expectancy at age one

C. Literacy

D. Per capita income

Ans. D (Park 18th ed., p 16)

278.  All the statements are true about standardization except:

A. Standardization allows comparison to be made between two different populations

B. The national population is always taken as the standard population

C. For Direct Standardization, age specific rates of the study population are applied to that of the standard population

D. For Indirect Standardization age specific rates of the standard population are applied to the study population

Ans. B (Park 18th ed., p 53-54)

279.  All the following are true in a randomized control trial (RCT) except:

A. Baseline characteristics of intervention and control groups should be similar

B. Investigator’s bias is minimized by double blinding

C. The sample size required depends on the hypothesis

D. The drop-outs from the trial should be excluded from the analysis

Ans. C (Park 18th ed., p 76)

280.  Study the following table cerefully and answer the following question:

                                        Disease

         Test result   Present          Absent

         +                   40                   225

         –                   10                   225

         What is the sensitivity of diagnostic test?

A. 45                                   B.  20

C. 80                                   D.  50

Ans. C (Park 18th ed., p 117)

281.  Pre-treatment evaluation for Lithium therapy should include:

A. Fasting blood sugar        B.  Serum creatinine

C. Liver function tests        D.  Platelet count

Ans. B (Harrison 16th ed., p 1703; Katzung 9th ed., p 478)

282.  According to the World Health report 2000, India’s health expenditure is:

A. 4.8% of G.D.P               B.  5.2% of G.D.P

C. 6.8% of G.D.P               D.  7% of G.D.P

Ans. B (World Health Report, p 204)

283.  The premium of the “Community based Universal Health Insurance Scheme” launched during 2003-04 ranges from:

A. Rs. 1 per day poor and individual to

     Rs. 2 per day family of seven

B. Rs. 1 per day poor and individual to

     Rs. 3 per day family of seven

C. Rs. 2 per day poor and individual to

     Rs. 2 per day family of seven

D. Rs. 1 per day poor and individual to

     Rs. 7 per day family of seven

Ans. A (www.niacl.com)

284.  In which of the following year the Transplantation of Human Organs Act was passed by Government of India?

A. 1994                               B.  1996

C. 2000                               D.  2002

Ans. A (www.w3c.org)

285.  Indian (economic) real GDP growth for the year 2003 is:

A. 6.0                                  B.  6.5

C. 7.8                                  D.  10.5

Ans. C (economic time.indiatimes.com)

286.  A 6-month-old infant had itchy erythematous papules and exudative lesions on the scalp, face, groins and axillae for one month. She also had vesicular lesions on the palms. The most likely diagnosis is:

A. Congenital syphilis         B.  Seborrhoeic dermatitis

C. Scabies                           D.  Psoriasis

Ans. C (Neena Khanna p 264)

287.  Pterygium of nail is characteristically seen in:

A. Lichen planus                 B.  Psoriasis

C. Tinea unguium               D.  Alopecia areata

Ans. A (Neena Khanna p 46)

288.  A patient had seven irregular hyperpigmented macules on the trunk and multiple small hyperpigmented macules in the axillae and groins since early childhood. There were no other skin lesions. Which is the most likely investigation to support the diagnosis?

A. Slit lamp examination of eye

B. Measurement of intraocular tension

C. Examination of fundus

D. Retinal artery angiography

Ans. A (Harrison 16th ed., p 2457)

289.  A 24-year-old unmarried woman has multiple nodular, cystic, pustular and comadonic lesions on face, upper back and shoulders for 2 years. The drug of choice for her treatment would be:

A. Acitretin                         B.  Isotretioin

C. Doxycycline                   D.  Azithromycin

Ans. B (Harrison 16th ed., p 295; Katzung 9th ed., p 1024)

290.  A 45-year-old farmer has itchy erythematous papular lesions on face, neck, ‘V’ area of chest, dorsum of hands and forearms for 3 years. The lesions are more severe in summers and improve by 75% in winters. The most appropriate test to diagnose the condition would be:

A. Skin biopsy

B. Estimation of IgE levels in blood

C. Patch test

D. Intradermal prick test

Ans. C (Neena Khanna p 77)

291.  Finger Print Bureau was first established in:

A. England                          B.  China

C. India                               D.  Singapore

Ans. C (Parikh 6th ed., p 215; Reddy 22nd ed., p 67)

292.  Spalding’s sign occurs after:

A. Birth of live foetus

B. Death of foetus in uterus

C. Rigor mortis of infant

D. Cadaveric spasm

Ans. B (Parikh 6th ed., p 236, 575; Reddy 22nd ed., p 341)

293.  Medical qualifications awarded by institutions out side India and recognized by MCI are registered in:

A. First schedule of Indian Medical Council Act 1956

B. Second schedule of Indian Medical Council Act 1956

C. Part I of thid schedule of Indian Medican Countil Act 1956

D. Part II of third schedule of Indian Medical Council Act 1956

Ans. D (Parikh 6th ed., p 124; Reddy 22nd ed., p 21)

294.  Scab or Crust of abrasion appears brown:

A. Between 12-24 hours

B. Between 2-3 days

C. Between 4-5 days

D. Between 5-7 days

Ans. B (Parikh 6th ed., p 43; Reddy 22nd ed., p 138)

295.  Which of the following tests is used to detect semen?

A. Phenophthalein test        B.  Reine’s test

C. Barberio’s test                D.  Paraffin test

Ans. C (Parikh 6th ed., p 726; Reddy 22nd ed., p 328)

296.  The presence of anti-Saccharomyces cerevisae antibody is a surrogate marker of one of the following.

A. Coeliac disease               B.  Crohn’s disease

C. Ulcerative colitis            D.  Tropical sprue

Ans. B (Harrison 16th ed., p 1781)

297.  The most common cause of gastric outlet obstruction in India is:

A. Tuberculosis                   B.  Cancer of stomach

C. Duodenal lymphoma      D.  Peptic ulcer disease

Ans. D (S Das A Concise Textbook of Surgery 3rd ed., p 848)

298.  Which of the following parasitic infestation can lead to malasorption syndrome?

A. Amoebiasis

B. Ascariasis

C. Hookworm infestation

D. Giardiasis

Ans. D (Harrison 16th ed., p 1249)

299.  Which of the following is not a feature of hypercalcemia:

A. Diarrhoea                       B.  Polyuria

C. Depression                     D.  Vomiting

Ans. A (Harrison 16th ed., p 2252)

300.  Joint erosions are not a feature of:

A. Rheumatoid arthritis

B. Psoriasis

C. Multicentric reticulohistiocytosis

D. Systemic lupus erythematosus

Ans. D            (Harrison 16th ed., p 1998)