ALL-INDIA MD/MS ENTRANCE EXAMINATION-JANUARY-2003

1. An anesthetist orders a new attendant to bring the oxygen cylinder. He will ask the attendant to identify the correct cylinder by following color code:

1.Black cylinder with white shoulders.
2.Black cylinder with gray shoulders.
3.White cylinder with black shoulders.
4.Grey cylinder with white shoulders.

2. During rapid sequence induction of anesthesia:
1.Sellick’s maneuver is not required.
2.Pre-oxygenation is mandatory.
3.Suxamethonium is contraindicated.
4.Patient is mechanically ventilated before end tracheal incubation.

3. A 5-year-old boy suffering from Duchenne muscular dystrophy has to undergo tendon-lengthening procedure. The most appropriate anesthetic would be:
1.Induction with intravenous thiopentone and N2O; and halothane for maintenance.
2.Induction with intravenous protocol and N2O; and oxygen for maintenance.
3.Induction with intravenous suxamethonium and N2O; and halothane for maintenance.
4.Inhalation induction with inhalation halothane and N2O; oxygen for maintenance.

4. A 25 years old male is undergoing incision and drainage of abscess under general anesthesia with spontaneous respiration. The most efficient anaesthetic circuit is:
1.Mapleson A.
2.Mapleson B.
3.Mapleson C.
4.Mapleson D.

5. In all of the following conditions neuraxial blockade is absolutely contraindicated, except:
1.Patient refusal.
2.Coagulopathy
3.Severe hypovolemia.
4.Pre-existing neurological deficits.

6. Interscalene approach to brachial plexus block does not provide optimal surgical anaesthesia in the area of distribution of which of the following nerve:
1.Musculocutaneous.
2.Ulnar
3.Radial
4.Median.

7.The commonest variation in the arteries arising from the arch of aorta is:
1.Absence of brachiocephalic trunk.
2.Left vertebral artery arising from the arch.
3.Left common carotid artery arising from brachiocephalic trunk.
4.Presence of retroesophageal subelavian artery.

8. The blood vessel related to the paraduodenal fossa is:
1.Gonadal Vein.
2.Superior mesenteric artery.
3.Portal vein.
4.Inferior mesenteric vein.

9. The nerve commonly damaged during McBurney's incision is:
1.Subcostal
2.Iliohypogastric.
3.11th Thoracic.
4.10th thoracic.

10. The lumbar region of the vertebral column permits all of the following movements except:
1.Flexion
2.Extension
3.Lateral Flexion
4.Rotation

11. All of the following are examples of traction epiphysis, except:
1.Mastoid process.
2.Tubercles of Humerus.
3.Trochanters of femur.
4.Condyles of tibia.

12. All of the following statements are true for metaphysis of bone except:
1.It is the strongest part of bone.
2.It is the most vascular part of bone.
3.Growth activity is maximized here.
4.It is the region favouring hematogenous spread of infection.

13. All of the following features can be observed after the injury to axillary nerve except:
1.Loss of rounded contour of shoulder.
2.Loss of sensation along lateral side of upper arm.
3.Loss of overhead abduction.
4. Atrophy of deltoid muscle.

14. All of the following muscles are grouped together as muscles of mastication except:
1.Buccinator.
2.Masseter.
3.Temporalis.
4.Pterygoids.

15. Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:
1.Subcostal.
2.Iliohypogastric.
3.Ilioinguinal.
4.Genitofemoral

16. The right coronary artery supplies all of the following parts of the conducting system in the heart except:
1.SA Node.
2.AV Node.
3.AV Bundle.
4.Right boundle branch.

17. A commonest cause for neuralgic pain in foot is:
1.Compression of Communication between medical and lateral planter nerves.
2.Exaggeration of longitudinal arches.
3.Injury to deltoid ligament.
4.Shortening of planter aponeurosis.

18. The main enzyme responsible for activation of xenobiotics is:
1.Cytochrome P-450
2.Glutathione S-transferase.
3.NADPH cytochrome P-450-reductase.
4.Glucuronyl transferase.

19. The primary defect which leads to sickle cell anemia is:
1.An abnormality in porphyrin part of hemoglobin.
2.Replacement of glutamate by valine in B-chain of HbA.
3.A nonsense mutation in the B-chain of HbA.
4.Substitution of valine by glutamate in the a-chain of Hba.

20. A 40 years old lady delivered a full term baby. On examination of the baby, the neonatologist noted certain urogenital abnormality. He took the following the picture. The most likely diagnosis is:

1.Urogenital sinus.
2.Hypertrophied clitoris.
3.Miocropenis.
4.Vulval hematoma.

21. Decreased Glycolytic activity impairs oxygen transport by hemoglobin due to:
1.Reduced energy production.
2.Decreased production of 2,3-bisphosphoglycerate.
3.Reduced synthesis of hemoglobin.
4.Low levels of oxygen.

22. The primary role of chaperones is to help in:
1.Protein synthesis.
2.Protein degradation.
3.Protein denaturation.
4. Protein folding.

23. The conversion of an optically pure isomer (enantiomer) into a mixture of equal amounts of both dextro and levo forms is called as:
1.Polymerization.
2.Stereoisomerization.
3.Racemization.
4.Fractionation.

24. The protein rich inbasic amino acids, which functions in the packaging of DNA in chromosomes, is:
1.Histone.
2.Collagen.
3.Hyaluronic acid binding protein.
4.

25. A 56 year old man presents in the casualty with severe chest pain and difficulty in breathing. His ECG was taken immediately.\

The above ECG suggest the following diagnosis:

1.Ventricular fibrillation.
2.Acute pulmonary embolism.
3.Second degree heart block.
4.Atrial fibrillation.

26. An enzyme involved in the catabolism of fructose to pyruvate in the liver is:
1.Glyceraldehyde-3-phosphate Dehydrogenase.
2.Phosphoglucomutase.
3.Lactate-dehydrogenase.
4.Glucokinase.

27. The following separation technique depends on the molecular size of the protein:
1.Chromatography on a carboxymethyl (CM) cellulose column.
2.Iso-electric focusing.
3.Gelfiltration chromatography.
4.Chromatography on a diethylaminoethly (DEAE) cellulose column.

28. The substances present in the gall bladder stones or the kidney stoens can be best identified by the following technique:
1.Fluorescence spectroscopy.
2.Electron microscopy.
3.Nuclear magnetic resonance.
4.X-ray diffraction.

29. Which of the following symbol represent adopted individuals:

30. The parameters of sensitivity and specificity are used for assessing:
1.Criterion validity.
2.Construct validity.
3.Discriminant validity.
4.Content validity.

31. An increase in which of the following parameters will shift the O2 dissociation curve to the left.
1. Temperature.
2. Partial pressure of CO2
3. 2,3 DPG concentration.
4. Oxygen affinity of haemoglobin.

32. At the end of a balanced anaesthesia technique with non-depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?
1.Pancuronium.
2.Gallamine.
3.Atracurium.
4.Vecuronium.

33. A 64 Year old hypertensive obese female was undergoing surgery for fracture femur under general anaesthesia. Intra operatively her end-tidal carbon-dioxide decreased to 20 from 40mm of Hg. followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?
1.Fat embolism.
2.Hypovolemia.
3.Bronchospasm.
4.Myocradial infarction.

34. A lesion of ventrolateral part of spinal cord will lead to loss (below the level of lesion) of:
1.Pain sensation on the ipsilateral side.
2.Proprioception on the contralateral side.
3.Pain sensation on the contralateral side.
4.Propriception on the ispilateral side.

35. A 30 year old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:
1.Medial rectus and superior division of oculmotor nerve.
2.Inferior oblique and inferior division of oculomotor nerve.
3.Lateral rectuas and abducent nerve.
4.Superior rectus and trochlear nerve.

36. The cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:
1. Transitional
2. Stratified squamous
3. Stratified cuboidal.
4. Stratified columnar.

37. Injury to radial nerve in lower part of spiral groove:
1. Spares nerve supply to extensor carpiradialis longus.
2. Results in paralysis of anconeus muscle.
3. Leves extension at elbow joint intact.
4. Weakens pronation movement.

38. In a patient with a tumor in Superior medistinum compressing the superior vena cava, all the following venis would serve as alternate pathways forthe blood to return to the right atrium, except:
1.Lateral thoracic vein.
2.Internal thoracic vein.
3.Hemiazygos vein.
4.Vertebral venous plexus.

39. B-oxidation of odd-chain fatty acids produces:
1.Succinyl CoA.
2.Propionyl CoA.
3.Acetyl CoA.
4.Malonyl CoA.

40. The buffering capacity of a buffer is maximum at pH equal to:
1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

41. Which of the following is present intracellularly in muscle cells:
1. Insulin.
2. Corticosteroid.
3. Epinephrine.
4. Glucagon.

42. Which of the following is not a post transcriptional modification of RNA?
1. Splicing.
2. 5' Capping.
3. 3' polyadenylation.
4. Glycosylation.

43. Serum total lactate dehydrogenase level will NOT be raised in:
1. Muscle crush injury.
2. Stroke.
3. Myocardial infrction.
4. Hemolysis.

44. A married middle aged female gives history of repeated abortions for the past 5 years. The given below is conceptions pre-natal karyogram.

This karyogram suggests the following:
1. Klinefelter's syndrome.
2. Turner's syndrome.
3. Down's syndrome.
4. Patau's syndrome.

45. Chi-square test is used to measure the degree of:
1. Causal relationship between exposure and effect.
2. Association between two variables.
3. Correlation between two variables.
4. Agreement between two observations.

46. Elements of primary health care include all of the following except:

1. Adequate supply of safe water and basic sanitation.
2. Providing essential drugs.
3. Sound referral system.
4. Health Education.

47. For the calculation of positive predictive value of a screening test, the denominator is comprised of:

1. True positives +False negatives.
2. False positives + True negatives.
3. True positives + False positives.
4. True positives + True negatives.

48. Elemental iron and folic acid contents of pediatric iron-folic acid tablets supplied under Rural child Health (RCH) Program are:

1. 20 mg iron & 100 micrograms folic acid.
2. 40 mg iron & 100 micrograms folic acid.
3. 40 mg iron & 50 micrograms folic acid.
4. 60 mg iron & 100 micrograms folic acid.

49. In the management of leprosy, Lepromin test is most useful for:

1. Herd Immunity.
2 .Prognosis.
3. Treatment.
4. Epidemiological investigations.

50. A measure of location which divides the distribution in the ratio of 3:1 is:

1. Median.
2. First quartile.
3. Third quartile.
4. Mode.

51. The following statements about meningococcal meningitis are true, except:

1. The source of infection is mainly clinical cases.
2. The disease is more common in dry and cold months of the year.
3. Chemoprophylaxis of close contacts of cases is recommended.
4. The vaccine is not effective in children below 2 years of age.

52. The Protein Efficiency Ratio (PER) is defined as:

1. The gain in weight of young animals per unit weight of protein-consumed.
2. The product of digestibility coefficient and biological value.
3. The percentage of protein absorbed into the blood.
4. The percentage of nitrogen absorbed from the protein absorbed from the diet.

53. The Vitamin A supplement administered in Prevention of nutritional blindness in children programme" contain:

1. 25,000 i.u./ml.
2. 1 lakh i.u./m.l.
3. 3 lakh i.u./m.l.
4. 5 lakh i.u./m.l.

54. The syndromic management of urethral discharge includes treatment of:

1. Neisseria gonorrhoeae and herpes genitalis.
2. Chalamydia trachomatis and herpes genitalis.
3. Neisseria gonorrhoeae and Chlamydia trachomatis.
4. Syphilis and chancroid.

55. Acantholysis is characteristic of:

1. Pemphigus vulgaris.
2. Pemphigoid.
3. Erythema multiforme.
4. Dermatitis hepetiformis.

56. Mummification refers to:

1. Hardening of muscles after death.
2. Colliquative putrifaction.
3. Saponification ofsubcutaneous fat.
4. Dessication of a dead body.

57. A patient has been allegedly bitten by cobra snake. The venom in such a bite would be:

1. Musculotoxic.
2. Vasculotoxic.
3. Cardiotoxic.
4. Neurotoxic.

58. All the following are related to legal responsibility of an insane person except.

1. Mc Naughten's rule
2. Durham's rule.
3. Curren's rule.
4. Rule of nine.

59. All of the following infections are often associated with acute intravascular hemolysis except:

1. Clostridium tetani.
2. Bartonella bacilliformis.
3. Plasmodium falciparum.
4. Babesia microti.

60. All of the following are the electrocardiographic features of severe hyperkalemia except.

1. Peaked T waves.
2. Presence of U waves.
3. Sine wave pattern.
4. Loss of P waves.

61. The correct sequence of cell cycle is:

1. G0-G1-S-G2-M.
2 .G0-G1-G2-S-M.
3 .G0-M-G2-S-G1.
4 .G0-G1-S-M-G2.

62. In suspected case of death due to poisoning where cadaveric rigidity is lasting longer than usual, it may be a case of poisoning due to:

1. Lead.
2. Arsenic.
3. Mercury.
4. Copper

63. A 70 year old male patient presented with history of chest painand was diagnosed to have coronary artery disease. During routine evaluation, an ultrasound of the abdomen showed presence of gallabladder stones. There was no past history of biliary colic or jaundice. What is the best treatment advice for such a patient for his gallbladder stones.

1. Open cholecystectomy.
2. Lapaoscopic cholecystectomy.
3. No surgery for gallbladder stones.
4. ERCP and removal of gallbladder stones.

64. Commonest cause of sporadic encephalitis is:

1. Japanese B Virus
2. Herpes Simplex Virus.
3. Human Immunadeficiency Virus.
4. Rubeola Virus.

65. Raised serum level of lipoprotein (a) is a predictor of:

1. Cirrhosis of liver.
2. Rheumatic arthritis.
3. Atherosclerosis.
4. Cervical cancer.

66. Haemorrhage secondary to heparin administration can be best corrected by administration of:

1. Vitamin K.
2. Whole blood.
3. Protamine.
4. Ascorbic acid.

67. An anxius mother brought her 4 year old daughter to the pediatrician. The girl was passing loose bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered the stool examination which showed the following organisms. Identify the organism:
<pic 67>

1. Entamoeba histolytica
2. Giardia lamblia
3. Cryptosporidium
4. E. Coli

68. Which one of the following conditions may lead to exudative pleural effusion

1. Cirrhosis.
2. Nephrotic syndrome.
3. Congestive heart failure.
4. Bronchogenic carcinoma.

69. Heat labile instruments for use in surgical procedures can be best sterilized by:

1. Absolute alcohol.
2. Ultra violet rays.
3. Cholorine releasing compounds.
4. Ethylene oxide gas.

70. A 60 years old man is diagnosed to be suffering from Legionnaires disease after he returns home from attending a convention. He could have acquired it:

1. From a person suffering from the infection while traveling in the aeroplane.
2. From a chronic carrier in the convention center.
3. From inhalation of the aerosal in the air conditioned room at convention center.
4. By sharing an infected towel with a fellow delegate at the convention.

71. In post-operative intensive careunit, five patients developed post-operative wound infection on the same day. The best method to prevent cross infection occuring in other patients in the same ward is to:

1. Give antibiotics to all other patients in the ward.
2. Fumigate the ward.
3. Disinfect the ward with sodium hypochlorite.
4. Practice proper hand washing.

72. The earliest immunoglobulin to be synthesized by the fetus is:

1. IgA.
2. IgG.
3. IgE.
4. IgM.

73. The following are true regarding Lyme's Disease, except:

1. It is transmitted by ixodes tick.
2. Erythema chronicum migrans may be a clinical feature.
3. Borrelia recurrentis is the aetiological agent.
4. Rodents act as natural hosts.

74. A 55 year old lady presenting to out patent department (OPD) with postmenopausal bleding for 3 months has a 1x1 cm nodule on the anterior lib of cervix. The most appropriate investigation to be done subsequently is:

1. Pap smear.
2. Punch biopsy.
3. Endocervical curettage.
4. Coloposcopy.

75. A hemodynamically stable nulliparous patient with ectopic preganancy has adnexal mass of 2.5 x 3 cms and Beta hCG titre of 1500 miu/ml. What modality of treatment is suitable for her:

1. Conservative management.
2. Medical Management.
3. Laparoscopic Surgery.
4. Laparotomy.

76. A primigravida at 37 week of gestation reported to labour room with central placenta praevia with heavy bleeding per vaginum. The fetal heart rate was normal at the time of examination. The best management option for her is:

1. Expectant management.
2. Caesarean section.
3. Induction and vaginal delivery.
4. Induction and forceps delivery.

77. A case of Gestational Trophoblastic Neoplasia belongs to high risk group if disease develop after:

1. Hydatidiform mole.
2.Full term pregancy.
3. Spontaneous abortion.
4. Ectopic Pregancy.

78. All of the following are known risk factors for development of endometrial carcinoma except:

1. Obesity.
2. Family History.
3. Use of Hormone Replacement Therapy
4. Early Menopause.

79. In actinomycosis of the spine, the abscess usually erodes:

1. Intervertebral disc.
2. Into the pleural cavity.
3. Into the reteroperitoneal space.
4. Towards the skin.

80. A ten-year old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:

1. Tuberculosis.
2. Juvenile rheumatoid arthritis.
3. Haemophilia.
4. Villonodular synovitis.

81. A vascular necrosis can be possible sequelae of fracture of all the following bones, except:

1. Femur neck
2. Scaphoid.
3. Talus.
4. Calcaneum.

82. A 5 year old boy has been diagnosed to have posterior superior retraction pocket cholesteatoma. All would constitute part of the management, except:

1. Audiometry.
2. Mastoid exploration.
3. Tympanoplasty.
4. Myringoplasty.

83. A 31 year old female patient complaints of bilateral impairment of hearing for the past 5 years. On examination, tympanic membrance is normal and aduiogram shows a bilateral conductive deafness. Impedance audiometry. Shows as type of curve and acoustic reflexes are absent. All constitute part of treatment, except:

1. Hearing aid.
2. Stapedectomy.
3. Sodium Fluoride.
4. Gentamicin.

84. A middle aged male comes to the outer patient department (OPD) with the only complaint of hoarseness of voice for the past 2 years. he has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a portion both cords was seen. Management would include all except:

1. Cessation of smoking.
2. Bilateral cordectomy.
3. Microlaryngeal surgery for biopsy.
4. Regular follow-up.

85. A couple, with a family history of beta thalassemia major in a distant relative. has come for counseling. The husband had HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is:

1. 50%
2. 25%
3. 5%
4. 0%

86. A 5 year old boy passed 18 loose stools in last 24 hour and vomited twice in last 4 hour. he is irritable but drinking fluids. The optimal therapy for this child is:

1. Intravenous fluids.
2. Oral rehydration therapy.
3. Intravenous fluid initially for 4 hours followed by oral fluids.
4. Plain water ad libitum.

87. A 2 month old baby with accute icteric viral hepatitis like illness slips into encephalopathy after 48 hours. The mother is a known hepatitis B carrier. Mother's hepatitis B virus serological profile is most likely to be:

1. HBsAg positive only.
2. HbsAg and HBeAg positve.
3. HBsAg and HBe antibody positive.
4. HBV DNA positive.

88. Thirty-eight children consumed eatables procured from a single source at a picnic party. Twenty children developed abdominal cramps followed by vomiting and watery diarrhea 6-10 hours after the party. The most likely etiology for the outbreak is:

1. Rotavirus infection.
2. Entero-toxigenic E.Coli infection
3. Staphylococcol toxin.
4. Claustridium perfringens infection.

89. A 7 ear old girl from Bihar presented with three epidodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non-palpable liver and mild ascites. Portal vein was not visualized on ultrasonography. Liver function tests were normal and endoscopy reveled esophageal varices. The most likely diagnosis is:

1. Kala azar with portal hypertension.
2. Portal hypertension of unknown etiology.
3. Chronic liver disease with portal hypertension.
4. Portal hypertension due to extrahepatic obstruction.

90. A 40 year old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of:

1. Dohle bodies
2. Hypersegmented neutrophils.
3. Spherocytes.
4. Howell-Jolly bodies.

91. Which of the heart valve is most likely to be involved by infective endocarditis following a septic abortion?

1. Aortic valve.
2. Tricuspid valve.
3. Pulmonary valve.
4. Mitral valve.

92. Central nervous system manifestations in chronic renal failure are a result of all of the following, except:

1. Hyperosmolarity.
2. Hypocalcemia.
3. Acidosis.
4. Hyponatremia.

93. An increased incidence of cholangiocarcinoma is seen in all ofthe following, except:

1. Hydatid cyst of liver.
2. Polycystic disease of liver.
3. Sclerosing cholangitis.
4. Liver flukes.

94. Strong correlation with colorectal cancer is seen in:

1. Peutz-Jegher's polyp.
2. Familial polyposis coli.
3. Juvenile polyposis.
4. Hyperplastic polyp.

95. Medullary carcinoma of the thyroid is associated with which of the following syndrome:

1. MEN I.
2. MEN II.
3. Fraumeni syndrome.
4. Hashimoto's thyroiditis

96.Granulocytopenia, gingival hyperplasia and facila hirsutism are all possible side effects of one of the following anticonvulsant drugs.

1. Phenytoin.
2. Valproate.
3. Carbamazepine.
4. Phenobarbitone.

97. Bacitracin acts on:

1. Cell Wall
2. Cell Membrane.
3. Nucleic Acid.
4. Ribosome.

98. All of the following drugs act on cell membrance, except:

1. Nystatin.
2. Griseofulvin.
3. Amphotericin B
4. Polymixin B.

99. Two students. Vineet and Kamlesh were asked to demonstrate in dogs the role of sinus nerve in hypovolemic shock. Vineet severed the sinus nerve when the mean blood pressure (MBP) was 85mm Hg and Kamlesh cut the sinus nerve when the mean blood pressure was 60mm Hg. On cutting the sinus nerve:

1. Vineet recorded an increase in MBP but Kamlesh recorded a decrease in MBP.
2. Vineet recorded a decrease in MBP but Kamlesh recorded an increase in MBP.
3. Both recorded an increase in MBP.
4. Both recorded in decrease in MBP.

100. As a part of space-research program, a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take-off, and once after the spacecraft entered the designated orbit around the earth. For a proper comparison, the pre-flight blood pressure should be recorded in:

1. The lying down position.
2. The sitting position.
3. The standing position.
4. Any position, as long as the post-flight recording is made in the same position.

101. The renal plasma flow (RPF) of a patient was to be estimated through the measurement of Para Amino Hippuric acid (PAH) clearance. The technician observed the procedures correctly but due to an error in the weighing inadvertently used thrice the recommended does of PAH. The RPF estimated is likely to be:

1. False-high.
2. False-low
3. False-high or false-low depending on the GFR.
4. Correct and is unaffected by the PAH overdose.

102. The EEG record shown below is normally recordable during which stage of sleep?

1. Stage I.
2. Stage II.
3. Stage III.
4. Stage IV.

103. Figure below represents the pH of the digestive juices aspirated from the alimentary tract as a function of position along the alimentary tract during digestion of a meal:

<pic 103>

1. A typical value for Y2 is 9.0
2. A typical value for Y3 is 10.0
3. The segment C represents the pylorus.
4. The digestive enzymes active in segment A are inactivated in segment B.

104. Which of the following statements represent most correct interpretation from the ECG wave from given below:

<pic 104>

1. X originated form an atrial ectopic focus.|
2. X reset the cardiac rhythm.
3. Both heart sounds would have been present at X beat.
4. The path of spread of excitation was normal.

105. All of the following are features of hallucinations, except:

1.It is independent of the will of the observer.
2.Sensory organs are not involved.
3.It is a vivid as that in a true sense perception.
4. It occurs in the absence of perceptual stimulus.

106. All of the following statements regarding bio availability of a drug are true except:

1. It is the proportion (fraction) of unchanged drug that reaches the systemic circulation.
2. Bioavailability of an orally administered drug can be calculated by comparing the Area Under Curve (0- ) after oral and intravenous (iv) administration.
3.Low oral bioavailability always and necessarily mean poor absorption.
4.Bioavailability can be determined from plasma concentration or urinary excretion data.

107. The extent to which ionisation of a drug takes place is dependent upon pKa of the drug and the pH of the solution in which the drug is dissolved. which of the following statements is not correct.

1.pKa of a drug is the pH at which the drug is 50% ionized.
2.Small changes of pH near the pKa of a weak acidic drug will not affect its degree of ionisation.
3.Knowledge of pKa of a drug is useful in predicting its behaviour in various body fluids.
4.Phenobarbitonewith a pKa of 7.2 is largely ionized at acid pH and will be about 40% non-ionised in plasma.

108. Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not correct example:

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorthiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

109. Defirium tremens is characterized by confusion associated with:

1. Autonomic hyperactivity and tremors.
2. Features of intoxication due to alcohol.
3. Sixth nerve palsy.
4. Korsakoff psychosis.

110. High resolution computed tomography of the chest is the ideal modality for evaluating:

1. Pleural effusion.
2. Interstitial lung disease.
3. Lung mass.
4. Mediastinal adenopathy.

111. Which one of the following is a recognized X-Ray feature of rheumatoid arthritis?

1. Juxta-articular osteosclerosis.
2. Sacroilitis.
3. Bone erosions.
4. Peri-articular calcification.

112. A 25 year old man presented with fever, cough, expectoration and breathlessness of 2 months duration. Contrast enhanced computed tomography of the chest showed bilateral upper lobe fibrotic lessons and mediastinum had enlarged necrotic nodes with peripheral rim enhancement. Which one of the following is the most probable diagnosis?

1. Sarcoidosis.
2. Tuberculosis.
3. Lymphoma.
4. Silicosis.

113. A 60 year old male presented to the emergency with breathlessness, facial swelling and dilated veins on the chest wall. The most common cause is:

1. Thymoma
2. Lung Cancer.
3. Hodgkin's lymphoma.
4. Superior vena caval obstruction.

114. A vitreous aspirate has been collected in an emergency at 9 pm what advice you like to give to the staff on duty regarding the overnight storage of the sample.

1. The sample should be kept at 4° C.
2. The sample should be incubated at 37°C.
3. The sample should be refrigerated deep freezer.
4. The sample should be refrigerated for the initial 3 hours and then incubated at 37°C.

115. A 20 year old man complains of difficulty in reading the newspaper with his right eye. Three weeks after sustaining a gunshot injury to his left eye. The most likely diagnosis is:
1. Macular edema.
2. Sympathetic ophthalmia.
3. Optic nerve avulsion.
4. Delayed vitreous hemorrhage.

116. A recurrent bilateral conjunctivitis occurring with the onset of hot weather in young boys with symptoms of burning, itching, and lacrimation with polygonal raised areas in the palpebral conjunctiva is:

1. Trachoma.
2. Phlyctenular conjunctivitis.
3. Mucopurulent conjunctivitis.
4. Vernal kerato conjunctivitis.

117. A patient is on follow-up with you after enucleation of a painful blind eye. After enucleation of the eyball, a proper sized artifical prosthetic eye is advised after a postoperative period of:

1. About 10 days
2. About 20 days.
3. 6-8 weeks.
4. 12-24 weeks.

118. A patient using contact lens develops corneal infection. Laboratory diagnosis of acanthamoeba keratitis was established. The following is the best drug for treatment:

1. Propamidine.
2. Neosporine.
3. Ketocanazole
4. Polyhexamethylene biguanide.

119. One unit of fresh blood raisesthe HB% concentration by:

1. 0.1gm%
2. 1gm%
3. 2gm%
4. 2.2gm%

120. Early stage of trauma is characterized by:
1. Catabolism
2. Anabolism
3. Glycogenesis.
4. Gluconeogenesis.

121. All of the following conditions may predispose to pulmonary embolism except:

1. protein S deficiency.
2. Malignancy.
3. Obesity.
4. Progesterone therapy.

122. An early systolic murmur may be caused by all of the following except:

1.Small ventricular septal defect.
2.Papillary muscle dysfunction.
3.Tricuspid regurgitation.
4.Aortic stenosis.

123. Bedsore is an example of:

1.Tropical ulcer.
2.Trophic ulcer.
3.Venous ulcer.
4.Post thrombotic ulcer.

124. Marjolin's ulcer is a:

1.Malignant ulcer found on the scar of burn.
2.Malignant ulcer found on infected foot.
3.Tropic ulcer.
4.Melency's gangrene.

125. If a patient with Raynaud's disease immersed his hand in cold water, the hand will

1.Become red.
2.Remain Unchanged.
3.Turn white.
4.Become blue.

126. The best treatment for cystic hygroma is:

1.Surgical excision.
2.Radiotherapy.
3.Sclerotherapy.
4.Chemotherapy.

127. which of the following is most suggestive of neonatal small bowel obstruction:

1.Generalised abdominal distension.
2.Failure to pass meconeum in the first 24 hours.
3.Bilious vomiting.
4.Refusal of feeds.

128. What is most characteristic of congenital hypertrophic pyloric stenosis:

1.Affects the first born female child.
2.The pylori tumour is best feld during feeding.
3.The patient is commonly marasmic.
4.Loss of appetite occurs early.

129. What is the most appropriate operation for a solitary nodule in one lobe of thyroid:

1.Lobectomy.
2.Hemithyroidectomy.
3.Nodule removal.
4.Partial lobectectomy with 1 cm margin around nodule.

130. All of the following may occur in Noonan's syndrome except:

1.Hypertrophic cardiomyopathy.
2.Crypto orchitis
3.Infertility in females.
4.Autosomal dominant transmission.

131. SAFE strategy has been developed for the control of:

1.Onchocerciasis.
2.Trachoma.
3.Refractive error.
4.Ocular trauma.

132. The commonest cause of low vision in India is:

1.Uncorrected refractive errors.
2.Cataract.
3.Glaucoma.
4.Squint.

133. Most important epidemiological tool used for assessing disability in children is:

1.Activities of Daily living (ADL) scale.
2.Wing's Handicaps, Behavior and Skills (HBS) Schedule.
3.Binet and Simon IQ tests.
4.Physical Quality of Life Index (PQLI)

134. Scope of family planning services include all of the following except:

1.Screening for cervical cancer.
2.Providing services for unmarried mothers.
3.Screening for HIV infection.
4.Providing adoption services.

135. Class II exposure in animal bites includes the following:

1.Scratches without oozing of blood.
2.Licks on a fresh wound.
3.Scratch with oozing of blood on palm.
4.Bites from wild animals.

136. Elemental iron and folic acid contest of iron & folic acid adult tablets supplied under the National Programme for Anaemia Prophylaxis are:

1. 60mg of elemental iron and 250 micrograms of folic acid.
2. 100 mg of elemental iron and 500 micrograms of folic acid.
3. 120 mg of elemental iron and 750 micrograms of folic acid.
4. 200 mg of elemental iron and 1000 micrograms of folic acid.

137. Denominator while calculating the secondary attack rate includes:

1. All the people living in next fifty houses.
2. All the close contacts.
3. All susceptibles amongst close contact.
4. All susceptibles in the whole village.

138. The response which is graded by an observer on an agree or disagree continuum is based on:

1.Visual analog scale.
2.Guttman Scale.
3.Likert Scale.
4.Adjectival scale.

139. For calculation of sample size for a prevalence study all of the following are necessary except:

1. Prevalence of the disease in population.
2. Power of the study.
3. Significance level.
4. Desired precision.

140. Leprosy is considered a public health problem if the prevalence of leprosy is more than:

1. 1 per 10,000
2. 2 per 10,000
3. 5 per 10,000
4. 10 per 10,000

141. In one single visit, a 9 month-old, unimmunized childcan begiven the following vaccination:

1.Only BCG.
2.BCG, DPT-1, OPV-1.
3.DPT-1, OPV-1, Measles.
4.BCG,DPT-1, OpV-1, Measles.

142. For controlling an outbreak of cholera, all of the following measures are recommended except:

1.Mass chemoprophylaxis.
2.Proper disposal of excreta.
3.Chlorination of Water.
4.Early detection and management of cases.

143. A child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11 Kg. respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is?

1Classify as pneumonia and refer urgently to secondary level hospital.
2.Classify as pneumonia, start antibiotic and advise to report after 2 days.
3.Classify as severe pneumonia, start antibiotics and refer urgently.
4.Classify as severe pneumonia and refer urgently.

144. A 5 year old boy has multiple asymptomatic oval and circular faintly hypopigmented macules with fine scalng on his face. The most probable clinical diagnosis is:

1.Pityriasis versicolor.
2.Indeterminate leprosy.
3.Pityriasis alba.
4.Acrofacial vitiligo.

145. A 40 year old male developed persistent oral ulcers followed by multiple flaccid bullae on trunk and extremities. Direct examination of a skin biopsy immunofluorescence showed intercellular igG deposits inthe epidermis. The most probable diagnosis is:

1.Pemphigus vulgaris.
2.Bullous Pemphigoid.
3.Bullous Lupus erythematosus.
4.Epidermolysis bullosa acquisita.

146. The test likely to help in diagnosis of a patient who presents with an itchy annular plaque on the face is

1. Gram Stain
2. KOH Mount
3. Tissue Smear
4. Woods Lamp Examination

147. Blackening and tattooing of skin and clothing can be best demonstrated by

1. Luminol spray
2. Infra red photography
3. UV light
4. Magnifying lens

148 Post mortem lividity is unlikely to develop in a case of

1. Drowning in well
2. Drowning in fast flowing river
3. Post mortem submersion
4. Drowning in clorinated swimming pool

149 The following situations are associated with rise of temperature after death EXCEPT

1. Burns
2. Heat Strokes
3. Pontine Hemorrhage
4. Septicemia

150 Troponin T is preferable to CPK-MB in the diagnosis of acute MI in all of the following situations except

1. bed side diagnosis of MI
2. Post operatively after CABG
3. Reinfarction after 4 days
4. Small Infarcts

151. In prenatal diagnostic technique Act 1994 which one of the following is not a ground for carrying out prenatal test?

1. Pregnant women above 35 years of age
2. History of two or more spontaneous abortion of fetal loss.
3. When fetal heart rate is 160 per min at fifth and 120 per min at ninth month.
4. History of exposure to potentially teratogenic drugs.

152. Perjury means giving willfull false evidence by a witness while under oath, the witness is liable to be prosecuted for perjury and the imprisonment may extend to seven years. This falls under which section of IPC?

1. 190 of Indian Penal Code.
2. 191 of Indian Penal Code.
3. 192 of Indian Penal Code.
4. 193 of Indian Penal Code.

153. The most reliable criteria in Gustafson's method of identification is:

1.Cementum apposition.
2.Transparency of root.
3.Attrition.
4.Root resorption.

154. The most common cause of tricuspid regurgitation is secondary to:

1. Rheumatic heart disease.
2. Dilatation of right ventricle.
3. Coronary artery disease.
4. Endocarditis due to intravenous drug abuse.

155. An eleven year old boy is having tinea capitis on his sclap. The most appropriate line of treatment is:

1. Oral griseofulvin therapy.
2. Topical griseofulving therapy.
3. Shaving of the scalp.
4. Selenium sulphide shampoo.

156. Absence seizures are characterized on EEG by:

1. 3Hz spike & wave.
2. 1-2Hz spike & wave.
3. Generalized polysikes.
4. Hyparrythmia.

157. All of the following are associated with low C3 levels except:

1.Post streptococcal glomerulonephritis.
2.Membrano-proliferative Glomerulonephritis.
3.Good pasture's disease.
4.Systemic lupus erythematosus.

158. Diagnostic features of allergic broncho-pulmonary aspergillosis (ABPA) include all of the following except:

1.Changing pulmonary infiltrates.
2.Peripheral eosinophilia.
3.Serum precipitins against Aspergillosis fumigatus.
4.Occurance in patients with old cavitary lesions.

159. Normal anion gap metabolic acidosis is caused by:

1.Cholera.
2.Starvation
3.Ethylene glycol poisoning.
4.Lactic acidosis.

160. The syndrome of inappropriate antidiuretic hormone is characterized by the following

1. Hyponatremia andurine sodium excretion >20meq/l.
2. Hypernatremia andurine sodium exeretion < 20meq/l.
3. Hyponatremia and hyperkalemia.
4. Hypernatremia and hypokalemia.

161. All of the following heart sounds occur shortly after S2 except:

1. Opening snap.
2. Pericardial knock.
3. Ejection click.
4. Tumor plop.

162. Pulmonary hypertension may occur in all of the following conditions except:

1. Toxic oil syndrome.
2. Progressive systemic sclerosis.
3. Sickle cell anaemia.
4. Argemone mexicana poisoning.

163. Causes of metabolic alkalosis include all the following except.

1. Mineralocorticoid deficiency.
2. Bartter's syndrome.
3. Thiazide diuretic therapy.
4. Recurrent vomiting.

164. The most frequent cause of recurrent genital ulcertion in a sexually active male is:

1. Herpes genitalis.
2. Aphthous ulcer.
3. Syphilis.
4. Chancroid.

165. The most effective drug against M. leprae is:

1. Dapsone.
2. Rifampicin.
3. Clofazamine.
4. Prothionamide.

166. An 8 month old child presented with itchy, exudative lesions on the face, palms and soles, The siblings also have similar complaints. The treatment of choice in such a patient is:

1. Sytemic ampicillin.
2. Topical betamethasone.
3. Systemic prednisolone.
4. Topical permethrin.

167. A 30-yer-old HIV positive patient presents with fever, dyspnoea and non-productive cough. Patient is cyanosed. His chest X-ray reveals bilateral, symmetrical interstitial infiltrates. The most likely diagnosis is:

1. Tuberculosis.
2. Cryptococcosis.
3. Pneunocytis carinii pneumonia.
4. Toxoplasmosis.

168. Extensive pleural thickening and calcification expecially involving the diaphragmatic pleura are classical features of:

1. Coal worker's pneumoconiosis.
2. Asbestosis.
3. Silicosis.
4. Siderosis.

169. Commonest presentation of neurocysticercosis is:

1. Seizures.
2. Focalneurological deficits.
3. Dementia.
4. Radiculopathy.

170. A 55 year old man who has been on bed rest for the past 10 days, complains of breathlessness andchest pain. The chest X-ray is normal. The next investigation should be:

1. Lung ventilation-perfusion scan.
2. Pulmonary arteriography.
3. Pulmonary venous angiography.
4. Echocardiography.

171. Which of the following is the most common location of hypertensive hemorrhage?

1. Pons.
2. Thalamus.
3. Putamen/external capsule.
4. Subcortical white matter.

172. A 60 year-old man with diabetes mellitus presents with painless, swollen right ankle joint. Radiographs ofthe ankle show destroyed joint with large number ofloose bodies. The most probable diagnosis is:

1. Charcot's joint
2. Clutton's joint.
3. Osteoarthritis.
4. Rheumatoid arthritis.

173. All of the following statements regarding the ECG in acute pericarditis are true except:

1. T-wave inversions develop before ST elevations return to baseline.
2. Global ST segment elevation is seen in early pericarditis.
3. Sinus tachycardia is a common finding.
4. PR segment depression is present in majority of patients.

174. Type IV hypersensitivity to Mycobacterium tuberculosis antigen may manifest as:

1. Iridocylitis.
2. Polyarteritis nodosa.
3. Phlyctenular conjunctivitis.
4. Giant cell arteritis.

175. In a patient with AIDS chorioretinitis is typically caused by:

1. Cytomegalvirus.
2. Toxoplasma gondii.
3. Cryptococcus neoformans.
4. Histoplasma capsulatum.

176. The following are true for Bordetella perussis except.

1. It is a strict human pathogen.
2. It can be cultured from the patient during catarrhal stage.
3. It leads to invasion of the respiratory mucosa.
4. Infection can be prevented by a acellular vaccine.

177. All of the following drugs are used for management of post partum haemorrhage except:

1. Misoprostol.
2. Oxytocin.
3. Prostaglandin.
4. Mifepristone (RU-486)

178. Laporatomy performed in a case of ovarian tumor revealed unilateral ovarian tumor with ascities positive for malignatn cells and positive pelvic lyjph nodes. All other structures were free of disease. what is stage of the disease:

1. Stage IIc.
2. Stage IIIa.
3. Stage IIIb.
4. Stage IIIc.

179. B Lynch suture is applied on:

1. Cervix.
2. Uterus.
3. Fallopian tubes.
4. Ovaries.

180. Pure gonadal dysgenesis will be diagnosed in the presence of::

1. Bilateral streak gonads.
2. Bilateral dysgenetic gonads.
3. One side streak and other dygenetic gonads.
4. One side streak and other normal looking gonad.

181 Cut-off value of cervical length at 24 weeks of gestation for prediction of preterm delivery is:

1. 0.5cm.
2. 1.5cm
3. 2.5cm
4. 3.5cm

182. All of the following may be observed in a normal pregnancy except:

1. Fall in serum iron concentration falls.
2. Increase in serum iron building capacity.
3. Increase in blood viscosity increases.
4. Increase in blood oxygen carrying capacity.

183. A 50 Kg. man with severe metabolic acidosis has the following parameters:pH 7.05. pCO2 12mm Hg., pO2 108mm Hg. HCO3 5 meq/L. base excess-30 mEa/L. The approximate quantity of sodium bicarbonate that he should receive in half hour is:

1. 250mEq.
2. 350mEq.
3. 500mEq.
4. 750mEq.

184. Pyometra is a complication associated with all of the following conditions except:

1. Carcinoma of the vulva.
2. Carcinoma of the cervix.
3. Carcinoma of endometrium.
4. Pelvic radiotherapy.

185. A hypertensive pregnant woman at 34 weeks comes with history of pain in abdomen, bleeding per vaginum and loss of fetal movements. On examinationthe uterus is contracted with increased uterine tone. Fetal heart sounds are absent. The most likely diagosis is:

1. Placenta praevia.
2. Hydramnios.
3. Premature labour.
4. Abruptio placenta.

186. Most common cause of first trimester abortion is:

1. Chjromosomal abnormalities.
2. Syphilis.
3. Rhesus isoimmunisation.
4. Cervical incompetence.

187. A 38 year old man is posted for extraction of last molar tooth under general anaesthesia as a day care case. He wishes to resume his work after 6 hours. which one of the following induction agents is preferred:

1. Thiopentone sodium
2. Ketamine.
3. Diazepam.
4. propofol

188. All of the follwing are mechanisms of action of emergency contraception except:

1. Delaying ovulation.
2. Inhibiting fertilization.
3. Preventing implantation of the fertilized egg.
4. Interrupting an early pregnancy.

189. A 20 year old woman gives a history of sharp pain in the lower abdomen for 2-3 days every month approximately 2 weeks before the menses. The most probable etiology for her pain is:

1. Endometriosis.
2. Dysmenorrhea.
3. Pelvic tuberculosis.
4. Mittelschmerz.

190. The blood gas parameters: pH 7.58, PCO2 23 mmHg PO2, 300 mmHg and oxygen saturation 60% are most consistent with:

1. Carbon monoxide poisoning.
2. Ventilatory malfunction.
3. Voluntary hyper ventilation.
4. Methyl alcohol poisoning.

191. Sciatic nerve palsy may occur in the following injury:

1. Posterior dislocation of hip joint.
2. Fracture neck of femur.
3. Trochanteric fracture.
4. Anterior dislocation of hip.

192. A 30 year old male was brought to the casualty following a road traffic accident. His physical examination revealed that his right lower limb was short, internally rotated, and flexed and adducted at the hip. The most likely diagnosis is:

1. Fracture neck of femur.
2. Trochanteric fracture.
3. Central Fracture dislocation of hip.
4. Posterior dislocation of hip.

193. Which one of the following tests will you adopt while examining a knee joint where you suspect an old tear of anterior cruciate ligament?

1. Posterior drawer test.
2. MC Murry test.
3. Lachman test.
4. Pivot shift test.

194. Type I Thyroplasty is for:

1. Vocal cord medialization.
2. Vocal cord laterlization.
3. Vocal Cord shortening.
4. Vocal cord lengthening.

195. Carharts notch in audiogram is deepest frequency of:

1. 0.5KHz
2. 2 KHz.
3. 4 KHz.
4. 8 KHz.

196. An eight-year-old boy had abdominal pain, fever with bloody diarrhea for 18 months. His height is 110 cms and weight is 14.5 kg. stool culture was negative for known enteropathogens. The sigmoidoscopy was normal. During the same period, child had an episode of renal colic and passed urinary gravel. The mantoux test was 5X 5 mm. The most probable diagnosis is:

1. Ulcerative colitis.
2. Crohn's disease.
3. Intestinal tuberculosis.\
4. Strongyloidosis

197. A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HBs Ag. The mother was also HBs Ag carrier. The mother's hepatitis B serological profile is likely to be:

1. HBs Ag positive only.
2. HBsAg and HBeAg positivity.
3. HBsAg and anti-Hbe antibody positivity.
4. Mother infected with mutant HBV.

198. A 15 year old healthy boy with no major medical problem complaints that he breaks out with blocky areas of erthema that are pruritic over skin of his arm, leg and trunk every time within an hour of eating sea foods. The clinical features are suggestive of:

1. Localised immune-complex deposition.
2. Cell mediated hypersensitivity.
3. Locallized anaphylaxis.
4. Release of complement C3b.

199. A 2-month baby presents with history of jaundice, turmeric colored urine and pale stools since birth. Examination reveals liver span of 10 cms. Firm in consistency and spleen of 3 cms. The most specific investigation for establishing the diagnosis would be:

1. Liver function tests.
2. Ultrasound abdomen
3. Peroperative Cholangiogram.
4. Liver biopsy.

200. Transient myeloproliferative disorder of the new born is seen in association with:

1. Turner syndrome.
2. Down syndrome.
3. Neurofibromatosis.
4. Ataxia telangiectasia.

201. A 1-moth old baby presents with frequent vomiting and failure to thrive. There are features of moderate dehydrtion. Blood sodium is 122mEa/l and potassium is 6.1 mEq/l. The most likely diagnosis is:

1. Gitelman syndrome.
2. Bartter syndrome.
3. 21-hydroxylase deficiency.
4. 11-b hydroxylase deficiency.

202. A male child of 15 years, with a mental age of 9 years has an IQ of:

1. 50
2. 60
3. 70
4. 80

203. The most appropriate drug used for chelation therapy in beta thalassemia major is:

1. Oral desferroxamine.
2. Oral deferiprone.
3. Intramuscular EDTA.
4. Oral Succimer.

204. Which endocrine disorder is associated with epiphyseal dysgenesis?

1. Hypothyrodism.
2. Cushings syndrome.
3. Addison's disease.
4. Hypoparathyroidism.

205. An albino girls gets married to a normal boy. What are the chances of their having an affected child and what are the chances of their children being carriers?

1. None affected, all carriers.
2. All normal.
3. 50% carriers.
4. 50% affected. 50% carriers.

206. A 63-year-old man presented with massive splenomegaly, lymphadenopathy and a total leucocyte count of 17000 per mm3. The flowcytometery showed CD 19 positive, CD5 positive, DC 23 negative, monoclonal Bcells with bright kappa positivity comprising 80% of the peripheral blood lymphoid cells. The most likely diagnosis is:

1. Mantle cell lymphoma.
2. Splenic lymphoma with villous lymphocytes.
3. Follicular lymphoma.
4. Hairy cellleukemia.

207. Memory T cells can be identified by using the following marker:
1. CD45 RA.
2. CD45 RB.
3. CD45RC.
4. CD45RO.

208. All of the following statements about NK cells are true. except:
1. They are derived from large granular cells.
2. They comprise about 5% of human peripheral lymphoid cells.
3. They are MHC restricted cytotoxic cells
4. They express lgG Fc receptors.

209. Which of the following increases the susceptibility to coronary artery disease:

1. Type V hyperlipoproteinaemia.
2. Von will Brandt’s disease.
3. Nephritic syndrome.
4. Systemic lupus erythematosus.

210. MHC class 3 Genes Encode;

1. Complement Component C3
2. Tumor necrosis factor.
3. Interleukin 2.
4. Beta 2 microglobulin.

211. The HLA class 3 rejection genes are important elements in :
1. Transplant rejection phenomenon.
2. Governing susceptibility of autoimmune diseases.
3. Immune surveillance.
4. Antigen presentaion and elimination.

212. Gluten sensitve enteropthy is most strongly associated with:

1. HLA-DQ2
2. HLA-DQ4
3. HLA-DQ3
4. Blood group ‘B’

213. Most sensitve and specific test ofr diagnosis of iron efficiency is :

1. Serum iron levels.
2. Serum ferritin levels.
3. Serum transferring receptor population :
4. Transferrin saturation.

214. All the statrment about lactoferrin are true, except:

1. It is present in secondary granules of neutrophil
2. It is present in exocrine secretios of body.
3. It has great affinity for iron.
4. It transports iron for erythropoiesis.

215. All of the following are poor prognostic factors for acute myeloid leukemias, except:

1. Age more than 60 years.
2. Leucocyte count more than 1,000,000/ul.
3. Secondary leukenias.
4. presence of t (8:21)

216. Leukoelrythroblastic picture may be seen in all of the following except:

1. Myelofibrois.
2. Metastatic careinoma.
3. Gaucher’s disease.
4. Thalassemia.

217. Vortex vein invasion is commonly seen in:

1. Retinoblastoma.
2. Malignant melanoma.
3. Optic nerve gliomas.
4. Medullo-epitheliomas.

218. Hereditary retinoblastomas develop the following choromosomal deletion:

1. 13q 14
2. 13p14
3. 14p13
4. 14q13

219. All of the following are useful intravenous therapy for hypertensicve emergencies except:

1. Fenoldopam.
2. Urapidil
3. Enalpril
4. Nifedipine.

220. Porphobilinogen in urine produces pink color with:

1. Fouchet’s reagent.
2. Benedict’s reagent.
3. Sodium nitropruside.
4. Ehrlich’s aldehyde reagent.

 221. Cardiac output measured by thermodilution technique is unreliable in all of the following situations except:

1. Ventricular septal defect.
2. Tricuspid regurgitation.
3. Low cardiac output
4. Pumonary regugitation

222. Exercise testing is absolutely contraindicated in which one week following :

1.One week following myocardial infarction
2. Unstable angina.
3. Aortic stenosis
4. peripheral vascular dicase.

223. Osteomatacia is associated with:

1. Decrease in osteoid volume.
2. Derease in osteoid surface.
3. increase in osteoid maturiaton time
4. Increase in mineral apposition rate.

224. A nineteen year old female with short stature wide spread nipples and primary amenorrhoea most likely has a karyotype of :

1. 47, XX +18
2. 46,XXY
3. 47,XXY
4. 45X.

225. Which of the following procedures are wsed as routine technique for karyotyping using light microscopy ?

1. C- banding
2. G- banding
3. Q- banding
4. B-rd V- staning

226 A 23- year old woman has experience episod of myalgias, pleural effusion, peicarditis and arthralgias without joint deformity over course of several years. The best laboratory screening test to diagnose her disease would be:

1. CD4 Lymphocyte count.
2. Erythrocyte sedimentation rate.
3. Antinuclear antibody.
4. Assay for thyroid hormones.

227. A5-year old boy is detected to be HBs A g positive in two separte occasions during a screening program for hepatitis B He is otherwise asymptomatic. Child was given 3 doses of recombinant hepatitis B vaccine at the age of one year. His mother was treated for chronic hepatitis B infection around the same time The next relevant step for further investigating the child ould be to:

1. Obtain Hbe antibodies.
2. obtain anti - HBs levels.
3. Repeat HBs Ag
4.. Repeat antother cours of hepatitis B vaccine.

228. Which of the following hepatitis viruses have significant perinatal transmission:

1. Hepatitis E virus.
2. Hepatitis C virus.
3. Hepatitis B virus.
4. Hepatitis A virus.

229.The diffusion capacity of lung (DL CO)is decreased in all of the following conditions except:

1. Interstitial lung disease.
2. Goodpastur’s syndrome.
3. Emphysema.
4. primary pulmonary hypertension.

230.Osler;s nodes are typically seen in which one of the follwing :

1. chronic candida endocarditis.
2. Acute staphylococcal endocarditis
3. pseuduomonas endocarditis.
4. Libman sack’s endocarditis.

231. Thiamine deficiency is known to occur in all of the following except:

1. Food faddist.
2. Homocstinemia
3. Chronic alcoholic.
4. chronic heart failure patient on diuretics.

232 . During cardiopulmonary resusitaton intravenous calcium glouconate is indicated under all for the follwing circumstances except:

1. After I min. of arrest routinely.
2. Hypocalcemia
3. Calcium channel blocker toxicity
4. Electromechanical dissociaton.

233. Radiaton exposure during infancy has been linked to which one of the following carcinoma :

1. Breast.
2. Melanoma.
3. Thyroid.
4. Lung.

234. The induction agent of choice in day care anaesthesia is :

1. Sevoflurane.
2. Ketamine .
3. propofol.
4. Methohexitone .

235. Bostentan is a:

1. Serotonin uptake injibitor.
2. Endothelin receptor antagonist.
3. Leukotriene modifier.
4. Calciuim sensitizer.

236. Recurrent ischemic events following thrombolysis has been patho-physiologically linked to which of the following factors :

1. Antivodies to thrombolytic agents
2. fibrinopeptide A
3. Lipoprotein (a) [LP(a)]
4. Triglycerides.

237 The middle cardiac vein is locted at the

1. Anterior interventricular sulcus.
2. Posterior interventricular sulcus.
3. Posterior AV groove.
4. Anterior AV groove

238. Induction agent that may cause adrenal cortex suppeession is :

1. Ketamine
2. Etomidate.
3. propofol.
4. Thiopentone

239 Which of the following statements is true about the autonomic nerves system

1. The sympathetic outflow the CNS is through both the cranial nerves and the sympathetic chain
2. The parasympathetic outflow from the CNS is through cranial nerves only
3. The superior hypogastric plexus is located at the anterior aspect of the aortic befrucation and fifth lumbar vertebra.
4. The superir hypogastric plexus contains sympathetic fibers only.

240. Which of the following is pan - T laymphocyte marier?

1. CD 2.
2. CD 3.
3. CD 19.
4. CD 25.

241. Study this formula carefully:

True positives

--------------------------------X100

True positives +False negatives

This denotes:

1. Sensitivity.
2. Specificity.
3. Positive Predctive value.
4. Negative Predictive value.

242 A oisteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation the following :

1. Omental bursa [lesser sac].
2. Greater sac.
3. Right subphrenic space.
4. Hepatorenal space [ pouch of Morison].

243 The “P” value of a randomised controlled trial comparing operation A [new procedure] &opertion B [ Gold standard] is 0.04. From this, we conclude that:

1. Type II error is small & we can accept the findings of the study.
2. The probability of false negative conclusion that operation A is better than operation B, when in truth it is not, is 4%.
3. The power of study to detect a difference between operation A&B is 96% .
4. the probability of a false positive conclusion that operation ‘a is better that operation B, when in truth it is not, is 4%.

244. Which of the following statements is true for excitat0ry postsynaptic potentials [EPSP];

1. Are self propagating.
2. Show all or none response.
3. Are proportional to the amount of transmitter released by the presynaptic neuron.
4. Are inhibitory at presynaptic terminal.

245. Synaptic conduction is mostly orthodromic because:

1 Dendrities cannot be depolarized.
2. Once repolariced, an area cannot be depolarized,
3. The strength of antidromic impulse is less esynatic ter minal.
4. Chemical mediator is located only in the presynatic terminal.

246. Following are the reatures of corticospinal involvement except;

1. Cog-wheel rigidity.
2. Spasicity.
3. Planter extensor response.
4. Exaggerated deep tenedon reflexes.

247. A 55- year -old woman has recurrent urinary retention after a hysterectomy done for huge fibroid. The most likely cause is:

1. Atrophic and stenotic urethra.
2. Lumbar disc prolapse.
3. Injury to the bladder neck.
4. Injury to the hypogastric plexi.

248. The cell junctions allowing exchange of cytoplasmic molecules between the two cells are called:

1. Gap junctions.
2. Tight junctions.
3. Anchoring junctions.
4. Focal junctions.

249. The collagen triple helix structure is not found in :

1. Cytoplasm.
2. Golgi apparatus.
3. Lumen of endoplasmic reticulum.
4. Intracellular vesicles.

250. Restriction fragment length polymophism is used for:

1. Analysis of chromosome structure.
2. DNA estimation.
3. Synthesis of nucleic acid.
4. Detecting proteins in a cell.

251. Positive feedback action of estrogen for inducing lulteinizing hormone surge is associated with one of the follwing steroid hormone ratios in peripheral circulation:

1. High estrogen: low progesterone.
2. Low estrogen: high progesterone.
3. Low estrogen: low progesterone.
4. High estrogen: high progesterone.

252. All of the following are impulse control disorders except;

1. Pyromania.
2. Trichotillomania.
3. Kleptomania.
4. Capgras’ sydrome.

253. A 20- year-old man has presented with increased alcohol consumption and sexual indulgence, irritability, lack of sleep, and not feeling fatigued even on prolonged periods of activity. Activity. All these changes have beenpresent for 3 weeks . The most likely diagnosis is:

1. Alcohol dependence.
2. Schizophrenia.
3. Mania.
4. Impulsive control disorder .

254. An alcoholic is brought to the Emergency OPD with the complaint of irrelevant talking. He had stopped using alcohol three days back. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. ‘There is no history of head injury. The most likely diagnosis is:

1. Dementia praecox.
2. Delirium tremens.
3. Schizophrenia.
4. Korsakoff’s psychosis.

255. A 41 year lod married female presented with headacje for the last six month . she had several consultations. All her investigatons were found to be within normal limits. She still insists that threr is something wrong in her head and seeks another consulatatin. The most likel diagnosis is :

1. Phobia .
2. Psychogenic headache.
3. Hypochondriasis Depression.
4. Depression

256. Behaviour therapy to change maladaptive behaviors using reponse as reinforcer uses the principles of :

1. Classical conditioning
2. Moneling.
3. Social learning.
4. Operant conditioning.

257. A 15 year old boy feels that the dirt has hung onto him whenever he passes through the dirty street. This repetitive thought causes much distress and anxiety. He knows that there is actually no such thing after he has cleaned once but he is not satisfied and is compelled to think so. This has led to social withdrawal. He spends much of his time thinking about the dirt and contamination. This has affected his studies also. The most likely diagnosis is:

1. Obsessive compulsive disorder.
2. Conduct disorder.
3. Agoraphobia.
4. Adjustment disorder.

258. A 50 year old man has presented with pain in back, lack of interest in recreational activities. Low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucination. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including hacmogram, renal function tests, liver function tests, electrocardiogram did not reveal any abnormality. This patient sould be treated with:

1.Haloparidol.
2. Sertraline.
3. Alprazolarn.
4. Olanzapine.

259. Fraying and cupping of metaphyses of long bones in an child does not occur in:

1. Rickets.
2. Lead poisoning.
3. Metaphyseal dysplasia.
4. Hypophosphatasia.

260. A classical expansive lytic lesion in the transverse process of a vertebra is seen in:

1. Osteosarcoma.
2. Aneurysmal bone cyst.
3. Osteoblastoma.
4. Metastasis.

261. CT scan of a patient with history of head injury shows a biconvex hyperdense lesion displacing the grey-white matter interface. The most likely diagnosis is:

1. Subdural hematoma.
2. Diffuse axonal injury.
3. Extradural hematoma.
4. Hemorrhagic contusion.

262. Which of the following is the best choice to evaluate radiologically a posterior fossa tumor?

1. CT scan.
2. MRI.
3. Angiography
4. Myelography.

263. Most suitable radioisotope of iodine for treating hyperthyroidism is:

1. I 123
2. I 125
3. I 131
4. I 132

264. In the presence of vasopressin the greatest fraction of filtered water is re-absorbed which part of the nephron:

1. Proximal tubule.
2. Distal tubule.
3. Loop of Henle.
4. Collecting duct.

265. A one-year-old child having leucocoria was detected to be having a unilateral, large retinoblastoma filling half the globe. Current therapy would involve:

1. Enucleation.
2. Chemotherapy followed by local dyes.
3. Direct Laser ablation using photo dynamic cryotherapy.
4. Scleral radiotherapy followed by chemotherapy.

266. A child has got a congenital catract involving the visual axis which was detected by the parents right at birth. This child should be operated.

1. Immediately.
2. At 2 months of age.
3. At 1 year of age when the globe becomes normal sized.
4. After 4 year when entire ocular and orbital growth become normal.

267. A lady wants LASIK surgery for her daughter. She asks for your opinion. All the following things are suitable for performing LASIK except:

1. Myopia of 4 Diopters.
2. Age of 15 years.
3. Stable refraction for 1 year.
4. Corneal thickness of 600 microns.

268. Fasanella Servat operation is specififcally indicated in:

1 Congenital ptosis.
2. Steroid induced ptosis.
3. Myasthenia gravis.
4. Horner’s syndrome.

269. The operation of plication of inferior lid retractors is indicated in:

1. Senile ectropion.
2. Senile entropion.
3. Cicatricial entropion.
4. Paralytic entropion.

270. Which of the following lasers is used for treatment of bening prostatic hyperplasia as well as urinary calculi?

1. CO2 laser.
2. Excimer laser.
3. Ho: YAG laser.
4. Nd: YAG laser.

271. A 65-year-old male smoker presents with gross total painless hematuria. The most likely diagnosis is:

1. Carcinoma urinary bladder.
2. Benign prostatic hyperplasia.
3. Carcinoma prostate.
4. Cystolithiasis.

272. A 10-mm calculus in the right lower ureter associated with proximal hydrouretero-nephrosis is best treated with:

1. Extracorporeal shockwave lithotripsy.
2. Antegrade percutaneous access.
3. Open ureterolithotomy.
4. Ureteroscopic retrieval.

273. Semen analysis of a young man who presented with primay infertility revealed low volume, fructose negative ejaculate with azoospermia. Which of the following is the most useful imaging modality to evaluate the cause of his infertility?

1. Colour duplex ultrasonography of the scrotum.
2. Transrectal ultrasonography.
3. Retrograde urethrography.
4. Spermatic venography.

274. An eight-year-old boy presents with back pain and mild fever. His plain X-ray of the dorso-lumbar vertrbra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnoisi is:

1. Ewing’s sarcoma.
2. Tuberculosis.
3. Histiocytosis.
4. Metastasis.

275. Cardiac or central nervous system toxicity may result when standard lidocaine doses are administered to patients with circulatory failure. This may be due to the following reason:

1. Lidocaine concentration are initially higher in relatively well perfused tisseues such as brain and heart.
2. Histamine receptors in brain and heart gets suddenly activated in circulatory failure.
3. There is a sudden out-burst of release of adreneline, noradreneline and dopamine in brain and heart.
4. Lidocaine is converted into a toxic metabolite due to its longer stay in liver.

276. A post-operative cardiac surgical patient developed sudden hypotension, raised central venous pressure, pulses paradoxus at the 4th post operative hour. The most probable diagnosis is .

1.Excessive mediastinal bleeding.
2. Ventricular dysfunction.
3. Congestive cardiac failure.
4. Cardiac tamponade.

277. A 70 year old patient with benign prostatic hyperplasia underwent transurethral resection of prostate under spinal anaesthersia. One hour later, he developed vomiting and altered sensorium. The most probable sause is:

1. Over dosage of spinal anaesthetic agent.
2. Rupture of bladder.
3. Hyperkalemia.
4. Water intoxication

278. Kinebock’s disease is due to avascular necrosis of:

1. Femoral neck.
2. Medial cuneiform bone.
3. Lunate bone.
4. Scaphoid bone.

279. A 50-year old male. Working as a hotel cook, has four dependent family members. He has been diagnosed with an early stage squamous cell cancer of anal canal. He has more than 60% chances of cure. The best treatment option is:

1. Abdomino-perineal resection.
2. Combined surgery and radiotherapy.
3. Combined chemotherapy and radiotherapy.
4. Chemotherapy alone.

280. Which one of the following radio-isotopes is commonly used as a source for external beam radiotherapy in the treatment of cancer patients:

1. Strontium-89.
2. Radium-226.
3. Cobalt-59.
4. Cobalt-60.

281. All of the following statements are correct about potassium balance, except:

1. Most of potassium is intracellular.
2. Three quarter of the total body potassium is found in skeletal muscle.
3. Intracellular potassium is released into extra-cellular space in response to severe injury.
4. Acidosis leads to movement of potassium from extracellular to intracellular fluid compartment.

282. Hypocalcemia is characterized by all of the following features except:

1. Numbness and tingling of circumoral region.
2. Hyperactive tendon reflexes.
3. Shortening of Q-T interval in ECG.
4. Carpopedal spasm.

283. The best time for surgery of hypospadias is:

1. 1-4 months of age.
2. 6-10 months of age.
3. 12-18 months of age.
4. 2-4 years of age.

284. Which of the following is not true about Berger’s disease?

1. The pathologic changes are proliferative and usually confined to measangial cells:
2. Hematuria may be gross or microscopic.
3. On immunofluorescence deposits contain both IgA and IgG.
4. Absence of associated protyeinuria is pathognomonic.

285. The organism most commonly causing genital filariasis in most parts of Bihar and Eastern U.P. is:

1. Wuchereria bancrofti.
2. Brugia malayi.
3. Onchocerca volvulus.
4. Dirofilaria.

286. Which one of the following statements is false with regard in Xanthogranulomatous pyelonephritis in children.

1. Often affects those younger than 8 years of age.
2. It affects the kidney focally more frequently than diffusely.
3. Boys are affected more frequently.
4. Clinical presentation in children is same as in adults.\

287. The Hunterian Ligature operation is performed for:

1. Varicose veins.
2. Arteriovenous fistulae.
3. Aneurysm.
4. Acute ischemiz.

288. Pseudoclaudication is due to the compression of:

1. Femoral artery.
2. Femoral nerve.
3. Cauda Equina.
4. Popliteal artery.

289. Sympathectomy is indicated in all the following conditions except:

1. Ischaemic ulcers.
2. Intermittent claudication.
3. Anhidrosis.
4. Acrocyanosis.

290. Which one of the following statements is false with regard to pyaria in children?

1. Presence of more than 5 WBC/hpf (high power field) for girls and more than 3 WBC/hpf for boys.
2. Infection can occur without pyuria.
3. Pyuria may be present without Urinary tract infection.
4. Isolated pyuria is neither confirmatory nor diagnostic for Urinary tract infection.

291. Which one of the folloing is the most common cause of abdominal mass in neonates?

1. Neuroblastomas.
2. Wilms’ tumour.
3. Distended bladder.
4. Multicystic dysplastic kidneys.

292. All of the following are risk factors for deep vein thrombosis (DVT) except:

1. Duration of Surgery more than thirty minutes.
2. Obesity.
3. Age less than forty years.
4. Use of the oestrogen-projesterone contraceptive pills.

293. A labourer involved with repair-work of sewers was admitted with fever, jaundice and renal failure. The most appropriate test to diagnose the infection in this patient is:

1. Weil Felix test.
2. Paul Bunnel test.
3. Microscopic agglutination test.
4. Micro immunofluorescence test.

294. A chest physician performs bronchoscopy in the procedure room of the out patient department. To make the instrument safe for use in the next patient waiting outside. The most appropriate method to disinfect the endoscope is by:

1. 70% alcohol for 5 min.
2. 2% gluteraldelyde for 20 min.
3. 2% formaldehyde for 10 min.
4. 1% sodium hypochlorite for 15 min.

295. Which of the following statements is true about rabies virun:

1. It is a double stranded RNA virus.
2. Contains a DNA dependant RNA polymerase.
3. RNA has a negative polarity.
4. Affects motor neurons

296. Which of the following statements is true about endemic typhus.

1. Is caused by R. rickettsii.
2. Is transmitted by the bite of fleas.
3. Has no mammalian reservoir.
4. Can be cultured in chemical defined culture medium.

297. A 45 year old female is having bilatertal ovarian mass, ascites and omental caking on CT scan, There is high possibility that patient is having .

1. Benign ovarian tumor.
2.Malignant epithelial ovarian tumor.
3. Dysgerminoma of ovary.
4. Lymphoma of ovary.

298. The commonest cause of an obliterative stricture of the membranous urethra is:

1. Fall-astride injury.
2. Road-traffic accident with fracture pelvis and rupture urethra.
3. Prolonged catheterization
4. Gonococcal infection.

299. Which of the following is an absolute indication for surgery in cases of benign prostatic hyperplasia:

1. Bilateral hydroureteronephrosis.
2. Nocturnal frequency.
3. Recurrent urinary tract infection.
4. Voiding bladder pressures> 50 cm of water.

300. A 27 year old man presents with a left testicular tumor with a 10 cm retroperitoneal lymph node mass. The treatment of choice is

1. Radiotherapy .
2. Immunotherapy with interferon and interleukins.
3. Left high inguinal orchiectomy plus chemotherapy.
4. Chemotherapy alone.